bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeting PCSK9 as a key player in lipid metabolism: exploiting the therapeutic and biosensing potential of aptamers
Authors: Mahjoubin-Tehran Maryam , Rezaei Samaneh , Santos Raul D. , Jamialahmadi Tannaz , Almahmeed Wael , Sahebkar Amirhossein
Published: May 2024

The degradation of low-density lipoprotein receptor (LDLR) is induced by proprotein convertase subtilisin/kexin type 9 (PCSK9), resulting in elevated plasma concentrations of LDL cholesterol. Therefore, inhibiting the interactions between PCSK9 and LDLR is a desirable therapeutic goal for managing hypercholesterolemia. Aptamers, which are RNA or single-stranded DNA sequences, can recognize their targets based on their secondary structure. Aptamers exhibit high selectivity and affinity for binding to target molecules. The systematic evolution of ligands by exponential enrichment (SELEX), a combination of biological approaches, is used to screen most aptamers in vitro. Due to their unique advantages, aptamers have garnered significant interest since their discovery and have found extensive applications in various fields. Aptamers have been increasingly utilized in the development of biosensors for sensitive detection of pathogens, analytes, toxins, drug residues, and malignant cells. Furthermore, similar to monoclonal antibodies, aptamers can serve as therapeutic tools. Unlike certain protein therapeutics, aptamers do not elicit antibody responses, and their modified sugars at the 2’-positions generally prevent toll-like receptor-mediated innate immune responses. The focus of this review is on aptamer-based targeting of PCSK9 and the application of aptamers both as biosensors and therapeutic agents.
Exosome-sheathed porous silica nanoparticle-mediated co-delivery of 3,3′-diindolylmethane and doxorubicin attenuates cancer stem cell-driven EMT in triple negative breast cancer
Authors: Sarkar Rupali , Biswas Souradeep , Ghosh Rituparna , Samanta Priya , Pakhira Shampa , Mondal Mrinmoyee , Dutta Gupta Yashaswi , Bhandary Suman , Saha Prosenjit , Bhowmik Arijit , Hajra Subhadip
Published: May 2024

Background

Therapeutic management of locally advanced and metastatic triple negative breast cancer (TNBC) is often limited due to resistance to conventional chemotherapy. Metastasis is responsible for more than 90% of breast cancer-associated mortality; therefore, the clinical need to prevent or target metastasis is immense. The epithelial to mesenchymal transition (EMT) of cancer stem cells (CSCs) is a crucial determinant in metastasis. Doxorubicin (DOX) is the frequently used chemotherapeutic drug against TNBC that may increase the risk of metastasis in patients. After cancer treatment, CSCs with the EMT characteristic persist, which contributes to advanced malignancy and cancer recurrence. The latest developments in nanotechnology for medicinal applications have raised the possibility of using nanomedicines to target these CSCs. Hence, we present a novel approach of combinatorial treatment of DOX with dietary indole 3,3′-diindolylmethane (DIM) which is an intriguing field of research that may target CSC mediated EMT induction in TNBC. For efficient delivery of both the compounds to the tumor niche, advance method of drug delivery based on exosomes sheathed with mesoporous silica nanoparticles may provide an attractive strategy.

Results

DOX, according to our findings, was able to induce EMT in CSCs, making the breast cancer cells more aggressive and metastatic. In CSCs produced from spheres of MDAMB-231 and 4T1, overexpression of N-cadherin, Snail, Slug, and Vimentin as well as downregulation of E-cadherin by DOX treatment not only demonstrated EMT induction but also underscored the pressing need for a novel chemotherapeutic combination to counteract this detrimental effect of DOX. To reach this goal, DIM was combined with DOX and delivered to the CSCs concomitantly by loading them in mesoporous silica nanoparticles encapsulated in exosomes (e-DDMSNP). These exosomes improved the specificity, stability and better homing ability of DIM and DOX in the in vitro and in vivo CSC niche. Furthermore, after treating the CSC-enriched TNBC cell population with e-DDMSNP, a notable decrease in DOX mediated EMT induction was observed.

Conclusion

Our research seeks to propose a new notion for treating TNBC by introducing this unique exosomal nano-preparation against CSC induced EMT.

Graphical Abstract
Change in substance use among patients in opioid maintenance treatment: baseline to 1-year follow-up
Authors: Bjørnestad Endre Dahlen , Vederhus John-Kåre , Clausen Thomas
Published: May 2024

Background

Individuals with opioid use disorder (OUD) often have concurrent use of non-opioid substances. When patients enter opioid maintenance treatment (OMT), less is known about outcomes regarding the use of other types of drugs. Here we aimed to investigate changes in substance use among patients entering outpatient OMT, from treatment initiation to 1-year follow-up.

Methods

We used data from the prospective Norwegian Cohort of Patient in OMT and Other Drug Treatment Study (NorComt). Among 283 patients who entered OMT at participating facilities across Norway, 179 were assessed at follow-up. Of these patients, 131 were in a non-controlled environment, and were included in the present analysis. The main outcome was change in substance use. Logistic regression analysis was applied to identify factors associated with abstinence from all substances (other than agonist medication) at follow-up.

Results

Along with opioid use, most patients reported polysubstance use prior to entering treatment. No significant differences were found in baseline characteristics between the included and non-included groups when examining attrition. At the 1-year follow-up, reduced substance use was reported. While in treatment, around two-thirds of patients continued using other drugs to varying degrees. At follow-up, about one-third of patients reported abstinence from all drugs, apart from the agonist medication. Factors related to abstinence included a goal of abstinence at baseline (OR = 5.26; 95% CI 1.14–19.55; p = 0.013) and increasing age (OR = 1.05; 95% CI 1.00–1.09; p = 0.034).

Conclusions

The majority of patients entering OMT used other substances in addition to opioids. About one-third of patients reported abstinence at the 1-year follow up. Although the majority of patients continued co-use of other drugs while in treatment, for most substances, less than 10% reported daily use at follow-up, with the exception of cannabis which was used daily/almost daily by about 2 in 10. Higher age and treatment goal at the start of OMT were important factors related to reducing concomitant substance use during treatment. These findings suggest that many patients entering OMT are in need of treatment and support related to the use of other substances, to further improve prognosis.

Clinical trial registration

Clinicaltrials.gov no. NCT05182918. Registered 10/01/2022 (the study was retrospectively registered).
Quality check: concordance between two monitoring systems for postoperative organ/space-surgical site infections in rectal cancer surgery. Linkage of data from the Catalan Cancer Plan and the VINCat infection surveillance programme
Authors: Matallana Carlota , Pera Miguel , Espin-Basany Eloy , Biondo Sebastiano , Badia Josep M , Limon Enric , Pujol Miquel , de Lacy Borja , Aliste Luisa , Borràs Josep M , Manchon-Walsh Paula
Published: May 2024

Background

The Catalan Cancer Plan (CCP) undertakes periodic audits of cancer treatment outcomes, including organ/space surgical site infections (O/S-SSI) rates, while the Catalan Healthcare-associated Infections Surveillance Programme (VINCat) carries out standardized prospective surveillance of surgical site infections (SSI) in colorectal surgery. This cohort study aimed to assess the concordance between these two monitoring systems for O/S-SSI following primary rectal cancer surgery.

Methods

The study compared O/S-SSI incidence data from CCP clinical audits versus the VINCat Programme in patients undergoing surgery for primary rectal cancer, in 2011-12 and 2015-16, in publicly funded centres in Spain. The main outcome variable was the incidence of O/S-SSI in the first 30 days after surgery. Concordance between the two registers was analysed using Cohen’s kappa. Discordant cases were reviewed by an expert, and the main reasons for discrepancies evaluated.

Results

Pooling data from both databases generated a sample of 2867 patients. Of these, O/S-SSI was detected in 414 patients—235 were common to both registry systems, with satisfactory concordance (κ = 0.69, 95% confidence interval 0.65–0.73). The rate of discordance from the CCP (positive cases in VINCat and negative in CCP) was 2.7%, and from VINCat (positive in CCP and negative in VINCat) was 3.6%. External review confirmed O/S-SSI in 66.2% of the cases in the CCP registry and 52.9% in VINCat.

Conclusions

This type of synergy shows the potential of pooling data from two different information sources with a satisfactory level of agreement as a means to improving O/S-SSI detection. ClinicalTrials.gov Identifier: NCT06104579. Registered 30 November 2023.
Fecal Coprococcus, hidden behind abdominal symptoms in patients with small intestinal bacterial overgrowth
Authors: Guo Huaizhu , Chen Yuzhu , Dong Wenxin , Lu Siqi , Du Yanlin , Duan Liping
Published: May 2024

Background

Small intestinal bacterial overgrowth (SIBO) is the presence of an abnormally excessive amount of bacterial colonization in the small bowel. Hydrogen and methane breath test has been widely applied as a non-invasive method for SIBO. However, the positive breath test representative of bacterial overgrowth could also be detected in asymptomatic individuals.

Methods

To explore the relationship between clinical symptoms and gut dysbiosis, and find potential fecal biomarkers for SIBO, we compared the microbial profiles between SIBO subjects with positive breath test but without abdominal symptoms (PBT) and healthy controls (HC) using 16S rRNA amplicon sequencing.

Results

Fecal samples were collected from 63 SIBO who complained of diarrhea, distension, constipation, or abdominal pain, 36 PBT, and 55 HC. For alpha diversity, the Shannon index of community diversity on the genus level showed a tendency for a slight increase in SIBO, while the Shannon index on the predicted function was significantly decreased in SIBO. On the genus level, significantly decreased Bacteroides, increased Coprococcus_2, and unique Butyrivibrio were observed in SIBO. There was a significant positive correlation between saccharolytic Coprococcus_2 and the severity of abdominal symptoms. Differently, the unique Veillonella in the PBT group was related to amino acid fermentation. Interestingly, the co-occurrence network density of PBT was larger than SIBO, which indicates a complicated interaction of genera. Coprococcus_2 showed one of the largest betweenness centrality in both SIBO and PBT microbiota networks. Pathway analysis based on the Kyoto Encyclopedia of Genes and Genome (KEGG) database reflected that one carbon pool by folate and multiple amino acid metabolism were significantly down in SIBO.

Conclusions

This study provides valuable insights into the fecal microbiota composition and predicted metabolic functional changes in patients with SIBO. Butyrivibrio and Coprococcus_2, both renowned for their role in carbohydrate fermenters and gas production, contributed significantly to the symptoms of the patients. Coprococcus’s abundance hints at its use as a SIBO marker. Asymptomatic PBT individuals show a different microbiome, rich in Veillonella. PBT’s complex microbial interactions might stabilize the intestinal ecosystem, but further study is needed due to the core microbiota similarities with SIBO. Predicted folate and amino acid metabolism reductions in SIBO merit additional validation.
Evaluation of the rapid Idylla IDH1-2 mutation assay in FFPE glioma samples
Authors: Solomon James P. , Munoz-Zuluaga Carlos , Slocum Cheyanne , Dillard Alicia , Cong Lin , Wang Jiajing , Lindeman Neal , Kluk Michael , Liechty Benjamin , Pisapia David , Rennert Hanna , Velu Priya D.
Published: May 2024

IDH1 and IDH2 mutational status is a critical biomarker with diagnostic, prognostic, and treatment implications in glioma. Although IDH1 p.R132H-specific immunohistochemistry is available, it is unable to identify other mutations in IDH1/2. Next-generation sequencing can accurately determine IDH1/2 mutational status but suffers from long turnaround time when urgent treatment planning and initiation is medically necessary. The Idylla assay can detect IDH1/2 mutational status from unstained formalin-fixed paraffin-embedded (FFPE) slides in as little as a few hours. In a clinical validation, we demonstrate clinical accuracy of 97% compared to next-generation sequencing. Sensitivity studies demonstrated a limit of detection of 2.5-5% variant allele frequency, even at DNA inputs below the manufacturer’s recommended threshold. Overall, the assay is an effective and accurate method for rapid determination of IDH1/2 mutational status.
Occurrence of gastrointestinal nematodes in lambs in Norway, as assessed by copromicroscopy and droplet digital polymerase chain reaction
Authors: Gravdal Maiken , Woolsey Ian David , Robertson Lucy Jane , Höglund Johan , Chartier Christophe , Stuen Snorre
Published: May 2024

Background

Gastrointestinal nematodes (GINs) have a major impact on sheep production, health, and welfare worldwide. Norway is no exception, but there are only a few studies on the prevalence of GINs in Norwegian sheep. The aim of this study was to investigate the current occurrence of the most important nematodes in sheep flocks in Norway.

Faecal samples were collected from flocks in 2021/2022, mainly from three geographical regions in Norway, i.e., northern, eastern, and western. In each of 134 flocks included, individual samples from 10 lambs (autumn) were pooled. Third stage larvae (L3) were cultivated and harvested (Baermann method) from the pooled samples. The DNA was then extracted and further analysed using droplet digital PCR (ddPCR). This enables assessment of the proportions of the three most important nematode species/genera, i.e., H. contortus, T. circumcincta, and Trichostrongylus. The fractional abundance/relative proportion of each species/genus was assessed by performing duplex assays with universal strongyle and species/genus-specific primers and probe sets. In addition, the occurrence of Nematodirus eggs was assessed by standard faecal egg counts (i.e., McMaster method).

Results

Of the 134 flocks sampled, 24 were from the northern region, 31 from eastern, and 71 from western Norway. In addition, some flocks from central (n = 7), and southern (n = 1) Norway were included. Among the sampled flocks, T. circumcincta occurred most commonly (94%), followed by H. contortus (60%) and Trichostrongylus (55%), and Nematodirus (51%). In general, mixed infections were observed, with 38% and 18% of flocks infected with three or all four genera, respectively.

Conclusions

The results of this study indicate that GINs are widespread in Norway. Teladorsagia circumcincta seems to be present in most flocks based on this screening. Moreover, the results show that Nematodirus spp. infect lambs throughout the country, predominantly N. battus, and indicate that this nematode has become more abundant, which could lead to an increase in nematodirosis.
A novel mouse model for investigating α-synuclein aggregates in oligodendrocytes: implications for the glial cytoplasmic inclusions in multiple system atrophy
Authors: Ishimoto Tomoyuki , Oono Miki , Kaji Seiji , Ayaki Takashi , Nishida Katsuya , Funakawa Itaru , Maki Takakuni , Matsuzawa Shu-ichi , Takahashi Ryosuke , Yamakado Hodaka
Published: May 2024

The aggregated alpha-synuclein (αsyn) in oligodendrocytes (OLGs) is one of the pathological hallmarks in multiple system atrophy (MSA). We have previously reported that αsyn accumulates not only in neurons but also in OLGs long after the administration of αsyn preformed fibrils (PFFs) in mice. However, detailed spatial and temporal analysis of oligodendroglial αsyn aggregates was technically difficult due to the background neuronal αsyn aggregates. The aim of this study is to create a novel mouse that easily enables sensitive and specific detection of αsyn aggregates in OLGs and the comparable analysis of the cellular tropism of αsyn aggregates in MSA brains. To this end, we generated transgenic (Tg) mice expressing human αsyn-green fluorescent protein (GFP) fusion proteins in OLGs under the control of the 2’, 3’-cyclic nucleotide 3’-phosphodiesterase (CNP) promoter (CNP-SNCAGFP Tg mice). Injection of αsyn PFFs in these mice induced distinct GFP-positive aggregates in the processes of OLGs as early as one month post-inoculation (mpi), and their number and size increased in a centripetal manner. Moreover, MSA-brain homogenates (BH) induced significantly more oligodendroglial αsyn aggregates than neuronal αsyn aggregates compared to DLB-BH in CNP-SNCAGFP Tg mice, suggestive of their potential tropism of αsyn seeds for OLGs. In conclusion, CNP-SNCAGFP Tg mice are useful for studying the development and tropism of αsyn aggregates in OLGs and could contribute to the development of therapeutics targeting αsyn aggregates in OLGs.
Simultaneous fermentation and enzymatic biocatalysis—a useful process option?
Authors: Oehlenschläger Katharina , Schepp Emily , Stiefelmaier Judith , Holtmann Dirk , Ulber Roland
Published: May 2024

Biotransformation with enzymes and de novo syntheses with whole-cell biocatalysts each have specific advantages. These can be combined to achieve processes with optimal performance. A recent approach is to perform bioconversion processes and enzymatic catalysis simultaneously in one-pot. This is a well-established process in the biorefinery, where starchy or cellulosic material is degraded enzymatically and simultaneously used as substrate for microbial cultivations. This procedure leads to a number of advantages like saving in time but also in the needed equipment (e.g., reaction vessels). In addition, the inhibition or side-reaction of high sugar concentrations can be overcome by combining the processes. These benefits of coupling microbial conversion and enzymatic biotransformation can also be transferred to other processes for example in the sector of biofuel production or in the food industry. However, finding a compromise between the different requirements of the two processes is challenging in some cases. This article summarises the latest developments and process variations.

Graphical Abstract
Loss of staminodes in Aquilegia jonesii reveals a fading stamen–staminode boundary
Authors: Johns Jason W. , Min Ya , Ballerini Evangeline S. , Kramer Elena M. , Hodges Scott A.
Published: May 2024

The modification of fertile stamens into sterile staminodes has occurred independently many times in the flowering plant lineage. In the genus Aquilegia (columbine) and its closest relatives, the two stamen whorls closest to the carpels have been converted to staminodes. In Aquilegia, the only genetic analyses of staminode development have been reverse genetic approaches revealing that B-class floral identity genes are involved. A. jonesii, the only species of columbine where staminodes have reverted to fertile stamens, allows us to explore the genetic architecture of staminode development using a forward genetic approach. We performed QTL analysis using an outcrossed F2 population between A. jonesii and a horticultural variety that makes fully developed staminodes, A. coerulea ‘Origami’. Our results reveal a polygenic basis for staminode loss where the two staminode whorls are under some level of independent control. We also discovered that staminode loss in A. jonesii is not complete, in which staminode-like traits sometimes occur in the inner fertile stamens, potentially representing a fading boundary of gene expression. The QTLs identified in this study provide a map to guide future reverse genetic and functional studies examining the genetic basis and evolutionary significance of this trait.
Wandering spleen presenting in the form of right sided pelvic mass and pain in a patient with AD-PCKD: a case report and review of the literature
Authors: shibiru Yitagesu aberra , wondimu Sahlu , almaw Wassie
Published: May 2024

Background

Wandering spleen is a rare clinical entity in which the spleen is hypermobile and migrate from its normal left hypochondriac position to any other abdominal or pelvic position as a result of absent or abnormal laxity of the suspensory ligaments (Puranik in Gastroenterol Rep 5:241, 2015, Evangelos in Am J Case Rep. 21, 2020) which in turn is due to either congenital laxity or precipitated by trauma, pregnancy, or connective tissue disorder (Puranik in Gastroenterol Rep 5:241, 2015, Jawad in Cureus 15, 2023). It may be asymptomatic and accidentally discovered for imaging done for other reasons or cause symptoms as a result of torsion of its pedicle and infarction or compression on adjacent viscera on its new position. It needs to be surgically treated upon discovery either by splenopexy or splectomy based on whether the spleen is mobile or not.

Case presentation

We present a case of 39 years old female Ethiopian patient who presented to us complaining constant lower abdominal pain especially on the right side associated with swelling of one year which got worse over the preceding few months of her presentation to our facility. She is primiparous with delivery by C/section and a known case of HIV infection on HAART. Physical examination revealed a right lower quadrant well defined, fairly mobile and slightly tender swelling. Hematologic investigations are unremarkable. Imaging with abdominopelvic U/S and CT-scan showed a predominantly cystic, hypo attenuating right sided pelvic mass with narrow elongated attachment to pancreatic tail and absent spleen in its normal position. CT also showed multiple different sized purely cystic lesions all over both kidneys and the pancreas compatible with AD polycystic kidney and pancreatic disease.

With a diagnosis of wandering possibly infarcted spleen, she underwent laparotomy, the finding being a fully infarcted spleen located on the right half of the upper pelvis with twisted pedicle and dense adhesions to the adjacent distal ileum and colon. Release of adhesions and splenectomy was done. Her post-operative course was uneventful.

Conclusion

Wandering spleen is a rare clinical condition that needs to be included in the list of differential diagnosis in patients presenting with lower abdominal and pelvic masses. As we have learnt from our case, a high index of suspicion is required to detect it early and intervene by doing splenopexy and thereby avoiding splenectomy and its related complications.
ABWOA: adaptive boundary whale optimization algorithm for large-scale digital twin network construction
Authors: Feng Hao , Cao Kun , Huang Gan , Liu Hao
Published: May 2024

Digital twin network (DTN) as an emerging network paradigm, have garnered growing attention. For large-scale networks, a crucial problem is how to effectively map physical networks onto the infrastructure platform of DTN. To address this issue, we propose a heuristic method of the adaptive boundary whale optimization algorithm (ABWOA) to solve the digital twin network construction problem, improving the efficiency and reducing operational costs of DTN. Extensive comparison experiments are conducted between ABWOA and various algorithms such as genetic algorithm, particle swarm optimization, artificial bee colony, differential evolution algorithm, moth search algorithm and original whale optimization algorithm. The experimental results show that ABWOA is superior to other algorithms in terms of solution quality, convergence speed, and time cost. It can solve the digital twin network construction problem more effectively.
Bridging borders: assessing the impact of semester-long study abroad programs on intercultural competence development in undergraduate engineering students
Authors: Jaiswal Aparajita , Sapkota Muna , Acheson Kris
Published: May 2024

Background

Working and interacting with people from diverse backgrounds have become common in Engineering. Research has indicated that engineering graduates face challenges while working with a diverse workforce. Therefore, it is vital for higher education institutions to help engineering students develop intercultural competence skills by engaging them in intercultural learning activities. This study explores the impact of a semester-long study abroad program and its new curriculum on the intercultural learning gains of undergraduate engineering students. The study used a mixed methods design to assess the intercultural learning gains of the students enrolled in a study abroad program.

Results

The results of the study indicated that overall, as a group, students demonstrated significant gains in their Intercultural Development Inventory (IDI) scores from the pre- to post-test. Moreover, hierarchical clustering was conducted to group students into three clusters based on their IDI scores. The results of the clustering helped us to understand the differential growth of students from their pre- to post-test. Based on clustering students were grouped into high, moderate and low intercultural learning clusters. Further inductive thematic analysis was conducted to understand the depth of intercultural awareness of the students in general and discipline specific for each cluster. The results of the thematic analysis revealed that students in cluster 1 showed a deeper understanding of cultural differences, mindfulness, and openness while interacting with people from other cultures, whereas the students in clusters 2 and 3 showed moderate to superficial level of intercultural awareness.

Conclusions

The implication of the study extends to both practice and theory. From the practice perspective, the study discusses the need for creating intentionally structured study abroad programs that encourage students to reflect on their intercultural experiences and internalize takeaways. From the theory perspective, the study contributes to the Intercultural Development Continuum model, as it emphasizes the importance of meaningful gains in intercultural competence. The study also suggests strategies to improve the intercultural learning experiences of students that could help them move towards more intercultural mindsets.
Pre-operative mechanical bowel preparation and prophylactic oral antibiotics for pediatric patients undergoing elective colorectal surgery: a protocol for a randomized controlled feasibility trial
Authors: Briatico Daniel , Flageole Helene , Al-Shahwani Noora , Farrokhyar Forough , VanHouwelingen Lisa
Published: May 2024

Background

Infections after elective colorectal surgery remain a significant burden for patients and the healthcare system. Adult studies suggest that the combination of oral antibiotics and mechanical bowel preparation is effective at reducing infections after colorectal surgery. In children, there is limited evidence for either of these practices and the utility of combining oral antibiotics with mechanical bowel preparation remains uncertain.

Methods

This study aims to determine the feasibility of conducting a randomized controlled trial assessing the efficacy of oral antibiotics, with or without mechanical bowel preparation, in reducing the rates of post-operative infection in pediatric colorectal surgery. Participants aged 3 months to 18 years undergoing elective colorectal surgery will be randomized pre-operatively to one of three trial arms: (1) oral antibiotics; (2) oral antibiotics and mechanical bowel preparation; or (3) standard care. Twelve patients will be included in each trial arm. Feasibility outcomes of interest include the rate of participant recruitment, post-randomization exclusions, protocol deviations, adverse events, and missed follow-up appointments. Secondary outcomes include the rate of post-operative surgical site infections, length of hospital stay, time to full enteral feeds, reoperation, readmission, and complications.

Discussion

If the results of this trial prove feasible, a multi-center trial will be completed with sufficient power to evaluate the optimal pre-operative bowel preperation for pediatric patients undergoing elective colorectal surgery.

Trial registration

ClinicalTrials.gov: NCT03593252.
Central sleep apnea in chronic heart failure with hypoxemia - treatment efficacy and hemodynamic effects of three different treatment modalities: a case report
Authors: Müller Christoph , Kerl Jens , Dellweg Dominic
Published: May 2024

Background

The optimal treatment for central sleep apnea (CSA) depends on the underlying pathophysiology and should consider the potential for hemodynamic impairment when using positive airway pressure devices. While the long-term effects on overall cardiovascular outcome have been investigated for different device settings, the immediate hemodynamic consequences are not well understood. This is mainly due to a lack of hemodynamic monitoring during routine polysomnographic assessment. The application of most monitoring devices is either restricted by their invasiveness, e.g. in thermodilution, or cannot be used continuously like in echocardiography. Impedance cardiography (ICG), however, enables physicians to implement a continuous non-invasive monitoring of different hemodynamic parameters which can be useful in various clinical scenarios. In sleep medicine, the hemodynamic effect of initiating positive airway pressure treatment in patients with pre-existing heart failure should be of special concern.

Case presentation

In this case report, we compare the efficacy of three different treatment modalities in a patient with CSA related to chronic heart failure considering the resolution of respiratory events on polysomnography (PSG). In addition, we outline the hemodynamic effects of each treatment device using ICG for non-invasive hemodynamic monitoring. Regarding the reduction of respiratory central events, long-term oxygen treatment (LTOT) and adaptive servoventilation (ASV) proved to be more efficient compared with automatic positive airway pressure (APAP). Hemodynamically, substantial differences of the cardiac performance were observed between the treatment devices. This especially applied to ASV which led to a pronounced drop in cardiac output.

Conclusion

Our case report indicates that treatment of CSA may induce significant changes of hemodynamic parameters which would remain undetected during routine polysomnographic assessment. We conclude that non-invasive hemodynamic monitoring may be considered when positive airway pressure treatment is initiated in patients at risk of hemodynamic impairment.
Spontaneous retroperitoneal hematoma treated with transarterial embolization: a systematic review and metanalysis
Authors: Tiralongo Francesco , Toscano Stefano , Mosconi Cristina , Iezzi Roberto , Giurazza Francesco , Castiglione Davide Giuseppe , Falsaperla Daniele , Vacirca Francesco , Ini’ Corrado , Corvino Fabio , Lavalle Salvatore , Venturini Massimo , Foti Pietro Valerio , Palmucci Stefano , Basile Antonio
Published: May 2024

Purpose

The purpose of this systematic review and meta-analysis was to evaluate the safety, technical, and clinical effectiveness of percutaneous Transarterial Embolization (TAE) in treating spontaneous retroperitoneal hematomas as well as assess treatment outcomes in patients who underwent target or empirical embolization.

Materials and methods

Through the PubMed, Embase, and Google Scholar databases, an extensive search was performed in the fields of spontaneous retroperitoneal hematomas treated with transcatheter arterial embolization.

We collected pooled data on 141 patients from 6 separate articles selected according to the inclusion and exclusion criteria.

Results

Technical success rate was 100% in all six studies, for both targeted and empirical embolization. The clinical success rate varied from 56.3 to 89.5%.

The total number of complications related to the embolization procedure was 10 events out of 116 procedures analyzed.

Empirical or empirical embolization was performed in three studies, where the source of active bleeding was not evident during DSA. A meta-analysis compared the rebleeding rates between targeted and empirical embolization groups. The odds ratio from pooled data from the three assessed studies (72 patients) showed no significant difference in rebleeding rates after empirical TAE compared with targeted TAE.

Conclusions

TAE is a safe, effective, and potentially life-saving procedure for the treatment of life-threatening spontaneous retroperitoneal hematomas. Empirical and targeted TAE procedures demonstrate a relatively low risk of complications, compared to the high technical and relatively high clinical success rates.
Infectious factors in myocarditis: a comprehensive review of common and rare pathogens
Authors: Yao Zongjie , Liang Mingjun , Zhu Simin
Published: May 2024

Background

Myocarditis is a significant health threat today, with infectious agents being the most common cause. Accurate diagnosis of the etiology of infectious myocarditis is crucial for effective treatment.

Main body

Infectious myocarditis can be caused by viruses, prokaryotes, parasites, and fungi. Viral infections are typically the primary cause. However, some rare opportunistic pathogens can also damage heart muscle cells in patients with immunodeficiencies, neoplasms and those who have undergone heart surgery.

Conclusions

This article reviews research on common and rare pathogens of infectious myocarditis, emphasizing the complexity of its etiology, with the aim of helping clinicians make an accurate diagnosis of infectious myocarditis.
Grading of skull base meningiomas by combined perfusion: arterial spin labeling and T2* dynamic susceptibility perfusion
Authors: Eissa Lamya , Gamaleldin Omneya , Khalifa Mohamed Hossameldin
Published: May 2024

Background

Conventional MRI has no distinction between high- and low-grade meningiomas, which has a crucial for choice of therapeutic plan, especially skull base meningiomas which need more meticulous endoscopy-approached surgery. The aim of our study was to evaluate role of perfusion by arterial spin labeling and dynamic susceptibility perfusion in grading of skull base meningiomas.

Results

The relative arterial spin labeling (ASL), tumor blood flow (TBF), and tumor blood volume (TBV) ratios showed significant differences between low- and high-grade meningiomas.

Conclusions

MRI perfusion is a useful in differentiation between low- and high-grade meningiomas. There is significant correlation between ASL and DSC perfusion supporting possibility of using ASL in clinical practice as an alternative technique to DSC perfusion, particularly for patients with renal impairment where no contrast injection needed.
FGF21 mediating the Sex-dependent Response to Dietary Macronutrients
Authors: Soto Sauza Karla A , Ryan Karen K
Published: May 2024

Sex is key variable influencing body composition and substrate utilization. At rest, females maintain greater adiposity than males and resist the mobilization of fat. Males maintain greater lean muscle mass and mobilize fat readily. Determining the mechanisms that direct these sex-dependent effects is important for both reproductive and metabolic health. Here, we highlight the fundamental importance of sex in shaping metabolic physiology and assess growing evidence that the hepatokine fibroblast growth factor-21 (FGF21) plays a mechanistic role to facilitate sex-dependent responses to a changing nutritional environment. First, we examine the importance of sex in modulating body composition and substrate utilization. We summarize new data that point toward sex-biased effects of pharmacologic FGF21 administration on these endpoints. When energy is not limited, metabolic responses to FGF21 mirror broader sex differences; FGF21-treated males conserve lean mass at the expense of increased lipid catabolism, whereas FGF21-treated females conserve fat mass at the expense of reduced lean mass. Next, we examine the importance of sex in modulating the endogenous secretion of FGF21 in response to changing macronutrient and energy availability. During the resting state when energy is not limited, macronutrient imbalance increases the secretion of FGF21 more so in males than females. When energy is limited, the effect of sex on both the secretion of FGF21 and its metabolic actions may be reversed. Altogether, we argue that a growing literature supports FGF21 as a plausible mechanism contributing to the sex-dependent mobilization vs preservation of lipid storage and highlight the need for further research.
Prognostic Analysis of 131I Efficacy After Papillary Thyroid Carcinoma Surgery Based on CT Radiomics
Authors: Cao Huijun , Shangguan Linjue , Zhu Hanlin , Hu Chunfeng , Zhang Tong , Han Zhijiang , Wei Peiying
Published: May 2024

Objective

To develop and validate a radiomics-clinical combined model combining preoperative computed tomography (CT) and clinical data from patients with papillary thyroid carcinoma (PTC) to predict the efficacy of initial postoperative 131I treatment.

Methods

A total of 181 patients with PTC who received total thyroidectomy and initial 131I treatment were divided into training and testing sets (7:3 ratio). Univariate analysis and multivariate logistic regression were used to screen clinical factors affecting the therapeutic response to 131I treatment and construct a clinical model. Radiomics features extracted from preoperative CT images of PTCs were dimensionally reduced through recursive feature elimination and least absolute shrinkage and selection operator. Logistic regression was used to establish a radiomics model, and a radiomics-clinical combined model was developed by integrating the clinical model. The area under the curve (AUC), sensitivity, and specificity were used to evaluate the prediction performance of each model.

Results

Multivariate analysis revealed that pre-131I treatment serum thyroglobulin was an independent clinical risk factor affecting the efficacy of initial 131I treatment (P = .002), and the AUC, sensitivity, and specificity for predicting the efficacy of initial 131I treatment were 0.895, 0.899, and 0.816, respectively. After dimensionality reduction, 14 key CT radiomics features of PTCs were included. The established radiomics model predicted the efficacy of 131I treatment in the training and testing sets with AUCs of 0.825 and 0.809, sensitivities of 0.828 and 0.636, and specificities of 0.745 and 0.944, respectively. The combined model improved the AUC, sensitivity, and specificity in both sets.

Conclusion

The preoperative CT-based radiomics model can effectively predict the efficacy of initial postoperative 131I treatment in patients with intermediate- or high-risk PTC, and the radiomics-clinical combined model exhibits better predictive performance.
Key Considerations for Studying the Effects of High-Fat Diet on the Nulligravid Mouse Endometrium
Authors: Skalski Hilary J , Arendt Amelia R , Harkins Shannon K , MacLachlan Madison , Corbett Cody J M , Goy Robinson W , Kapoor Amita , Hostetter Galen , Chandler Ronald L
Published: May 2024

The obesity epidemic continues to increase, with half of US women predicted to be obese by 2030. Women with obesity are at increased risk for not only cardiovascular and liver disease, but also reproductive disorders. Although mouse models are useful in studying the effects of obesity, there is inconsistency in obesity-induction methods, diet composition, and mouse strains, and studies using female mice are limited. In this study, we sought to compare the effects of a 45% high-fat diet (HFD) versus a 60% HFD on the uterine estrous cycle of nulligravid C57BL/6J mice. For 22 weeks, we placed a total of 20 mice on either a 60% HFD, 45% HFD, or each HFD-matched control diet (CD). Both HFDs produced significant weight gain, with 60% HFD and 45% HFD gaining significant weight after 2 weeks and 15 weeks, respectively. Additionally, both HFDs led to glucose intolerance, fatty liver, and adipocyte hypertrophy. Mice fed 60% HFD displayed hyperphagia in the first 12 weeks of HFD treatment. Moreover, 60% HFD-treated mice had a longer estrous cycle length and an increased percentage of estrus stage samplings compared to CD-treated mice. Estrous cycle stage-controlled 60% HFD-treated mice displayed an increased estrogen-to-progesterone ratio and decreased ovarian corpora lutea compared to CD-treated mice, which may underlie the observed estrous cycle differences. There was no significant difference between diets regarding endometrial morphology or the percent of endometrial CD45+ immune cells. Our results indicate that consideration is needed when selecting a HFD-induced obesity mouse model for research involving female reproductive health.
The effect of informing patients with video before cardiac surgery on intensive care experience: A randomized controlled trial
Authors: Digin Figen , KALKAN Alev
Published: May 2024

Objectives: To study the effect of informing patients with video before cardiac surgery on intensive care experience.
Methods: This randomized controlled trial was conducted between December 2021 and December 2022 in the cardiovascular surgery clinic of a public hospital with the participation of 90 patients (45 patients in experimental group - 45 patients in control group) who were scheduled to undergo cardiac surgery. Patient Information Form and Intensive Care Experiences Scale were used for study data. Patients in experimental group were informed with video about the intensive care before cardiac surgery.
Results: It was found that the total score on ICES of the experimental group (74.5±3.9) was statistically and significantly higher than that of the control group (63.9±6.4) (p<0.001). The sub-dimension of awareness of surroundings (20.8±1.7), the frightening experiences (18.6±1.0), and the recall of experience (18.5±1.5) and satisfaction with care (16.7±1.4) were found to be statistically significantly higher in the experimental group, than in the control group sub-dimension scores (p<0.001).
Conclusion: It was found that informing patients with video about the intensive care setting and process before cardiac surgery had a positive effect on the intensive care experience.
Note: The study was produced from a master’s thesis and was not presented. All participants gave informed consent for the study, and that their anonymity was preserved.
Trial Registration NO.: NCT05255887.
doi: https://doi.org/10.12669/pjms.40.6.8627
How to cite this: Kalkan A, Digin F. The effect of informing patients with video before cardiac surgery on intensive care experience: A randomized controlled trial. Pak J Med Sci. 2024;40(6):1067-1072. doi: https://doi.org/10.12669/pjms.40.6.8627
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Prediction model for severe maternal morbidity in pregnant women with hypertensive disorders of pregnancy
Authors: Bian Yan , Zheng Shuisen , Liu Xiuwu , Jiang Xiuming
Published: May 2024

Objectives: To investigate risk factors for severe maternal morbidity (SMM) in pregnant women with hypertensive disorders of pregnancy (HDP) and to develop a risk prediction model.
Methods: A prospective observational cohort study was conducted among pregnant women who were hospitalized for hypertensive disorders of pregnancy (HDP) between January 2016 and December 2020 in Fujian College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Province, China (a training set), and a risk predictive model was constructed. Pregnant women with HDP who were hospitalized between January 2021 and December 2021 were selected as a validation set. Concordance index (C-index) and calibration curves were used to test predictive model discrimination and calibration.
Results: We included 970 pregnant women (790 in the training set and 180 in the validation set). Least absolute shrinkage and selection operator regression was used to screen for nine related variables such as intra-uterine growth retardation (IUGR), diastolic blood pressure (DBP) and systolic blood pressure (SBP) at suspected diagnosis, total bilirubin, albumin (ALB), uric acid, total cholesterol, serum magnesium, and suspected gestational age. SBP at suspected diagnosis (OR =1.22, 95%CI:1.08–1.42) and total cholesterol (OR = 1.78, 95% CI:1.17–2.80) were independent risk factors of severe maternal morbidity in pregnant women with HDP. A nomogram was constructed, and internal validation of the nomogram model was done using the bootstrap self-sampling method. C-index in the training and the validation set was 0.798 and 0.909, respectively.
Conclusion: Our prediction model can be used to determine gestational hypertension severity in pregnant women.
Abbreviations:SMM: Severe maternal morbidity; HDP: Hypertensive disorders of pregnancy; LASSO: Least absolute shrinkage and selection operator; IUGR: intrauterine growth retardation; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; ALB: Serum albumin concentration; URIC: Serum uric acid concentrations.
doi: https://doi.org/10.12669/pjms.40.6.9095
How to cite this: Bian Y, Zheng S, Liu X, Jiang X. Prediction model for severe maternal morbidity in pregnant women with hypertensive disorders of pregnancy. Pak J Med Sci. 2024;40(6):1054-1062. doi: https://doi.org/10.12669/pjms.40.6.9095
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Subclinical hypocalcaemia in dairy cows: definition and implications
Authors: Valldecabres Ainhoa , Silva-del-Río Noelia
Published: May 2024

Understanding the dynamics of postpartum blood calcium concentration and its association with cows' health and performance is key to making prophylactic and treatment decisions for subclinical hypocalcaemia. The objective of this article is to summarise results from observational epidemiological studies looking at the associations between postpartum blood calcium concentration and production, reproduction or health in dairy cows, in order to provide readers with a better understanding of subclinical hypocalcaemia and its potential implications.
Bolt Insights
Authors: Dalrymple Will
Published: May 2024

New technology and techniques can directly monitor the stresses and strains experienced by bolts, with the purpose of checking they remain tightly connected, as well as monitoring the health of the surrounding machine,
Bolt Glue
Authors: Dalrymple Will
Published: May 2024

Threadlocker aims to seal the gaps between nut and bolt, providing a rigid, immobile and vibration-resistant joint. It comes in both pre-applied and post-applied forms,