bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma Metabolic Characteristics and Potential Biomarker Combinations in Schizophrenia Patients With Tardive Dyskinesia
Authors: Lu Chenghao , Dong Yeqing , Qi Dan , Liu Nannan , Li Yanzhe , Chi Jinghui , Wang Xinxu , Zeng Min , Liu Feng , Li Shen , Li Jie
Published: January 2025

Background and Hypothesis

The pathogenesis of tardive dyskinesia (TD) remains unclear, involving multiple biological pathways. This study aimed to explore biomarkers of TD through untargeted metabolomics for the early identification of TD.

Study Design

This study recruited 84 schizophrenia (SZ) patients with TD and 160 SZ patients without TD. TD diagnosis was based on the Schooler–Kane criteria, and the severity of TD and psychiatric symptoms were assessed using the Abnormal Involuntary Movement Scale and the Positive and Negative Syndrome Scale. Fasting blood samples were collected from all patients and subjected to untargeted metabolomics analysis using Ultra-high-performance liquid chromatography-high resolution mass spectrometry, allowing for the quantification and profiling of 699 metabolites. Data were analyzed with orthogonal partial least squares discriminant analysis, and receiver-operating characteristic curves.

Study Results

In TD, 57 metabolites exhibited significant changes (variable importance of projection > 1, false discovery rate-adjusted P < .05), primarily involving amino acids and lipids. These changes predominantly affected the phenylalanine, tyrosine, and tryptophan pathway (impact = 0.5, P = .0252), as well as the phenylalanine metabolism pathway (impact = 0.36, P = .0498). N-Acetyl-l-phenylalanine (B = 2.249, t = 4.56, P < .001, 95% CI, 1.302–3.286) and Succinylcarnitine (AcCa(4:0-DC)) (B = 1.009, t = 3.07, P = .002, 95% CI, 0.362–1.656) are negatively related to the total abnormal involuntary movement scale score. Additionally, 5 differential metabolites had area under the curve (AUC) values greater than 0.7 for diagnosing TD, with the combined diagnostic capability exceeding 0.8 (AUC = 0.817, 95% CI, 0.759–0.875).

Conclusions

In TD, disruptions in amino acid and lipid metabolism were predominantly observed. Amino acids and lipid metabolites may be involved in the development of TD. Additionally, a biomarker panel composed of amino acids and lipids can be used for the differential diagnosis of TD.
Evaluating UCE Data Adequacy and Integrating Uncertainty in a Comprehensive Phylogeny of Ants
Authors: Borowiec Marek L , Zhang Y Miles , Neves Karen , Ramalho Manuela O , Fisher Brian L , Lucky Andrea , Moreau Corrie S
Published: January 2025

While some relationships in phylogenomic studies have remained stable since the Sanger sequencing era, many challenging nodes remain, even with genome-scale data. Incongruence or lack of resolution in the phylogenomic era is frequently attributed to inadequate data modeling and analytical issues that lead to systematic biases. However, few studies investigate the potential for random error or establish expectations for the level of resolution achievable with a given empirical dataset and integrate uncertainties across methods when faced with conflicting results.

Ants are the most species-rich lineage of social insects and one of the most ecologically important terrestrial animals. Consequently, ants have garnered significant research attention, including their systematics. Despite this, there has been no comprehensive genus-level phylogeny of the ants inferred using genomic data that thoroughly evaluates both signal strength and incongruence. In this study, we provide insight into and quantify uncertainty across the ant tree of life by utilizing the most taxonomically comprehensive Ultraconserved Elements dataset of ants to date, including 277 (81%) of recognized ant genera from all 16 extant subfamilies, and representing over 98% of described species. We use simulations to establish expectations for resolution, identify branches with less-than-expected concordance, and dissect the effects of data and model selection on recalcitrant nodes.

Simulations show that hundreds of loci are needed to resolve recalcitrant nodes on our genus-level ant phylogeny. This demonstrates the continued role of random error in phylogenomic studies. Our analyses provide a comprehensive picture of support and incongruence across the ant phylogeny, while offering a more nuanced depiction of uncertainty and significantly expanding generic sampling. We use a consensus approach to integrate uncertainty across different analyses and find that assumptions about root age exert substantial influence on divergence dating. Our results suggest that advancing the understanding of ant phylogeny will require not only more data but also more refined phylogenetic models. We also provide a workflow for identifying under-supported nodes in concatenation analyses, outline a pragmatic way to reconcile conflicting results in phylogenomics, and introduce a user-friendly locus selection tool for divergence dating.
Stakeholder-informed refinement of a behavioral sleep/circadian intervention for gynecologic cancer survivors: an application of the MOST preparation phase
Authors: Fox Rina S , Brandon Krista , Badger Terry A , Gaumond Julia S , Morales Ana Acuña , Ong Jason C , Parthasarathy Sairam , Rini Christine , Zee Phyllis C , Tanner Edward J , Ancoli-Israel Sonia , Penedo Frank J , Siddique Juned , Wu Lisa M , Reid Kathryn J , Kaiser Karen
Published: January 2025

Background

Sleep disturbance is among the most frequent and distressing symptoms reported by gynecologic cancer survivors. Existing evidence-based behavioral sleep interventions are limited by implementation burden, which can decrease adherence.

Purpose

As part of the preparation phase of the multiphase optimization strategy (MOST), this study solicited stakeholder feedback to maximize adherence in a planned behavioral sleep/circadian intervention optimization trial.

Methods

Thirteen post-treatment survivors of early-stage gynecologic cancer completed the protocol for the planned optimization trial, including simultaneous receipt of all candidate intervention components. This included six weeks of combined sleep restriction, stimulus control, and systematic exposure to morning bright light. Participants then completed a semi-structured interview to provide feedback on their experience. We used a rapid analytic approach to quickly identify actionable feedback from de-identified transcripts.

Results

Participants generally reacted positively to the intervention components. Actionable feedback identified recommended protocol modifications and was categorized into four overarching themes: (i) remove barriers to engagement; (ii) revise for clarity; (iii) augment content; and (iv) consider individual circumstances.

Conclusions

Rapid qualitative analysis enabled us to effectively modify our planned study protocol on an expedited timeline. This approach is consistent with the core principles of MOST and can be incorporated into the Preparation phase to enhance optimization efforts.
An eco-physiological model of forest photosynthesis and transpiration under combined nitrogen and water limitation
Authors: Fransson Peter , Lim Hyungwoo , Zhao Peng , Tor-ngern Pantana , Peichl Matthias , Laudon Hjalmar , Henriksson Nils , Näsholm Torgny , Franklin Oskar
Published: January 2025

Although the separate effects of water and nitrogen (N) limitations on forest growth are well known, the question of how to predict their combined effects remains a challenge for modeling of climate change impacts on forests. Here, we address this challenge by developing a new eco-physiological model that accounts for plasticity in stomatal conductance and leaf N concentration. Based on optimality principle, our model determines stomatal conductance and leaf N concentration by balancing carbon uptake maximization, hydraulic risk and cost of maintaining photosynthetic capacity. We demonstrate the accuracy of the model predictions by comparing them against gross primary production estimates from eddy covariance flux measurements and sap-flow measurement scaled canopy transpiration in a long-term fertilized and an unfertilized Scots pine (Pinus sylvestris L.) forest in northern Sweden. The model also explains the response to N fertilization as a consequence of (i) reduced carbon cost of N uptake and (ii) increased leaf area per hydraulic conductance. The results suggest that leaves optimally coordinate N concentration and stomatal conductance both on short (weekly) time scales in response to weather conditions and on longer time scales in response to soil water and N availabilities.
Sepsis‐induced NET formation requires MYD88 but is independent of GSDMD and PAD4
Authors: Englert Hanna , Rangaswamy Chandini , Kullik Giuliano A. , Divivier Mylène , Göbel Josephine , Hermans‐Borgmeyer Irm , Borgmeyer Uwe , Mowen Kerri A. , Beerens Manu , Frye Maike , Mailer Reiner K. , Gelderblom Mathias , Stavrou Evi X. , Preston Roger J. S. , Schneider Stefan W. , Fuchs Tobias A. , Renné Thomas
Published: January 2025

Neutrophils are peripheral blood‐circulating leukocytes that play a pivotal role in host defense against bacterial pathogens which upon activation, they release web‐like chromatin structures called neutrophil extracellular traps (NETs). Here, we analyzed and compared the importance of myeloid differentiation factor 88 (MYD88), peptidyl arginine deiminase 4 (PAD4), and gasdermin D (GSDMD) for NET formation in vivo following sepsis and neutrophilia challenge. Injection of lipopolysaccharide (LPS)/E. coli or the transgenic expression of granulocyte colony‐stimulating factor (G‐CSF), each induced NET‐mediated lethal vascular occlusions in mice with combined genetic deficiency in Dnase1 and Dnase1l3 (D1/D1l3−/−). In accordance with the signaling of toll‐like receptors, Myd88/D1/D1l3−/− animals were protected from the formation of lethal intravascular NETs during septic conditions. However, this protection was not observed during neutrophilia. It was unexpected to find that both Gsdmd/D1/D1l3−/− and Pad4/D1/D1l3−/− mice were fully capable of forming NETs upon LPS/E.coli challenge. Sepsis equally triggered a similar inflammatory response in these mice characterized by formation of DNA‐rich thrombi, vessel occlusions, and mortality from pulmonary embolism, compared to D1/D1l3−/− mice. Pharmacologic GSDMD inhibitors did not reduce PMA‐stimulated NET formation in ex vivo models either. Similarly, neither Pad4 nor GSDMD deficiency affected intravascular occlusive NET formation upon neutrophilia challenge. The magnitude of NET production, multi‐organ damage, and lethality were comparable to those observed in challenged control mice. In conclusion, our data indicate that NET formation during experimental sepsis and neutrophilia is regulated by distinct stimulus‐dependent pathways that may be independent of canonical PAD4 and GSDMD.
Reliability and Validity of the Turkish Version of Early-Onset Scoliosis Self-Report Questionnaire
Authors: Goker Barlas , Beydemir Ataberk , Yavuz Yasemin , Kinikli Gizem Irem , Ramazanov Rafik , Anderson Kayla Erin , Olgun Zeynep Deniz , Demirkiran Halil Gokhan , Yazici Muharrem
Published: January 2025

Objective:

Early-Onset Scoliosis Self-Report Questionnaire (EOSQ-SELF) is a recently developed self-reported questionnaire based on the widely adopted Early-Onset Scoliosis Questionnaire and evaluates health-related quality of life in children with early-onset scoliosis over 8 years of age. To date, the questionnaire does not have a validated version in Turkish. The aim of this study was to translate EOSQ-SELF into Turkish and evaluate its reliability and validity.

Methods:

Content validity was assessed through the item (I-CVI) and scale (S-CVI) content validity indices. The distribution of survey responses was analyzed and ceiling and floor effects were calculated with descriptive statistics. Internal consistency was measured with the Cronbach alpha coefficient. Construct validity was evaluated by comparing the responses between EOSQ-SELF and Scoliosis Research Society questionnaire-22 revised.

Results:

Eighty-five patients (30 males and 55 females) diagnosed with early-onset scoliosis completed the EOSQ-SELF questionnaire. The I-CVI for the relevance of 30 questions was found to be 0.875 for 3 questions and 1.0 for the remaining questions, whereas the S-CVI was 0.9875. The I-CVI for the clarity of 30 questions was found 0.500 for 1 question, 0.875 for 3 questions, and 1.0 for the remaining questions. The S-CVI value for clarity was 0.97083. The Cronbach alpha coefficient for the total score of the Turkish EOSQ-SELF was recorded at 0.942. Common domains were significantly correlated with the Scoliosis Research Society questionnaire-22 revised.

Conclusions:

We found excellent internal consistency in our study and were able to demonstrate the reliability as well as the validity of EOSQ-SELF in Turkish.

Level of Evidence:

Level I—diagnostic.
Albumin-based nanocarriers loaded with novel Zn(II)-thiosemicarbazone compounds chart a new path for precision breast cancer therapy
Authors: Danişman-Kalindemirtaş Ferdane , Özerkan Dilşad , Kariper İshak Afşin , Erdemir Cilasun Gökçe , Ülküseven Bahri , Erdem-Kuruca Serap
Published: January 2025

This study explores the therapeutic potential of albumin-bound Zn(II)-thiosemicarbazone compounds (Alb-ZnTcA, Alb-ZnTcB) against breast cancer cells. Previous research indicates that these compounds hinder cancer cell proliferation by blocking DNA synthesis, promoting oxidative stress to induce apoptosis, and disrupting the cell cycle to inhibit cellular division. This study focuses on the loading and characterization of these potentially chemically unstable compounds on bovine serum albumin-based nanocarriers. Accordingly, unlike previous studies using albumin nanoparticles, in this study, ultraviolet light was used to precisely bind the therapeutic agent to albumin during the integration of thiosemicarbazones, achieving controlled nanoparticle size to control nanoparticle size. The mean diameter of Alb-ZnTcA nanoparticles was 32 nm, while Alb-ZnTcB exhibited an average diameter of 43 nm. Notably, Alb-ZnTcA displayed the highest cytotoxicity toward breast cancer cells, suggesting an optimal size for cellular uptake. Additionally, albumin-bound compounds showed enhanced cytotoxicity at lower concentrations, potentially minimizing adverse side effects. Apoptosis analysis indicated that both Alb-ZnTcA and Alb-ZnTcB induce cell death predominantly through apoptosis, effectively preventing the uncontrolled proliferation of cancer cells. These findings demonstrate the potential of Zn(II)-thiosemicarbazone compounds loaded on albumin-based nanocarriers for breast cancer treatment. The increased potency of Alb-ZnTcA and Alb-ZnTcB compared to free compounds, along with their ability to activate apoptotic signaling pathways in MCF-7 breast cancer cells, highlights a promising approach for future cancer therapies. This study suggests that albumin-bound Zn(II)-thiosemicarbazone compounds could offer a targeted and effective strategy in breast cancer treatment, leveraging the advantages of nanocarrier-based delivery systems.
Pharmacokinetic Boosting of Calcineurin Inhibitors in Transplantation: Pros, Cons, and Perspectives
Authors: Pattanaik Smita , Monchaud Caroline
Published: January 2025

The concept of pharmacokinetic (PK) boosting of calcineurin inhibitors (CNI) emerged after the FDA approval of cyclosporine-A. Several studies followed, and the proof of concept was well established by the late 1990s. This also continued for the next blockbuster immunosuppressant, tacrolimus. The driver for such research was an endeavor to save costs, as both drugs were expensive due to patent protection. Two CYP inhibitors, ketoconazole and diltiazem, have been extensively studied in this context and continue to be prescribed off-label along with the CNI. It has been observed that using ketoconazole reduces the dose requirement of tacrolimus by about 50% and 30% with diltiazem, which is in conformity with their pharmacological actions. Off-label co-prescription of these drugs with CNI is often encountered in low and middle-income countries. The foremost reason cited is economic. This article collates the evidence from the clinical studies that evaluate the PK-boosting effects of CNI and also reviews the gaps in the current evidence base. The current knowledge prevents the transplant community from making meaningful inferences about the risks and benefits of such strategies. Although the PK-boosting strategy can lead to serious adverse events, emerging evidence suggests that it may be advantageous for individuals with high CNI dose requirements. Hence, PK boosting may be an unmet need in the therapeutics of CNI. Nevertheless, there are several unanswered questions surrounding such use, and therefore, this merits testing in well-designed clinical studies. Moreover, drugs with better safer profiles and a history of successful PK boosting may be considered for evaluation with CNI.
Rho(D) immune globulin shortage and fetal Rh(D) screening with cell-free DNA
Authors: Grace Matthew R. , Goodhue Brighton , Vora Neeta L.
Published: January 2025

Purpose of review

Despite the availability of Rh(D) immune globulin (RhIg) to prevent alloimmunization in Rh(D)-negative pregnant patients, anti-Rh(D) alloimmunization remains a prevalent cause of hemolytic disease of the fetus and newborn (HDFN). Recent RhIg shortages have caused clinicians and professional societies to identify methods to prioritize RhIg administration. New cell-free DNA (cfDNA) tests to predict fetal red blood cell antigen genotypes have been proposed as an option to prioritize the administration of RhIg to Rh(D)-negative pregnant people.

Recent findings

Commercial laboratories offer fetal Rh(D) genotype testing as part of cfDNA screening for fetal aneuploidy. Studies indicate that these tests have a high sensitivity and specificity for the detection of fetal Rh(D) status. Considering the current RhIg shortage, the American College of Obstetricians & Gynecologists (ACOG) suggests that utilizing cfDNA tests to determine fetal Rh(D) status is a reasonable approach to prioritize RhIg administration when supply is limited.

cfDNA screening for fetal Rh(D) status is a reasonable approach to triage the administration of RhIg in the setting of the current RhIg shortage. Utilization of cfDNA screening for fetal Rh(D) and other red blood cell antigen status is likely to increase in routine care. Research, professional society guidance, and education are necessary to ensure well tolerated and equitable utilization.
Transscleral Pars Plana Choroid Ablation Using the Iridex Laser System Yields Improvements for Surgical Insertion of the Port Delivery Implant in a Minipig Model
Authors: Shelton Amy , Schutten Melissa , Fuji Reina N. , Boyd Ryan , Stevenson Victoria , Leahy Matthew , Knupp Lauren , Lieng Juelline , Thompson Devon , Tam Tammy , LaMarche Kevin , Barteselli Giulio , Malhotra Varun , Bantseev Vladimir
Published: January 2025

Purpose:

To evaluate an alternative surgical approach for Port Delivery System with ranibizumab (PDS) implant and a novel application of Iridex laser system in Gottingen minipig model.

Methods:

A total of seventeen male minipigs (Part 1: 9 animals in non-recovery and Part 2: 8 animals observed for 8-days post-surgery Part 2) received PDS implant insertion into each eye. The effect of Iridex 810 nm infrared diode laser with varying energy (power or duration) on transscleral pars plana ablation, surrounding ocular tissue and postsurgical vitreous hemorrhage (VH) was investigated.

Results:

The most effective laser parameters for transscleral pars plana ablation in mitigating vitreous hemorrhage with no surrounding tissue damage were continuous wave mode, 1750 mW, 1000 ms, and 16 spots (8 overlapping spots/sweep applied over 2 rows) across a 4 mm segment, posterior to the limbus, delivering a total energy of 28 J. Minimal self-limiting scleral hemorrhage was observed with two of the implants and no VH were observed. µCT imaging was consistent with clinical ophthalmic

observations.

On microscopic observations, no tissue damage was observed at these laser settings.

Conclusion:

This Göttingen minipig model demonstrated a novel application of Iridex laser for transscleral pars plana ablation that streamlines the PDS implantation surgery.
Predictors of Health Care Disparities in Fuchs Dystrophy Treatment Using the IRIS Registry
Authors: Jiang Yu , Davidson Oliver , Blazes Marian , Rajesh Anand E. , Lomazow Whitney , Bagsadarova Yelena , Lee Aaron Y. , Lee Cecilia S. , Sundararajan Miel ,   on behalf of the IRIS Registry Analytic Center Consortium
Published: January 2025

Purpose:

To evaluate associations between sociodemographic factors and surgical management in patients with Fuchs Endothelial Corneal Dystrophy (FECD).

Methods:

Patients >40 years old with FECD diagnosis and subsequent corneal edema between 2007 and 2020 were identified from the American Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight). Multivariable Cox proportional hazards models were fit to examine the relationships between sociodemographic variables and time from FECD diagnosis to penetrating keratoplasty (PK) and endothelial keratoplasty (EK)/PK.

Results:

A total of 20,366 patients with FECD diagnosis and subsequent corneal edema were identified. Of the 4313 patients who underwent either EK or PK (any surgery), 374 patients underwent PK, 4037 underwent EK, and 98 received both interventions. After controlling for age, sex, and insurance status, Black or African American patients were 1.48 times as likely (hazard ratio 1.48, 95% confidence intervals (CI), 1.06–2.07) to undergo PK as compared with White patients and were less likely to receive any surgery (HR 0.83, 95% CI, 0.74–0.94). Asian patients were less likely (HR: 0.57, 95% CI, 0.43–0.75) to undergo any surgery. Female patients were more likely to undergo PK and less likely to undergo any surgery than male patients, and older patients were less likely to undergo any surgery with each increasing decade of life. There were no significant differences when stratified by insurance type.

Conclusions:

Age, sex, race and ethnicity, and insurance type are associated with varying rates of different surgical interventions for FECD.
Laennec approach for anatomical liver resection assisted by laparoscopy or robotics: a multicenter cohort study
Authors: Li Binghua , Yin Dalong , Zhang Qifan , Qin Lei , Li Jianwei , Hong Zhixian , Zhu Peng , Ding Guangyu , Shi Zhitian , Zhang Changhe , Zhang Kai , Peng Jin , Yue Yang , Chen Chaobo , Liu Lianxin , Zheng Shuguo , Chen Xiaoping , Gao Qiang , Zhang Bixiang , Yu Decai
Published: January 2025

Introduction:

Laennec’s capsule serves as a critical anatomical landmark in liver resection. Despite its potential, a lack of large-scale prospective studies limits the widespread use of the Laennec approach for minimally invasive hepatectomy. This multicenter cohort study aimed to compare the outcomes of the traditional and Laennec approaches in minimally invasive anatomical hepatectomy across multiple centers in China.

Methods:

A total of 445 patients from 11 centers were included, with 339 undergoing the Laennec approach and 106 receiving the traditional approach. Intraoperative parameters such as the duration of hepatic pedicle isolation, hepatic vein exposure, parenchymal transection, and liver mobilization were analyzed. Postoperative outcomes, including recurrence-free survival and R0 resection rates, were also assessed. Additionally, a series of subgroup analyses were conducted to evaluate the efficacy of the Laennec approach.

Results:

The Laennec approach demonstrated notable intraoperative advantages, including reduced durations for hepatic pedicle isolation, liver mobilization, hepatic vein exposure, and parenchymal transection. Robotic-assisted procedures, in particular, showed superior outcomes when compared with laparoscopic platform. The Laennec approach proved highly effective across various liver diseases, particularly hepatocellular carcinoma, hemangioma, and hepatolithiasis. The Laennec gap, a distinct gap between the liver parenchyma and surrounding vasculature, played a key role in identifying candidates for the Laennec approach. Subgroup analysis revealed that although the Laennec approach provides significant intraoperative benefits, these advantages do not seem not to translate into substantial postoperative improvements.

Conclusions:

The Laennec approach offers clear intraoperative advantages over the traditional approach when utilizing laparoscopic or robotic systems. These findings support the Laennec approach as a standardized technique for anatomical liver resection.
A nomogram for predicting lymph node metastases in nonmetastatic muscle-invasive bladder cancer: a SEER-based investigation
Authors: Wu Jie , Shang Bing-Qing , Shou Jian-Zhong , Wang Zong-Ping
Published: January 2025

This study aimed to develop a predictive nomogram model and a risk classification system to predict the likelihood of lymph node metastases for non-metastatic muscle-invasive bladder cancer (MIBC) patients using a large population-based cancer database. According to our nomogram, larger tumor size, overlapping lesions, young age, female, poorly differentiated histological grade, and advanced T stage, are independent risk factors for pN+. A precise nomogram model predicting pN+ probability for MIBC patients can support patient risk stratification and outcome estimation, and eventually guide clinical decision-making.
Chronic Liver Disease as a Risk Factor For Post-ERCP Complications
Authors: Changela Madhav , Bahirwani Janak , Tan Ernestine Faye , Patel Nishit , Basida Sanket , Kaneriya Maulik , Singh Amanda , Mehta Deep , Suthar Kaushalkumar , Duarte-Chavez Rodrigo
Published: January 2025

Introduction:

Endoscopic retrograde cholangiopancreatography (ERCP) is indicated for multiple pancreatic and biliary pathologies and carries a heightened risk profile compared with other endoscopic procedures. Considerable research has been directed towards discerning risk factors associated with complications such as post-ERCP pancreatitis and post-ERCP bleeding. Despite this, data on chronic liver disease (CLD) as a risk factor for complications is limited. We aimed to assess the outcomes of patients with CLD who underwent therapeutic or diagnostic ERCP to determine whether these patients had different outcomes relative to patients without CLD.

Methods:

We used the National Inpatient Sample (NIS) database to inquire for all adult patients who underwent ERCP between 2016 and 2019 using the International Classification of Disease, Tenth Revision (ICD-10) coding. The group was stratified into 2 groups: patients with CLD and those without. The main outcome we looked at was the rate of post-ERCP pancreatitis, post-ERCP hemorrhage, and perforation between the 2 groups. The secondary outcomes were in-hospital mortality and length of stay. A multivariate regression model was used to estimate the association of CLD with ERCP outcomes.

Results:

We identified a total of 883,825 patients who underwent ERCP between 2016 and 2019. Among these, 21,212 (2.4%) had CLD and 862,613 (97.6%) did not have CLD. The mean age for patients in liver disease group was 61.66 years and in group without liver disease was 60.46 years. The predominant ethnicity in both groups was whites. Additional admission-related factors are outlined in Table 1. The rate of post-ERCP pancreatitis (8.8% vs. 6.7%, P < 0.001) with adjusted odds ratio (aOR) 1.3; and post-ERCP hemorrhage (8.8% vs. 6.69%, P < 0.001) with aOR 1.35, was higher in the patient group with CLD. The rate of post-procedure perforation was not significantly different in both groups. For secondary outcomes; the in-hospital mortality (3.03% vs. 1.58%, P < 0.001) and length of stay (7 days vs. 3 days, P < 0.001) were higher in the patients with chronic liver disease. The outcomes are mentioned in Table 2.

Conclusion:

Although ERCP is considered a safe procedure, it is one of the endoscopic procedures associated with the highest risk of complications. As a result, risk stratification is crucial. Certain demographics, conditions like end-stage renal disease, liver cirrhosis, and procedural factors have been identified as risk factors for post-ERCP complications. Our study represents newer data, with use of revised ICD codes, to demonstrate increased risk in patients with liver disease. On the basis of these results, ERCP should be used judiciously in this population and further studies are required for identifying reversible risk factors to improve outcomes.
Noncardiac surgery for severe pulmonary hypertension: two surgeries in one patient and a review of the literature
Authors: Wiewiora Maciej , Nowowiejska–Wiewiora Alicja , Gasior Mariusz , Piecuch Jerzy
Published: January 2025

Background:

Budd–Chiari syndrome is a rare and severe vascular liver disease. We presented patient with fulminant liver failure secondary to leiomyosarcoma of the IVC and thrombosis

Case presentation:

A 44-year-old female presented with fulminant liver failure secondary to inferior vena cava (IVC) thrombosis. Contrast-enhanced computed tomography subsequently revealed a thrombus within the IVC, extending cranially to the right atrium and caudally to the renal veins. The patient’s condition, characterized by early comatose symptoms, necessitated surgical intervention. Under extracorporeal circulation, a right atriotomy with thrombus lesion removal and descending thrombectomy of the IVC was performed. Hepatic congestion resolved after the thrombus was removed. A pathological examination of the excised thrombus revealed the presence of high-grade leiomyosarcoma.

Conclusions:

In cases where a thrombus extends from the IVC to the right atrium, urgent surgical intervention with extracorporeal circulation should be considered.
A case of sustained fetal atrial flutter at 25-week gestation: diagnostic challenges and therapeutic strategies
Authors: Qatza Ayham , Tawashi Kenana , Sheikh Sobeh Ahmed , Takkem Saleh
Published: January 2025

Introduction:

Sustained fetal tachycardia is an uncommon phenomenon in gestations (approximately 0.1%). Atrial flutter (AF) accounts for 10–30% of fetal tachyarrhythmias, which is characterized by a rapid atrial rate estimated at 300–600 beats per minute, associated with variable degrees of atrioventricular conduction.

Case presentation:

A 29-year-old asymptomatic woman, pregnant for the third time, was diagnosed with a male fetus at 25 weeks gestation exhibiting sustained atrial flutter with rapid ventricular response (2:1 and 1:1 AV block). Maternal digoxin reduced the fetal ventricular rate to 120 bpm, mitigating hydrop risk. The infant was delivered via cesarean at 35 weeks, presenting with low blood pressure (80/50 mmHg) and an irregular pulse (160 bpm). The electrocardiogram showed AF; intravenous amiodarone was administered, and the rhythm successfully converted to a normal sinus rhythm.

Clinical discussion:

Fetal arrhythmias in pregnant women require detailed assessment and treatment, including maternal history, electrocardiogram, and renal function assessment. The approach to treatment involves the use of transplacental antiarrhythmics, where digoxin is considered the first line of treatment. Other options include sotalol and flecainide. The mother should be monitored for side effects, with follow-up in the postpartum period for the infant.

Conclusion:

Fetal AF may occur in the second trimester and requires an increased awareness of this life-threatening arrhythmia. Whatever the gestational age, early recognition of fetal tachycardia is important due to the potential for adverse and life-threatening outcomes.
Returning to Work After Cancer Treatment: An Exploratory Sequential Mixed-Methods Study Guided by Transitions Theory
Authors: Galica Jacqueline , Alsius Agnès , Walker Lauren , Stark Debora , Noor Hamza , Kain Danielle , Booth Christopher , Wickenden Amy
Published: January 2025

Background

Although many individuals return to work after cancer treatment, supports to facilitate this transition are ineffective or lacking. Transitions Theory can be useful to conceptually explain the transition back to work after cancer; however, no known studies have used Transitions Theory to empirically examine this transition.

Objective

To explore how and why Transition Theory concepts can be used to understand individuals’ transition back to work after cancer treatment.

Methods

Using an explanatory sequential mixed-methods design, breast or colorectal cancer survivors who had returned to work completed questionnaires aligned with Transitions Theory concepts. Spearman correlations were used to explore associations, and significant results were used to draft interview questions. One-to-one telephone interviews with a subsample of participants provided elaborations to quantitative results. Qualitative data were analyzed using template analysis.

Results

Among the 23 participants who returned questionnaires, most identified as female (n = 21 [91%]) and had been back at work for 28.9 months (range, 3-60). The sample’s productivity loss was 7.42%, indicating an incomplete mastery of their return to work. Only 2 significant associations were revealed with higher productivity loss: higher anxiety (r = 0.487, P = .019) and a greater number of unmet relational needs (r = 0.416, P = .048). Twelve participants engaged in interviews wherein explanations for quantitative results were uncovered.

Conclusions

To support a smoother transition back to work after cancer, assessment and interventions should focus on individuals’ psychological well-being and relationship needs.

Implications for Practice

Transitions Theory can be useful in developing interventions to support a successful return to work after cancer.
Mediating Role of Parent-Child Conflict in the Association Between Parental Anxiety and Emotional Behavioral Problems Among Children With Leukemia
Authors: Wang Mengjia , Hu Ziyue , Xiang Mingli , Lin Jia , Zhang Ruixing
Published: January 2025

Background

There is a documented risk of emotional and behavioral disorders in children with leukemia. Assessing the factors contributing to their behavioral disorders is particularly important from a prevention perspective.

Objective

The aim of this study was to study the influencing factors of internalizing and externalizing behaviors in children with leukemia from the perspective of adult family members.

Methods

Cluster sampling was utilized to recruit a sample of 219 children diagnosed with leukemia. The caregivers of these children completed assessments on parental anxiety, parent-child conflict, and internalizing and externalizing child behavior problems.

Results

Study findings indicate that children diagnosed with leukemia exhibit significant internalizing and externalizing behavior problems. Parental anxiety has a positive direct impact on both the internalizing and externalizing behavioral difficulties experienced by their children. Furthermore, parental anxiety indirectly influences the occurrence of internalizing and externalizing behavior problems through parent-child conflict.

Conclusion

Findings underscore the potential for enhancing the parent-child relationship as a means to mitigate children’s internalizing and externalizing problems by reducing parent-child conflict and parental anxiety.

Implications for Practice

The child and family-centered care approach in pediatric nursing is fundamental in assessing and addressing the needs of the child and family. To ameliorate emotional behavior issues in children with leukemia, the quality of the parent-child relationship needs to be considered as a pivotal component of family-based interventions and clinical practice.
Remote Symptom Monitoring in Thoracic Surgery Patients After Discharge
Authors: Sewell Marisa , Boerner Thomas , Harrington Caitlin , Hsu Meier , Tan Kay See , Carr Rebecca A. , Jones Susan , Zocco Daniel , Adusumilli Prasad S. , Bains Manjit S. , Bott Matthew J. , Downey Robert J. , Huang James , Isbell James M. , Park Bernard J. , Rocco Gaetano , Rusch Valerie W. , Sihag Smita , Jones David R. , Cracchiolo Jennifer , Molena Daniela
Published: January 2025

Objective:

Evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms.

Summary Background Data:

Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity for early identification of abnormal symptoms at home before deterioration.

Methods:

An online symptom-tracking platform for thoracic surgery patients was created on the basis of opinions from stakeholders and a review of the literature. Starting in February 2021, patients were educated about the symptom tracker in preoperative clinics. After discharge, patients received a series of electronic surveys covering 23 symptom domains assessed using a Likert scale for severity. Moderate symptoms prompted a “yellow alert,” and severe symptoms prompted a “red alert,” both notifying the nursing team and prompting appropriate action. Patients were considered responders if they completed at least 1 survey.

Results:

In total, 1997 patients were enrolled; 76% (n=1520) were responders. Responders were younger, more likely to be White, less likely to have medical comorbidities, and less likely to be readmitted (odds ratio, 0.53 [95% CI, 0.37-0.76]; P<0.001). Responders who were readmitted had a higher percentage of red alerts (47% vs. 24%; P<0.001) and yellow alerts (74% vs. 61%; P=0.016), compared with responders who were not readmitted.

Conclusions:

Electronic reporting adds an additional mechanism of communication between the patient and the clinical team, with the potential to lower the odds of readmission.
Unexpected stability of the iron(II) complex by an asymmetrical Schiff base from Fe(III): structure, magnetic and Mössbauer investigations
Authors: Tesfaye Dawit , Gebrezgiabher Mamo , Braun Jonas , Sani Taju , Diliberto Sebastien , Boulet Pascal , Kalarikkal Nandakumar , Anson Christopher E. , Powell Annie K. , Thomas Madhu
Published: January 2025

The asymmetric Schiff base prepared
in situ
from ethylenediamine and pyridine-2-carboxaldehyde reacts with Fe(ClO
4
)
3
·6H
2
O to form the Fe(II) complex [FeL
2
](ClO
4
)
2
with L =
N
,
N
-diethyl-
N
′-(pyridin-2-yl)methylene)ethane-1,2-diamine, where the Fe(III) starting material has been unexpectedly reduced to Fe(II). This complex was characterized by elemental analysis, infrared spectra, single crystal and powder X-ray diffraction measurements, variable temperature DC magnetic measurement and room temperature Mössbauer spectroscopy. The asymmetric ligand L coordinates in a tridentate fashion through its pyridyl, azomethine and amino nitrogen atoms, generating a distorted octahedral geometry around the central metal ion. Variable temperature magnetic studies and a Mössbauer measurement show that the iron is locked in the low spin Fe(II) states.
Modelling pacemaker oscillations in lymphatic muscle cells: lengthened action potentials by two distinct system effects
Authors: Hancock Edward J. , Macaskill Charlie , Zawieja Scott D. , Davis Michael J. , Bertram Christopher D.
Published: January 2025

Lymphatic system failures contribute to cardiovascular and various other diseases. A critical function of the lymphatic vascular system is the active pumping of fluid from the interstitium back into the blood circulation by periodic contractions of lymphatic muscle cells (LMCs) in the vessel walls. As in cardiac pacemaking, these periodic contractions can be interpreted as occurring due to linked pacemaker oscillations in the LMC membrane potential (M-clock) and calcium concentration (C-clock). We previously reported a minimal model of synchronized dual-clock-driven oscillations. While this qualitatively replicated the period of oscillations under different conditions, it did not replicate the action potential shape as it varied under those conditions, particularly as regards the extent or lack of a systolic plateau. Here, we modify the model to replicate the plateau behaviour. Using phase-plane analysis we show two qualitatively different dynamical mechanisms that could account for plateau formation, one largely M-clock-driven, the other largely C-clock-driven. The second case occurs with the introduction of a ryanodine receptor; in both cases, we find improved predictions for calcium levels. With enhanced fidelity to the experimental data, the improved model has the potential to help determine opportunities for pharmacological treatment of lymphatic system pumping defects.
Dormancy in the origin, evolution and persistence of life on Earth
Authors: Webster Kevin D. , Lennon Jay T.
Published: January 2025

Life has existed on Earth for most of the planet’s history, yet major gaps and unresolved questions remain about how it first arose and persisted. Early Earth posed numerous challenges for life, including harsh and fluctuating environments. Today, many organisms cope with such conditions by entering a reversible state of reduced metabolic activity, a phenomenon known as dormancy. This process protects inactive individuals and minimizes the risk of extinction by preserving information that stabilizes life-system dynamics. Here, we develop a framework for understanding dormancy on early Earth, beginning with a primer on dormancy theory and its core criteria. We hypothesize that dormancy-like mechanisms acting on chemical precursors in a prebiotic world may have facilitated the origin of life. Drawing on evidence from phylogenetic reconstructions and the fossil record, we demonstrate that dormancy is prevalent across the tree of life and throughout deep time. These observations lead us to consider how dormancy might have shaped nascent living systems by buffering stochastic processes in small populations, protecting against large-scale planetary disturbances, aiding dispersal in patchy landscapes and facilitating adaptive radiations. Given that dormancy is a fundamental and easily evolved property on Earth, it is also likely to be a feature of life elsewhere in the universe.
Pseudomonas fungipugnans sp. nov., a potently antifungal bacterium isolated from moss
Authors: Schnyder Anya , Kalawong Ratchara , Eberl Leo , Agnoli Kirsty
Published: January 2025

A novel strain, 681, was isolated from a moss sample taken from the Chrutzelried woods in Canton Zürich, Switzerland. The strain showed potent activity against several fungi and oomycetes. It was affiliated to the Pseudomonas genus by 16S rRNA gene sequence phylogeny. Genome sequencing showed a G+C content of 59.9 mol%. The highest average nucleotide identity was 86.63%, and the highest digital DNA–DNA hybridization value was 32.2% (with Pseudomonas nunensis ln5), considerably below the thresholds for species delineation. Multi-locus phylogeny using 81 concatenated sequences indicated that the strain represented a new species within the Pseudomonas mandelii subgroup. This study details its characterization as a new species. The 681 genome was screened in silico using antiSMASH to reveal candidate secondary metabolite clusters for the strong antifungal activity exhibited by 681. Of the 15 clusters identified, we disrupted the seven best and tested for activity against Fusarium solani. The pyrrolnitrin, rhizoxin, novel PKS-NRPS and acaterin gene clusters contributed significantly to the observed antifungal activity. Phenotypic analyses found that strain 681 cells were aerobic, Gram-negative, motile rods (mean length 2.60 µm and mean width of 0.67 µm) with one to three polar flagella. Optimal growth was at 30 °C, but growth also occurred at 8 °C. The pH range was 6–7, with some growth at pH 8. Robust growth occurred at 0–3% (w/v) NaCl and weak growth at 4% (w/v) NaCl, with the optimum at 1% (w/v) NaCl. Strain 681 was oxidase positive, hydrolysed arginine under anaerobic conditions, showed intense fluorescence on King’s medium B and produced a hypersensitive response in tobacco leaves. Following our investigations, we propose the designation Pseudomonas fungipugnans sp. nov. for this new species. The type strain, 681, is available from the DSMZ and LMG/BCCM culture collections under the designations DSM 115721 and LMG 33039, respectively.
Mapping interactions within the NMD decapping complex reveals how Upf1 recruits Dcp2 onto mRNA targets
Authors: Ruiz-Gutierrez Nadia , Dupas Jeanne , Auquier Elvire , Barbarin-Bocahu Irène , Gaudon-Plesse Claudine , Saveanu Cosmin , Graille Marc , Hir Hervé Le
Published: January 2025

Upf1 RNA helicase is a pivotal factor in the conserved nonsense-mediated mRNA decay (NMD) process. Upf1 is responsible for coordinating the recognition of premature termination codons (PTC) in a translation-dependent manner and subsequently triggering mRNA degradation. Multiple factors assist Upf1 during these two consecutive steps. InSaccharomyces cerevisiae,Upf2 and Upf3 associated to Upf1 (Upf1-2/3) contribute to PTC recognition but are absent from the Upf1-decapping complex that includes Nmd4, Ebs1, Dcp1, and Dcp2. Despite their importance for NMD, the organization and dynamics of these Upf1-containing complexes remains unclear. Here, we show how distinct domains of Upf1 make direct contacts with Dcp1/Dcp2, Nmd4 and Ebs1 using recombinant proteins. These proteins also bind to each other forming an extended network of interactions within the Upf1-decapping complex. Dcp2 and Upf2 are shown to compete for the same binding site in the Upf1 N-terminal CH domain. This finding accounts for the isolation of two mutually exclusive Upf1-containing complexes from cell lysates. Furthermore, we show how Nmd4-assisted recruitment of Upf1 promotes the anchoring of the decapping protein to the mRNA.
Investigating the relationship between adolescent mental health and wellbeing in a nationally representative survey of 11-16 year olds in Wales
Authors: Mahedy Liam , McDonald Basil , Greene Giles , Davies Alisha , John Ann
Published: January 2025

Background

Improving mental health (MH) and wellbeing (WB) of children is a national priority, yet there is no consensus on how these constructs are defined, nor the relationship between them. This is essential to ensure action is directed to where it has the greatest potential to prevent poorer MH and WB.

Methods

The School Health Research Network includes 191,975 pupils from 196 secondary schools in Wales (94% coverage of all schools). Annual pupil health survey data was used to investigate the relationship between MH (Strengths and Difficulties Questionnaire Total Difficulties (SDQTD)) and WB (Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS)) in a multilevel modelling framework. The primary sample size comprised any 11-to 16-year-old pupils with a pair of SWEMWBS and SDQTD scores in the 2019 or 2021 survey (N=191,975). Adjustment was made for variables hypothesised to influence MH or WB, grouped into demographic, behavioural, social, and structural domains.

Findings

Worsening SDQTD categories predicted lower SWEMWBS scores in a clinically significant dose-response relationship in the fully adjusted model, ranging from slightly raised SDQTD (b= −1.68, 95% CI = −1.76, −1.61), high SDQTD (b= −2.41, 95% CI = −2.51, −2.31), and very high SDQTD (b= −3.63, 95% CI = −3.71, −3.55). Sensitivity analysis including pupils with missing SDQTD scores showed a similar pattern of results.

Conclusion

These findings indicate a strong negative association between MH difficulties and WB among pupils in Wales. Determining whether treatment and prevention techniques for poor MH are shared or distinct could help allocate resources and efforts efficiently.