bluuebunny/crossref_metadata_2025 huggingface dataset:
Estrogen Receptor Blockade Potentiates Immunotherapy for Liver Metastases by Altering the Liver Immunosuppressive Microenvironment
Authors: Benslimane Yasmine , Amalfi Kevin , Lapin Sara , Perrino Stephanie , Brodt Pnina
Published: July 2024

Liver metastases (LM) remain a major cause of cancer-related death and are a major clinical challenge. LM and the female sex are predictors of a poorer response to immunotherapy but the underlying mechanisms remain unclear. We previously reported on a sexual dimorphism in the control of the tumor microenvironment (TME) of colorectal carcinoma liver metastases (CRCLM) and identified estrogen as a regulator of an immunosuppressive TME in the liver. Here we aimed to assess the effect of estrogen deprivation on the cytokine/chemokine profile associated with CRCLM, using a multiplex cytokine array and the RNAscope technology, and its effects on the innate and adaptive immune responses in the liver. We also evaluated the benefit of combining the selective estrogen-receptor degrader Fulvestrant with immune checkpoint blockade for the treatment of CRCLM. We show that estrogen depletion altered the cytokine/chemokine repertoire of the liver, decreased macrophage polarization, as reflected in reduced accumulation of tumor infiltrating M2 macrophages and increased the accumulation of CCL5+/CCR5+ CD8+ T and NKT cells in the liver TME. Similar results were obtained in a murine pancreatic ductal adenocarcinoma model. Importantly, treatment with Fulvestrant also increased the accumulation of CD8+CCL5+, CD8+CCR5+ T and NK cells in the liver TME and enhanced the therapeutic benefit of anti-PD1 immunotherapy, resulting in a significant reduction in the outgrowth of LM. Taken together, our results show that estrogen regulates immune cell recruitment to the liver and suggest that inhibition of estrogen action could potentiate the tumor-inhibitory effect of immunotherapy in hormone-independent and immunotherapy-resistant metastatic cancer.

Significance:

The immune microenvironment of the liver plays a major role in controlling the expansion of hepatic metastases and is regulated by estrogen. We show that treatment of tumor-bearing mice with an estrogen receptor degrader potentiated an anti-metastatic effect of immunotherapy. Our results provide mechanistic insight into clinical findings and a rationale for evaluating the efficacy of combination anti-estrogen and immunotherapy for prevention and/or treatment of hepatic metastases in female patients.
Los significados de familias para niñas y niños sin cuidados parentales
Authors: Martínez-Sierra Pedro Daniel
Published: July 2024

(analytical)The meanings of family for orphaned girls and boys, a highly invisible social issue, are analyzed. The causes are multifaceted: abandonment, violence, homicides, femicides, disappearances, human trafficking, natural disasters, diseases, and others. These factors violate the human rights of this population by transgressing one of their fundamental rights: living in a family. In this qualitative study, three girls and three boys aged 8 to 11 years, who lack parental care and are awaiting the resolution of their family situation or adoption by a new family, participated. Drawing and interview techniques were employed to gather their opinions on what they expected from living in a family. These opinions areclosely aligned with the nuclear family model, expressing aspirations and desires to be fulfilled as part of it.
Novel Long Noncoding RNA
HEAT4
Affects Monocyte Subtypes, Reducing Inflammation and Promoting Vascular Healing
Authors: Kneuer Jasmin M. , Grajek Ignacy A. , Winkler Melanie , Erbe Stephan , Meinecke Tim , Weiss Ronald , Garfias-Veitl Tania , Sheikh Bilal N. , König Ann-Christine , Möbius-Winkler Maximilian N. , Kogel Alexander , Kresoja Karl-Patrik , Rosch Sebastian , Kokot Karoline E. , Filipova Vanina , Gaul Susanne , Thiele Holger , Lurz Philipp , von Haehling Stephan , Speer Thimoteus , Laufs Ulrich , Boeckel Jes-Niels
Published: July 2024

BACKGROUND:

Activation of the immune system contributes to cardiovascular diseases. The role of human-specific long noncoding RNAs in cardioimmunology is poorly understood.

METHODS:

Single-cell sequencing in peripheral blood mononuclear cells revealed a novel human-specific long noncoding RNA called
HEAT4
(heart failure–associated transcript 4).
HEAT4
expression was assessed in several in vitro and ex vivo models of immune cell activation, as well as in the blood of patients with heart failure (HF), acute myocardial infarction, or cardiogenic shock. The transcriptional regulation of
HEAT4
was verified through cytokine treatment and single-cell sequencing. Loss-of-function and gain-of-function studies and multiple RNA–protein interaction assays uncovered a mechanistic role of
HEAT4
in the monocyte anti-inflammatory gene program.
HEAT4
expression and function was characterized in a vascular injury model in NOD.CB17-Prkdc scid/Rj mice.

RESULTS:

HEAT4
expression was increased in the blood of patients with HF, acute myocardial infarction, or cardiogenic shock.
HEAT4
levels distinguished patients with HF from people without HF and predicted all-cause mortality in a cohort of patients with HF over 7 years of follow-up. Monocytes, particularly anti-inflammatory CD16
+
monocytes, which are increased in patients with HF, are the primary source of
HEAT4
expression in the blood.
HEAT4
is transcriptionally activated by treatment with anti-inflammatory interleukin-10.
HEAT4
activates anti-inflammatory and inhibits proinflammatory gene expression. Increased
HEAT4
levels result in a shift toward more CD16
+
monocytes.
HEAT4
binds to S100A9, causing a monocyte subtype switch, thereby reducing inflammation. As a result,
HEAT4
improves endothelial barrier integrity during inflammation and promotes vascular healing after injury in mice.

CONCLUSIONS:

These results characterize a novel endogenous anti-inflammatory pathway that involves the conversion of monocyte subtypes into anti-inflammatory CD16
+
monocytes. The data identify a novel function for the class of long noncoding RNAs by preventing protein secretion and suggest long noncoding RNAs as potential targets for interventions in the field of cardioimmunology.
Progressive Kidney Failure by Angiotensinogen Inactivation in the Germline
Authors: Wopperer Florian J. , Olinger Eric , Wiesener Antje , Broeker Katharina A.E. , Knaup Karl X. , Schaefer Jan T. , Galiano Matthias , Schneider Karen , Schiffer Mario ,   Genomics England Research Consortium, Büttner-Herold Maike , Reis André , Schmieder Roland , Pasutto Francesca , Hilgers Karl F. , Poglitsch Marko , Ziegler Christine , Shoemaker Robin , Sayer John A. , Wiesener Michael S.
Published: July 2024

BACKGROUND:

Autosomal recessive renal tubular dysgenesis is a rare, usually fatal inherited disorder of the renin-angiotensis system (RAS). Herein, we report an adolescent individual experiencing an unknown chronic kidney disease and aim to provide novel insights into disease mechanisms.

METHODS:

Exome sequencing for a gene panel associated with renal disease was performed. The RAS was assessed by comprehensive biochemical analysis in blood. Renin expression was determined in primary tubular cells by quantitative polymerase chain reaction and in situ hybridization on kidney biopsy samples. Allele frequencies of heterozygous and biallelic deleterious variants were determined by analysis of the Genomics England 100,000 Genomes Project.

RESULTS:

The patient was delivered prematurely after oligohydramnios was detected during pregnancy. Postnatally, he recovered from third-degree acute kidney injury but developed chronic kidney disease stage G3b over time. Exome sequencing revealed a previously reported pathogenic homozygous missense variant, p.(Arg375Gln), in the
AGT
(angiotensinogen) gene. Blood AGT concentrations were low, but plasma renin concentration and gene expression in kidney biopsy, vascular, and tubular cells revealed strong upregulation of renin. Angiotensin II and aldosterone in blood were not abnormally elevated.

CONCLUSIONS:

Renal tubular dysgenesis may present as chronic kidney disease with a variable phenotype, necessitating broad genetic analysis for diagnosis. Functional analysis of the RAS in a patient with
AGT
mutation revealed novel insights regarding compensatory upregulation of renin in vascular and tubular cells of the kidney and in plasma in response to depletion of AGT substrate as a source of Ang II (similarly observed with hepatic
AGT
silencing for the treatment of hypertension).
Feature attention graph neural network for estimating brain age and identifying important neural connections in mouse models of genetic risk for Alzheimer’s disease
Authors: Moon Hae Sol , Mahzarnia Ali , Stout Jacques , Anderson Robert J. , Han Zay Yar , Tremblay Jessica T. , Badea Cristian T. , Badea Alexandra
Published: July 2024

Alzheimer’s disease (AD), a widely studied neurodegenerative disorder, poses significant research challenges due to its high prevalence and complex etiology. Age, a critical risk factor for AD, is typically assessed by comparing physiological and estimated brain ages. This study utilizes mouse models expressing human alleles of APOE and human nitric oxide synthase 2 (hNOS2), replicating genetic risks for AD alongside a human-like immune response. We developed a multivariate model that incorporates brain structural connectomes, APOE genotypes, demographic traits (age and sex), environmental factors such as diet, and behavioral data to estimate brain age. Our methodology employs a Feature Attention Graph Neural Network (FAGNN) to integrate these diverse datasets. Behavioral data are processed using a 2D convolutional neural network (CNN), demographic traits via a 1D CNN, and brain connectomes through a graph neural network equipped with a quadrant attention module that accentuates critical neural connections. The FAGNN model demonstrated a mean absolute error in age prediction of 31.85 days and a root mean squared error of 41.84 days, significantly outperforming simpler models. Our analysis further focused on the brain age delta, which assesses accelerated or delayed aging by comparing brain age, predicted by FAGNN, to the chronological age. A high-fat diet and the presence of the human NOS2 gene were identified as significant accelerators of brain aging in the old age group. Key neural connections identified by FAGNN, such as those between the cingulum, corpus callosum, striatum, hippocampus, thalamus, hypothalamus, cerebellum, and piriform cortex, were found to be significant in the aging process. Validation using diffusion MRI-based metrics, including fractional anisotropy and return-to-origin probability measures across these connections, revealed significant age-related differences. These findings suggest that white matter degradation in the connections highlighted by FAGNN plays a key role in aging. Our findings suggest that the complex interplay of APOE genotype with sex, immunity, and environmental factors modulates brain aging and enhance our understanding of AD risk in mouse models of aging.
Amanita amplivelata, (Amanitaceae, Agaricales), a remarkable new Eurasian species of the section Vaginatae
Authors: HANSS JEAN-MICHEL , BOZOK FUAT , ASSYOV BORIS , YARAR MAHMUT , BOROVIČKA JAN , ŠEVČÍKOVÁ HANA , CORRIOL GILLES , MOREAU PIERRE-ARTHUR , TAŞKIN HATIRA
Published: July 2024

Amanita amplivelata is introduced as a new species, based on numerous collections from geographically distant areas of Europe and the Near East (Bulgaria, the Czech Republic, France and Türkiye). This new species is likely ectomycorrhizal with Populus spp. in natural poplar stands, urban settings, and plantations. Detailed description and illustrations of its morphological features are presented. Phylogenetic analysis of nrITS and combined nrITS, nrLSU and TEF-1α sequences placed it in a separate stirp in Clade 5 of section Vaginatae. The ample, saccate volva with a peculiar microscopic architecture confirms relatively close phylogenetic relationships with A. crocea and A. dryophila. The distinction of the new species from other phylogenetically related or morphologically similar taxa is outlined.
Typification of three names in the genera Plectranthus and Coleus (Lamiaceae)
Authors: DEVANATHAN KRISHANAMOORTHY , DHATCHANAMOORTHY NARAYANASAMY
Published: July 2024

Lectotypes have been designated for Plectranthus bicolor Blume, P. macrophyllus Blume and Coleus sparsiflorus Elmer. The choices of lectotypes are discussed and an image of each type has also been provided.
Five new species of Heteropoda Latreille, 1804 spiders (Araneae: Sparassidae) from Southeast Asia
Authors: KORAI SHAKAL KHAN , JÄGER PETER
Published: July 2024

Five new species of Heteropoda (Araneae: Sparassidae, Heteropodinae) from Southeast Asia are described: H. acris spec. nov. (male, female; Vietnam), H. cuspidata spec. nov. (male; Malaysia), H. papilionacea spec. nov. (female; Malaysia), H. pilata spec. nov. (female; Thailand), and H. verticalis spec. nov. (male; Malaysia). The female of H. jasminae Jäger, 2008 is described for the first time (locality: Vietnam). All these new species are diagnosed, described, and illustrated. Additionally, a distribution map for all species is given.
An integrative taxonomy of some close related Palaearctic Macromia spp. (Anisoptera: Macromiidae)
Authors: YU XIN , REN YANYU , LI XINGGANG , LI LINYAN , JIN HONGGUANG
Published: July 2024

An integrative taxonomy combining morphological and molecular data confirmed that both Macromia amphigena Selys, 1871 and M. manchurica Asahina, 1964 have been assigned to separate species hypotheses, although there is hybridization between the members of these taxa. Scientific names Macromia clio Ris, 1916 and Macromia kubokaiya Asahina, 1964 are shown to be junior synonyms of M. amphigena. Macromia amphigena exhibits a large range of intraspecies morphological variation within its wide distribution, which covers most of East Asia. Macromia berlandi Lieftinck, 1941 is treated as a junior synonym of M. cupricincta Fraser, 1924 based on previous research and the present study. Some traditional diagnostic morphological characters are deemed not suitable for species diagnosis. Integrative taxonomy can help researchers to filter out amphibolous morphological features and find more credible characters for future taxonomy.
Transferability and Explainability of Deep Learning Emulators for Regional Climate Model Projections: Perspectives for Future Applications
Authors: Baño-Medina Jorge , Iturbide Maialen , Fernández Jesús , Gutiérrez José Manuel
Published: July 2024

Regional climate models (RCMs) are essential tools for simulating and studying regional climate variability and change. However, their high computational cost limits the production of comprehensive ensembles of regional climate projections covering multiple scenarios and driving Global climate models (GCMs) across regions. RCM emulators based on deep learning models have recently been introduced as a cost-effective and promising alternative that requires only short RCM simulations to train the models. Therefore, evaluating their transferability to different periods, scenarios, and GCMs becomes a pivotal and complex task in which the inherent biases of both GCMs and RCMs play a significant role. Here, we focus on this problem by considering the two different emulation approaches introduced in the literature as perfect and imperfect, that we here refer to as perfect prognosis (PP) and model output statistics (MOS), respectively, following the well-established downscaling terminology. In addition to standard evaluation techniques, we expand the analysis with methods from the field of explainable artificial intelligence (XAI), to assess the physical consistency of the empirical links learnt by the models. We find that both approaches are able to emulate certain climatological properties of RCMs for different periods and scenarios (soft transferability), but the consistency of the emulation functions differs between approaches. Whereas PP learns robust and physically meaningful patterns, MOS results are GCM dependent and lack physical consistency in some cases. Both approaches face problems when transferring the emulation function to other GCMs (hard transferability), due to the existence of GCM-dependent biases. This limits their applicability to build RCM ensembles. We conclude by giving prospects for future applications.

Significance Statement

Regional climate model (RCM) emulators are a cost-effective emerging approach for generating comprehensive ensembles of regional climate projections. Promising results have been recently obtained using deep learning models. However, their potential to capture the regional climate dynamics and to emulate other periods, emission scenarios, or driving global climate models (GCMs) remains an open issue that affects their practical use. This study explores the potential of current emulation approaches incorporating new explainable artificial intelligence (XAI) evaluation techniques to assess the reliability and transferability of the emulators. Our findings show that the different global and regional model biases involved in the different approaches play a key role in transferability. Based on the results obtained, we provide some prospects for potential applications of these models in challenging problems.
Vertical Velocity Dynamics in the North Atlantic and Implications for AMOC
Authors: Fraser Neil J. , Fox Alan D. , Cunningham Stuart A. , Rath Willi , Schwarzkopf Franziska U. , Biastoch Arne
Published: July 2024

The Atlantic meridional overturning circulation (MOC) is traditionally monitored in terms of zonally integrated transport either in depth space or in density space. While this view has the advantage of simplicity, it obscures the rich and complex three-dimensional structure, so that the exact physics of the downwelling and upwelling branch remains poorly understood. The near-equivalence of the depth- and density-space MOC in the subtropics suggests that vertical and diapycnal volumes transports are intimately coupled, whereas the divergence of these two metrics at higher latitudes indicates that any such coupling is neither instantaneous nor local. Previous work has characterized the surface buoyancy forcing and mixing processes which drive diapycnal volume transport. Here, we develop a new analytical decomposition of vertical volume transport based on the vorticity budget. We show that most terms can be estimated from observations and provide additional insights from a high-resolution numerical simulation of the North Atlantic. Our analysis highlights the roles of 1) relative vorticity advection for the sinking of overflow water at the northern subpolar North Atlantic boundaries and 2) the geostrophic β effect for the sinking of dense waters in the intergyre region. These results provide insights into the coupling between density- and depth-space overturning circulations.

Significance Statement

The purpose of this study is to better understand where and why dense water sinks in the North Atlantic. This is important because dense water sinking in the North Atlantic is a crucial component of the global thermohaline circulation. Our results reveal the primary controls on dense water sinking at a regional level and highlight the importance of mesoscale processes at high latitudes in shaping the circulation and heat distribution throughout the Atlantic Ocean.
Improving energy consumption for dynamic intake and exhaust FAÇADES: A new setup design: Part B
Authors: Hosseinalipour S.M. , Al-Taee Ammar A. Hussain , Asiaei Sasan
Published: July 2024

Dynamic insulation technology adjusts thermal resistance to reduce building energy consumption in response to climate changes. Sustainable building practices prioritize optimizing the building envelope to enhance energy efficiency and regulate the interaction between indoor and outdoor environments. The previous part of this study (Part A) provided an overview of dynamic insulation technology and its potential effectiveness in Iraqi structures with intermittent heating and cooling. The successful implementation of dynamic thermal insulation necessitates careful planning and design solutions that balance performance and efficiency. This paper (Part B) three wall models (static, dynamic, modified dynamic) to evaluate their thermal performance during the heating season. The results demonstrate that the intake facade achieves a preheating efficiency of 77% for the dynamic wall and 81.8% for the modified dynamic wall at the maximum permissible fresh air limit. This improvement in efficiency enhances the quality and conditions of fresh air intake. Additionally, the modified dynamic wall exhibits a notable 50% reduction in pressure loss compared to the dynamic wall, resulting in lower intake or exhaust fan power and thus energy consumption. The results of this paper will guide the presentation of cooling season results and the experimental aspect of future work, offering valuable insights for further exploration.

Practical applications

This study aims to enhance the efficiency of dynamic facades by investigating the physical phenomena within wall layers. The paper delves into the determination of optimal airflow patterns within facades, the assessment of airflow path modifications, and the evaluation of energy efficiency achieved by implementing dynamic insulation at the intake and exhaust facades during the heating season. The findings contribute to streamlining design complexities and expanding design options for specific climates, thereby ensuring the pragmatic implementation of this technology.
Infectious keratitis in pediatric population aged less than two years: a tertiary eye institute experience
Authors: Soleimani Mohammad , Baharnoori Seyed Mahbod , Ghafarian Sadegh , Atighehchian Mehrnaz , Cheraqpour Kasra , Tabatabaei Seyed Ali , Ghanbari Hamidreza , Soleimanzadeh Mahdi , Bijani Faezeh Moghimpour , Almasi Solmaz , Zeidabadinejad Haniyeh , Davarpanah Ali , Sajedi Marzieh , Sefidan Bahram Bohrani , Habeel Samer , Masoumi Ahmad , Zamani Mohammad Hossein , Djalilian Ali R.
Published: July 2024

Background

Infectious keratitis is a serious ocular condition, which can lead to corneal scarring, vision loss, and even blindness. Pediatric infectious keratitis accounts for about 13% of all cases, although there is a lack of comprehensive data regarding keratitis in less than two years of age population group. This study was aimed to determine predisposing factors, clinical characteristics, microbial profile, and management of infectious keratitis in a population of children aged less than two years.

Materials and methods

A retrospective study was carried out in a tertiary eye institute over a period of 18 years from July 2005 to December 2022. Collected data was analyzed for demographics, predisposing factors, clinical features, and treatment methods.

Results

Fifty-seven cases of keratitis were identified. Age of the patients ranged from 1 to 24 months (Median: 6, interquartile range: 2–10). Thirty cases were male (52.6%). Predisposing factors were identified in 39 cases (68.4%): consisting of prior ocular trauma (n = 15), previous intraocular surgery (n = 11), ocular surface disease (n = 10), nasolacrimal duct obstruction (n = 4), prematurity (n = 3), developmental delay (n = 2), TORCH infection (n = 1), and contact lens (n = 1). Corneal thinning was observed in 29 eyes (50.9%), which progressed to perforation in 13 eyes (22.8%). Three patients developed endophthalmitis (95% CI, 1.5–13.4%). Most eyes had negative smear (60.4%) and culture (59.6%) results. Pseudomonas aeruginosa was the most common microorganism (11 of 21). Candida albicans was isolated in one case. In vitro susceptibility results showed good coverage of the combined ceftazidime and vancomycin regimen (100%). Surgical procedures were carried out in 35 eyes (61.4%) and 15 eyes required tectonic procedures (26.3%).

Conclusion

Despite good coverage of medical treatment over cultured isolates, surgical tectonic intervention was required in nearly a quarter of cases to resolve the corneal infection. This finding indicates the necessity of prompt patient referring, corneal sampling and initiation of the treatment.
Comparative genomic analysis of nickel homeostasis in cable bacteria
Authors: Hiralal Anwar , Geelhoed Jeanine S. , Neukirchen Sinje , Meysman Filip J. R.
Published: July 2024

Background

Cable bacteria are filamentous members of the Desulfobulbaceae family that are capable of performing centimetre‑scale electron transport in marine and freshwater sediments. This long‑distance electron transport is mediated by a network of parallel conductive fibres embedded in the cell envelope. This fibre network efficiently transports electrical currents along the entire length of the centimetre‑long filament. Recent analyses show that these fibres consist of metalloproteins that harbour a novel nickel‑containing cofactor, which indicates that cable bacteria have evolved a unique form of biological electron transport. This nickel‑dependent conduction mechanism suggests that cable bacteria are strongly dependent on nickel as a biosynthetic resource. Here, we performed a comprehensive comparative genomic analysis of the genes linked to nickel homeostasis. We compared the genome‑encoded adaptation to nickel of cable bacteria to related members of the Desulfobulbaceae family and other members of the Desulfobulbales order.

Results

Presently, four closed genomes are available for the monophyletic cable bacteria clade that consists of the genera Candidatus Electrothrix and Candidatus Electronema. To increase the phylogenomic coverage, we additionally generated two closed genomes of cable bacteria: Candidatus Electrothrix gigas strain HY10‑6 and Candidatus Electrothrix antwerpensis strain GW3‑4, which are the first closed genomes of their respective species. Nickel homeostasis genes were identified in a database of 38 cable bacteria genomes (including 6 closed genomes). Gene prevalence was compared to 19 genomes of related strains, residing within the Desulfobulbales order but outside of the cable bacteria clade, revealing several genome‑encoded adaptations to nickel homeostasis in cable bacteria. Phylogenetic analysis indicates that nickel importers, nickel‑binding enzymes and nickel chaperones of cable bacteria are affiliated to organisms outside the Desulfobulbaceae family, with several proteins showing affiliation to organisms outside of the Desulfobacterota phylum. Conspicuously, cable bacteria encode a unique periplasmic nickel export protein RcnA, which possesses a putative cytoplasmic histidine‑rich loop that has been largely expanded compared to RcnA homologs in other organisms.

Conclusion

Cable bacteria genomes show a clear genetic adaptation for nickel utilization when compared to closely related genera. This fully aligns with the nickel‑dependent conduction mechanism that is uniquely found in cable bacteria.
Evaluation of the effect of trendelenburg position duration on intracranial pressure in laparoscopic hysterectomies using ultrasonographic optic nerve sheath diameter measurements
Authors: Guloglu Hulya , Cetinkaya Dilek , Oge Tufan , Bilir Ayten
Published: July 2024

Background

During laparoscopic surgery, pneumoperitoneum and Trendelenburg positioning applied to provide better surgical vision can cause many physiological changes as well as an increase in intracranial pressure. However, it has been reported that cerebral autoregulation prevents cerebral edema by regulating this pressure increase. This study aimed to investigate whether the duration of the Trendelenburg position had an effect on the increase in intracranial pressure using ultrasonographic optic nerve sheath diameter (ONSD) measurements.

Methods

The near infrared spectrometry monitoring of patients undergoing laparoscopic hysterectomy was performed while awake (T0); at the fifth minute after intubation (T1); at the 30th minute (T2), 60th minute (T3), 75th minute (T4), and 90th minute (T5) after placement in the Trendelenburg position; and at the fifth minute after placement in the neutral position (T6). Results: The study included 25 patients. The measured ONSD values were as follows: T0 right/left, 4.18±0.32/4.18±0.33; T1, 4.75±0.26/4.75±0.25; T2, 5.08±0.19/5.08±0.19; T3, 5.26±0.15/5.26±0.15; T4, 5.36±0.11/5.37±0.12; T5, 5.45±0.09/5.48±0.11; and T6, 4.9±0.24/4.89±0.22 ( p < 0.05 compared with T0). ). No statistical difference was detected in all measurements in terms of MAP, HR and ETCO2 values compared to the T0 value (p > 0.05).

Conclusions

It was determined that as the Trendelenburg position duration increased, the ONSD values ​​increased. This suggests that as the duration of Trendelenburg positioning and pneumoperitoneum increases, the sustainability of the mechanisms that balance the increase in intracranial pressure becomes insufficient.

Trial registration

This study was registered at Clinical Trials.gov on 21/09/2023 (registration number NCT06048900).
Importance of hospital and clinical factors for early mortality in Takotsubo syndrome: Insights from the Swedish Coronary Angiography and Angioplasty Registry
Authors: Gudmundsson Thorsteinn , Redfors Björn , Råmunddal Truls , Angerås Oskar , Petursson Petur , Rawshani Araz , Hagström Henrik , Alfredsson Joakim , Ekenbäck Christina , Henareh Loghman , Skoglund Kristofer , Ljungman Charlotta , Mohammad Moman , Jernberg Tomas , Fröbert Ole , Erlinge David , Omerovic Elmir
Published: July 2024

Background

Takotsubo syndrome (TTS) is an acute heart failure syndrome with symptoms similar to acute myocardial infarction. TTS is often triggered by acute emotional or physical stress and is a significant cause of morbidity and mortality. Predictors of mortality in patients with TS are not well understood, and there is a need to identify high-risk patients and tailor treatment accordingly. This study aimed to assess the importance of various clinical factors in predicting 30-day mortality in TTS patients using a machine learning algorithm.

Methods

We analyzed data from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR) for all patients with TTS in Sweden between 2015 and 2022. Gradient boosting was used to assess the relative importance of variables in predicting 30-day mortality in TTS patients.

Results

Of 3,180 patients hospitalized with TTS, 76.0% were women. The median age was 71.0 years (interquartile range 62–77). The crude all-cause mortality rate was 3.2% at 30 days. Machine learning algorithms by gradient boosting identified treating hospitals as the most important predictor of 30-day mortality. This factor was followed in significance by the clinical indication for angiography, creatinine level, Killip class, and age. Other less important factors included weight, height, and certain medical conditions such as hyperlipidemia and smoking status.

Conclusions

Using machine learning with gradient boosting, we analyzed all Swedish patients diagnosed with TTS over seven years and found that the treating hospital was the most significant predictor of 30-day mortality.
Safety and efficacy of minimally invasive gastrectomy for older patients with gastric cancer after neoadjuvant chemotherapy and immunotherapy: a propensity score-matched analysis
Authors: Cui Hao , Yuan Zhen , Liang Wenquan , Cao Bo , Chen Lin , Cui Jianxin , Wei Bo
Published: July 2024

Background

The effect of neoadjuvant immunotherapy on minimally invasive gastrectomy (MIG) in older patients with gastric cancer remains controversial. This study aimed to evaluate the safety, and efficacy of MIG for older patients who underwent neoadjuvant chemotherapy and immunotherapy (NICT).

Methods

The clinical data of 726 older patients aged over 65 years who underwent upfront MIG or MIG after NICT in the Department of General Surgery, Chinese PLA General Hospital First Medical Center between Jan 2020 and Nov 2023 were retrospectively analyzed. Propensity score-matched (PSM) analysis at a ratio of 1:2 was performed to reduce bias from confounding patient-related variables, short- and long-term outcomes were compared between the two groups.

Results

The baseline characteristics were comparable between 61 patients in the NICT-MIG group and 114 patients in the MIG group after PSM (P > 0.05). The major pathological response (MPR) rate and pathological complete response (pCR) rate were 44.2% and 21.3%, respectively, in the NICT-MIG group. Patients in the NICT-MIG group had longer operation times (P = 0.005) and postoperative days (P = 0.030) than those in the MIG group. No significant differences were found in intraoperative bleeding, number of retrieved lymph nodes, first flatus day, R0 resection rate, overall postoperative complication (POC) morbidity, severe POC morbidity, 2-year overall, and recurrence-free survival between the MIG and NICT-MIG groups (P > 0.05). Multivariate logistic analysis revealed that an estimated blood loss > 200 mL (P = 0.010) and a lymphocyte-to-monocyte ratio (LMR) ≤ 3.25 (P = 0.006) were independent risk factors for POCs after MIG in older patients.

Conclusion

The safety, and efficacy of NICT-MIG were comparable to those of upfront MIG in older patients with GC. Patients with an estimated blood loss > 200 mL or an LMR ≤ 3.25 should be carefully evaluated for an increased risk of POCs in older patients who undergo MIG.

Trial registration

Chinese Clinical Trial Registry (Registration Number: ChiCTR2400086827).
Sodium selenite attenuates inflammatory response and oxidative stress injury by regulating the Nrf2/ARE pathway in contrast-induced acute kidney injury in rats
Authors: Xiang Haiyan , Tan Qianlin , Zhang Yun , Wu Yan , Xu Yaling , Hong Yuanhao , Li Gen
Published: July 2024

Background

Contrast-induced acute kidney injury (CI-AKI) is an acute renal complication that occurs after intravascular contrast agent administration. Sodium selenite (SS) is an inorganic source of Se and has potent antioxidant properties. This study intends to examine its anti-inflammatory and antioxidant effects in CI-AKI.

Methods

A rat CI-AKI model was established with the pretreatment of SS (0.35 mg/kg). Hematoxylin-eosin staining was employed for histopathological analysis of rat kidney specimens. Biochemical analysis was conducted for renal function detection. Tissue levels of oxidative stress-related markers were estimated. Reverse transcription-quantitative polymerase chain reaction revealed the mRNA levels of proinflammatory cytokines. Western blotting showed the Nrf2 signaling-related protein expression in the rat kidney.

Results

SS administration alleviated the renal pathological changes and reduced the serum levels of serum creatinine, blood urea nitrogen, neutrophil gelatinase-associated lipocalin, cystatin C, and urinary level of kidney injury molecule-1 in CI-AKI rats. SS attenuated oxidative stress and inflammatory response in CI-AKI rat kidney tissues. SS activated the Nrf2 signaling transduction in the renal tissues of rats with CI-AKI.

Conclusion

SS ameliorates CI-AKI in rats by reducing oxidative stress and inflammation via the Nrf2 signaling.
Anti-C5 monoclonal antibody treatment showing pathological resolution of complement-mediated atypical hemolytic uremic syndrome: a case report
Authors: Kurihara Shigekazu , Yamaguchi Akinori , Sonoda Kosuke , Yamada Yosuke , Harada Makoto , Hashimoto Koji , Shimojo Hisashi , Ikeda Yoichiro , Kamijo Yuji
Published: July 2024

Background

No reports have shown histological changes before and after anti-C5 monoclonal antibody treatment in patients with atypical hemolytic uremic syndrome (aHUS). Here, we report a rare case of complement-mediated aHUS with a complement factor H (CFH) mutation and anti-CFH antibodies who underwent multiple kidney biopsies.

Case presentation

A 53-year-old woman developed aHUS with CFH gene mutation [c.3572C > T (p. Ser1191 Leu)] and anti-CFH antibodies. Her father had succumbed to acute kidney injury (AKI) in his 30 s. She exhibited AKI, thrombocytopenia, and hemolytic anemia with schistocytes. After improving the platelet count with one session of plasma exchange, a kidney biopsy was performed one month after the onset of symptoms. Blood vessel thrombosis, obvious endothelial swelling, endocapillary hypercellularity, and subendothelial exudative lesions in the glomeruli and arterioles were detected. Anti-C5 monoclonal antibody treatment with eculizumab immediately improved disease activity. A second biopsy 3 months later revealed marked improvement of endothelial injuries with residual membrane double contours and exudative lesions. A third biopsy at 17 months after gradual improvement of kidney function showed a further decrease of double contours along with alterations of the exudative lesions to fibrous intimal thickening.

Conclusions

This is the first report showing the pathophysiology of aHUS in the kidneys and the efficacy of anti-C5 monoclonal antibody treatment by presenting serial kidney pathological features before and after anti-C5 monoclonal antibody treatment. Since her CFH mutation was considered the most important pathological condition, treatment centered on eculizumab was administered, resulting in a good long-term prognosis. In addition, kidney pathological resolution in aHUS occurred over 1 year after anti-C5 monoclonal antibody treatment.
Diagnosis and treatment of secondary nephrotic syndrome with rash as the first symptom: a case report
Authors: Qin Bowen , Li Yueqiang , Kuang Dong , Yang Xi , Pan Chunyu , Cai Xiaojing , Li Junhua
Published: July 2024

Background

Membranous nephropathy (MN) is a common type of nephrotic syndrome (NS) in adults, accounting for about 20–30% of cases. Although secondary to specific factors, the coexistence of MN and mantle cell lymphoma (MCL) has been scarcely reported in clinical literature.

Case presentation

A 59-year-old Chinese male was admitted to the hospital with a generalized pruritic rash with bilateral lower extremity edema, which did not improve significantly after symptomatic treatment. He had undergone renal biopsy, and the diagnosis was thought to be secondary MN (SMN), therefore, we did a lymph node biopsy on the patient and found that MN was complicated with MCL. Soon after, the patient was admitted to the hematology department for a BR chemotherapy regimen (composed of bendamustine 90 mg/m2 BSA (body surface area), rituximab 375 mg/m2 BSA and dexamethasone 5 mg), and during the post-treatment follow-up, both his symptoms and renal function improved.

Conclusions

The mechanism underlying the combination of SMN and MCL remains elusive and exceedingly rare, consequently often overlooked in clinical practice. This case serves to offer valuable clinical insights for diagnosis and treatment, while emphasizing the pivotal role of renal pathology in clinical assessment.
Risk factors associated with underweight in children aged one to two years: a longitudinal study
Authors: Manoochehri Sara , Faradmal Javad , Poorolajal Jalal , Asadi Fatemeh Torkaman , Soltanian Ali Reza
Published: July 2024

Background

Underweight is a prevalent health issue in children. This study aimed to identify factors associated with underweight in children aged 1–2 years in Hamadan city. Unlike the studies conducted in this field, which are cross-sectional and do not provide information on the effect of age changes on underweight, our longitudinal approach provides insights into weight changes over time. On the other hand, this study focuses on the high-risk age group of 1 to 2 years, which has only been addressed in a few studies.

Methods

In this longitudinal study, 414 mothers with 1 to 2 year-old children referred to the health centers of Hamadan city, whose information is in the SIB system, a comprehensive electronic system, were examined to identify factors related to underweight. The response variable was weight-for-age criteria classified into three categories: underweight, normal weight, and overweight. A two-level longitudinal ordinal model was used to determine the factors associated with underweight.

Results

Of the children studied, 201 (48.6%) were girls and 213 (51.4%) were boys. Significant risk factors for underweight included low maternal education (AOR = 3.56, 95% CI: 1.10–11.47), maternal unemployment (AOR = 3.38, 95% CI: 1.05–10.91), maternal height (AOR = 0.85, 95% CI: 0.79–0.92), lack of health insurance (AOR = 2.85, 95% CI: 1.04–7.84), gestational age less than 24 years (AOR = 3.17, 95% CI: 16.28–0.97), child age 12–15 months (AOR = 2.27, 95% CI: 1.37–3.74), and child's birth weight (AOR = 0.63, 95% CI: 0.70–0.58).

Conclusion

Based on the results of the present study, it seems that the possibility of being underweight among children is more related to the characteristics of mothers; therefore, taking care of mothers can control some of the weight loss of children.
Dairy intake and cardiovascular diseases risk factors: a cross-sectional study on Iranian obese and overweight women
Authors: Hosseininasab Dorsa , Shiraseb Farideh , Ghaffarian-Ensaf Rasool , Hosseini Shabnam , da Silva Alessandra , Hajinasab Mohammad Mahdi , Barry Vaughn W. , de Courten Barbora , Mirzaei Khadijeh
Published: July 2024

Objective

Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of death worldwide. Dietary interventions can directly affect several ASCVD risk factors. This study aimed to assess an association between dairy consumption and the odds of ASCVD and its risk factors in women with overweight and obesity.

Methods

The present cross-sectional study was conducted on 390 Iranian women aged 18–48 years and body mass index (BMI) ≥ 25 kg/m². Dairy consumption was assessed using a 147-item food frequency questionnaire. Participants were divided into tertiles based on their dairy consumption with 130 (33.3%) women in each category.

Results

The participants had an average age of 36.73 ± 9.18 years, and the mean BMI was 31.28 ± 4.30 kg/m2. In the unadjusted model, individuals in the third tertile of dairy consumption had 0.79 times lower odds of ASCVD compared to those in the first tertile (OR: 0.21; 95% Confidence Interval (CI): 0.11, 0.41; P-value = 0.001). Additionally, we observed a significant inverse relationship between higher dairy intake and adiposity markers, blood pressure, and Triglyceride glucose-body mass index (TyG-BMI).

Conclusion

The study revealed a negative association between dairy intake and the risk of ASCVD but this association diminished after adjusting for confounding factors. It also found a negative association between dairy consumption with BMI, fat mass index, body fat, blood pressure, and TyG-BMI.
The abortion trend after the pronatalist turn of population policies in Iran: a systematic review from 2005 to 2022
Authors: Shirdel Elham , Asadisarvestani Khadijeh , Kargar Fatemeh Hami
Published: July 2024

Objective

Given Iran’s recent shift towards pronatalist population policies, concerns have arisen regarding the potential increase in abortion rates. This review study examines the trends of (medical), intentional (illegal), and spontaneous abortions in Iran over the past two decades, as well as the factors that have contributed to these trends.

Methods

This paper reviewed research articles published between 2005 and 2022 on abortion in Iran. The study employed the PRISMA checklist for systematic reviews. Articles were searched from international (Google Scholar, PubMed, Science Direct, and Web of Science) and national databases (Magiran, Medlib, SID). Once the eligibility criteria were applied, 42 records were included from the initial 349 records.

Results

Abortion is influenced by a variety of socioeconomic and cultural factors and the availability of family planning services. Factors that contribute to unintended pregnancy include attitudes toward abortion, knowledge about reproductive health, access to reproductive health services, and fertility desires, among others. In addition to health and medical factors, consanguineous marriage plays an important role in spontaneous and therapeutic abortion. A higher number of illegal abortions were reported by women from more privileged socioeconomic classes. In comparison, a higher number of medical and spontaneous abortions were reported by women from less privileged socioeconomic classes.

Conclusion

Iranian policymakers are concerned about the declining fertility rate and have turned to pronatalist policies. From a demographic standpoint, this seems to be a reasonable approach. However, the new population policies, particularly, the Family Protection and Young Population Law, along with creating limitations in access to reproductive health services and prenatal screening tests as well as stricter abortion law could potentially lead to an increase in various types of abortions and their associated consequences.
Retrospective analysis of hospital electronic health records reveals unseen cases of acute hepatitis with unknown aetiology in adults in Oxfordshire
Authors: Tan Cedric C. S. , Kelly Gavin , Cregan Jack , Wilson Joseph D. , James Tim , Chand Meera , Hopkins Susan , Swets Maaike , Baillie J. Kenneth , Jeffery Katie , Walker Ann Sarah , Eyre David W. , Stoesser Nicole , Matthews Philippa C.
Published: July 2024

Background

An outbreak of acute severe hepatitis of unknown aetiology (AS-Hep-UA) in children during 2022 was subsequently linked to infections with adenovirus-associated virus 2 and other ‘helper viruses’, including human adenovirus. It is possible that evidence of such an outbreak could be identified at a population level based on routine data captured by electronic health records (EHR).

Methods

We used anonymised EHR to collate retrospective data for all emergency presentations to Oxford University Hospitals NHS Foundation Trust in the UK, between 2016–2022, for all ages from 18 months and older. We investigated clinical characteristics and temporal distribution of presentations of acute hepatitis and of adenovirus infections based on laboratory data and clinical coding. We relaxed the stringent case definition adopted during the AS-Hep-UA to identify all cases of acute hepatitis with unknown aetiology (termed AHUA). We compared events within the outbreak period (defined as 1st Oct 2021—31 Aug 2022) to the rest of our study period.

Results

Over the study period, there were 903,433 acute presentations overall, of which 391 (0.04%) were classified as AHUA. AHUA episodes had significantly higher critical care admission rates (p < 0.0001, OR = 41.7, 95% CI:26.3–65.0) and longer inpatient admissions (p < 0.0001) compared with the rest of the patient population. During the outbreak period, significantly more adults (≥ 16 years) were diagnosed with AHUA (p < 0.0001, OR = 3.01, 95% CI: 2.20–4.12), and there were significantly more human adenovirus (HadV) infections in children (p < 0.001, OR = 1.78, 95% CI:1.27–2.47). There were also more HAdV tests performed during the outbreak (p < 0.0001, OR = 1.27, 95% CI:1.17–1.37). Among 3,707 individuals who were tested for HAdV, 179 (4.8%) were positive. However, there was no evidence of more acute hepatitis or increased severity of illness in HadV-positive compared to negative cases.

Conclusions

Our results highlight an increase in AHUA in adults coinciding with the period of the outbreak in children, but not linked to documented HAdV infection. Tracking changes in routinely collected clinical data through EHR could be used to support outbreak surveillance.