bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and characterization of a novel Pavlovskyella (Acari: Argasidae) from Chile, parasite of the culpeo fox (Lycalopex culpaeus)
Authors: Muñoz-Leal Sebastián , Kneubehl Alexander R , Ardiles Karen , Parragué-Migone Catalina , Troncoso-Toro Ignacio , Oyarzún-Ruiz Pablo , Lopez Job E
Published: November 2024

Soft ticks (Argasidae) of the subgenus Pavlovskyella Pospelova-Shtrom are worldwide distributed parasites of medical importance. However, the systematics of the subgenus are currently under debate because genetic data shows that the group is paraphyletic. Meanwhile, species of Pavlovskyella continue to be discovered. In this study a novel species of the subgenus is described from specimens collected on a fox in central Chile. The larva of this new species differentiates from other Pavlovskyella spp. by having the following combination of characters: subpyriform dorsal plate; 15 pairs of setae, 7 anterolateral, 3 central, and 5 posterolateral, and hypostome with denticles in the distal third. Nymphs and adults of the species lack cheeks, eyes or bulging structures on the flank, but exhibit dorsoventral grooves, and humps on tarsi I, II, and III. Moreover, a patch of glabrous integument appears on the distal portion of coxal folds. A phylogenetic analysis using the mitogenome indicates a monophyletic group composed by Ornithodoros (Pavlovskyella) brasiliensis Aragão, Ornithodoros (Pavlovskyella) furcosus Neumann, Ornithodoros (Pavlovskyella) improvisus Muñoz-Leal & Venzal, and Ornithodoros (Pavlovskyella) rostratus Aragão. Interestingly, a phylogeny using 18S–28S rDNA sequences shows that South American Pavlovskyella spp. are paraphyletic, as depicted in previous studies. Adding species of the subgenus from the Neotropical region to phylogenetic analyses could aid to solve this paraphyly. Furthermore, this is the fifth species of Pavlovskyella described in South America, and the second in Chile.
Making administrative work matter in public service delivery: a lens for linking practice with the purpose of office
Authors: Karmsteen Kirstine
Published: November 2024

Among the general public as well as in the scientific literature, administrative work is widely associated with heavy bureaucratic procedures that are disconnected from serving clients. Less is said and written about the importance of administrative work in delivering public service. Drawing on a relational theoretical approach and based on an ethnographic field study in two municipal child welfare units in Denmark (including 38 days of observations and 30 interviews), this study shows how administrative work plays three key functions in various accountability relations and that these functions aid street-level bureaucrats in mastering the complexities of their work. The study offers a theoretical framework that delineates the functions of administrative work in complex street-level practice. By demonstrating how administrative work may contribute positively to fulfilling the purposes of street-level work, this study contributes to developing our understanding of administrative work as an invaluable part of street-level work and provides a more nuanced foundation for future studies on the virtues and issues of administrative work.
Pain Psychology for Clinicians
Authors: Cianfrini Leanne R. , Richardson Elizabeth J. , Doleys Daniel
Published: November 2024

Pain Psychology for Clinicians equips general medical providers with core psychological and communication strategies to implement in their care of patients with chronic pain. Given the opioid crisis and its intersection with adequate chronic pain management, there is increasing focus on assisting patients with self-management of their pain through the use of interdisciplinary modalities. However, despite the evidence base for efficacy, pain psychology remains largely relegated to formal interdisciplinary outpatient programs or referral-based private practice settings that may not be available in a provider’s community. This book will present how to briefly and effectively incorporate key concepts from cognitive–behavioral therapy (CBT), acceptance and commitment therapy (ACT), motivational interviewing (MI), and other orientations into any health care setting in order to lessen the frustration of both the patient and provider. Dialogs and vignettes will demonstrate how the provider can use these strategies to foster positive clinical outcomes in difficult contexts, such as patients who are noncompliant or avoidant, who are overly reliant on the physician, who are misusing opioids, and who are depressed or suicidal, angry, or anxious. With the use of these strategies, the provider will garner confidence and enhance the overall atmosphere of clinical practice when assisting patients with chronic pain.
Rewiring of Uric Acid Metabolism in the Intestine Promotes High-Altitude Hypoxia Adaptation in Humans
Authors: Su Qian , Li Yu-Chun , Zhuang Dao-Hua , Liu Xin-Yuan , Gao Han , Li Dong , Chen Yu , Ge Ming-Xia , Han Yi-Ming , Gao Zong-Liang , Yin Fan-Qian , Zhao Long , Zhang Yun-Xia , Yang Li-Qin , Zhao Qin , Luo Yong-Jun , Zhang Zhigang , Kong Qing-Peng
Published: November 2024

Adaptation to high-altitude hypoxia is characterized by systemic and organ-specific metabolic changes. This study investigates whether intestinal metabolic rewiring is a contributing factor to hypoxia adaptation. We conducted a longitudinal analysis over 108 days, with seven time points, examining fecal metabolomic data from a cohort of 46 healthy male adults traveling from Chongqing (a.s.l. 243 m) to Lhasa (a.s.l. 3,658 m) and back. Our findings reveal that short-term hypoxia exposure significantly alters intestinal metabolic pathways, particularly those involving purines, pyrimidines, and amino acids. A notable observation was the significantly reduced level of intestinal uric acid, the end product of purine metabolism, during acclimatization (also called acclimation) and additional two long-term exposed cohorts (Han Chinese and Tibetans) residing in Shigatse, Xizang (a.s.l. 4,700 m), suggesting that low intestinal uric acid levels facilitate adaptation to high-altitude hypoxia. Integrative analyses with gut metagenomic data showed consistent trends in intestinal uric acid levels and the abundance of key uric acid-degrading bacteria, predominantly from the Lachnospiraceae family. The sustained high abundance of these bacteria in the long-term resident cohorts underscores their essential role in maintaining low intestinal uric acid levels. Collectively, these findings suggest that the rewiring of intestinal uric acid metabolism, potentially orchestrated by gut bacteria, is crucial for enhancing human resilience and adaptability in extreme environments.
iModulonDB 2.0: dynamic tools to facilitate knowledge-mining and user-enabled analyses of curated transcriptomic datasets
Authors: Catoiu Edward A , Krishnan Jayanth , Li Gaoyuan , Lou Xuwen A , Rychel Kevin , Yuan Yuan , Bajpe Heera , Patel Arjun , Choe Donghui , Shin Jongoh , Burrows Joshua , Phaneuf Patrick V , Zielinski Daniel C , Palsson Bernhard O
Published: November 2024

iModulons—sets of co-expressed genes identified through independent component analysis (ICA) of high-quality transcriptomic datasets—provide an unbiased, modular view of an organism's transcriptional regulatory network. Established in 2020, iModulonDB (iModulonDB.org) serves as a centralized repository of curated iModulon sets, enabling users to explore iModulons and download the associated transcriptomic data. This update reflects a significant expansion of the database—19 new ICA decompositions (+633%) spanning 8 925 expression profiles (+1370%), 503 studies (+2290%) and 12 additional organisms (+400%)—and introduces new features to help scientists decipher the mechanisms governing prokaryotic transcriptional regulation. To facilitate comprehension of the underlying expression profiles, the updated user-interface displays essential information about each data-generating study (e.g. the experimental conditions and publication abstract). Dashboards now include condition-specific coloring and highlight data generated from genetically perturbed strains, enabling users to rapidly interpret disruptions in transcriptional regulation. New interactive graphs rapidly convey omics-derived indicators (e.g. the explained variance of ICA decompositions, genetic overlap between iModulons and regulons). Direct links to operon diagrams (BioCyc) and protein-protein interaction networks (STRING) provide users with seamless access to external resources for further assessment of iModulons. Lastly, a new suite of search-driven and species-wide analysis tools promotes user-engagement with iModulons, reinforcing iModulonDB’s role as a dynamic, interactive knowledgebase of prokaryotic transcriptional regulation.
A genomic database furnishes minimal functional glycyl-tRNA synthetases homologous to other, designed class II urzymes
Authors: Patra Sourav Kumar , Douglas Jordan , Wills Peter R , Betts Laurie , Qing Tang Guo , Carter Charles W
Published: November 2024

The hypothesis that conserved core catalytic sites could represent ancestral aminoacyl-tRNA synthetases (AARS) drove the design of functional TrpRS, LeuRS, and HisRS ‘urzymes’. We describe here new urzymes detected in the genomic record of the arctic fox, Vulpes lagopus. They are homologous to the α-subunit of bacterial heterotetrameric Class II glycyl-tRNA synthetase (GlyRS-B) enzymes. AlphaFold2 predicted that the N-terminal 81 amino acids would adopt a 3D structure nearly identical to our designed HisRS urzyme (HisCA1). We expressed and purified that N-terminal segment and the spliced open reading frame GlyCA1–2. Both exhibit robust single-turnover burst sizes and ATP consumption rates higher than those previously published for HisCA urzymes and comparable to those for LeuAC and TrpAC. GlyCA is more than twice as active in glycine activation by adenosine triphosphate as the full-length GlyRS-B α2 dimer. Michaelis–Menten rate constants for all three substrates reveal significant coupling between Exon2 and both substrates. GlyCA activation favors Class II amino acids that complement those favored by HisCA and LeuAC. Structural features help explain these results. These minimalist GlyRS catalysts are thus homologous to previously described urzymes. Their properties reinforce the notion that urzymes may have the requisite catalytic activities to implement a reduced, ancestral genetic coding alphabet.
CTR-DB 2.0: an updated cancer clinical transcriptome resource, expanding primary drug resistance and newly adding acquired resistance datasets and enhancing the discovery and validation of predictive biomarkers
Authors: Jiang Jianzhou , Ma Yajie , Yang Lele , Ma Shurui , Yu Zixuan , Ren Xinyi , Kong Xiangya , Zhang Xinlei , Li Dong , Liu Zhongyang
Published: November 2024

Drug resistance is a principal limiting factor in cancer treatment. CTR-DB, the Cancer Treatment Response gene signature DataBase, is the first data resource for clinical transcriptomes with cancer treatment response, and meanwhile supports various data analysis functions, providing insights into the molecular determinants of drug resistance. Here we proposed an upgraded version, CTR-DB 2.0 (http://ctrdb.ncpsb.org.cn). Around 190 up-to-date source datasets with primary resistance information (129% increase compared to version 1.0) and 13 acquired-resistant datasets (a new dataset type), covering 10 856 patient samples (111% increase), 39 cancer types (39% increase) and 346 therapeutic regimens (26% increase), have been collected. In terms of function, for the single dataset analysis and multiple-dataset comparison modules, CTR-DB 2.0 added new gene set enrichment, tumor microenvironment (TME) and signature connectivity analysis functions to help elucidate drug resistance mechanisms and their homogeneity/heterogeneity and discover candidate combinational therapies. Furthermore, biomarker-related functions were greatly extended. CTR-DB 2.0 newly supported the validation of cell types in the TME as predictive biomarkers of treatment response, especially the validation of a combinational biomarker panel and even the direct discovery of the optimal biomarker panel using user-customized CTR-DB patient samples. In addition, the analysis of users’ own datasets, application programming interface and data crowdfunding were also added.
Tumor purity estimated from bulk DNA methylation can be used for adjusting beta values of individual samples to better reflect tumor biology
Authors: Sasiain Iñaki , Nacer Deborah F , Aine Mattias , Veerla Srinivas , Staaf Johan
Published: November 2024

Epigenetic deregulation through altered DNA methylation is a fundamental feature of tumorigenesis, but tumor data from bulk tissue samples contain different proportions of malignant and non-malignant cells that may confound the interpretation of DNA methylation values. The adjustment of DNA methylation data based on tumor purity has been proposed to render both genome-wide and gene-specific analyses more precise, but it requires sample purity estimates. Here we present PureBeta, a single-sample statistical framework that uses genome-wide DNA methylation data to first estimate sample purity and then adjust methylation values of individual CpGs to correct for sample impurity. Purity values estimated with the algorithm have high correlation (>0.8) to reference values obtained from DNA sequencing when applied to samples from breast carcinoma, lung adenocarcinoma, and lung squamous cell carcinoma. Methylation beta values adjusted based on purity estimates have a more binary distribution that better reflects theoretical methylation states, thus facilitating improved biological inference as shown for BRCA1 in breast cancer. PureBeta is a versatile tool that can be used for different Illumina DNA methylation arrays and can be applied to individual samples of different cancer types to enhance biological interpretability of methylation data.
Multidisciplinary management strategies for recurrent brain metastasis after prior radiotherapy: An overview
Authors: Kotecha Rupesh , La Rosa Alonso , Brown Paul D , Vogelbaum Michael A , Navarria Pierina , Bodensohn Raphael , Niyazi Maximilian , Karschnia Philipp , Minniti Giuseppe
Published: November 2024

As cancer patients with intracranial metastatic disease experience increasingly prolonged survival, the diagnosis and management of recurrent brain metastasis pose significant challenges in clinical practice. Prior to deciding upon a management strategy, it is necessary to ascertain whether patients have recurrent/progressive disease vs adverse radiation effect, classify the recurrence as local or distant in the brain, evaluate the extent of intracranial disease (size, number and location of lesions, and brain metastasis velocity), the status of extracranial disease, and enumerate the interval from the last intracranially directed intervention to disease recurrence. A spectrum of salvage local treatment options includes surgery (resection and laser interstitial thermal therapy [LITT]) with or without adjuvant radiotherapy in the forms of external beam radiotherapy, intraoperative radiotherapy, or brachytherapy. Nonoperative salvage local treatments also range from single fraction and fractionated stereotactic radiosurgery (SRS/FSRS) to whole brain radiation therapy (WBRT). Optimal integration of systemic therapies, preferably with central nervous system (CNS) activity, may also require reinterrogation of brain metastasis tissue to identify actionable molecular alterations specific to intracranial progressive disease. Ultimately, the selection of the appropriate management approach necessitates a sophisticated understanding of patient, tumor, and prior treatment-related factors and is often multimodal; hence, interdisciplinary evaluation for such patients is indispensable.
Efficacy of 3D-TSE sequence-based radiosurgery in prolonging time to distant intracranial failure: A session-wise analysis in a histology-diverse patient cohort
Authors: Akdemir Eyub Y , Gurdikyan Selin , Rubens Muni , Abrams Kevin J , Sidani Charif , Chaneles Margaret C , Hall Matthew D , Press Robert H , Wieczorek D Jay , Tolakanahalli Ranjini , Gutierrez Alonso N , Gal Omer , La Rosa Alonso , Kutuk Tugce , McDermott Michael W , Odia Yazmin , Mehta Minesh P , Kotecha Rupesh
Published: November 2024

Background

Stereotactic radiosurgery (SRS) for patients with brain metastases (BM) is associated with a risk of distant intracranial failure (DIF). This study evaluates the impact of integrating dedicated 3D fast/turbo spin echo (3D-TSE) sequences to MPRAGE in BM detection and DIF prolongation in a histology-agnostic patient cohort.

Methods

The study population included adults treated with SRS from February 2019 to January 2024 who underwent MPRAGE alone or dual sequence with the addition of 3D-TSE starting from February 2020. Median times to DIF were estimated using the Kaplan–Meier method.

Results

The 216 study patients who underwent 332 SRS courses for 1456 BM imaged with MPRAGE and 3D-TSE (primary cohort) were compared to a control cohort (92 patients, 135 SRS courses, 462 BM). In the session-wise analysis, the median time to DIF between the cohorts was significantly prolonged in the primary vs. control cohorts (11.4 vs. 6.8 months, P = .029), more pronounced in the subgroups with 1–4 metastases (14.7 vs. 8.1 months, P = .008) and with solitary BM (36.4 vs. 10.9 months, P = .001). While patients relapsing on immunotherapy or targeted therapy did not significantly benefit from 3D-TSE (7.2 vs. 5.7 months, P = .280), those who relapsed on chemotherapy or who were off systemic therapy (including synchronous metastases) exhibited a trend toward longer time to DIF with 3D-TSE integration (14.7 vs. 7.9 months, P = .057).

Conclusions

Implementing 3D-TSE sequences into SRS practice increases BM detection across all patients and translates into clinical relevance by prolonging time to DIF, particularly in those with limited intracranial disease and those not receiving central nervous system-active agents.
Neighborhood disadvantage is associated with treatment access outcomes and survival among individuals with a primary brain tumor
Authors: Stockdill Macy L , Vo Jacqueline B , Celiku Orieta , Kim Yeonju , Karim Zuena , Vera Elizabeth , Miller Hope , Gilbert Mark R , Armstrong Terri S
Published: November 2024

Background

Neighborhood disadvantage is linked to lower rates of healthcare access. To understand how residence affects the primary brain tumor (PBT) population, we assessed neighborhood disadvantage and population density with treatment access outcomes among a cohort of 666 adult participants with a PBT and study entry data in a large observational study at the National Institutes of Health (NIH) (NCT#: NCT02851706).

Methods

We assessed neighborhood disadvantage (measured by the area deprivation index [ADI]) and population density with symptom duration before diagnosis and time to treatment using ordinal logistic and linear regression. Kaplan–Meier survival curves were estimated by population density and ADI, overall and stratified by residential distance to the NIH, tumor grade, and age.

Results

Among 666 participants, 24% lived in more disadvantaged areas. Among the overall sample, there were no associations between ADI or population density with symptom duration, but the time to any treatment was longer for patients living in more disadvantaged neighborhoods (β = 7.78; 95% confidence interval [CI] = 0.02, 15.55), especially among those with low-grade PBTs (β = 36.19; 95%CI = 12.17, 60.20). Time to treatment was longer for those in nonurbanized areas and further from the NIH (β = 0.63; 95% CI = 0.08, 1.17). Patients living in more disadvantaged neighborhoods had higher 5-year survival compared with patients living in less disadvantaged neighborhoods (P = .02).

Conclusions

Individuals with low-grade PBTs living in more disadvantaged neighborhoods and further from NIH had a longer time to treatment. Future efforts should focus on strategies to reach patients living in disadvantaged neighborhoods.
Pegylated liposomal doxorubicin in partially platinum-sensitive, platinum-resistant, or platinum-refractory ovarian cancer: a prospective study
Authors: Zhang Ying , Yuan Zhen , Zhang Guo-Nan , Li Qing-Shui , Cui Man-Hua , Cheng Wen-Jun , Meng Yuan-Guang , Wu Xiao-Hua , Yue Ying , Wang Li , Hou Jian-Qing , Li Chang-Zhong , Qu Peng-Peng , Sun Li-Xin , Tao Guang-Shi , Li Gui-Ling , Chen Ya-Qing , Ren Fang , Cao Dong-Yan , Shen Keng
Published: November 2024

Background

This study aimed to evaluate the efficacy and safety of pegylated liposomal doxorubicin (PLD) for patients with partially platinum-sensitive, platinum-resistant, or platinum-refractory ovarian cancer.

Methods

Patients with partially platinum-sensitive, platinum-resistant, or platinum-refractory ovarian cancer were recruited in this prospective, open-label, single-arm, multicenter study. Eligible patients were given 4-6 cycles of PLD (40 mg/m2 on day 1, every 4 weeks). The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), quality of life, and safety. Exploratory endpoints included the change trend of CA125 and platinum-free interval.

Results

Between June 2017 and November 2020, 167 eligible patients were included in the full analysis set. The median PFS and OS were 6.8 months (95% CI, 4.4-9.3 months) and 19.1 months (95% CI, 15.0-23.3 months), respectively. The ORR and DCR were 32.3% and 60.5%, respectively. The ORR (62.3 vs 22.5%) and DCR (84.9 vs 60.7%) of patients with a CA125 decrease after the first cycle were significantly higher than those without a CA125 decrease (all P < .05). Grade ≥ 3 and serious adverse events were reported in 9.9% and 3.9% of patients, respectively. No treatment-related death was observed.

Conclusion

PLD showed promising efficacy and manageable tolerability in patients with partially platinum-sensitive, platinum-resistant, or platinum-refractory ovarian cancer.

ClinicalTrials.gov Identifier: Chinese Clinical Trial Registry, ChiCTR1900022962.
ALTERED MERISTEM PROGRAM1 impairs RNA silencing by repressing the biogenesis of a subset of inverted repeat-derived siRNAs
Authors: Li Jing , Le Brandon , Wang Xufeng , Xu Ye , Wang Suikang , Li Hao , Gao Lei , Mo Beixin , Liu Lin , Chen Xuemei
Published: November 2024

RNA silencing negatively regulates gene expression at the transcriptional and posttranscriptional levels through DNA methylation, histone modification, mRNA cleavage, and translational inhibition. Small interfering RNAs (siRNAs) of 21 to 24 nucleotides are processed from double-stranded RNAs by Dicer-like (DCL) enzymes and play essential roles in RNA silencing in plants. Here, we demonstrated that ALTERED MERISTEM PROGRAM1 (AMP1) and its putative paralog LIKE AMP1 (LAMP1) impair RNA silencing by repressing the biogenesis of a subset of inverted repeat (IR)-derived siRNAs in Arabidopsis (Arabidopsis thaliana). AMP1 and LAMP1 inhibit Pol II-dependent IR gene transcription by suppressing ARGONAUTE 1 (AGO1) protein levels. Genetic analysis indicates that AMP1 acts upstream of RNA polymerase IV subunit 1 (NRPD1), RNA-dependent RNA polymerase 2 (RDR2), and DCL4, which are required for IR-induced RNA silencing. We also show that AMP1 and LAMP1 inhibit siRNA-mediated silencing in a different mechanism from that of AGO4 and DCL3. Together, these results reveal two previously unknown players in siRNA biogenesis from IRs-AGO1, which promotes IR transcription, and AMP1, which inhibits IR transcription indirectly through the repression of AGO1 expression.
The Real Guarantee in De Se thought: How to characterize it?
Authors: García-Carpintero Manuel
Published: November 2024

Castañeda, Perry and Lewis argued that, among singular thoughts in general, thoughts about oneself ‘as oneself’—first-personal thoughts, which Lewis aptly called de se—have a distinctive character that traditional views of contents cannot characterize. Drawing on Anscombe, Annalisa Coliva has argued that a feature she calls Real Guarantee marks apart de se thoughts—as opposed to others including Immunity to Error through Misidentification that have been proposed for that role. I'll argue that, while her work points to a truly distinguishing feature of the de se, we need an account of the notion other than hers and Echeverri's recent development of it. I'll offer an alternative, drawing on Léa Salje's work. Finally, I'll briefly outline how, thus understood, the Real Guarantee feature could be adequately explained by theories of de se thoughts like the one I favour, even if it is an open option to just explain it away.
Ending a special relationship: Toward an ethics of divorce
Authors: Betzler Monika
Published: November 2024

Romantic partnerships are typically among the most important goods in our lives. But love sometime ends, and so too do relationships. Divorcing partners are particularly vulnerable to being wronged and harmed. The aim of this paper is to develop an ethics of divorce, by establishing that divorce is a condition for the possibility of the distinct value of romantic partnerships. Different sets of rights are specified here: the divorcee's right to explanation, the right to participation and the right to transitional goods; and the divorcer's right to relational freedom. Violations of these rights indicate the distinct wrongs and harms of divorce. The paper then explains the corresponding duties in divorce that might avoid these wrongs and mitigate these harms, and highlights the distinct status of these duties: while they continue to be special, they are residual duties grounded in the fact that the partners once committed to their partnership.
Post-intervention control in HIV immunotherapy trials
Authors: Sandel Demi A. , Rutishauser Rachel L. , Peluso Michael J.
Published: November 2024

Purpose of review

While post-treatment control following interruption of standard-of-care antiretroviral therapy (ART) is well described, post-intervention control following immunotherapy in HIV cure-related clinical trials is less well understood. We provide an overview of recent studies that have identified post-intervention controllers and review the mechanisms that may drive this biologically important phenotype.

Recent findings

Post-intervention controllers have been identified in recent immunotherapy trials testing broadly neutralizing antibodies, immune modulators, modified T cells, checkpoint inhibitors, and gene therapy administered individually or in combination. Currently, there is substantial variability in how each trial defines post-intervention control, as well as in how the mechanisms underlying such control are evaluated. Such mechanisms include ongoing activity of both exogenous and autologous antibodies, as well as changes in HIV-specific T cell function.

While no therapeutic strategy to date has succeeded in definitively inducing HIV control, many studies have identified at least a small number of post-intervention controllers. The field would benefit from a standardized approach to defining and reporting this phenotype, as well as standardization in the approach to assessment of how it is achieved. Such efforts would allow for comparisons across clinical trials and could help accelerate efforts toward an HIV cure.
Efficacy and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Atrial Fibrillation and Liver Cirrhosis
Authors: Chou Tien-Shin , Lin Yuan , Tsai Ming-Lung , Tseng Chin-Ju , Dai Jhih-Wei , Yang Ning-I , Lin Chih-Lang , Chen Li-Wei , Hung Ming-Jui , Chen Tien-Hsing
Published: November 2024

Objective:

Comparing direct oral anticoagulants (DOACs) and warfarin’s efficacy and safety in patients with nonvalvular atrial fibrillation (AF) and liver cirrhosis (LC).

Background:

Evidence of the pharmacodynamics of DOACs is limited in patients with AF and LC.

Methods:

A retrospective cohort study was conducted in the largest hospital system in Taiwan, involving patients with AF and LC for the years 2012 to 2021. Hazards of thromboembolic events (ischemic stroke, transient ischemic attack, and systemic embolism), intracranial hemorrhage, gastrointestinal, major bleeding, and all-cause mortality were investigated with a new-user, active comparator design. Inverse probability of treatment weighting was applied to balance potential confounders between treatment groups.

Results:

In total, 478 DOAC users and 247 warfarin users were included. DOACs and warfarin demonstrated similar trends in preventing thromboembolic events, namely ischemic stroke [adjusted hazard ratio (aHR), 1.05 (95% CI: 0.42-2.61)], transient ischemic attack [aHR, 1.36 (95% CI: 0.18-10.31)], and systemic embolism [aHR, 0.49 (95% CI: 0.14-1.70)]. DOAC use was associated with a similar risk of intracranial hemorrhage [aHR, 0.65 (95% CI: 0.26-1.59)] and gastrointestinal bleeding [aHR, 0.64 (95% CI: 0.39-1.03)], a decreased risk of major bleeding [aHR, 0.64 (95% CI: 0.42-0.99)], and a reduction in mortality [aHR, 0.73 (95% CI: 0.54-0.99)]. DOAC users exhibited a significant reduction in major bleeding risk in patients with Child-Pugh class A (aHR, 0.48; 95% CI: 0.33-0.70).

Conclusions:

DOACs showed potential safety advantages over warfarin for patients with nonvalvular AF and LC, particularly in reducing major bleeding risk in those with Child-Pugh class A.
Strategies, Technologies, and Tips for Successful Cecal Intubation
Authors: Miller Alexander , Anderson Joseph C.
Published: November 2024

Successful cecal intubation is crucial in ensuring a complete evaluation of the colonic mucosa. Although completion of colonoscopies should be successful in close to 100% of all examinations in the hands of experienced gastroenterologists, there are some patients with colons which can be difficult to navigate. Factors such as older age, presence of diverticular disease, as well as high or low body mass index can present challenges for endoscopists. Challenges can be divided into those that are left sided and are associated with severe angulations of the colon versus those that are right sided and present as redundant colons. Both require different strategies to achieve completion. This review will cover methods, technologies as well the evolution of colonoscope insertion tubes which can help in navigating colons, especially those that are challenging. There will also be a discussion about basic principles and techniques that should be employed in all colonoscopies.
The bronchiectasis microbiome: current understanding and treatment implications
Authors: Narayana Jayanth Kumar , Mac Aogáin Micheál , Hansbro Philip M. , Chotirmall Sanjay H.
Published: November 2024

Purpose of review

Advances in DNA sequencing and analysis of the respiratory microbiome highlight its close association with bronchiectasis phenotypes, revealing fresh opportunities for diagnosis, stratification, and personalized clinical intervention. An under-recognized condition, bronchiectasis is increasingly the subject of recent large-scale, multicentre, and longitudinal clinical studies including detailed analysis of the microbiome. In this review, we summarize recent progress in our understanding of the bronchiectasis microbiome within the context of its potential use in treatment decisions.

Recent findings

Diverse microbiome profiles exist in bronchiectasis, in line with the established disease heterogeneity including treatment response. Classical microbiology has established Pseudomonas aeruginosa and Haemophilus influenza as two microbial markers of disease, while holistic microbiome analysis has uncovered important associations with less common bacterial taxa including commensal an/or pathobiont species, including the emerging role of the fungal mycobiome, virome, and interactome. Integration of airway microbiomes with other high-dimensional biological and clinical datasets holds significant promise to determining treatable traits and mechanisms of disease related to the microbiome.

The bronchiectasis microbiome is an emerging and key area of study with significant implications for understanding bronchiectasis, influencing treatment decisions and ultimately improving patient outcomes.
The correlation of acupuncture and moxibustion points for the treatment of diminished ovarian reserve and premature ovarian failure: A systematic review based on complex network
Authors: Yang Zhihong , Zhu Zhou , Yang Xiaofang , Zhang Wei , Chen Panbi , Jin Linming , Luo Qiuping , Meng Yuqiong , Liu Jiamin
Published: November 2024

Background:

Infertility rates have risen in recent years, with diminished ovarian reserve (DOR) affecting 10% of infertile women, accounting for approximately 20% of ovarian disorders. This highlights the importance of exploring effective treatments for DOR. This study investigates acupoint compatibility rules in acupuncture and moxibustion therapies for DOR and premature ovarian failure (POF) using complex network analysis. It also provides insights into acupuncture and moxibustion approaches for managing these conditions.

Methods:

Clinical studies on acupuncture and moxibustion treatments for DOR and POF were retrieved from 5 databases, including China National Knowledge Infrastructure, SinoMed, Wanfang, CQVIP, and PubMed, covering the period from January 1, 2007, to September 15, 2024. Literature was screened based on inclusion and exclusion criteria to build a comprehensive database of acupuncture and moxibustion prescriptions for these conditions. Association rule analysis was performed using IBM SPSS Modeler 18.0, and complex network analysis was conducted with Gephi 0.9.2 software.

Results:

A total of 70 articles and 67 acupoints from 70 prescriptions were analyzed, with 665 occurrences of these acupoints. The most frequently used acupoint was Guanyuan (RN4), followed by Sanyinjiao (SP6), Zusanli (ST36), Shenque (RN8), Bladder 23 (BL23), and Zigong (EX-CA1). These acupoints were primarily related to the Ren (RN) and Bladder (BL) meridians. Jiaohui points, dorsal Yu points, and 5 Shu points were the most commonly utilized specific points. The combination of Sanyinjiao (SP6) and Guanyuan (RN4) had the strongest association. Complex network analysis revealed a small-world network effect, with 24 core acupoints, including Guanyuan (RN4) and Zusanli (ST36), serving as key nodes.

Conclusion:

Acupuncture treatments for DOR and POF primarily focus on the abdomen and lower back regions. Specific acupoints, such as rendezvous points, are frequently combined with distantly located points. These combinations are guided by therapeutic principles aimed at nourishing the kidney, strengthening the spleen, regulating liver qi, calming the heart, and promoting blood circulation.
Study on the impact of refractive anisometropia on strabismus, stereopsis, and amblyopia in children
Authors: Qiao Shanli , Chen Jing , Zhang Jianfei , Sun Changfeng
Published: November 2024

To preliminarily explore the correlation between different types and degrees of refractive errors and strabismus, amblyopia, and stereopsis. A retrospective collection was conducted on a total of 145 patients with anisometropia who visited our hospital for strabismus and pediatric ophthalmology from January 2023 to August 2023.Based on the nature of anisometropia in both eyes, it was divided into 4 groups: Farsighted anisometropia (36 cases); myopic anisometropia (38 cases); astigmatic anisometropia (35 cases); mixed anisometropia (36 cases), and 30 children with normal vision were collected. Both groups of subjects underwent routine slit lamp and fundus examinations to exclude other organic eye diseases. The test indexes were: visual acuity, diopter, strabismus, far-stereoscopic vision, near-stereoscopic Titmus, and random static zero-order stereoscopic vision. The results of this study showed that compared with the normal control group, the incidence of strabismus was higher in the anisometropia group. When the refractive error was ≥1.00D, the far stereopsis and random dot static 0-order stereopsis in the anisometropia group decreased more significantly, and the difference between the groups was statistically significant (P < .05). Far-sighted and mixed astigmatism were more prone to amblyopia than myopia and regular astigmatism (P < .05). However, there was no statistical difference in near stereopsis Titmus between the anisometropia group and the control group (P > .05). Children with anisometropia are more likely to have strabismus, stereopsis and amblyopia than normal children.
Diagnostic value of CT in patients with stable chronic obstructive pulmonary disease at high altitude: Observational study
Authors: Zou Xingxiong , Tian Bowen , Lin Qingqing , Xia Junjie , Qiu Yu , Huang Ling , Li Wenjun , Yang Ming , Gao Feng
Published: November 2024

This research aims to explore the diagnostic value of computed tomography (CT) indicators in patients with stable chronic obstructive pulmonary disease (COPD) in a plateau of China, and to find out the correlation between CT indexes and lung function and symptoms. This study screened out 53 stable COPD patients and 53 healthy people through inclusion and exclusion criteria in Hongyuan county, Aba Prefecture, Sichuan Province, between July 2020 and December 2020, and then collected their baseline data, conducted lung function tests and chest CT scans, and collected COPD Assessment Test (CAT), modified Medical Research Council Dyspnea Scale (mMRC) scores. The CT indexes of the 2 groups were compared, binary logistic regression was used to analyze the influence of COPD, the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the CT indexes for COPD. The Spearman test was used to understand the correlation analysis between the CT indexes and lung function, symptom score, and the number of acute exacerbations. Multiple linear regression was used to analyze the influencing factors of lung function. The percentage of low-attenuation areas less than −950 Hounsfield units (%LAA−950; t = −4.387,P = 0), percentage of wall area (WA%; t = −4.501, P = 0), and thickness–diameter ratio (TDR; t = −4.779, P = 0) in the COPD group were higher than those in the normal group. ROC shows that: %LAA−950 (P = .047) and TDR (P = .034) were independent influence in COPD in the plateau. %LAA−950 combined with TDR (AUC = 0.757, P < .001) had the value of diagnosis of COPD in the plateau. All 3 indexes are negatively correlated with lung function, and positively correlated with the symptoms and the number of acute exacerbations. Multiple linear regression analysis showed that the main factors for decrease of ratio of measurement to prediction of forced expiratory volume to the first second (FEV1%) included %LAA−950 (OR = −0.449, P < .001) and WA% (OR = −0.516, P < .001). CT indexes have a certain diagnostic value in patients with stable COPD at high altitude.
Exploring the Relationship between Sleep Pattern and Quality of Life in the Middle-aged Population Based on Fuzzy-set Qualitative Comparative Analysis
Authors: Lv Cheng , Ren Jiaju , Zhu Yanbo
Published: November 2024

This study aims to investigate the effects of 7 factors (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction), as measured by the Pittsburgh Sleep Quality Index, on the quality of life (QOL) in middle-aged individuals. A total of 194 middle-aged individuals aged 45 to 59 years participated in this study. The Chinese version of the medical outcomes study 36-item short-form health survey and the Pittsburgh Sleep Quality Index were used to assess the QOL and sleep quality, respectively. The relationship between sleep patterns and QOL was analyzed using fuzzy-set qualitative comparative analysis. Improvement in sleep disturbances and reduction in the use of sleeping medications are necessary conditions for enhancing QOL. Two configurations of sleep patterns positively influence QOL: the “sufficiency type” with high level of sleep duration, non-sleep disturbances, and non-daytime dysfunction as core conditions; and the “efficiency type” with high habitual sleep efficiency and non-daytime dysfunction as core conditions. Three configurations of sleep patterns negatively influence QOL: the “low-quality type” with non-high-level subjective sleep quality, sleep duration, and habitual sleep efficiency as core conditions; the “barrier type” with high level of sleep disturbances, non-high-level sleep latency, and non-high-level subjective sleep quality/sleep duration as core conditions; and the “drug-based type” with high level of use of sleeping medications and subjective sleep quality as core conditions. Using the fuzzy-set qualitative comparative analysis method, this study initially reveals that the influence of sleep patterns on QOL in middle-aged individuals is a holistic effect combining multiple elements. This deepens and enriches the understanding of the relationship between sleep patterns and QOL and expands new perspectives for more in-depth research on how to improve the QOL of middle-aged individuals through sleep interventions.
Increased serum leptin levels are associated with metabolic syndrome and semen parameters in patients with infertility
Authors: Dong Zhen , Song Xin , Dong Deping , Cai Zhikang
Published: November 2024

This study aims to ascertain the associations between serum leptin levels and metabolic syndrome and semen parameters in patients with infertility. A total of 200 patients who were diagnosed as primary infertility in our hospital were enrolled in this study, and they were divided into MetS group and non-MetS group. About 30 healthy men were enrolled as the control group. The general information, blood lipids, reproductive hormones and semen parameters were collected. We used the Student t test, the Chi-square test, the Kruskal–Wallis test, and the spearman correlation analysis to analyze their relationships. BMI, glucose, TG, follicle-stimulating hormone (FSH), and leptin were significantly higher in MetS infertile patients (P < .001; P < .005; P < .001; P < .001; and P < .001, respectively). While T and high-density lipoprotein (HDL) were significantly lower in MetS infertile patients (P < .01, and P < .001, respectively). Leptin was correlated with sperm progressive motility (R = −0.312, P < .01), and normal morphology (R = −0.458, P < .001). Moreover, sperm concentration was correlated with FSH (R = −0.268, P < .001) and inhibin B (R = 0.401, P < .001), and normal morphology was correlated with HDL (R = 0.233, P < .001) and TG (R = −0.182, P < .01). In primary infertile patients, sperm normal morphology were found to be depressed and related to MetS. Leptin was increased in patients diagnosed with MetS and associated with semen parameters.
Analysis of carotid ultrasound in a high-stroke-risk population
Authors: Wang ChunFang , Geng Lirong , Hou Lijun
Published: November 2024

This study aims to explore the risk factors for carotid plaque (CP) and carotid common artery intima-media thickening (CCAIMT) and clarify the relationship between the risk factors with the number of CPs and the side of CCAIMT in a high-stroke-risk population in Qujing, Yunnan, China. Carotid ultrasonography was performed in 430 participants with high stroke risk, who were divided into different groups according to their ultrasound results. The risk factors and blood biochemical indices were recorded for assessment. The prevalence rates of CP and CCAIMT were 88.1% and 70.5%, respectively. Multivariate logistic regression analysis identified age and lack of physical exercise as risk factors of CP. Compared to participants without CP, participants who performed little physical exercise were prone to have one CP, while participants with risk factors for smoking, older age, and physical inactivity were more likely to have several CPs. Risk factors for CCAIMT were older age, male, and the levels of low density lipoprotein cholesterol. Risk factors for left CCAIMT included a history of hyperlipidemia and low density lipoprotein cholesterol, while male sex was the sole risk factor for right CCAIMT. Finally, male sex and advanced age were identified as risk factors for dual CCAIMT. The research reveals the risk factors for CP and CCAIMT, also clarifies the relationship between the risk factors, CP numbers, and the side of CCAIMT.
Research progress of probiotics and their protective strategy in the field of inflammatory bowel disease treatment: A review
Authors: Xiong Ming , Sun Wanlei
Published: November 2024

Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory disease characterized by recurrent episodes and difficult-to-cure symptoms. Although the pathogenesis of IBD is closely related to host genetic susceptibility, intestinal microbiota, environmental factors, and immune responses, leading to mucosal damage and increased intestinal permeability. Intestinal mucosal injury in IBD patients causes pathogenic bacteria and pathogenic factors to invade the intestine, leading to disturb the structure and metabolic products of intestinal flora. Researchers have found that probiotics, as live microbial agents, can effectively inhibit the growth of pathogenic bacteria, regulate intestinal flora, optimize intestinal microecology, restore intestinal homeostasis, and promote intestinal mucosal repairing. During the oral delivery process, probiotics are susceptible to adverse physiological factors, leading to reduced bioavailability. Additionally, the oxidative stress microenvironment induced by intestinal mucosal damage makes it difficult for probiotics to colonize the intestinal tract of IBD patients, thereby affecting their probiotic effect. This research mainly introduces and reviews the advantages and disadvantages of probiotics and their protective strategies in the treatment of IBD, and prospects the future development trends of probiotics and their protective strategies. Probiotics can effectively inhibit the growth of harmful microorganisms, regulate the structure of the intestinal microbiota, and promote mucosal repairing, thereby reducing immune stress and alleviating intestinal inflammation, providing a new perspective for the treatment of IBD. The development of single-cell encapsulation technology not only effectively maintaining the biological activity of probiotics during oral delivery, but also endowing probiotics with additional biological functions naturally achieved through surface programming, which has multiple benefits for intestinal health.