bluuebunny/crossref_metadata_2025 huggingface dataset:
The protein kinase C modulator bryostatin-1 therapeutically targets microglia to attenuate neuroinflammation and promote remyelination
Authors: Gharibani Payam , Abramson Efrat , Shanmukha Shruthi , Smith Matthew D. , Godfrey Wesley H. , Lee Judy J. , Hu Jingwen , Baydyuk Maryna , Dorion Marie-France , Deng Xiaojing , Guo Yu , Calle Andrew J. , A. Hwang Soonmyung , Huang Jeffrey K. , Calabresi Peter A. , Kornberg Michael D. , Kim Paul M.
Published: January 2025

In multiple sclerosis (MS), microglia and macrophages within the central nervous system (CNS) play an important role in determining the balance among demyelination, neurodegeneration, and myelin repair. Phagocytic and regenerative functions of these CNS innate immune cells support remyelination, whereas chronic and maladaptive inflammatory activation promotes lesion expansion and disability, particularly in the progressive forms of MS. No currently approved drugs convincingly target microglia and macrophages within the CNS, contributing to the lack of therapies aimed at promoting remyelination and slowing disease progression for individuals with MS. Here, we found that the protein kinase C (PKC)–modulating drug bryostatin-1 (bryo-1), a CNS-penetrant compound with an established human safety profile, shifts the transcriptional programs of microglia and CNS-associated macrophages from a proinflammatory phenotype to a regenerative phenotype in vitro and in vivo. Treatment of microglia with bryo-1 stimulated scavenger pathways, phagocytosis, and secretion of factors that prevented the activation of neuroinflammatory reactive astrocytes while also promoting neuroaxonal health and oligodendrocyte differentiation. In line with these findings, systemic treatment of mice with bryo-1 augmented remyelination after a focal demyelinating injury. Our results demonstrate the potential of bryo-1 and possibly a wider class of PKC modulators as myelin-regenerative and supportive agents in MS and other neurologic diseases.
High-frequency epidural electrical stimulation reduces spasticity and facilitates walking recovery in patients with spinal cord injury
Authors: Romeni Simone , Losanno Elena , Emedoli Daniele , Albano Luigi , Agnesi Filippo , Mandelli Carlo , Barzaghi Lina Raffaella , Pompeo Edoardo , Mura Cinzia , Alemanno Federica , Tettamanti Andrea , Castellazzi Paola , Ciucci Chiara , Fossati Veronica , Toni Laura , Caravati Heike , Bandini Andrea , Del Carro Ubaldo , Agosta Federica , Filippi Massimo , Iannaccone Sandro , Mortini Pietro , Micera Silvestro
Published: January 2025

Spinal cord injury (SCI) causes severe motor and sensory deficits, and there are currently no approved treatments for recovery. Nearly 70% of patients with SCI experience pathological muscle cocontraction and spasticity, accompanied by clinical signs such as patellar hyperreflexia and ankle clonus. The integration of epidural electrical stimulation (EES) of the spinal cord with rehabilitation has substantial potential to improve recovery of motor functions; however, abnormal muscle cocontraction and spasticity may limit the benefit of these interventions and hinder the effectiveness of EES in promoting functional movements. High-frequency excitation block introduced in peripheral nerve stimulation could reduce abnormal activity and lead to more physiological activation patterns. Here, we evaluated the application of high-frequency EES (HF-EES) in alleviating undesired muscular cocontraction and spasticity in two patients with motor incomplete SCI implanted with a commercial 32-channel EES paddle commonly used for pain therapy. To design custom HF-EES protocols, we first mapped the muscles targeted by different EES configurations. Our results showed that HF-EES substantially reduced patellar reflex in one participant and eliminated both patellar reflex and ankle clonus in the other participant. By combining HF-EES and low-frequency EES (LF-EES) to enhance functional movements with intensive rehabilitation, we observed notable improvements in lower limb kinematics, muscle strength, and clinical lower limb motor assessments over the trial period. This study suggests that HF-EES could be an important supplementary tool in SCI treatment, emphasizing the importance of personalized rehabilitation approaches and advanced tools to optimize EES treatments and offering hope for individuals with SCI-related motor deficits.
Cenozoic pure-shear thickening of the northern Tibetan Plateau margin: Implications for diverse plateau uplift mechanisms controlled by convergent obliquity
Authors: Gao Shibao , Wu Lei , Lin Xiubin , Cowgill Eric , An Kaixuan , Chen Hanlin , Cheng Xiaogan , Yang Shufeng
Published: January 2025

How the deformed Tibetan lithosphere absorbed the convergence of India and Eurasia during the Cenozoic remains enigmatic, primarily due to significant variation in lithospheric deformation across different margins of the plateau. The northern margin of the Tibetan Plateau is uniquely defined by the ∼1600-km-long Altyn Tagh fault system. How this plateau margin uplifted for 2−4 km under a strike slip-dominated deformation regime remains a subject of debate. Understanding the SE Tarim Basin north of this plateau margin is crucial for addressing this issue, as it contains thousands of meters of Cenozoic sediments sourced from the Tibetan Plateau. Here we use well-logging, isopach mapping, and seismic reflection data to characterize the Cenozoic deposition and deformation processes of the SE Tarim Basin, which are closely related to the uplift mechanism of the northern plateau margin. The results show that (1) the Cenozoic strata exhibit minimal variations in thickness, with no evident thickening toward the Tibetan Plateau; (2) the basin has been deformed by high-angle, basement-involved compressional faults since ca. 16 Ma, mainly through the reactivation of pre-Cenozoic structures; and (3) the maximum Cenozoic shortening is merely ∼0.9 km in the area we studied. These findings, integrated with other geological and geophysical observations, argue against the long-distance continental subduction of the Tarim Basin beneath the Tibetan Plateau, which requires the development of a foreland basin with sediments thickening toward the orogen and low-angle, thin-skinned fold-thrust belts involving ∼100−150 km of shortening in the SE Tarim Basin. These results, together with vertical Moho offsets across the fault system, lead us to propose lithospheric-scale pure-shear thickening as the Cenozoic uplift mechanism of the northern Tibetan Plateau margin. By further comparing the various uplift mechanisms operating on different margins of the Tibetan Plateau, we emphasize the significant role of convergent obliquity in controlling diverse plateau uplift mechanisms.
Wilson’s disease manifesting as refractory rickets
Authors: Verma Rajesh , Bal Kallupurakkal Arjun , Chakraborty Rajarshi
Published: January 2025

Wilson’s disease is a metabolic disorder affecting the liver, brain, skin and osteo-muscular organs. Refractory rickets is an unusual phenomenon in Wilson’s disease. This 27-year-old man was primarily treated for rickets for 20 years without success and later developed features of tremulousness of limbs and dysphonia when he was evaluated for Wilson’s disease. On treatment with a chelating agent, he showed clinical improvement neurologically. This case report emphasises on the consideration of Wilson’s disease early in a case of rickets for better clinical outcome.
Lyme disease periprosthetic joint infection
Authors: Yang Theodore , Shweta FNU , Greatens Marcus , Webb Jonathan
Published: January 2025

Periprosthetic joint infection (PJI) is a devastating complication of total joint surgery. Surgical management of PJI has increased surgical risks and is costly to the healthcare system. This case study presents a unique clinical scenario involving a patient who was diagnosed with Lyme PJI at the total knee arthroplasty site after undergoing surgical management. Lyme PJI is a rare condition, and there is limited guidance on the diagnosis and management of this condition. It should be considered in the differential of certain individuals with appropriate epidemiological risk factors. This report aims to highlight the complexities associated with the diagnosis and management of periprosthetic Lyme infections.
Disseminated enterovirus infection treated with intravenous immunoglobulin in a patient on maintenance ocrelizumab for multiple sclerosis
Authors: Nel Henco , Merritt Adam , Lawson Eli , Porter Michelle
Published: January 2025

We present a case of a woman in her 40s with disseminated enterovirus infection in the setting of maintenance therapy with ocrelizumab for relapsing-remitting multiple sclerosis. The patient originally presented with fever, bilateral lower limb swelling and hypoalbuminaemia. She subsequently developed a productive cough and diarrhoea, and a viral respiratory multiplex panel detected rhino/enterovirus. Despite supportive care, the patient continued to deteriorate with persistent high-grade fevers and progressive derangement of her liver biochemistry. Repeat viral respiratory multiplex testing failed to detect rhino/enterovirus and, therefore, she was investigated for a fever of unknown origin. However, initial extensive special investigations identified no alternate infective, inflammatory or malignant cause. On further testing, enterovirus RNA was detected by specific monoplex nucleic acid amplification test (NAAT) in whole blood, stool and from a targeted enterovirus nasopharyngeal swab. The patient was eventually treated with intravenous immunoglobulin, which led to marked clinical and biochemical improvement.
Solid pseudopapillary epithelial neoplasm of the pancreas with liver metastasis
Authors: Gehlot Pravinkumar Kanaram , Sethna Kayomarz Sohrab
Published: January 2025

A girl in early adolescence presented with complaints of abdominal pain lasting for 4 months, along with a palpable lump in the epigastric region. A CT scan revealed a large solid-cystic mass lesion measuring 9.5×10.7×12.1 cm, involving the body and tail of the pancreas. Additionally, well-defined hypodense lesions in the liver, localised to segments VIII and IVa, were observed, with the aetiology being indeterminate. An endoscopic ultrasound-guided biopsy of the pancreatic mass confirmed a diagnosis of solid pseudopapillary epithelial neoplasm (SPEN). Ultrasonography (USG) of the liver suggested liver metastasis. Surgical excision of the pancreatic mass and complete excision of the liver metastases were performed with the aid of intraoperative USG. No other sites of metastasis were identified. Liver surface masses, measuring 4×3 cm and 5×3 cm in segments VIII and IVa, respectively, were excised, along with a 13×10×6 cm mass in the pancreatic body and tail. Microscopic examination revealed tumour cells arranged in pseudopapillary and solid patterns. The cells were round to oval with eosinophilic cytoplasm, and areas of necrosis, hyalinisation, cholesterol clefts and calcification were identified, consistent with SPEN. The liver lesions were confirmed as metastases of SPEN. All surgical margins were clear, and the three lymph nodes examined were free of tumour involvement. Immunohistochemistry was negative for synaptophysin and chromogranin, supporting the diagnosis of SPEN. Less than 2% of the tumour cells were positive for Ki-67. A final diagnosis of SPEN of the pancreas with liver metastases was established. The patient is currently on routine follow-up and remains disease-free 4 months postsurgery.
Neonatal upper limb arteriovenous malformation: a therapeutic challenge
Authors: Kolkur Karthik , Murumkar Vivek Shriram , Suryawanshi Pradeep , Patnaik Suprabha
Published: January 2025

Arteriovenous malformations (AVMs) are rare congenital vascular malformations with associated morbidities. We describe a neonatal case of upper limb high-flow AVM presenting with upper limb soft tissue mass and postnatal high-output heart failure. Doppler study suggested high-flow AVM, and later magnetic resonance angiography of the right upper limb confirmed the diagnosis. The baby was managed with respiratory support, compression bandage and limb elevation, oral sirolimus and percutaneous embolisation. After percutaneous embolisation using glue, there was a reduction in the size of swelling with wound healing. Post embolisation, the baby remained haemodynamically stable on room air and gained weight on breastfeeds. Treatment of upper limb AVMs is best achieved with a multidisciplinary team to obliterate the arteriovenous shunt to prevent high-output cardiac failure and improve the quality of life.
Intravitreal steroid-associated central serous chorioretinopathy
Authors: Temkar Shreyas , Rajasekar Goutham , Nair Shruti , Deb Amit Kumar
Published: January 2025

Central serous chorioretinopathy (CSC) is a known side effect of systemic steroid therapy. The role of intravitreal steroids in causing CSC is controversial. We present two cases of acute CSC that developed after intravitreal steroid injections. One was a case of diabetic macular oedema; another was a case of branch retinal vein occlusion-related macular oedema. Both cases showed complete resolution of cystoid oedema after intravitreal triamcinolone acetonide injection, but there was a progressive increase in neurosensory detachment (NSD), leading to a suspicion of CSC. Fundus fluorescein angiography confirmed the diagnosis. The first case was treated with focal laser, and the second one was treated with oral eplerenone. There was complete resolution of NSD in both cases. This report adds to the evidence that intravitreal steroids can indeed cause acute CSC. A high index of suspicion for CSC should be maintained in cases where NSD increases following intravitreal steroid administration.
Association between recorded physical activity and cancer progression or mortality in individuals diagnosed with cancer in South Africa
Authors: Mabena Ntokozo , Rugbeer Nivash , Lehmann Sandra , Torres Georgia , Patel Deepak , Mabunda Mosima , Greyling Mike , Thornton Jane S , Choi Yun-Hee , Stranges Saverio , Patricios Jon S
Published: January 2025

Objectives

This study aimed to determine the association between progression and mortality in individuals with stage 1 cancer and their recorded physical activity before the diagnosis of the cancer.

Methods

We included 28 248 members with stage 1 cancers enrolled in an oncology programme in South Africa. Physical activity was recorded using fitness devices, logged gym sessions and participation in organised fitness events. Levels of physical activity over the 12 months before cancer diagnosis were categorised as no physical activity, low physical activity (an average of <60 min/week) and moderate to high physical activity (≥60 min/week). Measured outcomes were time to progression, time to death and all cause mortality.

Results

Physically active members showed lower rates of cancer progression and lower rates of death from all causes. The HR for progression to higher stages or death was 0.84 (95% CI 0.79 to 0.89), comparing low activity with no physical activity, and 0.73 (95% CI 0.70 to 0.77), comparing medium to high physical activity with no physical activity. The HR for all cause mortality was 0.67 (95% CI 0.61 to 0.74), comparing low physical activity with no activity, and 0.53 (95% CI 0.50 to 0.58), comparing medium to high physical activity with no physical activity.

Conclusions

Individuals engaging in any level of recorded physical activity showed a reduced risk of cancer progression or mortality than those not physically active. There was a further reduction among individuals with moderate to high levels of physical activity compared with those with lower levels.
Study protocol for an international registry observational study evaluating clinical outcomes of transcatheter versus standard surgical mitral valve operation for secondary mitral regurgitation: the TEERMISO study
Authors: Nappi Francesco , Singh Sanjeet Singh Avtaar , Salsano Antonio , Spadaccio Cristiano , Shingu Yasushige , Wakasa Satoru , Fiore Antonio
Published: January 2025

Background

Secondary mitral regurgitation (SMR) is a condition affecting the left ventricle (LV) rather than the mitral valve (MV). If the MV remains structurally unchanged, enlargement of the LV or impairment of the papillary muscles can occur. Several mechanical interventions are available to dictate the resolution of MR. However, there is a lack of robust data to compare MV replacement, MV repair (including subvalvular repair) and transcatheter mitral valve procedures (TMVp). This study aims to compare the effectiveness and clinical outcomes of TMVp using the edge-to-edge mitral valve repair technique and standard surgical mitral valve procedures in patients with SMR.

Methods and analysis

Five cardiac surgery centres from four European countries and Japan have collaborated to create a multicentre observational registry (TEERMISO). The registry will enrol consecutive patients who underwent mechanical intervention for SMR between January 2007 and December 2023. The investigators assessed the difference between replacement and repair for both the standard surgical approach and the transcatheter procedure. The main clinical outcome will be the degree of LV remodelling as assessed by the Left Ventricular End-Diastolic Volume Index at 10 years. The study will measure several secondary endpoints, including all-cause mortality as the primary endpoint, followed by functional status, hospitalisation, neurocognition, physiological measures (echocardiographic assessment), adverse events and reoperation.

Ethics and dissemination

Ethics approval was obtained in Montpellier University Hospital on 24 May 2022 (Institutional Review Board Approval Number: IRB-MTP_2022_05_202201143). The results of the main study and each sub-analysis will be submitted for publication in a peer-reviewed journal.

Trial registration number

NCT05090540.
Prevalence and factors associated with severe fatigue 2 years into the COVID-19 pandemic: a cross-sectional population-based study in Geneva, Switzerland
Authors: Graindorge Clément Romain Hugo , Schrempft Stephanie , Pullen Nick , Baysson Hélène , Zaballa María-Eugenia , Stringhini Silvia , Nehme Mayssam , Guessous Idris
Published: January 2025

Objectives

This study aims (1) to assess the prevalence of severe fatigue among the general population of Geneva, 2 years into the COVID-19 pandemic and (2) to identify pandemic and non-pandemic factors associated with severe fatigue.

Design

Cross-sectional population-based survey conducted in Spring 2022.

Setting

General adult population of Geneva, Switzerland.

Participants

6870 adult participants, randomly selected from the general population, included in the Specchio-COVID-19 cohort study, were invited to answer an online health survey.

Outcome and cofactor measure

Prevalence of severe fatigue was measured by the Chalder Fatigue Questionnaire with a cut-off score≥4 out of 11. We assessed prevalence ratios of severe fatigue considering sociodemographic factors, health and behavioural characteristics (body mass index, depression, recent diagnosis of chronic disease or allergy, acute health event, smoking status, physical activity and sleep quality) and recent self-reported COVID-19 infections.

Results

A total of 4040 individuals participated (participation rate 59%, 58% were women, mean age 53.2 (SD=14.1 years)). Overall prevalence of severe fatigue was 30.7% (95% CI=29.2%–32.1%). After adjusting for age, sex, educational level and pre-existing comorbidities, the following characteristics were associated with severe fatigue: individuals aged 18–24 years (adjusted prevalence ratio (aPR)=1.39 (1.10–1.76)) and 25–34 years (aPR=1.23 (1.05–1.45)), female sex (aPR=1.28 (1.16–1.41)), depression (aPR=2.78 (2.56–3.01)), occurrence of health events unrelated to COVID-19 (aPR=1.51 (1.38–1.65)) and self-reported COVID-19 infection in the past 12 months (aPR=1.41 (1.28–1.56)). After further adjustment for depression, previous associations were maintained except for young age.

Conclusions

About one-third of the adult general population of Geneva experienced severe fatigue, 2 years into the COVID-19 pandemic. Heightened fatigue among young adults is partly explained by depressive symptoms. Recent COVID-19 infection is substantially associated with severe fatigue, regardless of infection severity or co-occurrence of depressive disorder.

Trial registration number

CCER project ID 2020-00881.
Effect of exercise on kidney-relevant biomarkers in the general population: a systematic review and meta-analysis
Authors: Liu Qiaoling , Celis-Morales Carlos , Lees Jennifer , Mark Patrick , Welsh Paul
Published: January 2025

Objective

Physical activity (PA) has been generally recognised as beneficial for health. The effect of a change in PA on kidney biomarkers in healthy individuals without kidney disease remains unclear. This manuscript synthesised the evidence of the association of changes in PA with kidney biomarkers in the general population free from kidney disease.

Design

Systematic review and meta-analysis.

Data sources

Embase, PubMed, MEDLINE and Web of Science databases were searched from inception to 12 March 2023.

Eligibility criteria for selecting studies

Studies of longitudinal or interventional design were selected initially. The following studies were excluded: (1) case-control studies, (2) studies where PA was measured at a single time point, (3) populations with known kidney disease, (4) studies evaluating the impact of a single episode/event of PA and (5) non-English language studies.

Data extraction and synthesis

Two independent reviewers extracted data from a pre-designed table and assessed the risk of bias using the Cochrane Risk of Bias tool. Data were pooled using a random-effects model. Hedge’s g was used to synthesise effect sizes and obtain an overall estimate. Heterogeneity between studies was measured using I2. Funnel plots and Egger’s test were performed to evaluate the risk of biased results.

Results

16 interventional studies with randomised or non-randomised designs involving 500 participants were identified. The median follow-up was 84 days. 10 studies were at high risk of bias. Studies with low quality were published prior to the year 2000. Changes in PA were found only to have a positive association with serum creatinine (SCr) (Hedge’s g=0.69; 95% CI 0.13, 1.24; I2=81.37%) and not with plasma renin activity (PRA), urea, or urine albumin-to-creatinine ratio (UACR). The positive association was only observed in people with obesity and those who exercised for more than 84 days.

Conclusions

Higher levels of PA are associated with increased SCr levels in healthy people. It remains unclear if this association is related to impaired kidney function or gain in muscle mass, as data on other kidney biomarkers did not support a certain link.

PROSPERO registration number

This review has been registered on PROSPERO (CRD42023407820).
Reducing postoperative blood product usage and costs in cardiothoracic surgery: the implementation of a multispecialty perioperative care model incorporating a haemostasis checklist
Authors: Smith Christopher Daniel , De Luca Adrian , Hibbert Peter , Sundararajan Krishnaswamy
Published: January 2025

Transfusion of blood products following cardiothoracic surgery represents a significant proportion of national blood product usage, has significant cost implications and is associated with increased 30-day mortality. Following identification of an increase in blood product use, we implemented a healthcare improvement initiative using a perioperative care model and establishment of a new multispecialty cardiothoracic surgery taskforce to further define and tackle the problem. The initiative incorporated a bundle of preoperative identification of high-risk patients, an intraoperative haemostasis checklist, a programme of unit education focussing on bleeding postbypass and use of thromboelastography and introduction of postoperative protocols for identification and escalation of bleeding. Following intervention, a 60% reduction in blood product use within the first 12 hours of cardiopulmonary bypass was observed. Red cell, cryoprecipitate and fresh frozen plasma usage were particularly reduced with 57%, 47% and 72% reductions, respectively, following intervention and similar results were maintained on repeat audit 1-year postintervention, with on average 84 fewer blood products used per 100 patients. This resulted in an estimated cost saving of AU$36 928 per 100 patients. This quality initiative was successful in overcoming traditional silos of care and describes how quality improvement methodology utilising a multispecialty and multidisciplinary approach can be applied to solve complex issues in the perioperative period. Here, we demonstrate a reproducible and sustainable model for reducing blood product use in the cardiothoracic perioperative population.
Transradial cerebral angiography in the neonate and infant: a case series
Authors: Schoeman Sean , Pukenas Bryan , Escobar Fernando , Acord Michael , Cajigas-Loyola Stephanie , Vatsky Seth
Published: January 2025

Background

We aim to share our experience of transradial access (TRA) for cerebral angiography and intervention in five patients ranging from 6 days to 7 months of age.

Methods

In this institutional review board-approved, retrospective case series, we reviewed all patients who underwent TRA for cerebral angiography with and without intervention. We describe three techniques for radial artery cannulation, namely: (1) bareback; (2) with a micropuncture sheath; and (3) with an intravenous catheter. Demographic, clinical, procedural, and imaging data were abstracted from the patients’ medical records.

Results

From September 2019 to August 2023, five patients (median age and weight, 24 days (range 6–218 days) and 4.2 kg (range 3.2–6.2 kg)) underwent TRA for cerebral angiography. Four patients underwent diagnostic cerebral angiography, two via left TRA and two via right TRA. One patient was definitively treated with endovascular embolization for an arteriovenous fistula. Median procedural length was 1.5 hours (range 1–2.2 hours) and median effective skin dose was 88.7 mGy (range 48.8–140.3 mGy). No procedures required conversion to femoral artery access to obtain diagnostic quality imaging or to facilitate intervention. No complications related to the accessed radial artery were recorded.

Conclusions

We have demonstrated that TRA in the neonate and infant is feasible. In our experience this technique is safe and effective for diagnostic cerebral angiography. Additionally, select intervention via TRA in this population may be possible as demonstrated by our single example of endovascular management of an intracranial fistula.
Clinically relevant haemolysis after transcatheter aortic valve implantation with new-generation balloon-expandable valve
Authors: Higuchi Ryosuke , Takamisawa Itaru , Kitamura Mitsunobu , Nanasato Mamoru , Ohno Makoto , Isobe Mitsuaki
Published: January 2025

Background

Valve-related haemolysis is a known complication following prosthetic valve surgery. Haemolysis after transcatheter aortic valve implantation (TAVI) has been reported in some studies, all of which were non-critical. Data related to haemolysis associated with new-generation balloon-expandable valve (BEV) are scarce.

Methods

Among 441 patients who underwent TAVI between April 2023 and June 2024, 282 patients treated with new-generation BEV were analysed. Haemolysis was defined based on the lactate dehydrogenase, haemoglobin, reticulocyte and haptoglobin levels. Clinically relevant haemolysis was defined as a case requiring transfusion and/or reintervention.

Results

Clinically relevant haemolysis occurred in 6 of 282 patients (2.1%), with median age of 84 years. Three (50%) received a 20 mm valve, and the oversizing ranged from −6.6% to +2.7%. All patients (100%) exhibited paravalvular leakage at the native commissural sites, with moderate or greater paravalvular leakage in two (33%). Lactate dehydrogenase levels exceeded 1200 IU/L in five (83%), four (67%) required transfusion and three (50%) underwent reintervention: balloon aortic valvuloplasty in one and valve-in-valve procedures in two. Haemolysis regressed in three reintervention cases; however, one patient died 9 days postoperatively due to COVID-19. Among three patients (50%) managed conservatively, one developed prosthetic valve endocarditis, whereas another showed spontaneous regression of haemolysis. Over a median follow-up of 218 days, five patients (83%) survived.

Conclusion

Clinically relevant haemolysis occurred in 2.1% of patients undergoing TAVI with new-generation BEV, with 67% requiring transfusion and 50% undergoing reintervention. Further research is warranted to identify risk factors and optimise management strategies for haemolysis.
Artificial intelligence in rheumatology research: what is it good for?
Authors: Sequí-Sabater José Miguel , Benavent Diego
Published: January 2025

Artificial intelligence (AI) is transforming rheumatology research, with a myriad of studies aiming to improve diagnosis, prognosis and treatment prediction, while also showing potential capability to optimise the research workflow, improve drug discovery and clinical trials. Machine learning, a key element of discriminative AI, has demonstrated the ability of accurately classifying rheumatic diseases and predicting therapeutic outcomes by using diverse data types, including structured databases, imaging and text. In parallel, generative AI, driven by large language models, is becoming a powerful tool for optimising the research workflow by supporting with content generation, literature review automation and clinical decision support. This review explores the current applications and future potential of both discriminative and generative AI in rheumatology. It also highlights the challenges posed by these technologies, such as ethical concerns and the need for rigorous validation and regulatory oversight. The integration of AI in rheumatology promises substantial advancements but requires a balanced approach to optimise benefits and minimise potential possible downsides.
Low apolipoprotein A1 and high apolipoprotein B levels indicate specific lipid changes in treatment naïve early psoriatic arthritis
Authors: Ishchenko Alla , Van Mechelen M , Storms Lies , de Vlam Kurt , Pazmino Sofia , Neerinckx Barbara , Verschueren P , Lories Rik
Published: January 2025

Objectives

To investigate serum lipid profile in early, treatment-naïve psoriatic arthritis (PsA) and to determine whether changes in classical lipids or apolipoproteins are specific to PsA.

Methods

Total cholesterol, non-high-density lipoprotein cholesterol (non-HDL-c), low-density lipoprotein cholesterol (LDL-c), HDL-c, triglycerides, apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) were compared in newly diagnosed untreated PsA patients (n=75) to sex- and age-matched controls (healthy control (HC)) (n=61) and early untreated rheumatoid arthritis (RA) patients (n=50).

Results

Among classical lipid measurements, HDL-c levels were lower in PsA than in HC and RA (df 2, χ210, p=0.006, PsA vs HC p=0.013). Significant differences in ApoA1 and ApoB levels were observed between PsA, RA and controls. ApoB was higher in PsA than in RA patients but lower than in controls (df2, χ243.8; p<0.001). ApoA1 was markedly lower in PsA patients compared with both RA and controls (df2, χ2118.9; p<0.001). In regression models, the levels of ApoA1, adjusted for additional factors, were predictive of PsA diagnosis with 90.6% accuracy. In receiver operating characteristic analysis, ApoA1 was predictive of the diagnosis of PsA with a specificity of 82.4% and a sensitivity of 83.8% at an optimal cut-off value of 1403 µg/mL (area under the curve (95% CI), 0.886 (0.83 to 0.941)).

Conclusion

Early, treatment-naïve PsA patients exhibit a distinct pro-atherogenic lipid profile, characterised by decreased ApoA1 and increased ApoB levels, distinguishing them from early RA patients and healthy controls. These findings highlight the potential of apolipoprotein measurements to serve as more accurate indicators of lipid disturbances in PsA than traditional serum lipids and as aid to diagnosis of patients presenting with early arthritis.
Evaluating equity reporting within systematic reviews of pre-exposure prophylaxis (PrEP)
Authors: Paris Bethany , Batioja Kelsi , Lin Vanessa , Hartwell Micah
Published: January 2025

Background

Pre-exposure prophylaxis (PrEP) is a medicine that can reduce HIV transmission. Given the disproportionate impact of HIV on minority communities, health equity is an important consideration in PrEP research. We aimed to assess equity reporting in systematic reviews of PrEP using the PROGRESS Plus framework.

Methods

We conducted a systematic search of PubMed (MEDLINE), Embase and Cochrane databases for systematic reviews or meta analyses of PrEP usage. We then used the PROGRESS Plus framework to extract inclusion of the following domains: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, social capital, age and disability.

Results

After screening search articles, our sample included 36 systematic reviews and meta-analyses (SRMAs). 24 (66.7%) were conducted within the USA. Few (2/36, 5.6%) were found to mention adherence to any equity reporting framework. Place and gender/sex were the most reported elements of the framework with inclusion in 34 of 36 studies. Age (30/36, 83.3%) and race/ethnicity (24/36, 66.7%) were also commonly reported. All other criteria were reported in less than half of included SRMAs; religion had the lowest inclusion at 0/36 (0%), followed by disability (1/36, 2.8%). Among the 36 SRMAs, 19 (52.78%) did not conduct any subgroup analyses among domains; those most commonly analysed were gender/sex and age.

Conclusion

Our study found nearly all SRMAs regarding HIV PrEP reported on gender/sex and age; however, other influential equity criteria were often overlooked. Further attention to the reporting of PROGRESS Plus items within these SRMAs may reduce barriers for PrEP utilisation, thus improving HIV prevention strategies.
Independent companies in the tobacco supply chain: transparency and environmental social governance
Authors: Dunwoodie Stirton Fred , Hiscock Rosemary , Mehegan John , Gallagher Allen W A , Bloomfield Michael J
Published: January 2025

Objective

Previous research has identified that transnational tobacco companies lack transparency and that they hide their harms to health and nature behind environmental, social and governance (ESG) reporting. Our objective was to find whether independent tobacco supply chain companies similarly lack transparency on tobacco-related activities while prominently displaying ESG.

Methods

In this cross-sectional study, mentions of tobacco supply chain activities and ESG company official documentation and websites were explored for independent tobacco supply chain companies (n=80) with identified annual reports included in the Tobacco Supply Chain Database. Bivariable statistical analysis tested for differences in the visibility of tobacco supply chain contribution and ESG within official documents and websites. In depth exploration was undertaken for seven case study companies.

Results

Independent tobacco supply chain companies were significantly less likely to mention their tobacco supply chain contribution than ESG (31% and 80%, respectively p<0.001) in annual reporting. Tobacco supply chain contribution was also less prominent than ESG on websites (29% and 79%, respectively, mentioned on the home page or a home page menu p<0.001). The companies were making median annual profits of over US$2 million (n=76), with a large variation of revenue from tobacco activity (5–100%) where it was reported (n=9).

Conclusions

Independent tobacco supply chain companies undertake ESG activities that they prominently display in official reporting and on websites while often being less transparent about their tobacco supply chain contribution. Potential investors and customers may thus be misled about the companies’ true nature. More rigorous reporting requirements are needed.
Trauma Survivors Network: history and evolution of a program empowering survivors and families impacted by traumatic injury
Authors: Flores Eileen M , Michetti Christopher P , Fakhry Samir M , Joseph Katherine , Wysocki Elizabeth , Newcomb Anna
Published: January 2025

The Trauma Survivors Network (TSN), a program of the American Trauma Society (ATS), has a unique history spanning decades with a vision to continue expanding and strengthening services to support survivors and families impacted by traumatic injury. Since the COVID-19 pandemic, the ATS has adapted TSN services to provide both virtual and in-person services for trauma survivors, increasing equity and inclusion for many survivors to access TSN services for the first time. The recent policy changes in the American College of Surgeons Committee on TraumaNew Standards for Care of the Injured Patientprovide an impetus for the TSN to grow and expand services in support of a diverse group of trauma survivors and their loved ones. This paper highlights the collateral impact of traumatic injury, the history and ongoing growth of the TSN and its services to date, the challenges encountered in establishing and maintaining the TSN program, and the equity and inclusion that the TSN offers internationally to support a diverse range of survivors with various forms of trauma and polytrauma.
Parents’ COVID-19 stressors and associations with self-rated health, symptoms of mental health problems, and substance use: a cross-sectional study
Authors: Fortier Janique , Salmon Samantha , Taillieu Tamara , Stewart-Tufescu Ashley , MacMillan Harriet L. , Tonmyr Lil , Gonzalez Andrea , Kimber Melissa , Roos Leslie , Sareen Jitender , Afifi Tracie O.
Published: January 2025

The aim of this study was to understand associations between pandemic stressors and parents’ self-rated physical and mental health; symptoms of mental health problems, and at-risk substance use problems. Data were collected from February 2022 to March 2022 as part of Wave 2 of the Well-being and Experiences Study in Manitoba, Canada ( n = 749). Stressors frequently identified since the onset of the pandemic included inability to spend time with family and friends, worry about getting coronavirus disease-2019 (COVID-19), and travel restrictions. In the past month, the most frequently identified stressors were worry about getting COVID-19, travel restrictions, public health restrictions, and worry about the future. The stressors with the greatest number of associations with worse health outcomes included: job loss or financial burden; feeling lonely or isolated; disrupted or poor sleep; uncertainty about the future; accessing health care for any reason; increased conflict in relationships; cancellation of surgeries, caregiving for children; and inability to spend time with family. Understanding the COVID-19 stressors that were associated with health and substance problems can inform clinical approaches to respond to pandemic-related problems, as well as public health preparedness to mitigate declines in parents’ health and well-being in the context of future pandemics.
Projected background and sensitivity of AMoRE-II
Authors: Agrawal A. , Alenkov V. V. , Aryal P. , Beyer J. , Bhandari B. , Boiko R. S. , Boonin K. , Buzanov O. , Byeon C. R. , Chanthima N. , Cheoun M. K. , Choe J. S. , Choi Seonho , Choudhury S. , Chung J. S. , Danevich F. A. , Djamal M. , Drung D. , Enss C. , Fleischmann A. , Gangapshev A. M. , Gastaldo L. , Gavrilyuk Y. M. , Gezhaev A. M. , Gileva O. , Grigorieva V. D. , Gurentsov V. I. , Ha C. , Ha D. H. , Ha E. J. , Hwnag D. H. , Jeon E. J. , Jeon J. A. , Jo H. S. , Kaewkhao J. , Kang C. S. , Kang W. G. , Kazalov V. V. , Kempf S. , Khan A. , Khan S. , Kim D. Y. , Kim G. W. , Kim H. B. , Kim Ho-Jong , Kim H. J. , Kim H. L. , Kim H. S. , Kim M. B. , Kim S. C. , Kim S. K. , Kim S. R. , Kim W. T. , Kim Y. D. , Kim Y. H. , Kirdsiri K. , Ko Y. J. , Kobychev V. V. , Kornoukhov V. , Kuzminov V. V. , Kwon D. H. , Lee C. H. , Lee DongYeup , Lee E. K. , Lee H. J. , Lee H. S. , Lee J. , Lee J. Y. , Lee K. B. , Lee M. H. , Lee M. K. , Lee S. W. , Lee Y. C. , Leonard D. S. , Lim H. S. , Mailyan B. , Makarov E. P. , Nyanda P. , Oh Y. , Olsen S. L. , Panasenko S. I. , Park H. K. , Park H. S. , Park K. S. , Park S. Y. , Polischuk O. G. , Prihtiadi H. , Ra S. , Ratkevich S. S. , Rooh G. , Sala E. , Sari M. B. , Seo J. , Seo K. M. , Sharma B. , Shin K. A. , Shlegel V. N. , Siyeon K. , So J. , Sokur N. V. , Son J. K. , Song J. W. , Srisittipokakun N. , Tretyak V. I. , Wirawan R. , Woo K. R. , Yeon H. J. , Yoon Y. S. , Yue Q. ,   The AMoRE Collaboration
Published: January 2025

AMoRE-II aims to search for neutrinoless double beta decay ($$0\nu \beta \beta $$

0
ν
β
β

) with an array of 423 $$\hbox {Li}_2^{100}\hbox {MoO}_4$$

Li
2
100

MoO
4

crystals operating in the cryogenic system as the main phase of the Advanced Molybdenum-based Rare process Experiment (AMoRE). AMoRE has been planned to operate in three phases: AMoRE-pilot, AMoRE-I, and AMoRE-II. AMoRE-II is currently being installed at the Yemi Underground Laboratory, located approximately 1000 m deep in Jeongseon, Korea. The goal of the experiment is to reach an exclusion half-life sensitivity to the $$0\nu \beta \beta $$

0
ν
β
β

of $$^{100}$$

100

Mo on the level of $$T^{0\nu \beta \beta }_{1/2} > 6 \times 10^{26}$$

T

1
/
2

0
ν
β
β

>
6
×

10
26

year that covers completely the inverted Majorana neutrino mass hierarchy region of (15–46) meV. To achieve this, the background level of the experimental configurations and possible background sources of gamma and beta events should be well understood. We have intensively performed Monte Carlo simulations using the GEANT4 toolkit in all the experimental configurations with potential sources. We report the estimated background level that meets the $$10^{-4}$$

10

-
4

counts/(keV$$\cdot $$
·
kg$$\cdot $$
·
year) requirement for AMoRE-II in the Region Of Interest (ROI) and show the projected half-life sensitivity based on the simulation study.
BLACK ENTREPRENEURIAL SUCCESS: THE EFFECT OF THE NEIGHBORHOOD TYPE
Authors: OGBOLU MICHAEL
Published: January 2025

Americans tend to cluster into distinct neighborhoods based on their race/ethnicity. The extent of this clustering can be seen in the differences in the racial/ethnic constitution of the U.S. inner cities and the suburbs. This clustering profoundly affects the success of ethnic entrepreneurs, who are usually dependent on co-ethnic patronage in their ethnic enclaves because of their ethnic identity. Successful ethnic entrepreneurship affects the economic vibrance of the ethnic enclave, the neighborhood’s health and the inhabitants’ wealth. Most African American-owned businesses are in African American enclaves, which are usually in urban areas and depend primarily on African American customers for survival. Individual and group outcomes are influenced by how individuals develop their social identities based on demographic characteristics (Miller, 2019). Social identity theory postulates that the social category into which individuals fall and to which individuals feel they belong forms the basis of their identity (Tajfel and Turner, 1979). However, there are some instances where these expected outcomes are violated. Unlike other ethnic-owned businesses in other ethnic enclaves that are thriving, African American-owned businesses continue to suffer higher failure rates and lower founding rates. As reported in an earlier study, one reason for the low entrepreneurship rates for Blacks is consumer attitudes toward Black entrepreneurs. Consumer attitudes can influence patronage, especially when information asymmetry or bias exists. This paper further explores the relationship between consumer attitudes and intended patronage of Black-owned businesses in the context of neighborhood type. Findings and implications are discussed.
The Microbiology, Management and Outcomes of Native Joint Septic Arthritis of the Hand in Adults of Southeast Queensland
Authors: FORMAN Lee , FORMAN Ariadne , ALCORN Kylie
Published: January 2025

Background: Native joint septic arthritis (NJSA) of the hand is poorly studied. Management guidelines are extrapolated from large joint infections despite differences in epidemiology, anatomy and aetiology. Limited evidence suggests shorter courses of antibiotics can achieve outcomes comparable to longer courses. The aim of our study is to characterise the presentation, management and outcomes of NJSA of the hand in an adult cohort from Southeast Queensland (SEQ) and determine if the route or duration of antibiotics affected the outcome. Our cohort was compared to those in the literature to determine if already published data could be applicable to our population.

Methods: A coding based retrospective cohort of adult patients between 2016 and 2022 were assessed. The cohort was divided into short/long course antibiotics and primarily intravenous/oral route for outcome comparison.

Results: Seventy-four patients were included with a joint culture positive rate of 75%. The most common aetiology of infection was direct trauma and the most common pathogen was Staphylococcus aureus. Resolution was achieved in 86% of patients after 1-year follow-up, with a median antibiotic duration of 14 days, and 48% had non-infectious sequelae. Failure to achieve resolution was associated with females and taking immunosuppressants. No significant difference was detected when analysed for primary route or duration of antibiotics.

Conclusions: There was no difference in the rate of resolution attributable to the route or duration of antibiotics. We demonstrated comparability between our cohorts’ demographics, management and outcomes with those in the literature. Based on the findings in our study, noting the retrospective nature and small cohort, the authors conclude for uncomplicated NJSA of the hand, a total antibiotic duration of 14 days in addition to early surgical intervention is likely to be successful in most patients.

Level of Evidence: Level III (Therapeutic)
The Initial Characteristics of Paediatric Supracondylar Humerus Fractures Led to Cubitus Varus Deformity and Delayed Displacement
Authors: TAKAGI Takehiko , AIBARA Noriyuki , YAMAGUCHI Sakura , SEKI Atsuhito , TAKAYAMA Shinichiro
Published: January 2025

Background: Supracondylar humerus fractures are the most common type of elbow fracture in children, with a variety of complications such as cubitus varus deformity. The most important goal of the initial treatment is to avoid complicated deformities. In the present study, we investigated cubitus varus deformity and discussed the ideal initial treatment for supracondylar humerus fractures.

Methods: There were 58 conservative cases (26 girls and 32 boys) and 115 operative cases (40 girls and 75 boys) with supracondylar humerus fractures. We evaluated the correlation between the following factors on injury in the conservative cases: Gartland classification, presence of comminuted medial fractures, medial shift length, anterior spike length, age, sex, affected side (as explanatory variables) and the factors of cubitus varus deformity as response variables by using the linear regression model for multivariable analysis. Moreover, we evaluated the changes in displacement after the operation in the operative cases, adding the presence of medial pins and the number of pins as explanatory variables.

Results: Injury severity (Gartland classification) was a significant factor for cubitus varus deformity. The presence of comminuted bone fragments on the medial side, anterior spike length, age, sex and affected side were not significant factors of cubitus varus deformity. However, medial displacement on injury was a significant factor of both cubitus varus deformity. In the operative case study, medial displacement was a significant factor in cubitus varus deformity. The presence of comminuted bone fragments on the medial side, number of pins and age were also significant factors for cubitus varus deformities.

Conclusions: The present study concluded that it is important to perform accurate reduction and fixation, with special attention to medial shift and medial comminuted fragments to avoid cubitus varus deformity.

Level of Evidence: Level IV (Therapeutic)