bluuebunny/crossref_metadata_2025 huggingface dataset:
Acetabular “Fleck” Sign: Outcomes of Surgical Repair
Authors: Chen Stephanie , Tulchin-Francis Kirsten , Gaines Dan , Kadado Allen , Smith Craig , Klingele Kevin
Published: March 2024

Background:

Traumatic, posterior hip dislocations in the pediatric population are typically managed by closed reduction to achieve a concentric hip joint. The presence of an acetabular “fleck” sign, despite concentric reduction, has been shown to signify significant hip pathology. The purpose of this study was to evaluate the outcomes of open labral repair through a surgical hip dislocation (SHD) in a consecutive series of patients with an acetabular “fleck” sign associated with a traumatic hip dislocation/subluxation.

Methods:

A retrospective review of patients between 2008 and 2022 who presented to a single, level 1 pediatric trauma center with a traumatic posterior hip dislocation/subluxation was performed. Patients were included if they had an acetabular “fleck” sign on advanced imaging and underwent open labral repair through SHD. Medical records were reviewed for sex, age, laterality, mechanism of injury (MOI), and associated orthopaedic injuries. The modified Harris hip score (mHHS) was utilized as the primary clinical outcomes measure. Patients were assessed for the presence of heterotopic ossification (HO) and complications, including implant issues, infection, avascular necrosis (AVN), and post-traumatic dysplasia.

Results:

Twenty-nine patients (23 male, average age: 13.0±2.7 y; range: 5.2 to 17.3) were identified. Eighteen injuries were sports related, 9 caused by motor vehicle accidents, and 1 pedestrian struck. All patients were found to have an acetabular “fleck” sign on CT (26 patients) or MRI (5 patients). Associated injuries included: femoral head fracture (n=6), pelvic ring injury (n=3), ipsilateral femur fracture (n=2), and ipsilateral PCL avulsion (n=1). At the latest follow-up (2.2±1.4 y), all patients had returned to preinjury activity/sport. Three patients developed asymptomatic, grade 1 HO in the greater trochanter region. There was no incidence of AVN. One patient developed post-traumatic acetabular dysplasia due to early triradiate closure. mHHS scores showed excellent outcomes (n=21, 94.9±7.4, range: 81 to 100.1).

Conclusions:

The acetabular “fleck” sign indicates a consistent pattern of osteochondral avulsion of the posterior/superior labrum. Restoring native hip anatomy and stability is likely to improve outcomes. SHD with open labral repair in these patients produces excellent clinical outcomes, with no reported cases of AVN.

Level of Evidence:

Level IV—therapeutic.
New latency-promoting agents for a block-and-lock functional cure strategy
Authors: Pellaers Eline , Denis Alexe , Debyser Zeger
Published: March 2024

Purpose of review

Currently, HIV-infected patients are treated with antiretroviral therapy. However, when the treatment is interrupted, viral rebound occurs from latently infected cells. Therefore, scientists aim to develop an HIV-1 cure which eradicates or permanently silences the latent reservoir.

Recent findings

Previously, scientists focused on the shock-and-kill cure strategy, which aims to eradicate the latent reservoir using latency-reactivating agents. Limited success shifts the interest towards the block-and-lock cure approach, which aims to achieve a functional cure by “blocking” HIV-1 transcription and “locking” the provirus in a deep latent state, resistant to treatment-interruption. In this strategy, latency promoting agents are used to induce transcriptional silencing and alter the epigenetics environment at the HIV promotor.

For the block-and-lock cure strategy to succeed more investigation into the transcriptional and epigenetic regulation of HIV-1 gene expression is necessary to design optimal latency-promoting agents. In this review, we will discuss the latency promoting agents that have been described in literature during the past 2 years (2022–2023).
Cutaneous Hydrophilic Polymer Embolism: An Important and Overlooked Clinical Entity
Authors: Chan Kimberly Pei Rui , Lee Joyce Siong See , Lim Joel Hua Liang
Published: March 2024

Hydrophilic polymer embolism from vascular medical devices is an underrecognized clinical entity that can cause deleterious end-organ ischemia and culminate in mortality. This is concerning as we are in the era where minimally invasive procedures are commonplace. Diagnosis is often made retrospectively after obtaining histopathological tissue samples showing endoluminal, cerebriform, amorphous, anucleate, basophilic, nonrefractile, nonpolarizable foreign body material. We detail 2 more cases of cutaneous hydrophilic polymer embolism to underscore its salient clinicopathological features and increase awareness of this important iatrogenic entity.
Perineural Infiltration: A Comprehensive Review of Diagnostic, Prognostic, and Therapeutic Implications
Authors: Torre-Castro Juan , Ríos-Viñuela Elisa , Balaguer-Franch Inmaculada , Díaz de Lezcano Ignacio , Aguado-García Ángel , Nájera Laura , Suárez Dolores , Requena Luis
Published: March 2024

Perineural infiltration refers to a neoplastic cell involvement in, around, and through the nerves. It is considered as one of the neoplastic dissemination pathways. Thus, its identification is crucial to establish the prognosis of some malignant skin neoplasms, such as squamous cell carcinoma, and explains the locally aggressive behavior of cutaneous neoplasms, such as microcystic adnexal carcinoma. We have conducted a review of malignant and benign skin tumors in which perineural infiltration has been described, and we also discuss some histopathological findings that may simulate perineural infiltration.
Identification of At-Risk Patients That Need More Intensive Treatment Following mTBI: Post-Hoc Insights From the UPFRONT-Study
Authors: Scheenen Myrthe E. , van der Horn Harm J. , de Koning Myrthe E. , van der Naalt Joukje , Spikman Jacoba M.
Published: March 2024

Objective:

To investigate which factors within an at-risk group make patients less likely to benefit from preventive treatment following mild traumatic brain injury (mTBI).

Setting:

Inclusion in 3 level I trauma centers in the Netherlands. Data collection through surveys as outpatients.

Participants:

mTBI patients (18-66 years), reporting 3 or more complaints 2 weeks postinjury (at-risk status). Eighty-four patients included and randomized (39 patients cognitive behavioral therapy, 45 patients telephonic counseling). Eighty patients filled out the questionnaires 12 months postinjury. Post hoc analysis investigating 80 patients as 1 at-risk group receiving psychological treatment.

Design:

Post hoc study of a randomized controlled trial (RCT). Binomial logistic regression performed determining which variables 2 weeks postinjury contributed strongly to unsuccessful return to work/study (RTW) and unfavorable outcome at 12 months.

Main measures:

RTW and functional outcome as measured with the Glasgow Outcome Scale-Extended (GOSE) at 12 months postinjury.

Results:

Out of 80 patients, 43 (53.8%) showed a favorable functional outcome at 12 months, and 56 (70%) patients had a full RTW. Patients with unfavorable outcome had a higher age and higher reports of anxiety, depression at 2 weeks and 12 months postinjury. Patients with an unsuccessful RTW had a higher age and higher reports of depression, and posttraumatic stress disorder at 2 weeks and 12 months postinjury. A logistic regression model for functional outcome (GOSE) was statistically significant (χ²7 = 40.30, P < .0001). Of 6 predictor variables, 3 were significant: anxiety, depression, and treatment condition. For RTW, logistic regression was also statistically significant (χ²7 = 19.15, P = .008), with only 1 out of 6 predictor variables (ie, age) being significant.

Conclusion:

Main findings comprise differences in demographic and psychological measures between patients with favorable and unfavorable outcomes and patients with RTW versus no RTW. Prediction models of outcome and RTW showed several psychological measures at 2 weeks greatly determining patients' likelihood benefitting from the preventive treatment. Results suggest that from the beginning there are some patients for whom a short preventive treatment is not sufficient. Selection and treatment of at-risk patients might be better based on psychological symptoms instead of posttraumatic complaints.
Neurobehavioral Symptoms in Spanish-Speaking Individuals With Subconcussive Injuries
Authors: Krch Denise , Lequerica Anthony H. , Arango-Lasprilla Juan Carlos , Corrigan John D.
Published: March 2024

Objective:

To examine whether exposure to high-risk events causing injury to the head or neck has an effect on neurobehavioral symptoms in the absence of an alteration of consciousness in Spanish-speakers.

Setting:

Web-based survey.

Participants:

Seven hundred forty-eight individuals from Spain and Latin America, aged 18 to 65 years, with 10 years or more of education. Thirty-nine participants failed quality checks and were excluded. Seven hundred nine participants were included in the analyses.

Design:

Cross-sectional study. Subconcussive exposure was defined as endorsing exposure to one or more high-risk scenarios in the absence of any alteration of consciousness. Three injury groups were derived: No Head Injury, Subconcussive Exposure, and traumatic brain injury (TBI). The Subconcussive Exposure group was further divided into Single and Multiple Exposures. Two analyses were conducted: the effect of lifetime exposure to injury (No Head Injury, Subconcussive Exposure, TBI) on neurobehavioral symptoms; the effect of Subconcussive Exposure Frequency (No Head Injury, Single Exposure, Multiple Exposures) on neurobehavioral symptoms.

Main Measures:

Spanish Ohio State University Traumatic Brain Injury Identification Method Self-Administered-Brief (OSU TBI-ID SAB); Neurobehavioral Symptom Inventory (NSI).

Results:

There was a significant effect for Injury group on the NSI partial eta-squared (ηp
2 = 0.053) and a significant effect of Exposure Frequency group on the NSI (ηp
2 = 0.40). Individuals with subconcussive exposures reported significantly more neurobehavioral symptoms than those with no history of head injury and significantly less symptoms than those with TBI. Individuals with multiple subconcussive exposures reported significantly more neurobehavioral symptoms than those with single and no exposure.

Conclusion:

This research expands the utility of the OSU-TBI-ID SAB as a lifetime TBI history assessment tool to one capable of evaluating subconcussive exposure dosing effects in Spanish-speakers. Such an index may facilitate establishment of subconcussive exposure prevalence rates worldwide, leading to improved understanding of the chronic effects of high-risk exposures.
Prognostic impact of thrombocytosis in gastric cancer—A retrospective study
Authors: Castro Bárbara Neto , Costa Catarina , Martins Daniel , Amado Andreia , Santos Mariana , Graça Susana , Tavares Amélia , Ferreira António , Viveiros Fernando , Vale Sílvio , Oliveira Manuel
Published: March 2024

BACKGROUND:

Solid tumors are a common cause of secondary thrombocytosis, which has been identified as a prognostic factor in various cancers. However, the impact of thrombocytosis on the prognosis of gastric cancer is not yet well defined. The aim of this study was to assess the prevalence and prognostic value of thrombocytosis in patients with gastric cancer.

METHODS:

This was a retrospective study of patients with gastric carcinoma treated surgically, with curative intent, in our hospital, Centro Hospitalar Vila Nova de Gaia/Espinho, between January 2009 and December 2019. Clinical files were consulted and clinicopathological characteristics were analyzed.

RESULTS:

In the present sample (n = 352), the prevalence of pretreatment thrombocytosis was 16.5%. Thrombocytosis was associated with more advanced T stage, greater number of metastatic nodes, and more frequent lymphatic and venous permeation. The presence of thrombocytosis had a negative impact on disease-free survival (hazard ratio [HR] 3.54, 95% confidence interval [CI] 2.35–5.33, P < .001) and overall survival (HR 4.45, 95% CI 2.95–6.71, P < .001).

CONCLUSIONS:

The presence of pretreatment thrombocytosis had a negative impact on overall survival and disease-free survival and thus could be used as an independent prognostic factor.
An update on dietary therapies in paediatric Crohn's disease
Authors: Gkikas Konstantinos , Svolos Vaios , White Bernadette , Gerasimidis Konstantinos
Published: March 2024

Purpose of review

This article provides a literature update on original articles published in the past 18 months (May 2022–November 2023) in the dietary management of paediatric Crohn's disease.

Recent findings

There is more data to support the use of exclusive enteral nutrition in the management of active Crohn's disease in children. Several food-based dietary therapies have been proposed for the management of Crohn's disease. There is an interest in precision nutritional therapy in Crohn's disease, but current data are scarce.

Exclusive enteral nutrition is an effective treatment for paediatric Crohn's disease. Predictors of response to exclusive enteral nutrition include mild disease phenotype and ileal disease involvement, although data remain inconclusive. Adherence to exclusive enteral nutrition is cornerstone to its efficacy. Treatment with exclusive enteral nutrition modifies the gut microbiome, modulates bile acid metabolism and has significant effects on host immune responses. More studies are expected in which drugs need to be combined with dietary therapies and microbial therapeutics. The efficacy of Crohn's disease exclusion diet coupled with partial enteral nutrition is supported by independent studies, but tolerance remains an issue, particularly for long-term disease management. More research is anticipated in precision nutritional therapy in paediatric Crohn's disease, but currently no recommendations can be made.
Plant proteins: are they a good alternative to animal proteins in older people?
Authors: Toutirais Lina , Vaysse Carole , Gueugneau Marine , Walrand Stephane
Published: March 2024

Purpose of review

This review provides the latest insight into the impact of consuming plant-based protein for older people.

Recent findings

According to the latest data, a healthy diet rich in plant-based-protein-rich-food could promote healthy aging. This health effect is partly because of the amino acid composition of proteins, as well as to the important constituents such as fiber and bioactive compounds found in the matrix. Furthermore, even though animal protein is more effective at stimulating muscle protein synthesis, a high consumption of plant protein (beyond 31 g/day) appears to enhance physical performance and reduce the risk of frailty in older individuals.

Recent literature highlights numerous health benefits for older people associated with a substantial intake of plant-based vs. animal-based protein, both in preventing and mitigating chronic age-related diseases and reducing the risk of all-cause mortality. However, a high intake of plant-based protein-rich products could pose risks of malnutrition and fiber-related intestinal intolerances. Further research is needed to assess the risk–benefit ratio of a high consumption of plant proteins in older individuals before we can make robust recommendations on how far animal proteins can be healthfully replaced with plant proteins.
Analysis of the inhibitory effect of a refined human resources salary system on job transfer and transfer tendency of nurses
Authors: Liu Xue-Ming , Geng Li-Xuan , Zhang Hong , Han Jian-Fei , Wang Zhi-Guo
Published: March 2024

To evaluate the impact of a refined human resources salary system on job transfer and transfer tendency. From January 2019 to December 2019, a refined human resources salary system reform was implemented at the Tangshan Workers’ Hospital in Hebei Province, and the job transfer and transfer tendency of clinical nurses was assessed using the nurse job transfer tendency scale before and 1 year after the intervention. A total of 640 nurses completed the intervention and evaluation. The results showed that the job transfer rate following the intervention reduced to 0.22%. The total score of clinical nurse job transfer tendency was (10.80 ± 3.23) before the intervention and (9.66 ± 3.58) after 1 year of intervention, which was substantially lower (P < .001). The satisfaction scores of nurses on performance-based salary increased significantly from (67.83 ± 18.54) before the intervention to (80.66 ± 15.87) after intervention, with varying degrees of increase observed in each dimension (P < .001). The refined human resources salary system effectively reduced job transfer and transfer tendency of clinical nurses in hospital nursing management, and can be widely promoted and applied.
Network pharmacological analysis on the mechanism of Linggui Zhugan decoction for nonalcoholic fatty liver disease
Authors: Gao Songlin , Wei Liuting , Qin Yan , Zhang Peng , Quan Tingwei , Liang Fei , Huang Guihua
Published: March 2024

Nonalcoholic fatty liver disease (NAFLD), represents a chronic progressive disease that imposes a significant burden on patients and the healthcare system. Linggui Zhugan decoction (LGZGD) plays a substantial role in treating NAFLD, but its exact molecular mechanism is unknown. Using network pharmacology, this study aimed to investigate the mechanism of action of LGZGD in treating NAFLD. Active ingredients and targets were identified through the integration of data from the TCMSP, GEO, GeneCards, and OMIM databases. Cytoscape 3.9.1 software, in conjunction with the STRING platform, was employed to construct network diagrams and screen core targets. The enrichment analysis of gene ontology and the Kyoto Encyclopedia of Genes and Genomes pathways were conducted by using the R. Molecular docking of the active ingredients and core targets was performed with AutoDock Vina software. We obtained 93 and 112 active ingredients and potential targets using the bioinformatic analysis of LGZGD in treating NAFLD. The primary ingredients of LGZGD included quercetin, kaempferol, and naringenin. The core targets were identified AKT1, MYC, HSP90AA1, HIF1A, ESR1, TP53, and STAT3. Gene ontology function enrichment analysis revealed associations with responses to nutrient and oxygen levels, nuclear receptor activity, and ligand-activated transcription factor activity. Kyoto Encyclopedia of Genes and Genomes signaling pathway analysis implicated the involvement of the PI3K-Akt, IL-17, TNF, Th17 cell differentiation, HIF-1, and TLR signaling pathways. Molecular docking studies indicated strong binding affinities between active ingredients and targets. LGZGD intervenes in NAFLD through a multi-ingredient, multi-target, and multi-pathway approach. Treatment with LGZGD can improve insulin resistance, oxidative stress, inflammation, and lipid metabolism associated with NAFLD.
The association between COVID-19 and infertility: Mendelian randomization analysis
Authors: Zhang Mei , Wen Tingyuan , Wang Dejing
Published: March 2024

Since December 2019, COVID-19 has triggered a global pandemic. The association of COVID-19 with the long-term reproductive situation of women and males is not clear. Thus, our aim was to assess the causal association between COVID-19 and infertility using Mendelian randomization (MR) analysis based on the OpenGWAS database. Two-sample MR analysis was conducted using one genome-wide association study (GWAS) on COVID-19 and infertility in individuals of European ancestry. The summary data of genetic variation come from the GWAS in European populations. We applied several MR methods, including MR Egger, weighted median, inverse variance weighted, simple mode, weighted mode, to test causal relationships. After observing the statistical analysis results of MR, we conducted sensitivity analysis to test robustness. After gene prediction, it was found that there was no clear causal relationship between COVID-19 and male infertility in MR analysis [OR 0.4702 (95% CI, 0.1569–1.4093), P = .178]. Moreover, COVID-19 was not associated with female infertility [OR 0.9981 (95% CI, 0.763–1.544), P = .646]. Sensitivity analysis showed that the MR results were robust [level pleiotropy, male: (MR–Egger, intercept = 0.1967434; se = 0.1186876; P = .2392406); female: (MR–Egger, intercept = −0.05902506; se = 0.05362049; P = .3211367)]. To further validate the impact of COVID-19 on infertility, we added a covariate (sex hormone binding global levels, abortion) to the MR analysis, which is a multivariate MR analysis. According to univariate and multivariate MR analyses, the evidence does not support that COVID-19 is a causal risk factor for infertility in European population. This information can provide information for doctors in reproductive centers when managing infertility patients.
Late onset neonatal sepsis: Can plasma gelsolin be a promising diagnostic marker?
Authors: Mokhtar Wesam A. , Sherief Laila M. , Kamal Naglaa M. , ElSheikh Azza O. , Omran Farida H. , Abdulsaboor Ahmed , Sakr Maha M.H. , El Gebally Shreif , Shehab Mohamed M. M. , Alfaifi Jaber , Turkistani Reem , Aljuaid Futun , Oshi Mohammed A.M. , Elbekoushi Fouad B.A. , Mokhtar Ghada A.
Published: March 2024

Plasma gelsolin (pGSN) correlates with clinical improvement in septic patients. We aimed to investigate pGSN levels as a diagnostic and prognostic marker of neonatal late-onset-sepsis (LOS). A case-control study was done on 184 neonates (92 with LOS and 92 controls). All participants were subjected to detailed history taking, full clinical evaluation, sepsis workup, and pGSN enzyme-linked immunosorbent-assay measurement. We detected significantly lower pGSN level among cases compared to controls (90.63 ± 20.64 vs 451.83 ± 209.59). It was significantly related to the severity of sepsis and mortality, with significantly lower values among cases with septic shock and multiorgan failure and non-survivors. Follow-up pGSN significantly increased after sepsis improvement in survivors compared to admission values. pGSN might be a reliable diagnostic and prognostic marker for LOS.
The effect of 8-week combined balance and plyometric on the dynamic balance and agility of female adolescent taekwondo athletes
Authors: Shen Xiang
Published: March 2024

Objectives:

To investigate the effect of combined balance and plyometric training (PT) on the agility and dynamic balance of adolescent taekwondo athletes.

Methods:

Thirty female adolescent taekwondo players volunteered to participate and were randomly assigned to the combined balance training and PT (CT; n = 15) and PT (n = 15) groups. The CT group performed balance training combined with PT 3 times a week for 6 weeks (40 minutes of plyometrics and 20 minutes of balance training) while the PT group performed only PT for the same period (3 sets × 8–12 reps for each exercise). Both groups received the same routine technical taekwondo training.

Results:

Post-intervention assessments revealed that both groups significantly improved their dynamic posture stability index scores (DPSI; forward jump [F-DPSI] and lateral jump [L-DPSI]). However, participants in the CT group achieved notably superior outcomes in the F-DPSI and L-DPSI scores compared with those achieved by their PT counterparts. The center of pressure metrics exhibited improvements post-intervention, with scores of specific measures in the PT group surpassing those in the CT group. Additionally, the 5-0-5 test scores exhibited improvements post-intervention, with scores of specific measures in the PT group surpassing those in the CT group, and the TAST (Taekwondo Specific Agility Test) of the CT group and the PT changed significantly after the intervention.

Conclusion:

An 8-week regimen that integrates balance and plyometric training effectively augments knee function and proprioception in adolescent Taekwondo athletes. This study underscores the potential benefits of a combined training approach, providing coaches and athletes with valuable insights into Taekwondo training.
Reducing the length of stay for patients stranded in the emergency department: A single-center prospective study of 18,631 patients in China
Authors: Shang Manman , Zheng Guifang , Li Zhenyu , Liu Qing , Lin Ling , Li Yueping , Wu Yong , Wei Qin
Published: March 2024

The purpose of this study was to reduce the length of stay (LOS) for patients stranded in the emergency department (ED) of a Grade III A hospital in China, and to improve patient flow and increase bed capacity. We utilized a pre-/postintervention design and employed the Six Sigma methodology, which is based on the DMAIC cycle (define, measure, analyze, improve, and control), to evaluate and improve the existing process. Data from 18,631 patients who were stranded in the ED were collected and analyzed. The median LOS for stranded patients decreased from 17.21 (6.22, 27.36) hours to 13.45 (5.56, 25.85) hours (P < .05). Similarly, the median LOS for admitted patients decreased from 19.64 (7.77, 27.68) hours to 15.92 (6.19, 26.24) hours (P < .05). The median LOS for patients with an ED triage Level IV decreased from 16.15 (5.80, 26.62) hours to 12.59 (5.20, 24.97) hours (P < .05). In addition, the average hospitalization days of hospitalized patients decreased from 0.92 days to 0.82 days (P < .05). Furthermore, the bed utilization rate increased from 66.79% to 72.29% (P < .05). The number of bed turnovers in the ED resuscitation room increased from 20.30 to 21.96 (P < .05). We had effectively met our goal of minimizing ED patient LOS. Six Sigma method can effectively shorten patient LOS by measuring and analyzing the key factors affecting patient LOS, and by implementing measures such as strict implementation of emergency classification and triage system, establishment of multidisciplinary cooperative team, reasonable allocation of human resources, information management of bed resources, and improvement of performance appraisal scheme to improve and control the effectiveness of patient LOS.
Uterine rupture in patients with a history of hysteroscopy procedures: Case series and review of literature
Authors: Shao Liping , Yang Zhilong , Yan Huifang , Xu Rong
Published: March 2024

Rationale:

Uterine rupture during pregnancy poses significant risks to both the fetus and the mother, resulting in high mortality and morbidity rates. While awareness of uterine rupture prevention after a cesarean section has increased, insufficient attention has been given to cases caused by pregnancy following hysteroscopy surgery.

Patient concerns:

We report 2 cases here, both of whom had a history of hysteroscopy surgery and presented with severe abdominal pain during pregnancy.

Diagnoses:

Both patients had small uterine ruptures, with no significant abnormalities detected on ultrasonography. The diagnosis was confirmed by a CT scan, which showed hemoperitoneum.

Interventions:

We performed emergency surgeries for the 2 cases.

Outcomes:

We repaired the uterus in 2 patients during the operation. Both patients recovered well. The children survived. No abnormalities were detected during their follow-up visits.

Lessons:

Attention should be paid to the cases of pregnancy after hysteroscopy.
Nomogram model for predicting early recurrence for resectable pancreatic cancer: A multicenter study
Authors: Man Quan , Pang Huifang , Liang Yuexiang , Chang Shaofei , Wang Junjin , Gao Song
Published: March 2024

Pancreatic cancer is a highly aggressive malignancy that is characterized by early metastasis, high recurrence, and therapy resistance. Early recurrence after surgery is one of the important reasons affecting the prognosis of pancreatic cancer. This study aimed to establish an accurate preoperative nomogram model for predicting early recurrence (ER) for resectable pancreatic adenocarcinoma. We retrospectively analyzed patients who underwent pancreatectomy for pancreatic ductal adenocarcinoma between January 2011 and December 2020. The training set consisted of 604 patients, while the validation set included 222 patients. Survival was estimated using Kaplan–Meier curves. The factors influencing early recurrence of resectable pancreatic cancer after surgery were investigated, then the predictive model for early recurrence was established, and subsequently the predictive model was validated based on the data of the validation group. The preoperative risk factors for ER included a Charlson age-comorbidity index ≥ 4 (odds ratio [OR]: 0.628), tumor size > 3.0 cm on computed tomography (OR: 0.628), presence of clinical symptoms (OR: 0.515), carbohydrate antigen 19-9 > 181.3 U/mL (OR 0.396), and carcinoembryonic antigen > 6.01 (OR: 0.440). The area under the curve (AUC) of the predictive model in the training group was 0.711 (95% confidence interval: 0.669–0.752), while it reached 0.730 (95% CI: 0.663–0.797) in the validation group. The predictive model may enable the prediction of the risk of postoperative ER in patients with resectable pancreatic ductal adenocarcinoma, thereby optimizing preoperative decision-making for effective treatment.
Compound heterozygosity for Southeast Asian hereditary persistence of fetal hemoglobin and β0-thalassemia results in thalassemia intermedia: Pedigree analysis and genetic research in a family from South China. A case report
Authors: Wang Guangli , Deng Huiping , Peng Peng , Zheng Haiqing , Tian Baodong , Zhu Chunjiang
Published: March 2024

Rationale:

Compound heterozygotes for deletional β-thalassemia can be difficult to diagnose due to its diverse clinical presentations and no routine screenings. This can lead to disease progression and delay in treatment.

Patient concerns:

We reported pedigree analysis and genetic research in a family with rare β-thalassemia.

Diagnosis:

Pedigree analysis and genetic research demonstrated that the patient was a compound heterozygote for β-thalassemia CD17/Southeast Asian hereditary persistence of fetal hemoglobin deletion, inherited from the parents. Magnetic resonance imaging T2* examination revealed severe iron deposition in the liver. Echocardiography revealed endocardial cushion defect.

Interventions:

The patient was treated with Deferasirox after receiving the final molecular genetic diagnosis. The initial once-daily dose of Deferasirox was 20 mg/kg/d.

Outcomes:

The patient discontinued the medication three months after the first visit. Two years later, the patient visited the Department of Hepatobiliary and Pancreatic Diseases. He was recommended to undergo splenectomy after surgical repair of the congenital heart disease. However, the patient refused surgical treatment because of the economic burden.

Lessons:

We report that fetal hemoglobin is a sensitive indicator for screening large deletions of the β-globin gene, which can be effectively confirmed by the multiplex ligation-dependent probe amplification assay. In non-transfusion-dependent thalassemia patients, iron status assessment should be regularly performed, and iron chelation treatment should be initiated early. This case will provide insights for the diagnosis of rare genotypes of β-thalassemia and has important implications for genetic counseling.
Why patients self-refer to the emergency service for nonurgency?: A mix-method survey from a family medicine perspective
Authors: Tuz Canan , Özçakir Alis
Published: March 2024

The definition of “nonurgent emergency service visits” is visits to conditions for medical conditions that require attention but are not life-threatening immediately or severe enough to require urgent intervention. This study aims to investigate the reasons why patients choose to self-refer to the emergency service (ES) instead of their primary care health center for nonurgent complaints. The study was carried out in a tertiary hospital. The survey consisted of 2 parts with sociodemographic questions, knowledge of their family physician, and the reason why it has been applied to the ES with multiple choice answers. Of the 325 patients, the mean age was 34.5 years and 54.2% were women. Also, 26 of the patients were reported as “urgent” by the doctor. The main reasons underlying self-referred patients were classified into 4 themes: “urgency” (13.8%), advantages of ES (12.9%); disadvantages of primary care (25.1%), and other (45.9%). The most common reason patients self-refer to the ES was their belief in “being urgent” (61%). In this study, 26.8%, (n = 84) of the patients are not happy with their family physicians, while only 13.2% (N = 43) prioritize the ES advantages.
Proposed minimal standards for description of new taxa of the class Halobacteria
Authors: Cui Heng-Lin , Hou Jing , Amoozegar Mohammad Ali , Dyall-Smith Mike L. , de la Haba Rafael R. , Minegishi Hiroaki , Montalvo-Rodriguez Rafael , Oren Aharon , Sanchez-Porro Cristina , Ventosa Antonio , Vreeland Russell H.
Published: March 2024

Halophilic archaea of the class Halobacteria are the most salt-requiring prokaryotes within the domain Archaea. In 1997, minimal standards for the description of new taxa in the order Halobacteriales were proposed. From then on, the taxonomy of the class Halobacteria provides an excellent example of how changing concepts on prokaryote taxonomy and the development of new methods were implemented. The last decades have witnessed a rapid expansion of the number of described taxa within the class Halobacteria coinciding with the era of genome sequencing development. The current members of the International Committee on Systematics of Prokaryotes Subcommittee on the Taxonomy of Halobacteria propose these revisions to the recommended minimal standards and encourage the use of advanced technologies in the taxonomic description of members of the Halobacteria. Most previously required and some recommended minimal standards for the description of new taxa in the class Halobacteria were retained in the present revision, but changes have been proposed in line with the new methodologies. In addition to the 16S rRNA gene, the rpoB′ gene is an important molecular marker for the identification of members of the Halobacteria. Phylogenomic analysis based on concatenated conserved, single-copy marker genes is required to infer the taxonomic status of new taxa. The overall genome relatedness indexes have proven to be determinative in the classification of the taxa within the class Halobacteria. Average nucleotide identity, digital DNA–DNA hybridization, and average amino acid identity values should be calculated for rigorous comparison among close relatives.
A multidimensional investigation of sleep and biopsychosocial profiles with associated neural signatures
Authors: Perrault Aurore A. , Kebets Valeria , Kuek Nicole M. Y. , Cross Nathan E. , Tesfaye Rackeb , Pomares Florence B. , Li Jingwei , Chee Michael W.L. , Dang-Vu Thien Thanh , Yeo B.T. Thomas
Published: March 2024

Sleep is essential for optimal functioning and health. Interconnected to multiple biological, psychological and socio-environmental factors (i.e., biopsychosocial factors), the multidimensional nature of sleep is rarely capitalized on in research. Here, we deployed a data-driven approach to identify sleep-biopsychosocial profiles that linked self-reported sleep patterns to inter-individual variability in health, cognition, and lifestyle factors in 770 healthy young adults. We uncovered five profiles, including two profiles reflecting general psychopathology associated with either reports of general poor sleep or an absence of sleep complaints (i.e., sleep resilience) respectively. The three other profiles were driven by the use of sleep aids and social satisfaction, sleep duration and cognitive performance, and sleep disturbance linked to cognition and mental health. Furthermore, identified sleep-biopsychosocial profiles displayed unique patterns of brain network organization. In particular, somatomotor network connectivity alterations were involved in the relationships between sleep and biopsychosocial factors. These profiles can potentially untangle the interplay between individuals’ variability in sleep, health, cognition and lifestyle — equipping research and clinical settings to better support individual’s well-being.
Haplotype-resolved genome and population genomics of the threatened garden dormouse in Europe
Authors: Byerly Paige , von Thaden Alina , Leushkin Evgeny , Hilgers Leon , Liu Shenglin , Winter Sven , Schell Tilman , Buechner Sven , Meinig Holger , Lang Johannes , Famira-Parcsetich Eva , Stubbe Sarah , Gerheim Charlotte , Ben-Hamadou Alexander , Bolz Hanno , Betz Christian , Greve Carola , Mouton Alice , Bertolino Sandro , Verbeylen Goedele , Briner Thomas , Vinciguerra Lorenzo , Mueller Sarah , Nowack Carsten , Hiller Michael
Published: March 2024

Genomic resources are important for evaluating genetic diversity and supporting conservation efforts. The garden dormouse (Eliomys quercinus) is a small rodent that has experienced one of the most severe modern population declines in Europe. We present a high-quality haplotype-resolved reference genome for the garden dormouse, and combine comprehensive short and long-read transcriptomics datasets with homology-based methods to generate a highly complete gene annotation. Demographic history analysis of the genome revealed a sharp population decline since the last interglacial, indicating an association between colder climates and population declines prior to anthropogenic influence. Using our genome and genetic data from 100 individuals, largely sampled in a citizen-science project across the contemporary range, we conducted the first population genomic analysis for this species. We found clear evidence for population structure across the species core Central European range. Notably, our data shows that the Alpine population, characterized by strong differentiation and reduced genetic diversity, is reproductively isolated from other regions and likely represents a differentiated evolutionary significant unit (ESU). The predominantly declining Eastern European populations also show signs of recent isolation, a pattern consistent with a range expansion from Western to Eastern Europe during the Holocene, leaving relict populations now facing local extinction. Overall, our findings suggest that garden dormouse conservation may be enhanced in Europe through designation of ESUs.
Dating ammonia-oxidizing bacteria with abundant eukaryotic fossils
Authors: Liao Tianhua , Wang Sishuo , Zhang Hao , Stüeken Eva E. , Luo Haiwei
Published: March 2024

Evolution of a complete nitrogen cycle relies on the onset of ammonia oxidation, which aerobically converts ammonia to nitrogen oxides. However, accurate estimation of the antiquity of ammonia-oxidizing bacteria (AOB) remains challenging because AOB-specific fossils are absent and bacterial fossils amenable to calibrate bacterial molecular clocks are rare. Leveraging the ancient endosymbiosis of mitochondria and plastid, as well as using state-of-the-art techniques such as the Bayesian sequential dating approach, we obtained a robust timeline of AOB evolution calibrated by fossil-rich eukaryotic lineages. We show that the first AOB evolved in marine Gammaproteobacteria (Gamma-AOB) and emerged between 2.1 and 1.9 billion years ago (Ga), thus postdating the Great Oxidation Event (GOE; 2.4-2.32 Ga). To reconcile the sedimentary nitrogen isotopic signatures of ammonia oxidation occurring near the GOE, we propose that ammonia oxidation likely occurred at the common ancestor of Gamma-AOB and Gammaproteobacterial methanotrophs, or the actinobacterial/verrucomicrobial methanotrophs, which are known to have ammonia oxidation activities. We also do not rule out another possibility that nitrite was transported from the terrestrial habitats where ammonia oxidation by archaea likely took place. Further, we show that the Gamma-AOB predates the anaerobic ammonia oxidizing (anammox) bacteria which also emerged in marine environments, implying that the origin of ammonia oxidation constrained the origin of anammox as nitrite produced by the former fuels the latter. Our robustly calibrated molecular clocks support a new hypothesis that nitrogen redox cycle involving nitrogen oxides evolved rather late in the ocean.
Intraspecific variation of thermal tolerance in freshwater insects along elevational gradients: the case of a widespread diving beetle
Authors: Pallares Susana , Carbonell Jose Antonio , Picazo Felix , Bilton David T. , Millan Andres , Abellan Pedro
Published: March 2024

Species distributed along wide elevational gradients are likely to experience local adaptation and exhibit high plasticity of thermal tolerance traits, as these gradients are characterised by steep environmental changes over short geographic distances (i.e., strong selection differentials). However, the prevalence of adaptive clinal intraspecific variation in thermal tolerance with elevation remains unclear, and this aspect has been poorly studied in freshwater insects. We explored variation in upper (heat coma temperature) and lower (supercooling point) thermal limits and acclimation capacity among Iberian populations of the widespread aquatic beetle Agabus bipustulatus (fam. Dytiscidae) across a 2,000-m elevational gradient, from lowland to alpine areas. As minimum, maximum and mean temperatures decline with elevation, we predicted that higher elevation populations will show lower heat tolerances and higher cold tolerances. We also explored whether acclimation capacity is positively related with climatic variability across different elevations. We found significant variation in upper and lower thermal limits among populations of A. bipustulatus, but no evidence of local adaptation to different thermal conditions along the altitudinal gradient, as relationships between thermal limits and elevation or climatic variables were in general not significant. Plasticity of upper and lower thermal limits was overall and consistently low in all populations. These results suggest conservatism of the thermal niche, which might be the result of gene flow counteracting the effects of divergent selection, or adaptations in other traits that buffer the exposure of populations to climate extremes. The limited adaptive potential and plasticity of thermal tolerance found here for A. bipustulatus imply that even generalist species, distributed along wide environmental gradients, may have little resilience to global warming.
Unbiased estimation of the coefficient of determination in linear models: an application to fMRI encoding model comparison
Authors: Castellanos Agustin Lage , De Martino Federico , Valente Giancarlo
Published: March 2024

Neuroscientific investigation has greatly benefited from the combination of functional Magnetic Resonance Imaging (fMRI) with linearized encoding, which allows to validate and compare computational models of neural activity based on neuroimaging data. In linearized encoding, a multidimensional feature space, usually obtained from a computational model applied to the stimuli, is related to the measured brain activity. This is often done by mapping such space to a dataset (training data, orin-sample), and validating the mapping on a separate dataset (test data, orout-of-sample), to avoid overfitting. When comparing models, the one with the highest explained variance on the test data, as indicated by the coefficient of determination (R2), is the one that better reflects the neural computations performed by the brain. An implicit assumption underlying this procedure is that theout-of-sample R2is an unbiased estimator of the explanatory power of a computational model in the population of stimuli, and can therefore be safely used to compare models. In this work, we show that this is not the case, as theout-of-sample R2has a negative bias, related to the amount of overfitting in the training data. This phenomenon has dramatic implications for model comparison when models of different dimensionalities are compared. To this aim, we develop an analytical framework that allows us to evaluate and correct biases in bothin-andout-of-sample R2, with and without L2 regularization. Our proposed approach yields unbiased estimators of the populationR2, thus enabling a valid model comparison. We validate it through illustrative simulations and with an application to a large public fMRI dataset.
Long distance calls: negligible information loss of seabird social vocalisations over propagation down to the hearing threshold
Authors: Osiecka Anna N. , Bryndza Przemysław , Briefer Elodie F. , Wojczulanis-Jakubas Katarzyna
Published: March 2024

How well does the information contained in vocal signals travel through the environment? To assess the efficiency of information transfer in little auk (Alle alle,an Arctic seabird) calls over distance, we selected two of the social call types with the highest potential for individuality coding. Using available recordings of known individuals, we calculated the apparent source levels, with apparent maximum peak sound pressure level (ASPL) of 63 dB re 20 µPa at 1 m for both call types. Further, we created a sound propagation model using meteorological data collected in the vicinity of the little auk colony in Hornsund, Spitsbergen. Using this model, we simulated call propagation up to the putative hearing threshold of the species, calculated to equal ASPL of signals propagated to roughly one kilometre. Those propagated calls were then used in a permuted discriminant function analysis, support vector machine models, and linear models of Beecher’s information statistic, to investigate whether transmission loss will affect the retention of individual information of the signal. Calls could be correctly classified to individuals above chance level independently of the distance, down to and over the putative physiological hearing threshold. Interestingly, the information capacity of the signal did not decrease with propagation. While this study touches on signal properties purely and cannot provide evidence of the actual use by the animals, it shows that little auk signals can travel long distances with negligible information loss. For the animals, this could mean that they can recognize calls of the members of their social networks as far as those calls are actually audible, and support the hypothesis that vocalisations could facilitate long-distance communication in the species.
SMOC2, OGN, FCN3, and SERPINA3 could be biomarkers for the evaluation of acute decompensated heart failure caused by venous congestion
Authors: Yu Yiding , Yuan Huajing , Han Quancheng , Shi Jingle , Liu Xiujuan , Xue Yitao , Li Yan
Published: March 2024

Background

Venous congestion (VC) sets in weeks before visible clinical decompensation, progressively increasing cardiac strain and leading to acute heart failure (HF) decompensation. Currently, the field lacks a universally acknowledged gold standard and early detection methods for VC.

Methods

Using data from the GEO database, we identified VC’s impact on HF through key genes using Limma and STRING databases. The potential mechanisms of HF exacerbation were explored via GO and KEGG enrichment analyses. Diagnostic genes for acute decompensated HF were discovered using LASSO, RF, and SVM-REF machine learning algorithms, complemented by single-gene GSEA analysis. A nomogram tool was developed for the diagnostic model’s evaluation and application, with validation conducted on external datasets.

Results

Our findings reveal that VC influences 37 genes impacting HF via 8 genes, primarily affecting oxygen transport, binding, and extracellular matrix stability. Four diagnostic genes for HF’s pre-decompensation phase were identified: SMOC2, OGN, FCN3, and SERPINA3. These genes showed high diagnostic potential, with AUCs for each gene exceeding 0.9 and a genomic AUC of 0.942.

Conclusions

Our study identifies four critical diagnostic genes for HF’s pre-decompensated phase using bioinformatics and machine learning, shedding light on the molecular mechanisms through which VC worsens HF. It offers a novel approach for clinical evaluation of acute decompensated HF patient congestion status, presenting fresh insights into its pathogenesis, diagnosis, and treatment.