bluuebunny/crossref_metadata_2025 huggingface dataset:
Obinutuzumab versus rituximab for the treatment of refractory primary membranous nephropathy
Authors: Xu Mingyue , Wang Yifeng , Wu Meihe , Chen Ruiying , Zhao Wenqian , Li Mingxin , Hao Chuan-Ming , Xie Qionghong
Published: October 2024

Background

Rituximab has been shown effective in patients with primary membranous nephropathy refractory to glucocorticoids plus cyclophosphamide (GC + CTX) or calcineurin inhibitors (CNIs), but the response rates remain limited. Compared with rituximab, obinutuzumab is a humanized anti-CD20 monoclonal antibody with greater B-cell depletion capacity. This study was performed to investigate the effectiveness of obinutuzumab compared with rituximab in treating patients with refractory primary membranous nephropathy.

Methods

A retrospective study was conducted at Huashan Hospital, Fudan University between 1 January 2015 and 31 July 2024, and included adult patients with primary membranous nephropathy who met the following criteria: (i) resistance to GC + CTX and/or CNI regimens, (ii) dependence on CNIs or (iii) relapse within 1 year after CTX discontinuation. The patients subsequently received either obinutuzumab or rituximab. The primary endpoint was treatment response, which was defined as overall remission of nephrotic syndrome with no need for rescue therapy after obinutuzumab versus rituximab treatment. The secondary measures included immunological remission and safety profiles.

Results

Among the 51 participants, 20 received obinutuzumab and 31 received rituximab. The response rate was significantly greater in patients receiving obinutuzumab than in those receiving rituximab (90.0% vs 38.7%, P < .001) during a follow-up period of 24 [interquartile range (IQR) 10–34] months. Cox proportional hazards survival regression analysis also revealed the superior effectiveness of obinutuzumab (P < .001). Immunological remission rates were higher in patients receiving obinutuzumab at both 3 months (75.0% vs 20.0%, P < .001) and 6 months (87.5% vs 21.4%, P < .001). The safety profiles of the two treatments were comparable. Among the 19 non-responders treated with rituximab, 10 subsequently received obinutuzumab, and 8 achieved remission during a follow-up period of 20.0 (IQR 18.5–22.3) months.

Conclusion

This retrospective study suggests that obinutuzumab is an effective treatment option for patients with primary membranous nephropathy refractory to GC + CTX, CNI and rituximab regimens.
Combined transcranial direct current stimulation and pain neuroscience education for chronic low back pain: a randomized controlled trial
Authors: Alcon Cory , Zoch Christopher , Luetkenhaus Riley , Lyman Emily , Brizzolara Kelli , Goh Hui-Ting , Wang-Price Sharon
Published: October 2024

Objective

Priming the neural circuity likely targeted by pain neuroscience education (PNE), using transcranial direct current stimulation (tDCS) may enhance the efficacy of PNE. The aim of this study was to compare the effects of active tDCS + PNE to sham tDCS + PNE on measures of pain, pain behaviors, and cognitive function in participants with chronic low back pain (CLBP) and high pain catastrophizing.

Methods

20 participants were recruited and randomly allocated into the active tDCS + PNE (n = 10) or sham tDCS + PNE (n = 10) groups. All participants received five sessions of their assigned interventions over a 2-week period. The active tDCS + PNE group received 20 min of 2 mA, anodal current applied to the left dorsolateral prefrontal cortex.

Results

Within groups, both interventions demonstrated significant improvement in NPRS, PCS, and TSK. The active tDCS + PNE group also demonstrated significant improvement in the SCWT, CTMT2—Inhibitory, and CTMT2—Set Shifting. Between groups, the active tDCS + PNE group showed significantly greater improvement on the PCS, SCWT, and CTMT2—Inhibitory.

Conclusions

The results of this pilot study suggest that active tDCS + PNE appeared to provide greater improvement than sham tDCS + PNE on levels of pain catastrophizing and attentional interference in participants with CLBP and high pain catastrophizing, consistent with both interventions targeting brain regions involved in those processes. Considering the differences between groups, tDCS appears to provide a priming effect on PNE.

Perspective

This article presents evidence of a priming effect of transcranial direct current stimulation on pain neuroscience education in participants with chronic low back pain and high pain catastrophizing. The findings support that the combination of interventions improves pain behavior and cognitive function greater than pain neuroscience education alone.

Clinical trial registry

NCT05571215, The Effect of Combining Pain Neuroscience Education and Transcranial Direct Current Stimulation on Pain Catastrophizing, Kinesiophobia, and Pain in Patients With Chronic Low Back Pain, https://classic.clinicaltrials.gov/ct2/show/NCT05571215.
Croatian immigrants’ trust in the police in Croatia and abroad: The roles of police integrity and transnational migration factors
Authors: Liu Yang Vincent , Kutnjak Ivković Sanja , Pavlović Vinogradac Valentina
Published: October 2024

Research posits that immigrants view the police in the host countries more positively, especially when their experiences with the homeland police are unpleasant. However, empirical research often focuses on immigrants of color in White-dominant countries with drastically different cultures from their own. Using survey data of the first-generation Croatian immigrants in Germany (N = 274) and Ireland (N = 219), our research looks at how Croatian immigrants in two geopolitically adjacent countries perceive the police in both their homeland and current countries of residence. We find that police integrity factors have the greatest impact on immigrants’ trust in the police; namely, perceived corruption with the police consistently erodes Croatian immigrants’ trust in the police across contexts. The nature of immigrants’ previous contact with the police also helps determine their trust in the police in their host countries. Finally, transnational migration factors only have a conditional effect on the outcome.
Unravelling the neuroimmune nexus: insights into epilepsy pathology and the role of S100b protein in brain-gut axis modulation: a literature review
Authors: He Jianxun , Meng Qianling , Miao Chuhan , Hao Jing , Dai Mengliang
Published: October 2024

Epilepsy, a chronic neurological condition marked by recurrent, unprovoked seizures, involves complex pathophysiological mechanisms. Recent advancements have expanded our understanding from traditional neuronal dysfunction to include neuroimmune interactions and the influence of the brain-gut-bio-axis. This review explores the role of the S100b protein within these contexts, noted for its involvement in neuroinflammatory processes and as a potential biomarker. Furthermore, it discusses the emerging significance of the gut microbiome in modulating neuroimmune responses and seizure activity. The review integrates findings from recent studies, emphasizing the critical role of the S100b signalling pathway and the gut-brain axis in epilepsy pathology. The interplay between neuroimmune mechanisms and gut microbiota offers novel insights and potential therapeutic targets, underlining the need for further research to exploit these connections for clinical benefit.
Self-reported skin severity and quality of life in systemic sclerosis: multicentre validation of PASTUL
Authors: Spierings Julia , Welsing Paco M J , Colak Seda , Quah Helen , Del Galdo Francesco , Herrick Ariane L , Hughes Michael , Pauling John D , Ong Voon H , Denton Christopher P
Published: October 2024

Objectives

The aim of this study was to validate the Patient self-Assessment of Skin Thickness in Upper Limb (PASTUL) questionnaire in SSc and assess impact of skin involvement on health-related quality of life (HRQoL).

Methods

Participants were included in four UK centres. PASTUL specifies a grading of skin at eight sites corresponding to the modified Rodnan Skin Score (mRSS). Construct validity was assessed by comparing PASTUL scores with mRSS. HRQoL was evaluated with EuroQoL 5 dimension 5 levels (EQ5D5L) and Leeds SSc QoL questionnaires. Additionally, correlation between PASTUL and Scleroderma Skin Patient-Reported Outcome (SSPRO) was explored. Follow-up was 12 months.

Results

In total, 196 participants were included, mean age was 56.4 years (s.d. 13.9), 80.6% female (n = 158), mean disease duration 11.9 years (s.d. 9.9), 110 (56.1%) had lcSSc and 81 (41.3%) dcSSc. PASTUL and upper limb mRSS were well correlated at baseline, 6 and 12 months [intraclass correlation coefficients (ICC) = 0.67, 0.78 and 0.62, P < 0.001]. Test–retest reliability was good (ICC = 0.83, P < 0.001). There was a stronger correlation between PASTUL and upper limb mRSS in dcSSc compared with lcSSc (0.69 vs 0.51, P < 0.001). In participants with early disease (<4 years) PASTUL was moderately correlated with HRQoL (r = 0.53, P < 0.001); correlations were weaker in the whole group. Mean time to do the PASTUL self-assessment was 5.0 min (s.d. 3.7).

Conclusion

PASTUL is a feasible outcome tool that adds to assessments such as SSPRO. Skin thickening is correlated with HRQoL, particularly in early disease.
Determination of natural radioactivity levels in soil samples from irrigated vegetable farming land in and around Addis Ababa, Ethiopia
Authors: Hundie Tamiru Bayissa , Deressu Tilahun Tesfaye
Published: October 2024

Soil samples were collected from vegetable agricultural areas in and around Addis Ababa, and their levels of radioactivity were measured. Gamma spectrometry with high-purity germanium detector was used to quantify radioactivity level. The average concentration of 226Ra, 232Th, and 40K were 32.8 ± 2.1, 62.4 ± 4.4, and 544.3 ± 23.3 Bq kg−1 respectively. The mean values of 232Th and 40K are higher, whereas the value of 226Ra is comparable with world average values. Radiological hazard indices, including radium equivalent activity (Raeq), absorbed dose rate (Dr), outdoor annual effective dose equivalent (Deff), external hazard index (Hex), internal hazard index (Hin), and gamma radiation representative level index (Iγ), were calculated based on the activity concentration of 226Ra, 232Th and 40K. The mean values were 163.9 Bq kg−1, 78.7 nGy h−1, 0.10 mSv y−1, 0.44, 0.53, and 0.60 respectively. All indices are lower than global recommended limit values. These results revealed that radiation hazard due to radionuclides in the soil of the study area is insignificant.
Physiological liver microtissue 384-well microplate system for preclinical hepatotoxicity assessment of therapeutic small molecule drugs
Authors: Fäs Lola , Chen Minjun , Tong Weida , Wenz Friederike , Hewitt Nicola J , Tu Monika , Sanchez Katarzyna , Zapiórkowska-Blumer Natalia , Varga Hajnalka , Kaczmarska Karolina , Colombo Maria Vittoria , Filippi Bruno G H
Published: October 2024

Hepatotoxicity can lead to the discontinuation of approved or investigational drugs. The evaluation of the potential hepatoxicity of drugs in development is challenging because current models assessing this adverse effect are not always predictive of the outcome in human beings. Cell lines are routinely used for early hepatotoxicity screening, but to improve the detection of potential hepatotoxicity, in vitro models that better reflect liver morphology and function are needed. One such promising model is human liver microtissues. These are spheroids made of primary human parenchymal and nonparenchymal liver cells, which are amenable to high throughput screening. To test the predictivity of this model, the cytotoxicity of 152 FDA (US Food & Drug Administration)-approved small molecule drugs was measured as per changes in ATP content in human liver microtissues incubated in 384-well microplates. The results were analyzed with respect to drug label information, drug-induced liver injury (DILI) concern class, and drug class. The threshold IC50ATP-to-Cmax ratio of 176 was used to discriminate between safe and hepatotoxic drugs. “vMost-DILI-concern” drugs were detected with a sensitivity of 72% and a specificity of 89%, and “vMost-DILI-concern” drugs affecting the nervous system were detected with a sensitivity of 92% and a specificity of 91%. The robustness and relevance of this evaluation were assessed using a 5-fold cross-validation. The good predictivity, together with the in vivo-like morphology of the liver microtissues and scalability to a 384-well microplate, makes this method a promising and practical in vitro alternative to 2D cell line cultures for the early hepatotoxicity screening of drug candidates.
Genome Sequence Resources from Three Isolates of the Apple Canker Pathogen Neonectria ditissima Infecting Forest Trees
Authors: Bourras Salim , Vélëz Heriberto , Ihrmark Katarina , Corrales Gutiérrez Miguel Ángel , Elfstrand Malin , Garkava-Gustavsson Larisa , Falk Kerstin Dalman
Published: October 2024

Neonectria ditissima is a generalist ascomycete plant pathogen causing canker diseases on a variety of hardwood tree species and can cross-infect many of them. The fungus enters the plants through wounds throughout the year. N. ditissima is considered a major threat to apple production responsible for the fruit tree canker disease, which damages trees and causes rotting of fruits in storage. Nearby forests and shelter belts can serve as sources of inoculum for well-managed apple orchards. Thus, knowledge about the N. ditissima isolates infecting different host species is essential for designing integrated pest management strategies. Here, we describe the genomes of three N. ditissima isolates, Nd_iso34, Nd_iso35, and Nd_iso36, infecting European beech, American tulip tree, and American beech, respectively. We obtained genome assemblies of approximately 45 megabases for all isolates, covering 94% of the N. ditissima reference annotation, and 97% of the universal single-copy orthologs (BUSCOs). We conclude that these genome assemblies are a highly relevant resource considering the scarcity of genomic data available for N. ditissima.

[Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
A New Pilot Hole Preparation System for Percutaneous Pedicle Screw Placement
Authors: Feng Chaobo , Wang Longfei , Yang Sheng , Wu Xinbo , Fan Yunshan , Yan Huang , Chen Fangjing , Chen Jia , Wang Xiang , Guo Qishuai , Yao Longxiang , Zhao Yingchuan , He Shisheng , Ni Haijian
Published: October 2024

Study Design.

A randomized controlled study.

Objective.

To introduce a new pilot hole preparation system for percutaneous pedicle screw placement and investigate its efficiency and safety in comparison with the conventional method.

Summary of Background Data.

Placing screws accurately, rapidly, and safely with less radiation exposure is critical for minimally invasive lumbar interbody fusion (LIF). Optimizing pilot hole preparation instruments has important clinical implications.

Materials and Methods.

A total of 60 patients (180 screws) were included in this study. All patients were randomized into two groups (new system vs. conventional method) and performed single-level minimally invasive percutaneous fixation, interbody fusion, and unilateral decompression. Basic information, time of pilot hole preparation, time of screw placement, and fluoroscopy time were recorded. Screw placement accuracy was graded based on the Gertzbein-Robbins scale, and the angle between the screw axis and the pedicle axis was collected in postoperative CT.

Results.

There was no statistical difference in basic information between the 2 groups. The mean time of single pilot hole preparation was 4.08±1.01 minutes in the new system group and 5.34±1.30 minutes in the conventional method group (P<0.001). The time of single screw placement was significantly shorter in the new system group (0.82±0.20 vs. 1.72±0.33 min), and the fluoroscopy time was also less in the new system group (13.70±3.42 vs. 19.95±5.50 s) (P<0.001). Screw placement accuracy assessment showed that there were 85 (94.45%) A-grade screws in the new system group while 76 (84.44%) A-grade screws in the conventional method group (P=0.027).

Conclusions.

The new pilot hole preparation system has shown significant reductions in the time of pilot hole preparation, time of screw placement, and radiation exposure, and has good clinical application value.
Platelet-sparing properties of aprotinin
Authors: Vanglabeke Lennart L.W. , Rex Steffen , Van den Eynde Raf
Published: October 2024

BACKGROUND

Cardiac surgery involving cardiopulmonary bypass (CPB) is associated with the risk of acquired coagulopathy, including dysregulated fibrinolysis, which can result in life-threatening bleeding complications. Aprotinin, an antifibrinolytic agent, has been recommended for the prevention of these complications. Its effectiveness has been attributed to its ability to nonspecifically inhibit various serine proteases involved in the coagulation and fibrinolysis cascade. Additionally, aprotinin may protect platelets from CPB-induced dysfunction through a platelet-sparing effect, further enhancing its efficacy.

OBJECTIVES

The biochemical pathways underlying aprotinin's platelet-sparing effect remain unclear. Furthermore, it is uncertain to what extent this effect contributes to reducing blood loss and need for transfusion.

DESIGN

A scoping review

DATA SOURCES

MEDLINE, Embase and Cochrane were searched from inception until 21 December 2023.

ELIGIBILITY CRITERIA

Studies in which a platelet-sparing effect of aprotinin was investigated. These included systematic reviews; experimental, and observational studies describing healthy humans, patients, or animals undergoing any type of surgery; studies in which donated blood was used for in-vitro studies.

RESULTS

Sixty-four studies were deemed eligible, the majority of which observed a platelet-sparing effect, attributing it to the inhibition of platelet aggregation (via protection of glycoprotein (GP) IIb/IIIa receptors), platelet adhesion (by protection of GP Ib receptors), both aggregation and adhesion receptors, proteolysis of protease-activated receptor 1 receptors, platelet activation (by inhibition of plasmin) and platelet activation (by inhibition of thrombin). A dose-dependency of the platelet-sparing effect was investigated in both in-vitro studies and randomised controlled trials, yielding mixed results. No studies have explored the relative contribution of aprotinin's platelet-sparing effect and its antifibrinolytic effect in reducing blood loss and need for transfusion.

CONCLUSIONS

This review elucidated current knowledge on how aprotinin influences platelets and exerts its platelet-sparing effect, while highlighting gaps in the existing literature.
Injectable Intravitreal Fluocinolone Acetonide Implant for Chronic Postoperative CME in the Presence of Silicone Oil Tamponade
Authors: Patel Kishan G. , Flores Jessica , Abbey Ashkan M.
Published: October 2024

Purpose:

This report describes the use of the injectable intravitreal fluocinolone acetonide 0.18mg implant (FAI) for chronic postoperative cystoid macular edema (CME) in an eye with a silicone oil-filled vitreous cavity.

Methods:

A retrospective chart review was performed including surgical, clinical, and imaging data.

Results:

The patient had multiple complicated vitreoretinal surgical procedures including long-term silicone oil tamponade. The eye developed chronic CME, which responded to intravitreal steroid therapies and subsequently received FAI for longer-term control. The eye had no complications related to FAI.

Conclusion:

FAI is a long-acting steroid that may be beneficial in controlling chronic CME. It can be considered for use in eyes with silicone oil tamponade, but further studies are required to better understand the pharmacokinetics and utility of the FAI when injected into silicone oil-filled vitreous cavities.
Work Trajectories of Patients With Persistent Complaints After a COVID-19 Infection Receiving Allied Healthcare in the Netherlands
Authors: Ben Ângela Jornada , Verburg Arie Cornelis , Maas Esther T. , Hoogeboom Thomas J. , Gerards Marissa H. G. , Slotegraaf Anne I. , Cup Edith H. C. , Schaafsma Frederieke , W.J.G. Ostelo Raymond , van Dongen Johanna Maria ,   on behalf of the Dutch Consortium Allied Healthcare COVID-19, ParaCOV cohort study
Published: October 2024

Objectives

This study identifies work trajectories of patients with persistent complaints after a COVID-19 infection receiving allied healthcare and predictors of return work.

Methods

A prospective cohort of 1333 Dutch working-age patients with persistent complaints after a COVID-19 infection receiving allied healthcare between 2021 and 2022 were used. Sequence analysis was conducted to identify work trajectories over time and logistic regression to investigate predictors of return to work.

Results

Five hundred fifty-two unique work trajectories were identified. The proportion of return to work was 31.4% (n = 419). High health-related quality of life was associated with higher odds of return to work (OR = 1.02; 95% CI = 1.00 to 1.04).

Conclusions

Only one-third of patients returned to work 9 months after receiving allied healthcare. Return to work was best predicted by health-related quality of life although the model’s accuracy was poor.
Outcomes of Multiorgan Heart Transplant Between Donation After Circulatory Death and Brain Death
Authors: Endo Toyokazu , Trivedi Jaimin R. , Moore Stephanie , Fu Sheng , Samson Rohan , Gallo Michele , Pahwa Siddharth , Slaughter Mark S. , Schumer Erin M.
Published: October 2024

There is insufficient data on the outcomes of donation after circulatory death (DCD) multiorgan transplant that includes heart. The primary objective of this study is to compare the overall survival outcomes of DCD and donation after brain death (DBD) multiorgan transplants. We identified all heart transplant patients from 2019 to June of 2023 using the United Network for Organ Sharing (UNOS) Database who also received an additional organ (kidney, liver, and lungs). A total of 1,844 DBD and 91 DCD multiorgan transplants occurred within the study period, the majority being combined heart-kidney transplantation. More patients were listed at a higher status in the DBD group (p< 0.05) and were in the intensive care unit (ICU) before transplant (p< 0.05). Despite the higher ischemia time in the DCD group (p< 0.05), the overall unmatched survival did not differ between the two groups (p< 0.05). Within the heart-kidney transplants, the overall survival between DBD and DCD heart-kidney transplants did not differ in either unmatched or matched groups (unmatchedp= 0.5, matchedp= 0.5). In conclusion, the data on the outcomes of DCD multiorgan transplants are limited. Still, our analysis of the currently available data suggests that the overall survival is comparable in the DCD multiorgan transplants.
Effectiveness of accelerated rehabilitation surgical nursing on perioperative outcomes in patients with calcaneal fractures
Authors: Xie Qian , Zhao Bin , Fang Zhenhua
Published: October 2024

This study aims to evaluate the impact of accelerated rehabilitation nursing on perioperative outcomes in patients with calcaneal fractures. A total of 101 patients with calcaneal fractures admitted from December 2020 to December 2022 were included in this study. Patients were randomly assigned to an observation group (OG) of 51 patients receiving accelerated rehabilitation surgical nursing and a control group (CG) of 50 patients receiving conventional surgical nursing. Outcomes assessed included patient satisfaction, visual analog scale (VAS) scores before and after surgery, swelling reduction time, and complication rates. The satisfaction rate in the OG was 96.07%, significantly higher than the 80.00% observed in the CG. Post-operative VAS scores at day 4 and 6 were significantly lower in the OG compared to the CG. Swelling reduction time was shorter in the OG (152.56 ± 25.22 hours) compared to the CG (170.76 ± 22.51 hours). Additionally, the complication rate in the OG was significantly lower at 7.84% compared to 24.00% in the CG (P < .05).the implementation of accelerated rehabilitation nursing significantly shortened the average length of hospital stay for patients in the observation group. In contrast, patients in the control group, who received conventional nursing care, had a relatively longer hospital stay. In the perioperative treatment of calcaneal fractures, accelerated rehabilitation surgical nursing can significantly improve patient satisfaction, reduce pain, shorten the time for swelling to subside, and lower the incidence of complications. Additionally, it can shorten the hospital stay for patients, demonstrating its efficacy and potential for broader clinical application.
Relationship of body mass index and kidney outcomes in patients with primary glomerulonephritis: A systematic review and meta-analysis
Authors: Liu Qinling , Yao Tianhua , Chen Yan , Xiao Fei , Wu Yazhou , Dai Huanzi
Published: October 2024

Background:

Primary glomerulonephritis, is a major contributor to the development of chronic kidney disease and end-stage renal disease. Previous studies on the relationship between overweight/obesity with primary glomerulonephritis in the chronic kidney disease was inconsistent. This study aimed to systematically review and meta-analyze the relationship between body mass index and adverse kidney outcomes in patients with primary glomerulonephritis.

Methods:

PubMed, Embase, the Cochrane Library, and the China National Knowledge Infrastructure were searched. Patients were divided into an overweight/obesity group (group O) and a non-overweight/obesity group (group N) according to their body mass index values.

Results:

Twenty-six studies with 11,038 patients were selected. Patients in group O had deteriorated baseline characteristics, including worse baseline estimated glomerular filtration rate (weighted mean differences [WMD] = ‐5.99), higher Scr (WMD = 7.34), uric acid (WMD = 47.53), 24-hour proteinuria (WMD = 0.40), and a higher prevalence rate of hypertension (odds ratio, OR = 2.70) and diabetes mellitus (OR = 2.644). On the histopathologic level, patients in group O had a significantly lower total glomerular number (WMD = ‐2.30); however, no difference was observed in mesangial cell proliferation, endocapillary hypercellularity, crescents, sclerosis, and tubular atrophy/interstitial fibrosis between the 2 groups. The incidence of adverse renal outcomes in the 2 groups was similar (OR = 0.96). The meta-analysis of hazard ratios from Cox regressions indicated a strong association between overweight/obesity and poor renal outcomes in glomerulonephritis (HR = 1.17).

Conclusion:

Overweight/obesity glomerulonephritis patients had remarkably poor baseline clinicopathological characteristics. Being overweight or obesity would likely impact the progression of primary glomerulonephritis but not serious enough to contribute to significant poor renal outcomes, which could be prevented by aggressive therapy.
LEF1 is associated with immunosuppressive microenvironment of patients with lung adenocarcinoma
Authors: Liu Xiaoqing , Wang Chunlou , Zhang Xiaoling , Zhang Rongju
Published: October 2024

Wnt/β-Catenin pathway plays an important role in the occurrence and progression of malignant tumors, especially PD-L1-mediated tumor immune evasion. However, the role of TCF/LEF, an important member of the Wnt/β-catenin pathway, in the tumor immunosuppressive microenvironment of lung adenocarcinoma (LUAD) remains unknown. LUAD tissue-coding RNA expression data from The Cancer Genome Atlas and TIMER databases were used to analyze the expression of TCF/LEF transcription factors and their correlation with various immune cell infiltration. Immunohistochemistry and immunofluorescence were used to detect tissue protein staining in 105 patients with LUAD. LEF1, TCF7, TCF7L1 and TCF7L2 were all aberrantly expressed in the tumor tissues of LUAD patients with the data from The Cancer Genome Atlas (TCGA) database, tumor immune estimation resource (TIMER) database and results of immunohistochemistry, but only LEF1 expression was associated with 5-year overall survival in LUAD patients. LEF1 protein expression was associated with advanced tumor node metastasis (TNM) stage, lymphatic metastasis and local invasion in 105 cases LUAD patients. At the same time, LEF1 mRNA expression was also associated with immunosuppressive microenvironment in LUAD patients with the data from TCGA database and TIMER database. Results of immunohistochemistry and immunofluorescence in tumor tissues of 105 cases LUAD patients showed that there was a positively correlation between LEF1 protein expression and the infiltration of M2 macrophages and Treg cells. LEF1 was highly expressed in tumor tissues of LUAD patients, and highly expressed LEF1 was associated with the immunosuppressive microenvironment of LUAD patients.
Predictive value of prognostic nutritional index in patients undergoing gastrectomy for gastric cancer: A systematic review and meta-analysis
Authors: Deng Huachu , He Yiqiang , Huang Gaofei , Huang Yuetong , Wu Jiaheng , Qin Xingan
Published: October 2024

Background:

The value of prognostic nutritional index (PNI) in gastrectomy remains controversial. This meta-analysis aimed to evaluate the predictive value of PNI in patients undergoing gastrectomy for malignancy.

Methods:

We retrieved studies from medical literature databases to analyze the endpoints of overall survival, cancer-specific survival, recurrence-free survival, and clinicopathologic features. The hazard ratio (HR) and 95% confidence interval (CI) were used to access the survival prognostic value of PNI in patients after gastrectomy. Odds ratio and mean difference were used to evaluate the relationship between the low PNI and clinicopathologic features.

Results:

In total, we included 38 articles (39 trial comparisons) which contained 23,756 gastrectomy patients. The results showed that low PNI was associated with shorter overall survival (HR: 1.82, 95% CI 1.62–2.03), shorter cancer-specific survival (HR: 1.44, 95% CI 1.24–1.67), and shorter recurrence-free survival (HR: 2.52, 95% CI 1.41–4.47). Besides, patients with low PNI had a higher risk of postoperative complications compared with high PNI (HR: 1.65, 95% CI 1.30–2.09). And low PNI group was found to be related to older, lower BMI, larger tumor size, deeper tumor invasion, poorer differentiation, more advanced tumor stage, total gastrectomy, and the presence of lymph node metastasis, lymphatic invasion, and vessel invasion.

Conclusion:

PNI was significantly associated with survival and postoperative complications of gastric cancer patients undergoing gastrectomy. Therefore PNI has the potential to be a prognostic predictor for gastrectomy.
Effect of glucagon-like peptide-1 receptor agonists on prostate cancer: A review
Authors: Yu Xu , Liu Jie
Published: October 2024

Glucagon-like peptide-1 receptor agonist (GLP-1RA) is widely used in the treatment of type 2 diabetes mellitus (T2DM) for its significant hypoglycemic effect, weight loss and small side effects. Some studies have shown that GLP-1RA has an inhibitory effect on prostate cancer, and its application will produce adverse effects associated with an increased or decreased risk of some tumors. GLP-1R is widely expressed by various types of cells and tissues in the human body, so GLP-1RA has attracted wide clinical attention to the occurrence, development and prognosis of tumors, which brings more new directions and hopes for the treatment of prostate cancer. This paper describes the expression of glucagon-like peptide-1 receptor (GLP-1R) in prostate cancer and the effects of glucagon-like peptide-1 receptor agonist (GLP-1RA) on prostate cancer.
Potential association between mobile phone usage duration and postpartum depression risk: Evidence from a Mendelian randomization study
Authors: Ling Keng , Zhang Siyi , Jin Liqin , Wang Jianguo
Published: October 2024

The widespread adoption of mobile phones in daily life has raised concerns regarding their impact on mental health, including among postpartum women. Considering the rising prevalence of postpartum depression (PPD) and the pervasive use of mobile phones in modern society, this study aimed to rigorously investigate the causal relationship between mobile phone use duration and the risk of developing PPD. Data were collected through an online survey assessing mobile phone usage and mental health among postpartum women. The survey’s reliability and validity were evaluated using Statistical Package for the Social Sciences software. In total, 2015 participants completed the survey. To explore causal relationships, genetic data were sourced from open-access databases, and two-sample Mendelian randomization (MR) techniques were employed. Statistical analysis, including chi-square tests, revealed a significant association between higher mobile phone use and lower incidence of PPD. MR analysis supported these findings, indicating a protective effect of mobile phone use against PPD (P < .05 based on inverse variance weighting and the weighted median method). This MR-based study provides evidence that increased mobile phone use is associated with a decreased risk of PPD, suggesting that mobile phones could serve as an effective tool for PPD prevention. These findings highlight the importance of evidence-based evaluations of lifestyle factors in mental health research.
Relationship between relative fat mass and infertility: A cross-sectional study
Authors: Zhao Xi , Wu Yue , Hu Huangyu
Published: October 2024

Infertility is closely related to obesity. Relative fat mass (RFM) is a newer index for assessing percentage of body fat, which reflects the amount of body fat better than body mass index (BMI), but its relationship with infertility needs further study. The purpose of this study was to assess whether there was an association between RFM and infertility in women aged 20 to 44 years in the United States. The corresponding participants were selected from the National Health and Nutrition Examination Survey (NHANES) 2013 to 2018. RFM was used as the independent variable and infertility as the dependent variable. Multiple logistic regression and generalized additive models were used to explore the association between RFM and infertility, 2-stage linear regression models were used to calculate threshold effects, and subgroup analyses and tests of interactivity were used to find sensitive populations. A total of 2328 women aged 20 to 44 years were included. In the fully adjusted model, the risk of infertility increased by 6% for each increase in RFM (OR = 1.06, 95% CI: 1.00–1.12). There was a nonlinear relationship between RFM and infertility with 2 breakpoints of K1 = 31.04 and K2 = 48.4. There was a positive association between RFM and infertility on the right side of K1 and, on the left side of K2 (OR = 1.08, 95% CI: 1.01–1.16; OR = 1.07, 95% CI: 1.01–1.14). In contrast, no statistically significant association between RFM and infertility was found on the left side of K1 as well as on the right side of K2. There was a nonlinear relationship between RFM and infertility, with a positive association with infertility when RFM was in the range of 31.04 to 48.4.This suggests that RFM may be an alternative to BMI in the management of obese infertile women, but this needs to be further confirmed by prospective studies.
Cross-sectional study of factors associated with caregiver’s burden in patients diagnosed with psychotic disorders in urban India
Authors: Ansari Zarrin , Rashmi Abhilasha , Pawar Sudhir , Patil Anant , Sah Ranjit
Published: October 2024

Pharmacotherapy has deinstitutionalized the patients with psychotic disorder. This has led to the transfer of the caregiving burden from hospitals to family members of the patients. This study aimed to assess the caregivers’ burden and the factors associated with it objectively. This was a cross-sectional survey conducted amongst 143 caregivers of patients diagnosed with psychotic disorders reporting to a psychiatric outpatient department. The investigative tool used was a 12-item ZARIT Burden Interview (ZBI) questionnaire. The frequency of schizophrenia amongst patients with psychotic disorder was 68.5%. The median age of caregivers was 50 years in the “high burden” group, 40 years in the “moderate burden” group, and 34 years in the “no/mild burden” group. The mean score of burden experienced by the caregiver was 27.5 ± 9.7. The degree of burden was high in 66% of caregivers. The caregivers were generally more females, married, less educated, and mainly parents. A high degree of burden was associated with variables viz. female gender (OR 1.77 [0.88, 3.57], P = .043), low education status (OR 2.31 [1.09, 4.91] P = .002), unemployed status (OR 2.32 [1.12, 4.78] P = .027) and, increasing age of caregiver. No significant association was found between the degree of burden and variables, viz. marital status of caregivers, duration of caregiving, and duration of patient’s illness. The current study identifies variables that can predict caregiver’s burden. These results also suggest the implementation of psycho-educational, community-based programs which can address the core issues associated with caregiving.
Decoding skin mysteries: Unveiling the link between microbiota and keloid scars through a Mendelian randomization study
Authors: Zhou Jie , Xu Yixin , Wang Haitao , Chen Chao , Wang Kun
Published: October 2024

The cause of keloids remains unclear, but studies suggest a link between skin microbiota and keloid formation. However, the causal relationship has not been confirmed. This study utilized Genome-Wide Association Studies (GWAS) data from 2 population-based German cohorts, comprising a total of 1656 skin samples. To bolster the reliability of our results, we incorporated GWAS data from 3 keloid cohorts, encompassing 2555 patients and 870,556 controls (GWAS ID: keloid1, ebi-a-GCST90018874; keloid2, bbj-a-131; keloid3, ebi-a-GCST90018654). Subsequently, we employed bidirectional 2-sample Mendelian randomization (MR) analysis to probe the causal relationship between the variables. The primary method employed was the inverse-variance weighted (IVW) method, supported by heterogeneity analysis, horizontal pleiotropy testing, outlier detection, and “leave-one-out” sensitivity analysis. By synthesizing the results from 3 groups of MR analyses, we discovered a negative causal association between a.ASV063 [Finegoldia (unc.)] located on the volar forearm and keloid disease (IVW (keloid1) odds ratio (OR): 0.939, 95% confidence interval (CI): 0.886–0.994, P = .032; IVW (keloid2) OR: 0.897, 95% CI: 0.813–0.990, P = .031; IVW (keloid3) OR: 0.900, 95% CI: 0.825–0.981, P = .017). Similarly, a negative causal relationship may also exist between the genus: Bacteroides from the antecubital fossa and keloid disease (IVW (keloid1) OR: 0.928, 95% CI: 0.884–0.973, P = .002; IVW (keloid2) OR: 0.891, 95% CI: 0.820–0.968, P = .007; IVW (keloid3) OR: 0.918, 95% CI: 0.849–0.992, P = .030). Additionally, no reverse causation was found, with all analyses showing no signs of horizontal pleiotropy or heterogeneity. This study offers new insights for the prevention and treatment of keloids.
Severe multiple injuries in a 15-year-old boy with pelvic fracture complete anterior dislocation of the sacroiliac joint and rupture of the internal and external iliac arteries: A case report of a rare injury
Authors: Bao Yong-Gang , Li Shu , Liu Bao-Rui , Zhao Yi-Feng , Song Fu-Qiang , Wu Bin
Published: October 2024

Rationale:

Anterior dislocation of the sacroiliac joint combined with pelvic fractures is relatively rare in clinical practice. It is often associated with hemodynamic instability and severe injuries to other regions, resulting in a complex condition, prolonged treatment duration, and high rates of mortality and disability. However, there are few reports in the literature describing the diagnosis and treatment of anterior dislocation of the sacroiliac joint. In this case, the patient sustained a pelvic fracture with anterior sacroiliac joint dislocation and rupture of both the internal and external iliac arteries following a motor vehicle accident, making it an even rarer and more challenging case to treat. Reporting such cases can enhance the understanding of the diagnosis and treatment of anterior sacroiliac joint dislocation with rupture of the iliac arteries and provide valuable references for similar cases.

Patient Concerns:

The patient was riding an electric bicycle and was hit by a small truck, resulting in a pelvic fracture, anterior dislocation of the sacroiliac joint, and rupture of the internal and external iliac arteries.

Diagnosis:

The patient was diagnosed with open pelvic fracture (type C1.2), left complete anterior dislocation of the sacroiliac joint, left acetabular fracture, left internal and external iliac arteriovenous rupture.

Interventions:

emergency room resuscitation, intensive care unit resuscitation, 6 surgeries and perioperative management.

Results:

He has been discharged from the hospital for more than 1 year and was rechecked every month after discharge, the fracture has healed, there is no obvious pain and discomfort in and around the wound, he has been fitted with a prosthesis, and he is doing the walking function exercise.

Lessons:

Pelvic fracture with anterior sacroiliac dislocation is clinically rare and critical, and is associated with large vessel rupture, severe organ damage, and high mortality and disability rates. Rapid restoration of pelvic stability and hemodynamic stability is the key to treatment. Rapid transfer to a tertiary trauma center, rapid examination through the green channel to clarify the diagnosis, close intensive care, and reasonable multidisciplinary teamwork for surgical intervention are all valuable experiences that we have concluded.
Mediation effect of plasma metabolites on the relationship between immune cells and the risk of prostatitis: A study by bidirectional 2-sample and Bayesian-weighted Mendelian randomization
Authors: Ding Chao , Gong Quanhua , Wan Shui
Published: October 2024

According to the findings of multiple observational studies, immune disorder was a risk factor for prostatitis. However, it remained unknown whether there was a direct causal relationship between immune cells and prostatitis or whether this relationship was mediated by plasma metabolites. Based on the pooled data of a genome-wide association study (GWAS), a genetic variant was used to predict the effects of 731 immunophenotypes on the risk of prostatitis and determine whether the effects were mediated by 1400 metabolites. The bidirectional 2-sample Mendelian randomization (MR) method was adopted to uncover the causal relationship between immunophenotypes and prostatitis. Subsequently, a 2-step MR method was employed to evaluate whether the metabolites mediated this causal relationship and quantify the mediating effects and the corresponding ratios. In addition, the Bayesian-weighted Mendelian randomization (BWMR) method was employed to verify the results. Among the 731 immunophenotypes analyzed, 16 had causal relationships with the risk of prostatitis, including 11 with positive correlations (P < .05, beta > 0) and 5 with negative correlations (P < .05, beta < 0). The MR analysis screened out 9 metabolites related to the risk of prostatitis. The X − 24344 levels mediated the causal relationship between CD3 on CD39+ activated Treg and prostatitis (mediation effect: 0.01; ratio: 9.82%). Both histidine betaine (hercynine) levels and the proline-to-glutamate ratio mediated the causal relationship between CD14–CD16+ monocyte absolute count and prostatitis, with the mediation effects of −0.016 (14.20%) and −0.008 (7.24%), respectively. The glutamine degradant levels mediated the causal relationship between HLA DR+ CD4+ %T cells and prostatitis, with a mediation effect of −0.012, accounting for 8.07% of the total. The present study indicated that the immune cell subsets predicted based on gene expression profiles were potentially beneficial or harmful risk factors of prostatitis, and plasma metabolites may serve as the mediating factors of the relationship. The study thus shed light on deciphering the immunologic mechanism of prostatitis.
Comparison of third-generation minimally invasive surgery, split-drill osteotomy, and triplanar chevron osteotomy for treating mild to moderate hallux valgus with metatarsalgia in middle-aged women: An observational study
Authors: Cao Jianming , Guo Xuan , Zhang Yu , Wang Xin , Ni Yulong , Niu Chao , Yuan Ziyang , Xu Lihui , Zhang Fengqi
Published: October 2024

This retrospective study compared the clinical efficacy of third-generation minimally invasive surgery (3rd-MIS) split-drill osteotomy with soft tissue release to that of triplanar chevron osteotomy (TCO) for treating mild to moderate hallux valgus (HV) with metatarsalgia in middle-aged women. This study compared the efficacy of 3rd-MIS using split-drill osteotomy to that of TCO in treating mild to moderate HV with metatarsalgia in 52 middle-aged women from March 2022 to June 2023. Retrospectively analyzing a total of 52 patients (26 patients per group), we employed 2 distinct surgical methods across 2 groups in this study: the TCO group received a traditional TCO accompanied by soft tissue release, whereas the MIS group underwent a split-drill osteotomy with soft tissue release. The study compared the operation time, onset of weight-bearing, osteotomy healing, blood loss, pre- and postsurgery X-ray measurements, metatarsalgia, and foot function scores. In the TCO group, complications included peri-incisional numbness, elevation of the first metatarsal head with metatarsalgia, and bone hyperplasia with stiffness at the MTPJ in one patient each. In the MIS group, bunions were successfully corrected without significant complications like bone nonunion or avascular necrosis of the metatarsal head, and the metatarsal length was preserved. Significant differences in operation time, weight-bearing onset, healing, and blood loss were detected between groups (P < .05). Preoperatively, there were no significant differences in hallux valgus angle, 1–2 intermetatarsal angle, or distal metatarsal articular angle among the groups (P > .05). Nonetheless, notable postoperative differences were observed (P < .05). Foot function and pain scores, assessed by the American Orthopaedic Foot & Ankle Society and the Visual Analogue Scale, showed significant improvements in both groups following surgery. Both surgical techniques effectively corrected the HV angle without significant changes in the first metatarsal length. The MIS group experienced significantly less pain on the second day postsurgery, as indicated by lower Visual Analogue Scale scores (P < .05). Both techniques were similarly effective in treating metatarsalgia. 3rd-MIS split-drill osteotomy with soft tissue release offers several advantages over TCO techniques for treating mild to moderate HV with metatarsalgia in middle-aged women, such as reduced trauma, quicker healing, smaller scars, and less pain after surgery.