bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological and clinical role of TREM2 in liver diseases
Authors: Ma Ke , Guo Shouliang , Li Jin , Wei Tao , Liang Tingbo
Published: November 2024

Liver diseases constitute a major health burden worldwide, accounting for more than 4% of all disease-related mortalities. While the incidence of viral hepatitis is expected to decrease, metabolic liver disorders are increasingly diagnosed. Liver pathology is diverse, with functional and molecular alterations in both parenchymal and mesenchymal cells, including immune cells. Triggering receptor expressed on myeloid cells 2 (TREM2) is a transmembrane receptor of the immunoglobulin superfamily and mainly expressed on myeloid cells. Several studies have demonstrated that TREM2 plays a critical role in tissue physiology and various pathological conditions. TREM2 is recognized as being associated with the development of liver diseases by regulating tissue homeostasis and the immune microenvironment. The biological and clinical impact of TREM2 is complex, given its diverse context-dependent functions. This review aims to summarize recent progress in understanding the association between TREM2 and different liver disorders and shed light on the clinical significance of targeting TREM2.
Isofraxidin alleviated radiation-induced testicular damage via the Nrf2/HO-1-NLRP3/ASC Axis
Authors: Hu Changkun , Wu Zekun , Zhang Liangliang , Ma Zengchun , Liao Zebin , Gao Yue
Published: November 2024

OBJECTIVE:

Radiotherapy is used to treat patients with tumors; however, radiation (IR)-induced testicular injury, which has no effective treatment approved in clinical practice, significantly influences their prognosis and quality of life. The protective effects and underlying mechanisms of action of isofraxidin (IF) against IR-induced testicular injury were investigated.

Methods:

A mouse testis injury model was established using 5 Gy irradiation. H&E staining, immunofluorescence staining, and enzyme-linked immunosorbent assay were used to measure DNA damage, apoptosis, inflammatory reactions, and oxidative stress in the testes of mice after irradiation. The effectiveness of IF irradiation on testicular injury was evaluated, and the mechanisms of the related oxidative stress and inflammatory response pathways are discussed.

Results:

IF can improve IR-induced testicular injury by inhibiting the increased levels of DNA damage, apoptosis rate, oxidative stress, and inflammatory factors. The radioprotective effects of IF on testicular injury are mediated by the stimulation of Nrf2/HO-1 or suppression of NLRP3 inflammasome signaling pathways. In addition, crosstalk between the Nrf2/HO-1 and NLRP3 inflammasome signaling pathways was elucidated, in which the inhibition of the NLRP3 inflammasome was mediated by the activation of Nrf2 signaling with IF upon IR exposure.

Conclusion:

IF can be a potent radioprotective agent to mitigate testicular damage, and may provide a new therapeutic option to alleviate the side effects of radiotherapy in male patients with tumors.
Evolving COVID-19 Landscape: Assessing the Effectiveness and Safety Profile of Nirmatrelvir/Ritonavir in Adolescents
Authors: Lee Philip , Lee Kiriam Escobar , Anosike Brenda I.
Published: November 2024

This study evaluates nirmatrelvir/ritonavir (Paxlovid) in preventing severe coronavirus disease 2019 in adolescents (12–18). Conducted from January 2022 to July 2023, it compared hospital admissions and healthcare visits within 30 days post-treatment. Results showed similar follow-up rates between treated and untreated groups, with slightly more adverse effects in the nirmatrelvir/ritonavir group. Further research is needed to confirm its efficacy in this population.
Hospital Medicare Spending per Beneficiary: A Longitudinal Study
Authors: Xu Jing , Hamadi Hanadi , Zhao Mei , Boamah Sheila A. , Tafili Aurora , Spaulding Aaron
Published: November 2024

Goal

While studies have examined quality and health outcomes related to the Centers for Medicare & Medicaid Services’ (CMS’s) Hospital Value-Based Purchasing (HVBP) Program, a significant gap exists in the literature regarding the relationship between pay-for-performance initiatives and hospital financial performance in the program’s Efficiency and Cost Reduction domain. This study examined the association between hospitals’ cost inefficiency and participation in the HVBP Program by estimating the probability and magnitude of improvement or achievement in the program’s Efficiency and Cost Reduction domain.

Methods

The 2014–2019 Efficiency and Cost Reduction domain data were obtained from CMS and merged with the American Hospital Association’s Annual Survey Database. We conducted a zero-inflated negative binomial regression to account for the excessive number of zeros in the data.

Principal Findings

The negative binomial component of the model assessed the magnitude of the impact on the Efficiency and Cost Reduction improvement from each covariate, while the zero-inflated component assessed the odds of being in the “certain-zero” group, meaning no chance to improve or achieve. Hospital ownership, location, size, safety-net status, percentage of Medicare patients, and the number of registered nurses per bed were statistically significant. Additionally, the Herfindahl-Hirschman Index and teaching status significantly influenced efficiency performance.

Practical Applications

Changes in hospital performance in this domain exist and have evolved. Hospitals might be at a disadvantage with this performance measure because of their inherent organizational structure. The HVBP Program may not provide clear enough direction or actionable incentive to address the needs of stakeholders influenced primarily by measures of Medicare spending per beneficiary. This study’s findings hold practical value for policymakers, healthcare administrators, and researchers. Policymakers can use this information to tailor future pay-for-performance programs and effectively allocate resources. Healthcare administrators can identify areas for improvement and benchmark their performance against similar institutions. Researchers can explore the program’s long-term sustainability and investigate cost drivers within different hospital groups. By understanding the link between hospital characteristics and cost reduction, all stakeholders can contribute to a more efficient healthcare system.
A Socioecological Approach to Work Performance
Authors: Karni-Efrati Ziv , Egozi Laliv , Pardo Asher
Published: November 2024

Objectives

Chronic skin diseases (CSD) may lead to productivity losses. This mixed-methods study investigated symptom severity, social challenges, need for workplace accommodation, sick leave, and their association with perceived impaired work performance (IWP) among workers with CSD.

Methods

Data were collected from April to June 2023. Participants (n = 102) completed an online questionnaire sent from the Institute for Occupational Safety and Hygiene and almost 20% were interviewed. The analyses included logistic regression and structural equation models and a thematic analysis.

Results

Of participants, 72.3% reported perceived IWP. The need for workplace accommodation and sick leave duration were directly associated with IWP. These findings were integrated with common themes based on a socioecological approach.

Conclusions

By working together to address personal, interpersonal, organizational, and societal aspects associated with CSD, occupational physicians and stakeholders can alleviate perceived IWP.
Controlled low-density lipoprotein cholesterol attenuates cardiovascular risk mediated by elevated lipoprotein(a) after percutaneous coronary intervention
Authors: Mahmoud Ahmed K. , Awad Kamal , Farina Juan M. , Abbas Mohammed Tiseer , Ali Nima Baba , Abdalla Hesham M. , Badr Amro , Elahi Muhammad A. , Pereyra Milagros , Scalia Isabel G. , Javadi Niloofar , Bismee Nadera N. , Alsidawi Said , Lester Steven J. , Ayoub Chadi , Arsanjani Reza
Published: November 2024

Background

Lipoprotein(a) [Lp(a)] is an independent, causal risk factor for cardiovascular disease. However, it is still unclear whether controlling low-density lipoprotein cholesterol (LDL-C) to optimal levels can attenuate cardiovascular risk mediated by elevated Lp(a), especially in the setting of secondary prevention.

Methods

Adult patients with a baseline Lp(a) measurement who underwent percutaneous coronary intervention (PCI) and reached their LDL-C target levels (<70 mg/dl) at Mayo Clinic sites between 2006 and 2017 were included. Primary outcomes included major adverse cardiovascular events (MACE) and all-cause mortality. Kaplan–Meier curves were created to compare the survival probabilities among patients with Lp(a) ≥ 50 mg/dl compared with Lp(a) < 50 mg/dl. Multivariable Cox regression analyses were performed to quantify the association of elevated Lp(a) with our relevant outcomes and to control for possible confounders.

Results

In total, 878 patients (median age: 68 years, and 74% males) who underwent PCI were included for analysis. Of them, 29.7% had elevated Lp(a) ≥ 50 mg/dl. Kaplan–Meier curves did not reveal any significant difference in survival probabilities for elevated Lp(a) for any outcome including MACE (P = 0.91), all-cause mortality (P = 0.26), or the separate MACE components. Similarly, the multivariable analysis showed no significant association for MACE (hazard ratio: 1.07, 95% confidence interval: 0.84–1.37) or all-cause mortality (hazard ratio: 0.98, 95% confidence interval: 0.74–1.30).

Conclusion

In patients who underwent PCI and have their LDL-C controlled below 70 mg/dl, no significant association was found between elevated Lp(a) ≥ 50 mg/dl and risk for MACE or all-cause mortality.
Prevalence, antimicrobial resistance, and biofilm-formation of Listeria monocytogenes in bulk raw milk in East Azerbaijan province, Iran
Authors: Davarpanah Mona , Bialvaei Abed Zahedi
Published: November 2024

Introduction:

The aims of this study were to determine the prevalence, antimicrobial resistance and the biofilm-forming ability of Listeria spp. in bulk raw milk in East-Azerbaijan province, Iran.

Methods:

A total of 192 bulk raw milk samples were collected from six distinct parts of East-Azerbaijan province. Selective enrichment and isolation were done by using United States Department of Agriculture (USDA) method, then isolates were identified by biochemical tests and confirmed by polymerase chain reaction. Susceptibilities of isolates to different antibiotics were determined by using the disk diffusion assay. Two phenotypic methods were used for investigation of biofilm production: Congo red agar (CRA) and microtiter plate (MTP).

Results:

The prevalence of Listeria monocytogenes and other Listeria spp. were 11.97% and 0%, respectively. The highest prevalence rate was found in one of regions located in the center of province (30.43%) and northeast of province had the lowest prevalence rate (3.12%). All isolates were susceptible to vancomycin, erythromycin, chloramphenicol, kanamycin, gentamicin, tetracycline, streptomycin, amoxicillin-clavulanic acid and rifampicin. Only one isolates had intermediate susceptibility to ciprofloxacin. There was the highest resistance to nalidixic acid (100%), followed by to ampicillin (17.39%), and penicillin (13.04%), and the lowest resistance to clindamycin (8.6%) was observed. Based on MTP, 91.30% of isolates were weak biofilm formers. Biofilm production of L. monocytogenes using CRA plates showed that 34.78% and 52.17% of isolates were positive and intermediate biofilm producers, respectively.

Conclusion:

The results indicate that prevalence rate of L. monocytogenes is relatively high and there is a potential risk for consumers of raw and unpasteurized milk.
Evaluation of genes involved in the binding and invasion of Klebsiella pneumoniae including fimH-1, entB, iutA, rmpA and cnf-1 genes in patients with urinary tract infection
Authors: Yousefi Bahman , Abdolshahi Anna , Dadashpour Mehdi , Pahlevan Daryoush , Ghaffari Hadi , Eslami Majid
Published: November 2024

Introduction:

Klebsiella pneumoniae is a member of the Enterobacteriaceae that causes nosocomial infections. The aim of this study was to identify the binding, invasive and pathogenic profiles of K. pneumoniae isolates in urinary tract infection.

Materials and methods:

This study was performed with 70 isolates. The antibiotic susceptibility testing was conducted by 12 antibiotics. The presence of virulence genes (fimH-1, mrkD, kpn, ycfM, entB, iutA, irp-1, irp-2, ybtS, fyuA, iroN, rmpA, magA, traT, hlyA and cnf-1) done by PCR.

Results:

The strains resistant to imipenem, also resistant to the cefotaxime/ceftazidime and azteronam. 96.4% of rmpA strains also had entB and 92.8% had ycfM gene. Of the 12 strains containing cnf1, all also had fimH and the mrkD gene. These strains had a high resistance the amoxicillin, tobramycin, ciprofloxacin and gentamicin. Strains containing the hlyA all had fimH and were high resistant to the amoxicillin/clavulanic acid, amikacin, and tobramycin. magA-containing strains had low resistance to amikacin and azteronam.

Conclusion:

It is recommended that imipenem resistant strains be resistant to cefotaxime, ceftazidime, and aztereonam, and that these antibiotics not be used to treat these strains. Interestingly, strains with the cnf-1 were all sensitive to imipenem, so imipenem is a good option for treating these strains. Strains that had the hlyA all had the fimH gene and had a very high resistance to the amoxicillin/clavulanic acid, amikacin and tobramycin. magA-containing strains all had entB and had low resistance to amikacin and aztereonam. Therefore, amikacin and aztereonam are recommended for the treatment of these strains containing.
Detection of some virulence genes among clinical Pseudomonas aeruginosa isolates in Baghdad
Authors: Khazaal Saba Saadoon , Fadhil Yasir B. , Talha Mustafa Hasan , Al-Alak Shaymaa Khudhr
Published: November 2024

Purpose:

The objectives of the current study are to detect some important virulence genes inPseudomonas aeruginosa, which isolated from clinical samples in Baghdad's different hospitals.

Methods:

A total of 40 clinicalP. aeruginosaisolates were collected from different hospitals in Baghdad city. The isolates were identified using morphological tests and confirmed by conventional PCR by using specific primer for16S rDNAgene. To extract DNA from the isolates, a genomic DNA kit was used molecular detection of two virulence genes:ompAandpapC, which were amplified by PCR.

Results:

All 40 isolates were identified morphological and genetic tests. Moreover, the prevalence of virulence genes by PCR demonstrated that that (27.5%) and (17.5%)P. aeruginosaisolates carried theompAandpapCgenes, respectively. These genes are associated to biofilm formation. TheompAwas the most predominant gene.

Conclusion:

The current data support the occurrence ofP. aeruginosaexhibiting important virulence genes, which indeed make these bacteria provide such a significant threat to public health.
Methicillin-resistant Staphylococcus aureus strains isolated from foodhandlers, community nasal carriers and bovine mastitis
Authors: Soltan Dallal Mohammad Mehdi , Salehipour Zohreh , Abdi Milad
Published: November 2024

Objective:

Methicillin-resistant Staphylococcus aureus (MRSA) is a prevalent bacterial pathogen that is isolated from various environments. The aim of this study was to survey MRSA strains from foodhandlers, community nasal carriers, and bovine mastitis.

Materials and methods:

A total of 374 samples from community nasal carriers (105), bovine mastitis (173), and foodhandlers (96) were screened for Staphylococcus aureus. Antimicrobial susceptibility testing and methicillin resistance using mecA-specific PCR assay, an oxacillin agar screen test, cefoxitin disk diffusion assay, production of penicillin-binding protein (PBP), β-lactamase production, and antimicrobial MIC (minimum inhibitory concentration) assay were performed for all S. aureus isolates.

Results:

MRSA isolates were isolated from 38.8% of community nasal carriers, 14.7% of bovine mastitis, and 23.5% of foodhandlers. Expression of the mecA gene was the most common MRSA trait for human isolates and hyperproduction of β-lactamase was the most common antimicrobial resistance factor for bovine mastitis isolates.

Conclusion:

MRSA strains were isolated from foodhandlers, community nasal carriers, and bovine mastitis. Therefore, due to the possibility of contamination of human and animal resources, the control of important pathogens such as MRSA is important.
Neuroendocrine Tumors in Horseshoe Kidneys: A Review of the Literature With Report of a Novel Finding Expanding Their Morphologic Spectrum
Authors: Billis Athanase , Freitas Leandro L.L. , Silva Frederico G.C. , Ferreira Ubirajara , Matheus Wagner E. , Selegatto Ivan B. , Oliveira Caio de , Tognoli Thais A. , Etchebehere Elba C.S.C.
Published: November 2024

Horseshoe kidney is a rare congenital anomaly with an unusually higher frequency of neuroendocrine tumors. Symptoms are rare, and, in most of the cases, are incidentally diagnosed. The clinical behavior of these tumors is heterogeneous and can be difficult to predict based on histology alone. Necrosis and percentage of Ki-67 may have a role in prognosis. Almost all tumors are carcinoids (well-differentiated neuroendocrine tumors) observed at an early age and with no sex dominance. It is not known the reason for the higher frequency of neuroendocrine tumors in horseshoe kidneys and the histogenesis is unknown. One of the hypotheses supports that renal carcinoid tumors may arise from neuroendocrine cells within foci of metaplastic or teratomatous epithelium within the kidney. With consonance with this hypothesis, there are reports of carcinoids in horseshoe kidneys associated with a cystic lesion lined by the intestinal epithelium, with mucinous differentiation and osseous metaplasia, arising in a mature teratoma of the kidney, arising within mature teratoma and clear cell renal cell carcinoma, with a mucinous cystadenoma element, and arising within mature cystic teratoma synchronous with primary adenocarcinoma. There is only one reported large cell neuroendocrine carcinoma of a horseshoe kidney in a 57-year-old Chinese woman. Herein, we report a patient that to the best of our knowledge is the first case of a combined well-differentiated neuroendocrine tumor and large-cell neuroendocrine carcinoma with rhabdoid features in horseshoe kidney. The histologic component of rhabdoid features expands the morphologic spectrum of neuroendocrine tumors in the horseshoe kidney. We provide a comprehensive review of the literature summarizing pertinent key clinical and pathologic aspects.
A Proposal for Revised and Simplified Renal Pelvic Urothelial Carcinoma Staging Criteria
Authors: Machacek Miranda E. , Wang Hanzhang , Devins Kyle , Sadow Peter M. , Wu Chin-Lee , Oliva Esther , Saylor Philip J. , Cornejo Kristine M.
Published: November 2024

Staging of renal pelvic urothelial carcinoma can be challenging due to anatomic variation at the renal pelvis compared with ureter and bladder and calls into question the prognostic accuracy of the current TNM staging. In this study, we determined staging and cancer-specific survival (CSS) in 141 patients undergoing nephroureterectomy for renal pelvic urothelial carcinoma (pTa=50, pT1=29, pT2=10, pT3=36, and pT4=16). Under current staging criteria, we found no significant difference in CSS between adjacent staging categories step-wise across pTa, pT1, pT2, and pT3 tumors. When pT3 tumors were subcategorized into renal medulla, peripelvic adipose, or renal cortex invasion with or without peripelvic adipose invasion, we found that cortical invasion was associated with significantly worse CSS compared with medulla or peripelvic adipose invasion only. We next revised staging criteria such that pT1 correlated with invasion of lamina or muscularis propria (n=37), T2 with invasion of medulla or peripelvic adipose only (n=26), and pT3 with cortical invasion (n=12). Under the new criteria, better separation of survival curves was achieved; however, pT1 and pT2 remained statistically insignificant. When further redefining pT3 as invasive of cortex only (n=12) and combining medulla with lamina and muscularis propria invasion as a lower stage (pT1, n=63), there was further improvement in the prognostic stratification. Therefore, our data show that consideration of revised and simplified T staging criteria at the renal pelvis is warranted, wherein invasion of any anatomic structure up to the cortex shows a similar prognosis (combined pT1 category) and invasion of cortex showing significantly worse prognosis (pT3).
Treatment of prehypertension among adults with HIV
Authors: Yan Lily D. , Rouzier Vanessa , Sufra Rodney , Sauveur Reichling St , Guiteau Colette , Lee Myung Hee , Ogyu Anju , Mourra Nour , Oparil Suzanne , Théard Michel , Brisma Jean Pierre , Alfred Jean Patrick , Deschamps Marie D. , Pape Jean W. , McNairy Margaret L.
Published: November 2024

Objective:

Elevated blood pressure (BP), even at prehypertensive levels, increases cardiovascular disease risk among people with HIV (PWH); yet international guidelines in low-income countries recommend treatment initiation at BP at least 140/90 mmHg. We determined the efficacy, feasibility, and acceptability of treating prehypertension in PWH in Haiti.

Design:

An unblinded randomized clinical trial (enrolled April 2021–March 2022) with 12-month follow-up.

Setting:

GHESKIO Centres, Port-au-Prince, Haiti.

Participants:

Two hundred fifty adults with HIV with prehypertension (SBP 120–138 or DBP 80–89) not on medication, aged 18–65 years, virally suppressed, and without pregnancy, diabetes, or kidney disease.

Intervention:

Participants were randomized to treatment (amlodipine 5 mg) or control (no amlodipine unless two BP ≥140/90 mmHg).

Main outcome measure:

Primary outcome was mean change in SBP between intervention versus control groups from enrollment to 12 months.

Results:

Among 250 adults, median age was 49 years, 40.8% were women. Baseline median BP was 129/78 mmHg intervention versus 128/77 mmHg control. After 12 months, the difference in mean change between study groups for SBP was -5.9 mmHg [95% confidence interval (95% CI) -8.8 to -3.0] and for DBP was -5.5 mmHg (95% CI -7.9 to -3.2). At 12 months, 5.6% intervention and 23.0% control participants developed incident hypertension (hazard ratio 0.18; 95% CI 0.07–0.47). There were no differences in viral load suppression at 12 months or drug-related serious adverse events. Intervention acceptability was high among providers and participants in qualitative interviews.

Conclusion:

In PWH in a resource-poor setting, prehypertension treatment was feasible, acceptable, and effective in reducing mean SBP and incident hypertension.

Registration:

Clinicaltrials.gov NCT04692467
The Added Value of Apparent Diffusion Coefficient and Histogram Analysis in Assessing Treatment Response of Locally Advanced Cervical Cancer
Authors: Saleh Gehad A. , Elged Basma A. , Saleh Manal M. , Hassan Amany , Karam Rasha
Published: November 2024

Objective

The aim of the study is to assess the diagnostic performance of quantitative analysis of diffusion-weighted imaging in assessing treatment response in cervical cancer patients.

Methods

A retrospective analysis was done for 50 patients with locally advanced cervical cancer who received concurrent chemoradiotherapy and underwent magnetic resonance imaging and diffusion-weighted imaging. Treatment response was classified into 4 categories according to RECIST criteria 6 months after therapy completion. Apparent diffusion coefficient (ADC) values were measured using both region of interest (ROI) ADC and whole lesion (WL) ADC histogram for all cases at both baseline pretreatment and posttreatment Magnetic resonance imaging studies. Changes in ADC values were calculated and compared between groups.

Results

The percentage change of ROI-ADCmean at a cutoff value of >20 had excellent discrimination of responders versus nonresponders, while the percentage change of WL-ADCmean, ADCmin, and ADCmax at cutoff values of >12.5, >35.8, and > 19.6 had acceptable discrimination of responders versus nonresponders. Logistic regression analysis revealed that only baseline WL ADCmin was a statistically significant independent predictor of response. Cancer cervix patients with baseline ADCmin < or equal to 0.73 have 12.1 times higher odds of exhibiting a response.

Conclusions

The percentage change of ROI-ADCmean and WL histogram ADCmean values after concurrent chemoradiotherapy can predict response. Pretreatment WL histogram ADCmin was a statistically significant independent predictor of posttherapy response.
Prostate Cancer Risk Prediction Model Using Clinical and Magnetic Resonance Imaging–Related Findings: Impact of Combining Lesions' Locations and Apparent Diffusion Coefficient Values
Authors: Nakai Hirotsugu , Takahashi Hiroaki , LeGout Jordan D. , Kawashima Akira , Froemming Adam T. , Klug Jason R. , Korfiatis Panagiotis , Lomas Derek J. , Humphreys Mitchell R. , Dora Chandler , Takahashi Naoki
Published: November 2024

Objectives

The aims of the study are to develop a prostate cancer risk prediction model that combines clinical and magnetic resonance imaging (MRI)–related findings and to assess the impact of adding Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesions-level findings on its diagnostic performance.

Methods

This 3-center retrospective study included prostate MRI examinations performed with clinical suspicion of clinically significant prostate cancer (csPCa) between 2018 and 2022. Pathological diagnosis within 1 year after the MRI was used to diagnose csPCa. Seven clinical, 3 patient-level MRI-related, and 4 lesion-level MRI-related findings were extracted. After feature selection, 2 logistic regression models with and without lesions-level findings were created using data from facility I and II (development cohort). The area under the receiver operating characteristic curve (AUC) between the 2 models was compared in the PI-RADS ≥3 population in the development cohort and Facility III (validation cohort) using the Delong test. Interfacility differences of the selected predictive variables were evaluated using the Kruskal-Wallis test or chi-squared test.

Results

Selected lesion-level features included the peripheral zone involvement and apparent diffusion coefficient (ADC) values. The model with lesions-level findings had significantly higher AUC than the model without in 655 examinations in the development cohort (0.81 vs 0.79, respectively, P = 0.005), but not in 553 examinations in the validation cohort (0.77 vs 0.76, respectively). Large interfacility differences were seen in the ADC distribution (P < 0.001) and csPCa proportion in PI-RADS 3–5 (P < 0.001).

Conclusions

Adding lesions-level findings improved the csPCa discrimination in the development but not the validation cohort. Interfacility differences impeded model generalization, including the distribution of reported ADC values and PI-RADS score-level csPCa proportion.
Preoperative Computed Tomography Radiomics-Based Models for Predicting Microvascular Invasion of Intrahepatic Mass-Forming Cholangiocarcinoma
Authors: Zhu Yong , Chen Jiao , Cui Wenjing , Cui Can , Jin Hailin , Wang Jianhua , Wang Zhongqiu
Published: November 2024

Objectives

The aim of the study is to investigate the ability of preoperative CT (Computed Tomography)-based radiomics signature to predict microvascular invasion (MVI) of intrahepatic mass-forming cholangiocarcinoma (IMCC) and develop radiomics-based prediction models.

Materials and Methods

Preoperative clinical data, basic CT features, and radiomics features of 121 IMCC patients (44 with MVI and 77 without MVI) were retrospectively reviewed. The loading and display of CT images, delineation of the volume of interest, and feature extraction were performed using 3D Slicer. Radiomics features were selected by the LASSO logistic regression model. Multivariate logistic regression analysis was used to establish the radiomics model, radiologic model, and combined model in the training set (n = 85) to predict the MVI of IMCC, and then verified in the validation set (n = 36).

Results

Among the 3948 radiomics features extracted from multiphase dynamic enhanced CT imaging, 16 most stable features were selected. The AUC of the radiomics model for predicting MVI in the training set and validation set were 0.935 and 0.749, respectively. The AUC of the radiologic model for predicting MVI in the training set and validation set were 0.827 and 0.796, respectively. When radiomics and radiologic models are combined, the predictive performance of the combined model (constructed with shape, intratumoral vessels, portal venous phase tumor-liver CT ratio, and radscore) is optimal, with an AUC of 0.958 in the training set and 0.829 in the test set for predicting MVI.

Conclusions

CT radiomics signature is a powerful predictor for predicting MVI. The preoperative combined model (constructed with shape, intratumoral vessels, portal venous phase tumor-liver CT ratio, and radscore) performed well in predicting the MVI.
Cerebral amyloid angiopathy: one single entity?
Authors: Koemans Emma A. , van Etten Ellis S.
Published: November 2024

Purpose of review

Cerebral amyloid angiopathy (CAA) is a common brain disorder among the elderly and individuals with Alzheimer's disease, where accumulation of amyloid-ß can lead to intracerebral hemorrhage and dementia. This review discusses recent developments in understanding the pathophysiology and phenotypes of CAA.

Recent findings

CAA has a long preclinical phase starting decades before symptoms emerge. Its pathophysiology follows consecutive stages of amyloid-ß deposition, decreased vascular reactivity, nonhemorrhagic changes, and ultimately hemorrhages. Although impaired perivascular clearance is the leading hypothesis underlying CAA, several lines of evidence suggest that glymphatic dysfunction also plays a significant role in the disease process. Despite its common pathway, the disease course is variable. Some patients develop more microbleeds, while others develop larger hemorrhages, suggesting a differentiation in vascular remodeling. Some patients with CAA develop a symptomatic immune response, and inflammation could be an important contributor to vascular damage in CAA in general. Furthermore, the prion-like transmission of amyloid-β has been identified as a cause of iatrogenic CAA occurring decades after neurosurgical procedures involving cadaveric dura mater.

Emerging evidence of sporadic, hereditary, inflammatory, and iatrogenic CAA suggests a complex interplay between brain clearance, inflammation and vascular remodeling leading to a diverse clinical phenotype.
Does dietary intake of vitamin A and beta-carotene increase the risk of hypertension?
Authors: Rahmanian Sasan , Salimi Zahra , Masoumvand Mohammad , Aghakhani Nejad Zohre , Ghorbani Hesari Mohamadtaghi , Mirshafaei Seyed Reza , Keshavarz Mohammadian Mohammad , Abbasi Mobarakeh Khadijeh , Ataei Kachooei Masoomeh , Shamsi-Goushki Ali , Khoshdooz Sara , Bahmani Parsa , Doaei Saeid , Kooshki Akram , Gholamalizadeh Maryam
Published: November 2024

Background

Hypertension (HTN) is a major global public health issue influenced by genetics and lifestyle factors such as diet and psychological stress. Previous research suggests a potential link between HTN and dietary vitamin A intake. This study aims to explore the association between HTN and the intake of various forms of vitamin A.

Methods

This cross-sectional study was conducted on 1239 patients with HTN and 2945 normotensive individuals aged 35–70 years in Sabzevar, Iran. Dietary vitamin A intake was assessed using the Nutritionist IV software and a food frequency questionnaire.

Result

A positive association was found between HTN with total vitamin A intake [odds ratio (OR): 1.03, 95% confidence interval (CI): 1.01–1.05, P = 0.04] and β-carotene intake (OR: 1.03, 95% CI: 1.02–1.05, P = 0.03) after adjusting for age and sex. These associations remained statistically significant after adjusting for physical activity and BMI. The association between HTN and β-carotene intake remained significant after additional adjustment for calorie intake. No significant association was observed between dietary retinol intake and HTN.

Conclusion

Increased dietary intake of vitamin A and β-carotene may be associated with a higher risk of HTN. Further longitudinal studies are needed to confirm these findings and elucidate the underlying mechanisms.
General principles of communication among nurses in a long-term care unit: a best practice implementation project
Authors: Felizardo Helena , Cardoso Daniela , Nogueira Paula , Bastos Joana , Casimiro Daniela , Nogueira Pedro , Cardoso Ana Filipa , Apóstolo João , Vrbová Tereza , Klugar Miloslav , Klugarová Jitka
Published: November 2024

Introduction:

In health care, effective communication enhances teamwork and safety by minimizing adverse events. Evidence suggests that ongoing education should include communication skills training, as interprofessional communication relies on tools that facilitate seamless interaction.

Objective:

This project aimed to improve communication practices among nurses in a long-term care unit by promoting evidence-based recommendations.

Methods:

This project followed the seven phases proposed by the JBI Evidence Implementation Framework. This framework is grounded in an audit, feedback, and re-audit process, along with a structured approach to addressing barriers to compliance with best practices. JBI's Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) approach were also used.

Results:

A baseline audit was conducted focusing on three audit criteria. Compliance was measured by observing 250 handovers and administering a questionnaire to 14 nurses. After analyzing the results, the nursing team identified barriers and designed strategies to promote change, such as educational sessions and a focus group. The results of the follow-up audit showed significant improvements across all criteria. Nurses received training in communication for Criterion 1, which improved from 0% to 78%. For Criterion 2, training in teamwork and conflict management improved from 21% to 50%. For Criterion 3, the use of a structured communication tool (ISBAR) during handovers improved from 43.6% to 91%.

Conclusions:

The nursing team's involvement enabled effective change. Adapting ISBAR to a long-term care unit was an unexpected goal. The next objective is to refine and share it with similar units. Integrating communication training into health care institutions’ priorities is crucial, and future audits will ensure sustainability.

Spanish abstract:

http://links.lww.com/IJEBH/A295
Genome description of a potentially new species of Streptomyces isolated from the Indian Sundarbans mangrove
Authors: Ghosh Anwesha , Bhambra Simran Kaur , Chandrasekaran Raghu , Bhadury Punyasloke
Published: November 2024

A potentially new species of Streptomyces was isolated from station 177 of the Sundarbans Seasonal Time Series in Indian Sundarbans mangrove. The isolate was cultured from sediment sample on TYS medium of salinity 15. Sequencing and annotation of the 16S rRNA showed 100% identity against S. laurentii NPS17 against GenBank/ENA/DDBJ. Annotation of the whole genome against GTDB database showed closest identity with S. terrae SKN60 and belong to the same clade as S. roseicoloratus TRM44457T and S. laurentii ATCC 31255. The genome is about 7.2 Mb and has a G+C % of 73%. The average amino acid identity (AAI) was 85.01% with S. roseicoloratus and 80.34% with S. roseolus. The assembly reflected the presence of all essential genes and has 19 biosynthetic gene clusters predicted.
The Impact of Health Information Technology on Patient Safety
Authors: Danso Gideon , Lasim Obed Owumbornyi
Published: November 2024

Introduction

Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety. We conclude that health information technology improves patient’s safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines. There should be no doubt that health information technology is an important tool for improving healthcare quality and safety.

Method

A cross-sectional survey was conducted among some health care professionals at St. Gregory Catholic Hospital, Gomoa Buduburam. A self-administered questionnaire was used to elicit information on informed consent, confidentiality and medico legal issues. Data collected was analyzed using SPSS version 20.

Results

A total of 70 health care workers were enrolled on the study representing 70% response rate. The study revealed about 98% knows that Health Information Technology (HIT) is important in delivering care to patients; and 86% of the respondents indicated that HIT has reduced medical errors. About 82% of the responded that HIT has made health care delivery easier and faster and hence reducing awaiting time. About 90% of the responded that HIT has helped in transferring medical records of patient from one facility to the other in case of emergency.

Conclusion

Impact of Health Information Technology on patient safety and their perception are positive. However, regular training on the update and use of Health Information Technology will be necessary in order to ensure continuous improvement of the quality of health care delivery.
SARS-CoV-2 EndoU-ribonuclease regulates RNA recombination and impacts viral fitness
Authors: Zhou Yiyang , Ahearn Yani P. , Lokugamage Kumari G. , Alvarado R. Elias , Estes Leah K. , Meyers William M. , McLeland Alyssa M. , Morgan Angelica L. , Murray Jordan T. , Walker David H. , Johnson Bryan A. , Routh Andrew L. , Menachery Vineet D.
Published: November 2024

Coronaviruses (CoVs) maintain large RNA genomes that frequently undergoes mutations and recombination, contributing to their evolution and emergence. In this study, we find that SARS-CoV-2 has greater RNA recombination frequency than other human CoVs. In addition, coronavirus RNA recombination primarily occurs at uridine (U)-enriched RNA sequences. Therefore, we next evaluated the role of SARS-CoV-2 NSP15, a viral endonuclease that targets uridines (EndoU), in RNA recombination and virus infection. Using a catalytically inactivated EndoU mutant (NSP15H234A), we observed attenuated viral replicationin vitroandin vivo. However, the loss of EndoU activity also dysregulated inflammation resulting in similar diseasein vivodespite reduced viral loads. Next-generation sequencing (NGS) demonstrated that loss of EndoU activity disrupts SARS-CoV-2 RNA recombination by reducing viral sub-genomic message but increasing recombination events that contribute to defective viral genomes (DVGs). Overall, the study demonstrates that NSP15 plays a critical role in regulating RNA recombination and SARS-CoV-2 pathogenesis.
Plasma glycome reflects low back pain progression and is not predictive of acute-to-chronic pain transition
Authors: Elgaeva Elizaveta E. , Trbojević-Akmačić Irena , Ugrina Ivo , Vilaj Marija , Slana Anita , Pribic Tea , Tsepilov Yakov A. , Karssen Lennart C. , Aulchenko Yurii S. , Dagostino Concetta , Allegri Massimo , Skelin Andrea , Primorac Dragan , Buyse Klaas , Van Zundert Jan , Lauc Gordan , Williams Frances M.K. , Freidin Maxim B.
Published: November 2024

Aims

To investigate if the plasma N-glycome would provide a biomarker of acute-to-chronic low back pain (LBP) transition.

Patients & Methods

A prospective longitudinal sample of n = 1,114 individuals enrolled at the first ever episode of LBP and followed-up for three months. Total plasma N-glycome was measured and compared at the baseline and follow-up.

Results

Initial pro-inflammatory patterns of plasma N-glycome change to normal levels between baseline and follow-up in those who resolved from LBP, but not in those who remained at pain after three months. Baseline levels of N-glycans were not predictive of the risk of chronic LBP at follow-up.

Conclusion

Total plasma N-glycan levels may reflect ongoing inflammation that is aberrant and promotes ongoing pain and chronicity of symptoms.
Performance characteristics and potential public health impact of improved pre-erythrocytic malaria vaccines targeting childhood burden
Authors: Malinga Josephine , Braunack-Mayer Lydia , Masserey Thiery , Cavelan Aurélien , Chandramohan Daniel , Dicko Alassane , Ouédraogo Jean-Bosco , Kelly Sherrie L , Le Rutte Epke A , Nekkab Narimane , Penny Melissa A
Published: November 2024

New malaria vaccine development builds on groundbreaking recommendations and roll-out of two approved pre-erythrocytic vaccines (PEVs); RTS,S/AS01 and R21/MM. Whilst these vaccines are effective in reducing childhood malaria within yearly routine immunization programs or seasonal vaccination, there is little evidence on how different PEV efficacies, durations of protection, and spacing between doses influence the potential to avert uncomplicated and severe childhood malaria. Mainly, lacking understanding of the required vaccine properties and delivery strategies that lead to an effective childhood vaccine with multi-year protection. We used an individual-based model of malaria transmission informed by trial data to quantify trade-offs between PEV performance properties and impact across different endemicities, deployment schedules, and coverage levels.

We found that deploying a vaccine with 90% initial efficacy, with a six to 12-month half-life duration of protection, co-administered with a blood-stage drug, followed by yearly boosters, results in 60-80% yearly incidence reduction, consistent with seasonal RTS,S and R21 trials. Halting vaccination after five years, leads to sustained protection of at least a 35% incidence reduction in children <six years in the 12 months following cessation in settings wherePfPR2-10<30%. Increasing the half-life duration to 12 -18 months or reaching more children provides the same health impact with lower vaccine efficacy. Without a booster (fourth dose), high efficacy (>90%) and longer half-life duration (>12 months) are required to sustain impact beyond primary vaccination, averting up to half the preceding year’s burden. The contribution of each property to the overall impact varies by setting and clinical endpoint, indicating that public health goals should dictate key vaccine performance criteria.

Overall, our findings support the need for well-defined target product profiles for long duration vaccines linking priority use cases of where, how, and to whom to deploy new malaria vaccines, to maximize public health impact.
The mitotic CIP2A-TOPBP1 axis facilitates mitotic pathway choice between MiDAS and MMEJ
Authors: Martin Peter R , Nieminuszczy Jadwiga , Kozik Zuza , Jakub Nihal , Lecot Maxime , Vorhauser Julia , Lane Karen A , Kanellou Alexandra , Mansfeld Jörg , Pearl Laurence H , Oliver Antony W , Downs Jessica A , Choudhary Jyoti , Day Matthew , Niedzwiedz Wojciech
Published: November 2024

Mitotic DNA double-strand breaks (DSBs) accumulate in response to replication stress or BRCA1/2 deficiency posing a significant threat to genome stability as repair by non-homologous end-joining (NHEJ) and homologous recombination (HR) is inactivated in mitosis. Mitotic cells instead rely on the mechanisms of microhomology mediated end-joining (MMEJ) and mitotic DNA synthesis (MiDAS). However, how these pathways are regulated in mitosis remains unknown. Here we reveal the CIP2A-TOPBP1 complex facilitates recruitment of SMX complex components to mitotic chromatin marked by CIP2A, through a CDK1-dependent interaction between TOPBP1 BRCT 1/2 and SLX4 phospho-threonine1260, that drives MiDAS. Furthermore, CIP2A promotes the recruitment of Polθ to facilitate mitotic MMEJ. This defines a mechanistic framework for mitotic DSB repair, where simultaneous disruption of MiDAS and MMEJ pathways underpins the synthetic lethality observed in BRCA1/2-deficient cells following CIP2A depletion. These findings provide critical insights into mitotic DNA repair and highlights therapeutic opportunities in HR deficient tumours.
Synergistic effects of tRNA modification defects inEscherichia coliK12
Authors: Bacusmo Jo Marie , Babor Jill , Hu Jennifer , Cao Bo , Kellner Stefanie , Szkrybalo Sierra , Yuan Yifeng , Sander Serena , Kuipers Paul , deMott Michael , Mori Hirotada , Dedon Peter , de Crécy-Lagard Valérie
Published: November 2024

tRNAs are the central adaptor molecule in translation and require a wide variety of post-transcriptional modifications to fulfill their functions. The model gram-negativeEscherichia coliK-12 is one of the handfuls of bacteria where all the tRNA modifications and corresponding genes have been characterized. This work dissects epistatic relationships between tRNA modification genes inE. coliby conducting a synthetic lethal screen revealing 5 pairs of modifications that cannot be deleted in combination when cells are grown in rich media, and 15 pairs of modifications that lead to growth defects when deleted in combination. ThetruAgene involved in the insertion of Psi residues at positions 38 to 40 in multiple tRNAs gave the highest number of synthetic lethality phenotypes that could be complemented by the expression of thetruAgenein transand in some cases suppressed by the overexpression of target tRNAs. A pilot phenotype screen of strains lacking two tRNA modifications genes viable in rich media lead to the identification of growth conditions that exhibited poor growth. This work lays the foundation to dissect the role of modifications in tRNA quality control.
Immune Evasion, Cell-Cell Fusion, and Spike Stability of the SARS-CoV-2 XEC Variant: Role of Glycosylation Mutations at the N-terminal Domain
Authors: Li Pei , Faraone Julia N. , Hsu Cheng Chih , Chamblee Michelle , Liu Yajie , Zheng Yi-Min , Xu Yan , Carlin Claire , Horowitz Jeffrey C. , Mallampalli Rama K. , Saif Linda J. , Oltz Eugene M. , Jones Daniel , Li Jianrong , Gumina Richard J. , Bednash Joseph S. , Xu Kai , Liu Shan-Lu
Published: November 2024

SARS-CoV-2 continues to evolve, producing new variants that drive global COVID-19 surges. XEC, a recombinant of KS.1.1 and KP.3.3, contains T22N and F59S mutations in the spike protein’s N-terminal domain (NTD). The T22N mutation, similar to the DelS31 mutation in KP.3.1.1, introduces a potential N-linked glycosylation site in XEC. In this study, we examined the neutralizing antibody (nAb) response and mutation effects in sera from bivalent-vaccinated healthcare workers, BA.2.86/JN.1 wave-infected patients, and XBB.1.5 monovalent-vaccinated hamsters, assessing responses to XEC alongside D614G, JN.1, KP.3, and KP.3.1.1. XEC demonstrated significantly reduced neutralization titers across all cohorts, largely due to the F59S mutation. Notably, removal of glycosylation sites in XEC and KP.3.1.1 substantially restored nAb titers. Antigenic cartography analysis revealed XEC to be more antigenically distinct from its common ancestral BA.2.86/JN.1 compared to KP.3.1.1, with the F59S mutation as a determining factor. Similar to KP.3.1.1, XEC showed reduced cell-cell fusion relative to its parental KP.3, a change attributed to the T22N glycosylation. We also observed reduced S1 shedding for XEC and KP.3.1.1, which was reversed by ablation of T22N and DelS31 glycosylation mutations, respectively. Molecular modeling suggests that T22N and F59S mutations of XEC alters hydrophobic interactions with adjacent spike protein residues, impacting both conformational stability and neutralization. Overall, our findings underscore the pivotal role of NTD mutations in shaping SARS-CoV-2 spike biology and immune escape mechanisms.