bluuebunny/crossref_metadata_2025 huggingface dataset:
Administering the maternal appeasing substance before slaughter to improve carcass characteristics of finishing cattle
Authors: Mackey Shea J , Cooke Reinaldo F , Pickett Autumn T
Published: April 2024

Two experiments evaluated carcass characteristics of finishing steers administered the maternal bovine appeasing substance (mBAS) prior to slaughter. In Exp. 1, 954 Angus-influenced finishing steers housed in 6 original pens were used. Each original pen was split into a pair of experimental pens 14.3 d ± 3 d prior to slaughter, in a manner that number of steers and average pen body weight (BW; 636 ± 4 kg) were similar. An oiler containing mBAS (Ferappease Finish Cattle 5%; FERA Diagnostics and Biologicals; College Station, TX) was added to one of the experimental pens 7 d prior to slaughter (n = 6), whereas the other pen did not contain an oiler (CON; n = 6). The oiler delivered 120 mL of mBAS/steer during a 7-d period. Steer BW was recorded 7 d prior to and during loading (final BW) to the packing plant. No treatment effects were detected (P ≥ 0.51) for BW gain, final BW, and proportion of carcasses that graded Choice or Prime. Carcass dressing percentage was greater (P = 0.02) in mBAS compared with CON steers (65.9% vs. 64.2%; SEM = 0.5), which was not sufficient to impact hot carcass weight (HCW; P = 0.29). Incidence of dark-cutting carcasses did not differ between treatments (P = 0.23). In Exp. 2, 80 Angus-influenced finishing steers housed in 16 pens (5 steers/pen; 600 ± 4 kg of BW) were used. Pens were arranged in 4 rows of 4 pens/row, and rows were alternately assigned to receive an oiler containing mBAS (n = 8) or mineral oil (CON+; n = 8) 7 d prior to slaughter. Oilers were designed to deliver 120 mL/steer of mBAS or mineral oil during the 7-d period. Steer BW was recorded as in Exp. 1, and a blood sample was collected during exsanguination. No treatment effects were detected (P ≥ 0.20) for BW parameters, carcass marbling score, backfat thickness, Longissimus muscle area, yield grade, and proportion of carcasses that graded Choice or Prime. Carcass dressing was greater (P = 0.02) in mBAS steers compared with CON + (60.6 vs. 59.6%; SEM = 0.3) but HCW did not differ (P = 0.47) between treatments. Plasma cortisol concentration was less (P < 0.01) in mBAS steers compared with CON + (11.7 vs. 20.8 ng/mL; SEM = 1.6). Incidence of dark-cutting carcasses did not differ (P = 0.53) between treatments. In summary, mBAS administration to finishing cattle using oilers during the last 7 d on feed alleviated the adrenocortical stress response elicited by the process of slaughter, which likely resulted in increased carcass dressing.
UPLC-MS based metabonomics revealed the protective effects of Buyang Huanwu decoction on ischemic stroke rats
Authors: Wang Rou-jun , Ma Guang-chao , Yu Shun , Zhang Mei , Pu Shi-biao
Published: April 2024

Objective

Storke is a leading cause of death and disability affecting million people worldwide, 80% of which is ischemic stroke (IS). Recently, traditional Chinese medicines (TCMs) have received great attentions in treating IS due to their low poisonous effects and high safety. Buyang Huanwu Decoction (BHD), a famous and classical Chinese prescription, has been used for treating stroke-induced disability for centuries. Yet, its underlying mechanism is still in fancy.

Methods

We first constructed an IS model by middle cerebral artery occlusion (MCAO). Then, a metabonomics study on serum samples was performed using UHPLC-QTOF/MS, followed by multivariate data analysis including principal components analysis (PCA) and orthogonal partial least squares-discriminate analysis (OPLS-DA).

Results

Metabolic profiling of PCA indicated metabolic perturbation caused by MCAO was regulated by BHD back to normal levels, which is in agreement with the neurobehavioral evaluations. In the OPLS-DA, 12 metabolites were screened as potential biomarkers involved in MCAO-induced IS. Three metabolic pathways were recognized as the most relevant pathways, involving one carbon pool by folate, sphingolipid metabolism and inositol phosphate metabolism. BHD significantly reversed the abnormality of 7 metabolites to normal levels.

Conclusions

This is the first study to investigate the effect of BHD on IS at the metabolite level and to reveal the underlying mechanisms of BHD, which is complementary to neurobehavioral evaluation. In a broad sense, the current study brings novel and valuable insights to evaluate efficacy of TCMs, to interpret the action mechanisms, and to provide the theoretical basis for further research on the therapeutic mechanisms in clinical practice.
Risk of human leptospirosis in Colombia: spatiotemporal analysis and related hydroclimatic factors
Authors: Montenegro-Idrogo Juan José , Bonilla-Aldana D Katterine , Rodríguez-Morales Alfonso J
Published: April 2024

Background

Leptospirosis is an endemic zoonosis in tropical areas that is mainly related to rural activities; nevertheless, human leptospirosis (HL) outbreaks differ among regions. In Colombia, HL notifications are mandatory. Our objective was to determine the spatiotemporal distribution of HL in Colombia during 2007–2018 and its relationship with the main hydroclimatic variables.

Methods

We determined the estimated incidence and lethality of HL according to department and year. The Bayesian spatiotemporal analysis of an autoregressive model (STAR) model included HL cases and hydroclimatic factors (average temperature, rainfall and relative humidity) for quarterly periods.

Results

During the study period, 10 586 HL cases were registered (estimated incidence: 1.75 cases x 105) and 243 deaths by HL (lethality 2.3%). The STAR model found association of HL risk with temperature (RR:6.80; 95% CI 3.57 to 12.48) and space. Quindío and three other Amazonian departments (Guainía, Guaviare and Putumayo) had a positive relationship with a significant number of HL cases, adjusted for quarterly precipitation and humidity.

Conclusion

Spatial analysis showed a high risk of HL in departments of the western Andean Colombian regions. By contrast, in the spatiotemporal model, a higher HL risk was associated with temperature and departments of the North Colombian Amazon regions and Quindío in the Colombian Andean region.
Presymptomatic Leaf Reflectance of Fusarium virguliforme-Infected Soybean Plants in Greenhouse Conditions
Authors: Brown Mariama T. , Oh Sungchan , Rainey Katy M. , Telenko Darcy E. P.
Published: April 2024

Sudden death syndrome of soybean is caused by a soilborne pathogen, Fusarium virguliforme. Prior to visible foliar symptoms, a destructive technique can be carried out to diagnose root infection. Hyperspectral sensors can be a presymptomatic and nondestructive alternative for plant disease diagnosis. This study was designed to relate leaf spectral reflectance to F. virguliforme root infection in the absence of foliar symptoms. Soybean plants were grown under controlled greenhouse conditions. The spectral reflectance of the plants was measured weekly beginning at 21 days after transplanting up until 42 days after transplanting using a swing hyperspectral imaging system fixed on a gantry. Destructive root sampling confirmed F. virguliforme root infection using real-time PCR. The most relevant wavelengths for discrimination were selected using the ReliefF algorithm. Three machine learning models (partial least squares discriminant analysis, support vector machine, and random forest) were evaluated for classification accuracy using the selected wavelengths. Relevant wavelengths for differentiating between the healthy and F. virguliforme-infected plants were found in the visible and red-edge region from 500 to 750 nm and the shortwave infrared region from 1,400 to 2,350 nm. In the absence of visible foliar symptoms, classification results showed over 79% mean F1 scores for all models. Partial least squares discriminant analysis was able to differentiate healthy and F. virguliforme-infected plants with a mean F1 score of 83.1 to 85.3% and a kappa statistic of 0.43 to 0.54. This work supports the use of hyperspectral remote sensing for early presymptomatic disease diagnosis under a controlled environment.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Impact of Applicants’ Characteristics and Geographic Connections to Residency Programs on Preference Signaling Outcomes in the Match
Authors: Benjamin William J. , Lenze Nicholas R. , Bohm Lauren A. , Thorne Marc C. , Abraham Reeni , Sepdham Dan , Mihalic Angela P. , Kupfer Robbi A.
Published: April 2024

Purpose

To assess the impact of applicant and residency program characteristics on preference signaling outcomes in the Match during the first 2 years of implementation across 6 specialties.

Method

Data were obtained from the Texas Seeking Transparency in Application to Residency survey for applicants applying into otolaryngology during the 2020–2021 and 2021–2022 application cycles and into dermatology, internal medicine (categorical and preliminary year), general surgery, and urology during the 2021–2022 application cycle. The primary outcome was signal yield, defined as the number of interviews at signaled programs divided by the total number of signals sent. Associations with applicant-reported characteristics and geographic connections to residency programs were assessed using Wilcoxon rank sum testing, Spearman’s rank correlation testing, and ordinary least squares regression.

Results

1,749 applicants with preference signaling data were included from internal medicine (n = 884), general surgery (n = 291), otolaryngology (n = 217), dermatology (n = 147), urology (n = 124), and internal medicine preliminary year (n = 86). On average 60.9% (standard deviation 32.3%) of signals resulted in an interview (signal yield). There was a stepwise increase in signal yield with the percentage of signals sent to programs with a geographic connection (57.3% for no signals vs. 68.9% for 5 signals, P < .01). Signal yield was positively associated with applicant characteristics, such as United States Medical Licensing Exam Step 1 and 2 scores, honors society membership, and number of publications (P < .01). Applicants reporting a lower class rank quartile were significantly more likely to have a higher percentage of their interviews come from signaled programs (P < .01).

Conclusions

Signal yield is significantly associated with geographic connections to residency programs and applicant competitiveness based on traditional metrics. These findings can inform applicants, programs, and specialties as preference signaling grows.
Development and Pilot Testing of a Longitudinal Skills-Based Feedback and Conflict Resolution Curriculum for Internal Medicine Residents
Authors: Ortiz Worthington Rebeca , Sekar Dheepa , McNeil Melissa , Rothenberger Scott , Merriam Sarah
Published: April 2024

Problem

Physicians in training are responsible for leading clinical teams, coordinating interdisciplinary management, navigating conflict, and supervising and giving feedback to junior learners. Giving feedback and resolving conflict are key leadership skills for internal medicine (IM) residents, many of whom desire additional training. Although these skills are integral to successful leadership for physicians in training, residents receive little explicit education and existing curricula have not established best practices for skill acquisition.

Approach

Study authors designed a pilot longitudinal, skills-based curriculum to teach first- through third-year IM residents at the University of Pittsburgh how to give formative feedback and engage in conflict resolution. From February to May 2021, authors delivered a series of interactive lectures utilizing frameworks, workplace-based scenarios, skills practice, and discussion. Skills transfer was evaluated with novel pre- and postcurriculum objective structured clinical examinations (OSCEs) wherein participants played the role of senior resident. Each OSCE involved 2 feedback and 2 conflict resolution stations. OSCE performances were evaluated using an author-created checklist with a 1–4 rating scale. The exposure group comprised post-OSCE participants who attended the curriculum. Data were analyzed using a mixed effects regression model.

Outcomes

Thirty-six residents participated in curriculum evaluation, and 23 were included in postcurriculum data analysis. Within feedback, the skill “explores feedback content” significantly improved for exposure group participants (precurriculum median, 2.64; postcurriculum, 3.24; P < .05). For conflict resolution, among the exposure group, the skill “identifies a common goal, value, or purpose” significantly improved (pre, 3.10; post, 3.62; P < .05).

Next Steps

This curriculum and evaluation can serve as a stepping stone for further evidence-based leadership frameworks, curricula, and evaluations developed specifically for physicians within their unique leadership roles. The feedback and conflict resolution frameworks used in this curriculum can be applied to various medical specialties, with specialty-relevant scenario adaptations for interactive skills practice.
Social Network Analysis in Undergraduate and Postgraduate Medical Education: A Scoping Review
Authors: Steinert Yvonne , Fontes Kimberly , Mortaz-Hejri Sara , Quaiattini Andrea , Yousefi Nooraie Reza
Published: April 2024

Purpose

Social network analysis (SNA) is a theoretical framework and analytical approach used to study relationships among individuals and groups. While SNA has been employed by many disciplines to understand social structures and dynamics of interpersonal relationships, little is known about its use in medical education. Mapping and synthesizing the scope of SNA in undergraduate and postgraduate medical education can inform educational practice and research.

Method

This scoping review was based on searches conducted in Medline, Embase, Scopus, and ERIC in December 2020 and updated in March 2022. After removal of duplicates, the search strategy yielded 5,284 records, of which 153 met initial inclusion criteria. Team members conducted full-text reviews, extracted relevant data, and conducted descriptive and thematic analyses to determine how SNA has been used as a theoretical and analytical approach in undergraduate and postgraduate medical education.

Results

Thirty studies, from 11 countries, were retained. Most studies focused on undergraduate medical students, primarily in online environments, and explored students’ friendships, information sharing, and advice seeking through SNA. Few studies included residents and attending staff. Findings suggested that SNA can be a helpful tool for monitoring students’ interactions in online courses and clinical clerkships. SNA can also be used to examine the impact of social networks on achievement, the influence of social support and informal learning outside the classroom, and the role of homophily in learning. In clinical settings, SNA can help explore team dynamics and knowledge exchange among medical trainees.

Conclusions

While SNA has been underutilized in undergraduate and postgraduate medical education, findings indicate that SNA can help uncover the structure and impact of social networks in the classroom and the clinical setting. SNA can also be used to help design educational experiences, monitor learning, and evaluate pedagogical interventions. Future directions for SNA research in medical education are described.
In Search of a “Metric System” for Measuring Faculty Effort: A Qualitative Study on Educational Value Units at U.S. Medical Schools
Authors: Maggio Lauren A. , Costello Joseph A. , Kolars Joseph C. , Cervero Ronald M. , Jackson Kevin M. , Durning Steven J. , Ma TingLan
Published: April 2024

Purpose

Faculty at academic health centers (AHCs) are charged with engaging in educational activities. Some faculty have developed educational value units (EVUs) to track the time and effort dedicated to these activities. Although several AHCs have adopted EVUs, there is limited description of how AHCs engage with EVU development and implementation. This study aimed to understand the collective experiences of AHCs with EVUs to illuminate benefits and barriers to their development, use, and sustainability.

Method

Eleven faculty members based at 10 AHCs were interviewed between July and November 2022 to understand their experiences developing and implementing EVUs. Participants were asked to describe their experiences with EVUs and to reflect on benefits and barriers to their development, use, and sustainability. Transcripts were analyzed using thematic analysis.

Results

EVU initiatives have been designed and implemented in a variety of ways, with no AHCs engaging alike. Despite differences, the authors identified shared themes that highlighted benefits and barriers to EVU development and implementation. Within and between these themes, a series of tensions were identified in conjunction with the ways in which AHCs attempted to mitigate them. Related to barriers, the majority of participants abandoned or paused their EVU initiatives; however, no differences were identified between those AHCs that retained EVUs and those that did not.

Conclusions

The collective themes identified suggest that AHCs implementing or sustaining an EVU initiative would need to balance benefits and barriers in light of their unique context. Study findings align with reviews on EVUs and provide additional nuance related to faculty motivation to engage in education and the difficulties of defining EVUs. The lack of differences observed between those AHCs that retained EVUs and those that did not suggests that EVUs may be challenging to implement because of the complexity of AHCs and their faculty.
Hypotension Prediction Index Is Equally Effective in Predicting Intraoperative Hypotension during Noncardiac Surgery Compared to a Mean Arterial Pressure Threshold: A Prospective Observational Study
Authors: Mulder Marijn P. , Harmannij-Markusse Mirjam , Fresiello Libera , Donker Dirk W. , Potters Jan-Willem
Published: April 2024

Background

The Hypotension Prediction Index is designed to predict intraoperative hypotension in a timely manner and is based on arterial waveform analysis using machine learning. It has recently been suggested that this algorithm is highly correlated with the mean arterial pressure itself. Therefore, the aim of this study was to compare the index with mean arterial pressure–based prediction methods, and it is hypothesized that their ability to predict hypotension is comparable.

Methods

In this observational study, the Hypotension Prediction Index was used in addition to routine intraoperative monitoring during moderate- to high-risk elective noncardiac surgery. The agreement in time between the default Hypotension Prediction Index alarm (greater than 85) and different concurrent mean arterial pressure thresholds was evaluated. Additionally, the predictive performance of the index and different mean arterial pressure–based methods were assessed within 5, 10, and 15 min before hypotension occurred.

Results

A total of 100 patients were included. A mean arterial pressure threshold of 73 mmHg agreed 97% of the time with the default index alarm, whereas a mean arterial pressure threshold of 72 mmHg had the most comparable predictive performance. The areas under the receiver operating characteristic curve of the Hypotension Prediction Index (0.89 [0.88 to 0.89]) and concurrent mean arterial pressure (0.88 [0.88 to 0.89]) were almost identical for predicting hypotension within 5 min, outperforming both linearly extrapolated mean arterial pressure (0.85 [0.84 to 0.85]) and delta mean arterial pressure (0.66 [0.65 to 0.67]). The positive predictive value was 31.9 (31.3 to 32.6)% for the default index alarm and 32.9 (32.2 to 33.6)% for a mean arterial pressure threshold of 72 mmHg.

Conclusions

In clinical practice, the Hypotension Prediction Index alarms are highly similar to those derived from mean arterial pressure, which implies that the machine learning algorithm could be substituted by an alarm based on a mean arterial pressure threshold set at 72 or 73 mmHg. Further research on intraoperative hypotension prediction should therefore include comparison with mean arterial pressure–based alarms and related effects on patient outcome.

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Radiation Proctitis in Patients With Locally Advanced Cervical Cancer Treated by Chemoradiation
Authors: Sauvage Louis-Marie , Bentahila Rita , Tran Yohan , Guénégou-Arnoux Armelle , Fabiano Emmanuelle , Bats Anne-Sophie , Borghese Bruno , Durdux Catherine
Published: April 2024

Background:

Radiation proctitis is a misunderstanding complication of chemoradiation in locally advanced cervical cancer. The objective of our study is to provide a detailed description and analysis of predictive factors associated with radiation proctitis in a retrospective cohort of patients treated by chemoradiation for locally advanced cervical cancer.

Methods:

All patients treated by exclusive chemoradiation or chemoradiation followed by brachytherapy for locally advanced cervical cancer from 2011 to 2017 were included in the study. A bivariate analysis was conducted to establish correlations between the occurrence of radiation proctitis and various clinical and technical variables.

Results:

A total of 128 patients were included in the study. The mean dose (SD) to the planning target volume was 47.1 Gy (6.2). Fifty-nine (46.1%) patients underwent brachytherapy. Sixteen patients (12.5%) developed radiation proctitis, grade 2 or higher in 12 patients (9.3%). In univariate analysis, anticoagulant or antiplatelet treatments (P=0.039), older age (P=0.049), rectal volume irradiated at 40 Gy (P=0.01) and 30 Gy (P=0.037) were significantly associated with the occurrence of a grade ≥2 radiation proctitis. The delivered dose to 2 cm3 of rectum (D2cm3) showed a potential association with the occurrence of radiation proctitis of all grades (P=0.064).

Conclusion:

This study highlights clinical and technical factors that should be considered in assessing the risk of radiation proctitis. These results contribute to a better understanding of this complication.
Implementation and Mixed-Methods Assessment of an Early Mobility Interprofessional Education Simulation
Authors: Smith Leslie M. , Campbell Denise , Prush Nicholas , Trojanowski Suzanne , Sherman Erica , Yost Elizabeth
Published: April 2024

Introduction

Extended periods of bed rest and mechanical ventilation (MV) have devastating effects on the body.

Background

Early mobility (EM) for patients in respiratory failure is safe and feasible, and an interprofessional team is recommended. Using simulation to train EM skills improves student confidence. The purpose of this study was to enable health care student collaboration as an interprofessional team in providing safe management and monitoring during an EM simulation for a patient requiring MV.

Methods

Nursing (n = 33), respiratory (n = 7), occupational (n = 24), and physical therapist students (n = 55) participated in an EM interprofessional education (IPE) simulation experience. A mixed-methods analytic approach was used with pre/post quantitative analysis of the Student Perceptions of Interprofessional Clinical Education—Revised, Version 2 instrument and qualitative analysis of students' guided reflection papers.

Results

Pre/post surveys completion rate was 39.5% (n = 47). The Student Perceptions of Interprofessional Clinical Education—Revised, Version 2 instrument indicated a significant improvement (P = .037) in students' perceptions of interprofessional collaborative practice. Qualitative data showed a positive response to the EM simulation IPE. Themes reflected all 4 Interprofessional Education Collaborative competencies.

Discussion

This study demonstrated improved perception of interprofessional collaborative practice and better understanding of the Interprofessional Education Collaborative competencies.

Conclusion

Students collaborated in the simulation-based IPE to provide EM for a patient requiring MV and reported perceived benefits of the experience.
Nuclear KRT19 is a transcriptional corepressor promoting histone deacetylation and liver tumorigenesis
Authors: Han Shixun , Fan Haonan , Zhong Guoxuan , Ni Lei , Shi Wenhao , Fang Yushan , Wang Chenliang , Wang Li , Song Lang , Zhao Jianhui , Tang Mei , Yang Bing , Li Li , Bai Xueli , Zhang Qi , Liang Tingbo , Xu Yanhui , Feng Xin-Hua , Ding Chen , Fang Dong , Zhao Bin
Published: April 2024

Background and Aims:

Epigenetic reprogramming and escape from terminal differentiation are poorly understood enabling characteristics of liver cancer. Keratin 19 (KRT19), classically known to form the intermediate filament cytoskeleton, is a marker of stemness and worse prognosis in liver cancer. This study aimed to address the functional roles of KRT19 in liver tumorigenesis and to elucidate the underlying mechanisms.

Approach and Results:

Using multiplexed genome editing of hepatocytes in vivo, we demonstrated that KRT19 promoted liver tumorigenesis in mice. Cell fractionation revealed a previously unrecognized nuclear fraction of KRT19. Tandem affinity purification identified histone deacetylase 1 and REST corepressor 1, components of the corepressor of RE-1 silencing transcription factor (CoREST) complex as KRT19-interacting proteins. KRT19 knockout markedly enhanced histone acetylation levels. Mechanistically, KRT19 promotes CoREST complex formation by enhancing histone deacetylase 1 and REST corepressor 1 interaction, thus increasing the deacetylase activity. ChIP-seq revealed hepatocyte-specific genes, such as hepatocyte nuclear factor 4 alpha (HNF4A), as direct targets of KRT19-CoREST. In addition, we identified forkhead box P4 as a direct activator of aberrant KRT19 expression in liver cancer. Furthermore, treatment of primary liver tumors and patient-derived xenografts in mice suggest that KRT19 expression has the potential to predict response to histone deacetylase 1 inhibitors especially in combination with lenvatinib.

Conclusions:

Our data show that nuclear KRT19 acts as a transcriptional corepressor through promoting the deacetylase activity of the CoREST complex, resulting in dedifferentiation of liver cancer. These findings reveal a previously unrecognized function of KRT19 in directly shaping the epigenetic landscape in cancer.
Comprehensive pan-cancer analysis of 33 human cancers reveals immunotherapeutic value of focal adhesion tyrosine kinase
Authors: Shi Yujing , Ju Mengyang , Zhang Yumeng , Liang Liang , Sun Xinchen , Di Xiaoke
Published: April 2024

The immune environment in tumors is the key factor affecting the survival and immunotherapeutic response of patients. This research aimed to explore the underlying association between focal adhesion tyrosine kinase (FAK/PTK2) and cancer immunotherapy in 33 human cancers. Gene expression data and clinical features of 33 cancers were retrieved from the Cancer Genome Atlas Database. The immunotherapy cohorts included GSE67501, GSE78220, and IMVIGOR210, which were derived from the comprehensive gene expression database or from previous studies. Clinical parameters including patient age, gender, survival rate, and tumor stage were analyzed to evaluate the prognostic value of FAK/PTK2. FAK/PTK2 activity was detected by single-sample gene set enrichment analysis and used to compare the difference between FAK/PTK2 transcriptome and protein expression levels. To better understand the role of FAK/PTK2 in cancer immunotherapy, we analyzed its correlations with tumor microenvironment and with immune processes/elements (e.g., immune cell infiltration, immunosuppressants, and stimulants) and major histocompatible complexes. Potential pathways associated with FAK/PTK2 signaling in cancers were also explored. Correlations between FAK/PTK2 and 2 immunotherapeutic biomarkers (tumor mutation load and microsatellite instability) were studied. Finally, the 3 independent immunotherapy cohorts were used to study the relationship between FAK/PTK2 and immunotherapeutic response. Although FAK/PTK2 is not closely associated with age (13/33), gender (5/33), or tumor stage (5/33) in any of the studied human cancers, it has potential prognostic value for predicting patient survival. Consistency between FAK/PTK2 activity and expression exists in some cancers (3/33). Generally, FAK/PTK2 is robustly correlated with immune cell infiltration, immune modulators, and immunotherapeutic markers. Moreover, high FAK/PTK2 expression is significantly related to immune-relevant pathways. However, FAK/PTK2 is not significantly correlated with the immunotherapeutic response. Research on the immunotherapeutic value of FAK/PTK2 in 33 human cancers provides evidence regarding the function of FAK/PTK2 and its role in clinical treatment. However, given the use of a bioinformatics approach, our results are preliminary and require further validation.
Efficacy and safety of stem cells in the treatment of ischemic stroke: A meta-analysis
Authors: Xiong Yu , Guo Xiumei , Gao Wen , Ke Chuhan , Huang Xinyue , Pan Zhigang , Chen Chunhui , Zheng Hanlin , Hu Weipeng , Zheng Feng , Yao Hao
Published: April 2024

Background:

Stem cell therapy on ischemic stroke has long been studied using animal experiments. The efficacy and safety of this treatment in ischemic stroke patients remain uncertain.

Methods:

We searched for all clinical randomized controlled trials published before October 2023, on PubMed, EMBASE, and the Cochrane Library using predetermined search terms, and performed a meta-analysis of the efficacy of stem cell therapy in ischemic stroke patients.

Results:

13 studies that included 592 ischemic stroke patients were reviewed. The mRS (MD −0.32, 95% CI −0.64 to 0.00, I
2 = 63%, P = .05), NIHSS (MD −1.63, 95% CI −2.69 to −0.57, I
2 = 58%, P = .003), and BI (MD 14.22, 95% CI 3.95–24.48, I
2 = 43%, P = .007) showed effective stem cell therapy. The mortality (OR 0.42, 95% CI 0.23–0.79, I
2 = 0%, P = .007) showed improved prognosis and reduce mortality with stem cell therapy.

Conclusion:

Stem cell therapy reduces mortality and improves the neurological prognosis of ischemic stroke patients. However, due to the different types of stem cells used and the limited data in the reported studies, the safety of clinical applications of stem cells in patients with ischemic stroke must be carefully evaluated. Future randomized controlled trials with large sample sizes from controlled cell sources are warranted to validate this finding.
Unmasking a hidden culprit: late-presenting congenital diaphragmatic hernia beyond infancy: A case report and literature review
Authors: Koh Wen-Harn , Ko Po-Jui , Su Yu-Tsun , Tsai Yu-Cheng , Kek Ho-Poh , Tsai Ching-Chung
Published: April 2024

Background:

Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with abnormal diaphragm development, typically diagnosed prenatally or soon after birth. Late-presenting CDH presents diagnostic challenges due to nonspecific symptoms that can lead to misdiagnoses.

Methods:

This report discusses a 35-month-old female initially presenting with predominant gastrointestinal symptoms and minimal respiratory distress. Initial radiographic findings suggested a left tension pneumothorax, prompting further investigation.

Results:

Subsequent diagnostic efforts revealed a Bochdalek-type left CDH, with several abdominal organs herniated into the thoracic cavity. The case was managed through laparotomy, where herniated contents were successfully repositioned into the abdominal cavity. This intervention underscores the need for high clinical suspicion and the importance of distinguishing between similar presentations, such as tension pneumothorax and tension gastrothorax, which require different management strategies.

Conclusion:

The case illustrates the importance of considering CDH in differential diagnoses for older pediatric patients with atypical symptoms. Early recognition and appropriate management are key to improving patient outcomes.
Early respiratory interventional therapy combined with antifungal agent for endobronchial cryptococcosis: A case report and literature review.
Authors: Li Qinglan , Wen Daxiong , Chen Yong , Yang Longfeng , Li Jing , Luo Shaohua
Published: April 2024

Rationale:

Cryptococcosis presenting as endobronchial obstruction and lung collapse is an extremely rare occurrence. While these patients were treated with antifungal agents, unfortunately, half of them showed a suboptimal response.

Patient concerns:

A 45-year-old immunocompetent male was admitted to the hospital due to a cough, yellow phlegm, and dyspnea persisting for 5 months. Chest computer tomography revealed a mass in the right main bronchus accompanied by right lower lobe atelectasis.

Diagnoses:

Endobronchial cryptococcosis presenting as endobronchial obstruction and lung collapse.

Interventions:

Early rigid bronchoscopic therapy was performed to resect endobronchial obstruction, which combined with antifungal agent.

Outcomes:

The patient recovered well with completely clinical and radiologic resolution at 1 year follow-up.

Lessons:

This case provides a good example of successful utilization of the early respiratory interventional therapy combined with antifungal agent in obstructive endobronchial cryptococcosis.
Nurses’ comfort and well-being: A descriptive study to find out the relationship between nurses’ awareness of self-comfort and well-being at long-term care settings in the state of Kuwait
Authors: Abdelaliem Sally Mohammed Farghaly , Saed Boswihi Hasna’a Salem
Published: April 2024

The study aims to examine out nurses’ awareness of self-comfort and well-being in long-term care settings in the state of Kuwait to avoid profession burnout. Nurses are vital resource to health care institutions, the attention on nurses’ comfort and well-being should be given valued concerns by top management, as poor staff well-being can pose risks among them and may result in poor performance such as less quality care that is result from less productivity and if the staff well-being ignored the institution performance might be underachieved. A descriptive cross-sectional study design was utilized. The questionnaire assessed participants’ socio-demographic data, comfort, and well-being. Data were collected from 260 (86.7% response rate) nurses over the course of 3 months from long-term care facilities in 2 different organizations in Kuwait. The overall nurses’ comfort level was moderate with a mean percent score of 67.55 ± 12.50. However, the overall nurses’ well-being level was low with a mean percent score of 49.58 ± 6.93. As well as, a strong, positive, and significant correlation was noticed between overall nurses’ comfort and its domains with the overall nurses’ well-being and its domain. The regression analysis revealed that nurses’ perception of their comfort may predict their well-being (P < .001) and explained 34% of the variation in nurses’ well-being (R
2 = 0.470, β = 0.428, F = 34.762, P < .001). This study emphasized on the importance of creating a healthy, comfortable work environment that promotes nurses’ well-being, as well as eliminating discomfort and job dissatisfaction from the organizational culture among nurses as it effects on the organizational performance, productivity, and quality of care.
A bibliometric analysis of non-coding RNA studies in acute pancreatitis
Authors: Zhu Xiaodong , Liu Kunrong , Tang Xiping , Chen Guozhong
Published: April 2024

Background:

Non-coding RNA (ncRNA) is a type of RNA that does not code for proteins and plays a crucial role in the onset, progression, diagnosis, and therapy of acute pancreatitis. However, bibliometric, and visual analyses of studies on acute pancreatitis and ncRNA are lacking. This study seeks to provide a bibliometric overview of the knowledge structure and research hotspots of ncRNA in the field of acute pancreatitis research.

Materials and methods:

Literature search and collection of information in the field of ncRNA-related research in acute pancreatitis from 2000-2023 through the Web of Science Core Collection. Use CiteSpace and VOSviewer to visually analyze countries, institutions, authors, and keywords.

Results:

A total of 563 articles have been published in the field of ncRNA-related research in acute pancreatitis, and the number of publications in this field is gradually increasing. The largest number of publications was from China. Four clusters were produced by the co-occurrence cluster analysis of the top 89 keywords: studies of ncRNA in inflammation, autophagy, and apoptosis in acute pancreatitis; studies related to microRNA expression in pancreatic cancer among ncRNA; studies related to microRNAs as diagnostic and therapeutic markers in acute pancreatitis; and studies related to ncRNA in acute pancreatitis; The key words “injury,” “pathway” and “extracellular vesicles” are the key words of emerging research hotspots.

Conclusion:

In conclusion, ncRNA research in acute pancreatitis is an established discipline. Researchers can use the research hotspots and frontiers in this field as a guide for choosing their research direction.
The effect of hyperbaric oxygen therapy on hematological indices and biochemical parameters in patients with diabetic foot
Authors: Ercan Erdinç , Aydin Gamze , Erdoğan Bülent , Özçelik Fatih
Published: April 2024

Background:

Diabetes Mellitus (DM) is a metabolic disease with a high morbidity and mortality and increasing in prevalence all over the world. Due to the hypoxic, ischemic, inflammatory, and infective environment in DM, diabetic foot ulcers have been treated with medico-surgical interventions and adjuvant hyperbaric oxygen Therapy (HBOT). The purpose of this study was to evaluate the effects of HBOT on hematological indices and biochemical parameters in patients with diabetic foot.

Methods:

The study group was formed from the file records of 103 male patients who applied to Yunus Emre State Hospital HBOT Center between September 1, 2016 and December 31, 2020, and were treated HBOT with a multidisciplinary approach.

Results:

There were negative low correlations between number of HBOT sessions and Mean Corpuscular Hemoglobin (MCH) (P = .037, r = −0.207) and Blood Urea Nitrogen (BUN) (P = .037, r = −0.222). White Blood Cell Count (WBC), Neutrophils (NEU), Monocytes (MON), Platelet Count (PLT), and Plateletcrit (PTC) parameters were found to be decreased, and an increase in lymphocytes (LYM), Eosinophils (EOS), Mean Corpuscular Hemoglobin Concentration (MCHC), and Red Cell Distribution Width (RDW) parameters were detected after the treatments (P < .05). Again, after the treatment, glucose (Glu), C-Reactive Protein (CRP), direct bilirubin, and total protein (TP) levels were decreased, and uric acid (UA) levels increased (P < .05).

Conclusion:

HBOT improved hematological indices in patients and had a beneficial effect on biochemical parameters, particularly Glu and CRP levels. Adjuvant HBOT alleviates diabetic inflammation and has a beneficial effect on diabetic patient treatment.
Comprehensive assessment of the effects of concurrent strength and endurance training on lipid profile, glycemic control, and insulin resistance in type 2 diabetes: A meta-analysis
Authors: Sun Yaowei , Lu Bin , Su Wenbo , Song Xu , Shang Xueyan , Zheng Jing , Wang Jing , Yun Hezhang
Published: April 2024

Background:

To investigate the effect of concurrent strength combined with endurance training on the lipid and glucose profile of type 2 diabetes mellitus (T2DM) using Meta-analysis.

Methods:

The literature was searched from PubMed, Web of Science, EBSCO, and China National Knowledge Infrastructure(CNKI) databases for relevant randomized controlled trials with dates from the date of establishment to June 2023, and the included studies were individually assessed according to the Cochrane Risk of Bias tool in the Cochrane Systematic Assessor’s Handbook, and the data were analyzed using RevMan 5.4 analysis software to analyze and process the data.

Results:

A total of 9 articles were included, including 589 subjects, including 308 in the experimental group and 281 in the control group. The results of Meta analysis showed that concurrent strength combined with endurance training improved TC (SMD = −1.12, 95% CI = [−1.81, −0.44], P < 0.01), TG (SMD = −0.46, 95% CI = [−0.85, −0.07], P < 0.05), LDL-C (SMD = −1.3, 95% CI = [−2.09, −0.50], P < 0.01), HDL-C (SMD = 0.61, 95% CI = [0.05, 1.17], P < 0.05), FBG (SMD = −0.65, 95% CI = [−1.27, −0.04], P < 0.05), HOMA-IR (SMD = −1.23, 95% CI = [−2.40, −0.06], P < 0.05).

Conclusion:

Concurrent strength combined with endurance training has a positive effect on the improvement of lipid and glucose profile in patients with type 2 diabetes.
Efficacy and safety of nalbuphine for epidural labor analgesia at high altitude: An observational study
Authors: Wang Pengxia , Yu Ping , Cheng Sen , Wu Xinting , Li Xuemei , Zeng Yinying , Liu Shanshan
Published: April 2024

Xining is located at the eastern edge of the Qinghai-Tibet Plateau, with an average altitude of >7000 feet (>2000 m). Nalbuphine is a kappa-opioid receptor agonist that can provide analgesia with fewer side effects than other opioid analgesics. This study aimed to evaluate pain control, side effects, and neonatal outcomes from combining nalbuphine with sufentanil and ropivacaine in 600 women during epidural anesthesia while giving birth at a high altitude in Xining, China. A total of 600 parturients receiving epidural labor analgesia were randomly divided into 2 groups, each group 300 parturients. The nalbuphine group received nalbuphine, sufentanil, and ropivacain, the control group only received sufentanil and ropivacain. The analgesic effect was evaluated through the Visual Analogue Scale scores. Neonatal outcomes were mainly evaluated through the Apgar Scores. Compared to the control group, the nalbuphine group showed lower Visual Analogue Scale scores at all time points after analgesia (P < .05). In comparison with the control group, parturients in the nalbuphine group showed lower incidence rates of fever at delivery, 24-hour postpartum bleeding, and pruritus (P < .05). However, between the 2 groups, there were no statistically significant differences in the remaining maternal and infant outcomes and neonatal outcomes (P > .05). Moreover, no adverse effects on neonatal outcomes were observed. The findings from this study support findings from previous studies that nalbuphine provided safe epidural analgesia without significant side effects for the mother and infant, and showed both safety and efficacy when used during labor at high altitude.
Folliculitis might be associated with pathergy-positivity in patients with Behçet syndrome
Authors: Altan Ferhatoğlu Zeynep , Altinişik Dursun Dorukhan , Özdede Ayşe , Özkoca Defne , Güner Sabriye , Yildiz Kadir Atacan , Kutlubay Zekayi , Seyahi Emire , Hamuryudan Vedat
Published: April 2024

Pathergy test indicates nonspecific hyper-reactivity of the skin to aseptic trauma in Behçet syndrome (BS) and is considered as an adjunctive diagnostic test with a good specificity albeit with low sensitivity. We tested the hypothesis that a relationship exists between active clinical manifestations of BS and the pathergy-positivity when performed simultaneously. Pathergy test and detailed dermatologic examination were done in 105 BS patients (60M/45F); who were seen consecutively at the multi-disciplinary BS outpatient clinic in a single tertiary center. Information regarding demographic and clinical characteristics, pathergy test results at diagnosis, and details about treatment were obtained from patient charts. Disease activity was assessed using Behçet Disease Current Activity Form. Among 105 patients, 27 (25.7%) were pathergy-positive at the time of the study visit whereas 40.9% were pathergy-positive at the time of the diagnosis. There was no relation between pathergy test and patient age or disease duration, either. Pathergy-positivity was significantly more common in patients with folliculitis compared to those without folliculitis (40.7% vs 19.2%; P = .026). The test was also positive in all 3 patients with leg ulcers due to venous stasis. We found that among all skin-mucosa lesions only the presence of folliculitis was associated with pathergy positivity with statistical significance. It was also remarkable that the current pathergy was positive in all 3 patients with active leg ulcers but this finding warrants further studies because of the low patient numbers.
Immune checkpoint inhibitor-related adrenal hypofunction and Psoriasisby induced by tislelizumab: A case report and review of literature
Authors: Deng Yisi , Huang Manling , Deng Runpei , Wang Jun
Published: April 2024

Rationale:

Immune-related adverse events following treatment with immune checkpoint inhibitors can affect almost every organ. Tislelizumab, a novel humanized Ig G4 programmed death receptor 1 inhibitor, was started for bladder cancer in 2019, but the adverse effects of this drug may not yet be known due to its short time on the market, and there are still some clinical safety concerns. There are few reports of adrenal insufficiency after tislelizumab treatment, which is easily missed, misdiagnosed and life-threatening.

Patient concerns:

A 67-year-old male with bladder cancer who developed rash, water-sodium retention, electrolyte disturbances, hypoalbuminemia, low-grade fever, nausea and vomiting, and fatigue after 2 cycles of tislelizumab.

Diagnosis:

Immune checkpoint inhibitor-related adrenal hypofunction and Psoriasisby.

Interventions:

Suspended tislelizumab treatment and continued glucocorticoid therapy.

Outcomes:

The patient showed significant improvement in the above symptoms. But bladder cancer reemerged at the same site.

Conclusions:

The advent of immune-related adverse events has increased the complexity of the application of tislelizumab in the treatment of bladder cancer and further research is needed to develop the best treatment guidelines. Early diagnosis and treatment are crucial since the adverse events could endanger lives.
Sacubitril/valsartan can improve the cardiac function in heart failure patients with a history of cancer: An observational study
Authors: Chen Zhulu , Zhang Chuan , Zhu Yuxi , Gao Diansa , Mao Min , Zuo Zhong
Published: April 2024

Sacubitril/Valsartan, the combination of angiotensin receptor inhibitor and neprilysin inhibitor, is now becoming the class 1 recommendation for HFrEF. Some studies have shown the positive effect of Sacubitril/Valsartan on HFrEF cancer patients, while there is devoid of evidence about the effect of this drug in aged cancer patients with HFmrEF and HFpEF. By searching the patients with a diagnosis of both cancer and Heart failure (HF) over 65, the patients who had received treatment with Sacubitril/Valsartan were selected as the candidates for Sacubitril/Valsartan group, and the patients who had received conventional HF therapy without Sacubitril/Valsartan were chosen as the control group. Data were collected for up to 9 months. We filtered 38 patients and 50 patients valid for Sacubitril/Valsartan group and control group, respectively. After initiation of heart failure management, our study found a better cardiac condition in Sacubitril/Valsartan group, having better LVEF, LVFS, NT-proBNP in 3rd, 6th, 9th month (P < .05) and better NYHA function classification after the treatment. We also observed fewer cases of deterioration on LAD (P = .029) and LVEDD (P = .023) in Sacubitril/Valsartan group. In subgroup analysis, our study showed that all 3 kinds of HF patients had better LVEF, LVFS, and NT-proBNP in Sacubitril/Valsartan group (P < .05). Our study further indicated that Sacubitril/Valsartan can improve cardiac function and benefit cardiac remolding in aged cancer patients of all 3 kinds of HF. This is the first study to provide new evidence for the use of Sacubitril/Valsartan in aged cancer patients of 3 kinds of HF.