bluuebunny/crossref_metadata_2025 huggingface dataset:
SGLT2 inhibitors: from glucose-lowering to cardiovascular benefits
Authors: Preda Alberto , Montecucco Fabrizio , Carbone Federico , Camici Giovanni G , Lüscher Thomas F , Kraler Simon , Liberale Luca
Published: March 2024

An increasing number of individuals are at high risk of type 2 diabetes (T2D) and its cardiovascular complications, including heart failure (HF), chronic kidney disease (CKD), and eventually premature death. The sodium-glucose co-transporter-2 (SGLT2) protein sits in the proximal tubule of human nephrons to regulate glucose reabsorption and its inhibition by gliflozins represents the cornerstone of contemporary T2D and HF management. Herein, we aim to provide an updated overview of the pleiotropy of gliflozins, provide mechanistic insights and delineate related cardiovascular (CV) benefits. By discussing contemporary evidence obtained in preclinical models and landmark randomized controlled trials, we move from bench to bedside across the broad spectrum of cardio- and cerebrovascular diseases. With landmark randomized controlled trials confirming a reduction in major adverse CV events (MACE; composite endpoint of CV death, non-fatal myocardial infarction, and non-fatal stroke), SGLT2 inhibitors strongly mitigate the risk for heart failure hospitalization in diabetics and non-diabetics alike while conferring renoprotection in specific patient populations. Along four major pathophysiological axes (i.e. at systemic, vascular, cardiac, and renal levels), we provide insights into the key mechanisms that may underlie their beneficial effects, including gliflozins’ role in the modulation of inflammation, oxidative stress, cellular energy metabolism, and housekeeping mechanisms. We also discuss how this drug class controls hyperglycaemia, ketogenesis, natriuresis, and hyperuricaemia, collectively contributing to their pleiotropic effects. Finally, evolving data in the setting of cerebrovascular diseases and arrhythmias are presented and potential implications for future research and clinical practice are comprehensively reviewed.
Intestinal Adipocytes Transdifferentiate into Myofibroblast-like Cells and Contribute to Fibrosis in Crohn’s Disease
Authors: Geng Zhijun , Li Jing , Zuo Lugen , Zhang Xiaofeng , Wang Lian , Xia Yongsheng , Yang Jingjing , Yin Lixia , Song Xue , Wang Yueyue , Chai Damin , Deng Min , Ge Yuanyuan , Wu Rong , Hu Jianguo
Published: March 2024

Background and Aims

Intestinal fibrotic stenosis is a major reason for surgery in Crohn’s disease [CD], but the mechanism is unknown. Thus, we asked whether intestinal adipocytes contribute to intestinal fibrosis. Adipocytes were found to transdifferentiate into myofibroblasts and confirmed to be involved in mesenteric fibrosis in our recent study. Here, we investigated the role and possible mechanisms of intestinal adipocytes in intestinal fibrosis in CD.

Methods

The intestinal tissue of patients with CD with or without fibrotic stenosis [CDS or CDN] and normal intestinal tissue from individuals without CD were obtained to assess alterations in submucosal adipocytes in CDS and whether these cells transdifferentiated into myofibroblasts and participated in the fibrotic process. Human primary adipocytes and adipose organoids were used to evaluate whether adipocytes could be induced to transdifferentiate into myofibroblasts and to investigate the fibrotic behaviour of adipocytes. LPS/TLR4/TGF-β signalling was also studied to explore the underlying mechanism.

Results

Submucosal adipocytes were reduced in number or even absent in CDS tissue, and the extent of the reduction correlated negatively with the degree of submucosal fibrosis. Interestingly, submucosal adipocytes in CDS tissue transdifferentiated into myofibroblast-like cells and expressed collagenous components, possibly due to stimulation by submucosally translocated bacteria. Lipopolysaccharide [LPS]-stimulated human primary adipocytes and adipose organoids also exhibited transdifferentiation and profibrotic behaviour. Mechanistically, TLR4-mediated TGF-β signalling was associated with the transdifferentiation and profibrotic behaviour of intestinal adipocytes in CDS tissue.

Conclusions

Intestinal adipocytes transdifferentiate into myofibroblasts and participate in the intestinal fibrosis process in CD, possibly through LPS/TLR4/TGF-β signalling.
Accelerated MEN2A in homozygous RET carriers in the context of consanguinity
Authors: Machens Andreas , Dralle Henning
Published: March 2024

Background

Homozygous mutations, 2 identical gene versions (alleles), 1 from each biological parent, are exceptional. Clinical descriptions of affected families, comprising few carriers only, are scattered throughout the literature, hindering evidence generation.

Methods

Included in this literature analysis were 5 RET families with ≥1 homozygous carrier and ≥3 heterozygous carriers per family.

Results

In consanguineous families with first-degree cousins, homozygotes presented with node-positive medullary thyroid cancer and pheochromocytoma in their mid-teens, whereas heterozygotes presented in their end-30s and early 40s. Homozygotes developed node-positive medullary thyroid cancer 27.4 years and pheochromocytoma 23 years earlier than heterozygotes. These age differences were smaller in the 15 families carrying founder mutation p.Leu666delinsAsnSer, whereas homozygotes developed node-positive medullary thyroid cancer in their mid-40s, 6 years earlier than heterozygotes in their early 50s.

Conclusion

These results, limited in scope and size and modulated by extent of consanguinity, are consistent with moderate dose–response effects accelerating MEN2A development.
Forensic DNA phenotyping: a review on SNP panels, genotyping techniques, and prediction models
Authors: Terrado-Ortuño Nuria , May Patrick
Published: March 2024

In the past few years, forensic DNA phenotyping has attracted a strong interest in the forensic research. Among the increasing publications, many have focused on testing the available panels to infer biogeographical ancestry on less represented populations and understanding the genetic mechanisms underlying externally visible characteristics. However, there are currently no publications that gather all the existing panels limited to forensic DNA phenotyping and discuss the main technical limitations of the technique. In this review, we performed a bibliographic search in Scopus database of phenotyping-related literature, which resulted in a total of 48, 43, and 15 panels for biogeographical ancestry, externally visible characteristics, and both traits inference, respectively. Here we provide a list of commercial and non-commercial panels and the limitations regarding the lack of harmonization in terms of terminology (i.e., categorization and measurement of traits) and reporting, the lack of genetic knowledge and environment influence to select markers and develop panels, and the debate surrounding the selection of genotyping technologies and prediction models and algorithms. In conclusion, this review aims to be an updated guide and to present an overview of the current related literature.
Decadal (2010–2019) variability in the marine ecosystems of the North Atlantic
Authors: González-Pola César , Mills Katherine E , Beszczynska-Möller Agnieszka , Bresnan Eileen , Birchenough Silvana N R
Published: March 2024

The “Symposium on Decadal Variability of the North Atlantic and its Marine Ecosystems: 2010–2019” took place in Bergen, Norway, from 20 to 22 May 2022. This event, hosted by the Institute of Marine Research, was jointly sponsored by ICES and NAFO and constitutes the fourth in a series of these symposia that started in 1991. The first symposium’s aim was to review the hydrobiological variability in the decade of the 1980s, addressing the physical environment, plankton, invertebrates, and fish. Subsequent symposia maintained the classical structure, whilst a new theme session covering social sciences was added to the programme in the 2022 edition. Studies of climate impacts on marine ecosystems and living marine resources, including trends and regime shifts, emerged from increasingly longer ecosystem time series across the North Atlantic and subarctic regions. This symposium collection presents key findings discussed during the symposium. Whilst some progress has been made in advancing our ability to understand new trends and patterns of climate change and variability across physical, plankton, and fish communities, more work is needed to integrate these physical-ecological processes and scales with social science.
In-situ heating-and-electron tomography for materials research: from 3D (in-situ 2D) to 4D (in-situ 3D)
Authors: Hata Satoshi , Ihara Shiro , Saito Hikaru , Murayama Mitsuhiro
Published: March 2024

In-situ observation has expanded the application of transmission electron microscopy (TEM) and has made a significant contribution to materials research and development for energy, biomedical, quantum, etc. Recent technological developments related to in-situ TEM have empowered the incorporation of three-dimensional observation, which was previously considered incompatible. In this review article, we take up heating as the most commonly used external stimulus for in-situ TEM observation and overview recent in-situ TEM studies. Then, we focus on the electron tomography (ET) and in-situ heating combined observation by introducing the authors’ recent research as an example. Assuming that in-situ heating observation is expanded from two dimensions to three dimensions using a conventional TEM apparatus and a commercially available in-situ heating specimen holder, the following in-situ heating-and-ET observation procedure is proposed: (i) use a rapid heating-and-cooling function of a micro-electro-mechanical system holder; (ii) heat and cool the specimen intermittently and (iii) acquire a tilt-series dataset when the specimen heating is stopped. This procedure is not too technically challenging and can have a wide range of applications. Essential technical points for a successful 4D (space and time) observation will be discussed through reviewing the authors’ example application.
When all else fails: the colo-duodenal anastomosis
Authors: Dewhurst Suzannah L , Sarofim Mina , Wijayawardana Ruwanthi , Morris David L
Published: March 2024

Total enterectomy is an exceedingly rare procedure performed out of necessity due to massive intestinal infarction, trauma, or peritoneal malignancy. This case describes a 47-year-old patient who has successfully undergone the procedure to manage mesenteric ischaemia. Bowel continuity was achieved with a duodenocolonic anastomosis, and the patient has been transitioned to life-long total parental nutrition. This case highlights that carefully selected patients can achieve long-term survival with good quality of life rather than palliation.
Actinomyces as a rare cause of appendicitis: a case report
Authors: Gao Yijun , Jhamb Shaurya , Hayler Raymond , Trickett Chloe , Kwok Allan
Published: March 2024

Actinomycosis remains a rare and often underdiagnosed cause of appendicitis with only 10% of cases diagnosed prior to surgery. It is an important cause to consider particularly in the setting of an indolent infection with nonspecific symptoms. We present a 22 years old male who presented with 3 weeks history of lower abdominal pain who underwent laboratory investigations and imaging studies suggestive of acute appendicitis. He underwent an emergency laparoscopic caecectomy with histopathology of the specimen suggestive of actinomycosis. He recovered well postoperatively and was discharged home with a prolonged course of oral penicillins. Preoperative diagnosis of actinomycosis is uncommon and accounts for ~10% of cases. Definitive diagnosis is usually through histopathology or tissue/fluid culture. Treatment usually involves a combination of surgical resection and antibiotic therapy with a success rate of >90%.
Genetic Basis and Evolutionary Forces of Sexually Dimorphic Color Variation in a Toad-Headed Agamid Lizard
Authors: Lu Bin , Qiu Xia , Yang Weizhao , Yao Zhongyi , Ma Xiaofeng , Deng Shunyan , Zhang Qi , Fu Jinzhong , Qi Yin
Published: March 2024

In the animal kingdom, sexually dimorphic color variation is a widespread phenomenon that significantly influences survival and reproductive success. However, the genetic underpinnings of this variation remain inadequately understood. Our investigation into sexually dimorphic color variation in the desert-dwelling Guinan population of the toad-headed agamid lizard (Phrynocephalus putjatai) utilized a multidisciplinary approach, encompassing phenotypic, ultrastructural, biochemical, genomic analyses, and behavioral experiments. Our findings unveil the association between distinct skin colorations and varying levels of carotenoid and pteridine pigments. The red coloration in males is determined by a genomic region on chromosome 14, housing four pigmentation genes: BCO2 and three 6-pyruvoyltetrahydropterin synthases. A Guinan population-specific nonsynonymous single nucleotide polymorphism in BCO2 is predicted to alter the electrostatic potential within the binding domain of the BCO2-β-carotene complex, influencing their interaction. Additionally, the gene MAP7 on chromosome 2 emerges as a potential contributor to the blue coloration in subadults and adult females. Sex-specific expression patterns point to steroid hormone-associated genes (SULT2B1 and SRD5A2) as potential upstream regulators influencing sexually dimorphic coloration. Visual modeling and field experiments support the potential selective advantages of vibrant coloration in desert environments. This implies that natural selection, potentially coupled with assortative mating, might have played a role in fixing color alleles, contributing to prevalence in the local desert habitat. This study provides novel insights into the genetic basis of carotenoid and pteridine-based color variation, shedding light on the evolution of sexually dimorphic coloration in animals. Moreover, it advances our understanding of the driving forces behind such intricate coloration patterns.
Challenges, limitations, and pitfalls of PET and advanced MRI in patients with brain tumors: A report of the PET/RANO group
Authors: Galldiks Norbert , Kaufmann Timothy J , Vollmuth Philipp , Lohmann Philipp , Smits Marion , Veronesi Michael C , Langen Karl-Josef , Rudà Roberta , Albert Nathalie L , Hattingen Elke , Law Ian , Hutterer Markus , Soffietti Riccardo , Vogelbaum Michael A , Wen Patrick Y , Weller Michael , Tonn Joerg-Christian
Published: March 2024

Brain tumor diagnostics have significantly evolved with the use of positron emission tomography (PET) and advanced magnetic resonance imaging (MRI) techniques. In addition to anatomical MRI, these modalities may provide valuable information for several clinical applications such as differential diagnosis, delineation of tumor extent, prognostication, differentiation between tumor relapse and treatment-related changes, and the evaluation of response to anticancer therapy. In particular, joint recommendations of the Response Assessment in Neuro-Oncology (RANO) Group, the European Association of Neuro-oncology, and major European and American Nuclear Medicine societies highlighted that the additional clinical value of radiolabeled amino acids compared to anatomical MRI alone is outstanding and that its widespread clinical use should be supported. For advanced MRI and its steadily increasing use in clinical practice, the Standardization Subcommittee of the Jumpstarting Brain Tumor Drug Development Coalition provided more recently an updated acquisition protocol for the widely used dynamic susceptibility contrast perfusion MRI. Besides amino acid PET and perfusion MRI, other PET tracers and advanced MRI techniques (e.g. MR spectroscopy) are of considerable clinical interest and are increasingly integrated into everyday clinical practice. Nevertheless, these modalities have shortcomings which should be considered in clinical routine. This comprehensive review provides an overview of potential challenges, limitations, and pitfalls associated with PET imaging and advanced MRI techniques in patients with gliomas or brain metastases. Despite these issues, PET imaging and advanced MRI techniques continue to play an indispensable role in brain tumor management. Acknowledging and mitigating these challenges through interdisciplinary collaboration, standardized protocols, and continuous innovation will further enhance the utility of these modalities in guiding optimal patient care.
The experience of caregiving for adults with benign brain tumors: An integrative review
Authors: McDaniel Amanda Kate , Carlson Barbara , Dunn Ian F , Nipp Ryan
Published: March 2024

Background

Caregiving for the adult benign brain tumor (aBBT) population is unique, as patients’ extended period of survivorship poses significant challenges related to the long-term sequelae of the disease and the foreboding possibility of recurrence. In this integrative review, we examined the caregiving experience across the spectrum of the aBBT population.

Methods

We searched OVID, CINAHL, and PubMed databases from 2000 to 2022. We included studies primarily focused on caregivers of aBBT and written in English.

Results

Among 594 papers identified in the initial review, we included a final list of 7 papers. Among these 7 papers, 5 central themes emerged. First, we identified a theme surrounding psychosocial and emotional needs, which included the social isolation of caregiving. The second theme related to informational care needs, including what is considered to be the normal course of recovery after surgery. The third theme focused on access to services, including specialist neurosurgical care, and the fourth theme related to financial strain and the economic burdens associated with long-term follow-up. Lastly, we found a theme surrounding family role changes, which included the shift from spouse to caregiver.

Conclusions

In this review, we identified themes highlighting similarities to the high-grade glioma population. However, we uncovered distinct differences in terms of caregiver characteristics, length of survivorship, and the burden of caregiving over time. Collectively, our findings underscore the incomplete understanding of the caregiving experience across the spectrum of the aBBT population.
Water and other volatiles on Mars
Authors: Hu Sen , Gao Yubing , Zhou Zhan , Gao Liang , Lin Yangting
Published: March 2024

This perspective reviews the recent advances in martian water and other volatiles and addresses the associated scientific questions for future martian exploration missions.
Increasing inequalities in longevity among Italian workers
Authors: Ardito Chiara , Zengarini Nicolás , Leombruni Roberto , Costa Giuseppe , d’Errico Angelo
Published: March 2024

This article examines the evolution of inequalities in life expectancy at 65 and all-cause mortality by socio-economic position (SEP) among Italian workers. Period life tables and negative binomial regression models are used to estimate longevity inequalities. The empirical assessment is carried out on two administrative datasets, one covering the entire population of private sector workers for the years 1990–2019 and the other covering the entire workforce in Turin for the years 1981–2019. We find that social inequalities in life expectancy and all-cause mortality have increased among Italian workers in recent decades. Several robustness checks confirm this worrying trend, especially for men. Longevity has improved for workers in the middle and high SEPs, while it has hardly changed for workers in the lowest SEP. We show that the estimated life expectancy differentials translate into a loss of pension wealth for the most disadvantaged categories, which also increases over time.
Tangled Webs of Trust: A Study of Public Trust in Risk Regulation
Authors: Hawkins Joanne
Published: March 2024

This article provides an empirically grounded understanding of public trust in the context of risk regulation, specifically through a case study of shale gas exploration and fracking. It offers insight into the factors underpinning public trust and explores the empirical reality of the socially embedded and relational nature of trust. The article engages with the often-neglected dynamics of trust and how relationships between different levels of trust (eg institutional, interpersonal, wider system) operate. It shows how trust, far from complying with many existing linear conceptualisations, is complex and messy, involving a web of ongoing and interactive relationships within and between these levels. By mapping empirical data against our theoretical understandings, this article offers an alternative insight into the trust relationship, better positioning us to understand trust as an ongoing process, rather than an end product.
Relating ciliary propulsion morphology and flow to particle acquisition in marine planktonic ciliates I: the tintinnid ciliateAmphorides quadrilineata
Authors: Jiang Houshuo , Buskey Edward J
Published: March 2024

The marine tintinnid ciliate Amphorides quadrilineata is a feeding-current feeder, creating flows for particle encounter, capture and rejection. Individual-level behaviors were observed using high-speed, high-magnification digital imaging. Cells beat their cilia backward to swim forward, simultaneously generating a feeding current that brings in particles. These particles are then individually captured through localized ciliary reversals. When swimming backward, cells beat their cilia forward (=ciliary reversals involving the entire ring of cilia), actively rejecting unwanted particles. Cells achieve path-averaged speeds averaging 3–4 total lengths per second. Both micro-particle image velocimetry and computational fluid dynamics were employed to characterize the cell-scale flows. Forward swimming generates a feeding current, a saddle flow vector field in front of the cell, whereas backward swimming creates an inverse saddle flow vector field behind the cell; these ciliary flows facilitate particle encounter, capture and rejection. The model-tintinnid with a full-length lorica achieves an encounter rate Q ~29% higher than that without a lorica, albeit at a ~142% increase in mechanical power and a decrease in quasi-propulsive efficiency (~0.24 vs. ~ 0.38). It is also suggested that Q can be approximated by π(W/2 + l)2U, where W, l and U represent the lorica oral diameter, ciliary length and swimming speed, respectively.
Evidence for an RNAi-independent role of Arabidopsis DICER-LIKE2 in growth inhibition and basal antiviral resistance
Authors: Nielsen Carsten Poul Skou , Arribas-Hernández Laura , Han Lijuan , Reichel Marlene , Woessmann Jakob , Daucke Rune , Bressendorff Simon , López-Márquez Diego , Andersen Stig Uggerhøj , Pumplin Nathan , Schoof Erwin M , Brodersen Peter
Published: March 2024

Flowering plant genomes encode four or five DICER-LIKE (DCL) enzymes that produce small interfering RNAs (siRNAs) and microRNAs, which function in RNA interference (RNAi). Different RNAi pathways in plants effect transposon silencing, antiviral defense, and endogenous gene regulation. DCL2 acts genetically redundantly with DCL4 to confer basal antiviral defense. However, DCL2 may also counteract DCL4 since knockout of DCL4 causes growth defects that are suppressed by DCL2 inactivation. Current models maintain that RNAi via DCL2-dependent siRNAs is the biochemical basis of both effects. Here, we report that DCL2-mediated antiviral resistance and growth defects cannot be explained by the silencing effects of DCL2-dependent siRNAs. Both functions are defective in genetic backgrounds that maintain high levels of DCL2-dependent siRNAs, either with specific point mutations in DCL2 or with reduced DCL2 dosage because of heterozygosity for dcl2 knockout alleles. Intriguingly, all DCL2 functions require its catalytic activity, and the penetrance of DCL2-dependent growth phenotypes in dcl4 mutants correlates with DCL2 protein levels but not with levels of major DCL2-dependent siRNAs. We discuss this requirement and correlation with catalytic activity but not with resulting siRNAs, in light of other findings that reveal a DCL2 function in innate immunity activation triggered by cytoplasmic double-stranded RNA.
ABSCISIC ACID-INSENSITIVE 5-KIP-RELATED PROTEIN 1-SHOOT MERISTEMLESS modulates reproductive development of Arabidopsis
Authors: Wang Wan-Ni , Wei Yu-Ting , Zhao Sheng-Ting , Yu Fu-Huan , Wang Jing-wen , Gu Cheng-yue , Liu Xin-Ran , Sai Na , Zhu Jin-Lei , Wang Qi-Meng , Bao Qin-Xin , Mu Xin-Rong , Liu Yu-xin , Loake Gary J , Jiang Ji-hong , Meng Lai-Sheng
Published: March 2024

Soil (or plant) water deficit accelerates plant reproduction. However, the underpinning molecular mechanisms remain unknown. By modulating cell division/number, ABSCISIC ACID-INSENSITIVE 5 (ABI5), a key bZIP (basic (region) leucine zippers) transcription factor, regulates both seed development and abiotic stress responses. The KIP-RELATED PROTEIN (KRP) cyclin-dependent kinases (CDKs) play an essential role in controlling cell division, and SHOOT MERISTEMLESS (STM) plays a key role in the specification of flower meristem identity. Here, our findings show that abscisic acid (ABA) signaling and/or metabolism in adjust reproductive outputs (such as rosette leaf number and open flower number) under water-deficient conditions in Arabidopsis (Arabidopsis thaliana) plants. Reproductive outputs increased under water-sufficient conditions but decreased under water-deficient conditions in the ABA signaling/metabolism mutants abscisic acid2-1 (aba2-1), aba2-11, abscisic acid insensitive3-1 (abi3-1), abi4-1, abi5-7, and abi5-8. Further, under water-deficient conditions, ABA induced-ABI5 directly bound to the promoter of KRP1, which encodes a CDK that plays an essential role in controlling cell division, and this binding subsequently activated KRP1 expression. In turn, KRP1 physically interacted with STM, which functions in the specification of flower meristem identity, promoting STM degradation. We further demonstrate that reproductive outputs are adjusted by the ABI5–KRP1–STM molecular module under water-deficient conditions. Together, our findings reveal the molecular mechanism by which ABA signaling and/or metabolism regulate reproductive development under water-deficient conditions. These findings provide insights that may help guide crop yield improvement under water deficiency.
Effects of Online Unfolding Case Studies on Clinical Reasoning and Academic Performance of Undergraduate Nursing Students
Authors: Sultan Bushra , Victor Gideon , Naeem Farah , Gul Hajira
Published: March 2024

A single-episode online case study increases cognitive load in contrast to an unfolding online case study, which decreases cognitive load, improves academic performance, and enhances clinical reasoning. However, online utilization of unfolding case studies is limited. A one-group pretest posttest experimental design was employed with 45 nursing students in a pathophysiology course. Data were collected using Lasater’s clinical reasoning scale and quiz scores to assess academic performance. The academic performance and clinical reasoning of nursing students were significantly higher with online unfolding case studies (p < .001), providing support for the use of the online unfolding case study method.
Higher Neck Pain Intensity and Pain Catastrophizing Soon After A Whiplash Injury Partially Explain the Presence of Persistent Headache
Authors: Anarte-Lazo Ernesto , Falla Deborah , Rodriguez-Blanco Cleofas , Bernal-Utrera Carlos
Published: March 2024

Objective:

To understand whether pain-related factors soon after a whiplash injury can explain the presence of chronic headache.

Materials and Methods:

A prospective study with a follow-up of 6 months was performed including 42 patients with acute whiplash-associated disorders. Neck pain intensity, the Neck Disability Index, the Tampa Scale Kinesiophobia, Pain Catastrophizing Scale, and the Anxiety State-Trait Scale were assessed at baseline. Differences in clinical characteristics between those with and without headache at 6 months were determined. The relative risk of presenting with headache was evaluated. A logistic regression model was performed to assess which factors at baseline could explain the presence of headache at 6 months.

Results:

At 6 months, 1/3 of the sample presented with chronic headache. Significant differences were found for several outcome measures when people with and without headache were compared (P<0.001). The highest relative risk of presenting with headache was found for moderate/severe levels of pain catastrophizing during the acute phase (RR=15.00, 95%CI=3.93, 57.22). The level of neck pain intensity and pain catastrophizing at baseline partially explained the presence of headache at 6 months (R2=0.627).

Discussion:

The risk of presenting with persistent headache attributed to a whiplash injury is increased when people present with higher neck pain intensity and pain catastrophizing soon after a whiplash injury. Evaluating neck pain intensity and pain catastrophizing at baseline may assist in identifying those more likely to develop chronic headache, potentially providing an opportunity for early targeted interventions.
Factors Associated With Caregiver Reporting of Developmental Concerns Among Children in Low-Income Communities
Authors: Yepez Catherine E. , Isbell Ann M. , Anderson Christopher E. , Whaley Shannon E.
Published: March 2024

Early detection and access to interventions for developmental delays in young children have been shown to improve health, social, and academic outcomes later in life. The purpose of this study is to examine the factors associated with caregivers' perception of child developmental concerns in low-income communities. A countywide survey was conducted in Los Angeles County (LAC), California, among 4,863 participating Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) families with children ages 1–4 years. Proportional odds ordinal logistic regression was used to evaluate the association between the severity of reported developmental concerns and respondent characteristics. Results indicate that demographic characteristics, support systems, health care visits during COVID-19, and maternal symptoms of depression are associated with higher odds of reporting more severe developmental concerns among the WIC population. Advancing policies, programs, and research that aim to improve early detection and access to childhood professionals for all families will be essential to allow all children in low-income households to optimize their development.
Factors Associated With Service Referrals and Uptake in Early Head Start
Authors: Carleton Russell A. , DiGirolamo Ann M. , McGarrie Lisa , Whitmore Ani S. , Gilmer-Hughes Annelise
Published: March 2024

Secondary analysis of the Early Head Start Family and Child Experiences Survey 2018 data set (Baby FACES 2018) explored links between family risk events and referral-making and referral uptake among families receiving Early Head Start (EHS) services. Referrals to both behavioral health and entitlement programs were considered. Results showed that referrals to behavioral health programs were much more likely to be given to families receiving care from home-based care than center-based care, and that referrals were slightly more likely to be given to families who did not have any family risk events. Several factors also moderated the relationship between family risk and referrals, including perceived closeness of the parent/caregiver–EHS staff relationship, family conflict, and caregiver depression. There were no observed effects for referrals to entitlement programs. Caregiver depression weakened the link between family risk and service uptake for entitlement programs.
Association between bridging therapy and posttransplant outcomes in patients with HCC within Milan criteria: A systematic review and meta-analysis
Authors: Arvind Ashwini , Seif El Dahan Karim , Malhotra Riya , Daher Darine , Rich Nicole E. , Patel Madhukar S. , VanWagner Lisa B. , Lieber Sarah R. , Cotter Thomas G. , Louissaint Jeremy , Mufti Arjmand R. , Kulik Laura , Pillai Anjana , Parikh Neehar D. , Singal Amit G.
Published: March 2024

Liver transplantation is the curative therapy of choice for patients with early-stage HCC. Locoregional therapies are often employed as a bridge to reduce the risk of waitlist dropout; however, their association with posttransplant outcomes is unclear. We conducted a systematic review using Ovid MEDLINE and EMBASE to identify studies published between database inception and August 2, 2023, which reported posttransplant recurrence-free survival and overall survival among patients transplanted for HCC within Milan criteria, stratified by receipt of bridging therapy. Pooled HRs were calculated for each outcome using the DerSimonian and Laird method for a random-effects model. We identified 38 studies, including 19,671 patients who received and 20,148 patients who did not receive bridging therapy. Bridging therapy was not associated with significant differences in recurrence-free survival (pooled HR: 0.91, 95% CI: 0.77–1.08;I2=39%) or overall survival (pooled HR: 1.09, 95% CI: 0.95–1.24;I2=47%). Results were relatively consistent across subgroups, including geographic location and study period. Studies were discordant regarding the differential strength of association by pretreatment tumor burden and pathologic response, but potential benefits of locoregional therapy were mitigated in those who received 3 or more treatments. Adverse events were reported in a minority of studies, but when reported occurred in 6%–15% of the patients. Few studies reported loss to follow-up and most had a risk of residual confounding. Bridging therapy is not associated with improvements in posttransplant recurrence-free or overall survival among patients with HCC within Milan criteria. The risk-benefit ratio of bridging therapy likely differs based on the risk of waitlist dropout.
Solution is not simple; sodium-glucose cotransporter-2 inhibitor use in Conn syndrome
Authors: Soyaltin Utku
Published: March 2024

Purpose

In patients with bilateral primary hyperaldosteronism (PA) and those with unilateral PA who are unwilling or unable to undergo adrenalectomy an increase in plasma renin activity (PRA) provided by mineralocorticoid receptor antagonists (MRAs) therapy reflects sufficient antagonism for elevated aldosterone. Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) have cardiovascular, renal protective properties and some clinical data have shown an increase in PRA levels with SGLT2-i. Here, we present our experience of using SGLT2-i in PA patients with suppressed PRA despite 100 mg/day spironolactone therapy.

Cases

We prospectively evaluate the laboratory values of seven patients who were diagnosed with bilateral hyperaldosteronism. All of them were diabetic and had an HbA1c <7% with metformin treatment alone. Spironolactone was started in all of the patients after diagnosis and although the dose was increased to 100 mg/day, PRA levels remained <1 ng/ml/h. Metformin treatment was changed to empagliflozin in all patients and PRA was checked again at the sixth month of treatment.

Results

Metformin treatment was changed to empagliflozin in all patients and PRA was checked again at the sixth month of treatment. Mean PRA levels were 0.464 ± 0.189 ng/ml/h before the treatment change and increased to mean 3.257 ± 1.881 ng/ml/h in the sixth month (P = 0.008). The mean PRA was >1 ng/ml/h except for one patient in the sixth month of treatment.

Conclusion

Larger molecular and clinical studies are needed to understand whether the increase in PRA after empagliflozin treatment indicates interference, whether spironolactone treatment has become more effective, or whether empagliflozin has aldosterone receptor antagonism apart from its known effects.
A comparison among oscillometric waveforms in healthy nonpregnant women, pregnancy and hypertensive disorders of pregnancy
Authors: Ringrose Jennifer S. , Sridar Sangita , Araneta Patricia , Chan Lillian , Kassam Jalisa , Wirzba Mira , Greeff Kate , Ramsay Gillian , Sia Winnie , Khurana Rshmi , Bader Erin , Padwal Raj
Published: March 2024

Objective

Understanding of how oscillometric waveforms (OMW) vary between pregnant and nonpregnant individuals remains low. An exploratory analysis was completed to assess for quantitative and qualitative changes in OMW and oscillometric envelope features in pregnancy.

Design and methods

Eighteen pregnant individuals (over 20 weeks gestational age) and healthy, nonpregnant (HNP) women were recruited. Six HNP were matched to six healthy pregnant (HP) women, and six pregnant women with a hypertensive disorder of pregnancy (HDP) by age, arm circumference, and cuff size. Blood pressure measurements were completed per the International Organization for Standardization (ISO) protocol using a custom-built oscillometric device as the test device and two-observer mercury auscultation as the reference measurement. Auscultatory blood pressure and blood pressure derived from slope-based and fixed ratio algorithms were determined. OMW and envelope features were compared among groups.

Results

In HNP, HP, and HDP groups respectively: mean auscultatory blood pressure (systolic mean ± SD/diastolic mean ± SD) was 103.4 ± 12.2/67.1 ± 7.9; 109.5 ± 3.1/58.1 ± 6.4; 135.6 ± 18.9/85.1 ± 14.2 mmHg. HDP had significantly higher auscultatory systolic and diastolic blood pressure than the HP group (P = 0.001). The pregnant groups had a lower average pulse width (mean ± SD: HNP = 0.8 ± 0 s, HP = 0.6 ± 0.1 s, HDP = 0.6 ± 0.1 s; HP vs. HNP mean difference [adjusted P value]: 0.2 [P = 0.004], HDP vs. HNP 0.1 [P = 0.018]) compared with the HNP group. The HDP group had a larger area under the OMW envelope than the HNP group (mean ± SD: HNP = 22.6 ± 3.4; HDP = 28.5 ± 4.2; HDP vs. HNP mean difference [adjusted P value]: 5.9 P = 0.05).

Conclusion

In this exploratory work, differences in the OMW morphology and parameters were found in pregnancy and in hypertensive disorders of pregnancy compared with healthy controls. Even small differences may have important implications in algorithm development; further work comparing OMW envelopes in pregnancy is needed to optimize the algorithms used to determine blood pressure in pregnancy.
Total disc replacement compared with fusion for cervical degenerative disc disease
Authors: Zhai Shuchao , Li Aimin , Li Xiang , Wu Xingguo
Published: March 2024

Study design:

The present study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

Objective:

The present study aimed to conduct a systematic review of overlapping meta-analyses comparing ACDR with fusion for treating CDDD in order to assist decision makers in their selection among conflicting meta-analyses and to provide treatment recommendations based on the best available evidence.

Summary of background data:

Although several meta-analyses have been performed to compare total disc replacement (TDR) and fusion for treating cervical degenerative disc disease (CDDD), their findings are inconsistent.

Methods:

Multiple databases were comprehensively searched for meta-analyses comparing TDR with fusion for treating CDDD. The meta-analyses that comprised only randomized controlled trials (RCTs) were included. Two authors independently assessed the meta-analysis study quality and extracted the data. The Jadad decision algorithm was used to ascertain which meta-analysis studies represented the best evidence.

Results:

A total of 14 meta-analysis studies were included. All these studies only included RCTs and were determined as Level-II evidence.

Conclusions:

Cervical disc arthroplasty was superior compared to anterior discectomy and fusion for the treatment of symptomatic cervical disc disease.
Comparison of absolute renal uptake by using Tc-99m MAG-3 and Tc-99m DMSA
Authors: Dilawar Hasnain , Habib Salman , Rana Razia , Ahmed Akhtar , Iqbal Javaid , Abdul Rehman Talal , Hadi Imran , Fatima Shazia
Published: March 2024

Purpose

The purpose of this study is to compare the value of absolute renal uptake (ARU %) in patients by using Tc-99m MAG-3 and Tc-99m DMSA scan.

Material and methods

Absolute renal uptake is calculated using Tc-99m MAG-3 and Tc-99m DMSA in renal scintigraphy, Itoh and Tauex kidney depth methods used, respectively. n = 40 adult patients of both genders were included. All patients underwent Tc-99m MAG-3 and Tc-99m DMSA, respectively.

Results

The values of ARU (%) were calculated separately in selected patients n = 40, (left = 17, right = 23 normal functioning kidneys) by MAG-3 and DMSA. Absolute renal uptake (%) of Tc-99m MAG-3 in left kidneys was found to be 15.2 ± 3.4, with spilt renal function 79.2 ± 14.7 and ARU (%) in right kidneys 16.2 ± 3.4 with spilt renal function 77.5 ± 19. Absolute renal uptake of Tc-99m DMSA in left kidneys was 17.5 ± 3.2 and in right kidneys 17.9 ± 4.5 with spilt renal function 81.8 ± 10.7 and 79.3 ± 13.8 for left and right kidney, respectively. Statistical analysis showed strong Pearson correlation.

Conclusion

Absolute renal uptake % was found to be more reliable in cases of bilateral compromised kidneys. ARU (%) calculated by Tc-99m MAG-3 solely can be used as predictor of renal function. The use of Tc-99m MAG-3 has more advantages than Tc-99m DMSA alone in renal scintigraphy as dynamic scintigraphy gives less radiation burden to patient, more information regarding renal function, and shorter stay time at hospital in comparison to static renal imaging. SRF % is less reliable than ARU (%).
Cardiovascular risk assessment in inflammatory bowel disease with coronary calcium score
Authors: Chaudhry Waqar Arif Rasool , Ashfaq Muhammad , Kaur Parvinder , Kumar Mahendra , Faraz Maria , Malik Jahanzeb , Mehmoodi Amin
Published: March 2024

The interplay between inflammatory bowel disease (IBD) and atherosclerotic cardiovascular disease (ASCVD) underscores the intricate connections between chronic inflammation and cardiovascular health. This review explores the multifaceted relationship between these conditions, highlighting the emerging significance of the coronary calcium score as a pivotal tool in risk assessment and management. Chronic inflammation, a hallmark of IBD, has far-reaching systemic effects that extend to the cardiovascular system. Shared risk factors and mechanisms, such as endothelial dysfunction, lipid dysfunction, and microbiome dysregulation, contribute to the elevated ASCVD risk observed in individuals with IBD. Amidst this landscape, the coronary calcium score emerges as a means to quantify calcified plaque within coronary arteries, offering insights into atherosclerotic burden and potential risk stratification. The integration of the coronary calcium score refines cardiovascular risk assessment, enabling tailored preventive strategies for individuals with IBD. By identifying those at elevated risk, healthcare providers can guide interventions, fostering informed shared decision-making. Research gaps persist, prompting further investigation into mechanisms linking IBD and ASCVD, particularly in the context of intermediate mechanisms and early atherosclerotic changes. The potential of the coronary calcium score extends beyond risk assessment—it holds promise for targeted interventions. Randomized trials exploring the impact of IBD-modifying therapies on ASCVD risk reduction can revolutionize preventive strategies. As precision medicine gains prominence, the coronary calcium score becomes a beacon of insight, illuminating the path toward personalized cardiovascular care for individuals living with IBD. Through interdisciplinary collaboration and rigorous research, we embark on a journey to transform the paradigm of preventive medicine and enhance the well-being of this patient population.
Retroperitoneal laparoscopic partial nephrectomy with selective renal artery clamping for renal cell carcinoma: initial outcomes
Authors: Do Truong-Thanh , Pham Thanh-Dat , Do Minh-Tung , Le Van-Hung , Nguyen Duc-Minh , Nguyen Huy-Hoang , Nguyen Duc-Linh , Thao Nguyen Dac , Nguyen Dao-Uyen
Published: March 2024

Introduction:

To explore the feasibility and safety of retroperitoneal laparoscopic partial nephrectomy (RLPN) with selective artery clamp (SAC) in patients with renal cell carcinoma (RCC).

Methods:

The authors recruited three men and two women who underwent RLPN for T1 RCC between December 2022 and May 2023 at a tertiary hospital. The median age of the patients was 32 years (range, 25–70 years). The tumour size ranged from 3 to 4.5 cm. The R.E.N.A.L scores were 4x, 5p, 8a, 5a, and 8ah. The median preoperative eGFR was 96.9 (74.3–105.2). Renal computed tomography angiography was performed before the surgery to evaluate the artery branches. The operation time, number of clamped arteries, warm ischaemic time (WIT), intraoperative blood loss, RCC type, postoperative hospital stay, changes in renal function, and complications were evaluated. The follow-up duration was 6 months.

Results:

The median operation time was 120 (75–150) minutes. One artery was clamped in four patients, while three were clamped in one patient. The median WIT was 22 (15–30) min, and the median blood loss was 150 (100–300) ml. No complications were recorded, and the resection margin was negative in all patients. The median decrease in eGFR was 6 (4–30%).

Conclusions:

RLPN with SAC for T1 RCC is safe and feasible in clinical practice.
Hypercholesterolemia: a literature review on management using tafolecimab: a novel member of PCSK9 monoclonal antibodies
Authors: Qureshi Zaheer , Khanzada Mikail , Safi Adnan , Fatima Eeshal , Altaf Faryal , Vittorio Timothy J.
Published: March 2024

Background:

Cardiovascular diseases (CVD) persist as the leading cause of mortality globally, with atherosclerotic cardiovascular disease (ASCVD), including hypercholesterolaemia, being a significant contributor. Hyperlipidemia management includes various lipid-lowering drugs, including statins, Bempedoic acid, inclisiran, Lomitapide, ANGPTL3 inhibitors, and PCSK9 inhibitors. Statins have traditionally dominated lipid management therapies; however, a subset of patients remains unresponsive or intolerant to this therapy, necessitating novel therapeutic approaches. Tafolecimab, a promising and novel PCSK9 monoclonal antibody, demonstrated significant LDL-C reduction and a favourable safety profile in clinical trials.

Objective:

This review aimed to discuss the role and efficacy of Tafolecimab in the management of hypercholesterolaemia.

Methods:

The authors searched online databases, including PubMed, Scopus, and Embase, for articles related to talofecimab.

Discussion:

The efficacy of Tafolecimab in diverse patient populations, including those with comorbid conditions and various lipid disorders, has been explored. Ongoing trials, such as CREDIT-1, CREDIT-2, and CREDIT-4, have provided valuable insights into Tafolecimab’s potential as a lipid-lowering agent. Moreover, the drug’s extended dosing interval may enhance patient compliance and reduce treatment costs. It has also been found that Tafolecimab has more affinity for PCSK9 and a longer duration of LDL-C reduction than other monoclonal antibody drugs such as evolocumab. Thus, this review focuses on Tafolecimab, a novel PCSK9 monoclonal antibody, its mechanism of action, clinical trial outcomes, safety profile, and potential role in hypercholesterolaemia management. Despite its assuring potential, the long-term impact of Tafolecimab on cardiovascular outcomes remains to be fully elucidated, necessitating further research. Regulatory authorities like the FDA and EMA should also evaluate Tafolecimab’s risks and benefits.

Conclusion:

In conclusion, Tafolecimab shows potential as an innovative therapeutic option for hypercholesterolaemia, particularly in patients with specific risk factors, but warrants additional research.