bluuebunny/crossref_metadata_2025 huggingface dataset:
Venetoclax treatment in patients with cancer has limited impact on circulating T and NK cells
Authors: Teh Charis E. , Peng Hongke , Luo Meng-Xiao , Tan Tania , Trussart Marie , Howson Lauren J. , Chua Chong Chyn , Muttiah Christine , Brown Fiona , Ritchie Matthew E. , Wei Andrew H. , Roberts Andrew W. , Bryant Vanessa L. , Anderson Mary Ann , Lindeman Geoffrey J. , Huang David C. S. , Thijssen Rachel , Gray Daniel H. D.
Published: December 2022

Venetoclax is an effective treatment for certain blood cancers, such as chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML). However, most patients relapse while on venetoclax and further treatment options are limited. Combining venetoclax with immunotherapies is an attractive approach; however, a detailed understanding of how venetoclax treatment impacts normal immune cells in patients is lacking. In this study, we performed deep profiling of peripheral blood (PB) cells from patients with CLL and AML before and after short-term treatment with venetoclax using mass cytometry (cytometry by time of flight) and found no impact on the concentrations of key T-cell subsets or their expression of checkpoint molecules. We also analyzed PB from patients with breast cancer receiving venetoclax long-term using a single-cell multiomics approach (cellular indexing of transcriptomes and epitopes by sequencing) and functional assays. We found significant depletion of B-cell populations with low expression of MCL-1 relative to other immune cells, attended by extensive transcriptomic changes. By contrast, there was less impact on circulating T cells and natural killer (NK) cells, with no changes in their subset composition, transcriptome, or function following venetoclax treatment. Our data indicate that venetoclax has minimal impact on circulating T or NK cells, supporting the rationale of combining this BH3 mimetic drug with cancer immunotherapies for more durable antitumor responses.
Molecular barcoding of Melissa officinalis L. (badranjboye) in Iran and identification of adulteration in its medicinal services
Authors: Koohdar Fahimeh , Sheidai Masoud
Published: December 2022

Medicinal plants are an important source for treatment of diseases in many countries. Today, controlling the quality of the products of medicinal plants is an important task. Customer health may be in danger due to the fraud and misconduct by the sales associates in the sales centers. Melissa officinalis L. (Lamiaceae) is an important medicinal plant used for treatment of several diseases. In Iran, the species of Dracocephalum, Hymencrater, Nepeta and Stachys are mistakenly sold under the name of Badranjboye that have different pharmaceutical properties. For avoiding this mistake, this investigation was performed with the following aims: 1) Checking for the cheating and identifying the Badranjboye in the Iran’s market of medicinal plants, 2) Providing the molecular barcode for the medicinal species of Melissa. For this purpose, Market-sold plant samples (leaves) and original reference plant species were compared by morphology, odor as well as Internal transcribed spacer (ITS) and chloroplast DNA ((psbA–trnH) and (trnL–trnF)) sequences. Various molecular analyses, such as sequencing, determination of genetic distance, and construction of phylogenetic tree were performed. These reports have shown that internal transcribed spacer (ITS) and chloroplast DNA (psbA–trnH) sequences are an efficient molecular marker to produce barcode gap and differentiating Melissa officinalis from other species.
The effect of positive end-expiratory pressure on intracranial pressure in obese and non-obese severe brain injury patients: a retrospective observational study
Authors: Zhou Dawei , Li Tong , Fei Shuyang , Wang Chao , Lv Yi
Published: December 2022

Background

The effect of positive end-expiratory pressure (PEEP) on intracranial pressure (ICP) had never been studied in obese patients with severe brain injury (SBI). The main aim was to evaluate the effect of PEEP on ICP in SBI patients with mechanical ventilation according to obesity status.

Methods

SBI patients admitted to the ICU with mechanical ventilation between 2014 and 2015 were included. Demographic, hemodynamic, arterial blood gas, and ventilator data at the time of the paired PEEP and ICP observations were recorded and compared between obese (body mass index ≥ 30 kg/m2) and non-obese SBI patients. Generalized estimating equation (GEE) model was used to assess the relationship between PEEP and ICP in obese and non-obese SBI patients, respectively.

Results

Six hundred twenty-seven SBI patients were included, 407 (65%) non-obese and 220 (35%) obese patients. A total of 30,415 paired PEEP and ICP observations were recorded in these patients, 19,566 (64.3%) for non-obese and 10,849 (35.7%) for obese. In the multivariable analysis, a statistically significant relationship between PEEP and ICP was found in obese SBI patients, but not in non-obese ones. For every cmH2O increase in PEEP, there was a 0.19 mmHg increase in ICP (95% CI [0.05, 0.33], P = 0.007) and a 0.15 mmHg decrease in CPP (95% CI [-0.29, -0.01], P = 0.036) in obese SBI patients after adjusting for confounders.

Conclusions

The results suggested that, contrary to non-obese SBI patients, the application of PEEP may produce an increase in ICP in obese SBI patients. However, the effect was modest and may be clinically inconsequential.
Psychometric properties of the Arabic version of the Oviedo Grit Scale (A-EGO) in non-clinical adults from the general population
Authors: Fekih-Romdhane Feten , Postigo Álvaro , González-Nuevo Covadonga , Dabbous Mariam , Malaeb Diana , Obeid Sahar , Hallit Souheil
Published: December 2022

Background

Given the high clinical utility of grit, and the lack of measures that assess this construct among the Arabic-speaking populations, we propose to examine the psychometric properties of an Arabic translation of the Oviedo Grit Scale (A-EGO) in terms of internal consistency, factor structure, convergent validity, and measurement invariance in a sample of Lebanese adults from the general population.

Methods

We performed a cross-sectional, online study among 575 participants from the Lebanese general population (mean age = 26.28 years [SD: 8.83], 72.7% females). The unidimensional factorial structure of the A-EGO was analyzed by confirmatory factor analysis (CFA) using the MPlus8 program. The mean and variance adjusted weighted least squares (WLSMV) was used as the estimation method. The reliability of the scores, the evidence of validity in terms of measurement invariance and correlation with other variables were analyzed.

Results

The present results show that the 10 items of the A-EGO loaded on one factor. The internal consistency was excellent in our sample, as evidenced by a Cronbach’s alpha value of .93. Multi-group confirmatory factor analyses demonstrated invariance across gender, governorate, and marital status at the configural, metric and scalar levels. Additionally, A-EGO scores showed moderate and positive correlations with self-control (r = .442), conscientiousness (r = .478), and productiveness facet (r = .506), supporting the convergent validity of the A-EGO.

Conclusion

Our findings indicate that the A-EGO has good psychometric properties and can be recommended for the assessment of grit among the broader Arabic-speaking people worldwide. Making this scale available in the Arabic language will hopefully foster research in this area in Arab countries.
Co-development of an evidence-based personalised smoking cessation intervention for use in a lung cancer screening context
Authors: Quinn-Scoggins Harriet D. , Murray Rachael L. , Quaife Samantha L. , Smith Pamela , Brain Kate E. , Callister Matthew E. J. , Baldwin David R. , Britton John , Crosbie Philip A. J. , Thorley Rebecca , McCutchan Grace M.
Published: December 2022

Background

Optimising smoking cessation services within a low radiation-dose computed tomography (LDCT) lung cancer screening programme has the potential to improve cost-effectiveness and overall efficacy of the programme. However, evidence on the optimal design and integration of cessation services is limited. We co-developed a personalised cessation and relapse prevention intervention incorporating medical imaging collected during lung cancer screening. The intervention is designed to initiate and support quit attempts among smokers attending screening as part of the Yorkshire Enhanced Stop Smoking study (YESS: ISRCTN63825779). Patients and public were involved in the development of an intervention designed to meet the needs of the target population.

Methods

An iterative co-development approach was used. Eight members of the public with a history of smoking completed an online survey to inform the visual presentation of risk information in subsequent focus groups for acceptability testing. Three focus groups (n = 13) were conducted in deprived areas of Yorkshire and South Wales with members of the public who were current smokers or recent quitters (within the last year). Exemplar images of the heart and lungs acquired by LDCT, absolute and relative lung cancer risk, and lung age were shown. Data were analysed thematically, and discussed in stakeholder workshops. Draft versions of the intervention were developed, underpinned by the Extended Parallel Processing Model to increase self-efficacy and response-efficacy. The intervention was further refined in a second stakeholder workshop with a patient panel.

Results

Individual LDCT scan images of the lungs and heart, in conjunction with artistic impressions to facilitate interpretation, were considered by public participants to be most impactful in prompting cessation. Public participants thought it important to have a trained practitioner guiding them through the intervention and emphasising the short-term benefits of quitting. Presentation of absolute and relative risk of lung cancer and lung age were considered highly demotivating due to reinforcement of fatalistic beliefs.

Conclusion

An acceptable personalised intervention booklet utilising LDCT scan images has been developed for delivery by a trained smoking cessation practitioner. Our findings highlight the benefit of co-development during intervention development and the need for further evaluation of effectiveness.
Relapse in class II orthognathic surgery: a systematic review
Authors: Eckmüller Stephanie , Paddenberg Eva , Hiller Karl-Anton , Proff Peter , Knüttel Helge , Kirschneck Christian
Published: December 2022

Objectives

Relapse after orthognathic surgery seems to depend on diverse factors. Proffit et al. postulated in 2007 a “hierarchy of stability” (Head Face Med 6:66, 2007), ranking posttreatment stability after various orthognathic procedures, but no systematically reviewed evidence was provided. Therefore, the aim of this review was to investigate the extent of class II relapse in orthognathic surgery of Angle class II patients depending on the surgical procedure used.

Materials and methods

Seven databases were searched for randomized and controlled clinical trials to compare relapse in surgical procedures for Angle class II patients. After duplicate study selection, data extraction and risk of bias assessment were performed with the ROBINS-I tool as well as data synthesis by frequency distribution, followed by assessment of the quality of evidence with GRADE.

Results

Four non-randomized cohort-studies with a total of 132 patients were included. Bimaxillary procedures as well mandibular advancement procedures proved to be highly stable. Single jaw interventions at the maxilla achieved mostly stable results at sagittal dimension and problematic stability in the vertical dimension. However, there were only limited data available with low quality of evidence.

Conclusions

Limited existing evidence of low quality partly support the postulated hierarchy of stability of Proffit et al. (Head Face Med 6:66, 2007) and indicates that a surgical correction of class II dysgnathia with bimaxillary procedures and mandibular advancement seems to be highly stable. However, additional studies are needed to address the relation between relapse and surgical orthognathic intervention.

Trial registration PROSPERO 2019 CRD42019144873.
The societal impact of implementing an at-home blood sampling device for chronic care patients: patient preferences and cost impact
Authors: Lingervelder Deon , Kip Michelle M. A. , Wiese Eva D. , Koffijberg Hendrik , Ijzerman Maarten J. , Kusters Ron
Published: December 2022

Background

Diabetes mellitus, cardiovascular diseases, chronic kidney disease, and thyroid diseases are chronic diseases that require regular monitoring through blood tests. This paper first investigates the experiences of chronic care patients with venipuncture and their expectations of an at-home blood-sampling device, and then assesses the impact on societal costs of implementing such a device in current practice.

Methods

An online survey was distributed among chronic care patients to gain insight into their experience of blood sampling in current practice, and their expectations of an at-home blood-sampling device. The survey results were used as input parameters in a patient-level monte carlo analysis developed to represent a hypothetical cohort of Dutch chronically ill patients to investigate the impact on societal costs compared to usual care.

Results

In total, 1311 patients participated in the survey, of which 31% experience the time spent on the phlebotomy appointment as a burden. Of all respondents, 71% prefer to use an at-home blood-sampling device to monitor their chronic disease. The cost analysis indicated that implementing an at-home blood-sampling device increases the cost of phlebotomy itself by €27.25 per patient per year, but it reduces the overall societal costs by €24.86 per patient per year, mainly due to limiting productivity loss.

Conclusions

Patients consider an at-home blood-sampling device to be more user-friendly than venous phlebotomy on location. Long waiting times and crowded locations can be avoided by using an at-home blood-sampling device. Implementing such a device is likely cost-saving as it is expected to reduce societal costs.
The satisfaction with radiology residency training in China: results of a nationwide survey
Authors: Wang Peicheng , Zhang Jingfeng , Chen Yanhua , He Yanrong , Shen Lijun , Jiang Maoqing , Yang Zhenghan , Zheng Jianjun , Wang Zhenchang , Zhu Jiming
Published: December 2022

Background

National data on the satisfaction of radiology residents enrolled in standardized residency training (SRT) are rather scarce in China. This study identified a set of potential factors concerning SRT satisfaction among radiology residents as well as the association between SRT satisfaction and post-competency and well-being.

Methods

A total of 3666 radiology residents who were receiving SRT during 2020 in China were recruited across all 31 provinces. The cumulative odds logistic regression was used to examine the potential factors associated with SRT satisfaction as well as associations between satisfaction and well-being, burnout, professional identity and competency.

Results

The prevalence of satisfaction with SRT was 68.6%. Participants who were male, worked in central China, aged more than 28 years old, had long working hours and claimed increased workload during the COVID-19 pandemic were more likely to be unsatisfied with the SRT program. Participants who were more satisfied with the radiation protection were more likely to report higher degree of SRT satisfaction (OR = 3.00, 95% CI 2.58–3.50). In addition, SRT satisfaction was positively associated with well-being, professional identity, competency and lower burnout.

Conclusions

Perceived satisfaction can be introduced into hospital management, as it may reflect the overall situation of the residents during residency training and influence radiologists’ well-being, professional identification and competency. Appropriate measures should be taken to reduce the risk of radiation exposure, ensure employee safety (such as risk assessment system and paid time off), provide radiology residents with fair treatment and guarantee the time out of working for optimizing their professional ability.
Primary leiomyosarcoma of the spine: an analysis of imaging manifestations and clinicopathological findings
Authors: Zhang Jiahui , Chen Yongye , Xing Xiaoying , Wang Qizheng , Liu Ke , Zhang Enlong , Lang Ning
Published: December 2022

Background

Primary leiomyosarcoma of the spine is extremely rare and lacks specific clinical symptoms. This study investigated the imaging manifestations and clinicopathological findings of primary leiomyosarcoma of the spine, aiming to improve the radiologists’ understanding of the disease and reduce misdiagnoses.

Methods

The clinical, imaging, and pathological manifestations in eleven patients with pathologically confirmed primary leiomyosarcoma of the spine were retrospectively analyzed. The imaging features analyzed included lesion location, shape, border, size, and density/intensity, and adjacent bone destruction status, residual bone trabeculae, vertebral compression, and contrast enhancement.

Results

The patients’ primary clinical symptom was usually focal pain. Primary leiomyosarcoma of the spine was mostly a solitary lesion and tended to occur in the posterior elements. The tumors had a lobulated shape with osteolytic bone destruction, ill-defined borders, and could involve multiple segments. Computed tomography (CT) examination showed isodense masses. Six patients showed residual bone trabeculae. Two patients had miscellany T2-weighted imaging (T2WI) signals, while the tumor and spinal cord of the remaining patients were isointense on T1-weighted imaging (T1WI) and T2WI. Among the seven patients who underwent contrast-enhanced scanning, six displayed homogeneous enhancement. Eight patients underwent gross-total tumor resection with no recurrence.

Conclusions

Primary leiomyosarcoma of the spine tends to be a solitary lesion in the posterior elements and appears as a lobulated mass with osteolytic bone destruction and an ill-defined border. The tumor and spinal cord can be isointense on T1WI and T2WI. Contrast-enhanced scanning displays homogeneous enhancement. The lesion tends not to recur after surgical gross-total tumor resection.
Oxidative stress biomarkers in dogs with benign prostatic hyperplasia
Authors: Domoslawska Anna , Zduńczyk Sławomir , Kankofer Marta , Bielecka Arleta
Published: December 2022

Background

The aim of this study was to evaluate total antioxidant capacity (TAC) and biomarkers of lipid and protein peroxidation in the blood serum of dogs with benign prostatic hyperplasia (BPH). The study was conducted on 36 intact male dogs of various breeds. The dogs were assigned to two groups: BPH group (n = 18) and non-affected group (n = 18). Blood samples were collected from the cephalic vein. The antioxidant status of the serum was assessed using TAC. The levels of bityrosine, formylkynurenine and SH-groups were used as protein peroxidation biomarkers and the level of radical cations of N,N-diethyl-paraphenylene diamine (RC-DEPPD) was used as a marker for lipid peroxidation. TAC and the concentrations of SH-groups and RC-DEPPD in the serum were determined spectrophotometrically, the concentrations of bityrosine and formylokynurenine, were determined using spectrofluorimetric methods.

Results

The mean value of TAC in the serum was significantly lower (P = 0.01) in BPH dogs than in non-affected dogs (3.10 ± 0.56 vs 4.20 ± 1.60 μmol/g protein). Mean levels of protein and lipid oxidation biomarkers showed a trend towards oxidative imbalance, but there were no statistically significant differences between dogs with BPH and controls (P > 0.05).

Conclusion

In conclusion, significantly lower serum TAC in dogs with BPH compared to non-affected dogs suggests a potential involvement of oxidative stress in the pathogenesis of BPH in dogs. More studies are needed to clarify the role of oxidative stress in the development of BPH in dogs.
Prevention of violence against children in the home: an overview of reviews protocol
Authors: Cuartas Jorge , McCoy Dana , Yoshikawa Hirokazu , Bass Michelle , Salazar Ana , Metheny Nicholas , Knaul Felicia
Published: December 2022

Background

Violence against children (VAC) in the home, or by household members, is a widespread problem with devastating and costly consequences for individuals and societies. In the past two decades, much research has been dedicated to the prevention of VAC in the home, in particular, in low- and- middle-income countries, but there are few systematic examinations of the growing body of literature. We present a protocol for an overview of reviews to synthesize the evidence from recent reviews on the effectiveness and characteristics of both universal and selective interventions to prevent VAC in the home or by household members.

Methods

We will conduct an overview of reviews of quantitative studies of universal and selective interventions to prevent VAC in the home published after 2000. Our outcomes will be VAC in the home (e.g., physical, sexual, or psychological violence or neglect) and drivers or direct risk factors for VAC (e.g., beliefs or attitudes towards VAC, parenting stress). We will search for reviews in multiple databases using controlled vocabularies and keywords. We will use the AMSTAR 2 to assess the quality of reviews and will extract information on outcomes, main results, and geographic distribution of primary studies, among other data. We will conduct a narrative synthesis of the findings.

Discussion

The proposed overview will provide timely evidence on effective strategies to prevent VAC in the home and will identify the key strengths and limitations of the current body of evidence on this topic. In doing so, we will inform future research, policy, and practice aimed at building effective strategies to prevent VAC globally.

Systematic review registration

PROSPERO CRD42022304784.
Normalized generalized Bessel function and its geometric properties
Authors: Zayed Hanaa M. , Bulboacă Teodor
Published: December 2022

The normalization of the generalized Bessel functions $\mathrm{U}_{\sigma,r}$

U

σ
,
r

$(\sigma,r\in \mathbb{C}\mathbbm{)}$
(
σ
,
r
∈

C
)

defined by $$\begin{aligned} \mathrm{U}_{\sigma,r}(z)=z+\sum_{j=1}^{\infty} \frac{(-r)^{j}}{4^{j} (1)_{j}(\sigma )_{j}}z^{j+1} \end{aligned}$$

U

σ
,
r

(
z
)
=
z
+

∑

j
=
1

∞

(
−
r
)

j

4
j

(
1
)

j

(
σ
)

j

z

j
+
1

was introduced, and some of its geometric properties have been presented previously. The main purpose of the present paper is to complete the results given in the literature by employing a new procedure. We first used an identity for the logarithmic of the gamma function as well as an inequality for the digamma function to establish sufficient conditions on the parameters so that $\mathrm{U}_{\sigma,r}$

U

σ
,
r

is starlike or convex of order α$(0\leq \alpha \leq 1)$
(
0
≤
α
≤
1
)
in the open unit disk. Moreover, the starlikeness and convexity of $\mathrm{U}_{\sigma,r}$

U

σ
,
r

have been considered where the leading concept of the proofs comes from the starlikeness of the power series $f(z)=\sum_{j=1}^{\infty}A_{j}z^{j}$
f
(
z
)
=

∑

j
=
1

∞

A
j

z
j

and the classical Alexander theorem between the classes of starlike and convex functions. We gave a simple proof to show that our conditions are not contradictory. Ultimately, the close-to-convexity of $(z\cos \sqrt{z} ) \ast \mathrm{U}_{\sigma,r}$
(
z
cos

z

)
∗

U

σ
,
r

and $(\sin z ) \ast \frac {\mathrm{U}_{\sigma,r}(z^{2})}{z}$
(
sin
z
)
∗

U

σ
,
r

(

z
2

)

z

have been determined, where “∗” stands for the convolution between the power series.
Quercetin inhibits the progression of endometrial HEC-1-A cells by regulating ferroptosis—a preliminary study
Authors: Li Xiaoqin , Zhu Qianqian , Ma Meng , Guo Haiyan
Published: December 2022

Background

Endometrial carcinoma (EC) is one of the most common female reproductive system tumors, which seriously threatens women's health. This preliminary study aimed to investigate the effects of quercetin on the EC cells and explore the potential mechanism.

Methods

In this study, the effects of quercetin on endometrial cancer HEC-1-A cells were studied by a series of cell biological methods, including CCK-8 detection of cell activity, Western blotting of ferroptosis-related proteins, apoptosis detection, reactive oxygen species (ROS) detection and other detections.

Results

Our results showed that quercetin inhibited the proliferation and migration of EC cells, induced cell apoptosis, and affected the cell cycle. Furthermore, the anti-tumor effect of quercetin was related to the induction of ferroptosis in the EC cells.

Conclusions

Our study shows quercetin may exert anti-tumor effects, which may be related to the regulation of ferroptosis. Our study provides evidence for the future treatment of EC with small molecule drugs.
Limosilactobacillus reuteri and caffeoylquinic acid synergistically promote adipose browning and ameliorate obesity-associated disorders
Authors: Liu Yameng , Zhong Xianchun , Lin Suqin , Xu Hualing , Liang Xinyu , Wang Yibin , Xu Jingyi , Wang Kanglong , Guo Xiaozhen , Wang Jiawen , Yu Minjun , Li Cuina , Xie Cen
Published: December 2022

Objective

High intake of caffeoylquinic acid (CQA)-rich dietary supplements, such as green coffee bean extracts, offers health-promoting effects on maintaining metabolic homeostasis. Similar to many active herbal ingredients with high pharmacological activities but low bioavailability, CQA has been reported as a promising thermogenic agent with anti-obesity properties, which contrasts with its poor oral absorption. Intestinal tract is the first site of CQA exposure and gut microbes might react quickly to CQA. Thus, it is of interest to explore the role of gut microbiome and microbial metabolites in the beneficial effects of CQA on obesity-related disorders.

Results

Oral CQA supplementation effectively enhanced energy expenditure by activating browning of adipose and thus ameliorated obesity-related metabolic dysfunctions in high fat diet-induced obese (DIO) mice. Here, 16S rRNA gene amplicon sequencing revealed that CQA treatment remodeled the gut microbiota to promote its anti-obesity actions, as confirmed by antibiotic treatment and fecal microbiota transplantation. CQA enriched the gut commensal species Limosilactobacillus reuteri (L. reuteri) and stimulated the production of short-chain fatty acids, especially propionate. Mono-colonization of L. reuteri or low-dose CQA treatment did not reduce adiposity in DIO mice, while their combination elicited an enhanced thermogenic response, indicating the synergistic effects of CQA and L. reuteri on obesity. Exogenous propionate supplementation mimicked the anti-obesity effects of CQA alone or when combined with L. reuteri, which was ablated by the monocarboxylate transporter (MCT) inhibitor 7ACC1 or MCT1 disruption in inguinal white adipose tissues to block propionate transport.

Conclusions

Our data demonstrate a functional axis among L. reuteri, propionate, and beige fat tissue in the anti-obesity action of CQA through the regulation of thermogenesis. These findings provide mechanistic insights into the therapeutic use of herbal ingredients with poor bioavailability via their interaction with the gut microbiota.
Total arch and descending thoracic aortic replacement for massive hemoptysis requiring CPR caused by intrapulmonary penetration of chronic dissecting aortic aneurysm: a case report
Authors: Mikami Tsubasa , Yamauchi Takashi , Sakakibara Satoshi , Ito Yoshito , Suhara Hitoshi , Hayashi Yukio , Kuratani Toru , Masai Takafumi , Sawa Yoshiki
Published: December 2022

Background

Intrapulmonary penetration of the thoracic aorta is a rare, life-threatening complication of a chronic dissecting aortic aneurysm. It causes massive hemoptysis requiring prompt intervention to prevent fatal airway bleeding. A surgical approach that enables diverse surgical maneuvers and intraoperative organ protection is crucial.

Case presentation

A 62-year-old man, who underwent graft replacement of the ascending aorta for an acute type A aortic dissection 20 months before, developed massive hemoptysis and cardiac arrest. The hemoptysis was secondary to an aortopulmonary fistula from a rapidly expanding dissecting aortic aneurysm. However, a successful return of spontaneous circulation was achieved with cardiopulmonary resuscitation, including establishment of veno-arterial extracorporeal membrane oxygenation. The patient successfully underwent a total arch and descending thoracic aortic replacement. This was achieved by a median sternotomy combined with a left thoracotomy using a straight incision with a rib-cross (SIRC) approach. The patient was uneventfully discharged and remained well for the following 2 years.

Conclusions

When performing a surgical graft replacement for an aortopulmonary fistula with a thoracic aortic aneurysm, the surgical approach chosen is critical. A surgical procedure using a median sternotomy combined with a left thoracotomy and a SIRC approach can be an effective therapeutic option.
Selection and validation of reference genes for the normalization of quantitative real-time PCR in different muscle tissues of rabbits
Authors: Ni Mengke , Li Zhichao , Li Jing , He Hui , Wang Yaling , Jiang Yixuan , Wang Xianwei , Li Zhuanjian , Li Ming , Xu Huifen
Published: December 2022

Background

In molecular biology studies, the selection of optimal reference genes is of vital importance for accurately quantifying gene expression. The purpose of the present study was to screen the most stable reference genes in different muscle tissues of New Zealand white rabbits and Yufeng yellow rabbits.

Methods and results

Results indicated that the most stable reference genes in the muscle tissues of New Zealand white rabbits were HPRT1, ACTB and PPIC, while HPRT1, PPIC, and RPL13A were the most stable reference genes in muscle tissues of Yufeng yellow rabbits. However, in the longissimus dorsi muscle and the abdominal wall muscle of both varieties, the most stable reference genes were HPRT1, RPL13A, and SDHA. In the quadriceps femoris muscle, the most stable reference genes were ACTB, HPRT1, and SDHA. Furthermore, the relative abundance of MYOG, MYH3 and MSTN was used to confirm the suitability and reliability of the selected most stable reference genes and the most unstable reference gene. Results revealed the same expression patterns of these myogenic genes when normalized according to the most stable genes, while normalization against the unstable reference gene altered the observed expression patterns.

Conclusions

Taken together, our results demonstrated that the most stable reference genes varied among different muscle tissues and different breeds of rabbits. However, HPRT1, PPIC and SDHA presented high stability among all examined reference genes; thus, the combined analysis of HPRT1/ PPIC/ SDHA gene provides the best reference for RT-qPCR in muscle tissues of New Zealand white rabbits and Yufeng yellow rabbits, while HPRT1 is a better choice than other reference genes when using a single reference gene to assess target gene expression. Our results provide basic data for better measuring target gene expression profiles in muscle tissues of rabbits.
Patterns and barriers of mental health service utilization among medical students: a cross-sectional study
Authors: Abdel-Hady Doaa , Baklola Mohamed , Terra Mohamed , El-Gilany Abdel-Hady
Published: December 2022

Background

The prevalence of mental health problems among medical students has been steadily rising. It is greater than the prevalence of mental health problems among other students, negatively impacting students, and their future careers. The study aims to estimate the prevalence of the self-reported need for mental health care, the pattern of utilization of mental health services, and the different barriers that hinder medical students from seeking professional help.

Results

This study was conducted among medical students at Mansoura University, using a structured self-reported online questionnaire to collect the need for mental health services, sociodemographic details, the pattern of utilization of mental health services, and the barriers using a Likert scale of 30 items named Barriers to Access to Care Evaluation Version 3. According to this study, 77.77% felt the need for mental health care. The independent predictors for feeling the need for mental health care were female sex and urban residence with an adjusted odds ratio of 2.7 and 1.9, respectively. Regarding mental healthcare needs, most of the barriers were instrumental and attitudinal related. Lack of information about how to access services and solve the problem by themselves was the most common barriers followed by time and financial affords.

Conclusions

It appears that Mansoura medical students are at higher risk of feeling the need for mental care. Considerable barriers to help-seeking remain prevalent, including both logistical (e.g., time) and informational (e.g., lack of knowledge about the available services).
Electrocorticography-Guided Resection Enhances Postoperative Seizure Freedom in Low-Grade Tumor-Associated Epilepsy: A Systematic Review and Meta-Analysis
Authors: Warsi Nebras M. , Mohammad Amro H. , Zhang Frederick , Wong Simeon M. , Yan Han , Mansouri Alireza , Ibrahim George M.
Published: December 2022

BACKGROUND:

Low-grade cerebral neoplasms are commonly associated with medically intractable epilepsy. Despite increasing evidence that epileptogenic brain regions commonly extend beyond visible tumor margins, the utility of extended surgical resections leveraging intraoperative electrocorticography (ECoG) remains unclear.

OBJECTIVE:

To determine whether ECoG-guided surgery is associated with improved postoperative seizure control.

METHODS:

We performed a systematic review and meta-analysis encompassing both adult and pediatric populations. The primary outcome measure was postoperative seizure freedom as defined by Engel class I outcome. Class I/II outcome served as a secondary measure. Relevant clinical and operative data were recorded. A random-effects meta-analysis based on the pooled odds ratio (OR) of seizure freedom was performed on studies that reported comparative data between ECoG-guided surgery and lesionectomy.

RESULTS:

A total of 31 studies encompassing 1115 patients with medically refractory epilepsy met inclusion criteria. Seven studies reported comparative data between ECoG-guided surgery and lesionectomy for meta-analysis. Tumor resection guided by ECoG was associated with significantly greater postoperative seizure freedom (OR 3.95, 95% CI 2.32-6.72, P < .0001) and class I/II outcome (OR 5.10, 95% CI 1.97-13.18, P = .0008) compared with lesionectomy. Postoperative adverse events were rare in both groups.

CONCLUSION:

These findings provide support for the utilization of ECoG-guided surgery to improve postoperative seizure freedom in cases of refractory epilepsy associated with low-grade neoplasms. However, this effect may be attenuated in the presence of concomitant cortical dysplasia, highlighting a need for improved presurgical and intraoperative monitoring for these most challenging cases of localization-related epilepsy.
Ocular Optical Coherence Tomography in the Evaluation of Sellar and Parasellar Masses: A Review
Authors: Banc Ana , Biousse Valérie , Newman Nancy J. , Kedar Sachin
Published: December 2022

Compression of the anterior visual pathways by sellar and parasellar masses can produce irreversible and devastating visual loss. Optical coherence tomography (OCT) is a noninvasive high-resolution ocular imaging modality routinely used in ophthalmology clinics for qualitative and quantitative analysis of optic nerve and retinal structures, including the retinal ganglion cells. By demonstrating structural loss of the retinal ganglion cells whose axons form the optic nerve before decussating in the optic chiasm, OCT imaging of the optic nerve and retina provides an excellent tool for detection and monitoring of compressive optic neuropathies and chiasmopathies due to sellar and parasellar masses. Recent studies have highlighted the role of OCT imaging in the diagnosis, follow-up, and prognostication of the visual outcomes in patients with chiasmal compression. OCT parameters of optic nerve and macular scans such as peripapillary retinal nerve fiber layer thickness and macular ganglion cell thickness are correlated with the degree of visual loss; additionally, OCT can detect clinically significant optic nerve and chiasmal compression before visual field loss is revealed on automated perimetry. Preoperative values of OCT optic nerve and macular parameters represent a prognostic tool for postoperative visual outcome. This review provides a qualitative analysis of the current applications of OCT imaging of the retina and optic nerve in patients with anterior visual pathway compression from sellar and parasellar masses. We also review the role of new technologies such as OCT-angiography, which could improve the prognostic ability of OCT to predict postoperative visual function.
Subclassification of Knosp Grade 4 Pituitary Adenoma: Bringing Insights Into the Significance of Tumor Growth Pathways
Authors: Xiao Limin , Ouyang Taohui , Wu Bowen , Xie Shenhao , Tang Bin , He Yulin , Ding Han , Wu Xiao , Hong Tao
Published: December 2022

BACKGROUND:

Understanding the growth pathway of Knosp grade 4 pituitary adenoma (KG4PA) has a direct impact on surgical planning and safety for tumor eviction.

OBJECTIVE:

To analyze the different characteristics between KG4PAs with a focus on the tumor growth pathway and its relationship to the cavernous segment of internal carotid artery.

METHODS:

Clinical data from 129 patients with KG4PAs who underwent endoscopic endonasal surgery were retrospectively reviewed. A subclassification scheme was proposed based on the tumor growth pathway and its relevant features. The clinical connotation of the subclassification on surgical outcomes was also analyzed.

RESULTS:

The KG4PAs were classified into 3 types based on the tumor growth pathway and its relevant features: groups A, B, and AB. The gross total resection rate in group A (51.2%) was much lower than that in group B (87.5%) and AB (87%) with a significant difference between the 3 groups (P = .0004). The overall rate of visual function improvement, preoperative cranial nerve (CN) palsy improvement, and postoperative hormonal remission was 85.1%, 83.3%, and 85.7%, respectively. The rate of transient CN palsy, permanent CN palsy, permanent diabetes insipidus, panhypopituitarism, CSF leakage, and internal carotid artery injury was 7.8%, 3.9%, 4.7%, 2.3%, 1.5%, and 0.7%, respectively.

CONCLUSION:

The subclassification strengthens our understanding of KG4PAs on tumor growth corridors and topographic relations of tumor and cavernous segment of internal carotid artery. Furthermore, the distinction into groups 4A, 4B, and 4AB is of benefits for selecting approaches, predicting risk and avoiding complications, and generating more tailored individualized surgical strategies for KG4PAs with better outcomes.
Intraoperative Ultrasonography in Endoscopic Approaches for Orbital Lesions: A Single-Center Case Series
Authors: Zoli Matteo , Sollini Giacomo , Martinoni Matteo , Rustici Arianna , Guaraldi Federica , Asioli Sofia , Fabbri Viscardo Paolo , Cirillo Luigi , Pasquini Ernesto , Mazzatenta Diego
Published: December 2022

BACKGROUND:

Recently, endoscopic approaches for orbital lesions have been proposed. Their results seem promising; however, orbital surgery remains challenging with possible significant morbidity, mostly because of orbital structures manipulation. Ultrasonography is an innovative intraoperative imaging technique that can assist the surgeon in these approaches.

OBJECTIVE:

To assess the role of intraoperative ultrasound (IOUS) in endoscopic orbital surgery.

METHODS:

All consecutive patients with orbital tumors operated in our institution through an endoscopic approach with IOUS have been prospectively collected from 2019 to May 2021.

RESULTS:

Fifteen patients were included. Based on tumor location, evaluated on preoperative MRI, the endoscopic endonasal approach was preferred in 7 tumors in medial quadrants while the endoscopic transpalpebral in 8 lateral ones. During surgery, IOUS allowed us to identify the tumors and the most relevant anatomic structures in all cases. Time spent for IOUS preparation before the first scan was 8 ± 6 minutes on average, and each intraoperative scan took approximately 30 to 120 seconds. Gross tumor removal was achieved in 8 patients, subtotal in 3, while in 4 patients, surgery was limited to a biopsy. No surgical complications were observed.

CONCLUSION:

IOUS has allowed us to localize the lesion and to identify the straighter surgical corridor and assess the tumor resection, effectively helping the surgeon and potentially reducing operative complications. This tool provides a real-time image, not affected by the orbital structures shift, which can be dynamically assessed multiple times during surgery. However, it is hampered by the need of specific training and possible artifacts.
In-Human Report of S2 Alar-Iliac Screw Placement Using Augmented Reality Assistance
Authors: Judy Brendan F. , Liu Ann , Jin Yike , Ronkon Charles , Khan Majid , Cottrill Ethan , Ehresman Jeff , Pennington Zach , Bydon Ali , Lo Sheng-Fu L. , Sciubba Daniel M. , Molina Camilo A. , Witham Timothy F.
Published: December 2022

BACKGROUND:

S2 alar-iliac (S2AI) screws provide spinopelvic fixation with the advantages of minimized dissection, easier rod contouring, and decreased symptomatic screw-head prominence. However, placement of S2AI screws may be challenging because of the anatomy of the lumbosacral junction. Augmented reality is a nascent technology that may enhance placement of S2AI screws.

OBJECTIVE:

To report the first in-human placement of augmented reality (AR)–assisted S2 alar-iliac screws and evaluate the accuracy of screw placement.

METHODS:

A retrospective review was performed of patients who underwent AR-assisted S2AI screw placement. All surgeries were performed by 2 neurosurgeons using an AR head-mounted display (Xvision, Augmedics). Screw accuracy was analyzed in a blinded fashion by an independent neuroradiologist using the cortical breach grading scale.

RESULTS:

Twelve patients underwent AR-assisted S2AI screw placement for a total of 23 screws. Indications for surgery included deformity, degenerative disease, and tumor. Twenty-two screws (95.6%) were accurate—defined as grade 0 or grade 1. Twenty-one screws (91.3%) were classified as grade 0, 1 screw (4.3%) was grade 1, and 1 screw (4.3%) was grade 3. All breaches were asymptomatic.

CONCLUSION:

AR-assisted S2AI screw placement had an overall accuracy rate of 95.6% (grade 0 and grade 1 screws) in a cohort of 12 patients and 23 screws. This compares favorably with freehand and robotic placement.
1,2
AR enables spine surgeons to both better visualize anatomy and accurately place spinal instrumentation. Future studies are warranted to research the learning curve and cost analysis of AR-assisted spine surgery.
Infiltrating circulating monocytes provide an important source of BMP4 at the early stage of spinal cord injury
Authors: Shen Weiyun , Liu Shuxin , Wei Xiaojing , Wang Yaping , Yang Lin
Published: December 2022

Bone morphogenetic protein (BMP)4 plays a critical role in regulating neuronal and glial activity in the course of spinal cord injury (SCI). The underlying cause and cellular source of BMP4 accumulation at the injured spinal cord remain unclear. Here, we observed that plasma BMP4 levels are statistically higher in SCI patients than in healthy donors. When comparing rats in the sham group (T9 laminectomy without SCI) with rats in the SCI group, we found a persistent decline in BBB scores, together with necrosis and mononuclear cell accumulation at the contusion site. Moreover, during 2 weeks after SCI both plasma and cerebrospinal fluid levels of BMP4 displayed notable elevation, and a positive correlation. Importantly, percentages of circulating BMP4-positive (BMP4+) monocytes and infiltrating MDMs were higher in the SCI group than in the sham group. Finally, in the SCI+clodronate liposome group, depletion of monocytes effectively attenuated the accumulation of both BMP4+ MDMs and BMP4 in the injured spinal cord. Our results indicated that, following SCI, infiltrating MDMs provide an important source of BMP4 in the injured spinal cord and, therefore, might serve as a potential therapeutic target.
In silico and in vitro analysis of THCA synthase gene in Moroccan Cannabis sativa, L
Authors: Badrana Fadwa , El Fahime El Mostafa , Mokhtari Abdelrhani , Soulaymani Abdelmajid , Safini Najete , Chaouni Bouchra , Malka Gabriel , El Amri Hamid
Published: December 2022

Background: Cannabis ( Cannabis sativa, L.) is an archaic, most infamous plant with unique therapeutic characteristics, and great economic interest. The identification of its THCAS synthesizing enzyme was a great leap forward in Cannabis investigation. However, basic molecular biology for THCAS gene expression remains largely unstudied. In this paper, we explored the ability of bioinformatics resources in the design of molecular cloning protocol and prediction of three-dimensional structure of recombinant THCAS in Moroccan Cannabis sativa variety.

Methods:  We described conventional experiments performed in vitro. We used specific primers to isolate the nucleotide sequence of THCAS from the leaves of Cannabis, without including the native signal sequence.we prepared the gene by amors containing specific adapters to integrate the gene into the expression vector PpinkαHC, transforming E.coli bacteria, in order to express the gene in Pichia pasteri yeast.

Results: As a result, we found high sequence similarity with THCAS and the mRNA precursor of the same gene as previously reported. In addition, we predicted the structure of the recombinant THCAS using the organic crystal structure prediction method, the amino acid sequence reference, and the artificial intelligence technology.

Conclusions: In this study, we have successfuly cloned recombinant THCAS enzyme in E.Coli for further expression in host Pichia pastori.
Factors affecting HBV DNA suppression in chronic hepatitis B patients treated with tenofovir disoproxil fumarate
Authors: Darmadi Darmadi , Lindarto Dharma , Siregar Jelita , Widyawati Tri , Rusda Muhammad , Amin Mustafa Mahmud , Yusuf Fauzi , Eyanoer Putri Chairani , Lubis Masrul , Rey Imelda
Published: December 2022

Background: This study aims to determine the factors affecting HBV DNA suppression in chronic hepatitis B patients with tenofovir disoproxil fumarate (TDF).

Methods: A case-control was carried out from October 2021 to August 2022 on 182 chronic hepatitis B patients who had TDF therapy regularly for 24 weeks at H. Adam Malik and USU Hospitals in Medan, Indonesia. The history of the samples was obtained, followed by physical examination, and blood collection. CTLA-4 polymorphism examination was carried out using real-time PCR, while the serum CTLA-4 levels were assessed with ELISA.

Results: The results showed that CTLA-4, HBV DNA, ALT, and CTLA-4 -1661G>A polymorphisms have a relationship with HBV DNA suppression in chronic hepatitis B patients with TDF.

Conclusions: The levels of CTLA-4, HBV DNA, ALT, and CTLA-4 -1661G>A polymorphism have a potential relationship with the suppression of HBV DNA in chronic hepatitis B patients with TDF.