bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost-effectiveness of home care services versus hospital care for pediatric patients worldwide: A protocol for systematic review and meta-analysis
Authors: Lopes-Júnior Luís Carlos , Pessanha Raphael Manhães , Bomfim Emiliana , de Lima Regina Aparecida Garcia
Published: October 2022

Background:

Despite the expansion of home care services (HCS) in several countries, there is still a need to systematically investigate the available evidence on the cost-effectiveness of this type of service compared to hospital care in the world, particularly for the pediatric population. Hence, we aimed to systematically synthesize and critically evaluate the evidence on the cost-effectiveness of HCS versus in-hospital services worldwide.

Methods:

A systematic review and meta-analysis protocol guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Ten databases will be searched: MEDLINE/PubMed, Cochrane Library, Excerpta Medica database, cummulative index to nursing and allied health literature (CINAHL), Web of Science, SCOPUS, Science Direct, PsycINFO, Latin American and Caribbean Health Sciences Literature and Chinese national knowledge infrastructure with no restrictions on publication date or languages. A checklist for assessing the quality of reporting of economic evaluation studies will be applied. To assess the methodological quality of evidence from observational research on comparative effectiveness, the Good Research for Comparative Effectiveness Checklist v5.0 will be used. The heterogeneity among the studies will be assessed using the I
2 statistic test. According to the results of this test, we will verify whether a meta-analysis is feasible. If feasibility is confirmed, a random-effect model analysis will be carried out. For data analysis, the calculation of the pooled effect estimates will consider a 95% CI and alpha will be set in 0.05 using the R statistical software, v.4.0.4. In addition, we will rate the certainty of evidence based on Grading of Recommendations Assessment, Development and Evaluation. All methodological steps of this review will be performed independently and paired by 2 reviewers and conducted and managed in the EPPI-Reviewer Software™.

Results:

The results may have relevance for the basis of public health policies, regarding the forms of organization of HCS, especially in terms of complete economic evaluations through cost-effectiveness analysis in relation to hospital care.

Conclusion:

To the best of our knowledge this will be the first systematic review and metanalysis to synthesize and critically evaluate the evidence on the cost-effectiveness of HCS versus in-hospital services worldwide. The review will adopt a rigorous approach, adhering to PRISMA Statement 2020, using a comprehensive and systematic search strategy in 10 databases, further the gray literature, pre-prints, with no time period or language restrictions.
Comparative efficacy and safety of pharmacological interventions for severe COVID-19 patients: An updated network meta-analysis of 48 randomized controlled trials
Authors: Cheng Qinglin , Zhao Gang , Chen Junfang , Jia Qingjun , Fang Zijian
Published: October 2022

Background:

To date, there has been little agreement on what drug is the "best" drug for treating severe COVID-19 patients. This study aimed to assess the efficacy and safety of different medications available at present for severe COVID-19.

Methods:

We searched databases for randomized controlled trials (RCTs) published up to February 28, 2022, with no language restrictions, of medications recommended for patients (aged 16 years or older) with severe COVID-19 infection. We extracted data on trials and patient characteristics, and the following primary outcomes: all-cause mortality (ACM), and treatment-emergent adverse events (TEAEs).

Results:

We identified 4021 abstracts and of these included 48 RCTs comprising 9147 participants through database searches and other sources. For decrease in ACM, we found that ivermectin/doxycycline, C-IVIG (i.e., a hyperimmune anti-COVID-19 intravenous immunoglobulin), methylprednisolone, interferon-beta/standard-of-care (SOC), interferon-beta-1b, convalescent plasma, remdesivir, lopinavir/ritonavir, immunoglobulin gamma, high dosage sarilumab (HS), auxora, and imatinib were effective when compared with placebo or SOC group. We found that colchicine and interferon-beta/SOC were only associated with the TEAEs of severe COVID-19 patients.

Conclusion:

This study suggested that ivermectin/doxycycline, C-IVIG, methylprednisolone, interferon-beta/SOC, interferon-beta-1b, convalescent plasma (CP), remdesivir, lopinavir/ritonavir, immunoglobulin gamma, HS, auxora, and imatinib were efficacious for treating severe COVID-19 patients. We found that most medications were safe in treating severe COVID-19. More large-scale RCTs are still needed to confirm the results of this study.
Discovery of resident memory T cells in inflammatory vitiligo: A case report
Authors: Xu YanLi , Zhang Bao-Xiang , Lin Mao , Zhang Lu
Published: October 2022

Rationale:

The purpose of this report was to describe resident memory cluster of differentiation 8 (CD8) + T cells may contribute to the progression of inflammatory vitiligo.

Patient concerns:

A 32-year-old male has a stable vitiligo for 1 year, then some patches present inflammatory erythema. Two years later, the inflammatory patches enlarged and joined together, and the remaining 2 common patches shows repigmentation and no change respectively. Both CD69 + CD8 + T cells and CD103 + CD8 + T cells showed marked increase in inflammatory vitiligo than common vitiligo.

Diagnosis:

Histological findings show that the numbers of lymphocytes are increased in inflammatory vitiligo than common vitiligo. Immunofluorescence staining show that the numbers of CD69 + CD8 + T cells demonstrated a marked increase in inflammatory vitiligo than common vitiligo.

Interventions:

Without any intervention.

Outcomes:

The previous upper 2 patches on the abdomen with erythematous rim were enlarged and joined together. However the lowest lesion with uninflamed common rim on the abdomen remained static, the one on the right groin showed spot-like repigmentation.

Lessons:

This case report demonstrates that resident memory CD8 + T cells may contribute to the progression of inflammatory vitiligo.
Cognitive functioning and prevalence of seizures among older persons in Uganda: A hospital-based, cross-sectional study
Authors: Kaddumukasa Mark , Bongomin Felix , Mugenyi Levicatus , Kiyingi Micheal , Katabira Elly , Sajatovic Martha
Published: October 2022

There is limited data on the prevalence of seizures and dementia among older persons in Uganda. We evaluated cognitive functioning, and the prevalence and factors associated with seizures among older persons attending an outpatient medical clinic in Uganda. We randomly selected older adults (60 years and above) attending Kiruddu National Referral Hospital medical outpatient clinics between October 2020 and March 2021. We excluded individuals with a history of head injury, brain tumors, mental retardation, co-morbidity with HIV and patients who have had recent brain surgery. Cognitive functioning was assessed using the Identification for Dementia in Elderly Africans (IDEA) tool. We enrolled 407 participants, with a median (inter-quartile range) age of 67 (64–73) years. Majority were female (n = 292, 71.7%). The prevalence of seizure was 1.5% (95% confidence interval [CI]: 0.7–3.3). All 6 participants reported generalized tonic-clonic seizure type. Self-reported seizure was associated with being female (adjusted prevalence ratio [aPR]: 0.79, 95%CI: 0. 67–0.93, P = .02) and residing in Mukono district (aPR: 17.26, 95%CI: 1.64–181.55, P = .018). Overall, 114 (28.1%) participants had cognitive deficit; 9 (2.2%) dementia and 105 (25.9%) impaired cognition. Cognitive deficit was independently associated with female gender (aPR: 0.61, 95%CI: 0.44–0.85, P = .003), formal employment (aPR: 0.53, 95%CI: 0.35–0.81, P = .003), age 70–74 (aPR: 1.69, 95%CI: 1.00–2.86, P = .049), and ≥ 75 years (aPR: 2.81, 95%CI: 1.71–4.61, P = .001). Prevalence of seizures among participants with cognitive deficit was 5.3% (6/114). Among older persons attending a medical clinic in Uganda, almost one-third had cognitive deficit with seizure prevalence being higher among these individuals.
Novel clinical biomarkers in blood and pleural effusion for diagnosing patients with tuberculosis distinguishing from malignant tumor
Authors: Wang Jian , Feng Zhe-Xiang , Ren Tao , Meng Wei-Yu , Khan Imran , Fan Xing-Xing , Pan Hu-Dan , Liu Liang , Tang Yi-Jun , Yao Xiao-Jun , Li Run-Ze , Wang Mei-Fang , Leung Elaine Lai-Han
Published: October 2022

Pleural effusion (PE) is a common manifestation of tuberculosis (TB) and malignant tumors but tuberculous PE (TPE) is difficult to distinguish from malignant PE (MPE), especially by noninvasive detection indicators. This study aimed to find effective detection indices in blood and PE for differentiating TB from a malignant tumor. A total of 815 patients who were diagnosed with TB or cancer in Hubei Shiyan Taihe Hospital from 2014 to 2017 were collected. Amongst them, 717 were found to have PE by thoracoscopy. Clinical characteristics, patients’ blood parameters and PE indicator information were summarized for analysis. Patients with MPE had higher percentages to be bloody and negative of Rivalta test in PE than those with TPE. For clinical indicators, comparison of the specific parameters in blood showed that 18 indicators were higher in the TPE group than in the MPE group. By contrast, 12 indicators were higher in the MPE group than in the TPE group (P < .01). In addition, in PE tests, 3 parameters were higher in the TPE group, whereas other 4 parameters were higher in the MPE group (P < .01). Then, for clinical diagnosing practice, ROC analysis and principal component analysis were applied. The top 6 relevant indicators with area under curve over 0.70 were screened out as follows: hydrothorax adenosine dehydrogenase (pADA, 0.90), hydrothorax high-sensitivity C reactive protein (0.79), percentage of blood monocyte (sMONp, 0.75), blood high-sensitivity C reactive protein (sHsCRP, 0.73), erythrocyte sedimentation rate (0.71) and blood D-dimer (0.70). Moreover, logistic regression model revealed that a specific combination of 3 biomarkers, namely, pADA, sMONp and sHsCRP, could enhance the distinguishment of TB from malignant tumor with PE (area under curve = 0.944, 95% confidence interval = 0.925–0.964). The diagnostic function of the top single marker pADA in patients from different groups was analyzed and it was found to maintain high specificity and sensitivity. The 6 indicators, namely, pADA, hydrothorax high-sensitivity C reactive protein, sMONp, sHsCRP, sESR and blood D-dimer, showed significant diagnostic value for clinicians. Further, the combination of pADA, sMONp and sHsCRP has high accuracy for differential diagnosis for the first time. Most interestingly, the single marker pADA maintained high specificity and sensitivity in patients with different statuses and thus has great value for rapid and accurate diagnosis of suspected cases.
Prevalence and coagulation correlation of anticardiolipin antibodies in patients with COVID-19
Authors: Zeng Hui , Cai Meihong , Xue Han , Xie Wen , Long Xinghua
Published: October 2022

We aimed to determine prevalence and characteristics of anticardiolipin antibodies (ACLs) and its correlations with laboratory coagulation variables in patients with coronavirus disease 2019 (COVID-19). We retrospectively analyzed the prevalence of serum ACLs and its correlation with coagulative laboratory variables in 87 patients with COVID-19. ACLs were detected in 13/21 (61.91%) critically ill patients, and 21/66 (31.82%) in non-critically ill patients. For ACLs, IgA, and IgG were the most common types. The prevalence of IgG in critical ill patients was much higher than that in non-critical patients with odd ratio = 2.721. And the levels of all isotypes of ACLs in critically ill patients were much higher than those in non-critically ill patients. Correlation analysis showed that activated partial thromboplastin time and thrombin time had weak correlation with ACLs-IgG (R = 0.308, P = .031; R = 0.337, P = .018, respectively). Only the prevalence of ACLs-IgG shows a significant difference when compared critically ill patients with non-critically ill patients. ACLs do not seem to have a clear correlation with thrombosis occurred in COVID-19 patients.
Frontotemporal degeneration genetic risk loci and transcription regulation as a possible mechanistic link to disease risk
Authors: Sawyer Russell P. , Stone Hillarey K. , Salim Hanan , Lu Xiaoming , Weirauch Matthew T. , Kottyan Leah
Published: October 2022

The etiology of Frontotemporal Degeneration (FTD) is not well understood. Genetic studies have established common genetic variants (GVs) that are associated with increased FTD risk. We review previous genome wide association studies (GWAS) of FTD and nominate specific transcriptional regulators as potential key players in the etiology of this disease. A list of GVs associated with FTD was compiled from published GWAS. The regulatory element locus intersection (RELI) tool was used to calculate the enrichment of the overlap between disease risk GVs and the genomic coordinates of data from a collection of >10,000 chromatin immunoprecipitation (ChIP-seq) experiments. After linkage disequilibrium expansion of the previously reported tag associated GVs, we identified 914 GV at 47 independent risk loci. Using the RELI algorithm, we identified several transcriptional regulators with enriched binding at FTD risk loci (0.05 < corrected P value <1.18 × 10−27), including Tripartite motif-containing 28 (TRIM28) and Chromodomain-Helicase DNA-binding 1 (CHD1) which have previously observed roles in FTD. FTD is a complex disease, and immune dysregulation has been previously implicated as a potential underlying cause. This assessment of established FTD risk loci and analysis of possible function implicates transcriptional dysregulation, and specifically particular transcriptional regulators with known roles in the immune response as important in the genetic etiology of FTD.
Risk factors of postoperative hydrocephalus following decompressive craniectomy for spontaneous intracranial hemorrhages and intraventricular hemorrhage
Authors: Wu Yi-Chieh , Liao Hsiang-Chih , Lin Jang-Chun , Chou Yu-Ching , Ju Da-Tong , Hueng Dueng-Yuan , Tang Chi-Tun , Tseng Kuan-Yin , Chou Kuan-Nien , Lin Bon-Jour , Feng Shao-Wei , Chen Yi- An , Chung Ming-Hsuan , Wang Peng-Wei , Liu Wei-Hsiu
Published: October 2022

Introduction:

Hydrocephalus is a complication of spontaneous intracerebral hemorrhage; however, its predictive relationship with hydrocephalus in this patient cohort is not understood. Here, we evaluated the incidence and risk factors of hydrocephalus after craniectomy.

Methods:

Retrospectively studied data from 39 patients in the same hospital from 2016/01 to 2020/12 and analyzed risk factors for hydrocephalus. The clinical data recorded included patient age, sex, timing of surgery, initial Glasgow Coma Scale score, intracerebral hemorrhage (ICH) score, alcohol consumption, cigarette smoking, medical comorbidity, and blood data. Predictors of patient outcomes were determined using Student t test, chi-square test, and logistic regression.

Results:

We recruited 39 patients with cerebral herniation who underwent craniectomy for spontaneous supratentorial hemorrhage. Persistent hydrocephalus was observed in 17 patients. The development of hydrocephalus was significantly associated with the timing of operation, cigarette smoking, and alcohol consumption according to the Student t test and chi-square test. Univariate and multivariate analyses suggested that postoperative hydrocephalus was significantly associated with the timing of surgery (P = .031) and cigarette smoking (P = .041).

Discussion:

The incidence of hydrocephalus in patients who underwent delayed operation (more than 4 hours) was lower than that in patients who underwent an operation after less than 4 hours. nonsmoking groups also have lower incidence of hydrocephalus. Among patients who suffered from spontaneous supratentorial hemorrhage and need to receive emergent craniectomy, physicians should be reminded that postoperative hydrocephalus followed by ventriculoperitoneal shunting may be necessary in the future.
Hemicranial postural headache as a first symptom of a spontaneous carotid cavernous fistula: A case report
Authors: Liu Li , Zhong Yushi , Wu Bin , Tang Xianbi , Yi Ziwei , Pan Chuzheng
Published: October 2022

Rationale:

Spontaneous carotid cavernous fistula (CCF) is rare, and the expression of headache caused by it can be variable.

Patient concerns:

A case of a man hospitalized for high-intensity hemicranial headache which was aggravated by lying down and relieved when standing or sitting. The pain was of a pulsating character, localized on the right, behind the eye, followed by nausea and vomiting. He gradually appeared with ophthalmoplegia, decreased visual acuity and epistaxis.

Diagnosis:

Digital subtraction angiogram (DSA) showed a pseudoaneurysm arising from the internal carotid artery (ICA) that projected anteriorly and medially into the sphenoid sinus with occluded fistula.

Interventions:

The pseudoaneurysm was successfully treated with covered stent.

Outcomes:

The patient was then followed up clinically at the outpatient and seen in the outpatient clinic with no further episodes of nasal bleeding or new neurologic deficit. The vision loss and ophthalmoparesis were unchanged.

Lessons:

Hemicranial postural headache may be the first and characteristic sign of spontaneous CCF.
Analysis of 2 men with t(8;22)(q13;q13) and t(8;14)(q13;q22) chromosomal translocation karyotypes
Authors: Sun Qijia , Zhang Xiaoyu , Zhan Peng , Tian Wenjie , Wang Yanli , Yang Xiao
Published: October 2022

Male infertility is a multifactorial condition that is closely associated with chromosomal abnormalities. Reciprocal chromosomal translocation (RCT) is a significant structural genetic abnormality. The specific mechanisms of forms of RCT affecting male infertility include the product of chromosomally unbalanced gametes, thereby disrupting the structure and function of important genes responsible for spermatogenesis. RCT breakpoints have been found to disrupt gene structure and function in many medical fields However, the relationship between RCT breakpoints and male infertility remains to be determined. The purpose of this study is to describe 2 male carriers of RCTs 46,XY,t(8;22)(q13;q13) and 46,XY,t(8;14)(q13;q22). Both patients were collected from the second hospital of Jilin University. Semen parameters were detected using the computer-aided semen analysis system. Cytogenetic analysis was performed using standard operating procedure. Related genes on chromosomal breakpoints were searched using Online Mendelian Inheritance in Man. One man had semen parameters within the normal range, but the couple was infertile after 5 years of marriage. The other man showed normal semen parameters, and his wife had experienced 2 spontaneous miscarriages. Using a literature search, the association between chromosome 22q13 breakpoint and fertility were investigated. The results suggest that physicians should focus on the clinical phenotype of the patients and the breakpoints of RCT in genetic counseling. An important gene related to human male infertility is clearly located in chromosome region 22q13, and its function is worthy of further study.
MRI changes of adjacent segments after transforaminal lumbar interbody fusion (TLIF) and foraminal endoscopy: A case–control study
Authors: Wang Shunmin , Yang Deyu , Zheng Gengyang , Cao Jie , Zhao Feng , Shi Jiangang , You Ruijin
Published: October 2022

Background:

Intervertebral foramen endoscopy has developed rapidly, but compared with transforaminal lumbar interbody fusion (TLIF), the progress of degeneration is unknown. We aim to compare the changes of intervertebral disc and intervertebral foramen in adjacent segments after TLIF and endoscopic discectomy for patients with lumbar disc herniation (LDH).

Methods:

From 2014 to 2017, 87 patients who were diagnosed with single-level LDH and received surgery of TLIF (group T, n = 43) or endoscopic discectomy (group F, n = 44) were retrospectively analyzed. X-ray, MRI, CT and clinical symptoms were recorded before operation and at the last follow-up (FU). The neurological function was originally evaluated by the Japanese Orthopaedic Association (JOA) scores. Radiological evaluation included the height of intervertebral space (HIS), intervertebral foramen height (FH), intervertebral foramen area (FA), lumbar lordosis (CA) and intervertebral disc degeneration Pfirrmann scores.

Results:

There was no significant difference in baseline characteristics, JOA improvement rate, reoperation rate and complications between the two groups. The age, average blood loss, average hospital stays and average operation time in group F were lower than those in group T. During the last FU, HIS, CA and FA decreased in both groups, and the changes in group T were more significant than those in group F (P < .05). There was no significant difference in FH changes between the two groups (P > .05).

Conclusion:

Both TLIF and endoscopic surgery can achieve good results in the treatment of LDH, but the risk of lumbar disc height loss and intervertebral foramina reduction in the adjacent segment after endoscopic surgery is lower.
Accuracy and reproducibility of shear wave elastography according to the size and elasticity of lesions: A phantom study
Authors: Kim Harim , Kim Haejung , Han Boo-Kyung , Choi Ji Soo , Ko Eun Sook , Ko Eun Young
Published: October 2022

While the extrinsic factors affecting reproducibility of shear wave elastography (SWE) have been well documented, there are few resources assessing intrinsic characteristics of the lesion affecting the reproducibility and accuracy of SWE. In this regard, this study aimed to evaluate the accuracy of measured elasticity and the reproducibility of SWE according to the lesion size and stiffness. Two breast radiologists examined 20 targets of 4 different levels of stiffness and 5 different sizes (2.5, 4, 7, 11, and 18 mm) in a customized elasticity phantom. The B-mode image, color elastography image, and kPa measurement were obtained twice by each examiner with a 1-week interval. Inter- and intra-observer reproducibility and the accuracy of measured kPa were analyzed using intraclass correlation coefficient (ICC) and Bland-Altman analysis. Subgroup analysis was run to evaluate the effect of lesion size and stiffness on the reproducibility and accuracy of measured kPa. Inter- and intraobserver reproducibility for measuring kPa showed excellent agreement (ICC: 0.9742 and 0.9582; ICC: 0.9932 and 0.9294). The size and stiffness of the targets did not affect reproducibility. The overall accuracy of measured kPa was very high (ICC: 0.8049). In the subgroup analysis, targets that were ≤4 mm in size showed lower accuracy (ICC: 0.542), whereas targets that were 7 and 11 mm in size showed higher accuracy (ICC: 0.9832 and 0.9656, respectively). SWE shows excellent reproducibility regardless of lesion size or stiffness in phantom targets. The accuracy of measured kPa is high in lesions that are 7 and 11 mm in size but is low in lesions that are ≤4 mm in size.
Complementary and alternative medicines chosen for specific health problems: Internet survey using the I-CAM-Q in Japan: A STROBE-compliant cross-sectional study
Authors: Tabata Ryo , Yamaguchi Harutaka , Ookura Yoshihiro , Tani Kenji
Published: October 2022

This study investigated the different complementary and alternative medicines (CAMs) adopted by people in Japan, as well as the health problems treated with CAMs. Understanding more about this topic will facilitate the appropriate incorporation of CAMs into conventional medicine when treating health problems. Data were collected through an online survey based on the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). The study examined CAM utilization among people aged 20 years or older; 164 valid responses were collected (18.9%). We adopted a cross-sectional design. We then compared the relationships between the specific health problems reported by participants, their self-help practices, and the kinds of healthcare specialists consulted. We also examined participants’ reasons for using CAMs and their responses regarding the usefulness of the CAMs adopted. We found that self-help/CAM practices differed for specific health problems. Participants with musculoskeletal and heart problems were more likely to use poultices. Those with respiratory and digestive problems were more likely to practice yoga, tai chi, and qigong. Those with digestive and neurological problems were more likely to use aromatherapy. The I-CAM-Q questionnaire also revealed the purpose and usefulness of the CAMs utilized as well as the participants’ attitudes regarding conventional medicine. The study showed that participants find physicians less helpful than other options for treating their health problems. Additionally, when asked whether it was helpful to consult with a specific professional for health problems, there was a higher percentage of participants who answered “Very helpful” for professionals, like massage, judo, acupuncture, and moxibustion therapists, than for physicians. The results of this study will help to inform medical providers of the most appropriate types of CAMs for dealing with various health problems.
Changes of ACE2 in different glucose metabolites and its relationship with COVID-19
Authors: Lu Yamin , Xing Chenhao , Lv Xiuqin , Zhang Cuigai , Liu Guangxia , Chen Fang , Hou Zhan , Zhang Donghui
Published: October 2022

Background:

To study the changes and effects of angiotensin-converting enzyme 2 (ACE2)/angiotensin 1-7 (Ang1-7) and ACE/AngII in people with different glucose metabolisms and to explore the possible mechanisms underlying the severity of COVID-19 infection in diabetic patients.

Methods:

A total of 88 patients with type 2 diabetes, 72 patients with prediabetes (impaired fasting glucose, 30 patients; impaired glucose regulation, 42 patients), and 50 controls were selected. Changes and correlations of ACE2, Ang1-7 and other indicators were detected among the three groups. Patients were divided into four groups according to the course of diabetes: <1 year, 1–5 years, 5–10 years, and >10 years. ACE2 and Ang1-7 levels were compared and analyzed.

Results:

ACE2 and Ang1-7 increased with the severity of diabetes (P
0 < .05 or P < .01). The levels of ACE2 and Ang1-7 in the longer course group were lower than those in the shorter course group, whereas the levels of ACE, Ang II, and interleukin-6 (IL-6) gradually increased (P < .05). Pearson correlation analysis showed that ACE2 was positively correlated with IL-6, FBG, and 2hPBG levels in the prediabetes group. In the diabetic group, ACE2 was positively correlated with Ang1-7 and negatively correlated with ACE, AngII, IL-6, and C-reactive protein levels. Multiple linear regression analysis showed that IL-6 and ACE were the main factors influencing ACE2 in the diabetic group.

Conclusion subsections:

ACE2/Ang1-7 and ACE/AngII systems are activated, and inflammatory cytokine release increases in prediabetes. With the prolongation of the disease course, the effect of ACE2/Ang1-7 decreased gradually, while the effect of ACE/AngII increased significantly. Dysfunctions of ACE2/Ang1-7 may be one of the important mechanisms underlying the severity of COVID-19 infection in patients with diabetes.
Interobserver variability in ultrasound assessment of thyroid nodules
Authors: Alyami Jaber , Almutairi Fahad F. , Aldoassary Sultan , Albeshry Amani , Almontashri Ali , Abounassif Mazen , Alamri Majed
Published: October 2022

The first diagnostic tool for thyroid disease management is ultrasound. Despite its importance, ultrasound is an extremely subjective procedure that requires a high level of performance skill. Few studies have assessed thyroid ultrasound performance and its effectiveness, particularly the variability between observers in the assessment of ultrasound images. This study evaluated the variability in ultrasound assessments and diagnoses of thyroid nodules between 2 radiologists. In this retrospective study, 75 thyroid nodules in 39 patients were reviewed by 2 experienced radiologists. The nodule composition, margin, shape, calcification, and vasculitis were determined using echogenicity. The study evaluation included these 5 assessments and the final diagnosis. Interobserver variation was determined using Cohen kappa statistics. The interobserver agreements in the interpretation of echogenicity, shape, and margin were fair (κ = 0.21–0.40), whereas there were substantial agreements for vascularity and calcification (κ = 0.62–0.78). The agreements between the observers for individual ultrasound features in this study were the highest for vascularity and the presence/absence of calcification. The interobserver reproducibility for thyroid nodule ultrasound reporting was adequate, but the diagnostic evaluation ability of the observers was inconsistent. The variability in the interpretation of sonographic features could influence the level of suspicion of thyroid malignancy. This study emphasizes the need for consistency in the training of sonographic interpretation of thyroid nodules, particularly for echogenicity, shape, and margin.
Treatment effect of metformin combined with atorvastatin in reducing in-stent restenosis after percutaneous coronary intervention in coronary artery disease patients with type 2 diabetic patients
Authors: Chen Mingli , Ma Fangfang , Su Baohua , Wang Caihong , Zheng Qun , Zhang Yu , Li Meng , Liu Shuai , Zhang Shuzhi , Yuan Lansuo
Published: October 2022

To investigate the effectiveness of metformin and atorvastatin in preventing in-stent restenosis (ISR) on coronary patients with type 2 diabetes mellitus with percutaneous coronary intervention within 8 to 12 months after rapamycin-eluting stent implantation. A total of 1278 consecutive patients implanted with rapamycin-eluting stent from January 2012 to December 2019, who underwent coronary computed tomography or coronary angiography within 8 to 12 months. The patients were categorized into atorvastatin 20 mg, or atorvastatin 20 mg + metformin 1.5/d, or atorvastatin 40 mg + metformin 1.5/d groups. The clinical characteristics of the 3 groups were compared. The correlation between variables and ISR was analyzed. A total of 701 patients participated in the study. The ratio of ISR/nonstenosis (P = .039) and fasting blood sugar (P = .001) differed significantly in the 3 groups. Logistic regression showed that d, L, different therapeutic agents, and dosage groups were independent risk factors of ISR. The longer L and smaller d may increase ISR incidence with 8 to 12 months after percutaneous coronary intervention. Both metformin and atorvastatin are beneficial in reducing stent restenosis by a dose-dependent manner. An increasing dose of atorvastatin and a combination of metformin decreases the incidence of ISR in patients.
Assessment of the risk factors associated with type 2 diabetes and prediabetes mellitus: A national survey in Vietnam
Authors: Phan Duong Huong , Vu Trang Thu , Doan Vu Tuan , Le Toan Quang , Nguyen Thanh Duc , Van Hoang Minh
Published: October 2022

This study aims to estimating the prevalence of type 2 diabetes and prediabetes among adult from 30 to 69 years old and assess the association of risk factor with the conditions. A total of 5244 aged 30 to 69 years old were participated in this cross-sectional study, using nationally representative sampling frame. All participants were taking blood sample to measure fasting blood glucose level and 2-hour postload oral glucose tolerance test by National Hospital of Endocrinology, Vietnam. Multinomial logistic regressions with baseline-category logit models were conducted to identify factors associated with diabetes and prediabetes among respondents. The prediabetes prevalence was in 17.9% and diabetes in 7.3%. Patients who were male (reference group vs female OR = 0.79; 95% CI: 0.64, 0.97), in the 50 to 59 years old group (OR = 1.60; 95% CI: 1.28, 2.00), have hypertension and WHR risk have higher prevalence to have prediabetes (OR = 1.31; 95% CI: 1.12, 1.53; OR = 1.37; 95% CI: 1.11, 1.70, respectively). Male patients (reference group vs female OR = 0.62; 95% CI: 0.45, 0.84), patients who were in 40 to 49; 50 to 59; 60 to 69 years old, those who were housewife (OR = 2.17; 95% CI: 1.43, 3.28; OR = 2.85; 95% CI: 1.91, 4.27; OR = 3.12; 95% CI: 2.08, 4.69; OR = 1.71; 95% CI: 1.22, 2.40, respectively). Diabetes have significant associated with participants have hypertension (OR = 1.19; 95% CI: 1.72, 2.70). The common factor directly related to prediabetes and diabetes in both genders is age. Other factors directly associated with prediabetes and diabetes include BMI, WHR, hypertension, educational level, and job.
Metastatic malignant melanoma from anorectum presenting as an isolated breast tumor: A case report and literature review
Authors: Yi Xiaokang , Chen Hao , Wang Ankang , Liu Feng , Zhang Hua-Mao
Published: October 2022

Rationale:

Anorectal malignant melanoma regularly exhibits a biological aggressive behavior which is metastasizing to lung, bone, brain or other organs and tissues early in the course of the disease. Compared with melanoma in the other parts of the body, anorectal malignant melanoma is relatively rare. Metastatic to the breast tissue from anorectal malignant melanoma or from other extra-mammary tumors are very rare.

Patient concerns:

We report the case of a 65-year-old female who suffering from anorectal malignant melanoma and implemented complete surgical resection. Two years later, a space-occupying lesion in the outer upper quadrant of the right breast was observed on a chest CT.

Diagnosis:

The right breast was excised, and breast metastasis of anorectal malignant melanoma was histologically confirmed.

Interventions:

Radical mastectomy of the right breast was performed, and no lymph nodes or other metastases were observed.

Outcomes:

The patient’s operative course was uneventful. The patient completely recovered and transfers to the oncology department for further treatment.

Lesson:

The patient presented with an isolated breast tumor. Duo to Malignant melanoma could mimic many kind of poorly differentiated tumors, it is difficult to diagnose accurately, especially when it appears as an isolated mammary tumor. Because of the treatment measures and prognosis between malignant melanoma and breast cancer are entirely different.
Predictors of impaired effectiveness of carbon nanoparticle-based central lymph node tracing in patients who underwent surgery for papillary thyroid cancer: A retrospective cohort study
Authors: Chen Ping-Ping , Zhang Xing , Li Jia-Gen , Chen Gun
Published: October 2022

Carbon nanoparticles (CNs) are used in papillary thyroid cancer (PTC) surgery to facilitate central lymph node dissection (CLND) and protect the parathyroid glands (PGs). However, some cases develop hypoparathyroidism after using CNs. This cohort study was undertaken to explore the predictors of the reduced effectiveness of CNs. Data on patients with PTC who underwent surgery wherein CNs were used during CLND were reviewed retrospectively. Patients who did not develop hypoparathyroidism and developed hypoparathyroidism were classified into Group A and B, respectively. Demographic and clinical characteristics were compared between the 2 groups. Univariate and multivariate logistic regression analysis were performed on related variables. The receiver operating characteristic curve was used to evaluate the predictors of the binary logistic model and the cutoff value of each predictor was obtained. A total of 265 patients were included. Compared with Group A, the patients in Group B had a higher body mass index (BMI) (P = .003), were more frequently associated with Hashimoto thyroiditis (HT) (P = .001), and tumors were larger in size (P = .026). Multivariate logistic regression analyses were performed on these variables and showed that HT (P = .001) and tumor size (P = .001) predicted the impaired role of CNs. CNs are not always useful in protecting PG function in patients who undergo CLND for PTC. In patients with coexisting HT (blood thyroid peroxidase antibody [TPOAb] level higher than 44.0 IU/mL or blood anti-thyroglobulin antibody [ATG] level higher than 125.0 IU/mL) or a tumor size exceeding 1.1 cm in diameter, the protective role of CNs may be impaired.
Radioiodine Therapy in Pediatric Differentiated Thyroid Cancer
Authors: Kumar Praveen , Damle Nishikant Avinash , Bal Chandrasekhar
Published: October 2022

Thyroid cancer is very rare in children. 131I therapy after thyroidectomy is established in pediatric differentiated thyroid cancer (DTC). Pediatric DTC guideline is silent on the optimum amount of 131I that could be safely and effectively administered to children who are more radiosensitive. Like adult DTC, children are also given 131I therapy empirically based either on age or body weight. Pediatric DTC guideline recommends that patient-specific dosimetry is important in children. Still, due to the low incidence rate and the practical difficulties of dosimetry, it has neither been established nor adopted in routine practice. This review article aims to discuss current approaches of 131I therapy in children and young adult patients with DTC and dosimetric data obtained by several investigators. Efforts are required to simplify dosimetric procedures and precise results, especially in determining lesion size. We prefer 3-dimensional dosimetry over planar dosimetry, where lesion size could be measured accurately. 124I PET/CT-based dosimetry is expected to give accurate dosimetric results. The most challenging aspect is that no randomized controlled trials are available to compare the empiric 131I therapy results versus dosimetry-based treatment outcomes in children and young adults. Suppose dosimetry-based 131I therapy could be shown to have better outcomes, namely, successful ablation rate, better disease-free survival, and lesser treatment-emergent adverse events than empirical 131I treatment. In that case, one can argue in favor of the former. Unfortunately, no convincing study is currently available. Thus, there is a need for a randomized control trial to settle this issue.
Clinical Forecasting usingEx VivoDrug Sensitivity Profiling of Acute Myeloid Leukemia
Authors: Andersen Aram N. , Brodersen Andrea M. , Ayuda-Durán Pilar , Piechaczyk Laure , Tadele Dagim Shiferaw , Baken Lizet , Fredriksen Julia , Stoksflod Mia , Lenartova Andrea , Fløisand Yngvar , Enserink Jorrit M.
Published: October 2022

Acute Myeloid Leukemia (AML) is a heterogeneous malignancy involving the clonal expansion of myeloid stem and progenitor cells in the bone marrow and peripheral blood. Most AML patients eligible for potentially curative treatment receive intensive chemotherapy. Risk stratification is used to optimize treatment intensity and transplant strategy, and is mainly based on cytogenetic screening for structural chromosomal alterations and targeted sequencing of a selection of common mutations. However, the forecasting accuracy of treatment response remains modest. Recently,ex vivodrug screening has gained traction for its potential in personalized treatment selection, as well as a tool for identifying and mapping patient groups based on relevant cancer dependencies. We systematically evaluated the use of drug sensitivity profiling for predicting patient survival and clinical response to chemotherapy in a cohort of AML patients. We compared computational methodologies for scoring drug efficacy and characterized tools to counter noise and batch-related confounders pervasive in high-throughput drug testing. We show thatex vivodrug sensitivity profiling is a robust and versatile approach to patient prognostics that comprehensively maps functional signatures of treatment response and disease progression. In conclusion,ex vivodrug profiling can accurately assess risk of individual AML patients and may guide clinical decision-making.
Are female scientists underrepresented in self-correcting science for honest error?
Authors: Ribeiro MD , Mena-Chalco J , Rocha KA , Pedrotti M , Menezes P , Vasconcelos SMR
Published: October 2022

Retractions are among the effective measures to strengthen the self-correction of science and the quality of the literature. When it comes to self-retractions for honest errors, exposure of one’s own failures is not a trivial matter for researchers. However, self-correcting data, results and/or conclusions has increasingly been perceived as good research practice, although rewarding such practice challenges traditional models of research assessment. In this context, it is timely to investigate who have self-retracted for honest error in terms of country, field, and gender. We show results on these three factors, focusing on gender, as data is scarce on the representation of female scientists in efforts to set the research record straight. We collected 3,822 retraction records, including research articles, review papers, meta-analyses, letters, and others, from the Retraction Watch Database (2010-2021). We screened the dataset collected for research articles retracted for honest error, excluding retractions by publishers, editors, or third parties, and those mentioning any investigation issues. We then categorized the records according to country, field, and gender, after selecting research articles with a sole corresponding author. Our results show that female scientists account for 25% of self-retractions for honest error, with the highest share for women affiliated with US institutions.
Lysosomal swelling and lysis mediate delivery of C3 toxins to their cytoplasmic targets
Authors: Turner Madison , Plumb Jonathan , Merrill A. Rod , Grinstein Sergio , Westman Johannes
Published: October 2022

Unlike other cholera-like toxins that contain separate binding/translocation and catalytic subunits, C3-like mono-ADP-ribosyltransferases consist of a single subunit that serves both functions. The manner whereby C3 toxins reach the host cell cytoplasm is poorly understood and was addressed in this study by monitoring the fate of fluorescently-labelled C3larvinA. Following binding to the macrophage membrane in a discontinuous, punctate pattern, the toxin was internalized, traversing the endocytic pathway to reach lysosomes. Strikingly, the lysosomes of C3larvinA-treated cells underwent massive swelling over the course of 1-4 hrs. Lysosomal swelling preceded the extensive rearrangement of the cellular F-actin caused by ADP-ribosylation of cytosolic Rho-GTPases. This suggested that lysosome swelling might be required for escape of the toxin into the cytoplasm where the GTPases reside. Accordingly, preventing swelling by osmotic manipulation or by arresting macropinocytosis precluded the F-actin rearrangement. Toxin-induced swelling was associated with leakage of sulforhodamine B and dextran from the lysosomes, implying membrane rupture or activation of mechano-sensitive pores, enabling the toxin itself to reach the cytosol. Finally, comparison of the cellular traffic and actin remodelling activities of C3larvinA with that of two related toxins, C3larvintruncand Plx2A, highlighted the importance of the N-terminal α1-helix for lysosomal swelling and successful infection.
Deciphering the non-coding code of pathogenicity and sexual differentiation in the human malaria parasite
Authors: Batugedara Gayani , Lu Xueqing M. , Abel Steven , Chahine Zeinab , Hristov Borislav , Williams Desiree , Hollin Thomas , Wang Tina , Cort Anthony , Lenz Todd , Thompson Trevor , Prudhomme Jacques , Tripathi Abhai K. , Xu Guoyue , Cudini Juliana , Dogga Sunil , Lawniczak Mara , Stafford Noble William , Sinnis Photini , Le Roch Karine G.
Published: October 2022

The complex life cycle ofPlasmodium falciparumrequires coordinated gene expression regulation to allow host cell invasion, transmission, and immune evasion. However, this cascade of transcripts is unlikely to be regulated by the limited number of identified parasite-specific transcription factors. Increasing evidence now suggests a major role for epigenetic mechanisms in gene expression in the parasite. In eukaryotes, many lncRNAs have been identified and shown to be pivotal regulators of genome structure and gene expression. To investigate the regulatory roles of lncRNAs inP. falciparumwe explored the intergenic lncRNA distribution in nuclear and cytoplasmic subcellular locations. Using nascent RNA expression profiles, we identified a total of 1,768 lncRNAs, of which 58% were identified as novel lncRNAs inP. falciparum. The subcellular localization and stage-specific expression of several putative lncRNAs were validated using RNA fluorescence in situ hybridization (RNA-FISH). Additionally, the genome-wide occupancy of several candidate nuclear lncRNAs was explored using Chromatin Isolation by RNA Purification (ChIRP). ChIRP-seq of candidate lncRNAs revealed that lncRNA occupancy sites within the parasite genome are focal and sequence-specific with a particular enrichment for several parasite-specific gene families, including those involved in pathogenesis, erythrocyte remodeling, and regulation of sexual differentiation. We further validated the function of one specific lncRNA (lncRNA-ch14) using the CRISPR-Cas9 genome editing tool. Genomic and phenotypic analysis of the △lncRNA-ch14 line demonstrated the importance of this lncRNA in sexual differentiation and sexual reproduction. Our findings bring a new level of insight into the role of lncRNAs in pathogenicity, gene regulation and sexual differentiation. These findings also open new avenues for targeted approaches towards therapeutic strategies against the deadly malaria parasite.
Mechanical thrombectomy of the anterior circulation ischemic stroke whatever the low-volume operator : comparison to a 90 days follow-up
Authors: Herpe Guillaume , Dumas Victor , Guillevin Rémy
Published: October 2022

Background

To date, benefit of successful recanalization of acute stroke has been described mainly for high volume operator.

Purpose

To evaluate if a successful MT performed by a low-volume operator is a strong predictor of patient’s good clinical outcome.

Materials and Methods

A consecutive monocentric observational study from June 1, 2016 to December 31, 2018 at the University Hospital of Poitiers. Patient management included mechanical thrombectomy and eventual IVT. The interventional neuroradiologist on duty classified the recanalization according a standardized mTICI reading grid. ∆mRS was defined as the difference between 90 days and initial mRS. Association were studied using Chi-square test and Pearson’s and Fisher’s correlation with a threshold at 0.05. The main criterion was the reliability between mTICI and ∆mRS.

Results

Among the 304 MT, 127 patients were finally included. High mTICI score was significantly associated with high ∆mRS (p = 0.04), using the mTICI dichotomization, patients with successful MT had significantly better outcome than patient with lower mTICI whatever the initial mRS (p = 0.008). There was a correlation between age categories greater than or equal to 80 y.o (p=0.03) and high initial NIHSS categories greater than or equal to 18 (p=0.004) with regard to the ∆mRS. No statistical significance were obtained between sexe (p=0.63), diabetes mellitus (p=0.25), VIT (p=0.16) and thrombus’s lateralization (p=0.26) with regard to ∆mRS.

Conclusion

This study highlights the place and performances of low-volume operator in the treatment of acute stroke.

Summary Statement

Despite low-volume operators, a successful mechanical thrombectomy is a strong prognostic factor for good clinical outcome.

Key Results

- Mechanical thrombectomy performed in a low volume center is a safe therapy and strongly linked to good clinical outcome.

- Our low volume-operators centre has reached a high reperfusion rate and a majority of good clinical outcome

- This study highlights the place and performances of low-volume operator in the treatment of acute stroke.