bluuebunny/crossref_metadata_2025 huggingface dataset:
The controversial expression of SOX2 in gastric cancer and its correlation with Helicobacter pylori infection: A meta-analysis
Authors: Li Ning , Pang Yu , Sang Jing , Sun Yong , Hou Weiwei
Published: October 2022

Background:

The expression of sex-determining region Y (SRY)-like high-mobility group (HMG) box 2 (SOX2) in gastric cancer and the prognosis of patients are controversial. This study analyzed the relationship between SOX2 expression and baseline data, clinicopathological parameters, prognosis, and Helicobacter pylori infection in patients with gastric cancer, and provided new supplements for the diagnosis and treatment of gastric cancer.

Methods:

The articles which reported SOX2 expression in gastric cancer from medical database was collected. The literature search was conducted in PubMed, Google Scholar, Cochrane library, SpringerLink, China National Knowledge Infrastructure, Web of Science, and Wanfang databases, which were written in English and Chinese.

Results:

A total of 32 articles, including 4641 gastric cancer patients. The results showed that SOX2 expression in gastric cancer group was lower than that in the para-cancerous control group (P < .001). Statistical difference was found between the SOX2 expression and differentiation (Well/Moderate vs Poor), TNM stage (I/II vs III/IV), lymphatic invasion (N0 vs N+), edge infiltration (R0 vs R1), and H pylori infection in the pathological parameters. The prognosis analysis showed that the level of SOX2 expression was unrelated to the overall survival of patients (P = .329). No statistical difference was observed between the SOX2 expression and the baseline data of the patients (all P > .05).

Conclusions:

Although downregulation expression of SOX2 are related to clinicopathological parameters in gastric cancer, which is not correlated with prognosis. This controversy over the expression of SOX2 will provide a new idea for the study of gastric cancer.
Prognostic nomogram for female patients suffering from non-metastatic Her2 positive breast cancer: A SEER-based study
Authors: Wu Jiangwen , Xie Zhaomin , Xiao Yu , Wang Bingbing , Zhang Pengcheng
Published: October 2022

This paper aimed at constructing and validating a novel prognostic nomogram, so that physicians forecast the overall survival (OS) rates of female patients suffering from non-metastatic human epidermal growth element receptor-2 (HER2) positive breast.

Information of primary female her2 positive breast cancer patients without metastasis was obtained from the Surveillance, Epidemiology, and End Results (SEER) database with given inclusion and exclusion standards. Independent variables were obtained greatly by performing univariable and multivariate analyses. Based on those independent predictors, a novel prognostic nomogram was constructed for predicting the survival of those with 3- and 5-year OS. Then, concordance index (C-index), receiver operating characteristic curve (ROC), and calibration plot were adopted for the assessment of the predictive power of the nomogram.

A total of 36,083 eligible patients were classified into a training cohort (n = 25,259) and a verification cohort (n = 10,824) randomly. According to the identification of multivariate analysis, survival was predicted by age at diagnosis, marital status, race, site, T stage, N stage, progesterone receptor (PR) status, estrogen receptor (ER) status, surgery, radiation, and chemotherapy independently. A nomogram was established by applying the training cohort. The nomogram displayed excellent discrimination and performance as indicated by the C-index (0.764, 95% confidence interval: 0.756–0.772), and the 3- and 5-year area under the curve of ROC (AUC) values (0.760 and 0.692 respectively). The calibration plots for forecasting the 3- and 5-year OS were in great agreement.

The OS for female her2 positive breast cancer patients without metastasis was predicted by constructing a nomogram on basis of the SEER database. A precise survival prediction could be offered for each patient.
Reduced incidence of CIED infections with peri- and post-operative antibiotic use in CRT-P/D and ICD procedures
Authors: Senaratne Janek Manoj , Wijesundera Jessica , Chhetri Usha , Beaudette Diane , Sander Andrea , Hanninen Mike , Gulamhusein Sajad , Senaratne Mano
Published: October 2022

Higher cardiac implantable electronic device (CIED) infection incidence has been observed with cardiac resynchronization therapy pacemaker/defibrillator (CRT-P/D) and implantable cardioverter defibrillator (ICD) devices compared to traditional pacemakers with a 1.2% rate reported at 1 year. CIED infection management has high morbidity/mortality. A previous study from this institution demonstrated significantly reduced CIED infection rate when peri/post-operative antibiotics were given for traditional pacemaker procedures. The present study examines CIED infection incidence following peri/post-operative antibiotics during CRT-P/D and ICD procedures. All patients who underwent CRT-P/D and ICD procedures from 1996 to 2015 received IV cephalexin/clindamycin pre- and 8-hours post-procedure followed by 5 days of oral therapy. There were 427 procedures (CRT-P = 146 (34.2%); CRT-D = 142 (33.3%); ICD = 139 (32.6%)). Mean age at time of procedure was 61.6 years. Mean follow-up duration was 4.26 years. CIED infection occurred in 6 patients (ICD = 4, CRT-P = 1, CRT-D = 1), amounting to a rate of 4.96/1000 device-years in total. Times to CIED infection from procedure were: 1.7, 3.5, 6.7, 7.3, 7.9 and 9.2 years. Five out of 6 infections occurred in patients with repeat procedures. This study demonstrates that administration of peri- followed by post-operative antibiotics during CRT-P/D and ICD procedures is associated with a very low rate of CIED infection. This rate of 4.96 infections per 1000 device-years compares favorably to contemporary rates of 8.9 infections per 1000 device-years. Most CIED infections occur late and well-beyond the 1-year follow-up of the Prevention of Arrhythmia Device Infection Trial, the largest trial on this question. This approach should be considered pending a definitive trial
Successful treatment of Talaromyces marneffei pneumonia in a HIV-negative renal transplantation recipient: A case report
Authors: Cai De-Han , Wang Jun , Fang Xiao-Lin
Published: October 2022

Rationale:

Talaromyces marneffei causes life-threatening opportunistic fungal infections in immunocompromised patients. It often has a poorer prognosis in non-human immunodeficiency virus (HIV)-infected than in HIV-infected individuals because of delayed diagnosis and improper treatment.

Patient concerns:

A 51-year-old man presented with complaints of pyrexia, cough, and expectoration that had lasted for 15 day. This patient has been taking anti-rejection medication since kidney transplant in 2011.

Diagnosis:

T marneffei pneumonia; post renal transplantation; renal insufficiency; hypertension.

Interventions:

Intravenous moxifloxacin was administered on admission. After the etiology was established, moxifloxacin was discontinued and replaced with voriconazole. The tacrolimus dose was adjusted based on the blood concentration of tacrolimus and voriconazole.

Outcomes:

The patient was successfully treated and followed-up without recurrence for 1 year.

Lessons:

A high degree of caution should be maintained for the possibility of T marneffei infection in immunodeficient non-HIV patients who live in or have traveled to T marneffei endemic areas. Early diagnosis and appropriate treatment can prevent progression of T marneffei infection and achieve a cure. Metagenomic next-generation sequencing (mNGS) can aid the physician in reaching an early pathogenic diagnosis. Close monitoring of tacrolimus and voriconazole blood levels during treatment remains a practical approach at this time.
The difficult removal of tracheal tube after general anesthesia: A case report
Authors: Li Man , Yan YaLan , Li PeiYu , Zhang Lan
Published: October 2022

Background:

Laryngeal injury is common after endotracheal intubation, presenting with varying degrees of edema, ulceration, granulation, and limited vocal cord movement, usually resulting in lumen narrowing. In these cases, laryngeal edema is a common complication after intubation, usually caused by direct pressure and inflammatory reaction caused by endotracheal intubation on the contact surface.

Case presentation:

A 71-year-old female was scheduled to undergo open reduction and internal fixation of femoral neck. On admission, she was diagnosed with femoral neck fracture. Tracheal intubation induced by general anesthesia was successful, but the tracheal catheter was difficult to remove after the operation. After 2 days of detumescence in ICU, the extubation was successful under the condition of complete recovery of spontaneous breathing.

Conclusions:

Patients undergoing general anesthesia may have laryngeal or glottic edema due to operation time, operation and other reasons, resulting in difficulty in extubation after general anesthesia. The extubation action shall be gentle. In case of obvious resistance, it shall not be forcibly extubated to prevent serious dyspnea after extubation.
Serum anti-Müllerian hormone recovery after ovarian cystectomy for endometriosis: A retrospective study among Korean women
Authors: Lee Juhun , Hong Dae Gy
Published: October 2022

Serum anti-Müllerian hormone (sAMH) is a useful marker of ovarian reserve. In many patients, the sAMH levels gradually recover after falling to the lowest level after surgery (nadir phenomenon). This study aimed to analyze the factors related to sAMH recovery from the nadir after an ovarian cystectomy for endometriosis among Korean women. A total of 159 patients with ovarian endometriosis were included in the study. The sAMH levels were measured before surgery and at least twice within 12 months after the surgery. The patients were divided into two groups: those with recovery (nadir group) and those without recovery (reduction group). Postoperative recovery of the sAMH levels from the nadir was not related to the stage and bilaterality of the lesion, surgical methods, such as robot-assisted or laparoscopic surgery, or surgical time. In the nadir group, the level of preoperative cancer antigen 125 was significantly higher, and it decreased significantly after the surgery than in the reduction group (P = .02 and P = .02). Additionally, the postoperative C-reactive protein (CRP) level was significantly higher in the nadir group, and it increased significantly after the surgery than in the reduction group (P = .03 and P = .04). The increasing degree of perioperative CRP level showed a cutoff value on the receiver operating characteristic curve (0.735 mg/dL, area under curve = 0.604; P = .04). Increased serum CRP levels after surgery are significantly related to the recovery of sAMH levels from the nadir. Therefore, postoperative serum CRP level could be used as a marker to predict the sAMH nadir after surgery.
KRAS, NRAS, BRAF, PIK3CA, and AKT1 signatures in colorectal cancer patients in south-eastern Romania
Authors: Brinzan Costel Stelian , Aschie Mariana , Cozaru Georgeta Camelia , Deacu Mariana , Dumitru Eugen , Burlacu Ionut , Mitroi Anca
Published: October 2022

Somatic mutations in the oncogenes of the epidermal growth factor receptor signaling pathway play vital roles in colorectal carcinogenesis and have been closely linked with clinical resistance to monoclonal therapy. In this study, we have analyzed the mutation frequencies of 5 genes and compared the genetic findings with clinicopathological variables in order to determine diagnostically relevant alterations and compare these findings with those of other studies In our Sanger sequencings, KRAS (exons 2, 3, and 4), NRAS (exons 2, 3, and 4), PIK3CA (exons 9 and 20), BRAF (exon 15), AKT1 (exon 2) genes, and microsatellite instability (MSI) status were analyzed using an ABI 3500 analyzer in a cohort of 58 Romanian colorectal cancer (CRC) patients who underwent surgical resection at Emergency County Clinical Hospital in Constanța, Romania. In our series, mutation rates of KRAS, BRAF, PIK3CA, and AKT1 genes were 39.63%, 8.62%, 6.88%, and 3.44%, respectively. By contrast, we did not find any tumor harboring mutation in the NRAS gene. Notably, the KRAS and PIK3CA mutations were not mutually exclusive, 1 patient harbored 2 mutations in exon2, codon 12 (Gly12Val) of KRAS and exon 20, codon 1047 (His1047Arg) of PIK3CA. The finding of our study are generally consistent with data found in the literature. Regarding to clinicopathological variables, mutation of KRAS was associated with distant metastasis at the time of diagnosis, while mutation of BRAF was significantly associated with MSI-H in contrast with MSI-L/MSS tumors. Moreover, PIK3CA mutation tends to be located in the proximal segment of the colon and to be well/moderately differentiated compared to wild-type tumors. In conclusion, the assessment of these mutations suggests that CRC patients from southeast Romania exhibit a mutation profile similar to other populations. These results could contribute to creating a better method of qualifying patients for molecularly targeted therapies and obtaining better screening strategies.
P16 and P21 are involved in the pathogenesis of endometrial thinning: A cross-sectional study
Authors: Le Aiwen , Li Qifeng , Zheng Xianchan , Yang Huan
Published: October 2022

P16 plays a role in the negative regulation of cell proliferation, regulating cell apoptosis to control the growth of tumor cells. P21 is a nuclear protein that suppresses DNA synthesis and inhibits cell division. This study aimed to examine the expression and roles of P16 and P21 in endometrial thinning. Thirty cases of endometrial biopsy diagnosed as endometrial thinning were assessed by p16 and p21 immunohistochemistry from March 2014 to August 2020 in Huazhong University of Science and Technology Union Shenzhen Hospital. Another thirty cases of normal endometrium in the same period were assessed as controls. The specimens underwent histological analysis, and P16 and P21 were assessed by immunohistochemistry. There were no statistically significant differences in age, menstrual cycle, BMI, sex hormone levels, gravidity and parity between the two groups (all P > .05). In the endometrial thinning group, P16 was expressed in the endometrial adenoid nucleus, cytolymph and interstitial cell nucleus. In the normal group, P16 was mainly expressed in the endometrial adenoid nucleus, with some P16 signals detected in the endometrial interstitial nucleus. P21 expression was mainly detected in the endometrial adenoid nucleus. P16 and P21 amounts in endometrial thinning cases were significantly lower than those of the normal endometrial group. There was no correlation between p16 and p21 amounts. This study revealed aberrant expression of P16 and P21 in the endometrium might be due to a compensatory effect of the thin endometrium to increase cell proliferation and suppress cell apoptosis. However, the pathological roles of P16 and P21 in endometrial thinning and the contribution of cell senescence deserve further investigation.
Prognostic significance of CD56 antigen in newly diagnosed multiple myeloma: A real-world retrospective study
Authors: Li Liping , Li Xiaofeng , Shang An , Zhao Yan , Jin Lifang , Zhao Meng , Shen Weizhang
Published: October 2022

The prognostic value of plasma cell CD56 expression of patients with multiple myeloma (MM) has been reported in many studies, but the results are controversial. This study aimed to examine the prognostic significance of CD56 in MM patients.

Eighty seven patients with newly diagnosed MM were enrolled in this study, and their clinical characteristics, immunophenotypes, and cytogenetics were retrospectively analyzed to explore the prognostic significance of CD56 expression. Multiparameter flow cytometry was used to detect MM in bone marrow samples from all patients. Patients were divided into 2 groups based on whether they expressed CD56: CD56 + group and CD56 − group.

After 4 cycles of chemotherapy, the overall response rate of the CD56 − patients was lower than that of the CD56 + patients (60.0% vs 81.1%, P = .036). Survival analysis showed that the median progression-free survival (PFS) was 10 months for the CD56 − group and 27 months for the CD56 + group (P = .007). The median overall survival (OS) of patients for the CD56 − group was 25 months versus not reached in the CD56 + group (P = .010). In addition, among the high-risk patients detected by fluorescence in situ hybridization (FISH), the median PFS was 4 months for the CD56 − group and 16 months for the CD56 + group (P = .012). The median OS of the CD56 + group and CD56 − group was 36 months and 15 months, respectively, with statistically significant differences (P = .017).

Our study confirmed that CD56 − patients with MM had a worse prognosis than that of CD56 + patients with MM. Among the patients with ≥ 2 high-risk cytogenetics, the existence of the CD56 negativity can further identify MM patients with poor PFS and OS.
COL11A1 as a potential prognostic target for oral squamous cell carcinoma
Authors: Di Yong-Bin , Bao Yang , Guo Jie , Liu Wei , Zhang Su-Xin , Zhang Guan-Hua , Li Tian-Ke
Published: October 2022

Oral squamous cell carcinoma (OSCC) is a malignant tumor occurring in the oral cavity. However, the molecular mechanism of OSCC is not clear. Bioinformatics was used to screen and identify role of collagen type X1 alpha 1 (COL11A1) on OSCC. 200 patients with OSCC were recruited. Clinical and follow-up data were recorded and COL11A1 expression levels were tested. Pearson chi-square test and Spearman correlation coefficient were used to analyze relationship between prognosis and related parameters in patients with OSCC. Univariate and multivariate Logistic regression, univariate and multivariate Cox proportional risk regression were used for further analysis, survival curve was drawn. Through bioinformatics analysis, OSCC patients with higher expression of COL11A1 have poor overall survival compare with OSCC patients with lower expression of COL11A1 (hazard ratios [HR] = 1.32, P = .047). Pearson chi-square test showed that age (P = .011), tumor grade (P = .023), COL11A1 (P < .001) was significantly correlated with prognosis of OSCC. Univariate Logistic regression analysis showed age (odds ratio [OR] = 2.102, 95% confidence intervals [95%CI]: 1.180-3.746, P = .012), tumor grade (OR = 1.919, 95%CI: 1.093-3.372, P = .023) and COL11A1 (OR = 12.775, 95%CI: 6.509-25.071, P < .001). Multivariate Logistic regression analysis showed that COL11A1 (OR = 12.066, 95%CI: 6.042-24.096, P < .001) was significantly associated with prognosis of patients with OSCC. Univariate Cox regression analysis showed that age (HR = 1.592, 95%CI: 1.150-2.205, P = .005), tumor grade (HR = 1.460, 95%CI: 1.067-1.999, P = .018) and COL11A1 (HR = 1.848, 95%CI: 1.340-2.548, P < .001) were significantly correlated with survival time of OSCC patients. Multivariate Cox regression analysis showed that tumor grade (HR = 1.466, 95%CI: 1.064-2.020, P = .019) and COL11A1 (HR = 1.645, 95%CI: 1.164-2.325, P = .005) were significantly correlated with survival time of OSCC patients. COL11A1 is significantly correlated with occurrence of OSCC. When COL11A1 is highly expressed, prognosis of patients with OSCC is worse and the survival time is shorter.
Effect of erbium family laser etching on shear bond strength of enamel surfaces: A meta-analysis-PRISMA
Authors: Jiang Tao , Gong Qi , Liu Ying , Zhang Pan-Pan , Zhang Li
Published: October 2022

Background:

Recently, laser etching has appealed to people’s attention. It is meaningful to compare the effect of erbium-doped yttrium-aluminum-garnet (Er:YAG) and erbium-chromium; yttrium-scandium-gallium-garnet (Er,Cr:YSSG) laser etching parameters with acid etching on bond strength of enamel surfaces. As far as we know, there still remains no related meta-analysis. To evaluate the efficacy of Er:YAG and Er,Cr:YSSG lasers etching on shear bond strength (SBS) of brackets bonded to enamel. The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, conducted with literature search.

Methods:

Twelve relevant randomized controlled trials (RCTs) were included.

Results:

The pooled analysis of SBS showed that there were no significant differences between erbium family lasers and acid etching. In the mass, we noticed they did not achieve statistical significance in the lasers etching and acid etching. However, pooled analysis of 5 studies showed the SBS bonding to enamel was lower in Er,Cr:YAG laser group compared with acid group. As a whole, there were statistical significance between erbium lasers groups and acid etching group in adhesive remnant index (ARI) aspects, which less adhesives remained can reduce damage to enamel. With regard to the rate of teeth with ARI score ≤2, the results in Er:YAG laser etching group were obviously higher than acid etching group.

Conclusion:

Our data indicated that erbium lasers may be considered bonding of brackets to enamel instead of acid etching bonding to enamel.
The number of beds occupied is an independent risk factor for discharge of trauma patients
Authors: Halvachizadeh Sascha , Leibovitz Daniel , Held Leonhard , Jensen Kai Oliver , Pape Hans-Christoph , Muller Dominik , Neuhaus Valentin
Published: October 2022

Reducing the burden of limited capacity on medical practitioners and public health systems requires a time-dependent characterization of hospitalization rates, such that inferences can be drawn about the underlying causes for hospitalization and patient discharge. The aim of this study was to analyze non-medical risk factors that lead to the discharge of trauma patients. This retrospective cohort study includes trauma patients who were treated in Switzerland between 2011 and 2018. The national Swiss database for quality assurance in surgery (AQC) was reviewed for trauma diagnoses according to the ICD-10 code. Non-medical risk factors include seasonal changes, daily changes, holidays, and number of beds occupied by trauma patients across Switzerland. Individual patient information was aggregated into counts per day of total patients, as well as counts per day of levels of each categorical variable of interest. The ARIMA-modeling was utilized to model the number of discharges per day as a function of auto aggressive function of all previously mentioned risk factors.

This study includes 226,708 patients, 118,059 male (age 48.18, standard deviation (SD) 22.34 years) and 108,649 female (age 62.57, SD 22.89 years) trauma patients. The mean length of stay was 7.16 (SD 14.84) days and most patients were discharged home (n = 168,582, 74.8%). A weekly and yearly seasonality trend can be observed in admission trends. The mean number of occupied trauma beds ranges from 3700 to 4000 per day. The number of occupied beds increases on weekdays and decreases on holidays. The number of occupied beds is a positive, independent risk factor for discharge in trauma patients; as the number of occupied beds increases at any given time, so does the risk for discharge.

The number of beds occupied represents an independent non-medical risk factor for discharge. Capacity determines triage of hospitalized patients and therefore might increase the risk of premature discharge.
Feasibility of the modified inverted L-shaped approach for posterolateral tibial plateau fracture: A retrospective study
Authors: Yang Xiaohai , Pan Mingming , He Hanliang , Jiang Weimin
Published: October 2022

Approaches for treating posterolateral tibial plateau fractures vary among surgeons, and the inverted L-shaped approach is a known option. This article aims to introduce a new modified posterolateral inverted L-shaped approach for isolated posterolateral tibial plateau fractures and study its feasibility. Medical records of patients with posterolateral tibial plateau fractures were reviewed. Plain radiographs were obtained during the follow-up period, and the hospital for special surgery (HSS) score was used to assess the function of the injured limb. Perioperative complications were recorded and followed-up. In total, 32 patients with posterolateral tibial plateau fractures were treated using a modified posterolateral approach. The mean age of the patients was 44 ± 11 years (28–64 years). All patients successfully underwent surgery and were followed-up for a mean duration of 13 ± 2 months (10–16 months). On plain radiographs, fracture lines were fuzzy 3 months after surgery and disappeared 12 months after surgery. No perioperative complications occurred during the follow-up period. The HSS score was evaluated 12 months after surgery, and the mean score was 91 ± 5 points (81–97 points), including 25 excellent cases and 7 good cases. The modified posterolateral inverted L-shaped approach has the advantages of small soft tissue dissection, fracture reduction under direct vision, easy internal fixation, and a lower risk of neurovascular injury. This approach is feasible for the treatment of isolated posterolateral tibial plateau fractures, and further high-quality randomized control trials are required to confirm its clinical efficacy.
Interaction of basic diseases and low red blood cell count as critical murderer of wound infection after osteosarcoma resection: Wound infection after osteosarcoma resection
Authors: Chen Fei , Wang Jie , Zhao Xin , Lv Xian-qiang
Published: October 2022

Background:

Surgical wound infection is one of the common complications in patients after osteosarcoma resection. It is imperative to grasp the risk factors comprehensively. Therefore, this study aimed to explore the risk factors of wound infection and deeply analyze the correlation between risk factors and wound infection.

Methods:

The study subjects were 101 patients who underwent osteosarcoma resection between April 2018 and August 2021. The diagnosis of postoperative wound infection was confirmed by postoperative observation of the incision, ultrasound imaging, and pathogenic examination. This study included a series of potential factors, mainly laboratory examination indicators and patients’ general information. The statistical methods had Pearson Chi-square test, Spearman-rho correlation test, multifactorial linear regression model, logistic regression analysis, and receiver operating characteristic (ROC) curve.

Results:

Pearson Chi-square test and Spearman correlation test showed that red blood cell (RBC) count (P = .033) and basic diseases (P = .020) were significantly correlated with a surgical wound infection after osteosarcoma resection. Logistic regression analysis manifested that basic disease (OR = 0.121, 95% CI: 0.015‐0.960, P = .046) and RBC (OR = 0.296, 95% CI: 0.093‐0.944, P = .040) have a clear correlation with whether the patients have surgical wound infection after osteosarcoma resection. And the interaction of basic diseases and RBC could diagnose the surgical wound infection sensitively and accurately (AUC = 0.700, P = .014, 95% CI = 0.564‐0.836) via the ROC analysis.

Conclusion:

Patients with basic diseases and low RBC were risk factors for surgical wound infection after osteosarcoma resection.
Counseling for the man with severe male infertility
Authors: Belladelli Federico , Muncey Wade , Seranio Nicolas , Eisenberg Michael L.
Published: October 2022

Purpose of review

This review summarize the proper counseling for men with severe male factor infertility.

Recent findings

Men who are experiencing infertility should have a semen analysis, the results of which may imply additional investigations, including genetic and hormonal. Moreover, possible modifiable factors that may harm men's reproductive health should be carefully evaluated. Finally, different treatment options are available.

Approximately 15% of couples struggle with infertility. Complete evaluations of both men and women are required to determine the etiology of infertility and determine appropriate treatment.
Role of microbiome in kidney stone disease
Authors: Galán-Llopis Juan A. , Sánchez-Pellicer Pedro , Navarro-López Vicente
Published: October 2022

Purpose of review

The process of renal stone formation is complex, multifactorial, and variable depending on the type of stone. The microbiome, whether by direct or indirect action, is a factor that both promotes the formation and protects from developing of renal stones. It is a highly variable factor due to the great interindividual and intraindividual variability that it presents. In recent years, with the incorporation of nonculture-based techniques such as the high-throughput sequencing of 16S rRNA bacterian gene, both intestinal and urinary microbiota have been deeply studied in various diseases such as the kidney stone disease.

Recent findings

This review has examined the new insights on the influence of the intestinal and urinary microbiome in nephrolithiasis disease and its usefulness as a diagnostic and prognostic tool, highlighting its contribution to the pathogenesis, its ability to modulate it and to influence disease development.

The incidence of urolithiasis has been increasing considerably. These patients represent a significant expense for national health systems. With the knowledge of the influence of the urobiome and intestinal microbiota on the urolithiasis, it could be possible to modulate it to interrupt its development.
Correlation of Global and Regional Amyloid Burden by 18F-Florbetaben PET/CT With Cognitive Impairment Profile and Severity
Authors: Pena Pardo Francisco José , García Vicente Ana María , Amo-Salas Mariano , Mondéjar Marín Beatriz , Navarro Muñoz Santiago , García Hortelano Piedad , Rueda Medina Ignacio , García Pérez Eloy , Padilla-Bermejo Amanda , Poblete García Víctor Manuel , Marsal Alonso Carlos , Soriano Castrejón Ángel
Published: October 2022

Purpose

To assess the correlation between profile and severity deterioration in the neuropsychological assessment and the most affected regions in amyloid PET semiquantification. The influence of vascular risk and other potential confounding factors was also evaluated.

Methods

A retrospective, observational, and multicenter study including all patients referred for amyloid PET in daily practice was conducted. Patients underwent neuropsychological assessment, and cognitive decline severity and domain(s) affected were recorded. The patients were grouped according to cognitive impairment (CI) profile and severity: (A) no CI, single-domain amnestic CI, multiple-domain amnestic CI, and nonamnestic CI; and (B) mild CI, moderate and severe dementia. An adapted Framingham Stroke Risk Profile was calculated for each individual. Depression and parkinsonism were also recorded. Standardized quantitative analysis software was used to obtain standardized uptake value ratio (SUVR) values from PET/CT images. The corresponding associations were assessed with the most appropriate statistical tests.

Results

One hundred twenty-nine patients were included (62 men, 67 women; 64.67 ± 7.47 years old). Significant differences in global and regional amyloid load were exclusively found in women between non-CI and moderate dementia (P = 0.006, for total-cerebellum SUVR). Posterior and anterior cingulates and prefrontal cortex best represented CI severity (P = 0.003, 0.006, and 0.006, respectively). No relationship between the CI profile and the regional amyloid load was shown. A significantly high positive correlation was found between age and vascular risk and between these variables and amyloid load in nearly all regions, especially in women with moderate dementia.

Conclusion

Semiquantitative analysis of amyloid PET by SUVR values revealed a significant correlation between amyloid burden and CI severity, although only in women.
Three-Dimensional-Printed Splint for Use in Pediatric Mandibular Fracture
Authors: Yang Chengshuai , Zhang Shilei , Zhang Yong
Published: October 2022

Mandibular fractures are the most common type, accounting for about 71% of facial fractures in children. The mandible is the only movable bone in the craniomaxillofacial region. The injury of the mandible has a serious impact on the functions of children’s mouth opening, chewing, pronunciation, and occlusion. Therefore, the treatment of children’s mandibular fractures is particularly important. Because of the characteristics of children with permanent tooth germ blocking and strong skeletal development, the treatment methods of adults cannot simply be used in children with mandibular fractures. Here, we demonstrate the simple, reliable method using 3-dimensional-printing splint for stability of the fracture segments in pediatric patients.
Predictive Factors of Outcomes in Helmet Therapy for Deformational Plagiocephaly and Brachycephaly
Authors: Hauc Sacha C. , Long Aaron S. , Rivera Jean Carlo , Ihnat Jacqueline , Littlefield Timothy R. , Shah Hemali P. , Pondugula Nishita , Junn Adam H. , Almeida Mariana N. , Alper David , Persing John , Alperovich Michael
Published: October 2022

Deformational plagiocephaly and brachycephaly, or abnormal flattening of the infant skull due to external forces, are often managed with orthotic helmet therapy. Although helmet therapy is widely used, the factors that predict poor outcomes are not well characterized. In this study of over 140,000 patients who received helmet therapy, older age and greater severity at presentation, and noncompliance with treatment were each independently associated with worse craniometric and provider-reported outcomes. Each additional point of cranial vault asymmetry index or cephalic index at a presentation is associated with an increased likelihood of residual brachycephaly at completion [odds ratio (OR): 1.067; 95% Cl: 1.058–1.075; P<0.0001 and OR: 2.043; 95% CI: 2.021–2.065; P <0.0001, respectively], whereas each additional point of cranial vault asymmetry index at a presentation associated with increased likelihood of residual asymmetry at completion (OR: 2.148; 95% Cl: 2.118–2.179; P<0.0001). Patients were more likely to have residual brachycephaly or asymmetry with increasing age at treatment initiation (OR: 1.562; 95% CI: 1.524–1.600; P<0.0001 and OR: 1.673; 95% Cl: 1.634–1.713; P <0.0001, respectively, for each additional month of age at initiation). These results highlight a need for prompt referral for helmeting, especially in cases with severe features or when patients present late to care. Potentially modifiable factors are age at helmeting and compliance with treatment protocols, and consideration of these factors may be important for achieving success in some cases.
Comparison of Nasopharyngeal Airway Volume in Cleft Lip and Palate Patients With Normal Individuals Using Cone Beam Computed Tomography
Authors: Eslami Neda , Hoseini Zarch Hossein , Jahanbin Arezoo , Darabi Zakie , Moayedi Sedigheh
Published: October 2022

This study aimed to compare nasopharyngeal airway volume in cleft lip and palate patients with normal individuals using Cone Beam Computed Tomography (CBCT). In this cross-sectional study, 40 CBCT scans of 9 to 12-years-old patients were enrolled and divided into 3 groups: normal individuals (n=16), unilateral cleft lip and palate (UCLP, n=14) and bilateral cleft lip and palate patients (BCLP, n=10). Superior and middle pharyngeal airway volumes and nasal width were measured and compared between 3 groups. ANOVA and χ2 tests were used for statistical comparison. P<0.05 was considered significant. Superior airway volume was not significantly different between the 3 groups (P=0.36). However, there was a significant difference between the 3 groups regarding middle pharyngeal volume (P=0.49) and nasal width (P=0.021). There was not a significant difference in the upper and middle pharyngeal volume and also nasal width between the 2 sexes. Considering different dimensions of evaluation of the pharyngeal airway volume of cleft lip and palate patients, the evaluation of airway volume is essential during orthodontic or orthognathic surgical treatments that expand or protect the maxilla.
Successful Electroconvulsive Therapy in Idiopathic Intracranial Hypertension With Mood Disorder and Partial Empty Sella Syndrome
Authors: Parker Maxwell T. , Putinta Kevin M. , Carr Brent R.
Published: October 2022

Patients with idiopathic intracranial hypertension (IIH) often experience significant burden from psychiatric comorbidities. Mood disorders are present in up to half of all patients with IIH, and they are often refractory to treatment by psychopharmacologic agents. Electroconvulsive therapy (ECT) is the criterion standard for treatment of patients with the most severe psychiatric burden but has relative contraindications in those possessing pathologies that raise intracranial pressure (ICP). There is a growing body of literature that a multidisciplinary care model would allow for patients with elevated ICP to receive ECT safely. Despite the high prevalence of mood disorders in patients with IIH, there are only 2 published case reports describing ECT delivery to patients from this cohort. We report our own case of a patient with IIH and major depressive disorder who received 38 bitemporal treatments with a positive response and no change in baseline ICP. Her positive response, along with the absence of elevation of ICP, aligns with the prior reports; however, her IIH symptoms have not responded as reported in the 2 cases—despite receiving more than 4 times the amount of treatments. Moreover, our patient possessed unique imaging for a partial empty sella syndrome, which has recently been found to be the only significant finding in patients who had a mood disorder before IIH diagnosis, versus a mood disorder developing after IIH diagnosis. This case serves to provide evidence of the safety and success of ECT in patients with IIH, relying on multidisciplinary care from psychiatry, neurology, and neuro-ophthalmology.
Postanesthesia Recovery Unit Optimization for Patients With Postictal Agitation Secondary to Electroconvulsive Therapy
Authors: Arora Vivek , Tuttle Kelsey , Borisovskaya Anna
Published: October 2022

Objectives

The occurrence of postictal agitation (PIA) can rapidly alter and intensify the level of care that electroconvulsive therapy (ECT) patients require during their recovery in the postanesthesia care unit (PACU). This operational analysis was undertaken to determine the impact PIA has on phase 1 PACU resources.

Methods

This operational analysis was undertaken at the Seattle Division of the US Department of Veterans Affairs Puget Sound Health Care System. From August 2019 to April 2020, we prospectively collected data on the recovery from ECT of 61 unique patients who underwent a total of 334 ECT sessions. Utilization of PACU resources was assessed by determining the PACU length of stay (LOS), onset of PIA, severity of PIA, and duration of agitation in encounters complicated by PIA.

Results

Seventy-nine occurrences of PIA occurred during the 334 ECT encounters. The mean ± SD PACU LOS was longer in encounters complicated by the occurrence of PIA compared with those not complicated by PIA (72 ± 32 and 59 ± 18 minutes respectively; P-value <0.05). Postanesthesia care unit LOS and mean duration of agitation increased as severity of PIA increased.

Conclusions

The occurrence of PIA can rapidly alter and intensify the level of care that ECT patients may require. Postictal agitation has a significant impact on the phase 1 PACU LOS of patients undergoing ECT. Phase 1 PACU staffing models should factor in the acute and prolonged care needs of patients who develop PIA during the recovery from ECT.
Identification of novel orthonairoviruses from rodents and shrews in Gabon, Central Africa
Authors: Ozeki Takehiro , Abe Haruka , Ushijima Yuri , Nze-Nkogue Chimène , Akomo-Okoue Etienne F. , Ella Ghislain W.E. , Koumba Lilian B.M. , Nso Branly C.B.B. , Mintsa-Nguema Rodrigue , Makouloutou-Nzassi Patrice , Makanga Boris K. , Nguelet Fred L.M. , Ondo Georgelin N. , Mbadinga Marien J.V.M. , Igasaki Yui , Okada Sayaka , Hirano Minato , Yoshii Kentaro , Lell Bertrand , Bonney Laura C. , Hewson Roger , Kurosaki Yohei , Yasuda Jiro
Published: October 2022

In Africa, several emerging zoonotic viruses have been transmitted from small mammals such as rodents and shrews to humans. Although no clinical cases of small mammal-borne viral diseases have been reported in Central Africa, potential zoonotic viruses have been identified in rodents in the region. Therefore, we hypothesized that there may be unrecognized zoonotic viruses circulating in small mammals in Central Africa. Here, we investigated viruses that have been maintained among wild small mammals in Gabon to understand their potential risks to humans. We identified novel orthonairoviruses in 24.6 % of captured rodents and shrews from their kidney total RNA samples. Phylogenetic analysis revealed that the novel viruses, Lamusara virus (LMSV) and Lamgora virus, were closely related to Erve virus, which was previously identified in shrews of the genus Crocidura and has been suspected to cause neuropathogenic diseases in humans. Moreover, we show that the LMSV ovarian tumour domain protease, one of the virulence determination factors of orthonairoviruses, suppressed interferon signalling in human cells, suggesting the possible human pathogenicity of this virus. Taken together, our study demonstrates the presence of novel orthonairoviruses that may pose unrecognized risks of viral disease transmission in Gabon.
A global pangenome for the wheat fungal pathogen Pyrenophora tritici-repentis and prediction of effector protein structural homology
Authors: Moolhuijzen Paula M. , See Pao Theen , Shi Gongjun , Powell Harold R. , Cockram James , Jørgensen Lise N. , Benslimane Hamida , Strelkov Stephen E. , Turner Judith , Liu Zhaohui , Moffat Caroline S.
Published: October 2022

The adaptive potential of plant fungal pathogens is largely governed by the gene content of a species, consisting of core and accessory genes across the pathogen isolate repertoire. To approximate the complete gene repertoire of a globally significant crop fungal pathogen, a pan genomic analysis was undertaken for Pyrenophora tritici-repentis (Ptr), the causal agent of tan (or yellow) spot disease in wheat. In this study, 15 new Ptr genomes were sequenced, assembled and annotated, including isolates from three races not previously sequenced. Together with 11 previously published Ptr genomes, a pangenome for 26 Ptr isolates from Australia, Europe, North Africa and America, representing nearly all known races, revealed a conserved core-gene content of 57 % and presents a new Ptr resource for searching natural homologues (orthologues not acquired by horizontal transfer from another species) using remote protein structural homology. Here, we identify for the first time a non-synonymous mutation in the Ptr necrotrophic effector gene ToxB, multiple copies of the inactive toxb within an isolate, a distant natural Pyrenophora homologue of a known Parastagonopora nodorum necrotrophic effector (SnTox3), and clear genomic break points for the ToxA effector horizontal transfer region. This comprehensive genomic analysis of Ptr races includes nine isolates sequenced via long read technologies. Accordingly, these resources provide a more complete representation of the species, and serve as a resource to monitor variations potentially involved in pathogenicity.
DeepCIP: a multimodal deep learning method for the prediction of internal ribosome entry sites of circRNAs
Authors: Zhou Yuxuan , Wu Jingcheng , Yao Shihao , Xu Yulian , Zhao Wenbin , Tong Yunguang , Zhou Zhan
Published: October 2022

Motivation

Circular RNAs (circRNAs) have been found to have the potential to code proteins. Internal ribosome entry sites (IRESs) are key RNA regulatory elements for the translation of proteins by circRNAs through a cap-independent mechanism. IRES can be identified by bicistronic assay, but the method is time-consuming and laborious. Therefore, it is important to develop computational methods for facilitating IRES identification, evaluation, and design in circRNAs.

Results

In this study, we proposed DeepCIP, a multimodal deep learning approach for circRNA IRES prediction, by exploiting both sequence and structure information. As far as we know, DeepCIP is the first predictor for circRNA IRESs, which consists of an RNA processing module, an S-LSTM module, a GCN module, a feature fusion module, and an ensemble module. The comparative studies show that DeepCIP outperforms other comparative methods and justify the effectiveness of the sequence model and structure model of DeepCIP for extracting features. We found that the integration of structural information on the basis of sequence information effectively improves predictive performance. For the real circRNA IRES prediction, DeepCIP also outperforms other methods. DeepCIP may facilitate the study of the coding potential of circRNAs as well as the design of circRNA drugs. DeepCIP as a standalone program is freely available athttps://github.org/zjupgx/DeepCIP.
Diverse photoperiodic gene expression patterns are likely mediated by distinct transcriptional systems in Arabidopsis
Authors: Leung Chun Chung , Tarté Daniel A. , Oliver Lilijana S. , Gendron Joshua M.
Published: October 2022

Photoperiod is an annual cue measured by biological systems to align growth and reproduction with the seasons. In plants, photoperiodic flowering has been intensively studied for over 100 years, but we lack a complete picture of the transcriptional networks and cellular processes that are photoperiodic. We performed a transcriptomics experiment on Arabidopsis plants grown in 3 different photoperiods, and find that nearly one-third of the known genes show photoperiodic alteration in gene expression. Gene clustering, daily expression integral calculations and cis-element analysis then separate photoperiodic genes into co-expression subgroups that display 19 diverse seasonal expression patterns, opening the possibility that many photoperiod measurement systems work in parallel in Arabidopsis. Then, functional enrichment analysis predicts co-expression of important cellular pathways. To test these predictions, we generated a comprehensive catalog of genes in the phenylpropanoid biosynthesis pathway, overlaid gene expression data and demonstrated that photoperiod intersects with the two major phenylpropanoid pathways differentially, controlling flavonoids but not lignin. Finally, we describe the development of a new app that visualizes photoperiod transcriptomic data for the wider community.
Using machine learning and clinical registry data to uncover variation in clinical decision making
Authors: James Charlotte , Allen Michael , James Martin , Everson Richard
Published: October 2022

Clinical registry data contains a wealth of information on patients, clinical practice, outcomes and interventions. Machine learning algorithms are able to learn complex patterns from data. We present methods for using machine learning with clinical registry data to carry out retrospective audit of clinical practice. Using a registry of stroke patients, we demonstrate how machine learning can be used to: investigate whether patients would have been treated differently had they attended a different hospital; group hospitals according to clinical decision making practice; identify where there is variation in decision making between hospitals; characterise patients that hospitals find it hard to agree on how to treat. Our methods should be applicable to any clinical registry and any machine learning algorithm to investigate the extent to which clinical practice is standardized and identify areas for improvement at a hospital level.