bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart failure with improved ejection fraction: patient characteristics, clinical outcomes and predictors for improvement
Authors: Segev Amitai , Avrahamy Benny , Fardman Alexander , Matetzky Shlomi , Freimark Dov , Regev Ohad , Kuperstein Rafael , Grupper Avishay
Published: July 2024

Background

Heart failure with improved ejection fraction (HFimpEF) is a recently recognized entity presenting a diagnostic and therapeutic challenge. Our aim was to characterize the profile of HFimpEF patients and evaluate predictors for EF lack of improvement among heart failure with reduced ejection fraction (HFrEF) patients.

Methods

We included ambulatory HFrEF patients (EF≤40%) between January 1, 2015, and September 1, 2022, with two consecutive echocardiography exams at least 6 months apart. HFimpEF was defined as improved EF from ≤40%–>40% and by ≥10%.

Results

A total of 567 HFrEF patients (72% male, 54.3 ± 14.4 years old) were analyzed. Patients without EF improvement were more likely to be male, had more comorbidities, ischemic cardiomyopathy (ICMP), markers of adverse cardiac remodeling (lower EF and higher left and right ventricular diameters) and presence of late gadolinium enhancement (LGE) in MRI (P < 0.05 for all). In a multivariate analysis, male sex, ICMP, lower EF, larger ventricular size and LGE remained independent predictors for lack of EF improvement. A prediction model for lack of EF improvement including LVEF, LV diameter, diastolic blood pressure and ischemic etiology exhibited an area under the ROC curve of 0.77 (95% CI 0.73–0.81; P < 0.001). HFimpEF patients had better prognosis with lower hospitalizations and mortality rates. Guideline directed medical therapy (GDMT) were associated with improved outcomes in both groups regardless of EF improvement.

Conclusions

Lack of improvement in EF among HFrEF patients may be predicted by HF etiology and imaging parameters of adverse cardiac remodeling, and is associated with worse prognosis. GDMT were associated with improved outcomes in both HFimpEF and HFrEF patients.
The influence of gender on outcomes following transcatheter aortic valve implantation
Authors: Lodo Vittoria , Italiano Enrico G. , Weltert Luca , Zingarelli Edoardo , Perrucci Chiara , Pietropaolo Claudio , Buono Gabriella , Centofanti Paolo
Published: July 2024

Objectives

This study aimed to compare gender-related differences in short- and long-term outcomes after transcatheter aortic valve implantation.

Methods

Patients who underwent transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) from September 2017 to December 2022 were enrolled. The primary endpoint was 5-year all-cause mortality. The secondary endpoints were 30-day mortality and the incidence of post-procedural complication. Patients were separated according to gender before statistical analysis. To compare patients with similar baseline characteristics, we performed a propensity matching.

Results

A total of 704 patients [females, 361 (51.3%); males, 343 (48.7%)] were enrolled. Compared to women, men had a higher incidence of smoking (40.5% vs. 14.7%, p < 0.001), diabetes (32.9% vs. 25.1%, p < 0.025), peripheral artery disease (35.8% vs. 18.3%, p < 0.001), and previous cardiac surgery (13.7% vs. 7.2%, p = 0.006) and a lower ejection fraction [56.6 (9.3) vs. 59.8 (7.5), p = 0.046]. Female patients were frailer at the time of the procedure [poor mobility rate, 26% vs. 11.7%, p < 0.001; CCI (Charlson comorbidity index) 2.4 (0.67) vs. 2.32 (0.63), p = 0.04]. Despite these different risk profiles, no significant differences were reported in terms of post-procedural outcomes and long-term survival. Propensity score matching resulted in a good match of 204 patients in each group (57.9% of the entire study population). In the matched cohort, men had a significantly higher incidence of new pacemaker implantation compared to women [33 (16.2%) vs. 18 (8.8%)]. The Kaplan–Meier 5-year survival estimate was 82.4% for women and 72.1% for men, p = 0.038.

Conclusions

Female gender could be considered as a predictor of better outcomes after TAVI.
Association between glycemia and multi-vessel lesion in participants undergoing coronary angiography: a cross-sectional study
Authors: Dong Hezeng , Liu Zhaozheng , Chen Hao , Ba Jin , Shi Rui , Jin Qu , Shao Xiao , Tian Tenghui , Yin Jinzhu , Chang Liping , Deng Yue
Published: July 2024

Background

This study aims to elucidate the association between glycemia and the occurrence of multi-vessel lesions in participants undergoing coronary angiography.

Methods

We analyzed 2,533 patients with coronary artery disease who underwent coronary angiography. Of these, 1,973 patients, identified by the endpoint of multi-vessel lesions, were examined using univariate and multivariate logistic regression analyses to determine the relationship between glycemia levels and multi-vessel lesion occurrence.

Results

The analysis included 1,973 participants, among whom 474 patients were identified with coronary multi-vessel lesions. Univariate logistic regression analysis demonstrated a positive correlation between glycemia and the occurrence of coronary multi-vessel lesions (OR 1.04; 95% CI 1.01–1.08; p = 0.02). The adjusted model indicated that for each unit increase in glycemia, the risk of developing coronary multi-vessel lesions increased by 4%, showing a significant correlation (p < 0.05). Subgroup analyses revealed that the impact of glycemia on multi-vessel lesions in patients with PCI varied according to gender, age, and smoking status, with the effect being more pronounced in men, older patients, and smokers.

Conclusion

Our findings establish a significant association between glycemia and the incidence of multi-vessel lesions, particularly pronounced in male patients, individuals over 45, and smokers.
Comparative study on pore-connectivity and wettability characteristics of the fresh-water and saline lacustrine tuffaceous shales: triggering mechanisms and multi-scale models for differential reservoir-forming patterns
Authors: Yang Wei , Shen Baojian , Zhang Zilong , Zhao Rui , Hou Haodong , Li Zhiming , Ding Mou , Hu Hanwen , Feng Fan , Xie Ming
Published: July 2024

Although particular attention has been paid to responses of hydrocarbon storage and percolation capacity to the devitrification concerning lacustrine tuffaceous shale reservoirs in recent years, there is still a lack of systematical and comparative investigation on differential patterns and potential triggering mechanisms concerning development of the pore-microfracture systems and characteristics of surface wettability between the fresh-water and saline lacustrine settings, which is of considerable importance in fully understanding of genesis and spatial distribution of dessert reservoir intervals of tuffaceous shale reservoirs, and to provide further conceptual basis for deciphering shale-oil movability of saline lacustrine fine-grained mixed sedimentary sequences. In this study, tuffaceous shales from both the Upper Triassic Yanchang Formation in the Ordos Basin and Middle Permian Jingjingzigou Formation in the Junggar Basin are targeted to unravel the differential behavior of tuff devitrification and potential impacts on reservoir wettability and pore connectivity concerning fresh-water and saline lacustrine settings, and we present new results here from integrated analyses and combined interpretation of FE-SEM, Image Pro Plus (IPP) software image processing, contact angle and spontaneous imbibition experiments. In view of comparative analysis from representative samples, the tuffaceous shales from saline lacustrine environments are characterized by well-developed intergranular-intercrystalline and dissolution pores, and inorganic microfractures, generally yield a higher plane porosity of representative pore-fracture spaces and spontaneous imbibition slopes, a relatively lower average of n-decane contact angles and corresponding wettability parameters. The saline lacustrine tuffaceous shales are thus suspected to have undergone more intense devitrification resulting in a higher amount of devitrification and associated dissolution pores, and a relatively better connectivity between isolated micropore systems with adjacent microfractures. This would significantly facilitate the interface wettability reversal and occurrence of movable hydrocarbon fluid in microscopic reservoir spaces. Finally, a comprehensive and conceptual model is established illustrating the effects of differential devitrification on reservoir-forming patterns concerning tuffaceous shales developed in the fresh-water and saline lacustrine settings, respectively. These findings are of great theoretical and practical significance to enrich theory of high-quality reservoir formation and shale-oil accumulation in saline lacustrine tuffaceous shale reservoirs, and lay the foundation for guiding efficient exploration of continental fine-grained mixed sedimentary sequences.
Challenges experienced by students studying medicine through English medium instruction
Authors: Alanazi Khatmah , Curle Samantha
Published: July 2024

English is increasingly being used as a medium of instruction (EMI) in many institutions for teaching academic subjects, such as physical science and medicine. Although research evidence is emerging to support the positive effects EMI has on student learning such as preparing them for professional careers and improving their English language proficiency, students also encountre challenges when studying through EMI, particularly linguistic related challenges. This study aims to investigate the challenges that medical students face when learning medicine through EMI in medical context in Saudi Arabia. To achieve this aim, a mixed-method research approach was adopted.A questionnaire was distributed to 373 students studying at four medical schools, and follow-up with semi-structured interviews with 60 students. The findings revealed that students encountered numerous challenges when studying medicine through EMI including reading medical materials, understanding lectures taught purely in English, giving presentaions and speaking fluently. Notably, these challenges were more salient in the students’ first or second years of their university studies, however dissipated as students progressed in their studies. Pedagogical implications of these findings are discussed.
The predictive effect of cultural orientation and perceived school climate on the formation of teachers’ growth mindsets
Authors: Zhang Kai , He Wu-jing
Published: July 2024

This study aimed to examine the predictive effect of cultural orientation and perceived school climate on the formation of teachers’ growth mindsets. A total of 811 middle school teachers (26.88% females; mean age = 29.77) from Shanghai City, mainland China, participated in the study. The growth mindset inventory, Hofstede’s cultural dimensions, and the school-level environment questionnaire were used to assess teachers’ growth mindset beliefs, cultural orientations, and perceptions of school climates, respectively. Hierarchical multiple regression analyses were applied to test the hypothesized roles of teachers’ cultural orientations and perceived school climates in predicting the formation of their growth mindsets. Two interesting findings were obtained. First, regarding the effect of cultural orientation, teachers’ growth mindset belief was positively predicted by the Confucian dimension of cultural value in relation to long-term orientation but negatively predicted by the dimensions of power distance and uncertainty avoidance. Second, regarding the predictive effect of school climate, growth mindset was positively predicted by three school climate factors: school resources, decision-making, and instructional innovation. These findings provide empirical evidence for the perspectives of social cognitive theory and cultural and ecological psychology by highlighting the contextual sensitivity of growth mindset formation. These findings also have practical implications because they highlight the need to consider cultural and school climate factors in the promotion of teachers’ growth mindsets.
Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis
Authors: Xu Xiang , Li Chengqian , Yu Xiaolong , Wang Guoqiang , Guo Yanjun , Ni Huaiwen , Zhao Wenjuan , Wang Yangang , Dong Bingzi
Published: July 2024

Background

Lymph node metastasis is the major cause of increased recurrence and death in patients with papillary thyroid carcinoma (PTC). We evaluate the clinicopathologic factors affecting excellent response (ER) in patients with PTC with lymph node metastasis following operation and 131I ablation therapy.

Methods

A total of 423 patients with PTC with lymph node metastasis who underwent thyroidectomy and postoperative 131I ablation therapy were enrolled. The relationship between clinicopathological factors affecting ER achievement was analyzed.

Results

Multivariate analysis showed that the foci diameter (≤1 cm), unifocal, combination with Hashimoto’s thyroiditis (HT), lymph node metastases rate (LR) (≤40%), no postoperative lymph node metastasis, low preablative stimulated thyroglobulin (ps-Tg) level (≤3.87 ng/mL), and the time of 131I ablation therapy (one time) were positively correlated with the ER achievement [odds ratio (OR): 1.744, 3.114, 3.920, 4.018, 2.074, 9.767, and 49.491, respectively; all p < 0.05]. The receiver operating characteristic (ROC) curves showed that the cutoff values of ps-Tg and LR were 4.625 ng/mL and 50.50%, respectively. The AUC of ROC of ps-Tg and LR for predicting ER achievement was 0.821 and 0.746, respectively. The Tg and the cumulative risk of non-ER elevated with the increase of LR, especially for the high-level ps-Tg (>4.625 ng/mL) group.

Conclusion

The foci diameter and number, combination with HT, LR, and ps-Tg level are independent factors for ER. Ps-Tg level and LR are valid predictive factors for the efficacy of 131I therapy in patients with PTC. The predictive value of the cumulative risk of non-ER can be improved by the combination of ps-Tg and LR.
Effects of mulching and flooding on soil nutrients and bacterial community structure under Phyllostachys praecox
Authors: Gao Jianshuang , Yang Chaofeng , Zhuang Shunyao , Gui Renyi
Published: July 2024

Phyllostachys praecox is a shallow-rooted bamboo that often encounters hypoxia conditions which could be induced by long-term organic material mulching or flooding. It is important to uncover the effect of mulching and flooding on soil nutrient, ammonia-oxidizing microbes, and bacterial diversity. We set up field pot experiments with three treatments (control, mulching, and flooding) under P. praecox. Mulching or flooding altered soil conditions significantly, and both increased ammonium-nitrogen (NH4+-N), total phosphorus (TP), available P (AP), and available potassium (AK) concentrations, and decreased oxygen (O2) concentrations over control. Flooding increased pH and decreased nitrate-nitrogen (NO3−-N), while mulching decreased soil pH and NO3−-N. As O2 content decreased, archaeal 16S rRNA, amoA gene copies of ammonia-oxidizing archaea (AOA) and ammonia oxidizing bacteria (AOB) increased. Mulching and flooding decreased Shannon, ACE and Chao 1 diversity when compared with the control, and as the O2 contents decreased, bacterial diversity decreased. Redundancy Analysis revealed O2, NO3−-N, AK, AP, and pH were the major factors driving bacterial community structure. Correlation Analysis showed AK and O2 contents were highly correlated with bacterial community structure. In addition, structural equation modeling indicated that O2 facilitated efficient soil N use mainly through soil pH, AK content, and bacterial diversity. Mulching or flooding exerted great effects on environment factor and bacterial community structure, which could be exploited to facilitate the regulation of soil O2 conditions for sustainable P. praecox production.
Systems biology-based analysis exploring shared biomarkers and pathogenesis of myocardial infarction combined with osteoarthritis
Authors: Luo Yuan , Liu Yongrui , Xue Weiqi , He Weifeng , Lv Di , Zhao Huanyi
Published: July 2024

Background

More and more evidence supports the association between myocardial infarction (MI) and osteoarthritis (OA). The purpose of this study is to explore the shared biomarkers and pathogenesis of MI complicated with OA by systems biology.

Methods

Gene expression profiles of MI and OA were downloaded from the Gene Expression Omnibus (GEO) database. The Weighted Gene Co-Expression Network Analysis (WGCNA) and differentially expressed genes (DEGs) analysis were used to identify the common DEGs. The shared genes related to diseases were screened by three public databases, and the protein-protein interaction (PPI) network was built. GO and KEGG enrichment analyses were performed on the two parts of the genes respectively. The hub genes were intersected and verified by Least absolute shrinkage and selection operator (LASSO) analysis, receiver operating characteristic (ROC) curves, and single-cell RNA sequencing analysis. Finally, the hub genes differentially expressed in primary cardiomyocytes and chondrocytes were verified by RT-qPCR. The immune cell infiltration analysis, subtypes analysis, and transcription factors (TFs) prediction were carried out.

Results

In this study, 23 common DEGs were obtained by WGCNA and DEGs analysis. In addition, 199 common genes were acquired from three public databases by PPI. Inflammation and immunity may be the common pathogenic mechanisms, and the MAPK signaling pathway may play a key role in both disorders. DUSP1, FOS, and THBS1 were identified as shared biomarkers, which is entirely consistent with the results of single-cell RNA sequencing analysis, and furher confirmed by RT-qPCR. Immune infiltration analysis illustrated that many types of immune cells were closely associated with MI and OA. Two potential subtypes were identified in both datasets. Furthermore, FOXC1 may be the crucial TF, and the relationship of TFs-hub genes-immune cells was visualized by the Sankey diagram, which could help discover the pathogenesis between MI and OA.

Conclusion

In summary, this study first revealed 3 (DUSP1, FOS, and THBS1) novel shared biomarkers and signaling pathways underlying both MI and OA. Additionally, immune cells and key TFs related to 3 hub genes were examined to further clarify the regulation mechanism. Our study provides new insights into shared molecular mechanisms between MI and OA.
Nutritional status affects immune function and exacerbates the severity of pulmonary tuberculosis
Authors: Lu Chunli , Xu Yunyi , Li Xueya , Wang Min , Xie Bei , Huang Yaling , Li Yan , Fan Jiahua
Published: July 2024

Aim

To comprehensively evaluate the association and impact of nutritional status and immune function on the severity of pulmonary tuberculosis (PTB).

Methods

This descriptive cross-sectional study involved 952 participants who were diagnosed with active PTB. Severe PTB involves three or more lung field infections based on chest radiography. Nutritional status was evaluated using various indicators, including body mass index (BMI), the nutritional risk screening score (NRS-2002), total protein (TP), prealbumin (PA), transferrin (TRF), and serum albumin (ALB) levels and the prognostic nutritional index (PNI). Immune dysfunction was defined as a CD4+ count <500 cells/µl or a CD4+/CD8+ ratio <1. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were also calculated. Multivariate logistic and generalized linear regression were used to assess the associations between nutritional status, immune function, the severity of PTB, and the number of infected lung fields, adjusting for age, sex, and diabetes. Mediation analysis was conducted to evaluate the extent to which immune function mediated the impact of nutritional status on the severity of PTB. Sensitivity analysis was performed to enhance the robustness of the results.

Results

Compared to those in the general PTB group, patients in the severe PTB group tended to be older men with diabetes. Higher nutritional risk, higher proportion of immune dysfunction and lower lymphocyte counts were observed in the severe group. BMI and the PNI were found to be protective factors, while PLR was identified as a risk factor for disease severity. Immune dysfunction and the PLR are mediators of the relationship between nutritional status and PTB severity. When BMI, the PNI, and the PLR were combined with traditional clinical indicators, these parameters showed promising diagnostic value, and the AUC reached 0.701 (95% CI: 0.668–0.734).

Conclusion

The findings suggest that nutritional status is significantly associated with the severity of PTB, and immune function mediates the effects of nutritional status on the severity of PTB. Maintaining adequate BMI, PNI levels, and immune function or reducing PLR levels helps reduce the risk of severe PTB.
Case report: Variability in clinical manifestations within a family with incontinentia pigmenti
Authors: Belysheva Tatiana , Nasedkina Tatiana , Kletskaya Irina , Volchek Dana , Barinova Irina , Semenova Vera , Gadzhigoroeva Aida , Zelenova Ekaterina , Valiev Timur , Sharapova Elena , Michenko Anna , Allenova Anastasiia , Ponomareva Darya
Published: July 2024

Diagnosing skin diseases in children can be a complex interdisciplinary problem. Incontinentia pigmenti (IP), also known as Bloch-Sulzberger syndrome, is a rare hereditary genodermatosis related to a mutation in the IKBKG gene. We present a family case of IP described from the perspective of various specialists, including dermatologists, oncologists, geneticists, dentists, and trichologists. The peculiarity of this case is the development of squamous cell carcinoma (SCC) on the shin of a 10-year-old female patient with IP. The patient had a positive family history: her mother and two sisters also displayed clinical manifestations of IP with involvement of skin, teeth and hair. The presence of exons 4–10 deletion in the IKBKG gene in all affected females was confirmed by detailed genetic evaluation using long-range PCR, and also high degree of X-chromosome inactivation skewing was demonstrated. The family underwent a comprehensive examination and was followed up for 2 years with successful symptomatic treatment of dermatologic manifestations. Recommendations were also made regarding dental and hair problems. By the end of the follow-up period, patients had stabilized, with the exception of a 36-year-old mother who developed generalized morphea. The study demonstrates the varying expressiveness of clinical symptoms among family members and emphasizes the importance of timely diagnosis for effective management of patients with IP.
Case Report: The effect of automated manual lymphatic drainage therapy on lymphatic contractility in 4 distinct cases
Authors: Aldrich Melissa B. , Rasmussen John C. , Karni Ron J. , Fife Caroline E. , Aviles Frank , Eckert Kristen A. , Melin M. Mark
Published: July 2024

Introduction

Automated manual lymphatic drainage therapy (AMLDT) is available for home use in the form of a pneumatic mat of 16 pressurized air channels that inflate and deflate to mimic the stretch and release action of manual lymphatic drainage therapy. Four cases (a patient with complex regional pain syndrome and lymphedema, a healthy patient, a breast cancer survivor with chronic pain, and a patient with a history of abdominal surgery) underwent near-infrared fluorescence lymphatic imaging (NIRFLI) with AMLDT to evaluate the effect of AMLDT on lymphatic pumping and pain.

Methods

Each patient received 32–36 injections of 25 μg indocyanine green (ICG) on the anterior and posterior sides of their body and underwent 1 h of NIRFLI to assess the drainage of ICG laden lymph toward regional nodal basins at baseline. Each patient lay supine on the mat for 1 h of AMLDT with NIRFLI to assess lymphatic flow during treatment. A final NIFRFLI assessment was done 30–60 min posttreatment with the patient in the supine and prone position. Patients reported baseline and posttreatment pain using the Visual Analogue Scale. An imager analyzed NIRFLI images using ImageJ (US National Institutes of Health). Using time stamps of the first and last images to determine time lapsed and the number of pulses observed in a timeframe, pulsing frequency (pulses/min) was obtained to assess lymphatic function.

Results

All 4 cases completed the NIRFLI and AMLDT without complications; all 3 patients with baseline pain reported reduced pain posttreatment. AMLDT appeared to alter lymphatic contractility, with both increased and decreased pulsing frequencies observed, including in nonaffected limbs. Pulsing frequencies were very heterogeneous among patients and varied within anatomic regions of the same patient.

Discussion

This proof-of-concept study suggests that AMLDT may impact lymphatic contractility. Further research on its effect on lymphatic function is warranted.
The effect of gut microbiome and plasma metabolome on systemic sclerosis: a bidirectional two-sample Mendelian randomization study
Authors: Xie Shasha , Meng Qiming , Wang Lin
Published: July 2024

Background

Cellular and molecular biology, combined with research on the human microbiome and metabolome, have provided new insights into the pathogenesis of systemic sclerosis (SSc). However, most studies on gut microbiota (GM) and metabolome in SSc are observational studies. The impact of confounding factors and reverse causation leads to different insights. To shed light on this matter, we utilized Mendelian randomization (MR) to determine the causal effect of GM/metabolites on SSc.

Methods

Based on summary-level data from genome-wide association studies, bidirectional Two-sample MR was conducted involving 196 GM, 1400 plasma metabolism, and 9,095 SSc. Inverse Variance Weighting (IVW) was mainly used for effect estimation.

Results

Forward MR analysis found that three GM and two plasma metabolites are causally related to SSc. IVW results showed Victivallaceae (family) (OR, 1.469; 95%CI, 1.099–1.963; p = 0.009) and LachnospiraceaeUCG004 (genus) (OR, 1.548; 95%CI, 1.020–2.349; p = 0.04) were risk factor of SSc. Conversely, Prevotella7 (genus) (OR, 0.759; 95%CI, 0.578–0.997; p = 0.048)was a protective factor of SSc. The results on plasma metabolites indicated that Pregnenediol disulfate (C21H34O8S2) levels (OR, 1.164; 95%CI, 1.006–1.347; p = 0.041)was a risk factor of SSc, while Sphingomyelin (d18:1/19:0, d19:1/18:0) levels (OR, 0.821; 95%CI, 0.677–0.996; p = 0.045)was a protective factor of SSc. Reverse MR analysis did not find causally relationship between SSc and the above GM/plasma metabolites.

Conclusion

Our results revealed the causally effect between GM/plasma metabolites and SSc. These findings provided new insights into the mechanism of SSc. In particular, we demonstrated Prevotella7 was a protective factor of SSc despite its controversial role in SSc in previous researches.
Prevalence, risk factors, and outcomes of dysphagia after stroke: a systematic review and meta-analysis
Authors: Song Wenjing , Wu Minmin , Wang Haoran , Pang Ruifeng , Zhu Luwen
Published: July 2024

Background

Dysphagia is a common complication after stroke, which not only brings adverse outcomes but also greatly affects the quality of life of patients. At present, there is no systematic review or meta-analysis to comprehensively evaluate the epidemiological characteristics of post-stroke dysphagia (PSD). A systematic review of the prevalence, risk factors, and prognosis of PSD is essential.

Methods

Through 31 December 2022, a comprehensive literature search was performed for observational studies related to PSD. Five databases were retrieved. Random-effects models were used to estimate the pooled prevalence, odds ratio (OR), and 95% CIs.

Results

A total of 34 studies were included, and the results showed that the overall prevalence of PSD was 46.6% (95% CI, 0.405–0.528). The prevalence of dysphagia in ischemic stroke and hemorrhagic stroke was 43.6% (95% CI 0.370–0.501) and 58.8% (95% CI 0.519–0.654), respectively. The prevalence of PSD in Africa was 49.4% (95% CI, 0.196–0.792), in Asia was 40.1% (95% CI, 0.348–0.454), in Europe was 45.8% (95% CI, 0.327–0.590), in North America was 44.3% (95% CI, 0.370–0.517), in South America was 57.5% (95% CI, 0.441–0.708), and in Oceania was 64.1% (95%CI, 0.558, 0.724). In risk factor analysis, hypertension, previous stroke, and atrial fibrillation were significantly associated with the occurrence of PSD, pooled OR = 1.179 [(95% CI, 1.002–1.386), p < 0.05], pooled OR = 1.514 [(95% CI, 1.204–1.905), p < 0.001], and pooled OR = 1.980 [(95% CI, 1.580–2.481), p < 0.001]. In outcome studies, the prevalence of aphasia and dysarthria in PSD was 35.6% (95% CI, 0.213–0.499) and 54.5% (95% CI, 0.293–0.798), respectively. The prevalence of respiratory tract infection was 27.1% (95%CI, −0.038–0.579), and the prevalence of pneumonitis was 32.1% (95% CI, 0.224–0.418). Persistence of dysphagia at discharge and at 1 month was 74.5% (95% CI, 0.621–0.869) and 50.9% (95% CI, 0.142–0.876), respectively. Mortality rates for PSD patients during admission and discharge at 1 month, 3 months, and 1 year were 11.8% (95% CI, 0.083–0.152), 26.5% (95% CI, 0.170–0.359), 25.7% (95% CI, 0.19–0.324), and 31.3% (95% CI, 0.256–0.369), respectively.

Conclusion

This study found that the overall prevalence of PSD was 46.6%. Prevalence is most influenced by the diagnosis method. Hypertension, history of stroke, atrial fibrillation, patient age, and stroke severity were risk factors significantly associated with PSD. The prevalence of aphasia, dysarthria, respiratory tract infection, and pneumonitis in PSD patients is 2–4 times that of patients without PSD.

Systematic review registration: www.crd.york.ac.uk/PROSPERO, PROSPERO, CRD42021252967.
Causality between multiple autoimmune disorders and migraine and its subtypes: a two-sample Mendelian randomization study
Authors: Li Rui , Han Jing , Shao Guoliang , Liu Changyue , Li Shuo , Wang Mengmeng , Yang Dianhui
Published: July 2024

Introduction

Several studies have reported associations between various autoimmune diseases and migraine. Using Mendelian randomization (MR), this study aimed to evaluate the interplay between autoimmune diseases and migraine.

Methods

Here, instrumental variables, exposure factors, and outcome factors for 10 common autoimmune diseases and migraine and its subtypes were screened. This screening utilized comprehensive statistics from Europe’s largest genome-wide association study and performed reverse MR analysis on positive results. The causality between autoimmune diseases and migraine was comprehensively assessed using multiple analytical methods. Additionally, sensitivity analyses, such as the horizontal diversity heterogeneity and leave-one-out method, were performed.

Results

Random-effects inverse variance weighting analysis revealed a causal correlation between autoimmune hyperthyroidism and migraine (p = 0.0002), and this association was consistent across both migraine with aura (MA; p = 0.006) and migraine without aura (MO; p = 0.017). In addition, there was a positive causal association between systemic lupus erythematosus (SLE) and MA (p = 0.001) and between hypothyroidism and MO (p = 0.038). There is insufficient evidence to substantiate a causal link between outcomes and other autoimmune-related disorders, and reverse MR results did not reveal a causal relationship between migraines and these autoimmune disorders. The validity of the results was demonstrated by a sensitivity analysis; horizontal pleiotropy and heterogeneity were not observed.

Discussion

This study observed a positive genetic association between autoimmune hyperthyroidism and migraines. In addition, SLE positively affects MA, and hypothyroidism contributes to the incidence of MO. These results have great significance for future research and prevention of migraine.
Temporary Gasserian ganglion stimulation utilizing SNM electrode in subacute herpetic trigeminal neuralgia
Authors: Niu Jiejie , Wang Chenhui , Wang Xing , Lu Guijun
Published: July 2024

Objective

Gasserian ganglion stimulation (GGS) is a neuromodulation technique that has been extensively applied in treating postherpetic trigeminal neuralgia. However, permanent implantation of GGS was preferred in most treatment approaches. Few studies have investigated temporary GGS for the treatment of acute/subacute herpetic trigeminal neuralgia. Moreover, previous research has reported lead dislocation when utilizing traditional electrodes, which was associated with poor pain relief. In GGS research, preventing the accidental displacement of lead following implantation has consistently been a primary objective.

Methods

We report a case of a 70-year-old woman with subacute herpetic trigeminal neuralgia who underwent temporary GGS for 14 days utilizing a sacral neuromodulation (SNM) quadripolar-tined lead. Computed tomography-guided percutaneous foramen ovale (FO) puncture and temporary SNM electrode implantation were performed during the surgery. A telephone interview was conducted to record a 12-month follow-up.

Results

At admission, zoster-related trigeminal pain severity was assessed to be 9/10 on the visual analog scale (VAS). After a 14-day GGS treatment, the pain assessed on the VAS score reduced to 1/10 at discharge but increased to 4/10 at the 12-month follow-up after surgery. Additionally, the anxiety level improved from 58 points to 35 points on the Self-Rating Anxiety Scale (SAS), and the depression level improved from 62 points to 40 points on the Self-Rating Depression Scale (SDS). The Physical Component Summary score of the 12-item Short-Form Health Survey (SF-12) increased from 33.9 to 47.0, and the Mental Component Summary (MCS) score of the SF-12 increased from 27.4 to 41.9.

Conclusion

Temporary GGS might be a potentially effective treatment for subacute herpetic trigeminal neuralgia, and an SNM electrode might be a good choice for reducing the risk of dislocation.
Disease-modifying rdHSV-CA8* non-opioid analgesic gene therapy treats chronic osteoarthritis pain by activating Kv7 voltage-gated potassium channels
Authors: Zhuang Gerald Z. , Goins William F. , Kandel Munal B. , Marzulli Marco , Zhang Mingdi , Glorioso Joseph C. , Kang Yuan , Levitt Alexandra E. , Sarantopoulos Konstantinos D. , Levitt Roy C.
Published: July 2024

Chronic pain is common in our population, and most of these patients are inadequately treated, making the development of safer analgesics a high priority. Knee osteoarthritis (OA) is a primary cause of chronic pain and disability worldwide, and lower extremity OA is a major contributor to loss of quality-adjusted life-years. In this study we tested the hypothesis that a novel JDNI8 replication-defective herpes simplex-1 viral vector (rdHSV) incorporating a modified carbonic anhydrase-8 transgene (CA8*) produces analgesia and treats monoiodoacetate-induced (MIA) chronic knee pain due to OA. We observed transduction of lumbar DRG sensory neurons with these viral constructs (vHCA8*) (~40% of advillin-positive cells and ~ 50% of TrkA-positive cells colocalized with V5-positive cells) using the intra-articular (IA) knee joint (KJ) route of administration. vHCA8* inhibited chronic mechanical OA knee pain induced by MIA was dose- and time-dependent. Mechanical thresholds returned to Baseline by D17 after IA KJ vHCA8* treatment, and exceeded Baseline (analgesia) through D65, whereas negative controls failed to reach Baseline responses. Weight-bearing and automated voluntary wheel running were improved by vHCA8*, but not negative controls. Kv7 voltage-gated potassium channel-specific inhibitor XE-991 reversed vHCA8*-induced analgesia. Using IHC, IA KJ of vHCA8* activated DRG Kv7 channels via dephosphorylation, but negative controls failed to impact Kv7 channels. XE-991 stimulated Kv7.2–7.5 and Kv7.3 phosphorylation using western blotting of differentiated SH-SY5Y cells, which was inhibited by vHCA8* but not by negative controls. The observed prolonged dose-dependent therapeutic effects of IA KJ administration of vHCA8* on MIA-induced chronic KJ pain due to OA is consistent with the specific activation of Kv7 channels in small DRG sensory neurons. Together, these data demonstrate for the first-time local IA KJ administration of vHCA8* produces opioid-independent analgesia in this MIA-induced OA chronic pain model, supporting further therapeutic development.
Diet affects inflammatory arthritis: a Mendelian randomization study of 30 dietary patterns causally associated with inflammatory arthritis
Authors: Wang Haiyang , Wu Qinglin , Qu Pengda , Wang Shiqi , Du Shiyu , Peng Zhaorong , Tao Licheng , Wang Wuxia , Tang Xiaohu
Published: July 2024

Background

The causal associations between dietary intake and the risk and severity of Inflammatory Arthritis (IA) are currently unknown.

Objective

In this study, we aimed to investigate the causal relationship between nine dietary categories (30 types of diet) and IA using Mendelian randomization (MR).

Methods

We analyzed data from 30 diets and IA in a genome-wide association study (GWAS). Single nucleotide polymorphisms (SNPs) that could influence the results of MR analyses were screened out through the Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test. SNPs were analyzed through two-sample bidirectional MR using inverse variance weighting, MR-Egger regression, and weighted median method. The multiplicity and heterogeneity of SNPs were assessed using MR-Egger intercept term tests and Cochran’s Q tests. FDR correction was used to correct the p-values.

Results

IVW results showed that Beef intake [Odds ratio (OR) = 2.862; 95% confidence interval (CI), 1.360–6.021, p = 0.006, p_fdr < 0.05] was positively associated with rheumatoid arthritis(RA); Dried fruit intake (OR = 0.522; 95% CI, 0.349–0.781, p = 0.002, p_fdr < 0.05), and Iron intake (OR = 0.864; 95%CI, 0.777–0.960, p = 0.007, p_fdr < 0.05) were negatively associated with RA, all of which were evidence of significance. Fresh fruit intake (OR = 2.528. 95% CI, 1.063–6.011, p = 0.036, p_fdr > 0.05) was positively associated with psoriatic arthritis (PsA); Cheese intake (OR = 0.579; 95% CI, 0.367–0.914, p = 0.019, p_fdr > 0.05) was negatively associated with PsA; both were suggestive evidence. Processed meat intake (OR = 0.238; 95% CI, 0.100–0.565, p = 0.001, p_fdr < 0.05) was negatively associated with reactive arthritis (ReA), a protective factor, and significant evidence. All exposure data passed the heterogeneity check (Cochrane’s Q test p > 0.05) and no directional pleiotropy was detected. Leave-one-out analyses demonstrated the robustness of the causal relationship in the positive results.

Conclusion

Our study presents genetic evidence supporting a causal relationship between diet and an increased risk of IA. It also identifies a causal relationship between various dietary modalities and different types of IA. These findings have significant implications for the prevention and management of IA through dietary modifications.
Gallbladder cancer masquerading as xanthogranulomatous cholecystitis: a case report and literature review
Authors: Deng Xu , Yang Chun-yuan , Tian Wei , Zhu Zong-long , Tian Jian-xing , Huang Rui , Xia Ming , Pan Wei
Published: July 2024

Xanthogranulomatous cholecystitis (XGC) is a rare type of cholecystitis that, despite being benign poses diagnostic challenges due to its low prevalence and need for consensus on diagnostic criteria. Consequently, distinguishing XGC from gallbladder cancer (GBC) is challenging, leading to clinical misdiagnoses. This article presents a case where a patient initially diagnosed with GBC was later found to have XGC.
Investigating underlying molecular mechanisms, signaling pathways, emerging therapeutic approaches in pancreatic cancer
Authors: Mustafa Mohd , Abbas Kashif , Alam Mudassir , Habib Safia , Zulfareen  , Hasan Gulam Mustafa , Islam Sidra , Shamsi Anas , Hassan Imtaiyaz
Published: July 2024

Pancreatic adenocarcinoma, a clinically challenging malignancy constitutes a significant contributor to cancer-related mortality, characterized by an inherently poor prognosis. This review aims to provide a comprehensive understanding of pancreatic adenocarcinoma by examining its multifaceted etiologies, including genetic mutations and environmental factors. The review explains the complex molecular mechanisms underlying its pathogenesis and summarizes current therapeutic strategies, including surgery, chemotherapy, and emerging modalities such as immunotherapy. Critical molecular pathways driving pancreatic cancer development, including KRAS, Notch, and Hedgehog, are discussed. Current therapeutic strategies, including surgery, chemotherapy, and radiation, are discussed, with an emphasis on their limitations, particularly in terms of postoperative relapse. Promising research areas, including liquid biopsies, personalized medicine, and gene editing, are explored, demonstrating the significant potential for enhancing diagnosis and treatment. While immunotherapy presents promising prospects, it faces challenges related to immune evasion mechanisms. Emerging research directions, encompassing liquid biopsies, personalized medicine, CRISPR/Cas9 genome editing, and computational intelligence applications, hold promise for refining diagnostic approaches and therapeutic interventions. By integrating insights from genetic, molecular, and clinical research, innovative strategies that improve patient outcomes can be developed. Ongoing research in these emerging fields holds significant promise for advancing the diagnosis and treatment of this formidable malignancy.
Clinical analysis of special types of tracheobronchial foreign bodies in children
Authors: Cai Hao , Gao Jinjian
Published: July 2024

Objectives

To explore the clinical diagnosis and treatment of special types of tracheobronchial foreign bodies in children and provide a reference for clinicians to formulate treatment plans.

Methods

Clinical data of 29 children with special types of tracheobronchial foreign bodies who were treated at The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University between June 2017 and June 2022 were collected and analyzed, and their diagnosis and treatment processes were reviewed.

Results

All 29 special types of foreign bodies were successfully removed using rigid bronchoscopy under general anesthesia, with no surgical complications.

Conclusions and significance

For the treatment of special types of tracheobronchial foreign bodies, clinicians should make detailed surgical plans and select appropriate instruments according to different conditions to improve the surgical success rate and reduce the occurrence of complications.
Application of network pharmacology in traditional Chinese medicine for the treatment of digestive system diseases
Authors: Zheng Shihao , Liang Yijun , Xue Tianyu , Wang Wei , Li Size , Zhang Peng , Li Xiaoke , Cao Xu , Liu Qiyao , Qi Wenying , Ye Yongan , Zao Xiaobin
Published: July 2024

With the general improvement in living standards in recent years, people’s living habits, including their dietary habits, have changed. More people around the world do not follow a healthy diet, leading to an increase in morbidity and even mortality due to digestive system diseases, which shows an increasing trend every year. The advantage of traditional Chinese medicine (TCM) in treating digestive system diseases is evident. Consequently, the mechanisms of action of single Chinese herbs and compound Chinese medicines have become the focus of research. The research method of the network pharmacology system was highly consistent with the holistic concept of TCM, and provided a new perspective and theoretical basis for basic research on digestive system diseases. This article summarizes the common databases currently used in research on TCM. It also briefly introduces the basic methods and technologies of network pharmacology studies. It also summarizes the advancements of network pharmacology technology through a comprehensive literature search on PubMed. Based on this analysis, we further explored the role of TCM in treating digestive system diseases, including chronic gastritis, gastric cancer, ulcerative colitis, and liver cirrhosis. This study provides new ideas and references for treating digestive system diseases with TCM in the future and serves as a reference for relevant researchers.
Targeting heme in sickle cell disease: new perspectives on priapism treatment
Authors: Silveira Tammyris Helena Rebecchi , Calmasini Fabiano Beraldi , de Oliveira Mariana Gonçalves , Costa Fernando Ferreira , Silva Fábio Henrique
Published: July 2024

Men with sickle cell disease (SCD) frequently experience priapism, defined as prolonged, painful erections occurring without sexual arousal or desire. This urological emergency can lead to penile fibrosis and permanent erectile dysfunction if not treated adequately. Due to its complex pathophysiology, there is currently no effective preventative treatment for this condition. Recent studies have highlighted the dysfunction of the nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) pathway in erectile tissues as a critical mechanism in developing priapism in SCD. Additionally, further research indicates that intravascular hemolysis promotes increased smooth muscle relaxation in the corpus cavernosum and that excess heme may significantly contribute to priapism in SCD. Pharmacological treatments should ideally target the pathophysiological basis of the disease. Agents that reduce excess free heme in the plasma have emerged as potential therapeutic candidates. This review explores the molecular mechanisms underlying the excess of heme in SCD and its contribution to developing priapism. We discuss pharmacological approaches targeting the excess free heme in the plasma, highlighting it as a potential therapeutic target for future interventions in managing priapism.
Measuring the concentration of military power in the international geopolitical system: Singer’s methodology using only military indicators
Authors: Bunyavejchewin Poowin , Thavornyutikarn Supruet , Faugchun Pattanarat , Kamonpetch Porntep
Published: July 2024

This study quantitatively examines the impact of the COVID-19 pandemic on the concentration of military power within the international geopolitical system from 2014 to 2023. Utilizing a modified Composite Indicator of National Capability (mCINC) based on defense budgets and military personnel, this study analyzes the relative concentration of military capabilities among 145 states. Derived from the Correlates of War Project, our methodology enables an examination of variations in military capability concentration, especially during the pandemic years. The results trend towards the dispersion of military capabilities, with notable variations observed during the COVID-19 period, reflecting a more equitable distribution among states, notably major powers. These variations are attributed to a decrease in military capabilities among democracies, particularly the United States, and an increase in Russia’s military power. The study concludes that the pandemic years have led to a nuanced adjustment towards greater multipolarity, hinting at potential instability and uncertainty in geopolitics.