bluuebunny/crossref_metadata_2025 huggingface dataset:
PRMT1‐mediated BRD4 arginine methylation and phosphorylation promote partial epithelial–mesenchymal transformation and renal fibrosis
Authors: Xiong Chongxiang , Chen Haishan , Su Baoting , Zhang Li , Hu Jingxiang , Wang Qiaowen , Zhuang Shougang
Published: January 2025

Bromodomain‐containing protein 4 (BRD4) plays a vital role in fibrosis of various organs. However, the underlying mechanism of BRD4 in renal fibrosis remains unclear. To construct in vitro and in vivo models of renal fibrosis, TCMK‐1 cells were subjected to TGF‐β1 treatment and mice were subjected to UUO surgery and adenine induction. IP assay was used for arginine asymmetric dimethylation (ADMA) level, ubiquitination degradation of Snail, and acetylation level of Snail test. Co‐IP was used to validate the interactions of BRD4, protein arginine methyltransferase‐1 (PRMT1), and Snail. HE staining and Masson staining were used for morphological examination of renal tissue. BRD4 was abnormally overexpressed during renal fibrosis. TGF‐β1‐induced fibrosis and partial epithelial–mesenchymal transition (pEMT) could be inhibited by BRD4 silencing. PRMT1 mediated ADMA level of BRD4 to enhance BRD4 phosphorylation and its protein stability. Snail protein degradation was attenuated by BRD4 overexpression in an acetylation‐dependent manner in TCMK‐1 cells. Furthermore, PRMT1 inhibitor abolished BRD4 overexpression‐induced fibrosis and pEMT in TGF‐β1‐treated TCMK‐1 cells and Snail overexpression reversed BRD4 silencing‐induced inhibition of fibrosis and pEMT. What's more, the reduction of BRD4 arginine methylation inhibited BRD4 phosphorylation and Snail expression to alleviate renal fibrosis in UUO surgery and adenine induction mice. Collectively, PRMT1‐mediated BRD4 arginine methylation and phosphorylation promoted pEMT and renal fibrosis through regulation of Snail expression.
Relationship Between Clinical Decision-Making and Moral Distress in Neonatal Intensive Care Unit Nurses
Authors: Nobahar Monir , Ghorbani Raheb , Alipour Zeinab , Jahan Elahe
Published: January 2025

Background:

In the neonatal intensive care unit (NICU), nurses care for premature and critically ill neonates, interact with parents, and make clinical decisions regarding the treatment of neonates in life-threatening conditions. The challenges of managing unstable conditions and resuscitation decisions can cause moral distress in nurses.

Purpose:

This study aims to determine the relationship between clinical decision-making and moral distress in NICU nurses.

Methods:

This cross-sectional, multicenter, descriptive correlational study involved 190 nurses working in 7 NICUs across hospitals in Khorramabad and Semnan in 2023. Data were collected using demographic questionnaires, the Clinical Decision-Making Laurie Scale (2001), and the Moral Distress Scale-Revised (MDS-R).

Results:

All nurses in these NICUs were female. No significant correlation was found between clinical decision-making and moral distress (r = −0.03, P = .684). The moral distress score was low. In decision-making, 57.9% of nurses exhibited intuitive analysis (understanding without a rationale). Multiple linear regression analysis revealed that age, education level, and job position were significantly related to clinical decision-making; and being married and having children were inversely correlated with moral distress.

Implications for Practice:

20% of nurses exhibited interpretive intuitive clinical decision-making, which involves care complexities, cognitive understanding, and task-based decisions. Nursing managers should focus on refining these decision-making strategies for NICU nurses.

Implications for Research:

Given the importance of clinical decision-making in the NICU, future research should use quantitative and qualitative methods to explore the decision-making processes and moral distress in NICU nurses.
Outcomes Associated With Care Models for Neonates With Complex Medical Needs
Authors: Loewen Nicole , Ranger Manon , Kieran Emily
Published: January 2025

Background:

Neonates with complex medical needs (NCMNs) are a small proportion of neonatal intensive care unit admissions but are high healthcare utilizers. Since 2018, NCMNs at our hospital have been cared for by the Neonatal Complex Care Team. This model has yet to be evaluated.

Purpose:

To inform the evaluation of our care model, we examined literature on care practices for the management of NCMNs and utilized that to define outcome measures.

Data Sources:

MEDLINE and Cumulated Index to Nursing and Allied Health Literature were searched. Inclusion dates: January 1, 1993, until July 15, 2023.

Study Selection:

The PRISMA extension for scoping reviews was used. The population was neonates in the neonatal intensive care unit, the concept was models of care, and the context was medical complexity. Two reviewers performed the title/abstract screening and full-text review. A total of 148 articles were screened, 17 fully reviewed, and 5 articles included.

Data Extraction:

Data extraction was completed by one reviewer utilizing resources from the Joanna Briggs Institute.

Results:

Care practices ranged from structured discharge meetings with families to an inpatient care model. Few reported new clinical models, and long-term health outcome data were limited. Multidisciplinary care teams emerged as crucial to in-hospital care and smooth discharge. Length of stay and readmission were identified as key outcomes for clinical program evaluation.

Implications for Practice and Research:

There is limited literature on this topic; however, we identified themes and outcomes that are useful for clinical program evaluation. Long-term evaluation of novel models of care is needed.
Regenerative Peripheral Nerve Interface Surgery to Treat Chronic Postamputation Pain: A Prospective Study in Major Lower Limb Amputation Patients
Authors: Lee Jennifer C. , Kubiak Carrie A. , Best Christine S.W. , Hamill Jennifer B. , Ki Jamie , Kim Hyungjin Myra , Roth Randy S. , Kozlow Jeffrey H. , Tinney Melissa J. , Geisser Michael E. , Cederna Paul S. , Kemp Stephen W.P. , Kung Theodore A.
Published: January 2025

Objective:

The objective was to assess the postsurgical outcomes of regenerative peripheral nerve interface (RPNI) surgery in a prospective cohort of major lower extremity amputation patients with chronic postamputation pain.

Background:

Chronic pain in lower limb amputation patients is commonly the result of neuroma formation after traumatic peripheral nerve injury. By implanting more proximal transected nerve ends into autologous free muscle grafts, RPNI surgery can treat postamputation pain by diminishing the development of neuromas. RPNI surgery in prior retrospective studies has been shown to mitigate postamputation pain.

Methods:

Twenty-two lower limb amputation patients with established chronic postamputation pain were recruited from 2 studies in this prospective study. All patients underwent RPNI surgery to treat identified symptomatic neuromas within the residual limb. Patient-reported outcome instruments were administered preoperatively and postoperatively at 1 week, 4 months, and 12 months to examine residual limb pain (McGill Pain Questionnaire, PROMIS Pain Intensity, and PROMIS Pain Interference), phantom limb pain (modified PROMIS Pain Intensity and Phantom Limb sensation questionnaire), psychosocial status (PHQ-9, GAD-7, and PCS), and functional (OPUS) outcomes.

Results:

RPNI surgery significantly improved residual limb pain. While phantom limb sensation improved significantly, phantom limb pain demonstrated a modest decrease. Psychosocial outcomes also improved significantly after RPNI surgery. Prosthetic use slightly increased, and patients did not experience loss of function.

Conclusions:

RPNI surgery leverages the processes of reinnervation to successfully treat residual limb pain and improve psychosocial outcomes in patients with chronic postamputation pain. Phantom limb pain may be more difficult to treat in chronic pain patients who have central sensitization at the time of surgery.
Importance of Post-Reduction CT Scans in Posterior and Transverse Posterior Wall Acetabular Fracture-Dislocations
Authors: Gardner Samantha R. , Haase Douglas R. , Gattu Nikhil , Warner Stephen J. , Chip Routt Milton L. , Kellam Patrick , Eastman Jonathan G.
Published: January 2025

OBJECTIVES:

To report the frequency of patients with pre- and post-reduction computed tomography (CT) scans associated with acetabular fracture-dislocations and the change of associated intra-articular fragments occurring with joint reduction.

METHODS:

Design: Retrospective case series.

Setting:

Regional Level 1 trauma center.

Patient Selection Criteria:

Patients who sustained an OTA/AO 62A1 and 62B1 posterior wall or transverse posterior wall acetabular fracture-dislocations with pre- and post-reduction CT imaging from February 2020 until July 2023.

Outcome Measures and Comparisons:

Intra-articular fragments were identified and change in position (fossa to cranial, intra-articular to extra-articular, etc.) noted from pre- to post-reduction scans. Operative reports and post-operative CT scans were reviewed to determine the frequency of fragment retrieval.

RESULTS:

119 out of 394 (30.2%) patients meeting fracture pattern inclusion received a CT scan prior to hip reduction. Of the 394 patients, 100 (25.9%) had pre- and post-reduction CT scans and were studied (average age of 35.5 years (range 16 - 87 years), 59 male). 45 of 100 patients (45%) had pre-reduction CT imaging demonstrating the presence of intra-articular fragment(s). 30 of 45 patients with a pre-reduction intra-articular fragment (66.7%) had an intra-articular fragment location change during the reduction. Of the 55 patients who did not have an intra-articular fragment on pre-reduction imaging, 28 of 55 (50.9%) had at least 1 intra-articular fragment on the post-reduction CT. Complete fragment retrieval was performed in 71.4% of patients.

CONCLUSIONS:

The study demonstrated 30.2% of patients with posterior wall and transverse posterior wall acetabular fracture-dislocations received a CT scan prior to hip reduction. It was common to find intra-articular fragments on the post-reduction CT in patients who did not have them on the pre-reduction CT. Obtaining and scrutinizing the post-reduction CT scan provided accurate knowledge of the location of all osseous fragments associated with the fracture-dislocations which facilitated thorough preoperative planning, intraoperative implementation, and hopeful long-term patient outcomes.

LEVEL OF EVIDENCE:

Prognostic Level IV.
Persistent elite controllers as the key model to identify permanent HIV remission
Authors: Gasca-Capote Carmen , Ruiz-Mateos Ezequiel
Published: January 2025

Purpose of review

To summarize the heterogeneity in the elite controllers population with the aim to identify a compatible profile with a persistent HIV remission, making distinction between persistent elite controllers, people with HIV (PWHIV) who permanently maintain virological control in the absence of antiretroviral treatment (ART), and transient elite controllers, PWHIV who eventually lose virological control. For this purpose, it is important to consider the mechanisms and biomarkers that have previously been associated with the maintenance and loss of the natural virological control.

Recent findings

Transient elite controllers, before losing virological control, exhibit a distinct metabolomic, proteomic, microRNAs (miRNA), immunological and virological profile compared to persistent elite controllers. In addition to a reduced and less polyfunctional HIV-specific T-cell response, transient elite controllers show a greater proportion of intact proviruses integrated into genic regions. In contrast, persistent elite controllers display a privileged HIV-1 reservoir profile with absence of detected intact proviruses or low proportion of clonal intact proviruses preferentially integrated into genomic features associated with HIV-1 transcriptional repression.

According to previous studies, the comprehensive characterization of persistent elite controllers might be crucial to identify other PWHIV with this distinct profile as spontaneously cured.
Monocytes across life span in HIV infection: lights and shadows
Authors: Neri Alessia , Olivieri Giulio , Pighi Chiara , Amodio Donato , Cotugno Nicola , Palma Paolo
Published: January 2025

Purpose of review

This review highlights the role of monocytes in the pathogenesis of HIV-1 infection, focusing on their involvement in the inflammatory response and their function as viral targets and long-term reservoirs.

Recent findings

Monocytes have been categorized into three subsets: classical, intermediate, and nonclassical, each with distinct functional characteristics. Advances in genetic sequencing technologies have enabled a more in-depth exploration of the phenotypic and functional variations among these subsets, particularly in the context of HIV. These findings underscore their role as crucial components of the immune response and as reservoirs for the virus.

Previous studies on the role of monocytes have demonstrated their contribution to persistent infection and chronic immune activation, especially in adults living with HIV. The lessons learned from these studies should now be harnessed to design studies focused on newborns and children with vertically acquired HIV.
It's all in the gut: the central role of the gut and microbiome in preventing disease progression in simian immunodeficiency viruses infected African nonhuman primates
Authors: Raehtz Kevin D. , Pandrea Ivona , Apetrei Cristian
Published: January 2025

Purpose of review

Typically, both HIV-infected humans and simian immunodeficiency virus (SIV)-infected Asian nonhuman primates (NHPs) eventually progress to AIDS, while African NHPs that are natural hosts of SIV do not, in spite of life-long, high levels of viral replication. Lack of disease progression in African NHPs is not due to some adaptation by the virus, but rather to host adaptations to the virus. Central to these adaptations is maintenance of the gut integrity during acute viral replication and inflammation, which allows natural hosts to avoid the chronic inflammation characteristic to pathogenic HIV/SIV infection.

Recent findings

It has been recently shown that natural hosts of SIVs, such as the African green monkey (AGM), avoid damage to the mucosal epithelium through wound healing mechanisms, possibly with the contribution of a unique anti-inflammatory microbiome. Furthermore, these mechanisms are independent of viral replication, and CD4+ T-cell activation or depletion.

Future SIV research on natural hosts should focus on further elucidating the anti-inflammatory state of their gut, and the role of microbiome/dysbiosis in the pathogenesis of SIV infection, with the goal of development new regiments or treatments to reduce or even halt the vicious cycle of gut damage and inflammation triggered by pathogenic HIV/SIV infection.
Unveiling the Silent Pandemic: Impact of Severe Mental Illness on Cardiovascular Health in the United States
Authors: Agarwal Srishty , Katoch Tavishi , Said Aimen , Kanagala Sai Gautham , Anamika FNU , Jayaraman Dilip Kumar , Jain Rohit
Published: January 2025

Severe mental illness (SMI) encompasses depression, bipolar disorder, and schizophrenia which affect the daily quality of life. While it has a significant impact on their social life, it is also supposedly linked with various comorbidities, of which, cardiovascular disease (CVD) is the most frequently reported. Various biological, behavioral, and genetic mechanisms are thought to play a role: hypothalamic-pituitary-adrenal axis, autonomic nervous system dysregulation, inflammation, and psychotropic medications. Lack of exercise, low-fiber diet, smoking, substance abuse, and failure of medicine compliance also strongly contribute to the increased risk for CVD-related death. The understanding of the complex relationship between CVD and SMI would thus play a significant role in decreasing the incidence of CVD-related morbidity and mortality. This article aims to review and explain the hypothesized increased risk of CVD events in patients with SMI.
Lassa fever: urgent measures for protection and control in West Africa
Authors: Rauf Sameer Abdul , Ahmed Rubayyi , Jamalvi Syed Abdan , Ali Syed Khizar , Kumar Neeraj , Haque Md Ariful
Published: January 2025

Lassa fever, caused by the Lassa virus, is a severe public health concern in West Africa, particularly in Nigeria, where it leads to thousands of annual deaths. This review provides insights into the epidemiology, risk factors, clinical presentation, diagnosis, and impact on public health. Lassa fever’s diagnostic challenges and its potential complications are discussed. Health organizations’ response to control and prevent outbreaks is highlighted, including developing treatment and prevention strategies. Current management approaches, emerging therapies, and promising preventive measures like vaccines are explored. In conclusion, Lassa fever’s threat demands a comprehensive response involving collaboration, research, education, and the prioritization of measures to protect the well-being and stability of affected communities in West Africa.
The effect of probiotic administration on the severity of menopausal symptoms and mental health of postmenopausal women: a triple-blind randomized controlled trial in the West of Iran
Authors: Ayubi Erfan , Abdoli Sara , Mehrpooya Maryam , Karami Zahra , Jenabi Ensiyeh , Ghaleiha Ali , Soltani Farzaneh , Salehi Amir Mohammad
Published: January 2025

Objective

Menopausal symptoms are a reproductive health issue for women. Some studies have suggested that the use of probiotics may alleviate the severity of menopausal symptoms and mental health status. This study aimed to evaluate the effect of probiotic administration on the severity of menopausal symptoms and improve mental health in postmenopausal women in Hamadan, Western Iran.

Methods

A triple-blind randomized controlled trial was conducted from February 20, 2023, to August 23, 2023, at the Comprehensive Health Service Centers in Hamadan City, Western Iran. Participants were randomized to intervention and control groups. The participants in the intervention group were administered probiotic supplements in 200 mg daily capsules for 6 weeks, and those in the control group received 200 mg daily capsules containing starch powder for 6 weeks. The primary outcomes were measured using the Menopausal Rating Scale and Depression Anxiety and Stress Scale questionnaires at baseline, week 3, and week 6.

Results

A total of 84 women took part in the study, with 42 individuals assigned to each of the intervention and control groups, respectively. The findings indicated no significant differences in baseline characteristics between the study groups (P > 0.05). The results indicated that the study outcomes changed differently over time between the two groups. The participants in the intervention group exhibited greater improvements in depressive symptoms, anxiety, and stress symptoms, as well as in physical, psychological, and urogenital symptoms at both week 3 and week 6, compared with the control group (P < 0.05).

Conclusions

This study provides evidence regarding potential treatment effects of probiotics consumption in alleviating physical and mental symptoms related to menopause. Further multicenter and large-scale clinical trials with longer follow-up are recommended.
Energy-based interventions for genitourinary syndrome of menopause: a systematic review of randomized controlled trials and prospective observational studies
Authors: Zerzan Nicholas L. , Greer Nancy , Ullman Kristen E. , Sowerby Catherine , Diem Susan , Ensrud Kristine , Forte Mary L. , Anthony Maylen C. , Landsteiner Adrienne , Butler Mary , Wilt Timothy J. , Danan Elisheva R.
Published: January 2025

Importance

Hormone treatments for genitourinary syndrome of menopause (GSM) symptoms have limitations. There is interest in nonhormone therapies, including energy-based interventions. Benefits and harms of energy-based interventions are not currently well known.

Objective

The aim of this study was to assess the benefits and harms of energy-based therapies (eg, CO2 laser, Er:YAG laser, and radiofrequency) for GSM. Outcomes of interest are the eight “Core Outcomes in Menopause” and include the following: dyspareunia, vulvovaginal dryness, vulvovaginal discomfort/irritation, dysuria, change in most bothersome symptom, quality of life, treatment satisfaction, and treatment adverse effects.

Evidence Review

Eligible studies included English language randomized controlled trials (RCT) or prospective observational studies of energy-based treatments with ≥8 weeks follow-up in postmenopausal women with ≥1 GSM symptom and studies of any design reporting adverse effects ≥12 months postintervention. Ovid/MEDLINE, Embase, and CINAHL were searched from inception to December 11, 2023 using vocabulary and natural language terms, along with free-text words. Two authors extracted data and assessed the quality of included studies.

Findings

We identified 32 unique studies (16 RCT; 1 quasi-RCT; 15 nonrandomized). Ten RCT and the quasi-RCT were rated low to moderate risk of bias (RoB) and underwent data extraction. Included studies evaluated CO2 laser (k = 7), Er:YAG laser (k = 3), or radiofrequency and CO2 laser (k = 1). CO2 laser compared with sham (k = 4) may result in little to no difference in dysuria, dyspareunia, or quality of life (low certainty of evidence [COE]). CO2 laser compared with vaginal conjugated estrogens cream (k = 2) may result in little to no difference in dyspareunia, dryness, discomfort/irritation, dysuria, or quality of life (low COE). Treatment effects on all other outcomes and effects of Er:YAG laser or radiofrequency on any outcome are very uncertain (very low COE). Studies noted few adverse events and no serious adverse events.

Conclusions and Relevance

CO2 laser resulted in little to no difference in outcomes compared with sham or vaginal estrogen; the evidence is very uncertain on the effect of energy-based interventions versus all other comparators for all other outcomes. Adverse event reporting was limited. There is a need for further evidence assessing energy-based interventions.
Hsa_circ_0109623 regulates the progression of autoimmune liver disease through Hsa_miR_146b-3p/Sortilin 1–mediated activation of CD4+ T cells
Authors: Lv Xinliang , Zhu Li , Feng Shijie , Yang Siyu , Li Guohua , Zhan Jinqin , Tan Yuchun , Liu Yuquan , Zhang Jinliang , Wang Yujin , Cheng Yucheng , Fu Ping , Xu Yushan , Zheng Chenhong
Published: January 2025

Background:

Autoimmune hepatitis (AIH) is a chronic liver disease characterized by immune-mediated liver inflammation. Despite its global prevalence, the pathogenesis of AIH remains poorly understood, and there is a lack of specific biomarkers and targeted treatments. This study aimed to investigate the role of hsa_circ_0109623, hsa-miR-146b-3p, and Sortilin 1 (SORT1) in AIH and their potential as therapeutic targets.

Methods:

We collected liver tissue samples and peripheral blood mononuclear cells from patients with AIH and healthy controls and performed RT-PCR, western blotting, flow cytometry, and other molecular biology techniques to analyze the expression of hsa_circ_0109623, hsa-miR-146b-3p, and SORT1. We also used bioinformatics tools to predict the interaction between these molecules and conducted luciferase reporter assays to confirm their binding.

Results:

hsa_circ_0109623 was significantly upregulated in patients with AIH and positively correlated with inflammatory activity. We also found that hsa_circ_0109623 could enhance CD4+ T-cell activation and promote the expression of proinflammatory cytokines. Conversely, hsa-miR-146b-3p was downregulated in patients with AIH and negatively correlated with the expression of hsa_circ_0109623 and SORT1. In addition, hsa-miR-146b-3p acted as a sponge for hsa_circ_0109623, inhibiting CD4+ Th1 cell polarization and cytokine production. SORT1 was also upregulated in patients with AIH and acted as a sponge for hsa-miR-146b-3p, promoting CD4+ Th1 cell polarization and cytokine expression. Furthermore, hsa_miR_146b-3p/SORT1 can regulate the STAT1/STAT4 signaling pathway mediating the progression of AIH.

Conclusions:

The hsa_circ_0109623/hsa-miR-146b-3p/SORT1 axis plays a crucial role in the pathogenesis of AIH by regulating CD4+ T-cell activation and cytokine production. These molecules may serve as potential biomarkers and therapeutic targets for AIH. Further research is needed to validate these findings and explore their clinical applications.
Survival benefit associated with liver transplantation for hepatocellular carcinoma based on tumor burden scores at listing
Authors: Liu Hao , Zhang Wei , Di Mengyang , Lee Hang , Shi Liuhua , Wang Xixi , Xingyu Zhang , Powers Colin A. , Sethi Vrishketan , Li Xingjie , Xiao Yao , Crane Andrew , Kaltenmeier Christof , Alberola Ramon Bataller , Behari Jaideep , Duarte-Rojo Andres , Hughes Dempsey , Malik Shahid , Jonassaint Naudia , Geller David , Tohme Samer , Gunabushanam Vikraman , Tevar Amit , Cruz Ruy , Hughes Christopher , Dharmayan Stalin , Ayloo Subhashini , Humar Abhinav , Molinari Michele
Published: January 2025

Introduction:

Liver transplantation (LT) provides significant survival benefits to patients with unresectable HCC. In the United States, organ allocation policies for HCCs within the United Network for Organ Sharing criteria do not prioritize patients based on their differences in oncological characteristics. This study assessed whether transplant-associated survival benefits (TASBs) vary among patients with different tumor burden scores (TBS) measured at the time of listing.

Methods:

We analyzed data from adults applying for HCC MELD exception points between 2002 and 2019, with follow-up until December 2023, using the Scientific Registry of Transplant Recipients. TBS was determined based on the largest tumor diameter and number of HCCs. Patients were categorized into low (≤3), intermediate (3.1–5), and high (>5) TBS groups. TASB was measured as the difference in 5-year survival with and without LT.

Results:

This study included 36,634 LT candidates. High-TBS patients had higher waitlist dropout rates and marginally lower post-transplant survival, resulting in a significantly greater TASB. The 5-year TASB for the low, intermediate, and high TBS groups were 15.7, 22.1, and 25.0 months, respectively. The adjusted survival benefit expressed in 5-year survival differences was 21.9%, 34.5%, and 39.4% in the low, intermediate, and high TBS groups, respectively (p<0.001).

Conclusions:

Higher TBS during listing correlates with greater LT benefits for patients with unresectable HCC within UNOS criteria. We conclude that organ allocation policies in the United States should prioritize patients with high TBS due to their increased risk of dropout and comparable post-transplant survival when compared to patients with less advanced tumors.
End-procedural adherence to recommended hemodynamic targets does not improve the outcome of elective TIPS in patients with cirrhosis
Authors: Roccarina Davide , Saltini Dario , Adotti Valentina , Rosi Martina , Senzolo Marco , Nardelli Silvia , Bianchini Marcello , Biribin Lara , Caporali Cristian , Margherita Falcini , Ragozzino Lucia , Guasconi Tomas , Casari Federico , Gioia Stefania , Campani Claudia , Prampolini Francesco , Ingravallo Angelica , Gitto Stefano , Aspite Silvia , Arena Umberto , Citone Michele , Gaggini Melania , Ridola Lorenzo , Barbiero Giulio , De Masi Salvatore , Riggio Oliviero , Merli Manuela , Fanelli Fabrizio , Montagnese Sara , Marra Fabio , Schepis Filippo , Vizzutti Francesco
Published: January 2025

Background and Aims:

In clinical practice, the reduction of portocaval pressure gradient (PCPG) following TIPS does not always meet the recommendation of current guidance. We evaluated the impact of different degrees of PCPG reduction, measured at the end of an elective TIPS, on ascites control, recurrence of portal hypertension–related bleeding (PHRB), and survival.

Approach and Results:

Patients with cirrhosis receiving TIPS for refractory ascites (RA) or for the secondary prophylaxis of PHRB were consecutively enrolled. Reduction in PCPG was defined as inadequate hemodynamic response (IHR) ﻿in patients not achieving a PCPG <12 mm Hg for both secondary prophylaxis of PHRB and RA, or a reduction of at least 50% only for PHRB. Four hundred fifteen patients were analyzed. An adequate hemodynamic response (AHR) was achieved in 66%. Fifty percent of patients received an under-dilated (≤7 mm) endoprosthesis. No significant differences between patients with IHR and AHR were observed in rebleeding rate and ascites control, while overt HE was higher in AHR. Regardless of TIPS indication, survival was not significantly different between IHR and AHR, while advanced age and liver function before TIPS were significantly associated with a higher cumulative incidence of liver-related death. Notably, in patients with RA ﻿the cumulative incidence of liver-related mortality was higher when AHR was defined as a post-TIPS PCPG <12 mm Hg or a reduction ≥50%.

Conclusions:

AHR measured at the end of an elective TIPS may not be essential to define the eventual outcome, while a marked drop in PCPG could negatively affect the prognosis of patients with RA.
Nurse practitioner and physician associate mentorship: Improving retention and employment experiences
Authors: Yun Boyon , Gilbert Adam C. , Li Hsin-Fang , Scanlan James M. , Coleman Andrea L.
Published: January 2025

Background:

Clinician turnover is costly for health care organizations.

Local problem:

A retention strategy for newly hired nurse practitioners (NPs) and physician associates (PAs) was needed at our organization.

Methods:

A quality improvement project was conducted to determine whether a mentorship program could improve retention and employment experiences of newly hired NPs and PAs.

Interventions:

A one-to-one mentorship program was implemented for newly hired NPs and PAs. (a) Retention and productivity data were compared for mentee participants vs. nonparticipants. (b) Mentee and mentor participants completed two program evaluation surveys to examine the program's impact on their employment experiences.

Results:

Sixty-eight mentee–mentor pairs completed their mentoring relationship during the first 3 years of the program. Retention was higher among mentee participants vs. nonparticipants during their first (96% vs. 85%, p = .0332) and second year of employment (83% vs. 65%, p = .0480). Productivity during the first year was similar for mentee participants and nonparticipants (38th percentile vs. 37th percentile, p = .84). Most participants (≥69%) believed the program improved onboarding, personal and professional growth, work environment, and NP and PA community connection.

Conclusions:

The mentorship program improved first- and second-year retention of newly hired NPs and PAs and employment experiences of program participants. By our estimates, the program helped retain 15 NPs and PAs who would have otherwise left the organization, yielding potential organizational savings of $1.29M–$1.72M. A mentorship program can be an effective retention strategy for reducing health care turnover and related costs.
Analyzing the clinical characteristics of the SCAMP5 gene in gliomas and establishing a predictive model
Authors: Wu Bin , Zeng Ling , Liu Li , Tang Xianbi , Zhong Yushi
Published: January 2025

Gliomas are frequently occurring tumors in the nervous system. The secretory carrier membrane protein 5 (SCAMP5) plays a distinct role in the cytosolic function of mammalian cells and is associated with different neurological disorders. However, how SCAMP5 is expressed and its prognostic value in gliomas is unclear. The datasets were downloaded from the Chinese Glioma Genome Atlas website (http://www.cgga.org.cn/). We conducted a Cox survival analysis to establish a correlation between SCAMP5 gene expression and the general survival rate of patients with glioma. We performed Gene Ontology analysis to determine the biological functions of the SCAMP5 gene. Finally, we constructed a prediction model using primary relapse state type, age, grade, isocitrate dehydrogenase mutation status, 1p/19q co-deletion status, and the SCAMP5 gene expression value. Using this model, we can forecast the survival rates of patients for 1, 2, 3, 5, and 10 years. SCAMP5 was enriched in low-grade gliomas and isocitrate dehydrogenase mutant gliomas, 1p19q-deficient gliomas. SCAPM5 is an independent prognostic factor for the overall survival of glioma patients. Predictive models developed by SCAMP5 were able to predict well the long-term survival of patients. The evidence suggests that the SCAMP5 gene plays a significant function in glioma patients. There is a clear correlation between the expression of the SCAMP5 gene and the overall survival of glioma patients.
Evaluation of anemia among pregnant women in a hilly district of western Nepal: A hospital based cross-sectional study
Authors: Subedi Prativa , Adhikari Prakash , Shah Sangam , KC Anil , Yadav Gopal Kumar , Paudel Basanta Sharma , Subedi Pratik , Thapa Anish , Sah Michael Kumar , Oli Aadhar , Sah Ranjit
Published: January 2025

Iron deficiency anemia remains a significant public health concern, particularly among pregnant women and children. The prevalence of anemia is higher in lower middle income countries including Nepal. Despite government efforts, progress in reducing anemia in the last 15 years has been slow, especially in remote hilly regions. While investing in anemia control can yield substantial economic returns, there have not been adequate studies to cover diverse geographical areas of Nepal. This study aims to determine the prevalence of anemia in a hilly district of western Nepal. A retrospective cross-sectional study was conducted among the 350 pregnant women visiting for ante natal checkup in Burtibang primary hospital from July 15, 2022 to Jan 15, 2023. The factors associated with the prevalence of anemia was calculated by using multivariate logistics regression analysis at P < .05 and ANOVA test was done to calculate the differences in hemoglobin level across the different characteristics of the pregnant women. More than 2 out of 5 pregnant women (43.1%) had anemia with 57.6% having mild anemia and 42.4% of the women having moderate to severe level of anemia. The mean Hb level of the pregnant women was 10.8 (±1.0) g/dL. Women on second (adjusted odds ratio [aOR]: 0.06; 95% CI: 0.03–0.11) and third trimester of their pregnancy (aOR: 0.06; 95% CI: 0.02–0.16) had lower odds of having anemia. A moderate level of correlation of Hb level with the gestational age (R = 0.574, P value: <.001) was seen in the study. The prevalence of anemia is a serious public health problem among the women visiting ante natal checkup in Burtibang hospital. Later trimester of the pregnancy had higher risks of having anemia in comparison to the first and the gestational age of the women was a significant predictor of Hb level among the population.
Clinical efficacy of Chinese traditional herbal medicine (Fufang Xuanju capsule) on males of late-onset hypogonadism presenting with sexual dysfunction
Authors: Zhang Huihui , Deng Shidong , Liu Lingzhi , Wang Yurou , Fei Kuilin
Published: January 2025

This study aimed to assess the efficacy and safety of Fufang Xuanju capsule in males with late-onset hypogonadism (LOH) complaining of sexual dysfunction during 3 months period. We identified the patients through questionnaires and laboratory examinations. Patients in the treatment group (n = 57) and placebo group (n = 50) received Fufang Xuanju capsules (3.78 g) or placebo capsules daily for 3 months, respectively. After treatment, the plasma total testosterone of both groups sustained, however, libido and erectile dysfunction in patients of the treatment group but not placebo group were significantly improved, measured by elevated scores of International Index of Erectile Function-5. The overall efficacy rate of Fufang Xuanju capsule for LOH was 71.9%. The most striking clinical effects were observed in patients exhibiting mild and moderate erectile dysfunction. No severe adverse effects were observed during the period of study. The remaining parameters such as total prostate-specific antigen, prostate volume and uroflow rate remained stable. Fufang Xuanju capsule proves to be an effective and safe treatment in a short time to alleviate symptoms of sexual dysfunction in LOH patients, especially in those exhibiting mild and moderate erectile dysfunction. Little effect on the level of total testosterone makes it well suitable for LOH patients which have contraindications of testosterone replacement therapy.
A case report of Henoch–Schönlein purpura in the elderly complicated by multisystem involvement
Authors: Na Song , Zhang Lei , Kou Luxin , Xu Jinquan , Gang Li
Published: January 2025

Rationale:

Henoch–Schönlein purpura (HSP), a vasculitis caused predominantly by immunoglobulin A vasculitis deposition in the blood vessel wall. It frequently affects multiple organs, however, intussusception and cardiac involvement in the elderly is extremely rare. Currently, the diagnosis of patients with atypical HSP is very difficult. Drugs and treatments lack adequate evidence-based medical proof to improve patients’ long-term outcomes. We report a case of an elderly patient with allergic purpura involving the intestines, kidneys and heart, and discuss the diagnosis and treatment of patients with atypical clinical symptoms.

Patient concerns:

A 72-year-old woman whose initial symptoms were unusual, and the progression of the disease is irregular.

Diagnoses:

The patient with HSP gradually developed intussusception, renal failure and cardiac involvement.

Interventions and outcomes:

The patient developed kidney injury and intussusception, we sequentially administered surgical intervention, glucocorticoids, hemofiltration and hemoperfusion, and her condition showed improvement. Unfortunately, by the time cardiac complications develop, the patient’s condition deteriorated rapidly. At last, the patient died.

Lessons:

HSP with renal failure, intussusception, and cardiac complication is extremely rare. When patients with atypical HSP, we should always be alerted to changes in their condition. And take into account factors such as the severity of symptoms, patient preferences and complications in order to determine the most suitable therapies.
Thread fragrant moxibustion for a young women with atypical hand herpes zoster: A case report
Authors: Zhang Yi-Mei , Wang Yong-Cheng , Han Xing-Jun , Xu Zhi-Wei , Zhao Xing-Lin , Yuan Xiao-Fen , Wang Wen-Xiu , Jia Hong-Ling
Published: January 2025

Rationale:

Hand herpes zoster (HHZ) is a very rare skin disease in clinical practice. Due to the lack of specificity in its early clinical manifestations, HHZ is easily misdiagnosed as hand eczema or other lesions. Herein, we present a case with atypical HHZ.

Patient concerns:

A 25-year-old woman experienced left palm pain accompanied by upper limb stabbing pain, general weakness, and low-grade fever after staying up late. At first, she was diagnosed with peripheral nerve compression and hand eczema, and received relevant symptomatic treatment, but her condition did not improve. Diagnosed with herpes zoster on the hand after skin biopsy, treated with thread fragrant moxibustion (TFM).

Diagnoses:

The HHZ diagnosis was established based on clinical appearance and dermatological findings eventually.

Interventions:

The intervention project was TFM treatment once a day in the acupuncture and moxibustion department, and the whole treatment period lasted for 10 days.

Outcomes:

After 3 more TFM treatments were given, the burning sensation and itching in her palms as well as the pulsatility of the finger blood vessels had significantly reduction, the visual analog scale scores significantly decreased. After 10 treatments, the patient’s herpes gradually falls off, revealing pink new skin without any discomfort.

Lessons:

Herpes zoster can appear in any part of the human body with different clinical manifestations. Herpes zoster in the hands is very rare in clinical practice, and it is often misdiagnosed as hand eczema or other lesions in the early stages of the disease. The case is not only highlights the challenging diagnosis in the absence of a characteristic rash at the initial stage but also confirmed the definite therapeutic effect of TFM on herpes zoster.
Prevalence of depressive, anxiety, and stress symptoms and barriers to mental health services among medical students at Jazan University, Saudi Arabia: A cross-sectional study
Authors: Albasheer Osama , Al Ageeli Essam , Aljezani Turki I. , Bakri Khalid A. , Jathmi Salman M. , Maashi Abdullah , Abo Khirat Ahmad , Hakami Ali W. , Haddadi Arif A. , Ali Suhaila , Abdelmola Amani , Ahmed Anas
Published: January 2025

Medical students represent the future of the healthcare workforce. However, the demanding nature of medical education places them at an increased risk of mental health issues. Ensuring their mental well-being is crucial for maintaining a competent and compassionate healthcare system. This study aims to determine the prevalence of depression, anxiety, and stress, along with barriers to accessing mental health services among medical students. A cross-sectional self-administered online survey conducted among medical students of Jazan University, Saudi Arabia, from September 2023 to March 2024. Descriptive and inferential statistical analyses were conducted using International Business Machines Corporation Statistical Package for the Social Sciences version 27.0.1 (Chicago). The study included 390 participants. Median scores for depression, anxiety, and stress were 14.00, 12.00, and 16.00, respectively, with interquartile ranges of 4.00 to 22.00, 4.00 to 20.00, and 6.00 to 24.00. Depression severity categories showed that 38.2% were normal, while 11.5%, 31.8%, 13.6%, and 4.9% experienced mild, moderate, severe, and extremely severe symptoms, respectively. Anxiety severity classifications revealed 37.4% as normal, with 6.2%, 17.4%, 10.0%, and 29.0% falling into mild, moderate, severe, and extremely severe categories, respectively. For stress, 49.2% were normal, while 11.0%, 16.7%, 14.1%, and 9.0% experienced mild, moderate, severe, and extremely severe levels, respectively. Barriers to accessing mental health care included a preference for self-management, confidentiality concerns, societal judgment, and fears of career-related repercussions. This study highlights a high prevalence of depression, anxiety, and stress among medical students at Jazan University, with notable gender differences and symptom severity. Addressing barriers to mental health care, such as confidentiality concerns and societal stigma, is essential to improving service utilization and student well-being.
Treatment of intra-bony defect and periodontal phenotype modification therapy (PhMT): A one-year follow-up case report
Authors: Alqahtani Ali Fahed
Published: January 2025

Rationale:

The treatment of a patient with an intrabony defect using periodontal phenotype modification therapy (PhMT) is alternative approach in correcting intrabony defects and changing periodontal phenotypes.

Patient concerns:

A 27-year-old male patient arrived with a severe intrabony defect and a poor periodontal phenotype. The patient received PhMT, which includes nonsurgical periodontal therapy, bone grafting, and orthodontic treatment. After 1 year, there were considerable changes in the intrabony defect, periodontal phenotype, and general oral health.

Diagnoses:

A 27-year-old male patient had a profound intrabony defect (10 mm) and a poor periodontal phenotype (thin gingiva, high frenum attachment).

Interventions:

The patient received PhMT, which includes nonsurgical periodontal therapy (scaling and root planing), bone grafting (allograft), and orthodontic treatment (correcting tooth placement). After 1 year, there were considerable improvements: Intrabony defect reduction (from 10 to 3 mm), improved periodontal phenotype (thickened gingiva, decreased frenum attachment), and improved dental health (lower pocket depths, increased attachment levels). PhMT successfully repaired the intrabony deficiency and altered the patient’s periodontal phenotype.

Outcomes:

Improved dental health and aesthetics were the result of the comprehensive treatment, which addressed the problem as well as the patient’s underlying periodontal features.

Lessons:

The efficacy of PhMT in correcting intrabony abnormalities and altering periodontal phenotypes is demonstrated in this case study. This strategy presents a viable remedy for patients with intricate periodontal requirements.
MicroRNA-204 may predict the renal function in patients with chronic kidney disease
Authors: Xiaoyun Guo , Hongjun Li , Cuijing Meng , Li Rong , Mei Zhang
Published: January 2025

Background:

Chronic kidney disease significantly affects human health by loss of excretory kidney function. MicroRNAs have potential predictive and therapeutic significance for chronic kidney disease and fibrosis-related kidney diseases. This study aimed to investigate expression profiling and clinical significance of microRNA-204 (miR-204) expression in patients with chronic kidney disease.

Methods:

A total of 126 patients with chronic kidney disease and age-matched 126 healthy controls were enrolled in this study. Blood samples were collected from participants and expression levels of miR-204 were detected using reverse transcription quantitative polymerase chain reaction. Expression of inflammatory cytokines in glomerular cells was measured using reverse transcription quantitative polymerase chain reaction. Inflammatory cytokines in serum were analyzed using enzyme-linked immunosorbent assay in all participants. Multivariate Cox-regression analysis was used to analyze the association between serum level of miR-204 and inflammation, renal fibrosis, and degree of chronic kidney disease.

Results:

Chronic kidney disease patients had higher inflammatory cytokines including IL-1β, IL-6, TNF-α, IL-10, and IL-17 than healthy volunteers. Expression levels of inflammatory cytokines (IL-1β, IL-6, TNF-α, IL-10, and IL-17) were upregulated in patients with chronic kidney disease compared to healthy volunteers. Serum level of miR-204 was lower in chronic kidney disease patients than healthy patients. Expression of miR-204 was higher in healthy volunteers than patients with chronic kidney disease. In addition, expression of miR-204 was lower in glomerular cells in chronic kidney disease patients than those in the healthy volunteers. Furthermore, higher serum level of miR-204 was associated with better renal function in chronic kidney disease patients than patients who had lower serum level of miR-204. High serum levels of miR-204 were associated with degree of renal fibrosis and injury of chronic kidney disease patients. Multivariate Cox-regression analysis identified expression of miR-204 was positively correlated with inflammation in patients with chronic kidney disease.

Conclusion:

Outcomes indicate that serum levels of miR-204 are downregulated in serum in patients with chronic kidney disease. Data suggest that serum levels of miR-204 can be used to evaluate the renal function in patients with chronic kidney disease.