bluuebunny/crossref_metadata_2025 huggingface dataset:
Subclinical atrial fibrillation/atrial high-rate episodes: what significance and decision-making?
Authors: Boriani Giuseppe , Tartaglia Enrico , Trapanese Paola , Tritto Francesco , Gerra Luigi , Bonini Niccolò , Vitolo Marco , Imberti Jacopo F , Mei Davide A
Published: February 2025

Subclinical atrial fibrillation (AF) and atrial high-rate episodes (AHREs) are often detected incidentally through cardiac implantable electronic devices or wearables, especially in asymptomatic patients. These episodes pose a clinical challenge as they are associated with an increased risk of stroke, albeit at a lower rate compared with clinical AF. This review discusses the evolving understanding of AHRE, highlighting the uncertainties regarding optimal management, particularly the use of oral anticoagulants. Two key trials, ARTESiA and NOAH-AFNET 6, investigated anticoagulation in patients with device-detected AHRE. ARTESiA found that apixaban significantly reduced stroke or systemic embolism, but with an increased risk of major bleeding. In contrast, NOAH-AFNET 6, which tested edoxaban, did not demonstrate a significant benefit in reducing cardiovascular events but also observed higher bleeding rates. A meta-analysis of these trials confirmed the efficacy of oral anticoagulants in lowering ischaemic stroke risk, though with an elevated bleeding risk. Given these findings, clinical decision-making in patients with AHRE must be individualized, taking into account stroke risk, bleeding risk, and patient preferences. Shared decision-making is crucial to balance the benefits and risks of anticoagulation, especially in the context of progression to clinical AF and its associated stroke risk. Moreover, it is essential to educate patients about the risk of bleeding complications and emphasize the importance of close monitoring. Future research may further clarify optimal anticoagulation strategies and better define high-risk subgroups that would most benefit from therapy.
Cardiac involvement in Fabry disease: Recent advances, unresolved issues, and unmet needs
Authors: Pieroni Maurizio , Zocchi Chiara , Ciabatti Michele
Published: February 2025

Fabry disease is an X-linked lysosomal storage disorder caused by deficient activity of the enzyme α-galactosidase A, leading to the accumulation of globotriaosylceramide in various tissues, including the heart. Cardiac involvement is a prominent feature and a major cause of morbidity and mortality in Fabry disease, manifesting as left ventricular hypertrophy, myocardial ischaemia, heart failure, and arrhythmias. Secondary mechanisms, triggered by lysosomal storage, contribute to myocardial damage, in particular, myocardial inflammation. Early cardiac involvement can be subtle, but with disease progression, it becomes a major determinant of morbidity and mortality. Recent progresses in diagnostic techniques, such as advanced cardiac magnetic resonance imaging with T1 and T2 mapping, have improved early detection of Fabry-related cardiac disease. Enzyme replacement therapy and newer treatments like chaperone therapy have shown potential in managing cardiac manifestations when initiated early, while the progression of cardiac involvement may be difficult to halt in patients diagnosed late in the disease course. Gene therapy and substrate reduction therapy are emerging treatment modalities that hold promise but require further clinical evaluation. The limited efficacy of available therapies and the variability of cardiac response to treatment represent main unresolved issues, together with challenges in monitoring disease progression, and the need for additional therapeutic strategies targeting secondary mechanisms. Unmet needs in clinical practice include the identification of disease-specific and cardiac-specific biomarkers for early detection, staging, and monitoring cardiac damage. Similarly, strategies for prognostic stratification and better prevention of cardiovascular complications are essential to improve the care of these patients.
Pacing of the specialized His Purkinje conduction system: ‘HOW and FOR WHOM’
Authors: Chiarazzo Emanuele , Golia Paolo , Bressi Edoardo , Grieco Domenico , De Ruvo Ermenegildo , Calò Leonardo
Published: February 2025

The human heart’s conduction system consists of specialized cardiomyocytes that generate and transmit electrical impulses, leading to the rhythmic and synchronized contraction of the atria and ventricles, which is crucial for the normal cardiac cycle. In conduction system pacing (CSP), pacing leads are placed in the His bundle region and the left bundle branch area to achieve physiological cardiac activation. This method offers a more natural alternative to the myocardial stimulation provided by conventional right ventricular pacing and biventricular pacing. In this review, we describe the implantation techniques for CSP and discuss the current recommendations for their use.
May Measurement Month 2022: an analysis of blood pressure screening results from Nigeria
Authors: Amusa Ganiyu A , Wahab Kolawole W , Kolo Philip M , Odili Augustine , Aje Akinyemi , Iheonye Henry , Ogunmodede James A , Alaofin Wemimo A , Bello Abiodun H , Abubakar Sani A , Nwazor Ernest , Ayoola Yekeen , Okafor Umezurike H , Beaney Thomas , Kerr Gabriele , Poulter Neil R , Omotoso Ayodele B
Published: February 2025

The May Measurement Month (MMM) campaign was carried out in Nigeria in 2022 to raise awareness of high blood pressure (BP). Here, we report on the campaign's findings.

Adults aged ≥ 18 years were recruited opportunistically at public and private areas, pharmacies, clinics and hospitals across the six geopolitical zones of Nigeria. Three seated BP readings were taken for each participant, and a questionnaire on demographics, lifestyle factors, and comorbidities was completed. Hypertension was defined as a systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg or being on antihypertensive medication. Controlled hypertension was defined as being on antihypertensive medication with a BP <140/90 mmHg. Multiple imputation was used to estimate any missing BP readings. In total, 5798 were screened, with a mean age of 44.2 years and 54.8% were female. Of all participants, 2330 (40.2%) had hypertension, of whom 1362 (58.5%) were aware, and 1241 (53.3%) were on antihypertensive medication. Of those on antihypertensive medication, 522 (42.1%) had controlled BP, and of all participants with hypertension, 22.4% had controlled BP.

The MMM campaign in Nigeria identified significant numbers of participants with either untreated or inadequately treated hypertension. There is a poor awareness and unacceptably high burden of hypertension amongst the Nigerian population. Urgent actions are required to improve the awareness of hypertension and reduce its associated health burden in Nigeria.
Association of pre-admission exercise habit with post-discharge outcomes for older patients with heart failure
Authors: Nakade Taisuke , Maeda Daichi , Matsue Yuya , Kagiyama Nobuyuki , Fujimoto Yudai , Sunayama Tsutomu , Dotare Taishi , Jujo Kentaro , Saito Kazuya , Kamiya Kentaro , Saito Hiroshi , Ogasahara Yuki , Maekawa Emi , Konishi Masaaki , Kitai Takeshi , Iwata Kentaro , Wada Hiroshi , Kasai Takatoshi , Nagamatsu Hirofumi , Momomura Shin-ichi , Minamino Tohru
Published: February 2025

Aims

The benefits of exercise in patients with heart failure are well documented. However, to date, the association between exercise habits and prognosis is yet to be evaluated. In this study, we investigated the association between pre-hospital exercise habits and post-discharge prognosis in older adult patients with heart failure.

Methods

This post-hoc analysis utilised data from the FRAGILE-HF study, which included 1,262 patients aged ≥ 65 years who required hospitalisation for heart failure decompensation. Exercise habits before hospitalisation were assessed through a three-question physical activity assessment tool. The primary outcome was all-cause mortality.

Results

Of the 1,262 patients, 587 (46.5%) reported no regular exercise habits before hospitalisation. No significant differences were observed in the histories of heart failure hospitalisations or other comorbidities. However, patients in the exercise habit group consistently exhibited better physical function, such as greater grip strength, gait speed, and short physical performance battery scores, than those in the non-exercise habit group. In addition to physical function, patients with exercise habits exhibited significantly lower all-cause mortality than those without exercise habits (log-rank test, p=0.019). The adjusted Cox regression models suggested that pre-hospital exercise was associated with a lower mortality risk (hazard ratio, 0.75; 95% confidence interval, 0.58–0.98; p=0.035).

Conclusion

Exercise habits before hospitalisation were significantly associated with better strength and physical function and lower post-discharge all-cause mortality in older adult patients with heart failure. These findings highlight the importance of assessing exercise habits for risk stratification among this population.
‘Notre-Dame de Bon Secours’: celebrity, ambition and memory in the fashioning of Thérésia Cabarrus Tallien
Authors: Adams Christine
Published: February 2025

Thérésia Cabarrus (Tallien), one of the best-known female names associated with the French Revolutionary years, emerged as an important point of contact in networks that helped individuals at risk flee France during the Terror. It became part of her claim to celebrity status as she navigated between the politics of the Old Regime and the new. Two aristocratic women she helped escape via Bordeaux wrote about her in their memoirs. While shaped by their own world-views and political allegiances, they offer insight to Cabarrus’ efforts to carve out a meaningful role for herself under the new republican regime while drawing on the Old Regime model of female courtiers who made use of their relationships with powerful men to exercise political influence. Her heroic efforts, which Cabarrus emphasized while seeking celebrity under the Directory, are overshadowed in historical memory by her role as ‘Queen of the Directory’.
Factors influencing spatial variability in the trophic transfer of essential nutrients from plankton to European sardine (Sardina pilchardus)
Authors: Neven Carolin Julie , Soudant Philippe , Marchal Paul , Lefebvre Sébastien , Lefebvre Alain , Wacquet Guillaume , Quere Claudie , Pernet Fabrice , Giraldo Carolina
Published: February 2025

Phytoplankton play a crucial role in marine food webs as they supply essential fatty acids (FA) to higher trophic levels, from small pelagic fish to top predators, through the intermediary action of zooplankton. Thus, the composition and nutritional value of plankton communities expectably influence abundance and condition of predators potentially leading to spatial variation in trophic transfer. Through the analysis of the FA profile of zooplankton and European sardine (Sardina pilchardus), and of the community composition of phytoplankton and zooplankton, we investigated (i) large-scale spatial variability in the trophic transfer of FA from plankton to small pelagic fish and (ii) the factors influencing this transfer in the English Channel. We found that the FA composition of zooplankton and sardine differed between the western and eastern basins of the English Channel (WEC and EEC, respectively), reflecting differences in plankton community composition. The FA profile of sardine varied further with regard to energy allocation strategies and conditions. This suggests a strong bottom-up influence of plankton community composition on the spatial variability of FA transfer with an additional impact of fish physiological status. Understanding the reasons behind the separation pattern of sardines between the WEC and the EEC would be helpful to inform fisheries and ecosystem-based management advice.
Lysis of Escherichia coli by colicin Ib contributes to bacterial cross-feeding by releasing active β-galactosidase
Authors: Lerminiaux Nicole A , Kaufman Jaycee M , Schnell Laura J , Workman Sean D , Suchan Danae M , Kröger Carsten , Ingalls Brian P , Cameron Andrew D S
Published: February 2025

The diffusible toxin ColIb produced by Salmonella enterica serovar Typhimurium SL1344 is a potent inhibitor of Escherichia coli growth. To identify and parameterize metabolic cross-feeding in states of competition, we established defined communities in which E. coli was the only species able to access a sole carbon source, lactose. Although ColIb was predicted to undermine cross-feeding by killing the lactose-converting E. coli, S. enterica populations thrived in co-culture. We discovered that ColIb caused the release of active β-galactosidase from E. coli cells, which induced galactose uptake by S. enterica. Although iron limitation stimulates ColIb production and makes E. coli more sensitive to the toxin, ColIb killing in iron-limited conditions did not enhance iron acquisition or siderophore scavenging by S. enterica. Also unexpected was the rapid rate at which resistance to ColIb evolved in E. coli through spontaneous mutation of the ColIb receptor gene cirA or horizontal acquisition of the S. enterica colicin immunity gene imm. Mathematical modelling effectively predicted the growth kinetics of E. coli and S. enterica populations, revealing a tractable system in which ColIb can shrink a competitor population while simultaneously amplifying the metabolic contributions of the suppressed population.
Exploring the Anti-Obesity Effects of Lactobacillus in C57BL/6 mice: Mechanisms, Interventions, and Future Directions
Authors: Lim Sharoen Yu Ming , Chong E-Jayn , Mah Weng Yan , Pan Yan , Fang Chee Mun , Murugaiah Chandrika , Alshagga Mustafa
Published: February 2025

Lactobacillus species show strong potential in fighting obesity-related inflammation and metabolic issues. Obesity causes inflammation in adipose tissue, which harms insulin sensitivity and leads to fat buildup. Lactobacillus strains like L. gasseri, L. reuteri, and L. plantarum help regulate lipid metabolism by boosting key genes, preventing fat cell formation, and encouraging fat breakdown. They also produce short-chain fatty acids (SCFAs) that improve gut health, activate metabolic pathways, and reduce inflammation. Studies in animals have shown that Lactobacillus can reduce body weight, fat, and inflammation, with L. plantarum being especially effective in improving gut microbiota and liver function. When combined with other probiotics or prebiotics, these strains work even better, enhancing lipid metabolism and reducing inflammation. These results suggest that Lactobacillus could be an effective way to manage obesity and related health problems by influencing metabolism, gut health, and inflammation. However, more research, particularly human clinical trials, is needed to confirm its potential as a dietary treatment for obesity.
Possible Constraints on Asteroid-Mass Primordial Black Holes from Solar System Cratering
Authors: Santarelli Andrew D , Caplan Matthew E , Smith Nevin T
Published: February 2025

Due to their novel cratering mechanism, primordial black holes (PBHs) in the asteroid mass window of about 1017 to 1019 g can produce surface features on solar system bodies that are distinguishable from traditional impact craters. High resolution surface scans of old cratered solar system bodies therefore provide a way to test compact dark matter candidates like PBHs. In this work, we calculate the flux of PBHs across three targets: the Moon, Mercury, and Ganymede. We consider PBHs from both the galactic halo and thick dark disk, and include modulation due to annual and galactic orbits, gravitational focusing, and the vertical oscillation of the solar system. We show that non-detection of a PBH crater on all three of these bodies has the potential to constrain PBHs as dark matter near the evaporation limit, potentially improving current constraints by up to about an order of magnitude, or roughly 1018 g.
Devil’s Staircase and Power-Law due to Desynchronization in a Laboratory Plasma
Authors: Fukuyama Takao , Noguchi Kojiro , Miyoshi Hiroto
Published: February 2025

Applying a periodic external force to chaotic ionization waves in a laboratory plasma induces system transitions to a phase-synchronized state. Upon systematically varying the intensity and frequency of the applied periodic external force as control parameters, a devil’s staircase structure was observed in the desynchronization graph, which represents the time evolution of the phase difference and depicts the system’s return to its original state after phase synchronization. The average duration of the phase-synchronized state was examined by changing the parameters governing the system (i.e., the strength and frequency of the external force). The results revealed a power-law of type-I intermittency between the parameters and duration of the phase-synchronized state.
Preventing Falls in Older Adults after Upper Limb Fractures: A Scoping Review
Authors: Lobo Bárbara Santos , Amaral Alfonsi Maynara , Lima Camila Astolphi , Felipe Sarah Giulia Bandeira , Kristensen Morten Tange , Beaupre Lauren A , Sherrington Catherine , Bruder Andrea M , Perracini Monica Rodrigues
Published: February 2025

Objectives

The objective was to identify and describe fall prevention strategies in upper limb fracture rehabilitation for older people using recent fall prevention guidelines as a standard.

Methods

A systematic search was conducted in 9 electronic databases (PUBMED/MEDLINE, EBSCOhost, Cochrane Library, Lilacs, SPORTDiscus, CINAHL, Web of Science, AgeLine, and SciELO), grey literature, and in bibliographic and citation searching of selected articles between May and December 2022 and updated between February and March 2024. Two independent reviewers screened citations for inclusion. Data extraction was performed by 1 reviewer and verified by a second reviewer. A frequency of strategies and content analysis syntheses were conducted.

Results

A broad search strategy was used, initially identifying 25,945 articles and including 6 randomized clinical trials. The grey literature search identified 18 records. Five studies included forearm fractures, 1 upper limb fracture, and no study exclusively rehabilitation after humerus fractures. None of the studies provided comprehensive multifactorial fall risk assessments to guide tailored interventions. Assessments mainly focused on gait and balance. Exercise was the most offered intervention alone or in combination with education. Exercise programs were aligned with recommendations to include progressive balance and functional exercises overall. However, the frequency of 3 or more times weekly was less frequently offered. The grey literature showed a lack of fall prevention-specific information after upper limb fractures and mostly called attention to fall prevention after hip fractures.

Conclusion

Upper limb fracture rehabilitation in older adults, considered at high risk of falling, did not include comprehensive and tailored multifactorial fall assessment and intervention. Unequivocally, exercise programs were overall aligned with recent recommendations and were the most frequent intervention. There is a crucial gap for humerus fractures. This study can help align the treatment of upper limb fractures with updated fall prevention recommendations and impact future research, guiding and influencing implementation in clinical practice.

Impact

There is an urgent need to implement comprehensive and tailored multifactorial fall assessments and interventions in rehabilitation programs for older adults recovering from upper limb fractures. Guidelines should direct this work to enhance clinical practice.
Beyond Rice: The Rise of Salt-Tolerant Potatoes and Sweetpotatoes in Bangladesh?
Authors: Günther Manuela Kristin , Lüttringhaus Sophia , von Witzke Katarina , Ewell Hanna , Nawrotzki Raphael , Miethbauer Thomas
Published: February 2025

In southern Bangladesh, where rice dominates as the staple crop, the introduction of salt-tolerant potato and sweetpotato varieties aims to enhance agricultural productivity and address food and nutrition insecurity in response to climate change and soil salinisation. This study evaluates the impact of an intervention that disseminated improved varieties alongside agronomy and nutrition training. Using ex-post data from 1,621 farmers, treated and untreated, recalling the 2022/23 and 2018/19 seasons, a matched difference-in-difference analysis reveals an average treatment effect of the treated on sweet potato yield of 4.8 tonnes/ha (33% increase) but no effect on potato yield. Yet, there is evidence for widespread disadoption of the improved varieties. Results from a Heckman selection model including robustness checks for heterogeneity, suggest positive yield effects stem mostly from training. Although no significant difference in food and nutrition security was observed between treated and comparison households, we note a shift in cultivation patterns. Potatoes, traditionally grown by men as cash crops, were increasingly cultivated by women to combat food insecurity, whilst sweetpotatoes, traditionally grown for consumption, became more commercialised. This study shows the importance of timely planned evaluations of agriculture projects that carefully consider the interplay of adoption, training, consumption, and gender, highlighting the need for locally targeted initiatives to address food and nutrition insecurity in climate-vulnerable regions.
Expression complementation between fundamental biological pathways in Populus hybrid contributes to heterosis in cadmium (Cd) accumulation and tolerance
Authors: Li Mengge , Heng Qimeng , Yan Xinyang , Guo Mengfan , Liu Zhaoming , Chen Zheng , Gao Tao , He Xuelian , Zhang Zheyuan , Chen Yinglong , Yong Jean W H , Wang Rongkai , Fan Junfeng , Zhang Yi
Published: February 2025

To reveal the pattern of heterosis in cadmium (Cd) bio-accumulation of poplar and whether the heterosis can promote the phytoremediation efficiency of Cd-polluted soil, the poplar hybrid variety QB-5 (I-101 × 84K) and its female parent I-101 (Populus alba) and male parent 84K (P. alba × P. glandulosa) were employed in a hydroponic experiment and a field trial. BPHs of leaf biomass, leaf area, free proline, CAT, SA and Cd bio-accumulation reached 100.30%, 97.23%, 57.96% 176.41%, 102.94% and 164.17%, respectively, under Cd exposure. A more in-depth analysis unveiled that most traits related to Cd bio-concentration, including root parameters, Cd translocation factor (TF), and Cd bioconcentration factor (BCF) in leaves, were dominant in 84K. In contrast, traits related to stress tolerance were dominant in I-101. Weighted gene co-expression network analysis (WGCNA) revealed that hub genes responsible for Cd translocation and bioconcentration were dominantly expressed in 84K, resulting in superior leaf Cd concentration in males compared to females. Conversely, most genes responsible for stress tolerance were highly expressed in I-101. The hybrid exhibited a high-parent complementation pattern for critical traits and relevant hub genes, contributing to better-parent heterosis for these traits. Overexpression of PagP5CS1, a gene showing above-high-parent expression in hybrid, increased Cd tolerance and Cd bio-accumulation in poplar, providing molecular evidence for the dominance hypothesis of heterosis. The efficiency of phytoremediation for Cd-contaminated soil can be largely promoted by exploring and utilizing heterosis in Cd tolerance and Cd bio-accumulation.
Rapid and simple detection of anilinopyrimidine resistance in Botrytis cinerea by combining recombinase polymerase amplification with the CRISPR/Cas12a assay
Authors: Fan Fei , Wu Min-Yi , Zhang Hui-Qin , Li Guoqing , Luo Chaoxi
Published: February 2025

Anilinopyrimidine (AP) fungicides have been widely adopted to control Botrytis cinerea since the 1990s. As a high-risk pathogen for the development of fungicide resistance, B. cinerea developed resistance to AP fungicides soon after their application. To ensure the proper use of these fungicides, it is necessary to establish a rapid and simple method for resistance detection. Our previous study demonstrated that the E407K mutation in Bcmdl1 was the major mutation conferring AP resistance in China. Based on the combination of recombinase polymerase amplification (RPA) and CRISPR/Cas12a nucleic acid detection assay (RPA/Cas12a detection assay), a simple method for the rapid detection of AP resistance was established by specifically identifying this resistance-related mutation. The new detection assay could precisely identify the E407K mutants from other mutants and wild-type isolates within 50 minutes, relying solely on a water/metal bath and a UV flashlight. Moreover, this assay could detect genomic DNA at concentration as low as 1.8 × 106 fg/μL, which is comparable with conventional PCR, indicating its high sensitivity. High specificity among different species were also observed in this assay. Above all, this assay was compatible with a two-minute DNA extraction method, implying its feasibility for field application. In conclusion, the RPA/Cas12a detection assay developed in this study is rapid and simple, making it an ideal method for AP resistance detection in local agencies and other points of care. Instant information on resistance monitoring can provide important guidance on resistance management.
Procyanidin B2 attenuates pathological cardiac fibrosis and inflammation: role of PPARγ
Authors: Li Chun Xia , Wu Ruo Man , Xie Qian Lin , Wang Fei , Le Xu Xiao
Published: February 2025

Procyanidin B2 (PB2) is a prominent procyanidin isomer. Its effects and mechanisms in cardiac remodeling are not fully understood. Peroxisome proliferator-activated receptor gamma (PPAR-γ) plays a crucial role in regulating cardiac hypertrophy, fibrosis, and inflammation. This study aims to investigate the effect of PB2 on pathological cardiac fibrosis and inflammation, focusing on the underlying mechanisms involving PPAR-γ. In vitro, cardiac fibrosis was induced in cardiac fibroblasts using angiotensin II. In vivo, a mouse model of pathological cardiac fibrosis was generated through transverse aortic constriction to induce pressure overload. We found that PB2 inhibited proliferation, differentiation, collagen accumulation, and the NF-κB inflammation pathway in cardiac fibroblasts triggered by angiotensin II. These inhibitory effects were negated by the PPAR-γ antagonist GW9662 and RNA interference. Additionally, PB2 directly elevated PPAR-γ expression in cardiac fibroblasts. Similarly, PB2 alleviated transverse aortic constriction-induced cardiac dysfunction, myocardial fibrosis, and inflammation in mice. These cardioprotective effects of PB2 in vivo were counteracted by co-administration with GW9662. Correspondingly, the upregulation of PPAR-γ protein expression by PB2 in pressure-overloaded hearts was also counteracted by GW9662 co-administration. In conclusion, this study demonstrates that PB2 exerts protective effects against pathological cardiac fibrosis and inflammation through a PPAR-γ dependent mechanism.
Action mechanisms of polysaccharides in Chinese herbal decoctions
Authors: Xu Wenfeng , Zhao Jing , Li Shaoping
Published: February 2025

Water decoction is the main form of traditional Chinese medicine (TCM) administered in clinics. Polysaccharides are major components of decoction. Recent studies reported that polysaccharides possess multiple pharmacological activities. However, the mechanism by which oral Chinese herbal polysaccharides play vital roles in the body remains uncertain. This review discussed the polysaccharides in Chinese herbal decoctions and their effects, direct and indirect. The direct impact from polysaccharides includes being absorbed into the body immunity regulation through Peyer's patches; electrostatic adsorption, hydrophobic interaction, and glycoprotein receptors-induced antibacterial effects; prebiotic functions; gut microbiota structural regulation; and increasing the relative abundance of beneficial bacteria. The indirect effects of the polysaccharides in Chinese herbal decoctions include phytochemical toxicity reduction and activity enhancement. Finally, their clinical and research significance is summarized and future research directions are discussed.

Graphical abstract: http://links.lww.com/AHM/A155.
Discovery of Soluble Epoxide Hydrolase Inhibitors Based on the Skeleton of Piperine: Synthesis, Properties, Molecular Dynamics Simulation, and Their Potentials in Acute Lung Injury
Authors: Zhang Juan , Yang Xue-Tao , Zhang Min , Zhu Qi-Meng , Yao Da-Hong , Ma Xiao-Chi , Hammock Bruce D. , Sun Cheng-Peng
Published: February 2025

Soluble epoxide hydrolase (sEH) emerges as a target of interest for inflammatory diseases. Piperine is a natural amide alkaloid from Piper nigrum and displays an inhibitory effect toward sEH, therefore, a library of urea-type analogues were designed and synthesized based on its skeleton, and analyzed the structure-activity relationship. Piperine derivatives 11e, 11h, 11j, and 11o showed inhibitory potentials toward sEH with IC50 values from 20 nM to 70 nM. Compound 11h attenuated the pathological course of LPS-mediated acute lung injury (ALI) in vivo. Furthermore, levels of cytokines TNF-α, IL-6, MPO, and LDH were decreased after administration of 11h. The LPS-mediated inflammation and redox unbalance, including expressions of COX-2, HO-1, ICAM-1, VCAM-1, p-p65/p65, GCLM, and Nrf2, were ameliorated through NF-κB and Nrf2 pathways via enhancing levels of EETs in LPS-exposed ALI mice after compound 11h treatment. Molecular docking demonstrated that the aromatic unsaturated group of 11h occupied a hydrophobic pocket and its urea group formed three hydrogen bonds with Asp333, Tyr381, and Tyr465, which stabilized the active conformation of the ligand. These findings demonstrated that compound 11h may serve as a lead compound for developing sEH inhibitors and treating inflammation related to diseases, such as ALI.

Graphical abstract: http://links.lww.com/AHM/A153.
Comparison of machine learning algorithms for automatic prediction of Alzheimer disease
Authors: Aslan Emrah , Özüpak Yildirim
Published: February 2025

Background:

Alzheimer disease is a progressive neurological disorder marked by irreversible memory loss and cognitive decline. Traditional diagnostic tools, such as intracranial volume assessments, electroencephalography (EEG) signals, and brain magnetic resonance imaging (MRI), have shown utility in detecting the disease. However, artificial intelligence (AI) offers promise for automating this process, potentially enhancing diagnostic accuracy and accessibility.

Methods:

In this study, various machine learning models were used to detect Alzheimer disease, including K-nearest neighbor regression, support vector machines (SVM), AdaBoost regression, and logistic regression. A neural network was constructed and validated using data from 150 participants in the University of Washington’s Alzheimer’s Disease Research Center (Open Access Imaging Studies Series [OASIS] dataset). Cross-validation was also performed on the Alzheimer Disease Neuroimaging Initiative (ADNI) dataset to assess the robustness of the models.

Results:

Among the models tested, K-nearest neighbor regression achieved the highest accuracy, reaching 97.33%. The cross-validation on the ADNI dataset further confirmed the effectiveness of the models, demonstrating satisfactory results in screening and diagnosing Alzheimer disease in a community-based sample.

Conclusion:

The findings indicate that AI-based models, particularly K-nearest neighbor regression, provide promising accuracy for the early detection of Alzheimer disease. This approach has potential for further development into practical diagnostic tools that could be applied in clinical and community settings.
Changes in musculoskeletal pain among computer workers when working from home
Authors: Casjens Swaantje , Griemsmann Stephanie , Hosbach Ingolf , Wechsler Konstantin , Weber Britta , Clarenbach Claudia , Petersen Jens , Neubauer Birger , Ellegast Rolf , Behrens Thomas
Published: February 2025

Objectives

This study evaluated the impact of increased working from home on musculoskeletal pain before and after the SARS-CoV-2 pandemic.

Methods

In an online survey (September 2023 to April 2024), pain was rated on a numeric rating scale. The impact of working from home and covariates on new pain onset and exacerbation was modeled using logistic regression analyses.

Results

Of 1,064 participating computer workers, 968 were working from home. Working from home compared to office-only work, showed a trend of increasing pain. Longer remote working hours and poorer workstation setups also increased the risks for pain (e.g., new neck or upper back pain OR 2.02, 95% CI 1.08-3.76).

Conclusions

Preventing musculoskeletal pain should involve improving remote workstation ergonomics, promoting healthy lifestyles, participation in regular occupational health screenings, and supporting employees with anxiety or depression symptoms.
Work-related Musculoskeletal Disorders among Women Office Workers in Kingdom of Saudi Arabia: A Cross-sectional Study on the Impacts of Ergonomics Knowledge in the Work from Home Era
Authors: Bin sheeha Bodor
Published: February 2025

Objectives

The working-from-home trend aimed at enhancing work-life balance may increase absenteeism due to musculoskeletal disorders (MSDs). This study aims to assess office ergonomic knowledge, estimate the prevalence of MSDs, and identify the risk factors that may increase MSD risk.

Design

A cross-sectional design was employed using a valid and reliable questionnaire to attain the objectives.

Results

MSDs were prevalent, most commonly affecting the shoulders. The mean ergonomic knowledge score was 3.98 out of nine. According to ROSA, 83% of the workers had a low MSD risk, whereas 16% had a high risk.

Conclusion

The study revealed the high prevalence of MSDs. Most of the employees had a low MSD risk, and their knowledge of ergonomics was low to moderate. The factors concluded may assist in tailoring the educational program.
The Role of Artificial Intelligence in Supporting the Core Mission of Nursing
Authors: Virkstis Katherine
Published: February 2025

Artificial intelligence (AI) has the potential to revolutionize nursing practice and care delivery by streamlining workflows, enhancing patient insights, and reducing cognitive burden. However, leaders must recognize that the adoption of AI introduces both promise and uncertainty. Nurse leaders must navigate the tension between driving innovation and addressing concerns about ethical implications, reliability, and the need to preserve high-quality, person-centered care. This article examines how leaders can thoughtfully integrate AI to support the core mission of nursing: to protect, promote, and optimize health for patients and communities.
Workforce Assessment of Nurse Anesthetists to Mitigate Intent to Leave and Improve Labor Participation
Authors: Wilbanks Bryan A. , Effinger Betsy
Published: February 2025

OBJECTIVE

The purpose of this study was to analyze the nurse anesthesia workforce in rural settings to identify strategies to improve retention of employees and encourage increased labor participation.

BACKGROUND

Nurse anesthetists are the primary anesthesia provider for many rural areas and are critical in providing patients' access to care. Anesthesia shortages have a disproportionate impact on at-risk populations and contribute heavily to rural hospital closures.

METHODS

This was an exploratory study using a cross-sectional design with paper-based surveys delivered via postal mail.

RESULTS

Although salary was the top response supporting retention, other effective nonmonetary approaches that included guaranteed time off, feeling valued, and fellow employee morale were identified.

CONCLUSION

The findings of this study imply that work-life balance with flexibility in scheduling are effective tools to reduce intent to leave and recruitment of nurse anesthetists. Recruitment efforts need to focus more on female providers because they have the greatest potential to enhance labor participation. Nurse executives can use this information to collaborate with the recruitment and retention of these advanced practice providers.
Creating a Standardized Approach to Program Evaluation in a Magnet Recognized Pediatric Hospital System
Authors: Schwartzkopf Deborah , Bosak Kelly , Godfrey Nelda , Nelson-Brantley Heather , Paramesh Colleen
Published: February 2025

A standardized process for systematic program evaluation adds value to an organization. Using a goal-based framework, a standardized evaluation template was designed and piloted in the ambulatory setting of a 5-time Magnet®designated, regional, quaternary pediatric hospital system. Executive level decision-makers reported the template met implementation criteria for acceptability, appropriateness, and feasibility for use within the organization. Application of the template in a pilot program yielded valuable, cost-effective, unbiased formative and summative information for decision making.
Enhancing Hospital Throughput: A Multidisciplinary Approach to Facilitating Discharges in a Pediatric Setting
Authors: Harrison Meghan W. , Molina Adolfo L , Wu Chang L. , Shaughnessy Erin E.
Published: February 2025

Introduction:

Recent postpandemic respiratory viral surges have highlighted challenges in inpatient capacity at children’s hospitals. Our hospital identified a key bottleneck affecting our ability to accommodate patients: afternoon discharge clustering. We sought to improve throughput efficiency by increasing the percentage of patients discharged outside peak hours.

Methods:

We established an interdisciplinary committee to study our discharge process. We obtained baseline data from January 2021 to April 2022 and determined our peak discharge hours, 11 am–5 pm, when 72% of discharges occurred. Key drivers were identified using the model for improvement, and interventions were trialed using plan-do-study-act cycles. Percent of patients discharged outside peak hours was determined using statistical process control charts (p-charts) as our primary measure. We aimed to improve this percentage by 20% from baseline. Secondary measures were the percentage of discharge orders placed before 9 am and the percentage of patients discharged before 11 am. Balancing measures included average hospital length of stay, discharge turnover time, and patient satisfaction surveys.

Results:

The mean percentage of nonpeak discharges between 5 pm and 11 am increased from a baseline of 28% to 36%. Discharge orders placed before 9 am increased from 4% to 16%. Patients discharged before 11 am increased from 7% to 19%. There were no significant changes in length of stay, discharge turnover time, or patient satisfaction with the discharge process. Key interventions included stakeholder involvement and incentives to support faculty and trainee workflow adjustments, including rounding practices.

Conclusions:

Our team increased the percentage of patients discharged during nonpeak hours and promoted discharge when medically ready.
Penis Reconstruction With Latissimus Dorsi Flap and Challenges for Penis Prosthesis in Phalloplasty
Authors: Nasır Serdar
Published: February 2025

Background

Several methods of penile reconstruction have been described. Free flaps are considered the most functional and aesthetically appropriate treatment method. The main purpose of this reconstruction is to create the urinary tract and provide the most aesthetically similar structure to the biological penile tissue while also providing penile tissue of a size that will ensure adequate sexual intercourse.

This method was investigated through a retrospective analysis of patients who underwent penile reconstruction with a latissimus dorsi free flap, which we believe provides all these features. Thirty patients who underwent surgery between 2020 and 2023 were included in the study group.

Methodology

Latissimus dorsi flap is an important option for patients who need penile reconstruction, including those who want the donor site morbidity to be in a hidden area and those who have concerns about penis size.

Result

Tissue of a size that provides sexual function and a structure in which a penile prosthesis can be easily inserted is obtained in patients who have undergone penile reconstruction with the latissimus dorsi. In addition, there was no problem in creating a glans penis or corona using this method. Pendular urethral reconstruction was not performed in this case series.

Conclusions

We think that penile reconstruction with Latissimus dorsi, together with some of the modifications described, is one of the most functional and aesthetically appropriate methods.
The Modified Fragility Index and Perioperative Albumin as Predictors of Complications in Complex Abdominal Wall Reconstruction
Authors: Ash Makenna , Marxen Troy , Su Shannon , Losken Albert
Published: February 2025

Background and Significance

Complex abdominal wall reconstruction (CAWR) is performed to restore the structure and function of the abdominal wall. These procedures carry the risk of complications such as delayed wound healing, skin necrosis, infection, recurrence, or even death. The 5-factor modified fragility index (5-mFI) has gained popularity as a concise method of evaluating preoperative risk across various surgical specialties. Additionally, perioperative hypoalbuminemia has been previously associated with delayed wound healing after surgery. The purpose of this study was to assess the utility of the 5-mFI in combination with perioperative albumin levels for assessing risk in complex abdominal wall reconstruction.

Methods

This was a retrospective, single-institution chart review study of all patients who underwent CAWR by the senior author (A.L.) from 2002 to 2023. Demographics, comorbidities, details of surgery, perioperative albumin levels, ASA scores, and complications were collected for each patient. Five-factor modified fragility indices were calculated for each patient. Statistical analysis consisted of χ2 and Fisher exact tests for categorical variables, t tests for continuous variables, and multivariate analysis.

Results

Our analysis included 437 patients. The average age of our patients was 54.3 years, the average BMI was 32.1 kg/m2, and the average length of follow-up with the plastic surgery service was 264 days. A total of 118 (27.0%) developed complications, with the most common complications being delayed wound healing (89 patients, 20.4%) and infection (78 patients, 17.8%). Other complications included skin necrosis, fistula formation, hematoma, seroma, infection, and death. Sixty patients (13.7%) experienced recurrence of their hernias within the follow-up period. An mFI of 2 or greater was significantly associated with delayed wound healing (LR, 11.42; P = 0.0436) as well as skin necrosis (LR, 4.826; P = 0.028). The presence of an mFI of 2 or greater and perioperative hypoalbuminemia was significantly associated with development of major complications (LR, 3.221; P = 0.0457), delayed wound healing (LR, 5.999; P = 0.0143), skin necrosis (LR, 9.19; P = 0.0024), and mortality (LR, 5.287; P = 0.0215). On multivariate analysis, the presence of an mFI of 2 or greater when combined with perioperative hypoalbuminemia was found to be independently associated with mortality (LR, 1524.5; P < 0.0001).

Conclusions

We found the 5-factor mFI to be significantly associated with delayed wound healing and skin necrosis in our patient population. When an mFI of 2 or greater was present along with perioperative hypoalbuminemia, patients were significantly more likely to experience complications, issues with wound healing, and mortality. Surgeons should take these findings into account when counseling patients preoperatively.
Comparison of dual-agent alpha-blocker treatment with single agent in management of refractory lower urinary tract symptoms
Authors: Ranjan Kumar Rajiv , Singh Dineshwar Pratap , Sarkar Debansu
Published: February 2025

Introduction:

In patients with enlarged prostate whose lower urinary tract symptoms (LUTS) are refractory to an initial alpha-blocker, there are several options, including surgery, alternative alpha-blockers, or dose escalation. Alpha-blockers used clinically do not differ in efficacy, but only in their side effects profile. The possibility of synergy between different classes of alpha-blockers has not yet been explored. In this study, we compared the efficacy of single (silodosin) and dual (silodosin + alfuzosin) alpha-blocker therapy for treating patients with refractory LUTS due to an enlarged prostate. Additionally, we studied the incidence of adverse effects of single and dual alpha-blocker therapy.

Materials and methods:

It was a prospective comparative observational study with 250 participants, conducted at the department of urology, a tertiary care hospital in eastern India. Male patients with moderate to severe LUTS (international prostate symptoms score [IPSS] >7) of all age groups with enlarged prostate were included in this study.

Results:

The demographic profiles of the patients including age, baseline maximum flow rate, baseline IPSS, and adverse effects were comparable for both the groups. Mean improvement in IPSS and maximal uroflow rate were significantly higher in the dual alpha-blocker therapy group without significant difference in adverse effects between the 2 groups.

Conclusion:

Results of dual alpha-blocker therapy in refractory LUTS due to enlarged prostate are encouraging with acceptable adverse effects.
HGCPep: A Hypergraph-based Deep Learning Model for Enhancing Representation of Peptide Features in Cancer-associated ncPEPs Identification
Authors: Long Wentao , Li Zhongshen , Jin Junru , Qiao Jianbo , Wang Yu , Wei Leyi
Published: February 2025

The emergence of non-coding RNA-encoded small peptides (ncPEPs) has sparked significant interest within the realm of cancer immunotherapy, owing to their potential as valuable therapeutic targets and biomarkers. The identification and characterization of cancer-associated ncPEPs assume a crucial role in propelling cancer research forward and augmenting our comprehension of immune-related processes. However, prevailing methods for cancer-associated ncPEPs identification primarily rely on sequence order, neglecting the latent relationships between peptides. As widely acknowledged in the central dogma, peptides are translated from RNA via a many-to-many mapping. In this study, we capitalize on the translation relationship and introduce a hypergraph-based model called HGCPep to enhance the representation of peptide features. Specifically, RNA is regarded as a hyperedge connecting the peptides that are translated from it. Our experimental results validate that the HGCPep approach, leveraging the strengths of hypergraph and convolutional neural networks, outperforms alternative methodologies in the recognition of ncPEPs. Additionally, employing a reduction tool, we visualize the results of multi-label classification within a 2D latent space, shedding light on how multi-label classification task influence the representation of peptides. The dataset and source code of our proposed method can be found viahttps://github.com/Longwt123/HGCPep_Github.