bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular Risk Management in Patients Treated With Janus Kinase Inhibitors
Authors: Shah Jill T. , Shah Keya T. , Femia Alisa N. , Lo Sicco Kristen I. , Merola Joseph F. , Weber Brittany , Garshick Michael S.
Published: August 2023

The Janus kinase-signal transducer and activator of transcription pathway plays a critical role in the pathogenesis of many immune-mediated inflammatory diseases (IMIDs). Although Janus kinase inhibitors (JAKi) are an effective treatment for several IMIDs, they have come under scrutiny as a class because of a potential risk of venous thromboembolism and cardiovascular (CV) events, specifically noted with the oral JAKi, tofacitinib, as reported in the ORAL Surveillance Trial of a high CV risk rheumatoid arthritis population. This trial resulted in a black box warning from the Food and Drug Administration and European Medicines Agency regarding risk of venous thromboembolism and CV events that was extended across several types of JAKi (including topical ruxolitinib) when treating IMIDs, leading to considerable controversy. Included is an up-to-date review of the current and rapidly evolving literature on CV risk in patients with IMIDs on JAKi therapy, including identification of potential risk factors for future venous thromboembolism and CV events on JAKi therapy. We suggest a comprehensive, multimodal, and systematic approach for evaluation of CV risk in patients considering taking JAKi and emphasize that cardiologists play an important role in risk stratification and mitigation for patients with high CV risk factors or on long-term JAKi therapies.
Changing Faces: Factors Associated with the Intention to Pursue Plastic Surgery and Practice in Underserved Areas
Authors: Nguyen Mytien , Kaminaka Annette , Brutus Nicholas N. , Gonzalez Luis A. , Ratanpal Amit , Alperovich Michael , Jeffe Donna B. , Ata Ashar , Mason Hyacinth R. C. , Butler Paris D.
Published: August 2023

Background:

Improving the number of plastic and reconstructive surgeons who provide care to patients in underserved communities is critical to achieving health equity. We aimed to identify factors associated with graduating medical students’ intentions to pursue plastic surgery and practice in underserved areas.

Methods:

De-identified data for US medical school graduates were obtained from the Association of American Medical Colleges for students who matriculated in academic years 2007–2008 and 2011–2012. Data collected included self-reported demographic and future practice intentions. Multivariate analysis was conducted to determine indicators of students’ interest in plastic surgery, and their intention to practice in underserved areas.

Results:

Of the 57,307 graduating US medical students in our cohort who completed the Graduation Questionnaire, 532 (0.9%) reported an intention to pursue plastic surgery. Hispanic [adjusted odds ratio (aOR): 1.45; 95% confidence interval (95% CI), 1.07–1.98] and multiracial (aOR: 1.59; 95% CI, 1.03–2.45) students were more likely to pursue plastic surgery compared with other surgical specialties. Among students interested in plastic surgery, compared with non-Hispanic White students, Black (aOR: 6.15; 95% CI, 1.96–19.26) students were more likely to report intention to practice in underserved areas. Students with community-engagement experiences were more likely to report intention to practice in underserved areas.

Conclusions:

Diversity among medical trainees pursuing plastic and reconstructive surgery is critical for maintaining and expanding plastic surgery services rendered in underserved areas. These findings suggest that student demographics and experiences with community-engagement experiences are positive indicators of practicing in underserved communities.
Effects of Tongmai Yangxin pills on ventricular remodeling in myocardial ischemia-reperfusion rats
Authors: Chen Rui , Meng Ke , Wang Caijun , Lyu Qingbo , Jiang Di , Ding Xinya , Xu Jinpeng , Wang Lin , Wang Yujing , Zhou Kun , Wang Yi
Published: August 2023

Objective:

This study aimed to determine whether Tongmai Yangxin pills (TM) can attenuate ventricular remodeling (VR) and to explore the underlying mechanisms.

Methods:

After the myocardial ischemia-reperfusion (I/R) injury model has been established, the rats were divided into seven groups: control, Sham, I/R, TM (1.0 g/kg), TM (2.0 g/kg), TM (4.0 g/kg), and Tongxinluo capsules, respectively. Experimental parameters were assessed on days 3 and 28 after drug administration. Cardiac structure and function were assessed by echocardiography. Myocardial ischemia was quantified using triphenyl tetrazolium chloride staining, and the cardiac pathology was evaluated using hematoxylin-eosin staining. Myocardial enzyme and oxidant activities were detected using an automatic biochemical analyzer and kit, respectively. Masson’s trichrome staining was used to analyze the degree of collagen deposition. The expression levels of inflammation and fibrosis-related proteins were detected using enzyme-linked immunosorbent assays.

Results:

After 3 days of administration, TM improved cardiac function and morphology. It effectively reduced the area of myocardial infarction in I/R rats, inhibited the abnormal activity of myocardial enzymes, and significantly reduced superoxide dismutase activity, as well as C-reactive protein, tumor necrosis factor-α, and interleukin-1β expression at the protein level. TM administration inhibited oxidative stress, inflammation, and myocardial pathological damage. After 28 d of administration, TM improved heart function; inhibited ventricular dilation and the thinning of the ventricular wall; significantly reduced the protein expression of connective tissue growth factor, matrix metalloproteinase 2, and matrix metalloproteinase 9; and decreased the degree of myocardial fibrosis.

Conclusions:

TM can effectively reduce the infarct size, improve the cardiac structure and function, reduce myocardial collagen deposition, and attenuate VR. The underlying mechanisms involve the inhibition of inflammatory responses in the early stages and a reduction of myocardial fibrosis in the late stages.

Graphical abstract:

http://links.lww.com/AHM/A60
Association Between Benefit Finding and Self-care Management in Heart Failure Patient-Caregiver Dyads
Authors: Fang Wenjie , Chen Cancan , Zhang Xiuting , Li Jinliang , Li Ximiao , Fan Xiuzhen
Published: August 2023

Background

Inadequate self-care management has been reported in patients with heart failure (HF) and their family caregivers. However, evidence on the influencing factors and corresponding action paths for self-care management within a dyadic context is limited.

Objective

The aim of this study was to examine dyadic associations between benefit finding and self-care management in HF patient-caregiver dyads and the mediating role of mutuality in these associations.

Methods

This cross-sectional study was conducted in China, and a convenience sample of 253 HF patient-caregiver dyads was included in the analysis. Dyadic benefit finding and mutuality, patients' self-care management, and caregivers' contributions to self-care management were measured using self-reported questionnaires. The actor-partner interdependence model and actor-partner interdependence mediation model were adopted to analyze the data.

Results

Patients' benefit finding had an actor effect on their own self-care management (β = 0.134, P < .05) and a partner effect on caregivers' contributions to self-care management (β = 0.130, P < .05). Similarly, caregivers' benefit finding had an actor effect on their contributions to self-care management (β = 0.316, P < .01) and a partner effect on patients' self-care management (β = 0.187, P < .01). Moreover, patients' mutuality completely mediated the actor effect of their benefit finding on self-care management (β = 0.127; 95% confidence interval, 0.032–0.233), and caregivers' mutuality partially mediated the actor effect of their benefit finding on contributions to self-care management (β = 0.060; 95% confidence interval, 0.012–0.124). In addition, caregivers' mutuality completely mediated the partner effect of patients' benefit finding on caregivers' contributions to self-care management (β = 0.036; 95% confidence interval, 0.009–0.081).

Conclusions

The findings revealed the importance of benefit finding and mutuality, 2 modifiable factors positively associated with dyadic HF self-care management. Dyadic interventions targeting on enhancing benefit finding and mutuality should be designed and implemented to improve HF self-care management.
Psychometric validation of the Cognitive Abilities Screening Instrument using Rasch analysis in people with dementia
Authors: Lee Shu-Chun , Lee Ya-Chen , Chiu En-Chi
Published: August 2023

This study aimed to examine unidimensionality of the Cognitive Abilities Screening Instrument (CASI) using Rasch analysis and estimate Rasch person reliability in people with dementia. CASI data of people with dementia was collected from medical records of one general hospital in northern Taiwan. A total of 506 people with dementia were recruited from the Department of Neurology. The confirmatory factor analysis was first conducted to verify the fitness of one-factor model of the CASI. Unidimensionality was confirmed through 2 assumptions: the infit and outfit mean square were 0.5 to 1.5, and residual variance of the first principal component in principal component analysis was ≤20%. Rasch person reliability was estimated after undimensionality was supported. The results of one-factor model had shown that the Comparative Fit Index = 0.99, Tucker Lewis Index = 0.99, Root Means Square Error of Approximation = 0.015, and Standardized Root Mean Square Residual = 0.067, representing a good fit to the model. Both the infit and outfit mean square were ranged 0.87 to 1.37 and 0.86 to 1.42, respectively, and low residual variance of the first principal component (12.3%). Rasch person reliability result of 0.58 was satisfactory. The person-item map indicated the difference between item difficulty and person ability was within the acceptable limits (0.22 logits). Differential Item Function was found between −0.48 to 0.44 logits for gender, indicating the CASI functioned similarly for both genders. The 46 items of the CASI showed a unidimensional construct. The CASI had been demonstrated as a valid and reliable screening tool for assessing overall cognitive function in people with dementia, capturing their cognitive functions effectively.
Effect of Jin three needles combined with Tong Qiao and blood activation Tang on neurological function, coagulation function and serum level in stroke patients
Authors: Xiao Zhong-Xiang , Zhang Shi-Dong , Zeng Li
Published: August 2023

To investigate the efficacy and safety of Jin three needles combined with Tong Qiao Wu Blood-streaming Tang in patients with acute ischemic stroke (AIS), this retrospective study analyzed the data of patients with AIS between January 2017 and December 2022. The National Institutes of Health Stroke Scale (NIHSS) scores, blood neuron-specific enolase, S100β protein (S100β), fibrinogen (FIB), cerebral infarct volume, D-dimer (D-D), prothrombin time (PT), activated partial thromboplastin time, hypersensitive c-reactive protein (hs-CRP), serum tumor necrosis factor-α (TNF-α), and homocysteine (Hcy) were compared between the 2 groups. The treatment effect was significantly better in the observation group than in the comparison group (P < .05). The NIHSS score, neuron-specific enolase, S100β, and cerebral infarct volume were significantly lower in both groups after treatment than before treatment (P < .05). FIB and D-D levels were significantly lower and APTT and PT levels were significantly higher in both groups after treatment than before treatment (P < .05). TNF-α, hs-CRP, and Hcy were significantly lower in both groups after treatment than before treatment, and TNF-α, hs-CRP and Hcy were significantly lower in the observation group than in the comparison group (P < .05). No statistically significant difference in the incidence of adverse reactions occurred between the 2 groups (P > .05). Combining Jin three needles can improve the therapeutic effect in patients with AIS, promote the recovery of neurological function, improve coagulation function, and reduce the inflammatory response with good safety.
Global research on portal vein thrombosis and liver transplantation: A bibliometric and visualized study
Authors: Zhong Ling , Ren Ting-Ting , Shi Lei , Deng Qian , Hong Li , Yu Chao , Yun Tan , Chen Xi Jun
Published: August 2023

In recent years, the association between portal vein thrombosis and liver transplantation has extensive attention from physicians worldwide. However, there is no available literature on bibliometric analysis in this research area. Herein, we aimed to conduct a bibliometric analysis to identify the hotspots and frontiers of research related to portal vein thrombosis and liver transplantation. Documents published between 2002 and 2022 were retrieved and downloaded from the Web of Science Core Collection database. VOSviewer was utilized to generate a visualization network map of authors, nations, institutions, journals, and keyword co-occurrence/clustering. Additionaly, CiteSpace was used to analyze the keywords with the strongest bursts. A total of 1272 articles and reviews were extracted from the database. The author Marco Senzolo published the largest number of papers. The United States was the most prolific country, and Hope-Bochon (France) was the top productive institution. Liver Transplantation was the most prolific journal in the field. The most commonly identified keywords in the study were cirrhosis, risk factors, portal vein thrombosis, and management, as revealed by the keyword co-occurrence analysis. It is suggested that patients with cirrhosis, portal vein thrombosis prevention, and management measures for portal vein thrombosis have been prominet topics in recent years. Furthermore, an analysis of keywords with the strongest citation bursts highlighted pediatric liver transplantation, direct oral anticoagulants, and nonalcoholic fatty liver disease as current research trends. Research in portal vein thrombosis and liver transplantation exhibits a general upward trend. The latest hot topics within this area of study involve pediatric patients and nonalcoholic fatty liver disease.
Anesthesia management of patients undergoing thoracic endovascular aortic repair: A retrospective analysis of single center
Authors: Liu Ying-chun , Sun Yan-ting , Yao Yun-tai ,   the Evidence in Cardiovascular Anesthesia (EICA) Group
Published: August 2023

Thoracic endovascular aortic repair (TEVAR) is a new alternative surgical treatment for aortic pathologies, which is more minimally invasive. The aim of current study was to summarize the single-center experience of general anesthesia for patients undergoing TEVAR. In adult patients undergoing surgery for congenital heart disease, the strategy of “fast-track” anesthesia with early extubation in theater is associated with a shorter intensive care unit (ICU) stay, and lower health-care-related costs. Fast-track anesthesia has not been assessed in patients under TEVAR. Adult patients who received general anesthesia for TEVAR in our center from January 2020 to December 2020 were included. Baseline characteristics, airway management, anesthetic techniques and major complications were collected. A total of 204 (171 male, mean age 58.1 ± 11.5 years) patients met inclusion criteria for this study. The distribution of pathologies included 29 descending thoracic aneurysms, 87 type B dissections, and 88 intramural hematoma/perforating aortic ulcer. Etomidate was the induction agent in 190 (93.1%) patients, compared with propofol in 16 (7.8%). Cisatracurium was the muscle relaxant in 201 (98.5%), compared with rocuronium in 3 (1.5%). Midazolam (benzodiazepines) was given to 124 (60.8%) patients during anesthesia induction. General anesthesia was maintained with sevoflurane in 85.3% (174) patients, dexmedetomidine in 201 (98.5%) and propofol in 204 (100%). Postoperative length of stay (LOS) in the hospital was 6.0 (5.0–7.8) days. LOS in the ICU was 23.0 (20.0–27.8) hours. Overall neurologic event rate was 2.0% (n = 4) (spinal cord ischemia 1.5% [n = 3]; stroke 0.5% [n = 1]). After matching, patients who received “fast-track” anesthesia had a shorter LOS in ICUs (21.0 [18.0–24.0] vs 24.0 [20.0–44.0] hours; P = .005), and a shorter postoperative LOS in hospital (5.0 [4.0–7.0] vs 6.0 [5.0–8.0] days; P = .001). There were no in-hospital deaths. Fast-track anesthesia is feasible and safe in patients underwent TEVAR. This management strategy is associated with shorter LOS of ICU and total postoperative hospital stays. An early extubation strategy should be implemented for hemodynamically stable patients.
Network pharmacology-based strategic prediction and target identification of apocarotenoids and carotenoids from standardized Kashmir saffron (Crocus sativus L.) extract against polycystic ovary syndrome
Authors: Tiwari Anshuly , Modi Siddharth J. , Girme Aboli , Hingorani Lal
Published: August 2023

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women of reproductive age, characterized by a range of symptoms, including irregular menstrual cycles, excess male hormones (androgens), metabolic abnormalities such as hyperinsulinemia, hyperlipidemia, and metabolic disturbances like glucose imbalance. Botanical supplements are perceived first and safe choice over available regimens to regulate PCOS. There are several reports available stating that apocarotenoids, carotenoids, and whole extracts of Crocus sativus were identified to have a potential role in the management of women health. This study aimed to propose a network pharmacology-based method to determine the potential therapeutic pathways of phytoconstituents (apocarotenoids and carotenoids) of UHPLC-PDA standardized stigma-based Crocus sativus extract (CSE) for the management of PCOS. Furthermore, to validate the potential targets and signaling pathways, these apocarotenoids, and carotenoids were screened for molecular docking and in silico absorption, distribution, metabolism, excretion, and toxicity (ADMET) predictions. The information regarding PCOS-related genes was retrieved from the PCOS knowledge database (PCOSKB), resulting in an established network between putative targets of PCOS and Crocus sativus extract phytochemicals to prevail the mechanism of action. Based on the screening conditions, 4 prominent targets namely, serine/threonine kinase 1 (AKT1), signal transducer and activator of transcription (STAT3), mitogen-activated protein kinase 3 (MAPK3), and mitogen-activated protein kinase 1 (MAPK1), were identified through network analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis suggested that MAP kinase and serine-threonine pathways were found prominent targets in PCOS. Further, a molecular docking study shows that crocetin, picrocrocin, and safranal had the best binding affinity for the identified targets. In silico ADMET results revealed that carotenoids and apocarotenoids were found to have the maximum bioavailability and were able to cross the blood-brain barrier without any toxic effects. The combined results revealed that the apocarotenoids and carotenoids of Crocus sativus extract could act on various targets to regulate multiple pathways related to PCOS.
Planning and effectiveness of intensive rehabilitation as a treatment for a patient with neurosarcoidosis: A case report
Authors: Takeshima Shinichi , Furuya Toshiki , Yamamoto Mariko , Noma Marie , Kawate Nobuyuki
Published: August 2023

Introduction:

Neurosarcoidosis tends to prolong the duration of treatment and may result in a decline in physical function requiring rehabilitation. Because of a rare disease, the adjustment of oral steroid dosage, which is the cornerstone of treatment, is highly dependent on professional experience in general. Therefore, the number of hospitals that can perform dosage adjustment is very limited, and it is difficult to provide concurrent intense rehabilitation at the same hospital over a long period of time, and there are no reports that mention this.

Patient concerns:

A 49-year-old man, who presented with impaired consciousness, dysphagia and right hemiplegia, was diagnosed with neurosarcoidosis based on a previous diagnosis of sarcoidosis, laboratory test results, and clinical symptoms. High-dose oral steroid therapy was initiated and he was transferred to our rehabilitation hospital for progressive disuse approximately 2 months after the disease onset.

Diagnoses:

This case was diagnosed as “probable” neurosarcoidosis.

Interventions:

The steroid dose was not reduced during rehabilitation treatment in our hospital considering the risk of relapse of the primary disease due to steroid reduction. His training regimen focused on minimum activities of daily living was performed, and its effectiveness was determined during approximately 60 days after the initiation of rehabilitation.

Outcomes:

Two months after admission, he was independently eating, transferring, and toileting under supervision. He was discharged home 3 months after admission.

Lessons:

Intensive rehabilitation can be one of the effective comprehensive treatment strategy for patients with neurosarcoidosis. On the other hand, since there is no consensus treatment method, the duration of rehabilitation and goal setting should be adjusted based on an understanding of the characteristics of the disease and the overall treatment plan.
Adult granulosa cell tumor of the testis with malignant tendency: A case report with genetic analysis using high-throughput sequencing
Authors: Deng Lili , Zeng Jingjing , Qiu Jin Feng , Yang Li Hua , Ma Jie
Published: August 2023

Background:

The adult granulosa cell tumor of the testis is a rare sex-cord/stromal tumor, with a potentiality for late recurrence and metastasis. Because of its rarity, this tumor is poorly understood, particularly in terms of its molecular features. As a result, it is necessary to register each occurrence in order to study the evolution of this rare malignancy and develop therapeutic strategies.

Methods:

A 50-year-old man discovered a painless right testicular mass unexpectedly, and the mass steadily expanded for 2 months. Ultrasonography showed a 5.2 cm × 4.0 cm × 3.6 cm mass in the right testicle. A right radical orchiectomy was performed on September 7, 2016. The pathologic diagnosis was a testicular adult granulosa cell tumor. The post-computed tomography scans and bone scintigraphy ruled out distant metastases. A high-throughput sequencing of 520 cancer-related genes revealed FOXL2 C134W, CDKN2A E87Gfs*24, TP53 S183*, TERT c.-124C > T, and H3F3A K28R mutations in this case. Because the patient stated he would be unable to return to the hospital for a follow-up appointment on time, he elected to have 4 cycles of adjuvant chemotherapy BEP (bleomycin, etoposide, and cisplatin) after the right radical orchiectomy.

Results:

The patient has not had a clinical recurrence or metastasis in 6 years.

Conclusion:

Surgery together with adjuvant chemotherapy may be useful treatment options for these individuals with malignant tendencies who are unable to visit the hospital for a follow-up appointment on time. Adult testicular granulosa cell tumors have a relatively complex genetic profile; their etiology is linked to a number of common driver genes, including TERT, CDKN2A, TP53, and H3F3A.
Genetic analysis and management of a familial hypercholesterolemia pedigree with polygenic variants: Case report
Authors: Han Yu , Zhang Lin , Tao Huimin , Wu Jiebin , Zhai Jingfang
Published: August 2023

Rationale:

Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder typically caused by low density lipoprotein receptor (LDLR) gene mutation. Herein, we reported a FH pedigree with polygenic variants: LDLR, apolipoprotein B (APOB), and epoxide hydrolase 2 (EPHX2).

Patient concerns:

A 10-year-old boy mainly presented multiple skin xanthomas and hypercholesterolemia. His family visited our hospital and was performed with pedigree whole exome sequencing (WES) at 20 + 3 weeks gestation of the mother’s second pregnancy.

Diagnoses:

Based on the clinical features and genetic analysis, the pedigree was diagnosed with familial hypercholesterolemia.

Interventions:

After genetic counseling, the couple opted to continue the pregnancy. Treatment advice and follow-up were offered to them.

Outcomes:

A novel compound heterozygous LDLR mutation: c.1009G>T and c.68-2A>G, derived from his parents respectively was revealed through pedigree WES, meanwhile, a maternal APOB gene variant: c.1670A>G and a paternal EPHX2 gene variant: c.548 dup of the proband were found together. Furthermore, the same compound heterozygous LDLR mutation as his was confirmed in his sister without APOB and EPHX2 variants in her fetal stage.

Lessons:

WES combined with clinical features is essential for the diagnosis of FH, however, prenatal genetic testing results might bring more challenges to prenatal genetic counseling. Furthermore, it is more important to provide the guidance and early intervention for such families in the long run.
The effect of Dipeptidyl peptidase 4 (DPP-4) inhibitors on hemoglobin level in diabetic kidney disease: A retrospective cohort study
Authors: Zeng Lingfeng , Chan Gordon C.K. , Ng Jack K.C. , Fung Winston W.S. , Chow Kai-Ming , Szeto Cheuk-Chun
Published: August 2023

Anemia typically develops early in the course of diabetic kidney disease (DKD). There are data to show that dipeptidyl-peptidase-4 (DPP-4) inhibitors affect hematopoietic growth factor activity and hemoglobin level. We retrospectively reviewed 443 DKD patients who were started on DDP-4 inhibitor therapy in 2019. Their hemoglobin level at baseline (6–12 months before treatment), pretreatment (0–6 months before treatment), and post-treatment periods (within 6 months after DPP-4 inhibitor), concomitant estimated glomerular filtration rate (eGFR), HbA1c, peripheral blood white cell and platelet counts were reviewed. The severity of kidney failure was classified according to the Kidney Disease: Improving Global Outcomes stages. The hemoglobin level had a small but significant decline from 11.98 ± 2.07 to 11.87 ± 2.12 g/dL from pretreatment to post-treatment period (paired Student t test, P < .0001). From the pre- to post-treatment period, the decline of hemoglobin level was 0.10 ± 0.89 g/dL, which was significantly less than that from baseline to pretreatment period (0.24 ± 0.90 g/dL, P = .0008). The change in hemoglobin level had a positive correlation with the change in HbA1c level (R = 0.218, P < .0001), but did not correlate with the type of DPP-4 inhibitor or pretreatment eGFR. There was no significant change in peripheral blood white cell or platelet count during the same period. DPP-4 inhibitor ameliorates hemoglobin decline in DKD. The effect of DPP-4 inhibitor on hemoglobin is statistically significant but clinically modest, and did not correlate with the concomitant change in kidney function.
Brief pain inventory and pain detection questionnaire based on WeChat and paper versions for collecting data on patients with herpes zoster-induced neuralgia: An analysis for their validity and reliability
Authors: Du Zhong-Ju , Wang Bo , He Jie , Zhang Hua
Published: August 2023

Background:

This study explored the validity and reliability of brief pain inventory (BPI) and pain detection questionnaire (PD-Q) based on WeChat and paper versions for collecting data on patients with herpes zoster-induced neuralgia.

Methods:

The study participants were 160 patients with herpes zoster-induced neuralgia admitted in our hospital from December 2017 to June 2020. Initially, the participants were randomly divided into group A (n = 80) and group B (n = 80). Then, they were required to complete the Chinese versions of the BPI and PD-Q. In group A, the WeChat version was finished first, followed by the paper version. In group B, the paper version was completed first, followed by the WeChat version. Then, the test–retest reliability was analyzed by comparing the intraclass correlation coefficient (ICC) between the 2 groups. Bland–Altman plots and Pearson correlation coefficient were used to analyze the concordance between the paper and WeChat versions.

Results:

Patients generally preferred the WeChat version of the BPI and PD-Q, particularly men and patients with pain duration ≥ 30 minutes. Specifically, no significant differences in the completion time of the BPI and PD-Q was found between the 2 groups. All patients had high test–retest reliability and internal consistency for both WeChat and paper versions (BPI: ICC, 0.913; Cronbach alpha coefficient, 0.959; PD-Q: ICC, 0.825; Cronbach alpha coefficient, 0.894). Bland–Altman plots indicated no significant systematic deviations between the WeChat and paper versions. Pearson correlation coefficient revealed a strong correlation between BPI (Spearman, 0.928) and PD-Q (Spearman, 0.830) questionnaires.

Conclusion:

The WeChat and paper versions of the BPI and PD-Q have good repeatability, reliability, and consistency for collecting data on patients with herpes zoster-induced neuralgia.
Lateral single incision laparoscopic totally extraperitoneal hernioplasty (L-SILTEP) after laparoscopic radical prostatectomy: A rare case report with literature review
Authors: Wang Zhuoyin , Li Qilei , Tang Jiansong , Zhu Farong , Chen Yong , Lin Sen , Zhang Yizhong
Published: August 2023

Introduction:

Single-incision laparoscopic totally extraperitoneal hernioplasty is a commonly used surgical procedure for the treatment of inguinal hernia. However, it is difficult to use traditional single incision laparoscopic totally extraperitoneal hernioplasty to treat inguinal hernia after laparoscopic radical prostatectomy. We successfully and smoothly cured a patient with left inguinal hernia after laparoscopic radical prostatectomy using lateral single incision laparoscopic totally extraperitoneal hernioplasty.

Case presentation:

We report the case of a 70-year-old man who underwent laparoscopic radical prostatectomy 2 years earlier and had an evanescent mass in the left inguinal region for 1 month.

Diagnosis:

On the basis of preoperative abdominal computed tomography and intraoperative findings, the patient was diagnosed with a left indirect inguinal hernia, and post-laparoscopic radical prostatectomy.

Interventions:

The patient underwent lateral single incision laparoscopic totally extraperitoneal hernioplasty.

Outcomes:

The patient recovered well after the operation, and there were no postoperative complications or recurrence of inguinal hernia 3 months after the operation.

Conclusion:

For patients who have undergone laparoscopic radical prostatectomy, lateral single-incision laparoscopic totally extraperitoneal hernioplastycan be performed.
Rare case of endometrial vascular dystrophy: Three case reports
Authors: Huang JinCheng , Zhang WenJian , Guo Min , Tang Kun , Zheng YongJuan , Li CuiFen
Published: August 2023

Rationale:

Endometrial vascular dystrophy refers to abnormal vessels that are very tortuous, dilated, and sometimes thrombosed. Endometrial vascular dystrophy is rare under hysteroscopy.

Patient:

All three patients had a history of abnormal uterine bleeding. The duration of vaginal bleeding ranged from 1 month to 2 years. There was no history of unusual diseases, alcohol or drug abuse, or genetic history.

Diagnoses:

Endometrial vascular dystrophy.

Intervention:

Three patients underwent hysteroscopy and curettage under intravenous general anesthesia. Pathological examination showed secretory endometrium, with one case coexisting with endometrial polyps.

Outcomes:

No recurrence was found during postoperative follow-up at 12 months.

Lessons:

Endometrial vascular dystrophy is a rare hysteroscopy phenomenon shown in the secretory endometrium. We believe that it was a capillary loop with different manifestations.
Acute mesenteric ischemia secondary to superior mesenteric vein thrombosis in a patient with liver cirrhosis: A case report
Authors: Mitev Stefan , Topalova-Dimitrova Antoniya , Varlyakov Anton , Popov Dimitar
Published: August 2023

Rationale:

Acute mesenteric ischemia due to superior mesenteric vein (SMV) thrombosis is a rare yet potentially life-threatening emergency. Our case report explores this condition in the context of a patient with liver cirrhosis due to Wilson disease. We specifically highlight the complex derangement of the coagulative balance in liver cirrhosis.

Patient concerns:

A 34-year-old female with Wilson disease-related cirrhosis presented with intractable abdominal pain, nausea, and vomiting that showed no response to antispasmodic medication.

Diagnoses:

A contrast-enhanced abdominal computed tomography scan and Doppler ultrasound confirmed an intraluminal filling defect in the SMV, leading to the diagnosis of SMV thrombosis.

Interventions:

Prompt anticoagulation, intravenous fluids, and an antibiotic were initiated. Surgical consultation recommended conservative therapy with close monitoring.

Outcomes:

Over the following 2 days, the patient’s condition improved considerably, with almost complete resolution of her symptoms. Genetic testing identified a 4G/4G homozygous genotype of the plasminogen activator inhibitor 1 gene, associated with a higher risk of thrombosis in the vessels of internal organs. After 2 months of sustained anticoagulant therapy, a follow-up contrast-enhanced computed tomography scan revealed near-complete recanalization of the SMV, and the patient remained symptom-free.

Lessons:

This case underscores the importance of early detection and treatment of acute mesenteric ischemia in patients with liver cirrhosis, as well as the potential role of genetic factors in thrombosis.
Application of noninvasive test (acoustic attenuation imaging and ultrasonic shear wave elastography) to grade nonalcoholic fatty liver disease: An observational study
Authors: Liu Guo Tao , Ni Qing Feng , Zhang Yu Hang , Dong Xue Ming , Zhou Chao , Shen Bo , Zhu Jing Ya , Chen Ya Juan , Zhu Zheng
Published: August 2023

The aim of this study was to validate the diagnostic efficacy of acoustic attenuation imaging (ATI) and ultrasonic shear wave elastography (SWE) in classifying nonalcoholic fatty liver disease (NAFLD). A total of 100 patients with NAFLD were recruited from our hospital between January 2021 and December 2022. Patient demographics and clinical data were collected, and 2-dimensional ultrasound was used to screen patients based on liver echo characteristics. Patients without liver space-occupying lesions underwent routine ultrasound examinations. Imaging or serology was used to confirm the presence of fatty liver in patients or healthy individuals. Patients with alcoholic liver disease (alcohol equivalent content < 20 g/day for women, <30 g/day for men), as well as those with lenticular degeneration, total parenteral nutrition, autoimmune liver disease, drug-induced hepatitis, and viral hepatitis, were excluded from the study. Out of the 100 included patients, 24 had normal liver, 21 had mild fatty liver, 30 had moderate fatty liver, and 25 had severe fatty liver. There were age differences between the normal group and patients with mild fatty liver, and the average body mass index (BMI) varied across the 4 groups. As the severity of the disease increased, the average BMI also increased (P < .05). The ATI scores and SWE scores differed significantly among the different groups (P < .05), with both scores showing an upward trend as the fatty liver condition worsened. Correlation analysis revealed positive correlations between ATI and SWE scores and the degree of fatty liver (P < .05), positive correlations with BMI (P < .05), and negative correlations with high-density lipoprotein cholesterol expression (P < .05). The area under the curve (AUC) for the ATI score in diagnosing different degrees of fatty liver was > 0.750, and the AUC for the SWE score was also > 0.750. The AUC for SWE score in diagnosing different degrees of fatty liver ranged from 1.01 to 4.57, while the combined AUC for ATI and SWE scores was > 0.850, with respective cutoff values of 3.62, 5.72, and 7.57 based on the maximum approximate entry index. The combination of ATI and SWE has a significant impact on the grading diagnosis of NAFLD, and its application can be extended to clinical practice.
Predictive value and accuracy of prenatal four-dimensional color ultrasound for fetal abnormal development
Authors: Zhang Li , Jin Tian-liang
Published: August 2023

To investigate the value and accuracy of prenatal GE-E10 ultrasound Equipment in predicting fetal abnormal development. 160 pregnant women and women who received prenatal ultrasound examination were selected. Before delivery, all pregnant women were examined by conventional two-dimensional and four-dimensional (4D) ultrasound. 18 fetuses with abnormal development were detected by gold standard in 160 pregnant women. Sensitivity and specificity of two-dimensional color ultrasound in diagnosing fetal abnormal development were 78.38% and 82.60%. The sensitivity and specificity of 4D color ultrasound in diagnosing fetal abnormal development were 81.15% and 83.43%. ROC showed that the AUC (0.873) of 4D color ultrasound was higher than that of two-dimensional color ultrasound (0.827). The diagnostic efficiency of 4D ultrasound is greater. The accuracy, specificity and sensitivity of 4D color ultrasound in the diagnosis of fetal abnormal development is high, and it is valuable for prenatal screening of macrosomia and low birth weight.
A correlational and cross-sectional study on the relationship between internalized stigma and religious coping in patients with schizophrenia
Authors: Erdoğan Kaya Ayşe , Aydinoğlu Ünsal
Published: August 2023

Self stigmatization, which occurs as a result of internalization of public stigma in severe mental illnesses, is a factor that impairs the mental well-being of individuals and their compliance with treatment. Data on exactly which factors are associated with internalized stigma are still insufficient. Our aim in this clinical study is to investigate the relationship between internalized stigma and religious coping in patients with schizophrenia. Sociodemographic Data Form, Religious Coping Scale, internalized stigma of mental illness (ISMI) Scale were applied to 147 schizophrenic patients who were followed up by the community mental health center and met the inclusion criteria. The results were analyzed with IBM SPSS 22 package program. Descriptive statistics, Mann-Whitney U test, Pearson Chi-Square, Fisher Exact test, Spearman correlation analysis and multiple linear regression analysis were applied. There was a negative correlation between positive and negative religious coping in patients with schizophrenia (r: −0.467, P < .001); a positive correlation between negative religious coping and social withdrawal (r: 0.711, P < .001) and perceived discrimination (r: 0.706, P < .001); negative correlation between positive religious coping and social withdrawal (r: −0.343, P < .001) and perceived discrimination (r: −0.302, P < .001). There was no significant relationship between other subdimensions of ISMI and religious coping scale. There was a significant negative correlation between ISMI total score and positive religious coping (r: −0.256, P: .002), a significant positive correlation with negative religious coping (r: 0.683, P < .001). Multiple linear regression analysis was applied to reveal the explanatory effect of age, duration of illness and religious coping on internalized stigma, and according to the model obtained (R = 0.729, R2 = 0.516, F = 32.071, P < .001), 51.6% of the change in the total score of the ISMI can be explained by this model. The significant relationship between positive and negative religious coping and internalized stigma in patients included in the study suggests that it may be beneficial to consider religious coping attitudes in addition to other interventions in the fight against stigma in severe mental illnesses such as schizophrenia.
Effects of a program consisting of strain/counterstrain technique, phonophoresis, heat therapy, and stretching in patients with temporomandibular joint dysfunction
Authors: Azam Insha , Chahal Aksh , Kapoor Gaurav , Chaudhuri Pooja , Alghadir Ahmad H. , Khan Masood , Kashoo Faizan Z. , Esht Vandana , Alshehri Mohammed M. , Shaphe Mohammad Abu , Khan Abdur Raheem , Singh Gurjant
Published: August 2023

Background:

The present study was conceptualized as a pilot study to examine the effects of a 3-week program consisting of strain/counterstrain technique (SCST), phonophoresis, heat therapy, and stretching exercises on pain and functions in patients with temporomandibular dysfunction (TMD).

Methods:

Seven participants (mean age 25.85 years) diagnosed with TMD having pain in the temporomandibular joint (TMJ) area with decreased jaw opening were recruited for the study. Treatment interventions consisting of SCST, phonophoresis (ultrasound gel mixed with diclofenac gel), heat therapy, and stretching (mouth-opening) exercises were performed 3 days a week for 3 weeks. SCST was performed on the masseter, medial, and lateral pterygoid muscles. No control group was present in the study.

Results:

Paired samples t test revealed a significant difference in numerical pain rating scale (NPRS) (decreased by 50%, P < .001) and jaw functional limitation scale (JFLS) (reduced by 59.58%, P < .001) scores after 3 weeks of intervention. A large effect size (Cohen d = −3.00 for NPRS and −3.16 for JFLS) was observed for both variables. No correlation (R = 0) was found between the baseline values of NPRS and JFLS.

Conclusion:

A 3-week program consisting of SCST, phonophoresis, heat therapy, and stretching exercises was effective in reducing the pain and improving the functions related to TMJ in patients suffering from TMD. However, a randomized controlled trial is needed to reach a definite conclusion.
Visualizing burst spots on research for four authors in MDPI journals named to be Citation Laureates 2021 using temporal bar graph
Authors: Ho Sam Yu-Chieh , Chien Tsair-Wei , Chou Willy
Published: August 2023

Background:

The appearance of a topic in a document stream is signaled by a burst of activity, with certain features rising sharply in frequency as the topic emerges. Although temporal bar graph (TBG) is frequently applied to present the burst spot in the bibliographical study, none of the research has combined the inflection point (IP) to interpret the burst spot feature. The aims of this study are to improve the traditional TBG and apply the TBG to understand better the evolution of a topic (e.g., publications and citations for a given author).

Methods:

The EISTL model, including entity, indicator, selection of a few vital ones (named attributes) with higher values in quantity (e.g., the citation data of the top 10 entities), TBG and line-chart plots to verify the trend of interest, was proposed to demonstrate the TBG as a whole. The IP locations compared to the median point in data along with the heap map and line-chart trend were identified. The burst strength was computed. A dashboard on Google Maps was designed and launched for bibliometric analysis. Four authors in MDPI (Multidisciplinary Digital Publishing Institute) journals named to be Citation Laureates 2021 were recruited to compare their research achievements shown on the TBG, particularly displaying the burst spots and the recent developments and stages (e.g., increasing, ready to increase, slowdown, or decreasing).

Results:

We observed that the highest burst strengths in publication and citations are earned by Barry Halliwell (8.99) and Jean-Pierre Changeux (18.01). The breakthrough of TBG using the EISTL model to display the influence of authors in academics was made with 2 parts of the primary IP point and the trend feature in the data.

Conclusion:

The dashboard-type TBG shown on Google Maps is unique and innovative and able to provide deeper insights to readers, not merely limited to the publications and citations for a given author as we did in this study.
Development and validation of a nomogram for risk of pulmonary metastasis in non-papillary thyroid carcinoma: A SEER-based study
Authors: Li Yonghao , Gao Xuefei , Guo Tiantian , Liu Jing
Published: August 2023

In this study, a nomogram was established and validated by assessing the risk factors for the development of pulmonary metastases in patients with non-papillary thyroid carcinoma (NPTC) and was used to predict the risk of developing pulmonary metastases. Demographic and clinicopathological variables of patients with NPTC from 2010 to 2015 in the Surveillance, Epidemiology, and End Results database were retrospectively analyzed, and independent risk factors were identified using χ2 tests and full subset regression analysis. Based on this, a nomogram was developed and validated for predicting the risk of pulmonary metastasis in patients with NPTC. The predictive performance of the nomogram was calculated using the consistency index, and the clinical application value of the nomogram was evaluated using calibration curve and decision curve analyses. In addition, risk stratification of patients with NPTC based on these results was performed to facilitate early diagnosis and treatment of patients with pulmonary metastases in the clinic. Data from 1435 patients with NPTC were used for the analysis based on the inclusion and exclusion criteria. Statistical analysis yielded a high risk of pulmonary metastasis in patients with older age, high T-stage, poorly differentiated, undifferentiated thyroid carcinoma, follicular thyroid carcinoma (NOS), and the presence of other distant metastases. We further developed a nomogram with a consistency index of 0.898 (95% confidence interval: 0.880–0.920) in the training cohort and 0.895 (95% confidence interval: 0.862–0.927) in the validation cohort. The calibration curve and decision curve analyses also demonstrated the strong reliability and accuracy of this clinical prediction model. In this study, a nomogram was constructed to accurately identify patients with NPTC at a high risk of pulmonary metastasis, which will help clinicians in personalized decision-making.
A multilocus genetic risk score for obesity: Association with BMI and metabolic alterations in a cohort with severe obesity
Authors: Sag Sabine Julia Maria , Mueller Stephanie , Wallner Stefan , Strack Christina , Hubauer Ute , Mohr Margareta , Zeller Judith , Loew Thomas , Rehli Michael , Wimmer Julia , Zimmermann Martina Erika , Maier Lars Siegfried , Fischer Marcus , Baessler Andrea
Published: August 2023

Genome wide association studies have identified numerous single nucleotide polymorphisms (SNPs) associated with obesity, yet effect sizes of individual SNPs are small. Therefore, the aim of our study was to investigate whether a genetic risk score (GRS) comprising risk alleles of SNPs identified in the GIANT consortium meta-analyses shows association with body mass index (BMI) and other BMI related metabolic alterations in a cohort with an extreme phenotype. Genotyping of 93 SNPs was performed in 314 obese individuals (mean BMI 40.5 ± 7.8 kg/m², aged 45 ± 12 years), participating in a standardized weight reduction program, and in 74 lean controls (mean BMI 24.6 ± 3.3 kg/m², aged 41.7 ± 13.4 years). Allele numbers of all 93 SNPs were added to a GRS. Anthropometric parameters, parameters of glucose/insulin and lipid metabolism were assessed standardized after a 12 hours fast. GRS was significantly different between controls and obese individuals (unweighted GRS: 86.6 vs 89.0, P = .002; weighted GRS: 84.9 vs 88.3, P = .005). Furthermore, linear regression analysis showed significant associations of GRS with BMI (P < .0001), weight (P = .0005), waist circumference (P = .0039), fat mass (P < .0001) and epicardial fat thickness (P = .0032), yet with small effect sizes (r² < 0.06). In conclusion, in our study GRS could differentiate between extreme obese and lean individuals, and was associated with BMI and its related traits, yet with small effect sizes.