bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of part-time patching in preventing recurrence after bilateral lateral rectus recession in children with intermittent exotropia
Authors: Han Jae Yong , Han Jinu , Han Sueng-Han
Published: December 2023

Background

This study evaluate the efficacy of part-time patching in preventing recurrence after bilateral lateral rectus recession (BLR) in patients with intermittent exotropia (IXT).

Methods

A total of 190 children aged 3–13 years who experienced recurrence after BLR for IXT and received part-time patching were retrospectively reviewed. The patching was prescribed for 2 h per day for more than 6 months. Patients who had a recurrence of 18 PD or more underwent reoperation. Changes in exodeviation and reoperation ratio after part-time patching were analyzed.

Results

A total of 34 patients (17.9%) received reoperation after part-time patching, and the reoperation ratio after 2 years was 20.3% as per the Kaplan–Meier survival analysis. Patients with a recurrence of 7 to 10 PD showed a significantly better effect compared to those with a recurrence of more than 10 PD (p < 0.001), and the reoperation ratio was also lower in the survival analysis (p = 0.004). The factor associated with reoperation in patients with part-time patching was the duration between the operation and the initiation of part-time patching (hazard ratio [HR] = 1.006, p = 0.002).

Conclusions

Part-time patching was effective in maintaining the efficacy of surgery and delaying the need of reoperation after BLR. This effect was better in patients with a recurrence of ≤ 10 PD.
A cross-sectional study on stool- and gastrointestinal-related outcomes of Mexican infants consuming different formulae
Authors: Maasakkers Carlijn M. , Hageman Jeske H.J. , Balcazar Muñoz Olivia , Gómez Tamayo Tomás , Blanco Montero Andrés , Garza Lara Luis Gerardo , Flores-López Regina , Contreras Fernández Miriam , Morán Ramos Sofía , Lambers Tim T.
Published: December 2023

Background

Immaturities present at birth, such as in the gut microbiome and digestive, nervous, and immune system, resolve with time. Nevertheless, this may result in mild digestive symptoms early in life, particularly in formula-fed infants. Formula composition and processing may impact this discomfort. This study therefore aimed to assess stool characteristics and gastrointestinal symptoms of healthy infants fed different formulae.

Methods

A multicenter, cross-sectional, observational trial was performed in Mexico between November 2019 and January 2022, where exclusively formula-fed infants (n = 342, aged 1–4 months) were studied in four groups based on their existing formula use. Feeding was continued per practice following label instructions. For 7 days, parents/caregivers were requested to record fecal characteristics, using the Amsterdam Infant Stool Scale, and rate gastrointestinal symptoms. Stool samples were collected to determine pH, dry matter content, and fecal calprotectin levels.

Results

Most infants had a soft/formed stool consistency, although odds for hard stools were different between groups. Gastrointestinal symptom scores revealed significant differences for burping and diarrhea, while other symptoms did not differ between groups. No significant differences between groups were found for stool frequency, dry matter content, and fecal pH. Although calprotectin was within the expected healthy ranges, significant differences among groups were seen. Furthermore, calprotectin significantly correlated with the severity of the gastrointestinal symptoms burping, flatulence, abdominal distension, and diarrhea.

Conclusions

Differences in stool characteristics and specific differences in gastrointestinal symptoms were observed between different formula brand users. This may potentially be explained by the different composition and processing of the formulae, although there are multiple factors that influence the assessed outcomes.

Trial registration

The study was registered in the Netherlands Trial Registry (NL7805), linked to https://trialsearch.who.int/, on 11/06/2019.
Maternal psychological stress during pregnancy and newborn telomere length: a systematic review and meta-analysis
Authors: Moshfeghinia Reza , Torabi Ali , Mostafavi Sara , Rahbar Shiva , Moradi Mohammad Sanyar , Sadeghi Erfan , Mootz Jennifer , Vardanjani Hossein Molavi
Published: December 2023

Introduction

Telomeres protect the ends of chromosomes, and shorter leukocyte telomeres are associated with major group diseases. Maternal psychological stress may be related to the shortening of telomeres in infants. This systematic review and meta-analysis set out to consolidate the varying effect sizes found in studies of maternal psychological stress and telomere length (TL) in newborns and identify moderators of the relationship between stress during pregnancy and newborn TL.

Methods

Our systematic review was registered in Prospero. Six databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, and CINAHL Complete) were searched for records in English from inception to February 10, 2023. Observational studies were included that measured the relationship of psychological stress of the mother during pregnancy on the TL of the newborn. The Newcastle–Ottawa quality assessment scale was used to assess the quality of the included studies. A random-effect model was selected. Statistical analysis performed by Stata software version 17.

Results

Eight studies were included for qualitative and four for quantitative analysis. There was an inverse statistically significant relationship between maternal stress and newborn TL; A one score increase in maternal psychological stress resulted in a 0.04 decrease in the TL of the newborn (B = -0.04, 95% CI = [-0.08, 0.00], p = 0.05). Selectivity analysis showed that the pooled effect size was sensitive to one study; After removing this study, the pooled effect size remained significant (B = -0.06, 95% CI = [-0. 10, -0.02], p < 0.001).

Conclusion

Physiological and environmental factors can significantly affect the TL of newborns. Our results support a significant impact of maternal psychological stress on the TL of a newborn. This association demonstrates the significance of stress in influencing the telomere length, which can be a contributing factor in the infant’s future. Therefore, recognizing this association is crucial for understanding and addressing potential health risks and necessitates the need for additional future studies to validate our findings.
Effect of acute and long-term exercise on leptin levels in depressed outpatients
Authors: Heinen Darlene , Heissel Andreas , Heinzel Stephan , Fydrich Thomas , Ströhle Andreas , Rapp Michael A. , Vogel Heike
Published: December 2023

Background

Depression is a leading cause of disability worldwide and a significant contributor to the global burden of disease. Altered leptin levels are known to be associated with depressive symptoms, however discrepancies in the results of increased or decreased levels exist. Due to various limitations associated with commonly used antidepressant drugs, alternatives such as exercise therapy are gaining more importance. Therefore, the current study investigates whether depressed patients have higher leptin levels compared to healthy controls and if exercise is efficient to reduce these levels.

Methods

Leptin levels of 105 participants with major depressive disorder (MDD; 45.7% female, age mean ± SEM: 39.1 ± 1.0) and 34 healthy controls (HC; 61.8% female, age mean ± SEM: 36.0 ± 2.0) were measured before and after a bicycle ergometer test. Additionally, the MDD group was separated into three groups: two endurance exercise intervention groups (EX) differing in their intensities, and a waiting list control group (WL). Leptin levels were measured pre and post a 12-week exercise intervention or the waiting period.

Results

Baseline data showed no significant differences in leptin levels between the MDD and HC groups. As expected, correlation analyses displayed significant relations between leptin levels and body weight (HC: r = 0.474, p = 0.005; MDD: r = 0.198, p = 0.043) and even more with body fat content (HC: r = 0.755, p < 0.001; MDD: r = 0.675, p < 0.001). The acute effect of the bicycle ergometer test and the 12-week training intervention showed no significant changes in circulating leptin levels.

Conclusion

Leptin levels were not altered in patients with major depression compared to healthy controls and exercise, both the acute response and after 12 weeks of endurance training, had no effect on the change in leptin levels.

Trial registration

The study was registered at the German register for clinical studies (DRKS) and the International Clinical Trials Registry Platform of the World Health Organization https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00008869 on 28/07/2015.
“One community at a time”: promoting community resilience in the face of natural hazards and public health challenges
Authors: Ma Chenwei , Qirui Chen , Lv Yang
Published: December 2023

Background

Resilience is vital for facing natural disasters and public health challenges. Despite the significance of resilience-building activities, there is a scarcity of locally-tailored planning and response strategies, leaving communities incapable of addressing the unique challenges posed by natural disasters and public health crises. This study aims to explore how the “One Community at a Time” approach enhances community resilience in facing natural hazards and public health challenges.

Methods

A systematic review was conducted over journal articles published from January 2001 to April 2023 through PRISMA approach. Multiple databases such as Web of Science and Scopus were thoroughly searched. We used independent screening by two researchers and painstaking data extraction using standardized forms. This approach was adopted to assure the reliability, validity, and precision of our study selection and analysis. The included studies’ quality was evaluated by the Mixed Methods Appraisal Tool.

Results

In the evaluation, 35 studies were deemed eligible for inclusion and underwent in-depth examination. Several major components of “One Community at a Time” have been identified, including social capital and networks, local knowledge and learning, effective governance and leadership, preparedness and response capacity, and adaptive infrastructure and resources. This framework highlights the significance of individualized approaches to resilience-building initiatives, recognizing that each community has specific strengths, needs, and challenges.

Conclusion

Relevant stakeholders can adapt suitable resilient strategies to help prepare and recover from natural hazards and public health challenges. By adopting a localized strategy, stakeholders can collaborate to develop a culture of readiness and resilience, ultimately leading to more sustainable and resilient communities. This framework advises community-based groups, local government, and other stakeholders on prioritizing partnerships, preparedness planning, community participation, and leadership as essential components of creating and maintaining resilience. “One Community at a Time” framework offers practical guidance for community-based organizations, local government, and other stakeholders to prioritize partnerships, preparedness planning, community participation, and leadership as essential components of creating and sustaining resilience.
‘I cannot see ahead’: psychological distress, doomscrolling and dark future among adult survivors following Mw 7.7. and 7.6 earthquakes in Türkiye
Authors: Kartol Aslı , Üztemur Servet , Yaşar Pınar
Published: December 2023

Background

The earthquakes, which occurred on 6 February 2023, affecting a total of eleven provinces in Türkiye, with magnitudes of 7.7 and 7.6, and killing around 50,000 people, caused the greatest loss of life compared to previous earthquakes in Türkiye. In this study, we analyse the psychological status of the adult individuals who experienced the earthquakes three months after the earthquakes in terms of different variables.

Methods

In this research, an analytical cross-sectional study was conducted by applying face-to-face and online questionnaires to 402 adult individuals who had experienced the earthquake. The Depression, Anxiety and Stress Scale (DASS-21), the Dark Future Scale and Doomscrolling Scale were applied. The relationships between variables are discussed in this study using the predictive correlational model.

Results

The results revealed that the participants had very high levels of future anxiety and moderate levels of doomscrolling after the earthquake. Although their psychological distress levels were relatively low, as the psychological distress levels of adult individuals who experienced the earthquake increased, their doomscrolling also increased. In addition, as individuals’ future anxiety increases, their doomscrolling increases similarly. The mediation analysis reveals that the mediating role of future anxiety between psychological distress and doomscrolling is significant (p < .001).

Conclusion

Individuals are more exposed to negative news streams in negative life events that occur beyond their control and they need to search for information. Increased levels of depression, anxiety and stress lead to more exposure to this flow. In addition, future anxiety is also an important trigger of this behaviour. The effects of psychological distress on individuals who survived the earthquake are discussed in the context of the literature.
Orthodontic management of a developing dentigerous cyst related to lower second molar: a case report
Authors: El-Beialy Amr Ragab , BinRahima Abdulmonem Moftah , Al Shhab Mohammed , Mostafa Yehya
Published: December 2023

The dentigerous cyst is a developmental odontogenic asymptomatic cyst, that is associated with the crown of an unerupted or impacted tooth. Early diagnosis is important to avoid any future complications and choose the best treatment option. The purpose of this case report is to describe the management of a dentigerous cyst related to lower second molar in a young female patient using orthodontic traction as a conservative treatment approach. This procedure helps to spare the patient an unnecessary surgical excision procedure and the associated excessive bone removal for a safety margin, stimulates bone healing and promotes the eruption of the cyst-associated tooth.
Evaluation of the reasons for preferring root canal treatment in mature permanent teeth potentially indicated for pulp preservation: a clinical case/photo-based questionnaire study
Authors: Yi Jin-Kyu , Kim An Na , Kwon Kyung Hee
Published: December 2023

Background

With advances in pulp preservation procedures (PPP), indications for PPP extend to exposed pulp with symptoms in teeth with carious lesions. Scenario/text-based questionnaire studies report a high preference for PPP for exposed pulp with no pulpal symptoms. However, negative perceptions towards PPP for exposed pulp in carious teeth are prevalent among dentists. Identifying the differences in PPP preference rates in questionnaire studies and actual clinical situations is necessary to determine the current status of PPP. In this study, a clinical case/photo-based design was devised to overcome the limitations of scenario/text-based questionnaires. This study aimed to evaluate the reasons dentists prefer root canal treatment (RCT) in cases where PPP is potentially indicated.

Methods

A questionnaire containing three cases of PPP with successful results was administered to dentists. The cases were selected to elicit comprehensive responses from the dentists. Clinical photos of the pulp exposure sites were presented to dentists without describing the tooth conditions, including the extent of pulp exposure and tooth decay, pulpal surface conditions, or restorability. The questions were focused on the reasons for selecting RCT in cases where was practiced. Questionnaire data were collected using Google e-forms. Chi-squared and Fisher’s exact test (P < 0.05) were used for statistical analyses.

Results

Pulpal diagnosis was not a dominant factor in treatment decision-making for pulp exposure during caries removal. Reasons for selecting RCT where PPP was potentially indicated included the event of pulp exposure itself and the dentists’ desire to prevent post-PPP symptoms. Apart from symptomatic pulp, the tooth conditions influenced the establishment of pulpal diagnosis and selection of treatment modality. Moreover, the tooth condition and dentists’ desire for good patient prognosis influenced the negative perceptions towards PPP.

Conclusions

Unfavourable tooth conditions, in association with a desire for preventing post-PPP symptoms, prevent dentists from attempting PPP for pulp exposed during caries removal with no/slight symptoms. Improving negative perceptions towards PPP through accumulation of data on the high success rates of PPP is a prerequisite for achieving widespread application of PPP.
Quality of life in patients in South Korea requiring special care after fixed implants: a retrospective analysis
Authors: Yoo Soo-Yeon , Kim Hyun-Jong , Kim Seong-Kyun , Heo Seong-Joo , Koak Jai-Young , Park Ji-Man
Published: December 2023

Background

The study on oral health-related quality of life (OHRQoL) of disabled patients is rare but critical for welfare of patients. The aim of this study was to examine the effect of fixed implants in edentulous areas on OHRQoL in Korean disabled patients.

Methods

The OHRQoL of 63 disabled individuals was evaluated using the Oral Health Impact Profile (OHIP)-14 questionnaires and studied by potential affecting variables such as age, sex, disability severity, and time of disability acquisition. Wilcoxon-signed rank tests were used to examine the OHIP-14 scores for those who had pre/post-fixed implants. Multiple linear regression analysis was used to examine the relationships between factors and OHIP-14 scores before and after implants. A partial correlation analysis was also performed to determine which variables influenced OHIP-14 scores before and after treatment. The Mann-Whitney test was employed for sex and time of disability acquisition analysis (α = 0.05).

Results

Significant improvement was found in OHIP-14 post-implant treatment scores (P < .001). After implant treatment, the severity of disability produced significantly different results (P = .009). Pearson’s correlation coefficient between severity of disability and pre/post-implant OHIP-14 scores was 0.265 (P = .030). After controlling for severity of disability, the results showed older patients had lower OHIP-14 scores (P = .032). No differences were found for sex or time of disability acquisition (congenital vs. acquired).

Conclusions

Fixed implant treatment improved OHRQoL for disabled patients, and the severity of disability was positively correlated with improvement of OHRQoL. For patients with a similar level of disability, the OHRQoL decreased with age.
Proteomic analysis reveals the molecular mechanism of Astragaloside in the treatment of non-small cell lung cancer by inducing apoptosis
Authors: Liu Jiaqi , Sun Yan , Chen Wenjing , Deng Lingling , Chen Mengmeng , Dong Jingcheng
Published: December 2023

Background

Astragaloside III (AS III), a saponin-like metabolite derived from the traditional Chinese medicine Astragali Radix, has been shown to be effective in the treatment of cancer and heart failure, and a variety of digestive disorders. However, its molecular mechanism in the treatment of non-small cell lung cancer (NSCLC) is unknown.

Methods

Human lung cancer A549 cells and NCI-H460 cells and a normal human lung epithelial cell BEAS-2B were treated with different concentrations of AS III. CCK-8 and EdU staining were used to determine the anti-proliferative effects of AS III in vitro. Quantitative proteomic analysis was performed on A549 cells treated with the indicated concentrations of AS III, and the expression levels of apoptosis-related proteins were examined by Western blotting.

Results

AS III treatment significantly inhibited proliferation and increased apoptosis in A549 and H460 cells and modulated functional signaling pathways associated with apoptosis and metabolism. At the molecular level, AS III promoted a reduction in the expression of ANXA1 (p < 0.01), with increased levels of cleaved Caspase 3 and PARP 1. In addition, AS III treatment significantly decreased the LC3-I/LC3-II ratio. The results of experiment in vitro showed that AS III promoted NSCLC apoptosis by down-regulating the phosphorylation levels of P38, JNK, and AKT (p < 0.01), inhibiting the expression of Bcl-2 (p < 0.01), and up-regulating the expression of Bax (p < 0.01).

Conclusion

These findings provide a mechanism whereby AS III treatment induces apoptosis in NSCLC cells, which may be achieved in part via modulation of the P38, ERK and mTOR signaling pathways.
Conceptualising the empowerment of caregivers raising children with developmental disabilities in Ethiopia: a qualitative study
Authors: Szlamka Zsofia , Ahmed Ikram , Genovesi Elisa , Kinfe Mersha , Hoekstra Rosa A. , Hanlon Charlotte
Published: December 2023

Background

Caregivers of children with developmental disabilities (DDs) in Ethiopia experience stigma and exclusion. Due to limited existing services and substantial barriers to accessing care, they often lack support. Caregiver empowerment could help address injustices that hinder their capacity to support their child as they would like. The aim of this study was to explore the meaning and potential role of empowerment for caregivers raising a child with a DD and how empowerment was situated in relation to other priorities in service development.

Methods

This was a qualitative phenomenological study. Semi-structured interviews were conducted in Amharic and English with caregivers of children with a DD (n = 15), clinicians (n = 11), community-based health extension workers (n = 5), representatives of non-governmental organisations working with families with DDs (n = 17), and representatives of local authorities in health, education, and social care (n = 15). Data were analysed thematically.

Results

Three main themes were developed: “Barriers to exercising caregivers’ agency”; “Whose decision is it to initiate empowerment?”; and “Supporting caregivers through support groups”. Caregiver capacity to do what they thought was best for their child was undermined by poverty, a sense of hopelessness, experience of domestic abuse and multiple burdens experienced by those who were single mothers. Caregivers were nonetheless active in seeking to bring about change for their children. Caregivers and professionals considered support groups to be instrumental in facilitating empowerment. Participants reflected that caregiver-focused interventions could contribute to increasing caregivers’ capacity to exercise their agency. A tension existed between a focus on individualistic notions of empowerment from some professionals compared to a focus on recognising expertise by experience identified as vital by caregivers. Power dynamics in the context of external funding of empowerment programmes could paradoxically disempower.

Conclusion

Caregivers of children with DDs in Ethiopia are disempowered through poverty, stigma, and poor access to information and resources. Shifting power to caregivers and increasing their access to opportunities should be done on their own terms and in response to their prioritised needs.
Decision tool of medical endoscope maintenance service in Chinese hospitals: a conjoint analysis
Authors: Zheng Jun , Wei Jingming , Xie Ying , Chen Siyao , Li Jun , Lou Ligang , Sun Jing , Feng Jingyi
Published: December 2023

Background

Medical devices are instruments, apparatus, appliances, software, implants, reagents, materials or other articles that are intended for use in the treatment or diagnosis of disease or injury in humans. Concerning medical endoscope devices, which enable doctors to observe and manipulate the area under examination through a puncture hole in the body cavity or organ, hospitals predominantly consider the quality and cost of maintenance services when making their selection. The effective and efficient provision of maintenance services plays a crucial role in ensuring cost-effective and high-quality management of medical devices. In this study, we have developed an innovative decision tool that analyzed key factors impacting the choice of medical devices’ maintenance service. This tool assists hospitals in evaluating and selecting appropriate maintenance services for medical device, specifically endoscopy devices. Moreover, it also serves as a valuable resource for manufacturers and suppliers to enhance their after-sales service offerings.

Methods

A cross-sectional survey was undertaken in 50 Chinese hospitals, including primary and tertiary hospitals. Moreover, 56 medical staff and 65 medical engineers were recruited from 50 Chinese hospitals to participate the survey. A comprehensive set of factors were defined and investigated. Conjoint analysis and orthogonal design were used for survey design and statistical analysis.

Results

Factors importance and utility values of decision-making factors were analyzed at the aggregate, occupation, and medical institution levels. (1) At the aggregate level, the most critical factor is “maintenance response” and the least important one is “maintenance efficiency”. (2) At the occupation level, medical staff paid more attention to “maintenance response” while medical engineers paid more attention to “maintenance quality”. (3) At the medical institution level, Primary hospitals paid more attention to “maintenance price”, while tertiary hospitals paid more attention to “maintenance quality”.

Conclusions

In general, this study provides a more scientific decision-making tool to both hospitals in choosing maintenance service for medical device such as endoscopy, and it also helps manufacturers and suppliers improve the after-sales service.
Acidosis-mediated increase in IFN-γ-induced PD-L1 expression on cancer cells as an immune escape mechanism in solid tumors
Authors: Knopf Philipp , Stowbur Dimitri , Hoffmann Sabrina H. L. , Hermann Natalie , Maurer Andreas , Bucher Valentina , Poxleitner Marilena , Tako Bredi , Sonanini Dominik , Krishnamachary Balaji , Sinharay Sanhita , Fehrenbacher Birgit , Gonzalez-Menendez Irene , Reckmann Felix , Bomze David , Flatz Lukas , Kramer Daniela , Schaller Martin , Forchhammer Stephan , Bhujwalla Zaver M. , Quintanilla-Martinez Leticia , Schulze-Osthoff Klaus , Pagel Mark D. , Fransen Marieke F. , Röcken Martin , Martins André F. , Pichler Bernd J. , Ghoreschi Kamran , Kneilling Manfred
Published: December 2023

Immune checkpoint inhibitors have revolutionized cancer therapy, yet the efficacy of these treatments is often limited by the heterogeneous and hypoxic tumor microenvironment (TME) of solid tumors. In the TME, programmed death-ligand 1 (PD-L1) expression on cancer cells is mainly regulated by Interferon-gamma (IFN-γ), which induces T cell exhaustion and enables tumor immune evasion. In this study, we demonstrate that acidosis, a common characteristic of solid tumors, significantly increases IFN-γ-induced PD-L1 expression on aggressive cancer cells, thus promoting immune escape. Using preclinical models, we found that acidosis enhances the genomic expression and phosphorylation of signal transducer and activator of transcription 1 (STAT1), and the translation of STAT1 mRNA by eukaryotic initiation factor 4F (elF4F), resulting in an increased PD-L1 expression. We observed this effect in murine and human anti-PD-L1-responsive tumor cell lines, but not in anti-PD-L1-nonresponsive tumor cell lines. In vivo studies fully validated our in vitro findings and revealed that neutralizing the acidic extracellular tumor pH by sodium bicarbonate treatment suppresses IFN-γ-induced PD-L1 expression and promotes immune cell infiltration in responsive tumors and thus reduces tumor growth. However, this effect was not observed in anti-PD-L1-nonresponsive tumors. In vivo experiments in tumor-bearing IFN-γ−/− mice validated the dependency on immune cell-derived IFN-γ for acidosis-mediated cancer cell PD-L1 induction and tumor immune escape. Thus, acidosis and IFN-γ-induced elevation of PD-L1 expression on cancer cells represent a previously unknown immune escape mechanism that may serve as a novel biomarker for anti-PD-L1/PD-1 treatment response. These findings have important implications for the development of new strategies to enhance the efficacy of immunotherapy in cancer patients.
Ultrasound-targeted microbubble destruction promotes PDGF-primed bone mesenchymal stem cell transplantation for myocardial protection in acute Myocardial Infarction in rats
Authors: Sun Zhenxing , Cai Yu , Chen Yihan , Jin Qiaofeng , Zhang Ziming , Zhang Li , Li Yuman , Huang Lei , Wang Jing , Yang Yali , Lv Qing , Han Zhengyang , Xie Mingxing , Zhu Xiangming
Published: December 2023

Background

Ultrasound-targeted microbubble destruction (UTMD) has emerged as a promising strategy for the targeted delivery of bone marrow mesenchymal stem cells (MSCs) to the ischemic myocardium. However, the limited migration capacity and poor survival of MSCs remains a major therapeutic barrier. The present study was performed to investigate the synergistic effect of UTMD with platelet-derived growth factor BB (PDGF-BB) on the homing of MSCs for acute myocardial infarction (AMI).

Methods

MSCs from male donor rats were treated with PDGF-BB, and a novel microbubble formulation was prepared using a thin-film hydration method. In vivo, MSCs with or without PDGF-BB pretreatment were transplanted by UTMD after inducing AMI in experimental rats. The therapeutic efficacy of PDGF-BB-primed MSCs on myocardial apoptosis, angiogenesis, cardiac function and scar repair was estimated. The effects and molecular mechanisms of PDGF-BB on MSC migration and survival were explored in vitro.

Results

The results showed that the biological effects of UTMD increased the local levels of stromal-derived factor-1 (SDF-1), which promoted the migration of transplanted MSCs to the ischemic region. Compared with UTMD alone, UTMD combined with PDGF-BB pretreatment significantly increased the cardiac homing of MSCs, which subsequently reduced myocardial apoptosis, promoted neovascularization and tissue repair, and increased cardiac function 30 days after MI. The vitro results demonstrated that PDGF-BB enhanced MSC migration and protected these cells from H2O2-induced apoptosis. Mechanistically, PDGF-BB pretreatment promoted MSC migration and inhibited H2O2-induced MSC apoptosis via activation of the phosphatidylinositol 3-kinase/serine-threonine kinase (PI3K/Akt) pathway. Furthermore, crosstalk between PDGF-BB and stromal-derived factor-1/chemokine receptor 4 (SDF-1/CXCR4) is involved in the PI3K/AKT signaling pathway.

Conclusion

The present study demonstrated that UTMD combined with PDGF-BB treatment could enhance the homing ability of MSCs, thus alleviating AMI in rats. Therefore, UTMD combined with PDGF-BB pretreatment may offer exciting therapeutic opportunities for strengthening MSC therapy in ischemic diseases.
Lymphovascular invasion is a significant risk factor for non-sentinel nodal metastasis in breast cancer patients with sentinel lymph node (SLN)-positive breast cancer: a cross-sectional study
Authors: Wei Chunyu , Deng Yongqing , Wei Suosu , Huang Zhen , Xie Yujie , Xu Jinan , Dong Lingguang , Zou Quanqing , Yang Jianrong
Published: December 2023

Background

A connection between lymphovascular invasion and axillary lymph node metastases in breast cancer has been observed, but the findings are inconsistent and primarily based on research in Western populations. We investigated the association between lymphovascular invasion and non-sentinel lymph node (non-SLN) metastasis in breast cancer patients with sentinel lymph node (SLN) metastasis in western China.

Methods

This study comprised 280 breast cancer patients who tested positive for SLN through biopsy and subsequently underwent axillary lymph node dissection (ALND) at The People’s Hospital of Guangxi Zhuang Autonomous Region between March 2013 and July 2022. We used multivariate logistic regression analyses to assess the association between clinicopathological characteristics and non-SLN metastasis. Additionally, we conducted further stratified analysis. Results: Among the 280 patients with positive SLN, only 126 (45%) exhibited non-SLN metastasis. Multivariate logistic regression demonstrated that lymphovascular invasion was an independent risk factor for non-SLN in breast cancer patients with SLN metastasis (OR = 6.11; 95% CI, 3.62–10.32, p < 0.05). The stratified analysis yielded similar results.

Conclusions

In individuals with invasive breast cancer and 1–2 positive sentinel lymph nodes, lymphovascular invasion is the sole risk factor for non-SLN metastases. This finding aids surgeons and oncologists in devising a plan for local axillary treatment, preventing both over- and undertreatment.
Comparing breath hold versus free breathing irradiation for left-sided breast radiotherapy by PlanIQ™
Authors: Yuan Ke , Yao Xinghong , Liao Xiongfei , Diao Pen , Xin Xin , Ma Jiabao , Li Jie , Orlandini Lucia Clara
Published: December 2023

Background

Breast cancer is the most widespread cancer in women and young women worldwide. Moving towards customised radiotherapy, balancing the use of the available technology with the best treatment modality may not be an easy task in the daily routine. This study aims to evaluate the effectiveness of introducing IQ-feasibility into clinical practice to support the decision of free-breathing (FB) versus breath-hold (BH) left-sided breast irradiations, in order to optimise the technology available and the effectiveness of the treatment.

Methods

Thirty-five patients who received 3D radiotherapy treatment of the left breast in deep-inspiration BH were included in this retrospective study. Computed tomography scans in FB and BH were acquired for each patient; targets contoured in both imaging datasets by an experienced radiation oncologist, and organs at risk delineated using automatic segmentation software were exported to PlanIQ™ (Sun Nuclear Corp.) to generate feasibility dose volume histogram (FDVHs). The dosimetric parameter of BH versus FB FDVH, and BH clinical dataset versus BH FDVH were compared.

Results

A total of 30 patients out of 35 patients analysed, presented for the BH treatments a significant reduction (p < 0.05) in the heart mean dose ($${{\text{D}}}_{{\text{m}}}$$

D
m

), volume receiving 5 Gy ($${{\text{V}}}_{5{\text{Gy}}}$$

V

5
Gy

) and 20 Gy ($${{\text{V}}}_{20{\text{Gy}}}$$

V

20
Gy

), of 35.7%, 54.5%, and 2.1%, respectively; for the left lung, a lower reduction was registered and significant only for $${{\text{V}}}_{5{\text{Gy}}}$$

V

5
Gy

(21.4%, p = 0.046). For the remaining five patients, the FDVH cut-off points of heart and lung were superimposable with differences of less than 1%. Heart and left lung dosimetric parameters of the BH clinical plans are located in the difficult zone of the FDVH and differ significantly (p < 0.05) from the corresponding parameters of the FDVH curves delimiting this buffer area between the impossible and feasible zones, respectively.

Conclusion

The use of PlanIQTM as a decision-support tool for the FB versus BH treatment delivery modality allows customisation of the treatment technique using the most appropriate technology for each patient enabling accurate management of available technologies.
Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S
Authors: Yang Tzong-Hann , Chen Yu-Fu , Cheng Yen-Fu , Huang Jue-Ni , Wu Chuan-Song , Chu Yuan-Chia
Published: December 2023

Objectives

The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults.

Methods

We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model—which had the greatest AUC of 0.83 (95% CI 0.81–0.85)—was then only used on the holdout testing data.

Results

On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79–0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques—specifically, the LGBM classifier—with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects.

Conclusions

Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.
Safety and antitumor activity of metformin plus lanreotide in patients with advanced gastro-intestinal or lung neuroendocrine tumors: the phase Ib trial MetNET2
Authors: Pusceddu Sara , Corti Francesca , Prinzi Natalie , Nichetti Federico , Ljevar Silva , Busico Adele , Cascella Tommaso , Leporati Rita , Oldani Simone , Pircher Chiara Carlotta , Coppa Jorgelina , Resi Veronica , Milione Massimo , Maccauro Marco , Miceli Rosalba , Tamborini Elena , Perrone Federica , Spreafico Carlo , Niger Monica , Morano Federica , Pietrantonio Filippo , Seregni Ettore , Mariani Luigi , Mazzaferro Vincenzo , Di Liberti Giorgia , Fucà Giovanni , de Braud Filippo , Vernieri Claudio
Published: December 2023

In retrospective studies, metformin use has been associated with better clinical outcomes in diabetic patients with advanced, well-differentiated neuroendocrine tumors (WDNETs). However, prospective evidence of metformin safety and activity is lacking. Here, we conducted the first-in-human phase Ib MetNET2 trial to investigate the safety and antitumor activity of metformin in combination with the somatostatin analog lanreotide autogel (ATG) in both diabetic and non-diabetic patients with advanced WDNETs of the gastrointestinal (GI) or thoracic tract. Enrolled patients received lanreotide ATG 120 mg plus oral metformin, up to a maximum dosage of 2550 mg/day. We enrolled 20 patients, of whom 18 (90%) and 2 (10%) had WDNETs of the GI and thoracic tract, respectively. Fourteen patients (70%) were non-diabetic. With a 5% incidence of SAEs, the study met its primary objective of demonstrating treatment safety. With a median follow-up of 39 months (95% CI 28-NE), median PFS was 24 months (95% CI 16-NE), with 12-month and 24-month PFS probability of 75% (95% CI 58–97) and 49% (95% CI 31–77), respectively. We found no statistically significant PFS differences between diabetic and non-diabetic patients. Among exploratory analyses, the presence of tumor genomic alterations in DNA damage pathways was associated with trend towards worse PFS, whereas a precocious reduction of HOMA-IR index and plasma cholesterol concentration showed a trend towards an association with better PFS. In conclusion, metformin plus lanreotide ATG is a safe and well tolerated combination treatment that is associated with promising antitumor activity in both non-diabetic and diabetic patients with WDNETs, and that warrants further investigation in larger clinical trials.
Physical activity status prevents symptoms of long covid: Sulcovid-19 survey
Authors: Rocha Juliana Quadros Santos , Caputo Eduardo Lucia , Vieira Yohana Pereira , Afonso Max dos Santos , Duro Suele Manjourany Silva , de Oliveira Saes Mirelle
Published: December 2023

Background

Physical activity is indicated as a treatment for Long COVID, but prevention is unknown. This study aimed to investigate the relationship between physical activity (PA) before and after acute SARS-Cov-2 infection and the presence of Long COVID symptoms in adults.

Methods

We used data from the Sulcovid-19, a longitudinal study carried out with individuals who were infected by SARS-Cov-2 between December/2020 and March/2021. Participants were asked about 19 symptoms commonly associated with long COVID. Three PA variables were built, as follows: (1) remained inactive; (2) became inactive; (3) remained active.

Results

2.919 people were interviewed. The prevalence of individuals who had at least one symptom of Long COVID is 48.3% (95%CI 46.5–51.1). Our results showed that 71.8% (95%CI 70.1–73.4) of the individuals remained inactive, 14.9% (95%CI 13.6–16.2) became inactive and 13.3% (95% CI 12.1–14.6) remained active. The likelihood of experiencing long COVID symptoms was reduced in the musculoskeletal (PR 0.70; 95%CI 0.49–0.99), neurological (PR 0.61; 95%CI 0.43–0.88), and respiratory (PR 0.58; 95%CI 0.35–0.96) systems in those who remained active. In addition, the likelihood of experiencing Long COVID symptoms was 7% less in those who remained active.

Conclusions

Continuous PA practice showed important protection effect for Long COVID symptoms in adults.
Splenogonadal fusion: a case report
Authors: Oshiba Ahmed , Abdallah Dina , Abdelaziz Marwa , Ibrahim Amir , Kotb Mostafa , Eshiba Samar , Rizvi Maryam
Published: December 2023

Background

Accessory splenic tissue is a commonly encountered phenomenon in medical literature. Typically, these accessory spleens are found in close proximity to the main spleen, either in the hilum or within the surrounding ligaments. Nevertheless, it is noteworthy that they can also be located in unusual sites such as the jejunum wall, mesentery, pelvis, and, exceptionally rarely, the scrotum. The first documented case of accessory splenic tissue in the scrotum was reported by Sneath in 1913 and is associated with a rare congenital anomaly called splenogonadal fusion. This report describes an infant who presented with a scrotal mass noted by his mother and after examination, investigations, and surgical exploration, it was revealed to be splenogonadal fusion.

Case description

An 8-month-old Caucasian male patient presented with a mass in the left testicle and bluish discoloration of the scrotum, which had been incidentally noticed in the previous 2 months. The general physical examination was unremarkable. Other than a palpable scrotal mass that was related to the upper pole of the testis, the rest of examination was unremarkable. Imaging revealed that this mass originated from the tail of the epididymis without infiltrating the testis and tumor markers were normal. On inguinal exploration, a reddish brown 2 × 2 cm mass was found attached to the upper pole and was completely excised without causing any harm to the testis, vessels, or epididymis. Histopathological evaluation confirmed the presence of intratesticular ectopic splenic tissue.

Conclusion

Although uncommon, splenogonadal fusion can be included in the differential diagnosis of a testicular swelling. Accurate diagnosis allows for appropriate treatment planning which helps to avoid unnecessary radical orchiectomy, which can have a significant impact on the patient’s reproductive and psychological wellbeing.
Emotional dysmetria after cerebellar-pontine stroke: a case report
Authors: Long Rebecca M. , DuVal Michèle , Mulvany-Robbins Bridget , Wagner Amanda N. , Jickling Glen C.
Published: December 2023

Introduction

Pseudobulbar affect, or emotional dysregulation, commonly occurs following stroke. However, it is frequently missed in cases involving the cerebellum, resulting in a lack of treatment, which can directly impact stroke rehabilitation.

Case presentation

A 63-year-old Caucasian female with no history of mood disorders presented with gait instability, dysarthria, and right sided hemiplegia, secondary to cerebellar and pontine ischemic stroke from a basilar occlusion. She underwent endovascular therapy and her deficits gradually improved. However during recovery she began to develop uncontrollable tearfulness while retaining insight that her emotional expression was contextually inappropriate. She was treated with a selective serotonin reuptake inhibitor with reported improvements in her emotional regulation at one year follow up.

Conclusion

This case highlights cerebellar injury as a potential cause of poorly regulated emotions, or an emotional dysmetria. The recognition of this disorder in patients with cerebellar or pontine strokes is critical, as untreated pseudobulbar affect can impact future stroke rehabilitation.
Early detection of infectious bovine keratoconjunctivitis with artificial intelligence
Authors: Gupta Shekhar , Kuehn Larry A. , Clawson Michael L.
Published: December 2023

Artificial intelligence (AI) was developed to distinguish cattle by their muzzle patterns and identify early cases of disease, including infectious bovine keratoconjunctivitis (IBK). It was tested on 870 cattle in four locations, with 170 developing IBK. The AI identified 169 of the 170 cases prior to their identification by veterinarians, and another 17 cases that remained free of IBK signs (sensitivity = 99.4%, specificity = 97.6%). These results indicate the AI can detect emerging IBK cases by muzzle images very early in the disease process and be used as an intervention tool in the prevention of IBK outbreaks.
Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses
Authors: Zheng Yafang , Zhang Lijuan , Ma Shihong , Wu Bian , Chen Peipei , Xu Yan , Tan Wenting , Li Hanzhan , Wu Qiaomei , Zheng Jingxia
Published: December 2023

Background

Numerous studies have explored care interventions to improve the psychological outcome of intensive care unit (ICU) patients, but inconclusive evidence makes it difficult for decision-makers, managers, and clinicians to get familiar with all available literature and find appropriate interventions. This umbrella review aimed to analyze the relationship between care intervention and psychological outcomes of ICU patients based on existing systematic reviews.

Methods

An umbrella review of evidence across systematic reviews and meta-analyses published between 1987 and 2023 was undertaken. We systematically searched reviews that examined the association between care intervention and the improvement of adverse psychological outcomes in ICU patients using PubMed, EMBASE, Web of Science, Cochrane Library, and manual reference screening. The measurement tool (AMSTAR 2) was applied to evaluate the methodological quality of included studies. The excess significance bias, between-study heterogeneity expressed by I2, small-study effect, and evidence class were estimated.

Results

A total of 5110 articles were initially identified from the search databases and nine of them were included in the analysis. By applying standardized criteria, only weak evidence was observed in 13 associations, even though most included reviews were of moderate to high methodological quality. These associations pertained to eight interventions (music therapy, early rehabilitation, post-ICU follow-up, ICU diary, information intervention, preoperative education, communication and psychological support, surrogate decision-making) and five psychological outcomes (post-intensive care syndrome, transfer anxiety, post-traumatic stress disorder, anxiety, and depression). Weak or null association was shown among the rest of the associations (e.g., weak association between music therapy and maternal anxiety or stress level).

Conclusions

The evidence of these eight supporting interventions to improve the adverse psychological outcomes of ICU patients and caregivers was weak. Data from more and better-designed studies with larger sample sizes are needed to establish robust evidence.