bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Childhood Immune Thrombocytopenia Associated With Acquired Toxoplasmosis? An Unusual Case of Infection That Led to Acute ITP in a Greek Male Toddler and Implications for Guidelines
Authors: Stogiannis Dimitris , Blanas Kostas , Tsapra Eleni , Theodora Marianna
Published: October 2023

Introduction:

Childhood immune thrombocytopenic purpura (ITP) is a heterogeneous immune-mediated process triggered by infections, vaccines, allergies and parasites. Currently, there is little evidence in the literature beyond case reports of an association with Toxoplasma gondii (T. gondii).

Methods:

The authors describe the unusual case of an earlier healthy 2.5-year-old Greek boy who developed acute ITP with a life-threatening platelet count a few days after a T. gondii infection. Evidence for the infection onset was found incidentally 3 months after the initial admission to the hospital and only after any other plausible cause of thrombocytopenia was excluded, according to diagnosis guidelines.

Results:

The boy underwent 3 intravenous immunoglobulin treatments within a trimester, a period during which his alarming platelets count levels led to housebound activities. A quite slow recovery was only ignited after the third treatment, which was administered in conjunction with a mild antibiotic medication for the T. gondii infection. Full recovery was obtained 9 months after the initial admission, although the boy’s potential scored high in clinical prediction models for developing transient ITP.

Conclusion:

There is a need for more research on ITPs with no obvious cause to investigate a causal association with toxoplasmosis. Currently, testing for diseases of greater rarity and of higher diagnostic cost than T. gondii is included in the ITP guidelines. Hence, routinely testing for toxoplasmosis when considering potential childhood ITP triggers and infection treatment complementary to treating the ITP might be the key to accelerating the healing process and improving the quality of life of otherwise confined children.
Current knowledge and availability of machine learning across the spectrum of trauma science
Authors: Gauss Tobias , Perkins Zane , Tjardes Thorsten
Published: October 2023

Purpose of review

Recent technological advances have accelerated the use of Machine Learning in trauma science. This review provides an overview on the available evidence for research and patient care. The review aims to familiarize clinicians with this rapidly evolving field, offer perspectives, and identify existing and future challenges.

Recent findings

The available evidence predominantly focuses on retrospective algorithm construction to predict outcomes. Few studies have explored actionable outcomes, workflow integration, or the impact on patient care. Machine Learning and data science have the potential to simplify data capture and enhance counterfactual causal inference research from observational data to address complex issues. However, regulatory, legal, and ethical challenges associated with the use of Machine Learning in trauma care deserve particular attention.

Machine Learning holds promise for actionable decision support in trauma science, but rigorous proof-of-concept studies are urgently needed. Future research should assess workflow integration, human-machine interaction, and, most importantly, the impact on patient outcome. Machine Learning enhanced causal inference for observational data carries an enormous potential to change trauma research as complement to randomized studies. The scientific trauma community needs to engage with the existing challenges to drive progress in the field.
Validation of the knowledge evaluation questionnaire of the cardiopulmonary resuscitation training program in high school students
Authors: Calvo-Francés Fernando , Cilleros-Pino Lucía , Barraza-Illanes Paula Andrea , Díaz-Hernández Maximino , Hernández-Rodríguez José Enrique
Published: October 2023

There is an urgent need for generalized training in cardiopulmonary resuscitation (CPR) techniques, starting with secondary education. Validated instruments for assessing the efficacy of such interventions are not yet available. This study aimed to validate an evaluation questionnaire of a CPR training program for high school students, to analyze the levels of readability, difficulty, reliability, and content validity, as well as the fit the purpose for which they were designed, the trait they are intended to measure. An instrumental study was conducted in 2 phases. In the first phase, an inter-judge validation was carried out with 11 experts in CPR accredited instructors of basic and advanced CPR by the American Heart Association. In the second phase, the psychometric properties were evaluated from the perspective of Item Response Theory. During May of the 2017/18 and 2018/19 academic years, 259 4th-year secondary school students from a high school in the southeastern area of the island of Gran Canaria (mean age: 15.78 years; 50.60% male) were surveyed anonymously using the questionnaire to be validated. The questionnaire was easily readable (74.12 Flesch-Szigriszt Index); the difficulty level (Easy/Very Easy) in the context of this secondary school level of education and the ability level of the respondents overlapped sufficiently and there was no gender bias. The questionnaire was able to discriminate between respondents of slightly more than 7 levels of expertise, from low knowledge of CPR to high knowledge of CPR (Separation Index 7.53). The model fit was excellent (infit = 1/outfit = 1.01). The content validity index was adequate. The separation index and reliability exceeded what was considered adequate for guaranteed use. The level of difficulty of the items and the level of ability of the respondents is in line with the educational level of the students. The questionnaire did not produce a gender bias in response probability. The questionnaire is easily understandable and can discriminate between different levels of ability without differential gender bias, and its reliability is outstanding, as it exceeds the minimum criteria.
A case of successful hormone therapy for refractory hypotension following viral encephalitis: Case report
Authors: Zhang Congcong , Zhang Jiangshan , Liao Zhongkai
Published: October 2023

Rationale:

Refractory hypotension is a life-threatening condition that can result from various causes. We report a rare case of refractory hypotension following herpes simplex virus type 1 encephalitis that was successfully treated with hormone therapy.

Patient concerns:

The patient was a 66-year-old male who was admitted to the hospital because of fever, chills, convulsions, and impaired consciousness. He developed respiratory failure and was intubated. Cerebrospinal fluid metagenomic sequencing confirmed herpes simplex virus type 1 infection. He received piperacillin-tazobactam for anti-infection, acyclovir for antiviral therapy, and dexamethasone for anti-inflammatory therapy. He had repeated episodes of hypotension despite fluid resuscitation and vasopressor therapy.

Diagnosis:

The diagnosis of herpes simplex virus type 1 encephalitis complicated by refractory hypotension was based on the patient’s epidemiological history, clinical manifestations, laboratory tests, and imaging studies. Cerebrospinal fluid examination was the most important diagnostic method, which could detect viral nucleic acids. Head magnetic resonance imaging showed a large recent lesion in the right temporal-parietal and insular lobes.

Interventions:

The treatment of refractory hypotension mainly included anti-infection, antiviral, anti-inflammatory, and hormone therapy. Hormone therapy used methylprednisolone shock treatment until tapering withdrawal. Other treatments included fluid resuscitation, vasopressors, anticonvulsants, etc.

Outcomes:

The patient’s blood pressure stabilized after receiving methylprednisolone shock treatment, and his mean arterial pressure increased from 73 mm Hg to 92 mm Hg within 24 hours. Three months later, the patient’s blood pressure was normal without medication, and he had a good social and physical recovery.

Lessons:

This case illustrates the possible role of hormone therapy in restoring blood pressure in patients with refractory hypotension following viral encephalitis. It suggests that adrenal insufficiency or autonomic dysfunction may be involved in the pathophysiology of this condition. Further studies are needed to confirm the efficacy and safety of hormone therapy in this setting.
Study on the relationship between scoliosis and vision problems: A narrative review
Authors: Pan Yingsen , Zhang Haoyang , Ye Xin , Li Shuailin , Li Xiaoming , Li Zengtu , Ying Xiaoming
Published: October 2023

Adolescent scoliosis is one of the most common surgical disorders of the pediatric spine. With timely detection and early treatment, most scoliotic children can avoid major and expensive surgery. Vision problems are also frequently found at an early age and can take a toll on individuals quality of life. However, scoliosis, a severe health hazard to adolescents, is often accompanied by vision problems clinically, including myopia, astigmatism, strabismus, amblyopia, horizontal paralysis, and blindness. And people with genetic defects have a higher probability of suffering both spinal problems and vision problems than those with nongenetic defects. However, many individuals viewed scoliosis and vision problems as 2 irrelevant diseases. This review searched PubMed, China National Knowledge Infrastructure, and Web of Science for studies on adolescent, scoliosis, eye diseases, myopia, strabismus, spinal disorders, and vision problems for almost 3 decades, and thus confirmed the potential relationship between adolescent scoliosis and vision problems.
Establishment and validation of a novel risk model based on CD8T cell marker genes to predict prognosis in thyroid cancer by integrated analysis of single-cell and bulk RNA-sequencing
Authors: Du Jian , Song Cheng-Fei , Wang Shu , Tan Yu-Cheng , Wang Jiang
Published: October 2023

Papillary thyroid cancer (PTC) is a histological type of thyroid cancer, and CD8T is important for the immune response. The single-cell RNA data were acquired from Gene Expression Omnibus. SingleR package was used for cluster identification, and CellChat was exploited to evaluate the interaction among several cell types. Bulk RNA data obtained from the cancer genome atlas were used for determination of prognosis using Kaplan–Meier and Receiver Operating Characteristic curve. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were applied for assessment of function enrichment. The drug sensitivity was calculated in Gene Set Cancer Analysis. The regulatory network was constructed by STRING and Cytoscape. We identified 23 cell clusters and 10 cell types. Cell communication results showed CD8T cell was vital among all immune cell types. Enrichment analysis found the marker genes of CD8T cell was enriched in some signal pathways related to tumor development. Overall, FAM107B and TUBA4A were considered as hub genes and used to construct a risk model. Most immune checkpoint expressions were upregulated in tumor group. Tumor mutation burden results indicated that prognosis of PTC was not related to the mutation of hub genes. Drug sensitivity analysis showed some drugs could be effectively used for the treatment of PTC, and regulatory network identified some targets for the immunotherapy. A 2-gene model of PTC was developed based on the single-cell RNA and bulk RNA data. Besides, we found CD8T was essential for the immune response in PTC.
Construction and validation of a immune-related prognostic gene DHRS1 in hepatocellular carcinoma based on bioinformatic analysis
Authors: Xu Sa , Wang Wei , Meng Tao , Wang Fuyan , Wang Guoxing , Huang Fan , Wang Guobin , Yu Xiaojun , Wu Ruolin , Hou Liujin , Ye Zhenghui , Zhang Xinghua , Zhao Hongchuan , Shen Yuxian
Published: October 2023

A member of the short-chain dehydrogenase/reductase superfamily (DHRS1, SDR19C1) is a member of the short-chain dehydrogenase/reductase superfamily and a potential predictor of hepatocellular carcinoma (HCC). However, the role of DHRS1 in HCC immunity remains unclear. We systematically analyzed the association between DHRS1 and HCC immunity with transcriptional and clinical data from the Tumor Immune Estimation Resource, an integrated repository portal for tumor immune system interactions, and cBioPortal databases. Six DHRS1-associated immunomodulators strongly correlated with survival and were uncovered by exploiting univariate and multivariate Cox analyses. We created a risk score for each patient by adding the points from each immunomodulator and then classified them into high and low risk categories. Survival analysis were used to compare the overall survival between the 2 groups, and the receiver operating characteristic curve was applied to assess the accuracy of the risk score. Data from our center were adopted as the external validation set, the risk score was calculated using the risk coefficient of the 6 genes in the training cohort, and survival analysis were executed to verify the experimental group results. A nomogram was ultimately constructed with the R package. Our data revealed a correlation between the levels of immune cell infiltration and either the DHRS1 gene copy numbers or mRNA levels in HCC. Second, we generated a signature based on the 6 DHRS1-related immunomodulators (KDR, TNFRSF4, CD276, TNFSF4, SLAMF6, and SIGLEC9). We postulate that the generated risk scores would serve as an independent indicator of HCC prognosis, with an area under the receiver operating characteristic curve for the risk score of 0.743. We further established external validation sets to reconfirm the predictive validity of the risk score. Finally, a prognostic nomogram and calibration curve were created. The DHRS1 gene may exert an impact on HCC immunity. We posit that the nominated immune signature based on DHRS1-associated immunomodulators could constitute a promising prognostic biomarker in HCC.
Outcomes of the electromagnetic navigation bronchoscopy using forceps for lung lesion suspected malignancy: A retrospective study
Authors: Kim Tae Hun , Kim Mi-Ae , Kim Hyun Jung , Kwon Yong Shik , Park Jae Seok , Park Sun Hyo
Published: October 2023

Many studies have reported electromagnetic navigation bronchoscopy (ENB) diagnostic yields and the importance of size and computed tomography (CT) bronchus sign. This study aimed to determine the diagnostic yield of ENB alone, using forceps biopsy and cytology. We analyzed the factors associated with yield and complications according to gross specimen size. This retrospective study included patients who underwent ENB using forceps for suspected lung lesions on CT between January 2020 and December 2022 in South Korea. Factors related to the ENB diagnostic yield and complications were evaluated, and the impacts of gross specimen size and cytology were analyzed. A total of 276 patients were analyzed. The final diagnostic yield was 75.5% after excluding indeterminate cases. Sensitivity and specificity were 74.2% and 100%, respectively. Pneumothorax developed in 1.4% (4/276) of cases, with no grade 3 or higher bleeding. Univariable analysis showed that the number of biopsies and the size of the gross specimen were related to the diagnosis. Multivariable analyses showed that a larger lesion size on CT was a significant factor for diagnosis. The gross size of the specimens was not significantly associated with epinephrine use. ENB had acceptable diagnostic yield and safety for diagnosing lung lesions with suspected malignancy. Obtaining more tissue through biopsy may not increase bleeding or pneumothorax complications. Identifying patients with lesion characteristics, including CT bronchus sign, would help increase ENB diagnostic yield.
Exploration of potential targets and mechanisms of naringenin in the treatment of nonalcoholic fatty liver disease through network pharmacology
Authors: Yu Chenyang , Han Duan , Yu Jingfang , Zhu Ran , Zhu Cuiyan , Wang Fule , Zhang Tiefeng
Published: October 2023

Objective:

This study aimed to use network pharmacology to investigate the molecular mechanisms and potential targets of naringenin (NR) for nonalcoholic fatty liver disease (NAFLD) treatment to offer new drug development ideas.

Methods:

The structure and compound information of NR were obtained from PubChem and the traditional Chinese medicine system pharmacology database and analysis platform. The traditional Chinese medicine system pharmacology database and analysis platform Database, Comparative Toxicogenomics Database and Encyclopedia of Traditional Chinese Medicine Database were then used to predict the related targets of NR. Online mendelian inheritance in man, Disgenet, Gene cards, The therapeutic target database and Drug bank were used to screen NAFLD targets, and the intersection analysis was performed with the targets of NR active components to obtain the targets of NR in the treatment of NAFLD. The protein-protein interaction network of therapeutic targets was constructed by protein-protein interaction networks functional enrichment analysis 11.0, and gene ontology (GO) functional enrichment analysis and Kyoto encyclopedia of genes and genomes pathway enrichment analysis of therapeutic targets was performed by Metascape platform.

Results:

In this study, 171 NR targets and 1748 potential targets of NAFLD were screened, and 89 crossover targets and 16 core targets were screened and finally obtained. A total of 176 GO items were obtained by GO enrichment analysis (P < .05), including 389 biological process, 6 cell composition and 30 molecular function. A total of 137 signaling pathways were obtained by Kyoto encyclopedia of genes and genomes pathway enrichment and screening (P < .05). The core targets of NR in the treatment of NAFLD are TP53, CASP3, PRKCA, AKT1, RELA, PPARG, NCOA2, CYP1A1, ESR1, MAPK3, STAT3, JAK1, MAPK1, TNF, PPARA and PRKCB. Enrichment analysis showed that NR mainly involved in biological processes such as cellular response to nitrogen compound, regulation of miRNA transcription and negative regulation of miRNA-mediated gene silencing. It regulates Hepatitis B, Lipid and atherosclerosis, cytomegalovirus infection, Hepatitis C, AGE-RAGE signaling pathway in diabetic patients complications and other ways play a role in the treatment of NAFLD.

Conclusions:

The therapeutic effect of NR on NAFLD has the characteristics of multi-targets and multi-pathways, which provides a preliminary theoretical basis for clinical trials and the development of new drugs.
Prevalence of Plasmodium species in Badr Governorate, Madinah Province, Saudi Arabia using microscopy and rapid diagnostic test
Authors: Hassanein Raafat Abdel Moneim , Alkurbi Mohammed Othman , Alsobhi Saad Hussain
Published: October 2023

Malaria infection still represents a notable public health risk in Saudi Arabia. This cross-sectional study aimed to determine the prevalence of Plasmodium species among clinically suspected cases who presented at Badr General Hospital and healthcare facilities in selected regions of Badr Governorate, Madinah Province, Saudi Arabia between January 2021 and January 2022. A total of 493 suspected patients were recruited from Badr Governorate, investigated for malaria infection using CBFME and rapid diagnostic test- CareStart Malaria Pf/PAN (HRP2/pLDH) Ag Combo rapid diagnostic tests. The results showed that malaria infection was 34 (6.89%) cases among 493 suspected patients using microscopic examination as reference test. Moreover, subjects aged 31 to 40 years and those aged 51 to 60 years had the highest (50%) and lowest (8.82%) percentages of malaria cases. Plasmodium vivax (19/34, 55.88%) was higher than P falciparum (15/34, 44.1%) as the causative agents of malaria cases. The majority of malaria cases (29/34, 80.9%) among non-Saudi mainly from Sudan (15/34, 44.1%), Pakistan (5/34, 14.7%), Bangladesh (5/34, 14.7%) and India (4/34, 11.76%) whereas malaria cases among Saudis (5/34, 14.7%). In addition, the majority of malaria cases (32/34, 94.11%) among male subjects while (2/34, 5.88%) among females. The current study revealed that malaria transmission is still active in Badr Governorate, Madinah Province, Saudi Arabia and represents a public health concern. Further screening implements and continuous epidemiological monitor of the status of malaria infection in Kingdom of Saudi Arabia are thus warranted to improve its controlling activities and eradicate malaria endemicity in the country.
General anesthesia versus combined interscalene nerve/superficial cervical plexus block in arthroscopic rotator cuff repair: A randomized prospective control trial
Authors: Kilbasanli Seval , Kaçmaz Mustafa
Published: October 2023

Background:

In this study, interscalene brachial plexus block (ISB) with superficial cervical plexus block added and general anesthesia (GA) application were evaluated in terms of intraoperative hemodynamics, operative time and postoperative analgesia need in patients who underwent rotator cuff tear repair.

Methods:

70 patients aged between 18 and 75 years were included in this prospective study. Arthroscopic rotator cuff tear repair surgery was performed in all patients. The patients were randomized into 2 groups, namely Group ISB who received a combination of superficial cervical plexus block added to the Interscalene Nerve Block, and Group GA, for those who received GA. Duration of operation, waiting times, intraoperative hemodynamic data, postoperative visual analog scale (VAS), analgesic requirement, as well as patient and surgeon satisfaction levels, were compared between the 2 groups.

Results:

While VAS values at the post-anesthesia care unit were lower in ISB group at 2 and 24 hours (P < .05), there was no significant difference between VAS values measured at 6th and 12th hours (P ≥ .05). In the GA group, postoperative morphine and diclofenac consumption was higher, and rescue analgesia was needed earlier (P < .05). The hospital stay was shorter (P < .05), and surgeon and patient satisfaction were higher in the ISB group (P < .05).

Conclusion subsections:

In rotator cuff tear repair anesthesia, ISB with superficial cervical plexus block provides adequate intraoperative anesthesia, low postoperative VAS level, reduced and deferred consumption of opioids and nonsteroidal anti-inflammatory drugs, higher patient and surgeon satisfaction and early discharge.
Prevalence of high blood pressure and its associated factors among students in Shenyang, China: A cross-sectional study
Authors: Zhang Dan , Sun Baijun , Yi Xiaodan , Dong Nan , Gong Guifang , Yu Wenbo , Guo Lianying
Published: October 2023

There is growing evidence that the prevalence of high blood pressure is increasing, and it may have serious consequences. However, research on the prevalence and influencing factors of high blood pressure among primary and secondary school students is still relatively scarce. This study aims to investigate the prevalence and influencing factors of high blood pressure among primary and secondary school students in Shenyang, in order to provide scientific evidence for the prevention and management of this disease. From April to May 2020, 4892 students aged 7 to 17 years were selected as the survey subjects, and on-site physical measurements and questionnaire surveys were conducted. The prevalence of high blood pressure was described. Restricted cubic spline was used to analyze the dose-response relationship between sleep duration, BMI and the risk of high blood pressure. Logistic regression was used to analyze the risk factors. Multiplicative and additive models were used to analyze the interaction between sleep duration and BMI. The results showed that the overall prevalence of high blood pressure among students aged 7 to 17 years in Shenyang was 9.9%, with a higher prevalence in females than males (12.1% vs 7.9%) and in urban areas than suburban areas (11.8% vs 7.7%). The prevalence was lowest in students with normal weight (8.3%) and highest in those who were obese (12.5%). The prevalence fluctuated to some extent among different age groups, but overall, it increased with age, with the lowest prevalence in primary school students (7.0%), 11.4% in mild school students, and the highest prevalence of 14.3% in high school students. Multivariable analysis showed that the risk of high blood pressure in female students was 1.90 times higher than that in male students (95% CI: 1.54–2.35), and the risk in suburban areas was 0.65 times lower than that in urban areas (95% CI: 0.52–0.81). Students with a BMI ≥ 21 kg/m2 had a 1.58 times higher risk than those with a BMI < 21 kg/m2(95% CI: 1.28–1.96), while those with a sleep time ≥ 8 hours had a 0.80 times lower risk than those with a sleep time < 8 hours (95% CI: 0.65–0.99). Exercise can significantly reduce the risk of high blood pressure, while using electronic devices for more than 0.5 hours significantly increases the risk of high blood pressure. BMI and sleep duration have no interaction effect on the risk of high blood pressure. To reduce the prevalence of high blood pressure, students should reduce the use of electronic devices, ensure adequate exercise, maintain a reasonable weight, and ensure sufficient sleep.
Exploring the mechanism of action of Qian Lie Xing Fang during the treatment of benign prostatic hyperplasia via network pharmacology and molecular dynamics simulation analyses
Authors: Xiang Jingjing , Li Zefei , Wang Chaoyang
Published: October 2023

This study aimed to explore the historical research progress on benign prostatic hyperplasia from the perspective of traditional Chinese medicine theory and the treatment of benign prostatic hyperplasia (BPH) with Qian Lie Xing Fang (QLXF) via the warming and tonifying of kidney yang, promotion of blood circulation, and clearing of meridians. First, network pharmacology analysis was used to screen and identify possible pathways for BPH treatment with QLXF. Subsequently, molecular docking analysis helped explore the mechanism of action by which the components of QLXF affected androgen receptor (AR) and type 5 phosphodiesterase inhibitor (PDE-5) levels. Targets for treatment with QLXF were identified from the online Mendelian inheritance in man and DisGeNET databases. BPH-related genes were identified using GeneCards and online Mendelian inheritance in man databases, and their intersection was used to construct a protein–protein interaction network analysis graph. Subsequently, gene ontology and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were performed. The semiflexible docking of the ingredients of QLXF acting on the 2 targets was performed via molecular docking and molecular dynamics simulation, to elucidate the mechanism of action by which the active ingredients affect AR and PDE-5 levels further. This enabled us to explore the pattern of interactions between small active ingredient molecules, the target protein, and the stability after binding at the microscopic level. Gene ontology enrichment analysis showed that QLXF affected several processes, such as DNA transcription factor binding, kinase binding, protein homodimerization activity, protein structure domain-specific binding, and protein-coupled amine receptor activity in BPH patients. KEGG results showed that chemical carcinogenic reactive oxidative species and the JAK-STAT, Pl3k-Akt, FoxO, NF-κB, and other pathways were significantly enriched. Conducting molecular docking studies to investigate the interaction of active components from QLXF with AR and PDE-5, it was found that MOL002260 may possess the potential to inhibit PDE-5 activity, while MOL010578 may exhibit the capability to inhibit AR activity. QLXF is closely associated with various biological processes and KEGG signaling pathways related to BPH. The active ingredients of QLXF were investigated for their interactions with AR and PDE-5, with a primary focus on the small molecules MOL002260 and MOL010578.
Differences in productivity and collaboration patterns on spine-related research between neurosurgeons and orthopedic spine surgeons: Bibliometric analysis
Authors: Hsiung Chun , Chou Willy , Chien Tsair-Wei , Chou Po-Hsin
Published: October 2023

Background:

Spinal surgeries are commonly performed by neurosurgeons and orthopedic spine surgeons, with many spine-related articles published by them. However, there has been limited research that directly compares their research achievements. This article conducted a comparative analysis of spine-related research achievements between neurosurgeons and orthopedic spine surgeons. This study examines differences in productivity and impact on spine-related research between them using these measures, particularly with a novel clustering algorithm.

Methods:

We gathered 2148 articles written by neurosurgeons and orthopedic spine surgeons from the Web of Science core collections, covering the period from 2013 to 2022. To analyze author collaborations, we employed the follower-leader clustering algorithm (FLCA) and conducted cluster analysis. A 3-part analysis was carried out: cluster analysis of author collaborations; mean citation analysis; and a category, journal, authorship, L-index (CJAL) score based on article category, journal impact factors, authorships, and L-indices. We then utilized R to create visual displays of our findings, including circle bar charts, heatmaps with dendrograms, 4-quadrant radar plots, and forest plots. The mean citations and CJAL scores were compared between neurosurgeons and orthopedic spine surgeons.

Results:

When considering first and corresponding authors, orthopedics authors wrote a greater proportion of the articles in the article collections, accounting for 75% (1600 out of 2148). The CJAL score based on the top 10 units each also favored orthopedic spine surgeons, with 71% (3626 out of 6139) of the total score attributed to them. Using the FLCA, we observed that orthopedic spine surgeons tended to have more collaborations across countries. Additionally, while citation per article favored orthopedic spine surgeons with standard mean difference (= −0.66) and 95%CI: −0.76, −0.56, the mean CJAL score in difference (= 0.34) favored neurosurgeons with 95%CI: 0.24 0.44.

Conclusion:

Orthopedic spine surgeons have a higher number of publications, citations, and CJAL scores in spine research than those in neurosurgeons. Orthopedic spine surgeons tend to have more collaborations and coauthored papers in the field. The study highlights the differences in research productivity and collaboration patterns between the 2 authors in spine research and sheds light on potential contributing factors. The study recommends the use of FLCA for future bibliographical studies.
Clinical factors associated with extended hospitalization in pediatric patients ≥3 years of age with respiratory syncytial virus or human metapneumovirus infection: A Japanese single-center, retrospective study
Authors: Hayashida Shingo , Nagano Nobuhiko , Morohashi Tamaki , Momoki Emiko , Nezu Keiko , Shimozawa Katsuyoshi , Ishii Wakako , Okahashi Aya , Morioka Ichiro
Published: October 2023

Respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) infections are common in children worldwide. However, the clinical factors related to extended hospitalization in Japanese patients aged ≥3 years remain elusive. We aimed to elucidate the clinical risk factors contributing to hospital stays ≥7 days in patients with RSV and hMPV infections. Patients ≥3 years of age who were hospitalized due to RSV or hMPV infection between 2014 to 2020 were included. Twenty-one RSV- and 27 hMPV-infected patients were enrolled. Patients were divided into 2 groups: hospitalization for ≥ and <7 days. Univariate and multivariate analyses determined the clinical risk factors contributing to hospital stay ≥7 days. The RSV- and hMPV-infected patients had similar clinical characteristics. The clinical risk factors contributing to extended hospitalization were analyzed in the 48 infected patients of the 2 groups. The presence of prophylactic antibiotics usage, co-bacterial colonization, and underlying diseases were extracted by univariate analysis (P < .05). In multivariate analysis, underlying diseases were determined as an independent clinical risk factor (odds ratio 8.09, P = .005). Underlying diseases contributed to extended hospitalization in RSV- or hMPV-infected patients ≥3 years of age.
Clinical effect of aerobic exercise training in chronic obstructive pulmonary disease: A retrospective study
Authors: Zeng Qigang , Liao Wangwang , Fang Wentao , Liu Shuling , Duan Chenxia , Dai Yong , Wei Chenggong
Published: October 2023

Aerobic exercise training is a kind of pulmonary rehabilitation for lung diseases. This was a retrospective study to assess the efficacy of aerobic exercise training in chronic obstructive pulmonary disease (COPD) at a stable stage. A total of one hundred and fifty-six stable COPD patients who had accepted self-education only or self-education combined with an aerobic exercise training between January 2017 to January 2019 were reviewed retrospectively. A total of 79 patients who had received self-education combined with an aerobic exercise training schedule comprised the aerobic exercise training group (AET group) and 77 patients who had received self-education only were regarded as the education group (EDU group). The acute incidence rate in AET group was 7.6% better than that in EDU group 20.7% (P < .05). The AET group patients expressed higher levels of 6 minutes walking distance (6MWD) (P < .05) and better evaluations of both lung function (P < .05) and T lymphocyte immune response (P < .05), as well as significantly decreased chronic obstructive pulmonary disease assessment test (CAT) scores and modified British medical research council (mMRC) grades (P < .05). Patients in EDU group did not report any changes in any of these characteristics. The aerobic exercise training intervention contributed to an increasing in 6MWD and decrease in CAT scores and mMRC grades, as well as improving the T lymphocyte immune response in stable COPD patients.
Enhanced CT-guided adrenal venous sampling versus traditional X-ray-guided adrenal venous sampling in patients with primary aldosteronism
Authors: Chen Chen , Li Fang , Han Jun , Chen Xiuqing
Published: October 2023

To compare the accuracy, safety, operation time, and radiation dose of enhanced computed tomography (CT)-guided adrenal vein sampling (AVS) versus traditional X-ray-guided AVS in patients with primary aldosteronism. A total of 97 patients with primary aldosteronism were randomly assigned to either the enhanced CT-guided group (n = 48) or the traditional X-ray-guided group (n = 49). Baseline characteristics were compared between the 2 groups. The primary outcome was the accuracy of AVS, assessed by aldosterone-to-cortisol ratio. Secondary outcomes included safety measures (intraoperative and postoperative complication rates, procedure termination rates, blood pressure, and heart rate changes), operation time, and radiation dose. The CT-guided group demonstrated significantly higher aldosterone-to-cortisol ratios, indicating improved accuracy in AVS (P < .001). The CT-guided group also showed significantly lower intraoperative blood pressure change and intraoperative heart rate change compared to the X-ray-guided group (P < .05). In addition, the CT-guided group had significantly shorter operation times (P < .001) and lower radiation exposure (P < .001). The enhanced CT-guided AVS demonstrated significantly better accuracy, safety, and efficiency compared to traditional X-ray-guided AVS in patients with primary aldosteronism. The enhanced CT-guided approach also resulted in lower radiation exposure for patients, making it a favorable option in the diagnosis and treatment of primary aldosteronism.
Antimitochondrial antibody associated with liver cirrhosis in patients with primary biliary cholangitis
Authors: Jin Yujiao , Wang Miaochan , Liu Yuan , Xu Aifang
Published: October 2023

Antimitochondrial antibody (AMA) serves as a serological marker for diagnosing primary biliary cholangitis (PBC). However, the association between AMA and prognosis for PBC patients remains unclear. The objective of this study was to investigate the relationship between AMA and cirrhosis in PBC patients. This retrospective study enrolled 225 PBC patients, including 127 with liver cirrhosis and 98 without cirrhosis. AMA was tested by indirect immunofluorescence (IIF) with rat kidney as the substrate. AMA-M2 and M2-3E were detected by line immunoassay (LIA). The overall positivity rate for AMA detection in PBC patients was 80.9%. The positivity rates of IIF-AMA, AMA-M2, and M2-3E were significantly higher in patients with liver cirrhosis than in those without cirrhosis (73.2% vs. 52.0%, 74.0% vs. 51.0%, and 80.3% vs. 60.2%, respectively). In multivariate logistic regression, IIF-AMA (OR: 3.05, 95% CI: 1.59–5.87), AMA-M2 (OR: 3.11, 95% CI: 1.61–6.01), and M2-3E (OR: 3.29, 95% CI: 1.63–6.66) remained significantly associated with an increased incidence of liver cirrhosis. Moreover, in multinomial logistic regression, IIF-AMA (compensated cirrhosis, OR: 3.55, 95% CI: 1.49–8.44; decompensated cirrhosis, OR: 2.86, 95% CI: 1.32–6.18), AMA-M2 (compensated cirrhosis, OR: 4.74, 95% CI: 1.94–11.58; decompensated cirrhosis, OR: 2.51, 95% CI: 1.19–5.33), and M2-3E (compensated cirrhosis, OR: 4.92, 95% CI: 1.74–13.96; decompensated cirrhosis, OR: 2.91, 95% CI: 1.28–6.64) were all found to be associated with different stages of liver cirrhosis. AMA was found to be associated with the occurrence of liver cirrhosis in PBC patients. Additionally, AMA was also related to different stages of liver cirrhosis, including compensated and decompensated cirrhosis.
Dissection of action mechanisms of Zuogui Pill in the treatment of liver cancer based on machine learning and network pharmacology: A review
Authors: Guang Biao , Gao Xiang , Chen Xiangrong , Li RuiLing , Ma Li
Published: October 2023

This study aimed to investigate the underlying mechanism of Zuogui Pill in its efficacy against liver cancer, employing a combination of data mining approaches and network pharmacology methods. A novel clustering analysis algorithm was proposed to identify the core gene modules of Zuogui Pill. This algorithm successfully identified 5 core modules, with the first large module comprised of twelve proteins forming a 12-clique, representing the strongest connections among them. By utilizing GEO platform, ten key target proteins were detected, including FOS, PTGS2, and MYC. According to the GO annotation and KEGG analysis, desired target proteins were significantly enriched in various biological processes (BP). The analysis showed that ten key targets were strongly associated with signaling pathways mainly centered on MAPK and PI3K-Akt pathway. Additionally, molecular docking revealed strong binding affinities between core active ingredients of Zuogui Pill and these key targets, and the best affinity modes were observed for PTGS2-Sesamin, PRKCA-Sesamin, FOS-delta-Carotene. In order to establish the relationships between clinical symptoms and drug targets, a heterogeneous targets-related network was constructed. A total of 60 key target-symptom association pairs were detected, exemplified by the strongly association between fever and PTGS2 through the intermediary of Shu Di Huang. In summary, symptom-target associations are valuable in uncovering the underlying molecular mechanisms of Zuogui Pill. Our work reinforced the notion that Zuogui pill exhibits therapeutic potential on liver cancer through network targets, as well as synergistic effects of multi-component and multi-pathway. This study provided specific references for future experiments at the cost of less time.
Prevalence and risk factors associated with drug resistant bacteria in neonatal and pediatric intensive care units: A retrospective study in Saudi Arabia
Authors: Bazaid Abdulrahman S. , Aldarhami Abdu , Bokhary Nada A. , Bazaid Mohammed B. , Qusty Mohammad F. , AlGhamdi Thamer H. , Almarashi Abdullatif A.
Published: October 2023

Successful empirical antibiotic therapy for infected patients with multi drug resistant bacteria (MDR) can be challenging task in various healthcare settings, including neonatal and pediatric intensive care units (NICU and PICU, respectively), unless an up-to-date comprehensive local antibiogram data is available. Thus, this project aimed to investigate the prevalence of MDR among PICU and NICU patients as well as the identification of risk factors associated with recovered MDR bacteria. This was a retrospective study of PICU and NICU patients admitted with bacterial infection of MDR organisms between October 2020 and May 2021. Frequency distribution, Chi-square test were applied to verify the significance differences among subgroups and to identify risk factor associated with each group. About 36.4% of recruited patients were neonates, while the remaining percentage (63.6%) were pediatric. The most predominant site of infection among these patients were revealed as urinary tract (35%), followed by bloodstream (20.0%), wound/skin (12.9%) and respiratory system (11.4%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified as the most common microbe across these sites of infections (30.7%), followed by Escherichia coli (25.0%), Klebsiella pneumoniae (22.9%) and Serratia (10.0%). High mortality rate was significantly associated with patients who were on mechanical ventilators (28.9%, OR 5.5; 95% CI), followed by patients had invasive operation (27.5%, OR, 8.04; 95% CI) and those who required a total parental nutrition (TPN) since almost one-half of these cases have (46.2%) died. In addition, mortality rate was relatively higher among patients infected with species of Serratia (28.6%) and Enterobacter (20.0%). These data highlighted that MRSA was the main MDR bacteria isolated from PICU and NICU followed by gram-negative bacteria, which were associated with high mortality rate. Therefore, infection control measures and continuous monitoring of emerging MDR bacteria should be applied to limit the bacterial infections in NICU and PICU patients.
Practical study on the application of full-cycle fast track surgical nursing model in patients with replantation of severed fingers: A retrospective analysis
Authors: Ju Hui , Li Ling , Wang Xiangyun , Mu Jing , Ge Lei , Wu Shumin
Published: October 2023

To explore the effect of full-cycle fast track surgical (FTS) nursing in patients with replantation of severed fingers, and observe its effect on functional recovery of replanted fingers and quality of life of patients. From January 2021 to December 2022, 86 patients with replantation of severed fingers were selected from Rizhao People’s Hospital, 41 patients were given routine perioperative care, 45 patients were given full-cycle rapid rehabilitation surgical care. Compare the relevant indexes of the 2 groups of patients during hospitalization. Three months after discharge, the finger function recovery of the 2 groups were compared, and the quality of life of the patients was scored with the QL-Index scale, and the satisfaction was evaluated at the same time. The first time of getting out of bed and the time of hospitalization in the full-cycle FTS nursing group were significantly shorter than those in the conventional nursing group, and the incidence of postoperative nausea, vomiting, constipation and venous thromboembolism were significantly lower than those in the conventional nursing group. The anxiety score was significantly lower than that in the conventional nursing group, the difference was statistically significant (P < .05). There was no significant difference in the incidence of arteriovenous crisis between the 2 groups (P > .05). Three months after discharge, the scores of finger sensation and movement, quality of life and satisfaction of patients in the FTS nursing group were higher than those in the conventional nursing group, and the difference was statistically significant (P < .05). Full-cycle fast track surgical nursing model can improve the in-patient experience, reduce the incidence of complications, promote rapid rehabilitation, improve the quality of life of patients, and improve satisfaction.
Fibrinogen; a predictor of injury severity and mortality among patients with traumatic brain injury in Sub-Saharan Africa: A cross-sectional observational study
Authors: John Baptist Ssenyondwa , Joel Kiryabwire , Kaddumukasa Martin , Michael Devereaux , Kasereka Kamabu Larrey , Galukande Moses , Kaddumukasa Mark , Sajatovic Martha , Timothy Kabanda Makumbi
Published: October 2023

Studies show that fibrinogen concentrations <2 g/L in patients with traumatic brain injury (TBI) is associated with increased mortality. However, little is known regarding fibrinogen levels and TBI severity as well as mortality in sub-Saharan Africa despite shouldering a high burden of TBI. We therefore set out to determine whether fibrinogen levels are associated with TBI severity and outcome. To determine the sensitivity and specificity of fibrinogen levels and the association with severity and mortality among TBI patients at Mulago Hospital. We prospectively enrolled 213 patients with TBI aged between 13 and 60 years of age and presenting within 24 hours of injury. Patients with preexisting coagulopathy, concurrent use of anticoagulant or antiplatelet agents, preexisting hepatic insufficiency, diabetes mellitus and who were pregnant were excluded. Fibrinogen levels were determined using the Clauss fibrinogen assay. Logistic regression analyses were conducted to identify the association between fibrinogen level and 7-day outcomes. Majority of the patients were male (88.7%) and nearly half were aged 30 or less (48.8%). Fibrinogen levels <2 g/L were observed in 35.1% of the study participants. The average time spent in the study was 3.7 ± 2.4 days. The sensitivity and specificity using fibrinogen <2 g/L was 56.5% and 72.9% respectively. Fibrinogen levels predict TBI severity with an AUC = 0.656 (95% CI 0.58–0.73: P = .000) Fibrinogen levels <2 g/L (hypofibrinogenemia) were independently associated with severe TBI. (Adjusted odds ratio 2.87 CI, 1.34–6.14: P = .007). Levels above 4.5 g/L were also independently associated with injury severity (adjusted odds ratio 2.89, CI 1.12–7.48: P < .05) Fibrinogen levels more than 4.5 g/L were independently associated with mortality (OR 4.5, CI; 1.47–13.61, P < .05). The fibrinogen level is a useful tool in predicting severity including mortality of TBI. Fibrinogen levels may be used as an additional tool to screen TBI patients for injury severity especially among patients with Glasgow coma scale scores of <14.