bluuebunny/crossref_metadata_2025 huggingface dataset:
Total Prostate-Specific Antigen (PSA) Testing in Capillary Samples: Proof-of-Principle and Feasibility Study for Home Self-Testing for Prostate Cancer
Authors: Sodi Ravinder , Young Noel , Tetucci Alessandra , Woolley Timothy , Shah Vishal , Maund Isabella
Published: December 2024

Background

There is growing interest in the use of capillary blood sampling (CBS) for testing biochemical analytes owing to the advantages it offers including home surveillance of chronic conditions. In this study, we aimed to determine whether the use of CBS was a viable and feasible method for testing total prostate-specific antigen (TPSA) concentrations in men with prostate disease.

Methods

Men with known prostate disease were recruited from a urology clinic where they were being treated or followed up. Samples were collected in serum separating tubes by the finger-prick method using validated devices. Simultaneously, venous blood was collected by venipuncture. We used validated immunoassays on both the Roche (Cobas 801) and Beckman (DXi) platforms to measure TPSA.

Results

In total, 66 adult men between 26 and 64 years of age were tested. Across the concentration range of normal (0.3 µg/L) to pathological (314 µg/L), the results between CBS and venous samples were highly comparable and correlated (r = 0.997). The average bias was 0.112 µg/L or 1.07% and was not significant (P = 0.274). Overall, there was no apparent proportional or constant bias observed. Our data showed that TPSA may be stable in CBS stored at ambient temperature for up to 8 days in the samples tested using either the Roche or Beckman assays.

Conclusions

This feasibility study shows that CBS and venous samples are highly correlated and there was negligible bias. Further validation work is now required for the measurement of TPSA in CBS and determining outcomes in men with prostate disease.
A novel tank-mix formulation increases the efficacy of alphabaculoviruses on different phylloplanes
Authors: Mehrvar Ali , Ghanbari Solmaz , Söylemezoğlu Gökhan , Toprak Umut
Published: December 2024

Spodoptera littoralis Boisduval (Lepidoptera: Noctuidae) and Spodoptera exigua Hübner (Lepidoptera: Noctuidae) pose substantial threats to many crops, necessitating the exploration of biopesticides as potential chemical alternatives. One alternative is baculoviruses; however, their instability in the field has hindered their widespread use. Host plant phylloplane affects baculovirus activity at varying levels in different host plants. Formulation contributes significantly to optimizing the baculoviral stability on different phylloplanes against environmental conditions; however, it is expensive and difficult to make in developing or nondeveloped countries. In the current study, we developed a simple tank-mix application (MBF-Tm5) for immediate use, resembling the characteristics of a suspension concentrate formulation for Spodoptera littoralis nucleopolyhedrovirus (SpliNPV) and Spodoptera exigua multiple nucleopolyhedrovirus (SeMNPV). We examined their biological activity against 2nd instar larvae first on an artificial diet under laboratory conditions and on eggplant and pepper phylloplane in greenhouse conditions compared to plain viruses. This formulation exhibited no significant improvement in the biological activity of both viruses on an artificial diet under laboratory conditions but significantly improved the biological activity of both viruses on both plants under greenhouse conditions. The original activity remaining (OAR%) of both unformulated and formulated viruses decreased over time under greenhouse conditions; however, the OAR value of both viruses on eggplants was significantly higher than on pepper plants. Overall, the tank-mix simple formulation of baculoviruses might be a great alternative for improved stability in nature, providing better control.
Characteristics of structurally finite classes of order-preserving three-valued logic maps
Authors: Esin Anton A
Published: December 2024

This paper investigates structural properties of monotone function classes within the framework of three-valued logic (3VL), aiming to characterize dependencies and constraints that ensure structural finiteness and order-preserving properties. This research delves into characteristics of structurally finite classes of order-preserving 3VL map. Monotonicity plays a critical role in understanding functional behaviour, which is essential for structuring closed logical operations within $ P_{k} $. We define $ F $ as a closed class in $ P_{k} $, consisting only of mappings that comply with specified operations and are strictly confined to $ P_{k} $. The notation $ F(n) $ represents the subset of mappings in $ F $ dependent on $ n $ variables, highlighting the limited scope of inputs and their respective outputs. Further analysis through $ CR(F) $ facilitates the identification of precursor subclasses within $ F $, which have not yet achieved closure under all necessary operations—a pivotal step in constructing intermediate mapping classes. Within the framework of 3VL, the study examines order-preserving maps $ f_{D}, f_{K}, f_{M^{(2)}}, f_{DM^{(2)}}, f_{KM^{(2)}} $, deliberately excluding the sets $ D, K, M^{(2)} $, where $ DM^{(2)} $ is defined as $ D \cap M^{(2)} $ and $ KM^{(2)} $ as $ K \cap M^{(2)} $. The lattice framework in $ P_{k}(1) $ for $ k = 3 $ systematically organizes these mapping classes based on their completeness properties, with particular emphasis on classes such as $ M $, which is characterized as a comprehensive set governed by the operations of maximum and minimum.

Our theorems establish structural finiteness for classes of unary order-preserving maps, emphasizing their two-variable dependency in class construction. This study extends existing findings on single-variable monotonic functions within 3VL by integrating criteria of linear order. Key results include the classification of mapping classes $ F \subseteq M $ containing $ M^{(1)}_{3} $, categorized into distinct groups: $ M^{(1)}_{3}, KM^{(2)}, DM^{(2)}, M^{(2)}, K, D, M $. Inclusion relations are visualized diagrammatically, showing the hierarchical structure of these monotone classes, ultimately validating the structural finiteness of classes incorporating all unary order-preserving maps within the broader context of 3VL.
Probabilistic Richardson extrapolation
Authors: Oates Chris J , Karvonen Toni , Teckentrup Aretha L , Strocchi Marina , Niederer Steven A
Published: December 2024

For over a century, extrapolation methods have provided a powerful tool to improve the convergence order of a numerical method. However, these tools are not well-suited to modern computer codes, where multiple continua are discretized and convergence orders are not easily analysed. To address this challenge, we present a probabilistic perspective on Richardson extrapolation, a point of view that unifies classical extrapolation methods with modern multi-fidelity modelling, and handles uncertain convergence orders by allowing these to be statistically estimated. The approach is developed using Gaussian processes, leading to Gauss–Richardson Extrapolation. Conditions are established under which extrapolation using the conditional mean achieves a polynomial (or even an exponential) speed-up compared to the original numerical method. Further, the probabilistic formulation unlocks the possibility of experimental design, casting the selection of fidelities as a continuous optimization problem, which can then be (approximately) solved. A case study involving a computational cardiac model demonstrates that practical gains in accuracy can be achieved using the GRE method.
Simultaneous triple peptic perforations: a report of an extremely rare case
Authors: La Van Phu , Tong Hai Duong , La Vinh Phuc , Le Thanh Nhat Minh , Tran Quan Minh , Dang Cong Phi , Doan Anh Vu
Published: December 2024

Peptic ulcer perforations are common in surgical emergencies, whereas double perforations are rare, and triple peptic perforations are even exceedingly rare, with only a few cases documented. While undetected perforation during surgery can be fatal, the absence of standardized procedures for managing multiple perforations remains an ongoing challenge for surgeons. Herein, we describe a rare case of simultaneous triple peptic perforations in an elderly man with a prolonged history of analgesic and corticosteroid use. This case underscores the importance of screening multiple peptic perforations intraoperatively. Subtotal gastrectomy is suggested as an effective option when simple closure of perforations is infeasible.
Perforation of sigmoid colon by a migrated intrauterine contraceptive device (IUCD), diagnosis and surgical management: a case report
Authors: Khan Muhammad E A , Kelly Elaine , Haidaran Ahmed I D
Published: December 2024

We describe the case of a 43-year-old woman presented with an 8-month history of intermittent non-specific abdominal pain. She had an Intrauterine Contraceptive Device (IUCD) inserted 4-years ago and the device was still in-situ. After initial gynaecological assessment, further clinical radiological investigations, computerized tomography imaging showed that the intraluminal part of the radiological foreign body was seen to be possibly perforating the sigmoid colon after having migrated. Diagnostic laparoscopy confirmed this and a laparotomy was performed to remove the foreign body (IUCD) followed by primary closure of the defect in the sigmoid colon.
Clinical outcomes and complications of retained biliary stents during the COVID-19 pandemic: a case series
Authors: Kandel Bishnu P , Luitel Prajjwol , Shrestha Asim , Sharma Deepak , Manandhar Narendra , Maskey Sumita P , Bhandari Ramesh S , Lakhey Paleswan J
Published: December 2024

Biliary stents are widely used following endoscopic management of choledocholithiasis. Removal is recommended within 3–6 months to prevent complications. This study analyzed cases of retained biliary stents managed at our institution. Data on patient demographics, duration of stent retention, complications, and management outcomes were collected and analyzed. The mean age of the patients was 60 years (range: 50–82), and the mean stent retention duration was 29.5 months (range: 12–52 months). Acute cholangitis (83.3%) was the most frequent clinical presentation. Endoscopic stone removal was successful in two cases (33.3%), while the remaining four required open bile duct exploration due to technical challenges. Retained biliary stents are associated with severe complications such as recurrent choledocholithiasis and acute cholangitis, often necessitating invasive interventions. These findings underscore the critical importance of timely stent retrieval to minimize morbidity.
A pipeline for validation of Serendipita indica effector-like sRNA suggests cross-kingdom communication in the symbiosis with Arabidopsis
Authors: Nasfi Sabrine , Shahbazi Saba , Bitterlich Katharina , Šečić Ena , Kogel Karl-Heinz , Steinbrenner Jens
Published: December 2024

Bidirectional communication between pathogenic microbes and their plant hosts via small RNA (sRNA)-mediated cross-kingdom RNAi (ckRNAi) is a key element for successful host colonization. Whether mutualistic fungi of the Serendipitaceae family, known for their extremely broad host range, use sRNAs to colonize plant roots is still under debate. To address this question, we developed a pipeline to validate the accumulation, translocation, and activity of fungal sRNAs in post-transcriptional silencing of Arabidopsis thaliana genes. Using stem–loop quantitative reverse transcription–PCR, we detected the expression of a specific set of Serendipita indica (Si) sRNAs, targeting host genes involved in cell wall organization, hormonal signalling regulation, immunity, and gene regulation. To confirm the gene silencing activity of these sRNAs in plant cells, SisRNAs were transiently expressed in protoplasts. Stem–loop PCR confirmed sRNA expression and accumulation, while qPCR validated post-transcriptional gene silencing of their predicted target genes. Furthermore, Arabidopsis ARGONAUTE 1 immunoprecipitation revealed the loading of fungal SisRNAs into the plant RNAi machinery, suggesting the translocation of SisRNA from the fungus into root cells. In conclusion, this study provides a blueprint for rapid selection and analysis of sRNA effectors and further supports the model of cross-kingdom communication in the Sebacinoid symbiosis.
Detection and Successful Treatment of Gunshot Wound to the Femoral Artery and Vein Four Days Post-incident: A Case Study
Authors: Yatsun Vladyslav , Yatsun Oleksandr
Published: December 2024

This case study presents the successful treatment of a 26-year-old male who experienced profuse bleeding from a gunshot wound to his thigh 4 days after the initial injury. The patient underwent surgery performed by a military vascular surgeon, during which previously undetected injuries to the femoral artery and vein were identified. The surgeon conducted a femoral artery alloprosthesis and sutured the damaged femoral vein. Following the surgery, the patient received post-operative conservative treatment and vacuum-assisted closure therapy, resulting in no complications or development of irreversible ischemic manifestation. The clinical case demonstrates the possible positive effects of placing an endovascular balloon in the main artery (more proximal lesion) for prolonged bleeding control without the use of a tourniquet. In this case, the role of the endovascular balloon was played by a hematoma. As a result, the lower extremity survived 4 days before the arterial blood flow reconstruction was done. Although such a model of bleeding control is absolutely unacceptable for planned specialized surgery or even military surgery at a medical assistance level of II-III, it may be considered as a lifesaving measure when surgical intervention is not immediately available.
A general strategy for engineering GU base pairs to facilitate RNA crystallization
Authors: Ren Yangyi , Lin Xiaowei , Liao Wenjian , Peng Xuemei , Deng Jie , Zhang Zhe , Zhan Jian , Zhou Yaoqi , Westhof Eric , Lilley David M J , Wang Jia , Huang Lin
Published: December 2024

X-ray crystallography is a fundamental technique that provides atomic-level insights into RNA structures. However, obtaining crystals of RNA structures diffracting to high resolution is challenging. We introduce a simple strategy to enhance the resolution limit of RNA crystals by the selective substitution of Watson–Crick pairs by GU pairs within RNA sequences. Our approach has successfully yielded high-resolution structures for eight unique RNA crystals. Notably, six instances showed marked resolution enhancement upon GC/AU to GU base pair substitution, with two cases achieving high-resolution structures from initially poor data. In one case, reverting GU to GC base pairs also improved resolution. Our method facilitated the first structural determinations of the Long Interspersed Nuclear Element-1 and Olfactory Receptor family 4 subfamily K member 15 ribozymes, the 2′-deoxyguanosine-III riboswitch and the Broccoli RNA aptamer. The placement of GU base pairs within the first 5′ helical stem of any given RNA species, or in one peripheral stem, is shown to be sufficient. These results offer a simple and effective approach for designing sequences or selecting sequences from homologous sequences, for high-resolution RNA structure determination.
The impact of traumatic brain injury on visual processing: a neuro-ophthalmological perspective
Authors: Tukur Hajar Nasir , Uwishema Olivier , Sheikhah Dalal , Akbay Hatice , Chehab Tarek Emir , Wellington Jack
Published: December 2024

Introduction

Traumatic brain injury (TBI) is a critical global health issue characterized by perturbance in cerebral function attributed to mechanical force. TBI often precipitates significant visual impairment that negatively impacts the patients’ quality of life. This review examines the effects of TBI on visual function from a neuro-ophthalmological perspective, focusing on the assessment, diagnostics, and management of associated sequelae.

Methods

A comprehensive literature review was conducted using PubMed/MEDLINE, ScienceDirect, and Google Scholar to garner and collate relevant data.

Results

TBI may result in visual field defects, ocular motor dysfunction, insufficiency of accommodation, and photosensitivity. Early detection remains a profound challenge, partly due to a dearth of standardized protocols for evaluating visual impairment. Diagnostic methodologies include visual field testing, ocular motility assessments, and fundus photography, while rehabilitation approaches encompass vision therapy and low-vision rehabilitation.

Conclusion

Establishing hospital-based multidisciplinary teams is essential for effectively addressing TBI-related visual impairment. Future research should prioritize evidence-based treatment protocols and explore diverse vision rehabilitation strategies through large-scale studies.
The association between comprehensive dietary antioxidant index and erectile dysfunction in adult men: a cross-sectional study from the 2001-2004 U.S. National Health and Nutrition Examination Survey
Authors: Liu Meijun , Zhang Peihai
Published: December 2024

Background

Increasing evidence suggests that a diet rich in antioxidants may prevent erectile dysfunction (ED), but the impact of comprehensive dietary antioxidants on ED has been little studied.

Aim

To investigate the association between the composite dietary antioxidant index (CDAI) and ED risk in adult men.

Methods

The study performed a cross-sectional analysis using data from the 2001-2004 National Health and Nutrition Examination Survey to investigate the association between the composite dietary antioxidant index (CDAI) and ED. The connection between the CDAI and ED was assessed using univariate and multivariate weighted logistic regression models, as well as the restricted cubic spline.

Outcomes

Association between the CDAI and the prevalence of ED.

Results

The study included a total of 3699 participants, among whom 1042 were diagnosed with ED, resulting in a prevalence of 28.17%. Multivariate weighted logistic regression consistently showed a negative association between the CDAI and ED (OR = 0.95, 95% CI: 0.92-0.98, P = .005). The group with the highest CDAI (Q4) had a 33% reduced risk of ED than the group with the lowest CDAI (Q1) when the CDAI was regarded as a categorical variable (OR = 0.67, 95% CI: 0.49-0.91, P = .014). Restricted cubic spline analysis showed that the CDAI was linearly related to the risk of ED (non-linearity P = .652). Furthermore, subgroup analysis indicated that the inverse relationship between CDAI and ED was more pronounced in individuals under 60 years of age, those with diabetes, and those without hypertension.

Clinical Implications

Dietary strategies to increase antioxidant intake might offer a potential approach to reducing ED risk and supporting men’s sexual health.

Strengths and Limitations

This is a large-scale study investigating the association between the CDAI and ED. However, as a cross-sectional study, the timeliness of the dataset and the recall bias inherent in dietary data somewhat limit the reliability of the results.

Conclusion

This study identified a significant inverse association between the CDAI and ED risk among adult men in the United States; however, as a cross-sectional study, this research cannot establish causation, and further longitudinal studies are needed to validate these findings and provide more definitive evidence.
Preventing Clostridioides difficile Infection Recurrence
Authors: Nackerdien Zeena
Published: December 2024

Nurses safeguard patients with proven practices.
Whooping Cough Cases Are on the Rise in the United States
Authors: Roush Karen
Published: December 2024

Decreased vaccine coverage and waning immunity are cited as factors.
Salaries for RNs and LPNs Rose in 2023 for Third Consecutive Year
Authors: Roush Karen
Published: December 2024

NPs also saw gains, but only slightly above the rate of inflation.
Sustainability in Reconstructive Breast Surgery: An Eco-audit of the Deep Inferior Epigastric Perforator Flap Pathway
Authors: Ahmed Zahra , Zargaran Alexander , Zargaran David , Sousi Sara , Hakimnia Keiron , Panagiota Glynou Sevasti , Davies Julie , Hamilton Stephen , Mosahebi Afshin
Published: December 2024

Background:

The deep inferior epigastric perforator (DIEP) flap provides an effective and popular means for autologous breast reconstruction. However, with the complexity of the pathway, the environmental impact of the pathway has yet to be evaluated.

Methods:

A retrospective analysis of 42 unilateral DIEPs at a single reconstructive center was performed. Process mapping and life-cycle analyses were performed for equipment, staff, patients, and land. A bottom-up approach was adopted to calculate carbon dioxide equivalent estimates for the initial consultation, preoperative, intraoperative, and immediate postoperative periods.

Results:

This study estimated the carbon footprint of a patient undergoing DIEP flap surgery to be approximately 233.96 kg CO2eq. Induction, maintenance, and running of anesthesia had the highest overall contribution to the carbon footprint (158.17 kg CO2eq, 67.60% overall). Patient and staff travel contributed more than 15% overall carbon emissions in this study. The impact of sterilization was less than half of that from waste management (0.81 versus 1.81 kg CO2eq, respectively). Waste management alone contributed 4.21 kg CO2eq of the overall carbon emissions, the majority of which was accountable to the incineration of 14.75 kg of noninfectious offensive waste.

Conclusions:

This study estimates the carbon footprint of the DIEP pathway. Strategies to mitigate the impact of carbon emissions including usage of reusable vs single-use equipment, virtual consultations, standardization of equipment packs, and optimizing waste disposal were suggested areas for improvement. Data from manufacturers on life-cycle assessments were limited, and further work is needed to fully understand and optimize the impact of DIEP surgery on the environment.
LRP4 mutations promote tumor progression and resistance to anti-PD-1 therapy in recurrent hepatocellular carcinoma
Authors: Sun Rongqi , Liu Kaixuan , Pan Siyuan , Ye Yuhang , Li Ning , Chen Shuangyi , Cui Xinyi , Zhang Yuxi , Chen Long , Pan Jingyue , Hu Zhiqiang , Luo Chubin , Fan Jia , Zhou Zhengjun , Zhou Shaolai , Zhou Jian
Published: December 2024

Background and Aims:

HCC recurrence is a major factor limiting long-term survival and the cause of most deaths in patients with HCC. However, molecular characterization and potential therapeutic targets of recurrent HCC remain mostly unknown.

Approach and Results:

We performed whole-exome sequencing in 63 matched primary and recurrent HCC tumors and combined the data with whole-genome sequencing results in 43 paired samples from our previous study. Sanger sequencing was used to identify all low-density lipoprotein receptor-related protein 4 (LRP4) coding exons in 203 additional patients with recurrent HCC. We identified LRP4 somatic mutations in 7.8% (24/309) of recurrent tumors and only 0.97% (3/309) of primary tumors (p<0.001). Prognosis after the second liver resection was poorer in patients with an LRP4 mutation. Biofunctional investigations demonstrated that inactivating LRP4 mutations promoted tumor progression and immunosuppression. Mechanistically, mutated LRP4 reduced intratumoral conventional type 1 dendritic cell and CD8+ T cell infiltration by repressing C-C motif chemokine ligand 4 expression and secretion through activation of β-catenin signaling, resulting in resistance to anti-programmed cell death protein-1 therapy. Patients with recurrent HCC carrying an LRP4 mutation did not benefit from anti-programmed cell death protein-1 treatment after their second resection surgery. A β-catenin inhibitor–reversed LRP4-induced resistance to anti-programmed cell death protein-1 therapy in humanized tumor-bearing mice.

Conclusions:

Our results identified novel LRP4 mutations important in recurrent HCC. Inactivating LRP4 mutations were associated with resistance to anti-programmed cell death protein-1 therapy and could be useful biomarkers for precision therapy in patients with recurrent HCC.
Mindfulness Smartphone Application Implementation to Impact Stress and Burnout in Adult Healthcare Professionals
Authors: White Peggi , Williams Rhonda , Harrington Jamie
Published: December 2024

Many healthcare professionals are experiencing increased stress and burnout, worsened by the COVID-19 pandemic, leading to negative individual and organizational outcomes such as mental illness, maladaptive coping, job dissatisfaction, poor patient care, and higher turnover costs. Mindfulness practice is a promising evidence-based approach to impact stress and burnout. This quality improvement pilot project evaluated the impact of a free mindfulness smartphone application on stress and burnout levels in certified or licensed adult healthcare professionals over 6 weeks. Using a quasi-experimental pre- and post-intervention design, the project assessed the Mindfulness Coach application’s (app) impact on stress and burnout using the Perceived Stress Scale and the Mini Z 2.0 survey. The results indicated that using the app significantly reduced perceived stress but did not impact burnout symptoms.
Transforming the logistics of liver transplantation with normothermic machine perfusion: Clinical impact versus cost
Authors: Gao Qimeng , Alderete Isaac S. , Aykun Nihal , Samy Kannan P. , Nauser Christopher L. , Raigani Siavash , DeLaura Isabel F. , Kahan Riley , Anwar Imran J. , Abraham Nader , Dunkman W. Jonathan , Miller Timothy E. , King Lindsay Y. , Berg Carl L. , Vikraman Deepak S. , Ravindra Kadiyala , Rege Aparna S. , Collins Bradley H. , McElroy Lisa M. , Jamieson Ian , Knechtle Stuart J. , Sudan Debra L. , Barbas Andrew S.
Published: December 2024

Normothermic machine perfusion (NMP) facilitates the utilization of marginal liver allografts. It remains unknown whether clinical benefits offset additional costs in the real-world setting. We performed a comparison of outcomes and hospitalization costs for donor livers preserved by NMP versus static cold storage at a high-volume center. Adult patients receiving deceased donor liver transplants preserved by either NMP (TransMedics Organ Care System) or static cold storage between January 1, 2021, and December 31, 2023, were included. Donor and recipient characteristics, operative parameters, post-transplant outcomes, and hospitalization costs were compared. A total of 144 NMP and 149 static cold storage cases were included. A higher proportion of NMP cases were donation after circulatory death (38.2% vs. 4.7%, p<0.001). Despite a significantly higher Liver Donor Risk Index (2.1 vs. 1.7, p<0.001) and longer preservation time (877 vs. 355 min, p<0.001), recipients of NMP experienced lower rates of reperfusion syndrome (4.3% vs. 32.9%, p<0.001), less blood loss (1.5 vs. 3.0 L, p<0.001), and required less blood product transfusion. This resulted in shorter operative time for NMP cases (357 vs. 438 min, p<0.001) and significant reductions in both intensive care unit (3 vs. 5 d, p=0.005) and hospital length of stay (11 vs. 13 d, p=0.03). NMP facilitated the transition of cases to daytime hours (88.9% vs. 46.3%, p<0.001). Despite the clinical and logistical benefits observed, index hospitalization costs were significantly higher in the NMP cohort ($256,810 vs. $209,144, p<0.001), driven largely by higher organ acquisition costs ($135,930 vs. $50,940, p<0.001). In conclusion, utilization of NMP comes with an attendant increase in cost but provides substantial clinical benefit. Transplant programs must weigh these considerations in their practice environments before initiating an NMP program.
The status of maternal syphilis in India: status quo?
Authors: Kuppusamy Periyasamy , Sachdeva Geetanjali , Gajbhiye Rahul K. , Nagarajan Muruganandam
Published: December 2024

Syphilis is a major public health concern particularly in vulnerable populations. Maternal syphilis mainly causes congenital syphilis, which contributes to the high risk of stillbirth. Data on the prevalence and trends of maternal syphilis in the Indian population are very limited. This narrative review assesses current trends, geographic distribution, and determinants of syphilis in pregnancy and its potential impact on birth outcomes. The incidence of syphilis is increasing worldwide, the seroprevalence of syphilis in pregnancy among Indian women was 0.14% in 2015, and the prevalence was lower (0.10%) in the following HIV sentinel surveillance year from 2016–2017 to 2020–2021. Population-based screening for syphilis during pregnancy is very low (<25%) in low-income and middle-income countries (LMICs), and the screening rate is even lower in India (37%). As syphilis cases is on the rise globally, the public health workforce needs to increase screening rates and effectively implement existing guidelines in Indian medical settings.
A retrospective cohort studying about time to recovery and its predictors among children aged 6–59 months admitted with severe acute malnutrition to inpatient therapeutic feeding centers at public hospitals in west Shoa Zone, Western Ethiopia.2022 G.C.
Authors: Mekonnen Chala , Abebe Mitsiwat , Mosisa Wagari
Published: December 2024

Background:

World Health Organization recommends in patient therapeutic feeding program as a standard treatment protocol for the management of complicated severe acute malnutrition. This program has been decentralized to public hospitals in Ethiopia. Early recovery is a performance indicator for severe acute malnourished children for the therapeutic feeding.

Objective:

The aim of the study was to assess time to recovery and its predictors among children aged 6-59 months admitted with severe acute malnutrition to inpatient therapeutic feeding centers at hospitals in west Shoa zone, Ethiopia.

Methods:

Institution based retrospective cohort study was conducted on 428 children aged 6 to 59 months admitted with Severe Acute malnutrition cases at selected hospitals in West Shewa zone from January 1, 2017 to December 30, 2021. A total of 428 charts were selected using a systematic random sampling method and 395 of them were used for the final analysis. Kaplan–Meier estimates and survival curve were used to estimate the survival time, log-rank test was used compare survival time between groups of categorical variables, and Cox-proportional hazard model was used to identify significant predictor of the time to recovery. P value <0.05 was considered statistically significant.

Results:

The nutritional of recovery rate was 81.27% (95% CI; 77.09-84.83) with a median nutritional recovery time of 15 days (IQR; 10). The predictors of time to recovery were having HIV (AHR = 0.31, 95% CI, 0.14-0.66), Tuberculosis (AHR = 0.25, 95% CI, 0.16-0.38), not breast feeding until 24 months (AHR = 0.29, 95% CI, 0.22-0.41), partially vaccinated for age (AHR = 0.43, 95% CI, 0.31-0.61), Admitted during production season (AHR = 0.49, 95% CI, 0.37-0.67) and not took deworming (AHR = 0.60, 95% CI, 0.48-0.75) were associated with longer periods of nutritional recovery time.

Conclusion and recommendations:

Both percentage of recovery and the recovery time were within the acceptable minimum standards. But special attention has to be given to children who having HIV, Tuberculosis, breast feeding less than 24 months, partially vaccinated for their age, children admitted during production season and not supplementing with deworming during inpatient management. The health workers with different stages of health administer must increase the awareness of breastfeeding, fully vaccination and ways of preventing communicable disease.
Genetic evidence of circulating metabolites linking to gastric cancers: a two-sample Mendelian randomization study
Authors: Haiwen Yu , Yongjian Liu , Penglong Xie , Wanting Feng , Dongchu Xu
Published: December 2024

Observational studies have implicated that blood metabolites were correlated with gastric cancer. This study was designed to reveal the potential causal link between gastric cancer and the levels of circulating metabolites. Single-nucleotide polymorphisms associated with lipid traits in univariate analysis were obtained from the Genome Wide Association Study (GWAS) repositories, involving 8299 European individuals, respectively. Blood metabolites in multivariate analysis were obtained from the latest GWAS Catalog, covering 850 known and 241 unknown metabolites, plus 309 metabolite ratios. Data on gastric cancer were obtained from the FinnGen Consortium, including 279 444 individuals of European descent, 1037 cases of which were gastric cancer. Subsequently, MR analysis was performed using conventional methods, including inverse variance-weighted, weighted median, weighted-mode, simple-mode and MREgger regression to demonstrate the causal relationship between circulating metabolites and gastric cancer. Two-sample Mendelian randomization method showed that seven circulating metabolites (X-24588, SAH to ribothymidine ratio, histidine to asparagine ratio, 1-dihomo-linolenylglycerol, ribothymidine, 2-linoleoylglycerol levels, and 2ʹ-o-methyluridine) were causally associated with the risk of gastric cancer. After verification of MR results and meta-analysis, levels of histidine to asparagine ratio, SAH to ribothymidine ratio, and 2ʹ-o-methyluridine consistently achieved statistical significance. Furthermore, histidine metabolism was identified as the most significant metabolic pathway. It is indicated that three circulating metabolites (histidine to asparagine ratio, SAH to ribothymidine ratio, and 2ʹ-o-methyluridine) achieved statistical significance in the casual relationship with the occurrence of gastric cancer, indicating that histidine metabolism may serve as the crucial metabolic pathway and therapeutic targets for gastric cancer.
The diagnostic dilemma of adult-onset Still’s disease: a case report
Authors: Yadav Manoj Kumar , Rauniyar Aarati , Magar Lalkiran Gharti , Rouniyar Sangam , Adhikari Bigyan , Sah Sandip Kumar
Published: December 2024

Introduction and importance:

Adult-onset Still’s disease (AOSD) is a rare auto-inflammatory disorder, characterized by high-grade fever, arthritis, and a variety of systemic signs/symptoms. AOSD is very often misdiagnosed because of the overlapping clinical features, necessitating a thorough differential diagnosis, especially in cases of fever of unknown origin (FUO).

Case presentation:

A 55-year-old male with high-grade fever, myalgia, and arthralgia for the past 4 weeks. Yamaguchi criteria for AOSD met following an extensive evaluation. Laboratory findings showed leukocytosis with neutrophilic predominance, elevated ferritin levels, and mild abnormalities in liver function tests. The patient was started on intravenous corticosteroids, followed by oral corticosteroids in tapering dose of the drug and the introduction of methotrexate as a steroid-sparing agent (DMARDs).

Clinical discussion:

The case illustrates the diagnostic challenges associated with AOSD in older persons and the importance to consider this condition in the context of a FUO. The diagnosis of AOSD remains exclusive, yet effective management typically involves corticosteroids and DMARDs.

Conclusion:

AOSD, though rare, can occur uncommonly in older populations. This case highlights the need for awareness among clinicians to ensure early diagnosis and appropriate management, ultimately aiding in better outcomes of patient.
Shortened NIHSS for Rapid Stroke Assessment in Emergency Care Settings
Authors: Rahnemayan Sama , Ala Alireza , Taghizadeh Nasrin , Sadeghi-Hokmabadi Elyar , Entezari Ipak , Shamsvahdati Samad
Published: December 2024

Objectives:

The National Institutes of Health Stroke Scale (NIHSS) is widely used to assess ischemic stroke severity, but its full 11-item version can be time-consuming. This study evaluates the NIHSS-8, a shortened version, for its efficacy compared with NIHSS-11 in an emergency department setting.

Methods:

A cohort study was conducted from May 2018 to May 2019 at Imam Reza Hospital, Tabriz, Iran. Patients with suspected acute stroke were assessed using both NIHSS-11 and NIHSS-8. The modified Rankin Scale (mRS) was used to evaluate patient outcomes at discharge. Correlations between NIHSS-8, NIHSS-11, and mRS were analyzed, and diagnostic performance metrics were calculated.

Results:

The study included 292 patients with a mean age of 70.40 years. Approximately 68.5% of patients were categorized as having moderate stroke severity using NIHSS-11, with a similar 67.1% using NIHSS-8. The correlation between NIHSS-11 and NIHSS-8 scores was high (intraclass correlation coefficient of 0.970). Both scales showed strong relationships with mRS at discharge but were not significantly correlated with long-term outcomes. NIHSS-8 demonstrated a sensitivity of 97.5% and specificity of 96.9%, while NIHSS-11 showed 100% sensitivity and 96.9% specificity.

Conclusions:

NIHSS-8 is a reliable and efficient alternative to NIHSS-11 for assessing stroke severity in emergency departments. It provides high sensitivity and specificity while being less time-consuming, making it suitable for rapid stroke assessment and triage.
Peatland restoration can provide climate change mitigation over all time-scales: A UK case-study
Authors: Zhang Xiao , Ots Minna , Johnston Eleanor , Brown Kathryn , Doar Nigel , Lynch John
Published: December 2024

Peatlands provide one of the largest terrestrial carbon stocks in the UK. However, a large proportion of peatlands are drained for peat extraction, agriculture and other uses, turning them into a major source of the UK’s land use greenhouse gas (GHG) emissions. Successful restoration can ultimately return peatlands into carbon sinks. However, rewetting - the primary step in peatland restoration - can reduce CO2emissions while increasing CH4emissions. This may result in little overall climate benefit, or even increased warming for several years post peatland restoration, as CH4is a short-lived but strong GHG, and may overpower the reduction in CO2. Such consequences are rarely explored in detail, since most studies are based on comparing total CO2-equivalent emissions pre- and post-restoration using the 100-year Global Warming Potential (GWP100), which can fail to reveal the full dynamics. We evaluated the emissions and resultant climate impacts from peatland restoration using data from The Wildlife Trusts, a federation of UK-based conservation charities, as a case-study. The total emissions of each restoration stage were estimated by multiplying peatland areas under restoration with up-to-date UK emission factors (EF), then compared under multiple pulse emission metrics (GWP100, GWP20, GTP100) to indicate the impacts over a range of time-horizons, and GWP* to reveal the varying warming impacts over time. We also used Monte-Carlo Simulation to investigate the uncertainties in total emissions drawing from EF ranges. We found that the restoration so far has provided large emission reductions under all metrics, even considering the uncertainties. Increased CH4is unlikely to cause extra warming in the extremely near-term (<20 years), and if the peatlands are maintained in their rewetted states, they can contribute to net-cooling in the long term. There is less certainty over the climate benefits of further restoration, from rewetted to “near-natural” states, especially in the shorter term, but we argue that any risks are low, while this continued restoration will provide further ecological benefits and support biodiversity. Our study lends further support for peatland restoration in the UK and other regions with similar habitats, and provides insight into the climate roles of peatlands more broadly.
Simulating Alpha Particle Doses at the Micron Scale from Prostate Cancer Patient Derived Bone Metastatic Biopsies Using GATE
Authors: Said Abdulaziz , Hamdi Mahdjoub , Salerno Isabella , Benabdallah Nadia , Turtle Norman F. , Abou Diane , Allan Thomas M. , Mikell Justin , Thorek Daniel
Published: December 2024

Radiopharmaceutical therapies are poised to enhance patient care for several currently untreatable metastatic cancers. Radium-223 dichloride citrate is indicated for treatment of bone metastatic castrate resistant prostate cancer, serving as the primary use of alpha particle emitting radium to irradiate bone lesions. Improvements and refinement of such therapies relies on patient centric and micro scale quantification to assess and compare efficacy. Computational modeling and Monte Carlo simulations provide a valuable tool for understanding micro scale phenomena of radiopharmaceutical therapies. Via simulation, we undertake and illuminate dose profiles of radium-223 dichloride treatment, evaluating energy and dose distributions based on primary, patient-derived specimens. A set of four activity distributions were simulated on three patient bone lesion biopsy samples. These simulations validate the novel tool for micron-scale modeling with patient-derived specimens. Ablative dose profiles are shown to be driven by uptake distributions as well as the target tissues’ microstructure.
Low and facultative mycorrhization of ferns in a low-montane tropical rainforest in Ecuador
Authors: Michel Jennifer , Lehnert Marcus , Nebel Martin , Quandt Dietmar
Published: December 2024

Arbuscular mycorrhizal fungi (AMF) are amongst the most studied plant symbionts and regularly found in terrestrial plants. However, global estimates of AMF abundance amongst all land plants are difficult because i) the mycorrhizal status of many non-commercial, wild plant species is still unknown ii) numerous plant species engage in facultative symbiosis, meaning that they can, but do not always do, associate with mycorrhiza and iii) mycorrhizal status can vary amongst individuals of one same plant species at one location, as well as for different plant species within a given genus or family.

To gain new insights to the pristine distribution of the plant-AMF symbiosis, we investigated the mycorrhizal status of one of the oldest lineages of extant vascular plants, Polypodiophyta (aka ferns), in one of the hotspots of natural plant diversification, the tropical rainforest. Providing a new data set of AMF abundance for 79 fern species, we hypothesized that (1) AMF would be found in 60-80% of the studied plants and (2) plant species with AMF symbionts would be more abundant than non-mycorrhizal species.

Both hypotheses were rejected while unexpected observations were made: (1) AMF occurred in 33% of studied species, representing 56% of the studied fern families, (2) AMF colonisation was not correlated with species abundance, (3) a small but significant proportion of AMF-positive ferns was epiphytic (7%) and (4) as expected, mycorrhization was inconsistent among different populations of the same species.

Together this empirical data supports recent reservations regarding global abundance of AMF, and further demonstrates that mycorrhization is not a taxonomic trait. In addition, the occurrence of AMF in epiphytic plants and no net benefits of AMF for plant abundance indicate that the mycorrhization observed here is on the commensalism, possibly parasitism, side of the symbiosis spectrum.

Highlights

Small fraction of fern species mycorrhized (33% species level, 56% of families)

Mycorrhization of species can vary with location (facultative symbiosis)

AMF colonisation does not increase plant species abundance

AMF presence in epiphytic ferns suggests commensalism / parasitism
Larger perivascular space volume fraction is associated with worse post-stroke sensorimotor outcomes: An ENIGMA analysis
Authors: Chakraborty Stuti , Choupan Jeiran , Marin-Pardo Octavio , Khan Mahir H. , Barisano Giuseppe , Tavenner Bethany P. , Donnelly Miranda R. , Abdullah Aisha , Andrushko Justin W. , Banaj Nerisa , Borich Michael R. , Boyd Lara A. , Buetefisch Cathrin M. , Conforto Adriana B. , Cramer Steven C. , Domin Martin , Adrienne Dula A. , Ferris Jennifer K. , Hordacre Brenton , Kautz Steven A. , Jahanshad Neda , Lotze Martin , Nishimura Kyle , Piras Fabrizio , Revill Kate P. , Schweighofer Nicolas , Soekadar Surjo R. , Srivastava Shraddha , Thomopoulos Sophia I. , Vecchio Daniela , Westlye Lars T. , Winstein Carolee J. , Wittenberg George F. , Wong Kristin A. , Thompson Paul M. , Liew Sook-Lei
Published: December 2024

BACKGROUND

Perivascular Spaces (PVS) are a marker of cerebral small vessel disease (CSVD) that are visible on brain imaging. Larger PVS has been associated with poor quality of life and cognitive impairment post-stroke. However, the association between PVS and post-stroke sensorimotor outcomes has not been investigated.

METHODS

602 individuals with a history of stroke across 24 research cohorts from the ENIGMA Stroke Recovery Working Group were included. PVS volume fractions were obtained using a validated, automated segmentation pipeline from the basal ganglia (BG) and white matter centrum semiovale (CSO), separately. Robust mixed effects regressions were used to a) examine the cross-sectional association between PVS volume fraction and post-stroke sensorimotor outcomes and b) to examine whether PVS volume fraction was associated with other measures of CSVD and overall brain health (e.g., white matter hyperintensities [WMHs], brain age [measured by predicted age difference, brain-PAD]).

RESULTS

Larger PVS volume fraction in the CSO, but not BG, was associated with worse post-stroke sensorimotor outcomes (b = -0.06, p = 0.047). Higher burden of deep WMH (b = 0.25, p <0.001), periventricular WMH (b = 0.16, p <0.001) and higher brain-PAD (b = 0.09, p <0.001) were associated with larger PVS volume fraction in the CSO.

CONCLUSIONS

Our data show that PVS volume fraction in the CSO is cross-sectionally associated with sensorimotor outcomes after stroke, above and beyond standard lesion metrics. PVS may provide insight into how the overall vascular health of the brain impacts inter-individual differences in post-stroke sensorimotor outcomes.