bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole Genomes Inform Genetic Rescue Strategy for Montane Red Foxes in North America
Authors: Quinn Cate B , Preckler-Quisquater Sophie , Buchalski Michael R , Sacks Benjamin N
Published: September 2024

A few iconic examples have proven the value of facilitated gene flow for counteracting inbreeding depression and staving off extinction; yet, the practice is often not implemented for fear of causing outbreeding depression. Using genomic sequencing, climatic niche modeling, and demographic reconstruction, we sought to assess the risks and benefits of using translocations as a tool for recovery of endangered montane red fox (Vulpes vulpes) populations in the western United States. We demonstrated elevated inbreeding and homozygosity of deleterious alleles across all populations, but especially those isolated in the Cascade and Sierra Nevada ranges. Consequently, translocations would be expected to increase population growth by masking deleterious recessive alleles. Demographic reconstructions further indicated shallow divergences of less than a few thousand years among montane populations, suggesting low risk of outbreeding depression. These genomic-guided findings set the stage for future management, the documentation of which will provide a roadmap for recovery of other data-deficient taxa.
How to scan naked DNA using promiscuous recognition and no clamping: a model for pioneer transcription factors
Authors: Goluguri Rama Reddy , Ghosh Catherine , Quintong Joshua , Sadqi Mourad , Muñoz Victor
Published: September 2024

Most DNA scanning proteins uniquely recognize their cognate sequence motif and slide on DNA assisted by some sort of clamping interface. The pioneer transcription factors that control cell fate in eukaryotes must forgo both elements to gain access to DNA in naked and chromatin forms; thus, whether or how these factors scan naked DNA is unknown. Here, we use single-molecule techniques to investigate naked DNA scanning by the Engrailed homeodomain (enHD) as paradigm of highly promiscuous recognition and open DNA binding interface. We find that enHD scans naked DNA quite effectively, and about 200000-fold faster than expected for a continuous promiscuous slide. To do so, enHD scans about 675 bp of DNA in 100 ms and then redeploys stochastically to another location 530 bp afar in just 10 ms. During the scanning phase enHD alternates between slow- and medium-paced modes every 3 and 40 ms, respectively. We also find that enHD binds nucleosomes and does so with enhanced affinity relative to naked DNA. Our results demonstrate that pioneer-like transcription factors can in principle do both, target nucleosomes and scan active DNA efficiently. The hybrid scanning mechanism used by enHD appears particularly well suited for the highly complex genomic signals of eukaryotic cells.
Strong and efficient bismuth telluride-based thermoelectrics for Peltier microcoolers
Authors: Zhuang Hua-Lu , Cai Bowen , Pan Yu , Su Bin , Jiang Yilin , Pei Jun , Liu Fengming , Hu Haihua , Yu Jincheng , Li Jing-Wei , Wang Zhengqin , Han Zhanran , Li Hezhang , Wang Chao , Li Jing-Feng
Published: September 2024

Thermoelectric Peltier coolers (PCs) are being increasingly used as temperature stabilizers for optoelectronic devices. Increasing integration drives PC miniaturization, requiring thermoelectric materials with good strength. We demonstrate a simultaneous gain of thermoelectric and mechanical performance in (Bi, Sb)2Te3, and successfully fabricate micro PCs (2 × 2 mm2 cross-section) that show excellent maximum cooling temperature difference of 89.3 K with a hot-side temperature of 348 K. A multi-step process involving annealing, hot-forging and composition design, is developed to modify the atomic defects and nano- and microstructures. The peak ZT is improved to ∼1.50 at 348 K, and the flexural and compressive strengths are significantly enhanced to ∼140 MPa and ∼224 MPa, respectively. These achievements hold great potential for advancing solid-state refrigeration technology in small spaces.
Engineering spin-dependent catalysts: chiral covalent organic frameworks with tunable electroactivity for electrochemical oxygen evolution
Authors: Li Ziping , Xiao Yueyuan , Jiang Chao , Hou Bang , Liu Yan , Cui Yong
Published: September 2024

The chiral-induced spin selectivity (CISS) effect offers promising prospects for spintronics, yet designing chiral materials that enable efficient spin-polarized electron transport remains challenging. Here, we report the utility of covalent organic frameworks (COFs) in manipulating electron spin for spin-dependent catalysis via CISS. This enables us to design and synthesize three three-dimensional chiral COFs (CCOFs) with tunable electroactivity and spin-electron conductivity through imine condensations of enantiopure 1,1′-binaphthol-derived tetraaldehyde and tetraamines derived from 1,4-benzenediamine, pyrene, or tetrathiafulvalene skeletons. The CISS effect of CCOFs is verified by magnetic conductive atomic force microscopy. Compared with their achiral analogs, these CCOFs serve as efficient spin filters, reducing the overpotential of oxygen evolution and improving the Tafel slope. Particularly, the diarylamine-based CCOF showed a low overpotential of 430 mV (vs reversible hydrogen electrode) at 10 mA cm−2 with long-term stability comparable to the commercial RuO2. This enhanced spin-dependent OER activity stems from its excellent redox-activity, good electron conductivity and effective suppression effect on the formation of H2O2 byproducts.
Pandemic shocks and macroprudential policy
Authors: Bratsiotis George J , Gloria Manuel
Published: September 2024

We introduce an extended borrower–saver DSGE (Dynamic Stochastic General Equilibrium) model, where classifications of occupations are split further into two subcategories, according to whether their occupation is directly “affected” by a pandemic shock. We find that, contrary to the standard literature, during a pandemic shock an increase in the Loan-to-Value (LTV) ratio can increase social welfare and make all four agent types (borrowers affected, borrowers non-affected, savers affected, and savers non-affected) better off. Countercyclical optimal LTV rules are shown to increase social welfare, with savers gaining at the expense of borrowers, including those mostly affected by the pandemic. An interest rate mortgage subsidy to those worst affected (“affected” mortgage borrowers), in coordination with stricter monetary and LTV policy, are shown to increase both social welfare and the welfare of borrowers and savers affected by the pandemic.
Phenotypic age mediates effects of Life's Essential 8 on reduced mortality risk in US adults
Authors: Zhao Yuxuan , Yang Haiming , Jiao Rong , Wang Yueqing , Xiao Meng , Song Mingyu , Yu Huan , Liao Chunxiao , Pang Yuanjie , Gao Wenjing , Huang Tao , Yu Canqing , Lv Jun , Li Shengxu , Qi Lu , Li Liming , Sun Dianjianyi
Published: September 2024

Objective

This study aimed to find out whether phenotypic age could mediate the protective effects of a healthy lifestyle on mortality.

Methods

We included adult participants with available data for individual phenotypic age (PhenoAge) and Life's Essential 8 (LE8) scores from the National Health and Nutrition Examination Survey 2005–2010 (three cycles) and linked mortality records until 31 December 2019. Adjusted hazard ratios (HR) were estimated to evaluate the associations of PhenoAge and LE8 scores with all-cause and cardiovascular mortality risk. Mediation analyses were performed to estimate the proportional contribution of PhenoAge to the effect of LE8 on mortality risks.

Results

A 1-year increment in PhenoAge was associated with a higher risk of all-cause (HR = 1.04 [95% confidence interval, 1.04–1.05]) and cardiovascular (HR = 1.04 [95% confidence interval, 1.04–1.05]) mortality, independent of chronological age, demographic characteristics, and disease history. High level of LE8 (score: 80–100) was associated with a 3.30-year younger PhenoAge. PhenoAge was estimated to mediate 36 and 22% of the effect of LE8 on all-cause and cardiovascular mortality, respectively (all P < 0.001). As for single-metric scores of LE8, PhenoAge mediated 30%, 11%, 9%, and 7% of the effects of the healthy diet, smoking status, blood pressure, and physical activity on all-cause mortality risk, respectively (all P < 0.05).

Conclusion

Adherence to LE8 recommendations slows phenotypic aging. PhenoAge could mediate the effect of LE8 on mortality risk.
The impact of intersectionality on the experience of medical trainees
Authors: Walker Zachary , Murphy Ellen , Sain Cody , Ohiomoba Ramael , Lasic Morana , Lanes Andrea , Ginsburg Elizabeth
Published: September 2024

Diverse trainees have different training experiences than non-diverse trainees; however, it has not been demonstrated if the number of diverse traits (DTs) (i.e. intersectionality) contributes to worse experiences. Our objective was to understand if the number of DTs a trainee has impacts their training experience. We distributed a survey to medical trainees at Mass General Brigham from 15/12/23 to 15/4/24. DTs were based on race/ethnicity, gender-identity, sexual orientation, birthplace, disability, and highest parental education. A total of 134 responses were obtained. Respondents with 1 DT were more likely to report dissatisfaction with the quality of their training compared to those with 0 DT (P = 0.03). However, this did not remain true for those with 2 or 3+ DT (P = 0.39, P = 0.59). Only respondents with 1 DT disagreed that they had similar opportunities for academic success to those of their peers (P = 0.03) and agreed that they had to work harder than others to be valued equally (P < 0.01). Respondents with 3+ DTs felt that their institution was not diverse (P < 0.01) and racist (P < 0.01) compared to respondents with zero DTs. Therefore, trainees with DTs had different training experiences than trainees with zero DTs, but the number of DTs did not consistently correlate with the quality of their experience. We believe this data is important for administrators to understand how intersectionality effects the trainee experience. Additionally, we believe this data can be used to gauge disparities in education and create an avenue to address issues, such as discrimination, microaggressions, and low retention rate of diverse applicants.
How does health visiting in the first year of life vary by family characteristics? A longitudinal analysis of administrative data
Authors: Bunting C , Clery A , McGrath-Lone L , Liu M , Kendall S , Bedford H , Cavallaro F , Saloniki E C , Harron K , Woodman J
Published: September 2024

Background

The health visiting service in UK promotes the health and wellbeing of families with young children and comprises a universal offer (three mandated contacts between birth and 12 months) and additional contacts based on need. We aimed to understand how the level of health visiting support received varies by family characteristics.

Methods

Using the Community Services Data Set linked to Hospital Episode Statistics, we identified 52 555 children in 10 local authorities with complete health visiting data for 12 months between April 2016 and March 2020. We analysed variation in health visiting contacts by deprivation, child ethnicity, maternal age, adversity and previous live births.

Results

41 340/52 555 children (79%) received the universal service; 63% received ≥1 additional contact and 25% received ≥3 additional contacts. The likelihood of receiving ≥3 additional contacts was greatest for children whose mothers had a history of hospital admissions relating to mental health, violence, self-harm or substance misuse (adjusted relative risk = 1.55, 95% confidence interval 1.26–1.92).

Conclusions

Most families received health visiting support in addition to the universal service. Policymakers and commissioners should consider how health visiting services can be expanded or targeted more effectively to ensure all families receive the support they need.
The Question of Blanchot in Beckett’s Three Dialogues and The Unnamable
Authors: Berbic Adem
Published: September 2024

While the possible influence of the French writer Maurice Blanchot on Samuel Beckett’s writing has long been one of the more vexing questions in Beckett scholarship, textual echoes, thematic correspondences and circumstantial clues now make it likelier than not that Beckett encountered Blanchot’s writing in the late 1940s and early 1950s. The personal documents of Georges Duthuit—Beckett’s close friend in this period, during the writing of both Three Dialogues (1949) and the ‘Trilogy’ of novels (1951–1953)—shed further light on this connection. They suggest that Three Dialogues is a continuation of Beckett’s decades-long thought on habit, as first articulated in Proust (1930), and that Duthuit (re)introduced Beckett to Blanchot’s work at the time of writing Three Dialogues. This article explores connections between Blanchot’s Thomas l’obscur (1941) and ‘De l’angoisse au langage’ (1943), and published and manuscript versions of Beckett’s Three Dialogues and L’Innommable, as well as between the problematics posed by the latter two texts. Finally, it suggests that L’Innommable is not a reflection but a radicalization of Blanchot’s thought, such that Blanchot missed the full extent of its radicality in his own review of the novel.
Efficacy, safety and optimal intervention of belimumab for proliferative lupus nephritis patients in real-world settings: LOOPS registry
Authors: Sakai Hidenori , Miyazaki Yusuke , Nakayamada Shingo , Kubo Satoshi , Hanami Kentaro , Fukuyo Shunsuke , Yamaguchi Ayako , Miyagawa Ippei , Ueno Masanobu , Tanaka Hiroaki , Todoroki Yasuyuki , Ohkubo Naoaki , Funada Masashi , Matsunaga Satsuki , Tanaka Yoshiya
Published: September 2024

Objectives

This study investigated the efficacy, safety and predictive factors of belimumab (BEL) in induction therapy for patients with proliferative lupus nephritis (LN) in real-world settings.

Methods

Patients with biopsy-proven ISN/RPS class III or IV LN, with or without coexisting class V LN, who underwent standard of care (SoC), glucocorticoid (GC) and either mycophenolate mofetil or cyclophosphamide treatments were included. Participants were treated with SoC (SoC group, n = 32) or BEL and SoC (BEL+SoC group, n = 30). The primary end point was complete renal response (CRR) at 52 weeks.

Results

Baseline patient characteristics were not significantly different between the two groups. The 52-week retention rate of BEL was 90.0%. The BEL+SoC group showed significantly higher CRR and primary efficacy renal response achievement at 52 weeks and significantly lower GC dosage, adverse events and Systemic Lupus International Collaborating Clinics damage index scores. Multivariate analysis of CRR achievement at 52 weeks revealed that the lack of estimated glomerular filtration rate (eGFR) improvement at 4 weeks was associated with CRR failure in the SoC group. A shorter duration (cut-off of 42 days) between the start of induction therapy and addition of BEL was also related to the CRR in the BEL+SoC group.

Conclusion

BEL, in addition to SoC, controls disease activity, reduces GC use and suppresses organ damage in case of proliferative LN. Earlier BEL induction within 6 weeks may help achieve CRR in treatment-resistant cases without eGFR improvement at 4 weeks after induction therapy.
Validation of the International Myositis Assessment and Clinical Studies Group guideline on cancer risk stratification
Authors: Tang Iris Yan Ki , Chan Shirley Chiu Wai , Li Philip Hei , Li Wai Ling , Luk Lucas Tsz Ho , Chan Dennis , Ho Roy , Lai Billy Tin Lok , Lee Patrick Man Leung , Tang Vivian Hoi Shan , So Ho
Published: September 2024

Objectives

Adult-onset idiopathic inflammatory myopathies (IIMs) are associated with cancer. Guideline on cancer risk stratifications and screening in IIM patients was recently published, but their external validity remains verified. We evaluated its applicability and reliability among a Hong Kong IIM cohort.

Methods

The longitudinal observational cohort collected data from IIM patients fulfilling relevant classification criteria from eight rheumatology centres in Hong Kong. Demographic, clinical and laboratory data were reviewed from 2004 to 2023. IIM patients were stratified into standard, intermediate or high-risk subgroups according to the IMACS guideline. The occurrence of malignancy at or after IIM diagnosis was analysed. Independent risk factors for cancer were evaluated.

Results

A total of 479 patients were included with 327 females (68.3%) and mean age of IIM diagnosis at 54.5 ± 13.6 years. In total, 214 (44.7%) and 238 (49.7%) patients were stratified to high and intermediate risk groups, respectively. Only 5.6% belonged to the standard-risk group. Sixty patients (12.5%) had cancer within 3 years of IIM diagnosis. Nasopharyngeal (25%), lung (21.1%) and breast (10.5%) were the top three cancers. Significantly more patients (44, 20.6%) in the high-risk group developed cancer within 3 years, compared with intermediate (6.7%, P < 0.001) and standard-risk (0%, P = 0.009) groups. Risk factors for cancer included older age (OR: 1.048, 95%CI: 1.019–1.078), Gottron’s rash (OR: 2.453, 95%CI: 1.123–5.356), absence of interstitial lung disease (OR 2.695, 95% CI: 1.154–6.295), anti-TIF1g positivity (OR: 4.627, 95% CI: 2.046–10.461) and anti-SAE1 positivity (OR: 5.325, 95% CI: 1.271–22.300).

Conclusions

Our real-world study supported the accuracy of cancer risk stratification. The vast majority of IIM patients would be subjected to extensive cancer screening when the guideline was applied.
Erosion regression in patients with rheumatoid arthritis after upadacitinib—a pilot study using high resolution peripheral quantitative computed tomography
Authors: So Ho , Cheng Isaac , Chow Evelyn , Wu Qihan , Li Martin , Hung Vivian , Qin Ling , Wong Chun-Kwok , Tam Lai-Shan
Published: September 2024

Objectives

To evaluate whether inhibition of Janus kinases (JAK) 1 could lead to erosion repair on high-resolution peripheral quantitative CT (HR-pQCT) in patients with active RA.

Methods

This was a prospective, non-randomized pilot study. We enrolled 20 adult patients with active RA with ≥1 bone erosion on HR-pQCT. They were given upadacitinib 15 mg once daily for 24 weeks. HR-pQCT of the metacarpophalangeal joint was performed at baseline and 24-week. The serum bone biomarkers level was evaluated before and after treatment. Twenty age-and-sex matched RA patients from another study treated with conventional synthetic DMARDs (csDMARDs) were included as active controls.

Results

Nineteen patients in the upadacitinib group completed the study procedures. After 24 weeks, despite similar improvement in disease activity, a reversed trend in the mean erosion volume change on HR-pQCT was observed comparing the upadacitinib and active control group (upadacitinib group: −0.23 ± 3.26 mm3vs control group: 1.32 ± 6.05 mm3, P = 0.131). A greater proportion of erosions in the upadacitinib group demonstrated regression (27% vs 12%, P = 0.085). Using general estimating equation (GEE), the use of upadacitinib was significantly associated with erosion regression (OR: 3.61, 95% CI: 1.00–13.00, P = 0.049) after adjusting for the difference in disease duration. The serum levels of bone resorption markers reduced after upadacitinib treatment. No new safety signal was noted.

Conclusion

Despite a similar improvement in RA disease activity after upadacitinib compared with csDMARDs, a differential regression of erosion on HR-pQCT was observed in patients received upadacitinib. The potential role of JAK1 inhibition in erosion repair should be investigated.
Credit ratings: strategic issuer disclosure and optimal screening
Authors: Cohn Jonathan B , Rajan Uday , Strobl Günter
Published: September 2024

We consider a model in which a security issuer can manipulate information observed by a credit rating agency (CRA). We show that stricter screening by the CRA can sometimes lead to increased manipulation by the issuer. Accounting for the issuer’s behavior pulls optimal CRA screening toward the extremes of laxness or stringency. Surprisingly, an improvement in prior asset quality can result in more rating errors. In a two-period version of the model, stricter screening can result in more short-run rating errors. Our results suggest complex interplay between issuer and CRA behavior, complicating the evaluation of CRA policy effectiveness.
Adapting lipidomic sample processing methods for boars housed in commercial settings
Authors: Mills Kayla M , Minton Amanda M , Ferreira Christina R
Published: September 2024

Multiple reaction monitoring (MRM) profiling is a sensitive method of lipid screening that has the capability to distinguish between different fertility phenotypes in gilts. However, MRM profiling has not yet been utilized to evaluate fertility phenotypes in boars. Markers indicative of fertility status in boars would be valuable as inclusion of subfertile boars in breeding programs results in a loss of efficiency and negative economic consequences. In addition, semen samples for lipidomic analysis are transported in liquid nitrogen or on dry ice to suspend metabolic activity within the sperm cells, however, these cryopreservation techniques are not commonly available at commercial boar studs. Therefore, the objective of this study was to develop a method of sample processing for MRM profiling that suspends metabolic activity within semen without freezing the sample. Five, sexually mature boars of similar genetics enrolled in a commercial breeding program were collected for the study. Following collection, ejaculates were aliquoted into methanol to suspend metabolic activity and shipped to Purdue University overnight for lipid extraction. Lipids were extracted using the Bligh and Dyer method and MRM profiling was used for lipid screening. A total of 329 ion transitions (MRMs) related to lipids were detected with most lipids being characterized as plasma membrane lipids (74%) which were comprised of phosphatidylcholines (40%), ceramides (16%), phosphatidylethanolamines (11%), and phosphatidylserines (7%). acylcarnitines (AC) represented approximately 8% of the ejaculate lipidome. Hierarchical cluster and principal component analysis revealed that boars have a distinct ejaculate lipidome profile based on major plasma membrane lipid classes. In addition, we observed that one boar was unique in his abundance of AC which are related to progressive motility and sperm cell metabolism. These results indicate that this method of sample processing for MRM profiling is suitable to be used to evaluate the lipidome of ejaculates from commercial boars and has the potential for broader applications across different livestock species in commercial environments.
Investigation of the toxicity and safety concerns of transgenic maize seeds expressing immunogenic F and HN protein genes against Newcastle disease virus
Authors: Bhutta Muhammad Saad , Shahid Naila , Ajmal Sara , Shakoor Sana , Khursheed Zainab , Salisu Ibrahim B , Ahmad Sheraz , Azam Saira , Yasmeen Aneela , Latif Ayesha , Rao Abdul Qayyum
Published: September 2024

Introduction

The presented study investigated the potential toxicity and safety concerns associated with transgenic maize seeds expressing immunogenic F and HN protein genes against Newcastle disease virus (NDV).

Methodology

The experiment involved feeding Sprague–Dawley rats with transgenic maize seeds formulated into standard diets at levels of 30% (w/w) for a duration of 90 days. The rats were divided into three groups, with 10 rats per group. We assessed various parameters including overall appearance, feed consumption, body weight, organ weight, hematological parameters, serum chemistry, and histopathology.

Results

The results of these assessments were compared between the control group and the treatment groups. The study findings revealed that there were no significant differences between the control and treatment groups in terms of overall appearance, feed consumption, body weight, organ weight, hematological parameters, serum chemistry, microscopic histopathology, and gross appearance of tissues. These observations suggest that the consumption of transgenic maize seeds did not lead to any treatment-related adverse effects or toxicological issues. Furthermore, the transgenic maize seeds were found to be nutritionally equivalent to their non-transgenic counterpart.

Conclusion

Overall, no physiological, pathological, or molecular toxicity was observed in the Rats fed with transgenic feed.However, it is important to note that this study focused specifically on the parameters measured and the outcomes observed in Sprague–Dawley rats, and further research and studies are necessary to fully evaluate the safety and potential applications of transgenic edible vaccines in humans or other animals.
Urinary bladder carcinogenic potential of 4,4′-methylenebis(2-chloroaniline) in humanized-liver mice
Authors: Suzuki Shugo , Gi Min , Kobayashi Takuma , Miyoshi Noriyuki , Yoneda Nao , Uehara Shotaro , Yokota Yuka , Noura Ikue , Fujioka Masaki , Vachiraarunwong Arpamas , Kakehashi Anna , Suemizu Hiroshi , Wanibuchi Hideki
Published: September 2024

Occupational exposure to 4,4′-methylenebis(2-chloroaniline) (MOCA) has been linked to an increased risk of bladder cancer among employees in Japanese plants, indicating its significance as a risk factor for urinary bladder cancer. To investigate the role of MOCA metabolism in bladder carcinogenesis, we administered MOCA to non-humanized (F1-TKm30 mice) and humanized-liver mice for 4 and 28 wk. We compared MOCA-induced changes in metabolic enzyme expression, metabolite formation, and effects on the urinary bladder epithelium in the 2 models. At week 4, MOCA exposure induced simple hyperplasia, cell proliferation, and DNA damage in the urothelium of the humanized-liver mice, whereas in the non-humanized mice, these effects were not observed. Notably, the concentration of 4-amino-4′-hydroxylamino-3,3′-dichlorodiphenylmethane (N-OH-MOCA) in the urine of humanized-liver mice was more than 10 times higher than that in non-humanized mice at the 4-wk mark. Additionally, we observed distinct differences in the expression of cytochrome P450 isoforms between the 2 models. Although no bladder tumors were detected after 28 wk of treatment in either group, these findings suggest that N-OH-MOCA significantly contributes to the carcinogenic potential of MOCA in humans.
Palmatine ameliorates N‐methyl‐N'‐nitrosoguanidine‐induced chronic atrophic gastritis through the STAT1/CXCL10 axis
Authors: Zhou Yuan , Wang Qiaojiao , Tang Wanyu , Ma Zhengcai , Yang Zhipeng , Li Xuegang , Chen Wanqun , Ma Hang , Ye Xiaoli
Published: September 2024

Chronic atrophic gastritis (CAG) is a prevalent preneoplastic condition of the stomach. Palmatine (PAL), an isoquinoline alkaloid isolated from Rhizoma Coptidis (RC), has significant anti‐inflammatory properties and is often used to treat gastrointestinal disorders. However, the mechanism of PAL on CAG remains unclear. In this study, N‐methyl‐N'‐nitrosoguanidine (MNNG) was used to induce CAG inflammatory disease models in vivo and in vitro. The efficacy of five alkaloids in RC and the dose‐dependent effects of the most effective PAL in CAG mice were evaluated in two animal experiments. RNA‐seq and western blot revealed that PAL significantly improved IL‐17, TNF, and NF‐kappa B inflammation‐related signaling pathways. Further hub gene prediction and experimental validation revealed that PAL modulated the STAT1/CXCL10 axis, thereby exerting attenuation of CAG through the regulation of IL‐17, TNF‐α, and p‐p65 expression. In conclusion, PAL was proposed to mitigate MNNG‐induced CAG, potentially through the inhibition of oxidative stress and inflammatory responses via the STAT1/CXCL10 axis. This approach is an effective complement to the use of PAL in the treatment of CAG.
Developing Cultural Awareness in Nursing Students Using a Multimodal Strategy
Authors: Pool Natalie , Gryskiewicz Courtney , Dunemn Kathleen N.
Published: September 2024

Cultural awareness is linked with improved patient outcomes across populations but can be challenging for nurse educators to teach. The purpose of this study was to evaluate the impact of a multimodal strategy for increasing cultural awareness in prelicensure nursing students using a quasi-experimental, mixed-methods design. Following implementation of curricular revisions, analysis of the Cultural Competence Self-Assessment Checklist was completed for a sample of 106 students. Results were statistically significant across all areas and analysis of reflective writing resulted in three major themes. Designing cultural awareness learning activities should be a major focus of nurse educators.
Best Practices in Telecritical Care: Expert Consensus Recommendations From the Telecritical Care Collaborative Network
Authors: Scott Benjamin K. , Singh Jaspal , Hravnak Marilyn , Everhart Sonia S. , Armaignac Donna Lee , Davis Theresa M. , Goede Matthew R. , Haranath Sai Praveen , Kordik Christina M. , Laudanski Krzysztof , Pappas Peter A. , Patel Subhash , Rincon Teresa A. , Scruth Elizabeth A. , Subramanian Sanjay , Villanueva Israel , Williams Lisa-Mae , Wilson Rodney , Pamplin Jeremy C.
Published: September 2024

OBJECTIVES:

Telecritical care (TCC) refers to the delivery of critical care using telehealth technologies. Despite increasing utilization, significant practice variation exists and literature regarding efficacy remains sparse. The Telecritical Care Collaborative Network sought to provide expert, consensus-based best practice recommendations for the design and delivery of TCC.

DESIGN:

We used a modified Delphi methodology. Following literature review, an oversight panel identified core domains and developed declarative statements for review by an expert voting panel. During three voting rounds, voters agreed or disagreed with statements and provided open-ended feedback, which the oversight panel used to revise statements. Statements met criteria for consensus when accepted by greater than or equal to 85% of voters.

SETTING/SUBJECTS:

The oversight panel included 18 multidisciplinary members of the TCC Collaborative Network, and the voting panel included 32 invited experts in TCC, emphasizing diversity of discipline, care delivery models, and geography.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We identified ten core domains: definitions/terminology; care delivery models; staffing and coverage models; technological considerations; ergonomics and workplace safety; licensing, credentialing, and certification; trust and relationship building; quality, safety, and efficiency, research agenda; and advocacy, leading to 79 practice statements. Of 79 original statements, 67 were accepted in round 1. After revision, nine were accepted in round 2 and two in round 3 (two statements were merged). In total, 78 practice statements achieved expert consensus.

CONCLUSIONS:

These expert consensus recommendations cover a broad range of topics relevant to delivery of TCC. Experts agreed that TCC is most effective when delivered by care teams with specific expertise and by programs with explicit protocols focusing on effective communication, technical reliability, and real-time availability. Interventions should be tailored to local conditions. Although further research is needed to guide future best practice statements, these results provide valuable and actionable recommendations for the delivery of high-quality TCC.
Lymphomatoid Papulosis Type D in a Mestizo-Ancestry Man
Authors: Villegas-González Sofía Saraí , Gómez Nadia , Magaña Mario
Published: September 2024

Lymphomatoid papulosis (LyP) belongs to the CD30+ skin lymphoproliferative disorders; it is defined as a chronic, recurrent, self-healing eruption of papules and small nodules with the histopathologic features of a cutaneous T-cell lymphoma. It is classified according to histopathology into subtypes A to F and with chromosomal rearrangement 6p25.3. Type D is characterized by epidermotropism of atypical CD8+ and CD30+ lymphocytes, small to medium size, forming papules and nodules with erosion and necrosis, which represents a formidable challenge in the differential diagnosis with aggressive cutaneous cytotoxic lymphomas. We present the clinical case of a 22-year-old man with subacute dermatosis, who underwent a skin biopsy with a report of LyP. Immunohistochemistry showed negative CD4, CD5, granzyme-B markers and positive CD3, CD30, CD8, CD56, and (T-cell intracellular antigen 1) TIA-1 markers, concluding the diagnosis of type D LyP. The course of the disease is recurrent; however, the prognosis is good with a 10-year survival of 100%. We present the case of a mestizo-ancestry patient who developed a type-D LyP, and, to the best of our knowledge, there are no publications of type D LyP from Latin-American authors or about mestizo-ancestry (or hispanic) patients; therefore, we consider of relevance to inform about these findings.
Finger SBP measurement as a way to manage hypertension in patients with markedly calcified arteries: a case report
Authors: Hamdan Rémy , Baldassini Anne-Laure , Vilcan Alice , Alan Guillaume , Ighilkrim Karine , Gauchon-Rousseau Célia , Du Besset Anne-Claire
Published: September 2024

Overestimation of blood pressure (BP) resulting from medial artery calcification (MAC) is a cause of pseudoresistant hypertension. In this condition, there is no noninvasive way to reliably assess the BP. We report the case of a 62-year-old man who had a four-limb MAC, hypertension despite five antihypertensive molecules, and significant orthostatic hypotension following the addition of the fifth drug. Hypotension symptoms resolved after discontinuation of two treatments. Subsequently, measurement of finger SBP (FSBP) by laser Doppler flowmeter (LDF) was used to estimate upper-limb SBP. While the brachial SBP was greater than 170 mmHg, the FSBP was always less than 140 mmHg. In the absence of upper-limb artery disease, by evidencing the discrepancy between FSBP and brachial SBP, LDF-obtained FSBP could be a reliable tool to ascertain pseudohypertension and monitor the antihypertensive treatment.
Nailfold videocapillaroscopy as a non-invasive tool for the assessment of peripheral microangiopathy in cardiovascular diseases
Authors: Baroutidou Amalia , Arvanitaki Alexandra , Pagkopoulou Eleni , Anyfanti Panagiota , Ziakas Antonios , Kamperidis Vasileios , Giannakoulas George , Dimitroulas Theodoros
Published: September 2024

Cardiovascular disease (CVD) remains the main cause of morbidity and mortality worldwide. Accumulating evidence supports the presence of endothelial and microvascular dysfunction in CVD, which can be assessed using several methods in peripheral organs and tissues. Naifold videocapillaroscopy (NVC) is an established, noninvasive, easily applicable technique for the assessment of peripheral microcirculation. There is limited capillaroscopic data in the field of CVD, though, and the diagnostic or possible prognostic significance of the capillaroscopic alterations in this population is still a matter of research. This review aims to summarize the current knowledge on the capillaroscopic findings in patients with cardiovascular risk factors or established atherosclerotic and nonatherosclerotic CVD, focusing on the possible correlations of these alterations with clinical and laboratory markers of cardiac function.
Reproducibility of daytime hypertension, night-time hypertension, and nocturnal blood pressure dipping patterns in young to middle age patients with stage 1 hypertension
Authors: Palatini Paolo , Battista Francesca , Mos Lucio , Rattazzi Marcello , Ermolao Andrea , Vriz Olga , Mazzer Adriano , Saladini Francesca
Published: September 2024

Objective:

To investigate the reproducibility of ambulatory BP sub-periods and nocturnal dipping phenotypes assessed twice 3 months apart in young-to-middle-age untreated individuals screened for stage 1 hypertension.

Design and methods:

We investigated 1096, 18-to-45-year old participants from the HARVEST. Their office BP was 145.8 ± 10.4/93.7 ± 5.7 mmHg. Office BP and 24 h BP were measured at baseline and after 3 months. Office, 24-h, daytime and night-time hypertensions, and nocturnal dipping patterns were defined according to the 2023 ESH guidelines. Between-recording agreement was evaluated with kappa statistics.

Results:

Reproducibility evaluated with weighted kappa was moderate for both 24 h hypertension (K = 0.48) and daytime hypertension (K = 0.50) and was only fair for night-time hypertension (K = 0.36). Between-measurement agreement was even worse for isolated night-time hypertension (K = 0.24), and was poor for office hypertension (K = 0.14). The better reproducibility of daytime than night-time period was confirmed by the analysis of BP as continuous variable (all between-period differences, P < 0.001). Nondipping was present in 31.8%, and showed a fair agreement (K = 0.28,). Poorer agreement was shown by extreme dipping (K = 0.18) and reverse dipping (K = 0.07).

Conclusions:

These data show that within the ambulatory sub-periods, daytime hypertension has a better reproducibility than night-time hypertension. This suggests that the better association with adverse outcomes shown by sleep BP compared to wake BP in observational studies is not due to a better reproducibility of the former. The between-measurement agreement is even worse for isolated nocturnal hypertension and dipping patterns, especially for extreme and reverse dipping. Thus, these BP phenotypes should be confirmed with repeat ambulatory BP monitoring.
Impact of changes in left heart geometry on predicting new-onset atrial fibrillation in patients with hypertension
Authors: Kim Hyue Mee , Hwang In-Chang , Park Jiesuck , Choi Hye Jung , Choi Hong-Mi , Yoon Yeonyee E. , Cho Goo-Yeong
Published: September 2024

Background:

Hypertension-induced left ventricular hypertrophy (LVH) increases end-diastolic LV pressure and contributes to left atrial enlargement (LAE), which are associated with development of atrial fibrillation. However, the impact of LVH and LAE and their regression following antihypertensive therapy on atrial fibrillation incidence remains unclear.

Methods:

This retrospective analysis included consecutive patients with sinus rhythm who underwent echocardiography at hypertension diagnosis and after 6–18 months between 2006 and 2021 at tertiary care centres in Korea. LVH was defined as LV mass index greater than 115 g/m2 (men) and greater than 95 g/m2 (women), and LAE was defined as LA volume index greater than 42 ml/m2. The occurrence of new-onset atrial fibrillation (NOAF) was assessed in relation to changes in LVH and LAE status.

Results:

Among the 1464 patients included, 163 (11.1%) developed NOAF during a median 63.8 [interquartile range (IQR) 35.9–128.5] months of surveillance period. New-onset LVH [adjusted hazard ratio (aHR) 1.88, 95% confidence interval (CI) 1.20–2.94, P = 0.006] and LAE (aHR 1.89, 95% CI 1.05–3.40, P = 0.034) were significant predictors of NOAF. Conversely, regression of LVH (aHR 0.51, 95% CI 0.28–0.91, P = 0.022) or LAE (aHR 0.30, 95% CI 0.15–0.63, P = 0.001) was associated with a reduced risk for developing NOAF. Patients with both LVH and LAE at follow-up echocardiography had a higher risk for NOAF (aHR 4.30, 95% CI 2.81–6.56, P < 0.001) than those with either LVH or LAE or those with neither.

Conclusion:

The changes in left heart geometry can serve as a predictive marker for NOAF in patients with hypertension.
INTRAVITREAL METHOTREXATE INJECTION FOR THE TREATMENT AND PREVENTION OF PROLIFERATIVE VITREORETINOPATHY
Authors: Hughes Patrick J. , Bhagat Neelakshi , Gonzalez-Martinez Orlando G. , Zarbin Marco A.
Published: September 2024

Purpose:

To report on our experience using intravitreal methotrexate (MTX) in patients with retinal detachment associated with proliferative vitreoretinopathy and/or open globe injury.

Methods:

This study performed a retrospective chart review of a consecutive series of 21 eyes of 21 patients who underwent serial intravitreal MTX injection for treatment and/or prevention of proliferative vitreoretinopathy from December 2021 to January 2024.

Results:

Twenty-one patients underwent pars plana vitrectomy, membrane peeling, laser photocoagulation, silicone oil infusion, and intravitreal MTX injection. Postoperatively, all eyes received a series of intravitreal MTX (400 μg/0.1 mL) injections. Optimally, injections were administered weekly for 8 weeks and every 2 weeks for four weeks for a total of 13 injections, beginning intraoperatively at the conclusion of retinal reattachment surgery. Mean baseline preoperative and postoperative visual acuity was logarithm of the minimum angle of resolution 3.2 (approximately hand motions vision) and 2.5 (between CF and hand motions vision), respectively, yielding an average improvement in visual acuity of 0.7 logarithm of the minimum angle of resolution units (0 ETDRS lines/letters). These 21 patients received an average of 10.5 injections. With a single operation, detachments in 19 (90%) of 21 eyes were successfully reattached. Corneal epithelial defects were noted in 7 (33%) of 21 patients.

Conclusion:

Serial intravitreal MTX injection was associated with 90% single operation retinal reattachment rate in the setting of retinal detachment with proliferative vitreoretinopathy or retinal detachment at high risk of proliferative vitreoretinopathy.
Expert Consensus on the Clinical Application of Oral Small-molecule Antiviral Drugs Against COVID-19
Authors:   Society of Bacterial Infection and Resistance of Chinese Medical Association, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine
Published: September 2024

Although COVID‑19 no longer constitutes a “public health emergency of international concern”, which still has being spreading around the world at a low level. Small molecule drugs are the main antiviral treatment for novel coronavirus recommended in China. Although a variety of small‑molecule antiviral drugs against COVID‑19 have been listed in China, there is no specific drug recommendation for special populations. Society of Bacterial Infection and Resistance of Chinese Medical Association, together with the National Clinical Research Center for Respiratory Disease, and the National Center for Respiratory Medicine, organized domestic experts in various fields such as respiratory, virology, infection, critical care, emergency medicine and pharmacy to release Expert Consensus on the Clinical Application of Oral Small‑Molecule Antiviral Drugs against COVID‑19. The main content of this consensus includes the introduction of seven small‑molecule antiviral drugs against COVID‑19, focusing on the drug recommendations for 14 special groups such as the elderly, patients with complicated chronic diseases, tumor patients, pregnant women, and children, and providing suggestions for clinicians to standardize drug use.

Practice guideline registration:

International Practice Guideline Registration for Transparency (PREPARE-2023CN617)
Characteristics and Risk Factors of Infections among Patients with Autoimmune Bullous Diseases: A Retrospective Single-Center Study in China
Authors: Zhou Feiran , Zheng Xiaoping , Yang Yixuan , Yang Qingluan , Zhou Jingyu , Xu Haoxin , Luo Xiaoqun , Shao Lingyun , Zhang Wenhong , Li Zhonghua , Ruan Qiaoling
Published: September 2024

Background:

Since infections can lead to adverse outcomes in autoimmune bullous diseases (AIBD), this study aimed to analyze infection characteristics in AIBD, predict infection risk factors and provide probable suggestions to infection prevention, which will spot a light on early discovery and prevention of infections in AIBD patients.

Methods:

This is a retrospective study of the medical records of inpatients diagnosed with AIBD at the Department of Infectious Diseases and Dermatology, Huashan Hospital from January 2017 to December 2021. We collected patients’ clinical manifestations and laboratory examination results. Risk factors for infections were evaluated using multivariate logistic regression.

Results:

A total of 263 AIBD patients were included in the study. The overall incidence of infection was 42.2% (111/263). Pemphigus had a higher infection rate (74/142, 52.1%) than bullous pemphigoid (37/121, 30.6%). Among the patients with infections, 49.5% (55/111) had bacterial infections, 13.5% (15/111) had fungal infections, 2.7% (3/111) had virus infections, and 34.2% (38/111) had mixed infections. Staphylococcus aureus and Candida were the most common pathogens in localized infections, while Cryptococcus and Candida were predominant in systemic infections. In the multivariate logistic model, pemphigus (odds ratio [OR] = 2.56, 95% confidence interval [CI] 1.41–4.63), hypoalbuminemia (OR = 3.78, 95% CI 1.68–8.50), and systemic glucocorticoid treatment (OR = 4.67, 95% CI 2.51–8.68) were independent risk factors for infection in AIBD patients. Bullous pemphigoid (OR = 3.99, 95% CI 1.03–15.45), high-dose (average > 24 mg/day) compared to low-dose (average ≤ 6 mg/day) and medium-dose (average 6–24 mg/day) systemic glucocorticoid treatment (OR = 19.31, 95% CI 3.32–112.28, and OR = 5.71, 95% CI 1.37–23.79) were associated with increased risk factors of systemic infection in AIBD patients with systemic glucocorticoid treatment. A methylprednisolone dose averaging 14 mg/day over the past three months had a 75.0% positive predictive value for infections in AIBD patients.

Conclusions:

The incidence of infection in AIBD patients is high, with a broad spectrum of pathogens and infection locations. AIBD patients undergoing systemic glucocorticoid treatment, especially those receiving high doses in the previous three months, should be cautious about infection.
Comparison of clinical outcomes in women with surgically treated early primary cervical cancer: Lymphadenectomy versus sentinel lymph node biopsy
Authors: Ting Wan-Hua , Chen Hui-Hua , Hsieh Shu-Wei , Wei Ming-Chow , Hsiao Sheng-Mou
Published: September 2024

Background:

The primary objective of this study was to elucidate the impact of sentinel lymph node (SLN) mapping and biopsy techniques on the clinical outcomes of women with early primary cervical cancer.

Methods:

All consecutive women with clinically determined stage I-IIA cervical cancer who underwent lymph node assessment with either SLN mapping or conventional pelvic/para-aortic lymphadenectomy were reviewed.

Results:

Women in the SLN group (n=33) had fewer total dissected pelvic nodes (8.3±5.9 versus 17.4±7.7, p<0.001), less intraoperative blood loss (513±332mL versus 1228±1170mL, p<0.001), a shorter length of hospital stay (7.1±2.4 versus 10.2±6.1 days, p=0.004) and a trend toward a lower incidence of lymphocysts (3% versus 14%, p=0.090) than women in the conventional lymphadenectomy group (n=74). The rates of recurrence-free survival (3-year: 87.6% vs. 82.9%) and overall survival (3-year: 100% vs. 91.0%) did not differ between the SLN group and the conventional lymphadenectomy group (p=0.846 and p=0.254, respectively).

Conclusion:

SLN biopsy does not seem to be associated with an inferior survival outcome compared with conventional lymphadenectomy in women with early primary cervical cancer. In addition, it is associated with less blood loss and a shorter length of hospital stay.