bluuebunny/crossref_metadata_2025 huggingface dataset:
Reference intervals of biochemical analytes in healthy adults from northern China: A population-based cross-sectional study
Authors: Jia Siming , Wei Liu , Shi Xiaoying , Sun Dacheng , Shi Tailong , Lv Hongzhi , Chen Wei
Published: October 2023

Reference intervals (RIs) of laboratory testing play a fundamental role in medical activities. RIs vary greatly for populations in different areas This study aimed to evaluate the age- and sex-specific reference intervals for a healthy population in a typical city of northern China. A cross-sectional study was performed in 4 tertiary care centers of Shijiazhuang of China, biochemical analytes were analyzed using a Beckman Coulter AU5800 (Beckman Coulter Inc., Brea, CA). A total of 42,979 healthy individuals were involved in this study. Grouped by age- and sex-specific, reference intervals of all the measures have been established. We found that different age groups of males and females have significant differences (all P < .001) in levels of various biochemical analytes. We provided a comprehensive age- and sex-specific RIs for biochemical analytes, which showed dynamic changes with both age and sex. For the local population, the reference intervals established here can be adopted in other clinical laboratories after appropriate validation.
Prevalence of bacillary layer detachment in diabetic macular edema and response to 3 anti-vascular endothelial growth factor treatment
Authors: Chen Yann-Guang , Chang Yun-Hsiang , Shen Hsin-Ching , Pao Shu-I. , Hou Yu-Chih , Liang I-Chia
Published: October 2023

Spectral-domain optical coherence tomography is widely used in maculopathy, including diabetic macular edema (DME). Bacillary layer detachment (BALAD) is a novel optical coherence tomography finding, defined as the separation of the intraretinal layer between the inner segment myoids and ellipsoids. A total of 161 treatment-naïve eyes with centrally involved DME that underwent 3 monthly loading doses of anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections were enrolled and analyzed retrospectively. BALAD was found in 6.2% of eyes with concurrent subretinal fluid (SRF). All eyes were divided into 3 groups: no either group had neither SRF or BALAD; the SRF only group had SRF but no BALAD; and the BALAD group had both SRF and BALAD. A significant increase in baseline central foveal thickness (CFT) in the BALAD group was observed (no either vs SRF only vs BALAD, baseline CFT: 387.6 ± 74.29 vs 440.6 ± 106.79 vs 642.0 ± 188.86; P < .01). Total resolution of BALAD was noted after anti-VEGF therapy, along with a significant decrease in CFT in all groups (CFT decrease: 82.4 ± 87.07 vs 187.6 ± 138.88 vs 252.1 ± 127.63; P < .01). Eyes with BALAD tended to have the worst baseline visual acuity (baseline logarithm of the minimum angle of resolution VA: 0.76 ± 0.353 vs 0.63 ± 0.303 vs 1.15 ± 0.300; P = .046) but showed the most improvement after treatment (logarithm of the minimum angle of resolution VA change: −0.14 ± 0.235 vs −0.22 ± 0.275 vs −0.27 ± 0.250; P = .079). After resolution of BALAD, all eyes in the BALAD group exhibited ellipsoid zone and/or interdigitation zone disruption corresponding to the BALAD area. BALAD is a novel optical coherence tomography finding associated with a spectrum of diseases including DME. With anti-VEGF therapy, total resolution of BALAD and a significant decrease in CFT can be obtained. However, ellipsoid zone/interdigitation zone disruption tended to develop.
Mean power output for muscular endurance exercises and maximal oxygen uptake in military young adults
Authors: Lin Gen-Min , Tsai Kun-Zhe , Lee Duck-Chul , Sui Xuemei , Lavie Carl J.
Published: October 2023

The American Heart Association recommends a cardiopulmonary exercise test (CPET) and some alternative exercise tests to evaluate maximal oxygen uptake (VO2max) of youth. Power output has shown a high correlation with VO2max on a CPET. However, the correlations between mean power output (MPO) for muscular endurance exercises and VO2max measured from a CPET are not established in young adults. Forty-five volunteers, with an average age of 29.93 ± 7.05 years, from a sample of 1120 military personnel in Taiwan who attended a 2-minute pushup test and a 2-minute sit-up test were included in the current study. These volunteers subsequently underwent a CPET using the Bruce protocol to assess VO2max. According to the physics rule, MPO (watts) for the muscular endurance test was defined as a product of moving distance and force: [1/5 × body height (m) × numbers performed × body mass (kg) × gravity (9.8 m/s2)]. Pearson correlation analyses were performed. For the 2-min pushups, the correlations (r) between pushup numbers and VO2max with and without body mass adjustment were 0.541 (P< .01) and 0.188 (P= .21), respectively, while the correlation (r) between MPO and VO2max with and without body mass adjustment were 0.410 and 0.557 (bothP< .01), respectively. For the 2-minute sit-ups, the correlations (r) between sit-up numbers and VO2max with and without body mass adjustment were 0.529 (P< .01) and 0.291 (P= .052), respectively, while the correlations (r) between MPO and VO2max with and without body mass adjustment were 0.318 (P= .03) and 0.705 (P< .01), respectively. In military young adults, MPO for both the 2-minute sit-up and the 2-minute pushup tests could be used as alternative field-based methods to estimate VO2max.
Association between Helicobacter pylori infection and colorectal polyps
Authors: Basmaci Nergis , Karataş Ali , Ergin Mustafa , Dumlu Giyaseddin Şükrü
Published: October 2023

It was aimed to investigate whether the Helicobacter pylori infection is related to the frequency, localization, size and number of colorectal polyps. The data of 4561 patients who underwent esophagogastroduodenoscopy and colonoscopy were analyzed retrospectively. Patients with and without polyps at colonoscopy were grouped and the frequency of H pylori infection was compared in these patients. The relationship between the groups was evaluated with statistical methods. It was determined that the rate of H pylori infection was higher in patients with colorectal polyps than in patients without polyps (P < .005). Patients with multiple polyps, polyps larger than 1 cm, and tubulovillous and villous adenoma from polyp types had a higher rate of H pylori infection (P = .095; P .004; P .001). When the polyps were evaluated according to their localization, H pylori infection rates were not different between the groups (P = .341). It has been observed that the rate of H pylori infection is higher in large polyps, multiple polyps, tubulovillous and villous adenomas, which are known to have a higher risk of malignancy.
Prospective comparative analysis of zero-heat-flux thermometer (SpotOn®) compared with tympanic thermometer and bladder thermometer in extremely aged patients undergoing lower extremity orthopedic surgery
Authors: Park Chunghyun , Kim Taeyeon , Oh Soojeong , Bang Yun-Sic
Published: October 2023

Thermoregulation is important for maintaining homeostasis in the body. It can be easily broken under anesthesia. An appropriate method for measuring core body temperature is needed, especially for elderly patients, because the efficiency of thermoregulation gradually decreases with age. Zero-heat-flux (ZHF) thermometry (SpotOn) is an alternative, noninvasive method for continuous temperature monitoring at the skin surface. The aim of this study was to examine the accuracy and feasibility of using the SpotOn sensor in lower extremity orthopedic surgery in elderly patients aged over 80 years by comparing a SpotOn sensor with 2 other reliable minimally invasive methods: a tympanic membrane thermometer and a bladder thermometer. This study enrolled 45 patients aged over 80 years who were scheduled to undergo lower extremity surgery. Body temperature was measured using a SpotOn sensor, a tympanic membrane thermometer and a bladder thermometer. Agreements between the SpotOn sensor and the other 2 methods were assessed using Bland and Altman plots for repeated measures adjusted for unequal numbers of measurements per patient. Compared with bladder temperature, bias and limits of agreement for SpotOn temperature were 0.07°C ± 0.58°C. Compared with tympanic membrane temperature, bias and limits of agreement for SpotOn temperature were −0.28°C ± 0.61°C. The 3M SpotOn sensor using the ZHF method for patients aged over 80 years undergoing lower extremity surgery showed feasible measurement value and sensitivity.
Initial β-hCG levels and 2-day-later increase rates effectively predict pregnancy outcomes in single blastocyst transfer in frozen-thawed or fresh cycles: A retrospective cohort study
Authors: Ozer Gonul
Published: October 2023

To investigate whether the initial beta-human chorionic gonadotropin (β-hCG) levels and their rate of increase differ after single fresh and frozen blastocyst transfers, and whether these values effectively predict pregnancy outcomes. This retrospective cohort study was conducted at the Sisli Memorial Hospital, assisted reproductive technology, and Reproductive Genetics Center in Istanbul, Turkey, between January 2016 and January 2022. Three thousand two hundred thirty-eight single blastocyst transfers with positive pregnancy test results were evaluated. Of these, 738 were fresh transfer cycles and 2500 were frozen-thawed embryo transfer (FET) cycles. β-hCG test results from 9 days after fresh and FET cycles were compared between the groups with biochemical pregnancy, early pregnancy loss, and live birth outcomes. The threshold values were determined for each pregnancy outcome. The rate of increase between the first and second β-hCG tests performed 2 days apart was determined for each pregnancy outcome. Finally, the listed values were compared between the FET and fresh cycle. Mean baseline β-hCG levels were significantly higher in FET cycles than in fresh cycles, regardless of pregnancy outcomes (P < .005). Baseline β-hCG levels were higher in fresh cycles with live births (171.76 ± 109.64 IU/L) compared to biochemical and clinical pregnancy losses (50.37 ± 24.31 and 114.86 ± 72.42, respectively) (P < .001). Live births in FET cycles resulted in higher baseline β-hCG levels (193.57 ± 100.38 IU/L) compared to biochemical and clinical pregnancy loss groups (68.41 ± 51.85 and 149.29 ± 96.99 IU/L, respectively) (P < .001). The β-hCG threshold for live birth for fresh cycles was 116.5 IU/L (sensitivity 80%, specificity 70%, positive predictive value 90%, negative predictive value 54%) and 131.5 IU/L for FET cycles (sensitivity 71%, specificity 68%, positive predictive value 87%, negative predictive value 50%). The percentage of the area under the curve for single fresh blastocyst transfers was 0.81 and 0.76 for frozen transfers. The rate of increase in β-hCG was similar in fresh and FET cycles. Initial β-hCG levels and 2-day increases are effective parameters for diagnosing pregnancy in fresh and FET cycles. The initial β-hCG level was significantly higher in the FET cycles than in the fresh cycles. Predicting outcomes earlier helps clinicians to manage and follow high-risk pregnancies.
Black necrosis of the glans penis associated with calciphylaxis: A case report
Authors: Yu Youwei , Chen Yangxi , Yang Fan , Song Qitai
Published: October 2023

Rationale:

Calciphylaxis, known as calcific uremic arteriolopathy, is a rare cause of dry gangrene. Despite an increase in the clinical recognition of demographic characteristics and risk factors associated with calciphylaxis, it remains a poorly understood disease with high mortality.

Patient concerns and diagnoses:

We present a 45-year-old man, who was diagnosed with calciphylaxis disease, with a history of diabetes mellitus, end-stage renal disease and cirrhosis with a half-month evolution of painful dry gangrene on his glans penis and scrotum. The patient also presented with gangrene of fingers.

Interventions and outcomes:

The patient and his family opted for palliative care. However, he died eventually.

Lessons:

This case contributed to the current understanding of calciphylaxis. Since no standard treatment is available and the prognosis remained poor, early, and accurate diagnosis of calciphylaxis is important. We here report the current case and provide data for the diagnosis and treatment of this kind of disease.
Anesthesia management of a patient with claustrophobia undergoing surgery for rhegmatogenous retinal detachment: A case report
Authors: Li Xiang , Zhou Qiaomei , Zhang Xingan , Xu Bo
Published: October 2023

Introduction:

Claustrophobia is a form of phobic anxiety disorder characterized by panic attacks. Anesthesia in patients with claustrophobia poses a challenge because these patients reject all treatments in an enclosed space. When such patients are treated in uncomfortably enclosed environments, it can cause mental distress and even sudden psychiatric death.

Case presentation:

We report the case of a 55-year-old man with severe anxiety disorder and claustrophobia who required anesthesia for the surgical treatment of rhegmatogenous retinal detachment. This patient had a history of severe anxiety and claustrophobia for more than 40 years, without having received any treatment for the condition. The patient had failed to tolerate multiple chamber surgeries. Following multidisciplinary discussion, the patient’s surgery was performed under general anesthesia in the operating room after the patient underwent induction of anesthesia outside the operating room.

Conclusions:

This case report shows that patients with claustrophobia need to be provided a comfortable environment for induction and awakening from anesthesia.
Development and validation of prognostic nomogram for elderly patients with clear cell renal cell carcinoma based on the SEER database
Authors: Lin Mingxin , Wang Cong , Zhou Jianan
Published: October 2023

This study sought to establish nomogram models of overall survival (OS) in patients with elderly clear cell renal cell carcinoma (ECCRCC). The Surveillance, Epidemiology, and End Results database provided data of the ECCRCC-afflicted patients diagnosed during the period from 2010 to 2015. This data was subsequently segregated into the training and validation sets randomly in a 7:3 ratio. The calibration curves, the receiver operating characteristic curves, the decision curve analysis and the Concordance index (C-index) were applied for the model evaluation. 9201 eligible cases from 2010 to 2015 were extracted; 6441 were included in the training cohort and 2760 in the validation cohort. The C-index for the training and validation sets were 0.710 and 0.709, respectively. The receiver operating characteristic and decision curve analysis curves demonstrated that nomograms outperformed the AJCC stage in predictive performance. Moreover, the nomogram was found to match closely with the actual observation, as indicated by the calibration plots. To make predictions with regard to the survival of the ECCRCC-afflicted individuals, and as a guide for treatment, the new nomogram could be used.
The effect of vitamin D supplementation on some metabolic parameters in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis of 8 RCTs
Authors: Chen Xuemeng , Zhao Ye , Zhang Ran , Zhao Yan , Dai Liheng
Published: October 2023

Background:

To systematically evaluate the effects of vitamin D supplementation in patients with nonalcoholic fatty liver disease (NAFLD).

Methods:

National Library of Medicine, Cochrane Library, Elsevier, China National Knowledge Infrastructure, Web of Science, WANFANG databases, and Google Scholar were retrieved to collect relevant randomized controlled trials, which are published from the earliest records the time the database was created to April 2023. Meta-analysis was conducted by using Review Manager 5.4 software after evaluating in terms of inclusion and exclusion criteria. The outcome indicators include 25-hydroxyvitamin D [25(OH)D] levels, insulin resistance index (homeostasis model assessment of insulin resistance), fasting blood glucose, and fasting insulin levels (FINS).

Results:

Eight randomized controlled trials with a total of 657 patients are included. Vitamin D supplementation increased 25(OH)D levels significantly (mean difference [MD] = 2.01, 95% confidence intervals [CI]: 0.94 to 3.08, P < .05) and vitamin D supplementation had a significant effect on insulin resistance index (MD = −0.54, 95% CI: −1.28 to 0.20, P = .16), fasting glucose (MD = −0.59, 95% CI: −1.50 to 0.32, P = .20), and FINS levels (MD = −0.30, 95% CI: −0.77 to 0.17, P = .21) had no significant effect.

Conclusion:

Vitamin D supplementation improves 25(OH)D levels in patients with nonalcoholic fatty liver disease, but there is no effect on homeostasis model assessment of insulin resistance, fasting blood glucose, or FINS.
The effect of acupressure on sleep quality in patients with leukemia: a single-center, randomized controlled trial
Authors: Molaee Hanieh , Goli Rasoul , Faraji Navid , Najafali Dizaji Niloofar , Bagheri Mojde , Shakorzadeh Sina , Hassanpour Amireh , Imanzadeh Fatemeh , Lameei Raheleh
Published: October 2023

Background:

Sleep disturbances are a common problem among patients with leukemia, adversely impacting their quality of life and overall well-being. Acupressure has been suggested as a non-pharmacological intervention for improving sleep quality. Therefore, the present study aimed to determine the effect of acupressure on sleep quality in patients with leukemia.

Methods:

This is a single-blinded randomized controlled trial with a pretest-posttest design in which a total of 68 participants were randomly allocated into two groups: an intervention group receiving acupressure therapy on the SP6 point for 10 minutes twice a day, in the morning and evening, and a control group receiving routine care. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at baseline and after a 4-week intervention period. To evaluate the obtained data, coded research units were used and the results were analyzed by statistical software SPSS version 25 and by chi-square, Fisher, and t-tests.

Results:

The results revealed a significant improvement in sleep quality among participants in the intervention group compared to the control group after the acupressure therapy on the SP6 point (P<0.001). The mean PSQI score decreased from 16.39±1.32 to 12.27±1.84 in the intervention group, whereas it only decreased from 16.78±1.38 to 16.21±1.40 in the control group.

Conclusion:

Acupressure appears to be an effective non-pharmacological intervention for improving sleep quality in patients with leukemia. The findings of this study could contribute to developing comprehensive supportive care strategies in the management of leukemia, ultimately enhancing the overall well-being and quality of life of these patients.
The mean platelet volume (MPV) in patients with systemic lupus erythematosus (SLE) and its correlation with disease activity: a cross-sectional/case–control study
Authors: Khadra Mariam , Drie Tasneem S. , Kudsi Maysoun
Published: October 2023

Introduction:

Systemic lupus erythematosus (SLE) is a systemic disease, with unknown etiology. The authors aimed in this study to determine the connection between mean platelet volume (MPV) and disease activity of SLE. Although it has been studied in other rheumatological conditions like rheumatoid arthritis, its role in adult patients with SLE needs to be defined, especially in Syria.

Materials and methods:

The authors have included in a cross-sectional study, 80 patients with SLE and 80 controls.

The SLE group was divided into two groups based on their disease activity index: the active disease group and the non-active disease group.

In all groups, MPV and erythrocyte sedimentation rate (ESR) were analyzed. Clinical findings and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were evaluated in all patients.

Results:

MPV was significantly lower in SLE patients compared to the control group (8.49±1.2 fl and 10.0±0.5 fl, respectively) (P=0.001). A decrease in MPV below the cut-off value (7.2 fl) increased the risk of active disease by an odds ratio of 9.79 (95% CI: 3.4–27.9) (P<0.001).

Conclusion:

MPV may be a disease activity indicator in patients with SLE. MPV is reduced in patients with active SLE and presents an inverse correlation with SLEDAI.
Wound assessment fundamentals for nurses
Authors: Butzlaff Alice
Published: October 2023

Knowing how to describe a wound is essential for quality assessment, documentation, and monitoring of patient healing.
Gender Differences in Work-Life Integration, Career Satisfaction, and Burnout in Pediatric Emergency Medicine Physicians
Authors: Skotnicki Brielle Stanton , Wilson Paria M. , Kazmerski Traci M. , Manole Mioara D. , Kinnane Janet M. , Lunoe Maren M.
Published: October 2023

Objective

Women physicians report worse work-life integration, career satisfaction, and burnout than men. No studies have evaluated work-life integration and career satisfaction in pediatric emergency medicine (PEM) or explored gender differences for these outcomes. This study aims to (1) compare work-life integration, career satisfaction, and burnout in women and men PEM physicians and (2) compare associated individual and occupational factors to distinguish modifiable factors.

Methods

We distributed an electronic survey to assess well-being parameters in PEM physicians. We assessed career satisfaction and work-life integration with single-item measures. We used a 2-item screen to measure burnout. We performed descriptive analyses, univariate analysis to compare gender differences, and multivariate logistic regression analysis for each outcome.

Results

Two hundred thirty-nine PEM physicians participated, yielding a response rate of 50% (57% women; age range, 30–80 years). Overall satisfaction with work-life integration was 42.9%, with 34.3% of women reporting appropriate work-life integration, compared with 55.4% of men (P = 0.001). Career satisfaction rate was 77.8%, with 71.6% of women reporting career satisfaction, compared with 86.1% of men (P = 0.008). Burnout rate was 44.5%, with 53.7% of women reporting burnout compared with 33.7% of men (P = 0.002). Modifiable factors identified include perception of unfair compensation, inadequate physical and mental health support provided by organization, feeling unappreciated, inadequate provider staffing, inadequate resources for patient care, lack of advance notice or control of work schedule, and inadequate sleep.

Conclusions

Of PEM physicians, women have worse work-life integration, less career satisfaction, and more burnout than men. The PEM community should devote resources to modifiable occupational factors to improve gender disparities in well-being parameters.
Hepatitis B virus clinical and virologic characteristics in an HIV perinatal transmission study in sub-Saharan Africa
Authors: Bhattacharya Debika , Guo Rong , Tseng Chi-Hong , Emel Lynda , Sun Ren , Zhang Tian-hao , Chiu Shih-Hsin , Stranix-Chibanda Lynda , Chipato Tsungai , Ship Hannah , Mohtashemi Neaka Z. , Kintu Kenneth , Manji Karim P. , Moodley Dhayendre , Maldonado Yvonne , Currier Judith S. , Thio Chloe L.
Published: October 2023

Objectives:

To describe the clinical and virologic characteristics of HIV−HBV coinfection, including the predictors of high maternal HBV viral load in pregnant women with HIV in sub-Saharan Africa (SSA).

Methods:

HPTN 046 was a HIV perinatal transmission clinical trial evaluating infant nevirapine vs. placebo. Women-infant pairs (n = 2016) were enrolled in SSA from 2007 to 2010; 1579 (78%) received antiretrovirals (ARV). Maternal delivery samples were retrospectively tested for hepatitis B surface antigen (HBsAg), and if positive, were tested for hepatitis B e antigen (HBeAg) and HBV viral load (VL). High HBV VL was defined as ≥106 IU/ml.

Results:

Overall, 4.4% (88/2016) had HBV co-infection, with geographic variability ranging from 2.4% to 8.7% (P < 0.0001); 25% (22/88) were HBeAg positive with prevalence in countries ranging from 10.5% to 39%. Fifty-two percentage (40/77) of those with HBV received ARV, the majority (97%) received 3TC as the only HBV active agent. HBeAg positivity was associated with high maternal HBV VL, odds ratio (OR) 37.0, 95% confidence interval (CI) 5.4−252.4. Of those with high HBV VL, 40% (4/10) were receiving HBV active drugs (HBV-ARV). HBV drug resistance occurred in 7.5% (3/40) receiving HBV-ARV.

Conclusions:

In SSA, HBV co-infection is common in pregnant women with HIV. HBsAg and HBeAg prevalence vary widely by country in this clinical trial cohort. HBeAg is a surrogate for high HBV viral load. HBV drug resistance occurred in 7.5% receiving HBV-ARV with lamivudine as the only HBV active agent. These findings reinforce the importance of HBsAg screening and early treatment with two active agents for HBV.
People with HIV at the end-of-life and their next-of-kin/loved ones are willing to participate in interventional HIV cure-related research
Authors: Ndukwe Samuel O. , Patel Hursch , Shelton Brittany , Concha-Garcia Susanna , Dullano Cheryl , Solso Stephanie , Hendrickx Steven , Riggs Patricia K. , Villa Thomas J. , Kaytes Andy , Taylor Jeff , Little Susan J. , Lessard David , Arora Anish K. , Costiniuk Cecilia T. , Eskaf Shadi , Smith Davey M. , Gianella Sara , Dubé Karine
Published: October 2023

Introduction:

The Last Gift study at the University of California San Diego (UCSD), United States enrolls terminally ill people with HIV (PWH) in HIV cure research.

Methods:

From 2017 to 2022, we conducted surveys with Last Gift participants and their next-of-kin/loved ones to evaluate willingness to participate in different types of HIV cure research at the end of life (EOL). We analyzed willingness data descriptively.

Results:

We surveyed 17 Last Gift participants and 17 next-of-kin/loved ones. More than half of Last Gift participants (n = 10; 58.8%) expressed willingness to participate in studies involving totally new treatments or approaches (’first-in-human’ studies), a combination of different approaches, the use of unique antibodies, proteins or molecules, or therapeutic vaccines. Under one-quarter of Last Gift participants (n = 4; 23.5%) expressed willingness to participate in research involving interventions that may shorten their life expectancy to benefit medical research. Most Last Gift participants and their next-of-kin/loved ones also expressed high acceptance for various types of donations and biopsies at the EOL (e.g. hair donations and skin, lymph node or gut biopsies).

Discussion:

Knowing whether people would be willing to participate in different types of EOL HIV cure research can help inform the design of future innovative studies. As a research community, we have a duty to design studies with adequate safeguards to preserve the public trust in research and honor PWH's important gift to humanity.
Immune Features of Disparate Liver Transplant Outcomes in Female Hispanics With Nonalcoholic Steatohepatitis
Authors: Sosa Rebecca A. , Terry Allyson Q. , Ito Takahiro , Naini Bita V. , Zheng Ying , Pickering Harry , Nevarez-Mejia Jessica , Busuttil Ronald W. , Gjertson David W. , Kupiec-Weglinski Jerzy W. , Reed Elaine F. , Kaldas Fady M.
Published: October 2023

Background.

Nonalcoholic steatohepatitis (NASH) is a severe immune-mediated stage of nonalcoholic fatty liver disease that is rapidly becoming the most common etiology requiring liver transplantation (LT), with Hispanics bearing a disproportionate burden. This study aimed to uncover the underlying immune mechanisms of the disparities experienced by Hispanic patients undergoing LT for NASH.

Methods.

We enrolled 164 LT recipients in our institutional review board-approved study, 33 of whom presented with NASH as the primary etiology of LT (20%), with 16 self-reported as Hispanic (48%). We investigated the histopathology of prereperfusion and postreperfusion biopsies, clinical liver function tests, longitudinal soluble cytokines via 38-plex Luminex, and immune cell phenotypes generated by prereperfusion and postreperfusion blood using 14-color flow cytometry and enzyme-linked immunosorbent assay.

Results.

Hispanic LT recipients transplanted for NASH were disproportionately female (81%) and disproportionately suffered poor outcomes in the first year posttransplant, including rejection (26%) and death (38%). Clinically, we observed increased pro-inflammatory and apoptotic histopathological features in biopsies, increased AST/international normalized ratio early posttransplantation, and a higher incidence of presensitization to mismatched HLA antigens expressed by the donor allograft. Experimental investigations revealed that blood from female Hispanic NASH patients showed significantly increased levels of leukocyte-attracting chemokines, innate-to-adaptive switching cytokines and growth factors, HMGB1 release, and TLR4/TLR8/TLR9/NOD1 activation, and produced a pro-inflammatory, pro-apoptotic macrophage phenotype with reduced CD14/CD68/CD66a/TIM-3 and increased CD16/CD11b/HLA-DR/CD80.

Conclusions.

A personalized approach to reducing immunological risk factors is urgently needed for this endotype in Hispanics with NASH requiring LT, particularly in females.
Effects of Adding Congested Segment IV to the Left Lateral Graft on Short-term Outcomes in Pediatric Living-donor Liver-transplant Recipients
Authors: Aoki Hikaru , Ito Takashi , Hirata Masaaki , Kadohisa Masashi , Yamamoto Miki , Uebayashi Elena Yukie , Shirai Hisaya , Okumura Shinya , Masano Yuki , Ogawa Eri , Okamoto Tatsuya , Okajima Hideaki , Hatano Etsuro
Published: October 2023

Background.

In some pediatric patients undergoing living-donor liver transplantation, segment IV without the middle hepatic vein can be added to a left lateral segment graft to obtain larger graft volume. Because no clear consensus on this technique exists, this study investigated the effects of congested areas on postoperative outcomes in pediatric patients with biliary atresia undergoing living-donor liver transplantation.

Methods.

We retrospectively reviewed data of recipients with biliary atresia aged ≤15 y who had undergone living-donor liver transplantation at Kyoto University Hospital between 2006 and 2021 and with graft-to-recipient weight ratios (GRWR) of ≤2%. Based on the percentage of congested area in the graft, patients were classified into the noncongestion (n = 40; ≤10%) and congestion (n = 13; >10%) groups. To compare the differences between groups with similar nooncongestive GRWRs and investigate the effect of adding congested areas, patients in the noncongestion group with GRWRs of ≤1.5% were categorized into the small noncongestion group (n = 24).

Results.

GRWRs and backgrounds were similar between the noncongestion and congestion groups; however, patients in the congestion group demonstrated significantly longer prothrombin times, higher ascites volumes, and longer hospitalization. Further, compared with the small noncongestion group, the congestion group had significantly greater GRWR and similar noncongestive GRWR; however, the congestion group had significantly longer prothrombin time recovery (P = 0.020, postoperative d 14), higher volume of ascites (P < 0.05, consistently), and longer hospitalization (P = 0.045), requiring significantly higher albumin and gamma-globulin transfusion volumes than the small noncongestion group (P = 0.027 andP = 0.0083, respectively). Reoperation for wound dehiscence was significantly more frequent in the congestion group (P = 0.048).

Conclusions.

In pediatric liver-transplant recipients, adding a congested segment IV to the left lateral segment to obtain larger graft volume may negatively impact short-term postoperative outcomes.
Effect of Standardized Reminder Calls on Trauma Patient No-Show Rate
Authors: Bauerle Wayne B , Reese Vanessa , Stoltzfus Jill , Benton Adam , Knipe Joshua , Wilde-Onia Rebecca , Castillo Roberto , Thomas Peter , Cipolla James , Braverman Maxwell A
Published: October 2023

BACKGROUND:

Most patients who sustain a traumatic injury require outpatient follow-up. A common barrier to outpatient postadmission care is patient failure to follow-up. One of the most significant factors resulting in failure to follow-up is age more than 35 years. Recent work has shown that follow-up telephone calls reduce readmission rates. Our aim was to decrease no-show appointments by 10% in 12 months.

STUDY DESIGN:

The electronic medical records at our level I and II trauma centers were queried for all outpatient appointments for trauma between July 1, 2020, and June 9, 2021, and whether the patient attended their follow-up appointment. Patients with visits scheduled after August 1, 2021, received 24- and 48-hour previsit reminder calls. Patients with visits scheduled between July 1, 2020, and August 1, 2021, did not receive previsit calls. Both groups were compared using multivariable direct logistic regression models.

RESULTS:

A total of 1,822 follow-up opportunities were included in the study. During the pre-implementation phase, there was a no-show rate of 30.9% (329 of 1,064 visits). Postintervention, a 12.2% reduction in overall no-show rate occurred. A statistically significant 11.2% decrease (p < 0.001) was seen in elderly patients. Multivariate analysis showed standardized calls resulted in significantly decreased odds of failing to keep an appointment (adjusted odds ratio = 0.610, p < 0.001).

CONCLUSIONS:

Reminder calls led to a 12.2% reduction in no-show rate and were an independent predictor of a patient’s likelihood of attending their appointment. Other predictors of attendance included insurance status and abdominal injury.
Nocardia otitidiscaviarum causing pulmonary nocardiosis: a case report and its review of literature
Authors: SRIVASTAVA SAUMYA , SAMADDAR ARGHADIP , KHAN SALMAN , Tak Vibhor , Bohra Gopal Krishna , Sharma Deepak , GHOSH ARNAB , NAG VIJAYA LAKSHMI
Published: October 2023

Background: Infections caused by Nocardia spp. can occur in immunocompromised as well as immunocompetent individuals. Although nocardiosis is rare, it is being increasingly recognized owing to the rise in occurrence rate over the years. The documentation of pleural involvement in nocardiosis is rare in India, especially in the northwestern region. Here, we report a case of pleural nocardiosis in an immunocompromised patient.
Case: We report a case of pulmonary nocardiosis in an immunocompromised individual caused by Nocardia otitidiscaviarum.  
Discussion: Pulmonary nocardiosis caused by Nocardia otitidiscaviarum may go unnoticed without clinical suspicion. Correct and timely identification is the key to proper patient management.
Conclusion: Coordination between clinicians and microbiologists is necessary for early diagnosis and appropriate management of nocardiosis.
Arthrobacter vasquezii sp. nov., isolated from a soil sample from Union Glacier, Antarctica
Authors: Valenzuela-Ibaceta Felipe , Carrasco Valentina , Lagos-Moraga Sebastián , Dietz-Vargas Claudio , Navarro Claudio A. , Pérez-Donoso José M.
Published: October 2023

A Gram-stain-positive, catalase-positive, non-motile bacteria, with a rod–coccus cycle (designated as EH-1B-1T) was isolated from a soil sample from Union Glacier in Ellsworth Mountains, Antarctica. Strain EH-1B-1T had an optimal growth temperature of 28 °C and grew at pH 7–10. The major cellular fatty acids were anteiso-C15 : 0, iso-C15 : 0, C16 : 0 and anteiso-C17 : 0. The G+C content based on the whole genome sequence was 63.1 mol%. Strain EH-1B-1T was most closely related to members of the genus

Arthrobacter

, namely

Arthrobacter subterraneus

and

Arthrobacter tumbae

. The strain grew on tryptic soy agar, Reasoner’s 2A agar, lysogeny broth agar and nutrient agar. The average nucleotide identity and digital DNA–DNA hybridization values between strain EH-1B-1T and its closest reference type strains ranged from 78 to 88 % and from 20.9 to 36.3 %, respectively. Based on phenotypic, chemotypic and genotypic evidence, it is proposed that strain EH-1B-1T represents a novel species of

Arthrobacter

, for which the name Arthrobacter vasquezii sp. nov. is proposed, with strain EH-1B-1T (RGM 3386T=LMG 32961T) as the type strain.
A structural and functional analysis of opal stop codon translational readthrough during Chikungunya virus replication
Authors: Li Raymond , Sun Kaiwen , Tuplin Andrew , Harris Mark
Published: October 2023

Chikungunya virus (CHIKV) is an alphavirus, transmitted by Aedes species mosquitoes. The CHIKV single-stranded positive-sense RNA genome contains two open reading frames, coding for the non-structural (nsP) and structural proteins of the virus. The non-structural polyprotein precursor is proteolytically cleaved to generate nsP1-4. Intriguingly, most isolates of CHIKV (and other alphaviruses) possess an opal stop codon close to the 3′ end of the nsP3 coding sequence and translational readthrough is necessary to produce full-length nsP3 and the nsP4 RNA polymerase. Here we investigate the role of this stop codon by replacing the arginine codon with each of the three stop codons in the context of both a subgenomic replicon and infectious CHIKV. Both opal and amber stop codons were tolerated in mammalian cells, but the ochre was not. In mosquito cells all three stop codons were tolerated. Using SHAPE analysis we interrogated the structure of a putative stem loop 3′ of the stop codon and used mutagenesis to probe the importance of a short base-paired region at the base of this structure. Our data reveal that this stem is not required for stop codon translational readthrough, and we conclude that other factors must facilitate this process to permit productive CHIKV replication.
Network level enrichment provides a framework for biological interpretation of machine learning results
Authors: Li Jiaqi , Segel Ari , Feng Xinyang , Tu Jiaxin Cindy , Eck Andy , King Kelsey , Adeyemo Babatunde , Karcher Nicole R. , Chen Likai , Eggebrecht Adam T. , Wheelock Muriah D.
Published: October 2023

Machine learning algorithms are increasingly used to identify brain connectivity biomarkers linked to behavior and clinical outcomes. However, non-standard methodological choices in neuroimaging datasets, especially those with families or twins, have prevented robust machine learning applications. Additionally, prioritizing prediction accuracy over biological interpretability has made it challenging to understand the biological processes behind psychopathology. In this study, we employed a linear support vector regression model to study the relationship between resting-state functional connectivity networks and chronological age using data from the Human Connectome Project. We examined the effect of shared variance from twins and siblings by using cross-validation, either randomly assigning or keeping family members together. We also compared models with and without a Pearson feature filter and utilized a network enrichment approach to identify predictive brain networks. Results indicated that not accounting for shared family variance inflated prediction performance, and the Pearson filter reduced accuracy and reliability. Enhancing biological interpretability was achieved by inverting the machine learning model and applying network-level enrichment on the connectome, while directly using regression coefficients as feature weights led to misleading interpretations. Our findings offer crucial insights for applying machine learning to neuroimaging data, emphasizing the value of network enrichment for comprehensible biological interpretation.
Biological and genomic resources for the cosmopolitan phytoplankton Bathycoccus: Insights into genetic diversity and major structural variations
Authors: Dennu Louis , Devic Martine , Rigonato Janaina , Falciatore Angela , Lozano Jean-Claude , Vergé Valérie , Mariac Cédric , Joli Nathalie , Jaillon Olivier , Sabot François , Bouget François-Yves
Published: October 2023

Population-scale sequencing has become a standard practice to explore the natural genetic diversity underlying adaptation, notably in land plants. However, current sequencing initiatives for eukaryotic phytoplankton primarily concentrate on creating reference genomes for model organisms and characterizing natural communities through metagenomics approaches. Consequently, few species have been thoroughly sequenced and intraspecific genetic diversity remains virtually undescribed, limiting our understanding of diversity and adaptation mechanisms. Here we report a biological and genomic resource to explore the genetic diversity of the cosmopolitan and ecologically importantBathycoccusgenus. To span broad geographical and temporal scales, we selected available strains in collection and previously isolated strains from the Banyuls bay (Mediterranean sea) as well as newly isolated strains from the Baffin bay (Arctic ocean). By combining Oxford Nanopore Technology long reads and Illumina short reads technologies, we produced and annotated 28Bathycoccus sp. de novoassembled genomes of high quality, including 24 genomes ofBathycoccus prasinosstrains along a latitudinal gradient between 40° and 78° North, one reference genome of theBathycoccus calidusspecies and 3 genomes of a yet undescribedBathycoccusspecies namedBathycoccus catiminus. We assessed the genetic diversity of this genus through phylogenomic analyses and highlighted the central role of this genomic resource in providing new insights into the diversity of outlier chromosomal structures. TheBathycoccusbiological and genomic resources offer a robust framework for investigating the diversity and adaptation mechanisms of eukaryotic phytoplankton in the Ocean.

Significance statement

Comparative and functional approaches for the study of eukaryotic phytoplankton and their adaptation to latitudes and seasons that rely on extensive biological and genomic resources are currently lacking. Here we report such resources and describe the natural diversity of the cosmopolitan phytoplanktonBathycoccus, providing insights into its species and intraspecific diversity and establishing it as a robust model for functional and ecological studies.
Pan-cancer analysis reveals multifaceted roles of retrotransposon-fusion RNAs
Authors: Lee Boram , Park Junseok , Voshall Adam , Maury Eduardo , Kang Yeeok , Kim Yoen Jeong , Lee Jin-Young , Shim Hye-Ran , Kim Hyo-Ju , Lee Jung-Woo , Jung Min-Hyeok , Kim Si-Cho , Khanh Chu Hoang Bao , Kim Da-Won , Kim Minjeong , Choi Eun-Ji , Hwang Ok Kyung , Lee Ho Won , Ha Kyungsoo , Choi Jung Kyoon , Kim Yongjoon , Choi Yoonjoo , Park Woong-Yang , Lee Eunjung Alice
Published: October 2023

Transposon-derived transcripts are abundant in RNA sequences, yet their landscape and function, especially for fusion transcripts derived from unannotated or somatically acquired transposons, remains underexplored. Here, we developed a new bioinformatic tool to detect transposon-fusion transcripts in RNA-sequencing data and performed a pan-cancer analysis of 10,257 cancer samples across 34 cancer types as well as 3,088 normal tissue samples. We identified 52,277 cancer-specific fusions with ∼30 events per cancer and hotspot loci within transposons vulnerable to fusion formation. Exonization of intronic transposons was the most prevalent genic fusions, while somatic L1 insertions constituted a small fraction of cancer-specific fusions. Source L1s and HERVs, but not Alus showed decreased DNA methylation in cancer upon fusion formation. Overall cancer-specific L1 fusions were enriched in tumor suppressors while Alu fusions were enriched in oncogenes, including recurrent Alu fusions inEZH2predictive of patient survival. We also demonstrated that transposon-derived peptides triggered CD8+ T-cell activation to the extent comparable to EBV viruses. Our findings reveal distinct epigenetic and tumorigenic mechanisms underlying transposon fusions across different families and highlight transposons as novel therapeutic targets and the source of potent neoantigens.
Temperature effects on the magnitude of the bovineex vivoimmune response towardsMycoplasmopsis bovis
Authors: Démoulins Thomas , Yimthin Thatcha , Lindtke Dorothea , Eggerschwiler Lukas , Siegenthaler Raphael , Labroussaa Fabien , Jores Joerg
Published: October 2023

Although cattle are the mammalian species with most global biomass associated with a huge impact on our planet, their immune system remains poorly understood. Notably, the bovine immune system has peculiarities such as an overrepresentation of γδ T cells that requires particular attention, specifically in an infectious context. In line of 3R principles, we developed anex vivoplatform to dissect host-pathogen interactions. The experimental design was based on two independent complementary readouts: firstly, a novel 12-14 color multiparameter flow cytometry assay measuring maturation (modulation of cell surface marker expression) and activation (intracellular cytokine detection) of monocytes, conventional and plasmacytoid dendritic cells, natural killer cells, γδ T cells, B and T cells; secondly, a multiplex immunoassay monitoring bovine chemokine and cytokine secretion levels. The experiments were conducted on fresh primary bovine blood cells exposed toMycoplasmopsis bovis(M. bovis), a major bovine respiratory pathogen. Besides reaffirming the tight cooperation of the different primary blood cells, we also identified novel key players such as strong IFN-γ secreting NK cells, whose role was so far largely overlooked. Additionally, we compared the host-pathogen interactions at different temperatures, including commonly used 37 °C, ruminant body temperature (38-38.5 °C) and fever (≥39.5 °C). Strikingly, working under ruminant physiological temperature influenced the capacity of most immune cell subsets to respond toM. boviscompared to 37 °C. Under fever-like temperature conditions the immune response was impaired compared to physiological temperature. Our experimental approach, phenotypically delineating the bovine immune system provided a thorough vision of the immune response towardsM. bovisand the influence of temperature towards that immune response.
Unveiling APOL1 Haplotypes: A Novel Classification Through Probe-Independent Quantitative Real-Time PCR
Authors: Dogan Murat , Watkins Christine , Ingram Holly , Moore Nicholas , Rucker Grace M. , Gower Elizabeth G. , Eason James D. , Bhalla Anshul , Talwar Manish , Nezakatgoo Nosratollah , Eymard Corey , Helmick Ryan , Vanatta Jason , Bajwa Amandeep , Kuscu Canan , Kuscu Cem
Published: October 2023

Introduction

Apolipoprotein-L1 (APOL1) is a primate-specific protein component of high- density lipoprotein (HDL). Two variants of APOL1 (G1 and G2), provide resistance to parasitic infections in African Americans but are also implicated in kidney-related diseases and transplant outcomes in recipients. This study aims to identify these risk variants using a novel probe- independent quantitative real-time PCR method in a high African American recipient cohort. Additionally, it aims to develop a new stratification approach based on haplotype-centric model.

Methods

Genomic DNA was extracted from recipient PBMCs using SDS lysis buffer and proteinase K. Quantitative PCR assay with modified forward primers and a common reverse primer enabled us to identify single nucleotide polymorphisms (SNPs) and the 6-bp deletion quantitatively. Additionally, we used sanger sequencing to verify our QPCR findings.

Results

Our novel probe-independent qPCR effectively distinguished homozygous wild-type, heterozygous SNPs/deletion, and homozygous SNPs/deletion, with at least 4-fold differences. High prevalence of APOL1 variants was observed (18% two-risk alleles, 34% one-risk allele) in our recipient cohort. Intriguingly, up to 12-month follow-up revealed no significant impact of recipient APOL1 variants on transplant outcomes. Ongoing research will encompass more time points and a larger patient cohort, allowing a comprehensive evaluation of G1/G2 variant subgroups categorized by new haplotype scores, enriching our understanding.

Conclusions

Our cost-effective and rapid qPCR technique facilitates APOL1 genotyping within hours. Prospective and retrospective studies will enable comparisons with long-term allograft rejection, potentially predicting early/late-stage transplant outcomes based on haplotype evaluation in this diverse group of kidney transplant recipients.