bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of admission serum triglyceride levels with intensive care unit hospitalization rates in acute pancreatitis patients: A retrospective study
Authors: Wen Shuaiyong , Zhang Yu , Zhao Guijie , Tu Zhengwei , Zhang Kun , Cui Yunfeng
Published: May 2024

Acute pancreatitis (AP) is a complex and unpredictable condition, of which hypertriglyceridemia (HTG) is the third most prevalent cause. This study aimed to conduct a retrospective analysis of clinical data from hospitalized AP patients to uncover a potential correlation between triglyceride (TG) levels and the necessity for intensive care unit (ICU) admission. This retrospective cohort study utilized the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV) critical care dataset, incorporating data from 698 patients with hypertriglyceridemic acute pancreatitis (HTG-AP). The analysis employed the RCS model along with univariate and multivariate logistic regression methods to affirm the association between triglyceride levels and ICU admission. Subgroup analysis was performed to investigate specific populations. The study included 698 patients with AP, 42.41% of whom experienced HTG during hospitalization. RCS analysis revealed a linear association between TG levels and risk of ICU admission (p for nonlinear = .219, p for overall = .009). Multivariate logistic regression analysis indicated an increased risk of ICU admission in the TG range of 1.7–5.65 mmol/L (aOR = 1.83, 95% CI 1.12–2.99, P = .015) and TG >11.3 mmol/L (aOR = 5.69, 95% CI 2.36–13.74, P < .001) compared to the normal group. Similar results were observed across the various subgroups. As triglyceride levels increased, there was a corresponding increase in ICU admissions. Patients within the 1.7 to 5.65 mmol/L and > 11.3 mmol/L triglyceride groups exhibited higher rates of ICU admissions. Moreover, we observed a higher risk of ICU hospitalization even with mild TG elevation.
Characterizing colon lipomas: Insights from a retrospective analysis of clinical presentation and management strategies
Authors: Uygur Furkan Ali , Kuloğlu Ersin , Aydin Gökhan , Muhtaroğlu Ali , Dülger Ahmet Cumhur
Published: May 2024

This retrospective study aims to examine the characteristics and treatment approaches of colon lipomas, which are benign tumors found in the colon. We analyzed a cohort of 25 patients, focusing on demographic characteristics, clinical presentation, location and size of the lipoma, concomitant pathologies, and treatment methods. The average age of the patients was 67.3 years, with 36% being male and 64% female. The majority of lipomas were located in the ascending colon (52%), and their median size was 2 cm. The predominant presenting symptom was constipation, affecting 83.3% of the symptomatic patients. Surgical resection was undertaken in only 1 patient due to obstruction. Statistically significant differences were observed between symptomatic and asymptomatic patients regarding various parameters, including the size of the lipoma (P = .033). Colon lipomas are generally benign and frequently asymptomatic but may necessitate different treatment approaches depending on their size, location, and the presence of symptoms. Further studies are imperative to refine treatment strategies and enhance patient care outcomes.
Clinical inertia in thyrotropin suppressive therapy for low-risk differentiated thyroid cancer: A real-world experience at an endocrine center in Bangkok
Authors: Thewjitcharoen Yotsapon , Chatchomchuan Waralee , Wanothayaroj Ekgaluck , Butadej Siriwan , Nakasatien Soontaree , Krittiyawong Sirinate , Rajatanavin Rajata , Himathongkam Thep
Published: May 2024

The management of low-risk differentiated thyroid cancer (DTC) has evolved over time toward treatment de-escalation. However, overtreatment with supraphysiological dose of levothyroxine (LT4) continues to be observed despite current clinical guideline. This study aimed to assess the actual thyrotropin suppressive therapy for low-risk DTC patients at an endocrine center in Bangkok. This retrospective study included patients with low-risk DTC who were regularly follow-up for at least 18 months at Theptarin Hospital between 2016 and 2022. The serum thyroid stimulating hormone (TSH) levels were stratified as TSH < 0.1 mIU/L; TSH 0.1 to 0.5 mIU/L; TSH 0.5 to 2.0 mIU/L; and TSH > 2.0 mIU/L. The initial risk stratification (IRS) and dynamic risk stratification were determined at 12 months of follow-up after completing the initial treatment and at the last visit. The clinical factors associated with overtreatment with LT4 were analyzed. A total of 102 patients (83.3% female, age at diagnosis 41.8 ± 13.6 years, mean tumor size 1.6 ± 1.0 cm) were evaluated with a mean follow-up of 5.9 years. The IRS classified 92.2% of patients after the initial treatment and 93.1% of patients at the last follow-up visit into the excellent response category. The mean LT4 daily dosage at the last follow-up was 121.3 ± 44.8 µg/day. Serum TSH levels were in an appropriate target range according to IRS in only 8.8% (9/102) of the patients and then improved to 19.6% (20/102) at the last follow-up visit. Further analysis showed that treating physicians with ≥10 years of practice was associated with severe TSH suppression therapy (TSH < 0.1 mIU/L). Despite the current clinical guideline recommendations and scientific evidences, less than one-fifth of low-risk DTC patients achieved the appropriate serum TSH target. While the proportion of an optimum LT4 suppressive had improved during the study period, further efforts are needed to overcome this clinical inertia.
Resting energy expenditure differs among individuals with different levels of perceived thermal sensitivity: A cross-sectional study
Authors: Mun Sujeong , Yoo Junghun , Lee Sanghun , Yim Mi Hong , Kim Soyoung , Kim Daehyeok , Kim Min-Ji , Lee Youngseop , Park Jeong Hwan
Published: May 2024

Metabolic rate has been used in thermophysiological models for predicting the thermal response of humans. However, only a few studies have investigated the association between an individual’s trait-like thermal sensitivity and resting energy expenditure (REE), which resulted in inconsistent results. This study aimed to explore the association between REE and perceived thermal sensitivity. The REE of healthy adults was measured using an indirect calorimeter, and perceived thermal intolerance and sensation in the body were evaluated using a self-administered questionnaire. In total, 1567 individuals were included in the analysis (women = 68.9%, age = 41.1 ± 13.2 years, body mass index = 23.3 ± 3.3 kg/m2, REE = 1532.1 ± 362.4 kcal/d). More women had high cold intolerance (31.8%) than men (12.7%), and more men had high heat intolerance (23.6%) than women (16.1%). In contrast, more women experienced both cold (53.8%) and heat (40.6%) sensations in the body than men (cold, 29.1%; heat, 27.9%). After adjusting for age, fat-free mass, and fat mass, lower cold intolerance, higher heat intolerance, and heat sensation were associated with increased REE only in men (cold intolerance, P for trend = .001; heat intolerance, P for trend = .037; heat sensation, P = .046), whereas cold sensation was associated with decreased REE only in women (P = .023). These findings suggest a link between the perceived thermal sensitivity and REE levels in healthy individuals.
Arthroscopic debridement and microfracture for bilateral osteochondral lesions on the lateral process of the talus involving the subtalar joint: A case report
Authors: Yabiku Hiroki , Matsui Tomohiro , Sugimoto Takeshi , Nagamoto Hideaki , Tome Yasunori , Nishida Kotaro , Kumai Tsukasa
Published: May 2024

Rationale:

Osteochondral lesions on the lateral process of the talus involving the subtalar joint are rare; the optimal surgical treatment remains to be clarified as there are few reports. Additionally, bilateral cases are extremely rare. Therefore, the clinical outcomes of the surgical treatment for bilateral osteochondral lesions on the lateral process of the talus involving the subtalar joint have not been fully elucidated.

Patient concerns:

A 16-year-old boy who played soccer presented to our hospital with bilateral hindfoot pain. The symptoms persisted even after 3 months of conservative treatment. The patient and family requested surgical treatment to relieve the symptoms.

Diagnoses:

The patient was diagnosed with bilateral osteochondral lesions on the lateral process of the talus, involving the subtalar joint based on computed tomography and magnetic resonance imaging findings.

Interventions:

Arthroscopic debridement and microfracture were performed bilaterally.

Outcomes:

Postoperative computed tomography and magnetic resonance imaging of both feet revealed remodeling of the subchondral bone. The patient returned to play at the pre-injury level with no pain.

Lessons:

This report describes a case of bilateral osteochondral lesions on the lateral process of the talus, involving the subtalar joint. Arthroscopic debridement and microfracture were effective in relieving symptoms and the subchondral bone remodeling. To the best of our knowledge, this is the first report of arthroscopic treatment of osteochondral lesions of the lateral process of the talus involving the subtalar joint.
Impact of hyponatremia in patients hospitalized in Internal Medicine units: Hyponatremia in Internal Medicine units
Authors: Ternero-Vega Jara Eloísa , Jiménez-de-Juan Carlos , Castilla-Yelamo Javier , Cantón-Habas Vanesa , Sánchez-Ruiz-Granados Elena , Barón-Ramos Miguel Ángel , Ropero-Luis Guillermo , Gómez-Salgado Juan , Bernabeu-Wittel Máximo
Published: May 2024

The aim of this study was to analyze the impact and the clinical and evolutionary characteristics of hypotonic hyponatremia in patients hospitalized in Internal Medicine units. Prospective multicenter observational study of patients with hypotonic hyponatremia (<135 mmol/L) in 5 hospitals in southern Spain. Patients were included according to point prevalence studies carried out every 2 weeks between March 2015 and October 2017, by assessing demographic, clinical, analytical, and management data; each patient was subsequently followed up for 12 months, during which time mortality and readmissions were assessed. A total of 501 patients were included (51.9% women, mean age = 71.3 ± 14.24 years), resulting in an overall prevalence of hyponatremia of 8.3%. The mean comorbidities rate was 4.50 ± 2.41, the most frequent diagnoses being heart failure (115) (23%), respiratory infections (65) (13%), and oncological pathologies (42) (6.4%). Of the total number of hyponatremia cases, 180 (35.9%) were hypervolemic, 164 (32.7%) hypovolemic, and 157 (31.3%) were euvolemic. A total of 87.4% did not receive additional diagnostic tests to establish the origin of the condition and 30% did not receive any treatment. Hospital mortality was 15.6% and the mean length of stay was 14.7 days. Euvolemic and admission hyponatremia versus hyponatremia developed during admission were significantly associated with lower mortality rates (P = .037). Mortality at 1 year and readmissions were high (31% and 53% of patients, respectively). Hyponatremia was common in Internal Medicine areas, with hypervolemic hyponatremia being the most frequent type. The mortality rate was high during admission and at follow-up; yet there is a margin for improvement in the clinical management of this condition.
The usefulness of universal ultrasound before hospital discharge for early diagnosing hip dysplasia in Korean neonates with breech presentation in a single center: A retrospective study
Authors: Shon Seung Woo , Park Su Jeong , Bae Mi Hye , Park Kyung Hee
Published: May 2024

Developmental dysplasia of the hip (DDH) is a broad-spectrum disorder. Early diagnosis and treatment are important for improved prognosis and a lower risk of long-term complications. Selecting high-risk infants is important for the early diagnosis of DDH using ultrasonography; however, there are no standard international guidelines. This study aimed to identify the usefulness of universal ultrasound before hospital discharge in breech-born neonates and proposes selective ultrasound for high-risk patients. A retrospective chart review was conducted to identify breech-born neonates who underwent hip ultrasonography before discharge for the detection of DDH between 2019 and 2023. Patients were categorized into DDH and non-DDH groups according to the ultrasound results. We compared sex, gestational age, birth weight, first-born status, twin pregnancy, associated anomalies, presence of symptoms, physical examination results, and timing of the first hip ultrasound. The medical records of the mothers were reviewed to identify the amount of amniotic fluid and duration of breech presentation. This study included 102 patients, of whom 62 and 40 were assigned to the non-DDH and DDH groups, respectively. Congenital anomalies, positive symptoms, and positive physical examination results were significant risk factors. However, female sex, first-born status, and oligohydramnios were not statistically significant. The duration of breech presentation during pregnancy was not significant. Additionally, the risk of Pavlik harnesses was higher in patients who underwent a positive physical examination. Universal ultrasonography before discharge is not recommended for the early diagnosis of DDH in all breech-born neonates because of the high rate of overdiagnosis. We recommend that ultrasonography be performed in patients with congenital anomalies, except for foot problems, or in those with a positive physical examination conducted by trained specialists.
Efficacy and safety of orlistat in controlling the progression of prediabetes to diabetes: A meta-analysis and systematic review
Authors: Gao Zhao , Huang Mengwen , Wang Jiaxin , Jia Huihui , Lv Pin , Zeng Jing , Ti Guixiang
Published: May 2024

Background:

The aim of this study is to examine the impact of the Orlistat on glucose levels and glucose tolerance in individuals with prediabetes, as well as assess its efficacy and safety in preventing the progression to diabetes.

Methods:

For achieving the appropriate randomized controlled trials, we enrolled the public datas from the following electronic databases: The Cochrane library, Embase, China National Knowledge Infrastructure, VIP, Wan-Fang, and China Biology Medicine disc. The article focused on the orlistat intervention of glucose tolerance and glycemic status in prediabetic patients. We restricted the publication time from the creation to May 2023.

Results:

Six subjects were included in the study, with a total of 1076 participants (532 in the control group vs 544 in the experimental group). The results indicated that the orlistat can reduce the fasting blood glucose [relative risk (RR) = −2.18, 95% confidence intervals (CI) (−2.471, −1.886)], as well as the 2 hour postprandial blood glucose [RR = −1.497, 95% CI (−1.811, −1.183)]. Furthermore, it can prevent the impaired glucose tolerance patients to type 2 diabetes mellitus [RR = 0.605, 95% CI (0.462, 0.791)], and reversal the impaired glucose tolerance [RR = 2.092, 95% CI (1.249, 3.503)].

Conclusions:

In prediabetic people, the orlistat can control weight, reduce the fasting blood glucose and the 2 hour postprandial blood glucose, and then delay the progression of diabetes. However, due to the quantitative restrictions, additional high-quality study needs to be conducted to improve the reliability of the results.
Development of a delayed chronic subdural haematoma 3 years after traumatic brain injury with urinary incontinence: a case report
Authors: Khulsai Muhammad Sameer , Nasir H. Saad , Raja Huda , Nadeem Abdullah , Raufi Nahid , Khan Atiq Ahmed
Published: May 2024

Introduction:

The authors present a case of a delayed chronic subdural haematoma, a rare occurrence that manifested 3 years after a traumatic brain injury, accompanied by an unexpected symptom of urinary incontinence. Chronic subdural haematoma (CSDH) is a well-known condition characterised by the accumulation of old, liquefied blood under the dura mater, usually following minor head trauma. However, the atypical presentation of CSDH in a young patient without predisposing factors and the association with urinary incontinence challenge conventional understanding. This report explores the clinical manifestations, radiological findings, and management of this exceptional case, providing valuable insights into this unusual presentation.

Case presentation:

In this report, the authors present the case of a 23-year-old male with an unremarkable medical history, devoid of prior neurological deficits, who presented with persistent headaches, memory impairment, left-right disorientation, slurred speech, and urinary incontinence, troubling him for the past month. The patient had a history of a traumatic brain injury from a road traffic accident 3 years earlier, initially devoid of concerning symptoms. Imaging revealed a large heterogeneous mass lesion in the left fronto-parietal lobe consistent with a chronic subdural haematoma. The patient underwent surgical evacuation and excision of the haematoma, leading to the successful resolution of symptoms.

Clinical discussion:

Conventionally, chronic subdural haematoma is observed in elderly individuals following minor head trauma. However, this case challenges the traditional understanding by highlighting its delayed occurrence in a young patient without known predisposing factors. This case emphasises the need to consider delayed presentations even without immediate neurological deficits. The unexpected symptom of urinary incontinence underscores the necessity of comprehensive evaluations to understand the associated neurological effects of CSDH. A surgical approach was crucial for both diagnosis and treatment, underscoring the significance of prompt intervention in such atypical cases.

Conclusion:

This exceptional case sheds light on a delayed chronic subdural haematoma occurring years after traumatic brain injury in a young patient without known risk factors. The presence of urinary incontinence as a symptom further amplifies the uniqueness of this case. Understanding and recognising atypical presentations of CSDH is vital for accurate diagnosis and timely intervention. This report underscores the importance of vigilance and an integrated approach to managing patients with subdural haematomas, particularly in unexpected demographics and circumstances, to ensure optimal outcomes and patient well-being.
Large nasopalatine duct cyst in a child patient: a case report
Authors: Khalil Ali , Albash Ziad
Published: May 2024

Introduction and importance:

Nasopalatine duct cyst (NPDC) is one of the most common non-odontogenic cysts of the oral cavity, which it can arise at any age but is seen rarely in children. These cysts are usually asymptomatic, and are detected by routine radiographs.

Case presentation:

This case report presents the management of a large nasopalatine duct cyst in an 11-year-old pediatric patient. The patient presented with symptoms such severe mobility in central incisors and swelling in the anterior part of the palate. Diagnostic imaging confirmed the presence of a large cyst in the nasopalatine region. Surgical intervention was performed to excise the cyst, and the central incisors were splinted with a rigid splint for 4 weeks.

Clinical discussion:

The case of a large nasopalatine duct cyst in a child patient poses several important clinical considerations. Nasopalatine duct cysts are relatively rare, especially in pediatric patients, making this case particularly noteworthy. The presentation of a large cyst in a child raises questions about the etiology, diagnosis, and treatment options for such cases.

Conclusions:

This case report highlights the importance of considering nasopalatine duct cysts as a differential diagnosis in pediatric patients presenting with maxillary swelling and associated symptoms. Early recognition and appropriate management are essential to prevent potential complications and ensure optimal outcomes for the patient. The nasopalatine duct cyst that occurs at children may be aggressive and led to severe loss in the supporting alveolar bone with teeth mobility.
Goals, Structure, and Financing of Surgical Residency Training
Authors: Klingensmith Mary E. , Minter Rebecca M. , Fisher Karen , Berry Cherisse D. , Cooke David Tom , Phillips Linda G. , Sidawy Anton N. , Freischlag Julie A.
Published: May 2024

Objective:

As part of the Blue Ribbon Committee II, review current goals, structure and financing of surgical training in Graduate Medical Education (GME) and recommend needed changes.

Background:

Surgical training has continually undergone major transitions with the 80-hour work week, earlier specialization (vascular, plastics, and cardiovascular), and now entrustable professional activities as part of competency-based medical education (CBME). Changes are needed to ensure the efficiencies of CBME are utilized, that stable graduate medical education funding is secured, and that support for surgeons who teach is made available.

Methods:

Convened subcommittee discussions to determine the needed focus for recommendations.

Results:

Five recommendations are offered for changes to GME financing, incorporation of CBME, and support for educators, students, and residents in training.

Conclusions:

Changes in surgical training related to CBME offer opportunities for change and innovation. Our subcommittee has laid out a potential path forward for improvements in GME funding, training structure, compensation of surgical educators, and support of students and residents in training.
Blue Ribbon Committee I Review: Findings and Impact
Authors: Flynn Timothy C. , Brennan Murray F. , Ellison E. Christopher , Freischlag Julie A. , Malangoni Mark A. , Pellegrini Carlos A. , Sachdeva Ajit K. , Turner Patricia L. , Warshaw Andrew L. , Zinner Michael J.
Published: May 2024

Objective:

Review the subsequent impact of recommendations made by the 2004 American Surgical Association Blue Ribbon Committee (BRC I) Report on Surgical Education.

Background:

Current leaders of the American College of Surgeons and the American Surgical Association convened an expert panel to review the impact of the BRC I report and make recommendations for future improvements in surgical education.

Methods:

BRC I members reviewed the 2004 recommendations in light of the current status of surgical education.

Results:

Some of the recommendations of BRC I have gained traction and have been implemented. There is a well-organized national curriculum and numerous educational offerings. There has been greater emphasis on preparing faculty to teach, and there are ample opportunities for professional advancement as an educator. The number of residents has grown, although not at a pace to meet the country’s needs either by total number or geographic distribution. The number of women in the profession has increased. There is greater awareness and attention to resident (and faculty) well-being. The anticipated radical change in the educational scheme has not been adopted. Training in surgical research still depends on the resources and interests of individual programs. Financing student and graduate medical education remains a challenge.

Conclusions:

The medical landscape has changed considerably since BRC I published its findings in 2005. A contemporary assessment of surgical education and training is needed to meet the future needs of the profession and our patients.
Evidence of positive selection and a novel phylogeny among five subspecies of song sparrow (Melospiza melodia) in Alaska
Authors: Oliver Brown Caitlyn C. , Collier Keiler A. , Mills Kendall K. , Spaulding Fern , Glenn Travis C. , Pruett Christin L. , Winker Kevin
Published: May 2024

Under local adaptation, populations evolve traits in response to the local environment. Isolated island populations often experience different selection pressures than their mainland counterparts, which enables the study of how phenotypes and genotypes respond to different selection regimes. We used a group of five phenotypically differentiated subspecies of song sparrow (Melospiza melodia) in Alaska to examine the effects of local adaptation. Song sparrows occur across southern Alaska from Attu Island in the western Aleutian Islands, to southeast Alaska. Moving from western to eastern Alaska these populations demonstrate striking body size differences (larger-to-smaller) and a change from a sedentary to a migratory/partially migratory life-history strategy. We examined the phenotypic attributes of these populations and used whole-genomic data to determine relationships and test candidate loci for evidence of selection. Phenotypic measurements of museum specimens (n = 227) quantified the dramatic size differences among these populations, with westernmostM. m. maximabeing ∼1.6 times larger than easternmostM. m. rufina. Ultraconserved elements (UCEs) were extracted for phylogenetic reconstruction and candidate genes were extracted for selection testing. We analyzed 26 candidate genes for body size, migration and dispersal, color, and salt tolerance. Two of the candidate genes showed signs of positive selection:BCO1(associated with plumage color) andKCTD21(associated with dispersal). Phylogenetic analysis of UCEs showedM. m. maximaas sister to the other AlaskaM. melodiasubspecies. This suggestsM. m. maximacolonized earliest, perhaps before the last glacial maximum, and that Alaska was later recolonized by ancestors of the remaining four subspecies.
The Src-family kinase Lyn plays a critical role in establishing and maintaining B cell anergy by suppressing PI3K-dependent signaling
Authors: Fiske Brigita E. , Wemlinger Scott M. , Crute Bergren W. , Getahun Andrew
Published: May 2024

Although the Src family kinase (SFK) Lyn is known to be involved in induction and maintenance of peripheral B cell tolerance, the molecular basis of its action in this context remains unclear. This question has been approached using conventional as well as B cell-targeted knockouts of Lyn, with varied conclusions likely confused by collateral loss of Lyn functions in B cell and myeloid cell development and activation. Here we utilized a system in which Lyn gene deletion is tamoxifen inducible and B cell restricted. This system allows acute elimination of Lyn in B cells without off-target effects. This genetic tool was employed in conjunction with immunoglobulin transgenic mice in which peripheral B cells are autoreactive. DNA reactive Ars/A1 B cells require continuous inhibitory signaling, mediated by the inositol phosphatase SHIP-1 and the tyrosine phosphatase SHP-1, to maintain an unresponsive (anergic) state. Here we show that Ars/A1 B cells require Lyn to establish and maintain B cell unresponsiveness. Lyn primarily functions by restricting PI3K-dependent signaling pathways. This Lyn-dependent mechanism complements the impact of reduced mIgM BCR expression to restrict BCR signaling in Ars/A1 B cells. Our findings suggest that a subset of autoreactive B cells requires Lyn to become anergic and that the autoimmunity associated with dysregulated Lyn function may, in part, be due to an inability of these autoreactive B cells to become tolerized.
STGram: Non-Invasive Visualization and Analysis of Circadian Rhythms Through Surface Temperature Monitoring
Authors: Shi Shoi , Natsume Tohru
Published: May 2024

Circadian rhythms, integral to physiological and behavioral processes, are influenced by environmental cues and developmental stages. This study explores the visualization and analysis of circadian rhythms through non-invasive monitoring of surface body temperature (STGram: Surface Thermo Deviations gram), focusing on the effects of jet lag in international travelers and the developmental progression of circadian rhythms in infants. Using a compact, wearable thermometric device, we collected data from adults experiencing jet lag and a 3-month-old infant over five months. Our analysis identified clear circadian shifts in travelers and illustrated the gradual establishment of circadian rhythms in the infant. These findings underscore the effectiveness of surface body temperature as a marker for circadian rhythm analysis, offering a valuable tool for understanding circadian dynamics and their impact on health. This methodological approach has significant implications for circadian rhythm research, health management, and the study of physiological development.
Trend and Factors Associated with Cardiovascular Risk in Peru: An Analysis of the National Demographic and Family Health Survey, 2014-2022
Authors: Vera-Ponce Víctor Juan , Zuzunaga-Montoya Fiorella E. , Vásquez-Romero Luisa Erika Milagros , Loayza-Castro Joan A. , Valladares-Garrido Mario J. , Gutierrez De Carrillo Carmen Inés
Published: May 2024

Introduction

Cardiovascular diseases (CVD), which encompass a broad array of disorders impacting both the heart and circulatory system, remain a predominant source of mortality and morbidity that takes a toll on populations around the world.

Objective

This study focuses on the prevalence and trends of cardiovascular risk (CVR) in Peru from 2014 to 2022 and the factors associated with these conditions.

Methods

We conducted a cross-sectional analytical study using a database from the National Survey of Demography and Family Health collected from 2014 to 2022, covering individuals aged 40 to 75. Measurements included blood pressure, smoking, and body mass index (BMI), among others, using the World Health Organization’s (WHO) risk calculator. Stratified sampling methods were applied, and participants lacking interest variables were excluded.

Results

The prevalence of low and high CVR was 74.89% and 4.48%, respectively. Variations in CVR trends were observed from 2014 to 2022. Factors significantly associated with higher CVR included male sex, older age, higher education, wealth, smoking habits, obesity, and health conditions such as hypertension and type 2 diabetes.

Conclusions

The study revealed a significant prevalence of CVR factors in the studied population. The critical importance of addressing these prevalent factors in public health policies and strategies for preventing and managing cardiovascular diseases is strongly highlighted.
Hypertension-associated Medical Expenditures Among Privately Insured US Individuals Aged 18 to 64 Years in 2021
Authors: Kumar Ashutosh , He Siran , Pollack Lisa M. , Lee Jun Soo , Imoisili Omoye , Wang Yu , Kompaniyets Lyudmyla , Luo Feijun , Jackson Sandra L.
Published: May 2024

Background

There are no recent estimates for hypertension-associated medical expenditures. This study aims to estimate hypertension-associated incremental medical expenditures among privately insured US adults.

Methods

We conducted a retrospective cohort study using IQVIA’s Ambulatory Electronic Medical Records-US dataset linked with PharMetrics Plus claims data. Privately insured adults aged 18–64 years with ≥1 blood pressure measurement in 2020–2021 were included.

Hypertension was identified as having ≥1 diagnosis code or ≥ 2 blood pressure measurements of ≥140/90 mmHg, or ≥1 antihypertensive medication in 2021. Annual total expenditures were estimated using a generalized linear model (GLM) with gamma distribution and log-link function. Out-of-pocket (OOP) expenditures were estimated using a two-part model that included logistic and GLM regression. Overlap propensity-score weights from logistic regression were used to obtain a balanced sample on hypertension status.

Results

Among the 393,018 adults, 156556 (40%) were identified with hypertension. Compared to individuals without hypertension, those with hypertension had $2,926 (95% CI, $2,681–$3,170) higher total expenditures, and $328 (95% CI, $300–$355) higher OOP expenditures. Adults with hypertension had higher total inpatient ($3,272; 95% CI, $1,458–$5,086) and outpatient ($2,189; 95% CI, $2,009–$2,369) expenditures, when compared with those without hypertension. Hypertension-associated incremental total expenditures were higher for women ($3,242; 95% CI, $2,915–$3,569) than for men ($2,521; 95% CI, $2,139–$2,904).

Conclusions

Among privately insured US adults, hypertension was associated with higher medical expenditures, including higher inpatient and OOP expenditures. These findings may help assess the economic value of interventions effective in preventing hypertension.
Let-7restrains an oncogenic circuit in AT2 cells to prevent fibrogenic cell intermediates in pulmonary fibrosis
Authors: Seasock Matthew J. , Shafiquzzaman Md , Ruiz-Echartea Maria E. , Kanchi Rupa S. , Tran Brandon T. , Simon Lukas M. , Meyer Matthew D. , Erice Phillip A. , Lotlikar Shivani L. , Wenlock Stephanie C. , Ochsner Scott A. , Enright Anton , Carisey Alex F. , Romero Freddy , Rosas Ivan O. , King Katherine Y. , McKenna Neil J. , Coarfa Cristian , Rodriguez Antony
Published: May 2024

Analysis of lung alveolar type 2 (AT2) progenitor stem cells has highlighted fundamental mechanisms that direct their differentiation into alveolar type 1 cells (AT1s) in lung repair and disease. However, microRNA (miRNA) mediated post-transcriptional mechanisms which govern this nexus remain understudied. We show here that thelet-7miRNA family serves a homeostatic role in governance of AT2 quiescence, specifically by preventing the uncontrolled accumulation of AT2 transitional cells and by promoting AT1 differentiation. Using mice and organoid models, we demonstrate genetic ablation oflet-7a1/let-7f1/let-7dcluster (let-7afd) in AT2 cells prevents AT1 differentiation and results in accumulation of AT2 transitional cells in progressive pulmonary fibrosis. Integration of AGO2-eCLIP with RNA-sequencing from AT2 cells uncovered the induction of direct targets oflet-7in an oncogene feed-forward regulatory network including BACH1/EZH2/MYC which drives an aberrant fibrotic cascade. Additional analyses using CUT&RUN-sequencing revealed an epigenetic role oflet-7in induction of chromatin histone acetylation and methylation and maladaptive AT2 cell reprogramming. This study identifieslet-7as a key gatekeeper of post-transcriptional and epigenetic chromatin signals to prevent AT2-driven pulmonary fibrosis.
Epidermal cell fusion promotes the transition from an embryonic to a larval transcriptome inC. elegans
Authors: Funk Owen H. , Levy Daniel L. , Fay David S.
Published: May 2024

Cell fusion is a fundamental process in the development of multicellular organisms, yet its impact on gene regulation, particularly during crucial developmental stages, remains poorly understood. TheCaenorhabditis elegansepidermis comprises 8–10 syncytial cells, with the largest integrating 139 individual nuclei through cell–cell fusion governed by the fusogenic protein EFF-1. To explore the effects of cell fusion on developmental progression and associated gene expression changes, we conducted transcriptomic analyses ofeff-1fusion-deficient mutants. Our RNAseq findings showed widespread transcriptomic changes that were enriched for epidermal genes and key molecular pathways involved in epidermal function during larval development. Subsequent single-molecule fluorescencein situhybridization validated the altered expression of mRNA transcripts, confirming quantifiable changes in gene expression in the absence of embryonic epidermal fusion. These results underscore the significance of cell–cell fusion in shaping transcriptional programs during development and raise questions regarding the precise identities and specialized functions of different subclasses of nuclei within developing syncytial cells and tissues.
Mesendodermal cells fail to contribute to heart formation following blastocyst injection
Authors: Li Biyi , Kwon Chulan
Published: May 2024

Blastocyst complementation offers an opportunity for generating transplantable whole organs from donor sources. Pluripotent stem cells (PSCs) have traditionally served as the primary donor cells due to their ability to differentiate into any type of body cell. However, the use of PSCs raises ethical concerns, particularly regarding their uncontrollable differentiation potential to undesired cell lineages such as brain and germline cells. To address this issue, various strategies have been explored, including the use of genetically modified PSCs with restricted lineage potential or lineage-specified progenitor cells as donors. In this study, we tested whether nascent mesendodermal cells (MECs), which appear during early gastrulation, can be used as donor cells. To do this, we induced Bry-GFP+MECs from mouse embryonic stem cells (ESCs) and introduced them into the blastocyst. While donor ESCs gave rise to various regions of embryos, including the heart, Bry-GFP+MECs failed to contribute to the host embryos. This finding suggests that MECs, despite being specified from PSCs within a few days, lack the capacity to assimilate into the developing embryo.
SARS-CoV-2 infection unevenly impacts metabolism in the coronal periphery of the lungs
Authors: Laro Jarrod , Xue Biyun , Zheng Jian , Ness Monica , Perlman Stanley , McCall Laura-Isobel
Published: May 2024

Highlights

COVID-19 significantly decreases amino acids, fatty acids, and most eicosanoids

SARS-CoV-2 preferentially localizes to central lung tissue

Metabolic disturbance is highest in peripheral tissue, not central like viral load

Spatial metabolomics allows detection of metabolites not altered overall

SARS-CoV-2, the virus responsible for COVID-19, is a highly contagious virus that can lead to hospitalization and death. COVID-19 is characterized by its involvement in the lungs, particularly the lower lobes. To improve patient outcomes and treatment options, a better understanding of how SARS-CoV-2 impacts the body, particularly the lower respiratory system, is required. In this study, we sought to understand the spatial impact of COVID-19 on the lungs of mice infected with mouse-adapted SARS2-N501YMA30. Overall, infection caused a decrease in fatty acids, amino acids, and most eicosanoids. When analyzed by segment, viral loads were highest in central lung tissue, while metabolic disturbance was highest in peripheral tissue. Infected peripheral lung tissue was characterized by lower levels of fatty acids and amino acids when compared to central lung tissue. This study highlights the spatial impacts of SARS-CoV-2 and helps explain why peripheral lung tissue is most damaged by COVID-19.
One probe fits all: a highly customizable modular RNAin situhybridization platform expanding the application of SABER DNA probes
Authors: Ustyantsev Kirill , Stranges Mattia , Volpe Filippo Giovanni , Mouton Stijn , Berezikov Eugene
Published: May 2024

In situhybridization (ISH) of RNA is a key method to visualize gene expression patterns in complex biological samples. The technique is indispensable for biological research related to e.g. development, disease, gene function, and the validation of novel cell types identified by single-cell sequencing methods. Especially in non-mammalian models lacking accessibility to a broad spectrum of antibodies, ISH remains a major research tool. Diverse available ISH protocols require different custom hybridization probe types, design, and/or proprietary signal detection chemistry. This makes it hard to navigate for a beginner and increases the research costs when multiple methods need to be applied. Here, we describe OneSABER – a unified open platform connecting commonly used canonical and recently developed single- and multiplex, colorimetric, and fluorescent ISH approaches. This platform uses a single type of ISH DNA probes adapted from the signal amplification by exchange reaction (SABER) method. We demonstrate applications of the proposed ISH framework in whole-mount samples of the regenerative flatwormMacrostomum lignano, advancing this animal as a powerful model for stem cell and regeneration research.
Diabetes and Stroke: Does an Excess Risk of Hemodynamic Cerebral Ischemia Exist?
Authors: Petitjean Christian , Labreuche Julien
Published: May 2024

BACKGROUND

Diabetes is an independent risk factor for ischemic stroke. This study was undertaken to determine whether hemodynamic cerebral ischemia (HCI), which increases stroke severity, is more frequent in diabetic patients.

METHODS

Between 01/01/1990 and 30/06/2019, we revascularized 4117 carotid bifurcations in 3739 patients (2683 men and 1056 women; mean age: 71 (range: 28–97) years; 940 (25.1%) diabetics and 2799 (74.9%) nondiabetics). HCI was diagnosed clinically, under regional anesthesia, when a shunt needed to be inserted.

RESULTS

The HCI rate during carotid-clamping, requiring shunt placement, was 11.0% (114/1034) for diabetics and 7.1% (219/3083) for nondiabetics (odds ratio,1.62 [95% CI, 1.27–2.05];P<0.0001).

CONCLUSIONS

Diabetes was associated with increased HCI risk in our patients with carotid stenosis. This HCI-associated excess risk might explain, in part, stroke severity in diabetics and heightened surgical risk. It might be prevented by HCI detection and modification of therapeutic management.
Factors Associated With Chronic Arthropathy And Rheumatological Diseases After Chikungunya Infection in Colombia: A Case-Control Study
Authors: Luna Guillermo Alejandro Ramírez , Paz Fabian Méndez
Published: May 2024

Objective

To identify the factors associated with the development of chronic arthropathy and rheumatological conditions in individuals who presented with clinical chikungunya infection.

Methods

A case-control study was carried out among individuals with a clinical diagnosis of chikungunya treated at a Colombian Health Provider Institution between 2014 and 2015. Two logistic regression models were constructed: one excluding the variables with more than 50% of the missing data, and another with all the variables but with the imputed data.

Results

In total 133 cases and 216 controls were obtained (349 individuals). In both models, female gender was a risk factor (OR: 2.27, CI95: 1.03 - 4.97, p = 0.04, and OR: 2.37, CI95: 1.09 - 5.17, p = 0.029, respectively), while acute involvement of the wrists was a protective factor (OR: 0.44, CI95: 0.20 - 0.95, p < 0.037; and OR: 0.29, CI95: 0.13 - 0.65, p = 0.003 respectively). Arthralgia duration was a risk factor in the imputed data model (OR: 1.03, CI95: 1.00 - 1.06, p = 0.02).

Conclusion

Female gender and the duration of joint symptoms in the acute phase were the main risk factors for the development of chronic chikungunya arthropathy or rheumatological pathology. Wrist involvement was a protective factor. Only rheumatoid arthritis was found to be a rheumatological disease associated with chikungunya infections. Finally, this study suggests that the interaction between usual cardiovascular factors could enhance the probability of developing chronic symptoms.
Exploring the Relationship Between Global Well-being and CO2Emissions
Authors: Ware Juliet
Published: May 2024

This study provides an exploratory statistical assessment of the relationship between individual well-being and CO2per capita emissions, and of the mediating factors of this relationship. Building on research which urges sustainable development to integrate subjective well-being, we collected 45 multidisciplinary indices that consider the environmental and human health of every member state of the United Nations (N= 196 countries). We are curious to understand whether the relationship between individual happiness and GHG per capita emissions is mediated by the collected indices. Well-being positively and significantly predicts CO2per capita emissions at a global level. Access to adequate water, multidimensional poverty, and gender inequality show evidence of full mediation of this relationship, while seventeen other variables show evidence of partial mediation. These findings provide practical implications for policy recommendations to downscale carbon consumption while ensuring human well-being.
Predictive Biophysical Neural Network Modeling of a Compendium ofin vivoTranscription Factor DNA Binding Profiles forEscherichia coli
Authors: Lally Patrick , Gómez-Romero Laura , Tierrafría Víctor H. , Aquino Patricia , Rioualen Claire , Zhang Xiaoman , Kim Sunyoung , Baniulyte Gabriele , Plitnick Jonathan , Smith Carol , Babu Mohan , Collado-Vides Julio , Wade Joseph T. , Galagan James E.
Published: May 2024

The DNA binding of mostEscherichia coliTranscription Factors (TFs) has not been comprehensively mapped, and few have models that can quantitatively predict binding affinity. We report the global mapping ofin vivoDNA binding for 139E. coliTFs using ChIP-Seq. We used these data to train BoltzNet, a novel neural network that predicts TF binding energy from DNA sequence. BoltzNet mirrors a quantitative biophysical model and provides directly interpretable predictions genome-wide at nucleotide resolution. We used BoltzNet to quantitatively design novel binding sites, which we validated with biophysical experiments on purified protein. We have generated models for 125 TFs that provide insight into global features of TF binding, including clustering of sites, the role of accessory bases, the relevance of weak sites, and the background affinity of the genome. Our paper provides new paradigms for studying TF-DNA binding and for the development of biophysically motivated neural networks.
Initiation of Lumen Formation from Junctions via Differential Actomyosin Contractility Regulated by Dynamic Recruitment of Rasip1
Authors: Yin Jianmin , Schellinx Niels , Maggi Ludovico , Gundel Kathrin , Wiesner Cora , Kotini Maria Paraskevi , Lee Minkyoung , Phng Li-Kun , Belting Heinz-Georg , Affolter Markus
Published: May 2024

Vascular lumens are essential for the dispersal of nutrients, oxygen, and immune cells throughout the body.De novolumen formation necessitates the precise segregation of junctional proteins from apical surfaces. Direct visualization of this process and a comprehensive understanding on how the apical and junctional compartments are segregated and established remain elusive, due to the lack of visualizable systems, proper reporters and manipulative tools. Using zebrafish as an experimental model, we have established a wealth of molecular reporters, photo-convertible and optogenetic tools and combined them with genetic analyses to study the establishment of apical domains from pre-apical junctional complexes. Our study identified Rasip1 as one of the earliest apical proteins recruited, peripheralizing cortical contractility at the junctional patches by inhibiting NMII at the center, thereby initiating the outward flow of junctional complexes. After the establishment of the apical compartments, Rasip1 shuttles between junctions and the apical compartments to the high-tension sites and tunes down the local hyper contractility, restricting Cdh5 to junctions by suppressing apical contractility. Above all, the formation ofde novolumens and maintenance of junctional integrity depend on the precise control of contractility within the apical compartments and junctions, orchestrated by the dynamic recruitment of Rasip1.