bluuebunny/crossref_metadata_2025 huggingface dataset:
The factors of perceived disease knowledge and self-care behavior in type 2 diabetic patients with chronic kidney disease: A cross-sectional study
Authors: Wang Shu-Li , Shien Tiffany Wan-Hua , Chen Tzu-Hui , Hsiao Pei-Ni , Hsiao Shih-Ming , Kung Lan-Fang , Hwang Shang-Jyh , Chiu Yi-Wen , Tsai Yi-Chun , Chang Jer-Ming
Published: November 2023

Chronic kidney diseases (CKD) is an important public health issue worldwide, and diabetes mellitus is the main cause of CKD. Having sufficient disease knowledge and good self-care behavior both help to prevent the progression of diabetes mellitus and CKD. This cross-sectional study enrolled 181 type 2 diabetic patients with CKD from July 2017 to October 2017. Perceived Kidney Knowledge survey and structured questionnaires of self-care behavior were used to measure perceived disease knowledge and CKD Self-Care (CKDSC) scales respectively with the determinants analyzed by linear regression. Meanwhile, socio-demographic information, kidney function and laboratory data were collected. Of 181 enrolled patients, the mean age was 66.8 ± 9.7 years, 59.1% were male and the mean estimated glomerular filtration rate was 33.1 ± 23.1 mL/min/1.73 m2. The mean scores of CKDSC and perceived disease knowledge were 63.2 and 22.4, respectively. High scores of disease knowledge were significantly correlated with low glycated hemoglobin (P = .03) and high scores of overall self-care behavior (P = .03) and aspects of self-care behavior, including diet (P = .003), exercise (P = .02), and home blood pressure monitoring (P = .04). The relationship between young age and high scores of disease knowledge was found (P = .001); however, old age was significantly associated with high scores of overall self-care behavior (P < .001) while additionally, married patients had high scores of regular medication behavior (P = .03). Our findings identified the significant factors correlated with disease knowledge and self-care behavior in type 2 diabetic patients with CKD. Healthcare givers should establish personalized health education plans to improve perceived disease knowledge and self-care behavior.
The effectiveness and safety of herbal medicine on suicidal behavior: A PRISMA-compliant systematic review and meta-analysis
Authors: Kwon Chan-Young , Lee Boram
Published: November 2023

Background:

Suicide is the leading cause of death worldwide. Herbal medicine (HM) has been reported to be related to clinical improvement of some risk factors for suicide including depression. This systematic review aimed to comprehensively investigate the effectiveness and safety of HM on suicidal behaviors.

Methods:

Fifteen electronic databases were searched to search relevant intervention studies, up to September 2022. The methodological quality of the included studies was assessed using the modified Cochrane risk-of-bias tool. In the included studies, outcome on suicidal behavior were analyzed, and the effect sizes were presented as mean differences (MDs) or risk ratios (RRs) with their 95% confidence intervals (CIs) through meta-analysis. The strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results:

A total of 13 randomized controlled trials (RCTs) were included in this review. Two RCTs of HM in patients with suicidal behavior found significant benefits of HM as an adjunct to fluoxetine or cognitive therapy in improving symptoms of depression. In 11 RCTs of HM in patients with other conditions, there was no statistically significant difference between HM and antidepressants in cognitive disturbance (MD, 0.12; 95% CIs, −0.20 to 0.45), a subscale of the Hamilton Rating Scale for Depression (HAMD), and suicidal ideation (0.18; −0.16 to 0.53), an item of HAMD. The overall quality of the included studies was poor. The strength of evidence assessed by GRADE was low or very low.

Conclusions:

Though some of the studies reported significant benefits of HM in improving suicidal behavior in patients with depression, further clarification on some unsolved questions is needed in future well-designed clinical trials.
Heart rate variability analysis in toxic leukoencephalopathy-induced malignant catatonia: A case report
Authors: Srichawla Bahadar S. , Kipkorir Vincent , Hayward Lawrence
Published: November 2023

Rationale:

Toxic leukoencephalopathy, a condition resulting from exposure to toxic substances, can lead to malignant catatonia, a severe motor dysfunction with symptoms such as muscle rigidity and high-spiking fever, hypertensive urgency, and tachycardia. This case study investigates the relationship between toxic leukoencephalopathy-induced malignant catatonia and heart rate variability (HRV), a marker of autonomic nervous system function.

Patient Concerns:

A 51-year-old male presented to the emergency department with acute onset of progressively worsening mental status.

Diagnoses:

The patient was diagnosed with cocaine-induced toxic leukoencephalopathy causing malignant catatonia.

Interventions:

A 5-day escalating treatment regimen was instituted for the management of malignant catatonia until resolution. Daily HRV parameters in the temporal and frequency domain, geometric data, and cardiac entropy were recorded using HRVAnalysis v.1.2 (ANS Lab Tools). The HRV analysis was correlated with pharmacologic management, the Bush-Francis catatonia rating scale, and hemodynamic parameters, including blood pressure, heart rate, and temperature.

Outcomes:

The results showed a correlation between the severity and frequency of malignant catatonic episodes and the patient autonomic dysfunction. Improvement in malignant catatonia with pharmacological management was associated with an improved HRV, including elevated rMSSD, SDNN, cardiac entropy, and pNN50%.

Lessons:

Malignant catatonia is associated with decreased HRV, and its management is associated with an increase. This suggests a link between malignant catatonia and autonomic dysfunction, highlighting the potential benefits of treating malignant catatonia to improve autonomic function and reduce cardiovascular risk.
Colon micro- and macrooesofagisation in interposed pedicled colonic right half segments for esophagus reconstruction
Authors: Wozniak Slawomir , Tabola Renata , Grabowski Krzysztof
Published: November 2023

Treatment of esophageal burns may require surgical transplantation (interposition) of the colon or stomach. The interposed parts change their function and morphology. To investigate the macro- and microchanges in the transplanted colonic segment we analyzed in long-term follow-up (up to 29 years) the group of 21 patients in a retrospective study who underwent surgical interposition of pedicled colonic right half segments for esophageal burns. The data were analyzed statistically with the software package Statistica 13 (StatSoft Polska, Cracow). All calculations were performed with a significant level of P = .05. We evaluated the macro- and microanatomy of the grafts using radiology, endoscopy and histology. The adaptation of the transplanted tube was excellent. The diameter of the colonic tube was normal (35–60 mm) in 60% of females and 100% of males. Typical macrooesophagisation was found in all patients, while microoesophagisation involved inflammation, which gradually resolved over a period of about 5 years to be replaced by edema without fibrosis. Only in few patients persistent reflux was present, leading to erosions or ulcerations. All symptoms subsided after conservative treatment. We concluded macrooesophagization developed gradually after surgery, and was fully developed after 15 to 20 years. Microoesophagization appeared soon after interposition, and was obvious after 5 years. No metaplasia or dysplasia were observed (except in 1 patient), and the number of goblet cell remained constant.
Big data analysis identified a telomere-related signature predicting the prognosis and drug sensitivity in lung adenocarcinoma
Authors: Zhang Weiyi
Published: November 2023

Telomeres exert a critical role in chromosome stability and aberrant regulation of telomerase may result in telomeres dysfunction and genomic instability, which are involved in the occurrence of cancers. However, limited studies have been performed to fully clarify the immune infiltration and clinical significance of telomeres-related genes (TRGs) in lung adenocarcinoma (LUAD). The number of clusters of LUAD was determined by consensus clustering analysis. The prognostic signature was constructed and verified using TCGA and GSE42127 dataset with Least Absolute Shrinkage and Selection Operator cox regression analysis. The correlation between different clusters and risk-score and drug therapy response was analyzed using TIDE and IMvigor210 dataset. Using several miRNA and lncRNA related databases, we constructed a lncRNA-miRNA-mRNA regulatory axis. We identified 2 telomeres-related clusters in LUAD, which had distinct differences in prognostic stratification, TMB score, TIDE score, immune characteristics and signal pathways and biological effects. A prognostic model was developed based on 21 TRGs, which had a better performance in risk stratification and prognosis prediction compared with other established models. TRGs-based risk score could serve as an independent risk factor for LUAD. Survival prediction nomogram was also developed to promote the clinical use of TRGs risk score. Moreover, LUAD patients with high risk score had a high TMB score, low TIDE score and IC50 value of common drugs, suggesting that high risk score group might benefit from receiving immunotherapy, chemotherapy and target therapy. We also developed a lncRNA KCNQ1QT1/miR-296-5p/PLK1 regulatory axis. Our study identified 2 telomeres-related clusters and a prognostic model in LUAD, which could be helpful for risk stratification, prognosis prediction and treatment approach selection.
Differential expression of BCL11b and CDKN2A in CD30-positive peripheral T cell lymphoma: Retrospective study
Authors: Wang Yajing , Zhang Fei , Gao Ning , Bu Peng , Cui Wei , Xi Yanfeng
Published: November 2023

Peripheral T-cell lymphoma is a disease that includes multiple T-cell lymphoma subtypes. It is still unclear whether CD30 can be used as a new target molecule and classification standard for PTCL. Differences in the molecular characteristics of CD30-positive PTCL and CD30-negative PTCL have rarely been reported. This study aimed to analyze the expression of BCL11b and CDKN2A in CD30-positive PTCL and CD30-negative PTCL, in order to guide the pathological classification, prognosis, and clinical treatment of PTCL. Immunohistochemical staining and quantitative reverse-transcription PCR (qRT-PCR) were performed on formalin-fixed paraffin-embedded tissue. Verification of BCL11b and CDKN2A expression in ALCL, PTCL-NOS, AITL and NK/TCL. Based on immunohistochemical analysis, the expression level of BCL11b in the lymph node reactive hyperplasia control group was high at 85.0%, which was higher than 68.8% in CD30-positive PTCL and 44.1% in CD30-negative PTCL (P < .05, respectively). CDKN2A showed expression rates of 70.0% in the control group, 79.2% in CD30-positive PTCL and 79.4% in CD30-negative PTCL. qRT-PCR showed that the relative BCL11b mRNA expression levels in patients with PTCL were lower than those in the control group (0.694 vs 1.832, P = .045). Univariate analysis showed that international prognostic index score, CD30 expression, and BCL11b expression were closely related to prognosis (P < .05, respectively). Multivariate Cox regression analysis revealed that high expression of BCL11b mRNA was an independent factor affecting prognosis (respectively, P < .05). Spearman correlation analysis indicated that BCL11b expression had a significant positive correlation with CD30 expression (P = .005). These results indicate that BCL11b may be involved in CD30 differentiation and PTCL prognosis. The detection and targeting of BCL11b and CD30 may provide new strategies for the treatment and classification of PTCL.
Nursing care for children with fulminant myocarditis treated with extracorporeal membrane oxygenation
Authors: Wang Zaihua , Shao Ying , Yang Liu , Li Xiaodan , Hao Lina
Published: November 2023

To summarize the nursing experience of treating pediatric fulminant myocarditis with extracorporeal membrane oxygenation (ECMO). The intensive care unit of our hospital treated 6 children with fulminant myocarditis with ECMO from 2019 to 2022. The main nursing measures included establishing an ECMO rescue team, preparing before initiation of ECMO, management of arterial and venous catheters, enteral nutrition support, reducing the risk of infection aggravation, anticoagulation management, prevention of bleeding and thrombosis, management of ECMO pump failure, and post-ECMO care. One child’s family abandoned treatment and left the hospital, while the other 5 children were transferred to the cardiovascular department after stable weaning from ECMO and continued treatment, with good condition, and eventually discharged. Pediatric fulminant myocarditis has a high mortality rate, but detailed evaluation and nursing care can improve the outcome of these patients.
The relationship between Alzheimer disease and thyroiditis: A two-sample Mendelian randomization study
Authors: Yu Haiyang , Song Xuejie
Published: November 2023

This study aims to investigate the causal effect of Alzheimer disease on thyroiditis using medical English and the Nature journal style. Genome-wide association data for Alzheimer disease and thyroiditis were obtained from the Mendelian Randomization (MR) platform. Single nucleotide polymorphisms (SNPs) significantly associated with Alzheimer disease were identified and used as instrumental variables (IVs) to examine the causal relationship between Alzheimer disease and thyroiditis, employing a 2-sample MR study design. Five statistical methods, including inverse-variance weighted (IVW) method, weighted median estimation, simple mode estimation, weighted mode estimation, and MR-Egger regression, were utilized. In the study, 13 single nucleotide polymorphisms (SNPs) were identified to be significantly associated with Alzheimer disease (P < 5 × 10–8, linkage disequilibrium r2 < 0.001). Upon evaluation using different methods, a consistent association between Alzheimer disease and thyroiditis was observed inverse variance-weighted method [IVW]: odds ratio [OR] 1.32, 95% confidence interval [CI] 1.01–1.72; weighted median estimator: OR 1.32, 95% CI 1.01–1.72; Mendelian randomization Egger regression: OR 1.29, 95% CI 0.92–1.81), indicating a positive correlation between Alzheimer disease and increased risk of thyroiditis. There was no evidence suggesting that the observed causal relationship between Alzheimer disease and thyroiditis risk could be influenced by pleiotropy (Mendelian randomization Egger intercept 0.0058, P = .88. Our MR analysis reveals causal association of Alzheimer disease and thyroiditis, despite observational studies reporting an association between Alzheimer disease and thyroiditis.
Maturity degree assessment of hospital ward system using integrated fuzzy AHP-TOPSIS model
Authors: Li Lan , Tong Junping , Wang Huan , Ren Ruihua , Xiong Luning , Wang Jiyun
Published: November 2023

Background:

The hospital ward system is the core service unit of a hospital and an important aspect of hospital management. The maturity of the hospital ward system represents the level of development and improvement in ward management and services. In order to improve the quality of hospital services, it is significant to assess the maturity of the ward system. Although various assessment methods have been proposed in existing studies, there are some issues such as a single-dimensional factor system, subjectivity in qualitative factor values, and insufficient objectivity in the evaluation methods.

Methods:

Therefore, based on the data collection of the factors used in the existing literature, this study made correlation analysis, determined the similarity of factors, and established a maturity assessment factor system satisfying distinctiveness and comprehensiveness. Furthermore, an evaluation method for the weights of each factor was proposed based on the fuzzy analytic hierarchy process, while taking account of the ambiguity of expert information. In addition, through the technique for order of preference by similarity to ideal solution method, an objective evaluation method for the maturity of the hospital ward system was established. Finally, a case study involving 6 hospitals in a specific location was conducted.

Results:

There are a total of 16 factors used to assess the maturity of the hospital ward system, among which the most important is Doctor service. The maturity degree of the 6 researched hospitals are 0.4517, 0.0035, 0.4254, 0.8681, 0.6636, 0.1586, and the maturity degree of the 6 researched hospitals are II, I, II, IV, III, I.

Conclusion:

The factor system constructed in this study effectively reflected the importance of human-related factors in the development process of ward system. The evaluation results were consistent with the actual situation, demonstrating the effectiveness of the proposed method.
The ulcerative colitis endoscopic index of severity score is superior to reflecting long-term prognosis in ulcerative colitis patients treated with vedolizumab
Authors: Yan Jing , Liu Ailing , Fang Liang , Wu Jun , Ding Xueli , Xu Yonghong
Published: November 2023

The scoring systems commonly used to assess endoscopic disease severity of ulcerative colitis (UC) in clinical research and practice include the Mayo endoscopic score (MES), ulcerative colitis endoscopic severity index (UCEIS), and degree of ulcerative colitis burden of luminal inflammation (DUBLIN). We aimed to assess and compare the predictive efficacy of the MES, DUBLIN score and UCEIS score for prognosis in UC patients treated with vedolizumab (VDZ).

Seventy-four UC patients who treated with VDZ from September 2021 to February 2023 were retrospectively enrolled. We used the MES, DUBLIN and UCEIS score to evaluate endoscopic findings. The predictive capability of these 3 scores for surgery or therapeutic escalation was assessed using the receiver operating characteristic curve.

The mean MES, DUBLIN and UCEIS score significantly improved from 2.83 ± 0.38, 7.80 ± 1.82 and 6.24 ± 1.51 to 2.07 ± 0.88, 5.57 ± 2.68, and 3.72 ± 2.12, respectively (P < .001). Lower pre-therapeutic UCEIS scores were associated with favorable short-term outcomes. Importantly, the post-therapeutic UCEIS score showed the best predictive capability with an area under curve of 0.871 (95% confidence interval: 0.767–0.976), specificity of 0.654, sensitivity of 0.900, and cutoff value of 3.5. A UCEIS score of ≥ 4 after treatment was correlated with surgical operation or treatment escalation.

The UCEIS score is superior to the MES and DUBLIN score in reflecting short-term outcomes and long-term prognosis in UC patients treated with VDZ, and clinical remission could be defined as a UCEIS score ≤ 3.
Relationship between TLR-2 level and clinical or radiological severity on patients with tuberculosis spondylitis in Dr. Wahidin Sudirohusodo hospital Makassar
Authors: Arifin Jainal , Saleh M. Ruksal , Argo Risang Setyo , Kennedy Dave , Usman M. Andry , Singjie Leonard Christianto
Published: November 2023

Spinal tuberculosis or TB spondylitis is one of the most common types of extra pulmonary tuberculosis, which is about 15% of all cases. It causes severe morbidity, neurological deficits, and severe deformities in the patients. The growth of Mycobacterium tuberculosis in culture specimens obtained from infected tissue is the single gold standard diagnostic test for spinal TB. Toll-like receptor (TLR) is one of the important receptors in the first-line defence system against microbes. TLR-2 and TLR-4 are known to be associated with tuberculosis infection. Based on this background, the researchers were interested in examining the relationship between TLR-2 levels and the clinical and radiological severity of TB spondylitis patients. A cross-sectional study was conducted with patients diagnosed with tuberculosis spondylitis at Dr Wahidin Sudirohusodo Makassar. Patients diagnosed with TB spondylitis confirmed by blood tests, GeneExpert, and magnetic resonance imaging without prior treatment were included. Data analysis were conducted by using descriptive analysis and one-way ANOVA for bivariate analysis. The mean value of TLR2 levels in TB spondylitis patients was 9.1 g/dL. TLR2 levels in paraesthesia were significantly higher than normal (P < .05). Similar trend were analyzed on the motor neurologic status with TLR2 levels in paraparesis were significantly higher than those in normal (P < .05). There is a significant relationship between the TLR2 levels in TB spondylitis and their impaired motor and sensory function. Spinal destruction has been shown to provide significant relationship with TLR2 value in spondylitis TB.
Effects of music therapy on pain relief during fundus screening in infants: Randomized controlled clinical trial
Authors: Chen Renyi , Duan Shijie , Wang Yin , He Fengqin , Ren Li , Peng Wentao
Published: November 2023

Background:

To determine the efficacy of music therapy on pain relief during fundus screening in infants.

Methods:

The sample consisted of infants aged 0 to 3 months who required fundus screening. Infants were randomized to fast music, slow music, and control groups. All groups underwent fundus screening under topical anesthesia. Music therapy was provided to the music groups prior to, during, and after the operation. The patient’s heart rate (HR), transcutaneous oxygen saturation, and crying decibel were measured. The Face, Legs, Activity, Cry, Consolability scale was used for pain measurement.

Results:

A total of 300 subjects’ data were collected. The quantitative analysis revealed that in both music groups, peripheral capillary oxygen saturation and satisfaction levels increased while pain scores decreased (P < .05). The slow music group’s HR was shown to have significantly decreased (P < .05).

Conclusion:

Music therapy can effectively reduce pain and crying, and increase blood oxygen saturation during fundus examination of infants. Music with a rhythm of 60 to 80 beats per minute can decrease HR. Music therapy must be remembered to increase infants’ comfort during fundus examination.
B cells intervention in inflammatory mechanism of ankylosing spondylitis: A visualization analysis for the past 20 years
Authors: Yu Qing , Liu Zhaoyi , Xu Xiaohan , Liu Hongxiao
Published: November 2023

Ankylosing spondylitis (AS) is an autoimmune disease with complex inflammatory mechanism. The aim of this study is to apply the methods of bibliometrics and knowledge mapping to analyze the research trends and hot spots of B cells intervention in inflammatory mechanism of AS. Global published articles on B-cells intervention in inflammatory mechanism of AS were retrieved from the Web of Science (WOS) database from 2004 to 2023. CiteSpace 6.1.R6 software was used to conduct the visualization analysis of countries, authors, institutions, references and keywords in this field. A total of 359 related articles were collected. Since 2004, the number of articles published in the field of B cells intervention in inflammatory mechanism of AS has shown a fluctuating upward trend. The 29 core authors are part of a research group centered on Bowness, Paul and Breban, Maxime. The main research institutions are Anhui Med Univ and Charite. Co-citation analysis reveals that research in this field is currently focused on “intergenic region” and “bone mineral density.” Keyword analysis shows that the current research hotspots and trends in this field mainly focus on the cellular immune mechanism, humoral immune mechanism and clinical application value of B cells intervention in inflammatory mechanism of AS. In the past 20 years, the research on the mechanism of B cells intervention in AS inflammation has focused on B cells intervention in AS inflammation through humoral and cellular immune mechanisms. The future research focus may tend to use B cells as a new therapeutic target for AS.
Prevalence of depression and anxiety among diabetic patients in Egypt: A cross-sectional study
Authors: Abd-Elgawad Mohamed , Abdelsattar Nada K. , Genedy Gehad T. , Madeeh Alyaa K. , Khamis Moaz , Ryaad Mahmoud , Hassaan Wessam H. , Abdullah Eman A. , Mustafa Marwa G. , Assar Ahmed , Farhat Abdullah M. , Soliman Youssef , Shrestha Abhigan Babu , Taha Amira Mohamed
Published: November 2023

Depression and anxiety are highly prevalent among diabetics and may reduce their quality of life. However, data is limited on the prevalence of depression and anxiety among Egyptian diabetics. Therefore, we aimed to assess the prevalence of anxiety and depression and their association with different demographics and comorbidities among Egyptian diabetics. This multicentric cross-sectional study included 679 patients with diabetes in Fayoum, Egypt. We assessed the prevalence of depression and anxiety using the Hospital Anxiety and Depression Scale and collected socio-demographic characteristics with other relevant clinical variables. We used descriptive statistics to describe demographic characteristics and frequency of depression and anxiety. We applied logistic regression to measure the association between the different covariates and depression/anxiety. Of 679 diabetic patients, 65.4% were females, and 54.1% were above 50 years old. The median (IQR) age was 52 [43, 60]. Overall, 34.2% had depression, and 38% had anxiety. The results of multiple logistic regression suggested that age (odds ratio [OR] = 2.28, 95% confidence interval [CI] [1.54, 3.41]), neuropathy (OR = 2.25, 95% CI [1.38, 3.70]), sexual dysfunction (OR = 2.24, 95% CI [1.02, 4.96]), the presence of coma or spasm (OR = 2.82, 95% CI [1.44, 5.72]), and anxiety (OR = 3.15, 95% CI [2.21, 4.52]) were associated with increased risk of depression among diabetics. For anxiety, only the presence of depression was strongly associated with an increased risk of anxiety (OR = 2.99, 95% CI [2.12, 4.24]). Over one-third of Egyptian diabetics had depression and anxiety. Depression and anxiety may be associated with poor clinical outcomes in diabetics.
Research progress of glucocorticoid resistance in chronic rhinosinusitis with nasal polyps: A review
Authors: Chen Langlang , Fan Xin , Yang Lina , Han Lu , Wang Ningbo , Bian Ka
Published: November 2023

Chronic rhinosinusitis with nasal polyps (CRSwNP) is one of the common chronic inflammatory diseases in otolaryngology. Glucocorticoid (GC) acts as the first-line drug for the treatment of CRSwNP in clinical practice, and they play an irreplaceable role in reducing nasal mucosal inflammation and restoring the normal physiological function of the nasal mucosa. However, many patients are still insensitive to GC treatment, known as GC resistance, which leads to poor control of the disease, and the underlying mechanisms are still not fully elucidated. This article provides a comprehensive overview of the research progress of GC resistance of patients with CRSwNP in recent years.
Reliability and validity of eye–hand coordination pointing tests for older adults
Authors: Saito Kazuo , Suzuki Makoto , Koyama Maki , Yamamoto Junichi , Futaki Toshiko
Published: November 2023

To examine the reliability and validity of eye–hand coordination pointing with pencil test (EHCPPT), which evaluates the spatial and temporal displacement of rhythmic movements. One hundred and thirty-five older adults participated in our study. Reproducibility of the EHCPPT was assessed by the participants tapping on the center of the circles using a tablet pen in response to 2 types of stimulus sound sequences (Test A and B) across 2 separate trials, the first and second half. Construct validity was assessed by comparison in the distances between ultimate and current processing abilities, based on the spatial and temporal displacement relationship across Test A and Test B. Concurrent validity was assessed by examining the relationship between the distances between ultimate and current processing abilities and the motor and cognitive functions. Spatial and temporal displacements showed an excellent intraclass correlation coefficient in both Tests A and B of EHCPPT. The distance between ultimate and current processing ability, based on the relationship of spatial and temporal displacement, was significantly shorter in Test A compared to Test B. Spatial and temporal displacements were correlated with motor and cognitive functions. The spatial and temporal displacements of EHCPPT indicated reproducibility and validity in older adults. The EHCPPT may serve as a rhythmic movement reflecting motor and cognitive functions.
Influence of minimum segment width on intensity-modulated radiotherapy plan for left-sided breast cancer after breast conserving surgery
Authors: Wang Ning , Chen Lijuan , Huang Guosen , Sun Haitao
Published: November 2023

To research the influence of the minimum segment width (MSW) on intensity-modulated radiotherapy (IMRT) plan for left breast cancer after breast conserving surgery and provide a reference for plan optimization. Ten patients with left-sided early-stage breast cancer after breast-conserving surgery (BCS) were selected for postoperative radiotherapy. The Monaco 5.11 treatment planning system (TPS) was used, and the optimization parameters of the plan were fixed, while MSW were set to 0.5, 1, 1.5, and 2 cm, and four 5 field-IMRT plans were designed for every patient. The plan quality and execution efficiency of each plan were compared, including planning target volume (PTV) dose, organs at risk (OAR) dose, segments number (SN), monitor units (MU), delivery time (DT), and dose verification results. With the increase of the MSW, the dose indexes of the OAR were similar (P > .05). The D
2%, D
98%, and D
50% of the PTV gradually deviated from the prescription dose, and the uniformity gradually deteriorated (P < .05). The gamma passing rates (GPR) of dose verification and the dose deviation of the PTV were similar (P > .05). The SN, MU, and DT gradually decreased (P < .05), but the amplitude change caused by each increase of 0.5 cm gradually decreased, the decrease of 0.5 to 1 cm was the largest, reaching 16.41%, 21.25%, and 0.35 minutes, respectively, while the 3 values of 1.5 and 2 cm were close. When using Monaco 5.11 TPS to design IMRT plan for left breast cancer after BCS, 1.5 cm MSW could ensure better dose coverage and uniformity of the PTV, as little as possible exposure dose to the OAR, and high dose verification accuracy. The SN, MU, and DT were significantly reduced, and the treatment efficiency was improved.
Identification of LGR4 as a prognostic biomarker in KRAS-mutant lung adenocarcinoma: Evidence from integrated bioinformatics analysis
Authors: Dodin Yasmeen
Published: November 2023

Globally, lung cancer is the leading cause of cancer-related deaths, primarily non-small cell lung cancer. Kirsten Rat Sarcoma Oncogene Homolog (KRAS) mutations are common in non-small cell lung cancer and linked to a poor prognosis. Covalent inhibitors targeting KRAS-G12C mutation have improved treatment for some patients, but most KRAS-mutant lung adenocarcinoma (KRAS-MT LUAD) cases lack targeted therapies. This gap in treatment options underscores a significant challenge in the field. Our study aimed to identify hub/key genes specifically associated with KRAS-MT LUAD. These hub genes hold the potential to serve as therapeutic targets or biomarkers, providing insights into the pathogenesis and prognosis of lung cancer. We performed a comprehensive analysis on KRAS-MT LUAD samples using diverse data sources. This included TCGA project data for RNA-seq, clinical information, and somatic mutations, along with RNA-seq data for adjacent normal tissues. DESeq2 identified differentially expressed genes (DEGs), while weighted gene co-expression network analysis revealed co-expression modules. Overlapping genes between DEGs and co-expression module with the highest significance were analyzed using gene set enrichment analysis and protein-protein interaction network analysis. Hub genes were identified with the Maximal Clique Centrality algorithm in Cytoscape. Prognostic significance was assessed through survival analysis and validated using the GSE72094 dataset from Gene Expression Omnibus (GEO) database. In KRAS-MT LUAD, 3122 DEGs were found (2131 up-regulated, 985 down-regulated). The blue module, among 25 co-expression modules from weighted gene co-expression network analysis, had the strongest correlation. 804 genes overlapped between DEGs and the blue module. Among 20 hub genes in the blue module, leucine-rich repeats containing G protein-coupled receptor 4 (LGR4) overexpression correlated with worse overall survival. The prognostic significance of LGR4 was confirmed using GSE72094, but surprisingly, the direction of the association was opposite to what was expected. LGR4 stands as a promising biomarker in KRAS-MT LUAD prognosis. Contrasting associations in TCGA and GSE72094 datasets reveal the intricate nature of KRAS-MT LUAD. Additional explorations are imperative to grasp the precise involvement of LGR4 in lung adenocarcinoma prognosis, particularly concerning KRAS mutations. These insights could potentially pave the way for targeted therapeutic interventions, addressing the existing unmet demands in this specific subgroup.
Gas therapy strategies for depression and schizophrenia: A review
Authors: Tao Xun , Zhu Xiaoxuan , Liu Yang , Wang Ling , Wang Dan , Sun Lin , Li Changjiang , Lian Bo , Wang Yingshuai , Chen Feng
Published: November 2023

Depression and schizophrenia are 2 serious mental disorders. Their effective treatment is an urgent medical and social problem at present. Drug treatment is the basic measure to improve mental disorders, especially serious mental disorders. However, the side effects of traditional antipsychotic drugs cannot be avoided. Surprisingly, in recent years, it has been found that nitric oxide (NO), carbon monoxide (CO), hydrogen sulfide (H2S) and hydrogen (H2) can regulate corresponding signal pathways to treat mental diseases in animal models. More importantly, as gas signal molecules, they will not bring toxicity and side effects after metabolism. Therefore, in this review, we analyzed the effects of gas on depression and schizophrenia through endogenous gas generation and external gas delivery strategies in some animal models. Endogenous gas generation strategy: summarized the therapeutic mechanism of gas signaling molecules on depression and schizophrenia, and listed the main ways to inhibit or stimulate gas generation. External gas delivery strategy: The common external stimuli-responsive gasotransmitter prodrugs and some study of these prodrugs in the treatment of depression and schizophrenia are summarized. We also analyzed the prospects of nano-gas carrier in the treatment of depression and schizophrenia. Through this review, we hope to provide guidance for treating depression and schizophrenia by regulating relevant gas signal pathways, and provide reference for developing safe and effective drugs for treating mental disorders by summarizing exogenous gas drugs.
Ultrasonographic Features of Nonneoplastic Protrusions in Pancreatic Cysts by Contrast-Enhanced Endoscopic Ultrasound
Authors: Hisa Takeshi , Kudo Akiharu , Shimizu Takehiro , Nishiyama Shigeru , Yamada Takahiro , Osera Shozo , Fukushima Hideki , Tomori Akihisa
Published: November 2023

Objectives

Most of the pancreatic cyst protrusions detected by B-mode endoscopic ultrasound (BM-EUS) are nonneoplastic and are not enhanced by contrast-enhanced EUS (CE-EUS) using ultrasound contrast agent (USCA). This study aimed to identify useful findings for distinguishing between neoplastic and nonneoplastic pancreatic cyst protrusions on BM-EUS to facilitate efficient USCA use.

Materials and Methods

A total of 151 pancreatic cyst protrusions in 119 consecutive patients who underwent CE-EUS were analyzed. We focused on the echo level (hyperechoic/isoechoic/hypoechoic/anechoic), base type (sessile without a basal waist/sessile with a basal waist/pedunculated), surface type (smooth/irregular), and the presence/absence of a hyperechoic surface layer. Enhanced and unenhanced protrusions on CE-EUS were interpreted as neoplastic and nonneoplastic, respectively.

Results

Forty-five and 106 protrusions were enhanced and unenhanced, respectively, on CE-EUS performed using USCA. In univariable analysis of predictors of nonneoplastic protrusion on BM-EUS, the following factors were found to be significant: echo level (hypoechoic/anechoic), base type (sessile with a basal waist/pedunculated), a smooth surface, and a hyperechoic surface layer. Of these, only a hyperechoic surface layer remained significant in the multivariable analysis (P < 0.0001; odds ratio, 40.74; 95% confidence interval, 7.07–387.49).

Conclusions

Pancreatic cyst protrusions with a hyperechoic surface layer on BM-EUS are suggestive of nonneoplastic disease.
Outcomes of a Fatigue Management Intervention for People With Post COVID-19 Condition
Authors: Stapleton Tadhg , Norris Louise , Clancy Kathleen , O’Gorman Aoife , Bannan Ciaran , Kent Brian , Conlon Peter , Nadajaran Parthiban , Kerr Colm , Connolly Deirdre
Published: November 2023

Objective

Fatigue is identified as one of the most prevalent and persistent problems reported by people with post COVID-19 condition that negatively impacts on everyday living and resumption of pre–COVID-19 lifestyle. A pilot occupational therapy fatigue management intervention was designed for patients presenting with post COVID-19 condition fatigue.

Design

A retrospective analysis was carried out after the delivery of the fatigue management intervention. Self-reported measures of fatigue, well-being, and health status were taken at baseline and repeated at 2 wks after intervention. Baseline and postintervention scores were compared using nonparametric analysis.

Results

Sixty participants (73% female), median age 50.5 yrs (range, 17–74), 93% reporting symptoms persisting for 12 wks or longer, completed the fatigue management intervention. All participants reported moderate to severe fatigue impacting on everyday activity at baseline. The greatest impact of fatigue was on engagement in leisure and work activity. Statistically significant improvement in fatigue (P < 0.001), well-being (P < 0.001), and health status (P < 0.001) were noted after the intervention.

Conclusions

Findings indicate the potential of occupational therapy fatigue management interventions to enable self-management strategies and reduce the negative impact of fatigue among people with post COVID-19 condition.
Experimental and numerical analyses of alternate materials for performance enhancement of Jaipur foot
Authors: Mali Harlal Singh , Singh Shamsher , Savasni Smitkumar
Published: November 2023

Background:

The Jaipur foot is the gold standard in low-cost prosthetics, and the amputee population in low-income and middle-income countries has benefited immensely from this innovation. The ability of the Jaipur foot to mimic the behavior of a regular foot, albeit to a limited extent, has made it a popular choice among clinicians and patients. However, the immense popularity has also hindered further research because minimal efforts have been made to investigate the scope of improvement of the Jaipur foot, particularly with new materials.

Objective:

This article focuses on numerical and experimental analyses of various materials for the performance enhancements of the Jaipur foot.

Methods:

Contemporary materials are used in finite element analysis to filter the most suitable alternate material for microcellular rubber. The performance of the Jaipur foot fabricated with alternate material is compared with the conventional Jaipur foot through compression testing simulating gait cycle conditions.

Results:

The EVA foot showed 1–3 mm higher deformation than the MCR foot during the dorsiflexion or heel strike phases, which indicates an appropriate shock absorption and energy storage capacity in heel striking conditions. In forefoot strike phase or plantarflexion, the EVA foot and MCR foot showed identical behavior in deformations. Replacing the MCR with EVA also resulted in reduced weight of the Jaipur foot by 23%.

Conclusions:

The weight reduction can help the amputee to expend less energy, thereby improving patient comfort and walking patterns and hence a more natural performance similar to a regular human foot.
Photon-Counting Computed Tomography Versus Energy-Integrating Dual-Energy Computed Tomography: Virtual Noncontrast Image Quality Comparison
Authors: Dane Bari , Ruff Andrew , O'Donnell Thomas , El-Ali Alexander , Ginocchio Luke , Prabhu Vinay , Megibow Alec
Published: November 2023

Purpose

This study aimed to compare the image quality of portal venous phase–derived virtual noncontrast (VNC) images from photon-counting computed tomography (PCCT) with energy-integrating dual-energy computed tomography (EI-DECT) in the same patient using quantitative and qualitative analyses.

Methods

Consecutive patients retrospectively identified with available portal venous phase–derived VNC images from both PCCT and EI-DECT were included. Patients without available VNC in picture archiving and communication system in PCCT or prior EI-DECT and non–portal venous phase acquisitions were excluded. Three fellowship-trained radiologists blinded to VNC source qualitatively assessed VNC images on a 5-point scale for overall image quality, image noise, small structure delineation, noise texture, artifacts, and degree of iodine removal. Quantitative assessment used region-of-interest measurements within the aorta at 4 standard locations, both psoas muscles, both renal cortices, spleen, retroperitoneal fat, and inferior vena cava. Attenuation (Hounsfield unit), quantitative noise (Hounsfield unit SD), contrast-to-noise ratio (CNR) (CNRvascular, CNRkidney, CNRspleen, CNRfat), signal-to-noise ratio (SNR) (SNRvascular, SNRkidney, SNRspleen, SNRfat), and radiation dose were compared between PCCT and EI-DECT with the Wilcoxon signed rank test. A P < 0.05 indicated statistical significance.

Results

A total of 74 patients (27 men; mean ± SD age, 63 ± 13 years) were included. Computed tomography dose index volumes for PCCT and EI-DECT were 9.2 ± 3.5 mGy and 9.4 ± 9.0 mGy, respectively (P = 0.06). Qualitatively, PCCT VNC images had better overall image quality, image noise, small structure delineation, noise texture, and fewer artifacts (all P < 0.00001). Virtual noncontrast images from PCCT had lower attenuation (all P < 0.05), noise (P = 0.006), and higher CNR (P < 0.0001–0.04). Contrast-enhanced structures had lower SNR on PCCT (P = 0.001, 0.002), reflecting greater contrast removal. The SNRfat (nonenhancing) was higher for PCCT than EI-DECT (P < 0.00001).

Conclusions

Virtual noncontrast images from PCCT had improved image quality, lower noise, improved CNR and SNR compared with those derived from EI-DECT.
Pharmacokinetics and Tolerability of the Cancer-Targeting MRI Contrast Agent MT218 in Healthy Males
Authors: Li Yajuan , Apseloff Glen , Tweedle Michael F. , Gao Songqi , Henry Eugenia , Lu Zheng-Rong
Published: November 2023

Objective

The aim of this study was to evaluate the pharmacokinetics and safety profile of MT218, a peptide-targeted gadolinium-based contrast agent, in healthy males.

Materials and Methods

This was a double-blind, randomized, placebo-controlled, single-ascending-dose study including 30 healthy male subjects. In each dose group (0.01, 0.02, 0.04, and 0.08 mmol/kg), 4 subjects received MT218 and 2 subjects received placebo (saline) in bolus injections. The highest dose group (0.08 mmol/kg) was assessed in 2 cohorts, 1 fasted and 1 nonfasted. Clinical laboratory tests, vital signs, and electrocardiograms were investigated. Gadolinium concentrations were measured in plasma samples collected before administration and over a 24-hour period postinjection, and in urine specimens collected until 22 days. A noncompartmental model was used for pharmacokinetic analysis. A clinical and biological safety follow-up was carried out for up to 6 months.

Results

No clinically significant modifications in biochemistry, hematology, urinalysis, electrocardiogram parameters, or vital signs were reported at any time point for any treatment group. No serious adverse events were observed in any dose group. Transient dizziness, hyperhidrosis, and injection site coldness were the main adverse events reported in both the MT218 and placebo groups. The mean total apparent clearance decreased slightly with increasing dose, and the median plasma t1/2ranged from 1.7 hours in the 0.01 mmol/kg group to 2.7 hours in the 0.08 mmol/kg nonfasted group. MT218 was rapidly excreted via renal filtration with 42.9% to 52.8% of the injected dose measured in urine within the first hour after administration, and 92.5% to 117.3% in urine within 24 hours. No Gd was detected by inductively coupled plasma mass spectrometry in urine after 21 days.

Conclusion

Single intravenous administration of MT218 was safely tolerated in the healthy males. Itspharmacokineticparameters and safety profile are well aligned with those of other gadolinium-based contrast agents.
The Role of Dual-Phase 18F-FP-CIT PET to Early Diagnosis of Corticobasal Syndrome
Authors: Kim Min Seung , Park Dong Gueu , Shin In Ja , An Young Sil , Yoon Jung Han
Published: November 2023

Background

Corticobasal syndrome (CBS) is a neurodegeneration characterized by asymmetric parkinsonism, dystonia, myoclonus, and apraxia. In the early stage, CBS presents with asymmetric parkinsonism and cortical symptoms (apraxia and alien hand), and neuroimaging finding is often vague, making early clinical differentiation from idiopathic Parkinson disease (IPD) challenging. This study was performed to delineate the specific patterns of cortical hypoperfusion, dopamine transporter (DAT) uptake using dual-phase FP-CIT PET in discriminating between CBS and IPD at early stage.

Patients and Methods

The study enrolled clinically diagnosed CBS (n = 11) and IPD (n = 22) patients (age and sex matched). All participants underwent dual-phase 18F-FP-CIT PET, and regional SUV ratio (SUVR) was obtained by semiquantitative analysis. The early perfusion imaging and DAT imaging were compared between groups.

Results

The regional SUVRs (early phase) of the frontal lobe, thalamus, cingulate, and caudate were significantly lower in patients with CBS, whereas the SUVR of occipital lobe was lower in the IPD group. The CBS group exhibited more prominent asymmetry than the IPD group, particularly in the perirolandic area, superior frontal gyrus, and anterior parietal lobe in early phase PET. Striatal DAT uptake (delayed phase) revealed that the caudate showed lower SUVR and prominent asymmetry in the CBS group, and the caudate-to-putamen ratio (CP ratio) was significantly lower in CBS patients (P < 0.001). Among the parameters (early and delayed), the CP ratio in DAT exhibited the most powerful discriminative power from receiver operating characteristic curve comparison (area under curve = 0.983).

Conclusions

This study demonstrated that the dual-phase FP-CIT PET is useful in differentiating CBS and IPD in the early stage of the disease, and a lower CP ratio of DAT imaging is highly informative for distinguishing between corticobasal degeneration and IPD.
18F-FDG PET/CT Imaging of Idiopathic Granulomatous Mastitis
Authors: Muthuswamy Keerthini , Subesinghe Manil
Published: November 2023

A 43-year-old woman, who presented with a suspected left breast abscess, underwent serial ultrasounds, which demonstrated inflammatory changes that were nonresponsive to antibiotics and which spread to the contralateral breast. 18F-FDG PET/CT demonstrated diffuse heterogeneous intense FDG uptake in both breasts with reactive axillary nodes. Breast biopsy confirmed granulomatous inflammation, and overall findings were consistent with idiopathic granulomatous mastitis. In the absence of histological analysis, idiopathic granulomatous mastitis is an important differential diagnosis to consider for bilateral abnormal breast uptake, and early recognition can facilitate prompt commencement of treatment.