bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatosplenic schistosomiasis, treatment outcomes and associated factors among adult patients treated at public hospitals in the Harari Region of Ethiopia: retrospective cross-sectional study
Authors: Kumela Derara , Ahmed Aliyi , Mehadi Ame , Wondimneh Fenta , Ahmed Mohammed , Yusuf Ahmednajash , Weldegebreal Fitsum
Published: November 2024

Background

Schistosomiasis is one of the neglected tropical diseases that pose a significant burden in developing countries, particularly in sub-Saharan Africa. Hepatosplenic schistosomiasis (HSS) is a substantial cause of morbidity and mortality. This study aimed to determine clinical patterns, outcomes and factors associated with HSS in the Harari Region of Ethiopia.

Methods

An institutional-based retrospective cross-sectional study was conducted among 93 adult patients diagnosed with HSS at public hospitals in the Harari Region from December 2018 to November 2022. Data were extracted from medical records using a standardized data extraction tool. EpiData version 4.2 and SPSS version 26.0 were used for data entry and analysis. Fisher's exact test was used to identify the association between dependent and independent variables, and statistical significance was declared at p<0.05.

Results

In the current study, HSS-related mortality was recorded in 7.5% of patients. Recurrent episodes of upper gastrointestinal (GI) bleeding (p=0.04), hypotension (p=0.02), altered mental status at admission (p=0.009) and antibiotic use for the treatment of spontaneous bacterial peritonitis (p=0.04) were significant factors associated with HSS-related mortality.

Conclusions

The study found that treatment outcomes of HSS patients were strongly associated with recurrent upper GI bleeding, hypotension, altered mental status and antibiotic use for spontaneous bacterial peritonitis treatment. The use of antibiotics for spontaneous bacterial peritonitis treatment was strongly associated with the treatment outcome of patients with HSS and was unique to our study. Adequate recording of patient data, improving chart keeping, integration of preventive and curative programs, improvement of the diagnostic tools, comprehensive treatment guidelines, early diagnosis and treatment are strongly recommended. Rigorous prospective studies that can fully reflect cause-and-effect relationships are crucial to fill fundamental evidence gaps.
Pulmonary melioidosis mimicking lung cancer: a diagnostic challenge
Authors: Yang Xiaohong , Ying Zhuopeng , Zhan Yuefu , Chen Jianqiang
Published: November 2024

Background

The overlapping clinical and radiographic features of pulmonary melioidosis and lung cancer present diagnostic challenges to healthcare providers in endemic settings.

Methods

We compared the clinical, laboratory and imaging characteristics of 19 pulmonary melioidosis cases with those of 15 cases of small cell lung cancer (SCLC) and 17 cases of non-small cell lung cancer (NSCLC).

Results

Compared with SCLC/NSCLC cases, those with pulmonary melioidosis were more likely to have diabetes, have fever, neutrophilia and leukocytosis on presentation (p<0.05). While certain CT imaging features were shared between pulmonary melioidosis and SCLC (‘frozen mediastinum sign’, ‘vascular encasement sign’), extensive liquefactive necrosis, uneven ring-enhancement, circular lesions and ‘air-bubble’ signs were more commonly seen in pulmonary melioidosis cases than in those with SCLC/NSCLC (p<0.05).

Conclusions

Despite the similarities in presentation of pulmonary melioidosis, SCLC and NSCLC, several clinical, laboratory and imaging factors may help delineate these diagnoses and improve patient care.
Determinants of antiretroviral therapy adherence among people living with HIV in a poor urban setting in Ghana: a hospital-based cross-sectional study
Authors: Adjei-Mensah Evelyn , Alhassan Yakubu , Owusu Richmond , Kretchy Irene A
Published: November 2024

Background

Without a cure, antiretroviral therapy (ART) continues to be the primary mode of managing HIV, transforming it from a formerly lethal disease to a less severe one. Adherence to ART can be impacted by several factors, including poor quality of care.

Methods

A quantitative cross-sectional study design was used to assess the factors that influence adherence to ART among adults receiving care at two health facilities in Accra. A structured interviewer-administered questionnaire was used to collect data on factors associated with medication adherence using a modified four-item Medication Adherence Rating from 255 people living with HIV (PLHIV). Descriptive statistics were used to summarise the data, while multiple binary logistic regression was used to assess the factors influencing adherence to ART.

Results

Adherence to HIV medication was 44.7% among PLHIV. Adherence was positively correlated with high client health service satisfaction (adjusted OR [AOR]: 26.59, 95% CI 7.46 to 94.82, p<0.001), increased privacy at the HIV clinics (AOR: 3.40, 95% CI 1.40 to 8.21, p<0.007) and among PLHIV who had been diagnosed with HIV for ≥5 y (AOR: 7.59, 95% CI 2.76 to 20.85, p<0.001).

Conclusions

Adherence to ART was significantly low among study participants. The study highlights the importance of maintaining privacy and confidentiality at the facility while ensuring client satisfaction with HIV care to promote adherence to ART.
Revised taxonomy of Synodontis catfishes (Siluriformes: Mochokidae) from the Lake Tanganyika basin reveals lower species diversity than expected
Authors: Englmaier Gernot K , Blažek Radim , Zimmermann Holger , Bartáková Veronika , Polačik Matej , Žák Jakub , Mulokozi Deogratias P , Katongo Cyprian , Büscher Heinz H , Mabo Lwabanya , Koblmüller Stephan , Palandačić Anja , Reichard Martin
Published: November 2024

Synodontis Cuvier, 1816 is a species-rich group of African catfishes. Prior to this analysis, 13 species of Synodontis were recognized from Lake Tanganyika and its tributaries, composing the only extant lacustrine radiation of the genus, with a unique origin of obligate brood parasitism among all fishes. Species differentiation and phylogenetic relationships of this group remained largely unresolved. Herein, the taxonomy of Synodontis in the Lake Tanganyika basin is revised, including redescriptions of all species and an updated identification key. Genetic (mitochondrial and nuclear genomic markers) and morphological data suggest a lower species diversity than previously recognized, supporting the distinction of 10 Synodontis species in the lake basin. Based on our findings, we recognize Synodontis grandiops, Synodontis ilebrevis, and Synodontis lucipinnis as junior synonyms of Synodontis multipunctatus, Synodontis polli, and Synodontis petricola, respectively. No recent material of Synodontis dhonti and Synodontis tanganyicae (with Synodontis lacustricolus as a synonym) was available. Morphometric/meristic data suggest their close relationship to Synodontis granulosus. Sequencing of historical specimens inferred S. tanganyicae as sister to S. granulosus but with a 1.7% divergence based on mitochondrial data. In contrast to previous studies, phylogenomic data support the lacustrine assemblage of Synodontis in Lake Tanganyika as monophyletic.
Cave-dwelling calcareous sponges (Porifera: Calcarea) from the Marquesas Islands, French Polynesia
Authors: Lopes Matheus Vieira , Pérez Thierry , Klautau Michelle
Published: November 2024

The Marquesas Islands harbour numerous underwater caves, with different geomorphologies and a rich diversity of invertebrates dominated by sponges. However, although calcareous sponges are known to be abundant in cryptic habitats, only one of the four species reported from Marquesas was found in caves. Hence, our objective was to study the diversity of cave-dwelling calcareous sponges from the Marquesas Islands. Sponges were collected in semi-dark or dark caves, most of them being lava tubes. Through morphological and molecular (ITS and C-LSU) tools, five species were identified, four of them new to science: Borojevia moana sp. nov., Bidderia watremezi sp. nov., Leucascus polynesiensis sp. nov., Leucandra cavernicola sp. nov., and Murrayona phanolepis. In general, sponge assemblages in caves are different from those on adjacent rocky shores. Indeed, in French Polynesia, Leucascus polynesiensis sp. nov. was the sole species found inside and outside caves. We found that M. phanolepis is a cave-dwelling and widespread species, which might represent a cryptic diversity. Besides, aliactine spicules could be a synapomorphy in the subclass Calcaronea. Even though the number of species for the region is still underestimated, it is noticeable that Marquesan caves seem to harbour a unique diversity of calcareous sponges.
Vascular Complications After Venoarterial Extracorporeal Membrane Oxygenation Support: A CT Study
Authors: Djavidi Nima , Boussouar Samia , Duceau Baptiste , Bahroum Petra , Rivoal Simon , Hariri Geoffroy , Lancelot Aymeric , Dureau Pauline , Abbes Ahmed , Omar Edris , Charfeddine Ahmed , Lebreton Guillaume , Redheuil Alban , Luyt Charles-Edouard , Bouglé Adrien
Published: November 2024

OBJECTIVES:

Vascular complications after venoarterial extracorporeal membrane oxygenation (ECMO) remains poorly studied, although they may highly impact patient management after ECMO removal. Our aim was to assess their frequency, predictors, and management.

DESIGN:

Retrospective, observational cohort study.

SETTING:

Two ICUs from a tertiary referral academic hospital.

PATIENTS:

Adult patients who were successfully weaned from venoarterial ECMO between January 2021 and January 2022.

INTERVENTIONS:

None.

PRIMARY OUTCOME:

Vascular complications frequency related to ECMO cannula.

MEASUREMENTS AND MAIN RESULTS:

A total of 288 patients were implanted with venoarterial ECMO during the inclusion period. One hundred ninety-four patients were successfully weaned, and 109 underwent a CT examination to assess for vascular complications until 4 days after the weaning procedure. The median age of the cohort was 58 years (interquartile range [IQR], 46–64 yr), with a median duration of ECMO support of 7 days (IQR, 5–12 d). Vascular complications were observed in 88 patients (81%). The most frequent complication was thrombosis, either cannula-associated deep vein thrombosis (CaDVT) (n = 63, 58%) or arterial thrombosis (n = 36, 33%). Nonthrombotic arterial complications were observed in 48 patients (44%), with 35 (31%) presenting with bleeding. The most common site of CaDVT was the inferior vena cava, occurring in 33 (50%) of cases, with 20% of patients presenting with pulmonary embolism. There was no association between thrombotic complications and ECMO duration, anticoagulation level, or ECMO rotation flow. CT scans influenced management in 83% of patients. In-hospital mortality was 17% regardless of vascular complications.

CONCLUSIONS:

Vascular complications related to venoarterial ECMO cannula are common after ECMO implantation. CT allows early detection of complications after weaning and impacts patient management. Patients should be routinely screened for vascular complications by CT after decannulation.
The Future of Artificial Intelligence and Genetic Insights in Precision Cardiovascular Medicine: A Comprehensive Review
Authors: Chandra Sekar Praveen Kumar , Veerabathiran Ramakrishnan
Published: November 2024

A medical condition called cardiovascular disease (CVD) affects the heart or blood vessels, and about 40% of its causes can be attributed to genetic factors. The pathophysiology of CVD is still unknown despite numerous studies identifying important environmental and genetic factors. Genetic data research has significantly increased due to the application of genome-wide association studies. The utilization of artificial intelligence (AI) technology demonstrates clear advantages in managing intricate projects, outperforming traditional statistical methods in processing such data. The use of AI in the status of genetic research on CVD and medicine is briefly reviewed in the opening section of this article. Then, it gives a complete picture of how AI is used in genetic CVD research, including genetic data-driven diagnosis and prognosis, genetic variation analysis, gene expression profiles, gene interactions, and analysis of genes using knowledge bases. Even though much research has yielded significant findings, it is still early. The main disadvantages are database limitations, the underuse of AI in systematic biology analysis, and the lack of a theoretical framework for interpreting analysis results. The paper concludes with future directions and the significance of creating comprehensive, high-quality, large-sample-size data-sharing resources. Much research is going into how to use AI analysis techniques to help with development. Being creative with computers can help make new CVD intervention protocols and develop and test theoretical models.
Effect of endothelial responses on sepsis-associated organ dysfunction
Authors: Wu Miao , Yan Yan , Xie Xinyu , Bai Jiawei , Ma Chengtai , Du Xianjin
Published: November 2024

Sepsis-related organ dysfunction is associated with increased morbidity and mortality. Previous studies have found that the endothelium plays crucial roles in maintaining the vascular permeability during sepsis, as well as in regulating inflammation and thrombosis. During sepsis, endothelial cells may release cytokines, chemokines, and pro-coagulant factors, as well as express adhesion molecules. In general, endothelial responses during sepsis typically inhibit bacterial transmission and coordinate leukocyte recruitment to promote bacterial clearance. However, excessive or prolonged endothelial activation can lead to impaired microcirculation, tissue hypoperfusion, and organ dysfunction. Given the structural and functional heterogeneity of endothelial cells in different organs, there are potential differences in endothelial responses by organ type, and the risk of organ damage may vary accordingly. This article reviews the endothelial response observed in sepsis and its effects on organ function, summarizes current progress in the development of therapeutic interventions targeting the endothelial response, and discusses future research directions to serve as a reference for researchers in the field.
Impacts of Helicobacter pylori infection and eradication on gastrointestinal microbiota: An up-to-date critical review and future perspectives
Authors: Li Yu , He Cong , Lu Nonghua
Published: November 2024

Helicobacter pylori (H. pylori) infects approximately half of the population worldwide and causes chronic gastritis, peptic ulcers, and gastric cancer. Test-and-treat strategies have been recommended for the prevention of H. pylori-associated diseases. Advancements in high-throughput sequencing technologies have broadened our understanding of the complex gastrointestinal (GI) microbiota and its role in maintaining host homeostasis. Recently, an increasing number of studies have indicated that the colonization of H. pylori induces dramatic alterations in the gastric microbiota, with a predominance of H. pylori and a reduction in microbial diversity. Dysbiosis of the gut microbiome has also been observed after H. pylori infection, which may play a role in the development of colorectal cancer. However, there is concern regarding the impact of antibiotics on the gut microbiota during H. pylori eradication. In this review, we summarize the current literature concerning how H. pylori infection reshapes the GI microbiota and the underlying mechanisms, including changes in the gastric environment, immune responses, and persistent inflammation. Additionally, the impacts of H. pylori eradication on GI microbial homeostasis and the use of probiotics as adjuvant therapy are also discussed. The shifts in the GI microbiota and their crosstalk with H. pylori may provide potential targets for H. pylori-related gastric diseases and extragastric manifestations.
SPLASH: Split-Body Randomized Clinical Trial of Poly-l-Lactic Acid for Adipogenesis and Volumization of the Hip Dell
Authors: Zubair Raheel , Ishii Lisa , Loyal Jameson , Hartman Nina , Fabi Sabrina G.
Published: November 2024

BACKGROUND

Injectable poly-l-lactic acid (PLLA-SCA) increases extracellular matrix to improve skin quality. The hip dell is an underappreciated element of gluteal aesthetics. Adipose tissue has roles in aesthetics and skin functioning.

OBJECTIVE

To investigate the efficacy of PLLA-SCA treatment to induce adipogenesis and volumize the hip dell.

MATERIALS AND METHODS

This was a double-blinded, split-body trial of 15 women with hip dell volume deficits. Each subject was randomized to have 1 hip dell treated with 150 mg of PLLA-SCA while the contralateral hip dell received the equivalent volume of saline. Subjects received 3 treatments at 1-month intervals and were followed for 9 months. Assessments included physician global aesthetic improvement scale, ultrasonography, and histologic examination.

RESULTS

Blinded investigators rated PLLA-SCA–treated hip dells as improved and much improved. The dermis and adipose layers increased in thickness by 26.1% and 27%. These measures, in addition to collagen and elastic fiber quality, were significantly improved compared with saline-treated hip dells, which did not change from baseline. Subject satisfaction was also significantly greater on the PLLA-SCA–treated side. No subject experienced significant adverse effects.

CONCLUSION

Poly-l-lactic acid is a safe and effective method for durable volumization and aesthetic improvement of the hip dell. PLLA-SCA may promote adipogenesis and elastogenesis.
Impact of biliary-pancreatic double stents on EUS-guided tissue acquisition among patients with solid pancreatic lesions: A multicenter study
Authors: Shang Guochen , He Qi , Han Chaoqun , Guo Xianwen , Chen Weigang , Ding Zhen , Lin Rong
Published: November 2024

Background and Objective

Although the impact of biliary stents on the accuracy of EUS-guided tissue acquisition (EUS-TA) is still controversial, the influence of biliary-pancreatic double stents on EUS-TA is even more inconclusive. The aim of the study was to determine whether the diagnostic yield of EUS-FNA in the diagnosis of solid pancreatic lesions will be affected after placement of biliary-pancreatic double stents.

Methods

A multicenter retrospective study including patients who underwent EUS-FNA with biliary duct obstruction was performed. Patients were divided into 2 groups according to whether there were biliary-pancreatic double stents before EUS-FNA. The patients' EUS-FNA report, histopathological results, and clinical case data were reviewed and compared.

Results

Ninety-two patients were included, 42 with biliary-pancreatic double stents and 50 without any stents. The puncture time taken by EUS-FNA was significantly longer in the stent group than the no-stent group (19 vs. 15 min, P < 0.001). No significant differences were observed in accuracy (90.5% vs. 94%), sensitivity (89.5% vs. 93.6%), specificity (100% vs. 100%), NPV (50% vs. 50%), PPV (100% vs. 100%), respectively, in both groups. Patients with larger lesions (OR = 1.600, 95% CI: 1.124–2.277) and those who required more passes had a higher diagnostic yield (OR = 9.376, 95% CI: 1.356–64.819) by multivariate analysis.

Conclusions

ERCP before EUS-FNA is feasible for the treatment of solid pancreatic lesions causing obstructive jaundice. It will not have a negative impact on the diagnostic accuracy and surgical complications, but the EUS-FNA operation time will be prolonged.
“Pushed to Their Limits”
Authors: Rush Christina L. , Brewer Julie R. , Levey Nadine , Presciutti Alexander M. , McDermott Katherine , Pasinski Roger , Yousif Neda , Gholston Milton , Raju Vidya , Greenberg Jonathan , Ritchie Christine S. , Vranceanu Ana-Maria
Published: November 2024

Older adults from underserved backgrounds experience chronic pain at a rate of 60% to 75%. Pharmacological treatments have limited efficacy and involve considerable risks. Mind-body interventions hold promise to improve pain outcomes but are typically not implemented in community clinics in which they are needed most, thus contributing to health disparities in chronic pain treatment. We conducted qualitative focus groups and interviews with 20 providers (eg, primary care doctors, nurses, administrators). We sought their perspectives on barriers and facilitators to implementing an evidence based mind-body activity program for older adults with chronic pain at an underserved community health clinic in Massachusetts. Subthemes were identified within 2 superordinate domains (barriers and facilitators) using a hybrid inductive-deductive thematic analysis approach following the Framework Method. Providers discussed facilitators (partner with clinic staff to facilitate referrals and buy-in, integrate referrals through the electronic medical record, offer groups in different languages, post and tailor advertisements) and barriers (limited staff bandwidth, scheduling challenges, inconsistent patient participation). These results will directly inform tailoring and subsequent effectiveness testing and implementation of the pain management program for older underserved adults with chronic pain in this community health care setting.
miRNAs, dd-cf-DNA, and Chemokines as Potential Noninvasive Biomarkers for the Assessment of Clinical Graft Evolution and Personalized Immunosuppression Requirement in Solid Organ Transplantation
Authors: Millán Olga , Julian Judit , Brunet Mercè
Published: November 2024

The use of noninvasive biomarkers may reduce the need for biopsy and guide immunosuppression adjustments during transplantation. The scientific community in solid organ transplantation currently considers that chemokines, T- and B-cell immunophenotypes, and gene expression, among other molecular biomarkers, have great potential as diagnostic and predictive biomarkers for graft evolution; however, in clinical practice, few valid early biomarkers have emerged. This review focuses on the most relevant scientific advances in this field in the last 5 years regarding the role of 3 biomarkers: miRNAs, chemokines, and ddcf-DNA, in both adult and pediatric populations. An update was provided on the scores based on the combination of these biomarkers. The most-featured articles were identified through a literature search of the PubMed database. This review provides a comprehensive analysis of the potential clinical applications of these biomarkers in the diagnosis and prediction of graft outcomes and discusses the reasons why none have been implemented in clinical practice to date. Translating these biomarkers into routine clinical practice and combining them with pharmacogenetics and pharmacokinetic monitoring is challenging; however, it is the key to present/future individualized immunosuppressive therapies. It is essential that they be shown to be applicable and robust in real-life patient conditions and properly evaluate their added value when combined with the standard-of-care factor monitoring for graft clinical assessment. Partnership strategies among scientists, academic institutions, consortia, including expert working groups and scientific societies, and pharmaceutical and/or biotechnology companies should promote the development of prospective, randomized, multicenter intervention studies for adequate clinical validation of these biomarkers and their monitoring frequency, and their commercialization to make them available to transplant physicians.
New Ideas in Narrative Practice for Mind and Body Healing
Authors: LIU Ren , ZHANG Xiaocong , WANG Yiming , OU Chengying , XIE Shunyi , WEN Baosen , HAN Ying
Published: November 2024

To enrich the specific methods of narrative clinical practice in Chinese medicine and stimulate the innovation of narrative medicine practice in China, we advise that medical professionals should integrate theories and treatments related to acupuncture, massage and positive psychology into their narrative medicine practice, taking into account the current state of clinical practice of acupuncturists and the importance of positive emotions in the field of psychology. This paper elucidates the value of combining acupuncture, massage, and positive psychology from the perspectives of mechanisms and clinical correlations, highlighting their impacts on patients’ physical and mental health. To promote the integration of positive psychology with acupuncture and massage, it is proposed to refine the understanding of the efficacy of acupuncture points and develop theories on stimulating positive psychology in acupuncture and massage further more.
Effects of pretreatment with long-acting gonadotropin-releasing hormone agonists on pregnancy outcomes in patients with minimal and mild peritoneal endometriosis: A retrospective study of 274 frozen–thawed embryo transfer cycles
Authors: Wang Jieyu , Wei Minling , Xu Aike , Zhang Songying
Published: November 2024

To investigate the effects of pretreatment with long-acting gonadotropin-releasing hormone agonist (GnRH-a) before frozen–thawed embryo transfer (FET) on pregnancy outcomes in patients after minimal–mild (stages I–II) peritoneal endometriosis surgery. A retrospective cohort study was performed from March 2018 to May 2019. Overall, 274 patients met inclusion criteria of undergoing FET after minimal/mild peritoneal endometriosis surgery. For the FET protocol, patients were divided into 2 groups: GnRH-a plus hormone replacement therapy (HRT) (group A, n = 154) and HRT-only (group B, n = 120), with the former divided into 2 subgroups receiving 1 (group A1, n = 80) or 2 doses (group A2, n = 74) of GnRH-a. Basic characteristics and pregnancy outcomes of groups A and B and groups A1 and A2 were compared. Clinical pregnancy rate (CPR) and live birth rate (LBR) were the primary outcomes and logistic regression was used to analyze independent correlation factors. The CPR and LBR in group A were 58.4% and 50.0%, respectively, and were not significantly higher than in group B (49.2% and 40.0%; respectively, χ2
 = 2.339, P = .126 and χ2
 = 2.719, P = .099, respectively). CPR and LBR in group A1 were not significantly lower than those in group A2 (52.5% and 45.0% vs 64.9% and 55.4%, respectively; χ2
 = 2.420, P = .120 and χ2
 = 1.665, P = .197, respectively). However, group A2’s CPR and LBR were significantly higher than group B’s (64.9% and 55.4% vs 49.2% and 40.0%, respectively; χ2
 = 4.560, P = .023 and χ2
 = 4.375, P = .026, respectively). Logistic regression analysis showed that GnRH-a pretreatment (1 or 2 doses) had no significant effect on CPR and LBR compared with the HRT-only group. Patients with minimal–mild (stages I–II) peritoneal endometriosis surgery may not require GnRH-a pretreatment before FET.
The relationship of pan-immune-inflammation value (PIV) and HALP score with prognosis in patients with atrial fibrillation
Authors: Eyiol Azmi
Published: November 2024

Because earlier studies have proven a link between hemoglobin, albumin, lymphocyte, and platelet (HALP) and pan-immune-inflammation value (PIV) scores and inflammation, we examined if these 2 markers had predictive value in patients with atrial fibrillation (AF). In the intensive care unit, 444 patients with and without AF were retrospectively analyzed. Patients with and without AF were compared with regard to their HALP and PIV scores. High and low categories of HALP and PIV scores were established based on the cutoff values. Furthermore, using receiver operating characteristic analysis, the mortality predictive efficacy of these scores was assessed in 230 patients with AF. Patients with AF had a significantly higher PIV score than those without AF; however, the HALP score found to be lower (P < .05 for all groups). The receiver operating characteristic analysis revealed that the HALP score exhibited a sensitivity of 66.7% and a specificity of 75.3% at a cutoff value of 2.037 (AUC: 0.753, P < .001). The PIV score cutoff value was 1062.7, but the sensitivity and specificity were both 55.7% and 55.8%, respectively (AUC: 0.571, P < .05). The mechanical ventilation requirement and in-hospital mortality rate were significantly higher in the high PIV (PIV > 1062.7) and low HALP (HALP ≤ 2.037) groups. There is a significant association between the HALP and PIV scores assessed upon admission and critically ill patients with AF. Although the HALP score serves as a powerful prognostic factor for these patients, the PIV lacks the capability to predict mortality.
Feasibility of Early 68Ga-FAP-2286 PET Imaging: A Case Study
Authors: Banihashemian Seyedeh Somayyeh , Divband Ghasemali , Shahrnoy Abdolghafar Abolhosseini , Nami Reza , Nasiri Meysam , Akbari Mohammad Esmaeil
Published: November 2024

Fibroblast activation protein (FAP) has emerged as a promising molecular target for diagnostic and therapeutic strategies. Previous research, including our own study and other published reports, has highlighted the potential of FAP inhibitors labeled with 68Ga as effective diagnostic radiopharmaceuticals. In this study, we present a comparative analysis of early and late PET/CT scans, using 68Ga-FAP-2286, for the detection of tumor lesions in a patient with metastatic breast adenocarcinoma.
Utilizing 99mTc-FAPI-46 SPECT/CT in Detection of Peritoneal Carcinomatosis in Gastric Poorly Differentiated Adenocarcinoma
Authors: Raeisi Nasrin , Tanha Amin Saber , Aryana Kamran , Soltani Ehsan , Barashki Somaye
Published: November 2024

We introduce a 61-year-old man with poorly differentiated gastric adenocarcinoma, who previously underwent surgical treatment. In this presentation, he complained of a newly appeared midabdominal mass after the latest chemotherapy session. He was a candidate for diagnostic laparotomy, but in the setting of trial, 99mTc-FAPI-46 SPECT/CT was performed revealing 2 peritoneal masses, which were the only findings of diagnostic surgery subsequent to the scan. This report presents the first case of 99mTc-FAPI-46 SPECT/CT in metastasis workup of gastric adenocarcinoma.
Trends in Timely Access to High-quality and Affordable Surgical Care in the United States
Authors: Mullens Cody Lendon , Ibrahim Andrew M. , Clark Nina M. , Kunnath Nicholas , Dieleman Joseph L. , Dimick Justin B. , Scott John W.
Published: November 2024

Objective:

To quantify recent trends in access to timely, high-quality, affordable surgical care in the United States.

Background:

Insufficient access to surgical care remains an ongoing concern in the United States. Previous attempts to understand and quantify barriers to access to surgical care in the United States lack a comprehensive, policy-relevant lens.

Methods:

This observational cross-sectional study evaluates multiple domains of access to surgical care across the United States from 2011 to 2015 and 2016 to 2020. Our stepwise model included timeliness (<60-minute drive time), quality (surgically capable hospital with ≥3 CMS stars), and affordability (neither uninsured nor underinsured) of access to surgical care using a novel combination of data from the American Hospital Association, Medicare claims, Centers for Medicare and Medicaid Services' Five-Star Quality Rating System, the American Community Survey, and the Medical Expenditure Panel Survey.

Results:

The number of Americans lacking access to timely, high-quality, affordable surgical care increased from 97.7 million in 2010 to 2015 to 98.7 million in 2016 to 2020. Comparing these 2 periods, we found improvements in the number of Americans lacking access due to being uninsured (a decrease from 38.5 to 26.5 million). However, these improvements were offset by increasing numbers of Americans for whom timeliness (increase from 9.5 to 14.1 million), quality (increase from 3.4 to 4.9 million), and underinsured status (increase from 46.3 to 53.1 million) increased as barriers to access. Multiple sensitivity analyses using alternative thresholds for each access domain demonstrated similar trends. Those with insufficient access to care tended to be more rural (6.7% vs 2.0%, P < 0.001), lower income (40.7% vs 30.0%, P < 0.001), and of Hispanic ethnicity (35.9% vs 15.8%, P < 0.001).

Conclusions:

Nearly 1 in 3 Americans lack access to surgical care that is timely, high-quality, and affordable. This study identifies the multiple actionable drivers of access to surgical care that notably can each be addressed with specific policy interventions.
The History of Clinical Nurse Specialists in Emergency Care
Authors: Miller Jacob A. , Cornell Marcia S. , Foley Andi
Published: November 2024

The Clinical Nurse Specialist (CNS) role has been instrumental in advancing nursing practice, healthcare delivery, and patient outcomes across various specialties, particularly in emergency care. This manuscript provides an extensive review of the history of CNSs in emergency settings, exploring the development of the practice model, the challenges encountered, and their impact on patient and organizational outcomes.
Ionizing radiation has negligible effects on the age, telomere length and corticosterone levels of Chornobyl tree frogs
Authors: Burraco Pablo , Gabor Caitlin , Bryant Amanda , Gardette Vanessa , Lengagne Thierry , Bonzom Jean Marc , Orizaola Germán
Published: November 2024

The accident that occurred at the Chornobyl nuclear power plant (Ukraine, 1986) contaminated a large extension of territory after the deposition of radioactive material. It is still under debate whether the chronic exposure to the radiation levels currently present in the area has long-term effects on organisms, such as decreases in longevity. Here, we investigate whether current levels of radiation in Chornobyl negatively impact the age of the Eastern tree frog
Hyla orientalis
. We also explore whether radiation induces changes in an ageing marker, telomere length or the stress hormone corticosterone. We found no effect of total individual absorbed radiation (including both external and internal exposure) on frog age (
n
= 197 individuals sampled in 3 consecutive years). We also did not find any relationship between individual absorbed radiation and telomere length, nor between individual absorbed radiation and corticosterone levels. Our results suggest that radiation levels currently experienced by Chornobyl tree frogs may not be high enough to cause severe chronic damage to semi-aquatic vertebrates such as this species. This is the first study addressing age and stress hormones in Chornobyl wildlife, and thus future research will confirm if these results can be extended to other taxa.
Seeing the piles of the velvet bending under our finger sliding over a tactile stimulator improves the feeling of the fabric
Authors: Mouchnino Laurence , Camillieri Brigitte , Faucheu Jenny , Juganaru Mihaela , Moinon Alix , Blouin Jean , Bueno Marie-Ange
Published: November 2024

Using friction modulation to simulate fabrics with a tactile stimulator (i.e. virtual surface) is not sufficient to render fabric touch and even more so for hairy fabrics. We hypothesized that seeing the pile of the velvet darken or lighten depending on changes in the finger movement direction on the virtual surface should improve the velvet fabric rendering. Participants actively rubbed a tactile device or a velvet fabric looking at a screen that showed a synthesized image of a velvet that either remained static (V-static) or darkening/lightening with the direction of touch (V-moving). We showed that in V-moving condition, the touched surface was always perceived rougher, which is a descriptor of a real velvet (Experiment 1). Using electroencephalography and sources localization analyses, we found increased activity in the occipital and inferior parietal lobes (Experiment 2) when seeing dark and shining traces during back-and-forth finger movements over the virtual surface. This suggests that these two posterior cortical regions work together to evaluate visuo-tactile congruence between the seen and the felt (tactile). The visuo-tactile binding, evidenced by neural synchronization (specifically, theta band (5–7 Hz) oscillation) in the left inferior posterior parietal lobule, is consistent with enhanced integration of information and probably contributed to the emergence of a more realistic velvet representation.
Bacterial Engineered Living Materials modulate Mechanosignaling in Mammalian Cells
Authors: Ostmann Katharina , Muñoz-Guamuro Geisler , Becker Jan , Baños Miguel , Saikumar Sairam , Bennewitz Roland , Duong Cao Nguyen , Sankaran Shrikrishnan , Weber Wilfried
Published: November 2024

Engineered living materials (ELMs) are gaining momentum for biomedical applications as self-replenishing drug depots, smart wound dressings, or as wearable sensors. Current studies on ELM-host interaction are mainly limited to the exchange of biochemical cues between ELMs and surrounding cells and tissues. Here we show that the genetically programmed mechanical properties of ELMs modulate mechanosignaling pathways in mammalian cells cultivated onto the living materials. To this aim, we genetically modulated curli fiber production inE. coliand analyzed the impact on the mechanical properties of the resulting ELMs. The living materials were used as matrix for the cultivation of mammalian cells engineered with a fluorescent reporter to indicate the activation of the mechano-responsive Hippo signaling pathway. We demonstrate that different genetically programmed ELM compositions translated into differential regulation of mechanosignaling in mammalian cells. These findings provide the perspective of using ELMs as extracellular matrix with genetically programmable mechanics for mammalian cells while also highlighting the need to consider the mechanical properties of therapeutic ELMs when assessing interaction with surrounding tissues.

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Using Quality Improvement Tools to Reduce Macerated Stillbirth by 50% in the Volta Region of Ghana in a Two Years Period
Authors: Danso Gideon , Boadu Richard Okyere
Published: November 2024

Stillbirth rate is an indirect measure of the quality of management of pregnancy, labour and delivery. The loss of a baby due to stillbirth does not only affect pregnant women but also takes a great toll on family’s health and wellbeing. In Ghana, stillbirths account for a large proportion of perinatal mortalities. We used small multiple graphs to compare the rate of stillbirth in the Volta region from (2014-2016) to the national target for stillbirth.

Inferences from the graph shows that there was a gap of 10.4 per 1,000 live births between the national target of 12 per 1,000 live births. Fresh still birth also had a mean of 37.2 per 1000 live births showing a gap of 25.2 between the national target. The gap between the national target and macerated still birth is 50.8. This shows significant change in the stillbirth rate in the region and requires attention. In view of this, this study aims to reduce stillbirth (macerated) by 50% in two years period.
A macrophage-smooth muscle cell axis influences vascular remodeling through activation of the EGFR pathway in giant cell arteritis
Authors: Chevalier Kevin , Dionet Léa , Breillat Paul , Poux Margot , Dang Julien , Terris Benoit , Bruneval Patrick , Mouthon Luc , Lenoir Olivia , Tharaux Pierre-Louis , Terrier Benjamin
Published: November 2024

Background.

The role of macrophages and vascular resident cells appears to be predominant in the pathophysiology of giant cell arteritis (GCA). We investigated the role of epithelial growth factor receptor (EGFR) signaling pathway, especially through its activation by heparin-binding epidermal growth factor (HB-EGF) and/or amphiregulin (AREG) in this setting.

Materials and Methods.

Serum samples and temporal artery biopsies (TAB) were obtained from patients enrolled in a prospective cohort of systemic vasculitis. Human THP-1, a monocytic cell line, and human aortic vascular smooth muscle cells (VSMC) were used forin vitrostudies.

Results.

Using multiplex immunohistochemistry, TAB from GCA patients showed higher expression of AREG, HB-EGF, EGFR and phospho-EGFR as compared to control arteries. AREG, HB-EGF and EGFR were predominantly expressed by macrophages, whereas EGFR and phosphor-EGFR were expressed by αSMA-positive cells in the media. Increased levels of AREG and HB-EGF were found in culture supernatants of M1 macrophages, whereas M2 macrophages produced only HB-EFG. AREG and HB-EGF did not increase the production of pro-inflammatory cytokines by THP-1 or macrophages but activated the p38 MAPK pathway. Using transcriptomic and Western blot analysis of human aortic VSMC, AREG and especially HB-EGF induced cell proliferation pathway, enhanced interferon alpha and gamma responses, and activation of the MAPK pathway. Finally, AREG and HB-EGF increased both VSMC proliferation and migration, which were completely inhibited by AG1478, an EGFR inhibitor.

Conclusion.

We show that both AREG and HB-EGF may play a role in the pathophysiology of GCA, especially in the remodeling phase of the disease.
ImmunoStruct: Integration of protein sequence, structure, and biochemical properties for immunogenicity prediction and interpretation
Authors: Givechian Kevin Bijan , Rocha João Felipe , Yang Edward , Liu Chen , Greene Kerrie , Ying Rex , Caron Etienne , Iwasaki Akiko , Krishnaswamy Smita
Published: November 2024

Epitope-based vaccines are promising therapeutic modalities for infectious diseases and cancer, but identifying immunogenic epitopes is challenging. The vast majority of prediction methods are sequence-based, and do not incorporate wide-scale structure data and biochemical properties across each peptide-MHC (pMHC) complex. We present ImmunoStruct, a deep-learning model that integrates sequence, structural, and biochemical information to predict multi-allele class-I pMHC immunogenicity. By leveraging a multimodal dataset of∼27,000 peptide-MHC complexes that we generated with AlphaFold, we demonstrate that ImmunoStruct improves immunogenicity prediction performance and interpretability beyond existing methods, across infectious disease epitopes and cancer neoepitopes. We further show strong alignment within vitroassay results for a set of SARS-CoV-2 epitopes. This work also presents a new architecture that incorporates equivariant graph processing and multi-modal data integration for the long standing task in immunotherapy.
Real-Time Closed-Loop Feedback System For Mouse Mesoscale Cortical Signal And Movement Control: CLoPy
Authors: Gupta Pankaj K. , Murphy Timothy H.
Published: November 2024

We present the implementation and efficacy of an open-source closed-loop neurofeedback (CLNF) and closed-loop movement feedback (CLMF) system. In CLNF, we measure mm-scale cortical mesoscale activity with GCaMP6s and provide graded auditory feedback (within ∼50 ms) based on changes in dorsal-cortical activation within regions of interest (ROI) and with a specified rule. Single or dual ROIs (ROI1, ROI2) on the dorsal cortical map were selected as targets. Both motor and sensory regions supported closed-loop training in male and female mice. Mice modulated activity in rule-specific target cortical ROIs to get increasing rewards over days (RM ANOVA p=2.83e-5) and adapted to changes in ROI rules (RM ANOVA p=8.3e-10, Table 4 for different rule changes). In CLMF, feedback was based on tracking a specified body movement, and rewards were generated when the behavior reached a threshold. For movement training, the group that received graded auditory feedback performed significantly better (RM-ANOVA p=9.6e-7) than a control group (RM-ANOVA p=0.49) within four training days. Additionally, mice can learn a change in task rule from left forelimb to right forelimb within a day, after a brief performance drop on day 5. Offline analysis of neural data and behavioral tracking revealed changes in the overall distribution of ΔF/F0values in CLNF and body-part speed values in CLMF experiments. Increased CLMF performance was accompanied by a decrease in task latency and cortical ΔF/F0amplitude during the task, indicating lower cortical activation as the task gets more familiar.
Neurovirulent and non-neurovirulent strains of HIV-1 and their Tat proteins induce differential cytokine-chemokine profiles
Authors: Rao Vasudev R. , Rodriguez Milka , Byrareddy Siddappa N. , Ranga Udaykumar , Prasad Vinayaka R.
Published: November 2024

HIV-1 enters the central nervous system (CNS) early in infection, and a significant proportion of people with HIV experience CNS complications despite anti-retroviral therapy. Chronic immune dysfunction, inflammatory cytokines and chemokines, and viral proteins like Tat and gp120 released by HIV-1-infected immune cells are implicated in the pathogenesis of HIV-1-associated neurocognitive disorders (HAND). To elucidate the contribution of non-viral factors to CNS complications in people with HIV-1, a comparative analysis of neurovirulent subtype B (HIV-1ADA) and non-neurovirulent subtype C (HIV-1Indie-C1) isolates was performed. Culture supernatants from HIV-1-infected PBMCs, either with or without immunodepletion of Tat and gp120, were used to treat SH-SY5Y neuroblastoma cells. HIV-1ADA-infected PBMC media showed significantly higher cytotoxicity than HIV-1IndieC1-infectedPBMCmedia, notwithstanding the depletion of Tat and gp120, highlighting the role of non-viral factors contributing to neurotoxicity. A comparison of inflammatory profiles revealed that HIV-1ADAmedia contained elevated levels of cytokines (IL-1α, IL-1β, IL-6, TNFα) and chemokines (CCL2, CCL3, CCL4, IP10). Given the involvement of Tat in upregulating immune mediators, PBMCs from healthy subjects were treated with recombinant purified Tat from subtype B or C. Subtype B Tat induced a stronger inflammatory response than subtype C Tat. These results confirm that both viral and non-viral immune factors mediate neuronal damage in people with HIV.
DNA Extraction Protocols for Animal Fecal Material on Blood Spot Cards
Authors: Llarena Ann-Katrin , Haverkamp Thomas H.A. , Gulliksen Wenche Støldal , Herstad Kristin , Holst-Jensen Arne , Skjerve Eystein , Rannem Lisbeth , Rodriguez-Campos Sabrina , Øines Øivind
Published: November 2024

Background

Collecting fecal samples using dry preservatives is an attractive option in large epidemiological studies as they are easy to use, cheap and independent of cold chain logistics. Here, we test four DNA extraction methods with the aim of identifying an efficient procedure to extract high-quality DNA from fecal material of canine, sheep, equine, bovine, and pig collected on dry blood spot cards, with the goal of generating good quality shotgun metagenomics datasets. Further, the suitability of Illumina shotgun metagenomic sequencing at 20million PE read depth was assessed on its ability to successfully characterize the taxonomic and functional aspects of the resulting fecal microbiome.

Methods

DNA was extracted from pig feces and mock communities collected on blood spot cards using four DNA extraction methods; two different methods of the QIAsymphony® PowerFecal® Pro DNA Kit, the ZymoBIOMICS™ DNA Miniprep Kit, and the MagNA Pure 96 DNA and Viral NA Small Volume Kit. Possible extraction bias was controlled by amplicon sequencing of mock communities. Fecal samples from canine, sheep, equine, bovine, and pig were thereafter subjected to the best performing DNA extraction method and shotgun metagenomic sequencing to determine sequencing efforts for functional and taxonomic analysis.

Results

The four DNA extraction methods demonstrated similar community composition in the sequenced bacterial mock community. The QIAsymphony® PowerFecal® Pro DNA Kit was identified as the DNA extraction method of choice, and the resulting DNA was subjected to shotgun metagenomic sequencing with 20million PE reads. We found that higher number of reads increased the richness of observed genera between 100,000 and 5 million reads, after which higher sequencing effort did not increase the richness of the metagenomes. As for functional analysis, the number of low abundance functions in the metagenomes of the animals’ feces increased with sequencing depth above 20 million PE reads.

Conclusion

Our experiments identified several methods suitable for extracting DNA from feces collected on blood spot cards. The Qiagen’s Blood and Tissue kit on the QiaSymphony platform fulfilled the criteria of high yield, quality, and unbiased DNA, while maintaining high throughput for shotgun metagenomic sequencing. A sequencing depth of 20 million PE reads proved adequate for taxonomic estimations and identifying common functional pathways. Detecting rarer traits, however, requires more sequencing effort.