bluuebunny/crossref_metadata_2025 huggingface dataset:
The ascorbate biosynthesis pathway in plants is known, but there is a way to go with understanding control and functions
Authors: Smirnoff Nicholas , Wheeler Glen L
Published: February 2024

Ascorbate (vitamin C) is one of the most abundant primary metabolites in plants. Its complex chemistry enables it to function as an antioxidant, as a free radical scavenger, and as a reductant for iron and copper. Ascorbate biosynthesis occurs via the mannose/l-galactose pathway in green plants, and the evidence for this pathway being the major route is reviewed. Ascorbate accumulation is leaves is responsive to light, reflecting various roles in photoprotection. GDP-l-galactose phosphorylase (GGP) is the first dedicated step in the pathway and is important in controlling ascorbate synthesis. Its expression is determined by a combination of transcription and translation. Translation is controlled by an upstream open reading frame (uORF) which blocks translation of the main GGP-coding sequence, possibly in an ascorbate-dependent manner. GGP associates with a PAS-LOV protein, inhibiting its activity, and dissociation is induced by blue light. While low ascorbate mutants are susceptible to oxidative stress, they grow nearly normally. In contrast, mutants lacking ascorbate do not grow unless rescued by supplementation. Further research should investigate possible basal functions of ascorbate in severely deficient plants involving prevention of iron overoxidation in 2-oxoglutarate-dependent dioxygenases and iron mobilization during seed development and germination.
Contrasting cytosolic glutathione redox dynamics under abiotic and biotic stress in barley as revealed by the biosensor Grx1–roGFP2
Authors: Bohle Finja , Klaus Alina , Ingelfinger Julian , Tegethof Hendrik , Safari Nassim , Schwarzländer Markus , Hochholdinger Frank , Hahn Matthias , Meyer Andreas J , Acosta Ivan F , Müller-Schüssele Stefanie J
Published: February 2024

Barley is a staple crop of major global importance and relatively resilient to a wide range of stress factors in the field. Transgenic reporter lines to investigate physiological parameters during stress treatments remain scarce. We generated and characterized transgenic homozygous barley lines (cv. Golden Promise Fast) expressing the genetically encoded biosensor Grx1–roGFP2, which indicates the redox potential of the major antioxidant glutathione in the cytosol. Our results demonstrated functionality of the sensor in living barley plants. We determined the glutathione redox potential (EGSH) of the cytosol to be in the range of –308 mV to –320 mV. EGSH was robust against a combined NaCl (150 mM) and water deficit treatment (–0.8 MPa) but responded with oxidation to infiltration with the phytotoxic secretome of the necrotrophic fungus Botrytis cinerea. The generated reporter lines are a novel resource to study biotic and abiotic stress resilience in barley, pinpointing that even severe abiotic stress leading to a growth delay does not automatically induce cytosolic EGSH oxidation, while necrotrophic pathogens can undermine this robustness.
Normalization of kinship relations to enrich family network analysis: case study on China biographical database
Authors: Li Bin , Yuan Yiguo , Lu Xuehui , Bol Peter K
Published: February 2024

Kinship is an important issue in history studies. The kinship database is the key resource to analyze the structure, succession, and evolution of families. However, one kinship could be expressed by different words, and one kinship word may be vague and ambiguous in natural languages, especially in pre-modern Chinese. As in the well-known China Biographical Database, which contains 484,066 kinship instances, there are more than 400 kinship words. Thus, the relations extracted from history texts cannot be directly used to build family networks. In this article, we put forward a novel method to normalize kinship relations by three basic relations: father–descendant, mother–descendant, and husband–wife, as well as the gender of each person. All types of kinships are normalized to these three basic relations. In this way, we identified 178,390 basic kinship relations to fully describe the original 462,147 unambiguous kinship instances, while finding 3,989 inconsistencies and inferring 5,805 missing persons. Then, we generate 29,423 families by basic kinship relations and analyze the properties of families, such as their sizes, depths, and intermarriages across families. This type of family analysis had been almost impossible prior to normalizing kinship relations. Therefore, this technique enables improved family database construction and deeper quantitative analysis.
An integrated in vitro carcinogenicity test that distinguishes between genotoxic carcinogens, non-genotoxic carcinogens, and non-carcinogens
Authors: Chapman Katherine E , Shah Ume-Kulsoom , Fletcher Jessica F , Johnson George E , Doak Shareen H , Jenkins Gareth J S
Published: February 2024

Chemical safety testing plays a crucial role in product and pharmacological development, as well as chemoprevention; however, in vitro genotoxicity safety tests do not always accurately predict the chemicals that will be in vivo carcinogens. If chemicals test positive in vitro for genotoxicity but negative in vivo, this can contribute to unnecessary testing in animals used to confirm erroneous in vitro positive results. Current in vitro tests typically evaluate only genotoxicity endpoints, which limits their potential to detect non-genotoxic carcinogens. The frequency of misleading in vitro positive results can be high, leading to a requirement for more informative in vitro tests. It is now recognized that multiple-endpoint genotoxicity testing may aid more accurate detection of carcinogens and non-carcinogens. The objective of this review was to evaluate the utility of our novel, multiple-endpoint in vitro test, which uses multiple cancer-relevant endpoints to predict carcinogenic potential. The tool assessed micronucleus frequency, p53 expression, p21 expression, mitochondrial respiration, cell cycle abnormalities and, uniquely, cell morphology changes in human lymphoblastoid cell lines, TK6 and MCL-5. The endpoints were used to observe cellular responses to 18 chemicals within the following categories: genotoxic carcinogens, non-genotoxic carcinogens, toxic non-carcinogens, and misleading in vitro positive and negative agents. The number of endpoints significantly altered for each chemical was considered, alongside the holistic Integrated Signature of Carcinogenicity score, derived from the sum of fold changes for all endpoints. Following the calculation of an overall score from these measures, carcinogens exhibited greater potency than non-carcinogens. Genotoxic carcinogens were generally more potent than non-genotoxic carcinogens. This novel approach therefore demonstrated potential for correctly predicting whether chemicals with unknown mechanism may be considered carcinogens. Overall, while further validation is recommended, the test demonstrates potential for the identification of carcinogenic compounds. Adoption of the approach could enable reduced animal use in carcinogenicity testing.
Identification of Hammerhead-variant ribozyme sequences in SARS-CoV-2
Authors: Liu Getong , Jiang Hengyi , Chen Dongrong , Murchie Alastair I H
Published: February 2024

The SARS-CoV-2 RNA virus and variants, responsible for the COVID-19 pandemic has become endemic, raised a need for further understanding of the viral genome and biology. Despite vast research on SARS-CoV-2, no ribozymes have been found in the virus genome. Here we report the identification of 39 Hammerhead-variant ribozyme sequences (CoV-HHRz) in SARS-CoV-2. These sequences are highly conserved within SARS-CoV-2 variants but show large diversity among other coronaviruses. In vitro CoV-HHRz sequences possess the characteristics of typical ribozymes; cleavage is pH and ion dependent, although their activity is relatively low and Mn2+ is required for cleavage. The cleavage sites of four CoV-HHRz coincide with the breakpoint of expressed subgenomic RNA (sgRNAs) in SARS-CoV-2 transcriptome data suggesting in vivo activity. The CoV-HHRz are involved in processing sgRNAs for ORF7b, ORF 10 and ORF1ab nsp13 which are essential for viral packaging and life cycle.
Linear DNA-driven recombination in mammalian mitochondria
Authors: Fragkoulis Georgios , Hangas Anu , Fekete Zsófia , Michell Craig , Moraes Carlos T , Willcox Smaranda , Griffith Jack D , Goffart Steffi , Pohjoismäki Jaakko L O
Published: February 2024

Mitochondrial DNA (mtDNA) recombination in animals has remained enigmatic due to its uniparental inheritance and subsequent homoplasmic state, which excludes the biological need for genetic recombination, as well as limits tools to study it. However, molecular recombination is an important genome maintenance mechanism for all organisms, most notably being required for double-strand break repair. To demonstrate the existence of mtDNA recombination, we took advantage of a cell model with two different types of mitochondrial genomes and impaired its ability to degrade broken mtDNA. The resulting excess of linear DNA fragments caused increased formation of cruciform mtDNA, appearance of heterodimeric mtDNA complexes and recombinant mtDNA genomes, detectable by Southern blot and by long range PacBio® HiFi sequencing approach. Besides utilizing different electrophoretic methods, we also directly observed molecular complexes between different mtDNA haplotypes and recombination intermediates using transmission electron microscopy. We propose that the known copy-choice recombination by mitochondrial replisome could be sufficient for the needs of the small genome, thus removing the requirement for a specialized mitochondrial recombinase. The error-proneness of this system is likely to contribute to the formation of pathological mtDNA rearrangements.
Curriculum and Competency Guidelines for the Advanced Care Practitioner in Infectious Disease
Authors: Smith Miriam A , Zelenetz Paul , Kim Angela , Donaghy Henry , Gould J Scott , McLeod-Sordjan Renee
Published: February 2024

Background

Changes in the health care delivery system have altered the way internal medicine (IM) is practiced, with inclusion of subspecialty advanced care practitioners (ACPs) as vital members of the health care team.

Methods

ACPs are provided the clinical settings and educational resources within an academic center to become competent in recognizing and managing common and complicated infectious diseases (ID). The ID ACP will be given progressive responsibility with expectations for achievement of milestones as they develop into competent practitioners. We seek to ensure quality, cost-effective, and comprehensive patient-centered care on the ID service in the inpatient and ambulatory settings in compliance with national standards and scope of practice recommendations and regulations.

Results

In recognition of the expanding role of ACPs, we developed a curriculum and guidelines in the subspecialty of ID.

Conclusions

Our proposal greatly adds to the available literature for ACPs to provide the full spectrum of ID practice.
Characteristics and Outcomes of Pregnant Women Hospitalized With Laboratory-Confirmed Respiratory Syncytial Virus Before and During the COVID-19 Pandemic
Authors: Milucky Jennifer , Patel Kadam , Patton Monica E , Kirley Pam Daily , Austin Elizabeth , Meek James , Anderson Evan J , Brooks Alicia , Brown Chloe , Mumm Erica , Salazar-Sanchez Yadira , Barney Grant , Popham Kevin , Sutton Melissa , Talbot H Keipp , Crossland Melanie T , Havers Fiona P ,   RSV-NET Surveillance Team, Chai Shua J , Armistead Isaac , Yousey-Hindes Kimberly , Openo Kyle P , Henderson Justin , Bye Erica , Pacheco Francesca , Rowlands Jemma V , Bennett Nancy M , Hendrick M Andraya , Schaffner William , Hill Mary
Published: February 2024

Background

Respiratory syncytial virus (RSV) can cause severe disease among infants and older adults. Less is known about RSV among pregnant women.

Methods

To analyze hospitalizations with laboratory-confirmed RSV among women aged 18 to 49 years, we used data from the RSV Hospitalization Surveillance Network (RSV-NET), a multistate population-based surveillance system. Specifically, we compared characteristics and outcomes among (1) pregnant and nonpregnant women during the pre–COVID-19 pandemic period (2014–2018), (2) pregnant women with respiratory symptoms during the prepandemic and pandemic periods (2021–2023), and (3) pregnant women with and without respiratory symptoms in the pandemic period. Using multivariable logistic regression, we examined whether pregnancy was a risk factor for severe outcomes (intensive care unit admission or in-hospital death) among women aged 18 to 49 years who were hospitalized with RSV prepandemic.

Results

Prepandemic, 387 women aged 18 to 49 years were hospitalized with RSV. Of those, 350 (90.4%) had respiratory symptoms, among whom 33 (9.4%) were pregnant. Five (15.2%) pregnant women and 74 (23.3%) nonpregnant women were admitted to the intensive care unit; no pregnant women and 5 (1.6%) nonpregnant women died. Among 279 hospitalized pregnant women, 41 were identified prepandemic and 238 during the pandemic: 80.5% and 35.3% had respiratory symptoms, respectively (P < .001). Pregnant women were more likely to deliver during their RSV-associated hospitalization during the pandemic vs the prepandemic period (73.1% vs 43.9%, P < .001).

Conclusions

Few pregnant women had severe RSV disease, and pregnancy was not a risk factor for a severe outcome. More asymptomatic pregnant women were identified during the pandemic, likely due to changes in testing practices for RSV.
Confronting the Disruption of the Infectious Diseases Workforce by Artificial Intelligence: What This Means for Us and What We Can Do About It
Authors: Langford Bradley J , Branch-Elliman Westyn , Nori Priya , Marra Alexandre R , Bearman Gonzalo
Published: February 2024

With the rapid advancement of artificial intelligence (AI), the field of infectious diseases (ID) faces both innovation and disruption. AI and its subfields including machine learning, deep learning, and large language models can support ID clinicians’ decision making and streamline their workflow. AI models may help ensure earlier detection of disease, more personalized empiric treatment recommendations, and allocation of human resources to support higher-yield antimicrobial stewardship and infection prevention strategies. AI is unlikely to replace the role of ID experts, but could instead augment it. However, its limitations will need to be carefully addressed and mitigated to ensure safe and effective implementation. ID experts can be engaged in AI implementation by participating in training and education, identifying use cases for AI to help improve patient care, designing, validating and evaluating algorithms, and continuing to advocate for their vital role in patient care.
Epidemiology, Clinical Characteristics, and Diagnostic Testing Practices for Pneumocystis Pneumonia–Associated Hospitalizations, United States, 2019–2022
Authors: Benedict Kaitlin , Baggs James , Gold Jeremy A W
Published: February 2024

Among 9196 hospitalizations involving Pneumocystis pneumonia, those without HIV had higher in-hospital mortality (24.3% vs 10.5%, P < .001) when compared with those with HIV. These findings underscore the continued importance of Pneumocystis pneumonia clinical awareness and the need for comprehensive prophylaxis guidance, particularly for certain patients without HIV who are immunosuppressed.
Cholera Deaths During Outbreaks in Uvira, Eastern Democratic Republic of the Congo, 10–35 Months After Mass Vaccination
Authors: Bugeme Patrick Musole , Xu Hanmeng , Hutchins Chloe , Dent Juan , Saidi Jaime Mufitini , Rumedeka Baron Bashige , Itongwa Moïse , Mashauri Joël Faraja Zigashane , Masembe Lulela Faraja , Bengehya Justin , Kulondwa Jean-Claude , Debes Amanda K , Ciglenecki Iza , Tshiwedi Esperance , Kitoga Faida , Bodisa-Matamu Tavia , Nadège Taty , Kavunga-Membo Hugo , Lunguya Octavie , Welo Placide Okitayemba , Knee Jackie , Mukadi-Bamuleka Daniel , Azman Andrew S , Malembaka Espoir Bwenge
Published: February 2024

Our understanding of the burden and drivers of cholera mortality is hampered by limited surveillance and confirmation capacity. Leveraging enhanced clinical and laboratory surveillance in the cholera-endemic community of Uvira, eastern Democratic Republic of Congo, we describe cholera deaths across 3 epidemics between September 2021 and September 2023 following mass vaccination.
Discovery of diffuse radio source in Abell 1060
Authors: Kurahara Kohei , Akahori Takuya , Oki Aika , Omiya Yuki , Nakazawa Kazuhiro
Published: February 2024

Non-thermal components in the intra-cluster medium (ICM), such as turbulence, magnetic field, and cosmic rays, imprint the past and current energetic activities of jets from active galactic nuclei (AGN) of member galaxies as well as disturbance caused by galaxy cluster mergers. Meter- and centimeter-radio observations of synchrotron radiation allow us to diagnose the nonthermal component. Here we report on our discovery of an unidentified diffuse radio source, named the Flying Fox, near the center of the Abell 1060 field. The Flying Fox has an elongated ring-like structure and a central bar shape, but there is no obvious host galaxy. The average spectral index of the Flying Fox is −1.4, which is steeper than that for radio sources seen at meter wavelengths. We discussed the possibilities of radio lobes, phoenixes, radio halos and relics, and an odd radio circle. In conclusion, the Flying Fox is not clearly explained by known radio sources.
Hydrostatic pressure impedes the degradation of sinking copepod carcasses and fecal pellets
Authors: Franco-Cisterna Belén , Stief Peter , Glud Ronnie N
Published: February 2024

Fast-sinking zooplankton carcasses and fecal pellets appear to contribute significantly to the vertical transport of particulate organic carbon (POC), partly because of low temperature that decreases microbial degradation during the descent into the deep ocean. Increasing hydrostatic pressure could further reduce the degradation efficiency of sinking POC, but this effect remains unexplored. Here, the degradation of carcasses and fecal pellets of the abundant marine copepod Calanus finmarchicus was experimentally studied as a function of pressure (0.1–100 MPa). Samples were either exposed to elevated pressure in short 1-day incubations or a gradual pressure increase, simulating continuous particle sinking during a 20-day incubation. Both experiments revealed gradual inhibition of microbial respiration in the pressure range of 20–100 MPa, corresponding to 2–10-km depth. This suggests that hydrostatic pressure impedes carbon mineralization of fast-sinking carcasses and fecal pellets and enhances the deep-sea deposition rate of zooplankton-derived organic material.
Age-specific transmission dynamics of SARS-CoV-2 during the first 2 years of the pandemic
Authors: Boldea Otilia , Alipoor Amir , Pei Sen , Shaman Jeffrey , Rozhnova Ganna
Published: February 2024

During its first 2 years, the SARS-CoV-2 pandemic manifested as multiple waves shaped by complex interactions between variants of concern, non-pharmaceutical interventions, and the immunological landscape of the population. Understanding how the age-specific epidemiology of SARS-CoV-2 has evolved throughout the pandemic is crucial for informing policy decisions. In this article, we aimed to develop an inference-based modeling approach to reconstruct the burden of true infections and hospital admissions in children, adolescents, and adults over the seven waves of four variants (wild-type, Alpha, Delta, and Omicron BA.1) during the first 2 years of the pandemic, using the Netherlands as the motivating example. We find that reported cases are a considerable underestimate and a generally poor predictor of true infection burden, especially because case reporting differs by age. The contribution of children and adolescents to total infection and hospitalization burden increased with successive variants and was largest during the Omicron BA.1 period. However, the ratio of hospitalizations to infections decreased with each subsequent variant in all age categories. Before the Delta period, almost all infections were primary infections occurring in naive individuals. During the Delta and Omicron BA.1 periods, primary infections were common in children but relatively rare in adults who experienced either reinfections or breakthrough infections. Our approach can be used to understand age-specific epidemiology through successive waves in other countries where random community surveys uncovering true SARS-CoV-2 dynamics are absent but basic surveillance and statistics data are available.
Prediction of general practice licensure/certification examination performance by a measure of ‘questionable’ activities in clinical practice: a retrospective cohort study
Authors: Magin Parker , Ralston Anna , Fielding Alison , Holliday Elizabeth , Tran Michael , Tapley Amanda , van Driel Mieke , Ball Jean , Moad Dominica , Mitchell Ben , Fisher Katie , FitzGerald Kristen , Spike Neil , Turner Rachel , Davey Andrew
Published: February 2024

Purpose

‘Low-value’ clinical care and medical services are ‘questionable’ activities, being more likely to cause harm than good or with disproportionately low benefit relative to cost. This study examined the predictive ability of the QUestionable In Training Clinical Activities Index (QUIT-CAI) for general practice (GP) registrars’ (trainees’) performance in Australian GP Fellowship examinations (licensure/certification examinations for independent GP).

Methods

The study was nested in ReCEnT, an ongoing cohort study in which Australian GP registrars document their in-consultation clinical practice. Outcome factors in analyses were individual registrars’ scores on the three Fellowship examinations (‘AKT’, ‘KFP’, and ‘OSCE’ examinations) and pass/fail rates during 2012–21. Analyses used univariable and multivariable regression (linear or logistic, as appropriate). The study factor in each analysis was ‘QUIT-CAI score percentage’—the percentage of times a registrar performed a QUIT-CAI clinical activity when ‘at risk’ (i.e. when managing a problem where performing a QUIT-CAI activity was a plausible option).

Results

A total of 1265, 1145, and 553 registrars sat Applied Knowledge Test, Key Features Problem, and Objective Structured Clinical Exam examinations, respectively. On multivariable analysis, higher QUIT-CAI score percentages (more questionable activities) were significantly associated with poorer Applied Knowledge Test scores (P = .001), poorer Key Features Problem scores (P = .003), and poorer Objective Structured Clinical Exam scores (P = .005). QUIT-CAI score percentages predicted Royal Australian College of General Practitioner exam failure [odds ratio 1.06 (95% CI 1.00, 1.12) per 1% increase in QUIT-CAI, P = .043].

Conclusion

Performing questionable clinical activities predicted poorer performance in the summative Fellowship examinations, thereby validating these examinations as measures of actual clinical performance (by our measure of clinical performance, which is relevant for a licensure/certification examination).
Patient preference, efficacy, and compliance with zoledronic acid for glucocorticoid-induced osteoporosis in patients with autoimmune diseases
Authors: Kim Ji-Won , Jung Ju-Yang , Kim Hyoun-Ah , Son Heejun , Suh Chang-Hee
Published: February 2024

Purpose

We evaluated the preference, patient satisfaction, and efficacy of zoledronic acid compared with oral bisphosphonates (BPs) for glucocorticoid-induced osteoporosis (GIOP) in patients with autoimmune diseases.

Methods

We enrolled 50 patients with new fractures or osteoporosis detected on follow-up bone densitometry after at least 1 year of oral BP use among patients diagnosed with GIOP during treatment for autoimmune diseases. After 1 year of zoledronic acid treatment, patients completed a survey for preference and satisfaction assessment. Treatment efficacy was analysed by comparing bone mineral density changes and fractures with those in a control group of patients who continued oral BP use.

Results

Age, sex, treatment duration, and medication history did not differ significantly between the two groups. Among the participants, 86.7% preferred and were more satisfied with intravenous zoledronic acid than with oral BPs, primarily because of the convenience of its administration interval. Only two patients (4%) reported infusion-related adverse events with zoledronic acid. Furthermore, no significant differences were observed in the annualized percentage change in the bone mineral density of the lumbar spine, femur neck, and hip between patients receiving zoledronic acid and those receiving oral BPs. The occurrence of new fractures was consistent across both groups, with two cases in each, showing no significant differences.

Conclusion

Patients showed a preference for and greater satisfaction with zoledronic acid, and its efficacy in treating osteoporosis was comparable to that of oral BPs. Therefore, zoledronic acid is a suitable treatment option for GIOP in patients with autoimmune diseases.
Evaluation of practice nurses’ management of paediatric psychosocial problems in general practice
Authors: Koet Lukas B M , Gerger Heike , Jansen Wilma , Bindels Patrick J E , de Schepper Evelien I T
Published: February 2024

Background

Child mental health services are under major pressure worldwide. In the Netherlands, Youth Mental Health Practice Nurses (YMHPNs) have been introduced in general practice to improve access to care. In this study, we evaluated care delivered by YMHPNs.

Methods

We used medical records of a population-based cohort (21 717 children, 0–17 years). Characteristics of children consulting a YMHPN, type of problem, care delivered by YMHPNs and referrals were assessed using quantitative content analysis.

Results

Records of 375 children (mean age 12.9 years, 59.2% girl) were analysed. These children were often in their adolescence (57.3% was between 13 and 17 years), and more often female than male (59.2% vs 40.8%). YMHPNs had a median of four consultations (IQR 2–7) with the child. YMHPNs managed a variety of psychosocial problems. YMHPNs managed 22.4% of children without need of referral, 52.0% were eventually referred for additional care. 13.3% of children dropped out during the treatment trajectory. In the remaining 12.3% of children, the treatment trajectory was stopped because the child was already attending specialized services, the treatment trajectory was still ongoing or the medical record was inconclusive.

Conclusions

YMHPNs successfully managed one in four children with psychosocial problems without need for referral. Nevertheless, most children were eventually referred for additional care.
Translation of mechanistic advances in preeclampsia to the clinic: Long and winding road
Authors: Thadhani Ravi , Cerdeira Ana Sofia , Karumanchi S. Ananth
Published: February 2024

As one of the leading causes of premature birth and maternal and infant mortality worldwide, preeclampsia remains a major unmet public health challenge. Preeclampsia and related hypertensive disorders of pregnancy are estimated to cause >75 000 maternal and 500 000 infant deaths globally each year. Because of rising rates of risk factors such as obesity, in vitro fertilization and advanced maternal age, the incidence of preeclampsia is going up with rates ranging from 5% to 10% of all pregnancies worldwide. A major discovery in the field was the realization that the clinical phenotypes related to preeclampsia, such as hypertension, proteinuria, and other adverse maternal/fetal events, are due to excess circulating soluble fms‐like tyrosine kinase‐1 (sFlt‐1, also referred to as sVEGFR‐1). sFlt‐1 is an endogenous anti‐angiogenic protein that is made by the placenta and acts by neutralizing the pro‐angiogenic proteins vascular endothelial growth factor (VEGF) and placental growth factor (PlGF). During the last decade, this work has spawned a new era of molecular diagnostics for early detection of this condition. Antagonizing sFlt‐1 either by reducing production or blocking its actions has shown salutary effects in animal models. Further, in early‐stage human studies, the therapeutic removal of sFlt‐1 from maternal circulation has shown promise in delaying disease progression and improving outcomes. Recently, the FDA approved the first molecular test for preterm preeclampsia (sFlt‐1/PlGF ratio) for clinical use in the United States. Measuring serum sFlt‐1/PlGF ratio in the acute hospital setting may aid short‐term management, particularly regarding step‐up or step‐down of care, decision to transfer to settings better equipped to manage both the mother and the preterm neonate, appropriate timing of administration of steroids and magnesium sulfate, and in expectant management decisions. The test itself has the potential to save lives. Furthermore, the availability of a molecular test that correlates with adverse outcomes has set the stage for interventional clinical trials testing treatments for this disorder. In this review, we will discuss the role of circulating sFlt‐1 and related factors in the pathogenesis of preeclampsia and specifically how this discovery is leading to concrete advances in the care of women with preeclampsia.
Prognostic model for predicting the survival benefit of adjuvant chemotherapy for elderly patients with stage II colon cancer: a population-based study
Authors: Yu Guanhua , Wei Ran , Liu Hengchang , Liu Yixiao , Guan Xu , Wang Xishan , Jiang Zheng
Published: February 2024

Objectives

Adjuvant chemotherapy benefits in elderly patients with stage II colon cancer (CC) remain controversial. We aimed to construct a nomogram to estimate the chemotherapy survival benefits in elderly patients.

Methods

The training and testing cohort were patients with stage II CC older than 70 years from the Surveillance, Epidemiology, and End Results (SEER) database, while the external validation cohort included patients from the National Cancer Center (NCC). Cox proportional hazard models were used to determine the covariates associated with overall survival (OS). Using the risk factors identified by Cox proportional hazards regression, a nomogram was developed to predict OS. Nomogram precision was assessed using receiver operating characteristic and calibration curves.

Results

The present study recruited 42 097 and 504 patients from the SEER database and NCC, respectively. The OS of patients who underwent surgery plus adjuvant chemotherapy was considerably longer than patients who underwent surgery alone. The nomogram included variables related to OS, including age, year of diagnosis, sex, AJCC T stage, tumor location, tumor size, harvested lymph nodes, and chemotherapy. According to the nomogram score, the elderly patients were separated into high- and low-risk groups, with high-risk group nomogram scores being greater than the median value, and vice versa. Patients in the high-risk group witnessed worse prognosis and were more likely to benefit from postoperative chemotherapy.

Conclusion

This nomogram can be regarded as a useful clinical tool for assessing the potential adjuvant chemotherapy benefits and for predicting survival in elderly patients with stage II CC.
Transvenous Compared With Leadless Pacemakers: A meta-analysis comparing TP versus LP
Authors: Habboush Shady , Elmoursi Ahmed , Gadelmawla Ahmed F. , Masoud Amr T. , Khalil Mohamed , Sheashaa Hesham , Merza Nooraldin , Massoud Ahmed T.
Published: February 2024

This study aims to compare the effectiveness of leadless pacemakers (LPs) and transvenous pacemakers and to examine the safety of both methods. We included patients undergoing single-chamber pacemaker implantation, either LP or TVP. Our outcomes were successful implantation rate, major complication, vascular injury, tamponade, and pneumothorax. We performed a double-arm analysis comparing LP versus TVP, with risk ratio (RR) and 95% confidence interval. A total of 10 studies were included in this meta-analysis. Regarding efficacy endpoints, RR revealed no significant difference between the LP and transvenous pacemaker groups in terms of successful rate of implantation (RR = 1.00; P = 0.77). Regarding safety outcomes, LP experienced lower incidence of major complications (RR = 0.47; P = 0.01), infection (RR = 0.24; P = 0.001), and tamponade (RR = 0.36; P = 0.01). There was no significant difference between both groups regarding pneumothorax (RR = 0.35; P = 0.22) and vascular injury (RR = 1.55; P = 0.25). The study findings suggest that both LPs and TVPs have similar effectiveness. Moreover, the incidences of pneumothorax, vascular injuries, and major complications were found to be comparable between the 2 methods. However, LPs were found to have lower rates of infection and tamponade.
Ingrown Toenails: A Survey Among Dermatologists on Current Treatments
Authors: Dressler Corinna , Nast Alexander , Heuer Ruben , Löser Christoph R.
Published: February 2024

BACKGROUND:

To date, there is no formal consensus on how to treat ingrown toenails. Despite the risk of causing irreparable damage to the nail, highly invasive procedures are still common. Less-invasive, matrix-directed techniques with shorter downtime and high cure rates exist, but, perhaps because of a lack of awareness, appear not to have been universally adopted.

OBJECTIVE:

The authors' study sought to generate data on common practices in the treatment of ingrown toenails.

MATERIALS AND METHODS:

The authors developed and conducted an online survey to ask dermatologists/dermatosurgeons how they would proceed in 9 different cases of ingrown toenails based on photographs.

RESULTS:

The authors received 154 replies. Nonsurgical interventions, including advice on nail care/foot baths/ointments/wraps/padding, were always the most frequently chosen option. Removal of the lateral nail plate followed by chemical partial matricectomy (phenolization) was the most or second-most frequently chosen surgical intervention. The answers were highly heterogeneous, and there was no unanimity based on morphology alone.

CONCLUSION:

Except for a preference for nonsurgical interventions, the authors could not identify any clear treatment standards. The heterogeneity of treatment approaches suggests the need for a guideline.
The effects of video double-lumen tubes on intubation complications in patients undergoing thoracic surgery
Authors: Shui Weikang , Hu Wei , Ma Wenwen , Han Yuting , Hao Ian Yifei , Zhu Shiyao , Sun Yuefeng , Deng Zhijie , Gao Ya , Heng Lei , Zhu Shanshan
Published: February 2024

BACKGROUND

Tracheal injuries, vocal cord injuries, sore throat and hoarseness are common complications of double-lumen tube (DLT) intubation.

OBJECTIVE

This study aimed to evaluate the effects of ’video double-lumen tubes’ (VDLTs) on intubation complications in patients undergoing thoracic surgery.

DESIGN

A randomised controlled study.

SETTINGT

Xuzhou Cancer Hospital, Xuzhou, China, from January 2023 to June 2023.

PATIENTS

One hundred eighty-two patients undergoing elective thoracic surgery with one-lung ventilation were randomised into two groups: 90 in the DLT group and 92 in the VDLT group.

INTERVENTION

VDLT was selected for intubation in the VDLT group, and DLT was selected for intubation in the DLT group. A fibreoptic bronchoscope (FOB) was used to record tracheal and vocal cord injuries.

MAIN OUTCOME MEASURES

The primary outcomes were the incidence of moderate-to-severe tracheal injury and the incidence of vocal cord injury. The secondary outcomes included the incidence and severity of postoperative 24 and 48 h sore throat and hoarseness,

RESULTS

The incidence of moderate-to-severe tracheal injury was 32/90 (35.6%) in the DLT group, and 45/92 (48.9%) in the VDLT group (P = 0.077; relative risk 1.38, 95% CI, 0.97 to 1.95). The incidence of vocal cord injury was 31/90 (34.4%) and 34/92 (37%) in the DLT and VDLT groups, respectively (P = 0.449). The incidence of postoperative 24 h sore throat and hoarseness was significantly higher in the VDLT group than in the DLT group (for sore throat: P = 0.032, relative risk 1.63, 95% CI, 1.03 to 2.57; for hoarseness: P = 0.018, relative risk 1.48, 95% CI, 1.06 to 2.06).

CONCLUSION

There was no statistically significant difference in the incidence of moderate-to-severe tracheal injury and vocal cord injury between DLTs and VDLTs. While improving the first-attempt success rate, intubation with VDLT increased the incidence of postoperative 24 h sore throat and hoarseness.

TRIAL REGISTRATION

Chinese Clinical Trial Registry identifier: ChiCTR2300067348.
EUS–guided radiofrequency ablation of solid pancreatic lesions: An updated review
Authors: Ofosu Andrew , Ramai Daryl , Morgan Amanda , Chan Christina , Adler Douglas G. , Siddiqui Ali
Published: February 2024

Recent years have brought to light newly developed therapeutic modalities for the treatment of premalignant and malignant pancreatic lesions. The role of EUS–guided radiofrequency ablation (EUS-RFA) as a treatment modality for malignant pancreatic lesions is still under evaluation. Several animal studies and human studies have demonstrated the safety and efficacy of EUS-RFA in the management of premalignant and malignant pancreatic lesions.

EUS-RFA therapy can potentially ablate these lesions safely and with minimally invasive techniques. In this article, we provide an updated review of the application of EUS-RFA of pancreatic lesions. We also review the clinical efficacy and safety of this technique and future directions.
A risk-scoring model based on endobronchial ultrasound multimodal imaging for predicting metastatic lymph nodes in lung cancer patients
Authors: Huang Zhihong , Wang Lei , Chen Junxiang , Zhi Xinxin , Sun Jiayuan
Published: February 2024

Background and Objectives

Endobronchial ultrasound (EBUS) imaging is a valuable tool for predicting lymph node (LN) metastasis in lung cancer patients. This study aimed to develop a risk-scoring model based on EBUS multimodal imaging (grayscale, Doppler mode, elastography) to predict LN metastasis in lung cancer patients.

Patients and Methods

This retrospective study analyzed 350 metastatic LNs in 314 patients with lung cancer and 124 reactive LNs in 96 patients with nonspecific inflammation. The sonographic findings were compared with the final pathology results and clinical follow-up. Univariate and multivariate logistic regression analyses were performed to evaluate the independent risk factors of metastatic LNs. According to the β coefficients of corresponding indicators in logistic regression analysis, a risk-scoring model was established. Receiver operating characteristic curve was applied to evaluate the predictive capability of model.

Results

Multivariate analysis showed that short axis >10 mm, distinct margin, absence of central hilar structure, presence of necrosis, nonhilar vascularity, and elastography score 4 to 5 were independent predictors of metastatic LNs. Both short axis and margin were scored 1 point, and the rest of independent predictors were scored 2 points. The combination of 3 EBUS modes had the highest area under the receiver operating characteristic and accuracy of 0.884 (95% confidence interval, 0.846–0.922) and 87.55%, respectively. The risk stratification was as follows: 0 to 2 points, malignancy rate of 11.11%, low suspicion; 3 to 10 points, malignancy rate of 86.77%, high suspicion.

Conclusions

The risk-scoring model based on EBUS multimodal imaging can effectively evaluate metastatic LNs in lung cancer patients to support clinical decision making.
Sex Differences in Depressive Symptoms in 1308 Patients Post-Stroke at Entry to Cardiac Rehabilitation
Authors: Du XiaoWei , Brooks Dina , Oh Paul , Marzolini Susan
Published: February 2024

Purpose:

The objective of this study was to determine whether a sex difference exists in the prevalence of post-stroke depressive symptoms (PSDS) at entry to cardiac rehabilitation (CR) and to determine the correlates of PSDS in all patients, and in women and men separately.

Methods:

People post-stroke at entry to CR from database records (2006-2017) were included. Bivariate analyses identified PSDS correlates (≥16 on the Center for Epidemiologic Studies Depression Scale) in all patients and women and men separately.

Results:

Patients (n = 1308, 28.9% women), mean age of 63.9 ± 12.9 yr, were 24.2 ± 9.9 mo post-stroke at CR entry. Among all patients, 30.0% had PSDS. A greater proportion of women than men had PSDS (38.6 vs 26.6%; P < .001). Correlates of PSDS in all patients were sex (women) (OR = 1.6: 95% CI, 1.14-2.12), being unemployed, ≤60 yr old, prescribed antidepressant medication, having lower cardiorespiratory fitness (peak oxygen uptake [V̇o
2peak]), chronic obstructive pulmonary disease (COPD), higher body mass index (BMI), no transient ischemic attack, and longer time from stroke to CR entry (>12 mo). Correlates in women were being obese (BMI ≥ 30), 51-70 yr old, prescribed antidepressant medication, and not married. Correlates in men were being ≤60 yr old, unemployed, prescribed antidepressant medication, having lower V̇o
2peak, sleep apnea, COPD, and no hypertension.

Conclusion:

Women were disproportionately affected by PSDS at entry to CR in bivariate and multivariable analyses. Women and men had mostly unique correlates of PSDS, indicating tailored strategies to address PSDS are required. PSDS disproportionately affected patients with longer delay to CR entry, suggesting efforts should target timely referral to facilitate earlier and repeated assessments and management.
Ambulatory Extracorporeal Membrane Oxygenation Use in Patients Listed for Lung Transplant
Authors: Trivedi Jaimin R. , Endo Toyokazu , Sharma Anya , Fox Matthew P. , Slaughter Mark S. , van Berkel Victor H.
Published: February 2024

There has been an increase in the use of extracorporeal membrane oxygenation (ECMO) to bridge critically ill patients to lung transplant (LTX). This study evaluates how ambulatory status on ECMO affected waitlist and post-LTX outcomes. The United Network of Organ Sharing (UNOS) database was queried for patients aged of greater than or equal to 18 years and between 2016 and 2021 to identify pre-LTX patients supported by ECMO. The patients were classified in venous-arterial (VA) ECMO and veno-venous (VV) ECMO cohorts and further classified as ambulatory (AMB) and non-AMB (nAMB). Each cohort was controlled against the non-ECMO patients. Univariate statistical tests, as well as Kaplan–Meier survival curves, were used for analysis. The 90 day waitlist survival was the highest among the non-ECMO group (96%), but both AMB VV and VA groups had superior survival compared to the nAMB group (85% vs. 75%, 78% vs. 65%, p < 0.01). After adjusting for the median lung allocation score (LAS) (88) in the VV ECMO group, the waitlist survival was superior in the AMB VV ECMO compared to those not on ECMO (86% vs. 78%, p > 0.01). The 1 year post-LTX survival between non-ECMO and AMB VV ECMO was comparable (88% vs. 88%, p = 0.66). Ambulating patients or use of physical therapy while on ECMO can help improve lung transplant outcomes.
Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis
Authors: Yi Chi Zhang , Gang Ou , Xiao Li Feng , Ya Lu , Zhijun Zhou , Yong Gang Du , Dan Ran , Xin Liu , Yang Liu , Peng Zhang , Yi Luo , Dong Lin , De Chun Zhang
Published: February 2024

Background:

Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently no systematic comparison between LaTME and TaTME of mid and low rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of LaTME and TaTME in mid and low rectal cancer.

Methods:

Articles included searching through the Embase, Cochrane Library, PubMed, Medline, and Web of science for articles on LaTME and TaTME. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022380067).

Results:

There are 8761 participants included in 33 articles. Compared with TaTME, patients who underwent LaTME had no statistical difference in operation time (OP), estimated blood loss (EBL), postoperative hospital stay, over complications, intraoperative complications, postoperative complications, anastomotic stenosis, wound infection, circumferential resection margin, distal resection margin, major low anterior resection syndrom, lymph node yield, loop ileostomy, and diverting ileostomy. There are similarities between LaTME and TaTME for 2-year DFS rate, 2-year OS rate, distant metastasis rat, and local recurrence rate. However, patients who underwent LaTME had less anastomotic leak rates (RR 0.82; 95% CI: 0.70–0.97; I
2 = 10.6%, P = .019) but TaTME had less end colostomy (RR 1.96; 95% CI: 1.19–3.23; I
2 = 0%, P = .008).

Conclusion:

This study comprehensively and systematically evaluated the differences in safety and effectiveness between LaTME and TaTME in the treatment of mid and low rectal cancer through meta-analysis. Patients who underwent LaTME had less anastomotic leak rate but TaTME had less end colostomy. There is no difference in other aspects. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research.
Treatment of kyphotic deformity in Kümmell’s disease through vertebral body screw fixation and intertransverse process grafting: A case report
Authors: Kang Hui , Wei Tanjun , Zeng Wenbo , Lan Shenghui
Published: February 2024

Rationale:

Kümmell’s disease, also well acknowledged as delayed posttraumatic vertebral body collapse, it is a rare condition which mainly occurs in elderly people more than 50 years old, with the thoracolumbar junction being mostly affected.

Patient concerns:

In this research, we employed posterior short-segment screw fixation within the injured vertebral region, coupled with intertransverse process bone grafting, to address Kümmell’s disease. A 57-year-old female was admitted to our institution with incapacitating back pain and obvious kyphotic deformity.

Diagnoses:

The diagnosis of Kummell disease was mainly depended on clinical symptoms and imaging examinations.

Interventions:

In this research, we employed posterior short-segment screw fixation within the injured vertebral region, coupled with intertransverse process bone grafting, to address Kümmell’s disease.

Outcomes:

The patient could walk independently with the help of a thoracolumbosacral orthosis brace on postoperative Day 2. No pains, kyphotic deformity and neurological deficits were observed during the 36 months of postoperative follow-up. These improvements can be visualized through postoperative magnetic resonance imaging and CT scans. Short-segment screw fixation provides short-term stability to the fracture site and accelerates fracture healing. Subsequently, the healed intervertebral and transverse process grafts offer long-term stability, a fact corroborated by postoperative CT scans.

Lessons:

In summary, for Kümmell’s disease patients exhibiting kyphotic deformity without neurological deficits or compression, posterior short-segment vertebral screw fixation with intertransverse process bone grafting stands as a viable alternative treatment approach.