bluuebunny/crossref_metadata_2025 huggingface dataset:
The Burden of Human Metapneumovirus- and Influenza-Associated Hospitalizations in Adults in New Zealand, 2012–2015
Authors: Aminisani Nayyereh , Wood Timothy , Jelley Lauren , Wong Conroy , Sue Huang Q
Published: February 2024

Background

Unlike influenza, information on the burden of human metapneumovirus (HMPV) as a cause of hospitalizations in adults with acute respiratory illness (ARI) is limited.

Methods

We compared the population-based incidence, seasonality, and clinical characteristics of these 2 viral infections among adults aged ≥20 years with ARI hospitalizations in Auckland, New Zealand, during 2012–2015 through the Southern Hemisphere Influenza Vaccine Effectiveness Research and Surveillance (SHIVERS) project.

Results

Of the 14 139 ARI hospitalizations, 276 of 6484 (4.3%) tested positive for HMPV and 1342 of 7027 (19.1%) tested positive for influenza. Crude rates of 9.8 (95% confidence interval [CI], 8.7–11.0) HMPV-associated and 47.6 (95% CI, 45.1–50.1) influenza-associated ARI hospitalizations were estimated for every 100 000 adult residents annually. The highest rates for both viruses were in those aged ≥80 years, of Māori or Pacific ethnicity, or living in low socioeconomic status (SES) areas. HMPV infections were more common than influenza in those with chronic medical conditions.

Conclusions

Although HMPV infections accounted for fewer hospitalizations than influenza in adults aged ≥20 years, HMPV-associated ARI hospitalization rates were higher than influenza in older adults, Māori and Pacific people, and those of low SES. This highlights a need for vaccine/antiviral development.
Pyrrho’s Buddha on Duḥkha and the Liberation from Views
Authors: Gold Jonathan C
Published: February 2024

This article presents a rereading of Buddhist scriptures from the Pāli Nikāyas in the light of Christopher Beckwith’s 2015 theory that Pyrrho professed early Buddhist ideas. This changes, above all, how we read one of the central terms in Buddhism, dukkha/duḥkha (usually “suffering,” now “unreliable” or “precarious”). I argue that many scriptures make better sense with Pyrrho’s reading and, moreover, that it reveals a depth of wisdom in many otherwise obscure passages in early Buddhist teachings. Through an exploratory, hermeneutic method, the article suggests a reconceptualization of Buddhist scriptures and philosophy in the light of Pyrrho.
Efficacy of ergosterol peroxide obtained from the endophytic fungus Acrophialophora jodhpurensis against Rhizoctonia solani
Authors: Daroodi Zoha , Taheri Parissa , Tarighi Saeed , Iranshahi Mehrdad , Akaberi Maryam
Published: February 2024

Aim

To investigate antifungal activity of the extract and major metabolite of the endophytic fungus Acrophialophora jodhpurensis (belonging to Chaetomiaceae) against crown and root rot caused by Rhizoctonia solani (teleomorph: Thanatephorus cucumeris), as an important pathogen of tomato.

Methods and Results

The endophytic fungus A. jodhpurensis, has high inhibitory effect against R. solani AG4-HG II in vitro and in vivo. The media conditions were optimized for production of the endophyte’s metabolites. The highest amounts of secondary metabolites were produced at pH 7, 30°C temperature, and in the presence of 0.5% glucose, 0.033% sodium nitrate, and 1 gl−1 asparagine as the best carbon, nitrogen, and amino acid sources, respectively. The mycelia were extracted by methanol and the obtained extract was submitted to various chromatography techniques. Phytochemical analysis via thin-layer chromatography (TLC) and nuclear magnetic resonance (NMR) spectroscopy showed that ergosterol peroxide was the major component in the extract of this endophyte. Antifungal activities of the methanolic extract and ergosterol peroxide in the culture media were studied against R. solani. Minimum inhibitory concentrations of the extract and ergosterol peroxide against the pathogen were 600 and 150 µg ml−1, respectively. Ergosterol peroxide revealed destructive effects on the pathogen structures in microscopic analyses and induced sclerotia production. Histochemical analyses revealed that it induced apoptosis in the mycelia of R. solani via superoxide production and cell death. Application of ergosterol peroxide in the leaf disc assay reduced the disease severity in tomato leaves.

Conclusions

Antifungal metabolites produced by A. jodhpurensis, such as ergosterol peroxide, are capable of controlling destructive Rhizoctonia diseases on tomato.
Do the general public get cancer statistics?—a questionnaire survey in Japan
Authors: Gatellier Laureline , Charvat Hadrien , Ito Yuri , Matsuda Tomohiro
Published: February 2024

Objectives

The public does not always understand key information conveyed by epidemiologists and statisticians. The purpose of this study was to understand the level of public access to, trust in, and comprehension of, cancer statistics through a population-based survey in Japan.

Methods

We used an online research method, requesting online responses to a 15-question questionnaire. The survey was sent to males and females aged 20 years and older, selected by sex, age and prefecture to match the national population proportions shown in the latest census. The final number of valid responses was 10 477. The statistical analyses mainly used χ2 testing.

Results

Respondents were not frequently exposed to cancer statistics regardless of sex or age group, nor did they necessarily have confidence in the statistics. The increase of collected information and trust in cancer statistics was aligned with increasing age and cancer exposure. Respondents found Relative Risk and Relative Survival Rate easier to understand and more useful than the Standardized Incidence Ratio. In addition, those with cancer experience, higher income and were elderly gave more accurate responses when asked questions related to cancer incidence and probability of getting cancer.

Conclusions

Our respondents showed limited familiarity with cancer statistical indicators. Enhanced awareness of indicators such as infographics and visual tools has the potential to enhance cancer visibility, thereby promoting public prevention and early detection efforts. Educating cancer patients about pertinent indicators can boost their confidence in managing their condition. Conversely, the introduction of indicators unrelated to the public should be discouraged.
Outdoor air pollution exposure and uterine cancer incidence in the Sister Study
Authors: Brown Jordyn A , Ish Jennifer L , Chang Che-Jung , Bookwalter Deborah B , O’Brien Katie M , Jones Rena R , Kaufman Joel D , Sandler Dale P , White Alexandra J
Published: February 2024

Background

Outdoor air pollution is a ubiquitous exposure that includes endocrine-disrupting and carcinogenic compounds that may contribute to the risk of hormone-sensitive outcomes such as uterine cancer. However, there is limited evidence about the relationship between outdoor air pollution and uterine cancer incidence.

Methods

We investigated the associations of residential exposure to particulate matter less than 2.5 µm in aerodynamic diameter (PM2.5) and nitrogen dioxide (NO2) with uterine cancer among 33 417 Sister Study participants with an intact uterus at baseline (2003-2009). Annual average air pollutant concentrations were estimated at participants’ geocoded primary residential addresses using validated spatiotemporal models. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals for the association between time-varying 12-month PM2.5 (µg/m3) and NO2 (parts per billion; ppb) averages and uterine cancer incidence.

Results

Over a median follow-up period of 9.8 years, 319 incident uterine cancer cases were identified. A 5-ppb increase in NO2 was associated with a 23% higher incidence of uterine cancer (hazard ratio = 1.23, 95% confidence interval = 1.04 to 1.46), especially among participants living in urban areas (hazard ratio = 1.53, 95% confidence interval = 1.13 to 2.07), but  PM2.5 was not associated with increased uterine cancer incidence.

Conclusion

In this large US cohort, NO2, a marker of vehicular traffic exposure, was associated with a higher incidence of uterine cancer. These findings expand the scope of health effects associated with air pollution, supporting the need for policy and other interventions designed to reduce air pollutant exposure.
An Armenian Invocational Prayer of a Now Lost Homily of Jacob of Serugh on Jonah and the Ninevites
Authors: Hilkens Andy
Published: February 2024

This article offers the editio princeps and translation of the Armenian invocational prayer of a homily on Jonah and the Ninevites that was probably translated from Syriac. The homily was likely written by Jacob of Serugh and as such the prayer is the only remnant of what was once a full Armenian translation of a full Syriac text, both of which have been lost. In the prayer Jacob compares Jonah’s conversation with the sailors to Pilate’s trial of Christ. This critical edition takes into account five witnesses that are extant in four manuscripts. One other manuscript was inaccessible. A sixth manuscript, which may have contained the full text, is lost and presumed destroyed.
Functional identification of cis-regulatory long noncoding RNAs at controlled false discovery rates
Authors: Dhaka Bhavya , Zimmerli Marc , Hanhart Daniel , Moser Mario B , Guillen-Ramirez Hugo , Mishra Sanat , Esposito Roberta , Polidori Taisia , Widmer Maro , García-Pérez Raquel , Julio Marianna Kruithof-de , Pervouchine Dmitri , Melé Marta , Chouvardas Panagiotis , Johnson Rory
Published: February 2024

A key attribute of some long noncoding RNAs (lncRNAs) is their ability to regulate expression of neighbouring genes in cis. However, such ‘cis-lncRNAs’ are presently defined using ad hoc criteria that, we show, are prone to false-positive predictions. The resulting lack of cis-lncRNA catalogues hinders our understanding of their extent, characteristics and mechanisms. Here, we introduce TransCistor, a framework for defining and identifying cis-lncRNAs based on enrichment of targets amongst proximal genes. TransCistor’s simple and conservative statistical models are compatible with functionally defined target gene maps generated by existing and future technologies. Using transcriptome-wide perturbation experiments for 268 human and 134 mouse lncRNAs, we provide the first large-scale survey of cis-lncRNAs. Known cis-lncRNAs are correctly identified, including XIST, LINC00240 and UMLILO, and predictions are consistent across analysis methods, perturbation types and independent experiments. We detect cis-activity in a minority of lncRNAs, primarily involving activators over repressors. Cis-lncRNAs are detected by both RNA interference and antisense oligonucleotide perturbations. Mechanistically, cis-lncRNA transcripts are observed to physically associate with their target genes and are weakly enriched with enhancer elements. In summary, TransCistor establishes a quantitative foundation for cis-lncRNAs, opening a path to elucidating their molecular mechanisms and biological significance.
Activation of zinc uptake regulator by zinc binding to three regulatory sites
Authors: Choi Yunchan , Koh Junseock , Cha Sun-Shin , Roe Jung-Hye
Published: February 2024

Zur is a Fur-family metalloregulator that is widely used to control zinc homeostasis in bacteria. In Streptomyces coelicolor, Zur (ScZur) acts as both a repressor for zinc uptake (znuA) gene and an activator for zinc exporter (zitB) gene. Previous structural studies revealed three zinc ions specifically bound per ScZur monomer; a structural one to allow dimeric architecture and two regulatory ones for DNA-binding activity. In this study, we present evidence that Zur contains a fourth specific zinc-binding site with a key histidine residue (H36), widely conserved among actinobacteria, for regulatory function. Biochemical, genetic, and calorimetric data revealed that H36 is critical for hexameric binding of Zur to the zitB zurbox and further binding to its upstream region required for full activation. A comprehensive thermodynamic model demonstrated that the DNA-binding affinity of Zur to both znuA and zitB zurboxes is remarkably enhanced upon saturation of all three regulatory zinc sites. The model also predicts that the strong coupling between zinc binding and DNA binding equilibria of Zur drives a biphasic activation of the zitB gene in response to a wide concentration change of zinc. Similar mechanisms may be pertinent to other metalloproteins, expanding their response spectrum through binding multiple regulatory metals.
Consuming Patients’ Days: Time Spent on Ambulatory Appointments by People With Cancer
Authors: Kagalwalla Sana , Tsai Alexander K , George Manju , Waldock Anna , Davis Sydney , Jewett Patricia , Vogel Rachel I , Ganguli Ishani , Booth Christopher , Dusetzina Stacie B , Rocque Gabrielle B , Blaes Anne H , Gupta Arjun
Published: February 2024

Background

In qualitative work, patients report that seemingly short trips to clinic (eg, a supposed 10-minute blood draw) often turn into “all-day affairs.” We sought to quantify the time patients with cancer spend attending ambulatory appointments.

Methods

We conducted a retrospective study of patients scheduled for oncology-related ambulatory care (eg, labs, imaging, procedures, infusions, and clinician visits) at an academic cancer center over 1 week. The primary exposure was the ambulatory service type(s) (eg, clinician visit only, labs and infusion, etc.). We used Real-Time Location System badge data to calculate clinic times and estimated round-trip travel times and parking times. We calculated and summarized clinic and total (clinic + travel + parking) times for ambulatory service types.

Results

We included 435 patients. Across all service day type(s), the median (IQR) clinic time was 119 (78-202) minutes. The estimated median (IQR) round-trip driving distance and travel time was 34 (17-49) miles and 50 (36-68) minutes. The median (IQR) parking time was 14 (12-15) minutes. Overall, the median (IQR) total time was 197 (143-287) minutes. The median total times for specific service type(s) included: 99 minutes for lab-only, 144 minutes for clinician visit only, and 278 minutes for labs, clinician visit, and infusion.

Conclusion

Patients often spent several hours pursuing ambulatory cancer care on a given day. Accounting for opportunity time costs and the coordination of activities around ambulatory care, these results highlight the substantial time burdens of cancer care, and support the notion that many days with ambulatory health care contact may represent “lost days.”
The Treatment of Burkitt Lymphoma With the Berlin-Frankfurt-Münster Protocol With Rituximab and Consolidative Autologous Transplantation
Authors: Broccoli Alessandro , Argnani Lisa , Gugliotta Gabriele , Pellegrini Cinzia , Casadei Beatrice , Bagnato Gianmarco , Gentilini Marianna , Stefoni Vittorio , Zinzani Pier Luigi
Published: February 2024

Introduction

Intensive treatment approaches are required for adult patients with Burkitt lymphoma (BL), although an univocal standard of care still does not exist. The use of frontline autologous stem cells transplantation (ASCT) is debated.

Patients and Methods

Between 2004 and 2020, 50 patients with BL were treated with the Berlin-Frankfurt-Münster (BFM). Treatment plan consisted of 3 blocks, A (ifosfamide, vincristine, methotrexate, etoposide, and cytarabine), B (vincristine, cyclophosphamide, methotrexate, and doxorubicin), and C (vindesine, methotrexate, etoposide, and cytarabine), each repeated twice, every 28 days. Rituximab was given at day 1 each block. Intrathecal prophylaxis was given once per each block. ASCT was scheduled at the end of the 6 blocks after conditioning.

Results

Median age at onset was 38 years (range 16-72); stages III-IV disease was observed in 82% of cases; bulky disease occurred in 44% of the patients, with B-symptoms in 38%. Stem cell harvest was performed in 72% of patients, who all received a subsequent ASCT. The full 6 blocks treatment was completed in 70% of the patients. The overall response rate was 74%, with a complete response rate of 60%. Ten-year overall survival and progression-free survival were 83.7% and 76.0%, respectively, without reaching the median. Ten-year disease-free survival was 80.3%. Grades 3-4 neutropenia, thrombocytopenia, anemia, and mucositis were seen in 96%, 60%, 32%, and 24% of patients. Infections occurred in 60% of patients.

Conclusion

Intensive treatment according to BFM protocol, with rituximab and ASCT, appears feasible, safe, and highly effective in adult patients with BL, as confirmed by long-term survival rates reflecting response maintenance.
The policewoman: A tale of recruitment, retention, and experiences at nine agencies
Authors: Skaggs Sherry Lynn , Hardwick Kisha , Montgomery Lauren , Harris Chris
Published: February 2024

Since the death of Tyre Nichols in Memphis, TN, and others at the hands of police officers across the country, there has been a growing movement to defund police across the United States. In addition to this movement, police agencies have faced rapidly declining application pools. Fewer applicants, combined with retention issues faced by many departments, have caused staffing issues and led to many cultural impacts within the departments. Among these issues, one noticeable concern has been the ability to recruit and retain female. Through an analysis of interviews with female law enforcement personnel, this study examines problems faced with recruitment of new female officers, retention of veteran female officers, and experiences of women within nine police departments in a southern U.S. state.
Are gout patients with negative dual-energy computed tomography for monosodium urate crystal deposition easy to treat?
Authors: Laurent Victor , Jauffret Charlotte , Ducoulombier Vincent , Pacaud Aurore , Legrand Julie , Verdun Stéphane , Norberciak Laurène , Budzik Jean-François , Pascart Tristan
Published: February 2024

Objectives

To determine the clinical associations and predictive value of two thresholds of negative dual-energy CT (DECT) for MSU crystal deposition in gout patients initiating urate-lowering therapy (ULT) and identify which threshold is more clinically relevant.

Methods

Patients from the CRYSTALILLE cohort with a diagnosis of gout naïve to ULT with baseline DECT scans of the knees and feet were selected. Two thresholds of positivity for DECT detection of MSU crystal deposition were considered (<0.01 cm3 and <0.1 cm3). Baseline characteristics and the prediction of key outcomes after ULT initiation, including reaching serum urate (SU) levels <6.0 and 5.0 mg/dl and occurrence of flares at 6, 12 and 24 months, associated with both thresholds of negative DECTs were compared with those of patients having positive DECT scans.

Results

A total of 211 patients, median age 66.2 years [interquartile range (IQR) 57–75.8], with a median symptom duration of 3 years (IQR 0–7.8) were included. A total of 38/211 (18%) and 90/211 (43%) had negative DECT scans for the 0.01 and 0.1 cm3 thresholds, respectively. Factors associated with negative DECT scans were younger age, shorter symptom duration and an absence of cardiovascular disease for both volume thresholds. A total of 9/39 (23.1%), 3/26 (11.5%) and 1/18 (5.6%) patients with <0.1 cm3 MSU crystals had flares at 6, 12 and 24 months, respectively, compared with 18/45 (40.0%), 9/36 (25.0%) and 2/18 (11.1%) patients with ≥0.1 cm3 (P > 0.05). Overall, 95 patients (68.3%) reached SU levels <6.0 mg/dl and 68 (48.9%) reached levels <5.0 mg/dl, without any difference between positive and negative DECTs, with ULT dosages that tended to be lower in patients with negative DECTs.

Conclusion

The 0.1 cm3 threshold was better correlated with clinical presentation and evolution than the 0.01 cm3 threshold. Gout patients with negative DECTs exhibit milder disease and a lower comorbidity burden. They do not exhibit particularly easy-to-treat hyperuricaemia but they may have a lower risk of flares.
Nigella sativaoil exhibits anti-aging effects in transgenic Alzheimer’sDrosophila melanogastervia anti oxidant pathways: survival-rate and life span studies
Authors: Mukhtar A I , Danborno B , Sadeeq A A
Published: February 2024

In this article we aime to investigate he anti-aging effect of Nigella sativa oil. Transgenic flies engineered under UAS/GAL4 system were acquired from the Bloomington Drosophila stock center. For methodology, (LC50), 30 flies 2–3 days old were divided into four groups, and exposed to diets of 30, 60, 90, and 120 μL/10 g in 3 replicates at a density of 30 flies per vial. Mortality was recorded daily for 7 consecutive days. For survival, (150) 2–3 days adult flies were divided into four groups (I-IV), 100 flies in each group. Group I which served as control fed on 10 g of diet only, group II was fed 10 g of diet only, group III (AB42 + low dose) was fed on 10 g diet +6.39ul NSO, group IV (AB42 + high dose) was fed 10 diet + 12.77ul NSO. The administration lasted for 28 days. For the third phase, a similar protocol was adopted with each group having (400) flies, this phase lasted f till the last fly died. The effect of NSO was assessed by; Studying the mortality daily. Results revealed the lethal concentration of LC50 NSO to be 25.54 mg it was also observed from the study that exposure to NSO in food media at low doses has increased the lifespan of AB-42 treated flies. In conclusion, findings from this study suggest the efficacy of low-dose NSO increased the survival and life span of the AB-42 flies.
Remarkably High Internal Transcribed Spacer Haplotype Diversity of the Fungal Select Agent Coniothyrium glycines Discovered Throughout Its Range in Sub-Saharan Africa
Authors: Bach Rachel A. Koch , Murithi Harun M. , Slocum Clint R. , Coyne Danny , Clough Steven J.
Published: February 2024

Red leaf blotch of soybean, caused by the fungus Coniothyrium glycines, is a foliar disease characterized by blotching, necrosis, and defoliation that has only been reported from Africa. The species is listed as a Select Agent by the Federal Select Agent Program due to its potentially devastating impacts to soybean production should it spread to the United States. Despite its potential import, very few isolates are available for study. Herein, we obtained 96 new C. glycines isolates from six soybean-producing countries throughout sub-Saharan Africa. Along with 12 previously collected ones, we sequenced each at the internal transcribed spacer (ITS) region. Between all isolates, we identified a total of 28 single-nucleotide polymorphisms and 23 haplotypes. One hypothesis to explain the tremendous diversity uncovered at the ITS—which is generally conserved within a species—is that our current species concept of C. glycines is too broad and that there may be multiple species that cause red leaf blotch. Zambia contained the highest haplotype diversity, a significant fraction of which remains unsampled. Most haplotypes were specific to a single country, except for two, which were found in Zambia and either neighboring Mozambique or Zimbabwe. This geographic specificity indicates that the ITS region may be useful for identifying source populations or routes of transmission should this pathogen spread beyond Africa. The observed geographic partitioning of this pathogen is likely the result of millions of years of replication on little-studied native hosts, given that soybean has only been cultivated in Africa since the early 1900s.
Movement-evoked Pain versus Pain at Rest in Postsurgical Clinical Trials and in Meta-analyses: An Updated Systematic Review
Authors: Gilron Ian , Lao Nicholas , Carley Meg , Camiré Daenis , Kehlet Henrik , Brennan Timothy J. , Erb Jason
Published: February 2024

Background

Given the widespread recognition that postsurgical movement-evoked pain is generally more intense, and more functionally relevant, than pain at rest, the authors conducted an update to a previous 2011 review to re-evaluate the assessment of pain at rest and movement-evoked pain in more recent postsurgical analgesic clinical trials.

Methods

The authors searched MEDLINE and Embase for postsurgical pain randomized controlled trials and meta-analyses published between 2014 and 2023 in the setting of thoracotomy, knee arthroplasty, and hysterectomy using methods consistent with the original 2011 review. Included trials and meta-analyses were characterized according to whether they acknowledged the distinction between pain at rest and movement-evoked pain and whether they included pain at rest and/or movement-evoked pain as a pain outcome. For trials measuring movement-evoked pain, pain-evoking maneuvers used to assess movement-evoked pain were tabulated.

Results

Among the 944 included trials, 504 (53%) did not measure movement-evoked pain (vs. 61% in 2011), and 428 (45%) did not distinguish between pain at rest and movement-evoked pain when defining the pain outcome (vs. 52% in 2011). Among the 439 trials that measured movement-evoked pain, selection of pain-evoking maneuver was highly variable and, notably, was not even described in 139 (32%) trials (vs. 38% in 2011). Among the 186 included meta-analyses, 94 (51%) did not distinguish between pain at rest and movement-evoked pain (vs. 71% in 2011).

Conclusions

This updated review demonstrates a persistent limited proportion of trials including movement-evoked pain as a pain outcome, a substantial proportion of trials failing to distinguish between pain at rest and movement-evoked pain, and a lack of consistency in the use of pain-evoking maneuvers for movement-evoked pain assessment. Future postsurgical trials need to (1) use common terminology surrounding pain at rest and movement-evoked pain, (2) assess movement-evoked pain in virtually every trial if not contraindicated, and (3) standardize movement-evoked pain assessment with common, procedure-specific pain-evoking maneuvers. More widespread knowledge translation and mobilization are required in order to disseminate this message to current and future investigators.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Molecular mechanisms in MASLD/MASH-related HCC
Authors: Wang Xiaobo , Zhang Liang , Dong Bingning
Published: February 2024

Liver cancer is the third leading cause of cancer-related deaths and ranks as the sixth most prevalent cancer type globally. NAFLD or metabolic dysfunction–associated steatotic liver disease, and its more severe manifestation, NASH or metabolic dysfunction–associated steatohepatitis (MASH), pose a significant global health concern, affecting approximately 20%–25% of the population. The increased prevalence of metabolic dysfunction–associated steatotic liver disease and MASH is parallel to the increasing rates of obesity-associated metabolic diseases, including type 2 diabetes, insulin resistance, and fatty liver diseases. MASH can progress to MASH-related HCC (MASH-HCC) in about 2% of cases each year, influenced by various factors such as genetic mutations, carcinogen exposure, immune microenvironment, and microbiome. MASH-HCC exhibits distinct molecular and immune characteristics compared to other causes of HCC and affects both men and women equally. The management of early to intermediate-stage MASH-HCC typically involves surgery and locoregional therapies, while advanced HCC is treated with systemic therapies, including anti-angiogenic therapies and immune checkpoint inhibitors. In this comprehensive review, we consolidate previous research findings while also providing the most current insights into the intricate molecular processes underlying MASH-HCC development. We delve into MASH-HCC–associated genetic variations and somatic mutations, disease progression and research models, multiomics analysis, immunological and microenvironmental impacts, and discuss targeted/combined therapies to overcome immune evasion and the biomarkers to recognize treatment responders. By furthering our comprehension of the molecular mechanisms underlying MASH-HCC, our goal is to catalyze the advancement of more potent treatment strategies, ultimately leading to enhanced patient outcomes.
Rethinking Sjögren Beyond Inflammation: Considering the Role of Nerves in Driving Disease Manifestations
Authors: Sanchez Victor , Dobzinski Noa , Fox Robert , Galor Anat
Published: February 2024

Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease characterized by destruction of mucosal glands resulting in dry eye and dry mouth. Ocular presentations can be heterogenous in SS with corneal nerves abnormalities that are structural, functional, or both. Some individuals present with corneal hyposensitivity, with a phenotype of decreased tear production and epithelial disruption. Others present with corneal hypersensitivity, with a phenotype of neuropathic pain including light sensitivity and pain out of proportion to signs of tear dysfunction. A similar correlate can be found outside the eye, with dry mouth predominating in some individuals while pain conditions predominate in others. Understanding how nerve status affects SS phenotype is an important first step to improving disease management by targeting nerve abnormalities, as well as inflammation.
Bilateral Superior Ophthalmic Vein Involvement in a Case With Orbital Sarcoidosis
Authors: Teope Jonnah Kristina , Takahashi Yasuhiro
Published: February 2024

A 71-year-old Japanese man presented with a 2-month history of diplopia. He had been followed up at another hospital for ocular sarcoidosis for 3 years. On initial consultation, the best-corrected decimal visual acuity was 0.3 on OU. Slit-lamp and funduscopic examinations were unremarkable. The left lacrimal gland was easily palpable. The patient had restricted infraduction in the OD. MRI showed thickened superior ophthalmic veins on both sides and an enlarged left lacrimal gland. Blood tests showed elevated soluble interleukin-2 receptors. Biopsy of the enlarged lacrimal gland showed numerous epithelioid granuloma and lymphocytic infiltrates consistent with sarcoidosis. No other systemic sarcoidal lesions were detected. The patient started to take prednisolone of 30 mg/day, and the dose was tapered by 5 mg every 2 weeks. At 1 month after taking prednisolone, imaging showed no thickening of the superior ophthalmic veins. At 5 months follow-up, the left lacrimal gland was not palpable, limitation of infraduction improved, and diplopia resolved.
Effect of residual sphere on uncorrected visual acuity and satisfaction in patients with monofocal and multifocal intraocular lenses
Authors: Schallhorn Steven C. , Hettinger Keith A. , Hannan Stephen J. , Venter Jan A. , Teenan David , Schallhorn Julie M.
Published: February 2024

Purpose:

To assess the effect of residual sphere on vision and satisfaction in pseudophakic patients.

Setting:

Private clinics, United Kingdom.

Design:

Retrospective case series.

Methods:

A multivariate model evaluated the effect of 1-month residual sphere on outcomes of pseudophakic patients. Odds ratios (ORs) were calculated to assess the relative risk of not achieving ≥20/20 monocular uncorrected distance visual acuity (UDVA), ≥20/50 uncorrected near visual acuity (UNVA), and not being satisfied with vision. ORs were assessed for residual sphere −1.00 to +1.00 diopter (D) in quarter-diopter steps, using 0.00 D as a reference.

Results:

The analysis included 38 828 multifocal and 11 571 monofocal intraocular lenses (IOLs). The residual myopic sphere ≤−0.25 D and hyperopic sphere ≥+0.50 D had a clinically meaningful effect on UDVA. Although monofocal IOLs had an improvement in UNVA with every additional 0.25 D of myopia, the change in ORs with increasing myopia was not significant for multifocal IOLs. The mean improvement in UNVA comparing eyes with 0.00 D and −1.00 D sphere was 0.26 logMAR for monofocal and 0.03 logMAR for multifocal IOLs. Low near-addition IOLs had a slightly higher gain in UNVA with increasing myopia, but the gain was not as substantial as with monofocal IOLs. The effect of ametropia on satisfaction was more pronounced for multifocal IOLs. For every 0.25 D of residual myopia, there was >25% increase in dissatisfied patients.

Conclusions:

Although myopia improved UNVA in eyes with monofocal IOL, multifocal IOLs did not benefit from residual myopia. Multifocal IOL patients desiring distance vision should be targeted closest to emmetropia, even if it means targeting slight hyperopia.
Long-term functional outcome between Yamane technique and retropupillary iris-claw technique in a large study cohort
Authors: Guerin Pier Luigi , Guerin Gian Marco , Pastore Marco Rocco , Gouigoux Stefano , Tognetto Daniele
Published: February 2024

Purpose:

To evaluate which secondary intraocular lens (IOL) implantation technique was more successful in achieving the best postoperative results and refractive outcomes between retropupillary iris-claw IOL (ICIOL) and flanged intrascleral IOL (FIIOL) fixation with the Yamane technique.

Setting:

Eye Clinic of the University of Trieste, Trieste, Italy.

Design:

Retrospective observational study.

Methods:

116 eyes of 110 patients who underwent ICIOL or FIIOL were analyzed. Patients with follow-up shorter than 6 months or with incomplete clinical data were excluded. Collected data included demographics, ocular comorbidity, indication of surgery, intraocular pressure, early (≤1 month) and late (>1 month) postoperative complications, corrected distance visual acuity (CDVA), and manifest refraction at the last follow-up visit.

Results:

50% (n = 58) of eyes underwent FIIOL and 50% (n = 58) ICIOL implantation for aphakia (n = 44, 38%) and IOL dislocation (n = 72, 62%). No statistically significant differences in demographics, comorbidity, follow-up duration, postoperative complications, and surgical indications were found. The refractive prediction error (RPE) was 0.69 ± 0.94 diopter (D) in the FIIOL group and 0.21 ± 0.75 D in the ICIOL group (P = .03), indicating residual hyperopia after both techniques. RPE, mean absolute error, and median absolute error were higher in the FIIOL group (P = .003). ICIOL implantation was more successful in obtaining a RPE between −0.50 D and +0.50 D (52% of ICIOL, n = 30, and 31% of FIIOL, n = 18).

Conclusions:

Both techniques were effective in increasing preoperative CDVA with no statistical difference between them. Although complication rates did not significantly differ, the FIIOL group exhibited less predictable refractive outcomes. Adjusting the dioptric power of the 3-piece IOL, as performed in ciliary sulcus implantation, to prevent myopic shift, is not recommended.
Global burden of all cause-specific injuries among children and adolescents from 1990 to 2019 : a prospective cohort study
Authors: Li Cong , Jiao Jinghua , Hua Guangyao , Yundendorj Gantugs , Liu Shunming , Yu Honghua , Zhang Lijun , Yang Xiaohong , Liu Lei
Published: February 2024

Background:

To assess the burden and change in incidence, death, and disability-adjusted life years (DALYs) for all-cause-specific injuries among children and adolescents in 204 countries and territories between 1990 and 2019.

Materials and Methods:

Data were extracted from the Global Burden of Disease, Injury, and Risk Factor Study 2019 (GBD 2019). Global, regional, and country-level age-standardized rate (per 100,000) of incidence (ASRI), mortality (ASRM), and DALYs (ASRD) with 95% uncertainty interval (95% UI) of injuries were estimated by age, sex, socio-demographic index (SDI), and all-cause specific injuries from 1990 to 2019.

Results:

Overall, the ASRI, ASRM, and ASRD of injury were 9006.18 (95%UI: 7459.74 to 10918.04), 23.04 (20.00 to 26.50), and 2020.19 (1759.47 to 2318.64) among children and adolescents worldwide in 2019, respectively. All the above indicators showed a downward trend from 1990 to 2019. In level 2 cause of injury, both the global transport injury and unintentional injury declined during the study years, while self-harm and interpersonal violence-related injury showed an increasing trend. High SDI regions had higher ASRI of injuries, but low SDI regions had higher ASRM and ASRD of injuries globally in 2019. Males had a higher burden of injuries than those in females. The ASRI of injuries is higher in adolescents aged 15-19 years, whereas the mortality and DALYs rate are higher among children under 5 years old. Moreover, adolescents aged 15-19 years and individuals living in Central Asia, Middle East, and Africa had higher ASRI, ASRM, and ASRD of injuries owing to self-harm and interpersonal violence. Generally, falls and road traffic injuries are the leading cause of injury among the population aged 0-19 years worldwide, but self-harm, interpersonal violence, and conflict and terrorism are also leading types of injuries in some regions, particularly in Low- and Middle-Income Countries.

Conclusions:

Injury remains a major global public health problem among children and adolescents, although its burden at the worldwide level showed a decreasing trend from 1990 to 2019. Of concern, the burden of injuries caused by transport injuries, and unintentional injuries has shown a downward trend in most countries, while the burden caused by self-harm and interpersonal violence has shown an upward trend in most countries. These findings suggest that more targeted and specific strategies to prevent the burden of injuries should be reoriented, and our study provides important findings for decision-makers and healthcare providers to reduce injury burden among children and adolescents.
Development and external validation of a prediction model for digit replantation failure after traumatic amputations based on a prospective multicenter cohort
Authors: Gao Tao , Bao Bingbo , Lin Junqing , Tian Maoyuan , Xia Lei , Wei Haifeng , Cai Qianying , Zhu Hongyi , Zheng Xianyou
Published: February 2024

Background:

Failure of digit replantation after traumatic amputation is difficult to predict. We aimed to develop a prognostic model to better identify factors that better predict replantation failure following traumatic digit amputation.

Materials and methods:

In this multicenter prospective cohort, we identified patients who had received digit replantation between January 1, 2015, and January 1, 2019. Univariable and multivariable analyses were performed successively to identify independently predictive factors for failure of replanted digit. To reduce overfitting, the Bayesian information criterion was used to reduce variables in the original model. Nomograms were created with the reduced model after model selection. This model was then internally validated with bootstrap resampling and further externally validated in validation cohort.

Results:

Digit replantation was failed in 101 of 1062 (9.5%) digits and 146 of 1156 digits (12.6%) in the training and validation cohorts, respectively. We found that six independent prognostic variables were associated with digit replantation failure: age, mechanism of injury, ischemia duration, smoking status, amputation pattern (complete or incomplete), and surgeon’s experience. The prediction model achieved good discrimination, with concordance indexes of 0.81 (95% CI, 0.76-0.85) and 0.70 (95% CI, 0.65-0.74) in predicting digit failure in the training and validation cohorts, respectively. Calibration curves were well-fitted for both training and validation cohorts.

Conclusions:

The proposed prediction model effectively predicted the failure rate of digit replantation for individual digits of all patients. It could assist in selecting the most suitable surgical plan for the patient.
Data-driven coaching to improve statewide outcomes in CABG: before and after interventional study
Authors: Mejia Omar A.V. , Borgomoni Gabrielle B. , de Freitas Fabiane Letícia , Furlán Lucas S. , Orlandi Bianca Maria M. , Tiveron Marcos G. , Silva Pedro Gabriel M de B e , Nakazone Marcelo A. , Oliveira Marco Antonio P de , Campagnucci Valquíria P. , Normand Sharon-Lise , Dias Roger D. , Jatene Fábio B. ,   REPLICCAR Study Group
Published: February 2024

Background:

The impact of quality improvement initiatives Program (QIP) on coronary artery bypass grafting surgery (CABG) remains scarce, despite improved outcomes in other surgical areas. This study aims to evaluate the impact of a package of QIP on mortality rates among patients undergoing CABG.

Materials and methods:

This prospective cohort study utilized data from the multicenter database Registro Paulista de Cirurgia Cardiovascular II (REPLICCAR II), spanning from July 2017 to June 2019. Data from 4,018 isolated CABG adult patients were collected and analyzed in three phases: before-implementation, implementation, and after-implementation of the intervention (which comprised QIP training for the hospital team). Propensity Score Matching was used to balance the groups of 2,170 patients each for a comparative analysis of the following outcomes: reoperation, deep sternal wound infection/mediastinitis ≤ 30 days, cerebrovascular accident, acute kidney injury, ventilation time>24 hours, length of stay<6 days, length of stay>14 days, morbidity and mortality, and operative mortality. A multiple regression model was constructed to predict mortality outcomes.

Results:

Following implementation, there was a significant reduction of operative mortality (61.7%, P=0.046), as well as deep sternal wound infection/mediastinitis (P<0.001), sepsis (P=0.002), ventilation time in hours (P<0.001), prolonged ventilation time (P=0.009), postoperative peak blood glucose (P<0.001), total length of hospital stay (P<0.001). Additionally, there was a greater use of arterial grafts, including internal thoracic (P<0.001) and radial (P=0.038), along with a higher rate of skeletonized dissection of the internal thoracic artery.

Conclusions:

QIP was associated with a 61.7% reduction in operative mortality following CABG. Although not all complications exhibited a decline, the reduction in mortality suggests a possible decrease in failure to rescue during the after-implementation period.
Surgical outcomes and survival following esophagectomy for squamous cell carcinoma with or without liver cirrhosis: retrospective cohort study
Authors: Park Seong Yong , Shin Jaeseung , Jeon Yeong Jeong , Lee Junghee , Cho Jong Ho , Kim Hong Kwan , Choi Yong Soo , Zo Jae Il , Shim Young Mog
Published: February 2024

Background & Aims:

Esophageal squamous cell carcinoma (ESCC) shares common risk factors with liver cirrhosis (LC). The influence of LC in patients with ESCC has not been fully investigated. This study aimed to investigate the postoperative and long-term survival outcomes of esophagectomy for ESCC according to LC presence.

Methods:

Among patients who underwent curative-intent surgery for ESCC between 1994 and 2018, 121 patients with Child–Pugh class A LC and 2810 patients without LC were compared.

Results:

Among the LC patients, 73 (60.3%) were diagnosed with LC before surgery and 48 (39.7%) were diagnosed intraoperatively. There were no significant differences in baseline characteristics between patients with LC and those without LC. However, intraoperative blood loss was higher, and operation time, hospital stay, and intensive care unit stay were longer in patients with LC than in those without LC. Moreover, the reoperation, 30-day morbidity (60.6% vs. 73.6%, P=0.006) and 90-day mortality (2.2% vs. 4.9%, P=0.049) were significantly higher in patients with LC. The 5-year overall survival (OS) rate was significantly higher in patients without LC than in those with LC. After adjusting the confounding variables, LC was an adverse risk factor of OS (hazard ratio 1.402, P=0.004). Among patients with LC, the Model of End-Stage Liver Disease score was related to the development of complications of grade more than III (odds ratio 1.459, P=0.013).

Conclusion:

ESCC patients with Child–Pugh class A LC have high incidences of postoperative morbidity and mortality, and poor OS. Thus, careful patient selection, meticulous operation, and careful postoperative care are needed.
Right gastroepiploic artery length determined anastomotic leakage after minimally invasive esophagectomy for esophageal cancer- a prospective cohort study
Authors: Li KunKun , Wang YingJian , Zhang TaiMing , Zhang Liang , Zhao ShuLin , Chen Liang , Bao Tao , Zhao XiaoLong , Xie XianFeng , Guo Wei
Published: February 2024

Background:

This prospective cohort study, conducted at a high-volume esophageal cancer center from July 2019 to July 2022, aimed to investigate the link between the right gastroepiploic artery (RGEA) length and anastomotic leakage (AL) rates following minimally invasive esophagectomy (MIE). Real-world data on stomach blood supply in the Chinese population were examined.

Materials and Methods:

A total of 516 cases were enrolled, categorized into two groups based on the Youden index-determined optimal cut-off value for the relative length of RGEA (length of RGEA/length of gastric conduit, 64.69%) through ROC analysis: Group SR (short RGEA) and Group LR (long RGEA). The primary observation parameter was the relationship between AL incidence and the ratio of direct blood supply from RGEA. Secondary parameters included the mean length of the right gastroepiploic artery, greater curvature, and the connection type between right and left gastroepiploic vessels. Patient data were prospectively recorded in electronic case report forms.

Results:

The study revealed median lengths of 43.60 cm for greater curvature, 43.16 cm for the gastric conduit, and 26.75 cm for RGEA. AL, the most common postoperative complication, showed a significant difference between groups (16.88% vs. 8.84%, P=0.01). Multivariable binary logistic regression identified Group SR and LR (Odds ratio: 2.651, 95% CI: 1.124–6.250, P=0.03) and Neoadjuvant therapy (Odds ratio: 2.479, 95% CI: 1.374–4.473, P=0.00) as independent predictors of AL.

Conclusions:

The study emphasizes the crucial role of RGEA length in determining AL incidence in MIE for esophageal cancer. Preserving RGEA and fostering capillary arches between RGEA and LGEA are recommended strategies to mitigate AL risk.
Development and validation of a nomogram for pneumonia risk in burn patients with inhalation injury: a multicenter retrospective cohort study
Authors: Li Shijie , Li Dawei , Li Yalong , Liu Xizhu , Song Yaoyao , Xie Xiaoye , Luo Peng , Yuan Huageng , Shen Chuan’an
Published: February 2024

Background:

Burn patients with inhalation injury are at higher risk of developing pneumonia, and yet there is no reliable tool for the assessment of the risk for such patients at admission. This study aims to establish a predictive model for pneumonia risk for burn patients with inhalation injury based on clinical findings and laboratory tests.

Method:

This retrospective study enrolled 546 burn patients with inhalation injury. They were grouped into a training cohort and a validation cohort. The least absolute shrinkage and selection operator (LASSO) regression analysis and binary logistic regression analysis were utilized to identify risk factors for pneumonia. Based on the factors, a nomogram for predicting pneumonia in burn patients with inhalation injury was constructed. Areas under the receiver operating characteristic curves (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the efficiency of the nomogram in both the training and validation cohorts.

Results:

The training cohort included 432 patients, and the validation cohort included 114 patients, with a total of 225 (41.2%) patients experiencing pneumonia. Inhalation injury, tracheal intubation/tracheostomy, low serum albumin, and high blood glucose were independent risk factors for pneumonia in burn patients with inhalation injury and they were further used to build the nomogram. The AUC of the nomogram in the training and validation cohorts were 0.938 (95% CI, 0.917-0.960) and 0.966 (95% CI, 0.931-1), respectively. The calibration curve for probability of pneumonia showed optimal agreement between the prediction by nomogram and the actual observation, and the DCA indicated that the constructed nomogram conferred high clinical net benefit.

Conclusion:

This nomogram can accurately predict the risk of developing pneumonia for burn patients with inhalation injury, and help professionals to identify high-risk patients at an early stage as well as to make informed clinical decisions.