bluuebunny/crossref_metadata_2025 huggingface dataset:
Partial replacement of soybean meal with full-fat black soldier fly larvae meal in plant-based nursery diets did not influence fecalEscherichia colicolony forming units or improve fecal consistency when pigs were weaned into non-disinfected pens
Authors: Christensen B , Zhu C , Niazy M , McCullough T , Ricker N , Huber L
Published: October 2023

At weaning, one hundred pigs (21 d of age; 6.96 ± 0.23 kg BW) were used to determine the effect of partially replacing soybean meal (SBM) in corn- and SBM-based nursery diets on growth performance, fecal scores, Escherichia coli (E. coli) colony forming units (CFU), and cecal mucosal microbial profile when weaned into non-disinfected nursery pens. Pens were randomly assigned to one of four dietary treatments (n = 5): high-complexity (contained highly digestible animal proteins and 10.8% SBM) with and without 3,000 ppm ZnO (HC + and HC−, respectively; representative of commercial diets), low-complexity (corn- and SBM-based; 31.8% SBM; LC), or LC with 30% inclusion of full-fat black soldier fly larvae meal (BSFLM) to partially replace SBM (LCFL; 8.0% SBM). Diets were fed for 14 d (phase I), followed by 4 wk of a common corn-SBM diet (phase II). Fecal E. coli CFU and cecal mucosal microbial 16s rRNA community profiles were assessed 7 d after weaning. During phase I, pigs fed LC and LCFL had lower average daily gains (P < 0.05) than pigs fed HC + and HC−, which were not different. Average daily feed intake was not different for pigs fed LC and LCFL, but lower than for pigs fed HC− (P < 0.001); pigs fed HC + had greater feed intake in phase I vs. all other treatment groups (P < 0.001). Upon nursery exit, only pigs fed LCFL had lower BW than pigs fed HC− (P < 0.05), with intermediate values observed for HC + and LC. Day 3 fecal scores were greater for pigs fed LCFL vs. HC + (P < 0.05) and day 7 E. coli CFU were greater for all treatment groups vs. HC + (P < 0.001). Pigs fed HC− (P < 0.01), LC (P < 0.05), and LCFL (P < 0.05) had lower alpha diversity for cecal mucosal microbiota compared to HC+. At the genus level, pigs fed LC had lower Lactobacillus relative abundance vs. pigs fed HC + (P < 0.01). Therefore, BSFLM can partially replace SBM without sacrificing growth performance vs. nursery pigs fed corn- and SBM-based diets, but both groups had reduced phase I growth performance vs. pigs fed highly digestible diets containing animal proteins when weaned into non-disinfected pens. The BSFLM did not influence fecal E. coli CFU or improve fecal consistency after weaning and therefore, is less effective at minimizing digestive upsets vs. HC + diets.
Fossil frogs (Eleutherodactylidae: Eleutherodactylus) from Florida suggest overwater dispersal from the Caribbean by the Late Oligocene
Authors: Vallejo-Pareja Maria Camila , Stanley Edward L , Bloch Jonathan I , Blackburn David C
Published: October 2023

Establishment of extant terrestrial vertebrate faunas in North America was influenced by a set of factors associated with temporal changes in climate and ecology that operated at different geographic scales. While the biogeography of extant taxa can be inferred from phylogenies, these omit lineages that have gone regionally extinct and for which the only direct evidence is the fossil record. A comprehensive study of anurans from the Late Oligocene of Florida reveals an abundance of fossils referred to Eleutherodactylus. Time-calibrated molecular phylogenies have suggested that this genus originated in the Caribbean in the Early Oligocene and then colonized Central America in the Middle Miocene. Here, we describe the first records of pre-Quaternary fossils referred to Eleutherodactylus from Florida. Results from analysis of inter- and intraspecific variation in anatomy, size, and shape of isolated bones of fossil and extant species suggest that the fossils represent adult individuals with an estimated body size (snout–urostyle length) of 16.8–29.8 mm. We show that Eleutherodactylus was established by the Late Oligocene in North America well before colonizing Central America in the Miocene. We provide, for the first time, evidence of dispersal of amphibians from the Caribbean into North America during the Late Oligocene.
The Cell-Free DNA Virome of 108,349 Dutch Pregnant Women
Authors: Linthorst Jasper , Baksi Moezammin M. M. , Welkers Matthijs R. A. , Sistermans Erik A.
Published: October 2023

Pregnancy increases the body's vulnerability to infectious disease, and current guidelines during pregnancy include minimizing possible exposure to viral infection. In cases where viral infection does occur, these can cause mild to severe complications in both mother and fetus; many viruses that result in such complications are DNA viruses. Current diagnosis technology for DNA viruses relies largely on polymerase chain reaction (PCR), which is very sensitive but generally targeted at a specific virus and so tends to not be very comprehensive. In addition, this testing is normally performed only on those who are at high risk or expressing symptoms. To more fully understand the effect and prevalence of DNA viruses in pregnancy, this study used noninvasive prenatal testing (NIPT) that captures cell-free DNA (cfDNA) to examine the DNA virome in pregnant women between 2017 and 2020.

Data included deidentified NIPT results for 108,349 individuals, and DNA sequences were used to screen for 224 DNA viruses. Viruses that were genetically similar were differentiated based on taxonomy through a meticulous decision tree to avoid generalized errors in categorizing them. The most commonly detected virus was parvovirus B19, occurring in approximately 1 in 3000 cfDNA reads. High viral loads were also observed for hepatitis B, Bocaparvovirus, papillomavirus, adenovirus, adeno-associated virus, Epstein-Barr virus (EBV)/herpesvirus 4, cytomegalovirus (CMV), herpesvirus 6, and torque teno virus.

A cross-examination of demographic and pregnancy factors revealed many associations, most of which remained significant after adjustments for multiple comparisons. Available characteristics included maternal age, body mass index (BMI), gestational age, fetal fraction, and the number of sequenced reads with the presence of viral DNA in the samples. Detection of viral DNA was associated with lower BMI, along with a lower concentration of cfDNA and a higher fetal fraction. When individual viruses were analyzed, CMV had the most significant relationship with gestational age and maternal age. Results additionally showed that low fetal fraction was associated with lower detection of viral DNA for specific viruses.

These results show that it is feasible to detect viral DNA in NIPT samples. If viral DNA can be detected, there is potential to diagnose infection and to possibly prevent complications due to the virus. Current clinical practice does not use NIPT as a diagnostic tool for viral infection, but there is potential for this in the future. Further research should focus on clinical utility, sensitivity, specificity, and accuracy, as well as the relationship of viral DNA with low fetal fraction.
Negative-Pressure Wound Therapy for Open Abdomen in Surgical Reintervention after Curative Surgery of Peritoneal Malignancy Increases the Risk of Recurrence
Authors: Rabel Thomas , Bonnot Pierre-Emmanuel , Hadeedi Omar , Kepenekian Vahan , Bernard Lorraine , Friggeri Arnaud , Glehen Olivier , Passot Guillaume
Published: October 2023

OBJECTIVE

Negative-pressure wound therapy for open abdomen (NPWTOA) helps reduce the risk of abdominal compartment syndrome. However, the risk of recurrence of cancer is unclear when NPWTOA is applied after oncologic resection. The aim of this study was to evaluate the effects of NPWTOA used for major complications on patients treated with cytoreductive surgery for peritoneal malignancy (PM).

METHODS

All patients who underwent an NPWTOA after potentially curative surgery of PM in a single institution were included. These patients were pair matched 1:3 on the Peritoneal Cancer Index, completeness of cytoreduction using a scoring index, and PM origin with patients who underwent surgical reintervention without NPWTOA after curative surgery of PM. Survival among the two groups was compared using the Kaplan-Meier method.

RESULTS

Between 2011 and 2017, among 719 curative surgeries for PM, 13 patients underwent an NPWTOA after surgical reintervention. Researchers paired 9 of these patients to 27 others without NPWTOA after surgical reintervention. Median overall survival was 4.8 and 35 months (P = .391), and median disease-free survival was 4.0 and 13.9 months (P = .022) for the NPWTOA and non-NPWTOA groups, respectively.

CONCLUSIONS

The use of the NPWTOA during surgical reintervention after curative surgery for PM may increase the risk of early recurrence.
Assessing Nutrition Status in an Outpatient Wound Center: A Feasibility Study
Authors: LaValey Collette , Novosel Lorraine M.
Published: October 2023

OBJECTIVE

To explore the feasibility of using the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutrition status of patients with chronic wounds receiving care in an outpatient wound clinic.

METHODS

The PG-SGA was administered to a single cohort convenience sample of adults with chronic wounds who presented to an outpatient wound clinic. The authors performed univariate descriptive analyses and calculated interrater reliability.

RESULTS

Nutrition assessments were completed with 15 clinic patients. Patients required an average of 6.5 minutes (range, 3.5–10 minutes) to complete their component of the PG-SGA, exceeding the target goal of 5 minutes or fewer. Dietitians required an average of 2 minutes per patient to complete the professional component of the PG-SGA (physical examination). The nutrition assessment process was rated highly favorable. Resources to conduct the study at the site were available 100% of the time.

CONCLUSIONS

The PG-SGA demonstrates promise for use in the chronic wound population and could be incorporated into clinical care in settings equipped with appropriate and adequate resources. The complexities of workforce stability and resource availability, in addition to the ongoing need to be responsive to patient challenges, must be acknowledged in the planning of future studies.
Using Compression Therapy to Treat Bilateral Lower Limb Edema in Patients with Lung Cancer: A Case Series
Authors: Kayauchi Naomi , Nagatsu Takako , Satoh Hiroaki
Published: October 2023

Although rare, marked bilateral leg edema (BLE) can occur in patients with lung cancer. Systemic therapy for the underlying disease is important, but adjunct therapy might also be helpful. In this case series, the authors report on treating BLE in patients with lung cancer with compression therapy using elastic stockings and bandages. From April 2013 to March 2022, the authors conducted a retrospective survey of seven patients who developed marked BLE and received compression therapy. They evaluated effects based on improvements in subjective symptoms as well as objective findings 2 months after the start of the therapy. The bandage therapy was useful in patients who were driver-gene negative, but it was not effective in those who already had “progressive disease” with specific agents for their driver genes. No adverse events were observed. Compression therapy, even when attached or detached by nonmedical personnel, may provide favorable effects and should be considered as an adjunct treatment option in this population, in addition to effective systemic cancer therapy. These results indicate that a prospective clinical trial would be worthwhile.
The Role of Patient Engagement in Surgical Site Infection Reduction: A Process Improvement Project
Authors: Cox Jill , Douglas Lisa , Wemmer Valerie , Kaminsky Kathleen
Published: October 2023

BACKGROUND

Surgical site infections (SSIs) are the second most common healthcare-associated infection, with prevention being a high-priority goal for all healthcare organizations. Although routine surveillance and standardized prevention protocols have long been used, patient engagement is an additional intervention that should be considered and may be beneficial in SSI prevention.

OBJECTIVE

To determine if the development of a standardized patient education discharge plan for management of a surgical site and/or surgical drain would contribute to a reduction in SSI rates in inpatients undergoing colorectal, plastic, or general surgery.

METHODS

A preintervention/postintervention design was used. Before intervention, patients and surgeons were surveyed regarding various discharge practices related to surgical incision/drain care. The intervention consisted of implementing a standardized discharge plan including standardized education and patient discharge kits. After implementation, patients were surveyed regarding discharge practices. Patient survey responses and SSI rates were compared between the preintervention and postintervention time frames.

RESULTS

Rates of SSIs decreased across all three surgical specialties during the project period: colorectal SSIs decreased from 3.2% to 2.7%, plastics from 1.2% to 0.5%, and general from 0.86% to 0.33%. Improvements were also realized in patient survey responses to various aspects of surgical incision/drain care.

CONCLUSIONS

Patient engagement may be an important strategy to integrate with SSI evidence-based care bundles. Active engagement of surgical patients perioperatively has the potential to improve the patient experience, which ultimately can result in improved healthcare outcomes for this population.
A Preliminary Look at the Macrovascular System for Transmetatarsal Amputation Success
Authors: Ansert Elizabeth , Najjar John , Snyder Robert J.
Published: October 2023

OBJECTIVE

Transmetatarsal amputation (TMA) is a commonly used level of amputation that preserves most of the foot’s function and independence. However, many TMAs fail, and patients go onto higher amputations. The primary endpoint of this study is to determine if source artery occlusions are correlated with TMA flap failure.

METHODS

A total of 82 patients with TMAs were retrospectively reviewed for healing rates between 2009 and 2019 at a single center. Forty-five of the patients had an angiogram, which was analyzed for source artery and overall TMA failure. Of the initial 82 patients, a cohort of 12 had documentation of specific flap failure and an angiogram performed. This cohort of 12 patients was used for correlation of flap failure with source artery occlusion.

RESULTS

Overall, the TMA healing rate was 45.28%. No correlation was noted between a specific source artery occlusion and overall TMA failure. However, a moderate positive correlation was seen with dorsalis pedis artery and peroneal artery occlusions and dorsal flap failure. No correlation was seen with the posterior tibial artery and plantar flap failure. A moderate negative correlation was seen with peroneal artery occlusion and plantar flap failure.

CONCLUSIONS

The authors concluded that retrograde flow through the angiosome principle is what allowed for successful outcomes in TMAs. Physicians are urged to carefully plan, dissect, and preserve these vessels to help prevent TMA flap failure, especially in patients with vascular risk or disease.
Necrotizing Soft-Tissue Infections: A Case-Based Review
Authors: Desai Vidhi , Vokey Susan , Vaughan Stephen , Somayaji Ranjani
Published: October 2023

Necrotizing fasciitis is a rapidly progressive soft-tissue infection with tissue necrosis and a high mortality rate. This case-based review provides an overview of an approach to the diagnosis and management of necrotizing fasciitis for clinicians.

GENERAL PURPOSE

To review the assessment and management of necrotizing fasciitis.

TARGET AUDIENCE

This continuing-education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES

After participating in this educational activity, the participant will:

1. Identify the etiologic pathogens for necrotizing fasciitis.

2. Summarize assessment guidelines for patients who present with signs of necrotizing fasciitis.

3. Explain recommended treatment protocols for patients who have necrotizing fasciitis.
Spontaneous Preterm Birth: a Fetal-Maternal Metabolic Imbalance
Authors: Battat Tayla Lanxner , Erez Offer
Published: October 2023

Preterm delivery is a major global health problem associated with increased neonatal morbidity and mortality. To develop effective strategies to reduce preterm birth, it is important to address the causes of and risk factors for this condition. Maternal metabolism plays a crucial role in pregnancy outcomes, as it affects the availability of nutrients, energy, and other essential factors required for fetal development and growth. Several aspects of maternal metabolism can potentially contribute to the risk of preterm delivery. Severe energy deficiency as observed in women suffering from eating disorders can affect the hypothalamic-pituitary-gonadal axis resulting in amenorrhea and infertility, suggesting that maintaining a minimum maternal weight is essential to uphold a functional reproductive system, thus ensuring a successful pregnancy. Maternal undernutrition as observed in past famine and observations and animal studies may affect fetal growth and trigger an early activation of the parturition pathway leading to preterm delivery. A correlation exists between maternal size and gestation duration. Obesity is associated with a higher likelihood of medically indicated preterm birth. Low maternal body mass index and low gestational weight gain during pregnancy have been associated with preterm birth, potentially due to fetal-maternal metabolic imbalance; however, the exact mechanism remains to be determined, thus emphasizing the importance of appropriate weight management before and during pregnancy. Addressing metabolic-related risk factors for preterm delivery requires a comprehensive approach to reduce the burden of preterm delivery and improve neonatal outcomes. This review aims to explore various aspects of fetal-maternal metabolic imbalance that could potentially contribute to preterm birth. By doing so, we suggest a novel and comprehensive approach that sheds light on the intricate connection between fetal-maternal imbalance and the susceptibility to preterm birth.
New insights into the molecular basis of alcohol abstinence and relapse in alcohol-associated liver disease
Authors: Diaz Luis Antonio , Winder Gerald Scott , Leggio Lorenzo , Bajaj Jasmohan S. , Bataller Ramon , Arab Juan Pablo
Published: October 2023

Alcohol use disorder remains a significant public health concern, affecting around 5% of adults worldwide. Novel pathways of damage have been described during the last years, providing insight into the mechanism of injury due to alcohol misuse beyond the direct effect of ethanol byproducts on the liver parenchyma and neurobehavioral mechanisms. Thus, the gut-liver-brain axis and immune system involvement could be therapeutic targets for alcohol use disorder. In particular, changes in gut microbiota composition and function, and bile acid homeostasis, have been shown with alcohol consumption and cessation. Alcohol can also directly disrupt intestinal and blood-brain barriers. Activation of the immune system can be triggered by intestinal barrier dysfunction and translocation of bacteria, pathogen-associated molecular patterns (such as lipopolysaccharide), cytokines, and damage-associated molecular patterns. These factors, in turn, promote liver and brain inflammation and the progression of liver fibrosis. Other involved mechanisms include oxidative stress, apoptosis, autophagy, and the release of extracellular vesicles and miRNA from hepatocytes. Potential therapeutic targets include gut microbiota (probiotics and fecal microbiota transplantation), neuroinflammatory pathways, as well as neuroendocrine pathways, for example, the ghrelin system (ghrelin receptor blockade), incretin mimetics (glucagon-like peptide-1 analogs), and the mineralocorticoid receptor system (spironolactone). In addition, support with psychological and behavioral treatments is essential to address the multiple dimensions of alcohol use disorder. In the future, a personalized approach considering these novel targets can contribute to significantly decreasing the alcohol-associated burden of disease.
Natural Radioactivity of Granitic Rocks and Their Health Risk around Ingesana Mountains, Sudan
Authors: Fadol Nooreldin , Abdelrazig Ali , Idriss Hajo , Alashban Yazeed , Shubayr Nasser
Published: October 2023

This work was carried out mainly to analyze radioactive elements40K,232Th, and226Ra and non-radioactive elements in some granitic rocks and study their health risk for humans and non-humans. Radioisotope activity was evaluated using a high-purity germanium (HPGe) detector, and various radiological hazard indices were calculated. We also measured some non-radioactive elements using x-ray fluorescence analysis and performed Pearson correlation analysis to examine the relationships between the radionuclides and the non-radioactive elements. Furthermore, we used the ERICA software to estimate the total dose rate per organism for some non-human biota. The means of226Ra,232Th, and40K are 25.13 ± 5.22 Bq kg−1, 29.01 ± 6.95 Bq kg−1, and 323.07 ± 97.83 Bq kg−1, respectively. Hence,226Ra,232Th, and40K radioactivities were lower than the worldwide average limits. The226Ra,232Th, and40K levels were under the global average values. The hazardous radiometric variables were computed, and the findings observed that the mean absorbed dosage was 23.48 ± 7.36 nGy h−1, the yearly effective dose rate was 29.82 ± 10.46 μSv y−1, and the radium equivalent activity was 88.88 ± 18.64 Bq kg−1. The average dose and yearly effective dose rates were lower than the global average absorbed dose rate of 60 nGy h−1and the ICRP standard of 1.0 mSv y−1. The results of Ra-equivalent activity were lower than the recommended maximum criterion for building materials limit of Ra-equivalent activity (370 Bq kg−1) proposed by UNSCEAR. Tests of Pearson correlation coefficients indicate a substantial positive relationship between226Ra and232Th and a modest correlation between226Ra and40K. Meanwhile, no association between226Ra and40K and non-radioactive components has been identified. Thorium-232 exhibits a moderately favorable connection with Ti, Fe, and Ni. The estimated total dose rate per organism for the studied non-human is less than the ambient dose rate. However, the total dose rate for small burrowing mammals and reptiles exceeds the background exposure rate. In accordance with the findings, granite rocks may be safe to use as construction materials and pose no threat to human health.
Effects of Cumulative Head Impact Exposure in Adolescent Male Contact and Collision Sport Student Athletes
Authors: Ransom Danielle M. , Ahumada Luis , Amankwah Ernest K. , Katzenstein Jennifer M. , Goldenberg Neil A. , Bauer Timothy A. , Mularoni P. Patrick
Published: October 2023

Objective:

This prospective cohort study aimed to investigate the association between head impact exposure (HIE) and neuropsychological sequelae in high school football and ice hockey players over 1 year.

Setting:

Community sample.

Participants:

A cohort of 52 adolescent American football and ice hockey players were enrolled in the study, with a final study sample of 35 included in analyses.

Design:

The study followed a prospective cohort design, with participants undergoing neuropsychological screening and accelerometer-based measurement of HIE over 1 season.

Main Measures:

Changes in cognition, emotions, behavior, and reported symptoms were assessed using standardized neuropsychological tests and self-reported questionnaires.

Results:

Cumulative HIE was not consistently associated with changes in cognition, emotions, behavior, or reported symptoms. However, it was linked to an isolated measure of processing speed, showing inconsistent results based on the type of HIE. History of previous concussion was associated with worsened verbal memory recognition (ImPACT Verbal Memory) but not on a more robust measure of verbal memory (California Verbal Learning Test [CVLT]). Reported attention-deficit/hyperactivity disorder history predicted improved neurocognitive change scores. No associations were found between reported history of anxiety/depression or headaches/migraines and neuropsychological change scores.

Conclusion:

Overall, our findings do not support the hypothesis that greater HIE is associated with an increase in neuropsychological sequelae over time in adolescent football and ice hockey players. The results align with the existing literature, indicating that HIE over 1 season of youth sports is not consistently associated with significant neuropsychological changes. However, the study is limited by a small sample size, attrition over time, and the absence of performance validity testing for neurocognitive measures. Future studies with larger and more diverse samples, longer follow-up, and integration of advanced imaging and biomarkers are needed to comprehensively understand the relationship between HIE and neurobehavioral outcomes. Findings can inform guidelines for safe youth participation in contact sports while promoting the associated health and psychosocial benefits.
Accelerated corneal crosslinking with 20′-soaking hydroxypropyl methyl cellulose/riboflavin vs conventional crosslinking with 30′-soaking dextran/riboflavin
Authors: Chacra Lily M. , Helwe Chadi , Assaf Jad F. , Yehia Madeleine , Baroud Serge , Torres-Netto Emilio A. , Hafezi Farhad , Awwad Shady T.
Published: October 2023

Purpose:

To evaluate and compare functional and structural outcomes of accelerated corneal crosslinking (A-CXL) using riboflavin with hydroxypropyl methyl cellulose (HPMC) vs conventional corneal crosslinking (C-CXL) using riboflavin with dextran.

Setting:

American University of Beirut Medical Center, Beirut, Lebanon.

Design:

Retrospective analysis.

Methods:

Retrospective analysis of 83 eyes of 73 patients with mild to moderate keratoconus. First group (n = 44 eyes) underwent C-CXL using a 30-minute riboflavin/dextran soaking between June 2014 and March 2016. Second group (n = 39 eyes) underwent A-CXL using a 20-minute riboflavin/HPMC soaking between April 2016 and December 2017. Patients were evaluated preoperatively and at 1, 3, and 12 months postoperatively. Main outcome measures were simulated keratometry (simK), maximum axial keratometry (Kmax), demarcation line depth, and haze intensity measured using optical coherence tomography–based image analysis software.

Results:

Demarcation line (DL) was 298.30 ± 64.60 μm and 335.61 ± 99.76 μm for C-CXL and A-CXL groups, respectively (P = .04). Haze profile was similar for both groups. The mean simK values were reduced from 46.93 ± 3.50 and 46.44 ± 2.93 preoperatively to 46.18 ± 3.65 and 45.54 ± 2.78 at 12 months postoperatively, for C-CXL and A-CXL, respectively (P = .003 for both groups). The mean Kmax decreased from 52.46 ± 4.82 and 51.50 ± 3.87 preoperatively to 51.30 ± 4.42 and 50.30 ± 3.52 postoperatively, for the C-CXL and A-CXL, respectively (P < .001 for both groups). There was no difference in the simK and Kmax changes between the C-CXL and A-CXL groups (P = .814 and P = .913), visual acuity, and refraction between the 2 groups (P > .05).

Conclusions:

A-CXL with a 20-minute riboflavin/HPMC soaking produced deeper DL and similar corneal haze, topographic, refractive, and visual results to C-CXL with a 30-minute riboflavin/dextran soaking.
Integrated skin microbiome and metabolome analyses reveal altered bacterial community composition and metabolites in psoriasis
Authors: Tao Rong , Wan Zhe , Li Ruo-Yu , Wang Ruo-Jun
Published: October 2023

Objective:

Current theories highlight the role of the microbiome in the pathogenesis of psoriasis. Additionally, abnormal metabolism can alter disease processes in terms of occurrence, progression, and prognosis. Therefore, an integrative microbiome and metabolome analysis of the skin may aid in understanding the disease pathogenesis and identify therapeutic targets for psoriasis.

Methods:

We recruited 22 patients with psoriasis and 22 age- and sex-matched healthy controls. Skin swabs were collected from the participants’ scalps. All samples underwent amplicon sequencing of the ITS1 and V3V4 16S rRNA regions and metabolome analysis.

Results:

The psoriatic lesions were characterized by higher bacterial diversity, significantly higher abundances of Corynebacterium and Staphylococcus, and a lower abundance of Cutibacterium compared with healthy controls. However, no significant alterations in the fungal diversity or fungal taxonomies were detected. Metabolome analysis revealed that prostaglandin-related metabolites, nucleotides, and cysteine- and methionine-related metabolites were significantly enriched in patients with psoriasis, and these metabolites were positively correlated with the disease-associated bacteria Staphylococcus and Corynebacterium.

Conclusions:

We demonstrated significant alterations in the skin microbiome and metabolome in patients with psoriasis compared with healthy controls.
Metabolic signatures in pancreatic ductal adenocarcinoma: diagnostic and therapeutic implications
Authors: Gong Ruining , Hu Yonglu , Yu Qian , Fang Lin , Ren He
Published: October 2023

Pancreatic ductal adenocarcinoma (PDAC) is the prototypical aggressive cancer that develops in nutrient-deficient and hypoxic microenvironment. PDAC overcomes these restrictions by employing unconventional tactics for the procurement and usage of fuel sources. The substantial reprogramming of PDAC cell metabolism is driven by oncogene-mediated cell-autonomous pathways. PDAC cells use glucose, glutamine, and lipids for energy and depend on autophagy and macropinocytosis for survival and growth. They also interact metabolically with non-cancerous cells, aiding tumor progression. Many clinical trials focusing on altered metabolism are ongoing. Understanding the metabolic regulation of PDAC cells will not only help to increase understanding of the mechanisms of disease progression but also provide insights for the development of new diagnostic and therapeutic approaches.
Predictors of Survival After Heart Transplant in the New Allocation System: A UNOS Database Analysis
Authors: Trivedi Jaimin , Pahwa Siddharth , Rabkin David , Gallo Michele , Guglin Maya , Slaughter Mark S. , Abramov Dmitry
Published: October 2023

Clinical predictors of posttransplant graft loss since the United Network for Organ Sharing (UNOS) heart allocation system change have not been well characterized. Single organ adult heart transplants from the UNOS database were identified (n = 10,252) and divided into a test cohort (n = 6,869, 67%) and validation cohort (n = 3,383, 33%). A Cox regression analysis was performed on the test cohort to identify recipient and donor risk factors for posttransplant graft loss. Based on the risk factors, a score (max 16) was developed to classify patients in the validation cohort into risk groups of low (≤1), mid (2–3), high (≥4) risk. Recipient factors of advanced age, Black race, recipient blood group O, diabetes, etiology of heart failure, renal dysfunction, elevated bilirubin, redo-transplantation, elevated pulmonary artery pressure, transplant with a durable ventricular assist device, or transplant on extracorporeal membrane oxygenation (ECMO) or ventilator were associated with more posttransplant graft loss. Donor factors of ischemic time and donor age were also associated with outcomes. One year graft survival for the low-, mid-, high-risk groups was 94%, 91%, and 85%, respectively. In conclusion, easily obtainable clinical characteristics at time of heart transplant can predict posttransplant outcomes in the current era.
Personalized acute kidney injury treatment
Authors: Porschen Christian , Strauss Christian , Meersch Melanie , Zarbock Alexander
Published: October 2023

Purpose of review

Acute kidney injury (AKI) is a complex syndrome that might be induced by different causes and is associated with an increased morbidity and mortality. Therefore, it is a very heterogeneous syndrome and establishing a “one size fits all” treatment approach might not work. This review aims to examine the potential of personalized treatment strategies for AKI.

Recent findings

The traditional diagnosis of AKI is based on changes of serum creatinine and urine output, but these two functional biomarkers have several limitations. Recent research identified different AKI phenotypes based on clinical features, biomarkers, and pathophysiological pathways. Biomarkers, such as Cystatin C, NGAL, TIMP2∗IGFBP7, CCL14, and DKK-3, have shown promise in predicting AKI development, renal recovery, and prognosis. Biomarker-guided interventions, such as the implementation of the KDIGO bundle, have demonstrated an improvement in renal outcomes in specific patient groups.

A personalized approach to AKI treatment as well as research is becoming increasingly important as it allows the identification of distinct AKI phenotypes and the potential for targeted interventions. By utilizing biomarkers and clinical features, physicians might be able to stratify patients into subphenotypes, enabling more individualized treatment strategies. This review highlights the potential of personalized AKI treatment, emphasizing the need for further research and large-scale clinical trials to validate the efficacy of these approaches.
Prevention and management of antibiotic associated acute kidney injury in critically ill patients: new insights
Authors: Karimzadeh Iman , Strader Michael , Kane-Gill Sandra L. , Murray Patrick T.
Published: October 2023

Purpose of review

Drug associated kidney injury (D-AKI) occurs in 19–26% of hospitalized patients and ranks as the third to fifth leading cause of acute kidney injury (AKI) in the intensive care unit (ICU). Given the high use of antimicrobials in the ICU and the emergence of new resistant organisms, the implementation of preventive measures to reduce the incidence of D-AKI has become increasingly important.

Recent findings

Artificial intelligence is showcasing its capabilities in early recognition of at-risk patients for acquiring AKI. Furthermore, novel synthetic medications and formulations have demonstrated reduced nephrotoxicity compared to their traditional counterparts in animal models and/or limited clinical evaluations, offering promise in the prevention of D-AKI. Nephroprotective antioxidant agents have had limited translation from animal studies to clinical practice. The control of modifiable risk factors remains pivotal in avoiding D-AKI.

The use of both old and new antimicrobials is increasingly important in combating the rise of resistant organisms. Advances in technology, such as artificial intelligence, and alternative formulations of traditional antimicrobials offer promise in reducing the incidence of D-AKI, while antioxidant medications may aid in minimizing nephrotoxicity. However, maintaining haemodynamic stability using isotonic fluids, drug monitoring, and reducing nephrotoxic burden combined with vigilant antimicrobial stewardship remain the core preventive measures for mitigating D-AKI while optimizing effective antimicrobial therapy.
Revisiting the promise, practice and progress of resuscitative endovascular balloon occlusion of the aorta
Authors: Marsden Max , Lendrum Robert , Davenport Ross
Published: October 2023

Purpose of review

The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) to temporarily control bleeding and improve central perfusion in critically injured trauma patients remains a controversial topic. In the last decade, select trauma services around the world have gained experience with REBOA. We discuss the recent observational data together with the initial results of the first randomized control trial and provide a view on the next steps for REBOA in trauma resuscitation.

Recent findings

While the observational data continue to be conflicting, the first randomized control trial signals that in the UK, in-hospital REBOA is associated with harm. Likely a result of delays to haemorrhage control, views are again split on whether to abandon complex interventions in bleeding trauma patients and to only prioritize transfer to the operating room or to push REBOA earlier into the post injury phase, recognizing that some patients will not survive without intervention.

Better understanding of cardiac shock physiology provides a new lens in which to evaluate REBOA through. Patient selection remains a huge challenge. Invasive blood pressure monitoring, combined with machine learning aided decision support may assist clinicians and their patients in the future. The use of REBOA should not delay definitive haemorrhage control in those patients without impending cardiac arrest.
Cleft lip and palate risk factors among otorhinolaryngology: Head and neck surgery patients in two hospitals
Authors: Darjazini Nahas Louei , Hmadieh Mariam , Audeh Mayssam , Yousfan Abdulmajeed , Almasri Imad Addin , Martini Nafiza
Published: October 2023

Cleft lip and/or palate is the most prevalent type of head and neck deformity, accounting for 65% of cases. The occurrence of this condition is influenced by both genetic and environmental factors. Cleft defects are classified into 2 types: syndromic cleft lip and palate syndrome and non-syndromic cleft lip and palate syndrome. Cleft lip with or without cleft palate is the most common type of cleft defect, and the surgical repair is the primary treatment option for patients. Our study was a retrospective case–control study that included 132 cases of patients with cleft defects and 132 healthy babies without cleft defects serving as controls. Personal information, including the name, age, and origin of the participants, was collected. Additionally, we collected information on all potential risk factors, including medical history, daily habits, consanguinity between parents, and family history. Information was collected in Excel and analyzed using the Statistical Package for Social Sciences and a Chi-Square test was performed to determine the results and their relationship to cleft lip and palate. Our study identified various risk factors that have a significant association with cleft lip and palate with a P-value <5% in addition to factors that are not considered risk factors. Using relative risk analysis, we were able to rank the top 5 most significant and influential risk factors. The most impactful factor was not taking folic acid during pregnancy. The primary risk factors associated with cleft lip and palate include a family history of the condition, lack of folic acid supplementation, maternal age over 35 years, and high temperatures exceeding 39 °C. Consequently, we recommend that mothers who intend to conceive should take folic acid supplements at a dose of 0.4 to 0.8 mg during the initial trimester of pregnancy. Additionally, we advise careful monitoring of all risk factors, particularly during the first trimester of pregnancy.
Mechanism of Liuwei Dihuang Pills in treating osteoporosis based on network pharmacology
Authors: Wang Xiqoqiang , Li Hongtao , Long Longhai , Song Chao , Chen Rui , Pan Hongyu , Qiu Junjie , Liu Bing , Liu Zongchao
Published: October 2023

Osteoporosis is a prevalent age-related disease that poses a significant public health concern as the population continues to age. While current treatments have shown some therapeutic benefits, their long-term clinical efficacy is limited by a lack of stable curative effects and significant adverse effects. Traditional Chinese Medicine has gained attention due to its positive curative effects and fewer side effects. Liuwei Dihuang Pill has been found to enhance bone mineral density in patients with osteoporosis and rats, but the underlying mechanism is not yet clear. To shed more light on this problem, this study aims to explore the pharmacological mechanism of Liuwei Dihuang Pill in treating osteoporosis using network pharmacology and molecular docking. The findings indicate that Liuwei Dihuang Pills treat osteoporosis through various targets and channels. Specifically, it mainly involves TNF, IL17, and HIF-1 signaling pathways and helps regulate biological processes such as angiogenesis, apoptosis, hypoxia, and gene expression. Furthermore, molecular docking demonstrates excellent binding properties between the drug components and key targets. Therefore, this study offers a theoretical foundation for understanding the pharmacological mechanism and clinical application of Liuwei Dihuang Pills in treating osteoporosis more comprehensively.
Comparative efficacy and safety of Chinese patent medicines of acute ischemic stroke: A network meta-analysis
Authors: Xu Yuan , Cao Shan , Wang Shu-fei , Hou Xin-li , Guo Si-si , Gou Xiao-jun
Published: October 2023

Background:

Acute ischemic stroke (AIS) is characterized by high morbidity, disability, mortality, recurrence, and economic burden. Clinical trials have demonstrated that the clinical efficacy of combining oral Chinese patent medicines (CPMs) with chemical drugs (CDs) is better than that of CDs alone. In this study, we performed a network meta-analysis (NMA) of RCTs to assess the efficacy of different CPMs in combination with CDs in the treatment of AIS.

Methods:

Search 6 databases from the beginning to January 10, 2023. The Cochrane Risk of Bias tool assessed the methodological quality of the included studies. The NMA was then performed using the STATA 13.0 program. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the studied treatments, and cluster analysis was used to compare the effects of CPMs between 2 different outcomes.

Results:

A total of 94 eligible RCTs, involving 9581 participants, were included in this analysis. Nine CPMs, including Nao-mai-li granule (NML), Nao-mai-tai granule (NMT), Qi-long granule (QL), Long-sheng-zhi capsule (LSZ), Nao-xin-tong capsule (NXT), Nao-xue-shu oral liquid (NXS), Tong-xin-luo capsule (TXL), Xiao-shuan-chang-rong capsule (XSCR), and Xue-shuan-xin-mai-ning capsule (XSXMN) were included. Regarding the clinical effective rate, all types of CPMs + CDs treatments were significantly better than CDs treatments alone, with significant differences among the 9 selected CPMs. Compared with CDs, results showed that NXS + CDs performed best in improving clinical effective rate [OR = 4.73; 95% CI: 1.26–17.78; (SUCRA: 76.1%)]. TXL + CDs showed the most effective effect in alleviating National Institutes of Health Stroke Scale (NIHSS) [MD = −3.84; 95% CI: −5.23, −2.45; (SUCRA: 81.6%)]; NXT + CDs were most effective in improving Barthel index [MD = 13.05; 95% CI: 3.98–22.12; (SUCRA: 63.5%)]. Combined with other outcome indicators and the results of cluster analysis, NXS + CDs may assist in the potential optimal treatment regimen for AIS.

Conclusion:

In conclusion, CPMs were found to be beneficial as adjuvant therapy in patients with AIS. Taking into account the clinical effective rate and other outcomes, NXS + CDs may be the most effective option to improve the condition of AIS patients.
A prognostic and immunotherapy effectiveness model for pancreatic adenocarcinoma based on cuproptosis-related lncRNAs signature
Authors: Zhang Ning , Yu Xuehua , Sun Hui , Zhao Yunhong , Wu Jing , Liu Gaifang
Published: October 2023

Pancreatic adenocarcinoma (PAAD) results in one of the deadliest solid tumors with discouraging clinical outcomes. Growing evidence suggests that long non-coding RNAs (lncRNAs) play a crucial role in altering the growth, prognosis, migration, and invasion of pancreatic cancer cells. Cuproptosis is a novel type of cell death induced by copper (Cu) and is associated with mitochondrial respiration during the tricarboxylic acid cycle. However, the relationship between lncRNAs related to cuproptosis and PAAD is poorly studied. In this study, we investigated the association between a signature of cuproptosis-related lncRNAs and the diagnosis of PAAD. Genomic data and clinical information were obtained using the TCGA dataset, while cuproptosis-related genes (CRGs) from previous studies. Co-expression analysis was utilized to identify lncRNAs associated with cuproptosis. We developed and verified a prognostic risk model following a classification of patients into high- and low-risk categories. The prediction capacity of the risk model was assessed using a number of methods including Kaplan–Meier analysis, receiver operating characteristic (ROC) curves, nomograms, and principal component analysis (PCA). Furthermore, differentially expressed genes (DEGs) were used to perform functional enrichment analyses, and to examine the behaviors of various risk groups in terms of immune-related activities and medication sensitivity. We identified 7 cuproptosis-related lncRNA signatures, including CASC19, FAM83A-AS1, AC074099.1, AC007292.2, AC026462.3, AL358944.1, and AC009019.1, as overall survival (OS) predictors. OS and progression-free survival (PFS) showed significant differences among patients in different risk groups. Independent prognostic analysis revealed that the cuproptosis-related lncRNA signatures can independently achieve patient prognosis. The risk model demonstrated strong predictive ability for patient outcomes, as evidenced by ROC curves, nomograms, and PCA. Higher tumor mutation burden (TMB) and lower tumor immune dysfunction and exclusion (TIDE) scores were observed in the high-risk group. Additionally, the low-risk group was hypersensitive to 3 anti-cancer medications, whereas the high-risk group was hypersensitive to one. A prognostic risk model with a good predictive ability based on cuproptosis-related lncRNAs was developed, providing a theoretical basis for personalized treatment and immunotherapeutic responses in pancreatic cancer.
Identification of pyroptosis-related lncRNA subtype and signature predicts the prognosis in bladder cancer
Authors: Zeng Tao , Ye Jianzhong , Wang Heng , Tian Wen
Published: October 2023

Pyroptosis is a new type of programmed cell death involved in all stages of tumorigenesis. Herein, a comprehensive study was conducted to evaluate the prognostic significance of pyroptosis-related lncRNAs in bladder cancer. Consensus clustering analysis was performed to identify the subclusters of bladder cancer. The prognostic pyroptosis-related lncRNA signature was constructed using LASSO Cox regression analysis. Consensus clustering identified 2 clusters of bladder cancer. Interestingly, significant differences in the ESTIMAE score, immune cell infiltration and immune checkpoint expression were obtained between the 2 clusters. A signature consisting of 11 pyroptosis-related lncRNAs was established and it had a good performance in predicting the overall survival rate of bladder cancer, with an AUC of 0.713. Moreover, pyroptosis-related lncRNA signature acted as a risk factor in bladder cancer. Bladder cancer patients with high-risk score had a higher tumor grade and higher clinical stage. A significant correlation was obtained between the risk score and immune cell infiltration. The expression of most checkpoints was higher in bladder cancer patients with high-risk score. A novel pyroptosis-related lncRNA signature was identified with prognostic value for bladder cancer patients. Pyroptosis-related lncRNAs have a potential role in cancer immunology and may serve as prognostic or therapeutic targets in bladder cancer.