bluuebunny/crossref_metadata_2025 huggingface dataset:
Cone beam computed tomography changes upon oral appliance therapy for adult patients with obstructive sleep apnea: A non-randomized clinical trial
Authors: Khasawneh Lina , Al Mortadi Noor , Abu-Ishqair Eslam , Khassawneh Basheer , Alzoubi Karem H.
Published: October 2024

Background:

Obstructive sleep apnea (OSA) is caused by narrowing or obstruction of the airway lumen at single or multiple levels of the airway, starting from the nasal cavity up to the larynx. Oral appliance therapy for the management of OSA is prescribed as an alternative treatment option for patients with mild to moderate OSA who fail to adhere to Continuous Positive Airway Pressure (CPAP) therapy. Treatment with oral appliances addresses the craniofacial deficiencies that cause OSA by providing means to mandibular advancement and palatal expansion, thus opening the airways and potentially preventing airway collapse during sleep. Imaging the upper airway is employed to investigate the narrowing or the obstruction in the airway. Three-dimensional imaging modalities such as cone beam computed tomography (CBCT) allow for detecting obstructions before commencing treatment and for evaluating changes in the upper airway dimensions after treatment. To evaluate the effect of the biomimetic oral appliance therapy (BOAT) device on the airway measurements taken from a CBCT before and after treatment in correlation with the changes in the AHI.

Trial design:

A non-randomized clinical trial.

Methods:

About 17 patients with mild-moderate OSA (9 males, 8 females; age, mean [SD]: 45.76 [10.31]) underwent BOAT therapy. Subjects had 2 months of follow-up visits, including examinations for progress and adjustment of the appliances. The mean apnea–hypopnea index (AHI) with no appliance in the mouth before BOAT and after treatment was recorded. The midpalate screw mechanism of the appliance was advanced once per week. The subjects were asked to wear the appliance for 10 to 12 h/d and night. Pre and Post CBCT were taken. Paired T-test was used to analyze the results.

Results:

The treatment duration was 15.4 ± 6.3 months. Before treatment, at the diagnosis stage, the mean AHI of the sample (n = 17) was 24.0. After treatment, the mean AHI fell by 5% to 22.8% (P = .019), indicating enhanced upper airway functions. Airway measurements from the CBCT were not statistically significant despite improvement in the polysomnographic parameters.

Conclusion:

CBCT is a valuable tool for airway assessment and the determination of upper airway anatomic risk factors for OSA.
High-intensity focused ultrasound (HIFU) for the treatment of female urinary incontinence: A retrospective analysis
Authors: Önder Dirican Aylin , Ceran Mehmet Ufuk , Kahraman Oğuzhan , Sönmez Mehmet Giray
Published: October 2024

This study aims to demonstrate the effectiveness of high-intensity focused ultrasound, a noninvasive treatment, for managing urinary incontinence (UI) in women. This is a single-center, retrospective study involving 28 women. Patients, aged between 32 and 65, were included. Patients with insulin-dependent diabetes, neurological disease, active urinary tract infection, undiagnosed vaginal bleeding, who had incontinence surgery, and receiving estrogen therapy were excluded from the study. Incontinence severity was evaluated with the International Incontinence Consultation Questionnaire Short Form (ICIQ-SF). Patients were evaluated before treatment and 6 months after treatment using the ICIQ-SF and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Assessment short form. In the analysis of numerical variables independent or paired t test or linear mixed effects models were used. Least square means were used in post hoc comparisons. Mean age of the patients was 45.50 ± 7.59 years. There were 18 (64%) stress urinary incontinence (SUI) and 10 (36%) mixed urinary incontinence (MUI). Six months after treatment, mean ICIQ-SF and Pelvic Organ Prolapse/Urinary Incontinence Short Form Questionnaire scores showed a significant positive change. After the procedure, UI completely disappeared in 43% of the patients. The rate of severe UI decreased from 39% to 8%, and very severe UI decreased from 8% to 0%. Incontinence severity was significantly different in the MUI and SUI groups before and after the procedure. After the procedure, UI completely disappeared in 67% of the patients in the SUI group, while it remained at a mild level in 33%. The decrease in ICIQ-SF score in the SUI group was significantly higher than that in the MUI group. There were no severe adverse events, in 4 patients there was mild vaginal discharge which resolved in 1 week. This study showed that high-intensity focused ultrasound treatment, can be effective and safe even in a single session. Selection and recall biases are potential biases in retrospective studies. Lacking a control group is another limitation. Although advances in technology are very important for medical treatments, their effectiveness and safety need to be proven. Future research in this area with a larger sample size and a prospective design will offer further evidence supporting effectiveness of this treatment model.
Positive association between constipation and mild cognitive impairment in elders: A cross-sectional study
Authors: Huang Kai-Yong , Yu Zhen-Zhen , Tu Jia-Jun , Tang Xian-Yan , Huang Jin-Meng , Lu Tian-Ming , Lu Yu-Qian , Huang Mei-Chun , Zhou Jing , Maier Andrea B. , Ye Kaisy Xinhong , Yang Zi , Feng Lei , Lu Guo-Dong
Published: October 2024

This study aimed to examine the association between constipation and mild cognitive impairment (MCI); and further elucidate the possible mechanisms involved. A cross-sectional study was conducted among community-dwelling elders (N = 789) in Nanning, China. Trained research staffs collected detailed information through questionnaires and physical examinations. A Bayesian network model was used to explore the hypothesized causal path. Synergistic effects of constipation with infrequent fruit consumption, inactive physical exercise, or history of stroke were observed in the risks of MCI occurrence. The Bayesian network model analyses showed 3 hypothesized causal-association paths leading to MCI occurrence. Among these, constipation, history of stroke, and years of schooling were directly related to the occurrence of MCI. Years of schooling indirectly affected MCI through infrequent fruit consumption and constipation; or through inactive physical exercises and history of stroke. This study demonstrates a direct association between constipation and increased risks of MCI.
From apoptosis to pyroptosis: A two-decade analysis of spinal cord injury systematic review
Authors: Yang Rui , Guo Yuhuai , Yin Hongna
Published: October 2024

Background:

Spinal cord injury has a significant impact on patients’ physical and mental health, with cell death playing a key role in the pathology.

Methods:

The Web of Science Core Collection database was searched and screened according to inclusion criteria for publications between January 1, 2000 and December 31, 2023. Bibliometric analysis was conducted using bibliomatrix R-package, CiteSpace, and VOSviewer software.

Results:

A total of 2309 publications were identified, with a stable growth in the first 13 years and accelerated growth in the past decade, indicating an increasing trend in this field. These publications on cell death after spinal cord injury originated from 251 countries/regions. China contributed the most publications, with funding support primarily from China, and Wenzhou Medical University in China being the leading institution with the highest number of publications. Salvatore Cuzzocrea was the most influential author. The research direction in this field after 2000 mainly focused on topics such as apoptosis, autophagy, mesenchymal stem cells, mammalian target of rapamycin pathway, ferroptosis, functional recovery, neuronal regeneration, and NOD-like receptor protein 3.Current hot topics and future research trends revolve around extracellular vesicles including exosomes, extracellular vesicle-mediated mesenchymal stem cells, microRNA, autophagy, NOD-like receptor protein 3 inflammasome-mediated cell pyroptosis, and mechanisms of glial scar formation.

Conclusion:

Publications in this field have grown rapidly in the past 2 decades and are expected to keep increasing. Current hot topics include mesenchymal stem cells, apoptosis, autophagy, and ferroptosis. Future research will focus on extracellular vesicle-mediated mesenchymal stem cells, autophagy, inflammasome-mediated cell pyroptosis, and glial scar formation.
Appropriate linear stapler selection for avoiding postoperative pancreatic fistula after distal pancreatectomy: A retrospective cohort study
Authors: Naito Kei , Shinmura Kazuyasu , Suzuki Takayuki , Maeda Shintaro , Kuboki Satoshi , Ohtsuka Masayuki
Published: October 2024

Background:

Despite the progress in surgical techniques and perioperative managements, the incidence of postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) remains high. Recently, pancreatic dissection using a linear stapler has been widely performed; however, risk factors influencing the occurrence of POPF after DP using a liner stapler is not fully understood. The purpose of this paper was to evaluate whether the relations between staple height and pancreatic thickness or main pancreatic duct (MPD) diameter influenced the incidence of POPF.

Methods:

Patients who underwent DP without other organ resections between 2015 and 2022 were retrospectively reviewed. Compression Index (CI) was defined as staple height/pancreatic thickness, and Suturing Index (SI) was defined as staple height/ MPD diameter.

Results:

In 51 patients undergoing DP, 16 patients (31.4%) developed POPF. ROC analyses revealed that lower CI and higher SI significantly increased the incidence of POPF, and the cutoff values were 0.186 and 0.821, respectively. Univariate and multivariate analyses revealed that CI ≤ 0.186 and SI ≥ 0.821 were independent risk factors for POPF after DP. Moreover, the incidence of POPF in patients fulfilling both CI > 0.186 and SI < 0.821 was 5.9%, which was extremely lower than in those without fulfilling the criteria (44.1%), suggesting that this new criteria in combination with CI and SI was an excellent predictor of POPF.

Conclusions:

It is possible that stapler cartridge selection using our new criteria in combination with CI and SI may reduce the incidence of POPF.
Clinical effect analysis of vertebroplasty with high viscosity and standard bone cement for Kummell disease
Authors: Wang Jian , Zhang Jianxin , Huang Jianbiao , Chen Jie , Dong Qunwei , Zhu Hui , Huang Xusheng , Luo Jianxian
Published: October 2024

This study aims to observe and compare the effects of high-viscosity bone cement versus standard bone cement on the postoperative outcomes of percutaneous vertebroplasty (PVP) in patients with Kummell disease. A retrospective analysis was conducted on 135 patients with Kummell disease who underwent PVP between January 2019 and May 2023. Patients were divided into 2 groups: the high-viscosity group (group H, 63 cases) received high-viscosity bone cement during surgery, while the standard group (group S, 72 cases) received standard bone cement. Surgery duration, bone cement volume, bone cement leakage rate, as well as preoperative and postoperative evaluations using the Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI), anterior vertebral height, and kyphotic Cobb angle were recorded and compared between the 2 groups. In the group H, significant improvements were observed in VAS scores, ODI, anterior vertebral height, and Cobb angle at 24 hours, 3 months, and 1 year postoperatively compared to preoperative values (P < .01). In the group S, VAS scores and ODI showed significant improvement at 24 hours, 3 months, and 1 year postoperatively (P < .01), but there were no significant differences in anterior vertebral height or Cobb angle compared to preoperative values (P > .05). Comparatively, the group H demonstrated superior outcomes in terms of bone cement volume, leakage rate, recovery of anterior vertebral height, and Cobb angle correction at 24 hours, 3 months, and 1 year postoperatively (P < .05). However, there were no significant differences between the 2 groups in terms of surgery duration, VAS scores, and ODI at the same time points (P > .05). PVP is an effective treatment for Kummell disease, providing significant pain relief and improved spinal function. The use of high-viscosity bone cement allows for greater volume infusion, better restoration of vertebral height, and correction of deformities, while also reducing the risk of cement leakage.
Peripheral blood lymphocyte subpopulations as predictive biomarkers for first-line programmed death 1 inhibitors efficacy in esophageal squamous cell carcinoma: A retrospective study
Authors: Sun Jiukang , Gan Wenyuan , Yao Jialin , Han Zhihang , Fang Zhang , Xiong Weili , Li Dongqing , Wu Jianhui , Cao Lei , Zhu Lingjun
Published: October 2024

Esophageal cancer (EC) poses a significant global health burden, necessitating effective treatment strategies. Immune checkpoint inhibitors have emerged as a promising therapeutic option for EC, but the identification of predictive biomarkers remains crucial for optimizing patient outcomes. We conducted a retrospective analysis of medical records from advanced esophageal squamous cell carcinoma patients treated with first-line programmed death 1 inhibitors. Peripheral blood lymphocyte subpopulations were evaluated using flow cytometry, while hematological tests provided data on neutrophil, lymphocyte, and monocyte counts. Cox regression and logistic regression analyses were employed to explore the association between lymphocyte subpopulations, baseline characteristics, and progression-free survival (PFS). Among the 100 initially included patients, 70 met eligibility criteria. Multivariate Cox regression analysis revealed a significant association between high CD16+CD56+ lymphocyte proportions and longer PFS, independent of other clinical variables. Similarly, a high CD4+/CD8+ ratio was correlated with prolonged PFS. Kaplan–Meier survival curves supported these findings. Logistic regression analysis indicated no significant differences in the CD4+/CD8+ ratio and CD16+CD56+ lymphocytes concerning baseline characteristics, suggesting their potential as independent prognostic markers. Our study highlights the predictive value of peripheral blood CD16+CD56+ lymphocytes and the CD4+/CD8+ ratio for the efficacy of programmed death 1 inhibitors in advanced esophageal squamous cell carcinoma patients. These findings underscore the importance of peripheral blood biomarkers in guiding personalized immunotherapy strategies and improving outcomes for EC patients.
Diagnosis and treatment of 2 cases with cryptogenic stroke due to patent foramen ovale in children: A case report
Authors: Gong Jie , Zhang Huayong , Li Changjian , Zhang Yong
Published: October 2024

Rationale:

Arterial ischemic stroke is a general term for necrosis of brain tissue due to insufficient blood supply to the brain from various causes. About 30% of these cases are of unknown origin and are known as cryptogenic strokes (CS).

Patient concerns:

We report 2 female patients, one 5 years and 5 months old and the other 6 years old. Both children had clinical manifestations of CS, and after ruling out other possible etiologies, we finally suspected that CS was associated with patent foramen ovale (PFO).

Diagnoses:

Case 1 was diagnosed with PFO, paradoxical embolism, and third-degree atrioventricular block, and case 2 was diagnosed with PFO, paradoxical embolism, and refractory mycoplasma pneumonia.

Interventions:

Case 1 underwent permanent pacemaker placement at the same time as PFO closure. Case 2 underwent conservative anticoagulation with poor therapeutic results and subsequently underwent PFO closure.

Outcomes:

Patient 1 underwent PFO closure, which resulted in relief of neurologic symptoms and no recurrence of neurologic symptoms after 10 months of follow-up. In case 2, the child’s neurologic symptoms improved after PFO closure.

Lessons:

Although most children with PFO do not require targeted interventions, a few cases involving PFO and CS may benefit from closure of the foramen ovale.
Bibliometric analysis of chondrocyte apoptosis in knee osteoarthritis
Authors: Zhang Hongxing , Yang Yao , Gao Minglei , Peng Jiafeng , Li Danyang , Zhu Junchen
Published: October 2024

Background:

Apoptosis, a form of programmed cell death, plays a significant role in osteoarthritis; however, bibliometric studies in this field remain scarce. Bibliometrics provides a visual representation of research outcomes and trends, guiding future investigations.

Method:

Journal data from January 1, 2013, to December 31, 2023, in this field were obtained from the Web of Science (WOS) core database. Analysis was conducted using VOSviewer and CiteSpace.

Results:

Analysis revealed that over the past decade, 794 articles were published in 299 journals by 4447 authors from 49 countries and 877 institutions. The top contributors were China, the United States, and the United Kingdom. Zhuang Chao emerged as the most prolific author, and “osteoarthritis and cartilage” ranked as the most frequently cited journal. Keyword clustering focused on mechanisms, inflammation, and cartilage. The most-cited article was “chondrocyte apoptosis in the pathogenesis of osteoarthritis” in the “International Journal of Molecular Sciences.” Burst word analysis highlighted extracellular matrix, circular RNA, micro RNA, indicating current research hotspots.

Conclusion:

Utilizing bibliometrics and visual analysis, we explored the hotspots and trends in the field of chondrocyte apoptosis in osteoarthritis. Extracellular matrix, Circular RNA, Micro RNA, among others, are likely to become future research focal points and frontiers.
The mechanism of quercetin in treating intracerebral hemorrhage was investigated by network pharmacology and molecular docking
Authors: Zhang Zi-You , Lv Xiao-Yu , Zhou Xin-Pei , Xiang Hai-Tao , He Yu-Song , Li Xu-Yang , Yan Ting-Ting , Zhong Yang-Yang , Li Zhuang , Zhang Ben-Si
Published: October 2024

Background:

The aim of this study was to explore the molecular mechanism of quercetin in the treatment of intracerebral hemorrhage.

Methods:

Quercetin target genes and intracerebral hemorrhage target genes were collected from 5 databases. After standardized conversion of the obtained target genes through uniprot database, cross genes of the 2 were obtained using Venny 2.1 online tool. Further, protein interaction relationships were obtained in the String database, and then core target genes were screened and visualized by Cytoscape software, and cross genes were enriched by GO and KEGG pathways. Finally, the active drug ingredients and target proteins were verified and visualized by computer.

Results:

In this study, 197 quercetin targets were identified as potential targets for the treatment of intracerebral hemorrhage, and 7 core target genes (TP53, STAT3, AKT1, SRC, JUN, TNF, and IL6) were screened. The GO and KEGG analyses further shed light on the molecular mechanisms underlying quercetin’s treatment of intracerebral hemorrhage, involving multiple biological processes and signaling pathways (such as cancer pathways, lipids, and atherosclerosis). The stable binding of quercetin to these 7 key targets was confirmed by molecular docking simulation.

Conclusion:

Quercetin may treat intracerebral hemorrhage through multi-target-multi-pathway mechanisms, including regulating apoptosis, inhibiting inflammatory response, inhibiting iron death, and regulating angiogenesis, which can help alleviate nerve damage caused by intracerebral hemorrhage
The prognostic role of survivin expression in breast cancer: A systematic review and meta-analysis
Authors: Bolat Kucukzeybek Betul , Kucukzeybek Yuksel , Basbinar Yasemin , Ellidokuz Hulya , Tekindal Mustafa Agah , Dinckal Cigdem , Tarhan Mustafa Oktay
Published: October 2024

Background:

Breast cancer is a heterogeneous condition with variations in histopathological, genomic, and biological characteristics. Although clinicopathological prognostic factors and gene expression profiles are commonly used to guide treatment decisions in patients with breast cancer, there is still a need for new prognostic markers. One potential marker is survivin, a protein belonging to the apoptosis inhibitor family. However, studies examining the relationship between survivin and prognosis in breast cancer have yielded inconsistent results. This study aimed to evaluate the impact of survivin expression on the prognosis of breast cancer patients through a meta-analysis.

Methods:

Studies evaluating survivin expression were sourced from the PubMed, Embase, and Cochrane databases. We conducted a meta-analysis based on full-text articles that evaluated the relationship between survivin expression and survival by immunochemistry or polymerase chain reaction. The studies were initially divided into 2 groups based on the evaluation of overall survival (OS) and disease-free survival (DFS). Subsequently, each group was further categorized according to the method used to detect survivin expression. Statistical analyses for this study were conducted using Stata and JAMOVI.

Results:

After screening with keywords, we identified 24 retrospective studies evaluating OS and 15 retrospective studies evaluating DFS, which were included in the analysis. We found that the studies in the meta-analysis were not heterogeneous, and this remained consistent when categorizing the groups by survivin expression detection. Survivin expression was associated with OS (HR 1.23, 95% CI 0.81–1.65) and DFS (HR 0.89, CI 0.42–1.36), indicating poor prognosis. This significant relationship between survivin expression and survival persisted when the studies were categorized by the detection method, either immunohistochemistry or polymerase chain reaction.

Conclusion:

In this study, we evaluated the prognostic significance of survivin expression in patients with breast cancer through a meta-analysis. These results support the use of survivin expression as a prognostic marker in breast cancer, potentially guiding treatment decisions.
Fatal Zargar grade 3b corrosive injury after hydrochloric acid ingestion: A case report
Authors: Yu Ching-Hsiang , Su Yu-Jang , Lai Yen-Chun
Published: October 2024

Rationale:

Caustic substance ingestion is an emergency and life-threatening condition as it leads to tissue damage, acidosis, and multiorgan failure. This study presents a case report of hydrochloric acid ingestion and notably dark-red urine output due to acute tubular necrosis.

Patient concerns:

A 59-year-old male presented with attempted suicide by ingesting 500 mL of hydrochloric acid (37%), and complained of severe abdominal pain and shortness of breath. Upon arrival, his vital signs showed a temperature of 34.3°C, blood pressure of 104/77 mm Hg, a pulse rate of 135 beats per minute, and the Glasgow Coma Scale E4V2M6. Following Foley catheter insertion, dark, bloody urine resulting from acute tubular necrosis was observed. His creatinine level was 1.1 mg/dL, and urinalysis showed 38 red blood cells per high-power field. Arterial blood gas analysis revealed metabolic acidosis.

Diagnoses:

The patient’s condition rapidly deteriorated in the emergency room, revealing diffuse circumferential ulceration with necrosis in the esophagus (Zargar score grade 3b). An exploratory laparotomy was performed for acidosis with intractable shock, revealing up to 1500 mL of bloody ascites, and ischemic changes with loss of peristalsis throughout the small bowel to the cecum.

Interventions:

Esophagostomy with T-tube insertion was performed. Notably, stomach necrosis with perforation was identified, prompting a surgical consultation for primary perforation closure.

Outcomes:

During the operation, the patient experienced hemodynamic instability. The family confirmed the “Do Not Resuscitate” status, and he died in a critical state.

Lessons:

For corrosive injuries, early endoscopy was crucial in assessing the extent of the damage and guiding treatment in this patient. It is essential to perform an early endoscopic examination in cases of acute nephrotoxic tubular necrosis following hydrochloric acid ingestion. Surgical intervention is warranted if necrosis is detected in the corrosive tissue.
Knowledge of emergency nurses and related factors toward geriatric: a cross-sectional study
Authors: Asri Azam Al-Sadat , Yeganeh Rastekanary Mohammad Reza , Maroufizadeh Saman , Ghorbani Vajargah Pooyan , Karkhah Samad , Javadi-Pashaki Nazila
Published: October 2024

Background:

This study aimed to evaluate the geriatric knowledge of emergency nurses and related factors.

Materials and methods:

This cross-sectional study was conducted on nursing students at Guilan University of Medical Sciences in Iran. The objective was to assess the geriatric knowledge of nurses working in the emergency departments of educational and therapeutic centers in Rasht City. The sample was selected through a census sampling method, including all nurses employed in these departments. Data collection was carried out using a three-part questionnaire, which included sections on ‘personal and occupational characteristics’ and the ‘Questionnaire of Awareness about the Facts of Aging (FAQ)’.

Results:

A total of 190 emergency department nurses participated in this study. The mean age of the participants was 34.41 years (SD=6.37). The mean score for geriatric knowledge among the nurses was 6.58 (SD=2.24). No statistically significant associations were found between geriatric knowledge and the personal or occupational variables of the nurses. Also, the results showed that changes in nurses’ geriatric knowledge are explained to a small extent through personal and occupational characteristics.

Conclusion:

Overall, these results highlight the urgent need for targeted interventions to improve emergency nurses’ understanding of geriatric care. Furthermore, given the lack of significant correlations with demographic and occupational variables, future research should investigate additional factors that may influence emergency nurses’ knowledge in this area.
Solid-pseudopapillary neoplasm of the pancreas in a 12-year-old female: case report
Authors: Yadav Kundan Kumar , Yadav Krishna , Adhikhari Binaya , Yadav Pratibha , Yadav Prashant
Published: October 2024

Introduction and importance:

A solid-pseudopapillary tumor of the pancreas is a rare solid neoplasm. It is an uncommon exocrine tumor that accounts for 1–3% of exocrine pancreatic tumors.

Case presentation:

The authors have reported two cases of solid-pseudopapillary neoplasm of the pancreas with a median age of 12 years, both in females with abdominal pain.

Clinical discussion:

Both cases are in females with different treatment modalities. The patient underwent distal pancreatectomy in the first case and enucleation of mass from the distal pancreas in the second case because the size of the tumor is 5 cm and does not involve the bile duct and major pancreatic duct.

Conclusion:

The authors discussed two cases of solid-pseudopapillary neoplasm of the pancreas both in a 12-year-old female—both the patients presented with abdominal pain. The patient underwent a different treatment. The diagnosis was confirmed by radiological investigation through non-contrast and contrast CT and supported by histopathology findings.
Fournier’s gangrene in voluminous inguinoscrotal herniation: Case report and review of literature
Authors: Pereira Magnum Adriel Santos , Lopes de Castro Gustavo , Freitas Jorge Barros , Martins Lincoln José Trindade , Filó Maitê Salem , Barroso André Renato Moura
Published: October 2024

Introduction:

Fournier’s gangrene (FG) is a polymicrobial life-threatening infection that affects perineal region and may extend to genitalia and abdominal wall. Necrotizing fasciitis is a rare condition and its association with large inguinoscrotal hernia even rarer. With high mortality rate, some predisposing factors are diabetes and immunodeficiency.

Case presentation:

We report a case of a 48-year-old man with Fournier’s gangrene associated with voluminous inguinoscrotal herniation which evolved to hernia sac exposure after debridement.

Discussion:

FG pathophysiology initiates with a localized infection by a combination of gram positive, gram negative and anaerobic bacteria, and its advancing leads to local inflammatory response, thrombosis, blood flow reduction and ischemia. Diagnosis depends on clinical presentation and image evaluation.

Conclusion:

FG management has been standard in the literature, however its association with inguinoscrotal hernias have not been considered in guidelines. Early diagnosis and proper clinical and surgical treatment are fundamental to avoid life-threatening complications and morbidities.
Risk of second primary cancers in nodal non-Hodgkin lymphoma patients by primary lymph node location: a retrospective cohort population-based study
Authors: Hemade Ali , Hallit Souheil
Published: October 2024

Background:

Non-Hodgkin lymphoma (NHL) is a diverse group of blood cancers with increasing incidence and survival rates due to advancements in treatment and early detection. However, NHL survivors are at significant risk of developing second primary cancers, which can adversely impact their long-term survival.

Methods:

This retrospective population-based cohort study utilized data from the Surveillance, Epidemiology, and End Results database, covering 17 geographic areas in the United States from 2000 to 2021. The authors included patients diagnosed with nodal NHL as a first primary cancer and excluded those diagnosed at autopsy or via death certificate only. Standardized Incidence Ratios, Absolute Excess Risks, and Person-Years at Risk were calculated to evaluate the risk of developing SPCs according to the primary lymph node site and stratified by latency periods following the initial NHL diagnosis.

Results:

The cohort included 54 012 NHL patients. The authors’ results showed that for most SPCs, the risk of development was different for different primary NHL lymph node locations. The highest risks were observed for thyroid cancer, acute myeloid leukemia, and Hodgkin lymphoma. Notably, the risk for thyroid cancer was highest in the first year post-diagnosis, while hematological malignancies such as acute myeloid leukemia and Hodgkin lymphoma showed elevated risks in the intermediate and late latency periods.

Conclusion:

NHL survivors are at an increased risk of developing SPCs, influenced by the primary lymph node site and latency period. These findings highlight the need for tailored surveillance strategies and preventive measures to mitigate the long-term risks of SPCs in NHL survivors. Further research is necessary to elucidate the underlying mechanisms and to develop targeted interventions for this high-risk population.
A Modified Bleaching Method for Multiplex Immunofluorescence Staining of FFPE Tissue Sections
Authors: Wang Dan , Cheung Alison , Mawdsley Gordon E. , Liu Kela , Yerofeyeva Yulia , Thu Kelsie L. , Yoon Ju-Yoon , Yaffe Martin J.
Published: October 2024

Multiplex immunofluorescence (mIF) staining plays an important role in profiling biomarkers and allows investigation of co-relationships between multiple biomarkers in the same tissue section. The Cell DIVE mIF platform (Leica Microsystems) employs an alkaline solution of hydrogen peroxide as a fluorophore inactivation reagent in the sequential staining, imaging, and bleaching protocol for use on FFPE sections. Suboptimal bleaching efficiency, degradation of tissue structure, and loss of antigen immunogenicity occasionally are encountered with the standard bleaching process. To overcome these impediments, we adopted a modified photochemical bleaching method, which utilizes an intense LED light exposure concurrent with the application of hydrogen peroxide. Repeated stain/bleach rounds with different antibodies were performed on breast tissue and other tissue sections. Residual signal after conventional bleaching and the modified technique were compared and tissue integrity and antigen immunogenicity were assessed. The modified technique effectively eliminates fluorescence signal from previous staining rounds and produces consistent results for multiple rounds of staining and imaging. With the modified method, photochemical treatments did not destroy tissue sub-cellular contents, and the tissue antigenicity was well preserved during the entire mIF process. Overall processing time was reduced from 36 to 30 hours in an mIF procedure with 8 rounds. With the conventional method, tissue quality was highly degraded after 8 rounds. The new technique allows reduced turn-around time, provides reliable fluorophore removal in mIF with excellent maintenance of tissue integrity, facilitating studies of the co-localization of multiple biomarkers in tissues of interest.
Three-Dimensional Changes of Alveolar Ridges and Nasolabial Structures Following a Digital Nasoalveolar Molding Therapy With a Novel Nasal Stent Activation Protocol
Authors: Parakarn Hathaichanok , Pisek Poonsak , Wangsrimongkol Buddhathida
Published: October 2024

Digital orthodontics has been integrated into NasoAlveolar Molding (NAM) therapy to overcome challenges in the conventional NAM method. This study introduced an individualized Digital NAM (iDNAM) and evaluated the changes in the alveolar ridges and nasolabial morphology after iDNAM treatment. Prospective data were collected from 15 infants with complete unilateral cleft lip and palate who underwent iDNAM therapy. An intraoral-and-nasolabial scan was used to create a virtual setup model and plate generation. A total of 2 plates were required under the iDNAM treatment protocol. The first iDNAM plate has a specific interior and exterior design to allow continuous force application with minimal plate adjustment. After an intermediate scan, a nasal stent was meticulously incorporated into the second plate for nasal molding. To activate the nasal stent, a silicone molding extension was used instead of manually adding acrylic. The alveolar cleft gap was significantly reduced by 7.48 ± 2.06 mm. On the cleft side, statistically significant increases occurred in nostril height, columellar length, and nasal base–columellar angle (2.08 ± 0.63 mm, 2.58 ± 0.28 mm, and 22.29 ± 0.88 degrees, respectively). By using 2 serial plates, iDNAM improved the alveolar cleft gap and the nasal morphology in complete unilateral cleft lip and palate. An addition of a nasal extension to the second iDNAM plate presents a challenge as accurate positioning is required for appropriate activation force. The iDNAM plate design and nasal activation protocol reduce the need for chairside adjustment and the number of appointments.
A Comparative Study of Traditional and Computer-aided Surgical Simulation Guides in Orthognathic Correction of Bimaxillary Protrusion
Authors: Yang Guojun , Xie Fang , Chen Fuhuan , Li Lei , Li Binghang , Dong Yuting , Yang Bin
Published: October 2024

Objective:

To compare the efficacy of traditional occlusal guides with computer-aided surgical simulation (CASS) guides in enhancing postoperative outcomes for patients with bimaxillary protrusion.

Methods:

This retrospective study evaluated 34 patients undergoing anterior maxillary and mandibular subapical osteotomy at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences. Fourteen patients were treated using traditional occlusal guides, whereas 20 patients were treated with CASS guides (median age 28.6 years, median follow-up 259 days). Pre and postoperative cephalometric indicators were measured using cephalometric software. Data analysis was conducted using SPSS 14.0, with significant differences determined at P < 0.05.

Results:

All 34 patients experienced primary healing without complications. Follow-up indicated significant improvements in key cephalometric measurements in the CASS group compared with the traditional group, including mandibular position (SNB angle, P < 0.001), jaw relationship (ANB angle, P < 0.001), facial angle (FH-NPo, P = 0.002), and condyle-to-sella distance (Co-S, P = 0.024). The CASS group also showed better aesthetic outcomes, with significant reductions in overjet (P = 0.012), overbite (P = 0.001), and improved alignment of upper and lower incisors (U1-L1 angle, P = 0.031).

Conclusion:

CASS-guided surgery offers a superior alternative to traditional methods for treating bimaxillary protrusion, providing more precise and aesthetically pleasing results. This study highlights the significant advantages of using advanced digital simulation and 3-dimensional printing technologies in orthognathic surgery.
Multidisciplinary Treatment of A Class III Patient With Giant Open Bite Secondary to Macroglossia
Authors: Sun Xiaoshuang , Gao Heyou , Al-Watary Mohammed Qasem , Li Jihua
Published: October 2024

Skeletal Class III malocclusion deformity is one of the most common maxillofacial malocclusions in East Asia and is either due to maxillary retrusion, mandibular protrusion, or both. It could cause functional and aesthetic problems. This deformity could be attributed to either hereditary or environmental factors or both. Tongue lymphangioma-induced skeletal class III deformity with open bite is a relatively rare condition. Therefore, its management poses a significant challenge to surgeons and requires a multidisciplinary approach. In this case report, such deformity was successfully managed through a multidisciplinary approach.
The role of digital health interventions in supporting family caregivers for people with dementia to improve quality of life
Authors: Farnood Annabel , Johnston Bridget , Evans Catherine
Published: October 2024

Purpose of review

Dementia is a chronic progressive terminal condition. Most care is provided by family caregivers (including close friends); their wellbeing is a public health priority. Caregivers manage increasingly complex needs with disease progression, and declining cognitive and physical function. This can impact the well-being of caregivers, and meaningful support is essential. This review article aims to understand what the benefits and challenges of digital health interventions are and provide considerations for future development of digital health interventions for family caregivers for people with dementia, to improve quality of life.

Recent findings

Benefits include the valuable source of support from connective platforms; 24/7 accessibility; and opportunity for remote monitoring. However, this needs to balance with challenges, including the privacy of data concerns; and the digital divide driving inequalities in care provision for family caregivers with no access to internet devices.

Digital health interventions can positively impact the overall well-being of family caregivers for people with dementia. If challenges are addressed and digital health interventions are designed to meet priorities for family caregivers, this can help improve the quality of life for family caregivers of people with dementia.
Programming the mechanical properties of double-corrugated metamaterials by varying mountain-valley assignments
Authors: Li Mengyue , Peng Rui , Ma Jiayao , Chen Yan
Published: October 2024

Origami metamaterials have gained significant attention in recent years, with extensive analysis conducted on their mechanical properties. Previous studies have primarily focused on the effects of design angles, panel side lengths, folding angles or other geometric and material parameters. However, mountain-valley crease assignments of origami patterns, which significantly effect both the geometric and mechanical properties, have yet to be studied in depth. In this article, we create a series of double-corrugated metamaterials with diverse mountain-valley assignments and analyse their Poisson’s ratios and mechanical properties under compression loading. The findings of our study demonstrate that varying the mountain-valley assignments allows for the construction of metamaterials with consistent or distinct Poisson’s ratios. These assignments have the capability to program the magnitude and to vary the rate of the folding angles. Furthermore, the mechanical properties of the corresponding metamaterials, in particular the specific energy absorption (SEA) and normalized stiffness, exhibit positive correlations with the respective folding angles. Our study highlights the significance of varying mountain-valley assignments as a promising approach for designing origami metamaterials and programming their mechanical properties.

This article is part of the theme issue ‘Origami/Kirigami-inspired structures: from fundamentals to applications’.
Evaluating dynamic models for rigid-foldable origami: unveiling intricate bistable dynamics of stacked-Miura-origami structures as a case study
Authors: Fang Hongbin , Wu Haiping , Liu Zuolin , Zhang Qiwei , Xu Jian
Published: October 2024

Recent advances in origami science and engineering have particularly focused on the challenges of dynamics. While research has primarily focused on statics and kinematics, the need for effective and processable dynamic models has become apparent. This paper evaluates various dynamic modelling techniques for rigid-foldable origami, particularly focusing on their ability to capture nonlinear dynamic behaviours. Two primary methods, the lumped mass–spring–damper approach and the energy-based method, are examined using a bistable stacked Miura-origami (SMO) structure as a case study. Through systematic dynamic experiments, we analyse the effectiveness of these models in predicting bistable dynamic responses, including intra- and interwell oscillations, in different loading conditions. Our findings reveal that the energy-based approach, which considers the structure’s inertia and utilizes dynamic experimental data for parameter identification, outperforms other models in terms of validity and accuracy. This model effectively predicts the dynamic response types, the rich and complex nonlinear characteristics and the critical frequency where interwell oscillations occur. Despite its relatively increased complexity in model derivation, it maintains computational efficiency and shows promise for broader applications in origami dynamics. By comparing model predictions with experimental results, this study enhances our understanding of origami dynamics and contributes valuable insights for future research and applications.

This article is part of the theme issue ‘Origami/Kirigami-inspired structures: from fundamentals to applications’.
Energy-harvesting tile incorporating an origami coupling mechanism
Authors: Khazaaleh Shadi , Dalaq Ahmed S. , Daqaq Mohammed F.
Published: October 2024

We present the design and evaluation of a simple, compact and efficient electromagnetic energy harvesting tile that can be used to harness energy from footsteps. The proposed harvester incorporates a translational–rotational origami-inspired coupling mechanism to transform the axial loads exerted by human footsteps into a localized rotation of an electromagnetic generator. The coupling mechanism employs a non-rigid tunable Kresling spring, the restorative behaviour of which is tunable to maximize energy transduction from the applied load to the generator. A computational model is developed to optimize the design parameters of the mechanism, which are then utilized to fabricate a prototype of the energy harvester. The tile is tested under loading conditions that mimic a human step, where it is demonstrated that it is capable of generating 4.18 W of electrical power per step with a surface power density of 2609 μW cm
−2
.

This article is part of the theme issue ‘Origami/Kirigami-inspired structures: from fundamentals to applications’.
Molecular analysis of HBV pre-core gene mutations in patients co-infected with HIV at a tertiary care hospital in North India
Authors: Sami Hiba , Asaad Mohd , Firoze Safiya , Husaini Syed Haider Mehdi , Khan Parvez A , Fatima Nazish , Raza Adil , Khan Haris M
Published: October 2024

Objective: Hepatitis B virus (HBV) spontaneous mutations may impact the severity of liver disease. This study aimed to assess the mutations in the PC region in HBV-HIV co-infected patients. Additionally, we explored its association with genotypes and examined the clinical implications.
Methods: A total of 100 patients of HBV-HIV co-infected, and 50 HBV mono-infected were included in the study. Serum samples from individuals with detectable HBV DNA were submitted to polymerase chain reaction (PCR) amplification using pre-core primers. The pre-core region of the HBV genome was sequenced and analysed for PC mutant variants. PCR products underwent purification by the QIAquick Gel Extraction Kit (Qiagen, Germany), quantification was done on the Nanodrop 2000 spectrophotometer and sequencing by Sanger method at Eurofins Genomics. The generated sequences were assembled, annotated, were aligned in one frame, analyzed for the mutations and phylogenetic analysis was performed using the UGENE software. Phylogenetic analysis was used to carry out the genotyping.
Results: The pre-core region was successfully amplified and sequenced in a total of 27 samples (16 HBV-HIV co-infected; 11 HBV mono-infected). Phylogenetic analysis revealed HBV genotypes D and A across all study samples, with genotype D comprising 24 (88.9%), and genotype A accounting for 3 (11.1%). A T to C mutation in the pre-core region at nucleotide position 1912 was found in 48.1% of the patients. A1850T, C1858T, G1899A, G1862T, G1951T, T1812C, T1809G, and additional novel pre-core region mutations, including C1936T, A2011G, T2020A, and C2044T were among the other HBV pre-core mutations found in this study. The genotyping results indicated that the patients had HBV genotypes A (11.1%) and D (88.9%). The incidence of detected pre-core mutations did not differ significantly between those with HBV mono-infection and those with HBV-HIV dual infection.
Conclusion: This study emphasized the occurrence of PC mutations in HBV-HIV co-infected patients. Mutation T1912C was predominantly found in genotype D, whereas some mutations such as T1809C, A1850T, and C1858T were exclusively found in genotype A. Some of the mutations found in this study were already reported in previous studies, but some novel mutations were also reported. Further studies are required to study the clinical correlation of these novel mutations.
SAMSN1 causes sepsis immunosuppression by inducing macrophages to express coinhibitory molecules that causes T cell exhaustion via KEAP1-NRF2 signaling
Authors: Li Yao , Li Tingting , Xiao Fei , Wang Lijun , Liao Xuelian , Kang Yan , Zhang Wei
Published: October 2024

Immunosuppression has been found to be closely related to the pathogenesis of sepsis, but the underlying mechanisms have not yet been fully elucidated. In this study, we identified that SH3 domain and nuclear localization signals 1 (SAMSN1), a gene encoding a putative adaptor protein, plays an important role in immunosuppression in sepsis. The expression of SAMSN1 was significantly increased in patients with sepsis and was positively correlated with sepsis mortality. When sepsis occurs, the number of monocyte-macrophages increases significantly, among which SAMSN1 is highly expressed. SAMSN1 binds to KEAP1, causing NRF2 to dissociate from the KEAP1-NRF2 complex and translocate into the nucleus, promoting the transcription of co-inhibitory molecules CD48/CD86/CEACAM1, which bind to their corresponding receptors 2B4/CTLA4/TIM3 on the surface of T cells, inducing T cell exhaustion. SAMSN1 blockade alleviated organ injuries and improved survival of septic mice. Our study reveals a novel mechanism that triggers immunosuppression in sepsis and may provide a candidate molecular target for sepsis immunotherapy.