bluuebunny/crossref_metadata_2025 huggingface dataset:
Co-disposal as an alternative method for waste rock and tailings management–a review of geochemical aspects
Authors: Deni M C N , Afandi K , Sinamo B , Satriawan A
Published: December 2024

Gold mining and processing activities produce at least two materials with adverse impacts on the environment: waste rock and tailings. Waste rock is generally disposed of in a waste rock dump (WRD) or in-pit backfill, while tailings are disposed to facilities such as landfill, tailings dam, or in-pit backfill. This separation is a common practice that requires a large area and specific technical considerations of respective materials and locations. Geochemically, waste rock can be potentially acid forming (PAF) and produce acid mine drainage, while tailings geotechnically have low stability due to the very fine particles. Combining these two materials in one placement location, known as co-disposal, is expected to benefits the geochemical and geotechnical aspects. The present research aims to design a geochemically-safe co-disposal of waste rock and tailings. Field kinetic geochemical tests were carried out using a 200-liter barrel in an open space area with different co-disposal compositions and treatments to identify the leachate and surface water quality. The results show that co-disposal with a 2:1 ratio of waste rock to tailings composition with the addition of lime sand of 15 kg/ton of tailings and compaction process gives the best results on leachate water quality under the natural condition during the test. This series of tests concluded to determine geochemical factors in co-disposal quality, namely pH value of tailings, lime dosage, the quality and exposure period of the waste rock, and the compaction process of the co-disposal layers.
The effectiveness of fly ash and fly ash-cement mixtures as stabilizing materials for high plasticity clay
Authors: Pujiastuti H , Fitrayudha A , Adiansyah J , Ubaidillah A S , Winarti D , Wahyuningsih T , Efendy A , Fariyadin A , Isfanari  , Pascanawati M S , Muttaqin A , Ilmi M K , Samengasbumi R P , Sambesa A R , Rizki R , Fawaid M
Published: December 2024

The increasing activity of burning coal as fuel for Steam Power Plants (PLTU) will increase the amount of fly ash waste, urging the industry to maximize waste utilizations as, for instance, a stabilizing material for high plasticity clay. This research examined the effectiveness of clay + fly ash and clay + fly ash + cement stabilization in increasing the strength of road subgrade. The results showed that fly ash and fly ash + cement improved clay properties, demonstrated by the value of unsoaked CBR (5.78%) and soaked CBR (3.11%) of unstabilized clay. Clay + 20% fly ash yielded optimum CBR value (23,13%), and stabilizing clay subgrade on a 50-meter section using 20% fly ash at a cost of IDR 18,329,675. The mix of 40% fly ash + 15% cement yielded optimal CBR value (42.70%) at a cost of IDR 18,359,435.00. The evaluation of soil properties and cost analysis, shows that the most efficient mixture variation is 40% fly ash and 15% cement for clay stabilization.
G‐protein‐coupled receptor 41 in cardiomyocytes: Effect of butyrate on intracellular Ca2+ and sarcomere shortening
Authors: Yao Youxiu , Yang Xiaomei , Moore Brittni N. , Zhu Tianyue , Lester Laeben , Johns Roger A. , Pluznick Jennifer L. , Gao Wei Dong
Published: December 2024

G‐protein‐coupled receptor 41 (GPR41) is a Gαi‐coupled receptor activated by short‐chain fatty acids (SCFAs). Here, we tested that GPR41 is also expressed in cardiomyocytes and exerts a direct negative inotropic effect when activated by SCFA butyrate. Primary cardiomyocytes were isolated from wild‐type (WT) and GPR41 knockout (GPR41−/−) adult mice and intracellular Ca2+ concentration and cell shortening were measured using the IonOptix system. RNA localization (RNAScope), quantitative real‐time polymerase chain reaction (qRT‐PCR), immunofluorescence staining, and western blot were used to examine the expression of GPR41 in adult primary cardiomyocytes of WT and GPR41−/− mice. The effect of butyrate on shortening and intracellular Ca2+ transient via GPR41 was also tested in cardiomyocytes. We demonstrated for the first time the presence of GPR41s on cardiomyocytes. Butyrate dose‐dependently decreased cell shortening and the amplitude of intracellular Ca2+ transients in cardiomyocytes from WT but not GPR41−/− mice. In WT cardiomyocytes, butyrate decreased caffeine‐mediated amplitudes of intracellular Ca2+ transients from the sarcoplasmic reticulum (SR). Moreover, the inhibitory effects of butyrate on cell shortening and intracellular Ca2+ were pertussis toxin (PTX)‐sensitive. Finally, butyrate decreased the activity of sarcoendoplasmic reticulum Ca2+‐ATPase (SERCA) and cellular 3′‐5′‐cyclic adenosine monophosphate (cAMP) content. In conclusion, GPR41 is expressed on cardiomyocytes. Butyrate, a known GPR41 agonist, reduces cardiomyocyte shortening and intracellular Ca2+ transient via decreasing Ca2+ content in the SR by inhibiting SERCA activity in a PTX‐dependent manner. These findings establish that GPR41 is directly activated by SCFAs to decrease contraction and intracellular Ca2+ transient, highlighting the potential inhibitory role of GPR41 in cardiomyocytes.
Macrophage extracellular traps are induced by Mycoplasma bovis in bovine macrophages through NADPH oxidase/ROS‐dependent manner and their antibacterial efficacy
Authors: Baz Ahmed Adel , Chen Shengli , Hao Huafang , Jin Xiangrui , Lan Shimei , Li Zhangcheng , Jin Shanyu , Zhang Yifan , Chu Yuefeng
Published: December 2024

Mycoplasma bovis has emerged as a significant pathogen in cattle, leading to considerable economic losses in the cattle industry. It is associated with various clinical syndromes, including pneumoniae, mastitis, and arthritis. The innate immune response, particularly macrophages, plays a crucial role in combating infections caused by such pathogens. The release of macrophage extracellular traps (METs) represents a novel defense mechanism employed by macrophages; however, the impact of M. bovis on the formation of METs in bovine macrophages remains unknown. Therefore, the primary objective of this study is to investigate the mechanism by which M. bovis affects the formation of bovine METs and to evaluate their bactericidal efficacy. Our findings revealed that the bovine macrophage cell lines released DNA fibrils that colocalized with histones and cellular proteins in response to M. bovis infection, as visualized by confocal and scanning electron microscopy. Moreover, the formation of METs was found to depend on NADPH oxidase, which is crucial for reactive oxygen species generation. Importantly, the formation of METs led to cell lysis in response to M. bovis infection, as indicated by the release of lactate dehydrogenase, and this process was found to be independent of apoptosis and pyroptosis. Moreover, the release of METs in response to M. bovis infection was effective in both killing and restricting its growth. Overall, our study first described how METs were produced in bovine macrophages that responded to M. bovis and demonstrated their significant function in bacterial killing, which is helpful to improve our understanding of the host's immune defense against this pathogen.
Pediatric Lateral Condyle Fractures With Elbow Dislocation: Revisiting the Song Classification of the Most Severe Injuries
Authors: Campbell Leigh , Baker Courtney E. , Rees Andrew B. , Johnson Samuel R. , Schultz Jacob D. , Wollenman Lucas C. , Sborov Katherine D. , Hysong Alexander A. , Louer Craig R. , Lempert Nathaniel L. , Moore-Lotridge Stephanie N. , Schoenecker Jonathan G.
Published: December 2024

Introduction:

Lateral condyle fractures are the second most common pediatric elbow fracture and are at risk for malunion, nonunion or avascular necrosis. The Song or Jakob classification guides management and risk of complications. However, many lateral condyle fractures have accompanying bony or soft tissue injuries, including elbow dislocations, which are not represented in the current Song or Jakob classification systems. Little is known about the incidence and outcomes of these more complex injuries. The purpose of this study was to describe the largest known case series of these injuries and characterize the incidence and outcomes.

Methods:

Injury, presentation, treatment, and outcome data were retrospectively gathered on pediatric elbow fractures at a single center from November 2007 to October 2017.

Results:

Of 4607 pediatric elbow fractures, 492 were lateral condyle fractures, with 30 cases (6.1%) presenting with concomitant elbow dislocation. Predominantly affecting males (76.7%) with a median age of 6.9 years, these injuries often resulted from intermediate energy mechanisms. High rates of coincident neurovascular deficits (23%), skin tenting (13.3%), and polytrauma (13.3%) were observed. All cases were treated surgically, primarily within 24 hours, with no instances of AVN, nonunion, or fixation failure reported. Across the cohort, there were 2 (6.7%) pin tract infections, 2 cases required return to the operating room, and 12 (40.0)% patients requiring outpatient physical therapy for elbow stiffness.

Conclusions:

Lateral condyle fractures with concomitant ulnohumeral dislocation are distinct and unstable injuries requiring prompt inpatient treatment. Current classification systems do not adequately address this fracture-dislocation combination, risking underdiagnosis and potentially delayed reduction of a dislocated elbow. We propose adding a “Song 6” or “Jakob 4” category to existing classifications to ensure these injuries are properly identified and managed. This amendment will improve clinical awareness, facilitate timely intervention, and optimize outcomes for pediatric patients with these complex fractures.

Level of Evidence:

IV
Comparison of treatment regimens for unresectable stage III epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer
Authors: Dai Xin , Xu Qian , Sheng Lei , Zhang Xue , Huang Miao , Li Song , Huang Kai , Chu Jiahui , Wang Jian , Li Jisheng , Liu Yanguo , Zhou Jianyuan , Nie Shulun , Liu Lian
Published: December 2024

Background:

Durvalumab after chemoradiotherapy (CRT) failed to bring survival benefits to patients with epidermal growth factor receptor (EGFR) mutations in PACIFIC study ( evaluating durvalumab in patients with stage III, unresectable NSCLC who did not have disease progression after concurrent chemoradiotherapy). We aimed to explore whether locally advanced inoperable patients with EGFR mutations benefit from tyrosine kinase inhibitors (TKIs) and the optimal treatment regimen.

Methods:

We screened the PubMed, Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases from January 1, 2000 to December 31, 2022 and performed a meta-analysis based on a Bayesian framework, with progression-free survival (PFS) and overall survival (OS) as the primary endpoints.

Results:

A total of 1156 patients were identified in 16 studies that included 6 treatment measures, including CRT, CRT followed by durvalumab (CRT-Durva), TKI monotherapy, radiotherapy combined with TKI (RT-TKI), CRT combined with TKI (CRT-TKI), and TKI combined with durvalumab (TKI-Durva). The PFS after the TKI-containing treatments was significantly longer than after the TKI-free treatments (hazard ratio [HR] = 0.37, 95% confidence interval [CI], 0.20–0.66). The PFS of TKI monotherapy was significantly longer than CRT (HR = 0.66, 95% CI, 0.50–0.87) but shorter than RT-TKI (HR = 1.78, 95% CI, 1.17–2.67). Furthermore, the PFS of RT-TKI or CRT-TKI were both significantly longer than that of CRT or CRT-Durva. RT-TKI ranked first in the Bayesian ranking, with the longest OS (60.8 months, 95% CI = 37.2–84.3 months) and the longest PFS (21.5 months, 95% CI, 15.4–27.5 months) in integrated analysis.

Conclusions:

For unresectable stage III EGFR mutant NSCLC, RT and TKI are both essential. Based on the current evidence, RT-TKI brings the best survival advantage, while CRT-TKI needs further estimation. Large randomized clinical trials are urgently needed to explore the appropriate application sequences of TKI, radiotherapy, and chemotherapy.

Registration:

PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; No. CRD42022298490.
Enhanced hepatitis B virus–specific immunity by combining neutralizing antibody therapy and DNA vaccination in a murine model of chronic hepatitis B virus infection
Authors: Beretta Maxime , Vesin Benjamin , Wei Yu , Planchais Cyril , Rosenbaum Pierre , Ait-Goughoulte Malika , Pelletier Nadège , Hardy David , Mouquet Hugo , Bourgine Maryline
Published: December 2024

Background and Aims:

Successful treatment of chronic HBV infection remains a great challenge due to the difficulty in inducing efficient immune responses. Here, we investigated the therapeutic potential of DNA vaccination combined with a potent HBV broadly neutralizing antibody targeting the small surface viral antigen.

Approach and Results:

C57BL/6 mice were transduced with adeno-associated virus-HBV and were treated twice a week with HBV broadly neutralizing antibodies for 5 weeks. A DNA-based vaccine encoding the HBV core, envelope, and polymerase proteins was administered once to mice 3 weeks after initiating antibody therapy. The antiviral effects and antigen-specific immune responses were evaluated before and for 8 weeks after therapeutic vaccination. Vaccine administration with or without antibody treatment induced the development of functional HBV-specific CD8+ T cells and envelope-specific resident memory T cells in the liver. The combination of antibody treatment and DNA vaccination enhanced the recruitment of B and CD8+ T lymphocytes into the liver of HBV-carrier mice 2 weeks after vaccination. However, although still detectable 2 months after vaccination, HBV-specific CD8+ T cells showed an exhausted phenotype, suggesting that they are dysfunctional. In contrast, more effective control of antigenemia was observed following combination therapy, which was associated with the presence of HBs-specific memory B cells.

Conclusions:

Although the combination therapy did not result in a functional cure, our findings indicate it produced additive effects on the development of HBV-specific T cells in the liver immediately following treatment, offering a better insight into the mechanisms underlying hepatic tolerance.
Medication-Induced Lymphomatoid Granulomatosis Presenting as a Solitary Periocular Cutaneous Lesion
Authors: Shott Molly , Wang Diane , Bertus Brooke , Han Peng Cheng , Veltri Lauren , Codrea Vlad , Nguyen John
Published: December 2024

Lymphomatoid granulomatosis, a rare lymphoproliferative disorder, was previously defined by categorical pulmonary involvement with possible invasion into the skin, central nervous system, liver, and kidneys. However, recent reports have documented confirmed cases of lymphomatoid granulomatosis without lung involvement. Here, the authors describe a 70-year-old male with rheumatoid arthritis on methotrexate who presented with an ulcerating lesion on the right lower eyelid, initially suspicious for a basal cell carcinoma. Biopsy and immunohistochemical staining revealed grade 3 lymphomatoid granulomatosis. Further workup showed no systemic involvement. The patient’s presentation was thought to be secondary to chronic immunosuppression with methotrexate. Upon withdrawal of the medication, the lesion regressed. To our knowledge, this is the first case report of methotrexate-induced lymphomatoid granulomatosis presenting with a singular periocular cutaneous lesion.
Orbital Cellulitis Secondary to Dacryocystitis: A Case Series and Literature Review
Authors: O’Rourke Michéal , Tang Yi Fan , Pick Zelda , Tan Jennifer S. , Tan Priscilla E. Z. , Athavale Dnyaneshwar D. , O’Donnell Brett , Selva Dinesh , Gajdatsy Adam , Hardy Thomas G. , McNab Alan , Khong Jwu Jin
Published: December 2024

Purpose:

This study aimed to determine risk factors, and describe management and outcomes in patients who developed orbital cellulitis secondary to dacryocystitis.

Methods:

Multicenter retrospective case series with 18 patients and review of published cases.

Results:

The mean age was 62 years, 56% were female and 50% had recurrent dacryocystitis. Visual acuity was reduced in the affected eye with a mean of 0.27 logMAR (Snellen 20/40) which improved to 0.15 logMAR (Snellen 20/30) at final follow up. Two cases (12%) had dacryoliths and 1 patient had sarcoidosis within the lacrimal sac. Gram-positive bacteria were identified in 73% (11/15), gram-negative bacteria in 13% (2/15), and mixed infection in 13% (2/15), respectively. Cases who had dacryocystorhinostomy as definitive treatment, either acutely (n = 3) or electively (n = 10) had full resolution. Transcutaneous drainage of the medial wall abscess in 10 patients helped resolve acute cellulitis. Four patients declined dacryocystorhinostomy after transcutaneous drainage; 2 had repeated dacryocystitis and orbital cellulitis, while 2 had no further infective episodes. One immunosuppressed patient had rapid progression to non-perception-of-light vision due to fungal invasion. Forty-six published cases reported up to 28% permanent loss of vision (perception-of-light and non-perception-of-light). Dacryoliths were discovered in 17% of published cases.

Conclusions:

Orbital cellulitis complicating dacryocystitis appears to be related to recurrent dacryocystitis and possibly the presence of dacryoliths. Immunosuppression is identified as a poor prognostic factor in this series. While transcutaneous drainage works well as a temporizing measure, dacryocystorhinostomy either done acutely or deferred until resolution of orbital cellulitis is required for definitive cure.
Adalimumab Use in Severe Recalcitrant Vulval Lichen Sclerosus and Vulval Lichen Planus
Authors: Courtney Ashling , Adamson Sarah Rose , Veysey Emma
Published: December 2024

Objectives

This case series aims to evaluate the demographic features, disease characteristics, and treatment outcomes of 8 patients receiving subcutaneous (SC) adalimumab for severe, refractory vulval lichen sclerosus (VLS) and/or vulval lichen planus (VLP). Both conditions are chronic inflammatory dermatoses that significantly impair quality of life, and although first-line treatment typically involves potent to ultrapotent topical corticosteroids, managing severe cases is challenging due to a lack of FDA-approved systemic therapies. Adalimumab, a TNF-α inhibitor, may offer a promising alternative by targeting the inflammatory cytokine implicated in the pathogenesis of both conditions.

Methods

Eight patients received SC adalimumab for VLS and/or VLP at a tertiary referral vulvar disorders clinic from September 2020 to June 2024. Among the 8 patients, 4 had VLS/VLP clinical overlap, 2 had VLP, and 2 had VLS. Evaluation included patient-reported outcome measures (PROMs) namely the vulval life quality index (VLQI) and numerical rating scales for itch and pain, and objective clinical severity was assessed by a vulvar dermatologist based on cutaneous signs and architectural features.

Results

Adalimumab was well tolerated by 6 of 8 patients who received treatment for at least 9 months. Varying degrees of clinical improvement were observed in cutaneous signs and PROMs, including significant reductions in vulval life quality index scores for 6 patients. Architectural changes remained stable throughout treatment for all patients.

Conclusion

This case series indicates that SC adalimumab may be a treatment option for patients with severe, refractory VLS and VLP, as demonstrated by significant improvements in PROMs. The observed clinical benefits suggest that adalimumab targets key inflammatory pathways in these conditions. Controlled trials are necessary to further validate these findings and define adalimumab's role in managing severe refractory VLS and VLP. Future research should also investigate long-term efficacy and safety, as well as potential predictors of treatment response, to optimize care for this challenging patient population.
Abnormal Upper Gastrointestinal Motility Reduces the Efficacy of Colectomy for Colonic Inertia
Authors: Dourado Justin , Garoufalia Zoe , Emile Sameh Hany , Wignakumar Anjelli , Rogers Peter , Weiss Brett P. , Meknarit Sarinya , Mavarantonis Sofoklis , Wexner Steven D. , DaSilva Giovanna
Published: December 2024

This systematic review aimed to assess the effects of upper gastrointestinal (UGI) dysmotility on outcomes of surgical treatment of colonic inertia (CI). This PRISMA-compliant systematic review and meta-analysis searched PubMed, Scopus, Google Scholar, and clinicaltrials.gov through October 2023 for studies that assessed outcomes of CI patients who underwent colectomy while putting data on UGI motility in context. The primary outcome was postoperative persistence or recurrence of constipation. Secondary outcomes were postoperative complications, continence, and quality of life (QoL) improvements. The revised tool to assess the risk of bias in nonrandomized studies of interventions was used to assess the risk of bias, and the certainty of evidence was graded using the GRADE approach. Eight studies (1991 to 2013) included data on UGI evaluation of CI patients; 12.8 to 24.3% were tested for concomitant GI dysmotility. High rates of motility abnormalities were in the small bowel (31.4%), stomach (34.1%), and esophagus (48.5%). Patients with UGI dysmotility and CI were more likely to experience constipation recurrence (OR: 10.71, 95% CI: 2.17; 52.87, P=0.004) and less likely to have postoperative QoL improvements (OR: 0.16, 95% CI: 0.04; 0.65, P=0.010) compared with patients with CI and no abnormal UGI testing. There were no differences in postoperative complications (OR: 1.59, 95% CI: 0.64; 4.267, P=0.542) or continence (OR: 0.29, 95% CI: 0.06; 1.47, P=0.0136) rates. Large subsets of CI patients with concomitant UGI dysmotility may be preoperatively underdiagnosed. UGI dysmotility may be associated with a higher risk of postoperative recurrence of constipation and suboptimal improvements in QoL. We recommend routine UGI evaluation before surgery for CI.
Malaria pervasiveness in Sub-Saharan Africa: Overcoming the scuffle
Authors: Alum Esther Ugo , Tufail Tabussam , Agu Peter Chinedu , Akinloye Dorcas Ibukun , Obaroh Israel O.
Published: December 2024

Malaria has posed a momentous health and economic burden to the Sub-Saharan African region. The Sub-Saharan African region accounts for more than 90% of global malaria-related mortality and morbidity. Pregnant women and children under 5 years old are the most vulnerable. Mosquitoes transmit the plasmodium which is the parasite responsible for malaria. The climatic conditions, poverty, and poor healthcare system of the Sub-Saharan African region are some factors fueling this menace. There have been concerted efforts to annihilate malaria but the scuffle has been a tedious one. Malarial eradication campaigns have been focused on mosquito control through the use of insecticide-treated bed nets, use of indoor insecticide sprays, and use of larvicides. The use of artemisinin in combination with other drugs has been effective to some extent. Despite the aforementioned strategies, the pervasiveness of malaria infection in the Sub-Saharan African region is worrisome. Thus, strengthening the already existing control measures, finding novel measures through intensive research, and embracing malaria vaccination could help accelerate the overcoming of this scuffle. In this review, we utilized relevant published data from various databases to reexamine the factors fueling malaria pervasiveness in this region and spelled out point-by-point intervention protocols to end malaria scuffle.
Complete remission after pembrolizumab monotherapy in a non-small cell lung cancer patient with PD-L1 negative, high tumor mutational burden, and positive tumor-infiltrating lymphocytes: A case report
Authors: Li Suoni , Ma Jiequn , Bai Jie , Zhao Zheng
Published: December 2024

Rationale:

Immune checkpoint inhibitors have been used to treat cancer patients. Non-small cell lung cancer (NSCLC) patients with a high expression level of programmed cell death ligand-1 (PD-L1) could benefit from immune checkpoint inhibitor monotherapy. However, treating NSCLC patients with PD-L1 negative is still a clinical challenge. The utilization of new-type tumor markers as predictive indicators of therapeutic efficacy, with the aim of guiding clinical medication strategies, has emerged as a paramount focus of clinical investigation and interest.

Patient concerns and diagnoses:

We reported a 72-year-old male with cough diagnosed as poorly differentiated metastatic lung adenocarcinoma (cT3N2M1, stage IV). He tested negative for driver gene mutations, and PD-L1 negative (＜1%), but a high tumor mutational burden (30.9 and 39.1 mutations/Mb in the lung tissue and blood, respectively), and positive tumor-infiltrating lymphocytes.

Interventions:

The patient received pembrolizumab monotherapy.

Outcomes:

After 8 treatment cycles over 5 months, repeat examinations showed significantly reduced lung mass and circulating tumor DNA abundance. The patient reached clinical complete remission and had long-term survival with no significant adverse events.

Lessons:

A comprehensive evaluation of multiple tumor biomarkers should be considered in NSCLC patients. Pembrolizumab monotherapy could benefit NSCLC patients with negative driver genes, PD-L1 negative, a high tumor mutational burden, and positive tumor-infiltrating lymphocytes.
Acute myeloid leukemia treatment outcomes with isocitrate dehydrogenase mutations: A systematic review and meta-analysis
Authors: Qin Han , Xu Rui , Yang Yingchao
Published: December 2024

Background:

Isocitrate dehydrogenase (IDH) gene alterations and acute myeloid leukemia (AML) treatment results remain controversial. This study reviews the literature on IDH mutations in AML to determine the foundation of individualized therapy and improve effectiveness, survival time, and recurrence rate.

Methods:

Seven English and 2 Chinese databases were searched for literature on IDH mutations and AML outcomes. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

Results:

Twenty studies were included in this analysis. For the prognostic influence of IDH mutation on AML patients, the pooled HRs of overall survival in AML patients were 0.76 (95% CI, 0.63–0.93); the pooled HRs of event-free survival were 1.34 (95% CI, 1.15–1.57; heterogeneity: I
2 = 52.2%, P = .027 < 0.05); the pooled HRs of recurrence free survival were 0.79 (95% CI, 0.61–1.02). The pooled HRs of overall survival in AML patients with mutant IDH1 were 1.62 (95% CI, 1.42–1.86) and of mutant IDH2 were 1.07 (95% CI, 0.89–1.29). The pooled HRs for event-free survival in AML patients with mutant IDH1 were 1.71 (95% CI, 1.40–2.08) and of mutant IDH2 were 0.93 (95% CI, 0.65–1.34). No evidence of publication bias was observed.

Conclusions:

Different subtypes of IDH mutations may lead to different AML prognoses, suggesting the feasibility of personalized treatment for AML patients.
The effect of integrated medical care on the daily life of patients with coronary heart disease
Authors: Xiao Han , Deng Youlun , Xiao Hui , Liu Xiaoqiong , Qin Nian
Published: December 2024

This study aims to explore the impact of comprehensive medical care on the daily life of patients with coronary heart disease (CHD) and to evaluate its effectiveness in improving quality of life, alleviating symptoms, and reducing the risk of cardiac events. A new comprehensive medical care scheme combining Traditional Chinese Medicine nursing differentiation, collaborative nursing interventions, and specialized community care was proposed. Patients with CHD were recruited as study subjects. Data were collected via questionnaires and interviews to assess the real-world impact of comprehensive medical care on the daily lives of patients. Significant improvements were observed in the observation group across multiple metrics. Baseline characteristics between the 2 groups showed no significant differences initially. Post-intervention, the observation group demonstrated significant improvements in left ventricular ejection fraction and self-assessment of stress (SAS), with left ventricular ejection fraction values increasing to 53.8% compared to 47.2% in the control group, and SAS scores decreasing markedly (P < .05). Additionally, the Disease Severity Index (DSI) indicated a significant reduction in disease severity in the observation group compared to a nonsignificant change in the control group (P > .05). Quality of life, assessed via MacNew and activities of daily living scores, also improved significantly post-intervention in the observation group compared to the control group (P < .05). Furthermore, the observation group exhibited a lower incidence of myocardial ischemia, myocardial infarction, and thrombosis over a 3-year period, with patient satisfaction significantly higher in the observation group (90% reported perfect contentment) compared to the control group (70% reported perfect contentment; P < .001). These findings suggest that the comprehensive nursing care approach significantly enhances cardiac function, quality of life, and patient satisfaction in CHD patients.
Knowledge, attitudes, and practices on hypertension among the health science faculty and students at the University of Namibia: A cross-sectional study
Authors: Keendjele Tuwilika, P.T. , Amkongo Mondjila , Mojiminiyi Frank , Namene Johanna , Niiteta Katrina , Katali Ottilie, K.H. , Nashihanga Tunelago, E. , Nelongo Josefina , Shilumba Moneni, L. , Mkandla Zibusiso
Published: December 2024

Hypertension is a serious health concern, especially in developing countries, and assessing people’s knowledge, attitudes, and practices (KAP) is important for its awareness and management. This cross-sectional study aimed to assess the KAP on hypertension among students and staff from the Health Sciences and Veterinary Medicine Faculty of the University of Namibia. A cross-sectional study design was conducted on adult participants who completed the KAP questionnaire while resting, and thereafter their blood pressure (BP) was measured. This study was conducted in September 2023. The sample comprised 99 participants (77 females and 22 males) aged 18 to 64 years. The majority (94%) of the participants had normal BP (≥140/90 mm Hg). The systolic BP of females (113.13 ± 13.70 mm Hg) was significantly lower (P = .011) than that of males (121.64 ± 13 mm Hg); however, there was no significant difference in diastolic BP between the 2 genders (73.58 ± 9.37 for females and 75.95 ± 10.55 for males; P = .311). Approximately 85% of the participants demonstrated a good understanding of the risk factors associated with hypertension. About 91% of the participants believed that hypertension is a serious health problem and were willing to change their daily routine to better manage their hypertension. Only approximately 39% of the participants regularly monitored their BP. Just above 50% of the participants regularly engaged in physical activities and made dietary modifications to maintain a healthy heart. It is important to host regular hypertension campaigns among health science personnel, as this would help refresh and improve their KAP in prevention and management.
Development and application of a predictive model for survival and drug therapy based on COVID-19-related lncRNAs in non-small cell lung cancer
Authors: Huang Ziyuan , Han Zenglei , Zheng Kairong , Zhang Yidan , Liang Yanjun , Zhu Xiao , Zhou Jiajun
Published: December 2024

Numerous studies have substantiated the pivotal role of long non-coding RNAs (lncRNAs) in the progression of non-small cell lung cancer (NSCLC) and the prognosis of afflicted patients. Notably, individuals with NSCLC may exhibit heightened vulnerability to the novel coronavirus disease (COVID-19), resulting in a more unfavorable prognosis subsequent to infection. Nevertheless, the impact of COVID-19-related lncRNAs on NSCLC remains unexplored. The aim of our study was to develop an innovative model that leverages COVID-19-related lncRNAs to optimize the prognosis of NSCLC patients. Pertinent genes and patient data were procured from reputable databases, including TCGA, Finngen, and RGD. Through co-expression analysis, we identified lncRNAs associated with COVID-19. Subsequently, we employed univariate, LASSO, and multivariate COX regression techniques to construct a risk model based on these COVID-19-related lncRNAs. The validity of the risk model was assessed using KM analysis, PCA, and ROC. Furthermore, functional enrichment analysis was conducted to elucidate the functional pathways linked to the identified lncRNAs. Lastly, we performed TME analysis and predicted the drug sensitivity of the model. Based on risk scores, patients were categorized into high- and low-risk subgroups, revealing distinct clinicopathological factors, immune pathways, and chemotherapy sensitivity between the subgroups. Four COVID-19-related lncRNAs (AL161431.1, AC079949.1, AC123595.1, and AC108136.1) were identified as potential candidates for constructing prognostic prediction models for NSCLC. We also observed a positive correlation between risk score and MDSC, exclusion, and CAF. Additionally, two immune pathways associated with high-risk and low-risk subgroups were identified. Our findings further support the association between COVID-19 infection and neuroactive ligand-receptor interaction, as well as steroid metabolism in NSCLC. Moreover, we identified several highly sensitive chemotherapy drugs for NSCLC treatment. The developed model holds significant value in predicting the prognosis of NSCLC patients and guiding treatment decisions.
Heparin-induced thrombocytopenia during anticoagulation therapy for COVID-19-related pulmonary embolism: A case report
Authors: Zhang Yu , Chen Zhenling , Li Jianying , Wang Xuejing , Liu Yi
Published: December 2024

Rationale:

One of the main characteristics of COVID-19 is the high incidence of venous thromboembolism, particularly pulmonary embolism. Anticoagulation therapy is the primary treatment for pulmonary embolism. Heparin-induced thrombocytopenia (HIT) is an antibody-mediated adverse reaction to heparin that occurs during its use of heparin drugs. The main clinical manifestation is a decrease in platelet count, which can lead to the formation of arterial and venous thrombosis and, in severe cases, even death. Herein, we present a case of HIT that occurred during anticoagulation therapy for COVID-19, complicated by pulmonary embolism.

Patient concerns:

An 86-year-old man with COVID-19 experienced a significant decrease in platelet count and progression of venous thrombosis in the lower extremities during anticoagulation therapy with nadroparin.

Diagnoses:

The 4T score was 6; therefore, HIT was considered.

Interventions and outcomes:

All heparin-based drugs were discontinued, and argatroban was administered as anticoagulation therapy. The patient’s platelet count was monitored, and it gradually returned to normal.

Lessons:

Clinicians should remain vigilant to venous thromboembolism for COVID-19 patients even after recovery. During anticoagulant therapy, if thrombocytopenia occurs, HIT should be considered due to its high mortality rate. The 4T scoring system was used for the initial assessment. HIT antibodies can be detected, if necessary, to assist in diagnosis and reduce the occurrence of severe HIT. In the future, by detecting certain biomarkers, we can screen out patients with HIT who are more prone to thrombotic events, thereby minimizing the risk of bleeding caused by anticoagulation.
Risk factor analysis and nomogram model establishment for in-hospital death of elderly patients with surgically treated traumatic acute subdural hematoma
Authors: Wu Ruhong , Liu Chunbo , Shi Jia , Jia Geng , Qin Huaping
Published: December 2024

The purpose of this study was to investigate the risk factors for in-hospital death in elderly patients with surgically treated traumatic acute subdural hematoma (ASDH) and to construct a nomogram model for in-hospital death risk prediction. We analyzed 104 elderly patients who underwent decompressive craniotomy (DC) for isolated traumatic ASDH between May 2013 and May 2021 in our department. Independent factors for in-hospital death were identified via univariate and multivariate logistic regression analyses, and a nomogram model was constructed and validated. The overall in-hospital mortality rate was 58.7% (61/104). Sex (odds ratio [OR] = 11.94), dilated pupils (bilateral vs absent; OR = 194.16) and subarachnoid hemorrhage (SAH) (OR = 16.01) were independent risk factors for in-hospital death. A nomogram model for in-hospital death risk prediction was constructed based on these variables. Statistical analysis revealed that this model had good predictive performance, and receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of the nomogram model was 0.916 (95% confidence interval [CI] = 0.861–0.970). The calibration plot, which compared the predicted effective rate and observed effective rate, revealed the accurate predictive ability of the model. The model was internally validated via 200 bootstrap samples to calculate the discrimination accuracy, and the concordance index was 0.891. Decision curve analysis (DCA) demonstrated that the nomogram was clinically beneficial. The most important risk factors for in-hospital death in elderly patients with surgically treated traumatic ASDH were sex, dilated pupils, and SAH. The nomogram constructed from these data could be a promising and convenient tool to predict in-hospital death risk, but further external validation is needed.
Metastatic dedifferentiated liposarcoma of the mediastinum with osteosarcomatous differentiation: A case report
Authors: Hu Cong , Nong Shuxiong , Liu Aihua , Huang Weiling , Qi Yin , Wang Ying , Ye Yingfang , Jiang Yuancheng , Chen Yixin , Zhang Qi , Wu Meng
Published: December 2024

Rationale:

Liposarcoma is a malignant tumor of adipocytic differentiation that rarely arises within the mediastinum. Most of the existing data available comes from scattered case reports and a few small series.

Patient concerns:

A 51-year-old man was admitted with cough and sputum accompanied by fever. X-ray and CT showed a bulky anterior mediastinal mass that was initially misdiagnosed as a teratoma. PET/CT demonstrated a lesion on that location showing a small area of moderately intense uptake. After surgical excision, histopathological examination via hematoxylin and eosin first revealed the diagnosis of malignant undifferentiated tumors. The results of immunohistochemical evaluations were as follows: P63 (scattered +), VIMENTIN (giant cell +), CD68 (KPI; giant cell +), SMA (−), and Ki-67 (Li: 50%). Molecular pathology: MDM2 gene status (+) with amplification.

Diagnoses:

The final histopathological diagnosis was dedifferentiated liposarcoma with osteosarcomatous differentiation.

Interventions:

The patient underwent left mediastinal tumor resection, left upper lobe wedge resection and postoperative chemotherapy.

Outcomes:

Mediastinal recurrences and chest wall metastases occurred quickly before the second round of chemotherapy 2 months later. Four months after surgery, the patient died.

Lessons:

This paper presents a case of dedifferentiated liposarcoma with osteosarcomatous differentiation in a rare location: the mediastinum. Correct diagnosis is of importance for appropriate choice of therapy. Clinicians should be aware of the presence of a dedifferentiated liposarcoma within a mass on the mediastinum and enhancing treatment and management strategies for affected patients.
Cutting-edge and topical issues in the treatment of breast cancer with traditional Chinese medicine based on CiteSpace bibliometric analysis
Authors: Chai Jiapeng , Zhang Nan , Li Tie , Jiang Hailin , Zhao Jinying , Li Xuefeng , Wang Heran , Zhang Jiaxun , Wang Lin , Zhang Qi , Jiang Yuxin , Wang Fuchun
Published: December 2024

Background:

Breast cancer poses a significant health threat to women, marked by high incidence and mortality rates. Although modern treatment primarily involves surgery and chemotherapy, which may reduce quality of life, limited analysis exists on the effects of traditional Chinese medicine (TCM) on this aspect. In this paper, bibliometric software was used to study the literature related to TCM in the treatment of breast cancer to provide researchers with new insights and directions for development.

Methods:

By using CiteSpace and VOSviewer, we conducted an analysis of literature on TCM in breast cancer treatment from the Web of Science Core Collection (2013–2023). The assessment encompassed countries, institutions, journals, authors, keywords, and references, providing a comprehensive overview of developments in the field.

Results:

Analyzing 7419 articles, this study revealed an increasing trend in TCM research on breast cancer from 2013 to 2023. China and its institutions, particularly Beijing University of Chinese Medicine, made significant contributions. Liu Zhishun emerged as the most prolific author, while Y. Macpherson received the highest number of citations. The journal Evidence-Based Complementary and Alternative Medicine received the highest number of citations. Research primarily centers on TCM approaches for enhancing breast cancer patients’ quality of life and elucidating their underlying mechanisms.

Conclusion:

Numerous studies have investigated TCM in treating female breast cancer, revealing treatment trends, analyzing major research topics, currently focusing on acupuncture, breastfeeding, and TCM, which have a greater impact on positively ameliorating breast cancer. Influential authors and publications were also identified. These insights provide valuable guidance for future research, contributing to the foundation for developing effective TCM strategies for breast cancer.
Amoxicillin-associated hemorrhagic colitis: A case report and literature review
Authors: Xiong Yu-Ling , Peng Chao , Deng Ying-Jiang , Li Wei , Huang Yin , Tian Yue
Published: December 2024

Rationale:

Antibiotic-associated hemorrhagic colitis (AAHC) is a special type of antibiotic-associated colitis. Due to the increased use of antibiotics, especially amoxicillin, which is commonly used in clinical practice, the incidence of antibiotic-associated hemorrhagic colitis has also increased. However, doctors have insufficient understanding of this disease, and patients may be missed or misdiagnosed.

Patient concerns:

A 71-year-old female patient was admitted to our hospital with abdominal pain, diarrhea, and bloody stools. There was a history of oral amoxicillin before the onset of the disease.

Diagnosis:

The final diagnosis of this patient was amoxicillin-associated hemorrhagic colitis.

Interventions:

The patient stopped using antibiotics and was given “Bifidobacterium quadruplex live bacterial tablets and L-glutamine sodium gualenate granules” orally.

Outcomes:

After oral administration, the patient’s symptom rapidly were completely alleviate. Follow-up colonoscopy revealed normal mucosal images.

Lesson:

Through this case report, doctors should increase their understanding of the disease, especially for patients with sudden abdominal pain accompanied by bloody stools as the main complaint, it is significant to attend to inquiries about the history of antibiotic use, such as amoxicillin, and pay attention to the discovery of acid-producing Klebsiella in the fecal microbiota.
Anti-NMDAR encephalitis presenting with persistent fever and meningitis and responding well to distinctive individualized first-line treatment: A case report
Authors: Jin Xin , Zhuang Jianhua , Xu Jin
Published: December 2024

Rationale:

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis characterized by diverse neurological and psychiatric symptoms. It predominantly affects young women, particularly those with ovarian teratomas. However, cases without teratomas are also commonly reported, often exhibiting poorer treatment responses and higher relapse rates. Persistent fever and signs of meningitis are rare in such cases. Diagnosis is confirmed through the detection of anti-NMDAR antibodies.

Patient concerns:

A 15-year-old female presented with episodic loss of consciousness, fever, nuchal rigidity, limb convulsions, and psychiatric symptoms following a stressful exam period. Initial symptomatic treatments were ineffective.

Diagnosis:

The diagnosis of anti-NMDAR encephalitis was confirmed through lumbar puncture, brain imaging, and the detection of anti-NMDAR antibodies in cerebrospinal fluid and serum.

Interventions:

The patient received tailored first-line therapy, including high-dose methylprednisolone and 3 courses of intravenous immunoglobulin (IVIG).

Outcomes:

The patient exhibited significant clinical improvement, with a reduction in seizure frequency and eventual complete seizure control. Body temperature normalized, and follow-up showed progressive recovery in cognitive and motor functions.

Lessons:

This case highlights the importance of early diagnosis and individualized treatment in anti-NMDAR encephalitis. Repeated IVIG courses proved effective, underscoring the need for personalized treatment plans in managing this condition. Persistent fever and signs of meningitis were rare and contributed to the diagnostic challenge, highlighting the clinical complexity of this case.
Effectiveness of virtual reality in cardiac rehabilitation patients for exercise capacity and negative emotions: A systematic review and meta-analysis
Authors: Zhang Meijun , Liu Si , Xiong Xiaoyun , Liu Mengdie , Wang Ying , Yang Ying , Xiang Qin
Published: December 2024

Background:

The significance of virtual reality (VR) technology as an alternative or complementary modality to traditional cardiac rehabilitation is of increasing interest. Numerous studies have examined the effects of virtual reality technology in cardiac rehabilitation patients, but the results have been inconsistent.

Methods:

We conducted a systematic search of the Cochrane Library, Web of Science, PubMed, Embase, Scopus, ProQuest, OVID, CINAHL, SinoMed, CNKI, WanFang, VIP Database, and ReadShow databases following the Program for Systematic Review and Meta-Analysis guidelines. The search included studies published up until June 30, 2024. The Cochrane Risk of Bias Tool was used to examine the methodological quality of the included randomized controlled studies. When feasible, a meta-analysis was performed to calculate the pooled effects using Review Manager (version 5.3). Otherwise, narrative summaries were performed.

Results:

A total of 11 studies with 1093 patients were included. The results of systematic review and meta-analysis showed that virtual reality technology improved patients’ exercise capacity (mean difference: 53.26, 95% confidence interval [CI]: 45.14–61.37; P < .00001); anxiety (standardized mean difference [SMD]: −0.39, 95% CI: −0.69, −0.08, P = .01); depression (SMD: −0.48, 95% CI: −0.79, −0.17; P = .003); stress (SMD: −0.72, 95% CI: −1.03, −0.40; P < .00001); emotional tension (SMD: −0.81, 95% CI: −1.15, −0.47; P < .00001); emotional tension (SMD: −0.64, 95% CI: −0.98, −0.30; P = .0002), and intrapsychic stress (SMD: −0.56, 95% CI: −0.90, −0.23; P = .0009).

Conclusion:

Virtual reality-based interventions can be effective in improving patients’ exercise capacity and negative emotions. However, further research is needed to determine the efficacy of VR for other clinical outcomes.