bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpretable machine learning model for early prediction of acute kidney injury in patients with rhabdomyolysis
Authors: Zhang Ximu , Liang Xiuting , Fu Zhangning , Zhou Yibo , Fang Yao , Liu Xiaoli , Yuan Qian , Liu Rui , Hong Quan , Liu Chao
Published: August 2024

Background

Rhabdomyolysis (RM) is a complex set of clinical syndromes. RM-induced acute kidney injury (AKI) is a common illness in war and military operations. This study aimed to develop an interpretable and generalizable model for early AKI prediction in patients with RM.

Methods

Retrospective analyses were performed on 2 electronic medical record databases: the eICU Collaborative Research Database and the Medical Information Mart for Intensive Care III database. Data were extracted from the first 24 hours after patient admission. Data from the two datasets were merged for further analysis. The extreme gradient boosting (XGBoost) model with the Shapley additive explanation method (SHAP) was used to conduct early and interpretable predictions of AKI.

Results

The analysis included 938 eligible patients with RM. The XGBoost model exhibited superior performance (area under the receiver operating characteristic curve [AUC] = 0.767) compared to the other models (logistic regression, AUC = 0.711; support vector machine, AUC = 0.693; random forest, AUC = 0.728; and naive Bayesian, AUC = 0.700).

Conclusion

Although the XGBoost model performance could be improved from an absolute perspective, it provides better predictive performance than other models for estimating the AKI in patients with RM based on patient characteristics in the first 24 hours after admission to an intensive care unit. Furthermore, including SHAP to elucidate AKI-related factors enables individualized patient treatment, potentially leading to improved prognoses for patients with RM.
Erectile Dysfunction Risk Among Patients With Diabetes Mellitus Using Sodium–Glucose Cotransporter 2 Inhibitors
Authors: Hu Wei-Syun , Lin Cheng-Li
Published: August 2024

The aim of this study was to explore the incidence of new-onset erectile dysfunction (ED) in diabetes mellitus (DM) patients with sodium–glucose cotransporter 2 inhibitors (SGLT2I) use compared with a control group of non-SGLT2I use by propensity score matching approach. Cox proportional hazards regression models were used to examine the effect of SGLT2I and risk factors on the risk of developing ED, presented as a hazard ratio with a 95% confidence interval. One lakhs fifty nine thousand seven hundred seventy three patients with DM using SGLT2I and 159,773 propensity score matching patients with DM who had never used SGLT2I were included. SGLT2I users had a higher risk of ED than the non-SGLT2I users (adjusted hazard ratio = 1.55, 95% confidence interval = 1.40–1.72). The likelihood of developing ED was higher in patients with SGLT2I use was found.
COMPARATIVE STUDY BETWEEN THE EFFECTIVENESS OF AMNION-CollaGee [COLLAGEN–GELATIN–ELASTIN] AS A BIOLOGICAL PRODUCT WOUND DRESSING AND CONVENTIONAL DRESSING ON THE DONOR SITE OF THE SPLIT THICKNESS SKIN GRAFT IN ANIMALS MODEL (RATS)
Authors: Alasadi Haider Ayad Ashour , Krishnan Illayaraja , Kamisan Ixora , Chin Tan Geok , Lokanathan Yogeswaran , Busra Mohd Fauzi Mh , Imran Farrah Hani , Latar Nani Harlina Md
Published: August 2024

Background

The clinical application of amniotic membrane wound healing products is limited partially due to handling challenges. Amnion-CollaGee sponge dressing (ACS) provides better alternatives to traditional therapy in facilitating wound healing.

Objective

To optimize the effectiveness of ACS as a healing agent in donor-site split-thickness skin graft (STSG) based on in vitro outcomes. Followed by comparing wound healing rates, pain sensitivity, and risks of infection between investigator ACS dressing with currently conventional Duoderm dressing (DD) via in vivo analysis.

Materials and methods

Seven male Sprague-Dawley rats underwent STSG harvesting, with 1x1cm grafts taken from both the right and left sides of the animals' backs. The wounds on the right side (Group 1) were dressed with ACS, while the wounds on the left side (Group 2) were dressed with DD. The donor site wounds were assessed on the seventh, fourteenth, and twenty-first days of the experiment. Primary outcomes measured were rate of healing, pain sensitivity, potential risks of infection. Secondary outcomes were lesion vascularity, pigmentation and histopathological features.

Results

The size of the wounds treated with ACS was statistically smaller compared to that treated with DD. On day 21st, both types of dressings showed complete healing, thus, contributing to better aesthetic value. Additionally, superior pain suppression was witnessed at ACS-treated graft sites compared to DD. Histopathological reports displayed better post-traumatic wound site inflammatory control, less tissue scarring, and abundant collagen growth in the ACS wing compared to the DD counterpart.

Conclusion

The biological ACS dressing appeared to facilitate rapid wound healing rates, reduce the risk of exposed wound infections, and enhance pain suppression in rodent models.

ACS based dressing agents are future interventional breakthroughs in graft donor site wound management.
The Impact of Cardiopulmonary Rehabilitation on Ventriculoarterial Coupling in Post-Coronavirus Disease-2019 Patients
Authors: Gounaridi Maria-Ioanna , Souvaliotis Nektarios , Vontetsianos Angelos , Chynkiamis Nikolaos , Lampsas Stamatios , Theofilis Panagiotis , Anastasiou Artemis , Goliopoulou Athina , Tzima Ioanna , Katsarou Ourania , Bakakos Petros , Vavouranakis Manolis , Koulouris Nikolaos , Siasos Gerasimos , Oikonomou Evangelos
Published: August 2024

Purpose:

Coronavirus disease-2019 (COVID-19) affects the cardiovascular system even after the acute phase of the disease. Cardiopulmonary rehabilitation may improve post-COVID-19 symptoms. This study aims to evaluate the impact of a cardiopulmonary rehabilitation program after acute COVID-19 on arterial stiffness, left ventricular function, and ventriculoarterial coupling (VAC).

Methods:

Forty-eight adults were examined 1 (T0) and 3-mo (T1) following recovery from COVID-19 and randomized 1:1 to participate or not in a 3-mo rehabilitation program. Matched subjects were enrolled as a non-COVID-19 group. Arterial stiffness was evaluated by carotid-femoral pulse wave velocity (PWV). Left ventricular (LV) systolic performance was evaluated with global longitudinal strain (GLS). The PWV/LV-GLS ratio was calculated as an index of VAC. High-sensitivity C reactive protein (hs-CRP) was measured.

Results:

At T0, convalescent patients with COVID-19 had impaired PWV (P = .001) and reduced VAC (P = .001) compared to non-COVID-19 subjects. PWV (8.15 ± 1.37 to 6.55 ± 0.98 m/sec, P < .001) and LV-GLS (−19.67 ± 1.98 to −21.3 ± 1.93%, P < .001) improved only in convalescent patients with COVID-19 undergoing rehabilitation. Similarly, VAC was only improved in the rehabilitation group (−0.42 ± 0.11 to −0.31 ± 0.06 m · sec−1 ·%−1, P < .001). A significant improvement in VO2max was noted after rehabilitation (15.70 [13.05, 21.45] to 18.30 [13.95, 23.75] ml · kg−1 · min−1, P = .01). Finally, hs-CRP was improved in both groups with a significantly greater improvement in the rehabilitation group.

Conclusion:

A 3-mo rehabilitation program in convalesced patients with COVID-19 enhances the recovery of arterial stiffness, left ventricular function, and VAC, highlighting the beneficial mechanisms of rehabilitation in this patient population.
Effect of Inspiratory Muscle Training on Outcomes After Cardiac Surgery
Authors: Fang Linqi , Cheng Anqi , Zhu Zhaohua , Shao Mengming , Wang Guoai
Published: August 2024

Purpose:

Inspiratory muscle training (IMT) has emerged as a potential intervention to improve respiratory outcomes for patients undergoing cardiac surgery. However, the extent of the IMT effects on preoperative and postoperative respiratory metrics remains uncertain. Hence, we designed this study to determine the effects of IMT on various outcomes of patients undergoing cardiac surgery.

Methods:

We conducted a comprehensive meta-analysis of studies evaluating the impact of preoperative and postoperative IMT on various respiratory variables and postsurgical outcomes. We synthesized data from multiple studies, encompassing diverse patient populations and IMT protocols. The key outcomes included the maximal inspiratory pressure (MIP), forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and others.

Results:

Our meta-analysis results showed that preoperative IMT significantly improved the MIP values with a pooled standard mean difference (SMD) of 0.62. The hospital stay length was also reduced with a SMD of − 0.4. Other variables such as FEV1 and FVC also improved significantly. Postoperative IMT improved the MIP and peak flow rate values, but the evidence was less robust than with preoperative interventions. We observed high heterogeneity across studies for several outcomes and found evidence of publication bias for some postoperative measures.

Conclusion:

Both preoperative and postoperative IMT offer benefits for patients undergoing operations, especially by enhancing respiratory muscle strength and potentially reducing hospital stays. However, the presence of heterogeneity and publication bias underscores the need for further standardized research to consolidate these findings and standardize IMT protocols for optimal patient outcomes.
CHARACTERISTICS OF “NOTCH” IN RETINOPATHY OF PREMATURITY AFTER INTRAVITREAL RANIBIZUMAB MONOTHERAPY
Authors: Zhang Fengjun , Zou Qiong , Liu Qiuping , You Zhipeng
Published: August 2024

Purpose:

To explore the clinical features and significance of “notch” in reactivation of retinopathy of prematurity (ROP) post–intravitreal ranibizumab (IVR) monotherapy.

Methods:

Ninety-six infants (173 eyes) with Type 1 or aggressive ROP (A-ROP) post-IVR monotherapy were retrospectively analyzed; 51 eyes were notch (+) and 122 eyes were notch (−). General demographics and clinical outcomes were compared by notch status for Type 1 and A-ROP.

Results:

The notch primarily appeared in Stage 2 ROP (84.4% and 78.9%) at the junction of Zones I and II (68.8% and 63.2%) on the temporal side in Type 1 ROP and A-ROP. Notch was present in the Type 1 ROP group before first IVR but posttreatment in the A-ROP group. A significantly higher reactivation rate, longer follow-up duration, and postmenstrual age at the last follow-up were seen in the notch (+) versus the notch (−) group. In the notch (+) ROP group, the mean gestational age (28.34 ± 0.93 vs. 29.94 ± 1.48 weeks) was significantly lower in reactivated versus regressed eyes.

Conclusion:

Notches appeared at different times but similar locations in Type 1 ROP and A-ROP. The reactivation rate after IVR was increased in ROP with notches. Notch may be a useful biomarker for reactivation after IVR in ROP.
Disentangling the spinal mechanisms of illusory heat and burning sensations in the thermal grill illusion
Authors: Mitchell Alexandra G. , Ehmsen Jesper Fischer , Christensen Daniel Elmstrøm , Stuckert Anna Villaume , Haggard Patrick , Fardo Francesca
Published: August 2024

The thermal grill illusion (TGI), a phenomenon in which the juxtaposition of innocuous warm and cold temperatures on the skin elicits a burning sensation, offers a unique perspective to how pain occurs in response to harmless stimuli. We investigated the role of the spinal cord in the generation of the TGI across 2 experiments (total n = 80). We applied heat and cold stimuli to dermatomes, areas of skin innervated by a single spinal nerve, that mapped onto adjacent or nonadjacent spinal segments. Enhanced warm and burning ratings during the TGI were observed when cold and warm stimuli were confined within the same dermatome. Furthermore, we found the spatial organisation of warm and cold stimuli within and across dermatomes affected TGI perception. Perceived warmth and burning intensity increased when the cold stimulus projected to the segment more caudal to the warm stimulus, whereas perceived cold during the TGI decreased compared with the opposite spatial arrangement. This suggests that the perception of TGI is enhanced when cold afferents are projected to spinal segments positioned caudally in relation to those receiving warm afferents. Our results indicate distinct interaction of sensory pathways based on the segmental arrangement of afferent fibres and are consistent with current interpretations of the spread and integration of thermosensory information along the spinal cord.
High-Dose Propranolol for Severe and Chronic Aggression in Autism Spectrum Disorder
Authors: London Eric B. , Zimmerman-Bier Barbie L. , Yoo J. Helen , Gaffney Joseph W.
Published: August 2024

Background

Despite the use of behavioral interventions and psychotropic medications, many individuals with autism spectrum disorder (ASD) who engage in severe aggression remain refractory to conventional treatment. Propranolol, a beta-blocker, has accumulated much anecdotal evidence as a promising option. However, well-designed studies are rare, and the apprehension about cardiovascular side effects from large doses continues to exist.

Purpose

The aims of this study were (1) to demonstrate the feasibility of treating aggression with high-dose propranolol using telehealth study visits and (2) to document cardiac safety.

Methods

This study utilized a randomized, double-blind, placebo-controlled, crossover design. Dosing was titrated up in a flexible but stepwise fashion until therapeutic response was obtained or up to 200 mg tid. Following washout, those who were assigned propranolol were crossed over to placebo and vice versa. Six participants between the ages 12–19 participated. The primary outcome measures were the final Clinical Global Impression Improvement Scale (CGI-I) and the Aberrant Behavior Checklist—Community Irritability (ABC-C/I) scores at 200 mg tid.

Results

The CGI-I indicated a 50% reduction in symptoms in the propranolol phase, while the ABC-I indicated a 37% reduction in comparison to placebo. The effect sizes (r) for the CGI-I and the ABC-C/I were large, −0.74 and −0.64, respectively. The average blood pressure was 122/68 during the placebo phase and 109/72 during the propranolol phase. All Holter monitor exams were unremarkable.

Conclusion

These results suggest that propranolol is an effective option in decreasing aggression in individuals with ASD. As this was a small study, a larger clinical trial is needed.
Development and validation of a virtual teaching method for minimally invasive surgery skills: a prospective cohort study
Authors: Das Bibek , Ledesma Frances , Naik Ravi , Law Sarah , Soleimani-Nouri Payam , Khan Omar A , Mylonas George , Pai Madhava , Ashrafian Hutan , Spalding Duncan , Fehervari Matyas
Published: August 2024

Introduction:

The COVID-19 pandemic led to a significant reduction in operative exposure for surgical trainees, necessitating alternative training methods to mitigate the impact on surgical education. This study sought to evaluate whether minimally invasive surgery (MIS) skills could be taught remotely using widely available technology with objective assessments of proficiency.

Methods:

This was a pilot observational study with a comparative assessment of face-to-face (F2F) and virtual training of novice learners in MIS skills. Performance and objective cognitive workload parameters [Surgical Task Load Index (SURG-TLX) score, heart rate, and pupil metrics] were evaluated. The assessments were peg transfer [McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS)] and suturing [Suturing Training and Testing (SUTT)] tasks performed using box trainers. Virtual teaching was conducted by expert trainers using a web-based streaming platform.

Results:

Technical challenges of delivering a virtual MIS skills course were addressed after a pilot course. Participants (n=20) in the final course had similar baseline characteristics and were randomly allocated to F2F (n=8) and virtual (n=12) teaching groups. Participants in the online group completed the peg transfer task faster than the F2F group (11.25 min vs. 16.88 min; P=0.015). There were no significant differences in all other MISTELS and SUTT performance measures between groups. Cognitive workload parameters (SURG-TLX score, heart rate, and pupil metrics) were also similar between groups.

Conclusion:

This study has demonstrated that virtual teaching of MIS skills using a web-based streaming platform is feasible and effective, providing the foundation for low-cost, effective, and scalable MIS skills programs in the future.
An update of the diagnosis, treatment, and prevention of leprosy: A narrative review
Authors: Huang Chien-Yuan , Su Shih-Bin , Chen Kow-Tong
Published: August 2024

Leprosy is an infectious disease that remains a public health concern. It is caused by acid-fast Bacillus leprae, which primarily affects the skin and peripheral nerves, potentially leading to long-term disability and stigma. However, current and previous efforts have focused on developing better diagnostic and therapeutic interventions for leprosy, and its prevention needs to be addressed. In this review, we organize the currently published papers and provide updates on the global epidemiology, diagnosis, treatment, and prevention of leprosy. Several online databases, including MEDLINE (National Library of Medicine, Bethesda, MD), PubMed, EMBASE, Web of Science, and Google Scholar, were searched to collect relevant published papers. As a public health issue, the World Health Organization set the goal of leprosy elimination with a prevalence of <1 case per 10,000 people, which was achieved in 2000 and in most countries by 2010, mainly owing to the treatment of leprosy using drugs starting in 1980 and no-cost access for patients since 1995. Although diagnostic and therapeutic techniques have improved, the new occurrence of leprosy remains a critical global disease burden. With continuous technological improvements in diagnosing and treating leprosy, obtaining more relevant healthcare knowledge and preventing leprosy disability are crucial.
Surgical removal of the largest transgastric migrated gossypiboma: A case report
Authors: Haji Mohamad Aya , Al-Jawad Mohammad , Anadani Abdulrazak , Matar Hilal , Niazi Ammar
Published: August 2024

Rationale:

Gossypiboma is a term that refers to the condition of accidentally retained surgical gauze after surgeries. While many manifestations and complications are possible in this case, the migration of the retained gauze into the gastric cavity is one of the rarest. In this paper, we report the largest migrated surgical towel to the gastric cavity in the literature, measuring 90 cm × 90 cm.

Patient concerns:

A 33-year-old woman with recurrent epigastric pain unresponsive to treatment was referred to our hospital. She had undergone an open surgery cholecystectomy 11 years before admission during wartime in Syria.

Diagnoses:

Abdominal computed tomography with contrast showed a large mass in the stomach, indicating malignancy. However, upper gastrointestinal endoscopy revealed a gray–black foreign body occupying the entire gastric lumen, which indicated the presence of bezoar. Upon surgery, the final diagnosis of gastric gossypiboma was made; which was a retained surgical towel from the previous cholecystectomy that had fully migrated to the stomach and resembled both malignancy and bezoar upon investigation.

Interventions:

The patient underwent open surgery to excise the foreign body.

Outcomes:

The gossypiboma was successfully removed, and the patient was discharged 5 days after the operation without complications.

Lessons:

Retained surgical items, such as gossypiboma, can lead to significant medical complications. The migration of gossypiboma to the stomach, though rare, poses challenges in diagnosis and management, often requiring open surgical removal to prevent adverse outcomes. Early detection and intervention are crucial to avoiding associated morbidity and mortality. It is important to consider gossypiboma in patients with unexplained abdominal pain following surgery and to emphasize meticulous sponge counting to prevent this complication.
Effects of integrative therapy with Du Meridian moxibustion, ear acupuncture, and alprazolam on cardiac function and neurotransmitter levels in patients with coronary heart disease and insomnia: An observational study
Authors: Huang Xiaoxia , Li Rui , Zhang Shuai , Liu Kang , Shen Lirong , Shi Ying , Hu Zongde
Published: August 2024

To explore the effects of Du Meridian moxibustion combined with ear acupuncture on clinical symptoms and serum neurotransmitters in patients with coronary heart disease and insomnia. This study is a retrospective study. From June 2021 to May 2023, 116 patients with coronary heart disease and insomnia treated at our hospital were selected as subjects. They were divided into 2 groups according to the treatment. The control group received treatment with alprazolam, while the experimental group received Du Meridian moxibustion combined with ear acupuncture in addition to alprazolam treatment. The efficacy of the 2 groups was compared, and the levels of cardiac function indicators, serum melatonin, leptin, and neurotransmitters were measured. The total effectiveness rate in the experimental group was 93.10% (with a cure rate of 36.21%, a significant improvement rate of 41.38%, and an effective rate of 15.52%), which was significantly higher than the 79.31% in the control group (with a cure rate of 24.14%, a significant improvement rate of 32.76%, and an effective rate of 22.41%) (P < .05). Both groups exhibited an increase in left ventricular ejection fraction, stroke volume, and cardiac output after treatment compared to before treatment. Additionally, left ventricular end-systolic diameter decreased after treatment compared to before treatment, but the cardiac function was compared between the 2 groups after treatment (P > .05). In both groups, serum melatonin and serotonin (5-HT) levels increased after treatment compared to before treatment, while serum leptin, dopamine, and glutamate levels decreased after treatment compared to before treatment. Furthermore, the experimental group had higher serum melatonin, 5-HT, and gamma-aminobutyric acid levels compared to the control group, and lower serum leptin, dopamine, and glutamate levels compared to the control group (P < .05). The serum traditional Chinese medicine syndrome score and Pittsburgh sleep quality index score of the 2 groups decreased after treatment, and the experimental group was lower than the conventional group (P < .05). The combination of Du Meridian acupuncture with ear acupuncture in the treatment of insomnia in coronary heart disease can regulate the expression of serum melatonin, leptin, and neurotransmitters, alleviate symptoms, and improve therapeutic efficacy.
The risk factors for burnout among nurses: An investigation study
Authors: Wang Kunyu , Wang Xia , Han Ying , Ye Chunfen , Pan Lifen , Zhu Changcai
Published: August 2024

The objective of this investigation study is to examine the levels of burnout and work engagement among nurses working on the front lines of the COVID-19 pandemic. Additionally, we aim to analyze the risk factors associated with nurse burnout. This investigation study included a sample of 1764 registered nurses from 6 tertiary comprehensive hospitals in Wuhan. A total of 1800 questionnaires were distributed via email between January 2021 and July 2021, and 1764 completed questionnaires were returned. Nurses who had been on the front lines of the COVID-19 fight for more than six months were included in the study. The Maslach Burnout Inventory-General Survey (MBI-GS) scale was utilized to assess burnout levels among all nurses. Work engagement was measured using the Utrecht Work Engagement Scale (UWES). The general health of the nurses was evaluated using the General Health Questionnaire-12 (GHQ-12) score. Demographic and clinical data, including age, sex, hospital, department, education, years of experience, daily overtime, weekly rest time, number of night shifts per month, smoking or drinking habits, marital status, etc, were also collected. Statistical analyses were performed using SPSS 25.0. The GHQ-12 scores in the FC group were significantly higher than those in the non-frontline COVID-19 (NFC) group. Compared to the average value of the 2 groups, we found that the dimension 2 average value of UWES in NFC group (3.52 ± 1.07) were remarkably higher than that in FC group (3.40 ± 1.08, P < .05). Furthermore, the dimension 1 (emotional exhaustion) average value and dimension 2 (depersonalization) average value of MBI-GS in NFC group were remarkably declined than that in FC group. Spearman rank correlation showed that negative correlation among the average value of each dimension and the overall average values between MBI-GS and UWES. Logistic regression analysis showed that daily Overtime, fight against COVID-19, GHQ-12 score and dimension 2 of UWES were the risk factors for nurse burnout. In summary, this study showed that the dimension 1 (emotional exhaustion) average value and dimension 2 (depersonalization) average value of MBI-GS in NFC group were remarkably declined than that in FC group. This study may provide some basis for addressing nurse burnout.
Effect of health education combined with biofeedback electrical stimulation on early pelvic floor function and psychology: A retrospective study
Authors: Yuan Feng , Hu Ying , Yang Chunrong
Published: August 2024

To investigate the effects of health education combined with biofeedback electrical stimulation on maternal postpartum pelvic floor function and psychology. The clinical data of 80 patients with postpartum pelvic floor dysfunction (PFD) from May 2020 to May 2022 were selected as retrospective study subjects, and 40 cases were divided into the comparison group and the observation group according to the different intervention methods. Among them, the comparison group implemented biofeedback electrical stimulation and guidance, and the observation group implemented Greene health education and Kegel pelvic floor rehabilitation training intervention based on the comparison group. The differences in pelvic floor muscle strength, sexual quality of life, anxiety, and depression in the 2 groups with postpartum PFD were compared. Comparison of pelvic floor muscle strength: before the intervention (P > .05) and after the intervention, the anterior resting mean electromyography (EMG), slow muscle mean EMG, fast muscle maximum EMG, and mixed muscle mean EMG values of patients in the observation group were higher than those in the comparison group, and the posterior resting mean EMG values were lower than those in the comparison group (P < .05). There was no statistically significant difference in the Hospital Anxiety and Depression Scale (HADS) scores and anxiety and depression subscale scores between the 2 groups of patients before intervention (P > .05). After the intervention, the HADS scores and anxiety and depression subscale scores were lower than those before the intervention in both groups, and the differences were statistically significant in the intervention group than in the comparison group (P < .05). There was no statistically significant difference between The Chinese Female Sexual Life Quality Questionnaire scores of both groups before the intervention (P > .05). Sexual desire, vaginal lubrication, sexual arousal, sexual satisfaction, orgasm, and painful intercourse improved in both groups after the intervention, and the scores in the intervention group were higher than those in the comparison group (P < .05). Health education combined with biofeedback electrical stimulation can effectively improve the quality of patients’ sexual life, improve the pelvic floor muscle strength of patients with postpartum PFD, enhance patients’ confidence, reduce patients’ anxiety and depression, and effectively improve patients’ psychological status.
Video quality of nonalcoholic fatty liver disease on TikTok: A cross-sectional study
Authors: Cheng Di , Ren Kuiwu , Gao Xiang , Li Kangkang , Wu Panpan , Yang Rui , Cui Tao , Song Kun , Yu Jiangtao
Published: August 2024

The short-video application TikTok shows great potential for disseminating health information. We assessed the content, sources, and quality of information in videos related to nonalcoholic fatty liver disease (NAFLD) on TikTok. Our study aims to identify upload sources, content, and characteristic information for NAFLD videos on TikTok and further evaluate factors related to video quality. We investigated the top 100 videos related to NAFLD on TikTok and analyzed the upload sources, content, and characteristics of these videos. Evaluate video quality using the DISCERN tool and Global Quality Score (GQS). In addition, the correlation between video quality and video characteristics is further studied. In terms of video sources, the majority of NAFLD videos on TikTok (85/100, 85%) were posted by doctors, ensuring the professionalism of the content, and among the video content, disease knowledge was the most dominant video content, accounting for 57% (57/100) of all videos, and the average DISCERN and GQS scores of all 100 videos were 39.59 (SD 3.31) and 2.99 (SD 0.95), respectively. DISCERN and GQS data show that videos related to NAFLD do not have high-quality scores on TikTok, mainly fair (68/100, 68%) and moderate (49/100, 49%). In general, the quality of NAFLD video information from professional content and professional sources was higher than that of nonprofessional sources and nonprofessional content, the video quality of general surgeons was better than that of other department physicians, and the video quality of junior physicians was better than that of senior physicians. In terms of video correlation, durations, the number of fans, and the total number of works were negatively correlated with DISCERN scores (R < 0, P < .05), while likes, comments, collections, shares, and days since upload were not significantly correlated with DISCERN and GQS scores (P > .05). The medical information on TikTok is not rigorous enough to guide patients to make accurate judgments, platforms should monitor and guide publishers to help promote and disseminate quality content.
Neutrophil and neutrophil extracellular trap involvement in neutrophilic asthma: A review
Authors: Li Yuemu , Yang Tianyi , Jiang Baihua
Published: August 2024

Asthma is a highly prevalent chronic inflammatory disease characterized by variable airflow obstruction and airway hyperresponsiveness. Neutrophilic asthma (NA) is classified as “type 2 low” asthma, defined as 65% or more neutrophils in the total cell count. There is no clear consensus on the pathogenesis of NA, and the accumulation of neutrophils and release of neutrophil extracellular traps (NETs) may be responsible for its development. A NET is a large extracellular meshwork comprising cell membrane and granule proteins. It is a powerful antimicrobial defence system that traps, neutralizes, and kills bacteria, fungi, viruses, and parasites and prevents the spread of microorganisms. However, dysregulation of NETs may lead to chronic airway inflammation, is associated with worsening of asthma, and has been the subject of major research advances in chronic lung diseases in recent years. NA is insensitive to steroids, and there is a need to find effective biomarkers as targets for the treatment of NA to replace steroids. This review analyses the mechanisms of action between asthmatic neutrophil recruitment and NET formation and their impact on NA development. It also discusses their possible therapeutic significance in NA, summarizing the advances made in NA agents and providing strategies for the treatment of NA, provide a theoretical basis for the development of new therapeutic drugs, thereby improving the level of diagnosis and treatment, and promoting the research progress in the field of asthma.
From thinning to disappearance: A case report on the healing pattern of multiple and giant plantar warts
Authors: Yu Tao , Yuan Cheng-da
Published: August 2024

Rationale:

Plantar warts, caused by human papillomavirus (HPV) infection, are a common skin condition on the plantar surface. Despite the availability of various treatments, achieving satisfactory outcomes remains elusive. This study explores a novel therapeutic approach combining traditional Chinese medicine (TCM) soaking therapy with cryotherapy to address this challenge.

Patients concerns:

This study focuses on 3 patients who presented with multiple and giant plantar warts, each with a disease duration exceeding 2 years. These patients had undergone numerous unsuccessful cryotherapy treatments, leaving them with persistent and troublesome warts.

Diagnoses:

All 3 patients were diagnosed with multiple and giant plantar warts caused by HPV infection.

Interventions:

Following unsuccessful cryotherapies, the patients were administered TCM soaking therapy as an adjunct treatment.

Outcomes:

Remarkably, all 3 patients achieved complete remission of their plantar warts within 2 to 4 months after combining cryotherapy with TCM soaking therapy.

Lessons:

Our findings suggest that relying solely on cryotherapy is insufficient for effectively treating plantar warts. The key to successful treatment lies in inhibiting wart proliferation and continuously thinning them, which can be achieved through soaking in TCM. This study demonstrates the potential of combining cryotherapy with TCM soaking as a novel and effective therapeutic approach for treating multiple and giant plantar warts.
Effect of cognitive behavior-aided counseling on entrepreneurial self-efficacy of students of home economics education in South-East Nigeria
Authors: Nwakpadolu Glory Mmachukwu , Ede Moses Onyemaechi , Nwadi Calister Lebechukwu , Ede Kelechi Ruth , Okoro Joy Oluchukwu , Onyishi Uchechukwu Charles , Omeke Faith , Oneli Joy Obiageli
Published: August 2024

Background:

Raising potential entrepreneurs to advance the economy of nations through education has been projected by scholars. On the contrary, Nigerian students lack the enthusiasm and internal force to pursue the aims enshrined in their courses of study. Rather they prefer white-cola jobs to the entrepreneurial intention of the institutions. Given this reason, we tested the effect of cognitive behavior-aided counseling on entrepreneurial self-efficacy of students of Home Economics in South-East Nigeria.

Methods:

This is a pretest and posttest with a follow-up group randomized control design. A total of 119 Home Economics Education students from Universities and Colleges of Education were measured and screened using an entrepreneurial self-efficacy scale and inclusion criteria. Data collected from the pretest, post-test, and follow-up test were statistically analyzed using repeated measures of Analysis of Variance statistical method. The effect size of the cognitive behavior-aided counseling intervention on entrepreneurial self-efficacy was reported using partial eta square. The follow-up data was tested using a Univariate analysis.

Results:

The result showed that cognitive behavior-aided counseling intervention had a significant effect on entrepreneurial self-efficacy among the Universities and Colleges of Education in South-East Nigeria. A follow-up result also showed that intervention had a significant effect on participants’ entrepreneurial self-efficacy.
Application of objective optical quality analysis system in guiding early posterior capsule opacification laser treatment: An observational study
Authors: Zhang Hui , Wu Qin , Xu Dongyan , Wang Jing
Published: August 2024

In the present study, we aimed to demonstrate the objective guiding role of objective scatter index (OSI) in patients with early stage posterior capsule opacification (PCO), especially in patients with multifocal intraocular lens (IOL) implantation. A prospective randomized case analysis was conducted on elderly patients experiencing PCO, exhibiting best-corrected visual acuity (BCVA) below 0.2 LogMAR. Exclusion criteria comprised patients with diabetes, glaucoma, high myopia, trauma, endothelial dystrophy, maculopathy or prior eye surgery affecting visual acuity. The main observational indicators were patient gender, age, post-cataract surgery duration, BCVA (LogMAR), and OSI values. For patients undergoing laser posterior capsulotomy, meticulous documentation of pre-laser OSI values and post-laser OSI values was undertaken. Subjective visual quality was then compared using the Chinese version visual function index-14 (VF-14-CN). The study comprised 65 eyes from 56 patients. PCO developed, on average, 2.06 ± 0.94 years (ranging from 0.5 to 4 years) after the initial surgery, with the OSI consistently exceeding 3.0. Among these cases, only 40 eyes underwent laser posterior capsulotomy using Nd:YAG laser, including 26 eyes implanted with monofocal IOLs and 14 eyes implanted with multifocal IOLs. Following laser posterior capsulotomy for early-stage secondary cataracts, there was a significant decrease in OSI values compared to the presurgery state, coupled with a notable increase in VF-14-CN scores. Among the 14 cases with multifocal IOL implantation, pre-laser VF-14-CN scores were lower compared to those with monofocal IOLs. Post-laser posterior capsulotomy, patients reported a marked improvement in self-perceived symptoms. The OQAS functioned as an objective assessment metric for the laser treatment of early stage PCO. In cases involving multifocal IOL implantation, the visual disturbance caused by PCO was more pronounced, underscoring the significance of OSI as a valuable guide for laser treatment in these patients.
Nonocclusive mesenteric ischemia after percutaneous kyphoplasty: A case report
Authors: Wang Pengrui , Song Meina , Zhu Xinxin , Ren Weihong , Li Haixiao , Cao Sanli , Sun Shuhua , Pan Wei , Shi Shaohui
Published: August 2024

Rationale:

Percutaneous kyphoplasty (PKP) is a minimally invasive technique employed for treating vertebral compression fractures. Although PKP is simple and relatively safe, severe complications are possible. Here, we report a new, severe complication linked to this procedure, namely nonocclusive mesenteric ischemia (NOMI).

Patient concerns:

An 83-year-old female patient, previously in good health, fell backward, landing on her buttocks, and subsequently experienced persistent low-back pain that exacerbated during turning or sitting up.

Diagnoses:

Lumbar spine radiography revealed wedge deformity of the L1 vertebral body. Lumbar spine magnetic resonance imaging indicated a fresh compression fracture of the L1 vertebral body.

Interventions:

On the 2nd day following the trauma, the patient underwent PKP under local anesthesia. Anesthesia was satisfactory, and the procedure progressed smoothly.

Outcomes:

The patient experienced mild discomfort in the right abdomen within the 1st hour to 3 days postoperatively, mild abdominal distension on the 4th day, and sudden severe abdominal pain on the 5th day. Immediate abdominal computed tomography revealed ischemic changes in the ascending colon and hepatic flexure, accompanied by hepatic portal venous gas. An hour later, abdominal pain spontaneously subsided. Approximately 5 hours later, an enhanced abdominal computed tomography revealed no filling defects in the mesenteric vasculature, absence of luminal narrowing or occlusion, enhanced intestinal walls, and a notable improvement in hepatic portal venous gas. Considering NOMI and ischemia related to superior mesenteric artery spasm, vasodilator therapy (papaverine hydrochloride) was initiated, leading to favorable outcomes. On day 17, pathological examination of the hepatic flexure revealed moderate, acute, and chronic mucosal inflammation, along with interstitial fibrous tissue proliferation, providing clear evidence supporting ischemic changes. She was discharged on day 18 after a successful recovery.

Lessons:

The occurrence of NOMI after PKP is uncommon. Yet, once it happens, delayed diagnosis or misdiagnosis can lead to serious consequences such as intestinal necrosis and abdominal infection, even endangering the patient’s life. We currently lack experience in preventing this complication, but timely diagnosis and appropriate intervention are effective measures in treating such complications.
Thyroid dysfunction and risk of different types of dementia: A systematic review and meta-analysis
Authors: Ye Jianbo , Huang Zhenxing , Liang Chunfeng , Yun Zhang , Huang Lili , Liu Yuping , Luo Zuojie
Published: August 2024

Background:

The impact of thyroid function on the risk of various types of dementia, including Alzheimer’s disease (AD) and vascular dementia (VD), remains unclear. This meta-analysis investigates the association between thyroid dysfunction and the risk of these dementia types, aiming to inform strategies for dementia prevention.

Methods:

A comprehensive search was conducted in PubMed, Embase, and the Cochrane Library for studies published up to February 2023, focusing on the risk of thyroid dysfunction in dementia. We excluded duplicates, studies without full text, those with incomplete data, animal studies, case reports, and reviews. Data analysis was performed using STATA 15.1 software.

Results:

Our analysis indicated that overt hyperthyroidism significantly increases the risk of all studied dementia types (OR = 1.18, 95% CI: 1.04–1.35). In contrast, overt hypothyroidism was associated with a decreased risk of AD (OR = 0.73, 95% CI: 0.55–0.98) and VD (OR = 0.71, 95% CI: 0.62–0.82). Subclinical hyperthyroidism also showed a significant association with an increased risk of any dementia (OR = 1.26, 95% CI: 1.09–1.46) and specifically VD (OR = 6.70; 95% CI: 1.38–32.58).

Conclusion:

This study suggests that overt hypothyroidism may reduce the risk of dementia, including AD and VD, whereas overt and subclinical hyperthyroidism are linked to an increased risk. These findings highlight the importance of monitoring thyroid function as a preventative measure against dementia.
Evaluating diabetic foot care knowledge and practices at education level
Authors: Alrashed Fahad Abdulaziz , Iqbal Muhammad , Al-Regaiey Khalid A. , Ansari Asrar Ahmad , Alderaa Asma A. , Alhammad Saad A. , Alsubiheen Abdulrahman M. , Ahmad Tauseef
Published: August 2024

Diabetic foot is one of the complications in type 2 diabetes mellitus. Adequate knowledge and practice are an important aspect to control further deteriorating conditions such as ulcers and amputations. Thus, the objective of this cross-sectional study was to investigate the impact of the education levels of diabetic patients on diabetic foot care knowledge and practice. This cross-sectional study with a convenient sampling technique was conducted on 534 patients with diabetes mellitus from public and private care hospitals. The data was collected using a validated, pretested and structured bilingual (Arabic, English) questionnaire. There were 534 patients interviewed, 39.1% of whom were males and 60.9% of whom were females and 61.4% of the patients had had T2DM for over 10 years. There was a significant difference in education levels between the male and female patients (53.8% and 46.2%, P = .001). Furthermore, 83.9% patients were married. The difference in education between the married and the single, divorced, and widowed patients was significant (P = .007). Patients with uncontrolled HbA1c were 2.43 times more likely to have hypertension (RR = 2.43, P = .03), while patients with highly uncontrolled diabetes had 3.1 times more chances of hypertension (RR = 3.1, P = .009). Heart disease prevalence was 3.27 times higher in diabetes patients with uncontrolled HbA1c and 3.37 times higher in patients with highly uncontrolled HbA1c. Patients with diabetes who have been diabetic for more than 10 years have a greater risk of heart disease (RR = 2.1; P = .03). Patients with lower education levels exhibited more diabetic complications compared to patients with higher education levels (P < .05). The present study highlights the importance of education and awareness campaigns targeting diabetic patients, especially those with lower education levels, to improve diabetes control and prevent, or manage, comorbidities. Healthcare providers should also prioritize patient education and medication adherence to improve diabetes management and reduce the risk of complications.
Tremendous and infrequently adenoid cystic carcinoma of the breast without any metastasis for more than 20 years: A case report
Authors: Liu Ye , Zhu Lichao , Guo Lei , Yang Haiyuan , Wang Shuqing , Sun Guoxin , Li Jiang , Liu Kuan , Wang Changyou , Huang Shengli , Zhao Yating
Published: August 2024

Rationale:

Breast adenoid cystic carcinoma is an extremely rare tumor that is incompletely understood, accounting for less than <0.1% of all breast cancers, with an average diameter of 3 cm, and it is extremely rare to see a large, non-metastatic breast adenoid cystic carcinoma with a diameter of about 30 cm. Since this disease is extremely rare, there are few reports in the literature and limited data on clinical diagnosis and treatment. We present a case of a 71-year-old woman with a large, non-metastatic adenoid cystic carcinoma of the left breast and share our opinion on the diagnosis and treatment of this case.

Patient concerns:

A 71-year-old woman with a 20-year-old left breast mass with local bleeding and rupture for 1 hour presented to our hospital for further diagnosis and treatment. A computed tomography scan showed a large soft tissue mass shadow in the left breast and malignancy was considered. Subsequently, tissue aspiration pathology was performed and the results confirmed adenoid cystic carcinoma of the breast.

Diagnosis:

Intraoperative pathology results of radical mastectomy for left breast cancer diagnosed adenoid cystic carcinoma of the breast and immunohistochemistry results of triple-negative breast cancer.

Interventions and Outcomes:

Treatment of adenoid cystic carcinoma of the breast included neoadjuvant chemotherapy for breast cancer, radical mastectomy of the left breast, and postoperative chemotherapy. Initially, neoadjuvant chemotherapy for breast cancer was performed, and the TAC regimen was used to successfully reduce the size of the tumor and gain access to surgical treatment for breast cancer. The patient has recovered well after the surgery, with no wound infection or ulceration, and is now waiting for the patient’s physical function to recover for postoperative chemotherapy, with no obvious discomfort.

Lessons:

Adenoid cystic carcinoma tumors are usually around 3 cm; such a huge 30 cm adenoid cystic carcinoma of the breast is extremely rare, and it is extremely rare to find a breast malignancy that has not developed regional lymph node and distant metastases for more than 20 years. Clinicians must remain vigilant for early breast malignancies at a high age of incidence and conduct further research for diagnosis to avoid delays.