bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic analysis of hyperparasitic viruses associated with entomopoxviruses
Authors: Barth Zachary K , Hicklin Ian , Thézé Julien , Takatsuka Jun , Nakai Madoka , Herniou Elisabeth A , Brown Anne M , Aylward Frank O
Published: July 2024

Polinton-like viruses (PLVs) are a diverse group of small integrative dsDNA viruses that infect diverse eukaryotic hosts. Many PLVs are hypothesized to parasitize viruses in the phylum Nucleocytoviricota for their own propagation and spread. Here, we analyze the genomes of novel PLVs associated with the occlusion bodies of entomopoxvirus (EPV) infections of two separate lepidopteran hosts. The presence of these elements within EPV occlusion bodies suggests that they are the first known hyperparasites of poxviruses. We find that these PLVs belong to two distinct lineages that are highly diverged from known PLVs. These PLVs possess mosaic genomes, and some essential genes share homology with mobile genes within EPVs. Based on this homology and observed PLV mosaicism, we propose a mechanism to explain the turnover of PLV replication and integration genes.
Generation and Characterization of Ex Vivo Expanded Tumor-infiltrating Lymphocytes From Renal Cell Carcinoma Tumors for Adoptive Cell Therapy
Authors: Einstein David J. , Halbert Brian , Denize Thomas , Matar Sayed , West Destiny J. , Gupta Mamta , Andrianopoulos Emanuelle , Seery Virginia , Herman Courtney , Onimus Kenneth , Wells Adrian , Bunch Brittany , Signoretti Sabina , Natarajan Arvind , Veerapathran Anand , McDermott David F.
Published: July 2024

Autologous therapeutic tumor-infiltrating lymphocyte (TIL) therapy is a promising strategy to enhance antitumor immunity. Optimization of ex vivo TIL expansion could expand current immunotherapy options. Previous attempts to generate TIL in renal cell carcinoma (RCC) have been technically challenging. We applied a second-generation manufacturing process, currently used to generate the melanoma TIL product lifileucel, in RCC. Resected primary and metastatic RCC samples were processed using the Gen 2 manufacturing process comprising of pre-Rapid Expansion Protocol (pre-REP) and REP steps. We assessed REP TILs for viability and performed phenotypic and functional characterization. We correlated the tumor immune microenvironment (TIME) with successful TIL expansion. Eight of 11 RCC samples underwent successful REP. Three failed cases demonstrated low CD8/FoxP3 ratio and high expression of PD-1 within FoxP3 cells. Expression of exhaustion markers differed between the TIME and expanded TILs; the latter had a TIM3-high/PD-1-low phenotype but retained functional capacity comparable to lifileucel. The Gen 2 manufacturing process used for lifileucel successfully expanded functional TILs from RCC samples, enabling further study in a clinical trial. TIME features such as low CD8/FoxP3 ratio and high PD-1 expression within FoxP3 cells warrant study as potential biomarkers of successful TIL expansion.
Effect of Arm-Ergometry Versus Treadmill Supervised Exercise on Cardiorespiratory Fitness and Walking Distances in Patients With Peripheral Artery Disease
Authors: Magalhães Sandra , Santos Mário , Viamonte Sofia , Ribeiro Fernando , Martins Joana , Schmidt Cristine , Martinho-Dias Daniel , Cyrne-Carvalho Henrique
Published: July 2024

Purpose:

To compare arm-ergometry and treadmill supervised exercise training on cardiorespiratory fitness and walking distances in patients with peripheral artery disease (PAD).

Methods:

ARMEX was a single-center, single-blinded, parallel group, non-inferiority trial enrolling symptomatic patients with PAD. Patients were randomized (1:1 ratio) to a 12-wk arm-ergometry (AEx) or standard treadmill (TEx) supervised exercise training protocol. The powered primary end point was the change in peak oxygen uptake (VO2) at 12 wk, measured on a treadmill cardiopulmonary exercise test (CPX). Secondary outcomes included changes in VO2 at the first ventilatory threshold (VT-1), ventilatory efficiency (ratio of minute ventilation [VE] to carbon dioxide production [VCO2], VE/VCO2), walking distances by CPX and 6-min walking test (6MWT), and self-reported walking limitations.

Results:

Fifty-six patients (66 ± 8 yr; 88% male) were randomized (AEx, n = 28; TEx, n = 28). At 12 wk, VO2peak change was not significantly different between groups (0.75 mL/kg/min; 95% CI, −0.94 to 2.44; P = .378), despite a significant increase only in AEx. VO2 at VT-1 improved in both groups without between-group differences, and VE/VCO2 slope improved more in AEx. The TEx attained greater improvements in walking distance by CPX (121.08 m; 95% CI, 24.49-217.66; P = .015) and 6MWT (25.08 m; 95% CI, 5.87-44.29; P = .012) and self-perceived walking distance.

Conclusions:

Arm-ergometry was noninferior to standard treadmill training for VO2peak, and treadmill training was associated with greater improvements in walking distance. Our data support the use of treadmill as a first-line choice in patients with PAD to enhance walking capacity, but arm-ergometry could be an option in selected patients.
When Tuberculin Stings: A Case of Panophthalmitis Following Tuberculin Skin Test
Authors: Majumder Anindya Kishore , Majumder Parthopratim Dutta
Published: July 2024

Purpose:

To report a case of allergic reaction to a tuberculin skin test that incited a panophthalmitis-like reaction with exudative retinal detachment.

Method:

Retrospective Chart Review

Result:

A 38-year-old woman presented with sudden onset ocular pain, redness, and protrusion of both eyes following a tuberculin skin test, part of the investigative process for her recent high-grade fever. On presentation to us, her visual acuity was limited to the perception of light in both eyes. Ophthalmic examination revealed fibrinous anterior chamber reaction, sluggish pupils, diffuse conjunctival chemosis, limited ocular movement in all gazes, and inadequate eyelid closure due to proptosis in both eyes. Fundus examination of both eyes showed grade 3+ vitritis and exudative bullous retinal detachment. All other laboratory investigations were within normal limits. The patient demonstrated a remarkable response to pulse corticosteroid therapy, with significant alleviation of ocular symptoms and partial resolution of inflammation. Further treatment was initiated with oral corticosteroids and mycophenolate mofetil, followed by the addition of cyclosporine, which facilitated complete resolution of the exudative retinal detachment with restoration her BCVA to 6/9.

Conclusion:

This case underscores the importance of ophthalmologists recognizing that acute allergic reactions secondary to tuberculin skin tests can, on rare occasions, present as uveitis, and highlights the need for appropriate management of such conditions.
FLUCTUATING EXUDATION IN NON-NEOVASCULAR GEOGRAPHIC ATROPHY
Authors: Bottazzi Leonardo , Servillo Andrea , Zucchiatti Ilaria , Sacconi Riccardo , Querques Lea , Bandello Francesco , Querques Giuseppe
Published: July 2024

PURPOSE:

To report a case series of exudation in non-neovascular geographic atrophy (GA), which fluctuated and spontaneously almost resolved during the follow-up.

METHODS:

A retrospective study was designed to include consecutive cases with geographic atrophy (GA) secondary to age-related macular degeneration (AMD) associated with intraretinal fluid (IRF) but without macular neovascularization (MNV). Three eyes of 2 patients (one male, one female) were enrolled. Spectral domain optical coherence tomography (SD-OCT) and angiographies (OCT angiography and/or dye angiographies) were performed to confirm diagnosis of IRF and the absence of MNV.

RESULTS:

At baseline best-corrected visual acuity (BCVA) was between 20/50 and 20/36. SD-OCT displayed IRF in the inner and outer retinal layers with an increased central macular thickness. OCT-A and dye angiographies did not show any abnormal neovascular network. Of note, fluorescein angiography showed a leakage in correspondence of the intraretinal cysts, differently from the degenerative pseudocysts. After one month of follow-up, BCVA remained stable, while the IRF spontaneously almost resolved in all cases.

DISCUSSION:

To our knowledge, this is the first report of a fluctuating exudation in non-neovascular GA. Future studies are required to better define this potential novel clinical phenotype.
Risk Factors for Disease Progression in Glaucoma Patients With Disk Hemorrhage
Authors: Lee Ji Young , Choi Jin A.
Published: July 2024

Précis:

Glaucoma eyes with recurrent disk hemorrhage were associated with increased systolic blood pressure and diastolic blood pressure, and increased visit-to-visit diastolic blood pressure variability was associated with glaucoma progression.

Purpose:

In this study, we investigated the effects of the clinical characteristics of disk hemorrhage (DH) and hemodynamic factors on glaucoma progression.

Methods:

This retrospective cohort study included 81 eyes with open angle glaucoma and nonrecurrent or recurrent DH. Recurrent DH was further classified according to the DH location. Visual field (VF) progression was determined using event-based analysis and Guided Progression Analysis software. The coefficient of variation (CV) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was used to measure visit-to-visit variability. Kaplan-Meier survival analysis was used to compare the cumulative risk ratio of progression between groups.

Results:

The recurrent DH group had significantly higher SBP and DBP (P=0.014 and=0.021, respectively) and a higher proportion of VF progression (P=0.019) than the nonrecurrent DH group. In particular, females with recurrent DH had the highest cumulative probability of VF progression (P=0.047, log-rank test). Recurrent DH in a different quadrant was associated with the highest cumulative probability of VF progression than nonrecurrent DH (P=0.038, log-rank test). In Cox regression analysis, higher visit-to-visit DBP variability, female gender, and recurrent DH in a different quadrant were significantly associated with glaucoma progression.

Conclusion:

In glaucomatous eyes with DH, increased visit-to-visit DBP variability was associated with glaucoma progression. Our results suggest that hemodynamic factors are involved in the recurrence of DH and progression of glaucoma.
Wipe-Out Following Gonioscopy-Assisted Transluminal Trabeculotomy Combined With Phacoemulsification
Authors: Ozmen Mehmet Cuneyt , Acar Burak , Uysal Betul Seher
Published: July 2024

Précis:

We report a case of a 62-year-old male patient who developed a wipe-out phenomenon after uncomplicated gonioscopy-assisted transluminal trabeculotomy combined with cataract surgery.

A 62-year-old male patient with a diagnosis of pseudo-exfoliation and open angle glaucoma underwent uncomplicated gonioscopy-assisted transluminal trabeculotomy (GATT) combined with phacoemulsification surgery due to advanced glaucomatous damage and high intraocular pressure. Postoperative decrease in visual acuity and central visual field deterioration suggested a wipe-out phenomenon. Although the wipe-out phenomenon has been reported after other surgeries in patients with advanced glaucoma, as far as we know, this is the first report of a wipe-out phenomenon secondary to GATT combined with phacoemulsification surgery. This complication, which can lead to severe vision loss, should be considered before the surgical decision.
Neighborhood Poverty and Clinic Attendance in the Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program
Authors: Ramachandran Rithambara , Hicks Patrice M. , Lu Ming-Chen , Niziol Leslie M. , Woodward Maria A. , Elam Angela R. , Johnson Leroy , Kershaw Martha , Musch David C. , Bicket Amanda , John Denise , Killeen Olivia J. , Newman-Casey Paula Anne
Published: July 2024

Précis:

Higher neighborhood-level poverty is associated with greater odds of missing a free eye disease screening appointment, underscoring the importance of community-based interventions to address upstream social determinants of health.

Purpose:

To investigate the association between neighborhood-level characteristics and attendance for a free eye disease screening.

Methods:

The MI-SIGHT program is conducted in 2 community clinics in Southeastern Michigan. Participant-level demographics were extracted from electronic health records. Neighborhood-level characteristics, including Area Deprivation Index (ADI), median household income (HHI), percent of households with >30% rent burden, percent of households without vehicles, percent of households in subsidized housing, and energy burden, were obtained from the Wisconsin Neighborhood Atlas and the United States census. Logistic regression was used to model the probability of clinic visit attendance, which was the main outcome measure.

Results:

One thousand four hundred thirty-one participants were scheduled for screening appointments between July 2020 and November 2021, with a no-show rate of 23%. Individuals lived an average of 7.7 miles from each clinic (SD=8.1) and in neighborhoods with a mean ADI of 6.8 (SD=3.2, 1–10 scale, where 10 is the most deprived). After adjusting for age, sex, race, and ethnicity, participants from neighborhoods with higher deprivation were more likely to have missed clinic visits. For example, there was an 8% higher odds of missed clinic visits for every 1-point increase in ADI (odds ratio, OR=1.08, P=0.020) and an 18% higher odds of a missed visit with every 10% increase in households without a vehicle (OR=1.18, P=0.013).

Conclusions:

Higher neighborhood-level poverty was associated with greater odds of missing a free eye disease screening appointment after adjusting for individual characteristics. Increased neighborhood-level resources are likely needed to bolster engagement in preventive eye care.
Awareness of Skin Cancer in the Prospective Epidemiological Research Studies in Iran Guilan Cohort Study Population
Authors: Eftekhari Hojat , Joukar Farahnaz , Faraji Niloofar , Hassanipour Soheil , Esfandyari Alireza , Naghipour Mohammadreza , Mansour-Ghanaei Fariborz
Published: July 2024

Objectives

This study aimed to investigate the level of awareness of skin cancer among the Prospective Epidemiological Research Studies in Iran (PERSIAN) Guilan cohort study (PGCS) population.

Methods

This cross-sectional study was conducted on 625 participants of PGCS in Guilan, Iran, in 2022. The demographic and clinical information of the participants was recorded, and individuals with a history of skin cancer were excluded from the study. The awareness about skin cancer was collected using a questionnaire containing 26 questions with a cutoff score of 13 as an average score. All data were analyzed using IBM SPSS Version 21, considering a significance level < .05.

Results

Out of 625 participants, 41.84% were male. About 218 (32.9%) participants had a level of awareness about skin cancer higher than the average, in which 169 (25.5%), 276 (41.7%), 18 (2.8%), and 134 (20.2%) of participants had a higher-than-average score in epidemiology, causes, clinical manifestations, and prevention and treatment fields, respectively. The findings illustrated that the awareness score about skin cancer was significantly different based on gender, source of information on causes, and scope of clinical manifestations (p < .05). Also, the level of education and visiting a doctor could significantly affect the level of awareness (p < .05).

Conclusion

The PGCS population had low awareness of skin cancer. Identifying knowledge gaps can guide the development of targeted educational resources. Dermatology nurses can play a key role in creating and implementing health education programs that promote early detection of cancer symptoms, starting with increasing knowledge about early warning signs.
“Near Miss”: A Mixed-Methods Analysis of Medical Student Assignments in Patient Safety
Authors: Plugge Thomas , Breviu Amanda , Lappé Katie , Sakaeda Mariah , Raaum Sonja
Published: July 2024

The purpose of this study is to inform the curriculum for Entrustable Professional Activity 13 through analysis of fourth year medical student patient safety event assignments. From 2016 to 2021, students were asked to identify a patient safety event and indicate if the event required an incident report. Assignments were reviewed and coded based on Joint Commission incident definitions. Qualitative analysis was performed to evaluate incident report justification. There were 473 student assignments included in the analysis. Assignments reported incidents regarding communication, medical judgment, medication errors, and coordination of care. Students indicated only 18.0% (85/473) would warrant an incident report. Justification for not filing an incident report included lack of harm to the patient or that it was previously reported. Students were able to identify system issues but infrequently felt an incident report was required. Justifications for not filing an incident report suggest a need for a curriculum focused on the value of reporting near misses and hazardous conditions.
Hepatic arterial chemotherapy infusion combined with tyrosine kinase inhibitors and PD-1 inhibitors for advanced hepatocellular carcinoma with high risk: a propensity score matching study
Authors: Zuo Mengxuan , Zheng Guanglei , Cao Yuzhe , Lu Hailei , Li Da , An Chao , Fan Weijun
Published: July 2024

Objective:

To ascertain the therapeutic efficacy and safety of FOLFOX (oxaliplatin, fluorouracil, and leucovorin)-based hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors (TKI) and programmed cell death protein-1 inhibitors (PD-1 inhibitors) (triple therapy), as a first-line treatment in high-risk advanced hepatocellular carcinoma (aHCC with Vp4 portal vein invasion or/and tumor diameter ≥10 cm).

Methods:

This retrospective multicenter study included 466 high-risk aHCC patients treated with either triple therapy (n=245) or dual therapy (TKI and PD-1 inhibitors, n=221). The overall survival, progression-free survival, objective response rate, and safety were compared between the two groups. Propensity score matching was performed to reduce bias between the two groups.

Results:

After propensity score matching (1:1), 194 patients in each group were analyzed. The triple-therapy group showed a longer median overall survival (24.6 vs. 11.9 months; HR=0.43, P<0.001) and a longer median progression-free survival (10.0 vs. 7.7 months; HR=0.68, P=0.002) than the dual-therapy group. The survival rates at 6, 12, and 24 months were 94.2, 71.0, and 50.8% for triple therapy and 75.9, 49.9, and 26.8% for dual therapy. The objective response rate in the triple-therapy group was significantly higher (57.7 vs. 28.9%, P<0.001). In the triple-therapy group, more patients converted to non-high-risk (68.0 vs. 36.6%, P<0.001) and received salvage liver resection or ablation after downstaging conversion (16.5% vs. 9.2%, P=0.033). The grade 3/4 adverse events were 59.2 and 47.4% in the triple-therapy group and dual-therapy group, respectively (P=0.022).

Conclusion:

FOLFOX-based hepatic arterial infusion chemotherapy plus TKI and PD-1 inhibitors significantly improve survival prognosis compared with TKI plus PD-1 inhibitors. This is a potential first-line treatment for high-risk aHCC, with a relatively controlled safety profile.
Using a Reconstructive Ladder for Surgical Reconstruction of Transplant Ureteral Stricture Disease
Authors: Ji Emily , Rosenfeld Jonathan , Boehm Devin , Arteaga Rebecca , Raikar Aidan , Kim Jaewoo , Lee Ziho
Published: July 2024

Objective:

Reconstruction of transplant ureteral stricture disease (USD) is a challenging surgical problem. In this article, we review our reconstructive ladder for robotic reconstruction of transplant USD and report our outcomes.

Materials and Methods:

We performed a retrospective review of patients undergoing robotic transplant reimplantation for USD after kidney transplantation at our institution between 11/2021 and 3/2023. Only patients with at least 1-year follow-up were included. The first rung of our reconstructive ladder is a side-to-side nontransecting reimplant. We prefer this method whenever possible because it avoids transection of the ureter, preserving the fragile blood supply. When this technique is not possible, because of long stricture length and/or limited bladder mobility, we proceed to the second rung of our reconstructive ladder, a Boari flap reconstruction. Surgical success in our cohort was defined as being hardware-free without evidence of ureteral obstruction on imaging.

Results:

There were 6 patients in our cohort: 3 underwent side-to-side reconstruction and 3 underwent Boari flap reconstruction. Median console time was 139 minutes (interquartile range [IQR] 85-175), estimated blood loss was 25 milliliters (IQR 25-81), and length of stay was 1 day (IQR 1-3). We had one major (Clavien ≥ III) complication, which was an intensive care unit transfer postoperatively for hypertension requiring a nicardipine drip. Median follow-up was 14 months (IQR 13-18) with a 100% surgical success rate.

Conclusion:

Utilization of a reconstructive ladder for management of transplant USD may allow for a systematic approach based on reconstructive principles. Our approach was associated with excellent intermediate-term outcomes.
Synchronous Insertion of Hyaluronic Acid-Based Biodegradable Rectal Spacer for Primary Prostate Cryotherapy
Authors: Parr Nigel J. , Dudderidge Timothy
Published: July 2024

Purpose:

Recently, biodegradable spacers have been introduced to reduce rectal wall toxicity during external beam radiotherapy for prostate cancer. Rectal wall damage with fistula formation is a major complication of primary and salvage prostate cryotherapy. In theory, biodegradable spacers can be used to protect the rectum from the damage associated with cryotherapy. We describe a case of rectal spacer insertion for primary cryotherapy in a patient with high-risk localized prostate cancer who was unsuitable for other radical treatments because of previous treatment of rectal cancer, detailing the rationale for spacer selection, technique, and outcomes.

Materials and Methods:

A 57-year-old man was referred, following a regional specialist multidisciplinary team discussion, for an opinion regarding possible primary prostate cryotherapy. He had a history of anterior resection with chemoradiotherapy, followed by local relapse treated with total colectomy with ileoanal pouch formation and suffering from major postoperative complications. After further assessment and because of concern regarding damage to the efferent pouch limb during freezing, the possibility of spacer insertion between the ileoanal segment was considered and discussed. A hyaluronic acid gel spacer was selected and offered “off licence” on a compassionate basis. The spacer was introduced immediately before cryotherapy.

Results:

Recovery was uncomplicated apart from transient intermittent perineal pain, with good early functional and oncological outcomes.

Conclusions:

This is the first report of synchronous insertion of a hyaluronic acid gel spacer in prostate cryotherapy. We believe that the technique merits further investigation, with the potential to reduce complications and enhance freezing of the posterior aspect of the gland during cryotherapy.
Covered Versus Uncovered Metal Stents for the Drainage of the Malignant Distal Biliary Obstruction With ERCP
Authors: Guzmán-Calderón Gerly Edson , Chirinos Juan , Díaz-Arocutipa Carlos , Vesco Eduardo , Huerta-Mercado Jorge , Cedrón Hugo , Montezuma Dora , Poppele Gunther , Aparicio José Ramón
Published: July 2024

Introduction and Aim:

Unresectable malignant distal biliary obstruction is a condition that should be treated with drainage and clearance of the biliary duct. self-expanded metal stents (SEMS) are known to be better and more effective than plastic stents because the patency is longer. The actual evidence is insufficient to recommend if it is better the use of SEMSu over SEMSc or vice versa for the drainage of the malignant distal biliary obstruction during ERCP. We performed a systematic review and meta-analyses to demonstrate if exists superiority between one or other type of SEMS performed by ERCP.

Materials and Methods:

We conducted a systematic review in different databases, such as PubMed, Cochrane, Medline, and OVID database. A search was made of all studies published up to May 2023.

Results:

Seven studies were analyzed. A total of 1070 patients were included. Of the total of patients, 48.9% were male. The cumulative stent patency, the failure rate, the survival probably and the adverse events rate, were similar between SEMSc and SEMSu groups. The stent migration rate was higher in the SEMSc group (RR=2.34 [95% CI: 1.35-4.08]). The tumor overgrowth was higher in the SEMSc group (RR=2.05 [95% CI: 1.13-3.72]). The tumor ingrowth was higher in the SEMSu group (RR=0.25 [95% CI: 0.11-0.61]).

Conclusions:

The conclusions of our study show that there are no differences between the use of uncovered SEMS and covered SEMS for palliative treatment of distal biliopancreatic obstructions, and it has no impact on mortality or patient survival. New functional studies regarding the type of stent cover, radial force or length thereof are required.
The efficacy and safety of modified transbronchial cryobiopsy in the diagnosis of interstitial lung disease
Authors: Long Wenting , Luo Jingying , Ma Libing , Wei Jianghong , Xiang Hui , Hong Liuyan , Luo Miao
Published: July 2024

The objective of this study is to investigate the efficacy and safety of flexible transbronchial cryobiopsy (TBCB) in the diagnosis of diffuse parenchymal lung disease (DPLD) in a routine bronchoscopy examination room under analgesia and sedation, using neither endotracheal intubation or rigid bronchoscope nor fluoroscopy or general anesthesia. The data from 50 DPLD patients with unknown etiology who were treated in the Affiliated Hospital of Guilin Medical College from May 2018 to September 2020 were collected, and 43 were eventually included. The specimens obtained from these 43 patients were subjected to pathological examination, pathogenic microorganism culture, etc, and were analyzed in the clinical-radiological-pathological diagnosis mode to confirm the efficacy of TBCB in diagnosing the cause of DPLD. Subsequently, the intraoperative and postoperative complications of TBCB and their severity were closely observed and recorded to comprehensively evaluate the safety of TBCB. For the 43 patients included, a total of 85 TBCB biopsies were performed (1.98 [1, 4] times/case), and 82 valid tissue specimens were obtained (1.91 [1, 4] pieces/case), accounting for 96.5% (82/85) of the total sample. The average specimen size was 12.41 (1, 30) mm2. Eventually, 38 cases were diagnosed, including 11 cases of idiopathic pulmonary fibrosis, 5 cases of connective tissue–related interstitial lung disease, 5 cases of nonspecific interstitial pneumonia, 4 cases of tuberculosis, 4 cases of occupational lung injury, 3 cases of interstitial pneumonia with autoimmune characteristics, 1 case of lung cancer, 2 cases of interstitial lung disease (unclassified interstitial lung disease), 1 case of hypersensitivity pneumonitis, 1 case of pulmonary alveolar proteinosis, and 1 case of fungal infection. The remaining 5 cases were unclarified. For infectious diseases, the overall etiological diagnosis rate was 88.4% (38/43). With respect to complications, pneumothorax occurred in 4 cases (9.3%, 4/43, including 1 mild case and 3 moderate cases), of which 3 cases (75%) were closed by thoracic drainage and 1 case (25%) was absorbed without treatment. In addition, 22 cases experienced no bleeding (51.2%) and 21 cases suffered bleeding to varying degrees based on different severity assessment methods. TBCB is a minimally invasive, rapid, economical, effective, and safe diagnostic technique.
Higher systemic inflammation response index is associated with increased risk of heart failure in adults: An observational study
Authors: Wang Xiao , Wang Min , Shen Yishi
Published: July 2024

Inflammation has been established to play a crucial role in the onset of heart failure (HF) for many years, and the systemic inflammation response index (SIRI) is a new and comprehensive indicator reflecting the inflammation status in human body. The aim of this investigation was to determine the potential relationship between HF and SIRI in adults. For this investigation, we used cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), which was conducted from 2009 to 2018. The study utilized multivariable linear regression models to examine the potential independent relationship between HF and SIRI. Additionally, a subgroup analysis and interaction test were carried out. To illustrate the nonlinear relationship, threshold effect analysis and fitted smoothing curves were also used. 26,303 eligible subjects aged ≥ 20 years were enrolled as the final samples. HF participants exhibited significant higher SIRI compared with non-HF participants [1.89 ± 1.33 vs 1.25 ± 0.95 (1000 cells/μL), P < .0001]. Multivariate logistic regression showed that those in the highest SIRI quartile had a significantly greater risk of HF by 130% (OR = 2.30, 95% CI 1.41–3.76; P < .0001). In addition, nonlinear relationship between HF and SIRI with the inflection point of 2.2 (1000 cells/μL) was observed. According to our research, adult HF prevalence and SIRI are positively correlated. This implies that SIRI could be a valuable biomarker for determining HF risk in the clinic.
Analyzing collaboration and impact: A bibliometric review of four highly published authors’ research profiles on collaborative maps
Authors: Chou Willy , Chow Julie Chi
Published: July 2024

The concept of impact beam plots (IBPs) has been introduced in academia as a means to profile individual researchers. Despite its potential, there has been a lack of comprehensive analysis that evaluates the research profiles of highly published authors through the lens of collaborative maps. This study introduces a novel approach, the rating scale for research profiles (RSRP), to create collaborative maps for prolific authors. The initial hypothesis posited that each of the research profiles would attain a grade A, necessitating empirical verification. This research employed collaborative maps to analyze the publication patterns of authors using the Web of Science database, focusing on co-authorship patterns and the impact of their scholarly work. The study relied on various bibliometric indicators, such as publication count, citation metrics, h-index, and co-authorship networks, to provide a detailed assessment of the contributions made by each author in their field. Additionally, authors’ IBPs were generated and assessed alongside collaborative maps, using a grading scale ranging from A (excellent) to F (lacking any articles as first or corresponding author). The analysis confirmed that all 4 research profiles achieved a grade A, with their centroids located in the third quadrant, indicating a high level of scholarly impact. The h-indexes for the authors were found to be 38, 51, 53, and 59, respectively. Notably, Dr Tseng from Taiwan showed a distinct pattern, with a significant number of solo-authored publications in the second quadrant, in contrast to the other 3 authors who demonstrated a greater emphasis on collaboration, as evidenced by their positioning in the first quadrant. The study successfully demonstrates that RSRP and IBPs can be effectively used to analyze and profile the research output of highly published authors through collaborative maps. The research confirms the initial hypothesis that all 4 profiles would achieve a grade A, indicating an excellent level of scholarly impact and a strong presence in their respective fields. The utility of collaborative maps can be applied to bibliometric indicators in assessing the contributions and impact of scholars in the academic community.
Does aortic calcification really affect anastomotic leakage after rectal cancer surgery?
Authors: Diao Yu-Hang , Chen Jian , Liu Yang , Peng Dong , Yang Dong
Published: July 2024

The purpose of the current study was to analyze whether aortic calcification had impact on the anastomotic leakage (AL) after rectal cancer (RC) surgery. We collected patients’ information from January 2011 to January 2020 in a single teaching hospital. Preoperative computed tomography images were obtained. Abdominal aortic calcification (AAC), superior mesenteric aortic calcification, and inferior mesenteric aortic calcification were recorded. The difference of AL and grade C AL was calculated. A total of 2412 RC patients were included in this study. Ninety-seven (4.0%) RC patients experienced AL and 47 (1.9%) RC patients experienced grade C AL. The amount of AAC, superior mesenteric aortic calcification, and inferior mesenteric aortic calcification was 1546 (64.1%), 128 (5.3%), and 31 (1.3%). The AL group had higher portion of AAC (P = .019) than the no AL group, and the grade C AL group had higher portion of AAC (P = .016) than the no grade C AL group. In univariate logistic regression analysis, AAC was a significant potential factor for AL (P = .021, OR = 1.739, 95% CI = 1.088–2.779) and grade C AL (P = .019, OR = 2.339, 95% CI = 1.115–4.986). However, in multivariate logistic regression, AAC was not an independent predictive factor for AL (P = .157, OR = 1.443, 95% CI = 0.871–2.358) or grade C AL (P = .064, OR = 2.055, 95% CI = 0.960–4.399). AAC was associated with higher amount of AL and grade C AL, however, AAC was not an independent predictive factor for AL or grade C AL.
Colonoscopic removal of an intrauterine device with rectal perforation: A case report
Authors: Ye Lingrun , Zhu Yuanyuan , Zhu Fanglai
Published: July 2024

Rationale:

The intrauterine device is one of the effective, safe, convenient, economical, and reversible contraceptive methods. Although its contraceptive effect is definite, some female patients may experience complications such as expulsion, bleeding, and pregnancy with the device in place. Rectal perforation is one of the rare and serious complications, which can lead to complications such as abdominal infection and intestinal adhesions, severely affecting the quality of life of patients.

Patient concerns:

A 34-year-old female was sent to the Department of Gastroenterology with noticeable left lower quadrant abdominal pain. She had presented with abdominal discomfort and anal tenesmus 1 year earlier. Two months ago, her abdominal pain had gradually worsened and she was presented to our hospital.

Diagnoses:

Investigations, including colonoscopy and computed tomography scan, had revealed an intrauterine device migrated and perforated into the rectum.

Interventions and outcomes:

The patient underwent successful colonoscopic removal of the intrauterine device. She recovered well after the treatment.

Lessons:

This case proves that endoscopic therapy can be considered the preferred method for removing intrauterine devices displaced into the digestive tract lumen.
Research on acupuncture and glial cells: A bibliometric analysis
Authors: Liu Qiong , Ai Kun , Jiang Xin-Ru , Yang Jing-Jing , Chen Lin , Cao Si-Hui , He Hao-Long , Liu Xia , Liu Mi
Published: July 2024

Background:

There are a growing number of studies on the effect of acupuncture on glial cells in the central nervous system; however, there are few related bibliometric analyses in this area. Therefore, the purpose of this bibliometric study was to visualize the literature on acupuncture-regulated glial cells.

Methods:

On November 23, 2022, regular and review articles on acupuncture and glial cell-related research were retrieved from the Web of Science Core Collection database. The R package “bibliometrix” was used to summarize the main findings, count the occurrences of the top keywords, visualize the international collaboration network, and generate a 3-field plot. The VOSviewer software was used to conduct both co-authorship and co-occurrence analyses. CiteSpace was used to identify the best references and keywords with the highest citation rates.

Results:

Overall, 348 publications on acupuncture and glial cells were included. The publications were primarily from China, Korea, and the United States of America. The majority of publications were found in relevant journals. Apart from “acupuncture” and “glial cells,” the most frequently used keywords were “neuroinflammation,” “hyperalgesia,” and “pain.”

Conclusion:

This bibliometric study mapped a fundamental knowledge structure comprising countries, institutions, authors, journals, and articles in the research fields of acupuncture and glial cells over the last 3 decades. These results provide a comprehensive perspective on the wider landscape of this research area.
Using Trastuzumab Deruxtecan to treat advanced metastatic breast cancer in patients with varying HER2 expression levels: A single-center experience in Taiwan
Authors: Wu Chung-Wei , Cheng Fiona Tsui-Fen
Published: July 2024

To observe the clinical outcomes of patients diagnosed with metastatic breast cancer undergoing Trastuzumab Deruxtecan (T-DXd) therapy in a real-world setting. The study retrospectively reviewed and collected medical data from 13 patients at Shin Kong Wu Ho-Su Memorial Hospital who underwent T-DXd treatment over a period from April 2022 to June 2023. Demographics, pathological characteristics, treatment patterns, and outcomes were descriptively analyzed. Thirteen patients diagnosed with metastatic breast cancer underwent T-DXd treatment between April 2022 and June 2023. This study observed that T-DXd was effective in patients with high human epidermal growth factor receptor 2 (HER2) levels. In patients with low HER2, the majority also experienced favorable responses. Only 2 patients exhibited poor or no response: one was a BRCA2 carrier with unmanageable disease progression, and the other had a HER2 1 + status with multiorgan metastases whose cancer was not controlled by T-DXd. Additionally, 2 patients with no HER2 expression responded well to T-DXd treatment. T-DXd is a valuable treatment alternative for patients with breast cancer, including those with HER2-high, HER2-low, and HER2-negative statuses. In this study, the majority of patients experienced positive therapeutic effects. However, this evaluation relied on a limited sample size and short-term observations. Additional studies involving larger and more diverse patient groups and long follow-up durations are required.
Association between patients with migraine and sarcopenia: A retrospective study
Authors: Lee Dong Ah , Lee Ho-Joon , Kim Jinseung , Park Kang Min
Published: July 2024

Recently, interest in sarcopenia has been increasing in patients with various neurological diseases. Thus, we investigated the presence of sarcopenia in patients with episodic migraine (EM) based on temporal muscle thickness (TMT). This was a retrospectively observational study following STROBE guidelines. We enrolled patients with EM and healthy controls. Both groups underwent brain magnetic resonance imaging, including three-dimensional T1-weighted imaging. We calculated the TMT using T1-weighted imaging, which is a marker for sarcopenia. We compared TMT between patients with EM and healthy controls, and analyzed it according to presence of migraine aura. We retrospectively enrolled 82 patients with EM and 53 healthy controls. TMT was not different between patients with EM and healthy controls (10.804 ± 2.045 mm in patients with EM vs 10.721 ± 1.547 mm in healthy controls, P = .801). Furthermore, TMT was not different according to presence of migraine aura in patients with EM (10.994 ± 2.016 mm in patients with migraine aura vs 10.716 ± 2.071 mm in those without, P = .569). There were no correlations between TMT and clinical characteristics in patients with EM, including age, age of onset, duration of migraine, headache intensity, and headache frequency. This study found no statistical difference in TMT between patients with EM and healthy controls or between patients with EM with and without aura. These findings suggest that there is no evidence of sarcopenia in patients with EM.
Involvement of serotonergic receptors in depressive processes and their modulation by β-arrestins: A review
Authors: Tejeda-Martínez Aldo R. , Ramos-Molina Ana R. , Brand-Rubalcava Patricia A. , Flores-Soto Mario E.
Published: July 2024

Over time, several studies have been conducted to demonstrate the functions of the neurotransmitter 5-hydroxytryptamine (5-HT), better known as serotonin. This neurotransmitter is associated with the modulation of various social and physiological behaviors, and its dysregulation has consequences at the behavioral level, leading to various neurophysiological disorders. Disorders such as anxiety, depression, schizophrenia, epilepsy, sexual disorders, and eating disorders, have been closely linked to variations in 5-HT concentrations and modifications in brain structures, including the raphe nuclei (RN), prefrontal cortex, basal ganglia, hippocampus, and hypothalamus, among others. The involvement of β-arrestin proteins has been implicated in the modulation of the serotonergic receptor response, as well as the activation of different signaling pathways related to the serotonergic system, this is particularly relevant in depressive disorders. This review will cover the implications of alterations in 5-HT receptor expression in depressive disorders in one hand and how β-arrestin proteins modulate the response mediated by these receptors in the other hand.
Publication practices of medical students at medical schools in Palestine: experiences, attitudes, and barriers to publishing
Authors: Jobran Afnan W.M. , AlSamhori Jehad Feras , Atyani Moath Rushdi , Abdulrazzak Mohammed , Islam Zarmina , Safdar Sifwa , Ahmad Shoaib , Ali Hassam
Published: July 2024

Introduction and importance:

The progression in research and studies made by each nation’s scientific communities serves as one of the primary metrics for evaluating that nation’s scientific development; in this study of medical students at Palestinian medical colleges, attention was given to individuals who had been involved in research activities during their undergraduate training.

Materials and methods:

The authors conducted an online survey among medical students in Palestinian medical institutions, focusing on those engaged in research processes throughout their undergraduate studies. The study started in March 2022 and ended in the final week of May 2022. Participants were instructed to respond to statements regarding research work in the online self-administered questionnaire.

Results:

In the authors’ study, out of 425 participants, only 4.9% published an article. There were no significant gender disparities between males and females who published at least one article. There was a strong association between the year of study and publishing, with clinical students being more likely to publish (90.4%) than preclinical students (8.6%). The authors’ study revealed that students published either to enhance their curriculum vitae (33.0%) or out of personal interest (19.0%).

Conclusion:

While participants in the authors’ study demonstrate high levels of awareness and favorable attitudes toward research, active participation in the research community is still insufficient. More opportunity and mentorship are among the stated obstacles to participation in research. To overcome these obstacles, the authors suggest making long-term investments in research training, starting research clubs, and offering coaching and mentorship.
HIV Outcomes Among Women Living With HIV Who Experienced Early Sexual Violence Across Four Sub-Saharan African Countries
Authors: Lee Chiara-lyse , Low Andrea , Kreniske Philip , Mugurungi Owen , Ndagije Felix , Tenthani Lyson , Abrams Elaine J. , Teasdale Chloe A.
Published: July 2024

Background:

Early experiences of sexual violence may influence HIV care and treatment outcomes among women living with HIV (WLHIV). We examined whether self-report by WLHIV of being forced into their first sexual experience was associated with awareness of HIV-positive status, being on antiretroviral therapy (ART) and being virologically suppressed.

Setting:

We conducted a secondary analysis using nationally representative, cross-sectional Population-based HIV Impact Assessment surveys from Lesotho, Malawi, Zambia, and Zimbabwe conducted from 2015 through 2017.

Methods:

Adjusted logistic regression models with survey weights and Taylor series linearization were used to measure the association between forced first sex and 3 HIV outcomes: (1) knowledge of HIV status among all WLHIV, (2) being on ART among WLHIV with known status, and (3) virological suppression among WLHIV on ART.

Results:

Among WLHIV, 13.9% reported forced first sex. Odds of knowledge of HIV status were not different for WLHIV with forced first sex compared with those without (adjusted odds ratio [aOR], 1.17; 95% CI: 0.95 to 1.45). Women living with HIV with forced first sex had significantly lower odds of being on ART (aOR 0.74, 95% CI: 0.57 to 0.96) but did not have lower odds of virological suppression (aOR 1.06, 95% CI: 0.80 to 1.42) compared with WLHIV without forced first sex.

Conclusions:

While high proportions of WLHIV were on ART, report of nonconsensual first sex was associated with a lower likelihood of being on ART which may suggest that early life trauma could influence long-term health outcomes.
Carbapenem-Resistant Citrobacter amalonaticus and VRE Bacteremia in an Immunocompetent Patient after Urologic Rezum Procedure
Authors: Midlick David , Harhay Jason , Summers Nathan A
Published: July 2024

2. Abstract

In this case, we present a 62-year-old man who presented with gross hematuria, fever, and chills one day after undergoing Rezum procedure and found to have carbapenem-resistant Citrobacter amalonaticus and vancomycin-resistant Enterococcus faecalis bacteremia. The patient was treated with daptomycin, eravacycline, and ceftalozane-tazobactam with positive results. We discuss our case and treatment of C. amalonaticus bacteremia, a pathogen with limited existing literature on its incidence, presentation, and treatment.
Noviherbaspirillum album sp. nov., an airborne bacteria isolated from an urban area of Beijing, China
Authors: Li Xia-Yun , Fang Xiao-Mei , Jia Hui-Ting , Bai Jing-Lin , Su Jing , Zhang Yu-Qin , Yu Li-Yan
Published: July 2024

A Gram-negative, ellipsoidal to short-rod-shaped, motile bacterium was isolated from Beijing's urban air. The isolate exhibited the closest kinship with Noviherbaspirillum aerium 122213-3T, exhibiting 98.4 % 16S rRNA gene sequence similarity. Phylogenetic analyses based on 16S rRNA gene sequences and genomes showed that it clustered closely with N. aerium 122213-3T, thus forming a distinct phylogenetic lineage within the genus Noviherbaspirillum. The average nucleotide identity and digital DNA–DNA hybridization values between strain I16B-00201T and N. aerium 122213-3T were 84.6 and 29.4 %, respectively. The respiratory ubiquinone was ubiquinone 8. The major fatty acids (>10 %) were summed feature 3 (C16:1ω6c/C16:1ω7c, 43.3 %), summed feature 8 (C18:1ω7c/C18:1ω6c, 15.9 %) and C12:0 (11.0 %). The polyamine profile showed putrescine as the predominant compound. The polar lipid profile consisted of diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, unknown lipids and unknown phosphatidylaminolipids. The phenotypic, phylogenetic and chemotaxonomic results consistently supported that strain I16B-00201T represented a novel species of the genus Noviherbaspirillum, for which the name Noviherbaspirillum album sp. nov. is proposed, with I16B-00201T (=CPCC 100848T=KCTC 52095T) designated as the type strain. Its DNA G+C content is 59.4 mol%. Pan-genome analysis indicated that some Noviherbaspirillum species possess diverse nitrogen and aromatic compound metabolism pathways, suggesting their potential value in pollutant treatment.