bluuebunny/crossref_metadata_2025 huggingface dataset:
Single-center Experience With Upadacitinib for Adolescents With Refractory Inflammatory Bowel Disease
Authors: Spencer Elizabeth A , Bergstein Suzannah , Dolinger Michael , Pittman Nanci , Kellar Amelia , Dunkin David , Dubinsky Marla C
Published: December 2023

Background

Upadacitinib (UPA) is a novel selective JAK inhibitor approved for adults with ulcerative colitis (UC) and with positive phase 3 data for Crohn’s disease (CD). Pediatric off-label use is common due to delays in pediatric approvals; real-world data on UPA are needed to understand the safety and effectiveness in pediatric IBD.

Methods

This is a single-center retrospective case series study of adolescents (12-17 years) with inflammatory bowel disease IBD on UPA. The primary outcome was postinduction steroid-free clinical remission (SF-CR) defined as Pediatric UC Activity Index (PUCAI) or Pediatric CD Activity Index (PCDAI) ≤10. Secondary outcomes include postinduction clinical response (decrease ≥12.5 in PUCAI/PCDAI), postinduction C-reactive protein (CRP) normalization, 6-month SF-CR, and intestinal ultrasound response and remission. Adverse events were recorded through last follow-up.

Results

Twenty patients (9 CD, 10 UC, 1 IBD-U; 55% female; median age 15 years, 90% ≥2 biologics) were treated with UPA for ≥12 weeks (median 51 [43-63] weeks). Upadacitinib was used as monotherapy in 55% and as combination with ustekinumab and vedolizumab in 35% and 10%, respectively. Week 12 SF-CR was achieved in 75% (15/20) and 80% (16/20) with CRP normalization. About 3/4 (14/19) achieved SF-CR at 6 months. Adverse event occurred in 2 patients (10%): Cytomegalovirus colitis requiring hospitalization and hyperlipidemia requiring no treatment. In the 75% with ultrasound monitoring, response and remission were achieved in 77% and 60%, respectively.

Conclusion

While awaiting pediatric registration trials, our data suggest that UPA is effective in inducing and maintaining SF-CR in adolescents with highly-refractory IBD with an acceptable safety profile.
Quantification of intraspecific and interspecific competition in fish species of the Aegean Sea
Authors: Koutsidi Martha , Lazaris Alexis , Peristeraki Panagiota , Tserpes George , Tzanatos Evangelos
Published: December 2023

Competition shapes species coexistence and community assembly, playing a central role in maintaining biodiversity and ecosystem resilience. Here, we used an asymmetric competition index that quantifies the possible competitive effect of a species on any other, using southern Aegean Sea nekton biomass from the Mediterranean International Trawl Survey dataset, combined with data on six traits relevant to trophic ecology and spawning. We modeled the effect of selected haul-level covariates on the competition index, and we indicated competition variation across depth and habitats. Most species experienced stronger inter- than intra-specific competition. Both the higher-than-expected significance of interspecific competition (in comparison to intraspecific that is generally anticipated to be higher) and the existence of an extensive network of multiple competitive interactions indicated, are associated with high biodiversity, combined to the absence of dominance by one or a few species in the community (no species is disproportionally highly abundant in comparison to others); the latter may be relevant to community stability and resilience. The quantification of competition across marine ecosystems can help predict how fish communities will respond to future resource availability and environmental conditions.
Effects of dietary supplementation of different levels of gamma-aminobutyric acid on reproductive performance, glucose intolerance, and placental development of gilts
Authors: Ma Shuo , Li Jinfeng , Ye Hongxuan , Huang Shuangbo , Huang Zihao , Wu Deyuan , Ma Kaidi , Xie Junyan , Yin Yulong , Tan Chengquan
Published: December 2023

This study aimed to investigate the effects of dietary gamma-aminobutyric acid (GABA) supplementation on reproductive performance, glucose intolerance, and placental development of gilts during mid-late gestation. Based on the principle of backfat thickness consistency, 124 gilts at 65 d of gestation were assigned to three dietary groups: CON (basic diet, n = 41), LGABA (basic diet supplemented with 0.03% GABA, n = 42), and HGABA (basic diet supplemented with 0.06% GABA, n = 41). The litter performance, glucose tolerance, placental angiogenesis, and nutrients transporters were assessed. The LGABA group improved piglet vitality and placental efficiency and decreased area under the curve of glucose tolerance test compared to the CON group (P < 0.05). Meanwhile, the LGABA group enhanced placental vessel density, platelet endothelial cell adhesion molecule-1 levels and gene expression of fibroblast growth factor 18 (P < 0.05). Furthermore, LGABA showed an uptrend in glucose transporter type 1 mRNA level (P = 0.09). Taken together, this study revealed that the dietary supplementation of 0.03% GABA can improve piglet vitality, glucose intolerance, and placental development of gilts.
Intraspecific morphological variations in the Iranian endemic freshwater crab Potamon strouhali (Decapoda: Brachyura: Potamidae)
Authors: Najafi Movahhed , Keikhosravi Alireza , Naderloo Reza
Published: December 2023

Potamon strouhali Pretzmann, 1976 is endemic to Iran, and distributed in a small heterogeneous region of the southern Persian plateau that includes two main drainage basins, the Khalij Fars-Oman and Markazi basins. Two subspecies of P. strouhali were previously recognized, but these, together with another species described that same year, P. eiseltiPretzmann, 1976, were all considered to be one species based on shared gonopod morphology. We examined individuals from the complete distributional range covering the type localities of all three taxa using morphological and morphometric-geometric data. The linear morphometric results using 21 characters and geometric-morphometric analysis of carapace shape were consistent. The results of the analysis indicated that P. strouhali has two main morphological populations and the subspecies are thus junior subjective synonyms of these two morphotypes. Potamon eiselti and P. s. shurium are attributed to morphotype 1 and P. s. strouhali to morphotype 2.
Immigrants’ subjective well-being in Europe: Variation by regional attitudes towards immigrants
Authors: Šedovič Michaela
Published: December 2023

Research suggests that migrants’ well-being varies with their lived environment. This variation’s potential but under-researched driver is non-migrants’ attitude towards immigrants (ATI). Using pooled European Social Survey data (2010–18) for twenty-two destination countries, I address the question, ‘Are more positive ATI in regions where migrants live associated with their higher life satisfaction?’. To answer it, I estimate models of life satisfaction regressed on a summed index of six measures of ATI aggregated to the regional level and control for individual-level predictors and country, year, and origin fixed effects. I find a significant association between more negative regional ATI and lower migrant well-being. Its strength is comparable with the most important known individual-level predictors of well-being (e.g., education). My descriptive results further show that the length of stay at the destination moderates the strength of association (only those more recently arrived are affected). Despite well-attested links between feelings of discrimination and well-being, I show that those who express greater discrimination are not more sensitive to ATI. This suggests that each measure speaks to a separate mechanism for experiencing discrimination. Showing that ATI is strongly related to migrants’ well-being implies that the lived environment should be at the forefront of the migration outcomes research.
Predicting intracranial involvement: Unveiling perineural spread in COVID-19-associated mucormycosis, a novel phenomenon
Authors: Nidhin Das K , Sharma Vidhu , Gupta Diksha , Tiwari Sarbesh , Elhence Poonam , Jain Vidhi , Soni Kapil , Goyal Amit
Published: December 2023

This study aimed to investigate the risk factors associated with intracranial involvement in COVID-19-associated mucormycosis (CAM) and to develop a nomogram model for predicting the risk of intracranial involvement, with a specific focus on perineural spread. An ambispective analysis was conducted on 275 CAM patients who received comprehensive treatment. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors, and a nomogram was created based on the results of the multivariable analysis. The performance of the nomogram was evaluated using a receiver operating characteristic (ROC) curve, and the discriminatory capacity was assessed using the area under the curve (AUC). The model's calibration was assessed through a calibration curve and the Hosmer Lemeshow test. In the results, the multivariable logistic regression analysis revealed that age (OR: 1.23, 95% CI 1.06–3.79), HbA1c (OR: 7.168, 95% CI 1.724–25.788), perineural spread (OR: 6.3, 95% CI 1.281–19.874), and the disease stage were independent risk factors for intracranial involvement in CAM. The developed nomogram demonstrated good discriminative capacity with an AUC of 0.821 (95% CI 0.713–0.909) as indicated by the ROC curve. The calibration curve showed that the nomogram was well-calibrated, and the Hosmer Lemeshow test yielded a P-value of 0.992, indicating a good fit for the model. In conclusion, this study found that CAM particularly exhibits perineural spread, which is a predictive factor for intracranial involvement. A nomogram model incorporating age, HbA1c, disease stage, and perineural spread was successfully developed for predicting intracranial involvement in CAM patients in both in-patient and out-patient settings.
Alaska’s climate sensitive Yukon–Kuskokwim Delta supports seven million Arctic-breeding shorebirds, including the majority of six North American populations
Authors: Lyons James E , Brown Stephen C , Saalfeld Sarah T , Johnson James A , Andres Brad A , Sowl Kristine M , Gill Robert E , McCaffery Brian J , Kidd Lindall R , McGarvey Metta , Winn Brad , Gates H River , Granfors Diane A , Lanctot Richard B
Published: December 2023

Baseline information about declining North American shorebird populations is essential to determine the effects of global warming at low-lying coastal areas of the Arctic and subarctic, where numerous taxa breed, and to assess population recovery throughout their range. We estimated population sizes on the Yukon–Kuskokwim Delta (YKD) in western Alaska on the eastern edge of the Bering Sea. We conducted ground-based surveys during 2015 and 2016 at 589 randomly selected plots from an area of 35,769 km2. We used stratified random sampling in 8 physiographic strata and corrected population estimates using detection ratios derived from double sampling on a subset of plots. We detected 11,110 breeding individuals of 21 taxa. Western Sandpiper (Calidris mauri), Red-necked Phalarope (Phalaropus lobatus), Dunlin (subspecies C. alpina pacifica), and Wilson’s Snipe (Gallinago delicata) were the most abundant taxa. We estimated that ~7 million individual shorebirds were breeding on the entire YKD in 2015 and 2016. Our surveys of this region provided robust population estimates (coefficient of variations ≤ 0.35) for 14 species. Our results indicate that the YKD supports a large proportion of North America’s breeding populations of the Pacific Golden-Plover (Pluvialis fulva), the western population of a Whimbrel subspecies (Numenius phaeopus hudsonicus), a Bar-tailed Godwit subspecies (Limosa lapponica baueri), Black Turnstone (Arenaria melanocephala), a Dunlin subspecies (C. alpina pacifica), and Western Sandpiper. Our study highlights the importance of breeding shorebirds of this relatively pristine but climatically sensitive deltaic system. Estuaries and deltaic systems worldwide are rapidly being degraded by anthropogenic activities. Our population estimates can be used to refine prior North American population estimates, determine the effects of global warming, and evaluate conservation success by measuring population change over time.
Enhanced recovery after surgery in patients after hip and knee arthroplasty: a systematic review and meta-analysis
Authors: Zhang Qingqing , Chen Yuzhang , Li Yi , Liu Ruikang , Rai Saroj , Li Jin , Hong Pan
Published: December 2023

Purpose

Enhanced recovery after surgery (ERAS) was characterized as patient-centered, evidence-based, multidisciplinary team-developed routes for a surgical speciality and institution to improve postoperative recovery and attenuate the surgical stress response. However, evidence of their effectiveness in osteoarthroplasty remains sparse. This study aimed to develop an ERAS standard and evaluate the significance of ERAS interventions for postoperative outcomes after primary total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Methods

We searched Medline, Embase, Cochrane databases, and Clinicaltrials.gov for randomized controlled trials, cohort studies, and case–control studies until 24 February 2023. All relevant data were collected from studies meeting the inclusion criteria. Two reviewers independently assessed the risk of bias and extracted data. The primary outcome was the length of stay (LOS), postoperative complications, and readmission rate. The secondary outcomes included transfusion rate, mortality rate, visual analog score (VAS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Short Form 36 (SF-36) bodily pain (SF-36 BP), SF-36 physical function (SF-36 PF), oxford knee score, and range of motion (ROM).

Results

A total of 47 studies involving 76 971 patients (ERAS group: 29 702, control group: 47 269) met the inclusion criteria and were included in the meta-analysis. The result showed that ERAS could significantly shorten the LOS (WMD = −2.65, P < .001), reduce transfusion rate (OR = 0.40, P < .001), and lower 30-day postoperative mortality (OR = 0.46, P = .01) without increasing postoperative complications or readmission rate. Apart from that, ERAS may decrease patients’ VAS (WMD = −0.88, P = .01) while improving their ROM (WMD = 6.65, P = .004), SF-36 BP (WMD = 4.49, P < .001), and SF-36 PF (WMD = 3.64, P < .001) scores. However, there was no significant difference in WOMAC, oxford knee score between the ERAS and control groups.

Furthermore, we determined that the following seven components of the ERAS program are highly advised: avoid bowel preparation, PONV prophylaxis, standardized anesthesia, use of local anesthetics for infiltration analgesia and nerve blocks, tranexamic acid, prevent hypothermia, and early mobilization.

Conclusion

Our meta-analysis suggested that the ERAS could significantly shorten the LOS, reduce transfusion rate, and lower 30-day postoperative mortality without increasing postoperative complications or readmission rate after THA and TKA. Meanwhile, ERAS could decrease the VAS of patients while improving their ROM, SF-36 BP, and SF-36 PF scores. Finally, we expect future studies to utilize the seven ERAS elements proposed in our meta-analysis to prevent increased readmission rate for patients with THA or TKA.
Development and characterization of a dynamic mass instrument (DMI) for use in microwave heating experiments
Authors: Cole James D , Sheridan Simon , Lim Sungwoo , Sargeant Hannah M , Anand Mahesh , Morse Andrew D
Published: December 2023

This study describes the development of an instrument known as the dynamic mass instrument (DMI) for use in microwave heating experiments that will allow greater insight in to the efficacy of the technique. A commercially available load cell is used as the main mechanism of mass measurement with a load arm used to provide microwave isolation of the load cell. The DMI is capable of measuring changes in mass with a mass range of 100 g to 200 g with an accuracy of ± 0.1 g in an environment of 250 W, 2.45 GHz microwaves under a working pressure of 3 mbar. A series of calibrations and experiments have been performed to quantify and clarify the behaviour of the instrument in different environments and scenarios and to ensure the DMI meets preset requirements. The DMI will, in future work, be used in In Situ Resource Utilisation experiments to examine in greater detail the efficacy of using microwave heating as a water extraction technique.
Forging monetary unification through novation: the TARGET system and the politics of central banking in Europe
Authors: Murau Steffen , Giordano Matteo
Published: December 2023

When the European Monetary Union became effective in January 1999, the accounting treatment for claims and obligations which the Eurosystem’s National Central Banks (NCBs) incur against each other in the ‘Trans-European Automated Real-Time Gross Express Transfer’ (TARGET) system remained unspecified. Only later in 1999, the Governing Council of the European Central Bank (ECB) decided that these claims and obligations should be shifted to the ECB’s balance sheet as a central counterparty—a process called ‘novation’. This ex-post decision completed monetary unification by uniquely ‘stitching together’ NCBs’ balance sheets while profoundly transforming the role of the ECB’s balance sheet. First, novation centralised it at the Eurosystem’s apex, which had not been politically feasible ex ante. Secondly, novation repurposed it into a multilateral mechanism to provide automatic, unlimited funding for cross-border payment imbalances. Thirdly, novation allowed monetary technocrats to operationalise it as an autonomous ‘firefighting’ balance sheet for unconventional monetary policy.
Gender, Symbolic and Social Boundaries, and Deconversion from the Church of Jesus Christ of Latter-Day Saints
Authors: Jindra Ines W , Thompson Jenna , Giesler Fredi
Published: December 2023

The Church of Jesus Christ of Latter-Day Saints is characterized by specific expectations in the realm of gender roles and sexuality, expectations which can be interpreted as heteronormative symbolic boundaries between the LDS Church and the world at large. In this article, through qualitative interviews, we explore the ways 27 women who leave the Church are influenced by, respond to, and ultimately reject some of the symbolic boundaries. We found that many women struggle with gendered expectations regarding home, careers, with norms regarding heterosexuality and sexuality within marriage, and gender identity conformity expectations, rejecting them at different times in their lives. Intersecting with the life course, we demonstrate how the interaction between the rejection of these symbolic boundaries and experienced social boundaries in the form of exclusion from the family, community, and church-related institutions contributes to deconversion and shapes its consequences afterward.
The Uncertainty in Family Caregivers of Hospitalized Persons With a Stroke in Saudi Arabia
Authors: Alselami Seham , Butcher Howard K. , Longo Joy
Published: December 2023

Uncertainty is a universal experience of family caregivers caring for persons with a stroke and affects caregivers' readiness to care for their family members with a stroke. Guided by the unitary caring theory and unitary-caring hermeneutic-phenomenological research method, this study was conducted among 15 family caregivers of persons in the hospital who have survived strokes through in-depth semi-structured interviews. Five essences emerged from the analysis: living in a dark reality; yearning for professional support; enduring a life full of tribulations; attempting resolution; and creating new patterns of living. Each of the 5 essences was interpreted from Smith's unitary caring theory perspective.
Prospective Multicenter Preliminary Validation of Limb Deformity–modified Scoliosis Instruments in Pediatric Patients With Limb Deformity
Authors: Moon Tyler James , Canitia Emily , Amakoutou Kouami , Jasty Naveen , Sachwani Numera , Flanagan Jill C. , Liu Raymond W.
Published: December 2023

Introduction:

There are few disease-specific patient-reported outcome measures (PROMs) for use in pediatric limb deformity (LD), with authors instead relying on generic PROMs such as the Pediatric Outcomes Data Collection Instrument (PODCI) to assess treatment outcomes from the patient’s perspective. The purpose of this study was to perform preliminary validation of 2 disease-specific PROMs in pediatric patients with LD.

Methods:

LD modifications were created by substituting the word “limb” for “back” in the Early Onset Scoliosis Questionnaire (EOSQ, ages 10 and younger) and the Scoliosis Research Society (SRS, ages 11 to 18) survey, creating the LD-EOSQ and LD-SRS instruments. Children were preoperatively administered the age-appropriate LD-PROMs (n=34 LD-EOSQ; n=30 LD-SRS) and PODCI questionnaires. LD-PROMs were assessed for construct (convergent and discriminant) validity, floor and ceiling effects, content validity, and minimal clinically important difference.

Results:

Both LD-EOSQ and LD-SRS demonstrated excellent preliminary convergent validity with similar PODCI domains and discriminant validity with demographic information, deformity data, and LLRS-AIM scores. There were minimal floor or ceiling effects. Content validity was achieved in 100% of LD-EOSQ surveys and more than 80% of LD-SRS surveys. Minimal clinically important difference was 0.4 for LD-EOSQ and 0.3 for LD-SRS.

Conclusions:

The LD-EOSQ for patients aged 10 and under and LD-SRS for patients aged 11 to 18 demonstrated preliminary validity and reliability in the pediatric LD population. These measures provide more information specifically related to familial impact in younger children and self-image and mental health in adolescents compared to the PODCI and should be further evaluated for use in these patients.

Level of Evidence:

Level II—diagnostic. Prospective cross-sectional cohort design.
Clinical and Histopathologic Study of Apocrine-Type Mixed Tumor of the Skin
Authors: Ishihara Yuri , Ogita Azusa , Ito Keigo , Saeki Hidehisa , Ansai Shin-ichi
Published: December 2023

Mixed tumor of the skin (MTS) is a tumor characterized by folliculosebaceous–apocrine differentiation. Because of the wide range of histological variations, understanding the unique features of MTS can help improve diagnosis. This study describes the histopathological characteristics of MTS, mainly apocrine-type MTS (AMT), using 166 cases of AMT. We found that nodular aggregates of myoepithelial cells, mucinous changes in the stroma, and follicular differentiation were standard characteristic features of MTS. Among the cases studied, 67% showed prominent follicular germinative cells and 40% showed prominent lipomatous metaplasia in the stroma. These cases often pose difficulties for the diagnosis of AMT because of insufficient evidence of sweat glands or myoepithelial cell differentiation. This is the first study to examine how the histological features of AMT change as the tumor extends deeper into the dermis. We found that the proportion of AMT with folliculosebaceous differentiation and large lumina increased as it got deeper into the dermis. Histopathological diagnosis of MTS is vital because the clinical symptoms lack specificity. This study enhances our understanding of the histopathological characteristics of MTS.
Comparison of Different Techniques for the Assessment of Sentinel Lymph Node Biopsy in Melanoma: A Systematic Review
Authors: Izzo Sara , Molle Marcello , Gesuete Francesco Paolo , De Intinis Claudia , Izzo Paolo , Izzo Luciano , Nicoletti Giovanni Francesco
Published: December 2023

Background:

The gold standard for sentinel lymph node staging in melanoma is the use of the combined technique of radioisotope plus blue dye. New techniques and alternative methods have been proposed, with the promise of achieving comparable efficacy. We then carried out a literature search.

Methods:

We conducted a literature search using the "sentinel lymph node biopsy" and "melanoma" keywords, then selected the case-control studies (the quality of which was assessed using the STROBE criteria).

Results:

Twelve studies of 13,017 were selected, concerning the identification rate of indocyanine green fluorescence and indocyanine green-99mtc-nanocolloid techniques. We have found a comparable identification rate between the various techniques, even if given the small population present for some techniques, the results did not reach statistical significance.

Conclusions:

The use of new techniques in sentinel lymph node detection promises results comparable to the gold standard techniques, but further studies are needed to validate these methods in the context of melanoma surgery.
Response of 21 Hyaluronic Acid Fillers to Recombinant Human Hyaluronidase
Authors: Park Kristen E. , Mehta Preeya , Kherani Femida , Lee Wendy W. , Woodward Julie A. , Foster Jill A. , Zhang-Nunes Sandy
Published: December 2023

Background:

One benefit of hyaluronic acid fillers is the ability to dissolve them using hyaluronidase. With the increasing number of fillers entering the market, it is crucial to understand each of these fillers’ responsiveness to hyaluronidase.

Methods:

Twenty-one hyaluronic acid fillers of 0.2 mL aliquots each were placed on slides. Twenty units of recombinant human hyaluronidase were injected into the aliquots every 30 minutes for a total of 120 units recombinant human hyaluronidase injected over 3 hours. With each injection, videos and photographs were taken from bird’s eye and lateral views to measure aliquot height. Stirring videos were graded by three oculoplastic surgeons, and these grades were used to categorize each filler’s responsiveness.

Results:

Restylane Lyft, Restylane-L/Eyelight, and Resilient Hyaluronic Acid (RHA) 1/Redensity were the least resistant. The moderately resistant group comprised of Restylane Silk, Juvéderm Volbella, Revanesse Versa/Lips, and Belotero Balance on the less resistant side to Juvéderm Vollure, RHA 2, Restylane Contour, Juvéderm Ultra, Restylane Refyne, Belotero Intense, Restylane Kysse, RHA 3, Juvéderm Ultra Plus, and Restylane Defyne on the more resistant side. The most resistant were RHA 4, Juvéderm Voluma, Belotero Volume, and Juvéderm Volux. The most resistant fillers required 120 units of hyaluronidase per 0.2 mL filler to dissolve.

Conclusions:

With the increasing popularity of fillers comes the increasing need to dissolve them for both ischemic and nonischemic complications. The majority of hyaluronic acid fillers available on the market are very resistant to hyaluronidase, which must be considered when determining the amount of hyaluronidase to dissolve a particular filler.
Acceptance of Young Saudi Women to Undergo Cosmetic Surgery and Factors Influencing Their Decision
Authors: Alkhathami Ali M. , Alhassan Turki S. , Fayi Khalid A. , Albrahim Razan A. , Al-jabr Khalid H. , Alghamdi Abdullrahman A.
Published: December 2023

Background:

The cosmetic procedure is a treatment modality for improving the appearance of a person, and it may involve either surgical or nonsurgical interventions. The number of women who undergo cosmetic surgery in Saudi Arabia has increased dramatically. In fact, the reasons for the increase in the number of cosmetic procedures include the growth impact of social media and the pursuit of perfection. The study aimed to determine the level of acceptance of cosmetic surgery among young Saudi women, and the factors influencing their decisions.

Methods:

This cross-sectional study was conducted among literate Saudi women during March 2023 to April 2023. A self-reported questionnaire was used, which investigated the demographics, acceptance, and information about cosmetic surgery and social media.

Results:

A total of 1685 female participants were included in this study: 62.6% were students, 73.6% were single, and 65.8% were aged 18–23 years. The levels of acceptance were high among 38.9% of the participants, and the level of acceptance was significantly affected by age (P = 0.0001), social status (P = 0.0001), work (P = 0.0001), education (P = 0.001), and income (P = 0.001). Up to 86.1% of the participants had not undergone cosmetic surgery, and the reasons for undergoing surgery commonly included dissatisfaction with appearance and social media.

Conclusions:

The acceptance of cosmetic surgery in this study was low, and it was affected by several demographics of the participants. For instance, social media played a crucial role in driving women to undergo such procedures.
Split-thickness Plantar Skin Graft for Foot Syndactyly
Authors: Tomioka Yoko K. , Okazaki Mutsumi , Matsutani Hitomi
Published: December 2023

For the treatment of syndactyly, the submalleolar or inguinal area is the common donor site for skin grafts. However, high skin tension of the submalleolar area could potentially delay wound healing or cause scarring. Skin grafts from the inguinal area cause pigmentation. In this study, we have harvested split-thickness skin grafts from the plantar area to treat syndactyly and evaluated the healing course and aesthetic outcome. We analyzed 13 recipient and nine donor sites in eight patients, aged 13–68 months (average 25 months), with syndactyly of the foot. The minimum follow-up was 14 months, and average follow-up period was 22.3 months. Aesthetic outcomes including color and texture match, wound healing of donor site using Vancouver Scar Scale, and complications of both sites were assessed in all patients. At the recipient sites, the graft survived well, and the lack of pigmentation of the graft led to good color match. At the donor sites, hypertrophic scar and high scar scale were seen around postoperative month 3, but were momentary, as all donor sites matured to a flat and soft scar. Morbidity of split-thickness skin graft from the plantar region is limited. It causes minimum scarring of the nonexposed area. Moreover, because it does not cause pigmentation, the split-thickness skin graft technique is a reasonable option for the treatment of syndactyly.
Sub-Gluteus Maximus Fascial Plane and Perineural Hydrodissection as Novel Treatment for Posterior Femoral Cutaneous Nerve Entrapment
Authors: Hu Yao-Wen Eliot
Published: December 2023

Posterior femoral cutaneous nerve (PFCN) entrapment due to overuse is rarely reported in the literature, and treatment is limited. Conventional treatment includes focused rehabilitation exercises, computed tomography–guided or magnetic resonance (MR)–guided nerve blocks, MR-guided cryoablation, and surgical decompression, but data for treatment validation and efficacy are lacking. Sub-gluteus maximus fascial plane and perineural hydrodissection may offer an effective alternative treatment for PFCN entrapment, especially given reports of successful cases with similar procedural techniques in other anatomical locations and structures.
Campylobacter fetus-induced primary psoas abscess in patient with gouty arthritis: A case report and literature review
Authors: Luo Xiaodong , He Yanfang , Zha Daogang , Kang Chunyu , Sijie Yuan
Published: December 2023

Rationale:

Campylobacter fetus is rare pathogen with high mortality rate in immunosuppressive hosts. This study aimed to summarize clinical and pathological presentation of C fetus induced psoas abscess.

Patient concerns:

A 66-year-old male patient with long medical history of poorly-controlled gouty arthritis and steroid intake complained of a severe low back pain. Physical examination showed tenderness in his psoas.

Diagnoses:

The patient underwent puncture biopsy to the lesion in the psoas under ultrasound guidance. The lesion was indicated as abscess by pathological examination, and its pathogen was indicated as C fetus by the next generation sequencing.

Interventions:

Meropenem 1 g q8.h were administered intravenously for 10 days. Then the antibiotic treatment was switched to amoxicillin/clavulanate potassium 0.375g q.8.h and levofloxacin 0.5g q.d oral administration when discharge.

Outcomes:

The patient’s fever and low back pain improved and infectious parameters declined. He was discharged in good general condition with advice for further monitoring and therapy. In the first month follow-up, the patient did not report recurrence or aggravation of his symptoms.

Lessons:

C fetus should be noticed in immunosuppressive patient with exposure to livestock who present with rare systematic or local invasive infection. We advocated the meropenem for the first-line treatment against C fetus.
Retinitis pigmentosa with or without skeletal abnormalities due to homozygous mutations in the CWC27 gene: A case report
Authors: Qi Yang-Fan , Ma Xiaoping , Lin Shuang-Zhu , Wang Wan-Qi , Li Jia-Yi , Chen Qian-Dui , Liu Li
Published: December 2023

Rationale:

Retinitis pigmentosa with or without skeletal abnormalities (RPSKA) is an autosomal recessive disorder caused by mutations in the CWC27 gene. Skeletal dysplasia and non-syndromic retinitis pigmentosa are typical manifestations, and most patients present with retinopathy such as retinitis pigmentosa and limited visual field. Its clinical manifestations are complex and diverse, often involving multiple systems. Examples include short finger deformities, peculiar facial features, short stature, and neurodevelopmental abnormalities, and it is easy to misdiagnose clinically, and early diagnosis is crucial for prognosis.

Patient concerns:

A 2-year and 2-month-old female child was admitted to the hospital due to “unsteady walking alone and slow reaction for more than half a year.” After admission, the child was found to have delayed motor development, accompanied by special face, abnormal physical examination of the nervous system, cranial MRI Dandy-Walker malformation, considering developmental delay.

Diagnoses:

Whole exome sequencing of the family line revealed the presence of a c.617(exon7)C>A pure mutation in the CWC27 gene in the affected child (this locus has been reported in the clinical literature); the final diagnosis is RPSKA.

Interventions:

Unfortunately, there is no specific drug for the disease; we give children rehabilitation training treatment.

Outcomes:

During follow-up process we found that children’s condition is better than before.

Lessons subsections as per style:

We reported a case of RPSKA caused by mutations in the CWC27 gene. This study adds to our understanding of the clinical phenotype of TBL1XR1 mutations and provides a realistic and reliable basis for clinicians.
Multimodal MRI-based radiomic nomogram for predicting telomerase reverse transcriptase promoter mutation in IDH-wildtype histological lower-grade gliomas
Authors: Huo Xulei , Wang Yali , Ma Sihan , Zhu Sipeng , Wang Ke , Ji Qiang , Chen Feng , Wang Liang , Wu Zhen , Li Wenbin
Published: December 2023

The presence of TERTp mutation in isocitrate dehydrogenase-wildtype (IDHwt) histologically lower-grade glioma (LGA) has been linked to a poor prognosis. In this study, we aimed to develop and validate a radiomic nomogram based on multimodal MRI for predicting TERTp mutations in IDHwt LGA. One hundred and nine IDH wildtype glioma patients (TERTp-mutant, 78; TERTp-wildtype, 31) with clinical, radiomic, and molecular information were collected and randomly divided into training and validation set. Clinical model, fusion radiomic model, and combined radiomic nomogram were constructed for the discrimination. Radiomic features were screened with 3 algorithms (Wilcoxon rank sum test, elastic net, and the recursive feature elimination) and the clinical characteristics of combined radiomic nomogram were screened by the Akaike information criterion. Finally, receiver operating characteristic curve, calibration curve, Hosmer–Lemeshow test, and decision curve analysis were utilized to assess these models. Fusion radiomic model with 4 radiomic features achieved an area under the curve value of 0.876 and 0.845 in the training and validation set. And, the combined radiomic nomogram achieved area under the curve value of 0.897 (training set) and 0.882 (validation set). Above that, calibration curve and Hosmer–Lemeshow test showed that the radiomic model and combined radiomic nomogram had good agreement between observations and predictions in the training set and the validation set. Finally, the decision curve analysis revealed that the 2 models had good clinical usefulness for the prediction of TERTp mutation status in IDHwt LGA. The combined radiomics nomogram performed great performance and high sensitivity in prediction of TERTp mutation status in IDHwt LGA, and has good clinical application.
Case report: Successful sequential therapy of crizotinb and entrectinib in ROS1-positive non-small-cell lung cancer with brain metastasis in later-settings
Authors: Dong Wen , Zhuge Jinke , Yu Pengli , Liu Kai , Yang Mingxing , Wang Hongkang
Published: December 2023

Rationale:

Crizotinib has been approved in many countries for the treatment of patients with advanced ROS1-rearranged non-small cell lung cancers (NSCLC). Entrectinib is a ROS1 inhibitor that has been designed to effectively penetrate and remain in the central nervous system (CNS) and has been recommended as first-line therapy. Few reports have precisely described sequential crizotinb followed by entrectinib in patients with ROS1 fusion in later settings.

Patient concerns:

A 56-year-old man with a history of occasional smoking visited our hospital with cough, sputum, and shortness of breath.

Diagnosis:

He was diagnosed with right lung adenocarcinoma (T4N2M1a, stage IV) after image and histological examination, without EGFR or ALK fusion mutation.

Interventions:

He received three prior lines of therapies, including chemotherapy, nivolumab monotherapy, and paclitaxel plus anlotinib, with progression-free survival (PFS) of 5, 2, and 11.5 months, respectively. Then the patient began to have headaches and dizziness, and brain magnetic resonance imaging showed multiple brain metastases. Next-generation sequencing (NGS) of the biopsy from neck lymph node identified EZR-ROS1 (1.25% abundance). After 2 months of crizotinib (250 mg daily) plus bevacizumab, all pulmonary and brain lesions decreased, but a small liver lesion was discovered. As treatment went on for another 4 months, the liver lesion continued to grow while other lesions kept decreased or stable state. NGS analysis on the peripheral blood found the disappearance of EZR-ROS1 fusion and a new NTRK2 mutation (c.5C>T, p.Ser2Leu, 0.34% abundance) without other targetable molecular alteration. He received entrectinib (600 mg daily) plus bevacizumab and achieved a partial response. After 7 months of therapy, examination revealed progression of brain lesions.

Outcomes:

The patient had a total PFS of 13 months from sequential crizotinib and entrectinib therapy.

Lessons:

A ROS1-rearranged NSCLC with CNS metastases responded to sequential tyrosine kinase inhibitors treatment of crizotinb followed by entrectinib. This report has potential implications in guiding decisions for the treatment after crizotinib resistance.
Expression of PTP4A1 in circulating tumor cells and its efficacy evaluation in patients with early- and intermediate-stage esophageal cancer
Authors: Wu Jie , Wang Wen-Xiang , Zhou Yong , Yang De-Song , Wu Zhi-Ning , Li Xu , Tang Jin-Ming
Published: December 2023

The objective of this study is to investigate the expression of protein tyrosine phosphatase type I (PTP4A1) in circulating tumor cells (CTCs) in patients with early- and intermediate-stage esophageal cancer and its clinical value in evaluating patient prognosis. Tissue and peripheral blood samples were collected from patients with esophageal cancer, as well as their clinical data. Follow-up was performed on all patients. PTP4A1 expression in the CTCs of patients were analyzed by regression analysis, and its correlation with the clinical characteristics of esophageal cancer was discussed. The numbers of mixed tumor cells and T-CTCs were significantly correlated with lymph node metastasis. Advanced tumor-node metastasis (TNM) stage (odds ratio = 12.063) and lymph node metastasis (odds ratio = 13.541) were influencing factors of PTP4A1+MCTC expression disorders in patients with esophageal cancer. The receiver operating characteristic curve showed that TNM stage and lymph node metastasis had a high predictive efficiency for PTP4A1+MCTCs, with an area under the ROC curve of 0.725. PTP4A1+mixed tumor cells had strong predictive value for the efficacy of neoadjuvant therapy, with a sensitivity of 94.7% and a specificity of 63.6%. Advanced TNM stage and lymph node metastasis are influencing factors for increased CTCs and poor expression of PTP4A1 in patients with esophageal cancer.
The clinical efficacy of Shenxiang Suhe Pill administration in posterior circulation ischemic vertigo: A randomized controlled trial
Authors: Zhang Yongjian , Xu Lin , Wang Xiaoping , Ma Jianjun , Song Xiaping , Lv Heng , Jin Luyao
Published: December 2023

Background:

Shenxiang Suhe Pill (SXSHP) is a traditional Chinese medicine (TCM) widely used to treat coronary heart disease. The present study aims to investigate the effect of SXSHP on posterior circulation ischemic (PCI) vertigo.

Methods:

One hundred and twenty patients with PCI vertigo were randomly divided into the control, low-dose, and high-dose groups with 40 patients in each group. The control group was treated with basic Western medicine. The low-dose and high-dose groups were treated with 0.7 g SXSHP once a day in the morning and twice a day in the morning and evening, respectively. The assessments were performed on days 14 and 28. The traditional Chinese medicine symptom score, average blood flow velocity of vertebral artery and basilar artery, blood viscosity, blood lipids, serum C-reactive protein level (CRP), blood routine test, and liver and kidney function were compared before and after treatment among the 3 groups.

Results:

In the evaluation of the traditional Chinese medicine symptom score, both low-dose and high-dose SXSHP treatments showed higher efficacy than the control group (P = .013). The average blood flow velocity of vertebral artery and basilar artery in the 3 groups showed an upward trend from baseline (P < .05). The blood viscosity and levels of fibrinogen, hematocrit, and CRP in the 3 groups showed a downward trend from baseline level (P < .05). The levels of total cholesterol, triglycerides, low-density lipoprotein, and CRP in the low-dose group and high-dose group were lower than those in the control group on day 28 (P < .05). There were no significant differences in the routine blood test and liver and kidney function between the low-dose and high-dose groups compared with the baseline values (P > .05).

Conclusion:

SXSHP effectively improved PCI vertigo by inhibiting blood viscosity, regulating blood lipid levels, anti-inflammation, and improving cerebrovascular blood flow without affecting liver and kidney functions.
Ultrasound-guided percutaneous microwave ablation of gallbladder polyps: A case report
Authors: Zhao Huajiao , Chen Yanwei , Zhang Zheng , Shang Mengyuan , Cai Yun , Ge Jingwen , Min Xin , Wu Xincai , Zhao Shuangshuang , Chen Baoding
Published: December 2023

Rationale:

Gallbladder polyps are a general term for localized lesions in which the gallbladder wall protrudes into the gallbladder cavity, and benign lesions are common. Although current guidelines recommend cholecystectomy for gallbladder polyps ≥ 10 mm in size, the probability of finding cancer in postoperative pathological specimens is low. We should avoid unnecessary cholecystectomy and treat polyps with gallbladder preservation. Microwave ablation is safe and effective for the treatment of solid lesions, and can inactivates polyps while preserving gallbladder. Hence, we report a case of ultrasound-guided percutaneous microwave ablation of gallbladder polyps.

Patient concerns:

A 72-year-old female patient had previously diagnosed a gallbladder polyp, but it was not taken seriously. Recently, the patient had occasional right upper abdominal discomfort and a desire to preserve gallbladder.

Diagnoses:

Ultrasound showed a medium hyperechoic papillary protrusion in the gallbladder without echo behind, and the changed position did not move. Contrast-enhanced ultrasound (CEUS) showed no malignant signs. The diagnosis was a gallbladder polyp.

Interventions:

The bile is drained and the drainage tube is fixed under real-time ultrasound guidance, then the gallbladder cavity is flushed and filled. Saline was injected between the serous and mucosal layers of the gallbladder to form an “edema band” to protect the gallbladder wall. Then, ultrasound-guided biopsy of gallbladder polyps was performed and sent for histological examination. Finally, the microwave needle was inserted into the target area under real-time ultrasonic guidance, and ablation was performed for 3 minutes (20 W). Postoperative CEUS: No significant enhancement was observed in the lesion.

Outcomes:

Within 6 months of follow-up, the patient’s gallbladder systolic function was normal, and there was no discomfort and no recurrence. The lesion reduction rate reached 100% at 1 week after surgery.

Lessons:

Ultrasound guided percutaneous microwave ablation of gallbladder polyps not only preserves the gallbladder but also inactivates the polyps without affecting the systolic function of the gallbladder, which provides a new idea for the treatment of gallbladder polyps.
Factors influencing the supportive care needs of female patients with genital cancer in South Korea
Authors: Son Yu-Jung , Nam Keum-Hee , Shim JaeLan
Published: December 2023

Genital cancers are particularly important compared to other cancers because of the psychological impact they have on the individual. This study investigated the complexity in illness and quality of life among female genital cancer patients and determined the effects of these factors on supportive care needs to provide evidential data for the development of nursing intervention strategies to reduce supportive care needs in female genital cancer patients. This cross-sectional study collected data from July 22 to August 17, 2021. The study subjects were 103 female outpatients and inpatients aged 19 years or older who were treated for cervical cancer, endometrial cancer, ovarian cancer, or other female genital cancers such as vulvar cancer and vaginal cancer in a university hospital in Korea. The data were analyzed with t-tests and Scheffé’s test using SPSS 26.0. The factors affecting supportive care needs were examined using hierarchical regression. The average age of the subjects was 56.41 (±9.91) years. Cervical cancer was the most common diagnosis at 42.7%, followed by ovarian cancer at 34.0%, and endometrial cancer at 21.4%. The factors affecting supportive care needs included a middle school education or below (β = 0.21, P = .028), unemployment (β = 0.23, P = .018), complexity in illness (β = 0.32, P < .001), and quality of life (β = −0.68, P < .001). Developing a strategy for managing the complexity in illness and quality of life caused by various variables including disease stage and type of treatment is necessary to reduce the supportive care needs of female genital cancer patients. Improving their quality of life through effective communication with healthcare providers is essential.