bluuebunny/crossref_metadata_2025 huggingface dataset:
Ecological Connectivity of Plant Communities for Red Blotch Disease Dynamics Revealed by the Dietary Profiles and Landscape-Level Movement of Spissistilus festinus
Authors: Hoyle Victoria , Headrick Heather , Cooper W. Rodney , Fendell-Hummel Hannah G. , Cooper Monica L. , Flasco Madison , Cieniewicz Elizabeth , Heck Michelle , Fuchs Marc
Published: January 2025

The epidemiological relationship between arthropod dispersal and plant communities is poorly understood at the landscape level. We investigated the connectivity of natural and cultivated plants in vineyard ecosystems for red blotch disease dynamics by characterizing the dietary history of Spissistilus festinus, a treehopper vector of grapevine red blotch virus (GRBV). Molecular analysis of the gut content of 205 S. festinus caught in 71 vineyard sites and the flora proximal to vineyards in Napa Valley, California, USA revealed a total of 171 genera from 61 plant families with a preeminence of Asteraceae, Fabaceae, and Vitaceae over two growing seasons, illustrating dietary profiles composed primarily of natural vegetation. An indicator species analysis identified the strength of ecological associations by showing distinct seasonal feeding trends related to weather patterns and host repertoires unique to some vineyard sites with estimated S. festinus travel distances of up to two kilometers. Potential reproductive and overwintering hosts of S. festinus were identified in natural habitats and an ecological relatedness between free-living vines in riparian corridors and vineyards for GRBV transmission was documented. Together, our findings on landscape vegetation connectivity and S. festinus dispersal transformed our understanding of red blotch disease ecology and informed disease management options.
Distribution of propiconazole-resistant Geotrichum candidum in peach orchards with or without cull fruit amendments
Authors: Schnabel Guido , Gelain Jhulia , Luo Chaoxi , Zhao Bingyu
Published: January 2025

Resistance to propiconazole in G. candidum was reported previously in isolates collected from peaches after cold storage, but the origin of resistance was unclear. If resistance had been generated and selected in the packinghouse with postharvest propiconazole drenches, we would expect to find resistance in the sour rot pathogen only in orchards that had received cull fruit returned to the orchard floor from the packinghouse. In this study, 70 G. candidum isolates were collected from 7 orchards that had received cull fruit in the past from a packinghouse with documented resistance in G. candidum in stored fruit and six orchards that had never received cull fruit. Species identification was confirmed through species-specific PCR. Results showed a similar prevalence of sensitive, reduced-sensitive, and resistant isolates in cull and non-cull orchards. Sequencing of the GcCYP51B gene identified previously reported genotypes leading to E126K, Y143F, and G460S mutations and a newly described genotype consisting of a set of combined mutations, Y143F and L389V. Further investigation into alternate genetic determinants of resistance revealed that overexpression of the GcCYP51A or GcCYP51B genes was not involved in resistance to propiconazole. Our findings suggest that propiconazole resistance in G. candidum, first found in a peach packinghouse, originated in the field, likely from decades of demethylation inhibitor (DMI) fungicide applications to control preharvest diseases of peaches.
Experience of Medical School Faculty in the Transition From Lectures to Active Learning: A Phenomenographic Study
Authors: Huggett Kathryn N. , Smith Gary A. , Hsieh Peggy H. , Ownby Allison R.
Published: January 2025

Purpose

Although there is a robust literature on the benefits and outcomes of active learning in medical education, little is known about the faculty experience of transitioning from lecture-based teaching to active learning in the preclinical, foundational science curriculum. The authors explored how faculty describe changing from lecture to active learning and how that change relates to the loci of control and basic psychological needs of faculty.

Method

Using a phenomenographic approach, the authors interviewed faculty at 3 medical schools who taught before, during, and after required shifts to active learning. Interviews were conducted, recorded, and transcribed between February and May 2022. Open-ended interview questions were developed to allow participants to share significant experiences and perspectives. The researchers collaboratively attributed participants’ statements into categories of description of the change phenomenon. These categories were then grouped into an outcome space that represented aspects of the phenomenon and the relationships among them.

Results

The 15 participants described the change in instructional focus from lecture to active learning in 2 fundamentally different ways, defining the outcome space as 2 parallel sets of categories of description. A process set of categories describes the change in instructional focus from lecture to active learning as a process of instructional change, change in role, and socialization with other educators. The other categories correspond to motivation or demotivation via external and internal regulations related to self-determination theory.

Conclusions

This study offers valuable insights into the interconnected aspects of this educational transformation, providing perspectives that can guide future efforts in curriculum redesign and faculty support programs. Recommendations include engaging faculty in all stages of the transition, acknowledging and building on existing pedagogical innovation at the school, and providing options for faculty rather than a single prescribed approach. Future research should explore optimal approaches, timing, and support for curricular transitions.
Electronic Flashcards in Health Professions Education: A Scoping Review
Authors: Barrison Philip D. , Balczewski Emily A. , Capellari Emily , Landis-Lewis Zach , Vinson Alexandra H.
Published: January 2025

Purpose

Electronic flashcards (EFs) are a widely used learning resource in medical education. This scoping review provides a comprehensive overview of the existing empirical research on EFs and a direction for future research on EF interventions. The authors organized the reviewed articles into 4 nonmutually exclusive categories: development, delivery, utilization, and associated outcomes.

Method

In this scoping review, search queries were composed for 6 databases (PubMed, Embase, Education Resource Information Center, Web of Science, PsychInfo, and the Cumulative Index to Nursing and Allied Health Literature). The database search was conducted on April 12, 2024, for articles published before this date using the following keywords (as well as other keywords): anki, quizlet, firecracker, osmosis, flashcard, spaced repetition, spaced interval training, spaced interval learning, spaced test, and parallel curriculum. Two reviewers screened the studies for eligibility and performed data extraction between August 12, 2024, and September 26, 2024.

Results

Sixty-four studies were included in the review. Most articles were published in the last 6 years (2019-2024) (49 [77%]), in the United States (45 [7%]), and in the context of undergraduate medical education (42 [66%]). The studies predominantly focused on the utilization (51 [78%]) and associated outcomes (38 [59%]) of EFs. In contrast, EF development (12 [19%]) and delivery methods (16 [25%]) were less frequently examined.

Conclusions

This review of the rapidly increasing body of research on EFs suggests broad use and satisfaction among health professions learners; however, much work remains to be done to systematically understand EF development and delivery. Future research directions may consider more systematic investigations of how decisions made during the development and delivery of EFs affect downstream use and learning outcomes. Addressing these gaps will deepen the understanding of how EFs affect medical education pedagogy and facilitate the informed integration and refinement of these tools within curricula.
A Systems Approach to Improving Well-Being in Graduate Medical Education
Authors: Adibe Bryant , Brown Lawrence , Goulder Alison , Lee Elizabeth , Owen Leena , Roberts William , Yarru Gabrielle
Published: January 2025

The imperative to improve the well-being of graduate medical education (GME) trainees has been well documented. While existing interventions have largely centered on increasing individual trainee resilience, less focus has been on the role of national health policy, economics, and the overall U.S. care delivery system in acting as antecedent contributors to burnout among learners. To explore the impact of these national system level factors, Princeton University hosted the Systems Summit on Clinical Wellbeing in October 2023. Co-sponsored by the Accreditation Council for Graduate Medical Education, American Medical Association, and Healing Works Foundation, the event brought together thought leaders, policymakers, and experts from a myriad of backgrounds, including GME leaders and trainees.

Through a systems lens, summit attendees identified opportunities and barriers for well-being at both the national and health care organization levels. At the national level, identified barriers included historical national policy decisions, longstanding economic pressures in health care, and their combined cumulative impact on trainees. At the health care organization level, trainees pointed to an incongruity between common institutional wellness offerings and their more immediate support needs, along with unsustainable workload expectations, including the added toll of non-physician tasks (e.g., scheduling). A lack of appropriate tools for assessing well-being through a systems lens further compounds these issues. More actionable outputs may be achievable through the integration of operationally oriented well-being metrics (e.g., clinical and academic workload hours, call frequency, stay intent).

Long overdue updates to ill-fated national policy decisions, along with a redirection of the focus of GME well-being efforts at the programmatic level, could, in combination, fundamentally reshape the experience of trainees, contributing to lower incidences of depression, exhaustion, and burnout.
Use of Virtual Reality Glasses During Healthcare
Authors: Sousa Vitória Talya dos Santos , Nogueira Maria Rayssa do Nascimento , Braga Hévila Ferreira Gomes Medeiros , Leite Ana Caroline Rocha de Melo , Melo Emanuella Silva Joventino , Vasconcelos Patrícia Freire de
Published: January 2025

Integrating technology into healthcare services has direct implications for the efficacy and performance of client care. In view of this, the aim was to identify the possibilities of using virtual reality glasses in healthcare. An integrative literature review was conducted in October 2024, searching in MEDLINE, LILACS, BDENF, Scopus, Web of Science, EMBASE, and Science Direct. Original articles were included without restriction on publication period or language, whereas duplicates and those not addressing the guiding question were excluded. The level of evidence was evaluated following Melnyk and Fineout-Overholt's method. Data were synthesized in tables, figures, and in narrative form. The 47 studies in the final sample were published between 2007 and 2024, with most conducted in Turkey and predominantly clinical trials. Various models of glasses were used, with VRBox being the most cited, and video interventions were prominent. Main focuses of use included areas such as rehabilitation, invasive procedures, preoperative care, obstetrics, examinations, dentistry, and wound care. The use of virtual reality glasses has proven effective for distraction, pain reduction, and anxiety management across various health domains. Experimental studies indicate a high level of scientific evidence, which is essential for evidence-based practices; however, more objective investigations are still needed.
Role of follicular homing natural killer cells in HIV infection
Authors: Ponnan Sivasankaran Munusamy , Govindaraj Sakthivel , Velu Vijayakumar
Published: January 2025

Purpose of review

Natural killer (NK) cells are integral components of the innate immune system, serving a vital function in eliminating virally infected cells. This review highlights the significance of CXCR5+ NK cells in the context of chronic HIV/SIV infection and viral control.

Recent findings

Controlled HIV/SHIV infection results in a substantial increase in the population of CXCR5+ NK cells within the B-cell follicles of secondary lymphoid organs (SLOs). These CXCR5+ NK cells display enhanced functional characteristics, including elevated expression of activation markers and increased cytokine production, which are essential for effective viral control. These follicular NK cells are shown to be enriched in IL-15 signaling, and CXCR5 NK cells are negatively associated with viral burden during chronic HIV and SHIV infection.

The distinct phenotypic and functional attributes of CXCR5+ NK cells, particularly in the lymphoid tissues of individuals living with HIV, emphasize their critical contribution to the anti-HIV-1 immune response. A comprehensive understanding of the mechanisms and roles of CXCR5+ NK cells may present novel therapeutic strategies aimed at enhancing NK-mediated viral control.
Workplace physical activity, sitting time, and menopause symptoms
Authors: Carter Sophie E. , Beaumont Alexander J. , Campbell Amy K.
Published: January 2025

Objective

Increasing numbers of women are in employment during the menopause; however, menopause symptoms can negatively impact capacity to work. Aspects of the work environment, such as the amount of time spent in physical activity (PA) and sitting, may influence symptoms, yet this is unexplored. This study aimed to explore relationships between workplace PA and sitting, and menopause symptom severity.

Methods

Using a cross-sectional study design, 264 perimenopausal or postmenopausal women were recruited to complete an online questionnaire assessing their self-reported workplace PA and sitting time, and their menopause symptom severity (menopause quality of life, hot flash interference, symptom severity). Multiple linear regression analyses examined the associations between menopause symptom severity and the time spent in PA (standing, walking, and physically demanding tasks) and sitting during work hours. Binomial logistical regression was used to assess if menopause symptom severity predicts whether women meet workplace activity guidelines.

Results

No significant associations were observed between the time spent in PA or sitting while at work and menopause symptom severity (P > 0.05). Menopause symptom severity did not significantly predict whether women met workplace activity guidelines (P > 0.05).

Conclusions

In a cohort of perimenopausal and postmenopausal women, self-reported time spent in PA and sitting while at work is not associated with menopause symptom severity. Further research is needed using device-based methods to assess PA and sitting time, to explore in more detail the influence of the time spent in these behaviors while at work on menopause symptoms.
Recent advances in MASLD genetics: Insights into disease mechanisms and the next frontiers in clinical application
Authors: Chen Vincent L. , Brady Graham F.
Published: January 2025

Metabolic dysfunction–associated steatotic liver disease (MASLD) is the most common chronic liver disease in the world and a growing cause of liver-related morbidity and mortality. Yet, at the same time, our understanding of the pathophysiology and genetic underpinnings of this increasingly common yet heterogeneous disease has increased dramatically over the last 2 decades, with the potential to lead to meaningful clinical interventions for patients. We have now seen the first pharmacologic therapy approved for the treatment of MASLD, and multiple other potential treatments are currently under investigation—including gene-targeted RNA therapies that directly extend from advances in MASLD genetics. Here we review recent advances in MASLD genetics, some of the key pathophysiologic insights that human genetics has provided, and the ways in which human genetics may inform our clinical practice in the field of MASLD in the near future.
Safety of Nirmatrelvir-Ritonavir Administration in Children With Immunodeficiency and/or Comorbidities With SARS-CoV-2 Infection: A Retrospective Clinical Report
Authors: Bernardi Stefania , Roversi Marco , Torelli Antonio , Musolino Antonio , Nicastri Emanuele , Palma Paolo , Rossi Paolo , Vallesi Leonardo , Corsetti Tiziana , Lancella Laura , Lucarelli Barbarella , Galaverna Federica , Villani Alberto , Perno Carlo Federico , Raponi Massimiliano ,   KIDS Study Group
Published: January 2025

Introduction:

Despite the generally mild course of COVID-19 in children, immunocompromised patients may experience complications or severe infection. This study reports the clinical outcomes of pediatric patients treated with nirmatrelvir and ritonavir (N/R) for SARS-CoV-2 infection.

Methods:

We retrospectively reported the data of children with any immunodeficiency with COVID-19 who received N/R treatment between March 2022 and June 2023 at the Bambino Gesù Children’s Hospital. Patients were treated with N/R for 5 days. We compared liver and kidney function before and after treatment with N/R and looked for a relationship between the duration of COVID-19 infection and the time from positivity to administration of N/R administration.

Results:

A total of 85 pediatric immunocompromised patients with COVID-19 were included in the study, with a mean age of 10.7 years (SD 4.8), mostly males (60%). We found a significant difference in the viral load before and after N/R administration. Four patients (4.7%) experienced adverse events related to N/R therapy. One of these had to discontinue N/R administration. Three patients (3.5%) experienced negative effects of drug interactions during N/R therapy, namely an increase of sirolimus and ciclosporin serum levels. A significant positive correlation was found between the time from SARS-CoV-2 positivity to N/R administration and the duration of SARS-CoV-2 swab positivity (R = 0.78, P < 0.001), suggesting that the earlier N/R is administered, the shorter the duration of COVID-19 in the study sample.

Conclusion:

Our experience shows that N/R is reasonably safe in the pediatric population and could favor viral clearance, thus reducing the duration of infection.
Improved Uptake of Vaccinations in Children With Adverse Events Following Immunization After Specialist Immunization Service Intervention in an Australian Pediatric Hospital
Authors: Yee Jialin Sabrina , Doyle Rebecca , Wen Sophie Chien-Hui
Published: January 2025

Background:

Adverse Events Following Immunization (AEFI) have significant implications for public health, potentially leading to decreased immunization rates and vaccine hesitancy. Understanding the characteristics and outcomes of children experiencing AEFI is crucial for effective intervention strategies and informed decision-making. This study aimed to describe the diverse range of AEFI presentations, identify common referral sources and assess factors influencing vaccination uptake following specialist consultation.

Methods:

A single-center retrospective cohort study was conducted from 2019 to 2022, analyzing AEFI data from 191 children referred to a Specialist Immunization Service (SIS) at an Australian pediatric health service. Demographic data, referral details, vaccination history, and AEFI types were considered. Statistical analyses, including univariate and multivariate models, were employed to predict vaccination outcomes post-SIS consultation.

Results:

The median age of children referred was 2 years. General practitioners were the major referral source (68%). Urticarial rash was the most prevalent AEFI referred (29%). Pneumococcal conjugate vaccine was the most implicated vaccine (38%). The majority (69%) were successfully vaccinated following SIS consultation with 3% experiencing a subsequent AEFI (all mild). Older age is found to be associated with less likelihood for vaccination (odds ratio = 0.93, 95% confidence interval: 0.88–0.99, P = 0.027). Formal reporting of AEFI was low (26%).

Conclusions:

Severe adverse events, including anaphylaxis, were rare, and a SIS played an important role in vaccinating children following AEFI. Vaccination following urticarial rash is likely safe, and options such as a drop-in immunization center in a hospital setting may reduce delay to the next dose in scheduled vaccinations following AEFI. AEFI reporting needs to be promoted, and a patient-initiated reporting system may enhance this.
Quality management for nurses performance and commitment on government hospitals: A cross-sectional study
Authors: Alzoubi Majdi M. , AL-Mugheed Khalid , Al-Zoubi Khaled M. , Al-Oweidat Islam , Saeed Alabdullah Amany Anwar , Abdelaliem Sally Mohammed Farghaly
Published: January 2025

Healthcare organizations and public institutions give more priority to commitment and performance as tools to measure nursing care outcome with regards to patient’s safety and quality care. Our aim was to evaluate the level of nurse’s commitment and performance among Jordanian nurses. A cross-sectional study was conducted in between September and October 2018 among 132 nurses in 2 major government hospitals in Jordan. The subjects were selected using Proportionate stratified random sampling. The data were collected using a self-administered questionnaire. The nurses showed moderate job performance with total mean (131.6 ± 8.5). The level of commitment was moderate (56.4 ± 1.9). Nurses’ commitment (r = 0.384; P < .01) and performance (r = 0.33; P < .01) was significantly and positively correlated with educational level and work experience (r = 0.374; P < .01). No significant difference observed between male and female in terms of performance and commitment (P > .05). Nurse performance and commitment were influenced by education and experience with education (β = 0.291, P < .001) contributing significantly than experience (β = 0.280, P < .001). The findings of the study have broadened the scope of knowledge in the existing literature. Stakeholders should strengthen continued education to nurses and stimulate their love of the nursing profession.
Cardiac arrest following blunt trauma-induced tension viscerothorax mimicking tension pneumothorax: A rare case report
Authors: Yuan Zhuo , Liao Changsheng , Zhang Songtao , Wang Aiwen , Zhou Congcong , Yi Wenbin , Han Zehao , Xue Shaoxiong , Shen Xuefeng
Published: January 2025

Rationale:

Tension viscerothorax is a severe condition characterized by significant increases in thoracic pressure due to the herniation of abdominal organs into the thoracic cavity. It is commonly observed in children with congenital diaphragmatic hernias or as a postoperative complication, while tension viscerothorax resulting from blunt trauma is rare.

Patient concerns:

A 48-year-old male was urgently admitted to the emergency department with dyspnea following a fall from a height of 15 m.

Diagnoses:

The patient, presenting in shock and based on clinical signs, was initially diagnosed with a tension pneumothorax (TPT). Bedside point-of-care ultrasound (POCUS) revealed substantial parenchymal echo abnormalities in the left thoracic cavity and cardiac displacement to the right, suggesting a left-sided tension viscerothorax. Thoracic and abdominal computed tomography confirmed the diagnosis of a rare left-sided tension viscerothorax.

Interventions:

Due to the delayed diagnosis, the patient experienced a cardiac arrest. Following cardiopulmonary resuscitation and advanced life support, the patient regained spontaneous circulation and underwent an emergency laparotomy to reduce abdominal organs and repair a diaphragmatic hernia. Postoperatively, the patient received comprehensive medical care.

Outcomes:

The patient recovered well postsurgery and was discharged after an 18-day hospital stay. Follow-up over 2 years revealed no significant complications.

Lessons:

Blunt trauma-induced tension viscerothorax is rare and can easily be confused with TPT, leading to misdiagnosis. Early use of bedside POCUS is recommended for suspected cases to expedite identification and management, thereby improving survival rates.
Efficacy of topical carbonic anhydrase inhibitors in treating taxane drug-induced cystoid macular edema: A case report
Authors: Hou Xianbing , Chen Dandan , Lu Yingxue
Published: January 2025

Rationale:

Taxanes, derived from Taxus chinesnsis, stabilize microtubules and include drugs like Paclitaxel, Docetaxel, and Nab-paclitaxel. These are commonly used to treat various malignant tumors. However, Taxane-drug-induced cystoid macular edema (TDICME) is a rare and often under-recognized complication.

Patient concerns:

A male patient, aged sixty-three, who was diagnosed with poorly differentiated gastric adenocarcinoma, experienced a progressive decline in visual acuity in both eyes after a 4-month course of nab-paclitaxel therapy.

Diagnoses:

Upon Fundus examination, bilateral cystoid macular edema (CME) was seen.

Interventions:

Undergo treatment with carbonic anhydrase inhibitors and discontinue the use of nab-paclitaxel.

Outcomes:

After eleven days of treatment with carbonic anhydrase inhibitors, the patient reported significant improvement in visual acuity. Furthermore, CME was completely resolved in both eyes 8 weeks after stopping nab-paclitaxel.

Lessons:

This case highlights the potential therapeutic effectiveness of topical carbonic anhydrase inhibitors in treating TDICME. Our findings underscore the importance of monitoring and addressing ocular side effects in patients undergoing Taxane therapy, ultimately contributing to enhanced patient quality of life and treatment outcomes.
Berry syndrome, a rare congenital cardiac structural abnormality with 1-stage surgical repair: A case report
Authors: Su Yueqiu , Leng Zhou
Published: January 2025

Rationale:

Berry syndrome is a complex congenital heart anomaly characterized by a combination of aortopulmonary window, interrupted aortic arch or hypoplastic aortic arch or coarctation of the aorta, anomalous origin of the right pulmonary artery, patent ductus arteriosus, and intact ventricular septum. It is an extremely rare condition, with approximately 100 reported cases to date.

Patient concerns:

In this article, we report a case of a 6-year-old girl with Berry syndrome who presented with significant ischemic and hypoxic symptoms.

Diagnoses:

Based on the patient’s medical history and examinations, a definitive diagnosis of Berry syndrome was established.

Interventions:

She underwent a 1-stage surgical treatment and had a successful discharge. The surgical process was aimed to preserve the growth potential of the aorta and pulmonary arteries while achieving unobstructed left ventricular outflow and continuity of the aortic arch, ensuring no shunting between the main pulmonary arteries.

Outcomes:

Intraoperative transesophageal echocardiography confirmed continuous flow through the aortic arch and no shunting between the MPA and the aorta.
Efficacy and safety of herbal medicine treatment on postsurgical recovery in gastric cancer patients: A systematic review and meta-analysis
Authors: Kim Soo-Dam , Pyo Sook-Jin , Kim Dong-Hyeon , Yoo Hwa-Seung , Park So-Jung
Published: January 2025

Background:

Gastric cancer (GC) is the second most prevalent cancer in Korea, and is associated with significant morbidity and mortality. Although advancements in early detection and treatment have improved survival rates, management of postsurgical recovery remains vital. Herbal medicine (HM) has emerged as a potential adjunct therapy for enhancing the recovery and quality of life (QoL) of patients post-GC surgery.

Methods:

This systematic review and meta-analysis evaluated the efficacy and safety of HM in the postsurgical recovery of patients with GC. We searched both Korean and international databases and identified 16 randomized controlled trials that met our inclusion criteria. We assessed the study quality using the Cochrane Risk of Bias tool and analyzed the data using the Review Manager Software (RevMan).

Results:

Our analysis included 1546 patients from selected studies, demonstrating that HM significantly improved gastrointestinal recovery times, including the time to first flatus, bowel movement, and return of bowel sounds. Significant improvements were also observed in nutritional markers, such as albumin and prealbumin, along with beneficial effects on immune markers, such as CD3+ and CD4+ levels. QoL assessments using the WHOQOL-BREF and QLQ-C30 indicated substantial improvements. HM had a favorable safety profile, showing a reduced incidence of adverse effects compared to the controls.

Conclusion:

The findings suggest that HM can significantly enhance recovery and improve quality of life following GC surgery, with a favorable safety profile. However, due to the considerable heterogeneity in study results, extended clinical trials and rigorous follow-ups are recommended to comprehensively assess long-term effects and side effects.
Early hematological indices as a predictor of placenta accreta in women with high suspicion of accreta
Authors: Al-Nuaimi Ali Mohammed Ali , Al-Nuaimi Zahraa Mohammed Ali
Published: January 2025

There is a lack of early biomarkers to predict the placenta accreta spectrum; thus, searching for available and easily obtained markers such as hematological indices is an attractive option. The current study is a diagnostic accuracy study included 198 women; all women underwent an assessment of their hematological indices during their first trimester as part of their routine antenatal care. All women included in the study had a high suspicion of developing placenta accreta spectrum; the women were followed up until their delivery. White blood cell, neutrophil count, and red cell distribution width (RDW) were significantly higher in the women with accreta than those without accreta. RDW had fair ability (area under the curve, 0.707) as a predictor of accreta. RDW had the highest positive and lowest negative likelihood ratios (indicating better value than the rest of the markers). In multivariate analysis, RDW and the platelet-lymphocyte ratio were independently associated with accreta after adjustment to the effects of age, gestational age, gravida, parity, abortion, and past medical/surgical history. In conclusion, simple, early blood count parameters may be utilized for placenta accreta; RDW appears to be the best predictor of placenta accreta.
Study on mechanism of iridoid glycosides derivatives from Fructus Gardeniae in treatment of hepatic encephalopathy by network pharmacology and molecular docking technology
Authors: Liu Fangzhou , Li Meng , Li Yuanbai , Du Yu , Li Yihao , Yang Yang
Published: January 2025

Background:

This study aims to explore the mechanism of the iridoid glycosides from Fructus Gardeniae (IGFG) in treating hepatic encephalopathy (HE) by combining network pharmacology and molecular docking technology.

Methods:

Firstly, we collected the targets of IGFG and HE. The targets of IGFG were predicted through the CTD, SWISS and TCMSP database and the targets of HE were screened through the DisGeNET database. Then the targets of IGFG and HE were mapped to attain the common target of IGFG in treating HE. Then, chemicals-target-disease network was constructed. Secondly, we constructed protein–protein interactions (PPI) network using STRING database and Cytoscape software. Moreover, we screened the core targets according to the degree value. Thirdly, the mechanism of IGFG in treating HE was revealed by Gene ontology and KEGG enrichment analysis. Meanwhile, chemicals-target-pathway network was constructed. Finally, to further verify the analysis results, molecular docking study was conducted.

Results:

Network pharmacology indicates that there are 12 common targets between IGFG and HE. Eleven core targets were identified by the construction of PPI network. Association for core targets, and related pathways was analyzed, implying that core targets related to these pathways are AKT1, tumor necrosis factor, MTOR, CHUK, PPP2CA, IKBKB, AKT2, IKBKG, IL1B, NFKBIA, and CASP8. The main mechanism of IGFG in treating HE is closely related to inhibit inflammatory reaction, regulate immunity, promote hepatocyte regeneration, reduce hepatocyte apoptosis, maintain liver function homeostasis and antiviral function. Finally, the results of molecular docking showed that the binding free energy of geniposide with the core target was less than −5 kJ/mol, which indicated that geniposide could spontaneously bind to the receptor protein and had strong binding force.

Conclusion:

IGFG can achieve simultaneous intervention of HE by inhibit inflammatory reaction, regulate immunity, promote hepatocyte regeneration, reduce hepatocyte apoptosis, maintain liver function homeostasis and antiviral function. It presents the network regulation mechanism of mutual influence and complex correlation. This study provides a scientific basis for IGFG in the treatment of patients with HE.
Epidemiology of imported travelers with dengue fever in Taiwan from 2011 to 2020
Authors: Wu Pi-Yu , Lin Fu-Huang , Hsieh Chi-Jeng , Chou Yu-Ching , Yu Chia-Peng
Published: January 2025

We collected data on imported dengue cases between 2011 and 2020 from Taiwan’s Centers for Disease Control to determine changes in the case number and importation rate of dengue. We used open data provided by Taiwan’s Centers for Disease Control to extract the number of confirmed imported cases of dengue between 2011 and 2020. From 2011 to 2020, 2883 imported cases of dengue were reported in Taiwan. The importation rate was 25.8 to 46.4 per 100,000 inbound travelers from 2011 to 2020, peaking in 2020. Disease incidence varied between sexes, age groups, seasons (P < .001), and residence from 2011 to 2020. Numerous dengue cases were imported from Indonesia (548 cases), Vietnam (516 cases), and the Philippines (500). For travelers from Taiwan, the risk ratio of becoming infected by dengue was 31,712 for traveling to the Maldives, 3153 to Cambodia, and 996 to Myanmar. In this study, more serotype 1 and 2 strains were reported by Vietnam, and more serotype 3 and 4 strains were reported by Indonesia. Our data indicate that the rate of imported cases of dengue significantly increased annually from 2011 to 2020 in Taiwan, especially during the COVID-19 pandemic (46.4 per 100,000 inbound travelers).
Uncommon ileal perforation due to intestinal tuberculosis: A case report and literature review
Authors: Ju Jianhua , Liu Jingyu , Dong Wei , Zhong Yuxu , Chu Haibo
Published: January 2025

Rationale:

Tuberculosis (TB) is a chronic granulomatous infectious disorder, caused by Mycobacterium tuberculosis. Extrapulmonary TB, which accounts for 20% of cases, includes intestinal TB in 10%. Gastrointestinal TB leads to intestinal perforation in 4% to 7.6% of cases, with a mortality rate of 30%.

Patient concerns:

We conducted a retrospective analysis of a patient with ileal perforation due to intestinal TB. A male in his early 20s (initial weight, 35 kg) presented with a 2-day history of abdominal pain, exhibiting tenderness, rebound tenderness, and muscular guarding upon physical examination. Computed tomography (CT) imaging revealed a significant amount of free gas and fluid in the abdominal cavity. Subsequently, the patient underwent ileal repair and ileostomy.

Diagnoses:

Histopathological examination confirmed multifocal amorphous pink caseating necrotic material and Langhans giant cells in the mesenteric lymph nodes. A polymerase chain reaction (PCR) assay confirmed infection with M tuberculosis.

Interventions:

On the 20th postoperative day, enteral nutrition was initiated concomitantly with antitubercular therapy (ATT). After 1 month, enteral nutrition and oral diet were alternated for 2 months, then changed to oral diet alone, and the patient was discharged to continue ATT. Five months later, the patient’s weight increased by 20 kg, and he began exercising outdoors. The patient underwent a successful ostomy reversal.

Outcomes:

At the 12-month follow-up, his body weight had increased to 65 kg, PCR testing was negative for M tuberculosis, and antituberculosis drugs were discontinued.

Lessons:

This case highlights the successful management of ileal perforation due to intestinal TB with peritonitis, without complications such as fistulas. Diagnosis of small bowel perforations due to intestinal TB remains challenging even for experienced clinicians, and surgical approaches are controversial. We emphasized the significance of diagnostics of such cases and often requiring a multidisciplinary approach involving various medical teams.
Cord blood IgG for respiratory syncytial virus and subsequent infection during the COVID-19 pandemic
Authors: Ogasawara Ritsuko , Urashima Mitsuyoshi
Published: January 2025

The resurgence of respiratory syncytial virus (RSV) infection among Japanese infants during the coronavirus disease 2019 pandemic might be due to a decrease in cord blood anti-RSV immunoglobulin G (IgG) positivity resulting from reduced maternal RSV exposure. This study examined changes in the positivity before and during the pandemic to clarify the relationship between this positivity and infantile/severe RSV infections. Data from a prospective cohort study conducted in Tokyo, Japan, involving mother–child pairs of infants born between February 2019 and August 2022 were reanalyzed. Cord blood anti-RSV IgG levels measured by enzyme-linked immunosorbent assay were classified as positive, gray zone, and negative. We examined the relationship between antibody positivity and infantile (≤12 months old) and/or severe RSV infections as diagnosed by pediatricians. A total of 319 families participated. There was a significant decrease in cord blood anti-RSV IgG positivity from 65.1% in 2019 to 50.9% in 2022 (P = .02). Among infants followed up until their 2nd birthday, 43 (33.1%) were diagnosed with RSV infections. Of these cases, 5 were infantile/severe and occurred among the 50 infants classified as negative or gray zone, while none were observed among the 80 infants classified as positive (P = .004). Infantile/severe RSV infection was identified in 4 (16.7%) born during the pandemic, representing a significantly higher rate than 1 (0.9%) born before the pandemic (P < .001). This study revealed an association between lower cord blood anti-RSV IgG positivity during the coronavirus disease 2019 pandemic compared to before the pandemic, and an increased risk of subsequent infant/severe RSV infections.
Comparison of 18F-FDG-PET/CT scans in patients diagnosed with sarcoidosis and tuberculosis
Authors: Pinar Deniz Pelin , Duru Çetinkaya Pelin , Hanta İsmail , Arslan Merisa Sinem , Güney İsa Burak
Published: January 2025

Positron emission tomography/computed tomography (PET/CT) is widely used to differentiate benign and malignant lesions. However, increased fluorodeoxyglucose (FDG) uptake may occur under certain benign conditions, leading to potential false positives in malignancy assessments. Tuberculosis and sarcoidosis are 2 conditions that can exhibit FDG uptake, presenting with both lymph node and extrathoracic involvement, alongside pulmonary manifestations. This study aimed to explore the utility of PET/CT in distinguishing between thoracic and extrathoracic involvement in patients with sarcoidosis and tuberculosis. A retrospective analysis was conducted on patients diagnosed with sarcoidosis or tuberculosis, either pathologically or microbiologically, who underwent 18F-FDG-PET/CT as part of their diagnostic process. This study evaluated demographic data, PET/CT findings, involvement sites, and maximum standardized uptake values (SUVmax) in patients with tuberculosis and sarcoidosis. PET/CT images of 62 patients (44 with tuberculosis and 18 with sarcoidosis) were analyzed. The median patient age was 55 years. Lymph node involvement in the cervical, abdominal, retro-pancreatic, inguinal, and extrathoracic regions was significantly more prevalent in patients with sarcoidosis than in those with tuberculosis (50% vs 20.5%, P = .0031; 27.8% vs 4.5%, P = .018; 22.2% vs 0%, P = .005; 27.8% vs 6.8%, P = .039; and 66.7% vs 27.3%, P = .009, respectively). No statistically significant difference was found in SUV values between patients with tuberculosis and those with sarcoidosis with regard to mediastinal lymph node, extrathoracic lymph node, lung, and bone PET/CT involvement. In conclusion, 18F-FDG-PET/CT imaging does not appear to be a reliable method for differentiating sarcoidosis and tuberculosis from malignant lesions, as it is not feasible to distinguish between sarcoidosis and tuberculosis solely based on 18F-FDG-PET/CT SUVmax values. Nevertheless, the increased prevalence of extrathoracic lymph node involvement in sarcoidosis compared to tuberculosis may offer valuable insights for clinicians in differential diagnosis.
Identification of hub genes and potential molecular mechanisms related to radiotherapy in thyroid cancer
Authors: Liao Chun-Tao , Tu Xing-Feng , Lin Guo-Liang , Zhang De-Jie , Li Peng-Fei , Zhang Ming
Published: January 2025

Radiotherapy is a common approach during the treatment of thyroid cancer (THCA). It is urgent to identify the radiotherapy-related gene and explore the underlying mechanisms. An message RNA expression clinical data was gained from the Cancer Genome Atlas. The differential expression genes between normal individuals and THCA patients were identified by the “limma” package of R software. The differential expression genes between the patients without radiation therapy and the patients with radiation therapy were also obtained via the same method. Survival analysis, gene set enrichment analysis, immune analysis, drug sensitivity analysis, gene–miRNA, and nomogram analysis were performed to explore the radiotherapy-related gene value. The results showed that 354 DGEs between the THCA patients without radiation therapy and THCA patients with radiation therapy including the 148 up-regulated genes and 206 down-regulated were screened and displayed by volcano plot. A gene enrichment analysis showed radiation-related genes were enriched in various pathways such as mineral absorption, complement and coagulation cascades, B cell receptor signaling pathway, salivary secretion, and hematopoietic cell lineage. Then the hub-related-radiotherapy prognosis gene LRP1B was identified. The expression analysis showed that the LRP1B expression level was higher in normal individuals than in THCA patients with an obvious difference via T test in independent samples and paired samples. Immune analysis results showed that the stroma score, immune score, and ESTIMATES score were higher in the low-risk score than in the high-risk score. LRP1B is a vital gene that executes function via a variety of pathways in THCA patients with radiotherapy. Radiotherapy could reduce the expression of LRP1B and AL356596.1. Moreover, the constructed nomogram is based on risk score and clinical features, and it had a great function in predicting survival time for patients.
Investigating the correlation between gut microbiota and prostate cancer through a two-sample Mendelian randomization analysis
Authors: Guo Lingyu , An Tian
Published: January 2025

Previous studies in observational epidemiology have suggested a potential correlation between the gastrointestinal tract microbiota and prostate cancer. However, the causal relationship between the 2 remains uncertain, our objective was to thoroughly examine the influence of the gut microbiome on the progression of prostate cancer. In this study, we focused on investigating the gut microbiome as an exposure factor, specifically analyzing data from the MiBioGen consortium, which had a substantial sample size of 18,340 participants. As our disease outcome, we utilized prostate cancer data from the FinnGen genome-wide association study, which involved 13,216 participants. To establish causal relationships, we conducted a comprehensive Mendelian randomization analysis employing multiple methods, including inverse variance-weighted, Mendelian randomization-Egger, maximum likelihood, and weighted median approaches. Additionally, we performed sensitivity analysis to address issues such as heterogeneity and horizontal pleiotropy, ensuring the robustness of our findings. The results obtained through inverse variance-weighted analysis revealed that certain microbial groups exhibited a protective effect on prostate cancer. Specifically, the phylum Verrucomicrobia, particularly the family Rikenellaceae, and the genera Anaerotruncus, Eisenbergiella, Olsenella, and Parabacteroides were found to have a beneficial impact. Conversely, the class Bacilli, class Erysipelotrichia, order Erysipelotrichales, order Lactobacillales, family Erysipelotrichaceae, and the genera Marvinbryantia, Romboutsia, Ruminococcaceae UCG002, and Sutterella had an adverse influence on prostate cancer. The sensitivity analysis did not reveal any such outliers, further strengthening the validity of our results. To summarize, a cause-and-effect connection was discovered between various types and prostate cancer. Nevertheless, additional randomized controlled experiments are required for validation.
Report on the clinical outcomes of using postural drainage with intervertebral space as the main focus for managing thoracolumbar tuberculosis: Eight case reports
Authors: Xing Hao , Li Jianhua , Chang Zhengqi
Published: January 2025

Rationale:

Conservative treatment has shown limited effectiveness in managing thoracolumbar tuberculosis (TB) that extends to the intervertebral space, as antibiotics are unable to penetrate avascular intervertebral discs, while conventional surgery is known for its extensive trauma and slow healing process.

Patient concerns:

Infection of the thoracic and lumbar vertebrae with tuberculosis can lead to difficulties in treatment due to involvement of the intervertebral space.

Diagnosis:

The diagnosis of TB was confirmed through clinical manifestations, impact studies, and T-spot experiments.

Interventions:

A retrospective analysis was conducted on the clinical data of 8 patients with thoracolumbar spinal TB who underwent postural drainage focusing on the intervertebral space as a treatment from June 2012 to August 2019. The average duration of treatment was 7.75 ± 10.19 months. Among the patients, there were 2 cases of thoracolumbar and 6 cases of lumbar spine involvement, with 6 cases affecting a single segment and 2 cases involving 2 segments. The total number of affected vertebrae included 4 thoracic, 12 lumbar, and 2 sacral vertebrae. All patients received standardized quadruple antituberculosis treatment (HRZE scheme). Specific postural drainage paths and catheter placement locations were determined based on clinical imaging results, and percutaneous catheter placement was performed with the assistance of foraminoscopy. Erythrocyte sedimentation rate, C-reactive protein, Visual Analogue Scale score, American Spinal Cord Injury Association score, and Oswestry function index were statistically analyzed before, after postural drainage, and at the final follow-up.

Outcomes:

The average operation time was 44.38 ± 10.50 minutes, with a blood loss of 6.88 ± 2.59 mL. The average catheter drainage time was 13.25 ± 4.95 days, and the follow-up period ranged from 36 to 122 months. The average total drainage volume was 281.25 ± 167.69 mL. Significant improvements were observed in erythrocyte sedimentation rate, C-reactive protein, Visual Analogue Scale score, American Spinal Cord Injury Association score, and Oswestry functional index at 7 days after postural drainage and at the last follow-up compared to before postural drainage (P < .05). At the last follow-up, there were 8 cases with no recurrence reported among the patients.

Lessons:

The utilization of positional drainage in the intervertebral space, coupled with chemotherapy, has demonstrated encouraging clinical results and may be deemed appropriate for treatment.