bluuebunny/crossref_metadata_2025 huggingface dataset:
The Systematics of Olivine CaO + Cr-Spinel in High-Mg# Arc Volcanic Rocks: Evidence for in-Situ Mantle Wedge Depletion at the Arc Volcanic Front
Authors: Straub Susanne M , Batanova Valentina , Sobolev Alexander , Gómez-Tuena Arturo , Espinasa-Perena Ramon , Fleming W Lindsey , Bindeman Ilya N , Stuart Finlay M , Widom Elisabeth , Iizuka Yoshiyuki
Published: December 2023

We investigated the state of the arc background mantle (i.e. mantle wedge without slab component) by means of olivine CaO and its Cr-spinel inclusions in a series of high-Mg# volcanic rocks from the Quaternary Trans-Mexican Volcanic Belt. Olivine CaO was paired with the Cr# [molar Cr/(Cr + Al) *100] of Cr-spinel inclusions, and 337 olivine+Cr-spinel pairs were obtained from 33 calc-alkaline, high-K and OIB-type arc front volcanic rocks, and three monogenetic rear-arc basalts that lack subduction signatures. Olivine+Cr-spinels display coherent elemental and He–O isotopic systematics that contrast with the compositional diversity of the bulk rocks. All arc front olivines have low CaO (0.135 ± 0.029 wt %) relative to rear-arc olivines which have the higher CaO (0.248 ± 0.028 wt %) of olivines from mid-ocean ridge basalts. Olivine 3He/4He–δ18O isotope systematics confirm that the olivine+Cr-spinels are not, or negligibly, affected by crustal basement contamination, and thus preserve compositional characteristics of primary arc magmas. Variations in melt H2O contents in the arc front series and the decoupling of olivine CaO and Ni are inconsistent with controls on the olivine CaO by melt water and/or secondary mantle pyroxenites. Instead, we propose that low olivine CaO reflects the typical low melt CaO of high-Mg# arc magmas erupting through thick crust. We interpret the inverse correlation of olivine CaO and Cr-spinel Cr# over a broad range of Cr# (~10–70) as co-variations of CaO, Al and Cr of their (near) primary host melts, which derived from a mantle that has been variably depleted by slab-flux driven serial melt extraction. Our results obviate the need for advecting depleted residual mantle from rear- and back-arc region, but do not upset the larger underlying global variations of melt CaO high-Mg# arc magmas worldwide, despite leading to considerable regional variations of melt CaO at the arc front of the Trans-Mexican Volcanic Belt.
The m6A reader ECT1 drives mRNA sequestration to dampen salicylic acid–dependent stress responses in Arabidopsis
Authors: Lee Keun Pyo , Liu Kaiwei , Kim Eun Yu , Medina-Puche Laura , Dong Haihong , Di Minghui , Singh Rahul Mohan , Li Mengping , Qi Shan , Meng Zhuoling , Cho Jungnam , Zhang Heng , Lozano-Duran Rosa , Kim Chanhong
Published: December 2023

N 6-methyladenosine (m6A) is a common epitranscriptional mRNA modification in eukaryotes. Thirteen putative m6A readers, mostly annotated as EVOLUTIONARILY CONSERVED C-TERMINAL REGION (ECT) proteins, have been identified in Arabidopsis (Arabidopsis thaliana), but few have been characterized. Here, we show that the Arabidopsis m6A reader ECT1 modulates salicylic acid (SA)–mediated plant stress responses. ECT1 undergoes liquid–liquid phase separation in vitro, and its N-terminal prion-like domain is critical for forming in vivo cytosolic biomolecular condensates in response to SA or bacterial pathogens. Fluorescence-activated particle sorting coupled with quantitative PCR analyses unveiled that ECT1 sequesters SA-induced m6A modification-prone mRNAs through its conserved aromatic cage to facilitate their decay in cytosolic condensates, thereby dampening SA-mediated stress responses. Consistent with this finding, ECT1 overexpression promotes bacterial multiplication in plants. Collectively, our findings unequivocally link ECT1-associated cytosolic condensates to SA-dependent plant stress responses, advancing the current understanding of m6A readers and the SA signaling network.
Unitarity violation in field theories of Lee–Wick’s complex ghost
Authors: Kubo Jisuke , Kugo Taichiro
Published: December 2023

Theories with fourth-order derivatives, including the Lee–Wick finite QED model and quadratic gravity, have a better UV behavior, but the presence of negative metric ghost modes endangers unitarity. Noticing that the ghost acquires a complex mass by radiative corrections, Lee and Wick, in particular, claimed that such complex ghosts would never be created by collisions of physical particles because of energy conservation, so that the physical S-matrix unitarity must hold. We investigate the unitarity problem faithfully, working in the operator formalism of quantum field theory. When complex ghosts participate, a complex delta function (a generalization of the Dirac delta function) appears at each interaction vertex, which enforces a specific conservation law of complex energy. Its particular property implies that the naive Feynman rule is wrong if the four-momenta are assigned to the internal lines after taking account of the conservation law in advance. We show that complex ghosts are actually created and unitarity is violated in such fourth-order derivative theories. We also find a definite energy threshold below which ghosts cannot be created: The theories are unitary and renormalizable below the threshold.
Ongoing reporting obligations of a Cyprus International Trust
Authors: Neocleous Elias , Christodoulou Elena , Christodoulou Alexis
Published: December 2023

This article discusses the ongoing reporting obligations of a Cyprus International Trust in the context of evolving compliance requirements, particularly in relation to the latest European anti-money-laundering directives. It highlights the transposition of the 5th AMLD into Cyprus law and the recent European Court of Justice decision limiting public access to Ultimate Beneficial Owner (UBO) registers. The article also explores the laws governing regulated professionals and the disclosure of trust data in Cyprus; and further examines the Cyprus UBO register of express trusts and the limited access granted to the public, touching on the challenges that lie ahead.
Impact of Coriandrum sativum seeds extract on albino rats’ testicular toxicity caused by carbendazim
Authors: Tousson Ehab , Shalaby Somaya Y , El-Gharbawy Doaa M , Akela Mohamed A , Rabea Mohamed , Kandil Eman H
Published: December 2023

Background

A broad spectrum carbamate fungicide called carbendazim (Carb) is used to combat a number of different fungal diseases. One of the extensively utilized medicinal plants in oriental countries is Coriandrum sativum.

Aim

In the current study, the impact of C. sativum seeds extract (CSE) on albino rats’ testicular toxicity caused by carbendazim was investigated.

Materials and methods

A total of 50 male albino rats were classified into 5 groups [Gp1, Control Gp; Gp2, Coriandrum Gp (CSE); Gp 3, carbendazim Gp (Carb); Gp 4, Co treated CSE with Carb (CSE + Carb); Gp 5, Post treated Carb with CSE (Carb + CSE)].

Results

Carb induced elevation in serum LH. FSH, testicular malondialdehyde (MDA), testicular nitric oxide (NO) markers and testicular injury and it reduced serum testosterone, testicular glutathione (GSH), testicular catalase and PCNA. Treatments of Carb with CSE (CSE + Carb and/or Carb + CSE) improved these parameters and reduced testicular toxicity with best results for Carb + CSE than CSE + Carb.

Conclusions

The above findings revealed that; Carb induced testicular toxicity and it supported the hypothesis that the antioxidant characteristics of one or more of CSE constituents can reduce the testicular toxicity of Carb.
Effect of human chorionic gonadotropin injection before frozen-thawed embryo transfer: A retrospective cohort study
Authors: Xin Xin , Dong Li , Guan Lu , Wang Yixuan , Li Jiaxi , Lian Fang
Published: December 2023

The aim of this study is to investigate the effect of human chorionic gonadotropin (hCG) in hormone replacement regimen for frozen-thawed embryos. We performed a retrospective cohort study and included patients who underwent frozen embryo transfer (FET) between January 1, 2020 and May 31, 2022. According to the protocols for the FET cycle, the patients were divided into control (n = 238) and hCG groups (n = 216). The clinical pregnancy rate, live birth rate, early abortion rate, late abortion rate, and ectopic pregnancy rate were compared between the 2 groups. There was a significant difference in clinical pregnancy rate between the hCG and control groups (55.1% vs 45.8%, P = .048). The ectopic pregnancy rate decreased (5.0% vs 6.4%, P = .654), while the live birth rate increased (36.1% vs 29.0%, P = .105) in the hCG group. However, these differences were not statistically significant. The administration of hCG injection in HRT-FET cycles alone was also found to be associated with clinical pregnancy by logistic regressive analysis. HCG injection in the hormone replacement regimen for FET increased the clinical pregnancy rate.
Application effect of PDCA circulation on nursing quality management and risk control in digestive endoscopy room
Authors: Xu Yan , Shi Chunhua , Liu Yun
Published: December 2023

To explore the application effect of plan, do, check, action (PDCA) cycle on nursing quality management and risk control in digestive endoscope room. Ninety patients who received digestive endoscopy care before undergoing PDCA circulation mode risk control from January 2022 to April 2022 were selected as the Common group. From May 2022 to December 2022, 156 patients who underwent digestive endoscopy care after undergoing PDCA cycle mode risk control were selected as the PDCA group. Compare the infection status of patients in the endoscope room and the qualification of the air in the endoscope room before and after PDCA circulation management. Compare the respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, and nursing satisfaction of patients in the Common group and the PDCA group. Compare the qualified rate of endoscopic cavity disinfection before and after PDCA cycle management, the qualified rate of endoscopic external disinfection, and the management score. Four patients in the Common group developed infection, with an infection rate of 4.44%. One case of infection occurred in the PDCA group, with an infection rate of 0.64%. The qualified rate of the endoscope room air in the Common group was 92.22%, while the qualified rate of the endoscope room air in the PDCA group was 98.72%. Compared with the Common group, the infection rate of patients in the PDCA group significantly decreased, and the qualified rate of air in the endoscope room significantly increased. The respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, nursing errors, and nursing complaint rates of patients in the PDCA group were significantly lower than those in the Common group, and nursing satisfaction was significantly higher than those in the Common group. The qualified rate of endoscopic cavity disinfection and endoscopic external disinfection in the PDCA group were significantly higher than those in the Common group. Compared with before management, the scores of post management, nursing safety, disinfection and isolation, instruments, theoretical tests, and operational tests of nursing personnel after management increased significantly. The PDCA cycle is well applied in nursing quality management and risk control in the digestive endoscope room.
What is known about osteoporosis research in Latin America?: A bibliometric analysis of three decades
Authors: Barros-Sevillano Shamir , Espinoza-Martinez David , Rubio-Zavaleta Luis
Published: December 2023

Identifying the gaps in scientific production in a topic allows directing research in order to make better public investment decisions. Bibliometric data on osteoporosis in Latin America are very limited and unclear and, given the impact of this disease in this region, it is relevant to analyze the latest trends in the subject. The study approach was quantitative, observational-descriptive, cross-sectional. Data were collected from journals indexed in Scopus between 1990 and 2019, using a search strategy that included Medical Subject Headings terms for “Osteoporosis” and other related terms, as well as VOSviewer software to create cooperative and co-occurrence word maps. 3261 documents were analyzed, with an annual scientific production rate of 5% (163 documents), where 73.9% were original articles. The countries with the highest scientific production in osteoporosis were Brazil (55.2%) and Argentina (18%). Extra-regional cooperation was mainly with the United States (16.35%) and Spain (5.18%). Six of the 10 most productive countries had their own government agencies as the main funders. The National Council for Scientific and Technological Development was the institution that funded the most (n = 194). The term “osteoporosis” together with the terms “bone mineral density,” “fractures,” and “menopause” were the most frequently addressed subjects. Latin American scientific production in osteoporosis has shown a significant increase. However, in the last 3 years it has shown a slight reduction. Greater intraregional collaboration involving universities, institutions and health societies is needed.
The clinical features of severe COVID-19 with respiratory failure: A Chinese single-center retrospective study
Authors: Liu Guosheng , Du Chunhong , Du Weicheng , You Deyuan
Published: December 2023

The global pandemic of COVID-19, caused by the novel coronavirus SARS-CoV-2, has resulted in widespread alterations to public health measures worldwide. This observational study aimed to assess the clinical features and results of respiratory failure in patients with severe COVID-19. A single-center observational study was performed at a Chinese hospital between November 1, 2022, and February 31, 2023. All 182 enrolled patients were diagnosed with respiratory failure, 84 patients were infected with COVID-19, and the other 98 patients were not infected. A review of available medical records at admission and discharge, including neuroimaging, laboratory values at admission, mortality, length of hospitalization, and hospital costs, was conducted during the COVID-19 pandemic. All 182 eligible patients completed the follow-up. There was no significant difference in baseline characteristics between respiratory failure combined with COVID-19 (P > .05). Respiratory failure combined with COVID-19 infection may lead to higher 30-day mortality (16.36% vs 7.14%, P = .005), longer hospital stays (22.5 ± 5.9 vs 12.8 ± 4.2, P < .001), larger hospitalization costs (P < .001), and increased hospitalization complications, such as pulmonary embolism (10.30% vs 4.76%, P = .039), deep vein thrombosis (33.33% vs 18.57%, P = .001), incidence of 7-day delirium (69.70% vs 46.19%, P < .001), and respiratory failure (38.18% vs 24.77%, P = .005). If respiratory failure occurs while the patient is infected with COVID-19, treatment and prognosis worsen. Our understanding of COVID-19 and the care we provide to patients with respiratory failure is crucial to better prepare for a potential pandemic.
Patient prognosis and prediction model for taking Kampo formulas in dysmenorrhea: An observational study
Authors: Maeda-Minami Ayako , Kawamoto Ayako , Yoshino Tetsuhiro , Yokoyama Yuta , Suzuki Sayo , Horiba Yuko , Nakamura Tomonori , Mimura Masaru , Watanabe Kenji
Published: December 2023

Two representative Kampo formulas, keishibukuryogan and tokishakuyakusan, are frequently prescribed for patients with dysmenorrhea. We previously constructed a model that could predict which of these 2 formulas was most suitable, which is based on 4 subjective symptoms and 3 objective signs. To evaluate the prognosis of patients with dysmenorrhea using the established prediction model and assess the treatment outcomes between those treated in accordance with the prediction model and those who received various other treatments. In this retrospective, observational study, we included patients with menstrual pain who visited the Kampo Clinic at the Keio University Hospital for the first time between October 2014 and December 2020. These patients were monitored over a 90-day follow-up period. Participants were categorized into 2 groups: model-accordance and various-options. The progression of visual analogue scale (VAS) values was evaluated by determining the slopes from regression analysis between these 2 groups, with changes corroborated by the medical records. The study comprised 57 patients: 37 in the model-accordance group and 20 in the various-options group. Notably, the various-options group reported a significantly higher number of subjective symptoms (P = .03). The VAS value showed a decline, as indicated by the negative slope value of the regression line, across both groups – irrespective of their classification. There were no significant differences in the occurrence of adverse events between the 2 groups. The prognosis of patients with dysmenorrhea and the incidence of adverse events remained consistent, regardless of whether the treatment approach was in accordance with the prediction model or varied. Further studies are warranted to assess the prognosis when Kampo formulas are chosen based on the prediction model in the various-options population.
COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics
Authors: Filip Florin , Avramia Ramona , Terteliu-Baitan Monica , Cocuz Maria - Elena , Filip Roxana
Published: December 2023

Rationale:

The COVID-19 pandemic had a dramatic effect on various health systems in terms of admissions and outcomes, including pediatric surgery activity. The aim of this paper was to analyze the outcome of SARS-CoV-2-positive patients admitted to our department during the regional COVID-19 pandemic in North-Eastern Romania. We also evaluated the changes generated in our daily practice by the COVID-19 pandemic and the dynamic response to this major challenge.

Patient concerns:

The patients presented with symptoms related to their primary diagnosis: local pain and deformity in case of fractures; pain, swelling, and erythema in case of abscess; pain and decreased range of motion (ROM) in case of intolerance to metal implants. Other specific concerns are mentioned on an individual basis.

Diagnoses:

Eighteen patients (of which 4 had acute appendicitis and were included in a previous article), representing 1.18% of the total number of admissions, tested positive for SARS-CoV-2. There were 4 patients with fractures, 3 patients with soft tissue abscess or cellulitis, 2 patients with intolerance to metal implants, 1 patient with facial burn, 1 patient with thumb laceration, 1 patient with liver trauma, 1 patient with undescende testis, and 1 patient with symptomatic inguinal hernia, respectively. Boys represented 11/ 14 (78.57%) of the cases. The mean age of the patients was 9 years 11 months. There were only mild COVID-19 cases.

Interventions:

Surgery was performed in 13/ 14 (95.71%) of cases. The fractures were treated with open reduction internal fixation (ORIF); incision and drainage (I & D) were performed in case of soft tissue abscess; the metal implants were removed in case of local intolerance. Other conditions (burn, inguinal hernia, undescended testis, skin laceration) were treated specifically. Only 1 patient with liver laceration was treated conservatively under close hemodynamic monitoring.

Outcomes:

The mean length of stay (LoS) was 2.71 days. The infection with the SARS-CoV-2 virus had no deleterious effect on the surgical outcome among the 14 patients included in the study. There were no surgical complications during admission and no patient returned for late complications related to their primary disease or SARS-CoV-2 infection.

Lessons:

The SARS-CoV-2 infection had no significant influence on the outcome of pediatric surgical cases included in the study. We noticed a significant (31.54%) decrease in the number of admissions compared to the previous 2-year interval before the COVID-19 pandemic. Fast and adequate adjustment of the daily activity imposed by the COVID-19 pandemic was feasible and may be used in the future should similar epidemiological emergencies occur.
The correlation of lymphocytes with disease progression of COVID-19
Authors: Chu Ming , Zhao Xiaobao , Tang Lu , Zhang Siwei , Zhang Shengkun , Huang Dongdong , Wang Fuxiang , Wei Lanlan
Published: December 2023

The aim of this study is to evaluate the potential of lymphocytes as biomarkers to predict the decline of coronavirus disease 2019 (COVID-19). Lymphocytes were counted in 164 moderate COVID-19 patients in Shenzhen, China. Among the moderate infected patients, 12.2% (20/164) progressed to severe cases after admission. Compared with the stable patients, the counts of lymphocytes, both total T lymphocytes and CD4+ T lymphocytes, in the severe patients, were lower. The aggravation of moderate infected patients was significantly associated with lymphocyte count (hazard ratio [HR] = 0.91; 95% confidence interval [CI]: 0.84–0.99), total T lymphocyte count (HR = 0.91; 95% CI: 0.84–0.99), and CD4+ T lymphocyte count (HR = 0.91; 95% CI: 0.85–0.98). Total T lymphocytes and CD4+ T lymphocytes could be important biomarkers to evaluate the risk of aggravation for moderate infected COVID-19 patients. The patients with low percentages of total T lymphocytes and CD4+ T lymphocytes need more attention.
Risk of gastric cancer in relation with serum cholesterol profiles: A nationwide population-based cohort study
Authors: Oh Mi Jin , Han Kyungdo , Kim Bongseong , Lim Joo Hyun , Kim Bokyung , Kim Sang Gyun , Cho Soo-Jeong
Published: December 2023

Obesity is a known risk factor for gastric cancer. However, the relationship between serum lipids and gastric cancer risk has not been fully established. We investigated the relationship between serum cholesterol levels and gastric cancer risk using a nationwide population cohort. Adults who received health care screening in 2009 from the Korean National Health Insurance Service were enrolled. Gastric cancer risk in relation to quartiles of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) were compared according to sex, using adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Among 9690,168 subjects enrolled, 92,403 gastric cancer cases were diagnosed. Higher HDL-C levels were associated with lower gastric cancer risk in the total population, men, and women (aHR [for the highest quartile] = 0.98 [0.96–0.99, P < .0001], aHR = 0.98 [0.96–1.004, P = .0004], and aHR = 0.91 [0.88–0.94, P < .0001], respectively). HDL-C showed consistent trends regardless of age or statin use. Higher LDL-C levels were also associated with lower gastric cancer risk in the total population (aHR = 0.92 [0.91–0.94], P < .0001) and men (aHR = 0.94 [0.91–0.96], P < .0001), but not in women (P = .4073). A subgroup analysis of LDL-C showed significant interactions with age and statin use (P
interaction < .0001 and P
interaction = .0497, respectively). The risk of gastric cancer was higher in subjects with elevated LDL-C levels in the younger group (age < 55, HR [for the highest quartile] = 1.02 [0.99–1.04] in the total population; HR = 1.03 [1.003–1.06] in men), the risk was lower in subjects with elevated LDL-C in the elderly (age ≥ 55, HR = 0.93 [0.91–0.95] in the total population; HR = 0.94 [0.92–0.96] in men). Elevated TC was associated with lower gastric cancer risk in the total population (aHR = 0.95 [0.94–0.97], P < .0001), but not in each sex separately (P = .3922 in men; P = .1046 in women). Overall, higher HDL-C levels may play a protective role in gastric cancer pathogenesis. The association between LDL-C/TC and gastric cancer seems to vary according to sex, age, and statin use. Especially in young males under age 55, high LDL-C and TC levels were associated with higher risk of gastric cancer.
A new strategy for the treatment of heavily pretreated metastatic breast cancer: A case report and review of the literature
Authors: Ge Ting-Ting , Pan Xiao-Juan , Zuo Xi-Meng , Shi Xiao-Guang , Wang Yu-Kun , Sun Ping , Gao Xiang , Feng Xue , Gao Shuang , Wang Tang-Shun
Published: December 2023

Background:

Breast cancer is one of the most common type of cancers worldwide and remains a critical health issue. Although there are numerous treatment options for advanced metastatic breast cancer, the results are not satisfactory, particularly for triple-negative breast cancer. New treatment modalities need to be explored.

Case presentation:

We present the case of a breast cancer patient with multiple metastases who achieved a good response and tolerance to the combination treatment of utidelone plus capecitabine. After being treated with 10 cycles of combined treatment, the patient is now in a good general condition with a progression-free survival time of 10 months.

Conclusion:

To our knowledge, this is the first report of utidelone plus capecitabine successfully treating a patient with heavily pretreated metastatic breast cancer. This combined treatment offers a new option for patients with multi-drug resistant breast cancer.
Efficacy and safety of baricitinib in patients with severe COVID-19: A systematic review and meta-analysis
Authors: Song Wenxin , Sun Shishen , Feng Yilong , Liu Liujun , Gao Tianqi , Xian Shaoxiang , Chen Jie
Published: December 2023

Background:

This study aimed to investigate the efficacy and safety of baricitinib in patients with severe coronavirus disease 2019 (COVID-19).

Methods:

Databases were searched for studies that compared the clinical efficacy and adverse effects of baricitinib with standard therapy for the treatment of severe COVID-19 and clearly reported relevant outcomes published until December 31, 2022. The corresponding data were extracted from these studies. A fixed-effects model was used to calculate the pooled estimates. The study protocol can be accessed at PROSPERO (CRD42023394173).

Results:

The baricitinib group had a significantly lower mortality rate and proportion of patients who received mechanical ventilation than the control group (OR = 0.61, 0.57; P = .008, 0.02; 95% CI 0.42–0.88; 0.35–0.92; I2 = 71% and 86%, respectively). The length of hospital stay and rates of severe adverse events were not significantly different between the 2 groups.

Conclusion:

Baricitinib reduces mortality and mechanical ventilation requirements in patients with severe COVID-19. Therefore, we developed a comprehensive understanding of the role of baricitinib in patients with severe COVID-19.
A case of multisystem inflammatory syndrome in children: A case report
Authors: Jiang Junsheng , Fan Zheng , Mao Yueyan
Published: December 2023

Rationale:

Multisystemic inflammatory syndrome is a syndrome of multisystem involvement caused by a novel coronavirus infection that can lead to cardiogenic shock and death in children.

Patient concerns:

A 4-year-old girl was diagnosed with multiple organ and multiple system involvement after Kawasaki disease.

Diagnosis:

Novel coronavirus infection-associated multisystem inflammatory syndrome in children was considered.

Interventions:

The patients received aspirin, methylprednisolone and gammaglobulin to treat multisystem inflammatory syndrome.

Outcomes:

After treatment, the child recovered and was discharged from the hospital.

Lessons:

Multisystem inflammatory syndrome is often mistaken for Kawasaki disease, fortunately, their treatments are similar, the purpose of this case is to remind clinicians of the need for early management of children with multisystem failure following novel coronavirus infection, increase the detection rate, and save the life of the child.
Contrast-enhanced MRI findings of patients with acute Bell palsy within 7 days of symptom onset: A retrospective study
Authors: Seok Jung Im , Park Jae Han , Park Jung A , Do Youngrok
Published: December 2023

The brain magnetic resonance imaging (MRI) findings seen in patients with Bell palsy are abnormal contrast enhancement of affected facial nerves. Previous studies were conducted on a few patients, mainly those who had experienced palsy for several weeks. This study investigated the diagnostic usefulness of MRI by examining MRI findings of acute Bell palsy (within 7 days of symptom onset) in a large cohort. Among the patients with Bell palsy (idiopathic unilateral facial palsy) who visited the hospital, 123 patients who underwent contrast-enhanced MRI of the internal auditory canal within 7 days of symptom onset were reviewed retrospectively. MRI examination results were investigated along with the patient’s clinical symptoms and electrodiagnostic test results. Based on the MRI results, the frequency of abnormal contrast enhancement and contrast-enhanced areas were investigated. Of the 123 patients, 13 (11%) had normal brain MRI results, and 110 (89%) had abnormal findings. The frequency of abnormal contrast enhancement was not significantly associated with test timing (P = .56). Of the 110 patients with abnormal findings, 65 (59%) showed contrast enhancement in the labyrinthine segment and 36 (33%) in both the labyrinthine segment and geniculate ganglion. Most patients with Bell palsy who are in the acute phase showed abnormal contrast enhancement in their facial nerves, and similar findings were even observed in the examination conducted on the day of symptom onset. Brain MRI helps in the diagnosis of acute Bell palsy.
Diagnostic value of the combination of circulating serum miRNAs and CA125 in endometriosis
Authors: Chen Guansheng , Guo Jiayi , Li Wenjing , Zheng Rong , Shang Hongyu , Wang Yongjun
Published: December 2023

Circulating microRNAs (miRNAs) can serve as noninvasive biomarkers for endometriosis, but their diagnostic and prognostic values require investigation. This study evaluated the potential of 6 miRNAs in diagnosing endometriosis and predicting fertility. The study included patients with endometriosis (stages I–IV) and controls admitted to Sun Yat-Sen Memorial Hospital between May 2013 and March 2014. The serum expression levels of 6 miRNAs (miR-199a, miR-145*, miR-122, miR-9*, miR-141*, and miR-542-3p) were determined using qRT-PCR. Receiver operating characteristics curves were used to determine the diagnostic accuracy. The study included 155 patients with endometriosis and 77 controls. The model combining miR-199a, miR-122, miR-145*, and miR-141* with the carbohydrate antigen 125 (CA125) exhibited 81.8% sensitivity and 92.6% specificity and an area under the curve of 0.939 for diagnosing endometriosis. When combining miR-199a, miR-122, miR-145*, miR-542-3p, and CA125, the receiver operating characteristics curve showed an area under the curve of 0.759 and 79.6% sensitivity and 73.5% specificity for stage I/II versus III/IV endometriosis. Circulating miRNA levels were associated with pelvic adhesions (miR-199a, P < .05), lesion distribution (miR-9*, miR-145*, and miR-141*; all P < .05), and the presence of deep infiltrating endometriosis (miR-199a and miR-122; both P < .001). The expression levels of miR-199a, miR-122, and miR-542-3p decreased with an increasing endometriosis fertility index. The model combining circulating miRNAs (miR-199a, miR-122, miR-145*, and miR-141*) and CA125 is promising for diagnosing endometriosis and its severity. miR-199a, miR-122, and miR-542-3p were associated with the endometriosis fertility index and might be used to predict fertility preoperatively, but these results require confirmation.
Cornual pregnancy rupture and massive hemorrhage: A case report
Authors: Cai Xiaqin , Fu Yizhou , Hong Ke , Zhou Yuefang , Qi Guangju
Published: December 2023

Background:

Corneal pregnancy is rare and difficult to detect in the early stages. Due to the abundant blood supply in this area, a rupture can result in massive internal bleeding, shock, and even death. Therefore, immediate surgery is necessary, and patients must replenish their blood volume as soon as possible to ensure blood supply to important organs. For those whose blood pressure cannot immediately rise, surgery should be performed while resisting shock to buy time.

Case summary:

We present the case of a 34-year-old Chinese woman at 19 weeks of gestation who had a corneal pregnancy. No abnormalities were detected in the examinations in the first trimester. This patient was 19 weeks pregnant and sought medical advice due to sudden lower abdominal pain, syncope, and hemorrhagic shock. After rescue and treatment, she recovered and was discharged from the hospital, afterwards, the patient gave birth to a child 7 years later.

Conclusion:

The early diagnosis of cornual pregnancy is mainly based on ultrasound. However, there is a high incidence of missed diagnosis and misdiagnosis of this disease. Patients may face serious and life-threatening conditions in case of the rupture of cornual pregnancy. This disease can be mainly treated by surgery.
A case report of a patient with ductal carcinoma and a malignant phyllodes tumor in situ in 2 separate breasts
Authors: Li Chen , Zhang Chun
Published: December 2023

Rationale:

Breast malignant phyllodes tumors (MPT) are quite uncommon. It is rarely reported that they occur in conjunction with breast cancer. We detailed a case in which an MPT and ductal carcinoma in situ carcinoma occurred simultaneously in 2 different breasts.

Patient concerns:

A 79-year-old female patient was seen for a rapidly growing lump in the upper left quadrant of her breast. The lump was described as huge, hard, irregular, and palpable. MRI of the breasts revealed a big mass in the left breast and a smaller lump in the right.

Diagnosis:

Ductal carcinoma in situ with breast MPT.

Interventions:

We performed a double mastectomy. Post-operative endocrine treatment was suggested.

Outcomes:

During the 18-month follow-up period, no signs of recurrence or metastasis were seen. The ultrasound examination of the chest wall showed no abnormality. Bilateral axillary and supraclavicular ultrasonography showed no lymphadenectasis and a CT scan of the lungs showed no suspicious cancer nodules.

Lessons:

It is possible for MPT and ductal carcinoma in situ to occur simultaneously in different breasts. Surgeons need to integrate clinical observations, imaging tools, and patient history to make an early diagnosis. Before undergoing surgery, a thorough examination of both breasts is required.
Machine-learning-algorithms-based diagnostic model for influenza A in children
Authors: Zeng Qian , Yang Chun , Li Yurong , Geng Xinran , Lv Xin
Published: December 2023

Background:

At present, nucleic acid testing is the gold standard for diagnosing influenza A, however, this method is expensive, time-consuming, and unsuitable for promotion and use in grassroots hospitals. This study aimed to establish a diagnostic model that could accurately, quickly, and simply distinguish between influenza A and influenza like diseases.

Methods:

Patients with influenza-like symptoms were recruited between December 2019 and August 2023 at the Children’s Hospital Affiliated to Shandong University and basic information, nasopharyngeal swab and blood routine test data were included. Computer algorithms including random forest, GBDT, XGBoost and logistic regression (LR) were used to create the diagnostic model, and their performance was evaluated using the validation data sets.

Results:

A total of 4188 children with influenza-like symptoms were enrolled, of which 1992 were nucleic acid test positive and 2196 were matched negative. The diagnostic models based on the random forest, GBDT, XGBoost and logistic regression algorithms had AUC values of 0.835,0.872,0.867 and 0.784, respectively. The top 5 important features were lymphocyte (LYM) count, age, serum amyloid A (SAA), white blood cells (WBC) count and platelet-to-lymphocyte ratio (PLR). GBDT model had the best performance, the sensitivity and specificity were 77.23% and 80.29%, respectively.

Conclusions:

A computer algorithm diagnosis model of influenza A in children based on blood routine test data was established, which could identify children with influenza A more accurately in the early stage, and was easy to popularize.
Causal relationship between dried fruit intake and meniscal injuries: Two-sample Mendelian randomization
Authors: Deng Guang-Hua
Published: December 2023

To investigate the causal relationship between dried fruit intake and meniscal injuries using Mendelian randomization (MR). Data were pooled from large-scale genome wide association studies (GWAS), and genetic loci independently associated with dry fruit intake and meniscal injuries in populations of European origin were selected as instrumental variables. Three MR analyses, inverse variance weighting (IVW), weighted median (WME) and MR-Egger, were used to investigate the causal relationship between dried fruit intake and meniscal injuries. The results were tested for robustness by heterogeneity and multiplicity tests, and sensitivity analyses were performed using the “leave-one-out” method. The IVW results showed an OR (95 % CI) of 0.47 (0.28–0.78), P = .003, indicating a causal relationship between dried fruit intake and meniscus injury. And no heterogeneity and multiplicity were found by the test and sensitivity analysis also showed robust results. The present study used a 2-sample MR analysis, and by analyzing and exploring the genetic data, the study showed that too little intake of dry fruits is a risk factor for meniscal injuries.
Full thermal ablation versus partial thermal ablation for secondary hyperparathyroidism: A meta-analysis.
Authors: Gong Lifeng , Liu Xiaowu , Yang Qichao , Jiang Wei , Liu Xiaoming , Li Xianping , Xu Wei
Published: December 2023

Background:

Regarding the thermal ablation treatment of refractory secondary hyperparathyroidism (SHPT), there is no consensus on the ablation range of the hyperplastic parathyroid gland. Therefore, this meta-analysis was conducted to evaluate the efficacy and complications between full and partial thermal ablation in patients with refractory SHPT.

Methods:

Databases including PubMed, EMbase, the Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang databases were searched from inception to July 1, 2023. Eligible studies comparing full thermal ablation and partial thermal ablation for SHPT were included. Data were analyzed using Review Manager Version 5.3.

Results:

Four studies were included in the meta-analysis. Three cohort studies and one randomized controlled trial involving 62 patients in the full thermal ablation group and 63 patients in the partial thermal ablation group were included. The serum parathyroid hormone (PTH), calcium, and phosphorus levels after full ablation were all lower than those after partial ablation (P < .05). There was no significant difference between the partial and full ablation groups concerning the incidence rate of severe hypocalcemia (P = .09). There was no significant difference between the partial and full ablation groups concerning symptom improvement, including bone joint pain, itching, and myasthenia (P < .05).

Conclusion:

Full ablation was superior to partial ablation in terms of reducing PTH, calcium and phosphorus levels. Full ablation might not significantly increase the incidence of severe hypocalcemia. Larger multicentre randomized controlled trials are necessary to confirm the conclusion.
Knowledge, attitude, and adherence to coronavirus preventive measures among residents of the Kingdom of Saudi Arabia
Authors: Al Rajeh Ahmed M. , Naser Abdallah Y.
Published: December 2023

Since the SARS-CoV-2 virus, the virus that causes COVID-19, has been spreading globally, variants have emerged and been identified in many countries around the world. This descriptive cross-sectional study aimed to explore the level of knowledge, attitude, and adherence to coronavirus variant preventive measures among residents of the Kingdom of Saudi Arabia. This is a cross-sectional online survey that was conducted between April and November 2020 and involved the residents of the Kingdom of Saudi Arabia. An electronic invitation for participation was sent to prospective participants, including the link to the research instrument, using social media websites. A total of 780 participants responded to a 4-part online survey developed by the investigators. The findings revealed that 72.9% of the participants (95% CI: 69.6%–75.9%) had a high level of knowledge about COVID-19; 78.2% said they supported all precautionary measures put in place by health authorities; only 29% wore face masks; and 93% wash their hands at least 5 times a day. Furthermore, 69% of the residents were always covering their mouth and nose when coughing or sneezing with a piece of tissue paper, while 71% were observing physical distancing. Participants showed a positive attitude towards supporting all the precautionary measures being put in place by the health authorities and the efforts made by healthcare workers in the kingdom. Residents in Saudi Arabia showed a high level of knowledge of COVID-19 variants. Higher levels of education, being employed, and higher income were factors that influenced participants’ knowledge positively (P < .05). Females and younger age were predictors of a better attitude towards COVID-19 (P < .01).The majority of the residents were afraid of the spread and mutation of the coronavirus. This study highlights the value of continuing community service learning programs for raising knowledge retention and adherence to coronavirus variant prevention strategies.
Causal associations between circulation β-carotene and cardiovascular disease: A Mendelian randomization study
Authors: Liu Shuangyan , Wu Qiaoyu , Wang Shangshang , He Ying
Published: December 2023

The causal association between circulating β-carotene concentrations and cardiovascular disease (CVD) remains controversial. We conducted a Mendelian randomization study to explore the effects of β-carotene on various cardiovascular diseases, including myocardial infarction, atrial fibrillation, heart failure, and stroke. Three single nucleotide polymorphisms (SNPs) associated with the β-carotene levels were obtained by searching published data and used as instrumental variables. Genetic association estimates for 4 CVDs (including myocardial infarction, atrial fibrillation, heart failure, and stroke) in the primary analysis, blood pressure and serum lipids (high-density lipoprotein [HDL] cholesterol, LDL cholesterol, and triglycerides) in the secondary analysis were obtained from large-scale genome-wide association studies (GWASs). We applied inverse variance-weighted as the primary analysis method, and 3 others were used to verify as sensitivity analysis. Genetically predicted circulating β-carotene levels (natural log-transformed, µg/L) were positively associated with myocardial infarction (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.02–1.18, P = .011) after Bonferroni correction. No evidence supported the causal effect of β-carotene on atrial fibrillation (OR 1.02, 95% CI 0.96–1.09, P = .464), heart failure (OR 1.07, 95% CI 0.97–1.19, P = .187), stroke (OR 1.03, 95% CI 0.93–1.15, P = .540), blood pressure (P > .372) and serum lipids (P > .239). Sensitivity analysis produced consistent results. This study provides evidence for a causal relationship between circulating β-carotene and myocardial infarction. These findings have important implications for understanding the role of β-carotene in CVD and may inform dietary recommendations and intervention strategies for preventing myocardial infarction.
Radiation shielding effects of lead equivalent thickness of a radiation protective apron and distance during C-arm fluoroscopy-guided pain interventions: A randomized trial
Authors: Kim Cho Long , Jeong Hae Chang , Kim Jae Hun
Published: December 2023

Background:

The present study aimed to evaluate the degree of radiation shielding effects according to lead equivalent thickness and distance during C-arm fluoroscopy-guided lumbar interventions.

Methods:

The exposure time and air kerma were recorded using a fluoroscope. The effective dose (ED) was measured with and without the shielding material of the lead apron using 2 dosimeters at 2 positions. According to the lead equivalent thickness of the shielding material and distance from the side of the table, the groups were divided into 4 groups: group 1 (lead equivalent thickness 0.6 mm, distance 0 cm), group 2 (lead equivalent thickness 0.6 mm, distance 5 cm), group 3 (lead equivalent thickness 0.3 mm, distance 0 cm), and group 4 (lead equivalent thickness 0.3 mm, distance 5 cm). Mean differences such as air kerma, exposure time, ED, and ratio of EDs (ED with protector/ED without protector) were analyzed.

Results:

A total of 400 cases (100 cases in each group) were collected. The ratio of ED was significantly lower in groups 1 and 2 (9.18 ± 2.78% and 9.56 ± 3.29%, respectively) when compared to that of groups 3 and 4 (21.93 ± 4.19% and 21.53 ± 4.30%, respectively). The reductive effect of a 5-cm distance was 33.3% to 36.1% when comparing the ED between groups 1 and 2 and groups 3 and 4.

Conclusions:

The 0.3- and 0.6-mm lead equivalent thickness protectors have a radiation attenuation effect of 78.1% to 78.5% and 90.4% to 90.8%, respectively. The 5-cm distance from the side of the table reduces radiation exposure by 33.3% to 36.1%.
Exploring the top-cited literature in telerehabilitation for joint replacement using the descriptive, diagnostic, predictive, and prescriptive analytics model: A thematic and bibliometric analysis
Authors: Chuang Hua-Ying , Ho Sam Yu-Chieh , Chou Willy , Tsai Chia-Liang
Published: December 2023

Background:

Telerehabilitation offers a novel approach supplementing or replacing traditional physical rehabilitation. While research on telerehabilitation for joint replacement (TJR) has expanded, no study has investigated the top 100 cited articles (T100TJR) using the descriptive, diagnostic, predictive, and prescriptive analytics (DDPP) model. This study aims to examine the features of T100TJR in TJR through the DDPP approaches.

Methods:

A comprehensive search of the Web of Science Core Collection was conducted to locate all pertinent English-language documents from the database’s inception until August 2, 2023. The T100TJR articles were then identified based on citation counts. The DDPP analytics model, along with 7 visualization techniques, was used to analyze metadata elements such as countries, institutions, journals, authors, references, and keywords. An impact timeline view was employed to highlight 2 particularly noteworthy articles.

Results:

We analyzed 712 articles and observed a consistent upward trend in publications, culminating in a noticeable peak in 2022. The United States stood out as the primary contributor. A detailed examination of the top 100 articles (T100TJR) revealed the following leading contributors since 2010: the United States (by country), University of Sherbrooke, Canada (by institutions), 2017 (by publication year), and Dr Hawker from Canada (by authors). We delineated 4 major themes within these articles. The theme “replacement” dominated, featuring in 89% of them. There was a strong correlation between the citations an article garnered and its keyword prominence (F = 3030.37; P < .0001). Additionally, 2 particularly high-impact articles were underscored for recommendation.

Conclusions:

Telerehabilitation for TJR has seen rising interest, with the U.S. leading contributions. The study highlighted dominant themes, especially “replacement,” in top-cited articles. The significant correlation between article citations and keyword importance indicates the criticality of keyword selection. The research underscores the importance of 2 pivotal articles, recommending them for deeper insights.