bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of lack of response to methotrexate in juvenile idiopathic arthritis associated uveitis
Authors: Mapelli Chiara , Miserocchi Elisabetta , Nassisi Marco , Beretta Gisella B , Marelli Luca , Leone Gaia , Marino Achille , Chighizola Cecilia , Cincinelli Gilberto , Giani Teresa , Nucci Paolo , Viola Francesco , Filocamo Giovanni , Minoia Francesca ,   Pediatric Rheumatology Associated Group of the Milan Area, Agostoni Carlo , Baldo Francesco , Baselli Lucia , Costi Stefania , Di Stasio Fabiana , Gattinara Maurizio , Lanni Stefano , Petaccia Antonella , Rossano Martina , Vianello Federica
Published: February 2024

Objectives

To investigate clinical features associated with lack of response to MTX in juvenile idiopathic arthritis associated uveitis (JIA-U).

Methods

Clinical records of JIA-U patients were retrospectively reviewed. Differences among variables were assessed by Mann–Whitney and χ2 or Fisher’s exact tests as appropriate. Association between predictors and requirement of a biological disease-modifying antirheumatic drug (bDMARD) was evaluated by univariate Cox regression analysis and Kaplan–Meier curves. A multivariable logistic model was applied to estimate strength of association, adjusting for potential confounders.

Results

Data from 99 JIA-U patients treated with MTX were analysed (82.8% female), with a mean follow up of 9.2 years and a mean age at uveitis onset of 5.7 years. In 65 patients (65.7%) at least one bDMARD to control uveitis was required. Children requiring a bDMARD for uveitis had lower age at JIA and uveitis onset, more frequent polyarticular course, higher frequency of bilateral uveitis at onset and higher prevalence of systemic steroids’ use. Despite similar frequency of ocular damage at onset, MTX non-responders showed a higher percentage of ocular damage at last visit. Younger age at JIA onset, polyarticular course and a history of systemic steroids’ use resulted independent factors associated to lack of response to MTX at Cox regression analysis. Kaplan–Meier curves and the multivariate model confirm the independent role of both polyarticular course and systemic steroids’ use.

Conclusions

Younger age at JIA onset, polyarticular course and a history of systemic steroids’ use are predictors of a worse response to MTX in JIA-U.
Cardiac involvement in eosinophilic granulomatosis with polyangiitis: acute eosinophilic myocarditis and chronic inflammatory cardiomyopathy
Authors: Liu Xiaohang , Zhou Yangzhong , Li Jing , Guo Tianchen , Lv Zhuoyao , Zhang Dingding , Feng Xiaojin , Zhang Jingdai , Fang Ligang , Tian Xinping , Zeng Xiaofeng , Chen Wei
Published: February 2024

Objectives

Currently, cardiac involvement is used to describe all eosinophilic granulomatosis with polyangiitis (EGPA) cardiac problems. However, heterogeneity exists among them. We aimed to depict the disease spectrum of EGPA cardiac involvement and identify the high-risk population.

Methods

We included EGPA patients hospitalized in our centre from 2012 to 2023 and in public databases. Based on the cardiac enzymes, cardiac MRI and endomyocardial biopsy results, the patients were divided into three groups: eosinophilic myocarditis (EGPA-EM), chronic inflammatory cardiomyopathy (EGPA-ICM) and EGPA-Control. Their clinical, laboratory, imaging results and prognoses were collected and compared.

Results

A total of 193 EGPA patients were included, 118 with cardiac involvement (74 EGPA-EM, 44 EGPA-ICM) and 75 control. Among EGPA-Control, EGPA-ICM and EGPA-EM, eosinophil increased (6.12/8.71/10.42 × 109/l, P < 0.01), ANCA positivity decreased (41.33/31.82/14.86%, P < 0.01) and lung involvement was reduced (73.33/72.73/43.24%, P = 0.02). In EGPA-EM, cardiac troponin was further elevated (0.27 vs 6.00 ng/ml, P < 0.01), ejection fractions decreased (57.79 vs 33.20%, P < 0.01) while more ST-T abnormality was observed (41.89 vs 20.45%, P = 0.02). The prognosis of EGPA-EM was significantly worse, with a 14.86% death rate and 2-year event-free survival rate below 50%. Furthermore, we proposed a LATE-EAST diagnostic score (7 items, 9 points) to discriminate EGPA-EM from EGPA-ICM using 4 points as threshold [area under the receiver operating characteristic curve 0.85 (95% CI 0.78–0.92), sensitivity 0.78, specificity 0.86].

Conclusions

We first proposed different subtypes of cardiac involvement in EGPA. Identification and treatment of EGPA-EM needs improvement. LATE-EAST score could recognize the high-risk EGPA-EM effectively. Multi-disciplinary treatment is warranted, immunosuppressive therapy should be given in a timely manner and anti-IL-5 antibodies should be be tested in trials.
Development of a human liver microphysiological coculture system for higher throughput chemical safety assessment
Authors: Ip Blanche C , Madnick Samantha J , Zheng Sophia , van Tongeren Tessa C A , Hall Susan J , Li Hui , Martin Suzanne , Spriggs Sandrine , Carmichael Paul , Chen Wei , Ames David , Breitweiser Lori A , Pence Heather E , Bowling Andrew J , Johnson Kamin J , Cubberley Richard , Morgan Jeffrey R , Boekelheide Kim
Published: February 2024

Chemicals in the systemic circulation can undergo hepatic xenobiotic metabolism, generate metabolites, and exhibit altered toxicity compared with their parent compounds. This article describes a 2-chamber liver-organ coculture model in a higher-throughput 96-well format for the determination of toxicity on target tissues in the presence of physiologically relevant human liver metabolism. This 2-chamber system is a hydrogel formed within each well consisting of a central well (target tissue) and an outer ring-shaped trough (human liver tissue). The target tissue chamber can be configured to accommodate a three-dimensional (3D) spheroid-shaped microtissue, or a 2-dimensional (2D) cell monolayer. Culture medium and compounds freely diffuse between the 2 chambers. Human-differentiated HepaRG liver cells are used to form the 3D human liver microtissues, which displayed robust protein expression of liver biomarkers (albumin, asialoglycoprotein receptor, Phase I cytochrome P450 [CYP3A4] enzyme, multidrug resistance-associated protein 2 transporter, and glycogen), and exhibited Phase I/II enzyme activities over the course of 17 days. Histological and ultrastructural analyses confirmed that the HepaRG microtissues presented a differentiated hepatocyte phenotype, including abundant mitochondria, endoplasmic reticulum, and bile canaliculi. Liver microtissue zonation characteristics could be easily modulated by maturation in different media supplements. Furthermore, our proof-of-concept study demonstrated the efficacy of this coculture model in evaluating testosterone-mediated androgen receptor responses in the presence of human liver metabolism. This liver-organ coculture system provides a practical, higher-throughput testing platform for metabolism-dependent bioactivity assessment of drugs/chemicals to better recapitulate the biological effects and potential toxicity of human exposures.
Moderating Effect of Sex on the Relationship Between Physical Activity and Quality of Life in Coronary Heart Disease Patients in China
Authors: Wang Jianhui , Smith Sidney C. , Dong Jianxiu , Chen Changxiang , Miller Nancy Houston , Chang Wenhong , Ma Yi , Liu Huaping
Published: February 2024

Purpose:

The aim of this study was to investigate the moderating effect of sex on the relationship between physical activity (PA) and quality of life (QoL) in Chinese patients with coronary heart disease (CHD) not participating in cardiac rehabilitation.

Methods:

Chinese patients with CHD (aged 18-80 yr) were selected 12 mo after discharge from three Hebei Province tertiary hospitals. The International Physical Activity Questionnaire was used to assess PA in metabolic equivalents of energy (METs) and the Chinese Questionnaire of Quality of Life in Patients With Cardiovascular Disease was used to assess QoL. Data were analyzed using Student’s t test and the χ2 test, multivariant and hierarchical regression analysis, and simple slope analysis.

Results:

Among 1162 patients with CHD studied between July 1 and November 30, 2017, female patients reported poorer QoL and lower total METs in weekly PA compared with male patients. Walking (β= .297), moderate-intensity PA (β= .165), and vigorous-intensity PA (β= .076) positively predicted QoL. Hierarchical regression analysis showed that sex moderates the relationship between walking (β= .195) and moderate-intensity PA (β= .164) and QoL, but not between vigorous-intensity PA (β=−.127) and QoL. Simple slope analysis revealed the standardized coefficients of walking on QoL were 0.397 (female t = 8.210) and 0.338 (male t= 10.142); the standardized coefficients of moderate-intensity PA on QoL were 0.346 (female, t = 7.000) and 0.175 (male, t= 5.033).

Conclusions:

Sex moderated the relationship between PA and QoL among patients with CHD in China. There was a greater difference in QoL for female patients reporting higher time versus those with lower time for both walking and moderate-intensity PA than for male patients.
ChatGPT enters the room: what it means for patient counseling, physician education, academics, and disease management
Authors: Momenaei Bita , Mansour Hana A. , Kuriyan Ajay E. , Xu David , Sridhar Jayanth , Ting Daniel S.W. , Yonekawa Yoshihiro
Published: February 2024

Purpose of review

This review seeks to provide a summary of the most recent research findings regarding the utilization of ChatGPT, an artificial intelligence (AI)-powered chatbot, in the field of ophthalmology in addition to exploring the limitations and ethical considerations associated with its application.

Recent findings

ChatGPT has gained widespread recognition and demonstrated potential in enhancing patient and physician education, boosting research productivity, and streamlining administrative tasks. In various studies examining its utility in ophthalmology, ChatGPT has exhibited fair to good accuracy, with its most recent iteration showcasing superior performance in providing ophthalmic recommendations across various ophthalmic disorders such as corneal diseases, orbital disorders, vitreoretinal diseases, uveitis, neuro-ophthalmology, and glaucoma. This proves beneficial for patients in accessing information and aids physicians in triaging as well as formulating differential diagnoses. Despite such benefits, ChatGPT has limitations that require acknowledgment including the potential risk of offering inaccurate or harmful information, dependence on outdated data, the necessity for a high level of education for data comprehension, and concerns regarding patient privacy and ethical considerations within the research domain.

ChatGPT is a promising new tool that could contribute to ophthalmic healthcare education and research, potentially reducing work burdens. However, its current limitations necessitate a complementary role with human expert oversight.
Construction and validation of a nomogram prediction model for chronic low back pain after PKP for lumbar compression fractures
Authors: Deng Guang-hua
Published: February 2024

The aim was to study the independent risk factors for chronic low back pain after lumbar compression fractures undergoing percutaneous kyphoplasty (PKP), and to establish a nomogram prediction model accordingly. Data were collected from patients with lumbar compression fractures from January 2017 to December 2021 at the Affiliated Hospital of Xinjiang Medical University. Univariate and multivariate logistic regression analyses were used to determine the independent risk factors for chronic low back pain after receiving PKP for lumbar compression fractures, and the corresponding nomogram was established. Receiver operating characteristic (ROC) curves were plotted and area under the curve (AUC) was calculated, and calibration curves and decision curve analysis (DCA) were plotted to evaluate the model performance. A total of 792 patients with lumbar compression fractures were included in the study, and 188 patients had chronic postoperative low back pain, with an incidence of 23.74%. After univariate and multivariate logistic regression analysis, a total of 5 variables were identified as independent risk factors for chronic low back pain after undergoing PKP for lumbar compression fractures, namely having diabetes (OR, 1.607; 95% CI, 1.157–3.205), preoperative T value < −2.5 SD (OR, 2.697; 95% CI, 1.417–5.021), multiple lumbar fractures (OR, 1.815; 95% CI, 1.415–3.201), lumbar compression ≥ 50% (OR, 2.854; 95% CI, 1.411–6.524), and bone cement leakage (OR, 2.911; 95% CI, 1.715–6.817). The nomogram for chronic low back pain after PKP for lumbar compression fractures constructed in this study has good predictive accuracy and helps orthopedic surgeons to intervene earlier in patients at high risk of chronic low back pain after undergoing PKP for lumbar compression fractures.
Prenatal diagnosis of 7q11.23 microdeletion: Two cases report and literature review
Authors: Lv Xin , Yang Xiao , Li Linlin , Yue Fagui , Zhang Hongguo , Wang Ruixue
Published: February 2024

Rationale:

Chromosome microdeletions within 7q11.23 can result in Williams-Beuren syndrome which is a rare autosomal dominant disorder. Williams-Beuren syndrome is usually associated with developmental delay, cardiovascular anomalies, mental retardation, and characteristic facial appearance.

Patient concerns:

Two pregnant women underwent amniocentesis for cytogenetic analysis and chromosomal microarray analysis (CMA) because of abnormal ultrasound findings. Case 1 presented subependymal cyst and case 2 presented intrauterine growth restriction, persistent left superior vena cava and pericardial effusion in clinical ultrasound examination.

Diagnoses:

Cytogenetic examination showed that the 2 fetuses presented normal karyotypic results. CMA detected 1.536 Mb (case 1) and 1.409 Mb (case 2) microdeletions in the region of 7q11.23 separately.

Interventions:

Both couples opted for the termination of pregnancies based upon genetic counseling.

Outcomes:

The deleted region in both fetuses overlapped with Williams-Beuren syndrome. To our knowledge, case 1 was the first reported fetus of Williams-Beuren syndrome with subependymal cyst.

Lessons:

The genotype-phenotype of Williams-Beuren syndrome is complicated due to the phenotypic diversity. For prenatal cases, clinicians should consider the combination of ultrasonography, traditional cytogenetic, and molecular diagnosis technology when genetic counseling.
Association of lncRNA SOX2OT rs9839776 polymorphism with gastric cancer risk in Korean: Case-control study
Authors: Hong Jang Hee , Jin Eun-Heui , Sung Jae Kyu , Chang In Ae , Kang Hyojin , Lee Sang-Il
Published: February 2024

Aberrant regulation of the long non-coding RNA SRY-box transcription factor 2 overlapping transcript (SOX2OT) has been reported in various diseases including gastric cancer (GC). However, an association between the well-studied rs9839776 single nucleotide polymorphism in SOX2OT and GC susceptibility has not been reported. This study aimed to evaluate the association between the rs9839776 single nucleotide polymorphism in SOX2OT and GC risk. Genotyping of rs9839776 was conducted using TaqMan genotyping assay for 460 patients with GC and 386 controls. We found that the dominant model (CT+TT) and rs9839776 T allele were significantly associated with decreased GC risk (P = .046, adjusted odds ratio [AOR] = 0.72, 95% confidence interval [CI] = 0.52–1.00 and P = .044, AOR = 0.74, 95% CI = 0.56–0.99, respectively). In addition, stratified analysis revealed that the dominant model (CT+TT) and rs9839776 T allele were significantly associated with decreased risk of lymph node metastasis-negative (P = .039, AOR = 0.67, 95% CI = 0.46–0.98 and P = .049, AOR = 0.71, 95% CI = 0.51–1.00, respectively) and tumor stage I (A+B)/II (A+B+C) (P = .028, AOR = 0.66, 95% CI = 0.50–0.96 and P = .041, AOR = 0.71, 95% CI = 0.52–0.99, respectively) GC. Our findings suggest that the rs9839776 T allele may be a protective factor against GC susceptibility. Further research is needed to clarify whether rs9839776 affects SOX2OT expression.
Effectiveness of Zhibai Dihuang pill (Chinese herbal formula) in combination with western drugs in the treatment of recurrent aphthous stomatitis: A systematic review and meta-analysis
Authors: Peng Shuang-li , Ge Ya-mei , Yu Xing-yu , Chen Hong-ci , Song Deng-qin , Pu Hui-yun , Yang Ping
Published: February 2024

Background:

The pain caused by recurrent aphthous stomatitis (RAS) and the recurrent nature of RAS lead to diminished quality of life for RAS patients. An alternative treatment for RAS is the oral administration of the Chinese herbal medicine Zhibai Dihuang pill (ZBDHP). Our study aims to investigate the clinical efficacy of ZBDHP when used in combination with Western medicine (WM) for the treatment of RAS and its effectiveness in preventing the recurrence of RAS.

Methods:

Following the PRISMA 2020 guidelines, we conducted a literature search on 7 electronic databases according to predefined criteria. The methodological quality of randomized controlled trials (RCTs) was evaluated based on the Cochrane Handbook, and data analysis was performed using RevMan 5.3 software.

Results:

A meta-analysis which included 7 studies and 669 participants in total was carried out in this study. The quantitative analysis revealed that the combined treatment of ZBDHP and WM has witnessed significantly improved overall clinical efficacy (RR = 1.20, 95% CI [1.12, 1.28], P < .05), reduced recurrence rate (RR = 0.24, 95% CI [0.13, 0.45], P < .05), decreased ulcer area (MD = −0.75, 95% CI [−0.91, −0.59], P < .05), and reduced pain visual simulation score (MD = −0.42, 95% CI [−0.52, −0.33], P < .05). No significant heterogeneity was observed among the studies. Qualitative analysis showed that the combination therapy significantly reduced serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 and interleukin-10, shortened ulcer healing time and pain disappearance time, with no adverse effects observed.

Conclusion:

It was found that the combination of ZBDHP and WM is more effective in treating RAS than the use of WM alone, which thus provides clinicians with a more optimal treatment option. However, due to limitations in the methodological quality of the included original studies and the small sample size, we hold the opinion that more rigorous and scientific clinical trials are needed to further evaluate the efficacy of ZBDHP in treating RAS.
Comparison of testosterone, FSH, LH and E2 hormone levels in infertility suspected males with COVID-19 infection
Authors: Gökalp Özkorkmaz Ebru , Özdemir Başaran Süreyya , Afşin Muhamet , Aşir Firat
Published: February 2024

Background:

Coronavirus disease 2019 (COVID-19) is an infectious disease that has many adverse impacts on many systems including reproduction. The direct effects of COVID-19 on urogenital system are still open to argue. This study aimed to compare testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) hormone levels in COVID-19 infected male individuals with infertility suspicion.

Methods:

One hundred five control (healthy) and 105 COVID-19 infected males aged between 20 to 54 years old were enrolled in the study. All patients were either diagnosed with primary or secondary infertility suspicion. The COVID-19 infection was diagnosed via reverse-transcription polymerase chain reaction test. Blood samples from patients were analyzed from the control and COVID-19 group to measure serum testosterone, FSH, LH, and E2 levels. Hormone levels were statistically compared between groups with the Independent T test.

Results:

In control and COVID-19 patients, no significance was determined for FSH and LH hormone values. Testosterone hormone were significantly decreased and E2 level was statistically increased in COVID-19 patients compared to that in the control group (P < .001).

Conclusion:

COVID-19 is a viral disease that affects organ including gonads. COVID-19 infection decreased testosterone levels and increased E2 levels, which leading to disorders in male and female reproductivity.
Self-limited corneal ectasia in a post-LASIK eye after cataract surgery: A case report
Authors: Chang Hao-Yun , Ho Wei-Ting
Published: February 2024

Introduction:

To present a case with a history of laser in situ keratomileusis (LASIK) developing central conic protrusion after phacoemulsification cataract surgery, which spontaneously resolved 5 months postoperatively.

Patient concerns:

A 55-year-old female who underwent myopic LASIK surgery 10 years ago presented to the clinic with bilateral cataracts and without ectasia. Following phacoemulsification cataract surgery and intraocular lens implantation in the right eye, the patient experienced a significant increase in spherical equivalent and corneal astigmatism.

Diagnoses:

Based on a central conic protrusion on topography examination, surgically-induced corneal ectasia was diagnosed.

Interventions:

Topical lubricants, corticosteroids, and serial follow-up with corneal topography.

Outcomes:

The corneal protrusion gradually resolved over a period of 5 months.

Lessons:

For post-LASIK patient who developed corneal protrusion following uneventful cataract surgery with a clear corneal incision, the clear corneal wound may have disrupted the biomechanical stability of the post-LASIK eye, compromising the peripheral stromal integrity. Additionally, postoperative inflammation could have contributed to corneal ectasia. Smaller clear corneal wounds or scleral tunnel entry during cataract surgery in post-LASIK eyes should be considered. Monitoring wound healing and using topical steroids can aid in achieving satisfactory outcomes and reducing the potential vision-threatening complications associated with corneal ectasia.
Association between initial microcirculation disturbance patients and mortality in patients who are critically ill: A retrospective cohort study
Authors: Guo Tongwu , Zheng Rui , Yi Huanying , Yang Yuanzheng
Published: February 2024

Impact of microcirculation status from mortality of critically ill population has been investigated for decades, but the prognosis of early initial microcirculation disturbance in critically ill population in the intensive care unit remains to be explored. The cohort study was conducted using the medical information database for intensive care IV. Critically ill adult in intensive care unit have been enrolled and categorized by early microcirculation status. Cox Proportional-Hazards models have been utilized for testing intermediaries and assess the relationship between combined early initial microcirculation disturbance and mortality. Several 2286 patients were initially screened. Some patients with a highest lactate level >2.2 mmol/L on the firstly day of admission (n = 1468) were then extracted for further analysis. 735 patients received in the initial microcirculation disturbance group as well as 733 patients were in the hyperlactatemia group. In those with elevated lactate, the 28-day mortality of early microcirculation disturbance was higher than that of hyperlactatemia alone (7-day mortality [16.19% vs 12.68%; Adjusted hazard ratio 1.35, 95% confidence intervals 1.03 to 1.78, P = .029], 28-day mortality [33.33% vs 27.28%; adjusted HR 1.34, 95% confidence interval 1.11 to 1.67, P = .002]). Early microcirculatory disturbances (increased PV-ACO2/CA-VO2 ratio and higher initial blood lactate level) were more reliable predictors of in-hospital mortality than early isolated lactate elevation.
Identification of 6 cuproptosis-related genes for active ulcerative colitis with both diagnostic and therapeutic values
Authors: Zou Menglong , Zhang Wei , Zhu Ying , Xu Yin
Published: February 2024

Cuproptosis has been reported to affect a variety of diseases. Therefore, we aimed to examine the role of cuproptosis-related genes in active ulcerative colitis (UC). We acquired 2 datasets of active UC from the Gene Expression Omnibus database and created immune cell infiltrations to research immune cell dysregulation. Based on the cuproptosis gene set and differentially expressed genes (DEGs), we identified the differentially expressed genes of cuproptosis (CuDEGs). We then used 2 machine learning methods to screen hub CuDEGs. Subsequently, we performed validation on additional datasets and investigated the relationship between hub CuDEGs and drug treatments. Thirty-five controls with inactive UC and 90 patients with active UC were obtained from the training sets. A total of 9157 DEGs and 27 CuDEGs were identified, respectively. Immune cell infiltration analysis revealed that patients with active UC exhibited higher levels of activated dendritic cells and neutrophils as well as lower levels of CD8+ T cells, regulatory T cells (Tregs), and macrophage M2. A six-gene cuproptosis signature was identified using machine learning algorithms. We further validated that the 6 hub CuDEGs showed a strong correlation with active UC and acted as cuproptosis-related biomarkers of active UC. Moreover, the expression of ATOX1 was downregulated, and SUMF1, MT1G, ATP7B, FDX1, and LIAS expression was upregulated in the colonic mucosa of active UC patients who responded to golimumab or vedolizumab therapy. With the exception of ATP7B, the expression patterns of hub CuDEGs before and after infliximab treatment of patients with active UC were similar to those of golimumab and vedolizumab. Cuproptosis and active UC have a complex relationship, as illustrated in our study. ATOX1, SUMF1, MT1G, ATP7B, FDX1, and LIAS are cuproptosis-related hub genes of active UC. Our study opens new avenues for investigating UC progression and developing novel therapeutic potential targets for the disease.
Risk perception and its predictors towards type 2 diabetes mellitus among students in Universiti Kebangsaan Malaysia
Authors: Mohd Rawi Siti Bazlina , Low Yan Fay Zoey , Muhammad Khairus Nur Fatin Fasihah , Annandan Shevin Kumar , Mohd Sani Nur’Ain , Mat Termizi Muhammad Hadri , Ahmad Norfazilah , Ibrahim Roszita
Published: February 2024

Type 2 diabetes mellitus (T2DM) has become increasingly prevalent among young adults. Risk perception is believed to be an important determinant of preventive health behaviors; however, young adults remain unaware of the benefits. The current study aimed to examine Malaysian public university students’ perceived risk of developing T2DM and its predictors. This cross-sectional study involved a total of 1078 healthy students at Universiti Kebangsaan Malaysia (UKM). The validated Malay version of the Questionnaire on Risk Perception of Developing Non-Communicable Diseases in Malaysia was used to assess their perceived risk of developing T2DM in the future. Multiple logistic regression was used to analyze the data regarding the predictors of perceived risk to obtain the final model after controlling the potential confounders. . It was found that the majority of respondents (83.8%) perceived low risk of developing T2DM. Results from the multiple logistic regression indicated that respondents from non-health related faculties (OR, 1.71: 95% CI 1.162, 2.515), smoking (OR, 8.43: 95% CI 1.108, 64.130), consume fast food ≥ 3 times/month (OR, 1.56: 95% CI 1.104, 2.207), and snacking ≥ 3 times/week (OR, 1.79: 95% CI 1.262, 2.550) were significant positive predictors while family history of diabetes was a negative predictor (OR, 0.50: 95% CI 0.350, 0.695). Students who self-rated themselves as practising healthy lifestyles and actively seeking health information perceived a low risk of developing diabetes in the future. . The findings indicate that students perceived their risk as low even though they have the risk. This creates an urgent need to emphasize the necessity of diabetes prevention education, especially on socio-behavioral factors, to address the widespread misunderstandings among university students regarding diabetes risk factors to reduce diabetes incidence.
Air tamponade in vitrectomies for primary rhegmatogenous retinal detachment caused by superior breaks
Authors: Zheng Lin , Wu Chan , Luo Mingyue , Zhao Xinyu , Zhao Nan , Chen Youxin
Published: February 2024

The effectiveness of filtered air tamponade for superior retinal breaks was well established. This study was performed to compare the treatment efficacy of pars plana vitrectomies (PPV) with filtered air and silicone oil (SO) for patients with rhegmatogenous retinal detachment (RRD) caused by superior breaks with no or mild proliferative vitreoretinopathy. Patients of RRD with superior breaks who underwent PPV with filtered air (Group A) and SO (Group S) tamponade were reviewed retrospectively. Age, gender, laterality, lens status, duration of symptoms, macular status, proliferative vitreoretinopathy grade, use of perfluorocarbon liquid, early and late postoperative complications, follow-up duration were acquired. The primary anatomic reattachment after the first surgery and the final rate of successful reattachment was compared as the main outcome. Secondary outcomes were long-term postoperative best-corrected visual acuity (BCVA), rate of deferred cataract removal, surgical complications and total surgery number. The primary anatomic success rate was 88% (14/16 eyes) in Group A and 100% (16/16 eyes) in group S, which was not significantly different (P = .484). Both groups achieved 100% final anatomic success. The rate of cataract removal was 57.1% and 100% (P = .016), and the duration from first surgery to cataract surgery was 231.38 ± 241.23 and 156.36 ± 110.09 days (P = .428) for group A and group S, respectively. The rate of postoperative epiretinal membrane was 21.4% vs 25.0% (P = 1.000). Postoperative BCVA was associated with preoperative BCVA after multiple linear analysis. The primary and final anatomic success rate for PPV with air tamponade and SO in treating RRD with superior breaks were not statistically different. The rate of deferred cataract removal was higher in patients with SO as tamponade.
Systemic inflammation response index (SIRI) on the 3rd postoperative day are associated with severe pneumonia in cerebral hemorrhage patients: A single-center retrospective study
Authors: Zhao Yongfeng , Wang Xian , Ren Hongbo , Yao Yuan
Published: February 2024

Inflammatory response was involved in the progression of cerebral hemorrhage. We sought to explore the associations of easily obtained inflammatory indicators including blood cell counts and the ratios of different blood cells counts with pneumonia and severe pneumonia in cerebral hemorrhage patients. We carried 1 retrospective study including 200 patients with cerebral hemorrhage and surgeries. The associations of neutrophils, lymphocytes, monocytes, platelets, systemic immune inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) with pneumonia and severe pneumonia in cerebral hemorrhage patients were estimated by univariate analysis and multivariate logistic regression model. Among the 200 patients included, there were a total of 163 (81.5%) had pneumonia after surgeries. Among 163 cerebral hemorrhage patients with pneumonia, 60 (36.8%) cases were evaluated as severe pneumonia. The level of SIRI on the 1st postoperative day in patients with severe pneumonia was higher than non-severe pneumonia (10.89 ± 12.10 × 109/L vs 7.14 ± 9.76 × 109/L, P = .003). The level of SIRI on the 3rd postoperative day in patients with severe pneumonia was more significantly higher (7.98 ± 7.46 × 109/L vs 4.10 ± 3.74 × 109/L, P < .001). The results of multivariate analysis showed that SIRI level on the 3rd postoperative day (>6.5 × 109/L) was associated with severe pneumonia in cerebral hemorrhage patients (OR: 4.409, 95% CI: 1.799–10.806, P = .001). SIRI was possibly a superior predictor for severe pneumonia in cerebral hemorrhage patients compared with other inflammatory indicators. On the one hand, we intend to validate the cutoff value of SIRI for predicting severe pneumonia in larger samples and multicenter studies. On the other hand, we also intend to use this index to guide the choice of antibacterial drugs in order to better benefit patients.
Predicting diagnostic gene biomarkers in patients with diabetic kidney disease based on weighted gene co expression network analysis and machine learning algorithms
Authors: Gao Qian , Jin Huawei , Xu Wenfang , Wang Yanan
Published: February 2024

The present study was designed to identify potential diagnostic markers for diabetic kidney disease (DKD). Two publicly available gene expression profiles (GSE142153 and GSE30528 datasets) from human DKD and control samples were downloaded from the GEO database. Differentially expressed genes (DEGs) were screened between 23 DKD and 10 control samples using the gene data from GSE142153. Weighted gene co expression network analysis was used to find the modules related to DKD. The overlapping genes of DEGs and Turquoise modules were narrowed down and using the least absolute shrinkage and selection operator regression model and support vector machine-recursive feature elimination analysis to identify candidate biomarkers. The area under the receiver operating characteristic curve value was obtained and used to evaluate discriminatory ability using the gene data from GSE30528. A total of 110 DEGs were obtained: 64 genes were significantly upregulated and 46 genes were significantly downregulated. Weighted gene co expression network analysis found that the turquoise module had the strongest correlation with DKD (R = −0.58, P = 4 × 10-4). Thirty-eight overlapping genes of DEGs and turquoise modules were extracted. The identified DEGs were mainly involved in p53 signaling pathway, HIF-1 signaling pathway, JAK − STAT signaling pathway and FoxO signaling pathway between and the control. C-X-C motif chemokine ligand 3 was identified as diagnostic markers of DKD with an area under the receiver operating characteristic curve of 0.735 (95% CI 0.487–0.932). C-X-C motif chemokine ligand 3 was identified as diagnostic biomarkers of DKD and can provide new insights for future studies on the occurrence and the molecular mechanisms of DKD.
Ultrasound surveillance for deep venous thrombosis and subsequent venous thromboembolism in adults with trauma: A systematic review and meta-analysis
Authors: Al-Sharydah Abdulaziz M. , Alshahrani Mohammed S. , Maghrabi Khalid , Tashkandi Wail , Amer Marwa
Published: February 2024

Background:

Studies have shown routine ultrasound surveillance (RUSS) will facilitate deep vein thrombosis (DVT) detection in patients with trauma and reduce the subsequent incidence of pulmonary embolism (PE); however, the findings were inconsistent. In adults with trauma at a high risk of venous thromboembolism, this systematic review and meta-analysis compared RUSS outcomes with those of “no RUSS.”

Methods:

Three databases were screened for relevant articles from inception to October 18, 2021. Randomized controlled trials (RCTs) and observational studies comparing RUSS with no RUSS were included. We used relative risks (RRs), odds ratios (ORs), and mean differences to pool effect estimates for dichotomous and continuous outcomes. The cochrane risk of bias or the risk of bias in non-randomized studies of interventions were used to assess bias risk. The grading of recommendations, assessment, development, and evaluation framework assessed the certainty of the evidence.

Findings:

Out of 1685 articles, 5 met the inclusion criteria (RCT: 1; observational studies: 4). Observational studies suggested RUSS is associated with higher odds of DVT detection (OR, 4.87; 95% confidence interval [CI], 3.13–7.57; very low certainty). Whereas higher risks of DVT were associated with RUSS in the RCT (distal DVT: RR, 15.48; 95% CI, 7.62–31.48; low certainty, and proximal DVT: RR, 2.37; 95% CI, 1.04–5.39; very low certainty). Reduced odds of PE risk were observed with the RUSS (OR, 0.47; 95% CI, 0.24–0.91; very low certainty). Observational studies indicated that RUSS had an uncertain effect on mortality (OR, 0.46; 95% CI, 0.06–3.49). In the RCT, times to proximal and distal DVT diagnoses were shorter with RUSS (proximal DVT, mean difference 2.25 days shorter [95% CI, 5.74–1.24]; distal DVT, mean differences 1.56 days shorter [95% CI, 4.22–1.12]; very low certainty for both). Increasing bleeding risk was not linked to the RUSS group (RR, 1.24; 95% CI, 0.31–4.92).

Interpretation:

The RUSS efficacy in adults with trauma at high risk for venous thromboembolism showed that it increases DVT detection, decreases PE incidence, and shortens the time to DVT diagnosis, with an uncertain impact on mortality. The evidence is low or very low in certainty because of bias, inconsistency, imprecision, and indirectness.
Zavegepant nasal spray for the acute treatment of migraine: A meta analysis
Authors: Waqas Muhammad , Ansari Faizan Ur Rehman , Nazir Anam , Hussain Khadija Saleem Raza , Sarfraz Zouina , Sarfraz Azza , Sarfraz Muzna , KC Manish
Published: February 2024

Background:

Zavegepant nasal spray is a novel CGRP receptor antagonist that has been developed for the acute treatment of migraine – a prevalent disease leading to disability and economic burden. The meta-analysis aims to quantify the efficacy of Zavegepant compared to standard care or placebo in achieving pain freedom, freedom from most bothersome symptoms (MBS), sustained pain freedom, and pain relapse at 2 to 48 hours.

Methods:

Databases and registers were systematically searched to identify relevant clinical trials. Two independent reviewers used a standardized data extraction form to collect relevant data on primary and secondary outcomes. Statistical analysis was performed in RevMan 5.4 software. The efficacy of Zavegepant was compared to placebo using odds ratios (OR) with 95% confidence intervals (CI). Heterogeneity was assessed using the I2 statistic, chi-square test, Z value, and P value. Cochrane ROB-2 and ROBINS-I tools were used to assess the biases (osf.io/b32ne).

Results:

Of 36 identified studies, 3 were included in this meta-analysis. Zavegepant was more effective in achieving pain freedom (OR: 1.6, P < .00001), and freedom from MBS at 2 hours (OR = 1.4, P < .00001). The intervention group demonstrated a higher likelihood of sustained pain freedom between 2 and 48 hours (OR = 1.74, P < .00001). Although there was a trend towards reduced pain relapse between 2 and 48 hours in the intervention group, the difference was insignificant (OR = 0.67, P = .11).

Conclusion:

This meta-analysis confirms the effectiveness of Zavegepant nasal spray in treating acute migraine, with significant improvements in pain and symptom relief. Further research is needed to determine the effect on pain relapse and overall safety.
Fatal invasive pulmonary aspergillosis in non-immunocompromised host: A case report
Authors: Ao Wanping , Huang Ping , Wang Jinjing , Fu Xiaoyun , Fu Bao
Published: February 2024

Rationale:

Invasive pulmonary aspergillosis (IPA) is an uncommon but life-threatening disease. The disease often occurs in immunocompromised patients or critically ill patients. Here, we reported that IPA occurred in a non-immunocompromised host.

Patient concerns:

A 45-year-old man was admitted to the hospital for 1 week due to fever and cough. He was engaged in waste recycling and lived in a dark and humid environment for a long time.

Diagnosis:

Invasive pulmonary aspergillosis.

Interventions:

Next generation sequencing and pathological examination of alveolar lavage fluid indicated aspergillus infection. He received voriconazole infusion after admission. After 5 weeks of antifungal treatment, his condition improved significantly and discharged.

Outcome:

One week after discharge, his condition deteriorated again and returned to the hospital. Unfortunately, he died.

Lesson:

The immunocompetent adults can develop invasive pulmonary aspergillosis if they are exposed to high-risk environments. IPA in non-immunocompromised host should arouse the vigilance of clinicians.
Nasal microbes in allergic rhinitis children with or without sublingual immunotherapy
Authors: Shen Xiao-Fei , Teng Zhi-Pan , Li Qi , Yu Zhen-Kun
Published: February 2024

The mechanism of allergic rhinitis (AR) remains unclear. Most researchers believe that AR is the result of a combination of environmental and genetic factors. Sublingual immunotherapy (SLIT) is a treatment that can change the natural course of AR through immunomodulatory mechanism and maintain efficacy after the treatment. Nasal cavity is the main site where AR patients contact with external allergens, produce inflammatory reactions and nasal symptoms. Therefore, in this study, we investigate the nasal microbiome in AR patients, and the changes after SLIT. In this cross-sectional study, nasal swabs for microbiome analysis were collected from 3 groups: SLIT-naïve AR patients (AR group), AR patients undergoing SLIT treatment over 2 years (SLIT group) and a control group (CG). The characteristics of nasal microbiome of each groups were produced by 16s-rDNA sequencing technology. The Simpson index of AR group was significantly higher than that of CG and SLIT groups, but not different between SLIT group and CG group. The abundance of Bacteroidete and Firmicutes remarkably increased in the AR group, but Bacteroidete reduced to CG level after SLIT. AR patients have different nasal microbiome composition, but we do not know how it happened and whether the AR condition affected nasal microbiome composition or nasal microbiome affected AR.
Effect of governor vessel moxibustion (GVM) therapy with mild to moderate psoriasis: A randomized clinical trial
Authors: Sun Dan , Feng Wen-Ya , Mou Jing-Kang , Chen Lu , Zhao Yi-Ding , Yan Xiao-Ning , Li Wen-Bin
Published: February 2024

Background:

It was hypothesized that governor vessel moxibustion (GVM) therapy may improve the course of mild to moderate psoriasis (PS) in patients.

Methods:

A randomized, controlled clinical trial lasting 40 days was conducted at the Shaanxi Provincial Hospital of Chinese Medicine. Investigators were blinded to patient groupings. Individuals with mild to moderate PS ranging in age from 18 to 70 years were enrolled. GVM therapy was administered one every 10 days for 40 days with 1.5 hours on the governor meridian in the GVM therapy group. The PS area and severity index (PASI) and dermatological life quality index (DLQI) scores were monitored before and after treatment.

Results:

There was a significant reduction in the mean PASI score in the GVM therapy group of 0.76 points (2.37 [2.61]; SE, 0.39) after 40 days of treatment compared with the control group (3.12 [2.12], SE, 0.32) (P < .01). There were also significantly greater changes in the DLQI scores of the GVM therapy group (4.23 [2.25]; SE, 0.34) compared with those in the control group (8.91 [3.85]; SE, 0.59) (P < .001).

Conclusion:

GVM therapy effectively reduced both PASI and DLQI scores in patients with mild to moderate PS.
Comparison of subperiosteal or subgaleal drainage and subdural drainage in patients with chronic subdural hematoma: A systematic review and meta-analysis
Authors: Song Ling , Zhou Kun , Wang Cheng , Chen Junquan , Feng Bin , Deng Xiaopeng , Du Xiaolin
Published: February 2024

Background:

Chronic subdural hematoma (CSDH) is a relatively common disease, especially in the elderly, for which there is no clear standard of treatment available. The authors systematically evaluated the efficacy of various surgical procedures for the treatment of chronic subdural hematoma.

Methods:

Electronic databases of PubMed, EmBase, Web of Science, Medicine, and the Cochrane Library were searched systematically. Based on the PRISMA template, we finally selected and analyzed 13 eligible papers to evaluate the effect of different drainage methods on CSDH. The primary outcomes were recurrence and clinical outcomes. Secondary outcomes were mortality and postoperative complications and other parameters.

Results:

The meta-analysis included 3 randomized controlled trials and 10 retrospective studies (non-randomized controlled trials) involving 3619 patients. The pooled results showed no statistically significant difference between non-subdural drainage (NSD) and subdural drainage (SD) in mortality and complication rates (P > 0.05). Additionally, overall pooled results showed that the use of NSD (10.9%) has a lower recurrence rate than the use of SD (11.7%), but the results were not statistically significant (relative risk ratio [RR] = 0.98; 95% confidence interval [CI] = 0.70–1.45;I2 = 47%;P = .92). However, the difference between NSD and SD in postoperative bleeding rate reached statistical significance (RR = 2.39; 95% CI = 1.31–4.36;I2 = 0 %;P = .004). Subgroup analysis showed that SD was associated with similar recurrent CSDH (RR = 0.75; 95% CI = 0.52–1.09;I2 = 0%;P = .14), good recovery (RR = 0.98; 95% CI = 0.93–1.04;I2 = 0%;P = .50), and mortality (RR = 0.98; 95% CI = 0.37–2.57;I2 = 0%;P = .96), compared to NSD.

Conclusions:

These results suggest that NSD and SD are equally effective in the treatment of patients with CSDH, with no difference in final clinical characteristics and radiologic outcomes. However, in patients with limited subdural space after evacuation of a hematoma, NSD may be the preferred strategy to avoid iatrogenic brain injury.
Effect of long-acting versus short-acting glucagon-like peptide-1 receptor agonists on improving body weight and related metabolic parameters in type 2 diabetes: A head-to-head meta-analysis
Authors: Yuan Xia , Gao Zhe , Hao Zhihua , Ma Huijuan , Duan Kaixin , Yang Caixuan
Published: February 2024

Background:

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) showed great value in treating nonalcoholic fatty liver disease (NAFLD). We aimed to compare the effectiveness of long-acting and short-acting GLP-1RAs on improving body weight and related metabolic parameters in patients with type 2 diabetes (T2DM) as a reference for the treatment of NAFLD with T2DM.

Methods:

We searched eligible randomized controlled trials (RCTs) in PubMed, Embase, Cochrane and web of science database until August 2023. The risk of bias of included RCTs were assessed by the Risk Assessment of Cochrane Review items. We mainly drew forest plots to compare the effects of long and short acting GLP-1 RAs using RevMan 5.4.

Results:

Twelve RCTs involving 2751 patients were included in our meta-analysis. Compared with short-acting GLP-1 RAs, the long-acting group was better in body weight (P < .00001, MD = −0.65, 95% confidence interval [CI] [−0.90, −0.40], I2 = 20%), and the same results in glycosylated hemoglobin (HbA1c) (P < .00001, MD = −0.43, 95% CI [−0.54, −0.33], I2 = 55%) and fasting plasma glucose (FPG) (P < .00001, MD = −0.77, 95% CI [−1.01, −0.52], I2 =70%). For the lipid parameters, long-acting drugs lowered cholesterol (TC) (P = .02, SMD = −0.19, 95% CI [−0.35, −0.03], I2 =57%) and low-density lipoprotein (LDL) (P = .02, SMD = −0.17, 95% CI [−0.33, −0.02], I2 =51%) more significantly compared with short-acting drugs. But treatment differences were not significant in triglycerides (TG) (P = .40, SMD = −0.05, 95% CI [−0.15, −0.06], I2 = 0%), and high-density lipoprotein (HDL) (P = .85, SMD = −0.01, 95% CI [−0.11, −0.09], I2 = 0%).

Conclusion:

Long-acting GLP-1RAs may be more promise than short-acting GLP-1RAs in improving weight and related metabolic parameters.