bluuebunny/crossref_metadata_2025 huggingface dataset:
Tilianin obtained from Agastache mexicana inhibits monoamine oxidase and modifies depressive behavior in rats
Authors: Rodríguez-Wilson Edgar , Estrada-Soto Samuel , Rubio-Osornio Moisés , Tristán-López Luis , Navarrete-Vázquez Gabriel , Gutiérrez-Hernández Abraham , Montes Sergio
Published: October 2024

Background

Agastache mexicana is used in traditional medicine to treat anxiety, insomnia, pain, among others. In a previous study, the methanolic extract exerted anxiolytic and sedative effects, as observed behaviorally, associated with one of its major components, tilianin.

Objective

To assess the effect produced by the extracts and tilianin obtained from Agastache mexicana on depressive-induced behavior model and on the activity of monoamine oxidases (MAOs).

Methods

The depression experimental model consisted of the forced swimming test in rats. MAOs activity was evaluated in cortex and hippocampus from the tilianin and Agastache extracts treated rats using specific inhibitors for each isoform. The quantification of monoamines was carried out using an High Performance Liquid Chromatography method.

Results

An increase in the swimming time was observed in rodents treated with doses of 16 (226.6 ± 5.5 seconds) and 50 mg/kg (237.8 ± 5.7 seconds) of tilianin, methanolic (260.4 ± 3 seconds), and hydroalcoholic extracts (249.6 ± 2.6 seconds) at 100 mg/kg. MAOs activity was significantly decreased in brain tissue from animals treated with 16 and 50 mg/kg of tilianin, methanolic, and hydroalcoholic extracts at 100 mg/kg.

Conclusions

The tilianin effect on monoamine oxidases inhibition is confirmed, suggesting its potential use in the treatment of certain neurological disorders.
Surgical resection of late extrahepatic metastasis of hepatocellular carcinoma 11 years after initial diagnosis: case report and literature review
Authors: Baz Carolina , Nudotor Richard , Ian Bussey , Garg Ravin , Gibson Glen
Published: October 2024

Hepatocellular carcinoma (HCC) is the second most common cause of cancer mortality worldwide. Liver resection is considered the pillar of curative treatment, although it is usually reserved for early-stage localized disease since the presence of metastases carries a poor prognosis. Despite advances in imaging, surgical techniques, and systemic therapy, the recurrence rate after oncologic resection remains high, even with localized disease. In the setting of extrahepatic HCC recurrence, there is no consensus regarding the best treatment strategy. Nevertheless, while the development of metastasis can be considered an expression of systemic disease, surgical resection may prolong survival. We report the case of a patient with a history of an oncologic hepatic resection for HCC, successfully treated with resection of an isolated peritoneal cavity metastasis. This case demonstrates that an aggressive approach involving the resection of extrahepatic HCC metastasis should be considered in select patients with the intention of achieving prolonged survival.
Successful surgical repair of a huge left ventricular pseudoaneurysm after repair of left ventricular rupture during mitral valve replacement
Authors: Hayashi Kyoka , Ushioda Ryohei , Maruoka Jun , Shimizu Kaname , Shirakura Kentaro , Mochizuki Nobuhiro , Setogawa Yuki , Okubo Ryo , Hiroyuki Miyamoto , Takahashi Shougo , Kunioka Shingo , Tsutsui Masahiro , Hiroyuki Kamiya
Published: October 2024

A 78-year-old man underwent pericardial patch repair for left ventricular (LV) rupture during mitral valve replacement. After the first operation, a huge (>10 cm) LV pseudoaneurysm was detected, necessitating reoperation. LV rupture is a rare but often fatal complication of mitral valve replacement. Although repair of LV rupture during mitral valve replacement has been reported, the development of pseudoaneurysm after such repair is exceedingly rare. In this case, we successfully treated a huge LV pseudoaneurysm using two pericardial patches to sandwich the rupture hole from the inside.
Multi-scale phenotyping of senescence-related changes in roots of rapeseed in response to nitrate limitation
Authors: James Maxence , Masclaux-Daubresse Céline , Balliau Thierry , Marmagne Anne , Chardon Fabien , Trouverie Jacques , Etienne Philippe
Published: October 2024

Root senescence remains largely unexplored. In this study, the time-course of the morphological, metabolic, and proteomic changes occurring with root aging were investigated, providing a comprehensive picture of the root senescence program. We found novel senescence-related markers for the characterization of the developmental stage of root tissues. The rapeseed root system is unique in that it consists of the taproot and lateral roots. Our study confirmed that the taproot, which transiently accumulates large quantities of starch and proteins, is specifically dedicated to nutrient storage and remobilization, while the lateral roots are mainly dedicated to nutrient uptake. Proteomic data from the taproot and lateral roots highlighted the different senescence-related events that control nutrient remobilization and nutrient uptake capacities. Both the proteome and enzyme activities revealed senescence-induced proteases and nucleotide catabolic enzymes that deserve attention as they may play important roles in nutrient remobilization efficiency in rapeseed roots. Taking advantage of publicly available transcriptomic and proteomic data on senescent Arabidopsis leaves, we provide a novel lists of senescence-related proteins specific or common to root organs and/or leaves.
Wanted dead or alive: epistemic logic for impure simplicial complexes
Authors: van Ditmarsch Hans , Kuznets Roman
Published: October 2024

We propose a logic of knowledge for impure simplicial complexes. Impure simplicial complexes represent synchronous distributed systems under uncertainty over which processes are still active (are alive) and which processes have failed or crashed (are dead). Our work generalizes the logic of knowledge for pure simplicial complexes, where all processes are alive, by Goubault et al. In our semantics, given a designated face in a complex, a formula can only be true or false there if it is defined. The following are undefined: dead processes cannot know or be ignorant of any proposition, and live processes cannot know or be ignorant of factual propositions involving processes they know to be dead. The semantics are therefore three-valued, with undefined as the third value. We propose an axiomatization that is a version of the modal logic S5. We also show that impure simplicial complexes correspond to certain Kripke models where agents’ accessibility relations are equivalence relations on a subset of the domain only.
A Nançay Radio Telescope study of the hyperactive repeating FRB 20220912A
Authors: Konijn David C , Hewitt Danté M , Hessels Jason W T , Cognard Ismaël , Huang Jeff , Ould-Boukattine Omar S , Chawla Pragya , Nimmo Kenzie , Snelders Mark P , Gopinath Akshatha , Manaswini Ninisha
Published: October 2024

The repeating fast radio burst source FRB 20220912A was remarkably active in the weeks after its discovery. Here, we report 696 bursts detected with the Nançay Radio Telescope (NRT) as part of the Extragalactic Coherent Light from Astrophysical Transients (ÉCLAT) monitoring campaign. We present 68 observations, conducted from 2022 October to 2023 April, with a total duration of 61 h and an event rate peaking at $75^{+10}_{-9}$ bursts per hour above a fluence threshold of 0.59 Jy ms in the $1.2\!-\!1.7$ GHz band. Most bursts in the sample occur towards the bottom of the observing band. They follow a bimodal wait-time distribution, with peaks at 33.4 ms and 67.0 s. We find a roughly constant dispersion measure (DM) over time ($\delta$DM $\lesssim$ 2 pc cm$^{-3}$) when taking into account ‘sad-trombone’ drift, with a mean drift rate of $-8.8\,$ MHz ms$^{-1}$. None the less, we confirm small $\sim 0.3$ pc cm$^{-3}$ DM variations using microshot structure, while finding that microstructure is rare in our sample–despite the 16 $\mu$s time resolution of the data. The cumulative spectral energy distribution shows more high-energy bursts ($E_\nu \gtrsim 10^{31}$ erg Hz$^{-1}$) than would be expected from a simple power-law distribution. The burst rate per observation appears Poissonian, but the full set of observations is better modelled by a Weibull distribution, showing clustering. We discuss the various observational similarities that FRB 20220912A shares with other (hyper)active repeaters, which as a group are beginning to show a common set of phenomenological traits that provide multiple useful dimensions for their quantitative comparison and modelling.
Modelling stellar irradiances I: the transition regions of FGKM stars
Authors: Deliporanidou E , Del Zanna G
Published: October 2024

We employed advanced ionization equilibrium models that we developed in Dufresne et al. (2024), which include charge transfer and density effects, to model UV stellar irradiances for a sample of stars. Our sample includes $\epsilon$ Eridani (K2 V), $\alpha$ Centauri A (G2 V), Procyon (F5 V), and Proxima Centauri (M5.5 Ve). We measured line fluxes from STIS data sets and used O iv and O v as density diagnostics to find the formation pressure of ions in the transition region (TR) and adopted a simple differential emission measure (DEM) modelling. Our findings indicate significant improvements in modelling spectral lines from anomalous ions such as Si iv, C iv, and N v of the Li- and Na-like sequences, which produce the strongest lines in the UV. For example, the Si iv lines were under-predicted by a factor of 5 and now are within 40 per cent the observed fluxes. The improved models allow us to obtain for the first time reliable estimates of some stellar chemical abundances in the TR. We compared our results with available photospheric abundances in the literature and found no evidence for the first ionization potential (FIP) effect in the TR of our stellar sample. Finally, we compared our results with the solar TR that can also be described by photospheric abundances.
PerturBase: a comprehensive database for single-cell perturbation data analysis and visualization
Authors: Wei Zhiting , Si Duanmiao , Duan Bin , Gao Yicheng , Yu Qian , Zhang Zhenbo , Guo Ling , Liu Qi
Published: October 2024

Single-cell perturbation (scPerturbation) sequencing techniques, represented by single-cell genetic perturbation (e.g. Perturb-seq) and single-cell chemical perturbation (e.g. sci-Plex), result from the integration of single-cell toolkits with conventional bulk screening methods. These innovative sequencing techniques empower researchers to dissect perturbation effects in biological systems at an unprecedented resolution. Despite these advancements, a notable gap exists in the availability of a dedicated database for exploring scPerturbation data. To address this gap, we present PerturBase, the most comprehensive database designed for the analysis and visualization of scPerturbation data (http://www.perturbase.cn/). PerturBase curates 122 datasets from 46 publicly available studies, covering 115 single-modal and 7 multi-modal datasets that include 24 254 genetic and 230 chemical perturbations from approximately 5 million cells. The database, comprising the ‘Dataset’ and ‘Perturbation’ modules, provides insights into various results, encompassing quality control, denoising, differential gene expression analysis, functional analysis of perturbation effects and characterization of relationships between perturbations. All the datasets and results are presented on user-friendly, easy-to-browse web pages and can be visualized through intuitive and interactive plot and table formats. In summary, PerturBase stands as a pioneering, high-content database intended for searching, visualizing and analyzing scPerturbation datasets, contributing to a deeper understanding of perturbation effects.
Light-chain (AL) amyloidosis for nephrologists—treatment standard
Authors: Anand Shankara , O'Neill-Dee Maggie , Sanchorawala Vaishali , Verma Ashish
Published: October 2024

Amyloidosis is a group of complex diseases caused by the misfolding and aggregation of proteins into amyloid fibrils. Light-chain (AL) amyloidosis is one of the most prevalent forms of amyloidosis, characterized by the gradual proliferation of light chains from plasma cell clones. A growing body of evidence has contributed to our understanding of its pathogenesis, presentation and clinical course. Increased recognition of its clinical sequelae has increased the prevalence of AL amyloidosis. Renal involvement, seen in up to 70% of cases, is particularly challenging due to its impact on quality of life and access to treatment options. Thus, early recognition of its unique sequelae, appropriate staging and a comprehensive understanding of treatment options balanced by their organ toxicities are crucial to managing this disease. We review the current treatment standards and discuss novel developments in the pathophysiology, diagnosis, outcome prediction and management of AL amyloidosis for the Nephrologist.
Molecular and clinical heterogeneity within MYC-family amplified medulloblastoma is associated with survival outcomes: A multicenter cohort study
Authors: Schwalbe Edward C , Lindsey Janet C , Danilenko Marina , Hill Rebecca M , Crosier Stephen , Ryan Sarra L , Williamson Daniel , Castle Jemma , Hicks Debbie , Kool Marcel , Milde Till , Korshunov Andrey , Pfister Stefan M , Bailey Simon , Clifford Steven C
Published: October 2024

Background

MYC/MYCN are the most frequent oncogene amplifications in medulloblastoma (MB) and its primary biomarkers of high-risk (HR) disease. However, while many patients’ MYC(N)-amplified tumors are treatment-refractory, some achieve long-term survival. We therefore investigated clinicobiological heterogeneity within MYC(N)-amplified MB and determined its relevance for improved disease management.

Methods

We characterized the clinical and molecular correlates of MYC- (MYC-MB; n = 64) and MYCN-amplified MBs (MYCN-MB; n = 95), drawn from >1600 diagnostic cases.

Results

Most MYC-MBs were molecular group 3 (46/58; 79% assessable) and aged ≥3 years at diagnosis (44/64 [69%]). We identified a “canonical” very high-risk (VHR) MYC-amplified group (n = 51/62; 82%) with dismal survival irrespective of treatment (11% 5-year progression-free survival [PFS]), defined by co-occurrence with ≥1 additional established risk factor(s) (subtotal surgical-resection [STR], metastatic disease, LCA pathology), and commonly group 3/4 subgroup 2 with a high proportion of amplified cells. The majority of remaining noncanonical MYC-MBs survived (i.e. non-group 3/group 3 without other risk features; 11/62 (18%); 61% 5-year PFS). MYCN survival was primarily related to molecular group; MYCN-amplified SHH MB, and group 3/4 MB with additional risk factors, respectively defined VHR and HR groups (VHR, 39% [35/89]; 20% 5-year PFS/HR, 33% [29/89]; 46% 5-year PFS). Twenty-two out of 35 assessable MYCN-amplified SHH tumors harbored TP53 mutations; 9/12 (75%) with data were germline. MYCN-amplified group 3/4 MB with no other risk factors (28%; 25/89) had 70% 5-year PFS.

Conclusions

MYC(N)-amplified MB displays significant clinicobiological heterogeneity. Diagnostics incorporating molecular groups, subgroups, and clinical factors enable their risk assessment. VHR “canonical” MYC tumors are essentially incurable and SHH-MYCN-amplified MBs fare extremely poorly (20% survival at 5 years); both require urgent development of alternative treatment strategies. Conventional risk-adapted therapies are appropriate for more responsive groups, such as noncanonical MYC and non-SHH-MYCN MB.
Mapping the Evidence for Measuring Energy Expenditure and Indicating Hypermetabolism in Motor Neuron Disease: A Scoping Review
Authors: Roscoe Sarah A , Allen Scott P , McDermott Christopher J , Stavroulakis Theocharis
Published: October 2024

Objective

To map the international methods used to measure energy expenditure of adults living with motor neuron disease (MND) and to highlight discrepancies when indicating hypermetabolism in the MND literature.

Background

A decline in the nutritional status of patients is associated with exacerbated weight loss and shortened survival. Assessments of energy expenditure, using a variety of methods, are important to ensure an adequate energy intake to prevent malnutrition-associated weight loss. Assessments of energy expenditure are also commonly used to indicate hypermetabolism in MND, although these approaches may not be optimal.

Methods

A protocol based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews Guidelines was developed. Three electronic databases (Medline [Ovid], CINAHL [EBSCO], and Web of Science) were exhaustively searched. Identified publications were systematically screened according to predefined PICOS eligibility criteria. The primary outcome was the identification of methods used to measure energy expenditure in MND. The secondary outcome was the identification of applications of energy expenditure assessments to indicate hypermetabolism in MND.

Results

Thirty-two observational primary research publications were identified. Thirteen (40.6%) were longitudinal in design, with data on repeated measurements of energy expenditure presented in 3 (9.4%). Thirteen (40.6%) were case-control studies, of which 11 use a matched control group. Pulmonary function was used to assess eligibility in 10 publications. Energy expenditure was measured using indirect calorimetry (IC) in 31 studies. Discrepancies in the durations of fasted, measurement, and washout periods were observed. Of all included publications, 50% used assessments of resting energy expenditure to identify hypermetabolism. Bioelectrical impedance analysis was used to assess body composition alongside energy expenditure in 93.8% of publications.

Conclusions

Resting energy expenditure is most frequently measured using an open-circuit IC system. However, there is a lack of a standardized, validated protocol for the conduct and reporting of IC and metabolic status in patients with MND.
Lyme disease and occupation
Authors: Douglas James D M , Scott Ruth
Published: October 2024

Lyme disease is a clinically complex and interesting zoonosis, caused by spirochete Borrelia burgdorferi , which is transmitted from wild animals to humans, by ticks.Humans have always worked in forests, but the complex forest ecosystem is changing with climate change. Tick-borne disease is now more common than Hand–arm Vibration Syndrome. Occupational health needs to respond with risk assessments, worker information and equipment to reduce tick acquisition. New pathogens and vaccines are future problems and solutions.
Beyond Human Babesiosis: Prevalence and Association of Babesia Coinfection with Mortality in the United States, 2015–2022: A Retrospective Cohort Study
Authors: Ssentongo Paddy , Venugopal Natasha , Zhang Yue , Chinchilli Vernon M , Ba Djibril M
Published: October 2024

Background

The prevalence of Babesia coinfecting tick-borne zoonoses and mortality outcomes are not fully elucidated. The objective of the present study was to determine babesiosis coinfection prevalence rates and estimate the association with severe disease and mortality.

Methods

We queried the TriNetX database between 2015 and 2022 for patients with babesiosis. The prevalence of Babesia coinfecting tick-borne zoonoses was estimated. The analysis focused on babesiosis coinfection with Borrelia burgdorferi, ehrlichiosis, and anaplasmosis. The exposure was coinfection, and the control group was the Babesia-only group. The primary outcome was 90-day mortality from the diagnosis of Babesia. Secondary outcomes were prevalence of coinfection, association of coinfection with acute respiratory distress syndrome, multiorgan failure, and disseminated intravascular coagulation. A multivariable logistic regression model was employed to estimate the disease severity and mortality risk associated with coinfections.

Results

Of the 3521 patients infected with Babesia, the mean age (SD) was 56 (18) years, 51% were male, and 78% were White. The frequency of overall malignancies, lymphomas, and asplenia was 19%, 2%, and 2%, respectively. Temporal distribution of coinfections followed the overall babesiosis pattern, peaking in the summer months. The prevalence of 1 or more coinfections was 42% (95% CI, 40%–43%). The rate of coinfection with Borrelia burgdorferi was the highest at 41% (95% CI, 39%–42%), followed by ehrlichiosis at 3.7% (95% CI, 3.1%–4.4%) and anaplasmosis at only 0.3% (95% CI, 0.2%–0.6%). Doxycycline was more likely to be prescribed in the coinfection group than the Babesia-only group (25% vs 18%; P < .0001). Overall, 90-day mortality was 1.4% (95% CI, 1.0%–1.8%). After adjusting for potential confounding factors, compared with the babesiosis-only group, the likelihood of 90-day mortality was lower in the coinfection group (adjusted odds ratio, 0.43; 95% CI, 0.20–0.91). Severe disease did not differ significantly between the 2 groups.

Conclusions

In this extensive study of >3000 patients with babesiosis in the United States, 4 in 10 patients had coinfecting tick-borne zoonoses. The prevalence rates of coinfection were highest with Borrelia burgdorferi, followed by ehrlichiosis, and lowest with anaplasmosis. Coinfection with other tick-borne infections was not associated with severe disease. It is plausible that this finding is due to the likelihood of treatment of coinfections with doxycycline. Future studies are needed to investigate the possible therapeutic benefits of doxycycline in babesiosis patients as, to date, no trials with doxycycline have been conducted in human patients with Babesia infections.
Indirect Detection for Higgs Portal Majorana Fermionic Dark Matter
Authors: Haba Naoyuki , Ikemoto Junpei , Shimizu Yasuhiro , Yamada Toshifumi
Published: October 2024

We study the $\gamma$-ray signal emitted from dark matter (DM) pair annihilation in the Higgs portal Majorana fermion DM model. In the model, a Majorana fermion DM $\chi$ couples with the Standard Model (SM) Higgs field $H$ through a higher-dimensional term $-{\cal L}\supset H^\dagger H \bar{\chi }\chi /\Lambda$, where $\Lambda$ is a cutoff scale [1]. The pair annihilation of $\chi$ through the above term produces the Higgs boson and the longitudinal modes of $W,Z$ gauge bosons. The Milky Way dwarf spheroidal satellite galaxies (dSphs) are used as the most promising targets to search for the $\gamma$-ray signal of the model, due to high DM density and lack of astrophysical backgrounds. The Fermi Large Area Telescope (Fermi-LAT) is used for the search, for its high sensitivity [2]. In this work, we use 14-year Fermi-LAT data from 16 dSphs, to constrain the DM pair annihilation cross section for the DM mass range from 125 GeV to 100 TeV.
Essential Competencies for Oncology in Physical Therapist Professional Education Programs: Results of a Mixed Methods Modified Delphi Study
Authors: Harrington Shana E , Wilson Christopher M , Rinehart-Ayres Margaret E , Westlake Frances , VanHoose Lisa
Published: October 2024

Objective

The objective was to establish consensus-based competencies for oncology within physical therapist professional education programs in the United States.

Methods

A mixed-methods approach implementing a sequential exploratory design that included 3 phases was used to establish oncology competencies for physical therapist professional education programs. Participants in each phase were physical therapists representing diverse practice settings, experience levels, and geographical regions. Student physical therapists were included in phases 2 and 3. Three online focus groups were followed by an in-person group discussion to establish cancer-related themes, domains of practice, and competencies. Participants evaluated the competencies in a 3-round modified Delphi study for relevance and clarity. Each competency required 80% consensus using a Likert scale (1 = not at all relevant/clear, 5 = extremely relevant/clear). It was not accepted if a competency did not meet the 80% threshold by the end of round 3.

Results

Six domains of practice and 28 competencies were developed and evaluated. Within the 6 domains, 21 competencies were accepted: general cancer concepts (n = 4), musculoskeletal system (n = 3), neurologic system (n = 5), integumentary system (n = 2), cardiovascular and pulmonary system (n = 5), and involvement of multiple systems across the lifespan (n = 2). Along with the 21 competencies, participants also recommended 11 overarching oncology themes to incorporate into physical therapist professional education programs. Delivering cancer content using a body systems approach was recommended.

Conclusion

As the number of survivors of cancer continues to grow, integration of these essential competencies within physical therapist professional education programs will improve the profession’s capacity to provide quality care to meet the societal need of persons living with and beyond cancer.

Impact

Academic and clinical educators should integrate these competencies to ensure that physical therapist professional education programs appropriately prepare physical therapists for providing care for persons living with and beyond cancer across the lifespan.
The relationship between Zoster serology, vaccination uptake and infection rates: a single-centre cross-sectional study
Authors: Ahmed Saad , Lauran Martin , Ugwoke Adaeze , Walton Tom , Holroyd Chris , Galloway James
Published: October 2024

Objective

This study aimed to assess the prevalence of Varicella-Zoster Virus (VZV) immunity, vaccination uptake and incidence of VZV-related events in inflammatory arthritis (IA) patients initiating biologic or targeted synthetic disease-modifying antirheumatic drugs.

Methods

An observational study was conducted in a single hospital between March 2019 and December 2020. Ninety-three IA patients were included. Data were collected from electronic health records and analysed using the chi-squared test.

Results

The majority of patients (91.4%) were seropositive for VZV, reaffirming the necessity for vaccination. In total, 8.6% of the cohort received the Zostavax vaccine, despite a small yet significant number of patients (4.3%) experiencing Herpes Zoster after initiating treatment. Multiple factors contributed to low vaccine uptake, including limited vaccine availability, discrepancies between the British Society for Rheumatology and Joint Committee on Vaccination and Immunisation guidelines, vaccine hesitancy and concerns regarding vaccine efficacy and risks.

Discussion

Significant VZV immunity exists among patients prior to targeted therapy commencement. Risk factors for VZV-related events include Janus kinase inhibition, increasing age and long-term steroid use. VZV-related events occurred exclusively in patients with prior viral immunity. Despite most patients having serological evidence of prior VZV exposure, our study exposes critical gaps between current clinical guidelines and practice, particularly in VZV vaccine uptake. Barriers to vaccination include inconsistent guidelines, limited vaccine availability and patient-level hesitancy. This is concerning as our cohort demonstrated small but significant rates of zoster, mostly among patients on long-term steroids.
Assessment of local diagnostic reference levels (LDRLS) for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) mammography in Tamil Nadu, India
Authors: Adhimoolam Saravana Kumar , Kumar Sudhir , Manojkumar Thangavel , Devanand Bala Lakshmoji , Elango Nagappan , Govindarajan Nagarajarao , Sapra Balvinder Kaur
Published: October 2024

The purpose of this study was to assess local diagnostic reference levels (LDRLs) for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) mammography in India. Data from 1500 women were collected from five different mammography facilities in major cities in Tamil Nadu, India. The mean of mean glandular dose were used to arrive at an LDRL. The noted mean compressed breast thickness was 55.26 ± 3.4. The recorded mean MGDs for the five centres were 3.1 ± 0.1 and 3.8 ± 0.2 mGy for FFDM and DBT, respectively. The 75th percentile value for all five centers is 3.3 and 4.0 mGy for FFDM and DBT, respectively. The LDRLs found in the current study were also compared with those from earlier studies conducted in other nations, such as the United Kingdom, Malaysia, Morocco, and Ghana. The present study is the first of its kind to determine the LDRL for the FFDM and DBT scanners operating in the Tamil Nadu region, India, and is proposed as a starting point that will allow professionals to evaluate and optimize their practice. Furthermore, similar studies in other regions of India are necessary in order to establish National DRLs.
Development and safety of investigational and approved drugs targeting the RAS function regulation in RAS mutant cancers
Authors: Li Jinjin , Wu Wentong , Chen Jiajia , Xu Zhifei , Yang Bo , He Qiaojun , Yang Xiaochun , Yan Hao , Luo Peihua
Published: October 2024

The RAS gene family holds a central position in controlling key cellular activities such as migration, survival, metabolism, and other vital biological processes. The activation of RAS signaling cascades is instrumental in the development of various cancers. Although several RAS inhibitors have gained approval from the US Food and Drug Administration for their substantial antitumor effects, their widespread and severe adverse reactions significantly curtail their practical usage in the clinic. Thus, there exists a pressing need for a comprehensive understanding of these adverse events, ensuring the clinical safety of RAS inhibitors through the establishment of precise management guidelines, suitable intermittent dosing schedules, and innovative combination regimens. This review centers on the evolution of RAS inhibitors in cancer therapy, delving into the common adverse effects associated with these inhibitors, their underlying mechanisms, and the potential strategies for mitigation.
The biological basis for current treatment strategies for granulomatous disease in common variable immunodeficiency
Authors: van Stigt Astrid C. , Gualtiero Giulia , Cinetto Francesco , Dalm Virgil A.S.H. , IJspeert Hanna , Muscianisi Francesco
Published: October 2024

Purpose of review

The pathogenesis of granulomatous disease in common variable immunodeficiency (CVID) is still largely unknown, which hampers effective treatment. This review describes the current knowledge on the pathogenesis of granuloma formation in CVID and the biological basis of the current treatment options.

Recent findings

Histological analysis shows that T and B cells are abundantly present in the granulomas that are less well organized and are frequently associated with lymphoid hyperplasia. Increased presence of activation markers such as soluble IL-2 receptor (sIL-2R) and IFN-ɣ, suggest increased Th1-cell activity. Moreover, B-cell abnormalities are prominent in CVID, with elevated IgM, BAFF, and CD21low B cells correlating with granulomatous disease progression. Innate immune alterations, as M2 macrophages and neutrophil dysregulation, indicate chronic inflammation. Therapeutic regimens include glucocorticoids, DMARDs, and biologicals like rituximab.

Our review links the biological context of CVID with granulomatous disease or GLILD to currently prescribed therapies and potential targeted treatments.
Paucity of gastrointestinal plasma cells in common variable immunodeficiency
Authors: Marsden Jan Willem N. , Laclé Miangela M. , Severs Mirjam , Leavis Helen Louisa
Published: October 2024

Purpose of review

Common variable immunodeficiency enteropathy (CVID-E) is a noninfectious complication of CVID caused by chronic inflammation of the gastrointestinal (GI) tract. Based on literature, a paucity or lack of plasma cells, although not obligatory for diagnosis, is a pathognomonic feature of CVID and more frequent in CVID-E. However, there is no consensus on standardized histopathological analysis of this feature in biopsies. In this systematic review, we highlight methods of reproducible plasma cell quantification of biopsies in CVID and describe the plasma cell counts and classes as presented in the literature.

Recent findings

Reduced plasma cell counts are commonly found over the entire GI tract, except for in the oesophagus. Immunoglobulin A+ (IgA+) plasma cells appear to be the most commonly reduced plasma cell class in CVID, yet there is scarce literature on the predictive value of low IgA+ plasma cell counts in CVID-E.

We propose two optimized methodologies of quantification using a cut-of value of <10 plasma cells per HPF at 40× magnification, or a proportion of ≥1–5% of total mononuclear cells, recorded over ≥3 sections, and in ≥2 biopsies, as the most conservative agreeable definitions for a paucity of plasma cells to be used in diagnostics and further research.
Preventing perioperative infections: a call to action for anesthesiologists
Authors: Gerasimov Madina , Lin Della M. , Munnur Uma , Donnelly Melanie
Published: October 2024

Purpose of review

Surgical site infections (SSI) are one of the most costly complications and hospital organizations are promoting multidisciplinary approaches to address this harm. Anesthesiologists are increasingly recognized as key players influencing surgical outcomes and patient safety, and play a key role in preventing SSIs.

Recent findings

Recent guidelines and strategies to prevent SSI are focused on the areas which anesthesiologists can impact including antimicrobial prophylaxis, proper hand hygiene, decontamination of environmental surfaces and operating room equipment coming in direct contact with patients.

Timely interventions, including appropriate antibiotics’ administration, practicing sterile and aseptic techniques when performing intraoperative procedures and handling medications are impactful steps in the process of improving rates of SSIs. Multidisciplinary participation in local and regional collaborative initiatives to improve adherence to best practices as well as integrated education of all the stakeholders are some of the principles of patient-centered care described in our review.
Dental sedation permit requirements for physician anesthesiologists in the United States and the European Union: a review
Authors: Yun Steve , Martin-Orr Nathanial , Hendrix Max
Published: October 2024

Purpose of review

This review addresses the dental sedation permit requirements for physician anesthesiologists in the United States and the European Union (EU). The regulatory landscape for office-based anesthesia, including dental settings, is often described as the ‘Wild West’ of patient safety, making it crucial to outline the similarities and differences in dental anesthesia regulations and offer practical guidelines for regulators.

Recent findings

There is virtually no literature that addresses the issue of dental sedation permits for physicians. By summarizing the variation in language and terminology from state to state, this review highlights the inconsistencies and gaps in dental regulations. The review also highlights the limited specific guidance on the permit process for physicians administering dental anesthesia.

By comparing dental anesthesia regulations and guidelines across all U.S. states and the EU, the review aims to offer practical guidelines for regulators to institute an oversight process that is fair to physician anesthesiologists and does not impede their ability to practice in the dental office setting. This framework for credentialing and permitting physicians in dental office-based anesthesia settings is informed by existing safety recommendations and best practices.
The Impact of a Brief Educational Seminar on Pediatric Pain-focused Cognitive-Behavioral Therapy for School Providers
Authors: Siebert Elliane , Pierce Steven J. , Ely Samantha L. , Cunningham Natoshia R.
Published: October 2024

Objectives:

Pediatric chronic pain is common and can be detrimental to children’s social, emotional, and school functioning. Nonpharmacological approaches to chronic pain, like cognitive- behavioral therapy (CBT), can be effective. Schools could provide children with chronic pain access to these interventions. However, school professionals (ie, nurses and mental health providers) are seldom trained in CBT, creating a barrier to accessing such help. A seminar was created to introduce CBT strategies for chronic pediatric pain to school professionals. Feasibility, acceptability, and self-reported knowledge gained from the seminar were examined.

Materials and Methods:

Two introductory seminars (~2.5 h each) were held separately for the Michigan Association of School Nurses and the health department of Northwest Michigan (n = 71 total). The seminar provided an understanding of pain and pain-focused CBT strategies (eg, activity pacing, positive self-statements, and psychoeducation). Fifty-two school nurses, 16 mental health professionals, and 3 participants (unidentified title) rated program acceptability and self-reported knowledge of CBT before and after training (1 = strongly disagree, 5 = strongly agree).

Results:

Of the respondents, 89.6% agreed the training was helpful, and 87.5% were interested in additional training. For all questions relating to knowledge of CBT, a mixed-model interaction showed a meaningful, increase of at least 1 point (on a 5-point Likert Scale), F(2, 69.83) = 3.93, P = 0.024.

Conclusion:

This study underscores the feasibility and acceptability of training school health providers in CBT for pediatric chronic pain. This project also established key partnerships in Michigan to expand future work in this realm with more comprehensive training and assessment of outcomes.
Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma
Authors: Dos Santos Rocha Andre , Betello Marco , Nikolaou Argyro , Südy Roberta , Albu Gergely , Schiffer Eduardo
Published: October 2024

Resistance to the effects of rocuronium and other neuromuscular blocking agents (NMBA) has been previously reported, including delayed onset of relaxation, rapid recovery and incomplete paralysis under recommended doses. These conditions have been associated with denervation injury, burns, immobilisation, infections, metabolic disorders, and drug interactions.

In this report, we describe the case of a young male without any known pre-disposing factor for NMBA resistance, who failed to attain muscle relaxation with non-depolarising NMBA despite high doses of rocuronium and atracurium during two surgeries for colorectal cancer, several months apart. Investigations for drug failure and genetic testing did not indicate a plausible cause. After chemotherapy and tumour resection, the patient underwent a third surgical procedure under general anaesthesia with normalised NMBA response.

Patient's written consent was obtained for publication.
SEROUS RETINAL DETACHMENT DUE TO CRYPTOCOCCOSIS IN AN IMMUNOCOMPETENT PATIENT
Authors: Carvalho Araujo Anna Carolina , Said Isadora L. , Moussallem Bruna , Bordon Arnaldo F.
Published: October 2024

Purpose:

To report a case of bilateral ocular cryptococcosis in an immunocompetent patient without neurologic findings.

Methods:

Case report.

Results:

A 30-year-old healthy Caucasian man presented with painless blurred vision in the left eye. Examination showed bilateral serous detachments and white retinal lesions. The visual acuity (VA) was 20/40 in the right eye and hand motions in the left eye. Neurologic workup and serologies were negative, and a computer tomography-positron emission tomography scan showed diffuse lymph node enlargement with metabolic activity and a suspected lymphoproliferative disorder. The myelogram and immunohistochemistry were normal. A biopsy of the cervical lymph nodes was positive for Cryptococcus neoformans. He was treated with antifungal medications and had complete resolution of the subretinal fluid and VA improvement.

Conclusion:

Cryptococcosis is a rare entity in an immunocompetent person. A systemic workup is necessary to diagnose cryptococcosis and initiate prompt treatment.
Qufeng Tongluo Decoction May Alleviate Podocyte Injury Induced by High Glucose and Hydrogen Peroxide by Regulating Autophagy
Authors: Ruan Zhichao , Liu Jiangteng , Liu Weijing , Huang Weijun
Published: October 2024

Background:

Diabetic kidney disease is a significant complication of diabetes. Previous studies have confirmed that Qufeng Tongluo (QFTL) decoction can alleviate podocyte injury in a diabetic rat model, but its mechanism remains unclear. The present in vitro study investigated QFTL’s mechanism in protecting podocytes.

Methods:

The mouse podocyte clone 5 (MPC-5) cell line stimulated by high glucose and hydrogen peroxide was used as a model for podocyte injury. The cells were treated with QFTL, QFTL + SC79 (activator of the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), and C2 ceramide (inhibitor of the PI3K/Akt). Immunofluorescence, western blot and polymerase chain reaction (PCR) were employed to detect the expression of microtubule-associated protein 1 light chain 3 (LC3), sequestosome 1 (SQSTM1/p62), PI3K, Akt, and phosphatase and tensin homolog (PTEN) proteins and their messenger RNA (mRNA) levels.

Results:

High glucose and hydrogen peroxide stimulation may disrupt podocytes’ cytoskeletal structure, while QFTL may mitigate these structural changes. After the SC79 intervention, QFTL’s alleviation of the cytoskeletal structure damage disappeared. High glucose and hydrogen peroxide stimulation decreased the expression of LC3 in MPC-5 cells, whereas QFTL upregulated its expression, but this effect was reversed by the SC79 intervention. Interestingly, P62 decreased after high glucose + hydrogen peroxide stimulation, and QFTL failed to upregulate P62. The expression levels of PI3K, Akt, and PTEN in the model group decreased, which were improved by QFTL.

Conclusion:

These results suggest that QFTL can maintain the stability of autophagic flux in injured podocytes, which may be related to its ability to improve P62 expression but not to regulating the PI3K/Akt signaling pathway.
Occupational Burnout
Authors: Gates Tracy , Scott Blake , Merlo Kelsey , Charles Dannelle , Dunn Elizabeth , Miklaszewski Christopher , Marshall Jennifer
Published: October 2024

Objective

Florida’s public health workforce faced unprecedented challenges during the compounding COVID-19 pandemic and record-setting hurricane seasons. The objective of this study was to understand burnout within this essential workforce and identify strategies to better support them.

Methods

A cross-sectional survey addressing burnout, job satisfaction, turnover intention, job demands, job resources, and organizational support in 2021 was completed by 891 Florida Department of Health workers and analyzed by the research team.

Results

Approximately half of the respondents reported experiencing burnout, which is linked to job dissatisfaction and turnover intention. Strategies to effectively support and retain this essential workforce include improving staffing, salaries, flexibility, trainings, resources, and leadership.

Conclusions

As infectious disease outbreaks and extreme weather events continue to occur, effectively supporting the public health workforce is critical to protecting and promoting the health and well-being of all Floridians.
Mediating Role of Burnout on the Association Between Work-Related Boredom and Insomnia Among Korean Wage Workers
Authors: Shin Soonsu , Ryoo Jae-Hong
Published: October 2024

Objective

This cross-sectional study aimed to determine the mediating role of burnout in the relationship between work-related boredom and insomnia among Korean workers.

Methods

Data from 30,992 wage workers in the sixth Korean Working Conditions Survey were analyzed. The odds ratio and 95% confidence interval for insomnia according to work-related boredom were estimated using a survey-weighted logistic regression model. A mediation analysis was performed with burnout as the mediator.

Results

The survey-weighted logistic regression model revealed that work-related boredom was significantly associated with an increased risk of insomnia. In the mediation model, both the total and direct association of work-related boredom on insomnia were statistically significant. Moreover, the indirect association, mediated by burnout, was also significant, accounting for 23.38% of the total association.

Conclusions

Our findings burnout may play a mediating role between work-related boredom and insomnia.
Pure Squamous Cell Carcinoma of the Prostate With a Complete Remission to Gemcitabine-Cisplatin: Case Presentation and Literature Review
Authors: Yang Yang , Shen Yilin , Zarrabi Kevin K. , Deng Yutao , Tester William
Published: October 2024

Squamous cell carcinoma of prostate is a very rare condition and little is known regarding the appropriate managment. Here we reported our patient with pure squamous cell carcinoma of prostate who had complete remission with gemcitabine and cisplatin treatment which last 5 months. Based on his genomic study of prostate cancer, he enrolled to our clinical trial and now receiveing mTOR pathway inhibtor. We also briefly reviewed previous cases of metastatic squamous cell carcinoma of prostate and their managment.
Oral Microbiome and Cognition Among Black Cancer Caregivers
Authors: Yang Irene , Alford Taqiyya , Brewster Glenna , Geurs Nicolaas , Wharton Whitney , Yeager Katherine , Houser Madelyn
Published: October 2024

Background

Despite known links between oral health and dementia and the growing understanding of the role of the human microbiome in health, few studies have explored the relationship between the oral microbiome and cognition. Additionally, there is a notable absence of research on how the oral microbiome is associated with cognitive function in Black adult caregivers of cancer patients despite their elevated risk for both oral disease and cognitive impairment.

Objectives

This study aimed to characterize the oral microbiome of Black caregivers of people living with cancer and explore the association of the oral microbiome with cognitive performance.

Methods

Thirty-one self-identified Black or African American caregivers of cancer patients in the greater metropolitan Atlanta area participated in the study. They provided oral microbiome samples. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA), depressive symptoms with the Center for Epidemiological Studies-Depression Scale, and individual race-related stress with the Index of Race-Related Stress–Brief. Salivary microbiome diversity was analyzed using alpha and beta diversity metrics, and taxa associated with cognition were identified through differential abundance testing, adjusting for potential confounders.

Results

The mean age of participants was 54.8 years. MoCA scores ranged from 18 to 30, with a mean of 25. Participants were categorized into normal cognition (MoCA ≥ 26, n = 12) and low cognition (MoCA < 26, n = 16) groups. Education level and individual race-related stress were associated with cognition group and were controlled for in the oral microbiome analysis. Alpha and beta diversity analyses showed no significant overall differences between cognition groups. Differential abundance testing suggested 48 taxa were associated with cognition status, many of which are known to be associated with periodontal disease and cognition.

Discussion

This study revealed associations between cognition status and specific oral bacteria, many of which are known to be associated with periodontal disease and cognitive impairment. These findings underscore the complex relationship between oral health and cognitive function, suggesting a need for further research to develop oral microbiome profiles capable of identifying individuals at risk for cognitive decline and guiding targeted interventions for promoting overall well-being and cognitive health.