bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of different medical treatments for primary hyperaldosteronism: a systematic review and network meta-analysis
Authors: Ho Wen-Yu , Hsiao Ching-Chung , Wu Ping-Hsun , Chen Jui-Yi , Tu Yu-Kang , Wu Vin-Cent , Chen Jia-Jin
Published: March 2024

Background:

The effectiveness and side effects between different medical treatments in patients with primary hyperaldosteronism have not been systematically studied.

Objective:

To analyze the efficacy between different mineralocorticoid receptor antagonists (MRAs) and epithelial sodium channel (ENaC) inhibitors in a network meta-analysis (NMA) framework, while also evaluating adverse events.

Design:

Systematic review and NMA.

Data sources and methods:

The systematic review and NMA was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, MEDLINE, the Cochrane library, and Excerpta Medica database (EMBASE) were searched for randomized controlled trials (RCTs) involving adult patients with primary hyperaldosteronism until 23 June 2023. Studies that compared the efficacy and side effects of different medical treatments of primary hyperaldosteronism were included. The primary outcomes included the effect on blood pressure, serum potassium, and major adverse cardiovascular events. The secondary outcomes were adverse events related to MRAs (hyperkalemia and gynecomastia). Frequentist NMA and pairwise meta-analysis were conducted.

Results:

A total of 5 RCTs comprising 392 participants were included. Eplerenone, esaxerenone, and amiloride were compared to spironolactone and demonstrated comparable effect on the reduction of systolic blood pressure. In comparison to spironolactone, eplerenone exhibited a less pronounced effect on reducing diastolic blood pressure [−4.63 mmHg; 95% confidence interval (CI): −8.87 to −0.40 mmHg] and correcting serum potassium (−0.2 mg/dL; 95% CI: −0.37 to −0.03 mg/dL). Spironolactone presented a higher risk of gynecomastia compared with eplerenone (relative risk: 4.69; 95% CI: 3.58–6.14).

Conclusion:

The present NMA indicated that the blood pressure reduction and potassium-correcting effects of the three MRAs may demonstrate marginal differences, with confidence levels in the evidence being very low. Therefore, further research is needed to explore the efficacy of these MRAs, especially regarding their impact on mortality and cardiovascular outcomes.

Trial registration:

PROSPERO (CRD: 42023446811).
Fournier’s gangrene: a review of predictive scoring systems and practical guide for patient management
Authors: Bowen Daniel , Hughes Thomas , Juliebø-Jones Patrick , Somani Bhaskar
Published: March 2024

This article aims to provide a practical guide for patient management and an overview of the predictive scorings for Fournier’s gangrene (FG) that are available to aid clinicians. A literature was performed reviewing currently used scoring systems for FG and presenting a practical guide for its management based on the available evidence. There are four specific scoring systems available for the assessment of FG although few other non-specific and generic tools also exist. These specific tools include Laboratory Risk Indicator for Necrotizing Fasciitis, Fournier’s Gangrene Severity Index, Uludag Fournier’s Gangrene Severity Index, and Simplified Fournier’s Gangrene Severity Index and help calculate expected mortality. Our proposed algorithm covers primary assessment, resuscitative interventions, initial investigations, urgent care, post-operative care, and long-term follow-up. The management of the FG patient can be divided into initial resuscitation, surgical debridement, ongoing ward management with antibiotic therapy, wound reconstruction, and long-term follow-up. Each facet of care is vital and requires multidisciplinary team expertise for optimal outcomes. Whilst mortality continues to improve, it remains significant, reflecting the severe and life-threatening nature of FG. More research is certainly needed into how this care is individualised, and to ensure that long-term outcomes in FG include quality of life measures after discharge.
Label-free quantitative proteomics reveals the mechanisms of Aurora kinase B in renal cell carcinoma
Authors: Li Yulong , Yang Yang
Published: March 2024

Background:

Renal cell carcinoma is the most common form of kidney cancer which is a global threat to human health, needing to explore effective therapeutic targets and treatment methods. Aurora kinase B acts as an important carcinogenic role in various kinds of tumors, while its mechanism in renal cell carcinoma is indistinct. Herein we explore the underlying mechanism of Aurora kinase B in renal cell carcinoma.

Methods and results:

Label-free quantitative proteomics analysis was employed to analyze the differentially expressed proteins in 786-O cells which were treated with si-Aurora kinase B or si-ctrl. In the current study, 169 differentially expressed proteins were identified. The top 10 upregulated proteins were MX2, IFI44L, ISG20, DDX58, F3, IFI44, ECE1, PRIC285, NIT1, and IFIT2. The top 10 downregulated proteins were FKBP9, FSTL1, DDAH1, TGFB2, HMGN3, COIL, FAM65A, PTPN14, ARFGAP2, and EIF2C2. GO enrichment analysis showed that these differentially expressed proteins participated in biological processes, including defense response to virus, response to virus, and type I interferon signaling pathway. These differentially expressed proteins participated in cellular components, including focal adhesion, cell-substrate adherens junction, cell-substrate junction, and endoplasmic reticulum lumen. These differentially expressed proteins participated in molecule functions, including guanyl nucleotide binding, nucleotidase activity, double-stranded RNA binding, 2′-5′-oligoadenylate synthetase activity, and virus receptor activity. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that the significantly changed proteins including OAS3, OAS2, JAK1, TAP1, and RAC1 were involved in Epstein-Barr virus infection.

Conclusions:

Taken together, our results demonstrate the possible mechanisms that Aurora kinase B may participate in renal cell carcinoma. These findings may provide insights into tumorigenesis and a theoretical basis for developing potential therapies of renal cell carcinoma.
Nationwide prevalence of glucocorticoid prescriptions over 17 years and osteoporosis prevention among long-term users
Authors: Bjornsdottir Hulda Hrund , Einarsson Ólafur Brynjólfur , Gröndal Gerdur , Gudbjornsson Bjorn
Published: March 2024

Objectives:

Glucocorticoid steroids are frequently prescribed, and side effects are well-known, such as glucocorticoid-induced osteoporosis. Our aim was to estimate the nationwide trend in the prevalence of glucocorticoid steroid prescriptions over 17 years and to elucidate the proportion of patients on long-term glucocorticoid steroid therapy who receive active bone protective therapy. As well as to examine which medical specialties prescribe glucocorticoid steroids the most.

Methods:

This study was a retrospective observational registry study extended over 17 years (2003–2020). Data were retrieved from the Icelandic Prescription Medicine Register on all delivered glucocorticoid steroids (Anatomic therapeutic chemical code: H02AB) for oral use. Long-term users were defined as those who annually received ⩾90 defined daily doses of glucocorticoid steroids.

Results:

Annually, 3.8% of the population received oral glucocorticoid steroids, from 3.3% in 2006 to 4.3% in 2017. Prednisolone was most frequently prescribed. Females dispatched glucocorticoid steroid prescriptions more often than males (55.8%). Males and females reached their peak prevalence between the ages of 60 and 70. General practitioners most often prescribe glucocorticoid steroids, followed by physicians in training, rheumatologists, internists, and medical students. Of those who received prescriptions for glucocorticoid steroids, 12.2%–18.1% were classified as long-term users. A declining number of patients have been receiving bone-protective therapy in recent years. Only 13.0% of chronic users received bone protective therapy in 2020.

Conclusion:

The use of glucocorticoid steroids has increased during the last 2 decades despite improvements in treatment for inflammatory disorders. The prevalence of long-term users has remained stable. Meanwhile, the use of parallel active bone-protective therapy among long-term users of glucocorticoid steroids is declining. Thus, improvements in prophylaxis for corticosteroid-induced osteoporosis are urgently needed for patients who require long-term treatment with glucocorticoid steroids.
Childhood trauma, challenging experiences, and posttraumatic growth in ayahuasca use
Authors: Cassidy Ksenia , Healy CJ , Henje Eva , D’Andrea Wendy
Published: March 2024

Challenging experiences in ayahuasca use, childhood trauma, and posttraumatic growth have not been investigated systematically. This study aimed to explore whether a self-reported history of childhood trauma was associated with challenging experiences during acute ayahuasca effects and whether such challenging experiences were associated with beneficial long-term outcomes measured by posttraumatic growth. For this study, 231 individuals (mean age 40.29, 48% women) completed an online survey about traumatic experiences in childhood, challenges during acute ayahuasca effects, and perceived benefits of those challenges. This study found that people with histories of childhood trauma were not at greater risk of adverse or challenging experiences during acute ayahuasca effects than people without histories of childhood trauma ( r = .080, p = .281, 95% CI [–.066, .223]). Additionally, there was no difference in posttraumatic growth among those who had history of childhood trauma versus those who did not ( r = –.016, p = .837, 95% CI [–.166, .135]). People who have experienced more challenges during acute ayahuasca effects did not experience more ayahuasca-related posttraumatic growth ( r = .137, p = .076, 95% CI [–.014, .281]). These findings are important, as they may indicate that childhood trauma exposure does not pose the same risk for a poor treatment response to ayahuasca, as it predicts in other forms of intervention.
Impact of mHealth application on adherence to cardiac rehabilitation guidelines after a coronary event: Randomised controlled clinical trial protocol
Authors: Cruz-Cobo Celia , Bernal-Jiménez María Ángeles , Calle-Pérez Germán , Gheorghe Livia , Gutiérrez-Barrios Alejandro , Cañadas-Pruaño Dolores , Rodríguez-Martín Amelia , Tur Josep A , Vázquez-García Rafael , Santi-Cano María José
Published: March 2024

Background

Coronary disease is the main cause of death around the world. mHealth technology is considered attractive and promising to promote behavioural changes aimed at healthy lifestyle habits among coronary patients. The purpose of this study is to evaluate the efficacy of an mHealth intervention regarding improved results in secondary prevention in patients after an acute myocardial infarction (AMI) or angina in terms of lifestyle, clinical variables and therapeutic compliance.

Methods

Randomised clinical trial with 300 patients who underwent a percutaneous coronary intervention (PCI) with stent implant. They will be assigned to either the mHealth group, subject to a self-monitored educational intervention involving an internet application installed on their mobile phone or tablet, or to a control group receiving standard healthcare (150 patients in each arm). The primary outcome variables will be adherence to the Mediterranean diet, physical activity, smoking, therapeutic compliance, knowledge acquired, user-friendliness and satisfaction with the application. Measurements of blood pressure, heart rate, body weight, waist circumference (WC) and the 6-min walk test will be taken. Furthermore, the blood lipid profile, glucose and HbA1c will be evaluated. Clinical interview will be conducted, and validated questionnaires completed. The primary quantitative results will be compared using an analysis of covariance adjusted for age and sex. A multivariate analysis will be performed to examine the association of the intervention with lifestyle habits, the control of cardiovascular risk factors (CDRFs) and the results after the hospital discharge (major adverse events, treatment compliance and lifestyle).

Conclusions

The study will provide evidence about the effectiveness of an mHealth intervention at improving the lifestyle of the participants and could be offered to patients with coronary disease to complement existing services.

Trial registration

NCT05247606. [ https://ClinicalTrials.gov ]. 21/02/2022
Right-Wing Twitter Users in France Exhibit Growing Homophily Compared With Left and Center Users
Authors: Gurchani Muhammad Umer
Published: March 2024

The purpose of this research is to enhance our understanding of homophilic behaviors—where individuals prefer to associate with others like themselves—on Twitter, particularly focusing on how these behaviors vary across different political affiliations. While a general increase in homophily is a well-documented phenomenon in social networks, its expression within the diverse political contexts on Twitter remains underexplored. This study seeks to understand how political alignment influences homophily and its possible role in reinforcing extreme viewpoints. In particular, the research examines the patterns of interaction within political communities on French Twitter, delineating between right-wing, left-wing, and centrist groups. The findings reveal a significant pattern: right-wing groups demonstrate a marked increase in homophily over time, suggesting a stronger predilection for in-group interaction when compared with their centrist and left-wing counterparts. In addition, the study monitors the evolution of follower networks among these political clusters, providing insights into the shifting popularity of political parties within each group. By analyzing the social connections within these clusters, the study offers a detailed perspective on the dynamics of political homophily on Twitter and how it evolves, informing our understanding of political communication and group behavior in the digital age.
No Targets, Just Vibes: Tuned Advertising and the Algorithmic Flow of Social Media
Authors: Brown Maria-Gemma , Carah Nicholas , Robards Brady , Dobson Amy , Rangiah Lillian , De Lazzari Chiara
Published: March 2024

Digital advertising’s cultural surround is algorithmically tuned. The popular narrative about digital advertising is that it is hyper-targeted and customized. In this article, we argue that digital platforms’ targeted advertising is more productively understood as tuned advertising, where algorithmic models optimize the resonance between ads and consumers in a continuous rhythmic flow of images, videos, and text. We develop the concept of tuned advertising by drawing on a study conducted with 204 young people from the Australian state of Victoria, where they sent us over 5,169 screenshots of alcohol, gambling, and unhealthy food ads they saw in their digital feeds. We identify five different “vibes” in the collections of ads they sent us that reflect different subjectivities and practices of consumption. We argue that digital platforms create a mode of advertising organized around tuning the vibe between ads, content, and users.
Curating Emergent Publics Through Domain Crossing
Authors: Scacco Joshua M. , Saffer Adam J.
Published: March 2024

Audiences for messages divide attention among a variety of media outlets, sources, and venues. Such segmentation creates a challenge for message creators to (re)engage audiences’ attentional capacities. This research investigates how domain elites may curate emergent attentive publics for public affairs content by engaging in processes of domain crossing to potentially redirect audience attention. Conceptually, we contribute to historic and contemporary understandings of how societal leaders attempt to build engaged and attentive publics for their messages. Methodologically, we employ large data and network analytic methods to study the creation of emergent publics online around a pseudo-event. We illustrate how leader-directed domain crossing could overcome audience challenges in a fragmented media ecology.
Digital humanities: Mission accomplished? An analysis of scholarly literature
Authors: Salerno Emanuele
Published: March 2024

The field of digital humanities (DH) has evolved throughout the parallel evolution of computers, software and networking techniques, as well as the different attitudes of interested scholars. Since the earliest historical phases of this research field, scholars have been debating whether it can be considered as a new academic discipline and whether it is revolutionary in nature. About 20 years ago, the early denotation of ‘humanities computing’ evolved to the present label of DH, and deep changes occurred in digital information technologies, as well as in their humanities applications. Meanwhile, dedicated academic curricula were launched, thus adding an argument in favor of the debated disciplinarity of DH. This paper gives an account of the relevant scholarly debate, distinguishing between the early period and the most recent years; it then tries to frame this process in a model of scientific revolution.
Sex Workers in Canada Face Unequal Access to Healthcare: A Systems Thinking Approach
Authors: Squires Kaitlyn
Published: March 2024

Objectives:

Despite Canada’s universal health system, sex workers across the country face an alarmingly high number of barriers when they seek to healthcare services. This has resulted in unmet healthcare needs and substantially poorer health outcomes than the general Canadian population. The objective of this study was to use a systems thinking approach to gain an in-depth understanding of the barriers sex workers face and how access could be improved.

Methods:

The analysis was conducted using a systems thinking methodology, which incorporates systems tools and inquiry processes. The methodology comprised 2 domains of inquiry: (1) Problem Landscape, (2) Solutions Landscape. Systems tools and methods, such as causal loop diagrams, iceberg diagram, and systems mapping, investigated the problem landscape for understanding the interconnected nature of the issue, alongside review of both published and gray literature. An environmental scan explored the current solutions landscape. These methods connected through systemic inquiry processes, including ongoing review and application of diverse perspectives, boundary judgments, interrelationships; enabled gaps and levers of change to be determined.

Results:

The main barriers sex workers face are stigma, criminalization, accessibility, and cost of healthcare. The stigma of sex work stems from otherization, paternalism, and moralistic, faith-based beliefs. The barriers unique to sex work are stigma and criminalization; both of which surface as avoidance, dislike, and/or fear of medical professionals. Five gaps each with a lever of change to improve access were identified: (1) Stigma – Collectivization and external collaboration, (2) Criminal status of sex work – Decriminalization, (3) Lack of adequate education - Improved healthcare professional training and anti-discriminatory health policies, (4) Lack of support – Increased community-based healthcare services, (5) Cost of healthcare – Universal coverage of “secondary” healthcare components.

Conclusion:

Through reducing the stigma surrounding sex work, making changes that improve the healthcare services that sex workers receive, and collaboration between involved parties, sex workers can be prevented from falling through the cracks of the Canadian healthcare system; lessening the health inequities sex workers face and improving their health outcomes.
Cognitive Function and Participation of Stroke Survivors Living With Companion Animals: A Cross-Sectional Study
Authors: Demeter Naor , Zilcha-Mano Sigal , Zukerman Sandra , Josman Naomi
Published: March 2024

Introduction/Objectives:

Companion animals (CAs) may benefit human health, but few studies have examined their impact on stroke survivors. This study examines participation, quality of life (QoL), attachment, cognition, and executive function differences between stroke survivors living with and without CAs.

Methods:

In this cross-sectional, community-setting study, 25 stroke survivors with a CA and a matched group of 27 without a CA completed standard tools.

Results:

Stroke survivors with a CA scored significantly higher in participation and 1 cognitive performance test. No significant differences were found in other cognitive measures or QoL, and attachment to a CA was not correlated with participation or QoL within the research group. However, lower attachment avoidance correlated with better participation in survivors living with dogs.

Conclusion:

Living with CAs, especially dogs, might be associated with some cognitive function and participation benefits among stroke survivors. The link between CAs and cognitive function is unclear: Survivors with higher cognitive functioning might be more capable of caring for a CA, or having and caring for a CA might promote better cognitive function. Attachment patterns also might explain stroke survivors’ participation levels. Further study is warranted.
Institutional Ownership and Stock Liquidity: Evidence From an Emerging Market
Authors: Bao Dinh Ngoc , Tran Van Nguyen Hong
Published: March 2024

This research investigates whether institutional ownership contributes to enhancement of stock liquidity in emerging markets. The study examines data of listed companies on the Vietnamese stock market. Using a comprehensive data set for all stocks listed on Ho Chi Minh Stock Exchange (HOSE) and Hanoi Stock Exchange (HNX) from 2008 to 2017, the statistical findings consistently demonstrate that institutional ownership has a negative impact on stock liquidity. In other words, the empirical evidence supports the adverse selection hypothesis that the upward trend of institutional ownership could reduce stock liquidity because the institutional investors with superior and advantageous information could exacerbate informational asymmetry issues. By using a case study in Vietnam, this research makes an original contribution to the academic literature by examining the relationship between institutional investors and stock liquidity in emerging markets. In addition, this study offers policymakers, authorities, agencies, and managers some insightful recommendations and implications that will help to not only promote the active participations of professional institutions but also improve stock liquidity, fairness, and efficiency.
A (Meta) Picture is Worth a Thousand “Likes:” An Analysis of Engagement with Sports Network Images on Instagram
Authors: Johnson Rich G. , Romney Miles , John Kevin
Published: March 2024

Previous studies on sports images have often focused on gender and race representation. However, with the rise of social media, sports photographers worldwide are fighting professionally produced and user-created images for audience attention. Recent scholarship has shown that stronger storytelling elements in sports photographs spur an increase in lower-level engagement metrics. The current study dives deeper into the types of images that generate key social media engagement. Researchers conducted a biometric analysis of 28 randomly sampled Instagram images from sports networks’ official feeds. Results indicate that social media images containing metacommunicative themes increase audience engagement. These findings offer insights into improving social media engagement for sports news sources.
Evaluation of Differences in Patellar Height After Patellar Stabilization Procedures Not Intended to Address Patella Alta: A Multicenter Study
Authors: Kreulen R. Timothy , Anderson Gregory , Yalcin Sercan , Hart Joseph M. , Shank Kaitlyn , Fury Matthew S. , Elias John J. , Tanaka Miho J. , Farrow Lutul D. , Diduch David R. , Cosgarea Andrew J.
Published: March 2024

Background:

Recent studies have reported conflicting results as to whether isolated medial patellofemoral ligament reconstruction (MPFLr) leads to decreased patellar height.

Purpose:

To investigate if patellar stabilization surgery not intended to address patella alta influences patellar height.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A multicenter retrospective chart review was conducted, and patients who underwent MPFLr, medializing tibial tuberosity osteotomy (TTO), and/or trochleoplasty between 2016 and 2020 were included. The Caton-Deschamps index (CDI) was calculated from radiographs obtained preoperatively, 2 weeks postoperatively, and 3 months postoperatively. The preoperative CDI value was compared with the 2-week postoperative and 3-month postoperative values according to stabilization procedure (isolated MPFLr, isolated TTO, MPFLr + TTO, MPFLr + trochleoplasty, and MPFLr + trochleoplasty + TTO) using the paired t test. Analyses of the 1-bundle versus 2-bundle MPFLr technique and the presence of lateral retinacular release or lateral retinacular lengthening were conducted on the isolated MPFLr and combined MPFLr + TTO cohorts.

Results:

A total of 356 knees were included. Statistically significant pre- to postoperative decreases in CDI were seen in all stabilization procedures analyzed ( P≤ .017 for all). Within the isolated MPFLr cohort, this significant decrease was seen at 2 weeks postoperatively with the 2-bundle technique (ΔCDI = −0.09; P < .001) but not with the 1-bundle technique (ΔCDI = −0.01; P = .621).

Conclusion:

The different surgical techniques analyzed in the current study affected patellar height, even when a distalizing TTO was not performed. The decrease was dependent on surgical technique, with a 2-bundle MPFLr leading to a statistically significant decrease and a 1-bundle MPFLr effecting no change.
Love as a Low Priority: Gender and Relationship History Differences in Singles’ Value of Romantic Partnership
Authors: Tessler Hannah , Choi Meera , Kao Grace
Published: March 2024

This study uses original data from the Dynamics of Social Life During COVID-19 Survey (DSL-COVID) to examine the importance of romantic partnership among heterosexual single adults in the United States. We find that almost 40 percent of single adults report that having a long-term committed romantic relationship is “not at all important” to their lives. However, the importance of finding a romantic partner varies by gender and prior relationship experience. Compared to women with no prior romantic relationships, women who have been in a committed romantic relationship or have been married before are more likely to report having a romantic partner is not at all important. In contrast, men who have been in a committed romantic relationship are more likely to report that having a romantic partner is at least somewhat important compared to men with no relationship experience. Prior experience with romantic relationships is associated with lower value of romantic partnership for women, but a higher value of romantic partnership for men. These results have implications for union formation, as singles exhibit heterogeneous romantic relationship preferences. Future research on union formation should consider how singles value traditional romantic partnership and further explore how gender relates to dating and relationship decisions.
Perception of Nursing Students About Effective Clinical Teaching Environments: A Multi-Country Study
Authors: Al-Daken Laila , Lazarus Eilean R. , Al Sabei Sulaiman D. , Alharrasi Maryam , Al Qadire Mohammad
Published: March 2024

Background

The transition of nursing education from traditional methods to more advanced approaches is crucial for adequately preparing students to deliver competent care in tertiary care centers. Moreover, clinical faculty in nursing plays a key role in guiding nursing students through their clinical training in various healthcare settings.

Purpose

This study aims to describe the perceptions of undergraduate nursing students regarding the effectiveness of the learning environment and clinical teaching in clinical areas across various countries.

Methods

The study, conducted using a descriptive, cross-sectional research design, gathered data from 215 nursing students using the Clinical Learning Environment Inventory and Clinical Teaching Effectiveness Instrument. Data analysis included frequencies, percentages, mean, standard deviation, t-tests, analysis of variance, and correlation assessments to comprehend the impact of clinical teaching and learning environments.

Results

Nursing students’ perceptions of the clinical learning environment produced mean scores between 2.03 and 3.38 on a scale from 1 to 4, resulting in an overall mean score of 2.72 across 42 items. This indicates a general satisfaction with their clinical learning experiences. Regarding effective clinical teaching, the mean student responses varied from 3.02 to 3.40 out of a possible 5 points, with a total mean of 3.22. The study revealed notable correlations in the context of effective clinical teaching, particularly with demographic variables and the clinical learning environment. Specifically, a significant correlation with age ( r = .177, p = .009) and the clinical learning environment ( r = .572, p < .001) was identified.

Conclusion

The study concludes that students expressed overall satisfaction with their clinical learning experiences. They recognized the importance of participating in clinical training, fulfilling clinical responsibilities for assigned patients, exerting extra effort for learning, receiving support from preceptors in clinical settings, and being attentive to communications from staff. The collaboration between clinical preceptors and academic nursing lecturers is crucial in providing a positive learning environment for students to complete clinical tasks effectively.
Burden of intracranial artery calcification in white patients with ischemic stroke
Authors: Berghout Bernhard P , Camarasa Robin YR , Van Dam-Nolen Dianne HK , van der Lugt Aad , de Bruijne Marleen , Koudstaal Peter J , Ikram M Kamran , Bos Daniel
Published: March 2024

Introduction:

The diagnostic workup of stroke doesn’t identify an underlying cause in two-fifths of ischemic strokes. Intracranial arteriosclerosis is acknowledged as a cause of stroke in Asian and Black populations, but is underappreciated as such in whites. We explored the burden of Intracranial Artery Calcification (IAC), a marker of intracranial arteriosclerosis, as a potential cause of stroke among white patients with recent ischemic stroke or TIA.

Patients and methods:

Between December 2005 and October 2010, 943 patients (mean age 63.8 (SD ± 14.0) years, 47.9% female) were recruited, of whom 561 had ischemic stroke and 382 a TIA. CT-angiography was conducted according to stroke analysis protocols. The burden of IAC was quantified on these images, whereafter we assessed the presence of IAC per TOAST etiology underlying the stroke and assessed associations between IAC burden, symptom severity, and short-term functional outcome.

Results:

IAC was present in 62.4% of patients. Furthermore, IAC was seen in 84.8% of atherosclerotic strokes, and also in the majority of strokes with an undetermined etiology (58.5%). Additionally, patients with larger IAC burden presented with heavier symptoms (adjusted OR 1.56 (95% CI [1.06–2.29]), but there was no difference in short-term functional outcome (1.14 [0.80–1.61]).

Conclusion:

IAC is seen in the majority of white ischemic stroke patients, aligning with findings from patient studies in other ethnicities. Furthermore, over half of patients with a stroke of undetermined etiology presented with IAC. Assessing IAC burden may help identify the cause in ischemic stroke of undetermined etiology, and could offer important prognostic information.
Organizing States: The continuing relevance of formal organization within political administration
Authors: du Gay Paul , Lopdrup Hjorth Thomas
Published: March 2024

In this paper, we argue for the continuing relevance of formal organization. We do so by examining contemporary challenges to ‘formality’ in one particular sphere of organizational existence: that of political administration. We deploy the latter term to refer to those formal organizational activities involving the constitution, maintenance, projection and regulation of governmental authority. Political administration, we argue, maintains its distinctive character because of the singularity of its purpose or ‘core task’ – namely, the activity of governing in an official capacity through and on behalf of a state. We begin by outlining how formality has regularly been opposed to substance in the social sciences, and how this has led to a series of unfortunate misunderstandings concerning the status of ‘formal organization’. We then turn to show what it means to serve a state in a formal capacity. Here the concept of office is of crucial import and we seek to indicate its key components and their relation to classical organizational theorizing concerning formal organization. Having established the centrality of office to the organizational conduct of the work of the state, we proceed to examine two different but linked developments in politics and public management that have compromised or undermined formal official conduct in political administration and highlight the organizational, political and ethical problems they raise. These problems are not inconsequential but rather go to the heart of debates concerning intense political partisanship and radical scepticism towards public institutions. In taking this route, the paper makes two overall contributions. First, against the ongoing problematization of formality within organizational theorizing, we seek to revive the relevance of classical conceptions of formal organization for organization theory as a practical science. Second, we argue that formal organization within state, government and political administration remains practically crucial to navigating the ‘extreme circumstances’ that confront us in the here and now in what has been termed the ‘New Era of Tragedy’.
“Can the radical other be operationalized?” A commentary to Heinz Streib’s article “Wisdom and the Other: Responsiveness in development between the egocentric and xenocentric style”
Authors: Leistle Bernhard
Published: March 2024

In this commentary to Heinz Streib’s article “Wisdom and the Other,” I provide a different reading of Bernhard Waldenfels’ responsive phenomenology. In contrast to the author, I stress the relationality of Waldenfels’ conception of the radical Other which can only appear experientially by withdrawing from a meaning-bestowing, ordering response. It is only indirectly, through the inevitable insufficiency of our responses that the Other or alien presents itself. The intertwinement of alienness and order, I argue, leads to a responsive ethics in which morality und amorality must be distinguished contextually and situationally, not in absolute, timeless terms. This is problematic for Streib’s attempt to operationalize the radical Other in wisdom research, in at least two respects. For one, to integrate the radical Other as an evidential object into psychological models of wisdom goes against the alienness of the Other in Waldenfels. Secondly, from the perspective of a relational responsive ethics, wisdom cannot be defined by certain psychological and ethical traits. This second point is illustrated by Waldenfels’ understanding of Socrates which deviates significantly from the one presented in the article.
Cytoreductive therapy in younger adults with polycythemia vera: a meta-analysis of safety and outcomes
Authors: Chamseddine Reem S. , Savenkov Oleksandr , Rana Shehroz , Khalid Mohammed , Silver Richard T. , Kucine Nicole , Scandura Joseph M. , Abu-Zeinah Ghaith
Published: March 2024

Cytoreductive therapy is not routinely recommended for younger patients with polycythemia vera (PV) due to concern that treatment toxicity may outweigh therapeutic benefits. However, no systematic data support this approach. To support objective risk/benefit assessment of cytoreductive drugs in patients with PV aged <60 years (PV<60), this systematic review and meta-analysis was conducted to evaluate toxicity and disease-related complications in PV<60 treated with interferon alfa (rIFN-α) or hydroxyurea (HU). A search of PubMed, Scopus, Web of Science and Embase identified 693 unique studies with relevant keywords, of which 14 met inclusion criteria and were selected for analysis. The weighted average age of patients treated with rIFN-α was 48 years (n = 744 patients; 12 studies) and for HU was 56 years (n = 1397; 8 studies). The weighted average duration of treatment for either drug was 4.5 years. Using a Bayesian hierarchical model, the pooled annual rate of discontinuation due to toxicity was 5.2% for patients receiving rIFN-α (n = 587; 95% confidence interval [CI], 2.2-8.2) and 3.6% for HU (n = 1097; CI, 1-6.2). The average complete hematologic response for rIFN-α and HU was 62% and 52%, respectively. Patients experienced thrombotic events at a pooled annual rate of 0.79% and 1.26%; secondary myelofibrosis at 1.06% and 1.62%; acute myeloid leukemia at 0.14% and 0.26%; and death at 0.87% and 2.65%, respectively. No treatment-related deaths were reported. With acceptable rates of nonfatal toxicity, cytoreductive treatment, particularly with disease-modifying rIFN-α, may benefit PV<60. Future randomized trials prioritizing inclusion of PV<60 are needed to establish a long-term benefit of early cytoreductive treatment in these patients.
Resectable non-stage IV nonsmall cell lung cancer: the surgical perspective
Authors: Aigner Clemens , Batirel Hasan , Huber Rudolf M. , Jones David R. , Sihoe Alan D.L. , Štupnik Tomaž , Brunelli Alessandro
Published: March 2024

Surgery remains an essential element of the multimodality radical treatment of patients with early-stage nonsmall cell lung cancer. In addition, thoracic surgery is one of the key specialties involved in the lung cancer tumour board. The importance of the surgeon in the setting of a multidisciplinary panel is ever-increasing in light of the crucial concept of resectability, which is at the base of patient selection for neoadjuvant/adjuvant treatments within trials and in real-world practice. This review covers some of the topics which are relevant in the daily practice of a thoracic oncological surgeon and should also be known by the nonsurgical members of the tumour board. It covers the following topics: the pre-operative selection of the surgical candidate in terms of fitness in light of the ever-improving nonsurgical treatment alternatives unfit patients may benefit from; the definition of resectability, which is so important to include patients into trials and to select the most appropriate radical treatment; the impact of surgical access and surgical extension with the evolving role of minimally invasive surgery, sublobar resections and parenchymal-sparing sleeve resections to avoid pneumonectomy.
Comparative mitogenomic analysis of subterranean and surface amphipods (Crustacea, Amphipoda) with special reference to the family Crangonyctidae
Authors: Benito Joseph B. , Porter Megan L. , Niemiller Matthew L.
Published: March 2024

Mitochondrial genomes play important roles in studying genome evolution, phylogenetic analyses, and species identification. Amphipods (Class Malacostraca, Order Amphipoda) are one of the most ecologically diverse crustacean groups occurring in a diverse array of aquatic and terrestrial environments globally, from freshwater streams and lakes to groundwater aquifers and the deep sea, but we have a limited understanding of how habitat influences the molecular evolution of mitochondrial energy metabolism. Subterranean amphipods likely experience different evolutionary pressures on energy management compared to surface-dwelling taxa that generally encounter higher levels of predation and energy resources and live in more variable environments. In this study, we compared the mitogenomes, including the 13 protein-coding genes involved in the oxidative phosphorylation (OXPHOS) pathway, of surface and subterranean amphipods to uncover potentially different molecular signals of energy metabolism between surface and subterranean environments in this diverse crustacean group. We compared base composition, codon usage, gene order rearrangement, conducted comparative mitogenomic and phylogenomic analyses, and examined evolutionary signals of 35 amphipod mitogenomes representing 13 families, with an emphasis on Crangonyctidae. Mitogenome size, AT content, GC-skew, gene order, uncommon start codons, location of putative control region (CR), length of rrnL and intergenic spacers differed between surface and subterranean amphipods. Among crangonyctid amphipods, the spring-dwelling Crangonyx forbesi exhibited a unique gene order, a long nad5 locus, longer rrnL and rrnS loci, and unconventional start codons. Evidence of directional selection was detected in several protein-encoding genes of the OXPHOS pathway in the mitogenomes of surface amphipods, while a signal of purifying selection was more prominent in subterranean species, which is consistent with the hypothesis that the mitogenome of surface-adapted species has evolved in response to a more energy demanding environment compared to subterranean amphipods. Overall, gene order, locations of non-coding regions, and base-substitution rates points to habitat as an important factor influencing the evolution of amphipod mitogenomes.
Uncovering a multitude of stage-specific splice variants and putative protein isoforms generated along mouse spermatogenesis
Authors: Romeo-Cardeillac Carlos , Trovero María Fernanda , Radío Santiago , Smircich Pablo , Rodríguez-Casuriaga Rosana , Geisinger Adriana , Sotelo-Silveira José
Published: March 2024

Background

Mammalian testis is a highly complex and heterogeneous tissue. This complexity, which mostly derives from spermatogenic cells, is reflected at the transcriptional level, with the largest number of tissue-specific genes and long noncoding RNAs (lncRNAs) compared to other tissues, and one of the highest rates of alternative splicing. Although it is known that adequate alternative-splicing patterns and stage-specific isoforms are critical for successful spermatogenesis, so far only a very limited number of reports have addressed a detailed study of alternative splicing and isoforms along the different spermatogenic stages.

Results

In the present work, using highly purified stage-specific testicular cell populations, we detected 33,002 transcripts expressed throughout mouse spermatogenesis not annotated so far. These include both splice variants of already annotated genes, and of hitherto unannotated genes. Using conservative criteria, we uncovered 13,471 spermatogenic lncRNAs, which reflects the still incomplete annotation of lncRNAs. A distinctive feature of lncRNAs was their lower number of splice variants compared to protein-coding ones, adding to the conclusion that lncRNAs are, in general, less complex than mRNAs. Besides, we identified 2,794 unannotated transcripts with high coding potential (including some arising from yet unannotated genes), many of which encode unnoticed putative testis-specific proteins. Some of the most interesting coding splice variants were chosen, and validated through RT-PCR. Remarkably, the largest number of stage-specific unannotated transcripts are expressed during early meiotic prophase stages, whose study has been scarcely addressed in former transcriptomic analyses.

Conclusions

We detected a high number of yet unannotated genes and alternatively spliced transcripts along mouse spermatogenesis, hence showing that the transcriptomic diversity of the testis is considerably higher than previously reported. This is especially prominent for specific, underrepresented stages such as those of early meiotic prophase, and its unveiling may constitute a step towards the understanding of their key events.
Genome-wide characterization of the bHLH gene family in Gynostemma pentaphyllum reveals its potential role in the regulation of gypenoside biosynthesis
Authors: Qin Yanhong , Li Jinmei , Chen Jianhua , Yao Shaochang , Li Liangbo , Huang Rongshao , Tan Yong , Ming Ruhong , Huang Ding
Published: March 2024

Background

Gynostemma pentaphyllum, an ancient Chinese herbal medicine, serves as a natural source of gypenosides with significant medicinal properties. Basic helix-loop-helix (bHLH) transcription factors play pivotal roles in numerous biological processes, especially in the regulation of secondary metabolism in plants. However, the characteristics and functions of the bHLH genes in G. pentaphyllum remain unexplored, and their regulatory role in gypenoside biosynthesis remains poorly elucidated.

Results

This study identified a total of 111 bHLH members in G. pentaphyllum (GpbHLHs), categorizing them into 26 subgroups based on shared conserved motif compositions and gene structures. Collinearity analysis illustrated that segmental duplications predominately lead to the evolution of GpbHLHs, with most duplicated GpbHLH gene pairs undergoing purifying selection. Among the nine gypenoside-related GpbHLH genes, two GpbHLHs (GpbHLH15 and GpbHLH58) were selected for further investigation based on co-expression analysis and functional prediction. The expression of these two selected GpbHLHs was dramatically induced by methyl jasmonate, and their nuclear localization was confirmed. Furthermore, yeast one-hybrid and dual-luciferase assays demonstrated that GpbHLH15 and GpbHLH58 could bind to the promoters of the gypenoside biosynthesis pathway genes, such as GpFPS1, GpSS1, and GpOSC1, and activate their promoter activity to varying degrees.

Conclusions

In conclusion, our findings provide a detailed analysis of the bHLH family and valuable insights into the potential use of GpbHLHs to enhance the accumulation of gypenosides in G. pentaphyllum.
An empirical evaluation of approximate and exact regression-based causal mediation approaches for a binary outcome and a continuous or a binary mediator for case-control study designs
Authors: Caubet Miguel , L’Espérance Kevin , Koushik Anita , Lefebvre Geneviève
Published: March 2024

Background

In the causal mediation analysis framework, several parametric regression-based approaches have been introduced in past years for decomposing the total effect of an exposure on a binary outcome into a direct effect and an indirect effect through a target mediator. In this context, a well-known strategy involves specifying a logistic model for the outcome and invoking the rare outcome assumption (ROA) to simplify estimation. Recently, exact estimators for natural direct and indirect effects have been introduced to circumvent the challenges prompted by the ROA. As for the approximate approaches relying on the ROA, these exact approaches cannot be usedas ison case-control data where the sampling mechanism depends on the outcome.

Methods

Considering a continuous or a binary mediator, we empirically compare the approximate and exact approaches using simulated data under various case-control scenarios. An illustration of these approaches on case-control data is provided, where the natural mediation effects of long-term use of oral contraceptives on ovarian cancer, with lifetime number of ovulatory cycles as the mediator, are estimated.

Results

In the simulations, we found few differences between the performances of the approximate and exact approaches when the outcome was rare, both marginally and conditionally on variables. However, the performance of the approximate approaches degraded as the prevalence of the outcome increased in at least one stratum of variables. Differences in behavior were also observed among the approximate approaches. In the data analysis, all studied approaches were in agreement with respect to the natural direct and indirect effects estimates.

Conclusions

In the case where a violation of the ROA applies or is expected, approximate mediation approaches should be avoided or used with caution, and exact estimators favored.