bluuebunny/crossref_metadata_2025 huggingface dataset:
Multisite distribution of fibrillary inclusions in a patient with light chain proximal tubulopathy: A case report
Authors: Wang Yingying , Chen Kai , Zhou Shengguo , Zhang Wei
Published: August 2024

Rationale:

Light chain proximal tubulopathy (LCPT) is a rare form of renal impairment associated with multiple myeloma (MM). LCPT is caused by inclusions formed of free light chains that are typically crystalline, but can also be noncrystalline structures.

Patient concerns:

A 62-year-old man was hospitalized for the investigation of abnormal urine test results lasting for 1 year and kidney-function abnormalities persisting for more than 1 month.

Diagnoses:

Noncrystalline LCPT and MM.

Interventions:

The patient was treated with the lenalidomide, bortezomib, and dexamethasone and pomalidomide, bortezomib, and dexamethasone chemotherapy regimens.

Outcomes:

Complete remission of MM was achieved, and the patient’s renal function returned to normal.

Lessons:

This case report highlights the importance of renal pathology in the diagnosis of patients with unexplained chronic kidney disease and proteinuria.
Prognosis and metabolism with a Golgi apparatus-related genes-based formula in breast cancer
Authors: Lu Hang , Yu Xin , Li Wenge , Zhang Yimin , Sun Shengrong
Published: August 2024

The Golgi apparatus (GA), an organelle that processes, sorts, and transports proteins synthesized by the endoplasmic reticulum, is also involved in many cellular processes associated with cancer, such as angiogenesis, the innate immune response, and tumor invasion and migration. We aimed to construct a breast cancer (BC) prognosis prediction model based on GA-related genetic information to evaluate the prognosis of patients with BC more accurately than existing models and to stratify patients for clinical therapy. In this study, The Cancer Genome Atlas-breast invasive carcinoma was used as the training cohort, and the Molecular Taxonomy of Breast Cancer International Consortium cohort was used as the validation cohort. Using bioinformatics methods, we constructed a GA-related gene risk score (GRS). The GRS was used to divide BC patients into a high-GRS group and a low-GRS group, and functional analysis, survival analysis, mutation analysis, immune landscape analysis, and metabolic analysis were performed to compare the 2 groups. Finally, a nomogram was constructed for clinical application. The genes in the GRS model were mainly related to the glucose metabolism pathway, and the main mutations in the 2 groups of patients were mutations in TP53 and CHD1. The mutation rate in the high-GRS group was greater than that in the low-GRS group. The high GRS group had higher tumor immune activity glycolysis; the pentose phosphate pathway tended to be the dominant metabolic pathways in this group, while fatty acid oxidation and glutamine catabolism tended to be dominant in the low-GRS group. GA-related genes were used to construct a prediction model for BC patients and had high accuracy in predicting prognosis. The mutations associated with the GRS are mainly TP53 and CDH1. Interestingly, the GRS is correlated with glucose metabolism in terms of gene expression and functional enrichment. In summary, the role of GRS-related genes in glucose metabolism is worthy of further study.
Path analysis of the effect of positive psychological capital on health-promoting lifestyle in patients with COPD after pulmonary rehabilitation: An observational study
Authors: Xu Na , Li Rui , Feng Li , Liang Meng-yao
Published: August 2024

To investigate the effect of positive psychological capital on the health-promoting lifestyle of patients with chronic obstructive pulmonary disease (COPD) and the intermediary effects of life satisfaction and learned helplessness. A total of 482 patients who completed the pulmonary rehabilitation course at the Nantong Sixth People’s Hospital of Jiangsu Province were surveyed using a self-designed questionnaire battery, encompassing the positive psychological capital, health-promoting lifestyle, life satisfaction, and learned helplessness scales. A total of 469 of the 482 questionnaires distributed were effectively returned, leading to an effective response rate of 97.3%. The mean scores on the positive psychological capital, life satisfaction, learned helplessness, and health-promoting lifestyle scales were 105.56 ± 10.44, 19.89 ± 6.33, 50.14 ± 5.47, and 104.22 ± 10.44, respectively. The structural equation model demonstrated good fit indexes. The path analysis revealed that positive psychological capital had a direct effect of 0.431 on health-promoting lifestyle, while life satisfaction and learned helplessness had a mediating effect on this relationship (both P < .05). Patients with COPD have low levels of positive psychological capital and health-promoting lifestyle. Thus, addressing psychological problems and providing continuous rehabilitation nursing to strengthen the psychological construct are essential in this patient group. Moreover, the positive psychological capital of patients with COPD can directly predict their health-promoting lifestyle and exert an influence via the chain mediating effect of life satisfaction and learned helplessness. Therefore, clinical medical staff should assess the positive psychological capital of patients with COPD and adjust the daily rehabilitation activities according to the patients’ mental state. Furthermore, enhancing the patients’ life satisfaction by employing diverse strategies to reduce learned helplessness can notably improve the health-promoting lifestyle of those with COPD.
Unraveling the link between hypertriglyceridemia, dampness syndrome, and chronic diseases: A comprehensive observational study
Authors: Zhou Hui , Zhang Weizheng , Cai Xiangsheng , Yang Shuo , Liu Aolin , Zhou Xiaowen , Cai Jianxiong , Wu Darong , Zeng Hongli
Published: August 2024

To investigate the dampness syndrome score in hypertriglyceridemia and the correlations between hypertriglyceridemia and other chronic diseases and lifestyle factors. Data were retrospectively obtained from individuals who underwent physical examinations at Guangzhou Cadres Health Management Centre from May 2022 to May 2023. t Test, variance analysis, and chi-square test were used to compare the score of dampness syndrome and the prevalence of hypertriglyceridemia among different subgroups. Pearson, Spearman correlation analysis, and regression analysis were used to explore the correlations between hypertriglyceridemia and dampness syndrome, chronic diseases, and lifestyle factors. The prevalence of hypertriglyceridemia was 26.70%. Clinical test index and dampness syndrome score were significant differences between hypertriglyceridemia group and normal group (P < .05). Subgroup analyses as a function of the degree of triglyceridemia indicated that the dampness syndrome score increased with increasing degree of triglyceridemia (P < .05). Correlation analysis showed that hypertriglyceridemia was correlated with dampness syndrome, overweight/obesity, hypertension, diabetes, and other chronic diseases (P < .05). Multivariate logistic regression analysis showed that age, sex, marriage, education level, smoking, drinking, fruit consumption, vegetable consumption, milk and dairy product consumption, dessert or snack consumption, the degree of dampness syndrome, and engagement in exercise were associated with hypertriglyceridemia (P < .05). Hypertriglyceridemia is associated with a variety of chronic diseases and lifestyle factors, and is closely related to dampness syndrome. The score of dampness syndrome can reflect hypertriglyceridemia to a certain extent. It provides more clinical reference for the treatment of hypertriglyceridemia combined with the analysis of dampness syndrome of traditional Chinese medicine.
The clinical, economic, and humanistic burden of treatments for exocrine pancreatic insufficiency and cost-effectiveness of treatments: A systematic literature review
Authors: Chu Paula , Mioc Jasmina , Henry Owen , O’Donovan Peter
Published: August 2024

Background:

To examine the burden of exocrine pancreatic insufficiency (EPI), specifically the clinical impact of EPI on patients, their quality of life (QoL) and the cost-effectiveness of existing treatments.

Methods:

A systematic literature review was conducted using key search terms for the clinical, economic, and humanistic burden. Databases were searched from 2010 to 2022, with articles screened independently by 2 reviewers at abstract and full-text stage against pre-defined eligibility criteria.

Results:

Seventy-one publications were identified that reported relevant clinical, humanistic, and economic data. Prevalence and incidence of EPI varied across identified studies; EPI appears to be especially prevalent as a comorbid condition in patients with cystic fibrosis. EPI has a large impact on QoL, with lower QoL scores in patients with EPI compared with those without EPI. The instruments used to assess QoL, however, were inconsistent across studies. Where reported, economic burden studies highlighted that patients with EPI have higher healthcare resource utilization compared with those without, with costs increasing with disease severity.

Conclusion:

This systematic literature review highlights that patients with EPI have higher treatment costs and lower QoL scores than patients without EPI. The prevalence of EPI as a comorbid condition is high, particularly in patients with cystic fibrosis.
Association between the triglyceride–glucose index and mortality in critically ill patients: A meta-analysis
Authors: Nie Mengzhen , Jiang Biantong , Xu Yu
Published: August 2024

Background:

To further identify the association of the triglyceride–glucose (TyG) index with the risk of mortality among critically ill patients admitted to the intensive care unit (ICU).

Methods:

The PubMed, Web of Science, and EMBASE databases were searched for relevant studies up to February 2, 2024. The primary outcomes were in-hospital mortality and ICU mortality. The secondary outcomes were 30-day mortality, 90-day mortality, and 1-year mortality. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to evaluate the associations between the TyG index and the above endpoints. All the statistical analyses were performed with STATA 15.0 software.

Results:

Ten studies involving 22,694 patients were included. The pooled results demonstrated that an elevated TyG index indicated an increased risk of in-hospital mortality (HR = 1.76, 95% CI: 1.41–2.18, P < .001), ICU mortality (HR = 1.52, 95% CI: 1.33–1.74, P < .001), 30-day mortality (HR = 1.50, 95% CI: 1.02–2.19, P = .037), 90-day mortality (HR = 1.42, 95% CI: 1.01–2.00, P = .043), and 1-year mortality (HR = 1.19, 95% CI: 1.11–1.28, P < .001). Subgroup analysis for in-hospital mortality and ICU mortality based on sex, age, body mass index and hypertension showed similar results. However, subgroup analysis stratified by diabetes mellitus (DM) revealed that the associations of the TyG index with in-hospital mortality (HR = 2.21, 95% CI: 1.30–3.78, P = .004) and ICU mortality (HR = 1.93, 95% CI: 0.95–3.94, P = .070) were observed only among patients without DM.

Conclusion:

The TyG index was significantly associated with mortality among critically ill patients without DM, and an elevated TyG index predicted an increased risk of mortality.
Novel GJB2 mutation c.188delT compound with c.235delC causing non-syndromic hearing loss in a Chinese family: A case report
Authors: Tao Yilun , Hu Zhipeng , Han Dong , Song Wenxia , Wang Lihong , Wang Haiwei , Li Xiaoze
Published: August 2024

Rationale:

Congenital sensorineural hearing loss is a significant global health issue, primarily driven by genetic factors, such as mutations in the GJB2 gene. This report presents a Chinese girl with congenital deafness and a novel mutation of the GJB2 gene.

Patient Concerns:

A newborn Chinese girl exhibited signs of congenital deafness.

Diagnosis:

Congenital deafness was confirmed through comprehensive newborn hearing screenings that included otologic, audiologic, and physical examinations. Genetic analysis revealed a compound heterozygous mutation involving c.188delT and c.235delC in the GJB2 gene, indicating a genetic basis for her hearing loss.

Interventions:

The patient underwent cochlear implantation, which resulted in stable auditory outcomes.

Outcomes:

Despite follow-up difficulties, stable auditory outcomes were achieved post-cochlear implantation, highlighting the potential efficacy of this intervention in GJB2-related hearing loss.

Lessons:

This case study enriches our understanding of GJB2 mutations and underscores the critical role of genetic testing in diagnosing congenital sensorineural hearing loss. It emphasizes the necessity for early intervention and sustained interdisciplinary care to enhance the quality of life for patients with genetic hearing impairment.
A case report: Treatment of a patient with ruptured middle cerebral aneurysm in the second trimester of pregnancy
Authors: Li Wei , Liu Yang , Chu Fudi , Li Mingjian , Wang Jinpeng
Published: August 2024

Background:

To summarize the clinical experience of intracranial aneurysm clipping in the treatment of ruptured intracranial aneurysms in the second trimester of pregnancy.

Methods:

A case of ruptured middle cerebral aneurysm in the second trimester of pregnancy was reported. Craniotomy and aneurysm clipping were performed at 24 weeks of pregnancy, and fetal preservation was continued after the operation.

Results:

The prognosis of the parturient was good and the skull was missing on the operative side. A healthy baby boy was delivered by cesarean section 2 months after the operation, and skull repair was performed 4 months after the operation. During the follow-up for 1 year, the mother and son were healthy and no obvious sequelae were found.

Conclusion:

Ruptured intracranial aneurysm hemorrhage in mid-pregnancy is a rare and critical case. Summarizing the corresponding clinical experience will help to have a reference plan for the next time when facing a similar situation, and it will help to treat critically ill patients. The treatment of ruptured intracranial aneurysm in mid-pregnancy requires multidisciplinary collaboration, and cranial aneurysm clamping + fertility preservation can reduce the impact of radiation on the fetus and improve the prognosis for both the mother and the fetus.
Infectious wrist arthritis complicating acute carpal tunnel syndrome in a child: A CARE-compliant case report
Authors: Huang Jihui , Li Jun , Li Ruichen , Wu Xing , Lei Yuanxue , Zhou Zhiguo
Published: August 2024

Introduction:

The objective of this case report is to provide clinical evidence that acute infectious wrist arthritis in children can lead to the rare condition of acute carpal tunnel syndrome (ACTS). This article discusses in detail the characteristics of infectious wrist arthritis complicating ACTS in children in terms of etiology, pathogenic bacteria, treatment modalities, and sequelae to improve the understanding of this disease.

Patient concerns:

A 10-year-old male child presented with a 15-day history of swelling and pain in the left forearm, wrist, and hand.

Diagnoses:

Left-sided infected wrist arthritis complicating ACTS.

Interventions:

The child received emergency surgery and anti-infective treatment combined with regular rehabilitation.

Outcomes:

During the treatment period, the child’s wrist pain and swelling gradually improved, and wrist movement was restored compared with the preoperative period. At 6-month follow-up, the activities of the metacarpophalangeal joints of the left hand were close to normal, and the flexion of the left wrist joint was slightly limited.

Conclusion:

In infectious wrist arthritis in children, ACTS is a serious complication that requires aggressive surgical carpal tunnel release to avoid median nerve injury in addition to anti-infective therapy.
Rupture of intrahepatic bile duct after ERCP for common bile duct stone: A case report of rare complications
Authors: Ly Tuan Huu , Pham Quang Tien , Tran Loc Huynh , Tran Ha Nhat , Tran Phuoc Duy , Nguyen Khoa Hoang Anh , Le Truc Huynh Thanh , Pham Trung Quoc
Published: August 2024

Rationale:

Complications after endoscopic retrograde cholangiopancreatography (ERCP) are diverse and usually treated with nonoperative management or percutaneous drainage; however, there are still some rare, life-threatening complications. This is an extremely rare case of biliary peritonitis caused by rupture of the intrahepatic bile duct after ERCP.

Patient concerns:

A 63-year-old male underwent ERCP for common bile duct stones. On the second day after the procedure, the patient developed sepsis and abdominal distention. Contrast-enhanced computed tomography revealed a subcapsular hepatic fluid collection attached to the bile duct of segment VII.

Diagnoses:

Sepsis resulted in liver parenchyma rupture and intrahepatic bile duct injury after ERCP. Intraoperative cholangiography revealed a connection between a hole in the liver parenchymal surface and the intrahepatic bile duct.

Interventions:

Surgeons performed the cholecystectomy, inserted a T-tube into the common bile duct stones, sutured the defect, and put 2 drainage tubes around the lesion.

Outcomes:

Postoperative recovery was uneventful, and the patient was discharged on the 17th postoperative day.

Lessons:

Intrahepatic bile duct perforation after ERCP can lead to rupture of the liver parenchyma, biloma, or abdominal peritonitis. Multidisciplinary management is necessary to achieve favorable outcomes.
Pulmonary adverse reaction caused by furazolidone: Two case reports and a literature review
Authors: Zheng Cong , Cheng Yao , Huang Ping , Zhang Miaomiao , Ren Zhuochao , Zheng Xiaochun , Xuan Zixue , Shen Bin , Yang Xiuli
Published: August 2024

Rationale:

As one of the drugs used to treat Helicobacter pylori, furazolidone has been reported to cause gastrointestinal reactions, allergies, dizziness, and more. However, its related drug-induced lung injury has been rarely reported. Furthermore, there have been no reports of the timing for initiating hormone therapy when a pulmonary adverse reaction occurs.

Patient concerns:

We report 2 cases, both of them showed interlobular septal thickening and nodules on the chest computed tomography. One had more discomfort symptoms and had a higher eosinophil count than the normal range, while the other only had fever symptoms and had an eosinophil count within the normal range.

Diagnoses:

Pulmonary adverse reaction caused by furazolidone was diagnosed.

Interventions:

Furazolidone was discontinued, and the person with increased eosinophils received hormone therapy, while the other person did not.

Outcomes:

After discontinuation of medication and treatment, the symptoms of the 2 patients gradually improved.

Lessons:

This report suggests that furazolidone may cause pulmonary adverse reactions to raise clinical awareness, and for the first time indicates that hormone therapy is needed for patients whose eosinophils continue to increase after discontinuation.
The value of real-time shear wave elastography in spontaneous preterm birth
Authors: Lu Huiling , Liu Yang , Yang Fangrui , Wu Dan , Qi Jiarui , Ji Yonghao , Hu Mengli
Published: August 2024

This study aimed to investigate the predictive value of real-time shear wave elastography (SWE) for spontaneous preterm birth (SPB). This study prospectively selected 175 women with singleton pregnancies at 16 to 36 weeks of gestation. Cervical length (CL) and uterocervical angle (UCA) were measured using transvaginal ultrasonography. Real-time shear wave elastography was used to measure Young’s modulus values, including the average Young’s modulus (Emean) and the maximum Young’s modulus (Emax) at 4 points: point A on the inner lip of the cervical os, point B on the outer lip of the cervical os, point C on the inner lip of the external os, and point D on the outer lip of the external os. Receiver operating characteristic (ROC) curve analysis was performed to compare the accuracy of Young’s modulus values at the 4 points, CL, and UCA in predicting SPB. Significant variables were used to construct a binary logistic regression model to predict the multifactorial predictive value of SPB, which was evaluated using an ROC curve. A total 176 valid cases, including 160 full-term pregnancies and 16 SPB, were included in this study. Receiver operating characteristic curve analysis revealed that Emean at point A, as well as Emean and Emax at point D, had a relatively high accuracy in diagnosing SPB, with area under the curve values of 0.704, 0.708, and 0.706, respectively followed by CL (0.670), SWE at point C (Emean 0.615, Emax 0.565), SWE at point B (Emean 0.577, Emax 0.584), and UCA (0.476). Binary logistic regression analysis showed that comorbidities during pregnancy (including diabetes mellitus, hypertension, cholestasis and thyroid dysfunction), CL, and Emean at point A were independent predictors of preterm birth. In addition, the AUC value of the logistic regression model’s ROC curve was 0.892 (95% CI: 0.804–0.981), with a sensitivity of 0.867, specificity of 0.792, and Youden’s index of 0.659, indicating that the regression model has good predictive ability for SPB. Real-time shear wave elastography showed a higher predictive value for SPB than CL and UCA. The SWE combined with CL and comorbidities during pregnancy model has a good predictive ability for SPB.
The visceral adiposity index is associated with asthma, especially current asthma: A cross-sectional study of NHANES, 2003 to 2018
Authors: Xu Jiao , Liu Xiaowu , Tang Jianlei
Published: August 2024

To investigate the association between the visceral adiposity index (VAI) and asthma using data from National Health and Nutrition Examination Survey 2003 to 2018 by a cross-sectional study. We explored the potential relationship between the VAI and asthma incidence via a cross-sectional study of the National Health and Nutrition Examination Survey from 2003 to 2018. Multiple logistic regression analysis, restricted cubic spline analysis and subgroup analysis were performed. Among the 80,312 participants, 1984 had been told by a doctor or other health professional, and 1142 still had asthma. With all confounders controlled, the VAI was positively associated with asthma incidence (odds ratios 1.04, 95% confidence interval: 1.01, 1.08). When comparing the second, third, and fourth VAI quartiles to the lowest quartile, the adjusted odds ratios (95% confidence intervals) for asthma risk were 1.02 (0.86, 1.21), 1.14 (0.96, 1.36), and 1.18 (1, 1.39), respectively (P for trend = .02). Subgroup analysis revealed no significant interaction effect among the subgroups (P > .05). The positive association was stronger in current asthma patients (odds ratios 1.13, 95% confidence interval: 1.03, 1.24). When comparing the second, third, and fourth VAI quartiles to the lowest quartile, the adjusted odds ratios for current asthma risk were 1.15 (0.81, 1.64), 1.29 (0.91, 1.84), and 1.51 (1.01, 2.24), respectively (P for trend .04). The restricted cubic spline regression analysis did not reveal a nonlinear correlation between the VAI and asthma or current asthma. Subgroup analysis revealed a significant interaction effect between age (P for interaction = .03) and diabetes status (P for interaction = .02). Except in the age ≥60 years, Less than high school, normal body mass index subgroup, VAI, and current asthma were positively correlated. A positive relationship between the VAI and asthma incidence was observed. In particular, there was a strong positive correlation between the VAI score and current asthma. According to the subgroup analysis, more attention should be given to individuals aged 40 to 59 years who have diabetes.
Construction and verification of rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery: A pilot randomized controlled trial
Authors: Xu Qiuqin , Jiang Hongzhan , Li Yuanchan , Qi Xiushan , Chen Lijuan
Published: August 2024

Background:

To develop a nursing program for the prevention and rehabilitation of shoulder and neck discomfort after thyroid cancer surgery based on the empowerment theory, and to evaluate the application effect of the program.

Methods:

The prevention and rehabilitation nursing program for shoulder and neck discomfort after thyroid cancer surgery was established by literature review and the Delphi method. Between July 2022 and January 2023, a total of 62 postoperative thyroid cancer patients were recruited and randomly allocated to either the intervention group (n = 31) or the control group (n = 31) in this randomized controlled trial. Comparisons of shoulder and neck function, self-efficacy, and quality of life between the 2 groups were performed using a 2-sample independent t test, Wilcoxon rank-sum test, and repeated-measures analysis of variance.

Results:

At the end of the study, the control group and intervention group were 30 cases each completed the study. After the intervention, the self-efficacy score of the intervention group was higher than the control group (P < .05), and the score of emotional function, cognitive function, and overall health dimension of the intervention group was higher than the control group (P < .05). The pain dimension score of the intervention group was lower than the control group (P < .05). There were significant differences in the group and time effects of the total shoulder joint scores between the 2 groups (P < .05).

Conclusion:

This study demonstrated that the shoulder and neck rehabilitation nursing program can alleviate the symptoms of shoulder and neck discomfort and improve patients’ self-efficacy and quality of life.
Exploring the causal relationship between psoriasis and osteoarthritis through a 2-sample Mendelian randomization study
Authors: Yao Haoyu , Lu Peizhi , Li Ya , Yang Shuo , Wang Shijie , Fan Zihao , Ning Rende
Published: August 2024

Previous research has demonstrated a robust association between osteoarthritis (OA) and psoriasis. Notably, a significant proportion of psoriasis patients exhibit symptoms of arthritis, particularly psoriatic arthritis. However, a definitive causal relationship between psoriasis, psoriatic arthritis and OA remains to be established. This study aimed to elucidate the causal relationship between psoriasis, psoriatic arthritis, and osteoarthritis using a 2-sample Mendelian randomization approach. The causal relationship between psoriasis, psoriatic arthritis and OA was rigorously investigated using a 2-sample Mendelian Randomization (MR) approach. Instrumental variables pertinent to psoriasis, psoriatic arthritis and 4 distinct types of OA (knee osteoarthritis (KOA), hand osteoarthritis (HOA), total knee replacement (TKR), and total hip replacement (THR)) were sourced from extensive, published genome-wide association studies (GWAS). To estimate the causal effects, methodologies such as inverse variance weighting (IVW), MR-Egger, and weighted median estimation (WM) were employed. Mendelian Randomization analysis suggested a potential causal effect of psoriasis on osteoarthritis (OA). For hand OA (HOA), the P value was .381 (OR = 0.28); for knee OA (KOA), the P value was .725 (OR = 1.46); for TKR, the P value was .488 (OR = 0.274); and for THR, the P value was .454 (OR = 0.216). Furthermore, we explored the causality of psoriatic arthritis on OA. For HOA, the P value was .478 (OR = 0.0095); for KOA, the P value was .835 (OR = 0.345); for THR, the P value was .807 (OR = 0.120); and for TKR, the P value was .860 (OR = 0.190). Our findings indicate that there is no evidence of a causal connection between psoriasis or psoriatic arthritis and OA, suggesting that while psoriasis may contribute to arthritis, it does not influence OA development.
Assessment of readability, reliability, and quality of ChatGPT®, BARD®, Gemini®, Copilot®, Perplexity® responses on palliative care
Authors: Hancı Volkan , Ergün Bişar , Gül Şanser , Uzun Özcan , Erdemir İsmail , Hancı Ferid Baran
Published: August 2024

There is no study that comprehensively evaluates data on the readability and quality of “palliative care” information provided by artificial intelligence (AI) chatbots ChatGPT®, Bard®, Gemini®, Copilot®, Perplexity®. Our study is an observational and cross-sectional original research study. In our study, AI chatbots ChatGPT®, Bard®, Gemini®, Copilot®, and Perplexity® were asked to present the answers of the 100 questions most frequently asked by patients about palliative care. Responses from each 5 AI chatbots were analyzed separately. This study did not involve any human participants. Study results revealed significant differences between the readability assessments of responses from all 5 AI chatbots (P < .05). According to the results of our study, when different readability indexes were evaluated holistically, the readability of AI chatbot responses was evaluated as Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini®, from easy to difficult (P < .05). In our study, the median readability indexes of each of the 5 AI chatbots Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini® responses were compared to the “recommended” 6th grade reading level. According to the results of our study answers of all 5 AI chatbots were compared with the 6th grade reading level, statistically significant differences were observed in the all formulas (P < .001). The answers of all 5 artificial intelligence robots were determined to be at an educational level well above the 6th grade level. The modified DISCERN and Journal of American Medical Association scores was found to be the highest in Perplexity® (P < .001). Gemini® responses were found to have the highest Global Quality Scale score (P < .001). It is emphasized that patient education materials should have a readability level of 6th grade level. Of the 5 AI chatbots whose answers about palliative care were evaluated, Bard®, Copilot®, Perplexity®, ChatGPT®, Gemini®, their current answers were found to be well above the recommended levels in terms of readability of text content. Text content quality assessment scores are also low. Both the quality and readability of texts should be brought to appropriate recommended limits.
What is the authentic underlying reason of childbirth worries in Turkish population?: An observational study
Authors: Kaçar Nükhet , Bedir Findik Rahime , Moraloğlu Tekin Özlem
Published: August 2024

This study aims to determine women’s childbirth worries during antenatal. The research was carried out with 532 pregnant women in the antenatal clinic in Turkey as an observational study. Sociodemographic characteristics and scores of the Oxford Worries about Labor Scale of pregnant women were evaluated quantitatively. In addition, the answers given by the pregnant women to the open-ended question were themed. Although working status and receiving antenatal education reduce the fear of childbirth, birth scenes/stories on TV or social media, birth stories in the pregnant women’s friends/family, being stressed in daily life, and dysmenorrhea increase the worries about childbirth (WaC). In addition, primiparas experience more WaC than multiparas. The reasons for WaC in pregnant women were classified as birth pain, artificial pain, cesarean section/receiving anesthesia, intervention/examination, pandemic, people’s thoughts/experiences, birth process/insufficiency in birth, hospital/staff, fears about the baby, complications/death, and ignorance of the birth process. The results of this study reveal that WaC is a pivotal issue for pregnant women, for which managing the labor process, labor pain and labor fear is important. The stipulation of support for pregnant women is essential to enhance labor outcomes.
Effect of SARS-CoV-2 vaccination on the outcomes of assisted reproductive technology: A review
Authors: Kong Xiaoli , Shen Chaoyan , Liu Tao , Yang Aijun , Liu Xu , Hou Fangyu , Wang Wei , Yang Sanhui , Li Zewu , Wang Jingwen
Published: August 2024

It has been over 4 years since the coronavirus disease 2019 outbreak, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As an effective response to coronavirus disease 2019, the SARS-CoV-2 vaccines have been widely used around the world. However, couples who are planning to conceive naturally or by assisted reproductive technology (ART) are concerned about the impact of SARS-CoV-2 vaccines on pregnancy and offspring safety. Furthermore, in the initial stage of the epidemic, opinions among physicians and healthcare providers on whether ART patients should be immunized are divided due to the lack of data regarding the impact of the SARS-CoV-2 vaccine on ART. This is not the first, nor will it be the last time humans confront pandemics. It is time to summarize the experience about the effect of the SARS-CoV-2 vaccine on the outcomes of ART, which can provide a reference for the future. This paper reviewed relevant research, and significant adverse effects of the SARS-CoV-2 vaccine on the outcome of ART have not been observed. Considering the increased risk of serious complications in pregnant women infected with SARS-CoV-2, timely vaccination may be a wiser choice.
CT radiomics-based machine learning model for differentiating between enchondroma and low-grade chondrosarcoma
Authors: Yildirim Mustafa , Yildirim Hanefi
Published: August 2024

It may be difficult to distinguish between enchondroma and low-grade malignant cartilage tumors (grade 1) radiologically. This study aimed to construct machine learning models using 3D computed tomography (CT)-based radiomics analysis to differentiate low-grade chondrosarcoma from enchondroma. A total of 30 patients with enchondroma and 26 with chondrosarcoma were included in this retrospective study. Tumor volume segmentation was manually performed by 2 musculoskeletal radiologists. In total, 107 radiomic features were obtained for each patient. The intraclass correlation coefficient was used to assess interobserver reliability and estimate the absolute agreement between the 2 radiologists. Algorithm-based information gain was used as a feature reduction method, and the 5 most important features were detected. For classification, 7 machine learning models were utilized. Classification was carried out using either all features or 5 features. There was good to excellent agreement between the 2 radiologists for the 107 features of each patient. Therefore, a dataset containing 107 features was used for machine learning classification. When assessed based on area under curve (AUC) values, classification using all features revealed that naive Bayes was the best model (AUC = 0.950), while classification using 5 features revealed that random forest was the best model for differentiating chondrosarcoma from enchondroma (AUC = 0.967). In conclusion, machine learning models using CT-based radiomics analysis can be used to differentiate between low-grade chondrosarcoma and enchondroma.
The epidemiological and clinical characteristics of Langerhans cell sarcoma in the United States: A population study based on SEER data from 2000 to 2019
Authors: Mali Bahaa , Mali Ali , Mali Alaa , Abdulrazzak Mohammed , Jobran Afnan W. M.
Published: August 2024

Langerhans cell sarcoma (LCS) is a rare aggressive malignancy with a poor prognosis. Our knowledge about this condition is limited and mainly based on case reports, making it challenging to understand its epidemiology, clinical features, and patient outcomes. We conducted a retrospective study of LCS patients diagnosed between 2000 and 2019 using the Surveillance, Epidemiology, and End Results (SEER) database. The data were stratified based on age, race, stage, clinical pattern, and treatment method. Our study found that 57 LCS cases were reported in SEER registries between 2000 and 2019. Among these cases, most patients (50.9%) were over 60 years old and White (71.9%) with almost equal males to females ratio. About 45.6% of cases were localized while 47.4% were at distant stages. Of the patients, 50.9% underwent surgery, 45.6% received chemotherapy, and only 21.1% received radiotherapy. The overall survival rate for patients diagnosed with LCS in the United States is generally low with a 1-year overall rate of 63.8%. Certain factors can negatively impact prognosis, such as advanced stages of the disease, secondary tumors, or more than 1 tumor per patient. LCS is a rare disease with poor survival rates. Future research should incorporate global data for further statistically significant results. Moreover, investigating the molecular, genetic, and pathophysiological backgrounds of these tumors is crucial for developing targeted management strategies and improving prognosis.
Main pancreatic duct involved IPMN without high-risk factors: how to judge the degree of malignancy based on MPD dilation?
Authors: Zhu Yong , Mao Yingfan , Wang Jianhua , Wang Zhongqiu , Chen Xiao
Published: August 2024

The aim of this study was to evaluate the cutoff value for identifying malignance in main pancreatic duct (MPD)-involved intraductal papillary mucinous neoplasm (IPMN) with an MPD diameter ranging from 5 to 10 mm. Clinical-radiological characteristics of 142 patients, including MPD-involved IPMNs (n = 53) and branch-duct (BD)-IPMNs (n = 89) were analyzed. Logistic regression analysis was used to determine the risk factors of malignant IPMNs and invasive carcinoma. ROC curves were used to identify different cutoffs in terms of preoperative MPD values to predict the presence of invasive carcinoma as well as malignant IPMNs, and the prediction performance was evaluated. For MPD-involved IPMNs (5 mm < MPD < 10 mm), MPD diameter of 7.5 mm for discriminating malignant IPMNs (area under curve [AUC] = 0.67) and 7.7 mm for discriminating invasive IPMNs (AUC = 0.56) were found to be the optimal cutoff values at receiver operating characteristic curve (ROC) analysis. MPD > 7.5 mm and carbohydrate antigen19-9 (Ca19-9) > 37 U/ml were found to be predictors of malignant IPMNs at univariate, and MPD > 7.5 mm was a predictor in multivariate analysis in MPD-involved IPMNs. The AUC of the ROC curve of MPD (7.5 mm) combined with Ca19-9 in identifying malignant IPMNs was 0.73 in MPD-involved IPMNs. MPD (7.5 mm) combined with Ca19-9 performed well in identifying malignant IPMNs in MPD-involved IPMNs.
Causal relationship between telomere length and osteonecrosis: Bidirectional two-sample Mendelian randomization analysis
Authors: Liu Hao , Yan Wei , Li Jinsong , Luo Di , Yan Dezhi
Published: August 2024

Recent mounting evidence suggests that shortening of telomere length (TL) is associated with impaired bone health; yet, a genetic causal relationship between TL and osteonecrosis remains uncertain. This study aimed to investigate the potential causal relationship between TL and osteonecrosis using bidirectional two-sample Mendelian randomization (MR). Genome-wide association study summary statistics for TL were sourced from the IEU Open genome-wide association study project, while osteonecrosis data were obtained from the FinnGen Biobank database. A range of MR methodologies—including inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode—were utilized for analysis, along with the MR-Egger intercept method for horizontal pleiotropy assessment, and Cochran Q and leave-one-out methods for heterogeneity testing. The forward MR analysis indicated a significant causal relationship between TL and osteonecrosis, suggesting that genetically predicted shorter TL is associated with an elevated risk of developing osteonecrosis (OR = 0.611, 95% confidence interval 0.394–0.948, P = .028). The reverse MR analysis revealed no significant influence of osteonecrosis on TL (OR = 0.999, 95% confidence interval 0.994–1.005, P = .802). Analyses for heterogeneity and horizontal pleiotropy yielded robust results. Our study demonstrates that individuals with shorter TL have an increased risk of developing osteonecrosis, whereas osteonecrosis has no effect on TL.
The allocation and utilization efficiency of hospital beds in Sichuan Province, China
Authors: Zhou Minghua
Published: August 2024

Objective:

To analyze the allocation and utilization efficiency of hospital beds in Sichuan Province, China, and to provide a scientific basis for improving the rational allocation and efficient utilization.

Methods:

The supply and demand balance method, health resource agglomeration degree (HRAD), bed efficiency index and bed utilization model were used to evaluate the allocation and utilization efficiency of hospital beds in Sichuan Province from 2017 to 2021.

Results:

The number of hospital beds per 1000 population in Sichuan Province increased from 4.97 in 2017 to 5.94 in 2021. The overall supply and demand ratio of hospital beds in Sichuan Province is between 0.85 and 1.01, and the supply and demand situation is a basically balanced situation. The HRAD of hospital beds in Ya’an, Aba, Ganzi and Liangshan is <1, indicating that the equity of hospital beds by geography in these regions is low. The difference between HRAD and population agglomeration degree (PAD) in 9 regions, including Deyang, Aba, Ganzi and Liangshan, is <0, indicating that there are insufficient hospital beds in these areas relative to the agglomerated population. The bed efficiency index of hospital beds in 17 regions, including Chengdu, Zigong, Aba and Ganzi, are all <1, which means that hospital beds are operating with low efficiency. The bed utilization model of Panzhihua is efficiency type, that of Zigong, Deyang and Ziyang is pressure bed type, and that of Nanchong and Ya’an is idle type.

Conclusion:

The hospital bed allocation in Sichuan Province is relatively good, and the supply and demand situation is in a basically balanced situation. The hospital bed allocation in Aba, Ganzi and Liangshan is insufficient by geography and population. The overall operational efficiency of hospital beds is low, and there are more idle and pressure bed utilization models.
Long-term clinical efficacy of drug-coated balloon angioplasty for TASCII C/D femoropopliteal lesions in older patients with chronic limb-threatening ischemia: A retrospective study
Authors: Zhang Feng , Song Hai-Xia , Zheng Li-Hua , An Yan-Bo , Liu Peng
Published: August 2024

This study aimed to evaluate the long-term clinical outcomes of drug-coated drug (DCB) angioplasty for long femoropopliteal lesions in older patients with chronic limb-threatening ischemia (CLTI). In this multi-center retrospective study, we enrolled 119 patients with CLTI due to Trans-Atlantic Inter-Society Consensus (TASCII) C/D femoropopliteal lesions who underwent DCB angioplasty. A total of 119 patients with 122 limbs (TASCII C = 67, 54.9%; TASCII D = 55, 45.1%) were enrolled. At 36-month follow-up, primary patency, assisted primary patency, secondary patency, and freedom from target lesion revascularization were 47.3%, 49.8%, 59.5%, and 62.7%, respectively, and there was a significant improvement over baseline in Rutherford class (P < .001) and ankle-brachial index measurements (P < .001). Complex target lesions (P = .017) and 1 stenosis-free outflow vessel (P = .001) were risk predictors of freedom from clinically driven target lesion revascularization. Complex target lesions (P = .044), diabetes (P = .007), and 1 stenosis-free outflow vessel (P = .003) were risk predictors of restenosis. At 2 months, the ulcer healing rate was 96.3% (26/27). At 36 months, the limb salvage and survival rates were 85.8% and 83.3%, respectively. DCB angioplasty were safe and effective for older patients with CLTI attributable to femoropopliteal TASCII C/D lesions.
Path analysis for affecting the physical fitness of marine majors: A cross-sectional observational study from the perspective of health
Authors: Sun Yuepeng , Su Yu , Yuan Yufeng , Wang Quanjun
Published: August 2024

The physical fitness of marine major students is critically linked to their academic performance and future career prospects. To investigate the influence of various environmental factors on the physical fitness of maritime majors and to identify potential strategies for improving physical fitness among this population. A cross-sectional observational study was conducted among maritime students. The study surveyed and field-tested 517 male marine majors across 1st to 3rd-grade students using a combination of questionnaire surveys and on-site testing methods. There were no significant differences in body mass index (BMI) and social support among these 1st to 3rd-grade students; however, there were differences in sports lifestyle and physical fitness index (PFI). Social support positively correlated with a sports lifestyle. There is no correlation between BMI and PFI. Social support influences the sports lifestyle of marine majors, which in turn affects BMI and PFI. Pleasure-type and fitness-type sports lifestyles serve as mediators between social support and PFI, while BMI is also a mediator between sports lifestyle and PFI. Social support affects the sports lifestyle of marine majors, which affects BMI and directly influences PFI.
Machine learning models for differential diagnosing HER2-low breast cancer: A radiomics approach
Authors: Chen Xianfei , Li Minghao , Su Danke
Published: August 2024

To develop machine learning models based on preoperative dynamic enhanced magnetic resonance imaging (DCE-MRI) radiomics and to explore their potential prognostic value in the differential diagnosis of human epidermal growth factor receptor 2 (HER2)-low from HER2-positive breast cancer (BC). A total of 233 patients with pathologically confirmed invasive breast cancer admitted to our hospital between January 2018 and December 2022 were included in this retrospective analysis. Of these, 103 cases were diagnosed as HER2-positive and 130 cases were HER2 low-expression BC. The Synthetic Minority Oversampling Technique is employed to address the class imbalance problem. Patients were randomly split into a training set (163 cases) and a validation set (70 cases) in a 7:3 ratio. Radiomics features from DCE-MRI second-phase imaging were extracted. Z-score normalization was used to standardize the radiomics features, and Pearson’s correlation coefficient and recursive feature elimination were used to explore the significant features. Prediction models were constructed using 6 machine learning algorithms: logistic regression, random forest, support vector machine, AdaBoost, decision tree, and auto-encoder. Receiver operating characteristic curves were constructed, and predictive models were evaluated according to the area under the curve (AUC), accuracy, sensitivity, and specificity. In the training set, the AUC, accuracy, sensitivity, and specificity of all models were 1.000. However, in the validation set, the auto-encoder model’s AUC, accuracy, sensitivity, and specificity were 0.994, 0.976, 0.972, and 0.978, respectively. The remaining models’ AUC, accuracy, sensitivity, and specificity were 1.000. The DeLong test showed no statistically significant differences between the machine learning models in the training and validation sets (Z = 0, P = 1). Our study investigated the feasibility of using DCE-MRI-based radiomics features to predict HER2-low BC. Certain radiomics features showed associations with HER2-low BC and may have predictive value. Machine learning prediction models developed using these radiomics features could be beneficial for distinguishing between HER2-low and HER2-positive BC. These noninvasive preoperative models have the potential to assist in clinical decision-making for HER2-low breast cancer, thereby advancing personalized clinical precision.