bluuebunny/crossref_metadata_2025 huggingface dataset:
Incremental prognostic value of intensity-weighted regional calcification scoring using contrast CT imaging in TAVR
Authors: Abdelkhalek Mohamed , Bahadormanesh Nikrouz , Ganame Javier , Keshavarz-Motamed Zahra
Published: September 2023

Aims

Aortic valve calcification scoring plays an important role in predicting outcomes of transcatheter aortic valve replacement (TAVR). However, the impact of relative calcific density and its causal effect on peri-procedural complications due to sub-optimal valve expansion remains limited. This study aims to investigate the prognostic power of quantifying regional calcification in the device landing zone in the context of peri-procedural events and post-procedural complications based on pre-operative contrast computed tomography angiography (CCTA) images. Assess the effect of calcification on post-procedural device expansion and final configuration.

Methods and results

We introduce a novel patient invariant topographic scheme for quantifying the location and relative density of landing zone calcification. The calcification was detected on CCTA images based on a recently developed method using automatic minimization of the false positive rate between aortic lumen and calcific segments. Multinomial logistic regression model evaluation and ROC curve analysis showed excellent classification power for predicting paravalvular leakage [area under the curve (AUC) = 0.8; P < 0.001] and balloon pre-dilation (AUC = 0.907; P < 0.001). The model exhibited an acceptable classification ability for left bundle branch block (AUC = 0.748; P < 0.001) and balloon post-dilation (AUC = 0.75; P < 0.001). Notably, all evaluated models were significantly superior to alternative models that did not include intensity-weighted regional volume scoring.

Conclusions

TAVR planning based on contrast computed tomography images can benefit from detailed location, quantity, and density contribution of calcific deposits in the device landing zone. Those parameters could be employed to stratify patients who need a more personalized approach during TAVR planning, predict peri-procedural complications, and indicate patients for follow-up monitoring.
Combination of sacubitril/valsartan and blockade of the PI3K pathway enhanced kidney protection in a mouse model of cardiorenal syndrome
Authors: Tsukamoto Shunichiro , Wakui Hiromichi , Uehara Tatsuki , Shiba Yuka , Azushima Kengo , Abe Eriko , Tanaka Shohei , Taguchi Shinya , Hirota Keigo , Urate Shingo , Suzuki Toru , Yamada Takayuki , Kinguchi Sho , Yamashita Akio , Tamura Kouichi
Published: September 2023

Aims

Angiotensin receptor-neprilysin inhibitor (ARNI) is an established treatment for heart failure. However, whether ARNI has renoprotective effects beyond renin-angiotensin system inhibitors alone in cardiorenal syndrome (CRS) has not been fully elucidated. Here, we examined the effects of ARNI on the heart and kidneys of CRS model mice with overt albuminuria and identified the mechanisms underlying ARNI-induced kidney protection.

Methods and results

C57BL6 mice were subjected to chronic angiotensin II infusion, nephrectomy, and salt loading (ANS); they developed CRS phenotypes and were divided into the vehicle treatment (ANS-vehicle), sacubitril/valsartan treatment (ANS-ARNI), and two different doses of valsartan treatment (ANS-VAL M, ANS-VAL H) groups. Four weeks after treatment, the hearts and kidneys of each group were evaluated. The ANS-vehicle group showed cardiac fibrosis, cardiac dysfunction, overt albuminuria, and kidney fibrosis. The ANS-ARNI group showed a reduction in cardiac fibrosis and cardiac dysfunction compared with the valsartan treatment groups. However, regarding the renoprotective effects characterized by albuminuria and fibrosis, ARNI was less effective than valsartan. Kidney transcriptomic analysis showed that the ANS-ARNI group exhibited a significant enhancement in the phosphoinositide 3-kinase (PI3K)-AKT signalling pathway compared with the ANS-VAL M group. Adding PI3K inhibitor treatment to ARNI ameliorated kidney injury to levels comparable with those of ANS-VAL M while preserving the superior cardioprotective effect of ARNI.

Conclusion

PI3K pathway activation has been identified as a key mechanism affecting remnant kidney injury under ARNI treatment in CRS pathology, and blockading the PI3K pathway with simultaneous ARNI treatment is a potential therapeutic strategy for treating CRS with overt albuminuria.
Overcoming Barriers to Text and Data Mining in the Era of ChatGPT: The Proposed Data Act as a Game-Changer
Authors: Manteghi Maryna
Published: September 2023

Article 35 of the proposed Data Act intends to free databases comprised of machine-generated data from the constraints of sui generis database protection. The provision may provide some remedy for researchers facing challenges under the text and data mining (TDM) exceptions of the Directive on Copyright in the Digital Single Market. However, the wording of Art. 35 may also raise questions and create legal uncertainties for scholars, as scientific research is not the main aim of the proposed legislation. This article argues that, even after the proposed Art. 35 of the Data Act, some databases comprised of machine-generated data may still fall within the scope of the sui generis database protection under certain circumstances. The discussion revolves, inter alia, around the concept of recorded data in the context of the ‘obtaining-creating dichotomy’, the use of mixed databases and the notion of derived or inferred data, and the issue of researchers’ access to machine-generated data. The findings of this article are intended to offer guidance to researchers using Artificial Intelligence tools, such as ChatGPT, to mine databases on how they may effectively avoid a potential infringement of the sui generis database right. The paper hopes to encourage new changes in the EU regulation on TDM that could create a more balanced and research-friendly framework.
Evaluation of Predict, a prognostic risk tool, after diagnosis of a second breast cancer
Authors: Deng Zhengyi , Jones Miranda R , Wolff Antonio C , Visvanathan Kala
Published: September 2023

Background

The UK National Health Service’s Predict is a clinical tool widely used to estimate the prognosis of early-stage breast cancer. The performance of Predict for a second primary breast cancer is unknown.

Methods

Women 18 years of age or older diagnosed with a first or second invasive breast cancer between 2000 and 2013 and followed for at least 5 years were identified from the US Surveillance, Epidemiology, and End Results (SEER) database. Model calibration of Predict was evaluated by comparing predicted and observed 5-year breast cancer–specific mortality separately by estrogen receptor status for first vs second breast cancer. Receiver operating characteristic curves and areas under the curve were used to assess model discrimination. Model performance was also evaluated for various races and ethnicities.

Results

The study population included 6729 women diagnosed with a second breast cancer and 357 204 women with a first breast cancer. Overall, Predict demonstrated good discrimination for first and second breast cancers (areas under the curve ranging from 0.73 to 0.82). Predict statistically significantly underestimated 5-year breast cancer mortality for second estrogen receptor–positive breast cancers (predicted-observed = ‒6.24%, 95% CI = ‒6.96% to ‒5.49%). Among women with a first estrogen receptor–positive cancer, model calibration was good (predicted-observed = ‒0.22%, 95% CI = ‒0.29% to ‒0.15%), except in non-Hispanic Black women (predicted-observed = ‒2.33%, 95% CI = ‒2.65% to ‒2.01%) and women 80 years of age or older (predicted-observed = ‒3.75%, 95% CI = ‒4.12% to ‒3.41%). Predict performed well for second estrogen receptor–negative cancers overall (predicted-observed = ‒1.69%, 95% CI = ‒3.99% to 0.16%) but underestimated mortality among those who had previously received chemotherapy or had a first cancer with more aggressive tumor characteristics. In contrast, Predict overestimated mortality for first estrogen receptor–negative cancers (predicted-observed = 4.54%, 95% CI = 4.27% to 4.86%).

Conclusion

The Predict tool underestimated 5-year mortality after a second estrogen receptor–positive breast cancer and in certain subgroups of women with a second estrogen receptor–negative breast cancer.
Large spontaneous lung hernia—a case report
Authors: Devan Nair Hareshdeva , Thapa Bibhusal , Bhagwat Krishna
Published: September 2023

Intercostal lung hernias can be results of trauma or surgery. True spontaneous lung hernias thought to be a result of sudden acute increase in intrathoracic pressures are extremely rare. Only 51 cases have been reported in literature over the past four-and-half decades. We report a case of spontaneous chest wall posterior-lateral lung herniation that developed in a 73-year-old following severe coughing and straining during an episode of lower respiratory tract infection. Herein we present the unusual findings in the case and outline the pathophysiology of the problem and management options available.
Perceiving Threat
Authors: Stein Janice Gross
Published: September 2023

This chapter examines the contribution of political psychology to the analysis of threat perception and assessment by individual leaders in international politics. It focuses on the perception of threat and two analytically distinct but closely related concepts, the perceptions of the credibility of the threat, and the resolve of the threatener. The chapter first examines five non-psychological explanations of threat perception that scholars of international relations have identified and then moves to the analysis of cognitive and emotion-driven theories of threat perception. Perception is closely connected to the predictions and judgments that motivate action. Especially important in processes of threat perception are cognitive patterns and heuristics, information processing, emotional states, patterns of inference and attribution, and patterns of assessment of the likelihood and intensity of threat (Kahneman and Tersky, 1983). The chapter concludes by situating these theories within broader explanations by evolutionary psychologists of threat perception.
Political Communication
Authors: Young Dannagal G. , Miller Joanne M.
Published: September 2023

This chapter argues that the conventional theories and processes at the core of the discipline of political communication are rooted in assumptions that no longer hold and contexts that no longer exist. Today’s media users experience decentralized, interpersonal, horizontal, networked politically relevant communication every day. Users experience socially contextualized messaging within a networked system that is predicated on the economics and logics of media fragmentation and micro-segmentation. Message producers, political campaigns, and social media platforms integrate users’ social psychological characteristics into messaging content, aesthetics, and dissemination strategies. This chapter outlines how these qualitative changes necessitate a reimagining of the field of political communication. The shift away from traditional mass media models to networked, decentralized media systems through digital technologies has crucial implications for: (a) the scope of what constitutes political communication and (b) the integration of political psychology into the study of political communication.
Political Identities
Authors: Mason Lilliana
Published: September 2023

This chapter examines the nature and consequences of partisan and ideological identities. Such identities sit uncomfortably with normative ideals of democratic behavior because they can result in political behavior that is at odds with the ideal democratic citizen as rational, objective, and fully informed. Nonetheless, social identification with political groups drives political behavior and informs the study of citizens’ participation, organization, and judgment. This chapter reviews the application of social-psychological theories concerning social identity and intergroup conflict to political behavior. More specifically, the chapter reviews evidence on the effects of political identities on information processing, political action, political emotions, and prejudice against political opponents. The chapter makes clear that while voter political behavior is not often “rational” from an individual economic perspective, it is in line with predictable psychological motivations.
Emotional Processes in Intractable Conflicts
Authors: Cohen-Chen Smadar , Halperin Eran
Published: September 2023

Emotions have been described as the psychological fuel driving and escalating intractable conflicts. The role of emotional processes in intractable conflicts can be studied from two perspectives. The first perspective is a descriptive one, in which scholars examine the crucial role played by individuals’ and groups’ emotional experiences in conflict situations. Here, emotions have been studied as both outcomes (of appraisals) and antecedents (of attitudes and behaviors). The second perspective is an interventionist one, focusing on the way emotional change (or regulation) can promote conciliatory attitudes and behaviors among the conflict’s involved parties. The following chapter offers an integrative model, bringing together both the descriptive and the interventionist approaches. The model encapsulates both the role of emotional experiences in preserving or transforming conflicts, and the potential role of emotion regulation strategies in contributing to conflict resolution efforts.
Biology and Politics
Authors: Settle Jaime , Detert Laurel
Published: September 2023

Evidence for the biological origins of politics first emerged as early as the 1970s, and the Politics and the Life Sciences journal was founded in 1982, a testament to nascent interest in the discipline. Recognition of the potential for biological measurement of political attitudes persisted throughout the 1980s and 1990s, but it has only been in the last 15 years that the biology and politics research agenda has emerged as a robust area of inquiry, integrating biological processes into the study of a wide variety of political outcomes. Although certain facets of the research agenda have inspired controversy, there has come to be wide recognition that biological approaches to understanding politics—often rooted in evolutionary perspectives—can be informative and complementary to a broad range of topics within political psychology, such as attitudes, identity, participation, interest, sophistication, and information processing.
Political Language
Authors: Hopkins Nick
Published: September 2023

Politics is routinely prosecuted through the strategic crafting of representations of the social and material world designed to recruit support for the speaker’s social and political project. Such arguments routinely feature: constructions of the audience’s social identity that imply the speaker’s project is to be taken on by that audience as their own (and those of their opponents, rejected), interpretations of diverse culturally available resources (e.g., holy texts, national myths, metaphors) that lend authority to the speaker’s version of social and material reality, attacks on others’ constructions, and rebuttals of others’ attacks on one’s own position. This chapter reviews research addressing such features of political language across diverse domains (e.g., concerning abortion, industrial disputes, war), involving state and non-state actors, in both electoralist and non-electoralist politics.
Relationship of peak fluxes of solar radio bursts and X-ray class of solar flares: Application to early great solar flares
Authors: Matsumoto Keitarou , Masuda Satoshi , Shimojo Masumi , Hayakawa Hisashi
Published: September 2023

Large solar flares occasionally trigger significant space-weather disturbances that affect the technological infrastructures of modern civilization, and therefore require further investigation. Although these solar flares have been monitored by satellite observations since the 1970s, large solar flares occur only infrequently and restrict systematic statistical research owing to data limitations. However, Toyokawa Observatory has operated solar radio observations at low frequencies (at 3.75 and 9.4 GHz) since 1951 and captured the early great flares as solar radio bursts. To estimate the magnitudes of flares that occurred before the start of solar X-ray (SXR) observations with the Geostationary Operational Environmental Satellite (GOES) satellites, we show the relationship between microwave fluxes at 3.75 and 9.4 GHz and X-ray fluxes of flares that occurred after 1988. In total, we explored 341 solar flares observed with the Nobeyama Radio Polarimeters and Toyokawa Observatory from 1988–2014 and compared them with the SXR observations recorded by the GOES satellites. The correlation coefficient was approximately 0.7. Therefore, the GOES X-ray class can be estimated from the peak flux at 3.75 and 9.4 GHz with a large variance and an error of factor of 3 (1σ). Thus, for the first time, we quantitatively estimated the light curves of two early solar flares observed in 1956 February by the Toyokawa solar radio observations using the relationship between SXR thermal radiation and microwave nonthermal radiation (Neupert, 1968, ApJ, 153, 59).
AGN number fraction in galaxy groups and clusters at z < 1.4 from the Subaru Hyper Suprime-Cam survey
Authors: Hashiguchi Aoi , Toba Yoshiki , Ota Naomi , Oguri Masamune , Okabe Nobuhiro , Ueda Yoshihiro , Imanishi Masatoshi , Yamada Satoshi , Goto Tomotsugu , Koyama Shuhei , Lee Kianhong , Mitsuishi Ikuyuki , Nagao Tohru , Nishizawa Atsushi J , Noboriguchi Akatoki , Oogi Taira , Sakuta Koki , Schramm Malte , Shibata Mio , Terashima Yuichi , Yamashita Takuji , Yanagawa Anri , Yoshimoto Anje
Published: September 2023

One of the key questions on active galactic nuclei (AGN) in galaxy clusters is how AGN could affect the formation and evolution of member galaxies and galaxy clusters in the history of the Universe. To address this issue, we investigate the dependence of AGN number fraction (fAGN) on cluster redshift (zcl) and distance from the cluster center (R$/$R200). We focus on more than 27000 galaxy groups and clusters at 0.1 < zcl < 1.4 with more than 1 million member galaxies selected from the Subaru Hyper Suprime-Cam. By combining various AGN selection methods based on infrared (IR), radio, and X-ray data, we identify 2688 AGN. We find that (i) fAGN increases with zcl and (ii) fAGN decreases with R$/$R200. The main contributors to the rapid increase of fAGN towards high-z and cluster center are IR- and radio-selected AGN, respectively. These results indicate that the emergence of the AGN population depends on the environment and redshift, and galaxy groups and clusters at high z play an important role in AGN evolution. We also find that cluster–cluster mergers may not drive AGN activity in at least the cluster center, while we have tentative evidence that cluster–cluster mergers could enhance AGN activity in the outskirts of (particularly massive) galaxy clusters.
Gender difference in network relationship between inter-temporal decisions and prefrontal activation levels in internet gaming disorder
Authors: Zheng Hui , Zhou Weiran , Wang Min , Dong Hao-hao , Lu Chunlei , Zhang Jia-lin , Ma Xue-feng , Hu Yanbo , Dong Guang-Heng
Published: September 2023

Background

Impulsivity and decision-making are key factors in addiction. However, little is known about how gender and time sensitivity affect impulsivity in internet gaming disorder (IGD).

Objective

To investigate the gender difference of impulsive decision-making and relevant brain responses in IGD.

Methods

We conducted a functional magnetic resonance imaging (fMRI) study with 123 participants, including 59 IGD individuals (26 females) and 64 matched recreational game users (RGUs, 23 females). Participants performed a delay-discounting task during fMRI scanning. We examined gender-by-group effects on behavioral and neural measures to explore the preference for immediate over delayed rewards and the associated brain activity. We also investigated the network correlations between addiction severity and behavioral and neural measures, and analyzed the mediating role of brain activity in the link between delay discounting parameters and IGD severity.

Results

We found significant gender-by-group interactions. The imaging results revealed gender-by-group interactions in the dorsolateral prefrontal cortex, medial frontal gyrus, and inferior frontal gyrus (IFG). Post hoc analysis indicated that, for females, RGUs showed higher activity than IGD individuals in these brain regions, while for males IGD individuals exhibited higher activity than RGUs. The activation in the left IFG mediated the relation between Internet Addiction Test score and discount rate in females. In males, the activation in the right dlPFC mediated the relation between IAT score and time sensitivity.

Discussion

Our findings imply that male IGD participants demonstrate impaired intertemporal decisions associated with neural dysfunction. Influencing factors for impulsive decision-making in IGD diverge between males (time sensitivity) and females (discount rate). These findings augment our comprehension of the neural underpinnings of gender differences in IGD and bear significant implications for devising effective intervention strategies for treating people with IGD.
Oxidative Stress and Neural Dysfunction in Gastrointestinal Diseases: Can Stem Cells Offer a Solution?
Authors: Stavely Rhian , Ott Leah C , Sahakian Lauren , Rashidi Niloufar , Sakkal Samy , Nurgali Kulmira
Published: September 2023

Oxidative stress is involved in many gastrointestinal (GI) disorders as either the primary pathogenesis (radiation, chemotherapy, toxicity, ischemia-reperfusion) or a secondary driving force of disease progression (inflammation and diabetes). The GI tract is innervated intrinsically by the enteric nervous system (ENS) with a diverse role in maintaining gut homeostasis and GI motility. Complications in the physiological functioning of the ENS results in GI dysfunction that can result in debilitating sequelae from dysmotility greatly impacting quality of life and leading to potentially fatal complications. Therapeutics to remedy either oxidative stress or enteric neuronal dysfunction are severely limited, resulting in a critical gap in clinical care for GI disease and neurointestinal complications. Stem cell therapies have shown great promise in the treatment of several gut disorders via mechanisms including cell regeneration, anti-inflammatory activity, providing trophic support, and emerging evidence of antioxidant and neuroprotective functions. The potential of mesenchymal stem cell (MSC) therapies and recent evidence of their antioxidant and neuroprotective activity in several GI conditions are discussed. Finally, future therapeutic aspects of stem cell-based tools for combatting oxidative stress and enteric neuropathies in GI disease are considered.
Association of Genetic Variants with Postsurgical Pain: A Systematic Review and Meta-analyses
Authors: Frangakis Stephan G. , MacEachern Mark , Akbar T. Adam , Bolton Christian , Lin Victor , Smith Albert V. , Brummett Chad M. , Bicket Mark C.
Published: September 2023

Background

Postsurgical pain is a key component of surgical recovery. However, the genetic drivers of postsurgical pain remain unclear. A broad review and meta-analyses of variants of interest will help investigators understand the potential effects of genetic variation.

Methods

This article is a systematic review of genetic variants associated with postsurgical pain in humans, assessing association with postsurgical pain scores and opioid use in both acute (0 to 48 h postoperatively) and chronic (at least 3 months postoperatively) settings. PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from 2000 to 2022 for studies using search terms related to genetic variants and postsurgical pain in humans. English-language studies in adult patients examining associations of one or more genetic variants with postsurgical pain were included. The primary outcome was association of genetic variants with either acute or chronic postsurgical pain. Pain was measured by patient-reported pain score or analgesic or opioid consumption.

Results

A total of 163 studies were included, evaluating 129 unique genes and 594 unique genetic variants. Many of the reported significant associations fail to be replicated in other studies. Meta-analyses were performed for seven variants for which there was sufficient data (OPRM1 rs1799971; COMT rs4680, rs4818, rs4633, and rs6269; and ABCB1 rs1045642 and rs2032582). Only two variants were associated with small differences in postsurgical pain: OPRM1 rs1799971 (for acute postsurgical opioid use standard mean difference = 0.25; 95% CI, 0.16 to 0.35; cohort size, 8,227; acute postsurgical pain score standard mean difference = 0.20; 95% CI, 0.09 to 0.31; cohort size, 4,619) and COMT rs4680 (chronic postsurgical pain score standard mean difference = 0.26; 95% CI, 0.08 to 0.44; cohort size, 1,726).

Conclusions

Despite much published data, only two alleles have a small association with postsurgical pain. Small sample sizes, potential confounding variables, and inconsistent findings underscore the need to examine larger cohorts with consistent outcome measures.

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The Clinical Course of SARS-CoV-2 Infection in Patients With Autoimmune Neutropenia: A Retrospective Case Series Study
Authors: Rotulo Gioacchino Andrea , Ceglie Giulia , Candino Annalisa , Merola Antonella , Profeti Elisa , Giancotta Carmela , Mercadante Stefania , Santilli Veronica , Cotugno Nicola , Palma Paolo , Palumbo Giuseppe , Finocchi Andrea
Published: September 2023

Severe acute respiratory syndrome coronavirus 2 infection in children with autoimmune neutropenia may be a cause for concern. In this retrospective study, none of the 24 autoimmune neutropenia cases manifested severe coronavirus disease 2019. We found a significant improvement in neutrophils and a reduction in lymphocytes at post-infection follow-up compared with the median of previous values. We speculate that this paradoxical effect may be due to postinfection immunological phenomena.
Integrating Neonatal Intensive Care Into a Family Birth Center
Authors: Shuman Clayton J. , Morgan Mikayla , Vance Ashlee
Published: September 2023

Parent-infant separation resulting from admission to a neonatal intensive care unit (NICU) is often reported as the most challenging and distressing experience for parents. Aiming to mitigate the stress of parent-infant separation, a new neonatal care model was designed to integrate NIC with delivery and postpartum care. Yet, little is known about the model and its implementation. Therefore, using a qualitative descriptive design with field observations, we describe the characteristics of an integrated neonatal intensive care (I-NIC) model and examined perceptions of clinical staff (n = 8) and parents (n = 3). The physical layout of the I-NIC rooms required additional oxygen and suction columns and new signage to specify them as NICU-equipped. Other NICU-related equipment was mobile, thus moved into rooms when necessary. Nurses were cross-trained in labor/delivery, postpartum, neonatal care; however, nurses primarily worked within their specific area of expertise. Clinician and parent perceptions of the model were notably positive, reporting decreased anxiety related to separation, increased ability for chest feeding and skin-to-skin care, and improved interdisciplinary care. Future work is needed to understand implementation of the model in other settings, with specific attention to unit architecture, level of NICU care services, patient census, and staff and patient outcomes.
The impact of insulin induced lipohypertrophy on carotid intima-media thickness in patients with type 2 diabetes mellitus
Authors: Kirac Cem Onur , Sirikci Vehbi , Findikli Huseyin Avni
Published: September 2023

Lipohypertrophy (LH) is a major localized complication of insulin therapy. We aimed to investigate the association between insulin-induced LH and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (DM). A total of 75 patients with DM treated with insulin were included in this study. The insulin injection sites of the patients were evaluated by inspection and palpation and then radiologically with ultrasound. The CIMT of the patients was evaluated using ultrasonography. According to the guideline recommendation, the CIMT cutoff value was taken as 0.9 mm, and the patients were categorized into 2 groups according to the CIMT value and evaluated statistically. The presence of LH (CI: 1.379–30.000; OR = 6.432; P < .05), age (CI: 1.036–1.149; OR = 1091; P < .05), BMI (CI: 1.003–1.262; OR = 1.125; P < .05) and duration of DM (CI: 1.001–1.300; OR = 1.141; P < .05) were independent risk factors for high-CIMT in patients with DM. The most interesting result of this study was that the presence of LH was an independent risk factor for increased CIMT. According to this result, we think that LH may increase the risk of cardiovascular disease as well as being a complication that disrupts the blood glucose regulation of patients with DM and increases the cost of treatment.
Prediction model of liver metastasis risk in patients with gastric cancer: A population-based study
Authors: Huang Fang , Fang Meihua
Published: September 2023

Liver was the most common site of distant metastasis in patients with gastric cancer (GC). The prediction model of the risk of liver metastasis was rarely proposed. Therefore, we aimed to establish a prediction model for liver metastasis in patients with GC. In this retrospective cohort study, we extracted demographic and clinical data of all the GC patients from the Surveillance, Epidemiology, and End Results registration database from 2010 to 2015. Patients were divided into training set (n = 1691) for model development and testing set (n = 3943) for validation. Univariable and multivariable logistic regression analyses were carried out on the training set to screen potential predictors of liver metastasis and constructed a prediction model. The receiver operator characteristics curves with the area under curve values were used to assess the predictive performance of the liver metastasis prediction model. And a nomogram of the prediction model was also constructed. Of the total 5634 GC patients, 444 (7.88%) had liver metastasis. Variables including age, gender, N stage, T stage, Lauren classification, tumor size, histological type, and surgery were included in the liver metastasis prediction model. The study results indicated that the model had excellent discriminative ability with an area under curve of 0.851 (95% confidence interval: 0.829–0.873) in the training set, and that of 0.849 (95% confidence interval: 0.813–0.885) in the testing set. We have developed an effective prediction model with 8 easily acquired predictors of liver metastasis. The prediction model could predict the risk of liver metastasis in GC patients and performed well, which would assist clinicians to make individualized prediction of liver metastasis in GC patients and adjust treatment strategies in time to improve the prognosis.
Early detection of hypervascularization in hepatocellular carcinoma (≤2 cm) on hepatic arterial phase with virtual monochromatic imaging: Comparison with low-tube voltage CT
Authors: Yamaguchi Haruomi , Ichikawa Tomoaki , Morisaka Hiroyuki , Akai Hiroyuki , Izuka Keisuke , Ueno Takashi , Abe Osamu , Tsushima Yoshito
Published: September 2023

This study aims to assess the diagnostic value of virtual monochromatic image (VMI) at low keV energy for early detection of small hepatocellular carcinoma (HCC) in hepatic arterial phase compared with low-tube voltage (80 kVp) CT generated from dual-energy CT (DE-CT). A total of 107 patients with 114 hypervascular HCCs (≤2 cm) underwent DE-CT, 140 kVp, blended 120 kVp, and 80 kVp images were generated, as well as 40 and 50 keV. CT numbers of HCCs and the standard deviation as image noise on psoas muscle were measured. The contrast-to-noise ratios (CNR) of HCC were compared among all techniques. Overall image quality and sensitivity for detecting HCC hypervascularity were qualitatively assessed by three readers. The mean CT numbers, CNR, and image noise were highest at 40 keV followed by 50 keV, 80 kVp, blended 120 kVp, and 140 kVp. Significant differences were found in all evaluating endpoints except for mean image noise of 50 keV and 80 kVp. Image quality of 40 keV was the lowest, but still it was considered acceptable for diagnostic purposes. The mean sensitivity for detecting lesion hypervascularity with 40 keV (92%) and 50 keV (84%) was higher than those with 80 kVp (56%). Low keV energy images were superior to 80 kVp in detecting hypervascularization of early HCC.
Identification of common genetic features and pathways involved in pulmonary lymphangioleiomyomatosis and ER-positive breast cancer
Authors: Yang Lulu , Xiao Ying , Ren Siying
Published: September 2023

Accumulating evidence suggests that patients with pulmonary lymphangioleiomyomatosis (PLAM) have a markedly higher prevalence of breast cancer (BC) than the general population. However, the underlying pathophysiological mechanisms remain unclear. Therefore, in this study, we employed a bioinformatics approach to understand the association between PLAM and estrogen receptor (ER)-positive BC. The PLAM (GSE12027) and ER-positive BC (GSE42568, GSE29044, and GSE29431) datasets were obtained from the Gene Expression Omnibus database, and GEO2R was used to identify common differentially expressed genes (DEGs) between them. Functional annotation was performed, and a protein–protein interaction (PPI) network was constructed. Hub genes were identified and verified using western blotting and immunohistochemistry. We conducted an immune infiltration analysis; based on the results, selected 102 common DEGs for follow-up analysis. Functional analyses revealed that the DEGs were mostly enriched in cell proliferation, gene expression regulation, and tumor-related pathways. Four hub genes—ESR1, IL6, PLA2G4A, and CAV1—were further analyzed, and CAV1 was revealed to be associated with clinical outcomes and immune infiltration in ER-positive BC. This study proposes a common, possible pathogenesis of PLAM and ER-positive BC. These common pathways and pivotal genes may provide new directions for further mechanistic studies.
Potassium level changes in chronic kidney disease patients following balanced crystalloid administration in the emergency department
Authors: Kong Sungsig , Kwon Hyuksool
Published: September 2023

One common reason why clinicians are often hesitate to administer balanced crystalloids in the emergency department is the potential occurrence of unexpected hyperkalemia in patients with chronic kidney disease (CKD). In order to investigate the changes in potassium levels resulting from the administration of balanced crystalloids, specially Plasma Solution A (a generic version of Plasma-Lyte), to emergency department patients with CKD, we conducted an evaluation. A retrospective cohort study was conducted at a single academic hospital. Our study included patients with CKD who received intravenous Plasma Solution A and underwent electrolyte follow-up testing within 24 hours of administration. In total, there were 745 patients included in this study, of whom 87 had CKD. Through a 1:1 propensity score matching procedure for factors other than the estimated glomerular filtration rate, we matched 87 patients with normal kidney function to 87 CKD patients. For patients with CKD, the mean standard deviation SD administered volume of Plasma Solution A was 28.7 (21.0) mL/kg, and the mean SD administration duration was 13.2 (4.5) hours. The mean SD potassium level decreased from 4.3 (0.6) mmol/L to 4.1 (0.6) mmol/L (P = .029). Our study findings suggest that there may be no significant harmful increase in potassium levels or worsening of renal function within 24 hours after the intravenous administration of approximately 2 L of Plasma Solution A to patients with CKD.
Identification of key genes in salivary gland in Sjögren’s syndrome complicated with Hashimoto thyroiditis: Common pathogenesis and potential diagnostic markers
Authors: Zhang Kaiyuan , Yu Xue , Zhang Yuxin , Lu Dingqi , Yao Xinyi , Hong Tao , Ren Yating , Chen Liying , Wang Xinchang
Published: September 2023

The coexistence of Sjögren’s syndrome (SS) and Hashimoto thyroiditis (HT) has been confirmed, but the common mechanism of its co-occurrence remains unknown. This study aims to further explore the underlying mechanism and biomarkers for the co-occurrence of SS and HT. The Gene Expression Omnibus databases were used to obtain gene expression profiles for SS (GSE127952 and GSE23117) and HT (GSE29315 and GSE138198). Following identifying SS and HT’s shared differentially expressed genes, functional annotation, protein–protein interaction network creation, and module assembly were performed to discover hub genes. H&E staining and immunohistochemistry were performed to validate the expression of the hub genes in salivary glands. Finally, the receiver operating characteristic (ROC) curve was utilized to assess the discrimination of the hub genes as biomarkers in predicting SS, this study applied CIBERSORTx to analyze the immune infiltration in SS and HT in addition. A total of 48 common differentially expressed genes (48 upregulated genes and 0 downregulated genes) were chosen for further investigation. We analyzed the expression and function of PTPRC, CD69, IKZF1, and lymphocyte cytosolic protein 2 via H&E, immunohistochemistry, and ROC analysis. The 4 hub genes were mainly enriched in the T-cell receptor signaling pathway. We then evaluated and verified the diagnosis value of 4 hub genes in clinical minor labial gland biopsy of SS with HT, SS without HT, and non-SS. ROC analysis revealed that the 4 hub genes had a strong diagnostic value. Our study showed the common pathogenesis of SS and HT. These hub genes and diagnostic models may put forward some new insights for diagnosing and treating SS complicated with HT.
Exploring the synergistic pharmacological mechanism of Huoxiang Drink against irritable bowel syndrome by integrated data mining and network pharmacology
Authors: Wang Ruo-Hui , Lin Yi-Ke , Xie Hong-Kai , Li Hui , Li Mu , He Dong
Published: September 2023

Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, characterized by abdominal pain, bloating, and changes in bowel habits. Huoxiang Drink (HD), derived from traditional Chinese medicine, has been reported to effectively treat digestive disorders caused by external cold and internal dampness. However, the pharmaceutical targets and mechanisms for HD against IBS remain unclear. Data mining, bioinformatics analysis, and network pharmacology were employed to explore the potential pharmacological mechanisms of HD against IBS. In this study, we screened 50 core targets to investigate the pharmacological mechanisms of HD against IBS. Enrichment analysis revealed that HD may participate in various signaling pathways, especially the inflammation-related tumor necrosis factor, signaling pathway and hypoxia-inducible factor signaling pathway. Molecular docking results confirmed that MOL000098 (Quercetin), MOL000006 (Luteolin), MOL005828 (Nobiletin), MOL005916 (Irisolidone), and MOL004328 (Naringenin), as key active ingredients in HD, bound to core targets (tumor protein P53, tumor necrosis factor, matrix metalloproteinases 9, and vascular endothelial growth factor-A) for topical treatment of IBS. This study suggested that HD offered a potential therapeutic strategy against IBS. Our findings may facilitate the efficient screening of active ingredients in HD and provide a theoretical basis for further validating the clinical therapeutic effects of HD on treating IBS.
A case report: A patient rescued by VA-ECMO after cardiac arrest triggered by trigeminocardiac reflex after nasal surgery
Authors: Zhang Xu , Sun Bin , Pac-Soo Chen , Ma Daqing , Wang Liwei
Published: September 2023

Rationale:

Cardiac arrest (CA) caused by trigeminocardiac reflex (TCR) after endoscopic nasal surgery is rare. Hence, when a patient suffers from TCR induced CA in the recovery room, most doctors may not be able to find the cause in a short time, and standard cardiopulmonary resuscitation and resuscitation measures may not be effective. Providing circulatory assistance through venous-arterial extracorporeal membrane oxygenation (VA-ECMO) can help healthcare providers gain time to identify the etiology and initiate symptom-specific treatment.

Patient concerns:

We report a rare case of CA after endoscopic nasal surgery treated with VA-ECMO.

Diagnoses:

We excluded myocardial infarction, pulmonary embolism, allergies, hypoxia, and electrolyte abnormalities based on the relevant examination results. Following a multidisciplinary consultation, clinical manifestation and a review of previous literature, we reasoned that the CA was due to TCR.

Interventions:

VA-ECMO was established to resuscitate the patient successfully during effective cardiopulmonary resuscitation.

Outcomes:

ECMO was successfully evacuated a period of 190 minutes of therapy. The patient was discharged home on day 8.

Lessons:

TCR is notable during endoscopic nasal surgery. Our case indicates that CA in operating room is worth prolonged CCPR. The ideal time for ECPR implementation should not be limited within 20 minutes after CCPR.
Comparison between bioelectrical impedance analyses and dual-energy X-ray absorptiometry for accuracy in assessing appendicular skeletal muscle mass and diagnosing sarcopenia in hospitalized Chinese older adults
Authors: Liu Jianping , Chen Xiaoliang
Published: September 2023

The aim of this study was to compare bioelectrical impedance analysis (BIA) with dual-energy X-ray absorptiometry (DXA) and investigate the accuracy of BIA in assessing appendicular skeletal muscle mass (ASM) and diagnosing sarcopenia. A total of 90 elderly patients hospitalized in the Affiliated Hospital of Hangzhou Normal University from 2019 to 2020 were collected, including 42 males and 48 females. All patients underwent BIA and DXA examinations. Pearson correlation and Bland-Altman analysis were used to compare the differences between BIA and DXA in assessing ASM and diagnosing sarcopenia. ASM measured by BIA was higher than ASM measured by DXA, and there was statistical significance for all differences (P < .001); Pearson correlation analysis showed that ASM measured by BIA and DXA was positively correlated in both male (R = 0.94) and female (R = 0.97) patients (P < .001); Bland-Altman analysis showed that there was a high consistency between ASM detected by BIA and DXA; The detection rate of low muscle mass and sarcopenia by BIA and DXA was not statistically significant (P > .05). BIA (InBody720) has high accuracy in assessing ASM and diagnosing sarcopenia in hospitalized Chinese older adults, and has the advantages of convenient use, no radiation, and easy promotion, so it can be used as an early screening tool in primary hospitals lacking DXA.
Evaluation of 18-FDG PET diagnostic capabilities for cancer screening in heart transplant patients, a retrospective study
Authors: Sagnes Julie , Battistella Pascal , Paunet Tom , Mariano-Goulart Denis , Kucharczak Florentin
Published: September 2023

Evaluate 18-FDG positron emission tomography (PET) diagnostic capabilities for cancer screening in heart transplant patients. We conducted an anonymized retrospective observational study of heart transplant patients followed in the University Hospital of Montpellier, France. We analyzed 303 18-FDG PET from 158 patients. We compared demographic and clinical characteristics through uni- and multivariate analysis: in the cancer-free group, comparisons were made between the PET false positive (FP) group versus true negative (TN), and in the cancer group, comparisons were made between the PET false negative (FN) group versus true positive (TP). Out of the 303 exams, we found 245 TN, 26 TP, 26 FP and 6 FN. The sensitivity rate was calculated at 81%, the specificity rate at 90%, the positive predictive value at 50%, and the negative predictive value at 97%. The multivariate analysis showed an association between FP diagnosis and graft-PET delay (P value = .046, OR = 5.14, 95% CI [1.18–32.4]) and creatine reactive protein (CRP) ≥ 10 mg/L (P value = .042, OR = 4.21, 95% CI [1.02–17.2]). The estimated probability of FP by logit regression was 0.48 with 95% CI [0.21–0.77] when graft-PET delay ≥ 6 years and CRP ≥ 10 mg/L. No significative statistical link was found for the demographic or clinical characteristics in the FN group of patients with cancer, except for sex (all FN were men). 18-FDG PET performed very well in the follow-up of heart transplant patients for neoplasia screening, with better specificity than sensitivity. However, the study showed that almost 50% of FP can be predicted by considering only the graft-PET delay and CRP.
Association of radiotherapy with thoracic vertebral fractures in esophageal squamous cell carcinoma: A retrospective cohort study
Authors: Wu Xing-Qiang , Zhang Tian-Yue , Yang Fan , Feng Xin-Yi , Feng Yu-Ling , Wang Ling-Li , Chen Tian-Wu , Li Chun-Ping , Li Rui
Published: September 2023

To investigate the association between radiotherapy (RT) and thoracic vertebral fractures in esophageal squamous cell carcinoma (ESCC) and explore the risk factors of thoracic vertebral fracture in ESCC who underwent RT. This retrospective cohort study including 602 consecutive ESCC patients examined the association between RT and thoracic vertebral fractures using multivariable Cox proportional hazard models and relevant risk factors of thoracic vertebral fractures based on clinical and RT parameters in patients with ESCC. Followed for a median follow-up of 24 months, 54 patients had thoracic vertebral fractures. The multivariable analysis revealed RT as an independent risk factor after adjusting for clinical risk factors. Univariable analyses associated a 5-Gy increase in vertebral dose to single vertebrae and a 1-time increase in RT fraction with higher risk of vertebral fracture. Adding RT factors (vertebral dose and fraction) and mean vertebral hounsfield unit to the Cox models containing conventional clinical risk factors significantly improved the χ2 value for predicting vertebral fractures (all P < .001). This study revealed RT, as well as increased vertebral dose and RT fractions, as a significant, consistent, and strong vertebral fracture predictor in ESCC. Combined vertebral dose, RT fractions, and vertebral hounsfield unit provided optimal risk stratification for ESCC patients.