bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and screening of circular RNAs during adipogenic differentiation of ovine preadipocyte by RNA-seq
Authors: Shen Jiyuan , Jin Xiayang , Hao Zhiyun , Wang Jiqing , Hu Jiang , Liu Xiu , Li Shaobin , Zhao Fangfang , Li Mingna , Zhao Zhidong , Shi Bingang , Ren Chunyan
Published: February 2024

Circular RNAs (circRNAs) are a class of non-coding RNAs that play important roles in preadipocyte differentiation and adipogenesis. However, little is known about genome-wide identification, expression profile, and function of circRNAs in sheep. To investigate the role of circRNAs during ovine adipogenic differentiation, the subcutaneous adipose tissue of Tibetan rams was collected in June 2022. Subsequently, the preadipocytes were immediately isolated from collected adipose tissue and then induced to begin differentiation. The adipocytes samples cultured on days 0, 2, and 8 of preadipocytes differentiation were used to perform RNA sequencing (RNA-seq) analysis to construct the expression profiles of circRNAs. Subsequently, the function of differentially expressed circRNAs was investigated by performing the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of their parent genes. Finally, a circRNAs-miRNAs-mRNAs network involved in adipogenic differentiation was been analyzed. As a result, a total of 6,449 candidate circRNAs were identified in ovine preadipocytes. Of these circRNAs identified, 63 candidate circRNAs were differentially expressed among the three differentiation stages and their parent genes were mainly enriched in acetyl-CoA metabolic process, positive regulation of lipid biosynthetic process, positive regulation of steroid biosynthetic process, and focal adhesion pathway (P < 0.05). Based on a circRNAs-miRNAs-mRNAs regulatory network constructed, circ_004977, circ_006132 and circ_003788 were found to function as competing endogenous RNAs (ceRNAs) to regulate ovine preadipocyte differentiation and lipid metabolism. The results provide an improved understanding of functions and molecular mechanisms of circRNAs underlying ovine adipogenesis in sheep.
Mass Political Information on Social Media: Facebook Ads, Electorate Saturation, and Electoral Accountability in Mexico
Authors: Enríquez José Ramón , Larreguy Horacio , Marshall John , Simpser Alberto
Published: February 2024

Social media’s capacity to quickly and inexpensively reach large audiences almost simultaneously has the potential to promote electoral accountability. Beyond increasing direct exposure to information, high saturation campaigns—which target substantial fractions of an electorate—may induce or amplify information diffusion, persuasion, or coordination between voters. Randomizing saturation across municipalities, we evaluate the electoral impact of non-partisan Facebook ads informing millions of Mexican citizens of municipal expenditure irregularities in 2018. The vote shares of incumbent parties that engaged in zero/negligible irregularities increased by 6–7 percentage points in directly-targeted electoral precincts. This direct effect, but also the indirect effect in untargeted precincts within treated municipalities, were significantly greater where ads targeted 80%—rather than 20%—of the municipal electorate. The amplifying effects of high saturation campaigns are driven by citizens within more socially-connected municipalities, rather than responses by politicians or media outlets. These findings demonstrate how mass media can ignite social interactions to promote political accountability.
Compliance politics and international investment disputes: a new dataset
Authors: Strain Nicola , Lie Runar Hilleren , Chernykh Yuliya , Espelid Even , St John Taylor , Langford Malcolm , Cuervo-Lorens Isabella , Peat Daniel , Sarmiento Maria Florencia , Ripson Coen , Usynin Maxim , Adams Faadhil , Berge Tarald Gulseth , Létourneau-Tremblay Laura , Parekh Prevy , Gáspár-Szilágyi Szilárd , Link Morr , Eguia Lara , Stiansen Øyvind , Onyema Emilia
Published: February 2024

The ability to ensure compliance with investor-state arbitral awards is often regarded as one of the strengths of the international investment regime. Yet, there have been few systematic studies of compliance to assess the extent to which states have actually complied with adverse investor-state compensation awards. This paper presents a new dataset that enables empirical research on compliance with these decisions; it is the first publicly available dataset to focus on what happens after awards are handed down, and in this way complements other databases on international investment law. This paper explains the data collection process (and its associated challenges), discusses the design choices made in selecting inputs and variables, presents a descriptive overview of the data, and examines how variables can be used in future research. Moreover, various cases are used as illustrations of the challenges of collecting and coding data on post-award processes and we explore what missing data can tell us about compliance dynamics.
A case report and review of calcinosis cutis
Authors: Bender Tiffany , Burt Michael
Published: February 2024

Commonly associated with autoimmune and renal disorders, calcinosis cutis is a disorder of systemic calcium deposition in soft tissues. The pathophysiology of such deposition varies based on subtype, therefore treatment options vary not only in terms of severity of disease but also with subtype. This case report describes a 52-year-old female with systemic sclerosis and an extensive past medical history who initially presented with complaints of worsening left lower leg pain, a negative workup for deep vein thrombosis, and an extensive palpable mass in the posterior thigh with erythema, drainage, and purulence. With multiple treatment options exhausted from her autoimmune disorders, she ultimately required surgical resection for her refractory infected calcinosis cutis. Identification of calcinosis cutis subtype in conjunction with appropriate history and physical is crucial to determining indications for treatment.
On the M87 jet structure near the central engine
Authors: Beskin V S , Khalilov T I , Nokhrina E E , Pashchenko I N , Kravchenko E V
Published: February 2024

At present, there is no doubt that relativistic jets observed in active galactic nuclei pass from highly magnetized to weakly magnetized stage, which is observed as a break in the dependence on their width $d_{\rm jet}(z)$ on the distance z to the central engine. In this paper, we discuss the possibility of observing another break, which should be located at shorter distances. The position of this break can be associated with the region of formation of the dense central core near the jet axis which was predicted both analytically and numerically more than a decade ago, but has not yet received sufficient attention. In this case, the observed width should be determined by the dense core, and not by the total transverse size of the jet. The calculations carried out in this paper, which took into account both the transverse electromagnetic structure of the jet and the change in the spectrum of emitting particles along its axis, indeed showed such behaviour. We also found the evidence of the predicted break in the jet expansion profile using stacked 15 GHz Very Large Baseline Array (VLBA) image of M87 radio jet and constrain the light cylinder radius.
A new test of gravity – II. Application of marked correlation functions to luminous red galaxy samples
Authors: Armijo Joaquin , Baugh Carlton M , Norberg Peder , Padilla Nelson D
Published: February 2024

We apply the marked correlation function test proposed by Armijo et al. (Paper I) to samples of luminous red galaxies (LRGs) from the final data release of the Sloan Digital Sky Survey (SDSS) III. The test assigns a density-dependent mark to galaxies in the estimation of the projected marked correlation function. Two gravity models are compared: general relativity (GR) and $f(R)$ gravity. We build mock catalogues which, by construction, reproduce the measured galaxy number density and two-point correlation function of the LRG samples, using the halo occupation distribution model (HOD). A range of HOD models give acceptable fits to the observational constraints, and this uncertainty is fed through to the error in the predicted marked correlation functions. The uncertainty from the HOD modelling is comparable to the sample variance for the SDSS-III LRG samples. Our analysis shows that current galaxy catalogues are too small for the test to distinguish a popular $f(R)$ model from GR. However, upcoming surveys with a better measured galaxy number density and smaller errors on the two-point correlation function, or a better understanding of galaxy formation, may allow our method to distinguish between viable gravity models.
EGF‐driven EGFR/miR‐27b‐3p/FOXO1 promotes rat FSH synthesis and secretion
Authors: Ma Yi‐Ran , Gao Wei , Wang Hao‐Qi , Zhao Pei‐Sen , Zhang Yu‐Xin , Wei Fan‐Hao , Jiang Hao , Zhang Jia‐Bao , Yuan Bao , Gao Fei
Published: February 2024

The adenopituitary secretes follicle‐stimulating hormone (FSH), which plays a crucial role in regulating the growth, development, and reproductive functions of organisms. Investigating the process of FSH synthesis and secretion can offer valuable insights into potential areas of focus for reproductive research. Epidermal growth factor (EGF) is a significant paracrine/autocrine factor within the body, and studies have demonstrated its ability to stimulate FSH secretion in animals. However, the precise mechanisms that regulate this action are still poorly understood. In this research, in vivo and in vitro experiments showed that the activation of epidermal growth factor receptor (EGFR) by EGF induces the upregulation of miR‐27b‐3p and that miR‐27b‐3p targets and inhibits Foxo1 mRNA expression, resulting in increased FSH synthesis and secretion. In summary, this study elucidates the precise molecular mechanism through which EGF governs the synthesis and secretion of FSH via the EGFR/miR‐27b‐3p/FOXO1 pathway.
Beyond Skin Deep: Diagnostic Correlations Between Radiology and Dermatology: Part 1—Infectious Diseases, Neoplastic Disorders, and Genetic Syndromes
Authors: Fischer Sarah , Toker Michelle , Jaller Jose A. , Goldman Jessica , Shah Pooja R. , Wu Benedict , Mardakhaev Edward
Published: February 2024

Many disease processes demonstrate both dermatologic and radiologic findings. Through improved understanding of these manifestations, we can improve our diagnostic abilities and collaborate more effectively with clinicians. Part 1 of this review covers classic dermatologic and radiologic findings of disease processes, categorized as infectious diseases, neoplastic disorders, and genetic syndromes. Part 2 focuses on inflammatory disorders and arthritides. Although the list of disease processes with dermatologic and radiologic findings is extensive, this review focuses on a collection of diseases, which are either common or with particularly classic and notable manifestations. With a heightened understanding of these manifestations, radiologists can more effectively guide clinicians in ordering appropriate radiologic examinations, and together can efficiently arrive at accurate diagnoses for our patients.
Infiltration Technique for the Fourth FDS Opponensplasty Under WALANT
Authors: Jaroenporn Woraphon , Harnboonseth Wisaroot , Vechasilp Jaruwat , Pituckanotai Kwanchai
Published: February 2024

Background:

Wide-awake Local Anesthesia No Tourniquet (WALANT) is a surgical technique that relies on anesthetic and hemostatic agents to provide conditions suitable for hand surgery without sedation and a tourniquet. The opponensplasty using the fourth flexor digitorum superficialis tendon transfer with the pisiform pulley is one of the most used in severe carpal tunnel syndrome patient who is unable to perform thumb opposition due to thenar muscle atrophy with the benefit of small incision, less soft tissue dissection, easy to perform, good esthetic result and has minor morbidity. Key advantages of the pisiform pulley provide balancing abduction and flexion strength of the thumb. To date, there is no report using the WALANT technique for the fourth flexor digitorum superficialis opponensplasty with pisiform pulley.

Materials and Method:

Between January 2019 and January 2022, 18 patients (4 males and 14 females) with severe carpal tunnel syndrome with thenar muscle atrophy underwent fourth flexor digitorum superficialis opponensplasty as day surgery under the WALANT technique. Operative data, visual analog scale (VAS) pain scores, and complications were recorded. All patients underwent the procedure without any complications.

Results:

The average age of the patients was 58.4 (43 to 62) year-old. The average operative time was 38.4 (17 to 47) minutes. The average VAS score during the anesthetic injection was 6.43 (4 to -8). The average VAS pain score during the operation was 2.1 (1 to 3). The mean intraoperative blood loss was 3 (2.6 to 6.2) mL.

Conclusions:

The WALANT technique is safe and can be used as alternative anesthesia for the fourth flexor digitorum superficialis opponensplasty with pisiform pulley. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively.

Levels of Evidence:

Therapeutic study, level IV
Machine learning developed an intratumor heterogeneity signature for predicting prognosis and immunotherapy benefits in skin cutaneous melanoma
Authors: Zhang Wei , Wang Shuai
Published: February 2024

Background

Intratumor heterogeneity (ITH) is defined as differences in molecular and phenotypic profiles between different tumor cells and immune cells within a tumor. ITH was involved in the cancer progression, aggressiveness, therapy resistance and cancer recurrence.

Methods

Integrative machine learning procedure including 10 methods was conducted to develop an ITH-related signature (IRS) in The Cancer Genome Atlas (TCGA), GSE54467, GSE59455 and GSE65904 cohort. Several scores, including tumor immune dysfunction and exclusion (TIDE) score, tumor mutation burden (TMB) score and immunophenoscore (IPS), were used to evaluate the role of IRS in predicting immunotherapy benefits. Two immunotherapy datasets (GSE91061 and GSE78220) were utilized to the role of IRS in predicting immunotherapy benefits of skin cutaneous melanoma (SKCM) patients.

Results

The optimal prognostic IRS constructed by Lasso method acted as an independent risk factor and had a stable and powerful performance in predicting the overall survival rate in SKCM, with the area under the curve of 2-, 3- and 4-year receiver operating characteristic curve being 0.722, 0.722 and 0.737 in TCGA cohort. We also constructed a nomogram and the actual 1-, 3- and 5-year survival times were highly consistent with the predicted survival times. SKCM patients with low IRS scores had a lower TIDE score, lower immune escape score and higher TMB score, higher PD1&CTLA4 IPS. Moreover, SKCM patients with low IRS scores had a lower gene sets score involved in DNA repair, angiogenesis, glycolysis, hypoxia, IL2-STAT5 signaling, MTORC1 signaling, NOTCH signaling and P53 pathway.

Conclusion

The current study constructed a novel IRS in SKCM using 10 machine learning methods. This IRS acted as an indicator for predicting the prognosis and immunotherapy benefits of SKCM patients.
Image and Clinical Characteristics of the Right Coronary Artery Originating From the Left Coronary Sinus: A Database Review
Authors: Yuan Mingyuan , Zhang Jiani
Published: February 2024

This article systematically explores the imaging and clinical characteristics of a relatively rare cardiac anomaly: the right coronary artery originating from the left coronary sinus. Through a comprehensive analysis of existing literature, this study aims to provide a comprehensive understanding of the prevalence, diagnostic methods, and potential clinical implications of this anatomical variation. Anatomical classification is introduced, along with clinical imaging diagnostic methods, including coronary angiography, computed tomography, and magnetic resonance imaging. Additionally, the review delves into the clinical significance of this anomaly, including its potential associations with myocardial ischemia, arrhythmias, and acute cardiac events, outlining clinical approaches to diagnosing myocardial ischemia. The study results consolidate current knowledge about this cardiac variation, emphasizing the importance of recognizing and appropriately managing it in clinical practice.
Evidence-Based Approach to Chronic Antibiotic Refractory Pouchitis: A Review
Authors: Weber Andrew T. , Lichtenstein Gary R.
Published: February 2024

BACKGROUND:

Chronic antibiotic refractory pouchitis after restorative proctocolectomy with ileal pouch-anal anastomosis, characterized by at least 4 weeks of pouchitis symptoms that have not responded to standard antibiotic therapy, presents a therapeutic challenge for patients and healthcare providers.

OBJECTIVE:

The aim of this narrative review was to summarize the current evidence regarding management of chronic antibiotic refractory pouchitis.

DATA SOURCES:

Studies were identified through search of PubMed database from the National Library of Medicine.

STUDY SELECTION:

We included case series, cohort studies, randomized-controlled trials, and systematic reviews with meta-analyses that addressed chronic antibiotic refractory pouchitis management, with prioritization of data published within the last 3-5 years.

INTERVENTION:

Studies examining pharmacologic and select non-pharmacologic interventions were included.

MAIN OUTCOME MEASURE:

Outcomes measures included clinical, endoscopic, and histologic endpoints.

RESULTS:

Mesalamine has demonstrated efficacy in symptom improvement but no improvement in quality of life. Budesonide has demonstrated high rates of clinical remission that have mostly been sustained in a small number of patients. Anti-tumor necrosis factor alpha therapies have demonstrated efficacy in reaching clinical and even endoscopic endpoints, although rates of treatment discontinuation were not insignificant. Limited evidence is encouraging for use of ustekinumab in achieving clinical response. Data for vedolizumab are favorable across clinical, endoscopic, and histologic endpoints, including one of the only randomized, placebo-controlled trials. Non-medication therapies including hyperbaric oxygen therapy and fecal microbiota transplant have undergone limited evaluation and concerns about ultimate accessibility of these therapies remain.

LIMITATIONS:

Overall, studies assessing therapeutic options for chronic antibiotic refractory pouchitis are mostly limited to case series and retrospective studies with small sample sizes.

CONCLUSIONS:

Biologic therapies have demonstrated efficacy in the management of chronic antibiotic refractory pouchitis and offer a steroid-sparing option for refractory disease. Non-pharmacologic therapies, including hyperbaric oxygen and fecal microbiota transplant, require further exploration. See video.
Decongestion (instead of ultrafiltration?)
Authors: Schuermans Art , Verbrugge Frederik H.
Published: February 2024

Purpose of review

To summarize the contemporary evidence on decongestion strategies in patients with acute heart failure (AHF).

Recent findings

While loop diuretic therapy has remained the backbone of decongestive treatment in AHF, multiple randomized clinical trials suggest that early combination with other diuretic classes or molecules with diuretic properties should be considered. Mineralocorticoid receptor antagonists and sodium–glucose co-transporter-2 inhibitors are disease-modifying drugs in heart failure that favourably influence prognosis early on, advocating their start as soon as possible in the absence of any compelling contraindications. Short-term upfront use of acetazolamide in adjunction to intravenous loop diuretic therapy relieves congestion faster, avoids diuretic resistance, and may shorten hospitalization length. Thiazide-like diuretics remain a good option to break diuretic resistance. Currently, ultrafiltration in AHF remains mainly reserved for patient with an inadequate response to pharmacological treatment.

In most patients with AHF, decongestion can be achieved effectively and safely through combination diuretic therapies. Appropriate diuretic therapy may shorten hospitalization length and improve quality of life, but has not yet proven to reduce death or heart failure readmissions. Ultrafiltration currently has a limited role in AHF, mainly as bail-out strategy, but evidence for a more upfront use remains inconclusive.
Unmasking the invisible enemy: A case report of metagenomics-guided diagnosis and treatment of neonatal septic meningitis caused by Corynebacterium aurimucosum in a preterm infant with neonatal lupus erythematosus
Authors: Xia Qing , Gu Meiqun , Xu Yu , Sang Haoke , Lin Wenhua , Wang Yajun , Liu Kai
Published: February 2024

Rationale:

Neonatal septic meningitis is a serious condition that can be caused by various pathogens, includingCorynebacterium aurimucosum, a rare and opportunistic bacterium. We reports a case of infectious meningitis in a premature infant with neonatal lupus erythematosus caused byC aurimucosum. The purpose of this study is to explore the occurrence of meningitis caused byC aurimucosumin preterm infants with neonatal lupus erythematosus. We found that early diagnosis and treatment are crucial for this type of meningitis, especially for infants with impaired immunity or mothers receiving immunosuppressive therapy. This bacterium is rare in clinical practice, but it needs to be taken seriously.

Patient concerns:

The infant was born to a mother with systemic lupus erythematosus who had a history of long-term immunosuppressive therapy. The infant presented with preterm birth, purplish-red skin, fever, and widespread scarlet dermatitis. He also had positive anti-Ro/SSA and anti-La/SSB antibodies.

Diagnosis:

The infant was diagnosed with neonatal lupus erythematosus based on clinical and serological features. A lumbar puncture revealed septic meningitis with high levels of total nucleated cells, protein, and Pan’s test in the CSF. The macrogenic examination identifiedC aurimucosumas the causative agent. The culture of the mother’s vaginal secretion also revealed the same bacterium.

Interventions:

The infant was treated with anti-infective therapy with ceftriaxone, ampicillin, vancomycin, and meropenem. He also received prednisone and gammaglobulin infusion for neonatal lupus erythematosus.

Outcomes:

The infant’s temperature returned to normal, and his general condition and responsiveness improved. The CSF cytology and biochemistry normalized, and the culture was negative. The cranial MRI examination showed no abnormalities. The red rash disappeared, and the follow-ups after discharge revealed no complications.

Lessons:

This case highlights the importance of early diagnosis and treatment of neonatal septic meningitis caused byC aurimucosum, especially in infants with immunocompromised conditions or maternal history of immunosuppressive therapy.C aurimucosumshould not be overlooked as a potential pathogen in neonatal septic meningitis.
Neurological manifestations and complications of COVID-19 in patients admitted to a tertiary care center in Nepal during the second wave
Authors: Gajurel Bikram Prasad , Yadav Sushil Kumar , Nepal Gaurav , Pant Sobin , Yadav Manish , Shah Ravi , Shah Sumit
Published: February 2024

Neurological symptoms and signs of Coronavirus disease-19 (COVID-19) can accompany, follow, or precede respiratory symptoms and signs; hence, they are important in the diagnosis and management of COVID-19 patients. In this retrospective study conducted during the second wave of COVID-19, we included all patients diagnosed with COVID-19 using real-time polymerase chain reaction and admitted to the Tribhuvan University Teaching Hospital between June 2021 and October 2021. The patients were categorized into 2 groups: group A (with neurological manifestations or complications) and Group-B (without neurological manifestations or complications). The 2 groups were compared in terms of intensive care unit (ICU) admission, need for ventilatory support, length of hospital stay, and various outcomes. The study included 235 participants ranging in age from 13 to 102 years (mean age = 54 years, standard deviation = 18). Among the participants, 54.50% were male. The proportion of individuals in group A was higher (59.15%, N = 139) than that in Group-B (40.85%, N = 96). Notably, a significantly greater number of patients were admitted to the ICU in Group B than in Group A. However, there were no statistically significant differences in the need for ventilatory support or hospital stay between the 2 groups. Interestingly, group A showed a higher rate of improvement (Z = −3.1145, P = .00188, 95% CI), while Group-B had a higher rate of mortality (Z = 4.5562, P < .00001, 95% CI). Altered mental status and stroke have been specifically linked to poorer outcomes, whereas typical neurological manifestations, such as hyposmia, hypogeusia, dizziness, headache, and myalgia, are associated with better outcomes.
Effects and safety of endovascular recanalization for non-acute symptomatic intracranial vertebral artery occlusion with different risks
Authors: Chen Shunqiang , Xia Jinchao , Xiao Shuxin , Li Tianxiao , Wang Ziliang
Published: February 2024

There is no consensus on the optimal treatment for non-acute symptomatic intracranial vertebral artery occlusion, and endovascular recanalization is a challenging procedure. We report our clinical experience of endovascular recanalization in patients with non-acute symptomatic intracranial vertebral artery occlusion to assess the feasibility and safety of endovascular recanalization and determine the candidate patients for this procedure. Ninety-two patients with non-acute symptomatic intracranial vertebral artery occlusion who underwent endovascular recanalization from January 2019 to December 2021 were retrospectively analyzed. we grouped all patients according to imaging examination findings, occlusion length, duration, nature, calcification, and angulation to evaluate the risk of endovascular recanalization. The overall success rate of endovascular recanalization was 83.7% (77/92), and the perioperative complication rate was 10.9% (10/92). Among the 3 classification groups, the recanalization success rate gradually decreased from the low-risk group to the high-risk group (low-risk: 100%, medium-risk: 93.3%, high-risk group: 27.8%, P = .047), while the overall perioperative complication rate showed the opposite trend (0%, 10.0%, 38.9%, respectively, P = .001); the proportion of patients with 90-day modified Rankin Scale scores of 0–2 decreased successively (100%, 83.3%, and 22.2%, respectively, P < .026); 77 patients with successful recanalization were followed; the rate of restenosis/reocclusion increased sequentially (0%, 17.9%, and 80%, respectively, P = .000). Patients in the low- and medium-risk groups showed a good clinical course after endovascular recanalization. Among 88 patients (four patients lost to follow-up), with a median clinical follow-up of 13 months (interquartile range ¼, 7–16), the rate of stroke or death after 30 days was 17.4% (16/92). Endovascular recanalization is safe and feasible for low- and medium-risk patients with non-acute symptomatic intracranial vertebral artery occlusion; it is also an alternative to conservative therapy for the patients.
Recurrent hematuria involving urinary system with Klippel-Trenaunay syndrome: A case report
Authors: Lin Feng , Yang Kewei , Xu Jiadong , Wang Gang , Yang Lixia , Huang Jinrong , Li Dan
Published: February 2024

Rationale:

Klippel-Trenaunay syndrome (KTS) is a rare congenital venous malformation, it had been found to be caused by mutations of the phosphatidylinositol 4, 5-diphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene. Currently KTS is defined as a triad of skin wine pigmented spots, varicose veins and malformations of the lower extremities, and hypertrophy of bone and soft tissue, involving urinary system up to 6% to 30%. When the urinary system is involved, KTS is often presented as painless massive gross hematuria.

Patient concerns:

This article describes a woman who was hospitalized with painless massive gross hematuria. Physical examination revealed significant hypertrophy of the right lower limb with varicose veins, port-wine stains in the skin, and right perineal hemangiomatous changes with swelling. The patient was admitted to hospital 4 times for repeated hematuria and infection.

Diagnoses:

By physical examination, CT urography, ureteroscopy and cystoscopy, the patient was diagnosed to have Klippel-Trenaunay syndrome, involving the urinary system.

Interventions:

The patient hematuria improved after multiple indwelling D-J tubes and anti-inflammatory treatment.

Outcomes:

The final symptoms of hematuria improved significantly, follow-up so far has not recurred.

Lessons:

This case presents the possibility of painless gross hematuria with KTS. Most of patients can be improved by conservative treatment. Cystoscopic laser therapy is the preferred treatment for poor bleeding control. Cystectomy and nephrectomy should be considered when life-threatening.
Rodenticide poisoning leading to cerebral hemorrhage: A case report
Authors: He Qian-kun , Wu Yuan-hua , Lu Xiao-ying , Liu Ming-wei
Published: February 2024

Rationale:

Anticoagulant rodenticides (ARs) are a substantial fraction of murine types. AR poisoning causes bleeding from the skin, mucous membranes, and multiple organs. However, reports of AR-induced cerebral hemorrhage are scarce.

Patient concerns:

A 40-year-old male presented with dizziness, headache, and limb weakness for 5 days and with coagulopathy. Two days prior to the onset of these symptoms, the patient was exposed to dead mice.

Diagnoses:

Rodenticide intoxication-induced cerebral hemorrhage.

Interventions:

Vitamin K1 infusion, administration of dehydrating agents to reduce intracranial pressure, and correction of acid-base and electrolyte imbalances.

Outcomes:

After 9 days of treatment, the patient’s symptoms were relieved, and reexamination revealed that coagulation parameters returned to normal levels. The patient was eventually discharged for observation with oral vitamin K1.

Conclusions:

Rodenticide poisoning can lead to intracerebral hemorrhage, and treatment with vitamin K1 infusion is effective.

Lesson:

Rodenticide poisoning-induced cerebral hemorrhage is rarely reported. Because its symptoms are nonspecific, it is easy to miss the diagnosis or misdiagnose. When patients present with direct and indirect symptoms such as dizziness, headache, and limb weakness, rodenticide poisoning should be considered. Coagulation function and head computed tomography or magnetic resonance imaging examination should be performed at the earliest to confirm the diagnosis and provide timely treatment.
Williams-Beuren syndrome in pediatric T-cell acute lymphoblastic leukemia: A rare case report and review of literature
Authors: Yang Rong , Ai Yuan , Bai Ting , Lu Xiao-Xi , He Guoqian
Published: February 2024

Background:

Williams-Beuren syndrome (WBS) is a rare genetic disorder caused by hemizygous microdeletion of contiguous genes on chromosome 7q11.23. Although the phenotype features extensive heterogeneity in severity and performance, WBS is not considered to be a predisposing factor for cancer development. Currently, hematologic cancers, mainly Burkitt lymphoma, are rarely reported in patients with WBS. Here in, we report a unique case of T-cell acute lymphoblastic leukemia in a male child with WBS.

Methods:

This retrospective study analyzed the clinical data of this case receiving chemotherapy were analyzed. This is a retrospective study.

Results:

The patient, who exhibited a typical WBS phenotype and presented with hemorrhagic spots. Chromosomal genome-wide chip analysis (CMA) revealed abnormalities on chromosomes 7 and 9. The fusion gene STIL-TAL1 and mutations in BCL11B, NOTCH1, and USP7 have also been found and all been associated with the occurrence of T-cell leukemia. The patient responded well to the chemotherapy.

Conclusion:

To the best of our knowledge, this is the first reported case of WBS in T-cell acute lymphoblastic leukemia. We want to emphasize that the occurrence of leukemia in this patient might be related to the loss of 7q11.23 and microdeletion of 9p21.3 (including 3 TSGs), but the relationship between WBS and malignancy remains unclear. Further studies are required to clarify the relationship between WBS and malignancy.
Finite element study on three osteotomy methods for treating thoracolumbar osteoporotic fracture vertebral collapse complicated with neurological dysfunction
Authors: Long Zhisheng , Zhou Jingyu , Xiong Long , Chen Gang , Wen Jiabin
Published: February 2024

Background:

Surgical methods for patients with osteoporotic fracture vertebral collapse complicated with neurological dysfunction are still a topic of debate. We designed an improved osteotomy for the treatment of osteoporotic compression fracture patients with neurological dysfunction. Compared with traditional osteotomy methods such as pedicle subtraction osteotomy (PSO) and bone-disc-bone osteotomy (BDBO), the osteotomy range is reduced. Therefore, we use a finite element method to analyze the biomechanical conditions of these three osteotomy methods and provide a mechanical theoretical basis for the surgical treatment of these three osteotomy methods.

Methods:

Based on the CT scan of a patient with L1 osteoporotic fracture vertebral collapse and neurological dysfunction, the finite element model was constructed by importing Mimics software, and three different osteotomy models were established. The forces and displacements of internal fixation device, T1-L5 whole segment, T10 vertebral body, and T10/11 intervertebral disc were recorded under different working conditions.

Results:

The displacement levels of internal fixation device, T1-L5 spine, T10 vertebral body, and T10/11 intervertebral disc in the modified osteotomy group were between BDBO group and PSO group. The stress in BDBO group was concentrated in titanium mesh and its maximum stress was much higher than that in PSO group and modified osteotomy group. The mechanical distribution of T10/11 intervertebral disc showed that the maximum stress distribution of the three osteotomy methods was similar.

Conclusion:

The relatively simple modified osteotomy has certain advantages in stress and displacement. In contrast, the stability of BDBO group was poor, especially in the lumbar intervertebral disc and lumbar body. For this type of osteotomy patients, it is recommended to avoid postoperative flexion so as not to increase the load.
Stubborn hypoxemia after mild to moderate sedation and analgesia: A case report
Authors: Zou Jiayun , Wang Huazhen , Nan Yongshan , Jin Xianglan
Published: February 2024

Introduction:

Atelectasis typically denotes the partial or complete collapse of lung segments, lobes, or lobules in individuals, leading to a compromised respiratory function. The prevalence of perioperative atelectasis may be significantly underestimated, particularly among patients subjected to general anesthesia.

Patient concerns:

This article conducts a retrospective analysis of a case involving refractory hypoxemia in a patient with a liver tumor who was admitted to Yanbian University Affiliated Hospital (Yanbian Hospital) after undergoing mild-to-moderate sedation and analgesia outside the operating room.

Diagnosis:

Based on the results of CT examination and present history, the patient was diagnosed with intraoperative atelectasis.

Intervention:

After the surgery, the patient was transferred to the recovery ward, where nasal oxygen therapy and nebulized inhalation treatment were administered. Vital signs were closely monitored at the bedside, gradually returning to the preoperative baseline.

Outcome:

Postoperatively, the patient developed atelectasis, with the percentage of lung opacity shown in the image decreasing from 9.2% of the total thoracic cage area to 8.4%.

Conclusion:

During non-intubated intravenous anesthesia, patients with compromised pulmonary conditions are more susceptible to refractory hypoxemia. Therefore, a personalized approach should be adopted regarding oxygen concentration and the dosage and type of medication. Additionally, preparations for appropriate airway management measures are essential to safeguard patient safety in the event of respiratory issues.
The impact of a trial of labor after cesarean versus elective repeat cesarean delivery: A meta-analysis
Authors: Chen Xiao , Mi Mei-yan
Published: February 2024

Background:

The increasing global incidence of cesarean section has prompted efforts to reduce cesarean delivery rates. A trial of labor after cesarean (TOLAC) has emerged as an alternative to elective repeat cesarean delivery (ERCD) for women with a prior cesarean delivery. However, the available evidence on the comparative outcomes of these 2 options remains inconsistent, primarily due to varying advantages and risks associated with each. Our meta-analysis aims to compare the maternal-neonatal results in TOLAC and ERCD in women with prior cesarean deliveries.

Methods:

A comprehensive search was performed in PubMed, Embase, Cochrane library databases up to September,2022 to identity studies evaluating perinatal outcomes in women who underwent TOLAC compared to ERCD following a previous cesarean delivery. The included studies were subjected to meta-analysis using RevMan 5.3 software to assess the overall findings.

Results:

A total of 13 articles were included in this meta-analysis. Statistically significant differences were identified in the rate of uterine rupture (OR = 2.01,95%CI = 1.48–2.74, P < .00001) and APGAR score < 7 at 5 minutes (OR = 2.17,95%CI = 1.69–2.77, P < .00001) between the TOLAC and ERCD groups. However, no significant differences were observed in the rates of hysterectomy, maternal blood transfusion, postpartum infection, postpartum hemorrhage and neonatal intensive care unit (P ≥ .05) admission between the 2 groups.

Conclusions:

Our analysis revealed that TOLAC is associated with a higher risk of uterine rupture and lower incidence APGAR score < 7 at 5 minutes compared to ERCD. It is vital to consider predictive factors when determining the appropriate mode of delivery in order to ensure optimal pregnancy outcomes. Efforts should be made to identify the underlying causes of adverse outcomes and implement safety precautions to select suitable participants and create safe environments for TOLAC.
Long noncoding RNA LINC00921 serves as a predictive biomarker for lung adenocarcinoma: An observational study
Authors: Xu Hongyu , Xiong Weijie , Liu Xianguo , Wang Yang , Shi Maolin , Shi Yuhui , Shui Jia , Yu Yanxin
Published: February 2024

Lung adenocarcinoma (LUAD) is usually diagnosed at advanced stages. Hence, there is an urgent need to seek an effective biomarker to predict LUAD status. Long noncoding RNAs (lncRNAs) play key roles in the development of tumors. However, the relationship between LINC00921 and LUAD remains unclear. The gene expression data of LUAD were downloaded from the Cancer Genome Atlas database to investigate the expression level of LINC00921 in LUAD. Diagnostic ability analysis, survival analysis, tumor mutational burden analysis, and immune cell infiltration analysis of LINC00921 in LUAD patients were performed simultaneously. According to the median expression value of LINC00921, patients were divided into LINC00921 high- and low-expression groups. The function of LINC00921 in LUAD was identified through difference analysis and enrichment analysis. Moreover, drugs that may be relevant to LUAD treatment were screened. Finally, blood samples were collected for real-time polymerase chain reaction. LINC00921 was significantly lower in LUAD tumor tissues. Notably, patients with low expression of LINC00921 had a shorter median survival time. Decreased immune cell infiltration in the tumor microenvironment in the low LINC00921 expression group may contribute to poorer patient outcomes. Tumor mutational burden was significantly different in survival between the LINC00921 high- and low-expression groups. In addition, LINC00921 may exert an influence on cancer development through its regulation of target genes transcription. Glyceraldehyde-3-phosphate dehydrogenase-related drugs may be more likely to be therapeutically effective in LUAD. LINC00921 was able to be used as the potential diagnostic indicator for LUAD.
Five-year follow-up of sustained virological response with hepatitis C infection after direct-acting antiviral therapy: A single-center retrospective study
Authors: Li Mengyue , Li Yiting , Zhang Ying , Wang Xiangyang , Lin Chaoshuang
Published: February 2024

In recent years, direct-acting antivirals (DAAs) have dramatically improved the sustained virological response (SVR) rates in chronic hepatitis C (CHC) patients with their favorable safety and efficacy. However, there is a lack of data on the long-term prognosis of DAA therapy for CHC patients after achieving SVR in the real world. The aim of this study was to evaluate the long-term clinical prognosis of patients with chronic hepatitis C treated by DAA after achieving SVR. This study was a single-center, retrospective, observational study that included 243 CHC patients who reached SVR after DAA treatment in the Third Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2021, with a median follow-up period (FUP) of 24 months, to assess the long-term prognosis and clinical outcomes of CHC patients who reached SVR by DAA treatment. A total of 243 patients were enrolled in this study, 151 patients were male, the mean age of this study was 46.7 ± 12.3 years old, and 23.0% (n = 56) patients were cirrhosis in the baseline. At the end of follow-up, 9 patients (3.7%) progressed to hepatocellular carcinoma (HCC), and patients with cirrhosis at baseline (n = 5) had a significantly higher risk of HCC compared with noncirrhotic patients (n = 4; OR = 4.485, 95% CI: 1.162–17.318, P = .029); 2.9% patients (n = 7) relapsed at the median FUP of 12 months, and patients with genotype 3b had a significantly higher risk of relapsing than those without genotype 3b (OR = 18.48, P = .002, 95% CI: 2.866–119.169). ALT, AST, and ALB all showed improvement at the end of treatment compared with the baseline, remaining at normal levels during FUP meanwhile. The DAA-induced SVR was durable, with conspicuous improvement in clinical outcomes. Nevertheless, patients, especially patients with cirrhosis, still exist the risk of appearance of HCC after reaching SVR. Therefore, regular surveillance and monitoring is necessary even after patients reached SVR.
The effect and safety of obeticholic acid for patients with nonalcoholic steatohepatitis: A systematic review and meta-analysis of randomized controlled trials
Authors: Zhao Jie , Li Baozhen , Zhang Kai , Zhu Zhiyong
Published: February 2024

Background and aims:

Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NASH) is one of the primary causes of chronic liver disease worldwide. Obeticholic acid (OCA), a potent farnesoid X nuclear receptor activator, has shown promise for treating NASH-related fibrosis due to its anti-fibrotic effects. This study aimed to examine the efficacy of OCA for patients with NASH as well as to investigate its impact on dyslipidemia.

Method:

A search of databases including PubMed, Embase, and Cochrane Library from January 1, 2010, to November 1, 2022, was conducted to identify systematic reviews of randomized controlled trials involving NASH patients. Inclusion criteria comprised randomized controlled trials that specifically addressed NASH as diagnosed through magnetic resonance imaging, computed tomography, or histology. The results were then categorized, with consideration given to both biochemical and histological outcomes.

Result:

Five NASH studies were ultimately selected for further analysis. In terms of biochemical indicators, patients receiving OCA treatment showed improvements in alanine transaminase (mean difference: −19.48, 95% confidence interval [CI]: −24.39 to 14.58; P < .05) and aspartate aminotransferase (mean difference: −9.22, 95% CI: −12.70 to 5.74; P < .05). As for histological improvement, OCA treatment reduced fibrosis (odds ratio [OR]: 1.95, 95% CI: 1.47–2.59; P = .001) and steatosis (OR: 1.95, 95% CI: 1.47–2.59; P = .001). No significant differences were observed regarding adverse events (1.44, 95% CI: 0.57–3.62; P > .001). Regarding dyslipidemia, mean differences between total cholesterol and low-density lipoprotein were found to be high (0.33, 95% CI: 0.01–0.64, P < .05; 0.39, 95% CI: 0.04–0.73, P < .05). In the case of pruritus, OCA achieved a high OR (3.22, 95% CI: 2.22–4.74) compared with placebo.

Conclusion:

OCA also reduced several liver test markers compared to placebo, including the biochemical indicators alanine transaminase, aspartate aminotransferase, alkaline phosphatase, and γ-glutamyl transpeptidase, and improved hepatocellular ballooning, fibrosis, steatosis, and lobular inflammation. Although the incidence of adverse events did not significantly differ between OCA and placebo groups among NASH patients, OCA treatment was found to elevate total cholesterol and low-density lipoprotein levels, and the reported severity of pruritus increased with higher doses of OCA.
Insomnia among coronavirus disease 2019 survivors: A single-center cross-sectional study
Authors: Lu Man-Lu , Zhu Ji-Wei , Wu Jing-Lin , Lv Liang-Yan , Liu Lu , Kong Gui-Qing , Ding Chang-Ling , Yu Yan , Pan Lei
Published: February 2024

Since the coronavirus disease 2019 (COVID-19) epidemic, insomnia has become one of the longer COVID-19 symptoms. This study aimed to investigate insomnia among COVID-19 survivors and explore the occurrence and influencing factors of insomnia. A cross-sectional study was performed from December 2022 to February 2023 through an online questionnaire star survey with 8 questions. The insomnia severity index scale (ISI) was used to assess the severity of insomnia. Univariate analysis was used to analyze the factors related to COVID-19 infection. A total of 564 participants (183 males and 381 females) were surveyed in the present study. The prevalence of insomnia was 63.12%. Among these insomnia patients, there were 202 (35.82%) with sub-threshold symptoms, 116 (20.57%) with moderate symptoms, and 38 (6.74%) with severe symptoms. Univariate analysis indicated that there were statistically significant differences in the prevalence of insomnia among COVID-19 survivors of different ages, occupations, and educational levels (P < .05). Of the 356 insomnia patients, 185 (51.97%) did not take any measures against insomnia, while those who took drugs only, physical exercise only, drugs and physical exercise, and other measures were 90 (25.28%), 42 (11.80%), 17 (4.78%), and 22 (6.18%), respectively. Additionally, of the 107 insomnia patients with drug therapy, 17 (15.89%) took estazolam, 16 (14.95%) took alprazolam, 39 (36.45%) took zopiclone, and 35 (32.71%) took other drugs to improve insomnia symptoms. The prevalence of insomnia symptoms remains high among COVID-19 survivors in China. Education level and occupation may be the influencing factors. Unfortunately, most patients with insomnia do not take corresponding treatment measures.