bluuebunny/crossref_metadata_2025 huggingface dataset:
The proofreading exonuclease of leading-strand DNA polymerase epsilon prevents replication fork collapse at broken template strands
Authors: Ahmad Tasnim , Kawasumi Ryotaro , Taniguchi Tomoya , Abe Takuya , Terada Kazuhiro , Tsuda Masataka , Shimizu Naoto , Tsurimoto Toshiki , Takeda Shunichi , Hirota Kouji
Published: November 2023

Leading-strand DNA replication by polymerase epsilon (Polϵ) across single-strand breaks (SSBs) causes single-ended double-strand breaks (seDSBs), which are repaired via homology-directed repair (HDR) and suppressed by fork reversal (FR). Although previous studies identified many molecules required for hydroxyurea-induced FR, FR at seDSBs is poorly understood. Here, we identified molecules that specifically mediate FR at seDSBs. Because FR at seDSBs requires poly(ADP ribose)polymerase 1 (PARP1), we hypothesized that seDSB/FR-associated molecules would increase tolerance to camptothecin (CPT) but not the PARP inhibitor olaparib, even though both anti-cancer agents generate seDSBs. Indeed, we uncovered that Polϵ exonuclease and CTF18, a Polϵ cofactor, increased tolerance to CPT but not olaparib. To explore potential functional interactions between Polϵ exonuclease, CTF18, and PARP1, we created exonuclease-deficient POLE1exo−/−, CTF18−/−, PARP1−/−, CTF18−/−/POLE1exo−/−, PARP1−/−/POLE1exo−/−, and CTF18−/−/PARP1−/− cells. Epistasis analysis indicated that Polϵ exonuclease and CTF18 were interdependent and required PARP1 for CPT tolerance. Remarkably, POLE1exo−/− and HDR-deficient BRCA1−/− cells exhibited similar CPT sensitivity. Moreover, combining POLE1exo−/− with BRCA1−/− mutations synergistically increased CPT sensitivity. In conclusion, the newly identified PARP1-CTF18-Polϵ exonuclease axis and HDR act independently to prevent fork collapse at seDSBs. Olaparib inhibits this axis, explaining the pronounced cytotoxic effects of olaparib on HDR-deficient cells.
Deciphering spatially distinct immune microenvironments in glioblastoma using ferumoxytol and gadolinium-enhanced and FLAIR hyperintense MRI phenotypes
Authors: Stoller Jared , Kersch Cymon N , Muldoon Leslie L , Ambady Prakash , Harrington Christina A , Fu Rongwei , Raslan Ahmed M , Dogan Aclan , Neuwelt Edward A , Barajas Ramon F
Published: November 2023

Background

MRI with gadolinium (Gd)-contrast agents is used to assess glioblastoma treatment response but does not specifically reveal heterogeneous biology or immune microenvironmental composition. Ferumoxytol (Fe) contrast is an iron nanoparticle that localizes glioblastoma macrophages and microglia. Therefore, we hypothesized that the use of Fe contrast improves upon standard Gd-based T1-weighted and T2/FLAIR analysis by specifically delineating immune processes.

Methods

In this, HIPAA-compliant institutional review board-approved prospective study, stereotactic biopsy samples were acquired from patients with treatment-naïve and recurrent glioblastoma based on MR imaging phenotypes; Gd and Fe T1 enhancement (Gd+, Fe+) or not (Gd–, Fe–), as well as T2-Flair hyperintensity (FLAIR+, FLAIR–). Analysis of genetic expression was performed with RNA microarrays. Imaging and genomic expression patterns were compared using false discovery rate statistics.

Results

MR imaging phenotypes defined a variety of immune pathways and Hallmark gene sets. Gene set enrichment analysis demonstrated that Gd+, Fe+, and FLAIR+ features were individually correlated with the same 7 immune process gene sets. Fe+ tissue showed the greatest degree of immune Hallmark gene sets compared to Gd+ or Flair+ tissues and had statistically elevated M2 polarized macrophages, among others. Importantly, the FLAIR+ Gd+ and Fe– imaging phenotypes did not demonstrate expression of immune Hallmark gene sets.

Conclusions

Our study demonstrates the potential of Fe and Gd-enhanced MRI phenotypes to reveal spatially distinct immune processes within glioblastoma. Fe improves upon the standard of care Gd enhancement by specifically localizing glioblastoma-associated inflammatory processes, providing valuable insights into tumor biology.
Criminalizing Indigenous Belief: The Constitutional Deficits of Uganda’s Witchcraft Act
Authors: Kabumba Busingye
Published: November 2023

The 1995 Constitution of Uganda contains important human rights guarantees, including the freedoms of religion, expression, and association. At the same time, there continues to exist a law, first enacted during the colonial period, which criminalizes—as ‘witchcraft’—certain aspects of African traditional religion. This article considers the extent to which this law is consistent with the liberties promised and protected under the Constitution. Ultimately, it contends that the imperatives of both constitutional governance and the redress of historical injustice mandate a repeal of Uganda’s Witchcraft Act and all related legal enactments.
Women’s Education and Fertility: The Direct Relationship
Authors: Jejeebhoy Shireen J
Published: November 2023

The evidence suggests seven major points of interest concerning the direct relationship between women’s education and fertility: In the early stages of a country’s development, as measured by income and literacy levels, and in settings with wide gender disparities in literacy, a small amount of education may increase fertility. Any negative effect education has on fertility is likely to be negligible; An inverse relationship is observed largely in countries with higher levels of development and more egalitarian settings; In most societies, there appears to be a threshold level of education beyond which marked differentials in fertility are generated; the highest thresholds exist in the least developed societies and those in which gender disparities in literacy levels are widest; only among more developed and egalitarian societies do the thresholds possibly drop to zero years of schooling. Correspondingly, the level of education at which fertility is highest falls systematically with improvements in income, literacy, and gender disparities in literacy; Differentials between the least and most educated women become progressively wider with improvements in income and literacy levels and the narrowing of gender disparities in literacy; The relationship between education and fertility is dynamic, changing its shape over time from curvilinear to inverse and from sharply inverse to moderately inverse; Even within countries, the shape of the relationship is not uniformly inverse, being more inverse in better developed and urban areas; The impact of women’s education on fertility is usually stronger than that of men’s education or household socio-economic characteristics.
Education And Women’s Autonomy
Authors: Jejeebhoy Shireen J
Published: November 2023

The literature supports the hypotheses that education enhances women’s knowledge, decision-making power, confidence in interacting with the outside world, closeness to husband and children, and economic and social self-reliance. These effects of education are, however, by no means uniform across regions, cultures, or levels of development. Uneducated women often have relatively little autonomy, and highly educated women tend to have the most. What happens in between varies by culture and the extent of gender stratification. In other words, the norms of patriarchy play an important role in conditioning the impact of education on changes in women’s autonomy. In settings that are highly stratified by gender, women may have little autonomy until they have attained relatively high levels of education, whereas in more egalitarian settings, the thresholds are lower. These findings bear out the conclusions of Chapter 2, which also suggest that, in many settings, the effect of education in reducing fertility is observed only after moderate levels of education have been attained.
Education And Women’s Age At Marriage
Authors: Jejeebhoy Shireen J
Published: November 2023

The positive relationship of education to marital age is one of the most pervasive findings in the literature. In many contexts, however, the effect of a small amount of education on postponing marriage is minimal. For the most part, the tendency for education to raise marriage age becomes universal only after a few years of primary education. This pattern persists irrespective of the country’s overall levels of development and of gender disparity in literacy.
Fertility-Enhancing Effects Of Education
Authors: Jejeebhoy Shireen J
Published: November 2023

The literature strongly supports the existence of an inverse effect of education on the duration of both breast-feeding and abstinence. Even a small amount of education leads to a decline in these durations, although there is evidence that the effect becomes stronger at higher levels of education. The inverse relationship of education to durations of breast-feeding and abstinence is influenced by several changes in the situation of women. These include the increased awareness among educated women of alternatives to prolonged breast-feeding and abstinence; greater decision-making power among educated women concerning such personal aspects of their lives; and increased husband-wife intimacy among educated women. Finally, in contexts in which opportunities for women’s work outside the home are plentiful and where breast-milk substitutes are widely available and culturally acceptable, educated working women do seem to find breast-feeding incompatible with the demands of employment. They are, hence, more likely to breast-feed for shorter durations.
Women’s Education, Fertility Regulation, and Obstacles to Contraception
Authors: Jejeebhoy Shireen J
Published: November 2023

The relationship between women’s education and the practice of contraception is direct and consistent, especially after a small amount of education is attained. One reason for the relationship between education and contraceptive practice is that educated women face fewer obstacles relating to the practice of contraception than uneducated women face. Educated women have a more comprehensive knowledge of contraception, its mechanics and side-effects; they have more positive attitudes to the practice of deliberate fertility regulation; and they are less inhibited about discussing contraception and family size with their husbands.
Women’s Education and Fertility: The Relative Influence of Each Intervening Pathway
Authors: Jejeebhoy Shireen J
Published: November 2023

This chapter makes two points. First, the education-fertility relationship shifts from non-inverse to inverse as the setting becomes more developed or more egalitarian. Second, as the setting becomes more developed or more egalitarian, it takes less education to produce a pronounced reduction in fertility. The reason underlying both these observations is that, in lesser developed and more gender-stratified settings, the most powerful effects of education are to reduce such traditional inhibitions on child supply as prolonged breast-feeding or post-partum abstinence rather than to delay marriage, reduce family-size desires, or increase contraception. Only in more developed and more egalitarian settings are the effects of education on the latter variables more powerful than their effects on the former, resulting in the more uniform inverse effect of education on fertility seen in these settings.
Growth regulation by apyrases: Insights from altering their expression level in different organisms
Authors: Clark Greg , Tripathy Manas K , Roux Stanley J
Published: November 2023

Apyrase (APY) enzymes are nucleoside triphosphate (NTP) diphosphohydrolases that can remove the terminal phosphate from NTPs and nucleoside diphosphates but not from nucleoside monophosphates. They have conserved structures and functions in yeast, plants, and animals. Among the most studied APYs in plants are those in Arabidopsis (Arabidopsis thaliana; AtAPYs) and pea (Pisum sativum; PsAPYs), both of which have been shown to play major roles in regulating plant growth and development. Valuable insights on their functional roles have been gained by transgenically altering their transcript abundance, either by constitutively expressing or suppressing APY genes. This review focuses on recent studies that have provided insights on the mechanisms by which APY activity promotes growth in different organisms. Most of these studies have used transgenic lines that constitutively expressed APY in multiple different plants and in yeast. As APY enzymatic activity can also be changed post-translationally by chemical blockage, this review also briefly covers studies that used inhibitors to suppress APY activity in plants and fungi. It concludes by summarizing some of the main unanswered questions about how APYs regulate plant growth and proposes approaches to answering them.
Insight in obsessive-compulsive disorder: conception, clinical characteristics, neuroimaging, and treatment
Authors: Huang Yueqi , Weng Yazhu , Lan Lan , Zhu Cheng , Shen Ting , Tang Wenxin , Lai Hsin-Yi
Published: November 2023

Obsessive-compulsive disorder (OCD) is a chronic disabling disease with often unsatisfactory therapeutic outcomes. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has broadened the diagnostic criteria for OCD, acknowledging that some OCD patients may lack insight into their symptoms. Previous studies have demonstrated that insight can impact therapeutic efficacy and prognosis, underscoring its importance in the treatment of mental disorders, including OCD. In recent years, there has been a growing interest in understanding the influence of insight on mental disorders, leading to advancements in related research. However, to the best of our knowledge, there is dearth of comprehensive reviews on the topic of insight in OCD. In this review article, we aim to fill this gap by providing a concise overview of the concept of insight and its multifaceted role in clinical characteristics, neuroimaging mechanisms, and treatment for OCD.
Evaluating the OECD–FAO and USDA agricultural baseline projections
Authors: Fang Xiaoyi , Katchova Ani L
Published: November 2023

The Organization for Economic Cooperation and Development (OECD) in collaboration with the Food and Agricultural Organization (FAO), and the US Department of Agriculture (USDA) produce long-term agricultural projections for key indicators of agricultural commodities. These baseline projections play a key role in agricultural decision-making and policies. Our study compares the OECD–FAO and USDA baseline projections for harvested acres, production, and yield in the European Union, the US, and China for rice and wheat. We evaluate the accuracy by examining the projection error, including the magnitude of bias and variance as well as the significance of bias. We also compare the OECD–FAO and USDA projections’ predictive abilities using the modified Diebold–Mariano test. We find that the accuracy of the projections decreases as the projection horizon increases. Both agencies underestimate wheat projections in the European Union and China. USDA projections generally outperform OECD–FAO projections for most rice variables, while the reverse is found for longer-horizon EU wheat projections. This assessment may enable agencies to make more accurate projections and enable market participants to better understand these projections.
Can we rely on wearable sleep-tracker devices for fatigue management?
Authors: Reifman Jaques , Priezjev Nikolai V , Vital-Lopez Francisco G
Published: November 2023

Study Objectives

Wearable sleep-tracker devices are ubiquitously used to measure sleep; however, the estimated sleep parameters often differ from the gold-standard polysomnography (PSG). It is unclear to what extent we can tolerate these errors within the context of a particular clinical or operational application. Here, we sought to develop a method to quantitatively determine whether a sleep tracker yields acceptable sleep-parameter estimates for assessing alertness impairment.

Methods

Using literature data, we characterized sleep-measurement errors of 18 unique sleep-tracker devices with respect to PSG. Then, using predictions based on the unified model of performance, we compared the temporal variation of alertness in terms of the psychomotor vigilance test mean response time for simulations with and without added PSG-device sleep-measurement errors, for nominal schedules of 5, 8, or 9 hours of sleep/night or an irregular sleep schedule each night for 30 consecutive days. Finally, we deemed a device error acceptable when the predicted differences were smaller than the within-subject variability of 30 milliseconds. We also established the capability to estimate the extent to which a specific sleep-tracker device meets this acceptance criterion.

Results

On average, the 18 sleep-tracker devices overestimated sleep duration by 19 (standard deviation = 44) minutes. Using these errors for 30 consecutive days, we found that, regardless of sleep schedule, in nearly 80% of the time the resulting predicted alertness differences were smaller than 30 milliseconds.

Conclusions

We provide a method to quantitatively determine whether a sleep-tracker device produces sleep measurements that are operationally acceptable for fatigue management.
The effects of concurrent increases in supplementation of calcium and phytase on growth performance, balance of Ca and P, and bone mineralization in nursery pigs
Authors: Zhai Hengxiao , Bergstrom Jon , Zhang Jingcheng , Dong Wei , Wang Zhenzhen , Stamatopoulos Kostas , Cowieson Aaron J
Published: November 2023

The objective of this study was to investigate the effects of concomitantly increasing supplementation of Ca and phytase on growth performance, balance of Ca and P, and bone mineralization in nursery pigs. There were eight experimental diets. The positive control (PC) one and two were formulated to contain 0.64% and 0.85% total Ca, respectively, whereas the dietary concentrations of other nutrients were identical and adequate. The negative control (NC) was deficient in total Ca (0.48%) and total P (0.41%). Five combinations of incremental levels of Ca and phytase (0.48% and 1,750 phytase units [FYT]/kg, 0.52% and 2,000 FYT/kg, 0.55% and 2,250 FYT/kg, 0.59% and 2,600 FYT/kg, and 0.63% and 3,000 FYT/kg) were added to the NC to establish the remaining five experimental diets. Each diet was fed to six pens of six pigs (three barrows and three gilts per pen). All diets contained 3 g/kg TiO2, and fecal samples were collected from each pen during the trial. In the end, one pig per pen was euthanized to collect the right tibia and urine in bladder. The results showed that the pigs of NC gained less weight, consumed less feed, and utilized feed less efficiently than their counterparts fed the PC and the treatments with phytase (P < 0.01). With increasing supplementation of Ca and phytase, there was a tendency for gain:feed to decrease (P < 0.10). There was a significant reduction in bone dry weight; and in percentages, as well as weights of bone ash, Ca, and P; in pigs of NC compared with pigs of PC1, PC2, or phytase treatments. In comparison to PC2, PC1 and phytase treatments resulted in a higher percentage of bone P and greater weights of bone ash, Ca, and P (P < 0.05). There was no significant effect of concurrent supplementation of Ca and phytase on bone mineralization. The NC had significantly lower apparent total tract digestibility (ATTD) of Ca and P, lower concentrations of digestible Ca and P, but a higher ATTD Ca/ATTD P ratio than PC1, PC2, or the phytase treatments. The averages of ATTD of Ca and P in treatments with phytase were significantly higher than PC1 or PC2 (P < 0.01). With increasing addition of Ca and phytase, the ATTD of P, digestible Ca and P, and the ATTD Ca/ATTD P ratio increased linearly (P < 0.05), which contrasted with a linear reduction in ATTD of Ca (P < 0.05). Meanwhile, there was a linear (P < 0.01) increase in the concentration of urinary Ca. In conclusion, increasing the dietary supplementation of phytase in conjunction with the increasing dietary Ca level increased the dietary ATTD Ca/ATTD P ratio without damaging the absorption of P in the current study. The higher ATTD Ca/ATTD P ratio did not improve the bone mineralization markedly and thus the extra Ca was voided through urine.
The Short- and Longer-Term Effects of a Child Labor Ban
Authors: Piza Caio , Souza André Portela , Emerson Patrick M , Amorim Vivian
Published: November 2023

This paper investigates whether the 1998 Brazilian law that increased the minimum employment age from 14 to 16 lowered child labor and increased school attendance and whether those effects persisted beyond age 16. Using a regression discontinuity design, the results indicate that the ban had a significant impact on urban boys, a cohort that represents half of all paid child labor in Brazil. This cohort had a 35 percent decrease in paid labor, driven mainly by a decrease in informal work, and an 11 percent increase in the share of those only attending school. In addition, there is evidence that these effects persist past the age of enforcement where the affected cohort was less likely to work and more likely to be only attending school beyond age 16. Overall, the results suggest that enforced bans on child labor can have significant immediate and persistent impacts on affected populations.
Prelicensure Undergraduate Nursing Student Perceptions of Professional Identity in Nursing
Authors: Owens Rhoda A. , Denny Dawn L.
Published: November 2023

This qualitative descriptive study explored the perceptions of 63 prelicensure undergraduate nursing students about their learning experiences and the formation and development of professional identity in nursing (PIN). Students enrolled in a required course that included PIN concepts completed a guided reflective writing assignment. Four themes emerged with data analysis: 1) learning and applying ethics and values, 2) nursing knowledge is specific to nursing practice, 3) all nurses should be leaders, and 4) demonstrating professional comportment. Implications include effective use of reflective writing assignments to facilitate student PIN formation. Future research is warranted.
D-D and PLR, NLR combined forecasting first-line treatment: The short-term curative effect and prognosis of patients with SCLC
Authors: Hu Hui , Chen Wen-Jun , Sun Chuang , Xie Jun-Ping
Published: November 2023

The aim of this study was to evaluate the difference in D-dimer (D-D) combined with the platelet lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) before treatment in small cell lung cancer (SCLC) patients receiving first-line treatment and to analyze the efficacy and prognosis. We retrospectively collected the records of SCLC patients treated in our hospital from February 2019 to January 2023 and finally included 100 patients. A binary logistic regression analysis method was applied to analyze the relationship between D-D, PLR, and NLR and short-term efficacy. Univariate and multivariate Cox regression analyses were utilized to estimate the individual effect of plasma parameters on progression-free survival (PFS). The optimal cutoff values of D-D, PLR, and NLR for predicting survival outcome were determined by receiver operating characteristic curve analysis. Kaplan–Meier survival analysis was utilized to examine the correlation between D-D, PLR, and NLR the prognosis of SCLC patients. PLR was associated with a short-term curative effect in patients with SCLC (odds ratio: 0.326, 95% confidence interval [CI]: 0.135 0.790). Univariate Cox regression showed that D-D (hazard ratio [HR]: 0.495, 95% CI: 0.323–0.758), PLR (HR:0.420, 95% CI: 0.269–0.655) and NLR (HR: 0.407, 95% CI: 0.263–0.630) were associated with PFS in SCLC patients (P < .05). Multivariate Cox regression analysis showed that PLR (HR: 2.395, 95% CI: 1.468–3.906) and NLR (HR: 2.148, 95% CI: 1.319–3.499) correlated significantly with PFS (P < .05). The optimal cutoff values of D-D, PLR and NLR for predicting PFS were 0.88 mg/L (65.4% and 68.7%), 195.44 (61.5% and 81.2%) and 3.63 (63.5% and 81.2%), respectively, and the corresponding area under receiver (AUC) operating characteristic curve 0.691 (95% CI: 0.587–0.795), 0.721 (95% CI: 0.620–0.822) and 0.714 (95% CI: 0.614–0.815). When D-D was used in combination with PLR or NLR, the corresponding AUCs were 0.737 (95% CI: 0.640–0.835) and 0.761 (95% CI: 0.667–0.855). Pretreatment PLR is an independent predictor of short-term efficacy in SCLC patients. Pretreatment D-D, PLR and NLR are potential biochemical markers for predicting the prognosis of SCLC patients treated with first-line treatment. When D-D is combined with PLR and NLR, it shows stronger predictive ability.
Periodontal health of a low socioeconomic level population in Yucatan (Mexico): A cross-sectional study
Authors: Morales-Ruiz Pedro , Moreno-Barrera Alejandro , Ribas-Pérez David , Rodríguez-Menacho Diego , Flores-Fraile Javier , Gómez-Salgado Juan , Castaño-Seiquer Antonio
Published: November 2023

With the objective of assessing the periodontal health status, treatment needs, and oral hygiene habits of the population of Mérida, in Mexico, a descriptive cross-sectional study was performed. Four hundred forty individuals individually completed a questionnaire on oral health, oral hygiene habits, and quality of life. Additionally, a complete clinical dental examination was performed for each. For the statistical analysis, continuous variables (means and standard deviation) and categorical variables (frequencies) were studied. The associations were made using the analysis of variance test for continuous variables and the Chi-square test for categorical variables. The critical value to identify statistically significant differences was P < .05. The main concern of the population was the possible untreated caries they thought they had, with 36.21% followed by pain with 14.62%. Possible periodontal issues were the main discomfort for only 9%. The percentage of the sample that required periodontal intervention by a specialist was 21.14%. Statistically significant differences were found between age, place of residence, socioeconomic level, and schooling. There are great deficiencies in oral health in the studied group, which is accompanied by a great need for periodontal treatment. Periodontal health is closely related to oral hygiene, so the related sociocultural level should also be taken into account for the study of oral health in the most vulnerable populations. It is crucial to establish strategies to promote oral health.
Trichomonas vaginalis in bronchoalveolar lavage fluid of a patient with severe pneumonia detected by metagenomic next-generation sequencing: A case report
Authors: Li Zhenzhen , Wang Jiang , Gou Xuejing , Guo Zhendong , Xu Feng
Published: November 2023

Rationale:

Trichomonas vaginalis (T. vaginalis) is a common anaerobic parasitic protozoan. However, to the best of our knowledge, there are few reports documenting T. vaginalis infection outside the genitourinary tract. Severe pneumonia caused by T. vaginalis infection has been rarely reported.

Patient concerns:

The 80-year-old female patient had a 20-year history of type II diabetes; however, she was not on regular medication. She was hospitalized due to a coma which continued 2 hours caused by trauma after a car accident. After her admission, she was provided with continuous mechanical ventilation; during the ventilation, she was still in a coma, accompanied by repeated fever and presence of much yellow sticky phlegm. The head CT scan indicated temporal lobe hematoma and subarachnoid hemorrhage. The lung CT scan showed bilateral pulmonary inflammatory consolidation and mass lesions.

Diagnoses:

She was initially diagnosed with severe pneumonia and acute respiratory distress syndrome. Subsequently, fiberoptic bronchoscopy was conducted, and bronchoalveolar lavage fluid (BALF) was collected and sent for metagenomic next-generation sequencing (mNGS). The result indicated the presence of abundant sequences from the T. vaginalis genome. Thus, she was diagnosed with pulmonary T. vaginalis infection.

Intervention:

Anti-infective ornidazole treatment has significantly improved her symptoms.

Outcomes:

After treatment, the patient regained consciousness and was able to communicate, and there was no obvious expectoration, fever, or positive bronchus sign in the lungs. Thereby, she was discharged from the hospital.

Lessons:

Special attention should be paid to infections other than common bacterial infections, such as T. vaginalis. Moreover, infection of rare pathogenic microorganisms might show symptoms similar to common bacterial infection, leading to misdiagnosis, further highlighting the usefulness of mNGS in detecting pathogens in a timely, sensitive, and accurate manner.
Dural arteriovenous fistula with progressive dementia and parkinsonism: Two case reports and a literature review
Authors: Xie Jiangbo , Zhang Tingting , Zhang Ying , Wu Weiwei , Li Peichun , Zhang Xuezheng
Published: November 2023

Rationale:

Dural arteriovenous fistulas (DAVFs) are rare cerebral abnormal arteriovenous anastomoses. It is uncommon for DAVFs with parkinsonism and dementia, so it is easily misdiagnosed. Neuroimaging examinations show that multifocal DAVFs are related to venous thrombosis and white matter changes, suggesting that cerebral circulatory disorders caused by venous hypertensive encephalopathy lead to dementia in patients. Digital subtraction angiography confirmed the diagnosis and subsequent treatment of DAVFs.

Patient concerns:

We report 2 cases, one caused by bilateral white matter lesions and the other caused by bilateral thalamus lesions. Their symptoms are all manifested as progressive dementia and parkinsonism.

Diagnosis:

They were diagnosed with dural arteriovenous fistulas by digital subtraction angiography.

Outcomes:

The first patient developed progressive cognitive impairment, 6 months later, the patient developed bedridden, incontinence, and severe cognitive function.The second patient became increasingly bedridden 3 months after discharge and died of aspiration pneumonia.

Lessons:

There are few reports of progressive dementia and parkinsonism in DAVF patients, and neurologists should be vigilant to avoid misdiagnosing DAVF.
FN1 and TGFBI are key biomarkers of macrophage immune injury in diabetic kidney disease
Authors: Dou Fulin , Liu Qingzhen , Lv Shasha , Xu Qiaoying , Wang Xueling , Liu Shanshan , Liu Gang
Published: November 2023

The pathogenesis of diabetic kidney disease (DKD) is complex, and the existing treatment methods cannot control disease progression well. Macrophages play an important role in the development of DKD. This study aimed to search for biomarkers involved in immune injury induced by macrophages in DKD. The GSE96804 dataset was downloaded and analyzed by the CIBERSORT algorithm to understand the differential infiltration of macrophages between DKD and normal controls. Weighted gene co-expression network analysis was used to explore the correlation between gene expression modules and macrophages in renal tissue of DKD patients. Protein-protein interaction network and machine learning algorithm were used to screen the hub genes in the key modules. Subsequently, the GSE30528 dataset was used to further validate the expression of hub genes and analyze the diagnostic effect by the receiver operating characteristic curve. The clinical data were applied to explore the prognostic significance of hub genes. CIBERSORT analysis showed that macrophages increased significantly in DKD renal tissue samples. A total of ten modules were generated by weighted gene co-expression network analysis, of which the blue module was closely associated with macrophages. The blue module mainly played an important role in biological processes such as immune response and fibrosis. Fibronectin 1 (FN1) and transforming growth factor beta induced (TGFBI) were identified as hub genes of DKD patients. Receiver operating characteristic curve analysis was performed in the test cohort: FN1 and TGFBI had larger area under the curve values (0.99 and 0.88, respectively). Clinical validation showed that 2 hub genes were negatively correlated with the estimated glomerular filtration rate in DKD patients. In addition, FN1 and TGFBI showed a strong positive correlation with macrophage alternative activation. FN1 and TGFBI are promising biomarkers for the diagnosis and treatment of DKD patients, which may participate in immune response and fibrosis induced by macrophages.
A pan-cancer analysis of the MAPK family gene and their association with prognosis, tumor microenvironment, and therapeutic targets
Authors: Qin Yuan-Yuan , Yang Yan , Ren Yan-Hui , Gao Feng , Wang Min-Jie , Li Gang , Liu Yun-Xia , Fan Lei
Published: November 2023

The mitogen-activated protein kinases family of genes plays a crucial role in a wide range of inflammatory responses in the human body. The MAPK family of genes includes ERK, ERK5, JNK, P-38 mitogen-activated protein kinases. However, the correlation between MAPK family gene expression and pan-cancer prognosis, as well as the tumor microenvironment, has not been extensively studied. This study integrated multiple bioinformatics analysis methods to assess the expression and prognostic value of MAPK family genes, as well as their relationship with tumor microenvironment in patients with pan-cancer. The results showed that ERK, JNK, and P-38 MAPK expression were found to be significantly upregulated in rectum adenocarcinoma (READ), colon adenocarcinoma/rectum adenocarcinoma esophageal carcinoma (COADREAD), and kidney renal clear cell carcinoma (KIRC), and significantly downregulated in acute myeloid leukemia. And the results revealed good prognostic results for ERK, JNK, and P-38 MAPK in READ, COADREAD, and KIRC. We observed significant positive correlation between MAPK family gene expression and immune scores especially dendritic cells in READ, COADREAD, and KIRC. And we observed that the expression levels of MAPK family genes were significantly correlated with the expression of immune-related genes, such as CXCL1, CXCL2, CXCL8, CXCR1, CXCR2, CTLA-4, CD80, CD86, and CD28, suggesting their important role in regulating immune infiltrates and tumor progression. Therefore, our study suggested that MAPK family gene plays an important role in regulating immune infiltrates and tumor progression.
Efficacy and safety of agomelatine in the treatment of patients with depressive disorder: A meta-analysis
Authors: Guo Yue-Han , Zhou Le , Cui Zi-Ang , Wang Jian , Zhang Lei , Xu Ting , Xie Yi-Dan , Chen Hui
Published: November 2023

Objective:

To systematically assess the efficacy and safety of agomelatine in the treatment of patients with depressive disorder.

Methods:

Randomized controlled trials (RCTs) related to agomelatine in the treatment of patients with depressive disorder published in PubMed, Web of Science, CNKI, VIP, and Wangfang were retrieved. Extracted data on the efficacy and safety of agomelatine and placebo in the treatment of depressive disorder, and the collected data were processed by RevMan5.4 software.

Results:

A total of 10 RCTs were included. Meta-analysis showed that the HAMD-17 total scores of agomelatine group were statistically different from those of placebo group (odds ratio [OR]: 2.04, 95% confidence intervals [CIs]: 1.71–2.43, P < .001). High heterogeneity was found between agomelatine groups and placebo groups (P < .0001, and I2 = 78%), so a subgroup analysis was further performed, and the heterogeneity became insignificant (P = .33, and I2 = 14%) after excluding the studies, of which course of treatment was 24 weeks or the sample size was relatively small. The adverse events between agomelatine and placebo groups were not statistically significant (OR: 1.15, 95% CIs: 0.69–1.92; P = .05).

Conclusion:

Agomelatine was superior comparable to placebo in the treatment of patients with depressive disorder, and has fewer adverse events.
Gender authorship trends of gastric cancer in the top journals of gastroenterology: A 20-year perspective
Authors: Ma Xinyue , Huang Shu , Shi Huiqin , Tan Zhenju , Zhang Han , Shi Lei , Zhang Wei , Zhong Xiaolin , Lü Muhan , Chen Xia , Tang Xiaowei
Published: November 2023

Gender authorship trends have been explored in varied medical specialties, and no study had observed in the field of gastric cancer. Therefore, we aimed to access whether the “gender gap” in authorship existed in gastric cancer in the leading gastroenterological journals over the last 2 decades. All original articles published from 2000 to 2020 in 9 leading gastroenterological journals were collected. Information on the first and senior author’s gender, country of author’s institution, and impact factor of journals were collected. Chi-square tests and multivariable logistic regression were used for data analysis. A total of 5785 original articles were included and analyzed, of which 440 (7.61%) were articles on gastric cancer and 5345 (92.39%) covered other topics. Fewer female authors published original articles as first (19.32%, 85/440) and senior authors (14.32%, 63/440) compared with males. Remarkably, a significant increase in female authorship was discovered. The proportion of female first authors grown from 12.99% to 30.89% during the last 20 years (P < .001), but not in senior authors (P = .175). Multivariable logistic analysis showed that female first authors demonstrated a higher percentage when senior authors were female (odds ratio, 2.040; 95% confidence interval, 1.105–3.769). Although a statistically ascending tendency in female first authors on gastric cancer has been going on over the last 20 years, the exorbitant gender gap still exists. This gap may help explain the continued underrepresentation of women within both clinical work and academic research, and prompt us to look further for the underlying causes.
Change in expressional level and clinicopathological significance of miR-193b-3p in non-small cell lung cancer
Authors: Xiao Feng , Zhang Haiyan , Ding Haiping , An Chaolun , Gu Chunyan
Published: November 2023

To investigate and analyze changes in the expression level and clinicopathological significance of miR-193b-3p in non-small cell lung cancer (NSCLC). In the present study, Gene Expression Omnibus (GEO), Targetscan, starBase, and Metastases databases were retrieved for bioinformatics analysis. qRT-PCR was conducted to determine the expression level of miR-193b-3p in the serum or tissues of NSCLC patients. The correlation between the expression level of serum miR-193b-3p and the clinical characteristics of NSCLC patients was analyzed, and receiver operating characteristic (ROC) curves were analyzed to assess the diagnostic significance of serum expression of miR-193b-3p in NSCLC. The GEO2R tool was used to analyze the GSE102286 dataset in the GEO database, indicating that miR-193b-3p is one of the overexpressed miRNAs in NSCLC. Databases, such as TargetScan and starBase, were used to predict miR-193b-3p target genes. Finally, 153 target genes were retrieved, and gene ontology (GO) and KEGG analyses were conducted based on the Metascape database, which indicated that all 153 target genes participated in multiple biological processes and signaling pathways closely correlated with the genesis and progression of NSCLC. miR-193b-3p is highly expressed in the serum and cancer tissues of patients with NSCLC. The high miR-193b-3p expression group had a lower degree of cancer differentiation, a higher proportion of late TNM stage, and a greater incidence of lymph node metastasis. ROC curve analysis reported that the area under the curve was 0.89 (95% CI: 0.85–0.92). High miR-193b-3p expression levels were detected in NSCLC patients and were closely correlated with the degree of malignancy in NSCLC. miR-193b-3p expression levels have a diagnostic effect on NSCLC.
Acupuncture combined with Chinese herbal medicine in the treatment of perimenopausal insomnia: A systematic review and meta-analysis
Authors: Li Zhao , Yin Shao , Feng Jie , Gao Xu , Yang Qicheng , Zhu Fengya
Published: November 2023

Background:

Perimenopausal insomnia (PMI) is a relatively common menopausal symptom that can cause serious problems for the women themselves and their families. Today, the world is facing the trend and challenges of an aging population. It is reported that about 1.5 million women worldwide enter menopause every year, with sleep disorder identified as a core symptom. The efficacy of acupuncture combined with traditional Chinese medicine for treating PMI has been recognized by patients and doctors.

Methods:

We searched 8 databases to identify 15 randomized controlled trials evaluating the effects of acupuncture combined with traditional Chinese medicine on sleep in patients with PMI compared with Western medicine alone. Subsequently, data extraction and analysis were performed to assess the quality and risk of bias of the study method design, and a meta-analysis of the data was performed.

Results:

This study included 15 randomized controlled trials involving 1188 patients with PMI. The results show that acupuncture combined with traditional Chinese medicine seems to be more effective than Western medicine in the treatment of PMI: efficiency (RR: 1.18; 95% CI: 1.08, 1.29; P = .001); the Pittsburgh Sleep Quality Index (PSQI) (WMD: −2.77; 95% CI: 4.15–1.39; P < .0001); follicle-stimulating hormone (FSH) (WMD: −31.45; 95% CI: 42.7–20.2; P < .001) and the Hamilton Anxiety Score (HAMA) (WMD: −2.62, 95% CI: −3.93, −1.32; P < .0001). Compared with western medicine, E2 (WMD: 5.07; 95% CI: 5.78–15.92; P = .36) and LH (WMD: −4.86; 95% CI: 11.5–1.78; P = .151) had no difference.

Conclusion:

The current analysis results show that acupuncture combined with Chinese medicine seems to have a more positive effect than western medicine alone in improving sleep and FSHF in PMI patients, but no difference has been found in improving E2 and LH. This study provides a basis for acupuncture combined with Chinese medicine to treat PMI. However, due to the higher risk of evaluation in included studies, more rigorous randomized controlled trials and higher quality studies are needed to validate included studies.
Early clinical efficacy analysis of enhanced recovery following surgery combined with interscalene brachial plexus block for arthroscopic rotator cuff repair
Authors: Li Xiang , Jiang Hong-yang , Zhao Yong-jie , Liu Si-zhuo , Pan Ling-xiao
Published: November 2023

To explore the early clinical value of enhanced recovery after surgery (ERAS) with interscalene brachial plexus block (ISB) for arthroscopic rotator cuff repair (ARCR). We enrolled 240 patients who underwent arthroscopic rotator cuff repair, randomly divided into 3 groups (n = 80 each). Groups A, B, and C underwent only surgery, surgery + ERAS, and ISB + surgery + ERAS, respectively. We analyzed the clinical data and postoperative indicators for the 3 patient groups. Group comparisons of clinical data and postoperative indicators revealed no significant differences in clinical characteristics (P > .05). Group C showed superior Visual Analog Scale scores at 0–6 and 6–24 hours postoperatively (P < .05), and the shortest length of hospital stay (LOS) (P < .05). At 6 weeks and 3 months postoperatively, Constant-Murley shoulder score and University of California-Los Angeles scores were better in Groups B and C than in Group A (P < .05). Joint swelling was more common in Group A than in Groups B and C (P < .05) but with no significant difference in the incidence of postoperative stiffness (P > .05). ERAS can relieve postoperative pain, shorten LOS, and help restore shoulder joint mobility, thereby reducing postoperative swelling. ISB + ERAS optimized pain control and allowed a shorter LOS, but had similar effects on early functional recovery and complications.
Transient spinal cord dysfunction after surgery for intraspinal tumors: A case report
Authors: Tian Zhikang , Li Qingwei , Gao Sheng , Meng Chunyang
Published: November 2023

Rationale:

Limb dysfunction is not uncommon clinically after intramural tumor surgery. However, there are no relevant literature reports on the recovery of unilateral motor function caused by spinal cord dysfunction after short-term observation and treatment. The report of such cases is of great value for improving the cognition of postoperative complications of meningioma reducing misdiagnosis and providing reference for clinical treatment.

Patient concerns:

A 73-year-old female patient with numbness and weakness in both lower limbs accompanied by unstable walking for 2 months. Combined with imaging data and postoperative pathological diagnosis, it was diagnosed as thoracic spinal meningioma. The patient experienced transient unilateral limb dysfunction after surgery.

Diagnoses:

Magnetic resonance imaging and its enhanced magnetic resonance imaging suggest a space occupying lesion on the left side of the spinal canal at the level of the thoracic 3 to 4 vertebral body, possibly a meningioma. The postoperative pathology was grade I meningioma.

Intervention:

Administer 10 mL of dexamethasone, 1 g of methylprednisolone, and 250 mL of mannitol for treatment.

Outcomes:

After 3 hours, the patient’s muscle strength gradually recovered, and after 12 hours, it was better than the preoperative level.

Conclusion:

Spinal cord dysfunction may occur after surgery for intraspinal meningioma in the upper thoracic spine. Unlike spinal cord dysfunction caused by spinal cord injury, this dysfunction is short-term and transient. The use of hormones and diuretics is a feasible solution that can quickly restore patient limb function.
Intralymphatic histiocytosis of the upper eyelid in a patient of Korean descent: A case report
Authors: Ha Dong Hee , Kim Hee Sung , Lee Jeong Kyu
Published: November 2023

Rationale:

Diagnosing intralymphatic histiocytosis can be challenging due to its rarity. We present a case of intralymphatic histiocytosis in the upper eyelid of a Korean patient. We treated the condition by surgical debulking and intralesional triamcinolone injection.

Patient concerns:

A 59-year-old man was referred to our clinic with a 7-year history of unilateral swelling in the right upper eyelid. He had previously been treated with long-term oral steroids and immunosuppressants, but his eyelid swelling persisted. Unilaterally non-pitting erythematous edema was localized on the right upper eyelid without any itching or pain. His best corrected visual acuity at presentation was 20/20 for both eyes. Enhanced orbital computerized tomography revealed edematous soft tissue thickening in the right upper eyelid. In the laboratory testing, the erythrocyte sedimentation rate showed an increase of 19, and the antinuclear antibody titer was positive with a homogeneous pattern.

Diagnoses:

We diagnosed the patient with intralymphatic histiocytosis based on the histopathological findings.

Intervention:

We attempted surgical debulking and biopsy on the right upper eyelid due to the persistent symptoms and the absence of a definitive diagnosis.

Outcomes:

The patient has demonstrated significant improvement after receiving an intralesional triamcinolone injection in the right upper eyelid following the surgery and is currently under follow-up with no signs of recurrence.

Lesson:

Ophthalmologists should consider intralymphatic histiocytosis in cases of persistent eyelid swelling that do not respond to treatment, even in Asian patients. Surgical debulking and intralesional triamcinolone injections may be beneficial for improvement.