bluuebunny/crossref_metadata_2025 huggingface dataset:
New Persistent Opioid Use After Childbirth
Authors: Zipursky Jonathan S. , Everett Karl , Calzavara Andrew , Gomes Tara , Juurlink David N.
Published: November 2023

OBJECTIVE:

To examine factors associated with new persistent opioid use after childbirth.

METHODS:

We conducted a population-based cohort study of individuals who initiated opioid therapy within 7 days of discharge from hospital after delivery between September 1, 2013, and September 30, 2021. The primary outcome was new persistent opioid use, which was defined as one or more prescriptions for an opioid within 90 days of the first postpartum prescription and one or more subsequent opioid prescriptions in the 91–365 days afterward. We used multivariable logistic regression to assess patient-, pregnancy-, and prescription-related factors associated with new persistent opioid use after delivery.

RESULTS:

We identified 118,694 unique deliveries after which opioids were initiated, including 99,399 cesarean (83.7%) and 19,295 vaginal (16.3%) deliveries. Among mothers who initiated an opioid after delivery, 1,282 (10.8/1,000 deliveries) met our definition of new persistent opioid use in the subsequent year. Rates of new persistent opioid use were appreciably higher after vaginal (16.0/1,000) compared with cesarean (9.8/1,000) deliveries. Each additional 30 morphine milligram equivalents in the initial opioid prescription was associated with an increased risk of new persistent use after cesarean (adjusted odds ratio [aOR] 1.06, 95% CI 1.04–1.08) and vaginal (aOR 1.05, 95% CI 1.02–1.08) delivery. A concomitant benzodiazepine prescription after cesarean delivery was associated with a markedly increased risk of persistent opioid use (aOR 2.69, 95% CI 1.60–4.52).

CONCLUSION:

Among people who filled an opioid prescription after delivery, about 1% displayed evidence of persistent opioid use in the subsequent year. Initial prescriptions for large quantities of opioids and a concurrent benzodiazepine prescription may be important modifiable risk factors to prevent new persistent opioid use after delivery.
Pre-Delta, Delta, and Omicron Periods of the Coronavirus Disease 2019 (COVID-19) Pandemic and Health Outcomes During Delivery Hospitalization
Authors: Carlson Jeffrey , Simeone Regina M. , Ellington Sascha , Galang Romeo , DeSisto Carla L. , Fleming-Dutra Katherine , Riley Laura , Meaney-Delman Dana , Tong Van T.
Published: November 2023

OBJECTIVE:

To examine the relationship between coronavirus disease 2019 (COVID-19) diagnosis at delivery and adverse maternal health and pregnancy outcomes during pre-Delta, Delta, and Omicron variant predominance, with a focus on the time period of Omicron variant predominance.

METHODS:

We conducted a cross-sectional observational study with data from delivery hospitalizations in the Premier Healthcare Database from February 2020 to August 2023. The pre-Delta (February 2020–June 2021), Delta (July 2021–December 2021), and Omicron (January 2022–August 2023) periods of variant predominance were examined. Exposure to COVID-19 was identified by having a diagnostic code for COVID-19 during the delivery hospitalization. Adjusted prevalence ratios (aPRs) were calculated to compare the risks of adverse maternal and pregnancy outcomes for women with and without COVID-19 diagnoses at the time of delivery for each variant period.

RESULTS:

Among 2,990,973 women with delivery hospitalizations, 1.9% (n=56,618) had COVID-19 diagnoses noted at delivery admission discharge, including 26,053 during the Omicron period. Across all variant time periods, the prevalence of many adverse maternal and pregnancy outcomes during the delivery hospitalization was significantly higher for pregnant women with COVID-19 compared with pregnant women without COVID-19. In adjusted models, COVID-19 during the Omicron period was associated with significant increased risks for maternal sepsis (COVID-19: 0.4% vs no COVID-19: 0.1%; aPR 3.32, 95% CI, 2.70–4.08), acute respiratory distress syndrome (0.6% vs 0.1%; aPR 6.19, 95% CI, 5.26–7.29), shock (0.2% vs 0.1%; aPR 2.14, 95% CI, 1.62–2.84), renal failure (0.5% vs 0.2%; aPR 2.08, 95% CI, 1.73–2.49), intensive care unit admission (2.7% vs 1.7%; aPR 1.64, 95% CI, 1.52–1.77), mechanical ventilation (0.3% vs 0.1%; aPR 3.15, 95% CI, 2.52–3.93), in-hospital death (0.03% vs 0.01%; aPR 5.00, 95% CI, 2.30–10.90), stillbirth (0.7% vs 0.6%; aPR 1.17, 95% CI, 1.01–1.36), and preterm delivery (12.3% vs 9.6%; aPR 1.28, 95% CI, 1.24–1.33).

CONCLUSION:

Despite the possibility of some level of immunity due to previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, vaccination, or testing differences, risks of adverse outcomes associated with COVID-19 diagnosis at delivery remained elevated during the Omicron variant time period.
Predicting PD-L1 Status in Solid Tumors Using Transcriptomic Data and Artificial Intelligence Algorithms
Authors: Charifa Ahmad , Lam Alfonso , Zhang Hong , Ip Andrew , Pecora Andrew , Waintraub Stanley , Graham Deena , McNamara Donna , Gutierrez Martin , Jennis Andrew , Sharma Ipsa , Estella Jeffrey , Ma Wanlong , Goy Andre , Albitar Maher
Published: November 2023

Programmed death ligand-1 (PD-L1) immunohistochemistry (IHC) is routinely used to predict the clinical response to immune checkpoint inhibitors (ICIs); however, multiple assays and antibodies have been used. This study aimed to evaluate the potential of targeted transcriptome and artificial intelligence (AI) to determine PD-L1 RNA expression levels and predict the ICI response compared with traditional IHC. RNA from 396 solid tumors samples was sequenced using next-generation sequencing (NGS) with a targeted 1408-gene panel. RNA expression and PD-L1 IHC were assessed across a broad range of PD-L1 expression levels. AI was used to predict the PD-L1 status. PD-L1 RNA levels assessed by NGS demonstrated robust linearity across high and low expression ranges, and those assessed using NGS and IHC (tumor proportion score and tumor-infiltrating immune cells) had a similar pattern. RNA sequencing provided in-depth information on the tumor microenvironment and immune response, including CD19, CD22, CD8A, CTLA4, and PD-L2 expression status. Subanalyses showed a sustained correlation of mRNA expression with IHC (tumor proportion score and immune cells) across different solid tumor types. Machine learning showed high accuracy in predicting PD-L1 status, with the area under the curve varying between 0.83 and 0.91. Targeted transcriptome sequencing combined with AI is highly useful for predicting PD-L1 status. Measuring PD-L1 mRNA expression by NGS is comparable to measuring PD-L1 expression by IHC for predicting ICI response. RNA expression has the added advantages of being amenable to standardization and avoiding interpretation bias, along with an in-depth evaluation of the tumor microenvironment.
Atrial fibrillation: mechanism and clinical management
Authors: Hu Zhicheng , Ding Ligang , Yao Yan
Published: November 2023

Atrial fibrillation (AF), the most common sustained arrhythmia, is associated with a range of symptoms, including palpitations, cognitive impairment, systemic embolism, and increased mortality. It places a significant burden on healthcare systems worldwide. Despite decades of research, the precise mechanisms underlying AF remain elusive. Current understanding suggests that factors like stretch-induced fibrosis, epicardial adipose tissue (EAT), chronic inflammation, autonomic nervous system (ANS) imbalances, and genetic mutations all play significant roles in its development. In recent years, the advent of wearable devices has revolutionized AF diagnosis, enabling timely detection and monitoring. However, balancing early diagnosis with efficient resource utilization presents new challenges for healthcare providers. AF management primarily focuses on stroke prevention and symptom alleviation. Patients at high risk of thromboembolism require anticoagulation therapy, and emerging pipeline drugs, particularly factor XI inhibitors, hold promise for achieving effective anticoagulation with reduced bleeding risks. The scope of indications for catheter ablation in AF has expanded significantly. Pulsed field ablation, as a novel energy source, shows potential for improving success rates while ensuring safety. This review integrates existing knowledge and ongoing research on AF pathophysiology and clinical management, with emphasis on diagnostic devices, next-generation anticoagulants, drugs targeting underlying mechanisms, and interventional therapies. It offers a comprehensive mosaic of AF, providing insights into its complexities.
An atlas of immune cell transcriptomes in human immunodeficiency virus-infected immunological non-responders identified marker genes that control viral replication
Authors: Chen Yahong , Li Xin , Liu Shuran , Ao Wen , Lin Jing , Li Zhenting , Wu Shouli , Ye Hanhui , Han Xiao , Li Dongliang
Published: November 2023

Background:

Previous studies have examined the bulk transcriptome of peripheral blood immune cells in acquired immunodeficiency syndrome patients experiencing immunological non-responsiveness. This study aimed to investigate the characteristics of specific immune cell subtypes in acquired immunodeficiency syndrome patients who exhibit immunological non-responsiveness.

Methods:

A single-cell transcriptome sequencing of peripheral blood mononuclear cells obtained from both immunological responders (IRs) (CD4+ T-cell count >500) and immunological non-responders (INRs) (CD4+ T-cell count <300) was conducted. The transcriptomic profiles were used to identify distinct cell subpopulations, marker genes, and differentially expressed genes aiming to uncover potential genetic factors associated with immunological non-responsiveness.

Results:

Among the cellular subpopulations analyzed, the ratios of monocytes, CD16+ monocytes, and exhausted B cells demonstrated the most substantial differences between INRs and IRs, with fold changes of 39.79, 11.08, and 2.71, respectively. In contrast, the CD4+ T cell ratio was significantly decreased (0.39-fold change) in INRs compared with that in IRs. Similarly, the ratios of natural killer cells and terminal effector CD8+ T cells were also lower (0.37-fold and 0.27-fold, respectively) in the INRs group. In addition to several well-characterized immune cell-specific markers, we identified a set of 181 marker genes that were enriched in biological pathways associated with human immunodeficiency virus (HIV) replication. Notably, ISG15, IFITM3, PLSCR1, HLA-DQB1, CCL3L1, and DDX5, which have been demonstrated to influence HIV replication through their interaction with viral proteins, emerged as significant monocyte marker genes. Furthermore, the differentially expressed genes in natural killer cells were also enriched in biological pathways associated with HIV replication.

Conclusions:

We generated an atlas of immune cell transcriptomes in HIV-infected IRs and INRs. Host genes associated with HIV replication were identified as markers of, and were found to be differentially expressed in, different types of immune cells.
Implications of the Increasing Convergence of Video Gaming and Gambling: A Narrative Review
Authors: Mills Devin J. , Anthony Wen Li , Lee Uibin , Nower Lia
Published: November 2023

Two of the most popular recreational activities, video gaming and gambling, have converged in a number of different ways including through (1) social casino gaming, (2) loot boxes, (3) skin betting, (4) esports betting, and (5) play-to-earn video gaming. These convergences have brought about concerns, surrounding the increased risk of problems related to excessive use. The present paper reviews the current literature across these 5 areas of convergence, summarizing the implications for policy and future research. The findings from our review generally underscore the modest to strong increase in risk for harms due to these convergences that has important policy implications for regulation. However, much of the research continues to draw from convenience sampling and cross-sectional study designs. Therefore, though concerns regarding continued convergence persist, there is a strong need for further research in this area that utilizes more rigorous methods and employs a broader assessment of both video gaming and gambling engagement.

Deux des activités récréatives les plus populaires, les jeux vidéo et les jeux d’argent, ont convergé de différentes manières, notamment par le biais : (1) des jeux de casino sociaux, (2) des coffres de butin, (3) des paris Skin, (4) des paris sportifs en ligne, et (5) des jeux vidéo où l’on gagne de l’argent. Ces convergences ont suscité des inquiétudes quant au risque accru de problèmes liés à une utilisation excessive. Le présent document passe en revue la littérature actuelle dans ces cinq domaines de convergence, en résumant les implications pour la politique et la recherche future. Les résultats de notre examen soulignent généralement l’augmentation modeste à forte du risque de dommages due à ces convergences, qui a d’importantes implications politiques pour la réglementation. Toutefois, une grande partie de la recherche continue de s’appuyer sur des échantillonnages de commodité et des études transversales. Par conséquent, bien que les inquiétudes concernant la poursuite de la convergence persistent, il est absolument nécessaire de poursuivre les recherches dans ce domaine en utilisant des méthodes plus rigoureuses et en procédant à une évaluation plus large des jeux vidéo et de l’engagement dans les jeux d’argent.
Dose–response analysis of protracted absorbed organ dose and site-specific cancer incidence in Sweden after the Chernobyl nuclear power plant accident
Authors: Tondel Martin , Nordquist Tobias , Isaksson Mats , Rääf Christopher , Wålinder Robert
Published: November 2023

Background:

Adult males in Sweden exhibit an increased risk of cancer associated with an increased absorbed dose to the colon from the Chernobyl accident.

Methods:

A closed cohort, with information on hunter status, included all individuals living in northern Sweden in 1986. Complete annual information on exposure to 137Cs at the dwelling coordinate was available for a total of 2,104,101 individuals. A nested case-control method with four controls matched for year of cancer diagnosis and year of birth, was used. Individual absorbed organ doses were calculated between 1986 and 2020 including external and internal exposure. Hazard ratios (HR) per mGy with 95% confidence intervals (95% CI) were calculated using conditional logistic regression adjusted for rural/nonrural habitat, education level and pre-Chernobyl cancer incidence 1980 to 1985. A total of 161,325 cancer cases in males and 144,439 in females were included.

Results:

The adjusted HR per mGy for all cancer sites combined was 1.027 (95% CI = 1.022, 1.031) in males and 1.011 (95% CI = 1.006, 1.017) in females. In a post hoc analysis accounting for both remaining confounding from hunter lifestyle and the pre-Chernobyl cancer incidence by county, the adjusted HR per mGy for all cancer sites combined was 1.014 (95% CI = 1.009, 1.019) in males and 1.000 (95% CI = 0.994, 1.006) in females. The post hoc analysis suggested an increased risk of cancer in the colon, pancreas, and stomach, respectively, in males, and lymphoma in females.

Conclusions:

Increased cancer risk estimates were found for some specific cancer sites but remaining uncontrolled confounding due to hunter lifestyle could not be ruled out.
Tumor Necrosis Factor-α–Induced Protein-8–like 2 Transfected Adipose-Derived Stem Cells Regulated the Dysfunction of Monocrotaline Pyrrole–Induced Pulmonary Arterial Smooth Muscle Cells and Pulmonary Arterial Endothelial Cells
Authors: Li Jing , He Xin , Liu Feng , Zheng Xinglong , Jiang Jing
Published: November 2023

Pulmonary arterial hypertension (PAH) is characterized by pulmonary arterial endothelial cell (PAEC) dysfunction and pulmonary arterial smooth muscle cell (PASMC) activation. For decades, the therapies for PAH based on stem cells have been shown to be effective. Meanwhile, tumor necrosis factor-α–induced protein-8–like 2 (TIPE2) promote the viability of human amniotic mesenchymal stem cells. Therefore, we aimed to explore the role of TIPE2 in adipose-derived stem cells (ADSCs) and the function of TIPE2-transfected ADSCs in the regulation of PAH. We first explored the role and underlying molecular mechanism of TIPE2 in viability and migration of ADSCs. Moreover, the ADSCs transfected with TIPE2 were cocultured with monocrotaline pyrrole (MCTP)-stimulated PASMCs or PAECs. The effects and mechanisms of TIPE2-transfected ADSCs on MCTP-induced PASMCs and PAECs were further investigated. The results showed that TIPE2 overexpression promoted viability and migration of ADSCs by activating the TLR4-ERK1/2 pathway. In addition, TIPE2-transfected ADSCs inhibited the abnormal proliferation and the impaired apoptosis of PASMCs via NF-κB signaling and promoted the conversion of PASMCs from synthetic to contractile. Meanwhile, TIPE2-transfected ADSCs reduced the apoptosis, endothelial-to-mesenchymal transition, and migration of PAECs via PI3K/AKT signaling after MCTP treatment. MCTP-induced oxidative stress and inflammation of PAECs were significantly decreased by TIPE2-transfected ADSCs. In rat model, TIPE2-ADSCs administration further decreased the monocrotaline-induced increase in the right ventricular systolic pressure and ratio of right ventricle weight/left ventricle and septa weight (L + S) and right ventricle weight/body weight compared with the ADSCs group. In conclusion, TIPE2-transfected ADSCs dramatically attenuated the PAH via inhibiting the dysfunction of PASMCs and PAECs.
Liver Abscesses Due to Fusobacterium nucleatum: A Case Series
Authors: Elkhapery Ahmed , Malik Sheza , Chaudhary Pratibha , Abdalla Zeinab , Niu Chengu , Jain Tripti , Low Soon Khai , Abdelhay Ali , Portales-Castillo Carlos , Al Ali Omar , Orakzai Abdullah A. , Gurell Michael N. , Laguio-Vila Maryrose
Published: November 2023

Fusobacteriae are anaerobic gram-negative bacilli, classically involved in the development of septic thrombophlebitis of the internal jugular vein in Lemierre syndrome. The goal of this study is to describe the various presentations, treatment course, and outcomes of patients with Fusobacterium liver abscess(es) and review available literature on this topic. We retrospectively reviewed our microbiologic database for positive cultures of Fusobacteriae species in a tertiary care hospital from July 2018 through November 2022 and identified 5 cases of liver abscess that involved Fusobacterium nucleatum species. Patients presented with a syndrome of fever and chills, abdominal pain, and nausea and vomiting. Laboratory investigations revealed leukocytosis and transaminitis, and imaging revealed liver abscess(es). The identification of the F. nucleatum bacteria involved invasive aspiration of the abscess in all but one case, where it was identified on blood cultures. One patient had a florid picture of sepsis and acute respiratory distress syndrome. All patients responded well with intravenous antibiotics and were discharged home to complete a prolonged course until radiographic resolution. In 3 patients, history and imaging were suggestive of possible sources that may have hematogenously spread to the liver, with history of recent appendectomy in 1 patient, possible appendicitis on computed tomography of the abdomen in another patient, and recent dental manipulation in the third patient. In conclusion, Fusobacteriae should be included in the differential diagnosis of liver abscess, especially in the setting of recent appendicitis or dental disease. Effective treatment includes surgical drainage when feasible and prolonged course of antibiotics with goal of radiologic resolution.
An unusual presentation in pellucid marginal degeneration
Authors: Kodavoor Shreesha Kumar , Deb Bijita , Ramamoorthy Dandapani
Published: November 2023

Spontaneous and unilateral corneal perforation in pellucid marginal degeneration is rare and has no clear-cut management protocols, although multiple treatment strategies have been described in the literature with variable outcomes. We report a case of spontaneous corneal perforation in a 64-year-old patient with normal corneal thickness, which was managed with primary suturing and compression sutures that helped not only in the acute management of the disease but in the improvement of corrected distance visual acuity by topographic regularization. Another unusual feature seen in this case is only unilateral presentation, with the fellow eye being completely normal in an elderly patient.
Bilateral sequential implantation of a monofocal IOL and a pseudophakic sulcus-placed trifocal IOL in a young adult with posterior microphthalmos
Authors: Brito Pedro N. , João Marina D. , Domingues Manuel F.
Published: November 2023

An 18-year-old man enquired about the possibility of refractive surgery due to increasing difficulty performing near tasks. Corrected distance visual acuity was 20/25 with +10.00 −1.00 ×40 degrees right eye and 20/25 with +11.00 −1.00 ×120 degrees left eye. Corrected near visual acuity was Jaeger (J) 4. Optical biometry and corneal tomography revealed posterior microphthalmos with estimated intraocular lens (IOL) power >45.0 diopters (D) right eye and >47.0 D left eye. Considering the normal anterior segment morphology and the patient's high motivation for improving refractive error, refractive lens exchange was performed with monofocal +45.0 D IOLs. The residual refractive error was corrected by secondary bilateral implantation of a supplementary sulcus-placed trifocal IOL. One week after the second implant, uncorrected distance visual acuity was 20/25 right eye and 20/30 left eye, whereas the uncorrected near visual acuity improved to J2. Visual stability was verified at the third postoperative month with a residual refractive error of −0.50 × 120 degrees right eye and +1.50 −1.25 ×150 left eye.
Recurrent Achilles tendinitis after ophthalmic ofloxacin use
Authors: McGlone Cameron L. , Gabbard Ryan D. , Warwar Ronald E.
Published: November 2023

A 67-year-old woman developed recurrent fluoroquinolone-induced Achilles tendinitis after using topical ofloxacin for delayed sequential bilateral cataract surgeries, 2 weeks apart. Within days of the first surgery, she noted onset of left foot pain. Clinical examination and magnetic resonance imaging ultimately confirmed recurrence of left Achilles tendinitis. Her first episode of Achilles tendinitis occurred 13 years prior, after oral ciprofloxacin use for acute appendicitis. To our knowledge, this is the second report of topical ophthalmic-induced fluoroquinolone tendinopathy.
Inflammatory stress response after transanal vs laparoscopic total mesorectal excision: a cohort study based on the TaLaR trial
Authors: Chen Mian , Ye Fujin , Huang Pinzhu , Liang Zhenxing , Liu Huashan , Zheng Xiaobin , Li Wenxin , Luo Shuangling , Kang Liang , Huang Liang
Published: November 2023

Background:

Transanal total mesorectal excision (taTME) is a novel approach to radical surgery for low rectal cancer; however, it is not clear whether taTME causes a more severe inflammatory stress response than laparoscopic total mesorectal excision (laTME). Therefore, we conducted this study to address this question, with the secondary objective of analyzing the predictive effect of inflammatory indexes on postoperative infective complications between laTME and taTME.

Methods:

A total of 545 cases of laTME and 544 cases of taTME from the TaLaR randomized controlled trial were included. Inflammatory stress response was assessed via c-reactive protein (CRP), white blood cell count (WBC), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR) and prognostic nutritional index (PNI). Inflammatory indexes were measured and calculated pre-operatively (t1) and on post-operative days one (t2) and seven (t3). The accuracy of inflammatory indexes as predictor of infective complications was evaluated by areas under the ROC curve.

Results:

Preoperative blood parameters were comparable between the two surgical methods. There were no significant differences in CRP, WBC, NLR, PLR, LMR or PNI between the two surgical methods at any time point (P > 0.05). Among the inflammatory indexes at three time points, CRP on the first postoperative day was the most accurate predictor of infective complications, which is suitable for two surgical methods. The AUC was 0.7671 (P < 0.0001) with a cutoff of 39.84 mg/L, yielding 94% sensitivity and 47% specificity.

Conclusions:

Compared with laTME, taTME surgery has no obvious disadvantage with respect to postoperative inflammatory stress response. In addition, inflammatory indexes were favorable in predicting infective complications, with the best results for CRP on the first postoperative day. Defining the specific predictor for laTME and taTME is unnecessary.
HER2 overexpression predicts pathological T2 stage and improved survival in de novo muscle-invasive bladder cancer after immediate radical cystectomy: A retrospective cohort study
Authors: Kim So Won , Yu Hoon , Kim Yoonjuong , Nam Kyenghyun , Chae Han Kyu , Nam Wook , Eom Dae-Woon , Park Jong Yeon , Kim Sung Jin
Published: November 2023

Introduction:

Human epidermal growth factor receptor type 2 (HER2) overexpression is a prognostic factor and a therapeutic target for breast cancer; however, anti-HER2 therapies are ineffective in patients with bladder cancer. We investigated the effect of HER2 overexpression (HER2+) on the prognosis of muscle-invasive bladder cancer (MIBC).

Materials and methods:

This retrospective cohort study included patients who underwent initial transurethral resection of bladder tumors between 2005 and 2013 and were registered in the Korea National Health Insurance Database, which provides data on overall survival (OS). Sixty-one patients with clinically non-metastatic de novo MIBC were included in this study. As a subgroup, 33 patients who underwent immediate radical cystectomy (RC) were analyzed. Univariate and multivariate Cox proportional hazards models were used to identify prognostic factors for survival. A multivariable binary logistic regression model was used to identify the favorable T stage.

Results:

Among the 61 patients with d-MIBC, 14 were HER2+ and 47 HER2-. Age < 70 years (HR: 0.312, CI: 0.16–0.59, P < 0.001) and HER2+ status (HR: 0.40, CI: 0.19–0.85, P = 0.02) were favorable prognostic factors for OS after adjusting for clinical variables. In the RC subgroup, HER2+ status was a significant predictive factor for the pT2 stage (hazard ratio (HR): 36.8, CI: 4.83–797.41, P < 0.01). Age < 70 years (HR: 0.15, CI: 0.05–0.42, P < 0.001) and HER2+ status (HR: 0.11, CI: 0.02–0.54, P = 0.01) were favorable prognostic factors for OS after adjusting for RC pathological variables.

Conclusions:

HER2+ status could be a marker for an indolent subset of MIBC and could predict favorable survival regardless of RC status. Moreover, HER2+ status not only consistently predicted favorable T stage after RC, but also predicted better survival than pathological outcomes.
Clinical features of mesotherapy-associated non-tuberculous mycobacterial infections: A systematic review
Authors: Singsing Melissa E. , Duncan Steven G. , Vachon M. Jonathan , Goff Heather W.
Published: November 2023

Background:

Cutaneous infections from non-tuberculous mycobacteria (NTM) are a well-documented but poorly characterized adverse event following mesotherapy injections.

Objective:

This study aims to consolidate the available literature to characterize demographic and clinical features of mesotherapy-associated NTM infections.

Methods:

Using PRISMA guidelines, a systematic review of PubMed, Scopus, and Embase databases was undertaken for articles reporting cases of NTM skin infections following mesotherapy. Data were analyzed using Microsoft Excel.

Results:

Of 1966 search results, 30 articles (N = 423 patients) met inclusion criteria. Studies were largely from South America, and patients were mostly women aged 16-55 with NTM infections arising in the abdomen, buttocks, or thighs. Nearly all patients developed multiple, well-localized lesions without systemic symptoms. Effect summary by meta-analysis revealed most infections resolved after antibiotic therapy, though many patients required multiple antibiotic courses and/or agents to resolve infection. Infections often took weeks to resolve and were complicated by post-treatment scarring.

Limitations:

The main limitation of this study was the heterogeneity and lack of consistency between case reports.

Conclusion:

Cutaneous NTM infections associated with mesotherapy generally occur in women of childbearing age, arise from injections contaminated by the environment, and are often complicated by scarring/poor cosmesis and prolonged treatment course.
A case study of posterior reversible encephalopathy syndrome: Not always reversible with detrimental consequences
Authors: Green Rebecca
Published: November 2023

Posterior reversible encephalopathy syndrome, or PRES, is often an unrecognized sequela of uncontrolled hypertension that is associated with a significant risk of mortality. It is poorly understood and can lead to endothelial dysfunction with disturbance of the blood–brain barrier and subsequent brain edema. Headache, seizures, encephalopathy, and visual disturbances are among the most common symptoms associated with PRES. Testing and evaluation should be quickly initiated not only to solidify the diagnosis but also to rule out others such as infection or stroke. Prompt identification of the symptoms of PRES can potentially reverse long-term side effects such as life-long seizures or visual deficits.
Carotid endarterectomy for the management of carotid stenosis occurring concurrently with head and neck cancer
Authors: Telischi Julia , Nisenbaum Eric , Nicolli Elizabeth
Published: November 2023

Purpose of review

Currently, most patients with concurrent head and neck cancer (HNC) and carotid stenosis (CS) are treated disjointedly for their oncologic and vascular lesions. The purpose of this review is to evaluate literature exploring a novel approach to these cases that poses several advantages, in which carotid endarterectomy (CEA) is performed simultaneously with surgical resection of HNC.

Recent findings

Carotid stenosis is a common comorbidity of patients presenting with head and neck cancer as these pathologies have overlapping risk factors. Adjuvant oncologic therapy such as radiation therapy to the site of the lesion is known to increase development or progression of carotid stenosis. Performing simultaneous surgical management of CS and HNC decreases total procedures for the patient, provides a less challenging surgical field, and eliminates prioritization of treatment initiation for one pathology over the other. There has been limited reporting of simultaneous CEA with oncologic resection of HNC in the literature. However, of the 21 cases reviewed here, no perioperative strokes were reported with only one perioperative death from myocardial infarction.

Available literature supports that simultaneous CEA with oncologic resection of HNC is safe and may offer several advantages, although larger studies are required.
Cerebellar Dysfunction and Relationship With Psychopathology, Cognitive Functioning, Resilience, and Coping in Schizophrenia
Authors: Chew Qian Hui , Jia Shuhong , Sim Kang
Published: November 2023

In this study, we examined the cerebellar dysfunction in schizophrenia by evaluating the clinical, cognitive, resilience, and coping correlates of cerebellar signs (CSs) in 162 subjects (63 patients with schizophrenia and 99 healthy controls). The presence of CS was evaluated based on six clinical tests. Measures to assess the severity of psychopathology, cognitive functioning, resilience, and frequency of coping strategies used were included. Patients had more CS than controls. Patients with more CS were older, had more severe psychopathology, had poorer performance on Brief Assessment of Cognition for Schizophrenia token motor task, and used less self-distraction as a coping strategy than those with fewer CS. Patients without CS used less self-blame coping at higher level of resilience. The association of less self-distraction with more CS may be related to cognitive inflexibility as a result of cerebellar dysfunction. Greater attentiveness to the presence of CS in schizophrenia patients may aid in better management of their psychotic condition.
The Role of Superb Microvascular Imaging and Shear Wave Elastography in the Prediction of Hemorrhage Complications After Renal Parenchyma Biopsy
Authors: Günay Burak , Uslu Burak , Çelik Ahmet Onur , Korkmaz Selçuk , Ustabaşıoğlu Fethi Emre , Solak Serdar , Kula Osman , Tunçbilek Nermin
Published: November 2023

Objectives

The aim of study was to evaluate the diagnostic utility of the renal parenchyma elasticity with the shear wave elastography (SWE) and microvascularization with the superb microvascular imaging (SMI) technique before kidney biopsy and to predict the complication of hemorrhage before kidney biopsy.

Methods

A total of 75 patients were included in the prospective study. Before the biopsy, vascularity features of the kidney parenchyma in the area to be biopsied were assessed by SMI and parenchymal stiffness by SWE and were examined by 2 independent radiologists.

Results

A statistically significant difference was found in the SMI and SWE values between the groups with and without hematoma and hematuria when compared with the Student t test and Mann-Whitney U test (P < 0.05). The SWE hardness cutoff value, which maximizes the prediction of the development of hematuria, was found to be 18.40 kPa, and the sensitivity and specificity values were 84.4% and 62.8%, respectively. In SMI vascularity index values, the cutoff value was found to be 0.247410800 kPa, and sensitivity and specificity values were 81.3% and 83.7%, respectively. The cutoff value of the SMI vascularity index values that maximized the prediction of hematoma development was 0.297009650, and the sensitivity and specificity values were 87% and 87%, respectively.

Conclusions

We believe that evaluating and standardizing the microvascularization and elasticity of the kidney parenchyma before a percutaneous kidney biopsy will be potentially useful as a guiding method in the prediction of postbiopsy hemorrhage development.
Percutaneous Core Biopsy Devices
Authors: Strnad Benjamin S. , Kristeva Mariya , Itani Malak , Fetzer David T. , O'Connor Stacy D. , Patel Maitray D. , Middleton William D.
Published: November 2023

Percutaneous core-needle biopsy (PCNB) plays a growing and essential role in many medical specialties. Proper and effective use of various PCNB devices requires basic understanding of how they function. Current literature lacks a detailed overview and illustration of needle function and design differences, a potentially valuable reference for users ranging from early trainees to experts who are less familiar with certain devices. This pictorial aims to provide such an overview, using diagrams and magnified photographs to illustrate the intricate components of these devices. Following a brief historical review of biopsy needle technology for context, we emphasize distinctions in design between 2 major classes of PCNB devices (side- and end-cutting devices), focusing on practical implications for how each device is most effectively used. We believe a nuanced understanding of biopsy device function sheds light on certain lingering ambiguities in biopsy practice, such as the optimal needle gauge in organ biopsy, the benefits and risks associated with coaxial technique, the impact of needle selection and technique on bleeding, and the risk of unsuccessful sampling. In a subsequent pictorial, we will draw on the concepts presented here to illustrate examples of biopsy needle failure and how unrecognized needle failure can be an important and often preventable cause of increased biopsy risk and lower tissue yield.
Whole genome sequencing and genotyping Klebsiella pneumoniae multi-drug resistant hospital isolates from Western Kenya
Authors: Dinda Victor , Kimang’a Andrew Nyerere , Kariuki Daniel , Sifuna Anthony Wawire , O’Brien Thomas James , Welch Martin , Reva Oleg N
Published: November 2023

Klebsiella pneumoniae are a frequent cause of nosocomial infections worldwide. Sequence type 147 (ST147) has been reported as a major circulating high-risk lineage in many countries, and appears to be a formidable platform for the dissemination of antimicrobial resistance (AMR) determinants. However, the distribution of this pathogen in Western African hospitals has been scarcely studied. The main objective of this work was to perform whole genome sequencing of K. pneumoniae isolates from a referral hospital in Kakamega (Kenya) for genotyping and identification of AMR and virulence determinants.
Sulfurovum mangrovi sp. nov., an obligately chemolithoautotrophic, hydrogen-oxidizing bacterium isolated from coastal marine sediments
Authors: Li Yufei , Wang Shasha , Ji Bowen , Yuan Qing , Wei Shiping , Lai Qiliang , Wu Kaiyue , Jiang Lijing , Shao Zongze
Published: November 2023

A novel mesophilic, chemolithoautotrophic, hydrogen-oxidizing bacterium, designated strain ST1-3T, was isolated from mud sediment samples collected from mangroves in Jiulong River estuary. The cells were Gram-stain-negative, non-motile and rod-shaped. The temperature, pH and salinity ranges for growth of strain ST1-3T were 4–45 °C (optimum, 35 °C), pH 5.0–8.5 (optimum, pH 7.0) and 0–8.0 % (w/v) NaCl (optimum, 4.0 %). The isolate was an obligate chemolithoautotroph capable of growth using hydrogen as the only energy source, and molecular oxygen, thiosulphate and elemental sulphur as electron acceptors. The major cellular fatty acids of strain ST1-3T were summed feature 3 (C16 : 1
 ω7c and/or C16 : 1
 ω6c), C16 : 0 and summed feature 8 (C18 : 1
 ω7c). The major polar lipids were phosphatidylethanolamine, phosphatidyldimethyl ethanolamine and phosphatidylglycerol. The respiratory quinone was menaquinone-6. The genomic DNA G+C content was 43.6 mol%. Phylogenetic analysis based on 16S rRNA gene sequences and core genes showed that the novel isolate belonged to the genus

Sulfurovum

and was most closely related to

Sulfurovum lithotrophicum

42BKTT (94.7 % sequence identity). The average nucleotide identity and digital DNA–DNA hybridization values between ST1-3T and

S. lithotrophicum

42BKTT were 74.6 and 16.3 %, respectively. On the basis of the phenotypic, phylogenetic and genomic data presented here, strain ST1-3T represents a novel species of the genus

Sulfurovum

, for which the name Sulfurovum mangrovi sp. nov. is proposed, with the type strain ST1-3T (=MCCC M25234T=KCTC 25639T).
Genomic epidemiology of Streptococcus pneumoniae serotype 16F lineages
Authors: Mokaya Jolynne , Mellor Kate C. , Murray Gemma G. R. , Kalizang’oma Akuzike , Lekhuleni Cebile , Zar Heather J. , Nicol Mark P. , McGee Lesley , Bentley Stephen D. , Lo Stephanie W. , Dube Felix
Published: November 2023

Due to the emergence of non-vaccine serotypes in vaccinated populations,

Streptococcus pneumoniae

remains a major global health challenge despite advances in vaccine development. Serotype 16F is among the predominant non-vaccine serotypes identified among vaccinated infants in South Africa (SA). To characterize lineages and antimicrobial resistance in 16F isolates obtained from South Africa and place the local findings in a global context, we analysed 10 923 

S

.

pneumoniae

carriage isolates obtained from infants recruited as part of a broader SA birth cohort. We inferred serotype, resistance profile for penicillin, chloramphenicol, cotrimoxazole, erythromycin and tetracycline, and global pneumococcal sequence clusters (GPSCs) from genomic data. To ensure global representation, we also included

S. pneumoniae

carriage and disease isolates from the Global Pneumococcal Sequencing (GPS) project database (n=19 607, collected from 49 countries across 5 continents, 1995–2018, accessed 17 March 2022). Nine per cent (934/10923) of isolates obtained from infants in the Drakenstein community in SA and 2 %(419/19607) of genomes in the GPS dataset were serotype 16F. Serotype 16F isolates were from 28 different lineages of S. pneumoniae, with GPSC33 and GPSC46 having the highest proportion of serotype 16F isolates at 26 % (346/1353) and 53 % (716/1353), respectively. Serotype 16F isolates were identified globally, but most isolates were collected from Africa. GPSC33 was associated with carriage [OR (95 % CI) 0.24 (0.09–0.66); P=0.003], while GPSC46 was associated with disease [OR (95 % CI) 19.9 (2.56–906.50); P=0.0004]. Ten per cent (37/346) and 15 % (53/346) of isolates within GPSC33 had genes associated with resistance to penicillin and co-trimoxazole, respectively, and 18 % (128/716) of isolates within GPSC46 had genes associated with resistance to co-trimoxazole. Resistant isolates formed genetic clusters, which may suggest emerging resistant lineages. Serotype 16F lineages were common in southern Africa. Some of these lineages were associated with disease and resistance to penicillin and cotrimoxazole. We recommend continuous genomic surveillance to determine the long-term impact of serotype 16F lineages on vaccine efficacy and antimicrobial therapy globally. Investing in vaccine strategies that offer protection over a wide range of serotypes/lineages remains essential. This paper contains data hosted by Microreact.
No trade-off between ovary activation and immune protein expression in female bumble bees (Bombus impatiens)
Authors: McAfee Alison , Chapman Abigail , Bao Grace , Tarpy David R. , Foster Leonard J.
Published: November 2023

Evidence for a trade-off between reproduction and immunity has manifested in many animal species, including social insects. However, investigations in social insect queens present a conundrum: new gynes of many social hymenopterans, such as bumble bees and ants, must first mate, then transition from being solitary to social as they establish their nests, thus experiencing confounding shifts in environmental conditions. Worker bumble bees offer an opportunity to investigate patterns of immune protein expression associated with ovary activation while minimizing extraneous environmental factors and genetic differences. Here, we use proteomics to interrogate the patterns of immune protein expression of female bumble bees (Bombus impatiens) by 1) sampling queens at different stages of their life cycle, then 2) by sampling workers with different degrees of ovary activation. Patterns of immune protein expression in the hemolymph of queens are consistent with a reproduction-immunity trade-off, but equivalent samples from workers are not. This brings into question whether queen bumble bees really experience a reproduction-immunity trade-off, or if patterns of immune protein expression may actually be due to the selective pressure of the different environmental conditions they are exposed to during their life cycle.
Extreme gradient boosting machine learning algorithm identifies genome-wide genetic variants in prostate cancer risk prediction
Authors: Enoma David , Osamor Victor Chukwudi , Olubanke Ogunlana
Published: November 2023

Genome-wide association studies (GWAS) identify the variants (Single Nucleotide polymorphisms) associated with a disease phenotype within populations. These genetic differences are essential in variations in incidence and mortalities, especially for Prostate cancer in the African population. Given the complexity of cancer, it is imperative to identify the variants that contribute to the development of the disease. The standard univariate analysis employed in GWAS may not capture the non-linear additive interactions between variants, which might affect the risk of developing Prostate cancer. This is because the interactions in complex diseases such as prostate cancer are usually non-linear and would benefit from a non-linear Machine Learning gradient boosting viz XGBoost (extreme gradient boosting). We applied the XGBoost algorithm and an iterative SNP selection algorithm to find the top features (SNPs) that best predict the risk of developing prostate cancer with a Support Vector Machine (SVM). The number of subjects was 907, and input features were 1,798,727 after appropriate quality control. The algorithm involved ten trials of 5-fold cross-validation to optimize the dataset’s hyperparameters and the prediction task’s second module (utilizing SVM). The model achieved AUC-ROC cure of 0.66, 0.57 and 0.55 on the Train, Dev and Test sets, respectively. The area under the Precision-Recall Curve was 0.69, 0.60 and 0.57 on the Train, Dev and Test sets, respectively. Furthermore, the final number of predictive risk variants was 2798, associated with 847 Ensembl genes. Interaction analysis showed that Nodes were 339 and the edges were 622 in the gene interaction network. This shows evidence that the non-linear Machine learning approach offers excellent possibilities for understanding the genetic basis of complex diseases.
Deep Learning-based Optical Aberration Estimation Enables Offline Digital Adaptive Optics and Super-resolution Imaging
Authors: Qiao Chang , Chen Haoyu , Wang Run , Jiang Tao , Wang Yuwang , Li Dong
Published: November 2023

Optical aberrations degrade the performance of fluorescence microscopy. Conventional adaptive optics (AO) leverages specific devices, such as the Shack-Hartmann wavefront sensor and deformable mirror, to measure and correct optical aberrations. However, conventional AO requires either additional hardware or a more complicated imaging procedure, resulting in higher cost or a lower acquisition speed. In this study, we proposed a novel space-frequency encoding network (SFE-Net) that can directly estimate the aberrated point spread functions (PSFs) from biological images, enabling fast optical aberration estimation with high accuracy without engaging extra optics and image acquisition. We showed that with the estimated PSFs, the optical aberration can be computationally removed by deconvolution algorithm. Furthermore, to fully exploit the benefits of SFE-Net, we incorporated the estimated PSF with neural network architecture design to devise an aberration-aware deep-learning super-resolution (DLSR) model, dubbed SFT-DFCAN. We demonstrated that the combination of SFE-Net and SFT-DFCAN enables instant digital AO and optical aberration-aware super-resolution reconstruction for live-cell imaging.