bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinico-epidemiological study of snakebite: an audit of 13 years of data from a community-based treatment centre in eastern Nepal
Authors: Manandhar Srista , Chhetri Sunit , Basnet Rohan , Gautam Arun , Bhattarai Urza , Uprety Manish , Sharma Aarjav , Gautam Ujwal , Bhushal Madhav , Sharma Sanjib Kumar
Published: January 2025

Background

Snakebite envenomation is a global public health concern, especially in tropical and subtropical regions. We describe the demography, presentations, treatments and outcomes of snakebites from a community snakebite treatment centre in Nepal.

Methods

This was a retrospective study of snakebite cases from 2008 to 2021 presenting in a community-based treatment centre in eastern Nepal. The data were collected from predesigned forms in the centre.

Results

The median age of the victims (N=13 825) was 29 y (interquartile range 18–43) predominantly comprising farmers (39.5%). Cobras (Naja spp.) were the predominant species. Self-treatment practices like the application of tourniquets are common (74.5%) and antivenom was infused to 3.3% of victims. Motorcycles (57.9%) were the primary mode of transport, significantly reducing the time to reach healthcare centres compared with other means (p<0.001). The majority of patients visiting the community snakebite centre exhibited improvement (98.4%), with a low referral rate (0.6%) and case fatality rate (1.26%).

Conclusions

Snakebites are a common problem in rural Nepal. Neurotoxic envenomation, inflicted by the common cobra, predominates in this area. This community-based snakebite treatment centre, managed by paramedics, exemplifies the successful outcome of snakebite management in Nepal.
Snake envenomation in Florida: a 20-year analysis of epidemiology and clinical outcomes at a tertiary medical centre
Authors: Grace River C , Leonard Waverly , Zawoy Maggie , Beatty Norman L
Published: January 2025

Background

Venomous snakes are among the most lethal animals worldwide and envenomation survivors face lifelong morbidities. Envenomation is colloquially considered highly prevalent in the US state of Florida, yet envenomation trends here are currently unassessed.

Methods

We present a comprehensive analysis of causes, characteristics and treatments of Florida's snake envenomations via medical records review of envenomated patients presenting to a major academic medical centre between 2002 and 2022.

Results

Envenomation occurred predominantly in adult men when handling wild snakes. The major envenomating species were the pygmy rattlesnake (Sistrurus miliarius) and cottonmouth (Agkistrodon piscivorus), and most patients were bitten on their hand/finger. Oedema, paraesthesia and nausea were typical, although life-threatening symptoms presented in some after envenomation by the timber rattlesnake (Crotalus horridus) and eastern diamondback rattlesnake (Crotalus adamanteus). After being bitten, 10% of patients attempted contraindicated self-treatments. Although 2.03 h elapsed prior to patients encountering a healthcare provider, there was no correlation between patients’ distance from the hospital and their time until arrival. An additional 4.22 h elapsed prior to administration of antivenom, and three patients died during hospitalization.

Conclusions

Many envenomations were preventable incidents caused by intentional engagement with wild snakes. Education regarding avoidance of venomous snakes and seeking immediate medical care may reduce the prevalence and morbidity of future envenomations.
Health literacy among the rural Bangladeshi population on first aid measures and prevention of snakebite
Authors: Farheen Chowdhury , Rahman A K M F , Ghose Aniruddha , Amin Md R , Rahman Abu S M M , Sayeed Abdullah A , Rahaman F M A , Howlader Chinmaya , Khan Sayra , Rashid Rumana , Chowdhury Nusaer , Debi Geeta R , Rahman Md Sahidur , Faiz M A
Published: January 2025

Background

Bangladesh has a high rate of snakebite. In rural areas, there is a significant mortality and morbidity rate due to lack of awareness and inappropriate first aid practices. This study aims to determine the knowledge and practices of the rural population in two subdistricts of Bangladesh regarding snakebite prevention and first aid measures.

Methods

This cross-sectional survey is part of an intervention study that was carried out in 250 randomly selected primary sampling units of Shibganj in the Chapainawabganj district and Kalapara in the Patuakhali district of Bangladesh. We enrolled a total of 2954 participants. The practice and knowledge were regarded adequate when the score exceeded 50%. We conducted a binomial logistic regression to identify the factors associated with inadequate knowledge and practice.

Results

The community's knowledge (15.9%) and practice (14.5%) regarding snakebite prevention was insufficient. More than 77% and 45.4% of respondents believed that applying a tourniquet above the bite site and seeking a traditional healer after a snakebite were effective first aid measures. Poor knowledge was more likely to occur in farming, fishing, homemaker groups and those with lower incomes (11 000–24 000 Bangladeshi taka). Negative practices were associated with females and high family income.

Conclusions

This study highlights the necessity of community intervention, with a focus on appropriate first aid and prevention measures through widespread education.
Influence of Epichloë on the Microbiota of Established Lolium perenne Pastures in Aotearoa, New Zealand
Authors: Prout Bernadette M. , Mtandavari Yeukai F. , Jauregui Ruy , MacLean Paul , Shi Shengjing , Lee Charles K. , Griffiths Wendy M. , Hume David E. , Bell Nigel L.
Published: January 2025

Perennial ryegrass (Lolium perenne) is a critical species supporting New Zealand's intensive pasture-based agricultural industries. Perennial ryegrass forms a symbiotic, mutualistic association with asexual Epichloë, an endophytic fungus known to increase invertebrate pest resistance. Plant breeders have incorporated several strains of Epichloë in perennial ryegrass, including AR1 and AR37, which exhibit variations in their alkaloid production to target different pasture pests. The impact of Epichloë on ryegrass production and invertebrate pests has been extensively studied; however, little attention has been given to its effects on other associated microorganisms, particularly in established pastures. This study utilised 16S and ITS amplicon sequencing to explore the bacterial and fungal communities of established perennial ryegrass swards from three prominent New Zealand farming locations infected with different Epichloë strains. The value of this study was its replication of real-life farming pastures with different environmental and management variables. The results revealed that plant niche (rhizosphere, root/shoot endosphere) and farming site were the primary factors influencing microbiome variation. The correlation between the Epichloë strain and variations in the bacterial and fungal communities within perennial ryegrass were inconsistent, except for the shoot endosphere communities at one site (Burnham). However, differences in the relative abundance of individual fungal amplicon sequence variants were observed across sites between Epichloë treatments. The absence of significant correlations between Epichloë and the microbiome, coupled with the identification of core microbiota across all samples, contributes evidence that the Epichloë incorporation may not induce substantial variations in the microbiome of 3-year-old established perennial ryegrass pastures.
Pilot for Harmonization of Diagnostic Protocols for Tomato Brown Rugose Fruit Virus (ToBRFV) in Tomato and Pepper Seeds
Authors: Mavrodieva Vessela , Dennis Geoffrey , Xoconostle-Cázares Beatriz , Ong Kevin , Zale Brooke , Nickerson Jennifer , Podleckis Edward , Ramírez-Suárez Angel , Ortíz-Berrocal Marlene , Suazo Alonso , Bloem Stephanie
Published: January 2025

Global seed trade is subject to various national, regional, and international regulations to prevent the introduction and spread of harmful seed-borne and seed-transmitted pathogens. When the plant health regulatory agencies of trading partners employ different diagnostic protocols for the same pathogen, contradictory test results may require additional testing that can cause delays in trade. Establishing equivalence of diagnostic protocols may expedite trade by adding confidence to diagnostic test results. The member countries of the North American Plant Protection Organization (NAPPO) conducted a project evaluating several diagnostic protocols for a seed-transmitted virus, Tomato brown rugose fruit virus (ToBRFV), an emerging pathogen that has severely affected tomato and pepper fruit and seed production and trade globally. The objective of the study was to find protocols that could be harmonized among NAPPO member countries, thereby avoiding retesting of samples at different border points. The project was a collaboration between academia, industry, trade organizations, and national plant protection organizations (NPPO). Three end-point PCR and two real-time PCR protocols were evaluated via a ring test. Nine laboratories from Canada, the United States, and Mexico participated in the ring test, which generated 3,680 data points from analytical, diagnostic, and calibrator samples. Four out of five diagnostic protocols were found to be fully transferable, and three protocols demonstrated optimal performance for accurate, reproducible, and user-friendly detection. The results of this regional effort will simplify the detection of ToBRFV-infected seeds in NAPPO member countries and demonstrate a way to establish equivalency of testing methods between the NPPOs.
Imaging Patterns of Desmoid Tumors in the Head and Neck
Authors: Yang Johnny , Goldooz Matin , Kerby Elizabeth A. , Ryals Logan M. , Qobadi Mina , Taylor Charlotte S.
Published: January 2025

Commonly presenting in the abdomen, desmoid tumors (DT) are rare fibrotic musculoskeletal tumors that have a high recurrence rate. More rarely presenting in the head and neck, DTs have a tendency to aggressively displace and encase surrounding structures and therefore must be quickly diagnosed and treated with either a conservative or an aggressive approach. Although MRI is the preferred imaging modality used to evaluate DTs, the intralesional heterogeneity leads to a wide differential diagnosis and poses a significant challenge in making the correct diagnosis. As demonstrated in four cases, the presence of bone erosions can help differentiate DTs from other soft tissue tumors. Combining characteristic imaging findings with confirmatory immunohistochemistry tests may serve as a reliable diagnostic method for DTs.
The Importance of Sexual History-Taking Within Surgery
Authors: Chinn Justine O. , Hawn Mary T.
Published: January 2025

Sexual and reproductive health is an essential part of comprehensive medical care. As the field of medicine becomes more specialized and siloed and the diagnostic work-up in surgery more advanced, the risk of anchoring diagnoses and partitioning of care increases. Thus, the fundamentals of a complete patient history and review of each body system remain critical in ensuring that surgeons establish a broad differential diagnosis; provide comprehensive, well-rounded care to patients; and create opportunities for patient counseling and interventions. The article by Coleman and colleagues reports on an intervention that did not result in trainees being more likely to take a sexual history; however, the intervention group did ask significantly more questions regarding sexual health than the comparison group when they did take a sexual history. They highlight that there is a persistent gap in sexual history-taking, and that this results in potential misdiagnoses as well as missed opportunities to counsel patients about sexual and reproductive health. Clinicians have a responsibility to recognize factors that increase risk for their patients and provide appropriate counseling, which they cannot do if they are not asking all the necessary questions, even the difficult ones.
Integrated psychosocial support in the ICU
Authors: Rose Matthias , Schürmann Katrin , Ferentzi Hannah , Schmitt Katharina R.L.
Published: January 2025

Purpose of review

During treatment in the ICU, patients, relatives, as well as staff members are exposed to a variety of potentially traumatic experiences. The study explores current concepts to prevent negative effects on mental health resulting from intensive care treatment.

Recent findings

Most healthcare systems rely on consultation or liaison services to address mental health issues provided by mental health experts based outside of the ICU. Those services usually react to manifest comorbid mental conditions, but are less effective to prevent mental health issues. Integrated psychosocial support (IPS) models acknowledge the fact that psychosocial demands are inherent to ICU treatment rather than an individual concern. First experiences support the assumption that clinical psychologists embedded within the ICU team effectively address the need of early identification of mental health issues, and are able to intervene timely and appropriately to traumatic events on the unit. They professionalize psychosocial support structures and facilitate low-threshold support for team members.

Psychologists integrated in the ICU team can effectively target psychosocial needs of patients and relatives with varying complexity. They support the ICU team by taking on those tasks, and contribute to the overall resilience of the ICU team and its members.
Study on the effect of full body isometric resistance training on cardiovascular pressure response
Authors: Zhang Tingran , Yang Yi , Wang Kun , Liu Shiqi , Luo Jiong
Published: January 2025

Background and aims:

Exploring the effect of different isometric resistance training (IRT) on improving blood pressure, so as to provide important reference for the design of aerobic exercise prescription for IRT to improve blood pressure.

Methods:

Forty eight overweight or obese college students with irregular exercise habits were randomly divided into four groups and underwent exercise intervention three times a week for a total of 6 weeks. Cardiovascular changes were evaluated before the first and 18th exercise sessions, as well as 0, 30, and 60 min after exercise.

Results:

Heart rate (HR) of equal distance wall squat group (ISG) and whole body equal length exercise group (WIG) increased significantly immediately after exercise, but long-term IRT intervention significantly decreased systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) of WIG and ISG, SBP, and MAP of equal grip strength group (IHG), and DBP and MAP of equal curl up group (ICG); In the first exercise, ICG, ISG, and WIG significantly increased SBP and DBP immediately after exercise, ISG significantly increased MAP immediately after exercise, while in the 18th exercise, IHG, ISG, and WIG significantly increased SBP immediately after exercise, ISG significantly increased DBP and MAP immediately after exercise.

Conclusion:

IRT is a safe and easy to implement exercise mode. Long-term intervention can effectively control blood pressure, and will not cause excessive cardiovascular pressure response after a single exercise.
Toll-like receptor 4 inhibition by pyridostigmine is associated with a reduction in hypertension and inflammation in rat models of preeclampsia
Authors: Ali Md. Ahasan , Zeng Ming , Alkuhali Asma.A. , Zeng Zhaoshu , Yuan Meng , Wang Xiaomin , Liu Xiaoxu , Issotina Zibrila Abdoulaye , Liu Jinjun , Wang Zheng
Published: January 2025

Background:

Preeclampsia (PE) is marked by hypertension and detrimental sterile inflammatory response. Despite the reported anti-inflammatory effect of pyridostigmine bromide (PYR) in different models, its anti-inflammatory mechanism in PE is unclear. This study assessed whether such an anti-inflammatory effect involves inhibition of placental Toll-like receptor 4 (TLR4) signaling.

Methods:

Placental TLR4 expression and its signaling were assessed respectively in PE women and Sprague-Dawley rats with reduced uterine perfusion pressure (RUPP) induced on gestational day14 (GD14). RUPP and lipopolysaccharides (LPS, 5 μg/kg)-induced PE rats were treated with a selective TLR4 signaling inhibitor (TAK-242, 2.5 mg/kg/day). The effect of PYR (20 mg/kg/day) on TLR4 expression and signaling was also assessed in RUPP or LPS-infused rats. On GD19, rats’ mean arterial pressure (MAP) and samples were collected and processed. At the cellular level, the effect of acetylcholine (ACh), the indirect by-product of PYR activity, on LPS-stimulated HTR-8/SVneo cells was assessed.

Results:

Both PE women and RUPP rats had increased (P 
< 0.05) placental TLR4 expression and elevated (P 
< 0.05) MAP. Selective inhibition of TLR4 signaling with TAK-242 blunted (P < 0.05) RUPP-elevated MAP. Activation of TLR4 induced PE-like symptoms in dams, which were prevented by TAK-242. PYR reduced (P < 0.05) MAP and downregulated placental TLR4 expression and TLR4/TRAF6/NF-κB signaling-mediated inflammation in RUPP and in response to TLR4 selective activation. ACh inhibited the same signaling pathway in LPS-stimulated HTR-8 in vitro.

Conclusion:

Our data support that PYR attenuates placental TLR4 expression and inhibits TLR4/TRAF6/NF-κB signaling pathway-mediated inflammation in RUPP, clarifying the anti-inflammatory mechanisms of PYR in the PE rat model.
Chronic Pain Treatment Utilization in Rural Versus Urban/Suburban Inhabitants Following Traumatic Brain Injury
Authors: Bale Levi , Sevigny Mitch , Hoffman Jeanne M.
Published: January 2025

Objective: To determine whether there are differences in healthcare utilization for chronic pain based on location (rural vs urban/suburban) or healthcare system (civilians vs Military Service Members and Veterans [SMVs]) after moderate-severe TBI. Setting: Eighteen Traumatic Brain Injury Model Systems (TBIMS) Centers. Participants: A total of 1,741 TBIMS participants 1 to 30 years post-injury reporting chronic pain at their most recent follow-up interview. Primary Measures: Sociodemographic, injury, function outcome, pain, and pain treatment characteristics. Results: Participants were mostly male (72.9%), White (75.2%), civilian (76.9%), 46 years old on average, and had greater than high school education (59.9%). 32% of participants resided in rural areas and 67% in urban/suburban areas. No significant difference in healthcare utilization for chronic pain was observed between individuals living in rural versus urban/suburban locations after adjustment for relevant covariates. However, rural SMVs had odds ratios >3 for each major treatment category including medical services (OR = 3.56), exercise therapies (OR = 5.23), psychological services (OR = 4.43), complementary and alternative therapies (OR = 3.23), and pain rehabilitation program (OR = 4.16) compared to rural civilians. This same pattern of findings was seen SMVs in urban/suburban settings as well. Being married versus single, bachelor/graduate education versus high school or less, and employed versus unemployed all had odds ratios >1 for exercise therapies, psychological services, complementary and alternative therapies, and pain rehab program. Conclusion: Contrary to initial hypotheses, there were no significant differences in healthcare utilization for chronic pain treatment comparing those in rural versus urban/suburban areas. However, differences were found between SMVs and civilians across both rural and urban/suburban locations suggesting that SMVs have more access to chronic pain treatment. The improved access to social and financial services afforded by VHA programs to SMVs may serve as a model for improving healthcare utilization in similar civilian populations.
Anterior uveitis, pigmentary retinopathy, and pars plana exudates in Celiac disease
Authors: Agarwal Aniruddha , Rana Surinder S. , Gupta Kirti
Published: January 2025

Purpose:

To report a case of bilateral anterior uveitis, pigmentary retinopathy, and pars plana exudates in a patient with Celiac disease with complete resolution of inflammation following gluten-free diet.

Methods:

Retrospective case report

Results:

A 19-year-old Asian Indian girl presented with bilateral non-granulomatous anterior uveitis for the past 2 months. Examination revealed bilateral pigmentary retinopathy and exudates near the inferior pars plana in the left eye. Laboratory evaluation revealed positive anti-tissue transglutaminase antibody, low thyroid stimulating hormone, low serum ferritin, anemia, and vitamin D deficiency. Her duodenal biopsy was confirmatory for Celiac disease. After initiation of gluten-free diet, there was complete resolution of anterior segment inflammation and vitreous exudates.

Conclusions:

Celiac disease is a rare cause of corticosteroid-resistant uveitis with a handful of cases reported in the literature. This condition has protean manifestations and resolves with gluten-free diet.
Pharmacological Mechanism and Clinical Research Progress of Cordyceps Sinensis Preparations (Bailing Capsules) in the Treatment of Chronic Kidney Disease
Authors: Yang Linhui , Yin Tao , Li Yuehong
Published: January 2025

Chronic kidney disease (CKD) has a high incidence rate, and its treatment primarily focuses on managing the underlying condition, improving lifestyle, slowing the progression of renal dysfunction, and implementing renal replacement therapy when necessary. Cordyceps sinensis, a traditional remedy with over 2000 years of history in folk medicine, is known for its sweet taste and neutral nature. It is believed to nourish the lungs, strengthen the kidneys, and replenish essence and qi by acting on the lung and kidney meridians. Modern preparations of Cordyceps sinensis, such as Bailing capsules, are made from artificially fermented Cordyceps sinensis powder. Research has demonstrated the ability of Cordyceps sinensis to regulate immunity, reduce inflammation, and combat fibrosis. This article reviews the pharmacological mechanisms of Cordyceps sinensis in treating CKD, highlighting its anti-inflammatory, immunomodulatory, and renal function-enhancing effects. Clinical studies have shown that Cordyceps sinensis can lower inflammatory markers, improve kidney function, and exhibit synergistic effects when combined with angiotensin receptor blockers (ARBs) and other medications. Additionally, it is considered safe for use, making it a promising option for treating CKD in traditional Chinese medicine.
Extraintestinal Infections Caused by Aeromonas Species
Authors: Dsouza Nikhil Victor , Basak Sukanya , Shenoy M Suchitra
Published: January 2025

Purpose

The gram negative bacteria of genus Aeromonas is one of the emerging group of pathogens causing infections in humans, both in immunocompromised and immunocompetent. With the development of resistance toward beta-lactam antibiotics, knowledge, and approach regarding Aeromonas is warranted. The study analyses the clinical presentation, risk factors, antimicrobial susceptibility, and outcomes of 31 cases of Aeromonas infection.

Methods

A retrospective record-based study was conducted in a tertiary care hospital after the approval of the institutional ethics committee. All patients diagnosed and admitted with Aeromonas infection over a period of 4 years (2017–2020) were enrolled. All information was collected from medical records, laboratory information systems, and analyzed using SPSS 17.

Results

A total of 31 confirmed cases of Aeromonas were enrolled. Blood and pus/wound swab samples yielded maximum number of isolates. The predominant associated risk factors were type 2 diabetes mellitus and malignancy. Main presentations were bacteremia followed by wound infection with a mortality of 16%. Strains were sensitive toward tigecycline followed by co-trimoxazole, gentamicin, and fluoroquinolones.

Conclusions

The Aeromonas species present with diverse clinical disease and can easily acquire multidrug resistance via plasmids. In immunocompromised individuals, it can give rise to life threatening infections. These are organisms are widely present in the aquatic environment. Therefore, it is prudent to check the contamination of the water bodies by sources like aquaculture and agriculture wastes containing residual antimicrobial agents.
Obesity paradox in coronary artery disease: national inpatient sample analysis
Authors: Salman Ali , Saad Muhammad , Batool Ruqiat Masooma , Ibrahim Zainab Siddiqua , Waqas Saad Ahmed , Ahmed Syed Zaeem , Ahsan Syed Ibad , Aisha Eliza , Aamer Haiqa , Sohail Muhammad Umer , Ansari Ifrah , Afridi Muhammad Khalid , Makda Fatima Aman , Aamir Jazza
Published: January 2025

Background

Although existing literature highlights obesity as a significant predictor for coronary artery disease (CAD), the impact of BMI on hospital outcomes among CAD patients remains unclear.

Methods

We extracted data from the National Inpatient Sample database for adult patients with CAD from 2018 to 2020. The study cohort was stratified into six BMI categories: underweight, normal weight, overweight, class I obesity, class II obesity, and class III obesity. Using multivariable logistic and linear regression, we assessed the impact of BMI on in-hospital mortality, length of stay (LOS), and inflation-adjusted total charges.

Results

We identified a total of 3 693 570 hospitalizations (mean age: 69 ± 12 years). Underweight individuals had the highest in-hospital mortality rate (6.8%), followed by normal weight (5.2%), overweight (3.2%), class III obese (2.5%), class I obese (1.9%), and class II obese (1.8%) individuals. After adjusting for covariates, underweight patients had higher odds of in-hospital mortality compared to normal-weight individuals [odds ratio (OR), 1.38; 95% confidence interval (CI), 1.31–1.45; P < 0.001], while overweight or obese individuals had lower odds: overweight (OR, 0.75; 95% CI, 0.70–0.79; P < 0.001), obese class I: (OR, 0.54; 95% CI, 0.51–0.57; P < 0.001), obese class II: (OR, 0.56; 95% CI, 0.53–0.59; P < 0.001), obese class III: (OR, 0.78; 95% CI, 0.74–0.82; P < 0.001). Normal weight and underweight patients had the longest median LOS [5 days (3.0–9.0)]. Overweight patients incurred the highest total charges [$53 730 (28 587–105 184)].

Conclusion

Underweight patients experienced higher, while overweight and obese patients experienced lower in-hospital mortality than normal-weight patients, suggesting a protective effect of higher BMI against mortality in CAD.
Circadian rhythms, metabolism, and nutrition support in critically ill adult patients: a narrative review
Authors: Chiu Yu-Hsiang , Sharma Anushka , Dashti Hassan S.
Published: January 2025

Purpose of review

The human circadian system regulates several physiological processes, including metabolism, which becomes significantly disrupted during critical illness. The common use of 24-h continuous nutrition support feeding in the intensive care unit (ICU) may further exacerbate these disruptions; this review evaluates recent evidence comparing continuous and intermittent feeding schedules in critically ill adults.

Recent findings

Research comparing different feeding schedules in critically ill adults remains limited. Recent meta-analyses suggest that continuous and intermittent feeding schedules in the ICU have comparable adverse event profiles, including gastrointestinal intolerance. A retrospective study found that continuous feeding did not impact the 24-h glucose variation in critically ill adults, and a randomized controlled trial reported no significant differences in amino acid, lipid-based, or small molecule metabolite profiles between the two feeding regimens. Potential benefits of intermittent feeding include stimulation of muscle protein synthesis, preservation of normal hormone secretion, and improved attainment of nutritional goals.

Current evidence suggests comparable safety profiles for continuous and intermittent feeding schedules in critically ill adult patients. However, intermittent and daytime cyclic feeding are expected to align more closely with normal circadian physiology. Given the lack of existing supportive data, a dynamic approach – transitioning from continuous feeding in the early-acute metabolic phase to intermittent feeding or daytime cyclic feeding – may be appropriate.
When neck lymph nodes metastases do not origin from a head and neck unknown primary
Authors: Pamuk Erim , Simon Christian
Published: January 2025

Purpose of review

The evidence for a standardized approach to the management of cervical metastasis from a distant primary tumour is limited. The objective of this review is to provide an overview of the current status of research in this field and to present the latest diagnostic and therapeutic approaches.

Recent findings

Although infraclavicular tumours are typically observed to metastasise to levels IV and V of the neck, all levels may potentially be affected. In conjunction with imaging and immunohistochemical analyses, next-generation sequencing and artificial intelligence-based tools are emerging as potential methods for identifying the primary tumour. Cervical metastasis can be classified as N3 or M1 in accordance with the histology and site of the primary tumour. A neck dissection + adjuvant chemoradiotherapy may prove beneficial in selected patients with breast, nonsmall cell lung, renal cell, oesophageal and testicular cancers, resulting in improved survival rates.

The diagnosis and subsequent treatment of such cases requires the input of a multidisciplinary team, as the condition is often complex and requires a multifaceted approach. Isolated supraclavicular metastases should prompt the clinician to investigate a distant primary. In select patients with some types of primary tumours, surgical treatment of the neck may improve the prognosis. It is, therefore, essential to control the primary tumour in order to optimize the success of the overall treatment plan.
High-Density Fat Combined With Stromal Vascular Fraction Gel for the Treatment of Facial Localized Scleroderma
Authors: Zheng Yanan , Hu Yanuan , Wang Haipei , Miao Chunlei
Published: January 2025

Patients with localized scleroderma on the face typically exhibit asymmetrical linear or patchy skin lesions and indentations on areas such as the scalp and forehead, with a smooth, waxy surface. In the early stages, medication is used to control the progression of the disease. In later stages, plastic surgery is performed to repair facial skin lesions. The authors treated 2 patients with localized scleroderma of the face using high-density fat combined with stromal vascular fraction gel transplantation surgery. The patients were satisfied with the color and texture of their skin, as it closely resembled the surrounding normal skin. In addition, the facial indentations were corrected, restoring a normal appearance to the face. This method is aesthetically pleasing, durable, and safe.
Minimally Invasive Total Versus Supracervical Hysterectomy With Sacrocolpopexy
Authors: Giugale Lauren E. , Ruppert Kristine M. , Muluk Sruthi L. , Glass Clark Stephanie M. , Bradley Megan S. , Wu Jennifer M. , Matthews Catherine A.
Published: January 2025

Importance

Limited data exist comparing total laparoscopic hysterectomy (TLH) versus laparoscopic supracervical hysterectomy (LSCH) at the time of minimally invasive sacrocolpopexy for uterovaginal prolapse.

Objectives

The objective of this study was to compare TLH versus LSCH at the time of minimally invasive sacrocolpopexy for uterovaginal prolapse, hypothesizing that LSCH would demonstrate a higher proportion of recurrent prolapse, but a lower proportion of mesh exposures.

Study Design

This was a retrospective, secondary analysis comparing a prospective cohort of patients undergoing TLH sacrocolpopexy versus a retrospective cohort of patients who had undergone LSCH sacrocolpopexy. Our primary outcome was composite anatomic pelvic organ prolapse recurrence (prolapse beyond hymen, apical descent > half vaginal length, retreatment). Secondary outcomes included vaginal mesh exposures.

Results

There were 733 procedures: 184 (25.1%) TLH sacrocolpopexy and 549 (74.9%) LSCH sacrocolpopexy. Median follow-up was longer in the TLH cohort (369 [IQR 354–386] vs 190 [IQR 63–362] days, P < 0.01). There was no difference in composite prolapse recurrence between groups on bivariable analysis (3.3% vs 4.7%, P = 0.40). However, multivariable logistic regression demonstrated that TLH sacrocolpopexy had lower odds of composite pelvic organ prolapse recurrence than LSCH sacrocolpopexy (OR 0.21, 95% CI 0.05–0.82, P = 0.02). Among procedures with lightweight mesh types, TLH demonstrated a higher proportion of mesh exposures compared to LSCH (10 [5.4%] vs 4 [1.1%], P < 0.01); however, this was not significant after controlling for confounders (OR 4.51, 95% CI 0.88–39.25, P = 0.08). There were no differences in retreatment or reoperation.

Conclusion

For the treatment of uterovaginal prolapse, both TLH and LSCH are acceptable methods of concomitant hysterectomy at the time of minimally invasive sacrocolpopexy, albeit with likely different risk profiles.
The Pelvic Floor Disorders Network: Evolution Over Two Decades of Female Pelvic Floor Research
Authors: Richter Holly E. , Visco Anthony , Brubaker Linda , Sung Vivian , Nygaard Ingrid , Arya Lily , Menefee Shawn , Zyczynski Halina M. , Schaffer Joseph , Rogers Rebecca G. , Kenton Kimberly , Paraiso Marie F. R. , Fine Paul , Mazloomdoost Donna , Gantz Marie G.
Published: January 2025

Importance

This review aimed to describe research initiatives, evolution, and processes of the Eunice Kennedy Shriver National Institute of Child Health and Human Development–supported Pelvic Floor Disorders Network (PFDN). This may be of interest and inform researchers wishing to conduct multisite coordinated research initiatives as well as to provide perspective to all urogynecologists regarding how the PFDN has evolved and functions.

Study Design

Principal investigators of several PFDN clinical sites and Data Coordinating Center describe more than 20 years of development and maturation of the PFDN.

Results

Over two decades, the PFDN used an intentionally driven approach to answering clinically important questions to inform the surgical and nonsurgical care of women with pelvic floor disorders (PFDs) including pelvic organ prolapse, urinary incontinence, and fecal incontinence. From its inception, the PFDN refined network procedures and processes affecting trial design, protocol development, and standardization of outcomes and publications. This strategy resulted in a credible, robust, and productive portfolio of randomized clinical trials, secondary analyses, prospective cohort, and supplementary studies emphasizing the use of validated patient-reported outcomes, longer-term outcomes, an increase in translational science aims, and standardized long-term collection of adverse events.

Conclusions

The processes the PFDN has developed and implemented have led to impactful research initiatives in women's PFDs. Patient participants and research coordinators have been an integral part of this contribution. Through consistent funding and committed investigators, the state of science in the surgical and nonsurgical care and understanding of PFD pathophysiology has been advanced.
Genome-based reclassification of Suonthocola fibrivorans as a later heterotypic synonym of Diplocloster agilis
Authors: Heng Yu Chyuan
Published: January 2025

Both the genera Suonthocola and Diplocloster are members of the family Lachnospiraceae. Their type species, both Suonthocola fibrivorans Sanger_33T and Diplocloster agilis ASD5720T, were isolated from human faeces. A comparison of their 16S rRNA gene sequences revealed 100% similarity, suggesting their close relatedness and the possibility of belonging to the same species. To clarify their taxonomic relationship, genome-based analyses were carried out. Overall genomic relatedness indices analyses indicated that S. fibrivorans Sanger_33T shared average amino acid identity and percentage of conserved proteins prediction values higher than the Lachnospiraceae-specific genus-level thresholds with D. agilis ASD5720T, as well as the other two existing species of the genus Diplocloster. Additionally, S. fibrivorans Sanger_33T formed a distinct branch with D. agilis ASD5720T, clustering with the other two species of the genus Diplocloster into the same clade in both the 16S rRNA gene phylogenetic tree and the core-genome phylogenomic tree. Essentially, both the average nucleotide identity and digital DNA–DNA hybridization prediction values between S. fibrivorans Sanger_33T and D. agilis ASD5720T were above the recommended species boundaries. It is thus clear that S. fibrivorans Sanger_33T and D. agilis ASD5720T constitute the same species. On the basis of the earliest valid publication, priority is given to D. agilis Chaplin et al. 2022. Based on this, the orphan species S. fibrivorans Hitch et al. 2022 is reclassified as a later heterotypic synonym of D. agilis Chaplin et al. 2022, along with the reclassification of the genus Suonthocola Hitch et al. 2022 as a later synonym of Diplocloster Chaplin et al. 2022.
WITHDRAWN: Comparative Analysis of Machine Learning Models for Cancer Diagnosis
Authors: Eladl Omar
Published: January 2025

Withdrawal Statement

The authors have withdrawn this manuscript because of some errors and mistakes in the submission, including the data analysis and authority, that need to be corrected. A major reason for the manuscript being withdrawn is due to a lack of credit being given to the person who carried out the work. After reviewing the manuscript, we decided to withdraw it to make the necessary revisions before submitting it. Therefore, the authors do not wish this work to be cited as a reference for the project. If you have any questions, please contact the corresponding author.
CARDIAC DYSFUNCTION DURING ADVERSE MATERNAL OUTCOMES IN HYPERTENSIVE DISORDERS OF PREGNANCY
Authors: Giorgione Veronica , Kitt Jamie , Leeson Paul , Khalil Asma , O’Driscoll Jamie , Thilaganathan Basky
Published: January 2025

Background

Hypertensive disorders of pregnancy (HDP) are associated with significant cardiac remodeling during pregnancy and are important contributors to maternal morbidity and mortality. Whether acute adverse outcomes during HDP are associated with additional clinically relevant cardiac impairment has not been widely studied.

Methods

A prospective observational study was conducted on 255 women with HDP who underwent transthoracic echocardiography during the peripartum period. Maternal echocardiographic parameters, including left ventricular morphology and function, were analyzed to determine their association with adverse maternal outcomes by univariate and multivariate analyses. The composite adverse maternal outcome was defined as at least one of the following: admission to a high dependence unit, acute renal injury, adverse cardio-pulmonary events, stroke and disseminated intravascular coagulation.

Results

Adverse maternal outcomes occurred in 68 (26.7%) participants. Women with adverse outcomes had significantly higher left atrial volume index (LAVI) (28.8 [23.4-32.3] ml/m2vs 26.6 [22.2-30.9] ml/m2, p=0.045) and E/e′ ratio (7.8 [6.6-9.2] vs 7.0 [5.9-8.1], p=0.002) compared to those without complications. In multivariable analysis, both LAVI (adjusted OR 1.09 [1.02-1.16], p=0.009) and E/e′ ratio (adjusted OR 1.25 [1.04-1.49], p=0.018) remained independently associated with adverse maternal outcomes after adjusting for maternal factors and clinical variables.

Conclusions

Cardiac abnormalities, particularly in diastolic function, are more common in women with adverse maternal outcomes in HDP. Whether enhanced cardiovascular monitoring and management of these women in the peripartum period could have immediate and long-term health benefits requires further evaluation.

GRAPHIC ABSTRACT
State-dependent modulation of spiny projection neurons controls levodopa-induced dyskinesia in a mouse model of Parkinson’s disease
Authors: Zhai Shenyu , Cui Qiaoling , Wokosin David , Sun Linqing , Tkatch Tatiana , Crittenden Jill R. , Graybiel Ann M. , Surmeier D. James
Published: January 2025

In the later stages of Parkinson’s disease (PD), patients often manifest levodopa-induced dyskinesia (LID), compromising their quality of life. The pathophysiology underlying LID is poorly understood, and treatment options are limited. To move toward filling this treatment gap, the intrinsic and synaptic changes in striatal spiny projection neurons (SPNs) triggered by the sustained elevation of dopamine (DA) during dyskinesia were characterized using electrophysiological, pharmacological, molecular and behavioral approaches. Our studies revealed that the intrinsic excitability and functional corticostriatal connectivity of SPNs in dyskinetic mice oscillate between the on- and off-states of LID in a cell- and state-specific manner. Although triggered by levodopa, these rapid oscillations in SPN properties depended on both dopaminergic and cholinergic signaling. In a mouse PD model, disrupting M1 muscarinic receptor signaling specifically in iSPNs or deleting its downstream signaling partner CalDAG-GEFI blunted the levodopa-induced oscillation in functional connectivity, enhanced the beneficial effects of levodopa and attenuated LID severity.
Analyses of biomarkers for tremor using local field potentials recorded from deep brain stimulation electrodes in the thalamus
Authors: Kumaravelu Karthik , Schmidt Stephen L. , Zhao Yi , Vittert Allison , Swan Brandon D. , Oza Chintan S. , Peters Jennifer J. , Mitchell Kyle T. , Turner Dennis A. , Grill Warren M.
Published: January 2025

Background

Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) of the thalamus (TH) is an effective therapy for suppressing tremor. One of the critical challenges to optimizing VIM-DBS therapy is the lack of robust neural biomarkers that correlate well with tremor.

Objective

We conducted intraoperative local field potential (LFP) recordings from DBS electrodes placed in the TH (including VIM and ventralis oralis posterior-VOP) to quantify biomarkers of tremor. We used computational modeling to understand the biophysical basis of the recorded LFP signal.

Methods

We simultaneously recorded intraoperative TH LFP and tremor from the hand dorsum (34 participants) and during DBS at different frequencies (16 participants). Then, we simulated the effects of DBS and spatial distribution of tremor cells on calculated LFPs in a TH model.

Results

There was a moderate correlation between tremor and LFP spectral power in the theta and alpha bands (r = 0.445 and 0.389, respectively). There was a strong correlation between tremor and peak coherence between LFP and tremor signal (r = 0.559). Postural tremor was decoded from the LFP signal with an area under curve of ∼0.7. High frequency DBS reduced spectral power in the theta and alpha bands and tremor could be decoded from the LFP spectral power in the presence of DBS (0.429 goodness of fit R2). The theta power in the simulated LFP signal varied substantially with the specific location of the bipolar contact pair of the DBS electrode used for the LFP recordings as well as the spatial distribution of tremor cells.

Conclusions

Theta power alone was not sufficient for prediction of tremor control. Simulations indicated that the number and distribution of tremor cells surrounding the DBS lead may explain the lack of strong correlation between tremor and theta power.

HIGHLIGHTS

Recorded intraoperative thalamic LFP in patients with ET, PD, or multiple sclerosis.

Moderate correlation between tremor and spectral power in theta/alpha bands.

Strong correlation between tremor and LFP-Accelerometer coherence.

Tremor can be decoded from VIM-LFP with an AUC of 0.7.

Thalamic model indicated theta power dependent on tremor cell distribution.
MAIT cell deficiency exacerbates neuroinflammation in P301S human tau transgenic mice
Authors: Zhang Yuanyue , Yang Zhi , Tan Xiaosheng , Jiang Na , Cao Gaoyuan , Yang Qi
Published: January 2025

The role of immune cells in neurodegeneration remains incompletely understood. Our recent study revealed the presence of mucosal-associated invariant T (MAIT) cells in the meninges, where they express antioxidant molecules to maintain meningeal barrier integrity. Accumulation of misfolded tau proteins are a hallmark of neurodegenerative diseases. The role of MAIT cells in tau-related neuroinflammation and neurodegeneration, however, remains unclear. Here we report that the meninges of P301 mutant human tau transgenic mice had increased numbers of MAIT cells, which retained their expression of antioxidant molecules.Mr1−/−P301S mice that lacked MAIT cells exhibited increased tau pathology and hippocampus atrophy compared to controlMr1+/+P301S mice. Adoptive transfer of MAIT cells reduced tau pathology and hippocampus atrophy inMr1−/−P301S mice. Meningeal barrier integrity was compromised inMr/−/−P301S mice, but not in controlMr1+/+P301S mice. A distinctive microglia subset with proinflammatory gene expression profile (M-inflammatory) was enriched in the hippocampus ofMr1−/−P301S mice. The transcriptomes of the remaining microglia in these mice also shifted towards a proinflammatory state, with increased expression of inflammatory cytokines, chemokines, and genes related with ribosome biogenesis and immune responses to toxic substances. The transfer of MAIT cells restored meningeal barrier integrity and suppressed microglial inflammation in theMr1−/−P301S mice. Together, our data indicate an important role for MAIT cells in regulating tau-pathology-related neuroinflammation and neurodegeneration.
Four Potential Mechanisms Underlying Phytoplankton-Bacteria Interactions Assessed Using Experiments and Models
Authors: Weissberg Osnat , Aharonovich Dikla , Wu Zhen , Follows Michael J. , Sher Daniel
Published: January 2025

Phytoplankton growth and death depend on interactions with heterotrophic bacteria, yet the underlying mechanisms remain mostly unclear. We ask whether mathematical models explicitly representing four putative mechanisms of interaction (overflow metabolism, mixotrophy, exoenzymes and ROS detoxification) can recapitulate laboratory co-cultures betweenProchlorococcusand 8 heterotrophic bacteria, ranging from synergism to antagonism. Two fundamentally distinct modes of interaction emerge from the models: i) Organic carbon and nitrogen recycling through exoenzymes or overflow metabolism, where high biomass of both organisms leads to more productive systems and more recalcitrant organic matter. ii) Detoxification of ROS, where a small number of "exploited" heterotrophs are sufficient to supportProchlorococcussurvival. Cross feeding is likely more common in laboratory co-cultures, and most models cannot reproduce total inhibition ofProchlorococcus, suggesting additional mechanisms such as allelopathy. Key model parameters determining co-culture outcome are related to cell death and biomass recycling, providing priorities for future research.
Vortex lines in ultralight bosonic dark matter around rotating supermassive black holes
Authors: Korshynska K. , Prykhodko O. O. , Gorbar E. V. , Jia Junji , Yakimenko A. I.
Published: January 2025

Theoretical analysis of the interaction between superfluid dark matter and rotating supermassive black holes offers a promising framework for probing quantum effects in ultralight dark matter and its role in galactic structure. We study how black hole rotation influences the state of ultralight bosonic dark matter, focusing on the stability and dynamics of vortex lines. The gravitational effects of both dark matter and the black hole on the physical properties of these vortex lines, including their precession around the black hole, are analyzed.

Published by the American Physical Society
2025