bluuebunny/crossref_metadata_2025 huggingface dataset:
Leadership Behaviors That Impact Nurse Faculty Job Satisfaction: A Qualitative Descriptive Study
Authors: Heier Cori , Busenhart Cara A. , Park Shin Hye , Sanner-Stiehr Ericka , Brooks Joanna , Nelson-Brantley Heather
Published: October 2024

AIM

The aim of the study was to identify specific actionable behaviors academic nurse leaders can implement to improve nurse faculty job satisfaction.

BACKGROUND

The nurse faculty shortage is a persistent and worsening problem, with job dissatisfaction a significant contributor in the United States. However, little is known about actionable behaviors academic nurse leaders can do to improve nurse faculty job satisfaction.

METHOD

Qualitative semistructured interviews were conducted with 15 nurse faculty. Inductive thematic analysis was used to analyze and interpret the interviews.

RESULTS

Four themes emerged about academic nurse leader behavior: 1) build relationships with leaders and faculty, 2) create an environment where autonomy is valued, 3) facilitate faculty growth and development, and 4) serve as a role model.

CONCLUSION

Effective leadership contributes to nurse faculty job satisfaction. Academic nurse leaders need to be aware of their influential behaviors and intentionally contribute to creating a workplace environment that promotes nurse faculty job satisfaction.
Hereditary angioedema due to C1-inhibitor deficiency: current therapeutic approaches
Authors: Costanzo Giulia , Sambugaro Giada , Firinu Davide
Published: October 2024

Purpose of review

For decades, treatment options for hereditary angioedema (HAE) were limited by major adverse effects, insufficient efficacy, and difficult routes of administration. However, the growing body of knowledge regarding HAE pathophysiology has led to the development of innovative drugs for self-administered, on-demand therapy and for short- and long-term prophylaxis. This review provides a comprehensive overview of the approved drugs and the development of HAE treatments.

Recent findings

The implementation of new therapies will improve the application of individualized action plans based on the key goals of minimizing the number of attacks and meeting the complex needs of patients.

HAE is a rare genetic disease with a high impact on patients’ quality of life due to the unpredictability and variable severity of attacks. Advances in HAE research have allowed optimization of attack management and individualization of therapeutic approaches.
Diagnostic and Therapeutic Approach to the Major Secondary Causes of Arterial Hypertension in Young Adults: A Narrative Review
Authors: Munoz-Moreno Juan Manuel , Gamarra-Valverde Norma Nicole , Muedas-Porras Gabriela , Nombera-Aznarán Milagros , Aguilar-Figueroa Fabián , Gulati Martha
Published: October 2024

Arterial hypertension in young adults, which includes patients between 19 and 40 years of age, has been increasing in recent years and is associated with a significantly higher risk of target organ damage and short-term mortality. It has been reported that up to 10% of these cases are due to a potentially reversible secondary cause, mainly of endocrine (primary aldosteronism, Cushing’s syndrome, and pheochromocytoma/paraganglioma), renal (renovascular hypertension due to fibromuscular dysplasia and renal parenchymal disease), or cardiac (coarctation of the aorta) origin. It is recommended to rule out a secondary cause of high blood pressure (BP) in those patients with early onset of grade 2 or 3 hypertension, acute worsening of previously controlled hypertension, resistant hypertension, hypertensive emergency, severe target organ damage disproportionate to the grade of hypertension, or in the face of clinical or biochemical characteristics suggestive of a secondary cause of hypertension. The 2023 Guideline of the European Society of Hypertension recommends starting pharmacological therapy from grade 1 hypertension (BP ≥140/90 mm Hg), with the aim of achieving BP control of less than 130/80 mm Hg. It is important to highlight that the prevalence of secondary hypertension in these patients could be underestimated, given that there is little evidence available on the management of high BP in young adults, which is why we developed this narrative review on the diagnostic and therapeutic approach to the major secondary causes of arterial hypertension in young adults.
Ontology construction of traditional Chinese medicine diagnosis and treatment for myopia
Authors: Huo Ruili , Zhang Lei , Liu Sihong , Zhang Yu , Jia Siqi , Liu Bing , Chang Anne , Cui Yidi , Tong Lin
Published: October 2024

Objective:

To keep up with the progress of treatment for myopia in traditional Chinese medicine (TCM) through literature research, so as to determine data source of TCM diagnosis and treatment for myopia, from which entities are extracted for integration of relevant knowledge, and further formal expression and visualization of knowledge.

Methods:

Literature research and comparative analysis were used to determine the data source, and the 7-step method of constructing ontology was referred to for extraction of TCM diagnosis and treatment entities, which then was terminalized for development of classes and class hierarchy, and class properties, as well as creation of instances before consistency test of the ontology.

Results:

The ontology of TCM diagnosis and treatment for myopia includes 26 classes and 124 instances, 9 object properties, and 1 data property.

Conclusion:

The combination of ontology technology and TCM diagnosis and treatment knowledge of myopia contributes to the construction of a knowledge base of TCM diagnosis and treatment ontology for myopia, which realizes formal expression and visualization of relevant TCM knowledge, lays a foundation for the construction of TCM top-level ontology and ophthalmology ontology, and facilitates knowledge reusing and sharing.
The concept of nociplastic pain—where to from here?
Authors: Kosek Eva
Published: October 2024

Nociplastic pain, a third mechanistic pain descriptor in addition to nociceptive and neuropathic pain, was adopted in 2017 by the International Association for the Study of Pain (IASP). It is defined as “pain that arises from altered nociception” not fully explained by nociceptive or neuropathic pain mechanisms. Peripheral and/or central sensitization, manifesting as allodynia and hyperalgesia, is typically present, although not specific for nociplastic pain. Criteria for possible nociplastic pain manifesting in the musculoskeletal system define a minimum of 4 conditions: (1) pain duration of more than 3 months; (2) regional, multifocal or widespread rather than discrete distribution of pain; (3) pain cannot entirely be explained by nociceptive or neuropathic mechanisms; and (4) clinical signs of pain hypersensitivity present in the region of pain. Educational endeavors and field testing of criteria are needed. Pharmacological treatment guidelines, based on the three pain types, need to be developed. Currently pharmacological treatments of nociplastic pain resemble those of neuropathic; however, opioids should be avoided. A major challenge is to unravel pathophysiological mechanisms driving altered nociception in patients suffering from nociplastic pain. Examples from fibromyalgia would include pathophysiology of the peripheral as well as central nervous system, such as autoreactive antibodies acting at the level of the dorsal root ganglia and aberrant cerebral pain processing, including altered brain network architecture. Understanding pathophysiological mechanisms and their interactions is a prerequisite for the development of diagnostic tests allowing for individualized treatments and development of new strategies for prevention and treatment.
Chronic pain in European adult populations: a systematic review of prevalence and associated clinical features
Authors: Rometsch Caroline , Martin Alexandra , Junne Florian , Cosci Fiammetta
Published: October 2024

Chronic pain (CP) is a multifaceted and severely disabling persistent condition that affects individuals worldwide. A synthesis of epidemiological data is still lacking. The present systematic review aims at presenting point, period, and lifetime prevalence estimates of CP in the European adult population, as well as relevant features associated with it. Following PRISMA guidelines, a systematic search in PubMed, Web of Science, Embase, and Cochrane library was run from inception to May 2024, resulting in 39,832 hits. Among those, 132 full-text articles were assessed, and 23 studies comprising 862,013 participants with CP were included. The Joanna Biggs Institutes' Critical Appraisal Checklist for Studies Reporting Prevalence Data (JBI) was used for quality assessment. Findings showed a point prevalence ranging from 12% to 48%, a 6-month prevalence of 17.5% to 49.8%, a 12-month prevalence ranging from 8.1% to 44.6%, and a lifetime prevalence ranging from 12.7% to 33.7% independently from sex. Sociodemographic factors (eg, female sex, higher age, no partnership, lower education, unemployment) and clinical features (eg, medical diseases, mental disorders and burdens, healthcare utilization, functional impairment) were identified as being associated with CP. The variability in prevalence estimates can be reduced by applying consistent diagnostic criteria (eg, ICD-11) and by using standardized assessment tools (eg, scales, clinical interview). The high prevalence and the characteristics of the associated features support the need for adequate, multicomponent care paths to manage CP based on a comprehensive biopsychosocial model.
Prior Concussion History and Clinical Recovery Following Sport-Related Concussion in College Athletes
Authors: Gaudet Charles E. , Iverson Grant L. , Zafonte Ross , Berkner Paul D. , Cook Nathan E.
Published: October 2024

Objective:

The aim of this study was to assess whether a history of prior concussions, and especially multiple prior concussions, is associated with clinical recovery following a subsequent sport-related concussion among collegiate student athletes.

Design:

A naturalistic observational cohort study.

Setting:

Eleven National Collegiate Athletics Association Division III colleges.

Participants:

Collegiate athletes sustaining concussions from September 2014 through March 2020.

Independent Variables:

Participants were divided into 3 groups, athletes with: (1) no prior concussion history, (2) one prior concussion, and (3) 2 or more prior concussions.

Main Outcome Measures:

Survival analyses were used to compare time to return to school and sports among athletes with a history of 0, 1, or ≥2 prior concussions.

Results:

Among the 1132 college athletes, there were no statistically significant group differences between those with 0, 1, or ≥2 prior concussions in total time to return to school or sports. There was a statistically significant difference in the proportion of athletes with ≥2 prior concussions that had not fully returned to school, without accommodations, at 28 days (6.0%) compared to athletes with no prior concussions (2.2%; odds ratio = 2.80, 95% confidence interval 1.29-6.04).

Conclusions:

In summary, concussion history was not associated with time to return to sports following a subsequent sport-related concussion in these college athletes. On average, athletes with prior concussions did not take longer to return to school, although a slightly greater proportion of college athletes with ≥2 prior concussions had not fully returned to school, without accommodations, by 28 days following injury.
Systematic Review of Ex Vivo and In Vivo Pharmacokinetic Studies of Drugs Commonly Used During Extracorporeal Membrane Oxygenation
Authors: Dabirzadeh Anita , Decary Elizabeth , Fobisong Cajetan Nkong , Wasserman Samuel D. F. , Withington Davinia
Published: October 2024

Extracorporeal membrane oxygenation (ECMO) is a lifesaving treatment for critically ill patients in cardiac or respiratory failure refractory to conventional treatment. Patients on an ECMO circuit (pump, oxygenator, tubing) require numerous medications including sedatives, analgesics, cardioactive medications, and anticonvulsants. Currently, there are few dosing guidelines to optimize pharmacotherapy in this situation. A systematic review was conducted to describe pharmacokinetics (PK) of medications commonly used during ECMO. MEDLINE, Embase, Cochrane, BIOSIS, PubMed, and Web of Science databases were searched. All articles presenting ex vivo, animal, and human data on the PK of the subject medications in the ECMO circuit were included. Three authors independently examined citation titles and abstracts. Four authors extracted relevant details from included studies into standardized data extraction forms. Methodological quality was assessed using the ClinPK guidelines and the Joanna Briggs Institute Checklist. Forty-four studies examining 30 medications were included, 26 ex vivo studies (mostly adult circuits) and 18 observational studies (mainly neonatal patients). Pharmacokinetics varied depending on the medication’s characteristics, study type, and population. Study quality was variable, limiting the possibility of deriving hard dosing guidelines from this available literature. Further population PK studies are needed to adequately determine dosing guidelines in adults and children requiring ECMO.
TCM-Centric Innovations in WHO's International Standard Terminologies: A Qualitative Exploration
Authors: Lai Han , Moore Aaron Lee , Yan Xiaodan , Li Wei-hong
Published: October 2024

Traditional Chinese medicine (TCM) is increasingly recognized worldwide as a valuable complementary and alternative medicine. To facilitate global research and collaboration in this field, the World Health Organization (WHO) introduced the International Standard Terminologies on Traditional Chinese Medicine on March 3, 2022. This international terminology translation standard, IST 2022, goes beyond conventional translation by embracing three innovative features: 1) It reflects TCM's foundational philosophy of unity and opposition, emphasizing the interconnectedness among TCM terms during translation. This approach transcends individual term translations to explore the interrelationships among them. 2) It meticulously preserves the integrity of TCM theory. It achieves this by retaining transliterations for unique TCM terms that possess distinct features, thus upholding the essence of TCM. 3) It employs innovative Xiang (Image) cognition, a concept rooted in traditional Chinese thought by helping readers grasp visual and mental imagery associated with each term. This study presents a qualitative analysis based on interviews with 11 TCM translation experts, examining their perspectives on these features and their translational preferences across IST 2007 and 2022 versions. The findings contribute to the standardization and global harmonization of TCM terminology, advocating for clarity, precision, and the advancement of TCM in the international healthcare arena.
The prevalence of multisystem diagnoses among young patients with hypermobile Ehlers–Danlos syndrome and hypermobility spectrum disorder: A retrospective analysis using a large healthcare claims database
Authors: Kozyra Monika , Kostyun Regina , Strecker Sara
Published: October 2024

Clinical features of hypermobile Ehlers–Danlos syndrome (hEDS) and hypermobility syndrome (HMS) have classically focused on dysfunctions related to the musculoskeletal system. A growing body of literature suggests substantial multisystemic involvement, although this has not been recapitulated in a pediatric/young adult population. Leveraging a large United States healthcare claim database illuminates multisystem disorders among patients diagnosed with hEDS and HMS in the age range of 10 to 24. This was a retrospective review of patient records within the de-identified healthcare claims database, PearlDiver. Patients with a diagnosis of hEDS or HMS, and those without these diagnoses who were seen for their annual physical examination, between the ages of 10 and 24, were queried for the presence of additional medical conditions. Descriptive statistics were used to define the frequency of multisystem diagnoses. Nineteen thousand seven hundred ninety hEDS patients, 17,509 HMS patients, and 4,959,713 patients from the general population were analyzed. Within 2 years following hEDS or HMS diagnosis, digestive disorders were the most prevalent diagnosis, followed by cardiovascular conditions. Digestive disorders occurred in 54.6% of patients with hEDS and 41.6% of patients with HMS, compared to 28.5% of the general population. Cardiovascular disorders occurred in 43.6% of patients with hEDS and 21.8% of patients with HMS compared to 10.3% of the general population. Anxiety, respiratory disorders, and developmental disorders occurred in approximately 25% of the hEDS group and 20% of the HMS group, compared to ~15% of the general population, all statistically significantly higher in the hEDS and HMS groups. This study highlights multisystem diagnoses within the pediatric hEDS/HMS populations. hEDS patients had higher rates of multisystem diagnoses compared to HMS patients. These results suggest a high multisystem disease burden for young hEDS/HMS patients. Future research is needed to understand the timing and presentation of clinical symptoms for this population.
Application and clinical effects in lung bullae resection of CT 3-dimensional reconstruction
Authors: Song Shaohui , Yang Jianqiu , Liu Keyuan , Ye Xiangqing
Published: October 2024

Background:

To investigate the value and clinical effect of computed tomography (CT) 3-dimensional reconstruction technology in lung bullae resection.

Methods:

Ninety-eight patients who underwent thoracoscopic surgical resection of lung bullae in our hospital from February 2019 to February 2023 were selected and divided into 2 groups according to the principle of voluntary participation in the clinical trial, of which 43 cases underwent preoperative spiral CT for thin-layer enhancement or planar CT scanning of lung bullae (control group), and 43 cases were imaged with MimicsMedical 21 software for 3-dimensional reconstruction to develop a surgical plan (observation group). To compare the surgery-related indexes, postoperative complications, pain, and analgesic use between the 2 groups, we measured serum creatine phosphokinase and myoglobin levels.

Results:

The amount of surgical bleeding, drainage volume, hospital stay, and postoperative visual analog scale score of the research group were lower than those of the control group (P < .05), and the duration of analgesic medication was shorter than that of the control group (P < .05), and the levels of serum creatine phosphokinase and myoglobin were lower than those of the control group at 1 and 3 days postoperatively, and the differences were statistically significant (P < .05).

Conclusion:

Preoperative CT 3-dimensional reconstruction technique can clearly show the anatomical structures around the lung bullae and has its application value for precise lung bullae.
Modeling the effects of health-related habits and lifestyle on the general health of university students
Authors: Ezepue Evelyn I. , Ezepue Chukwubuike O. , Okafor Ngozi R. , Chukwujindu Gloria A. , Nduka Chinyere U. , Abiaeme Jonah U. , Okechukwu Ferdinand
Published: October 2024

The general health of undergraduate university students has long-term social and career implications. This study, involving a cross-sectional design, is aimed at modeling the impact of sleep quality, living condition, lifestyle, eating habit, financial situation and some demographic factors on the general health and wellbeing of university students. A sample of 699 undergraduate students who met the inclusion criteria where recruited from the Faculty of Education of the University of Nigeria, Nsukka, Nigeria for the study. Quantitative data were collected with the help of general heath questionnaire, sleep quality assessment questionnaire, lifestyle index, eating habit questionnaire, living condition questions, and demographic questions. Generalized linear regression analysis was used to evaluate the predictors of general health of the students while Chi-square measure of association was used to ascertain the relationship between sleep quality and living condition of the students. At 0.05 level of significance, the year of study, sex, Parents/guardians’ financial status, student’s financial situation last 1 month, living condition (living in overcrowded rooms), source of daily meals, number of times food is eating per day, change in eating habit, risky lifestyle and severe sleep difficulty have significant negative effect on the general health of the students. Eating 3 times a day improved the health of the students. Mitigating food insecurity, insufficient financial challenges and risky lifestyles of the students while improving the living conditions will improve the health and wellbeing of the students.
Relationship between albumin and rheumatoid arthritis: Evidence from NHANES and Mendelian randomization
Authors: Liu Ke , Zhang Le , Zhao Haoming , Tang Zuyu , Hua Sheng , Xiong Yixiao , Zhang Ziming , Ou Liang , Kuang Jianjun
Published: October 2024

With the rising incidence of rheumatoid arthritis (RA) and the increasing percentage of serum RF negativity, more and more accurate methods are urgently needed for the early diagnosis and prevention of RA, among which serum albumin (ALB) is closely related to the development of RA, and it is expected to become a new auxiliary diagnostic means, but its relationship with RA is not clear, so the present study aimed to investigate the Causal relationship. In this study, we used a generalized linear model and smoothed curve fitting to comprehensively evaluate the relationship between ALB and RA through the data of ALB and RA in the NHANES database, in addition, we further used inverse variance weighted (IVW) in Mendelian randomization (MR) in conjunction with the other 4 methods to further validate and clarify the causal relationship. The results were also examined for heterogeneity and horizontal pleiotropy to assess whether the results were robust. Finally, we used Bayesian co-localization analysis to clarify that ALB and RA share common genetic loci. In the observational study, after correction for multiple confounders, ALB remained more significantly negatively associated with RA (OR = 0.66, [95% CI = 0.51–0.86], P = .003), and subgroup analyses showed significant negative associations in both men and women (men: OR = 0.67, [95% CI = 0.46–0.99], P = .046; females: OR = 0.66, [95% CI = 0.44–1.00], P = .049). In further MR analysis, IVW: ALB on RA, OR = 0.70 [95% 0.52–0.93], P = .013; RA on ALB, OR = 0.95 [95% CI = 0.93–0.98], P < .001. The results of the MR analyses were in agreement with those of NHANES, which did not share a common genetic locus in co-localization analysis. There is a significant relationship between ALB and RA, and the reduction of ALB may be one of the risk factors for RA, as well as one of the outcomes in the development of RA.
Exploring causal correlations between inflammatory cytokines and coronary heart disease: A Mendelian randomization study
Authors: Lv Luo , Guo Yuli , Zheng Zhongyi , Li Bao
Published: October 2024

Coronary heart disease (CHD) is a global health concern, with inflammation significantly contributing to its pathogenesis. It is crucial to understand the relationship between inflammatory cytokines and CHD. This study investigates the causal correlations between circulating inflammatory cytokines and CHD using Mendelian randomization (MR), assessing both causative and resultant roles of these cytokines in CHD. In this bidirectional MR analysis, we used genetic data from a genome-wide association study (GWAS) of 60,801 CHD cases and 123,504 controls of European ancestry. We derived inflammatory cytokine data from a GWAS summary of 14,824 participants. The primary analytical approach was the inverse variance-weighted (IVW) method, supported by MR-Egger, weighted median, and weighted mode analyses. Heterogeneity was assessed using the Cochrane Q test, and horizontal pleiotropy was evaluated through the MR-Egger intercept and the MR-PRESSO global test, ensuring robustness against potential pleiotropic bias. This study pinpointed several cytokines as key upstream influencers on the risk of CHD, including eotaxin (CCL11) (odds ratio [OR]: 1.10, 95% confidence interval [CI]: 1.03–1.18, P = .003), C–C motif chemokine ligand 20 (CCL20) (OR: 1.15, 95% CI: 1.05–1.25, P = .002), macrophage colony-stimulating factor 1 (CSF1) (OR: 1.09, 95% CI: 1.01–1.17, P = .020), Fibroblast growth factor 21 (FGF21) (OR: 1.14, 95% CI: 1.01–1.29, P = .038), Fms-related tyrosine kinase 3 ligand (FLT3LG) (OR: 1.26, 95% CI: 1.09–1.44, P = .001), neurotrophin-3 (NT-3) (OR: 1.12, 95% CI: 1.01–1.24, P = .026), and leukemia inhibitory factor (LIF) (OR: 0.89, 95% CI: 0.80–0.99, P = .029). Conversely, T-cell surface glycoprotein CD5 (CD5) (beta: −0.15, 95% CI: −0.29 to −0.01, P = .042) were identified as downstream factors impacted by CHD. No evidence of heterogeneity or horizontal pleiotropy was detected across all results, and a leave-one-out analysis substantiated the robustness of these findings. These findings suggest that CCL11, CCL20, CSF1, FGF21, FLT3LG, NT-3, and LIF may play a crucial role in the pathogenesis of CHD. Additionally, CHD may impact the expression of CD5. Additional research is needed to explore the potential of these biomarkers in the prevention and treatment of CHD.
Carbon dioxide narcosis following cesarean section in a patient with severe pulmonary hypertension: A case report
Authors: Lyu Song , Liao Min
Published: October 2024

Rationale:

Managing anesthesia in patients with severe pulmonary conditions involves complex considerations, especially when dealing with high baseline CO2 levels. We present a case that demonstrates the challenges and complexities of anesthesia and postoperative analgesia in a patient with severe pulmonary hypertension and a history of lung disease exacerbated by the interactions of protein-bound drugs.

Patient Concerns:

A 37-year-old woman at 38 weeks of gestation presented with recurrent chest tightness, shortness of breath, and worsening symptoms over a week, which required emergency medical attention.

Diagnosis:

The patient was diagnosed with severe pulmonary hypertension, and echocardiography revealed a pulmonary artery pressure of 106 mm Hg upon admission. Postoperative complications included sudden unconsciousness after low dose (2 µg) sufentanil administration, indicative of carbon dioxide narcosis that could compound pharmacological interactions and her underlying condition.

Interventions:

The patient underwent a cesarean section under spinal anesthesia, which was complicated postoperatively by respiratory depression, requiring naloxone administration and intensive care.

Outcomes:

Despite initial postoperative challenges, the patient’s condition stabilized, allowing eventual discharge.

Lessons:

The clinical course highlighted the need for careful monitoring and prompt intervention in anesthesia in patients with severe pulmonary hypertension, particularly when administering multiple protein-bound drugs. Drug interactions can exacerbate the underlying condition, necessitating diligent oversight to prevent severe complications such as carbon dioxide narcosis.
Diagnostic efficacy and value of ultrasound in children’s scrotal testicular torsion: A retrospective analysis
Authors: Zeng Chen , Fang Lixiang , Li Wei , Chen Hailan
Published: October 2024

The purpose of this study is to explore the diagnostic efficacy and value of ultrasound detection for testicular torsion in children with scrotal and testicular diseases. A total of 120 children with acute scrotal swelling and pain who were treated in our hospital from August 2017 to August 2022 were selected for preliminary diagnosis through color Doppler ultrasound diagnostic instrument examination. The final diagnosis was made through surgical or conservative treatment. At the same time, 40 children with acute epididymitis during the same period were selected as the control group, and the clinical treatment of patients with testicular diseases was retrospectively analyzed. A total of 120 children were diagnosed with testicular torsion disease, with 57 cases affecting the left testicle and 63 cases affecting the right testicle. Ultrasound examinations revealed no blood flow signal in 78 cases, a significant reduction in blood flow in 38 cases, and no change in 4 cases. Among the pediatric patients who underwent manual reduction, 79 cases had a favorable prognosis. Surgical reduction was performed in 41 cases, with 35 cases successfully treated and 6 cases resulting in testicular removal. Follow-up examinations conducted 6 months to 1 year postoperatively showed testicular atrophy in 4 out of 35 cases with preserved testicles, while the 6 cases that underwent testicular resection had good outcomes. The non-active subgroup had a longer disease course and a greater degree of torsion (P < .05). There was no statistically significant difference in testicular volume and the ratio of healthy testicular volume between the 2 groups (P > .05). The sensitivity of ultrasound diagnosis was 95.24% (73/77), specificity was 78.57% (34/43), and accuracy was 89.29% (107/120). Ultrasound can effectively diagnose testicular torsion and evaluate the success rate of testicular reduction. Early treatment of patients with testicular torsion leads to better efficacy and higher survival rates.
Prognostic impact of next-generation sequencing on myelodysplastic syndrome: A single-center experience
Authors: Bülbül Hale , Kaya Özge Özer , Karadağ Fatma Keklik , Olgun Aybüke , Demirci Zühal , Ceylan Cengiz
Published: October 2024

Myelodysplastic syndromes (MDS) are clinically heterogeneous disorders characterized by peripheral blood cytopenias, poor differentiation, clonal hematopoiesis, and increased risk of developing acute myeloid leukemia (AML). While somatic mutations do not currently feature in prognostic scoring systems, they may impact the clinical phenotype. In recent years, next-generation sequencing (NGS) has enabled the opportunity to identify an increasing number of genetic abnormalities, including recurrent modifications in the TP53, DNMT3A, NRAS, NPM1, RUNX1, and FLT3 genes. Bone marrow aspirate samples of 56 patients with MDS were investigated for mutations using NGS. We compared the relationship between gene mutation status and laboratory characteristics, such as certain cytopenias, the revised international prognostic scoring system, MDS subtypes, karyotypes, AML development, and overall survival. Twenty-one genes were found to have gene mutations, including ASXL1, TET2, SRSF2, EZH2, CSF3R, NRAS, ETV6, SETBP1, RUNX1, DDX41, U2AF1, JAK2, FLT3ITD, SF3B1, DNAMT3A, PHF6, TP53, CEBPA, CBL, IDH2, and GATA2. At least one point mutation occurred in 64.2% of all patients, including 58.3% of those with normal cytogenetics. Thrombocytopenia (P = .016), anemia (P = .018), decreased overall survival (P = .017), and increased AML transformation (P = .023) have been revealed to be linked to non-SF3B1 mutations. MDS are frequently associated with somatic point mutations. According to early findings, NGS panels are extremely effective instruments that provide an entirely new viewpoint on the disease for particular individuals. Future prognostications will depend more on NGS because those who exhibit normal cytogenetics may additionally have gene mutations.
Exploring the potential mechanisms of Mahuang Fuzi Xixin decoction in treating elderly bronchial asthma through network pharmacology, molecular docking, and molecular dynamics simulations
Authors: Yu Hongpeng , Wei Xiaotong , Ding Huan , Hu Shaodan , Sun Feng , Cao Zhenghua , Shi Li
Published: October 2024

Modern medical practice has confirmed the efficacy of Mahuang Fuzi Xixin Decoction (MHFZXXD) in treating elderly bronchial asthma, but its specific mechanisms of action remain to be clarified. Therefore, this study utilizes network pharmacology, molecular docking techniques, and molecular dynamics simulations to explore the key active components, core target genes, and potential mechanisms of MHFZXXD in the treatment of elderly bronchial asthma. Active components and related targets of MHFZXXD were identified through the retrieval and screening of the TCMSP, Swiss Targets Prediction, and Uniprot databases. Relevant targets for elderly bronchial asthma were searched using the GeneCards, OMIM, and Pharm GKB databases, followed by the selection of intersecting targets between the drug’s active components and the disease. A PPI network diagram was created using String and Cytoscape software, and the intersecting targets of the disease and the active components of traditional Chinese medicine were imported into the DAVID database for GO and KEGG enrichment analysis to further explore their potential mechanisms of action. Subsequently, molecular docking and molecular dynamics simulations were performed using AutoDock Vina and Gromacs to verify the binding capacity and stability of the core genes with the key active components. The study results indicate that the active components of MHFZXXD, such as quercetin, luteolin, and kaempferol, target multiple genes including AKT1, EGF, MYC, TGFB1, PTEN, and CCND1. They exert effects through signaling pathways such as TNF, PI3K-Akt, and HIF-1. Molecular docking and dynamics simulations show that the core targets bind stably with the key active components. Overall, MHFZXXD may reduce inflammatory responses and improve hypoxic conditions and apoptosis during the progression of elderly bronchial asthma through multiple active components, targets, and signaling pathways, thereby delaying the malignant progression of the disease. This provides relevant evidence and experimental data for clinical treatment and further research.
Combination therapy of Sanjie Zhentong capsules for endometriosis: Impact on hormone regulation and serum expression of FOLR1 and MSLN
Authors: Cheng Xiaojuan , Lan Yibing , Zhang Linyun , Cheng Huaquan
Published: October 2024

Examining the impact of Sanjie Zhentong capsules on hormone levels and serum expression of folate receptor 1 (FOLR1) and Mesothelin (MSLN) in endometriosis patients. A cohort of 150 endometriosis patients admitted between June 2019 and June 2023 was divided into 2 groups based on Sanjie Zhentong intake, comprising 75 cases each. Comparative analyses encompassed uterine artery hemodynamic parameters, ultrasound (B-mode) findings, Visual Analog Scale scores, traditional Chinese medicine symptom scores, Endometriosis Health Profile-30 scores, and serum levels of FOLR1, MSLN, and sex hormones before and after treatment. Post-treatment, both groups exhibited increased peak systolic velocity compared to pretreatment, with the Sanjie Zhentong group showing a significantly higher increase (P < .05). Moreover, resistance index decreased in both groups post-treatment, with the Sanjie Zhentong group displaying a greater reduction (P < .05). Adnexal mass diameters, endometrial thickness, and uterine volume decreased post-treatment in both groups, with the Sanjie Zhentong group experiencing a more pronounced decrease (P < .05). Serum FOLR1, MSLN, and sex hormone levels also decreased post-treatment in both groups, with the Sanjie Zhentong group exhibiting a more significant decrease (P < .05). Additionally, pain scores, traditional Chinese medicine symptoms, and Endometriosis Health Profile-30 scores decreased post-treatment in both groups, with the Sanjie Zhentong group demonstrating a greater reduction (P < .05). Sanjie Zhentong capsules demonstrate efficacy in regulating sex hormones, reducing serum FOLR1 and MSLN expression, alleviating pain, shrinking adnexal masses, decreasing uterine size, and improving uterine artery blood flow in endometriosis patients.
Research progress on human papillomavirus-negative cervical cancer: A review
Authors: Shao Ning
Published: October 2024

Cervical cancer is the fourth most common cancer in women worldwide. The vast majority of cervical cancers are associated with human papillomavirus (HPV) infection, but a small proportion of cervical cancers occur independently of HPV infection, with different subtypes having varying rates of occurrence. Despite the presence of false negatives in current testing, improving the accuracy of detection is crucial for studying the pathogenesis of HPV-negative cervical cancer and improving the prognosis of these patients. Existing research suggests that HPV-negative cervical cancer has a different pathogenesis from HPV-positive cervical cancer, although the exact mechanism is not yet clear. It is currently believed to be associated with the immune microenvironment, certain tumor gene mutations, and some long noncoding RNAs. This article provides an overview of the latest research progress on HPV-negative cervical cancer, including possible reasons, pathogenesis, pathological features, and clinical characteristics, aiming to provide new insights for diagnosis, treatment, and prognosis improvement.
Network toxicology and molecular docking to investigative the non-acetylcholinesterase mechanisms and targets of cardiotoxicity injury induced by organophosphorus pesticides
Authors: Guo Yongmei , Li Nan
Published: October 2024

Background:

Organophosphorus pesticides (OPPs) are widely used in the world, however, OPP poisoning often occurs because of improper use and lack of protective measures. Cardiotoxicity injury induced by OPPs is insidious, and it does not receive attention until the end stage of OPP poisoning. Heart failure or arrhythmia gradually becomes the main lethal cause of OPP poisoning patients.

Methods:

In this study, network toxicology and molecular docking were employed to investigate the non-acetylcholinesterase targets and mechanisms of cardiotoxicity injury induced by OPPs.

Results:

One hundred twenty-three targets of dichlorvos, 205 targets of methidathion, and 337 targets of malathion were searched from SwissTargetPreict, STITCH and PharmMapper database. Additionally, 1379 targets related to cardiotoxicity injury were acquired from GeneCards and OMIM database. Ninety-six mutual targets between OPPs and cardiotoxicity injury were considered as the potential cardiotoxicity injury targets induced by OPPs. The protein–protein interaction (PPI) network was constructed using STING database, and 21 core targets were identified by Cytoscape software, such as AKT1, ESR1, HSP90AA1, MAPK1, MMP9, and MAPK8. Gene ontology and KEGG enrichment analysis revealed that cell migration, apoptotic process, protein phosphorylation and signal transduction were the major biological functions associated with OPPs-induced cardiotoxicity injury, and OPPs-induced cardiotoxicity injury might be regulated by MAPK, PI3K-Akt, VEGF signaling pathway. Docking results manifested that the best binding target for dichlorvos, methidathion and malathion were MAPK9 (−7.1 kcal/mol), MAPK1 (−8.1 kcal/mol) and HSP90AA1 (−8.6 kcal/mol) with the lowest affinity, respectively.

Conclusion:

The core targets and non-AchE mechanisms were explored by network toxicology and molecular docking, providing a theoretical basis for the treatment of OPP-induced cardiotoxicity injury.
Association of triglyceride–glucose index with diabetes or prediabetes in Chinese hypertensive patients: A retrospective cohort study
Authors: Wu Juan , Huang Jiefeng , Hong Miaoling , Xia Li , Lin Yuye , Chen Yiying , Zou Junzhong , Huang Sicong , Chen Yimei , Huang Xudong
Published: October 2024

Insulin resistance is a key factor in diabetes development. This study aimed to investigate the association between baseline triglyceride–glucose (TyG) index, a surrogate marker of insulin resistance, and the onset of hyperglycemia in Chinese individuals with hypertension. Using the Rich Healthcare Group database, this retrospective cohort study included 28,687 hypertensive individuals without preexisting diabetes. A wide range of demographic information and baseline biochemical indicators was collected and rigorously analyzed. This study utilized the Cox proportional hazards model and smooth curve fitting to explore the link between TyG index and the risk of developing hyperglycemia. The robustness of the findings was validated by sensitivity and subgroup analyses. During longitudinal monitoring of hypertensive patients in our retrospective cohort study, we observed that 5.31% (1524/28,687) progressed to diabetes, while 21.66% (4620/21,326) developed prediabetes. After adjusting for confounding variables, a statistically significant positive association was observed between the TyG index and the risk of hyperglycemia. Subgroup and sensitivity analyses further supported these findings, demonstrating consistent outcomes and reinforcing the robustness of our conclusions. The TyG index, which is significantly linked to hyperglycemia in hypertensives, can aid early risk identification and intervention.
Skin metastasis of BRCA mutated prostate cancer: A case report and a brief review of literature
Authors: Jubran Salim , Basso Umberto , Milani Anna , Erbetta Elisa , Di Marco Andrea , Pittarello Chiara , Cavasin Nicolò , Lai Eleonora , Stragliotto Silvia , Pierantoni Francesco , Zampiva Ilaria , Bimbatti Davide , Maruzzo Marco
Published: October 2024

Rationale:

Metastatic castration-resistant prostate cancer has a poor prognosis especially when harboring DNA damage repair gene mutations, nevertheless, in the case of pathogenic BRCA gene mutations, PARPi demonstrated a survival benefit and is a validated treatment. Nowadays, there is no data regarding unusual metastases after these drugs. Cutaneous metastases appear rarely in prostate cancer and were associated with a worse prognosis. Moreover, there are no consolidated data concerning skin tropism of prostate cancer cells, neither in the case of BRCA-associated cancers.

Patient concerns:

Here, we report the case of a patient with a long history of BRCA1-mutated metastatic castration-resistant prostate cancer who developed a skin lesion on the scalp while on his fifth line of systemic therapy with olaparib. After a complete radical surgical excision, the pathology report showed prostate cancer localization.

Diagnoses:

A diagnosis of skin metastasis from prostate cancer was reported.

Outcomes:

The patient then continued olaparib therapy; after 7 months from excision, he experienced further bone and biochemical progression but not cutaneous progression.

Lessons:

A literature review of all reported cases of cutaneous metastasis in prostate cancer was conducted to shed light on the incidence, clinical presentation, diagnosis, treatment, and prognosis of this entity. We also reviewed published cases of skin metastasis in BRCA-associated cancers with an effort to correlate skin involvement with PARPi treatment, BRCAness status, and prognosis.
Association between serum vitamin D, uric acid, C-reactive protein, and disease severity in ulcerative colitis: A retrospective study
Authors: Qin Xiang , Jin Li , Chen Tianzhu , He Beihui , Tan Panli
Published: October 2024

Ulcerative colitis (UC) is an inflammatory disease of the intestinal mucosa, and immunodeficiency is the main cause. Vitamin D (VD) has been shown to regulate many immune diseases, and studies have found that the level of uric acid (UA) and C-reactive protein (CRP) may also affect the severity of UC. This study aimed to investigate the correlation between VD levels and disease severity in UC patients. To determine serum VD levels in patients with UC of different ages and genders in China, and to study its correlation with UC, and to analyze its correlation with serum UA levels and CRP, so as to provide guidance for the prevention, diagnosis, and treatment of UC. One hundred three UC patients (64 males and 39 females, aged 16–75 years) were diagnosed with varying severity (mild, moderate, and severe). Serum VD levels, UA levels, and CRP levels were measured by electrochemiluminescence. The serum VD level of patients with severe UC was significantly lower than that of patients with mild UC. Gender was significantly correlated with serum UA, CRP, and disease severity in UC patients. Serum VD levels may affect the disease severity of UC patients, and patients with low serum VD content may have more severe disease. Gender affects serum UA, CRP, and disease severity. Males have significantly higher serum UA and CRP levels than females, while disease severity is generally lower than that of females. However, the mechanism of abnormal serum vitamin and trace element levels in UC patients remains to be further studied.
Predictive value of the CURB-65, qSOFA, and APACHE II for in-hospital mortality in patients with acute exacerbation chronic obstructive pulmonary disease
Authors: Zhang Jingliang , Feng Lanfang , Wu Huanhuan , Fang Shuangyan
Published: October 2024

This study aimed to evaluate the efficacy of Quick Sequential Organ Failure Assessment, Confusion, Urea, Respiratory Rate, Blood Pressure, and Age Above or Below 65 Years (CURB-65), and Acute Physiology and Chronic Health Evaluation (APACHE) II in predicting the in-hospital mortality of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This retrospective study was conducted on 1583 hospitalized patients diagnosed with AECOPD from 2017 to 2019. Appropriate clinical data were retrieved from medical records from the time of admission up until the patients were discharged. The patients’ most severe physiological condition and laboratory data within the first 24 hours of admission were used to determine CURB-65, Quick Sequential Organ Failure Assessment, and APACHE II scores. The accuracy of these 3 instruments in predicting the in-hospital mortality of patients with AECOPD was compared. It was observed that patients who had died had significantly higher APACHE II and CURB-65 scores (P < .05). Binary logistic regression analysis confirmed their significant association with mortality. The APACHE II score had a sensitivity of 91.6% and a specificity of 89.2%, while CURB-65 had a sensitivity of 94% and a specificity of 67.2%. The receiver operating characteristic curves for APACHE II and CURB-65 showed high predictive accuracy (area under the curve, 0.965 and 0.882, P < .001), respectively. Mortality rates substantially increased with higher scores (P < .001), reaching 38.2% for APACHE II scores ≥16 and 15.8% for CURB-65 scores ≥2. Our findings reveal a clear link between higher mortality rates and higher APACHE II and CURB-65 scores. The receiver operating characteristic curves’ strong predictive ability highlights the dependability of these scoring systems in assessing the risk of in-hospital mortality, making them useful tools for predicting the outcomes in critical care.