bluuebunny/crossref_metadata_2025 huggingface dataset:
Unraveling glioblastoma diversity: Insights into methylation subtypes and spatial relationships
Authors: Foltyn-Dumitru Martha , Alzaid Haidar , Rastogi Aditya , Neuberger Ulf , Sahm Felix , Kessler Tobias , Wick Wolfgang , Bendszus Martin , Vollmuth Philipp , Schell Marianne
Published: June 2024

Background

The purpose of this study was to elucidate the relationship between distinct brain regions and molecular subtypes in glioblastoma (GB), focusing on integrating modern statistical tools and molecular profiling to better understand the heterogeneity of Isocitrate Dehydrogenase wild-type (IDH-wt) gliomas.

Methods

This retrospective study comprised 441 patients diagnosed with new IDH-wt glioma between 2009 and 2020 at Heidelberg University Hospital. The diagnostic process included preoperative magnetic resonance imaging and molecular characterization, encompassing IDH-status determination and subclassification, through DNA-methylation profiling. To discern and map distinct brain regions associated with specific methylation subtypes, a support-vector regression-based lesion-symptom mapping (SVR-LSM) was employed. Lesion maps were adjusted to 2 mm³ resolution. Significance was assessed with beta maps, using a threshold of P < .005, with 10 000 permutations and a cluster size minimum of 100 voxels.

Results

Of 441 initially screened glioma patients, 423 (95.9%) met the inclusion criteria. Following DNA-methylation profiling, patients were classified into RTK II (40.7%), MES (33.8%), RTK I (18%), and other methylation subclasses (7.6%). Between molecular subtypes, there was no difference in tumor volume. Using SVR-LSM, distinct brain regions correlated with each subclass were identified: MES subtypes were associated with left-hemispheric regions involving the superior temporal gyrus and insula cortex, RTK I with right frontal regions, and RTK II with 3 clusters in the left hemisphere.

Conclusions

This study linked molecular diversity and spatial features in glioblastomas using SVR-LSM. Future studies should validate these findings in larger, independent cohorts to confirm the observed patterns.
PICC Your Poison: Resident Beliefs and Attitudes Regarding Discharge Parenteral Antibiotics for Patients Who Inject Drugs
Authors: Fabricant Scott A , Abramson Erika L , Hutchings Kayla , Vien Alexis , Scherer Matthew , Kapadia Shashi N
Published: June 2024

Background

Serious injection-related infections (SIRIs) in people who inject drugs often lead to prolonged hospitalizations or premature discharges. This may be in part due to provider reluctance to place peripherally inserted central catheters (PICCs) for outpatient parenteral antibiotic therapy in this population. Because internal medicine (IM) residents are often frontline providers in academic centers, understanding their perspectives on SIRI care is important to improve outcomes.

Methods

We surveyed IM residents in a large urban multicenter hospital system about SIRI care with a novel case-based survey that elicited preferences, comfort, experience, and stigma. The survey was developed using expert review, cognitive interviewing, and pilot testing. Results are reported with descriptive statistics and linear regression.

Results

Of 116 respondents (response rate 34%), most (73%) were uncomfortable discharging a patient with active substance use home with a PICC, but comfortable (87%) with discharge to postacute facilities. Many (∼40%) endorsed high levels of concern for PICC misuse or secondary line infections, but larger numbers cited concerns about home environment (50%) or loss to follow-up (68%). While overall rates were low, higher stigma was associated with more concerns around PICC use (r = −0.3, P = .002). A majority (58%) believed hospital policies against PICC use in SIRI may act as a barrier to discharge, and 74% felt initiation of medications for opioid use disorder (MOUD) would increase their comfort discharging with a PICC.

Conclusions

Most IM residents endorsed high levels of concern about PICC use for SIRI, related to patient outcomes and perceived institutional barriers, but identified MOUD as a mitigating factor.
Conservative treatment of sexual dysfunction among men undergoing prostate cancer treatment: a systematic review
Authors: da Fonseca Pedroso Isadora Martins , Siqueira Maria Luíza Souza , de Sousa Santos Thaísy Andressa Bastos Primo , de Paula Barbosa Keyla , de Lima Elio Armando Nunes , Sampaio Andréia Cristina Ribeiro Izidro , da Costa Cunha Katiane , da Silva Marianne Lucena , Alves Aline Teixeira
Published: June 2024

Introduction

One of the changes caused by pelvic cancers is the decrease in patients’ sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency.

Objectives

This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer.

Methods

Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome.

Results

Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported.

Conclusion

Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.
Evaluation of Compost and Manure Amendments for Suppressing Heterodera glycines
Authors: Yazdani Razieh , Yaghoubi Ali , Quintanilla Marisol
Published: June 2024

Soybean cyst nematode (SCN) is a major pest of soybean crops, causing significant yield losses and economic impact. Current management strategies primarily rely on resistant varieties, cover crops, and seed treatments. In addition, there is a growing interest in developing sustainable, ecologically based approaches to integrate SCN risk reduction into soybean production systems. This study aimed to evaluate the efficacy of various compost and manure amendments in suppressing SCN populations and promoting soybean productivity. An in vitro egg hatching assay was conducted to screen the inhibitory effects of different compost and manure extracts on SCN egg hatching. Results indicated that poultry manure, Layer Ash Blend, and swine manure extracts significantly inhibited SCN hatching compared with other treatments across multiple time points. Greenhouse trials further validated the effectiveness of Layer Manure, poultry manure, High Carbon Dairy Doo, and Seed Starter 101 in suppressing SCN cysts, eggs, and juveniles. A field microplot trial confirmed the potential of Layer Ash Blend and poultry manure in SCN management, with significant reductions in SCN populations and increased soybean yields. The study also investigated the impact of these amendments on promoting the population of bacterivorous and frugivorous nematodes, contributing to a biological diverse soil ecosystem. Overall, the results indicate that amending SCN-infested soil with specific compost or manure formulations can effectively suppress nematode populations while improving soybean productivity. These findings contribute to the development of sustainable strategies for SCN management in soybean production systems.
First Reported Sexual Recombination Between Pyrenophora teres Isolates from Barley and Barley Grass
Authors: Dahanayaka Buddhika Amarasinghe , Sotiropoulos Alexandros G. , Vaghefi Niloofar , Poudel Barsha , Martin Anke
Published: June 2024

Barley grass ( Hordeum leporinum), which often occurs in proximity to commercial barley ( H. vulgare) cultivars, is an alternative host to Pyrenophora teres, an economically important pathogen causing net blotch in barley. This study is the first to report the sexual recombination of P. teres isolates collected from barley with those collected from barley grass. The sexual recombination between P. teres isolates from barley and barley grass was confirmed using a neighbor-net network and haploblock plots based on whole-genome sequencing of seven progeny isolates. Pathogenicity assays revealed that P. teres isolates from barley grass were not host specific and could infect both barley and barley grass, and the progeny isolates were virulent on commercially grown barley cultivars. Our results contradict previous population and pathogenicity studies of P. teres isolates obtained from barley and barley grass that have reported that the two populations are genetically distinct and host specific, suggesting that isolates collected from barley or barley grass could be two different entities. Despite the genetic divergence of P. teres isolates from barley and barley grass revealed through our phylogenomic analysis, there seems to be no complete host or reproductive separation between these populations. Therefore, there is a potential for generation of novel pathotypes through sexual recombination between P. teres isolates associated with barley and barley grass, with a risk of increased impacts on commercial barley cultivars that do not carry resistance to these pathotypes.
Integration of physiological, miRNA‐mRNA interaction and functional analysis reveals the molecular mechanism underlying hypoxia stress tolerance in crucian carp (Carassius auratus)
Authors: Li Yongjuan , Wu Shenji , Huang Jinqiang , Zhao Lu
Published: June 2024

Hypoxia has become one of the most critical factors limiting the development of aquaculture. Crucian carp (Carassius auratus) is widely consumed fish in China, with excellent tolerance to hypoxic environment. However, the molecular mechanisms underlying hypoxia adaptation and tolerance in crucian carp remain unclear. Compared with the control, increased T‐SOD, CAT, GSH‐Px, T‐AOC, ALT, and AST activities and MDA, TCHO, and TG contents, and decreased TP and ATP contents were observed after hypoxia stress. Based on RNA‐seq, 2479 differentially expressed (DE) mRNAs and 60 DE miRNAs were identified, and numerous DE mRNAs involved in HIF signaling pathway (hif‐1α, epo, vegfa, and ho), anaerobic metabolism (hk1/hk2, pfk, gapdh, pk, and ldh) and immune response (nlrp12, cxcr1, cxcr4, ccr9, and cxcl12) were significantly upregulated after hypoxia exposure. Integrated analysis found that ho, igfbp1, hsp70, and hk2 were predicted to be regulated by novel_867, dre‐miR‐125c‐3p/novel_173, dre‐miR‐181b‐5p, and dre‐miR‐338‐5p/dre‐miR‐17a‐3p, respectively, and targets of DE miRNAs were significantly enriched in MAPK signaling pathway, FoxO signaling pathway, and glycolysis/gluconeogenesis. Expression analysis showed that the mRNA levels of vegfa, epo, ho, hsp70, hsp90aa.1, igfbp1, ldh, hk1, pfk, pk, and gapdh exhibited a remarkable increase, whereas sdh and mdh were downregulated in the H3h, H12h, and H24h groups compared with the control. Furthermore, research found that hk2 is a target of dre‐miR‐17a‐3p, overexpression of dre‐miR‐17a‐3p significantly decreased the expression level of hk2, while the opposite results were obtained after dre‐miR‐17a‐3p silencing. These results contribute to our understanding of the molecular mechanisms of hypoxia tolerance in crucian carp.
TAT‐beclin1 treatment accelerates the development of atherosclerotic lesions in ApoE‐deficient mice
Authors: Liu Lianbo , Wang Qingjie , Li Yawen , Cai Jiali , Wang Yexing , Li Yun , Wang Ruxing , Sun Ling , Zheng Xiaowei , Yin Anwen
Published: June 2024

The importance of autophagy in atherosclerosis has garnered significant attention regarding the potential applications of autophagy inducers. However, the impact of TAT‐Beclin1, a peptide inducer of autophagy, on the development of atherosclerotic plaques remains unclear. Single‐cell omics analysis indicates a notable reduction in GAPR1 levels within fibroblasts, stromal cells, and macrophages during atherosclerosis. Tat‐beclin1 (T‐B), an autophagy‐inducing peptide derived from Beclin1, could selectively bind to GAPR1, relieving its inhibition on Beclin1 and thereby augmenting autophagosome formation. To investigate its impact on atherosclerosic plaque progression, we established the ApoE−/− mouse model of carotid atherosclerotic plaques. Surprisingly, intravenous administration of Tat‐beclin1 dramatically accelerated the development of carotid artery plaques. Immunofluorescence analysis suggested that macrophage aggregation and autophagosome formation within atherosclerotic plaques were significantly increased upon T‐B treatment. However, immunofluorescence and transmission electron microscopy (TEM) analysis revealed a reduction in autophagy flux through lysosomes. In vitro, the interaction between T‐B and GAPR1 was confirmed in RAW264.7 cells, resulting in the increased accumulation of p62/SQSTM1 and LC3‐II in the presence of ox‐LDL. Additionally, T‐B treatment elevated the protein levels of p62/SQSTM1, LC3‐II, and cleaved caspase 1, along with the secretion of IL‐1β in response to ox‐LDL exposure. In summary, our study underscores that T‐B treatment amplifies abnormal autophagy and inflammation, consequently exacerbating atherosclerotic plaque development in ApoE−/− mice.
Outcomes of Ponseti Method for the Treatment of Clubfeet in Children With Spina Bifida
Authors: Schaibley Claire , Torres-izquierdo Beltran , Meyer Zachary , Hosseinzadeh Pooya
Published: June 2024

Introduction:

While the Ponseti method is the primary treatment for idiopathic clubfoot, its application in treating myelodysplastic clubfeet is less certain. Myelodysplastic clubfoot tends to be more severe and difficult to treat. Although the Ponseti method can initially correct these cases, there is conflicting evidence about recurrence rates and the need for additional treatment. This study aims to assess the effectiveness of the Ponseti method in treating myelodysplastic clubfeet compared with idiopathic clubfeet over a 20-year period.

Methods:

The study conducted a retrospective review of medical records from patients treated for clubfoot at a single institution (2002 to 2021), comparing children with myelodysplastic and idiopathic clubfoot. Included patients were under 18, initially treated with Ponseti-casting, and had a minimum 2-year follow-up. Data on demographics, treatment details, recurrence, and Patient-reported Outcomes Measurement Information System (PROMIS) scores were analyzed.

Results:

Forty-nine myelodysplastic and 512 idiopathic clubfeet in 366 patients met the inclusion criteria. Myelodysplastic cases had a median age of 5 months at presentation versus 2 months for idiopathic cases (P=0.002). Initial correction was achieved in 95% of idiopathic and 87.8% of myelodysplastic feet (P=0.185). Recurrence rates were higher in the myelodysplastic cohort, 65.3% versus 44.1% (P=0.005). Surgery was necessary to treat recurrence in 59.2% of myelodysplastic and 37.7% of idiopathic cases, P=0.003. Follow-up was 3.9±1.8 years for myelodysplastic and 3.3±1.5 years for idiopathic feet, P=0.030. Myelodysplastic feet had lower PROMIS mobility scores; 31.94±7.56 versus 49.21±8.64, P<0.001.

Conclusions:

To the best of our knowledge, we report the largest series of myelodysplastic clubfeet treated by Ponseti casting and the first to assess PROMIS data. Overall, the Ponseti method is as effective in obtaining initial correction in myelodysplastic clubfoot as it is in idiopathic clubfoot. However, myelodysplastic clubfeet has a higher risk of relapse and increased need for surgical interventions. Children with spina bifida may need closer follow-ups and more stringent adherence to bracing.

Level of Evidence:

Level III—therapeutic studies—investigating the results of treatment
Rituximab as a Therapeutic Strategy in Hemophagocytic Lymphohistiocytosis: Efficacy, Outcomes, and Survival—Insights From a Systematic Review
Authors: Qureshi Zaheer , Altaf Faryal , Jamil Abdur , Siddique Rimsha
Published: June 2024

Background:

Hemophagocytic lymphohistiocytosis (HLH) is a severe immunologic disorder that can be fatal if left untreated. The condition is characterized by excessive immune system activation and is often triggered by infections such as Epstein-Barr virus (EBV). Rituximab, an anti-CD20 monoclonal antibody, has been suggested as a treatment, particularly for EBV-associated HLH.

Methods:

A systematic review was conducted using PRISMA guidelines, with a literature search spanning PubMed, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria focused on studies that assessed rituximab’s efficacy in treating HLH. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports.

Results:

Of 783 identified records, 24 studies were included in the final analysis. Rituximab was typically administered at 375 mg/m2, with varying doses and treatment frequency. Clinical response, often seen within 1 month, was assessed by improvements in clinical symptoms and laboratory findings. Survival rates posttreatment displayed a wide range, with instances of complete remission and disease-free periods, as well as reports of relapse and mortality.

Conclusions:

Rituximab demonstrates the potential for significant clinical benefit in treating HLH, particularly when associated with EBV, showing promise in reducing disease activity and contributing to remission. These findings encourage further research and clinical trials to refine the therapeutic protocols and better understand the long-term effects of rituximab in HLH management.
Penile microbiome: decoding its impact on HIV risk
Authors: Nelson Sydney G. , Liu Cindy M.
Published: June 2024

Purpose of review

The penile microbiome has been linked to local inflammation and increased risk for sexually transmitted infections, including HIV. This review explores recent studies of this emerging area of HIV research

Recent findings

The male urogenital tract supports multiple distinct niches, where their associated microbiome are shaped by abiotic (e.g., oxygen, moisture) and biotic (e.g., host immunity) environmental factors and host behaviors, particularly sexual activity. In addition, male circumcision is a significant drivers of male genital microbiome in both children and adults. Recent sexual partner studies provide new insight into the exchange of genital bacteria and concurrent local immune changes that may impact HIV risk.

The male genital microbiome is shaped by the local microenvironment and host behaviors including sexual activity. Improving our understanding of the connection between the male genital microbiome, local inflammation, and HIV susceptibility, as well as how pro-inflammatory genital bacteria are transmitted between sexual partners may inform new strategies to prevent HIV transmission.
Human papillomavirus infection among adolescents living with HIV: a focus on prevention
Authors: Jongen Vita W. , van Dongen Nicola , Sohn Annette H.
Published: June 2024

Purpose of review

To highlight recent data on HPV infection and cervical precancerous lesions in adolescents with HIV, and priorities for primary and secondary HPV prevention.

Recent findings

Incident and persistent high-risk HPV infections and cervical abnormalities are higher among young women with perinatally acquired HIV compared to their HIV-negative peers; data on HPV among males with perinatally acquired HIV are scarce. HPV vaccination is highly effective in preventing HPV-related disease, but antibody titers may decline in people with HIV. It remains unclear if emerging recommendations to reduce vaccine schedules from three doses to two or one dose are appropriate for children and adolescents with perinatally acquired HIV. Due to higher risks of HPV-related cancers, screening guidelines for cervical cancer differ in their frequency and age at initiation for women with HIV, but there are no recommendations for women with perinatally acquired HIV; nor for anal cancer screening for men with perinatally acquired HIV.

Data on the effectiveness of reduced HPV vaccine schedules in children and adolescents with HIV are needed. Implementation research to guide strategies for vaccination, screening, and treatment should include children, adolescents, and young adults with perinatally acquired HIV to ensure they are not left behind.
The vaginal microbiome and HIV transmission dynamics
Authors: Cherenack Emily M. , Broedlow Courtney A. , Klatt Nichole R.
Published: June 2024

Purpose of review

Among women, having a nonoptimal, highly diverse vaginal microbiome dominated by bacteria other than optimal Lactobacillus species such as L. crispatus or L. jensenii predicts HIV transmission. Reducing HIV acquisition among women requires a better understanding of the mechanisms through which the vaginal microbiome impacts HIV transmission dynamics and how to more effectively treat and intervene. Technological advancements are improving the ability of researchers to fully characterize interacting host-bacteria mechanisms. Consequently, the purpose of this review was to summarize the most innovative research on the vaginal microbiome and its role in HIV transmission in the past year.

Recent findings

Studies combining multiomics, experimental, and translational approaches highlight the associations of a nonoptimal microbiome with maladaptive alterations in immune cell functioning, vaginal metabolites, host cell transcription, mucosal immunity, and epithelial barrier integrity. While there are multiple mechanisms proposed to increase HIV acquisition risk, there are virtually zero acceptable and effective treatments to improve the vaginal microbiome and immunity.

Women-centered solutions to modify the vaginal microbiome and bacterial metabolites should continue to be explored as a mechanism to reduce HIV acquisition.
Untangling the role of the microbiome across the stages of HIV disease
Authors: Ortiz Alexandra M. , Brenchley Jason M.
Published: June 2024

Purpose of review

The primate microbiome consists of bacteria, eukaryotes, and viruses that dynamically shape and respond to host health and disease. Understanding how the symbiotic relationship between the host and microbiome responds to HIV has implications for therapeutic design.

Recent findings

Advances in microbiome identification technologies have expanded our ability to identify constituents of the microbiome and to infer their functional capacity. The dual use of these technologies and animal models has allowed interrogation into the role of the microbiome in lentiviral acquisition, vaccine efficacy, and the response to antiretrovirals. Lessons learned from such studies are now being harnessed to design microbiome-based interventions.

Previous studies considering the role of the microbiome in people living with HIV largely described viral acquisition as an intrusion on the host:microbiome interface. Re-framing this view to consider HIV as a novel, albeit unwelcome, component of the microbiome may better inform the research and development of pre and postexposure prophylaxes.
Coexistence of Hashimoto’s thyroiditis, rheumatoid arthritis, Sjogren’s syndrome, and ulcerative colitis
Authors: Kudsi Maysoun , Khalayli Naram , Haj Ali Diaa , Al-Darwish Lama
Published: June 2024

Introduction and importance:

The coexistence of Hashimoto’s thyroiditis and ulcerative colitis has been previously mentioned, as these diseases are autoimmune diseases. Limited data about the coexistence of rheumatoid arthritis in patients with Hashimoto’s thyroiditis have been published till now. Meanwhile, the coexistence of Sjogren’s syndrome during the course of rheumatoid arthritis is well known. The coexistence of Hashimoto’s thyroiditis, Sjogren’s syndrome, and ulcerative colitis has also been reported in rare cases.

Case presentation:

A 32-year-old female, with a 10-year history of Hashimoto’s thyroiditis, 4 years of rheumatoid arthritis, and 2 years of secondary Sjogren’s syndrome, presented to our Rheumatology Department, complaining of fatigue, weight loss, intermittent abdominal pain, and bloody diarrhea for the last 6 weeks. Her colonoscopy findings were compatible with a diagnosis of ulcerative colitis.

Clinical discussion:

Multiple autoimmune syndromes are defined as the presence of three or more autoimmune diseases in the same patient. They have an increased frequency in patients with a previous history of another autoimmune disease, and a higher correlation with females. The prevalence is rare and was documented only by two systematic reviews, with the rest being separate case reports. Autoimmune thyroid disease and Sjögren’s syndrome were the most frequent diseases encountered, followed by rheumatoid arthritis, and systemic lupus erythematosus. The presence of these autoimmune diseases together suggests that they share a common pathological and physiological genesis.

Conclusion:

This is the first case report, to our knowledge, that describes the coexistence of Hashimoto’s thyroiditis, rheumatoid arthritis, Sjogren’s syndrome, and ulcerative colitis within 10 years, without a positive family history or psychological stress. Therefore, further studies and long-term surveys are needed to identify other factors that can contribute to the coexistence of these rare diseases.
Selective internal radiation therapy for unresectable HCC: The SIRT downstaging study
Authors: Regnault Hélène , Chalaye Julia , Galetto-Pregliasco Athena , Perrin Clara , Derbel Haytham , Amaddeo Giuliana , Mulé Sébastien , Lequoy Marie , Kobeiter Hicham , Reizine Edouard , Itti Emmanuel , Duvoux Christophe , Laurent Alexis , Leroy Vincent , Sommacale Daniele , Rasolonirina Diana , Luciani Alain , Calderaro Julien , Tacher Vania , Brustia Raffaele
Published: June 2024

Background:

Selective internal radiation therapy (SIRT) is recommended as a downstaging (DS) strategy for solitary unresectable HCC <8 cm. The aim of this study was to report the results of acquired experience in a tertiary center for all unresectable HCCs.

Methods:

We conducted a retrospective, observational study using data collected from consecutive patients undergoing SIRT between October 2013 and June 2020. DS was considered achieved when a curative treatment could be proposed 6 months after SIRT.

Results:

One hundred twenty-seven patients were included (male = 90%, 64 ± 11 y), of whom 112 (n = 88%) had cirrhosis. HCC was classified as BCLC stage C in 64 patients (50%), with a median diameter of 61 mm, an infiltrative pattern in 51 patients (40%), and portal vein invasion in 62 (49%) patients. Fifty patients (39%) achieved DS 6 months following SIRT, with 29 of them (23%) undergoing curative treatment in a median time of 4.3 months: 17 (13%) were transplanted, 11 (85%) had liver resection, and 1 patient had a radiofrequency ablation. The median overall survival of patients with or without DS was 51 versus 10 months, respectively (p < 0.001). In patients who achieved DS, progression-free survival was higher in patients who underwent surgery: 47 versus 11 months (p < 0.001). Four variables were independently associated with DS: age (OR: 0.96, 95% CI: [0.92, 0.99]; p = 0.032), baseline α-fetoprotein (OR: 1.00, 95% CI: [1.00, 1.00]; p = 0.034), HCC distribution (OR: 0.3, 95% CI: [0.11, 0.75]; p = 0.012), and ALBI grade (OR: 0.34. 95% CI: [0.14, 0.80]; p = 0.014).

Conclusions:

These results suggest that SIRT in patients with unresectable HCC could be an effective treatment: DS was achieved for around 39% of the patients and more than half of these then underwent curative treatment.
Screening patients in general practice for advanced chronic liver disease using an innovative IT solution: The Liver Toolkit
Authors: Prince David S. , Hoque Shakira , Kim Christy , Maher Salim , Miller Jane , Chomley Phoebe , Pritchard-Jones Janice , Spruce Sally , McGarry Nathan , Baker David , Elix Penelope , Liu Ken , Strasser Simone I. , Goodger Brendan , Zekry Amany , McCaughan Geoffrey W.
Published: June 2024

Background:

Identifying patients with undiagnosed advanced chronic liver disease (ACLD) is a public health challenge. Patients with advanced fibrosis or compensated cirrhosis have much better outcomes than those with decompensated disease and may be eligible for interventions to prevent disease progression.

Methods:

A cloud-based software solution (“the Liver Toolkit”) was developed to access primary care practice software to identify patients at risk of ACLD. Clinical history and laboratory results were extracted to calculate aspartate aminotransferase-to-platelet ratio index and fibrosis 4 scores. Patients identified were recalled for assessment, including Liver Stiffness Measurement (LSM) via transient elastography. Those with an existing diagnosis of cirrhosis were excluded.

Results:

Existing laboratory results of more than 32,000 adults across nine general practices were assessed to identify 703 patients at increased risk of ACLD (2.2% of the cohort). One hundred seventy-nine patients (26%) were successfully recalled, and 23/179 (13%) were identified to have ACLD (LSM ≥10.0 kPa) (10% found at indeterminate risk [LSM 8.0–9.9 kPa] and 77% low risk of fibrosis [LSM <8.0 kPa]). In most cases, the diagnosis of liver disease was new, with the most common etiology being metabolic dysfunction–associated steatotic liver disease (n=20, 83%). Aspartate aminotransferase-to-platelet ratio index ≥1.0 and fibrosis 4 ≥3.25 had a positive predictive value for detecting ACLD of 19% and 24%, respectively. Patients who did not attend recall had markers of more severe disease with a higher median aspartate aminotransferase-to-platelet ratio index score (0.57 vs. 0.46,p=0.041).

Conclusions:

This novel information technology system successfully screened a large primary care cohort using existing laboratory results to identify patients at increased risk ACLD. More than 1 in 5 patients recalled were found to have liver disease requiring specialist follow-up.
Arterial stiffness and cardiovascular risk in patients with nephrolithiasis: a 10-year prospective study
Authors: Comellato Gabriele , Caletti Chiara , Giani Anna , Macchi Federica , Mazzali Gloria , Faccioli Silvia , Zoico Elena , Andreola Stefano , Gambaro Giovanni , Zamboni Mauro , Fantin Francesco
Published: June 2024

Background:

Nephrolithiasis is frequently associated with cardiovascular diseases. These conditions present common risk factors: systemic inflammation that promotes oxidative stress leading to arterial wall stiffening may also play a role in plaque formation predisposing to nephrolithiasis.

Objectives:

The aim of this study was to evaluate arterial stiffness indices at baseline and after a 10-year follow-up, in patients with nephrolithiasis compared with patients without.

Methods:

A total of 82 patients (37 men; mean age 45 ± 13 years) were enrolled at the Geriatrics and Nephrology Outpatient Clinic: 66 were diagnosed with nephrolithiasis, whereas the control group consisted of 16 individuals. At baseline and after 10 years, they underwent clinical evaluation and arterial stiffness measurement, such as carotid-femoral pulse wave velocity (CF-PWV), by arterial applanation tonometry.

Results:

At baseline, when compared with the control group, patients with nephrolithiasis showed higher SBP and CF-PWV. After 10 years, patients with nephrolithiasis, but not those without, showed a significant raise in CF-PWV, even after adjustment for age and sex. In a stepwise regression model, with CF-PWV changes during the follow-up as the dependent variable, and age, sex, follow-up years, Δ mean arterial pressure, BMI, hypertension and nephrolithiasis as independent variables, nephrolithiasis was proved to be the only significant predictor of ΔCF-PWV, accounting for 6% of the variance.

Conclusion:

Our study shows higher baseline CF-PWV and greater increase in ΔCF-PWV within 10 years in individuals with nephrolithiasis than in those without, demonstrating an increased cardiovascular risk for nephrolithiasis patients.
Anterior Chamber Angle and Intraocular Pressure Control After Phacoemulsification in Primary Angle Closure With Different Mechanisms
Authors: Song Woo Keun , Sung Kyung Rim , Kim Ko Eun
Published: June 2024

Précis:

Different mechanisms of angle closure represented distinct aspects of intraocular pressure (IOP) control after phacoemulsification. Classification of angle closure mechanisms is necessary for postoperative IOP management and glaucoma progression in primary angle closure eyes.

Purpose:

To investigate the relationship between the anterior chamber angle (ACA) characteristics, measured by swept-source anterior segment optical coherence tomography (SS AS-OCT), and intraocular pressure (IOP) control after phacoemulsification in eyes with primary angle closure disease (PACD) with different angle closure mechanisms.

Methods:

PACD eyes were classified into 3 groups according to angle closure mechanisms using preoperative SS AS-OCT images; pupillary block (PB), plateau iris configuration (PIC), exaggerated lens vault (ELV). This retrospective, clinical cohort study included eighty-five eyes of 85 PACD patients: 34 with PB, 23 with PIC, and 28 with ELV. ACA parameters were measured preoperatively and 1 month postoperatively using SS AS-OCT. IOP measurements were performed preoperatively and during 6 months postoperatively. Postoperative IOP reduction and fluctuation were calculated, and their correlations with SS AS-OCT parameters were analyzed.

Results:

PIC group showed the lowest postoperative IOP reduction compared with the other groups (P=0.023). Preoperative ACA measurements were significantly associated with postoperative IOP reduction in ELV and PB groups, while postoperative measurements were in PIC group. Preoperative and postoperative change of iridotrabecular contact (ITC) index and area were correlated with postoperative IOP reduction in PB and ELV groups but not in PIC group. Postoperative ITC index (P=0.031) and area (P=0.003) showed significant correlations with postoperative IOP fluctuation only in PIC group.

Conclusions:

SS AS-OCT parameters including ITC index and area showed different associations with postoperative IOP control, which should be considered in determination of lens extraction and treatment of PACD eyes.
Arginine-Proline Metabolism as a Mediator in the Association Between Coal Dust Exposure and Lung Function
Authors: Su Xuesen , Sun Yuanyuan , Shi Yiwei , Kong Xiaomei , Liu Ting , Dong Hantian , Yu Xiao , Xue Ting , Zhang Chenwei , Zhang Xinri
Published: June 2024

Objectives

To investigate the mediating role of the activation degree of arginine-proline metabolism in the association of coal dust and decreased lung function.

Methods

Cumulative dust exposure (CDE) represented coal dust exposure, whereas the hydroxyproline-to-arginine concentration ratio (Hyp/Arg) in bronchoalveolar lavage fluid gauged arginine-proline metabolism activation. Pulmonary function indicators, including predicted value of forced vital capacity (FVC%pred), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC%), and the ratio of actual to predicted value of FEV1 (FEV1%pred), diffusing capacity of the lungs for carbon monoxide (DLCO%pred), difference value between alveolar air and arterial partial oxygen pressure (P(A−a) O2), and 6-minute walking distance test (6MWT), were assessed.

Results

Findings revealed a significant association between elevated CDE and increased Hyp/Arg, increased P(A−a) O2, decreased 6MWT, DLCO%pred, and decreased FVC%pred. However, no statistically significant association was found between CDE and FEV1%pred or FEV1/FVC%. The mediating effect of Hyp/Arg was significant for CDE’s impact on P(A−a) O2 and DLCO%pred but not on 6MWT and FVC%pred.

Conclusions

These results highlight the role of Hyp/Arg in mediating the association between CDE and lung function parameters, shedding light on potential therapeutic avenues for mitigating coal dust–induced lung function impairment.
The New Semisynthetic TORP: A Prosthesis for Ossicular Reconstruction Both With the Absence and the Presence of the Stapes Superstructure
Authors: Malafronte Giuseppe , Fetoni Anna Rita , Motta Gaetano , Presutti Livio
Published: June 2024

Objectives

To describe the new semisynthetic total ossicular replacement prosthesis (New-SSTORP) and to evaluate the New-SSTORP ossiculoplasty results both with the presence and absence of the stapes superstructure.

Study Design

Prospective study.

Setting

Tertiary referral center.

Methods

From April 2023 to May 2023, 18 New-SSTORP ossiculoplasties were performed by the first author. In all patients, the New-SSTORP was interposed between the footplate and the eardrum. The study group was divided into two groups (group A and group B). Group A included 13 patients with the absence of stapes superstructure. Group B included five patients with the presence of stapes superstructure. A successful reconstruction was defined as a postoperative air-bone gap ABG ≤20 dB. For all patients of groups A and B, the last audiometric control considered was performed in January 2024. The mean follow-up was 8½ months. The χ
2 test was used to compare results. p < 0.05 was considered significant.

Main Outcome Measures

Mean postoperative ABG ≤20 dB

Results

At the end of follow-up, the overall success rate (ABG ≤20 dB) of New-SSTORP ossiculoplasty was obtained in 88.8% (n = 16 of 18) of cases. In group A, the success rate of New-SSTORP ossiculoplasty occurred in 84.6% (n = 11 of 13) of cases, and in group B, the success rate of New-SSTORP ossiculoplasty occurred in 100% (n = 5 of 5) of cases. There was no audiological statistically significant difference between groups A and B (Fisher value is 1; p < 0.05). In all cases, the time for positioning of New-SSTORP was about 5 minutes

Conclusion

The New-SSTORP has a minimal technical challenge for building and placement. The New-SSTORP ossiculoplasty results are very good both with the presence and absence of SS.
Vasopressin, protein metabolism, and water conservation
Authors: Carty Joshua S. , Watts Jason A. , Arroyo Juan Pablo
Published: June 2024

Purpose of review

Highlight the mechanisms through which vasopressin and hypertonic stress regulate protein metabolism

Recent findings

Mammals have an ‘aestivation-like’ response in which hypertonic stress increases muscle catabolism and urea production

Vasopressin can directly regulate ureagenesis in the liver and the kidney

In humans chronic hypertonic stress is associated with premature aging, diabetes, cardiovascular disease, and premature mortality

There is an evolutionarily conserved ‘aestivation-like’ response in humans in which hypertonic stress results in activation of the vasopressin system, muscle catabolism, and ureagenesis in order to promote water conservation.
Bidirectional relationship between acute pancreatitis and pancreatic cancer
Authors: Jeon Christie Y. , Arain Mustafa A. , Korc Murray , Kozarek Richard A. , Phillips Anna E.
Published: June 2024

Purpose of review

The burdens of pancreatic ductal adenocarcinoma (PDAC) and acute pancreatitis are increasing globally. We reviewed current literature on whether acute pancreatitis is a causal factor for PDAC and examined clinical manifestations of PDAC-associated acute pancreatitis.

Recent findings

Recent findings detail the timing of acute pancreatitis before and after PDAC occurrence, further solidifying the evidence for PDAC-associated acute pancreatitis and for acute pancreatitis as a causal risk factor for PDAC. The risk of PDAC remains elevated above the general population in patients with distant history of acute pancreatitis. PDAC risk also increases with recurrent acute pancreatitis episodes, independent of smoking and alcohol. Mechanisms linking acute pancreatitis to PDAC include inflammation and neutrophil infiltration, which can be attenuated by suppressing inflammation and/or epigenetic modulation, thus slowing the progression of acinar-to-ductal metaplasia. Clinical presentation and management of acute pancreatitis in the context of PDAC are discussed, including challenges acute pancreatitis poses in the diagnosis and treatment of PDAC, and novel interventions for PDAC-associated acute pancreatitis.

PDAC risk may be reduced with improved acute pancreatitis prevention and treatment, such as antiinflammatories or epigenetic modulators. Increased acute pancreatitis and PDAC burden warrant more research on better diagnosis and management of PDAC-associated acute pancreatitis.
Urologic oncology considerations in transgender and gender diverse patients
Authors: Tinajero Juan , Rashid Tina
Published: June 2024

Purpose of review

This review delves into the pressing issue of urologic oncology considerations within the transgender and gender-diverse (TGD) community. With estimates suggesting that TGD individuals constitute 0.3 to 0.5% of adults worldwide, and this number steadily rising, our review examines the barriers that impede the delivery of excellent quality care, particularly in the context of cancer diagnosis and treatment.

Recent findings

Recent findings highlight disparities in cancer screening, diagnosis, and treatment access for TGD individuals. These challenges are compounded by a dearth of research and the failure of healthcare systems to account for gender identity and its nuances in data collection. Main themes in the literature include the impact of gender-affirming hormone therapy and surgery on cancer risk, challenges in prostate cancer screening and management, and considerations pertinent to testicular and other urological cancers in TGD patients.

The implications for clinical practice and research are profound and emphasize the need for multidisciplinary approaches that cater to the unique healthcare needs of TGD individuals. This includes comprehensive strategies for inclusive and accurate data collection, alongside the development of evidence-based guidelines for cancer screening and management tailored specifically to this population.
Atypical Presentations of Pediatric-Acquired Thrombotic Thrombocytopenic Purpura
Authors: Ziv Amit , Dardik Rima , Yacobovich Joanne , Uziel Yosef , Haviv Ruby , Avishai Einat , Kenet Gili , Toren Amos , Barel Ortal , Barg Assaf Arie
Published: June 2024

Background:

Immune thrombotic thrombocytopenic purpura (iTTP) in children is a rare, severe thrombotic microangiopathy. This condition is characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and organ ischemia due to reduced activity of the von Willebrand factor-cleaving protease ADAMTS13.

Methods:

A retrospective case series evaluating data collected from the medical files of 4 children diagnosed with iTTP.

Results:

The presented case series depicts a variety of iTTP presentations: 1 case of primary iTTP, 1 case induced by Shiga toxin, 1 associated with RAS-associated autoimmune leukoproliferative disease (RALD), and 1 initial manifestation of systemic lupus erythematosus (SLE). Notably, 2 patients recovered without undergoing plasma exchange.

Conclusion:

Early ADAMTS13 testing in children with unexplained hemolysis or thrombocytopenia is crucial. The diverse underlying causes, including infections and autoimmune disorders, underscore the complexity of iTTP in the pediatric population. These cases highlight the necessity for personalized treatment approaches that consider each patient's unique clinical situation and potential alternatives or modifications to conventional therapeutic regimens.
Association Among Individual Race, Hospital Racial Composition, and Access to Minimally Invasive Hysterectomy for Patients With Uterine Leiomyomas
Authors: Yoh Katherine , Prest Matthew , Huang Yongmei , Hou June Y. , Clair Caryn M. St. , Pua Tarah , Buckley Alexander , Khoury-Collado Fady , Accordino Melissa , Hershman Dawn L. , Wright Jason D.
Published: June 2024

OBJECTIVE:

To assess the relative associations of individual race and hospital racial composition on the likelihood of undergoing minimally invasive hysterectomy for the treatment of uterine leiomyomas in New York State.

METHODS:

We performed a retrospective cohort study that used the New York SPARCS (Statewide Planning and Research Cooperative System) database to identify women with uterine leiomyomas who underwent hysterectomy from 2000 to 2018. Hospitals were grouped by racial composition into quartiles based on the proportion of non-Hispanic Black (Black) patients, with quartile 1 corresponding to the lowest proportion of Black patients and quartile 4 corresponding to the greatest proportion of Black patients. Surgical route was characterized as minimally invasive (laparoscopic, vaginal, or robot-assisted) or abdominal hysterectomy. The contributions of individual race and hospital racial composition on route of hysterectomy were assessed with a series of logistic regression models accounting for patient and hospital characteristics.

RESULTS:

A total of 259,161 women with leiomyomas who underwent hysterectomies at 215 hospitals were identified. The rate of minimally invasive hysterectomy increased from 20.2% in 2000 to 65.7% in 2018. From 2000 to 2009, 29.6% of White patients underwent minimally invasive hysterectomy compared with 12.3% of Black women (P<.001). Minimally invasive hysterectomy was performed in 34.4% of patients in hospitals that served the lowest percentage of Black patients, compared with 15.9% in centers serving the highest percentage of Black patients (P<.001). Similar trends were noted for the 2010–2018 time period. In a series of models, both individual race (odds ratio [OR] 0.52; 95% CI, 0.48–0.56) and hospital racial quartile (OR 0.43; 95% CI, 0.32–0.58) remained associated with performance of minimally invasive hysterectomy.

CONCLUSION:

Black women and women who receive care at hospitals that serve a greater proportion of Black patients are less likely to receive minimally invasive surgery when undergoing definitive surgical management for uterine leiomyomas. These disparities are worsening.