bluuebunny/crossref_metadata_2025 huggingface dataset:
Two cases of spontaneous rupture of the uterine artery in the perinatal period: A case report
Authors: Hu Lingyun , Ning Jing , Li Li’an , Lu Yanping , You Yanqin
Published: May 2023

Rationale:

Uterine artery spontaneous rupture is a rare but potentially life-threatening complication during pregnancy and puerperium. The lack of typical symptoms makes it difficult to diagnose, which can result in serious consequences for both the mother and fetus.

Patient concerns:

Case 1 presented with fainting and lower abdominal discomfort, while Case 2 developed hypotension after delivery and remained in poor condition even after rehydration.

Diagnoses:

Both cases were diagnosed with uterine artery spontaneous rupture, with intraoperative findings revealing ruptures in different branches of the uterine artery.

Interventions:

Both cases underwent surgical interventions, with laparoscopic surgery performed in Case 1 and repair of the ruptured artery in Case 2.

Outcomes:

Both cases had successful outcomes, with the ruptured arteries repaired and the patients discharged from the hospital within a week after surgery.

Lessons:

Uterine artery spontaneous rupture is a rare but potentially life-threatening complication that may present with atypical symptoms. Early diagnosis and prompt surgical intervention are crucial in preventing serious complications for both the mother and fetus. Clinicians should maintain a high level of suspicion for this condition when evaluating patients presenting with unexplained symptoms or signs of peritoneal irritation during pregnancy and puerperium.
Case series: Primary aldosteronism diagnosed despite normal screening investigations: A report of three cases
Authors: Jia Minyue , Lin Liya , Yu Hanxiao , Yang Boyun , Xu Xiaohong , Song Xiaoxiao
Published: May 2023

Rationale:

Since the introduction of the aldosterone-to-renin ratio (ARR) as a screening tool for primary aldosteronism (PA), there has been a marked increase in the reported prevalence of this condition among hypertensive, even normotensive, subjects.

Patient concerns:

But ARR as a spot blood draw for estimating a patient’s aldosterone secretory status is influenced by many factors.

Diagnoses:

Here, we describe a series of patients with biochemically confirmed PA, whose diagnosis was delayed by the initial ARR assessment with non-suppressed renin.

Interventions:

Patient 1 had a history of resistant hypertension for many years and had a negative initial screening for secondary hypertension (including ARR). At the reevaluation, ARR was close to cutoff still with normal renin after strict and extended drug washout, and the further workup for PA demonstrated a unilateral aldosterone producing adenoma that was surgically removed, with subsequent complete biochemical remission and partial clinical success. Patient 2 was diagnosed with idiopathic hyperaldosteronism combined with obstructive sleep apnea syndrome, which could increase renin resulting in a negative ARR, and finally got a better treatment effect with PA-specific spironolactone, as well as continuous positive airway pressure. Patient 3 with hypokalemia as the main presentation was finally diagnosed with PA after excluding other diseases, and proceeded to laparoscopic adrenalectomy and histologically confirmed an aldosterone producing adenoma. Postoperatively, patient 3 achieved complete biochemical success without any medicine.

Outcomes:

The clinical status of all three patients was effectively managed, resulting in either complete resolution or notable improvement of their respective conditions.

Lessons:

After rigorous standardized diagnostic evaluation, there are still many reasons for ARR negative in PA, but they all basically occur in the background of normal or normal-high renin without suppression. A negative screening test result should be repeated and analyzed carefully if this is not consistent with the clinical picture. If, despite a repeatedly negative ARR, clinical suspicion remains high, we recommend consideration of further evaluation, including confirmatory tests and adrenal venous blood sampling (AVS) or even 68Ga-pentixafor PET/CT to better confirm the diagnosis and improve patient outcomes.
Positive lymph node ratio as a prognostic factor for gastric cancer patients: Is it going to supersede positive lymph node number in guidelines?
Authors: Çapkinoğlu Emir , Tufan Aydin Eray , Ömeroğlu Sinan , Tanal Mert , Güven Onur , Demir Uygar
Published: May 2023

Gastric malignancies constitute the sixth most common cancer with regards to incidence and have the fifth most mortality rates. Extended lymph-node dissection is the surgical modality of choice while treating advanced stage gastric cancer. It is yet a topic of debate, whether or not the amount of positive lymph nodes after a pathological examination following the surgical intervention is of prognostic value. In this study, it is aimed to evaluate the prognostic significance of positive lymph nodes following the surgery. A total of 193 patients who underwent curative gastrectomy between January 2011 and December 2015 have been considered for a retrospective data collection. The cases with R1-R2 resections, palliative or emergent surgeries are excluded. Metastatic to total number of lymph nodes, corresponded a ratio which was analyzed in this survey and practiced as a predictive parameter of disease outcome. This survey includes 138 male (71.5%) and 55 female (28.5%) patients treated between 2011 and 2015 in our clinic. The survey follow-up duration of the cases range between 0, 2, and 72 months, corresponding an average of 23.24 ± 16.99 months. We calculated cutoff value of 0.09 with, sensitivity is 76.32% for positive to total number of lymph nodes ratio, whereas specivity applies for 64.10%, positive predictive value for 58% and negative predictive value for 80.6%. Positive lymph node ratio has a prognostic value in terms of predicting the prognosis of the patients with gastric adenocarcinoma following a curative gastrectomy. This might in long term contribute to the prognostic analysis of patients if integrated in the current staging system.
An analysis of risk factors for clinically relevant pancreatic fistulas after laparoscopic pancreaticoduodenectomy
Authors: Chen Guoli , Zheng Zhifang , Yi Haizhao , Yue Qiuju , Li Lijie
Published: May 2023

This study aimed to explore the risk factors of clinically relevant pancreatic fistulas (PF) after laparoscopic pancreaticoduodenectomy (LPD). The clinical data of 80 patients who underwent pancreaticoduodenectomy in our hospital were retrospectively analyzed. The potential risk factors for PF after LPD were determined using univariate and multivariate logistic regression analyses. Results from the univariate analyses showed that the pancreatic duct diameter (P < .001), pancreatic texture (P < .001), abdominal infection (P = .002), and reoperation (P < .001) were associated with clinically relevant PF. Results from the multivariate logistic regression analysis showed that the pancreatic duct diameter (P = .002) and pancreatic texture (P = .016) were significant risk factors for clinically relevant PF. Based on this study, the pancreatic duct diameter and pancreatic texture are independent risk factors for clinically relevant PF after LPD.
Sleep quality after stroke: A systematic review and meta-analysis
Authors: Luo Ye , Yu Guofeng , Liu Yuanfei , Zhuge Chengjun , Zhu Yinge
Published: May 2023

Background:

Sleep-related problems are debilitating and long-lasting conditions in individuals with stroke. We aimed to estimate the prevalence of poor sleep quality after stroke by conducting a systematic review and meta-analysis.

Methods:

Five databases (PubMed, Embase, Web of Science, Scopus, and CINHAL) were searched for literature published before November 2022. Studies recruiting participants with stroke, using a validated scale to measure sleep quality and in English were included. We used the Agency for Healthcare Research and Quality Scale and Newcastle–Ottawa Scale to assess the quality of eligible studies. Pooled prevalence and subgroup analyses were performed to understand the variation in sleep quality among studies. We followed the PRISMA checklist to report the study.

Results:

Thirteen studies were included for analysis (n = 3886). The pooled prevalence of poor sleep quality was 53% (95% CI 41–65%). Studies using PSQI with a cutoff point of 7 had a prevalence of 49% (95% CI 26–71%), whereas those with a cutoff point of 5 had a higher prevalence of 66% (95% CI 63–69%) (P = .13). Geographical location could explain the prevalence variation between studies. The majority of included studies had a medium level quality of evidence (10/13).

Conclusion:

Poor sleep quality appears to be common in patients with stroke. Considering its negative impact on health, effective measures should be taken to improve their quality of sleep. Longitudinal studies should be conducted to examine the contributing factors and investigate the mechanisms that lead to poor sleep quality.
Asymptomatic Candida glabrata urinary tract infection in an immunocompetent young female: A case report
Authors: Deng Ruixin , Meng Xingye , Li Ruoyu , Wang Aiping , Song Yinggai
Published: May 2023

Introduction:

Fungal urinary tract infections (UTIs) are becoming increasingly common in hospitalized patients and Candida species are the most prevalent organisms. However, recurrent candiduria in young healthy outpatients is rare thus require further examination to find the etiologic factors.

Case presentation:

We described a case of recurrent asymptomatic c caused by azole-resistant C. glabrata in a healthy young female who only had previous use of antibiotics without other risk factors. However, after removal of the predisposing factor and the use of sensitive antifungal agents, the patient’s urine cultures remained positive. This phenomenon indicated to us that the patient might have an immune-related genetic deficiency. We found a novel caspase-associated recruitment domain-containing protein 9 (CARD9) gene mutation (c.808-11G > T) which might be the cause of recurrent asymptomatic candiduria in this immune-competent young female without any underlying diseases.

Conclusions:

We report a case of recurrent asymptomatic candiduria caused by azole-resistant Candida glabrata in a young healthy female with a novel CARD9 mutation. A functional study of this mutation should be performed in the future to determine its effect on asymptomatic fungal UTIs.
Rare perivascular epithelial cell tumor of the colon 18F-FDG PET/CT imaging: A case report
Authors: Chen Qianqian , Wang Peiqi , Zhang Xiao , Zhang Jinhe
Published: May 2023

Rationale:

Neoplasms with perivascular epithelioid cell differentiation (PEComas) are mesenchymal tumors that rarely occur in the colon. Here, we report the occurrence of a malignant PEcoma in the colon using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).

Patient concerns:

A 55-year-old woman was admitted to the hospital with abdominal pain for 10 days and a self-induced abdominal mass for 3 days. 18F-FDG PET/CT imaging showed a large hypermetabolic nodule and mass in the right mid-upper abdomen with heterogeneous density and a further increase in metabolism on the delayed scan.

Diagnoses:

PEComa of the colon.

Interventions:

Tumor resection was performed.

Outcomes:

The patient is well after 2 months of treatment, pending further follow-up.

Lessons:

Malignant perivascular epithelioid cell tumors originating in the colon are extremely rare, and our report suggests that PEComa should be considered as a differential diagnosis for 18F-FDG gastrointestinal malignancies. Additionally, 18F-FDG PET/CT may play a key role in the staging and extent of lesions in intestinal malignancies.
1-hour versus 3-hour 99mTc-PYP imaging to evaluate suspected cardiac transthyretin amyloidosis
Authors: Nichols Kenneth J. , Yoon Se-Young , Van Tosh Andrew , Palestro Christopher J.
Published: May 2023

The diagnosis of cardiac transthyretin amyloidosis can involve early or delayed 99mTc-pyrophosphate planar, single photon emission computed tomography (SPECT), and/or SPECT/CT imaging. We investigated whether image interpretations differed among modalities and time points. In this observational study, data were reviewed for 173 patients with suspected transthyretin amyloidosis who underwent planar and SPECT/CT 1 and 3 hours after radiopharmaceutical injection. Planar heart-to-contralateral lung ratios were calculated. Myocardial-to-rib uptake was independently scored on SPECT and SPECT/CT as follows: 0 (negative), 1 < rib (equivocal), 2 = rib (positive), or 3 > rib (positive), and the image quality was as follows:1 (poor), 2 (adequate), and 3 (good). Three-hour SPECT/CT readings were used as the reference standard against which the other readings were compared. Twenty-five percent of patients were positive (3-hour SPECT/CT score ≥ 2). Compared to 3-hour SPECT/CT readings, there was “fair agreement” (κ = .27 − .33) with SPECT, and “fair agreement” (κ = .23 − .31) with planar imaging at 1 and 3 hours. More patients had abnormal SPECT and SPECT/CT than planar imaging (24–25% vs 16–17%, P < .007). There were more equivocal cases for 1 and 3 hours planar imaging than for 1 and 3 hours SPECT (71–73% vs 23–26%, P < .001) and 1 and 3 hours SPECT/CT (3–5%, P < .001). SPECT/CT image quality was higher at 3 hours than at 1 hour and higher than that on SPECT (P = .001). Three-hour SPECT/CT readings provided the highest number of definitive readings, had the highest image quality, and constituted the preferred protocol for evaluating unselected populations of patients that have a clinical suspicion of possible cardiac amyloidosis.
How proximal femur fracture patients aged 65 and older fare in survival and cause of death 5+ years after surgery: A long-term follow-up
Authors: Hashimoto Kazuhiko , Shinyashiki Yu , Ohtani Kazuhiro , Kakinoki Ryosuke , Akagi Masao
Published: May 2023

Although the incidence of proximal femur fractures (PFFs) is increasing, few detailed reports on associated long-term outcomes and causes of death exist. We aimed to evaluate long-term outcomes and causes of death ≥5 years after surgical treatment of PFFs. This retrospective study included 123 patients (18 males, 105 females) with PFFs treated at our hospital between January 2014 and December 2016. Cases (median age: 90 [range, 65–106] years) comprised 38 femoral neck fractures (FNFs) and 85 intertrochanteric fractures (IFs). Surgical procedures included bipolar head arthroplasty (n = 35), screw fixation (n = 3), and internal fixation with nails (n = 85). The mean post-surgical follow-up time was 58.9 (range, 1–106) months. Surveyed items included survival (1 vs 5 years; sex; age, >90 vs <90 years; IF vs FNF), comorbidities, waiting time after the injury (died vs survived), operative time (proximal femoral nail antirotations [PFNA] vs FNF, died vs Survived), blood loss (PFNA vs FNF; died vs survived), and cause of death (IF vs FNF; <1 vs >1 year). Among all patients, 83.7% had comorbidities (IF, 90.5%; FNF, 81.5%). Among patients who died and survived, 89.1% and 80.5% had comorbidities, respectively. The most common comorbidities were cardiac (n = 22), renal (n = 10), brain (n = 8), and pulmonary (n = 4) diseases. Overall survival (OS) rates at 1 and 5 years were 88.9% and 66.7%, respectively. Male/female OS rates were 88.8%/88.3% and 66.6%/66.6% (P = .89) at 1 and 5 years, respectively. OS rates for the <90/≥90 age groups were 90.1%/76.7% and 75.3%/53.4 (P < .01) at 1 and 5 years, respectively. The 1- and 5-year OS (IF/FNF) rates were 85.7%/88.8% and 60%/81.5%, respectively; patients with IFs had significantly lower OS than those with FNFs at both timepoints (P = .015). There was a marked difference in the operative time between died (43.5 ± 24.0: mean ± S.D.) and survived (60 ± 24.4: mean ± S.D.) patients. The main causes of death were senility (n = 10), aspiration pneumonia (n = 9), bronchopneumonia (n = 6), worsening heart failure (n = 5), acute myocardial infarction (n = 4), and abdominal aortic aneurysm (n = 4). Overall, 30.4% of the cases were related to comorbidities and related causes (e.g., hypertension-related ruptured large abdominal aneurysm). Managing comorbidities may improve long-term postoperative outcomes of PFF treatment.
County-level Factors and Treatment Access Among Insured Women With Opioid Use Disorder
Authors: Leech Ashley A. , McNeer Elizabeth , Stein Bradley D. , Richards Michael R. , McElroy Tamarra , Dupont William D. , Patrick Stephen W.
Published: May 2023

Background:

An over 40% increase in overdose deaths within the past 2 years and low levels of engagement in treatment call for a better understanding of factors that influence access to medication for opioid use disorder (OUD).

Objective:

To examine whether county-level characteristics influence a caller’s ability to secure an appointment with an OUD treatment practitioner, either a buprenorphine-waivered prescriber or an opioid treatment program (OTP).

Research Design and Subjects:

We leveraged data from a randomized field experiment comprised of simulated pregnant and nonpregnant women of reproductive age seeking treatment for OUD among 10 states in the US. We employed a mixed-effects logistic regression model with random intercepts for counties to examine the relationship between appointments received and salient county-level factors related to OUD.

Measures:

Our primary outcome was the caller’s ability to secure an appointment with an OUD treatment practitioner. County-level predictor variables included socioeconomic disadvantage rankings, rurality, and OUD treatment/practitioner density.

Results:

Our sample comprised 3956 reproductive-aged callers; 86% reached a buprenorphine-waivered prescriber and 14% an OTP. We found that 1 additional OTP per 100,000 population was associated with an increase (OR=1.36, 95% CI: 1.08 to 1.71) in the likelihood that a nonpregnant caller receives an OUD treatment appointment from any practitioner.

Conclusions:

When OTPs are highly concentrated within a county, women of reproductive age with OUD have an easier time securing an appointment with any practitioner. This finding may suggest greater practitioners’ comfort in prescribing when there are robust OUD specialty safety nets in the county.
Identification and Prognostic Effect of Extramural Venous Invasion in Locally Advanced Esophageal Squamous Cell Carcinoma
Authors: Lin Zhen , Plukker John T.M. , Tian Dong-ping , Chen Shao-bin , Kats-Ugurlu Gursah , Su Min
Published: May 2023

The role of extramural venous invasion (EMVI) in esophageal cancer is still unclear. This study aimed to identify EMVI and assess its impact on survival and recurrences in esophageal squamous cell carcinoma (ESCC). Retrospectively, we reviewed resection specimens of 147 locally advanced ESCC (pT3-T4aN0-3M0) patients who had a curative intended surgery alone at the Cancer Hospital of Shantou University from March 2009 to December 2013. After confirming pT≥3 in hematoxylin-eosin tumor slides, EMVI was evaluated by Verhoeff and Caldesmon staining. The impact of EMVI with other clinicopathological characteristics and survival were analyzed using the χ2 test, Cox regression, and Kaplan-Meier method. EMVI was present in 30.6% (45/147) of the P≥T3 ESCCs and associated with lymph-vascular invasion and poor differentiation grade (P<0.05). Disease-free survival and overall survival in patients with EMVI-absent tumors were about 2.0 times longer than in those with EMVI-present tumors. In pN0 patients, EMVI-presence was associated with poor overall survival (HR 4.829, 95% CI 1.434–16.26, P=0.003) and Disease-free Survival (HR 4.026, 95% CI 0.685–23.32, P=0.018). In pN1-3 patients, EMVI had no additional effect on survival. Conclusions EMVI has an independent adverse prognostic effect on survival in ESCC patients after surgery alone. EMVI should be included in pathology reports as it might contribute to identify high-risk patients for potential additional treatment.
International Society of Urological Pathology Consensus Conference on Current Issues in Bladder Cancer. Working Group 4
Authors: Warrick Joshua I. , Al-Ahmadie Hikmat , Berman David M. , Black Peter C. , Flaig Thomas W. , Höglund Mattias , Bubendorf Lukas , van der Kwast Theodorus H. , Cheng Liang ,   the Members of the ISUP Bladder Tumor Consensus Panel
Published: May 2023

Molecular subtyping has been a major focus of bladder cancer research over the past decade. Despite many promising associations with clinical outcomes and treatment response, its clinical impact has yet to be defined. As part of the 2022 International Society of Urological Pathology Conference on Bladder Cancer, we reviewed the current state of the science for bladder cancer molecular subtyping. Our review included several different subtyping systems. We derived the following 7 principles, which summarize progress and challenges of molecular subtyping: (1) bladder cancer has 3 major molecular subtypes: luminal, basal-squamous, and neuroendocrine; (2) signatures of the tumor microenvironment differ greatly among bladder cancers, particularly among luminal tumors; (3) luminal bladder cancers are biologically diverse, and much of this diversity results from differences in features unrelated to the tumor microenvironment, such as FGFR3 signaling and RB1 inactivation; (4) molecular subtype of bladder cancer associates with tumor stage and histomorphology; (5) many subtyping systems include idiosyncrasies, such as subtypes recognized by no other system; (6) there are broad fuzzy borders between molecular subtypes, and cases that fall on these fuzzy borders are often classified differently by different subtyping systems; and (7) when there are histomorphologically distinct regions within a single tumor, the molecular subtypes of these regions are often discordant. We reviewed several use cases for molecular subtyping, highlighting their promise as clinical biomarkers. Finally, we conclude that data are currently insufficient to support the routine use of molecular subtyping to guide bladder cancer management, an opinion shared with the majority of conference attendees. We also conclude that molecular subtype should not be considered an “intrinsic” property of a tumor but should instead be considered the result of a specific laboratory test, performed using a specific testing platform and classification algorithm, validated for a specific clinical application.
Dashboards as Mechanisms for Community Empowerment: Developing a Prototype for Child and Adolescent Well-being in California
Authors: Anderson Nathaniel W. , Russ Shirley A. , Eisenberg Daniel , Halfon Neal
Published: May 2023

Context:

In recent years, stakeholders in public health have emphasized measuring young peoples' well-being as a more holistic and upstream approach to understanding their health and development. However, summarizing the available indicators of well-being in ways that strengthen ongoing policy and community efforts remains a challenge.

Program:

Our objective was to develop a measurement framework of young peoples' well-being that would be engaging and actionable to a broad and diverse set of stakeholders in California.

Implementation:

We began with a scan of the relevant literature documenting previous efforts to measure young peoples' well-being, both within the United States and internationally. Subsequently, we individually interviewed a set of key informants and then convened a multidisciplinary panel of experts to solicit feedback on our approach. Throughout this iterative and collaborative process, we developed and refined a measurement framework based on the information provided across these various sources.

Evaluation:

Findings suggest data dashboards are a promising approach for presenting a parsimonious yet holistic picture of young peoples' well-being. Dashboards can highlight well-being's multidimensionality by categorizing indicators over different domains. Our framework organizes indicators over 5 types: child-centric, subjective well-being, contextual determinants, developmental, and equity-focused. The design and flexibility of dashboards can also highlight important gaps in data collection that are of interest to end users such as indicators not yet collected among the broader population. Furthermore, dashboards can include interactive features, such as selecting key data elements, that can help communities articulate priority areas for policy action, thereby generating momentum and enthusiasm for future iterations and improvements.

Discussion:

Data dashboards are well suited for engaging a variety of stakeholders on complex multidimensional concepts such as young peoples' well-being. However, to fulfill their promise, they should be codesigned and codeveloped through an iterative process with the stakeholders and community members they intend to serve.
Understanding Over-immunization in North Dakota's Adult Population
Authors: Dykstra Allison , Woinarowicz Mary , Howell Molly
Published: May 2023

Context:

Over-immunization, or administration of excess doses of vaccine, is an understudied topic in immunization. Adult over-immunization is particularly understudied, so building a basic understanding of the sources and scope of over-immunization is necessary to direct action.

Objective:

The aim of this evaluation was to quantify the extent of over-immunization in North Dakota's adult population from 2016 to 2021.

Design:

Records for all pneumococcal, zoster, and influenza vaccines administered to adults in North Dakota were extracted from the North Dakota Immunization Information System (NDIIS) from January 1, 2016, through December 31, 2021. The NDIIS is a state-wide immunization registry that captures all childhood and most adult immunizations.

Setting:

North Dakota.

Participants:

North Dakotan adults 19 years or older.

Main Outcome Measure:

The number and percentage of adults identified as over-immunized as well as the number and percentage of doses identified as an extra dose.

Results:

Frequency of over-immunization was less than 3% for all vaccines over the 6-year period assessed. Pharmacies and private practices were the most common sources of over-immunization of adults.

Conclusions:

These data show that over-immunization is still an issue in North Dakota, although the percentage of the adult population impacted is low. Reducing over-immunization is worth pursuing but should be balanced with the importance of improving low immunization coverage rates in the state. Improving utilization of the NDIIS by adult providers can help prevent over-immunization and under-immunization alike.
Impact of hepatitis C cure on risk of mortality and morbidity in people with HIV after antiretroviral therapy initiation
Authors: Chalouni Mathieu , Trickey Adam , Ingle Suzanne M. , Sepuvelda Maria Antonia , Gonzalez Juan , Rauch Andri , Crane Heidi M. , Gill M. John , Rebeiro Peter F. , Rockstroh Jürgen K. , Franco Ricardo A. , Touloumi Giota , Neau Didier , Laguno Montserrat , Rappold Michaela , Smit Colette , Sterne Jonathan A.C. , Wittkop Linda
Published: May 2023

Objective:

Hepatitis C virus (HCV) co-infection is associated with increased morbidity and mortality in people with HIV (PWH). Sustained virological response (SVR) decreases the risk of HCV-associated morbidity. We compared mortality, risk of AIDS-defining events, and non-AIDS nonliver (NANL) cancers between HCV-co-infected PWH who reached SVR and mono-infected PWH.

Design:

Adult PWH from 21 cohorts in Europe and North America that collected HCV treatment data were eligible if they were HCV-free at the time of ART initiation.

Methods:

Up to 10 mono-infected PWH were matched (on age, sex, date of ART start, HIV acquisition route, and being followed at the time of SVR) to each HCV-co-infected PWH who reached SVR. Cox models were used to estimate relative hazards (hazard ratio) of all-cause mortality, AIDS-defining events, and NANL cancers after adjustment.

Results:

Among 62 495 PWH, 2756 acquired HCV, of whom 649 reached SVR. For 582 of these, at least one mono-infected PWH could be matched, producing a total of 5062 mono-infected PWH. The estimated hazard ratios comparing HCV-co-infected PWH who reached SVR with mono-infected PWH were 0.29 [95% confidence interval (CI) 0.12–0.73] for mortality, 0.85 [0.42–1.74] for AIDS-defining events, and 1.21 [0.86–1.72] for NANL cancer.

Conclusion:

PWH who reached SVR a short time after HCV acquisition were not at higher risk of overall mortality compared with mono-infected PWH. However, the apparent higher risk of NANL cancers in HCV-co-infected PWH who reached SVR after a DAA-based treatment compared with mono-infected PWH, though compatible with a null association, suggests a need for monitoring of those events following SVR.
Tryptophan metabolism, gut microbiota, and carotid artery plaque in women with and without HIV infection
Authors: Luo Kai , Wang Zheng , Peters Brandilyn A. , Hanna David B. , Wang Tao , Sollecito Christopher C. , Grassi Evan , Wiek Fanua , Peter Lauren St , Usyk Mykhaylo , Post Wendy S. , Landay Alan L. , Hodis Howard N. , Weber Kathleen M. , French Audrey , Golub Elizabeth T. , Lazar Jason , Gustafson Deborah , Sharma Anjali , Anastos Kathryn , Clish Clary B. , Knight Rob , Kaplan Robert C. , Burk Robert D. , Qi Qibin
Published: May 2023

Objective:

The perturbation of tryptophan (TRP) metabolism has been linked with HIV infection and cardiovascular disease (CVD), but the interrelationship among TRP metabolites, gut microbiota, and atherosclerosis remain unclear in the context of HIV infection.

Methods:

We included 361 women (241 HIV+, 120 HIV-) with carotid artery plaque assessments from the Women's Interagency HIV Study, measured ten plasma TRP metabolites and profiled fecal gut microbiome. TRP metabolites-related gut bacteria were selected through the Analysis of Compositions of Microbiomes with Bias Correction method. Associations of TRP metabolites and related microbial features with plaque were examined using multivariable logistic regression.

Results:

While plasma kynurenic acid (KYNA) (odds ratio [OR] = 1.93, 95% confidence interval [CI]:1.12, 3.32 per one SD increase; P = 0.02) and KYNA/TRP (OR = 1.83 [95%CI:1.08, 3.09], P = 0.02) were positively associated with plaque, indole-3-propionate (IPA) (OR = 0.62 [95%CI:0.40, 0.98], P = 0.03) and IPA/KYNA (OR = 0.51[95%CI:0.33, 0.80], P < 0.01) were inversely associated with plaque. Five gut bacterial genera and many affiliated species were positively associated with IPA (FDR-q < 0.25), including Roseburia sp., Eubacterium sp., Lachnospira sp., and Coprobacter sp.; but no bacterial genera were found to be associated with KYNA. Furthermore, an IPA-associated-bacteria score was inversely associated with plaque (OR = 0.47[95%CI:0.28, 0.79], P < 0.01). But no significant effect modification by HIV serostatus was observed in these associations.

Conclusions:

In a cohort of women living with and without HIV infection, plasma IPA levels and related gut bacteria were inversely associated with carotid artery plaque, suggesting a potential beneficial role of IPA and its gut bacterial producers in atherosclerosis and CVD.
Lincoln Sign in a Case of Primary Hyperparathyroidism on 18F-Fluorocholine PET/CT
Authors: Prakash Sneha , Damle Nishikant Avinash , Kumar Praveen , Dharmashaktu Yamini , Bal C.S.
Published: May 2023

Lincoln sign or black beard sign is one of the signs that have been classically described on bone scintigraphy in monostotic Paget disease, when mandible is involved. Extensive involvement of the mandible causes increased radiotracer uptake from one mandibular condyle to the other, resembling a black beard. We present the case of a 14-year-old girl with primary hyperparathyroidism who underwent an 18F-fluorocholine PE/CT to locate the parathyroid adenoma. MIP image of the PET/CT incidentally showed black beard sign due to increased radiotracer uptake in the mandible.
Congenital Heart Disease Illustrated
Authors: Loke Yue-Hin , Gupta Saurabh Kumar , Mandell Jason , Schidlow David , Wernovsky Gil , Olivieri Laura
Published: May 2023

In the modern era of cardiac imaging, there is increasing use of cardiac computed tomography and cardiac magnetic resonance for visualization of congenital heart disease (CHD). Advanced visualization techniques such as virtual dissection, 3-dimensional modeling, and 4-dimensional flow are also commonly used in clinical practice. This review highlights such methods in five common forms of CHD, including double outlet right ventricle, common arterial trunk, sinus venosus defects, Tetralogy of Fallot variants, and heterotaxy, providing visualizations of pathology in both conventional and novel formats.
Kaposi’s sarcoma herpesvirus viral FLICE inhibitory protein modulates A20 deubiquitinase activity
Authors: Herold Kevin , Ruffin Ayana , Chmura Jennifer C. , Dellomo Anna J. , Ehrlich ELANA
Published: May 2023

KSHV viral FLICE inhibitory protein (vFLIP) is a potent activator of NF-κB signaling and an inhibitor of apoptosis and autophagy. Inhibition of vFLIP function and NF-κB signaling promotes lytic reactivation. Here we provide evidence for a novel function of vFLIP through inhibition of the deubiquitinating (DUB) activity of the negative regulator, A20. We demonstrate direct interaction of vFLIP with the Itch/A20 ubiquitin editing complex and provide evidence for subsequent loss of A20 DUB activity. Our results provide further insight into the function of vFLIP in the regulation of NF-κB signaling.
Rhizobium acaciae sp. nov., a new nitrogen-fixing symbiovar isolated from root nodules of Acacia saligna in Tunisia
Authors: Hsouna Jihed , Ilahi Houda , Han Jia-Cheng , Gritli Takwa , Ellouze Walid , Zhang Xiao Xia , Mansouri Maroua , Rahi Praveen , El Idrissi Mustapha Missbah , Lamrabet Mouad , Oubla M'hamed , Courty Pierre Emmanuel , Wipf Daniel , Tambong James T. , Mnasri Bacem
Published: May 2023

Three bacterial strains, 1AS11T, 1AS12 and 1AS13, members of the new symbiovar salignae and isolated from root nodules of Acacia saligna grown in Tunisia, were characterized using a polyphasic approach. All three strains were assigned to the Rhizobium leguminosarum complex on the basis of rrs gene analysis. Phylogenetic analysis based on 1734 nucleotides of four concatenated housekeeping genes (recA, atpD, glnII and gyrB) showed that the three strains were distinct from known rhizobia species of the R. leguminosarum complex and clustered as a separate clade within this complex. Phylogenomic analysis of 92 up-to-date bacterial core genes confirmed the unique clade. The digital DNA–DNA hybridization and blast-based average nucleotide identity values for the three strains and phylogenetically related Rhizobium species ranged from 35.9 to 60.0% and 87.16 to 94.58 %, which were lower than the 70 and 96% species delineation thresholds, respectively. The G+C contents of the strains were 60.82–60.92 mol% and the major fatty acids (>4 %) were summed feature 8 (57.81 %; C18 : 1 ω7c) and C18 : 1 ω7c 11-methyl (13.24%). Strains 1AS11T, 1AS12 and 1AS13 could also be differentiated from their closest described species (Rhizobium indicum, Rhizobium laguerreae and Rhizobium changzhiense) by phenotypic and physiological properties as well as fatty acid content. Based on the phylogenetic, genomic, physiological, genotypic and chemotaxonomic data presented in this study, strains 1AS11T, 1AS12 and 1AS13 represent a new species within the genus Rhizobium and we propose the name Rhizobium acaciae sp. nov. The type strain is 1AS11T (=DSM 113913T=ACCC 62388T).
Within–patient and global evolutionary dynamics of Klebsiella pneumoniae ST17
Authors: Hetland Marit A. K. , Hawkey Jane , Bernhoff Eva , Bakksjø Ragna-Johanne , Kaspersen Håkon , Rettedal Siren I. , Sundsfjord Arnfinn , Holt Kathryn E. , Löhr Iren H.
Published: May 2023

Klebsiella pneumoniae

sequence type (ST) 17 is a global problem clone that causes multidrug-resistant (MDR) hospital infections worldwide. In 2008–2009, an outbreak of MDR ST17 occurred at a neonatal intensive care unit (NICU) in Stavanger, Norway. Fifty-seven children were colonized. We observed intestinal persistence of ST17 in all of the children for up to two years after hospital discharge. Here, we investigated the within–host evolution of ST17 in 45 of those children during long-term colonization and compared the outbreak with 254 global strains. Ninety-two outbreak-related isolates were whole-genome sequenced. They had capsule locus KL25, O locus O5 and carried yersiniabactin. During within–host colonization ST17 remained stable with few single nucleotide polymorphisms, no acquisition of antimicrobial resistance (AMR) or virulence determinants, and persistent carriage of a bla
CTX-M-15-encoding IncFII(K) IncFIB(K) plasmid (pKp2177_1). The global collection included ST17 from 1993 to 2020 from 34 countries, that were from human infection (41.3%), colonization (39.3%) and respiratory specimens (7.3%), from animals (9.3%), and from the environment (2.7%). We estimate that ST17 emerged mid-to-late 19th century (1859, 95 % HPD 1763–1939) and diversified through recombinations of the K and O loci to form several sublineages, with various AMR genes, virulence loci and plasmids. There was limited evidence of persistence of AMR genes in any of these lineages. A globally disseminated sublineage with KL25/O5 accounted for 52.7 % of the genomes. It included a monophyletic subclade that emerged in the mid-1980s, which comprised the Stavanger NICU outbreak and 10 genomes from three other countries, which all carried pKp2177_1. The plasmid was also observed in a KL155/OL101 subclade from the 2000s. Three clonal expansions of ST17 were identified; all were healthcare-associated and carried either yersiniabactin and/or pKp2177_1. To conclude, ST17 is globally disseminated and associated with opportunistic hospital-acquired infections. It contributes to the burden of global MDR infections, but many diverse lineages persist without acquired AMR. We hypothesize that non-human sources and human colonization may play a crucial role for severe infections in vulnerable patients, such as preterm neonates.
Application of bio-preservation to enhance food safety: A review
Authors: Ranathunga Nethma Samadhi , Wijayasekara Kaushalya Nadeeshani , Abeyrathne Edirisinghe Dewage Nalaka Sandun
Published: May 2023

Consumers and industry experts frequently have negative perceptions of most chemical preservatives. Although most people concede that they cannot resolve global food waste issues without preservatives, they prefer products without chemical preservatives. Numerous emerging technologies is now surpassing conventional methods for mitigating microbial food deterioration in response to consumer demand and fundamental health and safety considerations, including biological antimicrobial systems such as using food-grade microorganisms and their metabolites primarily originating from microorganisms, plants, and animals. Microbial compounds, including bacteriocins, bacteriophages, and anti-fungal agents, plant extracts such as flavonoids and essential oils; and animal-originated compounds, such as lysozyme, chitosan, and lactoferrin, are considered some of the major bio-preservatives. These natural compounds can be used alone or with other preservatives to improve food safety. Hence, the use of microbes or their metabolic byproducts to extend the shelf life of foods while maintaining safety standards is known as bio-preservation. To manufacture and consume foods in a safe condition, this review primarily aims to broaden knowledge amongst industry professionals and consumers regarding bio-preservation techniques, bio-preservatives, their classifications, and distinctive mechanisms to enhance food safety.
Establishment of a quality index of surfactin production during cheonggukjang fermentation
Authors: Ji Chang-Geun , Hong Jeong-Hwa , Lee Sang-Hyun
Published: May 2023

Surfactin, one of the most powerful biosurfactants, can be widely applied in agriculture, food, and pharmaceutics. The purpose of the present study was to establish suitable indicators for a rapid detection method that can confirm the surfactin productivity of cheonggukjang. In the present study, changes in the total number of bacteria were quantified according to the fermentation time of chenggukjang. Furthermore, physicochemical factors, such as pH, color value, surface tension, refractive index, absorbance, and protein contents, were assessed in chenggukjang viscous substances, and a correlation analysis between the physicochemical factors and surfactin contents was performed. We found that the protein contents gradually increased up to 48 h (4.21±0.11 mg/mL) without a change in the surface tension. Furthermore, the refractive index, absorbance at 280 nm, and color value were significantly increased as the fermentation time increased; however, there were no statistically significant differences after 36 h of fermentation. Interestingly, this result exhibited a tendency similar to the surfactin content according to fermentation time. These findings suggest that surfactin can be used as a suitable quality indicator and may provide an experimental basis for the fermented food industry.
Amyloid-β exposed astrocytes induce iron transport from endothelial cells at the blood-brain barrier by altering the ratio of apo- and holo-transferrin
Authors: Baringer Stephanie L. , Lukacher Avraham S. , Palsa Kondaiah , Kim Hyosung , Lippmann Ethan S. , Spiegelman Vladimir S. , Simpson Ian A. , Connor James R.
Published: May 2023

Excessive brain iron accumulation is observed in early in the onset of Alzheimer’s disease, notably prior to widespread proteinopathy. These findings suggest that increases in brain iron levels are due to a dysregulation of the iron transport mechanism at the blood-brain barrier. Astrocytes release signals (apo- and holo-transferrin) that communicate brain iron needs to endothelial cells in order to modulate iron transport. Here we use iPSC-derived astrocytes and endothelial cells to investigate how early-disease levels of amyloid-β disrupt iron transport signals secreted by astrocytes to stimulate iron transport from endothelial cells. We demonstrate that conditioned media from astrocytes treated with amyloid-β stimulates iron transport from endothelial cells and induces changes in iron transport pathway protein levels. The mechanism underlying this response begins with increased iron uptake and mitochondrial activity by the astrocytes which in turn increases levels of apo-transferrin in the amyloid-β conditioned astrocyte media leading to increased iron transport from endothelial cells. These novel findings offer a potential explanation for the initiation of excessive iron accumulation in early stages of Alzheimer’s disease. What’s more, these data provide the first example of how the mechanism of iron transport regulation by apo- and holo-transferrin becomes misappropriated in disease to detrimental ends. The clinical benefit from understanding early dysregulation in brain iron transport in AD cannot be understated. If therapeutics can target this early process, they could possibly prevent the detrimental cascade that occurs with excessive iron accumulation.

Significance Statement

Excessive brain iron accumulation is hallmark pathology of Alzheimer’s disease that occurs early in the disease staging and before widespread proteinopathy deposition. This overabundance of brain iron has been implicated to contribute to disease progression, thus understandingthe mechanism of early iron accumulation has significant therapeutic potential to slow to halt disease progression. Here, we show that in response to low levels of amyloid-β exposure, astrocytes increase their mitochondrial activity and iron uptake, resulting in iron deficient conditions. Elevated levels of apo (iron free)-transferrin stimulate iron release from endothelial cells. These data are the first to propose a mechanism for the initiation of iron accumulation and the misappropriation of iron transport signaling leading to dysfunctional brain iron homeostasis and resultant disease pathology.
A retinotopic code structures the interaction between perception and memory systems
Authors: Steel Adam , Silson Edward H. , Garcia Brenda D. , Robertson Caroline E.
Published: May 2023

Conventional views of brain organization suggest that the cortical apex processes internally-oriented information using an abstract, amodal neural code. Yet, recent reports have described the presence of retinotopic coding at the cortical apex, including the default mode network. What is the functional role of retinotopic coding atop the cortical hierarchy? Here, we report that retinotopic coding structures interactions between internally-oriented (mnemonic) and externally-oriented (perceptual) brain areas. Using fMRI, we observed robust, inverted (negative) retinotopic coding in category-selective memory areas at the cortical apex, which is functionally linked to the classic (positive) retinotopic coding in category-selective perceptual areas in high-level visual cortex. Specifically, these functionally-linked retinotopic populations in mnemonic and perceptual areas exhibit spatially-specific opponent responses during both bottom-up perception and top-down recall, suggesting that these areas are interlocked in a mutually-inhibitory dynamic. Together, these results show that retinotopic coding structures interactions between perceptual and mnemonic neural systems, thereby scaffolding their dynamic interaction.
New permanent stem cell niche for development and regeneration in a chordate
Authors: Vanni Virginia , Caicci Federico , Peronato Anna , Martello Graziano , Asnicar Davide , Gasparini Fabio , Ballarin Loriano , Manni Lucia
Published: May 2023

Stem cell niches are defined as the microenvironments where stem cells home, receiving stimuli defining their fate. In vertebrates, stem cell niches are stable and physically confined compartments.Botryllus schlosseriis an invertebrate colonial chordate where temporary stem cell niches have been identified in adult individuals that are cyclically resorbed and replaced by a new generation of clonal zooids.B. schlosserialso displays remarkable regenerative abilities, being capable of whole-body regeneration, but the cellular source of these processes is still unknown. Here we identified by means of a high-resolution morphological characterization a new putative stem cell niche in the ampullae of the circulatory system acting as a stem cell source during asexual reproduction. Stem cells of the ampullae travel via the circulatory system and contribute to the development of several organs and could explain where stem cells contributing to whole-body regeneration are stored. The ampullae niches are stable during the life cycle and regeneration ofB. schlosseri, while additional niches of the zooid are dynamically established and colonised by circulating stem cells. Our results reveal an unprecedented dynamicity of stem cell niches in highly regenerative invertebrates.