bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between triglyceride–glucose index trajectories and radiofrequency ablation outcomes in patients with stage 3D atrial fibrillation
Authors: Jia Sixiang , Yin Yanping , Mou Xuanting , Zheng Jing , Li Zhe , Hu Tianli , Zhao Jianqiang , Lin Jiangbo , Song Jiaqi , Cheng Fanli , Wang Yiran , Li Kaini , Lin Wenting , Feng Chao , Ge Weili , Xia Shudong
Published: April 2024

Background

This study investigates the relationship between triglyceride-glucose (TyG) index trajectories and the results of ablation in patients with stage 3D atrial fibrillation (AF).

Methods

A retrospective cohort study was carried out on patients who underwent AF Radiofrequency Catheter Ablation (RFCA) at the Cardiology Department of the Fourth Affiliated Hospital of Zhejiang University and Taizhou Hospital of Zhejiang Province from January 2016 to December 2022. The main clinical endpoint was determined as the occurrence of atrial arrhythmia for at least 30 s following a 3-month period after ablation. Using a latent class trajectory model, different trajectory groups were identified based on TyG levels. The relationship between TyG trajectory and the outcome of AF recurrence in patients was assessed through Kaplan-Meier survival curve analysis and multivariable Cox proportional hazards regression model.

Results

The study included 997 participants, with an average age of 63.21 ± 9.84 years, of whom 630 were males (63.19%). The mean follow-up period for the participants was 30.43 ± 17.75 months, during which 200 individuals experienced AF recurrence. Utilizing the minimum Bayesian Information Criterion (BIC) and the maximum Entropy principle, TyG levels post-AF RFCA were divided into three groups: Locus 1 low-low group (n = 791), Locus 2 low-high-low group (n = 14), and Locus 3 high-high group (n = 192). Significant differences in survival rates among the different trajectories were observed through the Kaplan-Meier curve (P < 0.001). Multivariate Cox regression analysis showed a significant association between baseline TyG level and AF recurrence outcomes (HR = 1.255, 95% CI: 1.087–1.448). Patients with TyG levels above 9.37 had a higher risk of adverse outcomes compared to those with levels below 8.67 (HR = 2.056, 95% CI: 1.335–3.166). Furthermore, individuals in Locus 3 had a higher incidence of outcomes compared to those in Locus 1 (HR = 1.580, 95% CI: 1.146-2).

Conclusion

The TyG trajectories in patients with stage 3D AF are significantly linked to the outcomes of AF recurrence. Continuous monitoring of TyG levels during follow-up may help in identifying patients at high risk of AF recurrence, enabling the early application of effective interventions.
Smart osteoclasts targeted nanomedicine based on amorphous CaCO3 for effective osteoporosis reversal
Authors: Yu Biao , Gao Qianmin , Sheng Shihao , Zhou Fengjin , Geng Zhen , Wei Yan , Zhang Hao , Hu Yan , Wang Sicheng , Huang Jianping , Li Mengmeng , Su Jiacan
Published: April 2024

Background

Osteoporosis is characterized by an imbalance in bone homeostasis, resulting in the excessive dissolution of bone minerals due to the acidified microenvironment mediated by overactive osteoclasts. Oroxylin A (ORO), a natural flavonoid, has shown potential in reversing osteoporosis by inhibiting osteoclast-mediated bone resorption. The limited water solubility and lack of targeting specificity hinder the effective accumulation of Oroxylin A within the pathological environment of osteoporosis.

Results

Osteoclasts’ microenvironment-responsive nanoparticles are prepared by incorporating Oroxylin A with amorphous calcium carbonate (ACC) and coated with glutamic acid hexapeptide-modified phospholipids, aiming at reinforcing the drug delivery efficiency as well as therapeutic effect. The obtained smart nanoparticles, coined as OAPLG, could instantly neutralize acid and release Oroxylin A in the extracellular microenvironment of osteoclasts. The combination of Oroxylin A and ACC synergistically inhibits osteoclast formation and activity, leading to a significant reversal of systemic bone loss in the ovariectomized mice model.

Conclusion

The work highlights an intelligent nanoplatform based on ACC for spatiotemporally controlled release of lipophilic drugs, and illustrates prominent therapeutic promise against osteoporosis.
Substance use patterns, sociodemographics, and health profiles of harm reduction service recipients in Burlington, Vermont
Authors: Erath Tyler G. , LaCroix Rosalie , O’Keefe Erin , Higgins Stephen T. , Rawson Richard A.
Published: April 2024

Background

Understanding current substance use practices is critical to reduce and prevent overdose deaths among individuals at increased risk including persons who use and inject drugs. Because individuals participating in harm reduction and syringe service programs are actively using drugs and vary in treatment participation, information on their current drug use and preferred drugs provides a unique window into the drug use ecology of communities that can inform future intervention services and treatment provision.

Methods

Between March and June 2023, 150 participants in a harm reduction program in Burlington, Vermont completed a survey examining sociodemographics; treatment and medication for opioid use disorder (MOUD) status; substance use; injection information; overdose information; and mental health, medical, and health information. Descriptive analyses assessed overall findings. Comparisons between primary drug subgroups (stimulants, opioids, stimulants-opioids) of past-three-month drug use and treatment participation were analyzed using chi-square and Fisher’s exact test.

Results

Most participants reported being unhoused or unstable housing (80.7%) and unemployed (64.0%) or on disability (21.3%). The drug with the greatest proportion of participants reporting past three-month use was crack cocaine (83.3%). Fentanyl use was reported by 69.3% of participants and xylazine by 38.0% of participants. High rates of stimulant use were reported across all participants independent of whether stimulants were a participant’s primary drug. Fentanyl, heroin, and xylazine use was less common in the stimulants subgroup compared to opioid-containing subgroups (p < .001). Current- and past-year MOUD treatment was reported by 58.0% and 77.3% of participants. Emergency rooms were the most common past-year medical treatment location (48.7%; M = 2.72 visits).

Conclusions

Findings indicate high rates of polysubstance use and the underrecognized effects of stimulant use among people who use drugs—including its notable and increasing role in drug-overdose deaths. Crack cocaine was the most used stimulant, a geographical difference from much of the US where methamphetamine is most common. With the increasing prevalence of fentanyl-adulterated stimulants and differences in opioid use observed between subgroups, these findings highlight the importance and necessity of harm reduction interventions (e.g., drug checking services, fentanyl test strips) and effective treatment for individuals using stimulants alongside MOUD treatment.
Lymphovascular invasion is associated with poor long-term outcomes in patients with pT1N0-3 or pT2-3N0 remnant gastric cancer: a retrospective cohort study
Authors: Sumiyoshi Shutaro , Ohashi Takuma , Kubota Takeshi , Nishibeppu Keiji , Owada Kaho , Kiuchi Jun , Shimizu Hiroki , Arita Tomohiro , Iitaka Daisuke , Yamamoto Yusuke , Konishi Hirotaka , Morimura Ryo , Watanabe Kenji , Kuriu Yoshiaki , Shiozaki Atsushi , Ikoma Hisashi , Fujiwara Hitoshi , Yamaoka Nobuki , Otsuji Eigo
Published: April 2024

Background

Lymphovascular invasion (LVI) is a poor prognostic factor in various malignancies. However, its prognostic effect in remnant gastric cancer (RGC) remains unclear. We examined the correlation between LVI and disease prognosis in patients with T1N0-3 or T2-3N0 RGC in whom adjuvant chemotherapy was not indicated and a treatment strategy was not established.

Methods

We retrospectively analyzed patients with T1N0-3 and T2-3N0 RGC who underwent curative surgery at the Kyoto Prefectural University of Medicine between 1997 and 2019 and at the Kyoto Chubu Medical Center between 2009 and 2019.

Results

Fifteen of 38 patients (39.5%) with RGC were positive for LVI. Patients with LVI had a significantly poorer prognosis for both overall survival ([OS]: P = 0.006) and recurrence-free survival ([RFS]: P = 0.001) than those without LVI. Multivariate analyses using the Cox proportional hazards model revealed LVI as an independent prognostic factor affecting OS (P = 0.024; hazard ratio 8.27, 95% confidence interval:1.285–161.6) and RFS (P = 0.013; hazard ratio 8.98, 95% confidence interval:1.513–171.2).

Conclusions

LVI is a prognostic factor for patients with T1N0-3 or T2-3N0 RGC. Evaluating LVI may be useful for determining treatment strategies for RGC.
Consumption of dietary fiber and APOA5 genetic variants in metabolic syndrome: baseline data from the Korean Medicine Daejeon Citizen Cohort Study
Authors: Kim Jimi , Baek Younghwa , Lee Siwoo
Published: April 2024

Background

Consumption of dietary fiber has been suggested as an important aspect of a healthy diet to reduce the risk of metabolic syndrome (MetS), including cardiovascular disease. The role of fiber intake in MetS might differ by individual genetic susceptibility. APOA5 encodes a regulator of plasma triglyceride levels, which impacts the related mechanisms of MetS. This study investigated the association between dietary fiber and the risk of MetS, assessing their associations according to APOA5 genetic variants.

Methods

A total of 1985 participants aged 30–55 years were included from a cross-sectional study based on the Korean Medicine Daejeon Citizen Cohort study at baseline (2017–2019). Dietary fiber intake was measured using a semiquantitative food frequency questionnaire. The APOA5 polymorphisms (rs2266788 A > G, rs662799 A > G, and rs651821 T > C) were genotyped using the Asia Precision Medicine Research Array. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs).

Results

A higher consumption of dietary fiber was associated with a lower prevalence of MetS (P = 0.025). Among the components of MetS, an inverse association with dietary fiber was observed in increased waist circumference (OR, 95% CI = 0.60, 0.41–0.88, P for trend = 0.009) and elevated triglycerides (OR, 95% CI = 0.69, 0.50–0.96, P for trend = 0.012). Regarding the interaction with APOA5 genetic variants, a stronger association with dietary fiber intake was shown in G allele carriers of rs662799 than in A/A carriers (OR, 95% CI = 2.34, 1.59–3.44, P for interaction = 0.024) and in C allele carriers of rs651821 than in T/T carriers (OR, 95% CI = 2.35, 1.59–3.46, P for interaction = 0.027).

Conclusions

The findings of this study suggest that the benefits of dietary fiber on the risk of MetS could be modified by genetic variants of the APOA5 gene, providing a more effective strategy for preventing MetS.
Sleep disturbance in Angelman syndrome patients
Authors: Qu Song , Wang Junyi , Guan Xingying , Song Cui , Wang Yanyan
Published: April 2024

Angelman syndrome (AS) is a neurodevelopmental disorder caused by abnormal expression of the maternal ubiquitin protein ligase E3A gene (UBE3A). As one of the most challenging symptoms and important focuses of new treatment, sleep disturbance is reported to occur in 70–80% of patients with AS and has a serious impact on the lives of patients and their families. Although clinical studies and animal model studies have provided some clues, recent research into sleep disorders in the context of AS is still very limited. It is generally accepted that there is an interaction between neurodevelopment and sleep; however, there is no recognized mechanism for sleep disorders in AS patients. Accordingly, there are no aetiologically specific clinical treatments for AS-related sleep disorders. The most common approaches involve ameliorating symptoms through methods such as behavioural therapy and symptomatic pharmacotherapy. In recent years, preclinical and clinical studies on the targeted treatment of AS have emerged. Although precision therapy for restoring the UBE3A level and the function of its signalling pathways is inevitably hindered by many remaining obstacles, this approach has the potential to address AS-related sleep disturbance.
An adapted protocol to derive microglia from stem cells and its application in the study of CSF1R-related disorders
Authors: Dorion Marie-France , Casas Diana , Shlaifer Irina , Yaqubi Moein , Fleming Peter , Karpilovsky Nathan , Chen Carol X.-Q. , Nicouleau Michael , Piscopo Valerio E. C. , MacDougall Emma J. , Alluli Aeshah , Goldsmith Taylor M. , Schneider Alexandria , Dorion Samuel , Aprahamian Nathalia , MacDonald Adam , Thomas Rhalena A. , Dudley Roy W. R. , Hall Jeffrey A. , Fon Edward A. , Antel Jack P. , Stratton Jo Anne , Durcan Thomas M. , La Piana Roberta , Healy Luke M.
Published: April 2024

Background

Induced pluripotent stem cell-derived microglia (iMGL) represent an excellent tool in studying microglial function in health and disease. Yet, since differentiation and survival of iMGL are highly reliant on colony-stimulating factor 1 receptor (CSF1R) signaling, it is difficult to use iMGL to study microglial dysfunction associated with pathogenic defects in CSF1R.

Methods

Serial modifications to an existing iMGL protocol were made, including but not limited to changes in growth factor combination to drive microglial differentiation, until successful derivation of microglia-like cells from an adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) patient carrying a c.2350G > A (p.V784M) CSF1R variant. Using healthy control lines, the quality of the new iMGL protocol was validated through cell yield assessment, measurement of microglia marker expression, transcriptomic comparison to primary microglia, and evaluation of inflammatory and phagocytic activities. Similarly, molecular and functional characterization of the ALSP patient-derived iMGL was carried out in comparison to healthy control iMGL.

Results

The newly devised protocol allowed the generation of iMGL with enhanced transcriptomic similarity to cultured primary human microglia and with higher scavenging and inflammatory competence at ~ threefold greater yield compared to the original protocol. Using this protocol, decreased CSF1R autophosphorylation and cell surface expression was observed in iMGL derived from the ALSP patient compared to those derived from healthy controls. Additionally, ALSP patient-derived iMGL presented a migratory defect accompanying a temporal reduction in purinergic receptor P2Y12 (P2RY12) expression, a heightened capacity to internalize myelin, as well as heightened inflammatory response to Pam3CSK4. Poor P2RY12 expression was confirmed to be a consequence of CSF1R haploinsufficiency, as this feature was also observed following CSF1R knockdown or inhibition in mature control iMGL, and in CSF1RWT/KO and CSF1RWT/E633K iMGL compared to their respective isogenic controls.

Conclusions

We optimized a pre-existing iMGL protocol, generating a powerful tool to study microglial involvement in human neurological diseases. Using the optimized protocol, we have generated for the first time iMGL from an ALSP patient carrying a pathogenic CSF1R variant, with preliminary characterization pointing toward functional alterations in migratory, phagocytic and inflammatory activities.

Graphical Abstract
Increased DNA methylation contributes to the early ripening of pear fruits during domestication and improvement
Authors: Song Bobo , Yu Jinshan , Li Xiaolong , Li Jiaming , Fan Jing , Liu Hainan , Wei Weilin , Zhang Lingchao , Gu Kaidi , Liu Dongliang , Zhao Kejiao , Wu Jun
Published: April 2024

Background

DNA methylation is an essential epigenetic modification. However, its contribution to trait changes and diversity in the domestication of perennial fruit trees remains unknown.

Results

Here, we investigate the variation in DNA methylation during pear domestication and improvement using whole-genome bisulfite sequencing in 41 pear accessions. Contrary to the significant decrease during rice domestication, we detect a global increase in DNA methylation during pear domestication and improvement. We find this specific increase in pear is significantly correlated with the downregulation ofDemeter-like1(DML1, encoding DNA demethylase) due to human selection. We identify a total of 5591 differentially methylated regions (DMRs). Methylation in the CG and CHG contexts undergoes co-evolution during pear domestication and improvement. DMRs have higher genetic diversity than selection sweep regions, especially in the introns. Approximately 97% of DMRs are not associated with any SNPs, and these DMRs are associated with starch and sucrose metabolism and phenylpropanoid biosynthesis. We also perform correlation analysis between DNA methylation and gene expression. We find genes close to the hypermethylated DMRs that are significantly associated with fruit ripening. We further verify the function of a hyper-DMR-associated gene,CAMTA2, and demonstrate that overexpression ofCAMTA2in tomato and pear callus inhibits fruit ripening.

Conclusions

Our study describes a specific pattern of DNA methylation in the domestication and improvement of a perennial pear tree and suggests that increased DNA methylation plays an essential role in the early ripening of pear fruits.
Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
Authors: Kikuchi Tomohiro , Hanaoka Shouhei , Nakao Takahiro , Nomura Yukihiro , Mori Harushi , Yoshikawa Takeharu
Published: April 2024

Objectives

To investigate the relationship between low kidney volume and subsequent estimated glomerular filtration rate (eGFR) decline in eGFR category G2 (60–89 mL/min/1.73 m2) population.

Methods

In this retrospective study, we evaluated 5531 individuals with eGFR category G2 who underwent medical checkups at our institution between November 2006 and October 2017. Exclusion criteria were absent for follow-up visit, missing data, prior renal surgery, current renal disease under treatment, large renal masses, and horseshoe kidney. We developed a 3D U-net-based automated system for renal volumetry on CT images. Participants were grouped by sex-specific kidney volume deviations set at mean minus one standard deviation. After 1:1 propensity score matching, we obtained 397 pairs of individuals in the low kidney volume (LKV) and control groups. The primary endpoint was progression of eGFR categories within 5 years, assessed using Cox regression analysis.

Results

This study included 3220 individuals (mean age, 60.0 ± 9.7 years; men, n = 2209). The kidney volume was 404.6 ± 67.1 and 376.8 ± 68.0 cm3 in men and women, respectively. The low kidney volume (LKV) cutoff was 337.5 and 308.8 cm3 for men and women, respectively. LKV was a significant risk factor for the endpoint with an adjusted hazard ratio of 1.64 (95% confidence interval: 1.09–2.45; p = 0.02).

Conclusion

Low kidney volume may adversely affect subsequent eGFR maintenance; hence, the use of imaging metrics may help predict eGFR decline.

Critical relevance statement

Low kidney volume is a significant predictor of reduced kidney function over time; thus, kidney volume measurements could aid in early identification of individuals at risk for declining kidney health.

Key points

• This study explores how kidney volume affects subsequent kidney function maintenance.

• Low kidney volume was associated with estimated glomerular filtration rate decreases.

• Low kidney volume is a prognostic indicator of estimated glomerular filtration rate decline.

Graphical Abstract
AI analytics can be used as imaging biomarkers for predicting invasive upgrade of ductal carcinoma in situ
Authors: Yoon Jiyoung , Yang Juyeon , Lee Hye Sun , Kim Min Jung , Park Vivian Youngjean , Rho Miribi , Yoon Jung Hyun
Published: April 2024

Objectives

To evaluate whether the quantitative abnormality scores provided by artificial intelligence (AI)-based computer-aided detection/diagnosis (CAD) for mammography interpretation can be used to predict invasive upgrade in ductal carcinoma in situ (DCIS) diagnosed on percutaneous biopsy.

Methods

Four hundred forty DCIS in 420 women (mean age, 52.8 years) diagnosed via percutaneous biopsy from January 2015 to December 2019 were included. Mammographic characteristics were assessed based on imaging features (mammographically occult, mass/asymmetry/distortion, calcifications only, and combined mass/asymmetry/distortion with calcifications) and BI-RADS assessments. Routine pre-biopsy 4-view digital mammograms were analyzed using AI-CAD to obtain abnormality scores (AI-CAD score, ranging 0–100%). Multivariable logistic regression was performed to identify independent predictive mammographic variables after adjusting for clinicopathological variables. A subgroup analysis was performed with mammographically detected DCIS.

Results

Of the 440 DCIS, 117 (26.6%) were upgraded to invasive cancer. Three hundred forty-one (77.5%) DCIS were detected on mammography. The multivariable analysis showed that combined features (odds ratio (OR): 2.225, p = 0.033), BI-RADS 4c or 5 assessments (OR: 2.473, p = 0.023 and OR: 5.190, p < 0.001, respectively), higher AI-CAD score (OR: 1.009, p = 0.007), AI-CAD score ≥ 50% (OR: 1.960, p = 0.017), and AI-CAD score ≥ 75% (OR: 2.306, p = 0.009) were independent predictors of invasive upgrade. In mammographically detected DCIS, combined features (OR: 2.194, p = 0.035), and higher AI-CAD score (OR: 1.008, p = 0.047) were significant predictors of invasive upgrade.

Conclusion

The AI-CAD score was an independent predictor of invasive upgrade for DCIS. Higher AI-CAD scores, especially in the highest quartile of ≥ 75%, can be used as an objective imaging biomarker to predict invasive upgrade in DCIS diagnosed with percutaneous biopsy.

Critical relevance statement

Noninvasive imaging features including the quantitative results of AI-CAD for mammography interpretation were independent predictors of invasive upgrade in lesions initially diagnosed as ductal carcinoma in situ via percutaneous biopsy and therefore may help decide the direction of surgery before treatment.

Key points

• Predicting ductal carcinoma in situ upgrade is important, yet there is a lack of conclusive non-invasive biomarkers.

• AI-CAD scores—raw numbers, ≥ 50%, and ≥ 75%—predicted ductal carcinoma in situ upgrade independently.

• Quantitative AI-CAD results may help predict ductal carcinoma in situ upgrade and guide patient management.

Graphical Abstract
Management regulations for odontogenic keratocyst: a case report and review of the literature
Authors: Grover Srishti , Hegde Shreya , Mascarenhas Roma
Published: April 2024

Background

Reconstruction of the entire dentition with odontogenic keratocyst is a very challenging quandary. Most cases of odontogenic keratocyst are often reported to be benign, resulting in severe occlusal discrepancies with the maxillary and mandibular dentition. Dental radiographs occasionally reveal an uncommon, locally aggressive developing cyst termed as odontogenic keratocyst, which is typically located in the posterior jaw. When this cyst occurs in the anterior region, it is often misdiagnosed with other periapical lesions due to its lack of response to pulp vitality tests.

Case presentation

This clinical case scenario demarcates the endodontic management of a patient diagnosed with odontogenic keratocyst. A 37-year-old Indian male patient reported to the department with throbbing pain in the lower left posterior tooth requiring endodontic therapy. This patient also presented with odontogenic keratocyst in the anterior region of the jaw, for which he had undergone surgical rehabilitation. This case report highlights the clinical protocol for the endodontic therapy in patient diagnosed with ododntogenic keratocyst. Masticatory impairment was not visible after the follow-up period and the treatment outcome was successful.

Conclusion

This case report details the presentation, characteristic radiographic findings, and endodontic management of a patient with an extremely rare condition of odontogenic keratocyst. The management involves multidisciplinary approach for the rehabilitation.
Acute invasive fungal sinusitis with orbital tip syndrome in patients on long-term use of ruxolitinib: a case report
Authors: Tang Zhiyuan , Shi Zhaohui
Published: April 2024

Introduction

A long-term ruxolitinib-treated patient with primary myelofibrosis, who was co-infected with aspergillosis infection during a short period, developed acute invasive fungal sinusitis with consequent orbit apex syndrome. This may be the first reported case in the world.

This is a 75-year-old Chinese man; the patient was admitted with 2-month history of headache accompanied by numbness and 8-day history of vision loss. The preliminary clinical diagnoses were suspected acute invasive fungal sinusitis or adenoid cystic carcinoma. We performed endoscopic debridement and antifungal therapy. About 90 days after surgery, magnetic resonance imaging revealed no recurrence of pathological tissue.

Conclusion

One of the bases for the occurrence of invasive fungal sinusitis may be the patient’s long-term use of ruxolitinib for essential thrombocythemia. Some patients with invasive fungal sinuses have atypical nasal symptoms and are referred to the corresponding departments with eye and headache as the first symptoms. It is suggested that enhanced magnetic resonance imaging should be performed at an early stage. Surgical treatment in combination with antifungal and enhanced immunotherapy can effectively prevent the spread of infection and reduce the risk of death.
Evaluating the biodistribution for [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 PET/CT with an inter- and intrapatient based analysis
Authors: Popescu Cristina E. , Zhang Boya , Sartoretti Thomas , Spielhofer Noel , Skawran Stephan , Heimer Jakob , Messerli Michael , Sauter Alexander , Huellner Martin W. , Kaufmann Philipp A. , Burger Irene A. , Maurer Alexander
Published: April 2024

Background

Liver uptake in [68Ga]Ga-PSMA-11 PET is used as an internal reference in addition to clinical parameters to select patients for [177Lu]Lu-PSMA-617 radioligand therapy (RLT). Due to increased demand, [68Ga]Ga-PSMA-11 was replaced by [18F]F-PSMA-1007, a more lipophilic tracer with different biodistribution and splenic uptake was suggested as a new internal reference. We compared the intra-patient tracer distribution between [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007.

Methods

Fifty patients who underwent PET examinations in two centers with both [18F]F-PSMA-1007 and [68Ga]Ga-PSMA-11 within one year were included. Mean standardized uptake values (SUVmean) were obtained for liver, spleen, salivary glands, blood pool, and bone. Primary tumor, local recurrence, lymph node, bone or visceral metastasis were also assessed for intra- and inter-individual comparison.

Results

Liver SUVmean was significantly higher with [18F]F-PSMA-1007 (11.7 ± 3.9) compared to [68Ga]Ga-PSMA-11 (5.4 ± 1.7, p < .05) as well as splenic SUVmean (11.2 ± 3.5 vs.8.1 ± 3.5, p < .05). The blood pool was comparable between the two scans. Malignant lesions did not show higher SUVmean on [18F]F-PSMA-1007. Intra-individual comparison of liver uptake between the two scans showed a linear association for liver uptake with SUVmean [68Ga]Ga-PSMA-11 = 0.33 x SUVmean [18F]F-PSMA-1007 + 1.52 (r = .78, p < .001).

Conclusion

Comparing biodistribution of [68Ga]Ga and [18F]F tracers, liver uptake on [68Ga]Ga-PSMA-11 PET is the most robust internal reference value. Liver uptake of [18F]F-PSMA-1007 was significantly higher, but so was the splenic uptake. The strong intra-individual association of hepatic accumulation between the two scans may allow using of a conversion factor for [18F]F-PSMA-1007 as a basis for RLT selection.
Development and psychometric evaluation of uncertainty about disease and treatment scale in hemodialysis patients: a sequential-exploratory mixed-method study
Authors: Rahimi Esbo Sobhan , Ghaffari Fatemeh , Fotokian Zahra , Nikbakht Hossein-Ali , Saadati Kiana
Published: April 2024

Background and objective

The need for long-term treatment and frequent visits to treatment centers for hemodialysis can lead to psychological problems such as Uncertainty about Disease and Treatment (UC about D&T) in patients with chronic kidney failure. In order to understand uncertainty about disease and treatment and to plan for preventive measures and care interventions in various dimensions, there is a need for reliable and valid tools. The present study was conducted to design and psychometrically evaluate the Uncertainty about Disease and Treatment Scale (UC about D&TS) in patients undergoing hemodialysis.

Methods

This study is of a methodological type and conducted in two stages. The first stage included a deductive (literature review) and an inductive approach (face-to-face interviews). In the second stage, psychometric indices of the UC about D&TS, including face validity (qualitative-quantitative), content validity (qualitative-quantitative), construct validity (exploratory factor analysis), and reliability (using Cronbach's alpha and McDonald's omega) were examined.

Results

In the literature review stage, 66 items were extracted, and in the qualitative stage, 48 items were extracted. After merging similar items, 29 items were entered into the psychometric process. No items were removed in the face and content validity stages. In the construct validity stage, five factors were extracted, including self-uncertainty, uncertain situation, uncertain future, uncertainty of treatment outcomes, and information uncertainty, which constituted a total of 82.16% of the total variance. In this stage, five items were removed from the study due to a corrected item-total correlation below 0.32, and four items were removed due to cross-loading. The α and Ω were calculated as 0.828 and 0.818, respectively. The measurement stability and standard error of measurement were estimated at 0.977 and 2.019, respectively.

Conclusion

The results showed that the UC about D&TS is a valid and reliable measure for patients undergoing hemodialysis. This scale is specifically designed to measure UC about D&T in hemodialysis patients, and it is recommended that healthcare providers (Hcps) use this scale in follow-up visits.
Disease and brain region specific immune response profiles in neurodegenerative diseases with pure and mixed protein pathologies
Authors: Bathe Tim , Hery Gabriela P. , Villareal Jonathan A. B. , Phillips Jennifer L. , Cohen Eric M. , Sharma Rohan V. , Tsering Wangchen , Prokop Stefan
Published: April 2024

The disease-specific accumulation of pathological proteins has long been the major focus of research in neurodegenerative diseases (ND), including Alzheimer’s disease (AD) and related dementias (RD), but the recent identification of a multitude of genetic risk factors for ND in immune-associated genes highlights the importance of immune processes in disease pathogenesis and progression. Studies in animal models have characterized the local immune response to disease-specific proteins in AD and ADRD, but due to the complexity of disease processes and the co-existence of multiple protein pathologies in human donor brains, the precise role of immune processes in ND is far from understood. To better characterize the interplay between different extracellular and intracellular protein pathologies and the brain’s intrinsic immune system in ND, we set out to comprehensively profile the local immune response in postmortem brain samples of individuals with “pure” beta-Amyloid and tau pathology (AD), “pure” α-Synuclein pathology in Lewy body diseases (LBD), as well as cases with Alzheimer’s disease neuropathological changes (ADNC) and Lewy body pathology (MIX). Combining immunohistochemical profiling of microglia and digital image analysis, along with deep immunophenotyping using gene expression profiling on the NanoString nCounter® platform and digital spatial profiling on the NanoString GeoMx® platform we identified a robust immune activation signature in AD brain samples. This signature is maintained in persons with mixed pathologies, irrespective of co-existence of AD pathology and Lewy body (LB) pathology, while LBD brain samples with “pure” LB pathology exhibit an attenuated and distinct immune signature. Our studies highlight disease- and brain region-specific immune response profiles to intracellular and extracellular protein pathologies and further underscore the complexity of neuroimmune interactions in ND.
Forest top canopy bacterial communities are influenced by elevation and host tree traits
Authors: Duan Yiwei , Siegenthaler Andjin , Skidmore Andrew K. , Chariton Anthony A. , Laros Ivo , Rousseau Mélody , De Groot G. Arjen
Published: April 2024

Background

The phyllosphere microbiome is crucial for plant health and ecosystem functioning. While host species play a determining role in shaping the phyllosphere microbiome, host trees of the same species that are subjected to different environmental conditions can still exhibit large degrees of variation in their microbiome diversity and composition. Whether these intra-specific variations in phyllosphere microbiome diversity and composition can be observed over the broader expanse of forest landscapes remains unclear. In this study, we aim to assess the variation in the top canopy phyllosphere bacterial communities between and within host tree species in the temperate European forests, focusing on Fagus sylvatica (European beech) and Picea abies (Norway spruce).

Results

We profiled the bacterial diversity, composition, driving factors, and discriminant taxa in the top canopy phyllosphere of 211 trees in two temperate forests, Veluwe National Parks, the Netherlands and Bavarian Forest National Park, Germany. We found the bacterial communities were primarily shaped by host species, and large variation existed within beech and spruce. While we showed that there was a core microbiome in all tree species examined, community composition varied with elevation, tree diameter at breast height, and leaf-specific traits (e.g., chlorophyll and P content). These driving factors of bacterial community composition also correlated with the relative abundance of specific bacterial families.

Conclusions

While our results underscored the importance of host species, we demonstrated a substantial range of variation in phyllosphere bacterial diversity and composition within a host species. Drivers of these variations have implications at both the individual host tree level, where the bacterial communities differed based on tree traits, and at the broader forest landscape level, where drivers like certain highly plastic leaf traits can potentially link forest canopy bacterial community variations to forest ecosystem processes. We eventually showed close associations between forest canopy phyllosphere bacterial communities and host trees exist, and the consistent patterns emerging from these associations are critical for host plant functioning.
Should prophylaxis against Pneumocystis jirovecii pneumonia be considered in selected patients with leprosy reactions?
Authors: Ramírez-Perea Nuria , Moran-Castaño Claudia , Perez-Molina Jose A.
Published: April 2024

Leprosy reactions often require prolonged high-dose steroids or immunosuppressive drugs, putting patients at risk of Pneumocystis jirovecii pneumonia (PJP). However, no PJP cases are reported, possibly due to dapsone treatment for leprosy. In patients with leprosy reactions not receiving dapsone because of toxicity or resistance and requiring long-term immunosuppression, PJP prophylaxis should be considered.
A novel multicriteria assessment framework for evaluating the performance of the EU in dealing with challenges of the low-carbon energy transition: an integrated Fermatean fuzzy approach
Authors: Kamali Saraji Mahyar , Streimikiene Dalia
Published: April 2024

Climate change, global warming, greenhouse gas emissions, and many other reasons have motivated countries worldwide to change energy systems to move toward low-carbon energy systems; however, the low-carbon energy transition has faced many challenges that motivate the present study to identify the challenges and evaluate the performance of the EU according to challenges. To this end, seventeen challenges were identified through a systematic literature review and classified into five groups: economic, institutional, technical, social, and environmental. Subsequently, fifty-three indicators were selected to measure the performance of the EU in dealing with challenges. Furthermore, a Fermatean “Stepwise Weight Assessment Ratio Analysis” method was applied to determine the subjective weight of identified challenges, while the method based on the removal effects of criteria was applied to determine the objective weight of selected indicators. Afterward, the “Technique for Order of Preference by Similarity to Ideal Solution” method was applied to evaluate the performance of the EU in dealing with the challenges of the low-carbon energy transition for 2015 and 2020. The results indicated that energy justice, mitigation costs, land use, and lack of infrastructure are the most significant social, economic, environmental, institutional, and technical challenges. Also, the Netherlands had the best performance in 2015, followed by Germany; in contrast, Germany improved its energy system and took first place in 2020.
Resilience as a psychiatric factor affecting outcomes after total joint arthroplasty: a systematic review
Authors: Kim Andrew G. , Sanghvi Parshva , Rizk Adam A. , Ahn Aaron , Pumo Thomas J. , Kamath Atul F.
Published: April 2024

Introduction

Mental and psychiatric status continue to be underscreened prior to total joint arthroplasty (TJA). Research on the role of resilience as a psychiatric factor affecting TJA outcomes remains limited. Therefore, our systematic review sought to evaluate the impact of patient resilience in TJA.

Methods

A systematic review of the literature from the Pubmed, MEDLINE, EBSCOhost, and Google Scholar online databases was performed in abidance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Studies reporting on outcomes following primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) segregated by patient resilience were included. Case reports, reviews, meta-analyses, and conference abstracts were excluded. Primary outcomes of interest included patient-reported outcomes (PROs), surgical outcomes, and postoperative opioid consumption.

Results

Twelve articles were included reporting on a total of 1,577 TJAs. There was a strong agreement that the Patient Reported Outcomes Measurement Information System (PROMIS)-Physical Health and Mental Health components were strongly predicted by patient resilience. However, there was inconclusive evidence regarding the impact of resilience on UCLA Activity Scales (UCLA) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) outcomes as well as postoperative hip and knee function. Similarly, conflicting evidence was presented regarding the effect of resilience on length of stay (LOS). Greater resilience was associated with reduced opioid usage in the immediate inpatient postoperative period. However, resilience had no significant effect on opioid requirements in the postoperative outpatient follow-up time frame.

Conclusion

The present analysis demonstrated mixed, inconclusive evidence regarding the impact of resilience on postoperative outcomes. The paucity of research evaluating this relationship warrants further investigation, examining both short and long-term outcomes. Due to the limited literature evaluating resilience as a predictor of outcomes following TJA, we cannot definitively rule out resilience as a valuable metric and must further examine its utility as a preoperative screening tool.

Level of evidence

III.
Art, science, and life: where arts-based research and social-ecological transformation can meet
Authors: Heines Maria Elizabeth , Breed Christina , Engemann Kristine , Knudsen Linette , Colo Lwandiso , Ngcobo Sifiso , Pasgaard Maya
Published: April 2024

Arts-based research offers an innovative approach to today’s social-ecological challenges. Many authors ascertain the transformative power of arts-based research lies in its ability to generate holistic and collaborative encounters which facilitate change. To advance critical discussions around arts-based research, the following article opens up pockets of success as well as the limitations and failures of the My Mabopane photovoice project. This project intended to support urban transformation in the City of Tshwane, South Africa, by asking participants to photograph and reflect upon a nearby green space afflicted with various social and environmental challenges. Results suggest alternative ways of knowing, which contribute to transformative learning, can link arts-based research to social-ecological transformation. However, despite this promising pathway, analyses also reveal realizing social-ecological transformation with arts-based research is no walk in the park. Rather problematic assumptions around knowledge and knowledge production, emerging in tensions between art and science, often trump the emancipatory intentions of photovoice. And broader structural challenges, that arts-based research situates itself in and against, pose a strong barrier for social-ecological transformation. In response to these barriers, this article argues for a collaborative arts-based research practice centering community realities on multiple scales via a merging of art, science, and life.
Does work–family conflict lead to abusive supervision in the construction projects? The role of project commitment and psychological resilience
Authors: Rafique Muhammad , Jaafar Mastura , Ahmed Saira , Amjad-ur-Rehman Muhammad
Published: April 2024

Drawing on conservation of resources theory, the study aimed to investigate the relationship between work–family conflict (time-based, strain-based and behavior-based) and project manager abusive supervision in the presence of mediating mechanism and boundary condition. Time-lagged data were collected from 235 respondents working on construction projects to examine the proposed relationships by utilizing regression analysis. Findings indicated that the dimensions of work–family conflict had a positive significant relationship with abusive supervision and negative relationship with project commitment. Additionally, project commitment mediated the relationships and psychological resilience were found to alleviate the negative influence of work–family conflict on project commitment. Surprisingly, the results delineated that strain-based work–family conflict have more pronounced influence in instigating abusive supervision. This study is unique as it broadens the empirical research on work–family conflict and more particularly negative supervisor behavior in the project context.
Progressive Impairment of Prepubertal Growth in Children With APECED
Authors: Saari Viivi , Alanko Venla , Holopainen Elina , Mäkitie Outi , Laakso Saila
Published: April 2024

Context

Subjects with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) have subnormal adult height. There are several potential APECED-related risk factors for suboptimal height attainment during childhood.

Objective

To determine the growth patterns in children with APECED.

Methods

This retrospective longitudinal study included 59 children with APECED from the Finnish national APECED cohort and assessed length/height and weight z-scores from birth to the end of prepuberty.

Results

Collectively, 59 children (30 [51%] girls) were included. Their median birth weight z-score (−0.60) was below the population average; 12 (20%) patients were born small for gestational age. Height attainment progressively declined from birth until the end of prepuberty (z-score −1.95), whereas weight-for-height z-score did not (+0.26). Of the 59 patients, 38 (64%) had all height z-scores below 0 during prepuberty, and 7 (12%) had z-scores below −2.0. Age at the end of prepuberty, number of APECED manifestations, duration of glucocorticoid treatment, and growth hormone deficiency correlated negatively with height z-score at the end of prepuberty (P < .0001; P = .041; P = .013; P = .034, respectively).

Conclusion

Children with APECED had a progressive growth impairment from birth through prepuberty. Multiple predisposing risk factors were recognized, including disease severity and growth hormone deficiency. Timely interventions are needed to ensure optimal height attainment and new treatment options need to be developed.
A 2023 International Survey of Clinical Practice Patterns in the Management of Graves Disease: A Decade of Change
Authors: Villagelin Danilo , Cooper David S , Burch Henry B
Published: April 2024

Context

Over the past several decades, there have been indications of potential shifts in the diagnostic strategies, treatment, and monitoring of patients with Graves disease (GD).

Objective

To evaluate current practices in managing GD and compare them to previous surveys

Methods

We used a global online survey of endocrinologists to assess shifts in the diagnosis, monitoring, and treatment in a typical patient with GD, as well as treatment variation in 5 different clinical scenarios.

Results

A total of 1252 respondents from 85 countries completed the survey. Methods used to diagnose an uncomplicated GD case have changed over the past decade, reflecting increased use of thyrotropin receptor antibody (TRAb) and reciprocal decreases in nuclear medicine studies. The preferred mode of therapy for uncomplicated GD was antithyroid drugs (ATDs) by 91.5% of respondents, radioactive iodine (RAI) therapy by 7%, and thyroidectomy by 1.5%. Compared with previous surveys, the use of RAI as a first-line choice decreased in all geographic regions. The United States had the sharpest decline in the selection of initial therapy with RAI, decreasing from 69% in 1990 to 11.1% in 2023. In patients with persistent TRAb positivity after 18 months, 68.7% of respondents would continue the use of ATDs. After a relapse of GD, resumption of ATDs was selected by 59.9% of respondents. In patients with active thyroid eye disease or planning pregnancy, ATDs were the first choice (67.5% and 72.8%, respectively), and thyroidectomy emerged as the second choice (22.9% and 15.6%, respectively).

Conclusion

Paradigm shifts have occurred in the management of uncomplicated GD and its variants, as well as the response to persistent and recurrent hyperthyroidism.