bluuebunny/crossref_metadata_2025 huggingface dataset:
Applications of Mass Spectrometry Proteomic Methods to Immunoglobulins in the Clinical Laboratory
Authors: Murray David L , Willrich Maria A V
Published: December 2024

Background

Immunoglobulin (Ig) measurements in the clinical laboratory have been traditionally performed by nephelometry, turbidimetry, electrophoresis, and ELISA assays. Mass spectrometry (MS) measurements have the potential to provide deeper insights on the nature of these markers.

Content

Different approaches—top-down, middle-down, or bottom-up—have been described for measuring specific Igs for endogenous monoclonal immunoglobulins (M-proteins) and exogenous therapeutic monoclonal antibody therapies (t-mAbs). Challenges arise in distinguishing the Ig of interest from the polyclonal Ig background. MS is emerging as a practical method to provide quantitative analysis and information about structural and clonal features that are not easily determined by current clinical laboratory methods. This review discusses clinically implemented examples, including isotyping and quantification of M-proteins and quantitation of t-mAbs within the polyclonal Ig background, as examples of how MS can enhance our detection and characterization of Igs.

This review of current clinically available MS proteomic tests for Igs highlights both analytical and nonanalytical challenges for implementation. Given the new insight into Igs from these methods, it is hoped that vendors, laboratorians, healthcare providers, and payment systems can work to overcome these challenges and advance the care of patients.
Further characterization of adrenocortical and thyroid hormone concentrations of leatherback turtles (Dermochelys coriacea) under various stressors, including validation of a plasma aldosterone assay
Authors: Innis Charles J , Graham Katherine M , Perrault Justin R , Harms Craig A , Christiansen Emily F , Dodge Kara L , Burgess Elizabeth A
Published: December 2024

Leatherback turtles (Dermochelys coriacea) are endangered by anthropogenic threats. Characterizing the physiologic response of leatherback turtles under various stressors may inform conservation strategies. In this study, a commercially available enzyme immunoassay for aldosterone was validated for leatherback turtle plasma, and it was used with previously validated assays for corticosterone and free thyroxine (fT4) to evaluate the physiologic status of leatherback turtles that were entangled in fishing gear, stranded on shore, nesting or intentionally captured at sea during ecologic studies. Mean aldosterone concentrations were significantly higher in entangled turtles (156 ± 102 pg/ml), stranded turtles (274 ± 165 pg/ml) and intentionally captured turtles (457 ± 464 pg/ml) than in nesting females (23 ± 16 pg/ml). In contrast, nesting females had higher fT4 (2.9 ± 0.6 pg/ml) compared to entangled turtles (0.8 ± 0.9 pg/ml), stranded turtles (0.7 ± 0.8 pg/ml) and intentionally captured turtles (0.3 ± 0.2 pg/ml). Corticosterone concentrations were significantly higher in stranded individuals (10.9 ± 6.6 ng/ml) compared with nesting (3.8 ± 2.0 ng/ml) and intentionally captured turtles (3.6 ± 2.5 ng/ml), with intermediate levels in entangled turtles (5.1 ± 2.8 ng/ml). This study provides additional insight into the variable physiologic status of leatherback turtles under the influence of different anthropogenic and natural stressors, and it provides an additional tool to evaluate the role of aldosterone in the acute stress response and health of endangered sea turtle species.
Real-World Impact of Uncontrolled Symptoms and Suboptimal Treatment Response in Patients With Crohn’s Disease in the United States and Europe
Authors: Kershaw Jim , Sanon Myrlene , Kachroo Sumesh , Barlow Sophie , Naessens Dominik , Willey Cynthia J , O’Neill Grace , Hoops Timothy
Published: December 2024

Background

Despite a wide range of available treatments, there is limited evidence as to why significant numbers of Crohn’s disease (CD) patients do not achieve disease remission or continue to have residual symptom burden. We aimed to quantify the impact of this suboptimal treatment on patient symptom incidence and severity, quality of life (QoL), and work impairment.

Methods

Data were derived from the Adelphi Real World CD Disease Specific Programme, a cross-sectional survey of CD patients and their treating physicians in France, Germany, Italy, Spain, the United Kingdom, and the United States between January 2020 and March 2021. Physicians reported on patients’ clinical history, disease status, symptom load, and treatment. Patients reported their QoL and activity impairment using the EQ-5D-5L and Work Productivity and Activity Impairment measures. Patients were divided into remitters, partial remitters, and non-remitters. Multivariate regression models were used to assess the impact of remission status on clinical and QoL outcomes.

Results

Of 1786 patients, 24.1% were remitters, 53.2% were partial remitters, and 22.7% were non-remitters. Partial remitters and non-remitters had a significantly higher symptom load than remitters (P < .05), and non-remitters were up to 15 times more likely to experience key symptoms than remitters. Both non-remitters and partial remitters were also significantly more likely to have increased symptom severity (P < .05). Non-remitters were more likely to have switched treatment and received more treatment lines, as well as having significantly worse QoL, than remitters.

Conclusions

Suboptimal treatment response was associated with increased symptoms and QoL burden. Despite the increased burden experienced, partial remitters were not more likely to switch or receive more treatment lines than remitters, demonstrating the need to initiate effective therapy.
Affective (counter)publics as a critical concept: rethinking affective publics from the history of Chinese Americans in the Exclusion Era
Authors: Dai Linjie
Published: December 2024

This article is an endeavor to further develop the concept of affective publics. I first situate the theorization of affective publics in the critiques of the Habermasian approach to the public sphere. Building on critical race, feminist and queer studies on affect, I examine the concept of affective publics from the lens of Chinese American history. I argue that we can expand the theoretical scope of the concept by: first, going beyond the association of affective publics with networked technologies and examining the circulation of affects before digital technologies; second, considering not only affective publics but also affective counterpublics, and how they are shaped by intersectional power dynamics; third, acknowledging the ambiguity of affective (counter)publics and not romanticizing either “affective” or “counter” in the concept. I contend that this reconstruction can help us better see affective (counter)publics as a critical concept.
Comparing the efficacy of different proton pump inhibitor dosing regimens for the treatment of gastroesophageal reflux disease: a systematic review and meta-analysis
Authors: Nguyen Tyra , Barnhill Katherine , Zhornitskiy Alex , Yu Kyung Sang , Fuller Garth , Makaroff Katherine , Spiegel Brennan M R , Gresham Gillian , Almario Christopher V
Published: December 2024

Several proton pump inhibitor (PPI) dosing regimens that vary by strength and frequency (once [Qday] or twice [BID] daily) are available to treat gastroesophageal reflux disease (GERD). We performed an updated systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the impact of various PPI regimens on esophageal healing and GERD and heartburn symptoms. To identify relevant studies, we searched EMBASE and PubMed in January 2023, which yielded 1381 records. Eligible RCTs included those that enrolled adults diagnosed with GERD and compared different dosing regimens within the same PPI. The outcomes were esophageal healing and resolution of GERD and heartburn symptoms within 12 weeks (i.e. short-term) and > 12 weeks (i.e. long-term). Meta-analysis pooling of the odds ratios with 95% confidence intervals were estimated using the random-effects inverse-variance model. Overall, a total of 38 RCTs across 20 countries (N = 15,540 patients, mean age 50 years, 55% male) were included. Most PPI trials compared half standard dose Qday versus standard dose Qday or standard dose Qday versus double standard dose Qday. In general, when considering daily dosing, higher PPI strength significantly improved esophageal healing and relief of GERD symptoms both in the short- and long-term. Fewer trials compared Qday versus BID dosing; the impact of BID dosing on outcomes was inconsistent across the different PPI strength comparisons. In conclusion, this meta-analysis revealed that increasing PPI Qday dosages led to improved GERD outcomes. However, few studies compared Qday to BID dosing; as twice daily PPI usage is common in clinical practice, further studies are warranted to determine whether such dosing improves clinical outcomes.
Predictors of persistent symptoms in eosinophilic esophagitis after remission: fibrostenosis, eosinophilia, anxiety, and depression
Authors: Beveridge Claire A , Hermanns Christina , Thanawala Shivani , Chatterjee Arjun , Sharma Neha , Vura Naga Venkata Rama Kirshna , Yang Qijun , Qin Yi , Thota Prashanthi , Hoscheit Matthew , Brown J Mark , Ivanov Andrei I , Lembo Anthony , Gabbard Scott , Rieder Florian
Published: December 2024

Eosinophilic Esophagitis (EoE) is a chronic inflammatory esophageal disorder, often associated with dysphagia, chest discomfort, and heartburn. There is limited information on persistent esophageal symptoms despite histologic remission (HR). We aimed to assess the prevalence and predictors of persistent esophageal symptoms in adult patients with EoE in HR. We performed a retrospective cohort study of adult EoE patients in HR (<15 eosinophils per high power field [eos/hpf]). Exclusion criteria included: no available data on symptoms, chronic opiate use, disorders of esophagogastric junction outflow on Chicago Classification version 4 diagnosis, esophageal candidiasis, erosive esophagitis, or other known cause of esophageal dysphagia besides EoE. Based on prior literature, definitions include: complete HR (<5 eos/hpf), partial HR (5–14 eos/hpf), and endoscopic fibrostenosis (rings and/or stricture). Esophageal symptoms were assessed within 2 weeks of HR and categorized into the major symptoms of dysphagia, chest pain, and heartburn. Given the retrospective nature of the study, a global symptom response (absence or presence) was used. Demographics, disease history, endoscopy reports, EoE endoscopic reference score, and histology were recorded. Univariate and multivariable logistic regression analyses were performed. Eosinophil thresholds for persistent symptoms were determined using receiver operating characteristics analyses. Of 289 EoE patients in HR, 133 (46%) had esophageal symptoms: dysphagia (N = 119; 41.2%), heartburn (N = 28; 20.8%), and chest pain (N = 10; 7.5%). Significant predictors for persistent dysphagia were anxiety (adjusted odds ratio [aOR] 3.77) and endoscopic fibrostenosis (aOR 3.87). Significant predictors for persistent heartburn with or without chest pain were anxiety or depression (aOR 12.2 and aOR 11.0) and partial HR (aOR 1.17 and aOR 1.18). Threshold eosinophil counts for persistent heartburn and chest pain were 2.5 and 3.5 eos/hpf, respectively (AUC 0.71 and 0.69). We report a high prevalence of persistent esophageal symptoms in EoE patients who are in HR. Risk factors include anxiety, depression, endoscopic fibrostenosis, and partial HR. These findings can help direct patient care, including endoscopic dilation and managing psychiatric comorbidities. Targeting less than 2.5 and 3.5 eos/hpf for heartburn and chest pain may be warranted.
Open Label Vancomycin in Primary Sclerosing Cholangitis-Inflammatory Bowel Disease: Improved Colonic Disease Activity and Associations With Changes in Host–Microbiome–Metabolomic Signatures
Authors: Quraishi Mohammed Nabil , Cheesbrough Jonathan , Rimmer Peter , Mullish Benjamin H , Sharma Naveen , Efstathiou Elena , Acharjee Animesh , Gkoutus Georgios , Patel Arzoo , Marchesi Julian R , Camuzeaux Stephane , Chappell Katie , Valdivia-Garcia Maria A , Ferguson James , Brookes Matthew J , Walmsley Martine , Rossiter Amanda E , van Schaik Willem , McInnes Ross S , Cooney Rachel , Trauner Michael , Beggs Andrew D , Iqbal Tariq H , Trivedi Palak J
Published: December 2024

Background

We conducted a single-arm interventional study, to explore mucosal changes associated with clinical remission under oral vancomycin (OV) treatment, in primary sclerosing cholangitis-associated inflammatory bowel disease (PSC-IBD); NCT05376228.

Methods

Fifteen patients with PSC and active colitis (median fecal calprotectin 459 µg/g; median total Mayo score 5) were treated with OV (125 mg QID) for 4 weeks and followed-up for a further 4 weeks of treatment withdrawal (8 weeks, end-of-study). Colonic biopsies were obtained at baseline and Week 4. Clinical assessments, and serum and stool samples (metagenomics, metatranscriptomics, and metabolomics) were collected at Weeks 0, 2, 4, and 8. The primary efficacy outcome measure was the induction of clinical remission.

Results

Oral vancomycin resulted in clinical remission in 12/15 patients and significant reductions in fecal calprotectin. Oral vancomycin was associated with reduced abundances of Lachnospiraceae, genera Blautia and Bacteroides; and enrichment of Enterobacteriaceae, and genera Veillonella, Akkermansia, and Escherichia. Oral vancomycin treatment was associated with the downregulation of multiple metatranscriptomic pathways (including short-chain fatty acid [SCFA] metabolism and bile acid [BA] biotransformation), along with host genes and multiple pathways involved in inflammatory responses and antimicrobial defence; and an upregulation of genes associated with extracellular matrix repair. Oral vancomycin use resulted in the loss of specific fecal SCFAs and secondary BAs, including lithocholic acid derivatives. Colitis activity relapsed following OV withdrawal, with host mucosal and microbial changes trending toward baseline.

Conclusions

Four weeks of OV induces remission in PSC-IBD activity, associated with a reduction in gut bacterial diversity and compositional changes relating to BA and SCFA homeostasis.
Echocardiography-guided percutaneous intramyocardial septal radiofrequency ablation procedure for the treatment of Fabry disease: a case report
Authors: Shi Xiaohe , Yang Fan , Wang Jing , Han Chao , Liu Liwen
Published: December 2024

Background

This is a case report of a patient with Fabry disease (FD). We successfully treated a patient with ventricular septal hypertrophy and left ventricular outflow tract (LVOT) obstruction caused by FD. We report our exclusive new surgery for patients with LVOT obstruction, percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) procedure™ (percutaneous intramyocardial septal radiofrequency ablation). The patient recovered well 7 months after operation, and no LVOT obstruction and arrhythmia occurred.

Case summary

A 51-year-old woman with chest tightness after satiety for ∼10 years, aggravated for 2 months. The patient had a history of multiple syncope, syncope after activity or emotional excitement. Echocardiogram demonstrated ventricular septal thickness of 22 mm by the report. Genetic testing revealed gene mutation, which was consistent with FD (GLA: c.643A > C). Biochemical evaluation reported reduced serum α-galactosidase A activity and abnormal serum Lyso-GL-3 enzyme activity. The patient and her families decided to perform PIMSRA operation. After the operation, the septal thickness steadily decreased to 16 mm over the course of 7 months. However, the patient’s symptoms improved significantly.

Discussion

This is the first case of cardiac involvement caused by FD mimicking hypertrophic cardiomyopathy treated with the innovative PIMSRA procedure. Percutaneous intramyocardial septal radiofrequency ablation procedure can be one of the effective treatments to alleviate cardiac hypertrophy and left ventricular obstruction in FD.
Advancements and applications of artificial intelligence in cardiovascular imaging: a comprehensive review
Authors: Fortuni Federico , Ciliberti Giuseppe , De Chiara Benedetta , Conte Edoardo , Franchin Luca , Musella Francesca , Vitale Enrica , Piroli Francesco , Cangemi Stefano , Cornara Stefano , Magnesa Michele , Spinelli Antonella , Geraci Giovanna , Nardi Federico , Gabrielli Domenico , Colivicchi Furio , Grimaldi Massimo , Oliva Fabrizio
Published: December 2024

Artificial intelligence (AI) is transforming cardiovascular imaging by offering advancements across multiple modalities, including echocardiography, cardiac computed tomography (CCT), cardiovascular magnetic resonance (CMR), interventional cardiology, nuclear medicine, and electrophysiology. This review explores the clinical applications of AI within each of these areas, highlighting its ability to improve patient selection, reduce image acquisition time, enhance image optimization, facilitate the integration of data from different imaging modality and clinical sources, improve diagnosis and risk stratification. Moreover, we illustrate both the advantages and the limitations of AI across these modalities, acknowledging that while AI can significantly aid in diagnosis, risk stratification, and workflow efficiency, it cannot replace the expertise of cardiologists. Instead, AI serves as a powerful tool to streamline routine tasks, allowing clinicians to focus on complex cases where human judgement remains essential. By accelerating image interpretation and improving diagnostic accuracy, AI holds great potential to improve patient care and clinical decision-making in cardiovascular imaging.
The acute effect of high-dose supplemental oxygen on haemodynamics assessed by echocardiography in patients with pulmonary vascular disease living in Quito at 2850 m: a randomized, single-blind, placebo-controlled crossover trial
Authors: Müller Julian , Lichtblau Mona , Saxer Stéphanie , Schmucki Mirjam , Furian Michael , Schneider Simon R , Herzig Joël J , Bauer Meret , Saragoni Diego , Schwarz Esther I , Cajamarca Elizabeth , Hoyos Rodrigo , Ulrich Silvia
Published: December 2024

Aims

More than 220 Mio people live at altitudes above 2000 m, many of whom have pre-existing chronic diseases, including pulmonary vascular diseases (PVDs) such as pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the acute effects of high-dose supplemental oxygen on pulmonary haemodynamics assessed by echocardiography in patients with PVD permanently living at 2850 m.

Methods and results

In a randomized, single-blind, placebo-controlled crossover trial, patients with PVD diagnosed with PAH or CTEPH were allocated to receive 10 L/min supplemental oxygen (FiO2 ≈ 95%) and placebo air administered via a facial mask with reservoir near their living altitude in Quito at 2850 m (FiO20.21, PiO2 ≈ 60% of sea level) in random order with a washout period of >2 h. After >15 min of breathing the respective FiO2, systolic pulmonary artery pressure (sPAP), cardiac output (CO), and other parameters were assessed by echocardiography. Furthermore, radial arterial blood gases were analysed. Twenty-eight patients with PVD (24 females, 26 PAH, age 45 ± 12 years) treated with phosphodiesterase-5 inhibitors (n = 28) and endothelin receptor antagonists (n = 9) were included. With oxygen vs. placebo air, sPAP was 57 ± 23 vs. 68 ± 24 mmHg, mean difference −11 mmHg (−15 to −6 mmHg, P < 0.001), CO was 3.2 ± 0.9 vs. 3.9 ± 1.1 L/min; −0.7 L/min (−0.9 to −0.4 L/min, P < 0.001), while sPAP/CO was unchanged, and the right ventriculo-arterial coupling was increased. PaO2 was 22.5 ± 9.7 vs. 7.6 ± 1.5 kPa; 14.9 kPa (11.4–18.4 kPa, P < 0.001).

Conclusion

High-dose oxygen therapy in prevalent patients with PVD living near 2850 m significantly lowered sPAP but also CO by a reduced heart rate, resulting in an unchanged pulmonary resistance. Whether longer-term oxygen therapy would improve pulmonary vascular resistance requires further investigation.

Registration

NCT06084559 URL: https://clinicaltrials.gov/study/NCT06084559.
An inquiry into the relationship between intelligence and prosocial behavior: Evidence from Swedish population registers
Authors: Elinder Mikael , Erixson Oscar
Published: December 2024

We investigate the relationship between intelligence and prosocial behaviour, using administrative data on cognitive ability, charitable giving, voting and possession of eco-friendly cars for 1.2 million individuals. We find strong positive associations for all three behaviours, which remain when using twin-pair fixed effects to account for confounders. We also find that general (fluid) intelligence is a stronger predictor than other dimensions of cognitive ability, and that most of the relationship remains after controlling for a set of mediators, suggesting a direct impact on prosocial behaviour. Finally, we show that cognitive ability is also positively related to a survey measure of altruism.
Overconfidence and Correlated Information Structures
Authors: Park Junghum
Published: December 2024

This paper analyses overconfident strategic traders whose private information involves correlated errors. The analysis on the effects of two types of overconfidence—overconfidence in own signals and underconfidence in others’ signals—provides richer implications than our typical understanding of overconfidence as follows: First, trading volume decreases (increases) with underconfidence in others’ signals (overconfidence in own signals). Second, whereas overconfidence in own signals can explain large trading volume more easily, underconfidence in others’ signals may cause trading volume and price informativeness to decrease with the number of traders. Third, overconfidence in own signals can lead to equilibrium multiplicity in information acquisition.
Parental Leave, Worker Substitutability, and Firms’ Employment
Authors: Huebener Mathias , Jessen Jonas , Kuehnle Daniel , Oberfichtner Michael
Published: December 2024

Motherhood and parental leave are frequent causes of worker absences and employment interruptions, yet little is known about their effects on firms. Based on linked employer-employee data from Germany, we examine how parental leave absences affect small-and medium-sized firms. We show that they anticipate the absence with replacement hirings in the six months before childbirth. A 2007 parental leave reform extending leave absences reduces firm-level employment and total wages up to three years after childbirth, driven by firms with few internal substitutes for the absent mother. However, we do not find longer-term effects on firms’ employment, wage bill, or likelihood to shut down. The reform led to an increase in replacement hirings, but firms did not respond to longer expected absences of mothers by subsequently hiring fewer young women. Overall, our findings show that anticipated, extended parental leave does not have a lasting impact on firms.
Flow of Ideas: Economic Societies and the Rise of Useful Knowledge
Authors: Cinnirella Francesco , Hornung Erik , Koschnick Julius
Published: December 2024

Economic societies emerged during the late eighteenth-century. We argue that these institutions reduced the costs of accessing useful knowledge by adopting, producing, and diffusing new ideas. Combining location information for the universe of 3,300 members across active economic societies in Germany with those of patent holders and World’s Fair exhibitors, we show that regions with more members were more innovative in the late nineteenth-century. This long-lasting effect of societies arguably arose through agglomeration economies and localized knowledge spillovers. To support this claim, we provide evidence suggesting an immediate increase in manufacturing, an earlier establishment of vocational schools, and a higher density of highly skilled mechanical workers by mid-nineteenth century in regions with more members. We also show that regions with members from the same society had higher similarity in industrial production and patenting, suggesting that societies facilitated spatial knowledge diffusion and, to some extent, shaped the direction of technological progress.
Long-term results of edge-to-edge and neochordal mitral repair for isolated anterior leaflet lesion: a propensity match analysis
Authors: Zancanaro Edoardo , Carino Davide , Lorusso Roberto , Del Forno Benedetto , Lapenna Elisabetta , Sala Alessandra , Ascione Guido , Scarale Maria Giovanna , Nonis Alessandro , Castiglioni Alessandro , Alfieri Ottavio , Maisano Francesco , De Bonis Michele
Published: December 2024

OBJECTIVES

Mitral regurgitation due to anterior mitral leaflet lesions is associated with an increased risk of mitral regurgitation recurrence after mitral valve repair compared with posterior leaflet-related lesions. Both edge-to-edge (E-to-E) and neochordal repair, associated with ring annuloplasty, have been used in our institution to address isolated anterior mitral leaflet lesions. The aim of this study was to compare the clinical and echocardiographic long-term results of those two approaches for isolated anterior mitral leaflet lesions by means of a propensity match analysis.

METHODS

An institutional database retrospective review within the time-frame 2000 to 2021 was carried out. The Kaplan–Meier method and cumulative incidence function were employed. Cox regression was used to identify the risk factor for mortality during the follow-up.

RESULTS

The estimated freedom from reoperative mitral valve surgery at 20 years was 78% in the E-to-E group and 64% in the neochordae group (P = 0.032). The longitudinal analysis performed to analyse the mitral regurgitation recurrence rate showed a higher rate of mitral regurgitation ≥3+ recurrence in the neochordae group at 5 (5.1% vs 8.7%), −10 (8.2% vs 13.2%), and 15 years (8.8% vs 16.5%) (P < 0.001).

CONCLUSIONS

Isolated anterior leaflet pathology can be effectively treated with E-to-E or neochordal repair and ring annuloplasty. In our series, clinical and echocardiographic results were better in E-to-E group. The excellent durability of this technique up to 20 years of follow-up, together with its simplicity and reproducibility, confirms the role the E-to-E techniques as an excellent treatment option for severe mitral regurgitation due anterior mitral leaflets lesions.
Postoperative bleeding in myocardial revascularization under cardiopulmonary bypass for patients treated with aspirin or dual antiplatelet therapy using reduced goal-directed anticoagulation
Authors: Eid Maroua , Dang Van Simon , Hamon Yveline , Rineau Emmanuel , Riou Jérémie , Baufreton Christophe
Published: December 2024

OBJECTIVES

Antiplatelet therapy increases the risk of bleeding and transfusion in patients undergoing extracorporeal circulation. Reduced goal-directed anticoagulation is a personalized approach to reduce the anticoagulation based on a lower targeted activated clotting time. We assessed whether reduced goal-directed anticoagulation using optimized extracorporeal circulation alleviates the risk of severe bleeding in patients treated by dual antiplatelet therapy (DAPT) compared to aspirin alone during coronary artery bypass grafting (CABG).

METHODS

A total of 2275 patients undergoing CABG from 2002 to 2022 were selected after propensity matching from a retrospective cohort of 3018 patients. Patients treated with a combination of aspirin and prasugrel or ticagrelor or clopidogrel were included in the DAPT group (n = 1111). Patients treated with aspirin alone (ASA) constituted the control group (n = 1164). Optimized extracorporeal circulation was conducted under reduced systemic anticoagulation with a target activated clotting time 250 s. Severe bleeding was assessed using 3 validated scores of bleeding: UDPB, E-CABG, and BARC-4.

RESULTS

While all scores showed low ranges of severe bleeding (<6%), they were significantly higher after DAPT compared to ASA (P values for UDPB, E-CABG, and BARC-4 at 0.016, 0.006, and 0.063, respectively). Higher maximal activated clotting time was associated with higher rate of transfusion (P < 0.001) and bleeding (P < 0.001) after multivariate adjustment. Mortality was 1.24% in DAPT vs 0.94% in ASA group (P = NS), whereas cardiac death, myocardial infarction, stroke, and transient ischaemic attack were low (<1%) and similar between groups.

CONCLUSIONS

Despite higher bleeding under DAPT compared to ASA alone, optimized extracorporeal circulation with reduced goal-directed anticoagulation alleviated severe bleeding which remained low in patients undergoing CABG.
The effect of virtual reality on postoperative anxiety and pain in patients following cardiac surgery: a randomized controlled trial
Authors: el Mathari Sulayman , Shehadeh Saadullah , Zwaan W Patrick , Boulidam Noor , Kuitert Lieke , Twisk Jos W R , Klautz Robert J M , de Lind van Wijngaarden Rob , Veen Kevin , Kluin Jolanda
Published: December 2024

OBJECTIVES

The VRECOVERY investigated the impact of virtual reality (VR) distraction therapy on postoperative pain, anxiety and quality of recovery in patients undergoing coronary artery bypass grafting surgery.

METHODS

A single-centre randomized controlled trial was conducted involving 192 participants, allocated to either the intervention or control group. Participants in the intervention group received VR distraction therapy on postoperative days 1, 2 and 3, while the control group received standard postoperative care. Primary outcomes were measured in both groups directly following the VR sessions of the intervention group. Outcomes included (i) postoperative pain [Numeric Rating Scale (NRS)], (ii) postoperative anxiety [State Trait Anxiety Inventory 6 questionnaire (STAI-6)] and (iii) quality of postoperative recovery [Quality of Recovery 15 questionnaire (QoR-15)].

RESULTS

A total of 100 participants completed the study, including 39 patients (mean age 69.1 ± 7.7 years) in the intervention group and 61 patients (mean age 66.8 ± 8.2 years) in the control group. Eighty-nine percent of participants was male. VR-distraction therapy demonstrated a significant difference in postoperative pain decrease between groups (NRS score; intervention group −1.45/day vs control group −0.73/day, P = 0.007), and an important overall difference in postoperative anxiety slopes (STAI-6 score; intervention group −0.60/day vs control group +0.09/day, P = 0.06). There was no effect observed on postoperative quality of recovery (P = 0.11).

CONCLUSIONS

The VRECOVERY trial suggests a beneficial impact of VR distraction therapy in reducing postoperative pain. There was no significant effect on postoperative anxiety and quality of recovery.
High barriers to treatment are associated with stereotactic radiation instead of surgery for patients with operable stage I non-small cell lung cancer
Authors: Rodriguez-Quintero Jorge Humberto , Kamel Mohamed K , Jindani Rajika , Zhu Roger , Loh Isaac , Vimolratana Marc , Chudgar Neel P , Stiles Brendon
Published: December 2024

OBJECTIVES

Although surgery is considered the standard of care for early-stage lung cancer, there has been increased use of stereotactic radiotherapy for operable patients in recent years. Given that this modality may be perceived as a more practical treatment, we hypothesized that it might be more often delivered to patients who experience barriers to care.

METHODS

The National Cancer Database (2018–2020) was queried for patients with clinical stage IA non-small cell lung cancer treated with surgery or stereotactic radiotherapy (48–60 Gy, 3–5 fractions), excluding patients with contraindications to surgery. Patients who had all the following characteristics were categorized as experiencing ‘high barriers’ to treatment: income below median national levels, lack of private insurance, treatment at a community facility and residence in non-metropolitan areas. Using multivariable logistic regression, the association between high barriers to treatment and stereotactic radiotherapy use was estimated.

RESULTS

A total of 60 829 patients were included, of whom 3382 (5.6%) experienced high barriers to treatment. Among them, 13 535 (22.3%) underwent stereotactic radiotherapy and 47 294 (77.7%) underwent surgery. Overall, more patients undergoing stereotactic radiotherapy faced high barriers to treatment compared to those who received surgery (8.6% vs 4.7%, P < 0.001). Geographic region was associated with the delivery of stereotactic radiotherapy (P < 0.001). The magnitude of such association was stronger among those who faced high barriers. In multivariable analysis, experiencing high barriers to treatment remained associated with receiving stereotactic radiotherapy (OR: 1.46, 95% CI 1.35–1.58).

CONCLUSIONS

The use of stereotactic radiotherapy is more prevalent among patients facing barriers to care. Further research is needed to clarify the role of this treatment modality in early-stage lung cancer.
Under what conditions do citizens support future-oriented welfare reforms? Public opinion and second dimension welfare politics
Authors: Garritzmann Julian L , Häusermann Silja , Pinggera Michael
Published: December 2024

Important reforms are necessary to adjust today’s welfare states to the challenges of post-industrial knowledge economies. Public opinion, however, is often sceptical towards large-scale reforms, especially when the benefits will accrue only in the future. We analyse the conditions that affect citizens’ support for such reforms on the basis of original survey experiments from two novel public opinion surveys in nine countries. We test the role of ‘supply-side factors’, referring to characteristics of the reform design itself (its policy field, distributive reform effect, time horizon, and costs) and ‘demand-side factors’, that is, respondents’ characteristics and ideological orientations. We argue and demonstrate that among these ‘demand-side factors’, positions on the socio-cultural ideological dimension between universalism and particularism are key to explaining support for future-oriented social investment reforms. We thereby provide robust new evidence highlighting the role of ‘second dimension politics’ for welfare state reform.
Does it matter where you’re from? Geographical variation in social mobility in Britain
Authors: Breen Richard , In Jung
Published: December 2024

There is increasing interest among sociologists in geographical, or regional, variation in intergenerational mobility. The most important questions in studying this topic are, first, whether, and how much, variation there is between regions, and to what extent this is due to characteristics of places themselves, and how far to sorting or compositional differences—that is, to the spatial distribution of relevant individual and family variables. We analyse regional variation in social mobility in Great Britain, first asking whether there are differences in occupational attainment and intergenerational social mobility according to where a person was raised, and then asking whether these differences persist or disappear when we control for individual family factors that are known to influence social mobility. We also discuss some methodological problems that arise in trying to answer these questions: these have largely been neglected in the burgeoning literature on this topic. Overall, we find little evidence for any substantial effects of place of origin on social mobility in Britain once we take account of sorting.
Digest: Habitat associations shape a hybrid zone in killifish
Authors: Petersen Mary E , Rader Jonathan A
Published: December 2024

Hybrid zones provide valuable opportunities to interrogate the processes that drive speciation. In a new study, Hardy et al. (2025) demonstrate that the dominant vegetation type in patchy cordgrass salt marshes and mangrove swamps drives a mosaic hybrid zone between two species of killifish. Furthermore, the authors showed that hybridization is asymmetrical, and that Fundulus grandis is more likely to hybridize than F. heteroclitus. This study highlights the need for interdisciplinary study of the environmental context of reproductive isolation.
The relationship between self-care preparedness and quality of life in a 3-year-follow-up: a study in primary health care
Authors: Mikkonen Ulla , Tusa Nina , Sinikallio Sanna , Lehto Soili Marianne , Ruusunen Anu , Kautiainen Hannu , Mäntyselkä Pekka
Published: December 2024

Background

Measuring self-care preparedness may enable better support for patients in general practice.

Objective

This study assessed the relationship between the self-care preparedness index (SCPI) and health-related quality of life (HRQoL) in a longitudinal analysis over 36 months.

Methods

This was a secondary analysis of an intervention group of a randomized controlled trial. Participants were adults (n = 256) with hypertension, diabetes, or coronary artery disease in primary health care. The intervention group was included in the present study since they had answered SCPI as a part of the intervention. The relationship between SCPI and HRQoL (15D) and other outcomes were studied at baseline. The mean changes in SCPI and 15D were calculated from baseline up to 36 months. Regression-based analysis was used to study to what extent the baseline SCPI was associated with the change in SCPI and 15D and to what extent the change in SCPI was associated with the change in 15D.

Results

At baseline, 15D, physical activity, self-rated health, life satisfaction, and patient activation measures had a positive linear relationship with SCPI. Body mass index and depressive symptoms had a negative linear relationship with SCPI. The longitudinal association between changes in SCPI and 15D was statistically significant and positive. The adjusted β was + 0.19 (95% confidence interval: 0.07 to 0.30, P = .002).

Conclusion

Those patients who managed to increase their SCPI over the study period experienced an improvement in HRQoL.
Exploring polyamine metabolism of the yeast-like fungus, Emergomyces africanus
Authors: Koroleva Elizaveta , Toplis Barbra , Taylor Malcolm , van Deventer Corné , Steffen Heidi C , van den Heever Christiaan , Govender Nelesh P , de Hoog Sybren , Botha Alfred
Published: December 2024

Emergomyces africanus is a thermally dimorphic pathogen causing severe morbidity and mortality in immunocompromized patients. Its transition to a pathogenic yeast-like phase in the human host is a notable virulence mechanism. Recent studies suggest polyamines as key players in dimorphic switching, yet their precise functions remain enigmatic. This work aimed to explore polyamine metabolism of two clinical strains of E. africanus (CBS 136260 and CBS 140360) in mycelial and yeast-like phases. In this first report of the polyamine profile of E. africanus, we reveal, using mass spectrometry, spermidine, and spermine as the major polyamines in both phases. The secretion of these amines was significantly higher in the pathogenic yeast-like phase than in the mycelial phase, warranting further investigation into the implications thereof on virulence. Additionally, we detected the activity of several polyamine biosynthesis enzymes, including arginine decarboxylase, agmatinase, arginase, and ornithine decarboxylase, with significant differences in enzyme expression between morphological phases and strains. Finally, we provide initial evidence for the requirement for spermine, spermidine, and putrescine during the thermally induced dimorphic switch of E. africanus, with strain-specific differences in the production of these amines. Overall, our study presents novel insight into polyamine metabolism and its role in dimorphism of E. africanus.
Impact of liquid antibacterial soap and hand sanitizer on DNA transfer in forensic investigations: an experimental study
Authors: Sessa Francesco , Panepinto Elisabetta , Salerno Monica , Chisari Mario , Esposito Massimiliano , Cocimano Giuseppe , Pomara Cristoforo
Published: December 2024

DNA transfer, whether intentional or not, is becoming an important part of forensic evidence gathering and analysis. This study seeks to determine the impact of liquid antibacterial soap and hand sanitizer use on the DNA present on the palm of hands that may potentially reduce direct transfer. Twelve volunteers were enrolled and typed. After, each palm was swabbed, ignoring previous activities in order to collect background DNA profiles. Subsequently, each subject washed his/her hands for 30 s with antibacterial soap first, and after with sanitizing gel and then air-dried them, after drying, each palm was immediately swabbed for DNA typing. The results of this study demonstrated that the possibility of recovering a complete profile from a hand swab is strictly related to previous activity: considering the results of the samples taken before handwashing, there is the possibility of having a median recovery of 80.01%, while it is very low (median recovery was 3.43%) after hand washing with antibacterial soap followed by alcohol-based hand sanitizer. Analyzing the results after handwashing we were unable to detect any drop-in alleles. Moreover, we determined that in 11/12 samples less than 9 alleles were detected: considering that the kit used for the profiling could analyze 23 STRs it is possible to conclude that we obtain inconclusive profiles. Based on the findings of the present study, it is more difficult to obtain a perpetrator’s profile if he/she used liquid antibacterial soap hand sanitizer immediately before the criminal action.
Quantifying forensically relevant vertebrate scavenging: a pilot study to develop a methodological framework using cape grey mongoose (Galerella pulverulenta) as an illustrative model
Authors: Finaughty Devin Alexander , French Gabriella May , Adams Kara Sierra , Spies Maximilian Jan , Gibbon Victoria Elaine
Published: December 2024

Currently, forensic death investigations in the Western Cape, South Africa do not account for vertebrate scavenging activity; however, previous research in the city of Cape Town has shown a significant impact on the rate of decomposition due to scavenging by the local Cape grey mongoose (Galerella pulverulenta). This pilot study aimed to develop a framework to more robustly quantifiably describe and analyse the scavenging behaviour of this species on a single clothed 60 kg porcine carcass in a forensically significant location in Cape Town (ie, a region of the city with a proportionately large forensic case load). Feeding behaviours are the focus of this framework and analysis, but non-feeding behaviours in the immediate vicinity of the carcass are also distinguished and described. Additionally, it was assessed whether all behaviours varied in their frequency of occurrence as decomposition progressed. More than 40 hours of mongoose interaction with the carcass were recorded using motion-activated infrared-capable wildlife trail camera videography. The highest frequencies of scavenging activity were observed in the abdominal and the eye socket regions of the carcass. Abdominal feeding largely involved soft tissue modification, whereas more intensive activity in the eye socket suggested a higher likelihood of hard tissue scavenger artefacts being found there. A Kruskal-Wallis test confirmed that some feeding behaviours occur more frequently during specific decomposition stages. For example, scratching is common during the earlier stages of decomposition, ostensibly to create an opening in the flesh. Twisting whilst biting was only observed in latter stages of decomposition, likely due to the increased toughness of the soft tissue as it desiccated. This pilot research offers detailed insight into scavenger behaviours previously unreported in the forensic taphonomic literature, and proposes a provisional method of quantifiable analyses of scavenger behaviours that extends what has previously been published in the forensic taphonomic literature. Local validation of the observations is planned, and international replication of the research for diverse scavenger guilds is encouraged.
Current status of serum metabolites biomarkers for polyps and colorectal cancer: a systematic review
Authors: Abu Bakar Maryam Fatimah , Mohammed Nawi Azmawati , Chin Siok Fong , Makpol Suzana
Published: December 2024

Background

Early detection of colorectal cancer (CRC) is crucial to enhance the disease treatment and prognosis of patients. Colonoscopy remains the gold standard for CRC detection; however, it requires trained personnel with expensive tools. Currently, serum metabolites have been discovered to be used to discriminate patients with polyps and CRC. This study aimed to identify the most commonly detected predictive serum metabolites for polyps and CRC.

Methods

A systematic search of the Web of Science, PubMed, and Cochrane Library databases was conducted using PRISMA guidelines. Ten studies investigating serum metabolite biomarkers of CRC and polyps using different analytical platforms and study populations were included. QUADOMICS tool was used to analyse the quality of the included studies. All reported metabolites were then enriched into the pathways using MetaboAnalyst 5.0.

Results

We found that several potential signature metabolites overlapped between studies, including tyrosine, lysine, cystine, arabinose, and lactate for CRC and lactate and glutamate for polyps. The most affected pathways related to CRC were the urea cycle, glutathione metabolism, purine metabolism, glutamate metabolism, and ammonia recycling. In contrast, those affected in the polyps were the urea cycle, glutamate metabolism, glutathione metabolism, arginine and proline metabolism, and carnitine synthesis.

Conclusions

This review has found commonly detected serum metabolites for polyps and CRC with huge potential to be used in clinical settings. However, the differences between altered pathways in polyps and CRC, other external factors, and their effects on the regulation level, sensitivity, and specificity of each identified metabolite remained unclear, which could benefit from a further extensive cohort study and well-defined analysis equipment.
Exploring the Allelic Diversity of the Self-Incompatibility Gene Across Natural Populations in Petunia (Solanaceae)
Authors: Maenosono Taiga , Isono Kazuho , Kuronuma Takanori , Hatai Miho , Chimura Kaori , Kubo Ken-ichi , Kokubun Hisashi , Greppi Julián Alejandro , Watanabe Hitoshi , Uehara Koichi , Tsuchimatsu Takashi
Published: December 2024

Self-incompatibility (SI) is a genetic mechanism to prevent self-fertilization and thereby promote outcrossing in hermaphroditic plant species through discrimination of self and nonself-pollen by pistils. In many SI systems, recognition between pollen and pistils is controlled by a single multiallelic locus (called the S-locus), in which multiple alleles (called S-alleles) are segregating. Because of the extreme level of polymorphism of the S-locus, identification of S-alleles has been a major issue in many SI studies for decades. Here, we report an RNA-seq–based method to explore allelic diversity of the S-locus by employing the long-read sequencing technology of the Oxford Nanopore MinION and applied it for the gametophytic SI system of Petunia (Solanaceae), in which the female determinant is a secreted ribonuclease called S-RNase that inhibits the elongation of self-pollen tubes by degrading RNA. We developed a method to identify S-alleles by the search of S-RNase sequences, using the previously reported sequences as queries, and found in total 62 types of S-RNase including 45 novel types. We validated this method through Sanger sequencing and crossing experiments, confirming the sequencing accuracy and SI phenotypes corresponding to genotypes. Then, using the obtained sequence data together with polymerase chain reaction–based genotyping in a larger sample set of 187 plants, we investigated the diversity, frequency, and the level of shared polymorphism of S-alleles across populations and species. The method and the dataset obtained in Petunia will be an important basis for further studying the evolution of S-RNase–based gametophytic SI systems in natural populations.