bluuebunny/crossref_metadata_2025 huggingface dataset:
Oscillating US Department of Defense policies and medical record documentation of gender dysphoria in service members: an observational time-series analysis
Authors: Highland Krista B. , Klein David A. , Rogers Sydney , Velosky Alexander G. , Roberts Christina , Larson Noelle S.
Published: October 2024

Background

United States military policies regarding service by transgender service members have shifted several times within the past decade. The relationships between policy changes and electronic health record documentation of gender dysphoria, a current and historic policy requisite for gender affirming care receipt, in active duty service members remain unknown.

Methods

Bayesian estimator of abrupt change, seasonality, and trend models identified changepoints in the proportion of service members who had new and then historical medical record documentation consistent with gender dysphoria from January 2015 to August 2022. Changepoints were evaluated as they related to salient military policy-related events.

Results

Approximately 3,853 active duty and activated National Guard or Reserve service members received a documented diagnosis corresponding to gender dysphoria from January 2015 to August 2022. Four significant changepoints were identified across both time series. Salient historical events that occurred during the changepoint periods were identified for contextualization.

Conclusions

Clinical documentation of gender dysphoria oscillated with changes to policies and public statements by government leaders, which may in turn, impact military recruitment and retention. This study highlights the need for equitable policies that optimize the strength of a diverse military force. Equity-oriented monitoring is needed to continually examine the impact of military service policies on readiness and retention to support actionable, data-driven improvements to policies and their implementation.
A qualitative study on rehabilitation services at primary health care: insights from primary health care stakeholders in low-resource contexts
Authors: Charumbira Maria Y , Kaseke Farayi , Conradie Thandi , Berner Karina , Louw Quinette A
Published: October 2024

Background

The chasm between rehabilitation needs and available rehabilitation services is widening. In most low-resource contexts, there are inadequate rehabilitation professionals at primary health care (PHC), leaving nonrehabilitation primary care providers’ (PCPs) and district rehabilitation professionals and managers to address patients’ rehabilitation needs. This study explored rehabilitation and non-rehabilitation PCPs’ and managers’ perspectives on the situation of rehabilitation service provision in PHC settings and the challenges experienced in providing rehabilitation care.

Methods

In this descriptive, exploratory qualitative study, individual semi-structured interviews and focus group discussions were conducted with purposefully sampled PCPs in Manicaland, Zimbabwe and Eastern Cape, South Africa. The transcripts were analysed thematically using Atlas.ti. version 22.2®.

Results

Thirty-six PCPs (29 nonrehabilitation and 7 rehabilitation) and one district manager participated in the study. The current PHC rehabilitation services in the two low-resource contexts were described as inadequate, if not nonexistent. District rehabilitation professionals attempted to fill the gap through outreach and home visits, but resource limitations, particularly in Zimbabwe, often hampered this strategy. The nonrehabilitation PCPs took on task-shifting roles in the identification, referral, and education of patients with rehabilitation needs in the absence of rehabilitation professionals at PHC. Challenges encountered in providing rehabilitation care at PHC included unsupportive leadership, human resource shortages, lack of comprehensive PHC rehabilitation guidelines, no or delayed rehabilitation referral, lack of clear communication strategies, and users’ low demand for PHC rehabilitation.

Conclusion

Tailored approaches, including context-specific rehabilitation guidance for existing task-shifting models, increased investment in rehabilitation and increased rehabilitation awareness, are needed to establish basic rehabilitation services in the described contexts because they are mostly absent. Importantly, the PHC systems in which rehabilitation is to be nested need to be strengthened.
Active CNS delivery of oxycodone in healthy and endotoxemic pigs
Authors: Bällgren Frida , Bergfast Tilda , Ginosyan Aghavni , Mahajan Jessica , Lipcsey Miklós , Hammarlund-Udenaes Margareta , Syvänen Stina , Loryan Irena
Published: October 2024

Background

The primary objective of this study was to advance our understanding of active drug uptake at brain barriers in higher species than rodents, by examining oxycodone brain concentrations in pigs.

Methods

This was investigated by a microdialysis study in healthy and endotoxemic conditions to increase the understanding of inter-species translation of putative proton-coupled organic cation (H+/OC) antiporter-mediated central nervous system (CNS) drug delivery in health and pathology, and facilitate the extrapolation to humans for improved CNS drug treatment in patients. Additionally, we sought to evaluate the efficacy of lumbar cerebrospinal fluid (CSF) exposure readout as a proxy for brain unbound interstitial fluid (ISF) concentrations. By simultaneously monitoring unbound concentrations in blood, the frontal cortical area, the lateral ventricle (LV), and the lumbar intrathecal space in healthy and lipopolysaccharide (LPS)-induced inflammation states within the same animal, we achieved exceptional spatiotemporal resolution in mapping oxycodone transport across CNS barriers.

Results

Our findings provide novel evidence of higher unbound oxycodone concentrations in brain ISF compared to blood, yielding an unbound brain-to-plasma concentration ratio (Kp,uu,brain) of 2.5. This supports the hypothesis of the presence of the H+/OC antiporter system at the blood–brain barrier (BBB) in pigs. Despite significant physiological changes, reflected in pig Sequential Organ Failure Assessment, pSOFA scores, oxycodone blood concentrations and its active net uptake across the BBB remained nearly unchanged during three hours of i.v. infusion of 4 µg/kg/h LPS from Escherichia coli (O111:B4). Mean Kp,uu,LV values indicated active uptake also at the blood-CSF barrier in healthy and endotoxemic pigs. Lumbar CSF concentrations showed minimal inter-individual variability during the experiment, with a mean Kp,uu,lumbarCSF of 1.5. LPS challenge caused a slight decrease in Kp,uu,LV, while Kp,uu,lumbarCSF remained unaffected.

Conclusions

This study enhances our understanding of oxycodone pharmacokinetics and CNS drug delivery in both healthy and inflamed conditions, providing crucial insights for translating these findings to clinical settings.
Long-term outcome of autologous haematopoietic stem cell transplantation in patients with systemic sclerosis: a comparison with patients treated with rituximab and with traditional immunosuppressive agents
Authors: Del Papa Nicoletta , Cavalli Silvia , Rindone Andrea , Onida Francesco , Saporiti Giorgia , Minniti Antonina , Pellico Maria Rosa , Iannone Claudia , Trignani Giorgia , D’Angelo Nicoletta , Sette Manuel , Greco Raffaella , Vitali Claudio , Caporali Roberto
Published: October 2024

Background

Autologous haematopoietic stem cell transplantation (AHSCT) is more effective than conventional immunosuppressive therapies (CIT) in improving the outcome of patients with rapidly progressive diffuse cutaneous systemic sclerosis (dcSSc). So far, there is still a paucity of data comparing AHSCT with rituximab (RTX). Aim of the study is to retrospectively compare, in patients with dcSSc, the effectiveness of AHSCT with that of RTX and CIT.

Methods

Thirty-five dcSSc AHSCT-treated patients were compared with 29 and 36 matched cases treated with RTX and CIT, respectively. The patients were followed up for 5 years by assessing selected outcome measures every year. Overall survival, modified Rodnan skin score (mRSS), lung function tests (FVC and DLCO), and the revised EUSTAR Activity Index (REAI) were the outcome measures chosen to evaluate the therapy efficacy.

Results

AHSCT was significantly more effective than RTX and CIT in prolonging survival, inducing a rapid reduction of the mRSS and REAI and maintaining the baseline level of lung function tests for a longer time. RTX therapy was also superior to CIT in reducing REAI, mRSS and in saving lung function.

Conclusion

AHSCT is more effective than both RTX and CIT in prolonging survival and inducing prolonged remission in patients with rapidly progressive dcSSc.
Revisiting Virchow’s triad: exploring the cellular and molecular alterations in cerebral venous congestion
Authors: Zhou Chen , Zhou Yifan , Ma Wei , Liu Lu , Zhang Weiyue , Li Hui , Wu Chuanjie , Chen Jian , Wu Di , Jiang Huimin , Ji Xunming
Published: October 2024

Background

Cerebral venous thrombosis (CVT) is a rare but serious condition that can lead to significant morbidity and mortality. Virchow’s triad elucidates the role of blood hypercoagulability, blood flow dynamics, and endothelial damage in the pathogenesis of CVT. Cerebral venous congestion (CVC) increases the risk of cerebral venous sinus thrombosis and can lead to recurrent episodes and residual symptoms. However, the precise mechanism by which blood congestion leads to thrombosis remains unclear. Our objective was to investigate the cellular and molecular alterations linked to CVC through analysis of the pathological morphology of venous sinus endothelial cells and transcriptomic profiling.

Results

This study demonstrated a remarkable correlation between CVC and the phenotypic transformation of endothelial cells from an anticoagulant to a procoagulant state. The findings revealed that cerebral venous stasis results in tortuous dilatation of the venous sinuses, with slow blood flow and elevated pressure in the sinuses and damaged endothelial cells of the retroglenoid and internal jugular vein ligation (JVL) rat model. Mechanistically, analysis of transcriptomic results of cerebral venous sinus endothelial cells showed significant activation of platelet activation, complement and coagulation cascades pathway in the JVL rats. Furthermore, the expression of von Willebrand factor (vWF) and coagulation factor VIII (F8) in the complement and coagulation cascades and Fgg and F2 in the platelet activation was increased in the cerebral venous sinuses of JVL rats than in sham rats, suggesting that endothelial cell injury in the venous sinus induced by CVC has a prothrombotic effect. In addition, endothelial cell damage accelerates coagulation and promotes platelet activation. Significantly, the concentrations of vWF, F2 and F8 in venous sinus blood of patients with internal jugular vein stenosis were higher than in their peripheral blood.

Conclusion

Collectively, our data suggest that CVC can induce endothelial cell damage, which then exhibits a procoagulant phenotype and ultimately increases the risk of CVT. This research contributes to our understanding of the pathophysiology of CVC associated with procoagulant factors and reexamines the components of Virchow’s triad in the context of CVC.
Contrasting responses of an invasive plant to herbivory of native and introduced insects
Authors: Fu Qiu-Yue , Wei Guan-Wen , Wang Mo-Zhu , Cui Yuan , Dong Bi-Cheng , Yu Fei-Hai
Published: October 2024

Background

Interactions between alien plants and insect herbivores in introduced ranges may determine their invasion success. However, few studies have investigated whether alien plants respond differently to native and introduced herbivores in their introduced ranges and whether genotypes of alien plants matter. We conducted a greenhouse experiment to examine the effects of herbivory by a native insect (Spodoptera litura), by an introduced insect (S. frugiperda), and simultaneously by both insect species on growth, morphology, and biomass allocation of 17 genotypes of an invasive alien clonal plant Hydrocotyle verticillata, and used selection gradient analysis to test which herbivory conditions favor selection of a specific leaf or root trait value.

Results

Different genotypes of H. verticillata showed significant variation in growth, morphology, and biomass allocation, but their responses to herbivory were relatively consistent. All three herbivory treatments significantly decreased total mass and stolon mass, but herbivory of S. frugiperda increased specific leaf area. Herbivory of S. litura and simultaneous herbivory of both insect species also decreased leaf mass, petiole mass, root mass, and ramet mass. Selection gradient analysis showed that leaf and root traits varied under different herbivory treatments. To achieve greater fitness, as measured by total mass and/or number of ramets, H. verticillata favored larger leaf area under herbivory by S. frugiperda, larger leaf area and lower specific leaf area under herbivory by S. litura, and larger leaf area, lower specific leaf area, and lower root-to-shoot ratio under simultaneous herbivory.

Conclusions

H. verticillata demonstrated contrasting responses to herbivory by native and introduced insects, showing a remarkable ability to coordinate leaf trait plasticity and optimize biomass allocation. This strategy allows H. verticillata to achieve greater fitness under various herbivory conditions, potentially contributing to its invasion success. These findings highlight the importance of plant–herbivore interactions in shaping invasion dynamics and underscore the complex adaptive mechanism that enables invasive plants to establish and spread in introduced ranges.
Lobar graft evaluation in cadaveric lobar lung redo transplantation after living-donor lobar lung transplantation: a case report
Authors: Watanabe Yui , Watanabe Tatsuaki , Hirama Takashi , Murai Sho , Ueda Kazunori , Oishi Hisashi , Akiba Miki , Watanabe Toshikazu , Suzuki Takaya , Notsuda Hirotsugu , Onodera Ken , Togo Takeo , Niikawa Hiromichi , Noda Masafumi , Okada Yoshinori
Published: October 2024

Background

Lung transplantation is a vital option for patients with end-stage lung disease. However, it faces a significant challenge due to the shortage of compatible donors, which particularly affects individuals with small chest cavities and pediatric patients. The novel approach of cadaveric lobar lung transplantation is a promising solution to alleviate the donor shortage crisis. Both the mid-term and long-term outcomes of lobar lung transplantation are comparable to those of standard lung transplantation. However, patients undergoing lobar lung transplantation reported a significantly higher rate of primary graft dysfunction compared to patients undergoing standard lung transplantation. Therefore, careful donor selection is critical to improve outcomes after lobar transplantation. However, no established method exists to evaluate each lung lobar graft of deceased donors. This case report describes a case of cadaveric lobar lung transplantation to overcome size mismatch and donor shortage, with particular emphasis on lobar graft evaluation.

Case presentation

A 39-year-old woman with scleroderma-related respiratory failure was listed for deceased donor lung transplantation due to a rapidly progressing disease. Faced with a long waiting list and impending mortality, she underwent bilateral living-donor lobar lung transplantation donated by her relatives. Post-transplant complications included progressive pulmonary vein obstruction and pleural effusion, which ultimately required retransplantation. An oversized donor with pneumonia in the bilateral lower lobes was allocated. Lung ultrasound was used to evaluate each lung lobar graft during procurement. The right upper and middle lobes and left upper lobe were confirmed to be transplantable, and lobar lung redo transplantation was performed. The patient’s post-transplant course was uneventful, and she was discharged home and returned to her daily activities.

Conclusions

This case highlights the clinical impact of cadaveric lobar lung transplantation as a feasible and effective strategy to overcome the shortage of donor lungs, especially in patients with small thoracic cavities. By establishing donor lung evaluation techniques and overcoming anatomical and logistical challenges, cadaveric lobar lung transplantation can significantly expand the donor pool and offer hope to those previously considered ineligible for transplantation.
Effects of Creatine Supplementation on the Performance, Physiological Response, and Body Composition Among Swimmers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Huang Dongxiang , Wang Xiaobing , Gonjo Tomohiro , Takagi Hideki , Huang Bo , Huang Wenrui , Shan Qi , Chow Daniel Hung-Kay
Published: October 2024

Background

Although recent studies have increasingly focused on examining the potential benefits of creatine supplementation to improve performance in swimming events, the impact of creatine supplementation on swimming performance remains a topic of debate and controversy. A comprehensive meta-analytical review was undertaken to evaluate the effects of creatine supplementation on the performance, physiological response, and body composition among swimmers.

Methods

The research methodology adhered strictly to the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was conducted across six databases (Cochrane Library, Web of Science, Scopus, Embase, PubMed, and SPORTDiscus) until March 23, 2024. Eligible studies that investigated the impact of creatine supplementation on swimming time, physiological parameters, and body composition in swimmers were included. For the meta-analysis, a random-effects model was employed to determine the collective effect and assess variations across distinct subgroups defined by swimming time, physiological metrics, and body composition. Meta-regression analysis was conducted on datasets comprising ten or more studies. Standardized mean differences (SMD) along with their corresponding 95% confidence intervals (CI) were calculated. To evaluate the methodological rigor of the included studies, the Physiotherapy Evidence Database (PEDro) scale was utilized.

Results

The systematic review included seventeen studies with a total of 361 subjects. No significant differences were observed in the overall effect during single sprint swimming (SMD: -0.05, 95% CI: -0.26, 0.15; p = 0.61), repeated interval swimming (SMD: -0.11; 95% CI: -0.46, 0.25; p = 0.56), physiological response (SMD: 0.04, 95% CI: -0.16, 0.23; p = 0.71), and body composition (SMD: 0.18; 95% CI: -0.05, 0.41; p = 0.12) between creatine and placebo groups.

Conclusions

Creatine supplementation exhibited ineffectiveness in enhancing the performance, physiological response, and body composition among swimmers.
The development and testing of a single-arm feasibility and acceptability study of a whole foods diet intervention for adults with prediabetes and their offspring
Authors: Sneed Nadia M. , Kelley Raegan , Turner Haley , Piano Mariann R. , Dagostino Chloe , Sellers Ashley , Bonnet Kemberlee , Schlundt David , Adams Laura E. , Heerman William J.
Published: October 2024

Background

Diet is considered a first-line treatment option for prediabetes, a condition that affects 96 million United States (U.S.) adults. Diet patterns that prioritize whole foods (e.g., Mediterranean) are currently recommended to treat prediabetes. However, no studies have tested whether a U.S.-style diet pattern that prioritizes whole foods can be used to treat prediabetes. The purpose of this study was to assess the feasibility and acceptability of a whole foods diet for adults with prediabetes and their offspring prior to conducting a larger clinical trial.

Methods

A 2-week single-arm pre-post experimental controlled-feeding intervention of a 2020–2025 Dietary Guidelines for Americans adapted whole foods diet (e.g., primarily focused on foods that have undergone limited processing or refinement) was conducted in adults (25–59 years) with prediabetes and their biological offspring (6–17 years). Families received 2 weeks of menus and grocery delivery and weekly counseling by a registered dietitian. Families were invited to attend an optional focus group session. Feasibility was based on having a ≥ 50% family completion rate with ≥ 80% completion of study outcomes. Measures included adult–child anthropometrics (weight [kg], body mass index [BMI] including BMI% and Z-scores for offspring, waist circumference [cm]) and child diet quality estimated using the 2015 Healthy Eating Index (HEI) from a single random food record. Wilcoxon signed rank was used to compare differences between baseline and 2-week anthropometrics measures and offspring total HEI scores. Qualitative data were analyzed using thematic analysis to understand factors attributed to diet adherence and acceptability.

Results

Eight families enrolled (n = 8 adults, n = 12 offspring), with 7 families completing the study (12% attrition) and completing 100% of study outcome measures. Adults experienced a median weight loss of − 1.0 kg from baseline to 2 weeks (79.5 kg to 78.5 kg). Offspring had a 24-point increase in total 2015 HEI scores (median difference 50 to 74). Focus group participants (n = 4 adults) reported being satisfied with the program and expressed a willingness to continue the diet despite identified barriers.

Conclusions

A whole foods diet that provides dietary support was found to be feasible and acceptable for families at risk for T2D. Future studies are needed to test the effects of the diet on prediabetes outcomes, diet quality, and diet adherence in adults and families.

Trial registration

NCT05483972 at ClinicalTrials.gov. Registered July 25, 2022. https://clinicaltrials.gov/study/NCT05483972?cond=prediabetes&term=whole%20foods%20&rank=1
Empagliflozin as a novel therapy for cirrhotic refractory ascites: a randomized controlled study
Authors: Bakosh Mohamed Fathy , Ghazy Ramy Mohamed , Ellakany Walid Ismail , Kamal Ahmed
Published: October 2024

Background

Cirrhotic refractory ascites (RA) patients have few alternatives for treatment. Empagliflozin is now known to have natriuretic and neurohormonal modulatory effects. This research investigated the safety and efficacy of empagliflozin in the management of RA when added to the standard of care (SoC) compared to SoC alone.

Methods

Patients were randomized to receive either a fixed dose of 10 mg of empagliflozin plus standard of care (SoC) or SoC alone. Patients were followed up for 3 months. The primary endpoint was achieving no need for large-volume paracentesis (LVP).

Results

Forty-two patients were randomized equally, and intention-to-treat was performed. There was a statistically significant decrease in the need for LVP in the empagliflozin group compared to the SoC group (100% in the SoC vs. 42.9% in the empagliflozin group, p < 0.001). By the end of the study, the total resolution of ascites was reported in approximately 24% of patients. Muscle cramps and newly developed hyponatremia were more common in the empagliflozin group, but they were mild. Acute kidney injury was more common in the SoC group.

Conclusions

Empagliflozin may be an effective option for use as an add-on therapy in the management of RA, with an accepted safety profile.

Trial registration

The trial was registered at www.clinicaltrials.gov under the identifier NCT05430243. The registration was submitted on 18/06/2022. It is available at https://clinicaltrials.gov/study/NCT05430243.

Graphical Abstract
Characterization of cancer-associated adipocytes by Raman spectroscopy and trajectory inference
Authors: Goffin Nicolas , Buache Emilie , Lalun Nathalie , Fernandes Marion , Miguel Ines , Muller Catherine , Vaysse Charlotte , Blanc Landry , Gobinet Cyril , Piot Olivier
Published: October 2024

Cancer-associated adipocytes (CAAs) have emerged as pivotal players in various cancers, particularly in such as breast cancer, significantly influencing their progression and therapy resistance. Understanding the adipocytes/cancer cells crosstalk is crucial for effective treatment strategies. Raman spectroscopy, a label-free optical technique, offers potential for characterizing biological samples by providing chemical-specific information. In this study, we used Raman spectroscopy and Trajectory Inference methods, specifically the Partition-based graph abstraction algorithm, to investigate the interactions between 3T3-L1 differentiated adipocytes and MDA-MB-231 breast cancer cells in a 2D co-culture model. We demonstrate the existence of subpopulations of adipocytes and the molecular changes associated with CAAs phenotype. This work contributes to understanding the role of CAAs in breast cancer progression and may guide the development of targeted therapies disrupting this interaction.
Characterization of a fluvial deltaic salt-influenced system for CO2 storage using seismic poststack inversion and self-organizing maps in the upper Miocene, Onshore Louisiana
Authors: Jacobsen Rae T. , Knapp James H. , Knapp Camelia C.
Published: October 2024

Basins that have historically been explored for hydrocarbons are now seen through a new perspective for carbon capture and storage. Legacy hydrocarbon reservoirs may now have the potential to become carbon storage targets. The Miocene Sandstone in southeastern Louisiana is a stratigraphic interval that contains favorable zones for carbon storage, and seismic interpretation is a critical tool for characterizing these sands and estimating the amount of possible carbon storage. New workflows leveraging machine learning and seismic inversion can be applied to legacy fields to generate a new estimate for pore space and carbon storage capacity. The study area contains a 3D seismic survey covering 310 mi2 (803 km2) and 17 wells in the southeastern Louisiana Gulf Coast. The area is structurally complex with salt domes and numerous faults. Shelf-edge deltas are the primary sediment input for the target reservoirs, and these fluvial-deltaic sediments provide high porosity and permeable sands. The workflow leverages self-organized maps (SOMs) to identify zones of interest laterally and vertically for carbon storage. SOM can be computed quickly for screening and provides an uplift in resolution for interpretation compared with single attributes. A model-based acoustic impedance inversion produces porosity information and improved resolution that can be used in conjunction with SOM outputs. The acoustic impedance results strongly correlate to porosity within the target sands, and the SOM and porosity maps delineate specific sand lobes for potential storage. Wellbore data within the sand lobe align with SOM and inversion results and show rock quality with 26% average porosity and 90 ft gross thickness. The research highlights a project sized target within the middle Miocene containing 16, 24, and 52 megatons (P10, P50, P90) of estimated CO2 storage. Using SOM and inversion maps together is an effective way for investigating an area for carbon storage targets.
Cardiometabolic Risk Assessment in Transgender Individuals—Differential Effect of Sex Hormones and Sex Chromosomes
Authors: Lei Yu , Wiik Anna , Connelly Margery A , Lindberg Linnea , Andersson Daniel P , Arver Stefan , Gustafsson Thomas , Tietge Uwe J F
Published: October 2024

Context

While transgender individuals represent a substantial group seeking medical care, the differential effect of sex on cardiometabolic risk metrics is incompletely understood.

Objective

The present study aimed to characterize the effect of sex hormones and chromosomes on a contemporary panel of cardiometabolic risk biomarkers and functional cardiovascular measurements.

Methods

A total of 17 transgender men and 17 transgender women were studied at baseline (T0), 4 weeks (hormonal castration, T1), and 11 months following gender-affirming hormone treatment (T12). We analyzed carotid intima-media thickness and arterial stiffness, lipoproteins, and other metabolites comprehensively by nuclear magnetic resonance spectroscopy and high-density lipoprotein–mediated cholesterol efflux capacity (CEC) from macrophages. T0 to T12 comparisons informed the effect of sex hormones, comparisons of genetic XX and XY individuals at T1 the effect of sex chromosomes.

Results

Vascular function was comparable at T12 and T0; systolic blood pressure increased in transgender men (P = .002). Transgender men developed a proatherogenic lipoprotein profile; estrogen treatment in transgender women tended to result in improvements. Several metabolites indicating increased diabetes risk including plasma glucose were changed in transgender men (P = .025), with opposite changes in transgender women (P = .002). Interestingly, at T1 apparent diabetes risk was lower in XX compared with XY individuals (P = .002). CEC decreased in transgender women (P < .01), while remaining unchanged in transgender men. However, in both groups the strong positive association of apolipoprotein A-1 with cholesterol efflux observed at T0 was lost at T12.

Conclusion

The results are consistent with increased cardiometabolic risk in transgender men, while transgender women show beneficial changes early during gender-affirming hormone therapy. Sex chromosomes have fewer intrinsic effects. XY individuals and transgender men display an increased apparent diabetes risk. Further research on cardiometabolic risk is needed for transgender individuals.
The Endocrine Feedback Loop Podcast: Past, Present, and Future
Authors: Hendrickson Chase D
Published: October 2024

In June 2024, the Endocrine Feedback Loop podcast recorded its fiftieth episode at the annual meeting of the Endocrine Society. Launched in May 2020, the podcast serves as a way for listeners to hear a critical analysis of recent and impactful research studies published in clinical journals of the Endocrine Society. The podcast follows methods proven effective in traditional journal clubs and adapts them to reach a wide audience with different levels of expertise in endocrinology. This Perspective outlines the history of the podcast, the process of producing a monthly episode, and the topics covered, as well as an assessment of the experience of producing the podcast and future plans for the Endocrine Feedback Loop.
Intraoperative Hypotension Prediction: Current Methods, Controversies, and Research Outlook
Authors: Mukkamala Ramakrishna , Schnetz Michael P. , Khanna Ashish K. , Mahajan Aman
Published: October 2024

Intraoperative hypotension prediction has been increasingly emphasized due to its potential clinical value in reducing organ injury and the broad availability of large-scale patient datasets and powerful machine learning tools. Hypotension prediction methods can mitigate low blood pressure exposure time. However, they have yet to be convincingly demonstrated to improve objective outcomes; furthermore, they have recently become controversial. This review presents the current state of intraoperative hypotension prediction and makes recommendations on future research. We begin by overviewing the current hypotension prediction methods, which generally rely on the prevailing mean arterial pressure as one of the important input variables and typically show good sensitivity and specificity but low positive predictive value in forecasting near-term acute hypotensive events. We make specific suggestions on improving the definition of acute hypotensive events and evaluating hypotension prediction methods, along with general proposals on extending the methods to predict reduced blood flow and treatment effects. We present a start of a risk-benefit analysis of hypotension prediction methods in clinical practice. We conclude by coalescing this analysis with the current evidence to offer an outlook on prediction methods for intraoperative hypotension. A shift in research toward tailoring hypotension prediction methods to individual patients and pursuing methods to predict appropriate treatment in response to hypotension appear most promising to improve outcomes.
Lack of Association of Chronological Age and Antithrombotic Agents With Acute Intracranial Hemorrhage in the Group of Older Adults With Traumatic Brain Injury
Authors: Kambara Mizuki , Ikawa Fusao , Hidaka Toshikazu , Yamamori Yuji , Yamamoto Yoshiaki , Michihata Nobuaki , Uchimura Masahiro , Yoshikane Tsutomu , Akiyama Yasuhiko , Horie Nobutaka , Hayashi Kentaro
Published: October 2024

BACKGROUND AND OBJECTIVES:

Some reports suggest that older patients with traumatic brain injury (TBI) are more likely to experience acute intracranial hemorrhage, resulting in poor outcomes. However, the association between precise chronological age and use of antithrombotic agents with acute intracranial hemorrhage in these patients remains unknown. The aim of this study was to determine factors associated with acute intracranial hemorrhage and poor outcomes in patients with TBI, including chronological age and use of antithrombotic agents.

METHODS:

Patients hospitalized for TBI between January 2006 and December 2021 were included. Patients were categorized by age groups of <65 years, 65 to 74 years, 75 to 84 years, and ≥85 years. Associations between each age group and acute intracranial hemorrhage, a poor outcome at discharge, and in-hospital mortality were evaluated.

RESULTS:

The cohort included 1086 patients, with 713 (65.7%) in the ≥65 age group. Although chronological age was associated with acute intracranial hemorrhage in patients aged <65 years (odds ratio [OR] 1.02; 95% CI 1.01-1.03), it was not associated with patients aged ≥65 years. None of the antithrombotic agents investigated were associated with acute intracranial hemorrhage in the group aged ≥65 years. Although chronological age was associated with a poor outcome in patients aged <65 years (OR 1.03; 95% CI 1.01-1.07), it was not associated in those aged ≥65 years. The ≥85 year age group (OR 2.30; 95% CI 1.18-4.51) compared with <65 years were significantly associated with a poor outcome. None of the antithrombotic agents investigated were associated with a poor outcome in the group aged ≥65 years.

CONCLUSION:

Our findings confirmed the lack of an association of chronological age and antithrombotic agents with acute intracranial hemorrhage in the group of older adults with TBI. Our findings suggest that antithrombotic agents may be safely used, even in older adults.
Laparoscopic-Assisted, Percutaneous Cryoablation: A Novel Technique for the Treatment of Abdominal Wall Soft Tissue Tumors
Authors: Ricker Ansley Beth , Stone Taylor J. , Jagosky Megan H. , Anderson Colin J. , Squires Malcolm H.
Published: October 2024

Introduction

Percutaneous cryoablation is a first-line therapeutic option for primary neoplasms and metastatic lesions of the musculoskeletal system. Treatment of abdominal wall tumors is challenging as surgical resection can be highly morbid and necessitate complex reconstructive surgery; the efficacy of cryoablation for abdominal wall tumors may be limited by inadequate posterior margins owing to the proximity of intra-abdominal organs. With laparoscopy and insufflation, peritoneal structures can be safely mobilized away from the abdominal wall, allowing for adequate deep margin freeze and visualization of the ice ball. We present two patients with abdominal wall soft tissue tumors treated with a novel approach of laparoscopic-assisted, percutaneous ultrasound-guided cryoablation.

Patients and Methods

Patient 1 is a 65-year-old female with metastatic extraskeletal myxoid chondrosarcoma, stable on systemic therapy, who presented with a new soft tissue metastasis to the abdominal wall. Resection would have necessitated a highly morbid complex abdominal wall reconstruction with mesh. Patient 2 is a 35-year-old female with a large abdominal wall desmoid tumor, diagnosed after miscarriage. Resection was relatively contraindicated owing to the morbidity of a complex abdominal wall reconstruction and concerns regarding potential future pregnancies after surgery.

Results

Both patients underwent procedures in the outpatient setting after discussion at multidisciplinary sarcoma tumor board. Laparoscopic enterolysis was performed to mobilize the bowel away from the abdominal wall, to allow direct visualization of the peritoneal aspect of the tumor, and to confirm adequacy of the posterior margin freeze of the lesion. Laparoscopic transversus abdominus preperitoneal (TAPP) blocks with local anesthetic were performed for postoperative pain control. Interventional radiology performed an ultrasound-guided cryoablation consisting of two freeze and thaw cycles. Both patients recovered well without complications and were without radiographic evidence of persistent or recurrent disease at 12 and 18 months postoperatively, respectively.

Conclusion

We report a novel approach of laparoscopic-assisted cryoablation for the treatment of abdominal wall soft tissue tumors. This allowed for successful minimally invasive local control of these large tumors that would have otherwise required highly morbid resections with complex abdominal wall reconstruction and mesh repair.
Φλεγμονώδεις μεσολαβητές στη χρόνια αποφρακτική πνευμονοπάθεια (ΧΑΠ)
Authors: Βουλγαρέλη Ηλέκτρα
Published: October 2024

Εισαγωγή: Η Χρόνια Αποφρακτική Πνευμονοπάθεια (ΧΑΠ) είναι μια κοινή νόσος που χαρακτηρίζεται από προοδευτική απόφραξη της ροής του αέρα και επηρεάζεται από γενετικούς και περιβαλλοντικούς παράγοντες. Τα ηωσινόφιλα έχουν εμπλακεί στην παθογένεση της ΧΑΠ, αναγνωρίζοντας δύο ενδοτύπους: τον ηωσινοφιλικό και τον μη ηωσινοφιλικό ενδότυπο. Η μελέτη μας έχει στόχο να διερευνήσει τη συσχέτιση μεταξύ της ηωσινοφιλικής φλεγμονής και της έκφρασης του mRNA των γονιδίων ELAVL1, ZfP36 και HNRNPD, τα οποία κωδικοποιούν τις πρωτεΐνες HuR, TTP και AUF-1, αντίστοιχα. Επιπλέον, στόχος είναι να εξετάσει την έκφραση της IL-9 και της IL-33 σε ασθενείς με ΧΑΠ με διαφορετικό ηωσινοφιλικό προφίλ. Η κατανόηση αυτών των μοριακών συσχετισμών θα μπορούσε να προσφέρει πληροφορίες για την ετερογένεια της ΧΑΠ και να παρέχει πιθανούς θεραπευτικούς στόχους. Μέθοδοι: 50 ασθενείς με ΧΑΠ εισήχθησαν στη μελέτη, εκ των οποίων οι 21 είχαν ηωσινοφιλική φλεγμονή και οι 29 είχαν μη ηωσινοφιλική φλεγμονή. Καταγράφηκαν επιδημιολογικά δεδομένα, συννοσηρότητες και η αναπνευστική λειτουργία των ασθενών. Μονοπύρηνα κύτταρα περιφερικού αίματος απομονώθηκαν για την ανάλυση του mRNA των γονιδίων ELAVL1, ZfP36 και HNRNPD και οι κυτταροκίνες ορού (IL-9 και IL-33) μετρήθηκαν με τεχνική ELISA. Αποτελέσματα: Η μελέτη περιελάμβανε 50 συμμετέχοντες, με το 66% να είναι άνδρες με μέση ηλικία τα 68 έτη (SD: 8,9 έτη). Η έκφραση του mRNA του γονιδίου ELAVL1 ήταν 0,45 φορές υψηλότερη σε σχέση με την πρωτεΐνη αναφοράς, τη β2 μικροσφαιρίνη, στην ομάδα των ασθενών με ΧΑΠ με μη ηωσινοφιλική φλεγμονή και 3,93 φορές υψηλότερη στην ομάδα με ηωσινοφιλική φλεγμονή (p = 0,11). Για το γονίδιο ZfP36, η έκφραση του mRNA ήταν 6,19 φορές υψηλότερη στους ασθενείς με μη ηωσινοφιλική φλεγμονή και 119,4 φορές υψηλότερη στους ασθενείς με ηωσινοφιλική φλεγμονή (p = 0,07). Ομοίως, η έκφραση του mRNA για το γονίδιο HNRNPD ήταν 0,23 φορές υψηλότερη στην ομάδα με μη ηωσινοφιλική φλεγμονή και 0,72 φορές υψηλότερη στην ομάδα με ηωσινοφιλική φλεγμονή (p = 0,06). Επιπλέον, τα επίπεδα της IL-9 στον ορό δεν έδειξαν στατιστικά σημαντική διαφορά μεταξύ της ομάδας με ηωσινοφιλική φλεγμονή και της ομάδας με μη ηωσινοφιλική φλεγμονή (58,03 pg/mL έναντι 52,55 pg/mL, p = 0,98). Ακόμη, δεν υπήρχε στατιστικά σημαντική διαφορά στα επίπεδα της IL-33 στον ορό μεταξύ των ασθενών με ΧΑΠ με ηωσινοφιλική φλεγμονή και εκείνων με μη ηωσινοφιλική φλεγμονή (39,61 pg/mL έναντι 37,94 pg/mL, p = 0,72). Συμπεράσματα: Τα δεδομένα υποδηλώνουν μια τάση, χωρίς όμως στατιστική σημαντικότητα, προς υψηλότερη έκφραση του mRNA για τα γονίδια ZfP36 και HNRNPD στους ασθενείς με ΧΑΠ με ηωσινοφιλική φλεγμονή σε σύγκριση με αυτούς με μη ηωσινοφιλική φλεγμονή.
Seasonal variability of epipelic microphytobenthos community in two subtidal areas of the Northern Adriatic Sea
Authors: MULE APURVA , NERI FRANCESCA , ROMAGNOLI TIZIANA , ACCORONI STEFANO , CARIDI FRANCESCA , CAMPANELLI ALESSANDRA , UBALDI MARIKA , SARNO DIANA , TOTTI CECILIA
Published: October 2024

We investigated the biodiversity and seasonality of subtidal benthic diatoms at two sites of the Northern Adriatic Sea differently affected by anthropogenic inputs. Sediment samples were collected seasonally, and diatom cells were then separated from the sediment using the density gradient centrifugation method. The total abundance of benthic diatoms ranged between 4,409 ± 1,638 and 77,663 ± 30,415 cells cm-2 and the biomass between 0.41 ± 0.22 and 3.66 ± 2.01 μg C cm-2. At both stations, the benthic diatoms showed a marked seasonal pattern, with maximum abundance, biomass and biodiversity in spring and minimum in summer. Motile life forms, such as Navicula, Nitzschia, Fallacia, and Psammodictyon, dominated in terms of abundance at both stations throughout the study period, while plocon (centric diatoms mainly belonging to Biddulphiaceae) increased under mixing conditions, when they represented the largest contributor to biomass. At both stations and in all seasons, the Si:N:P ratio highlighted the strong P limitation, typical of the Adriatic Sea. The ammonium concentration was the highest component of DIN in spring and summer when we observed the highest and lowest MPB abundance respectively. The preference of diatoms for ammonia, coupled with the increased daylight period, may have enhanced the spring growth, whereas in summer the hypoxic conditions may have caused a decrease. Despite the different environmental conditions, the two stations exhibited similar species compositions and seasonal trends, highlighting relative stability against anthropogenic pressures of a different nature.
Length-weight relationship and condition factor of Nile tilapia (Oreochromis niloticus) fed diets supplemented with guava and star gooseberry leaf extract
Authors: Kamble Manoj Tukaram , Salin Krishna Rugmini , Chavan Balasaheb Ramdas , Medhe Seema Vijay , Thompson Kim D. , Pirarat Nopadon
Published: October 2024

Background Nile tilapia (Oreochromis niloticus) is predominant cultured species in aquaculture. However, there is a scarcity of literature regarding relationship between guava and star gooseberry leaf extract and the condition factor. Thus, the present study aims to investigate the effect of guava and star gooseberry leaf extract-supplemented diets on the specific growth rate, length-weight relationship, and condition factor of Nile tilapia. Methods Six hundred and thirty Nile tilapia (8.7±0.4 g) were randomly distributed among twenty-one tanks (30 fish per tank) within a recirculation system. Over a 60-day period, the fish were fed diets supplemented with 5g/Kg and 10g/Kg of guava leaf extract (GLE-5, GLE-10), star gooseberry leaf extract (SGLE-5, SGLE-10), and a mixture of both (MxLE-5, MXLE-10). Subsequently, specific growth rate, length-weight relationship, and condition factor were determined. Results After 60 days, the specific growth rate was significantly higher in all the GLE, SGLE, and MxLE groups compared to the control group. The final lengths and weights differed significantly both in the control group and all the GLE, SGLE, and MxLE groups. The analysis of the regression equation indicated a positive correlation (r = 0.970, 0.977, 0.976, 0.974, 0.974, 0.974, and 0.969) between the length and weight of Nile tilapia in the control group and in all the GLE, SGLE, and MxLE groups. The regression exponent “b” values in all the GLE, SGLE, and MxLE groups were >3, indicating a positive allometric growth pattern in Nile tilapia compared to the control (b=2.866), which exhibited a negative allometry. The final condition factor values did not differ significantly in either the control group or any of the plant extract groups. Conclusions Nile tilapia exhibited positive allometric growth patterns and maintained good health when fed with GLE, SGLE, and MxLE groups. Therefore, these plant extracts demonstrate suitability for commercial Nile tilapia production.
Natural agents that are neuroprotective against mitochondria: a bibliometric-based research mapping 1998–2024, from cells to mitochondria
Authors: YURISALDI SALEH ARMAN , Yogi Saputra Dwi Arwandi
Published: October 2024

Introduction Mitochondria are cell organelles that function as the cell’s main power plant, producing ATP, the main energy molecule in cells. Mitochondria play an important role in the context of neuroprotection, and mitochondrial function has been implicated in various neurodegenerative diseases, including Alzheimer’s, Parkinson’s, and amyotrophic lateral sclerosis (ALS). Recent research in the field of neuroprotection has focused on the development of therapies that target mitochondria. Natural ingredients have long been used in traditional medicine and show potential as neuroprotective agents. Methods In this work, a literature review methodology is employed to gather data from the Scopus database using the keywords natural agents, herb*, neuroprotective, and mitochondria. The data were analyzed using Biblioshiny and VOSviewer software to produce visualizations and bibliometric maps. We conducted quantitative and qualitative analyses. Results The research trend found are documents by year, most global cited document, most relevant sources, A factorial map illustrating the leading contributors of papers, documents by author, documents by country or territory, documents by subject area, network visualization, overlay visualization of scopus database using vosviewer, density visualization, thematic map, thematic evolution, cluster analysis, qualitative analysis, and word cloud. Conclusions Natural Agent Neurotropik is a natural substance that influences the brain’s nervous system and peripheral nervous system, enhancing cognition, mood, and brain function. Derived from herbs, spices, and herbal products, it has advantages over other natural agents in energy production, brain biogenesis, and neuroprotection. Natural agents’ compositional heterogeneity affects reproductive results. Proper characterization and standardized extraction techniques are crucial for establishing plant extracts’ chemical profile. Dosage consistency is essential for standardized results. Long-term safety and potential toxicity should be evaluated. Comparing natural medicines with synthetic pharmaceuticals can enhance therapy efficacy and reduce drug resistance. Further research is needed to assess neuroprotection and mitochondrial function.