bluuebunny/crossref_metadata_2025 huggingface dataset:
Inert splint-driven oligonucleotide assembly
Authors: Mishin Andrew A , Groth Tobin , Green Richard E , Troll Christopher J
Published: December 2024

In this study, we introduce a new in vitro method for oligonucleotide fragment assembly. Unlike polymerase chain assembly and ligase chain assembly that rely on short, highly purified oligonucleotides, our method, named Splynthesis, uses a one-tube, splint-driven assembly reaction. Splynthesis connects standard-desalted “contig” oligos (∼150 nt in length) via shorter “splint” oligos harboring 5ʹ and 3ʹ blocking modifications to prevent off-target ligation and amplification events. We demonstrate the Splynthesis method to assemble a 741-bp gene fragment. We verify the assembled polymerase chain reaction product using standard molecular biology techniques, as well as long-read Oxford Nanopore sequencing, and confirm that the product is cloneable via molecular means, as well as Sanger sequencing. This approach is applicable for synthetic biology, directed evolution, functional protein assays, and potentially even splint-based ligase chain reaction assays.
Insights into the phylogeny of longhorn beetles from phylogenomic data
Authors: Song Nan , Wang Miaomiao , Zhai Qing , Zhang Huanhuan
Published: December 2024

Cerambycidae (Coleoptera: Chrysomeloidea) are a widely distributed group of insects with significant economic importance. Despite substantial efforts and some advancements in inferring the phylogeny of Cerambycidae, high-level phylogenetic relationships within the family, including subfamily and tribe-level classification, remain contentious. In this study, we performed whole-genome sequencing on a total of 65 species. We integrated these comprehensive genomic data with existing whole-genome and transcriptome data to conduct a phylogenetic analysis of Cerambycidae s.s. The results supported the monophyly of Lamiinae, Cerambycinae, and Spondylidinae, whereas Lepturinae and Prioninae were found to be non-monophyletic. Lamiinae were recovered as the sister group to all other Cerambycidae s.s. Spondylidinae were found to be sister to the clade comprising Lepturinae and Necydalinae, and Cerambycinae were identified as the sister group to the clade consisting of Prioninae and Parandrinae. Within Lamiinae, the tribes Mesosini, Saperdini, and Dorcaschematini were found to be monophyletic; however, Acanthocinini, Agapanthiini, Pogonocherini, Pteropliini, Lamiini, and Monochamini were non-monophyletic. This study supported the classification integrating the current Monochamini into Lamiini. Molecular dating analysis suggests that diversification within Cerambycidae s.s. began at the boundary between the Jurassic and Cretaceous periods, ~145 Mya.
Neurocranial anatomy of Paralligator (Neosuchia: Paralligatoridae) from the Upper Cretaceous of Mongolia
Authors: Kuzmin Ivan T , Sichinava Ekaterina A , Mazur Evgeniia V , Gombolevskiy Victor A , Sennikov Andrey G , Skutschas Pavel P
Published: December 2024

Neurocranial features appear to be phylogenetically informative and key in assessing the still contentious relationships within Crocodylomorpha. However, the braincases of many non-crocodylian taxa are incompletely studied precluding the assessment of evolutionary modifications at the base of Crocodylia. Here, we describe the braincase osteology and neuroanatomy of the paralligatorid crocodylomorph Paralligator from the Upper Cretaceous of Mongolia based on computed tomography (CT)-scanning, segmentation, and 3D modelling of several specimens. The anatomy of the brain endocast, nerves, and the paratympanic pneumatic cavities of Paralligator is consistent with its phylogenetic position close to or at the base of Eusuchia. Paralligator shares a suit of neuroanatomical features with basal eusuchians and crocodylians reflecting the plesiomorphic condition for Crocodylia. In addition, differences in the brain endocasts between the larger-sized individuals of Paralligator and Kansajsuchus and the smaller Shamosuchus are consistent with ontogenetic changes in extant crocodylians. This suggests that members of the more basal clade Paralligatoridae and the crown-group Crocodylia share similar brain modifications during ontogeny. We also review the distribution of the mesethmoid in Crocodylomorpha and show its presence in several clades including Paralligatoridae and Dyrosauridae.
Seed-transmission of turnip mosaic virus demonstrated unequivocally in a Brassica species
Authors: Abidin Nuraizat , Barbetti Martin John , You Ming Pei , Jones Roger Anthony Charles
Published: December 2024

Turnip mosaic virus (TuMV) causes important diseases in Brassicaceae crops worldwide. In 2023, Brassica rapa ssp. perviridis cv. Tendergreen seedlings with virus-like symptoms were found growing within an insect-proof glasshouse. The affected seed lot (A), three others of Tendergreen, and five belonging to other B. rapa subspecies, B. juncea or Wasabia japonica were sown in trays within Controlled Environment Rooms (CER’s) from which other plants were absent. TuMV was detected in 10% of seed lot A seedlings but none from other seed lots. Next, seed lot A (experiment 1) or seed from Tendergreen mother plants infected with B. napus TuMV resistance breaking strain isolate 12.1 (experiment 2) were sown in trays. In each experiment, these trays were subdivided into two batches, one being placed inside transparent plastic boxes, each batch then being placed in different CER’s. TuMV was detected in 10% and 9% of seedlings inside or outside the boxes (experiment 1), or 1% of seedlings from both situations (experiment 2). Since virus contamination by aphid vectors or contact was excluded, TuMV seed transmission was demonstrated unequivocally. A complete TuMV genome obtained from an infected seedling (isolate BRSB1, accession PQ160044) was compared with 44 other genomic sequences from TuMV phylogroup World-B. It belonged to the same subclade as Australian resistance breaking strain isolates 12.1 and 12.5 (99.9% nucleotide identities) and 10 New Zealand sequences (99.2-99.5% nucleotide identities). Our findings have important implications concerning sowing crops with TuMV-infected seed and spreading readily seed-borne or resistance breaking TuMV strains nationally or internationally.
Light‐exercise‐induced dopaminergic and noradrenergic stimulation in the dorsal hippocampus: Using a rat physiological exercise model
Authors: Hiraga Taichi , Hata Toshiaki , Soya Shingo , Shimoda Ryo , Takahashi Kanako , Soya Mariko , Inoue Koshiro , Johansen Joshua P. , Okamoto Masahiro , Soya Hideaki
Published: December 2024

Exercise activates the dorsal hippocampus that triggers synaptic and cellar plasticity and ultimately promotes memory formation. For decades, these benefits have been explored using demanding and stress‐response‐inducing exercise at moderate‐to‐vigorous intensities. In contrast, our translational research with animals and humans has focused on light‐intensity exercise (light exercise) below the lactate threshold (LT), which almost anyone can safely perform with minimal stress. We found that even light exercise can stimulate hippocampal activity and enhance memory performance. Although the circuit mechanism of this boost remains unclear, arousal promotion even with light exercise implies the involvement of the ascending monoaminergic system that is essential to modulate hippocampal activity and impact memory. To test this hypothesis, we employed our physiological exercise model based on the LT of rats and immunohistochemically assessed the neuronal activation of the dorsal hippocampal sub‐regions and brainstem monoaminergic neurons. Also, we monitored the extracellular concentration of monoamines in the dorsal hippocampus using in vivo microdialysis. We found that even light exercise increased neuronal activity in the dorsal hippocampal sub‐regions and elevated the extracellular concentrations of noradrenaline and dopamine. Furthermore, we found that tyrosine hydroxylase‐positive neurons in the locus coeruleus (LC) and the ventral tegmental area (VTA) were activated even by light exercise and were both positively correlated with the dorsal hippocampal activation. In conclusion, our findings demonstrate that light exercise stimulates dorsal hippocampal neurons, which are associated with LC‐noradrenergic and VTA‐dopaminergic activation. This shed light on the circuit mechanisms responsible for hippocampal neural activation during exercise, consequently enhancing memory function.
Original Research: Is Your Outpatient Office Prepared to Manage an Opioid Overdose?
Authors: Goldstein Nancy S. , Grubb Claire
Published: December 2024

Background:

Outpatient facilities, such as family and adult practice offices, psychiatric offices, and substance use treatment centers, should be equipped to manage medical emergencies and facilitate hospital transfers. Clinics that treat patients with opioid use disorder must be especially prepared to address respiratory arrest due to opioid overdose.

Purpose:

The objective of this integrative review was to identify emergency response initiatives already investigated or developed that could be adapted to address opioid-related medical emergencies in the outpatient adult treatment setting.

Methods:

Initial and updated literature searches were conducted using MEDLINE and PubMed. These searches yielded 207 and 60 articles of interest, respectively, and a total of 6 and 18 were selected for retrieval. Of these, 5 and 8, for a total of 13, met the inclusion criteria.

Results:

We found few publications in the mental health literature to inform or guide outpatient practitioners in preparing their offices for emergencies. This integrative review draws from all areas of the medical literature to identify emergency response strategies that have been developed for outpatient settings. We identified 4 major themes in office emergency preparedness: simulation training, response team organization, equipment readiness, and emergency action protocols.

Conclusion:

These 4 themes can provide guidance for improving readiness in medical offices, and in ambulatory mental health and substance use clinics. Researchers will need to develop emergency response algorithms that address these themes and assess patient outcomes.
Deep learning segmentation architectures for automatic detection of pancreatic ductal adenocarcinoma in EUS-guided fine-needle biopsy samples based on whole-slide imaging
Authors: Udriștoiu Anca Loredana , Podină Nicoleta , Ungureanu Bogdan Silviu , Constantin Alina , Georgescu Claudia Valentina , Bejinariu Nona , Pirici Daniel , Burtea Daniela Elena , Gruionu Lucian , Udriștoiu Stefan , Săftoiu Adrian
Published: December 2024

Background

EUS-guided fine-needle biopsy is the procedure of choice for the diagnosis of pancreatic ductal adenocarcinoma (PDAC). Nevertheless, the samples obtained are small and require expertise in pathology, whereas the diagnosis is difficult in view of the scarcity of malignant cells and the important desmoplastic reaction of these tumors. With the help of artificial intelligence, the deep learning architectures produce a fast, accurate, and automated approach for PDAC image segmentation based on whole-slide imaging. Given the effectiveness of U-Net in semantic segmentation, numerous variants and improvements have emerged, specifically for whole-slide imaging segmentation.

Methods

In this study, a comparison of 7 U-Net architecture variants was performed on 2 different datasets of EUS-guided fine-needle biopsy samples from 2 medical centers (31 and 33 whole-slide images, respectively) with different parameters and acquisition tools. The U-Net architecture variants evaluated included some that had not been previously explored for PDAC whole-slide image segmentation. The evaluation of their performance involved calculating accuracy through the mean Dice coefficient and mean intersection over union (IoU).

Results

The highest segmentation accuracies were obtained using Inception U-Net architecture for both datasets. PDAC tissue was segmented with the overall average Dice coefficient of 97.82% and IoU of 0.87 for Dataset 1, respectively, overall average Dice coefficient of 95.70%, and IoU of 0.79 for Dataset 2. Also, we considered the external testing of the trained segmentation models by performing the cross evaluations between the 2 datasets. The Inception U-Net model trained on Train Dataset 1 performed with the overall average Dice coefficient of 93.12% and IoU of 0.74 on Test Dataset 2. The Inception U-Net model trained on Train Dataset 2 performed with the overall average Dice coefficient of 92.09% and IoU of 0.81 on Test Dataset 1.

Conclusions

The findings of this study demonstrated the feasibility of utilizing artificial intelligence for assessing PDAC segmentation in whole-slide imaging, supported by promising scores.
An Approach for Improving the Detection and Quantitation of Buprenorphine and Its Metabolites in Maternal and Neonatal Hair
Authors: Alshogran Osama Y. , Zhao Wenchen , Krans Elizabeth E. , Caritis Steve , Shaik Imam H. , Venkataramanan Raman
Published: December 2024

Background:

Buprenorphine (BUP) use is prevalent in pregnant women with opioid use disorder (OUD). Drug monitoring during pregnancy is critical for optimizing dosing regimen and achieving the desired clinical outcomes. Hair can be used as a critical biological matrix for monitoring long-term exposure to drugs. The aim of this study was to optimize the methodology used to quantify BUP and its metabolites in hair samples.

Methods:

Conditions for hair sample processing (ie, hair washing, incubation temperature, and extraction time) were optimized to maximize extraction recovery. The LC-MS/MS strategy employed here used 4 deuterated internal standards for quantifying BUP and its major metabolites [norbuprenorphine (NBUP), buprenorphine glucuronide (BUP-G), and norbuprenorphine-glucuronide (NBUP-G)] in human hair samples. The optimized conditions were used to measure BUP and its metabolites in hair samples of 5 women undergoing OUD treatment and their neonates.

Results:

Unwashed hair samples processed by shaking with acetonitrile for 24 hours at 37 °C showed higher BUP (36%) and NBUP (67%) recovery, compared with those processed by incubation at room temperature. The standard curves showed excellent linearity over 0.05–100 ng/mL for BUP and NBUP and 0.1–200 ng/mL for BUP-G and NBUP-G. The assay was partially validated for reproducibility and accuracy and was successfully used for measuring BUP and metabolites in aforementioned hair samples. BUP was identified in all hair samples, while BUP-G was not. BUP was the primary analyte in maternal hair (median: 38.3 pg/mg; 25–75 percentile: 17–152.4 pg/mg), while NBUP-G was predominant in neonatal hair (median: 28.6 pg/mg; 25%–75% percentile: 1.9–112.8 pg/mg).

Conclusions:

The methodology used for quantifying BUP and its metabolites in hair samples of maternal female patients and their neonates is simple, accurate, and reproducible. The developed method may be useful for measuring fetal exposure to BUP during gestation.
Simultaneous Combination Therapy of Free Anterolateral Thigh Flap and Negative-pressure Wound Therapy With Penrose Drains for Thoracic Dead Space
Authors: Taga Marie , Umezawa Hiroki , Hokazono Yu , Kondo Akatsuki , Aoki Hironobu , Ogawa Rei
Published: December 2024

Open-window thoracostomy is an effective treatment for refractory postpneumonectomy empyema. However, it can leave large thoracic dead space, and bronchopleural fistulas (BPF) are a common major complication. These problems can be treated with myocutaneous flap transfer or negative-pressure wound therapy (NPWT). However, treatment is often difficult and prolonged. Here, we report 2 cases of free anterolateral thigh flap transfer followed immediately by NPWT combined with Penrose drains. Both patients, including 1 with BPF, had favorable postoperative courses and were discharged 28 and 14 days after reconstruction. Dead space infection and BPF recurrence were not observed after discharge. Following free flap transfer with NPWT combined with Penrose drains may efficiently eliminate dead space and accelerate wound healing in a large three-dimensional space.
Vessels encapsulating tumor clusters contribute to the intratumor heterogeneity of HCC on Gd-EOB-DTPA–enhanced MRI
Authors: Matsuda Kosuke , Ueno Akihisa , Tsuzaki Junya , Kurebayashi Yutaka , Masugi Yohei , Yamazaki Ken , Tamura Masashi , Abe Yuta , Hasegawa Yasushi , Kitago Minoru , Jinzaki Masahiro , Sakamoto Michiie
Published: December 2024

Background:

Vessels encapsulating tumor clusters (VETC) pattern is tumor vasculature of HCC and is a predictor of prognosis and therapeutic efficacy. Recent radiological studies have demonstrated the predictability of VETC from preoperative images, but the mechanisms of image formation are not elucidated. This study aims to determine the relationship between VETC and intratumor heterogeneity in Gd-EOB-DTPA–enhanced magnetic resonance imaging (EOB-MRI) and to provide its pathological evidence.

Methods:

Radiologists visually classified preoperative arterial- and hepatobiliary-phase EOB-MRI images of 204 surgically resected HCCs into patterns based on heterogeneity and signal intensity; these classifications were validated using texture analysis. Single and multiplex immunohistochemistry for CD34, h-caldesmon, and OATP1B3 were performed to evaluate VETC, arterial vessel density (AVD), and OATP1B3 expression. Recurrence-free survival was assessed using the generalized Wilcoxon test. The contribution of clinicoradiological factors to the prediction of VETC was evaluated by random forest and least absolute shrinkage and selection operator regression.

Results:

VETC was frequently found in tumors with arterial-phase heterogeneous hyper-enhancement patterns and in tumors with hepatobiliary-phase heterogeneous hyperintense/isointense patterns (HBP-Hetero). AVD and OATP1B3 expression positively correlated with signal intensity in the arterial and hepatobiliary phases, respectively. Intratumor spatial analysis revealed that AVD and OATP1B3 expression were lower in VETC regions than in tumor regions without VETC. Patients with HBP-Hetero tumors had shorter recurrence-free survival. Machine learning models highlighted the importance of serum PIVKA-II, tumor size, and enhancement pattern of arterial and hepatobiliary phase for VETC prediction.

Conclusions:

VETC is associated with local reductions of both AVD and OATP1B3 expression, likely contributing to heterogeneous enhancement patterns in EOB-MRI. Evaluation of the arterial and hepatobiliary phases of EOB-MRI would enhance the predictability of VETC.
Quantitative fibrosis identifies biliary tract involvement and is associated with outcomes in pediatric autoimmune liver disease
Authors: Khendek Leticia , Castro-Rojas Cyd , Nelson Constance , Alquraish Mosab , Karns Rebekah , Kasten Jennifer , Teng Xiao , Miethke Alexander G. , Taylor Amy E.
Published: December 2024

Background:

Children with autoimmune liver disease (AILD) may develop fibrosis-related complications necessitating a liver transplant. We hypothesize that tissue-based analysis of liver fibrosis by second harmonic generation (SHG) microscopy with artificial intelligence analysis can yield prognostic biomarkers in AILD.

Methods:

Patients from single-center studies with unstained slides from clinically obtained liver biopsies at AILD diagnosis were identified. Baseline demographics and liver biochemistries at diagnosis and 1 year were collected. Clinical endpoints studied included the presence of varices, variceal bleeding, ascites, HE, and liver transplant. In collaboration with HistoIndex, unstained slides underwent SHG/artificial intelligence analysis to map fibrosis according to 10 quantitative fibrosis parameters based on tissue location, including total, periportal, perisinusoidal, and pericentral area and length of strings.

Results:

Sixty-three patients with AIH (51%), primary sclerosing cholangitis (30%), or autoimmune sclerosing cholangitis (19%) at a median of 14 years old (range: 3–24) were included. An unsupervised analysis of quantitative fibrosis parameters representing total and portal fibrosis identified a patient cluster with more primary sclerosing cholangitis/autoimmune sclerosing cholangitis. This group had more fibrosis at diagnosis by METAVIR classification of histopathological review of biopsies (2.5 vs. 2; p = 0.006). This quantitative fibrosis pattern also predicted abnormal 12-month ALT with an OR of 3.6 (1.3–10, p = 0.014), liver complications with an HR of 3.2 (1.3–7.9, p = 0.01), and liver transplantation with an HR of 20.1 (3–135.7, p = 0.002).

Conclusions:

The application of SHG/artificial intelligence algorithms in pediatric-onset AILD provides improved insight into liver histopathology through fibrosis mapping. SHG allows objective identification of patients with biliary tract involvement, which may be associated with a higher risk for refractory disease.
Pain in chronic liver disease compared to other chronic conditions: Results from a contemporary nationally representative cohort study
Authors: Zhang Grace Y. , Cortella Aly , Lai Jennifer C. , Rubin Jessica B.
Published: December 2024

Background:

Pain is common in patients with chronic liver disease. Our limited understanding of patterns and severity of pain in this population hinders the development of effective cirrhosis-specific pain management strategies.

Methods:

Using cross-sectional data from the 2016–2021 National Health Interview Survey, we examined rates, severity, and functional limitations due to pain in respondents with liver disease (viral hepatitis, cirrhosis, and liver cancer), compared to the general population and those with other chronic conditions associated with pain (ie, arthritis, diabetes, and chronic kidney disease). Categorical and continuous variables were compared using χ2 and t test. Multivariable logistic regression was used to determine the predictors associated with pain and opioid use.

Results:

Our liver disease cohort comprised 5267 participants (63% viral hepatitis, 49% cirrhosis, and 2% liver cancer). Participants with liver disease were more likely to report pain than those without liver disease (42% vs. 22%); they were also more likely to report severe pain (42% vs. 30%) and functional limitations by pain (28% vs. 13%) (p < 0.001 for all). On multivariable logistic regression, liver disease is an independent predictor of pain (OR: 2.31, 95% CI: 2.05–2.59, p < 0.001), even after adjustment for demographic factors. Liver disease respondents had similar rates of pain as those with diabetes (p = 0.8) and were more functionally limited by pain than those with arthritis (p < 0.001). Adjusted for demographic and pain-related factors, liver disease was also an independent predictor of chronic opioid use (OR: 1.47, 95% CI: 1.12–1.92, p = 0.0054).

Conclusions:

Liver disease independently increases the likelihood of experiencing widespread and debilitating pain. Clinicians should consider liver disease a painful condition, ensuring that they are frequently assessing and appropriately treating pain in all liver disease patients.
Systemic immune-inflammation index and long-term mortality in patients with hypertension: a cohort study
Authors: Zheng Yaling , Zhong Dongling , Li Juan , Zhang Yue , Li Huijing , Liu Luoji , Ren Chi , Zhong Shan , Liu Xicen , He Xia , Jin Shiqi , Luo Lun
Published: December 2024

Objective:

The objective of this study was to examine the relationship between systemic inflammation and long-term mortality in patients with hypertension.

Methods:

The study employed a retrospective cohort design. The study population was derived from the National Health and Nutrition Examination Survey (NHANES), and the mortality data for this population was acquired from the National Death Index (NDI) database. Systemic inflammation was quantified by the Systemic Immune Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), which were then categorized into four groups (Q1–Q4, with Q4 representing the highest level of SII or SIRI). Weighted Cox regression models were constructed to investigate the association between mortality and SII and SIRI, with hazard ratios (HRs) subsequently calculated.

Results:

A total of 7431 participants were included in the analysis. The highest quantile (Q4) of SII was associated with a higher risk of all-cause mortality (hazard ratio 1.36, 95% CI 1.1–1.69, P < 0.001). After adjustment for important covariates, the association remained significant (hazard ratio 1.70, 95% CI 1.27–2.30, P < 0.001). The highest quantile (Q4) of SIRI was also associated with the highest risk of mortality (hazard ratio 2.11, 95% CI 1.64–2.70, P < 0.001), and this association remained significant after adjustment for important covariates (hazard ratio 1.64, 95% CI 0.61–1.22, P = 0.001).

Conclusion:

Both SII and SIRI scores were found to be associated with mortality rates in patients with hypertension. The findings suggest that these scores may serve as complementary biomarkers to the neutrophil-to-lymphocyte ratio (NLR) for assessing mortality risk in patients with hypertension. Further investigation is warranted to elucidate the underlying mechanisms that underpin this association.
Three Developments Related to ANSI/HPS Standard N13.56
Authors: Evans William
Published: December 2024

Three topics related to ANSI/HPS Standard N13.56, Sampling and Monitoring Releases of Airborne Radioactivity in the Workplace, are discussed. First, due to the omission of consideration of the activity’s half-life in the standard's continuous particulate air monitor (CPAM) quantitative method, it is possible for concentration estimates produced by that calculation to be underestimated. Second, the concentration estimate found in air grab sampling, as discussed in the standard, is not, as claimed, an average unless the activity is “long-lived” (negligible decay during sampling). It is nonetheless possible for this calculation to produce a concentration estimate that is not significantly different from the average, depending on both the half-life of the activity and the sampling time. Third, the issue of when to change the filter for the CPAM method is addressed.
A patient with long-term diabetes dies following infection with Francisella novicida in Guangdong province, China: a case report
Authors: Fan Linjin , Guan Jialong , Feng Lizhi , Wang Yulong , Zeng Huimin , Zhu Ying , Li Hao , Chen Qiang , Li Linghua , Qian Jun , Liu Linna , Li Yueping
Published: December 2024

The rarity of Francisella novicida infection in humans is well-known, and the F. novicida cases occur in immunocompromised patients or those with underlying health problems. Herein, we report the case of a patient with long-term diabetes who died following F. novicida infection that caused multiple organ failure, although F. novicida was effectively eliminated using antimicrobial therapy. Microbiological confirmation of F. novicida infection relies on metagenomic next-generation sequencing (mNGS) and pdpD-2 gene-specific identification. This study highlights the importance of early pathogen diagnosis in severely infected patients, particularly in cases of F. novicida, and indicates that mNGS is a useful tool for early diagnosis.
Association Between Alcohol Use and Primary Open Angle Glaucoma
Authors: Meller Leo L.T. , Saseendrakumar Bharanidharan Radha , Mahmoudinezhad Golnoush , Tavakoli Kiana , Wu Jo-Hsuan , Parikh Aman , Bhanvadia Sonali , Moghimi Sasan , Zangwill Linda , Weinreb Robert N. , Baxter Sally L.
Published: December 2024

Précis:

In a diverse database (All of Us), we report significant dose-response associations between alcohol use frequency and glaucoma, with alcohol use of 4 or more drinks per week associated with significantly increased odds of glaucoma.

Purpose:

Current evidence on the association between alcohol use and primary open angle glaucoma (POAG) is mixed. We utilize the diverse All of Us Research Program to further examine this relationship.

Methods:

This is a retrospective cohort study using the diverse All of Us Research Program, a nationwide effort by the United States National Institutes of Health to recruit those historically under-represented in biomedical research. Electronic health records and survey data from the All of Us program were analyzed. A randomized 1:4 case/control ratio was utilized for POAG patients and randomly selected control patients. χ2, bivariable, and multivariable regression were utilized to examine the associations between alcohol use and POAG.

Results:

Of the 3876 POAG patients, 2015 (52%) were female, 1943 (50%) were White, 1152 (30%) were Black, 117 (3%) were Asian, and 584 (15%) were Hispanic. Alcohol use of 4 or more drinks per week was significantly higher in the glaucoma cohort relative to controls (15% vs. 12%, P<0.001). On bivariate analysis, diagnosed alcohol misuse was associated with higher odds of POAG [odds ratio (OR): 1.20, 95% CI: 1.17–1.23, P<0.001]. In multivariable regression, more frequent alcohol use was associated with higher odds of glaucoma; alcohol use with a frequency of 4 or more drinks per week was significantly associated with increased odds of glaucoma (OR: 1.22, 95% CI: 1.03–1.44, P=0.023). This dose-response relationship was also observed and more pronounced for female participants, where alcohol use frequency of monthly or less was already associated with increased odds of glaucoma (OR: 1.21, 95% CI: 1.002–1.46, P=0.048).

Conclusion:

In the diverse All of Us database, there was a dose-response relationship between alcohol consumption and POAG risk, which was more pronounced in female participants. Overall, a higher frequency of alcohol consumption was associated with an increased risk of POAG; 4 or more drinks per week significantly was associated with higher glaucoma risk.
The Examination of Rehabilitation Factors Associated With Discharge Location After Spine Surgery for Cauda Equina Syndrome
Authors: Baumann Anthony N. , Mahajan Arushi , Callaghan Megan E. , Kuo Andy , Furey Christopher G. , Cheng Christina W.
Published: December 2024

Introduction:

Cauda equina syndrome (CES) is a serious medical condition affecting the lumbosacral spine that requires emergent surgical intervention to relieve symptoms and prevent lasting neurological deficits. Previous studies have shown discharge location after CES surgery may have been associated with increased complications and poor outcomes. The purpose of this study is to evaluate factors associated with home or nonhome discharge after surgery for CES to assist with appropriate discharge planning by the medical interdisciplinary team.

Review of Literature:

Little data exist regarding factors associated with discharge location after surgery for CES.

Subjects:

One hundred fourteen patients who had surgery for CES in a hospital setting.

Methods:

This study is a retrospective case control study. Surgery for CES was performed by both orthopedic surgeons and neurosurgeons. Main outcome measure was discharge to home (n = 61) or a nonhome location (n = 53). Data recorded include age, gender, type of surgery performed, preoperative symptoms, postoperative symptoms, and level of participation in physical therapy in the hospital. Statistical analysis included logistic regression with odds ratio (OR) and 95% confidence intervals (CI).

Results:

Total patients (n = 114) had a mean age of 55.4 ± 18.1 years with 52.6% being male. Some factors associated with home discharge after surgery for CES via univariate analysis included no preoperative bowel/bladder symptoms (OR = 3.12; 95% CI = 1.19-8.19; P = .02), higher preoperative motor score (OR = 2.40; 95% CI = 1.40-4.12; P = .002), increased postoperative motor score (OR = 3.67; 95% CI = 1.62-8.30; P = .002), increased first distance walked (OR = 1.06; 95%CI = 1.02-1.09; P = .002), and increased total distance walked over LOS (OR = 1.01; 95%CI = 1.00-1.01; P = .0001). Multivariate analysis showed that decreased total distance walked during acute care hospital admission was associated with nonhome discharge (P < .02).

Discussion and Conclusion:

There are various factors associated with particular discharge locations after CES surgery, such length of hospital stay, preoperative bowel and bladder function, extremity strength scores, and ability to ambulate after surgery with physical therapy. As discharge location may impact patient outcomes, it is important identify which rehabilitation factors may be associated with patient discharge location after surgery for CES.
Using the Delphi method to propose foods for special medical purposes health effect evaluation indicators
Authors: Ren Peng , Wang Hai-Yue , Li Zeng-Ning
Published: December 2024

Objective

The Delphi method was used to propose health effect evaluation indicators to assess foods for special medical purposes (FSMPs). This lays the foundation for the formation of a big data model for human health testing, as well as a big data platform for the health and safety evaluation of special medical foods.

Methods

The Delphi method was used to conduct two rounds of expert consultation on the constructed FSMP health effect evaluation indicators.

Results

Ten major items were identified after two rounds of expert consultation. Among these, there were 10 primary entries, 32 secondary entries, 50 tertiary entries, and 28 quaternary entries.

Conclusion

The complete list of evaluation indicators contains 10 entries, which can comprehensively and systematically monitor adverse reactions to the use of FSMPs. The present findings lay the foundation for a big data platform to evaluate the health and safety of special foods.
The emerging role of fasting-mimicking diets in cancer treatment
Authors: Zhai Yu-Jia , Si Pei-Yao , Liu Ming-Li , Huang Lan
Published: December 2024

Cancer is one of the most common causes of morbidity and mortality worldwide. The high demand for specific nutrients and the sensitivity to nutritional deficiencies are newly recognized features of cancer cells. Dietary interventions can suppress tumor demand for particular nutrients and alter certain nutrients to target a tumor's metabolic vulnerability. Cyclic fasting or fasting-mimicking diets (FMDs) are popular approaches that can reduce nutrient intake over a specific period. Accumulating evidence suggests that FMDs attenuate tumor growth by altering the energy metabolism of cancer cells. Furthermore, FMDs potentiate the sensitivity of tumors to conventional cancer treatments and limit adverse events. Recent findings also highlight the potential value of FMDs in boosting antitumor immune surveillance. However, clinical trials regarding the impact of FMDs on cancer patients remain limited and controversial. Here, we provide the latest information on the effects of FMDs on cancer progression and treatment, focusing on future clinical applications.
Rehabilitation interventions for malnutrition in head and neck cancer patients: Current state and future directions
Authors: Zhang Hao-Miao , Yu Li-Li
Published: December 2024

Head and neck cancer and the approaches used to treat it can cause symptoms such as mucositis, alteration or loss of taste, dysphagia, and xerostomia, which makes the incidence of malnutrition in head and neck cancer patients higher than in the general population of cancer patients. Malnutrition in patients with head and neck cancer is associated with the occurrence of treatment-related adverse events, an increase in overall economic cost, a decline in quality of life, and a poor prognosis. Therefore, rehabilitation interventions for malnutrition are necessary throughout the course of the disease. However, the importance of rehabilitation interventions for malnutrition in patients with head and neck cancer has not been fully recognized, and the optimal methods and timing of interventions are unclear. This article provides an overview of rehabilitation interventions for malnutrition, including nutritional supplementation, exercise-based interventions, nutritional counseling and cognitive improvement, and drug therapy, and discusses their advantages and disadvantages as well as potential future directions.
Development and validation of a nomogram for predicting the probability of serious complication in esophageal cancer patients after esophagectomy
Authors: Chong Fei-Fei , Huo Zhen-Yu , Zhang Meng-Yuan , He Xiu-Mei , Luo Si-Yu , Liu Jie
Published: December 2024

Background

Esophagectomy remains a procedure with one of the highest complication rates. This study aimed to develop and validate a model of nomogram for predicting the probability serious postoperative complications for the postoperative esophageal cancer (EC) patients.

Methods

An observational study was conducted at Daping Hospital, China, encompassing 529 postoperative EC patients from December 2014 to November 2023. We integrated independent prognostic factors to craft a predictive model, specifically a nomogram, designed to forecast the risk of severe postoperative complications.

Results

The incidence of serious complications for postoperative EC patients was 58.1%. A total of seven variables, including age, gender, bleeding volume during the operation (P = 0.035), operating time (P = 0.031), the Nutritional Risk Screening 2002 (NRS 2002) score (P = 0.027), the perioperative nutrition screen (PONS) score (P = 0.018), and cystatin C levels (P < 0.001), were applied to draw the nomogram of predicting serious complications after esophagectomy. The accuracy of predictive value for the model was quantified by Harrell’s C index at 0.690 (95% confidence interval = 0.596–0.785, P < 0.001).

Conclusion

We developed a nomogram system to demonstrate exceptional predictive capabilities for postoperative EC patients in forecasting the risk of serious complications. These results also emphasize the predictive value of the preoperative nutritional risk screening with NRS 2002 and PONS in EC patients undergoing esophagectomy.
Mitochondrial dysfunction and programmed cell death in osteosarcoma
Authors: Zhang Ke , Jiang Ming-Yang , Liu Kai-Cheng , Dai Yong-Heng , Bo Zhan-Dong
Published: December 2024

Osteosarcoma is the most prevalent primary malignant bone tumor, primarily affecting adolescents aged 15–25 years. It is characterized by a high recurrence rate, poor prognosis, and lack of important biomarkers. Significant mitochondrial dysfunction in osteosarcoma cells has been widely reported by recent studies. Dysfunctional mitochondria occupy an important position in cellular metabolic reprogramming, immune microenvironment regulation, and programmed cell death. Therefore, targeting mitochondrial dysfunction may represent a new mechanism to overcome therapeutic barriers in the treatment of osteosarcoma and provides crucial target molecules for further development of targeted therapies and immunotherapies. The present article summarizes the recent reports of mitochondrial dysfunction in osteosarcoma and links it to various programmed cell death mechanisms, aiming to provide the basis for further clinical practice.
Associations of Perceived Privacy at the Workplace With Short Sickness Absences in a Cohort of Finnish Office Workers
Authors: Haapakangas Annu , Ropponen Annina , Tulenheimo-Eklund Elina , Ruohomäki Virpi , Reijula Kari
Published: December 2024

Objective

To investigate perceived task privacy in 2022 associated with short (1–3 days) self-certified sickness absence (SA) in 2023.

Methods

A prospective cohort of 1400 Finnish office workers with survey data in 2022 about, for example, task privacy, telework, and office type were linked with employer-owned register data of SA in 2022–2023. Poisson regression models were used to obtain risk ratios with 95% confidence intervals.

Results

Each one-unit increase in task privacy was associated with a less likely short SA (risk ratio, 0.83–0.89; 95% confidence interval, 0.74–0.97), also across the amount of telework in 2022. The association was only statistically significant in activity-based offices.

Conclusions

Each one-unit increase in perceived task privacy at the office was associated with less likely short, self-certified, 1–3 days SA. Task privacy is an important factor to be considered in offices.
Double diabetes as a new challenge in diabetes categorization: Case reports
Authors: Karki Manoj , Bashyal Subodh , Devkota Sudhan , Sharma Aprajita , Rayamajhi Bidhata , Shrestha Ritika
Published: December 2024

Rationale:

Double diabetes, characterized by the coexistence of insulin resistance and autoimmune pancreatic β-cell destruction, is often underrecognized due to overlapping features of type 1 and type 2 diabetes.

Patient concerns:

Two female patients presented with elevated blood sugar levels during their second trimester of pregnancy. Both required insulin therapy during pregnancy to manage hyperglycemia.

Diagnoses:

Initially diagnosed as gestational diabetes mellitus, further investigations postpregnancy revealed autoimmune markers such as anti-glutamic acid decarboxylase 65 positivity and low c-peptide levels, confirming type 1 diabetes in both patients along with features of insulin resistance.

Interventions:

Both patients were treated with insulin therapy during pregnancy. Postdelivery, one achieved blood sugar control through lifestyle modifications, while the other required continued basal-bolus insulin therapy following an episode of diabetic ketoacidosis.

Outcomes:

Both patients achieved glycemic control. One transitioned off insulin, while the other remained on insulin therapy.

Lessons:

Double diabetes can masquerade as gestational diabetes and is prone to misdiagnosis. Early identification through autoimmune testing, c-peptide levels, and clinical vigilance is critical for timely and accurate management.
Rehabilitation of functional neurological disorder with lower limb powered robotic exoskeleton: A case report
Authors: Tham Shuen-Loong , Ong Ruth Choo Li , Ratha Krishnan Rathi
Published: December 2024

Rationale:

Functional neurological disorder (FND) is a disabling and challenging condition that straddles Neurology and Psychiatry. Prolonged symptoms in FND are associated with poor functional outcome. Multidisciplinary management often involves physiotherapy in assisting with rehabilitation of the motor dysfunction associated with this condition. Despite many motor training approaches and strategies being described and trialed, successful outcome remains challenging.

Patient concerns:

Impaired ambulatory function (i.e., short-distance walking with rollator frame and ankle-foot-orthoses on level ground) despite 2 years of physical therapy.

Diagnoses:

FND with prolonged lower limb weakness and sensory loss following a road traffic accident.

Interventions:

Lower limb powered robotic exoskeleton (PRE) followed by conventional physiotherapy in ambulatory training.

Outcomes:

Three sessions of physical therapy training with lower limb PRE resulted in significant functional improvements. The patient achieved independence in walking without any gait-aid. Progress was made in walking tolerance, balance and lower limb strength. Six-minute and 10-m walk tests improved approximately 3- and 4-fold, respectively. Consequent conventional physiotherapy treatment saw to further improvements. Ambulatory and functional gains were maintained and bettered 9 months on.

Lessons:

PRE can be beneficial as an adjunctive training device for motor training in patients with FND.
Advances in basic and translational research into nasopharyngeal carcinoma
Authors: Li Zhe , Chen Yupei , Ma Jun
Published: December 2024

According to the International Cancer Research Institute of the World Health Organization data, nasopharyngeal carcinoma (NPC) remains a significant health concern, particularly in regions such as Southeast Asia and southern China. Recently, substantial progress has been made in the field of basic and translational research on NPC, enhancing our understanding of the molecular mechanisms underlying the disease and paving the way for precise therapeutic approaches. This review summarizes the advances in NPC research, focusing on key areas that include radiotherapy and chemotherapy resistance and tumor metastasis, microenvironment, metabolism, microbiome, and biomarkers. Additionally, future research directions in NPC are discussed to provide valuable insights to advance the field further.
Age-Related Differences Between Juvenile and Adult Autoimmune Inflammatory Myopathies
Authors: Kaplan Melike Mehveş , Tekin Zahide Ekici , Çelikel Elif , Güngörer Vildan , Karagöl Cüneyt , Öner Nimet , Polat Merve Cansu , Öztürk Didem , Özçelik Emine , Ekici Mehveş Işıklar , Dağlı Pınar Akyüz , Erten Şükran , Acar Banu Çelikel
Published: December 2024

Background

Clinical features and prognosis of autoimmune inflammatory myopathies (AIMs) can vary depending on the age of disease onset. The aim of this study was to compare the demographic characteristics, clinical features, laboratory findings, and long-term prognosis of juvenile and adult AIMs.

Methods

Patients diagnosed with AIM between 2009 and 2023 in the pediatric rheumatology and rheumatology departments of our hospital were included in this medical records review study. Demographic characteristics, clinical features, laboratory findings, treatments, and prognosis of juvenile and adult AIM patients were compared with statistical methods.

Results

Of the 94 patients diagnosed with AIM, 34 (36.2%) patients were juvenile and 60 (63.8%) patients were adult. At the time of diagnosis, while Gottron papules, dysphonia, and subcutaneous edema were more common in juvenile patients, fever was more common in adult patients (p = 0.003, p = 0.05, p = 0.005 p = 0.05, respectively). During follow-up, while calcinosis was more common in juvenile patients, lung involvement and malignancy were more common in adult patients (p = 0.022, p = 0.009, p = 0.006, respectively). The methylprednisolone pulse therapy requirement was significantly higher in juvenile patients (p = 0.0001). Clinically inactive disease was more common in juvenile patients (p = 0.01).

Conclusions

AIM with different onset ages is associated with distinct clinical manifestations and outcomes. The present study reported that in AIM patients, lung involvement and malignancy increase with age while clinically inactive disease decreases.