bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term outcomes in patients with advanced intrahepatic cholangiocarcinoma treated with hepatic arterial infusion chemotherapy
Authors: Cowzer Darren , Soares Kevin , Walch Henry , Gönen Mithat , Boucher Taryn M , Do Richard K G , Harding James J , Varghese Anna M , Reidy-Lagunes Diane , Saltz Leonard , Connell Louise C , Abou-Alfa Ghassan K , Wei Alice C , Schultz Nikolaus , Kingham T Peter , D’Angelica Michael I , Drebin Jeffrey A , Balachandran Vinod , Sanchez-Vega Francisco , Kemeny Nancy E , Jarnagin William R , Cercek Andrea
Published: September 2024

Background

Hepatic artery infusion of chemotherapy has demonstrated disease control and suggested improvement in overall survival in intrahepatic cholangiocarcinoma. We report herein the long-term results and role of molecular alterations of a phase II clinical trial of hepatic artery infusion chemotherapy plus systemic chemotherapy, with a retrospective cohort of patients treated with hepatic artery infusion at Memorial Sloan Kettering Cancer Center.

Methods

This is a secondary analysis of a single-institution, phase II trial, and retrospective cohort of unresectable intrahepatic cholangiocarcinoma treated with hepatic artery infusion floxuridine plus systemic gemcitabine and oxaliplatin. The primary aim was to assess long-term oncologic outcomes. A subset underwent tissue-based genomic sequencing, and molecular alterations were correlated with progression-free survival (PFS) and overall survival.

Results

A total of 38 patients were treated on trial with a median follow-up of 76.9 months. Median PFS was 11.8 months (95% confidence interval [CI] = 11 to 15.1 months). The median overall survival was 26.8 months (95% CI = 20.9 to 40.6 months). The 1-, 2-, and 5-year overall survival rate was 89.5%, 55%, and 21%, respectively. Nine (24%) patients received hepatic artery infusion with mitomycin C post-floxuridine progression with an objective response rate of 44% and a median PFS of 3.93 months (95% CI = 2.33 months to not reached). A total of 170 patients not treated on the clinical trial were included in a retrospective analysis. Median PFS and overall survival were 7.93 months (95% CI = 7.27 to 10.07 months) and 22.5 months (95% CI = 19.5 to 28.3 months), respectively. Alterations in the TP53 and cell-cycle pathway had a worse PFS to hepatic artery infusion–based therapy compared with wild-type disease.

Conclusion

In locally advanced intrahepatic cholangiocarcinoma, hepatic artery infusion with floxuridine in combination with systemic therapy can offer long-term durable disease control. Molecular alterations may predict for response.
Synchronous cesarean delivery and revision of infected ventral hernia repair mesh in a complex abdominal wall
Authors: Bender Tiffany , Owen Parker , Johnson Kristopher , Sorrell Matthew , Rodel Rachel
Published: September 2024

Ventral hernias are a common abdominal wall defect vulnerable to the gravid abdomen’s physiological changes. This case report describes a 38-year-old gravida 3 para 2002 female with a complex abdominal surgical history and a chronic infection of the abdominal wall at the site of prior hernia repair with mesh. She was managed conservatively with antibiotics until delivery. Abdominal wall debridement and repair was coordinated with her 39-week cesarean, which allowed for a successful delivery of her infant paralleled with surgical management of the infected mesh.
Multiple fractures after low-energy trauma in an immunosuppressed lung transplant patient with severe osteoporotic bone texture—a challenge for traumatology and osteology
Authors: Andresen Julian Ramin , Direder Martin , Widhalm Harald K
Published: September 2024

Patients before and after lung transplantation often have osteoporosis with existing and recent symptomatic insufficiency fractures, which reduce the quality of life and increase general morbidity and mortality. Due to the reduced bone quality with a significantly increased fracture risk, even low-energy trauma results in the risk of acquiring multiple and complex fractures. The rarefied bone substance can be very challenging for subsequent osteosynthetic treatment. Antiosteoporotic medication is always necessary, and osteoanabolic therapy should be discussed in such cases. In the following, we report about the successful osteosynthetic treatment of an immunosuppressed patient with multiple fractures after a fall from low height. To support fracture healing with antiosteoporotic drug therapy, the patient was switched from antiresorptive to osteoanabolic medication, which resulted in complete fracture consolidation over the course of 6 months. There were also no new insufficiency fractures during this period; however, no improvement in bone density was achieved.
Multidisciplinary travel health education: current status and rationale for standardized competencies
Authors: Hess Karl M , Seed Sheila M , Clark Eva H , Lombardo Tara , Norman Francesca F , Flaherty Gerard
Published: September 2024

This perspective highlights the inconsistent integration of travel health education across medical, nursing and pharmacy educational programmes globally and calls for standardized travel health competencies based on the International Society of Travel Medicine’s (ISTM) Body of Knowledge to help improve patient care outcomes as global travel returns to pre-pandemic levels.
Hyperspectral imaging for chloroplast movement detection
Authors: Hermanowicz Paweł , Łabuz Justyna
Published: September 2024

We employed hyperspectral imaging to detect chloroplast positioning and assess its influence on common vegetation indices. In low blue light, chloroplasts move to cell walls perpendicular to the direction of the incident light. In high blue light, chloroplasts exhibit the avoidance response, moving to cell walls parallel to the light direction. Irradiation with high light resulted in significant changes in leaf reflectance and the shape of the reflectance spectrum. Using mutants with disrupted chloroplast movements, we found that blue light-induced changes in the reflectance spectrum are mostly due to chloroplast relocations. We trained machine learning methods in the classification of leaves according to the chloroplast positioning, based on the reflectance spectra. The convolutional network showed low levels of misclassification of leaves irradiated with high light even when different species were used for training and testing, suggesting that reflectance spectra may be used to detect chloroplast avoidance in heterogeneous vegetation. We also examined the correlation between chloroplast positioning and values of indices of normalized-difference type for various combinations of wavelengths and identified an index sensitive to chloroplast positioning. We found that values of some of the vegetation indices, including those sensitive to the carotenoid levels, may be altered due to chloroplast rearrangements.
Using scalable vector graphics in medieval Latin palaeography: new approaches, new conversations
Authors: Pohl Benjamin
Published: September 2024

The use of scalable vector graphics (SVG) in the study of pre-modern handwriting (palaeography) to date has been extremely limited, especially amongst scholars of the medieval Latin West and its manuscript culture(s). Informed by the author’s experience of using vector graphics for over a decade in researching and teaching medieval Latin palaeography in UK and EU Higher Education, this short article offers a starting point for further conversation. Following a general introduction and a concise survey of current practice, it discusses some basic SVG editing tools and exemplifies the utility of their application in three key areas of palaeographic study (tracing, analysis, and visualization) before highlighting, by way of conclusion, potential avenues of future development with the aim of enabling and encouraging colleagues to make greater use of SVG in their research and teaching.
A comparison of imprecise Bayesianism and Dempster–Shafer theory for automated decisions under ambiguity
Authors: Radzvilas Mantas , Peden William , Tortoli Daniele , De Pretis Francesco
Published: September 2024

Ambiguity occurs insofar as a reasoner lacks information about the relevant physical probabilities. There are objections to the application of standard Bayesian inductive logic and decision theory in contexts of significant ambiguity. A variety of alternative frameworks for reasoning under ambiguity have been proposed. Two of the most prominent are Imprecise Bayesianism and Dempster–Shafer theory. We compare these inductive logics with respect to the Ambiguity Dilemma, which is a problem that has been raised for Imprecise Bayesianism. We develop an agent-based model comparison that isolates the difference between the two inductive logics in their updating methods. We find that Dempster–Shafer theory does not avoid the Ambiguity Dilemma. We discuss the implications of this result.
DNA-binding proteins from MBD through ZF to BEN: recognition of cytosine methylation status by one arginine with two conformations
Authors: Zhang Xing , Blumenthal Robert M , Cheng Xiaodong
Published: September 2024

Maintenance methylation, of palindromic CpG dinucleotides at DNA replication forks, is crucial for the faithful mitotic inheritance of genomic 5-methylcytosine (5mC) methylation patterns. MBD proteins use two arginine residues to recognize symmetrically-positioned methyl groups in fully-methylated 5mCpG/5mCpG and 5mCpA/TpG dinucleotides. In contrast, C2H2 zinc finger (ZF) proteins recognize CpG and CpA, whether methylated or not, within longer specific sequences in a site- and strand-specific manner. Unmethylated CpG sites, often within CpG island (CGI) promoters, need protection by protein factors to maintain their hypomethylated status. Members of the BEN domain proteins bind CGCG or CACG elements within CGIs to regulate gene expression. Despite their overall structural diversity, MBD, ZF and BEN proteins all use arginine residues to recognize guanine, adopting either a ‘straight-on’ or ‘oblique’ conformation. The straight-on conformation accommodates a methyl group in the (5mC/T)pG dinucleotide, while the oblique conformation can clash with the methyl group of 5mC, leading to preferential binding of unmethylated sequences.
Light-chilling Stress Causes Hyper-accumulation of Iron in Shoot, Exacerbating Leaf Oxidative Damage in Cucumber
Authors: Takeuchi Ko , Ochiai Kumiko , Kobayashi Masaru , Kuroda Kouichi , Ifuku Kentaro
Published: September 2024

Iron availability within the root system of plants fluctuates depending on various soil factors, which directly impacts plant growth. Simultaneously, various environmental stressors, such as high/low temperatures and high light intensity, affect plant photosynthesis in the leaves. However, the combined effects of iron nutrient conditions and abiotic stresses have not yet been clarified. In this study, we analyzed how iron nutrition conditions impact the chilling-induced damage on cucumber leaves (Cucumis sativus L.). When cucumbers were grown under different iron conditions and then exposed to chilling stress, plants grown under a high iron condition exhibited more severe chilling-induced damage than the control plants. Conversely, plants grown under a low-iron condition showed an alleviation of the chilling-induced damages. These differences were observed in a light-dependent manner, indicating that iron intensified the toxicity of reactive oxygen species generated by photosynthetic electron transport. In fact, plants grown under the low-iron condition showed less accumulation of malondialdehyde derived from lipid peroxidation after chilling stress. Notably, the plants grown under the high iron condition displayed a significant accumulation of iron and an increase in lipid peroxidation in the shoot, specifically after light-chilling stress, but not after dark-chilling stress. This indicated that increased root-to-shoot iron translocation, driven by light and low temperature, exacerbated leaf oxidative damage during chilling stress. These findings also highlight the importance of managing iron nutrition in the face of chilling stress and will facilitate crop breeding and cultivation strategies.
Association analysis provides insights into molecular evolution in salt tolerance during tomato domestication
Authors: Wang Zhen , Hong Yechun , Li Dianjue , Wang Zhiqiang , Chao Zhen-Fei , Yu Yongdong , Zhu Guangtao , Zhu Jian-Kang
Published: September 2024

Salt stress impairs plant growth and development, generally resulting in crop failure. Tomato domestication gave rise to a dramatic decrease in salt tolerance caused by the genetic variability of the wild ancestors. However, the nature of artificial selection in reducing tomato salt tolerance remains unclear. Here, we generated and analyzed datasets on the survival rates and sodium (Na+) and potassium (K+) concentrations of hundreds of tomato varieties from wild ancestors to contemporary breeding accessions under high salinity. Genome-wide association studies revealed that natural variation in the promoter region of the putative K+ channel regulatory subunit-encoding gene KSB1 (potassium channel beta subunit in Solanum lycopersicum) is associated with the survival rates and root Na+/K+ ratios in tomato under salt stress. This variation is deposited in tomato domestication sweeps and contributes to modified expression of KSB1 by a salt-induced transcription factor SlHY5 in response to high salinity. We further found that KSB1 interacts with the K+ channel protein KSL1 to maintain cellular Na+ and K+ homeostasis, thus enhancing salt tolerance in tomato. Our findings reveal the crucial role of the SlHY5-KSB1-KSL1 module in regulating ion homeostasis and salt tolerance during tomato domestication, elucidating that selective pressure imposed by humans on the evolutionary process provides insights into further crop improvement.
Liechtenstein report—respecting settlor/founder intention: If wishes were horses, would trustees ride?
Authors: Gasser Johannes
Published: September 2024

Most Liechtenstein foundations and trusts are founded and settled by nominees. Although at first, only the nominees were considered to be able to exercise reserved powers, the new 2009 statutory foundation law shifted such powers to the effective founder, i.e. the nominee’s “client”, and, most recently, the Liechtenstein Supreme Court applied the same principles on trusts in favor of settlors. Founders or settlors may exert control over the foundation or trust in various ways. However, economic founders in most cases reserve such powers not for themselves, but for the foundation board which is required to seek their advice on their historical intent. Like letters of wishes, which are equally relevant and standard practice, such advice will guide the board when excluding or appointing beneficiaries or varying the foundation documents in other ways.
Methane emissions and rumen microbiome response during compensatory growth on either a forage or grain-based finishing diet in beef cattle
Authors: Clariget Juan M , Banchero Georgget , Ciganda Verónica , Santander Daniel , Keogh Kate , Smith Paul E , Kelly Alan K , Kenny David A
Published: September 2024

The aim of this experiment was to evaluate the effect of the level of prior nutritional restriction during backgrounding in Angus steers on methane (CH4) emissions, diet digestibility, rumen fermentation, and ruminal microbiome under either a forage or grain-based finishing diet. Eighty steers (body weight [BW]: 444 ± 39 kg, age: 18 ± 1 mo) were blocked and randomly assigned within the block to either an optimal (0.6 to 0.7 kg/d) or suboptimal (0.3 to 0.4 kg/d) growth rate to exploit compensatory growth (CG), during 97 d of backgrounding. Following, for 84 d, half of the steers in each group were finished on a forage diet while the other half were finished on a grain-based diet. During the backgrounding period, CH4 emissions tended (P ≤ 0.07) to be higher; however, CH4 intensity expressed by BW gain was 50% lower (P < 0.01) for optimal compared to suboptimal growth steers. BW gain, dry matter intake, diet digestibility, and ammonia nitrogen in the rumen were greater (P < 0.01) for optimal compared to suboptimal steers. During the finishing period, CH4 emissions in either forage or grain finishing diets were similar (P > 0.05) for both backgrounding treatments. However, due to greater BW gain in suboptimal steers (1.20 vs. 0.97 kg/d), their CH4 intensity-related coefficient decreased (P < 0.05) during the finishing period. Diet digestibility or any fermentation parameter was unaffected (P > 0.05) by previous backgrounding during the finishing period. In fact, rumen microbial abundance measured during finishing was not modified (P > 0.05) by previous backgrounding. Steers finished under grain conditions, had lower (P < 0.01) daily CH4 emissions and CH4 intensity. Additionally, grain-fed steers increased (P < 0.05) BW gain, diet digestibility, propionic, lactic, and valeric acids, Succinivibrionaceae family and Succiniclasticum, Erysipelotrichaceae UCG-002, Sharpea, and Megasphaera bacteria genera, compared to forage-fed steers. In conclusion, ruminal microbiome and fermentation, diet digestibility, and CH4 emissions were unaffected during finishing between prior levels of backgrounding growth. However, given the higher BW gain in suboptimal steers in both finishing diets, CH4 intensity was reduced in comparison to the optimal backgrounded steers. Nevertheless, lifetime emissions of the steers need to be assessed with the different dietary regimens, since suboptimal steers reduced CH4 emissions during the backgrounding period but, additional days of finishing were required to achieve the same BW as their contemporaries.
Drought and heat stress interactions modify photorespiration and hydrogen peroxide content in silver fir
Authors: Alongi Franklin , Petrík Peter , Ruehr Nadine K
Published: September 2024

Photorespiration (PR) greatly reduces net carbon assimilation in trees (by c. 25%), but has received recent attention particular for its potential role in stress-signaling through the accumulation of hydrogen peroxide (H2O2), a stress signaling agent. Despite an increasing frequency of drought and heat events affecting forests worldwide, little is known about how concurrent abiotic stressors may interact to affect PR and subsequent H2O2 accumulation in trees. Here, we sought to identify how drought and a compounded 1-day heat treatment individually and interactively affect PR (determined under variable O2) in Abies alba Mill. seedlings. Additionally, we quantified foliar H2O2 accumulation and enzymatic scavenging via peroxidase in relation to PR rates. We found drought stress to slightly increase PR (+5.2%) during mild-drought (12 days, Ψmd = −0.85 MPa), but ultimately to decrease PR (−13.6%) during severe-drought (26 days, Ψmd = −1.70 MPa) compared with the control, corresponding to increasing non-stomatal limitations of photosynthesis (i.e., decreased electron transport rate). The response of PR to heat stress was dependent on soil water availability as heat stress increased PR in control seedlings (+37.8%), but not in drought-stressed seedlings. Decreased PR during severe-drought corresponded to ~2× lower foliar H2O2 compared with the control. Despite increased PR under heat stress in control seedlings, foliar H2O2 decreased to near-zero likely due to enhanced scavenging as observed in ~2× greater peroxidase activity. Our results demonstrate that carbon loss to PR during drought stress can be highly dynamic, depending on the severity of soil dehydration. Additionally, increased PR under abiotic stress does not necessarily lead to accumulated H2O2, as tight regulation by scavenging enzymes instead minimize oxidative stress, reducing stress-signaling potential.
A process-based model of climate-driven xylogenesis and tree-ring formation in broad-leaved trees (BTR)
Authors: Zhao Binqing , Song Wenqi , Chen Zecheng , Zhang Qingzhu , Liu Di , Bai Yuxin , Li Zongshan , Dong Hanjun , Gao Xiaohui , Li Xingxing , Wang Xiaochun
Published: September 2024

The process-based xylem formation model is an important tool for understanding the radial growth process of trees and its influencing factors. While numerous xylogenesis models for conifers have been developed, there is a lack of models available for non-coniferous trees. In this study, we present a process-based model designed for xylem formation and ring growth in broad-leaved trees, which we call the Broad-leaved Tree-Ring (BTR) model. Climate factors, including daylength, air temperature, soil moisture and vapor pressure deficit, drive daily xylem cell production (fibers and vessels) and growth (enlargement, wall deposition). The model calculates the total cell area in the simulated zone to determine the annual ring width. The results demonstrate that the BTR model can basically simulate inter-annual variation in ring width and intra-annual changes in vessel and fiber cell formation in Fraxinus mandshurica (ring-porous) and Betula platyphylla (diffuse-porous). The BTR model is a potential tool for understanding how different trees form wood and how climate change influences this process.
Personal Experiences With Xylazine and Behavior Change: A Qualitative Content Analysis of Reddit Posts
Authors: Heidari Omeid , Sugarman Olivia K. , Winiker Abigail K. , Gattine Sabrina , Flanagan Vivian , Razaghi Roham , Saloner Brendan K.
Published: September 2024

Objectives

Xylazine is a rapidly spreading adulterant in the United States' drug supply and is increasingly associated with overdoses and severe wounds, but there is a dearth of information about the clinical presentation or means of treatment for human xylazine exposure. The objective of this study was to explore personal attitudes about xylazine in the drug supply and experiences with xylazine-related use among people who reported using drugs and contributed content to social media site Reddit.

Methods

To conduct a retrospective qualitative content analysis, the study team extracted all posts and comments from Reddit, which mentioned the terms “xylazine” or “tranq.” Content was extracted from 10 Reddit forums, or subreddits, specific to drug use, and included content created on or before the extraction date of January 2023. In total, 3284 posts were identified and 1803 were qualitatively coded using an inductive approach until meaning saturation was reached.

Results

Three themes emerged across comments and posts: (1) personal experiences with xylazine, including a negative impact on overdose, withdrawal, and wounds; (2) behavior changes in response to xylazine in the drug supply, including devising and sharing new harm reduction and detection tips, and reducing or abstaining from drug use altogether; (3) a perceived lack of treatment options for xylazine withdrawal and information sharing to help others self-treat withdrawal symptoms, most often with clonidine.

Conclusions

This study of people who reported using drugs with xylazine provides new insights into how xylazine is perceived, possible treatment modalities, and potential clinical research approaches.
Return-to-Play Outcomes in Elite Athletes After Cervical and Lumbar Motion Preservation Spine Surgery
Authors: Reyes Justin L. , Geraghty Elisabeth , Coury Josephine R. , Arvind Varun , Luzzi Andrew J. , Mastroianni Michael A. , Morrissette Cole R. , Obana Kyle O. , Trofa David P. , Ahmad Christopher S. , Sardar Zeeshan M. , Lehman Ronald A. , Lombardi Joseph M.
Published: September 2024

Study Design.

Systematic review.

Objective.

The primary purpose of this article was to survey the present literature and report on return-to-play (RTP) outcomes in elite athletes after undergoing motion preservation spinal surgery (MPSS).

Background.

For elite performance, athletes require adequate mobility throughout the trunk, torso, and spine to achieve maximal force production. Therefore, elite athletes who have failed conservative treatment may seek to undergo motion-preserving surgical options, such as total disc arthroplasty and lumbar microdiscectomy. Individual studies have reported on RTP outcomes following individual motion preservation surgical procedures, but no systematic reviews have formally reported on RTP outcomes, postoperative performance, and reoperation rates on these procedures in elite athletes.

Materials and Methods.

A systematic review was conducted from inception until February 2024 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. One reviewer queried PubMed for relevant studies that reported on RTP outcomes in elite athletes after MPSS based on title and abstract (n = 1404). After the original search query, an additional reviewer screened full-length articles. A total of 11 studies met the inclusion criteria. Special consideration was given to RTP rates, postoperative performance, and reoperation rates.

Results.

A total of 612 elite athletes from the National Basketball Association, Major League Baseball, National Football League, National Hockey League, and other professional sporting organizations underwent cervical and lumbar MPSS to treat various spinal pathologies. Various motion-sparing techniques were used to treat various pathologies. After undergoing MPSS, RTP rates ranged from 75% to 100% for lumbar cases and 83.3% to 100% for cervical cases. Postoperative performance varied with some athletes performing at the same level before surgery and some performing at a decreased level.

Conclusions.

MPSS is a feasible option when properly indicated. Future studies are needed to compare return to sport rates, postoperative performance, and reoperation rates between MPSS to spinal arthrodesis.
Holmium laser enucleation of the prostate versus transurethral resection of the prostate in treatment of benign prostatic hyperplasia: A meta-analysis of 13 randomized control trials
Authors: Daryanto Besut , Suryanullah Wisnu Syahputra , Putra Probo Yudha Pratama
Published: September 2024

Background

The prevalence of benign prostatic hyperplasia (BPH) in older men increases with age, beginning at 40–45 years and reaching to 60% by 60 years and 80% by 80 years. Surgical procedures such as holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) are the preferred treatments for BPH. Nevertheless, there is disagreement regarding the most efficient and safe treatment for BPH. The objective of this meta-analysis was to assess the efficacy and safety of HoLEP and TURP based on existing evidence.

Materials and methods

This meta-analysis was performed in accordance with the PRISMA guidelines. In February 2023, a literature review was conducted using PubMed, ScienceDirect, and the Cochrane Library, and the meta-analysis was performed using RevMan V.5.4.

Results

A total of 656 patients underwent HoLEP, and 653 patients underwent TURP. There was no statistically significant difference in the International Prostate Symptom Score at 1 month or at 3, 6, 18, 24, and 36 months; the HoLEP group showed a significant difference at 12 months. The pooled data from the maximum urinary flow rate at 1–12 months revealed no significant findings, but the TURP group showed significant results at 24 months. Meanwhile, the HoLEP group showed significant postvoid residual results. There was no significant difference in the quality of life between the groups. Patients who underwent HoLEP had shorter hospital stay and catheter usage period and had lower hemoglobin drop. The operating time was shorter in the TURP group. The difference in specimen weight between the 2 groups was not statistically significant. The overall complications were similar in both groups, but the HoLEP group received significantly fewer blood transfusions.

Conclusions

Holmium laser enucleation of the prostate demonstrated excellent efficacy and safety, with fewer hematological changes and complications; however, TURP had a shorter operating time.
HCC spatial transcriptomic profiling reveals significant and potentially targetable cancer-endothelial interactions
Authors: Lu Chenyue , Pankaj Amaya , Raabe Michael , Nawrocki Cole , Liu Ann , Xu Nova , Patel Bidish K. , Emmett Matthew J. , Coley Avril K. , Ferrone Cristina R. , Deshpande Vikram , Bhan Irun , Hoshida Yujin , Ting David T. , Aryee Martin J. , Franses Joseph W.
Published: September 2024

Background:

HCC is a highly vascular tumor, and many effective drug regimens target the tumor blood vessels. Prior bulk HCC subtyping data used bulk transcriptomes, which contained a mixture of parenchymal and stromal contributions.

Methods:

We utilized computational deconvolution and cell-cell interaction analyses to cell type-specific (tumor-enriched and vessel-enriched) spatial transcriptomic data collected from 41 resected HCC tissue specimens.

Results:

We report that the prior Hoshida bulk transcriptional subtyping schema is driven largely by an endothelial fraction, show an alternative tumor-specific schema has potential prognostic value, and use spatially paired ligand-receptor analyses to identify known and novel (LGALS9 tumor-HAVCR2 vessel) signaling relationships that drive HCC biology in a subtype-specific and potentially targetable manner.

Conclusions:

Our study leverages spatial gene expression profiling technologies to dissect HCC heterogeneity and identify heterogeneous signaling relationships between cancer cells and their endothelial cells. Future validation and expansion of these findings may validate novel cancer-endothelial cell interactions and related drug targets.
Global prevalence of cataract surgery
Authors: Hashemi Hassan , Fayaz Faezeh , Hashemi Alireza , Khabazkhoob Mehdi
Published: September 2024

Purpose of review

The objective of this review article is to ascertain the global distribution of cataract surgery and evaluate the extent of its coverage in recent years.

Recent findings

The cataract surgical rate (CSR) has been reported from 36 to 12 800 (per million population) across different countries. The average cataract surgical coverage (CSC) in the majority of countries was around 50% or lower. Additionally, in many countries, the efficient CSC (eCSC) deviates from the CSC, emphasizing the importance of attention to the quality of surgical procedures. Socioeconomic status and access to health services are key determinants in the distribution of cataract surgery. This procedure is more prevalent among older individuals, with a higher incidence among men and private insurances tend to cover a larger portion of cataract surgeries. The pandemic of COVID-19 has had a detrimental effect on cataract surgery rates in numerous countries.

The rate of cataract surgery and its extent of coverage in certain countries is inadequate. The primary factor influencing the quantity and coverage of cataract surgeries is the economic status of the countries. Additionally, government support through insurance and the provision of appropriate healthcare services can contribute to an increase in cataract surgeries.
Update on intraocular lens formulas
Authors: Raimundo Miguel , Findl Oliver
Published: September 2024

Purpose of review

This review aims to discuss recent advances in intraocular lens (IOL) power calculation, including newly introduced formulas, classification updates, comparative analyses between formulas, and emerging trends in the field.

Recent findings

A significant number of modern IOL power calculation formulas have become available, incorporating both established and novel concepts such as artificial intelligence and ray tracing. A revised classification system has been introduced, reflecting the underlying principles of each formula. Recent comparative studies demonstrate the excellent refractive outcomes achievable with modern formulas. Emerging trends, such as the use of sum-of-segments axial length and the incorporation of measured posterior corneal data, hold promise for refining predictions in cases of extreme axial lengths and nonphysiological corneas, respectively. Advances in optimization and analytical methods also have the potential to further enhance refractive results.

The field of IOL power calculation is continually evolving through iterative improvements in formula design, driven by new technologies, advanced instrumentation, and innovative analytical approaches. These advancements enable excellent refractive outcomes, even in atypical eyes.
A Qualitative Study Exploring Experiences in Caregiving for Patients With Advanced Wilson Disease
Authors: Baby Priya , Thomas Priya Treesa , P. Binesha , J. Jobimol , Kumar Gargi S. , M. Arun , Kamble Nitish , Yadav Ravi , Pal Pramod K.
Published: September 2024

BACKGROUND: Wilson disease (WD) is a rare disease characterized by impaired copper metabolism. It is usually diagnosed in children and has several distinct attributes that can make the caregiving experience different. The advanced stage of the illness is quite challenging, and caregiver experiences during this phase of the disease are underexplored. METHODS: The present study is an exploratory qualitative investigation with in-depth interviews aiming to understand the experiences of family caregivers of children with advanced WD receiving neuropalliative care services at a tertiary care hospital. Interviews from 7 family caregivers were recorded, transcribed, and analyzed using an inductive and interpretive approach. RESULTS: Family caregivers in the study were predominantly mothers. The major themes that emerged are: being a parent and the caregiver, uncertainty related to illness, financial implications, understanding the disease dynamics, constructive coping strategies, and extended family networks and societal influences. CONCLUSION: The experiences and the encounters of family caregivers of children with advanced WD are multifaceted. Their challenging experiences underscore the need for extended supportive services and neuropalliative nursing care to assist the caregivers and families, and navigate the process of treatment and rehabilitation for the child.
Meta-analysis of FTO expression on the clinicopathologic characteristics and prognosis of gastric cancer
Authors: Zhu Ciba , Da Mingxu , Wu Ziyao , Ma Jichun , Zhu Chenglou , An Xinqiao , Ji Dandan , Xu Chunling
Published: September 2024

Background:

Fat mass and obesity-related gene (FTO) is aberrantly expressed in various cancers including highly expressed in gastric cancer tissues. The aim of this meta-analysis was to explore the effect of FTO expression on clinicopathological and prognostic outcome of gastric cancer.

Methods:

China National Knowledge Infrastructure (CNK), Wanfang database, VIP database, Chinese biomedical literature database (CBM), PubMed, Web of Science, the Cochrane library and EMBASE database were searched to screen the literatures according to the inclusion criteria. The search time was the database establishment until May 2023. The two researchers independently searched and screened the literature, extracted pathological data, and conducted The Newcastle–Ottawa scale (NOS) quality evaluation. Analyze the correlation between FTO and pathological indicators of gastric cancer patients and the impact on prognosis, use and Stata 12.0, software for Meta-analysis.

Results:

A total of 1619 patients were studied in this study. The results of the Meta-analysis showed that higher expression levels of FTO were associated with TMN stage (OR = 1.83, 95% CI: 1.11–3.03, P = .019), liver metastases (OR = 3.73, 95% CI: 1.49–9.31, P = .005), vascular invasion (OR = 2.22, 95% CI: 1.36–3.61, P = .001), poorer overall survival (OS) (HR = 0.46, 95% CI: 0.34–0.58, P < .001) and recurrence-free survival (HR = 0.56, 95% CI: 0.40–0.73, P < .001) in gastric cancer patients. There was no significant relationship with the degree of differentiation (OR = 1.08, 95% CI: 0.49–2.35, P = .852), age (OR = 0.89, 95% CI: 0.71–1.11, P = .306), and gender (OR = 0.92, 95% CI: 0.74–1.14, P = .432).

Conclusion:

High expression of FTO was associated with risk of distant metastases and poor prognosis for patients with gastric cancer. FTO may be a potential prognostic biomarker for gastric cancer, but due to the limited number of literature, the above results need further research.
Ferroptosis: Regulatory mechanisms and potential targets for bone metabolism: A review
Authors: Zhang Yongjie , Hu Kangyi , Shang Zhengya , Yang Xiaorui , Cao Linzhong
Published: September 2024

Bone homeostasis is a homeostasis process constructed by osteoblast bone formation and osteoclast bone resorption. Bone homeostasis imbalance and dysfunction are the basis for the development of various orthopedic diseases such as osteoporosis, osteoarthritis, and steroid-induced avascular necrosis of femoral head. Previous studies have demonstrated that ferroptosis can induce lipid peroxidation through the generation of reactive oxygen species, activate a number of signaling pathways, and participate in the regulation of osteoblast bone formation and osteoclast bone resorption, resulting in bone homeostasis imbalance, which is an important factor in the pathogenesis of many orthopedic diseases, but the mechanism of ferroptosis is still unknown. In recent years, it has been found that, in addition to iron metabolism and intracellular antioxidant system imbalance, organelle dysfunction is also a key factor affecting ferroptosis. This paper takes this as the starting point, reviews the latest literature reports at home and abroad, elaborates the pathogenesis and regulatory pathways of ferroptosis and the relationship between ferroptosis and various organelles, and summarizes the mechanism by which ferroptosis mediates bone homeostasis imbalance, with the aim of providing new directions for the research related to ferroptosis and new ideas for the prevention and treatment of bone and joint diseases.
Characterization of growth arrest-specific transcript 5 and growth arrest-specific transcript 5-related m6A gene signature in glioma: An observational study
Authors: Liao Yutian , Du Li , Qiu Eryue , Zeng Yiqian
Published: September 2024

Glioma remains a significant clinical challenge and poses a dismal patient prognosis. This study focused on the long noncoding ribonucleic acid growth arrest-specific transcript 5 (GAS5) and explored the role of GAS5 and GAS5-related m6A genes in glioma. We explored the mechanisms of GAS5 expression in glioma using bioinformatic analysis based on glioma data from the Cancer Genome Atlas, GSE1142, and Chinese Glioma Genome Atlas databases. Kaplan–Meier curve analysis, nomogram construction, immune cell infiltration, drug sensitivity, mutations, and pathway analyses were performed to determine the GAS5 mechanism in glioma. Spearman correlation and weighted gene co-expression analyses were used to identify the GAS5-related m6A gene. Furthermore, we explored the correlation between GAS5, GAS5-related m6A gene, and clinical traits using analysis of variance. The Kaplan–Meier curve analysis suggested that patients with high expressions of GAS5 had better survival. The nomogram constructed indicated that GAS5 was an independent prognostic factor. Furthermore, GAS5 significantly correlated with plasma cells. GAS5 expression was significantly associated with biological processes, including oxidative phosphorylation, proteasome, and ribosome mitotic spindle. GAS5 expression was associated with sensitivity to erlotinib and gemcitabine. Differentially expressed GAS5 was significant in histology (P = 2.8e−09), grade (P = 3.7e−05), isocitrate dehydrogenase (IDH) mutation (P = 3.4e−17), 1p/19q co-deletion (Codel) status (P = 1.7e−08), and IDH mutation status and 1p/19q Codel status (P = 2.9e−18). Heterogeneous nuclear ribonucleoproteins C1/C2 (HNRNPC) gene was significant in IDH mutation (P = .008) and IDH mutation status and 1p/19q Codel status (P = 2.1e−05). GAS5 and HNRNPC expressions reflected the malignant grade of glioma and are associated with prognosis. The abnormal expression of GAS5 could be an important biomarker for guiding erlotinib and gemcitabine use in glioma treatment. GAS5 and heterogeneous nuclear ribonucleoproteins C1/C2 are potential diagnostic and prognostic markers for glioma.
The current status of early nursing for emergency pancreatitis and analysis of factors influencing prognosis: A retrospective study
Authors: Xu Lejuan , Li Fengxin , Wu Jiehua , He Liang , Gao Zhe
Published: September 2024

This study is to investigate the incidence of pain and the influencing factors of prognostic complications in early admission care of pancreatitis in the emergency department patients. This provides a basis for clinical nursing management and prognosis improvement. Hundred patients with acute pancreatitis admitted to the tertiary hospital between January 2021 and December 2023 were selected according to the inclusion and exclusion criteria. It collected basic baseline data and medical data of patients during admission, clarifies whether patients have complications, and analyzed the length of hospital stay. Comparing hospital stays >7 days with <7 days. A questionnaire on patient psychological status was collected, and single factor analysis was conducted on different prognostic factors. Binary logistic regression was used for single factor analysis, and P < .05 was considered statistically significant. The presence or absence of complications during treatment is the main criterion for determining the prognostic impact of pancreatitis in the emergency department patients. Among 100 patients, 26 (26%) had complications during hospitalization, 74 (74%) had no complications during hospitalization, and 64 (64%) had a stay of >7 days. There were statistically significant differences (P < .05) in smoking status and history of hypertension between the complication group and the non-complication group. In the comparison between the group with <7 days of hospitalization and the group with >7 days of hospitalization, age, education level, smoking status, and history of hyperlipidemia showed statistical significance (P < .05). The fasting days, BISAP score, first bowel movement time, C-reactive protein, blood urea nitrogen, albumin, duration of severe pain within 24 hours of admission, and duration of severe pain within 24 to 48 hours of admission were all statistically significant (P < .05). Pancreatitis in the emergency department patients are prone to exacerbation and prolonged pain during early hospitalization. In nursing, timely attention should be paid to the patient’s pain issues, timely pain relief measures should be taken, and the occurrence of complications should be reduced, reducing the patient’s hospitalization time. Meanwhile, it is necessary to constantly pay attention to changes in the patient’s gastrointestinal function and experimental indicators.
Residual gastritis associated with Strongyloides stercoralis infection: A case report
Authors: Cai Shanshan , Zhou Miaomiao , Zhang Yulian , Luo Wei , Xie Bushan
Published: September 2024

Rationale:

Strongyloides stercoralis, a rare human intestinal parasite, poses a significant health risk, capable of causing lifelong infection and even mortality due to its atypical manifestation of symptoms. In this case report, we reported a case of a patient diagnosed with S. stercoralis infection of the residual stomach and meticulously detail its treatment process, offering valuable insights and a reference point for clinicians.

Patient concerns:

we report a case of infection caused by S. stercoralis after subtotal gastrectomy (Billroth type II) in a 47-year-old middle-aged man. It presents with recurrent nausea and vomiting, accompanied by intermittent food residue vomiting and constipation.

Diagnoses:

Upon endoscopic examination, we observed mucosal swelling and erosion in the anastomosis and output ring of stomach, while pathological analysis confirmed the presence of Strongyloides stercoralis eggs. Subsequently, the administration of albendazole for anti-infection treatment proved to be effective, thereby reinforcing the diagnosis of S. stercoralis infection.

Intervensions:

The patient underwent aggressive management including fasting, fluid replacement, anti-infection therapy, albumin supplementation, and albendazole treatment at a dose of 300 mg/kg/day for 3 days to eliminate the parasite

Outcomes:

After treatment, the patient’s symptoms of nausea, vomiting, and constipation were alleviated and returned to normal upon discharge. Over the subsequent 3 years, the patient reported no instances of vomiting and experienced a recovery of digestive function compared to their discharge status.

Lessons:

S. stercoralis infection is relatively rare in the remnant stomach, endoscopic and pathological examination may be one of the important methods to diagnose S. stercoralis infection, and it is effective to treat albendazole according to the course of treatment.
Drug-induced hypersensitivity syndrome due to phenytoin: Case report and review of the literature
Authors: Wang Ling , Zhang Jie , Wang Xichun , Xu Yali
Published: September 2024

Rationale:

Drug hypersensitivity syndrome (DIHS) is a rare but potentially fatal adverse drug reaction characterized by fever, rash, and visceral organ damage, particularly affecting the liver. Early recognition and appropriate management are crucial to prevent serious complications. However, there is limited information on the clinical presentation and management of DIHS, especially in the context of antiepileptic drugs. This case report aims to highlight the importance of recognizing subtle clinical signs and symptoms of DIHS, which can be easily overlooked, particularly in the context of antiepileptic drug use.

Patient concerns:

We report a case of a 15-year-old male patient who developed DIHS after being prescribed phenytoin sodium for epilepsy. The patient presented with symptoms of fever, sore throat, rash, jaundice, and liver dysfunction. Initially, the patient did not receive glucocorticoids and experienced additional reactions to cefoxitin and phosphatidylcholine, likely due to cross-reactivity.

Diagnoses:

The diagnosis of DIHS was made based on the patient’s clinical presentation, including fever, extensive rash, organ involvement, and hematological abnormalities. The temporal association with the use of phenytoin sodium, along with the exclusion of other causes of fever and rash, supported the diagnosis.

Interventions:

Upon initiation of glucocorticoid therapy with dexamethasone, the patient’s symptoms significantly improved. The rash and pruritus decreased, and laboratory values showed improvement, with a decrease in liver enzymes and normalization of white blood cell counts.

Outcomes:

The patient’s fever resolved within 48 hours of starting corticosteroids, and there was no evidence of ongoing inflammation as indicated by a decrease in C-reactive protein levels. Furthermore, the patient’s 30-month follow-up revealed no recurrence of rash, liver dysfunction, or organic damage, indicating the long-term effectiveness of the treatment administered.

Lessons:

This case highlights the importance of recognizing the subtle clinical signs and symptoms of DIHS, especially in the context of antiepileptic drug use. It underscores the potential benefits of early initiation of glucocorticoid therapy in managing DIHS. The case also serves as a reminder of the potential for drug cross-reactivity in DIHS and the need for cautious drug selection during the acute phase of the syndrome.