bluuebunny/crossref_metadata_2025_split huggingface dataset:
A sustainable nutritional solution for fattening pigs based on 25-hydroxycholecalciferol and triterpenoids added to a low Ca diet containing phytase improves growth performance via the activation of muscle protein synthesis without compromising bone mineralization
Authors: Pérez-Calvo Estefania , McCormack Ursula M , Muns Ramon , Mulvenna Christina , Payling Laura , Romero Luis , Roger Laurent , Walsh Maria C 
Published: October 2024

Abstract
In the current climate of sustainable animal agriculture, nutritional strategies that support fattening swine growth performance and bone mineralization whilst reducing environmental impacts are much sought after. This study evaluated the effect of supplementing 25(OH)D3 with triterpenoids to a Ca-reduced diet containing phytase during the grower-finisher phase. Growth performance, bone composition, plasma metabolites and muscle gene expression were evaluated. Sixty crossbreed boar pigs (initial body weight (BW) 42.0 ± 5.1 kg at 12 wk of age) were assigned to three treatments with 20 pigs/treatment in a completely randomized design. Treatments comprised: 1) a standard commercial grower-finisher diet (positive control (PC)) containing 1,500 IU/kg vitamin D3 [3,585 kcal/kg digestible energy, 16.19% CP, 0.70% Ca, 0.29% standardized total tract digestible P]; 2) a negative control (NC) based on the PC with reduction in Ca and P (minus 30% and 10%, respectively); 3) the NC with vitamin D3 replaced by a commercially available compounds combination containing 25(OH)D3 and triterpenoids, dosed at 500 mg per kg of feed (TRT). All diets were provided ad libitum for 7 wk, and feed intake was recorded individually via electronic feeder stations. For the overall period, average daily gain and average daily feed intake were increased (P &lt; 0.05) in TRT vs. NC or PC (+ 13.0% and + 8.3%, respectively, vs. NC); final BW was 7.8% higher vs. NC (+ 5.2% vs. PC; P &lt; 0.05). Whole-body DXA-scanning at 19 wk of age showed that bone mineral density, content and percentage were reduced in NC vs. PC and equivalent to PC in TRT. Plasma 25(OH)D3 and P levels were raised in TRT (+ 33 ng/ml or 2.6-fold and + 0.55 mg/dL or 5.9%, respectively, vs. NC). The combination of 25(OH)D3 with triterpenoids was found to activate several biological pathways involved in muscle growth, including pathways that activate mTOR, a key central regulator of cell metabolism, growth, proliferation and survival when the gene expression was measured in the muscle tissue at 19 wk of age. These results suggest that the dietary combination of 25(OH)D3 with triterpenoids has the potential for use, alongside phytase, in supporting a reduction in Ca and P in the diet to reduce nutrient waste and improve the sustainability of production by promoting muscle growth and maintaining bone composition.
Pathophysiological Markers of Acute Respiratory Distress Syndrome Severity Are Correlated With Ventilation-Perfusion Mismatch Measured by Electrical Impedance Tomography
Authors: Spinelli Elena , Perez Joaquin , Chiavieri Valentina , Leali Marco , Mansour Nadia , Madotto Fabiana , Rosso Lorenzo , Panigada Mauro , Grasselli Giacomo , Vaira Valentina , Mauri Tommaso 
Published: October 2024

OBJECTIVES:
Pulmonary ventilation/perfusion (V/Q) mismatch measured by electrical impedance tomography (EIT) is associated with the outcome of patients with the acute respiratory distress syndrome (ARDS), but the underlying pathophysiological mechanisms have not been fully elucidated. The present study aimed to verify the correlation between relevant pathophysiological markers of ARDS severity and V/Q mismatch.

DESIGN:
Prospective observational study.

SETTING:
General ICU of a university-affiliated hospital.

PATIENTS:
Deeply sedated intubated adult patients with ARDS under controlled mechanical ventilation.

INTERVENTIONS:
Measures of V/Q mismatch by EIT, respiratory mechanics, gas exchange, lung imaging, and plasma biomarkers.

MEASUREMENTS AND MAIN RESULTS:
Unmatched V/Q units were assessed by EIT as the fraction of ventilated nonperfused plus perfused nonventilated lung units. At the same time, plasma biomarkers with proven prognostic and mechanistic significance for ARDS (carbonic anhydrase 9 [CA9], hypoxia-inducible factor 1 [HIF1], receptor for advanced glycation endproducts [RAGE], angiopoietin 2 [ANG2], gas exchange, respiratory mechanics, and quantitative chest CT scans were measured. Twenty-five intubated ARDS patients were included with median unmatched V/Q units of 37.1% (29.2–49.2%). Unmatched V/Q units were correlated with plasma levels of CA9 (rho = 0.47; p = 0.01), HIF1 (rho = 0.40; p = 0.05), RAGE (rho = 0.46; p = 0.02), and ANG2 (rho = 0.42; p = 0.03). Additionally, unmatched V/Q units correlated with plateau pressure (r = 0.38; p = 0.05) and with the number of quadrants involved on chest radiograph (r = 0.73; p < 0.01). Regional unmatched V/Q units were correlated with the corresponding fraction of poorly aerated lung tissue (r = 0.62; p = 0.01) and of lung tissue weight (rho: 0.51; p = 0.04) measured by CT scan.

CONCLUSIONS:
In ARDS patients, unmatched V/Q units are correlated with pathophysiological markers of lung epithelial and endothelial dysfunction, increased lung stress, and lung edema. Unmatched V/Q units could represent a comprehensive marker of ARDS severity, reflecting the complex organ pathophysiology and reinforcing their prognostic significance.
Differences in sex and age response to single pill combination based antihypertensive therapy reflecting in blood pressure and arterial stiffness
Authors: Brguljan Hitij Jana , Gaciong Zbigniew , Simić Dragan , Vajer Péter , Zelveian Parounak , Chazova Irina E. , Jelaković Bojan ,   Precious trial investigators
Published: October 2024

Objective:
There are noticeable sex differences in the treatment response to antihypertensives, with limited data on the response to single pill combinations. The aim of the PRECIOUS trial was to assess the treatment response to perindopril/amlodipine and perindopril/amlodipine/indapamide dual and triple single-pill combination in men and women.

Methods:
Four hundred and forty adults with essential hypertension were assessed in the 16-week interventional, open-label, prospective, international, multicentre trial. Based on the previous antihypertensive therapy, patients were assigned to either perindopril/amlodipine 4/5 mg or perindopril/amlodipine/indapamide 4/5/1.25 mg, with the initial dose up-titrated in 4-week intervals in case of uncontrolled blood pressure. An additional analysis was performed for sex- and age-related differences on the blood pressure response and arterial stiffness in men and women aged 35–74 years.

Results:
Women achieved better overall blood pressure control in all age groups, except for the 35–44 age group. Women presented higher average 24 h aortic augmentation indexes than men, but had more pronounced decreasing trends. The pulse wave velocity was only age-dependent, with reductions slightly greater in women. Both the aortic augmentation index and pulse wave velocity were significantly decreased in all groups compared to baseline.

Conclusions:
The results of the PRECIOUS trial contribute significant data to the expanding body of evidence on sex differences in hypertension, including the aspect of age-related changes during the life course of women. The differences between same-aged men and women tend to be smaller with advancing age, but with a greater treatment response in women in all age groups for all observed blood pressure parameters and arterial stiffness.

Trial registration:
ClinicalTrials.gov identifier NCT03738761
Giant lipomas: A 130-year literature review, case series, and introduction of an intuitive management algorithm
Authors: Marcasciano Marco , Greto Ciriaco Antonio , Fiorillo Maria Antonia , Cutuli Salvatore , Thom Douglas , Stagno D’ Alcontres Francesco , Delia Gabriele , Fanelli Benedetta , Luridiana Gianluigi , Casella Donato , Chang Chad , Greco Manfredi 
Published: October 2024

Background:
Lipomas are the most common benign mesenchymal tumors in adults. On the other hand, giant lipomas, defined as lipomas over >10 cm in length of over 1000 g in weight, are less frequently seen, can be clinically challenging to manage, and require careful attention. While most cases are benign, soft, asymptomatic masses, there is potential for functional limitation, nerve compression syndromes, and sarcomatous changes in such lesions.

Methods:
A case series is presented and an extensive review of the literature was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) declaration, since the first description of a giant lipoma reported in 1894, with the aim of providing an updated and comprehensive “state-of-the-art” on the management, diagnosis, and treatment of this entity. PubMed, Scopus, and Google Scholar databases were queried for relevant articles using the search terms “Giant lipoma” and “Massive lipoma” from 1894 to 2024.

Results:
Five consecutive clinical cases were reported. A total of 79 patients were identified from the 65 collected reports. Clinical characteristics of the lesions, surgical details, and patient characteristics are obtained and summarized. Preoperative/postoperative radiological/histological features are reported.

Conclusion:
Surgical excision remains the gold standard treatment for giant lipomas. According to existing literature, most recommendations are based on expert opinions and there is a paucity of guidelines or universal consensus on a treatment pathway for standardized, multidisciplinary management of such a challenging clinical condition.
Lifestyle modifications and environmental risk factors for glaucoma
Authors: Elhusseiny Abdelrahman M. , Aref Ahmad A. 
Published: October 2024

Purpose of review
To summarize recent evidence about the association between different lifestyle modifications and environmental risk factors and glaucoma.

Recent findings
Incorporating moderate exercise into the routine of glaucoma patients may help slow the progression of the condition. However, caution should be taken when using swim goggles, and it may be advisable to avoid certain yoga positions and heavy weight-lifting exercises, as they have been linked to intraocular pressure (IOP) spikes and potential risks for glaucoma patients. Various relaxation techniques may lower IOP. The evidence remains inconclusive about the association between vitamins intake and glaucoma. Dietary nitric oxide has been associated with a lower risk of glaucoma. Higher smoking intensity has been linked to faster visual field decline and retinal nerve fiber layer thinning. Additionally, there is currently insufficient evidence to support the use of marijuana in managing glaucoma, with side effects outweighing the proposed benefits. A significant association has been found between air pollutants and ganglion cell layer thinning, as well as a greater burden of glaucoma.

Summary
Lifestyle and environmental factors are increasingly recognized as significant contributors to glaucoma development and progression. These modifications should be integrated into a comprehensive treatment approach alongside medications or surgical interventions.
Traumatic cataract with iridodialysis
Authors: Chee Soon-Phaik , Weikert Mitchell P. , Wallace Ryan , De Francesco Ticiana , Ahmed Ike , Fram Nicole , McCabe Cathleen M. 
Published: October 2024

A 56-year-old woman presented with left blurring of vision for 6 months. She gave a history of previous left eye trauma for which she had undergone suturing of a corneal laceration. The right eye was 20/20 and normal. Her left visual acuity was hand motion. A linear corneal scar was present extending obliquely from 5 to 9 o'clock. In addition, there were iridodialysis from 8 to 1 o'clock, a fixed dilated pupil, and extensive zonulysis with displacement of a dense nuclear sclerotic cataract temporally (Figures 1 and 2

JOURNAL/jcrs/04.03/02158034-202411000-00015/figure1/v/2024-10-18T161301Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202411000-00015/figure2/v/2024-10-18T161301Z/r/image-tiff

). There was no vitreous in the anterior chamber. The posterior segment appeared normal, as were the intraocular pressures.
Ultrasound biomicroscopy of the anterior segment of the left eye confirmed the absence of zonular fibers from 6 to 12 o'clock. Optical coherence tomography was unable to capture any image of the macular or optic nerve. Corneal topography showed irregular astigmatism. The endothelial cell density was 1650 cells/mm2.
Describe how you would manage this case surgically, given that her financial resources were limited, and she was unable to afford a prosthetic iris.
PROTACs in platelets: emerging antithrombotic strategies and future perspectives
Authors: Trory Justin S. , Vautrinot Jordan , May Carl J. , Hers Ingeborg 
Published: October 2024

Purpose of review
Proteolysis-targeted chimeras (PROTACs) are heterobifunctional compounds that selectively target proteins for degradation and are an emerging therapeutic modality to treat diseases such as cancer and neurodegenerative disorders. This review will widen the area of application by highlighting the ability of PROTACs to remove proteins from the anucleate platelets and evaluate their antithrombotic potential.

Recent findings
Proteomic and biochemical studies demonstrated that human platelets possess the Ubiquitin Proteasomal System as well as the E3 ligase cereblon (CRBN) and therefore may be susceptible to PROTAC-mediated protein degradation. Recent findings confirmed that CRBN ligand-based PROTACs targeting generic tyrosine kinases, Btk and/or Fak lead to efficacious and selective protein degradation in human platelets. Downregulation of Btk, a key player involved in signalling to thrombosis, but not haemostasis, resulted in impaired in-vitro thrombus formation.

Summary
Platelets are susceptible to targeted protein degradation by CRBN ligand-based PROTACs and have limited ability to resynthesise proteins, ensuring long-term downregulation of target proteins. Therefore, PROTACs serve as an additional research tool to study platelet function and offer new therapeutic potential to prevent thrombosis. Future studies should focus on enhancing cell specificity to avoid on-target side effects on other blood cells.
Imaging for upper tract urothelial carcinoma: update of the evidence and a glimpse into the future
Authors: Laukhtina Ekaterina , Muin Dina , Shariat Shahrokh F. 
Published: October 2024

Purpose of review
Upper tract urothelial carcinoma (UTUC) is a rare malignancy posing significant diagnostic and management challenges. This review provides an overview of the evidence supporting various imaging modalities and offers insights into future innovations in UTUC imaging.

Recent findings
With the growing use of advancements in computed tomography (CT) technologies for both staging and follow-up of UTUC patients, continuous innovations aim to enhance performance and minimize the risk of excessive exposure to ionizing radiation and iodinated contrast medium. In patients unable to undergo CT, magnetic resonance imaging serves as an alternative imaging modality, though its sensitivity is lower than CT. Positron emission tomography, particularly with innovative radiotracers and theranostics, has the potential to significantly advance precision medicine in UTUC. Endoscopic imaging techniques including advanced modalities seem to be promising in improved visualization and diagnostic accuracy, however, evidence remains scarce. Radiomics and radiogenomics present emerging tools for noninvasive tumor characterization and prognosis.

Summary
The landscape of imaging for UTUC is rapidly evolving, with significant advancements across various modalities promising improved diagnostic accuracy, patient outcomes, and safety.
Intracranial aneurysm coexisting with pituitary adenoma: a systematic review
Authors: de Sena Barbosa Mateus Gonçalves , Otávio da Silva Vinícius , Santos Ferreira Luiz Henrique , de Souza Rafaela Luiza Vilela , Pipek Leonardo Zumerkorn , de Oliveira Almeida Gustavo , Figueiredo Eberval Gadelha , Rabelo Nicollas Nunes , Chaurasia Bipin 
Published: October 2024

Introduction:
The simultaneous occurrence of intracranial aneurysms (IA) and primary brain tumors (BT) is frequently reported, with an estimated incidence of 0.5–7.4%. Among the tumor types associated with IA, pituitary adenomas (PA) are the most prevalent.

Methods:
The authors selected articles, published from 1960 to December 2023, on the Medline, Embase, Scopus, Cochrane Library, and Web of Science databases. The extraction form contains information specific to the aneurysm and tumor, rupture of the aneurysm, treatment proposal for both and order of treatment and outcome.

Results:
The study evaluated 118 patients from 25 articles. The most frequent types of tumors were non-functioning hormone (NFA) producers, present in 45.8% (n=54) of the cases, and growth hormone (GH) secretors, which represent 23.0% (n=27) of the cases. The main treatment used was surgery, with subtotal resection (STR) performed in 4.2% (n=5) of cases, gross total resection (GTR) in 3.4% (n=4), and transsphenoidal resection (TSR) in 7.6% (n=9). 16.0% (n=19) of patients had two or more aneurysms concomitant with the adenoma. IA treatment was performed before PA surgery in 25 patients (21.2%) and 15 patients received simultaneous treatment to IA and PA (12.7%).

Conclusion:
Patients with PAs have a considerable prevalence of IAs. Hormonal imbalances and mechanical changes induced by tumor growth, particularly influenced by GH and IGF-1, contribute to this coexistence. Surgical intervention is common, requiring meticulous precautions to avoid complications. More longitudinal studies including close follow-up with a description of outcomes are necessary to guide treatment protocols for this condition.
Thoracic irrigation for prevention of secondary intervention after thoracostomy tube drainage for hemothorax: A Western Trauma Association multicenter study
Authors: Carver Thomas W. , Berndtson Allison E. , McNickle Allison G. , Boyle Kelly A. , Haan James M. , Campion Eric M. , Biffl Walter L. , Carroll Alyssa N. , Sise Michael J. , Berndt Kelsey S. , Burris Jennifer M. , Kopelman Tammy R. , Blank Jaqueline J. , Seamon Mark J. , Peschman Jacob R. , Morris Rachel S. , Kugler Nathan W. , Conrardy Ryan D. , Szabo Aniko , de Moya Marc A. 
Published: October 2024

BACKGROUND
Retained hemothorax (rHTX) requiring intervention occurs in up to 20% of patients who undergo chest tube (TT) placement for a hemothorax (HTX). Thoracic irrigation at the time of TT placement decreases the need for secondary intervention in this patient group but those findings are limited because of the single-center design. A multicenter study was conducted to evaluate the effectiveness of thoracic irrigation.

METHODS
A multicenter, prospective, observational study was conducted between June 2018 and July 2023. Eleven sites contributed patients. Patients were included if they had a TT placed for a HTX and were excluded if: younger than 18 years, TT for pneumothorax, thoracotomy or video-assisted thoracoscopic surgery performed within 6 hours of TT, TT >24 hours after injury, TT removed <24 hours, or death within 48 hours. Thoracic irrigation was performed at the discretion of the attending. Each hemithorax was considered separately if bilateral HTX. The primary outcome was secondary intervention for HTX-related complications (rHTX, effusion, or empyema). Secondary intervention was defined as: TT placement, instillation of thrombolytics, video-assisted thoracoscopic surgery, or thoracotomy. Irrigated and nonirrigated hemithoraces were compared using a propensity weighted analysis with age, sex, mechanism of injury, Abbreviated Injury Scale chest, and TT size as predictors.

RESULTS
Four hundred ninety-three patients with 462 treated hemothoraces were included, 123 (25%) had thoracic irrigation at TT placement. There were no significant demographic differences between the cohorts. Fifty-seven secondary interventions were performed, 10 (8%) and 47 (13%) in the irrigated and non-irrigated groups, respectively (p = 0.015). Propensity weighted analysis demonstrated a reduction in secondary interventions in the irrigated cohort (odds ratio, 0.56 (0.34–0.85); p = 0.005).

CONCLUSION
This Western Trauma Association multicenter study demonstrates a benefit of thoracic irrigation at the time of TT placement for a HTX. Thoracic irrigation reduces the odds of a secondary intervention for rHTX-related complications by 44%.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level II.
Genomic biosurveillance of the kiwifruit pathogen Pseudomonas syringae pv. actinidiae biovar 3 reveals adaptation to selective pressures in New Zealand orchards
Authors: Hemara Lauren M. , Hoyte Stephen M. , Arshed Saadiah , Schipper Magan M. , Wood Peter , Marshall Sergio L. , Andersen Mark T. , Patterson Haileigh R. , Vanneste Joel L. , Peacock Linda , Jayaraman Jay , Templeton Matthew D. 
Published: October 2024

AbstractIn the late 2000s, a pandemic ofPseudomonas syringaepv.actinidiaebiovar 3 (Psa3) devastated kiwifruit orchards growing susceptible yellow-fleshed cultivars. New Zealand’s kiwifruit industry has since recovered, following the deployment of the tolerant cultivar ‘Zesy002’. However, little is known about the extent to which the Psa population is evolving since its arrival. Over 500 Psa3 isolates from New Zealand kiwifruit orchards were sequenced between 2010 and 2022, from commercial monocultures and diverse germplasm collections. While effector loss was previously observed on Psa-resistant germplasm vines, effector loss appears to be rare in commercial orchards, where the dominant cultivars lack Psa resistance. However, a new Psa3 variant, which has lost the effectorhopF1c, has arisen. The loss ofhopF1cappears to have been mediated by the movement of integrative conjugative elements introducing copper resistance into this population. Following this variant’s identification,in plantapathogenicity and competitive fitness assays were performed to better understand the risk and likelihood of its spread. WhilehopF1closs variants had similarin plantagrowth to wild-type Psa3, a lab-generated ΔhopF1cstrain could outcompete wild-type on select hosts. Further surveillance was conducted in commercial orchards where these variants were originally isolated, with 6.6% of surveyed isolates identified ashopF1closs variants. These findings suggest that the spread of these variants is currently limited, and they are unlikely to cause more severe symptoms than the current population. Ongoing genome biosurveillance of New Zealand’s Psa3 population is recommended to enable early detection and management of variants of interest.