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Pulsed dye laser for nail psoriasis: A systematic review and meta-analysis

Journal of the American Academy of Dermatology 2025年

作者： Gratz, Ben W. Resnick, Gabriella F. Etcheverry, Maria J. Geng, Xue Stringer, Thomas P. Georgetown University School of Medicine Washington District of Columbia United States Department of Biostatistics Bioinformatics and Biomathematics Georgetown University Medical Center Washington District of Columbia United States Department of Dermatology MedStar Washington Hospital Center Washington District of Columbia United States

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COADVISE: Covariate Adjustment with Variable Selection in Randomized Controlled Trials

arXiv

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arXiv 2025年

作者： Liu, Yi Zhu, Ke Han, Larry Yang, Shu Department of Statistics North Carolina State University RaleighNC United States Duke Clinical Research Institute Duke University DurhamNC United States Department of Biostatistics and Bioinformatics Duke University School of Medicine DurhamNC United States Department of Public Health and Health Sciences Northeastern University BostonMA United States

Adjusting for covariates in randomized controlled trials can enhance the credibility and efficiency of treatment effect estimation. However, handling numerous covariates and their complex (non-linear) transformations poses a challenge. Motivated by the case study of the Best Apnea Interventions for Research (BestAIR) trial data from the National Sleep Research Resource (NSRR), where the number of covariates (p = 114) is comparable to the sample size (N = 196), we propose a principled Covariate Adjustment with Variable Selection (COADVISE) framework. COADVISE enables variable selection for covariates most relevant to the outcome while accommodating both linear and nonlinear adjustments. This framework ensures consistent estimates with improved efficiency over unadjusted estimators and provides robust variance estimation, even under outcome model misspecification. We demonstrate efficiency gains through theoretical analysis, extensive simulations, and a re-analysis of the BestAIR trial data to compare alternative variable selection strategies, offering cautionary recommendations. A user-friendly R package, Coadvise, is available to facilitate practical implementation. Copyright © 2025, The Authors. All rights reserved.

关键词： Sleep research

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B-cell infiltration distinguishes mucosal from skin patterns of rejection in facial vascularized composite allografts

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American Journal of Transplantation 2025年第6期25卷 1193-1207页

作者： Kauke-Navarro, Martin Crisler, William J. Younis, Nour Khetani, Radhika S. Sadigh, Sam Teague, Jessica E. Ho Sui, Shannan J. Ko, Christine Zhan, Qian Steuart, Samuel Treister, Nathaniel S. Pober, Jordan Azzi, Jamil Clark, Rachael A. Pomahac, Bohdan Department of Surgery Division of Plastic Surgery Yale School of Medicine New Haven CT United States Department of Dermatology Brigham and Women's Hospital Harvard Medical School Boston MA United States Transplantation Research Cenyounter Renal Division Brigham and Women's Hospital and Children's Hospital Boston MA United States Harvard Chan Bioinformatics Core Department of Biostatistics Harvard T.H. Chan School of Public Health Boston MA United States Department of Pathology Brigham and Women's Hospital Harvard Medical School Boston MA United States Department of Pathology Yale School of Medicine New Haven CT United States Division of Oral Medicine and Dentistry Brigham and Women's Hospital Boston MA United States Department of Immunobiology Yale School of Medicine New Haven CT United States

Rejection monitoring in facial vascularized composite allotransplantation traditionally focuses on skin biopsies. However, mucosal rejection frequently presents with more pronounced signs of immune activity. To explore mechanistic differences between skin and mucosal rejection, rejection and nonrejection biopsies from allograft skin and oral mucosa of 9 facial vascularized composite allotransplantation recipients were retrospectively analyzed using histology, multiplex immunostaining, and gene expression profiling, with peripheral blood mononuclear cells quantified via mass cytometry. Both skin and mucosa exhibited similar patterns of granzyme B expressing (GZMB⁺) T cells, indicating T cell–mediated rejection in both tissues. However, mucosa demonstrated additional CD19⁺ B cell infiltration and occasional plasma cells, which were absent in skin. These intramucosal B cells expressed AHNAK and CD43, suggesting they may be innate-like B cells (Bin cells). CD8⁺/GZMB⁺ cells and B cell populations were enriched in peripheral blood mononuclear cells during combined skin and mucosal rejection but not isolated skin rejection. These findings suggest distinct rejection mechanisms in skin and mucosa, with mucosa uniquely involving B cells. Current skin-focused rejection monitoring may overlook important mucosal rejection events, emphasizing the need to monitor both tissues concurrently. Mucosal biopsies could improve the accuracy in detecting acute rejection. © 2025 American Society of Transplantation & American Society of Transplant Surgeons

关键词： face transplant mucosa rejection skin VCA

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Cross-cultural Adaptation and Validation of the Italian Version of the Revised Perceived Perioperative Competence Scale

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Journal of Perianesthesia Nursing 2025年

作者： Giammaria, Chiara Panattoni, Nicolò Terrenato, Irene Spano, Alessandro De Leo, Aurora Tomei, Bernardino Di Simone, Emanuele Petrone, Fabrizio IRCCS Istituti Fisioterapici Ospitalieri DITRAR Research Unit IFO Rome Italy IRCCS - Regina Elena National Cancer Institute Clinical Trial Center Biostatistics and Bioinformatics Unit Rome Italy Nursing Department ASL Roma 6 Rome Italy

Purpose: The nurse's role in the operating room requires essential competencies throughout the care process, such as theoretical knowledge, technical skills, and problem-solving abilities assessed by the Revised Perceived Perioperative Competence Scale (PPCS-R). The study aims to translate, cross-culturally adapt, and validate the Italian version of the scale. Design: A cross-cultural adaptation and validation of the Italian version of PPCS-R. Methods: The revised English version of the 40-item scale PPCS-R was translated into Italian according to Beaton's guidelines. The scale's internal consistency was assessed using Cronbach's α coefficient, ensuring the instrument's reliability. An exploratory factor analysis was conducted, preceded by the Kaiser-Meyer-Olkin test and Bartlett's sphericity test. Statistical analyses were performed using SPSS version 29.1 (IBM Corp.). Findings: The exploratory factor analysis of the Revised Perceived Perioperative Competence Scale—Italian Version (PPCS-R ITA) (N = 509) confirmed the 6 factors served in the original version. The final Italian version of PPCS-R comprises 40 items grouped into 6 latent factors. Each latent component showed a high consistency per Cronbach's α. The statistical analyses of the study confirm the reliability and good consistency of the tool. Conclusions: The statistical analyses of the study confirm the reliability and consistency of the tool (Revised Perceived Perioperative Competence Scale—Italian Version). By investigating the perception of Italian professionals working in the operating room through a translated and validated scale, specific training and professional development needs of a specific context can be better understood to identify appropriate learning and management strategies. © 2025 The American Society of PeriAnesthesia Nurses

关键词： competence cross-cultural adaptation nurse operating room validation

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Automated Muscle and Fat Segmentation in Computed Tomography for Comprehensive Body Composition Analysis

arXiv

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arXiv 2025年

作者： Chen, Yaqian Gu, Hanxue Chen, Yuwen Yang, Jicheng Dong, Haoyu Cao, Joseph Y. Camarena, Adrian Mantyh, Christopher Colglazier, Roy Mazurowski, Maciej A. Department of Electrical and Computer Engineering Duke University DurhamNC27708 United States Department of Radiology Duke University DurhamNC27708 United States Department of Surgery Duke University School of Medicine DurhamNC27708 United States Department of Biostatistics & Bioinformatics Duke University DurhamNC27708 United States Department of Computer Science Duke University DurhamNC27708 United States

Body composition assessment using CT images can potentially be used for a number of clinical applications, including the prognostication of cardiovascular outcomes, evaluation of metabolic health, monitoring of disease progression, assessment of nutritional status, prediction of treatment response in oncology, and risk stratification for surgical and critical care outcomes. While multiple groups have developed in-house segmentation tools for this analysis, there are very limited publicly available tools that could be consistently used across different applications. To mitigate this gap, we present a publicly accessible, end-to-end segmentation and feature calculation model specifically for CT body composition analysis. Our model performs segmentation of skeletal muscle, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) across the chest, abdomen, and pelvis area in axial CT images. It also provides various body composition metrics, including muscle density, visceral-to-subcutaneous fat (VAT/SAT) ratio, muscle area/volume, and skeletal muscle index (SMI), supporting both 2D and 3D assessments. The model is shared for public use. To evaluate the model, the segmentation was applied to both internal and external datasets, with body composition metrics analyzed across different age, sex, and race groups. The model achieved high dice coefficients on both internal and external datasets, exceeding 89% for skeletal muscle, SAT, and VAT segmentation. The model outperforms the benchmark by 2.40% on skeletal muscle and 10.26% on SAT compared to the manual annotations given by the publicly available dataset. Body composition metrics show mean relative absolute errors (MRAEs) under 10% for all measures. Furthermore, the model provided muscular fat segmentation with a Dice coefficient of 56.27%, which can be utilized for additional analyses as needed. Our code is available at https://***/mazurowski-lab/ CT-Muscle-and-Fat-Se mentation it v eess. e © 2025, C

关键词： Cardiovascular surgery

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Atrial fibrillation first? Investigating rhythm control in de novo high-grade functional mitral regurgitation and atrial fibrillation

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Clinical Research in Cardiology 2025年 1-12页

作者： Ausbuettel, Felix Schuett, Harald Mueller, Hans-Helge Chatzis, Georgios Weyand, Sebastian Mueller, Julian Fichera, Carlo-Federico Schieffer, Bernhard Luesebrink, Ulrich Waechter, Christian Department of Cardiology University Hospital Marburg Baldingerstraße Marburg 35043 Germany Institute for Bioinformatics and Biostatistics Philipps University Bunsenstraße 3 Marburg 35037 Germany Department of Cardiology Ostalb Clinic Aalen Im Kaelblesrein 1 Aalen 73430 Germany Department of Cardiology University Heart Center Freiburg-Bad Krozingen Breisacher Straße 153 Freiburg 79110 Germany Faculty of Medicine Philipps-University Marburg Baldingerstraße Marburg 35043 Germany

Background: Atrial fibrillation (AF) and functional mitral regurgitation (FMR) frequently coexist, presenting significant challenges for therapeutic management. Current evidence offers limited direction on the prioritization of treatment for these conditions. This study aims to evaluate the impact of rhythm control on high-grade FMR and identify predictors of persistent high-grade FMR after AF treatment. Methods: This single-center study analyzed patients with newly diagnosed AF and concomitant high-grade FMR. Predictors of persistent high-grade FMR after rhythm control of AF were assessed by logistic regression. Results: Among 795 patients hospitalized with new-onset AF, 14% (111/795) were diagnosed with high-grade FMR. Rhythm control successfully restored sinus rhythm in 86.3% of cases. FMR severity improved in 58.8% of patients, effectively eliminating the need for further interventions in these cases. Independent baseline predictors of persistent high-grade FMR at follow-up included New York Heart Association (NYHA) class IV heart failure symptoms, mean pulmonary artery pressure (mPAP) > 20 mmHg, effective regurgitant orifice area (EROA) > 0.4 cm², vena contracta > 8 mm, and left atrial volume index (LAVI) > 48 mL/m². Conclusions: Rhythm control of AF significantly reduced the severity of FMR in most patients, eliminating the need for mitral valve (MV) intervention in these cases. The identified predictors of persistent high-grade FMR could contribute to refined risk assessment and assist in treatment decision-making, potentially supporting early referral for MV intervention in appropriate patients. © The Author(s) 2025.

关键词： Atrial fibrillation Heart failure Mitral regurgitation Mitral valve intervention Reverse remodeling Reversibility Rhythm control

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MorPhiC Consortium: towards functional characterization of all human genes

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Nature 2025年第8050期638卷 351-359页

作者： Adli, Mazhar Przybyla, Laralynne Burdett, Tony Burridge, Paul W. Cacheiro, Pilar Chang, Howard Y. Engreitz, Jesse M. Gilbert, Luke A. Greenleaf, William J. Hsu, Li Huangfu, Danwei Hung, Ling-Hong Kundaje, Anshul Li, Shuzhao Parkinson, Helen Qiu, Xiaojie Robson, Paul Schürer, Stephan C. Shojaie, Ali Skarnes, William C. Smedley, Damian Studer, Lorenz Sun, Wei Vidović, Dušica Vierbuchen, Thomas White, Brian S. Yeung, Ka Yee Yue, Feng Zhou, Ting Žurauskienė, Justina Zhong, Aaron Zheng, Shujian Zhao, Hengqiang Zhang, Nan Zhang, Zhehao Zhang, Stephen Zeng, Tony Yu, Bo Yordanova, Galabina N. Yang, Dapeng Xing, De Wang, Xianming Wang, Ping Torre, Denis Tang, Wenzhuo Shivalikanjli, Anu Sengupta, Kaustav Seker, Fidan Ventura, Enrique Sapena Ross, Nicolette C. Rivera-Diaz, Jamilex Rana, Arushi Pongpamorn, Praeploy Poirion, Olivier B. Pillai, Ajay Pilarczyk, Marcin Parker, Devon Ning, Gang Neyisci, Ozlem Nasam, Niharika Mittal, Varun Mitchell, Joshua M. Metzl-Raz, Eyal Meng, Chen Melo-Carrillo, Adrian McDonough, Justin A. Marengo, Gabriel Mao, Yuzhen Leite, Davi Lyra Luo, Renhe Liu, Nianping Liu, Dingyu Liu, Zukai Liu, Si Li, Zhaoheng Kraft, Katerina Koci, Orges A. Kirsammer, Gina Kendra, Angelina Hutter, Carolyn Huebner, Aaron J. Huang, Yung-Hsin Hu, Nan Gupta, Dipayan Gupta, Revant Guo, Tingfeng Griffiths, Alexandra M. Goyal, Juhee Glenn, Rachel A. Garofalo, Jessica L. Fukuda, Bryce Nobutoshi Fu, Yihao Flynn, William F. Flores, Jesse Fletcher, Colin F. Fleming, Patrick J. Felsenfeld, Adam L. Eraslan, Basak Doty, Anthony Dahlstrom, Thomas J. Chung, Caty E. Choudhary, Anshul Cho, Hyein S. Chen, Xintong Chen, Sijie Chan, Chia Baroch, Jacob J. Baker, Dylan S. Bai, Tao Avireddy, Rohan N. V. S. R. K. Amiri, Anahita Diniz, Juliana Alcoforado Abbaszadeh, Neda Robert H. Lurie Comprehensive Cancer Center Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL United States Department of Biochemistry and Biophysics University of California San Francisco CA United States Omics Section European Bioinformatics Institute (EMBL-EBI) European Molecular Biology Laboratory Hinxton United Kingdom Department of Pharmacology Center for Pharmacogenomics Northwestern University Feinberg School of Medicine Evanston IL United States William Harvey Research Institute Clinical Pharmacology and Precision Medicine Queen Mary University of London London United Kingdom Department of Dermatology Stanford University Stanford CA United States Department of Genetics Stanford University Stanford CA United States Basic Science and Engineering (BASE) Initiative Stanford University Stanford CA United States Department of Urology University of California San Francisco CA United States Department of Biostatistics Public Health Sciences Fred Hutchinson Cancer Center Seattle WA United States Developmental Biology Program Sloan Kettering Institute New York NY USA School of Engineering and Technology University of Washington Tacoma Tacoma WA United States Departments of Genetics and Computer Science Stanford University Stanford CA United States Jackson Laboratory for Genomic Medicine Farmington CT United States Knowledge Management Section European Bioinformatics Institute (EMBL-EBI) European Molecular Biology Laboratory Hinxton United Kingdom Molecular and Cellular Pharmacology Sylvester Comprehensive Cancer Center University of Miami Coral Gables FL USA Department of Biostatistics University of Washington Seattle WA United States Department of Biochemistry and Molecular Genetics Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine Chicago IL United States

Recent advances in functional genomics and human cellular models have substantially enhanced our understanding of the structure and regulation of the human genome. However, our grasp of the molecular functions of human genes remains incomplete and biased towards specific gene classes. The Molecular Phenotypes of Null Alleles in Cells (MorPhiC) Consortium aims to address this gap by creating a comprehensive catalogue of the molecular and cellular phenotypes associated with null alleles of all human genes using in vitro multicellular systems. In this Perspective, we present the strategic vision of the MorPhiC Consortium and discuss various strategies for generating null alleles, as well as the challenges involved. We describe the cellular models and scalable phenotypic readouts that will be used in the consortium's initial phase, focusing on 1,000 protein-coding genes. The resulting molecular and cellular data will be compiled into a catalogue of null-allele phenotypes. The methodologies developed in this phase will establish best practices for extending these approaches to all human protein-coding genes. The resources generated-including engineered cell lines, plasmids, phenotypic data, genomic information and computational tools-will be made available to the broader research community to facilitate deeper insights into human gene functions. © 2025. Springer Nature Limited.

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Association between transcriptomic metrics of exogenous antigen presentation and adaptive immunity with locoregional recurrence in localized estrogen receptor negative breast cancer: retrospective review of multi-institutional datasets

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Breast Cancer Research 2025年第1期27卷 1-12页

作者： Robinson, Timothy J. Liveringhouse, Casey L. Wilson, Christopher Friedman, Sam Nakashima, Justyn Mills, Matthew N. Purcell, Jacob D. Figura, Nicholas B. Dongliang, Du Thapa, Ram Welsh, Eric Ahmed, Kamran A. Grass, G. Daniel Fridley, Brooke L. Diaz, Roberto Department of Therapeutic Radiology Yale School of Medicine New Haven CT United States Department of Radiation Oncology H. Lee Moffitt Cancer Center and Research Institute Tampa FL United States Biostatistics and Bioinformatics Shared Resource H. Lee Moffitt Cancer Center and Research Institute Tampa FL United States Michigan State University College of Human Medicine East Lansing MI United States

Background: Transcriptomic features of breast cancer locoregional recurrence (LRR) remain poorly understood. We therefore sought to investigate transcriptomic features associated with LRR in newly diagnosed invasive breast tumors from our institutional dataset. Methods: Transcriptomic profiling was performed on 632 tumors from consecutive patients treated within our health system for newly diagnosed non-metastatic breast cancer. Univariable Cox models identified genes whose expression was associated with LRR (q-value < 0.05). Up-regulated (UR) genes were defined as hazard ratio (HR) > 1 and down-regulated (DR) genes were defined as HR < 1. Gene set enrichment analyses were performed for UR and DR gene sets and validated within two external cohorts of ER- tumors. Results: With a median follow-up of 7.6 years, we observed 38 LRRs: 28/481 (5.8%) in ER + and 10/151 (6.6%) in ER-. There were 43 UR and 7 DR genes associated with LRR in ER + tumors, while 417 UR and 1150 DR genes were associated with LRR in ER- tumors. UR genes in ER + tumors were enriched for roles in cell proliferation (q < 0.05). In contrast, LRR in ER- tumors was most strongly associated with DR genes enriched for MHC-II-mediated antigen presentation and T cell activation (q < 0.05). In external cohorts of ER- tumors, 97 significant DR genes (p < 0.05) were enriched for 18 pathways, including 5 pathways involved in MHC-II signaling, antigen presentation and T-cell activation. Conclusions: Transcriptomic patterns associated with LRR appear distinct between ER + and ER- tumors. In ER + tumors, LRR appears predominantly associated with proliferation, whereas ER- LRR suggests a robust pattern of suppressed antigen presentation via MHC-II. © The Author(s) 2025.

关键词： Breast cancer Estrogen receptor negative Immune response Locoregional control

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Gumbel-Softmax Flow Matching with Straight-Through Guidance for Controllable Biological Sequence Generation

arXiv

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arXiv 2025年

作者： Tang, Sophia Zhang, Yinuo Tong, Alexander Chatterjee, Pranam Department of Biomedical Engineering Duke University United States Management and Technology Program University of Pennsylvania United States Center of Computational Biology Duke-NUS Medical School Singapore Mila Quebec AI Institute Canada Université de Montréal Canada Department of Computer Science Duke University United States Department of Biostatistics and Bioinformatics Duke University United States

Flow matching in the continuous simplex has emerged as a promising strategy for DNA sequence design, but struggles to scale to higher simplex dimensions required for peptide and protein generation. We introduce Gumbel-Softmax Flow and Score Matching, a generative framework on the simplex based on a novel Gumbel-Softmax interpolant with a time-dependent temperature. Using this interpolant, we introduce Gumbel-Softmax Flow Matching by deriving a parameterized velocity field that transports from smooth categorical distributions to distributions concentrated at a single vertex of the simplex. We alternatively present Gumbel-Softmax Score Matching which learns to regress the gradient of the probability density. Our framework enables high-quality, diverse generation and scales efficiently to higher-dimensional simplices. To enable training-free guidance, we propose Straight-Through Guided Flows (STGFlow), a classifier-based guidance method that leverages straight-through estimators to steer the unconditional velocity field toward optimal vertices of the simplex. STGFlow enables efficient inference-time guidance using classifiers pre-trained on clean sequences, and can be used with any discrete flow method. Together, these components form a robust framework for controllable de novo sequence generation. We demonstrate state-of-the-art performance in conditional DNA promoter design, sequence-only protein generation, and target-binding peptide design for rare disease treatment. © 2025, CC BY-NC-ND.

关键词： Velocity distribution

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Quality for All: Clinical Trial Enrollment and End-of-Life Care in Solid and Hematologic Malignancies

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Cancer Medicine 2025年第9期14卷

作者： Rosen, Melissa R. Truong, Tracy Gervais, Catherine LeBlanc, Thomas W. Havrilesky, Laura J. Davidson, Brittany A. Department of Gynecology and Obstetrics Johns Hopkins University Baltimore MD United States Department of Biostatistics and Bioinformatics Duke University School of Medicine Durham NC United States Department of Hematologic Malignancies Duke University Medical Center Durham NC United States Department of Obstetrics and Gynecology Duke University Medical Center Durham NC United States

Background: Patients with incurable cancer deserve quality end-of-life (EOL) care. Despite established EOL quality metrics, many patients receive aggressive EOL care with limited goals of care (GOC) documentation. Concurrently, clinical trials are critical for advancing cancer care. We aim to identify associations between trial enrollment in the last year of life (YOL) and EOL quality metrics for adults with cancer to identify opportunities to advance goal-concordant care. Methods: This is a retrospective review of adult patients with cancer at a single academic institution who died between January 2018 and October 2022. Outcomes included: initiation of a new anticancer therapy, intensive care unit (ICU) admission, hospitalization, or emergency department (ED) encounter in the last 30 days of life (DOL), reception of anti-cancer treatment in the last 14 DOL, referral to hospice, referral to palliative care, and GOC documentation. Results: Among 9817 patients, 577 (5.9%) enrolled in clinical trials in the last YOL. Patients enrolled in trials were more likely to initiate new anticancer treatments in the last 30 DOL (p = < 0.001), less likely to have a palliative care referral (p = < 0.001) or GOC documentation (p = < 0.001), but were less likely to have an ED encounter in the last 30 DOL (p = 0.04) or die in an acute care setting (p = 0.015). Conclusions: Enrollment in clinical trials in the last YOL was associated with metrics of aggressive EOL care, with low rates of GOC documentation to determine if this care is goal-concordant. Low rates of palliative care and hospice engagement across the study population suggest opportunities for improvement for all patients, regardless of trial enrollment. © 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.

关键词： clinical trials end-of-life care goals of care

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