bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence of adverse outcome in donors after living donor liver transplantation: A meta-analysis of 60,829 donors
Authors: Xiao Jieling , Zeng Rebecca Wenling , Lim Wen Hui , Tan Darren Jun Hao , Yong Jie Ning , Fu Clarissa Elysia , Tay Phoebe , Syn Nicholas , Ong Christen En Ya , Ong Elden Yen Hng , Chung Charlotte Hui , Lee Shi Yan , Koh Jia Hong , Teng Margaret , Prakash Sameer , Tan Eunice XX , Wijarnpreecha Karn , Kulkarni Anand V. , Liu Ken , Danpanichkul Pojsakorn , Huang Daniel Q. , Siddiqui Mohammad Shadab , Ng Cheng Han , Kow Alfred Wei Chieh , Muthiah Mark D.
Published: November 2023

The scarcity of liver grafts has prompted developments in living donor liver transplantations (LDLT), with previous literature illustrating similar outcomes in recipients compared to deceased donor transplants. However, significant concerns regarding living donor morbidity and mortality have yet to be examined comprehensively. This study aims to provide estimates of the incidence of various outcomes in living liver donors. In this meta-analysis, Medline and Embase were searched from inception to July 2022 for articles assessing the incidence of outcomes in LDLT donors. Complications in the included studies were classified into respective organ systems. Analysis of incidence was conducted using a generalized linear mixed model with Clopper-Pearson intervals. Eighty-seven articles involving 60,829 living liver donors were included. The overall pooled incidence of complications in LDLT donors was 24.7% (CI: 21.6%–28.1%). The incidence of minor complications was 17.3% (CI: 14.7%–20.3%), while the incidence of major complications was lower at 5.5% (CI: 4.5%–6.7%). The overall incidence of donor mortality was 0.06% (CI: 0.0%–0.1%) in 49,027 individuals. Psychological complications (7.6%, CI: 4.9%–11.5%) were the most common among LDLT donors, followed by wound-related (5.2%, CI: 4.4%–6.2%) and respiratory complications (4.9%, CI: 3.8%–6.3%). Conversely, cardiovascular complications had the lowest incidence among the subgroups at 0.8% (CI: 0.4%–1.3%). This study presents the incidence of post-LDLT outcomes in living liver donors, illustrating significant psychological, wound-related, and respiratory complications. While significant advancements in recent decades have contributed towards decreased morbidity in living donors, our findings call for targeted measures and continued efforts to ensure the safety and quality of life of liver donors post-LDLT.
Posterior Canal Fibrosis: A Case Series
Authors: David Abel P. , Bolds Camilo , Wu Xin , Sharon Jeffrey D.
Published: November 2023

Objective

To establish a case series where loss of magnetic resonance fluid signal intensity in the posterior semicircular canal (SCC) corresponded with a functional deficit on clinical and video head impulse testing, and most likely a result of canal fibrosis or obstruction.

Patients

Three patients with an magnetic resonance imaging (MRI) showing loss of T2-weighted signal intensity in their posterior SCC corresponding to a vestibular weakness in that canal.

Interventions

All patients underwent a comprehensive neuro-otologic examination. Vestibulo-ocular reflex was evaluated using clinical head impulse testing (cHIT) and quantified with video head impulse testing. MRI for all patients was obtained using clinical protocols for gadolinium-enhanced MRI of the internal auditory canal on 1.5 or 3 T scanners, which all included high-resolution, heavily T2-weighted imaging of the membranous labyrinth.

Main Outcome Measure

Correlation of MRI findings with vestibular weakness in the corresponding posterior SCC.

Results

Subject 1 showed abnormal vHIT in the left lateral and left posterior SCCs. MRI showed loss of T2 signal intensity of the entire left posterior SCC as well as in the posterior limb of the superior SCC. Subject 2 showed isolated loss of function (cHIT) and low gain with catch-up saccade (vHIT) of the left posterior SCC. MRI showed loss of T2 signal intensity of the superior portion of the left posterior SCC, as well as in the posterior limb of the superior SCC. Subject 3 showed catch-up saccades of the left posterior SCC on cHIT and vHIT and loss of T2 signal intensity of the entire left posterior SCC and partial loss of bilateral lateral SCC on MRI.

Conclusions

In this case series, loss of posterior SCC function correlated with vestibular function testing and high-resolution, T2-weighted MRI findings, perhaps related to fibrosis of the posterior SCC.
Efficacy of Qingfei Paidu Granules combined with non-drug traditional Chinese medicine therapy in the treatment of patients with asymptomatic coronavirus disease: A retrospective study
Authors: Ling Li , Wang Xian , Zhang Yi , Yin Fang , Zhang Zhenyuan , Lyu Xiang
Published: November 2023

The aim of this study was to retrospectively analyze the clinical efficacy and safety of Qingfei Paidu granules (QFPG) combined with non-drug therapy of traditional Chinese medicine (TCM) in treating patients with asymptomatic coronavirus disease 2019 (COVID-2019). A total of 450 patients admitted to the wards of Chongming Changxing Island isolation site from April 1 to 18, 2022 were retrospectively analyzed and divided into 3 groups according to the treatment that they received. W1 was not treated (control group), and W2 was given QFPG (TCM treatment), W3 (TCM combined with TCM non-drug therapy) was treated with QFPG, five-element music therapy and Gong. We retrospectively analyzed the medical history data, including general information, time of first turning negative, length of hospital stays, number of cases classified as mild or ordinary, number of cases with adverse events/adverse reactions. The conversion to negative time of the 3 groups was 6.50, 4.40, and 3.81 days, respectively, and there were significant differences among the 3 groups (P < .001). The hospital duration in the 3 groups was 8.45, 5.72, and 5.53 days, respectively, and there were significant differences among the 3 groups (P < .001). The number of adverse events W1 (5/150, 3.3%), W2 (8/150, 5.3%), and W3 (4/150, 2.7%) was consistent among the 3 groups (P > .05). QFPG with TCM non-drug therapy is effective in patients with asymptomatic COVID-2019, which can effectively shorten the time to double negative and reduce the proportion of patients with mild disease.
A bibliometric and visualized analysis of meniscus suture based on the WOS core collection from 2010 to 2022: A review
Authors: Liu Xu , Liu Di , Opoku Michael , Lu Wenhao , Pan Linyuan , Li Yusheng , Zhu Heyuan , Xiao Wenfeng
Published: November 2023

Meniscus suture is an important treatment method for meniscus injury and contributes to the preservation of proprioception, restoration of knee biomechanics and alleviation of progressive osteoarthritis. However, there are few visualized analyses concerning the present studies of meniscus suture. This paper aims to evaluate the global trends, highlights and frontiers of meniscus suture. A bibliometric analysis was conducted based on the results of studies related to meniscus suture from web of science core collection. VOSviewer, GraphPad Prism, Microsoft Excel and R-bibliometrix were utilized for the bibliometric analysis of country and institution distribution, chronological distribution, source journals analysis, prolific authors and institutions analysis, keywords analysis, and reference co-citation analysis. A total of 950 publications on meniscus suture from 177 different sources were retrieved over the set time span. These publications were completed by 3177 authors from 1112 institutions in 54 countries. The United States was the most prolific country with 7960 citations and 348 publications (36.63%). Furumatsu Takayuki acted as the most prolific author (51 publications), while Robert F LaPrade with 1398 citations was the most-cited author. And more papers were published in the core journals, including American Journal of Sports Medicine, Arthroscopy-The Journal of Arthroscopic and Related Surgery, Knee Surgery Sports Traumatology Arthroscopy and Arthroscopy Techniques. Furthermore, “meniscus healing,” “meniscus root tear” seem to be the emerging research hotspots. Notably, the publication trend concerning the all-inside suture technique has been rising during the past decade. The number of research publications on meniscus suture has been continuously risen since 2010. The authors, publications and institutions from the United States and East Asia were still the mainstays in this field. And the all-inside suture may become the mainstream surgical technique in the future, with meniscus healing and meniscus root tears being research highlights recently.
Identification of biomarkers of acne based on transcriptome analysis and combined with network pharmacology to explore the therapeutic mechanism of Jinhuang ointment
Authors: Li Minghui , Gao Xue , Miao Tianai , Sun Hongfeng
Published: November 2023

The incidence of acne is on the rise due to unhealthy diet and living habits. Jinhuang ointment (JHO) is a classic prescription composed of 10 kinds of commonly used Chinese herbal medicine, which has been widely used in clinical prevention and treatment of skin inflammatory diseases since ancient times. However, the pharmacological mechanism and target of JHO are not clear. The acne microarray dataset was downloaded from gene expression omnibus database to identify differentially expressed genes (DEG). Immune infiltration was analyzed by CiberSort algorithm. HUB gene was identified by protein-protein interaction network. The gene expression omnibus dataset validates the biomarkers of acne with high diagnostic value. The potential active components and targets of JHO were obtained through Traditional Chinese Medicine Systems Pharmacology database, and the therapeutic targets were obtained by crossing with disease targets. R-packet is used for enrichment analysis. Molecular docking using Auto Dock Tools. A total of 202 DEGs were identified from 12 skin samples in the GSE6475. Immune infiltration analysis showed that there were a large number of macrophages and mast cells in acne skin. Gene set enrichment analysis analysis showed that DEGS was mainly involved in bacterial reaction, inflammatory reaction and so on. Six central genes and gene cluster modules were identified by Cytoscape software. A total of 185 JHO active components and 220 targets were obtained, of which 10 targets were potential targets for JHO in the treatment of acne. Kyoto encyclopedia of genes and genomes enrichment analysis showed that JHO treatment of acne was mainly related to Toll-like receptors, IL-17 and other signal pathways. The results of molecular docking showed that 5 active compounds in JHO had strong binding activity to the core protein receptor. IL-1 β, CXCL8, toll-like receptor 2, CXCL2, LCN2, and secretory phosphoprotein 1 may be potential biomarkers for early diagnosis of acne. JHO active components may regulate skin cell metabolism and inflammatory response and improve cellular immune microenvironment by acting on core targets (CXCL8, ESR1, IL-1 β, MMP1, MMP3, secretory phosphoprotein 1), thus achieving the purpose of treating acne. This is the result of the joint action of multiple targets and multiple pathways. It provides an idea for the development of a new combination of drugs for the treatment of acne.
Network pharmacology and molecular docking-based study on exploring the potential mechanism of Lycium barbarum L: In the treatment of atherosclerosis
Authors: Qin Xinchen , Xie Zikai , Chen Xi , Wang Xiaoxuan , Ma Lijuan
Published: November 2023

Background:

Goji berries (Lycium barbarum L) are herbal medicine that have a long history of use and multiple pharmacological activities. In this study, we investigated the potential therapeutic effects of Goji berries on atherosclerosis (AS) using network pharmacology and molecular docking.

Methods:

The active compounds of Goji berries were identified using the Traditional Chinese Medicine Systems Pharmacology platform, as well as the literature and the targets of each active compound were obtained using the Swiss Target Prediction database. The AS-related targets were collected from the GeneCards and OMIM databases to obtain the common targets of Goji berries and AS. The drug-compound-target-disease network and protein-protein interaction network were constructed using the Cytoscape software to obtain the core target proteins of Goji berries related to AS. Gene ontology analysis of the core targets and Kyoto encyclopedia of genes and genomes pathway enrichment analysis were performed by Metascape. The target-chemical correlations were verified using AutoDock molecular docking.

Results:

After analysis, 44 active compounds within Goji berries were obtained that exhibit associations with AS. Among these, the proteins exhibiting the highest degrees of interaction within the compound-targeted protein protein-protein interaction network were AKT1, SRC, MAPK3, MAPK1, RELA, and STAT3. The gene ontology-biology process analysis showed that compound-targeted proteins were mainly involved in regulating small molecule metabolic process, cellular response to chemical stress, reactive oxygen species metabolic process, and regulation of inflammatory response. Kyoto encyclopedia of genes and genomes pathway mainly included lipid and AS in which AKT1, SRC, MAPK3, and MAPK1 were involved. Advanced glycation end-product-receptor for advanced glycation end-product signaling pathway in diabetic complications, Chagas disease, and pancreatic disease. Molecular docking assessment showed that fucosterol is bound to AKT1, MAPK3, and SRC.

Conclusion:

This study demonstrates that network pharmacology and molecular docking analyses contribute to a better understanding of Goji berries active compounds and targets as potential therapeutic drugs for treating AS.
Investigating the therapeutic mechanism of Xiaotan Sanjie Formula for gastric cancer via network pharmacology and molecular docking: A review
Authors: Xu Xinxin , Yu Zhihong , Zeng Shuying
Published: November 2023

Xiaotan Sanjie Formula (XTSJF), a traditional Chinese prescription, holds promising potential in addressing gastric cancer (GC). Despite this, the fundamental constituents and underlying mechanisms that define XTSJF’s attributes remain enigmatic. Against this backdrop, this study endeavors to unravel the latent mechanisms driving XTSJF’s impact on GC, leveraging the synergistic prowess of network pharmacology and molecular docking methodologies. To understand the potential mechanism of XTSJF against GC, this study used network pharmacology, molecular docking, and bioinformatics analytic methodologies. There are 135 active components where the active ingredients with a higher degree value are quercetin, β-sitosterol, naringenin, nobiletin, and kaempferol and 167 intersecting targets in which TP53, MAPK3, MAPK1, STAT3, and AKT1 were key targets were identified in XTSJF in the treatment of GC. According to GO and KEGG analyses, XTSJF is mostly involved in the positive control of transcription from the RNA polymerase II promoter, enzyme interaction, and other biological processes in GC. KEGG analysis shows that XTSJF treated GC primarily by regulating signaling pathways including the TNF, PI3K-Akt, and MAPK signaling pathways. According to the results of the PPI network and molecular docking, quercetin, β-sitosterol, naringenin, nobiletin, and kaempferol exhibit stronger affinity with TP53, MAPK3, MAPK1, STAT3, and AKT1. This study indicates the active components of XTSJF as well as its possible molecular mechanism against GC, and it serves as a foundation for future fundamental research.
Global research hotspots and trends in exercise interventions for rheumatoid arthritis over the past two decades: A bibliometric and visualization study
Authors: Xu Jie , Chen Meng , Yu Yingli , Tang Liugang , Luo Xiaobing , Cheng Yuandong
Published: November 2023

Rheumatoid arthritis (RA) is a prolonged multifactorial autoimmune disease of unknown etiology. With the global population aging, the incidence of RA is increasing, highlighting the need for more effective treatments. Exercise interventions have been recognized as safe and effective for managing pain, improving function, and reducing fatigue in RA patients. However, the existing literature in this field lacks a thorough, organized, and clear line of analysis. In this study, we conducted a comprehensive analysis of the 20-year literature on exercise interventions for RA, aiming to identify hotspots and cutting-edge trends. Our objective is to provide subsequent researchers with valuable ideas and references. Using Cite Space, VOS viewer, and R-bibliometrix software for visualization and analysis, we compiled the main dataset from the web of science database, consisting of 1790 articles on exercise interventions in RA published between 2000 and 2023. Among these articles, the United States contributed the highest number of papers (433), while Karolinska Institutet ranked first institutionally with 90 papers. The study focused on the keyword’s quality of life, cardiovascular disease, aerobic exercise, social support, psychology, and multidisciplinary care. The research highlighted the importance of clinical efficacy studies that investigate different types of exercise modalities (cardiorespiratory aerobic, resistance, aquatic, and neurological) either alone or in combination, to improve pain and function and reduce cardiovascular disease risk in patients with RA. Additionally, sedentary behavior, fatigue, and multidisciplinary care were identified as potential areas for further research. Overall, this study provides a scientific perspective on exercise interventions for RA and offers valuable insights for academics, funding organizations, and policymakers.
Remimazolam-based anesthesia with flumazenil allows faster emergence than propofol-based anesthesia in older patients undergoing spinal surgery: A randomized controlled trial
Authors: Toyota Yukari , Kondo Takashi , Oshita Kyoko , Haraki Toshiaki , Narasaki Soshi , Kido Kenshiro , Kamiya Satoshi , Nakamura Ryuji , Saeki Noboru , Horikawa Yousuke T. , Tsutsumi Yasuo M.
Published: November 2023

Background:

Remimazolam is a novel, ultrashort-acting benzodiazepine that can be antagonized by flumazenil. This study aimed to determine whether remimazolam-based anesthesia with flumazenil provides a more rapid emergence than propofol-based anesthesia in older patients undergoing spinal surgery.

Methods:

This was a prospective, single-blind, randomized controlled trial. Forty-four patients > 75 years old who had undergone spinal surgery were enrolled in this study. They were randomly assigned to the remimazolam or propofol group (1:1) using a computer randomization system stratified by age and body weight. For anesthesia induction and maintenance, remifentanil was administered at a defined dose in both groups, and remimazolam or propofol was adjusted to maintain the bispectral index or state entropy monitoring within 40–60. All anesthetics were discontinued simultaneously after the postoperative X-ray and 0.5 mg flumazenil was administered to the remimazolam group. The primary outcome was extubation time after discontinuing anesthesia, and the secondary outcomes were time to eye opening, obeying commands, and achieving a white fast-track score (WFTS) of 12.

Results:

Thirty-nine patients were finally analyzed: remimazolam group (n = 20), propofol group (n = 19). There were no significant differences in intraoperative variables, such as operative time, anesthesia time, and patient background, between the 2 groups. Extubation times were significantly shorter in the remimazolam group than in the propofol group (4 vs 8 minutes, P < .001). The time to eye opening, obeying commands, and achieving a WFTS of 12 were significantly shorter in the remimazolam group (P < .001, for all comparisons).

Conclusion:

Remimazolam-based anesthesia with flumazenil resulted in a faster emergence than propofol-based anesthesia in older patients undergoing spinal surgery.
Adenomyoma recurrence 7 years after laparoscopic supracervical hysterectomy: A case report and literature review
Authors: Tien Chin-Tzu , Ding Dah-Ching
Published: November 2023

Rationale:

Adenomyosis, a gynecological condition characterized by endometrial tissue within the uterine myometrium, often leads to menstrual pain and heavy bleeding, significantly affecting the quality of life. The primary treatment for adenomyosis and leiomyomas is hysterectomy. However, in rare instances, these conditions can recur in the cervical stump following a hysterectomy.

Here, we present a case of cervical adenomyoma development after a prior laparoscopic supracervical hysterectomy.

Patient Concerns:

A 47-year-old woman sought medical attention due to increased vaginal bleeding.

Diagnoses:

She had undergone a laparoscopic supracervical hysterectomy 7 years earlier to address uterine myoma and adenomyosis. Just 1 month posthysterectomy, a pelvic ultrasound revealed the presence of a cervical stump measuring approximately 4.0 × 4.0 cm. Subsequent follow-up ultrasounds documented the gradual growth of the cervical mass. Two years ago, a recurrent myoma was identified, and the patient experienced intermittent vaginal bleeding. Over 7 years, the cervical mass increased from 4 to 7 cm. Preadmission pelvic ultrasonography confirmed the existence of cervical adenomyoma measuring 7 × 6 cm.

Interventions:

Consequently, the patient underwent a laparoscopic trachelectomy. Intraoperatively, an enlarged cervix, approximately 7 × 6 cm in size, containing adenomyoma was observed. A gross examination of the specimen indicated hypertrophic muscle tissue and hemorrhagic foci. Subsequent histopathological examination confirmed the presence of adenomyoma.

Outcomes:

Remarkably, the patient exhibited no recurrence over the subsequent 8 months.

Lessons:

The case presented here highlights the potential occurrence of cervical adenomyoma following a supracervical hysterectomy. Management options include hormone therapy and surgical excision. Furthermore, annual follow-up comprising ultrasound and pap smear evaluations is recommended for patients with supracervical hysterectomies to detect and address possible recurrences.
Management of hypertensive crisis in a patient with underlying kidney disease: A case report
Authors: Elendu Chukwuka , Amaechi Dependable C. , Elendu Tochi C. , Sucari Yuliana Paola Oros , Saggi Sehajmeet Kaur , Dang Kanishk , Ibhiedu Jennifer O.
Published: November 2023

Rationale:

This case report elucidates the management of a hypertensive crisis in a patient with underlying kidney disease, shedding light on the intricate interplay between these conditions. This unique case contributes valuable insights to the scientific literature.

Patient Concerns:

The patient exhibited severe headache, visual disturbances, and chest pain. Clinical evaluation revealed elevated blood pressure and impaired kidney function, emphasizing the importance of monitoring hypertension and renal health in such cases.

Diagnoses and Interventions:

The primary diagnoses included malignant hypertension and underlying kidney disease. Immediate interventions comprised intravenous antihypertensive agents and rigorous hemodynamic monitoring, yielding favorable outcomes. Blood pressure gradually returned to acceptable levels, and renal function improved during treatment.

Conclusions:

This case underscores the critical need for timely recognition and management of hypertensive crises in patients with preexisting kidney dysfunction. Simultaneously addressing both conditions is vital for successful outcomes. Healthcare practitioners must remain vigilant in assessing the intricate relationship between hypertension and kidney disease, employing tailored interventions for optimal results.

Lesson Learned:

The primary lesson from this case is the necessity of a comprehensive approach to managing hypertensive crises in individuals with underlying kidney disease. Early intervention and a multidisciplinary strategy are essential to achieve positive clinical outcomes and prevent potential complications.
Delivery of Care for Pediatric Patients Receiving Blinatumomab: A Children’s Oncology Group Study
Authors: Withycombe Janice S. , Kubaney Holly R. , Okada Maki , Yun Christine S. , Gupta Sumit , Bloom Caylie , Parker Veronica , Rau Rachel E. , Zupanec Sue
Published: November 2023

Background

Blinatumomab is an immunotherapy agent used in pediatric oncology for the treatment of B-lineage acute lymphoblastic leukemia. Administration of blinatumomab, via continuous 28-day infusion cycles, can present multiple decision points and challenges related to patient care. Nurses are at the forefront of coordinating and delivering care for patients receiving blinatumomab.

Objective

To describe the current state of practice across Children’s Oncology Group (COG) member institutions regarding blinatumomab administration in both inpatient and home/outpatient settings.

Methods

Between August and December 2021, a cross-sectional survey was used to determine current institutional practices related to blinatumomab administration. A single targeted respondent who was actively engaged in coordinating blinatumomab administration completed the survey on behalf of each COG institution.

Results

Survey participation rate was 78% (150/192). During the first 28-day blinatumomab cycle, 71 institutions (53%) reported patient hospital stays between 73 hours and 7 days; 42 (31%) reported hospital stays ≤72 hours, and only 12 (9%) reported hospitalization for the full 28-day infusion. Small- to medium-size institutions were more likely to report longer hospitalizations (P = .03). Most blinatumomab administration occurred in the outpatient setting, with low rates of unplanned clinic/emergency room visits.

Conclusions

The majority of COG institutions have navigated the complex coordination of care required for children to receive blinatumomab at home. Wide variations in practice were noted across institutions.

Implications for Practice

This study describes current institutional practices surrounding administration of 28-day blinatumomab infusions in children with leukemia and offers a starting point for institutional benchmarking and standardization of practice.
Foreign Accent Syndrome After COVID 19 Infection
Authors: Olguner Eker Ozlem , Gultekin Murat , Demirel Ozsoy Saliha
Published: November 2023

Foreign accent syndrome (FAS) is an extremely rare disorder characterized by the appearance of speech changes that are perceived by the speaker and listeners as an acquired foreign accent. It still remains a poorly understood condition. Three main types of FAS have been reported in the medical literature as neurogenic, psychogenic, and mixed type. Psychogenic FAS includes all cases of FAS in which an organic cause has not been identified and a clear psychological factor has been identified after careful clinical, neurological, and neuroradiological examination. Although the COVID-19 epidemic, which has been ongoing since February 2020, primarily manifests itself with upper respiratory tract infection findings, it is seen that it also causes a wide range of neurological and psychiatric signs and symptoms. In this study, a 42-year-old female patient who started to have speech disorder after COVID-19 infection is presented in the light of clinical history, diagnosis, and differential diagnosis literature findings.
Pathophysiological Hypothesis of COVID-19 Psychosis
Authors: Lisi Gisela Roxana Edith , Appiani Francisco , Basile María Eugenia , Garro Marcelo , Duarte Juan Manuel
Published: November 2023

In December 2019, a new coronavirus called SARS-CoV-2 was discovered in patients with pneumonia of unknown cause. Although respiratory symptoms mainly characterize infection by this virus, neuropsychiatric manifestations of the disease are becoming more and more frequent. Among them, the appearance of psychotic outbreaks in patients experiencing the infection or after a short time after it has resolved is remarkable. This narrative review aims to describe the possible relationship between SARS-CoV-2 and the onset of psychosis by developing the neurotropic capacities of the virus and analyzing the neurobiology of psychoses.
Drawing the Line Between Postacute Sequelae of COVID-19 and Functional Neurologic Disorders
Authors: Sales Paulo M.G. , Greenfield Melissa J. , Pinkhasov Aaron , Viswanathan Ramaswamy , Saunders Ramotse , Huremović Damir
Published: November 2023

Coronavirus disease 2019 (COVID-19) is an acute infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its multiple variants that classically presents with cough, fatigue, fever, headache, myalgias, and diarrhea. As vaccination becomes widely available and infection rates facilitate herd immunity across the globe, more attention has been given to long-term symptoms that may persist after the index infection, which include impairments in concentration, executive dysfunction, sensory disturbances, depression, anxiety, fatigue, and cough, among other symptoms classified under the umbrella term of postacute sequelae of SARS-CoV-2 infection (PASC).

Functional neurologic disorder (FND), also known as conversion disorder and functional neurologic symptom disorder, refers to the presence of one or more symptoms of altered voluntary motor or sensory function that are incompatible with and not better explained by a known neurological or medical condition that causes significant distress and functional impairment. Although the diagnosis of FND may not require the identification of an underlying psychological stressor, being diagnosed with an FND can worsen stigma and shift attention and resources away from other medical concerns that should be concomitantly addressed.

This review summarizes the literature on the overlapping nature and discrimination of PASC from FND in COVID-19 survivors. Based on this, we develop a treatment framework that targets unique domains of these complex overlapping presentations, following a multidisciplinary approach with an individualized treatment plan inclusive of physical and psychological interventions focused on functional rehabilitation.
Poststroke Mania During the COVID-19 Pandemic
Authors: Nagamine Takahiko
Published: November 2023

The pandemic of coronavirus infection 2019 (COVID-19) is stressing people's daily lives and making them more susceptible to various mental illnesses. Depression and suicide attempt as well as, strangely enough, manic patients are on the rise. The main complication of COVID-19 infection is ischemic stroke. Multiple lacunar infarcts in the white matter of the right middle cerebral artery region induce an imbalance of blood flow in the left and right cerebral cortex and risk causing mania. The increase in mania during the COVID-19 must be considered not only a primary increase due to stress but also poststroke mania secondary to COVID-19 infection.
Psychological Stress and Coping Strategy Profiles Among Frontline Medical Workers During the COVID-19 Pandemic
Authors: Yan Lihua , Li Jiahuan , Lin Pingzhen , Sun Jiwei
Published: November 2023

This study aimed to explore coping strategy profiles used by frontline medical workers and the psychological stress reactions associated with each category, in the COVID-19 pandemic context. Participants were 651 frontline medical workers recruited between February and March 2020. Psychological stress reactions (e.g., anxiety, depression) and coping strategies were assessed and analyzed using latent profile analysis and linear regression. Participants had three coping strategy profiles: coping inadequately (28.9%), coping appropriately (64.4%), and coping excessively (6.7%). Compared with coping appropriately, those who coped inadequately and excessively had higher psychological stress reactions levels. Levels of anxiety, depression, and posttraumatic stress disorder in excessive-coping individuals were higher than those who coped inadequately. Our findings elucidate the effectiveness of different coping strategy profiles and provide insights for developing targeted interventions to mitigate stress among medical workers. In light of these results, we recommend implementing stress management programs tailored to specific coping strategy profiles.
Reliability and Minimal Detectable Change for Respiratory Muscle Strength Measures in Individuals With Multiple Sclerosis
Authors: Aguilar-Zafra Sandra , Fabero-Garrido Raúl , del Corral Tamara , López-de-Uralde-Villanueva Ibai
Published: November 2023

Background and Purpose:

The test-retest reliability and minimal detectable changes (MDCs) for respiratory muscle strength measures have not been determined in individuals with multiple sclerosis (MS). This study determined the test-retest reliability and MDCs for specific respiratory muscle strength measures, as well as their associations with health-related quality of life (HRQoL), disability, dyspnea, and physical activity level measures in this population. In addition, the study examined differences in respiratory muscle strength between different degrees of disability.

Methods:

Sixty-one individuals with MS attended 2 appointments separated by 7 to 10 days. Respiratory muscle strength was evaluated by maximal inspiratory and expiratory pressures (MIP/MEP), HRQoL by EuroQol-5D-5L (index and visual analog scale [EQ-VAS]), disability by the Expanded Disability Status Scale, dyspnea by the Medical Research Council scale, and physical activity levels by the International Physical Activity Questionnaire.

Results:

Respiratory muscle strength measures had excellent test-retest reliability (ICC ≥ 0.92). The MDC for MIP is 15.42 cmH2O and for MEP is 17.84 cmH2O. Participants with higher respiratory muscle strength (MIP/MEP cmH2O and percentage of predicted values) had higher HRQoL (r = 0.54-0.62, P < 0.01, EQ-5D-5L index; r = 0.30-0.42, P < 0.05, EQ-VAS); those with higher expiratory muscle strength (cmH2O and percentage of predicted values) had lower levels of disability (r ≤ −0.66) and dyspnea (r ≤ −0.61). There were differences in respiratory muscle strength between different degrees of disability (P < 0.01; d ≥ 0.73).

Discussion and Conclusion:

Respiratory muscle strength measures provide excellent test-retest reliability in individuals with MS. MDCs can be interpreted and applied in the clinical setting. Low respiratory muscle strength can contribute to a poor HRQoL; specifically, expiratory muscle strength appears to have the strongest influence on disability status and dyspnea.
Effect of tuberculosis–HIV co-treatment on clinical and growth outcomes among hospitalized children newly initiating antiretroviral therapy
Authors: Cherkos Ashenafi S. , Cranmer Lisa M. , Njuguna Irene , LaCourse Sylvia M. , Mugo Cyrus , Moraa Hellen , Maleche-Obimbo Elizabeth , Enquobahrie Daniel A. , Richardson Barbra A. , Wamalwa Dalton , John-Stewart Grace
Published: November 2023

Objective:

Evaluate effects of tuberculosis (TB)–HIV co-treatment on clinical and growth outcomes in children with HIV (CHIV).

Design:

Longitudinal study among Kenyan hospitalized ART-naive CHIV in the PUSH trial (NCT02063880).

Methods:

CHIV started ART within 2 weeks of enrollment; Anti-TB therapy was initiated based on clinical and TB diagnostics. Children were followed for 6 months with serial viral load, CD4%, and growth assessments [weight-for-age z-score (WAZ), height-for-age z-score (HAZ), and weight-for-height z-score (WHZ)]. TB-ART treated and ART-only groups were compared at 6 months post-ART for undetectable viral load (<40 c/ml), CD4% change, and growth using generalized linear models, linear regression, and linear mixed-effects models, respectively.

Result:

Among 152 CHIV, 40.8% (62) were TB-ART treated. Pre-ART, median age was 2.0 years and growth was significantly lower, and viral load significantly higher in the TB-ART versus ART-only group. After 6 months on ART, 37.2% of CHIV had undetectable viral load and median CD4% increased by 7.2% (IQR 2.0–11.6%) with no difference between groups. The TB-ART group had lower WAZ and HAZ over 6 month follow-up [WAZ −0.81 (95% CI: −1.23 to −0.38], P < 0.001; HAZ −0.15 (95% CI: −0.29 to −0.01), P = 0.030] and greater rate of WAZ increase in analyses unadjusted and adjusted for baseline WAZ [unadjusted 0.62 (95% CI: 0.18–1.07, P = 0.006) or adjusted 0.58 (95% CI: 0.12–1.03, P = 0.013)].

Conclusion:

TB–HIV co-treatment did not adversely affect early viral suppression and CD4+ recovery post-ART. TB-ART-treated CHIV had more rapid growth reconstitution, but growth deficits persisted, suggesting need for continued growth monitoring.
Association of age at antiretroviral therapy initiation with CD4+ : CD8+ ratio recovery among virally suppressed people with HIV
Authors: Holden Clare J. , Lampe Fiona C. , Burns Fiona M. , Chaloner Clinton , Johnson Margaret , Kinloch-De Loes Sabine , Smith Colette J.
Published: November 2023

Objective:

To investigate the association of age at antiretroviral therapy (ART) initiation with CD4+ : CD8+ T-cell ratio in virally suppressed people with HIV on long-term ART, and to characterize potential CD4+ : CD8+ ratio recovery in this population by age.

Design:

A longitudinal study of people attending an HIV clinic at the Royal Free Hospital NHS Trust, London, who initiated ART between 2001 and 2015, and achieved and maintained HIV-1 viral suppression (viral load <1,000 copies/ml). The association of age group at ART initiation with CD4+ : CD8+ ratio at 5 and 10 years was assessed.

Methods:

Multivariable linear regression was used to investigate the relationship between age at ART initiation and log CD4+ : CD8+ ratio, adjusting for demographic factors (gender/HIV transmission route, ethnicity), baseline CD4+ count and calendar year.

Results:

The sample included 1859 people aged 20–78 (75% men, 56% white ethnicity). Overall, median CD4+ : CD8+ T-cell ratio increased from 0.24 at baseline to 0.77 at year 5 and 0.88 at year 10. Ratios increased among all age groups in unadjusted and adjusted models but increased less among older ages (baseline ages 60–69 and 70–79). Median ratios at year 5 were 0.85, 0.80, 0.72, 0.76, 0.6, and 0.44, respectively, among people aged 20–29, 30–39, 40–49, 50–59, 60–69 and 70–79 years at baseline.

Conclusion:

In a virally suppressed London population, age had a substantial impact on CD4+ : CD8+ ratio recovery, especially for those starting ART after age 60 years. Results may indicate the level of CD4+ : CD8+ ratio recovery possible in an HIV-positive, virally suppressed, aging population.
Does Dual-Energy Computed Tomography Material Decomposition Improve Radiomics Capability to Predict Survival in Head and Neck Squamous Cell Carcinoma Patients? A Preliminary Investigation
Authors: Bernatz Simon , Böth Ines , Ackermann Jörg , Burck Iris , Mahmoudi Scherwin , Lenga Lukas , Martin Simon S. , Scholtz Jan-Erik , Koch Vitali , Grünewald Leon D. , Koch Ina , Stöver Timo , Wild Peter J. , Winkelmann Ria , Vogl Thomas J. , Pinto dos Santos Daniel
Published: November 2023

Objective

Our study objective was to explore the additional value of dual-energy CT (DECT) material decomposition for squamous cell carcinoma of the head and neck (SCCHN) survival prognostication.

Methods

A group of 50 SCCHN patients (male, 37; female, 13; mean age, 63.6 ± 10.82 years) with baseline head and neck DECT between September 2014 and August 2020 were retrospectively included. Primary tumors were segmented, radiomics features were extracted, and DECT material decomposition was performed. We used independent train and validation datasets with cross-validation and 100 independent iterations to identify prognostic signatures applying elastic net (EN) and random survival forest (RSF). Features were ranked and intercorrelated according to their prognostic importance. We benchmarked the models against clinical parameters. Intraclass correlation coefficients were used to analyze the interreader variation.

Results

The exclusively radiomics-trained models achieved similar (P = 0.947) prognostic performance of area under the curve (AUC) = 0.784 (95% confidence interval [CI], 0.775–0.812) (EN) and AUC = 0.785 (95% CI, 0.759–0.812) (RSF). The additional application of DECT material decomposition did not improve the model's performance (EN, P = 0.594; RSF, P = 0.198). In the clinical benchmark, the top averaged AUC value of 0.643 (95% CI, 0.611–0.675) was inferior to the quantitative imaging-biomarker models (P < 0.001). A combined imaging and clinical model did not improve the imaging-based models (P > 0.101). Shape features revealed high prognostic importance.

Conclusions

Radiomics AI applications may be used for SCCHN survival prognostication, but the spectral information of DECT material decomposition did not improve the model's performance in our preliminary investigation.
Utilization of Radiomics Features Extracted From Preoperative Medical Images to Detect Metastatic Lymph Nodes in Cholangiocarcinoma and Gallbladder Cancer Patients: A Systemic Review and Meta-analysis
Authors: Mirza-Aghazadeh-Attari Mohammad , Afyouni Shadi , Zandieh Ghazal , Yazdani Nia Iman , Mohseni Alireza , Borhani Ali , Madani Seyedeh Panid , Shahbazian Haneyeh , Ansari Golnoosh , Kim Amy , Kamel Ihab R.
Published: November 2023

Objectives

This study aimed to determine the methodological quality and evaluate the diagnostic performance of radiomics features in detecting lymph node metastasis on preoperative images in patients with cholangiocarcinoma and gallbladder cancer.

Methods

Publications between January 2005 and October 2022 were considered for inclusion. Databases such as Pubmed/Medline, Scopus, Embase, and Google Scholar were searched for relevant studies. The quality of the methodology of the manuscripts was determined using the Radiomics Quality Score and Quality Assessment of Diagnostic Accuracy Studies 2. Pooled results with corresponding 95% confidence intervals (CIs) were calculated using the DerSimonian-Liard method (random-effect model). Forest plots were used to visually represent the diagnostic profile of radiomics signature in each of the data sets pertaining to each study. Fagan plot was used to determine clinical applicability.

Results

Overall sensitivity was 0.748 (95% CI, 0.703–0.789). Overall specificity was 0.795 (95% CI, 0.742–0.839). The combined negative likelihood ratio was 0.299 (95% CI, 0.266–0.350), and the positive likelihood ratio was 3.545 (95% CI, 2.850–4.409). The combined odds ratio of the studies was 12.184 (95% CI, 8.477–17.514). The overall summary receiver operating characteristics area under the curve was 0.83 (95% CI, 0.80–0.86). Three studies applied nomograms to 8 data sets and achieved a higher pooled sensitivity and specificity (0.85 [0.80–0.89] and 0.85 [0.71–0.93], respectively).

Conclusions

The pooled analysis showed that predictive models fed with radiomics features achieve good sensitivity and specificity in detecting lymph node metastasis in computed tomography and magnetic resonance imaging images. Supplementation of the models with biological correlates increased sensitivity and specificity in all data sets.
Multicenter Study of the Utility of Convolutional Neural Network and Transformer Models for the Detection and Segmentation of Meningiomas
Authors: Ma Xin , Zhao Lingxiao , Dang Shijie , Zhao Yajing , Lu Yiping , Li Xuanxuan , Li Peng , Chen Yibo , Mei Nan , Yin Bo , Geng Daoying
Published: November 2023

Purpose

This study aimed to investigate the effectiveness and practicality of using models like convolutional neural network and transformer in detecting and precise segmenting meningioma from magnetic resonance images.

Methods

The retrospective study on T1-weighted and contrast-enhanced images of 523 meningioma patients from 3 centers between 2010 and 2020. A total of 373 cases split 8:2 for training and validation. Three independent test sets were built based on the remaining 150 cases. Six convolutional neural network detection models trained via transfer learning were evaluated using 4 metrics and receiver operating characteristic analysis. Detected images were used for segmentation. Three segmentation models were trained for meningioma segmentation and were evaluated via 4 metrics. In 3 test sets, intraclass consistency values were used to evaluate the consistency of detection and segmentation models with manually annotated results from 3 different levels of radiologists.

Results

The average accuracies of the detection model in the 3 test sets were 97.3%, 93.5%, and 96.0%, respectively. The model of segmentation showed mean Dice similarity coefficient values of 0.884, 0.834, and 0.892, respectively. Intraclass consistency values showed that the results of detection and segmentation models were highly consistent with those of intermediate and senior radiologists and lowly consistent with those of junior radiologists.

Conclusions

The proposed deep learning system exhibits advanced performance comparable with intermediate and senior radiologists in meningioma detection and segmentation. This system could potentially significantly improve the efficiency of the detection and segmentation of meningiomas.
Solitary Dural Metastasis From Neuroblastoma Detected by 123I-MIBG SPECT/CT
Authors: Lu Xia , Xu Yanfeng , Wang Wei , Yang Jigang
Published: November 2023

123I-MIBG SPECT/CT was performed for follow-up in an asymptomatic 8-year-old girl with a history of neuroblastoma. The images showed an unsuspected abnormal accumulation in the head, which was identified as a hyperdense lesion of the dura with increasing MIBG uptake, suggesting the possibility of metastasis from neuroblastoma. A brain MRI with contrast showed a remarkably enhanced lesion beside the confluence of sinuses, which mimicked meningioma. Results of the surgical pathology are consistent with the diagnosis of dural metastasis from neuroblastoma.
Penile Evaluation: An Illustrated Review
Authors: Bass David , Clancy Kathleen , Gupta Akshya , Dogra Vikram
Published: November 2023

High-frequency ultrasound is the imaging modality of choice for evaluating penile pathology because of its easy access, low cost, and patient tolerance (The Penis, Diagnostic Ultrasound, second edtion. Boca Raton: CRC Press; 2007:957–978). This pictorial review will illustrate the sonographic features of emergent and nonemergent penile conditions such as penile fracture, spongial tear, urethral injury, various types of priapism, erectile dysfunction, penile abscess, and Mondor disease.