bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Cardiac Effects After Oxytocin 2.5 I U or Carbetocin 100  μg: A Randomised Controlled Trial in Women Undergoing Planned Caesarean Delivery
Authors: Bekkenes M.E. , Fagerland M.W. , Solberg O.G. , Aaberge L. , Klingenberg O. , Norseth J. , Rosseland L.A.
Published: September 2023

(Eur J Anaesthesiol. 2022;39:928–938)

While oxytocin can be cardioprotective at physiologic levels, higher concentrations are used to prevent postpartum hemorrhage (PPH) and can induce hypotension, ST-depression, tachycardia, arrhythmias, and prolongation of the QTc interval. Further cardiovascular (CV) effects caused directly by oxytocin can result in fatalities in patients with underlying myocardial disease. Such acute risk for susceptible patients warrants characterization of CV changes induced by intravenous oxytocin and its commonly used analog carbetocin as administered to prevent PPH. While carbetocin has demonstrated comparable or improved effect for stimulating uterine contractions and has similar hemodynamic effects to oxytocin, the comparative prevalence of adverse cardiac events is unknown. Myocardial distress can be measured by the release of circulating troponin I (cTnI) and troponin T (cTnT), which are considered indirect indicators of ischemic heart damage. This exploratory Phase 4 randomized trial queried the difference in troponin release following oxytocin or carbetocin administration to approximate the incidence of cardiac adverse events when used to prevent PPH in women undergoing planned cesarean delivery (CD).
Calcium for Pre-eclampsia Prevention: A Systematic Review and Network Meta-analysis to Guide Personalized Antenatal Care
Authors: Woo Kinshella M.L. , Sarr C. , Sandhu A. , Bone J.N. , Vidler M. , Moore S.E. , Elango R. , Cormick G. , Belizan J.M. , Hofmeyr G.J. , Magee L.A. , von Dadelszen P. ,   PRECISE Network
Published: September 2023

(BJOG. 2022;129:1833–1843)

Pre-eclampsia effects 2% to 5% of pregnancies. Health disparities are apparent with 99% of maternal pre-eclamptic deaths occurring in low- and middle-income countries (total deaths are between 30,000 and over 500,000 annually). A daily dose of aspirin (150 mg) has been shown to prevent 60% of preterm (<37 wk of gestation) pre-eclampsia, although it has not been shown to impact term pre-eclampsia (≥37 wk of gestation), accounting for over 70% of disease cases. Systematic reviews have shown that calcium supplementation can also decrease pre-eclampsia rates in parturient women [relative risk (RR) 0.45, 95% CI: 0.31-0.65] and decrease morbidity and preterm birth rates. The World Health Organization (WHO) has implemented a guideline of 1.5 to 2.0 g of calcium supplementation daily starting at 20 weeks of gestation for women not receiving adequate calcium through their diet. Questions remain regarding the appropriate calcium dose and which parturient women would benefit most from supplementation. This study aimed to determine the safety and effectiveness of calcium to help prevent pre-eclampsia, the optimal dosage amount (high dose of ≥1 g/d or low dose of <1 g/d), the optimal week of gestation that supplementation should commence, and which women would benefit the most from intervention.
Maternal Hypertensive Disorder of Pregnancy and Mortality in Offspring From Birth to Young Adulthood: National Population-based Cohort Study
Authors: Huang C. , Wei K. , Lee P.M.Y. , Qin G. , Yu Y. , Li J.
Published: September 2023

(BMJ 2022;379:e072157)

A large portion of pregnancies are affected by hypertensive disorders of pregnancy (HDP), and they have been associated with poor outcomes during pregnancy, labor, and delivery, and for children later in life. This study aimed to understand the association between overall and specific maternal HDP with overall and cause-specific mortality in children from birth to adulthood. Secondary to this aim, this study also investigated whether diabetes and education have an additional effect on children’s mortality and whether the timing of onset for HDP makes a difference. Primary outcomes were all causes of death, and secondary outcomes were specific causes: cancer, mental or behavioral disorders, conditions originating in the perinatal period, congenital malformations and chromosomal abnormalities, external causes, and diseases related to cardiovascular function, infection or parasite, endocrine, nutritional, or metabolic function, nervous system or sense organs, respiratory system function, digestive system function, musculoskeletal system or connective tissue, or genitourinary system function.
Time to Stop Early Treatment of Patent Ductus Arteriosus?
Authors: Backes C.H. , Slaughter J.L. ,   (commentary on Hundscheid et al. manuscript)
Published: September 2023

(N Engl J Med. 2023;388:1050–1051)

The ductus arteriosus briefly closes soon after birth in healthy term infants while staying open in most extremely preterm infants (<28 wk of gestation). While patent ductus arteriosus (PDA) has been shown to increase the risk of adverse outcomes, no causative pathway between PDAs and these complications have been established and optimal treatment for PDA in preterm infants is unclear.
Bilateral Foot Drop After Spinal Anesthesia for Cesarean Section
Authors: Dorjey Y.
Published: September 2023

(Int J Gynaecol Obstet. 2022;158:484–487)

Neurological complications after cesarean delivery (CD) under spinal anesthesia are rare. Bilateral foot drops are one such complication and are extremely uncommon. This brief communication aims to report a case of bilateral foot drop that a patient developed after spinal anesthesia for CD.
Toward Faster Revascularization in Large Vessel Acute Ischemic Stroke: Reducing Door-to-Groin Puncture Times
Authors: Rangel India C. , Krishna Chandan , Bendok Bernard R. , Turcotte Evelyn L. , Chong Brian W. , Kumar Gyanendra , Vanderhye Vanesa K. , Turkmani Ali
Published: September 2023

Stroke treatment has evolved immensely over the past 3 decades, with mechanical thrombectomy becoming the mainstay of treatment for large vessel occlusion (LVO). In this review, we describe the progression from PROACT I to the present day, and analyze existing literature to summarize the efficacy of current methods to treat LVO. We also describe the indications for mechanical thrombectomy and the strategies that have been implemented to enhance its efficacy, including a quality improvement project conducted at the Mayo Clinic. In addition, we discuss lessons from the implementation of mechanical thrombectomy and advancements in this technique over recent years.
Integrative Health An Overview for Nursing Practice
Authors: Helming Mary A.
Published: September 2023

Conventional Western medicine is considered a mainstream approach to healthcare, whereas non-mainstream approaches have included complementary and alternative medicine, referred to as CAM. Today, integrative medicine combines complementary and conventional approaches to care. This article describes terminology and features of complementary, alternative, and integrative methods, and the newer field of integrative nursing. A brief biblical perspective on integrative medicine is offered.
Emotional and Psychological Effects of the COVID-19 Pandemic on Nursing Students
Authors: Joseph Rachel A. , Turner Tracey , Akers Shanna W. , Whorley Elizabeth , Goodrich Cindy
Published: September 2023

The COVID-19 pandemic impacted the mental health and educational experiences of nursing students in undergraduate and graduate programs. A larger mixed-methods study aimed to understand how COVID-19 impacted personal lives and learning experiences of students across all programs levels. This article reports on qualitative data obtained from focus groups organized by student program level. Six themes emerged, including fear and uncertainty, trust in God, educational and career concerns, concerns about family, mental health issues, and isolation/lack of human touch. Key areas covered are the emotional and psychological effects of COVID-19 and its factors and the role of faith during COVID-19 among nursing students.
Split or whole liver transplantation? Utilization and posttransplant survival
Authors: Yu Zhuoting , Keskinocak Pinar , Magliocca Joseph F. , Romero Rene , Sokol Joel
Published: September 2023

Background:

Split liver transplantation (SLT), where a single donor liver is divided for transplantation to 2 recipients, has the potential to increase the availability of size-matched livers for pediatric candidates and expand the supply of donor organs available for adult candidates. Although SLT is a well-established technique, the number of SLTs has remained flat during the past 2 decades, partly due to concerns about the posttransplant survival of SLT recipients compared with whole liver transplantation (WLT) recipients. Prior work on SLT versus WLT survival analysis had limitations because, for pediatric recipients, it did not consider the correlations between donor age/weight and the allograft type, and for adult recipients, it may have included records where the donor livers did not meet the split liver criteria (splittable).

Methods:

Using the Organ Procurement and Transplantation Network’s database (2003–2019), this study analyzes and compares (i) key characteristics of donors and recipients, (ii) donor-recipient match dynamics (organ offers and accept/decline decisions), and (iii) recipient posttransplant survival, for SLT and WLT.

Results and Conclusions:

The results in this study show that the posttransplant survival of SLT and WLT recipients is similar (controlling for other confounding factors that may impact posttransplant survival), highlighting the importance of SLT for increasing the liver supply and potential benefits for both pediatric and adult candidates.
Harmonic components of photoplethysmography and pathological patterns: A cross-sectional study
Authors: Park Young-Jae , Lee Jin-Moo , Choi Ka-Hye
Published: September 2023

This study aimed to examine whether the 3 harmonic components (HCs) of photoplethysmography (PTG) – total harmonic distortion (THD), harmonic power (HP), and normalized harmonic amplitude (HA) – have aging effects and may serve as an arterial stiffness marker and examine the relationship between HCs and clinical severity of pathological patterns. This study had a retrospective chart review design, and electronic medical records of 173 female patients (age: 38.57 ± 11.64 years) were reviewed. Patients were asked to complete the phlegm, blood stasis (BS), and food retention (FR) pattern questionnaires and underwent PTG and the second derivative of PTG measurements. THD, HP, and HA data were extracted till the 12th HCs from the raw PTG data. THD and HA had an aging effect (β: −0.179 to −0.278) and were related to b/a (r: −02.76 to −0.455) and d/a (r: 0.265–0.360) of the second derivative of PTG. In the younger group (≤33 years), HP and HA were positively correlated with phlegm, BS, and FR patterns (r: 0.257–0.370), while HP was positively correlated with the FR pattern (r: 0.278–0.315) in the middle age group (34–45 years). In the older group (≥46 years), HP and HA were positively or negatively correlated with the phlegm pattern (r: ±0.263 to ±0.440). HCs may serve as an arterial stiffness marker, and may be partially related to phlegm, BS, and FR patterns. Aging effect needs to be considered when utilizing HCs as an indicator of phlegm, BS, and FR patterns.
Isolated retinal astrocytic hamartoma with 7-year follow-up: A case report
Authors: Wójcik-Niklewska Bogumiła , Sirek Sebastian , Tronina Agnieszka , Filipek Erita
Published: September 2023

Rationale:

Retinal astrocytic hamartoma (RAH) is a rare benign tumor originating from astrocytic cells located in the neural cell layer of the retina. It is commonly seen in patients with phakomatoses such as tuberous sclerosis complex or neurofibromatosis, rarely as an isolated retinal mass. This lesion is usually asymptomatic; however, these located in the area of the optic nerve, macula, or exhibiting the features of exudation, neovascularization may present visual disturbances and decreased visual acuity.

Patient concerns:

We present a rare case of a 15-year-old boy, with no significant past medical history, whose cause of visual disturbances turned out to be isolated RAH.

Diagnoses:

Based on the results of color images of the fundus, fluorescein angiography as well as the analysis of magnetic resonance imaging, the patient was diagnosed with RAH.

Interventions:

Additionally an B-scan ultrasonography, static and kinetic perimetry were performed.

Outcomes:

Fundoscopic examination showed a unilateral yellowish, well-circumscribed, mulberry-like lesion with a wide base, located in inferosnasal quadrant, in the vinicity of the optic nerve. The patient underwent neurological, pediatric, and genetic evaluations that excluded other pathological findings or underlying systemic disease.

Lessons:

The prognosis for RAH is generally good, however, the lesion requires regular ophthalmologic follow-up to rule out the progression of the tumor mass. The patient 7-year follow-up history is without evidence of tumor growth, local or general deterioration of the condition.
Demonstration of the impact of COVID-19 on metabolic associated fatty liver disease by bioinformatics and system biology approach
Authors: Huang Tengda , Zheng Dawei , Song Yujia , Pan Hongyuan , Qiu Guoteng , Xiang Yuchu , Wang Zichen , Wang Fang
Published: September 2023

Background:

Severe coronavirus disease 2019 (COVID-19) has caused a great threat to human health. Metabolic associated fatty liver disease (MAFLD) is a liver disease with a high prevalence rate. Previous studies indicated that MAFLD led to increased mortality and severe case rates of COVID-19 patients, but its mechanism remains unclear.

Methods:

This study analyzed the transcriptional profiles of COVID-19 and MAFLD patients and their respective healthy controls from the perspectives of bioinformatics and systems biology to explore the underlying molecular mechanisms between the 2 diseases. Specifically, gene expression profiles of COVID-19 and MAFLD patients were acquired from the gene expression omnibus datasets and screened shared differentially expressed genes (DEGs). Gene ontology and pathway function enrichment analysis were performed for common DEGs to reveal the regulatory relationship between the 2 diseases. Besides, the hub genes were extracted by constructing a protein-protein interaction network of shared DEGs. Based on these hub genes, we conducted regulatory network analysis of microRNA/transcription factors–genes and gene - disease relationship and predicted potential drugs for the treatment of COVID-19 and MAFLD.

Results:

A total of 3734 and 589 DEGs were screened from the transcriptome data of MAFLD (GSE183229) and COVID-19 (GSE196822), respectively, and 80 common DEGs were identified between COVID-19 and MAFLD. Functional enrichment analysis revealed that the shared DEGs were involved in inflammatory reaction, immune response and metabolic regulation. In addition, 10 hub genes including SERPINE1, IL1RN, THBS1, TNFAIP6, GADD45B, TNFRSF12A, PLA2G7, PTGES, PTX3 and GADD45G were identified. From the interaction network analysis, 41 transcription factors and 151 micro-RNAs were found to be the regulatory signals. Some mental, Inflammatory, liver diseases were found to be most related with the hub genes. Importantly, parthenolide, luteolin, apigenin and MS-275 have shown possibility as therapeutic agents against COVID-19 and MAFLD.

Conclusion:

This study reveals the potential common pathogenesis between MAFLD and COVID-19, providing novel clues for future research and treatment of MAFLD and severe acute respiratory syndrome coronavirus 2 infection.
Is conservative management a safe approach for patients with acute acalculous cholecystitis presenting with an acute abdomen?
Authors: Chang Chuheng , Wang Youyang , Shi Wen , Xu Haifeng , Huang Xiaoming , Jiao Yang
Published: September 2023

Patients with acute acalculous cholecystitis (AAC) often present with acute abdominal symptoms. However, recent clinical studies have suggested that some patients with AAC and an acute abdomen, especially when caused by viruses or rheumatic disease, may not require cholecystectomy and that conservative treatment is adequate. Whether cholecystectomy is superior to conservative treatment for patients with AAC presenting with a severe acute abdomen is still uncertain. This was a case series study of AAC-related literature published between 1960 and 2022. In total, 171 cases (104 viral infection-associated AAC and 67 rheumatic disease-associated AAC) were included. The prognoses of patients receiving cholecystectomy or conservative treatment were compared. To account for confounding factors, etiological stratification and logistic regression were performed. The prognosis was similar for patients undergoing cholecystectomy and conservative treatment (P value .364), and virus infection-associated AAC had a better prognosis than rheumatic disease-associated AAC (P value .032). In patients with AAC caused by viruses or rheumatic disease, the acute abdomen can be adequately managed by conservative treatment of the underlying etiology and does not mandate surgical intervention.
Comprehensive pan-cancer analysis of expression profiles and prognostic significance for NUMB and NUMBL in human tumors
Authors: Zhang Yue , Yang Hongxia , Liu Weizhe , Song Qiuhang , Li Yunfeng , Zhang Juanjuan , Zhou Dingyan , Li Aiying
Published: September 2023

NUMB has been initially identified as a critical cell fate determinant that modulates cell differentiation via asymmetrical partitioning during mitosis, including tumor cells. However, it remains absent that a systematic assessment of the mechanisms underlying NUMB and its homologous protein NUMBLIKE (NUMBL) involvement in cancer. This study aimed to investigate the prognostic significance for NUMB and NUMBL in pan-cancer. In this study, using the online databases TIMER2.0, gene expression profiling interactive analysis, cBioPortal, the University of ALabama at Birmingham CANcer data analysis Portal, SearchTool for the Retrieval of Interacting Genes/Proteins, and R software, we focused on the relevance between NUMB/NUMBL and oncogenesis, progression, mutation, phosphorylation, function and prognosis. This study demonstrated that abnormal expression of NUMB and NUMBL were found to be significantly associated with clinicopathologic stages and the prognosis of survival. Besides, genetic alternations of NUMB and NUMBL focused on uterine corpus endometrial carcinoma, and higher genetic mutations of NUMBL were correlated with more prolonged overall survival and disease-free survival in different cancers. Moreover, S438 locus of NUMB peptide fragment was frequently phosphorylated in 4 cancer types and relevant to its phosphorylation sites. Furthermore, endocytosis processing and neurogenesis regulation were involved in the functional mechanisms of NUMB and NUMBL separately. Additionally, the pathway enrichment suggested that NUMB was implicated in Hippo, Neurotrophin, Thyroid hormone, and FoxO pathways, while MAPK, Hippo, Rap1, mTOR, and Notch pathways were related to the functions of NUMBL. This study highlights the predictive roles of NUMB and NUMBL in pan-cancer, suggesting NUMB and NUMBL might be served as potential biomarkers for diagnosis and prognosis in various malignant tumors.
Molecular mechanism of Ruxian Shuhou prescription in the treatment of triple-negative breast cancer based on network pharmacology
Authors: Chu Meiling , Meng Tian , Zhou Yue , Jin Lan , Dai Qiuying , Ma Lina , Chen Hongfeng
Published: September 2023

We aimed to explore the molecular mechanism of Ruxian Shuhou prescription in the treatment of triple-negative breast cancer (TNBC) by using network pharmacology. The active components and targets of the prescription were obtained by Traditional Chinese medicine systems pharmacology database. Gencards database, online mendelian inheritance in man database, therapeutic target database, and DRUGBANK database were used to search for the TNBC-related targets. The potential targets of Ruxian Shuhou prescription for TNBC were screened out by the intersection of effective ingredient action targets and disease targets. A herb-active ingredient-target network was constructed and analyzed for key ingredients. A protein-protein interaction network was constructed for studying key targets. Furthermore, gene ontology analysis and Kyoto encyclopedia of genes and genomes pathway enrichment analysis were carried out. Finally, the relationship between key ingredients and key genes was evaluated by molecular docking. The key ingredients of Ruxian Shuhou prescription for the treatment of TNBC may be Quercetin, Luteolin and Kaempferol, while the key therapeutic targets may be protein kinase B, interleukin-6, cellular tumor antigen p53, and vascular endothelial growth factor A. The related signaling pathways were mainly involved in tumor, apoptosis and virus infection, among which the PI3K-Akt signaling pathway was the most closely related to TNBC. Molecular docking showed that the key ingredients had high binding activity with the key targets. The molecular mechanisms of Ruxian Shuhou prescription for TNBC are likely to involve multi-ingredient, multi-target and multi-pathway.
Crohn’s disease from past to present: Research trends and global outcomes with scientometric analysis during 1980 to 2022
Authors: Karabulut Alpaslan , Kaya Muhammed
Published: September 2023

Currently, there is no comprehensive bibliometric study in the literature on Crohn’s disease (CD). The aim of this study was to analyze articles published on CD using bibliometric and statistical methods. The aim was to identify current research trends, show global productivity, and determine important players such as countries, journals, institutions, and authors. A total of 16,216 articles published on CD between 1980 and 2022 were analyzed using various statistical and bibliometric methods. Bibliometric network visualization maps were used to perform trend topic analysis, citation analysis, and international collaboration analysis. Spearman’s correlation coefficient was used for correlation analysis. The top 3 contributing countries to the literature were the United States of America (USA) (n = 4344, 26.7%), the United Kingdom (UK) (n = 2036, 12.5%) and Germany (n = 1334, 8.2%). The most active institutions were Udice French Research Universities (n = 696), Assistance Publique Hopitaux Paris (n = 570), and Institut National de la Sante et de la Recherche Medicale Inserm (n = 479). The most productive journals were Inflammatory Bowel Diseases (n = 1100), Journal of Crohn’s & Colitis (n = 579), and Gut (n = 510). The most prolific author was Colombel JF. (n = 290). The most frequently researched topics from past to present included infliximab, ulcerative colitis, surgery, pediatrics, adalimumab, magnetic resonance imaging, inflammation, perianal CD/perianal fistula, azathioprine, magnetic resonance enterography, small bowel, stricture/strictureplasty, recurrence, therapy/treatment, ustekinumab, mucosal healing, biomarkers, fistula, quality of life, ultrasonography, epidemiology, capsule endoscopy, laparoscopic surgery/laparoscopy, endoscopy, disease activity, postoperative recurrence, and the Nucleotide Binding Oligomerization Domain Containing 2 gene. We have seen an exponential increase in worldwide publications on CD. In recent years, the major research topics related to CD have been ustekinumab, vedolizumab, fecal calprotectin, therapeutic drug monitoring, biologics, biomarkers, exclusive enteral nutrition, microbiome/microbiota, magnetic resonance enterography, anti-TNF, postoperative complications, and mucosal healing. We determined that countries with large economies, particularly the United States, United Kingdom, Germany, France, Canada, Italy, Japan and China, have taken the lead in research contributions to the development of CD literature.
Repetitive transcranial magnetic stimulation in the treatment of middle-aged and elderly major depressive disorder: A randomized controlled trial
Authors: Wang Xiaofang , Fan Xiubo , Zhang Lihui , Liu Xin , Ji Zhi
Published: September 2023

Background:

Studies have reported the use of repetitive transcranial magnetic stimulation (rTMS) in patients with major depressive disorder (MDD). However, most studies focus on antidepressant effect of rTMS, but few on cognitive aspects. The present study aimed to explore the effect of rTMS on BDNF levels and cognitive function in the treatment of middle-aged and elderly MDD.

Methods:

This was a randomized controlled trial. A total of 120 elderly patients with MDD treated in The Second Affiliated Hospital of Xi’an Medical University from January 2021 to January 2023 were selected as research subjects. The patients were randomly divided into control group (n = 60, patients received simple oral treatment with escitalopram and sham rTMS) and study group (n = 60, patients received oral treatment with escitalopram combined with rTMS) according to the random number table method. We compared the clinical efficacy, serum BDNF levels, and cognitive function between the 2 groups.

Results:

After treatment, the HAMD-17 score in the study group was lower than that in the control group [13.00 (12.00–16.00) vs 17.00 (15.00–19.00), P < .05], and the RBANS score was higher than that in the control group [166.00 (161.25–171.75) vs 133.00 (130.00–136.75), P < .05]. The total effective rate of the research group was 95.0%, which was higher than the 82.0% of the control group (P < .05). The serum BDNF levels [36.00 (33.00–38.00) vs 30.00 (28.00–32.00), P < .05] and MoCA scores [24.00 (22.00–26.75) vs 23.00 (21.00–25.00), P < .05] of the study group were higher than those of the control group. There were no significant adverse reactions during the treatment of both groups.

Conclusions:

Compared with oral escitalopram alone, repeated transcranial magnetic stimulation in the treatment of middle-aged and elderly patients with major depressive disorder can further improve the efficacy, and can more effectively improve the BDNF level and cognitive function, with ideal safety.
Resection for malignant tumors in the elbow and individualized reconstruction under assistance of 3D printing technology: A case report
Authors: Liao Guang-Jun , Su Qing , Zhang Yong-Quan , Chang Li-Ming
Published: September 2023

Rationale:

With a high failure rate and multiple postoperative complications, the resection for tumors in the elbow and reconstruction present a formidable challenge to orthopedic surgeons. The maturation of 3-dimension (3D) printing technology has facilitated the preoperative design, intraoperative navigation, and reconstruction of bone defects in patients with complex malignant tumors of the elbow joint. In order to improve prognosis, we explored a method of tumor resection and elbow reconstruction aided by 3D printing technology in this research.

Patient concerns:

The patient underwent nephrectomy for clear cell carcinoma of the left kidney 3 years ago. Six months ago, the patient presented with limited movement and lateral tenderness in the right elbow joint. The tumor puncture biopsy demonstrated renal clear cell carcinoma metastasis.

Diagnoses:

Renal clear cell carcinoma with distal humerus bone metastasis.

Interventions:

Thin-layer CT scan data of the patient was acquired, and a 3D reconstruction of both upper limb bones and joints was conducted, followed by a simulation of diseased tissue excision. According to the model, individualized osteotomy guidelines and elbow prostheses were designed and manufactured. Then, prior to the completion of the actual operation, a simulation of the preoperative phase was performed.

Outcomes:

The operation was completed without incident. At the 1-, 3-, and 6-month postoperative examinations, both the position and mobility of the prosthesis were found to be satisfactory, and no complications were observed. The hospital for special surgery score and mayo elbow performance score scores increased in comparison to the preoperative period.

Lessons:

For patients with complex tumors in the elbow joint, 3D printing technology may assist in the precise excision of the tumor and provide an individualized elbow joint prosthesis that is more precise and effective than traditional surgery. It can accomplish a satisfactory treatment effect for patients when combined with early postoperative scientific rehabilitation training, so it is a method worth promoting.
Inr tracking with face-to-face and phone app
Authors: Hanedan Muhammet Onur , Alkan Kayhan Semiha , Dizdar Ebru , Kiliç Aşkin , Arslan Ali Kemal , Yürük Mehmet Ali , Sayar Ufuk
Published: September 2023

Background:

Warfarin has a narrow therapeutic window. Maintaining the patient’s international normalized ratio (INR) within a predefined therapeutic range is one of the main challenges of warfarin treatment. This study aimed to compare the INR values of patients followed by face-to-face and telephone applications.

Methods:

This study was designed as a randomized controlled trial. Twelve patients living in a distant place were assigned to the experimental group, and 12 patients living nearby and followed-up in the outpatient clinic were assigned to the control group. A Patient Information Form and the Adherence to Refills and Medications Scale were used to collect data.

Results:

There was no significant difference between the groups in terms of demographic and clinical characteristics except for age (P > .05). The INR values of 67% of the patients followed in the outpatient clinic and 72% of the patients followed with the application were in the therapeutic range. There was no significant difference between the groups and medication adherence was high in both groups (P > .05).

Conclusion:

In light of the findings of our study, which demonstrated that the INR levels of patients who were monitored both face-to-face and via a telephone application were within the same therapeutic range, it was concluded that the telephone application can be used to manage warfarin therapy.
A rare imaging presentation with multisystemic clinicopathological features of Langerhans cell histiocytosis: Case report and literature review
Authors: Li Xiaofen , Wang Yulu , Liu Qian , Zeng Qingyun , Fu Huan , He Jianlin , Schmidt-Wolf Ingo G.H. , Sharma Amit , Liao Fengxiang
Published: September 2023

Rationale:

Langerhans cell histiocytosis (LCH) is a kind of rare disease in which dendritic cells proliferate abnormally. It often occurs in children and can involve any tissue and organ. The affected sites usually include bone, skin, pituitary gland, and lungs, while the thyroid gland and external auditory canal are rarely observed. The perineal and labial involvement of this disease has not been reported yet.

Patient concerns:

A 47-year-old female patient experienced a swelling of the anterior neck area without an obvious inducement. She noticed a quail egg-like mass on the left side, and the mass increased progressively within 3 months. The anterior neck area was found to be swollen, and some flaky red rashes were seen on the scalp and bilateral external auditory canals.

Diagnoses:

Imaging examination showed enlarged thyroid and cervical lymph nodes, multiple low-density nodules in the liver, and reduced signal in the posterior pituitary gland. The biopsy pathological result of the increased left cervical lymph node indicated that LCH was detected.

Interventions:

VP regimen (vincristine, dexamethasone per os) and related supportive treatments were given as inducing chemotherapy for 6 weeks.

Outcomes:

After the second chemotherapy, the rash on the scalp and external auditory canal improved, and the neck mass was significantly reduced. After the third chemotherapy, the rash was mostly disappeared, while the neck lumps increased during chemotherapy. Thus, clatribine chemotherapy was recommended as the follow-up.

Lessons:

Imaging examinations played an important role in the diagnosis and follow-up of the disease, especially 18F-FDG PET/CT, which could show multiple involving organs at the same time. When a patient suffering from diabetes insipidus, skin rash, or fever, has a high FDG uptake PET/CT result in multiple tissues and organs throughout the body, it is necessary to consider the possibility of LCH.
Revolutionising hepatocellular carcinoma surveillance: Harnessing contrast-enhanced ultrasound and serological indicators for postoperative early recurrence prediction
Authors: Tu Haibin , Feng Siyi , Chen Lihong , Huang Yujie , Zhang Juzhen , Wu Xiaoxiong
Published: September 2023

This study aimed to develop a noninvasive predictive model for identifying early postoperative recurrence of hepatocellular carcinoma (within 2 years after surgery) based on contrast-enhanced ultrasound and serum biomarkers. Additionally, the model’s validity was assessedthrough internal and external validation. Clinical data were collected from patients who underwent liver resection at the First Hospital of Quanzhou and Mengchao Hepatobiliary Hospital. The data included general information, contrast-enhanced ultrasound parameters, Liver Imaging Reporting and Data System (LI-RADS) classification, and serum biomarkers. The data from Mengchao Hospital were divided into 2 groups, with a ratio of 6:4, to form the modeling and internal validation sets, respectively. On the other hand, the data from the First Hospital of Quanzhou served as the external validation group. The developed model was named the Hepatocellular Carcinoma Early Recurrence (HCC-ER) prediction model. The predictive efficiency of the HCC-ER model was compared with other established models. The baseline characteristics were found to be well-balanced across the modeling, internal validation, and external validation groups. Among the independent risk factors identified for early recurrence, LI-RADS classification, alpha-fetoprotein, and tumor maximum diameter exhibited hazard ratios of 1.352, 1.337, and 1.135 respectively. Regarding predictive accuracy, the HCC-ER, Tumour-Node-Metastasis, Barcelona Clinic Liver Cancer, and China Liver Cancer models demonstrated prediction errors of 0.196, 0.204, 0.201, and 0.200 in the modeling group; 0.215, 0.215, 0.218, and 0.212 in the internal validation group; 0.210, 0.215, 0.216, and 0.221 in the external validation group. Using the HCC-ER model, risk scores were calculated for all patients, and a cutoff value of 50 was selected. This cutoff effectively distinguished the high-risk recurrence group from the low-risk recurrence group in the modeling, internal validation, and external validation groups. However, the calibration curve of the predictive model slightly overestimated the risk of recurrence. The HCC-ER model developed in this study demonstrated high accuracy in predicting early recurrence within 2 years after hepatectomy. It provides valuable information for developing precise treatment strategies in clinical practice and holds considerable promise for further clinical implementation.
Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report
Authors: Liao Chongzhou , He Zhenqiang , Wang Xiaoxiao , Guo Pu , Xiong Wei
Published: September 2023

Introduction:

Bladder diverticula (BD) can be classified into congenital and acquired forms, with the latter accounting for approximately 90% of all cases, primarily among male patients. Although BD-associated anatomical bladder outlet obstruction (BOO) is uncommon, existing literature suggests that congenital BD are more frequently observed in male children and rarely in female children. While around 70% of acquired BD are linked to BOO secondary to benign prostatic hyperplasia in male patients, clinical reports of female BD are less common. Furthermore, cases of female BD located posterior to the urethra, which lead to voiding difficulties, are exceedingly rare.

Case presentation:

Herein, we present a case of laparoscopic treatment in a 53-year-old female patient diagnosed with congenital bladder diverticulum causing progressively worsening dysuria. Voiding cystourethrography revealed a soft cystic protrusion of the posterior urethral wall during voiding, which reinforced the patient’s symptoms. Urodynamic examination showed elevated detrusor muscle contraction during voiding, a reduced urinary flow rate, and P/Q values indicative of significant BOO. Considering the patient’s clinical condition, we performed laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty.

Results:

The laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty procedures were completed thoroughly and with great success. However, complete removal of the diverticular epithelium proved challenging, resulting in an overall operative time of approximately 3 hours and 32 minutes. At the postoperative follow-up, the patient presented with symptoms of a lower urinary tract infection for a week, which were effectively resolved with oral antibiotics. At the 8-month follow-up, the patient reported normal urination and the absence of any discomfort during urination.

Conclusion:

Female bladder outlet obstruction resulting from posterior urethral BD can be challenging to visualize during transurethral cystoscopy, especially with limited angulation, and may even be overlooked. Furthermore, conventional transvaginal diverticulectomy is often difficult to perform effectively. Therefore, laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty are considered appropriate treatment options for such cases.
Predictive value of ACE I/D genetic polymorphism for 12-month all-cause mortality in patients with acute myocardial infarction
Authors: Tran Duy Cong , Do Minh Duc , Le Linh Hoang Gia , Thai Truc Thanh , Hoang Sy Van , Truong Binh Quang
Published: September 2023

The prognostic role of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) genetic polymorphism in patients with acute myocardial infarction (AMI) is controversial and inconsistent across various study populations. This study evaluated the predictive validity of the ACE I/D variant based on 12-month all-cause mortality in Vietnamese patients after AMI. This was an observational, prospective study conducted among AMI patients at Cho Ray Hospital between January 2020 and September 2021. All participants were identified for ACE I/D polymorphism using the polymerase chain reaction method, with follow-up on survival status at 12 months from the date of admission. The proportions of II, ID, and DD genotypes of the ACE I/D variant were 49.5%, 35.9%, and 14.6%, respectively. All-cause mortality after 12 months occurred in 58 cases (10.6%). The ACE I/D polymorphism did not affect all-cause mortality in the dominant (P = .196), recessive (P = .827), homozygous (P = .515), and heterozygous (P = .184) models. A subgroup analysis by usage status of angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (ACEI/ARB) showed that in the non-ACEI/ARB group, patients with the DD genotype had a lower cumulative survival probability than patients with the II/ID genotypes (hazard ratio [HR] = 3.97, 95% confidence interval [CI]: 1.21–13.04; P = .023). Among patients with Global Registry of Acute Coronary Events (GRACE) scores below the median (153.5 points), those with DD genotype had a higher risk of mortality than those with the II/ID genotypes (HR = 3.35, 95% CI: 1.01–11.11; P = .049). The ACE I/D genetic polymorphism was found not to be associated with 12-month all-cause mortality in Vietnamese patients with AMI. However, it was associated with mortality in patients who did not use ACEI/ARB and also whose GRACE scores were below 153.5 points.
Microliter whole blood neutrophil assay preserving physiological lifespan and functional heterogeneity
Authors: Li Chao , Hendrikse Nathan W. , Mai Makenna , Farooqui Mehtab A. , Argall-Knapp Zach , Kim Jun Sung , Wheat Emily A. , Juang Terry
Published: September 2023

Forin vitroneutrophil functional assays, neutrophils are typically isolated from whole blood, having the target cells exposed to an artificial microenvironment with altered kinetics. Isolated neutrophils exhibit limited lifespans of only a few hoursex vivo, significantly shorter than the 3-5 day lifespan of neutrophilsin vivo. In addition, due to neutrophils’ inherently high sensitivity, neutrophils removed from whole blood exhibit stochastic non-specific activation that contributes to assay variability. Here we present a method - named “μ-Blood” - that enables functional neutrophil assays using a microliter of unprocessed whole blood. μ-Blood allows multiple phenotypic readouts of neutrophil function (including cell/nucleus morphology, motility, recruitment, and pathogen control). In μ-Blood, neutrophils show sustained migration and limited non-specific activation kinetics (<0.1% non-specific activation) over 3-6 days. In contrast, neutrophils isolated using traditional methods show increased and divergent activation kinetics (10-70% non-specific activation) in only 3 h. Finally, μ-Blood allows the capture and quantitative comparison of distinct neutrophil functional heterogeneity between healthy donors and cancer patients in response to microbial stimuli with the preserved physiological lifespan over 6 days.
Decorin suppresses tumor lymphangiogenesis: A mechanism to curtail cancer progression
Authors: Mondal Dipon K. , Xie Christopher , Buraschi Simone , Iozzo Renato V.
Published: September 2023

The complex interplay between malignant cells and the cellular and molecular components of the tumor stroma is a key aspect of cancer growth and development. These tumor-host interactions are often affected by soluble bioactive molecules such as proteoglycans. Decorin, an archetypical small leucine-rich proteoglycan primarily expressed by stromal cells, affects cancer growth in its soluble form by interacting with several receptor tyrosine kinases (RTK). Overall, decorin leads to a context-dependent and protracted cessation of oncogenic RTK activity by attenuating their ability to drive a pro-survival program and to sustain a pro-angiogenic network. Through an unbiased transcriptomic analysis using deep RNAseq, we discovered that decorin downregulated a cluster of tumor-associated genes involved in lymphatic vessel development when systemically delivered to mice harboring breast carcinoma allografts. We found that Lyve1 and Podoplanin, two established markers of lymphatic vessels, were markedly suppressed at both the mRNA and protein levels and this suppression correlated with a significant reduction in tumor lymphatic vessels. We further discovered that soluble decorin, but not its homologous proteoglycan biglycan, inhibited lymphatic vessel sprouting in anex vivo3D model of lymphangiogenesis. Mechanistically, we found that decorin interacted with VEGFR3, the main lymphatic RTK, and its activity was required for the decorin-mediated block of lymphangiogenesis. Finally, we discovered that Lyve1 was in part degraded via decorin-evoked autophagy in a nutrient- and energy-independent manner. These findings implicate decorin as a new biological factor with anti-lymphangiogenic activity and provide a potential therapeutic agent for curtailing breast cancer growth and metastasis.
Changes in child and adolescent mental health across the COVID-19 pandemic (2018-2023): Insights from general population and clinical samples in the Netherlands
Authors: van Oers Hedy A. , Alrouh Hekmat , Tieskens Jacintha M. , Luijten Michiel A.J. , de Groot Rowdy , Broek Emma , van der Doelen Daniël , Klip Helen , De Meyer Ronald , van der Mheen Malindi , Ruisch I. Hyun , van den Berg Germie , Bruining Hilgo , Buitelaar Jan , van der Rijken Rachel , Hoekstra Pieter J. , Kleinjan Marloes , Lindauer Ramón , Oostrom Kim J. , Staal Wouter , Vermeiren Robert , Cornet Ronald , Haverman Lotte , Popma Arne , Bartels Meike , Polderman Tinca J. C. , Zijlmans Josjan
Published: September 2023

Background

The COVID-19 pandemic negatively affected child and adolescent mental health and at the end of the pandemic (April 2022) child mental health had not returned to pre-pandemic levels. We investigated whether this observed increase in mental health problems has continued, halted, or reversed after the end of the pandemic in children from the general population and in children in psychiatric care.

Methods

We collected parent-reported and child-reported data at two additional post-pandemic time points (November/December 2022 and March/April 2023) in children (8-18 years) from two general population samples (N=818-1056 per measurement) and one clinical sample receiving psychiatric care (N=320-370) and compared these with data from before the pandemic. We collected parent-reported data on internalizing and externalizing problems with the Brief Problem Monitor (BPM) and self-reported data on Anxiety, Depressive symptoms, Sleep-related impairments, Anger, Global health, and Peer relations with the Patient-Reported Outcomes Measurement Information System (PROMIS®).

Results

In the general population, parents reported no changes in externalizing problems but did report higher internalizing problems post-pandemic than pre-pandemic. Children also reported increased mental health problems post-pandemic, especially in anxiety and depression, to a lesser extent in sleep-related impairment and global health, and least in anger. In the clinical sample, parents reported higher internalizing, but not externalizing problems post-pandemic compared to the start of the pandemic. Children reported greatest increases in problems in anxiety, depression, and global health, to a lesser extent on sleep-related impairment, and least on anger.

Conclusions

Child mental health problems in the general population are substantially higher post-pandemic compared to pre-pandemic measurements. In children in psychiatric care mental health problems have increased during the pandemic and are substantially higher post-pandemic than at the start of the pandemic. Longitudinal and comparative studies are needed to assess what the most important drivers of these changes are.
Bayesian Spatiotemporal Projection of Chagas Disease Incidence in Brazil
Authors: Roubenoff Ethan
Published: September 2023

Chagas Disease is a parasitic infection caused by theT. Cruziparasite endemic to Central and South America and transmitted through contact withTriatomineinsects, commonly known as “kissing bugs.” Although the symptoms of Acute Chagas Disease (ACD) are nonspecific, untreated chronic infection can lead to heart disease, enlarged esophagus and colon, and stroke. Chagas disease has become increasingly rare owing to a series of public health interventions, including insect eradication campaigns in Brazil through the 1980’s that considerably reduced the number of new acute cases. However, hundreds of new acute cases still are diagnosed annually, primarily in the states of Pará, Amapá, and Acre. Moreover, the population in areas of high Chagas endemicity are changing: many areas are growing and becoming increasingly urban, whereas others are decreasing in population. We estimate the Incidence Rate (IR) for Acute Chagas disease over the period 2001-2019 in Brazil at the municipal level and investigate the variation of these rates with climatic factors. These estimates are used to project forward incidence of Acute Chagas Disease over the following decade 2020-2029. Modeling ACD presents numerous methodological challenges since incidence is rare, with extreme overdispersion of zero-case counts, and vectors exhibit a highly spatially- and temporally-clustered pattern. We use a spatially- and temporally-autoregressive small-area smoothing models to estimate the true latent risk in developing Acute Chagas Disease. The Bayesian model presented here involves spatio-temporal smoothing via a Zero-Inflated (Lambert 1992), Knorr-Held (2000)-Type spatio-temporal model with a BYM2 (Morris, 2019) spatial convolution to predict smoothed incidence rates of Chagas disease. As well, we include estimates of Brazil’s growing population and projected bioclimate to evaluate how climate and population change may affect ACD rates. We estimate that cases will continue to increase in the absence of control efforts, primarily driven by a growing peri-urban population in regions of Chagas endemicity.