bluuebunny/crossref_metadata_2025 huggingface dataset:
Flux Balance Analysis Reveals Potential Anti–HIV-1 Metabolic Targets
Authors: Han Runpeng , Luo Fei , Yu Haisheng , Yan Yajun , Gong Yan , Xie Conghua , Cheng Liang
Published: April 2024

Background

Human immunodeficiency virus type 1 (HIV-1) remains a persistent global health challenge. Therefore, a continuous exploration of novel therapeutic strategies is essential. A comprehensive understanding of how HIV-1 utilizes the cellular metabolism machinery for replication can provide insights into new therapeutic approaches.

Methods

In this study, we performed a flux balance analysis using a genome-scale metabolic model (GEM) integrated with an HIV-1 viral biomass objective function to identify potential targets for anti–HIV-1 interventions. We generated a GEM by integrating an HIV-1 production reaction into CD4+ T cells and optimized for both host and virus optimal states as objective functions to depict metabolic profiles of cells in the status for optimal host biomass maintenance or for optimal HIV-1 virion production. Differential analysis was used to predict biochemical reactions altered optimal for HIV-1 production. In addition, we conducted in silico simulations involving gene and reaction knock-outs to identify potential anti–HIV-1 targets, which were subsequently validated by human phytohemagglutinin (PHA) blasts infected with HIV-1.

Results

Differential analysis identified several altered biochemical reactions, including increased lysine uptake and oxidative phosphorylation (OXPHOS) activities in the virus optima compared with the host optima. In silico gene and reaction knock-out simulations revealed de novo pyrimidine synthesis, and OXPHOS could serve as potential anti–HIV-1 metabolic targets. In vitro assay confirmed that targeting OXPHOS using metformin could suppress the replication of HIV-1 by 56.6% (385.4 ± 67.5 pg/mL in the metformin-treated group vs. 888.4 ± 32.3 pg/mL in the control group, P < 0.001).

Conclusion

Our integrated host-virus genome-scale metabolic study provides insights on potential targets (OXPHOS) for anti-HIV therapies.
Diagnosis and rescue of malignant hyperthermia induced by anesthesia during radical surgery in a cervical cancer patient using the National Remote Emergency System: A case report
Authors: Xiao Yang , Yu Rou , Gu Juan
Published: April 2024

Rationale:

Malignant hyperthermia (MH) is a rare yet serious medical complication that typically arises following general anesthesia or the administration of specific anesthetics. Due to the infrequency of MH, anesthesiologists often lack sufficient expertise in identifying and managing it, leading to misdiagnosis and inappropriate treatment. There is an urgent need to enhance the diagnosis and management of MH through the utilization of relevant tools.

Patient concerns:

In this case, a 52-year-old woman underwent radical cervical cancer surgery under general anesthesia, with no family or significant medical history. She experienced a gradual increase in end-tidal carbon dioxide (ETCO2) to a maximum of 75 mm Hg and a rise in body temperature from 36.5 to 37.5 °C in a very short period, as well as a blood gas analysis showing a pH of 7.217.

Diagnosis:

The anesthesiologist immediately used The WeChat applet-based National Remote Emergency System for Malignant Hyperthermia (MH-NRES), and the score was 40, which indicated that the patient was very likely to have MH.

Interventions:

We immediately discontinued sevoflurane and switched total intravenous anesthesia to maintain general anesthesia, with a rapid intravenous infusion of dantrolene sodium.

Outcomes:

The ETCO2 and the temperature quickly dropped to normal, followed by successful completion of the surgery, and the patient was discharged 8 days after surgery.

Lessons:

The experience can provide a basis use of MH-NRES and improve the ability of anesthesiologists to deal with intraoperative MH as well as increase the survival probability of patients.
Prognostic significance of systemic inflammatory parameters in high-grade glial tumor patients: Two center experience
Authors: Oztep Eskici Sukran , Yilmaz Eda Bengi
Published: April 2024

We aimed to determine the prognostic values of the neutrophil-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, body mass index, and prognostic nutritional index scores in patients with high-grade glioma. This was a retrospective observational case series. Between 2015 and 2020, 79 patients with high-grade gliomas 2 oncology centers were included in our study. All patients (n = 79) had high-grade glial tumors and were treated with RT. Sixty-nine (87.3%) patients died, and the median 2 years overall survival was 12.7 months. Recurrence was observed in 25 (31.6%) patients at the end of the treatment. The median recurrence free survival was 24.4 months. There was no significant correlation between systemic inflammation indicators and survival parameters for OS and RFS. Only a marginally significant association between the neutrophil-lymphocyte ratio and RFS was found. Systemic inflammatory parameters and outcomes were not significantly correlated in patients with high-grade gliomas.
Migration of double-J ureteral stent in patients with ureteroileal anastomosis stricture undergoing radical cystectomy and orthotopic neobladder: Analysis risk factors of stent migration
Authors: Oh Chang Hoon , Cho Soo Buem , Lee Hyo Jeong , Kwon Hyeyoung , Hwang Yeok Gu
Published: April 2024

The objective was to evaluate the incidence and degree of double-J ureteral stent (DJUS) migration. Additionally, we aimed to investigate the risk factors associated with stent migration in the orthotopic neobladder group. In this retrospective study, 61 consecutive patients were included; 35 patients (45 DJUS placements) underwent radical cystectomy with orthotopic neobladder and 26 patients (35 DJUS placements) underwent urinary bladder without cystectomy between July 2021 and March 2023. All the patients were treated with a DJUS for ureteric strictures. The technical success rate was 100% in each group. The DJUS migration was significantly higher in the orthotopic neobladder group, with 22 of 45 cases (48.9%), compared to the urinary bladder group, which had 4 of 35 cases (11.4%) (P ≤ .001). Among the patients in the orthotopic neobladder group who experienced DJUS migration, stent dysfunction occurred in 18 cases (81.8%), which was statistically significant (P = .003). Multivariate logistic regression analysis revealed that only the size of the DJUS was significantly and positively associated with migration (odds ratio:10.214, P = .010). DJUS migration can easily occur in patients undergoing radical cystectomy and orthotopic neobladder, and smaller stent sizes are associated with a higher incidence of migration.
Association of carpal tunnel syndrome risk factors with treatment modality selection focusing on corticosteroid injection and surgery: A nationwide population-based study
Authors: Doh Chang Hyun , Kim Ye-Jee , Kim Jae Kwang , Lee Jongjin , Shin Young Ho
Published: April 2024

Several studies have revealed the risk factors for carpal tunnel syndrome (CTS). However, no studies have evaluated the influence of these risk factors on the selection of treatment modalities for CTS. This study aimed to determine the influence of CTS risk factors on the selection of CTS treatment modalities with a focus on corticosteroid injection (CI) and surgery. We conducted a retrospective cohort study of patients aged ≥20 years with newly diagnosed CTS in the Korean health insurance review and assessment service between 2010 and 2019. We evaluated the demographic information, the existence of CTS risk factors, and the applied treatment modalities for CTS, including CI and operation. The CTS risk factors include age, sex, diabetes mellitus, osteoarthritis of the hand or wrist, rheumatoid arthritis, hypothyroidism, gout, chronic kidney disease (CKD) on dialysis, antiestrogen or aromatase inhibitor medication, and a history of distal radius fracture (DRF). Multivariable logistic regression analyses were conducted. Age over 80 years was the most significantly associated factor for the selection of CI in CTS (odd ratio [OR], 2.149; 95% confidence interval [CI], 2.092 to 2.209; P < .001). Among underlying diseases or medications, CKD on dialysis (OR, 4.001; 95% CI, 3.819–4.193; P < .001) was the most significant associated factor for the selection of operation for CTS, followed by a history of DRF (OR, 1.803; 95% CI, 1.749–1.860; P < .001). Old age was the most significantly related factor for selecting CI. Among underlying diseases or medications, CKD on dialysis and the history of DRF were the most significantly related factors for selecting operative treatment. For these patients, clinicians should proactively consider an operation to reduce the long-term discomfort and economic burdens.
Weighted gene co-expression network analysis reveals key biomarkers and immune infiltration characteristics for bronchial epithelial cells from asthmatic patients
Authors: Liu Qianqian , Tang Xiaoli , Xu Haipeng , Wen Jie , Chen Yangyang , Xue Shoubin
Published: April 2024

Background:

Asthma ranks among the most prevalent non-communicable diseases worldwide. Previous studies have elucidated the significant role of the immune system in its pathophysiology. Nevertheless, the immune-related mechanisms underlying asthma are complex and still inadequately understood. Thus, our objective was to investigate novel key biomarkers and immune infiltration characteristics associated with asthma by employing integrated bioinformatics tools.

Methods:

In this study, we conducted a weighted gene co-expression network analysis (WGCNA) to identify key modules and genes potentially implicated in asthma. Functional annotation of these key modules and genes was carried out through gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Additionally, we constructed a protein–protein interaction (PPI) network using the STRING database to identify 10 hub genes. Furthermore, we evaluated the relative proportion of immune cells in bronchial epithelial cell samples from 20 healthy individuals and 88 asthmatic patients using CIBERSORT. Finally, we validated the hub genes and explored their correlation with immune infiltration.

Results:

Furthermore, 20 gene expression modules and 10 hub genes were identified herein. Among them, complement component 3 (C3), prostaglandin I2 receptor (PTGIR), parathyroid hormone-like hormone (PTHLH), and C-X3-C motif chemokine ligand 1 (CX3CL1) were closely correlated with the infiltration of immune cells. They may be novel candidate biomarkers or therapeutic targets for asthma. Furthermore, B cells memory, and plasma cells might play an important role in immune cell infiltration after asthma.

Conclusions:

C3, PTGIR, CX3CL1, and PTHLH have important clinical diagnostic values and are correlated with infiltration of multiple immune cell types in asthma. These hub genes, B cells memory, and plasma cells may become important biological targets for therapeutic asthma drug screening and drug design.
Prognostic impact of CD68+ tumor-associated macrophages in hepatocellular carcinoma: A meta-analysis
Authors: Jin Danwen , Qian Liyong , Chen Jiayao , Yu Ze , Dong Jinliang
Published: April 2024

Background:

Evidence from clinical research suggests that the tumor-associated macrophages (TAMs) were associated with prognosis in hepatocellular carcinoma (HCC). The aim of the present meta-analysis was to conduct a qualitative analysis to explore the prognostic value of CD68 + TAMs in HCC.

Methods:

This study conducted a systematic search in Pubmed, Embase, the Cochrane Library and China National Knowledge Internet from inception of the databases to November 2023. The hazard ratio (HR) and 95% confidence interval (CI) were calculated employing fixed-effect or random-effect models depending on the heterogeneity of the included trials. The Newcastle-Ottawa Scale was used to evaluate the risk of prejudice.

Results:

We analyzed 4362 HCC patients. The present research indicated that the expression levels Of CD68 + TAMs were significantly associated with overall survival (OS) (HR = 1.55, 95% CI: 1.30–1.84) and disease-free survival (DFS) (HR = 1.44, 95% CI: 1.17–1.78). Subgroup analysis based on cutoff values showed that the “Median” subgroup showed a pooled HR of 1.66 with a 95% CI ranging from 1.32 to 2.08, which was slightly higher than the “Others” subgroup that exhibited a pooled HR of 1.40 and a 95% CI of 1.07 to 1.84. The “PT” subgroup had the highest pooled HR of 1.68 (95% CI: 1.19–2.37), indicating a worse OS compared to the “IT” (pooled HR: 1.50, 95% CI: 1.13–2.01) and “Mix” (pooled HR: 1.52, 95% CI: 1.03–2.26) subgroups. Moreover, in the sample size-based analysis, studies with more than 100 samples (>100) exhibited a higher pooled HR of 1.57 (95% CI: 1.28 to 1.93) compared to studies with fewer than 100 samples (<100), which had a pooled HR of 1.45 (95% CI: 1.00–2.10).

Conclusions:

The analysis suggests that CD68 + TAMs were significantly associated with unfavorable OS and DFS in HCC patients, and may be served as a promising prognostic biomarker in HCC. However, more large-scale trials are needed to study the clinical value of TAMs in HCC.
The 100 top-cited articles on chronic kidney disease–mineral and bone disorder: A bibliometric analysis
Authors: Kang Ting , Mao Haixia , Zhang Dongmei , Tang Dan , Ou Santao
Published: April 2024

Background:

Tremendous scientific research has been conducted on chronic kidney disease–mineral and bone disorder (CKD–MBD), while only a few bibliometric analyses have been conducted in this field. In this study, we aim to identify 100 top-cited articles on CKD–MBD and analyze their main characteristics quantitatively.

Methods:

Web of Science was used to search the 100 top-cited articles on CKD–MBD. The following data were extracted and analyzed from the selected articles: author, country of origin, institutions, article type, publication journal, publication year, citation frequency, and keywords.

Results:

Among the 100 top-cited articles, the number of citations ranged between 181 to 2157, with an average number of citations of approximately 476. These articles were published in 23 different journals, with Kidney International publishing the most articles (n = 32). The largest contributor was the United States (n = 63), which was also the country that conducted the most collaborative studies with other nations. The University of Washington contributed the largest number of articles (n = 37). Block GA was the most common first-author (n = 7). The majority of articles were clinical research articles (n = 73), followed by reviews (n = 15). Although almost half of the articles had no keywords, the most concerned research direction was CKD-associated bone disease.

Conclusion:

This is the first bibliometric study of the 100 top-cited articles on CKD–MBD. This study provides the main academic interests and research trends associated with CKD–MBD research.
Cost-effectiveness analysis of durvalumab, tremelimumab, and etoposide-platinum in first-line treatment of extensive-stage small cell lung cancer
Authors: Meng Mingyu , Liu Xiaoxia , Liang Xueyan , Chen Xiaoyu , Li Yan
Published: April 2024

Background:

Durvalumab plus etoposide-platinum (DEP) showed sustained overall survival improvements in patients with extensive-stage small-cell lung cancer (ES-SCLC) compared to etoposide-platinum (EP), but adding tremelimumab to DEP (DTEP) did not significantly improve outcomes. A third-party payer perspective is taken here to evaluate the cost-effectiveness of DTEP, DEP, and EP for ES-SCLC.

Methods:

The cost-effectiveness was evaluated by partitioning survival models into 3 mutually exclusive health states. In this model, clinical characteristics and outcomes were obtained from the CASPIAN. Model robustness was evaluated through 1-way deterministic and probabilistic sensitivity analyses. Outcome measurements included costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio, life-years, incremental net health benefit, and incremental net monetary benefit. The analysis was conducted with a 10-year lifetime horizon in a United States setting.

Results:

Compared with EP, DEP, and DTEP were associated with an increment of 0.480 and 0.313 life-years, and an increment of 0.247 and 0.165 QALYs, as well as a $139,788 and $170,331 increase in cost per patient. The corresponding ICERs were $565,807/QALY and $1033,456/QALY, respectively. The incremental net health benefit and incremental net monetary benefit of DEP or DTEP were −0.685 QALYs and −$102,729, or −0.971 QALYs and −$145,608 at a willingness to pay threshold of $150,000/QALY, respectively. Compared with DTEP, DEP was dominated. DTEP and DEP were 100% unlikely to be cost-effective if the willingness to pay threshold was $150,000/QALY. DEP was cost-effective compared to EP when durvalumab was priced below $0.994/mg. Compared with EP, DEP, and DTEP were unlikely to be considered cost-effective across all subgroups.

Conclusion:

DEP and DTEP were not cost-effective options in the first-line treatment for ES-SCLC compared with EP, from the third-party payer perspective in the United States. Compared with DTEP, DEP was dominated.
Early intrauterine pregnancy with an intrauterine device in place and terminated with spontaneous abortion: A case report
Authors: Chu Yu-Qun , Tien Chin-Tzu , Ding Dah-Ching
Published: April 2024

Rationale:

The overall pregnancy rate in individuals with an intrauterine device (IUD) for contraception is <1%. If pregnancy occurs while an IUD is in place, there is a higher risk of an ectopic pregnancy. We report the case of a woman with an IUD who was 7 weeks pregnant and experienced a spontaneous abortion 1 week later.

Patient concern:

A 32-year-old woman presented to our outpatient department with intermittent vaginal staining for several days.

Diagnoses:

She was 7 weeks pregnant and had an IUD in place for over 4 years. A vaginal examination revealed no vaginal bleeding and no blood clots; however, a parous cervix was observed. The IUD string was not visible. Transvaginal ultrasonography revealed a gestational sac in the uterine cavity, with a fetal pole and a crown-rump length of 11.4 mm. The fetal heart rate was 159 beats/min. The IUD was located in the retroplacental region. The bilateral adnexa appeared normal (right ovary, 2.9 cm; left ovary, 2.5 cm). The patient was diagnosed with an intrauterine pregnancy with an IUD in place and threatened abortion.

Interventions:

Attempts to remove the IUD were abandoned due to its location, and conservative treatment was initiated with Utrogestan (100 mg) administered 3 times a day for 1 week. Bed rest was advised.

Outcomes:

Unfortunately, she experienced a complete abortion 1 week later.

Lessons:

The novelty of this case report lies in the rare occurrence of an intrauterine pregnancy with a long-term IUD in place, the challenges posed by the IUD’s specific location, and the complex management of threatened abortion in this context. Our case highlights the diagnostic management approach for intrauterine pregnancy with an IUD in place. Furthermore, it explores the impact of IUD location on pregnancy prognosis.
Giant retinal pigment epithelial tear following photodynamic therapy for the bullous variant of central serous chorioretinopathy: A case report
Authors: Kimura Eri , Miura Masahiro
Published: April 2024

Rationale:

The bullous variant of central serous chorioretinopathy (CSC) is a severe form of chronic CSC. Patients with the bullous variant of CSC have an increased risk of experiencing multiple pigment epithelial detachments (PEDs) and retinal pigment epithelium (RPE) tears. Photodynamic therapy (PDT) is a treatment for the bullous variant of CSC. RPE tear is a possible postoperative complication of PDT for eyes with PEDs. To our knowledge, no cases of giant RPE tears following PDT for the bullous variant of CSC have been reported previously. This case report presents the first instance of a giant RPE tear after half-time PDT for the bullous variant of CSC, accompanied by a series of images depicting the tear development.

Patient concerns:

A 63-year-old male patient presented with rapidly deteriorating vision in his left eye over a 3-month period. He also reported a previous episode of vision loss in his right eye 2 years prior. Best-corrected visual acuity (BCVA) in the left eye was 0.2.

Diagnosis:

The right eye was diagnosed with chronic non-bullous CSC, while the left eye was diagnosed with the bullous variant of CSC with a large PED.

Interventions:

Half-time PDT was administered to the left eye.

Outcomes:

One month after half-time PDT, a giant RPE tear exceeding 3 clock-hours in size was confirmed in the lower temporal quadrant of the left eye. Three months after the initial half-time PDT, a second half-time PDT was performed owing to recurrent retinal detachment. Two months after the second half-time PDT, the retinal detachment resolved, and BCVA improved to 0.4, 6 months after the second half-time PDT.

Lessons:

In cases where the bullous variant of CSC is complicated by extensive PED, clinicians should consider the potential development of a giant RPE tear as a treatment complication.
Antibiotic susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated at tertiary care hospital in Riyadh, Saudi Arabia
Authors: Al-Sarar Dalia , Moussa Ihab M. , Alhetheel Abdulkarim
Published: April 2024

Staphylococcus aureus is an important human pathogen that has a major impact on public health. The objective of the present work was to determine the prevalence and the pattern of antibiotic susceptibility in S aureus (MRSA) isolates from the King Khalid University Hospital (KKUH) in Riyadh, Saudi Arabia. The isolates were collected from different body sites of infection and the antibiotic susceptibility was confirmed on the Vitek 2 system. A total of 371 MRSA isolates from clinical samples were received over a 12-month period from January 2021 to December 2021. The results showed that infection was predominant among males (55.8%) and most of the isolates occurred in the older age groups, with a mean age of 43.7 years and an age span from <1 to 89 years old. The majority (34.5%) recovered from wound infection followed by (14.6%) from blood. We have observed peaks of MRSA infections during the autumn, especially in September and November. All MRSA isolates were resistant to Amoxicillin + clavulanic acid, Ampicillin, Imipenem, Oxacillin, Cloxacillin, and Penicillin while all isolates were sensitive to Daptomycin and Nitrofurantoin. Furthermore, Vancomycin was resistant in (0.3%) of MRSA isolates, and (2.9%) was resistant to Linezolid. The current study concluded that MRSA strains had developed resistance toward 24 tested antibiotics, including the previous effective drugs vancomycin and linezolid. Therefore, there is an urgent need for continuous review of infection control practices to prevent any further spread of resistant strains.
Primary intraorbital inflammatory lumpy lesion: A rare case report
Authors: Yang Jinxin , Liang Qianlei , Han Liang , Wang Yan , Guo Yongchuan
Published: April 2024

Rationale:

Eosinophilic angiocentric fibrosis (EAF) is considered to be a kind of benign IgG4-related disease, and it is more often found in the nasal cavity. We present a pretty rare case of orbital EAF that is unlike any other reported case for this case is an IgG4 negative orbital EAF and successfully treated by the fronto orbitozygomatic approach surgery.

Patient concerns:

This is a 68-year-old man from a rural area of Inner Mongolia Autonomous Region, went to our hospital for a 2-month history of vision loss with a local hospital orbital computer tomography which showed that there was a lesion in his left orbit. The inspection of the patient revealed that the patient left eye was protruding outward and the left eyelid unable to complete open or close. And his left eyeball movement had difficulty in all directions. Postoperative pathology diagnosed that this was a case of IgG4-negative EAF case.

Diagnoses:

Orbital EAF.

Interventions:

Surgical radical resection and postoperative glucocorticoid therapy.

Outcomes:

After surgery, the left eye vision of this patient increased to 0.6 tested in the standard logarithmic visual acuity chart. And his left eyeball movement dysfunction and eyeball outward protruding get a partially relief.

Lessons:

EAF occurring in the orbit is a very rare disease and immunohistochemical results of EAF can be IgG4 negative.
Aggressive vertebral hemangiomas contain no adipose tissue resulting in thoracic spine kyphosis: A case report
Authors: Wang Liang-Jie , Zou Hong-Mei , Hou Feng , Wang Guan-Xi , Gao Chuan-Ping
Published: April 2024

Rationale:

Aggressive vertebral hemangiomas (AVHs) destroy continuous vertebral bodies and intervertebral discs and resulting in spinal kyphosis is extremely rare. The very aggressive behavior was attributable to its significant vascular component and contained no adipose tissue.

Patient concerns:

We report a case of thoracic spine kyphosis of AVHs with multiple vertebral bodies and intervertebral disc destruction in a 45-year-old woman.

Diagnoses:

Based on the imaging studies, the patient underwent surgical removal of this lesion and spinal reconstruction. Histopathology consistent with vertebral hemangioma and contained no adipose.

Interventions:

The patient underwent surgical removal of the lesion and spinal reconstruction. After subperiosteal dissection of the paraspinal muscles and exposure of the laminae, the laminae of the T5–7 vertebrae were removed and exposing the lesion. The lesion was soft and showed cystic changes, completely curetted and autogenous bone was implanted. Vertebroplasty was performed through T3-T9 pedicles bilaterally. Pedicle screw fixation was performed for segmental fixation and fusion.

Outcomes:

After 9 days of operation, the incision healed cleanly and free of pain. She was discharged in good general condition. The patient remained asymptomatic after follow-up 6 months of postoperative.

Lessons:

AVHs destroy multiple vertebral bodies and intervertebral discs and resulting in spinal kyphosis is extremely rare.
Severe fibromyalgia alleviated by the unique muscle relaxation method of applying low force: A case report
Authors: Amitani Haruka , Nishi Ryusei , Fukumoto Takamasa , Hamada Kazumasa , Kato Ryuichi , Yamamoto Takako , Fuku Yuuki , Sagiyama Kenichiro , Asakawa Akihiro
Published: April 2024

Rationale:

Fibromyalgia (FM) is characterized by idiopathic persistent chronic pain in the ligaments or musculoskeletal system, and more than half of the patients with FM might have migraine headaches. Direct musculoskeletal intervention could be a non-pharmacological management to relieve symptoms. However, patients with severe FM often have intense pain from only a soft touch, thereby rendering musculoskeletal intervention challenging.

Patient concerns:

A 47-year-old man had progressing intense pain, and this affected his everyday life. There were no abnormal physical findings on laboratory examination such as levels of complement, antinuclear antibodies, and C-reactive protein, which were within normal limits. Magnetic resonance imaging did not indicate abnormalities.

Diagnoses, interventions, and outcomes:

The patient satisfied the American College of Rheumatology criteria. Finally, we made a final diagnosis of fibromyalgia. The therapeutic intervention of Kanshoho, the unique muscle relaxation technique with low force, relieved his pain.

Lessons:

If Kanshoho is carefully applied in a state of hospitalization under surveillance by an experienced physician, it could be a promising muscle relaxation method. Relaxing the trapezius muscle and reducing its intramuscular pressure might be key in treating patients with severe FM. However, it needs elucidation of its mechanism.
The impact of obesity-induced inflammation on clonal hematopoiesis
Authors: Pasupuleti Santhosh Kumar , Kapur Reuben
Published: April 2024

Purpose of review

This review meticulously delves into existing literature and recent findings to elucidate the intricate link between obesity and clonal hematopoiesis of indeterminate potential (CHIP) associated clonal hematopoiesis. It aims to enhance our comprehension of this multifaceted association, offering insights into potential avenues for future research and therapeutic interventions.

Recent findings

Recent insights reveal that mutations in CHIP-associated genes are not limited to symptomatic patients but are also present in asymptomatic individuals. This section focuses on the impact of obesity-induced inflammation and fatty bone marrow (FBM) on the development of CHIP-associated diseases. Common comorbidities such as obesity, diabetes, and infection, fostering pro-inflammatory environments, play a pivotal role in the acceleration of these pathologies. Our research underscores a notable association between CHIP and an increased waist-to-hip ratio (WHR), emphasizing the link between obesity and myeloid leukemia. Recent studies highlight a strong correlation between obesity and myeloid leukemias in both children and adults, with increased risks and poorer survival outcomes in overweight individuals.

We discuss recent insights into how CHIP-associated pathologies respond to obesity-induced inflammation, offering implications for future studies in the intricate field of clonal hematopoiesis.
Genomic Catastrophe (Chromothripsis and Polyploidy) Correlates With Tumor Distribution in Extrauterine High-grade Serous Carcinoma
Authors: Yoon Ju-Yoon , Sharma Aarti , Ligon Azra H. , Ramesh Rebecca G. , Soong T. Rinda , Xian Wa , Chapel David B. , Crum Christopher P.
Published: April 2024

Most extrauterine high-grade serous carcinomas (HGSCs) are thought to develop first in the distal fallopian tube. Most models of HGSC assume origin from relatively stable, noninvasive serous tubal intraepithelial carcinomas. However, widespread tumor involvement in the absence of a serous tubal intraepithelial carcinoma could occur after catastrophic genomic events (CGEs; such as chromothripsis or polyploidy). Twenty-six HGSCs assigned to fallopian tube (n = 9, group 1) and/or ovary (n = 9, group 2), and primary peritoneal (n = 8, group 3) were assessed by microarray (Oncoscan). CGEs were identified in 15/26 (57.7%); chromothripsis-like pattern in 13/26 (50.0%) and polyploidy in 6/26 (23.1%). CGE was seen in 4/9 (44.4%), 9/9 (100%), and 2/8 (25%) cases in groups 1. 2, and 3, respectively. Overall, CGEs were seen in 9/9 (100%) cases with grossly evident ovarian parenchymal involvement versus 6/17 (35.3%) without (P = 0.0024). Ovarian size (measured on the long axis) correlated with CGE positivity (P = 0.016). CGEs are significantly more common in HGSCs with ovarian parenchymal involvement compared with those limited to the fallopian tube and/or extraovarian tissues. These associations suggest geographically different tumor growth patterns and support the subdivision of HGSCs according to not only the stage but also tumor distribution. They have implications for clinical and pathologic presentation, trajectory of tumor evolution, and in the case of primary peritoneal HGSCs, potentially unique precursors to tumor transitions that could inform or influence cancer prevention efforts.
Postdischarge Mental Health Care and Emergency General Surgery Readmission for Patients With Serious Mental Illness
Authors: Brown Danielle E. , Rosen Claire B. , Roberts Sanford E. , Moneme Adora , Wirtalla Chris , Kelz Rachel R.
Published: April 2024

Objective:

To determine the association between postdischarge mental health care and odds of readmission after emergency general surgery (EGS) hospitalization for patients with serious mental illness (SMI).

Background:

A mental health visit (MHV) after medical hospitalization is associated with decreased readmissions for patients with SMI. The impact of a MHV after surgical hospitalization is unknown.

Methods:

Using Medicare claims, we performed a retrospective cohort study of hospitalized EGS patients with SMI aged above 65.5 (2016–2018). EGS included colorectal, general abdominal, hepatopancreatobiliary, hernia, intestinal obstruction, resuscitation, and upper gastrointestinal conditions. SMI was defined as schizophrenia spectrum, mood, or anxiety disorders. The exposure was MHV within 30 days of discharge. The primary outcome was 30-day readmission. Secondary outcomes included emergency department presentation and psychiatric admission. Inverse probability weighting was used to evaluated outcomes.

Results:

Of 88,092 analyzed patients, 11,755 (13.3%) had a MHV within 30 days of discharge. 23,696 (26.9%) of patients were managed operatively, 64,395 (73.1%) nonoperatively. After adjustment for potential confounders, patients with a postdischarge MHV had lower odds of acute care readmission than patients without a MHV in both operative (OR=0.60; 95% CI: 0.40–0.90) and nonoperative (OR=0.67; 95% CI: 0.53–0.84) cohorts. There was no association between postdischarge MHV and ED presentation or psychiatric admission in the operative or nonoperative groups.

Conclusions:

Postdischarge MHV after EGS hospitalization was associated with decreased odds of readmission for patients with SMI managed operatively and nonoperatively. In older EGS patients with SMI, coordination of MHVs may be a mechanism to reduce readmission disparities.
Effects of Integrating Different Types of Physical Activity Into Virtual Rapid Word Learning Instruction for Children Who Are Deaf and Hard of Hearing
Authors: Werfel Krystal L. , Lund Emily A.
Published: April 2024

The purpose of this study was to compare three intervention conditions in virtual rapid word learning instruction for young children who are deaf and hard of hearing (DHH): traditional, general physical activity, and semantic richness physical activity. We focused on an initial step in learning a new word: mapping a word form to a referent. Fourteen children who are DHH and 14 children with typical hearing (TH) participated in a pseudoword-learning virtual session in each condition, and receptive and expressive knowledge of targeted pseudowords was assessed. Of interest was the impact of different types of physical activity on rapid learning of word-like forms. There was an interaction of group and condition for expressive production of pseudowords. Children who were DHH learned to produce more pseudowords in the general physical activity condition, whereas children with TH learned to produce more pseudowords in the semantic richness physical activity condition. There were no effects of group or condition on receptive learning of pseudowords. Children who are DHH can rapidly map word-like forms to referents via teleintervention, and physical activity may interact with word learning differently for children who are DHH and children with TH.
Coordinating Multiple Language Levels in Writing
Authors: Silliman Elaine R. , Bahr Ruth H. , Danzak Robin L. , Brea-Spahn Maria Rosa
Published: April 2024

One aim of this article is to shift mindsets from the traditional identification of written language abilities that are “missing” in students with specific learning disabilities (SLDs) to writing assessment as the discovery of more complex language strengths foundational to success across disciplines. The multiple language-levels (MLL) perspective is grounded on identifying strengths in written language that may be present in students’ responses to classroom writing activities. We used MLL to examine the compositions of 19 students in grades 4–9 who were classified with SLDs and struggled with academic writing. Their writing assignment was to explain how astronauts wrote about space exploration. The MLL approach revealed hidden strengths at the big picture (global or thematic) and close-up (local) levels of composing. Patterns of strengths discovered at the global and local levels are described with four case examples and instructional implications are noted. Suggestions for treatment are also provided.
Evidence-based practice — implementation level and attitude among physical, occupational, and speech and language therapists in Germany: status quo
Authors: Reinecke Sarah , Mijic Marko , Gerhard Janina , Jung Andrés , Ernst Kathrin , Dreher Christian , Lohmann Marieke , Koch Maren , Jahjah Akram , Fichtemüller Andrea , Balzer Julia
Published: April 2024

Introduction:

Evidence-based practice (EBP) is an important component of clinical practice in public health. Its implementation involves interpreting scientific studies and then applying this knowledge to clinical decision-making. In Germany, the therapy professions are often trained in non-academic medical schools, and only a small number of therapists are university graduates.

Aims:

This study assessed the current status of EBP among physiotherapists, occupational therapists, and speech and language therapists and to determine whether academization influences the implementation of EBP in Germany.

Methods:

To assess the EBP implementation level and therapists’ attitudes toward EBP, a cross-sectional study was conducted using the German version of the Evidence-Based Practice Inventory (EBPI), which consists of five dimensions: attitude; subjective norm; perceived behavioral control; decision-making; and intention and behavior. The structural validity and internal consistency of the EBPI survey were also tested.

Results:

Of the 2,412 responses, only 557 were eligible. There were statistically significant differences between academically educated vs. non-academically educated therapists in four of the five EBPI dimensions. Furthermore, four of the five dimensions had sufficient unidimensionality and internal consistency.

Conclusion:

There are differences between academically educated and non-academically educated therapists regarding EBP knowledge, attitudes, and implementation. Academically educated therapists are more likely to use EBP than non-academically educated therapists. There are still barriers to clinical application that need to be addressed.

Spanish abstract:

http://links.lww.com/IJEBH/A195
Exceptional association of two species of bacteria causing acute appendicitis: Haemophilus influenzae and Enterobacter cloacae
Authors: ADIL Fatima Zahra , BENAISSA Elmostafa , BEN LAHLOU Yassine , LAAMARA Leila , BSSAIBIS Fatna , MALEB Adil , CHADLI Mariama , ELOUENNASS Mostafa
Published: April 2024

Appendicitis, typically caused by appendiceal lumen obstruction, is a prevalent abdominal surgical emergency worldwide. While most cases involve Enterobacterales, Haemophilus influenzae, primarily known for upper respiratory infections, is infrequently associated with gastrointestinal infections. This article presents an exceptional case of acute appendicitis caused by both Haemophilus influenza and Enterobacter cloacae in a 15-year-old child, highlighting the significance of recognizing uncommon pathogens in appendicitis and emphasizing the necessity for thorough microbiological investigations to refine diagnostic approaches.
Remodeling of the brain angioarchitecture in experimental chronic neurodegeneration
Authors: Thomsen Maj Schneider , Kostrikov Serhii , Routhe Lisa Juul , Johnsen Kasper Bendix , Helgudóttir Steinunn Sara , Gudbergsson Johann Mar , Andresen Thomas Lars , Moos Torben
Published: April 2024

Background

Chronic neurodegenerative diseases are characterized by substantial neuroinflammation with accumulation of macrophages, reactive microglia, and reactive astrocytes. Impairment of the brain vasculature is also commonly seen in chronic neurodegeneration with causal links warranting further investigation.

Methods

To address the effects of chronic neurodegeneration on regional vasculature, we performed a unilateral injection of a glutamate receptor agonist ibotenic acid into striatum of adult rats, which caused excitotoxicity in the substantia nigra pars reticulata (SNpr) due to imbalance between inhibitory inputs from the striatum and excitatory signals from the subthalamic nucleus. Brains were examined at 28 days (short-term neurodegeneration) and 91 days (long-term neurodegeneration). Dissected brain samples were analyzed for protein and gene expression using immunohistochemistry and qPCR. Brains were further analyzed for remodeling of vasculature labeled with wheat germ agglutinin (WGA) Alexa Fluor™ 647 conjugate using 3D deep confocal microscopy of optically cleared samples combined with machine learning-based image analysis.

Results

The resulting neurodegeneration was accompanied by neuroinflammation, verified by the expression of inflammatory markers with gradual, regional loss of brain tissue. An in-depth analysis of the angioarchitecture of the degenerating SNpr revealed substantial changes of the vasculature with higher density, increased diameter, and number of tortuous vessels already after 28 days continuing at 91 days. Interestingly, the vascular remodeling changes occurred without changes in the expression of endothelial tight junction proteins, vascular basement membrane proteins, or markers of angiogenesis.

Conclusions

These results demonstrate how neurodegeneration causing prominent tissue loss in SNpr also leads to substantial remodeling of the angioarchitecture, while not altering the structural integrity of the vessel wall judged from the continuous expression of hallmarks of brain endothelial cells and the vascular basement membrane. We propose that this remodeling occurs as a consequence of the loss of brain tissue and with the resulting changes leaving the vasculature prone to additional vascular pathologies like vessel occlusion or formation of aneurysms.
Enteric glia regulate Paneth cell secretion and intestinal microbial ecology
Authors: Prochera Aleksandra , Muppirala Anoohya N. , Kuziel Gavin A. , Soualhi Salima , Shepherd Amy , Sun Liang , Issac Biju , Rosenberg Harry J. , Karim Farah , Perez Kristina , Smith Kyle H. , Archibald Tonora H. , Rakoff-Nahoum Seth , Hagen Susan J. , Rao Meenakshi
Published: April 2024

Glial cells of the enteric nervous system (ENS) interact closely with the intestinal epithelium and secrete signals that influence epithelial cell proliferation and barrier formationin vitro. Whether these interactions are importantin vivo,however, is unclear because previous studies reached conflicting conclusions [1]. To better define the roles of enteric glia in steady state regulation of the intestinal epithelium, we characterized the glia in closest proximity to epithelial cells and found that the majority expressPLP1in both mice and humans. To test their functions using an unbiased approach, we genetically depleted PLP1+cells in mice and transcriptionally profiled the small and large intestines. Surprisingly, glial loss had minimal effects on transcriptional programs and the few identified changes varied along the gastrointestinal tract. In the ileum, where enteric glia had been considered most essential for epithelial integrity, glial depletion did not drastically alter epithelial gene expression but caused a modest enrichment in signatures of Paneth cells, a secretory cell type important for innate immunity. In the absence of PLP1+glia, Paneth cell number was intact, but a subset appeared abnormal with irregular and heterogenous cytoplasmic granules, suggesting a secretory deficit. Consistent with this possibility, ileal explants from glial-depleted mice secreted less functional lysozyme than controls with corresponding effects on fecal microbial composition. Collectively, these data suggest that enteric glia do not exert broad effects on the intestinal epithelium but have an essential role in regulating Paneth cell function and gut microbial ecology.
Cytogenetic comparison of Cuscuta psorothamnensis and C. veatchii (Convolvulaceae), two species originated from recurrent hybridization between the same diploid parents
Authors: Moura Amalia Ibiapino , Urdampilleta Juan , Garcia Miguel A. , Pedrosa-Harand Andrea , Stefanovic Sasa , Costea Mihai
Published: April 2024

Genus Cuscuta L. (Convolvulaceae) exhibits cases of hybridization and allopolyploidy. Section Denticulatae, subg. Grammica, includes four species: the allopolyploids, C. veatchii and C. psorothamnensis (2n = 60), which originated from two independent reticulation events between the diploids, C. denticulata and C. nevadensis (2n = 30). The allopolyploids are morphologically similar, but are differing in their geographical distribution and host specificity. While cytogenetic data have been reported for C. veatchii, this study aims to provide a comparative analysis with C. psorothamnensis. To characterize the chromosomal complement of C. psorothamnensis and compare it with C. veatchii, we used CMA/DAPI banding, FISH, and GISH. The karyotypes of both species displayed similarity in chromosome number, size, and symmetry, and interphase nucleus organization. Both species exhibited a pair of 5S and 35S rDNA sites adjacent on the same chromosome. The number of 5S rDNA sites in C. psorothamnensis is variable, with some individuals displaying four, five, and six sites. Our results show: 1) the chromosomal pair carrying adjacent 5S and 35S rDNA in C. denticulata is retained in the polyploids; 2) the loss of C. nevadensis rDNA sites occurred in both tetraploids; 3) C. psorothamnensis and C. veatchii are allopolyploids part of a species complex, originated from successive independent hybridization events between C. denticulata and C. nevadensis; and 4) C. psorothamnensis is probably more recent in origin than C. veatchii based on the degree of diploidization. This cytogenetic comparison allows us to understand the processes involved in the emergence of new polyploid species by hybridization.
The path toward generalizable clinical prediction models
Authors: Hieronymus Fredrik , Hieronymus Magnus , Sjöstedt Axel , Nilsson Staffan , Näslund Jakob , Lisinski Alexander , Østergaard Søren Dinesen
Published: April 2024

The peaking phenomenon refers to the observation that, after a point, the performance of prediction models starts to decrease as the number of predictors (p) increases. This issue is commonly encountered in small datasets (colloquially known as “small n, large p” datasets or high-dimensional data). It was recently reported based on analysis of data from five placebo-controlled trials that clinical prediction models in schizophrenia showed poor performance (average balanced accuracy, BAC, 0.54). This was interpreted to suggest that prediction models in schizophrenia have poor generalizability. In this paper we demonstrate that this outcome more likely reflects the peaking phenomenon in a small n, large p dataset (n=1513 participants, p=217) and generalize this to a set of illustrative cases using simulated data. We then demonstrate that an ensemble of supervised learning models trained using more data (18 placebo-controlled trials, n=4634 participants), but fewer predictors (p=33), achieves better prediction (average BAC = 0.64) which generalizes to out-of-sample studies as well as to data from active-controlled trials (n=1463, average BAC = 0.67). Based on these findings, we argue that the achievable prediction accuracy for treatment response in schizophrenia— and likely for many other medical conditions—is highly dependent on sample size and the number of included predictors, and, hence, remains unknown until more data has been analyzed. Finally, we provide recommendations for how researchers and data holders might work to improve future data analysis efforts in clinical prediction.