bluuebunny/crossref_metadata_2025 huggingface dataset:
Single center two years’ experience of Ozaki procedure: Early follow-up
Authors: Ozden Yasin , Ozcelik Safa , Ozdemir Kemal , Peynirci Ferdi , Ozden Seyma , Senocak Mutlu , Sensoz Yavuz , Kayacioglu, Ilyas
Published: November 2023

The Ozaki Procedure is an innovative surgical technique aiming of aortic valve neocuspidization using glutaraldehyde-treated autologous pericardium was first developed by Ozaki et al in 2007. With this newly developed technique, valve replacement was achieved without using prosthetic material due to both aortic stenosis and aortic insufficiency. Between December 2020 and December 2022, a total of 59 patients were operated on with the Ozaki Procedure due to aortic valve pathologies in our center. We evaluated the pre- and postoperative as well as the first-month data of a total of 44 patients with isolated the Ozaki Procedure and compared their echocardiographic changes. Patients with isolated aortic valve pathology were included in the study. Fifteen patients who underwent simultaneous coronary artery bypass surgery and Ozaki Procedure were excluded from the analysis. In the first month after the operation, n:2 (%4.5) patients died. When the preoperative and postoperative 1st month echocardiographic data of the remaining patients were compared, it was found that the decrease in mean gradient, max gradient and peak velocity values in the aortic valve was statistically significant. This is due to the fact that reaching neo-valves has very similar hemodynamics to the native aortic valve. Aortic valve neocuspidization by Ozaki Procedure may be a viable alternative to both surgical aortic valve replacement (AVR) and transcatheter aortic valve implantation. Its popularity and application is increasing all over the world. Short and mid-term results are available in the literature. The short and mid-term results are good, and the long-term results are hopeful.
Minocycline in depression not responding to first-line therapy: A systematic review and meta-analysis
Authors: Shamim Muhammad Aaqib , Manna Subhanwita , Dwivedi Pradeep , Swami Mukesh Kumar , Sahoo Swapnajeet , Shukla Ravindra , Srivastav Shival , Thaper Kashish , Saravanan Aswini , Anil Abhishek , Varthya Shoban Babu , Singh Surjit , Shamim Muhammad Aasim , Satapathy Prakisini , Chattu Soosanna Kumary , Chattu Vijay Kumar , Padhi Bijaya K. , Sah Ranjit
Published: November 2023

Background:

Major depressive disorder is often resistant to first-line treatment, with around 30% failing to respond to traditional therapy. Treatment-resistant depression results in prolonged hospitalization and healthcare costs. Anti-inflammatory drugs have shown promising results in depression not responding to initial therapy. Minocycline has anti-inflammatory properties and crosses the blood-brain barrier. It has demonstrated varied results in several randomized controlled trials (RCTs).

Methods:

We assessed the efficacy of minocycline compared to placebo in depression not responding to one first-line antidepressant via a systematic review and meta-analysis. We performed a comprehensive literature search across PubMed, Cochrane, and Scopus for RCTs. We visualized the results using forest plots and drapery plots. We assessed and explored heterogeneity using I
2, prediction interval, and meta-regression. Then, we rated the certainty of the evidence.

Results:

Four RCTs revealed a non-significant difference in depression severity [−3.93; 95% CI: −16.14 to 8.28], rate of response [1.15; 0.33–4.01], and rate of remission [0.94; 0.44–2.01]. However, the reduction in depression severity is significant at a trend of P < .1. The high between-study heterogeneity (I
2 = 78%) for depression severity could be answered by meta-regression (P = .02) for the duration of therapy.

Conclusion:

There is no significant difference with minocycline compared to placebo for depression not responding to first-line antidepressant therapy. However, the treatment response varies with treatment duration and patients’ neuroinflammatory state. Thus, larger and longer RCTs, especially in diverse disease subgroups, are needed for further insight. This is needed to allow greater precision medicine in depression and avoid elevated healthcare expenditure associated with hit-and-trial regimens.

Registration:

CRD42023398476 (PROSPERO).
Non-invasive alternative for phosphodiesterase inhibitor-refractory erectile dysfunction: Real-life experience with low-intensity extracorporeal shockwave therapy
Authors: Bayraktar Necmi
Published: November 2023

This retrospective study assessed the efficacy of low-intensity extracorporeal shockwave therapy (Li-ESWT) in the treatment of erectile dysfunction (ED) in patients unresponsive to phosphodiesterase inhibitors (PDE5is). Between May 2020 and December 2022, we retrospectively analyzed the records of 126 ED patients who underwent Li-ESWT post unsuccessful PDE5is trials, defined as inadequate response following at least 6 consistent trials with correct dosage (preference given to 20 mg tadalafil). Patients with neurogenic disorders were excluded. Patients’ ED severity was determined using the IIEF-5 score and further categorized into 2 groups. The Li-ESWT treatment protocol consisted of 12 weeks. Data was analyzed using descriptive statistics and paired t-tests. In the cohort of 126 patients, the mean age was 50.5 ± 12.4 years, with a BMI of 29.18 ± 3.49. Notably, 74.6% had ED for more than 12 months. Before Li-ESWT, 55.6% used sildenafil and 44.4% used tadalafil. Post 3 months of Li-ESWT, the average IIEF score rose significantly from 10.19 ± 7.71 to 14.29 ± 0.92 (P < .01). Particularly, Group 2 exhibited a significant improvement in their mean IIEF score from 13.78 ± 1.38 pretreatment to 21 ± 2.31 post-treatment. However, Group 1 (with higher diabetes prevalence) showed a marginal rise from 5.8 ± 1.47 to 6.1 ± 3.2 (P = .14). Similarly, the overall EHS score progressed significantly from 1.34 ± 0.8 to 2.3 ± 1.17 post-treatment. Post-treatment, while Group 1 showed no changes in successful vaginal penetration, Group 2 reported a dramatic increase in successes, from 16 before treatment to 68 after. This study demonstrated the efficacy of Li-ESWT for PDE5is-refractory ED, particularly in patients with moderate to mild ED. However, patients with severe ED and comorbidities did not show significant improvement. Further research with larger sample sizes, control groups, longer follow-up periods, and standardized protocols is required to confirm the effectiveness and limitations of Li-ESWT in ED treatment.
The relationship between neuropathic pain and the outcomes of minimally invasive pain management in rotator cuff ruptures
Authors: Balta Selin , Pekince Oguzhan
Published: November 2023

This study aimed to investigate how the presence of neuropathic pain related to partial rotator cuff tears affects the short-term results of subacromial injection and suprascapular nerve blockade therapy in patients with chronic shoulder pain. In this prospective observational study, shoulder pain via verbal numeric pain rating (VNPR, 0–10) and functional status through simple shoulder test (SST) were evaluated before and second week after procedure. After dividing as neuropathic pain and non-neuropathic pain groups, pre-procedural and follow-up scores concerning pain intensity, functional status, and whether there were those of patients with minimal clinically important change (MCIC) in areas of pain and function were evaluated. Between the groups including 140 patients, while there was no statistical difference in baseline pain intensity and functional status (P = .14,.11, respectively), outcomes of those without neuropathic pain were favored at the follow-up (P = .02,.01, respectively). Given baseline pain scores, the reduction (%) was significantly lower in neuropathic pain group (P = .03). There was no significant difference in patients with MCIC in pain intensity and functional status between the groups (P = .08,.59, respectively). An improvement was determined in pain intensity and functional status at the follow-up in both groups (P < .001). The improvement in pain intensity and functional status is poorer in patients with partial rotator cuff rupture-related neuropathic pain than in those without neuropathic pain. However neuropathic pain has no negative effect on the response to treatment.
FLAIR-hyperintense lesions in anti-MOG-associated encephalitis with seizures overlaying anti-N-methyl-D-aspartate receptor encephalitis: A case report
Authors: Fu Qingxi , Wang Guangying , Che Fengyuan , Li Dong , Wang Shougang
Published: November 2023

Rationale:

FLAIR-hyperintense lesions in anti-myelin oligodendrocyte glycoprotein (MOG)-associated encephalitis with seizures (FLAMES) is a rare clinical phenotype of anti-MOG; immunoglobulin G-associated disease is often misdiagnosed as viral encephalitis in the early stages. Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis caused by antibodies targeting the GluN1 subunit of the NMDAR. The coexistence of anti-NMDAR encephalitis and FLAMES is very rare.

Patient concerns:

A 20-year-old female patient initially presented with seizures accompanied by daytime sleepiness.

Diagnoses:

Magnetic resonance imaging revealed FLAIR-hyperintense lesions in unilateral cerebral cortex. NMDAR antibodies was positive in the cerebrospinal fluid and MOG antibodies in the serum.

Interventions:

Steroid therapy was administrated.

Outcomes:

The symptoms completely relieved. At 6-month follow-up, the patient’s condition remained stable. Magnetic resonance imaging showed no abnormalities in the unilateral cerebral cortex.

Conclusion:

When a patient with anti-NMDAR encephalitis or FLAMES is encountered in clinical practice, the coexistence of these diseases with double-positive anti-NMDAR and MOG antibodies should be considered and adopt appropriate evaluation and treatment.
Uterine torsion with degeneration and infarction of giant leiomyoma in a postmenopausal woman: A case report
Authors: Ye Zhongxue , Jiang Yafen , Yan Kun , Yu Chen
Published: November 2023

Rationale:

Uterine torsion and giant leiomyoma are both rare diseases. Uterine torsion combined with giant leiomyoma with degeneration or infarction is easy to be misdiagnosed. We wrote this case to increase the accuracy and timeliness of medical staff’s diagnosis and treatment of uterine fibroids combined with uterine torsion.

Patient concerns:

We present a case of uterine torsion with degeneration and infarction of giant leiomyoma in a 66-year-old postmenopausal woman, who had a lump in her pelvis 10 years ago and suffered from acute abdominal pain half a day before hospitalization.

Diagnosis:

The patient was considered as uterine torsion with huge abdominal mass by computed tomography and enhanced magnetic resonance imaging, and finally diagnosed as uterine torsion with giant leiomyoma through surgery and pathological examination.

Interventions and outcomes:

The patient underwent exploratory laparotomy. In addition to the removal of huge uterine fibroids, the hysterectomy with double appendages was conducted. The histopathologic analysis showed “(Uterine tumor) leiomyoma with extensive edema, degeneration, infarction and calcification.” The patient recovered well after operation and kept healthy in the follow-up to date.

Lessons:

Although uterine torsion is extremely rare, early diagnosis and treatment are essential to prevent serious complications.
A case report of acute myocardial infarction with extremely severe thrombocytopenia after percutaneous coronary intervention
Authors: Chen Shuai , Wang Hongqi , Ning Bin
Published: November 2023

Introduction:

The case report’s purpose is to remind doctors a rare complication named thrombocytopenia of antithrombotic drugs. As a result, severe bleeding or even life-threatening situations may be avoided.

Patient concerns:

A specific case of a patient with acute myocardial infarction, a significant decrease in platelet count was observed after percutaneous coronary intervention.

Diagnosis:

After ruling out other potential causes, the medical team considered tirofiban-induced thrombocytopenia as a possible explanation.

Interventions and outcomes:

Through careful monitoring and adjustment of medication, the patient’s platelet count eventually returned to normal.

Conclusion:

To ensure patient safety, it is advised to regularly monitor platelet counts at intervals of 2 to 6 hours before and after administering tirofiban.
Case report: Severe cholestatic jaundice associated with hyperthyroidism treated with methimazole
Authors: Liu Xiaoqiang , Xu Boming , Zeng Yilin , Chen Peizhong , Wang Yubin
Published: November 2023

Rationale:

We present a case of a 43-year-old female patient diagnosed with hyperthyroidism. This study aims to demonstrate the rare association between hyperthyroidism and severe cholestatic jaundice, and the effectiveness of methimazole treatment.

Patient concerns:

The patient developed severe jaundice, a typically mild symptom in most hyperthyroidism cases.

Diagnosis:

The severe jaundice was suspected to be a result of cholestasis induced by hyperthyroidism, with other potential causes such as drug-induced or autoimmune liver dysfunction being ruled out.

Outcomes:

The patient was effectively treated with methimazole. Outcomes: Treatment with methimazole alleviated the severe cholestatic jaundice and restored normal thyroid function.

Lessons:

The specific mechanism of cholestasis as a secondary complication of hyperthyroidism remains unclear, and there are no specific biochemical markers for cholestasis caused by this hormonal disease. This case underscores the possibility of severe jaundice as a clinical manifestation of hyperthyroidism, and highlights antithyroid drug treatment as an effective strategy for managing severe cholestatic jaundice.
Juan Bi Tang, a traditional Chinese medicine, for alleviating pain related to arteriovenous fistula in maintenance hemodialysis patients: An interventional pilot study with brief review
Authors: Hsu Yung-Tang , Chen Yung-Hsiang , Fu Chung-Ming , Lee Wen-Chin , Tsai Ming-Yen
Published: November 2023

Myofascial pain around an arteriovenous fistula (AVF) during hemodialysis (HD) can affect a patient compliance with HD and quality of life. Prolonged use of analgesics is often associated with increased adverse events. Juan Bi Tang (JBT) is an ancient decoction of Chinese traditional medicinal plants commonly used to treat spasms and pain in the shoulder and upper arm, and it is popularly believed to have favorable outcomes in Asian populations. This interventional prospective pilot study was worked to demonstrate the potential of JBT for fistula-associated myofascial pain in HD patients and to prepare for future randomized controlled trials. Eligible patients were enrolled in this study and took JBT to treat fistula-associated myofascial pain for 4 weeks. Pain scores on a visual analogue scale (VAS) were reported at baseline, after a 4-week intervention, and 2 weeks after completion of treatment. The Kidney Disease Quality of Life 36-Item Short Form and a safety laboratory monitor were statistically compared between different time points. A total of 20 patients were selected as eligible participants and completed the intervention and questionnaires. The mean VAS score was significantly reduced after JBT treatment (P < .01). Participants reported improved physical (P < .01) and mental health (P < .05) after treatment. However, only improvements in mental health were preserved 2 weeks after the end of treatment (P < .05). In this study, complementary JBT for HD patients with fistula-related myofascial pain was viable and well tolerated, and it demonstrated the expected effects on pain control.
Clinical outcomes of mild to moderate coronavirus disease 2019 patients treated with Regdanvimab in delta-variant outbreak: Retrospective cohort study
Authors: Noh Hyeong-Jun , Song Jin Hwa , Ham Sin Young , Park Yeonkyung , Won Ha-Kyeong , Kim Soo Jung , Chung Keun Bum , Kim Choon Kwan , Ahn Young Mee , Lee Byoung-Jun , Kang Hye-Rin
Published: November 2023

Regdanvimab is a novel neutralizing antibody agent used for the treatment of coronavirus disease 2019 (COVID-19). However, the effectiveness of regdanvimab in delta-variant patients has rarely been investigated. We examined the clinical outcomes and adverse events in COVID 19 patients treated with regdanvimab in the delta-variant era. Data were collected from laboratory-confirmed COVID-19 hospitalized patients who received regdanvimab in 2021 and categorized into pre-delta and delta variant groups. The primary outcome was the need for oxygen therapy. Rescue therapy, clinical improvement, and adverse events were analyzed. Among 101 patients treated with regdanvimab, 31 (30.7%) were delta patients and 49 (48.5) were pre-delta patients. 64.4% were male, the mean age was 60.3 years, and 70 patients (69%) had at least one underlying disease. The median interval from symptom onset to injection was 4 days. Twenty-three patients (23%) needed oxygen therapy, including 9 (29%) in the delta and 8 (16.3%) in the pre-delta group. (P = .176) The risk of early oxygen supplement was higher in the delta group (adjusted hazard ratio (aHR), 6.75; 95% confidence interval(CI), 1.53–29.8). The in-hospital survival rate was 100%, and no patients were admitted to the intensive care unit. Adverse events occurred in 43% of patients:13 (42%) delta patients and 23 (47%) pre-delta patients had any adverse events (P = .661). Patients treated with regdanvimab 4 days after symptom onset showed a favorable prognosis (aHR, 0.26; 95% CI, 0.26–0.91). We found that the high-risk mild to moderate COVID-19 patients treated with regdanvimab showed similar disease progression in delta-variant patients and pre-delta variants; however, we need to be more closely observed delta-variant patients than those in the pre-delta group despite regdanvimab treatment due to rapid disease aggravation.
Past, present, and future of global research on artificial intelligence applications in dermatology: A bibliometric analysis
Authors: Wang Guangxin , Meng Xianguang , Zhang Fan
Published: November 2023

In recent decades, artificial intelligence (AI) has played an increasingly important role in medicine, including dermatology. Worldwide, numerous studies have reported on AI applications in dermatology, rapidly increasing interest in this field. However, no bibliometric studies have been conducted to evaluate the past, present, or future of this topic. This study aimed to illustrate past and present research and outline future directions for global research on AI applications in dermatology using bibliometric analysis. We conducted an online search of the Web of Science Core Collection database to identify scientific papers on AI applications in dermatology. The bibliometric metadata of each selected paper were extracted, analyzed, and visualized using VOS viewer and Cite Space. A total of 406 papers, comprising 8 randomized controlled trials and 20 prospective studies, were deemed eligible for inclusion. The United States had the highest number of papers (n = 166). The University of California System (n = 24) and Allan C. Halpern (n = 11) were the institution and author with the highest number of papers, respectively. Based on keyword co-occurrence analysis, the studies were categorized into 9 distinct clusters, with clusters 2, 3, and 7 containing keywords with the latest average publication year. Wound progression prediction using machine learning, the integration of AI into teledermatology, and applications of the algorithms in skin diseases, are the current research priorities and will remain future research aims in this field.
Development and validation of a predictive model associated with lymph node metastasis of gastric signet ring carcinoma patients
Authors: Wang Wei , Xia Yang , He Chiyi
Published: November 2023

The risk factors for lymph node metastasis (LNM) in patients with gastric signet ring cell carcinoma (GSRC) have not been well-defined. This study was designed to prognosticate LNM in patients with GSRC by constructing and verifying a nomogram. A total of 2789 patients with GSRC from the Surveillance, Epidemiology, and End Results (SEER) database and Yijishan Hospital of Wannan Medical College (YJS) were retrospectively reviewed. A predictive model was established using logistic regression based on the SEER cohort. The performance of the model was evaluated using the concordance index (C-index) and decision curve analysis (DCA). In addition, its robustness was validated using the YJS cohort. Four independent predictors of LNM were identified in the SEER cohort. Next, a nomogram was constructed by incorporating these predictors. The C-index were 0.800 (95% confidence interval [CI] = 0.781–0.819) and 0.837 (95% CI = 0.784–0.890) in the training and external validation cohorts, respectively. The outcomes of DCA supported good clinical benefits. The proposed model for evaluating the LNM in patients with GSRC can help to avoid the misdiagnosis risk of N-stage, assist to screen the population suitable for neoadjuvant therapy and help clinicians to optimize clinical decisions.
Use of a radiomics-clinical model based on magnetic diffusion-weighted imaging for preoperative prediction of lymph node metastasis in rectal cancer patients
Authors: Li Yehan , Zeng Chen , Du Yong
Published: November 2023

Rectal cancer is the eighth most prevalent malignancy worldwide with a 3.2% mortality rate and 3.9% incidence rate. Radiologists still have difficulty in correctly diagnosing lymph node metastases that have been suspected preoperatively. To assess the effectiveness of a model combining clinical and radiomics features for the preoperative prediction of lymph node metastasis in rectal cancer. We retrospectively analyzed data from 104 patients with rectal cancer. All patients were selected as samples for the training (n = 72) and validation cohorts (n = 32). Lymph nodes (LNs) in diffusion-weighted images were analyzed to obtain 842 radiomic characteristics, which were then used to draw the region of interest. Logistic regression, least absolute shrinkage and selection operator, and between-group and within-group correlation analyses were combined to establish the radiomic score (rad-score). Receiver operating characteristic curves were used to estimate the prediction accuracy of the model. A calibration curve was constructed to test the predictive ability of the model. A decision curve analysis was performed to analyze the model’s value in clinical application. The area under the curve for the radiomics-clinical, clinical, and radiomics models was 0.856, 0.810, and 0.781, respectively, in the training cohort and 0.880, 0.849, and 0.827, respectively, in the validation cohort. The calibration curve and DCA showed that the radiomics-clinical prediction model had good prediction accuracy, which was higher than that of the other models. The radiomics-clinical model showed a favorable predictive performance for the preoperative prediction of LN metastasis in patients with rectal cancer.
A CARE-compliant article: A case report of unusual eschar and extensive soft tissue necrosis in Tsutsugamushi disease
Authors: Byeon Je Yeon , Kim Hyun , Lee Da Woon , Choi Hwan Jun
Published: November 2023

Rationale:

Tsutsugamushi disease is a common infectious disease in the Northern Hemisphere. A patient infected with tsutsugamushi disease will show a characteristic clinical course with eschar formation, which is mostly small and self-limited in nature without causing major problems. We report a rare case of unusually extensive necrosis started from a small eschar.

Patient concerns:

In this report, a 65-year-old female patient with a history of diabetes mellitus present an 8 × 6 cm-sized huge eschar and extensive soft tissue necrosis aggravated from a small eschar. Also, there were 3 other small eschars in the scalp and left flank area. In early July, she was farming in a field in Hongseong-gun, South Korea. She had been treated at another hospital for 2 weeks. However, the eschar became bigger and worse.

Diagnoses:

After admission, escharectomy was performed and extensive soft tissue necrosis was identified. Orientia tsutsugamushi antibody tests were positive from blood test. Providencia rettgeri and Enterococcus faecalis were detected in a tissue bacterial culture test.

Intervention:

While using oral azithromycin and intravenous imipenem/cilastatin, the necrosis of the thigh was excised and covered by lateral femoral circumflex artery based myocutaneous Keystone flap.

Outcomes:

The remaining small eschars recovered spontaneously, the large eschars that had caused necrosis were successfully treated, and all other clinical symptoms improved without complications.

Lessons:

For unusual eschar of an unknown cause, especially in patients with uncontrolled diabetes or immunocompromised, the possibility of Tsutsugamushi should be considered. Careful physical examination and proper management should be performed as soon as possible.
Sensorineural hearing loss induced by gefitinib: A CARE-compliant case report and literature reviews
Authors: Zhu Bao-chen , Yang Wen-hua , Huang Mao , Wang Jin-gui , Liang Yan , Lei Zhen-zhen , Zhang Sha-sha , Wang Ying , Sun Xiao-di , Gong Ying , Xue Chun-miao , Hua Guo-dong
Published: November 2023

Rationale:

Gefitinib is a potent and selective orally active growth factor receptor (EGFR)-tyrosine kinase inhibitor that is commonly used to treat advanced non-small cell lung cancer patients with activating EGFR mutations. Hearing impairment with gefitinib was sparsely reported. In this report, we describe a case of sensorineural deafness associated with the administration of gefitinib, with a Naranjo score of 7.

Patient concerns:

An 81-year-old female was diagnosed with lung adenocarcinoma with bone metastasis and an EGFR-activating mutation. The patient was prescribed gefitinib tablets at a daily dose of 250 mg for lung adenocarcinoma treatment. However, the patient experienced moderate to severe bilateral sensorineural deafness, primarily in her right ear, after taking gefitinib. Following the cessation of gefitinib administration, the patient exhibited partial restoration of auditory function. Upon resuming the medication, she experienced a worsening of deafness.

Diagnoses:

The otoscopic audiogram and hearing test indicated moderate to severe bilateral sensorineural deafness.

Interventions:

The otolaryngologist recommended bilateral hearing aids to enhance hearing function.

Outcomes:

Throughout our follow-up period, the patient did not receive a hearing aid implant.

Lessons:

This article first reported the ototoxicity caused by gefitinib. While rare, our report highlights that gefitinib-induced sensorineural deafness is possible and its mechanisms are still unclear. This adverse reaction should be monitored closely during clinical application of gefitinib to improve patient outcomes.
Prognostic value of CASC15 and LINC01600 as competitive endogenous RNAs in lung adenocarcinoma: An observational study
Authors: Zhou Fangbin
Published: November 2023

Long noncoding RNAs (lncRNAs) can directly or indirectly regulate gene expression through interacting with microRNAs (miRNAs). Competitive endogenous RNAs render the roles of lncRNAs more complicated in the process of tumor occurrence and progression. However, the prognostic value of lncRNAs as potential biomarkers and their functional roles as competitive endogenous RNAs have not been clearly described for lung adenocarcinoma (LUAD). In the present study, the aberrant expression profiles of lncRNAs and miRNAs were analyzed at cBioPortal by interrogating LUAD dataset from The Cancer Genome Atlas (TCGA) database with 517 tissue samples. A total of 92 lncRNAs and 125 miRNAs with highly genetic alterations were identified. Further bioinformatics analysis was performed to construct a LUAD-related lncRNA-miRNA-mRNA ceRNA network, which included 24 highly altered lncRNAs, 21 miRNAs and 142 mRNAs. Some key lncRNAs in this network were subsequently identified as LUAD prognosis-related, and of those, CASC15 and LINC01600 both performed the potential prognostic characteristics with LUAD regarding OS and recurrence. Comprehensive analysis indicated that the expression of LINC01600 was significantly associated with KRAS mutation and lymph node metastasis, and CASC15 and LINC01600 were significantly tended towards co-occurrence, which may be due to the similarity of genes co-expressed by these 2 lncRNAs. Our findings provided novel insight into better understanding of ceRNA regulatory mechanisms in the pathogenesis of LUAD and facilitated the identification of potential biomarkers for prognosis.
Smoking and the risk of atopic dermatitis: A two-sample mendelian randomization study
Authors: Wang Zhenni , Zhang Minghai
Published: November 2023

Atopic dermatitis (AD) is considered to be one of the most common chronic diseases. It has been shown that smoking is associated with atopic dermatitis, but previous studies were mainly observational, which may be biased. The present study conducted a 2-sample mendelian randomization (MR) study to investigate the causal relationship. The present study obtained data on “ever smoked” and “atopic dermatitis” from published large-scale genome-wide association studies. The data were obtained from the UK Biobank and BioBank Japan. Three methods were used to perform a 2-sample MR analysis and also performed sensitivity analysis. The odds ratio and 95% confidence interval (CI) between smoking and AD calculated by MR-Egger regression, weighted median, and random-effects inverse variance weighting method were 1.096 (95% CI.756–1.587) and 1.159 (95% CI 1.040–1.292), respectively, 1.137 (95% CI .975–1.325). The inverse variance weighting method showed statistical significance between the 2 and a causal relationship between smoking and AD. In conclusion, the results of our MR analysis suggest that smoking is likely to affect the incidence of AD.
Oxeiptosis core genes and their multi-omics analysis in hepatocellular carcinoma
Authors: Lin Sen , Li Jinghao , Zhao Ruiqi , Yu Mengjiao , Peng Lisheng
Published: November 2023

Oxeiptosis is a recently discovered caspase-independent, non-inflammatory programmed cell death modality. Current studies suggest that oxeiptosis has crucial effects on biological processes in a variety of diseases. However, the mechanism of oxeiptosis in hepatocellular carcinoma (HCC) remains unclear and no relevant studies have been published. Therefore, this study is intended to investigate the mechanism and prognostic role of oxeiptosis-related genes in HCC. We explored the mechanisms and molecular phenotypes underlying the role of oxeiptosis in HCC through multi-omics analysis. Firstly, we obtained RNA-sequencing and clinical data from public database and divided the samples into trial and validation cohorts in subsequent analyses. We then screened oxeiptosis core genes (OCGs) and screened prognosis-related genes. Based on different molecular markers, we identified the molecular phenotypes of HCC, and the potential OCGs molecular mechanisms were explored. Subsequently, we construct a prognostic prediction system for HCC. Finally, we analyzed the tumor microenvironment and the immune escape phenomenon. We screened a total of 69 OCGs, most of which were prognostic risk factors for HCC. A majority of OCGs were enriched in cell cycle regulation and mitotic processes, which were related to both tumor cell proliferation and death. We identified 2 different molecular typing options with significant differences in prognosis, function, and signaling pathway enrichment between different molecular subtypes. The prognostic prediction model combined with molecular phenotypes and had a good predictive effect. Finally, we found CD4 + T-cell exhaustion in samples with specific molecular phenotypes. Through multi-omics analysis of OCGs, we not only revealed the possible molecular mechanisms of OCGs in HCC but also provided a prognostic prediction system for clinical application through molecular typing and risk scoring model. Meanwhile, we found immune escape mechanisms in HCC.
Fgf2 and Ptpn11 play a role in cerebral injury caused by sevoflurane anesthesia
Authors: Zhang Lin , Xu Lingyan
Published: November 2023

Sevoflurane is a new inhaled anesthetic, which has better physical properties than the existing inhalational anesthetics, rapid induction, less tissue uptake, and faster recovery. Sevoflurane can directly dilators cerebral blood vessels and increase cerebral blood flow, but it also reduces cerebral oxygen metabolism rate, thereby reducing cerebral blood flow. However, the role of Fgf2 and Ptpn11 in cerebral injury caused by sevoflurane anesthesia remains unclear. The sevoflurane anesthesia brain tissue datasets GSE139220 and GSE141242 were downloaded from gene expression omnibus (GEO). Differentially expressed genes (DEGs) were screened and weighted gene co-expression network analysis (WGCNA) was performed. Construction and analysis of protein-protein interaction (PPI) Network. Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG), comparative toxicogenomics database (CTD) were performed. A heat map of gene expression was drawn. TargetScan was used to screen miRNAs regulating DEGs. 500 DEGs were identified. According to GO, in Biological Process analysis, they were mainly enriched in response to hypoxia, blood vessel development, inner ear development, neural tube closure, and aging. In Cellular Component (CC), they were mainly enriched in plasma membrane, integral component of membrane, and basal lamina. In Molecular Function (MF), they were mainly associated with protein binding, Wnt-activated receptor activity, and organic anion transmembrane transporter activity. In the KEGG analysis, they were mainly enriched in proteoglycans in cancer, pathways in cancer, transcriptional misregulation in cancer, basal cell carcinoma, thyroid hormone signaling pathway. In the Metascape enrichment analysis, the GO enrichment items revealed upregulated regulation of vascular endothelial cell proliferation, platelet-derived growth factor receptor signaling pathway, inner ear development, and response to hypoxia. A total of 20 modules were generated. Gene Expression Heatmap showed that the core genes (Fgf2, Pdgfra, Ptpn11, Slc2a1) were highly expressed in sevoflurane anesthesia brain tissue samples. CTD Analysis showed that the 4 core genes (Fgf2, Pdgfra, Ptpn11, Slc2a1) were associated with neurodegenerative diseases, brain injuries, memory disorders, cognitive disorders, neurotoxicity, drug-induced abnormalities, neurological disorders, developmental disorders, and intellectual disabilities. Fgf2 and Ptpn11 are highly expressed in brain tissue after sevoflurane anesthesia, higher the expression level of Fgf2 and Ptpn11, worse the prognosis.
A Prognostic Model for Critically Ill Children in Locations With Emerging Critical Care Capacity*
Authors: Chandna Arjun , Keang Suy , Vorlark Meas , Sambou Bran , Chhingsrean Chhay , Sina Heav , Vichet Pav , Patel Kaajal , Habsreng Eang , Riedel Arthur , Mwandigha Lazaro , Koshiaris Constantinos , Perera-Salazar Rafael , Turner Paul , Chanpheaktra Ngoun , Turner Claudia
Published: November 2023

OBJECTIVES:

To develop a clinical prediction model to risk stratify children admitted to PICUs in locations with limited resources, and compare performance of the model to nine existing pediatric severity scores.

DESIGN:

Retrospective, single-center, cohort study.

SETTING:

PICU of a pediatric hospital in Siem Reap, northern Cambodia.

PATIENTS:

Children between 28 days and 16 years old admitted nonelectively to the PICU.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Clinical and laboratory data recorded at the time of PICU admission were collected. The primary outcome was death during PICU admission. One thousand five hundred fifty consecutive nonelective PICU admissions were included, of which 97 died (6.3%). Most existing severity scores achieved comparable discrimination (area under the receiver operating characteristic curves [AUCs], 0.71–0.76) but only three scores demonstrated moderate diagnostic utility for triaging admissions into high- and low-risk groups (positive likelihood ratios [PLRs], 2.65–2.97 and negative likelihood ratios [NLRs], 0.40–0.46). The newly derived model outperformed all existing severity scores (AUC, 0.84; 95% CI, 0.80–0.88; p < 0.001). Using one particular threshold, the model classified 13.0% of admissions as high risk, among which probability of mortality was almost ten-fold greater than admissions triaged as low-risk (PLR, 5.75; 95% CI, 4.57–7.23 and NLR, 0.47; 95% CI, 0.37–0.59). Decision curve analyses indicated that the model would be superior to all existing severity scores and could provide utility across the range of clinically plausible decision thresholds.

CONCLUSIONS:

Existing pediatric severity scores have limited potential as risk stratification tools in resource-constrained PICUs. If validated, our prediction model would be a readily implementable mechanism to support triage of critically ill children at admission to PICU and could provide value across a variety of contexts where resource prioritization is important.
Methods Used to Control the Reproductive Choices of Women Who Are Sex Trafficked: Considerations for Health Care Providers
Authors: Limbaugh Lindsey , Gordon Mollie R. , Nguyen Phuong Thanh , Porter Mayrose , Coverdale John
Published: November 2023

Reproductive control or reproductive coercion has negative health consequences but has not been systematically studied within the context of sex trafficking. Our goal is to identify the range of methods used by sex traffickers and buyers to control the reproductive choices of trafficked women and to provide specific examples of these methods. We searched PubMed, Embase, and PsycInfo using the terms “reproductive control” or “reproductive coercion” and “human trafficking” or “sex trafficking,” including papers that contained original, specific examples of reproductive control occurring within the context of sex trafficking. These reports were described and categorized into established domains of reproductive control. Eight articles were located that met our inclusion criteria, of which 6 described outcomes of birth control sabotage, 2 described pressuring into pregnancy, 5 described controlling the outcome of a pregnancy, and 2 described forced birth control or sterilization. Our findings have implications for how to take sexual histories and for identifying and assisting trafficked persons.
Personalized Medicine in the Treatment of a Patient With Obsessive-Compulsive Disorder With Clomipramine
Authors: Preskorn Sheldon H. , Rode Ryan
Published: November 2023

Clomipramine (CIMI) is an effective treatment for obsessive-compulsive disorder in patients who have failed to respond to trials of selective serotonin transport inhibitors (eg, sertraline). The case presented here illustrates how knowledge of the pharmacodynamics and pharmacokinetics of CIMI in a specific patient can be used to personalize treatment to optimize the likelihood of efficacy (ie, maximum benefit to risk ratio). The approach described in this column considered: (1) the patient’s diminished ability to clear CIMI and its major metabolite, desmethlyclomipramine due to a genetic deficiency in cytochrome P450 2D6 enzyme activity, and (2) the patient’s ability to extensively convert CIMI to desmethlyclomipramine. That conversion impairs the ability to inhibit the serotonin transporter, the mechanism that is most likely responsible for the efficacy of CIMI in obsessive-compulsive disorder.
Epidemiological Profile of Victim Patients of Facial Canine and Human Bites in a Public Hospital
Authors: Rocha João Lucas Farias do Nascimento , Leão Cássio Cesar Arrais , Canedo Lucas Ribeiro , Macedo Luis Felipe Rosa de , Rosa Simone Corrêa , Macedo Jefferson Lessa Soares de
Published: November 2023

Introduction:

Bites are among the most common types of trauma to which humans are exposed. The possibility of disfiguring lesions and the transmission of infectious diseases with high morbidity make this trauma a public health problem.

Method:

This was a retrospective, descriptive study that analyzed the medical records of patients treated at the Emergency Unit of the Plastic Surgery Service of the Asa Norte Regional Hospital from March 2019 to March 2020. The variables analyzed included age, sex, origin, time interval from aggression to hospital care, aggressor agent, wound site, lesion characteristics, and treatment.

Results:

A total of 103 patients with a mean age of 25 years were evaluated. Most patients were male (57.3%), and 73.8% were from the Federal District. The most common type of treatment was direct suturing in 77.7% of cases, followed by local flaps (15.5%) or grafts (4.9%). There were no deaths or infections reported.

Conclusion:

The predominant profile of a facial bite victim is a young male adult living in the Federal District, bitten by a canine and treated with direct sutures. Adequate treatment for animal bites should include prevention of infection, such as rabies and tetanus, as well as primary wound closure for achieving a better prognosis and satisfactory esthetics for the patient.
A novel mouse model of cerebral adrenoleukodystrophy highlights NLRP3 activity in lesion pathogenesis
Authors: Hashemi Ezzat , Srivastava Isha Narain , Aguirre Alejandro , Yoseph Ezra Tilahan , Kaushal Esha , Awani Avni , Ryu Jae Kyu. , Akassoglou Katerina , Talebian Shahrzad , Chu Pauline , Pisani Laura , Musolino Patricia , Steinman Lawrence , Doyle Kristian , Robinson William H , Sharpe Orr , Cayrol Romain , Orchard Paul , Lund Troy , Vogel Hannes , Lenail Max , Han May Htwe , Bonkowsky Joshua Leith , Van Haren Keith P.
Published: November 2023

Objective

We sought to create and characterize a mouse model of the inflammatory, cerebral demyelinating phenotype of X-linked adrenoleukodystrophy (ALD) that would facilitate the study of disease pathogenesis and therapy development. We also sought to cross-validate potential therapeutic targets such as fibrin, oxidative stress, and the NLRP3 inflammasome, in post-mortem human and murine brain tissues.

Background

ALD is caused by mutations in the geneABCD1encoding a peroxisomal transporter. More than half of males with anABCD1mutation develop the cerebral phenotype (cALD). Incomplete penetrance and absence of a genotype-phenotype correlation imply a role for environmental triggers. Mechanistic studies have been limited by the absence of a cALD phenotype in theAbcd1-null mouse.

Methods

We generated a cALD phenotype in 8-week-old, maleAbcd1-null mice by deploying a two-hit method that combines cuprizone (CPZ) and experimental autoimmune encephalomyelitis (EAE) models. We employedin vivoMRI and post-mortem immunohistochemistry to evaluate myelin loss, astrogliosis, blood-brain barrier (BBB) disruption, immune cell infiltration, fibrin deposition, oxidative stress, and Nlrp3 inflammasome activation in mice. We used bead-based immunoassay and immunohistochemistry to evaluate IL-18 in CSF and post-mortem human cALD brain tissue.

Results

MRI studies revealed T2 hyperintensities and post-gadolinium enhancement in the medial corpus callosum of cALD mice, similar to human cALD lesions. Both human and mouse cALD lesions shared common histologic features of myelin phagocytosis, myelin loss, abundant microglial activation, T and B-cell infiltration, and astrogliosis. Compared to wild-type controls,Abcd1-null mice had more severe cerebral inflammation, demyelination, fibrin deposition, oxidative stress, and IL-18 activation. IL-18 immunoreactivity co-localized with macrophages/microglia in the perivascular region of both human and mouse brain tissue.

Interpretation

This novel mouse model of cALD suggests loss ofAbcd1function predisposes to more severe cerebral inflammation, oxidative stress, fibrin deposition, and Nlrp3 pathway activation, which parallels the findings seen in humans with cALD. We expect this model to enable long-sought investigations into cALD mechanisms and accelerate development of candidate therapies for lesion prevention, cessation, and remyelination.

Graphical Abstract
Women with breast implants have a higher rate of cardiac catheterization but a lower rate of percutaneous coronary intervention suggesting breast implant interference leads to higher false positive rates of cardiac stress imaging
Authors: Movahed Mohammad Reza , Irannejad Kyvan , Venard Emma , Keating Luke , Hashemzadeh Mehrnoosh , Hashemzadeh Mehrtash
Published: November 2023

Background

Breast implants cause attenuation during myocardial perfusion imaging (SPECT) and interfere with echocardiographic acoustic windows, which may cause false positive results. We hypothesized that false positive cardiac testing would lead to a lower rate of percutaneous intervention (PCI) in patients with breast implants who underwent cardiac catheterization.

Methods

Using ICD 10 codes for breast implants, cardiac catheterization, and percutaneous coronary interventions, we evaluated any association between these cardiac procedures and older adult women with breast implants.

Results

A total of 1,681,135 women 50 or older underwent cardiac catheterization and 792,760 of them underwent PCI. The total number of patients with breast implants who underwent cardiac catheterization was 1,980 (1.99%). The rate of cardiac catheterization was similar (2.99% vs 3.30%, p= 0.06). However, after multivariate adjustment, women with breast implants had a significantly higher rate of cardiac catheterization (OR: 1.12, CI: 1.00-1.25, P=0.05). Furthermore, women after undergoing cardiac catheterization had a lower unadjusted and adjusted rate of PCI (36.93% vs 47.08%, <0.001, unadjusted OR: 0.66, CI: 0.54-0.80, adjusted OR:0.79, CI: 0.64-0.97, p=0.02). Sensitivity analyses using different age cutoffs showed a similar pattern of findings.

Conclusions

Women with breast implants who underwent cardiac catheterization had significantly lower adjusted rates for PCI consistent with our hypothesis that breast implants may lead to higher false positive rates during cardiac ischemia testing. Therefore, women who consider breast implants should be informed about interference with cardiac diagnostic procedures.