bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical efficacy and mechanism of the combination of autologous platelet-rich gel and recombinant human acidic fibroblast growth factor in the management of refractory diabetic foot
Authors: Sheng Xia , Hu Ling , Li Ting , Zou Yi , Fu Hai-Yan , Xiong Guo-Ping , Zhu Yan , Deng Bo , Xiong Lei-Lei , Yin Xiao-Ling
Published: October 2024

Objective

This study aims to explore the influence of combining autologous platelet-rich gel (APG) with continuous vacuum-sealed drainage (CVSD) and the exogenous recombinant human acidic fibroblast growth factor (rh-aFGF) on the healing processes of diabetic foot ulcers (DFU). The primary objective is to elucidate the complex molecular mechanisms associated with DFU, providing innovative perspectives for its treatment.

Methods

Ninety patients diagnosed with DFU were randomly allocated into three distinct groups. Group A underwent CVSD following wound cleansing to facilitate healing. In Group B, in addition to conventional treatment, negative pressure wound therapy was applied, and rh-aFGF was introduced into normal saline for lavage, building upon the procedures of Group A. Group C received APG along with the interventions applied in Group B. The clinical efficacy of each group was systematically observed and analyzed. Additionally, changes in plasma oxidative stress, inflammatory markers, vascular endothelial growth factor (VEGF), and pigment epithelium-derived factor (PEDF) were assessed both before treatment and 14 days post-treatment.

Results

Following treatment, all groups exhibited commendable clinical efficacy. Group C demonstrated a superior wound healing rate, reduced frequency of dressing changes, and shorter wound healing duration (P< 0.05). Compared to baseline measurements, the levels of superoxide dismutase and PEDF increased, while malondialdehyde, VEGF, interleukin-6, interleukin-8, and monocyte chemotactic factor MCP-1 decreased in the wound tissue across all groups. Notably, Group C showed the most significant improvement in clinical efficacy and fortification of molecular mechanisms against oxidative stress (all P< 0.05).

Conclusions

The integrative therapeutic approach combining APG with CVSD and rh-aFGF demonstrates notable efficacy in advancing wound healing. This effectiveness is evident through the reduced frequency of dressing changes and alleviation of wound-related pain. Additionally, the treatment regimen improves the cure rate for challenging, refractory wounds. These favorable outcomes can be attributed to the reduction of oxidative stress levels, attenuation of the local inflammatory response, and the enhancement of the balance between PEDF and VEGF.
A guideline on biomarkers in the diagnosis and evaluation in axial spondyloarthritis
Authors: Liu Dong , Xie Ya , Tu Liudan , Wen Xianghui , Lv Qing , Liu Budian , Yang Mingcan , Wu Xinyu , Zheng Xuqi , Luo Xiqing , Zhou Liuzhong , Wu Jialing , Liu Bin , Wang Kun , Jin Ou , Wang Xiaohong , Qin Jie , Wu Lijun , Zhao Dongbao , He Dongyi , He Shanzhi , Huang Wenhui , Ye Shanhui , Zhou Huiqiong , Wu Jinyu , Wang Yongfu , Liu Shengyun , Li Zhenbin , Tan Zhiming , Xu Chiduo , Wang Youlian , Zheng Donghui , Zhan Feng , Lin Changsong , Wen Ya , Wu Jiayun , Wen Shenghui , Liao Zetao , Shen Yan , Yang Kehu , Gu Jieruo
Published: October 2024

Objective

To develop a guideline for selecting biomarkers in the diagnosis and assessment in patients with axial spondyloarthritis (axSpA).

Method

A joint effort was carried out by the core team, the literature review team and the multidisciplinary voting panel to formulate recommendations regarding biomarkers in axSpA, using an evidence-based and consensus-based strategy. Certainty of evidence and strength of recommendation were determined, and levels of agreement within the voting panel were calculated.

Results

A total of 20 recommendations were formulated in this guideline, with levels of agreement ranging from 6.48 to 9.71. The two strong recommendations, HLA-B27 testing in patients suspected of axSpA and regular-interval monitoring of CRP/ESR represent the status quo of axSpA evaluation, while the 13 conditional recommendations represent the promising biomarkers with clinical utility in diagnosis, disease activity assessment, prediction of radiographic progression and therapeutic responses. This guideline does not dictate clinical choices of tests on axSpA, and decisions should be made based on comprehensive consideration of costs, accessibility, patients’ values and willingness as well as the objective of testing in the local context.

Conclusion

This guideline addresses the interpretation of the clinical significance of biomarkers in axSpA, and the biomarkers endorsed in this guideline composed a clinical toolkit for healthcare professionals to choose from.
Integrated multi-level omics profiling of disulfidptosis identifis SPAG4 as an innovative immunotherapeutic target in glioblastoma
Authors: Chen Shenbo , Zeng Man , Chen Taixue , Ding Hui , Lin JiaHan , Ye Fuyue , Wu Ran , Yang Liangwang , Yang Kun
Published: October 2024

Objective

To investigate the association between disulfidptosis-related genes (DFRGs) and patient prognosis, while concurrently identifying potential therapeutic targets in glioblastoma (GBM).

Methods

We retrieved RNA sequencing data and clinical characteristics of GBM patients from the TCGA database. We found there was a total of 6 distinct clusters in GBM, which was identified by the t-SNE and UMAP dimension reduction analysis. Prognostically significant genes in GBM were identified using the limma package, coupled with univariate Cox regression analysis. Machine learning algorithms were then applied to identify central genes. The CIBERSORT algorithm was utilized to assess the immunological landscape across different GBM subtypes. In vitro and in vivo experiments were conducted to investigate the role of SPAG4 in regulating the proliferation, invasion of GBM, and its effects within the immune microenvironment.

Results

23 genes, termed DFRGs, were successfully identified, demonstrating substantial potential for establishing a prognostic model for GBM. Single cell analysis revealed a significant correlation between DFRGs and the progression of GBM. Utilizing individual risk scores derived from this model enabled the stratification of patients into two distinct risk groups, revealing significant variations in immune infiltration patterns and responses to immunotherapy. Utilizing the random survival forests algorithm, SPAG4 was identified as the gene with the highest prognostic significance within our model. In vitro studies have elucidated SPAG4’s significant role in GBM pathogenesis, potentially through the regulation of fatty acid metabolism pathways. Our in vivo investigations using a subcutaneous xenograft model have confirmed SPAG4’s influence on tumor growth and its capacity to modulate the immune microenvironment. Advanced research hints that SPAG4 might achieve immune evasion by increasing CD47 expression, consequently reducing phagocytosis.

Conclusions

These findings highlight SPAG4 as a potential GBM therapeutic target and emphasize the complexity of the immune microenvironment in GBM progression.
LncRNAs in tumor metabolic reprogramming and tumor microenvironment remodeling
Authors: Jiao Jianhang , Zhao Yangzhi , Li Qimei , Jin Shunzi , Liu Zhongshan
Published: October 2024

The tumor microenvironment (TME) is a complex and dynamic ecosystem composed of tumor cells, immune cells, supporting cells, and the extracellular matrix. Typically, the TME is characterized by an immunosuppressive state. To meet the demands of rapid proliferation, cancer cells undergo metabolic reprogramming, which enhances their biosynthesis and bioenergy supply. Immune cells require similar nutrients for activation and proliferation, leading to competition and immunosuppression within the TME. Additionally, tumor metabolites inhibit immune cell activation and function. Consequently, an immunosuppressed and immune-tolerant TME promotes cancer cell proliferation and metastasis. Long non-coding RNAs (lncRNAs), a category of non-coding RNA longer than 200 nucleotides, regulate tumor metabolic reprogramming by interacting with key enzymes, transporters, and related signaling pathways involved in tumor metabolism. Furthermore, lncRNAs can interact with both cellular and non-cellular components in the TME, thereby facilitating tumor growth, metastasis, drug resistance, and inducing immunosuppression. Recent studies have demonstrated that lncRNAs play a crucial role in reshaping the TME by regulating tumor metabolic reprogramming. In this discussion, we explore the potential mechanisms through which lncRNAs regulate tumor metabolic reprogramming to remodel the TME. Additionally, we examine the prospects of lncRNAs as targets for anti-tumor therapy and as biomarkers for tumor prognosis.
Oncolytic viruses: a potential breakthrough immunotherapy for multiple myeloma patients
Authors: Raimondi Vincenzo , Vescovini Rosanna , Dessena Mattia , Donofrio Gaetano , Storti Paola , Giuliani Nicola
Published: October 2024

Oncolytic virotherapy represents an innovative and promising approach for the treatment of cancer, including multiple myeloma (MM), a currently incurable plasma cell (PC) neoplasm. Despite the advances that new therapies, particularly immunotherapy, have been made, relapses still occur in MM patients, highlighting the medical need for new treatment options. Oncolytic viruses (OVs) preferentially infect and destroy cancer cells, exerting a direct and/or indirect cytopathic effect, combined with a modulation of the tumor microenvironment leading to an activation of the immune system. Both naturally occurring and genetically modified viruses have demonstrated significant preclinical effects against MM cells. Currently, the OVs genetically modified measles virus strains, reovirus, and vesicular stomatitis virus are employed in clinical trials for MM. Nevertheless, significant challenges remain, including the efficiency of the virus delivery to the tumor, overcoming antiviral immune responses, and the specificity of the virus for MM cells. Different strategies are being explored to optimize OV therapy, including combining it with standard treatments and targeted therapies to enhance efficacy. This review will provide a comprehensive analysis of the mechanism of action of the different OVs, and preclinical and clinical evidence, focusing on the role of oncolytic virotherapy as a new possible immunotherapeutic approach also in combination with the current therapeutic armamentarium and underlying the future directions in the context of MM treatments.
Research on comprehensive assessment of coastal erosion intensity based on multi index method
Authors: Fu Guowei , He Mingguang , Chen Xiaofeng , Fu Miao , Song Yanwei , Wei Chenglong , Wang Hongbing , Zhang Daheng
Published: October 2024

The intensity of coastal erosion is a measure of the strength of erosion processes affecting coastal areas. Traditionally, assessments of coastal erosion intensity have relied on singular indices, such as the rate of shoreline retreat or erosion, often prioritizing higher rates over lower ones. This approach, however, lacks comprehensive consideration and scientific rigor. In this study, we adopt a more holistic approach by examining the Qionghai-Wanning coast on the eastern side of Hainan Island. We selected four indices that reflect local conditions and influence coastal erosion strength: Annual rate of shoreline change (T1), Beach annual down-cutting rate (T2), Beach slope (T3), Average particle size of the beach (T4). These indices were used to comprehensively evaluate the erosion intensity of the Qionghai-Wanning coast. The evaluation results categorized the study area into six grades: serious erosion (3.45%), strong erosion (6.90%), erosion (20.69%), micro erosion (44.38%), stabilization (20.69%), and accretion (3.45%). The findings indicate that, under the broader environmental trends of global warming and rising sea levels, most sandy coasts exhibit micro-erosion intensity. Areas experiencing strong and serious erosion are predominantly influenced by human activities, such as those occurring in promenade bays, artificial islands, and harbors. To further understand the relationship between these factors and erosion intensity, we employed the Spearman correlation coefficient method. The analysis revealed that the T1 and the T2 are the primary factors influencing coastal erosion intensity, with the T4 serving as a secondary factor. These factors collectively impact the force and energy absorption of the coast through wave and tidal actions, ultimately determining the intensity of coastal erosion. The multi-index assessment method for coastal erosion intensity demonstrated an accuracy of 82.75%, providing a scientific basis for the management, protection, and restoration of coastal areas.
Efficacy of integrated traditional Chinese and western medicine in managing mild-moderate acute pancreatitis: a real-world clinical perspective analysis
Authors: Jia Sailei , Chen Qian , Liu Xitong , Li Yanhong , Wang Lihui , Li Xian , Hu Shixiang
Published: October 2024

Background

Given the prevalent utilization of integrated traditional Chinese and western medicine (ITCWM) in the management of acute pancreatitis, the majority of studies have concentrated on severe cases, lacking robust evidence-based medical research. Real-world investigations can provide an objective assessment of the clinical effectiveness of combining traditional Chinese medicine with western medicine. Consequently, relying on real-world research, we intend to evaluate the clinical efficacy and safety of the combined approach in treating mild to moderate acute pancreatitis.

Methods

A total of 563 AP patients from Henan Provincial Hospital of Traditional Chinese Medicine were collected from January 2019 to October 2023. A propensity score matching (PSM) analysis was conducted to evaluate the clinical efficacy of traditional Chinese medicine (TCM) in treating mild to moderate acute pancreatitis. Patients were divided into a control group (61 cases) and an integrated traditional Chinese and Western medicine (ITCWM) group (120 cases). To further assess the clinical efficacy of TCM enema in the treatment of mild to moderate acute pancreatitis, PSM analysis was conducted across three groups. The patients were categorized into a control group (n = 49), an oral TCM treatment group (OCM group, n = 274), and an oral TCM plus enema treatment group (OCM+E group, n = 131). Logistic regression was used to analyze factors after treatment in each group, and the Kaplan-Meier method compared symptom duration in each group.

Results

Compared with the control group, the ITCWM group significantly decreased C-reactive protein (CRP, mg/L) (17.8 [1.2–59.5] vs. 8.0 [3.3–33.5], P = 0.022), shortened the duration of abdominal distension, abdominal pain, nausea and bitter taste symptoms (P < 0.05), and shortened the length of hospital stay (median 19.0 and 11.5 days, respectively, P = 0.001); Compared with the other two groups, the neutrophil percentage (NEUT%) was lower (74.1 vs. 61.9 vs. 59.5, P < 0.05) and serum prealbumin (PA, mg/L) was higher (116.0 vs. 184.4 vs. 220.0, P < 0.05), the length of hospitalization (days) was shortened (19.0 vs.12.0 vs.10.0, P < 0.05) in the OCM+E group.

Conclusion

The combination of traditional Chinese medicine and modern medicine has been shown to effectively decrease inflammatory indicators in patients with mild to moderate acute pancreatitis, leading to a reduction in symptom duration and hospitalization period, as well as promoting disease recovery. Notably, the use of traditional Chinese medicine in conjunction with enema therapy yields more pronounced benefits.
Comparation of abdominal aortic balloon occlusion versus uterine artery embolization in the treatment of cesarean scar pregnancy
Authors: Rui Tan , Wei He , Huaibo Jing , Han Mou , Cheung Kenneth C. P. , Yang Chai
Published: October 2024

Study objective

This study is to uncover the advantages of abdominal aortic balloon occlusion in the uterine curettage treatment for patients with cesarean scar pregnancy (CSP).

Methods

To retrospectively analyze the clinical data of eighty patients with CSP after treatment in our hospital from 01/10/2019 to 01/05/2021. The 80 patients were divided into 2 groups: 41 patients were treated with abdominal aortic balloon occlusion and the control group (n = 39) underwent Uterine artery embolization (UAE). The amount of bleeding during the operation, the operation time of the uterine curettage, the X-ray fluoroscopy time under DSA, the surface dose in radiation, the length of hospital stay (LOS), and the postoperative complications were compared between these 2 groups (type II and type III).

Results

All the operations successfully retained the uterus. No balloon-related complications occurred in the experimental group. And in the control group, there were 14 cases of fever and 19 cases of pain after UAE. The fluoroscopy time of experimental group and control group were: (type II: (20.3 ± 7.1)s vs. (593.7 ± 284.5)s, p < 0.01), (type III: (21.2 ± 7.2)s vs. (509.8 ± 164.2)s, p < 0.01), the surface dose in radiation: (type II: (1.9 ± 0.7)mGy vs. (248.3 ± 85.9)mGy, p < 0.01), (type III: (2.1 ± 0.8)mGy vs.(252.0 ± 74.9)mGy, p < 0.01), the amount of bleeding during the operation: (type II:30.0(20.0, 50.0)ml vs. 20.0(10.0, 50.0)ml, p = 0.113), (type III:50.0 (17.5,162.5)ml vs. 50.0 (22.5, 72.5)ml, p = 0.623), the operation time of the uterine curettage:(type II: (54.8 ± 19.4)min vs.(43.9 ± 21.9)min, p = 0.071), (type III: (65.2 ± 50.4)min vs.(52.8 ± 20.1)min, p = 0.426), LOS: (type II:(5.4 ± 1.7)d vs.(5.4 ± 1.2)d, p = 0.816), (type III:(5.8 ± 2.4)d vs. (7.0 ± 1.7)d, p = 0.161). The follow-up was more than 3 months. No adverse reaction in the experimental group and 6 patients in the control group presented menstrual volume decrease.

Conclusion

No balloon-related complications occurred in the abdominal aortic balloon occlusion and lower radiation exposure for both the operator and patient. And both abdominal aortic balloon occlusion and UAE can effectively reduce the bleeding during uterine curettage in patients with type II and III CSP.
A randomized control trial evaluating the advice of a physiological-model/digital twin-based decision support system on mechanical ventilation in patients with acute respiratory distress syndrome
Authors: Patel Brijesh V. , Mumby Sharon , Johnson Nicholas , Handslip Rhodri , Patel Sunil , Lee Teresa , Andersen Martin S. , Falaschetti Emanuela , Adcock Ian M. , McAuley Danny F. , Takata Masao , Staudinger Thomas , Karbing Dan S. , Jabaudon Matthieu , Schellongowski Peter , Rees Stephen E. ,   On behalf of the DeVENT Study Group
Published: October 2024

Background

Acute respiratory distress syndrome (ARDS) is highly heterogeneous, both in its clinical presentation and in the patient’s physiological responses to changes in mechanical ventilator settings, such as PEEP. This study investigates the clinical efficacy of a physiological model-based ventilatory decision support system (DSS) to personalize ventilator therapy in ARDS patients.

Methods

This international, multicenter, randomized, open-label study enrolled patients with ARDS during the COVID-19 pandemic. Patients were randomized to either receive active advice from the DSS (intervention) or standard care without DSS advice (control). The primary outcome was to detect a reduction in average driving pressure between groups. Secondary outcomes included several clinically relevant measures of respiratory physiology, ventilator-free days, time from control mode to support mode, number of changes in ventilator settings per day, percentage of time in control and support mode ventilation, ventilation- and device-related adverse events, and the number of times the advice was followed.

Results

A total of 95 patients were randomized in this study. The DSS showed no significant effect on average driving pressure between groups. However, patients in the intervention arm had a statistically improved oxygenation index when in support mode ventilation (−1.41, 95% CI: −2.76, −0.08; p = 0.0370). Additionally, the ventilatory ratio significantly improved in the intervention arm for patients in control mode ventilation (−0.63, 95% CI: −1.08, −0.17, p = 0.0068). The application of the DSS led to a significantly increased number of ventilator changes for pressure settings and respiratory frequency.

Conclusion

The use of a physiological model-based decision support system for providing advice on mechanical ventilation in patients with COVID-19 and non-COVID-19 ARDS showed no significant difference in driving pressure as a primary outcome measure. However, the application of approximately 60% of the DSS advice led to improvements in the patient’s physiological state.

Clinical trial registration

clinicaltrials.gov, NCT04115709.
Gut heavy metal and antibiotic resistome of humans living in the high Arctic
Authors: Hauptmann Aviaja Lyberth , Johansen Joachim , Stæger Frederik Filip , Nielsen Dennis Sandris , Mulvad Gert , Hanghøj Kristian , Rasmussen Simon , Hansen Torben , Albrechtsen Anders
Published: October 2024

Contaminants, such as heavy metals (HMs), accumulate in the Arctic environment and the food web. The diet of the Indigenous Peoples of North Greenland includes locally sourced foods that are central to their nutritional, cultural, and societal health but these foods also contain high concentrations of heavy metals. While bacteria play an essential role in the metabolism of xenobiotics, there are limited studies on the impact of heavy metals on the human gut microbiome, and it is so far unknown if and how Arctic environmental contaminants impact the gut microbes of humans living in and off the Arctic environment. Using a multiomics approach including amplicon, metagenome, and metatranscriptome sequencing, we identified and assembled a near-complete (NC) genome of a mercury-resistant bacterial strain from the human gut microbiome, which expressed genes known to reduce mercury toxicity. At the overall ecological level studied through α- and β-diversity, there was no significant effect of heavy metals on the gut microbiota. Through the assembly of a high number of NC metagenome-assembled genomes (MAGs) of human gut microbes, we observed an almost complete overlap between heavy metal-resistant strains and antibiotic-resistant strains in which resistance genes were all located on the same genetic elements.
Efficacy of non-invasive brain stimulation for post-stroke sleep disorders: a systematic review and meta-analysis
Authors: Huang Linyu , Zhang Xingling , Zhang Jie , Li Long , Zhou Xianyu , Yang Tingyu , An Xuemei
Published: October 2024

Objective

This study aimed to systematically assess the clinical efficacy of non-invasive brain stimulation (NIBS) for treating post-stroke sleep disorders (PSSD).

Methods

We conducted thorough literature search across multiple databases, including PubMed, Web of Science, EmBase, Cochrane Library, Scopus, China Biology Medicine (CBM); China National Knowledge Infrastructure (CNKI); Technology Periodical Database (VIP), and Wanfang Database, focusing on RCTs examining NIBS for PSSD. Meta-analyses were performed using RevMan 5.4 and Stata 14.

Results

Eighteen articles were reviewed, including 16 on repetitive Transcranial Magnetic Stimulation (rTMS), one on Theta Burst Stimulation (TBS), and two on transcranial Direct Current Stimulation (tDCS). Meta-analysis results indicated that rTMS within NIBS significantly improved the Pittsburgh Sleep Quality Index (PSQI) score (MD = −1.85, 95% CI [−2.99, −0.71], p < 0.05), the 17-item Hamilton Depression Rating Scale (HAMD-17) score [MD = −2.85, 95% CI (−3.40, −2.30), p < 0.05], and serum brain-derived neurotrophic factor (BDNF) levels [MD = 4.19, 95% CI (2.70, 5.69), p < 0.05], while reducing the incidence of adverse reactions [RR = 0.36, 95% CI (0.23, 0.55), p < 0.05]. TBS significantly improved the PSQI score in patients with PSSD (p < 0.05). Conversely, tDCS significantly improved the HAMD-17 score in PSSD patients [MD = −1.52, 95% CI (−3.41, −0.64), p < 0.05]. Additionally, rTMS improved sleep parameters, including Stage 2 sleep (S2%) and combined Stage 3 and 4 sleep (S3 + S4%) (p < 0.05), while tDCS improved total sleep time (TST) and sleep efficiency (SE) (p < 0.05).Subgroup analysis results indicated: (1) Both LF-rTMS and HF-rTMS improved PSQI scores (p < 0.05). (2) Both rTMS combined with medication and rTMS alone improved PSQI scores (p < 0.05). Compared to the sham/blank group, the rTMS group showed improvements in SE, sleep latency (SL), S1%, S3 + S4%, and REM sleep (REM%). The rTMS combined with medication group showed improved SL compared to the medication-only group (p < 0.05).

Conclusion

NIBS effectively improves sleep quality, structure, depression levels, and BDNF levels in PSSD patients, while also being safe. Further investigations into the potential of NIBS in PSSD treatment may provide valuable insights for clinical applications.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, CRD42023485317.
Admission albumin-globulin ratio associated with delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage
Authors: Guo Xiumei , Xiong Yu , Gao Wen , Huang Xinyue , Zheng Hanlin , Wu Huiqiang , Jiang Xutang , Lin Qingxin , Xiao Yinfeng , Liu Qiaoling , Pan Zhigang , Chen Chunhui , Hu Weipeng , Stavrinou Pantelis , Liu Aihua , Wang Lingxing , Zheng Feng
Published: October 2024

Background

Despite the widespread use in ischemic stroke, cancer, and malnutrition, the predictive ability of serum albumin to globulin ratio (A/G) among patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) remains unknown. This study aimed to determine if serum A/G ratio is associated with the occurrence of delayed cerebral ischemia (DCI) after aSAH.

Methods

We retrospectively viewed the medical records of aSAH patients from 08/2017 to 08/2022. Serum albumin and globulin laboratory test results were collected within 24 hours after admission. Serum A/G were dichotomized based on whether the DCI occurred. Logistic regression was used to determine the predictors of DCI. The relationship between serum A/G and the occurrence of DCI was analyzed with receiver operating characteristic(ROC) curve.

Results

A total of 363 eligible patients with aSAH were included in the study, among which DCI occurred in 87 patients(23.97%). Serum A/G[OR=2.720, 95%CI (1.190-6.270), P=0.018], non-surgical[OR=0.228, 95%CI (0.065-0.621), P=0.008], lactate dehydrogenase[OR=1.004, 95%CI (1.000-1.008), P=0.029], P[OR=0.354, 95%CI (0.130-0.926), P=0.038], plasma fibrinogen[OR=1.266, 95%CI (1.019-1.583), P=0.035] were associated with the occurrence of DCI. ROC showed that serum A/G, non-surgical, LDH, P, plasma fibrinogen could predict the occurrence of DCI in aSAH patients with values 0.575, 0.560, 0.602, 0.571 and 0.539 for serum A/G, non-surgical, LDH, P, plasma fibrinogen, respectively.

Conclusions

In conclusion, serum A/G levels are correlated with DCI in individuals with aSAH, and high serum A/G levels on admission may be associated with the occurrence of DCI.
Akkermansia muciniphila is associated with normal muscle mass and Eggerthella is related with sarcopenia in cirrhosis
Authors: Efremova Irina , Alieva Aliya , Maslennikov Roman , Poluektova Elena , Zharkova Maria , Kudryavtseva Anna , Krasnov George , Zharikov Yury , Nerestyuk Yaroslav , Karchevskaya Anna , Ivashkin Vladimir
Published: October 2024

Background

Sarcopenia and gut dysbiosis are common in cirrhosis. The aim is to study the correlations between the gut microbiota taxa and muscle mass level in cirrhosis.

Methods

The study included 40 cirrhosis patients including 18 patients with sarcopenia. The gut microbiota composition was assessed using amplicon sequencing of the hypervariable V3-V4 regions of the 16S rRNA gene. The skeletal muscle mass, subcutaneous and visceral fat levels were assessed with abdominal computed tomography as skeletal muscle, subcutaneous and visceral fat indices (SMI, SFI and VFI).

Results

Patients with sarcopenia had more relative abundance (RA) of Agathobacter, Anaerostipes, Butyricicoccus, Dorea, Eggerthella, Microbacteriaceae, Veillonella and less RA of Akkermansiaceae, Akkermansia muciniphila, Verrucomicrobiae and Bilophila compared to patients with normal muscle mass. SMI directly correlated with RA of Akkermansia, Alistipes indistinctus, Anaerotruncus, Atopobiaceae, Bacteroides clarus, Bacteroides salyersiae, Barnesiellaceae, Bilophila wadsworthia, Pseudomonadota, Olsenella, and Parabacteroides distasonis, and negatively correlated with RA of Anaerostipes and Eggerthella. Sarcopenia was detected in 20.0% patients whose gut microbiota had Akkermansia but not Eggerthella, and in all the patients, whose gut microbiota had Eggerthella but not Akkermansia. The Akkermansia and Eggerthella abundances were independent determinants of SMI. RA of Akkermansia, Akkermansia muciniphila, Akkermansiaceae, Bacteroides salyersiae, Barnesiella, Bilophila, Desulfobacterota, Verrucomicrobiota and other taxa correlated positively and RA of Anaerovoracaceae, Elusimicrobiaceae, Elusimicrobium, Kiritimatiellae, Spirochaetota, and other taxa correlated negatively with the SFI. RA of Alistripes, Romboutsia, Succinivibrio, and Succinivibrionaceae correlated positively and RA of Bacteroides thetaiotaomicron correlated negatively with VFI.

Conclusion

The muscle mass level in cirrhosis correlates with the abundance of several gut microbiota taxa, of which Akkermansia and Eggerthella seems to be the most important.
Effect of malnutrition at admission on length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia: prospective cohort study
Authors: Gebregziabher Zewdu , Nane Debritu , Dake Samson Kastro , Handiso Yoseph Halala
Published: October 2024

Background

Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Even though malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical in patients in Ethiopia while nutritional assessment is also often a neglected component of the health service practice.

Objective

This study aims to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022.

Methods

A facility-based prospective cohort study was conducted among 398 admitted surgical adult patients. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 h within 48 h after admission (SGA). Data were collected by open data kit (ODK) version 2022.3.3 software while Stata version 14.1 software was employed for statistical analysis. Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusted for several potential confounders taken at admission. Adjusted hazard ratio (HR) with 95% confidence interval was used to show the effect of malnutrition.

Results

The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59–69%) according to subjective global assessment (SGA) classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11–13) as compared to well-nourished patients (8 days: 95% CI: 8–9), which means adult surgical patients who were malnourished at admission were at a higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29–0.47) as compared to well-nourished patients. The presence of comorbidity (AHR: 0.68, 95% CI: 0.50–90), poly medication (AHR: 0.69, 95% CI: 0.55–0.86), and history of admission (AHR: 0.70, 95% CI: 0.55–0.87) within the previous 5 years were found to be the significant covariates of LOS.

Conclusion

The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, poly medication, and history of admission were found to be the significant covariates of LOS. All stakeholders should pay attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.
Primary scrotal lipoma in a child: a rare case report and review of literature
Authors: Kong Meng , Bai Yuexia , Jia Jinhua , Liu Chuanyang , Zhang Shisong
Published: October 2024

Lipoma is a common benign tumor of the body surface, while scrotal lipoma is relatively rare. We report a case of scrotal lipoma in a 5-year-old boy, which presented as a progressively enlarging scrotal mass. Scrotal ultrasonography highly suggested a lipoma, and a scrotal mass resection was performed, leading to a final pathological diagnosis of benign scrotal lipoma.
Aphthous lesions turned out to be neonatal very early-onset inflammatory bowel disease: a case report
Authors: Hutmacher Felix , Doerig Selina , Grobholz Rainer , Köhler Henrik , Meyer Philipp , Baumann Philipp
Published: October 2024

Neonatal diagnosis of inflammatory bowel disease (IBD) proves challenging due to its non-specific symptoms. A term-born neonate showing states of inflammation and aphthae was treated for sepsis and candidiasis before being diagnosed with interleukin-10 receptor deficiency and consecutive IBD. The patient was finally successfully treated by stem cell transplantation. The case illustrates the difficulties of the diagnostic course in IBD as it may mimic other diseases and emphasizes the importance of considering rare differential diagnoses early in the diagnostic process.
A systematic review of surgical and interventional radiology procedures for pediatric idiopathic intracranial hypertension
Authors: Friso Sofia , Giacobbo Vittoria , Toscano Luca Mattia , Baldo Beatrice , Guariento Chiara , Lacarra Fabrizio , Pin Jacopo Norberto , Ancona Claudio , Sartori Stefano , Causin Francesco , Toldo Irene
Published: October 2024

Background

Idiopathic intracranial hypertension (IIH) is defined as elevated intracranial pressure and consequent symptoms (mainly headache and visual deterioration) occurring in the absence of secondary causes. Surgical and interventional radiology procedures should be considered for refractory IIH and mainly include cerebrospinal fluid (CSF) diversion techniques, optic nerve sheath fenestration (ONSF), and venous sinus stenting (VSS). Our study aims to review the current literature on the application of these techniques in clinical practice.

Methods

A systematic literature review on the surgical and interventional radiology treatment of IIH was conducted, focusing on ONSF, VSS, and CSF diversion techniques. According to PRISMA guidelines, all reports published in PubMed in the last 30 years (1993–2023) were considered, and among 722 papers, 48 were included in the present study, resulting in a total study population of 454 children or adolescents (11 months–17 years old).

Results

Among 454 patients, 193 underwent an invasive approach, divided into CSF diversion (115/193), ONSF (65/193), VSS (11/193), cranial subtemporal decompression (8/193), and internal cranial expansion (9/193). Sixteen of the 193 patients (8%) required reintervention due to relapsing symptoms or surgical complications, particularly those who underwent CSF diversion. Furthermore, 9/115 required shunt revision due to shunt obstruction or malfunction. We extracted data on the outcome of each procedure: of the 193 patients, 71 experienced a positive outcome with symptom resolution or improvement, while 27 demonstrated a negative outcome.

Discussion and conclusions

Severe and refractory cases of IIH are eligible for invasive treatments. CSF diversion is the most frequently used technique, despite its high failure risk and need for reintervention. ONSF has shown good results in terms of outcome and safety, particularly in children with visual symptoms. VSS is the most recent approach, indicated in children with stenosis of the venous sinus. In our study population, VSS demonstrated good results in terms of symptom resolution and need for reintervention, but its use remains limited to a few centers.

Systematic Review Registration

https://www.crd.york.ac.uk/, PROSPERO (CRD42024504244).
Edge advances in nanodrug therapies for osteoarthritis treatment
Authors: Liao Jinfeng , Gu Qingjia , Liu Zheng , Wang Hailian , Yang Xian , Yan Rongkai , Zhang Xiaofeng , Song Siyuan , Wen Lebin , Wang Yi
Published: October 2024

As global population and lifestyles change, osteoarthritis (OA) is becoming a major healthcare challenge world. OA, a chronic condition characterized by inflammatory and degeneration, often present with joint pain and can lead to irreversible disability. While there is currently no cure for OA, it is commonly managed using nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and glucosamine. Although these treatments can alleviate symptoms, it is difficult to effectively deliver and sustain therapeutic agents within joints. The emergence of nanotechnology, particularly in form of smart nanomedicine, has introduced innovative therapeutic approaches for OA treatment. Nanotherapeutic strategies offer promising advantages, including more precise targeting of affected areas, prolonged therapeutic effects, enhanced bioavailability, and reduced systemic toxicity compared to traditional treatments. While nanoparticles show potential as a viable delivery system for OA therapies based on encouraging lab-based and clinical trials results, there remails a considerable gap between current research and clinical application. This review highlights recent advances in nanotherapy for OA and explore future pathways to refine and optimize OA treatments strategies.
Prevalence and influence factor of drug-related problems in inpatients with kidney disease: a prospective single central study
Authors: Gu Guoguang , Li Yanping , Hu Yunyun , Zhao Hengyi , Wang Xingdong , Li Xiaomin , Zhang Xinran , Zhu Hong , Dai Xiaohua , Liu Xingxing , Miao Liyan , Zhu Jianguo , Hang Yongfu
Published: October 2024

Aims

To investigate the prevalence and influencing factors of drug-related problems (DRPs) in inpatients with kidney disease to provide reference data for pharmaceutical care.

Methods

The basic information, diagnoses, and medication reconciliation (MR) of inpatients in the Department of Nephrology at our hospital between October 2020 and September 2021 were collected. The Chinese-modified DRP version based on the PCNE classification (Version 9.1) was used to assess, intervene and statistically analyze the results of the patients’ DRPs. The influence factor of DRPs in inpatients with kidney disease was analyzed by the multivariate binary logistic regression.

Results

Of 623 patients included in this study, 132 (21.80%) had DRPs. The prevalence of anemia was significantly higher in patients with DRPs than those without DRPs (43.18% vs. 28.72%, p < 0.05), the mean number of drug types consumed (7.25 ± 3.44 with DRPs vs. 5.93 ± 3.58 without DRPs, p < 0.05) and the proportion of ≥5 drugs (%) (79.55% with DRPs vs 58.04% without DRPs, p < 0.05) were significantly increased. In addition, the prevalence of hypertension (76.52% vs. 68.64%), diabetes (27.27% vs. 22.20%) and hyperuricemia (16.67% vs. 13.65%) in DRP patients were higher than those without DRPs, but there was no statistical difference (p > 0.05). The logistic regression analysis showed that patients with anemia (OR = 1.702, 95%CI: 1.146–2.529, p = 0.008), average number of medication types taken (OR = 1.089, 95%CI: 1.034–1.147, p = 0.001) significantly increased the risk of DRPs. The distribution of harm levels was as follows: 78 problems (59.09%) were level C, 29 (21.97%) were level B, 10 (7.58%) were level D, 7 (5.30%) were level A, 7 (5.30%) were level E, and 1 (0.76%) were level F. All DRPs were resolved after 128 interventions.

Conclusion

Renal anemia, the average number of drug varieties consumed, and the proportion of ≥5 drugs are associated with the occurrence of DRPs. Pharmacists conducting MR services can reduce DRPs of inpatients in the department of nephrology and ensure patient drug safety.
Performance of a Global Functional Assay Based on Interferon-γ Release to Predict Infectious Complications and Cancer After Kidney Transplantation
Authors: Fernández-Ruiz Mario , Ruiz-Merlo Tamara , Rodríguez-Goncer Isabel , Caso José María , López-Medrano Francisco , Parra Patricia , San Juan Rafael , Polanco Natalia , González Esther , Andrés Amado , Aguado José María , Redondo Natalia
Published: October 2024

The QuantiFERON-Monitor assay (QTF-Monitor) is intended to assess innate and adaptive immune responses by quantifying interferon (IFN)-γ release upon whole blood stimulation with a TLR7/8 agonist and an anti-CD3 antibody. We performed the QTF-Monitor in 126 kidney transplant recipients (KTRs) at different points during the first 6 post-transplant months. The primary outcome was overall infection, whereas secondary outcomes included bacterial infection, opportunistic infection and de novo cancer. The association between IFN-γ production and outcomes was analyzed as “low” immune responses (<15 IU/mL) and as a continuous variable to explore alternative thresholds. There were no significant differences in the occurrence of overall infection according to the QTF-Monitor at any monitoring point. Regarding secondary outcomes, KTRs with a low response at week 2 experienced a higher incidence of bacterial infection (50.8% versus 24.4%; P-value = 0.006). Low response at month 1 was also associated with opportunistic infection (31.6% versus 14.3%; P-value = 0.033). The discriminative capacity of IFN-γ levels was poor (areas under the ROC curve: 0.677 and 0.659, respectively). No differences were observed for the remaining points or post-transplant cancer. In conclusion, the QTF-Monitor may have a role to predict bacterial and opportunistic infection in KTRs when performed early after transplantation.
Urban Cemeteries as Biodiversity Refuges: A Comparative Study of Plant Ecobiomorphs in Central Kazakhstan
Authors: Pozdnyakova Yelena , Murzatayeva Aigul
Published: October 2024

Cemeteries are often overlooked in ecological studies, yet they represent unique urban microhabitats that contribute to the preservation of diverse plant species, including those adapted to various ecological niches. This study aimed to assess the species composition, ecological classifications, and abundance of vascular plants in the cemetery and surrounding areas to explore cemeteries’ role in conserving plant ecobiomorph diversity in arid climates. This study identified 79 plant species from 23 families within the cemetery compared with 31 species from 11 families in the surrounding area. The plant community in the cemetery was dominated by mesophytes, suggesting favorable and stable conditions for plant growth, while xerophytes were more common in the surrounding areas, indicating harsher, drier conditions. The diversity of plant life forms, including perennial herbs, shrubs, and trees, was significantly higher within the cemetery, indicating a more complex and resilient ecosystem. Our study demonstrates that cemeteries act as vital refuges for plant biodiversity. They offer significantly higher species diversity and more complex ecosystem structures compared with the surrounding areas. These findings emphasize the critical role cemeteries play in urban biodiversity conservation, particularly in increasingly arid environments.
On-Farm Production of Renewable Energy in 2014–2022
Authors: Ryś-Jurek Roma
Published: October 2024

The main purpose of this study is to present family farms as consumers and producers of renewable energies which provide them with an opportunity to reduce operating costs. The time scope of the study is 2014–2022, and the Farm Accountancy Data Network is used as the data source. The following research methods were employed: comparative and descriptive analysis, intensity indicators, ranking assignment and panel regression. Based on the values of energy output and energy costs, the rankings revealed a strong position of the Netherlands and Germany. As demonstrated by the study, energy production and consumption volumes depend on the farms’ economic size, but are not impacted by production type. Another finding is that energy production covers only one-third of its costs. Also, both production volumes and costs were on a growth path on a year-over-year basis, with similar growth ratios. The European Union’s leaders in energy consumption and production are the Netherlands, Germany, Belgium, Denmark, Czech Republic, Hungary, Luxembourg, Slovakia and Sweden. The study included the structuring of panel models for energy output and costs and identified their determinants. Energy output depends on total inputs and grows as they grow. Energy costs, in turn, are related to utilized agricultural area, total output and family farm income. An important limitation of this study is that FADN is a provider of high-level data. Hence, it is impossible to tell what specific sources of renewable energy are used by farms, and how they are affected by such exogenous factors as climate, earmarked subsidies or energy policy. The findings from this study are discussed in the context of the European Commission’s recommendations laid down in the Bioeconomy Strategy of the EU (2013), the Seventh Environment Action Program, the New Innovation Agenda of the European Union, the Report “Transforming Our World: the United Nations 2030 Agenda for Sustainable Development” and the Circular Economy Action Plan.
Characterization of Natural Gas Hydrate Constrained by Well and Seismic Data in Qiongdongnan Basin
Authors: Yu Han , Wang Ju , Lei Zhangshu , Kuang Zenggui , Deng Wei , Lu Lei
Published: October 2024

This study investigates the natural gas hydrates within the Qiongdongnan Basin by integrating well-log and seismic data. Through pre-stack inversion and rock physics analysis, key parameters such as P-wave and S-wave impedances were utilized to distinguish hydrate-bearing formations from other geological bodies. A low-frequency model was constructed using the Inverse Distance Weighting (IDW) algorithm to improve the precision of parameter inversion. This study employs a multi-constraint inversion strategy, incorporating hard constraints from multiple wells and soft constraints from geological frameworks, ensuring reliable inversion results. Findings indicate that hydrate reservoirs are characterized by increased wave velocity and density due to hydrate accumulation, providing insights into the spatial distribution and characteristics of hydrates. This research enhances the understanding of hydrate reservoirs and offers valuable data for exploration in the Qiongdongnan Basin.
A Ru-Based Complex for Sustainable One-Pot Tandem Aerobic Oxidation-Knoevenagel Condensation Reactions
Authors: Arafa Wael A. A. , Nayl AbdElAziz A. , Ahmed Ismail M. , Youssef Ayman M. S. , Mourad Asmaa K. , Bräse Stefan
Published: October 2024

Our novel binuclear complex-anchored Ru(III) catalyst, designed and assembled by sonicating 2,2′-(4,6-dihydroxy-1,3-phenylene)bis(1H-benzo[d]imidazole-4-carboxylic acid), Ru(DMSO)4Cl2 and 4-methylpyridine, demonstrates remarkable efficiency and selectivity. It promotes one-pot reactions, including active methylenes and benzyl alcohols in water, via a tandem aerobic oxidation/Knoevenagel condensation process, yielding benzylidene malononitrile in excellent yields. The catalyst’s ability to oxidize benzyl alcohols to aldehydes, which then undergo Knoevenagel condensation with active methylenes, makes it a multifunctional catalyst. Notably, the catalyst can be successfully retrieved and recycled for five successive rounds with no significant decrease in catalytic efficiency. The ICP study showed that no catalyst leaching was observed, indicating that the designed catalyst is indeed heterogeneous. The Ru catalyst outperformed other documented catalysts in terms of lower dose, shorter duration, decreased working temperature, and the absence of dangerous additives. This demonstrates the catalyst’s robustness and sustainability, making it a promising candidate for future organic conversions and industrial uses.