bluuebunny/crossref_metadata_2025 huggingface dataset:
Gut Microbiota Disorders and Metabolic Syndrome: Tales of a Crosstalk Process
Authors: Nie Penghui , Hu Liehai , Feng Xiaoyan , Xu Hengyi
Published: November 2024

The microbiota in humans consists of trillions of microorganisms that are involved in the regulation of the gastrointestinal tract and immune and metabolic homeostasis. The gut microbiota (GM) has a prominent impact on the pathogenesis of metabolic syndrome (MetS). This process is reciprocal, constituting a crosstalk process between the GM and MetS. In this review, GM directly or indirectly inducing MetS via the host–microbial metabolic axis has been systematically reviewed. Additionally, the specifically altered GM in MetS are detailed in this review. Moreover, short-chain fatty acids (SCFAs), as unique gut microbial metabolites, have a remarkable effect on MetS, and the role of SCFAs in MetS-related diseases is highlighted to supplement the gaps in this area. Finally, the existing therapeutics are outlined, and the superiority and shortcomings of different therapeutic approaches are discussed, in hopes that this review can contribute to the development of potential treatment strategies.
The Long and Winding Road: Three-year Mortality Following Prescription of Multidrug Antibiotic Treatment for Mycobacterium avium complex Pulmonary Disease in United States Medicare Beneficiaries With Bronchiectasis
Authors: Varley Cara D , Ku Jennifer H , Henkle Emily , Strnad Luke , Winthrop Kevin L
Published: November 2024

Background/Aims

Although increased mortality has been reported among people with Mycobacterium avium complex pulmonary disease (MAC-PD), data are limited on survival associated with various antibiotic regimens used to treat MAC-PD. We conducted a comparative analysis of 3-year mortality in Medicare beneficiaries with bronchiectasis using various MAC-PD regimens.

Methods

We included Medicare beneficiaries aged ≥65 years with bronchiectasis (01/2006–12/2014). We limited our cohort to new MAC-PD therapy users. MAC-PD therapy was defined as ≥60-day prescriptions for a macrolide plus ≥1 other MAC-PD antibiotic. Guideline-based therapy (GBT) included a macrolide, ethambutol, and/or rifamycin. Using Cox proportional hazard models, we calculated adjusted hazard ratios (aHR) for death up to 3 years after therapy start between the following groups: (1) 2007 GBT versus non-GBT; (2) 2020 GBT versus non-GBT; and (3) macrolide-ethambutol-rifamycin (3-drug) versus macrolide-ethambutol (2-drug).

Results

We identified 4820 new MAC-PD therapy users, of whom 866 (17.9%) were deceased within 3 years of therapy initiation. Of 3040 (63.1%) beneficiaries prescribed 2007 GBT, 472 (15.5%) were deceased by 3 years, compared to 394 (22.1%) of 1780 (36.9%) prescribed non-GBT (aHR 0.82; 95% confidence interval [CI], .72–.94). We observed a similar trend for 2020 GBT versus non-GBT (aHR 0.81; 95% CI, .70–.94]). Three-year-mortality was similar between those starting 3-drug versus 2-drug regimens (aHR 0.89; 95% CI, .74–1.08]).

Conclusions

Among Medicare new MAC-PD therapy users, 3-year-mortality was higher in those prescribed non-GBT regimens compared to GBT regimens. Whether this finding suggests improved efficacy of GBT and/or differential characteristic of those using non-GBT regimens deserves further study.
Scaling relations between mass components and rotational velocity in disk galaxies
Authors: Lim Jin , Kim Sungeun
Published: November 2024

In this study, we re-evaluate the baryonic Tully–Fisher relation (BTFR) by analyzing the correlations between maximum rotational velocity and various mass components, including stellar mass, atomic hydrogen (H i) mass, baryonic mass, and dark matter mass in a sample of 141 disk galaxies from the SPARC (Spitzer Photometry and Accurate Rotation Curves) database, augmented by recent data on stellar and dark matter masses. We apply multiple statistical methods, including Monte Carlo orthogonal distance regression (MCODR), Monte Carlo least-squares (MCLS), and traditional least-squares (LS), to assess the impact of different fitting techniques on the derived scaling relations between the mass components (stellar, H i, and dark matter) and maximum rotational velocities of these galaxies. We find that the selection of statistical methods significantly influences the derived slopes and intercepts the relation between maximum rotational velocity and mass components. The MCODR method that accounts for errors in both variables consistently produces steeper slopes, suggesting a stronger correlation between stellar mass and rotational dynamics compared to other methods. In contrast, the MCLS method tends to yield flatter slopes, highlighting the sensitivity of this approach to outliers. Despite the variations in slope and intercept across different methods, the fundamental relation between baryonic mass and rotational velocity remains robust. We have also compared dark matter mass derived from different halo models [NFW (Navarro–Frenk–White) versus combined NFW + Dekel–Zhao profiles] and noted that the slope from the NFW profile is slightly steeper than that from the combined profile, highlighting the sensitivity of scaling relations to the selection of halo model. Overall, this study reinforces the robustness of the BTFR across different mass components in disk galaxies while emphasizing the critical role of statistical methods and dark matter profiles in analyzing galactic dynamics.
Evaluation of a novel nerve ablation technique to relieve lower back pain: a cadaveric feasibility pilot study
Authors: Jones-Whitehead Charlotte , Tran John , Wilson Timothy D , Loh Eldon
Published: November 2024

Introduction

Radiofrequency ablation is a treatment for facetogenic low back pain that targets medial branches of lumbar dorsal rami to denervate facet joints. Clinical outcomes vary; optimizing cannula placement to better capture the medial branch could improve clinical outcomes. A novel parasagittal technique was proposed from an anatomic model; this technique was proposed to optimize capture of the medial branch. The anatomic feasibility of the novel technique has not been evaluated.

Objective

To simulate and evaluate the proposed parasagittal technique in its ability to achieve proper cannula placement and proximity of uninsulated cannula tips to the medial branches of the dorsal rami in cadaveric specimens.

Methods

Under fluoroscopic guidance, the parasagittal technique was used to place 14 cannulae targeting the lumbar medial branches of 2 cadavers. Meticulous dissection was undertaken to assess cannula alignment and measure proximities to target nerves with a digital caliper.

Results

The novel parasagittal technique was successfully performed in a cadaveric model in 12 of 14 attempts. The technique achieved close proximity of cannula tips to medial branches (0.8 ± 1.1 mm). In 2 instances, cannulae were placed unsuccessfully; in one instance, the cannula was too far anterior, and in the other, it was too far retracted.

Conclusion

In this cadaveric simulation study, the feasibility of performing the parasagittal technique for lumbar radiofrequency ablation was evaluated. This study suggests that the parasagittal technique is a feasible option for lumbar medial branch radiofrequency ablation.
Inconsistency among evaluation metrics in link prediction
Authors: Bi Yilin , Jiao Xinshan , Lee Yan-Li , Zhou Tao
Published: November 2024

Link prediction is a paradigmatic and challenging problem in network science, which aims to predict missing links, future links, and temporal links based on known topology. Along with the increasing number of link prediction algorithms, a critical yet previously ignored risk is that the evaluation metrics for algorithm performance are usually chosen at will. This paper implements extensive experiments on hundreds of real networks and 26 well-known algorithms, revealing significant inconsistency among evaluation metrics, namely different metrics probably produce remarkably different rankings of algorithms. Therefore, we conclude that any single metric cannot comprehensively or credibly evaluate algorithm performance. In terms of information content, we suggest the usage of at least two metrics: one is the area under the receiver operating characteristic curve, and the other is one of the following three candidates, say the area under the precision-recall curve, the area under the precision curve, and the normalized discounted cumulative gain. When the data are imbalanced, say the number of negative samples significantly outweighs the number of positive samples, the area under the generalized Receiver Operating Characteristic curve should also be used. In addition, as we have proved the essential equivalence of threshold-dependent metrics, if in a link prediction task, some specific thresholds are meaningful, we can consider any one threshold-dependent metric with those thresholds. This work completes a missing part in the landscape of link prediction, and provides a starting point toward a well-accepted criterion or standard to select proper evaluation metrics for link prediction.
“It’s Just Really Important for Us All to Be on the Same Page”: Qualitative Evaluation of Factors That Influence Written Mobility Communication
Authors: Yin Sally , McRae Prue , Adsett Julie , Mudge Alison
Published: November 2024

Objective

Poor interdisciplinary team communication is a known barrier to increasing inpatient mobility. Understanding why and how clinicians from different disciplines communicate about mobility would help inform communication improvements. This qualitative interview study aimed to describe and explore clinician perceptions about written mobility communication and perceived barriers and enablers to this communication.

Methods

A rapid deductive qualitative approach was used to efficiently capture information for local improvement. Clinicians (physical therapists, nurses, physicians, and occupational therapists) working on 3 internal medicine wards in a metropolitan teaching hospital in Brisbane, Australia were purposefully sampled and invited to participate in individual interviews. Questions were based on the Consolidated Framework for Implementation Research. Interviews were recorded, transcribed, and analyzed using deductive and inductive thematic methods.

Results

From 17 interviews, key themes identified that written communication about patient mobility is important and valued by clinicians; clinicians learn documentation on the job, often from physical therapists; clinicians are not aware of organizational responsibility for mobility communication; multiple purposes for written communication contribute to multiple locations and inconsistency; and clinicians perceive that improvement would require a multidisciplinary and multilevel approach. Suggestions for improvement included the use of a common language, consistent use of existing bedside communication tools, and clearer responsibility for written communication about mobility.

Conclusion

Written communication about patient mobility was valued by clinicians, and a range of barriers to effective interdisciplinary communication was identified. Clear professional roles and responsibility for written mobility communication are important. Suggestions for improvement included an interdisciplinary language supported by multidisciplinary education and organizational governance.

Impact

Written communication about patient mobility is recognized as critical to safe, high-quality hospital care. Our findings suggest that successful mobility communication improvements must involve multiple disciplines and include clear organizational governance to support staff training, clear role responsibilities, and quality monitoring.

Lay summary

This study found that staff on a medical ward think writing about mobility is important for patient and staff safety. Having clear roles and responsibilities for writing about mobility is important and consistency may be improved through education and training.
The Role of Intermediaries in Selection Markets: Evidence from Mortgage Lending
Authors: Allen Jason , Clark Robert , Houde Jean-François , Li Shaoteng , Trubnikova Anna
Published: November 2024

We study the role of brokers in selection markets. We find broker-clients in the Canadian mortgage market are observationally different from branch-clients. They finance larger loans with more leverage and longer amortization. We build and estimate a model of mortgage demand to disentangle three possible explanations for these riskier product choices: (1) selection on observables, (2) unobserved borrower preferences for riskier loans, and (3) a causal effect of brokers. Although we find that brokers influence product choices, the main reason borrowers choose high-leverage products is unobserved preferences. Borrowers prefer larger loans and brokers facilitate qualification for them.
An artificial intelligence-based gout management system reduced chronic kidney disease incident and improved target serum urate achievement
Authors: Qi Han , Lu Jie , Dalbeth Nicola , Sun Mingshu , Liu Zhen , Ji Xiaopeng , Ji Aichang , Wang Can , Sun Wenyan , Li Xinde , He Yuwei , Cui Lingling , Han Lin , Chen Ying , Yan Fei , Zhang Yi , Terkeltaub Robert , Li Changgui
Published: November 2024

Objectives

Stage ≥3 chronic kidney disease (CKD) affects ∼25% of people with gout. The effects of urate-lowering therapy (ULT) on CKD incidence and progression have remained inconclusive. Here, we assessed the impact of a gout ULT clinic intervention using artificial intelligence (AI) on CKD incidence and achievement of serum urate (SU) target.

Methods

An observational study compared propensity score (PS)-matched gout cohorts from an AI-based Gout Intelligent Management System (GIMS) and a standard Electronic Medical Records system (EMRS) clinic database. The GIMS included a mobile application, data fusion interface and modules for expert consultation and laboratory results management. All patients had gout and a starting estimated glomerular filtration rate >60 ml/min. Using a 1:2 PS-matched cohort study design, we assessed the impact of the AI-based system on CKD outcomes and ULT effectiveness over 4 years of follow-up.

Results

Compared with EMRS, GIMS was associated with reduced incidence of CKD stage ≥3. Specifically, 169/4117 new-onset CKD stage ≥3 (incidence 4.1 per 100 person-years) with GIMS compared with 164/2128 with EMRS (incidence 7.7 per 100 person-years) during follow-up. More participants achieved SU <6.0 mg/dl with GIMS versus EMRS during follow-up (49.8% vs 25.9%, P < 0.001).

Conclusion

Application of the artificial intelligence-based Gout Intelligent Management System was associated with lower incidence of chronic kidney disease stage ≥3 and superior target serum urate achievement in people with gout. The Gout Intelligent Management System represents a novel approach to improve real-world renal outcomes and urate-lowering therapy success in gout.
Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis
Authors: Snoeck Henkemans Selinde V J , Vis Marijn , Koc Gonul Hazal , Luime Jolanda J , Kok Marc R , Tchetverikov Ilja , van der Kooij Sjoerd M , Bijsterbosch Jessica , van der Helm-van Mil Annette H M , de Jong Pascal H P
Published: November 2024

Objectives

To investigate the association between depression and anxiety and the inability to achieve remission in RA and PsA patients. In addition, the association between depressive and anxiety symptoms and disease activity components was explored.

Methods

A total of 400 RA and 367 PsA patients from the tREACH and DEPAR were included, respectively. Patients had a possible depression or anxiety disorder if they scored >7 on the Hospital Anxiety and Depression Scale (HADS). Remission was defined as DAS44 <1.6 in RA and DAPSA ≤ 4 in PsA. Mixed models were used to assess the association between depression/anxiety, at any timepoint during 2 years, and remission during 2 years, and to explore which disease activity components are most influenced by depression/anxiety.

Results

At baseline, 20% of RA patients had a possible depression and 30% a possible anxiety disorder. In PsA this was 18% and 23%. After adjustment for concurrent anxiety symptoms, depression was associated with a lower odds of achieving remission during 2 years of follow-up [OR 0.45 (95%CI 0.25–0.80) for RA and OR 0.24 (95%CI 0.08–0.71) for PsA]. Anxiety was not associated with remission after adjustment for concurrent depression symptoms. The presence of depression/anxiety was associated with higher tender joint count, worse general health, more pain and slightly elevated inflammation markers, but not with more swollen joints in both RA and PsA.

Conclusion

The presence of depressive symptoms in RA and PsA patients at baseline or during follow-up was associated with a lower likelihood of achieving remission. Healthcare professionals should, therefore, be aware of symptoms of depression.
Economic comparison of stocker cattle performance on winter wheat vs. summer-dormant tall fescue with nitrogen or interseeded alfalfa in the southern great plains
Authors: Adom Enoch , Biermacher Jon T , Brorsen B Wade , Interrante Sindy M , Lambert Dayton M , Butler Twain J
Published: November 2024

Winter wheat (Triticum aestivum L.) is a significant forage source for livestock grazing in the Southern Great Plains (SGP). However, increasing input costs and changing climate conditions compel producers and researchers to search for alternative forage systems, such as cool-season perennials. Specifically, cool-season perennials with summer dormancy traits can survive droughts in the SGP. This paper aimed to determine the net returns of three different types of cool-season perennial summer-dormant tall fescue [Schedonorus arundinaceus (Schreb.) Dumort., nom. cons.] systems either with N fertilizer or interseeded with alfalfa (Medicago sativa L.) and the traditional graze-out annual winter wheat forage system. The data were from a 5-yr experiment conducted in south-central Oklahoma. Animal performance results indicated that the traditional graze-out winter annual wheat forage system provided more total gains at 434 kg ha−1 than the three tall fescue variety systems at 326 kg ha−1 (P = 0.006) due to more grazing days. Thus, the gross revenue estimated at a cost of gain of $1.60 kg−1 gain for wheat at $694 ha−1 was greater than the average gross revenue of $521 ha−1 for the tall fescue systems. However, the average total cost for the perennial tall fescue systems ($374 ha−1) was less than the total cost ($594 ha−1) of the wheat system. Overall, the average net returns were similar for all grazing systems at about $145 ha−1.
Identification of a novel mycovirus belonging to the “flexivirus”-related family with icosahedral virion
Authors: Wu Chien-Fu , Okada Ryo , Neri Uri , Chang Yi-Cheng , Ogawara Takashi , Kitaura Kentaro , Komatsu Ken , Moriyama Hiromitsu
Published: November 2024

The order Tymovirales currently comprises five viral families with positive-sense RNA [(+)RNA] genomes that infect plants, fungi, and insects. Virion morphologies within the order Tymovirales differ between families, with icosahedral virions in the Tymoviridae and filamentous virions in the other “flexi”viridae families. Despite their different morphologies, these viruses are placed in the same order based on phylogenetic analyses of replicase-associated polyproteins. However, one of the families in the Tymovirales, Deltaflexiviridae, is considered to be capsidless because there have been no published reports of virion isolation. Here, we report that a new “flexivirus”-related (+)RNA virus, prospectively named Fusarium oxysporum icosahedral virus 1 (FoIV1), is icosahedral and that most deltaflexiviruses may have icosahedral virions. Phylogenetic analyses based on replicase-associated polyproteins indicated that FoIV1 forms a distinct group in the Tymovirales with some viruses originally assigned to the Deltaflexiviridae. Electron microscopy, protein analysis, and protein structure predictions indicate that FoIV1 open reading frame 4 encodes a single jelly-roll (SJR)-like coat protein (CP) that constitutes the icosahedral virions. Results of clustering analyses based on amino acid sequences and predicted CP structures suggested that most of the deltaflexiviruses have icosahedral virions composed of SJR-like CPs as in FoIV1, rather than having filamentous virions or capsidless. These results challenge the conventional understanding of viruses in the order Tymovirales, with important implications for revising its taxonomic framework and providing insights into the evolutionary relationships within this diverse and broad host range group of (+)RNA viruses.
Human immunodeficiency virus/acquired immune deficiency syndrome antiretroviral therapy initiated on the same day in treatment-naïve people with human immunodeficiency virus: A comparative study of efficacy and regimen
Authors: Yuan Jing , Deng Changgang , Li Qisui , Sun Yanyu , Huang Wei , Zhang Wei , Liu Min
Published: November 2024

Background:

Rapid initiation of antiretroviral therapy (ART) is recommended by guidelines, however, real-world studies of same-day initiation of ART in China are limited, and an optimal treatment regimen has yet to be identified. The study aims to provide a realistic reference for rapid initiation of ART.

Methods:

We retrospectively analyzed the clinical data of treatment-naïve people with human immunodeficiency virus (PWHs) who were diagnosed and prescribed same-day ART initiation from January 1, 2021 to December 31, 2022 at Chongqing Public Health Medical Center. PWHs voluntarily chose an ART regimen that divided them into two groups: National Free Antiretroviral Treatment Program (NFATP)-recommended regimens group (2 nucleoside reverse transcriptase inhibitors + non-nucleoside reverse transcriptase inhibitors/protease inhibitors) and bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) group. The primary endpoint was the virological outcome of the two groups for same-day ART initiation at 24 weeks and 48 weeks. The secondary endpoints included changes in CD4 counts, maintenance of the original ART regimen at 48 weeks, and lipid levels and renal function at 48 weeks.

Results:

A total of 255 PWHs were included in the study, including 131 (51.4%) in the NFATP group and 124 (48.6%) in the BIC/FTC/TAF group. The overall virological suppression rates at 24 weeks and 48 weeks were 78.2% (165/211) and 95.4% (207/217), respectively. At 24 weeks, the virologic suppression rate in the NFATP group was lower than that in the BIC/FTC/TAF group (65.3% [66/101] vs. 90.0% [99/110], P <0.001). The median increase in the CD4 count was 198.0 (126.0–300.0) cells/μL at 24 weeks, with 182.0 (108.0–245.0) cells/μL in the NFATP group and 219 (132.0–316.0) cells/μL in the BIC/FTC/TAF group (P = 0.035). At 48 weeks, there was no significant difference in the virological suppression rate or CD4 count between the groups. The 48-week initial ART regimen retention rates and treatment retention rates were significantly higher in the BIC/FTC/TAF group than in the NFATP group (91.1% (113/124) vs. 71.8% (94/131), 99.2% (118/119) vs. 93.0% (120/129), respectively). In terms of safety, there were no significant changes from baseline in levels of creatinine, estimated glomerular filtration rate (eGFR), or lipids in either group at 48 weeks.

Conclusions:

ART initiation on the day of diagnosis is effective, safe, and feasible, with satisfactory rates of virologic suppression, 48-week initial ART regimen retention rates, and treatment retention rates in treatment-naïve PWHs. In our study, the early virologic suppression rate, CD4 cell counts, and treatment retention of the BIC/FTC/TAF regimens were significantly better than those of the NFATP regimens.
Landscape of respiratory syncytial virus
Authors: Duan Yuping , Liu Zimeng , Zang Na , Cong Bingbing , Shi Yuqing , Xu Lili , Jiang Mingyue , Wang Peixin , Zou Jing , Zhang Han , Feng Ziheng , Feng Luzhao , Ren Lili , Liu Enmei , Li You , Zhang Yan , Xie Zhengde
Published: November 2024

Respiratory syncytial virus (RSV) is an enveloped, negative-sense, single-stranded RNA virus of the Orthopneumovirus genus of the Pneumoviridae family in the order Mononegavirales. RSV can cause acute upper and lower respiratory tract infections, sometimes with extrapulmonary complications. The disease burden of RSV infection is enormous, mainly affecting infants and older adults aged 75 years or above. Currently, treatment options for RSV are largely supportive. Prevention strategies remain a critical focus, with efforts centered on vaccine development and the use of prophylactic monoclonal antibodies. To date, three RSV vaccines have been approved for active immunization among individuals aged 60 years and above. For children who are not eligible for these vaccines, passive immunization is recommended. A newly approved prophylactic monoclonal antibody, Nirsevimab, which offers enhanced neutralizing activity and an extended half-life, provides exceptional protection for high-risk infants and young children. This review provides a comprehensive and detailed exploration of RSV’s virology, immunology, pathogenesis, epidemiology, clinical manifestations, treatment options, and prevention strategies.
Chandelier-assisted bimanual technique for securing infusion in eyes with hazy media
Authors: Ramamurthy Srishti Raksheeth , Dave Vivek Pravin
Published: November 2024

Purpose:

Hazy media with resultant difficulties in visualisation hamper the surgical approach and outcomes in various vitreoretinal surgical scenarios, including eyes with keratoprosthesis in situ. We propose a novel chandelier-assisted bimanual infusion using a flute needle to overcome the inability to secure infusion safely in such eyes.

Methods:

The surgical technique was performed with the assistance of chandelier illumination. The irrigation tubing from the vitrectomy machine was connected to a flute needle for infusion. A bimanual technique was utilized with the flute needle connected to infusion in one hand and the cutter in the other hand.

Results:

A 34-year-old monocular male patient with a keratoprosthesis in his seeing eye developed late-onset endophthalmitis with retroprosthetic membranes. The visual acuity had dropped from 20/20 to hand motions. Our novel bimanual technique helped secure infusion safely for vitrectomy. The patient recovered well to a visual acuity of 20/60 with a good anatomical outcome.

Conclusion:

Early vitrectomy may be essential for ensuring optimal outcomes in certain eyes with endophthalmitis. Surgical intervention in eyes with keratoprosthesis with secondary endophthalmitis is challenging due to difficulties in visualisation. This was overcome in our case with a novel bimanual chandelier-assisted technique for securing infusion.
Training in the Use of Myoelectric Prostheses Through the Combined Application of Immersive Virtual Reality, Cross-education, and Mirror Therapy
Authors: Calvo Sanz Jordi , Diaz Vela Mª Angeles , Jardón Huete Alberto , Bouallalene Jaramillo Karima , González-Román Loreto , Garrido-Pedrosa Jessica , Monné Cuevas Pol
Published: November 2024

Introduction

During the rehabilitation process (RHB) of the patient with traumatic upper-limb amputation, the use of immersive virtual reality (IVR) facilitates the incorporation of the prosthesis into the body schema. This reinforces and enhances sensorimotor and cognitive stimulation to improve motor learning and motor patterns, while normalizing global gestures.

Objectives

The aims of this study were to implement retraining of gestural acquisition and prosthetic control in patients with upper-limb injuries and amputations through IVR, and to then incorporate this in the normalization of functional patterns in activities of daily living (ADLs) with the work of “cross-education” as well as the therapy of observation of actions—mirror therapy to enhance the joint effect of the approach with IVR.

Methods

Standard sessions were established for transradial and transhumeral trauma patients with upper-limb amputation and traumatic injuries within the rehabilitation treatment. During the sessions, games and virtual environment were used. The software ran in desktop mode using a “Leap Motion” or for immersive versions of 3D glasses (Oculus Rift S).

Results

The application of IVR in combination with conventional treatment obtained significant benefits for functionality. These included learning correct motor execution as well as motivational and emotional state with distal traumatic injuries and upper-limb amputations with or without myoelectric prosthesis, obtaining 5.6 on average on the GROC (global rating of change) scale.

Conclusions

Immersive virtual reality shows benefit for the normalization of motor learning of functional patterns in DLA and on the emotional, motivational level of the patient.

Clinical Relevance

The integrated combination of cross-education, mirror therapy, and immersive virtual reality may represent greater acquisition of motor patterns in the prosthetic training of patients with upper-limb amputation.
Rehabilitating Amputated Hallux with Dental Implant–Supported Double Magnet in Y-Bar–Retained Prosthesis
Authors: Solanki Neeti , Singh Saumyendra V. , Arya Deeksha , Raghuvanshi Snehkiran , Mishra Brijesh
Published: November 2024

Introduction

Loss of hallux leads to aesthetic deficit and functional loss, with active push-off, weight-bearing ability, and pronation all being affected. Rehabilitation can be surgical or prosthetic; however, surgical alternatives can be unpredictable in terms of aesthetics and is not cost-effective. Therefore, prosthetic rehabilitation is often favored. However, loss of all 3 phalanges makes prosthetic rehabilitation challenging due to minimal scope of retention from the residual limb.

Materials and Methods

This technique presents a solution to this challenge, with an implant-supported, magnet-retained silicone prosthesis, having a novel abutment design, to provide dual (magnetic and frictional) retention.

Conclusions

The prosthetic design improved retention, facilitated easy handling by the patient, and prevented stress concentration on implant-bone interface.

Clinical Relevance

The prosthetic innovation improved retention during standing and walking, and increased the patient’s confidence to perform daily activities without fear of dislodgement.
An Unexpected Finding in an Adolescent Rowing Athlete With Angina Pectoris. A Case Report
Authors: Cotrim Nuno , Castilho Bruno , Cotrim Carlos , Guardado Jorge , Baquero Luís
Published: November 2024

Significant intraventricular gradient development during exercise is rare, usually occurring with left ventricular hypertrophy. The etiopathogenesis consists of the increase in nonobstructive physiological gradients; ventricular cavitary obliteration with consequent end-systolic obstruction; and midsystolic obstruction caused by systolic anterior movement of the mitral valve compromising flow. A correlation between intraventricular gradient development and various symptoms has been established. Chest pain is common in children and is a frequent reason for referral to pediatric cardiologists. Despite the benign nature of most pediatric chest pain, extensive and costly cardiac evaluation is common in these patients. In the case presented here, we describe an adolescent rowing athlete with excruciating effort angina only during upright exercise, which was replicated while performing an exercise stress echocardiography.
Defining of the nasal anthropometry on facial computed tomography in subjects with epilepsy and healthy subjects
Authors: Öksüzler Fatma Yasemin , Polat Sema , Öksüzler Mahmut , Özel Selma Ayşe , Tunç Mahmut , Özşahin Esin , Göker Pinar
Published: November 2024

Epilepsy is a frequent chronic and genetic brain disease. In diagnose of genetic and craniofacial disease, the face is one of the gold standard phenotypic features. This study was carried out to determine the angle and linear measurements of face region in Turkish healthy and epilepsy subjects, and to apply a feature selection method to identify the most important attributes that affect epilepsy decision. The retrospective and observational study was conducted with 120 subjects with epilepsy aged between 18 to 60 years (56 males; 64 females) and 60 healthy subjects aged between 18 and 55 years (29 males, 31 females). Pyramidal angle performed from 3 reference points, nasal bone length, the width of piriform aperture, nasofrontal angle, nasolabial angle, distance between glabella and nasion were measured on computed tomography. Also, we used supervised machine learning to learn classification models to detect epilepsy as our dataset has class label where 1 means epilepsy, 2 means healthy. The well-known classification model learning algorithms implemented in Weka (with version 3.8.6) machine learning toolkit were applied. All parameters excluding nasal bone length were higher in epilepsy patients than in healthy subjects. Also, there was a significant difference in nasal pyramidal angle nasal bone, nasal pyramidal angle nasal tip, piriform aperture, and nasal bone lengths between epilepsy and healthy subjects. However, age related changes for healthy subjects were no seen in healthy subjects. In epilepsy subjects there was a significant difference in 6 measurements all nasal pyramidal angles, piriform aperture width, nasofrontal angle, and nasolabial angle. Gender related changes were found in only nasal pyramidal angle nasal root and nasal bone of healthy subjects, in nasal pyramidal angle nasal bone, nasal bone length, nasofrontal angle of epilepsy subjects. We can say epilepsy may affect the some facial parameters and these, although anthropometric measurements are affected by age and gender parameters. Comprehensive knowledge of this region’s normal references ranges is essential for planning, proper selection of silicone implants or osteotomy determining the limitations of the surgical field and minimizing the risk of complication and performing aesthetic facial surgery or rhinoplasty in epilepsy patients.
Clinical value of transperineal ultrasound in evaluating the diagnostic grade of rectocele in Chinese women with obstructed defecation syndrome: An observational study
Authors: Jiang Yunlin , Fan Zhimin , Gao Ling , Shen Guangshu , Yue Jingjing , Wang Xiaofeng , Zheng Xueping , Xue Yahong
Published: November 2024

We aimed to evaluate the effectiveness of transperineal ultrasound (TPUS) in diagnosing rectocele, rectal intussusception (RI), enterocele, perineal descent (PD), and cystocele in Chinese women with obstructed defecation syndrome (ODS), and to determine the grading of rectocele via TPUS. Between January 2019 and December 2021, 107 obstructed defecation syndrome patients, with a mean age of 49.76 years, received TPUS and defecation proctography (DEP). Both methods were used to diagnose anorectal angle, rectocele, RI, enterocele, and PD, while cystocele and uterine prolapse were diagnosed only through TPUS. Agreement between DEP and TPUS diagnostic results was compared using Cohen kappa statistics. Seventy-six rectoceles were reported following DEP and 72 after TPUS. DEP detected 7 enteroceles, 6 of which were diagnosed simultaneously by TPUS. 43 patients presented dyssynergic defecation (DD) upon DEP, while 51 upon TPUS. DEP and TPUS detected PD in 13 and 11 patients respectively, and RI in 82 and 73, respectively. Rectocele (kappa = 0.738), RI (kappa = 0.711), DD (kappa = 0.774), enterocele (kappa = 0.847), and PD (kappa = 0.625) were obtained by Cohen kappa statistics, which indicated a good agreement between DEP and TPUS. The cutoff values for the diagnosis of moderate and severe rectocele with TPUS were 12.05 mm (AUC: 0.941) and 18.50 mm (AUC: 0.977), respectively. The DEP-determined and TPUS-determined anorectal angles were significantly correlated in the resting and Valsalva states (P < .01). Compared with DEP, while maintaining good agreement in detecting rectocele, RI, DD, enterocele, and PD, TPUS is a repeatable and noninvasive alternative. Threshold values of 12.05 mm and 18.50 mm on TPUS may diagnose moderate and severe rectocele, respectively.
Transcutaneous electrical stimulation of the stellate ganglion: A case report on its application in treating carotid sinus syndrome
Authors: Hou Taifu , Xu Mengya , Zhang Zhiguo
Published: November 2024

Rationale:

Syncope is a common condition in emergency departments, posing a diagnostic challenge due to its multifactorial nature. Among the potential causes, carotid sinus hypersensitivity leading to carotid sinus syndrome (CSS) is a significant consideration that can severely impact patient quality of life. Despite its importance, establishing effective treatment methods for CSS has been difficult.

Patient concerns:

A 43-year-old male presented with recurrent episodes of syncope, which significantly affected his daily life and well-being.

Diagnoses:

After a thorough evaluation, the patient was diagnosed with CSS, a condition that can be difficult to pinpoint and requires specialized diagnostic procedures to confirm.

Interventions:

The patient was treated with stellate ganglion block therapy, a targeted intervention aimed at addressing the underlying cause of CSS. This treatment was administered over a 12-day period.

Outcomes:

Following the treatment, the patient’s symptoms showed gradual improvement, and he was discharged after meeting the clinical cure criteria. During a 7-month follow-up, he remained symptom-free.

Lessons:

The case highlights the effectiveness of transcutaneous stellate ganglion block therapy in treating CSS. It suggests that further research and clinical trials are needed to validate this treatment’s efficacy, potentially offering a new therapeutic option for patients suffering from CSS.
Factors related to evacuation intention when a Level 4 evacuation order was issued among people with mental health illnesses using group homes in Japan: A cross-sectional study
Authors: Nakai Hisao , Oe Masato , Nagayama Yutaka
Published: November 2024

This study aimed to identify factors related to the intention to evacuate in a disaster following a Level 4 evacuation order among people with mental health illnesses living in group homes in Japan. The participants were people with mental health conditions living in group homes in Ishikawa Prefecture, Japan. We created an original self-administered questionnaire and conducted a survey among this group. Of the 625 people with mental health conditions using group homes, 152 (24.3%) responded. Of these, 110 (5.9%) who provided valid data were included in the analysis. A total of 85 (77.3%) people said that they intended to evacuate in the event of a Level 4 evacuation order. We controlled for gender, age group, type of disability, experience of participating in disaster training, fear of contracting COVID-19 during evacuation, and earthquake and flood disaster experience as confounders. After controlling for these variables, the factors associated with intention to evacuate under a Level 4 evacuation order included not having emergency food prepared (odds ratio [OR] 3.81, 95% confidence interval [CI]: 1.03–14.08); believing that group home users would help them during disasters (OR 3.08, 95% CI: 1.04–9.12); and planning to ask the local government for help (OR 2.84, 95% CI: 1.01–8.01). Group home managers should be aware that people who do not believe that other group home residents would help them, and those not wishing to seek help from local government, may decide not to evacuate. Longitudinal studies across diverse regions are needed to identify factors that affect evacuation intention.
The relationship between mental health problems and risk of infectious diseases: A Mendelian randomization analysis
Authors: Wang Ling , Fang Meilin , Wang Cunze , Li Jinglin , Huang Shasha , Li Wen , Zhuang Boyang , Gong Shurong
Published: November 2024

The causal effects of mental health problems on the risk of infectious diseases remain vague. Investigating them via observational study is challenging as it presents possible confounding factors. Therefore, the objective of this study was to utilize Mendelian randomization (MR) techniques to evaluate the causal relationship between mental health problems and the risk of infectious diseases. Multivariable MR analyses were performed using genome-wide association data for sleep disorders (N = 216,700), depression (N = 500,199), anxiety (N = 290,361), nervous feelings (N = 450,700), unspecified mental disorder (N = 218,792), pneumonia (N = 486,484), skin and subcutaneous tissue infection (SSTI; N = 218,792), intestinal infectious diseases (IIDs; N = 218,792), urinary tract infection (N = 463,010), and central nervous system (CNS) infections (N = 218,792) among individuals of European ancestry. Independent genetic variants significantly (P < 10−8) associated with each exposure were considered instruments. The primary analysis used an inverse variance-weighted method, followed by a series of sensitivity analyses. Genetically predicted sleep disorders were associated with an increased risk of SSTI (odds ratio [OR], 1.29 [95% confidence interval (CI), 1.05–1.59]; P = .017). Genetically predicted depression was linked with an increased risk of CNS infections (OR, 1.59 [95% CI, 1.00–2.53]; P = .049) and SSTI (1.24 [95% CI, 1.03–1.49]; P = .024). Genetically predicted anxiety was associated with IIDs (OR, 1.19 [95% CI, 1.03–1.37]; P = .017) and SSTI (OR, 1.21 [95% CI, 1.02–1.43]; P = .029). There was no significant causal evidence for genetic prediction of nervous feelings and unspecified mental disorders in IIDs, CNS infections, SSTI, pneumonia, or urinary tract infection. Sensitivity analyses showed that the above causal association estimates were robust. In this MR study, we demonstrated a causal relationship between sleep disorders, depression, anxiety, and the risk of infectious diseases. However, no evidence was found to support causality between nervous feelings, unspecified mental disorders, and the risk of infectious diseases.
Perinatal outcomes with a copper intrauterine device in situ after 28 gestational weeks: A retrospective study of sole center in southeast China
Authors: Chen Xiuying , Zhao Baihui
Published: November 2024

The purpose of this study was to investigate the pregnancy outcomes with a copper intrauterine device (IUD) in situ after 28 gestational weeks and the association between pregnancy with copper IUDs and neonatal congenital malformations. This retrospective study had compared the singleton pregnancies with the copper IUDs in situ and without after 28 gestational weeks in 1 delivery center of southeast China. The main exposure was a copper IUD in uterine cavity with pregnancy. The pregnant outcomes as preterm birth, premature rupture of membranes, infections were observed and compared. We had also compared neonatal congenital malformations in 2 groups. The statistical analysis was carried out using R (version 4.0.4; R Development Core Team) statistical software. Association between IUD use or duration of IUD use and adverse pregnancy outcomes were estimated using logistic model. Two-tailed P value < .05 was deemed statistically significant. A total of 148 pregnant women were included in our study, 74 with copper IUDs in situ were categorized into case group and 74 without IUDs during pregnancy into control group. No significant difference of maternal age, BMI, birth weight and gender were observed between 2 groups. In case group, the rates of preterm premature rupture of membranes (37.8%) and spontaneous preterm birth (23.0%) were significantly high compared to control group. Odds ratios of premature rupture of membranes and spontaneous preterm birth were 2.86 and 5.22 respectively. Women of elder age (≥35 years) in case group were more likely to experience premature rupture of membranes. The rates of neonatal congenital malformation were 10.8% (8/74) in case group and 1.4% (1/74) in control group respectively. We had found that pregnancy with copper IUD in situ increased the risk of premature rupture of membranes and spontaneous preterm birth after 28 gestation weeks, the risk of spontaneous preterm birth increased 5.22 times. Pregnancy with IUD in situ may be at increased risk of infection and neonatal malformation.
A real-world pharmacovigilance study of esketamine nasal spray
Authors: Chen Yaqing , Gu Hangye , Li Wenwei , Chen Yong
Published: November 2024

Mining and updating the post-marketing safety signals of esketamine nasal spray for better identification of adverse drug event (ADE) signals and medication monitoring during clinical use to ensure patient medication safety. Downloading data from the US Food and Drug Administration Adverse Event Reporting System from Q1 2019 to Q2 2023, the reporting odds ratio, proportional reporting ratio, Multi-item Gamma Poisson Shrinker, and Bayesian Confidence Propagation Neural Network methods of the disproportionality method were used to mine and analyze ADEs, and finally to screen for signals of ADEs with esketamine nasal spray as the primary suspected drug. The Preferred Terminology of the Medical Dictionary of Regulatory Activities (version 26.0) was used to standardize the description of ADEs and to attribute ADEs to the System Organ Classification. A total of 5132 ADEs reports of esketamine nasal spray as the primary suspected drug were obtained from the Food and Drug Administration Adverse Event Reporting System. The most frequently observed ADEs are dissociation, sedation, and hypertension, while some new rare signals have been detected, such as interstitial cystitis, substance abuse, and drug diversion. The present study identified significant new ADEs signals for esketamine nasal spray, which may provide a source for healthcare professionals to assess patients’ symptoms and risk identification.
An observational study on the application of fast-track cardiac anesthesia using target-controlled infusion of sufentanil and propofol in valve replacement surgery
Authors: Su Mingping , Ju Jifeng
Published: November 2024

The aim of this study was to evaluate the efficacy of fast-track cardiac anesthesia using target-controlled infusion of sufentanil and propofol in valve replacement surgery. The clinical data of 88 patients with rheumatic heart disease undergoing valve replacement surgery were retrospectively analyzed and grouped based on different treatment methods. Among them, 44 cases received fast-track cardiac anesthesia using target-controlled infusion of fentanyl and propofol from November 2019 to July 2021 were set as the control group, and 44 cases received fast-track cardiac anesthesia using target-controlled infusion of sufentanil and propofol from August 2021 to February 2022 were set as the study group. The study group showed shorter postoperative awakening time, extubation time, and hospital stay duration, and lower dosage of dopamine and nitroglycerin consumption compared to the control group (P < .05). At T5 and T6, both groups exhibited higher ACTH, cortisol (Cor), and C3a than at T0, and the study group showed significantly lower ACTH, Cor, and C3a at T5 and T6 than the control group (P < .05). At T7, the control group showed higher ACTH, Cor, and C3a than at T0, and ACTH, Cor, and C3a were significantly lower in the study group than in the control group at T7 (P < .05). Fast-track cardiac anesthesia using target-controlled infusion of sufentanil and propofol in valve replacement surgery has demonstrated favorable application effects, which stabilizes hemodynamics, alleviates myocardial damage, suppresses endocrine stress responses, and does not increase adverse reactions, thereby exhibiting good safety.