bluuebunny/crossref_metadata_2025 huggingface dataset:
A scoping review to determine if adverse human health effects are associated with use of pyrethroids for mosquito control
Authors: Kuczynski Lange Suzanne , Connelly C Roxanne , Tai Zoe , Foley Nicole , De Leon Rivera Juan , Lozano Saul , Nett Randall J
Published: February 2025

Mosquito control using pyrethrins and synthetic pyrethroids (PSP) is important for preventing vector-borne diseases. Although the benefits associated with PSP use are well-documented, public concern exists regarding potential human adverse health effects. The aim of this scoping review was to describe adverse human health effects associated with PSP use for community adult mosquito control. A literature search using the databases MEDLINE, EMBASE, Agricultural and Environmental Science Collection, CAB Abstracts, and Scopus obtained 6,154 original peer-reviewed articles published during 1 January 2000 to 22 May 2024. Articles were independently reviewed for inclusion using predetermined exclusion and inclusion criteria. Data were extracted from 10 included articles. Study designs included cohort (n = 5), cross-sectional (n = 2), and risk assessment (n = 4). One article included 2 study designs. Of the cohort studies, one was prospective and the remainder were retrospective. A causal relationship between PSP application for adult mosquito control and adverse human health impacts was not identified. No increases in acute health manifestations were reported. The 4 risk assessments estimated that PSP exposures were not above the regulatory level of concern; a meta-analysis determined the likelihood of PSP exposures exceeding the regulatory level of concern was <0.0001. The limited evidence indicated that PSP applied appropriately for control of nuisance mosquitoes or mosquitoes that transmit arboviruses do not pose acute or chronic human health risks. Continued investigation into potential human health impacts of PSP would help inform guidelines for adult mosquito control and help inform public health decision making.
The pre-exposure prophylaxis personal obstacle scale: measurement properties in English, German, and French
Authors: Ort Alexander , Bardy Tess L C
Published: February 2025

Background

This study aimed to validate the Pre-Exposure Prophylaxis Personal Obstacle Scale (PPOS) across English, German, and French (PPOS-EN/DE/FR) for men who have sex with men (MSM). The PPOS measures perceived barriers related to knowledge and uncertainty surrounding PrEP use, which are particularly important factors in the early stages of the PrEP Care Continuum (PCC).

Methods

The original PPOS was adapted and translated into German and French. Data were collected through an online survey in four European countries (N = 1124). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factor structure, while multigroup CFA (MGCFA) tested measurement invariance across language groups and adoption statuses.

Results

EFA revealed a two-factor structure: (i) “Impact of PrEP on personal health” and (ii) “Knowledge about PrEP.” CFA confirmed this structure, and measurement invariance was established across languages and adoption statuses with high reliability (α = 0·82, ω = 0·82).

Conclusions

The PPOS-EN/DE/FR is a valid and reliable tool for assessing personal obstacles to PrEP uptake among MSM across different languages. It supports public health efforts by identifying specific challenges to PrEP adoption, facilitating culturally sensitive interventions to improve uptake and reduce HIV transmission.
Approach to Janus kinase inhibition for juvenile dermatomyositis among CARRA and PReS providers
Authors: Sherman Matthew A , Nicolai Rebecca , Datyner Emily K , Rosina Silvia , Hamilton Angela , Ardalan Kaveh , Bader-Meunier Brigitte , Brown Amanda G , Jansen Marc H A , Kim Susan , Lang Bianca , Campanilho-Marques Raquel , McCann Liza J , Sanner Helga , Veldkamp Saskia R , Wilkinson Meredyth G Ll , Yi Belina Y , Kim Hanna , Tarvin Stacey E , Papadopoulou Charalampia ,   CARRA JDM Therapeutics Workgroup and the PReS JDM Working Party
Published: February 2025

Objectives

Janus kinase inhibition (JAKi) has been proposed as a treatment for idiopathic inflammatory myopathies to target increased interferon signalling. Predominantly retrospective reports have demonstrated effectiveness of JAKi in refractory juvenile dermatomyositis (JDM). However, JAKi remains an off-label treatment for JDM and there may be variation in use worldwide. An international survey was conducted to investigate approaches to JAKi for JDM.

Methods

The Childhood Arthritis and Rheumatology Research Alliance (CARRA) JDM Therapeutics workgroup and core members of the Paediatric Rheumatology European Society (PReS) JDM working party devised an electronic survey to assess the use of JAKi in JDM. CARRA and PReS members were invited by email to complete the survey.

Results

There were 229 respondents (18%), with 50% from the US and 29% from Europe. 150 had used JAKi for over 450 patients with JDM; among them, 77% noted clinical improvement in most or all patients and 17% reported side effects. The highest ranked perceived barriers to JAKi use were lack of clinical data and inability to obtain insurance approval. The highest ranked clinical indications for starting JAKi were refractory skin disease, refractory muscle disease, inability to wean steroids, and intolerance to other steroid-sparing agents.

Conclusion

Pediatric rheumatologists use JAKi off-label treatment for refractory JDM. Most providers noted clinical improvement in their patients. Barriers to JAKi use include lack of clinical data and insurance coverage. Clinical trials are needed to provide better data on the efficacy and safety of JAKi.
Transcriptome Analysis Reveals That a Gti1/Pac2 Family Gene, CpSge1, Regulates Fungal Growth, Stress Response, and Virulence in Cryphonectria parasitica
Authors: Lin Xiaorong , Yang Yuchen , Huang Can , Xiong Dianguang , Qiu Xiaolin , Tian Chengming
Published: February 2025

The Gti1/Pac2 family comprises crucial transcription factors widely distributed in fungi with generally two members Gti1 (also known as Wor1, Ryp1 or Sge1) and Pac2, where the Gti1 homologues play significant roles in growth, spore production, and pathogenicity of various pathogenic fungi. Despite its recognized significance, the roles of this family in Cryphonectria parasitica, the pathogen responsible for chestnut blight (a globally significant forest disease) remain unexplored. In this study, CpSge1 was identified in C. parasitica and then knocked out to explore its functions. The results showed that CpSge1 significantly affected vegetative growth, conidiation, hydrophobicity, and stress tolerance of C. parasitica. Notably, the CpSge1 deletion mutants were significantly less pathogenic compared to the wild type. Transcriptomic analysis of the wild type and the CpSge1 deletion mutant during vegetative growth and infection stages revealed that CpSge1 regulated a number of pathogenicity-related genes in C. parasitica. Yeast one hybrid verified the direct binding of CpSge1 to the promoter regions of genes encoding pectin lyase CpPL1 and major facilitator superfamily transporter CpMF1. In summary, these data suggest that CpSge1 is the core regulator of fungal growth, stress tolerance, gene expression, and virulence in C. parasitica, which may improve our understanding on the molecular pathogenesis of C. parasitica and then help us to develop effective control strategies.
Radial Inclination and Volar Tilt Following Ulnar Epiphysiodesis for Distal Radius Physeal Arrest
Authors: Mullin Edmund P. , Campbell Tanner R. , Bomar James D. , Edmonds Eric W.
Published: February 2025

Objective:

Physeal arrest of the distal radius is a known complication after pediatric distal radius fractures. When this occurs, ulnar epiphysiodesis has been shown to prevent further ulnar positive variance. The purpose of this study is to determine any difference in the radial inclination (RI) and volar tilt (VT) of the distal radius pre-ulnar and post-ulnar epiphysiodesis and whether the final distal radius radiographic measurements are associated with clinical outcomes.

Methods:

A review of children who underwent ulnar epiphysiodesis for premature radial physeal closure at a single institution was performed over a 12-year period. Exclusion criteria included patient-reported outcome measures (PROMs) <1 year. Preoperative and final follow-up radiographic measurements were obtained for RI and VT, with interobserver reliability recorded. Cutoffs for acceptable RI and VT were set at >10 degrees and between −10 degrees and 25 degrees, respectively. PROMs were recorded using the quick–disabilities of the arm, shoulder, and hand questionnaire-9 (quickDASH-9) ﻿and Single Assessment Numeric Evaluation (SANE) ﻿scores.

Results:

Forty-six wrists were included (age 13.9 ± 1.2 y) with a mean PROM duration of 5.2 ± 3.4 years (1.0 to 12.3 y). Neither RI (P = 0.123) nor VT (P = 0.305) changed significantly from preoperative to final follow-up. No significant correlation between distal radius measures and quickDASH-9 or SANE scores was observed: RI, P > 0.23, and VT, P > 0.28. Preoperatively, RI was unacceptable in 2 wrists, and VT was unacceptable in 5 wrists. While these 7 wrists became acceptable after ulnar epiphysiodesis, some acceptable wrists became unacceptable after the procedure.

Conclusions:

As predicted, distal radius radiographic parameters did not change after ulnar epiphysiodesis, and PROMs did not appear to correlate with acceptable RI or VT. The PROMs suggest that children do well with this procedure, but based on individual results, there appears to be room for improvement through future study and considerations for patient-specific treatment approaches.

Level of Evidence:

Level IV—cohort study.
Vascularized Proximal Radius Bone Graft for a Massive Elbow Bone Defect: An Anatomic Study and Case Report
Authors: Barrera-Ochoa Sergi , Martínez-Garza Julio A. , Ibañez Maximiliano , Prieto-Mere José A. , Bonilla-Chaperon Melissa , Soldado Francisco
Published: February 2025

From an anatomic perspective, this paper delineates the proximal radial bone branches of the radial artery (RA). We also report the successful clinical use of a vascularized proximal radius bone graft (VPRBG), supplied by the RA, in a complex case involving a massive osseous elbow defect. In 10 latex-colored upper limbs from fresh human cadavers, RA branches were dissected under ×2.5 loupe magnification, noting all periosteal and osseous branches for the proximal radius. VPRBG length was measured. In the proximal forearm, the RA provides 10 (range: 7 to 14) periosteal and osseous branches to supply the area from the radial head to the proximal diaphysis. A 15 cm (11 to 17) vascularized bone graft can be harvested from the proximal radius, and RA dissection generates a 12 cm (9 to 15) pedicle with a wide arc of rotation, readily capable of reaching the distal part of the humerus. We used a 14 cm long VPRBG for elbow arthrodesis to fill a 12 cm defect, caused by a previous recalcitrant elbow infection in a 68-year-old man. The patient experienced no postoperative complications and successful consolidation was achieved 6 months postoperatively, with flap survival confirmed. After 2 years of follow-up, the contoured dorsal plate was removed, with no signs of infection. Final Disabilities of the Arm, Shoulder, and Hand and Mayo Wrist scores were 23 and 88, respectively. A VPRBG might be a safe and effective surgical option for massive osseous elbow defects, whenever elbow arthrodesis is planned, where it should be combined with a one-bone forearm technique.
Efficacy and Safety of Chimeric Antigen Receptor (CAR)-T Cell Therapy in Patients with Non-Hodgkin Lymphoma
Authors: Jamil Abdur , Qureshi Zaheer , Siddique Rimsha , Altaf Faryal , Akram Hamzah , Jamil Rohma , Aslam Shehroz , Selene Insija I.
Published: February 2025

Objectives:

Non-Hodgkin lymphomas (NHL) are a diverse group of lymphoproliferative malignancies, often more unpredictable than Hodgkin lymphomas, with a higher likelihood of extranodal spread. NHL’s resistance to standard chemotherapy has increased, leading to a growing interest in personalized treatments like chimeric antigen receptor T-cell therapies (CAR-TCT).

Methodology:

A literature search was conducted across PubMed, ScienceDirect, Google Scholar, and the Cochrane Library for studies on CAR-TCT in NHL treatment published until July 2024. The outcomes assessed included overall survival (OS), event-free survival (EFS), progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs). Data were pooled using RevMan 5.41 and Comprehensive Meta-analysis 3.

Results:

Out of 532 articles, 8 met the inclusion criteria. CAR-TCT significantly improved OS (HR: 0.79; 95% CI: 0.63-1.00; P=0.05) and PFS (HR: 0.46; 95% CI: 0.36-0.58; P<0.00001) compared with standard chemotherapy. However, EFS was not significantly different (HR: 0.54; 95% CI: 0.26-1.09; P=0.09). About 76.6% of NHL patients responded to CAR-TCT, but the ORR was similar between CAR-TCT and standard therapy (MD: 19.23%; 95% CI: −11.34% to 49.80%; P=0.22). Safety analysis found a grade ≥3 AEs incidence comparable to CAR-TCT and standard care. However, CAR-TCT was associated with higher neutropenia risk but lower thrombocytopenia, anemia, and nausea risks.

Conclusion:

CAR-TCT significantly improves OS and PFS in refractory NHL but does not notably impact EFS. While its ORR is comparable to standard chemotherapy, CAR-TCT has a better safety profile, making it a promising treatment option.
Surgical Outcomes Following Distal Nerve Decompression in Patients With Trigeminal Neuralgia
Authors: Hazewinkel Merel H.J. , Knoedler Leonard , Remy Katya , Tseng Sierra , Austen William G. , Gfrerer Lisa
Published: February 2025

Background:

Patients with headache disorders may present with compression of distal trigeminal nerve branches as well as other head and neck nerve branches such as the occipital nerves. In addition, a coexisting diagnosis of trigeminal neuralgia of proximal origin may be present. This overlap in diagnoses complicates treatment. Therefore, this study aimed to investigate the therapeutic effects of distal nerve decompression surgery in patients with coexisting trigeminal neuralgia from a proximal origin.

Methods:

The charts of 1112 patients who underwent screening for nerve decompression surgery were retrospectively reviewed. Patients with trigeminal neuralgia who underwent nerve decompression surgery were included. Data regarding preoperative and postoperative pain characteristics were collected.

Results:

Seventeen (1.5%) patients met the inclusion criteria and underwent nerve decompression. Fifteen patients (56%) underwent occipital decompression (13 greater occipital nerve decompressions, and 10 lesser occipital nerve decompressions), 5 patients (19%) underwent frontal decompression (supraorbital nerve/supratrochlear nerve decompression), and 6 patients (22%) underwent temporal decompression (4 zygomaticotemporal decompressions and 2 auriculotemporal nerve decompressions). Among the patients who underwent occipital decompression, 11 (73%) patients reported ≥80% pain relief, 1 (6.7%) patient reported ≥50% pain relief, and 3 (20%) patients reported ≤20% pain relief. For frontal and/or temporal decompression, only 2 (28%) patients achieved substantial pain relief (100% and 50%), whereas 5 (71%) patients experienced ≤20% pain relief.

Conclusions:

Our results demonstrate that occipital nerve decompression is an effective treatment for alleviating occipital neuralgia in individuals with coexisting proximal trigeminal neuralgia. However, the outcomes of frontal and temporal decompression were less favorable.
Hand Surgery in Lebanon 2024: Excellence Despite Existing Gaps
Authors: Bakhach Joseph Y. , Doghman Jana H. , Beaineh Paul T. , Makkawi Kareem W.
Published: February 2025

Background:

Lebanon has always offered advanced hand surgery services in the Middle East. However, the acknowledgment of hand surgery as an independent entity is yet to be recognized, impacting the hand care services provided. This article analyzes the landscape of hand surgery in Lebanon in 2024.

Methods:

A list of registered plastic and orthopedic surgeons was obtained from the Lebanese Order of Physicians. Data on registered surgeons’ work settings and hand surgery subspecialty focus were obtained from the Lebanese Society of Plastic, Reconstructive, and Aesthetic Surgery, and the Lebanese Orthopaedic Society. Data on hand surgeons worldwide were extracted through direct contact with society presidents and from the most recent published records.

Results:

The work environment of the active surgeons fell into 3 categories: working full time in Lebanon, splitting work between Lebanon and abroad, and exclusively working abroad. The ratio of Lebanese surgeons practicing basic hand surgery is 3.28 per 100,000 people compared with a ratio of 0.1 per 100,000 people for specialized hand surgeons—well below the recommended ratio of 0.8. Seven other countries also experience a shortage in hand surgeons, 5 have a nearly adequate supply, and 5 have an oversupply.

Conclusions:

There is a shortage of specialized hand surgeons in Lebanon, compounded by a lack of recognition of this specialty at the public and private levels of the country. Implementation of strategies is needed to bridge this gap and add to the already offered contributions by existing expertise.
Identifying Contextual Workplace Stressors in a Division of Plastic and Reconstructive Surgery
Authors: Goodacre Viola , Adapa Karthik , Kwong Elizabeth , Vizer Lisa M. , Liu Chao-Chin , Charguia Nadia , Greenberg Caprice , Damitz Lynn A. , McHugh Damian , Mazur Lukasz M.
Published: February 2025

Background:

Healthcare professionals in plastic and reconstructive surgery (PRS) face unique stressors that contribute to burnout, increasing the risk of errors and compromising patient care. Despite this, there is limited research on PRS burnout in the United States. This study aimed to measure burnout rates and identify high-impact improvement targets within a PRS division at a US academic medical center.

Methods:

A sequential mixed-methods study was conducted, involving systems analysis and contextual design methods. All surgeons (n = 5) and nonsurgeons (n = 9) were invited to participate (total n = 14). Burnout rates were measured, and workplace stressors were identified using surveys, focus groups, and contextual inquiries. High-impact, low-effort improvement targets were determined through impact-effort matrices.

Results:

Survey data from 13 respondents revealed an 85% burnout rate. Three focus groups and 14 contextual inquiries were conducted. After 13 participants validated and prioritized 2 affinity diagrams and provided 24 high-priority stressors, 8 respondents completed 2 surveys that yielded 6 high-impact/low-effort targets for organizational improvement efforts.

Conclusions:

This study highlights the high prevalence of burnout in PRS and identifies specific improvement targets for both surgeons and nonsurgeons. Findings suggest strategies such as improving respect and recognition for surgeons and streamlining clinic flow for nonsurgeons. Implementing these targeted improvements can enhance the well-being of healthcare professionals and ultimately improve patient care. The study’s methods can be replicated by other healthcare organizations to identify and address burnout-related issues effectively.
Loss of mitochondrial amidoxime-reducing component 1 (mARC1) prevents disease progression by reducing fibrosis in multiple mouse models of chronic liver disease
Authors: Coyne Erin S. , Nie Yilin , Lee Darwin , Pandovski Sentibel , Yang Tiffany , Zhou Heather , Rosahl Thomas W. , Carballo-Jane Ester , Abdurrachim Desiree , Zhou Yongqi , Hendra Christopher , Ali Asad Abu Bakar , Meyers Stacey , Blumenschein Wendy , Gongol Brendan , Liu Yang , Zhou Yingjiang , Talukdar Saswata
Published: February 2025

Background:

Metabolic dysfunction–associated steatotic liver disease is a prevalent disease that affects nearly one-third of the global population. Recent genome-wide association studies revealed that a common missense variant in the gene encoding mitochondrial amidoxime reducing component 1 (mARC1) is associated with protection from metabolic dysfunction–associated steatotic liver disease, all-cause cirrhosis, and liver-related mortality suggesting a role for mARC1 in liver pathophysiology; however, little is known about its function in the liver. In this study, we aimed to evaluate the impact of mARC1 hepatoprotective variants on protein function, the effect of loss of mARC1 on cellular lipotoxic stress response, and the effect of global or hepatocyte-specific loss of mARC1 in various mouse models of metabolic dysfunction–associated steatohepatitis and liver fibrosis.

Methods﻿ and Results:

Expression and characterization of mARC1 hepatoprotective variants in cells and mouse liver revealed that the mARC1 p.A165T exhibited lower protein levels but maintained its mitochondrial localization. In cells, the knockdown of mARC1 improved cellular bioenergetics and decreased mitochondrial superoxide production in response to lipotoxic stress. Global genetic deletion and hepatocyte-specific knockdown of mARC1 in mice significantly reduced liver steatosis and fibrosis in multiple mouse models of metabolic dysfunction–associated steatohepatitis and liver fibrosis. Furthermore, RNA-seq analysis revealed that the pathways involved in extracellular matrix remodeling and collagen formation were downregulated in the liver, and the plasma lipidome was significantly altered in response to the loss of mARC1 in mice.

Conclusions:

Overall, we have demonstrated that loss of mARC1 alters hepatocyte response to lipotoxic stress and protects mice from diet-induced MASH and liver fibrosis consistent with findings from human genetics.
Effects of Home Neighborhood Tree Canopy Coverage on Mental Health Outcomes: A Traumatic Brain Injury Model Systems Investigation
Authors: Juengst Shannon B. , Kumar Raj G. , Holland Alexandra , Cohen Achituv , Nelson Trisalyn A. , Corrigan John D. , Sander Angelle M. , Perrin Paul B. , Venkatesan Umesh M. , Rabinowitz Amanda , Driver Simon , Wilmoth Kristin , Tefertiller Candace
Published: February 2025

Objective: Explore the relationship between tree canopy coverage (TCC) in one’s home neighborhood and mental health outcomes, and how these relationships differ by home neighborhood factors, among persons with traumatic brain injury (TBI) in the United States. Setting: Community. Participants: Enrolled in the TBI Model Systems National Database with completed follow-up interview after January 1, 2017. Design: Secondary analysis of cross-sectional data. Main Measures: Neighborhood (census tract) Percent TCC, depressive (Patient Health Questionnaire-9) and anxiety (General Anxiety Disorder-7) symptoms (scores ≥10 on each measure), personal/demographic (age, sex, education, homebound status), and neighborhood factors (type, socioeconomic disadvantage). Results: Separate negative binomial regression models were constructed for the 2 mental health outcomes (depression and anxiety symptoms). Covariates in final models were age, sex, neighborhood type, Functional Independence Measure (FIM) total (concurrent), driving status, homebound status, and neighborhood-level socioeconomic disadvantage. The interaction between Percent TCC and neighborhood type (but not homebound status) was significant for depression and anxiety symptoms. The nature of the significant interaction was such that, for both mental health outcomes, those living in rural neighborhoods with higher Percent TCC were more likely to have moderate to severe mental health symptoms. However, this effect was attenuated after adding neighborhood level socioeconomic disadvantage, suggesting that part of the effect may be due to socioeconomic characteristics of rural versus other neighborhoods. Conclusions: After adjusting for SDoH, the direct effect of TCC on mental health after TBI was small and opposite the direction hypothesized (higher TCC associated with poorer mental health), particularly for those living in rural neighborhoods potentially more likely to experience socioeconomic disadvantage. Our findings highlight the importance of evaluating interactions between different aspects of the social (eg, SDoH), natural (eg, greenspace), and built (eg, neighborhood type) environment to provide a comprehensive understanding of factors affecting health after TBI.
Update on diagnosis and management of radiation retinopathy
Authors: Lovett Eric A. , Fan Jason , Williams Basil K. , Di Nicola Maura
Published: February 2025

Purpose of review

Radiation retinopathy is a vision-threatening complication of radiotherapy involving the eye or surrounding structures. This review aims to summarize recent advances in understanding the incidence, risk factors, pathophysiology, and utilization of new diagnostic imaging tools for radiation retinopathy. It will also focus on the current prophylaxis approaches to prevent or delay the development of radiation-related side effects and treatment strategies once radiation retinopathy occurs.

Recent findings

The incidence of radiation retinopathy is influenced by radiation dose, fractionation schedule, and patient-specific factors such as diabetes mellitus and hypertension. Advances in imaging techniques, including optical coherence tomography angiography (OCTA) and ultra-widefield fluorescein angiography (UWFA), have enhanced early detection by identifying subclinical retinal changes. Novel insights into pathophysiology suggest a role for endothelial damage, inflammation, and oxidative stress in disease progression. Prophylactic approaches, such as intravitreal antivascular endothelial growth factor (anti-VEGF) agents, have shown promise in reducing the onset of retinopathy in high-risk patients. Therapeutic options, including intravitreal anti-VEGF and corticosteroids, have demonstrated efficacy in managing macular edema and preserving vision. However, the outcomes remain variable, necessitating personalized treatment strategies. To address some of these unanswered questions, the Diabetic Retinopathy Clinical Research Network (DRCR) Protocol AL is currently enrolling patients and preparing to analyze the long-term effects of treating patients prophylactically with intravitreal faricimab or the 0.19 mg fluocinolone acetonide implant compared to observation, to identify which patients will benefit from which specific regimen, therefore moving towards a personalized approach for this condition as well.

Radiation retinopathy remains a significant challenge in ophthalmology. Early recognition through advanced imaging and tailored interventions, including prophylaxis and treatment, are crucial for optimizing visual outcomes. Further research into underlying mechanisms and novel therapies is essential to reduce the burden of this condition and improve patient quality of life.
Association Between Sociodemographic Risk Factors and No-Show Propensity in a Glaucoma Population Before and During Covid-19 Pandemic
Authors: Kamdar Amey , Yohannes Gelila B. , Swaminathan Swarup S.
Published: February 2025

Précis:

Greater social vulnerability, younger age, non-white race, Hispanic ethnicity, non-English speaking, Medicaid insurance, and milder glaucoma were associated with higher no-show propensity, which worsened during the Covid-19 pandemic among those subjects who were older and more socially vulnerable.

Purpose:

To identify sociodemographic risk factors for higher likelihood to no-show among glaucoma subjects before and during the Covid-19 pandemic using the no-show propensity factor (NSPF), a novel attendance metric, which improves upon no-show percentages by adjusting for number of visits.

Methods:

We analyzed de-identified demographic, visit attendance, and social risk factor data (social vulnerability index (SVI) and area deprivation index (ADI) scores) of de-identified glaucoma subjects from the Bascom Palmer Glaucoma Repository, computed NSPF, and categorized scores as low, intermediate, or high by the 75th and 90th percentiles for the pre-pandemic and pandemic periods. We identified predictors of NSPF scores using univariable, multivariable, and logistic regression analyses.

Results:

Of 15,342 subjects, 11,474, 2,238, and 1,630 subjects had low, intermediate, and high NSPF scores respectively with no-show rates of 9.5%, 39.2%, and 57.8% respectively. Age (β=−0.039 per decade, P<0.001), Black race (β=0.152, P<0.001), Hispanic ethnicity (β=0.115, P<0.001), Medicaid (β=0.073, P<0.001), Spanish primary language (β=0.076, P<0.001), SVI scores (β=0.047 per 25% increase, P<0.001), ADI ranking (β=0.057 for highest quartile, P<0.001), and baseline moderate (β=−0.046, P<0.001) or severe (β=−0.077, P<0.001) glaucomatous disease were significant predictors of NSPF. Older age (odds ratio (OR) 1.15 per decade, P<0.001), higher overall SVI (OR 1.09 per 25% increase, P<0.001), Medicare/Tricare insurance (OR 1.13, P=0.044), and non-English/Spanish primary language (OR 1.43, P=0.020) were associated with worsening NSPF during the pandemic.

Conclusion:

Younger age, non-white race, Hispanic ethnicity, non-English primary language, Medicaid, milder glaucoma, and residence in vulnerable areas are risk factors for greater propensity to no-show.
Clinical analysis of 101 cases of infectious endophthalmitis
Authors: Li Shanshan , Song Xianfeng , Wang Xu , Du Xing , Yang Zhen , Tao Yuan
Published: February 2025

This study aimed to analyze the pathogenesis, clinical features, and treatment of infectious endophthalmitis and provide reference data for its prevention and treatment. The study retrospectively analyzed 101 cases of infectious endophthalmitis patients who received treatment at the Second People’s Hospital of Jinan from January 2020 to December 2022, including pathogenic factors, microbiology, treatment, and prognosis of the patients. We found that traumatic endophthalmitis accounted for 48.51% of all cases, with iron foreign bodies being the leading cause of injury, while postoperative endophthalmitis after intraocular surgery accounted for 32.67% of all cases, with cataract surgery being the leading cause. The improvement in posttreatment visual acuity varied significantly among different causes of pathogenesis, with intraocular surgery showing the most improvement. In particular, postcataract surgery endophthalmitis showed better improvement than noncataract surgery-related endophthalmitis. Staphylococcus epidermidis was the main pathogenic bacteria causing infectious endophthalmitis, followed by fungi. Vitrectomy and intravitreal injection were the main treatment methods, with pars plana vitrectomy (PPV) + intravitreal injection (IVT) having a longer treatment time than PPV, IVT, or other approaches. In conclusion, this study provided important reference data for the prevention and treatment of infectious endophthalmitis. Traumatic and postoperative endophthalmitis were the most common causes, with iron foreign bodies and cataract surgery being the main contributors, respectively. The improvement in posttreatment visual acuity varied significantly among different causes of pathogenesis, with postcataract surgery endophthalmitis showing better improvement. Staphylococcus epidermidis was the main pathogenic bacteria causing infectious endophthalmitis, and vitrectomy and intravitreal injection were the main treatment methods.
Exploring the mechanism of SLXG for treating nonalcoholic fatty liver disease based on network pharmacology and molecular docking
Authors: Wang Yang , Wang Jiaxing , Chen Zitong , Liu Bin , Wang Wujie , Li Yuliang
Published: February 2025

Background:

The Shugan Lidan Decoction and Chaihu Shugan formula are traditional Chinese medicine formulas for treating liver diseases, with a history of over a 1000 years. By comprehensively improving 2 traditional Chinese medicinal formulas, Shugan Lidan Xiaoshi Granules (SLXG) has been developed for the treatment of nonalcoholic fatty liver disease (NAFLD) and other liver-related metabolic diseases.

Methods:

First, the effective active ingredients and targets of SLXG were determined using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database. The treatment targets for NAFLD were identified using the GeneCards, OMIM, and CTD databases, and the intersection of the decoction and disease targets was obtained. The intersection targets were then subjected to protein–protein interaction network analysis, Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis, and gene ontology enrichment analysis. KEGG enrichment analysis revealed enrichment of the NAFLD pathway. Molecular docking was performed to validate the binding between the crucial targets enriched in this pathway and the corresponding active ingredients in SLXG.

Results:

A total of 219 disease intersection genes related to NAFLD were identified from the GeneCards, OMIM, and CTD databases, and 239 non-duplicated drug targets were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database. A total of 24 intersection target genes were obtained from both drug- and disease-related databases, with 6 genes enriched in the KEGG NAFLD pathway. Molecular docking results showed that the 13 gene–active ingredient bindings had a binding energy of less than −6.5.

Conclusion:

The use of network pharmacology and molecular docking technology has revealed the mechanism of action of SLXG in NAFLD treatment, thus laying a theoretical foundation for the clinical application of SLXG in NAFLD therapy.
Advances in the study of CCT3 in malignant tumors: A review
Authors: Bai Yun-Feng , Shi Xiao-Hui , Zhang Mo-Lemei , Gu Jia-hui , Bai Ta-La , Bai Yin-Bao
Published: February 2025

Malignant tumors are among the leading causes of death worldwide, with their underlying mechanisms remaining largely unclear. Tumorigenesis is a complex process involving multiple factors, genes, and pathways. Tumor cells are characterized by abnormal proliferation, infiltration, invasion, and metastasis. Improving tumor diagnosis rates and identifying novel molecular therapeutic targets are of great significance for the advancement of modern medicine. Chaperonin containing TCP-1 subunit 3 (CCT3) is one of the subunits of the chaperonin containing TCP-1 complex, a molecular chaperone involved in protein folding and remodeling. CCT3 plays a crucial role in maintaining protein homeostasis, with key substrates including tubulin and actin. In recent years, CCT3 has been reported to be abnormally expressed in various cancers, correlating with prognosis and therapeutic outcomes. In this review, we summarize the basic structure and function of chaperonin containing TCP-1 complex and CCT3, and discuss the role of CCT3 in tumor development. Additionally, we explore its potential applications in cancer diagnosis and treatment.
A comparison of the efficacy and safety of Chinese patent medicine combined with Western medicine for Helicobacter pylori-related gastric ulcer: A systematic review and network meta-analysis
Authors: Zhong Meiqi , Sun Qifang , Ren Baoping , Yu Chang , Zhou Shunhua , Gao Qing , Wang Xiaojuan , Yuan Chengzhi , Lu Jing , Peng Qinghua , Zeng Meiyan , Song Houpan
Published: February 2025

Background:

The aim of this network meta-analysis (NMA) was to compare the effectiveness and safety of different Chinese patent medicines (CPMs) combined with Western medicines (WMs) regimen versus WMs alone in the treatment of Helicobacter pylori-related gastric ulcer (GU).

Methods:

A comprehensive search was conducted on databases from their inception to May 31, 2023, to identify all randomized controlled trials (RCTs) that investigated the efficacy of CPMs in combination with conventional WMs in the treatment of patients with H pylori-related GU. Using Cochrane risk of bias assessment tool, we evaluated the methodological quality of RCTs. R version 4.2.3 and Stata version 15.1 software were cross-merged to conduct pairwise NMA.

Results:

A total of 35 studies involving 4667 patients and 11 CPMs were identified. Eleven CPMs were analyzed, including Pingwei Capsule (PWC), Kangfuxin Solution (KFXS), Shugan Jieyu Capsule (SGJYC), Weisu Granule (WSG), Qiwei Weitong Capsule (QWWTC), Beiling Weitong Granule (BLWTG), Anweiyang Capsule (AWYC), Jinghua Weikang Capsule (JHWKC), Weifuchun Tablet (WFCT), Wenweishu Capsule (WWSC), and Weidean Capsule (WDAC). Results showed that the combination of CPM and WM was more effective relative to the WM regimen alone. NMA revealed that WWSC combined with the WM yielded superior results in enhancing clinical outcomes and mitigating GU recurrence rates. PWC combined with the WM showed the best performance in improving the H pylori eradication rate. WFCT combined with the WM had the most optimal performance in controlling gastrin (GAS) and motilin (MTL) levels. KFXS combined with the WM showed the best results in terms of reducing the incidence of adverse events.

Conclusion:

Our NMA findings indicate that the combination of WWSC, PWC, WFCT, and KFXS with WM may be more effective and advantageous outcomes compared to other CPMs. Due to the limitations of this study, future research should employ larger sample sizes and multicenter RCTs to conduct real-world clinical studies.
Causal association of metformin treatment with diverse immune-mediated inflammatory diseases: A Mendelian randomization analysis
Authors: Liao Zheng , Su Chenguang , Li Jian , Liu Jinlong
Published: February 2025

Metformin has been shown to possess immune-modulating and anti-inflammatory effects in various animal and clinical studies. It is believed to be effective in treating some immune-mediated inflammatory diseases (IMIDs). However, there remains ongoing debate regarding the extent to which metformin can reduce the risk of developing IMIDs. We used the data from genome-wide association studies to explore the causal relationship between metformin treatment and some IMIDs through the Mendelian randomization (MR) analysis. Additionally, sensitivity analyses were performed using the Cochran Q-test, MR-PRESSO and “leave-one-out” to confirm the robustness of our conclusions. The MR analysis indicated that metformin treatment could reduce the risk of rheumatoid arthritis (RA) (OR = 0.018, 95% CI: 1.33 × 10−3–0.233, P = .002), multiple sclerosis (MS) (OR = 0.966, 95% CI: 0.936–0.997, P = .030) and primary sclerosing cholangitis (PSC) (OR = 6.82 × 10−4, 95% CI: 7.83 × 10−6–5.93 × 10−2, P = .001). But metformin treatment is not significantly associated with the risk of Crohn disease (OR = 0.994, 95% CI: 0.979–1.009, P = .431), ulcerative colitis (UC) (OR = 0.987, 95% CI: 0.965–1.009, P = .234), systemic lupus erythematosus (SLE) (OR = 164.373, 95% CI: 0.158–1.71 × 105, P = .150), autoimmune hepatitis (AIH) (OR = 2.909, 95% CI: 4.58 × 10−3–1.85 × 103, P = .746) and primary biliary cholangitis (PBC) (OR = 0.055, 95% CI: 1.44 × 10−3–2.112, P = .119). Due to the heterogeneity of the data from UC, SLE, MS, and PBC, we adjusted them. After adjustment, there is no change in the results for UC, SLE, MS, and PBC. The findings of this study support metformin treatment may reduce the risk of RA, MS, and PSC.
Comparative evaluation of HEART, T-MACS, and HE-MACS scores for risk stratification and management of patients with chest pain in the emergency department
Authors: Aktemur Mehmet Ragip , Songur Kodik Meltem , Capar Aktemur Fatma Naile , Aksay Ersin , Ersel Murat
Published: February 2025

This study evaluated the effectiveness of history, electrocardiogram, age, risk factors, and troponin (HEART), troponin-only Manchester acute coronary syndromes (T-MACS), and history and electrocardiogram-only Manchester acute coronary syndromes (HE-MACS) in diagnosing and managing acute coronary syndrome in patients presenting with chest pain in the emergency department. These scoring systems are crucial for risk stratification and the prediction of major adverse cardiac events (MACEs) and mortality within 30 days. A single-center prospective analytical study was conducted following the STROBE guidelines, with 560 patients presenting with chest pain or ischemic equivalent symptoms at the Ege University Faculty of Medicine Hospital from August 2020 to March 2021. The HEART, T-MACS, and HE-MACS scores were calculated for each patient, and their predictive values for MACE and mortality were analyzed using receiver operating characteristic analysis. The HEART score demonstrated an area under the curve (AUC) of 0.929 for predicting mortality, with 100% sensitivity and 81% specificity. It has been identified as the most reliable predictor of mortality. The T-MACS score showed an AUC of 0.875 for mortality prediction with 85.7% sensitivity and 83.9% specificity. It is particularly effective for high-risk patients, predicting 30-day MACE development rates, which is consistent with the literature. The HE-MACS score yielded an AUC of 0.729 for mortality prediction, with 71.4% sensitivity and 80.7% specificity. Although it effectively excludes MACE in very-low-risk patients, it is limited by its application to a highly isolated group. The discussion interprets the results and compares them with existing literature. The study confirms the high effectiveness of the HEART score in mortality risk assessment, the specificity of the T-MACS score for high-risk patients, and the utility of the HE-MACS score for excluding very-low-risk cases. The limitations of each scoring system are discussed and recommendations for their application in clinical practice are provided. The study concluded that selecting the most appropriate scoring system based on individual patient characteristics is essential for optimal patient management in the emergency department. For optimal patient management, it is essential to select the most appropriate scoring system based on the individual patient characteristics.
Primary cutaneous Mycobacteria avium complex infection in a systemic lupus erythematosus patient: A case report and review
Authors: Yao Qi-Hao , Xia Xiu-Jiao , Xu Jun-Zhu , Shen Hong , Yang Yang , Liu Ze-Hu
Published: February 2025

Rationale:

Nontuberculous mycobacteria infection is becoming more and more common in clinical practice, while skin and soft tissue infection is an important part. The evaluation of the immune status of patients has certain reference value for diagnosis and treatment.

Patient concerns:

A 48-year-old woman developed an erythematosus nodule with purulent discharge on the right hip for 4 months. She had a history of systemic lupus erythematosus for more than 20 years, in stable control with prednisone 10 mg/d, azathioprine 50 mg/12 h, and hydroxychloroquine 200 mg/12 h. There was no trauma prior to the lesion.

Diagnoses:

After excluding other sites involved, the patient was diagnosed as Mycobacterium avium primary cutaneous infection based on laboratory culture, biopsy, and sequencing techniques.

Interventions:

After surgical resection, a combination of oral azithromycin, rifampicin, and ethambutol hydrochloride was given.

Outcomes:

The lesion healed after 4 months with no relapse.

Lessons:

Primary cutaneous nontuberculous mycobacteria infection should raise more attention in immunocompromised and even immunocompetent populations.
Epidemiological investigation on an outbreak of food-borne disease caused by nitrite poisoning
Authors: Li Peng , Wu Ming-Yu , Wang Heng , Xu Hao-Di , Chen Yan , Chen Cheng-Ji , Wang Yu-Chao , Tang An , Yan Jian-Bo , Wu Chen , Tong Zhen-Dong
Published: February 2025

Sodium nitrite, often mistaken for common table salt or sugar due to its similar appearance, has resulted in poisoning incidents. This report details a cluster of sodium nitrite poisoning stemming from a dinner gathering on a maintenance ship. The epidemiological investigation aims to uncover the incident’s cause, provide clinical insights, and offer preventive recommendations for similar events in the future. Individual interviews were conducted with all suspected cases, capturing basic information, clinical symptoms and onset times, dining history, and food exposure. Gathering organizer and food preparer was interviewed to gather potential leads regarding the poisoning incident. Blood samples from cases were collected for methemoglobin testing, and samples of vomit, leftovers, and the dining environment were collected for sodium nitrite detection. A total of 11 people participated in the dinner party, and 6 of them developed symptoms, with an attack rate of 54.55%. Clinical presentations mainly included dizziness, weakness, nausea, vomiting, and cyanosis of the lips, with elevated methemoglobin levels. The shortest incubation period was 0.5 hours, the longest was 3 hours, with a median of 2 hours. All cases showed rapid symptom relief after treatment with the specific antidote methylene blue. A retrospective cohort study showed that the incidence rate among those who consumed vegetable and tofu soup was 85.71% (6/7), which was higher than that of nonconsumers (0/4), and the difference was statistically significant (relative risk = 7.000, 95% confidence interval = 1.140–42.969). Sodium nitrite concentrations in vomit samples ranged from 5.40 to 37.17 mg/kg, while leftovers showed levels of 170.88 mg/kg in a vegetable and tofu soup, 55.65 mg/kg in goose meat, and 9.17 mg/kg in other leftovers. Furthermore, environmental samples from the suspected condiment storage area tested positive for sodium nitrite. This cluster of sodium nitrite poisoning was due to the inadvertent use of sodium nitrite in cooking, mistaken for table salt. Public awareness campaigns on food safety should be intensified across multiple platforms, and enhanced oversight of nitrite usage is crucial to prevent similar poisoning incidents.
Reducing the workload of medical diagnosis through artificial intelligence: A narrative review
Authors: Jeong Jinseo , Kim Sohyun , Pan Lian , Hwang Daye , Kim Dongseop , Choi Jeongwon , Kwon Yeongkyo , Yi Pyeongro , Jeong Jisoo , Yoo Seok-Ju
Published: February 2025

Artificial intelligence (AI) has revolutionized medical diagnostics by enhancing efficiency, improving accuracy, and reducing variability. By alleviating the workload of medical staff, AI addresses challenges such as increasing diagnostic demands, workforce shortages, and reliance on subjective interpretation. This review examines the role of AI in reducing diagnostic workload and enhancing efficiency across medical fields from January 2019 to February 2024, identifying limitations and areas for improvement. A comprehensive PubMed search using the keywords “artificial intelligence” or “AI,” “efficiency” or “workload,” and “patient” or “clinical” identified 2587 articles, of which 51 were reviewed. These studies analyzed the impact of AI on radiology, pathology, and other specialties, focusing on efficiency, accuracy, and workload reduction. The final 51 articles were categorized into 4 groups based on diagnostic efficiency, where category A included studies with supporting material provided, category B consisted of those with reduced data volume, category C focused on independent AI diagnosis, and category D included studies that reported data reduction without changes in diagnostic time. In radiology and pathology, which require skilled techniques and large-scale data processing, AI improved accuracy and reduced diagnostic time by approximately 90% or more. Radiology, in particular, showed a high proportion of category C studies, as digitized data and standardized protocols facilitated independent AI diagnoses. AI has significant potential to optimize workload management, improve diagnostic efficiency, and enhance accuracy. However, challenges remain in standardizing applications and addressing ethical concerns. Integrating AI into healthcare workforce planning is essential for fostering collaboration between technology and clinicians, ultimately improving patient care.