bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Adding Adductor Canal Block to Sciatic Nerve Block in Hallux Valgus Surgery
Authors: Polat Ezgi , Kocoglu Hasan , ozden mesure gul nihan , sarar serhan , uygur mehmet esat
Published: October 2024

Background
Optimal postoperative multimodal analgesia strategies were still under investigation in many orthopedic surgeries. The aims of this study were to determine the effects of adding the adductor canal block to the popliteal sciatic nerve block on sedation need, tourniquet pain, postoperative pain, and patient-surgeon satisfaction in patients operated for hallux valgus correction.
Methods
In this prospective, randomized, and controlled clinical trial, group S patients were performed only popliteal sciatic nerve block with 10 ml 0,5% bupivacaine and 10 ml 2% prilocaine in the prone position, group S + A were performed adductor canal block with 10 ml of 0,5% bupivacaine and 10 ml of 2% prilocaine with popliteal sciatic nerve block.
Results
Demographic data, duration of surgery, tourniquet time, surgeon satisfaction, complication rate, motor block time, time to first pain, first analgesic administration time and opioid consumption were similar between the two groups. Sensory and motor block onset time, tourniquet pain and additional sedation need rate were statistically significantly lower and patient satisfaction was significantly higher in Group S + A.
Conclusion
Adding the adductor canal block to the popliteal sciatic nerve block increases the quality of the peripheral nerve block and patient satisfaction with decreasing tourniquet pain and sedation need in hallux valgus correction surgery.
Extraintestinal manifestations may increase the risk of synchronous and metachronous development of other extraintestinal manifestations in Crohn’s disease
Authors: Ozkahraman Adnan , Kayar Yusuf , Dertli Ramazan , Konur Sevki , Kilic Guner , Baran Bulent , Ormeci Asli Ciftcibasi , Akyuz Filiz , Demir Kadir , Besisik Fatih , Kaymakoglu Sabahattin
Published: October 2024

In this study, we evaluated the relationship between the development of different types of EIM in CD. Patients with CD who were under regular follow-up from March 1986to October 2011 were included in our study. Accompanying EIMs and time of development were recorded. The frequency of EIMs and their association with each other were investigated. 336 patients with CD (55.4% male) with a mean follow-up duration of 7.54 years were included in the study. At the onset of CD diagnosis 21.1% of patients had at least one EIM. The prevalence of EIMs was 47.3% at 25-year follow-up.The prevalence of multiple EIMs was 12.2% and 22.9% at the onset of CD and at 25-year follow-up, resepectively. Oral, joint and skin involvement (32.4%, 24.7%, 9.2%, respectively) were the most common EIMs. The development of peripheral arthritis was a significantly associated with axial spondiloarthropathy, skin involvement, ocular involvement, oral ulcers, and vascular thromboembolism (p<0.05).There was significant relationship between oral ulcers and peripheral arthritis, axial arthritis, skin involvement, ocular involvement, liver involvement and thromboembolism (p<0.05).Development of EIMs in patients with CD may trigger development of other EIMs during the course of disease.
Development of Comfort Scale for Injection
Authors: Yıldız Güzel Nur , Gök Meltem Şirin , Çiftçi Bahar
Published: October 2024

Background
Patients’ comfort level during the injection procedure affects the quality of care. However, the literature does not provide a valid, reliable, and specific measurement tool to measure this level.
Objective
The present study aimed to develop a valid and reliable measurement tool to determine patients’ comfort levels during the injection procedure.
Method
The study was designed methodologically. The study data were collected at two Hospitals. The sample consisted of 102 patients in the pilot application stage and 186 patients in the main application stage. The study’s data collection tools were the “Personal Information Form,” “VAS for Comfort,” and the “Comfort Scale for Injection” draft. The obtained data were used for validity and reliability analyses.
Results
The scale consisted of 10 items and two sub-dimensions: “Comfort during the Injection Procedure” and “Environmental Comfort.” The “VAS for Comfort” and the scale and its sub-dimensions showed a positive correlation. The Cronbach Alpha Value of the entire scale was found to be 0.899.
Conclusion
The data showed that the “Comfort Scale for Injection” is an adequate, valid, and reliable measurement tool for determining patients’ comfort level during the injection procedure. Measuring patients’ comfort levels during injection at regular intervals is recommended, as new studies are planned to increase injection comfort and adapt the “Comfort Scale for Injection” for different languages and cultures.
Clinical trial number:
not applicable.
Impact of Coronary Revascularization on Coronary Flow Capacity Measured by Transthoracic Doppler Echocardiography in Patients with Chronic Coronary Syndrome
Authors: Ueno Hiroki , Usui Eisuke , Hoshino Masahiro , Kanaji Yoshihisa , Sugiyama Tomoyo , Hada Masahiro , Nagamine Tatsuhiro , Hanyu Yoshihiro , Nogami Kai , Setoguchi Mirei , Sayama Kodai , Tahara Tomohiro , Matsuda Kazuki , Sai Rika , Sakamoto Tatsuya , Shimosato Hikaru , Watanabe Takahiro , Mineo Takashi , Yonetsu Taishi , Sasano Tetsuo , Kakuta Tsunekazu
Published: October 2024

Background
Coronary flow capacity (CFC) integrates quantitative assessment of hyperemic myocardial blood flow and coronary flow reserve. We aimed to evaluate the effect of elective percutaneous coronary revascularization (PCI) on CFC using serial stress transthoracic Doppler echocardiography (STDE).
Methods
Overall, 148 stable patients underwent STDE of the left anterior descending arteries (LAD), before and after elective PCI. Coronary flow velocity reserve (CFVR) was measured using basal and hyperemic diastolic peak velocity (hDPV). Vessels were classified into four CFC categories: severely, moderately, or mildly reduced CFC, and normal flow. Changes in hDPV and CFC status post-PCI, as well as predictors of hDPV increase, were assessed.
Results
Despite improvements in fractional flow reserve (FFR) in all cases, 31 cases (20.9%) showed a decrease in hDPV following PCI. Vessels with ischemic CFC, defined as moderately or severely reduced CFC, decreased from 46.6% (69/148) to 19.6% (29/148) post-PCI. Conversely, CFC worsened in 15.5% of patients. Multivariable analysis showed lower pre-PCI hDPV and ischemic CFC were independently predictive of higher-level (> 50%) hDPV increase after PCI.
Conclusions
Approximately 20% of FFR-guided LAD PCI resulted in decreased hDPV. CFC deterioration was not uncommon despite FFR improvement. Preprocedural non-invasive STDE may help identify lesions that benefit from revascularization.
Tackling “Small” Breast Cancer in Ultrasonography: What Are They and Why Does Screening Them Help?
Authors: WANG YING , Liu Danru , Xu Ping , Fu Lina , Ding Hong
Published: October 2024

Background The study defined a group of “small” breast cancer (BC) detected at ultrasonography (US) and investigated the pathological nature of these small BC. We also explored factors associated with their recurrence and metastasis. Supplementary diagnosis with mammography was also considered.
Methods This retrospective study included 491 BC patients pathologically confirmed with tumor size ≤ 10mm on US from January 2012 to December 2023; the study was approved by the institutional review board. We used chi-squared and unpaired independent t-tests to compare carcinoma in situ, including microinvasion (CIS) and invasive carcinoma regarding clinic, pathologic, US, and mammography characteristics. The characteristics associated with recurrence and metastasis were analyzed using univariate and multivariate Cox proportional hazard regression analysis.
Results The analysis of 491 patients found that: for CIS, those with calcification were likely to be diagnosed by mammography (P < 0.001); for invasive cancers, those with unclear margins, irregular shapes and more color flow were likely to be diagnosed by US (all P < 0.005). 409 (83.9%) of the 491 patients received US follow-up with a median of 46 months. 17 of the 409 patients (4.2%) experienced recurrences, metastasis, or both. Women aged 40 years or younger and patients with invasive ductal carcinoma had the highest hazard rates for recurrence and metastasis (all P < 0.046).
Conclusions For small BC, the sizes evaluated by US and pathology were partially in consistence. US diagnosis of invasive cancer had a relatively higher diagnostic rate, while mammography was advantageous in diagnosing CIS.
Novel Epitope-Based Diagnostic Probes Selected by Phage Display for the Serological Detection of HDV
Authors: Costa Mariana Araújo , de Souza Rayany Cristina , Roca Tárcio Peixoto , Araújo Adrhyan , de Souza Luiz Fellype Alves , Souza Rutilene Barbosa , Sabatini Rafaela , Andrade Bruno Silva , Soares Iara Pereira , Caixeta Douglas Carvalho , Guevara-Vega Marco , Lima Ildercílio Mota de Souza , Passos-Silva Ana Maísa , Martins Mario Machado , Rayashi Abel Dib , Matta Daniel Archimedes da , Vieira Deusilene , Goulart Luiz Ricardo , Sabino-Silva Robinson , Santos Fabiana de Almeida Araújo
Published: October 2024

HDV is associated with the worst prognosis of viral hepatitis and there is a considerable lack of testing for HDV in patients. Phage display was used to select HDV mimetic peptides through biopanning, followed by DNA sequencing and phage-ELISA. Based on the sequences of the selected peptides, we constructed a recombinant protein (rHDV) for use in an Enzyme-Linked Immunosorbent Assay (ELISA). We validated the test with 87 samples (anti-HDV+) and 93 HBV controls collected from a public diagnosis laboratory in the Amazon. HDV RNA detection and sequencing were performed, and statistical analysis was conducted to determine the reactivity of the peptides and protein. rHDV exhibits a sensitivity of 74.71%, a high specificity of 97.85%, and an area under the curve (AUC) of 0.8906. According to analyses of patients with active infection, the detection parameters improved, with a sensitivity of 88.0%, specificity of 98.92%, and AUC of 0.96. In this context, the application of rHDV in an ELISA was effective at discriminating patients with hepatitis D and monoinfected patients with hepatitis B, highlighting the potential use of another efficient, fast, portable, and inexpensive platform for HDV detection.
Gene Expression Study in Retinoblastoma Patients with Different Anaplasias and Lateralities
Authors: Li Wan , Xu Kang-Kang , Chen Fei
Published: October 2024

Background To investigate the differences in gene expression and functional enrichment associated with anaplasia and laterality in retinoblastoma patients.Methods Two datasets were selected from the GEO database of the National Center for Biotechnology Information of the US, including chip data of gene expression in tumor tissue from 36 patients with retinoblastoma. After grouping by anaplasia or laterality, the data were reanalyzed with Student’s t test in R and Bioconductor software. The functional enrichment of genes significantly related to anaplasia and laterality was explored via GSEA.Results The functions of synapse assembly and synaptic signaling were enhanced in clinical patients with severe anaplasia, while the function of photoreceptors was reduced; abnormal conjugate eye movement and lipid metabolic processes were upregulated in unilateral patients.Conclusions Gene expression may be different in retinoblastoma patients with different anaplasias and lateralities. The consequential difference in gene functional pathways could be associated with clinical symptoms.
Association Between Gut Microbiota Composition and Emotional Distress in Breast Cancer Patients Pre- and Post-Surgery
Authors: Qiu Xiaoxi , Iqbal Muhammad Asad , Shaibu Zakari , Wei Xi , Wang Zhulin , Sui Danjuan , Qin Rong , Yin Liang
Published: October 2024

Background
Breast cancer affects millions globally, often leading to significant mental health challenges like depressive symptoms and anxiety (emotional distress). In breast cancer patients, the microbiota-gut-brain axis' effect on various psychosocial states is unclear.
Methods
A prospective, observational clinical study was conducted at Jiangsu University Affiliated People's Hospital, recruiting breast cancer surgery candidates between March 10 and May 25, 2024. Participants provided informed consent and were assessed for demographic characteristics, Clinicopathological data, anxiety and depressive symptoms (emotional distress) using validated questionnaires (GAD-7 and PHQ-9). Preoperative and postoperative fecal samples were collected, processed and sequenced to analyze gut microbiota composition.
Results
The study included 20 breast cancer patients (average age 53.5 ± 5.7 years). Post-surgery, anxiety and depressive symptoms significantly increased, with moderate to severe anxiety rising from 10–80% and depressive symptoms from 5–70%. Higher education, palpable lumps, specific molecular subtypes, lymph node metastasis, and larger lump sizes were associated with increased depressive symptoms. Significant differences in gut microbiota beta diversity were observed between pre- and post-surgery, correlating with depressive symptoms. Seven genera showed significant abundance changes post-surgery, including decreases in Akkermansia and increases in Ligilactobacillus.
Conclusion
This study highlights the complex interplay between gut microbiota composition and depressive symptoms in breast cancer patients undergoing surgery. The findings emphasize the need to address mental health in cancer care and suggest a potential role for the gut microbiota in influencing emotional well-being. Further research could lead to personalized interventions targeting the gut-brain axis to improve outcomes for these patients.
Sucker rod straightness measurement method based on probability statistics of edge point detection
Authors: Zhu Li , Kang Yi_hua
Published: October 2024

Straightness is the basic measurement parameter in machining, and the traditional straightness measurement methods such as light gap method, table method, etc., have extremely low measurement efficiency and cannot achieve online real-time high-precision detection. Our research group has proposed a machine vision online detection based on 10 industrial camera arrays, which can obtain the surface profile straight line of the sucker rod by collecting the edge profile image of the sucker rod and performing morphological transformation. Compared with the traditional method, online nondestructive testing has good real-time performance and high accuracy, but due to the shortcomings of serious environmental pollution and strong noise in some industrial scenarios, the accuracy of the detected straight line is not high. This paper continues to discuss the straightness optimization design method, based on the probability t distribution of the data, reasonably select the sampled edge points, and remove the scene noise. Experiments show that, compared with the previous results, the straightness based on the probability and statistics method can strictly extract the contour sampling points with a confidence of 95%, and the accuracy is higher than that of the traditional Hough transform.
Shock caused by iodophor immersion irrigation of joint cavity : a case report
Authors: Amu Yida , Li Shihong , Zheng Xiaolong , Tang Yingchao , Liao Dongfa , Chen Song , Wang Wei , Xie Qingyun
Published: October 2024

Background: Iodophor, as a disinfectant, is widely used for skin disinfection in surgical procedures. Because of its good disinfection and sterilization function, iodophor is used for joint cavity immersion irrigation in orthopedic joint replacement surgery to reduce the incidence of postoperative infection. Adverse reactions caused by the use of iodophor have been rarely reported, and anaphylaxis has been reported in individual cases when iodophor disinfects the skin. Shock reaction caused by iodophor soaking to irrigate the joint cavity was the first finding.
Case presentation: A 57-year-old female patient underwent right total hip arthroplasty under general anesthesia due to osteoarthritis secondary to bilateral developmental dysplasia of the hip . Patient had stable vital signs prior to iodophor soak irrigation of joint cavity during surgery. When iodophor was poured into the joint cavity for soaking and flushing after acetabular polishing during the operation, the patient experienced a rapid decrease in blood pressure, with the initial blood pressure of 94/56 mmHg. When the blood pressure rapidly decreased to 53/28 mmHg, vasopressors were given and iodophor was sucked out of the joint cavity and flushed with normal saline. After the blood pressure decreased to 40/20 mmHg, the patient stopped decreasing and gradually increased to normal.
Conclusions: When iodophor is poured into the joint cavity for soaking and irrigation, rare shock reactions with rapid decrease of blood pressure occur, which need to be paid enough attention and rescue measures should be prepared in advance.
Development and validation of novel machine learning-based prognostic models and propensity score matching for comparison of surgical approaches in mucinous breast cancer: a multicenter study
Authors: Chen Chunmei , Wu Jundong , Xu Bo , Li Weiwen , Zhong Chengming , Yan Zhibing , Zhong Qipeng , Li Ronggang , Shao Mingtao , Dong Yan , Fang Yutong , Li Yong , Zhang Qunchen
Published: October 2024

Background Mucinous breast cancer (MBC) is a rare subtype of breast cancer with specific clinicopathologic and molecular features. Despite MBC patients generally having a favorable survival prognosis, there is a notable absence of clinically accurate predictive models. Methods 7553 patients diagnosed with MBC from the SEER database spanning 2010 to 2020 were included for analysis. Cox regression analysis was conducted to identify independent prognostic factors. Ten machine learning algorithms were utilized to develop prognostic models, which were further validated using MBC patients from two Chinese hospitals. Cox analysis and propensity score matching were applied to evaluate survival differences between MBC patients undergoing mastectomy and breast-conserving surgery (BCS). Results We determined that the XGBoost models were the optimal models for predicting overall survival (OS) and breast cancer-specific survival (BCSS) in MBC patients with the most accurate performance (AUC = 0.833–0.948). Moreover, the XBGoost models still demonstrated robust performance in the external test set (AUC = 0.856–0.911). We also developed an interactive web application to facilitate the utilization of our models by clinicians or researchers. Patients treated with BCS exhibited superior OS compared to those undergoing mastectomy (p < 0.001, HR: 0.60, 95% CI: 0.47–0.77). However, no significant difference was observed in the risk of breast cancer-related mortality. Furthermore, we identified a significant improvement in OS for patients aged 66 or older, white, divorced, with a household income exceeding $40,000, of grade I, HR+/HER2-, with T1 and T2 tumors, and not receiving chemotherapy when treated with BCS. Conclusion We have successfully developed 6 optimal prognostic models utilizing the XGBoost algorithm to accurately predict the survival of MBC patients. The external validation confirmed the high generalizability of our models. Notably, we observed a significant improvement in OS for patients undergoing BCS.
Predictive factors affecting lymph node metastasis in patients of resectable pancreatic neuroendocrine neoplasms：a single-center retrospective study
Authors: Dong Jie , Du Jing , Cai Juan-juan , Li Tao , Chen Xue-yang , Chen You-wei , Wang Lei , Wu Wei-quan
Published: October 2024

BACKGROUND
Pancreatic neuroendocrine neoplasms (pNENs) present great heterogeneity in biological behavior, histological characteristics and clinical manifestations. Monocyte-to-lymphocyte ratio (MLR) is a non-invasive and easy to obtain indicator, which can reflect disease severity in multiple tumors. Lymph node metastasis (LNM) has a great impact on patient's surgical approach and prognosis. Predicting LNM before surgery has a guiding significance for clinical treatment.
AIM
We aimed to evaluate the predictive factors including MLR associated with LNM of patients with resectable pNEN in our center.
METHODS
A total of 64 patients who underwent pNEN resection and lymph nodes dissection in our hospital from July 2014 until June 2023 were included in this study. Univariate and multivariate analyses were applied to identify predictive factors for LNM by analyzing clinical data, inflammatory markers, and pathological features.
RESULTS
Among the 64 patients, 15 (23.4%) patients were node positive. Univariate analysis showed that vascular invasion, peripheral nerve invasion, bilirubin level, tumor grade, tumor size and MLR (p<0.05 for all) were risk factor for LNM. Multivariate logistic analysis demonstrated that tumor size was the only independent risk factor for LNM in our research. Multivariate ROC analysis had better predictive performance than univariate analysis.
CONCLUSION
The preoperative MLR, vascular invasion, peripheral nerve invasion, bilirubin level, tumor grade and tumor size are potential predictors for LNM, especially during the initial diagnosis for resectable pNENs. Multivariate ROC analysis had better predictive performance than univariate analysis.
A comparison of frequentist and Bayesian approaches to the Personalised Randomised Controlled Trial (PRACTical) - Design and Analysis Considerations
Authors: Jackson Holly , Shou Yiyun , Azad Nur Amira Binte Mohamed , Chua Jing Wen , Perez Rebecca Lynn , Wang Xinru , de Kraker Marlieke E.A. , Mo Yin
Published: October 2024

Background
Multiple treatment options frequently exist for a single medical condition with no single standard of care (SoC), rendering a classic randomised trial comparing a specific treatment to a control treatment infeasible. A novel design, the personalised randomised controlled trial (PRACTical), allows individualised randomisation lists and borrows information across patient subpopulations to rank treatments against each other without comparison to a SoC. We evaluated standard frequentist analysis with Bayesian analyses, and developed a novel performance measure, utilising the precision in treatment coefficient estimates, for treatment ranking.
Methods
We simulated trial data to compare four targeted antibiotic treatments for multidrug resistant bloodstream infections as an example. Four patient subgroups were simulated based on different combinations of patient and bacteria characteristics, which required four different randomisation lists with some overlapping treatments. The primary outcome was binary, using 60-day mortality. Treatment effects were derived using frequentist and Bayesian analytical approaches, with logistic multivariable regression. The performance measures were: probability of predicting the true best treatment, and novel proxy variables for power (probability of interval separation) and type I error (probability of incorrect interval separation). Several scenarios with varying treatment effects and sample sizes were compared.
Results
The Bayesian model using a strong informative prior, was the most likely to predict the true best treatment (\(\:{P}_{best}\ge\:80\%\)) and gave the largest probability of interval separation (reaching a maximum of \(\:{P}_{IS}=96\%\)), at a given sample size. Both Bayesian and frequentist methods had a low probability of incorrect interval separation (\(\:{P}_{IIS}<0.05\)), for all sample sizes (\(\:N=500-5000\)) in the null scenarios considered. The sample size required for probability of interval separation to reach 80% (\(\:N=1500-3000\)), was larger than the sample size required for the probability of predicting the true best treatment to reach 80% (\(\:N\le\:500\)).
Conclusions
Bayesian analysis performed better than frequentist approaches in terms of predicting the true best treatment. Utilising uncertainty intervals on the treatment coefficient estimates are highly conservative, limiting applicability to large pragmatic trials.
The utility of customised tissue probability maps and templates for patients with idiopathic normal pressure hydrocephalus: a Computational Anatomy Toolbox (CAT12) study
Authors: Kanno Shigenori , Liu Junyan , Kawamura Ai , Ota Shoko , Kawakami Nobuko , Iseki Chifumi , Kakinuma Kazuo , Matsubara Shiho , Katsuse Kazuto , Sato Kazushi , Takeuchi Takashi , Tanaka Yoshitaka , Kodama Hiroyasu , Nagasaka Tatsuo , Sai Masahiro , Odagiri Hayato , Saito Mioko , Takanami Kentaro , Mugikura Shunji , Suzuki Kyoko
Published: October 2024

Background
Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is one of the neuroradiological characteristics of idiopathic normal pressure hydrocephalus (iNPH), which makes statistical analyses of brain images difficult. This study aimed to develop and validate methods of accurate brain segmentation and spatial normalisation in patients with DESH by using the Computational Anatomy Toolbox (CAT12).
Methods
Two hundred ninety-eight iNPH patients with DESH and 25 healthy controls (HCs) who underwent cranial MRI were enrolled in this study. We selected the structural images of 260 patients to create customised tissue probability maps (TPMs) and diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL) templates for patients with DESH (DESH-TPM and DESH-Template). The remaining images of 38 patients were used to evaluate the validity of the DESH-TPM and DESH-Template. DESH-TPM and DESH-Template were created using the 114 well-segmented images after the segmentation processing of CAT12. In the validation study, we compared the accuracy of brain segmentation and spatial normalisation among three conditions: customised condition, applying DESH-TPM and DESH-Template to CAT12 and patients’ images; standard condition, applying the default setting of CAT12 to patients’ images; and reference condition, applying the default setting of CAT12 to HC images.
Results
In the validation study, we identified three error types during segmentation. 1) The proportions of misidentifying the dura and/or extradural structures as brain structures in the customised, standard, and reference conditions were 10.5%, 44.7%, and 13.6%, respectively; 2) the failure rates of white matter hypointensity (WMH) cancellation in the customised, standard, and reference conditions were 18.4%, 44.7%, and 0%, respectively; and 3) the proportions of CSF-image deficits in the customised, standard, and reference conditions were 97.4%, 84.2%, and 28%, respectively. The spatial normalisation accuracy of grey and white matter images in the customised condition was the highest among the three conditions, especially in terms of superior convexity.
Conclusions
Appling the combination of DESH-TPM and DESH-Template to CAT12 could improve the accuracy of grey and white matter segmentation and spatial normalisation in patients with DESH. However, this combination could not improve the CSF segmentation accuracy. Another approach is needed to overcome this challenge.
Quality of Life in Children with Anorectal Malformations through years after surgery, an observational study
Authors: Nakhjiri Mobina Taghva , Shahmansouri Nazila , Shariat Mamak , Varnosfaderani Atefe Gilan , Adel Maryam Ghavami
Published: October 2024

Purpose: The primary objective of this study is to assess the Quality of Life (QOL) of children who have undergone surgery for ARM.
Methods: All the children aged 6-12 years old who had undergone surgery for ARM between 2012 and 2023 at our medical center were included in the study. The parents of 46 children participated in the study and completed the PedsQL 4.0 questionnaire.
Results: The mean age of the participants during the study period was 8.63 ± 1.69 years. The mean of the total QOL score of the participants was 92.65 from 100. The physical functioning had a mean of 97.09 from 100. The emotional functioning had a mean of 87.07 from 100. The mean of social functioning scores was 94.46 and the mean of school functioning scores was 89.35.
Conclusion: We concluded that as the children with ARM get older, the social component of QOL increases and the later the operation is performed in infancy, the better the emotional component of QOL will be through the years after surgery.
Minimally Invasive Mitral Valve Replacement Redo Surgery under Ventricular Fibrillation in a Patient with Dextrocardia and Situs Inversus Totalis: A Case Report
Authors: Han Yu , Zheng Junnan , Nadapana Pranav , Bagaskara Yedija , Lai Yilin , Zhao Haige
Published: October 2024

Background
Dextrocardia is a rare cardiac malposition where the heart’s normal orientation is reversed and is most commonly associated with situs inversus totalis (SIT). Such cases are technically challenging when heart surgery is needed, especially re-do surgery.
Case presentation:
A 72-year-old female patient was referred to our hospital with complaints of chest tightness and reduced activity tolerance. The patient had a history of mitral valve replacement (MVR) with a bioprosthesis ten years prior. Chest X-ray showed dextrocardia with SIT in the patient. Structural valve degeneration of the mitral bioprosthesis and moderate tricuspid regurgitation were observed by transthoracic echocardiography. The patient underwent a successful re-do mitral valve replacement under ventricular fibrillation (VF) via a left anterolateral mini-thoracotomy. The recovery of the patient was uneventful.
Conclusions
Redo MVR under VF without aortic cross-clamping through a mini-thoracotomy can be safely and effectively carried out in patients with SIT.
Optimized NGS-based de novo MET amplification detection for improved lung cancer patient management
Authors: Cabello-Aguilar Simon , Vendrell Julie A. , Evrard Solène , Thomas Quentin , Roch Benoît , Escudié Frédéric , Solassol Isabelle , Brousset Pierre , Mazières Julien , Solassol Jérôme
Published: October 2024

Background: MET amplification (METamp) is a noteworthy genomic alteration that can occur in patients with non-small cell lung cancer (NSCLC). It has been demonstrated to occur as a primary oncogenic driver that may exist prior to any treatment and is referred to as de novo METamp. Despite the recognized significance of this genetic alteration, routine large-scale screening for the early detection of de novo METamp is currently lacking in clinical practice and the clinical impact of de novo METamp in NSCLC remains poorly investigated.
Methods: In this study, we developed a NGS-based screening method for detecting and stratifying METamp optimized in silico, validated in a patient cohort (n = 72) and applied to 1,932 NSCLC patients. Clinical outcomes (OS and PFS) were assessed in de novo METamp cases (n = 46).
Results: The optimized NGS-based method achieved high confidence (F-score > 0.99) during in silico optimization. In vivo validation demonstrated high sensitivity (0.93) and specificity (0.97) compared to fluorescent in situ hybridization. de novo METamp was found in 2.4% of cases stratified into distinct amplification groups based on the amplification copy number ratio (CNR): Low- (1.5 < CNR ≤ 2.2), Medium- (2.2 < CNR ≤ 4), and High-amplification (CNR > 4). Significant differences in patient outcome (p < 0.001) were observed between the Low- (median OS: 35.9 months), Medium- (median OS: 14.3 months) and High-amplification (median OS: 3.3 months) groups. PFS under chemotherapy was notably reduced in the Medium/High-amplification groups compared to the Low-amplification group (p = 0.001).
Conclusions: Screening for METamp detection followed by stratification based on METamp levels may be considered in all NSCLC patients at diagnosis. This approach could potentially enhance treatment management effectiveness by facilitating inclusion in clinical trials.
Low-cost acrylic cranioplasty using an implant cast on a pre-printed 3D polylactic acid model in a child with a complicated osteolytic extradural hydatid cyst
Authors: Borni Mehdi , Kammoun Brahim , Taallah Marouen , Abdelmouleh Souhir , Boughariou Jihen , Boudawara Mohamed Zaher
Published: October 2024

Cranioplasty to restore calvarial defects involves reconstruction with alloplastic materials or autologous tissues in order to provide the best protection to all intracranial contents. Sometimes, autologous bone may not be available; therefore, different materials have emerged such as polymethylmethacrylate plate, titanium mesh, and hydroxyapatite. However, when it is impossible to replace the autologous bone, the aesthetic result is generally unsatisfactory. Some techniques like neuronavigation and computer-aided design can help overcome these problems. However, these techniques cost too much. By combining these techniques and that of 3D printing, some authors have provided an aesthetically precise and cost-effective implant using polymethylmethacrylate in patients with large craniectomy defects. Here, the authors report a case of a 6-year-old child with history of two previous surgeries for osteolytic extradural and complicated hydatid cyst followed by intra cerebral dissemination who was admitted for recurrence of his hydatid pathology. The child was scheduled for hydatid cysts resection and cranioplasty using the polymethylmethacrylate, after removal of the hydatid cysts, using a bone flap cast on a pre-printed cost effective polylactic acid 3D mold.
Mapping the intersection of demographics, behaviour, and government response to the COVID-19 pandemic
Authors: Bowdish Dawn , Kennedy Katherine , DeJong Erica , Chan Alexander , Kennedy Allison , Jamal Alainna , Surette Michael , Larché Maggie ,   Mark Larch, Hambly Nathan , Ask Kjetil , Atkinson Stephanie , McNicholas Paul , McGeer Allison , Coleman Brenda
Published: October 2024

During the early phase of the COVID-19 pandemic (March 2020-August 2021), the Province of Ontario enacted restrictions and recommendations that changed over time. We assessed individual and systemic factors shaping behaviours and contributing to exposure risk during this time. Participants across all age groups and health statuses adapted their behaviours in response to evolving regulations but older individuals and those with pre-existing conditions had the largest change in behaviour and when they developed COVID-19 or other influenza-like illnesses, had the most severe symptoms. Our analysis underscores the responsiveness of exposure risk to government-imposed restrictions, with increased stringency coinciding with decreased exposure risk among participants. These findings collectively emphasize the interplay between demographic factors and government interventions in shaping individual behaviours over the course of the pandemic. Understanding these dynamics is crucial for informing targeted interventions and mitigating the impact of future pandemics.
Fatigue, pain and faecal incontinence in adult Inflammatory Bowel Disease patients and the unmet need: a national cross-sectional survey
Authors: Hart Ailsa , Miller Laura , Büttner Fionn Cléirigh , Hamborg Thomas , Saxena Sonia , Pollok Richard CG , Stagg Imogen , Wileman Vari , Aziz Qasim , Czuber-Dochan Wladyslawa , Dibley Lesley , Mihaylova Borislava , Moss-Morris Rona , Roukas Chris , Norton Christine
Published: October 2024

Background and aims:
The co-existence of fatigue, pain and faecal incontinence in people with Inflammatory Bowel Disease (IBD) is unknown. We aimed to determine the presence of and relationship between these symptoms and patients’ desire for intervention.
Methods:
Adults with IBD in the UK , recruited form clinics, the national IBD-BioResource, a patient charity and social media sources, completed PROMIS validated patient-reported questionnaires to identify fatigue, pain and faecal incontinence, in addition to symptom severity and impact, disease activity, anxiety and depression questionnaires and questions about their desire for help with these symptoms. Statistical analysis used descriptive statistics to report presence of symptoms and Pearson correlation coefficients were calculated.
Results:
Of 8486 responses, 54% reported faecal incontinence, 24% reported fatigue, and 21% reported pain; 10% reported all three symptoms in the past 7 days. Only 29% reported none of these symptoms. Fatigue and pain were moderately correlated (Pearson correlation coefficient 0.57); both fatigue and pain had a lower correlation with faecal incontinence (0.43 and 0.46 respectively). On a 0-10 scale for severity, participants scored fatigue highest, followed by incontinence then pain. For impact, participants scored incontinence highest, followed by fatigue then pain. 56% reported depression (27% with clinically relevant levels) and 49% reported anxiety (20% with clinically relevant levels); 23% had previously medically diagnosed mental health disorders. 56% of respondents “definitely” wanted help for fatigue; 53% for incontinence; 42% for pain; 29% “definitely” wanted help with all three symptoms. Factors associated with all three symptoms were Crohn’s disease (compared with ulcerative colitis), IBD Control score, anxiety, depression, and a history of surgery.
Conclusions: Fatigue, pain and incontinence are common in IBD and patients desire help for these symptoms, currently a substantial unmet need. Anxiety and depression are common, are underdiagnosed, and are independently associated with these symptoms.
Whole Genome Sequence Analysis of Pulmonary Function and COPD in 44,287 Multi-ancestry Participants
Authors: Kim Wonji , Hu Xiaowei , Kim Kangjin , Chun Sung , Orchard Peter , Qiao Dandi , Ruczinski Ingo , Saferali Aabida , Aguet Francois , Antonacci-Fulton Lucinda , Balte Pallavi P. , Bartz Traci M. , Anamika Wardatul Jannat , Zhou Xiaobo , Duan JunYi , Brody Jennifer A. , Cade Brian E. , Daviglus Martha L. , Doddapaneni Harshavadran , Dugan-Perez Shannon , Dutcher Susan K , Frazer Chris , Gabriel Stacey B. , Gharib Sina A. , Gupta Namrata , Hobbs Brian D. , Kasela Silva , Loehr Laura R. , Metcalf Ginger A. , Muzny Donna M. , Oelsner Elizabeth C. , Rasmussen-Torvik Laura J. , Sitlani Colleen M. , Smith Joshua D. , Sofer Tamar , Xu Hanfei , Yu Bing , Zhang David , Ziniti John , Barr R. Graham , Carson April P. , Fornage Myriam , Hou Lifang , Kalhan Ravi , Kaplan Robert , Lappalainen Tuuli , London Stephanie J. , Morrison Alanna C. , O'Connor George T. , Psaty Bruce M. , Raffield Laura M. , Redline Susan , Rich Stephen S. , Rotter Jerome I. , Silverman Edwin K. , Manichaikul Ani , Cho Michael H.
Published: October 2024

Background
Whole genome sequence (WGS) data in multi-ancestry samples provide the opportunity to identify low-frequency or population-specific genetic variants associated with chronic obstructive pulmonary disease (COPD) and lung function.
Methods
We performed single variant, structural variant, and gene-based analysis of pulmonary function (FEV1, FVC and FEV1/FVC) and COPD case-control status in 44,287 multi-ancestry participants from the NHLBI Trans-Omics for Precision Medicine (TOPMed) Program. We validated a subset of findings using the UK Biobank, implicated effector molecules, and examined cell-type specific expression in lung scRNA-seq data sets.
Results
Applying a genome-wide significance threshold (P < 5x10-9) to our WGS analysis, we recapitulated evidence of association for previously reported loci, and further found evidence of association with lung function or COPD for novel regions located near LY86, MAGI1, and GRK7. Colocalization with gene expression quantitative trait loci (eQTL) from the Lung Tissue Research Consortium provided new support for known candidate genes including ADAM19, THSD4, C4B, and PSMA4, which were not specifically identified through integration with eQTL from other sources. Multi-ancestry analysis improved fine-mapping resolution, notably for loci with strong linkage disequilibrium in European ancestry, such as those near HTR4 and RIN3. In gene-based analysis of high-confidence loss of function variants, we found and replicated an association of HMCN1. Single-cell datasets nominated lung epithelial cells and immune cell types from our association studies, and fibroblasts for HMCN1. CRISPR targeting HMCN1 in IMR90 demonstrated reduced expression of collagen genes.
Conclusions
Our study demonstrates that genome-wide association study with larger multi-ancestry participants and WGS data helped to discover novel genomic regions and improved fine-mapping resolution for lung function and COPD.
Single-cell analysis supports key cell subpopulations for drug resistance and metastasis in prostate cancer
Authors: Zhao Hongfei , Li Jiaxuan , Yuan Ting , Sun Qi , Wang Guangkuo , Fang Han , Liu Huifang , Wang Yao , Song Xicheng
Published: October 2024

Although the long-term survival rate of localized prostate cnacer is high, prostate cancer is prone to drug resistance and metastasis after intensive multimodal therapy, significantly shortening patient survival. However, the mechanisms by which drug resistance and metastasis occur in prostate cancer are unknown, and there are no effective targeted drugs to treat metastatic prostate cancer. Therefore, the goal of this study was to construct a single-cell transcriptome atlas of prostate cancer by using single-cell RNA sequencing data through bioinformatics techniques, to explore the changes in abundance and function of different cell subpopulations during drug resistance and metastasis, and to speculate on the molecular pathways that may lead to drug resistance and metastasis. We analyzed the tumor cell subpopulation and predicted that the ASCL1, RORB, RBP1 and CALML5 might be the genes responsible for the development of drug resistance and metastasis, providing potential targets for targeted prostate cancer therapy. In addition, we performed differentiation potential analysis, trajectory analysis, and intercellular communication analysis on tumor cell subpopulations, which identified key ligand-receptor interactions between tumor cells and stromal cells that lead to disease progression, such as CCL5-SDC1/4, ICOSLG-ICOS and CD24-SIGLEC10. Our analysis identified potential targets to treat resistance and metastasis in prostate cancer, suggesting key ligand-receptor interactions that might contribute to disease progression, and provided valuable insights into targeted therapy for prostate cancer.
Exploring the posttreatment care experiences and unmet needs of breast cancer survivors: a descriptive phenomenological study
Authors: Xu Wenjing , Zhang Cuicui , Liao Changju , Zhu Lili , Gong Xue , Zhou Li , Liu Xiangyu
Published: October 2024

Background Addressing the unmet needs of breast cancer survivors’ post-treatment are crucial for enhancing their quality of life and promoting their overall health outcomes. This study aims to explore the unmet needs of post-treatment breast cancer survivors within social ecosystems. It provides a patient perspective for the development of a supportive framework that healthcare providers can use to assess and manage these unmet needs.
Methods Utilizing a qualitative descriptive design, this study conducted semi-structured interviews with twenty breast cancer survivors. Colaizzi’s 7-step method was employed for data analysis.
Results The study identified three themes and nine subthemes: (1) microsystem—normalization and self-growth (management of somatic symptoms and function, maintenance of body image, femininity, and sexuality, and adoption of healthy behaviors); (2) mesosystem—acceptance and respect in the family and workplace (internal to the mesosystem—strengthening family resilience; external to the mesosystem—provision of return-to-work assistance); (3) macrosystem—expansion of the support system (diverse treatment facility support, accessible integration of communities, health and payment policy favoritism, destigmatization of cancer).
Conclusion This study offers new insights into the perspectives of breast cancer survivors regarding unmet needs after completing active treatment. It recommends that the interdisciplinary team offers person-centered, integrated, and coordinated supportive care that addresses the individualized and complex needs of post-treatment breast cancer survivors and their caregivers. Future research should focus on developing survivorship care plan models that prioritize personalized support for individuals recovering from breast cancer treatment.
Prevalence of Malaria and Associated Risk Factors among Febrile Under-five Refugee Children Attending Panyadoli Health Centre III, Kiryandongo District, Mid-western Uganda
Authors: Acan Dorcus , Opiro Robert , Musinguzi Benson , Agaba Bosco B. , Alarakol Simon Peter
Published: October 2024

Background: Malaria presents a big threat to the health of refugees, internally displaced persons, returnees and other such persons affected by humanitarian emergencies, with almost two thirds of these groups of persons living in malaria endemic regions. The aim of this study was to determine the prevalence of malaria and associated risk factors among refugee children <5 years attending a Health Centre in Panyadoli Refugee Camp, Kiryandongo District.
Methods: A cross sectional survey was done between February to April 2022, targeting refugee children < 5 years old seeking health attention at Panyadoli Health Centre III in Kiryandongo District. Simple random sampling was employed to select 380 participants who were then tested for the presence of malaria parasites using Malaria Rapid Diagnostic Tests (RDTS) and Microscopy techniques. Data on risk factors of malaria was collected using a pre-tested and standardized semi-structured questionnaire. Bivariate and multivariate logistic regression analyses was used to identify the risk factors, at 95% confidence interval and p < 0.05.
Results:Malaria prevalence among the refugee children < 5 years attending Panyadoli HCIII was 12.6% [95% CI: 8.7–18.0]. The associated risk factors for malaria infection included: application of Indoor Residual Spraying (IRS) in last 12 months [AOR = 4.323; 95% CI: 1.231–7.212], history of malaria in children (AOR = 5.861; 95% CI: 1.562 - 8.433], and sleeping under insecticide treated nets (AOR = 3.141; 95% CI: 0.865 - 5.221).
Conclusion: Malaria remains a threat to refugee children <5 years old at Panyadoli Refugee Settlement Camp. Health education should aim to sensitize and encourage the community to embrace malaria prevention measures, majorly IPT for pregnant mothers, use of ITNs, and IRS of households.