bluuebunny/crossref_metadata_2025 huggingface dataset:
10237- MNG-8 AUTOMATED VOLUMETRY OF MENINGIOMAS IN CONTRAST-ENHANCED T1-WEIGHTED MRI USING DEEP LEARNING
Authors: Hirayama Ryuichi , Iwata Takamitsu , Yamada Shuhei , Nakamura Natsuki , Wada Yuki , Nishimoto Keisuke , Nakagawa Kanji , Kawamoto Yuki , Murakami Koki , Utshugi Reina , Yokota Chisato , Kijima Noriyuki , Kishima Haruhiko
Published: November 2024

BACKGROUND

With the widespread use of MRI equipment and brain docks, there are more opportunities to perform follow-up observation for meningiomas. In recent years, attempts have been made to predict prognosis by using tumor volume as an imaging biomarker. On the other hand, manual lesion extraction by a reader with anatomical knowledge is indispensable for volume measurement, which requires a certain amount of labor and time. We developed a simple and highly reproducible application for automated volume measurement of meningiomas using artificial intelligence and report its accuracy for use as an imaging biomarker of tumor volume in real clinical practice.

METHODS

178 patients with meningiomas who underwent MRI at Osaka University Hospital were included in the study. Contrast-enhanced T1-weighted images were used for manual lesion extraction by two neurosurgeons. These annotated image data were randomly divided into training (90%) and testing (10%). The deeplabV3 model was used to train the artificial intelligence, and leave-one-out cross-validation was used to train and validate the automated model. The test data were used for comparison, and the agreement rate (Dice index) on the images of the automatically extracted regions and the error rate of the calculated tumor volume (mean square error rate: RMSPE) were used as indices of measurement performance. Results: The agreement rate between the images of the automatically extracted area and the test data was 92.3± 5.1% on average. The error rate for volume was 9.5±1.2%. Conclusion: This application using artificial intelligence was considered to have a certain validity in terms of accuracy of automatic lesion extraction.
10009- COT-3 IMPACT OF LIVING CIRCUMSTANCES OF THE OLD GLIOMA PATIENTS ON EARLY INTERVENTION
Authors: Fujita Shohei , Kawanishi Yu , Fukuda Hitoshi , Nakajo Takahito , Ueba Tetsuya
Published: November 2024

AIM

Glioma is a growing malignant brain tumor, so early diagnosis and early treatment are important. The declining KPS due to symptom progression is associated with the declining postoperative KPS and tumor resection rate, shortened patient survival. The associating between social connections and medical treatment in elderly glioma patients is unclear. To determine whether social connections around the senior patient associate the decreasing postoperative KPS.

METHODS

We have studied 121 patients with glioma operative at the Kochi University Hospital from 2013 to 2022. Preoperative KPS decline outcome was defined as KPS<80. Patients’ social connections with their surroundings were classified into three groups based on record information: “living alone,” “senior couple,” and “with children’s involvement. “First, the patients were classified into a younger group under 60 years old (40 patients) and an elderly group over 60 years old (81 patients), and the preoperative KPS was compared between the two groups. Second, we examined whether social connections associated declining preoperative KPS in the elderly subgroup.

RESULTS

In the elderly group, the proportion of patients with declining preoperative KPS was 29/81, which was significantly higher than the proportion in the younger group (6/40) (P=0.031, chi-square test). In the elderly group, the rate of declining preoperative KPS according to social connections was lower in those with “ with children’s involvement “ (2/14) compared to those who “lived alone” (8/19) and those who “ senior couple “ (19/48), indicating that child involvement was associated with higher preoperative KPS in elderly patients with glioma.

CONCLUSION

Glioma patients over 60 years of age are at risk of declining preoperative KPS, especially in the setting of low children’s involvement. As the population continues to age, it will be necessary to consider the social connections between glioma patients and those around them and encourage early hospital visit.
IL-1 IDHWT GLIOBLASTOMA LONGITUDINAL MOLECULAR EVOLUTION
Authors: Lucas C G , Al-Adli N , Young J S , Gupta R , Morshed R A , Wu J , Ravindranthan A , Shai A , Oberheim Bush N A , Taylor J W , de Groot J , Villanueva-Meyer J E , Pekmezci M , Perry A , Bolen A W , Theodosopoulos P V , Aghi M K , Chang E F , Hervey-Jumper S L , Raleigh D R , Molinaro A M , Costello J , Diaz A A , Clarke J L , Butowski N A , Phillips J J , Chang S M , Berger M S , Solomon D A
Published: November 2024

We performed comprehensive histopathologic, genomic, and epigenomic evaluation of paired initial and recurrent glioblastoma specimens from 106 patients to investigate the molecular evolution and cellular phenotypes underlying differential treatment responses. While TERT promoter mutation and CDKN2A homozygous deletion were early events during gliomagenesis shared by initial and recurrent tumors, most other recurrent genetic alterations (e.g., EGFR, PTEN, NF1) were commonly private to initial or recurrent tumors indicating acquisition later during clonal evolution. Further, glioblastomas exhibited heterogeneous epigenomic evolution with subsets becoming more globally hypermethylated, hypomethylated, or remaining stable. Glioblastoma that underwent sarcomatous transformation at recurrence had inferior survival and were significantly enriched in NF1, TP53, and RB1 alterations and the Mesenchymal epigenetic class. Patients who developed somatic hypermutation following temozolomide treatment had significantly longer interval to disease recurrence and prolonged overall survival, and hypermethylation at four specific CpG sites in the promoter region of MGMT was significantly associated with this development of hypermutation. Finally, an epigenomic evolution signature incorporating change in DNA methylation levels across 347 critical CpG sites was developed that significantly correlated with clinical outcomes. This talk will describe how GBM undergoes heterogeneous genetic, epigenetic, and cellular evolution that underlies prognostically different treatment responses.
IL-5 EPIGENETIC REGULATION IN GLIOMA METABOLISM
Authors: Hashizume Rintaro
Published: November 2024

In most cancer cells including glioma cells, glucose is at-least partially metabolized to lactate through the Warburg Effect, which refers to the non-oxidative metabolism of glucose even in the presence of sufficient oxygen. In addition to the advantage conferred upon glioma cells by the canonical glycolysis pathway, through supporting rapid proliferation and survival, its end product, lactate, serves as a key factor to regulate H3K27 acetylation (H3K27ac) through histone deacetylases (HDACs). We and others have shown that increase lactate metabolism related to tumor progression in high-grade gliomas including diffuse midline glioma (DMGs). In the orthotopic DMG patient-derived xenograft models, the levels of lactate were elevated relative to the contralateral normal brain using hyperpolarized carbon-13 (13C) magnetic resonance spectroscopic imaging (MRSI), indicating increase lactate metabolism associated DMG growth. Deregulated glucose metabolism can be therapeutically targeted at different levels, from the master regulators that control glucose metabolism to key enzymes controlling rate-limiting steps in glycolytic pathways. Recent integrate analysis using RNA- and ChIP- sequencing uncovered a novel function of lactate in transcriptional regulation and chromatin machinery, offering a promising avenue for therapeutic exploration. Inhibition of lactate dehydrogenase (LDH), the enzyme involved in lactate production, induced loss of histone H3K27ac and regulated the expression of key morphogenesis genes. The epigenetic dysregulation in DMG harboring histone gene mutation, H3K27M, caused a global reduction of H3K27 methylation. While decreasing K27 methylation, the K27M mutation also causes an increase in H3K27ac, in turn, leads to extensive transcriptional reprogramming of mutant cells. These findings provide the rational for development of novel therapeutic strategies to target lactate-dependent epigenetic regulation in DMG. This new therapeutic approach may benefit not only the patients that are afflicted with highly aggressive brain cancers but also perhaps those afflicted with other cancer subtypes.
A systematic review of the ethnopharmacology and phytochemistry of Callistemon citrinus “Myrtaceae”: Implication for phytomedicine future prospect
Authors: Hope Onohuean , Naster Cherop , Sarah Nwozo O , Sarah Najophe E , Sarad Pawar Naik Bukke
Published: November 2024

Background

The increase in bacterial infection, combined with antibacterial resistance, remains a global threat, fueling the popularity of medicinal herbs as people seek alternatives to synthetic medicine. This review synthesizes scientific evidence regarding the medicinal uses of lemon bottle-brush (Callistemon citrinus (Curtis) (C. citrinus) to inspire future research prospects.

Methods

Scientific evidence was thoroughly synthesized from databases (PubMed, Web of science (WOS), and Scopus).

Results

One hundred articles reported the medicinal use of C. citrinus, while 39 (39%) provided evidence of its ethnopharmacology and phytochemistry. The C. citrinus medicinal plant research progresses at an annual growth rate of 6.41%. Most prolific authors were from India and Iran countries. The leaf extracts and essential oil are the most studied part of the plant for microbial sensitivity, respiratory disorders, haemorrhoids, and anti-inflammatory among several illness. Phytochemistry and phytomedicinal analysis of C. citrinus revealed several bioactive compounds, including 1, 8-cineole, α-pinene and β-pinene, and GC-MS and HPLC as the most used method of identification/characterization. Most of the included studies omitted information about the standardization preparation methods or formulation composition. Poor ethnobotanical studies, toxicological profile and efficacy studies of C. citrinus have hindered the possible translational progress. Also, despite its pharmacological implications, no study of human subjects and clinical trials has been done on the plants.

Conclusion

This systematic review shows the research progress and provides evidence of details of phytochemical constituents and ethnopharmacology benefits of C citrinus. It highlights research gaps and future engagement in advancing the medicinal use of C citrinus.
Comparison and analysis of alveolar bone structure characteristics in skeletal Class II and Class III malocclusion in the mandibular incisor region
Authors: Chen Yunqing , Zhao Binbin
Published: November 2024

The aim of this study was to explore the differences in alveolar bone structure characteristics in skeletal class II and class III malocclusion in the mandibular incisor region. From January 2021 to November 2023, 100 cases of skeletal malocclusion patients were selected from our hospital, including 56 cases of skeletal Class II malocclusion and 44 cases of skeletal Class III malocclusion. The alveolar bone structure characteristics in the mandibular incisor region of skeletal class II and class III malocclusion patients are compared. The labial alveolar bone attachment height and lingual alveolar bone attachment height were compared between patients with skeletal Class II and Class III malocclusion (P < .05). The labial alveolar bone thickness at the root apex in patients with skeletal Class II malocclusion was (3.96 ± 0.63) mm, which was higher than that in Class III malocclusion patients (P < .05). In patients with skeletal Class II malocclusion, the cementoenamel junction was 2, 4, 6 mm below, and at the root apex, the alveolar bone thickness was (0.19 ± 0.05) mm, (0.93 ± 0.10) mm, (2.10 ± 0.10) mm, and (12.26 ± 2.10) mm, respectively, which was higher than that in Class III malocclusion patients (P < .05). In patients with skeletal Class II malocclusion, the labial side alveolar bone area at the root apex was (3.89 ± 0.72) mm2, which was higher than in Class III malocclusion patients (P < .05). On the lingual side, the alveolar bone thickness below cementoenamel junction at 6 mm and at the root apex was (1.95 ± 0.45) mm2 and (1.92 ± 0.51) mm2, respectively, which were higher than in Class III malocclusion patients (P < .05). Compared to skeletal Class II malocclusion, in skeletal Class III malocclusion, the alveolar bone thickness in the mandibular incisor area is thinner and narrower. This should be given special attention during orthodontic treatment.
Evaluation of the efficacy and safety of acupuncture assisted treatment for atrial fibrillation: A systematic review and meta-analysis based on randomized controlled trials
Authors: Liu Yuqing , Pang Xuemeng , Wang Yajuan , Liu Xu , Jiang Hongju
Published: November 2024

Background:

To systematically evaluate the efficacy and safety of acupuncture in the treatment of atrial fibrillation (AF).

Methods:

Eight databases were searched. The search time limit is from January 2000 to November 2023. All randomized controlled trials on acupuncture treatment of AF were included. After the literature screening, data extraction and quality evaluation were carried out independently according to the inclusion and exclusion criteria, and the included literature was analyzed by Meta using RevMan 5.4 software.

Results:

A total of 15 research studies on randomized controlled trials were included, involving 1960 patients. The results of the meta-analysis showed that acupuncture therapy could increase the sinus cardioversion rate of patients with AF, and the difference was statistically significant (relative risk = 1.21, 25% confidence interval (CI) [1.11, 1.31], P < .001). The clinically effective rate of the acupuncture plus drug treatment group was higher than that of the drug treatment group (relative risk = 1.32, 95% CI [1.19, 1.46], P < .01). Acupuncture plus other conventional therapies treatment was more helpful in reducing the ventricular rate of patients with AF (mean difference = -7.89, 95% CI [-14.52, -1.26], P = .006). The cardioversion time of patients with AF treated with acupuncture plus conventional therapies was shorter than those treated with traditional therapies alone (standardized mean difference = -1.82, 95% CI [-3.28, -0.35], P = .01). No severe adverse reactions such as hemorrhage, hematoma, or local infection caused by acupuncture were reported in the study.

Conclusion:

The available evidence shows that acupuncture can effectively improve the total clinical effective rate and sinus rhythm recovery rate, shorten the recovery time of sinus rhythm, and reduce the ventricular rate, and there are no apparent adverse reactions. However, a limited number of studies may affect the generalizability of the findings. Future studies should include more extensive and diverse studies to enhance the power and generalizability of the findings.
Mendelian randomization analysis of two samples to determine the impact of immune cells on bronchitis
Authors: Tian Zhiyu , Jiang Zhanliang , Shi Li
Published: November 2024

Bronchitis is a common respiratory disease characterized by acute inflammation, edema, and necrosis of the small airways, leading to a significant pathological burden. Immune cells play a crucial role in combating bronchitis. This study aims to explore the causal relationship between immune cells and bronchitis using the Mendelian randomization approach. In this study, we screened 18,183 single nucleotide polymorphisms highly associated with immune cells and employed 5 Mendelian randomization methods to assess the potential causal link between different types of immune cells and bronchitis. Additionally, the study utilized inverse variance weighting and MR-Egger regression analysis to evaluate the heterogeneity and robustness of the causal estimates. The study found a significant causal association between 28 types of immune cells and the risk of bronchitis. These cell types mainly included T cells, monocytes, and B cells. For instance, CD25 on B cells and CD25 on IgD+ were associated with an increased risk of bronchitis, whereas IgD+ CD24‐ B cells and CD33‐ HLA DR‐ AC showed a protective effect against bronchitis. Moreover, the study validated the robustness of these findings through leave-one-out analysis and the MR-Egger method, and quantitatively illustrated the impact of immune cells on the risk of bronchitis through forest plots. This study reveals the dual role of immune cells in bronchitis. The identified types of immune cells may increase the risk of bronchitis by promoting inflammatory responses and cell-mediated immune reactions, while other cell types may offer protection by promoting immune balance and effective defense.
A review and bibliometric analysis of global research on non-pharmacologic management for neonatal and infant procedural pain
Authors: Chen Xin , Li Ruoyu , Xiong Anqi , Luo Biru
Published: November 2024

Repeated and prolonged exposure to pain can impair neurodevelopmental, behavioral, and cognitive outcomes in newborns. Effective pain management of newborns is essential, but there is no comprehensive analysis of the status of neonatal pain non-pharmacologic management research. Original publications related to the non-pharmacological management of neonatal pain were obtained from the Web of Science Core Collection (WOSCC) between 1989 and 2024. CiteSpace and VOSviewer were used to extract information about countries/regions, institutions, authors, keywords, and references to identify and analyze the research hotspots and trends in this field. 1331 authors from 51 countries and 548 institutions published studies on the non-pharmacological management of neonatal pain between 1989 and 2024, with the number of publications showing an overall upward trend. Canada emerged as the leading country in terms of publication volume, with the University of Toronto and The Hospital for Sick Children identified as key research institutions. High-frequency keywords included “procedural pain,” “management,” “sucrose,” “analgesia,” and “preterm infant,” resulting in 11 clusters. Keyword emergence analysis revealed that “neonatal pain,” “analgesia,” “oral sucrose,” and “oral glucose” were research hotpots. Analysis of highly cited papers showed that the most referenced articles were published in the Clinical Journal of Pain. Researchers’ interest in neonatal procedural pain has increased significantly over the past 30 years. This article can serve as a theoretical reference for future research on mild to moderate pain in neonates and infants, and it can provide ideas for exploring novel and secure pain management strategies.
Endoscopic nasal multilevel skull base reconstruction combined with lumbar cistern drainage in the treatment of infection caused by cerebrospinal fluid leakage: A case report
Authors: Zhou Longshan , Yang Xiaoqian , Lv Jiatao , Chong Zonglei
Published: November 2024

Rationale:

Traumatic cerebrospinal fluid leakage can cause complications such as meningitis, ventriculitis and brain abscess. It is necessary to formulate individualized treatment strategies, such as the use of antibiotics and skull base reconstruction methods. The application of nasal septum mucosal flap can significantly reduce the incidence of cerebrospinal fluid leakage. Neuroendoscope has been widely used in the treatment of skull base diseases, and the application of continuous lumbar cistern drainage technology has effectively controlled cerebrospinal fluid leakage. This paper introduces a case of long-term cerebrospinal fluid leakage complicated with infection. Neuroendoscopic multilevel skull base reconstruction combined with lumbar cistern drainage has achieved good clinical results, and this combined treatment is rarely reported in the literature. In order to promote the surgical effect of cerebrospinal fluid leakage, this combined treatment scheme is introduced here.

Patient concerns:

A 43-year-old male was admitted with headache for 7 days, aggravation with fever and vomiting for 2 days.

Diagnoses:

Cerebrospinal fluid culture suggests central nervous system infection, history and symptoms suggest traumatic cerebrospinal fluid rhinorrhea, and computed tomography (CT) shows old skull base fracture.

Interventions:

Intracranial infection was controlled after anti-infection treatment with sensitive antibacterial drug ceftriaxone sodium. Repair of cerebrospinal fluid rhinorrhea by transsphenoidal endoscope. Continuous lumbar cistern drainage (LCD) was performed after operation to promote the healing of the leak.

Outcomes:

After comprehensive treatment, the patient did not have CSF rhinorrhea again and was discharged.

Lessons:

Antibiotics combined with endoscopic multi-segment skull base reconstruction and lumbar cistern drainage are effective in treating infection caused by cerebrospinal fluid leakage.
Landscape of cardiorenal syndrome research: A bibliometric analysis
Authors: Sun Yan , Hua Bin , Bai Yan , Zheng Wang , Shen Lin , Niku Wangkang , Wei Yihong , Zhang Fan , Deng Bing
Published: November 2024

To comprehensively review cardiorenal syndrome (CRS)-related research, this study analyzes its whole landscape and future trends from a bibliometric perspective. Using “cardiorenal syndrome” as the key word, a representative dataset of CRS was constructed in the Web of Science Core Collection (Science Citation Index Expanded) database up to November 2023. VOSviewer (version 1.6.18) and R-Studio (version 1.4) were used to visualize CRS-related author and national collaboration networks, hotspot distribution clustering and historical citation networks. The annual number of publications shows an upward trend, especially since 2009. The United States is the most active country and closely cooperates with European countries. Cardiorenal Medicine is the journal that publishes the most CRS-related research. Urology & Nephrology and Cardiovascular System & Cardiology are the most prominent areas of CRS literature output. The leaders in CRS-related research are Ronco C from Italy and Mccullough PA, from the United States. Combined with keyword co-occurrence, theme evolution, and strategic distribution analysis, it was found that centering on the mechanism of CRS (cardiovascular lesions, venous congestion, and fibrosis), prognosis (transplantation, dialysis, hospitalization, mortality) and cardiac function management (b-type natriuretic peptide, diastolic dysfunction, left ventricular hypertrophy) is a possible research direction for a long time to come. Although CRS has a relatively short history, it has received a lot of attention and is currently enjoying a high level of overall acceptance. In conclusion, this study explores the major research areas, frontiers and trends in CRS, which are important for future research.
The clinical results and function of the intersegmental disc after posterior-only partial corpectomy for lumbar burst fractures
Authors: Liang Pengzhan , Chen Xiaodong , Shu Gao , Zhao Haibo , Lai Jinquan , Jiang Linbo , Yang Xuejun
Published: November 2024

We treated the burst spinal fracture with posterior subtotal corpectomy and reconstruction. In some cases, the endplate and the adjacent disc can be preserved during the operation. The adjacent disc retained its mobility after the removal of the posterior pedicle screws. This study evaluated the clinical results and function of the intersegmental caudal disc after the removal of posterior pedicle screws for lumbar burst fractures. The study analyzed retrospectively 36 patients with acute burst traumatic lumbar fractures who underwent posterior partial subtotal corpectomy and reconstruction with preservation of the inferior endplate of the fractured vertebral body and the adjacent caudal disc, and sequential removal of the posterior pedicle screw 1 year after the second surgery from March 2015 to December 2021. All patients were followed for approximately 1 year after pedicle screw removal. Demographic data, anterior vertebral body height, local kyphosis, motion, caudal disc degeneration, and clinical outcomes were evaluated. After removal of the posterior pedicle screws, the intersegmental disc retained a range of motion of 10.55 ± 5.58°, and the disc degeneration was graded by Pfirrmann criteria from 2.21 ± 1.15 before first surgery to 3.18 ± 1.46 at last follow-up after second surgery. There were 2 cases of superficial wound infection, and 5 cases of postoperative neuralgia recovering after 3 months. Anterior fusion was achieved, although postoperative subsidence of the mesh was observed in 6 cases and screw loosening in 9 cases. Posterior-only partial subtotal corpectomy with preservation of the adjacent caudal disc not only achieved a good clinical effect, but also preserved intersegmental caudal disc function after removal of posterior pedicle screws approximately 1 year later. This technique is a promising alternative for cases in which the endplate obviates injury.
The role of 1400 plasma metabolites in gastric cancer: A bidirectional Mendelian randomization study and metabolic pathway analysis
Authors: He Yihao , Cai Peiyuan , Hu Anchi , Li Jiali , Li Xuan , Dang Yini
Published: November 2024

While observational studies have illustrated correlations between plasma metabolites and gastric cancer (GC), the causal association between the 2 is still unclear. Our study aims to delineate the bidirectional relationship between plasma metabolites and GC and find potential metabolic pathways. We undertook a bidirectional 2-sample Mendelian randomization (MR) analysis to investigate the causal relationship, specificity, and direction of association between 1400 plasma metabolites and GC. The GWAS data for metabolites was obtained from a cohort of 8299 European individuals. And the GC’s GWAS data was from FinnGen Consortium with 2384 European individuals, and the GWAS catalog with 1029 European ancestry cases for validation. Causal estimates were primarily calculated by the inverse-variance weighted (IVW) method. To ensure robustness, we performed comprehensive sensitivity analyses to assess heterogeneity and address concerns regarding horizontal pleiotropy. We validated the forward relationship between metabolites and GC from another database and implemented meta-analysis. Furthermore, we conducted metabolic enrichment and pathway analysis of these causal metabolites using MetaboAnalyst5.0/6.0 with the database of Kyoto Encyclopedia of Genes and Genomes. All statistical analysis was carried out using R software. Metabolites like 2s, 3R-dihydroxybutyrate, 4-acetamidobutanoate, ferulic acid 4-sulfate and methyl indole-3-acetate was proven positively linked with the development of GC. Asparagine, glucose to maltose ratio, glycohyocholate, Gulonate levels, linoleoyl ethanolamide and Spermidine to (N(1) + N(8))-acetylspermidine ratio was proven to be negatively associated with GC. Moreover, linoleic acid, histidine, glutamine, bilirubin, Succinate to proline ratio were found to be potentially linked to the development of GC. Furthermore, our analysis identified 18 significant metabolic pathways, including Arginine and proline metabolism (P < .009) and Valine, leucine, and isoleucine biosynthesis (P < .031). Our findings offer evidence supporting potential casual relations between multiple plasma metabolites and GC. These findings may offer great potential for future application of these biomarkers in GC screening and clinical prevention strategies.
Comparison of stable carotid plaques in patients with mild-to-moderate carotid stenosis with vulnerable plaques in patients with significant carotid stenosis
Authors: Liu Yumeng , Wu Bokai , Wu Songxiong , Liu Zhenyu , Wang Panying , Lv Yungang , Wu Ruodai , Ji Bin , Peng Zhengkun , Lu Chao , Wei Dazhong , Li Guangyao , Liu Jia , Wu Guangyao
Published: November 2024

To compare the characteristics of stable and vulnerable carotid plaques, and investigate the diagnostic performance of wall shear stress (WSS) based on magnetic resonance plaque imaging in carotid plaques. Retrospectively analyzed and divided 64 atherosclerotic plaques into stable carotid plaque groups with mild-to-moderate stenosis and vulnerable carotid plaque groups with significant stenosis. Computational fluid dynamics simulations were performed to calculate WSS parameters by using three-dimensional wall geometry based on high-resolution magnetic resonance plaque imaging of carotid bifurcation and patient specific boundary conditions obtained through color Doppler ultrasound. WSS parameters including upstream (WSSup), downstream (WSSdown), and core (WSScore) of plaque. The WSS parameters values were compared between the stable and vulnerable carotid plaque groups. Receiver operating characteristic curves and area under the curve (ROC-AUC) and Python were used to evaluate discriminative efficacy of WSS. WSSdown exhibited significant decrease in the vulnerable carotid plaque group (2.88 ± 0.41 Pa) compared to the stable carotid plaque group (4.47 ± 0.84 Pa) (P = .003). The difference of WSSup (3.28 ± 0.85 Pa vs 4.02 ± 0.74 Pa) and WSScore (1.12 ± 0.18 Pa vs 1.38 ± 0.38 Pa) between the two groups were also pronounced (P = .02, 0.01, respectively). The ROC-AUC values for WSSup, WSSdown, WSScore were 0.75 (95% CI, 0.58–0.93), 0.96 (95% CI, 0.79–1.14), 0.69 (95% CI, 0.56–0.83) respectively. When the value of WSSdown was 3.5 Pa, the sensitivity was 93.7% (95% CI, 76.1–111), specificity and accuracy was 87.5% (95% CI, 70.0–105), 88.4% (95% CI, 70.6–105) respectively. Notably, among these parameters, WSSdown demonstrated the highest discriminative efficiency with a F1 Score of 0.90, Diagnostic Odds Ratio of 105.0 and Matthews Correlation Coefficient of 0.81. Vulnerable carotid plaques with significant stenosis have lower WSS compared to stable plaques with mild-to-moderate stenosis, and downstream WSS showing the highest diagnostic efficacy.
Analysis of influencing factors on cognition of organizational innovation climate among clinical nurses in China
Authors: Sun Jia-Xi , Liu Fu-Yan , Zhao Dan , Hao Wen-Nv
Published: November 2024

Establishing a positive organizational innovation climate can enhance nurses’ innovative performance and work quality. This study aims to explore the cognitive status and influencing factors of the organizational innovation climate among clinical nurses. The findings of this study will provide a scientific basis for developing innovative nursing talent teams and strengthening innovative management. This is a cross-sectional study. From July 2024 to September 2024, we conducted a paper questionnaire survey of 210 clinical nurses in 3 tertiary hospitals in China. Participants self-reported on general demographic questionnaires and organizational innovation climate scales. The collected data were analyzed using various statistical methods, including descriptive analysis, independent sample t-tests, one-way analysis of variance (ANOVA) tests, and multiple linear regression analysis. Multicollinearity was tested using the variance inflation factor and tolerance test. All analyses were performed using the SPSS software (version 26.0). P < .05 indicated that the difference was statistically significant. In this study, the score for organizational innovation climate among 210 clinical nurses was (73.70 ± 9.25). Organizational innovation incentive was the dimension having the highest score. Resource supply was the dimension having the lowest score. Multiple regression analysis showed that gender, highest education level, years of work experience, position, job satisfaction, and academic conference participation experience were the main factors influencing clinical nurses’ cognition of the organizational innovation climate (P < .05). In this study, the cognitive level of nurses’ organizational innovation climate was moderate level. To improve this level, nursing managers should develop targeted intervention measures for various influencing factors. It is recommended that nursing managers strategically integrate scientific research innovation training into their vocational training programs to stimulate nurses’ innovation consciousness and improve the quality of clinical nursing services.
Hub genes, diagnostic model, and predicted drugs related to ferroptosis in chronic rhinosinusitis with nasal polyps
Authors: Guo Qian , Dong Dong , Qiao Xinjie , Huang Shuman , Zhao Yulin
Published: November 2024

Significant progress has been made in the pathogenesis of chronic rhinosinusitis (CRS). However, the relationship between chronic rhinosinusitis with nasal polyps (CRSwNP) and ferroptosis, as well as its underlying molecular mechanism, remains unclear. This study aimed to investigate the correlation between CRSwNP and ferroptosis and identify key gene associated with ferroptosis that could impact the diagnosis and treatment of CRS. To achieve this, gene expression profiles containing CRSwNP and CRSsNP samples were obtained from the GEO database. In addition, from the FerrDb V2 database, we acquired 2 sets of genes that are connected with ferroptosis, giving us a combined number of 260 genes associated with this particular biological process. Differential analysis and weighted gene co-expression network analysis (WGCNA) were performed on nasal tissue samples from GSE36830, leading to the identification of 1 key gene related to ferroptosis and CRS. Using stepwise regression and logistic regression analysis, we constructed a diagnostic model for CRS using ALOX15. The AUC value demonstrates that the model exhibits a strong diagnostic performance. Furthermore, the connection between immune cell infiltration in the samples and hub gene was explored, suggesting the potential significance of the hub gene in the immune response to CRS. Finally, Five drugs targeting a central gene were identified from the DrugBank database, and a few of them have exhibited efficacy in the treatment of CRS or associated ailments. In conclusion, this model holds potential for supporting the diagnosis of CRS patients, while the central gene identified may contribute to a better understanding of CRS development and drug treatment.
Simultaneous bilateral midshaft clavicle fractures (Allman Type I): Case series
Authors: Cen Chaode , Xie Yuehua , Liu Mao , Wu Yan , Cao Aixin , He Daqing
Published: November 2024

Rationale:

A simultaneous bilateral fracture of the middle clavicle is a very rare injury in clinical practice, and the necessity of surgical intervention and treatment modality remains a topic of debate.

Patient concerns:

We report a case of multiple injuries in a 40-year-old woman following a road traffic accident and another case of polytrauma in a 46-year-old man following a collision injury.

Diagnoses:

The radiographs of the bilateral shoulder joints and the 3-dimensional reconstruction CT of the chest showed the fractures in the middle third of the clavicle on both sides. In addition, concurrent injuries were not overlooked.

Interventions:

Until the patient’s life-threatening injury is prioritized and the patient’s vital signs are stable, patients were treated with the anatomical locking plate to stabilize the bilateral clavicle fractures. Progressive functional exercises were implemented following the operation.

Outcomes:

At the 2-month follow-up examination, the patients showed excellent range of motion and functional outcomes.

Lessons:

Given the rarity of this combined injury, it is crucial to minimize the duration of functional impairment and encourage early functional exercises for both shoulder joints. We recommend that surgical indications be judiciously relaxed to allow for open reduction and internal fixation using locking plates.
Efficacy and safety of early administration of remdesivir in hemodialysis patients with COVID-19: A case report and literature review
Authors: Oshiro Nanako , Kinjo Takeshi , Aharen Daigo , Kudo Yuki , Katsuren Eisuke , Omine Kumiko , Nakamura Takuto , Zamami Ryo , Ishida Akio , Miyagi Kazuya , Nakamatsu Masashi , Yamamoto Kazuko , Kusunose Kenya , Fujita Jiro , Ohya Yusuke , Kohagura Kentaro
Published: November 2024

Rationale:

Although the mortality of severe coronavirus disease 2019 (COVID-19) has decreased after the emergence of the Omicron variant, it remains high in patients on hemodialysis (HD). Remdesivir (RDV) is considered as the first line drug for hospitalized COVID-19 patients, however the evidence regarding the usage in HD patients is lacking because clinical trials of RDV have excluded HD patients for safety reasons. Thus, accumulation of knowledge on the regimen, efficacy, and tolerability of RDV in HD patients is important.

Patient concerns:

A nosocomial COVID-19 cluster was occurred from August 31 to October 12 in 2021 when the Delta variant was predominant. During the cluster, 11 health-care workers and 20 inpatients including 7 HD patients were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Diagnoses:

The diagnosis of COVID-19 was confirmed by the real-time polymerase chain reaction (PCR) for SARS-CoV-2.

Interventions:

RDV was initiated within 16 hours after the onset of fever (≥ 37.4°C) or positive PCR result in all HD patients, and continued at 100 mg/day intravenously once daily for either consecutive 5 or 10 days.

Outcomes:

All patients fully recovered within 2 weeks and did not develop severe COVID-19. Two patients experienced mild liver dysfunction, but it was temporary and remitted spontaneously even continuing RDV treatment. Discontinuation of RDV therapy due to adverse events was not required in any patients.

Lessons:

Present cases indicated early intervention with RDV may contribute the favorable outcome and daily administration of RDV for up to 10 days was well tolerated even in HD patients. Literature review showed no previous article reported the efficacy and safety of such earlier and longer administration of remdesivir as in the present cases, therefore this report is informative for clinicians to consider the usage of RDV in HD patients.
Association between iridocyclitis and immune-related disease: A 2-sample Mendelian randomization study
Authors: Yao Yao , Wang Qian , Wei Wenbin
Published: November 2024

The genetic basis of iridocyclitis, an inflammatory eye disease, remains poorly understood, particularly in relation to autoimmune diseases. This study aimed to explore the causal associations between 6 immune-related diseases and iridocyclitis using Mendelian randomization (MR). A total of 230 single nucleotide polymorphisms (SNPs) significantly associated with systemic lupus erythematosus, ankylosing spondylitis (AS), rheumatoid arthritis (RA), Graves disease (GD), Crohn disease (CD), and allergic contact dermatitis were identified based on stringent MR assumptions. These SNPs served as instrumental variables to estimate the causal effect of each autoimmune disease on iridocyclitis risk. The analysis utilized the inverse variance weighted method, complemented by sensitivity analyses including MR-Egger regression and leave-one-out testing to assess pleiotropy and robustness. The MR analysis revealed significant associations between genetically predicted AS (odds ratio [OR]: 1.544, 95% confidence interval [CI]: 1.494–1.595, P = 1.99 × 10−226), RA (OR: 1.207, 95% CI: 1.052–1.385, P = .003), and CD (OR: 1.654, 95% CI: 1.263–2.166, P = 2.54 × 10⁻⁶) with an increased risk of iridocyclitis. Conversely, higher genetically predicted GD was associated with a decreased risk of iridocyclitis (OR: 0.763, 95% CI: 0.674–0.865, P = .0002). Although systemic lupus erythematosus and allergic contact dermatitis appeared to have a protective effect, these results were not statistically significant, and no causal relationship could be established. Heterogeneity was observed among the SNPs, but no significant horizontal pleiotropy was detected. This study identifies potential genetic links between AS, RA, CD, GD, and the risk of iridocyclitis, providing new insights into the genetic underpinnings of this eye disease. The results support the need for further investigation into the genetic and molecular mechanisms underlying these associations.
Exercise strategies for reversing cardiopulmonary deconditioning in obese children with bronchial asthma: A randomized comparative effectiveness study of constant-load and graded aerobic training
Authors: Elnaggar Ragab K. , Osailan Ahmad M. , Alghadier Mshari , Elnegamy Tamer E. , Morsy Walaa E. , Abdrabo Mohamed S. , Qissi Fahad A. , Shendy Mohammed A. , Mohamed Rania R. , Elfakharany Mahmoud S.
Published: November 2024

Background:

This study evaluates the differential effects of constant-load (CL-AE) and graded (G-AE) aerobic exercise training approaches on cardiopulmonary fitness and functional capacity in obese children with bronchial asthma (BA).

Methods:

Seventy-eight obese children with moderate BA (age: 14.14 ± 2.31 years; body mass index: 31.93 ± 1.26 kg/m2) were randomly assigned to 3 intervention-based groups: control, CL-AE, or G-AE group (n = 26 in a group). The cardiorespiratory fitness (peak oxygen uptake, minute ventilation [VE], ventilation-oxygen uptake ratio, stroke volume of oxygen, oxygen/carbon-dioxide exchange ratio, heart rate maximum, and heart rate recovery at one minute) and functional capacity (6-minute walk test and perceived dyspnea and fatigue) were assessed at the baseline and posttreatment.

Results:

The G-AE group exhibited more favorable changes in cardiorespiratory fitness [VO2peak (P = .03), VE (P = .021), VE/VO2 (P = .032), SVO2 (P = .025), O2/CO2 ratio (P = .004), HRmax (P = .016), HRR1 (P = .046)] and functional capacity [6-minute walk test (P = .021), dyspnea (P = .041), fatigue (P = .04)] as compared to the CL-AE group.

Conclusion:

The G-AE, compared to CL-AE, appears to be a more potent stimulus for enhancing cardiorespiratory fitness and functional capacity in obese children with BA. Further investigations are, however, required to corroborate the observed effects.
Differential analysis of microRNAs in plasma exosomes in patients with cerebral ischemic stroke
Authors: Lan Haifang , Yuan Shengshan , Song Yanlun , Liu Tingjun , Agarwal Gautam , Li Xuebin , Liang Lina , Wei Guijiang
Published: November 2024

The high incidence, disability, mortality, and recurrence rates of cerebral infarction impose a heavy burden on both the Chinese and global populations. It is essential for the early diagnosis, prevention, and protection against brain cell injury. To identify differentially expressed microRNAs (miRNAs) in plasma exosomes of patients with cerebral ischemic stroke, determine relevant biomarkers, and explore their potential signaling pathways. High-throughput sequencing was used to detect the expression of plasma exosomal miRNAs in patients with cerebral ischemic stroke and in a control group. Gene Ontology, Kyoto Encyclopedia of Genes and Genomes enrichment, and target gene network analyses were performed to investigate the target genes and signaling pathways of the differentially expressed miRNAs. The sequencing results identified 95 differentially expressed miRNAs, with 40 upregulated and 55 downregulated miRNAs. Among these, hsa-miR-1303, hsa-miR-125b-1-3p, and hsa-miR-548ab were significantly upregulated in the stroke group and downregulated in the normal control group, whereas hsa-miR-1289 was downregulated in the stroke group and upregulated in the normal group. Gene Ontology, Kyoto Encyclopedia of Genes, and genomes enrichment analyses indicated that the differentially expressed miRNAs and their target genes were mainly concentrated in the PI3K-AKt, mitogen-activated protein kinase, calcium, Ras, Rap1, and cAMP signaling pathways. The expression of plasma exosomal hsa-miR-1303, hsa-miR-125b-1-3p, and hsa-miR-1289 was significantly different in stroke patients than in the control group. These miRNAs may be involved in various signaling pathways related to cerebral infarction, providing a reference for further experimental research.
Efficacy of repetitive transcranial magnetic stimulation combined with peripheral magnetic stimulation on movement symptom and exploration of the optimal population in Parkinson’s disease: A randomized controlled trial
Authors: Sun Peili , Li Junrui , Shen Haiqing , Jiang Yongcheng , Wang Xinjue , Xu Tian , Shen Lihua , Gu Xiaosu
Published: November 2024

Background:

This study explores the efficacy of repetitive transcranial magnetic stimulation (rTMS) and rTMS combined with repetitive peripheral magnetic stimulation (rPMS) (hereinafter referred to as rTMS + rPMS) on motor symptoms and quality of life in Parkinson’s disease (PD), and explores whether there are differences between the two treatment methods; At the same time, analyze data from different subgroups to explore the influencing factors, in order to find the most suitable treatment group.

Methods:

Eighty patients with PD were randomly divided into rTMS and rTMS + rPMS groups and administered 10 Hz rTMS, and 10 Hz rTMS + 25 Hz rPMS, respectively, for 10 days. Before and after treatment, the PD Motor Function Rating Scale (UPDRS Part III, 10m Walk Timing Test, Stand Up Walk Test Evaluation Scale (TUG)) and PD Quality of Life Questionnaire (PDQ-39) were used to evaluate the motor symptoms and quality of life. After quantifying the treatment effect, a comparative analysis of the efficacy before and after treatment was conducted. Simultaneously, we divided the two treatment groups into different subgroups, compared the subgroups under the same treatment method, analyzed the relevant factors affecting the treatment method, and found the most suitable treatment group.

Results:

(1) After rTMS or rTMS + rPMS, all scoring scales improved compared to those before treatment (P < .05). Compared to rTMS, rTMS + rPMS resulted in greater improvements in overall motor function (UPDRS III) and quality of life (PDQ-39) (P < .05). (2) Patients with rigidity-based type as the main type may be the most suitable for these two treatment methods (P < .05).(3) There was no significant difference in treatment efficiency between the two treatment methods for patients with PD at different disease stages, sexes, or treatment ages(P > .05).

Conclusion:

Both rTMS and rTMS + rPMS can improve movement symptoms and quality of life in patients with PD. rTMS + rPMS was more beneficial for improving the overall motor function. Patients with rigidity-based type as the main type may be the most suitable for these two treatment methods. The therapies work in all age groups, all gender and irrespective of the disease stage with varying levodopa equivalent daily doses as well.