bluuebunny/crossref_metadata_2025 huggingface dataset:
Malignant transformation and tumour recurrence in sacrococcygeal teratoma: a global, retrospective cohort study
Authors: van Heurn Lieke J. , Derikx Joep P.M. , Hall Nigel , Aldrink Jennifer H. , Bailez Maria M. , Chirdan Lohfa B. , Fumino Shigehisa , Hesse Afua , Soyer Tuktu , StPeter Shawn , Twisk Jos , Yang Tianyou , van Heurn Ernst L.W. ,   The SCT-study consortium
Published: September 2024

Introduction:

Sacrococcygeal teratoma (SCT) is a rare congenital tumour. The risk of malignancy and recurrence is not well defined. Previous studies are small and report differing conclusions about the timing of surgery and the duration of follow-up. The authors studied the risk of malignant transformation and SCT recurrence after surgery to address these gaps.

Methods:

This was a global retrospective cohort study. Data of consecutive SCT patients was obtained from 145 institutes in 62 countries. Malignant transformation, defined as malignancy at initial resection, malignant recurrence or death due to malignancy, and its risk factors were analysed.

Results:

Of the 3612 included patients, 3407 entered analysis. The risk of malignant transformation of the initial tumour was 3.3, 5.1, 10.1, and 32.9% at age 3 months, 6 months, 1 year, and 2 years, respectively. After 6 years, the censored risk of malignancy (64%) did not further increase. Recurrent SCT was diagnosed in 349 (10.2%) children with 126 (36.1%) malignant recurrences. Risk factors for recurrence were Altman type II [odds ratio (OR): 1.6, 95% confidence interval (CI): 1.2–2.2], Altman type III (OR: 1.6, 95% CI: 1.2–2.3), initial immature histology (OR: 1.9, 95% CI: 1.4–2.6), and initial malignant histology (OR: 4.0, 95% CI: 2.9–5.4).

Conclusion:

The risk of malignancy at initial resection in SCT increases with age reaching a plateau at 6 years of age. Recurrence after resection occurred in 10% of patients and 36% of these were malignant at that time. Altman type II or type III, and immature or malignant histology were associated with recurrence.

Level of evidence:

Level III.
Clinical, sonographic, and molecular changes in calcific tendinitis of the shoulder following extracorporeal shockwave therapy: a prospective case–control study
Authors: Chou Wen-Yi , Wu Kuan-Ting , Chen Po-Cheng , Jhan Shun-Wun , Wu Chia-Feng , Cheng Jai-Hong
Published: September 2024

Background:

Extracorporeal shockwave therapy (ESWT) is the primary treatment for calcific tendinitis of the shoulders, but what are the effects of clinical, sonographic, and molecular markers following ESWT in treating calcific tendinitis of the shoulder?

Methods:

Twenty-eight patients were categorized into radiodense and radiolucent subgroups. In addition, clinical assessments included the visual analogue scale (VAS), Constant-Murley (CM) score, American Shoulder and Elbow Surgeon (ASES) score, sonographic evaluation, and serum enzyme-linked immunosorbent assay (ELISA). The participants completed a 1-year follow-up. All data were collected before and after treatment.

Results:

After 1 year of follow-up, all patients showed notable improvement in VAS, CM, and ASES scores, with no significant clinical variations among the subgroups. However, the radiolucent group showed significant complete resorption and size reduction at the final follow-up. The sonographic evaluation revealed improved tissue perfusion and reduced calcification from 3 to 12 months in all patients, including those in the radiolucent group, but complete resorption of calcific deposits did not occur. The percentage of tissue perfusion was improved at 1 and 3 months after ESWT. There were no significant differences in the levels of the molecular markers interleukin-1 beta (IL-1 β) or IL-33, but the level of insulin-like growth factor 1 (IGF-1) was notably increased at 1 and 3 months post-ESWT. The BMP7 level was increased at 3 months and was then decreased significantly at 6 and 12 months.

Conclusion:

ESWT improved symptoms, reduced calcification, enhanced tissue perfusion, and promoted angiogenesis and BMP7 activity. In particular, it benefited radiolucent type patients with better calcification resorption. Partial resorption led to improvements in transparency, and a second ESWT session at 3 months was recommended for optimal results.
Palliative Care and Advance Care Planning Intervention Fidelity Monitoring
Authors: Verma Manisha , Grudzen Corita R. , Izumi Seiko , Wenger Neil , El-Jawahri Areej , Ejem Deborah , Aslakson Rebecca A.
Published: September 2024

Over the past decade, the Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale, comparative effectiveness clinical trials evaluating palliative care and advance care planning interventions. These are complex multicomponent interventions that need robust but flexible fidelity monitoring. Fidelity is necessary to maintain both internal and external validity within palliative care intervention research and to ultimately evaluate the real-world impact of high-quality interventions. Different trials not only took varying approaches to fidelity monitoring but also uncovered both unique and common challenges and facilitators. This article summarizes 8 of these trials and highlights approaches, adaptations, barriers, and facilitators for intervention fidelity monitoring. Identifying and delivering core elements while simultaneously allowing adaptations of noncore elements is a vital part of fidelity monitoring. Dissemination of such experiences can inform both future palliative care research as well as ongoing implementation of palliative care and advance care planning interventions across diverse clinical practices. Adoption of rigorous intervention fidelity methods is critical to advancing the science and reproducibility of palliative care interventions.
Diagnostic accuracy of percutaneous transthoracic needle biopsy among peripheral pulmonary lesions: a multicenter observational study
Authors: Basiri Reza , Sharifnezhad Farzad , Jafarian Amir H. , Samadi Sara , Zarghi Amirreza
Published: September 2024

Introduction:

The diagnosis of peripheral pulmonary lesions (PPL) poses a significant challenge, prompting the widespread utilization of various modalities to ensure the precision in diagnosis. This study aims to assess the diagnostic accuracy of computed tomography-guided percutaneous transthoracic needle biopsy (CT-PTNB) in the context of pulmonary malignancy.

Methods and materials:

This multicenter retrospective observational study, included 1317 cases of CT-PTNB performed on adult patients with PPLs from January 2018 to December 2022 in Mashhad, Iran. The pathology results of CT-PTNB from 94 cases were compared to the definitive pathology results obtained through methods such as surgery to assess the sensitivity, specificity, and overall accuracy of CT-PTNB in diagnosing of pulmonary malignancy.

Results:

CT-PTNB exhibits an accuracy of 82.98%, with sensitivity and specificity rates of 75.41 and 91.43%, respectively. This study underscores the issue of false-negative results in CT-PTNB and underscores the importance of integrating clinical, radiological, and additional diagnostic modality to guide diagnostic decisions.

Conclusion:

In this large-scale multicenter study, the accuracy of CT-PTNB for diagnosis of pulmonary malignancy is acceptable but fairly low compared to previous studies.
Potassium dynamics in sickle cell anemia: clinical implications and pathophysiological insights
Authors: Obeagu Emmanuel Ifeanyi
Published: September 2024

Potassium dynamics are critical in the pathophysiology of sickle cell anemia (SCA), a genetic disorder characterized by the presence of abnormally shaped red blood cells that lead to various complications such as vaso-occlusive crises and hemolytic anemia. This review focuses on the clinical implications and pathophysiological insights of potassium regulation in SCA, highlighting its impact on disease progression and potential therapeutic strategies. The dysregulation of potassium transport in SCA leads to significant K+ efflux and cellular dehydration, exacerbating the sickling process. Dehydrated sickle cells, due to potassium loss, become more rigid and prone to causing blockages in small blood vessels, leading to painful vaso-occlusive crises and ischemia. Furthermore, chronic hemolysis in SCA, aggravated by potassium imbalance, contributes to severe anemia and systemic complications. These insights underscore the importance of maintaining potassium homeostasis to mitigate disease severity and improve patient outcomes. Therapeutic strategies targeting potassium regulation show promise in managing SCA. Inhibitors of the Gardos channel, such as senicapoc, have demonstrated potential in reducing sickling and hemolysis. Additionally, hydration therapy plays a crucial role in maintaining electrolyte balance and preventing RBC dehydration. A comprehensive approach that includes monitoring and correcting electrolyte imbalances, along with standard treatments like hydroxyurea and blood transfusions, is essential for effective disease management.
A rare well-differentiated renal retroperitoneal liposarcoma: a case report
Authors: Sukkari M.Walid , Ebedo Raghad , Hulou Saad , Shami Besher , Nastah Samer , Sabbagh Aziz
Published: September 2024

Introduction and importance:

Retroperitoneal liposarcomas (RPLPSs) are rare tumors that arise from mesenchymal cells in the peritoneum cavity. The sites of PRLPSs vary a lot, but renal PRLPSs are extremely rare (there are only 45 cases of Renal retroperitoneal liposarcomas on PubMed). In this case, the authors present a rare renal retroperitoneal liposarcoma case, describe the major concepts, and raise awareness about this rare tumor.

Case presentation:

A 44-year-old woman presented to the clinic with hirsutism and irregular menstruation; upon physical examination, a large abdominal mass was accidentally identified; the patient had Doppler ultrasound (Doppler US) and MRI, which both showed a mass arising from the right upper pole of the kidney, fine needle aspiration (FNA) confirmed the diagnosis of retroperitoneal liposarcoma, patient underwent surgical removal and her symptoms disappeared.

Clinical discussion:

The retroperitoneum is a cavity behind the abdominal wall containing organs like the pancreas and kidneys. Retroperitoneal tumors (RPTs) are rare neoplasms, primarily of mesenchymal origin. Retroperitoneal liposarcomas (RPLPS) are the most common RPT, often asymptomatic until large, and rarely metastasize but frequently recur. Liposarcomas are classified into five subtypes, with well-differentiated liposarcoma being the most common and characterized by high local recurrence. The presence of specific oncologic mutations affects the prognosis and the response to treatment.

Conclusion:

In rare cases, retroperitoneal liposarcomas can arise from sites near the kidney and compress the adjoining adrenal gland.
Falls among Pediatric Patients Receiving Home Care
Authors: Reader Ben , Javens Thomas , Albert Jaimie , Nelson Abigail , Wessells David
Published: September 2024

Children with medical complexity (CMC) often require home healthcare services to manage chronic health conditions. Evaluation of home safety is recommended when children transition from hospital to home care, though despite best efforts, safety events, such as falls, still occur. Understanding the prevalence and causal factors of falls in CMC is critical for the development of fall prevention interventions and protocols. This study aims to describe demographics and reasons for falls reported in CMC receiving home healthcare services. A retrospective analysis was performed using data from an incident reporting database from January 2019 to March 2023. Participants included CMC who received home healthcare services from a single institution and had at least one documented fall. A total of 43 falls were experienced by 31 unique participants. The participants were predominantly male (58.1%), White (71.0%), and non-Hispanic/Latino (96.8%), with a median age of 10 years at the time of the fall. Primary diagnoses of CMC with falls included neurological disorders (41.9%), congenital chromosomal abnormalities (25.8%), and oncological conditions (16.1%). The most common reasons for falls were loss of balance (32.6%), unknown factors (19.6%), and trip/slips (17.4%). Half of falls were deemed to be potentially preventable. This study provides valuable insight into falls among CMC receiving home healthcare services and emphasizes the multifactorial nature of fall risks in this population. Understanding demographic characteristics, diagnoses, and causal factors of falls is critical in the development of proactive fall prevention strategies. Responding proactively to mitigate fall risks is an important step in enhancing the safety and quality of life for CMC. Future collaborative research efforts are warranted to validate findings and evaluate potentially successful fall prevention interventions.
A Case Study for Training Interprofessional Teams in Addressing the Social Determinants of Health in Older Adults
Authors: Wynard Tammy , Voss Mitchell , McCann-Davis Nicole , McCleave Niaya
Published: September 2024

This case study addresses the interwoven nature of the social determinants of health, fall prevention, older adults, and home healthcare as a topic for teaching interprofessional education across professional development or academic settings. The case study challenges interprofessional learners to dissect and discuss the profile of the patient and other stakeholders, care team decisions, evidence-based research, and the considerations of significant variables on the implications for clinical reasoning and practice. Interprofessional education that includes case studies leads to the development of better skills related to clinical assessments and problem-solving. Sample facilitation questions and extensive research and resources are provided to assist those preparing to implement and facilitate the case study during an interprofessional education training session. We concluded our article by encouraging practitioners to share teaching strategies through publication so we can strengthen interprofessional education learning, as this contributes to stronger, more effective interprofessional education experiences, a need highlighted in the literature.
Prescriptions (Rx) for Prevention: Clinical Tools for Integrating Environmental Health into Pediatric Clinical Care
Authors: Bland Christopher , Zajac Lauren , Wilson Joseph , Guel Luz , Pendley Sofía Curdumí , Charlesworth Annemarie , Korfmacher Katrina , Newman Nicholas , Howarth Marilyn , Balk Sophie J. , Galvez Maida , Sheffield Perry
Published: September 2024

The integration of environmental health (EH) into routine clinical care for children is in its early stages. The vision of pediatric EH is that all clinicians caring for children are aware of and able to help connect families to needed resources to reduce harmful environmental exposures and increase health-enhancing ones. Environmental exposures include air pollution, substandard housing, lead, mercury, pesticides, consumer products chemicals, drinking water contaminants, industrial facility emissions and, increasingly, climate change-related extreme weather and heat events. An identified need is to simultaneously educate clinicians while connecting families to evidence-based EH interventions. Here, we describe a multi-decadal effort to create, refine, and disseminate a clinical tool called Prescriptions (Rxs) for Prevention that responds to that identified need. These tools are modeled on a risk communication framework and use a format that support clinicians when they screen their patients for EH concerns, to then counsel on those topics, and refer to EH resources if needed. Rxs for Prevention—tailored with local resources—are now in use at more than a dozen sites in multiple regions of the U.S. supporting the promotion of healthy homes, communities, and the broader environment for children. These Rxs are reducing barriers to EH integration by educating clinicians, linking families to community resources, and strengthening clinic and community connections. On-going evaluation can help further the implementation of the Rxs for Prevention to help achieve the long-term vision of integrating EH into routine clinical care.
Experiences and Lessons Learned From Surging the Governmental Public Health Workforce During the COVID-19 Pandemic
Authors: Lee Katie Morrison , Bosold Alyssa , Alvarez Cindy , Dada Oluwatosin O. , Porterfield Deborah S.
Published: September 2024

Context:

During the COVID-19 pandemic, the United States relied on the public health workforce to control the spread of COVID-19 while continuing to provide foundational public health services. Facing longstanding staffing shortages, state, tribal, local, and territorial (STLT) public health agencies (PHAs) used various strategies and supports to surge the workforce in response to the pandemic.

Objectives:

The study explored (1) the types of strategies and supports STLT PHAs used to surge the public health workforce during the pandemic, (2) assessments of surge strategies and supports, and (3) approaches to using the range of surge strategies available.

Design:

We conducted 27 semi-structured interviews in 2023 and performed thematic analysis.

Participants:

Interviewees included STLT public health officials, leaders of organizations that directly supported the COVID-19 workforce surge, and public health workforce experts indirectly involved in the workforce surge.

Results:

To surge the workforce, interviewees relied on partnerships, staffing agencies, the National Guard, the Centers for Disease Control and Prevention Foundation’s COVID-19 Corps, the Medical Reserve Corps, and other strategies. Interviewees valued strategies that rapidly engaged staff and volunteers at no cost to their PHA and flexible funding from the federal government to support surge efforts but noted shortcomings in the strategies and supports available. Interviewees described using multiple strategies simultaneously but noted challenges in implementing these strategies due to inadequate planning and insufficient staff and resources.

Conclusion:

The study underscores the need for STLT PHAs to establish mechanisms to surge the workforce as part of ongoing planning for emergency preparedness. Focus areas include building administrative and hiring capacity within STLT PHAs and sustaining partnerships and contractual agreements that helped fill staffing gaps during the pandemic. To support efforts to build workforce capacity to meet future surge management needs, STLT PHAs should consider creative solutions to attract and retain staff, as well as opportunities to engage students in public health work.
Addressing Systemic Inequities: An Evaluation of the Resilience Catalysts in Public Health Program
Authors: Ellis Wendy , Hayes Kristen , Salas Esmeralda , Bultema Stephanie A. , Gousse Tahlia , Chen Kuan-Lung Daniel
Published: September 2024

Context:

Resilience Catalysts (RC) in Public Health provides local health departments (LHDs) with a process and technical assistance (TA) to operationalize the Community Health Strategist (CHS) role, foster equity, and support community resilience through policy, practice, and program change across multiple sectors.

Objectives:

This evaluation sought to (1) identify essential elements of the RC process and TA that help LHDs address the systemic drivers of adversity and inequity, and (2) expand understanding of RC’s preliminary impact and inform implications for theory, practice, and funding in the post-COVID context.

Design:

The mixed-methods evaluation incorporated online surveys and semi-structured interviews. Key themes and takeaways were identified using framework analysis, constant comparison analysis, and descriptive statistics.

Setting:

The evaluation was conducted in 12 cities and counties across the United States, including California, Colorado, Florida, Iowa, Kentucky, Maryland, Massachusetts, New Jersey, North Carolina, Ohio, Tennessee, and Washington.

Participants:

Survey participants consisted of 29 representatives of 11 RC sites. Interview participants included 33 individuals: 19 representatives of 9 RC sites and 14 individuals representing RC TA providers and funders.

Main Outcome Measures:

The evaluation measured outcomes related to collaborative engagement, addressing inequity, systems change, knowledge change, ability to work within a local political and community context, sustainability, and scalability.

Results:

Evaluation results demonstrate outcomes related to community engagement, expansion of system-level thinking, advancing health and racial equity, clarity and understanding of RC process, building LHD and partners’ capacity and skills needed to embody the CHS role.

Conclusions:

The RC process prepared LHDs to operationalize the CHS role by providing the knowledge, skills, and capacities needed to understand root causes of adversity and inequity, address structural racism as a public health issue, and develop collaborative plans for addressing root causes.
Outcomes of Lymphoma Patients Admitted to the ICU Are Not Influenced by HIV Status: A Retrospective, Observational Cohort Study
Authors: El-Hibri Fouad , Al-Hindawi Ahmed , Singh Shivani , Bower Mark , Singh Suveer
Published: September 2024

Background:

Patients with lymphoma may require intensive care (ICU) because of disease- or treatment-related complications. The lymphoma–HIV interaction complicates management, but whether outcomes are worse in these patients, when critically ill, is unclear. A retrospective observational cohort study reviewed outcomes of patients admitted to ICU, subsequent 5-year survival, and prognostic factors.

Setting:

Academic ICU at the UK National Centre for HIV Malignancy.

Methods:

Records between 2007 and 2020 identified the following cohorts: HIV lymphoma, lymphoma alone, HIV alone, and patients without HIV/lymphoma. Patient demographics, lymphoma characteristics, ICU admission data, and survival outcomes were collected. Five-year survival outcomes were analyzed for the lymphoma cohorts. ICU outcomes were analyzed for all cohorts. Descriptive statistics summarized baseline characteristics and outcomes. Multivariate regression identified factors associated with ICU mortality.

Results:

Of 5929 patients admitted to the ICU, 63 had HIV lymphoma and 43 had lymphoma alone. Survival to ICU discharge was 71% and 72%, respectively. Adjusted log-odds ratio for ICU survival was significantly better in the comparator cohort. ICU survival between the HIV lymphoma and lymphoma-alone cohorts was not significantly different. Adjusted 5-year survival was not significantly different between lymphoma cohorts. Factors independently associated with a worse ICU survival prognosis were emergency admissions, Acute Physiology and Chronic Health Evaluation II score, initial lactate, and day requiring level 3 support. Mechanical ventilation and higher Acute Physiology and Chronic Health Evaluation II scores were independent risk factors for worse 5-year survival in the lymphoma cohorts.

Conclusions:

ICU outcomes and 5-year survival rates of patients with lymphoma were unaffected by HIV status, revealing favorable outcomes in patients with HIV-related lymphoma admitted to the ICU.
Nasopharyngeal Carcinoma Masquerading as Temporomandibular Disorder
Authors: Guzel Ceylan , Munevveroglu Sumer , Erten Fatma Dilek
Published: September 2024

Trismus, commonly associated with temporomandibular disorders (TMD), trauma, or infection, can occasionally manifest as a rare symptom of malignancy. The author present a case of misdiagnosed carcinoma initially presenting with features resembling TMD. A 72-year-old presented with left facial pain, earache, and progressive difficulty in mouth opening. Initial assessments suggested TMD, but further investigation revealed a nasopharyngeal mass indicating squamous cell carcinoma. This case underscores the need for a comprehensive approach in evaluating trismus to rule out malignancy. Early recognition and appropriate referral for further investigation, including imaging and biopsy, are essential for timely diagnosis and management of malignancy masquerading as TMD.
The Use of Bone Substitute Blocks in Minimally Invasive Orthognathic Surgery: Enhancing Jaw Stability and Healing
Authors: Claus Jonathas Daniel Paggi , Spinella Almeida Matheus , Correia Lopes Hugo Jose
Published: September 2024

This study aims to evaluate the use of bone substitute blocks (BSBs) in minimally invasive orthognathic surgery for the maxilla, mandible, and chin, highlighting their impact on jaw stability and bone healing. A retrospective analysis was conducted on 47 consecutive patients (33 females, 14 males; mean age: 27 y) who underwent bimaxillary advancement surgery. Procedures employed the minimally invasive orthognathic surgery approach. Bovine BSBs (Bio-Oss Collagen) were used to fill gaps in all cases. Postoperative follow-up included computed tomography scans at immediate and 1-year intervals. All patients achieved the desired clinical outcomes without complications such as wound dehiscence, infection, or nonunion. Visual Analog Scale scores indicated high levels of bone formation, with mean scores of 9.1 in the chin, 8.5 in the maxilla, and 7.9 in the mandible. The study supports the routine use of BSBs in orthognathic surgeries, though further research is needed to validate these findings and explore long-term outcomes.
The First Case of Intraportal Islet Implantation During Liver Machine Perfusion Allowing Simultaneous Islet-liver Transplantation in a Human - A New and Safe Treatment for End-stage Liver Disease Combined With Diabetes Mellitus
Authors: Zhao Qiang , Li Jiahao , Lin Zepeng , Tang Yunhua , Yang Daopeng , Qin Meiting , Ma Xue , Ji Haibin , Chen Honghui , Wang Tielong , Chen Maogen , Ju Weiqiang , Wang Dongping , Guo Zhiyong , Zhu Xiaofeng , Dan Jia , Hu Anbin , He Xiaoshun
Published: September 2024

Objective:

Evaluating the safety and efficacy of implanting a liver with islet grafts into patients with end-stage liver disease and diabetes mellitus (DM).

Background:

DM and end-stage liver diseases are significant health concerns worldwide, often coexisting and mutually influencing each other. Addressing both diseases simultaneously is paramount.

Methods:

We utilized the islet transplantation combined ischemia-free liver transplantation technique to treat a patient with hepatocellular carcinoma and type 2 diabetes mellitus. The liver was procured and preserved using the ischemia-free liver transplantation technique, and during normothermic machine perfusion, isolated and purified islet grafts were transplanted into the liver through the portal vein. Finally, the liver, incorporating with the transplant islet grafts, was implanted into the recipient without interruption of blood supply.

Results:

The patient received both liver and islet grafts from the same donor. The patient achieved insulin-independence by post-transplant day 9, and both liver and islet function remained robust. The patient was discharged on post-transplant day 16 and experienced no surgical or transplantation-related complications during the follow-up period. Furthermore, islet grafts presence was observed in liver biopsies after islet transplantation.

Conclusions:

This landmark case marks the inaugural application of ischemia-free liver transplantation in humans, signifying its potential as a promising treatment modality for end-stage liver disease with DM.
Is there a role for capsaicin in cancer pain management?
Authors: Gordon-Williams Richard , Harris Clara , Magee David J.
Published: September 2024

Purpose of review

Advances in oncological therapies have resulted in an increase in the number of patients living with and beyond cancer. The personal and societal impact of chronic pain in the survivor population represents an area of significant unmet need. Capsaicin (a TRPV1 agonist) may provide analgesia with limited systemic side effects. This review looks to summarise the most recent evidence regarding the use of capsaicin in the management of cancer pain.

Recent findings

Various international guidelines have recently endorsed the use of high concentration capsaicin patches in the treatment of chronic painful chemotherapy induced peripheral neuropathy. Numerous studies support the use of capsaicin in the treatment of peripheral neuropathic pain. This promising data is predominantly yielded from pain secondary to herpes zoster and diabetic neuropathy, with an expanding but small evidence base for its utility in other neuropathic pains. Emerging data suggests that treatments are better tolerated and provide analgesia more rapidly when compared with systemic treatments.

Whilst randomised controlled trial data in the treatment of cancer pain are lacking, recent large cohort studies, and international guidelines, support the use of high concentration capsaicin patches in a wide variety of neuropathic pain secondary to cancer treatments.
Two photons everywhere
Authors: Zubizarreta Casalengua E. , Laussy F. P. , ‍del Valle E.‍
Published: September 2024

We discuss two-photon physics, taking for illustration the particular but topical case of resonance fluorescence. We show that the basic concepts of interferences and correlations provide at the two-photon level an independent and drastically different picture than at the one-photon level, with landscapes of correlations that reveal various processes by spanning over all the possible frequencies at which the system can emit. Such landscapes typically present lines of photon bunching and circles of antibunching. The theoretical edifice to account for these features rests on two pillars: (i) a theory of frequency-resolved photon correlations and (ii) admixing classical and quantum fields. While experimental efforts have been to date concentrated on correlations between spectral peaks, strong correlations exist between photons emitted away from the peaks, which are accessible only through multi-photon observables. These could be exploited for both fundamental understanding of quantum-optical processes as well as applications by harnessing these unsuspected resources.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Diversity of HBV genotypes and their association with precore/basal core mutations among HBsAg positive patients in Ibadan, Nigeria
Authors: Faneye Adedayo Omotayo , Motayo Babatunde Olanrewaju , Mustafa Aisha , Odiabo Georgina
Published: September 2024

Background; Hepatis B virus (HBV) is the most implicated cause of severe liver disease and hepatocellular carcinoma worldwide. Studies have shown that the basal core protein (BCP) and precore protein (PC) of HBV play a significant role in HBV related carcinogenesis. There is paucity of data on type and effect of BCP and PC mutations in Nigeria. This study aims to genotype HBV and investigate any mutations within the BCP and PC among HBV patients in Ibadan, Nigeria.
Methods; Forty HBV DNA positive were recruited into this study, viral load assay and genotyping by nested multiplex PCR was done. The partial X gene region was amplified and Sanger sequenced. The BPC and PC genomic regions were then analyzed using bioinformatics.
 Results; Twenty-three participants recorded HBV DNA viral load of >20,000 International Units (IU), while 17 had <20,000 IU, while 28 samples were genotyped.  Five genotypes A, B, C, D and E and 4 mixed genotypes AC, AD ACD and ABCD were detected. Genotype AC was the most frequently encountered while genotypes E and B were the least encountered. Mutation was highest in ages 34 to 45 years. Double mutation A1762T and G1764A within the BCP region was the most encountered mutation.
Conclusions; We report a diverse HBV genetic landscape, with mixed infections between genotypes with BCP double mutation A1762T/G1764A, signaling the likelihood of poor HBV related liver disease prognosis. Our findings contribute to our understanding of the molecular characteristics of HBV and its potential implications for disease progression and management among HBV infected Nigerians.
Molecular and spatiotemporal characterization of cells in murine atherosclerotic plaques
Authors: Hou Pengbo , Liu Zhanhong , Fang Jiankai , Wang Ziyi , Liu Shisong , Wang Shiqing , Melino Gerry , Li Peishan , Shi Yufang , Shao Changshun
Published: September 2024

Objective

Single-cell technologies have revolutionized our understanding of the phenotypic and transcriptional diversity of aortic leukocytes in atherosclerotic humans and mice. However, enzymatically dissociated tissues lose the spatial context of plaque cellsin situ. Here we utilized imaging mass cytometry (IMC) combining with single-cell RNA sequencing (scRNA-seq) to characterize the spatial distribution dynamics, phenotypic transitions, metabolic and functional phenotypes, and the intercellular interaction networks of plaque cells during atherosclerotic progression. Additionally, the dynamic immune landscape of circulating leukocytes associated with atherosclerosis was characterized using cytometry of time of flight (CyTOF).

Approach and Results

A highly multiplexed IMC panel with 33 metal-conjugated antibodies was designed to generate 11 highly multiplexed histology images of aortic root tissues fromApoE-/-mice on high-fat diet at different stage of atherosclerosis. Using histoCAT, we identified 8 principal cell subtypes with distinct phenotypic and geographic dynamics. Furthermore, IMC-defined cell subsets partially corresponded to scRNA-seq-annotated aortic cell subtypes, including 4 macrophage subsets, neutrophils, smooth muscle cells (SMCs) and SMC-derived SEMs (Stem cell, endothelial cell and macrophage-like cell). Activation of inflammatory pathways, increased oxidative phosphorylation and augmented osteoclast differentiation were observed in macrophage populations, SMCs and SEMs from an early stage to advanced stage of atherosclerosis. Notably, cell neighborhood analysis by IMC uncovered multifaceted cell-cell interactions within the plaque, in particular in neutrophil-mediated interactions with smooth muscle cells and macrophages, which were confirmed by ligand-receptor interactions based on scRNA-seq data.

Additionally, characterization of the peripheral immune cells by CyTOF revealed an increased ratio of myeloid cells to lymphocytes, and certain neutrophil and monocyte subpopulations also exhibited enhanced lipid metabolism and glycolysis as well as activated inflammatory signaling.

Conclusion

This study provides a dynamic spatiotemporal landscape of atherosclerotic lesions and peripheral leukocytes. The new information based on IMC may help understand atherosclerotic pathology and develop novel therapeutic strategies.
Functional insights into the effect of feralisation on the gut microbiota of cats worldwide
Authors: Aizpurua Ostaizka , Botnen Amanda Bolt , Eisenhofer Raphael , Odriozola Iñaki , Santos-Bay Luisa , Bjørnsen Mads Bjørn , Gilbert MTP , Alberdi Antton
Published: September 2024

Feralisation, the process by which domesticated organisms revert to a wild state, is a widespread phenomenon across various species. Successfully adapting to a new environment with different access to food, shelter, and other resources requires rapid physiological and behavioural changes, which could potentially be facilitated by gut microbiota plasticity. To investigate whether alterations in gut microbiota support this transition to a feral lifestyle, we analysed the gut microbiomes of domestic and feral cats from six geographically diverse locations using genome-resolved metagenomics. By reconstructing 229 draft genomes from 92 cats, we identified a typical carnivore microbiome structure, with notable diversity and taxonomic differences across regions. While overall diversity metrics did not differ significantly between domestic and feral cats, hierarchical modelling of species communities, accounting for geographic and sex covariates, revealed distinct taxonomic and functional profiles between the two groups. While taxonomic enrichment was balanced, microbial functional capacities were significantly enriched in feral cats. These functional enhancements, particularly in amino acid and lipid degradation, correspond to feral cats’ dietary reliance on crude protein and fat. Additionally, functional differences were consistent with behavioural contrasts, such as the more aggressive and elusive behaviour measured in feral cats compared to the docile behaviour of domestic cats. Finally, the observed enrichment in short-chain fatty acid, neurotransmitter, and vitamin B12 production in feral cats aligns with improved cognitive function and potentially contributes to their heightened aggression and elusiveness. Our findings suggest that microbiome shifts may play a significant role in the development of physiological and behavioural traits advantageous for a feral lifestyle, supporting the adaptive success of feral cats in the wild.
Patient involvement in the biopsychosocial model of care integrated with primary health services: Experience from three health districts in South Kivu, Democratic Republic of Congo
Authors: Kasongo Bertin Mutabesha , Molima Christian Eboma Ndjangulu , Mparanyi Gérard Jacques , Makali Samuel Lwamushi , Mwene-Batu Pacifique Lyabayungu , Tambwe Albert Mwembo , Karemere Hermès , Bisimwa Ghislain Balaluka , Mukalay Abdon Mukalay wa
Published: September 2024

Introduction

Involving people in the provision of care and in decision-making about their health is one of the keys to success and to improving service delivery in the provision of quality health care. Patient involvement in the biopsychosocial model of care is poorly documented in the Democratic Republic of Congo (DRC). The aim of this study is to describe patients’ involvement in the choice of their health policy, their responsibility in holistic care and their capacity to support the biopsychosocial model.

Methods

This qualitative research was conducted in three health districts in the province of South Kivu, DRC. Using a tool inspired by the International Alliance of Patients’ Organizations’ Declaration of Patient-Centered Healthcare, we conducted 27 individual interviews between February and April 2024. These interviews concerned people in complex situations, attending health centers and belonging to patient clubs in six health areas covered by the study. A content analysis of the discourse from the various interviews was carried out.

Results

Patient involvement in the biopsychosocial model of care depended on multiple factors, including relational aspects (partnership between providers and patients, discussion of therapeutic possibilities and guidance for choice), educational aspects (advice and teaching received from caregivers, development of skills), empowerment (responsibility for care), organizational aspects (inclusive and participatory planning, access to different health services) and community aspects (role of entourage and patient clubs).

Conclusions

The various factors influencing patient involvement in the BPS model should be taken into account in the definition of policies and the process of integrating biopsychosocial care. Some of the strategies suggested to support the model, such as raising awareness of the humanization of care, improving the availability of resources and strengthening financial autonomy, will help to improve the quality of care and accessibility to quality health services.
Salicylic Acid restricts cell elongation and induces changes of vacuolar morphology and pH
Authors: Müller Jonas , König Yvonne , Kaiser Sabrina , Löfke Christian , Krebs Melanie , Scheuring David
Published: September 2024

The phytohormone salicylic acid (SA) is a key factor to balance plant defence as well as growth and development. While its role in plant defence has been investigated for decades, regulation of plant growth and development has only come into focus recently. It has been demonstrated that SA application inhibits growth independently of the established Non-expressor of Pathogenesis Related (NPR) receptors. However, the underlying mechanism of this growth inhibition on the cellular level remains largely elusive. Here we show that SA restricts cell elongation and induces changes of vacuolar morphology and pH. Rapidly upon SA application we observe homotypic vacuole fusion and a significant increase in vacuolar pH. These changes seem to be independent of the phytohormone auxin which has been reported to crosstalk with SA. By increasing vacuolar pH, SA directly impacts basic cellular functions such as vesicle trafficking or nutrient storage, leading eventually to cell size restriction and limited growth. Our results demonstrate an NPR-independent mechanism to attenuate growth, potentially allowing free resources to be relocated to withstand environmental stresses.

Graphical abstract

Salicylic Acid (SA) triggers a reduction in cell size and leads to a spherical vacuolar phenotype. This morphological change is accompanied by an increase in vacuolar pH, potentially due to the enhanced activity of a glycosylated SA (SAG) H+-antiporter and/or the inhibition of V-ATPase activity. In addition, SA disrupts the polarity of PIN2 auxin transporters, resulting in their uniform distribution across the cell membrane.
Deciphering the Cell-Specific Transcript Heterogeneity and Alternative Splicing during the Early Embryonic Development of Zebrafish
Authors: Lin Xiumei , Wang Xue , Liu Chang , Liu Chuanyu , Zeng Tao , Yuan Ziqi , Hu Meidi , Xiang Rong , Zhao Kaichen , Zhou Jie , Yang Shichen , Wang Yang , Meng Kaifeng , Wang Hui , He Guangli , Zhao Rui , Liu Jiaheng , Huang Yunqi , Pan Jingfang , Wang Jialu , Chen Junyi , Guo Fei , Dong Yuliang , Xu Xun , Luo Daji , Gu Ying , Liu Longqi , Dong Zhiqiang , Chen Liang
Published: September 2024

Cell fate determination during early embryonic development is a complex process modulated by gene expression. The intricate interplay of transcriptional and post-transcriptional regulation is integral to the developmental trajectory of embryogenesis, yet how RNA processing may contribute to early development programming is largely elusive. Leveraging recent technological advances in single-molecule nanopore sequencing, we developed a single-cell long-read transcriptome sequencing technology, allowing a clear view of transcript diversity during zebrafish embryogenesis during pre- and post-zygotic genome activation (ZGA). A closer examination of the dynamic transcript usage and potential alternative splicing revealed that abundant stage-specific transcripts with differential coding potentials are involved in distinct biological functions. Specifically, we identified two cell populations at the onset of ZGA based on isoform diversity instead of gene profiling, which followed divergent developmental trajectories toward the ectoderm and the presumptive ectoderm. These two populations of cells were characterized by divergent splicing regulations linked to differential RNA-binding proteins, including SNRPA and SFPQ. Altogether, using the single-cell long-read transcriptome sequencing strategy, we work has revealed the cell-specific transcriptome dynamics contributing to the cell fate determination during embryogenesis.
3D nanoscale architecture of the respiratory epithelium reveals motile cilia-rootlets-mitochondria axis of communication
Authors: Vijayakumaran Aaran , Godbehere Christopher , Abuammar Analle , Breusegem Sophia Y. , Hurst Leah R. , Morone Nobuhiro , Llodra Jaime , Dalbay Melis T. , Tanvir Niaj M. , MacLellan-Gibson K. , O’Callaghan Chris , Lorentzen Esben ,   CellMap Project Team,   FIB-SEM Technology, Murray Andrew J. , Narayan Kedar , Mennella Vito
Published: September 2024

A major frontier in single cell biology is decoding how transcriptional states result in cellular-level architectural changes, ultimately driving function. A remarkable example of this cellular remodelling program is the differentiation of airway stem cells into the human respiratory multiciliated epithelium, a tissue barrier protecting against bacteria, viruses and particulate matter. Here, we present the first isotropic three-dimensional map of the airway epithelium at the nanometre scale unveiling the coordinated changes in cellular organisation, organelle topology and contacts, occurring during multiciliogenesis. This analysis led us to discover a cellular mechanism of communication whereby motile cilia relay mechanical information to mitochondria through striated cytoskeletal fibres, the rootlets, to promote effective ciliary motility and ATP generation. Altogether, this study integrates nanometre-scale structural, functional and dynamic insights to elucidate fundamental mechanisms responsible for airway defence.
Detecting imported malaria infections in endemic settings using molecular surveillance: current state and challenges
Authors: Safarpour Mahdi , Sosa Luis Cabrera , Gamboa Dionicia , Van geertruyden Jean-Pierre , Delgado-Ratto Christopher
Published: September 2024

The Global Technical Strategy for Malaria 2016–2030 targets eliminating malaria from at least 35 countries and reducing case incidence by 90% globally. The importation of parasites due to human mobilization presents a significant challenge to achieve elimination as it can undermine local interventions. A thorough understanding of importation is necessary to support efforts to control and further lead to elimination. Parasite genetic data is extensively deployed to investigate the space-time spread of imported infections. In this matter, this systematic review aimed to aggregate evidence on the use of parasite genetic data for mapping imported malaria and the statistical analytical methods. We discuss the advantages and limitations of the deployed genetic approaches and propose a suitable type of genetic data and statistical framework to discriminate imported malaria infections from local infections. The findings provide actionable insights for national control programs, helping them select the most suitable methods for detecting imported cases while supporting the evaluation of elimination program performance, particularly in low transmission settings.
Evaluating and Addressing Demographic Disparities in Medical Large Language Models: A Systematic Review
Authors: Omar Mahmud , Sorin Vera , Agbareia Reem , Apakama Donald U. , Soroush Ali , Sakhuja Ankit , Freeman Robert , Horowitz Carol R , Richardson Lynne D. , Nadkarni Girish N , Klang Eyal
Published: September 2024

Background

Large language models (LLMs) are increasingly evaluated for use in healthcare. However, concerns about their impact on disparities persist. This study reviews current research on demographic biases in LLMs to identify prevalent bias types, assess measurement methods, and evaluate mitigation strategies.

Methods

We conducted a systematic review, searching publications from January 2018 to July 2024 across five databases. We included peer-reviewed studies evaluating demographic biases in LLMs, focusing on gender, race, ethnicity, age, and other factors. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools.

Results

Our review included 24 studies. Of these, 22 (91.7%) identified biases in LLMs. Gender bias was the most prevalent, reported in 15 of 16 studies (93.7%). Racial or ethnic biases were observed in 10 of 11 studies (90.9%). Only two studies found minimal or no bias in certain contexts. Mitigation strategies mainly included prompt engineering, with varying effectiveness.

However, these findings are tempered by a potential publication bias, as studies with negative results are less frequently published.

Conclusion

Biases are observed in LLMs across various medical domains. While bias detection is improving, effective mitigation strategies are still developing. As LLMs increasingly influence critical decisions, addressing these biases and their resultant disparities is essential for ensuring fair AI systems. Future research should focus on a wider range of demographic factors, intersectional analyses, and non- Western cultural contexts.