bluuebunny/crossref_metadata_2025 huggingface dataset:
Proper position of single and large (≥5 cm) hepatocellular carcinoma in Barcelona Clinic Liver Cancer classification
Authors: Kim Hyo-Sin , Choi Soo Jin Na , Lee Ho Kyun ,   on behalf of the Korean Liver Cancer Association
Published: October 2023

The purpose of this study was to evaluate the proper position of single large hepatocellular carcinoma (HCC) in the Barcelona Clinic Liver Cancer (BCLC) staging system. The data were collected from the nationwide multicentre database of the Korean Liver Cancer Association. Patients with single large (≥5 cm) HCC were separated from BCLC stage A patients and designated as Group X. The remaining BCLC stage A and stage B patients were classified as Group A and Group B, respectively. The survival outcomes of propensity score-matched groups were compared. Among the 3965 randomly selected patients, the number of patients in Group X, Group A, and Group B was 414, 2787, and 760, respectively. TriMatch analysis allowed us to obtain 116 well-balanced triplets. The 1-, 3-, and 5-year overall survival rates in Group X were worse than in Group A (91%, 71%, and 48% vs 90%, 78%, and 64%, respectively; P < .000). However, the rates were not different compared with those in Group B (91%, 71%, and 48% vs 90%, 69%, and 48%, respectively; P < .09). In multivariate analysis, Group X, Group B, age over 60 years, prothrombin time-international normalized ratio, and creatinine level were independent predictors of worse overall survival. Our findings suggest that Group X should be relocated to BCLC stage B rather than BCLC stage A.
Right femoral vein and right dorsal artery thrombosis in childhood acute myeloid leukemia: A case report
Authors: Ni Jiaqi , Chen Min , Su Yali , Gao Qianqian , Liu Lingjun , Lu Xiaoxi
Published: October 2023

Background:

It is rare for newly diagnosed (de novo) or newly treated acute myeloid leukemia (AML) complicated with thrombotic complications, especially combined arterial and venous thrombosis.

Methods:

We reported a 13-year-old boy diagnosed with AML and leukocytosis, who developed right femoral vein and right dorsal artery thrombosis during chemotherapy. After treatment with low molecular weight heparin, diosmin, and alprostadil, symptoms were relieved. Unfortunately, the child suffered from coagulopathy afterward, which was unexpectedly caused by vitamin K deficiency.

Results:

After supplementation with vitamin K and prothrombin complex concentrate, coagulation function recovered.

Conclusion:

For childhood AML patients with high thrombotic risks, close monitoring during anticoagulant treatment was necessary. Concomitantly, we should be alert to past medication history and combined medication use, especially those that may lead to vitamin K deficiency, secondary bleeding, and coagulation disorders. Rational use of antibiotics, anticoagulants, and antitumor drugs must be guaranteed.
A real-world study of recombinant human endostatin combined with PD-1/PD-L1 blockade and chemotherapy for patients with advanced non-small cell lung cancer negative for actionable molecular biomarkers
Authors: Zhao Jing-Wen , Wang Yin-Shuang , Gu Hang-Yu , Meng Zhuo-Nan , Wang Fu-Wei , Wu Guo-Qing , Zheng Ai-Hong
Published: October 2023

The ongoing ENPOWER study exploring the efficacy and safety of the recombinant human endostatin (endostar) combined with programmed cell death 1 antibody sintilimab and chemotherapy showed encouraging efficacy and safety in advanced non-squamous non-small cell lung cancer. To evaluate the real-world efficacy and safety of endostar combined with immune checkpoint inhibitor and chemotherapy (EIC) for advanced non-squamous non-small cell lung cancer patients negative for actionable molecular biomarkers (NSCLCnm), patients with advanced NSCLCnm hospitalized to Zhejiang Provincial People’s Hospital from January 2020 to December 2022 were screened for eligibility. The included patients were analyzed for the objective response rate (ORR) and disease control rate (DCR). The pre- and posttreatment expression levels of serum tumor associated biomarkers, chemokines and subpopulations of immune cells in peripheral blood were compared. For the 31 patients with advanced NSCLCnm treated with EIC, the median follow-up and treatment cycles were 18.0 months and 4, respectively. The ORR and DCR were 38.7% and 90.3%, respectively. For those who received EIC as first-line treatment, the ORR and DCR were 63.2% and 94.7%, respectively. EIC significantly decreased expression levels of carcinoma antigen 125, carcinoma embryonic antigen and cytokeratin 19 (P<0.05) in patients who were partial remission or stable disease. Among the 31 patients, 27 (87.1%) experienced at least 1 treatment-related adverse events, and 13 (41.9%) had the treatment-related adverse events of grade 3 or higher. No antiangiogenesis-related adverse events were observed. The current study showed that EIC was potentially effective for patients with NSCLCnm, especially when used as first-line therapy, and well tolerated.
Chylothorax after chimeric antigen receptor T cell therapy for relapsed and refractory diffuse large B-cell lymphoma: A case report
Authors: Chen Hsin-Hui , Kuo Cheng-Yi , Ho Ching-Liang , Chen Yeu-Chin
Published: October 2023

Rationale:

Anti-CD19-targeted chimeric antigen receptor (CAR) T cell therapy is effective in treating relapsed/refractory diffuse large B-cell lymphoma (DLBCL). This therapy is associated with several side effects that can be life-threatening such as cytokine release syndrome (CRS). However, chylothorax associated with CRS after CAR-T therapy has not been reported.

Patient concerns:

A 23-year-old male diagnosed with DLBCL relapsing after autologous peripheral blood stem cell transplantation was treated with anti-CD19-targeted CAR-T cell therapy. After CAR-T cell transfusion, he developed grade 3 CRS includes fever, dyspnea, tachycardia and hypotension. The symptoms of CRS persisted and chest plain film revealed bilateral pleural effusion.

Diagnosis:

Chylothorax was confirmed by the pleural effusion analysis that triglyceride level was 1061 mg/dL. Bacterial and fungal culture of pleural fluid reported no pathogen was detected. Cytological examination of pleural effusion revealed no malignant cells.

Interventions:

The chylothorax resolved after treatment with intravenous administration of tocilizumab.

Outcomes:

On 30-day follow-up, the patient was in stable clinical condition with complete remission of DLBCL on whole-body positron emission tomography scan.

Lessons:

We reported a rare case of CAR-T associated chylothorax in a patient with relapsed and refractory DLBCL. Grade 3 CRS with high interleukin-6 level was presented in our patient. The symptoms of CRS were improved with tocilizumab treatment and the chylothorax resolved later on. It is suggested that high interleukin-6 releases might induce chyle leakage resulting from activations of endothelium and coagulation. Our finding highlights the occurrence of chylothorax during the course of CAR-T cell therapy and the importance of proper monitoring and prompt management of this life-threatening side effect.
Successful chelation in beta-thalassemia major in the 21st century
Authors: Fragodimitri Christina , Schiza Vasiliki , Giakoumis Anastasios , Drakaki Kalliopi , Salichou Anastasia , Karampatsos Fotis , Yousef Jacqueline , Karageorga Markissia , Berdoukas Vasili , Aessopos Athanasios
Published: October 2023

This century has seen a revolution the management of beta-thalassemia major. Over a 12-year period to 2016, we aimed to analyze the benefits of such advances. In 209 patients, independent of the chelation regimen, ferritin, cardiac T2* and liver iron concentration changes were evaluated. We defined chelation success (ChS) as no iron load in the heart and acceptable levels in the liver. Over 3 early magnetic resonance imagings, the same parameters were assessed in 2 subgroups, the only 2 that had sufficient patients continuing on 1 regimen and for a significant period of time, 1 on deferrioxamine (low iron load patients n = 41, Group A) and 1 on deferoxamine-deferiprone (iron overloaded n = 60, Group B). Finally, 28 deaths and causes were compared to those of an earlier period. The 209 patients significantly optimized those indices, while the number of patients with chelation success, increased from 6% to 51% (P < .0001). In group A, ChS after about 8 years increased from 21 to 46% (P = .006), while in Group B, from 0% to 60% (P < .001) after about 7 years. Deaths over the 2 periods showed significant reduction. Combined clearance of cardiac and liver iron (ChS) is feasible and should become the new target for all patients. This requires, serial magnetic resonance imagings and often prolonged intensified chelation for patients.
Successful robot-assisted laparoscopic resection of pheochromocytoma in a patient with dilated cardiomyopathy: A case report on extremely high-risk anesthesia management
Authors: Huang Long , Wu Jiarui , Lian Baorong , Zhang Daxue , Zhai Yujia , Cao Liming
Published: October 2023

Rationale:

Anesthetic management during resection of pheochromocytoma is a huge challenge, especially when accompanied by dilated cardiomyopathy (DCM). However, there is a lack of research evidence in this area.

Patient concerns:

A 36-year-old man was admitted with a left retroperitoneal space-occupying lesion, present for 2 years. The patient also had DCM for 2 years. Blood analysis on admission showed elevated levels of norepinephrine and the N-terminus of the brain natriuretic peptide precursor. Abdominal computed tomography revealed a circular shadow in the left adrenal area. Echocardiography showed a cardiac ejection fraction of 31% to 37%, markedly enlarged left atrium and left ventricle, extensive cardiac hypokinesia, and reduced left ventricular diastolic and systolic functions.

Diagnoses:

The preoperative diagnosis was left paraganglioma/pheochromocytoma with DCM.

Interventions:

Multidisciplinary consultation, blood pressure measurements, and volume expansion measurements were performed preoperatively. Invasive arterial blood pressure, central venous pressure, depth of anesthesia, cardiac function, left heart volume, and body temperature were monitored intraoperatively.

Outcomes:

The adrenal pheochromocytoma was successfully removed, and the patient recovered well.

Lessons:

The anesthetic management for adrenal pheochromocytoma resection in adult patients with DCM is extremely high-risk but is evidently not impossible. Adequate preoperative evaluation and preparation, optimization of the anesthesia induction plan, close intraoperative monitoring of cardiac function and hemodynamic changes, and robot-assisted laparoscopic technology are the key success factors. The challenges to anesthetic management may be partly prevented with invasive monitoring techniques and minimally invasive surgery. This case confirms the importance of individual management and multidisciplinary cooperation for a successful outcome.
Perceptions of the effectiveness of non-pharmacological management of respiratory disorders among CRD patients
Authors: Aldabayan Yousef S.
Published: October 2023

Chronic respiratory diseases (CRDs) are among the leading cause of mortality worldwide. While pharmacological approaches are commonly used to manage symptoms, non-pharmacological management of CRDs is considered crucial in preventing disease progression and improving patient self-efficacy. To describe the perceived effectiveness of non-pharmacological management of CRDs among CRD patients and determine whether the CRD patients perceptions of the effectiveness of non-pharmacological management are associated with their demographic characteristics. An analytic cross-sectional study design was utilized. The non-pharmacological management practices of CRD patients and their perception of the effectiveness of these therapeutic measures were assessed using a researcher-developed questionnaire. Data collection took place in primary healthcare centers in Al Ahsa, Saudi Arabia from October 2021 to March 2022. The proportion of CRD patients who perceived that non-pharmacological interventions were effective was computed. Binary logistic regression was performed to determine the association between the demographic characteristics of the respondents and their perception of the effectiveness of non-pharmacological management. Among the 390 respondents, 42% perceived that non-pharmacological measures were effective. Half of the respondents believed that smoking cessation, influenza vaccination, improving physical activity, and nutrition support helped alleviate CRD symptoms, while less than half of the respondents considered pulmonary rehabilitation, educational programs, and oxygen therapy effective measures to control symptoms. Women were found to be 3.24 times more likely to perceive non-pharmacological interventions as effective (P < .0000) compared to men. Those with university-level education were 66.6% less likely to consider non-pharmacological interventions to be effective (P < .0000) than those who completed preuniversity-level education. Age and marital status did not significantly influence perceptions of effectiveness. Differences in the perceptions of the effectiveness of various non-pharmacological measures to alleviate CRD symptoms existed among the CRD patients of Al Ahsa. The perception of effectiveness was significantly associated with the patient’s gender and educational attainment.
Effect of adding abdominal bracing to spinal stabilization exercise on lumbar lordosis angle, extensor strength, pain, and function in patients with non-specific chronic low back pain: A prospective randomized pilot study
Authors: Park Han Soo , Park Si Won , Oh Jae-Keun
Published: October 2023

Trial design:

This study investigated the effect of adding abdominal bracing to spinal stability exercise in patients with chronic low back pain (CLBP). This prospective, randomized pilot study included 67 patients and was conducted at the sports medicine center of a single hospital.

Methods:

The abdominal bracing group (ABBG) underwent spinal stability exercise with abdominal bracing (N = 33), comprising 50 minutes training twice a week for 24 weeks. The control group performed only spinal stability exercise (N = 34) for 50 minutes twice a week for 24 weeks. The ABBG received abdominal bracing training at each session and applied abdominal bracing during the spinal stability exercise. The lumbar lordosis angle (LLA) and spine extensor muscle strength were measured. Spinal flexion angles were measured every 12° from 0° to 72°. The visual analog scale score and Oswestry disability index were measured before treatment and at 12 and 24 weeks after treatment.

Results:

The LLA increased over time in both the groups but was not significantly different between the groups. Spine extensor strength was improved over time in both the groups, and an interactive effect was observed at a spinal flexion angle of 60° and 72°. Pain and function were also improved over time in both the groups, but the effect was stronger in the ABBG than in the control group. In patients with CLBP, spinal stability exercise changed the LLA.

Conclusions:

Although adding abdominal bracing to spinal stability exercise did not affect the changes in the LLA, abdominal bracing improved the spinal extensor strength, pain, and function in patients with CLBP. Therefore, it is recommended to add abdominal bracing to spinal stability exercise to maintain the lordosis angle and to improve CLBP symptoms.
Risk factors of disturbed sleep phases to posterior circulation cerebral infarctions: A single-center retrospective study
Authors: Liu Lu , Wang Weiping , Gao Nan , Jia Tongle , Guo Li , Geng Liying , Ma Yaning
Published: October 2023

Posterior circulation stroke differs from anterior circulation stroke in terms of etiological, clinical, and prognostic properties. Sleep architecture is impaired in patients with acute stroke, which may correlate with disease severity and outcome, and the correlation between the location of cerebral infarction (CI) and sleep phase disturbance remains unknown. This study aimed to assess the correlation between disturbed sleep phases in CI and posterior circulation cerebral infarction (PCCI). We retrospectively enrolled 192 patients with first-onset acute CI, who were assigned to the anterior circulation cerebral infarction (n = 101) and PCCI (n = 91) groups. The polysomnograms in both groups were analyzed by phase. The proportions of sleep phases were significantly different between the 2 groups (P < .05). The awake (W) and non-rapid eye movement 3 (N3) phases were independently associated with PCCI in multivariate analysis. The W phase may be a risk factor for PCCI (odds ratio = 1.60, 95% CI 1.30–1.97), while the N3 phase may be a protective factor for PCCI (odds ratio = 0.498, 95% CI 0.353–0.703). This study demonstrated that CI causes different degrees of sleep phase disturbances, and the percentages of W and N3 phase disturbances were independent factors associated with PCCI. The former was a risk factor, whereas the latter was a protective factor. This study demonstrated the correlation between cerebral infarction and sleep phase disturbances from a new perspective and suggested that cerebral infarcts may alter the structure of sleep.
Neutrophil gelatinase-associated lipocalin serum level: A potential noninvasive biomarker of endometriosis?
Authors: Guney Gurhan , Taskin Mine Islimye , Laganà Antonio Simone , Tolu Ezgi , Aslan Figen , Hismiogullari Adnan Adil , Kaya Cihan
Published: October 2023

Neutrophil gelatinase-associated lipocalin (NGAL, also known as lipocalin-2) is an acute-phase protein expressed in many tissues and plays a role in cell proliferation, regulation, and epithelial-mesenchymal transformation. Therefore, this study aimed to investigate serum NGAL levels and endometrioma tissue expression in women with endometriosis. This cross-sectional study was conducted at a university hospital. The endometrioma group included 36 women who underwent ovarian cystectomy for endometrioma, which was compared with a control group (n = 36) of women who underwent ovarian cystectomy due to benign persistent cysts (follicle cyst, theca lutein cyst, and serous cystadenoma). NGAL levels were analyzed using both serum enzyme-linked immunosorbent assay analysis and immunohistochemical tissue staining. Serum C-reactive protein and CA-125 levels were also evaluated. NGAL serum levels were significantly higher in the endometrioma group than in the control group (P < .05). C-reactive protein and CA-125 levels were also significantly higher in the endometrioma group (P < .05) and were correlated with NGAL levels. Immunohistochemical staining for NGAL was also higher in the endometrioma group (P < .001). NGAL may be considered a potential noninvasive biomarker of endometriosis.
Effect of presbyopic correction lens on humphrey visual field testing in patients with multifocal intraocular lens
Authors: Kitnarong Naris , Petchyim Sakaorat , Jampathong Pennapar , Treesit Isaraporn , Limmahachai Arnan , Aurboonsong Tanakorn
Published: October 2023

Most previous studies on the effects of multifocal intraocular lenses (MIOL) on Humphrey visual field (HVF) used presbyopic corrective lens (PC). There has been insufficient data from patients with MIOL performing HVF with and without PC. This study aimed to determine the effect of PC on HVF testing in patients with MIOL. This was a prospective, comparative crossover study at the Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University between June 2015 and July 2018. Early-stage glaucomatous and non-glaucomatous pseudophakic patients with 2 models of MIOL completed HVF testing with and without PC. Mean deviation (MD), pattern standard deviation (PSD), and reliability indices (fixation losses, false positives, and false negatives) were compared. Ninety-four eyes of 59 patients were enrolled. After excluding patients with confirmed unreliable visual field, 82 eyes of 51 patients (male, 22; female, 29) with a mean age of 65.4 years were included in the study. Forty-nine eyes were non-glaucoma and 33 eyes were early-stage glaucoma. Forty-four eyes received TECNIS ZM900 and 38 eyes received Acrysof IQ ReSTOR SN6AD1. The overall MD standard deviation was −3.5 (2.1) with PC and −3.1 (2.1) without PC (P = .01). The overall PSD standard deviation was 2.8 (1.5) with PC and 2.7 (1.5) without PC (P = .93). The reliability indices were not statistically significantly different with and without PC. There was a good intraclass correlation (ICC) of MD (ICC = 0.87) and PSD (ICC = 0.88) with and without PC. Eyes with TECNIS ZM 900 had significantly better MD when performing HVF without PC (mean difference −0.7, P < .01), but not with Acrysof IQ ReSTOR SN6AD1 (mean difference −0.1, P = .74). Pseudophakic eyes with MIOL may not require PC during HVF testing regardless of the MIOL model. Although eyes with TECNIS ZM900 performed HVF without PC resulted in a significantly better MD value compared with PC, the difference was not clinically significant.
A retrospective study of Kaposi’s sarcoma in Hotan region of Xinjiang, China
Authors: Yang Hong Liang , He Feng , Jielili Aibibai , Zhang Zhi Rong , Cui Zhi Yong , Wang Jin Hua , Guo Hai Tao
Published: October 2023

Kaposi sarcoma (KS) is the most common cancer in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS). In 1994, Chang and Moore discovered Kaposi sarcoma associated herpesvirus for the first time in KS lesions in AIDS patients. KS is a low-grade mesenchymal neoplasm of blood and lymphatic vessels that primarily affects the skin, although the disease may become disseminated to the lymphatic system, lungs, airways, or abdominal viscera. In this research, clinical characteristics and treatment of patients of Kaposi sarcoma were retrospectively analyzed in Hotan District, Xinjiang China. We look into the clinical traits, prognosis, and therapy of Kaposi sarcoma. From May 2017 to August 2022, 32 patients were treated in the People’s Hospital of Hotan District, Xinjiang Uygur Autonomous Region, China. Twenty-two of these were classic Kaposi sarcomas (cKS), and 10 of these were Kaposi sarcomas linked to AIDS (AIDS-KS). The majority of KS patients were Uyghur. In terms of age at onset, AIDS-KS patients were younger than cKS patients. cKS and AIDS-KS are most frequently manifested in the feet and lower limbs. Ten patients with AIDS-KS have treated with combination antiretroviral therapy (combination antiretroviral therapy) combination chemotherapy, 5 of 10 patients had a complete response, 2 patients achieved partial response, the overall effective rate was 70%, and CD4 + T cells were greater than before. For cKS and AIDS-KS, the median overall survival was 56 and 50.8 months, respectively (P > .05). As a result, antiviral combination chemotherapy can also improve the prognosis of AIDS-KS patients.
A case report of primary biliary cholangitis combined with ankylosing spondylitis
Authors: Hou Chunfeng , Ren Chunfeng , Luan Luan , Li Shujie
Published: October 2023

Rationale:

A chronic autoimmune liver disease known as primary biliary cholangitis (PBC) that selectively destructs small intrahepatic biliary epithelial cells and may result in biliary cirrhosis and eventually liver transplantation or death. PBC is associated with various other extrahepatic autoimmune diseases; however, the combination of PBC with ankylosing spondylitis has been rarely reported in the literature. Here, we reported a case of PBC with ankylosing spondylitis to improve our understanding of such coexistence and provide new ideas for the treatment of such patients.

Patient concerns:

A 54-year-old man was presented to the Department of Rheumatology because of an abnormal liver function test for 7 years, chest and back pain for 1 year, and low back pain for 2 months.

Diagnoses:

Primary biliary cholangitis, ankylosing spondylitis, and old pulmonary tuberculosis.

Interventions:

The patient refused to use nonsteroidal anti-inflammatory drugs, conventional synthetic disease-modifying antirheumatic drugs, and biologic disease-modifying antirheumatic drugs; thus, he was treated with methylenediphosphonate (99Tc-MDP) and ursodeoxycholic acid (UDCA).

Outcomes:

The patient achieved remission with UDCA and 99Tc-MDP therapy.

Lessons:

In the treatment of PBC combined with other disorders, the characteristics of different diseases should be considered. The patient reported herein was treated with 99Tc-MDP and UDCA, and his condition improved; thus, we consider 99Tc-MDP to be an effective treatment. Furthermore, in line with the current understanding of the pathogenesis of PBC and ankylosing spondylitis, we hypothesize that interleukin-17 inhibitor is an effective treatment for such patients.
Inclusion of nutritional counseling and mental health services in HIV/AIDS management: A paradigm shift
Authors: Alum Esther U. , Obeagu Emmanuel Ifeanyi , Ugwu Okechukwu P.C. , Samson Awotunde O. , Adepoju Adeyinka O. , Amusa Mariam O.
Published: October 2023

Human immunodeficiency virus (HIV) infection is a public health challenge that can degenerate into acquired immunodeficiency syndrome (AIDS) if not properly managed. HIV infection shortens life expectancy to about 5 to 10 years compared to noninfected individuals. People living with HIV/AIDS (PLWHA) are prone to several health challenges as a result of a deranged immune system culminating in high morbidity and mortality. Depression is a common feature of PLWHA. Depression heightens the emergence of opportunistic infections in HIV-infected individuals, accelerates the progression to AIDS, and increased suicidal tendencies, morbidity, and mortality. Food insecurity with its resultant undernutrition contributes to HIV/AIDS-related deaths. Undernourished PLWHA are more prone to opportunistic infections due to poor immunity. Interestingly, proper diet intake can boost immunity, slow the progression of AIDS and opportunistic infections, enhance body weight, and retard depression tendencies. Undernutrition can also be ameliorated by incorporating nutritional counseling and oral nutrient supplementation in routine HIV/AIDS checkups. Therefore, to increase HIV/AIDS management outcomes, the integration of nutrition counseling, dietary supplements, and mental health services should be embraced. Thus, HIV/AIDS care centers should amplify these services. In this article, we isolated relevant studies from various databases, illuminated the interwoven relationship between HIV/AIDS, depression, and undernutrition, and also reemphasized the need for adequate nutritional intervention in the battle against HIV/AIDS. Thus, this study provides a reawakening call to focus on incorporating nutritional guides and mental health care in HIV/AIDS management protocols.
Screening for tuberculosis infection and effectiveness of preventive treatment among people with HIV in low-incidence settings
Authors: van Geuns Dorine , Arts Rob J.W. , de Vries Gerard , Wit Ferdinand W.N.M. , Degtyareva Svetlana Y. , Brown James , Pareek Manish , Lipman Marc , van Crevel Reinout
Published: October 2023

Objective:

To determine the yield of screening for latent tuberculosis infection (LTBI) among people with HIV (PWH) in low tuberculosis (TB) incidence countries (<10 TB cases per 100 000 persons).

Design:

A systematic review and meta-analysis were performed to assess prevalence and predictive factors of LTBI, rate of TB progression, effect of TB preventive treatment (TPT), and numbers needed to screen (NNS).

Methods:

PubMed and Cochrane Library were searched for studies reporting primary data, excluding studies on active or paediatric TB. We extracted LTBI cases, odds ratios, and TB incidences; pooled estimates using a random-effects model; and used the Newcastle–Ottawa scale for bias.

Results:

In 51 studies with 65 930 PWH, 12% [95% confidence interval (CI) 10–14] had a positive LTBI test, which was strongly associated with origin from a TB-endemic country [odds ratio (OR) 4.7] and exposure to TB (OR 2.9). Without TPT (10 629 PWH), TB incidence was 28/1000 person-years (PY; 95% CI 12–45) for LTBI-test positive versus 4/1000 PY (95% CI 0–7) for LTBI-test-negative individuals. Among 625 PWH (1644 PY) receiving TPT, 15 developed TB (6/1000 PY). An estimated 20 LTBI-positive individuals would need TPT to prevent one case of TB, and numbers NNS to detect LTBI or prevent active TB varied according to a-priori risk of LTBI.

Conclusion:

The relatively high prevalence of LTBI among PWH and the strong correlation with origin from a TB-endemic country support risk-stratified LTBI screening strategies for PWH in low-incidence countries and treating those who test positive.
A very rare case of bacteraemia in a 4-year-old girl with osteopetrosis with probable Leuconostoc lactis infection
Authors: Azghar Ali , Azizi Manal , Lahmer Mohammed , Benaissa Elmostapha , Ben Lahlou Yassine , Benajiba Noufissa , Elouennass Mostafa , Maleb Adil
Published: October 2023

Leuconostoc lactis

(LLac) is a Gram-positive coccus of the family

Leuconostocaceae

. It can be found in a variety of vegetables and dairy products. LLac is an opportunistic pathogen with intrinsic resistance to vancomycin and teicoplanin. In this case report, we discuss a rare case of LLac-associated bacteraemia in a patient with osteopetrosis. A 4-year-old girl was admitted to the paediatric emergency department with acute fever without other signs. Blood culture revealed an infection with LLac. Using the streptococcus antibiogram, the isolate was resistant to vancomycin, teicoplanin, rifampicin and sulfamethoxazole-trimethoprim but sensitive to β-lactams, gentamicin, streptomycin, azithromycin, clarithromycin, lincomycin, clindamycin and erythromycin. The patient was treated with intravenous ceftriaxone and gentamicin, and subsequently with oral amoxicillin. After a favourable course, she was discharged from the hospital on the 10th day. The modes of transmission and physiopathology of LLac remain unknown. Factors associated with this infection include compromised immunity, previous antibiotic therapy especially with vancomycin, and application of a central venous catheter. In our patient, the risk factors for infection were pancytopenia and multiple transfusions used to treat bone marrow failure. The source of the bacteraemia could have been the cutaneous route, but it could also have been digestive due to the reservoir of the bacteria. LLac is known as an opportunistic bacterium. Further studies on its pathogenesis and other risk factors are needed to understand the true prevalence of this potentially fatal bacterium in compromised individuals, such as the case of our patient.
Recombinant rotavirus expressing the glycosylated S1 protein of SARS-CoV-2
Authors: Philip Asha A. , Hu Sannoong , Dai Jin , Patton John T.
Published: October 2023

Reverse genetic systems have been used to introduce heterologous sequences into the rotavirus segmented double-stranded (ds)RNA genome, enabling the generation of recombinant viruses that express foreign proteins and possibly serve as vaccine vectors. Notably, insertion of SARS-CoV-2 sequences into the segment seven (NSP3) RNA of simian SA11 rotavirus was previously shown to result in the production of recombinant viruses that efficiently expressed the N-terminal domain (NTD) and the receptor-binding domain (RBD) of the S1 region of the SARS-CoV-2 spike protein. However, efforts to generate a similar recombinant (r) SA11 virus that efficiently expressed full-length S1 were less successful. In this study, we describe modifications to the S1-coding cassette inserted in the segment seven RNA that allowed recovery of second-generation rSA11 viruses that efficiently expressed the ~120-kDa S1 protein. The ~120-kDa S1 products were shown to be glycosylated, based on treatment with endoglycosidase H, which reduced the protein to a size of ~80 kDa. Co-pulldown assays demonstrated that the ~120-kDa S1 proteins had affinity for the human ACE2 receptor. Although all the second-generation rSA11 viruses expressed glycosylated S1 with affinity for the ACE receptor, only the S1 product of one virus (rSA11/S1f) was appropriately recognized by anti-S1 antibodies, suggesting the rSA11/S1f virus expressed an authentic form of S1. Compared to the other second-generation rSA11 viruses, the design of the rSA11/S1f was unique, encoding an S1 product that did not include an N-terminal FLAG tag. Probably due to the impact of FLAG tags upstream of the S1 signal peptides, the S1 products of the other viruses (rSA11/3fS1 and rSA11/3fS1-His) may have undergone defective glycosylation, impeding antibody binding. In summary, these results indicate that recombinant rotaviruses can serve as expression vectors of foreign glycosylated proteins, raising the possibility of generating rotavirus-based vaccines that can induce protective immune responses against enteric and mucosal viruses with glycosylated capsid components, including SARS-CoV-2.
Mast-Cell Expressed Membrane Protein-1 (MCEMP1) is expressed in classical monocytes and alveolar macrophages in Idiopathic Pulmonary Fibrosis and regulates cell chemotaxis, adhesion, and migration in a TGFβ dependent manner
Authors: Perrot Carole Y. , Karampitsakos Theodoros , Unterman Avraham , Adams Taylor , Marlin Krystin , Arsenault Alyssa , Zhao Amy , Kaminski Naftali , Katlaps Gundars , Patel Kapilkumar , Bandyopadhyay Debabrata , Herazo-Maya Jose D.
Published: October 2023

Background

Mast-Cell Expressed Membrane Protein-1 (MCEMP1) is higher in Idiopathic Pulmonary Fibrosis (IPF) patients with increased risk of death and poor outcomes. Here we seek to establish the mechanistic role of MCEMP1 in pulmonary fibrosis.

Methods

MCEMP1 expression was analyzed by single-cell RNA sequencing, immunofluorescence in Peripheral Blood Mononuclear Cells (PBMC) as well as in lung tissues from IPF patients and controls. Chromatin Immunoprecipitation (ChiP) and Proximity Ligation Assay (PLA) were used to study the transcriptional regulation ofMCEMP1. Transient RNA interference and lentivirus transduction were used to knockdown and knock-in MCEMP1 in THP-1 cells to study chemotaxis, adhesion, and migration. Bulk RNA sequencing was used to identify the mechanisms by which MCEMP1 participates in monocyte function. Active RHO pull-down assay was used to validate bulk RNA sequencing results.

Results

We identified increased MCEMP1 expression in classical monocytes and alveolar macrophages in IPF compared to controls. MCEMP1 was upregulated by TGFβ at the mRNA and protein levels in THP-1. TGFβ-mediated MCEMP1 upregulation results from the cooperation of SMAD3 and SP1 via concomitant binding to SMAD3/SP1cis-regulatory elements within theMCEMP1promoter. In terms of its function, we found that MCEMP1 regulates TGFβ-mediated monocyte chemotaxis, adhesion, and migration. 400 differentially expressed genes were found to increase after TGFβ stimulation of THP-1, further increased in MCEMP1 knock-in cells treated with TGFβ and decreased in MCEMP1 knockdown cells treated with TGFβ. GO annotation analysis of these genes showed enrichment for positive regulation of RHO GTPase activity and signal transduction. While TGFβ enhanced RHO GTPase activity in THP-1 cells, this effect was attenuated following MCEMP1 knockdown.

Conclusion

MCEMP1 is highly expressed in circulating classical monocytes and alveolar macrophages in IPF. MCEMP1 is regulated by TGFβ and participates in the chemotaxis, adhesion, and migration of circulating monocytes by modulating the effect of TGFβ in RHO activity. Our results suggest that MCEMP1 may regulate the migration and transition of monocytes to monocyte-derived alveolar macrophages during pulmonary fibrosis development and progression.
Developmental and housekeeping transcriptional programs display distinct modes of enhancer-enhancer cooperativity inDrosophila
Authors: Loubiere Vincent , de Almeida Bernardo P. , Pagani Michaela , Stark Alexander
Published: October 2023

Genomic enhancers are key transcriptional regulators which, upon the binding of sequence-specific transcription factors, activate their cognate target promoters. Although enhancers have been extensively studied in isolation, a substantial number of genes have more than one simultaneously active enhancer, and it remains unclear how these cooperate to regulate transcription. UsingDrosophilamelanogaster S2 cells as a model, we assay the activities of more than a thousand individual enhancers and a million enhancer pairs towards housekeeping and developmental core promoters with STARR-seq. We report that housekeeping and developmental enhancers show distinct modes of enhancer-enhancer cooperativity: while housekeeping enhancers are additive such that their combined activity mirrors the sum of their individual activities, developmental enhancers are synergistic and follow a multiplicative model of cooperativity. This developmental enhancer synergy is promiscuous and neither depends on the enhancers’ endogenous genomic contexts nor on specific transcription factor motif signatures, but it saturates for the highest levels of enhancer activity. These results have important implications for our understanding of gene-regulation in complex multi-enhancer loci and genomically clustered housekeeping genes, providing a rationale for strong and mild transcriptional effects of mutations within enhancer regions.
CRISPR-Cas tools for simultaneous transcription & translation control in bacteria
Authors: Cardiff Ryan , Faulkner Ian , Beall Juliana , Carothers James , Zalatan Jesse
Published: October 2023

Robust control over gene translation at arbitrary mRNA targets is an outstanding challenge in microbial synthetic biology. The development of tools that can regulate translation will greatly expand our ability to precisely control genes across the genome. InE. coli, most genes are contained in multi-gene operons, which are subject to polar effects where targeting one gene for repression leads to silencing of both genes. These effects pose a challenge for independently regulating individual genes in multi-gene operons. Here, we use CRISPR-dCas13 to address this challenge. We find that dCas13-mediated repression exhibits up to 6-fold lower polar effects compared to dCas9. We then show that we can selectively activate single genes in a synthetic multi-gene operon by coupling dCas9 transcriptional activation of an operon with dCas13 translational repression of individual genes within the operon. We also show that dCas13 and dCas9 can be multiplexed for improved biosynthesis of a medically-relevant human milk oligosaccharide. Taken together, our findings suggest that combining transcriptional and translational control can access effects that are difficult to achieve with either mode independently. These combined tools for gene regulation will expand our abilities to precisely engineer bacteria for biotechnology and perform systematic genetic screens.

Graphical Abstract
Neuronal “parts list” and wiring diagram for a visual system
Authors: Matsliah Arie , Yu Szi-chieh , Kruk Krzysztof , Bland Doug , Burke Austin , Gager Jay , Hebditch James , Silverman Ben , Willie Kyle , Willie Ryan , Sorek Marissa , Sterling Amy R. , Kind Emil , Garner Dustin , Sancer Gizem , Wernet Mathias F. , Kim Sung Soo , Murthy Mala , Seung H. Sebastian ,   the FlyWire Consortium
Published: October 2023

A catalog of neuronal cell types has often been called a “parts list” of the brain, and regarded as a prerequisite for understanding brain function. In the optic lobe ofDrosophila, rules of connectivity between cell types have already proven essential for understanding fly vision. Here we analyze the fly connectome to complete the list of cell types intrinsic to the optic lobe, as well as the rules governing their connectivity. We more than double the list of known types. Most new cell types contain between 10 and 100 cells, and integrate information over medium distances in the visual field. Some existing type families (Tm, Li, and LPi) at least double in number of types. We introduce a new Sm interneuron family, which contains more types than any other, and three new families of cross-neuropil types. Self-consistency of cell types is demonstrated through automatic assignment of cells to types by distance in high-dimensional feature space, and further validation is provided by algorithms that select small subsets of discriminative features. Cell types with similar connectivity patterns divide into clusters that are interpretable in terms of motion, object, and color vision. Our work showcases the advantages of connectomic cell typing: complete and unbiased sampling, a rich array of features based on connectivity, and reduction of the connectome to a drastically simpler wiring diagram of cell types, with immediate relevance for brain function and development.
An 11-point time course midgut transcriptome across 72 h after bloodfeeding provides detailed temporal resolution of transcript expression in the arbovirus vector,Aedes aegypti
Authors: Tsujimoto Hitoshi , Adelman Zach N.
Published: October 2023

As the major vector for dengue, Zika, yellow fever, and chikungunya viruses, the mosquitoAedes aegyptiis one of the most important insects in public health. These viruses are transmitted by bloodfeeding, which is also necessary for the reproduction of the mosquito. Thus, the midgut plays an essential role in mosquito physiology as the center for bloodmeal digestion and as an organ that serves as the first line of defense against viruses. Despite its importance, transcriptomic dynamics with fine temporal resolution across the entire digestion cycle have not yet been reported. To fill this gap, we conducted a transcriptomic analysis ofA. aegyptifemale midguts across a 72-h bloodmeal digestion cycle for 11 time points, with a particular focus on the first 24 h. PCA analysis confirmed that 72 h is indeed a complete digestion cycle. Cluster and GO enrichment analysis showed the orchestrated modulation of thousands of genes to accomplish the midgut's role as the center for digestion, as well as nutrient transport with a clear progression with sequential emphasis on transcription, translation, energy production, nutrient metabolism, transport, and finally, autophagy by 24–36 h. We further determined that many serine proteases are robustly expressed as if to prepare for unexpected physiological challenges. This study provides a powerful resource for the analysis of genomic features that coordinate the rapid and complex transcriptional program induced by mosquito bloodfeeding.
Developing a business intelligence tool for sustainability management
Authors: Chalmeta Ricardo , Ferrer Estevez Maria
Published: October 2023

Purpose

Business intelligence (BI) is a combination of computer systems and managerial processes to support decision-making. The balanced scorecard is a kind of business intelligence tool for performance measurement and management control aimed at balancing financial and non-financial as well as short- and long-term measures. The sustainable balanced scorecard is a modification of the original balanced scorecard developed to expressly consider governance, social, environmental and ethical issues, and therefore to allow sustainability concepts to be included within the strategy and the management of the organization. However, although the sustainable balanced scorecard is one of the most suitable tools for integrating sustainability within management, there are few examples of how to develop and implement it which can be used as reference models. To help solve this problem, this paper proposes a methodology for the development of a sustainable balanced scorecard, considering different phases such as planification, analysis, design or computer tool implementation, and describes the findings of three case studies.

Design/methodology/approach

The research was conducted using the qualitative multiple-case study method. This made it possible to establish the methodological issues regarding the performance and reporting of this study. Therefore, the research method for the conceptualization and execution of the case studies was divided into seven phases: definition of research goals and questions; proposed theoretical model; identification of units of analysis; case selection; definition of research methods and resources; fieldwork; data collection, classification of information and triangulation; formulation of the enhanced theory, model or methodology; and verification of the rigour and quality of the study.

Findings

Paper shows a methodology organized in phases, activities and tasks that allow a sustainable balanced scorecard to be planned, designed, built, computerized and controlled in order to integrate sustainability within the management systems of organizations.

Originality/value

This study contributes to the currently emerging sustainable balanced scorecard literature and practice and, more generally, to research on sustainability measurement and management. The methodology for sustainable balanced scorecard development and implementation showed in this paper contributes to the management and information systems theory because it makes it possible to overcome the shortcomings identified to date: it considers all the sustainability dimensions; it describes all the project life-cycle activities; it encourages stakeholders' participation; and it has been proved to work in real situations.
Risk accumulation assessment method for building construction based on complex network
Authors: Cao Dongqiang , Cheng Lianhua
Published: October 2023

Purpose

In the evolution process of building construction accidents, there are key nodes of risk change. This paper aims to quickly identify the key nodes and quantitatively assess the node risk. Furthermore, it is essential to propose risk accumulation assessment method of building construction.

Design/methodology/approach

Authors analyzed 419 accidents investigation reports on building construction. In total, 39 risk factors were identified by accidents analysis. These risk factors were combined with 245 risk evolution chains. Based on those, Gephi software was used to draw the risk evolution network model for building construction. Topological parameters were applied to interpret the risk evolution network characteristic.

Findings

Combining complex network with risk matrix, the standard of quantitative classification of node risk level is formulated. After quantitative analysis of node risk, 7 items of medium-risk node, 3 items of high-risk node and 2 items of higher-risk nodes are determined. The application results show that the system risk of the project is 44.67%, which is the high risk level. It can reflect the actual safety conditions of the project in a more comprehensive way.

Research limitations/implications

This paper determined the level of node risk only using the node degree and risk matrix. In future research, more node topological parameters that could be applied to node risk, such as clustering coefficients, mesoscopic numbers, centrality, PageRank, etc.

Practical implications

This article can quantitatively assess the risk accumulation of building construction. It would help safety managers could clarify the system risk status. Moreover, it also contributes to reveal the correspondence between risk accumulation and accident evolution.

Originality/value

This study comprehensively considers the likelihood, consequences and correlation to assess node risk. Based on this, single-node risk and system risk assessment methods of building construction systems were proposed. It provided a promising method and idea for the risk accumulation assessment method of building construction. Moreover, evolution process of node risk is explained from the perspective of risk accumulation.