bluuebunny/crossref_metadata_2025 huggingface dataset:
TMS disruption of the lateral prefrontal cortex increases neural activity in the default mode network when naming facial expressions
Authors: Pitcher David , Sliwinska Magdalena W , Kaiser Daniel
Published: December 2023

Recognizing facial expressions is dependent on multiple brain networks specialized for different cognitive functions. In the current study, participants (N = 20) were scanned using functional magnetic resonance imaging (fMRI), while they performed a covert facial expression naming task. Immediately prior to scanning thetaburst transcranial magnetic stimulation (TMS) was delivered over the right lateral prefrontal cortex (PFC), or the vertex control site. A group whole-brain analysis revealed that TMS induced opposite effects in the neural responses across different brain networks. Stimulation of the right PFC (compared to stimulation of the vertex) decreased neural activity in the left lateral PFC but increased neural activity in three nodes of the default mode network (DMN): the right superior frontal gyrus, right angular gyrus and the bilateral middle cingulate gyrus. A region of interest analysis showed that TMS delivered over the right PFC reduced neural activity across all functionally localised face areas (including in the PFC) compared to TMS delivered over the vertex. These results suggest that visually recognizing facial expressions is dependent on the dynamic interaction of the face-processing network and the DMN. Our study also demonstrates the utility of combined TMS/fMRI studies for revealing the dynamic interactions between different functional brain networks.
“O” no: a Reddit analysis of orgasmic dysfunction
Authors: Belcher Rachael , Sim Danielle , Meykler Marcella , Owens-Walton Jeunice , Hassan Naeemul , Rubin Rachel S , Malik Rena D
Published: December 2023

Background

Female Reddit users frequently discussed potential causes of orgasm difficulties and its implications on mental health and relationships.

Aim

This study aimed to evaluate the experiences of women discussing orgasms on the Internet site Reddit. We sought to qualitatively analyze the topics that arose in users’ discussions to better understand the potential causes of orgasm difficulties and its implications on quality of life.

Methods

Posts on the subreddit r/TwoXChromosomes containing the keywords “orgasm” and “climax” were included in the dataset. Posts and their associated comments were qualitatively analyzed using the grounded theory approach. Two independent researchers coded each thread to identify dominant themes and emergent concepts.

Outcomes

The most frequently coded primary topics included: (1) orgasm (32.2% [n = 337]), (2) psychological (17.8% [n = 186]), (3) relationships (15.4% [n = 161]), and (4) treatment (10.7% [n = 112]).

Results

Qualitative analysis of 107 threads and approximately 6300 comments resulted in 5 major categories: psychological aspect of orgasms, difficulty orgasming with partners, partners’ responses to orgasmic dysfunction, types of orgasms, and treatments for orgasmic dysfunction. Preliminary themes included (1) the presence of an emotional component or history of trauma related to orgasmic difficulty, (2) difficulty orgasming with a partner regardless of ability to orgasm during masturbation and a variety of stimulation required to orgasm, (3) mixed partner responses to orgasmic dysfunction, (4) the definition of a normal orgasm, and (5) self-motivated treatment for orgasmic dysfunction, including clitoral stimulation devices and masturbation techniques. Notably, few posters discussed their orgasmic dysfunction with healthcare providers.

Clinical Translation

The study reveals insights into the possible causes, psychosocial implications, and treatment of orgasm difficulties from a patient perspective, and can guide future research on female orgasms in a more precise, patient-oriented direction.

Strengths and Limitations

The anonymous nature of the forum allowed for insight into sensitive topics related to female orgasms and sexual trauma. Limitations include the demographic distribution of Reddit users, which was primarily younger women in their 20s and 30s, which restricts generalizability.

Conclusion

Reddit provides a medium for individuals with orgasm difficulties to discuss their experiences. Posts addressed users’ inability to orgasm, their mental health and relationships, the stimulation required for orgasm, and treatments for orgasmic dysfunction. Interestingly, very few posts discussed healthcare, potentially suggesting that women do not classify their orgasmic dysfunction as a health issue.
Effect of Return Electrode Placement at Apical Cochleostomy on Current Flow With a Cochlear Implant
Authors: Landsberger David M. , Long Christopher J. , Kirk Jonathon R. , Stupak Natalia , Roland J. Thomas
Published: December 2023

Objectives:

A method for stimulating the cochlear apex using perimodiolar electrode arrays is described. This method involves implanting an electrode (ECE1) into the helioctrema in addition to standard cochlear implant placement. One objective is to verify a suitable approach for implanting ECE1 in the helicotrema. Another is to determine how placement of ECE1 reshapes electric fields.

Design:

Two cadaveric half-heads were implanted, and electric voltage tomography was measured with ECE1 placed in many positions.

Results:

An approach for placing ECE1 was identified. Changes in electric fields were only observed when ECE1 was placed into the fluid in the helicotrema. When inside the helicotrema, electric voltage tomography modeling suggests an increased current flow toward the apex.

Conclusions:

Placement of ECE1 into the cochlear apex is clinically feasible and has the potential to reshape electric fields to stimulate regions of the cochlea more apical than those represented by the electrode array.
Praying the Psalms as a Nursing Resilience Intervention
Authors: Helms Kristin , Rajamohan Santhiny , Tedone Deborah
Published: December 2023

Nurses face a range of unhealthy organizational, physical, psychological, and spiritual issues that can lead to burnout, turnover, and leaving the profession. Nurses who use prayer for support may find their faith to be another source of tension when stressors endlessly continue without change despite prayer. Walter Brueggemann's states of orientation, disorientation, and reorientation in his classic work on praying the Old Testament book of Psalms offer a means for managing spiritual tension. Praying using the psalms can become a self-care tool for building resilience.
Lesser in Lebanon
Authors: Uppala Danny
Published: December 2023

During the aftermath of the Syrian civil war conflict, a short-term mission trip to Lebanon brought insight to this author. Reflection on the ministry of Jesus Christ allowed the author to consider how engagement in a short-term mission affects the individuals one has the intention to serve. Similarities between short-term missions and nursing practice through a biblical lens are considered.
Long-term Survival Among Patients With De Novo Human Epidermal Growth Receptor 2–Positive Metastatic Breast Cancer in Manitoba
Authors: McAndrew Erin N. , Graham Jeffrey , Dufault Brenden , Desautels Danielle N. , Kim Christina A.
Published: December 2023

Objectives:

Although metastatic breast cancer (MBC) is considered incurable, human epidermal growth receptor 2 (HER2)–directed therapy has improved outcomes significantly, with some patients experiencing durable responses to treatment. The aim of this study was to identify potential predictors of long-term survival (LTS) among patients with de novo HER2-positive MBC who received HER2-directed treatment.

Methods:

Eligible patients from 2008 to 2018 were identified using the Manitoba Cancer Registry. LTS was defined as survival ≥5 years from the time of diagnosis. Univariate logistic regression models were performed to assess variables of clinical interest and the odds of LTS. Overall survival (OS) was defined as the time from diagnosis of MBC to death of any cause. OS was estimated using the Kaplan-Meier method with log-rank comparative analyses as a univariate analysis. A Cox proportional hazards model was used for OS estimates in a univariate analysis.

Results:

A total of 62 patients were diagnosed with de novo HER2-positive MBC and received HER2-directed therapy. Eighteen (29%) achieved LTS. The median OS of the whole cohort was 50.2 months (95% CI: 28.6—not reached). Radiographic response to first-line treatment was associated with LTS; complete and partial responses were both associated with higher odds of LTS (odds ratio: 28.33 [95% CI: 2.47-4006.71, P = 0.0043] and odds ratio: 7.80 [95% CI: 0.7317-1072.00, P = 0.0972], respectively). The best radiographic response was associated with improved OS.

Conclusion:

Radiographic response to first-line HER2-directed therapy is a predictor for LTS in patients with de novo HER2-positive MBC. Larger studies are needed to identify patients who can safely discontinue HER2-targeted therapy.
CAPABLE: A Scoring System Utilizing Patient-Reported Measures to Evaluate Patient Experience After Mohs Surgery
Authors: Fox Matthew C. , Riddle Ashley O. , Cervantes Jose A. , Shelton Megan E. , Woody Meghan , Latour Emile , Hollmig S. Tyler , Bar Anna A. , Leitenberger Justin J.
Published: December 2023

BACKGROUND

Patient experience metrics are gaining prominence in health care. We introduce the CAPABLE survey to assess postoperative experiences of Mohs surgery patients.

OBJECTIVE

We sought to determine whether CAPABLE scores aligned with overall patient satisfaction in Mohs surgery.

METHODS

This was a cross-sectional, survey-based study of patients presenting for their first postoperative visit after Mohs surgery. The CAPABLE survey included questions on postoperative instructions, activity limitations, pain control, provider accessibility, and bleeding, followed by 2 overall satisfaction questions taken from the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems survey. The pilot study took place at the University of Texas Dell Medical School (DMS), followed by a validation study (n = 206) at DMS and Oregon Health and Science University (OHSU). We assessed for correlations between CAPABLE scores and overall satisfaction.

RESULTS

In the pilot study (n = 137), overall CAPABLE scores and scores of individual CAPABLE components correlated positively with overall satisfaction.

In the multisite validation study (n = 206) spanning DMS and OHSU, CAPABLE scores correlated positively with overall satisfaction.

CONCLUSION

The CAPABLE survey is a concise tool for assessing specific, actionable components of the postoperative patient experience in Mohs surgery, while correlating with overall patient satisfaction.
Anatomic Location Influences Duration of Local Lidocaine Anesthesia in Dermatologic Surgery
Authors: Navrazhina Kristina , Shah Kalee , Rigo Rachel , Shochat Tzippy , Minkis Kira
Published: December 2023

BACKGROUND

Although the onset and duration of local anesthetics are well-defined, how the anatomic site influences the duration of local anesthetics has not been well characterized in dermatology.

OBJECTIVE

To define the duration of local anesthesia by anatomic site.

MATERIALS AND METHODS

This was a prospective study. Adult healthy volunteers and patients undergoing Mohs micrographic surgery were invited to participate. The nose and the shin were chosen to represent highly and poorly vascularized anatomic sites, respectively. A total of 0.5 mL of buffered 1% lidocaine hydrochloride with 1:100,000 epinephrine was injected subcutaneously into each anatomic site of each participant. A pinprick test was used to assess adequate anesthesia until return of baseline sensation or visit completion.

RESULTS

This study enrolled 25 participants. Time to return of sensation was significantly shorter on the nose compared with the shin (p < .0001). On the nose, there was an association between male sex and shorter time to return of sensation.

CONCLUSION

Time to return of sensation is significantly shorter on the nasal ala compared with the shin, suggesting that patients may regain sensation sooner on highly vascularized sites. Defining the duration of local anesthetics based on anatomic regions is important for treatment planning in dermatologic procedures.
Skin Cancer Awareness and Knowledge About Sun Protection Practices in Solid Organ Transplant Recipients: Patient Survey Study
Authors: Farahbakhsh Navid , Potter Kathryn Anne , Nielson Colton , Longo Maria Isabel
Published: December 2023

BACKGROUND

Adequate sun protection practices in chronically immunosuppressed patients can minimize the burden of the most common type of skin cancer in this population. In addition, early recognition of skin cancer by patients can lead to decreased morbidity, and possibly mortality from the disease. Nevertheless, there are significant gaps in the knowledge of sun protection measures and early recognition of skin cancer.

OBJECTIVE

The aim of this study is to determine the risk factors of solid organ transplant recipients (SOTRs) for developing skin cancer and their sun exposure education and behavior post-transplantation.

MATERIALS AND METHODS

This study evaluates the responses of 107 SOTRs on their outlooks and beliefs of sunscreen usage, skin cancer, and sun exposure knowledge.

RESULTS

Our study identified several significant risk factors for the development of actinic keratosis or keratinocyte carcinoma in SOTRs including history of sunburn before age 18, blue eyes, history of tanning bed use, performing monthly skin exams, ability to identify precancerous skin lesions, and history of previous skin examinations.

CONCLUSION

A patient-centered approach needs to be used to properly educate patients on effective ways to reduce excessive sun exposure. Regular skin examinations, and patients continued education are necessary components in reducing the burden of skin cancer in SOTRs.
Patient Satisfaction Following Primary Closure or Second Intention Healing After Conventional Nasal Skin Cancer Excision: A Cross-sectional Cohort Study
Authors: Theelen Frederieke F.M. , Veldhuizen Inge J. , Zhou Chao , Lee Erica H. , van Hensbergen Lusanne J. , Broekhuysen Coralien L. , van der Hulst René R.W.J. , Hoogbergen Maarten M.
Published: December 2023

BACKGROUND

Nasal reconstruction after conventional surgical excision (CSE) of nonmelanoma skin cancer (NMSC) can be challenging. After excision and before the pathologic report, a simple reconstruction is favored. Yet, little is known about patient satisfaction after primary closure and second intention healing.

OBJECTIVE

Patient satisfaction after nasal defect reconstruction with primary closure or second intention healing, using the FACE-Q Skin Cancer.

METHODS

All patients who underwent CSE of nasal NMSC with immediate primary closure or second intention healing between March 2018 and March 2020 at Máxima Medisch Centrum Veldhoven were identified and asked to complete the FACE-Q Skin Cancer.

RESULTS

Of 183 patients, 140 patients completed the questionnaire. Fifty-five defects were closed by primary closure (38.5%) and 88 by second intention healing (61.5%). Thirty-one complications were reported (16.7%), of which 87.1% (n = 27) after second intention healing (p = .004). Both groups experienced high facial and scar satisfaction, low appearance-related distress, and no to minimal adverse effects. Second intention healing had 2.7 higher odds of achieving the maximum scar satisfaction score (p = .02).

CONCLUSION

This study shows high satisfaction on facial and scar appraisal, low appearance-related distress, and no to minimal adverse effects for second intention healing and primary closure after CSE of nasal NMSC.
Assessment of Donor Site Scar Outcomes, Healing Time, and Postoperative Complications Associated With Split Thickness Skin Grafts Harvested From the Hair Bearing Scalp
Authors: Bovenberg Maria Sarah , Williams Paige E. , Goldberg Leonard H.
Published: December 2023

BACKGROUND

The hair-bearing scalp is an underused donor site for split-thickness skin grafts (STSG).

OBJECTIVE

Evaluating the donor site scar outcomes, healing times, and complications associated with STSG harvested from the hair-bearing scalp.

MATERIALS AND METHODS

During this prospective observational study, donor site healing was assessed on postoperative Days 8 and 30. Donor site scar outcomes were quantified at 1 month using the Vancouver Scar Scale. All postoperative complications were collected during the 30-day follow-up window.

RESULTS

80% of donor sites was fully healed at 1-week follow-up. Vancouver Scar Scale score at the donor site was 0.26 at 1-month follow-up. All patients experienced full hair regrowth. Maximum pain scores were reported on the night of surgery (Vancouver Scar Scale 1.8), with quick resolution in days to follow. No major complications were reported. All STSG obtained from the scalp had full take and good texture and color match with the recipient site.

CONCLUSION

The hair-bearing scalp is an excellent donor site for split-thickness skin graft harvesting.
Bloodstream Infections in Children Hospitalized for Influenza, the Canadian Immunization Monitoring Program Active
Authors: Modler Jacqueline , Morris Shaun K. , Bettinger Julie A. , Bancej Christina , Burton Catherine , Foo Cheryl , Halperin Scott A. , Jadavji Taj , Kazmi Kescha , Sadarangani Manish , Schober Tilmann , Papenburg Jesse ,   for the Canadian Immunization Monitoring Program Active (IMPACT) Investigators
Published: December 2023

Background:

We aimed to estimate the proportion of children hospitalized for influenza whose illness was complicated by bloodstream infection, describe their clinical course, and identify the factors associated with bloodstream infection.

Methods:

We performed active surveillance for laboratory-confirmed influenza hospitalizations among children ≤16 years old at the 12 Canadian Immunization Monitoring Program Active hospitals, from the 2010–2011 to 2020–2021 influenza seasons. Factors associated with bloodstream infection were identified using multivariable logistic regression analyses.

Results:

Among 9179 laboratory-confirmed influenza hospital admissions, bloodstream infection occurred in 87 children (0.9%). Streptococcus pyogenes (22%), Staphylococcus aureus (18%) and Streptococcus pneumoniae (17%) were the most common bloodstream infection pathogens identified. Children with cancer [adjusted odds ratio (aOR): 2.78; 95% confidence interval (CI): 1.23–5.63], a laboratory-confirmed nonbloodstream bacterial infection (aOR: 14.1; 95% CI: 8.04–24.3) or radiographically-confirmed pneumonia (aOR: 1.87; 95% CI: 1.17–2.97) were more likely to experience a bloodstream infection, whereas children with chronic lung disorders were less likely (aOR: 0.41; 95% CI: 0.19–0.80). Disease severity markers such as intensive care unit admission (aOR: 2.11; 95% CI: 1.27–3.46), mechanical ventilation (aOR: 2.84; 95% CI: 1.63–4.80) and longer hospital length of stay (aOR: 1.02; 95% CI: 1.01–1.03) were associated with bloodstream infection. Bloodstream infection also increased the odds of death (aOR: 13.0; 95% CI: 4.84–29.1) after adjustment for age, influenza virus type and the presence of any at-risk chronic condition.

Conclusions:

Bloodstream infections, although infrequent, are associated with intensive care unit admission, mechanical ventilation, increased hospital length of stay and in-hospital mortality, thus requiring increased levels of care among pediatric influenza hospitalizations.
Nasal Methicillin-Resistant Staphylococcus aureus Culture Screens in the Setting of Universal Decolonization
Authors: Saha Arunava , O'Shea Paudel Erin
Published: December 2023

Introduction

The negative predictive value (NPV) of nasal methicillin-resistant Staphylococcus aureus (MRSA) screens has been compromised by universal decolonization practices. We aimed to determine the reliability of the nasal MRSA culture screen to deescalate antibiotic therapy in the setting of decolonization with ethyl alcohol.

Methodology

A retrospective observational cohort study was conducted using 62% ethanol solution intranasally per protocol. Patients were divided into 2 groups based on whether they received decolonization. Data were analyzed to determine NPV of the nasal MRSA culture screen with and without decolonization.

Results

A total of 505 cases were screened, and 128 subjects were included. One hundred two received decolonization, whereas 26 did not. Baseline characteristics were well balanced. Overall MRSA infection prevalence was 31.25%. The NPV was 73% in the decolonized group compared with 80% in the group without. Positive predictive value was 63% in the group receiving decolonization compared with 100% in the group without. There was also a higher specificity but lower sensitivity of the nasal MRSA culture screen in the decolonization group. Nine patients in the decolonization group required reescalation of antibiotics compared with nil in the other group.

Conclusions

Culture-based nasal MRSA screens are less accurate than PCR tests, as ethyl alcohol leads to false-negative results. A lower NPV in the decolonization group predisposes to increased false negative results, leading to inappropriate antibiotic deescalation and often requiring reinitiation. Nasal MRSA culture screen is less reliable if alcohol has already been administered for decolonization and cannot be used as an appropriate tool to guide antibiotic deescalation.
Remifentanil-induced hyperalgesia in healthy volunteers: a systematic review and meta-analysis of randomized controlled trials
Authors: Dello Russo Cinzia , Di Franco Valeria , Tabolacci Elisabetta , Cappoli Natalia , Navarra Pierluigi , Sollazzi Liliana , Rapido Francesca , Aceto Paola
Published: December 2023

Recent literature suggests that the withdrawal of remifentanil (RF) infusion can be associated with hyperalgesia in clinical and nonclinical settings. We performed a systematic review and a meta-analysis of randomized controlled trials with cross-over design, to assess the effect of discontinuing RF infusion on pain intensity and areas of hyperalgesia and allodynia in healthy volunteers. Nine studies were included. The intervention treatment consisted in RF infusion that was compared with placebo (saline solution). The primary outcome was pain intensity assessment at 30 ± 15 minutes after RF or placebo discontinuation, assessed by any pain scale and using any quantitative sensory testing. Moreover, postwithdrawal pain scores were compared with baseline scores in each treatment. Secondary outcomes included the areas (% of basal values) of hyperalgesia and allodynia. Subjects during RF treatment reported higher pain scores after discontinuation than during treatment with placebo [standardized mean difference (SMD): 0.50, 95% confidence interval (CI): 0.03-0.97; P = 0.04, I2 = 71%]. A significant decrease in pain scores, compared with baseline values, was found in the placebo treatment (SMD: −0.87, 95% CI: −1.61 to −0.13; P = 0.02, I2 = 87%), but not in the RF treatment (SMD: −0.28, 95% CI: −1.18 to 0.62; P = 0.54, I2 = 91%). The area of hyperalgesia was larger after RF withdrawal (SMD: 0.55; 95% CI: 0.27-0.84; P = 0.001; I2 = 0%). The area of allodynia did not vary between treatments. These findings suggest that the withdrawal of RF induces a mild but nonclinically relevant degree of hyperalgesia in HVs, likely linked to a reduced pain threshold.
Nurse practitioner and physician assistant transition to practice: A scoping review of fellowships and onboarding programs
Authors: Morgan Perri , Barnes Hilary , Batchelder Heather R. , Tuttle Brandi , Faraz Covelli Asefeh , Everett Christine , Jackson George L. , Anglin Lorraine , Ortiz Pate Nathalie , Dieter Patricia , Bludorn Janelle
Published: December 2023

Background:

Newly graduated nurse practitioners (NPs) and physician assistants (PAs) benefit from transition-to-practice (TTP) support to move successfully into practice. Transition-to-practice programs (i.e., onboarding programs and fellowships/residencies) hold promise for improving workforce outcomes.

Purpose:

The purpose of this scoping review was to describe the literature regarding NP/PA TTP programs.

Methodology:

Using the Joanna Briggs Institute methodology, a specific approach for systematically conducting reviews, publications from January 1990 to May 2022 were included for review if they addressed fellowships/residencies or onboarding programs for NPs or PAs. Final data extraction involved 216 articles.

Results:

The pace of publication increased over time, with a noticeable increase since 2015. Articles were most commonly about fellowships/residencies, NPs, and programs set in United States nonrural, acute care settings, and academic health centers.

Conclusions/Implications:

There is a gap in our understanding of onboarding programs and programs focusing on PAs, as well as TTP support in rural and primary care settings. In addition, there are few articles that assess TTP program outcomes such as benefits and costs. This review describes the need for more published literature in these areas.
College women with a disability and interpersonal violence: A call to action
Authors: Mueller Susan D. , Sutherland Melissa A.
Published: December 2023

Interpersonal violence is a serious public health issue, particularly in the young adult population. College women are more likely to experience interpersonal violence than the general population; college women with disabilities are at particularly high risk of victimization. Despite this reality, screening rates for interpersonal violence in college health centers remain low, and college women, both disabled and not, report unsatisfactory interactions with college health providers after an interpersonal violence experience. We provide suggestions for nurse practitioners working in college health which will assist them in their endeavors to screen college women, specifically college women with a disability, for interpersonal violence and to respond to the outcomes of those screenings using a trauma and disability-informed practice lens.
Risk factors for new vertebral compression fracture after vertebroplasty and efficacy of osteoporosis treatment: A STROBE-compliant retrospective study
Authors: Park Seongjoo , Sik Choi Sang , Kim Heezoo , Yoon Byun Sang , Lee Chung Hun
Published: December 2023

Vertebroplasty (VP) effectively treats vertebral compression fractures (VCFs). However, the issue of secondary new VCFs (SNVCFs) after VP is yet to be addressed. Therefore, identification of risk factors for SNVCFs after VP may aid the development of strategies to minimize SNVCF risk. This study aimed to retrospectively evaluate risk factors for SNVCFs after VP, including those associated with the type of anti-osteoporotic treatment administered after VP. Data from 128 patients who underwent single-level VP were collected and reviewed. Patients were divided into 2 groups: those with (n = 28) and without (n = 100) SNVCF within 1 year of VP. We collected the following patient data: age, sex, site of compression fracture, medical history, bone mineral density (BMD), history of long-term steroid use, history of osteoporosis drug use, duration between fracture and VP, VP implementation method (unilateral or bilateral), cement usage in VP, cement leakage into the disc, compression ratio before VP, pre- and postoperative recovery ratio of the lowest vertebral body height, and kyphotic angle of fractured vertebrae. These data were analyzed to identify factors associated with SNVCFs after VP and to investigate the effects of the type of anti-osteoporotic treatment administered for SNVCFs. SNVCFs occurred in 28 patients (21.9%) within 1 year of VP. Logistic regression analysis identified BMD, cement leakage into the disc, and long-term steroid use to be significantly associated with the occurrence of SNVCFs. The group treated with zoledronate after VP had a significantly reduced SNVCF incidence compared with the group treated with calcium (P < .001). In addition, the zoledronate group had a lower SNVCF incidence compared with the groups treated with alendronate (P = .05), selective estrogen receptor modulators (P = .26), or risedronate (P = .22). This study showed that low BMD, presence of an intradiscal cement leak, and long-term steroid use were risk factors for developing SNVCFs following VP. Additionally, among osteoporosis treatments prescribed for VP, zoledronate may be the preferred choice to reduce the risk of SNVCFs.
Early maladaptive schemas and the risk of nonsuicidal self-injury in college students: A retrospective study
Authors: Shi Ying , Song Yunping , Wang Liling , Liu Jingyi , Chen I-Jun
Published: December 2023

Early maladaptive schemas (EMSs) may be closely related to nonsuicidal self-injury (NSSI). The present study aimed to discuss the relationship between EMS and a personal history of NSSI. This was a retrospective study. A total of 1339 Chinese college students between 16 and 29 years old were asked to complete a questionnaire survey regarding their personal history of NSSI and EMSs. 116 college students reported a history of NSSI (NSSI group), who differed significantly in terms of all EMS-related scores than non-NSSI group(n = 1223). Logistic regression analysis showed that the scores in the disconnection/rejection schema domain exhibited by subjects who were the only child in their family could help differentiate between college students with or without NSSI. The emotional deprivation schema was significantly associated with the lifetime frequency of NSSI behaviors; the vulnerability to harm or illness schema was significantly associated with the internal emotion regulation function and pain associated with NSSI; and the enmeshment/underdeveloped self schema was significantly associated with the addictive features of NSSI. The self-sacrifice schema was significantly associated with the external emotion regulation function of NSSI; the enmeshment/underdeveloped self schema was positively related with the sensation-seeking function of NSSI; and the abandonment/instability schema was negatively related the sensation-seeking function of NSSI. The disconnection/rejection schema domain was highly related with NSSI behaviors. EMS is significantly associated with the history, functions, addictive features, and severity of NSSI. Every EMS is worthy of further investigation and discussion with patients in the context of NSSI behaviors during clinical therapy.
Computed tomography-based radiomics to assess risk stratification in pediatric malignant peripheral neuroblastic tumors
Authors: Wang Xiaoxia , Wang Xinrong , Wu Tingfan , Hu Liwei , Xu Min , Tang Jingyan , Li Xin , Zhong Yumin
Published: December 2023

This study aimed to develop and validate an analysis system based on preoperative computed tomography (CT) to predict the risk stratification in pediatric malignant peripheral neuroblastic tumors (PNTs). A total of 405 patients with malignant PNTs (184 girls and 221 boys; mean age, 33.8 ± 29.1 months) were retrospectively evaluated between January 2010 and June 2018. Radiomic features were extracted from manually segmented tumors on preoperative CT images. Spearman’s rank correlation coefficient and the least absolute shrinkage and selection operator (LASSO) were used to eliminate redundancy and select features. A risk model was built to stratify low-, intermediate-, and high-risk groups. An image-defined risk factor (IDRFs) model was developed to classify 266 patients with malignant PNTs and one or more IDRFs into high-risk and non-high-risk groups. The performance of the predictive models was evaluated with respect to accuracy (Acc) and receiver operating characteristic (ROC) curve, including the area under the ROC curve (AUC). The risk model demonstrated good discrimination capability, with an area under the curve (AUC) of 0.903 to distinguish high-risk from non-high-risk groups, and 0.747 to classify intermediate- and low-risk groups. In the IDRF-based risk model with the number of IDRFs, the AUC was 0.876 for classifying the high-risk and non-high-risk groups. Radiomic analysis based on preoperative CT images has the potential to stratify the risk of pediatric malignant PNTs. It had outstanding efficiency in distinguishing patients in the high-risk group, and this predictive model of risk stratification could assist in selecting optimal aggressive treatment options.
Prognostic role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and pan-immune-inflammation value in metastatic castration-resistant prostate cancer patients who underwent 177Lu–PSMA-617
Authors: Şahin Elif , Kefeli Umut , Zorlu Şevket , Seyyar Mustafa , Ozkorkmaz Akdag Mutianur , Can Sanci Pervin , Karakayali Anil , Ucuncu Kefeli Aysegul , Bakkal Temi Yasemin , Cabuk Devrim , Uygun Kazim
Published: December 2023

This study is aimed to investigate the prognostic significance of inflammation indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) in metastatic castration-resistant prostate cancer (mCRPC) patients who had received lutetium labeled prostate-specific membrane antigen (177Lu–PSMA-617) therapy. Sixty-one mCRPC patients who received 177Lu–PSMA-617 treatment and followed up in Kocaeli University were included. The relationship between overall survival (OS) and progression-free survival (PFS) and clinical and laboratory parameters was analyzed by multivariate analyses. The mean age was 69.8 ± 6.9 years. The mean follow-up time was 53.2 ± 24 months. The median OS was 14 (95% CI: 8.8–18.1) and the median PFS was 10.4 (95% CI: 4.7–17.2) months. NLR ≥ 2.7, PLR ≥ 134.27, SII ≥ 570.39, PIV ≥ 408.59 were considered as elevated levels. In the multivariate analysis for OS, baseline ECOG performance score (HR: 1.92, 95% CI: 1.01–3.65, P = .046), high albümin (HR: 0.36, 95% CI: 0.16–0.82, P = .015), primary resistant total prostate-specific-antigen (PSA) (HR: 4.37, 95% CI: 1.84–10.35, P = .001), high NLR (HR: 3.32, 95% CI: 1.66–6.65, P = .001), high MLR (HR: 2.53, 95% CI: 1.35–4.76, P = .004), high PLR (HR: 2.47, 95% CI: 1.23–4.96, P = .01), and high SII (HR: 2.17, 95% CI: 1.09–4.32, P = .027) were associated with shorter OS. However, PIV was not associated with survival (P = .69). No factor other than the primer-resistant PSA could be identified as having an impact on PFS (for the PSA, HR: 4.52, 95% CI: 1.89–10.76, P = .001). In this study, pretreatment NLR, MLR, PLR, and SII demonstrate as powerful independent prognostic indices predicting survival in patients with mCRPC receiving 177Lu–PSMA-617 therapy.
Analysis of risk factors and pregnancy outcomes in pregnant women with subchorionic hematoma
Authors: Xu Tiantian , Lun Weiwei , Wang Pengran , He Yuanfang
Published: December 2023

Subchorionic hemorrhage (SCH) or hematoma is one of the abnormal ultrasonic manifestations. At present, there are few studies on the pathogenesis of SCH, and its underlying mechanism is still unclear. It may be related to abnormal placenta formation and implantation, autoimmune dysfunction, and coagulation dysfunction. As a unique complication of pregnancy, SCH has a controversial effect on pregnancy outcome. The aim of the present study was to explore the possible etiology of SCH, especially its association with autoimmune dysfunctions, as well as the pregnancy outcomes of SCH patients. This retrospective cohort study was conducted at the Third Affiliated Hospital of Zhengzhou University. Patients with a singleton pregnancy of ≤14 weeks gestation from June 2021 to June 2022 were included. Patients with SCH detected by ultrasound were selected as the study group, while patients without SCH during the same period were chosen as the control group. Immunological indicators and pregnancy outcomes were primarily compared between the 2 groups. The decrease in protein S activity and antithrombin-III levels, the increase in homocysteine levels, and the presence of autoantibodies (such as lupus anticoagulant, anticardiolipin antibody, and antinuclear antibody spectrum) were found to be risk factors for SCH. SCH in the first trimester was associated with higher rates of premature rupture of membranes (13.5% vs 3.8%) and miscarriage (14.4% vs 6.4%). However, there were no significant differences in the rates of placental abruption, fetal distress, cesarean section, neonatal birth weight, and gestational age. The incidence of miscarriage was also significantly higher in patients with subchorionic hematoma (SCH) who tested positive for autoantibodies (28.2% vs 7.6%). There were no significant differences in other clinical characteristics and pregnancy outcomes between patients with SCH who had positive autoantibodies and those who did not. The occurrence of SCH may be related to maternal immune abnormalities. SCH may increase the risk of premature rupture of membranes and abortion. However, there is no correlation between the presence or absence of SCH and neonatal outcomes.
Liddle syndrome presenting with normal aldosterone levels: A case report
Authors: Wang Rongrong , Zhang Yan , Pan Runzhou , Zhang Rongju , Zhao Yongcai
Published: December 2023

Introduction:

Liddle syndrome is an autosomal dominant disorder characterized by hypertension, hypokalemia, low aldosterone levels, and reduced renin activity. Atypical Liddle syndrome can be easily misdiagnosed due to its clinical phenotypes resembling hyperaldosteronism.

Patient concern:

The patient was diagnosed with primary aldosteronism due to hypertension and hypokalemia, and underwent left adrenalectomy. After the operation, the patient still had hypertension and hypokalemia that were not easy to control and correct, and had acute cerebral infarction.

Diagnosis:

The genetic test showed that the base duplication in the coding region of SCN1B gene caused a frameshift mutation:c.1789dupC (p.Arg597fs), Liddle syndrome was diagnosed.

Intervention and outcomes:

The patient was treated with a low-sodium diet and oral triamterene. The serum potassium level returned to normal and the blood pressure was controlled.

Lessons:

Some Liddle syndrome may present with normal aldosterone levels, genetic testing is necessary for the diagnosis. If the diagnostic test of primary aldosteronism is positive, but the treatment with spironolactone is ineffective, we should actively search for other causes.
Effects of natural orifice transluminal endoscopic radical resection of the colon and targeted therapy on immune response and blood CA199 and CA242 levels in colorectal cancer
Authors: Liu Guiwei , Liu Jiawei , Ren Weidan , Yang Lisheng , Guo Qingjin , Ye Haopeng
Published: December 2023

To examine the effect of natural orifice transluminal endoscopic radical resection combined with targeted therapy on the immune system and serum levels of CA199 and CA242 in individuals with colorectal cancer. We enrolled 90 patients admitted to our hospital with a diagnosis of colorectal cancer between February 2020 and May 2022 and divided them into 2 groups according to the treatment methods: observation group (n = 45) and control group (n = 45). Patients in the control group underwent conventional laparoscopic radical resection of the colon followed by targeted therapy, whereas those in the observation group underwent natural orifice transluminal endoscopic radical resection of the colon and targeted therapy. Serum CA199 and CA242 levels, incidence of adverse events, clinical efficacy, perioperative indicators, and immune function indicators were compared between the 2 groups. The objective response rate (ORR) and disease control rate (DCR) were significantly higher in the observation group than in the control group (60.00% vs 35.6%, P = .020, and 91.1% vs 64.44%, P = .002, respectively). Compared with the control group, the observation group was associated with less blood loss (P = .003), shorter operation time (P = .011), shorter first exhaust time (P = .042), shorter borborygmus recovery time (P = .042), and shorter length of hospital stay (P = .020). After treatment, the CD3 + (P = .020), CD4 + (P = .008), and CD4+/CD8 + (P = .035) counts were lower, whereas the IgG (P = .014), IgM (P = .019), and IgA (P = .038) counts were higher in the observation group than in the control group. CA199 (P = .009) and CA242 (P = .001) levels were lower in the observation group than in the control group. The groups did not differ significantly in the incidence of adverse events (P = .842). The combination of natural orifice transluminal endoscopic radical resection for colorectal cancer and targeted therapy can shorten hospital stay, improve immune function, lower serum levels of CA199 and CA242, and exhibit good clinical efficacy.
Identification of lactylation gene CALML5 and its correlated lncRNAs in cutaneous melanoma by machine learning
Authors: Feng Hailiang , Chen Wei , Zhang Chen
Published: December 2023

As a product of glycolysis, lactate contributes to cancer proliferation, immunosuppression, and metastasis via histone lactylation. However, the relationship between cutaneous melanoma (CM) and lactylation-associated genes and lncRNAs has remained unclear. In this study, 4 mechanism learning algorithms and integrated bioinformatic analyses were employed to identify the core lactylation-associated genes and lncRNAs. Subsequently, 2 risk signatures based on the hub lactylation-associated genes and lncRNAs were constructed for CM patients. As a result, CALML5 was identified as a core lactylation-associated gene in CM, and its expression was found to be associated with patients survival and immune infiltration, suggesting its relevance as a potential therapeutic target. Additionally, this study provided clarification on hub CALML5-associated lncRNAs in CM, offering insights into their roles in the disease. Meanwhile, 2 identified risk signatures were both strongly linked to the prognosis and cancer growth of CM, underscoring their potential as valuable prognostic indicators. Furthermore, mechanistic analyses suggested a significant association between the risk signature and the immune microenvironment in CM, highlighting potential immune-related implications in disease progression. In conclusion, we propose that lactylation-associated genes and lncRNAs hold promise as potential targets in CM. Moreover, our findings revealed a significant correlation between lactylation and the immune microenvironment, providing crucial insights for guiding individualized treatment strategies in CM.
Prediction of MIGS outcomes on second eyes using first eyes’ response
Authors: Dickinson Anna , Leidy Luke , Nusair Omar , Rachapudi Sruti , Valenzuela Tony , Ramulu Pradeep , Mihailovic Aleksandra , Yohannan Jithin , Kaleem Mona , Johnson Thomas V. , An Jella
Published: December 2023

To evaluate how well outcomes following cataract extraction and microinvasive glaucoma surgery in one eye predict outcomes in sequential second eye. Retrospective study of 78 patients who underwent cataract extraction and microinvasive glaucoma surgery in both eyes. Linear regressions using Pearson correlation coefficients were used to evaluate correlations in intraocular pressure and glaucoma medication change between eyes. Multivariable logistic regression models were used to evaluate the associations between first-eye variables and the likelihood of second-eye surgical success at 6 months. Surgical success was defined as meeting target intraocular pressure without additional medications compared to baseline or secondary surgical interventions. Baseline ocular characteristics were comparable between fellow eyes, with the majority having mild glaucoma. Intraocular pressure changes between fellow eyes at 6 months were modestly correlated between eyes (R = 0.48; P < .001). Changes in glaucoma medications were strongly correlated between eyes at all time points, and month 6 demonstrated the most significant correlation (R = 0.80; P < .001). First and second eye cohorts achieved 82% and 83% surgical success. Multivariate analysis for predictive factors of successful second eye surgery showed patients with successful first eye surgery at 6 months were significantly more likely to have successful second eye surgery (odds ratio, 20.67; P < .001). Reductions in intraocular pressure and glaucoma medications at 6 months following surgery in first eyes are correlated to second eye reductions. Successful surgical outcomes at 6 months following first eye surgeries are strongly associated with successful sequential second eye outcomes.
Associations of neutrophil to lymphocyte ratio and red cell distribution width on different days with the prognosis of aneurysmal subarachnoid hemorrhage patients
Authors: Min Jie , Zhao Yongfeng , Wang Xian , Zhao Jian
Published: December 2023

The associations of neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) with the prognosis of aneurysmal subarachnoid hemorrhage (aSAH) patients were confirmed in a few studies. But NLR and RDW levels in most of these studies were on admission. Here we carried 1 retrospective study including 150 patients with aSAH who underwent surgeries in the First Affiliated Hospital of Yangtze University from January 2020 to February 2023 to explore the associations on the preoperative day, the first (1st), third (3rd), and seventh (7th) postoperative days. The level of RDW on the 3rd postoperative day and level of NLR on the 7th postoperative day in patients with poor prognosis were significantly higher than patients with good prognosis. The results of multivariate logistic analysis also confirmed the associations of RDW on the 3rd postoperative day (OR = 16.785, 95% CI: 4.077–69.107, P < .001) and NLR on the 7th postoperative day (OR = 8.399, 95% CI: 2.167–32.544, P = .002) with prognosis of aSAH patients. The results of receiver operating characteristic curve showed that cutoff values of RDW and NLR for predicting the prognosis in aSAH patients were 13.05% and 6.97, respectively. Higher RDW on the 3rd postoperative day and NLR on the 7th postoperative day were possibly associated with poor prognosis of aSAH patients. We should pay attention to the RDW and NLR levels during different hospitalization periods, especially in the short postoperative period. Moreover, the cutoff values for predicting prognosis need to be validated in larger-sample studies.
Horizontal semicircular canal benign paroxysmal positional vertigo treated by acupuncture and moxibustion: A case report
Authors: Cai Ying , Zhang Qi Wen , Li Shan , Zhang Quan Ai
Published: December 2023

Rationale:

Horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) is a second common canal of Benign Paroxysmal Positional Vertigo (BPPV); its actual incidence may have been underestimated because of its complex pathogenesis. Although the canalith repositioning maneuver is the treatment of choice, it has a high recurrence rate, affecting some patients’ lives and psychology. We submit a case report describing acupuncture and wheat grain moxibustion treatment for HSC-BPPV.

Patient concerns:

A 70-year-old patient with HSC-BPPV had low acceptability of the otolith repositioning treatment strategy and reported intolerance during the procedure. He turned to acupuncture as a result of recurrent attacks of vertigo.

Diagnoses:

Horizontal semicircular canal benign paroxysmal positional vertigo.

Interventions:

The intervention project was acupuncture followed by wheat grain moxibustion treatment, administered once every 2 days, 3 times a week. The whole treatment period lasted for 2 months.

Outcomes:

The patient’s clinical symptoms of vertigo improved significantly after 8 weeks of acupuncture and wheat grain moxibustion treatment. The Dizziness Handicap Inventory (DHI) and Visual Vertigo Analogue Scale (VVAS) scores decreased, thus verifying that the severity of vertigo was reduced.

Lessons:

This brief clinical report suggests that acupuncture therapy may be a complementary option for treating HSC-BPPV.