bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeted Therapy and Immunotherapy for Advanced Malignant Conjunctival Tumors: Systematic Review
Authors: Serbest Ceylanoglu Kubra , Guneri Beser Buse , Singalavanija Tassapol , Juntipwong Sarinee , Worden Francis Paul , Demirci Hakan
Published: January 2024

Purpose:

To review the outcomes of targeted therapy and immunotherapy in advanced conjunctival tumors, including conjunctival squamous cell carcinoma, conjunctival melanoma, and conjunctival lymphoma.

Methods:

A Pubmed database systematic search was performed between January 1999 and December 2022. The literature search was limited to studies published in English.

Results:

This review included 142 patients with advanced malignant conjunctival tumors from 42 articles. In the conjunctival squamous cell carcinoma group, 2 cases of advanced conjunctival squamous cell carcinoma treated with epidermal growth factor receptor inhibitors showed significant tumor size improvement after 7.5 months of follow-up. Among 7 cases treated with systemic immunotherapy, 5 cases (72%) had complete response (CR), 1 case (14%) showed partial response (PR), and 1 case (14%) had stable disease (SD) after 16 months. In the conjunctival melanoma group, among 18 cases treated with combined v-raf murine sarcoma viral oncogene homolog B1/mitogen-activated extracellular signal-regulated kinase inhibitors, 6 (33%) had CR, 5 (28%) had PR, 2 (11%) had SD, and 5 (28%) had progressive disease after 24.8 months of follow-up. Of 44 conjunctival melanoma cases treated with immunotherapy, 12 (28%) had CR, 9 (20%) had PR, 7(16%) had SD, and 16 (36%) had progressive disease after 14.2 months. Systemic Rituximab treatment for conjunctival lymphoma cases resulted in CR in 21 patients (63%), PR in 11 patients (33%), and SD in 1 patient (3%) after 20.5 months of follow-up. Intralesional Rituximab injections in 38 conjunctival lymphoma cases showed CR in 28 patients (75%), PR in 7 patients (19%), SD in 1 patient (2%), and progressive disease in 2 patients (4%) after 20.4 months of follow-up.

Conclusions:

Despite limited clinical case reports and short-term follow-ups, targeted therapy and immunotherapy have shown promising results for advanced malignant conjunctival tumors.
Treatment of Thyroid Eye Disease-Associated Ophthalmopathy and Myopathy With Intraorbital Injection of 5-Fluorouracil and Triamcinolone Acetonide
Authors: Kupcha Anna C. , Law James J. , Mawn Louise A.
Published: January 2024

Purpose:

The authors report a technique of local application of anti-metabolite and corticosteroid mixture in the orbit for treatment of thyroid orbitopathy with moderate-severe inflammation and muscle involvement.

Methods:

Patients of one orbital surgeon seen between March 2019 and May 2020 with active thyroid eye disease and restrictive strabismus were considered for local treatment of the myopathic component of the disease. A mixture of 1 ml 5-FU 50 mg/ml, 0.25 ml triamcinolone 40 mg/ml, and 1 ml lidocaine 2% is injected through the skin using a 25-gauge, 1.5-inch needle into the orbit adjacent to the affected extraocular muscle. Six patients were treated in the outpatient setting and 3 patients have been treated with this intervention intraoperatively at the time of orbital decompression. One was treated with the mixture reconstituted with hyaluronic acid (Healon GV) to address postoperative medial rectus fibrosis to the medial wall, this mixture was applied topically in the operative field and not injected.

Results:

All patients had subjective improvement in the eye movement limitation and 2 patients had a change in motility on exam that was temporally correlated to injections. One patient did not disclose high-dose aspirin intake before injection and experienced a retrobulbar hemorrhage immediately following injection which was successfully treated. No complications were noted as a result of the medication itself.

Discussion:

The combination of 5-fluorouracil and triamcinolone acetonide for orbital treatment may be a useful adjunct in treating patients with ongoing inflammatory activity, both in the office and in the operating room. The novel combination may optimize ophthalmic outcomes, modifying disease course in some patients.
Practice Patterns and Patient Experience of Care Among US Veterans with Prostate Cancer: A 10-Year Scoping Review
Authors: Patel Mital , Turner Erin , Edwards Natalie C. , Aworunse Olubiyi , Bhattacharyya Samir
Published: January 2024

Purpose:

This study evaluated and synthesized the literature on prostate cancer practice patterns and patient experience of care within the US Veterans Affairs (VA) population.

Materials and Methods:

A scoping review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews standards. Search terms were prostate cancer, Veterans, treatment patterns, healthcare, resource, patient experience, quality of care, healthcare quality. The search was limited to human studies published in English in the past 10 years (2013-2022). Studies were included if they evaluated treatment patterns, health care resource use, and/or patient experience of care among US Veterans with prostate cancer.

Results:

Among 150 included studies, most were retrospective VA database evaluations (n = 119, 79.3%) or retrospective cohort studies (n = 8, 5.3%), with the remaining being prospective observational cohort studies (n = 16, 10.7%), randomized controlled trials (n = 5, 3.3%), a meta-analysis (n = 1, 0.7%), and a provider survey (n = 1, 0.7%). Sample sizes ranged from 11 to 214,649 patients. The most common topics were pharmacological therapies (n = 28), racial/ethnic disparities (n = 27), and definitive radiation therapy or radical prostatectomy (n = 24). Some studies indicated Veterans may not have access to the same quality of prostate cancer care compared with the general population. Opportunities for improvement in shared decision making remain.

Conclusion:

Some findings from this scoping review indicate that Veterans may not have access to the same quality of prostate cancer care compared with the US general population. Research is needed to confirm whether observed practice pattern differences are warranted given the potential negative care impact.
Dependence of Cochlear Duct Length Measurement on the Resolution of the Imaging Dataset
Authors: Spahn Bjoern , Ilgen Lukas , Neun Tilmann , Müller-Graff Franz-Tassilo , Schendzielorz Philipp , Hagen Rudolf , Althoff Daniel , Zabler Simon , Rak Kristen
Published: January 2024

Hypothesis

Measurements of the cochlear duct length (CDL) are dependent on the resolution of the imaging dataset.

Background

Previous research has shown highly precise cochlear measurements using 3D-curved multiplanar reconstruction (MPR) and flat-panel volume computed tomography (fpVCT). Thus far, however, there has been no systematic evaluation of the imaging dataset resolution required for optimal CDL measurement. Therefore, the aim of this study was to evaluate the dependence of CDL measurement on the resolution of the imaging dataset to establish a benchmark for future CDL measurements.

Methods

fpVCT scans of 10 human petrous bone specimens were performed. CDL was measured using 3D-curved MPR with secondary reconstruction of the fpVCT scans (fpVCTSECO) and increasing resolution from 466 to 99 μm. In addition, intraobserver variability was evaluated. A best-fit function for calculation of the CDL was developed to provide a valid tool when there are no measurements done with high-resolution imaging datasets.

Results

Comparison of different imaging resolution settings showed significant differences for CDL measurement in most of the tested groups (p < 0.05), except for the two groups with the highest resolution. Imaging datasets with a resolution lower than 200 μm showed lower intraobserver variability than the other resolution settings, although there were no clinically unacceptable errors with respect to the Bland-Altman plots. The developed best-fit function showed high accuracy for CDL calculation using resolution imaging datasets of 300 μm or lower.

Conclusion

3D-curved MPR in fpVCT with a resolution of the imaging dataset of 200 μm or higher revealed the most precise CDL measurement. There was no benefit of using a resolution higher than 200 μm with regard to the accuracy of the CDL measurement.
Hearing Impairment and Severe Attention Deficit/Hyperactivity Disorder: A Nationwide Study
Authors: Tsur Nir , Zloof Yair , Rittblat Mor , Reuven Yonatan , Simchoni Maya , Derazne Estela , Yitzchaki Ziv , Adler Lior , Shlaifer Amir , Manuva Omer , Beer Zivan
Published: January 2024

Background

The association between hearing impairment and attention-deficit/hyperactivity disorder (ADHD) is unclear. Therefore, we aimed to assess this association in Israel's national sample of over 1.1 million adolescents.

Methods

We conducted a nationwide, population-based, cross-sectional study of all Israeli adolescents (n = 1,175,534, 58% males; mean age, 17 yrs) who were examined before mandatory military service during 2004 to 2020. Board-certified specialists confirmed diagnoses of hearing impairment and severe ADHD.

Main Outcomes and Measures

We compared the prevalence of severe ADHD in adolescents with and without hearing impairment. Associations were analyzed using logistic regression models and sensitivity analyses accounting for hearing impairment type (sensorineural vs. conductive) and severity.

Results

Of the 8,769 adolescents with hearing impairment, 57 were diagnosed with severe ADHD (prevalence = 0.65%). Of the 1,166,765 adolescents without hearing impairment, 3,936 were diagnosed with severe ADHD (prevalence = 0.29%). We found a significant association between hearing impairment and severe ADHD (odds ratio = 1.93 [95% confidence interval, 1.47–2.49]), which persisted in a multivariable model adjusted to age, sex, socioeconomic status, educational status, cognitive performance, and immigration status (odds ratio = 1.70 [95% confidence interval, 1.29–2.20]). The association also persisted when stratified by hearing impairment type (sensorineural vs. conductive) and severity.

Conclusions

Adolescents with hearing impairment had 70% increased odds of severe ADHD. Study findings suggest that active screening of patients with hearing impairment for ADHD should be considered.
Immunomodulatory Response of the Middle Ear Epithelial Cells in Otitis Media
Authors: Leffers David , Penxova Zuzana , Kempin Thorge , Därr Markus , Fleckner Jonas , Hollfelder Daniela , Ryan Allen F. , Bruchhage Karl-Ludwig , Kurabi Arwa , Leichtle Anke
Published: January 2024

Hypothesis

The middle ear (ME) epithelium transforms because of changed immunomodulation during infection.

Introduction

The epithelial cells of the tympanic cavity represent the first line of defense in the context of otitis media. They can convert from a typical mucosal site into a respiratory epithelium and vice versa. Our goal is to depict the specific immune response of epithelial cells after infection at the molecular level.

Methods

The investigations were carried out on healthy and inflamed ME tissue, removed during surgical interventions in mouse and human models, and in a human in-vitro cell model in human ME epithelial cell line. We determined the epithelial localization of the protein expression of Toll- and NOD-like immune receptors and their associated signaling molecules using immunohistochemistry. In addition, we examined growth behavior and gene expression due to direct stimulation and inhibition.

Results

We found clinically and immunobiologically confirmed transformation of the inflamed ME epithelium depending on their origin, as well as differences in the distribution of Toll-like receptors and nucleotide-binding oligomerization domain-like receptors in the epithelial cell lining. Dysregulated gene and protein expression of the inflammatory and apoptotic genes could be modulated by stimulation and inhibition in the epithelial cells.

Conclusions

The local ME mucosal tissue is believed to modulate downstream immune activity after pathogen invasion via intrinsic cellular mechanism. Using translation approaches to target these molecular pathways may offer more reliable clinical resolution of otitis media in the future.
Dental decision-making for persons with dementia: A systematic narrative review
Authors: Matsuda Shinpei , Yoshimura Hitoshi
Published: January 2024

Dental decision-making represents the establishment of a common understanding between the dental professional and the recipient of the intervention, which determines oral healthcare and dental treatment policies. Dental decision-making for persons with dementia can be challenging, and there have been no systematic reviews on this topic. Therefore, this systematic narrative review aimed to identify the current state of dental decision-making in persons with dementia. Literature search was performed using PubMed, Web of Science, Cochrane Library, CINAHL, and Google Scholar databases. Through the process of research selection, 7 articles with a high risk of bias were included in this study. This review clarified that there is limited information on the dental decision-making processes for persons with dementia. In conclusion, although this may be difficult due to different medical and socioeconomic conditions, the dilemma between the need to establish evidence for dental decision-making and medical ethics that prioritize a patient-centered position should be discussed globally in the future.
Efficacy and safety of Buzhongyiqi decoction combined with acupoint application for functional constipation in elderly people: A systematic review and meta-analysis
Authors: Chen Yanjie , Luo Shu , Luo Min
Published: January 2024

Purpose:

This study aimed to evaluate the efficacy and safety of Buzhongyiqi decoction combined with acupoint application in the treatment of functional constipation in elderly people.

Methods:

(1) Four Chinese databases (China National Knowledge Infrastructure, China Science Periodical Database, Chinese Citation Database, China Biology Medicine) and 4 foreign databases (PubMed, Web of Science, Cochrane Library, Embase) were searched, excluded, and included in randomized controlled trials of Buzhongyiqi decoction combined with acupoint application for the treatment of functional constipation in elderly people. (2) Systematic evaluation and meta-analysis using the RevMan 5.3 software. (3) Harbord linear regression and sensitivity analyses were conducted to evaluate publication bias using Stata 14.0. (4) Reliability of the conclusion assessment by sequential test analysis in TSA0.9 software. (5) Quality of evidence evaluation of outcome indicators was evaluated using Gradepro 3.6 software.

Results:

Eight randomized controlled trials including 658 case sample sizes were included. Compared with the control group, the intervention group showed improved clinical cure rate and effective rate of functional constipation in elderly people, reduced recurrence rate, and efficacy regulated the levels of defecation-related indices and indices of gastrointestinal function. In addition, trial sequential analysis indicated that the total clinical efficacy rate was conclusive, which showed that the therapeutic efficacy of the intervention group was superior to that of the control group. However, the incidence of adverse effects in intervention group was comparable to that of control group, and trial sequential analysis suggests that this result needs to be supported by additional research.

Conclusion:

Buzhongyiqi decoction combined with acupoint application has potential value in the treatment of functional constipation in elderly people. Currently, there is insufficient clinical evidence to objectively evaluate safety grades for this combination therapy.
Meta-analysis of risk factors for posttraumatic stress disorder in myocardial infarction
Authors: Liu Jingyu , Wang Lingyu , Wang Yimu , Fang Haiyan , Wang Xiang
Published: January 2024

Background:

The aim of this study was to identify the risk factors for posttraumatic stress disorder in patients with myocardial infarction.

Methods:

Cohort, case-control, and cross-sectional studies on posttraumatic stress disorder (PTSD) in patients with myocardial infarction were searched from PubMed, Embase, Cochrane Library, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Technology Journal database. The Newcastle-Ottawa Quality Assessment Scale was used to score the quality of the included literature in the cohort and case-control studies, and the cross-sectional studies were scored using the American Agency for Health Care Quality and Research cross-sectional study quality evaluation criteria. The literature was screened independently by 2 researchers, and if there was no consensus, the inclusion was decided by a third party. The extraction content included first author, publication year, sample size, PTSD assessment tool, PTSD assessment time, PTSD incidence, influencing factors, and study type. Meta-analysis of data was performed using Stata17.0 software.

Results:

Ten studies were included, including 2 cohort studies, 7 cross-sectional studies, and 1 case-control study, with a total sample size of 2371 patients, including 26 influencing factors. The results of meta-analysis showed that the prevalence of PTSD in patients with myocardial infarction was 21.2%. Statistically significant influencing factors were gender (odd ratio [OR] = 3.124), neuroticism score (OR = 2.069), and age (OR = 0.913).

Conclusions:

The prevalence of PTSD in patients with myocardial infarction in China is higher than that in other countries. Female and neurotic personality are risk factors for developing PTSD in patients with myocardial infarction, and old age is protective factor for developing PTSD in patients with myocardial infarction. Targeted measures should be taken to prevent and reduce the occurrence and development of PTSD in patients with myocardial infarction in the future.
The difference of transcriptome of HPV-infected patients contributes more to the occurrence of cervical cancer than the mutations of E6 and E7 genes in HPV16
Authors: Zhang Lihui , Li Mengyuan , Yuan Feiyan , Jiang Jingyuan , Zhang Xinmin
Published: January 2024

Human papillomavirus (HPV) E6 and E7 genes are biomarkers and drivers of the progression of cervical cancer (CxCa). The aim of this study was to investigate the relationship between HPV16 E6, E7 gene mutations and the occurrence and development of CxCa. Cervical exfoliated cells and clinical data of patients with cervical diseases were collected. Sample DNA was extracted, the E6 and E7 gene fragments were amplified by PCR, and the mutations were detected by Sanger sequencing and compared with standard sequences. Microarray was used to sequence the transcriptome of cells. Data of transcriptome analyzed and visualized using R software and its packages. Analysis of clinical characteristics demonstrated the association of HPV16 infection with CxCa (P < .05). Sanger sequencing results showed that the mutation sites of E6 gene included T178G/A, T350G, A131C, and T241G; among these, A131C and T241G were synonymous mutations. The mutation sites of E7 gene included A647G, T846C, G666A, T843C, and T760C, and all of them were synonymous mutations except A647G. There was no significant difference in the distribution of HPV16 E6, E7 mutations among CxCa, cervical intraepithelial neoplasia, and infection groups (P > .05). Compared with the non- CxCa group, gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of differentially expressed genes (DEGs) showed more significant enrichment of DEGs in the biological processes, pathways, and diseases closely related to cancer. Compared with the non-mutation group, the DEGs in the E6, E7 gene mutation group were significantly enriched in the events related to infection and immunity. To summarize, HPV16 may be associated with the occurrence and development of CxCa, but HPV16 E6 and E7 gene mutations have little effect on the occurrence and development of CxCa. Individual differences may have a greater effect on the progression of CxCa.
Advances and challenges of first-line immunotherapy for non-small cell lung cancer: A review
Authors: Guo Haiyang , Zhang Jun , Qin Chao , Yan Hang , Luo Xinyue , Zhou Haining
Published: January 2024

The current use of immune checkpoint inhibitors (ICIs) for the treatment of lung cancer has dramatically changed the clinical strategy for metastatic non-small cell lung cancer (mNSCLC). As a result of great achievements in clinical trials, 6 programmed death-1 inhibitors (sintilimab, camrelizumab, tislelizumab, pembrolizumab, cemiplimab, and nivolumab), 2 programmed death-ligand 1 inhibitors (sugemalimab and atezolizumab), and 1 cytotoxic T lymphocyte-associated antigen-4 inhibitor (ipilimumab) have been approved as first-line treatment for mNSCLC by the US Food and Drug Administration. Recently, research on ICIs has shifted from a large number of second-line to first-line settings in clinical trials. Results from first-line trials have shown that almost all driver-negative mNSCLC are treated with ICIs and significantly prolong patient survival; however, the low response rate and adverse reactions to immunotherapy remain to be addressed. Here, we summarize the use of ICIs, including monotherapy and combination therapy, in the first-line treatment of mNSCLC in recent years and discuss the low response rate and adverse reactions of ICIs as well as the challenges and expectations for the first-line treatment of mNSCLC in the future.
Professional identity, job satisfaction, and turnover intention among Chinese novice nurses: A cross-sectional study
Authors: Zhong Ying , Ma Huan , Zhang Cui-Cui , Jiang Qin-Ying , Li Jun , Liao Chang-Ju , Liang Yu-Fen , Shu Li
Published: January 2024

The world is faced with challenges due to a growing aging population and the increasing burden of chronic disease. The acute shortage of nurses and high turnover rates, particularly among novice nurses, are of great concern in many countries. Several studies have shown that turnover intention among nurses is influenced by professional identity and job satisfaction. However, to the best of our knowledge, no studies have examined this issue in the context of novice nurses. Thus, the present study aimed to explore the relationship between professional identity, job satisfaction, and turnover intention among novice nurses in China. From March 18 to April 23, 2022, a cross-sectional survey was carried out involving 532 novice nurses recruited from four public hospitals in Sichuan Province, China. Among the sample, 526 questionnaires were retrieved, with an effective response rate of 98.87%. The mean scores for turnover intention, professional identity, and job satisfaction were 13.02 ± 3.94, 36.17 ± 7.98, and 111.02 ± 21.46, respectively. High turnover intention was observed among novice nurses, of whom 54.37% (286/526) had high or very high turnover intention. Professional identity and job satisfaction among novice nurses were moderate. In terms of demographic characteristics, “Whether living with relatives” and “Monthly income” had a statistically significant impact on the turnover intention of novice nurses (P < .05). Both professional identity (r = −0.459) and job satisfaction (r = −0.517) were significantly and moderately negatively correlated with turnover intention (P < .01). The results of the multivariate linear regression analysis revealed that variables including “Whether living with relatives,” “Professional identity,” “Control and responsibility for work,” and “Benefits” jointly accounted for 29.9% of the variance related to turnover intention among novice nurses. “Whether living with relatives,” “Professional identity,” “Control and responsibility for work,” and “Benefits” were highly predictive of turnover intention levels among novice nurses. Hence, potential predictors of turnover intention should be considered, and intervention research should be conducted to reduce the level of turnover intention among novice nurses.
The second cutaneous anthrax infection diagnosed by metagenomic next-generation sequencing: A case report
Authors: Zheng Cuiying , Ye Jiaqing , Song Minghui , Guo Yumei , Gao Weili , Hao Jiahao , Feng Zhongjun , Zhang Lijie
Published: January 2024

Rationale:

Anthrax is a severe zoonotic infectious disease caused by Bacillus anthracis. Most reported cases were traditionally diagnosed through culture and microscopy. We reported here the second case of cutaneous anthrax diagnosed by metagenomic next-generation sequencing (mNGS).

Patient concerns:

A 63-year-old man had a history of contact with an unwell sheep, developing local redness and swelling on wrist. The dorsal side of the left hand and forearm, with tension blisters on the back of the left.

Diagnosis:

B anthracis was detected from culturing and mNGS of tension blisters.

Interventions:

On the second day of admission, the patient was administered 3.2 million units of penicillin every 6 hours, and isolated and closely observed.

Outcomes:

The patient improves and is discharged.

Lessons:

Traditional bacterial cultures are time-consuming, while mNGS offers the advantage of accurate, quick, high-throughput, unbiased sequencing of all genetic material in a sample, which is a good technical tool for assisting in the diagnosis of rare pathogen infections.
Long-term survival in a patient with multiple metastatic gastric cancer treated with PTX plus emvolimab and disitamab vedotin: case report and treatment experience: A case report
Authors: Zhou Yongjin , Zhang Meifeng , Dai Li , Yan Zhiqiang , Wang Haibin , Yang Hongxin , Jin Xiangren , Wang Qian
Published: January 2024

Rationale:

Most Chinese patients with locally advanced gastric cancer at diagnosis have an overall 5-year survival rate of <50%. Surgical resection alone is not suitable for patients with locally advanced gastric cancer. Currently, comprehensive treatment is the focus of locally advanced gastric cancer.

Patients concerns:

The patient, a 56-year-old female, was admitted to the hospital because of “4 + months of double hydronephrosis found during a physical examination.” Who was admitted for computer tomography and gastroscopy examinations, and take pathological tissue specimens during endoscopic examination.

Diagnoses:

Computed tomography assessment indicated ulcerative gastric cancer with an abdominal implant, bladder, and bone metastases. An endoscopic examination revealed that the ulcer of the gastric angle was huge, and through relevant auxiliary examinations, the diagnosis of this disease is gastric cancer complicated with multiple metastases to bladder, rectum, lumbar spine, and peritoneum. Clinically diagnosed as cT4bN3M1.

Interventions:

The patient is currently undergoing first, second, and third line neoadjuvant therapy, combined with immunotherapy, targeted therapy, neoadjuvant intraperitoneal systemic chemotherapy, nutritional support, and other treatment plans.

Outcomes:

After 15 cycles of treatment, the progression-free survival had reached 15 months. The patient had an NRS2002 score of 1, an ECOG score of I, a quality of life score of 55, albumin of 35.27 g/L, and a decrease in abdominal and pelvic fluid accumulation and exudation compared to before.

Lessons:

We demonstrated high survival of almost 3 years in a patient with gastric cancer that was complicated by bone, peritoneal, rectal, and bladder metastases. The combination of immunotherapy, targeted therapy, and neoadjuvant intraperitoneal systemic chemotherapy, along with the maintenance of nutritional status and CTCs could be a valuable modality for the subsequent treatment and observation of similar patients.
Can inactivation mutation in the thyroid stimulating hormone receptor gene and hyperthyroidism coexist?: A case report
Authors: Liu Yanfang , Li Jie , Gao Fei , Zhao Changjian , Yang Luyang , Liu Yunfeng
Published: January 2024

Introduction:

We found the G132R heterozygous mutation of thyroid stimulating hormone receptor (TSHR) gene in a patient with recurrent hypokalemia. Because the patient had a medical history of hyperthyroidism, the mutation was suspected to be related to hyperthyroidism at first. Subsequently, the expression and function studies in vitro were conducted.

Methods:

Wide-type TSHR and mutant TSHR (mutTSHR) were constructed in the phage vector and pEGFP-C1 vector. After transfection, the samples were collected for detection of mRNA level, protein expression, cell activity and cAMP content.

Results:

Compared with the wild-type TSHR, the mRNA level of the mutTSHR was not significantly different. But the protein expression, cell activity and cAMP content of the mutTSHR were significantly lower. So this indicated that the G132R mutation is a loss-of-function mutation.

Conclusion:

We identified the G132R monoallelic heterozygous mutation of TSHR gene in a patient with hyperthyroidism. Based on disease history of the patient, we speculated that the heterozygous mutation did not cause thyroid dysplasia or hypothyroidism for her. Our study enriched experiment content in vitro studies and clinical phenotype about the G132R mutation in TSHR gene.
Sagittal-spinopelvic alignment improves in patients with bilateral highly dislocated hip (Crowe type IV) after subtrochanteric shortening total hip arthroplasty: A retrospective radiographic study
Authors: Morimoto Tadatsugu , Kobayashi Takaomi , Tsukamoto Masatsugu , Yoshihara Tomohito , Hirata Hirohito , Toda Yu , Mawatari Masaaki
Published: January 2024

In patients with bilateral highly dislocated hips (HDHs), total hip arthroplasty with subtrochanteric shortening osteotomy (S-THA) is a viable option for achieving adequate reconstruction with restoration of the anatomical hip center. This procedure has the potential to improve sagittal spinopelvic alignment (SSPA). However, reports are scarce owing to the rarity of this disease. The objective of this study is to investigate pre- and post-operative SSPA in patients with HDHs who had undergone S-THA. This retrospective radiographic study included 55 patients (54 females and 1 male; average age, 63.1 ± 6.9 years) who underwent S-THA. Lateral spine radiographs in the standing position were obtained pre- and post-operatively. The SSPA included lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI), and intervertebral disc (ID) angle of L1/2–L5/S. The SSPA pre- and post-S-THA was compared using a paired t test. Pearson correlation coefficient was used to assess the relationships between parameters. The mean pre- and post-operative LL and SS values were 62° and 49° (LL) and 50° and 39° (SS), respectively (P < .001). The ID angle was significantly reduced post-operatively at all levels (P < .001). The correlation coefficients between preoperative LL and SS and postoperative LL and PI were 0.81 and 0.38, respectively (P < .01). The preoperative SSPA of Crowe type IV HDHs revealed excessive pelvic anteversion and lumbar hyperlordosis, with a high correlation between LL and SS, suggesting that these alterations were compensatory changes to maintain body balance. Furthermore, in patients with HDHs and residual spinal flexibility, restoring the original pelvic morphology with S-THA may contribute to improved SSPA.
Identification of a novel genomic variance of BRAF1 in papillary thyroid carcinoma: A case report
Authors: Wang Yuguo , Zhao Jian , Tan Zhihan , Du Jing , Zhang Linping , Xu Ying , Li Xiuying , Cai Yun , Wang Hui , Jiang Jianjun
Published: January 2024

Rationale:

Papillary thyroid carcinoma (PTC), the predominant subtypes accounting for approximately 85% of thyroid carcinomas, has a rapidly increasing global incidence rate. Statistically, approximately 74.6% PTC patients had the genomic variants of BRAF, especially BRAFV600E mutation, which has been reported to stratify patients and guide clinic-therapies. However, some PTC patients may carry other nonclassical mutation patterns of BRAF, due to the complex of genomic instability. And the spectrum of BRAF mutation was not fully characterized. We reported a novel BRAF mutation pattern of PTC.

Patient concerns:

A 59-year-old woman was admitted to our hospital because of the slight enlargement of bilateral cervical lymph nodes in July 2023.

Diagnosis:

Ultrasonography revealed that the bilateral thyroid nodules of the patients both presented 1 hypoechoic nodule, which was graded as 3 of the elastic score, and the small calcification in the right lobe (Chinese-Thyroid Imaging Reporting and Data System 4c). Pathological diagnosis showed the interstitial collagen change and focal follicular epithelial papillary hyperplasia with atypical hyperplasia of the bilateral thyroid. Further puncture pathology showed that the patient had a malignant thyroid lesion with the phenotypes of papillary carcinoma and diagnosed with malignancy subsequently. Additionally, the patient harbored a novel insert on BRAF exon 15, a 6-base fragment AGACAG inserting between c.1798 and c.1799.

Interventions:

The patient was undergone on microwave ablation of thyroid carcinoma on July 28, 2023. After the surgery, the patient was treated on anti-infection, cold saline external application of bilateral thyroid swelling supportive treatment.

Outcomes:

No postoperative complications or recurrence and metastasis were found.

Lessons:

This is the first case of the novel nonclassical genomic variant of BRAF. Our study extends the spectrum of BRAF mutations. The patient had a favorable response to microwave ablation, indicating that in spite of the association between this mutation and high-grade malignant phenotype, this genomic variant of BRAF did not have a detrimental effect on the response of clinical treatment.
Impact of filial piety on residents’ subjective well-being in China considering the moderating effect of income level
Authors: Peng Wang
Published: January 2024

Subjective well-being (SWB) reflects an individual’s subjective evaluation of overall life satisfaction and healthcare situation. As one of the most important concepts in traditional Chinese culture, filial piety refers to an ancient and significant ethical concept that originates from traditional Chinese culture. Filial piety emphasizes the respect, care, and filial devotion of children towards their parents, and has a complex influence on SWB. Moreover, in the context of rapid economic development, an individual’s income level significantly moderates the influence of filial piety. Revealing the influence of different types of filial piety on SWB is of great significance for enhancing residents’ SWB. However, existing studies rarely touch upon this topic. Therefore, this paper focuses on the 7 kinds of filial piety, establishes an ordered logit model based on the data from the China General Social Survey, and analyzes the influence of these 7 kinds of filial piety on SWB. On this basis, this study analyzes the moderating effect of income level. Finally, it further analyzes the regional heterogeneity of China in the influence of filial piety. Concepts such as constant respect for father’s authority, enhancing parents’ honor, and bearing sons for the purpose of lineage continuity, have negative impact on SWB. Superior economic conditions can neutralize and salvage these concepts to a certain extent, but they are ultimately negative. In regions with a minority population such as the 4 northeastern provinces, Inner Mongolia, Gansu, Ningxia, and Xinjiang, these concepts can increase SWB, which is restricted by the local economic level and might just be a transitional form of insufficient development. appreciating the kindness of upbringing; treating parents well under any circumstances; giving up personal ambitions to fulfill parents’ wishes, positively influence individual SWB, especially when income is substantial. The research results indicate that different type of filial piety has different impacts on SWB; income level has a significant moderating effect; and there are significant regional heterogeneities in the influence of filial piety. The results of this study provide a theoretical basis and reference for enhancing residents’ SWB.
Successful treatment of 1 patient with chlorine-induced ARDS using awake self-prone positioning and nasal high-flow oxygen: A case report
Authors: Wang Fugui , Liu Fangfang , Lu Houqing
Published: January 2024

Rationale:

Accidents involving chlorinated compounds in the context of cleaning are not uncommon. However, improving the treatment success rate for acute respiratory distress syndrome (ARDS) patients caused by chlorine gas presents significant challenges.

Patient concerns:

A 28-year-old female was admitted to the intensive care unit after accidental inhalation of chlorine gas resulting in ARDS.

Diagnoses:

The patient was diagnosed with ARDS attributed to chlorine gas exposure.

Interventions:

The intervention involved utilizing a combination of awake self-prone positioning (ASPP) and high-flow nasal oxygen therapy for treatment.

Outcomes:

After continuous ASPP and high-flow nasal oxygen therapy, the patient quickly recovered and was transferred out of the intensive care unit on the 6th day without any adverse events.

Lessons:

ASPP combined with high-flow nasal oxygen therapy can improve patients’ hypoxemia, prevent the need for intubation, avoid rapid deterioration of the condition, reduce treatment complexity, and lower mortality rate.
Implementation of Guidelines Limiting Postoperative Opioid Prescribing at a Children’s Hospital
Authors: Stephenson Krista J. , Krinock Derek J. , Vasquez Isabel L. , Shewmake Connor N. , Spray Beverly J. , Ketha Bavana , Wolf Lindsey L. , Dassinger Melvin S.
Published: January 2024

Objectives

Variability in opioid-prescribing practices after common pediatric surgical procedures at our institution prompted the development of opioid-prescribing guidelines that provided suggested dose limitations for narcotics. The aims of this study were to improve opioid prescription practices through implementation of the developed guidelines and to assess compliance and identify barriers preventing guideline utilization.

Methods

We conducted a single-center cohort study of all children who underwent the most common outpatient general surgery procedures at our institution from August 1, 2018, to February 1, 2020. We created guidelines designed to limit opioid prescription doses based on data obtained from standardized postoperative telephone interviews. Three 6-month periods were evaluated: before guideline implementation, after guideline initiation, and after addressing barriers to guideline compliance. Targeted interventions to increase compliance included modification of electronic medical record defaults and provider educations. Differences in opioid weight-based doses prescribed, filled, and taken, as well as protocol adherence between the 3 timeframes were evaluated.

Results

A total of 1033 children underwent an outpatient procedure during the 1.5-year time frame. Phone call response rate was 72.22%. There was a significant sustained decrease in opioid doses prescribed (P < 0.0001), prescriptions filled (P = 0.009), and opioid doses taken (P = 0.001) after implementation, without subsequent increase in reported pain on postoperative phone call (P = 0.96). Protocol compliance significantly improved (62.39% versus 83.98%, P < 0.0001) after obstacles were addressed.

Conclusions

Implementation of a protocol limiting opioid prescribing after frequently performed pediatric general surgery procedures reduced opioids prescribed and taken postoperatively. Interventions that addressed barriers to application led to increased protocol compliance and sustained decreases in opioids prescribed and taken without a deleterious effect on pain control.
Attenuated retinoic acid signaling is among the early responses in mouse uterus approaching embryo attachment
Authors: Diao Honglu , Xiao Shuo , Zhou Tong , Martin Taylor E. , Watford Wendy T. , Ye Xiaoqin
Published: January 2024

The uterus is transiently receptive for embryo implantation. It remains to be understood why the uterus does not reject a semi-allogeneic embryo (to the biological mother) or an allogeneic embryo (to a surrogate) for implantation. To gain insights, we examined uterine early response genes approaching embryo attachment on day 3 post coitum (D3) at 22 hours when blue dye reaction, an indication of embryo attachment, had not manifested in mice. C57BL/6 pseudo-pregnant (control) and pregnant mouse uteri were collected on D3 at 22 hours for microarray analysis. The self-assembling-manifold (SAM) algorithm identified 21,858 unique probesets. Principal component analysis indicated a clear separation between the pseudo-pregnant and pregnant groups. There were 106 upregulated and five downregulated protein-coding genes in the pregnant uterus with fold change (fc) >1.5 and q value <5%. Gene ontology (GO) analysis of the 106 upregulated genes revealed 38 significant GO biological process (GOBP) terms (P <0.05), and 32 (84%) of them were associated with immune responses, with a dominant natural killer (NK) cell activation signature. Among the top eight upregulated protein-coding genes, Cyp26a1 inactivates retinoic acid (RA) while Lrat promotes vitamin A storage, both of which are expected to attenuate RA bioavailability; Atp6v0d2 and Gjb2 play roles in ion transport and transmembrane transport; Gzmb, Gzmc, and Il2rb are involved in immune responses; and Tdo2 is important for kynurenine pathway. Most of these genes or their related pathways have functions in immune regulations. RA signaling has been implicated in immune tolerance and immune homeostasis, and uterine NK cells have been implicated in immunotolerance at the maternal-fetal interface in the placenta. The mechanisms of immune responses approaching embryo attachment remain to be elucidated. The coordinated effects of the early response genes may hold the keys to the question of why the uterus does not reject an implanting embryo.
Mapping the Terrain of Faculty Development for Simulation
Authors: Gardner Aimee K. , Rodgers David L. , Steinert Yvonne , Davis Rachel , Condron Claire , Peterson Dawn Taylor , Rohra Anita , Viggers Sandra , Eppich Walter J. , Reedy Gabriel
Published: January 2024

Understanding what interventions and approaches are currently being used to improve the knowledge, skills, and effectiveness of instructors in simulation-based education is an integral step for carving out the future of simulation. The current study is a scoping review on the topic, to uncover what is known about faculty development for simulation-based education.

We screened 3259 abstracts and included 35 studies in this scoping review. Our findings reveal a clear image that the landscape of faculty development in simulation is widely diverse, revealing an array of foundations, terrains, and peaks even within the same zone of focus. As the field of faculty development in simulation continues to mature, we would hope that greater continuity and cohesiveness across the literature would continue to grow as well. Recommendations provided here may help provide the pathway toward that aim.
Understanding the Effects of Health Care Distance Simulation
Authors: Charnetski Matthew D. , Wawersik Dawn , Palaganas Janice C. , Duff Jonathan P. , Bailey Shannon K. T. , Ramachandra Geethanjali , Birido Nuha , Elkin Rachel , Nair Bindhu , Thurber Peter , Gross Isabel T.
Published: January 2024

The use of distance simulation has rapidly expanded in recent years with the physical distance requirements of the COVID-19 pandemic. With this development, there has been a concurrent increase in research activities and publications on distance simulation. The authors conducted a systematic review of the peer-reviewed distance health care simulation literature. Data extraction and a risk-of-bias assessment were performed on selected articles. Review of the databases and gray literature reference lists identified 10,588 titles for review. Of those, 570 full-text articles were assessed, with 54 articles included in the final analysis. Most of these were published during the COVID-19 pandemic (2020–2022). None of the included studies examined an outcome higher than a Kirkpatrick level of 2. Most studies only examined low-level outcomes such as satisfaction with the simulation session. There was, however, a distinction in studies that were conducted in a learning environment where all participants were in different locations (“distance only”) as compared with where some of the participants shared the same location (“mixed distance”). This review exclusively considered studies that focused solely on distance. More comparative studies exploring higher level outcomes are required to move the field forward.
Health Care Simulation in Person and at a Distance
Authors: Birido Nuha , Brown Kristen M. , Olmo Ferrer Diego , Friedland Richard , Bailey Shannon K. T. , Wawersik Dawn , Charnetski Matthew , Nair Bindhu , Kutzin Jared M. , Gross Isabel T. , Palaganas Janice C.
Published: January 2024

Distance simulation is a method of health care training in which the learners and facilitators are in different physical locations. Although methods of distance simulation have existed in health care for decades, this approach to education became much more prevalent during the COVID-19 pandemic. This systematic review studies a subset of distance simulation that includes combined in-person and distance simulation elements, identified here as “mixed- distance simulation.” A review of the distance simulation literature identified 10,929 articles. Screened by inclusion and exclusion criteria, 34 articles were ultimately included in this review. The findings of this review present positive and negative aspects of mixed-distance simulation formats, a description of the most frequent configurations related to delivery, terminology challenges, as well as future directions including the need for faculty development, methodological rigor, and reporting details.
The Impact of Just-in-Time Simulation Training for Healthcare Professionals on Learning and Performance Outcomes: A Systematic Review
Authors: Patocka Catherine , Pandya Anjali , Brennan Erin , Lacroix Lauren , Anderson Ingrid , Ganshorn Heather , Hall Andrew K.
Published: January 2024

Although just-in-time training (JIT) is increasingly used in simulation-based health professions education, its impact on learning, performance, and patient outcomes remains uncertain. The aim of this study was to determine whether JIT simulation training leads to improved learning and performance outcomes. We included randomized or nonrandomized interventional studies assessing the impact of JIT simulation training (training conducted in temporal or spatial proximity to performance) on learning outcomes among health professionals (trainees or practitioners). Of 4077 citations screened, 28 studies were eligible for inclusion. Just-in-time training simulation training has been evaluated for a variety of medical, resuscitation, and surgical procedures. Most JIT simulation training occurred immediately before procedures and lasted between 5 and 30 minutes. Despite the very low certainty of evidence, this systematic review suggests JIT simulation training can improve learning and performance outcomes, in particular time to complete skills. There remains limited data on better patient outcomes and collateral educational effects.