bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial Intelligence in Plastic Surgery: Insights from Plastic Surgeons, Education Integration, ChatGPT’s Survey Predictions, and the Path Forward
Authors: Farid Yasser , Fernando Botero Gutierrez Luis , Ortiz Socorro , Gallego Sabrina , Zambrano Juan Carlos , Morrelli Humberto Uribe , Patron Alfredo
Published: January 2024

Background:

Artificial intelligence (AI) is emerging as a transformative technology with potential applications in various plastic surgery procedures and plastic surgery education. This article examines the views of plastic surgeons and residents on the role of AI in the field of plastic surgery.

Methods:

A 34-question survey on AI’s role in plastic surgery was distributed to 564 plastic surgeons worldwide, and we received responses from 153 (26.77%) with the majority from Latin America. The survey explored various aspects such as current AI experience, attitudes toward AI, data sources, ethical considerations, and future prospects of AI in plastic surgery and education. Predictions from AI using ChatGPT for each question were compared with the actual survey responses.

Results:

The study found that most participants had little or no prior AI experience. Although some believed AI could enhance accuracy and visualization, opinions on its impact on surgical time, patient recovery, and satisfaction were mixed. Concerns included patient privacy, data security, costs, and informed consent. Valuable AI training data sources were identified, and there was agreement on the importance of standards and transparency. Respondents expected AI’s increasing role in reconstructive and aesthetic surgery, suggesting its integration into residency programs, addressing administrative challenges, and patient complications. Confidence in the enduring importance of human professionals was expressed, with interest in further AI research.

Conclusion:

The survey’s findings underscore the need to harness AI’s potential while preserving human professionals’ roles through informed consent, standardization, and AI education in plastic surgery.
A Phase-III Noninferiority, Randomized Controlled Trial of Letibotulinum Toxin A for the Improvement of Moderate-to-Severe Glabellar Wrinkles in China
Authors: Xie Yun , Yang Xiumin , Liang Hong , Bo Hongliang , Lu Jianyun , Guo Qing , Li Li , Moon Hyoung-jin , Li Qingfeng
Published: January 2024

Background:

Letibotulinum toxin A has an established efficacy and safety profile for aesthetic treatment of glabellar wrinkles. This study was conducted to demonstrate the noninferiority of letibotulinum toxin A versus onabotulinum toxin A in improving the appearance of moderate-to-severe glabellar wrinkles in Chinese patients.

Methods:

This phase-III multicenter, randomized, parallel positive control, double-blinded study compared the efficacy and safety of letibotulinum toxin A and onabotulinum toxin A. Eligible participants were randomized 3:1 to receive 20 U of letibotulinum toxin A or onabotulinum toxin A and were observed for 16 weeks postinjection. The primary endpoint was noninferiority in the proportion of study participants receiving a score of 0 or 1 for glabellar wrinkles on a four-point photographic evaluation scale, as assessed by an institution evaluator at maximum frown at week 4. Secondary endpoints included assessments at rest, photographic assessment of efficacy, and subjective self-assessment of the study participants.

Results:

The proportion of participants (N = 500) receiving a score of 0 or 1 at maximum frown by the institution evaluator at week 4 was 88.49% for letibotulinum toxin A and 87.39% for onabotulinum toxin A (difference, 1.10%; 95% confidence interval, −5.02 to 8.82; P = 0.7469). No significant differences were observed between the treatments for secondary efficacy or safety endpoints. Participants’ self-assessment and satisfaction tended to be higher for letibotulinum toxin A than onabotulinum toxin A.

Conclusion:

Letibotulinum toxin A is noninferior to onabotulinum toxin A in improving the appearance of moderate-to-severe glabellar wrinkles in Chinese patients.
Astragaloside IV Alleviates Acute Liver Failure Induced by D-GalN/LPS by Upregulating Autophagy and Reducing Inflammation
Authors: Hong Meng , Lian Wenwen , Yang Ying , Chen Zhi
Published: January 2024

Acute liver failure (ALF) is a life-threatening condition that manifests in an extremely serious manner and progresses rapidly. The following study investigated the protective effect of astragaloside IV (AS-IV), a traditional Chinese drug, on ALF, and its underlying mechanisms, focusing on autophagy and inflammation regulation. Mice were randomly divided into a saline group, a D-galactosamine and lipopolysaccharide (D-GalN/LPS) group and an AS-IV group. Biochemical analysis, immunohistochemistry, cytometric bead array, high-throughput quantitative PCR, flow cytometry and Western analysis were used to assess inflammation and liver damage 5 hours after D-GalN/LPS exposure. AS-IV treatment reduced mortality by alleviating D-GalN/LPS-induced hepatic damage and decreasing inflammation (decreasing Ly6c+monocyte levels, reducing inflammatory cytokines and increasing anti-inflammatory factors) as well as upregulating autophagy. Furthermore, PCR array was employed to detect expression of autophagy-related genes, which demonstrated a Log2fold change in gene expression between the AS-IV and D-GalN/LPS groups ranging from 1.19 to -3.53, withTnfsf10showing the largest alteration between the two groups. These data suggest that AS-IV may alleviate ALF by upregulating autophagy and reducing inflammation, and it may therefore be an interesting drug for aleviating ALF.
A Tale of Mummified Eggs in Urine of a US Veteran
Authors: Abusalem Lana , Roy Arya Mariam , Siddiqui Shagufta , Hodges Anissa , Thapa Priyenka , Dare Ryan
Published: January 2024

Schistosomiasis is a neglected tropical disease that remains a major threat to global health. Schistosoma is known to cause chronic urogenital infections with an increased risk of bladder carcinomas. We present a case of chronic latent Schistosoma haematobium infection in a US veteran identified several years after his active military duty in Iraq and Kuwait. This case highlights the need for proactive screening of returning veterans from endemic areas. It also leads us to wonder how many infected veterans remain undiagnosed, and how many of those who develop urothelial carcinomas had prior exposure to schistosomiasis during their service.
Development of a Protocol for the Direct Breastfeeding of Premature Infants in Neonatal Intensive Care Units
Authors: Kim Eun Sook , Min Hyun Gi , Lee Ji Yeon , Lee Ji Yoon , Yi Young Hee
Published: January 2024

Purpose:

This study aimed to develop a direct breastfeeding protocol for premature infants admitted to neonatal intensive care units (NICUs) and investigate its efficacy.

Background:

Direct breastfeeding increases the amount and duration of breastfeeding. However, NICUs have low direct feeding rates owing to medical staff anxiety, lack of knowledge and experience, and fear of overwork. Accordingly, this study developed a protocol for direct breastfeeding in the NICU and evaluated its effect.

Methods:

The protocol was developed through a literature review, expert validation, and preliminary investigation. Its application effects were identified using a nonexperimental, evidence-based research design targeting premature infants, their mothers, and NICU nurses.

Results:

The protocol comprised 5 areas and 23 items. Application of the protocol resulted in continuous weight gain of the infants and increased self-efficacy in the mothers' direct breastfeeding (t = 3.219, P = .004). Significant increases were noted in NICU nurses' direct breastfeeding activities (t = 3.93, P < .001), breastfeeding rates in the NICU (P = .037), and direct breastfeeding rates (P = .007).

Conclusions:

Results underscore the value of an evidence-based protocol for improving breastfeeding rates in premature infants. This study highlights the need for continuous nursing education on protocol applications and human resource support.
What Clinical Parameter Strongly Associates White Matter Tract Alterations in a Multiple Sclerosis Population With Voiding Dysfunction? A Prospective Exploratory Study
Authors: Mazeaud C. , Choksi Darshil , Tran Khue , Schott Bradley , Jang Yongchang , Salazar B. H. , Karmonik C. , Khavari R.
Published: January 2024

Purpose:

To correlate clinical and urodynamics parameters in patients with multiple sclerosis (MS) presenting lower urinary tract symptoms (LUTS) with both Expanded Disability Status Scale (EDSS) and changes in white matter integrity as seen on diffusion tensor images (DTIs). LUTS worsen throughout MS, as does lesion burden. We investigated which symptoms correlated best with structural changes in the white matter structure.

Materials and Methods:

Ten adult women >18 years were recruited with stable MS for ≥ 3 months and voiding dysfunction defined as % of post-void residual/bladder volume (%PVR/BV) > 20%. Patients participated in a clinical Urodynamic Study and completed several questionnaires (ie, Hamilton Rating Scale, American Urologic Association Symptom Score, NBS-QoL). DTI images were acquired using a 7-Tesla Siemens MAGNETOM Terra MRI scanner. DTI maps were constructed, and individual patients were coregistered with the International Consortium of Brain Mapping-DTI-81 white matter atlas to extract fractional anisotropy and mean diffusivity (MD). Pearson's correlation test was performed between each white matter tracts (WMT) and clinical parameters and between clinical parameters and the EDSS score as well. P < 0.05 was considered significant.

Results:

Of the clinical parameters, %PVR/BV obtained from the average of multiple un-instrumented uroflow assessments had significant correlations with the greatest number of WMTs. Furthermore, we observed that in all recorded clinical parameters, %PVR/BV was the only significant parameter correlated with the EDSS score.

Conclusion:

This study demonstrates that %PVR/BV can be used as an objective parameter to gauge WMT changes and disease progression in patients with MS. Future studies are needed to refine this model.
Training in interventional pulmonology: a leap into the future
Authors: Lamb Carla , Sachdeva Ash
Published: January 2024

Purpose of review

This review holds significant relevance and is timely; as of June 2022, the United States Accreditation Council of Graduate Medical Education (ACGME) formally recognized interventional pulmonary medicine as a novel subspecialty with a unique fellowship training program pathway beyond Pulmonary and Critical Care Medicine. This recognition stands as a culmination of extensive efforts spanning decades, aimed at establishing a specialized training program for interventional pulmonary medicine beyond traditional Pulmonary and Critical Care Fellowship in the United States. Globally, there are apprenticeship models in non-US programs with ongoing efforts to further standardize training in interventional pulmonary medicine. It underscores the progressive evolution and innovative nature inherent to this subspecialty, signifying a distinctive leap forward in medical education and practice, which calls for further inventive development of training tools and standardized educational delivery.

Recent findings

Newly discovered insights from the recent literature review will highlight methodologies of procedural education and innovative training approaches. These findings will underscore the significance of standardized curriculum development within the field as well as ongoing challenges.

Identifying and addressing future challenges in integrating new technologies into clinical education and broadening the educational scope of trainees in this newly recognized subspecialty is crucial for enhancing competency. The implications of moving toward a more standardized process, creating new clinical pathways with research, and adopting emerging minimally invasive technologies aim to impact patient outcomes in both nonmalignant and malignant thoracic diseases. This progressive shift is redefining the specialty, moving beyond specific procedures, and pivoting towards a more distinct educational pathway. Such a transformation will lead to more diverse, comprehensive, and evidence-based driven patient care delivery.
Screening of coexpression genes of immune cells in breast cancer tissues
Authors: Zhang Yuan-Yuan , Gan Yi-Min
Published: January 2024

This study aimed to investigate immune cell infiltration (ICI) in breast cancer tissues and its impact on the prognosis of patients. The whole transcriptome sequencing data sets of breast tissue (GSE126125, GSE190275 and GSE45498) were downloaded from Gene Expression Omnibus database. Data sets, including 281 breast cancer tissue samples and 59 normal breast tissue samples. In this study, the CIBERSORT algorithm was used to calculate the infiltration content of 22 immune cells subtypes in breast cancer tissues and normal breast tissues. The ICI between normal and breast cancer tissue samples was examined through the Rank-sum test. Furthermore, Kaplan–Meier and the log-rank test were used for survival analysis. Univariate and multivariate COX analysis was used to screen the prognostic risk factors of breast cancer based on ICI. The correlation between 22 kinds of immune cells was analyzed by the Pearson test. The results of univariate COX analysis indicated that resting dendritic cells, eosinophils, resting mast cells, monocytes, and memory CD4 T cells resting were protective factors for the prognosis of breast cancer patients (hazard ratio [HR] < 1, P < .05). The activation of macrophage M0 and mast cells were also prognostic risk factors for breast cancer patients (HR > 1, P < .05). Besides, multivariate COX analysis showed that resting mast cells were independent protective factors for the prognosis of breast cancer patients (HR < 1, P < .05). Macrophage M0 and mast cell activation were independent risk factors for the prognosis of breast cancer patients (HR > 1, P < .05). High infiltration of macrophage M0 and activated mast cells is associated with poor prognosis. Meanwhile, macrophage M0 and activated mast cells promote breast cancer progression. Low infiltration of resting mast cells is associated with poor prognosis, which inhibits breast cancer progression.
Clinical efficacy of rhGM-CSF gel and medical collagen sponge on deep second-degree burns of infants: A randomized clinical trial
Authors: Luo Bin , Sun Hai-Tao , Wang Yu-Ting , Zhang Jin-Cheng , Xu Bai , Ji Xian-Zhen , Xie Rui-Zhang , Liu Qiong , Chen Ru-Jun
Published: January 2024

Background:

This study aimed to observe clinical efficacy of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) gel, medical collagen sponge and rhGM-CSF gel in combination with medical collagen sponge on deep second-degree burns of head, face or neck in infants.

Methods:

A total of 108 infants with deep second-degree burns on head, face or neck were randomly divided into rhGM-CSF group, medical collagen sponge group, and rhGM-CSF + medical collagen sponge group. The scab dissolving time, healing time, bacterial positive rate and Vancouver scar scale were evaluated and analyzed.

Results:

The data analysis showed that scab dissolving time and healing time were shorter in rhGM-CSF + medical collagen sponge group than that in rhGM-CSF group and medical collagen sponge group, and the difference was statistically significant (P < .05). Bacterial positive rate was lower in rhGM-CSF + medical collagen sponge group than that in rhGM-CSF group and medical collagen sponge group (P < .05). After 3 months, score of Vancouver scar scale (scar thickness, pliability, pigmentation and vascularity) was less in rhGM-CSF + medical collagen sponge group than that in rhGM-CSF group and medical collagen sponge group (P < .05).

Conclusion:

rhGM-CSF gel in combination with medical collagen sponge is significantly effective in treating deep second-degree burns of head, face or neck in infants. This combination is beneficial for infection control, acceleration of scab dissolving and wound healing, and reduction of scar hyperplasia and pigmentation, which is worthy of clinical application and promotion.
Clinical evaluation of targeted sedation nursing combined with comprehensive nursing in children with severe pneumonia
Authors: Yu Tao , Wang Ni , Li Aiwei , Xu Yeling
Published: January 2024

The severity of severe pneumonia in children depends on the degree of local inflammation, spread of lung inflammation and systemic inflammatory response. Appropriate care can effectively reduce the mortality of children with severe pneumonia. This study was designed to explore the nursing effect of targeted sedation nursing and comprehensive nursing intervention in children with severe pneumonia. Eighty children with severe pneumonia who complained of the main complaint were selected, and they were evenly distributed to receive comprehensive care (control group) and targeted sedation care and comprehensive care (observation group). In each group, different degrees of sedation, pain scores, and changes in adverse reactions were evaluated. Before nursing, the sedation and pain scores of the 2 groups of children were not statistically significant; after nursing, the sedation and pain scores of the 2 groups of children improved with time, and the sedation effect of the observation group was significantly lower than that of the control. In the group, the pain score was lower than that of the control group, indicating improvement. The SAS and SDS of the observation group were lower than those of the control group, while the social support score was significantly higher than that of the control group. The difference was statistically significant (P < .05). The accidental extubation, delirium, respiratory depression, and laryngospasm of the 2 groups of children were significantly improved, and the observation group was significantly less than the control group. This difference was statistically significant (P < .05). Targeted sedation nursing and comprehensive nursing intervention can effectively reduce the incidence of adverse reactions in children with severe pneumonia, reduce the pain and discomfort of children with severe pneumonia, and significantly improve the degree of sedation, which has certain reference value for the care of children with severe pneumonia.
Case report on postoperative coagulation abnormalities
Authors: Zhou Hongjing , Tang Yanyan , Zhang Yongtian , Zhu Yejing , Dong Shasha
Published: January 2024

Rationale:

Intracranial aneurysm (IA) is defined as a localized dilation of cerebral arteries. With the continuous development of modern medical technology, surgery is still one of the main treatment methods. Although there are various postoperative complications, abnormal coagulation function is rare, especially those caused by lupus antibodies after surgery. The patient not only experienced postoperative abnormalities in coagulation function, but also discovered the presence of lupus anticoagulants in their body. Is the patient suffering from coagulation dysfunction caused by lupus anticoagulants, how is lupus anticoagulant produced, and what’s special about treatment. With these questions in mind, we reviewed the entire treatment process of the patient.

Patient concerns:

A 69-year-old woman presented with “headache and dizziness with neck pain” and was eventually diagnosed with IA hemorrhage. The patient underwent craniotomy under general anesthesia, and provided targeted support and treatment. Postoperative symptoms such as coma and intermittent fever occurred, and coagulation indicators were generally normal. After symptomatic support treatment, such as anti-infection treatment, the patient’s temperature was gradually controlled. However, the abnormal clotting index and the efficacy of symptomatic therapeutic support, such as supplementation with coagulation factors, were not good. After further examination, the lupus anticoagulant was found, which provided us with a new treatment idea.

Diagnoses:

Coagulation disorders, postoperative IA, hypertension grade 3 (extremely high risk), coronary atherosclerotic atheropathy, and type 2 diabetes.

Interventions:

The patient developed abnormal coagulation function after craniotomy, and symptomatic support treatment with coagulation factor supplementation and plasma infusion was ineffective. Finally, the lupus anticoagulant was found after a series of relevant examinations. After timely adjustment of the treatment plan, the patient’s coagulation indices gradually improved.

Outcomes:

In this report, we present the case of a patient with abnormal coagulation function caused by the lupus anticoagulant after IA surgery.

Lessons:

The coagulation function of the patient was abnormal after craniocerebral operation. After coagulation factor supplementation, the coagulation index of the patient was still not well improved. After further examination, the lupus anticoagulant was found. The treatment plan was actively adjusted, and the patient’s condition gradually improved. Early recognition can allow doctors to provide appropriate therapy to patients.
Use total portosystemic shunt to rescue an emergency PNF with intractable hypotension: A case report
Authors: Zhang Yuncong , Dong He , Zhang Xue , Wang Juntao
Published: January 2024

Rationale:

Living donor allogeneic liver transplantation is a surgical treatment for patients with end-stage liver disease, wherein a healthy liver is implanted in the patient, facilitating the recovery of the liver function in patients with end-stage liver disease. However, primary nonfunction (PNF) may occur as a result of this procedure.

Patient concerns:

A case of an 65-year-old Asian male with a medical history of cirrhosis and hepatocellular carcinoma is described. Intractable hypotension occurred after open hepatic portal anastomosis, and large doses of vasoactive substances did not improve the condition.

Diagnosis:

PNF was diagnosed during surgery and it caused intractable hypotension.

Interventions:

we promptly used the total portosystemic shunt to achieve a successful rescue.

Outcomes:

The strengthening of perioperative management and active treatment allowed second liver transplantation and anhepatic phase of up to 10 hours, following which the patient was rescued.

Lessons:

The lesson we have learned is that total portosystemic shunt composited with careful anesthesia management can rescue the event of PNF with intractable hypotension in liver transplantation surgery. At the same time, we give attention to blood pressure, electrocardiogram, albumin, calcium, potassium, acidosis, coagulopathy, anti-infection, and protection of vital organs is essential for successful retransplant outcomes.
Identifying China’s distinctive academic fields among the top 2% of influential scientists: A bibliometric analysis using Rasch KIDMAP
Authors: Wu Alice-Like , Chou Willy
Published: January 2024

Background:

Leading scientists worldwide are recognized by their placement in the top 2% based on their career-spanning contributions, as categorized by the Science-Metrix classification. However, there has been little focus on the unique scientific fields and subfields that separate countries. Although the KIDMAP in the Rasch model has been utilized to depict student performance, its application in identifying distinctive academic areas remains unexplored. Our study uses this model to pinpoint unique research domains specific to countries based on the top 2% author data.

Methods:

We sourced our data from Elsevier career-long author database updated until the end of 2022. This encompassed 168 countries, 22 scientific domains, and 174 subdomains in 2021 and 2022 (with a total of 194,983 and 204,643 researchers, respectively). Our approach was threefold: identifying unique fields, subfields, and researchers. Visualizations included scatter plots, KIDMAP, and the Impact Bam Plot (IBP). China distinctive research areas were identified using the Rasch KIDMAP.

Results:

Key insights include the following: The US prevailing dominance in scientific domains in both 2021 and 2022. China distinct contribution in the “Enabling & Strategic Technologies” domain. China notable emphasis on the “Complementary & Alternative Medicine” subfield in 2022. Dr Phillip Low from the Mayo Clinic (US) emerged as a leading figure in the General & Internal Medicine research domain.

Conclusions:

Despite trailing the US in global research achievements, China showcased pronounced expertise in specific scientific areas, such as the “Complementary & Alternative Medicine” subfield in 2022, when compared to China other subfields based on the level of academic performance (−3.09 logits). Future research could benefit from incorporating KIDMAP visuals to gauge other countries’ strengths in various research sectors, expanding beyond the China-centric focus in this study.
Machine learning-based model for prediction of deep vein thrombosis after gynecological laparoscopy: A retrospective cohort study
Authors: Chen Xiao , Hou Min , Wang Dongxue
Published: January 2024

Successful monitoring of deep vein thrombosis (DVT) remains a challenging problem after gynecological laparoscopy. Thus, this study aimed to create and validate predictive models for DVT with the help of machine learning (ML) algorithms. A total of 489 patients from the Cancer Biology Research Center, Tongji Hospital were included in the study between January 2017 and February 2023, and 35 clinical indicators from electronic health records (EHRs) were collected within 24h of patient admission. Risk factors were identified using the least absolute shrinkage and selection operator (LASSO) regression. Then, the three commonly used DVT prediction models are random forest model (RFM), generalized linear regression model (GLRM), and artificial neural network model (ANNM). In addition, the predictive performance of various prediction models (i.e. the robustness and accuracy of predictions) is evaluated through the receiver operating characteristic curve (ROC) and decision curve analysis (DCA), respectively. We found postoperative DVT in 41 (8.38%) patients. Based on the ML algorithm, a total of 13 types of clinical data were preliminarily screened as candidate variables for DVT prediction models. Among these, age, body mass index (BMI), operation time, intraoperative pneumoperitoneum pressure (IPP), diabetes, complication and D-Dimer independent risk factors for postoperative DVT and can be used as variables in ML prediction models. The RFM algorithm can achieve the optimal DVT prediction performance, with AUC values of 0.851 (95% CI: 0.793–0.909) and 0.862 (95% CI: 0.804–0.920) in the training and validation sets, respectively. The AUC values of the other two prediction models (ANNM and GLRM) range from 0.697 (95% CI: 0.639–0.755) and 0.813 (95% CI: 0.651–0.767). In summary, we explored the potential risk of DVT after gynecological laparoscopy, which helps clinicians identify high-risk patients before gynecological laparoscopy and make nursing interventions. However, external validation will be needed in the future.
Association between lung function and bone mineral density in children and adolescents: Insights from the NHANES
Authors: Zhou Chunxiang , Zeng Wei , Chen Xiaoyan , Liu Xiang , Zheng Dayang , Yang Xu , Li Qian
Published: January 2024

Bone development and lung function are integral to child and adolescent health. Both influence an individual’s overall well-being and potentially affect long-term health. Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey, this study aims to elucidate the relationship between lung function and bone mineral density (BMD) in a representative sample of children and adolescents. The analysis covered 3410 participants aged 8 to 19 years. We employed weighted multivariate linear regression and restricted cubic spline curve visualizations to explore the intricate association between lung function metrics, particularly first-second expiratory volume 1 second/forced vital capacity ratio, and lumbar BMD. Our data indicated a positive association between lung function and lumbar BMD in children and adolescents. Specifically, higher lung function metrics were linked with increased lumbar BMD. This association was more pronounced in younger participants or those with a lower body mass index. A significant positive relationship exists between lung function and BMD in the pediatric population. Recognizing this association is crucial for holistic health strategies for children and adolescents. This study underscores the need for integrated health monitoring during formative years, which can influence health trajectories as these individuals transition to adulthood.
Prognostic factors and constructing a nomogram in tracheal cancer patients treated with surgical intervention: A study based on SEER database
Authors: Shi Wei , Ning Yanhong , Liu Xin , Liu Hang , Zhao Chunjuan , Wu Liyun
Published: January 2024

Although surgery is considered the first choice of treatment for patients diagnosed with tracheal cancer, the prediction of overall survival (OS) in patients undergoing surgical intervention is poor. To address this issue, we developed a nomogram that combined a risk classification system to estimate the OS of patients with tracheal cancer who underwent surgical intervention. A total of 525 qualified patients were selected from the surveillance, epidemiology, and end results database between 1975 and 2018 and were randomly divided into training and validation cohorts (7:3). The parameters of independent prognostic ability were determined using Cox regression analysis, and a nomogram was formed. The predictive ability of the nomogram was tested using the area under the curve of receiver operating characteristic curves and calibration curves. Survival curves were assessed between the different risk classification groups using the Kaplan–Meier method. The results indicated that Age, stage, histology, and tumor size were independent prognostic factors and were included in the predictive model. The calibration plots demonstrated good agreement between the nomogram prediction and actual observation for 24- and 36-month OS. The receiver operating characteristic curves suggested that the predictive model had good discrimination ability, with the area under the curves (training group 0.817, 0.785, and 0.801, respectively) and validation group (0.744, 0.794, and 0.822, respectively). Furthermore, the low-risk group had a better prognosis than the high-risk group in the total, training, and validation cohorts (all P < .001). This study established a novel nomogram system to predict OS and identify independent prognostic factors in patients with tracheal cancer who underwent surgical intervention. This model has the potential to assist doctors in making decisions regarding treatment options.
The association between atherosclerosis and nonalcoholic fatty liver disease
Authors: Lv Qing , Han Qianqian , Wen Ziyun , Pan Yunyun , Chen Jisheng
Published: January 2024

Atherosclerosis (AS) is closely related to nonalcoholic fatty liver disease (NAFLD), which promotes and exacerbates the development of AS. However, it is uncertain how the precise underlying mechanism occurs. Here, we attempted to further explore the association underlying atherosclerosis and nonalcoholic fatty liver disease through integrated bioinformatics analysis. Microarray data for atherosclerosis and nonalcoholic fatty liver disease were retrieved from the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) was used to identify the genes related to atherosclerosis and nonalcoholic fatty liver disease showing co-expression. Additionally, the common gene targets associated with atherosclerosis and nonalcoholic fatty liver disease were also analyzed and screened using data from 3 public databases [comparative toxicogenomics database (CTD), DISEASES, and GeneCards]. The Gene Ontology (GO) enrichment analysis and the Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis were performed using Metascape R, respectively. The protein–protein interaction networks (PPI) network was constructed using Cytoscape. According to the results of an analysis of common genes, matrix metalloproteinase 9 (MMP9) is co-expressed up-regulated in AS and NAFLD and is enriched in inflammatory and immune-related collaterals. Consequently, MMP9 may work together through immunity and inflammation to treat AS and NAFLD and may be a potential therapeutic target in the future. The findings of this study provide new insights into the shared association between AS and NAFLD. MMP9 is co-expressed up-regulated in AS and NAFLD, which be able to reveal the presence of co-expressed genes in atherosclerosis and NAFLD.
Meta-analysis of the efficacy of postoperative adjuvant chemotherapy for stage IB non-small cell lung cancer
Authors: Liu Siqi , Wan Sha , Feng Jinghui , Pang Yaqi , Wang Haiqing , Zeng Hui , Xu Xinhua
Published: January 2024

Background:

Many clinical trials have shown that postoperative adjuvant chemotherapy can provide a survival benefit for patients with stage IB non-small cell lung cancer. However, whether adjuvant chemotherapy should be routinely given after surgery remains controversial. Therefore, we performed a meta-analysis to investigate the efficacy of adjuvant chemotherapy versus surgery alone for stage IB non-small cell lung cancer (NSCLC).

Methods:

Relevant retrospective studies or randomized controlled trial comparing the efficacy of postoperative adjuvant chemotherapy versus observation on the survival outcomes of NSCLC patients up to October 30, 2023 were searched in PubMed, Web of Science, EMBASE, Cochrane Library, VIP database, Wanfang database, and China National Knowledge Internet database. Patient survival data, population characteristics, and other relevant information were extracted, and data were analyzed using Review Manager 5.4. The primary endpoints included overall survival, disease-free survival, and recurrence-free survival.

Results:

A total of 13 randomized controlled trials or cohort studies including 19,442 patients were included. The results of the meta-analysis showed that postoperative adjuvant chemotherapy in patients with stage IB NSCLC had better overall survival (odds ratio [OR] = 1.25, 95% confidence interval [CI] 1.19–1.31, P < .00001) and disease-free survival or recurrence-free survival (OR = 1.57, 95% CI 1.3–1.9, P < .00001) compared with observation; and the 4-year survival rate of patients who received postoperative adjuvant chemotherapy was better than the observation group (OR = 1.52, 95% CI 1.05–2.18, P = .03); and the 8-year survival rate of patients receiving postoperative adjuvant chemotherapy (OR = 1.5, 95% CI 0.94–2.4, P = .09) was comparable to the observation group.

Conclusion:

Receiving postoperative adjuvant chemotherapy improved people’s survival and prolonged disease-free survival and recurrence-free survival in patients with stage IB non-small cell lung cancer compared with surgery alone.
TYROBP as a molecular target in cholangiocarcinoma, renal cancer and abdominal aortic aneurysm
Authors: Jia Wei , Chen Lei , Hou Shiyang , Kang Chunbo , Deng Hongru
Published: January 2024

Cholangiocarcinoma occurs when there is a malignant tumor in the bile duct system. Renal cancer originates from renal tubular epithelial cells. Abdominal aortic aneurysm (AAA) is a permanently localized dilation caused by a lesion or injury to abdominal aortic wall. However, the relationship between TYROBP and cholangiocarcinoma, renal cancer and AAA remains unclear. The profiles of cholangiocarcinoma dataset GSE107943, renal cell carcinoma dataset GSE213324, and AAA dataset GSE47472 were downloaded from the GEO database using the platforms GPL18573, GPL24676, and GPL10558. DEGs were screened, WGCNA was performed as well as construction and analysis of PPI network. Functional enrichment analysis, GSEA, heat map of gene expression, survival analysis, and immune infiltration analysis were performed. The most relevant diseases to core genes were found by CTD. The GSE107943 dataset identified 3383 DEGs for cholangiocarcinoma, GSE47472 identified 95 DEGs for abdominal aortic aneurysm, and GSE213324 identified 10245 DEGs for renal cell carcinoma. For the GSE107943 cholangiocarcinoma dataset, GO analysis revealed enrichment in immune response, cell adhesion, extracellular space, and oxidoreductase activity. KEGG analysis indicated enrichment in metabolic pathways, the PI3K-Akt signaling pathway, cell apoptosis, the cell cycle, and the NF-kappa B signaling pathway. In the GSE47472 AAA dataset, GO analysis showed enrichment in neuroblast differentiation, cardiac muscle myofilament complex, and alkaline binding. KEGG analysis indicated enrichment in mRNA surveillance pathway and purine metabolism. In the GSE213324 renal cell carcinoma dataset, GO analysis indicated enrichment in immune system processes, cell adhesion, and membrane parts. KEGG analysis showed enrichment in cytokine-cytokine receptor interaction, calcium signaling pathway, and hematopoietic cell lineage. Furthermore, for cholangiocarcinoma (GSE107943), enriched terms associated with DEGs were in metabolic pathways, cell apoptosis, and the cell cycle. For AAA (GSE47472), enriched terms were in alkaline binding and cellular redox homeostasis. For renal cell carcinoma (GSE213324), enriched terms were in biological adhesion, regulation of immune system processes, and cell surface. Common core genes (ADH6, AGXT, CYP3A43, TYROBP) were identified for cholangiocarcinoma, renal cell carcinoma, and AAA. ADH6 and TYROBP were associated with cholangiocarcinoma, AAA, renal tumors, kidney diseases, atherosclerosis, and inflammation. TYROBP is abnormally expressed in cholangiocarcinoma, renal cancer and abdominal aortic aneurysm.
Synthetic biology approach revealed enhancement in haeme oxygenase-1 gene expression by codon pair optimization while reduction by codon deoptimization
Authors: Khandia Rekha , Pandey Megha Katare , Khan Azmat Ali , Baklanov Igor , Alanazi Amer M. , Nepali Prakash , Gurjar Pankaj , Choudhary Om Prakash
Published: January 2024

Haem oxygenase-1 (HO-1) is a ubiquitously expressed gene involved in cellular homoeostasis, and its imbalance in expression results in various disorders. To alleviate such disorders, HO-1 gene expression needs to be modulated. Codon usage bias results from evolutionary forces acting on any nucleotide sequence and determines the gene expression. Like codon usage bias, codon pair bias also exists, playing a role in gene expression. In the present study, HO-1 gene was recoded by manipulating codon and codon pair bias, and four such constructs were made through codon/codon pair deoptimization and codon/codon pair optimization to reduce and enhance the HO-1 gene expression. Codon usage analysis was done for these constructs for four tissues brain, heart, pancreas and liver. Based on codon usage in different tissues, gene expression of these tissues was determined in terms of the codon adaptation index. Based on the codon adaptation index, minimum free energy, and translation efficiency, constructs were evaluated for enhanced or decreased HO-1 expression. The analysis revealed that for enhancing gene expression, codon pair optimization, while for reducing gene expression, codon deoptimization is efficacious. The recoded constructs developed in the study could be used in gene therapy regimens to cure HO-1 over or underexpression-associated disorders.
A 30-year-old female with dermatomyositis without high elevation of muscle enzymes: a rare case report from Syria
Authors: Hamsho Suaad , Sleiay Bilal , Sleiay Mouhammed , Batrash Obeda , Alabdullah Hadi , Aboud Majed
Published: January 2024

Introduction and importance:

Dermatomyositis (DM), sometimes referred to as inflammatory and degenerative changes in the skin and muscles, is a rare autoimmune disorder. DM is distinguished by myopathic disease, symmetrical proximal muscle weakness, and increased creatine kinase (CK).

Case presentation:

A 30-year-old-female presented to the department of dermatology with a history of chronic right hand pain spreading to the shoulder, severe tachycardia, and dyspenia that increased during routine tasks like using the bathroom. What makes this case unique is that the CPK developed without doubling, and the final concentration was 207 ng/ml. Other common clinical symptoms include amyopathic/hypomyopathic muscle involvement and DM-specific rash (Gottron’s papules, heliotrope rash), and these manifestations were in our patients. Sun protection, topical treatment with corticosteroids and/or calcineurin inhibitors, and systemic medication should be utilized for all individuals with nonvasculopathic disease. In our case, the patient stopped using azathioprine and began taking methotrexate.

Clinical discussion:

Sun protection, topical therapy with corticosteroids and/or calcineurin inhibitors, and systemic medication should be utilized in layers for all individuals with nonvasculopathic illnesses. Mycophenolat Mofetil is beneficial in treating refractory illnesses as well as individuals with interstitial lung disease or substantial skin disease.

Conclusion:

Even if test findings are not conclusive, dermatomyositis should always be considered when muscular weakness manifests. It’s important to distinguish the disorder from connective tissue diseases like lupus erythematosus. In fact, to correctly diagnose DM, if there are any doubts, a muscle biopsy is required.
Severe re-impacted deciduous tooth in 25-years-old female with permanent dentition associated to high-risk oral-sinus communication surgery: a rare case report
Authors: Soualem Hajar , Chami Bassima
Published: January 2024

Introduction and importance:

The total re-impaction of primary tooth is a very uncommon phenomenon and few cases have been reported in the literature. “Re-Impaction of deciduous tooth ” is a rare phenomena involving more often mixed denture than permanent dentition.

Case presentation:

A completely re-impacted deciduous tooth in an adult patient presented an occlusal tooth decay. The presence of the decay cavity indicated that this tooth had once been erupted. After the removal, the tooth anatomy confirmed that it was deciduous tooth.

Clinical discussion:

The etiologies remain diverse but the local contributing factors local factors include odontomas, ankylosis, congenitally missing permanent teeth, trauma. The early diagnosis by knowledge of the clinical and radiological image of re-impaction allows early detection, which in turn prevents subsequent complications

Conclusion:

The clinicians must be aware that late discovery managing re-impacted and severely infraoccluded deciduous tooth is in risk of causing permanent injury.
Comparison of ventriculoperitoneal shunt versus endoscopic third ventriculostomy in managing hydrocephalus due to tuberculous meningitis: a randomized controlled trial with a 30-day follow-up
Authors: Raut Rupesh , Shams Shahzad , Scalia Gianluca , Umana Giuseppe Emmanuele , Ranganathan Sruthi , Rasheed Muddassar , Vats Atul , Chaurasia Bipin
Published: January 2024

Background:

Hydrocephalus is a significant complication arising from tuberculous meningitis (TBM). While ventriculoperitoneal shunt (VPS) remains the primary surgical approach for TBM-related hydrocephalus, there is a rising trend in the use of endoscopic third ventriculostomy (ETV).

Materials and methods:

This randomized controlled trial, conducted from February 2018 to July 2019, enroled 60 patients aged 20–50 with TBM-related hydrocephalus. Patients underwent either VPS or ETV. Both groups were followed up for a minimum of 30 days, evaluating clinical outcomes and modifications in the modified Vellore grading system. Glasgow Coma Scale (GCS) assessments were conducted at 7-days and 30-day post-surgery for both groups.

Results:

The mean GCS scores were comparable between the two groups on the 7th and 30th postoperative days. The association between modified Vellore Grade and treatment modality did not show statistically significant differences (P=1.0 and P=0.3) on the seventh and thirtieth postoperative days respectively.

Conclusions:

Both VPS and ETV demonstrate efficacy in managing hydrocephalus secondary to TBM in adult patients. Our 30-day outcomes did not reveal discernible differences between the two procedures. Therefore, considering technical expertise and experience with ETV, it may be considered as the primary choice for cerebrospinal fluid (CSF) diversion in TBM-associated hydrocephalus, owing to its avoidance of several lifelong complications linked with VPS.
Vertebral destruction in tuberculous spondylitis correlates with Toll-like Receptor 4 (TLR-4) levels: a cross-sectional study
Authors: Arifin Jainal , Sakti Muhammad , Massi Nasrum , Bukhari Agussalim , Hamid Firdaus , Winangun Putu A.N.
Published: January 2024

Background:

Tuberculous (TB) spondylitis is a hazardous infectious disease causing significant spinal deformity. Increased toll-like receptor-4 (TLR-4) activity promotes more extensive infections in patients with TB spondylitis, so it has the potential to be used as a biomarker to predict the severity. This study aims to determine the relationship between TLR-4 levels and the degree of vertebral destruction in TB spondylitis patients.

Materials and methods:

A cross-sectional study was conducted from May to October 2023. A total of 27 TB spondylitis samples were then measured for TLR-4 serum levels. Vertebral destruction is assessed based on the Spine At Risk Signs (SARS) criteria on X-ray and MRI examinations. Moreover, the degree of sensory and motor impairment was also assessed in this study. The Spearman correlation test assessed the correlation between TLR-4 levels and vertebral destruction.

Results:

Most of the samples in this study were less than 30 years old (10 people, 37%), female (14 people, 51.9%), had spinal destruction at 1 level (11 people, 40.7%), had paraplegia (8 people, 29.6%), and had hypoesthesia (11 people, 40.7%). TLR-4 levels had a mean value of 8254.1±1076.1 ng/ml. TLR-4 levels were positively correlated with the degree of vertebral destruction (r=0.599, P=0.001), motor disorders (r=0.632.x, P=0.000), and sensory disorders (r=0.574, P=0.002).

Conclusion:

TLR-4 levels are associated with the severity of vertebral destruction in TB spondylitis, so it has the potential to be used as a prognostic biomarker.
Need to Take Heart? Talk to Your Psychiatrist for 20 Minutes
Authors: Dinca Eduard B. , Balseanu Adrian T.
Published: January 2024

A powerful correlation exists between the equilibrium of the sympathetic and parasympathetic nervous systems and heart rate variability (HRV). Thus, HRV is useful as a physiological index of both physical and emotional health; autonomic nervous system dysregulation, with a sympathetic predominance and a low HRV, has been associated with a variety of physical (cardiovascular, neurological) and psychiatric disorders. We used a validated algorithm of measuring the HRV (noninvasive, 2-minute approach) in new psychiatric outpatients in first author's private practice. The subjects had an initial measurement, followed by a 20-minute consultation with minimal supportive psychotherapy, followed by an exit measurement. The initial study spanned the “COVID months”; to control for this variable, an identical study was performed in 2023. There was a highly significant decrease in the sympathetic predominance in the test groups; no such trend was found in the control groups. A short psychiatry consultation may be sufficient to decrease patients' sympathetic hyperactivity and improve their well-being.