bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Hilbert-differential phase contrast to scanning transmission electron microscopy
Authors: Iga Haruka , Shimizu Toshiki , Minoda Hiroki
Published: March 2024

We report a novel class of scanning transmission electron microscopy with Hilbert-differential phase contrast (HDP-STEM) that displays nanostructures of thin samples in a topographical manner. A semicircular π-phase plate (PP) was used as an optical device for manipulating electron waves in HDP-STEM. This is the different design from the Zernike PP used in our previous phase plate STEM (P-STEM), but both must be placed in the front focal plane of the condenser lens. HDP-STEM images of multiwalled carbon nanotubes showed higher contrast than those obtained by conventional bright-field STEM. As the PP of the HDP-STEM is nonsymmetrical, several different images were obtained by changing the detection conditions. A two-dimensional electron detector was also used to remove the scattering contrast component in the same way as with the Zernike PP and obtain an image containing only (differential) phase contrast.
Modelling metabolic fluxes of tomato stems reveals that nitrogen shapes central metabolism for defence against Botrytis cinerea
Authors: Lacrampe Nathalie , Lugan Raphaël , Dumont Doriane , Nicot Philippe C , Lecompte François , Colombié Sophie
Published: March 2024

Among plant pathogens, the necrotrophic fungus Botrytis cinerea is one of the most prevalent, leading to severe crop damage. Studies related to its colonization of different plant species have reported variable host metabolic responses to infection. In tomato, high N availability leads to decreased susceptibility. Metabolic flux analysis can be used as an integrated method to better understand which metabolic adaptations lead to effective host defence and resistance. Here, we investigated the metabolic response of tomato infected by B. cinerea in symptomless stem tissues proximal to the lesions for 7 d post-inoculation, using a reconstructed metabolic model constrained by a large and consistent metabolic dataset acquired under four different N supplies. An overall comparison of 48 flux solution vectors of Botrytis- and mock-inoculated plants showed that fluxes were higher in Botrytis-inoculated plants, and the difference increased with a reduction in available N, accompanying an unexpected increase in radial growth. Despite higher fluxes, such as those involved in cell wall synthesis and other pathways, fluxes related to glycolysis, the tricarboxylic acid cycle, and amino acid and protein synthesis were limited under very low N, which might explain the enhanced susceptibility. Limiting starch synthesis and enhancing fluxes towards redox and specialized metabolism also contributed to defence independent of N supply.
Stage-specific exposure of Caenorhabditis elegans to cadmium identifies unique transcriptomic response cascades and an uncharacterized cadmium responsive transcript
Authors: Almutairi Norah , Khan Naema , Harrison-Smith Alexandra , Arlt Volker M , Stürzenbaum Stephen R
Published: March 2024

Age/stage sensitivity is considered a significant factor in toxicity assessments. Previous studies investigated cadmium (Cd) toxicosis in Caenorhabditis elegans, and a plethora of metal-responsive genes/proteins have been identified and characterized in fine detail; however, most of these studies neglected age sensitivity and stage-specific response to toxicants at the molecular level. This present study compared the transcriptome response between C. elegans L3 vs L4 larvae exposed to 20 µM Cd to explore the transcriptional hallmarks of stage sensitivity. The results showed that the transcriptome of the L3 stage, despite being exposed to Cd for a shorter period, was more affected than the L4 stage, as demonstrated by differences in transcriptional changes and magnitude of induction. Additionally, T08G5.1, a hitherto uncharacterized gene located upstream of metallothionein (mtl-2), was transcriptionally hyperresponsive to Cd exposure. Deletion of one or both metallothioneins (mtl-1 and/or mtl-2) increased T08G5.1 expression, suggesting that its expression is linked to the loss of metallothionein. The generation of an extrachromosomal transgene (PT08G5.1:: GFP) revealed that T08G5.1 is constitutively expressed in the head neurons and induced in gut cells upon Cd exposure, not unlike mtl-1 and mtl-2. The low abundance of cysteine residues in T08G5.1 suggests, however, that it may not be involved directly in Cd sequestration to limit its toxicity like metallothionein, but might be associated with a parallel pathway, possibly an oxidative stress response.
Efficacy of methylprednisolone in very early systemic sclerosis: results of the ‘Hit Hard and Early’ randomized controlled trial
Authors: Kersten Brigit E , Lemmers Jacqueline M J , Vanhaecke Amber , Velauthapillai Arthiha , van den Hombergh Wieneke M T , van den Hoogen Frank H J , van den Ende Cornelia H M , Smith Vanessa , Vonk Madelon C
Published: March 2024

Objective

We hypothesized that glucocorticoids would induce remission in very early systemic sclerosis (SSc) patients by inhibition of inflammation driving the disease. We examined the efficacy and safety of methylprednisolone in very early SSc.

Methods

In this trial adults with puffy fingers for less than 3 years, specific auto-antibodies and meeting the Very Early Diagnosis of Systemic Sclerosis criteria were randomly assigned (2:1) to methylprednisolone 1000 mg i.v. or placebo for three consecutive days three times with monthly intervals. The primary end point was nailfold capillary density at week 12. Capillary density at 52 weeks, number of megacapillaries and patient-reported outcomes were secondary outcomes. In addition, we assessed disease progression and lung function decline over 52 weeks. We used linear regression analyses adjusted for baseline values and stratification variables to estimate differences between groups.

Results

Between February 2017 and February 2021, 87 patients were screened, of whom 30 (70% female, median [interquartile range, IQR] age 52.9 [40.8–60.8] years, median [IQR] disease duration 11.4 [4.6–18.6] months) were randomly assigned to methylprednisolone (n = 21) or placebo (n = 9). We found no difference in nailfold capillary density at 12 weeks (−0.5 [95% CI: −1.1, 0.2]) nor in any of the secondary outcomes. Eleven (37%) patients showed disease progression during 1 year follow-up, and seven (23%) patients had a relevant pulmonary function decline. No serious adverse events were reported.

Conclusion

No clinically relevant effect of short-term methylprednisolone in patients with very early SSc was observed. A substantial proportion of patients showed disease progression.

Trial registration

clinicaltrials.gov, NCT03059979.
Frequency and implications of malnutrition in systemic sclerosis
Authors: Fairley Jessica L , Hansen Dylan , Quinlivan Alannah , Proudman Susanna , Sahhar Joanne , Ngian Gene-Siew , Walker Jennifer , Host Lauren V , Morrisroe Kathleen , Stevens Wendy , Ross Laura , Nikpour Mandana
Published: March 2024

Objectives

To quantify the frequency and impact of malnutrition in systemic sclerosis (SSc), as diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria, based on weight loss, BMI and muscle atrophy.

Methods

Australian Scleroderma Cohort Study participants meeting ACR/EULAR criteria for SSc with ≥1 concurrent weight and height measurement were included. The chi-squared test, two-sample t-test or Wilcoxon’s rank-sum test was used for between-group comparison as appropriate. Multivariable logistic regression models were used to establish the determinants of malnutrition diagnosis. Kaplan–Meier and Cox proportional hazard models were used for survival analyses, based on malnutrition diagnosis, and individual GLIM criteria (percentage weight loss, BMI thresholds and presence of muscle atrophy).

Results

In this study of 1903 participants, 43% were diagnosed with malnutrition according to GLIM criteria, of whom 33% had severe malnutrition. Participants diagnosed with malnutrition were older, and more likely to have diffuse cutaneous SSc (dcSSc), higher SSc severity scores and RNA polymerase-3 positivity. Gastrointestinal (GI) involvement, multimorbidity, cardiopulmonary disease, raised inflammatory markers, hypoalbuminaemia and anaemia were more common in malnourished participants (P < 0.01). Multimorbidity (odds ratio [OR] 1.6; 95% CI: 1.2, 2.0; P < 0.01), pulmonary arterial hypertension (OR 2.1; 95% CI: 1.4, 2.0; P < 0.01) and upper GI symptoms (OR 1.6; 95% CI: 1.3, 2.0; P < 0.01) were all associated with malnutrition. Health-related quality-of-life (HRQoL) and physical function were poorer in malnourished participants. Survival was worse in those with malnutrition after adjusting for age, sex and dcSSc (hazard ratio 1.4; 95% CI: 1.1, 1.7; P < 0.01).

Conclusion

Malnutrition is common in SSc and confers poorer survival, HRQoL and physical function.
A New Path of Women’s Organizing: An Analysis of Female Folk Custom Groups in the Yimeng Mountain Area of China
Authors: Huang Cui , Ma Hongying
Published: March 2024

Female organizational development is the foundation for enhancing women’s political and economic capabilities. This study focuses on the urgent need for women’s participation in China’s rural revitalization and emphasizes the crucial role of promoting the organizational development of rural women. Drawing upon the innovation theory in evolutionary economics, we conducted a field survey in the Yimeng Mountain area of Shandong Province, China, involving 900 rural women. The study explores a new path of women’s organizing, specifically the innovation and transformation of rural female folk custom groups into formal organizations. Empirical analysis reveals that Village Two Committees exert the most influential positive effect on the organizational innovation of female folk custom groups among organizational factors. Additionally, institutional factors such as rural revitalization and culture construction significantly contribute to this transformation. Moreover, individual factors such as relative income levels and the exemplary role of rural capable women also exhibit significant positive influence.
Nighttime Applications of Germicidal UV Light to Suppress Cercospora Leaf Spot in Table Beet
Authors: Pethybridge Sarah J. , Rea Mark , Gadoury David M. , Murphy Sean , Hay Frank , Skinner Nicholas P. , Kikkert Julie R.
Published: March 2024

Cercospora leaf spot (CLS), caused by the hemibiotrophic fungus Cercospora beticola, is a destructive disease affecting table beet. Multiple applications of fungicides are needed to reduce epidemic progress to maintain foliar health and enable mechanized harvest. The sustainability of CLS control is threatened by the rapid development of fungicide resistance, the need to grow commercially acceptable yet CLS-susceptible cultivars, and the inability to manipulate agronomic conditions to mitigate disease risk. Nighttime applications of germicidal UV light (UV-C) have recently been used to suppress several plant diseases, notably those caused by ectoparasitic biotrophs such as powdery mildews. We evaluated the efficacy of nighttime applications of UV-C for suppression of CLS in table beet. In vitro lethality of UV-C to germinating conidia increased with increasing dose, with complete suppression at 1,000 J/m2. Greenhouse-grown table beet tolerated relatively high doses of UV-C without lethal effects despite some bronzing on the leaf blade. A UV-C dose >1,500 J/m2 resulted in phytotoxicity severities greater than 50%. UV-C exposure to ≤750 J/m2 resulted in negligible phytotoxicity. Older (6-week-old) greenhouse-grown plants were more susceptible to UV-C damage than younger (2- and 4-week-old) plants. Suppression of CLS by UV-C was greater when applied within 6 days of C. beticola inoculation than if delayed until 13 days after infection in greenhouse-grown plants. In field trials, there were significant linear relationships between UV-C dose and CLS control and phytotoxicity severity, and a significant negative linear relationship between phytotoxicity and CLS severity at the final assessment. Significant differences between UV-C doses on the severity of CLS and phytotoxicity indicated an efficacious dose near 800 J/m2. Collectively, these findings illustrate significant and substantial suppression by nighttime applications of UV-C for CLS control on table beet, with potential for incorporation in both conventional and organic table beet broadacre production systems.
A Path to High-Value Gastric Cancer Surgery Care Delivery
Authors: Teh Swee H. , Shiraga Sharon , Kellem Aaron M. , Li Robert A. , Le David M. , Arsalane Said P. , Khayat Fawzi S. , Li Yan , Gong I-Yeh , Lee Jessica M.
Published: March 2024

Objective:

To evaluate the feasibility, safety, and effectiveness of a comprehensive regional program, including the Minimally Invasive Recovery and Empowerment Care (MIREC) pathway, that can significantly reduce hospital stays after laparoscopic gastrectomy without increasing adverse events.

Background:

Cost-effectiveness and improving patient outcomes are crucial in providing quality gastric cancer care worldwide.

Methods:

To compare the outcomes of gastric cancer surgery using 2 different models of care within an integrated healthcare system from February 2012 to March 2023. The primary endpoint was the length of hospital stay. The secondary endpoints were the need for intensive care unit care, emergency room (ER) visits, readmission, reoperation, and death within 30 days after surgery.

Results:

There were 553 patients, 167 in the pre-(February 2012–April 2016) and 386 in the post-MIREC period (May 2016–March 2023). Perioperative chemotherapy utilization increased from 31.7% to 76.4% (P < 0.0001). Laparoscopic gastrectomy increased from 17.4% to 97.7% (P < 0.0001). Length of hospitalization decreased from 7 to 2 days (P < 0.0001), with 32.1% and 88% of patients discharged home on postoperative day 1 and postoperative day 2, respectively. When comparing pre- and post-MIREC, intensive care unit utilization (10.8% vs. 2.9%, P < 0.0001), ER visits (34.7% vs. 19.7%, P = 0.0002), and readmission (18.6% vs. 11.1%, P = 0.019) at 30 days were also considerably lower. In addition, more patients received postoperative adjuvant chemotherapy (31.4% to 63.5%, P < 0.0001), and the time between gastrectomy and starting adjuvant chemotherapy was also less (49–41 days; P = 0.002).

Conclusion:

This comprehensive regional program, which encompasses regionalization care, laparoscopic approach, modern oncologic care, surgical subspecialization, and the MIREC pathway, can potentially improve gastric cancer surgery outcomes. These benefits include reduced hospital stays and lower complication rates. As such, this program can revolutionize how gastric cancer surgery is delivered, leading to a higher quality of care and increased value to patients.
Theoretical Prediction of the 210Pb Burden in the Skeleton from Radon Exposure and Other Intake Routes
Authors: Wang Jing , Liu Yuanyuan , Wu Bin , Meng Xiangpeng , Wang Yu , Cheng Jianping
Published: March 2024

The 210Pb burden in the skeleton is a measurement value suitable for the estimation of the cumulative exposure to radon, based on which the resultant risk of lung cancer can be derived. There have been a handful of studies that successfully measured 210Pb activity in the bones of volunteers who had chronic exposure to high concentrations of radon occupationally or in their residences. However, the quantitative relationship between measured 210Pb activity and radon exposure remains elusive. Herein, we investigate the origin of the skeletal burden by employing the biokinetic model recommended by the International Commission on Radiological Protection and modeling various routes of intake. First, the baseline 210Pb burden for the general public regarding eating assorted foodstuffs and breathing normal air is obtained. It is found that this baseline burden ranges between 7.3 to 46.5 Bq for a 50-y-old (male) person, which characterizes a large variance due to the uncertainty of each route of intake. Next, we concentrate on radon exposure by referring to two experimental studies where the accounts of exposure and the measured 210Pb burden for each volunteer are documented in detail. From comparing our prediction and measurements, it is found that exposure to higher concentration of radon is the most significant source of 210Pb intake, and the quantitative differences can be reasonably explained by the uncertainty resulting from regular intake routes. This study establishes the theoretical foundation for assessing one’s risk of lung cancer due to radon exposure by measuring the 210Pb burden in bones.
Appropriate thromboprophylaxis strategy for COVID-19 patients on dosage, antiplatelet therapy, outpatient, and postdischarge prophylaxis: a meta-analysis of randomized controlled trials
Authors: Meng Jiahao , Tang Hang , Xiao Yifan , Liu Weijie , Wu Yumei , Xiong Yilin , Gao Shuguang
Published: March 2024

Background:

There was controversy surrounding the optimal thromboprophylaxis strategy for coronavirus disease 2019 (COVID-19) patients. This included debates on the dosage of anticoagulants for thromboembolism prophylaxis, the requirement for additional antiplatelet therapy, and the necessity of prophylaxis for outpatients and postdischarge. To explore this, the authors performed a meta-analysis of randomized controlled trials.

Methods:

PubMed, Cochrane Library, Embase, and Web of Science were last searched on 26 July 2023 for studies comparing the effect of different dose of anticoagulation, additional antiplatelet, and postdischarge prophylaxis for COVID-19 patients. The results of eligible studies were analyzed in terms of thromboembolism events, major bleeding and all-cause mortality during follow-up.

Results:

Our study included a total of 25 randomized controlled trials, involving 17 911 patients. Our results revealed that, compared to prophylactic dose, therapeutic dose showed lower thrombotic risk (RR, 0.66; 95% CI: 0.45–0.96) but had similar major bleeding risk for critically ill patients with COVID-19. On the other hand, intermediate dose and prophylactic dose demonstrated similar thromboembolism risk and major bleeding risk. For noncritically ill patients with COVID-19, therapeutic dose of anticoagulants was associated with lower thrombotic risk (RR, 0.50; 95% CI: 0.34–0.72) but, at the same time, increased the risk of major bleeding (RR, 2.01; 95% CI: 1.22–3.33). However, intermediate dose showed lower thromboembolism risk (RR, 0.38; 95% CI: 0.21–0.69) while maintaining a similar major bleeding risk. In critically ill patients, additional antiplatelet therapy showed similar thromboembolism, major bleeding risk, and mortality when compared to no treatment. For outpatients, additional prophylactic anticoagulation showed similar thromboembolism, major bleeding risk, and mortality when compared to no treatment. For postdischarge patients, postdischarge prophylaxis reduced thromboembolism risk (RR, 0.49; 95% CI: 0.31–0.76) but increased major bleeding risk (RR, 2.63; 95% CI: 1.13–6.14).

Conclusion:

For noncritically ill patients, therapeutic dose prophylactic anticoagulation significantly reduced venous thromboembolism but increases major bleeding risk. Intermediate dose effectively lowered venous thromboembolism without raising major bleeding risk. The optimal dose and need for additional antiplatelet therapy in critically ill patients, as well as the necessity of prophylactic anticoagulation in outpatient and postdischarge patients, required further investigation and confirmation through rigorous evidence studies.
Serial changes in diffusion tensor imaging metrics and therapeutic effects of repetitive transcranial magnetic stimulation in post-traumatic headache and depression: A case report
Authors: Yun Young-Ji , Kim Gi-Wook
Published: March 2024

Background:

Mild traumatic brain injury patients commonly complain headache and central pain, and the pain accompanies depressive mood change. This case study reports the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) in mild traumatic brain injury patient with headache and depression through objective serial changes of diffusion tensor imaging (DTI).

Methods:

The 51-year-old man complained of headache and depression despite conventional treatment for 13 months. We applied 15 times rTMS on the left dorsolateral prefrontal cortex. We checked the pain and depression through numeric rating scale (NRS) and Beck depression inventory (BDI) when admission, discharged, and 1 month after discharge. DTI was performed 3 times; before, during-day of rTMS 6th stimulation, and after-day of rTMS 15th stimulation. Then the reconstructed White matter related to pain and depression was obtained.

Results:

NRS and BDI showed significant improvement and it was maintained 1 year after discharge. DTI-based metrics of the White matters related to pain and depression gradually increased before – during – after rTMS.

Conclusion:

Studies focused on examining changes in pain, depression and DTI-based metrics of White matter are rare. This case is significant in that not only pain and depression improved after the rTMS, but also serial changes in White matter were observed in DTI.
Hemodialysis nurses’ knowledge, attitude, and practices in managing vascular access: A cross-sectional study in Saudi Arabia
Authors: Alsolami Enad , Alobaidi Sami
Published: March 2024

Hemodialysis continues to be the primary approach for renal replacement therapy. Vascular access (VA), particularly arteriovenous fistula or arteriovenous graft, is the preferred technique for establishing hemodialysis access due to its lower risk of infection and central venous stenosis compared to catheters. The aim of this cross-sectional investigation was to examine hemodialysis nurses’ knowledge, confidence, and practices in managing VA in Saudi Arabia. This is an online cross-sectional survey study that was conducted in Saudi Arabia between June and August 2023. This study utilized a previously validated questionnaire. Examined dialysis nurses’ knowledge, attitude, practice, and self-efficacy pertaining to VA cannulation and evaluation. Binary logistic regression analysis was used to identify predictors of better knowledge of dialysis VA. A total of 197 participants were involved in this study. Around one-third of the study participants (37.0%) reported that they have received specialized training in managing VA. Participants agreement (answered agree or strongly agree) on statements that examined attitudes toward dialysis VA cannulation and management was high and ranged between 75.0% and 93.0%. The majority of participants (97.5%) reported that they perform this assessment. Most nurses (65%) preferred the rope-ladder technique. Participants agreement on statements that examined self-efficacy on dialysis VA cannulation and management was high and ranged between 72.1% and 98.0%. The most commonly agreed upon statement was that “they have confident in performing hemodialysis access (arteriovenous fistula and arteriovenous graft) assessment before cannulation.” With 98.0% (answered agree and strongly agree). The mean knowledge score for our study sample was 6.4 (SD: 2.0) out of 12 (53.3%); which reflects marginal-level of knowledge on dialysis VA. Binary logistic regression analysis identified that nurses who have undergraduate degree are 92% more likely to be knowledgeable on dialysis VA compared to others (P < .05). Concerning VA, the level of knowledge among hemodialysis nurses working in Saudi Arabia was inadequate. Nurses who hold an undergraduate degree are presumed to have a more extensive understanding of dialysis VA. Further education programs are necessary for HD nurses to enhance their knowledge of VA, thereby optimizing their professional practices and enhancing the outcomes for their patients.
Bibliometric and visualized analysis of DME from 2012 to 2022
Authors: Liu Yi , Zhu Qiuyan , Jiang Pengfei , Yang Yang , Wang Mingyun , Liang Hao , Peng Qinghua , Zhang Qiuyan
Published: March 2024

Background:

Diabetic macular edema (DME) is the main cause of irreversible vision loss in patients with diabetes mellitus (DM), resulting in a certain burden to patients and society. With the increasing incidence of DME, more and more researchers are focusing on it.

Methods:

The papers related to DME between 2012 and 2022 from the Web of Science core Collection were searched in this study. Based on CiteSpace and VOS viewer, these publications were analyzed in terms of spatiotemporal distribution, author distribution, subject classification, topic distribution, and citations.

Results:

A total of 5165 publications on DME were included. The results showed that the research on DME is on a steady growth trend. The country with the highest number of published documents was the US. Wong Tien Yin from Tsinghua University was the author with the most published articles. The journal of Retina, the Journal of Retinal and Vitreous Diseases had a large number of publications. The article “Mechanisms of macular edema: Beyond the surface” was the highly cited literature and “Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema” had the highest co-citation frequency. The treatment, diagnosis, pathogenesis, as well as etiology and epidemiological investigation of DME, have been the current research direction. Deep learning has been widely used in the medical field for its strong feature representation ability.

Conclusions:

The study revealed the important authoritative literature, journals, institutions, scholars, countries, research hotspots, and development trends in in the field of DME. This indicates that communication and cooperation between disciplines, universities, and countries are crucial. It can advance research in DME and even ophthalmology.
Mechanistic insights into FEN1-mediated drug sensitivity and risk signature in colon cancer: An integrative bioinformatics study
Authors: Rao Chunhui , Tong Jingfei , Yang Yan
Published: March 2024

The overexpression of Flap endonuclease 1 (FEN1) has been implicated in drug resistance and prognosis across various cancer types. However, the precise role of FEN1 in colon cancer remains to be fully elucidated. In this study, we employed comprehensive datasets from The Cancer Genome Atlas, Gene Expression Omnibus, and Human Protein Atlas to examine FEN1 expression and assess its correlation with clinical pathology and prognosis in colon cancer. We utilized the pRRophetic algorithm to evaluate drug sensitivity and performed differential expression analysis to identify genes associated with FEN1-mediated drug sensitivity. Gene set enrichment analysis was conducted to further investigate these genes. Additionally, single-cell sequencing analysis was employed to explore the relationship between FEN1 expression and functional states. Cox regression analysis was implemented to construct a prognostic model, and a nomogram for prognosis was developed. Our analysis of The Cancer Genome Atlas and Gene Expression Omnibus datasets revealed a significant upregulation of FEN1 in colon cancer. However, while FEN1 expression showed no notable correlation with prognosis, it displayed associations with metastasis. Single-cell sequencing analysis further confirmed a positive correlation between FEN1 expression and colon cancer metastasis. Furthermore, we detected marked discrepancies in drug responsiveness between the High_FEN1 and Low_FEN1 groups, identifying 342 differentially expressed genes. Enrichment analysis showed significant suppression in processes related to DNA replication, spliceosome, and cell cycle pathways in the Low_FEN1 group, while the calcium signaling pathway, cAMP signaling pathway, and other pathways were activated. Of the 197 genes differentially expressed and strongly linked to FEN1 expression, 39 were significantly implicated in colon cancer prognosis. Finally, we constructed a risk signature consisting of 5 genes, which, when combined with drug treatment and pathological staging, significantly improved the prediction of colon cancer prognosis. This study offers novel insights into the interplay among FEN1 expression levels, colon cancer metastatic potential, and sensitivity to therapeutic agents. Furthermore, we successfully developed a multi-gene prognostic risk signature derived from FEN1.
Early complications in scoliosis surgery and relation to preoperative factors: A single-center retrospective study
Authors: Aksu Hale , Manduz Busra , Armagan Mustafa , Satoglu İsmail Safa , Hanci Volkan
Published: March 2024

In this study, we aimed to investigate the perioperative complications of the patients who underwent scoliosis surgery in our hospital and the factors that may affect the outcome. Between 2014 and 2018, scoliosis patients recorded data was examined retrospectively. Age, gender, height, body weight, comorbidity, Cobb index, scoliosis etiology, operation time, preoperative and postoperative hemoglobin, hematocrit, leukocyte, blood urea nitrogen, creatinine, coagulation value, operation time, level of instrumentation, intraoperative and postoperative blood loss, blood transfusion, intraoperative fluid administration, preoperative pulmonary function test values, blood gas values, urine outputs, hospital (LOS) and post anesthesia care unit stays, complications and mortality rates were examined. The files of 77 patients (48 female, 29 male) were retrospectively analyzed. The average age was 19.54 ± 16.32 years and 98.7% were elective surgery. The mean of LOS was 13.55 ± 9.13 days. As the preoperative hematocrit value decreases, LOS increases significantly. In patients with chronic obstructive pulmonary disease, smokers and high ASA scores, LOS is prolonged in patients with previous operations. As intraoperative colloid administration increased, crystalloid and blood products increased, it was also observed that the amount of crystalloid increased LOS. As the amount of intraoperative colloid or red blood cell administration increases, the duration of surgery and anesthesia increases, also increases the duration of post anesthesia care unit. Compared to patients with complications (n = 29) to the patients without complications (n = 47), it was found that they had longer anesthesia, and surgery times, also longer LOS times (P < .05). Our study showed that chronic obstructive pulmonary disease in the preoperative period, smoking, high ASA score, excessive use of colloid, prolonged duration of surgery and anesthesia, and long intubation durations increase the length of hospital stay. Preoperative comorbidity is directly related to postoperative complications and causes longer hospitalization after reconstructive scoliosis surgery.
Study on the optimal time limit of frozen embryo transfer and the effect of a long-term frozen embryo on pregnancy outcome
Authors: Wang Xue-Jiao , Chen Ming-Xing , Ruan Ling-Ling , Tan Li , Geng Li-Hong , Yang Hui-Jun , Fu Li-Juan , Zhong Zhao-Hui , Lv Xing-Yu , Ding Yu-Bin , Wan Qi
Published: March 2024

In this retrospective study conducted at Sichuan Jinxin Xinan Women and Children’s Hospital spanning January 2015 to December 2021, our objective was to investigate the impact of embryo cryopreservation duration on outcomes in frozen embryo transfer. Participants, totaling 47,006 cycles, were classified into 3 groups based on cryopreservation duration: ≤1 year (Group 1), 1 to 6 years (Group 2), and ≥6 years (Group 3). Employing various statistical analyses, including 1-way ANOVA, Kruskal–Wallis test, chi-square test, and a generalized estimating equation model, we rigorously adjusted for confounding factors. Primary outcomes encompassed clinical pregnancy rate and Live Birth Rate (LBR), while secondary outcomes included biochemical pregnancy rate, multiple pregnancy rate, ectopic pregnancy rate, early and late miscarriage rates, preterm birth rate, neonatal birth weight, weeks at birth, and newborn sex. Patient distribution across cryopreservation duration groups was as follows: Group 1 (40,461 cycles), Group 2 (6337 cycles), and Group 3 (208 cycles). Postcontrolling for confounding factors, Group 1 exhibited a decreased likelihood of achieving biochemical pregnancy rate, clinical pregnancy rate, and LBR (OR < 1, aOR < 1, P < .05). Furthermore, an elevated incidence of ectopic pregnancy was observed (OR > 1, aOR > 1), notably significant after 6 years of freezing time [aOR = 4.141, 95% confidence intervals (1.013–16.921), P = .05]. Cryopreservation exceeding 1 year was associated with an increased risk of early miscarriage and preterm birth (OR > 1, aOR > 1). No statistically significant differences were observed in birth weight or sex between groups. However, male infant birth rates were consistently higher than those of female infants across all groups. In conclusion, favorable pregnancy outcomes align with embryo cryopreservation durations within 1 year, while freezing for more than 1 year may diminish clinical pregnancy and LBRs, concurrently elevating the risk of ectopic pregnancy and preterm birth.
Littoral cell angioma of the spleen: A study of 10 cases case series and literature review
Authors: Shen Huaping , Zhu Yingjie , Zhong Jiajie , Shen Yang , Huang Yang , Song Pengtao , He Jian , Zhou Shiyu , Wu Xiaochang
Published: March 2024

Background:

Current study aimed to investigate the clinical characterization, differential diagnosis, and treatment of splenic littoral cell angioma (LCA).

Methods:

A retrospective analysis was performed for 10 LCA cases admitted to Huzhou Central Hospital from 2007 to 2023, for clinical manifestations, hematological tests, imaging features, pathological features, treatment methods, and prognosis along with the relevant literature was also reviewed.

Results:

During examinations, no specific clinical manifestations and hematological abnormalities were seen in all 10 cases of LCA. Imaging observations depicted single or even multiple spherical lesions in the spleen. Plains shown by computed tomography (CT) were found somewhat equal or slightly lower in density. On the other hand, magnetic resonance imaging (MRI) plain scans viz. T1 weighted image showed equal low and mixed signals while T2-weighted showed high and low mixed signals. Moreover, punctate low signals could be seen in high signals named “freckle sign” in MRI scans. On contrast-enhanced CT scans, the enhancement of the lesions was not obvious in the arterial phase, and some of the lesions showed edged ring-like enhancements and “filling lake” progressive enhancement during the venous phase and delayed phase. In multiple lesions, the number of enhanced scan lesions showed a variable changing pattern “less-more-less.” MRI-enhanced scan showed the characteristics of “fast in and slow out.” Microscopic examinations identified tumor tissue actually composed of sinus-like lacunae that anastomosed with each other in the form of a network. Furthermore, cystic expansion and pseudopapillary protrusions were also seen in the dilated sinus cavity which was lined with single-layer endothelial cells having conspicuous cytoplasmic hemosiderin. High immunophenotypic expressions of vascular endothelial cell phenotype (CD31, CD34, FVIII) and tissue cell phenotype (CD68) were also seen. Total and partial splenectomy were performed in 8 and 2 patients, respectively, and follow-up examinations showed survival in all patients with no recurrence.

Conclusion:

LCA is a rare splenic benign lesion with atypical clinical manifestations. CT and MRI imaging are important tools in preoperative diagnosis based on pathomorphological and immunohistochemical examinations. Splenectomy is a superior therapeutic choice with significant impacts and prognosis.
Comparison of hysterectomy cases performed by transvaginal natural orifice transluminal endoscopic surgery: A paired sample cross-sectional study
Authors: Zhang Ling-li , Wang Yi-si , Bai Li-ping , Zheng Ai
Published: March 2024

This study aimed to investigate the feasibility, indications, and benefits of transvaginal natural orifice transluminal endoscopic surgery (v-NOTES) hysterectomy for nonmalignant gynecological diseases. The clinical data, including the baseline information and surgical conditions of 81 patients who underwent v-NOTES hysterectomy for nonmalignant gynecological diseases in a tertiary university hospital from October 2018 to August 2022, were retrospectively analyzed and compared with the total laparoscopic hysterectomy group (200 cases) and the transumbilical laparoendoscopic Single Site Surgery group (150 cases). In comparison with the other 2 groups, the highest proportion of patients in the v-NOTES group had cervical intraepithelial neoplasia. Accordingly, mean preoperative uterine volume measured by sonography was significantly smaller in the v-notes group. In the v-NOTES group, the mean number of vaginal deliveries and age were significantly higher, while the mean number of previous abdominal surgeries was lower compared to the other 2 groups. The V-NOTES group had a shorter operation time, shorter postoperative urinary catheter insertion time, earlier intestinal recovery days, shorter hospital stay, and lower visual analogue scale scores after surgery, and the differences were statistically significant. When indicated appropriately, v-NOTES hysterectomy can be a feasible and advantageous surgical modality. In particular, in comparison to the laparoendoscopic Single Site Surgery and total laparoscopic hysterectomy groups, the v-NOTES group had advantages in postoperative recovery and had more aesthetic surgical results.
Health benefits of short Taichi Qigong exercise (STQE) to University Students’ core strength, lower limb explosive force, cardiopulmonary endurance, and anxiety: A Quasi experiment research
Authors: Wang Feng , Syed Ali Syed Kamaruzaman Bin
Published: March 2024

Background:

College students’ physical fitness has declined over the past decades. Taichi Qigong exercise offers numerous health benefits and could serve as a suitable option for them. Traditional programs, however, are time-consuming and necessitate long-term commitments. Therefore, a more cost-effective intervention is needed.

Methods:

The study enrolled a total of 31 students who actively participated in a 5-week STQE program, consisting of three 60-minute sessions per week. Physical and mental health assessments included the Plank test, vital capacity measurement, 1000/800 m run test, standing jump, and the Zung Self-Rating Scale. Data analysis was performed using SPSS.

Results:

Following the STQE intervention, participants showed improvement in core strength (28.1 seconds in the Plank test, P = .025) and lower limb explosive force (6.52 cm in the standing jump test, P = .011), accompanied by a decrease in anxiety levels (a reduction of 3.41 in the Zung Self-Rating Scale, P = .039). However, no significant improvements were observed in cardiopulmonary endurance, as evidenced by a non-significant increase of 237.84 mL in vital capacity (P = .134) and a non-significant reduction of 1.6 seconds in the 1000/800 m run test (P = .764).

Conclusion:

The study suggests that the STQE program effectively improves core strength, lower limb explosive force, and reduces anxiety levels among university students.
Advancements and progress in juvenile idiopathic arthritis: A Review of pathophysiology and treatment
Authors: Huang Helen Ye Rim , Wireko Andrew Awuah , Miteu Goshen David , Khan Adan , Roy Sakshi , Ferreira Tomas , Garg Tulika , Aji Narjiss , Haroon Faaraea , Zakariya Farida , Alshareefy Yasir , Pujari Anushka Gurunath , Madani Djabir , Papadakis Marios
Published: March 2024

Juvenile idiopathic arthritis (JIA) is a chronic clinical condition characterized by arthritic features in children under the age of 16, with at least 6 weeks of active symptoms. The etiology of JIA remains unknown, and it is associated with prolonged synovial inflammation and structural joint damage influenced by environmental and genetic factors. This review aims to enhance the understanding of JIA by comprehensively analyzing relevant literature. The focus lies on current diagnostic and therapeutic approaches and investigations into the pathoaetiologies using diverse research modalities, including in vivo animal models and large-scale genome-wide studies. We aim to elucidate the multifactorial nature of JIA with a strong focus towards genetic predilection, while proposing potential strategies to improve therapeutic outcomes and enhance diagnostic risk stratification in light of recent advancements. This review underscores the need for further research due to the idiopathic nature of JIA, its heterogeneous phenotype, and the challenges associated with biomarkers and diagnostic criteria. Ultimately, this contribution seeks to advance the knowledge and promote effective management strategies in JIA.
Puerperal septic shock complicated with symmetrical peripheral gangrene: A case report
Authors: Wang Yue , Tang Cen , Li Yajin , Hu Wanqin
Published: March 2024

Rationale:

Puerperal sepsis is a life-threatening condition caused by infection that can rapidly progress to multisystem infection and toxin-mediated shock. Symmetrical peripheral gangrene is defined as symmetrical distal ischemic damage in two or more sites in the absence of major vascular occlusive disease. The syndrome is devastating and rare. In this study, we introduce a case of puerperal septicemia complicated by symmetrical peripheral gangrene.

Patient concerns:

A 23-year-old woman delivered a live female infant vaginally after cervical balloon dilatation at 39 weeks of gestation. Persistent hyperthermia developed on the first postpartum day. After experiencing ventricular fibrillation, acute liver failure, and acute pulmonary edema, she developed blackened extremities on the 5th postpartum day.

Diagnoses:

Puerperal septicemia complicated by symmetrical peripheral gangrene.

Interventions:

Upon transfer to our hospital, the patient was enrolled in the intensive care unit and underwent anti-infective and amputation surgery.

Outcomes:

After the surgery, the patient recovered well and was successfully discharged from the hospital.

Lessons:

Early detection and timely treatment is the best way to reduce the mortality and sequelae of puerperal sepsis. Physicians should be alert to the possibility of comorbid symmetrical peripheral gangrene when sepsis patients present with hepatic impairment.
Visual analysis of global hemorrhagic fever with renal syndrome research from 1980 to 2022: Based on CiteSpace and VOSviewer
Authors: Zhou Wenfang , Dong Yonghai , Si Hongyu , Yang Cheng , Zhao Jun , Chen Xiaona , Ye Zhenzhen
Published: March 2024

Objective:

The development and current state of hemorrhagic fever with renal syndrome (HFRS) over the past 40 years are analyzed in this study, along with explored and discovered the hotspots and frontiers in the field, which serve as the foundation for future investigation.

Methods:

CiteSpace and VOSviewer analysis software were used to visually analyze the literature data on HFRS from 1980 to 2022, including the annual number of publications, countries and research institutions, authors, co-cited literature and keywords.

Results:

The number of pertinent papers published in the field of HFRS displayed an overall upward trend from 1980 to 2022. The United States, China, Germany, Sweden, and France are the top 5 countries in terms of publishing volume, with high intermediate centrality mainly concentrated in Europe and the United States. The top 10 co-occurring keywords were hemorrhagic fever, renal syndrome, infection, virus, epidemic, nephropathia epidemical, disease, hantavirus, outbreak, and transmission. According to keyword cluster analysis, there were 4 main research fields. In the HFRS-related study, there were mainly 21 notable keywords and “Korean hemorrhagic fever” had the highest hemorrhagic value (28.87).

Conclusion:

The United States, China, Germany, Sweden and other countries attached great importance to the HFRS-related research. Moreover, the collaboration between authors and institutions in various collaborator clusters should be strengthened. In recent decades, investigations have focused on the study of viral infection and the clinical symptoms and pathophysiology of HFRS. Future research may concentrate on factors affecting host population distribution and density, such as vaccine development and meteorological factors pertaining to virus transmission.
The transdifferentiation of human dedifferentiated fat cells into fibroblasts: An in vitro experimental pilot study
Authors: Lim Nam Kyu , Jeon Hong Bae , Kim Sungyeon
Published: March 2024

Background:

Skin grafting is a common method of treating damaged skin; however, surgical complications may arise in patients with poor health. Currently, no effective conservative treatment is available for extensive skin loss. Mature adipocytes, which constitute a substantial portion of adipose tissue, have recently emerged as a potential source of stemness. When de-lipidated, these cells exhibit fibroblast-like characteristics and the ability to redifferentiate, offering homogeneity and research utility as “dedifferentiated fat cells.”

Methods and results:

We conducted an in vitro study to induce fibroblast-like traits in the adipose tissue by transdifferentiating mature adipocytes for skin regeneration. Human subcutaneous fat tissues were isolated and purified from mature adipocytes that underwent a transformation process over 14 days of cultivation. Microscopic analysis revealed lipid degradation over time, ultimately transforming cells into fibroblast-like forms. Flow cytometry was used to verify their characteristics, highlighting markers such as CD90 and CD105 (mesenchymal stem cell markers) and CD56 and CD106 (for detecting fibroblast characteristics). Administering dedifferentiated fat cells with transforming growth factor-β at the identified optimal differentiation concentration of 5 ng/mL for a span of 14 days led to heightened expression of alpha smooth muscle actin and fibronectin, as evidenced by RNA and protein analysis. Meanwhile, functional validation through cell sorting demonstrated limited fibroblast marker expression in both treated and untreated cells after transdifferentiation by transforming growth factor-β.

Conclusion:

Although challenges remain in achieving more effective transformation and definitive fibroblast differentiation, our trial could pave the way for a novel skin regeneration treatment strategy.
Multiorgan failure caused by pembrolizumab and axitinib in a woman affected by metastatic clear cell renal cell carcinoma: A case report and literature review
Authors: Di Marco Andrea , Artioli Grazia , Favaretto Adolfo , Cavasin Nicolò , Basso Umberto
Published: March 2024

Rationale:

Treatment with a combination of immune checkpoint inhibitors (ICIs) (pembrolizumab or nivolumab) and oral Tyrosine Kinase Inhibitors (TKI) targeting angiogenesis (axitinib, cabozantinib or lenvatinib) has shown benefits in terms of efficacy and survival in metastatic renal cell carcinoma (mRCC), with a favorable toxicity profile. However, some rare and serious treatment-related adverse events can be difficult to manage.

Patient concerns:

Here we report the first case of an mRCC patient who, after only 2 administrations of pembrolizumab-axitinib, experienced severe multiorgan failure (MOF) with heart failure, oliguria and acute hepatitis requiring aggressive supportive treatment in intensive care unit.

Diagnoses:

A diagnosis of severe MOF induced by pembrolizumab plus axitinib was considered.

Interventions:

The patient was treated with dobutamine, levosimendan along with high-dose steroids under continuous cardiologic monitoring.

Outcomes:

After treatment, the patient had a full recovery and was discharged from the hospital.

Lessons:

We reviewed all the other cases of MOF reported during treatment with combined ICI-TKI in cancer patients in order to summarize incidence, clinical manifestations and management with a specific focus on the need for prompt recognition and aggressive management under multidisciplinary care.