bluuebunny/crossref_metadata_2025 huggingface dataset:
Highly engaging events reveal semantic and temporal compression in online community discourse
Authors: Desiderio Antonio , Mancini Anna , Cimini Giulio , Di Clemente Riccardo
Published: February 2025

People nowadays express their opinions in online spaces, using different forms of interactions such as posting, sharing and discussing with one another. How do these digital traces change in response to events happening in the real world? We leverage Reddit conversation data, exploiting its community-based structure, to elucidate how offline events influence online user interactions and behavior. Online conversations, as posts and comments, are analysed along their temporal and semantic dimensions. Conversations tend to become repetitive with a more limited vocabulary, develop at a faster pace, and feature heightened emotions. As the event approaches, the shifts occurring in conversations are reflected in the users’ dynamics. Users become more active and they exchange information with a growing audience, despite using a less rich vocabulary and repetitive messages. The recurring patterns we discovered are persistent across a wide range of events and several contexts, representing a fingerprint of how online dynamics change in response to real-world occurrences.
The development of a keratoacanthoma following injection of hyaluronic acid–based dermal fillers into the lips
Authors: Mackender Emma , Kamp Erin , Hendrix Nicole , Nardini Nastassia , Drake Paul
Published: February 2025

This case report illustrates an unusual case of a keratoacanthoma (KA) developing on the lips following repeated injections with hyaluronic acid-based dermal fillers. Hyaluronic acid dermal fillers dominate nonsurgical aesthetic treatments in the UK due to their effectiveness, while also being relatively safe. The vast increase in various filler products has resulted in an increase in adverse events, although these likely remain under-reported. There have been no previously reported cases of KA directly post-hyaluronic acid injections, and KAs are not currently considered a side-effect. The patient in our case had several risk factors for developing a KA, including high sun exposure and smoking, as well as a history of repeated injections performed by a lay practitioner. Moreover, poor injection technique and repeated trauma to the lips from the injections are also likely to be implicated. Given the all-time high increase in demand for cosmetic dermal fillers, we believe that KA should be considered a possible adverse reaction of dermal fillers, particularly in patients with other significant risk factors for KA development.
Early Soybean-Nematode Interactions: Transcriptomic Responses of Meloidogyne incognita at the Pre-Parasitic Stage and Metabolomic Profiling of Root Exudates
Authors: Dou Yuewen , Jiang Ye , Huang Minghui , Jiang Dan , Chang Doudou , Wu Lili , Wang Qi , Guo Lei , Wei Liuli , Xu Binyu , Li Chunjie , Wang Congli
Published: February 2025

Understanding the molecular and metabolic interplay between Meloidogyne incognita and soybean (Glycine max) root exudates is essential for unraveling plant-nematode interactions. This study investigates the transcriptomic responses of M. incognita during the pre-parasitic stage and the metabolomic changes in soybean root exudates influenced by nematode activity. Transcriptomic analysis identified 846 differentially expressed genes in nematodes exposed to root exudates (S-Mi) compared to nematodes alone (Mi). Upregulated genes, including those encoding sensory receptors such as G-protein coupled receptors, nuclear hormone receptors, acetylcholine receptors (AChRs), and key effectors, indicate a shift toward parasitic readiness. The downregulation of detoxification genes (e.g., cytochrome P450) and the upregulation of lysosome-related genes, such as cathepsins L-like cysteine proteases suggest metabolic reprogramming to support infection. Metabolomic profiling identified 781 metabolites across S-Mi, Mi, and Soy (root exudates alone), with enriched pathways such as tyrosine metabolism and cytochrome P450-related detoxification. Interestingly, amino acids like L-threonine and arginylthreonine were upregulated in S-Mi, suggesting their role in nematode attraction. Additionally, lipid-like metabolites, such as 3-epipapyriferic acid and physagulin F, were elevated, potentially influencing nematode behavior and modulating plant defense response. An integrated cellular model illustrates how nematode sensory receptors detect root signals, activating cAMP, PLC, and MAPK signaling cascades, as well as AChR-mediated ion channels, leading to effector gene activation and metabolic shifts. This study reveals a bidirectional interaction at the pre-parasitic stage, where soybean root exudates reprogram nematode metabolism, while nematodes, in turn, modify root exudates to influence plant defenses, offering novel targets for sustainable nematode management.
Alcoholic Cardiomyopathy in Patients With Advanced Alcoholic Liver Disease: Single-Center Experience and Review of Literature
Authors: Dhand Roshan , Okumura Kenji , Wolfe Kevin , Bodin Roxana , Nishida Seigo , Frishman William H. , Dhand Abhay
Published: February 2025

The impact of excessive alcohol on human health is associated with a lifetime cumulative use of alcohol and is further affected by various factors such as age, gender, nutritional status, concurrent cigarette smoking or drug use, diabetes, obesity, other cardiovascular diseases, and socio-economic status. Alcohol cardiomyopathy (ACM) is a type of acquired dilated cardiomyopathy, which is associated with long-term heavy alcohol consumption with historical rates varying from 3.8% to 47 % among patients with heart failure. Data regarding the prevalence of concurrent ACM in patients with alcoholic liver disease is limited. Among 483 patients with advanced liver disease who underwent liver transplant evaluation at a single transplant center during 2016–2021, based on screening transthoracic echocardiogram and a clear definition, none (0%) of the patients had alcoholic cardiomyopathy (range ejection fraction: 55–80%), 7% had left ventricular dilation (mild dilation: 82%), and 12.4% had diastolic dysfunction. We also review data regarding known risk factors, natural progression, and treatment of ACM, and further explore the evidence regarding the concurrence of alcohol-associated disease in liver with other organs such as heart and pancreas. In persons with excessive alcohol consumption, abstinence from alcohol or moderating its use has been shown to help decrease the progression of heart failure, arrythmias, and hypertension as well as liver dysfunction. Focus on the identification of both genetic markers and modifiable risk factors associated with various organ injuries in conjunction with public health policies for the safe use of alcohol is needed to mitigate the risk of alcohol use disorder.
Effectiveness of Mental Health Treatment Interventions for At-Risk Youth Within the Minnesota Runaway Intervention Program
Authors: Triliegi Romana , Fleming Elizabeth , LaBore Kathryn , Hurtley Karla
Published: February 2025

The Runaway Intervention Program (RIP) is a strengths-based, nurse-led home visitation and case management model for runaway youth at risk of sexual exploitation, violence, and mental health challenges. RIP aims to promote healthy development, reduce trauma responses, and lower risk behaviors. This study evaluates the effectiveness of three optional psychological interventions—individual therapy, group therapy, and combined therapy—administered by licensed mental health practitioners. Using archival data from 128 RIP participants enrolled between 2015 and 2019, the study assessed pretreatment and posttreatment posttraumatic stress disorder (PTSD) symptoms using the University of California Posttraumatic Stress Disorder Index.

Statistical analysis suggested a reduction in PTSD symptoms from pretreatment (M = 35.33, SD = 15.29) to posttreatment (M = 22.91, SD = 16.31), regardless of treatment type. There was no significant difference in symptom reduction between the three treatment modalities, indicating comparable effectiveness across modalities. Across all treatment modalities, clinically significant change analysis showed that 41% of participants recovered, 51% showed no change, 2% improved, and 6% deteriorated. These findings suggest that although RIP interventions effectively reduce PTSD symptoms, no single modality outperformed the others. The results underscore the value of flexible therapeutic options to address the diverse needs of runaway youth.
Identifying Human Trafficking in the Hospital via an Abuse Screening Tool
Authors: Weiss Kali , Harland Karisa K. , Findlay Shannon
Published: February 2025

Introduction

Healthcare professionals play a vital role in the identification and assistance of individuals affected by trafficking who are seen in the healthcare setting. The objective of this project was to analyze a screening tool with newly added questions specifically geared at human trafficking and determine its efficacy in identifying trafficked persons who were seen in the emergency department or who were inpatients.

Methods

This retrospective cohort study occurred at a large Level 1 trauma center located in the Midwest. Nursing staff administered a mandatory Abuse Risk + Human Trafficking tool. A retrospective chart review was conducted. Data from the abuse screen were reviewed from April 1, 2021, to February 28, 2023.

Results

Of all positive screens on the Abuse Risk + Human Trafficking tool, 33% were positive for at least one human trafficking question. Among those with a positive screen on the human trafficking questions, 25 screenings (20 adults, five minors) were associated with patients who had documentation highly concerning for trafficking. There were also 11 screenings with documentation highly concerning for trafficking that did not screen positive on any human trafficking questions and were positive for the non-human-trafficking questions only.

Discussion

The addition of three human trafficking questions to create the Abuse Risk + Human Trafficking tool resulted in an increase in the identification of individuals exploited by human trafficking in this hospital setting when compared with the existing Abuse Risk tool that did not have the additional human trafficking questions.
Risk factors of failure to achieve textbook outcome in patients after pancreatoduodenectomy: a systematic review and meta-analysis
Authors: Yuan Jiajun , Du Changjie , Wu Hongyu , Zhong Tao , Zhai Qilong , Peng Jialun , Liu Nan , Li Jinzheng
Published: February 2025

Background:

Pancreatoduodenectomy (PD) represents one of the most technically demanding surgical procedures, characterized by extensive surgical trauma and high perioperative morbidity. Single outcome measures are insufficient to comprehensively assess the surgical quality of PD. Textbook outcome (TO), as an integrated evaluation system incorporating multiple clinical parameters, offers an objective, reliable, and comprehensive assessment of surgical performance. This systematic review and meta-analysis aimed to identify risk factors associated with failure to achieve textbook outcome (non-TO) following pancreatoduodenectomy.

Materials and methods:

We systematically searched international databases (PubMed, Web of Science, EMBASE, and Cochrane Library) and Chinese databases (China National Knowledge Infrastructure, Weipu Chinese Journals Service Platform, Wanfang Data, and SinoMed) for studies on risk factors of failure to achieve textbook outcome after pancreatoduodenectomy from inception to 31 December 2024. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects models. Heterogeneity testing, sensitivity analysis, and publication bias assessment were conducted.

Results:

Ten studies involving 5238 patients were included in this meta-analysis. Among the 18 factors evaluated, five were significantly associated with failure to achieve textbook outcome after pancreatoduodenectomy: preoperative biliary drainage (OR = 2.09, 95%CI [1.30-3.36], P = 0.002), smaller tumor size (OR = 1.36, 95%CI [1.02-1.81], P = 0.04), soft pancreatic texture (OR = 2.25, 95%CI [1.01-5.02], P = 0.05), small pancreatic duct diameter (OR = 2.30, 95%CI [1.62-3.28], P < 0.00001), and increased intraoperative blood loss (OR = 4.14, 95%CI [1.16-14.83], P = 0.03). The remaining 13 factors showed no significant association with failure to achieve textbook outcome.

Conclusion:

This meta-analysis identified preoperative biliary drainage, tumor morphological characteristics (including size and texture), pancreatic duct diameter, and intraoperative blood loss as key factors affecting the achievement of textbook outcome after pancreatoduodenectomy. These findings may help surgeons identify high-risk patients for failure to achieve textbook outcome, enabling personalized surgical strategies and optimized perioperative management to improve textbook outcome rates.
Pharmacological prevention of gastrointestinal bleeding in critically Ill patients
Authors: Wong Adrian , Kane-Gill Sandra L. , Barletta Jeffrey F.
Published: February 2025

Purpose of review

Despite advances in critical care medicine, the incidence of clinically important upper gastrointestinal bleeding (UGIB) remains consistent. One therapy that reduces UGIB is the use of stress ulcer prophylaxis (SUP). In the past year, several key manuscripts have been published regarding SUP, providing updated recommendations for its prescription. In this review, we provide commentary on these recommendations and areas for future research.

Recent findings

Risk factors for UGIB include chronic liver disease, coagulopathy, severe neurologic illness or injury, and shock. The prescription of SUP is associated with a decreased occurrence of UGIB but no benefit in mortality. Although both histamine-2 receptor antagonists and proton pump inhibitors (PPIs) are recommended for SUP, it is possible that PPIs may be associated with increased mortality in critically ill patients. The short-term use of SUP is not expected to be associated with most adverse drug events, but inappropriate continuation of SUP increases this risk.

Patient-specific considerations based on recent data help with improving the prescription of SUP, although additional research is necessary. The use of artificial intelligence may be able to predict at risk patients with the potential to influence appropriate prescription of SUP and reduce the occurrence of UGIB.
Association between air pollution and osteoporosis: A Mendelian randomization study
Authors: Ju Mingyan , Liu Fanjie , Deng Tingting , Jia Xuemin , Xu Wenchang , Zhang Fengjun , Gong Menglin , Li Yuying , Yin Ying
Published: February 2025

Osteoporosis (OP) is a significant disease in the aging society, which poses a threat to the physical well-being of older adults. Some studies suggest that air pollution may contribute to an increased incidence of OP; however, this causal relationship has not been firmly established. To address this gap, we conducted Mendelian randomization (MR) analysis to assess the potential causal association between air pollution (including nitrogen dioxide [N = 456,380], nitrogen oxides [N = 456,380], particulate matter [PM]2.5 [N = 423,796], and PM10 [N = 455,314]) and total-body bone mineral density (BMD) (N = 56,284). We utilized summary data from IEU Open GWAS on the database of genome-wide association studies (GWAS) and employed inverse variance weighting (IVW) as our primary analytical approach. The findings from our MR study in the European population using the IVW method indicated a potential causal link between nitrogen oxides: β = −0.59, confidence interval (CI) = (−1.03 to −0.16), P = 0.008; PM2.5: β = −0.60, CI = (−1.12 to −0.08), P = .025. These results suggest that there might be a causative relationship between nitrogen oxides, PM2.5, and BMD with regards to OP development among individuals exposed to air pollution. Importantly, the observed associations passed all statistical tests without any evidence of heterogeneity or pleiotropy. Furthermore, the presence of air pollution was found to be associated with an elevated risk of developing OP. This study provides compelling evidence for a causal connection between nitrogen oxides, PM2.5, and OP, suggesting that reducing air pollution could play a crucial role in preventing OP development.
Etiological, clinical characteristics, and treatment of atypical femur fracture: A retrospective study
Authors: Wang Hongqing , Zhang Zhishan , Zhou Fang , Song Chunli , Yang Zhongwei , Hou Guojin , Tian Yun
Published: February 2025

This study aims to determine the etiology, clinical characteristics, and treatment of atypical femur fractures (AFFs). Clinical data from patients with an AFF who were treated in our hospital from January 2017 to June 2021 were retrospectively reviewed. The data were analyzed and summarized. Twenty-one patients (17 females and 4 males; average age, 66.59 ± 13.52 years; age range, 32–85 years) with AFFs (27 femurs [6 bilateral femurs]) were included in the current study. Based on relative risk analysis it was determined that the long-term use of bisphosphonates was a risk factor for AFFs. Using principal components analysis, severe osteoporosis, hip joint dysfunction, and structural abnormalities of the femur were shown to be risk factors for AFFs. Four femurs received non-surgical treatment, of which 2 were cured and the remaining 2 underwent surgical treatment. Twenty-five femurs received surgical treatment, of which 21 had intramedullary nail fixation and 4 had plate fixation. All fractures healed. The etiologic factors for AFFs are complex. Severe osteoporosis, hip joint dysfunction, and structural abnormalities of the femur were shown to be risk factors for AFFs based on principal components analysis. The appropriate treatment will be determined according to the characteristics of the fracture.
Effect of surgery on overall survival and cancer-specific survival in patients with primary HCC: A study based on PSM in the SEER cohort
Authors: Xia Lin , Yu Shuai-Xin , Bai Yu-Shuai , Liang Xiao , Wu Fu-Gui , Gao Yang , Chen Xiu-Li , Xiao Zhao-Xiong , Li Man
Published: February 2025

This study was designed to assess the effects of surgery method on overall survival (OS) and cancer-specific survival (CSS) in patients with hepatocellular carcinoma (HCC). This is a retrospective study. Patients diagnosed with primary HCC (N = 10,174) were identified from the Surveillance, Epidemiology, and End Results Database from 2010 to 2017 and categorized into surgical (N = 4950) and nonsurgical (N = 5224) groups. The characteristics of patients were balanced by propensity score matching. Multivariate Cox analysis was used to explore independent prognostic factors for outcomes in both groups, and the Kaplan–Meier curve showed survival rates in each group. The surgical patients were subclassified by surgical method, whether local tumor destruction, wedge or segmental resection, lobotomy resection, or liver transplantation (LT). Finally, survival rates in the 2 groups were investigated by subgroup analysis. After propensity score matching, sex, grade, tumor node metastasis III/IV, surgery, chemotherapy, alpha-fetoprotein, number of regional lymph nodes, other race, and age > 70 were independent prognostic factors in the 2 groups. The OS (HR = 0.290, P < .001) and CSS (HR = 0.274, P < .001) rates of patients were higher in the surgical group than in the nonsurgical group. There was no obvious improvement in CSS in patients who received radiotherapy combined with surgery compared with patients who only received radiotherapy (HR = 0.813, P = .279). LT was consistently found to be the best of the 4 surgical methods. The OS of stage II patients undergoing LT was better than that of corresponding stage III patients, and lobectomy resection was the best choice for stage IV patients (HR = 0. 417, P = .023). In grade III patients, the median CSS time was longer than the OS time. The survival rate of patients treated with chemotherapy combined with LT was higher than that of patients who did not receive chemotherapy and only received LT. Patients with HCC who underwent surgery had better OS and CSS. Subgroup analysis showed that LT can improve the survival rate and median survival time of patients.
An analysis of the top 500 anesthesiology publications with the highest altmetric attention scores
Authors: Ömür Arça Dilek , Bayram Başak , Boztaş Nilay , Erdemir İsmail , Çetin Murat , Sağiroğlu Gönül , Hanci Volkan
Published: February 2025

Altmetrics is a web-based measurement method that assesses the online dissemination and interactions of an article. We performed an altmetric analysis of 500 papers with the highest altmetric attention score (AAS) published in anesthesiology-related journals. Journals were identified from the Web of Science (WoS) Master Journal List by Clarivate using the category “Anesthesiology.” The altmetric data were obtained from the Altmetric Explorer database. The first 500 publications with the highest AAS scores among these journals were identified and analyzed. Using Spearman correlation, no correlation was observed between the AAS and either WoS or Google Scholar citations (R = 0.188, P < .001 and R = 0.161, P < .001, respectively). There was a weak correlation between blog mentions and both WoS citations and Google Scholar citations (R = 0.263, P < .001 and (R = 0.241, P < .001). A very strong correlation was observed between the number of Mendeley readers and both WoS and Google Scholar citations (R = 0.889, P < .001 and R = 0.905, P < .001). A significant difference in AAS and WoS citations was observed based on publication topic (P = .036 and P = .005, respectively), with algology being the most common topic (n = 206, 41.2%). Although AAS did not significantly affect traditional scientific citations, the analysis of subgroup correlations revealed notable differences. Our results suggest that traditional scientific citations (WoS and Google Scholar citations) are strongly influenced by the number of Mendeley readers. Further research is needed to understand these dynamics in academic discourse.
A case report of acute intermittent porphyria presenting with reversible cerebral vasoconstriction syndrome
Authors: Rao Wei , Li Lingjuan , Wu Lingfeng , Chai Wen , Li Jie
Published: February 2025

Rationale:

Acute intermittent porphyria (AIP), an autosomal dominant genetic disorder, is primarily characterized by neuropsychiatric abnormalities and intermittent abdominal pain; however, it is extremely rare for AIP to present with reversible cerebral vasoconstriction syndrome (RCVS).

Patient concerns:

Herein, we report a case of AIP presenting with RCVS in a patient admitted to our hospital.

Diagnoses:

We present a case of a 16-year-old female patient with clinical manifestations including abdominal pain, seizures, headache, and peripheral nerve lesions. Laboratory examination revealed small-cell hypochromic anemia, hyponatremia, hypochloremia, and a positive result of the urine porphobilinogen sun exposure test. The peripheral nerve injury was detected via electromyography. A left occipital epileptic discharge was observed on an electroencephalography. Brain magnetic resonance imaging (MRI) revealed abnormal signals in the bilateral temporal, parietal, and occipital lobes, and stenosis in multiple intracranial vasculatures. The patient was found to carry a mutation site in the hydroxymethylbilane synthase (HMBS) gene, and her father was heterozygous.

Interventions:

After treatment with high glucose, heme arginine, antiepileptic therapy, correction of electrolyte disorders, and nutritional support, the patient’s symptoms were improved considerably.

Outcomes:

Repeat brain MRI showed that the lesion disappeared and the intracranial vasculature returned to normal. The electromyography reexamination results also demonstrated that the peripheral nerve injury was relieved.

Lessons:

RCVS may occur in AIP patients, which is featured with abdominal pain, neuropsychiatric symptoms, and stenosis in multiple intracranial vasculatures. Urine porphobilinogen sun exposure test, brain MRI, and genetic examination can aid in a definitive diagnosis. A high glucose diet, heme arginine, and symptomatic treatment are effective in treating AIP presenting with RCVS.
Dissecting the association of genetically predicted neuroticism with pre-eclampsia: A 2-sample Mendelian randomization study
Authors: Xiu Xiaoyan , Yi Huangchang , Zu Yizheng , Lin Yingying , Yan Jianying
Published: February 2025

Previous observational clinical studies have found a causal relationship between neurotic personality traits and various disorders. However, the relationship between neurotic personality characteristics and pre-eclampsia (PE) is not unclear. Two-sample Mendelian randomization (MR) was employed to examine the influence of neurotic personality traits on the risk of PE. From the Finnish genome-wide database, we identified 32 single-nucleotide polymorphisms linked to neuroticism personality traits, excluding 7 confounding variables related to blood pressure and BMI. The number of tool variables associated with PE was 25. Causality was assessed using inverse variance weighting, weighted median, MR-Egger, and weighted model methods. Sensitivity analyses, such as Cochran’s Q statistic, MR-Egger intercept, MR pleiotropy residual sum and outlier, and leave-one-out analysis, were conducted to identify potential heterogeneity and horizontal pleiotropy. The present 2-sample MR study did not reveal any genetic associations between neuroticism and PE. A 2-sample Mendelian randomization analysis of 12 dichotomous neuroticism items indicated that genetic predisposition to worrying elevates the risk of PE. The inverse variance weighted method produced an odds ratio (OR) of 2.23 (95% CI: 1.36–3.65, P < .05), while the weighted median analysis indicated an OR of 2.41 (95% CI: 1.20–4.85, P < .05). However, there were no significant correlations between the MR Egger and weighted modes. This study found no genetic causal link between neuroticism and PE; however, carriers may have a genetically increased risk of PE, offering a more reliable foundation for future prevention efforts.
How does digital leadership affect teachers’ life satisfaction in primary and secondary schools: The sequential mediating role of digital technology skills and work engagement
Authors: Yuan Fang , Wang Jingxia
Published: February 2025

Teachers’ life satisfaction is a crucial determinant of their well-being and professional efficacy. While research has established digital leadership, digital technology skills, and work engagement as pivotal to life satisfaction, the intricate dynamics through which digital leadership affects the life satisfaction of primary and secondary school teachers remain underexplored. This study aims to elucidate the pathways by which digital leadership influences the life satisfaction of primary and secondary school teachers, with a focus on the sequential mediating effects of digital technology skills and work engagement. Conducted in April 2024, the survey garnered responses from 861 teachers (M = 36.94, SD = 9.579) in Shandong and Jiangsu Provinces, ensuring anonymity. Data were analyzed utilizing structural equation modeling in AMOS 24.0 and SPSS 24.0. The results indicate that: digital leadership directly predicts teachers’ life satisfaction; digital leadership influences teachers’ life satisfaction through the mediating roles of digital technology skills and work engagement separately; digital technology skills and work engagement play a chain mediating role between digital leadership and teachers’ life satisfaction. This study’s insights advance the comprehension of the mechanisms connecting digital leadership with teachers’ life satisfaction and offer actionable insights for improving the life satisfaction of educators in primary and secondary schools.
Therapeutic and hepatoprotective effect of tocilizumab combined with total glycosides of peony in systemic juvenile idiopathic arthritis
Authors: Gao Liya , Xie Jing , Ren Zhongyu , Wei Xiaoqiong , Tang Xuemei
Published: February 2025

This retrospective observational study aimed to evaluate the effectiveness and hepatoprotective effects of combination therapy with tocilizumab (TCZ) and total glycosides of peony (TGP) in treating systemic juvenile idiopathic arthritis (sJIA). Among the 119 sJIA patients enrolled, 49 received TCZ combined with TGP (study group) and 70 received TCZ not combined with TGP (control group). We compared clinical characteristics, 5 liver function indices (alanine aminotransferase [ALT]/aspartate aminotransferase [AST]/alkaline phosphatase/γ-glutamyltransferase/total bilirubin), transaminase (ALT/AST) Kaplan–Meier curves, and inflammatory indices between the groups. The study group showed significantly lower rates of abnormal ALT, AST, alkaline phosphatase, and γ-glutamyltransferase levels (P < .05). Among patients with abnormal liver function indices, transaminase abnormalities were the most common (87.50%), particularly after the first TCZ administration (44.64%). Analysis of Kaplan–Meier curves for transaminases for different treatment durations indicated significantly lower abnormal rates (ALT/AST > 1 and 3 × upper limit of normal) in the study group (P < .05). The Cox regression model and forest plot identified the group with the highest risk ratio (study group vs control group, hazard ratio = 3.985, 95% confidence interval: 1.997–7.952) as an independent risk factor for transaminase abnormalities. A comparison of therapeutic outcomes revealed a more obvious decrease in the number of patients with abnormal inflammation indices in the study group before and after treatment. Moreover, the erythrocyte sedimentation rate value in the study group at the last follow-up significantly lower than that in the control group (P < .05). The combination of TCZ and TGP effectively reduced inflammation and lowered the incidence of liver injury, suggesting it may be the preferred combination therapy for sJIA.
Impact of participation in sports safety education on sports injuries, sports safety awareness, and sports activity habits among young Korean athletes
Authors: Kwon Jeonga , Jang Jusun
Published: February 2025

Safety education is important for young athletes because it reduces injuries and serves as a stepping stone to becoming a professional athlete. Mandatory safety education and legislation for sports players are being discussed, but no progress has been made thus far. Therefore, this study investigated how young Korean athletes’ participation in sports safety education is related to sports injuries, sports safety awareness, and sports activity habits. We sourced all the data of 3262 professional athletes aged 13 to 18 years from the 2019 Sports Safety Accident Survey. We analyzed the data using SPSS for Windows (version 23.0; IBM Corp., Armonk, NY). Frequency analysis, chi-square analysis, and multivariate logistic regression were performed. The results revealed that the more athletes participate in safety education, the less likely they are to have sports injuries and the more likely they are to develop safety awareness and beneficial activity habits such as managing accidents. Additionally, those who participate in safety education are more likely to carry enough water to stay hydrated during exercise than those who do not. Overall, the results suggest that safety education should be emphasized for athletes from a young age, as it helps prevent injuries and improve performance. A governance-based safety education system must be established so young athletes can participate in safety education. Furthermore, safety education must be regular and sports-specific.
Feasibility and effects of the telerehabilitation program during hematopoietic stem cell transplantation
Authors: Kim Dae-Young , Choi Jinwoo , Kim Chung Reen , Lee Yoojin , Kim Youjin , Jo Jae-Cheol
Published: February 2025

This study aims to identify the feasibility and effects of the telerehabilitation program for patients with hematologic cancer who underwent hematopoietic stem cell transplantation (HSCT). In this single-arm prospective study, a telerehabilitation program was administered to patients who underwent HSCT. The program utilized a camera and video conferencing system, delivering 30-minute exercise sessions based on the Otago exercise. Baseline, immediate follow-up, and 3-month follow-up examinations were performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30, Beck Depression Inventory-II, fatigue severity scale, body composition, and a 10-item satisfaction survey. Fifteen (9 males and 6 females) completed the program. The mean number of exercise participation was 8.67 ± 1.91, and no adverse events or safety issues were reported. The results showed no significant deterioration in global health status, physical, role, emotional, cognitive, or social functioning as well as depression and fatigue. Physical function was well maintained without significant deterioration. In the satisfaction survey, participants believed that it was physically and mentally beneficial. This study showed that the telerehabilitation program may be helpful for patients undergoing HSCT. Direct communication with a physical therapist helped patients maintain their physical and mental health during isolation.
Modified Marionette lip-split incision for bucco-gingival cancer
Authors: Illescas Ralda Monica Maria , Tsao Chung-Kan , Lin Ta-Chun , Young Chi-Kuang , Hu Yu-Feng , Liao Chun-Ta , Kang Chung-Jan , Huang Shiang-Fu
Published: February 2025

Selection of incision in anterior bucco-gingival cancer is challenging. Midline vertical incision could lead to lower lip necrosis in cancer surgery due to vascular compromise of labial artery in lesion side. Marionette line incision decreases the risks of lower lip necrosis. However, it leads to oral commissure sagging and subsequent saliva drooling after wide excision and reconstruction. We modified the Marionette line with an upward and oblique manner in the beginning of incision (modified Marionette line incision, MMLI). The results were retrospectively analyzed in this study. A retrospective case series was conducted at Linkou Chang Gung Memorial Hospital (Taiwan), between 2019 and 2022. It comprised individuals diagnosed with oral squamous cell carcinoma (OSCC) at the bucco-gingival complex, and whose tumor was approached by the application of MMLI. Thirteen participants (92.31% male) with bucco-gingival OSCC and verrucous tumor, resected through the application of a MMLI, were included in this study. All the patients did not develop lower lip necrosis after radical surgery and reconstruction. The oral commissure sagging was successfully avoid after adopting MMLI. Lip insufficiency was presented in 2 patients, 1 patient presented drooling as a result of suboptimal defect reconstruction. Lip vermillion notching was observed in 1 case. No major postoperative complications developed after surgeries in all the patients. MMLI represents an effective approach for treatment of extensive buccal/anterior gingival OSCC, since it preserves lower lip vasculature and improves postoperative cosmesis. The commissure sagging and asymmetry were overcome by the modification of Marionette incision line.
Genetic insights into the relationship between immune cell traits and abnormal uterine bleeding: A Mendelian randomization study
Authors: Ou Wenting , Du Pan , Bai Xueling , He Yue
Published: February 2025

Abnormal uterine bleeding (AUB) is an inflammatory response involving immune cells, but the relationship between immune cell traits and AUB is highly complex and still largely unclear. This study utilized genetic data from a genome-wide association study of European participants. Mendelian randomization (MR) analysis methods, including inverse variance weighted (IVW) as the primary approach, weighted median, MR Egger regression, and Mendelian randomization pleiotropy residual sum and outlier, were employed for forward and reverse analyses. Sensitivity analyses validated the stability and reliability of the results. The IVW method indicated a potential causal relationship between CD45 on granulocyte (odds ratio [OR] = 0.916, 95% CI: 0.880–0.954, P = 1.974 × 10−5) with a decreased risk of menorrhagia. Two immune cell traits with P values < .001 were worthy of attention, CD25 on naive-mature B cell (OR = 0.935, 95% CI: 0.901–0.970, P = 3.882 × 10−4) may be associated with a decreased risk of menorrhagia, while human leukocyte antigen DR on plasmacytoid dendritic cell (OR = 1.089, 95% CI: 1.038–1.143, P = 5.126 × 10−4) may be associated with an increased risk of amenorrhea. No reverse causation was observed. Sensitivity analysis suggested no heterogeneity or horizontal pleiotropy (P > .05). No immune cell traits associated with or potentially related to oligomenorrhea were found. This MR study highlights the complex relationship between immune cell traits and AUB, offering insights into AUB’s pathogenesis and potential biomarkers. Further clinical and in vitro validation is needed to assess these findings, with future research exploring immune modulation therapies for early diagnosis and personalized treatment.
Bibliometric analysis of research on manual therapy for low back pain from 2013 to 2023
Authors: Guo Yi , Gong Zhichao , Liu Xiaowei , Ai Kun , Li Wu , Li Jiangshan
Published: February 2025

Background:

Low back pain (LBP) is one of the most common symptoms prompting patients to seek treatment. Manual therapy is widely used to treat LBP. Nevertheless, there is a scarcity of bibliometric analyses examining the worldwide utilization of manual therapy for the treatment of LBP.

Methods:

This research used the Online Bibliometric overview Platform website (https://bibliometric.com), CiteSpace (6.2.R4), and VOSviewer (1.6.19) to provide a comprehensive analysis of the current status and prospective developments in the field. The Web of Science Core Collection (WOSCC) database was searched for publications from August 1, 2013, to August 1, 2023 on manual therapy of low back pain.

Results:

Among the identified articles, 488 fit the criteria. The number of papers on manual therapy for LBP has progressively risen over in the past 10 years, whereas the average number of citations of these papers has decreased. The leading countries producing publications on this discipline were the USA, Canada, and China. There were 345 authors of the studies, with Christine M. Goertz having the most publications. The University of Southern Denmark was the institution that contributed the most to the field. The Journal of Manipulative and Physiological Therapeutics published many of the research papers in this field. Keyword analysis showed that the relationship between low back pain, spinal manipulation, and management has been present throughout the development of this research area.

Conclusions:

Spinal manipulation, management, randomized controlled trials, Physical therapy, care and disability are the current research hotspots in the treatment of LBP with manual therapy. In addition, research on complementary medicine and clinical practice guidelines may become an important trend in the future.
Association between subjective health status and responses to traditional Korean medicine assessments in healthy adults: A cross-sectional study
Authors: Lee Sanghun , Park Jeong Hwan
Published: February 2025

Subjective health status comprises an individual’s self-assessment of health and indicates their actual health outcomes. This study aimed to explore the relationship between traditional Korean Medicine (KM) inquiry outcomes and subjective health status to provide a better understanding of the potential benefits of KM practices, which have been overlooked in existing research. This observational study recruited 5987 healthy adults (age ≥ 19 years) between April 11, 2022, and December 19, 2023. Participants were surveyed using standardized KM inquiries and subjective health status assessments. Statistical analyses included chi-square tests and multivariate logistic regression analyses to examine the relationship between KM inquiry outcomes and subjective health status. An analysis of 4935 respondents who completed KM inquiries revealed that factors affecting subjective health status for both men and women included appetite, digestive discomfort, residual urine sensation, waking condition, cold intolerance, and exercise habits. Factors affecting subjective health status differed slightly by sex; for men, dry mouth and alcohol consumption were significant, whereas, for women, dry mouth, meal frequency, sleep quality, and feelings after sweating were significant. This study confirms the utility of KM inquiries in assessing the subjective health status of healthy adults and provides insights into the development of sex-specific lifestyle health-management strategies.
The chemical composition analysis of Yixin Tongmai Granules using UHPLC-MS/MS and exploration of its potential mechanism in treatment of coronary artery disease based on network pharmacology and molecular docking
Authors: Li Hongbin , Zhu Yuye
Published: February 2025

Yixin Tongmai Granules (YTG) is a popular Chinese herbal granules for the treatment of coronary artery disease (CAD), but its molecular pharmacological mechanism is still unclear. This article explores the mechanism of CAD treatment from the perspective of network pharmacology. We analyzed the chemical composition of YTG using UHPLC-MS/MS and identified 131 ingredients. The relative drug content of 33 ingredients exceeded 0.5%. These ingredients were further screened using the SwissADME platform with ADME criteria. Using the HIT database and SwissTargetPrediction platform, high probability targets for these ingredients were generated. Using Venn Diagram, 96 effective targets associated with CAD were identified, involving 14 core ingredients. This study imported these effective targets into the STRING platform and obtained the core targets through network topology analysis: TP53, STAT3, transcription factor Jun, MAPK3, MAPK1, AKT1, SRC, MYC, BCL2, transcription factor p65, TNF, and ESR2. Then enrichment analysis with Metascape platform indicated that, in the system network of YTG in anti-CAD, the principal pathways are “Lipid and Atherosclerosis”, “Pathways in cancer”, and “AGE-RAGE signaling pathway in diabetic complications.” Next, the affinities between the core ingredients and their associated core targets were examined individually through molecular docking. Finally, based on deep mining of PubMed literature, this study investigated the relationship between each core target and CAD, the relationship between each core target and its associated core ingredients, and inferred the main pharmacological ingredients of YTG, namely Tanshinone IIA, Cryptotanshinone, Caffeic acid, Denshensu, Ononin, and Formononetin.
Central-variant posterior reversible encephalopathy syndrome in association with adrenal insufficiency: A case report
Authors: Srichawla Bahadar S. , Kipkorir Vincent , Lalla Rakhee
Published: February 2025

Rationale:

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition often linked to hypertension, eclampsia, or renal failure. PRES typically presenting with seizures, headaches, visual disturbances, and altered mental status. A rarer form, the central variant of PRES, involves atypical radiologic findings such as edema in central brain structures. PRES has not been previously associated with adrenal insufficiency, making this case novel and significant.

Patient concerns:

A 59-year-old woman with a history of hypertension, chronic obstructive pulmonary disease, and previous COVID-19 infection presented to the emergency department with seizures and altered mental status. She exhibited a fluctuating systolic blood pressure (79–195 mm Hg) and had a Glasgow Coma Scale (GCS) score of 7.

Diagnoses:

Initial imaging and laboratory tests were inconclusive. Continuous electroencephalogram indicated focal cortical irritability, raising concerns about seizures. Brain magnetic resonance imaging revealed increased T2-weighted signals in the bilateral cerebellar hemispheres, consistent with central variant PRES. Endocrine evaluation showed primary adrenal insufficiency, confirmed by low AM cortisol levels and a positive cosyntropin stimulation test.

Interventions:

The patient was started on levetiracetam for seizure management and hydrocortisone for adrenal insufficiency. She was intubated for airway protection but later extubated as her condition stabilized.

Outcomes:

Follow-up magnetic resonance imaging showed progressive resolution of the cerebellar T2 hyperintensities. The patient was discharged on day 15 with no residual neurological deficits. At a 3-month follow-up, she remained seizure-free and continued oral hydrocortisone and levetiracetam.

Lessons:

This case highlights adrenal insufficiency as a possible novel precipitant of the central variant of PRES, emphasizing the need for prompt diagnosis and treatment to prevent serious neurological outcomes. The underlying pathophysiological mechanism of PRES from adrenal insufficiency is most likely labile blood pressure causing rapid alterations in cerebral perfusion pressure (CPP) precipitating PRES.
A boy and his mother with lipoprotein glomerulopathy: Two case reports and literature review
Authors: Zhang Shuya , Fan Lulu , Li Ziwei , Liu Tiantian , Jing Xiaoping , Guo Qingyin
Published: February 2025

Rationale:

Lipoprotein glomerulopathy (LPG) is a rare genetic kidney disorder. Here, we report a boy and his mother with LPG.

Patient concerns:

A 6-year-old boy was admitted to our hospital with a history of 6 months of experiencing foamy urine without apparent cause.

Diagnoses:

Urinalysis revealed 3+ protein and 2+ occult blood. A 24-hour urinary protein quantification measured 1110 mg. Other laboratory tests revealed that the level of serum albumin was 43.6 g/L, triglycerides 4.31 mmol/L were elevated, and high-density lipoprotein cholesterol 0.71 mmol/L were reduced, whereas total cholesterol and low-density lipoprotein cholesterol levels were normal. Renal biopsy revealed glomerular capillary loop expansion with lipoprotein thrombi on light microscopy, variable-sized vacuoles within the capillary loops on electron microscopy, positive Oil Red O staining, and positive immunofluorescence staining for ApoE. The mother of the patient had a history of uremia 5 years ago. Genetic testing confirmed a deletion of 9 nucleotides (CAAGCTGCG) in exon 4 of the ApoE gene at positions c.480–488 of the boy and his mother, resulting in a deletion of 3 amino acids (Lys143–Arg145del) in the ApoE amino acid sequence at positions 143–145, which was same variant as ApoE Tokyo/Maebashi.

Interventions:

The boy showed significant improvement after treatment with fenofibrate and telmisartan, with urine protein turning negative after 1 week and blood lipid levels returning to normal after 4 weeks.

Outcomes:

During 1 year follow-up period, the results of urine routine examination and blood lipid profile remained within normal ranges.

Lessons:

LPG is a rare and easily misdiagnosed kidney disease with no clinical characteristics. Early diagnosis by kidney biopsy and whole gene test is conducive to early detection and diagnosis, reducing missed diagnosis and misdiagnosis, and improving the long-term prognosis of patients.