bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased expression of the p-STAT3/IL-17 signaling pathway in patients with dermatomyositis
Authors: Li Dongmei , Jia Wen , Zhou Luyao , Hao Yiqun , Wang Kai , Yang Bo , Yang Jie , Luo Dongping , Fu Zili
Published: December 2022

Objectives

The aim is to explore the roles of phosphorylated signal transduction and activator of transcription 3 (p-STAT3) and interleukin (IL)-17 in patients with dermatomyositis (DM).

Methods

A total of 20 DM patients and 12 healthy controls were enrolled. Flow cytometry combined with counting was used to detect the number of Th17 cells. Western blotting and immunohistochemistry were used to examine the muscle levels of p-STAT3 and IL-17, and serum levels of IL-17 were measured by enzyme-linked immunosorbent assays.

Results

Muscle p-STAT3 and IL-17 levels, the number of Th17 cells, and serum IL-17 levels were markedly increased in DM. p-STAT3 and IL-17 were co-expressed in the muscle of DM patients. The p-STAT3 levels were correlated with the number of Th17 cells as well as muscle and serum IL-17 levels. The correlations of the p-STAT3 level with elevated levels of transaminases, myocardial enzymes, and the health assessment questionnaire score were significantly positive, while the correlation with manual muscle testing-8 was significantly negative. A receiver operating characteristic curve indicated the good predictive value of p-STAT3 for the occurrence of DM.

Conclusions

The increased p-STAT3/IL-17 signaling pathway activation in DM patients may induce muscle inflammation and necrosis, and it may be a potential target for DM.
CYCLeR—a novel tool for the full isoform assembly and quantification of circRNAs
Authors: Stefanov Stefan R , Meyer Irmtraud M
Published: December 2022

Splicing is one key mechanism determining the state of any eukaryotic cell. Apart from linear splice variants, circular splice variants (circRNAs) can arise via non-canonical splicing involving a back-splice junction (BSJ). Most existing methods only identify circRNAs via the corresponding BSJ, but do not aim to estimate their full sequence identity or to identify different, alternatively spliced circular isoforms arising from the same BSJ. We here present CYCLeR, the first computational method for identifying the full sequence identity of new and alternatively spliced circRNAs and their abundances while simultaneously co-estimating the abundances of known linear splicing isoforms. We show that CYCLeR significantly outperforms existing methods in terms of F score and quantification of transcripts in simulated data. In a in a comparative study with long-read data, we also show the advantages of CYCLeR compared to existing methods. When analysing Drosophila melanogaster data, CYCLeR uncovers biological patterns of circRNA expression that other methods fail to observe.
Cells with stochastically increased methyltransferase to restriction endonuclease ratio provide an entry for bacteriophage into protected cell population
Authors: Kirillov Alexander , Morozova Natalia , Kozlova Svetlana , Polinovskaya Vasilisa , Smirnov Sergey , Khodorkovskii Mikhail , Zeng Lanying , Ispolatov Yaroslav , Severinov Konstantin
Published: December 2022

The action of Type II restriction–modification (RM) systems depends on restriction endonuclease (REase), which cleaves foreign DNA at specific sites, and methyltransferase (MTase), which protects host genome from restriction by methylating the same sites. We here show that protection from phage infection increases as the copy number of plasmids carrying the Type II RM Esp1396I system is increased. However, since increased plasmid copy number leads to both increased absolute intracellular RM enzyme levels and to a decreased MTase/REase ratio, it is impossible to determine which factor determines resistance/susceptibility to infection. By controlled expression of individual Esp1396I MTase or REase genes in cells carrying the Esp1396I system, we show that a shift in the MTase to REase ratio caused by overproduction of MTase or REase leads, respectively, to decreased or increased protection from infection. Consistently, due to stochastic variation of MTase and REase amount in individual cells, bacterial cells that are productively infected by bacteriophage have significantly higher MTase to REase ratios than cells that ward off the infection. Our results suggest that cells with transiently increased MTase to REase ratio at the time of infection serve as entry points for unmodified phage DNA into protected bacterial populations.
Toehold clipping: A mechanism for remote control of DNA strand displacement
Authors: Faheem Hiba , Mathivanan Johnsi , Talbot Hannah , Zeghal Hana , Vangaveti Sweta , Sheng Jia , Chen Alan A , Chandrasekaran Arun Richard
Published: December 2022

The ability to create stimuli-responsive DNA nanostructures has played a prominent role in dynamic DNA nanotechnology. Primary among these is the process of toehold-based strand displacement, where a nucleic acid molecule can act as a trigger to cause conformational changes in custom-designed DNA nanostructures. Here, we add another layer of control to strand displacement reactions through a 'toehold clipping' process. By designing DNA complexes with a photocleavable linker-containing toehold or an RNA toehold, we show that we can use light (UV) or enzyme (ribonuclease) to eliminate the toehold, thus preventing strand displacement reactions. We use molecular dynamics simulations to analyze the structural effects of incorporating a photocleavable linker in DNA complexes. Beyond simple DNA duplexes, we also demonstrate the toehold clipping process in a model DNA nanostructure, by designing a toehold containing double-bundle DNA tetrahedron that disassembles when an invading strand is added, but stays intact after the toehold clipping process even in the presence of the invading strand. This work is an example of combining multiple physical or molecular stimuli to provide additional remote control over DNA nanostructure reconfiguration, advances that hold potential use in biosensing, drug delivery or molecular computation.
Wondering If I’d Get There Quicker If I Was a Man: Factors Contributing to Delayed Academic Advancement of Women in Infectious Diseases
Authors: Stead Wendy , Manne-Goehler Jennifer , Blackshear Leslie , Marcelin Jasmine R , Salles Arghavan , del Rio Carlos , Krakower Douglas
Published: December 2022

Background

Gender inequities in academic advancement persist in many specialties, including Infectious Diseases (ID). Prior studies of advancement disparities have been predominantly quantitative, utilizing large physician databases or surveys. We used qualitative methods to explore ID physicians’ experiences and beliefs about causes and ways to mitigate gender inequities in advancement.

Methods

We conducted semistructured focus group discussions with academic ID physicians in the United States at IDWeek 2019 to explore perceived barriers and facilitators to academic advancement. Participants were assigned to focus groups based on their academic rank and gender. We analyzed focus group transcripts using content analysis to summarize emergent themes.

Results

We convened 3 women-only focus groups (1 for instructors/assistant professors, 1 for associate professors, and 1 for full professors) and 1 men-only focus group of full professors (total N = 50). Our analyses identified several major themes on barriers to equitable academic advancement, including (1) interpersonal and institutional gender bias, (2) difficulty balancing the demands of family life with work life, and (3) gender differences in negotiation strategies.

Conclusions

Barriers to gender equity in academic advancement are myriad and enduring and span the professional and personal lives of ID physicians. In addition to swift enactment of policy changes directed at critical issues such as ending workplace harassment and ensuring adequate parental leaves for birth and nonbirth parents, leaders in academic medicine must shine a bright light on biases within the system at large and within themselves to correct these disparities with the urgency required.
Early stage of radiological expertise modulates resting-state local coherence in the inferior temporal lobe
Authors: Dong Minghao , Zhang Peiming , Chai Weilu , Zhang Xiaoyan , Chen Bihong T , Wang Hongmei , Wu Jia , Chen Chao , Niu Yi , Liang Jimin , Shi Guangming , Jin Chenwang
Published: December 2022

Background

The visual system and its inherent functions undergo experience-dependent changes through the lifespan, enabling acquisition of new skills. Previous fMRI studies using tasks reported increased specialization in a number of cortical regions subserving visual expertise. Although ample studies focused on representation of long-term visual expertise in the brain, i.e. in terms of year, monthly-based early-stage representation of visual expertise remains unstudied. Given that spontaneous neuronal oscillations actively encode previous experience, we propose brain representations in the resting state is fundamentally important.

Objective

The current study aimed to investigate how monthly-based early-stage visual expertise are represented in the resting state using the expertise model of radiologists.

Methods

In particular, we investigated the altered local clustering pattern of spontaneous brain activity using regional homogeneity (ReHo). A cohort group of radiology interns (n = 22) after one-month training in X-ray department and matched laypersons (n = 22) were recruited after rigorous behavioral assessment.

Results

The results showed higher ReHo in the right hippocampus (HIP) and the right ventral anterior temporal lobe (vATL) (corrected by Alphasim correction, P < 0.05). Moreover, ReHo in the right HIP correlated with the number of cases reviewed during intern radiologists’ training (corrected by Alphasim correction, P < 0.05).

Conclusions

In sum, our results demonstrated that the early stage of visual expertise is more concerned with stabilizing visual feature and domain-specific knowledge into long-term memory. The results provided novel evidence regarding how early-stage visual expertise is represented in the resting brain, which help further elaborate how human visual expertise is acquired. We propose that our current study may provide novel ideas for developing new training protocols in medical schools.
WDPhotTools – a white dwarf photometric toolkit in Python
Authors: Lam M C , Yuen K W , Green M J , Li W
Published: December 2022

From data collection to photometric fitting and analysis of white dwarfs, to generating a white dwarf luminosity function requires numerous astrophysical, mathematical, and computational domain knowledge. The steep learning curve makes it difficult to enter the field, and often individuals have to reinvent the wheel to perform identical data reduction and analysis tasks. We have gathered a wide range of publicly available white dwarf cooling models and synthetic photometry to provide a toolkit that allows (i) visualization of various models, (ii) photometric fitting of a white dwarf with or without distance and reddening, and (iii) the computing of white dwarf luminosity functions with a choice of initial mass function, main-sequence evolution model, star-formation history, initial–final mass relation, and white dwarf cooling model. We have recomputed and compared the effective temperature of the white dwarfs from the Gaia EDR3 white dwarf catalogue. The two independent works show excellent agreement in the temperature solutions.
A Method to Explore Variations of Ventilator-Associated Event Surveillance Definitions in Large Critical Care Databases in the United States
Authors: Wong An-Kwok Ian , Kim Han , Charpignon Marie-Laure , Carvalho Leandro , Monares-Zepeda Enrique , Madushani R. W. M. A. , Adhikari Lasith , Kindle Ryan D. , Kutner Michael , Celi Leo Anthony , Lough Mary E. , Mireles-Cabodevila Eduardo
Published: December 2022

OBJECTIVES:

The Centers for Disease Control has well-established surveillance programs to monitor preventable conditions in patients supported by mechanical ventilation (MV). The aim of the study was to develop a data-driven methodology to examine variations in the first tier of the ventilator-associated event surveillance definition, described as a ventilator-associated condition (VAC). Further, an interactive tool was designed to illustrate the effect of changes to the VAC surveillance definition, by applying different ventilator settings, time-intervals, demographics, and selected clinical criteria.

DESIGN:

Retrospective, multicenter, cross-sectional analysis.

SETTING:

Three hundred forty critical care units across 209 hospitals, comprising 261,910 patients in both the electronic Intensive Care Unit Clinical Research Database and Medical Information Mart for Intensive Care III databases.

PATIENTS:

A total of 14,517 patients undergoing MV for 4 or more days.

MEASUREMENTS AND MAIN RESULTS:

We designed a statistical analysis framework, complemented by a custom interactive data visualization tool to depict how changes to the VAC surveillance definition alter its prognostic performance, comparing patients with and without VAC. This methodology and tool enable comparison of three clinical outcomes (hospital mortality, hospital length-of-stay, and ICU length-of-stay) and provide the option to stratify patients by six criteria in two categories: patient population (dataset and ICU type) and clinical features (minimum Fio
2, minimum positive end-expiratory pressure, early/late VAC, and worst first-day respiratory Sequential Organ Failure Assessment score). Patient population outcomes were depicted by heatmaps with mortality odds ratios. In parallel, outcomes from ventilation setting variations and clinical features were depicted with Kaplan-Meier survival curves.

CONCLUSIONS:

We developed a method to examine VAC using information extracted from large electronic health record databases. Building upon this framework, we developed an interactive tool to visualize and quantify the implications of variations in the VAC surveillance definition in different populations, across time and critical care settings. Data for patients with and without VAC was used to illustrate the effect of the application of this method and visualization tool.
The Spillover Effects of Quality Improvement Beyond Target Populations in Mechanical Ventilation
Authors: Greenwald Andrew S. , Hauw-Berlemont Caroline , Shan Mingxu , Wang Shuang , Yip Natalie , Kurlansky Paul , Argenziano Michael , Bennett Bridgette , Langone Danielle , Moitra Vivek
Published: December 2022

OBJECTIVES:

To assess the impact of a mechanical ventilation quality improvement program on patients who were excluded from the intervention.

DESIGN:

Before-during-and-after implementation interrupted time series analysis to assess the effect of the intervention between coronary artery bypass grafting (CABG) surgery patients (included) and left-sided valve surgery patients (excluded).

SETTING:

Academic medical center.

PATIENTS:

Patients undergoing CABG and left-sided valve procedures were analyzed.

INTERVENTIONS:

A postoperative mechanical ventilation quality improvement program was developed for patients undergoing CABG.

MEASUREMENTS AND MAIN RESULTS:

Patients undergoing CABG had a median mechanical ventilation time of 11 hours during P0 (“before” phase) and 6.22 hours during P2 (“after” phase; p < 0.001). A spillover effect was observed because mechanical ventilation times also decreased from 10 hours during P0 to 6 hours during P2 among valve patients who were excluded from the protocol (p < 0.001). The interrupted time series analysis demonstrated a significant level of change for ventilation time from P0 to P2 for both CABG (p < 0.0001) and valve patients (p < 0.0001). There was no significant difference in the slope of change between the CABG and valve patient populations across time cohorts (P0 vs P1 [p = 0.8809]; P1 vs P2 [p = 0.3834]; P0 vs P2 [p = 0.7672]), which suggests that the rate of change in mechanical ventilation times was similar between included and excluded patients.

CONCLUSIONS:

Decreased mechanical ventilation times for patients who were not included in a protocol suggests a spillover effect of quality improvement and demonstrates that quality improvement can have benefits beyond a target population.
Bronchiectasis and COVID-19 infection: a two-way street
Authors: Oscullo Grace , Gómez-Olivas Jose Daniel , Beauperthuy Thais , Bekki Amina , Garcia-Ortega Alberto , Matera Maria Gabriella , Cazzola Mario , Martinez-Garcia Miguel Angel
Published: December 2022

Bronchiectasis (BE) has been linked to past viral infections such as influenza, measles, or adenovirus. Two years ago, a new pandemic viral infection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out and it still persists today, and a significant proportion of surviving patients have radiological and clinical sequelae, including BE. Our aim was to thoroughly review the information available in the literature on the bidirectional relationship between SARS-CoV-2 infection and the development of BE, as well as the impact of this infection on patients already suffering from BE. Available information indicates that only a small percentage of patients in the acute phase of coronavirus disease 2019 (COVID-19) pneumonia develop BE, although the latter is recognized as one of the radiological sequelae of COVID-19 pneumonia, especially when it is caused by traction. The severity of the initial pneumonia is the main risk factor for the development of future BE, but during the COVID-19 pandemic, exacerbations in BE patients were reduced by approximately 50%. Finally, the impact of BE on the prognosis of patients with COVID-19 pneumonia is not yet known.
Alternate Analysis of an In Vitro Solubility Study on the Lung Dissolution Rate of 238PuO2 Material Involved in the 2020 Incident at Los Alamos National Laboratory
Authors: Miller Guthrie , Dumit Sara , Poudel Deepesh , Klumpp John
Published: December 2022

This work presents an alternate analysis of an in vitro solubility study on the lung dissolution rate of 238PuO2 material involved in a recent inhalation incident at Los Alamos National Laboratory (LANL). The original dataset used in this work was retrieved from a recently published report. The present work shows an analysis of the same dataset by modeling the dissolution in separate time intervals rather than modeling the cumulative dissolution.
Effectiveness and safety of ear acupuncture for tension-type headache: A protocol for a systematic review and meta-analysis
Authors: Lou Fei , Lou Qihui , Li Jingjing , Zhang Xiaoli , Wang Wei
Published: December 2022

Introduction:

Tension-type headache (TTH) refers to a type of functionalism disease, which is commonly characterized by recurrent headaches of mild to moderate intensity, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity. Has significantly impacts on people’s work and life. Ear acupuncture as a traditional Chinese therapy, showing several advantages (e.g., safety, economy, and less side effects), has been extensively used to treat TTH. However, its curative effect is supported by limited evidence. Accordingly, the present study aims to comprehensively assess the reliability of ear acupuncture in TTH.

Methods and analysis:

The study will conduct a systematic review and meta-analysis. Seven databases, including the Embase, Cochrane Library, Pubmed, SinoMed, CNKI, VIP, and Wanfang Data, will be searched using predefined search terms to identify relevant studies. The primary outcomes will be the pain intensity, the pain frequency and the impact of headache. The methodological quality of the included studies will be assessed with a previously established checklist. The Cochrane Collaboration’s bias risk tool will be used for assessing the bias of included RCTs. Stata 17.0 software is used for meta-analysis.
Use of Tofacitinib for infant-onset STING-associated vasculopathy: A case report from China
Authors: Shen Danping , Fan Xiaorui , Zhou Qing , Xu Xuefeng , Lu Meiping
Published: December 2022

Background:

Stimulator of interferon gene (STING)-associated vasculopathy with onset in infancy (SAVI), caused by gain-of-function mutations in human transmembrane protein 173 (TMEM173), is characterized by widespread chronic inflammation primarily affecting the skin and lungs. Although SAVI is an inflammatory disease, typical anti-inflammatory agents have limited or no effect.

Methods and Results:

A 1-year-old boy presented with recurrent facial rashes since he was 8 months. Moreover, he suffered from recurrent oral ulcers, chronic cough, and failure to thrive. Laboratory parameters showed elevated erythrocyte sedimentation rate (ESR) and immunoglobulin levels. Chest high-resolution computed tomography (HRCT) showed interstitial lung disease (ILD). Whole-exome sequencing revealed a heterozygous mutation in the TMEM173 gene (c.463G > A, p.V155M). Ultimately, the patient was diagnosed with SAVI. Tofacitinib was initiated at the age of 19 months, resulting in the alleviation of facial rashes and improvement of ILD within 3 months.

Conclusion:

SAVI is a difficult-to-treat type I interferonopathy. We hope that JAKi treatment will prove valuable for SAVI patients.
HLA types and their association with end-stage renal disease in Vietnamese patients: A cross-sectional study
Authors: Le Pham Nhat-Minh , Ong Thinh Phuc , Vuong Nguyen Lam , Van Tran Bao , Nguyen Thi Thu Hoai
Published: December 2022

End-stage renal disease (ESRD) is a significant public health issue with an estimated increasing burden over the next 10 years. Early prediction of patients with a high risk of ESRD progression is crucial to monitor and initiate appropriate interventions, of which HLA alleles have been proposed as promising biomarkers. This cross-sectional study described HLA profiles of a Vietnamese cohort and investigated the association between HLA alleles and ESRD. All ESRD patients who were waitlisted to receive kidney transplant and potential donors in a tertiary hospital from March 2018 to April 2020 were invited to participate in the study. A total of 458 participants were eligible, including 126 ESRD patients and 126 family-related donors, 98 ESRD patients and 108 unrelated donors. HLA typing was performed using Luminex-based PCR-SSO technology. We found HLA-A*02, A*11, A*24, B*15, B*07, DRB1*12, DRB1*09, DQA1*01, DQA1*06, DQB1*03 and DQB1*05 as the most common alleles, which is similar to the general Vietnamese population and other countries in East and South-east Asia. HLA-B*07 (P = .040), DQA1*06 (P = .031), and DQB1*03 (P = .036) were susceptible to ESRD, while HLA-B*27 (P = .024) and DQB1*02 (P = .006) were associated with a decreased risk of ESRD.
Effects of temperature and humidity on peritonsillar abscess volume of emergency patients
Authors: Su Wei-Hsiang , Yu Shiou-Shyan , Wu Tai-Ching , Chang Shih-Lun
Published: December 2022

Climate and temperature have long been considered in relation to human diseases and mortality. In this study, we investigated whether daily temperature and humidity and patients’ personal history affect the volume of peritonsillar abscesses (PTAs). We included 52 patients with PTAs who were admitted to the emergency department of the study hospital; their computed tomography data were analyzed, and PTA volume was measured. We investigated the possible correlation between PTA volume and mean/minimum/maximum temperature and humidity. Furthermore, we obtained personal history data, including information on drinking status, smoking status, dental problems, and patients’ treatment experiences at local clinics before visiting the emergency department. The mean PTA volume was 3.93 mL, which was significantly correlated with temperature differences between 1 and 2 days before hospitalization and the day of hospitalization (P < .05) and also with a lack of treatment experience at local clinics (P < .001). However, no significant correlation was noted between PTA volume and the mean/minimum/maximum temperature and humidity on the day of hospitalization (P > .05). Similar findings were obtained for drinking status, smoking status, and dental problems (P > .1). PTA volume appears to be strongly associated with temperature differences between 1 and 2 days before hospitalization and the day of hospitalization. Patients with treatment experience at local clinics exhibited substantial increases in PTA volume. Thus, an increased PTA volume may be observed in patients who visit the emergency department without any treatment experience at local clinics or from environments that differ considerably from their current environment in terms of temperature.
Effects of a forced cycling program with cognitive stimulation on symptomatology, physical condition, and cognition in people diagnosed with Parkinson disease
Authors: Pereira-Pedro Karina Pitombeira , de Oliveira Iris Machado , Mollinedo Cardalda Irimia , Cancela-Carral José M.
Published: December 2022

Background and objectives:

Parkinson disease may present difficulties in performing dual tasks. The use of dual tasks during training can improve different abilities. Therefore, the objective of this study is creating a protocol, based on standard protocol items recommendations for interventional trials compliant, for a clinical trial study conduct, review, reporting, and interpretation. This protocol will provide the framework and a guide to a randomized double-blind study, that will be conducted to assess the influence of a cycling exercise program combined with a cognitive task, on cognitive and physical Parkinson disease aspects.

Methods:

Designed a protocol for a double-blind randomized study, where participants will perform a dual tasks intervention with cycling and a cognitive task. The revised version of the unified Parkinson disease rating scale, the Parkinson disease questionnaire, the timed up and go Test, the 30 seconds chair sit to stand test, the Stroop and the trail making test will be used to measure outcomes.

Discussion:

Research in Parkinson disease suggests that an improvement of motor and cognitive functions of Parkinson disease patients can be achieved by modifying different motor and cognitive pathways. The results of the present study will yield findings on both the physical and cognitive response to an intervention that combines a cognitive task with a motor task in Parkinson disease patients and will be essential tool for a better conducting of the clinical trial study.
Construction of ceRNA network and key gene screening in cervical squamous intraepithelial lesions
Authors: Qi Ding , Li Hongmei , Wang Shuoqi , Wang Shimeng , Zheng Rui , Liu Ning , Han Buwei , Liu Li
Published: December 2022

Background:

This study aimed to construct an endogenous competition network for cervical squamous intraepithelial lesions using differential gene screening.

Methods:

GSE149763 was used to screen differentially expressed long non-coding RNAs (lncRNAs) and mRNAs to predict correlated microRNAs (miRNAs). The correlated miRNAs and GSE105409 were used to screen differentially expressed miRNAs for differential co-expression analysis, and the co-expressed differentially expressed miRNAs were used to predict correlated mRNAs. Differentially expressed mRNAs, miRNAs, and lncRNAs were visualized, and differential gene screening, enrichment, and pathway analysis were performed.

Results:

The ceRNA network of cervical squamous intraepithelial was successfully established and a potential differentially expressed network was identified. The key genes were VEGFA and FOS, and the key pathway was the MAPK signaling pathway.

Conclusions:

The differential expression and potential effects of the lncRNA BACH1-IT1/miR-140-5p/VEGFA axis, key genes, VEGFA and FOS, and MAPK signaling in CIN were clarified, and the occurrence and potential effects of CIN were further clarified. The underlying molecular mechanism provides a certain degree of reference for subsequent treatments and experimental research.
Gastrointestinal bleeding during the transcatheter aortic valve replacement perioperative period: A Review
Authors: Lu Chuan , Zhang Yue
Published: December 2022

With the aging of the population, the incidence of senile degenerative valvular heart disease is expected to increase. Transcatheter aortic valve replacement (TAVR) has been used for patients at lower surgical risk with symptomatic severe aortic valve stenosis. Because of the improvements in TAVR technology and increasing experience of the operators, TAVR is regarded as a safe and feasible procedure. Bleeding events during the TAVR perioperative period, especially gastrointestinal (GI) bleeding, have been proven to be related to the long-term prognosis and mortality. Elderly patients with valvular heart disease are susceptible to GI bleeding because of their use of antithrombotic drugs, physical damage of coagulation factors, and GI angiodysplasia. Frequent GI bleeding and low levels of preoperative hemoglobin increase the risk of TAVR, especially for elderly patients. Because of these risks, which are easily overlooked, we should focus more attention on the perioperative management of TAVR. Reasonable screening tools, including blood examinations, risk evaluation scales, and endoscopy, are beneficial to the prevention of complications that can occur during the perioperative period. Additionally, medical therapy can safely help patients at high-risk for bleeding patients throughout the perioperative period. This study aimed to characterize the pathology of TAVR patients and discuss treatment strategies for GI bleeding during the perioperative period.
The risk between thyrotropin suppression and bone mineral density in differentiated thyroid cancer
Authors: Zou Yang , Li Bin , Wang Xiaodong , Mao Jingxin , Zhang Yanyan
Published: December 2022

Background:

The effect of thyroid stimulating endocrine (TSH) suppression medical aid on bone mineral density (BMD) of patients with differentiated thyroid carcinoma (DTC) or differentiated thyroid malignant neoplastic disease is still controversial. Our aim was to investigate the effect of TSH suppression therapy on BMD of patients with DTC.

Methods:

A total of 1651 DTC patients with TSH-suppression medical care were analyzed by RevMan 5.3 software (https://training.cochrane.org/online-learning/core-software/revman/revman-5-download) in the present study. The PubMed and Embase databases were consistently hunted for works revealed through July 29, 2022.

Results:

The results indicated that a significant association between femoral bone mineral density (FN-BMD) (P = .02) or lumbar spine bone mineral density (L-BMD) (P = .04) and DTC patients with TSH-suppression therapy. However, the total hip bone mineral density (TH-BMD) was not significantly related to DTC patients with TSH-suppression therapy (P = .11). For premenopausal women, it was shown that TH-BMD (P = .02) or L-BMD (P = .01) were closely related to DTC patients with TSH-suppression therapy. However, there was no relationship between FN-BMD and DTC patients with TSH-suppression therapy (P = .06). For postmenopausal women, TH-BMD was closely related to DTC patients with TSH-suppression therapy (P = .02). It was revealed that there was no significant difference between L-BMD (P = .16) or FN-BMD (P = .26) and DTC patients with TSH-suppression therapy. For men, there was no relationship between FN-BMD (P = .94) or L-BMD (P = .29) and DTC patients with TSH-suppression therapy.

Conclusion:

Our systematic review has demonstrated that TSH inhibition treatment mainly influence the TH-BMD or L-BMD of the DTC patients who were premenopausal women; the TH-BMD of the DTC patients who were postmenopausal women. In addition, there was no influence on the FN-BMD or L-BMD of the DTC patients who were men.
Does the length matter in acute appendicitis for the perforation risk?: A retrospective cohort study
Authors: Dibekoğlu Cengiz
Published: December 2022

It has been hypothesized that short appendices increase intraluminal pressure more rapidly and perforate more frequently than long appendices. Two hundred seventy-seven adult patients were retrospectively analyzed and underwent an appendectomy between January 2015 and August 2021. Data extracted from patient records included sex, age, time from admission to operation (hospital interval), weekday or weekend operation time, and operative and pathological findings. Operation was performed on 273 patients, of whom 178 (65.2%) were male and 95 (34.8%) female. The mean age of the male patients was 31.7 ± 08 (range 18–67), and that of the female patients was 38.9 ± 1.4 (range 18–78). Perforation was observed in 57 (20.9%) patients. Sex was not a factor in the development of perforation (P = .95). The mean age of the patients with and without perforation was 40.1 ± 2.2 and 32.7 ± 0.7, respectively. The perforation rate increased with age (P = .003). Appendix lengths were similar in both groups, and length was not a factor in the development of perforation (P = .83). This study found that the development of perforated appendicitis is not related to the length of the appendix. The risk of perforation increased with age.
The status quo and influencing factors of knowledge, attitude and practice of obstetric staff on the safe childbirth checklist
Authors: Li Xiaoyan , Yang Xiaochang , Wang Longqiong , Mao Jiayi , Xie Liling
Published: December 2022

Practical Guidelines for Safe Childbirth Checklist has not been widely used in medical institutions at all levels in China. This study aims to understand the current status of knowledge, attitude and practice of obstetric medical staff toward the Safe Childbirth Checklist and analyze its influencing factors to provide a reference for establishing the promotion of the checklist. Convenience sampling was used in a cross-sectional survey of 685 obstetric medical staff in Chongqing using a self-designed questionnaire to analyze their knowledge, attitude and practice of the checklist. The scores of knowledge, attitude and practice of obstetric medical staff on the checklist were 29.96 ± 5.44, 62.87 ± 9.11, and 37.74 ± 6.82, respectively. Occupation and hospital level were influencing factors of the knowledge and practice scores, while length of service was the only influencing factor of the knowledge score. Education was the influencing factor of attitude score. The total effects of the knowledge, facilitation and inhibition dimensions on practice were 0.671, 0.263 and -0.135, respectively. Mediating effects presented in the facilitation and inhibition of attitude in safe childbirth. Obstetrics medical staff know the checklist well, however, their attitudes and practices need to be improved. Managers should take targeted measures to strengthen the attitudes and practices of obstetric medical staff toward safe childbirth and promote the use of the checklist, thus providing a powerful safeguard for higher delivery quality and safer delivery.
A comparison of face-to-face endotracheal intubation and standard intubation using Airtraq video laryngoscope in morbidly obese patients: A randomized controlled trial
Authors: Nowak-Tim Justyna , Gaszynski Tomasz , Ratajczyk Pawel
Published: December 2022

Background:

Routine endotracheal intubation requires a patient in supine position with an operator standing behind the patient’s head. In case of a morbidly obese patient positioned in the recommended semi-recumbent position, an alternative method can be considered. Face-to-face intubation can be used both in patients in sitting as well as in prone position and when there is difficult access to the head. Evaluation of effectiveness and safety of face-to-face intubation in morbidly obese adult patients with body mass index over 40 kg m−2.

Methods:

The study was approved by the Local Ethics Committee and written informed consent from patients was obtained. We conducted a parallel randomized controlled trial with patients scheduled for elective sleeve gastrectomy. The trial was registered in ClinicalTrials with a number NCT04959149. Randomization and allocation to trial groups were carried out using the envelope method. The primary outcomes were the time of intubation and the first pass success of endotracheal intubation.

Results:

76 patients (routine intubation n = 36, face-to-face intubation n = 40) were included in the study with no dropouts. The intubation success rates were 82.5% versus 100%, mean intubation time was 17.1 ± 18 seconds versus 29 ± 11 seconds and the need for additional maneuvers (backward, upward, rightward pressure or flexing the neck) was 15% versus 19.5%, in face-to-face and routine intubation, respectively. No injuries to teeth or mucosa have been reported. There were no incidents of desaturation below 92% or other complications associated with intubation.

Conclusion:

Face-to-face intubation is shorter than the routine intubation in obese patients. This method may be an alternative to standard intubation in case of airway management in morbidly obese patients in semi-erect position; however, it requires both training and practice.
A network pharmacology study of mechanism and efficacy of Jiawei Huanglian-Wendan decoction in polycystic ovary syndrome with insulin resistance
Authors: Shi Na , Zhou Yuhe , Ma Hongbo
Published: December 2022

Polycystic ovary syndrome (PCOS) is a common reproductive metabolic disorder, normally accompanied by insulin resistance (IR). The specific pathogenesis of this disease remains unclear. To identify the underlying pathogenesis of PCOS with IR and explore the potential efficacy and mechanism of Jiawei Huanglian-Wendan decoction (JHWD) by a network pharmacology approach. The effective components and the potential drug and disease-related targets are retrieved. Drug-disease overlapped targets are being obtained by Venny analysis. The construction of protein-protein interaction network relied on Search Tool for the Retrieval of Interacting Genes/Proteins database (STRING), after uploading drug-disease overlapped targets. The drug-component-target-disease interaction network map was displayed , after importing their data into Cytoscape 3.7.2 software. Bioinformatics analyses are being performed by Metascape and Kyoto Encyclopedia of Genes and Genomes databases, respectively. Further, molecular docking analysis was carried out using AutoDock software. Finally, the influence of JHWD is verified by means of traditional Chinese medicine syndrome score, the rate of resumption of normal menstrual cycles and regular ovulation, the blood lipid levels, the blood glucose and insulin levels, and the inflammatory cytokines in PCOS with IR patients. Four primary interaction networks of JHWD are constructed. The enrichment analysis of PCOS-IR-related targets demonstrated that the top enriched pathways in the development of PCOS with IR are pathways in cancer, metabolic, phosphoinositide-3-kinase-protein kinase B signaling, lipid and atherosclerosis, and mitogen-activated protein kinase signaling pathways. Molecular docking analysis revealed strong binding interactions of the key targets with the active components. Further confirmations showed that the active components of JHWD exhibited significant clinical efficacy in improving the clinical syndromes, menstrual cyclicity and ovulatory function, and significantly reducing the blood lipid levels, blood glucose and insulin levels, and inflammatory cytokines in PCOS with IR patients. The combination of the network pharmacological analysis and clinical validation stated that the active compounds in JHWD could regulate glycolipid metabolism, reduce IR, and exert anti-inflammatory effects in the treatment of PCOS with IR, promoting Chinese classical formulations.
Simultaneous development of pneumonitis and autoimmune diabetes secondary to immune checkpoint inhibitor treatment with durvalumab in an advanced small cell lung cancer patient: A case report
Authors: Wen Yan-Ping , Xiao Hai-Wei , Yin Ju-Hua , Guo Hui-Ru , Shan Meng-Jun , Shen Li-Ping , Liu Ling-Shuang
Published: December 2022

Rationale:

Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of various types of cancers worldwide, which is the most significant breakthrough in cancer therapy in recent years. Despite their excellent benefits in anti-tumor efficacy, a subset of patients will experience various autoimmune toxicities, termed as immune-related adverse events (irAEs), which can affect almost any organ systems, but related to the pulmonary and pancreatic islets simultaneously has rarely been reported and discussed.

Patient concerns:

In this report, we describe a rare case of a 65-year-old man patient with advanced small cell lung cancer (SCLC) who suffered general fatigue, dry cough, chest tightness, shortness of breath and polyuria-polydipsia syndrome after the eighth cycle treatment with programmed cell death ligand-1 (PD-L1) inhibitor durvalumab.

Diagnoses:

According to the results of laboratory tests, chest computed tomography and multidisciplinary discussion, the patient was eventually diagnosed with ICI-related pneumonitis and autoimmune diabetes mellitus.

Interventions:

Multiple daily subcutaneous insulin injections, empirical anti-infection and immunosuppression treatment with corticosteroids were performed.

Outcomes:

After the cessation of durvalumab and comprehensive treatment, the patient’s respiratory condition was relieved significantly and his blood glucose was well controlled with insulin therapy.

Lessons:

With the widespread use of ICIs, there will be more patients developing these rare but severe irAEs in clinical practice, which should attract great attention of both clinicians and patients.
The 100 most cited articles have fewer citations than other bibliometric articles: A pairwise comparison using a temporal bubble graph
Authors: Hsieh Wan-Ting , Chien Tsair-Wei , Chou Willy
Published: December 2022

Background:

More than 400 articles with the title of 100 top-cited articles (Top100) have been published in PubMed. It is unknown whether their citations are fewer (or more) than those found in other bibliometric studies (Nontop100). After determining article themes using coword analysis, a temporal bubble graph (TBG) was used to verify the hypothesis that the Top100 had fewer citations than the Nontop100.

Methods:

Using the Web of Science core collection, the top 50 most cited articles were compiled by Top100 and Nontop100, respectively, based on the research area of biomedicine and bibliometrics only. Coword analysis was used to extract themes. The study results were displayed using 6 different visualizations, including charts with bars, pyramids, forests, clusters, chords, and bubbles. Mean citations were compared between Top100 and Nontop100 using the bootstrapping method.

Results:

There were 18 citations in total for the 2 sets of the 50 most cited articles (range 1–134; 5 and 26.5 for Top100 and Nontop100, respectively). A significant difference in mean citations was observed between the 2 groups of Top100 and Nontop100 based on the bootstrapping method (3, 95% confidence interval: [1.18, 4.82]; 26.5, 95% confidence interval: [23.82, 29.18], P < .001). The 11 themes were clustered using coword analysis and applied to a TBG, which is composed of 4 dimensions: themes, years, citations and groups of articles. Among the 2 groups, the majority of articles were published in the journal of Medicine (Baltimore), with 9 and 7, respectively.

Conclusion:

Eleven themes were identified as a result of this study. In addition, it reveals distinct differences between the 2 groups of Top100 and Nontop100, with the former containing more recently published articles and the latter containing more citations for articles. Clinical and research clinicians and researchers can use bibliometric analysis to appraise published literature and to understand the scientific landmark using TBG in bibliometrics.
Predictive factors for resection and survival in type A borderline resectable pancreatic ductal adenocarcinoma patients after neoadjuvant therapy: A retrospective cohort study
Authors: Secanella Luis , Busquets Juli , Peláez Núria , Sorribas María , Laquente Berta , Ruiz Sandra , Carnaval Thiago , Videla Sebastián , Fabregat Juan
Published: December 2022

Introduction:

Pancreatic cancer is the seventh leading cause of cancer-related death worldwide, and surgical resection with radical intent remains the only potentially curative treatment option today. However, borderline resectable pancreatic ductal adenocarcinomas (BR-PDAC) stand in the gray area between the resectable and unresectable disease since they are technically resectable but have a high probability of incomplete exeresis. Neoadjuvant treatment (NAT) plays an important role in ensuring resection success.

Different survival prognostic factors for BR-PDAC have been well described, but evidence on the predictive factors associated with resection after NAT is scarce. This study aims to study if CA 19-9 plasmatic levels and the tumor anatomical relationship with neighboring vascular structures are prognostic factors for resection and survival (both Overall Survival and Progression-Free Survival) in patients with type A BR-PDAC.

Methods:

This will be a retrospective cohort study using data from type A BR-PDAC patients who received NAT in the Bellvitge University Hospital. The observation period is from January 2010 until December 2019; patients must have a minimum 12-month follow-up. Patients will be classified according to the MD Anderson Cancer Center criteria for BR-PDAC.

Discussion:

Patients with BR-PDAC have a high risk for a margin-positive resection. Serum Carbohydrate Antigen 19-9 plasmatic levels and vascular involvement stand out as disease-related prognostic factors.

This study will provide valuable information on the prognostic factors associated with resection. We will exclude locally advanced tumors and expect this approach to provide more realistic resection rates without selecting those patients that undergo surgical exploration. However, focusing on an anatomical definition may limit the results’ generalizability.
Benefit of glucosyl Hesperidin in patients with primary biliary cholangitis: A multicenter, open-label, randomized control study
Authors: Moriya Kei , Asada Kiyoshi , Suzuki Shota , Enomoto Masahide , Fujinaga Yukihisa , Tsuji Yuki , Namisaki Tadashi , Yoshiji Hitoshi
Published: December 2022

Introduction:

Globally, the number of patients with primary biliary cholangitis (PBC) is increasing. Growing evidence suggests that oxidative stress plays a significant role in the pathogenesis of chronic liver disease regardless of its etiology. Hesperidin, a natural antioxidative substance derived from citrus peel, has been shown to have an anti-inflammatory effect in a rat arthritis model and may be a potential substance to attenuate intrahepatic inflammation in patients with PBC. In this study, the potential of glucosyl hesperidin as a therapeutic agent for PBC will be investigated through antioxidative stress mechanisms.

Methods:

Patients with PBC who are 20 years or older will be eligible to participate. Patients will be assigned to 1 of 2 groups and given either 500 or 1000 mg of glucosyl hesperidin per day. The primary endpoint is the ratio of changes in serum gamma-glutamyl transferase levels before and after 24 weeks of glucosyl hesperidin administration. The secondary endpoints are serum hepatobiliary enzyme levels (alkaline phosphatase, transaminase, and total bilirubin levels) and the protein expression levels of nuclear factor erythroid 2-related factor 2 and its target molecule 8, 16, and 24 weeks after administration compared to before administration.

Discussion:

The prospective clinical interventional study was designed to assess the supportive effect of glucosyl hesperidin on hepatic function in patients with PBC receiving basic ursodeoxycholic acid treatment.