bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood adversity and adolescent epigenetic age acceleration: the role of adolescent sleep health
Authors: DiMarzio Karissa , Rojo-Wissar Darlynn M , Hernandez Valencia Evelyn , Ver Pault Mikayla , Denherder Shane , Lopez Adamari , Lerch Jena , Metrailer Georgette , Merrill Sarah , Highlander April , Parent Justin
Published: January 2025

Study Objectives

We investigated how a dimension of early life adversity (ELA), capturing threat in the home, relates to later epigenetic age acceleration in adolescence through sleep (duration, efficiency, and timing) to empirically test theoretical models suggesting the importance of sleep as a key mechanism linking ELA with poor health outcomes and to expand the limited literature on sleep and epigenetic aging among youth.

Methods

We utilized data from 861 participants in the Future of Families and Child Wellbeing Study who participated in the actigraphy substudy at age 15. Sleep variables used were average total sleep time (TST), sleep efficiency (SE), and sleep onset timing. Home threat was determined at ages 3, 5, and 9 from parent reports on the Child Conflict Tactics Scale, and epigenetic aging was measured through DNA methylation analyses of saliva samples collected at age 15.

Results

Higher levels of childhood home threat exposure were associated with less adolescent TST, lower SE, and later sleep onset timing. Adolescent SE and timing were associated with a faster pace of aging and epigenetic age acceleration. SE and timing mediated the link between childhood home threat exposure and adolescent epigenetic aging.

Conclusions

Epigenetic embedding of childhood threat exposure in the home may occur through adversity-related sleep disturbances in adolescence. Findings warrant greater attention to pediatric sleep health in theoretical models of biological embedding of adversity and point to sleep health improvement as a potential way to prevent adversity-related epigenetic age acceleration. This paper is part of the Genetic and other Molecular Underpinnings of Sleep, Sleep Disorders, and Circadian Rhythms Including Translational Approaches collection.
“He’s a Full-Blown Narcissist:” Tracing an Emerging Cultural Narrative in Action
Authors: Sweet Paige L , Cooper Chiara E
Published: January 2025

The terms “narcissism” and “narcissistic personality disorder” have skyrocketed in popularity over the past several years. What does narcissism discourse accomplish for people who use it? In this paper, we trace the rise of “narcissism” through interviews with victim/survivors of psychological abuse. We find that using the language of narcissism allows people to: 1) reclaim their rationality, or make the case that they are not “the crazy one”; 2) cast the person who harmed them as ontologically “bad”; and 3) justify their decision to leave the relationship. Narcissism discourse therefore helps people organize action. We argue that even as “narcissism” promotes essentializing explanations about abusers and shifts responsibility for intimate abuse onto the victim – who must research narcissism and learn how to avoid narcissists – it also offers a way to make meaning about interpersonal imbalances of power, giving people resources to analyze the politics of intimacy in their lives.
Challenges in managing hump-nosed pit viper envenomation in southern India: a case study
Authors: Philip Anil M , John Jim O , George Lina J , Rajan Sethu
Published: January 2025

Snakebites are a significant health risk in India, with the ‘Big Four’ venomous species often overshadowing other deadly snakes like the hump-nosed pit viper (Hypnale hypnale). Despite its increasing recognition for causing severe envenomation, this species remains under-reported and inadequately addressed in treatment protocols. A woman aged in her sixties was bitten by a suspected hump-nosed pit viper while working in the fields. Despite receiving 26 vials of polyvalent antisnake venom, she developed persistent coagulopathy and anaphylaxis, requiring fresh frozen plasma and antibiotics. Coagulopathy and bleeding were controlled by day 5.This case highlights the need for species-specific antivenoms and improved management protocols for envenomation by Hypnale hypnale.
Redox Status-Selective Imaging of Iron in Vegetative and Pathogenic Fungal Cells Using Fluorescent Dyes Synthesized Via Simple Chemical Reactions
Authors: Aliyeva-Schnorr Lala , Heise Niels V. , Csuk René , Deising Holger B.
Published: January 2025

Iron plays a prominent role in various biological processes and is an essential element in almost all organisms, including plant-pathogenic fungi. As a transition element, iron occurs in two redox states, Fe2+ and Fe3+, the transition between which generates distinct reactive oxygen species (ROS) such as H2O2, OH− anions, and toxic OH· radicals. Thus, the redox status of Fe determines ROS formation in pathogen attack and plant defense and governs the outcome of pathogenic interactions. Therefore, spatially resolved visualization of Fe2+ and Fe3+ are essential to understand microbial pathogenesis. Here, we report a simple method for synthesis of the redox-state-selective dyes pyrene-tetramethyl piperidinyl oxyl (p-TEMPO) and 4-(4-methylpiperazine-1)-7-nitrobenz-2-oxa-1,3-diazole (MPNBD) for fluorescence microscopy-based imaging of Fe2+ and Fe3+ ions. Using these dyes, the occurrence and spatial distribution of Fe2+ and Fe3+ ions in vegetative and pathogenic hyphae of the hemibiotrophic maize anthracnose fungus Colletotrichum graminicola are shown.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Crop rotation effects on the population density of soybean soilborne pathogens under no-till cropping system
Authors: Yin Chuntao , Lahr Nathan , Sutradhar Apurba , Osborne Shannon , Lehman R. Michael , Schneider Sharon
Published: January 2025

Soilborne diseases are persistent problems in soybean production. Long-term crop rotation can contribute to soilborne disease management. However, the response of soilborne pathogens to crop rotation is inconsistent, and rotation efficacy is highly variable. Selection of proper crop plants and crop sequences for disease management is needed. In this research, the effects of crop rotation on soybean soilborne pathogens were evaluated in a long-term no-till crop rotation field trial in South Dakota. Five rotation treatments were evaluated in this field trial, including corn-soybean (CS; Zea mays L., Glycine max (L.) Merr.), corn-soybean-spring wheat-pea (CSSwP; wheat: Triticum aestivum L., pea: Pisum sativum subsp. arvense (L.) Asch.), corn-soybean-spring wheat-sunflower (CSSwSf; sunflower: Helianthus annus L.), corn-oat-winter wheat-soybean (COWwS; oat: Avena sativa L.), and corn-pea-winter wheat-soybean (CPWwS). Six soilborne pathogens that consistently threaten the United States soybean production were quantified in the field soils using quantitative PCR or egg extraction for soybean cyst nematode. Three soilborne pathogens, Macrophomina phaseolina, Fusarium oxysporum, and Pythium irregulare, were detected, whereas the population density of F. graminearum and F. virguliforme was not measurable in the soil samples. The number of soybean cyst nematode eggs or juveniles was zero or very low in all soil samples. Overall, crop rotation treatments affected the population density of three detected pathogens but varied by crop phase, year, and pathogen species. The population density of three detected pathogens was positively correlated with soil temperature but negatively correlated with soil volumetric water content. Notably, the CPWwS rotation treatment had a consistently lower M. phaseolina population compared with the other rotation treatments, regardless of crop phase and year. This study provided potential crop sequences that limit soilborne pathogen populations in the soil and may reduce disease incidence on the host crops.
Leveraging Artificial Intelligence to Develop a Decision-Support Tool for Visual Symptom Assessment of Grapevine Leafroll and Red Blotch Diseases
Authors: MacDonald Sarah Lewis , Shapland Tom , Fendell-Hummel Hannah G. , Hobbs Malcolm B. , Rohrs Jennifer K. , Cooper Monica L.
Published: January 2025

The timely detection of viral pathogens in vineyards is a critical aspect of management. Diagnostic methods can be labor-intensive and may require specialized training or facilities. The emergence of artificial intelligence (AI) has the potential to provide innovative solutions for disease detection but requires a significant volume of high-quality data as input. With that purpose, we partnered with wine grape growers to collect a robust dataset of verified images. We used those images to train an AI model and develop a handheld application as a decision-support tool for grapevine leafroll and red blotch diseases. The tool allows users to scan a grapevine canopy with a mobile device and view a confidence reading describing the likelihood that the imaged vine has visual symptoms consistent with leafroll, red blotch, or a healthy vine. The 86% accuracy under field conditions and generally positive user experience suggest there is potential for the trained use of AI as an investigative tool to quickly assess visual symptoms associated with these grapevine diseases.
Aggressiveness and phylogenetic relationship of Fusarium oxysporum associated with crown and root rot in pyrethrum plants
Authors: Liu Yuzhu , Vaghefi Niloofar , Idnurm Alexander , Ades Peter Kevin , Taylor Paul William James
Published: January 2025

In Australia, pyrethrum (Tanacetum cinerariifolium) cultivation provides a significant portion of the global supply of natural insecticidal pyrethrins. However, crown and root rots, along with stunted plant growth and plant loss during winter, are significant issues affecting certain sites. Several isolates of the Fusarium oxysporum species complex (FOSC) have been identified as causal agents of crown and root rot in pyrethrum, highlighting these as key pathogens contributing to this decline. However, the genetic and pathogenic diversity of the FOSC impacting pyrethrum is unclear. This study isolated F. oxysporum consistently from symptomatic and asymptomatic field-grown pyrethrum plant tissues, identified through morphological and multigene phylogenetic analyses. Phylogenetic analyses of partial gene sequences of calmodulin (cmdA), RNA polymerase II second largest subunit (rpb2), translation elongation factor 1-alpha (tef1-α) and β-tubulin (tub2) resolved the placement of these isolates within the context of different published FOSC taxonomies and revealed notable genetic diversity among the isolates. Glasshouse experiments effectively reproduced the crown and root rot symptoms observed in field conditions, demonstrating a similar level of aggressiveness among F. oxysporum isolates from pyrethrum plants. The results indicate the importance of soil-borne disease management to reduce yield decline in pyrethrum fields and will help with the selection of aggressive isolates for resistance screening of pyrethrum varieties.
Risk Prediction Model of Peristomal Skin Complications Among Patients with Colorectal Cancer and an Ostomy: A Cross-sectional Study in Shanghai, China
Authors: Ma Li-li , Zhang Ya-juan , Zhuang Hui-ren , Jiang Hui
Published: January 2025

OBJECTIVE

To analyze the risk factors for peristomal skin complications (PSCs) in patients with colorectal cancer and an ostomy, construct a prediction model, and verify its effectiveness.

METHODS

In this cross-sectional study, researchers recruited 265 patients with an ostomy at the stoma clinic of a tertiary hospital, from May 2022 to August 2023. Patients were divided into two groups: complications group (n = 81) and no complications group (n = 184). Researchers constructed a logistic regression prediction model using univariate and multivariate analyses. From May 2023 to August 2023, a validation group of 135 patients with an ostomy was selected for external validation of the model.

RESULTS

The incidence of PSCs was 30.57% in the modeling group and 30.37% in the validation group. The predictor variables were preoperative and postoperative health education, tumor therapy within 3 months, preoperative stoma positioning, stoma height, stoma type, and excrement state. The Hosmer-Lemeshow test yielded a P value of .513, the area under the ROC curve was 0.872, the Youden index was 0.561, and the sensitivity and specificity were 0.827 and 0.734. For external validation, the Hosmer-Lemeshow test yielded a P value of .835, the area under the ROC curve was 0.887, and the sensitivity and specificity were 0.905 and 0.720, respectively.

CONCLUSIONS

The prediction model demonstrates good predictive efficacy and can serve as a reference for clinical caregivers in identifying patients at high risk of PSCs.
Evaluation of Oncology/Hematology Nurses’ Proficiency in Assessing Lower-Extremity Skin and Edema in Patients with Cancer: An Observational Study
Authors: Genç Zeliha , Kebapci Ayda , Yildirim Dilek , Can Gulbeyaz , Zeytun Orhan , Kök Elif
Published: January 2025

OBJECTIVE

To assess the competency of oncology/hematology nurses in evaluating the lower extremities of patients with cancer for skin conditions and edema.

METHODS

This prospective and descriptive observational study was conducted with patients in a university hospital’s 48-bed oncology/hematology service. Patients with cancer admitted to the oncology/hematology service were examined independently by three evaluators (two nurse researchers and the patient’s primary nurse) daily. Interrater reliability for assessing patients’ right and left legs was determined using Fleiss κ statistics for categorical variables.

RESULTS

The study revealed a high degree of agreement among the three evaluators in the assessment of skin surface, skin color, and presence of petechiae and rashes on the right and left leg, as well as itching on the left leg. However, only moderate agreement was found for temperature assessment, ecchymoses edema on the left and right leg, and itching on the right leg. The reliability of the two researcher nurses’ assessment of edema on the right and left legs was excellent.

CONCLUSIONS

Although the agreement between the two researcher nurses was near excellent, only moderate agreement was observed among all evaluators in the edema assessment. The result underscores the importance of healthcare providers’ knowledge and enhancing clinical skills through innovative training strategies.
Markers for Pressure Injury Risk in Individuals with Chronic Spinal Cord Injury: A Pilot Study
Authors: Tzen Yi-Ting , Champagne Patricia T. , Wang Jijia , Klakeel Merrine , Tan Wei-Han , Bogie Kath M. , Koh Timothy J.
Published: January 2025

OBJECTIVE

To identify markers associated with pressure injury (PrI) history in individuals with spinal cord injury (SCI) using two approaches: skin blood flow (SBF) response toward localized heating, and serum marker for insulin resistance.

METHODS

For this cross-sectional, observational study of adults with chronic traumatic SCI at T12 and above, researchers recruited two groups of participants: with history of PrI (group 1), and without history of PrI (group 2). The study protocol included obtaining fasting blood samples and measurement of SBF at bilateral heels with localized heating of 42 °C for 30 minutes from all participants. Primary SBF outcomes were initial peak and plateau SBF normalized to baseline SBF. The primary outcome for insulin resistance was Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), calculated from fasting plasma glucose and insulin. Secondary outcomes included demographic and SCI information. Researchers used the Fisher exact test and Wilcoxon-Mann-Whitney test to compare the intergroup difference of categorical and continuous variables, respectively.

RESULTS

Sixteen adults completed this study (group 1, n = 7; group 2, n = 9). In comparison with group 2, group 1 had significantly higher HOMA-IR (3.90 ± 0.71 vs 1.45 ± 0.71), suggesting higher insulin resistance, and longer duration of injury (22.54 ± 7.24 vs 7.98 ± 6.58 years). There were no between-group differences in SBF or other secondary outcomes.

CONCLUSIONS

HOMA-IR is a novel serum index associated with PrI history in persons with chronic SCI. Future longitudinal study is warranted to examine the role of insulin resistance in increasing PrI risk for the SCI population.
Beyond the Case Study: Laboratory Activities to Complement Integumentary Education
Authors: Wendland Deborah M. , Panasci Kathryn , Martinez Hope A. , Mantanona John S. , Powers Melinda G. , Sausman Rachael L. , Gibbs Karen A.
Published: January 2025

OBJECTIVE

To present a full scope of detailed and engaging laboratory activities recommended by physical therapist clinicians and educators from across the US to assist health professions faculty to develop new or improve current integumentary/wound management (IWM) instruction.

METHODS

A three-round Delphi survey was conducted to update IWM curriculum recommendations for entry-level doctor of physical therapy education. First-round participants provided ideas for laboratory activities. Activity responses were discussed, edited for redundancy, and clarified. Missing information (eg, estimated cost and time required) was added to increase usability.

RESULTS

A total of 139 laboratory activities were recommended by survey participants. Many of the suggestions included inexpensive and readily available, do-it-yourself wound models requiring food or other moulage techniques. These simulations are elucidated to facilitate translation of ideas into classroom and community laboratory activities to promote student learning.

CONCLUSIONS

The literature supports that most entry-level healthcare profession programs report limited IWM education, emphasizing the need for effective and efficient use of IWM contact hours. Developing engaging and meaningful hands-on laboratory activities is vital to increasing student knowledge and skill in this area of clinical practice.
Long-term immune related adverse events
Authors: Plaçais Leo , Lambotte Olivier
Published: January 2025

Purpose of review

Long-term immune related adverse events (irAEs) are an increasing reality in cancer patients treated with immune checkpoint inhibitors (ICIs) but remain under-reported. With the number of ICI treated patients increasing, we here aimed to expose the current evidence on their clinical presentations and diagnosis criteria.

Recent findings

First described in ICI validation trials, long term irAEs were further characterized through retrospective studies, providing clues on their frequency, clinical spectrum, risk factors and impact on patient's quality of life. Recent recommendations proposed consensual definitions to delineate their different subtypes, from delayed/late-onset irAE to chronic active and inactive irAE, paving the way to future prospective studies.

Knowledge of the different long-term irAE subtypes risk and clinical presentation is required to increase their detection and diagnosis, to better weight therapeutic decisions and to improve cancer patient's care.
Chemotherapy-induced nausea and vomiting: can we do better?
Authors: Scotté Florian
Published: January 2025

Purpose of review

Although the management of nausea and vomiting induced by cancer treatments has evolved, several questions remain unanswered.

Recent findings

New antiemetics have been developed these last decades with therapeutic indications to be defined according to the anticancer regimen and partly as a consequence of the assessment of individual patient risk factors. Guidelines still seem to have a low level of knowledge and compliance, with a role for scientific societies in term of dissemination and education. A number of persistent issues relating to emesis still need improvement in prevention and management. Nausea remains a subjective semantic whose evaluation should possibly benefit from educational programs. The risk classification of anticancer drugs must be regularly updated, requiring regular literature reviews and the integration of data from clinical trials relating to emerging anticancer drugs. Recent data, particularly in the context of emerging drugs, highlight the importance to consider emesis’ impact beyond the 5-day period, with a potential adaptation of antiemetic prophylaxis, including the mode of administration of oral drugs.

Guidelines update is presented with literature answers to the current issues in order to improve quality of patient's management in the context of emesis related to anticancer therapies.
From basic to clinical and therapeutic insights: news on actinic keratosis and skin squamous cell carcinoma
Authors: Orte Cano Carmen , Suppa Mariano , Pastushenko Ievgenia , del Marmol Véronique
Published: January 2025

Purpose of review

Squamous cell carcinoma (SCC) is the second most common skin cancer, with an increasing incidence. This review highlights this past year's advances regarding the understanding of its pathogenesis, newly introduced diagnostic methods and updates in prevention and treatment.

Recent findings

While the pathogenesis of SCC progression remains unclear, new sequencing techniques are helping to better characterize these tumours at the molecular level. Recently introduced noninvasive imaging techniques are rapidly transforming SCC diagnosis and follow-up. Although nicotinamide has not demonstrated significant benefit in reducing SCC incidence among transplant recipients, larger studies are needed to achieve statistical power. Tirbanibulin, a new field treatment for actinic keratosis is now available and well tolerated for use in areas up to 100 cm2. Surgery remains the cornerstone of SCC treatment and can now be complemented with cemiplimab, when advanced.

Recent years have seen a diagnostic revolution in dermatology, driven by noninvasive imaging and artificial intelligence; however, the physiopathogenesis of SCC progression remains poorly understood. In treatment, immune checkpoint inhibitors have shown good survival outcomes for advanced SCC. Research continues in the neoadjuvant setting and among transplanted patients, with encouraging preliminary results.
Emerging toxicities in oncology
Authors: Mayeur Didier
Published: January 2025

Purpose of review

New anticancer drugs often are associated with improved results, such as objective response and disease-free survival. But with these new drugs, patients, caregivers and medical oncologist have to face new toxicities, quite different from the side effects of conventional chemotherapy. The aim of this review is to share the actual knowledge about these new toxicities.

Recent findings

We review here some of these new toxicities, as ocular, cardio, lung and mucocutaneous toxicities, as well as specific side effects of CAR-T cells. We also discuss a specific problem, which is financial toxicity.

With this review, caregivers and medical oncologists will be aware of these new toxicities and able to develop their own network of specialized practitioners to provide the best possible supportive care.
Understanding the Impacts of Surgical Drains on Postoperative Pain and Quality of Life
Authors: Gadiraju Goutam K. , Prospero Matthew R. , Tobias Finn , Malek Andrew J. , Reiche Erik , Broyles Justin M.
Published: January 2025

Background:

Surgical drains are commonly used in breast surgery and breast reconstruction for seroma prevention. Although many surgeons are aware that surgical drains can cause considerable discomfort to patients, less is understood about the specific impacts of drains on postoperative pain and quality of life (QOL).

Methods:

A cross-sectional survey was conducted among patients at our institution who had previously undergone mastectomy or breast reconstruction procedures to better understand patients’ experiences with surgical drains. Patients were asked to report their attitudes toward a series of QOL statements and rate postoperative pain using numeric pain scales. Pair-wise analysis was used to identify predictors of responses.

Results:

A total of 203 complete responses were recorded. Increased pain scale ratings for pain at the body wall, incision site, and drain entry site were significantly associated with drain duration at 2–3 weeks or longer (P < 0.05). Notably, 84.7% of patients reported that drains increased the difficulty of completing daily tasks. Most patients (66.0%) reported negative impacts on mood, and 37.0% reported apprehension toward undergoing future procedures that may require drains. Most patients (65.0%) also expressed that they would prefer to receive care from institutions that utilize improved alternatives to standard drains.

Conclusions:

Surgical drains cause substantial discomfort to most patients and exert several negative impacts on QOL. In addition to limiting drain use wherever possible, innovations in technique and the development of alternatives to existing drains may offer patients a less painful, improved postoperative recovery experience.
Need of the hour: A service failure recovery reorientation for U.S. hospitals
Authors: Chakraborty Subhajit , Pagán José A.
Published: January 2025

Issue

Many hospitals in the United States are facing significant postpandemic operational challenges largely as a result of increasing demand for health care services. Operational issues increase the risk of service failures. Improving the patient experience after service failures may lead to better outcomes for both patients and hospitals.

Critical Theoretical Analysis

Drawing support from service failure recovery and quality management paradigms, we suggest that hospitals could periodically obtain deidentified patient feedback data drawn from multiple sources—including social media—to build a comprehensive patient experience dashboard that can be used to improve health care quality.

Insight/Advance

We offer an overarching conceptual framework to support organizational learning and make hospitals more adaptive to patient feedback. Staff members and leaders could examine patient feedback data to identify service failures and take appropriate action to prevent their recurrence in hospitals. A patient experience dashboard can be developed to document and visualize remedial actions taken by hospitals against each past service failure and shared with all stakeholders.

Practice Implications

Reorienting health care as a service where hospitals immediately listen to patients and promptly address their questions and concerns may help to strengthen the continuity of health care services offered by hospitals as well as improve their financial position, quality of care, and the overall patient experience.
OPTIC PIT-LIKE MACULOPATHY WITH CLINICALLY OCCULT OPTIC DISC PIT Diagnostic imaging, clinical features, and management
Authors: Shukla Dhananjay , Kalliath Jay , Dhawan Anuradha ,   on behalf of the VRSI study group
Published: January 2025

Purpose:

To describe the diagnostic imaging, clinical features and management of pit-like maculopathy and clinically occult optic pit (OOPM).

Methods:

We retrospectively analyzed the demographics, imaging features and intervention details of the subjects with OOPM enrolled from 19 sites. The main outcome measure was detection of occult pit in OOPM.

Results:

Forty-seven eyes (46 subjects) with pit-like maculopathy without visible optic pit were studied. Maculopathy consisted of multilayered retinoschisis and/or serous detachment (44 eyes); 3 eyes showed non-glaucomatous nerve fiber layer defects. Optical coherence tomography (OCT) revealed a crater-like disc cavitation in 40 (85%) eyes. Infrared imaging and fluorescein angiography, when performed, revealed the occult pit in 5/18 (29%) and 3/13 (23%) eyes respectively. Clinical clues to an occult pit included anomalous or enlarged ONH and cilioretinal artery (36%, 33% and 32% eyes respectively). Twelve (26%) eyes had coexistent glaucoma. Follow-up was available for 35 (75%) eyes: 22 were observed; 11 underwent vitrectomy; 2 had gas injection. Intervention reduced macular fluid in 85% eyes and improved best-corrected visual acuity (p=0.012).

Conclusions:

OCT revealed a cavitation attributable to optic pit in most eyes with pit-like maculopathy, helped by clinical clues like anomalous/enlarged disc, and cilioretinal artery. Surgical intervention was infrequent but successful.
Role of Crosstalk Between Gut Microbiota and Immune Cells in Colorectal Cancer: A Narrative Review
Authors: Ye Mengke , Yuan Guangxun , Jin Yue , Zeng Xun
Published: January 2025

Colorectal cancer (CRC) ranks among the most prevalent and deadly cancers globally, with its incidence increasing due to lifestyle factors such as increased consumption of red meat and decreased vegetable intake. A distinctive aspect of CRC is its strong connection to the gut microbiota, which is crucial in both tumorigenesis and immune regulation. This narrative review provides a comprehensive analysis of the interactions between gut microbiota and the immune system, focusing on their importance in CRC progression and responses to immunotherapy. Imbalances in the composition of gut microbes are strongly associated with CRC development. Notably, species such as Fusobacterium nucleatum and Bacteroides fragilis have been identified as key regulators of immune responses within the tumor microenvironment. These microbes affect the functions of immune cells, such as T cells, macrophages and myeloid-derived suppressor cells, thereby influencing cancer progression and prognosis. Additionally, this review underscores the potential of gut microbiota as biomarkers for CRC detection and outcome prediction. There is also growing interest in the use of probiotics, fecal microbiota transplantation and dietary modifications as supplementary treatments. A deeper understanding of how microbial communities interact with the immune system may pave the way for novel personalized therapies, particularly by enhancing the effectiveness of immune checkpoint inhibitors.
Hematogenous Dissemination of Scedosporiosis in an Immunocompetent Patient
Authors: Berger Steven , Se Bobby , Delman Mark
Published: January 2025

Scedosporiosis is becoming an increasingly recognized cause of treatment-resistant opportunistic infections in immunocompromised patients. Fungal infections with Scedosporium spp. have also been seen in immunocompetent patients with previously damaged bronchopulmonary trees. Presentation may be associated with mycetoma, sinopulmonary involvement, extrapulmonary localized infections, and, in rare cases, disseminated infections. We present a case of an immunocompetent 57-year-old woman with prior pulmonary tuberculosis who was found to have Scedosporium boydii/apiospermum pneumonia and Scedosporium osteomyelitis. Multiple bone cultures were negative prior to diagnostic confirmation by 28S ribonucleic acid polymerase chain reaction sequencing. This case illustrates the rare occurrence of hematogenous spread in an immunocompetent patient and the diagnostic and therapeutic challenges associated with Scedosporium spp. infections.
Comparison of short-and long-term outcomes between endovascular and open repair for descending thoracic aortic aneurysm: a systematic review and meta-analysis
Authors: Liu Junning , Gou Dan , Xu Kanglin , Lu Ziao , Li Peidong , Lei Yong , Wang Yongjie , Yang Yuting , Liu Shiqiang , Zhu Guiying
Published: January 2025

Objective:

This systematic review and meta-analysis aimed to evaluate and compare the efficacy of endovascular versus open repair for the treatment of patients with descending thoracic aortic aneurysm (DTAA).

Methods:

A systematic search of the PubMed, Embase, and Cochrane Library databases for relevant studies was performed. Outcome data, including postoperative mortality and morbidity, operative details, all-cause survival, freedom from aortic-related survival and freedom from aortic-related re-intervention, were independently extracted by two authors in a standardized way.

Results:

Twenty-nine studies comprising 49 972 patients (22 049 endovascular repair; 27 923 open repair) were included. Endovascular repair was associated with a significantly lower postoperative mortality rate [odd ratio (OR): 0.57, 95% confidence interval (CI): 0.45-0.72; I2 = 72.58%] and morbidity. In terms of long-term survival, endovascular repair yielded better freedom from aortic-related survival [hazard ratio (HR): 0.71, 95% CI: 0.54-0.93, P = 0.012] but inferior freedom from aortic-related reintervention (HR: 2.10, 95% CI: 1.45-3.04, P < 0.001). Landmark analysis revealed that the open repair group experienced better all-cause survival beyond 16 months (HR: 1.64, 95% CI: 1.53-1.75, P < 0.001). In addition, in the subgroup of patients with intact DTAA, those who underwent open repair exhibited a higher rate of postoperative mortality (OR: 0.58, 95% CI: 0.38-0.88; I2 = 83.34%) but had better all-cause survival beyond 7 months (HR: 1.72, 95% CI: 1.61-1.84, P < 0.001) than those who underwent endovascular repair.

Conclusion:

Among patients treated for DTAA, endovascular repair was associated with better freedom from aortic-related survival, a lower risk for postoperative mortality and morbidity, and shorter lengths of intervention, intensive care unit stay, and hospital stay than those who underwent open repair. Open repair yielded significantly better long-term all-cause survival and freedom from aortic-related re-intervention than endovascular repair.
Multimodal large language models address clinical queries in laryngeal cancer surgery: a comparative evaluation of image interpretation across different models
Authors: Liang Bingyu , Gao Yifan , Wang Taibao , Zhang Lei , Wang Qin
Published: January 2025

Background and objectives:

Recent advances in multimodal large language models (MLLMs) have shown promise in medical image interpretation, yet their utility in surgical contexts remains unexplored. This study evaluates six MLLMs’ performance in interpreting diverse imaging modalities for laryngeal cancer surgery.

Methods:

We analyzed 169 images (X-rays, CT scans, laryngoscopy, and pathology findings) from 50 patients using six state-of-the-art MLLMs. Model performance was assessed across 1084 clinically relevant questions by two independent physicians.

Results:

Claude 3.5 Sonnet achieves the highest accuracy (79.43%, 95% CI: 77.02%-81.84%). Performance varied significantly across imaging modalities and between commercial and open-source models, with a 19-percentage point gap between the best commercial and open-source solutions.

Conclusion:

Advanced MLLMs show promising potential as clinical decision support tools in laryngeal cancer surgery, while performance variations suggest the need for specialized model development and clinical workflow integration. Future research should focus on developing specialized MLLMs trained on large-scale multi-center laryngeal cancer datasets.
Multimodal assessment predicts cognitive impairment after aneurysmal subarachnoid hemorrhage: a prospective cohort study
Authors: Liu Peng , Li Ruili , Zhang Tongyu , Xu Yueqiao , Yang Kun , Li Yuxia , Han Chuanliang , Yang Yang , Wang Changming , Lu Jie , Zhang Hongqi
Published: January 2025

Background:

Risk factors and mechanisms of cognitive impairment (CI) after aneurysmal subarachnoid hemorrhage (aSAH) are unclear. This study used a neuropsychological battery, MRI, ERP and CSF and plasma biomarkers to predict long-term cognitive impairment after aSAH.

Materials and methods:

214 patients hospitalized with aSAH (n = 125) or unruptured intracranial aneurysms (UIA) (n = 89) were included in this prospective cohort study. Neuropsychological tests were administered 7 to 24 months post-discharge. MRI, ERP, and CSF and plasma biomarkers were used to predict long-term CI, and area under ROC curves were calculated.

Results:

Patients with aSAH CI showed significant impairment across composite scores and cognitive domains on the neuropsychological battery vs. patients with aSAH No CI. On ALFF (MRI), the right medial orbitofrontal cortex (AUC = 0.78), right inferior frontal gyrus (AUC = 0.848), and right inferior parietal lobule (AUC = 0.868) distinguished aSAH CI from aSAH No CI. For ERP, consistent changes were found across specific EEG electrodes (FP1, F3, CP1, FP2, F4, CP2), including increased PA, prolonged PL and decreased ITPC. ITPC showed the highest sensitivity for distinguishing aSAH CI from aSAH No CI, followed by PA. Channel F4 (ITPC, AUC = 0.912, PA, AUC = 0.846), corresponding to the right inferior frontal gyrus, was the most sensitive for detecting CI, followed by channel CP2 (ITPC, AUC = 0.903, PA, AUC = 0.806), corresponding to the right inferior parietal lobule. CSF (Aβ42, Aβ40, p-tau181/Aβ42, p-tau181/total-tau, total-tau) and plasma biomarkers (Aβ-40, p-tau181) were significantly associated with long-term CI.

Conclusion:

ALFF, ERP, and CSF and plasma Aβ and tau levels and ratios have clinical utility for evaluating and predicting long-term cognitive impairment following aSAH. MRI may reveal the pathogenesis of cognitive impairment following aSAH. ERP can be administered at the bedside offering sensitive, non-invasive, repeatable, and sustainable monitoring, which is particularly suitable for immobile coma patients. ERP may represent a promising method to monitor neural function and its outcomes.
Safety and efficacy of minimally invasive associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): a systematic review and meta-analysis
Authors: Loke Sean , Ong Benedict Ding Chao , Ng Joanna , Kow Alfred Wei Chieh
Published: January 2025

Background:

Liver malignancies present substantial challenges to surgeons due to the extensive hepatic resections required, frequently resulting in posthepatectomy liver failure. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was designed to increase the resectable liver volume, yet it is associated with significant mortality and morbidity rates. Recently, minimally invasive techniques have been incorporated into ALPPS, with the potential to improve the procedure’s safety profile whilst maintaining efficacy.

Materials and methods:

This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase and Cochrane for all interventional studies that evaluated the operative outcomes of minimally invasive ALPPS compared to open ALPPS. Two independent reviewers appraised and extracted the summary data from published studies. Random effects meta-analyses were used for primary analysis.

Results:

Nine studies with 637 patients undergoing ALPPS were included. Meta-analyses indicated a statistically significant decreased risk of 90-day mortality (RR = 0.48, 95%CI: 0.29;0.80) and decreased overall length of hospital stay (MD = −8, 95%CI: −11.25;−4.74) in patients undergoing minimally invasive ALPPS compared to patients undergoing open ALPPS. No significant differences in terms of the rate of future liver remnant growth (MD = 11.37, 95%CI: −4.02;26.77) and risk of posthepatectomy liver failure (RR = 0.52, 95%CI: 0.09;2.97) were identified. Subgroup analyses identified a trend in lowering the risk of posthepatectomy liver failure in patients undergoing laparoscopic ALPPS compared to robotic ALPPS. In terms of oncologic surgical outcomes, 92% of patients undergoing minimally invasive ALPPS achieved negative margin resections, while 86% of patients undergoing open ALPPS achieved negative margin resections.

Conclusion:

This systematic review and meta-analysis provide evidence that minimally invasive ALPPS offers a safer alternative with reduced mortality and shorter hospital stays, while maintaining comparable efficacy in liver remnant growth and R0 resections. These findings highlight the potential of minimally invasive techniques to combat the criticism that ALPPS has been placed under.
Prevention strategies of esophageal stenosis after endoscopic resection for superficial esophageal cancer: a Bayesian network meta-analysis
Authors: Dong Yongqi , Xu Hongyan , Yu Wanli , Liu Zijing , Zhao Gang , Zhang Zhihuan , Xia Yuan , Xiao Shiyong , Yi Qianzhang , Lin Zebin
Published: January 2025

Introduction:

What interventions effectively prevent postoperative stenosis following endoscopic resection (ER) of superficial esophageal cancer? This study aimed to identify effective interventions or combinations through a systematic review and network meta-analysis.

Methods:

Six databases were systematically searched for eligible studies up to 30 April 2023, on interventions to prevent esophageal stenosis post-ER. Odds ratios (ORs) evaluated stenosis rate (primary outcome) and complications (secondary outcome), while mean differences (MD) evaluated endoscopic balloon dilatation (EBD) sessions post-stenosis.

Results:

Twenty-three studies involving 1271 patients and 11 different interventions were included. Eight interventions were effective in preventing post-ER stenosis: oral hydrocortisone sodium succinate and aluminum phosphate gel (OHA) (OR: 0.02, 95% credible interval [CrI]: 0.00–0.11), polyglycolic acid (PGA) + ST (OR: 0.02, 95% CrI: 0.00–0.23), oral tranilast (OT) + preemptive endoscopic balloon dilatation (PEBD) (OR: 0.08, 95% CrI: 0.01–0.77), botulinum toxin (BT) (OR: 0.10, 95% CrI: 0.03–0.32), ST (OR: 0.08, 95% CrI: 0.01–0.67), oral steroid (OS) (OR: 0.11, 95% CrI: 0.05–0.28), endoscopic triamcinolone injection (ETI) + OS (OR: 0.17, 95% CrI: 0.07–0.42), and ETI (OR: 0.18, 95% CrI: 0.11–0.30). Five interventions significantly reduced EBD sessions: PGA + ST (MD: −5.78, 95% CrI: −11.04 to −1.21), ETI + OS (MD: −3.27, 95% CrI: −5.37 to −0.72), OS (MD: −6.18, 95% CrI: −9.43 to −3.38), ETI (MD: −3.81, 95% CrI: −5.74 to −1.99), and BT (MD: −2.16, 95% CrI: −4.12 to −0.40). None of the interventions significantly increased complications.

Conclusions:

This study confirmed the efficacy of OS, ETI, and ETI + OS and verified five other interventions (OHA, PGA + ST, OT + PEBD, BT, and ST) in preventing stenosis. Notably, PGA + ST and BT also reduced the number of EBD sessions.
Gut microbiota and its impact on critical illness
Authors: Battaglini Denise , Torres Antoni
Published: January 2025

Purpose of review

This narrative review discusses the mechanisms connecting gut dysbiosis to adverse clinical outcomes in critically ill patients and explores potential therapeutic strategies.

Recent findings

In recent years, the study of microbiota in ICUs has gained attention because of its potential effects on patient outcomes. Critically ill patients often face severe conditions, which can compromise their immune systems and lead to opportunistic infections from bacteria typically harmless to healthy individuals. The relationship between aggressive medical treatments and microbiota composition remains unclear. Dysbiosis, characterized by reduced microbial diversity and the loss of beneficial bacteria, can lead to prolonged immunosuppression and increased pathogenic risks, contributing to infections and organ failure. Recent advancements in multiomics technologies have enhanced the understanding of host–microbe interactions and their implications in critical care.

The microbiota plays an important role in shaping outcomes for critically ill patients. According to evidence, alterations in the gut and lung microbiota are associated with disease severity, mortality, and overall patient recovery. Evolving research opens possibilities for personalized medicine by tailoring treatments based on individual microbiota profiles, though clinical applications are still developing.
Evaluating New Graduate Nurse Readiness for Practice
Authors: Catarelli Bryce , Thompson Lara , Zhang Xiaoxi , Weaver Michael
Published: January 2025

Background:

New graduate nurses (NGNs) often feel unprepared to enter the nursing workforce. Nurse educators can collaborate with clinical partners to identify gaps in practice readiness to meet the current needs of novice nurses and improve their preparation for practice.

Purpose:

To evaluate perceived practice readiness among NGNs on hire and to identify areas for potential improvement in the nursing curriculum.

Methods:

A retrospective cross-sectional study was conducted on NGN readiness using Casey-Fink Graduate Nurse Experience Surveys. Data from 273 NGNs hired between 2021 and 2023 within 1 large nonprofit academic hospital were analyzed.

Results:

Over 75% of NGNs reported feeling comfortable/confident with communication, delegation, and organizing/prioritizing patient care needs. The primary challenges highlighted included lack of confidence and providing end-of-life care. NGNs often feel uncomfortable independently managing codes, ventilators, and chest tubes.

Conclusion:

Nurse educators should prioritize clinical experiences to increase confidence and reinforce training for providing end-of-life care and complex hands-on skills.
A Vision for Advancing Nutrition Science in the United States
Authors: Woteki Catherine E. , Colón Frances
Published: January 2025

The President's Council of Advisors on Science and Technology published its findings and recommendations for improving the nation's health through nutrition science. The report recommends that the President give priority to equity in the design and conduct of nutrition research to provide a foundation for continued improvements to public health and to reduce inequities in the burden of diet-related diseases like heart disease, obesity, diabetes, and cancer. It also recommends strengthening the evidence base for future public and private sector actions. The President's Council of Advisors on Science and Technology emphasizes that the epidemic of diet-related diseases can be diminished but it will require combined efforts of public and private sectors, investment in implementation science to develop effective interventions for government programs, a diverse nutrition workforce, and a strong evidence base to inform changes to the food environment.
Superolateral Pedicle Breast Reduction for Patients with Medially Positioned Nipple-Areolar Complexes
Authors: Lava Christian X. , Li Karen R. , Episalla Nicole C. , Snee Isabel A. , Bell Alice C. , Fan Kenneth L. , Jabbour Samer F.
Published: January 2025

Background:

The superolateral pedicle (SLP) is commonly used in our practice in breast reductions (BR) where the nipple-areolar complex (NAC) is too medial, restricting pedicle movement and positioning. This study demonstrates the safety and efficacy of the SLP.

Methods:

A retrospective review of BR patients from September 2022 to January 2024 was conducted. Demographic data, comorbidities, operative details, and complications were collected.

Results:

A total of 164 breasts (84 patients) underwent BR: 135 (80.5%) used the SMP technique and 29 (17.7%) used the SLP technique. Median weight of breast tissue resected in SMP and SLP cohorts were 841.0 (range = 178-9,953) and 706.0 (range = 186-1,250) g, respectively (p=0.126). In the SLP group, 4 (13.8%) breasts experienced at least one complication, including seroma requiring aspiration (n=3, 10.3%) and abscess formation requiring antibiotics (n=2, 6.9%). In the SMP group, 18 (13.3%) breasts experienced at least one complication, including hematoma (n=7, 5.2%), abscess formation (n=4, 3.0%), seroma (n=3, 2.2%), dehiscence (n=2, 1.5%), partial nipple necrosis (n=1, 0.7%), and fat necrosis (n=1, 0.7%). There were 5 (3.0%) cases of reoperation, all in the SMP group. In a propensity score matching analysis, complication rates were comparable between SLP (n=30 breasts) and SMP (n=23 breasts) groups (average treatment effect on the treated (ATT)=0.067; p=0.713).

Conclusion:

The SLP technique for BR is safe and efficacious, showing complication rates comparable to the SMP technique, with no significant differences in resection weight. These findings support its viability as an alternative to traditional pedicle techniques in BRs.