bluuebunny/crossref_metadata_2025 huggingface dataset:
Umbilical cord blood stem cells as third-party adjuvant infusions in human leukocyte antigen antibody-positive patients undergoing haploidentical hematopoietic stem cell transplantation
Authors: Wang Yuying , Zhao Yiou , Fang Xiaosheng , Yuan Dai , Ding Mei , Lu Kang , Qu Huiting , Wang Na , Lv Xiao , Li Peipei , Zhen Changqing , Xu Hongzhi , Jiang Yujie
Published: September 2024

Introduction

Graft failure (GF) or poor graft function (PGF) remain critical obstacles in haploidentical hematopoietic stem cell transplantation (haplo-HSCT), especially in recipients with HLA antibodies. Here, we performed a retrospective cohort study to investigate the efficacy and safety of the use of unrelated umbilical cord blood stem cells (UCBs) as a third-party adjuvant infusion in patients with HLA-antibodies undergoing haplo-HSCT.

Methods

A total of 90 patients were divided into three groups: 17 patients in Group A (with positive HLA antibodies and who received UCB infusion), 36 patients in Group B (with positive HLA antibodies without UCB infusion), and 37 patients in Group C (without HLA antibody or UCB infusion).

Results

The median age of patients included in Groups A, B, and C was 43 (IQR, 27 - 49.5), 33 (IQR, 20 - 48.75), and 30 (IQR, 18 - 46.5) years, respectively. All but one patient in Group B achieved granulocyte recovery within 28 days after transplantation. The median time to granulocyte engraftment were all 12 days for patients in Groups A, B, and C, respectively. All the patients in Group A achieved 100% donor chimerism without UCB engraftment. There were no significant differences in granulocyte or platelet engraftment time between the three groups. There were 1, 5, and 0 patients in Groups A, B, and C, respectively, who developed PGF. The cumulative incidence rates for any grade of acute graft-versus-host disease (aGVHD) were comparable among the three groups. Patients in Group B presented a greater incidence of cGVHD than did those in Group A (P = 0.002) and Group C (P = 0.006). Patients in Group A presented more limited and milder cGVHD than those in Group C (P < 0.0001). The 1-year relapse-free survival (RFS) was 70.6% (95% CI, 0.47 - 0.87), 55.6% (95% CI, 0.40 - 0.70), and 77.9% (95% CI, 0.63 - 0.89) in Groups A, B, and C, respectively.

Discussion

Our results indicated that patients who were positive for HLA antibodies were at a greater risk of developing GF/PGF. Co-infusion with UCBs was safe and improved engraftment, cGVHD, and improved the 1-year RFS to some extent.
Cutaneous adaptive immunity and uraemia: a narrative review
Authors: Zibandeh Noushin , Li Zehua , Ogg Graham , Bottomley Matthew J.
Published: September 2024

Chronic kidney disease affects 1 in 10 people globally, with a prevalence twenty times that of cancer. A subset of individuals will progress to end-stage renal disease (ESRD) where renal replacement therapy is required to maintain health. Cutaneous disease, including xerosis and pruritus, are endemic amongst patients with ESRD. In the uraemia-associated immune deficiency of ESRD, impaired circulating immune responses contribute to increased infection risk and poorer vaccination response. Clinical manifestations of dysregulated adaptive immunity within the skin have been well-described and have been posited to play a role in cutaneous features of ESRD. However, our understanding of the mechanisms by which adaptive immunity within the skin is affected by uraemia is relatively limited. We provide an overview of how the cutaneous adaptive immune system is impacted both directly and indirectly by uraemia, highlighting that much work has been extrapolated from the circulating immune system and often has not been directly evaluated in the skin compartment. We identify knowledge gaps which may be addressed by future research. Ultimately, greater understanding of these pathways may facilitate novel therapeutic approaches to ameliorate widespread cutaneous symptomatology in ESRD.
Lanadelumab in a kidney transplant patient with hereditary angioedema due to C1-inhibitor deficiency and high cardiovascular risk - a case report
Authors: Gidaro Antonio , La Cava Leyla , Donadoni Mattia , Popescu Janu Valentina , Cogliati Chiara , Brucato Antonio Luca , Zanichelli Andrea , Cancian Mauro , Bizzi Emanuele
Published: September 2024

Introduction

Cardiovascular pathologies represent the first cause of death in uremic patients and are among the leading causes of mortality in patients with hereditary angioedema due to C1-inhibitor deficiency (HAE-C1INH). Before 2020, the most common treatment for long-term prophylaxis in HAE-C1INH patients in Italy was attenuated androgen, which may increase cardiovascular risk by multiple mechanisms.

Case description

We present a case report of a 56-year-old patient with HAE-C1INH type I affected by IgA nephropathy with severe kidney impairment. The patient experienced a first kidney transplant and, after late rejection, underwent a second kidney transplant. Further comorbidities included obesity, hypertensive cardiomyopathy, HCV liver disease, and dyslipidemia. His prophylactic therapy to prevent angioedema attacks had consisted of attenuated androgens for about 40 years. Since 2020, new modern targeted therapy for LTP, particularly lanadelumab, has shown promising results. The majority of patients with attenuated androgens have been successfully switched to lanadelumab, including our patient. Since introducing lanadelumab (300 mg subcutaneously every two weeks; after a six-month attack-free period, the dosing interval of lanadelumab was extended to four weeks), the patient has not experienced any acute HAE attack and did not report any adverse events. Moreover, we observed decreased total cholesterol, C-LDL, and body mass index, reducing the Matsushita et al. score for ten years of cardiovascular risk from 13.2% to 9.3%.

Conclusion

lanadelumab is effective and safe in preventing hereditary angioedema attacks, as well as in reducing cardiovascular risk in an immunosuppressed patient with significant comorbidities. The successful outcomes of this case highlight the potential of lanadelumab as a promising prophylactic therapy.
The rule of law system for China’s marine security
Authors: Wang Limei
Published: September 2024

This paper examines the current status of China’s legislation on safeguarding sovereignty and security, resource security, navigation security, ecological security, and regulating law enforcement and judicial activities, and summarizes the characteristics of existing marine security legislation. This paper utilizes literature analysis and comparative analysis methods, under China’s Overall National Security Outlook, this paper proposes a path of improvement by consolidating marine-related norms, promoting the formulation of a basic law on the seas, refining the legal provisions on marine security, improving the marine data classification and grading system and safeguarding marine data security, and pushing forward the reform of the adjudication mechanism of the maritime courts to enhance the ability to actively safeguard the rights and interests of the oceans and seas through the use of the rule of law.
Promoting coping competence for psychological stressors in nursing training: a controlled pedagogical intervention
Authors: Warwas Julia , Krebs Philine , Vorpahl Wiebke , Weyland Ulrike , Wilczek Larissa , Seeber Susan , Wittmann Eveline
Published: September 2024

Background

Multiple stressors as well as health-and quality-impairing effects of strain in the nursing profession require the systematic acquisition of competence in dealing with these demands, starting at the stage of initial vocational training. This study investigates whether an instructional design, which merges didactic principles of nursing education with concepts and training measures from stress psychology, promotes the acquisition of stress coping competence more effectively than regular teaching on the relevant curricular field at nursing schools.

Methods

The quasi-experimental study design, based on the Solomon four-group plan, included 332 trainees in Germany. The assessment of stress coping competence at the beginning and at the end of the intervention provided a video-stimulated situational judgment test covering nursing-specific stressful situations. All were validated by field experts. Complementing group comparisons, regression analyses examined intervention effects at the individual level while controlling for other predictors of learning success.

Results

The highest solution rates for the two basic dimensions of stress coping competence, i.e., (1) situation assessment and (2) strategy selection and justification, occurred in the treatment classes without a pretest. At the individual level, treatment effects were confirmed for the first dimension. Students with a migration background showed lower competence gains than other students.

Conclusion

The instructional design and the competence test provide valuable foundations for promoting and for diagnosing coping skills. Nevertheless, subsequent studies should examine adaptive support for different learner groups. Furthermore, additional observational phases should focus on the deliberate practice of acquired coping strategies in the practical training settings of nursing education.
Development of prognostic models for advanced multiple hepatocellular carcinoma based on Cox regression, deep learning and machine learning algorithms
Authors: Shen Jie , Zhou Yu , Pei Junpeng , Yang Dashuai , Zhao Kailiang , Ding Youming
Published: September 2024

Background

Most patients with multiple hepatocellular carcinoma (MHCC) are at advanced stage once diagnosed, so that clinical treatment and decision-making are quite tricky. The AJCC-TNM system cannot accurately determine prognosis, our study aimed to identify prognostic factors for MHCC and to develop a prognostic model to quantify the risk and survival probability of patients.

Methods

Eligible patients with HCC were obtained from the Surveillance, Epidemiology, and End Results (SEER) database, and then prognostic models were built using Cox regression, machine learning (ML), and deep learning (DL) algorithms. The model’s performance was evaluated using C-index, receiver operating characteristic curve, Brier score and decision curve analysis, respectively, and the best model was interpreted using SHapley additive explanations (SHAP) interpretability technique.

Results

A total of eight variables were included in the follow-up study, our analysis identified that the gradient boosted machine (GBM) model was the best prognostic model for advanced MHCC. In particular, the GBM model in the training cohort had a C-index of 0.73, a Brier score of 0.124, with area under the curve (AUC) values above 0.78 at the first, third, and fifth year. Importantly, the model also performed well in test cohort. The Kaplan–Meier (K-M) survival analysis demonstrated that the newly developed risk stratification system could well differentiate the prognosis of patients.

Conclusion

Of the ML models, GBM model could predict the prognosis of advanced MHCC patients most accurately.
Current perspectives on postoperative cognitive dysfunction in geriatric patients: insights from clinical practice
Authors: Zhang Liang , Qiu Yi , Zhang Zhi-feng , Zhao Yi-fan , Ding Yu-mei
Published: September 2024

Postoperative cognitive dysfunction (POCD) is a common and serious postoperative complication in elderly patients, affecting cognitive function and quality of life. Its pathophysiology is complex, involving age-related cognitive decline, surgical and anesthetic factors, systemic and neuroinflammation, as well as genetic and environmental contributors. Comprehensive preoperative assessment and optimization, the selection of appropriate anesthetic agents, minimally invasive surgical techniques, and early postoperative rehabilitation and cognitive training are effective strategies to reduce the incidence of POCD. Recent research suggests that anti-inflammatory drugs and neuroprotective agents may be promising in preventing POCD. Additionally, non-pharmacological interventions, including cognitive and physical training, have shown positive effects. Future research directions should include large-scale clinical trials and mechanistic studies to further understand and manage POCD, along with integrating new findings into clinical practice. Continuous education and training for healthcare professionals are essential to ensure the effective application of the latest research findings in patient care. Through multidisciplinary collaboration and ongoing improvements, these efforts can significantly enhance the cognitive function and quality of life of elderly surgical patients.
Research trends between childhood obesity and gut microbiota: a bibliometric analysis (2002–2023)
Authors: Wang Mengping , Zhang Zhen , Liu Yuxuan , Jian Enlin , Ye Peng , Jiang Hongjie , Yu Xiaoping , Cai Peiling
Published: September 2024

Background

In recent years, the prevalence of childhood obesity has escalated alarmingly, posing significant threats to the physical and mental well-being of children, with an elevated likelihood of persisting into adulthood. Notably, recent investigations have uncovered a profound association between intestinal microbiota, a crucial component of the internal milieu, and childhood obesity. Disturbances in intestinal microbiota and their by-products are now understood to be profoundly intertwined with the evolutionary pathway of childhood obesity. Bibliometric analysis offers a deep understanding of the current research landscape, so we apply it to a review of the emerging trends and patterns between childhood obesity and gut microbiota.

Materials and methods

We conducted a rigorous and extensive search of the Web of Science (WoS) Core Collection database, spanning the years from 1900 to 2023, to analyze scholarly articles pertaining to childhood obesity and gut microbiota. Utilizing VOSviewer, CiteSpace, the R package “bibliometrix,” and the online bibliometric analysis platform (https://bibliometric.com/), we delved into the intricate details of research hotspots, academic collaborations, and emerging trends within this domain.

Results

The exhaustive search encompassed the globe, uncovering a cumulative total of 1,384 pertinent studies originating from 429 nations. The results were compelling, revealing a profound influence exerted by the United States and China in this specific field of research. Furthermore, it was observed that the volume of scholarly works pertaining to childhood obesity and gut microbiota is steadily growing year on year. The current hot topics in this field include “abuse,” “maltreatment,” “adverse childhood experiences,” “students,” and “food addiction”.

Conclusion

This comprehensive review offers a meticulous exploration of the evolving trends and emerging research agendas pertaining to childhood obesity and gut microbiota over the past two decades. It strives to equip researchers with a thorough understanding of the key nations, institutions, journals, and potential collaborators in these specialized fields. Additionally, it sheds light on the current frontiers of research and strategic avenues for further exploration, thus serving as an invaluable resource for scholars delving deeper into the intricacies of childhood obesity and the gut microbiome.
Long non-coding RNA GRASLND links melanoma differentiation and interferon-gamma response
Authors: Fischer Kim Denise , Tiwari Shashank , Thier Beatrice , Qiu Lin Christina , Lin Tzu-Chen , Paschen Annette , Imig Jochen
Published: September 2024

Melanoma is a highly malignant tumor, that stands as the most lethal form of skin cancer and is characterized by notable phenotypic plasticity and intratumoral heterogeneity. Melanoma plasticity is involved in tumor growth, metastasis and therapy resistance. Long non-coding RNAs (lncRNAs) could influence plasticity due to their regulatory function. However, their role and mode of action are poorly studied. Here, we show a relevance of lncRNA GRASLND in melanoma differentiation and IFNγ signaling. GRASLND knockdown revealed switching of differentiated, melanocytic melanoma cells towards a dedifferentiated, slow-proliferating and highly-invasive cell state. Interestingly, GRASLND is overexpressed in differentiated melanomas and associated with poor prognosis. Accordingly, we found GRASLND expressed in immunological “cold” tumors and it negatively correlates with gene signatures of immune response activation. In line, silencing of GRASLND under IFNγ enhanced the expression of IFNγ-stimulated genes, including HLA-I antigen presentation, demonstrating suppressive activity of GRASLND on IFNγ signaling. Our findings demonstrate that in differentiated melanomas elevated expression of GRASLND interferes with anti-tumor effects of IFNγ, suggesting a role of GRASLND in tumor immune evasion.
Iron overload regulates cognitive function in rats with minimal hepatic encephalopathy by inducing an increase in frontal butyrylcholinesterase activity
Authors: Lan Hua , Yang Xuhong , Wang Minxing , Wang Minglei , Huang Xueying , Wang Xiaodong
Published: September 2024

Background and aims

This study aimed to investigate the effect of iron overload on acetylcholinesterase activity in the frontal lobe tissue of rats with minimal hepatic encephalopathy (MHE) and its relation to cognitive ability. By elucidating the potential mechanisms of cognitive impairment, this study may offer insights into novel therapeutic targets for MHE.

Materials and methods

Twelve Sprague-Dawley rats were purchased and randomly assigned to either the experimental or control group with six rats in each group. Following the induction of MHE, the Morris Water Maze (MWM) was utilized to assess spatial orientation and memory capacity. Subsequently, Magnetic Resonance Imaging (MRI) scans were performed to capture Quantitative Susceptibility Mapping (QSM) images of all rats' heads.

Results

Compared to the control group rats, the MHE model rats showed significantly reduced learning and memory capabilities as well as spatial orientation abilities (P < 0.05). Furthermore, the susceptibility values in the frontal lobe tissue of MHE model rats was significantly higher than that of the control group rats (P < 0.05), and the corresponding BuChE activity in the frontal lobe extract of model rats was significantly increased while BuChE activity in the peripheral blood serum was significantly decreased compared to the control group rats (P < 0.05). Meanwhile, our findings indicate a significant positive correlation between latency period and BuChE activity with susceptibility values in the MHE group.

Conclusion

The changes in BuChE activity in frontal lobe extract may be related to changes in spatial orientation and behavioral changes in MHE, and iron overload in the frontal lobe tissue may regulate changes in BuChE activity, BuChE levels appear to be iron-dependent.
Causal associations of white blood cell count and sudden sensorineural hearing loss: a bidirectional and multivariable Mendelian randomization study
Authors: Zhang Ling , Chen Jialei , Zhong Shixun , Luo Jing , Tang Ping
Published: September 2024

Background

Numerous compelling observational studies have demonstrated a plausible correlation between the white blood cell count and the susceptibility to sudden sensorineural hearing loss (SSNHL). Nevertheless, the exact causal relationship between these two factors remains ambiguous. The objective of our study was to assess the causal impact of white blood cell count on sudden sensorineural hearing loss through the implementation of a bidirectional and multivariable Mendelian randomization (MR) methodology.

Methods

Genetic data pertaining to white blood cell count were acquired from the Blood Cell Consortium, encompassing a total of 563,946 subjects. Concurrently, summary data on sudden sensorineural hearing loss were sourced from a Genome-Wide Association Study (GWAS), involving 196,592 participants, comprising 1,491 cases and 195,101 controls. The primary method employed for MR analysis was the Inverse Variance Weighted method (IVW), while sensitivity analysis utilized the Weighted Median method, MR-Egger method, and MR-PRESSO method.

Results

In IVW method, genetically predicted elevated lymphocyte cell count demonstrates an effective reduction in the risk of sudden sensorineural hearing loss (odds ratio = 0.747, 95% CI = 0.565–0.987, p = 0.04). These findings remain consistent in multivariate MR analysis, even after adjusting for monocyte cell count and neutrophil cell count levels (odds ratio = 0.929, 95% CI = 0.867–0.995, p = 0.036). However, there is no discernible evidence supporting a direct causal relationship between monocyte cell count and neutrophil cell count levels and the occurrence of SSNHL.

Conclusion

Within the normal range, higher lymphocyte cell count levels exhibit a potential protective effect against SSNHL. Meanwhile, no direct causal relationship are identified between monocyte cell count and neutrophil cell count levels and the risk of SSNHL.
Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults
Authors: Raja Adarsh , Asim Rabia , Shuja Muhammad Hamza , Raja Sandesh , Muhammad Tazheen Saleh , Bajaj Simran , Ansari Abdul Hadi , Ali Hamza , Magsi Iffat Ambreen , Faridi Muhammad Hammad , Sheikh Hamza Ali Hasnain , Imran Muhammad Junaid , Ahmed Muhammad , Asghar Muhammad Sohaib
Published: September 2024

Background

Migraine is a neurological condition marked by frequent headaches, which tends to be accompanied by nausea and vomiting in severe instances. Injectable therapies for migraine, such as monoclonal antibodies that target calcitonin gene-related peptide (CGRP), have proven to be effective and safe. While various oral drugs are available, none have been developed for migraines. Patients prefer oral therapies because they are easier to use, making atogepant, an orally accessible small-molecule CGRP receptor antagonist, a possible alternative.

Objectives

This systematic review and meta-analysis compared the safety and effectiveness of atogepant with placebo in treating migraine.

Methods

Adhering to the PRISMA guidelines, we meticulously gathered randomized controlled trials (RCTs) from databases including the Cochrane Library, PubMed, Science Direct, and ClinicalTrials.gov. Studies comparing atogepant with placebo and reporting monthly migraine days (MMDs) as the primary outcome along with secondary outcomes such as monthly headache days and acute medication use days were included. Two independent reviewers conducted the data extraction and quality assessment. Statistical analyses were carried out using RevMan, utilizing risk ratios for dichotomous outcomes and mean differences for continuous outcomes, and a random-effects model.

Results

Our primary outcome was the change in MMDs over 12 weeks, which showed a significant reduction with atogepant at dosages of 10, 30, and 60 mg. Secondary outcomes, such as monthly headache days, proportion of patients achieving a ≥ 50% reduction in MMDs, acute medication use days, and patient-reported outcomes, consistently showed that atogepant outperformed placebo, highlighting its effectiveness in reducing the migraine burden.

Conclusion

Higher doses of atogepant are more effective in lowering migraine and headache-related days and increasing quality of life metrics. However, this is accompanied by an increased incidence of adverse events, suggesting the need for careful dose optimization to balance the benefits and risks.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=563395. Unique Identifier: CRD42024563395.
Immunocytes do not mediate food intake and the causal relationship with allergic rhinitis: a comprehensive Mendelian randomization
Authors: Zhang Zhi-qiang , Li Jing-yang , Bao You-wei , Song Yu-Qi , Song Dong-xu , Wang Cheng , Zhu Xin-hua
Published: September 2024

Background

Observational studies indicate a correlation between food intake and allergic rhinitis. The potential interplay between the immune system and allergic rhinitis might contribute causally to both food intake and allergic rhinitis, providing promising therapeutic avenues. However, elucidating the causal relationship and immune-mediated mechanisms between food intake and allergic rhinitis remains a pending task.

Methods

We utilized a two-sample Mendelian randomization (MR) methodology to explore the causal relationship between food intake and allergic rhinitis. Furthermore, we investigated the potential causal relationship of immune cell signals with allergic rhinitis, as well as the potential causal relationship between food intake and immune cell signals. Moreover, employing both two-step Mendelian randomization and multivariable Mendelian randomization, we delved into the mediating role of immune cell signals in the causal relationship between food intake and allergic rhinitis. Leveraging publicly accessible genetic datasets, our analysis encompassed 903 traits, comprising 171 food intake features, 731 immune cell features, and one trait related to allergic rhinitis.

Result

We found causal relationships between seven types of food intake and allergic rhinitis, as well as between 30 immune cell phenotypes and allergic rhinitis. Furthermore, our two-step Mendelian randomization analysis and multivariable Mendelian randomization analysis indicate that immune cells do not mediate the causal relationship between food intake and allergic rhinitis.

Conclusion

To the best of our knowledge, we are the first to incorporate a large-scale dataset integrating immune cell features, food intake features, and allergic rhinitis into Mendelian randomization analysis. Our research findings indicate that there are causal relationships between six types of food intake and allergic rhinitis, as well as between 30 immune cell phenotypes and allergic rhinitis. Additionally, immune cells do not mediate these relationships.
Undernutrition and dietary diversity score and associated factors among lactating mothers in Northwest Ethiopia
Authors: Belay Mahider Awoke
Published: September 2024

Background

Maternal undernutrition negatively influences both maternal and child health, as well as economic and social development. Limited research has been conducted on both the nutritional status and dietary diversity score among lactating mothers. Therefore, the present study aimed to determine the magnitudes of undernutrition and dietary diversity scores and their associated factors among lactating mothers in Bahir Dar City, Northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from March to May 2021. Systematic random sampling and interview-administered questionnaires were employed. Dietary diversity score and nutritional status were measured using a 24-h recall and body mass index (BMI), respectively. Data entry and analysis were performed using EpiData version 3.02 and SPSS version 24 software, respectively. Both the bivariable and multivariable binary logistic regression analyses were performed, and the strength of association was measured in terms of odds ratio.

Results

The prevalence of undernutrition and low dietary diversity scores among respondents were 13.5% (95% CI; 10.4, 17.2) and 64.8% (95% CI, 60.0, 69.4), respectively. The significant factors for undernutrition were being young [AOR = 2.30, 95% CI (1.09, 5.43)], having low dietary diversity score [AOR = 2.26, 95% CI (1.01,5.10)], having poor nutritional knowledge [AOR = 2.56, 95% CI (1.03, 6.51)], meal frequency less or equal to 3 times per day [AOR = 4.06, 95% CI (0.71, 9.65)], educational status being primary school [AOR = 3.20, 95% CI (1.01, 9.11)], and educational status of husband being secondary school [AOR = 2.28, 95% CI (1.25, 8.53)]. Age between 20 and 30 years [AOR = 1.46, 95% CI (1.01, 2.48)], being food insecure [AOR = 3.41, 95% CI (1.21, 9.63)], and being poorest [AOR = 2.31, 95% CI (1.02, 5.32)] were associated with the dietary diversity score.

Conclusion

A high prevalence of undernutrition and low dietary diversity scores were recorded in the current study area. Age, educational status of lactating mothers and their husbands, nutritional knowledge, dietary diversity, and meal frequency were significant factors associated with undernutrition. Age, food security, and wealth index were associated with the dietary diversity score.
Urachal adenocarcinoma with cervical invasion misdiagnosed as primary cervical adenocarcinoma: a case report and literature review
Authors: Wang Yiran , Li Maomao , Yang Kaixuan , Li Qingli , Wang Ping
Published: September 2024

Background

Urachal carcinoma (UrC) is a rare malignancy with no known specific early symptoms. It is often diagnosed at advanced stages and is associated with poor prognosis.

Case presentation

This study presents a rare case of urachal adenocarcinoma (UrAC) invading the bladder and vagina in a female patient. Initially, the patient was misdiagnosed as having a primary cervical adenocarcinoma 2.5 years prior. Subsequently, anterior pelvic exenteration and bilateral ureterocutaneostomies were performed. Twenty months after the first surgery, the patient was diagnosed with rectal metastasis and received gemcitabine chemotherapy. After achieving a stable disease state, the patient underwent laparoscopic ultralow rectal anterior resection, ultralow anastomosis of the sigmoid colon and rectum, prophylactic transverse colostomy, and right common iliac and external iliac lymph node dissection. The patient then received a cycle of postoperative chemotherapy with oxaliplatin and capecitabine; however, treatment was stopped due to adverse reactions. The patient continues to receive regular follow-ups, and her general condition is good.

Conclusions

UrC is rare, and preoperative differential diagnosis is difficult. This is the first report of UrC being misdiagnosed as cervical cancer. The presented case highlights the importance of accurate histopathological examination and comprehensive analysis. Anterior pelvic exenteration was also identified as a potentially effective treatment strategy for patients with local pelvic recurrence of UrC, although further investigation is required.
Case report: Gastric metastasis of breast cancer
Authors: Zhao Qiandi , Zhang De , Wang Xinjian
Published: September 2024

Breast cancer stands as the foremost malignant tumor among women globally, with postoperative recurrence and metastasis significantly impacting patient prognosis. While metastasis to various sites has been reported, gastric involvement remains uncommon. Presenting a case of gastric metastasis a decade post-breast cancer surgery, we underscore the rarity of this occurrence. Our patient, an elderly woman, underwent left breast modified radical surgery ten years prior, followed by adjuvant chemotherapy, maintaining favorable health until experiencing abdominal discomfort two months ago. Contrast-enhanced computed tomography (CT) of the chest and upper abdomen unveiled diffuse abnormal enhancement in the gastric body and sinus wall. Subsequent gastroscopy revealed an ulcer near the gastric antrum, with immunohistochemical staining confirming invasive lobular carcinoma metastasis from the breast. We further conducted an extensive review of 23 cases with detailed information retrieved from PubMed, elucidating clinicopathological, endoscopic features, diagnostic modalities, and contemporary treatment strategies for breast-stomach metastasis. Our findings underscore the imperative of regular postoperative surveillance for breast cancer patients. Timely detection, accurate diagnosis, and appropriate intervention are paramount in managing gastric metastasis, significantly influencing patient outcomes.
The Spectrum of clinical manifestations in newborns with the COQ4 mutation: case series and literature review
Authors: Pan Pianpian , Zhou Na , Sun Yi , Chen Zhengrong , Han Jin , Zhou Wei
Published: September 2024

Background

Coenzyme Q10 (CoQ10) plays an important role in the electron transport chain within the human mitochondrial respiratory chain. The manifestations of this deficiency exhibit a diverse range. This study investigates the clinical manifestations of primary coenzyme Q10 deficiency in neonates with the COQ4 mutation to improve the diagnosis of the disease and the prognosis through targeted treatment.

Methods

We report 4 patients with primary coenzyme Q10 deficiency by COQ4 variants in neonates. A comprehensive literature search and review for original articles and case reports with COQ4 mutation published from January 1989 to November 2023 was performed through Pubmed. We review clinical manifestations, diagnostic approaches, and treatment monitoring in these and 20 previously reported patients.

Results

Within the cohort of four cases examined, three females and one male were identified from two distinct families. Specifically, case 1 and 2 consisted of monoamniotic twins. Cases 3 and 4 were siblings. A comprehensive review of 20 cases involving neonatal-onset COQ4 mutation was conducted. Half of the cases are Chinese. There was no statistically significant difference in the mortality between Chinese (9/12, 75%) and other regions (11/12, 91.7%) (P = 0.27). The survival time for the 24 cases was 60.0 ± 98.0 days (95% confidence interval CI: 0–252.0 days). The incidence of prenatal abnormalities in preterm infants was significantly higher than that in full-term infants (66.7% vs. 16.7%, P = 0.02). Hyperlactatemia was one of the most common manifestations, accounting for 75% of cases (18/24). Twenty of the 24 cases were diagnosed by whole exome sequencing. Only 9 patients received exogenous coenzyme Q10 treatment, and all the 4 surviving patients received coenzyme Q10 supplementation.

Conclusion

The prognosis of COQ4 mutation in the neonatal period indicates a low survival rate and an poor prognosis. This may be due to the incomplete understanding of the mechanism of how COQ4 gene defects lead to coenzyme Q10 deficiency and why CoQ10 supplementation does not respond well to treatment. To improve the diagnostic rate, in addition to genetic testing, mitochondrial functional verification should be prioritized in southern China, where the incidence is relatively high. It will facilitate more in-depth mechanistic studies.
Understanding necrotizing enterocolitis endotypes and acquired intestinal injury phenotypes from a historical and artificial intelligence perspective
Authors: Cuna Alain , Kumar Navin , Sampath Venkatesh
Published: September 2024

Necrotizing enterocolitis (NEC) remains a devastating disease in preterm and term neonates. Despite significant progress made in understanding NEC pathogenesis over the last 50 years, the inability of current definitions to discriminate the various pathophysiological processes underlying NEC has led to an umbrella term that limits clinical and research progress. In this mini review, we provide a historical perspective on how NEC definitions and pathogenesis have evolved to our current understanding of NEC endotypes. We also discuss how artificial intelligence-based approaches are influencing our knowledge of risk-factors, classification and prognosis of NEC and other neonatal intestinal injury phenotypes.
Interstitial lung disease associated with ALK inhibitors and risk factors: an updated comparative pharmacovigilance analysis
Authors: Dong Junli , Li Lulu , Deng Tiying , Song Haibin , Zhang Shaohui , Zhong Minyu
Published: September 2024

Background

Inhibitors of the anaplastic lymphoma kinase (ALK) gene mutation are first-line treatments in patients with ALK-positive lung cancer. The FDA label warns of the risk of interstitial lung disease (ILD) in patients receiving ALK TKIs. However, ILD associated with ALK TKIs is not fully understood. The aim of this study was to characterize the features of ALK TKI-related ILD and to explore risk factors for ALK TKI-related ILD.

Methods

FDA’s Adverse Event Reporting System (FAERS) reports from 2011 Q1 to 2023 Q2 were extracted and combined. Standardized MedDRA queries (SMQs) were used to search for AEs at the preferred term (PT) level. Four algorithms were employed to quantify the signals of ILD associated with ALK TKIs. The risk of ILD was further analyzed using logistic regression.

Results

A total of 20,064 reports of ALK TKIs and 640 (3.2%) reports of ILD AEs were extracted. Significant disproportionality was detected in all five ALK TKIs. Interstitial lung disease and pneumonitis were the most common lung toxicities induced by ALK TKIs. Results of further analyses revealed a different spectrum of lung toxicity among the various TKIs. The median time to onset of ILD related to ALK TKIs was 53 days (Q1:12, Q3:209), and more than 70% of AEs occurred within the first 2 months. Logistic regression analysis and risk prediction model both showed that different ALK TKIs and their combination with PPIs, amlodipine, and magnesium oxide were independent risk factors for ILD (p<0.05).

Conclusion

ALK TKIs have different safety profiles regarding lung toxicity, which normally occurs within the first 2 months. Administration in combination with PPIs, amlodipine, and magnesium oxide significantly increases the risk of ILD. These results provide risk prediction for ILD related to ALK TKIs and support pharmacovigilance to promote safe prescribing in oncology.
Hypoventilation training including maximal end-expiratory breath holding improves the ability to repeat high-intensity efforts in elite judo athletes
Authors: Woorons X. , Faucher C. , Dufour S. P. , Brocherie F. , Robach P. , Connes P. , Brugniaux J. V. , Verges S. , Gaston A. F. , Millet G. , Dupuy O. , Pichon A.
Published: September 2024

Purpose

To investigate the effects of a repeated-sprint training in hypoxia induced by voluntary hypoventilation at low lung volume (RSH-VHL) including end-expiratory breath holding (EEBH) of maximal duration.

Methods

Over a 4-week period, twenty elite judo athletes (10 women and 10 men) were randomly split into two groups to perform 8 sessions of rowing repeated-sprint exercise either with RSH-VHL (each sprint with maximal EEBH) or with unrestricted breathing (RSN, 10-s sprints). Before (Pre-), 5 days after (Post-1) and 12 days after (Post-2) the last training session, participants completed a repeated-sprint ability (RSA) test on a rowing ergometer (8 × 25-s “all-out” repetitions interspersed with 25 s of passive recovery). Power output (PO), oxygen uptake, perceptual-motor capacity (turning off a traffic light with a predetermined code), cerebral (Δ[Hbdiff]) and muscle (Δ[Hb/Mb]diff) oxygenation, cerebral total haemoglobin concentration (Δ[THb]) and muscle total haemoglobin/myoglobin concentration (Δ[THb/Mb]) were measured during each RSA repetition and/or recovery period.

Results

From Pre-to Post-1 and Post-2, maximal PO, mean PO (MPO) of the first half of the test (repetitions 1–4), oxygen uptake, end-repetition cerebral Δ[Hbdiff] and Δ[THb], end-repetition muscle Δ[Hb/Mb]diff and Δ[THb/Mb] and perceptual-motor capacity remained unchanged in both groups. Conversely, MPO of the second half of the test (repetitions 5–8) was higher at Post-1 than at Pre-in RSH-VHL only (p < 0.01), resulting in a lower percentage decrement score over the entire RSA test (20.4% ± 6.5% vs. 23.9% ± 7.0%, p = 0.01). Furthermore, MPO (5–8) was greater in RSH-VHL than in RSN at Post-1 (p = 0.04). These performance results were accompanied by an increase in muscle Δ[THb/Mb] (p < 0.01) and a concomitant decrease in cerebral Δ[THb] (p < 0.01) during the recovery periods of the RSA test at Post-1 in RSH-VHL.

Conclusion

Four weeks of RSH-VHL including maximal EEBH improved the ability of elite judo athletes to repeat high-intensity efforts. The performance improvement, observed 5 days but not 12 days after training, may be due to enhanced muscle perfusion. The unchanged oxygen uptake and the decrease in cerebral regional blood volume observed at the same time suggest that a blood volume redistribution occurred after the RSH-VHL intervention to meet the increase in muscle perfusion.
ame-miR-5119-Eth axis modulates larval-pupal transition of western honeybee worker
Authors: Dong Shunan , Li Kunze , Zang He , Song Yuxuan , Kang Jing , Chen Ying , Du Liting , Wang Ning , Chen Dafu , Luo Qingming , Yan Tizhen , Guo Rui , Qiu Jianfeng
Published: September 2024

The miRNA plays a key role in the regulation of hormone signaling in insects. The pathways by which miRNAs affect hormone levels are unclear in the honeybee (Apis mellifera), an indispensable pollinator in nature. In this study, ame-miR-5119 was overexpressed and knocked down in larvae by feeding mimics and inhibitors, respectively, and we determined that ame-miR-5119 regulates hormone signaling through the target gene ecdysis triggering hormone (Eth), which affects the larval-pupal transition of workers. The results showed that ame-miR-5119 with a length of 19 nt targets six genes related to the hormone pathway. We focused on Eth and found that ame-miR-5119 and Eth exhibited reverse expression patterns during the transition from larval to pupal stages in workers. Dual luciferase assay confirmed the negative regulatory between ame-miR-5119 and Eth. Overexpression of ame-miR-5119 decreased the mRNA level of Eth, and the Eth receptor (Ethr) expression was not significantly affected, but the expression levels of juvenile hormone (JH) pathway related genes juvenile hormone acid methyltransferase (Jhamt) and Krüppel homolog 1 (Kr-h1) were significantly reduced. In contrast, knockdown of ame-miR-5119 increased the mRNA level of Eth, and the expression of Ethr, Jhamt and Kr-h1 was significantly upregulated. ame-miR-5119 did not affect larval body weight. The number of larvae overexpressing ame-miR-5119 survived in the prepupal stage was lower than that in the control group, and the number of pupations reduced at 11-day-old. The number of larvae that knocked down ame-miR-5119 survived in the prepupal stage was significantly higher than that in the control group, and the number of pupations increased at 11-day-old. These results indicated that ame-miR-5119 negatively regulates the expression of Eth, indirectly inhibits the expression of Ethr, Jhamt, and Kr-h1, and affects the JH biosynthesis, thereby preventing the metamorphic transition from larva to pupa in worker bees. These findings provide evidence that the miRNA regulation of hormone levels in honey bees.
The impact of exercise intensity on depression in fibromyalgia: a randomized controlled trial
Authors: Vilarino Guilherme Torres , Coimbra Danilo Reis , Neiva Henrique Pereira , Andrade Alexandro
Published: September 2024

Background

Fibromyalgia (FM) is characterized by widespread chronic pain. Although pain is the main symptom, approximately 90% of patients have depression. This study aimed to analyze the effects of Resistance Training (RT) with low and high intensity on depression in patients with FM.

Methods

Thirty-eight women with FM and 31 healthy women were allocated to the low-intensity, high-intensity, preferred-intensity, and control groups. The patients underwent 8 weeks of supervised RT, with two sessions per week of approximately 1 h. The low-intensity resistance training group (LIRT) performed two sets of 12 maximum repetitions. The high-intensity resistance training group (HIRT) performed four sets with six maximum repetitions, and the preferred intensity group (PI) performed three sets, with eight to 12 repetitions, according to the patient’s tolerance. The healthy control group did not perform any type of exercise. Depression was assessed using the Beck depression inventory before the start of the intervention, after 4 and 8 weeks.

Results

FM patients have higher levels of depression than women without the disease. After 4 weeks, there was a difference in depressive symptoms between the HIRT and LIRT (p = 0.048), and the PI and LIRT (p = 0.048).

Conclusion

Prescribing RT with low or high intensity did not significantly reduce depression in patients with FM after 8 weeks, however, analyses between groups after 4 weeks indicated that low-intensity training is more effective than high-intensity training. The prescription of RT exercise to FM could vary among low, high, and preferred intensity, following the patient’s tolerance for pain.

Clinical trial registration

https://ensaiosclinicos.gov.br/rg/RBR-74pcmw, RBR-74pcmw.
What distinguishes life satisfaction from emotional wellbeing?
Authors: Fors Connolly Filip , Gärling Tommy
Published: September 2024

The aim of this registered report is to investigate how the core components of subjective wellbeing, Life Satisfaction (LS) and Emotional Wellbeing (EWB), differ with respect to their relationship to antecedent factors. Seven factors are proposed that have been found in previous research to antecede LS and EWB. Social Comparisons, Meaningfulness, Economic/Social Resources, and Opportunities are hypothesized to correlate more closely with LS than EWB, while Time Use, Hassles/Uplifts, and Neuroticism are hypothesized to correlate more strongly with EWB than LS. A combined online and paper-and-pencil survey was administered to a representative sample of 974 Swedish citizens aged 15 years or older. LS and EWB were measured by self-report methods that have been developed and used in previous research. Index measures were constructed from self-reports of each antecedent factor by means of ratings on two scales developed in this study. Multivariate regression and relative weight analyses confirmed two of the hypotheses in showing that Economic/Social Resources and Opportunities were significantly more strongly related with LS than EWB. Of those hypothesized to correlate more strongly with EWB than LS, support was obtained for Neuroticism. Social Comparisons, Meaningfulness, Time Use, and Hassles/Uplifts did not have different relationships with LS and EWB. The results confirm that to some extent antecedent factors are differentially associated with LS and EWB, thus contributing to a better understanding of the antecedents of the cognitive and affective components of subjective wellbeing. Future research should further explore the mechanisms underlying these different relationships as well as moderators and mediators of the relationships.
Perception of success among adults practicing various fighting arts
Authors: Ambroży Tadeusz , Serafin Natalia , Pawelec Przemysław , Piepiora Paweł Adam , Borysiuk Zbigniew , Kindzer Bogdan , Kasicki Krzysztof , Rydzik Łukasz , Cynarski Wojciech J.
Published: September 2024

Problem statement

Goal orientations, which influence learning and motivation, are categorized into task orientation (focused on skill development and personal mastery) and ego orientation (focused on outperforming others and gaining recognition). This study aims to explore how different demographics perceive success in martial arts.

Approach and purpose

The research questions focused on identifying correlations between perceptions of success and demographic factors: (1) sex, (2) age, (3) type of martial art practiced, and (4) nationality. These factors were examined to understand their impact on success perceptions among martial arts practitioners.

Materials and methods

The study utilized the Perception of Success Questionnaire (POSQ) to gather data from 268 participants—142 from Poland and 126 from Ukraine—selected through voluntary participation. Statistical analyses included standard deviation, coefficient of variability, Spearman’s rank correlation, and ANOVA for multifactor analysis.

Results

The study revealed a weak correlation between the type of martial art practiced and perception of success (rs = 0.38), indicating that the style of martial art has limited influence on success perception. There was a weak correlation between nationality and perception of success (rs = 0.20), suggesting cultural factors do not play a role. A strong correlation was found between age and perception of success (rs = 0.80), highlighting how perceptions evolve with age. A significant correlation was also found between sex and perception of success (rs = 0.90), which may reflect broader cultural patterns influenced by globalization.

Conclusion

While the study identifies important demographic correlations affecting perceptions of success in martial arts, the findings are constrained by the sample size and demographic distribution, which limits the generalizability of the results. Further research with a larger and more diverse sample is recommended to deepen understanding.