bluuebunny/crossref_metadata_2025 huggingface dataset:
Systemic immune inflammatory response index (SIIRI) in acute myocardial infarction
Authors: Muheeb Ghazi , Yusuf Jamal , Mehta Vimal , Faizuddin Md , Kurian Sumod , M. P. Girish , Gupta Mohit Dayal , Safal Safal , Gautam Ankur , Chauhan Narendra Kumar
Published: November 2024

Background

Different treatment approaches exist for non-ST elevation acute coronary syndrome (ACS) patients. This study assessed the systemic immune inflammatory response index (SIIRI) for its prognostic value and incremental clinical utility in determining optimal timing for percutaneous coronary intervention (PCI) in non-ST elevation myocardial infarction (NSTEMI) patients, particularly when troponin levels are initially negative.

Methods

This study included 1270 ACS patients: 437 STEMI, 422 NSTEMI, and 411 unstable angina. Patients were stratified by SIIRI levels measured at admission, and coronary artery disease severity was evaluated using the SYNTAX score. The primary endpoint was major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, stroke, and revascularization. Secondary endpoints encompassed individual MACE components and heart failure hospitalisations.

Results

The mean age was 54.93 years (83% male). SIIRI levels were significantly higher in STEMI patients (6.83 ± 6.43 × 105) compared to NSTEMI (4.5 ± 5.39 × 105) and unstable angina (3.48 ± 2.83 × 105) (P < 0.001). Area under the curve for SIIRI distinguished NSTEMI and unstable angina from STEMI (0.81 and 0.80), with optimal cut-off points of 4.80 × 105 and 4.25 × 105. In NSTEMI, 24.6% presented within 2 h of symptom onset, were troponin-negative, yet had elevated SIIRI. Post-PCI, SIIRI > 4.93 × 105 correlated with increased MACE at 1 year (17.2% vs 5%).

Conclusion

NSTEMI and unstable angina patients with SIIRI values >4.80 × 105 and 4.25 × 105 respectively, may require urgent intervention (<2 h). SIIRI can be of significant utility in patients of NSTEMI who present earlier with negative troponins. SIIRI can also aid in identifying high-risk individuals post-PCI, providing a valuable tool for early and accurate assessment.
Network pharmacology-based study on the mechanism of action of Trollius chinensis capsule in the treatment of upper respiratory tract infection
Authors: Wu Jun , Zhang Hai-Ping , Gao Jing-Wen , Liu Zhi-Feng , Jin Lei
Published: November 2024

Background:

Upper respiratory tract infection (URTI), one of the most common respiratory diseases, has a high annual incidence. Trollius chinensis capsule has been used to treat URTI in China. However, the underlying-mechanisms remain unclear.

Methods:

Network pharmacology was used to explore the potential mechanism of action of Trollius chinensis capsule in URTI treatment. The active compounds in Trollius chinensis were obtained from the TCMSP, SymMap, and ETCM databases. The TCMSP, PubChem, and SwissTargetPrediction databases were used to predict potential targets of Trollius chinensis. URTI-associated targets were gathered from GeneCards and DisGeNET databases. The key targets and signaling pathways associated with URTI were selected by network topology, GO, and KEGG pathway enrichment analysis. Molecular docking was used to verify the binding activity between active compounds and key targets.

Results:

Quercetin, pectolinarigenin, beta-sitosterol, acacetin and cirsimaritin are major active compounds in Trollius chinensis capsule. Eighty one candidate therapeutic targets were confirmed to be involved in protection of Trollius chinensis capsule against URTI. Among them, 7 key targets (TP53, IL6, AKT1, CASP3, CXCL8, MMP9, and EGFR) were verified to have good binding affinities to the main active compounds. Furthermore, enrichment analyses suggested that inflammatory response, virus infection and oxidative stress related biological processes and pathways were possibly the potential mechanism.

Conclusion:

Overall, the present study clarified that quercetin, pectolinarigenin, beta-sitosterol, acacetin and cirsimaritin are proved to be the main effective compounds of Trollius chinensis capsule treating URTI, possibly by acting on the targets of IL6, AKT1, CASP3, CXCL8, MMP9 and EGFR to play anti-infectious, anti-viral, and anti-oxidative effects. This study provides a new understanding of the active compounds and mechanisms of Trollius chinensis capsule in URTI treatment from the perspective of network pharmacology.
Ruptured coronary sinus aneurysm in pregnancy combined with cardiogenic shock and elevated V1 and aVR ST segments: Case report
Authors: Sun Yanhui , Lu Xing , Ma Honglan
Published: November 2024

Introduction:

Sinus of Valsalva aneurysm (SOVA), a rare cardiac malformation, is usually congenital and rarely acquired and most commonly occurring in the right coronary sinus. The clinical presentation of patients with SOVA varies. It is usually asymptomatic when it has not ruptured, and when it compresses neighboring structures or ruptures, it can lead to heart failure or shock, at which point urgent surgical intervention is usually required. Rupture of the sinus of Valsalva aneurysm (RSOVA) during pregnancy is really hard to come by, especially if the clinical presentations resemble that of an acute myocardial infarction. This report describes a pregnant woman with severe chest pain and hypotension with aVR and V1 ST-segment elevation due to RSOVA.

Patient concerns:

Effects of RSOVA on the fetus, disease survival, and prognosis.

Diagnosis:

RSOVA.

Interventions:

Open SOVA repair.

Outcomes:

The patient’s blood pressure returned to normal range and clinical symptoms disappeared after the surgery. After 3 months of follow-up, the patient was hemodynamically stable without chest discomfort, and an echocardiogram showed a normal aortic sinus.

Conclusion:

Progressive aneurysm dilatation or rupture has a poor prognosis. A thorough history and physical examination are fundamental, with echocardiography being the initial diagnostic tool of choice, and other ancillary tests (e.g., computed tomography) being used to complement and confirm the diagnosis. Surgery remains the current treatment of choice for patients with RSOVA, while the continuation of pregnancy in pregnant patients with RSOVA remains a case-by-case measure.
Evaluation of diagnostic value and Mendelian randomization study of appendicitis hub genes obtained by WGCNA analysis
Authors: Li Lian-Shuo , Tong Yue , Yuan Chao , Zhang Wei
Published: November 2024

The timely and precise diagnosis of appendicitis was deemed essential. This study sought to examine the diagnostic significance of hub genes linked to appendicitis and to delve deeper into the pathophysiology of the condition. Differential gene expression analysis revealed distinct genes in the appendicitis group compared to other abdominal pain group, while weighted gene co-expression network analysis identified appendicitis-associated modules. Further analysis of common genes was conducted using Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analysis. The diagnostic efficiency of hub genes was explored through the use of nomograms and receiver operator characteristic curves. Additionally, immunoinfiltration analysis was performed to investigate the immune cell infiltration in both groups. The causal relationship between hub genes and appendicitis, as well as gut microbiota and appendicitis, was ultimately examined through Mendelian randomization. By conducting differential expression analysis and weighted gene co-expression network analysis, a total of 757 common genes were identified. Subsequent Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment analyses revealed that these common genes were primarily associated with positive regulation of cell adhesion, focal adhesion, protein serine kinase activity, and amyotrophic lateral sclerosis. Utilizing Cytoscape software, the top 10 genes with the highest degree of interaction were identified as RPS3A, RPSA, RPL5, RPL37A, RPS27L, FLT3LG, ARL6IP1, RPL32, MRPL3, and GSPT1. Evaluation using nomograms and receiver operator characteristic curves demonstrated the diagnostic value of these hub genes. Ultimately, a causal relationship between hub genes and appendicitis was not identified in our study. Nevertheless, our findings indicate that appendicitis is correlated with 9 gut microbiota. This study identified 5 hub genes, specifically HSP90AA1, RPL5, MYC, CD44, and RPS3A, which exhibit diagnostic significance of appendicitis. Furthermore, the elucidation of these hub genes aids in enhancing our comprehension of the molecular pathways implicated in the development of appendicitis.
Clinical and genetic features of Fanconi anemia associated with a variant of FANCA gene: Case report and literature review
Authors: Zhong Lin , Zhang Wenhua , Zhang Kaihui , Li Chan , Mu Xiao , Chu Yan , Gai Zhongtao , Wei Haiyun
Published: November 2024

Rationale:

Fanconi anemia (FA) is a hereditary disease caused by mutations in the genes involved in the DNA damage repair pathway. The FANCA gene is the most commonly pathogenic gene, accounting for more than 60% of all causative genes.

Patient concerns:

The clinical case is a 3-year-old boy showed mild anemia and scattered bleeding spots the size of a needle tip all over his body.

Diagnoses:

Compound heterozygous mutation was identified in the FANCA gene in the FA case: c.1A > T from the father in exon 1; the deletion of chr16: 89857810-89858476 (exon13-14 del) from the mother; finally, the patient was diagnosed as Fanconi anemia.

Intervention:

After diagnosis, the child received chemotherapy (Ara-C + Flu + Cy + ATG). Then, the hematopoietic stem cell transplantation and unrelated umbilical cord blood transfusion were performed.

Outcomes:

The child is recovering well and is in regular follow-up.

Conclusion and Lessons:

The discovery of new mutations in the FANCA gene enriches the genetic profile of FA and helps clinicians to further understand this disease and guide genetic counseling and prenatal diagnosis. Whole-exome sequencing is a powerful tool for diagnosing FA.
Clinical model to predict the risk of nonalcoholic fatty liver disease: A secondary analysis of data from a cross-sectional study
Authors: Yang Bo , Zhong Xiang
Published: November 2024

This study aimed to develop and validate a clinical model for predicting the risk of nonalcoholic fatty liver disease (NAFLD) by using data from a cross-sectional study. This investigation utilized data from the Dryad database and employed multivariable logistic regression analysis, restricted cubic spline, and nomogram analysis to achieve comprehensive insights. The discrimination and calibration of the nomogram were evaluated using the receiver operating characteristic curve and calibration plot. A total of 1072 patients were included in the study, including 456 with non-NAFLD and 616 with NAFLD. Significant differences were observed in terms of sex, body mass index (BMI), tobacco, hypertension, diabetes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALT/AST ratio, uric acid (UA), fasting blood glucose (FBG), triglyceride (TG), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, and diastolic blood pressure (P < .05 for all comparisons). Multivariable logistic regression analysis indicated that sex, BMI, diabetes, ALT/AST ratio, UA, FBG, and TG were associated with an increased risk of NAFLD. Restricted cubic spline indicated a nonlinear relationship between the risk of NAFLD and variables including ALT/AST ratio, FPG, TG, and UA (P for nonlinearity < .01). The variables in the nomogram included BMI, diabetes, ALT/AST ratio, UA, FBG, and TG. The value of area under the curve was 0.790, indicating that the nomogram prediction model exhibited significant discriminatory accuracy. A reliable clinical model for predicting the risk of NAFLD was developed using readily available clinical data. The model can assist clinicians in identifying individuals with an increased risk of NAFLD, enabling early interventions for preventing and managing this prevalent liver disease.
Causal association between blood metabolites and abdominal aortic calcification: A bidirectional Mendelian randomization study
Authors: Yang Hongwei , Ou Wen , Song Xudong , Chen Aihua
Published: November 2024

Previous studies have reported correlations between metabolic factors and abdominal aortic calcification (AAC). However, the causal relationship between blood metabolites and AAC remains to be fully explored. We employed bidirectional two-sample Mendelian randomization (MR) to investigate the potential causal relationships between 486 blood metabolites and AAC. The inverse variance weighted method was primarily utilized for MR analysis, and the MR-Egger, weighted median, and Robust Adjusted Profile Score methods were used for supplementary analysis. Sensitivity analyses were conducted using Radial MR, MR-PRESSO, Cochran Q test, MR-Egger intercept, and leave-one-out analysis to evaluate the heterogeneity and pleiotropy. Furthermore, the Steiger test and linkage disequilibrium score regression were used to assess genetic correlation and directionality. Multivariable MR analysis was performed to evaluate the direct effect of metabolites on AAC. Through rigorous screening, we identified 6 metabolites with presumed causal effects on AAC: 4-methyl-2-oxopentanoate (effect size [ES] 0.46, 95% confidence interval [CI]: 0.10–0.82), erythrose (ES −0.35, 95% CI: −0.59 to −0.11), 10-undecenoate (11:1n1) (ES 0.14, 95% CI: 0.03–0.25), 1-myristoylglycerophosphocholine (ES 0.31, 95% CI: 0.11–0.50), glycerol 2-phosphate (ES 0.20, 95% CI: 0.04–0.37), and the unidentified metabolite X-11469 (ES 0.19, 95% CI: 0.08–0.30). Multivariable MR analysis revealed that genetically predicted erythrose, 10-undecenoate, 1-myristoylglycerophosphocholine, and X-11469 could directly affect AAC independent of other metabolites. Reverse MR analysis revealed an alteration in 12 blood metabolites due to AAC, including caffeine, 1,7-dimethylurate, arachidonic acid, and 1-arachidonoylglycerophosphocholine. This study provides evidence supporting a causal relationship between metabolites and AAC. These findings help elucidate the underlying biological mechanisms of AAC and may offer insights into screening, prevention, and treatment approaches.
Depression with comorbid juvenile-onset fibromyalgia syndrome novel treatment plan using interpersonal psychotherapy: A case report
Authors: Alkhawashki Samah H. , Algarzae Norah
Published: November 2024

Background:

Fibromyalgia syndrome (FMS) affects 2% to 4% of people, with increasing prevalence in Saudi Arabia reaching 13.4%. FMS can occur in adolescents, known as juvenile-onset fibromyalgia (JFM) with comorbidities including depression, anxiety, and psychological stress. Our patient presented to the child and adolescent psychiatry clinic at King Saud University Hospital Medical City. A year before coming to our clinic, at the age of 15 she was initially diagnosed with JFM followed by a comorbid persistent depressive disorder.

Methods:

As a novel treatment method, a combination treatment approach was used, including a pharmacological intervention with Duloxetine, and a non-pharmacological intervention with interpersonal psychotherapy for adolescents. She completed 16 weeks of therapy while monitoring for duloxetine response and side effects.

Results:

Depressive symptoms were in remission by treatment’s end and continued to be in her first month posttreatment follow-up, and the FMS symptoms were also controlled.

Conclusion:

Our present case highlights a combined approach to treat depression and JFM in adolescents as a novel intervention method thus we strongly recommend utilizing it for similar cases.
A large forearm subcutaneous hematoma after contrast extravasation requires surgical managements: A case report
Authors: Wu Chunqiao , Jin Zhexia , Yang Yongmei
Published: November 2024

Rationale:

Large extremity hematoma can rarely happen after contrast extravasation during a contrast-enhanced computed tomography scan. Some hematomas need prompt surgical managements.

Patient concerns:

A 77-year-old man had acute ischemic stroke and received the thrombolytic and antiplatelet therapies. He had a contrast extravasation during the computed tomography scan and developed a large hematoma in the right forearm, despite without evidence of compartment syndrome.

Diagnosis:

Right forearm hematoma, status post contrast extravasation.

Interventions:

The patient responded poorly to the routine care with arm elevation, cold pack, and wet dressing, and was finally treated by the surgical debridement, vacuum sealing drainage, fascioplasty, and skin flap repair.

Outcomes:

Right forearm wound healed with a scar.

Lessons:

Large extremity hematoma can happen after contrast extravasation during computed tomography scan, which may require surgical treatments. Careful preparation, close monitor, and prompt managements should be applied in high-risk patients.
Lung and bone metastases patterns in Ewing sarcoma: Chemotherapy improves overall survival
Authors: Liu Binbin , Tang Liyuan
Published: November 2024

Ewing sarcoma (ES) is a small round cell malignancy, mainly in the bone tissue, followed by the soft tissue. Lung metastases (LM) and bone metastases (BM) are the most common types of metastases. From 2010 to 2018, the Surveillance, Epidemiology, and End Results database diagnosed 242 cases of ES with LM, 186 cases of ES with BM, and 74 cases of ES with LM and BM. Univariate and multivariate logistic regression analyses were used to determine the risk factors for LM and/or BM, and Kaplan–Meier curves and Cox regression analysis were used to determine the prognostic factors for LM and/or BM. Tumor size ≥50 mm, N1 stage, BM, liver metastases, and surgical treatment were significantly correlated with LM; tumor size >100 mm, brain metastases, LM, surgical treatment, and chemotherapy were significantly correlated with BM; female, N1 stage, brain metastases, liver metastases, and surgical treatment were significantly correlated with LM and BM. Older age, BM, higher T stage, no surgical treatment, and no chemotherapy were harmful to the survival of ES patients with LM; older age, female, LM, and no chemotherapy were harmful to the survival of ES patients with BM; older age and no chemotherapy were harmful to the survival of ES patients with LM and BM. Larger tumor size, N1 stages, and organ metastases were significantly associated with ES patients with LM and/or BM. Chemotherapy is effective in improving the survival.
Global trends in acupuncture research: A scientometric analysis from 1980 to 2023
Authors: Öztekin Coşkun , Öztekin Aynure
Published: November 2024

The objective of this study was to examine articles on acupuncture from past to present, revealing prevalent research trends, showcasing global productivity, identifying international collaborations, and highlighting influential publications and journals in the field. We acquired a comprehensive dataset comprising 9340 articles pertaining to acupuncture that were published within the time frame spanning from 1980 to 2023. These articles were sourced from the Web of Science and underwent rigorous analysis through a diverse set of bibliometric techniques. Our analytical approaches encompassed trend keyword analysis, thematic evolution analysis, conceptual structure analysis, factor analysis, citation and co-citation analyses, as well as an exploration of international collaboration patterns. The 3 most productive countries were China (n = 3357), the USA (n = 1351), and South Korea (n = 814). The 3 most productive journals were Acupuncture in Medicine (n = 440), Evidence Based Complementary and Alternative Medicine (n = 415), and Medical Acupuncture (n = 400). The 3 journals with the highest h-index on acupuncture were the Journal of Alternative and Complementary Medicine (h = 45), Pain (h = 41), and the American Journal of Chinese Medicine (h = 35). The most active author was Park Hi-Joon (n = 128). According to the findings of the factor analysis, acupuncture literature was grouped around 3 main subfactors. The primary factor encompassed topics related to the effectiveness/applicability of the treatment method for various medical conditions and general principles of acupuncture methods and points. The second factor covered topics related to mental health and quality of life. The third subfactor addressed the qualitative and quantitative analysis direction of acupuncture, such as meta-analysis and systematic reviews, and randomized controlled trials. From the past to the present, the most extensively researched main topics in acupuncture literature have covered a wide range of subjects. Prominent themes among these topics included acupuncture methods and applications, pain management, the nervous system and acupuncture, mental health and acupuncture, quality of life, and general health. In recent years, emerging trends in acupuncture research have focused on neurological health issues, oncology and cancer treatment, women’s health and hormonal issues, sleep problems, digestive issues, and studies related to the quantitative and qualitative evaluation of acupuncture research.
Cognitive-behavioral therapy for negative symptoms of schizophrenia: A systematic review and meta-analysis
Authors: Xu Feifei , Xu Sheng
Published: November 2024

Background:

Cognitive-behavioral intervention techniques are increasingly demonstrating their efficacy in preventing relapses and managing problems in patients with schizophrenia. There is still variation in its effectiveness for negative symptoms, such as mood-related symptoms and motivation to engage socially.

Methods:

A systematic search was conducted in PubMed, Web of Science for English literature on cognitive-behavioral therapy (CBT) interventions in patients with schizophrenia. The search included randomized controlled trials and nonrandomized controlled trials. The search period extended from the inception of the databases to September 30, 2022. Two researchers independently performed quality assessment and data extraction based on predefined inclusion and exclusion criteria.

Results:

Discrepancies were resolved through discussion or consultation with a third researcher. Initially, 169 articles were retrieved through database searches and other means. After applying the inclusion and exclusion criteria, 10 randomized controlled studies were included in the final analysis. The intervention group comprised a total of 680 patients with schizophrenia, while the control group included 686 patients with schizophrenia. Meta-analysis results demonstrated a statistically significant difference in negative symptom reduction between the CBT intervention group (WMD = −1.19, 95% CI [−1.73, −0.66], P < .0001) and the control group.

Conclusion:

We have analyzed the effectiveness of CBT based on our previous research, CBT was found to effectively improve negative symptoms in individuals diagnosed with schizophrenia.
Association of daily selenium intake and glaucoma: A cross-sectional study
Authors: Zhao Rumin , Liu Tianwei , Zhao Bojun
Published: November 2024

The association between dietary selenium intake and glaucoma remains unclear. Using data from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES), this study aimed to investigate the relationship between glaucoma and dietary selenium intake. The study included subjects aged 40 years or older who participated in the NHANES dietary intake interview and vision health questionnaire. Diagnosis of glaucoma based on self-reporting or fundus imaging. To investigate the relationship between daily selenium consumption and glaucoma, logistic regression analyses were employed. The potential linear relationship was found using smooth curve fitting. Subgroup analyses were also used. We found higher dietary selenium intake was associated with an increased risk of glaucoma (odds ratio, 1.39; 95% confidence intervals,1.07–1.81) on multivariable analysis. A linear association was found between dietary selenium intake and the occurrence of glaucoma in this population (P
non-linearity = 0.951). Subgroup analyses showed a stable correlation between dietary selenium intake and the occurrence of glaucoma (all P for interaction > .05).This is the first study to look at the connection between dietary selenium intake and glaucoma based on the data from the 2005 to 2008 NHANES. Our findings suggested that dietary selenium intake maybe positively correlated with the risk of glaucoma in adults older than 40 years old. To find out the potential relationship between dietary selenium intake and glaucoma, More longitudinal studies are required.
Risk of malignancy in thyroid nodules with increased 11C-Choline uptake detected incidentally on PET/CT: A diagnostic accuracy study
Authors: Frota Lima Livia Maria , Bogsrud Trond Velde , Gharib Hossein , Ryder Mabel , Johnson Geoffrey , Durski Jolanta
Published: November 2024

Purpose:

The purpose was to evaluate the pathological nature of focal thyroid uptake seen in 11C-Choline PET/CT performed for prostate cancer.

Material and methods:

The study was IRB-approved. All 11C-Choline PET/CT exam reports for studies performed between January 01, 2018, and July 30, 2021, in male patients with prostate cancer in our institution were retrospectively reviewed. Exams with “focal thyroid uptake” on their final report were selected. Patients with surgery or ablation in the thyroid prior to the PET/CT, proven parathyroid adenomas or absent thyroid ultrasound were excluded. Repeated PET/CT exams of same patient were excluded. PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value (SUVmax) of the focal thyroid uptake. Available thyroid ultrasound images, cytology and pathology reports were reviewed. Statistical analyses were performed.

Results:

Out of 10,047 sequential 11C-Choline PET/CT studies, 318 reports included “focal thyroid uptake.” About 128 of these studies were repeat exams and were excluded. Additional 87 patients were excluded, because the uptake was determined to be adjacent, rather than confined to the thyroid gland. Out of the remaining 103 patients, 74 patients had focal thyroid uptake and concurrent thyroid sonographic evaluation. Out of the 74 focal uptakes evaluated with ultrasound, 21 were presumed benign thyroid nodules based on the ultrasound and 53 had further evaluation with biopsy. Sixty three nodules were benign (21 presumed benign on ultrasound and 42 cytology or surgical pathology-proven), 9 nodules were malignant and 2 remained indeterminate. There was no significant difference between the SUVs of the benign and malignant groups (P > .3).

Conclusion:

In this retrospective study of patients with prostate cancer who underwent 11C-Choline PET/CT, we identified a group of patients who underwent thyroid ultrasound for incidental finding of focal 11C-Choline thyroid uptake. Incidence of malignancy in this group was 12%. Therefore, further investigation with ultrasound and possibly ultrasound-guided biopsy may be warranted when a choline avid thyroid nodule is found incidentally on choline PET.
Midline Catheter-Associated Thrombosis (MCAT)
Authors: Schechter Max S. , Baron Sarah W. , Gohari Arash , Southern William N. , Galen Benjamin T.
Published: November 2024

Midline catheters, used for short- and intermediate-term venous access, are recommended to be placed with the tip in an upper arm vein rather than more proximally, in the axillary vein. Despite guidelines recommending against proximal location of the midline catheter tip, the impact of midline catheter tip location on midline catheter-associated thrombosis (MCAT) risk is unclear. Using a retrospective cohort of hospitalized patients who not only had a midline catheter but also had a chest x-ray and venous duplex performed, the authors evaluated whether axillary vein tip location increased the risk of MCAT. Of the 41 midline catheters with tips located in an arm vein, 17 (41.5%) resulted in a thrombus versus 7 (38.9%) of the 18 midline catheters with tips located in the axillary vein. When compared to midline catheter tips located in an arm vein, midline catheter tips located in the axillary vein were not significantly more likely to result in MCAT in unadjusted analysis (odds ratio [OR] = 0.90 [95% CI, 0.29–2.79], P = .85) or adjusted analysis (OR = 0.62 [95% CI, 0.18–2.12], P = .45). These findings support emerging evidence that there does not appear to be an increased risk of MCAT in midlines with an axillary vein tip location. The practice of avoiding the axillary vein for midline catheter tip placement should be reconsidered.
Complications Related to the Securement Device in Peripheral Intravenous Catheters
Authors: Ferraz-Torres Marta , Sancho-Sena Elena , Corcuera-Martinez María Inés , Martinez-Garcia Oscar , Suarez-Mier María Belén
Published: November 2024

Studies have not demonstrated the effectiveness of the different types of dressings in reducing the rate of complications. The purpose of this study was to determine which type of dressing is most beneficial in reducing the rate of complications. A total of 281 patients requiring a peripheral intravenous catheter were randomized to receive partially reinforced dressings or fully reinforced dressings (dressings with integral catheter securement). Patients were followed throughout their entire catheter course, and complications included infection, occlusion, phlebitis, accidental dislodgement, extravasation, and medical adhesive-related skin injury. Catheter outcome data were compared to determine whether statistically significant differences existed between the 2 groups. The groups had equivalent demographic characteristics and catheter indications. The average securement time with partially reinforced dressings was 2.72 days, and that for fully reinforced dressings was 2.64 days. However, catheters secured with fully reinforced dressings were associated with fewer total complications, such as infectious phlebitis (P = .043) and accidental dislodgement (P = .03). The fully reinforced securement device significantly reduced the rate of complications related to accidental dislodgement of the device and cases of infectious phlebitis. The use of fully reinforced dressings could reduce catheter-associated complications and improve the quality of patient care.
Impact of Severe Obesity on Major Perioperative Complications for Prolapse Surgery
Authors: Kisby Cassandra K. , Vermunt Jane , Maciejko Laura A. , Abd El Aziz Mohamed A. , Perry William , Occhino John A.
Published: November 2024

(Abstracted from Urogynecology 2024;30:658–664)

Discussions surrounding surgical approach and minimizing complications and perioperative risks are necessary for many surgeries. Obesity introduces additional variables and risks that need to be discussed in making decisions about pelvic reconstructive surgery, particularly because it is associated with comorbidities such as diabetes, cardiovascular disease, chronic kidney disease, and others.
Evaluation of Postoperative Outcomes Following Early and Late Palate Repair: A Preclinical Study
Authors: Aellos Fabiana , Verma Ishita , Ly Melody , Hoy Mackenzie , Quach Tom , Rosbander Isabel , Sandoval Alejandro , Wolvis Eppo , Turkkahraman Hakan , Helms Jill A.
Published: November 2024

Objective:

To quantitatively assess the impact of early versus late surgical intervention on midfacial growth using a mouse model.

Methods:

A full-thickness mucoperiosteal flap surgery was performed on newborn (P17) mice and on neonatal (P30) mice. High-resolution micro–computed tomographic imaging coupled with histomorphometric analyses was used to assess craniomaxillofacial growth. Histology and immunohistochemical analyses were used to assess cellular and molecular responses postsurgery.

Results:

Early surgical intervention at P17 resulted in significant midfacial growth arrest, with pronounced maxillary hypoplasia. Histomorphometric analyses revealed significant (P < 0.05) growth disruptions in the mid-palatal suture complex, including premature removal of the cartilaginous growth plate and its replacement by bone. In the suture itself, cell proliferation was significantly reduced (P < 0.05) compared with controls. The same surgical intervention performed in mice at P30 did not lead to significant midfacial growth arrest.

Conclusions:

Early surgical intervention in a mouse model mirrors the adverse growth outcomes in children undergoing early cleft repair. Molecular and cellular observations accompanying this midfacial growth arrest may inform therapeutic strategies to mitigate midfacial growth disturbances in patients and highlight the need for refined surgical techniques to minimize adverse growth outcomes.
Current management of acute appendicitis in adults: What you need to know
Authors: Diaz Jose J. , Ceresoli Marco , Herron Thomas , Coccolini Federico
Published: November 2024

Acute appendicitis is one of the most common acute surgical diseases in the world today. Acute appendicitis can present with a well-recognized clinical presentation with abdominal pain which localize in the right lower quadrant. This presentation is more typical in men than in women of child baring age. Several clinical and laboratory calculations can be used to increase the likelihood of making a correct diagnosis. Various imaging modalities can be used to make the diagnosis which include ultrasound, computer tomography, and magnetic resonance imaging. Each study has well known sensitivity/specificity of positive predictive value of making the diagnosis of appendicitis. The management of acute appendicitis is based on the presentation of the patient and dividing it into uncomplicated and complicated disease. Each requires management with antibiotics and followed with timely appendectomy. Recent studies have demonstrated nonoperative management of uncomplicated appendicitis without no fecalith that can be managed with antibiotics alone. Complicated acute appendicitis should undergo timely surgical intervention. Patients presenting with a large appendiceal abscess or phlegmon should undergo percutaneous drainage and antibiotic management. There are certain patient populations that should be considered for surgical intervention. Pregnant patients as well as immunosuppressed patients should undergo timely surgical intervention to decrease the risk of complications. This review outlines the current principles of the diagnosis, imaging, and treatment of acute appendicitis based on the best available evidence of acute appendicitis in adults.
Omitting Radiotherapy after Breast-Conserving Surgery in Luminal A Breast Cancer: The LUMINA Study
Authors: Laws Alison , Brackstone Muriel , Quan May Lynn
Published: November 2024

The modern generation of trials evaluating the role of adjuvant radiation have turned to genomic profiling as a further risk stratification tool. The LUMINA trial by Whelan and colleagues, published in the New England Journal of Medicine, applied Ki67 testing to identify those with luminal A disease and evaluated locoregional outcomes with breast-conserving surgery and endocrine therapy alone. This article was reviewed at the Canadian Association of General Surgeons’ “Evidence-Based Reviews in Surgery” webinar series. Here, we present the Evidence-Based Reviews in Surgery panel’s methodologic review and clinical commentary. The LUMINA study demonstrated very low rates of local recurrence in low-risk patients with luminal A biologic subtype treated with breast-conserving surgery and endocrine therapy alone without radiation. Although the LUMINA study was rigorously designed and executed, there are significant pragmatic limitations to the implementation of the proposed approach using their protocol. We advocate that there is no “one-size-fits-all” approach to early estrogen receptor+ breast cancer. The choice of treatment strategy should strongly consider patient goals and preferences, with the need for incorporation of quality of life and patient-reported endpoints into future studies evaluating this population to help guide these nuanced decisions.
Fisheries-induced life-history changes recover in experimentally harvested fish populations
Authors: van Dijk Stephan N. , Sadler Daniel E. , Watts Phillip C. , Uusi-Heikkilä Silva
Published: November 2024

Overfishing is one of the greatest threats to fish populations. Size-selective harvesting favours faster juvenile growth, younger maturation, small adult body size and low reproductive output. Such changes might be slow to recover and ultimately threaten population fitness and survival. To study the recovery potential of exploited experimental populations, we compared life-history traits in three differently size-selected experimental lines (large-selected, small-selected and random-selected) after five generations of harvesting and 10 subsequent generations of recovery (i.e. cessation of harvesting). We show that after a recovery period twice as long as the harvesting period, the differences in adult body size among the selection lines have eroded. While there was still a significant body size difference among the selection lines, this did not translate to differences in reproductive success. Although size-selective harvesting causes phenotypic changes in exploited fish populations, we show that such changes are reversible if the recovery period is long enough.
Quantifying Functional Conservation of Human and Mouse Regulatory Elements via FUNCODE
Authors: Fang Weixiang , Chen Chaoran , Zhang Boyang , Wang Yi , Zhao Ruzhang , Zhou Weiqiang , Ji Hongkai
Published: November 2024

Evolutionary conservation is crucial for understanding genome functions and lays the foundation for using animal models in studying human diseases. However, conventional conservation scores based on DNA sequence evolution do not capture the dynamic biochemical activities of DNA elements, termed functional conservation. Quantifying functional conservation has been limited by the availability of functional genomic data matched across species. To address this, we developed FUNCODE, a framework for characterizing functional conservation throughin silicosample matching. Applying FUNCODE to 2,595 uniformly processed datasets from the Encyclopedia of DNA Elements (ENCODE), we generated genome-wide FUNCODE scores for human and mouse regulatory elements, identifying 3.3 million functionally conserved human-mouse element pairs. We demonstrate FUNCODE’s diverse applications, including annotating 78,501 novel regulatory elements, transferring 37,968 high-resolution human ENCODE Hi-C loops in immune lineages to mice, identifying conserved functional signals for disease modeling, and enhancing cross-species integration of single-cell omics data.
DNA-SaM, a robust system for large-scale data storage
Authors: Huang Xiaoluo , Wang Yu , Xu Jiaxin , Nie Ziang , Huang Jiaquan , Wu Yaxin , Qin Zhiwei , Dai Junbiao , Wang Yang
Published: November 2024

DNA data storage offers a viable strategy to address the impending data explosion. Early attempts to harness DNA as a storage medium have encountered scalability limitations, largely due to the complexity of codec algorithms, the generation of biochemically harmful sequences and lack of a robust architecture. We present “DNA-SaM”, a novel system designed for DNA data storage, which achieves linear computational complexity and strict bio-constraint adherence, ensuring high coding efficiency and fidelity. It encoded data at speeds surpassing classic systems by over 2 orders of magnitude, with this superiority changes across various encoding algorithms. Importantly, DNA-SaM effectively eliminates any sequence that could be deleterious toin vitroandin vivobiochemical processes, including homopolymer runs, tandem repeat motifs, and potential promoter sequences,etc. It also involves an advanced DNA data storage architecture that incorporates a two-tiered indexing system and a novel “storage unit” distribution paradigm for large-scale data storage. It is further validated by practical data storage bothin vitroandin vivowith a 100% success rate. Our system is capable of storing data over 1039PB, which marks a critical advancement in the scalability of DNA-based data storage.
Natural variation of the streptococcal Group A carbohydrate biosynthesis genes impacts host-pathogen interaction
Authors: Tamminga Sara M. , Schipper Kim , Murner Nicholas , Davies Matthew , Berkhout Paul , Bessen Debra E. , Hendriks Astrid , Korotkova Natalia , Pannekoek Yvonne , van Sorge Nina M.
Published: November 2024

Streptococcus pyogenes(S. pyogenes) is a leading cause of infection-related mortality in humans globally. The characteristic cell wall-anchored Group A Carbohydrate (GAC) is expressed by allS. pyogenesstrains and consists of a polyrhamnose backbone with alternatingN-acetylglucosamine (GlcNAc) side chains, of which 25% are decorated with glycerol phosphate (GroP). The genes in thegacA-Lcluster are critical for GAC biosynthesis withgacI-Lbeing responsible for the characteristic GlcNAc-GroP decoration, which confers the agglutination in rapid test diagnostic assays and contributes toS. pyogenespathogenicity. Seminal research papers describedS. pyogenesisolates, so-called A-variant strains, that lost the characteristic GlcNAc side chain following serial animal passage. We performed genomic analysis of a single viable historic parent/A-variant strain pair to reveal a premature inactivating stop codon ingacI, explaining the described loss of the GlcNAc side chain. Subsequently, we analyzed the genetic variation of the 12gacA-Lgenes in a collection of 2,044S. pyogenesgenome sequences. Although allgacgenes (gacA-L) displayed genetic variation, we only identified 31 isolates (1.5%) with a premature stop codon in one of thegacgenes. Nearly 40% of these isolates contained a premature stop codon ingacH. To study the functional consequences of the different premature stop codons for GacH function, we plasmid-expressed threegacHvariants in aS. pyogenes gacH-deficient strain. Cell wall analysis confirmed GacH loss-of-function through the significant reduction of GroP. Complementary, we showed that strains expressinggacHloss-of-function variants were completely resistant to the human bactericidal enzyme group IIA-secreted phospholipase. Overall, our data provide a comprehensive overview of the genetic variation of thegacA-Lgene cluster in a global population ofS. pyogenesstrains and the functional consequences ofgacHvariation for immune recognition and clearance.

Data summary

AllS. pyogenesgenome sequences used for this analysis are available within the publication by Davieset al. (2019), ‘Atlas of group A streptococcal vaccine candidates compiled using large-scale comparative genomics’ Nature Genetics, 51(6):1035-43
A model, mixed-species urinary catheter biofilm derived from spinal cord injury patients
Authors: Noorian Parisa , Hamann Kailey , Hoque M. Mozammel , Espinoza-Vergara Gustavo , To Joyce , Leo Dominic , Chari Priyadarshini , Weber Gerard , Marial Obaydullah , Pryor Julie , Duggin Iain G. , Lee Bonsan Bonne , Rice Scott A. , McDougald Diane
Published: November 2024

Complex multispecies biofilms consistently colonise the interior of indwelling urinary catheters, causing persistent asymptomatic bacteriuria and frequent symptomatic episodes in long-term catheterized individuals. Simple single-species models often fail to capture the complexities of mixed-species interactions, leading to limited conclusions about microbial behaviour and treatment efficacy. Additionally, using lab-based organisms can obscure the genomic diversity found in real-world infections. The primary objective of this study was to establish a stable and reproduciblein vitrobiofilm model derived from the multi-species clinical flora associated with catheter-related infections, reflecting the dynamics ofin vivoinfections. Biofilm samples from clinical catheters of spinal cord injury (SCI) participants were used to establish polymicrobial macro-fluidic models within catheters. Metagenomic techniques using short-read Illumina and long-read Oxford Nanopore sequencing was used to assess the community composition, produce metagenome-assembled genomes (MAGs), analyse strain-level phylogeny diversity and single nucleotide polymorphisms (SNP) of isolates. Antibiotic resistance tests using our models highlighted the drastic differences between planktonic bacteria, single-species, and multispecies biofilms.In silicoanalysis of antibiotic resistance further revealed a high number of varied resistance genes present in these communities. The models developed and characterised in this study are expected to facilitate more effective strategies to prevent and treat catheter-associated infections.
Multi-Omics Single-Cell Analysis Reveals Key Regulators of HIV-1 Persistence and Aberrant Host Immune Responses in Early Infection
Authors: Lee Dayeon , Choi Sin Young , Shin So-I , An Hyunsu , Choi Byeong-Sun , Park Jihwan
Published: November 2024

The clearance of human immunodeficiency virus-1 (HIV-1) remains a significant public health challenge due to impaired cellular immune responses and HIV-1 maintenance during acute infection. However, the genetic and epigenetic changes influencing the immune response on host infected cells remain unclear. Here, this study analyzes HIV-1 infected CD4+ T cells from peripheral blood mononuclear cells from people living with HIV-1 (PLWH) during early infection (<6 months) using single-cell RNA and ATAC sequencing. It is observed that HIV-1 hinders the antiviral response, particularly by interfering with the interferon signalling pathway. Multimodal analysis identifies KLF2 as a key transcription factor in infected CD4+ T cells. Moreover, cells harbouring HIV-1 provirus are predominantly identified as Th17 cells, which exhibit elevated KLF2 activity. This suggests an increased susceptibility to HIV-1 infection and a constrained immune response due to the quiescent characteristics of these cells. The finding provides insights into the immune mechanisms and key regulators of HIV-1 maintenance in CD4+ T cells during the early stages of infection.
An institutional COVID-19 initiative: creation of a biobank and serological data analysis in pre- and post-vaccination cohorts
Authors: Fernandes-Siqueira Lorena O , Melo Raphael RRA , Wermelinger Luciana S , Almeida Fabio CL , Salmon Didier , Ferreira Gustavo C , Da Poian Andrea T
Published: November 2024

The COVID-19 pandemic has left a legacy in the management of health emergencies, but sentinel surveillance was relatively underused, despite its significant role in decision-making during epidemics. Here we describe a sentinel SARS-CoV-2 antigens’ serosurveillance carried out on a cohort of 395 individuals at a Brazilian institution, from October 2020 to December 2022. A total of 1,507 serum samples were analyzed for IgG and IgA against SARS-CoV-2 Spike (S) or nucleocapsid (N) proteins, in the pre- and post-vaccination periods. The latter included two doses of CoronaVac (group 1, G1), or ChAdOx-1 or BNT162b2 (group 2, G2), followed by heterologous booster doses. In the pre-vaccination phase, 26.5% of participants showed IgG positivity for S and 13.7% for N. After the vaccines’ first dose, S IgG response was positive in 66.6% or 98% of G1 or G2 participants, respectively, while 100% of the participants showed S IgG positivity after the second dose, and S IgG and IgA after the booster. This initiative enabled the examination of viral transmission beyond hospital environments, which is rarely explored in existing literature, and established protocols for managing future emergencies. In addition, a serum bank and a comprehensive database were established, now available to the scientific community.