bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and Safety of Tenofovir Amibufenamide and Tenofovir Alafenamide for First‐Time HBV‐Related Decompensated Cirrhosis
Authors: Rong Xinxin , Yang Guangde , Xu Yuanyuan , Chen He , Wang Xia , Fu Juanjuan , Li Li , Pan Xiucheng 
Published: October 2024

ABSTRACTClinical studies of tenofovir amibufenamide (TMF) and tenofovir alafenamide (TAF) treatment in patients with HBV‐related decompensated cirrhosis (HBV‐DC) are limited. This study evaluated the efficacy and safety of TMF versus TAF in naive‐treated patients with first‐time HBV‐DC. Based on the antiviral drug used, patients were categorised into the TMF group and the TAF group. Virological and serological responses, hepatic and renal functions and blood lipid changes in both groups were evaluated during 48 weeks of treatment. A total of 98 patients were enrolled, 45 in the TMF group and 53 in the TAF group. At 48 weeks of treatment, the proportions of patients who achieved complete virological response (CVR) were 85.7% and 90.7%, respectively (p = 0.791). Improvement of at least 2 points in Child–Turcotte–Pugh scores was observed in 64.3% versus 79.1% (p = 0.169) of the patients. There were no significant changes in serum creatinine, estimated glomerular filtration rate or total cholesterol from baseline to week 48 between the two groups. Cystatin C remained stable in the TMF group but increased over time in the TAF group (p < 0.001). Low‐density lipoprotein cholesterol remained stable in the TMF group but increased significantly in the TAF group at week 48 (p = 0.015). These results suggest that both TMF and TAF can rapidly suppress HBV replication, improve hepatic function and have no negative effects on renal function among patients with HBV‐DC. Regarding lipid metabolism, both showed a better safety, while regular monitoring of blood lipid levels is recommended.
Exploring the Relationship Between NOD2 Risk Variants and First Decompensation Events in Cirrhotic Patients With Varices
Authors: Karbannek Henrik , Reichert Matthias C. , Greinert Robin , Zipprich Alexander , Lammert Frank , Ripoll Cristina 
Published: October 2024

ABSTRACTBackground and AimsNOD2 mutations are associated with impaired gut mucosal barrier function. According to the systemic inflammation hypothesis, bacterial translocation is central in the development of decompensation. The aim was to evaluate whether the presence of NOD2 variants is associated with the development of first decompensation.MethodSecondary analysis of prospectively collected consecutive patients with compensated cirrhosis, who were screened between 2014 and 2018. Patients with and without NOD2 variants were compared and stratified analysis according to the presence of varices was performed.Results360 patients [239 (66%) men, median age 61 (53–69) years, 70 (19%) with NOD2 variants, 90 (25%) with varices] were followed for a median of 9 (4–16) months. Similar baseline characteristics were observed across NOD2 status groups, except for beta‐blocker use (45% vs. 32% amongst variant carriers vs. non‐carriers, p = 0.05). During follow‐up, 34 patients (12%) developed their first decompensation, with no differences according to NOD2 status [HR 1.75 (95% CI 0.84–3.67)]. On multivariate analysis, only MELD remained an independent predictor of decompensation. Amongst patients with varices (n = 90), 18 (24.4%) carried a NOD2 variants, with a higher incidence of first decompensation [HR 3.00 (95% CI 1.08–8.32)], primarily due to ascites [HR 3.32 (95% CI 1.07–10.32)]. In this subgroup, MELD [HR 1.18 (95% CI 1.06–1.32)] and NOD2 variants [HR 2.91 (95% CI 0.95–8.89)] were determined to be independent predictors of decompensation.ConclusionsThe presence of NOD2 risk variants leads to a greater incidence of first decompensation only in compensated patients with varices.
Damage to Mitochondria During the Cryopreservation, Causing ROS Leakage, Leading to Oxidative Stress and Decreased Quality of Ram Sperm
Authors: Zhang Liuming , Sun Yuxuan , Jiang Caiyu , Sohail Tariq , Sun Xiaomei , Wang Jian , Li Yongjun 
Published: October 2024

ABSTRACTSemen cryopreservation can achieve long‐term preservation of sperm. Ice crystal damage, as well as oxidative stress, result in mitochondrial dysfunction and a reduction in sperm motility after thawing. However, limited information exists regarding the impact of reactive oxygen species (ROS) and mitochondria on the cryopreservation of ram sperm. The primary objective of this study was to investigate the relationship between ROS and mitochondria concerning sperm quality during the cryopreservation of ram sperm. This investigation assessed sperm motility, kinematic characteristics, membrane integrity, acrosome integrity, mitochondrial membrane potential (MMP), adenosine triphosphate (ATP) levels, expression of mitochondrial respiratory genes (NDUFV2, SDHA, CYC1, and COXIV), ROS levels, malondialdehyde (MDA) content, phosphatidylserine externalisation rate, sperm ultrastructure, mtDNA copy number, expression of apoptosis‐related genes (Bax, Caspase‐3, and Caspase‐8), Cytochrome C, and Caspase‐3 content. The results showed the cryopreservation significantly (p < 0.05) decreased motility, kinetic parameters, membrane integrity, acrosome integrity, MMP, ATP, mRNA expression levels of mitochondrial respiratory‐related genes, and significantly (p < 0.05) increased ROS levels, MDA content, phosphatidylserine externalisation rate, damage of sperm ultrastructure, mtDNA copy number, mRNA expression levels of apoptosis‐related genes, Cytochrome C and Caspase‐3 content compared to the fresh semen group. In conclusion, the cryopreservation causes damage to mitochondria, leading to increased ROS and subsequent oxidative stress. This process also initiates mitochondrial dysfunction and interferes with the electron transport chain, ultimately resulting in decreased MMP and ATP production. Furthermore, the liberation of Cytochrome C prompted the increase in Caspase‐3 expression and subsequent sperm apoptosis occurred, ultimately leading to a deterioration in sperm quality after thawing.
Identification of the Novel HLA‐A*02:407 Allele by Sanger Dideoxy Nucleotide Sequencing
Authors: Li Xiao‐Feng , Zhang Xu , Lin Feng‐Qiu , Wei Min‐Jie , Li Jian‐Ping 
Published: October 2024

ABSTRACTHLA‐A*02:407 differs from HLA‐A*02:01:01:01 by one nucleotide substitution in codon 109 in exon 3.
A Novel HLA‐B*15 Variant Allele, HLA‐B*15:359, Identified by Sequencing‐Based Typing in a Chinese Individual
Authors: Li Xiao‐Feng , Zhang Xu , Lin Feng‐Qiu , Li Jian‐Ping 
Published: October 2024

ABSTRACTHLA‐B*15:359 differs from HLA‐B*15:01:01:01 by one nucleotide substitution in exon 3.
Acetylcholine Hydrolysis and Antidote Delivery Using a Histidine-Resorcinarene-based Nanocontainer
Authors: Mansurova E. E. , Maslennikov A. A. , Lyubina A. P. , Sapunova A. , Voloshina A. D. , Nizameev I. R. , Kadirov M. K. , Fazleeva R. R. , Yanilkin V. V. , Ziganshina A. Y. , Antipin I. S. 
Published: October 2024

Abstract
A new nanocarrier was developed for the delivery of an antidote for poisoning with organophosphorus compounds. The nanocarrier acts as an artificial esterase, hydrolyzing acetylcholine and releasing the antidote (atropine) when acetylcholine level is high. The nanocarrier was made using histidine-containing resorcinarene as a building block. Histidine-resorcinarene was preorganized in a microemulsion media and then polymerized with phenylboronic acid, which acts as a linker between the resorcinarene molecules. Antidote (atropine) was incorporated into the nanocarrier with an encapsulation efficiency of 52.2%. At a neutral pH of 7.4, the nanocarrier hydrolyzes acetylcholine to choline and acetic acid. The acid triggers dissociation of the boronate bonds to dissociate, resulting in nanocarrier degradation and the release of 64.4% of the antidote. Transmission electron microscopy (TEM), dynamic and static light scattering (DLS and SLS, respectively), and IR spectroscopy were utilized to characterize the structure of the nanocarriers. Cyclic voltammetry and NMR spectroscopy were employed to evaluate its ability to hydrolyze acetylcholine. Through fluorescence and NMR spectroscopy, it was demonstrated that the nanocarrier could release substrates (fluorescein and atropine) in in response to the presence of acetylcholine.
A Study on the Glucose Breath Test Positivity Rate and Occurrence of Small Intestine Bacterial Overgrowth‐Related Symptoms Caused by Long‐Term Use of Proton Pump Inhibitor (PPI) Versus Potassium‐Competitive Acid Blocker (P‐CAB) in Elderly Patients
Authors: Lim Na Rae , Lim Saenal , Chung Woo Chul 
Published: October 2024

Background/Aims: Long‐term acid suppression with proton pump inhibitors (PPI) leads to hypochlorhydria and facilitates the growth of bacterial flora in the small intestine. Novel acid‐suppressants called potassium‐competitive acid blockers (P‐CABs) seem to be superior to PPIs. However, data on the risk of small intestinal bacterial overgrowth (SIBO) in patients taking P‐CABs are limited.Method: We retrospectively analyzed a consecutive series of patients with long‐term acid‐suppressant (PPIs or P‐CABs) use for gastroesophageal reflux disease or nonsteroidal anti‐inflammatory drug (NSAID)‐induced gastropathy. All of them underwent endoscopic examinations and Helicobacter pylori testing and took PPIs or P‐CABs for at least 3 months. Glucose hydrogen breath tests (GBT) were performed to check for SIBO, and newly developed SIBO‐related symptoms including bloating, postprandial discomfort, diarrheas, and constipation, were evaluated.Results: A total of 142 patients were enrolled. Six patients were excluded due to equivocal Helicobacter pylori infection results. The frequency of positive GBTs was 31.7% (25/79) for PPI and 22.8% (13/57) for P‐CAB use (p = 0.15). Regarding GBT positivity, age‐related factor was found to be significant in multivariate analysis (p = 0.02). The results of multivariate analysis in cases of SIBO‐related symptoms showed that GBT positivity and PPI use were significant (p < 0.01).Conclusion: Long‐term use of gastric acid suppressants resulted in positive GBT in approximately 30% of patients, and the risk was particularly high in elderly patients. The occurrence of SIBO‐related symptoms was significant in long‐term use of PPIs and in patients with positive GBT.
Transitional Shock in Newly Graduated Registered Nurses From the Perspective of Self‐Depletion and Impact on Cognitive Decision‐Making
Authors: Yingnan Zhao , Ziqi Zhang , Ting Wang , Liqin Chen , Xiaoqing Shi , Lan Xu 
Published: October 2024

Background: Newly graduated registered nurses face more challenges than their experienced counterparts, as they not only confront the high pressures of an increasingly complex medical environment but also need to quickly adapt to their jobs and role transitions. The emotional burden arising at this stage is referred to as transitional shock. Self‐depletion, as proposed by Baumeister, refers to the process by which individuals exhaust their internal psychological control resources when facing challenges, subsequently affecting cognition and emotion. The occurrence of transitional shock and the process of individual self‐depletion appear to be closely related. However, to our knowledge, there has been limited research exploring the occurrence of transitional shock from the perspective of self‐depletion theory.Aim: Investigating the emergence process of transition shock through the lens of self‐depletion theory entails an examination of the mechanisms by which individuals engage in self‐regulation when confronted with challenges and how transition shock manifests throughout this process.Designs: A descriptive qualitative study.Methods: Between August and November 2023, using maximum variation sampling and purposive sampling methods, 16 nurses were selected for semistructured interviews at a tertiary hospital in Suzhou, China.Results: Employing thematic analysis, three interconnected themes were identified, encompassing the entry‐level workforce challenges, the subsequent effects of energy depletion, and the sources and replenishment of energy.Conclusion: As new nurses adapt to their roles and environments, they encounter numerous pressures that markedly drain their psychological energy. This ongoing depletion of self‐regulation energy can lead to transitional shock, impulsive decision‐making, and missed nursing care.Implications for Nursing Management: Managers should implement comprehensive support strategies, including optimized work environments, enhanced training, and personal development, to help newly graduated nurses successfully transition and improve care quality and retention.
Evaluation of Microleakage of Orthograde Root‐Filling Materials in Immature Permanent Teeth
Authors: Das Upma , Gautam Vanita , Shubham Snigdha , Raut Shristi 
Published: October 2024

Introduction: The absence of a barrier in an open root apex makes endodontic treatment challenging as root‐filling material can easily reach the surrounding tissue. The aim of the study was to compare the apical microleakage associated with mineral trioxide aggregate (MTA), biodentine, custom‐made gutta‐percha with MTA plus and custom‐made gutta‐percha with Adseal in immature permanent teeth by dye penetration method.Methods: Apical 2 mm of 60 single‐rooted mandibular premolar teeth was resected to create divergent open apices and 10 teeth each were filled with Biodentine plug, MTA plug, custom‐made gutta‐percha with MTA plus sealer and custom‐made gutta‐percha with Adseal sealer. Ten teeth each acted as positive and negative controls. All the samples were stored at 37°C at 100% humidity for 5 weeks and then immersed in 2% Rhodamine B dye for 24 h. Transverse sectioning was done apically at 1 mm and 3 mm to evaluate dye penetration under a fluorescence microscope using ImageJ software.Results: There was a significantly greater microleakage at 1 mm cross section compared to 3 mm (p < 0.0001). At 1 mm cross section, the apical microleakage was the highest for the MTA plug with a mean leakage percentage of 48.08 ± 16.38, a mean depth of leakage of 0.46 ± 0.10 mm and a mean area of leakage of 1.35 ± 0.74 mm2, compared to other groups, and the difference was statistically significant. However, at a 3 mm cross section, MTA plus sealer with gutta‐percha demonstrated the highest mean leakage percentage (25.01 ± 7.77) compared to other groups and the difference was statistically significant (p = 0.03).Conclusion: It can be concluded that the 3‐mm‐thick apical plug provided better sealing of the open apex compared to the 1 mm apical plug and there was no significant difference in microleakage among the Biodentine plug, MTA plug and Adseal sealer with gutta‐percha plug at 3 mm cross section.
BRCA1 Protein Expression in Epithelial Ovarian Cancer and Associated Clinicopathological Factors in Uganda
Authors: Okecha Tonny , Abila Derrick B. , Nabbale Dorothy L. , Katongole Fauz , Yahaya James J. , Lukande Robert , Kalungi Sam , Nalwoga Hawa 
Published: October 2024

Background: BRCA1 gene dysfunction seen in epithelial ovarian carcinomas often results from germline mutations, somatic mutations, and promoter methylation. Identification of tumors with loss of BRCA1 protein expression has shown to have therapeutic and prognostic implications. The aim of this study was to determine the expression of BRCA1 protein in epithelial ovarian cancer (EOC) and the associated clinicopathological characteristics.Methods and Results: This was a cross‐sectional laboratory‐based study that used paraffin‐embedded tissue blocks of patients histologically diagnosed with EOC from January 2010 to August 2018. Tissue sections were stained with hematoxylin and eosin (H&E) for histological confirmation and with immunohistochemistry (IHC) using a mouse‐derived monoclonal antibody MS110 for BRCA1 protein expression. The association between BRCA1 protein expression and independent variables was determined using Pearson’s Chi‐square test. A total of 104 tissue blocks from patients with EOC were included in the study with a mean age of 48.7 ± 12.8 years. Serous tumors were the most common which comprised 74.0% (77/104) of all the tumors and majority of them 75.3% (58/77) were high grade. Loss of expression of BRCA1 protein expression was found in 33.7% (33/98) of all the cases. There was no statistically significant association between BRCA1 expression and age of patients, tumor grade, and histological subtype.Conclusion: There is a high expression of altered BRCA1 expression in tissues of EOC. Although it has not shown association with age of patients, histology types, and tumor grade, further studies need to assess its influence of the survival of cancer patients with EOC.
Immediate Versus Staged Complete Revascularization for Patients With ST‐Segment–Elevation Myocardial Infarction and Multivessel Disease: A Network Meta‐Analysis of Randomized Trials
Authors: Elbadawi Ayman , Hamed Mohamed , Gad Mohamed , Elseidy Sheref A. , Barghout Mohamed , Jneid Hani , Mamas Mamas A. , Alfonso Fernando , Elgendy Islam Y. 
Published: October 2024

Background
The comparative outcomes with immediate, staged in‐hospital, and staged out‐of‐hospital complete revascularization for patients with ST‐segment–elevation myocardial infarction and multivessel disease remain unclear.

Methods and Results
An electronic search of MEDLINE, SCOPUS, and Cochrane databases was performed through August 2023 for randomized trials evaluating immediate, staged in‐hospital, and staged out‐of‐hospital complete revascularization for patients with ST‐segment–elevation myocardial infarction and multivessel disease. The primary outcome was major adverse cardiac events (MACEs). The final analysis included 9 trials with 4270 patients. The weighted follow‐up duration was 13.8 months. On pairwise meta‐analysis, there were no statistically significant differences between immediate versus staged nonculprit percutaneous coronary intervention (PCI) in MACEs (odds ratio, 0.79 [95% CI, 0.54–1.16]). Network meta‐analysis showed that there was no statistically significant difference in MACEs with staged in‐hospital nonculprit PCI (odds ratio, 1.29–[95% CI, 0.91–1.82]) compared with immediate nonculprit PCI, while there were higher odds of MACEs with out‐of‐hospital nonculprit PCI (odds ratio, 1.67–[95% CI, 1.21–2.30]) compared with immediate nonculprit PCI. Compared with immediate nonculprit PCI, there were higher odds of ischemia‐driven repeat revascularization with staged out‐of‐hospital nonculprit PCI (odds ratio, 2.26–[95% CI, 1.37–3.72]), but not with in‐hospital staged nonculprit PCI. There were no significant differences for the other outcomes among the 3 strategies.

Conclusions
Among patients with ST‐segment–elevation myocardial infarction with multivessel disease, an immediate nonculprit PCI approach was associated with similar clinical outcomes to the staged nonculprit PCI approach. The staged out‐of‐hospital nonculprit PCI approach was associated with a higher incidence of MACEs compared with the other strategies, which was driven by higher risk for ischemia‐driven repeat revascularization.
Long‐Term Durability of Transcatheter Aortic Valve Prostheses in Patients With Bicuspid Versus Tricuspid Aortic Valve
Authors: Li Hong‐De , Li Wei‐Ya , Li Jun‐Li , Peng Shi‐Qin , Feng Yuan , Peng Yong , Wei Jia‐Fu , Zhao Zhen‐Gang , Xiong Tian‐Yuan , Ou Yuan‐Wei Xiang , Wang Yan , Li Qing , Yang Hao‐Ran , Song Cheng‐Xiang , Yao Yi‐Jun , Zhu Zhong‐Kai , Liu Qi , Wang Xi , Chen Mao 
Published: October 2024

Background
Currently, there is a lack of evidence for the long‐term bioprosthetic valve durability of patients with bicuspid aortic valve (BAV) following transcatheter aortic valve replacement (TAVR).

Methods and Results

This study aimed to evaluate hemodynamic outcome, structural valve deterioration, and bioprosthetic valve failure during long‐term follow‐up after TAVR in patients with BAV versus patients with tricuspid aortic valve (TAV). Patients with BAV and TAV who underwent TAVR between 2012 and 2020, with echocardiography followed for at least 3 years, were included. Baseline characteristics, long‐term valve hemodynamic performance, structural valve deterioration, and bioprosthetic valve failure were compared between patients with BAV and TAV. A total of 170 patients with BAV and 145 patients with TAV were included. The mean duration of follow‐up for patients with BAV and TAV was 5.2±1.8 and 5.0±1.7 years. No significant differences were observed in the rates of structural valve deterioration and bioprosthetic valve failure between patients with BAV and TAV: structural valve deterioration, BAV 20 (11.8%) versus TAV 16 (11.0%) at last follow‐up (
P
=0.861); bioprosthetic valve failure, BAV 3 (1.8%) versus TAV 7 (4.8%) at last follow‐up (
P
=0.196). More than moderate intravalvular aortic regurgitation (1.8% versus 4.8%,
P
=0.196) and
paravalvular leak
(6.5% versus 3.4%,
P
=0.305) were rare in both patients with BAV and patients with TAV.

Conclusions
This study indicated satisfactory long‐term valve durability of TAVR in patients with BAV. Comparable hemodynamic outcome, structural valve deterioration, and bioprosthetic valve failure could be achieved in patients with BAV and TAV during long‐term follow‐up after TAVR.
Epigenetic Study of Cohort of Monozygotic Twins With Hypertrophic Cardiomyopathy Due to MYBPC3 (Cardiac Myosin‐Binding Protein C)
Authors: Peñarroya Alfonso , Lorca Rebeca , Rodríguez Reguero José Julián , Gómez Juan , Avanzas Pablo , Tejedor Juan Ramon , Fernandez Agustín F. , Fraga Mario F. 
Published: October 2024

Background
Hypertrophic cardiomyopathy is an autosomal dominant cardiac disease. The mechanisms that determine its variable expressivity are poorly understood. Epigenetics could play a crucial role in bridging the gap between genotype and phenotype by orchestrating the interplay between the environment and the genome regulation. In this study we aimed to establish a possible correlation between the peripheral blood DNA methylation patterns and left ventricular hypertrophy severity in patients with hypertrophic cardiomyopathy, evaluating the potential impact of lifestyle variables and providing a biological context to the observed changes.

Methods and Results

Methylation data were obtained from peripheral blood samples (Infinium MethylationEPIC BeadChip arrays). We employed multiple pair‐matched models to extract genomic positions whose methylation correlates with the degree of left ventricular hypertrophy in 3 monozygotic twin pairs carrying the same founder pathogenic variant (
MYBPC3
p.Gly263Ter). This model enables the isolation of the environmental influence, beyond age, on DNA methylation changes by removing the genetic background. Our results revealed a more anxious personality among more severely affected individuals. We identified 56 differentially methylated positions that exhibited moderate, proportional changes in methylation associated with left ventricular hypertrophy. These differentially methylated positions were enriched in regions regulated by repressor histone marks and tended to cluster at genes involved in left ventricular hypertrophy development, such as
HOXA5
,
TRPC3
,
UCN3
, or
PLSCR2
, suggesting that changes in peripheral blood may reflect myocardial alterations.

Conclusions
We present a unique pair‐matched model, based on 3 monozygotic twin pairs carrying the same founder pathogenic variant and different phenotypes. This study provides further evidence of the pivotal role of epigenetics in hypertrophic cardiomyopathy variable expressivity.