bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinicogenomic predictors of outcomes in patients with hepatocellular carcinoma treated with immunotherapy
Authors: Cowzer Darren , Chou Joanne F , Walch Henry , Keane Fergus , Khalil Danny , Shia Jinru , Do Richard K G , Yarmohammadi Hooman , Erinjeri Joseph P , El Dika Imane , Yaqubie Amin , Azhari Hassan , Gambarin Maya , Hajj Carla , Crane Christopher , Wei Alice C , Jarnagin William , Solit David B , Berger Michael F , O’Reilly Eileen M , Schultz Nikolaus , Chatila Walid , Capanu Marinela , Abou-Alfa Ghassan K , Harding James J
Published: June 2024

Introduction

Immune checkpoint inhibitor (ICI) combinations extend overall survival (OS) while anti-PD-1/L1 monotherapy is non-inferior to sorafenib in treatment-naïve, patients with advanced hepatocellular carcinoma (HCC). Clinicogenomic features are posited to influence patient outcomes.

Methods

The primary objective of this retrospective study was to define the clinical, pathologic, and genomic factors associated with outcomes to ICI therapy in patients with HCC. Patients with histologically confirmed advanced HCC treated with ICI at Memorial Sloan Kettering Cancer Center from 2012 to 2022 were included. Association between clinical, pathological, and genomic characteristics were assessed with univariable and multivariable Cox regression model for progression-free survival (PFS) and OS.

Results

Two-hundred and forty-two patients were treated with ICI-based therapy. Patients were predominantly male (82%) with virally mediated HCC (53%) and Child Pugh A score (70%). Median follow-up was 28 months (0.5-78.4). Median PFS for those treated in 1st line, 2nd line and ≥ 3rd line was 4.9 (range: 2.9-6.2), 3.1 (2.3-4.0), and 2.5 (2.1-4.0) months, respectively. Median OS for those treated in 1st line, 2nd line, and ≥ 3rd line was 16 (11-22), 7.5 (6.4-11), and 6.4 (4.6-26) months, respectively. Poor liver function and performance status associated with worse PFS and OS, while viral hepatitis C was associated with favorable outcome. Genetic alterations were not associated with outcomes.

Conclusion

Clinicopathologic factors were the major determinates of outcomes for patients with advanced HCC treated with ICI. Molecular profiling did not aid in stratification of ICI outcomes. Future studies should explore alternative biomarkers such as the level of immune activation or the pretreatment composition of the immune tumor microenvironment.
The Geography of Investor Attention
Authors: Mengoli Stefano , Pagano Marco , Pattitoni Pierpaolo
Published: June 2024

Local companies attract significantly more attention from investors than nonlocal companies, especially at times of news releases and high volatility. This attention gap widens especially when news is firm-specific rather than aggregate, and in response to idiosyncratic rather than market risk. Attention is causally related to perceived proximity: after a firm is acquired by a nonlocal one, local investors, compared with nonlocal investors, are more likely to reallocate attention away from it; conversely, COVID-19 travel restrictions led investors to reallocate attention toward local companies and away from nonlocal ones, especially those difficult to reach. Finally, local attention predicts volatility, bid-ask spreads, and nonlocal attention, but not vice versa. Our findings suggest that the geography of attention matters and is shaped by local investors’ information-processing advantage, not familiarity bias. (JEL D83, G11, G12, G14, L86, R32)

Received: 2 January 2024; Editorial decision: 13 March 2024 Editor: Isil Erel Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Psychosocial Interventions for Individuals With Comorbid Psychosis and Substance Use Disorders: Systematic Review and Meta-analysis of Randomized Studies
Authors: Siddiqui Salsabil , Mehta Dhvani , Coles Alexandria , Selby Peter , Solmi Marco , Castle David
Published: June 2024

Background and Hypothesis

Substance use is highly prevalent among people with schizophrenia (SCZ) and related disorders, however, there is no broad-spectrum pharmacotherapy that concurrently addresses both addiction and psychotic symptoms. Psychosocial (PS) interventions, which have yielded promising results in treating psychosis and substance dependence separately, demonstrate potential but have not been systematically evaluated when combined.

Study Design

Systematic review and random-effects meta-analyses of randomized controlled trials (RCTs) investigating PS interventions for individuals with comorbid substance use and psychotic disorders, encompassing SCZ and schizophrenia spectrum disorders (SSD). We included relevant studies published from MEDLINE, PsycINFO, and Google Scholar through May 2023.

Study Results

We included 35 RCTs (5176 participants total; approximately 2840 with SSD). Intervention durations ranged from 30 min to 3 years. Meta-analysis did not identify a statistically significant pooled PS intervention effect on the main primary outcome, substance use (18 studies; 803 intervention, 733 control participants; standardized mean difference, −0.05 standard deviation [SD]; 95% CI, −0.16, 0.07 SD; I2 = 18%). PS intervention effects on other outcomes were also not statistically significant. Overall GRADE certainty of evidence was low.

Conclusions

At present, the literature lacks sufficient evidence supporting the use of PS interventions as opposed to alternative therapeutic approaches for significantly improving substance use, symptomatology, or functioning in people with SCZ and related disorders. However, firm conclusions were precluded by low certainty of evidence. Further RCTs are needed to determine the efficacy of PS treatments for people with dual-diagnoses (DD), either alone or in combination with pharmacotherapy.
Facing antisemitism in Europe: individual and country-level predictors of Jews’ victimization and fear across twelve countries
Authors: Enstad Johannes Due
Published: June 2024

Rising antisemitism in the twenty-first century has alarmed Jewish communities and the general public, but antisemitic hate crime victimization remains understudied outside the US context. This study primarily relies on a comprehensive survey of 16,400 Jews across twelve European countries, supplemented with data from additional sources, to assess individual and country-level predictors of Jews’ experiences and fears of antisemitic harassment and violence. Multilevel models indicate that young age, perceived discrimination, identity visibility, and identification with Israel are pronounced individual risk factors for victimization. On the country level, negative opinion of Israel and Muslim population share predict victimization, highlighting the role of a “new” or Israel-derived antisemitism in the twenty-first century. The factors most strongly associated with fear are young age, previous victimization, perceptions of an ambient antisemitic threat, and recent occurrence of fatal antisemitic violence. Overall, the findings underscore the importance of integrating general theory on hate crime and victimization with context-specific factors when seeking to understand the experiences of targeted groups.
Sleep as a contributor to socioeconomic disparities in hypertension: The Midlife in the United States (MIDUS II) Study
Authors: Aqua Jasmine Ko , Barnum Olivia , Johnson Dayna A
Published: June 2024

Study Objectives

Hypertension is highly prevalent and is a major risk factor for cardiovascular disease. There is a higher burden of hypertension among individuals of lower socioeconomic status (SES), yet the role of sleep in understanding socioeconomic disparities in hypertension is unclear. We investigated whether sleep quality is a partial mediator of the association between SES and hypertension.

Methods

We used data from the Midlife in the United States II Study, 2004–2009 (n = 426). Analyses were conducted in 2023. Participants underwent 7-day actigraphy and clinical assessments. Sleep quality measures included actigraphy-defined wakefulness after sleep onset (WASO) and sleep efficiency. Hypertension was measured via three consecutive blood pressure readings, and SES was measured via educational attainment. Models were fit adjusting for age, gender, race, body mass index, and perceived stress.

Results

Participants had a mean age of 53.5 years (SD = 12.4) and 41.0% were African American. The prevalences of poor WASO (>30 minutes), low sleep efficiency (<85%), and hypertension were 77.7%, 67.1%, and 61.0%, respectively. Education was not associated with hypertension. However, individuals with low vs. high sleep efficiency had 24% higher prevalence of hypertension (aPR = 1.24, 95% CI: 1.02 to 1.51), higher systolic blood pressure (aβ = 4.61, 95% CI: 0.69 to 8.53), and higher diastolic blood pressure (aβ = 2.50, 95% CI: 0.10 to 4.89). Education was not significantly associated with sleep after adjustment. There was no evidence of sleep mediating the SES-hypertension relation.

Conclusions

Effective interventions to lower hypertension prevalence should consider targeting sleep quality. Future research should explore the intersectionality of SES and race in hypertension.
Evaluation of Stripe Rust Resistance and Chip Detection Resistance Genes in 286 Xinjiang Wheat Cultivars and Breeding Lines
Authors: Yan Haohao , Zhu Jianing , Jin Yongjin , Bai Xingxuan , Zeng Qingdong , Gao Haifeng , Ma Jinbiao , Huang Lili , Kang Zhensheng , Zhan Gangming
Published: June 2024

Wheat stripe rust is a destructive disease worldwide, caused by Puccinia striiformis f. sp. tritici (Pst). Resistance breeding is the most effective method of controlling stripe rust. Xinjiang is a relatively independent epidemic region of wheat stripe rust in China. In recent years, wheat stripe rust in this area has shown an upward trend. Therefore, the purpose of this study was to evaluate the resistance level of wheat cultivars (lines) to the prevalent Pst races and determine the genetic background of stripe rust resistance genes in Xinjiang. Six predominant Pst races in China were used to study resistance of 286 wheat cultivars (lines) at both the seedling stage under controlled conditions and the adult-plant stage under field conditions. In the seedling tests, 175 (61.19%) entries were resistant to the race CYR23, 125 (43.71%) to CYR29, 153 (53.50%) to CYR31, 88 (30.77%) to CYR32, 174 (60.84%) to CYR33, and 98 (34.27%) to CYR34. Among the resistant entries, 23 (8.04%) were resistant to all six races. In the field test, 135 (47.20%) entries were resistant to the tested mixed races. Through comparing the responses in the seedling and adult-plant stages, 109 (38.11%) entries were found to have adult-plant resistance (APR), and 14 (4.90%) entries have all-stage resistance (ASR). The 286 wheat entries were also tested using a wheat breeder chip containing 12 Yr resistance loci. Among these entries, 44 (15.38%) were found to have a single gene, 221 (77.27%) have two or more genes, and 21 (7.34%) have none of the 12 genes, including 144 (50.35%) with Yr30 and 5 (1.75%) with YrSP. Entries with two or more genes have stronger resistance to Pst. Overall, the majority of entries have all-stage and/or adult-plant resistance, but their genes for resistance in addition to the 12 tested Yr genes need to be determined. It is also necessary to introduce more effective resistance genes in the breeding programs to improve stripe rust resistance in wheat cultivars in Xinjiang.
Toll‐like receptor 4‐dependent innate immune responses are mediated by intracrine corticosteroids and activation of glycogen synthase kinase‐3β in astrocytes
Authors: Lai Wenfang , Huang Siying , Liu Junjie , Zhou Binbin , Yu Zhengshuang , Brown John , Hong Guizhu
Published: June 2024

Reactive astrocytes are important pathophysiologically and synthesize neurosteroids. We observed that LPS increased immunoreactive TLR4 and key steroidogenic enzymes in cortical astrocytes of rats and investigated whether corticosteroids are produced and mediate astrocytic TLR4‐dependent innate immune responses. We found that LPS increased steroidogenic acute regulatory protein (StAR) and StAR‐dependent aldosterone production in purified astrocytes. Both increases were blocked by the TLR4 antagonist TAK242. LPS also increased 11β‐hydroxysteroid dehydrogenase type 1 (11β‐HSD1) and corticosterone production, and both were prevented by TAK242 and by siRNAs against 11β‐HSD1, StAR, or aldosterone synthase (CYP11B2). Knockdown of 11β‐HSD1, StAR, or CYP11B2 or blocking either mineralocorticoid receptors (MR) or glucocorticoid receptors (GR) prevented dephosphorylation of p‐Ser9GSK‐3β, activation of NF‐κB, and the GSK‐3β‐dependent increases of C3, IL‐1β, and TNF‐α caused by LPS. Exogenous aldosterone mimicked the MR‐ and GSK‐3β‐dependent pro‐inflammatory effects of LPS in astrocytes, but corticosterone did not. Supernatants from astrocytes treated with LPS reduced MAP2 and viability of cultured neurons except when astrocytic StAR or MR was inhibited. In adrenalectomized rats, intracerebroventricular injection of LPS increased astrocytic TLR4, StAR, CYP11B2, and 11β‐HSD1, NF‐κB, C3 and IL‐1β, decreased astrocytic p‐Ser9GSK‐3β in the cortex and was neurotoxic, except when spironolactone was co‐injected, consistent with the in vitro results. LPS also activated NF‐κB in some NeuN+ and CD11b+ cells in the cortex, and these effects were prevented by spironolactone. We conclude that intracrine aldosterone may be involved in the TLR4‐dependent innate immune responses of astrocytes and can trigger paracrine effects by activating astrocytic MR/GSK‐3β/NF‐κB signaling.
Worse Pain and Disability at Presentation Predicts Greater Improvement in Pain, Disability, and Mental Health in Patients Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis
Authors: Anwar Fatima N. , Roca Andrea M. , Hartman Timothy J. , Nie James W. , Medakkar Srinath S. , Loya Alexandra C. , MacGregor Keith R. , Oyetayo Omolabake O. , Zheng Eileen , Federico Vincent P. , Sayari Arash J. , Lopez Gregory D. , Singh Kern
Published: June 2024

Study Design:

Retrospective Review.

Objective:

To assess the impact of preoperative pain and disability on patient-reported outcome measures (PROMs) following minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for degenerative spondylolisthesis.

Summary of Background Data:

Varying preoperative symptom severity in lumbar fusion patients alters perceptions of surgical success.

Methods:

Degenerative spondylolisthesis patients undergoing elective, primary, single-level MI-TLIF were stratified by preoperative symptom severity: Mild (VAS-B<7/ODI<50), Moderate (VAS-B≥7/ODI<50 or VAS-B<7/ODI≥50), and Severe (VAS-B≥7/ODI≥50). PROMs, Patient-reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), ODI, VAS-B, VAS-Leg (VAS-L), and 9-item Patient Health Questionnaire (PHQ-9) were compared at baseline, 6 weeks, and final follow-up (μ=16.3±8.8 mo). Postoperative PROMs, magnitudes of improvement, and minimal clinically important difference (MCID) achievement rates were compared between cohorts through multivariable regression.

Results:

A total of 177 patients were included. Acute postoperative pain and narcotic consumption were highest in the severe cohort (P≤0.003). All preoperative PROMs worsened from mild to severe cohorts (P<0.001). All PROMs continued to be significantly different between cohorts at 6 weeks and final follow-up, with the worst scores in the Severe cohort (P≤0.003). At 6 weeks, all cohorts improved in ODI, VAS-B, VAS-L, and PHQ-9 (P≤0.003), with the Moderate cohort also improving in PROMIS-PF (P=0.017). All Cohorts improved across PROMs at the final follow-up (P≤0.044). Magnitudes of improvement in ODI, VAS-B, and PHQ-9 increased with worsening preoperative symptom severity (P≤0.042). The Moderate and Severe cohorts demonstrated higher MCID achievement in ODI, VAS-B, and PHQ-9 rates than the Mild cohort.

Conclusions:

Despite preoperative pain and disability severity, patients undergoing MI-TLIF for degenerative spondylolisthesis report significant improvement in physical function, pain, disability, and mental health postoperatively. Patients with increasing symptom severity continued to report worse severity postoperatively compared with those with milder symptoms preoperatively but were more likely to report larger improvements and achieve clinically meaningful improvement in disability, pain, and mental health.
Unveiling the Rarity: CD20 Expression in Mycosis Fungoides and Its Clinical Significance
Authors: Shaker Nada , Sangueza Omar P.
Published: June 2024

Although CD20 expression is typically scarce in mycosis fungoides (MF), it is more commonly associated with T-cell lymphomas. Nevertheless, isolated instances of CD20-positive MF have been documented infrequently. Here, we present a unique case of CD20-positive MF in a 30-year-old man who manifested with a hypopigmented patch on the anterior chest. Histopathological examination revealed epidermotropic infiltrates of small- to medium-sized lymphocytes with hyperchromatic and cerebriform nuclei aligned along the basal and low-mid layers of the epidermis. Immunophenotypic analysis demonstrated neoplastic T cells expressing CD4+, CD8+, and CD3+ with the loss of CD7. Intriguingly, a notable subset of the neoplastic T cells exhibited CD20 expression. This case contributes to the sparse literature on CD20-positive MF and underscores its diagnostic and clinical ramifications. The role of B cells has been more thoroughly characterized in T-cell lymphomas other than MF. However, its significance in MF remains unclear due to the scarcity of reported cases. Some hypotheses propose that the B cells' expression might indicate immune dysregulation or complex interactions within the tumor microenvironment. Another perspective suggests it could signify a progression of the disease towards a more aggressive lymphoma phenotype. Further investigation and documentation of similar cases is imperative to elucidate the clinical features, prognosis, and optimal therapeutic strategies. The long-term prognosis and outcomes in patients with hypopigmented MF and CD20 positivity remain ambiguous, underscoring the necessity for continued research and scrutiny of analogous cases.
The predictors of intraoperative surgical expenses in liver resection for hepatocellular carcinoma
Authors: Huang Ching-Ting , Lin Chun-Chen , Lee King-Teh , Chang Wen-Tsan
Published: June 2024

Background

This study aimed to clarify the expenses associated with various items and predictors of intraoperative expenses in liver resection for hepatocellular carcinoma (HCC).

Materials and Methods

A total of 562 patients with HCC who underwent liver resection from January 2015 to December 2019 were enrolled in this retrospective study. The direct variables of total intraoperative expenses were the summation of surgeon's fee, anesthetic fee, fees for pharmacy, and disposable supplies, which were analyzed based on surgeons' seniority, patients' demographic features and comorbidity, clinical features of HCC, and complexity of surgery and surgical approach.

Results

Of the total cost, 43.3% accounted for expenses of disposing supplies, 32.8% for surgeons' fees, 15.9% for anesthetic fees, and 8.12% for pharmacy fees. A hierarchical model of multivariate regression analysis showed that the total expenses and that of disposable supplies were significantly higher in surgeons with seniority of over 26 years (P < 0.001) and those having a specialization of robotic surgery (P < 0.001). Further, the complexity and robotic approach of surgery predicted the total expenses (R
2 = 0.862, P < 0.001). Robotic approach and its disposable supplies and major liver resection increased by 93.2% and 20.1% (P < 0.001) of total expenses when compared to open liver resection or partial liver resection, respectively.

Conclusions

The study found that the robotic approach, disposable supplies, and complexity of surgery were the most important predictors of total intraoperative expenses for patients with HCC. Therefore, a cost-effectiveness analysis should be conducted to define the surgical value of the robotic approach for HCC resection.
Prognostic role of suPAR in acute pancreatitis: A protocol for systematic review
Authors: Rehan Syeda Tayyaba , Imran Laiba , Eqbal Farea , Khan Zayeema , Nashwan Abdulqadir J. , Asghar Muhammad Sohaib
Published: June 2024

Background:

Acute pancreatitis (AP) is a common emergency condition with high morbidity, mortality, and socio-economic impact. Soluble urokinase plasminogen activator receptor (suPAR) is a potential biomarker for AP prognosis. This study systematically reviews the literature on suPAR’s prognostic roles in assessing AP severity, organ failure, mortality, and other pathological markers.

Methods:

A comprehensive search of 5 databases up to March 19, 2023, was conducted, selecting cohort studies that examined suPAR’s relationship with AP outcomes. Outcome variables included AP severity, organ failure, mortality, hospital stay length, and suPAR’s association with other inflammatory markers. Our paper has been registered on Prospero (ID: CRD42023410628).

Results:

Nine prospective observational studies with 1033 AP patients were included. Seven of eight studies found suPAR significantly elevated in severe acute pancreatitis (P < .05). Four studies showed suPAR effectively predicted organ failure risk, and 4 studies concluded suPAR significantly predicted mortality (P < .05). The review had no high-risk studies, enhancing credibility.

Conclusion:

suPAR is a valuable prognostic marker in AP, significantly predicting severity, organ failure, hospital stay length, and mortality. Further large-scale studies are needed to explore suPAR’s role in other clinical outcomes related to AP disease course, to establish it as a mainstay of AP prognosis.
Ellipsoidal patellar bone tunnel fixation with Toggleloc suspension system for medial patellofemoral ligament reconstruction: A 5 years follow-up
Authors: Özdemir Uğur , Çinar Bekir Murat , Türker Mehmet , Uyar Ahmet Çağri , Serttaş Muhammed Fatih , Akar Abdülhalim , Şükür Erhan , Kochai Alauddin
Published: June 2024

Background:

This study aimed to evaluate the clinical and radiological features of the patella fixation technique using Toggleloc suspension system in a single ellipsoidal blind patellar tunnel during medial patellofemoral ligament (MPFL) reconstruction.

Methods:

This study included 52 patients (25 men, 27 women) who underwent MPFL reconstruction using a semitendinosus tendon graft. The graft was fixed to the ellipsoidal single blind tunnel opened on the medial side of the patella with an endobutton and was fixed to the femoral tunnel by using bioabsorbable screw. Clinical scores (Kujala score, Lysholm score, Tegner activity score and the visual analog scale [VAS] score) were evaluated preoperatively and at the end-follow up. Preoperative and postoperative radiological measurements (trochlea depth, sulcus angle, patellar height, patellar congruence angle, patellar tilt angle and lateral patellofemoral angle) were evaluated with X-ray (Merchant X-ray, anteroposterior and lateral radiography) and computed tomography (CT) of the knee.

Results:

Postoperative patellar redislocation or subluxation was not observed in any patient. Patellar congruence angle, patellar tilt angle and lateral patellofemoral angle mean values were found to return to normal values in the postoperative period and the results were statistically significant. Also statistically significant improvement in all clinical scores postoperatively. According to the Insall-Salvati index (ISI) and Caton-Deschamps index (CDI) on lateral radiography of the knee at 30° flexion, patellar height decreased in the postoperative period statistically significant. The CDI was above 1.3 in 17 (%32) of our patients. Thirteen of these values decreased to normal values. No radiological progression of patellofemoral osteoarthritis was observed in all patients at the final follow-up evaluation.

Conclusion:

In cases of patellofemoral instability, fixation of the tendon graft in blind ellipsoid tunnel using the Toggleloc suspension system provides satisfactory patellar graft fixation strength, significant functional improvement and a low failure rate.
Advancements in the physiopathological study of acupuncture treatment for insomnia: A review
Authors: Zhao Haishen , Liu Chengjun , Ye Hong , Shi Kejun , Yao Yijie , Wang Manya
Published: June 2024

Insomnia is a common sleep disorder that significantly impacts an individual’s psychological and physical health, characterized by persistent difficulties in falling asleep, decreased sleep quality, and impaired daytime functioning. Traditional treatment approaches primarily rely on pharmacotherapy and behavioral therapy, yet not all patients benefit from these methods, and they often come with certain side effects. Thus, identifying safe and effective alternative or adjunctive treatments is of paramount importance. The purpose of this paper is to review the research progress on acupuncture in the treatment of insomnia and to explore the mechanisms by which acupuncture may treat insomnia through regulating neurotransmitters and nervous system, anti-inflammatory actions, and improving neuroplasticity, providing evidence to support the broad application of acupuncture in clinical practice.
Effects of tracking linkage self-management mode on the compliance of prenatal examinations and delivery modes in primiparas
Authors: Yuan Yufan , Zhao Xiaojing , Kang Zhengli , He Xiufang , Song Xianfang
Published: June 2024

To explore the effects of tracking linkage self-management mode on the compliance of prenatal examinations and delivery modes in primiparas. A total of 270 primiparas undergoing prenatal examinations in Shijiazhuang Obstetrics and Gynecology Hospital were enrolled for prospective study between January 2021 and January 2022. They were divided into control group and observation group, 135 cases in each group. The control group was given routine management mode, while observation group was given tracking linkage self-management mode. All were intervened till discharge. The compliance (time and frequency of prenatal examinations), cognition of prenatal examinations, score of exercise of self-care agency scale, self-rating anxiety scale and self-rating depression scale, delivery modes and the occurrence of neonatal adverse outcomes were compared between the 2 groups. After intervention, total compliance rate of prenatal examinations in observation group was higher than that in control group (84.44% vs 72.59%) (P < .05). The scores of pregnancy care, genetic diseases counseling, prevention of birth defects and reasonable nutrition during pregnancy in observation group were higher than those in control group (P < .05), scores of health cognition, self-care skills, self-care responsibility and self-concept were higher than those in control group (P < .05), scores of self-rating anxiety scale and self-rating depression scale were lower than those in control group (P < .05), natural delivery rate was higher than that in control group (85.93% vs 74.81%) (P < .05), and incidence of neonatal adverse outcomes was lower than that in control group (0.74% vs 5.93%) (Fisher exact probability = 0.036). The application of tracking linkage self-management mode can significantly improve cognition to prenatal examinations, improve compliance of prenatal examinations and self-care ability, relieve anxiety and depression, increase natural delivery rate and reduce the incidence of neonatal adverse outcomes in primiparas.
Does adaptive radiotherapy for head and neck cancer favorably impact dosimetric, clinical, and toxicity outcomes?: A review
Authors: Simopoulou Foteini , Kyrgias George , Georgakopoulos Ioannis , Avgousti Rafaela , Armpilia Christina , Skarlos Pantelis , Softa Vasiliki , Theodorou Kiki , Kouloulias Vassilis , Zygogianni Anna
Published: June 2024

Purpose:

The current review aims to summarize the international experience of the impact of adaptive radiotherapy on dosimetry and clinical and toxicity outcomes. Additionally, it might trigger Radiation Oncologists to use ART and evaluate whether ART improves target volume coverage and/or normal tissue sparing and, consequently, therapeutic results.

Materials and methods:

We conducted an electronic literature search of PubMed/MEDLINE and ScienceDirect from January 2007 to January 2023. The search adhered to the PRISMA guidelines and employed keywords such as ART, HNC, parotid gland, and target volume. Furthermore, we examined the reference lists for studies pertinent to the present review. This study included both retrospective and prospective studies that were considered for inclusion.

Conclusion:

ART replanning appears to be a sustainable strategy to minimize toxicity by improving normal tissue sparing. Furthermore, it can enhance target volume coverage by correctly determining the specific dose to be delivered to the tumor. In conclusion, this review confirmed that ART benefits dosimetric, clinical/therapeutic, and toxicity outcomes.
Elevated neutrophil-to-lymphocyte ratio combined with decreased lymphocyte-to-monocyte ratio is associated with increased peripheral airway resistance in patients with hepatic steatosis
Authors: Shen Hsiao-Chin , Wang Ching-Hsiang , Yang Ching-Wen , Lin Yi-Hsuan , Yeh Hsiao-Yun , Perng Diahn-Warng , Yang Ying-Ying , Hou Ming-Chih
Published: June 2024

Although the link between hepatic steatosis and lung function has been confirmed, the focus has largely been on central airways. The association between hepatic steatosis and increased peripheral airway resistance has not yet been explored. Hepatic steatosis and increased peripheral resistance are connected with immunity dysregulation. High neutrophil-to-lymphocyte ratio (NLR) and low lymphocyte-to-monocyte ratio (LMR) have been recognized as indicators of immunity dysregulation. In this study, the association between hepatic steatosis and increased peripheral airway resistance was evaluated, and the effect of immunity dysregulation (high NLR/low LMR) on the increased peripheral airway resistance among patients with hepatic steatosis was explored. In this retrospective study, chest or abdomen CT scans and spirometry/impulse oscillometry (IOS) from 2018 to 2019 were used to identify hepatic steatosis and increased central/peripheral airway resistance in patients. Among 1391 enrolled patients, 169 (12.1%) had hepatic steatosis. After 1:1 age and abnormal ALT matching was conducted, clinical data were compared between patients with and without hepatic steatosis. A higher proportion of patients with hepatic steatosis had increased peripheral airway resistance than those without hepatic steatosis (52.7% vs 40.2%, P = .025). Old age, high body mass index, history of diabetes, and high NLR/low LMR were significantly correlated with increased peripheral airway resistance. The presence of hepatic steatosis is associated with increased peripheral airway. High NLR/low LMR is an independent associated factor of increased peripheral airway resistance in patients with hepatic steatosis. It is advisable for patients with hepatic steatosis to regularly monitor their complete blood count/differential count and undergo pulmonary function tests including IOS.
Prevalence of sarcopenia and association with HIV infection in China elderly: An observational study
Authors: Peng Tiecheng , Jin Xin , Xiong Chen , Juan He , Juhai Chen , Longhang Wang , Wang Yiyi
Published: June 2024

This article aims to analyze the prevalence of sarcopenia among the elderly in Guizhou Province, China, and its association with human immunodeficiency virus (HIV) infection. This cross-sectional study included 377 patients aged 60 and above in Guiyang Public Health Treatment Center from December 2022 to October 2023, including 231 patients in the community clinic and 146 HIV-infected individuals. According to the Asian Working Group for Sarcopenia 2019 Consensus to diagnose sarcopenia. Logistic regression was used to explore association between sarcopenia and HIV, and stratified by sex and age group. The prevalence of sarcopenia in the non-HIV infection elderly in Guizhou Province was 7.8% (21.3% in males and 5.5% in females), and the prevalence of sarcopenia in HIV-infected individuals was 29.5% (33.3% in males and 13.2% in females), with a statistically significant difference between HIV groups (χ2 = 30.946, P < .001). After control of gender, age, body mass index, body fat percentage, hypertension, diabetes, taking statins, smoking status, medium to high-intensity physical activity, whether childhood poverty, and parents died young, HIV infection was significantly associated with sarcopenia in the elderly (odds ratio = 4.635, 95% confidence interval  = 1.920–11.188, P = .001). The results of stratified regression were similar to the main results. The prevalence of sarcopenia in the elderly population in China was severe. HIV infection was a risk factor for sarcopenia. It is urgent to establish a prevention and treatment system for sarcopenia in the elderly population, especially for elderly HIV-infected male.
Clinical effectiveness of focused ultrasound combined with plasma radiofrequency ablation technique in the treatment of persistent strain rhinitis
Authors: Liu Shuhua , Xiao Yan , Xiao Kailan
Published: June 2024

Examine the effects of focused ultrasound in combination with plasma radiofrequency ablation technology on the physiological stability and postoperative recovery of persistent strain rhinitis. For a control experiment, 90 patients with persistent strain rhinitis were chosen and split into two groups: the control group (CG) and the experimental group (EG). The CG used conventional radiofrequency ablation technology, while the EG used focused ultrasound technology combined with radiofrequency ablation technology to treat persistent strain rhinitis. Between the EG and the CG, compare and contrast the recovery of nasal symptoms, nasal signs, postoperative discomfort, and postoperative respiratory status. One quarter after surgery, there was a substantial difference in physical sign ratings between the EG and the CG, and a particularly significant difference was seen after six months of treatment. One year following surgery, there was a statistical difference between the EG and the CG in the comparison of effective rates at various intervals, with a P value of .013. At 6 months following surgery, the MTT times in the EG and CG for the comparison of nasal function were 12.63 2.65 and 17.68 2.84, respectively, with statistically significant differences. The difference between the EG and the CG in the MTR comparison is statistically significant. In the comparison of NNO values between the EG and the CG after different treatment times. The nitric oxide value of the EG patients decreased over time, with statistical significance one month after surgery and one year after surgery. It is evident from the comparison of various symptom efficacy rates that the EG has a higher treatment effectiveness rate than the CG, and the total treatment effect difference following surgery has statistical significance. Indicators for PONV, PA, directional ability, respiratory recovery, and olfactory recovery performed better in the EG than in the CG, and the differences were statistically significant. Focused ultrasound and plasma radiofrequency ablation technology have a good therapeutic impact in the treatment of persistent strain rhinitis and can significantly reduce MTT. This technology can effectively improve symptoms such as nasal congestion, nasal flow, and headache in patients, and the therapeutic effect is long-lasting. The hospitalization time after treatment is significantly shortened.
The effect of hemispheric lesion location on trunk control
Authors: Delibaş Kati Şennur , Palaz Elif Ayşen , Güneş Gencer Yağmur , Hekim Hanife Hale , Temel Aksu Neriman , Yaman Aylin , Toraman Naciye Füsun
Published: June 2024

Background:

Trunk control is the basic component of postural control, and achieving trunk control is a complex process that can be achieved by dynamically building and maintaining neuromuscular function. Lateropulsion, which is also defined as the body falling to one side, is considered an important condition that is frequently encountered after stroke and affects trunk control. It is known that there are differences in the regulation of postural control and trunk control according to hemispheric localization. We had a very specific group of patients and tried to find out the outcomes prospectively in this study.

Methods:

The patients were divided into 2 groups those with right hemisphere lesions (Group 1) and those with left hemisphere lesions (Group 2). Comorbidity and cognitive function were evaluated using the Charlson Comorbidity Index (CMI) and Standardized Mini-Mental State Test (SMMSE). Activities of daily living were evaluated using the Turkish version of the Modified Barthel Index (MBI). The Stroke Rehabilitation Assessment of Movement Instrument (STREAM) test was used to assess trunk control and the Brunnstrom (BS) test was used to assess motor functions.

Results:

There was a significant difference between Groups 1 and 2 in terms of STREAM in lower extremity scores were higher in Group 2 (P < .05). The number of patients in BS lower extremity Stages IV-VI was higher in Group 1 and Group 2 (P < .05). It was determined that upper extremity, lower extremity and Total STREAM scores and BS Hand stage in Group 2 were significantly higher than Group 1 in patients with total middle cerebral artery (MCA) affected(P < .05).

Conclusion:

It was determined that trunk control was more affected in patients with right hemispheric lesions. Additionally, trunk control is significantly affected in patients with total MCA lesions.
The impact of educational attainment on mental health: A Causal Assessment from the UKB and FinnGen Cohorts
Authors: Jareebi Mohammad A. , Alqassim Ahmad Y.
Published: June 2024

Observational studies report inverse associations between educational attainment and depression/anxiety risks, but confounding hinders causal inference. This study aimed to assess potential causal relationships using Mendelian randomization (MR). Two-sample MR analysis was conducted using genetic instruments for education, smoking, body mass index, and physical activity from published genome-wide association studies. Depression and anxiety data came from the UK Biobank ([UKB] 117,782 individuals) and FinnGen (215,644 individuals) cohorts. Inverse variance weighted regression determined associations between exposures and mental health outcomes. Increased educational attainment was causally associated with reduced risks of depression (odds ratio [OR] = 0.99 per year, 95% confidence interval [CI]: 0.990–0.996, P < .001) and anxiety (OR = 0.99, CI: 0.98–0.991, P < .001) in both cohorts. Smoking initiation conferred higher risks of depression (UKB OR = 1.05, CI: 1.03–1.06, P < .001; FinnGen OR = 1.20, CI: 1.10–1.32, P < .001) and anxiety (FinnGen only, OR = 1.10, CI: 1.01–1.21, P < .05). Likewise, maternal smoking history associated with greater depression (UKB OR = 1.15, CI: 1.10–1.35, P = .027) and anxiety susceptibility (FinnGen OR = 3.02, CI: 1.67–5.46, P = .011). Higher body mass index elevated depression risk in both cohorts. Physical activity showed no clear associations. This MR study provides evidence that education may causally reduce mental health disorder risk. Smoking, obesity, and low activity appear detrimentally linked to depression and anxiety. Improving access to education could offer effective strategies for lowering population psychiatric burden.
Complete dislodgement of a mechanical valve prosthesis: A rare but potentially life-threatening event: a case report
Authors: Yu Aijia , Huang Yunzhou , Ren Shutang , Wang Cuihua , Zhou Jianhua , Ren Taojun
Published: June 2024

Rationale:

Complete dislodgement of a mechanical valve is extremely uncommon as a long-term issue after getting a substitute mitral valve, and this report details an incident of complete detachment of a mechanical valve.

Patient concerns:

A 50-year-old woman, who underwent mitral mechanical valve replacement 2 decades earlier at another facility, was urgently admitted due to sudden cardiogenic shock.

Diagnoses:

Transthoracic echocardiograms revealed severe malfunction of the mitral valve prosthesis, characterized by significant mitral regurgitation and moderate pulmonary hypertension. Following the insertion of extracorporeal membrane oxygenation and an intra-aortic balloon pump, the hemodynamics stabilized. Coronary angiography displayed the prosthetic mitral valve ring and leaflet floating in the left atrium, as confirmed by preoperative real-time 3-dimensional transesophageal echocardiography. A complete separation of the prosthetic ring and leaflet from the suture ring was observed.

Interventions:

The patient promptly underwent bioprosthetic mitral valve replacement.

Outcomes:

The patient’s postoperative course was uneventful, leading to discharge in good condition.

Lessons:

A crucial aspect is comprehending the structure of the prosthetic valve itself. The use of transthoracic echocardiography and real-time 3-dimensional transesophageal echocardiography provides additional structural and functional details, enhancing support for potential life-saving interventions. Echocardiography plays a significant role in evaluating the morphology and function of prosthetic valves.
Comparison of maternal neonatal outcomes of normotensive and hypertensive placental abruptions: A novel approach
Authors: Akkaya Hatice , Uysal Gulsum , Yilmaz Gamze
Published: June 2024

To analyze maternal and neonatal effects of placental abruption (PA) through a novel classification in the presence of hypertension. Initial hemoglobin parameters were also compared to predict pregnancy outcomes in addition to hypertension. This retrospective cohort designed study was conducted on 115 pregnant women with PA. The main parameters scanned and recorded from the hospital database and patient medical files. Two groups were classified regarding of presence or absence of hypertension (53 hypertensive, 62 normotensive). Maternal demographical and clinical characteristics (abdominal pain, vaginal bleeding) were recorded. APGAR scores below 5 at 1st and 5th minute, fetal or neonatal death, admission and length of stay in Neonatal Intensive Care Unit were also investigated and compared between the groups. Stillborn to live-born ratio and lower APGAR scores < 5 at 5th minute were significantly higher in hypertensive group than normotensive group (P = .006 and 0.047, respectively). Poor maternal outcomes were detected in the hypertensive group than normotensive group regarding rate of blood transfusion (27/53, 50.9%; 18/62, 29%, respectively, P = .017). More abdominal pain and less vaginal bleeding were seen in PA with HT. Higher lymphocyte count, mean platelet volume, and platelet distribution width were reported in hypertensive group. Poorer maternal and neonatal outcomes of hypertensive patients with PA were detected. These patients should deserve greater attention to assess not only the possible risks associated with abruption but also the accompanying complications.
Perioperative impact of ultrasound-guided ilioinguinal and iliohypogastric nerve blocks in patients undergoing pelvic fracture surgery
Authors: Shen Jie , Ma Hui , Yang Xiaohui , Hu Mingcan , Tian Jieyin
Published: June 2024

Pelvic fractures present a severe and complex clinical challenge. This study aimed to compare ultrasound-guided ilioinguinal (IIN) and iliohypogastric nerve (IHN) blocks with conventional general anesthesia (GA) in patients undergoing internal fixation surgery for pelvic fractures. A retrospective analysis was conducted on 100 patients equally divided into ultrasound-guided and control groups. The study monitored hemodynamics, intraoperative anesthesia drug usage, postoperative pain levels, and the incidence of adverse reactions between the 2 groups. The ultrasound-guided group underwent ultrasound-guided IHN and IIN blocks combined with GA. The ultrasound-guided group exhibited significant advantages for hemodynamic measurements at specific time points, lower consumption of Propofol and Remifentanil, and reduced pain intensity across all evaluated time intervals (P < .05). The incidence rate of adverse reactions was significantly lower in the ultrasound group (P = .016). Ultrasound-guided anesthesia is a superior alternative to conventional GA for managing pelvic fractures through internal fixation surgery. It offers advantages in terms of hemodynamic stability, drug consumption, postoperative pain management, and adverse reaction reduction.
Is there a change in the view of treatment for primary spontaneous pneumothorax?: The effect of thoracic CT and autologous blood pleurodesis: a retrospective cohort study
Authors: Özalp Tevrat , Karapinar Kemal
Published: June 2024

This study investigated recurrence rates and treatment efficacy based on tomographic findings during a long-term follow-up after primary spontaneous pneumothorax (PSP) treatment. We retrospectively analyzed patients with PSP treated at our hospital between 2003 and 2020. Patients were categorized into 2 groups based on computed tomography (CT) findings: group 1 (no bulla/bleb) and group 2 (bullae-bleb <3 cm). Data on demographics, recurrence, treatment methods, and outcomes were also collected and compared. A total of 251 PSP cases were evaluated, predominantly male (93.6%) with a mean age of 29.23 ± 1.14 years. Most cases (57%) occurred on the right side. Recurrence rates were highest within the first year (77.8%), with the first and second recurrences occurring at rates of 26% and 27.3%, respectively. In group 1 (n = 117), conservative treatment was applied in 15 cases, tube thoracostomy in 81, autologous blood pleurodesis (ABP) in 19, and surgery in 12. Recurrence rates were 46.6%, 21%, 5.3%, and 8.3%, respectively. In group 2 (n = 134), the recurrence rates were 50%, 32.7%, 20%, and 3.1%, respectively (P < .001). No mortality was observed for any patient. The treatment groups included conservative (n = 19), thoracostomy (n = 179), ABP (n = 34), and surgical (n = 44) groups. Recurrence rates were 47.3%, 27.4%, 11.8% (group 1: 5.3%, group 2: 20%, P = .035), and 4.5% (0% vs 6.3%), respectively. ABP effectively reduced recurrence in group 1 PSP patients without bullae or blebs on CT, potentially avoiding surgery. Video-assisted thoracoscopic surgery should be preferred in group 2 cases with bullae or blebs to minimize recurrence. These results underscore the importance of tailoring treatment strategies based on CT findings to optimize PSP management outcomes.