bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine learning applied in maternal and fetal health: a narrative review focused on pregnancy diseases and complications
Authors: Mennickent Daniela , Rodríguez Andrés , Opazo Ma. Cecilia , Riedel Claudia A. , Castro Erica , Eriz-Salinas Alma , Appel-Rubio Javiera , Aguayo Claudio , Damiano Alicia E. , Guzmán-Gutiérrez Enrique , Araya Juan
Published: May 2023

Introduction

Machine learning (ML) corresponds to a wide variety of methods that use mathematics, statistics and computational science to learn from multiple variables simultaneously. By means of pattern recognition, ML methods are able to find hidden correlations and accomplish accurate predictions regarding different conditions. ML has been successfully used to solve varied problems in different areas of science, such as psychology, economics, biology and chemistry. Therefore, we wondered how far it has penetrated into the field of obstetrics and gynecology.

Aim

To describe the state of art regarding the use of ML in the context of pregnancy diseases and complications.

Methodology

Publications were searched in PubMed, Web of Science and Google Scholar. Seven subjects of interest were considered: gestational diabetes mellitus, preeclampsia, perinatal death, spontaneous abortion, preterm birth, cesarean section, and fetal malformations.

Current state

ML has been widely applied in all the included subjects. Its uses are varied, the most common being the prediction of perinatal disorders. Other ML applications include (but are not restricted to) biomarker discovery, risk estimation, correlation assessment, pharmacological treatment prediction, drug screening, data acquisition and data extraction. Most of the reviewed articles were published in the last five years. The most employed ML methods in the field are non-linear. Except for logistic regression, linear methods are rarely used.

Future challenges

To improve data recording, storage and update in medical and research settings from different realities. To develop more accurate and understandable ML models using data from cutting-edge instruments. To carry out validation and impact analysis studies of currently existing high-accuracy ML models.

Conclusion

The use of ML in pregnancy diseases and complications is quite recent, and has increased over the last few years. The applications are varied and point not only to the diagnosis, but also to the management, treatment, and pathophysiological understanding of perinatal alterations. Facing the challenges that come with working with different types of data, the handling of increasingly large amounts of information, the development of emerging technologies, and the need of translational studies, it is expected that the use of ML continue growing in the field of obstetrics and gynecology.
First digital study of the frontal sinus of stem-Canini (Canidae, Carnivora): evolutionary and ecological insights throughout advanced diagnostic in paleobiology
Authors: Frosali Samuele , Bartolini-Lucenti Saverio , Madurell-Malapeira Joan , Urciuoli Alessandro , Costeur Loïc , Rook Lorenzo
Published: May 2023

Introduction

The phylogenetic and ecological importance of paranasal sinuses in carnivorans was highlighted by several previous authors, mostly in extant species. Nevertheless, no specific study on this feature on extant canids, and no one on fossil representatives of the family, has been published up to now. Here, we analyze for the first time the paranasal sinus of extant and fossil canids through computed tomographic techniques to characterize them morphologically and morphometrically, making ecological inferences.

Methods

To do so, we applied for the first time an innovative deformation-based morphometric approach.

Results

The results obtained for extant species highlight a remarkable correlation between morphology and ecomorphotypes previously defined by some scholars (namely hypercarnivorous group-hunters; small-prey hypercarnivores, mesocarnivores, hypocarnivores). Our results thus support the direct relationship between diet preferences and the development of frontal sinus in canids. Regarding fossil specimens, we reconstructed for the first time the frontal sinus of three Eucyon species and compared it to those of living forms.

Discussion

The best-preserved specimen, the only known cranium of Eucyon adoxus dated to the Late Pliocene of Saint-Estève (France), displayed similarities with hypercarnivorous group-hunter canids by the large sinus prominences. Given that the overall craniodental morphology of E. adoxus suggests that it acted as a small prey hypercarnivore—similar to extant Canis simensis—the aforementioned affinities might have evolved independently, in relation to high stresses during feeding. Overall, our study demonstrates that morphological inspection and deformation-based geometric morphometrics complement each other and allow a thorough investigation of sinus shape variability, thus enabling the study of sinus morphology in other fossil carnivorans with the ultimate goal of inferring their ecological preferences.
Quantitative assessment of hydrological response to vegetation change in the upper reaches of Luanhe River with the modified Budyko framework
Authors: Gao Huishan , Li Qingsong , Xiong Guangcheng , Li Baolu , Zhang Jincai , Meng Qingxiang
Published: May 2023

For assessing the influence of vegetation variation in upper reaches of Luanhe River (URLR) on streamflow, we first computed the equation between underlying surface parameter (ω) and the Normalized Difference Vegetation Index (NDVI). Then we introduced the vegetation information into the Budyko equation and established a modified Budyko equation. Finally, the impact of vegetation change on streamflow in URLR were estimated using the modified Budyko equation. Results showed that: (1) The NDVI in the URLR presented an increasing trend from 1982 to 2016, which is opposite to the runoff depth. The sudden change of NDVI occurred in 1998, and a simple linear model between ω and NDVI was obtained (p < 0.01). (2) The contribution rate of precipitation, potential evapotranspiration, NDVI, and anthropogenic factor on streamflow change during the changing period (1999–2016) are 44.99, 11.26, 29.45, and 17.30%, respectively. Although precipitation is still the main driver of runoff impact in the ULRB, with the increasing vegetation in the ULRB, vegetation has become the second driver of runoff impact followed by human activities and potential evapotranspiration. The mechanism of the effect of vegetation change on the water cycle needs to be further investigated. The results of this study can provide a theoretical basis for water use and conservation in the URLR.
Community-based forest management promotes survival-led livelihood diversification among forest-fringe communities in Uganda
Authors: Mawa Christopher , Tumusiime David Mwesigye , Babweteera Fred , Okwir Eric , Tabuti John Robert Stephen
Published: May 2023

Livelihood diversification is a prominent feature of rural households in developing countries. It is a strategy commonly pursued by households to enhance their resilience to shocks and/or risks that affect their livelihood. While a common characteristic of Uganda’s community-based forest management (CBFM) is the promotion of alternative livelihood activities to reduce household reliance on natural forest resources from gazetted forests, it is unclear how livelihood diversification has been embraced by households engaged in CBFM. We explore livelihood diversification using cross-sectional survey data collected from 423 households in villages adjacent to Collaborative Forest Management (CFM) compartments and non-CFM compartments of Budongo Central Forest Reserve as well as two Community Forests (CF) in mid-western Uganda. We quantified the levels of diversification and fitted a Gini-Simpson Diversity Index as the response variable in two Tobit regression models to examine the determinants of livelihood diversification among forest-fringe communities in CFM and CF sites. Our results reveal high levels of survival-led household livelihood diversification in the area, with an average household engaging in five livelihood activities that were predominantly on-farm or involved the extraction of forest products for subsistence. In the CFM sites, livelihood diversification levels significantly increased with household heads’ duration of residence in the village and membership in other social groups in the village. In villages adjacent to the community forests, only the household dependency ratio positively influenced household livelihood diversification. Membership in forest conservation groups did not significantly predict the level of household livelihood diversification. Given the current survival-led diversification that these communities pursue, we recommended that development and conservation agencies in the area and other similar sites of CBFM deliberately enhance household access to high-return on-farm and non-farm livelihood activities to achieve meaningful transformations in rural livelihoods.
High-throughput sequencing technology facilitates the discovery of novel biomarkers for antiphospholipid syndrome
Authors: Liu Qi , Yang Shuo , Tan Yuan , Cui Liyan
Published: May 2023

Antiphospholipid syndrome (APS) is characterized by arterial and venous thrombosis and/or morbid pregnancy, accompanied by persistent antiphospholipid antibody (aPL) positivity. However, due to the complex pathogenesis of APS and the large individual differences in the expression of aPL profiles of patients, the problem of APS diagnosis, prognosis judgment, and risk assessment may not be solved only from the antibody level. It is necessary to use new technologies and multiple dimensions to explore novel APS biomarkers. The application of next-generation sequencing (NGS) technology in diseases with a high incidence of somatic mutations, such as genetic diseases and tumors, has been very mature. Thus, we try to know the research and application progress of APS by NGS technology from genome, transcriptome, epigenome and other aspects. This review will describe the related research of NGS technology in APS and provide more reference for the deep understanding of APS-related screening markers and disease pathogenesis.
M-MDSC in vitro generation from mouse bone marrow with IL-3 reveals high expression and functional activity of arginase 1
Authors: Aintablian Arpa , Strozniak Sandra , Heuer Marion , Lutz Manfred B.
Published: May 2023

Myeloid-derived suppressor cells (MDSC) represent major regulators of immune responses, which can control T cells via their inducible nitric oxide synthase (iNOS)- and arginase 1 (Arg1)-mediated effector functions. While GM-CSF is well documented to promote MDSC development, little is known about this potential of IL-3, an established growth factor for mast cells. Here, we show that IL-3, similar to GM-CSF, generates monocytic MDSC (M-MDSC) from murine bone marrow (BM) cells after 3 days of in vitro culture. At this time point, predominantly CD11b+ CD49a+ monocytic and CD11b+ CD49a- FcεR I- neutrophilic cells were detectable, while CD11blow/neg FcεR I+ mast cells accumulated only after extended culture periods. Both growth factors were equivalent in generating M-MDSC with respect to phenotype, cell yield and typical surface markers. However, IL-3 generated M-MDSC produced less TNF, IL-1β and IL-10 after activation with LPS + IFN-γ but showed higher Arg1 expression compared to GM-CSF generated M-MDSC. Arg1 was further induced together with iNOS after MDSC activation. Accordingly, an increased Arg1-dependent suppressor activity by the IL-3 generated M-MDSC was observed using respective iNOS and Arg1 inhibitors. Together, these data indicate that M-MDSC can be generated in vitro by IL-3, similar to GM-CSF, but with increased Arg1 expression and Arg1-mediated suppression capacity. This protocol now allows further in vitro studies on the role of IL-3 for MDSC biology.
E. coli Nissle 1917 ameliorates mitochondrial injury of granulosa cells in polycystic ovary syndrome through promoting gut immune factor IL-22 via gut microbiota and microbial metabolism
Authors: Luo Man , Chen Yuanyuan , Pan Xiangyang , Chen Hongmei , Fan Lang , Wen Yi
Published: May 2023

Objective

Gut microbiota and its metabolites have regulatory effects on PCOS related ovarian dysfunction and insulin resistance. Escherichia coli Nissle 1917 (EcN) is a genetically controlled probiotic with an excellent human safety record for improving gut microbiome metabolic disorders and immune system disorders. Here we focused to explore the application and effect of probiotic EcN on the gut microbiota-metabolism-IL-22-mitochondrial damage axis in PCOS.

Methods

PCOS mice were constructed with dehydroepiandrosterone (DHEA) and treated with EcN, FMT or IL-22 inhibitors. Clinically control and PCOS subjects were included for further analysis. Serum and follicular fluid supernatant levels of sex hormones, insulin, glucose, cholesterol, and inflammatory factors were detected by ELISA and biochemical reagents. The pathological changes of ovarian tissues were observed by HE staining. The JC-1 level and COX4 gene expression in granulosa cells was detected by ELISA and RT-qPCR. The expressions of progesterone receptor A (PR-A), LC3II/I, Beclin1, p62 and CytC were detected by western blot. The number of autophagosomes in granulosa cells was observed by electron microscopy. 16S rRNA and LC-MS/MS were used to analyze the changes of gut microbiota and metabolism.

Results

EcN promoted the recovery of sex hormone levels and ovarian tissue morphology, promoted the expression of IL-22, COX4 and PR-A in granulosa cells, and inhibited mitophagy in PCOS mice. EcN decreased the number of gut microbiota, and significantly increased the abundance of Adlercreutzia, Allobaculum, Escherichia-Shigella and Ileibacterium in PCOS mice. EcN improved metabolic disorders in PCOS mice by improving Amino sugar and nucleotide sugar metabolism pathways. IL-22 was positively associated with Ileibacterium, Adlercreutzia and Progesterone, negatively associated with RF39, Luteinizing hormone, Testosterone, N−Acetylglucosamin, L−Fucose and N−Acetylmannosamin. FMT reconfirmed that EcN ameliorated mitochondrial damage in granulosa cells of PCOS mice by gut microbiota, but this process was blocked by IL-22 inhibitor. Clinical trials have further demonstrated reduced IL-22 levels and mitochondrial damage in granulosa cells in PCOS patients.

Conclusion

EcN improved IL-22 level and mitochondrial damage of granulosa cells in PCOS mice by promoting the recovery of sex hormone levels and ovarian tissue morphology, inhibiting the amount of gut microbiota, and promoting amino sugar and nucleotide sugar metabolism.
A single-cell RNA sequencing atlas of circulating leukocytes from healthy and osteosarcoma affected dogs
Authors: Ammons Dylan T. , Harris R. Adam , Hopkins Leone S. , Kurihara Jade , Weishaar Kristen , Dow Steven
Published: May 2023

Translationally relevant animal models are essential for the successful translation of basic science findings into clinical medicine. While rodent models are widely accessible, there are numerous limitations that prevent the extrapolation of findings to human medicine. One approach to overcome these limitations is to use animal models that are genetically diverse and naturally develop disease. For example, pet dogs spontaneously develop diseases that recapitulate the natural progression seen in humans and live in similar environments alongside humans. Thus, dogs represent a useful animal model for many areas of research. Despite the value of the canine model, species specific reagent limitations have hampered in depth characterization of canine immune cells, which constrains the conclusions that can be drawn from canine immunotherapy studies. To address this need, we used single-cell RNA sequencing to characterize the heterogeneity of circulating leukocytes in healthy dogs (n = 7) and osteosarcoma (OS) affected dogs (n = 10). We present a cellular atlas of leukocytes in healthy dogs, then employ the dataset to investigate the impact of primary OS tumors on the transcriptome of circulating leukocytes. We identified 36 unique cell populations amongst dog circulating leukocytes, with a remarkable amount of heterogeneity in CD4 T cell subtypes. In our comparison of healthy dogs and dogs with OS, we identified relative increases in the abundances of polymorphonuclear (PMN-) and monocytic (M-) myeloid-derived suppressor cells (MDSCs), as well as aberrations in gene expression within myeloid cells. Overall, this study provides a detailed atlas of canine leukocytes and investigates how the presence of osteosarcoma alters the transcriptional profiles of circulating immune cells.
Platelet-neutrophil interaction in COVID-19 and vaccine-induced thrombotic thrombocytopenia
Authors: Hirsch Johannes , Uzun Günalp , Zlamal Jan , Singh Anurag , Bakchoul Tamam
Published: May 2023

Coronavirus disease 2019 (COVID-19) is known to commonly induce a thrombotic diathesis, particularly in severely affected individuals. So far, this COVID-19-associated coagulopathy (CAC) has been partially explained by hyperactivated platelets as well as by the prothrombotic effects of neutrophil extracellular traps (NETs) released from neutrophils. However, precise insight into the bidirectional relationship between platelets and neutrophils in the pathophysiology of CAC still lags behind. Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare autoimmune disorder caused by auto-antibody formation in response to immunization with adenoviral vector vaccines. VITT is associated with life-threatening thromboembolic events and thus, high fatality rates. Our concept of the thrombophilia observed in VITT is relatively new, hence a better understanding could help in the management of such patients with the potential to also prevent VITT. In this review we aim to summarize the current knowledge on platelet-neutrophil interplay in COVID-19 and VITT.
Enhancing immune protection against MERS-CoV: the synergistic effect of proteolytic cleavage sites and the fusion peptide and RBD domain targeting VLP immunization
Authors: Oh Jeein , Park Uni , Kim Juhyung , Jeon Kyeongseok , Kim Chulwoo , Cho Nam-Hyuk , Choi Youn Soo
Published: May 2023

Introduction

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a zoonotic infectious virus that has caused significant outbreaks in the Middle East and beyond. Due to a highly mortality rate, easy transmission, and rapid spread of the MERS-CoV, it remains as a significant public health treat. There is currently no licensed vaccine available to protect against MERS-CoV.

Methods

In this study, we investigated whether the proteolytic cleavage sites and fusion peptide domain of the MERS-CoV spike (S) protein could be a vaccine target to elicit the MERS-CoV S protein-specific antibody responses and confer immune protection against MERS-CoV infection. Our results demonstrate that immunization of the proteolytic cleavage sites and the fusion peptide domain using virus-like particle (VLP) induced the MERS-CoV S protein-specific IgG antibodies with capacity to neutralize pseudotyped MERS-CoV infection in vitro. Moreover, proteolytic cleavage sites and the fusion peptide VLP immunization showed a synergistic effect on the immune protection against MERS-CoV infection elicited by immunization with VLP expressing the receptor binding domain (RBD) of the S protein. Additionally, immune evasion of MERS-CoV RBD variants from anti-RBD sera was significantly controlled by anti-proteolytic cleavage sites and the fusion peptide sera.

Conclusion and discussion

Our study demonstrates the potential of VLP immunization targeting the proteolytic cleavage sites and the fusion peptide and RBD domains of the MERS-CoV S protein for the development of effective treatments and vaccines against MERS-CoV and related variants.
Study protocol: Phase I/II trial of induced HLA-G+ regulatory T cells in patients undergoing allogeneic hematopoietic cell transplantation from an HLA-matched sibling donor
Authors: Lysandrou Memnon , Kefala Dionysia , Christofi Panayiota , Savvopoulos Nikolaos , Papayanni Penelope Georgia , Theodorellou Rodanthy , Sagiadinou Eleftheria , Zacharioudaki Vassiliki , Moukouli Maria , Tsokanas Dimitrios , Karavalakis Georgios , Liga Maria , Stavrinos Konstantinos , Papadopoulou Anastasia , Yannaki Evangelia , Spyridonidis Alexandros
Published: May 2023

Regulatory T-cell (Treg) immunotherapy has emerged as a promising and highly effective strategy to combat graft-versus-host disease (GvHD) after allogeneic hematopoietic cell transplantation (allo-HCT). Both naturally occurring Treg and induced Treg populations have been successfully evaluated in trials illustrating the feasibility, safety, and efficacy required for clinical translation. Using a non-mobilized leukapheresis, we have developed a good manufacturing practice (GMP)-compatible induced Treg product, termed iG-Tregs, that is enriched in cells expressing the potent immunosuppressive human leucocyte antigen-G molecule (HLA-G+). To assess the safety and the maximum tolerable dose (MTD) of iG-Tregs, we conduct a phase I–II, two-center, interventional, dose escalation (3 + 3 design), open-label study in adult patients undergoing allo-HCT from an HLA-matched sibling donor, which serves also as the donor for iG-Treg manufacturing. Herein, we present the clinical protocol with a detailed description of the study rationale and design as well as thoroughly explain every step from patient screening, product manufacturing, infusion, and participant follow-up to data collection, management, and analysis (registered EUDRACT-2021-006367-26).
A multicenter study on the quantification of liver iron concentration in thalassemia patients by means of the MRI T2* technique
Authors: Xu Fengming , Peng Yuzhao , Xie Hanhong , Liang Bumin , Yang Gaohui , Zhao Fanyu , Liu Yu , Peng Peng
Published: May 2023

Objective

To investigate the feasibility and accuracy of quantifying liver iron concentration (LIC) in patients with thalassemia (TM) using 1.5T and 3T T2* MRI.

Methods

1.5T MRI T2* values were measured in 391 TM patients from three medical centers: the T2* values of the test group were combined with the LIC (LICF) provided by FerriScan to construct the curve equation. In addition, the liver 3T MRI liver T2* data of 55 TM patients were measured as the 3T group: the curve equation of 3T T2* value and LICF was constructed.

Results

Based on the test group LICF (0.6–43 mg/g dw) and the corresponding 1.5T T2* value, the equation was LICF = 37.393T2*∧(−1.22) (R2 = 0.971; P < 0.001). There was no significant difference between LICe − 1.5T and LICF in each validation group (Z = −1.269, −0.977, −1.197; P = 0.204, 0.328, 0.231). There was significant consistency (Kendall's W = 0.991, 0.985, 0.980; all P < 0.001) and high correlation (rs = 0.983, 0.971, 0.960; all P < 0.001) between the two methods. There was no significant difference between the clinical grading results of LICe − 1.5T and LICF in each validation group (χ2 = 3.0, 4.0, 2.0; P = 0.083, 0.135, 0.157), and there was significant consistency between the clinical grading results (Kappa's K = 0.943, 0.891, 0.953; P < 0.001). There was no statistical correlation between the LICF (≥14 mg/g dw) and the 3T T2* value of severe iron overload (P = 0.085). The LICF (2–14 mg/g dw) in mild and moderate iron overload was significantly correlated with the corresponding T2* value (rs = −0.940; P < 0.001). The curve equation constructed from LICF and corresponding 3T T2* values in this range is LICF = 18.463T2*∧(−1.142) (R2 = 0.889; P < 0.001). There was no significant difference between LICF and LICe − 3T in the mild to moderate range (Z = −0.523; P = 0.601), and there was a significant correlation (rs = 0.940; P < 0.001) and significant consistency (Kendall's W = 0.970; P = 0.008) between them. LICe − 3T had high diagnostic efficiency in the diagnosis of severe, moderate, and mild liver iron overload (specificity = 1.000, 0.909; sensitivity = 0.972, 1.000).

Conclusion

The liver iron concentration can be accurately quantified based on the 1.5T T2* value of the liver and the specific LIC-T2* curve equation. 3T T2* technology can accurately quantify mild-to-moderate LIC, but it is not recommended to use 3T T2* technology to quantify higher iron concentrations.
Targeting heparan sulfate-protein interactions with oligosaccharides and monoclonal antibodies
Authors: Li Miaomiao , Pedersen Lars C. , Xu Ding
Published: May 2023

Heparan sulfate-binding proteins (HSBPs) are structurally diverse extracellular and membrane attached proteins that interact with HS under normal physiological conditions. Interactions with HS offer an additional level of control over the localization and function of HSBPs, which enables them to behave in a more refined manner. Because all cell signaling events start at the cell membrane, and cell-cell communication relies on translocation of soluble factors across the extracellular matrix, HS occupies an apical position in cellular signal transduction by interacting with hundreds of growth factors, cytokines, chemokines, enzymes, enzyme inhibitors, receptors and adhesion molecules. These extracellular and membrane proteins can play important roles in physiological and pathological conditions. For most HS-binding proteins, the interaction with HS represents an essential element in regulating their normal physiological functions. Such dependence on HS suggests that manipulating HS-protein interactions could be explored as a therapeutic strategy to selectively antagonize/activate HS-binding proteins. In this review, we will discuss current understanding of the diverse nature of HS-HSBP interactions, and the latest advancements in targeting the HS-binding site of HSBPs using structurally-defined HS oligosaccharides and monoclonal antibodies.
The impact of wearing a KN95 face mask on human brain function: evidence from resting state functional magnetic resonance imaging
Authors: Wu Xiaomeng , Ma Lifei , Yin Qiufeng , Liu Ming , Wu Kyle , Wang Dengbin
Published: May 2023

Background

Face masks are widely used in daily life because of the COVID-19 pandemic. The objective of this study was to explore the impact of wearing face masks on brain functions by using resting-state functional MRI (RS-fMRI).

Methods

Scanning data from 15 healthy subjects (46.20 ± 6.67 years) were collected in this study. Each subject underwent RS-fMRI scans under two comparative conditions, wearing a KN95 mask and natural breathing (no mask). The amplitude of low frequency fluctuation (ALFF) and functional connectivity under the two conditions were analyzed and then compared using the paired t-test.

Results

Compared with those of the no-mask condition, the ALFF activities when wearing masks were increased significantly in the right middle frontal gyrus, bilateral precuneus, right superior marginal gyrus, left inferior parietal gyrus, and left supplementary motor area and decreased significantly in the anterior cingulate gyrus, right fusiform gyrus, left superior temporal gyrus, bilateral lingual gyrus, and bilateral calcarine cortex (p < 0.05). Taking the posterior cingulate cortex area as a seed point, the correlations with the occipital cortex, prefrontal lobe, and motor sensory cortex were sensitive to wearing masks compared with not wearing masks (p < 0.05). Taking the medial prefrontal cortex region as a seed point, the functional connectivity with the bilateral temporal lobe, bilateral motor sensory cortex, and occipital lobe was influenced by wearing a KN95 mask (p < 0.05).

Conclusion

This study demonstrated that wearing a KN95 face mask can cause short-term changes in human resting brain function. Both local neural activities and functional connectivity in brain regions were sensitive to mask wearing. However, the neural mechanism causing these changes and its impact on cognitive function still need further investigation.
Progress in the clinical application of constraint-induced therapy following stroke since 2014
Authors: Cui Yinxing , Ma Ningyi , Liu Xuncan , Lian Yawen , Li Yinghua , Xu Guoxing , Zhang Jiaming , Li Zhenlan
Published: May 2023

Stroke is a group of cerebrovascular diseases with high prevalence and mortality rate. Stroke can induce many impairments, including motor and cognitive dysfunction, aphasia/dysarthria, dysphagia, and mood disorders, which may reduce the quality of life among the patients. Constraint-induced therapy has been proven to be an effective treatment method for stroke rehabilitation. It has been widely used in the recovery of limb motor dysfunction, aphasia, and other impairment like unilateral neglect after stroke. In recent years, constraint-induced therapy can also combine with telehealth and home rehabilitation. In addition, constraint-induced therapy produces significant neuroplastic changes in the central nervous system. Functional magnetic resonance imaging, diffusion tensor imaging, and other imaging/electrophysiology methods have been used to clarify the mechanism and neuroplasticity. However, constraint-induced therapy has some limitations. It can only be used under certain conditions, and the treatment time and effectiveness are controversial. Further research is needed to clarify the mechanism and effectiveness of CI therapy.
Advanced central nervous system imaging biomarkers in radiologically isolated syndrome: a mini review
Authors: Collorone Sara , Foster Michael A. , Toosy Ahmed T.
Published: May 2023

Radiologically isolated syndrome is characterised by central nervous system white-matter hyperintensities highly suggestive of multiple sclerosis in individuals without a neurological history of clinical demyelinating episodes. It probably represents the pre-symptomatic phase of clinical multiple sclerosis but is poorly understood. This mini review summarises our current knowledge regarding advanced imaging techniques in radiologically isolated syndrome that provide insights into its pathobiology and prognosis. The imaging covered will include magnetic resonance imaging-derived markers of central nervous system volumetrics, connectivity, and the central vein sign, alongside optical coherence tomography-related metrics.
Case Report: A tortuous diagnosis and successful multimodal treatment of thyroid follicular carcinoma with pelvic metastasis
Authors: Hong Zhi-Liang , Huang Hai-Jian , Chen Sheng , Yang Jian-Chuan , Wu Song-Song
Published: May 2023

Purpose

To provide reference method for the treatment of thyroid follicular carcinoma by studing the clinical imaging, pathological features and multimodal treatment of a case of thyroid follicular carcinoma with bone metastasis.

Methods

By identifying the case’s clinical, imaging, pathological features of a case of thyroid follicular carcinoma with bone metastasis, reflecting on the case’s diagnosis and treatment process, and referring to literature about the characteristics of thyroid follicular carcinoma, the study aims to provide reference for the treatment of this kind of disease.

Result

A 67-year-old male patient was admitted to the hospital with clinical symptoms of left pelvic pain. The biopsy pathology showed well-differentiated thyroid tissue. Considering his medical history, conclusion of thyroid follicular carcinoma metastasis could be made.The patient was stable and no tumor progression was observed after a combination of therapies including 131I and topical and targeted agents.

Conclusions

Thyroid follicular carcinoma are prone to bone metastasis, and bone metastasis is the first symptom in some cases. Clinical imaging and pathology are needed for correct diagnosis, and a successful treatment requires a combination of multiple approaches including 131I, which is a Radioactive Iodine Therapy(RAI), local therapy and targeted drug therapy.
Hybrid endoscopic-microscopic surgery for dumbbell-shaped trigeminal schwannoma: case report and literature review
Authors: Li Xinning , Han Song , Sun Xiaoyu , Bai Yang , Zhang Qiyan , Feng Sizhe , Liang Guobiao
Published: May 2023

Background

The surgery of dumbbell-shaped trigeminal neurinomas (TN) remains one of the most formidable challenges for neurosurgeons because of its location at great depth in the cranium and proximity to vital neurovascular structures.

Objective

To describe the feasibility of a novel technique, synchronous endoscopy and microsurgery via combined far-lateral supracerebellar-infratentorial and subtemporal approach, for resection of this rare entity.

Methods

A 53-year-old women presented with progressive left facial numbness for 2 months. Imaging examinations revealed a left-sided dumbbell-shaped TN afflicting the middle and posterior cranial fossa, and a single-stage combined multiportal endoscopic microscopic approach was attempted for tumor resection. Initially, a purely endoscopic far-lateral supracerebellar-infratentorial approach was used to remove the posterior fossa component with the aid of tentorium incision. Subsequently, a microsurgical subtemporal interdural approach was performed for the exposure and separation of tumor within the Meckel cave. Finally, the tumor was pushed into the porus trigeminus under microscopy, thus enabling tumor extraction for the supracerebellar space under endoscopy without anterior petrosectomy.

Results

The patient evolved favorably without additional neurological deficit after surgery, and postoperative imaging showed a complete resection of the tumor.

Conclusion

We describe the first account of multi-corridor hybrid surgery for removal of TN in a dumbbell configuration, which enables one-stage total tumor removal with minimal added morbidity. This hybrid technique may be an effective piece of the surgeon’s armamentarium to improve outcomes of patient with complex skull-base lesions. Further studies with larger case numbers are warranted to confirm the prognostic significance of this technique.
Intraductal papillary neoplasm of the bile duct presenting with hepatogastric fistula: a case report and literature review
Authors: Chan Wen-Hui , Chen Chien-Ming , Wang Shang-Yu , Wu Ren-Chin , Chen Tse-Ching , Lee Hao-Kang , Lin Cheng-Hui , Yeh Chun-Nan
Published: May 2023

Intraductal papillary neoplasm of the bile duct (IPNB) is an uncommon entity characterized by papillary growth within the bile duct lumen. IPNB is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm of the pancreas, which sometimes complicates with fistula formation to adjacent organs, mainly due to high-pressure related erosion from mucin-filled ducts. However, fistula formation from IPNB is quite rare. Here we report a case of IPNB complicated with hepatogastric fistula. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) revealed disproportional dilatation of left intrahepatic duct with intraluminal soft tissue nodules and fistulous connections to gastric high body. Endoscopy revealed ulcers with two fistulous orifices at upper gastric body. The patient underwent left hepatectomy with gastric wedge resection. Histopathology examination revealed IPNB with invasive cholangiocarcinoma, directly invading to gastric wall leading to hepatogastric fistula. In summary, we have presented the clinical, imaging and pathological findings, along with a comprehensive review of relevant literature, in order to enhance the understanding of this rare condition.
Comparison of long-term quality of life based on surgical procedure in patients with rectal cancer
Authors: Yuge Kotaro , Miwa Keisuke , Fujita Fumihiko , Murotani Kenta , Shigaki Takahiro , Yoshida Naohiro , Yoshida Takefumi , Koushi Kenichi , Fujiyoshi Kenji , Nagasu Sachiko , Akagi Yoshito
Published: May 2023

Introduction

Reports on the long-term quality of life (QOL) over 3 years after surgery in patients who have undergone surgery for rectal cancer are limited. Therefore, we aimed to evaluate the long-term QOL of patients who underwent high anterior resection (HAR), low anterior resection (LAR), internal sphincter resection (ISR), or abdominoperineal resection (APR) for rectal cancer.

Methods

A questionnaire regarding QOL was sent to 360 patients with rectal cancer who underwent curative resection by HAR, LAR, ISR, or APR between January 2005 and December 2015. QOL was assessed using the short-form 36 (SF-36) and modified fecal incontinence QOL (mFIQL) questionnaire. QOL between surgical procedures was analyzed using a multivariate model adjusted for age, sex, and postoperative time.

Results

A total of 144 patients responded with a median follow-up period of 94 months (range 38–233 months). According to surgical procedure, HAR was performed in 26 patients, LAR in 80 patients, ISR in 32 patients, and APR in 6 patients. Patients who underwent HAR had significantly better mFIQL scores than those who underwent LAR and ISR (p=0.013 and p=0004, respectively) and significantly better role/social component summary scores on the SF-36 subscales (p=0.007). No difference was observed in the mFIQL scores between patients who underwent ISR and those who underwent APR (p=0.8423). In addition, postoperative anastomotic leakage sutures did not influence the mFIQL and SF-36 scores after surgery.

Conclusion

The QOL of patients who underwent anus-preserving surgery was best in the HAR group, with the QOL of other groups similar to the APR group. These results suggest that anus- preserving surgery is acceptable from a QOL standpoint. However, a colostomy may be a more satisfactory procedure in some patients.
Transanal drainage tube for the prevention of anastomotic leakage after rectal cancer surgery: a meta−analysis of randomized controlled trials
Authors: Xia Shijun , Wu Wenjiang , Ma Lijuan , Luo Lidan , Yu Linchong , Li Yue
Published: May 2023

Background

Anastomotic leakage (AL) is a serious complication of anterior resection for rectal cancer. The use of transanal drainage tubes (TDT) during surgery to prevent AL remains controversial. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the efficacy of TDT in reducing AL.

Methods

Relevant data and studies published from inception until November 1, 2022, were retrieved from PubMed, Embase, and Cochrane Library databases to compare the incidence of AL after anterior resection for rectal cancer with and without TDT.

Results

This meta-analysis included 5 RCTs comprising 1385 patients. The results showed that the intraoperative use of TDT could not reduce the incidence of AL after rectal cancer surgery (risk ratio [RR], 0.91; 95% confidence interval [CI], 0.52–1.59; p = 0.75). A subgroup analysis of different degrees of AL revealed that TDT did not reduce the incidence of postoperative grade B AL (RR, 1.18; 95% CI, 0.67–2.09; p = 0.56) but decreased the incidence of grade C AL (RR, 0.28; 95% CI: 0.12–0.64; p = 0.003). Further, TDT did not reduce the incidence of AL in patients with rectal cancer and a stoma (RR, 2.40; 95% CI, 1.01–5.71; p = 0.05).

Conclusion

TDT were ineffective in reducing the overall incidence of AL, but they might be beneficial in reducing the incidence of grade C AL in patients who underwent anterior resection. However, additional multicenter RCTs with larger sample sizes based on unified control standards and TDT indications are warranted to validate these findings.
Impact of Atypical Hyperplasia at Surgical Margins on breast cancer outcomes in patients treated with neoadjuvant chemotherapy
Authors: Su An , Zhang Jing , Liu Jieqiong , Yang Yaping , He Zhou , Bao Haoshi , Deng Heran , Wu Jiannan
Published: May 2023

Background

Women with atypical hyperplasia (AH) is associated with a higher risk of future breast cancer. However, whether AH found at margins in patients with breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) needs re-excision is not well-defined. The aim of the present study was to evaluate the impact of AH at the surgical margins on the local recurrence and survival outcomes in breast cancer patients treated with NAC and BCS.

Methods

A retrospective analysis comparing patients who treated with NAC and BCS with AH at the margins to those without AH was performed.

Results

598 patients were included in this study. The 5-year rates of ipsilateral breast tumor recurrence (IBTR) were 4.6% and 6.2% in patients with and without AH, respectively. No significant differences were observed among the two groups in terms of IBTR, DMFS, or OS. HER2 overexpressing breast cancer patients with severe AH at margins have a significantly higher risk of IBTR compared to those without severe AH.

Conclusion

Our study suggests that the presence of AH at the surgical margins of BCS in patients who received NAC does not appear to increase the risk of ipsilateral breast cancer. Therefore, there is no need for surgeons to routinely perform additional re-excision of AH found at the margins of BCS in these patients. However, selective re-excision should be considered in certain cases, particularly in patients with HER2 overexpression.
Failure pattern and radiotherapy exploration in malignant pleural effusion non-small cell lung cancer treated with targeted therapy
Authors: Li Qingsong , Hu Cheng , Su Shengfa , Ma Zhu , Geng Yichao , Hu Yinxiang , Li Huiqin , Lu Bing
Published: May 2023

Purpose

Actionable mutations are common in non-small cell lung cancer(NSCLC)with malignant pleural effusion(MPE)(MPE-NSCLC). The pattern of failure in MPE-NSCLC treated with targeted therapy after MPE control remains unclear. We aimed to investigate the failure pattern of such patients in a cohort study and explore the possibility of radiotherapy.

Patients and methods

Computed tomography scans of 86 patients were reviewed in this study. We classified first pattern of failure after MPE control as initial disease sites only (IF), new distant sites only (NF), or IF and NF detected simultaneously (INF). Patients evaluated suitable for radiotherapy after disease progression were divided into two groups: D group without radiotherapy and RD group with radiotherapy. The Kaplan-Meier method and log-rank test were used for survival analyses.

Results

Disease progression after MPE control was observed in 42 patients with complete serial imaging. Median time to any progression was 9.5 months. Rate of the IF, NF and INF were 50%, 17% and 33% for all patients,60%,0% and 40% for patients with MPE recurrence (n=10,23.8%) and 47%, 22% and 31% for patients (n=32,76.2%) without MPE recurrence, respectively. Out of 10 patients(23.8%) with MPE recurrence, 7 patients simultaneous underwent primary tumor progression and 5 MPE were cytologically confirmed in 7 patients with examination. The overall survival (OS )rates at 1, 2, 3 years for the RD group and D group were 88.2%, 50.5%, 21.7% and 80.0%, 20.3%, 0%, respectively; the corresponding MST were 26.1 months and 17.5 months, respectively (χ2 = 4.959, p =0.026)

Conclusions

Our data indicates that 50% of patients with actionable mutations MPE- NSCLC after MPE control are likely to fail at their initial sites of disease and the use of radiotherapy may bring OS benefits during the course of their disease. Multicenter RCT is necessary to confirm the result in the future.
Cord blood fatty acid binding protein 4 and lipids in infants born small- or large-for-gestational-age
Authors: Liu Xin , Zheng Tao , Tao Min-Yi , Huang Rong , Zhang Guang-Hui , Yang Meng-Nan , Xu Ya-Jie , Wang Wen-Juan , He Hua , Fang Fang , Dong Yu , Fan Jian-Gao , Zhang Jun , Ouyang Fengxiu , Li Fei , Luo Zhong-Cheng
Published: May 2023

Aim

Adverse (poor or excessive) fetal growth “programs” an elevated risk of type 2 diabetes. Fatty acid binding protein 4 (FABP4) has been implicated in regulating insulin sensitivity and lipid metabolism relevant to fetal growth. We sought to determine whether FABP4 is associated with poor or excessive fetal growth and fetal lipids.

Methods

In a nested case-control study in the Shanghai Birth Cohort including 60 trios of small-for-gestational-age (SGA, an indicator of poor fetal growth), large-for-gestational-age (LGA, an indicator of excessive fetal growth) and optimal-for-gestational-age (OGA, control) infants, we measured cord blood concentrations of FABP4 and lipids [high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterols, triglycerides (TG)].

Results

Adjusting for maternal and neonatal characteristics, higher cord blood FABP4 concentrations were associated with a lower odds of SGA [OR = 0.29 (0.11–0.77) per log unit increment in FABP4, P = 0.01], but were not associated with LGA (P = 0.46). Cord blood FABP4 was positively correlated with both LDL (r = 0.29, P = 0.025) and HDL (r = 0.33, P = 0.01) in LGA infants only.

Conclusion

FABP4 was inversely associated with the risk of SGA. The study is the first to demonstrate LGA-specific positive correlations of cord blood FABP4 with HDL and LDL cholesterols, suggesting a role of FABP4 in fetal lipid metabolism in subjects with excessive fetal growth.
ANCA vasculitis expands the spectrum of autoimmune manifestations of activated PI3 kinase δ syndrome
Authors: Sood Amika K. , Francis Olivia , Schworer Stephen A. , Johnson Steven M. , Smith Benjamin D. , Googe Paul B. , Wu Eveline Y.
Published: May 2023

Activated phosphoinositide 3-kinase δ syndrome (APDS) is a combined immunodeficiency with a broad clinical phenotype, including not only an increased propensity for sinopulmonary and herpesviruses infections but also immune dysregulation, such as benign lymphoproliferation, autoimmunity, and malignancy. Autoimmune complications are increasingly recognized as initial presenting features of immune dysregulation in inborn errors of immunity (IEIs), including APDS, so awareness of the spectrum of autoimmune features inherit within these disorders is critical. We present here a patient vignette to highlight cutaneous antineutrophil cytoplasmic antibody (ANCA) vasculitis as an underrecognized autoimmune manifestation of APDS. The genetic defects underlying APDS result in increased PI3Kδ signaling with aberrant downstream signaling pathways and loss of B- and/or T-cell immunologic tolerance mechanisms, which promote the development of autoimmunity. An understanding of the molecular pathways and mechanisms that lead to immune dysregulation in APDS has allowed for significant advancements in the development of precision-medicine therapeutics, such as leniolisib, to reduce the morbidity and mortality for these patients. Overall, this case and review highlight the need to maintain a high index of suspicion for IEIs, such as APDS, in those presenting with autoimmunity in combination with a dysregulated immune phenotype for prompt diagnosis and targeted intervention.