bluuebunny/crossref_metadata_2025 huggingface dataset:
Squamous cell carcinoma and adenocarcinoma appeared at different cervical sites: a rare case report
Authors: Chen Huihui , Wang Qingqi , King Min , Huang Wei , zhang Hao , Li Jiaxin , Xu Donghan , Zhao Lin , Wu Bowen , Lin Xin , Li Liqi , Zheng Yuhong , Niu Yihao , Huang Donghui , Yan Peiyu
Published: July 2024

Background
The concurrent development of adenocarcinoma and squamous cell carcinoma in separate regions of the cervix is extremely rare. We report a case of HPV-related adenocarcinoma and squamous cell carcinoma occurring at distinct locations within the cervix in a patient with primary cervical cancer stage IA1.
Case presentation
A 54-year-old female patient was found to be HPV type 18 positive during a routine physical examination, with Liquid-based Cytology Test (LCT) of the cervix indicating Atypical Squamous Cells of Undetermined Significance (ASCUS). Subsequent colposcopy-directed cervical biopsies identified mid-to-low grade squamous cell carcinoma at several locations (3, 6, 9, 12 o'clock positions and the ECC),and the clinical diagnosis was stage IA1. Preoperative comprehensive abdominal magnetic resonance imaging, including contrast enhancement, did not indicate any lymph node enlargement, and computed tomography urography of the urinary system was unremarkable. The squamous cell carcinoma antigen level was within the normal range.
On May 22, 2023, the patient underwent laparoscopic radical resection of cervical cancer under general anesthesia and the postoperative pathology indicated HPV-related squamous cell carcinoma of the cervix (at 11-12 o'clock positions) and HPV-related cervical adenocarcinoma (at 1 o'clock and 3-4 o'clock positions). No cancer invasion was found in the vagina, vaginal margin, or bilateral parametrium. There was no lymphovascular, blood vessel, or nerve invasion. Immunohistochemistry: Adenocarcinoma: Ki-67(90%+), P40(-), P16(diffuse+), MLH1(+), MSH2(+), MSH6(+), PMS2(+), P53(-, mutant type), CK7(+), CEA(+), ER(-), PR(-); Squamous cell carcinoma: P40(partial+), P63(+), ki-67(90%+), CK7(+), P16(diffuse+).
Conclusions
In this instance, the concurrent manifestation of both squamous cell carcinoma and adenocarcinoma in the cervix, both associated with HPV infection, underscores the likely pivotal role of HPV infection in this unusual phenomenon.Proactive HPV vaccination at an early stage is an effective preventive measure, and regular cervical cancer screenings can aid in the early identification of lesions, leading to improved treatment results.
Effect of oligosaccharyl transglycosylation on the cytotoxicity of cardiac glycoside proscillaridin A and its ability to inhibit hepatitis B virus infection
Authors: Wakamatsu Akira , Fujisawa Yu , Ohashi Hiroyuki , Kinoshita Takashi , Dozaki Masahito , Suda Minoru , Honda Tomoyuki , Ohashi Takao , Kajiura Hiroyuki , Ueda Keiji , Fujiyama Kazuhito , Misaki Ryo
Published: July 2024

Proscillaridin A, a cardiac glycoside, has been reported to inhibit taurocholic acid uptake via the sodium taurocholate cotransporter polypeptide, a functional receptor for hepatitis B virus (HBV), thereby directly or indirectly inhibiting HBV infection. However, the strong cytotoxicity of proscillaridin A complicates its application as a drug. This study focuses on how the glycan structure of glycosides significantly influences their functions and explores the reduction of cytotoxicity through enzymatic modification of proscillaridin A’s glycan structure. Novel glycosides featuring GN1-type oligosaccharides, derived from sialo- or asialo-N-linked glycans, were synthesized using scillaren A as an acceptor substrate. Scillaren A contains a glucose residue β1,4-linked to the rhamnose residue of proscillaridin A. The synthesis employed Endo-CC-N180H, a mutant of endo-β-N-acetylglucosaminidase. These novel glycosides dramatically reduced cytotoxicity and enhanced cell viability in cultured human hepatocellular carcinoma HepG2 cells. Monitoring of cell death revealed that necrosis by proscillaridin A was suppressed in HepG2 cells treated with the novel glycosides. Furthermore, these novel glycosides maintained an inhibitory potency against HBV infection similar to those of proscillaridin A and scillaren A. These results indicate that the transfer of N-linked glycan-derived oligosaccharides to glycosides may provide a promising platform for endowing them with novel functions for food and pharmaceutical applications.
Non-union Treatment in the arm, wrist, and fingers: A Multicenter Retrospective Study Contrasting Conventional Treatment with the Allogeneic Cortical Bone Screw (Shark Screw®)
Authors: Huber Elisabeth , Jakob Gerd , Palle Wolfgang , Borchert Gudrun H. , Pastl Klaus
Published: July 2024

Introduction:
The cause of pseudarthrosis is the interaction of various biological and biomechanical factors with systemic and local interactions. Successful therapy consists of a combination of optimizing mechanical stability and activating biological factors. The conventional method for treating non-union is debridement and stabilization with metal hardware. But it leads to complications and a potential second operation for hardware removal. The human allogeneic cortical bone screw (Shark Screw®) provides a close contact between allograft and host bone, which is required for revascularisation and bone healing. The Shark Screw® merges human cortical bone properties with screw stability, addressing non-union surgery principles by integrating mechanical and biological aspects.
Material and Methods: The retrospective-multi-center study included 31 patients, 11treated with the conventional method(metal hardware ± graft) and 20 patients with the Shark Screw® (±graft). Patient demographics, non-union location, autograft and/or allograft use, follow-up time, complications, union-rate, time-to-union and time-to-return to work were recorded.
Results: Follow-up was 17 months in the conventional group and 12 months in the Shark Screw® group. The union rate was 72.7% in the conventional group and 95.0% in the Shark Screw® group. Time to union was significantly shorter in the Shark Screw® group with 12 weeks in comparison to 39 weeks in the conventional group. Conclusion The Shark Screw® presents a reliable option for treating non-unions in the shoulder, forearm, hand, and fingers. It demonstrates a low complication rate. The human allogeneic cortical bone screw (Shark Screw®) combines both stability and biology with a single transplant. The socioeconomic effect is another advantage using the Shark Screw®. Level of evidence: III
Laparoscopic sleeve gastrectomy and laparoscopic sleeve gastrectomy with jejunojejunal bypass surgery in patients with obesity: a correlation analysis between body weight, inflammation, glucose metabolism, and sex
Authors: Feng Feng , Gao Yuqi , Zhang Jiaqi , Wang Guiqi , Peng Liping , Liu Yunjiang
Published: July 2024

Background
Bariatric surgery, which can be performed via laparoscopic sleeve gastrectomy (LSG) or laparoscopic sleeve gastrectomy with jejunojejunal bypass (LSG + JJB), is a promising treatment for patients with obesity. However, the influencing factors in LSG and LSG + JJB surgery remain unclear.
Methods
This study included 60 patients with obesity, divided randomly into LSG group and LSG + JJB group based on the surgical type. The weight loss and diabetes remission were compared at 3 months after surgery. Blood glucose metabolism indices including fasting blood glucose (FBG), homeostatic model assessment of insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), as well as inflammatory factors were measured.
Results
We found that the hypoglycemic effect in the LSG + JJB group was significantly superior to that in the LSG group. In the LSG + JJB group, weight was associated with inflammatory factors, including IL-8 (r = 0.431, P = 0.017), TNF-α (r = 0.381, P = 0.038), IL-10 (r = 0.410, P = 0.024), and glucose metabolism indicators FBG (r = 0.360, P = 0.050) and HOMA-IR (r = 0.374, P = 0.042). In addition, we observed a correlation between inflammatory factors and glucose metabolism in this group. The operative effect was also found to correlate with sex; males showed a more optimal effect in decreasing glucose metabolism and reducing inflammatory factors than females who underwent LSG + JJB surgery.
Conclusion
LSG + JJB surgery was related to inflammation, glucose metabolism, and sex, providing valuable insights for effective treatment approaches targeting individuals with obesity.
Detection of hepatocellular carcinoma feeding vessels: MDCT angiography with 3D reconstruction versus digital subtraction angiography
Authors: Ahmed Ramy M. , Ali Wageeh A. , AbdelHakam Ahmed M. , Ahmed Sayed H.
Published: July 2024

Background:
Accurate detection of Hepatocellular carcinoma (HCC) feeding vessels during transcatheter arterial chemoembolization (TACE) is important for an effective treatment, while limiting non-target embolization. This study aimed to investigate the feasibility and accuracy of three dimensional (3D) CT angiography for tumor-feeding vessels detection before TACE compared to DSA.
Methods:
Sixty-nine consecutive patients referred for TACE from May 2022 to May 2023 were included. (3D) CT images were reconstructed from the pre-TACE diagnostic multiphasic contrast enhanced CT images and compared with non-selective digital subtraction angiography (DSA) images obtained during TACE for detection of HCC feeding vessels. A "Ground truth" made by consensus between observers after reviewing all available images to detect the true feeding vessels was the gold standard. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy and ROC curve with AUC were calculated for each modality and compared.
Results:
A total of 136 active HCCs were detected in the 69 consecutive patients included in the study. 185 feeding arteries were detected by 3D CT and DSA and included in the analysis. 3D CT detection of feeding arteries revealed mean sensitivity, specificity, PPV, NPV and accuracy of 91%, 71%, 98%, 36%, and 90%, respectively, with mean AUC = 0.81. DSA detection of feeding arteries revealed mean sensitivity, specificity, PPV, NPV, and accuracy of 80%, 58%, 96.5%, 16.5% and 78%, respectively, with mean AUC = 0.69.
Conclusions:
3D CT angiography images are more accurate than non-selective DSA in detection of HCC feeding arteries and very useful in planning for TACE procedure.
Trial registration:
This study was prospectively registered at Clinicaltrials.gov with ID NCT05304572; Date of registration: 2-4-2022.
Can appropriate surgical wound management prevent surgical site infection after malleolar fracture surgery?
Authors: Sugiura Sara , Oh Yoto , Kaku Takumi , Amano Yusuke , Yoshii Toshitaka
Published: July 2024

Purpose
Surgical wound healing failure is the most common complication of malleolar fracture surgery, and appropriate treatment is important to prevent surgical site infection (SSI). This study aimed to determine the incidence of wound healing failure and deep surgical site infection under strict standardized surgical wound management after malleolar fracture surgery.
Methods
Sixty-two patients who underwent surgery for malleolar fracture (AO/OTA classification 44) were reviewed. Strict assessment and surgical intervention were performed even for trivial failure in all wound healing failure cases. The exclusion criteria were open wound, tibial diaphysis fracture, and follow-up < 6 months. Surgical wound healing failure, deep SSI, and posterior fixation status were evaluated in the 42 patients (44A, n = 5; 44B, n = 30; 44C, n = 7) finally included in the study. Patients with a 44B fracture were divided into a B1/B2 group (n = 10) and a B3 group (n = 20) for subgroup analysis to clarify the relationship between severity of malleolar fracture and incidence of surgical wound healing failure.
Results
The incidence of surgical wound healing failure was 19%, but there were no deep SSI. Two of 6 patients who underwent internal fixation for posterior malleolar fragments were complicated with wound failure. Surgical wound healing failure incidence was higher in the B3 group than in the B1/B2 group (30% vs 10%, p = 0.37).
Conclusions
More cases of wound healing failure and less deep SSI were detected in this study compared with previous studies. Strict standardized surgical wound management could help to avoid SSI after malleolar fracture surgery.
Exploring the role of maternal routine and problem-solving actions in promoting child health and nutrition in Kenyan drylands: a qualitative study
Authors: Kiprono Patricia Jebet , Hensel Oliver , Kaufmann Bigitte A
Published: July 2024

Background
In the drylands of northern Kenya, mothers strive to promote the health and nutritional well-being of their children, but face many challenges. Most studies, especially those focusing on (agro-)pastoralists use a problem-lens, with recommended standard interventions to improve child nutrition that do not necessarily fit to the local conditions. This study aims to explore (agro-)pastoral women’s knowledge and their practical solutions in child nutrition and care, uncovering their routine and problem-solving actions.
Methods
The Activity Knowledge Analysis tool was used in 16 Focus Group Discussion sessions with caregivers of children below the age of five years from Rendille, Burji and Borana communities in Marsabit County, Kenya. The discussions were recorded, transcribed and thematically analysed using MAXQDA software.
Results
Mothers explained their routine actions which included age-appropriate feeding practices, maintaining hygiene, and facilitating the child’s developmental milestones to achieve their goal of having a healthy child. Some of the routine actions include providing special diets, responsive feeding; personal, food and environmental hygiene; massage, engagement in play and interaction to facilitate development. The challenges that mothers face include maintaining their own health, difficulties with feeding, and delayed developmental milestones. These challenges are further compounded by contextual factors; poverty, time constraints and lack of support. To overcome the challenges, mothers used a range of problem-solving actions, including enriching their children’s diets, diversifying their income sources, borrowing food or money, and seeking for social support from family members and the community.
Conclusion
Participatory approaches, such as the use of the Activity Knowledge Analysis tool, have proved useful in exploring caregivers' knowledge, challenges, routines and problem-solving actions that go unnoticed when using surveys, such as the knowledge, attitudes and practices survey. Interventions that take into account mothers’ knowledge and problem-solving activities are better adapted to the cultural, social, economic and environmental conditions and can therefore be more effective in improving the health and nutritional status of their children.
Osimertinib resistance-based immune prognostic related gene signature in EGFR mutant lung adenocarcinoma, in which PSMD11 promotes tumor progression
Authors: Bai Yuquan , Xu He , Gong Xiaokang , Bao Peilong , Zhao Jinbo , Tao Jiang
Published: July 2024

Background
At present, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) treatment, as the first-line treatment of lung adenocarcinoma (LUAD) with EGFR mutation, has achieved good clinical efficacy, but most patients will eventually develop acquired resistance. Therefore, there is an urgent need to develop a strong standard to identify drug-resistant patients with EGFR mutation who can benefit from other treatments.
Methods
Based on the differentially expressed genes between osimertinib (OSI)-resistant cells (PC9OR, H1975OR) and non OSI-resistant LUAD cells (PC9, H1975), the EGFR mutant LUAD prognosis related genes from TCGA database, and the immune genes from ImmPort and InnateDB websites, we constructed an immune prognosis model of OSI resistance to predict the outcome of EGFR mutant LUAD patients. Then, according to the risk score, EGFR mutant LUAD patients were divided into high- and low-risk groups, and the molecular, immune characteristics and responsiveness to chemotherapy and targeted drugs were analyzed. Next, PSMD11 was knocked down using siRNA to evaluate the effects of PSMD11 on PC9OR and H1975OR cells. Finally, the correlation between PSMD11 and OSI resistance was determined in vitro via CCK-8, colony formation assays and flow cytometry, and in vivo via western blot and immunohistochemistry.
Results
We constructed an immune prognostic prediction model consisting of four OSI-resistant genes (C3, PSMD11, G3BP1, TRIB2), and clarified its accuracy in predicting the prognosis of EGFR mutant LUAD patients. According to the risk score classification, high-risk EGFR mutant patients were more sensitive to traditional chemotherapy and targeted drugs, with higher expression of immune checkpoints PD-1, LAG3, IDO1, and more infiltration of CD8 + T cells, M0/M1 macrophages and NK cells. In addition, knockdown of PSMD11 could inhibit cell proliferation, promote cell apoptosis, and increase the sensitivity of drug-resistant cells to OSI. And compared with individual treatment, the combination treatment of PSMD11-siRNA and OSI in PC9OR and H1975OR cells could significantly inhibit cell proliferation and promote tumor growth. In addition, PSMD11 could promote the progression of OSI-resistant LUAD by activating the NF-κB/IL-6/STAT3 signaling pathway.
Conclusions
our work provide a powerful prediction tool for further screening OSI-resistant LUAD patients suitable for chemotherapy, targeted therapy and immunotherapy.
Bioactive amines in non-conventional edible plants from Brazil: health benefits and concerns
Authors: Dala-Paula Bruno Martins , Todescato Angélica Pereira , Gonçalves José Eduardo , Glória Maria Beatriz Abreu
Published: July 2024

Some bioactive amines in foods are associated with beneficial health effects, but also with food poisoning and intolerance. This study aimed to investigate the levels of nine bioactive amines in ten fruits and vegetables from Brazil using HPLC-FL. Total amine levels ranged from 3.24-58.83mg/kg in serralha and seriguela, respectively. Tryptamine was not detected in any sample. The highest spermidine level was found in seriguela (13.41mg/kg). Putrescine was the prevalent amine in custard apple, acerola, and ora-pro-nobis; spermidine, in jabuticaba, starfruit, and kale; tyramine, in seriguela and marolo. Histamine was detected only in ora-pro-nobis, serotonin, in starfruit, and high agmatine levels were found in acerola, starfruit and serralha. Based on amine levels, seriguela, marolo, custard apple, acerola, jabuticaba, and kale could be dietary sources of polyamines, and starfruit a source of serotonin. However, individuals in use of monoamine-oxidase inhibitors may consider limiting the consumption of seriguela and marolo to avoid adverse effects.
Prediction of coronary heart disease risk integrating polygenic risk scores and wearables
Authors: Shi Qiaoxin , Jang Haeyoon , Wang Mengyao , Yeung Shiu Lun Au , Luo Shan , Wan Eric Yuk Fai , Sharp Stephen J , Brage Soren , Wareham Nickolas , Kim Youngwon
Published: July 2024

Prediction of coronary heart disease (CHD) risk through standard equations relying on laboratory-based clinical markers has proven challenging and needs advancement. This study aims to derive and cross-validate CHD-risk prediction models based on lifestyle behaviours including wearables and polygenic risk scores (PRS), and compare their performance with the established Pooled Cohort Equations (PCE). This study included 291,151 white British individuals in the UK Biobank. Cox regression was applied to derive the Lifestyle-Based Model (LBM) for CHD-risk prediction incorporating age, sex, body mass index, dietary intake score (0-3; derived from self-reported food types), smoking status (never, previous, current), and physical activity (wearable-device-derived Euclidean Norm Minus One). Weighted PRS for CHD was calculated based on 300 genetic variants. Over a median 13.8-year follow-up, 13,063 CHD incidence cases were ascertained. The C-index (indicative of discrimination) of the LBM and PCE was 0.713 (95% Confidence Interval [CI]: 0.703-0.722) and 0.714 (95% CI: 0.705-0.724). Adding PRS to LBM and PCE increased the C-index to 0.733 (95% CI: 0.724-0.742) and 0.726 (95% CI: 0.716-0.735), respectively. The LBM with and without PRS both demonstrated good calibration, as evidenced by p-values of 0.997 and 0.999, respectively. The addition of PRS to LBM marginally improved calibration, with the slope increasing from 0.981 to 0.983. Integrating PRS resulted in a positive categorical net reclassification improvement (cut-off point: 7.5%) of 4.30% for LBM and 5.04% for PCE. Models incorporating either lifestyle behaviours alone or in combination with genetic traits demonstrated acceptable accuracy for CHD risk prediction.
Modulation of Hormonal, Metabolic, Inflammatory and Oxidative Stress Biomarkers in Women with Polycystic Ovary Syndrome following Combined (resistant and endurance) Training: A Randomized Controlled Trail
Authors: Nasiri Masoud , Monazzami Amirabbas , alavimilani Solmaz , Asemi Zatollah
Published: July 2024

Purpose
Polycystic ovary syndrome (PCOS) is a frequent disorder among women. Exercise training has been known as an effective treatment for this disorder; however, there is small amount of evidence examining the optimal exercise programs. We evaluated the function of combined (COM) training on metabolic, hormonal parameters, and biomarkers of oxidative stress and inflammation in PCOS patients.
Methods
This randomized controlled clinical trial was conducted on 30 women with PCOS divided (age: 23.8 ± 5.3 years, height:162.8 ± 4.9 cm, weight: 82.4 ± 9.7 kg, body mass index: 30.3 ± 3.9 kg/m2) into two groups to receive COM training intervention (n = 15) or control group (n = 15) for eight weeks. At the baseline and end-of-intervention, metabolic profiles including fasting plasma glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), lipid profiles, testosterone, free androgen index (FAI), sex hormone binding globulin, anti-Müllerian hormone, malondialdehyde, total antioxidant capacity, and high Sensitive-C reactive protein were evaluated
Results
After eight-week intervention in training group, insulin (P < 0.001), HOMA-IR (P < 0.001), total cholesterol (P < 0.001), LDL-cholesterol (P < 0.001), total testosterone (P < 0.001), AMH ( P = 0.02),MDA (P = 0.04) and FAI (P < 0.001) were significantly decreased, while QUICKI (P = 0.002) was remarkably increased compared with the control group. Moreover, findings showed that there are no significant differences in other variables in the training group compared to the control group.
Conclusions
We concluded that combined training is more effective than resistance or endurance trainings alone for treatment of PCOS, although further studies are needed to reach comprehensive data regarding the design of exercise protocols for PCOS patients.
Safety of Adenosine for Pediatric Tachyarrhythmia Treatment in the Emergency Department: a Multi-Hospital 10-year Cross-Sectional Study
Authors: Randall Melanie , Burt Tristen , Cruise Scott , Mesisca Michael , Minahan Thomas
Published: July 2024

Background
Supraventricular tachycardia is the most common dysrhythmia in children. Initial vagal maneuvers are successful less than half of the time. Adenosine, a potent AV nodal blocker with short half-life, is recommended as first line pharmacotherapy. Minor side effects from adenosine are common, but report of serious side effects such as sustained ventricular tachycardia, torsades de pointes, syncope or hypotension are confined to small case series or studies greater than 20 years old. We aimed to specifically identify the incidence of serious side effects of adenosine in children in the emergency department.
Methods
Between 2002 and 2022, all children less than 18 years old who received adenosine for tachyarrhythmia treatment in one of two emergency departments were included. The electronic record was reviewed for demographic information, patient history, treatments given, and side effects or complications were observed. Electrocardiograms before, during and after adenosine administration were reviewed.
Results
77 patients met inclusion criteria. There were 73 patients with an initial rhythm of typical SVT. The other four patients included one with SVT with aberrancy, one with a junctional rhythm, one with atrial fibrillation, and one with an undetermined narrow complex tachycardia. 50 patients had cardiac rhythm monitoring during adenosine administration. 17 of these patients had three or more consecutive ventricular beats following adenosine, however no patients required treatment. No patients had syncope. One patient had brief hypotension after adenosine that normalized without intervention. Four patients were electrically cardioverted due to persistent SVT. Twelve patients were placed on continuous antiarrhythmic medication for persistent SVT. The patient with atrial fibrillation remained in atrial fibrillation despite adenosine and electrical cardioversion three times. The patient with undetermined tachycardia had no response to adenosine or amiodarone, then had brief cardiac arrest after intubation. Echocardiography showed heart failure.
Conclusions
Adenosine treatment in typical supraventricular tachycardia in pediatric patients is safe.
The effectiveness of vitrified zygote accumulation for managing the extremely diminished ovarian reserve in infertile women: a retrospective cohort study
Authors: Huang Pi-Tsang , Tsai Ni-Chin , Lin Yu-Ju , Lien Hao-Ting , Hsiao Yu-Yang , Su Yu-Ting , Huang Hsuan-Wei , Lan Kuo-Chung
Published: July 2024

Background
Accumulated vitrified embryos are stored for later thawed transfer to deal with poor responders. However, the cost and outcome of vitrified zygotes have yet to be studied. Our study aimed to investigate the effectiveness of the vitrified zygote accumulation method in diminished ovarian reserve patients.
Methods
This retrospective study included 122 diminished ovarian reserve patients who met the Poseidon classification groups 3 and 4 from June 1, 2019, to December 31, 2022. The patients underwent controlled ovarian stimulation and embryo transfer using accumulated vitrified zygotes. The clinical pregnancy rate and live birth rate per embryo transfer and stimulation cycle are evaluated.
Results
Two hundred seventy-eight IVF/ICSI cycles in one hundred twenty-two females treated at our institution were divided into two groups, according to age < 40 years (n = 51) and ≥ 40 years (n = 71). The younger group had significantly more favorable outcomes than the older group only in live birth rates per cycle (12.6% vs. 4%, p = 0.029) and per transfer (24.1% vs. 9.9%, p = 0.027). However, the older group had more embryos per transfer (2.4 ± 0.9 vs. 2.0 ± 0.8, p = 0.014). There were no differences between the number of stimulation cycles per patient, the number of oocytes and mature oocytes retrieved, the number of transfer cycles per patient, the cost per patient, or transfer. We set a model mimicking the cost of fresh embryos. The zygote accumulation strategy costs were higher per patient and per cycle than those of the fresh embryo transfer model.
Conclusions
In diminished ovarian reserve women undergoing IVF/ICSI treatment, younger women had significantly better live birth rates than the older women applying the vitrified zygote accumulation strategy, even though the older group had a higher number of embryos per transfer. However, the zygote accumulation strategy benefits older women more than fresh embryo transfer. The strategy might cost more but decrease the anxiety and stress.
The effect on colorectal cancer incidence and stage with population-based FOBT-screening in Sweden
Authors: Wilén Hanna Ribbing , Jonsson Håkan , Blom Johannes
Published: July 2024

Aim
To investigate colorectal cancer (CRC) incidence and stage of disease in the population invited vs not invited to the guaiac-based Fecal Occult Blood (gFOBT) and Fecal Immunochemical Test (FIT) colorectal cancer screening program in Stockholm-Gotland, Sweden, 2008–2021 and to estimate the incidence rate by gender and localization in the colorectum.
Methods
The study cohort consisted of all 60-69-years-old residents of the Stockholm-Gotland region 2008–2012 according to the population register. Screening with biennial gFOBT was introduced in randomized birth cohorts from 2008 and replaced by FIT with cut-off level 40µg/g in women and 80µg/g in men for a positive test in 2015. Record linkage was made to the National Cancer Register and to the Swedish Colorectal Cancer Register (SCRCR). The age-standardized CRC incidence ratio was compared in invited and non-invited during screening and in 70-75-year-olds and assessed overall and by gender, CRC stage and localization.
Results
In total, 320 989 and 151 533 individuals were invited to a first gFOBT and FIT round, and 5 972 CRCs were diagnosed. During screening, the overall age-adjusted incidence ratio for the gFOBT- and FIT-invited compared to the non-invited was 0.99 (95% CI 0.91–1.07) and 1.03 (95% CI 0.93–1.15) respectively. Post screening, 70–75 years of age, the overall incidence rate was 12% lower among the invited than the non-invited (RR 0.88, 95% CI 0.81–0.97). During FIT screening, the incidence for stage I and proximal CRC was 38 and 23% higher than in the non-invited (RR 1.38, 95% CI 1.09–1.76 and RR 1.23, 95% CI 1.02–1.48 respectively). The incidence post screening was 22% lower regarding stage I CRC, 13% lower in women, and 17% lower for distal CRCs as compared to the non-invited (RR 95% CI 0.78 0.63–0.95, 0.87 0.76-1.00 and 0.83 0.74–0.94 respectively).
Conclusion
In the Stockholm-Gotland screening program the shift to FIT significantly increased the incidence rate in early staged and proximal CRCs as compared to the uninvited, and the significant decrease in the overall CRC incidence post screening was mainly seen in distal, early staged CRCs in women.
Development and validation of a prediction model for esophageal varices by changes in spleen size after Rex surgery
Authors: Chen Yunpei , Chen Zhiqiang , Chen Liu , Chen Jiancai , Zeng Linyi , Wen Zhe
Published: July 2024

Purpose To develop a noninvasive prediction model for esophageal varices (EVs) based on changes in spleen size after Rex surgery.
Method The clinical data of children with cavernous transformation of the portal vein who underwent Rex surgery at the Department of Hepatobiliary Surgery of our hospital from 2014-09 to 2021-12 were collected, and the children were divided into a no-to-mild group and a moderate-to-severe group according to the EV status on postoperative gastroscopy. Variables related to changes in spleen size were included in logistic regression models. Construction and internal validation of a postoperative moderate-to-severe EV risk prediction model.
Results A total of 78 children were included, 55 in the no-mild group and 23 in the moderate-severe group. The splenic thickness difference (STD), splenic long diameter difference (SDD), and splenic volume difference (SVD) were included in the multifactorial logistic regression analysis, and the regression equation obtained was modeled as logit(P)= -STDx0.18-SVDx0.011+0.502. The STD and SVD are independent risk factors for moderate-to-severe EV after surgery. The area under the ROC curve was 89.73%, the optimal threshold point was -0.952, and its specificity and sensitivity were 82.6% and 83.3%, respectively.The model was internally validated, and the C-index was 0.897, indicating good discrimination and calibration.
Conclusion The model constructed by multifactorial logistic regression is valuable and effective for the noninvasive detection of postoperative EVs, and deserves further research.
The effect of inflammatory cytokines on the risk of hypertrophic scar: A Mendelian Randomization Study
Authors: Qi seven , Ma Ashia , Lin Hai , Peng Liangyuan , Deng Eminlam
Published: July 2024

Objectives: Hypertrophic scar (HS) results from burns or trauma, causing aesthetic and functional issues. However, observational studies have linked inflammatory cytokines to HS, but the causal pathways involved are unclear. We aimed to determine how circulating inflammatory cytokines contribute to HS formation.
Methods:
Two-sample Mendelian randomization (MR) was used to identify genetic variants associated with hypertrophic scar in a comprehensive, publicly available genome-wide association study (GWAS) involving 766 patients and 207,482 controls of European descent. Additionally, data on 91 plasma proteins were drawn from a GWAS summary involving 14,824 healthy participants. Causal relationships between exposures and outcomes were investigated primarily using the inverse variance weighted (IVW) method. Furthermore, a suite of sensitivity analyses, including MR‒Egger and weighted median approaches, were concurrently employed to fortify the robustness of the conclusive findings. Finally, reverse MR analysis was conducted to evaluate the plausibility of reverse causation between hypertrophic scar and the cytokines identified in our study.
Results: In inflammatory cytokines, there was evidence of inverse associations of osteoprotegerin(OPG) levels(OR = 0.59, 95% CI =0.41~0.85, p=0.01), and leukemia inhibitory factor(LIF) levels(OR = 0.51, 95% CI =0.32~0.82, p=0.01) are a nominally negative association with hypertrophic scar risk, while CUBdomain-domain-containing protein 1(CDCP1) level(OR = 0.59, 95% CI =0.41~0.85, p=0.01) glial cell line-derived neurotrophic factor(GDNF) levels(OR = 1.42, 95% CI =1.03~1.96, p=0.01) and programmed cell death 1 ligand 1(PD-L1) levels(OR = 1.47, 95% CI =1.92~2.11, p=0.04) showed a positive association with hypertrophic scar risk. These associations were similar in the sensitivity analyses.
Conclusions: According to our MR findings, OPG and LIF have a protective effect on hypertrophic scar, while CDCP1, GDNF, and PD-L1 have a risk-increasing effect on Hypertrophic scar. Our study adds to the current knowledge on the role of specific inflammatory biomarker pathways in hypertrophic scar. Further validation is needed to assess the potential of these cytokines as pharmacological or lifestyle targets for hypertrophic scar prevention and treatment.
Magnetic beads as intravesical foreign bodies in children: Our clinical experience
Authors: Zeng Yefeng , Huang Shaogang , Yang Zhilin , Gu Xianbin , Sun Xuerui , Chen Pengyu , Li Shoulin
Published: July 2024

Purpose
Magnetic beads as intravesical foreign bodies in children are relatively rare. This study retrospectively analyzes the clinical data of five patients involving intravesical magnetic beads, summarizing diagnostic and therapeutic experiences.
Methods
From January 2018 to November 2023, five pediatric patients were treated for intravesical magnetic beads at Shenzhen Children's Hospital, China. We retrospectively reviewed and analyzed the records of these patients, including demographic characteristics, clinical symptoms, imaging studies, and treatment methods
Results
All intravesical magnetic beads were retrieved from patients’ bladders. The patients ranged from 12 to 14 years, with a mean age of 13 years. Depending on the number of magnetic beads, their aggregation state, and the time since insertion, Three cases were successfully retrieved via cystoscopy, one via laparoscopy under pneumovesicum, and another via open surgery. There were no complications observed during the postoperative follow-up.
Conclusion
Magnetic beads are a relatively rare type of intravesical foreign bodies and should be surgically removed as soon as possible. Cystoscopy is the first method for both diagnosis and treatment. When magnetic beads cannot be retrieved via cystoscopy, pneumovesicoscopy may be a viable option for the retrieval of foreign bodies. When endoscopic techniques are unsuitable or have failed, open surgery is a necessary option.
Intelligent real-time multi-functional packaging of rainbow trout fillet containing anthocyanin-rich Althaea Officinalis extract encapsulated with poly (vinyl alcohol) electrospun nanofiber mats
Authors: Roshani-Dehlaghi Negar , Ekrami Mohammad , Emam-Djomeh Zahra , Yousefi Shima
Published: July 2024

The current study was conducted to fabricate poly(vinyl alcohol) (PVA) electrospun nanofiber mats containing anthocyanin-rich Althaea Officinalis extract (AOEX; 5, 10, 15 and 20%v/v) to monitor the spoilage and enhance the shelf-life quality of rainbow trout fillet. The AOEX displayed colour change when subjected to the different pH buffer solutions. The optimum conditions for fabricating PVA nanofibers with a minimum diameter (204.9 nm) were found using response surface methodology (RSM). The viscosity, electrical conductivity and surface tension of PVA-AOEX solutions were significantly changed up to 993.2 cp, 1275.65 µS/cm and 54.16 mN/m, respectively, by increasing AOEX content. The IC50 values for DPPH and ABTS radical scavenging by AOEX were 375 and 800 ppm, respectively. The phytochemical and antibacterial properties of PVA-AOEX were improved by adding AOEX content. Microscopic images confirmed the increase in the diameter and roughness of PVA-AOEX nanofibers by adding the AOEX up to 480.9 nm. After the addition of AOEX, the PVA-AOEX nanofibers become more hydrophilic (θ = 47.6–73.1°), but the melting temperature (Tm) values of the PVA-AOEX nanofiber mats have decreased (217.6°C). Fourier-transform infrared spectroscopy (FTIR) showed that adding AOEX and electrospinning process does not have a negative effect on the structure of the PVA. The PVA-AOEX nanofibers mats, revealing that the real-time multi-functional innovative packaging changed colour from white to brown and, at the same time, exceeded the total viable count (TVC) and total volatile basic nitrogen (TVB-N) acceptance limit of rainbow trout fillet.
Is antiparasitic treatment beneficial in chronic subarachnoid neurocysticercosis? A comparative case series
Authors: Angerri-Nadal Mireia , Arroyo-Pereiro Pablo , Sauque Georgina , Pelegrin Ivan , Martínez-Yélamos Antonio , Martínez-Yélamos Sergio , Cabellos Carmen , Muñoz-Vendrell Albert
Published: July 2024

Neurocysticercosis is particularly severe when affecting the subarachnoid space (SUBNCC). While antiparasitic therapy effectively controls the infection, it can lead to significant complications. This study aims to characterize a cohort of patients with SUBNCC, with a focus on their clinical course depending on therapeutic interventions. We conducted an observational, retrospective study involving patients diagnosed with SUBNCC at a tertiary hospital between 1985 and 2022. The primary endpoint was to delineate the clinical progression and demographic features of the cohort. A secondary objective was to compare relapse rates between patients receiving antiparasitic treatment and those who did not. Fifteen patients were included, with a median age of 31 years, mainly from South America. Approximately 46.7% of patients experienced at least one relapse, with rates of 46% in patients initially treated with antiparasitic medication and 50% in those treated with steroids alone. Complication rates were similar between both groups. Comparison of time to relapse revealed no statistically significant difference (17/27 treated with antiparasitic medication versus 10/27 with corticosteroids only; p=0.39). In patients with SUBNCC, clinical relapses managed with corticosteroids alone do not appear to result in worse outcomes in terms of complications and relapse rates compared to those managed with antiparasitic medication.
Developing a monitoring protocol for a threatened species in a developing country: lessons learned from monitoring the Togean Islands babirusa
Authors: Jati Agus Sudibyo , Broto Bayu Wisnu , Dri Gabriela Franzoi , Rej Ikeu Sri , Mortelliti Alessio
Published: July 2024

Monitoring is a critical step in evaluating the efficacy of conservation measures, and having an effective monitoring protocol can serve as a warning system for population decline. We performed a power analysis to develop a camera trap-based monitoring protocol to detect occupancy changes of the endangered Togean Islands babirusa (Babyrousa togeanensis) as a case study for a threatened species in a developing country. We divided our study sites, representing the entire distribution range of the species, into three areas following the species occupancy probability: high, medium, and low occupancy, and estimated the required sampling efforts to detect declines in occupancy in each area. Under a realistic sampling scenario, our protocol is able to detect a 20% occupancy decline in high occupancy areas and a 40% decline in medium occupancy areas. The low occupancy area requires unrealistic sampling efforts to monitor changes in occupancy. We provide budgeting estimations relevant to developing countries in performing the monitoring protocol, as well as strategies to allocate limited funding. Furthermore, we derived some lessons from our study as guidelines for practitioners to develop and implement a cost-effective monitoring protocol for threatened species in developing countries, particularly by considering the species traits, management boundaries, priority areas, and budget constraints.
A Cohort, Semi-Randomized, Open Label Quality Improvement Patient Blood Management (PBM) Comparison of Point of Care Viscoelastic Coagulation Monitors in Cardiac Surgery
Authors: Spiess Bruce , Burger Melissa , Michael Mary Jane , Pellitier Peter , Garvan Cynthia , Zumberg Marc , Gore Stephanie
Published: July 2024

Purpose: Viscoelastic testing (VET), recommended for heart surgery, has not been adopted due to lack of timely point of care (POC) technology. Several POC VET devices have become available. The purposes of this quality initiative (QI), part of a patient blood management program-PBM), were to: 1) Compare two POC VET for timeliness 2) Survey need, ease of use, acceptability, and set up for the on-going PBM program.
Methods: The TEG-6s and the Quantra Q-plus Hemostasis Analyzer, were assessed in cardiac patients (n = 68) over a six-week period (May 15 -June 30, 2021). Timeliness of data acquisition was analyzed. Algorithms to assist physicians in therapeutic interventions were created. Cardiac members answered quality assessment surveys. Impacts on blood ordering were analyzed compared to a corresponding 6-week period pre COVID-19 epidemic.
Results: Prior to the QI initiative, respondents noted time problems for laboratory coagulation analysis and acquisition of blood products. TEG 6s reporting time was 24.9 +/-4 minutes. Quantra Qplus required 49% less time, 12.9 +/- 1.3 minutes (P<0.0001). No differences in transfusion were seen. The use of POC VET reduced blood products ordered, unused, returned to the blood bank.
Conclusions: We describe head-to-head testing prior to implementation as the next step in PBM QI. Quantra Qplus was twice as fast. Clinicians preferred the speed, ease of use, and interpretability of the Quantra. Large studies are needed to investigate the PBM benefit of POC VET.
Preparation and properties of nanocomposite films based on carboxymethylcellulose and melanin from Cladosporium endophytic fungus
Authors: Atakhanov Abdumutolib , Ashurov Nurbek , Abdurazakov Muhitdin , Shakhobutdinov Siroj , Yugay Svetlana , Mamadiyorov Burhon , Abdulmyanova Liliya , Ruzieva Dilaram , Nasmetova Saodat , Gulyamova Toshkhon , Yildiz Huseyin Bekir
Published: July 2024

Recently, there has been increased interest in melanins, representatives of the class of condensed polyphenols that find wide practical applications in various industries. In this study, melanin was isolated from the endophytic fungus Cladosporium sp.-HT207, and a polymer nanocomposite was developed based on melanin, using carboxymethylcellulose as a matrix. The structure and physicochemical properties of the nanocomposite films were studied using FTIR spectroscopy, X-ray diffraction, thermal analysis, atomic force microscopy, and mechanical testing. The antibacterial, antifungal, anti-inflammatory, and antioxidant activities of the nanocomposite films were also investigated. It has been found that films containing 0.15% of melanin nanoparticles exhibit relatively high anti-inflammatory and antioxidant activities. The resulting nanocomposite films may have applications in biomedicine, pharmaceuticals, and cosmetology.
First-trimester triglyceride glucose-body mass index as a risk marker for gestational diabetes mellitus
Authors: Xiang Junmiao , Guo XueKe , Pan Yundong , Cai Zhuhua
Published: July 2024

Introduction:
Gestational diabetes mellitus (GDM) is a significant pregnancy complication. Early identification of at-risk women is crucial for prevention. This study evaluates the first-trimester triglyceride glucose-body mass index (TyG-BMI) as a GDM predictor.
Methods
A retrospective study on 943 patients from The Third Affiliated Hospital of Wenzhou Medical University analyzed TyG-BMI’s correlation with GDM using logistic regression and stratified analyses. The area under the curve (AUC) assessed TyG-BMI’s diagnostic performance. Scatter plots and Pearson correlation analysis have clarified the link between TyG-BMI and neonatal birth weight, as well as the link between TyG-BMI and OGTT glycemic measures.
Results
In a study of 943 participants, 170 developed GDM, while 773 did not. Elevated TyG-BMI levels were linked to a higher GDM risk. The odds ratio (OR) for GDM was significant in all models, with the highest OR in the fully adjusted model (OR = 1.063, 95% CI: 1.031–1.097). TyG-BMI levels showed a linear relationship with GDM risk and outperformed other measures in diagnostic accuracy, with an AUC of 67.4% (95% CI: 62.9%-72%). TyG-BMI had a strong positive correlation with fasting blood glucose levels (r = 0.347, P < 0.001), but not with 1-hour or 2-hour levels in patients with GDM. It was also significantly higher in the triple positive group compared to single and double positive groups, although no significant link was found between TyG-BMI and neonatal birth weight.
Discussion
Our study indicates that the TyG-BMI index, measured in the first trimester, is an independent and effective predictor of GDM.
Admission Pulse Pressure and in-hospital mortality in Type A Acute Aortic Dissection- Result from a Chinese study
Authors: Liu Yuxin , Wang Liyuan , Zhang Shijie , Li Jinzhang , Cui Yuqi , Yun Yan , Ma Xiaochun , Zhang Haizhou
Published: July 2024

Objectives:
In recent years, several epidemiologic studies have shown that pulse pressure (PP) is a powerful predictor of mortality from many cardiovascular diseases. However, few studies have reported the association between PP and adverse events during hospitalization in patients with type A acute aortic dissection (TAAAD). The aim of this study was to evaluate the relationship between admission PP and in-hospital all-cause mortality, in patients with TAAAD.
Methods:
Patients with TAAAD admitted from January 2015 to December 2021 were included and divided into four groups according to the PP values measured at the time of admission: reduced group (PP ≤ 40 mmHg), normal group (40 < PP ≤ 56 mmHg), mildly elevated group (56 < PP ≤ 75 mmHg), and significantly elevated group (PP > 75 mmHg). A multivariate binary logistic regression model was constructed, plotted using nomogram and evaluated with ROC curve.
Results:
Admission PP and in-hospital all-cause mortality showed a "J-curve" correlation and in-hospital all-cause mortality was significantly higher in the significantly elevated group and reduced group (P = 0.003), respectively. Multivariate binary logistic regression analysis showed that significantly elevated PP (PP > 75 mmHg) (P<0.001) and reduced PP (P = 0.043), D-dimer (P<0.001), ascending aortic diameter (P = 0.037), Abdominal visceral vessels involved (P = 0.019), and coronary atherosclerosis (P = 0.017) and emergent surgery (P < 0.001) were independent predictive factors for in-hospital all-cause mortality. The AUC of ROC plotted was 0.825 (95% CI, 0.780–0.870).
Conclusions:
Our findings demonstrated a "J-curve" association of admission PP with in-hospital all-cause mortality in TAAAD. Significantly elevated and reduced admission PP, D-dimer, ascending aortic diameter and coronary atherosclerosis were independent risk factors for in-hospital all-cause mortality in patients with TAAAD, and emergent surgery was a protective factor.