bluuebunny/crossref_metadata_2025 huggingface dataset:
Generation of Inheritable A-to-G Transitions Using Adenine Base Editing and NG-PAM Cas9 in Arabidopsis thaliana
Authors: Tan Yi Yun , Liew Yin Yin , Lee Rachelle R. Q. , Castel Baptiste , Chan Nga Man , Wan Wei-Lin , Zhang Yizhong , Hu Donghui , Chan Persis , Kim Sang-Tae , Chae Eunyoung
Published: November 2024

Towards precise genome editing, base editors have been developed by fusing catalytically compromised Cas9 with deaminase components, mediating C-to-T (cytosine base editors) or A-to-G (adenine base editors) transition. We developed a set of vectors consisting of a 5′-NG-3′ PAM-recognizing variant of SpCas9 with adenosine deaminases TadA7.10 or TadA8e. Using a phenotype-based screen in Arabidopsis thaliana targeting multiple PDS3 intron splice sites, we achieved up to 81% somatic A-to-G editing in primary transformants at a splice acceptor site with NGG PAM, while 35% was achieved for the same target adenine with NGA PAM. Among tested vectors, pECNUS4 (Addgene #184887), carrying TadA8e, showed the highest adenine base editor (ABE) efficiency. With pECNUS4, we recreated a naturally occurring allele of DANGEROUS MIX3 ( DM3) in two generations, transgene-free, for NGC PAM. We also simultaneously base-edited four redundant DM1/SSI4 homologs, encoding nucleotide-binding leucine-rich repeat (NLR) proteins, using a single gRNA with NGA PAM targeting the conserved yet functionally crucial P-loop motif of NLR proteins. We found fixation of A-to-G in three NLR genes for all three possible adenine sites within base-editing window 3-9, as the edited genes segregate in T2. Multigene targeting succeeded in rescuing the previously reported autoimmune phenotype in two generations. Mediating desired ABE on seven NLR genes simultaneously was successful as well; above 77% editing was achieved in six of the seven possible targets in a T1 plant, with the remaining having a moderately high (32%) editing. ABE application to specifically inactivate functional motifs is anticipated to expedite the discovery of novel roles for proteins.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY 4.0 International license .
Overexpression of enhanced yellow fluorescent protein fused with Channelrhodopsin‐2 causes contractile dysfunction in skeletal muscle
Authors: Lamia Syeda N. , Davis Carol S. , Macpherson Peter C. D. , Willingham T. Brad , Zhang Yingfan , Liu Chengyu , Iannucci Leanne , Ganji Elahe , Harden Desmond , Bhattacharya Iman , Abraham Adam C. , Brooks Susan V. , Glancy Brian , Killian Megan L.
Published: November 2024

Skeletal muscle activation using optogenetics has emerged as a promising technique for inducing noninvasive muscle contraction and assessing muscle function both in vivo and in vitro. Transgenic mice overexpressing the optogenetic fusion protein, Channelrhodopsin 2‐EYFP (ChR2‐EYFP) in skeletal muscle are widely used; however, overexpression of fluorescent proteins can negatively impact the functionality of activable tissues. In this study, we characterized the contractile properties of ChR2‐EYFP skeletal muscle and introduced the ChR2‐only mouse model that expresses light‐responsive ChR2 without the fluorescent EYFP in their skeletal muscles. We found a significant reduction in the contractile ability of ChR2‐EYFP muscles compared with ChR2‐only and WT mice, observed under both electrical and optogenetic stimulation paradigms. Bulk RNAseq identified the downregulation of genes associated with transmembrane transport and metabolism in ChR2‐EYFP muscle, while the ChR2‐only muscle did not demonstrate any notable deviations from WT muscle. The RNAseq results were further corroborated by a reduced protein‐level expression of ion channel‐related HCN2 in ChR2‐EYFP muscles and gluconeogenesis‐modulating FBP2 in both ChR2‐EYFP and ChR2‐only muscles. Overall, this study reveals an intrinsic skeletal dysfunction in the widely used ChR2‐EYFP mice model and underscores the importance of considering alternative optogenetic models, such as the ChR2‐only, for future research in skeletal muscle optogenetics.
Do Danish ICU Survivors Remain Employed After ICU Discharge? A Register-Based Longitudinal Cohort Study
Authors: Hellmann Sophie Sell , Estrup Stine , Poulsen Lone Musaeus , Gøgenur Ismail , Mathiesen Ole , Thygesen Lau Caspar
Published: November 2024

OBJECTIVES:

Admission to ICU is associated with long-term consequences for the survivors. The study explores whether Danish ICU survivors remain employed after ICU discharge.

DESIGN:

A longitudinal register study of 16,284 Danish ICU survivors 25–67 years old 1:1 sex- and age-matched with general population references. Weekly prevalence proportions (%) of employed, public benefits, and deceased individuals were calculated based on the Danish Register-Based Evaluation and Marginalization Database and the Danish Civil Registration System until December 31, 2019. Age- and multivariate-adjusted hazard ratios (HRs) with 95% CIs were determined by Cox and Fine-Gray models.

SETTING:

Denmark has tax-funded healthcare and social security ensuring hospital treatment and social benefits free of charge for all Danish residents.

SUBJECTS:

The study included Danish residents acutely admitted to public ICU treatment for critical illness from 2010 to 2018.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The prevalences of employed ICU survivors increased from 30% at 2–8 weeks to 56% at 52 weeks after ICU discharge showing minor delay in women. The prevalences declined by age being 63%, 58%, 55%, and 52% in ages 25–42, 43–52, 53–58, and 59–63 years, respectively, 52 weeks after ICU discharge. The prevalences of employed ICU survivors declined by level of comorbidity being 64%, 53%, and 37% in ICU survivors of Charlson Comorbidity Index score 0, 1–2, or greater than or equal to 3, respectively, 52 weeks after ICU discharge. ICU survivors had higher risks of becoming retired (HR, 14.86; 95% CI, 8.69–25.41) or sickness absent (HR, 7.56; 95% CI, 7.16–7.98) when accounting for competing risks compared with the general population references.

CONCLUSIONS:

About half of ICU survivors remained employed 52 weeks after ICU discharge. Age and comorbidity were effect modifiers.
Sebaceous Carcinoma Arising in a Precursor Benign Sebaceoma: Rare Example Highlighting the Utility of Immunohistochemistry Including p53
Authors: Daruish Maged , Oguntunde Olubanji , Richards Martyn , Taibjee Saleem
Published: November 2024

Reports of sebaceous carcinoma arising from a pre-existing benign precursor are extremely sparse in the literature. We describe a case in which there was clear transition between sebaceoma and sebaceous carcinoma, with a different pattern of p53 staining in each component.
Immunohistochemistry for Immunoglobulin G4 on Paraffin Sections as a Diagnostic Test for Pemphigus
Authors: Abadjieva Tsvetana I. , Genova Sylvia N. , Pencheva Mina M. , Zhelyazkova Zhaneta H.
Published: November 2024

Pemphigus is a group of autoimmune bullous diseases mediated by autoantibodies most often of the immunoglobulin G class, subclasses immunoglobulin G1, and immunoglobulin G4 (IgG4), directed against desmosomal adhesion proteins of keratinocytes. This study aimed to evaluate IgG4 immunoreactivity on paraffin sections using immunohistochemistry in patients with pemphigus as a diagnostic test. Fifty formalin-fixed paraffin-embedded specimens from patients with pemphigus were selected. Fifty formalin-fixed paraffin-embedded specimens from patients with bullous diseases other than pemphigus were used as controls. Biopsies were performed on active lesions in newly diagnosed patients. Immunohistochemistry for IgG4 was performed on paraffin sections with an anti-immunoglobulin G4 antibody. Positivity was defined as distinctive, uninterrupted immunoreactivity localized to the intercellular junctions of keratinocytes. A finding that did not meet these criteria was defined as negative. Forty-three (86.0%) of the examined patients had pemphigus vulgaris and 7 (14%) had pemphigus foliaceus. Forty-nine (98.0%) specimens from patients with pemphigus were immunoreactive for IgG4, 1 (2%) upper back biopsy from the patient with oral pemphigus showed negative immunoreactivity for IgG4. Negative immunoreactivity was found in 45 (90%) controls. Five (10%) controls with bullous pemphigoid showed immunoreactivity for IgG4. Sensitivity of the method was established to be 98% and specificity 90%. Immunohistochemical examination for IgG4 for the diagnosis of pemphigus can be applied when direct immunofluorescence examination is unavailable. The advantage of this method is that it does not require special equipment and the histology slides are permanent.
Pigmented Syringomatous Carcinoma/Sweat Gland Carcinoma of the Vulva With Melanocytic Colonization: An Uncommon Presentation of a Rare Sweat Gland Neoplasm
Authors: Shaker Nada , Alazawi Sama , Sangueza Omar
Published: November 2024

Primary vulvar carcinomas are rare and constitute a diverse group of neoplasms. These primary tumors are typically classified based on their presumed tissue of origin or histological characteristics. Among these, carcinomas of sweat gland origin are particularly significant. They closely resemble similar malignancies in nonvulvar skin, including various cutaneous adnexal-type cancers such as apocrine and eccrine adenocarcinomas. Syringomatous carcinoma of the vulva is a rare malignant sweat gland neoplasm known for its infiltrative growth and tendency for local recurrence. Typically, these malignancies manifest as nonulcerated nodules or plaques, primarily in the head and neck region. The occurrence of syringomatous carcinoma in the vulvar region is exceptionally rare. Herein, we present a unique case of a 35-year-old woman with a dark mole measuring 1.5 × 1.0 cm on the vulva. Complete excision was performed to exhibit an infiltrative haphazard proliferation of elongated ductules and tubules, displaying significant cytologic atypia characterized by irregular nuclear contours and variably prominent nucleoli. Extensive melanocytic pigment deposition and stromal fibrosis were also observed. Immunohistochemical staining demonstrated positive expression of epithelial markers, including keratins (AE1/AE3) and epithelial membrane antigen, supporting the diagnosis of syringomatous carcinoma. CK7 and carcinoembryonic antigen were negative, whereas SOX10 and pan melanin highlighted admixed, cytologically bland melanocytes within the epidermis and neoplastic nests. This case represents a highly unusual presentation of syringomatous carcinoma associated with melanocyte colonization. Due to limited data on the optimal management strategies, a multidisciplinary approach involving gynecologic oncologists, dermatopathologists, and radiation oncologists is essential for treatment decisions. Long-term follow-up is crucial, considering the potential for local recurrence and metastatic spread, emphasizing the importance of comprehensive clinical management for favorable patient outcomes of this rare malignancy.
Unveiling Patient Expectations: Insights From a Cross-Sectional Study on Facial Aesthetic Treatments
Authors: Germani Marcelo , Borba Pietra Roschel , Carnevali Ana C.N. , Almeida Cláudia , Wille Isadora , Giro Gabriela , Munoz-Lora Victor R.M.
Published: November 2024

BACKGROUND

Patient expectations play a crucial role in aesthetic treatments, influencing satisfaction of treatment outcomes.

OBJECTIVE

To explore and assess the expectations of 102 participants undergoing various cosmetic interventions using the FACE-Q expectations scale.

MATERIALS AND METHODS

Participants, aged 20 to 64 years, seeking different facial aesthetic procedures completed the FACE-Q expectations scale before treatment. Data were analyzed, and the influence of age and treatment type on expectations was investigated.

RESULTS

The analysis revealed moderate overall expectations among participants, with no significant differences across different treatment modalities (p = .263). However, age significantly influenced expectations (p = .009), with younger adults (30–39 years) exhibiting higher expectations compared with older age groups. Correlation analysis confirmed a significant weak negative correlation between age and expectations (r = −0.210, p = .034). Multiple linear regression further identified age as a significant predictor of expectations (β = −0.564, p = .037).

CONCLUSION

This study provides insights into patient expectations in facial aesthetic procedures, emphasizing the role of age in shaping expectations. These findings underscored consistent beliefs in positive outcomes, irrespective of the cosmetic procedure to be realized. Future research should consider international collaborations and longitudinal studies to enhance understanding and optimize patient satisfaction in aesthetic treatments.
EVALUATION OF RETINAL ARTERIOLES IN RETINITIS PIGMENTOSA
Authors: Ota Junya , Inooka Taiga , Tomita Ryo , Kominami Taro , Koyanagi Yoshito , Ito Yasuki , Terasaki Hiroko , Nishiguchi Koji M. , Ueno Shinji
Published: November 2024

Purpose:

Retinal arterioles are attenuated in eyes with retinitis pigmentosa, but dimensions such as lumen diameter and wall thickness have not been thoroughly investigated. The aim of the study was to determine the dimensions of reduced retinal arterioles in eyes with retinitis pigmentosa.

Methods:

The study included 66 patients with retinitis pigmentosa (66 eyes) and 36 control participants (36 eyes) for whom adaptive optics recordings of the retinal arteries were available. Lumen diameter and wall thickness were measured on the adaptive optics images. The correlations between arteriole dimensions and clinical parameters were determined.

Results:

The mean lumen diameter was significantly smaller in patients with retinitis pigmentosa than in controls, while the mean wall thickness did not differ significantly. Lumen diameter was significantly and positively correlated with the mean deviation of the Humphrey 10-2 field analyzer and ellipsoid zone width. The wall thickness and wall-to-lumen ratio were significantly and positively correlated with age and systolic blood pressure but not with mean deviation and ellipsoid zone width.

Conclusion:

Retinal arteriole dimensions were significantly correlated with retinal degeneration and systemic factors.
Femoral neck fracture in a senile patient with primary hyperparathyroidism: A case report
Authors: Zhu Hong-Xia , Fu Lei , Xie Yu , Yuan Xiao , Chen Sheng-Tao , Xie Lun-Li
Published: November 2024

Rationale:

As a rare cause of femoral neck fracture, usually, hyperparathyroidism is missed diagnosed by orthopedist. Patient can present with various disappearance of clinical manifestations. Primary hyperparathyroidism in senile male population is commonly an asymptomatic disorder discovered incidentally through routine lab testing. Here, this study reports a case of femoral neck fracture in a senile patient with primary hyperparathyroidism.

Patients concerns:

A 70-year-old male patient with a known right femoral neck fracture associated with primary hyperparathyroidism.

Diagnoses:

A neck ultrasound (US) and computed tomography revealed a solid mass below the right lobe of the thyroid. X-ray plain and computed tomography confirmed right femoral neck fracture and multiple bone lesions. The routine lab testing showed hypercalcemia and hyperkalemia.

Interventions:

Before undergoing total hip arthroplasty surgery, patient was temporarily treated with hydration, diuretics, and calcitonin. Besides, the patient underwent parathyroidectomy of the enlarged parathyroid gland. Oral calcium preparations were routinely used for prevention of hypocalcemia.

Outcomes:

After completing all surgery, the patient was discharged without any complications including hypercalcemia and hyperkalemia.

Lessons:

Femoral neck fracture associated with primary hyperparathyroidism is a rare presentation. This case highlights that hypercalcemia and multiple osteopathy should be considered in the differential diagnosis in patients with pathological fracture caused by micro-traumatic injury.
Inactivation of β-coronavirus MHV-A59 by 2.8 GHz microwave
Authors: Xiao Yi , Peng Ruiyun , Wang Haoyu , Wang Hui , Dong Ji , Wang Kehui , Liu Wei , Zhao Li
Published: November 2024

From the severe acute respiratory syndrome coronavirus in 2003 to the severe acute respiratory syndrome coronavirus 2 in 2019, coronavirus has seriously threatened human health. Electromagnetic waves not only own high penetration and low pollution but also can physically resonate with the virus. Several studies have demonstrated that electromagnetic waves can inactivate viruses efficiently. However, there is still a lack of systemic studies to analyze the potential factors closely associated with the effectiveness of inactivation, such as pH, temperature, and so on. In this study, we evaluated the inactivation ability of a 2.8 GHz microwave (MW) on MHV-A59, a substitute virus for coronavirus. Moreover, the influences of environmental pH and temperature on inactivation abilities were also discussed. The results showed that the viral morphology was destroyed, and the infectivity of MHV-A59 was significantly decreased after exposure to a 2.8 GHz MW at a density of 100 mW/cm2. Furthermore, alteration of pH 8 could produce synergistic effects with MW on virus inactivation. And, it was also proved that MWs could inactivate viruses better at room temperature than that under lower environmental temperatures. These results suggested that electromagnetic wave has great promise to become an effective tool to eliminate coronavirus.
Assessment of the piriformis muscle and piriformis syndrome via Web of Science database: A bibliometric analysis
Authors: Polat Sema , Tunç Mahmut , Aksay Ufuk Can , Sönmez Elif İpek , Özşahin Esin , Göker Pinar
Published: November 2024

Background:

Piriformis syndrome, which is seen as the cause of 0.3% to 6% of low back pain, is a painful condition that occurs as a result of compression of the piriformis muscle on the sciatic nerve. Although there are many studies in the literature about piriformis syndrome, no bibliometric analysis has been found. This study aims to evaluate piriformis syndrome and conduct a bibliometric analysis of studies related to piriformis muscle and syndrome.

Methods:

This study was conducted on March 27, 2024, using data recorded in the Web of Science Core Collection Database. The search was made as “Topic = Piriformis OR Piriformis Syndrome.” Accordingly, 1345 results were found, and as a result of the necessary inclusion and exclusion criteria, 961 documents remained. The data was transferred to the VOSviewer software for further analysis.

Results:

961 documents based on piriformis muscle or piriformis syndrome were obtained. The country with the most publications was reported to be the USA with 31.42%. Other countries are ranked at around 5% or less. While 9 of the top 10 most cited institutions are based in the USA, clinics that make significant research contributions also attract attention among these institutions. Journals that publish articles containing piriformis syndrome are prominently surgery, physical therapy, anatomy, and general medicine journals. The most repeated keywords were reported as piriformis syndrome, diagnosis, pain, muscle, sciatic nerve, and hip. In contrast, the most repeated clinical terms were reported as approach, surgery, piriformis muscle, injection, sciatica, and compression.

Conclusion:

The findings obtained in this study are thought to be important for understanding to providing literature with new perspectives on this subject. They will also focus on the missing parts of the subject from this perspective. Also, this study would provide a novel perspective to the studies about piriformis syndrome and contribute to the researchers about the limits of the topic, and being aware of the active journals that publish papers on this issue would facilitate the work of the researchers.
Influence of a cardiac rehabilitation programme on the return to work of workers with ischaemic heart disease: Influence of a cardiac rehabilitation programme
Authors: Delgado-Calderón Manuel , Jiménez-Ortega Lara Estefanía , Ladisa María , Camacho-Vega Juan Carlos , Vilches-Arenas Ángel , Luque-Romero Luis Gabriel , Macías-Toronjo Israel , Fagundo-Rivera Javier , Gómez-Salgado Juan
Published: November 2024

This study aimed to examine the employment status of patients who have experienced ischemic heart disease one year after undergoing cardiac rehabilitation. For this, a quasi-experimental pre-post study without a control group of active workers aged 18 to 65 years diagnosed with ischemic heart disease and included in a cardiac rehabilitation programme was conducted. Sociodemographic and occupational data, cardiovascular risk factors and clinical-therapeutic data on heart disease were collected. A total of 214 patients were included, of which 115 patients returned to work. Several clinical factors contributing to return to work were identified: preserved left-ventricular ejection fraction (≥55%), < 3 obstructed coronary vessels, and stent revascularisation. Socio-occupational factors that may positively influence return to work were identified: age < 50 years, absence of anxious-depressive symptoms, higher level of education, and occupations with low physical strain. Cardiac rehabilitation is effective in improving cardiac function and health-related quality of life in workers with ischemic heart disease. Return to work and duration of temporary incapacity were associated with clinical-therapeutic variables and psycho-socio-occupational factors, such as type of job, physical strain, anxiety and depression, and age of the worker.
Ultrasound-guided femoral nerve block reduced the incidence of postoperative delirium after total knee arthroplasty: A double-blind, randomized study
Authors: Zhao Longbiao , Qiu Dongjie
Published: November 2024

Background:

Postoperative delirium (POD) is an acute brain dysfunction that mainly occurs in elderly patients after surgery. Postoperative pain is an important factor in the occurrence of POD, and effective pain management can reduce the risk of POD. Our study aims is to investigate the effect of ultrasound-guided femoral nerve block (FNB) on postoperative pain and the occurrence of POD after knee arthroplasty, and whether its mechanism is related to oxidative stress, inflammatory factors.

Methods:

Patients aged 65 to 80 years who were scheduled to undergo knee arthroplasty under general anesthesia from 2020 to 2023 were randomly divided into 2 groups: the control group (NC group) and the FNB analgesia group (FNB group). After anesthesia induction, the FNB group received ultrasound-guided FNB, whereas the NC group received an equal volume of normal saline. Visual analog scale (VAS), incidence of POD. the postoperative Quality of Recovery-15-Chinese version (QoR-15C) was been evaluated. Venous blood samples were collected from patients to detect the level of malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and C-reactive protein (CRP).

Results:

The VAS scores in the FNB group were significantly lower than those in the NC group at 24h. The summation of perioperative remifentanil usage and the number of remedial analgesia in the FNB group were significantly lower than those in the NC group. The incidence rate of POD in the FNB group is lower than the NC group. The occurrence of POD was markedly lower in the FNB group compared to the NC group. Compared with the NC group, the levels of MDA, GSH-Px, and CRP in the FNB group were lower on the first and third days after surgery. The QoR-15C score in the FNB group was higher on the 5th day after surgery.

Conclusion:

Ultrasound-guided FNB can reduce the incidence of POD after knee replacement surgery, and its mechanism may be related to analgesia improvement and reduction of postoperative inflammatory reaction.
Gut microbiota and short-chain fatty acids signatures in postmenopausal osteoporosis patients: A retrospective study
Authors: Li Shimei , Wang Jinzhi , Zhang Yingtong , Wang Jiangyan , Zhou Tianyu , Xie Youhong , Zhou Yilin , Tang Lin , Hu Li , Dong Qunwei , Sun Ping
Published: November 2024

Studies have shown that gut microbiota (GM) and its metabolites, short-chain fatty acids (SCFAs), are associated with the development of postmenopausal osteoporosis (PMO). This study explored the clinical and laboratory evidence of the relationship of GM and SCFAs to PMO and attempted to determine the potential mechanism of action. 18 patients (Collected from the First Affiliated Hospital of Guangdong Pharmaceutical University between January 2021 and August 2021) were included in this retrospective study, including 10 PMO women and 8 healthy young women as the healthy control (HC) group from Guangzhou, China. Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry. The composition of GM and its metabolites, SCFAs, in the fecal samples were measured by 16S rRNA gene sequencing and gas chromatography/mass spectrometry analysis, respectively. Compared with healthy control, PMO group had significantly decreased BMD in lumbar spines 1-4 (BMD_L) and femoral neck (BMD_F). 16S rRNA gene sequencing revealed that, compared with healthy control, PMO group had a markedly decreased abundance in Subdoligranulum, Norank_f_Muribaculaceae, and Alistipes at the genus level. Gas chromatography/mass spectrometry analysis indicated that the concentration of propanoic acid significantly dropped in PMO group. Additionally, we found that Subdoligranulum, Norank_f_Muribaculaceae, and Alistipes were positively correlated with BMD_L. Subdoligranulum and Norank_f_Muribaculaceae were also positively correlated BMD_F and propanoic acid, while Subdoligranulum is the only species that presented a strong correlation with the levels of acetic acid and butyric acid. Our findings indicated that, in postmenopausal women, there were evident changes in GM and SCFAs, and these changes were found correlated with patients’ BMD. These correlations provide novel insights into the underlying mechanism of PMO development, representative of early diagnostic markers and therapeutic targets that may improve the bone health in postmenopausal women.
Lateral center-edge angle in femoroacetabular impingement: from the sourcil or the rim of the acetabulum?
Authors: Çeltik Mustafa , Hapa Onur , Aydemir Selahaddin , Akin Eren , Arslan Ahmet Kaan , Duymaz Burak , Gürsan Onur
Published: November 2024

The correlation between clinical outcomes and preoperative/postoperative measures of the lateral center-edge angle (LCEA) will help establish the cutoff values for this measurement and determine whether to obtain it from the lateral acetabular rim (LCEAR) or the lateral end of the sourcil (LCEAS). The hypothesis was that the LCEAS would be more sensitive than the LCEAR. An upper cutoff value of LCEA could predict better functional outcomes in FAI patients. 106 patients (103 unilateral, 3 bilateral) who underwent hip arthroscopy surgery due to FAI and had a minimum 2-year follow-up were included. Patient-reported outcomes included the mHHS and visual analogue scale for pain (Pain VAS). Radiological parameters (alpha angle, LCEAS, LCEAR) were evaluated at the pelvis, 45° Dunn X-rays. A receiver operating characteristic analysis was used to evaluate the correlation between significant variables and achievement of patient-acceptable symptomatic state (PASS) and calculate area under the curve (AUC) and critical values for LCEA. The mean age of the patients was 34 ±10 years with a mean follow-up of 5 years. There were 75 male and 31 female patients. The mHHS improved from 57 ± 11 before surgery to 93 ± 8 after surgery (P < .001). The Pain VAS decreased from 6 before surgery to 1 after surgery (P < .001). A higher frequency of reaching the PASS threshold for mHHS was associated with lower preoperative and postoperative dunn LCEAS and postoperative dunn LCEAR. Preoperative dunn LCEAS ≤ 24.8° had an AUC of 0.67, predicting PASS (+) with 0.38 sensitivity and 0.93 specificity. Combining LCEAS with other parameters further improved predictability. LCEAS seems more predictive of clinical significance than LCEAR. However, predictivity exceeds the acceptable limit when they are measured together. The upper values for LCEAS and LCEAR seem to be 24° and 35°, respectively.
Exploring the link between serum uric acid and colorectal cancer: Insights from genetic evidence and observational data
Authors: Chen Ying , Zhang Shu , Wu Juanjuan , Xu Di , Wei Cong , Li Fajiu , Xie Guozhu
Published: November 2024

Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. Urate, known for its antioxidant properties, may influence CRC risk and prognosis, but research on this is limited. We used Mendelian randomization (MR) analysis to explore the causal relationship between serum urate levels and CRC risk. Additionally, we analyzed National Health and Nutrition Examination Survey data to assess the impact of serum urate on CRC prognosis. MR analysis in the European population indicated that higher serum urate levels are associated with a reduced CRC risk (odds ratios [OR] inverse-variance weighted: 0.90, 95% CI: 0.81–0.99, P = .04; OR MR-Egger: 0.86, 95% CI: 0.75–0.98, P = .03; OR Weighted-Median: 0.85, 95% CI: 0.74–0.96, P = .01; OR Weighted-Mode: 0.83, 95% CI: 0.74–0.94, P = .002). Validation datasets supported this (OR inverse-variance weighted: 0.83, 95% CI: 0.72–0.96, P = .011). However, National Health and Nutrition Examination Survey data showed that higher serum urate levels are linked to poorer CRC outcomes (HR 1.50, 95% CI: 1.08–2.10, P = .02). This study suggests that elevated serum urate levels may reduce CRC risk but are associated with worse prognosis in CRC patients, highlighting its potential as a biomarker for CRC risk and prognosis.
Prophylactic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for low-grade appendiceal mucinous tumors with early and limited disease after completely removed
Authors: Wang Chong , Jia Yun , Shi Guanjun , An Lubiao , Fan Xiwen , Zhang Pu , Ma Ruiqing
Published: November 2024

The necessity of prophylactic cytoreductive surgery (PCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for low-grade appendiceal mucinous neoplasms (LAMN) after complete removal is still controversial. This study aims to determine the role of PCRS + HIPEC and identify optimal strategies for managing these patients. One hundred fifty-nine patients who sought medical advice at Aerospace Center Hospital were retrospectively analyzed from January 2011 to December 2021. All the patients were divided into the PCRS group and the observation group. The data of surgical specimens and pathology was collected, and the effect on recurrence-free survival (RFS) was analyzed. Of these 159 patients, 88 were in the PCRS group, and 71 were in the observation group. The median follow-up time was 38 months. Seven patients recurred and developed into pseudomyxoma peritonei, 1 in the PCRS group and 6 in the observation group. The analysis of RFS showed that patients who underwent PCRS (P = .01) and HIPEC (P = .01) had better survival. After multivariate analysis, the surgical specimen accompanied by disseminated peritoneal adenocarcinoma was identified as an independent prognostic factor for RFS. In the study of surgical resection content, patients with greater omentum (P = .01) and bilateral fallopian tubes and ovaries of women (P = .002) resection had a more prolonged RFS with statistical significance. The research indicated that PCRS + HIPEC could prevent recurrence. Therefore this treatment were necessary for LAMN after complete removal in patients with a high risk of recurrence. However, it was not proven to be an independent factor for RFS, and a multicenter, prospective, randomized trial was need to definitively address the role of PCRS + HIPEC for LAMN after complete resection.
Transcatheter closure of paravalvular leakage through multiple approaches after surgical mechanical valve replacements: A retrospective study
Authors: Liu Yang , Xu Chennian , Jin Ping , Zhai Mengen , Tang Hao , Tian Zhiyuan , Wen Anguo , Qiao Rui , Yang Jian
Published: November 2024

Background:

Transcatheter closure of percutaneous paravalvular leak (PVL) is a technically challenging procedure, especially after surgical mechanical valve replacements (SMVR), as the risk of interference with the prosthetic valve discs and the complex interventional techniques required for mitral PVL closure. Our study was designed to review the results with transcatheter closure of PVL after SMVR.

Methods:

From January 2018 through December 2023, a total of 64 patients with PVL after SMVR underwent transcatheter closure with the help of preoperative 3-dimensional printing model and simulator for image evaluation. We reviewed the catheter techniques, perioperative characteristics, and prognosis.

Results:

The median follow-up was 28 (3–58) months. The procedure was successful in 60/64 (93.8%) patients. There were 36 aortic PVLs, 27 mitral PVLs, and 1 combined aortic and mitral PVL which were repaired by the transcatheter approach. A total of 24 patients had aortic valve replacements and 20 patients had mitral valve replacements, while 20 patients had previously combined aortic and mitral valve replacements. Procedural time was 35 to 300 (106.6±51.2) minutes. Fluoroscopic time was 8 to 50 (17.6±11.3) minutes. The hospital stay was 5 to 21 (8.1±3.5) days. A total of 47 (78.3%) patients improved by ≥1 New York Heart Association functional class at the 1-year follow-up.

Conclusion:

Complex catheter techniques were included in percutaneous closure of mechanical PVL. However, this minimally closure treatment could provide reliable outcomes and shorter hospital stays in selected patients.
Causal relationships between uremic metabolites or toxins and heart failure: Univariate and multivariate Mendelian randomization
Authors: Wei Mingyu , Hu Xianjing , Zhu Min , Zhang Shuai , Tian Zhenyu , Xie Pengxin , Cui Ming
Published: November 2024

Studies have shown that uremia, renal failure and heart failure (HF) are closely related. However, whether this association reflects a causal effect is still unclear. The aim of this study was to evaluate the causal effect of uremic metabolites or toxins on HF. Mendelian randomization (MR) analysis was conducted to evaluate the causal effect of 11 uremia-related metabolites on HF risk using single-nucleotide polymorphisms (SNPs) from a genome-wide association study. A protein–protein interaction network was constructed to study the function of SNPs corresponding to HF-related factors. Univariate and multivariate MR analyses demonstrated that lipoprotein A and apolipoprotein B were positively correlated with HF. The SNPs corresponding to these key factors were related mainly to MAP kinase activity and lipid metabolic processes. Overall, we identified 2 uremia-related exposure factors (lipoprotein A and apolipoprotein B) closely related to HF, laying a theoretical foundation for the treatment of HF with renal failure or uremia.
Causal effect of C-reaction protein and endometrial cancer: Genetic evidence of the role of inflammation in endometrial cancer
Authors: Zhao Chenyang , Chen Fei , Li Qiong , Tan Chen , Zhang Wei , Peng Lixiu , Yue Chaoyan
Published: November 2024

Consensus remains elusive regarding the relationship between C-reactive protein (CRP) levels and endometrial cancer (EC). Our study sought to elucidate the causal association between CRP and EC, aiming to contribute to the understanding of this complex interplay. We primarily utilized the random-effects inverse variance-weighted method. This approach served as the foundation for our analysis, complemented by 3 additional techniques, including Mendelian randomization-Egger, weighted-median, and weighted mode. A series of sensitivity analyses were also conducted to affirm the stability and reliability of our results. Employing the inverse variance-weighted method, our findings indicated that a one-unit increment in log-transformed CRP concentrations (mg/L) was associated with a relatively 9.7% increased risk of overall EC (odds ratio [OR] = 1.097, 95% confidence interval [CI]: 0.996–1.208, P = .061), an 11% higher risk of endometrioid endometrial cancer (OR = 1.110, 95% CI: 1.000–1.231, P = .049) and a 25% increased risk of non-endometrioid cancers (OR = 1.250, 95% CI: 1.005–1.555, P = .045). Sensitivity analyses did not reveal evidence of horizontal pleiotropy in the analysis of CRP and overall EC, endometrioid endometrial cancer, or non-endometrioid cancers (P > .05). In the reverse analysis, our data demonstrated that EC exert no reverse effect on CRP levels. Our study suggested causal relationships between CRP and an elevated risk of EC and its subtypes, which contribute to the ongoing discourse on the role of inflammation, as indicated by CRP levels, in the etiology of EC and its variants.
Urinary calculi successfully expelled in a patient through traditional Chinese exercise: A case report
Authors: You Chengheng , Li Jing Xian , Li Guanwu , Dun Rongliang , Fang Min , Zhu Qingguang
Published: November 2024

Rationale:

Urinary calculi are hard mineral deposits that typically require medication or surgery, such as lithotripsy. This case report presents traditional Chinese exercises (TCEs) as a potential alternative for stone expulsion.

Patient concerns:

A 41-year-old male with no history of urinary tract stones, experienced sudden severe lower back and abdominal pain accompanied by nausea and vomiting.

Diagnosis:

Computed tomography scan revealed a small calculus at the distal end of the left ureter (within the bladder wall), approximately 2 mm in size, with mild hydronephrosis in the ureter and renal pelvis.

Interventions:

The patient was initially prescribed medication for pain relief and was advised to engage in TCEs.

Outcomes:

Follow-up computed tomography scan after the exercise regimen showed complete expulsion and disappearance of the urinary calculi. The patient reported significant improvement in physical and mental health with no recurrence of calculi observed in subsequent checkups.

Lessons:

This case suggests that TCEs may facilitate the expulsion of small urinary calculi, offering a noninvasive treatment option. Further research is needed to confirm the therapeutic effects of TCEs on urinary calculi and to explore its potential mechanisms.
Genetically predict the association between 91 human blood cell perturbation phenotypes and IBD: A Mendelian randomization study
Authors: Yao Xin , Wang Song , Li Xiao , Wen Jieying , Huang Yunsi , Lan Weixuan , Huang Xuyu , Li Hao , Sun Yunlong , Zhao Xiaoqian , Zhang Tao
Published: November 2024

Inflammatory bowel disease (IBD), encompassing Crohn disease and ulcerative colitis, is a group of persistent and recurrent gastrointestinal disorders. Despite the prevalence of these conditions, no studies have been conducted to examine the connection between altered human blood cell phenotypes and the underlying mechanisms of IBD pathogenesis. By utilizing summary statistics from genome-wide association studies, we executed a systematic two-sample Mendelian randomization (MR) investigation on 91 genetically determined blood cell perturbation traits in relation to 3 separate IBD phenotypes. Our analysis sought to delineate the putative causal links between these blood cell perturbation phenotypes and IBD, thereby contributing to a more nuanced comprehension of the pathophysiological underpinnings and offering a foundation for the development of novel therapeutic approaches. The forward MR analysis identified 7 human blood cell perturbation phenotypes associated with various IBD outcomes, while the reverse MR analysis revealed that 9 human blood cell perturbation phenotypes were influenced by various IBD phenotypes. The study has uncovered human blood cell perturbation phenotypes associated with various IBD diseases, contributing to a deeper understanding of the pathogenesis of IBD. It also provides new insights for early clinical diagnosis, disease activity monitoring, immune surveillance, prognosis assessment, and personalized treatment.
The combination of Qing Kailing injection and clindamycin injection leads to systemic adverse reactions: Case report
Authors: Zhou Shenghui , Wang Shouhui , Wang Yajun , Xi Fenglin
Published: November 2024

Rationale:

It is imperative to be cautious about the potential systemic allergic reaction caused by the combined use of Qing Kailing Injection (QKI) and clindamycin as it may be life-threatening.

Patient concerns:

A 48-year-old female with a history of hypertension was admitted to a private hospital with a fever and cough. She was diagnosed with lung infection and received QKI infusion, followed by clindamycin infusion. During clindamycin infusion, the patient experienced convulsions followed by nausea and vomiting (gastric contents). Upon arrival at the emergency room, she lost consciousness, became agitated and sweaty, and had incontinence. Respiratory rate was measured at 32 breaths per minute, pulse rate was 180 beats per minute, temperature was 42°C, and blood pressure was unmeasurable.

Diagnosis:

Drug hypersensitivity reactions.

Interventions:

The patient immediately discontinued clindamycin, administered dexamethasone 10 mg intravenously, and was subsequently referred to our hospital for further treatment. Emergency physicians immediately provided oxygen inhalation via a face mask, administered midazolam for sedation and ibuprofen combined with physical measures for cooling, carried out fluid replacement, administered furosemide for diuresis, and avoided using allergenic drugs.

Outcomes:

The patient regained consciousness, without experiencing further convulsions, nausea, vomiting, fever, or abnormal urination, and their vital signs stabilized.

Lessons:

Caution should be exercised in the concurrent use of traditional Chinese medicine injections and antibacterial drugs in clinical treatment because of the potential for allergic reactions to both medications. If combination therapy is deemed necessary, adequate flushing of the infusion pipe with saline or replacement with a new infusion device is recommended, while closely monitoring the patient for any signs of allergic reactions.
The Necessity of Palliative Care Interventions in Emergency Departments
Authors: DesJardin Austin
Published: November 2024

Palliative care, a beacon of relief and comfort, ensures the best quality of life for patients nearing death, a patient population that often presents to emergency departments, by providing interventions to promote comfort and support final wishes. The purpose of this literature review was to examine the outcomes of palliative care interventions for adult patients with chronic illnesses who have died in emergency departments. The literature review was conducted in CINAHL, PubMed, SCOPUS, OVID, and APA Psych using the keywords “palliative,” “emergency department,” “adult,” and “chronic disease.” The search was limited to English language publications with no date limits and performed according to Preferred Reporting Items for Systematic reviews and Meta-Analysis statement standards. The search yielded 531 articles, with 226 duplicates excluded. After a review, only 16 articles met the inclusion criteria. Common interventions included implementing screening tools, enhancing communication skills, providing end-of-life care education, and health record alerts for palliative care criteria. This review highlights how critical palliative care interventions are needed in emergency departments. The inevitability of seriously ill patients presenting to emergency departments underscores the urgency and importance of palliative care interventions, leading to increased comfort and decreasing distressing symptoms experienced by dying patients.
Shifting the Landscape of Spine and Non-Spine Bone Metastases
Authors: Udovicich Cristian , Lo Simon S. , Guckenberger Matthias , Sahgal Arjun
Published: November 2024

Both spine and nonspine bone metastases are frequent sites of spread from solid organ malignancies. As bone metastases frequently cause significant morbidity for patients, it is critical to offer a treatment that can achieve rapid and durable symptomatic relief and local control, without being associated with serious risks of toxicity. Conventional palliative radiation therapy has a key treatment component in the multidisciplinary management of these patients; however, over the past decade, it has evolved to routinely deliver high biologically effective doses with precision in the form of stereotactic body radiation therapy. This change in paradigm is a result of the shifting landscape in cancer care, such that short-term pain relief is no longer the sole therapeutic aim for selected patients, and durable symptom relief and local tumor control are the goals. This review discusses the randomized prospective evidence, ongoing trials, approach to surveillance imaging, and treatment delivery for stereotactic body radiation therapy, to both spine and nonspine bone metastases, with a specific section on sacral metastases.
Autologous Micro-Fat Transplantation for Facial Sunken Treatment: Single-Center Experience
Authors: Jiang Mengyuan , Mao Xiyuan , Zhang Lu
Published: November 2024

Background:

Facial sunken deformities, congenital or acquired, are common in clinical practice for the reduction of soft or hard tissues. In clinical practice, filler injection and tissue transplantation are often used to improve facial contour. Among these, autologous fat grafting for treating facial contour defects is most common in clinical practice. Micro-fat, with relatively intact fat lobules, presents outstanding subcutaneous volumetric restoration and improvement of skin quality in skin rejuvenation.

Objectives:

This study showed our technique and experience of autologous micro-fat transplantation and its clinical effect on facial depression. The advantages and disadvantages between micro-fat transplantation and ordinary fat grafting for facial depression were also discussed.

Methods:

This study reviewed 22 facial sunken patients with micro-fat transplantation from February 2018 to December 2020. Participants under evaluation included 4 males and 18 females, with an average age of 38 years old. Surgical outcomes (defect augmentation, skin improvement), satisfaction (subjective and objective), and complication evaluations were performed for all participants.

Results:

During the follow-up (9.3±2.0 mo), the autologous micro-fat grafting led to prominent morphological adjustment with a low complication rate (1/22). Fourteen of the 22 patients (63.6%) achieved both objective and subjective satisfaction after a single treatment.

Conclusion:

This autologous micro-fat filling technology is a safe and ideal method for facial sunken correction, with persistent and stable postoperative outcomes.