bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-wide association study, combined with bulk segregant analysis, identify plant receptors and defense related genes as candidate genes for downy mildew resistance in quinoa
Authors: Fondevilla Sara , Calderón-González Álvaro , Rojas-Panadero Borja , Cruz Verónica , Matías Javier
Published: June 2024

Background

Downy mildew is the most relevant disease of quinoa and the most widespread. Though, little is known about the genetics of resistance to this disease. The objective of this study was to identify the genomic regions controlling downy mildew resistance in quinoa and candidate genes for this trait. With this aim we carried out a GWAS analysis in a collection formed by 211 quinoa accessions from different origins. This approach was combined with inheritance studies and Bulk Segregant Analysis (BSA) in a segregating population.

Results

GWAS analysis identified 26 genomic regions associated with the trait. Inheritance studies in a F2 population segregating for resistance revealed the existence of a major single dominant gene controlling downy mildew complete resistance in quinoa accession PI614911. Through BSA, this gene was found to be located in chromosome 4, in a region also identified by GWAS. Furthermore, several plant receptors and resistance genes were found to be located into the genomic regions identified by GWAS and are postulated as candidate genes for resistance.

Conclusions

Until now, little was known about the genetic control of downy mildew resistance in quinoa. A previous inheritance study suggested that resistance to this disease was a quantitative polygenic trait and previous GWAS analyses were unable to identify accurate markers for this disease. In our study we demonstrate the existence of, at least, one major gene conferring resistance to this disease, identify the genomic regions involved in the trait and provide plausible candidate genes involved in defense. Therefore, this study significantly increases our knowledge about the genetics of downy mildew resistance and provides relevant information for breeding for this important trait.
Lidocaine spray vs mepivacaine local infiltration for suturing 1st/2nd grade perineal lacerations: a randomised controlled non-inferiority trial
Authors: Restaino Stefano , Degano Matilde , Rizzante Elisa , Battello Ginevra , Paparcura Federico , Biasioli Anna , Arcieri Martina , Filip Gabriele , Vetrugno Luigi , Dogareschi Teresa , Bove Tiziana , Petrillo Marco , Capobianco Giampiero , Vizzielli Giuseppe , Driul Lorenza ,   LISPRAY Group, Moroni Rossana , Zanin Valentina , Tius Veronica , Celante Lisa , Sala Alessia , Poli Alice , Pregnolato Sara , Seminara Giuseppina , Cuman Margherita , Pellecchia Giulia , Occhiali Tommaso , Giorgiutti Cristina , Liviero Stefania , Mazzera Ilaria , Padovani Diana , De Gennaro Elena
Published: June 2024

Background

Perineal lacerations are a very common complication of post-partum. Usually, the repair of 1st and 2nd-grade lacerations is performed after the administration of local anesthesia. Despite the great relevance of the problem, there are only a few studies about the best choice of local anesthetic to use during suturing. We performed a randomised controlled trial to evaluate the efficacy and safety of the use of a local anesthetic spray during the suturing of perineal lacerations in the post-partum.

Methods

We compared the spray with the standard technique, which involves the infiltration of lacerated tissues, using the NRS scale. 136 eligible women who had given birth at University Hospital of Udine were enrolled and randomly assigned to receive nebulization of Lidocaine hydrochloride 10% spray (experimental group) or subcutaneous/submucosal infiltration of mepivacaine hydrochloride (control group) during suturing of perineal laceration.

Results

The lacerations included 84 1st-grade perineal traumas (61.7%) and 52 2nd-grade perineal traumas (38.2%). All the procedures were successfully completed without severe complications or serious adverse reactions. There were no statistically significant differences between the two groups in terms of blood losses or total procedure time. Moreover, there were no statistically significant differences in terms of NRS to none of the intervals considered. Regarding the application of the spray in the B group, in 36 cases (52.9%) it was necessary to improve the number of puffs previously supposed to be sufficient (5 puffs). Just in 3 cases, an additional injection was necessary (4.4%).

Conclusions

Our study demonstrates that lidocaine spray alone can be used as a first line of local anesthetic during the closure of I-II-grade perineal lacerations, as it has comparable efficacy to mepivacaine infiltration.

Trial registration

The trial was recorded on https://clinicaltrials.gov. Identification number: NCT05201313. First registration date: 21/01/2022. Unique Protocol ID: 0042698/P/GEN/ARCS.
Constructing a prognostic model for colon cancer: insights from immunity-related genes
Authors: Li Ansu , Li Qi , Wang Chaoshan , Bao Xue , Sun Feng , Qian Xiaoping , Sun Wu
Published: June 2024

Background

Colon cancer (CC) is a malignancy associated with significant morbidity and mortality within the gastrointestinal tract. Recurrence and metastasis are the main factors affecting the prognosis of CC patients undergoing radical surgery; consequently, we attempted to determine the impact of immunity-related genes.

Result

We constructed a CC risk model based on ZG16, MPC1, RBM47, SMOX, CPM and DNASE1L3. Consistently, we found that a significant association was found between the expression of most characteristic genes and tumor mutation burden (TMB), microsatellite instability (MSI) and neoantigen (NEO). Additionally, a notable decrease in RBM47 expression was observed in CC tissues compared with that in normal tissues. Moreover, RBM47 expression was correlated with clinicopathological characteristics and improved disease-free survival (DFS) and overall survival (OS) among patients with CC. Lastly, immunohistochemistry and co-immunofluorescence staining revealed a clear positive correlation between RBM47 and CXCL13 in mature tertiary lymphoid structures (TLS) region.

Conclusion

We conclude that RBM47 was identified as a prognostic-related gene, which was of great significance to the prognosis evaluation of patients with CC and was correlated with CXCL13 in the TLS region.
Analysis of clinical characteristics of different types of lung function impaiement in TDL patients
Authors: Zhao Jing , Cao Xiaoman , Li YunSong , Li Yang , Ma Teng , Liu Fangchao , Ruan Hongyun
Published: June 2024

Aim

The clinical characteristics associated with pulmonary function decline in patients with Tuberculosis-destroyed lung (TDL) remain uncertain. We categorize them based on the pattern of pulmonary function impairment, distinguishing between restrictive spirometric pattern (RSP) and obstructive spirometric pattern (OSP). We aim to compare the severity of these patterns with the clinical characteristics of TDL patients and analyze their correlation.

Method

We conducted a retrospective analysis on the clinical data of TDL patients who underwent consecutive pulmonary function tests (PFT) from November 2002 to February 2023. We used the lower limit formula for normal values based on the 2012 Global Lung Function Initiative. We compared the clinical characteristics of RSP patients with those of OSP patients. The characteristics of RSP patients were analyzed using the tertiles of forced vital capacity percentage predicted (FVC% pred) decline based on PFT measurements, and the characteristics of OSP patients were analyzed using the tertiles of forced expiratory volume in 1 s percentage predicted (FEV1% pred) decline.

Result

Among the RSP patients, those in the Tertile1 group (with lower FVC% pred) were more likely to have a higher of body mass index (BMI), spinal deformities, and C-reactive protein (CRP) compared to the other two groups (P for trend < 0.001, 0.027, and 0.013, respectively). Among OSP patients, those in the Tertile1 group (with lower FEV1% pred) showed an increasing trend in cough symptoms and contralateral lung infection compared to the Tertile 2–3 group (P for trend 0.036 and 0.009, respectively).

Conclusion

For TDL patients, we observed that Patients with high BMI, a higher proportion of spinal scoliosis, and abnormal elevation of CRP levels were more likely to have reduced FVC. Patients with decreased FEV1% pred have more frequent cough symptoms and a higher proportion of lung infections on the affected side.
Physicians’ understandings and experience of advance care planning in Norwegian nursing homes: a qualitative study
Authors: Ødbehr Liv , Hov Reidun , Sanaker Harald , Jensen Åsa Serholt , Korup Aina , Sandsdalen Tuva
Published: June 2024

Background

Advance care planning is a way of facilitating conversations with patients about future health care, values, and preferences at end of life. Nursing home physicians have the medical responsibility and the main obligation to facilitate planned meetings with patients. Although there has been a great deal of focus on establishing advance care planning in Norwegian nursing homes, it has yet to be widely implemented. Stated reasons are that the work routines in a nursing home do not include such meetings or that implementation seems complex due to frail patients. The aim of this study is thus to explore how physicians understand and experience advance care planning and follow-up of care plans in Norwegian nursing homes.

Methods

The study has a qualitative research design with a phenomenological-hermeneutic approach based on interviews of twelve nursing home physicians working in community care. Interviews were conducted in February 2023 to May 2023, using a semi-structured interview guide. All interviews were recorded on audio files, transcribed, and analyzed using structural text analysis.

Results

The findings are presented based on the following themes: (1) advance care planning is a dialog and a process, (2) advance care planning implies clarifying mutual expectations, and (3) advance care planning that brings relief and hope to patients is a medical art.

Conclusions

Advance care planning is a complex and dynamic process that implies medical treatment, decisions on treatment level, pain relief, and formulation of care plans where the patient’s self-determination and personal values are respected. It implies an ongoing dialogue between physicians, patients, and their relatives about values such as dignity, self-understanding, social relations, and existential questions at end of life. Advance care planning requires a holistic approach that meets patients’ psychological and existential needs such as comfort, trust, hope, and respect as well as their preferences and concerns.
Patterns and factors associated with dental service utilization among insured people: a data mining approach
Authors: Pouraskari Zahra , Yazdani Reza , Khademi Maryam , Hessari Hossein
Published: June 2024

Background

Insurance databases contain valuable information related to the use of dental services. This data is instrumental in decision-making processes, enhancing risk assessment, and predicting outcomes. The objective of this study was to identify patterns and factors influencing the utilization of dental services among complementary insured individuals, employing a data mining methodology.

Methods

A secondary data analysis was conducted using a dental insurance dataset from Iran in 2022. The Cross-Industry Standard Process for Data Mining (CRISP-DM) was employed as a data mining approach for knowledge extraction from the database. The utilization of dental services was the outcome of interest, and independent variables were chosen based on the available information in the insurance dataset. Dental services were categorized into nine groups: diagnostic, preventive, periodontal, restorative, endodontic, prosthetic, implant, extraction/surgical, and orthodontic procedures. The independent variables included age, gender, family size, insurance history, franchise, insurance limit, and policyholder. A multinomial logistic regression model was utilized to investigate the factors associated with dental care utilization. All analyses were conducted using RapidMiner Version 2020.

Results

The analysis encompassed a total of 654,418 records, corresponding to 118,268 insured individuals. Predominantly, restorative treatments were the most utilized services, accounting for approximately 38% of all services, followed by diagnostic (18.35%) and endodontic (13.3%) care. Individuals aged between 36 and 60 years had the highest rate of utilization for any dental services. Additionally, families comprising three to four members, individuals with a one-year insurance history, people contracted with a 20% franchise, individuals with a high insurance limit, and insured individuals with a small policyholder, exhibited the highest rate of service usage compared to their counterparts. The regression model revealed that all independent variables were significantly associated with the use of dental services. However, the patterns of association varied among different service categories.

Conclusions

Restorative treatments emerged as the most frequently used dental services among insured individuals, followed by diagnostic and endodontic procedures. The pattern of service utilization was influenced by the characteristics of the insured individuals and attributes related to their insurance.
Assessment of subclinical LV myocardial dysfunction in T2DM patients with diabetic peripheral neuropathy: a cardiovascular magnetic resonance study
Authors: Li Xue-Ming , Shi Ke , Jiang Li , Wang Jing , Yan Wei-Feng , Gao Yue , Shen Meng-Ting , Shi Rui , Zhang Ge , Liu Xiao-Jing , Guo Ying-Kun , Yang Zhi-Gang
Published: June 2024

Background

Diabetic peripheral neuropathy (DPN) is the most prevalent complication of diabetes, and has been demonstrated to be independently associated with cardiovascular events and mortality. This aim of this study was to investigate the subclinical left ventricular (LV) myocardial dysfunction in type 2 diabetes mellitus (T2DM) patients with and without DPN.

Methods

One hundred and thirty T2DM patients without DPN, 61 patients with DPN and 65 age and sex-matched controls who underwent cardiovascular magnetic resonance (CMR) imaging were included, all subjects had no symptoms of heart failure and LV ejection fraction ≥ 50%. LV myocardial non-infarct late gadolinium enhancement (LGE) was determined. LV global strains, including radial, circumferential and longitudinal peak strain (PS) and peak systolic and diastolic strain rates (PSSR and PDSR, respectively), were evaluated using CMR feature tracking and compared among the three groups. Multivariable linear regression analyses were performed to determine the independent factors of reduced LV global myocardial strains in T2DM patients.

Results

The prevalence of non-infarct LGE was higher in patients with DPN than those without DPN (37.7% vs. 19.2%, p = 0.008). The LV radial and longitudinal PS (radial: 36.60 ± 7.24% vs. 33.57 ± 7.30% vs. 30.72 ± 8.68%; longitudinal: − 15.03 ± 2.52% vs. − 13.39 ± 2.48% vs. − 11.89 ± 3.02%), as well as longitudinal PDSR [0.89 (0.76, 1.05) 1/s vs. 0.80 (0.71, 0.93) 1/s vs. 0.77 (0.63, 0.87) 1/s] were decreased significantly from controls through T2DM patients without DPN to patients with DPN (all p < 0.001). LV radial and circumferential PDSR, as well as circumferential PS were reduced in both patient groups (all p < 0.05), but were not different between the two groups (all p > 0.05). Radial and longitudinal PSSR were decreased in patients with DPN (p = 0.006 and 0.003, respectively) but preserved in those without DPN (all p > 0.05). Multivariable linear regression analyses adjusting for confounders demonstrated that DPN was independently associated with LV radial and longitudinal PS (β = − 3.025 and 1.187, p = 0.014 and 0.003, respectively) and PDSR (β = 0.283 and − 0.086, p = 0.016 and 0.001, respectively), as well as radial PSSR (β = − 0.266, p = 0.007).

Conclusions

There was more severe subclinical LV dysfunction in T2DM patients complicated with DPN than those without DPN, suggesting further prospective study with more active intervention in this cohort of patients.
Peak detection in intracranial pressure signal waveforms: a comparative study
Authors: Wei Miaomiao , Krakauskaite Solventa , Subramanian Sreya , Scalzo Fabien
Published: June 2024

Background

The monitoring and analysis of quasi-periodic biological signals such as electrocardiography (ECG), intracranial pressure (ICP), and cerebral blood flow velocity (CBFV) waveforms plays an important role in the early detection of adverse patient events and contributes to improved care management in the intensive care unit (ICU). This work quantitatively evaluates existing computational frameworks for automatically extracting peaks within ICP waveforms.

Methods

Peak detection techniques based on state-of-the-art machine learning models were evaluated in terms of robustness to varying noise levels. The evaluation was performed on a dataset of ICP signals assembled from 700 h of monitoring from 64 neurosurgical patients. The groundtruth of the peak locations was established manually on a subset of 13, 611 pulses. Additional evaluation was performed using a simulated dataset of ICP with controlled temporal dynamics and noise.

Results

The quantitative analysis of peak detection algorithms applied to individual waveforms indicates that most techniques provide acceptable accuracy with a mean absolute error (MAE)$$\le 10$$≤10ms without noise. In the presence of a higher noise level, however, only kernel spectral regression and random forest remain below that error threshold while the performance of other techniques deteriorates. Our experiments also demonstrated that tracking methods such as Bayesian inference and long short-term memory (LSTM) can be applied continuously and provide additional robustness in situations where single pulse analysis methods fail, such as missing data.

Conclusion

While machine learning-based peak detection methods require manually labeled data for training, these models outperform conventional signal processing ones based on handcrafted rules and should be considered for peak detection in modern frameworks. In particular, peak tracking methods that incorporate temporal information between successive periods of the signals have demonstrated in our experiments to provide more robustness to noise and temporary artifacts that commonly arise as part of the monitoring setup in the clinical setting.
A gamified virtual environment intervention for gait rehabilitation in Parkinson’s Disease: co-creation and feasibility study
Authors: Bosch-Barceló Pere , Masbernat-Almenara Maria , Martínez-Navarro Oriol , Tersa-Miralles Carlos , Pakarinen Anni , Fernández-Lago Helena
Published: June 2024

Background

Treadmill gait training has been shown to improve gait performance in People with Parkinson’s Disease (PwPD), and in combination with Virtual Reality, it can be an effective tool for gait rehabilitation. The addition of gamification elements can create a more stimulating and adherent intervention. However, implementation of new technologies in healthcare can be challenging. This study aimed to develop and evaluate the feasibility of a treadmill rehabilitation program in a Gamified Virtual Reality Environment (GVRE) for PwPD.

Methods

The GVRE was developed following a user-centered design approach, involving both PwPD and physiotherapists in the development and evaluation of the intervention. The intervention consisted of a walking simulation in three different environments (countryside, city, and park), which had a progressive increase in difficulty. To test its feasibility, three sessions were carried out with four PwPD and four physiotherapists. To assess the usability, the System Usability Scale (SUS), Assistive Technology Usability Questionnaire for people with Neurological diseases (NATU Quest) and Simulator Sickness Questionnaire (SSQ) were used. To assess the intervention’s acceptability, feedback and in-game performance was collected from participants.

Results

Results showed the feasibility of the intervention, with a SUS score of 74.82 ± 12.62, and a NATU Quest score of 4.49 ± 0.62, and positive acceptability feedback. Participants showed clear preferences for naturalistic environments, and gamification elements were seen as positive. Difficulty settings worked as intended, but lowered enjoyment of the experience in some cases.

Conclusions

This intervention was successfully shown as a feasible option for the training of gait under Dual Task conditions for PwPD. It offers a safe and replicable environment in which complex situations can be trained. However, further iterations of the intervention need to be improved in order to guarantee accurate tracking and a more realistic training progression.

Trial registration number

NCT05243394–01/20/2022.
Impact of repetitive transcranial magnetic stimulation on cortical activity: a systematic review and meta-analysis utilizing functional near-infrared spectroscopy evaluation
Authors: Chen Shao-Yu , Tsou Meng-Hsuan , Chen Kuan-Yu , Liu Yan-Ci , Lin Meng-Ting
Published: June 2024

Background

Repeated transcranial magnetic stimulation (rTMS) could induce alterations in cortical excitability and promote neuroplasticity. To precisely quantify these effects, functional near-infrared spectroscopy (fNIRS), an optical neuroimaging modality adept at detecting changes in cortical hemodynamic responses, has been employed concurrently alongside rTMS to measure and tailor the impact of diverse rTMS protocols on the brain cortex.

Objective

This systematic review and meta-analysis aimed to elucidate the effects of rTMS on cortical hemodynamic responses over the primary motor cortex (M1) as detected by fNIRS.

Methods

Original articles that utilized rTMS to stimulate the M1 cortex in combination with fNIRS for the assessment of cortical activity were systematically searched across the PubMed, Embase, and Scopus databases. The search encompassed records from the inception of these databases up until April, 2024. The assessment for risk of bias was also conducted. A meta-analysis was also conducted in studies with extractable raw data.

Results

Among 312 studies, 14 articles were eligible for qualitative review. 7 studies were eligible for meta-analysis. A variety of rTMS protocols was employed on M1 cortex. In inhibitory rTMS, multiple studies observed a reduction in the concentration of oxygenated hemoglobin [HbO] at the ipsilateral M1, contrasted by an elevation at the contralateral M1. Meta-analysis also corroborated this consistent trend. Nevertheless, certain investigations unveiled diminished [HbO] in bilateral M1. Several studies also depicted intricate inhibitory or excitatory interplay among distinct cortical regions.

Conclusion

Diverse rTMS protocols led to varied patterns of cortical activity detected by fNIRS. Meta-analysis revealed a trend of increasing [HbO] in the contralateral cortices and decreasing [HbO] in the ipsilateral cortices following low frequency inhibitory rTMS. However, due to the heterogeneity between studies, further research is necessary to comprehensively understand rTMS-induced alterations in brain activity.
Chronic active Epstein-Barr virus infection with reinfection of SARS-CoV-2: a case report
Authors: Wu Hongmei , Liu Li , Qu Jialin , Wang Chunrui , Shi Xiaofeng , Lei Yu
Published: June 2024

We describe the case of a 57-year-old male with jaundice, abdominal distension and fatigue. He was diagnosed as chronic active Epstein-Barr virus infection (CAEBV) due to intermittent elevated liver enzymes, hepatosplenomegaly and pancytopenia, with persistent positive of EBV biomarkers in blood and also positive in liver tissue. The patient was reinfected by SARS-CoV-2 within 2 months companied with CAEBV. The patient’s second infection with SARS-CoV-2 led to the aggravated liver dysfunction with pneumonia and re-admission. After receiving symptomatic treatment, the patient showed significantly improvement of symptoms with partially restoration of liver function. After discharge, the patient’s health status continued to deteriorate and eventually died. The instances of SARS-CoV-2 co-infection with the original chronic virus are not uncommon, but the exact mechanism of EBV and SARS-CoV-2 coinfection and the relationship between them are still unclear. Since co-infection of SARS-CoV-2 with original chronic virus might affect each other and lead disease aggravated and complicated, it is necessary to differentiate in the diagnosis of disease and it is important to be aware of the re-infection signs of SARS-CoV-2 in people with chronic virus infection diseases, as well as the risk of co-infection of SARS-CoV-2 with other viruses.
The efficacy of autologous matrix-induced chondrogenesis (AMIC) for osteochondral lesions of the talus in the mid-long term: a systematic review and meta-analysis
Authors: Jiang Ning , Li Haomin , Wang Jia , Shen Lin , Zeng Xiantie
Published: June 2024

Purpose

The objective of this study was to provide a comprehensive review of the existing literature regarding the treatment of osteochondral lesions of the talus (OLT) using autologous matrix-induced chondrogenesis (AMIC), while also discussing the mid-long term functional outcomes, complications, and surgical failure rate.

Methods

We searched Embase, PubMed, and Web of Science for studies on OLT treated with AMIC with an average follow-up of at least 2 years. Publication information, patient data, functional scores, surgical failure rate, and complications were extracted.

Results

A total of 15 studies were screened and included, with 12 case series selected for meta-analysis and 3 non-randomized controlled studies chosen for descriptive analysis. The improvements in the Visual Analog Scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot, and Tegner scores at the last follow-up were (SMD = − 2.825, 95% CI − 3.343 to  − 2.306, P < 0.001), (SMD = 2.73, 95% CI 1.60 to 3.86, P < 0.001), (SMD = 0.85, 95% CI 0.5 to 1.2, P < 0.001) respectively compared to preoperative values. The surgery failure rate was 11% (95% CI 8–15%), with a total of 12 patients experiencing complications.

Conclusion

The use of AMIC demonstrates a positive impact on pain management, functional improvement, and mobility enhancement in patients with OLT. It is worth noting that the choice of stent for AMIC, patient age, and OLT size can influence the ultimate clinical outcomes. This study provides evidences supporting the safety and efficacy of AMIC as a viable treatment option in real-world medical practice.
Investigation of mediastinal lymph node dissection in clinical stage IA pure-solid non-small cell lung cancer patients
Authors: Bu Jianlong , Pang Sainan , Kong Xianglong , Liu Benkun , Xiao Qifan , Qu Changfa
Published: June 2024

Objective

To explore the independent predictors of pathological mediastinal lymph node (pN2) metastasis in clinical stage IA (cIA) pure-solid non-small cell lung cancer (NSCLC) patients, and to find an appropriate method of mediastinal lymph node dissection.

Methods

This study retrospectively evaluated 533 cIA pure-solid NSCLC patients who underwent radical resection of lung cancer (lobectomy combined with systematic lymph node dissection) from January 2014 to December 2016. The relationship between clinicopathological characteristics and pN2 metastasis was analyzed, and the independent predictors of pN2 metastasis were determined by univariate and multivariate logistic regression analysis. We defined the new factor Y as composed of preoperative cT, CEA, and NSE.

Results

There were 72 cases (13.5%) of pN2 metastasis in cIA pure-solid NSCLC patients. Preoperative clinical tumor diameter (cT), serum CEA level, serum NSE level, and pathological status of station 10 lymph nodes were independent predictors of pN2 metastasis. Patients with cT ≤ 21.5 mm, CEA ≤ 3.85 ng/mL, NSE ≤ 13.40 ng/mL and negative station 10 lymph node group showed lower rates of pN2 metastasis. The new factor Y was an independent predictor of pN2 metastasis. Only 3 (2.1%) of 143 patients in the Y low-risk group showed pN2 metastasis.

Conclusion

For patients with low risk of pN2 metastasis, it might be feasible to take lobe-specific lymph node sampling or systematic lymph node sampling. As for those with high risk of pN2 metastasis, systematic lymph node dissection would be recommended.
Resection of the entire first rib for giant osteochondroma by trans manubrial approach: a case report and review of the literature
Authors: Chen Yong , Deng Kun , Zhao Chang , Xiao Wei , Tang Zhong
Published: June 2024

Background

First rib tumors are extremely rare. Its compression of neurovascularity can easily lead to severe complications such as thoracic outlet syndrome, so early surgical resection is crucial. However, there is no standardized approach to surgery.

Case presentation

A previously healthy 18-year-old Chinese male undergoes a chest computed tomography (CT) scan that incidentally reveals a raised calcified mass on the right first rib, which is most likely an osteochondroma when combined with magnetic resonance imaging (MRI). We achieved excellent results with resection and thoracic reconstruction by adopting an inverse L-shaped incision in the anterior chest and a longitudinal split of the sternum.

Conclusions

Our practice provides great reference for the surgical management of first rib tumors.
Advances in CAR-T-cell therapy in T-cell malignancies
Authors: Zheng Rubing , Zhu Xiaojian , Xiao Yi
Published: June 2024

Significant advances have been made in chimeric antigen receptor T (CAR-T)-cell therapy for the treatment of recurrent or refractory B-cell hematologic malignancies. However, CAR-T-cell therapy has not yet achieved comparable success in the management of aggressive T-cell malignancies. This article reviews the challenges of CAR-T-cell therapy in treating T-cell malignancies and summarizes the progress of preclinical and clinical studies in this area. We present an analysis of clinical trials of CAR-T-cell therapies for the treatment of T-cell malignancies grouped by target antigen classification. Moreover, this review focuses on the major challenges encountered by CAR-T-cell therapies, including the nonspecific killing due to T-cell target antigen sharing and contamination with cell products during preparation. This review discusses strategies to overcome these challenges, presenting novel therapeutic approaches that could enhance the efficacy and applicability of CAR-T-cell therapy in the treatment of T-cell malignancies. These ideas and strategies provide important information for future studies to promote the further development and application of CAR-T-cell therapy in this field.
Dietary ellagic acid therapy for CNS autoimmunity: Targeting on Alloprevotella rava and propionate metabolism
Authors: Han Bing , Shi Lin , Bao Ming-Yue , Yu Feng-Lin , Zhang Yan , Lu Xin-Yu , Wang Yang , Li Dong-Xiao , Lin Jing-Chao , Jia Wei , Li Xing , Zhang Yuan
Published: June 2024

Background

Mediterranean diet rich in polyphenolic compounds holds great promise to prevent and alleviate multiple sclerosis (MS), a central nervous system autoimmune disease associated with gut microbiome dysbiosis. Health-promoting effects of natural polyphenols with low bioavailability could be attributed to gut microbiota reconstruction. However, its underlying mechanism of action remains elusive, resulting in rare therapies have proposed for polyphenol-targeted modulation of gut microbiota for the treatment of MS.

Results

We found that oral ellagic acid (EA), a natural polyphenol rich in the Mediterranean diet, effectively halted the progression of experimental autoimmune encephalomyelitis (EAE), the animal model of MS, via regulating a microbiota-metabolites-immunity axis. EA remodeled the gut microbiome composition and particularly increased the relative abundances of short-chain fatty acids -producing bacteria like Alloprevotella. Propionate (C3) was most significantly up-regulated by EA, and integrative modeling revealed a strong negative correlation between Alloprevotella or C3 and the pathological symptoms of EAE. Gut microbiota depletion negated the alleviating effects of EA on EAE, whereas oral administration of Alloprevotella rava mimicked the beneficial effects of EA on EAE. Moreover, EA directly promoted Alloprevotella rava (DSM 22548) growth and C3 production in vitro. The cell-free supernatants of Alloprevotella rava co-culture with EA suppressed Th17 differentiation by modulating acetylation in cell models. C3 can alleviate EAE development, and the mechanism may be through inhibiting HDAC activity and up-regulating acetylation thereby reducing inflammatory cytokines secreted by pathogenic Th17 cells.

Conclusions

Our study identifies EA as a novel and potentially effective prebiotic for improving MS and other autoimmune diseases via the microbiota-metabolites-immunity axis.
Efficacy of highly bioavailable oral curcumin in asymptomatic or mild COVID-19 patients: a double-blind, randomized, placebo-controlled trial
Authors: Kishimoto Atsuhiro , Komiyama Maki , Wada Hiromichi , Satoh-Asahara Noriko , Yamakage Hajime , Ajiro Yoichi , Aoyama Hiroki , Katsuura Yasuhiro , Imaizumi Atsushi , Hashimoto Tadashi , Sunagawa Yoichi , Morimoto Tatsuya , Kanai Masashi , Kakeya Hideaki , Hasegawa Koji
Published: June 2024

Introduction

Even after the peak of the COVID-19 pandemic, the number of mild cases remains high, requiring continuous control. Curcumin, owing to its anti-inflammatory properties, can suppress vital proliferation and cytokine secretion in animal models. We developed a highly absorbable curcumin, curcuRouge® (cR), which is approximately 100 times more orally bioavailable than conventional curcumin. We evaluated the effect of cR on the inhibition of disease progression in asymptomatic or mildly symptomatic COVID-19 patients.

Methods

This study evaluated the effect of 7-day oral intake of cR (360 mg twice daily). Patients within 5 days of COVID-19 diagnosis were randomly assigned to a placebo or cR group in a double-blind manner.

Results

Primary endpoint events [body temperature (BT) ≥ 37.5 °C and saturation of percutaneous oxygen (SpO2) < 96%] were fewer than expected, and the rate of these events was 2.8% in the cR group (2/71) and 6.0% in the placebo group (4/67); hazard ratio (HR) = 0.532, 95% confidence interval (CI) 0.097–2.902. Patients receiving cR tended to take fewer antipyretic medications than those receiving placebo (HR = 0.716, 95% CI 0.374–1.372). Among patients with a normal range of BT at baseline, the BT change rate was significantly (p = 0.014) lower in the cR group (− 0.34%) versus placebo (− 0.01%).

Conclusion

The relative suppression of event rates and antipyretic medications taken, and significant decrease of subclinical BT support the anti-inflammatory effects of cR in asymptomatic or mildly symptomatic patients with COVID-19.

Trial registration: Japan Registry of Clinical Trials (CRB5200002).
Deciphering the landscape of lncRNA-driven ceRNA network in schizophrenia etiology
Authors: Mukhopadhyay Anirban , Singh Prithvi , Dohare Ravins , Thelma B. K.
Published: June 2024

Background

The unifying hypothesis of competing endogenous RNA (ceRNA) wherein crosstalk between coding (mRNAs) and long non-coding RNAs (lncRNAs) via microRNA (miRNA) response elements, creates a pervasive regulatory network across the transcriptome, has been implicated in complex disorders including schizophrenia. Even with a wide range of high-throughput data, the etiology of schizophrenia remains elusive, necessitating a more holistic understanding of the altered genetic landscape, shifting focus from solely candidate gene studies and protein-coding variants.

Objective

We developed lncRNA-associated ceRNA networks to elucidate global molecular/regulatory signatures underlying schizophrenia using diverse data in the public domain.

Methods

Microarray dataset associated with peripheral blood mononuclear cells (PBMCs) of schizophrenia and control patients was used to identify differentially expressed mRNAs. Weighted gene co-expression network analysis (WGCNA) was used to identify highly correlated hubs, and genes from these overlapping Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene ontology (GO) term genesets were considered key mRNA players. StarBase, Human MicroRNA Disease Database, and miRWalk were used to derive mRNA-miRNA and miRNA-lncRNA relationships. Finally, the key mRNAs, interacting lncRNAs and miRNAs were chosen to reconstruct sub-ceRNA networks based on network centrality scores.

Results

Bioinformatics analysis revealed the involvement of three differentially expressed mRNAs, namely ADRA1A, HAP1 and HOMER3 in the schizophrenia ceRNA networks with lncRNAs NEAT1, XIST, and KCNQ1OT1 modulating their activity by a suggestive sequestering of miR-3163, miR-214-3p and miR-2467-3p, respectively.

Conclusions

Furthermore, based on contextual evidence, we propose how ceRNAs could orchestrate crosstalk between neurostructural dynamics and immune/inflammatory processes and enable unifying these disparate models of schizophrenia etiology.
Relief of double-J stent-related symptoms: a comparison between mirabegron, tamsulosin and solifenacin
Authors: Elmarakbi Akrm A. , Elsayed Osama M. , Mohamed Tamer R. , Lotfy Amr M.
Published: June 2024

Background

Inserting ureteral stents is a routine intervention that often results in problems. The cornerstone for treating stent-related symptoms is pharmacological therapy. This study was conducted to evaluate and to compare the effectiveness of mirabegron, tamsulosin, solifenacin and control in reducing double-J stent-related symptoms.

Results

Patients were evaluated preoperatively, one week after stent insertion and two weeks after the start of medications by the Ureteral Stent Symptom Questionnaire (USSQ), International Prostate Symptom Score (IPSS), overactive bladder questionnaire (OAB-q) and visual analogue pain scale (VAPS). Solifenacin and mirabegron groups had significantly lower sexual scores after the 1st and 2nd weeks post-operatively (PO) when compared with the control group. Mirabegron group had significantly lower sexual scores after 1st and 2nd weeks PO when compared with patients in tamsulosin and solifenacin groups. Patients in mirabegron group had significantly fewer additional problems after the 1st and 2nd weeks PO when compared with patients in the control and tamsulosin groups.

Conclusions

To sum up, mirabegron was found to be superior to solifenacin in lowering urinary symptoms scores, sexual performance scores and work performance scores at both first and second weeks post-operatively. Mirabegron is a good alternative choice for SRSs when tamsulosin or solifenacin is ineffective or not tolerated.
The impact of deep learning on environmental science
Authors: Magazzino Cosimo
Published: June 2024

Deep Learning (DL), a subset of Machine Learning (ML), has emerged as a powerful tool in environmental science, reshaping the landscape of data analysis and interpretation. This study focuses on the remarkable impact of DL on various aspects of environmental science, including remote sensing, climate modelling, biodiversity assessment, pollution monitoring, and environmental health.
Clarifying Causal Effects of Interest and Underlying Assumptions in Randomized and Nonrandomized Clinical Trials in Oncology Using Directed Acyclic Graphs and Single-World Intervention Graphs
Authors: Tanaka Shiro , Muramatsu Yuriko , Inoue Kosuke
Published: June 2024

Recent clinical trials in oncology have used increasingly complex methodologies, such as causal inference methods for intercurrent events, external control, and covariate adjustment, posing challenges in clarifying the estimand and underlying assumptions. This article proposes expressing causal structures using graphical tools—directed acyclic graphs (DAGs) and single-world intervention graphs (SWIGs)—in the planning phase of a clinical trial. It presents five rules for selecting a sufficient set of adjustment variables on the basis of a diagram representing the clinical trial, along with three case studies of randomized and single-arm trials and a brief tutorial on DAG and SWIG. Through the case studies, DAGs appear effective in clarifying assumptions for identifying causal effects, although SWIGs should complement DAGs due to their limitations in the presence of intercurrent events in oncology research.
Comparison of different preoperative fasting times for pediatric elective surgical procedures: A randomized controlled trial
Authors: Jasarat Humna , Naumeri Fatima
Published: June 2024

Objective: To compare the mean residual gastric volume and gastric pH with standard and liberal fasting in children undergoing general anesthesia for elective procedures.
Methods: A randomized controlled trial (NCT 05922072) was conducted at Department of Pediatric Surgery, Mayo Hospital Lahore from June 2021 to December 2021 and 120 patients undergoing elective daycare surgical procedures under general anesthesia were enrolled. Patients were divided into Group-A (Standard fasting) and Group-B (Liberal fasting). Group-A with 6-, 4- and 2-hours Nil per oral (NPO) for solids/ formula milk, breast milk and clear fluid, while Group-B with six, four and one hour NPO for solids/ formula milk, breast milk and clear fluid respectively. Residual gastric volume and pH were measured after anesthetizing the patient. Effect modifiers like age, gender, duration of anesthesia and procedure were controlled through stratification. Post-stratification, t-test was applied and p-value less than 0.05 was taken as statistically significant.
Results: In Group-A, mean age was 6.1±4.5 years and 6.4±4.6 years in Group-B. Mean residual gastric volume with standard fasting was 0.67±0.48 ml and liberal fasting 0.80±0.44 ml (p value 0.13). Mean gastric fluid pH with standard fasting was 1.72±0.78 as compared to liberal fasting 1.63±0.70 (p value 0.53).
Conclusion: Free fluid fasting allows for significantly shorter fasting times, though statistically insignificant higher residual gastric volume was recorded in liberal fasting group with a lower pH.
doi: https://doi.org/10.12669/pjms.40.7.8403
How to cite this: Jasarat H, Naumeri F. Comparison of different preoperative fasting times for pediatric elective surgical procedures: A randomized controlled trial. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.8403
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Propuesta de lege ferenda desde el Derecho civil a la Ley 26/2007, de 23 de octubre, de responsabilidad medioambiental.
Authors: Corpas Pastor Luis
Published: June 2024

Sin desdeñar el sentido y alcance de la Ley de Responsabilidad Medioambiental, de 23 de octubre de 2007 (en adelante, LRM), basada en un modelo administrativista de responsabilidad objetiva y, supuestamente ilimitada, que tiene como principio «quien contamina paga», en nuestra opinión requiere una adecuación de sus planteamientos orientada hacia la responsabilidad civil en aquellos casos en los que se afecte el medio ambiente y se produzcan con ello daños a la salud de las personas. La relación entre el derecho medioambiental y la seguridad y salud es clara: se debería reducir la exposición a riesgos ambientales que pueden dañar la salud, como la contaminación del aire y del agua, a través de normas para garantizar un medioambiente seguro y que no nos enferme. Sin embargo, habría que cambiar el foco de la regulación, ya que más que gestionar los recursos naturales, previniendo la contaminación y preservando la biodiversidad con la imposición de prácticas sostenibles en diferentes industrias, dicha regulación debería enfocarse hacia una responsabilidad civil derivada del efectivo daño a la salud provocado en las personas por parte de quien contamina. Desde luego que es importante la gestión de residuos, la prevención de derrames tóxicos y el uso de energías limpias; pero más importante aún es garantizar la indemnización de las personas que sufren daños directos e indirectos por contaminación. Proponemos una relectura de la LRM, de acuerdo con los Objetivos de Desarrollo Sostenible y la Agenda 2030, la cual tiene a las personas entre sus ejes principales.
Los biobancos, las nuevas tecnologías, y los desafíos del presente y del futuro.
Authors: Fanni Simona
Published: June 2024

El presente estudio se enfoca en la dimensión de los biobancos, en cuanto protagonistas de la dimensión de la investigación científica y, en particular, biomédica. En esta óptica, se aborda el tema de la corporalidad informativamente proyectada, que los datos genéticos y de salud almacenados en los biobancos encarnan, a la búsqueda de un Habeas Data capaz de proporcionar repuestas efectivas y una protección adecuada en la era digital y algorítmica. Desde este punto de vista, se analiza el escenario multifacético, innovador y prometedor marco normativo de la Unión Europea, que actualmente lidera el panorama global en la esfera de la protección de los datos, de la inteligencia artificial y de la creación del Espacio Europeo de Datos Sanitarios. Conclusivamente, se sugiere que justamente el marco normativo de la Unión Europea puede representar un válido modelo universal para la gobernanza de los biobancos.
La acción popular en materia de medio ambiente. Propuestas de mejora.
Authors: Berrocal Acedo Alberto
Published: June 2024

La acción popular está permitida únicamente en los casos y formas expresamente previstos en las Leyes, resultando que en materia medioambiental no existe en nuestro ordenamiento jurídico interno una auténtica acción pública con carácter general, sino que esta ha sido reconocida solamente en algunos ámbitos concretos relacionados con el medio ambiente. Teniendo todos «el derecho a disfrutar de un medio ambiente adecuado para el desarrollo de la persona, así como el deber de conservarlo», según lo dispuesto en el artículo 45 de la Constitución Española, resultaría conveniente regular una acción popular genérica en el ámbito del medio ambiente, como ocurre, por ejemplo, en el campo del urbanismo. No obstante, vemos cómo, en ocasiones, el ejercicio de la acción pública da lugar a efectos perniciosos, siendo por ello por lo que sería necesario establecer límites a la misma.
Evaluation of the current situation of distance education, with reference to the own academic practice
Authors: Anna Kossak
Published: June 2024

I work at the Silesian University of Technology Faculty of Architecture in the Department of Residential and Public Utility Architectural Design, where I teach design classes (Design of Single Family Houses in the 3rd semester, Design of Small Service Objects in the 4th semester, Design of Large Service Objects in the 7th semester for full-time and part-time students, as well as design and seminar classes for the Master’s degree. Having worked remotely (100th students for 3 semesters, I came to the following observations about education in this mode:
Architectural Design Studio activities in times of pandemic. Alternative models and tools for managing mixed-mode teaching
Authors: Veronica Ferrari
Published: June 2024

This contribution deals with the experience of the Architectural Design in Historical Context Studio held by professors Luigi Spinelli, Barbara Bogoni and Eduardo Souto de Moura, that takes place in the second semester of the first year of the Master of Science in Architectural Design and History - AUIC school of the Politecnico di Milano. The course, held in English, is part of an international program that welcomes students from all over the world, offering them the opportunity to fully experience the integration of the different disciplinary components of design practice. The course aims to learn the fundamentals of architectural design and the application to the historical context of the city of Mantova of the theoretical, analytical, historical and instrumental knowledge that students have had the opportunity to develop and increase during their studies, to reach the definition of an architectural project developed in all its parts.