bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitude, and practice of stroke and thrombectomy among medical students in Henan, China
Authors: Gao Haobo , Zhu Pengcheng , Tan Hongtu , Shu Lingfeng , Dai Qinghai , Wang Jiabin , Wu Tao
Published: November 2024

To assess knowledge, attitude, and practice (KAP) of stroke and thrombectomy among medical students in Henan, China. A cross-sectional study was conducted on medical students from 5 universities in Henan, China between June and September, 2022, using a self-administered questionnaire. A total of 1105 medical students [697 (62.1%) females] participated. Their mean KAP scores were 11.1 ± 2.90, 35.37 ± 4.94, and 21.48 ± 5.51 out of 14, 44, and 24, respectively. Structural equation modeling revealed that, age (estimate = 0.351, P = .005) and education (estimate = 0.370, P = .024) positively affected knowledge, while major (estimate = −0.128, P = .017), internship experience in neurosurgery or neurology (estimate = −1.321, P < .001), and family history of stroke (estimate = −0.557, P < .001) negatively influenced knowledge. Knowledge (estimate = 0.649, P < .001) and having seniors over the age of 60 at home (estimate = 1.228, P = .001) had positive effects on attitudes, while internship experience in neurosurgery or neurology (estimate = −0.471, P = .090) and family history of stroke (estimate = −0.596, P = .020) had negative impact on attitudes. Moreover, knowledge (estimate = 0.230, P < .001) and attitudes (estimate = 0.628, P < .001) positively influenced practices, whereas sex (estimate = −1.141, P < .001), internship experience in neurosurgery or neurology (estimate = −0.578, P = .025), and family history of stroke (estimate = −0.523, P = .027) negatively influenced practices. Medical students in Henan, China showed adequate knowledge, positive attitude, and proactive practice toward stroke and thrombectomy. Age, sex, education, major, internship experience in neurosurgery or neurology, family history of stroke, having seniors over the age of 60 at home might have impact on their KAP.
Successful delivery in a cornual pregnancy after expectant management with traditional Chinese medicine and low-molecular-weight heparin: A case report
Authors: Lin Xiao , Fu Yizhou , Lin Richu , Cai Xiaqin , Zhang Mingli
Published: November 2024

Rationale:

Horn pregnancy is a rare subtype of ectopic pregnancy that presents a diagnosis and treatment challenge due to its nonspecific symptoms and high risk of rupture.

Patient concerns:

A 32-year-old woman without vaginal pregnancy with history of right corner who presented with painless vaginal bleeding.

Diagnoses:

A transvaginal ultrasound revealed a pregnancy sac implanted in the left corner of the uterus, confirming the diagnosis of a cornual pregnancy.

Interventions:

Treatment options include pharmacological or surgical interventions, and anticipatory treatment is rarely recommended. Conservative treatment was chosen after extensive consultation, and the patient was treated with low molecular weight heparin and traditional Chinese medicine.

Outcomes:

Subsequent ultrasound tests showed stable fetal development and a successful cesarean section.

Lessons:

This case highlights the success of combining low molecular weight heparin with traditional Chinese medicine in the treatment of cornual pregnancy. Factors affecting horn pregnancy, diagnostic challenges, and treatment considerations are discussed. Further research is necessary to determine the best management strategy and to ensure safe delivery for patients with impaired fertility but a strong desire to conceive.
Small prostate associated with higher incidence of detrusor underactivity and tendency of combination with bladder stone in patients with bladder outlet obstruction
Authors: Xiao Ning , Guo Guangrong , Tang Qi , Huang Yao , Pan Gaoyu , Wang Jianfeng
Published: November 2024

Benign prostate hyperplasia is the leading cause of lower urinary tract symptoms due to bladder outlet obstruction (BOO) in elderly male patients. The impact of prostate volume (PV) on clinical and urodynamic characteristics was evaluated in those patients with BOO requiring prostate de-obstruction maneuvers in this study. We retrospectively reviewed the clinical data of 301 patients underwent transurethral resection of prostate due to combination with urinary retention (UR) alone and bladder stone (BS) alone. The present study investigated the differences of subjective symptoms, sonographic parameters, and urodynamic characters and assessed the proportion of UR to BS as well as the incidence of detrusor underactivity (DU) in those patients according to PV. There was not a difference of age, international prostate symptoms scores, post-voiding residual, and peak flow rate (Qmax) among 3 groups (all P > .05), whereas increasing of intravesical prostate protrusion (IPP), bladder wall thick (BWT), detrusor pressure at Qmax, bladder contractility index, bladder outlet obstruction index (BOOI), and quality of life scores with enlargement of PV was found (all P < .05). Correlations between PV and IPP (R = 0.251), Qmax (R = -0.188), post-voiding residual (R = 0.215), BWT (R = 0.170), and quality of life scores (R = 0.165) at large prostate and relationships between BWT and BOOI (R = 0.246) and bladder contractility index (R = 0.239) in moderate prostate as well as IPP and BOOI (R = 0.204) in large prostate were significantly found (all P < .05). Significant higher proportion of UR was found in patients with moderate (18%) and large prostate (47.6%) when compared to that of small prostate (3.7%), whereas higher proportion of BS was found in patients with small prostate (96.7%) compared to that of moderate (82%) and large (52.4%) prostate. Lower incidence of DU was discovered in large prostate (31.9%) compared with small (55.6%) and moderate (47.2%) prostate. BOO patients with small prostate were associated with less severity of BOO but higher incidence of DU and had a tendency of occurrence of BS, which gave a support for the theory that multifactor involved in the formation of BS rather than BOO only.
Simpler and safer anastomosis by pancreaticogastrostomy using a linear stapler after pancreaticoduodenectomy
Authors: Okamoto Hirotaka , Yamamoto Atsushi , Kawashima Kenji , Fukasawa Toshio
Published: November 2024

Postoperative pancreatic fistula (POPF) remains a major and serious problem after pancreaticoduodenectomy (PD). In its presence, pancreatic juice may leak from the main duct or branches of the pancreatic stump. To prevent this, we have applied a newly modified anastomosis of pancreaticogastrostomy (PG) using a linear stapler (stapled PG). Clinical records of 30 consecutive patients who underwent PD were reviewed between 2013 and 2023 at our community hospital. Regarding procedures, 12 stapled PGs and eighteen pancreaticojejunostomies (PJs) were performed after PD, from 2018 to 2023 and from 2013 to 2017, respectively. The pancreas was transected for long compression by a linear stapler, involving: pre-compression for 5 min, stapling for 5 min, and dissection for 5 min. After removal of the staples at the main duct opening of the pancreatic stump, PG anastomosis was performed. The outer layer was anastomosed by a straight single row pancreas-transfixing suture with the posterior gastric wall, and inner layer duct-to-mucosa anastomosis was also performed in a radial axis manner. Anastomosis of PJ was conducted without using a linear stapler. POPF was defined as a clinical manifestation of POPF (grade B/C) based on the ISGPF (International Study Group of Pancreatic Fistula) criteria. None of the 12 patients who had undergone stapled PG developed clinically relevant POPF, whereas 5 (27%) patients who had received PJ developed POPF. Three patients showed POPF grade B and 2 patients exhibited POPF grade C. Stapled PG after PD may reduce clinically relevant POPF. Because our sample size was small, the further accumulation of cases is required to validate this method.
CCN3/NOV as a potential therapeutic target for diverticular disease: A proteome-wide Mendelian randomization study
Authors: Yoshikawa Masahiro , Asaba Kensuke
Published: November 2024

Genome-wide association studies (GWAS) identified over 100 susceptibility loci and candidate causal genes for diverticular disease (DD) at the transcriptional level. However, effective therapeutics or preventions based on underlying disease mechanisms remain to be elucidated. In this study, we explored potential causal genes for DD at the protein level. We used 2 GWAS summary statistics of DD; 1 was obtained from the United Kingdom Biobank (UKBB) with 31,917 cases and 419,135 controls, and the other from the FinnGen consortium with 30,649 cases and 301,931 controls. For the primary analysis, we employed proteome-wide Mendelian randomization (MR) studies using 738 cis-acting protein quantitative trait loci (pQTLs) for 735 plasma proteins from the 5 published studies. For external validation, we conducted 2-sample MR analyses using plasma pQTLs of the screened proteins from another study by deCODE genetics. Moreover, we performed a series of sensitivity analyses including reverse MR and Bayesian colocalization tests. The primary MR identified 4 plasma proteins that were associated with DD risk including CCN3/NOV (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97–0.99; P = 1.2 × 10−11 for UKBB. OR, 0.73; 95% CI, 0.66–0.81; P = 7.2 × 10−10 for FinnGen). The validation MR well replicated the primary result of CCN3/NOV (OR, 0.95; 95% CI, 0.93–0.96; P = 1.9 × 10−11 for UKBB. OR, 0.43; 95% CI, 0.33–0.56; P = 7.0 × 10−10 for FinnGen). Sensitivity analyses supported the causal association. We prioritized plasma CCN3/NOV protein as a protective factor for DD for follow-up functional studies to elucidate the disease mechanisms and therapeutics.
The role of blood cell morphology in understanding and diagnosing severe fever with thrombocytopenia syndrome (SFTS): Insights from a case report
Authors: Gu Kailong , Gao Jin , He Lingyan , Lu Zengyun , Zhang Yan
Published: November 2024

Rationale:

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonotic disease characterized by a high fatality rate of 12% to 15%. Despite hematologic abnormalities being frequently reported in SFTS patients, detailed characterization of peripheral blood cells, especially in severe cases, is scarce. This case report aims to fill this gap by describing the unique morphological features of blood cells in a patient with a severe outcome.

Patient concerns:

A male patient presented with severe symptoms of SFTS, including high fever and thrombocytopenia, and was subsequently infected with a highly virulent strain of the SFTS virus.

Diagnoses:

The patient was diagnosed with virus-associated hemophagocytic syndrome related to SFTS based on clinical presentation and laboratory findings.

Interventions:

The interventions included comprehensive supportive care and treatment aimed at managing the severe symptoms and complications associated with SFTS.

Outcomes:

Despite the interventions, the patient experienced significant morphological changes in white blood cells and ultimately succumbed to the illness.

Lessons:

The detailed description of abnormal cell morphology in this case provides valuable insights into the pathophysiology of SFTS. Recognizing these morphological abnormalities can aid in early detection and may have implications for assessing disease severity and guiding treatment strategies.
Vanishing Bile Duct Syndrome in Pediatric Hodgkin Lymphoma: First Statistical Analysis of All Published Cases in Children and a Case Report
Authors: Ul Ain Rahat , Gull Aiman , Mohsin Bushra , Rathore Zonaira , Faizan Mahwish
Published: November 2024

Hodgkin lymphoma with vanishing bile duct syndrome is a rare paraneoplastic syndrome and has never been studied in the pediatric population. The objectives of this study were to determine the clinical characteristics of this rare condition in children through a literature review, and a descriptive analysis of all published cases with the index case report. All reported cases fulfilling the inclusion criteria were found through a literature search, and analyzed in descriptive statistics. A total of 10 cases were included in the study with a median age of 9.5 years and a male-to-female ratio of 9:1. The median duration of symptoms was 5.5 weeks with 3 cases having jaundice before the symptoms of lymphoma. The median bilirubin level was 8.4 mg/dL. Seven cases received modified chemotherapy, and 5 used ursodeoxycholic acid. The survival rate was 50%. Normalization of liver functions after the lymphoma treatment was observed in 4 cases and was the only statistically significant factor (P=0.01) associated with the outcome. This is a rare entity in the pediatric population with a guarded prognosis comparable to the adult counterparts but a marked male predominance.
Leiomyosarcoma of the inferior vena cava: case report
Authors: Hafhaf Ouahiba , Bengrad Ahmed , Fliti Abdelhamid , Arbaoui Said , Anane Oussama , Abdellah Rezziki , Serji Badr , Benzirar Adnane , El Mahi Omar
Published: November 2024

Introduction and Importance:

Leiomyosarcomas of the inferior vena cava are exceedingly rare tumors, presenting diagnostic dilemmas due to their nonspecific clinical features. This case report aims to shed light on the challenges associated with diagnosing and managing such tumors, emphasizing the importance of a multidisciplinary approach. This article uses SCARE2023 criteria as a framework to sort out a case report in order[1].

Case Presentation:

We present a case of leiomyosarcoma of the inferior vena cava in a patient presenting with abdominal pain. Initial clinical signs, supported by computed tomography (CT) and magnetic resonance imaging (MRI), led to the suspicion of the tumor. Histological analysis confirmed the diagnosis, prompting surgical intervention.

Clinical Discussion:

The diagnosis of tumors within the inferior vena cava is often challenging due to their nonspecific presentation. Imaging modalities such as CT and MRI play an important role in describing the extent of the tumor and guiding surgical planning. Histological analysis remains supreme for definitive diagnosis. Surgical resection, aimed at complete excision, is the keystone of treatment to minimize the risk of recurrence.

Conclusion:

Leiomyosarcomas of the inferior vena cava pose diagnostic and therapeutic challenges due to their rarity and nonspecific clinical presentation. A comprehensive approach integrating clinical assessment, imaging, and histological analysis is essential for accurate diagnosis and optimal management. Multidisciplinary collaboration is key for navigating the complexities associated with these rare vascular neoplasms, ensuring positive patient outcomes.
Prevalence and determinants of poor sleep quality among patients of diabetes mellitus: A tertiary hospital based cross sectional study
Authors: Hamayal Muhammad , Shahid Warda , Wali Saad , Ahmad Naveed , Ahmad Raouf , Iftikhar Iqra , Tahir Muhammad Danyal , Hafeez Momina , Haseeb Abdul , Siddiqui Shajee Ahmad
Published: November 2024

Background:

The effects of diabetes on sleep quality are pronounced and have a cause-effect relationship. The major aim of this study was to check for the prevalence of poor sleep quality and associated factors among patients of diabetes mellitus in Pakistan as every 1 in 4th individual is suffering from diabetes in Pakistan.

Materials and Methods:

A hospital based cross-sectional study was conducted on diagnosed patients of diabetes mellitus from September 2023 to March 2024 using Pittsburgh Sleep Quality Index (PSQI). SPSS v.27 was used for data analysis. Frequencies, percentages for sample characteristics and means for PSQI were calculated. Chi-square and spearman were run for association and correlations respectively. Risk factors were predicted using binary logistic regression.

Results:

384 responses were collected with 12 excluded. The prevalence of poor sleepers came out to be 82% and poor sleep was significantly associated and correlated with increasing age, poor glycemic control, and metformin as well as income, education and duration of diabetes respectively. Presence of comorbidities and uncontrolled diabetes were the only associated risk factors.

Conclusions:

Pakistani population with diabetes mellitus have an extremely high rate of poor sleep quality which should be addressed by adding sleep quality-oriented guidelines in the management of diabetes.
Rituximab Treatment in Adult Patients With Idiopathic Inflammatory Myositis
Authors: Rojas Lilian Otalora , Ramsubeik Karishma , Sanchez-Ramos Luis , Motilal Shastri , Singh Jasvinder A. , Kaeley Gurjit S.
Published: November 2024

Objective

This systematic review and meta-analysis assess the efficacy and safety of rituximab (RTX) in treating idiopathic inflammatory myositis (IIM).

Methods

PubMed and Embase were systematically searched for trials and observational studies involving RTX use in IIM. Data were analyzed using a random-effects model to generate pooled estimates for overall response, complete remission, partial response, and adverse events, with subgroup analyses by myositis type and RTX dosage (PROSPERO registered number CRD42022353740). Risk of bias assessments were done using the Newcastle-Ottawa Scale for observational studies and risk of bias 1 tool for trials.

Results

Seventeen studies (1 randomized controlled trial and 16 observational studies), encompassing 362 patients, were included. The overall pooled response rate was 70% (95% confidence interval [CI]: 57%–82%; I
2 = 74%, p < 0.001). Complete remission occurred in 13% (95% CI: 3%–25%; I
2 = 79%, p < 0.001) and partial response in 48% (95% CI: 30%–67%; I
2 = 87%, p < 0.001), both with significant heterogeneity. Subgroup analysis revealed high response rates across all myositis types: polymyositis 69%, dermatomyositis 67%, antisynthetase syndrome 70%, juvenile dermatomyositis 60%, and immune-mediated necrotizing myopathy 86%. Response rates were similar between RTX induction doses of 1 g IV on days 0 and 14 (68%) and 375 mg/m2 weekly for 4 weeks (71%). Reported adverse events totaled 120, including infusion reactions (18.5%) and infections (12.4%).

Conclusions

RTX shows a favorable clinical response in IIM treatment, though response rates vary. There was a significant heterogeneity in treatment effect estimates that are based on a small number of patients. The incidence of infusion reactions and infections highlights the need for careful monitoring. Further controlled trials are essential to refine treatment protocols and evaluate long-term outcomes for RTX's role in IIM.
Trends in Medicare Reimbursement for Gender-Affirming Procedures
Authors: Corbett John , Johnson Mira , Gombaut Cindy , Ranganath Bharat , Chao Jerry W.
Published: November 2024

Background

Medicare reimbursement rates are essential knowledge for gender-affirming plastic surgeons. The goal of this project was to examine trends in Medicare reimbursement rates for gender-affirming plastic surgery procedures from 2007 to 2020.

Methods

Changes in reimbursement rates were measured for 35 commonly used gender-affirming procedure CPT codes from 2007 to 2020 adjusted for inflation to the 2020 US dollar value. The Unadjusted Percent Change in Consumer Price Index (CPI) was calculated using data from the US Bureau of Labor Statistics. Reimbursement rates were adjusted for inflation using the CPI for each year. Student t test was utilized for mean comparisons.

Results

Mean percent change in reimbursement rates was +16.01% while the percent change in CPI was +27.45%. Comparison between rate change of inflation versus rate change in adjusted medical reimbursement was significantly higher in the inflation group (P < 0.0001). Inflation adjustments for the Compound Annual Growth Rate was negative (−0.76%). The adjusted total percent change was also calculated at an average of −8.97%.

Conclusions

This is the first study evaluating trends in Medicare reimbursement rates for commonly selected gender-affirming procedures in the United States. After adjusting for inflation, Medicare reimbursement rates for all gender-affirming surgeries analyzed declined from the years 2007 to 2020 compared to expected inflation base. Increased consideration of these trends will be important for US policymakers, hospitals, and surgeons to ensure ease of access to gender-affirming care for transgender individuals.
Challenges in Radial Forearm Free Flap Surgery
Authors: Biagiotti Jessica , Longfellow Grace Anne , DiDonna Nicole , Khan Kamran , Knoll Gregory M. , Damitz Lynn
Published: November 2024

The radial forearm free flap (RFFF) has emerged as a leading option for microvascular reconstruction of head and neck soft-tissue defects. Despite the favorable outcomes conferred by RFFFs, complications such as skin graft loss and tendon exposure can occur. We present the case of a 77-year-old man who underwent RFFF reconstruction after excision of squamous cell carcinoma from the head and neck. The patient subsequently developed flexor tenosynovitis, septic arthritis of the wrist, and osteomyelitis of several carpal bones as a direct result of partial skin graft loss and prolonged tendon exposure at the donor site. To the best of our knowledge, this is the first reported case of this specific complication. Review of the literature reveals the need for continued research into RFFF donor site complications to mitigate the incidence of significant morbidity.
Expanding Applications and Future of Robotic Microsurgery
Authors: Wessel Kai J. , Dahmann Sonja , Kueckelhaus Maximilian
Published: November 2024

Robotic-assisted microsurgery has emerged as a transformative technology, offering enhanced precision for complex procedures across various fields, including lymphatic surgery, breast reconstruction, trauma, and neurosurgery. This paper reviews current advancements, applications, and potential future directions for robotic-assisted microsurgery. In lymphatic surgery, robotic systems such as Symani have improved precision in thoracic duct reconstruction and lymphatic vessel anastomoses, reducing morbidity despite longer surgery times. In breast reconstruction, robotic systems are being used to refine techniques like the miraDIEP approach, minimizing tissue damage and enhancing precision in individualized treatments. Trauma reconstruction, particularly for extremities, has also benefited from robotic assistance, enabling successful sutures in small vessels and nerves. Emerging applications in meningeal lymphatics show potential for treating neurodegenerative diseases through improved drainage. In neurosurgery, robots enhance precision in deep and narrow anatomic spaces, although advancements in specialized instruments are needed for full implementation. Future development of robotic microsurgery systems will focus on improved maneuverability, miniaturization, and integration of tools like augmented reality and haptic feedback. The goal is to combine robotic precision, data storage, and processing with human skills such as judgment and flexibility. Although robots are unlikely to replace surgeons, they are poised to play an increasingly significant role in enhancing surgical outcomes. As the technology evolves, further research and clinical trials are needed to refine robotic systems and validate their expanding applications in clinical practice.
Sphenoid Ridge in Fetuses: Size Analysis, Classification, and Clinical Implications
Authors: İnce Rümeysa , Çalişir Ebru Sena , Öztürk Cansu , Şencan Zeynep , Cihan Ömer Faruk , Beger Orhan
Published: November 2024

Objective:

To identify the size and angle of the sphenoid ridge (SR) in fetuses.

Methods:

Skull bases of 32 fetuses (11 males / 21 females) aged 17 to 32 weeks of gestations were included the study. The angle of SR (SRA), length of LW (SRL), and also LW widths at the midline (SRW-ML), at the midpoint (SRW-MP), and at the lateral point (SRW-L) were measured.

Results:

SRL, SRA, SRW-ML, SRW-MP, and SRW-L were measured as 22.98±4.62 mm, 150.69±8.05 degrees, 6.57±1.46 mm, 4.68±1.07 mm, and 2.68±0.71 mm, respectively. No significant difference was observed between the measurements in terms of sex and sides. Apart from SRA, the parameters were greater in the third-trimester fetuses than the second-trimester fetuses. SRA was similar in both trimester fetuses. SRA did not alter with advancing gestational weeks, but the other increased. In fetuses, only one configuration regarding SRA types was observed. Type A was observed in all fetuses. Linear function was calculated as y=1.411 + 0.902×age for SRL, y=−0.137 + 0.281×age for SRW-ML, and y=1.024 + 0.069×age for SRW-L.

Conclusion:

Our study provides beneficial data for neurosurgeons and anatomists to understand the development of SR in the prenatal period. The authors' regression equations for determining the growth dynamics of the ridge may be used to estimate SR parameters.
Relation of the Pituitary Gland With the Sella Turcica in Adult Patients With Chiari Malformation Type 1
Authors: Dolgun Habibullah , Ülkü Göktuğ , Elbir Cagri , Dinç Samet , Şener Burak , Kavcar Mustafa , Kalindemirtaş Merve , Beger Orhan
Published: November 2024

Objective:

This study aims to assess the relation of the pituitary gland height (PGH) with the heights of the tuberculum sellae (TSH) and dorsum sellae (DSH) in adult patients with Chiari malformation type 1 (CM1).

Methods:

Magnetic resonance imaging (MRI) views of 50 CM1 patients aged 20 to 71 years and 50 controls aged 20 to 65 years were included in the study.

Results:

CM1 patients (6.29±1.24 mm) had statistically similar PGH to controls (6.63±1.18 mm, P=0.171). TSH (10.11±2.18 mm), and DSH (8.87±1.88 mm) of these patients were statistically smaller than TSH (11.28±2.07 mm) and DSH (10.50±1.62 mm) of controls (P<0.01). In CM1, there was one male patient (2%) with PGH > 10 mm, whereas in controls, there was no case with PGH > 10 mm. Two CM1 patients (4%) had taller PGH compared with DSH, and 1 CM1 patient (2%) had taller PGH compared with TSH. In controls, all PGHs were smaller than TSHs and DSHs.

Conclusion:

In comparison with controls, CM1 patients had smaller TSH and DSH, but statistically similar PGH. Thus, a shallow sella on MRI image of a CM1 patient may result in the pituitary gland to appear longer than normal, and this may lead to erroneous diagnoses such as gland enlargement on their MRI images.
Lymph Node Metastasis of Head and Neck Cancer: A Bibliometric Analysis From 2000 to 2022
Authors: Zhang Ruizhe , Feng Bao , Ling Junjun , Zhuo Xianlu , Zhao Houyu
Published: November 2024

Lymph node metastasis (LNM) is a significant prognostic factor in head and neck cancer (HNC) patients. To obtain a better understanding of the worldwide prevalence and current research status, the authors conducted a comprehensive bibliometric analysis of literature published from 2000 to 2022. The contributions of institutions, journals, countries or regions, cited literature, keywords, and authors in global publications were concisely summarized using the COOC and VosViewer software tools. The data were extracted from the expansive Web of Science database. A total of 5478 papers were collected for analysis, and the number of publications has exhibited exponential growth over the last 22 years. The United States emerged as the most productive country, closely followed by China. Noteworthy institutions for their high productivity include the Sloan-Kettering Cancer Center, Sun Yat-Sen University, and the University of Texas MD Anderson Cancer Center. The Head & Neck and Oral Oncology journals lead in terms of publication volume. The main areas of research in this field were prognostication, radiotherapy, survival rates, sentinel lymph node biopsy, and the human papillomavirus. In addition, the analysis of author collaboration networks yielded valuable insights into the collaborative relationships within this research domain. Our research has identified the primary characteristics of highly impactful studies on LNM in HNC, providing significant insights into the advancements made in this area of research.
Delayed Mandibular Hematoma Following Selective Androgen Receptor Modulator (SARM) Usage
Authors: Mhanna Zeinab , Patmon Darin , Girotto John
Published: November 2024

Selective androgen receptor modulators (SARMs) have been used for various conditions since the late 1990s. Functioning similarly to testosterone, they are used to improve sexual function, skeletal muscle mass, and bone mass, and exhibit other favorable physiological effects. While SARMs are associated with side effects varying from edema to polycythemia, the biggest concern is their lack of regulation, as they are not FDA approved. Recent findings suggest the use of SARMs for reducing breast cancer tumor growth and is being explored for its effects in AR+/HER2−/ER+ advanced breast cancer development. Given the potential for SARMs in breast cancer treatment, plastic surgeons must begin to consider navigating the use of SARMs in practice and preoperative consultations regarding SARM usage. In addition, SARMs' anticoagulative properties must be further examined. This case presents a delayed hematoma following treatment for maxillary hypoplasia. Our findings indicate that the patients’ usage of SARMs is responsible for the postoperative complications.
FIBRINOGEN-LIKE PROTEIN 2 PROTECTS THE AGGRAVATION OF HYPERTRIGLYCERIDEMIA ON THE SEVERITY OF HYPERTRIGLYCERIDEMIA ACUTE PANCREATITIS BY REGULATING MACROPHAGES
Authors: Dong Xiuli , Xu Haibo , He Baiqi , Zhang Meijuan , Miu Wanqi , Huang Zhiming , Chen Chengshui
Published: November 2024

Objective: The mechanisms underlying the increased severity of hypertriglyceridemia acute pancreatitis (HTG-AP) remain poorly understood. Fibrinogen-like protein 2 (FGL2) has been identified as a regulator of macrophage activity, mediating immune suppression. This study aims to examine the role of FGL2 in the susceptibility to severe conditions of HTG-AP. Methods: Both wild-type and FGL2 gene knockout C57BL/6 mice were utilized to establish HTG, AP, and HTG-AP models using P-407 and/or caerulein. Serum levels of triglycerides, total cholesterol, amylase, and lipase were assessed via biochemical analysis. Pancreatic and lung tissue injuries were evaluated using hematoxylin and eosin staining. TNF-α, IL-1β, and IL-6 levels in serum and pancreatic tissues were quantified using enzyme-linked immunosorbent assay. Immunohistochemistry was used to assess the expression of FGL2, the macrophage marker CD68, and M1/M2 macrophage markers iNOS/CD163. Results: The animal models were successfully established. Compared to wild-type mice, FGL2 knockout resulted in increased pathological injury scores in the pancreas and lungs, as well as elevated TNF-α, IL-1β, and IL-6 levels in serum and pancreatic tissue in the HTG group, with more pronounced effects observed in the HTG-AP group. The AP group alone did not exhibit significant changes due to FGL2 knockout. Further analysis revealed that FGL2 knockout increased CD68 expression but reduced CD163 expression in the pancreatic tissues in the HTG group. In the HTG-AP group, there was a marked increase in CD68 and iNOS expressions, coupled with a reduction in CD163 expression. Conclusion: FGL2 knockout in HTG and HTG-AP mice resulted in increased inflammatory responses and a significant imbalance in M2 macrophages. These findings suggest that FGL2 plays a crucial role in mitigating the aggravation of HTG on the severity of HTG-AP by modulating macrophage activity.
Postoperative Exercise Training in Patients with Colorectal Liver Metastases A Randomized Controlled Trial
Authors: Thomsen Simon Nørskov , Krabek Rikke , Yfanti Christina , Sjöberg Stine , Sundberg Anna , Dalsgaard Ditte Munch , Thomsen Laura Mølgaard , Aasvang Eske Kvanner , Qvortrup Camilla , Mau-Sørensen Morten , Pedersen Bente Klarlund , Larsen Peter Nørgaard , Sillesen Martin Hylleholt , Schultz Nicolai Aagaard , Christensen Jesper Frank , Simonsen Casper
Published: November 2024

Background:

Postoperative morbidity can reduce quality of life, physical performance, and tolerability of postoperative chemotherapy in patients with colorectal liver metastases (CRLM). Exercise can improve these outcomes in some cancer populations. However, it remains unknown whether exercise can be delivered in the early postoperative period following surgery for CRLM without increasing the risk of harms.

Objective:

The primary objective was to compare the number of serious adverse events (SAEs) with exercise intervention versus control. The secondary objectives were to compare non-SAEs, chemotherapy dose modifications, patient-reported outcomes, cardiorespiratory fitness, and physical performance.

Methods:

Patients with CRLM scheduled to open surgery with or without postoperative chemotherapy were randomized 2:1 to intervention or control. The intervention group performed 30-50 min low-to-high intensity exercise 5 times/week for 8 weeks, initiated one day after postoperative hospital discharge. The primary outcome was SAEs. The secondary outcomes were SAEs; chemotherapy dose modifications; patient-reported outcomes; cardiorespiratory fitness; and physical performance.

Results:

Fifty-five participants were randomized. The number of SAEs was similar between the groups (between-group difference [95% CI]: -0.07 [-0.59; 0.43] events), whereas the number of non-SAEs was lower in intervention (between-group difference [95% CI]: -4.65 [-9.14; -0.17] events). We found between-group differences in time to postoperative chemotherapy (intervention: 25 days, control; 42 days) and chemotherapy dose modifications (RR [95%CI]: 0.55 [0.35; 0.88]). Additionally, we found between-group differences in quality of life, cardiorespiratory fitness, and physical performance, in favor of intervention.

Conclusions:

Early-onset postoperative exercise exhibit a favorable harms-benefit profile in patients with CRLM. This warrants further investigation in larger randomized controlled trials.

Trial registration:

Prospectively registered at clinicaltrials.gov (NCT04751773).
Metabolic Surgery: Progenitor of Effective Therapy for Atherosclerotic Cardiovascular Disease, Cancer, Type 2 Diabetes, and Obesity
Authors: Buchwald Henry
Published: November 2024

Metabolic surgery – operating on a normal organ for a beneficial metabolic gain – is not only an emerging discipline of surgery but the progenitor of therapy for the major global afflictions of atherosclerotic cardiovascular disease, cancer, type 2 diabetes, and obesity, as well as at least 18 other disease entities.
Abnormal metabolites in the dorsolateral prefrontal cortex of female epilepsy patients with migraine without aura
Authors: Wang Liping , Pu Huaxia , Zhou Jingyuan , Liu Wenyu , Zhang Shujiang , Tan Qiaoyue , Wan Xinyue , Wang Weina , Zhou Dong , Yue Qiang , Gong Qiyong
Published: November 2024

Epilepsy and migraine without aura (MWoA) are often comorbid, but the exact mechanisms are unclear. Magnetic resonance spectroscopy (1H-MRS) may help to understand the neurometabolic mechanisms in patients with epilepsy comorbid with MWoA (EWM). In this prospective cross-sectional study, we recruited 64 female patients, including 24 with EWM, 20 with epilepsy, and 20 with MWoA, as well as 20 age-level-matched and educational-level-matched female healthy controls from our hospital between August 2021 and November 2022. A single-voxel point-resolved spectroscopy sequence was used to acquire spectra of the bilateral dorsolateral prefrontal cortices (DLPFCs). Metabolites were quantified by linear combination model software, and the values were corrected for the partial volume effect of cerebrospinal fluid. MRS data comparisons were performed with multivariate analyses of variance. Correlation analyses were calculated between metabolites and main clinical data. The results showed that N-acetyl aspartate (NAA) was asymmetrical between the bilateral DLPFCs. Both NAA and myoinositol were significantly reduced in EWM than in healthy controls. Choline-containing compounds (Cho) were higher in MWoA than in the other three groups. Correlation analyses revealed that NAA of the right DLPFC and Cho of the bilateral DLPFCs in EWM were negatively related to migraine frequency. In addition, glutamate and glutamine (Glu and Gln, Glx) of the right DLPFC in EWM were negatively correlated with migraine severity. Our findings suggested that comorbid epilepsy and MWoA in female patients can lead to a synergistic reduction of both NAA and myoinositol, reflecting more serious injuries of neurons and glial cells.
Propagation effect of the thalamic feed-forward and feed-back inhibition in multi-type coupling models
Authors: Wu Quanjun , Li Ranran , Liu Yufan , Huang Suyuan , Chai Yuan
Published: November 2024

Seizure waves of epilepsy can propagate in a coupled thalamocortical model, which typically occurs in malfunctioning neuronal networks. However, it remains unclear whether thalamic feed-forward inhibition (FFI) and feed-back inhibition (FBI), the two most important microcircuits in this network, have propagation effects. In this study, we first investigated the importance of the pyramidal neuronal population–thalamic reticular nucleus and specific relay nucleus–thalamic reticular nucleus pathways in the Taylor model for seizure control as FFI and FBI, respectively. Subsequently, using the FBI as a crucial parameter, we constructed 2- and 3-compartment coupling models and evaluated their impact on seizure propagation in other chambers by varying the degree of coupling strength. Finally, we replicated the above study in a 10-compartment model to ensure the robustness of the findings. We confirmed that FBI is more effective by analyzing the combined effect of FFI and FBI, and the pathology state does advance as the coupling strength is increased. These findings elucidate the roles that these two pathways play in the propagation of epileptic seizures and may offer fresh perspectives on the clinical management of epilepsy.
A new case with coexistence of mosaic 48,XYYY/47,XYY, and CACNA1E variant in autism spectrum disorder
Authors: Kalayci Aysel , Agirbasli Deniz , Serdengecti Nihal , Alay Mustafa Tarik , Tarakcioglu Mahmut Cem , Seven Mehmet
Published: November 2024

Autism spectrum disorder (ASD) is a genetically heterogeneous neurobehavioral disorder. The etiology and the inheritance pattern are usually multifactorial. The index case is a 3-year-old male, whose family applied to the child psychiatry outpatient clinic due to failure to speak at 30 months. He had mild dysmorphic features. He is diagnosed with ASD according to DSM-V criteria. Chromosomal analysis revealed mos 48,XYYY[28]/47,XYY[72] karyotype. In FISH analysis, nuc ish (DXZ1x1, DYZ1x3)[44]/(DXZ1x1, DYZ1x2)[156] was detected. WES results displayed a heterozygous missense variant of uncertain significance c.3545G>A in the CACNA1E gene. XYY syndrome is one of the most common sex chromosome aneuploidies, and ASD is detected 20 times more likely than males in general population. To the best of our knowledge, the first case with the coexistence of mosaic 48,XYYY/47,XYY karyotype and CACNA1E variant together may contribute to phenotypic heterogeneity. Further investigation into the functionality of the variant in CACNA1E is needed.
Epidemiological and virological characteristics of people living with HIV on antiretroviral treatment for more than 6 months in virological failure in Brazzaville, Republic of Congo
Authors: Got Ferdinand Emaniel Brel , Malonga Gervillien Arnold , Malanda-Kiminou Juthèce Privat , Akolbout Maryse , Loubano-Mvoumbi Ghislain , Ebourombi Dagene , Diafouka Merlin , Ondzotto Gontran
Published: November 2024

Introduction. Virological failure is one of the main causes of failing to treat, and better management of HIV infection requires understanding and controlling the factors that contribute to this phenomenon. The main objective was to characterize the patients of the active file of the Brazzaville Outpatient Treatment Center in virological failure to identify predictive factors leading to virological failure.

Methods. Conducted between June and December 2020, this was a cross-sectional study. Patients enrolled were HIV-1-infected patients from the Brazzaville Outpatient Treatment Center receiving a potent combination therapy for at least 6 months but experiencing virological failure. Viral load was measured using the automated Abbott Real-time HIV-1 m2000rt System. Sociodemographic and clinical data were collected from a computerized patient record software called Santia. For the identification of the independent predictors of virological failure, statistical analysis was performed.

Results. A total of 109 patients with virological failure were recruited. The median age of the patients was 45 years (interquartile range: 37–52 years) and women were more represented (74%). More than half of the patients had World Health Organization stage IV HIV and the median duration of antiretroviral treatment was 96 months. The most followed treatment regimen was AZT+3TC+EFV (or nevirapine) with 48%, while the median viral load was 12985 copies ml−1.

Conclusion. In our study, we did not identify any sociodemographic or clinical variables predictive of virological failure. However, we felt that it would be desirable to carry out a study with temporal follow-up and the possibility of sequencing in order to identify the different circulating genotypes and resistance mutations.
Effects of a forefoot strengthening protocol on explosive tasks performance and propulsion kinetics in athletes: a single-blind randomized controlled trial
Authors: Tourillon Romain , Fourchet François , Edouard Pascal , Morin Jean-Benoît
Published: November 2024

Purpose

To investigate the effects of an 8-week “periodized high-load” forefoot strengthening protocol on athlete’s metatarsophalangeal joints (MTPj) flexion torque, MTPj flexors volume, sprint acceleration, cutting, and jumping overall performance and kinetics.

Methods

Twenty-height highly-trained athletes were randomized into a TRAINING or control group. Following a 4-week control period, TRAINING performed an 8-week forefoot strengthening protocol (2 sessions per week) followed by a 4-week detraining period. CONTROL group athletes were asked to continue their usual activities. During weeks 1, 5, 14 and 18, we assessed MTPj flexion torque, MTPj flexors volume, maximal sprint acceleration, 90-degree cutting, vertical and horizontal jumps, and foot-ankle hops. A linear mixed model was used along with individual statistical analyses using the minimal detectable change (MDC).

Results

TRAINING significantly and substantially increased MTPj flexion torque and MTPj flexors volume (effect size [ES]: 1.36-1.96; p<0.001) with 92% of athletes exceeding the MDC. Subsequently, TRAINING induced significant improvements in cutting and horizontal jumping performance (ES: 0.53-1.14; p<0.01) with 42 to 67% of athletes exceeding the MDC. These gains were partly attributed to enhanced medio-lateral ground reaction force transmission during cutting and increased propulsive horizontal force production and transmission during jumping (ES: 0.38-0.57; p<0.05). Despite no effects on overall sprint acceleration performance, vertical propulsion kinetics at maximal speed improved in TRAINING after intervention (ES: 0.87-1.19; p<0.01). No significant differences were found between the results of the interventional and detraining period demonstrating potential long-lasting effects.

Conclusion

An 8-week “periodized high-load” forefoot strengthening protocol allowed to improve MTPj maximal torque and MTPj flexors volume. This strength gains led also to cutting, horizontal jump overall performance and kinetics improvement as well as greater maximal speed propulsion kinetics. MTPj strength capacity may exert a more substantial impact on performance and kinetics on horizontally and medio-lateral-oriented explosive movements than on vertically-oriented ones.
Comprehensive multi-omics profiling of a healthy human cohort
Authors: de Visser Casper , Niehues Anna , Najdekr Lukáš , Toth Reka , Nazarov Petr V. , Vrbková Jana , Stanková Jarmila , Ekberg Sara , Moreno Elisa Conde , Ghimire Bishwa , Yadav Bhagwan , Matilla Pirkko , Puhka Maija , Lanza Val F. , Gloerich Jolein , Kulkarni Purva , Wessels Hans , Engelke Udo , Oldoni Emanuela , Andreu Toni , Saunders Gary , Muller Arnaud , Bendová Michaela , Rozankova Zuzana , Dzubak Petr , Pavlis Petr , Siska Bronislav , Scherer Andreas , Bermejo M Laura Garcia , Nordlund Jessica , van Gool Alain , Hajdúch Marián , ’t Hoen Peter A.C.
Published: November 2024

Multi-omics investigations hold promise for uncovering biomarker profiles crucial for disease diagnosis, prognosis, and monitoring interventions. However, these profiles are susceptible to technical and biological variation. Capturing biological variability and removing technical variability are essential for future studies. The EATRIS-Plus consortium analyzed blood samples from 127 healthy adults across twelve omics layers, resulting in one of the most comprehensive omics profiling datasets. These layers were analyzed and integrated with reproducible workflows. Sex significantly impacted all omics profiles, highlighting the need for sex-balanced studies. Age was associated with fewer omics features, but we could accurately predict participants’ age with epigenetic predictors(R2= 0.90). And we identified aging biomarkers in other omics layers. Strikingly, omics features including miR-877-5p, CDP-diacylglycerol,COQ10B,SH3GLB1, andMFSD14AmRNAs and immunoglobulin proteins were significantly (False Discovery Rate < 0.05) associated with the difference between biological and chronological age, but not with chronological age itself. The EATRIS-Plus dataset is FAIR and made accessible via the ClinData Portal and Zenodo repository. This reference dataset with normal ranges for abundance and variation of all omics features can guide future biomarker studies. The dataset enables power analyses and sample size estimations for future multi-omics studies and is ideal for benchmarking computational methods that integrate multi-omics data.
Biological age prediction using a novel DNN model based on steroid metabolic pathways
Authors: Wang Qiuyi , Wang Zi , Mizuguchi Kenji , Takao Toshifumi
Published: November 2024

Aging involves the progressive accumulation of cellular damage, leading to systemic decline and age-related diseases. Despite advances in medicine, accurately predicting Biological Age (BA) remains challenging due to the complexity of aging processes and the limitations of current models. This study introduces a novel method for predicting BA using a Deep Neural Network (DNN) based on steroid metabolic pathways. We analyzed 22 steroids from 148 serum samples of individuals aged 20 to 73, using 98 samples for model training and 50 for validation. Our model reflects the often-overlooked fact that aging heterogeneity expands over time and uncovers sex-specific variations in steroid interactions. This study identified key markers, including cortisol (COL), which underscore the role of stress-related and sex-specific steroids in aging. The resulting model establishes a biologically meaningful and robust framework for predicting BA across diverse datasets, supporting more targeted strategies in aging research and disease management.