bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and analysis of a CD8+ T cell-related prognostic signature for colorectal cancer based on bulk RNA sequencing and scRNA sequencing data: A STROBE-compliant retrospective study
Authors: Pan Zhenguo , Li Qianjun , Feng Yanling , Gao Chengcheng , Pan Feng
Published: September 2022

Colorectal cancer (CRC) is one of the most common malignancies worldwide, leading to a large number of cancer-related mortalities. Aberrant CD8+ T cell infiltration plays a critical role in tumor progression and patient prognosis. This study aimed to identify a prognostic model for CRC based on CD8+ T cell-related genes. The infiltration levels of immune cells in CRC tissues were accessed by the ESTIMATE algorithm. Weighted gene co-expression network analysis (WGCNA) analysis was used to select CD8+ T cell-related genes. Prognostic genes were identified using Cox regression analysis and Kaplan–Meier curves. The least absolute shrinkage and selection operator (LASSO) algorithm was used to construct prognostic models. Gene set enrichment analysis (GSEA) was performed to annotate enriched gene sets. Single-cell RNA (scRNA) sequencing analysis was used to examine gene expression in different cell types. We found that the downregulated infiltration level of CD8+ T cells was an independent prognostic factor for CRC and selected a cluster of differentially expressed genes correlated with CD8+ T cell infiltration (CD8TDEGs). Subsequently, we identified 18 prognostic CD8TDEGs, according to which patients were reclassified into two clusters with distinct overall survival. Seven prognostic CD8TDEGs were selected to calculate the constructed prognostic model’s risk scores. Interestingly, although CRC tissues with higher risk scores had higher infiltration levels of CD8+ T cells, the level of immune checkpoint genes was also high. Moreover, the scRNA-sequencing analysis showed that the expression levels of CD8TDEGs in the prognostic model varied among different types of cells. This study constructed a novel prognostic model for CRC and provided a foundation for targeting CD8+ T cell infiltration to improve the survival of CRC patients.
Clinical evidence of Xinbao Pills efficacy on chronic heart failure patients: A protocol for systematic review and meta-analysis
Authors: Huang Manhua , Li Zunjaing , Fan Ye , Li Dongli , Liu Quanle , Chen Baijian , Peng Zhe , Ding Banghan
Published: September 2022

Background:

Chronic heart failure (CHF) is a common cardiovascular disease and results in high rate of morbidity, mortality, hospitalizations, and disability, causing medical concern around the world. Xinbao Pill (XBP) has been widely applied to clinical practice for patients with CHF but lacks studies to verify its efficacy. This study provides a protocol of systematic review, with which we will verify the adjunctive efficacy and safety of XBP on CHF with evidence-based studies.

Methods:

Included studies will be retrieved according to inclusion and exclusion criteria from five English databases (the MEDLINE via PubMed, the Cochrane Library, EMBASE, the Web of Science and Ovid database), and four Chinese databases (China Science and Technology Journal Database [VIP], Chinese Biomedical Literature Database [CBM], Wan-fang Database, China National Knowledge Infrastructure [CNKI]) from October 1990 to October 2018. The New York Heart Association (NYHA), heart rate and mortality will be marked as major outcomes. We will use RevMan V.5.3 software to calculate the data synthesis and will conduct meta-analysis based on the collected data.

Results:

Mortality, NYHA function classification, heart rate, the left ventricular ejection fractions (LVEF), 6-minute walk test (6MWT), hospitalization or rehospitalization, NT-proBNP, and adverse effects will be measured and comprehensively assessed to evaluate the adjunctive effect of XBP on CHF from this systematic review and meta-analysis with current clinical evidence.

Conclusion:

The systematic review and meta-analysis will assess the adjunctive effect of XBP in the treatment of CHF with up-to-date clinical evidence.
Association between chromosome 22q11.2 translocation and male oligozoospermia
Authors: Zhan Peng , Hao Tingting , Yang Xiao , Zhang Yi
Published: September 2022

Chromosomal aberrations in peripheral blood are a major cause of reproductive disorders for the infertile couples. Reciprocal translocation is closely related to male infertility. The breakpoint of translocation may disrupt or dysregulate important genes related to spermatogenesis. The relationship between some breakpoints of chromosome and male infertility has been paid attention. Chromosome 22q11.2 translocation has not been reported with male infertility. The purpose of this study is to evaluate the relationship between chromosome 22q11.2 translocation and male infertility. All patients were collected from the second hospital of Jilin University. Semen parameters were detected using the computer-aided semen analysis system. Cytogenetic analysis was performed using standard operating procedure. Related genes on chromosomal breakpoints were searched using online mendelian inheritance in man (OMIM). The association between this breakpoint and spermatogenesis is also discussed. We report 6 cases of translocation in chromosome 22. Of 7 breakpoints involved in these translocations, the common feature is that they all included chromosome 22q11.2 translocation and presented with oligozoospermia. The analysis of breakpoint related genes showed testis-specific serine/threonine kinase 2 (TSSK2) gene is associated with human spermatogenesis impairment. Overall, these results suggest that the breakpoint involved in translocation deserves attention from physicians in genetic counseling. The breakpoint rearrangement has the possibility of disrupting spermatogenesis. The relationship between 22q11.2 breakpoint and male infertility deserves further study.
Successful management of a tracheomalacia patient with active endotracheal bleeding due to intraoperative innominate artery injury: A case report
Authors: Park Yoo Jung , Kim Eunji , Jung Hong Soo
Published: September 2022

Rationale:

Intraoperative innominate artery injury is life-threatening in tracheomalacia patients with prolonged tracheostomy. Anesthetic management is challenging in cases with massive hemorrhage into the endotracheal tube. We report a case in which we successfully managed a tracheomalacia patient with acute endotracheal bleeding due to innominate artery injury.

Patient concerns:

A 24-year-old patient with tracheomalacia was scheduled to undergo exploratory thoracotomy for the treatment of intermittent bleeding at the tracheostomy site. During exploration, sudden active bleeding due to innominate artery injury was observed in the endotracheal lumen.

Diagnoses:

The patient was diagnosed with tracheomalacia.

Interventions:

We immediately used the bronchoscope to place the tip of the endotracheal tube at the bleeding site and hyperinflated the cuff.

Outcomes:

The ballooned cuff compressed the active bleeding site, so no additional bleeding was detected by bronchoscopy, and no additional massive bleeding was observed in the operative field.

Lessons:

Immediate and appropriate overinflation of the endotracheal tube cuff by an anesthesiologist may provide improved surgical field visibility and time for critical surgical procedures in cases of massive hemorrhaging.
Pituitary adenomas in the elderly: Retrospective comparative analysis of clinical/tumor features and surgical data by age group
Authors: Rosinha Patrícia , Fonseca Liliana , Amaral Cláudia , Ribeiro Isabel , Cardoso Maria Helena
Published: September 2022

The increase in life expectancy along with technological advances has translated into a higher number of pituitary adenomas (PA) diagnosed from the age of 65. In the elderly, symptoms related to comorbidities might overlap with endocrine dysfunction, in addition to increasing anesthetic and surgical risks. This study aimed to compare baseline clinical and tumor features between patients with PA from different age groups: younger adults (YA), 18 to 64 years, and older adults (OA), ≥65 years. As secondary outcomes, we also intended to assess: clinical characteristics and tumor features in patients undergoing surgical intervention and surgical data and complications in patients undergoing transphenoidal surgery (TSS). This retrospective cohort study included patients diagnosed with PA in adulthood divided into YA and OA groups. The secondary outcomes were evaluated in the subgroups: patients who underwent pituitary surgery and patients specifically submitted to TSS, who had completed postoperative follow-up ≥ 6 months until July/2020. A total of 401 patients were included, 327 (81.5%) in the YA and 74 (18.5%) in the OA group. Hormone-secreting effects were more common in the YA group (P < .001) and mass effects in the OA group (P = .070). The prevalence of hypertension and diabetes was higher in the OA group (P = .002, P = .011). A larger proportion of nonfunctioning (NF) PA and prolactinomas was found in OA (P < .001) and YA (P = .012), respectively. Macroadenomas were more common in the OA group (P < .001). No differences were found in terms of invasiveness. In the secondary outcome analysis, there was a higher prevalence of NF-PA in those who underwent pituitary surgery. The rate of TSS-related complications was similar between the groups for major, minor and endocrine/electrolyte complications. OA-PA clinically differ from the younger: tend to present more frequently with chronic comorbidities and less frequently with hormone-secreting effects, are more often NF and larger in size without a significant increase in invasiveness. The TSS results were reassuring, proving to be equally safe for the elderly.
Relationship between physical activity, screen-related sedentary behaviors and anxiety among adolescents in less developed areas of China
Authors: Wen Xiaotong , Zhu Fuying , Yuan Zhaokang , Mao Zongfu
Published: September 2022

This study aimed to explore the association between physical activity, screen-related sedentary behaviors, and anxiety. The current study used latent profile analysis (LPA) to identify homogenous subtypes of anxiety among adolescents in less-developed areas of China. Data were aggregated from 6 schools in the less-developed areas of China in September 2018. In total, 900 students were evaluated using the 100-item Mental Health Test (MHT) and Youth Risk Behavior Surveillance System (YRBSS) questionnaire. The LPA was conducted to explore the potential classification of anxiety, which makes full use of all the sample data and explore heterogeneous classifications within groups. Logistic regression was used for the multifactor analysis. A P value <.05 was considered statistically significant. The entropy value suggested that the model with 3 latent profile was the best choice. There were 223 adolescents in the severe anxiety group, accounting for 24.78%. Logistics regression analysis of anxiety revealed that the risk of severe anxiety in boys was lower (odds ratio [OR] = 0.317, P < .001) than in girls. Students had a significantly lower probability of suffering from severe anxiety in using cellphones or computers ≤ 2 hours/day than those used cellphones or computers＞2 hours/day (OR = 0.391, P = .004). Decreasing screen-related sedentary behaviors should be a target of community and school-based interventions, because high screen-related sedentary behaviors were associated with higher odds of anxiety among adolescents in less developed area of China.
Effects of isometric training on the treatment of patients with neck pain: A meta-analysis
Authors: Yang Jiaqi , Yang Min , Lin Qinqin , Fu Jie , Xi Rui
Published: September 2022

Background:

The aim of this meta-analysis was to evaluate the effects of isometric training interventions on the treatment of patients with neck pain.

Methods:

Electronic databases, including PubMed, The Cochrane Library, Web of Science, etc., were retrieved and screened by computer, and 18 articles with a total of 868 samples were included. Review Manager 5.4 software was used for the meta-analysis.

Results:

The meta-analysis results showed that isometric training can reduce visual analogue scale scores of patients[weighted mean difference (95% confidence interval) = -0.80(-0.88, -0.73), P < .00001]; decrease patients neck disability index score, isometric training was better than the control group [weighted mean difference (95% confidence interval) = 5.55 (4.57, 6.53), P < .0001]; in improving patients’ motion of the sagittal plane [weighted mean difference (95% confidence interval) = 1.53 (-0.40, 3.63), P = .12], coronal plane [weighted mean difference (95% confidence interval) = 2.12 (0.56, 3.68), P = .008], horizontal plane [weighted mean difference (95% confidence interval) = 3.58 (1.56, 5.59), P = .0005], isometric training was superior to the control group. More than 20 isometric training interventions had more significant effects on visual analogue scale and range of motion. And isometric training for more than 8 weeks had more significant effects on the visual analogue scale and neck disability index scores.

Conclusion:

Isometric training has significant effects on relieving neck pain, improving neck dysfunction, and improving joint mobility. However, the two indicators of visual analogue scale and neck disability index had more influential factors; the sample size of most studies was relatively small, and the intervention measures in the control group were relatively simple. It is expected that more abundant research will expand and deepen in the future, laying the foundation for meta-analysis.
Evaluation of right ventricular function in patients with pulmonary arterial hypertension by different right ventricular-pulmonary artery coupling methods
Authors: Dong Yaling , Li Yu , Song Laichun
Published: September 2022

To compare the accuracy of end-systolic elasticity (E
es)/arterial elasticity (E
a) ratio measured by single beat estimation, pressure–volume loop and cardiac magnetic resonance (CMR) combined volume method in patients with pulmonary artery hypertension, and to find a feasible and reliable method to quantitatively evaluate the function of right ventricle in patients with pulmonary artery hypertension. Forty-nine pulmonary artery hypertension patients enrolled between May 2017 and May 2018 in our hospital were retrospectively analyzed. Firstly, measure E
es/E
a ratio by single beat estimation, pressure–volume loop and CMR combined volume method, then, compare E
es/E
a ratio with New York Heart Association (NYHA) classification and NT-proBNP value respectively to evaluate the accuracy of the 3 methods. E
es/E
a ratio measured by single beat estimation is 2.07 ± 1.01, correlation analysis is not statistically significant when compare with NYHA classification and NT-proBNP value (P > .05). E
es/E
a ratio measured by pressure–volume loop is 2.64 ± 1.48, correlation analysis is not statistically significant when compare with NYHA classification and NT-proBNP value (P > .05). E
es/E
a ratio measured by CMR combined volume method is 0.72 ± 0.43, correlation analysis is statistically significant when compare with NYHA classification and NT-proBNP with negative correlation (P < .05). E
es/E
a ratio decrease according to the increase of NT-proBNP value and the NYHA classification. There is linear regression equation between E
es/E
a ratio measured by CMR combined volume method and log (NT-proBNP) value: Y = –0.257X + 1.45, and the linear regression equation is statistically significant (P = .001). E
es/E
a ratio measured by CMR combined volume method is a feasible and reliable method to quantitatively evaluate the function of right ventricule in patients with pulmonary artery hypertension, which might be further verified in a larger patient population.
Fully covered self-expanding metallic stent placement or three-tube method for esophagomediastinal fistula: A STROBE-compliant article
Authors: Bi Yonghua , Chen Hongmei , Han Xinwei , Ren Jianzhuang
Published: September 2022

To determine the safety, feasibility and clinical outcomes of interventional methods for the management of esophagomediastinal fistula, and to investigate the effect of stent placement on fistula healing and the swallowing. Sixty consecutive patients with esophagomediastinal fistula were treated using interventional method and were retrospectively assessed. Patients received 3-tube but without covered stent placement were placed in group A, the remaining patients received covered stent placement with/without 3-tube method were placed in group B. Tubes and stents would be removed once fistula heals. Interventional procedures were technically successful all patients (100%). Esophageal stents and abscess drainage tubes were successfully removed from 14 patients. Three patients underwent stent removal during the perioperative period, resulting in a clinical success rate of 88.5% of 26 patients in group B. A total of 13 complications were found in all patients, including 5 major complications. Patients in group B showed a higher healing rate of abscess cavity and better dysphagia score than group A. During follow up, 17 patients in group A and 11 patients in group B were still alive. Interventional treatment is safe, feasible and efficacious for esophagomediastinal fistula; covered stent placement can promote fistula healing and improve swallowing.
The short-term effectiveness of scapular focused taping on scapular movement in tennis players with shoulder pain: A within-subject comparison
Authors: Kim Taegyu , Park Jae Myoung , Kim Young-Hoon , Park Jong-Chul , Choi Hokyung
Published: September 2022

This study aimed to investigate the short-term effectiveness of scapular focused taping (SFT) on scapular position and kinematics during the tennis serve among professional players with and without shoulder pain. The cohort included 7 players who had no history of non-shoulder pain (NSP) and 6 players with shoulder pain (SP). All participants performed tennis flat serves while the Qualisys motion capture system recorded three-dimensional scapular kinematic data according to the International Society of Biomechanics recommendations. SFT was applied to the participants’ torso aligned with the lower trapezius, and the same movements were repeated. In the SP group, the scapula was tilted more posteriorly after the application of SFT as compared to before at ball release and maximally externally rotated humerothoracic joint during tennis serve (t = −5.081, P = .004 and t = −2.623, P = .047, respectively). In the NSP group, the scapula was tilted more posteriorly with SFT as compared to without at first 75% timing of the cocking phase and maximally externally rotated humerothoracic joint (t = −3.733, P = .010 and t = −2.510, P = .046, respectively). And the SP group exhibited a more rotated scapula externally after the application of SFT as compared to before at Ball impact (t = 5.283, P = .003). SFT had a positive immediate effect on the scapular posterior tilting and external rotation during certain phases of the tennis serve among tennis athletes with and without shoulder pain. These findings may help clinicians and sports practitioners to prevent and rehabilitate shoulder injuries for overhead athletes.

Level of evidence: Level III; Case-Control Design; Comparative Study.
Prognostic factors for squamous cervical carcinoma identified by competing-risks analysis: A study based on the SEER database
Authors: Hu Chengfeng , Cao Junyan , Zeng Li , Luo Yao , Fan Hongyuan
Published: September 2022

Cervical cancer has a high incidence of malignant tumors and a high mortality rate, with squamous cervical carcinoma (SCC) accounting for 80% of cases. A competing-risks model is recommended as being more feasible for evaluating the prognosis and guiding clinical practice in the future compared to Cox regression. Data originating from the Surveillance, epidemiology, and end results (SEER) database during 2004 to 2013 were analyzed. Univariate analysis with the cumulative incidence function was performed to assess the potential risk of each covariate. Significant covariates (P < .05) were extracted for inclusion in a Cox regression analysis and a competing-risks model that included a cause-specific (CS) hazard function model and a sub-distribution (SD) hazard function model. A total of 5591 SCC patients met the inclusion criteria. The three methods (Cox regression analysis, CS analysis, and SD analysis) showed that age, metastasis, American Joint Committee on Cancer stage, surgery, chemotherapy, radiation sequence with surgery, lymph node dissection, tumor size, and tumor grade were prognostic factors affecting survival in patients with SCC. In contrast, race and radiation status were prognostic factors affecting survival in the Cox regression and CS analysis, but the results were different in the SD analysis. Being separated, divorced, or widowed was an independent prognostic factor in the Cox regression analysis, but the results were different in the CS and SD analyses. A competing-risks model was used as a new statistical method to more accurately identify prognostic factors than conventional Cox regression analysis leading to bias in the results. This study found that the SD model may be better suited to estimate the clinical prognosis of a patient, and that the results of an SD model analysis were close to those of a CS analysis.
Pyrazinamide related prolonged drug-induced liver injury: A case report
Authors: Wang Yeh-Chin , Chen Kai-Hsiang , Chen Yen-Lin , Lin Shu-Wen , Liu Wang-Da , Wang Jann-Tay , Hung Chien-Ching
Published: September 2022

Rationale:

Drug induced liver injury (DILI) is a common side effect causing treatment discontinuation during tuberculosis (TB) treatment, and pyrazinamide (PZA) usually leads to a delayed and prolonged abnormal liver function of the 4 standard anti-tuberculosis regimens. However, a prolonged hepatitis lasting more than 4 months is rarely reported.

Patient concerns:

A 78-year-old man presented with general weakness and poor appetite on his seventh week of anti-TB treatment for tuberculosis lymphadenitis.

Diagnosis:

Drug induced liver injury, PZA-related. NAT2 slow acetylator phenotype was accidentally found during workup of DILI.

Intervention:

A liver biopsy was performed and PZA-related DILI was suspected. All anti-TB medications were therefore discontinued.

Outcome:

After withholding all anti-TB medications for 4 months, the elevations of aminotransferases and hyperbilirubinemia completely resolved. Anti-TB therapy was switched to ethambutol and levofloxacin for 15 months without adverse events. Long-term ultrasound follow-up was performed and cervical lymphadenopathy completely resolved.

Conclusion:

Our patient presents with PZA related prolonged DILI resolved after drug discontinuation for 4 months. NAT2 slow acetylator phenotype may be related to this condition through unknown mechanisms.
Nomogram for predicting distant metastasis of male breast cancer: A SEER population-based study
Authors: Wang Dasong , Yang Lei , Yang Yan , Chen Maoshan , Yang Hongwei
Published: September 2022

The main purpose of this study was to build a prediction model for male breast cancer (MBC) patients to predict the possibility of distant metastasis. The Surveillance, Epidemiology, and End Results database was used to obtain data on patients with MBC. The patients were divided into a training set and a validation set at a ratio of 7:3. The risk variables of distant metastasis in the training set were determined by univariate and multivariate logistic regression analyses. And then we integrated those risk factors to construct the nomogram. The prediction nomogram was further verified in the verification set. The discrimination and calibration of the nomogram were evaluated by the area under the receiver operating characteristic curve, calibration plots, respectively. A total of 1974 patients (1381 in training set and 593 in validation set) were eligible for final inclusion, of whom 149 (7.55%) had distant metastasis at the diagnosed time. Multivariate logistic regression analyses presented that age, T stage, N stage, and hormone receptor status were independent risk factors for distant metastasis at initial diagnosis of male breast cancer. Finally, the 4 variables were combined to construct the nomogram. The area under the curve values for the nomogram established in the training set and validation set were 0.8224 (95%CI: 0.7796–0.8652) and 0.8631 (95%CI: 0.7937–0.9326), suggesting that the nomogram had good predictive power. The calibration plots illustrated an acceptable correlation between the prediction by nomogram and the actual observation, as the calibration curve was closed to the diagonal bisector line. An easy-to-use nomogram, being proven to be with reliable discrimination ability and accuracy, was established to predict distant metastasis for male patients with breast cancer using the easily available risk factors.
Esophageal Bougienage for Management of Lodged Esophageal Coins
Authors: Warner Tessa N. , Genereux Madeline , Price Amanda B. , Titus M. Olivia , Moake Matthew M.
Published: September 2022

Objectives

The aims of the study are to evaluate outcomes of esophageal bougienage for management of lodged esophageal coins and to assess the extent of bougienage usage and barriers among emergency providers.

Methods

We performed a retrospective chart review of pediatric patients with single lodged esophageal coins presenting to our single academic pediatric emergency department between November 2012 and December 2018. We compared procedural outcomes, complications, length of stay (LOS), and cost between those managed with bougienage and with endoscopy. We further surveyed emergency physicians to assess the extent of bougienage usage and barriers to utilization across different institutions.

Results

We identified 205 patients with single lodged esophageal coins presenting during our study window. One hundred forty-seven patients ultimately underwent bougienage with 97% success and no major complications. Fifty-six patients were managed by endoscopy with 100% success and one major complication. Bougienage had significantly lower LOS (median 2.18 vs 11.92 hours, P < 0.001) and hospital charges (median $3533 vs $12,679, P < 0.001) compared with endoscopy. We received 242 completed surveys representing 38 states from primarily academic pediatric emergency physicians. The majority of respondents (90%) used specialist consult with only 4.5% performing bougienage. A total of 36.4% of respondents had never heard of the procedure and only 16.1% had ever performed it. Barriers to usage included lack of provider training (95.6%), perceived risk of complications (94.4%), and perceived lack of success (80.5%).

Conclusions

Bougienage is safe and effective with significant LOS and cost benefits compared with endoscopy. Despite these advantages, the procedure is underused, because of lack of provider education and concerns regarding safety, efficacy, and both family and specialist preference, which are not supported by current literature. These data support the need for broader education regarding the bougienage technique, as well as larger prospective studies of its safety and outcomes.
A Von Hippel-Lindau Disease–Associated Microcystic Adenoma of the Ethmoid Sinus Mimicking Metastatic Clear Cell Renal Cell Carcinoma
Authors: Tsukamoto Suzune , Koyasu Sho , Sugimoto Akihiko , Matsunaga Mami , Nakamoto Yuji
Published: September 2022

A 38-year-old man with von Hippel-Lindau (VHL) disease and a history of renal cell carcinoma presented with a 2-month history of recurrent epistaxis. MRI revealed a microcystic tumor in the left ethmoid sinus with strong contrast enhancement. 18F-FDG PET/CT showed FDG uptake (SUVmax, 4.2) in the lesion. Under the suspicion of renal cell carcinoma metastasis, the patient underwent 2 surgical resections. However, based on the morphological and immunohistochemical findings, the patient was finally diagnosed with a VHL-associated microcystic adenoma of the ethmoid sinus, which is an extremely rare tumor that occurs in VHL disease.
Combination of Astrogliosis and Phosphorylated Tau for the Preclinical Diagnosis of Alzheimer Disease Using 3-Dimensional Stereotactic Surface Projection Images With 18F-THK5351
Authors: Imabayashi Etsuko , Saitoh Yuji , Tsukamoto Tadashi , Sakata Masuhiro , Takano Harumasa
Published: September 2022

The Alzheimer disease (AD) brain is characterized microscopically by the presence of extracellular amyloid plaques and intraneuronal neurofibrillary tangles consisting of phosphorylated tau aggregations. 18F-THK5351 is a first-generation PET tau tracer that also binds to monoamine oxidase B, which represents astrogliosis, and is useful to evaluate some non-AD neurodegenerative disorders. We examined the utility of 18F-THK5351 in preclinical AD using 3-dimensional stereotactic surface projection images optimized for its pathological accumulation by comparison with a normal dataset. By using this 18F-THK5351 3-dimensional stereotactic surface projection procedure, which can evaluate phosphorylated tau and neuroinflammation, we could diagnose preclinical AD effectively.
Medication-Related Osteonecrosis of the Jaw: 14 Years’ Retrospective Study on Pathogenetic Trigger Events
Authors: Marino Raffaele , Squillacioti Antonella , Lo Giudice Giorgio , Cicchiello Samuele , Scozzaro Calogero , Mummolo Stefano , De Ponte Francesco S. , Nastro Siniscalchi Enrico
Published: September 2022

Although events such as tooth extraction and oral surgery were considered for a while the sole triggering factor for Medication-Related Osteonecrosis of the Jaw (MRONJ), it is still unclear if trigger events may be precipitating factors that accelerate the onset of the disease that would have possibly occurred anyway. Therefore, this research aimed to retrospectively analyze MRONJ cases diagnosed in our tertiary referral hospital during the last 14 years, focusing on the onset of the disease, potential trigger events, and countermeasures to update the knowledge on their pathogenesis. An audit of patients diagnosed with MRONJ attending our department from 2008 to 2021was performed. χ2 test and Fisher exact test were employed to assess the relationship between the medications used and trigger events; χ2 test was also used to assess any relationship between MRONJ localization and drug, drug class, trigger, or trigger type. Seventy-six patients’ records were identified. Fifty-two records were selected for analysis. Trigger events for the onset of the disease were found in 35 cases (67.3%). χ2 test showed a correlation between the drug used and trigger event occurrence (P=0.045) confirmed by Fisher exact test (P=0.34). Visual histogram analysis showed positive correlation when Alendronate (12 cases, 85.7%), Zoledronate (12 cases, 75%), and Risedronate (2 cases, 100%) were administered. Subgroup analysis per underlying disease, showed a significant correlation between the drug used and trigger event occurrence in the osteoporosis group (χ2 test, P=0.021; Fisher exact test, P=0.009).
Serious Condylar Head Absorption in Children With Intracapsular Condylar Fractures Treated Operatively With Long Screws
Authors: Xu Jun-Yi , Zhou Hai-Hua , Lv Kun , Yang Rong-Tao , Li Zhi , Li Zu-Bing
Published: September 2022

Objective:

This study was performed to explore bone remodelling in children with intracapsular condylar fractures after the condylar fracture fragments were fixed using long screws and to offer possible explanations about the underlying mechanism.

Patient and Methods:

Records of children (less than 12 y old) who sustained intracapsular condylar fractures and fixed with long screws from May 2012 to January 2015 were retrieved. Age, gender, dates of injury, admission, and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods, and time of review were recorded and analyzed. Image dates of pretreatments and posttreatments, including the date of review, were also recorded.

Results:

A total of 8 patients completed their follow-up, and all patients (n=5) who were followed up after more than 3 months showed serious resorption of the condylar head. The condylar head resorbed until the height (or articular surface) dropped and aligned with the surface of the screw. The shortest time of absorption, as shown by the computed tomography scan was 106 days, and the longest time was 171 days (average time of 141.8 d).

Conclusions:

Intracapsular condyle fractures in children should be managed conservatively as much as possible. However, if the height of the fracture fragments drops remarkably, open reduction and rigid internal fixation become possible choices.
Ultrathin Supratrochlear Artery Cutaneous Branch Flaps for Large Defects Around Eyebrows
Authors: Liu Ying , Dai Xinyue , Li Ning , Lv Tianqi , Che Dehui , Han Jiyu , Dai Yue , Xiao Zhibo
Published: September 2022

Background:

The key point of repairing large defects around eyebrows is to keep the eyebrow undistorted. The limited skin elevates the application difficulty of conventional methods such as direct suture or local flap. Forehead pedicle flaps do well in tension control. However, most of them are too thick for defects because the frontalis muscle must be included. Recently, 1 stable supratrochlear artery cutaneous branch was found, which provides an opportunity to make an ultrathin forehead flap with a good blood supply. This study aims to investigate whether the supratrochlear artery cutaneous branch flap could perform good esthetic reconstruction for defects around the eyebrow.

Methods:

The authors retrospectively included 15 patients whose defect around the eyebrows was repaired by the supratrochlear artery cutaneous branch flap from June 2017 to June 2020. The authors followed up about their flap color and texture, scar, abnormal sensation, any complication, recurrence, and patient satisfaction for at least 6 months online or face-to-face.

Results:

All of the flaps survived, without distortion of the eyebrows or inner canthi. Similar flap color, texture, and thickness with the nearby skin were obtained, except 2 patients reported pigmentation. Donor and receptor scars were acceptable. There was no recurrence or other complications. All of the patients were satisfied with the surgery effect.

Conclusions:

The supratrochlear artery cutaneous branch flap is a valuable alternative method to repair large defects around the eyebrows. It can avoid facial distortion and achieve good esthetic outcomes in single-stage surgery.
Intraoperative Applications of Artificial Intelligence in Robotic Surgery: A Scoping Review of Current Development Stages and Levels of Autonomy
Authors: Vasey Baptiste , Lippert Karoline A.N. , Khan Danyal Z. , Ibrahim Mudathir , Koh Chan Hee , Layard Horsfall Hugo , Lee Keng Siang , Williams Simon , Marcus Hani J. , McCulloch Peter
Published: September 2022

Objective:

A scoping review of the literature was conducted to identify intraoperative artificial intelligence (AI) applications for robotic surgery under development and categorize them by (1) purpose of the applications, (2) level of autonomy, (3) stage of development, and (4) type of measured outcome.

Background:

In robotic surgery, AI-based applications have the potential to disrupt a field so far based on a master-slave paradigm. However, there is no available overview about this technology’s current stage of development and level of autonomy.

Methods:

MEDLINE and EMBASE were searched between January 1, 2010 and May 21, 2022. Abstract screening, full-text review, and data extraction were performed independently by 2 reviewers. The level of autonomy was defined according to the Yang and colleagues’ classification and stage of development according to the Idea, Development, Evaluation, Assessment, and Long-term follow-up framework.

Results:

One hundred twenty-nine studies were included in the review. Ninety-seven studies (75%) described applications providing Robot Assistance (autonomy level 1), 30 studies (23%) application enabling Task Autonomy (autonomy level 2), and 2 studies (2%) application achieving Conditional autonomy (autonomy level 3). All studies were at Idea, Development, Evaluation, Assessment, and Long-term follow-up stage 0 and no clinical investigations on humans were found. One hundred sixteen (90%) conducted in silico or ex vivo experiments on inorganic material, 9 (7%) ex vivo experiments on organic material, and 4 (3%) performed in vivo experiments in porcine models.

Conclusions:

Clinical evaluation of intraoperative AI applications for robotic surgery is still in its infancy and most applications have a low level of autonomy. With increasing levels of autonomy, the evaluation focus seems to shift from AI-specific metrics to process outcomes, although common standards are needed to allow comparison between systems.
Knockdown of sortilin improves the neurological injury and regional cerebral blood flow in rats after subarachnoid hemorrhage
Authors: Zhou Xiangyang , Lin Chunnan , Liang Haibo , Yang Jinhua , Ni Zepeng , Huang Yisheng
Published: September 2022

Subarachnoid hemorrhage (SAH) is a severe subtype of stroke. Sortilin protein is elevated in cerebrospinal fluid (CSF) of SAH patients. This study explored the mechanism of sortilin in SAH. SAH model was established by occipital cisternal blood injection. Neurological evaluation was performed on SAH rats using the Gracia scoring system and beam-balance tests. Regional cerebral blood flow (rCBF) and intracranial pressure (ICP) changes were measured using a laser Doppler blood flow monitor and an intraparenchymal Camino ICP probe. The correlation between rCBF changes and neurological deficit was analyzed using the Spearman method. Sortilin protein level in rat cerebral cortex and CSF was detected by Western blot. The Garcia score and beam-balance score of rats at 1, 12, 24, 48, and 72 h after SAH were lowered. Blood clots were observed on the ventral surface of the brain in SAH rats, around Willis ring, and ventral surface of brain stem, but no blood clots were found in the control group. At 1, 12, 24, 48, and 72 h after SAH in rats, the severity of SAH was aggravated, rCBF was decreased, and ICP was increased. The changes of rCBF in rat cerebral cortex at 1 and 72 h after SAH were correlated with the Garcia score. Sortilin was highly expressed in the cerebral cortex and CSF of SAH rats. Knockdown of sortilin improved the neurological injury and rCBF in rats. Sortilin was highly expressed in the cerebral cortex and CSF of SAH rats. Sortilin silencing improved neurological injury and CBF in rats.
SYSTEMATIC REVIEW PSYCHOEDUCATION OF ELDERLY WITH DEPRESSION IN PUBLIC HEALTH: PHILOSOPHICAL STUDY
Authors: Nurhidayati Tri , Pandin Moses Glorino Rumambo , Nadya Cindy
Published: September 2022

Introduction

The increasing number of elderly is a new challenge for the government and health care. The elderly can experience psychological disorders, one of which is depression. The phenomenon of depression that occurs can make sadness and affect the risk of suicide in the elderly. The lack of integration between mental health and primary healthcare services and the shortage of mental health specialists in the public health system contribute to underdiagnosis and undertreatment of depression.One of the strategy to reduce depression is psychoeducation. The purpose of this study was to describe appropriate psychoeducation for elderly people with depression in public health.

Methodology

this research design is a literature review, and article using 4 databases, science direct, ProQuest, PubMed, and CINHAL. 16 Article reviewed from 2018 to 2022. The keywords used in the literature search were: 1) psychoeducatioan AND depression AND elderly OR geriatric 2) Depression AND elderly OR geriatric. Protocol and evaluation of literature review using PRISMA checklist and Joanna Briggs Institute Guideline.

Results

Psychoeducation can be carried out with various themes, namely providing health information for the elderly such as hypertension and diabetes mellitus, maintaining daily routines, stress management, solving depression problems, social skills, breathing exercises, and information on drug side effects. Psychoeducation is more effective with involving friends, family, and the community.

Conclusion

Depression among the elderly will become the world’s problem in the future. Therefore, the quality of elderly depression care needs to be improved. Psychoeducation is more effective by involving family, friends and social environment. Hence, specific psychoeducation for elderly depression can be one of the standards in nursing competencies.
Mutational spectra distinguish SARS-CoV-2 replication niches
Authors: Ruis Christopher , Peacock Thomas P. , Polo Luis Mariano , Masone Diego , Alvarez Maria Soledad , Hinrichs Angie S. , Turakhia Yatish , Cheng Ye , McBroome Jakob , Corbett-Detig Russell , Parkhill Julian , Floto R. Andres
Published: September 2022

Exposure to different mutagens leaves distinct mutational patterns that can allow prediction of pathogen replication niches (Ruis 2022). We therefore hypothesised that analysis of SARS-CoV-2 mutational spectra might show lineage-specific differences, dependant on the dominant site(s) of replication and onwards transmission, and could therefore rapidly infer virulence of emergent variants of concern (VOC; Konings 2021). Through mutational spectrum analysis, we found a significant reduction in G>T mutations in Omicron, which replicates in the upper respiratory tract (URT), compared to other lineages, which replicate in both upper and lower respiratory tracts (LRT). Mutational analysis of other viruses and bacteria indicates a robust, generalisable association of high G>T mutations with replication within the LRT. Monitoring G>T mutation rates over time, we found early separation of Omicron from Beta, Gamma and Delta, while the mutational burden in Alpha varied consistent with changes in transmission source as social restrictions were lifted. This supports the use of mutational spectra to infer niches of established and emergent pathogens.
Simple Neurofeedback via Machine Learning: Challenges in real time multivariate assessment of meditation state
Authors: Kuriakose Sruthi Susan , Swamy Aishwarya , Venugopal Rahul , Sasidharan Arun
Published: September 2022

Attaining proficiency in meditation is difficult, especially without feedback since the mind may be easily distracted with thoughts and only long term efforts see any impact. Self-regulation would be much more effective if provided real time assessment and this can be achieved through EEG neurofeedback. Therefore, this work proposes a scheme for assessing meditation-like state in real time from short EEG segments, using low computational settings. Signal processing techniques are used to extract features from long term meditation practitioners’ multichannel EEG data. An autoencoder model is then trained on these features such that the model can be run in real time. Its reconstruction errors or its latent variables are used to provide non typical feedback parameters which are used to establish an objective measure of meditation ability. Our approach is optimised to have lightweight architectures handling small blocks of data and can be conveniently used on low density EEG acquisition systems as it requires only a few channels. However, our experimental results suggest that the meditation state has substantial overlap even in terms of multivariate EEG features and show prominent temporal dynamics, both of which are not captured using simple one class algorithms. Being an extremely flexible one-class model, we have described multiple improvements to the proposed autoencoder model to address the above issues and develop simple yet high precision neurofeedback protocols.
Control of lipolysis by a population of oxytocinergic sympathetic neurons
Authors: Li Erwei , Wang Luhong , Wang Daqing , Chi Jingyi , Smith Gordon I. , Klein Samuel , Cohen Paul , Rosen Evan D.
Published: September 2022

Oxytocin (OXT), a nine amino acid peptide produced in the hypothalamus and released by the posterior pituitary, has well-known actions in parturition, lactation, and social behavior1, and has become an intriguing therapeutic target for diseases like autism and schizophrenia2. Exogenous OXT has also been shown to promote weight loss, among other beneficial metabolic effects1,3, suggesting that its therapeutic potential may extend to diabetes and obesity1,4. It is unclear, however, whether endogenous OXT participates in metabolic homeostasis. Here we show that OXT is a critical regulator of adipose tissue lipolysis in both mice and humans. In addition, OXT serves to license the ability of β- adrenergic agonists to fully promote lipolysis. Most surprisingly, the relevant source of OXT in these metabolic actions is a previously unidentified subpopulation of tyrosine hydroxylase (TH)-positive sympathetic neurons. Our data reveal that OXT from the peripheral nervous system is an endogenous regulator of adipose and systemic metabolism.
Pronounced State Level Disparities in Medicaid Prescribing of Buprenorphine for Opioid Use Disorder (2019-2020)
Authors: Dana Sydney R. , Nichols Stephanie D. , McCall Kenneth L. , Piper Brian J.
Published: September 2022

Objective

To analyze buprenorphine prescription distribution across states in Medicaid patients during 2019-2020.

Methods

Buprenorphine prescriptions per Medicaid enrollee per state was calculated for 2019 and 2020. The totals of monoproduct buprenorphine were divided over the total of combination buprenorphine/naloxone in 2019 and 2020 to obtain the ratio of mono/combo. Data analysis was conducted with generic and brand name formulations of buprenorphine, and transmucosal buprenorphine/ naloxone combinations FDA-approved for OUD using Microsoft Excel. Formulations of buprenorphine indicated for pain were excluded. States outside 95% confidence intervals (mean +1.96*SD) were considered statistically significant.

Results

The overall change in buprenorphine prescribing between 2019 and 2020 was modest (+3.6%) but highly variable with > 10% increases in 17 states (Iowa = +100.5%, p < 0.05) but > 10% decrease in nine states (Alabama = −68.5%, p < 0.05). Total amount reimbursed in 2019 increased (+9.9%) to $1.42 billion in 2020. Branded formulations accounted for two-fifths (39.5%) of prescribing but over two-thirds (66.8%) of spending in 2020. There was a 50-fold difference in prescribing between the highest (Vermont = 219.5 prescription / 1,000 enrollees, p < 0.05) and lowest (Texas = 4.4) states in 2019. This disparity increased in 2020 resulting in a 278-fold difference.

Conclusions

The COVID-19 pandemic exacerbated state-level disparities in buprenorphine prescribing for OUD among Medicaid patients. Legislation on buprenorphine waivered providers and Medicaid expansion may explain the statistically significant percent changes in state buprenorphine prescriptions.