bluuebunny/crossref_metadata_2025 huggingface dataset:
72248 - Searching for biochemical peripheral markers of primary aldosteronism
Authors: Makhnov Nikita , Axling Fredrik , Barazeghi Elham , Åkerström Tobias , Hellman Per
Published: August 2024

Introduction

Primary aldosteronism (PA) is common, clinically elusive, and causes considerable morbidity and mortality. The current praxis of diagnosing PA is cumbersome, invasive, and depends on arbitrary thresholds. Very few cases are clinically discovered; new diagnostic methods are needed.

Method

Hypertensive patients were evaluated for PA in accordance with the current guidelines. Those diagnosed with PA underwent adrenal vein catheterization and/or adrenocortical positron emission tomography. Three groups were included: primary hypertension (HT), lateralized or unilateral PA (uPA), and bilateral PA (bPA).

Serum from 11 HT, 16 uPA, and 12 bPA patients was subjected to microRNA extraction and sequencing.

Serum from 29 HT, 26 uPA, and 29 bPA was subjected to a proximity extension assay on a cardiometabolic 384 protein panel (Olink® Explore 384).

Result

Several differentially expressed miRNAs were identified between the groups HT versus PA, but also uPA versus bPA. To validate our results in an external cohort, a machine learning model was developed and applied to an earlier published primary aldosteronism dataset (Decmann et al., 2019). This model could discriminate uPA from bPA successfully in 83% of the cases.

Numerous significantly different proteins were observed between the groups. Interestingly, one of the coagulation factors had a distinct elevated expression in both uPA and bPA versus HT, which could be confirmed by an ELISA assay. Validation using an external cohort is underway.

Discussion

Further studies of serum biomarkers as a tool for identifying PA and discriminating between uPA and bPA may aid in the diagnosis and subsequently improve the treatment outcomes of PA.
Note on International Protection
Authors:   Note by the High Commissioner
Published: August 2024

Three-quarters of a century since the Universal Declaration of Human Rights was adopted, the right to seek and enjoy asylum, enshrined in article 14 and one of the earliest human rights principles, remains elusive for many people who are forced to flee conflict and persecution. This note examines the progress made in securing the rights of refugees, asylum-seekers, returnees, internally displaced persons and stateless people, as well as the significant obstacles encountered, covering the period from July 2022 to June 2023. It analyses the protection landscape, including in forgotten crises and protracted situations of displacement, while highlighting efforts to facilitate solutions for the displaced.

The note describes the complementary efforts of the Office of the United Nations High Commissioner for Refugees and partners to strengthen responses to mixed movements of refugees and migrants, in support of the implementation of the Global Compact on Refugees and the Global Compact for Safe, Orderly and Regular Migration. It calls on States and all stakeholders to prepare concrete and meaningful pledges towards the 2023 Global Refugee Forum, unlocking opportunities for inclusion, development, education and other key areas that require support and investment. It also outlines the needs of people at heightened risk, including those with disabilities, women and children, and survivors of gender-based violence.

The note concludes that too many displaced and stateless people are unable to enjoy their rights and that UNHCR, governments and partners need to redouble efforts, working together with displaced and stateless people, to realize them in practice.
The Dilemma of Justice: The International Criminal Court’s Political Maneuver
Authors: Besmel Parwez
Published: August 2024

ABSTRACT∞

This article explores the perspectives of Afghan human rights advocates and academics on transitional justice, focused on the conundrum of the International Criminal Court (ICC) to investigate war crimes and crimes against humanity in Afghanistan. As a judicial entity, the ICC operates in a political environment. The tug of war of the ICC concerning what party to investigate is a testiment to this claim. In a recent twist, the new prosecutor, Karim Khan, issued a statement that his office would focus on crimes perpetrated by the Taliban and the Islamic State Khorasan Province, thus deprioritizing other parties, including the Afghan national security forces and the US military, that were determined by his predecessor. The Afghan human rights advocates and academics, while supporting accountability, criticize selective justice. The nature of war, the US–Taliban peace deal in 2020 and the collapse of the Afghan government in 2021 have furthered the dilemma of justice.
How Did COVID-19 Change the Delivery of Embedded Mental Health Services for U.S. Air Force Airmen? A Qualitative Look
Authors: Galloway Kristin L , Martinez Rachael N
Published: August 2024

Introduction

The coronavirus disease 2019 (COVID-19) pandemic, in addition to increased mental health difficulties for society as a whole, brought unique challenges and opportunities to mental health professionals attempting to address the issues under public health limitations. Occupationally embedded mental health professionals were uniquely challenged in quickly and creatively adjusting to physical quarantining and working from home. The purpose of this study was to inquire about and categorize the experiences of embedded mental health professionals and their clients in U.S. Air Force (USAF) operational units.

Methods

We conducted a qualitative analysis of semi-structured interviews with 26 embedded mental health professionals across 24 USAF installations and 15 Airmen clients from 5 of those installations. Their experiences within the pandemic context were systemically categorized into actionable themes through thematic content analysis.

Results

U.S. Air Force embedded mental health professionals and Airmen primarily identified the challenges of staying engaged when not face-to-face, higher incidence of mental health problems, decreased availability of clinical care and other support resources, technology as a face-to-face substitute, managing safety measures, delayed initiatives, and clinical boundary setting. Alternatively, embedded mental health professionals and Airmen identified strategies to alleviate pandemic limitations, such as using technology to interact, COVID-19 mitigating actions, developing initiatives to target their population needs, and using opportunities to help reduce stigma associated with seeking help for mental health.
The Relationship Between Physical Activity Profiles and Cardiovascular Disease Risk Factors: Results of a Cross-Sectional Survey of Active Duty U.S. Service Members
Authors: Dawood Jimmy , Mancuso James D , Chu Kasi , Ottolini Martin , Ahmed Anwar E
Published: August 2024

Introduction

This study aimed to identify subgroups of active duty U.S. service members (ADSMs) based on physical activity levels and their association with cardiovascular disease (CVD) risk factors. Our secondary aim was to assess how these profiles vary across sociodemographic factors.

Methods

A cross-sectional survey of ADSMs, yielding a 9.6% response rate and 17,166 usable surveys, was conducted by the DoD and RAND Corporation in 2018 using stratified random sampling. In this secondary analysis, latent subgroups of ADSMs were determined based on physical activity levels and a weighted multinomial logistic regression was used to examine associations.

Results

Three latent subgroups were identified as “High Activity” (17.1%), “Moderate Activity” (45.3%), and “Low Active” (37.6%). Older age, female, White (as compared to Hispanic), cohabiting, Air Force, Navy, and Coast Guard were associated with increased odds of “Low Active” membership. Compared to the “Low Active” class, the “High Active” class showed lower odds of hyperlipidemia (aOR = 0.62, 95% CI: 0.38, 0.99), hypertension (aOR = 0.69, 95% CI: 0.48, 0.98), and multimorbidity (aOR = 0.55, 95% CI: 0.38, 0.80). Compared to the “Low Active” class, the “Moderate Active” class showed lower odds of hyperlipidemia (aOR = 0.62, 95% CI: 0.47, 0.81) and multimorbidity (aOR = 0.66, 95% CI: 0.53, 0.83). Similar patterns of associations were seen in ADSMs who met the objectives for Healthy People 2030 (HP2030) standards.

Conclusions

The study emphasizes the importance of combining physical activity and strength training to reduce CVD risk factors, supporting the implementation of tailored physical activity programs within the military to align fitness standards.
An Implementation of Nuclear Many-Body Wave Functions by the Superposition of Localized Gaussians
Authors: Kimura Masaaki , Taniguchi Yasutaka
Published: August 2024

We introduce a new framework for the nuclear structure calculations, which describes the single-particle wave function as a superposition of localized Gaussians. It is a hybrid of the Hartree–Fock and antisymmetrized molecular dynamics (AMD) models. In the numerical calculations of oxygen, calcium isotopes, and $^{100}{\rm Sn}$, the framework shows its potential by significantly improving upon AMD and yielding results that are consistent with or even better than Hartree–Fock(–Bogoliubov) calculations based on harmonic oscillator expansions. In addition to the basic equations, general forms of the matrix elements are also given.
NDV targets the invasion pathway in malaria parasite through cell surface sialic acid interaction
Authors: Neog Siddharth , Vinjamuri Sandeep Reddy , Vijayan Kamalakannan , Kumar Sachin , Trivedi Vishal
Published: August 2024

Merozoites utilize sialic acids on the red blood cell (RBC) cell surface to rapidly adhere to and invade the RBCs. Newcastle disease virus (NDV) displays a strong affinity toward membrane‐bound sialic acids. Incubation of NDV with the malaria parasites dose‐dependently reduces its cellular viability. The antiplasmodial activity of NDV is specific, as incubation with Japanese encephalitis virus, duck enteritis virus, infectious bronchitis virus, and influenza virus did not affect the parasite propagation. Interestingly, NDV is reducing more than 80% invasion when RBCs are pretreated with the virus. Removal of the RBC surface proteins or the NDV coat proteins results in disruption of the virus binding to RBC. It suggests the involvement of specific protein: ligand interaction in virus binding. We established that the virus engages with the parasitized RBCs (PRBCs) through its hemagglutinin neuraminidase (HN) protein by recognizing sialic acid‐containing glycoproteins on the cell surface. Blocking of the HN protein with free sialic acid or anti‐HN antibodies abolished the virus binding as well as its ability to reduce parasite growth. Interestingly, the purified HN from the virus alone could inhibit the parasite's growth in a dose‐dependent manner. NDV binds strongly to knobless murine parasite strain Plasmodium yoelii and restricted the parasite growth in mice. Furthermore, the virus was found to preferentially target the PRBCs compared to normal erythrocytes. Immunolocalization studies reveal that NDV is localized on the plasma membrane as well as weakly inside the PRBC. NDV causes neither any infection nor aggregation of the human RBCs. Our findings suggest that NDV is a potential candidate for developing targeted drug delivery platforms for the Plasmodium‐infected RBCs.
Luteal Phase Defects and Progesterone Supplementation
Authors: Collins Lucas C. , Gatta Luke A. , Dotters-Katz Sarah K. , Kuller Jeffrey A. , Schust Danny J.
Published: August 2024

Importance:

Luteal phase defects (LPDs), or an insufficiency of progesterone production during the luteal phase of the menstrual cycle, have been identified as a potential cause of recurrent pregnancy loss (RPL), but its exact contribution to RPL is not well-defined. In addition, the role of exogenous progesterone supplementation during pregnancy remains controversial.

Objective:

The goal of this review is to provide an updated, evidence-based summary of LPD, including prevalence and potential pathophysiologic mechanisms, and to explore the current controversies regarding progesterone supplementation for management and treatment of RPL.

Evidence Acquisition:

A literature review identified relevant research using a PubMed search, Cochrane summaries, review articles, textbook chapters, databases, and society guidelines.

Results:

Endogenous progesterone plays a crucial role in the first trimester of pregnancy, and therefore, insufficiency may contribute to RPL. However, the precise relationship between LPD and RPL remains unclear. LPD is primarily a clinical diagnosis based on a luteal phase less than 10 days. Although there may be a possibility of incorporating a combined clinical and biochemical approach in defining LPD, the current lack of validated diagnostic criteria creates a challenge for its routine incorporation in the workup of infertility. Moreover, no treatment modality has demonstrated efficacy in improving fertility outcomes for LPD patients, including progesterone supplementation, whose inconsistent data do not sufficiently support its routine use, despite its minimal risk. It is imperative that women diagnosed with LPD should be worked up for other potential conditions that may contribute to a shortened luteal phase. Future work needs to focus on identifying a reproducible diagnostic test for LPD to guide treatment.

Conclusions and Relevance:

Currently, the perceived relationship between LPD and RPL is challenged by conflicting data. Therefore, patients with an abnormal luteal phase should undergo a thorough workup to address any other potential etiologies. Although supplemental progesterone is commonly used for treatment of LPD and RPL, inconsistent supporting data call for exogenous hormone therapy to be only used in a research setting or after a thorough discussion of its shortcomings.
Treatment of Nocardia Chorioretinitis Related Choroidal Neovascularization with Aflibercept: A Case of Unveiled Immunocompromise with anti-GM-CSF Antibodies
Authors: Korot Edward , Jaje Katherine E , Singhal Neena , Miglio Maria C
Published: August 2024

Purpose:

The purpose of this study was to describe a case of Nocardia chorioretinitis-related choroidal neovascularization (CNV) in a patient with anti-GM-CSF antibodies with resolution of choroidal neovascularization and visual recovery following a series of intravitreal anti-vascular endothelial growth factor.

Methods:

This study is a case report.

Results:

In our case, a 50-year-old female, thought to be immunocompetent, presented with metamorphopsia and decreased visual acuity in the left eye in the setting of disseminated Nocardiosis. She had evidence of a subfoveal Nocardia lesion with subretinal fluid and CNV. Following a series of off-label injections with aflibercept, the patient had improvement in lesion size, exudation, and visual acuity. Extensive workup yielded underlying immunocompromise due to presence of anti-GM-CSF antibodies, likely predisposing her to disseminated Nocardiosis.

Conclusion:

The use of aflibercept in Nocardia chorioretinitis led to resolution of neovascular activity with visual recovery in a patient with disseminated Nocardiosis.
Efficacy and Safety of Phaco-Goniosynechialysis in Advanced Primary Angle Closure Glaucoma With Severe Visual Field Loss
Authors: Qian Zhenbin , Pan Weihua , Nie Li , Lin Leilei , Wei Liqing
Published: August 2024

Précis:

Phacoemulsification with goniosynechialysis (phaco-GSL) demonstrates promise in safely and efficiently managing advanced primary angle closure glaucoma (PACG) cases with tunnel vision or limited temporal visual field. However, caution is advised for patients with only one functioning eye or high visual expectations.

Objective:

To assess the efficacy and safety of phaco-GSL in patients with end-stage PACG exhibiting tubular vision or temporal field island.

Patients and Methods:

This retrospective study evaluated 68 patients (74 eyes) diagnosed with advanced PACG and exhibiting either tubular vision or temporal field island. All patients underwent phaco-GSL and were monitored for at least 1 month postoperatively. The study analyzed changes in visual acuity (VA), intraocular pressure (IOP), medication use for antiglaucoma, and postoperative complications.

Results:

The mean follow-up time was 9.11 ± 10.49 months. The mean preoperative visual field deviation and VA were −28.01 ± 3.30 dB and 0.36 ± 0.37 log minimum angle of resolution unit, respectively. Postoperatively, the VA for over half (54.1%) of the eyes increased, 29.7% remained unchanged, and 16.2% worsened. The final IOP decreased significantly from 24.65 ± 8.61 to 14.81 ± 3.54 mm Hg. Glaucoma medication use also reduced from 1.46 ± 1.43 to 0.88 ± 1.18. The success rate was 48.6% for complete and 89.2% for qualified. IOP spikes (27.0%) and wipe-out (8.1%) were the most common postoperative complications. Vision recovered gradually in 5 of 6 wipe-out patients. One eye (1.4%) developed permanent vision loss with VA decreasing to hand motion.

Conclusion:

Phaco-GSL appears safe and effective in treating advanced PACG cases with tubular vision or temporal field island. However, caution is warranted when considering this treatment option for patients at high wipe-out risk or those with high expectations for visual outcomes.
Bioinformatics and machine learning approaches reveal key genes and underlying molecular mechanisms of atherosclerosis: A review
Authors: Su Xiaoxue , Zhang Meng , Yang Guinan , Cui Xuebin , Yuan Xiaoqing , Du Liunianbo , Pei Yuanmin
Published: August 2024

Atherosclerosis (AS) causes thickening and hardening of the arterial wall due to accumulation of extracellular matrix, cholesterol, and cells. In this study, we used comprehensive bioinformatics tools and machine learning approaches to explore key genes and molecular network mechanisms underlying AS in multiple data sets. Next, we analyzed the correlation between AS and immune fine cell infiltration, and finally performed drug prediction for the disease. We downloaded GSE20129 and GSE90074 datasets from the Gene expression Omnibus database, then employed the Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts algorithm to analyze 22 immune cells. To enrich for functional characteristics, the black module correlated most strongly with T cells was screened with weighted gene co-expression networks analysis. Functional enrichment analysis revealed that the genes were mainly enriched in cell adhesion and T-cell-related pathways, as well as NF-κ B signaling. We employed the Lasso regression and random forest algorithms to screen out 5 intersection genes (CCDC106, RASL11A, RIC3, SPON1, and TMEM144). Pathway analysis in gene set variation analysis and gene set enrichment analysis revealed that the key genes were mainly enriched in inflammation, and immunity, among others. The selected key genes were analyzed by single-cell RNA sequencing technology. We also analyzed differential expression between these 5 key genes and those involved in iron death. We found that ferroptosis genes ACSL4, CBS, FTH1 and TFRC were differentially expressed between AS and the control groups, RIC3 and FTH1 were significantly negatively correlated, whereas SPON1 and VDAC3 were significantly positively correlated. Finally, we used the Connectivity Map database for drug prediction. These results provide new insights into AS genetic regulation.
Prominent themes in shoulder dystocia research: A bibliometric and document-based analysis
Authors: Konac Ayse , Orhan Fatih
Published: August 2024

Background:

This study aims to comprehensively examine the academic development of shoulder dystocia (SD) through bibliometric and document analysis and to identify topics that can guide future research.

Methods:

In this study, performance, co-citation, co-word, and document analyses were used as bibliometric analysis techniques.

Results:

The study identified 3 main themes in terms of the intellectual structure of Shoulder Dystocia (SD): “Management of SD, Risk Factors and Associated Complications,” “Clinical Practices, Birth Abnormalities and Effects of Complications,” and “Impact of Education, Clinical Maneuvers and Fetal Health Outcomes.” Co-occurrence analysis identified 4 significant themes: “Management and Clinical Practice of SD,” “Fetal Macrosomia and Risk Factors,” “Obstetric Maneuvers and Brachial Plexus Injury,” and “Clinical Trends and Risks in SD.” Additionally, ten consolidated themes were identified as a result of thematic coding analysis.

Conclusion:

Shoulder dystocia remains a critical component of obstetric practice. Themes such as training and simulation, risk factors, and technical and management approaches are consistently emphasized. Technological advances and studies on how machine learning techniques can be used effectively in this field reflect innovative approaches in the scientific literature. This analysis confirms that shoulder dystocia is a complex topic requiring a multidisciplinary approach and that research in this field is constantly evolving.
Predicting septic shock in obstructive pyelonephritis associated with ureteral stones: A retrospective study
Authors: Min Kyungchan , Kim Bum Soo , Ha Yun-Sok , Chung Jae-Wook , Jang Gyuho , Noh Myung-giun , Ahn Hyeok , Lee Jun Nyung , Kim Hyun Tae , Yoo Eun Sang , Kwon Tae Gyun , Chun So Young , Park Hansoo
Published: August 2024

To identify the best combination of potential predictors of septic shock in patients with obstructive acute pyelonephritis associated with ureteral stones (OAPN-US) according to Sepsis-3 criteria. Patients who underwent percutaneous nephrostomy (PCN) with OAPN-US were retrospectively evaluated. Recursive feature elimination (RFE) was applied to patients with and without septic shock to identify factors associated with the prediction of progression to septic shock. We compared combinations of the selected features based on area under the receiver operating curve (AUROC) to determine which combination was most effective. This study included 81 patients who were treated with PCN due to OAPN-US. A comparison was made between 37 patients with septic shock (SS) and 44 patients without septic shock (NSS). SS group had a higher age, poorer Eastern Cooperative Oncology Group status, and significantly higher levels of positivity in urine cultures and blood cultures. There were also differences in laboratory tests between the 2 groups. Procalcitonin (PCT), international normalized ratio (INR), and absolute lymphocyte count (ALC) were selected based on RFE. We compared the predictive power for SS when each marker was used alone, when 2 markers were combined, and when all 3 markers were combined. Among these combinations, using all 3 variables together yielded the highest AUROC of 0.942. Of the 3 variables, PCT had the highest Gini importance score, indicating that it was the most influential factor. Clinical characteristics were different between the SS and the NSS groups. In patients with OAPN-US, the combination of PCT, ALC, and INR was an excellent predictor of septic shock.
Respiratory microbiome and clinical course of carbapenem-resistant Acinetobacter baumannii pneumonia in critically Ill patients
Authors: Yoon Jin Gu , Lim Sooyeon , Hyun Hak-Jun , Seong Hye , Noh Ji Yun , Song Joon Young , Kim Woo Joo , Cheong Hee Jin
Published: August 2024

Carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia has been a serious problem in the intensive care unit (ICU). However, defined characteristics of respiratory microbiome in CRAB pneumonia are lacking nowadays. This study aimed to analyze respiratory microbiome of CRAB pneumonia compared to non-CRAB pneumonia and reveal the clinical significance of respiratory microbiome data in these patients. Patients diagnosed with severe pneumonia with mechanical ventilation were enrolled in the ICU of a tertiary care hospital. Respiratory specimens were collected on days 1, 4, 7, and 14 in each participant via tracheal aspiration. Clinical data and outcomes of each enrolled patient were collected via electronic medical records. Microbiome analysis was conducted with collected respiratory specimens undergone by next-generation sequencing of microbial 16S ribosomal DNA. Six CRAB pneumonia, 4 non-CRAB pneumonia and 5 healthy controls were enrolled. In CRAB pneumonia, CRAB was detected in 3 patients by sputum culture at day 1, while it was negative at day 1 and detected later in the others by follow-up sputum culture. Beta diversity plot analysis showed differences between each group. Shannon index was decreased markedly at day 4 in CRAB pneumonia compared to the others. Among CRAB pneumonia cases, 3 respiratory specimens were culture-negative, but positive by microbiome analysis. Lower respiratory microbiome in CRAB pneumonia had distinct characteristics and early loss of diversity compared to non-CRAB pneumonia, which might be related to poor clinical course. Moreover, CRAB acquisition and colonization would be predicted by preemptive microbiome analysis, which will contribute to effective infection control in the ICU.
Current status and controversies in the treatment of neonatal hypoxic-ischemic encephalopathy: A review
Authors: Gao Hanhong , Jiang Hong
Published: August 2024

Neonatal hypoxic-ischemic encephalopathy is a type of traumatic brain injury caused by insufficient cerebral perfusion and oxygen supply in the perinatal neonate, which can be accompanied by different types of long-term neurodevelopmental sequelae, such as cerebral palsy, learning disabilities, mental retardation and epilepsy It is one of the main causes of neonatal death and disability, and it has caused a great burden on families and society. Therefore, this article mainly reviews the latest developments in mild hypothermia therapy and related drugs for neonatal hypoxic-ischemic encephalopathy.
The analysis on Tiam2 for expression in esophageal carcinoma: A descriptive study
Authors: Jintian Zhang , Sumei Li , Shouping Yuan
Published: August 2024

Rationale:

To investigate T lymphoma invasion and metastasis inducing factor 2 (Tiam2) protein for expression in esophageal carcinoma and relationship with clinical features among cases with tumors.

Patient concerns:

In primary esophageal cancer patients, surgical resection of tumor tissue was performed in 65 cases and adjacent normal esophageal tissue in 20 cases.

Diagnoses:

Primary esophageal carcinoma (57 cases squamous cell carcinoma, 8 cases adenosquamous carcinoma).

Interventions:

The expression level of Tiam2 protein in esophageal carcinoma tissues and normal esophageal tissues by SP immunohistochemical method. The expression intensity was quantitatively analyzed by using Image-pro plus software for image analysis, while SPSS26.0 software was used for a statistical analysis on the data.

Outcomes:

Tiam2 was highly expressed in esophageal squamous cell carcinoma and adenosquamous cell carcinoma, but low expressed in normal esophageal tissue. The expression level of Tiam2 protein was not correlated with gender and age of patients (P > .05), but was correlated with lymph node metastasis of esophageal carcinoma, TNM stage and differentiation degree of esophageal squamous cell carcinoma (P < .05). Tiam2 was positively correlated with Tiam1 for protein expression in esophageal carcinoma (r = .704, P < .001).

Lessons:

The increased expression of Tiam2 protein in esophageal cancer may be an early molecular event of esophageal cancer. Tiam2 protein has a high expression level in esophageal carcinoma related to lymph node metastasis, TNM stage and differentiation degree, which suggests that Tiam2 protein plays an important role in the invasion and metastasis of esophageal carcinoma. There is a positive correlation between Tiam2 and Tiam1 protein expressions in esophageal carcinoma, suggesting that the 2 proteins may have a definite internal relationship.
Integrative personalized medicine care for adjustment disorder of a post-COVID-19 patient: A CARE-compliant case report
Authors: Moon Won-Kyoung , Jeong Ja-Yeon , Park Sang-Woo , Yun Su-Yeon , Lee Euiju , Shin Seungwon
Published: August 2024

Rationale:

Depression is a common symptom in post-coronavirus disease 2019 (COVID-19) patients, which can be diagnosed with post-COVID-19 depression or adjustment disorder (AD) of post-COVID-19 syndrome. Recently, there have been reports of treating post-COVID-19 syndrome with herbal interventions. However, there are no studies of AD of post-COVID-19 syndrome treated with an integrative approach. This is a CARE-compliant case report of a patient diagnosed with AD of post-COVID-19 syndrome and improved with integrative personalized medicine care (IPMC).

Patient concerns:

An 84-year-old female patient presented symptoms of depression, insomnia, palpitations, and dyspepsia after COVID-19 diagnosis.

Diagnoses:

The patient was diagnosed with AD due to COVID-19 according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

Interventions:

The patient was treated with the IPMC approach: conventional Western drugs for symptom improvements with herbal medicine, acupuncture, and moxibustion therapies of traditional Korean medicine to enhance her general conditions.

Outcomes:

Depression, insomnia, palpitations, dyspepsia, and overall quality of life were assessed through various questionnaires before and after treatment. Scores notably decreased across depression scales, and insomnia severity improved significantly. After treatment, gastrointestinal symptoms vanished, and autonomic nervous system balance improved. Quality of life metrics also showed remarkable enhancement.

Lessons:

This study is the first case report to demonstrate improvement in AD of post-COVID-19 symptoms using IPMC. It is noteworthy that the patient in this study tapered off their antidepressant medication after the treatment with the IPMC approach. Further studies are needed to establish more qualified evidence to show the effectiveness and safety of IPMC for AD of post-COVID-19 syndrome.
Exploring the pharmacological mechanism of Xianlingubao against diabetic osteoporosis based on network pharmacology and molecular docking: An observational study
Authors: Yan Huili , Li Zongying , Zhang Zhongwen
Published: August 2024

Xianlinggubao formula (XLGB), is a traditional Chinese compound Medicine that has been extensively used in osteoarthritis and aseptic osteonecrosis, but its curative effect on diabetic osteoporosis (DOP) and its pharmacological mechanisms remains not clear. The aim of the present study was to investigate the possible mechanism of drug repurposing of XLGB in DOP therapy. We acquired XLGB active compounds from the traditional Chinese medicine systems pharmacology and traditional Chinese medicines integrated databases and discovered potential targets for these compounds by conducting target fishing using the traditional Chinese medicine systems pharmacology and Swiss Target Prediction databases. Gene Cards and Online Mendelian Inheritance in Man® database were used to identify the DOP targets. Overlapping related targets between XLGB and DOP was selected to build a protein–protein interaction network. Next, the Metascape database was utilized to enrich the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways. In addition, Auto-Dock Vina software was used to verify drug and target binding. In total, 48 hub targets were obtained as the candidate targets responsible for DOP therapy. The anti-DOP effect mediated by XLGB was primarily centralized on the advanced glycation end products (AGEs)-receptor for AGE signaling pathway in diabetic complications and osteoclast differentiation. In addition, AKT serine/threonine kinase 1, tumor necrosis factor, Interleukin-6, vascular endothelial growth factor A and peroxisome proliferator activated receptor gamma, which were considered as potential therapeutic targets. Furthermore, molecular docking results confirm the credibility of the predicted therapeutic targets. This study elucidates that XLGB may through regulating AGEs formation and osteoclast differentiation as well as angiogenesis and adipogenesis against DOP. And this study provides new promising points to find the exact regulatory mechanisms of XLGB mediated anti-DOP effect.
Successful percutaneous coronary intervention in a congenital single right coronary artery with acute myocardial infarction: A case report and literature review
Authors: Li Bin , Lv Jun , Han Shufang , Chen Ruimin , Hu Yuhong , Fang Jie , Wang Zheng , Zhong Weiwei , Hu Yue , Liu Wenyan , Jin Qun
Published: August 2024

Rationale:

Single coronary artery (SCA) is a rare coronary artery malformation. SCA combined with atherosclerotic plaques can cause severe and widespread myocardial ischemia and infarction, leading to hemodynamic instability and even sudden death.

Patient concerns:

A 48-year-old Chinese man was admitted for treatment of persistent chest tightness and panic for 5 hours. The patient was a lorry driver with high work intensity and mental stress, with body mass index of 33.78, history of smoking and alcohol consumption, but no history of hypertension and diabetes.

Diagnoses:

Admission examination showed Troponin was 183.083 µg/L and CK-MB value was >300 µg/L. The patient was diagnosed with a congenital single right coronary artery (RCA) with acute myocardial infarction (AMI) by coronary angiography (CAG). Due to atherosclerotic plaques rupture, a complete occlusion of the proximal RCA with thrombolysis in myocardial infarction grade 0 of distal blood flow were found.

Interventions and outcomes:

The patient was treated with thrombus aspiration and thrombolytic therapy by percutaneous coronary intervention under the support of intra-aortic balloon pump. Postoperative the chest tightness and panic were relieved, and CAG revealed that the proximal thrombus of the RCA was reduced, and distal blood flow was restored to thrombolysis in myocardial infarction grade 3. After 2 weeks of intensive antithrombotic and lipid-regulating drug therapy, the patient was successfully discharged. Follow-up for 6 months, the patient was able to live and work normally without experiencing chest tightness and chest pain. Computed tomography angiography (CTA) confirmed a congenital single RCA with patent lumen and no severe stenosis.

Lessons:

The congenital single RCA is very rare, and it is fatal in conjunction with acute coronary syndrome. Early detection and appropriate treatment is critical for AMI patient with single RCA. CAG is the gold standard for diagnosis of single RCA, and CTA is a necessary to describe the anatomical course of abnormal coronary arteries.
Oculomotor nerve palsy caused by imidacloprid at initial diagnosis: A case report
Authors: Jiang Huan , Bu Xiaoli , Liu Taixiang , Jiang Bing
Published: August 2024

Rationale:

Amid the pervasive deployment of imidacloprid, the incidence of poisoning from this compound has risen markedly. Those afflicted with imidacloprid poisoning typically exhibit symptoms ranging from headaches, dizziness, nausea, and abdominal pain, to impaired consciousness and breathlessness, yet instances of ocular paralysis induced by this toxin have not previously been documented.

Patient concerns:

When the pesticide spray inadvertently made contact with the patient’s eyes, they were seared with a burning sensation and discomfort. Subsequent to this incident, on the second day, the individual began to experience diplopia in the right eye and found it arduous to elevate his eyelids, indicating a challenge in achieving full extension.

Diagnoses:

Based on the medical history, symptoms, and signs, the patient was diagnosed with oculomotor nerve palsy caused by imidacloprid.

Interventions:

The treatment involved intravenous dexamethasone to reduce inflammatory response in the eye tissue; oral pantoprazole enteric-coated tablets to suppress acid production and protect the stomach; Xuesaitong administered intravenously to improve blood supply to the eye and promote metabolism of toxins; vitamin C, cobamamide, and vitamin B1 for nerve nutrition and antioxidant effects; local application of tobramycin-dexamethasone eye drops for anti-inflammatory purposes; and repeated flushing of the conjunctival sac with saline. Finally, the patient improved and was discharged.

Outcomes:

After active treatment, the patient finally improved diplopia and ptosis.

Lessons:

This report marks the first documentation of oculomotor nerve palsy induced by imidacloprid, featuring diplopia, and blepharoptosis without substantial limitation of ocular motility. Following therapeutic intervention, the patient showed marked improvement and was discharged from the hospital, providing a point of reference for the treatment of analogous cases in future clinical practice. It also serves as a reminder for the public to take appropriate precautions when using imidacloprid.
Atypical pulmonary thromboembolism caused by the mutation site SERPINC1 of the antithrombin III gene: A case report
Authors: Lin Miaoyuan , Sun Xishi , Wu Jun
Published: August 2024

Background:

Deficiency of natural anticoagulant antithrombin was first reported as a genetic risk factor for venous thromboembolism, antithrombin III (AT III) is encoded by the serpin family C member 1 (SERPINC1) gene, consisting of 432 amino acids, including 3 disulfide bonds and 4 possible glycosylation sites. Studies have shown that hereditary AT deficiency increases the incidence of venous thromboembolism by up to 20 times.

Case presentation:

The case presented a 27-year-old young man with no acquired risk factors and a sudden onset of right lower extremity venous thrombosis and pulmonary embolism. A heterozygous mutation in gene SERPINC1 of c.1154-14G>A was detected in the patient, which is a deleterious mutation resulting in reduced AT III activity and increased risk of thrombotic events. The patient received anticoagulant therapy for approximately 5 months, and the thrombus gradually dissolved and no recurrent thrombotic events occurred during follow-up.

Discussion:

AT deficiency is a rare autosomal dominant genetic disease, they are mainly divided into 2 types according to the different effects on the structure or function of the encoded protein. The patient had a mutation in the SERPINC1 gene (c.1154-14G>A). Several cases of this type of mutation have been reported since 1991, and it is classified as AT deficiency type I.

Conclusion:

Thrombosis in patients with antithrombin deficiency is often unpredictable and can lead to fatal pulmonary embolism. Early genetic testing for hereditary thrombophilia in venous thromboembolism patients without obvious high-risk factors is critical. Long-term anticoagulation treatment is an effective treatment, for this type of type I AT III deficiency combined with pulmonary embolism patients, warfarin is an effective anticoagulant drug.
Global research on emerging trends of obstetrics during the COVID-19 pandemic: A bibliometric analysis
Authors: Cai Qin-Yu , Pan Yun-Ren , Deng Bei-Ning , Hu Wen-Dong , He Zong-Yan , Zhang Xu , Tang Wei-Zhen , Liu Tai-Hang , Lan Xia
Published: August 2024

Coronavirus disease-2019 (COVID-19) has caused continuous effects on the global public, especially for susceptible and vulnerable populations like pregnant women. COVID-19-related studies and publications have shown blowout development, making it challenging to identify development trends and hot areas by using traditional review methods for such massive data. Aimed to perform a bibliometric analysis to explore the status and hotspots of COVID-19 in obstetrics. An online search was conducted in the Web of Science Core Collection (WOSCC) database from January 01, 2020 to November 31, 2022, using the following search expression: (((TS= (“COVID 19” OR “coronavirus 2019” OR “coronavirus disease 2019” OR “SARS-CoV-2” OR “2019-nCoV” OR “2019 novel coronavirus” OR “SARS coronavirus 2” OR “Severe Acute Respiratory Syndrome Coronavirus-2” OR “SARS-COV2”)) AND TS= (“obstetric*” OR “pregnancy*” OR “pregnant” OR “parturition*” OR “puerperium”))). VOSviewer version 1.6.18, CiteSpace version 6.1.R6, R version 4.2.0, and Rstudio were used for the bibliometric and visualization analyses. 4144 articles were included in further analysis, including authors, titles, number of citations, countries, and author affiliations. The United States has contributed the most significant publications with the leading position. “Sahin, Dilek” has the largest output, and “Khalil, Asma” was the most influential author with the highest citations. Keywords of “Cov,” “Experience,” and “Neonate” with the highest frequency, and “Systematic Review” might be the new research hotspots and frontiers. The top 3 concerned genes included ACE2, CRP, and IL6. The new research hotspot is gradually shifting from the COVID-19 mechanism and its related clinical research to reviewing treatment options for pregnant women. This research uniquely delves into specific genes related to COVID-19’s effects on obstetrics, a focus that has not been previously explored in other reviews. Our research enables clinicians and researchers to summarize the overall point of view of the existing literature and obtain more accurate conclusions.
Hypoxia-related signature to risk stratify patients for the benefit of immune checkpoint inhibitors therapy in head and neck squamous cell carcinoma: An experimental study
Authors: Zhao Yuemei , Yang Zhe , Fu Min , Wu Shuang , Wang Mingyu , Li Jinglong , Wang Zhanqiu , Li Wenfei
Published: August 2024

Background:

Increasing evidence has shown that hypoxia is a biomarker of tumor proliferation and metastasis. This research aimed to identify a hypoxia-associated gene prognostic index (HAGPI) in head and neck squamous cell carcinoma (HNSCC) and based on HAGPI-defined subgroups to predict prognosis and response to immune checkpoint inhibitors therapy.

Methods:

RNA-sequencing transcriptomic data for patients with HNSCC were downloaded from The Cancer Genome Atlas (TCGA). Protein–protein interaction network analysis was performed to select hypoxia-related hub genes. Univariate and multivariate cox regression analyses were used to identify hub genes to develop the HAGPI. Afterward expression data were imported into CIBERSORT to evaluate the relative proportion of 22 immune cells and compared the relative proportions of immune cells between the 2 HAGPI subgroups. The relationship between immunopheno score (IPS) and HAGPI was validated for immune checkpoint inhibitors (ICIs) response in TCGA cohorts.

Results:

The HAGPI was constructed based on HS3ST1, HK1, PGK1, STC2, SERPINE1, PKLR genes. In high-HAGPI patients, the primary and secondary endpoint events in TCGA and GEO cohorts were significantly lower than low-HAGPI groups (P < .05). HAGPI-high patients exhibited a poorer prognosis than HAGPI-low patients did. The abundance of M2 macrophages and NK cell were significantly enhanced in the high-HAGPI while T cells regulatory and T cells CD8, were markedly elevated in the low-HAGPI. Meanwhile, patients in the low-HAGPI patients had higher levels of immunosuppressant expression and less aggressive phenotypes. Furthermore, IPS analysis showed that the low-HAGPI group with higher IPS represented a more immunogenic phenotype.

Conclusion:

The current study developed and verified a HAPGI model that can be considered as an independent prognostic biomarker and elucidated the tumor immune microenvironment of HNSCC.
Significance of serum NLRP3 as a potential predictor of 5-year death in hemodialysis patients: A prospective observational cohort study
Authors: Jiang Yi , Xu Yandan , Wang Qiuli , Chen Zhiwei , Liu Chunya
Published: August 2024

Nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) is involved in inflammatory response. This study was done to explore the role of serum NLRP3 as a predictive biomarker of death after hemodialysis. In this prospective observational study of 331 patients undergoing maintenance hemodialysis, serum NLRP3 levels were measured. Univariate analysis and multivariate analysis were sequentially performed to determine predictors of 5-year death after hemodialysis. Age, major adverse cardiac and cerebral events (MACCE), and serum NLRP3 levels independently predicted 5-year mortality and overall survival (all P < .05). No interactions were found between serum NLRP3 levels and other variables, such as age, gender, hypertension, diabetes mellitus, primary renal diseases, and MACCE (all P interaction > .05). Serum NLRP3 levels were linearly correlated with risk of death and overall survival under restricted cubic spline (both P > .05) and substantially discriminated patients at risk of death under receiver operating characteristic curve (P < .001). Two models, in which age, MACCE, and serum NLRP3 were combined, were built to predict 5-year mortality and overall survival. The mortality prediction model had significantly higher predictive ability than age, AMCCE, and serum NLRP3 alone under receiver operating characteristic curve (all P < .05). The models, which were graphically represented by nomograms, performed well under calibration curve and decision curve. Serum NLRP3 levels are independently related to 5-year mortality and overall survival of patients after hemodialysis, suggesting that serum NLRP3 may be a potential prognostic biomarker of hemodialysis patients.
Primary breast angiosarcoma: A case report
Authors: Wang Yan , Xie Shengrong , Peng Dawei , Zhou Jin , Hu Shuangye
Published: August 2024

Rationale:

Primary breast angiosarcoma is a rare tumor, accounting for only 0.05% of all malignant breast tumors. The primary breast angiosarcoma typically presents with nonspecific clinical manifestations, which can easily lead to misdiagnosis. Potential factors contributing to misdiagnosis include skin changes that may be erroneously attributed to breast trauma-induced bruising and breast swelling that may be mistaken for inflammatory diseases or other benign tumors.

Patient concerns:

A 19-year-old female was admitted to the hospital due to repeated lump formation in the left breast for 9 months after left breast trauma.

Diagnoses:

The diagnosis of primary breast angiosarcoma was confirmed on hematoma biopsy.

Interventions:

Due to the patient’s condition, no special treatment was given postoperatively. After then, there was a recurrence in the chest wall, and the patient received 2 cycles of chemotherapy, resulting in a reduction in the size and lightening of the recurrent chest wall mass. When chemotherapy intolerance happened, the patient chose to discontinue treatment.

Outcomes:

After an 18-month follow-up, the recurrent chest wall mass increased and the patient died from bleeding.

Lessons:

Primary breast angiosarcoma has a low incidence but high malignancy, with a high recurrence and metastasis rate, leading to a poor prognosis. The adjuvant chemotherapy, radiotherapy, targeted therapy, and other treatments should be considered to reduce the local recurrence rate and prolong patient survival.