bluuebunny/crossref_metadata_2025 huggingface dataset:
Jesse Jackson
Authors: Stanford Karin L. , Jackson Ashley L.
Published: October 2024

The Reverend Jesse Louis Jackson Sr. (b. 8 October 8 1941) is an influential American civil rights leader, Baptist minister, and politician. He was born to Helen Burns and Noah Robinson in Greenville, South Carolina. His mother eventually married Charles Jackson, who later adopted and gave him a new last name. Jackson made historic strides as an African American candidate in his notable bids for the US presidency in 1984 and 1988. These presidential campaigns elevated the role of Blacks in politics—evidenced by Jackson’s status as the first African American to participate in a presidential debate and by successful voter registration campaigns. Jackson’s earliest civil rights action occurred in 1960 when he and seven other students led a sit-in at the segregated Greenville Public Library. Jackson attended the University of Illinois and later transferred to North Carolina A&T, where he became student body and chapter president of Omega Psi Phi fraternity. He also became active in conventional politics, joined the Young Democrats of North Carolina, and worked for North Carolina Governor Terry Sanford. Intent on becoming a minister, Jackson enrolled in Chicago Theological Seminary. During this period, his life changed drastically after meeting Reverend Dr. Martin Luther King Jr. in 1965 while participating in the Selma to Montgomery marches for voting rights. Dr. King appointed Jackson as the national director of Operation Breadbasket, a component of the Southern Christian Leadership Conference’s economic opportunities program. After Dr. King’s assassination, Jackson left the SCLC and established Operation PUSH, People United to Save Humanity, in 1971. In 1984, he created a “Rainbow Coalition” of marginalized groups to fight for human rights and gain a voice in politics. Jackson is renowned for his oratory and expert negotiating skills, marked by his many successful hostage negotiations, including the release of Navy Lieutenant Robert Goodman from Syria during the 1984 presidential election campaign. He is most well known for one of his most recited phrases, “I Am Somebody.” Later in his career, Jackson launched an annual Wall Street conference in partnership with the New York Stock Exchange, brokered deals with corporations to invest in Black communities, authored several books, and hosted a CNN weekly TV show titled “Both Sides with Jesse Jackson.” President Bill Clinton awarded Jackson the Presidential Medal of Freedom in 2000. Diagnosed with Parkinson’s disease in November 2017, he remains one of the most noted leaders of civil rights and global affairs.
Ten-Year Trends in Aerial Stem Rot Management: Evaluating Copper-Based Solutions for Sustainable Potato Cultivation
Authors: Wharton Phillip , Malek Alan , Malek Katie
Published: October 2024

Aerial stem rot (ASR) is an important disease of potato worldwide and is predominantly caused by the soft rot bacteria Pectobacterium carotovorum. It differs from black leg (caused by P. atrosepticum) as it is found later in the season after row closure. The pathogen enters through wounds in the stem and expands outward leaving a distinct black lesion. Lesions spread down the stem as opposed to black leg lesions which spread up the stem from diseased tubers. Ten years of field trials were conducted using a susceptible variety in a randomized complete block design. Treatments consisted of different formulations of copper fungicides starting at row closure and continuing on a seven-day schedule until vine kill. Disease incidence and severity was rated visually, and results were used to calculate the Relative Area Under the Disease Progress Curve (RAUDPC), showing the rate of disease progress. Results showed that the RAUDPC was consistently higher in the untreated check compared to fungicide-treated plots, suggesting these products significantly reduced both disease incidence and severity. However, while the fungicides reduced disease, this did not always translate into higher yields. Nevertheless, factorial analysis of variance of yield by treatment showed significant differences in total yields with fungicide-treated plots outperforming the untreated check with yields at least 3 tonnes/ha higher. There have been few studies on the efficacy of copper fungicides for control of ASR. The findings of this ten-year study should provide growers with the data necessary to make informed decisions on the management of ASR.
Compound heterozygous RYR1‐RM mouse model reveals disease pathomechanisms and muscle adaptations to promote postnatal survival
Authors: Liang Chen , Malik Sundeep , He Miao , Groom Linda , Ture Sara K. , O'Connor Thomas N. , Morrell Craig N. , Dirksen Robert T.
Published: October 2024

Pathogenic variants in the type I ryanodine receptor (RYR1) result in a wide range of muscle disorders referred to as RYR1‐related myopathies (RYR1‐RM). We developed the first RYR1‐RM mouse model resulting from co‐inheritance of two different RYR1 missense alleles (Ryr1TM/SC‐ΔL mice). Ryr1TM/SC‐ΔL mice exhibit a severe, early onset myopathy characterized by decreased body/muscle mass, muscle weakness, hypotrophy, reduced RYR1 expression, and unexpectedly, incomplete postnatal lethality with a plateau survival of ~50% at 12 weeks of age. Ryr1TM/SC‐ΔL mice display reduced respiratory function, locomotor activity, and in vivo muscle strength. Extensor digitorum longus muscles from Ryr1TM/SC‐ΔL mice exhibit decreased cross‐sectional area of type IIb and type IIx fibers, as well as a reduction in number of type IIb fibers. Ex vivo functional analyses revealed reduced Ca2+ release and specific force production during electrically‐evoked twitch stimulation. In spite of a ~threefold reduction in RYR1 expression in single muscle fibers from Ryr1TM/SC‐ΔL mice at 4 weeks and 12 weeks of age, RYR1 Ca2+ leak was not different from that of fibers from control mice at either age. Proteomic analyses revealed alterations in protein synthesis, folding, and degradation pathways in the muscle of 4‐ and 12‐week‐old Ryr1TM/SC‐ΔL mice, while proteins involved in the extracellular matrix, dystrophin‐associated glycoprotein complex, and fatty acid metabolism were upregulated in Ryr1TM/SC‐ΔL mice that survive to 12 weeks of age. These findings suggest that adaptations that optimize RYR1 expression/Ca2+ leak balance, sarcolemmal stability, and fatty acid biosynthesis provide Ryr1TM/SC‐ΔL mice with an increased survival advantage during postnatal development.
Therapeutic effects of FGF21 mimetic bFKB1 on MASH and atherosclerosis in Ldlr−/−.Leiden mice
Authors: Inia José A. , Attema Joline , de Ruiter Christa , Menke Aswin L. , Caspers Martien P. M. , Verschuren Lars , Wilson Maria , Arlantico Alexander , Brightbill Hans D. , Jukema J. Wouter , van den Hoek Anita M. , Princen Hans M. G. , Chen Mark Z. , Morrison Martine C.
Published: October 2024

Fibroblast growth factor 21 (FGF21) is a promising target for treatment of obesity‐associated diseases including metabolic dysfunction‐associated steatohepatitis (MASH) and atherosclerosis. We evaluated the effects of the bispecific anti‐FGF21‐β klotho (KLB) agonist antibody bFKB1 in a preclinical model of MASH and atherosclerosis. Low‐density lipoprotein receptor knockout (Ldlr−/−).Leiden mice received a high‐fat diet for 20 weeks, followed by treatment with an isotype control antibody or bFKB1 for 12 weeks. Effects on plasma risk markers and (histo)pathology of liver, adipose tissue, and heart were evaluated alongside hepatic transcriptomics analysis. bFKB1 lowered body weight (−21%) and adipose tissue mass (−22%) without reducing food intake. The treatment also improved plasma insulin (−80%), cholesterol (−48%), triglycerides (−76%), alanine transaminase (ALT: −79%), and liver weight (−43%). Hepatic steatosis and inflammation were strongly reduced (macrovesicular steatosis −34%; microvesicular steatosis −100%; inflammation −74%) and while the total amount of fibrosis was not affected, bFKB1 did decrease new collagen formation (−49%). Correspondingly, hepatic transcriptomics and pathway analysis revealed the mechanistic background underlying these histological improvements, demonstrating broad inactivation of inflammatory and profibrotic transcriptional programs by bFKB1. In epididymal white adipose tissue, bFKB1 reduced adipocyte size (−16%) and inflammation (−52%) and induced browning, signified by increased uncoupling protein‐1 (UCP1) protein expression (8.5‐fold increase). In the vasculature, bFKB1 had anti‐atherogenic effects, lowering total atherosclerotic lesion area (−38%). bFKB1 has strong beneficial metabolic effects associated with a reduction in hepatic steatosis, inflammation, and atherosclerosis. Analysis of new collagen formation and profibrotic transcriptional programs indicate that bFKB1 treatment may have antifibrotic potential in a longer treatment duration as well.
Antiplatelet Agents in Endovascular Neurointerventional Procedures
Authors: Flesher Kelley , Pathan Sophia , Kofke William Andrew
Published: October 2024

Minimally invasive, image-guided endovascular procedures are becoming increasingly prevalent as techniques and technologies have advanced, particularly within the realm of neurovascular interventions. Endovascular approaches ubiquitously result in endothelial injury with subsequent risk of thromboembolic complications. Periprocedural antiplatelet agent use is an integral component of the management of patients undergoing endovascular neurointerventional procedures. This patient population has a unique risk profile encompassing thromboembolic and hemorrhagic complications simultaneously, and the precise balance of these risks impacts patient outcomes almost as much as the interventional procedure itself. Clinical experience and study consensus demonstrate overall improved outcomes with the use of periprocedural antiplatelet agents, though current practices remain highly institution and practitioner-dependent. This focused review will discuss the major mechanisms of action of antiplatelet agents, and their clinical indications and management in the periprocedural neurointerventional setting. Despite the importance of antiplatelet agents in the management of neurointerventional patients, many questions remain. Further research and clinical expertise are needed to establish standardized, procedure-specific, antiplatelet regimens as well as standardized monitoring of antiplatelet agent regimen efficacy and safety.
Radiographic Indicators of Craniocervical Instability
Authors: Gordillo Alan J. , Magro Matt , Obiri-Yeboah Derrick , Patel Arpan A. , Sarel Vorster , Spiessberger Alexander
Published: October 2024

Study Design:

Single-institution retrospective review.

Objective:

To establish baseline ranges and variability of 7 radiographic measurements of the cervical spine in a healthy patient population as potential diagnostic tools for craniocervical instability.

Summary of Background Data:

Craniocervical instability, common in patients with connective tissue disease such as Ehlers-Danlos Syndrome, often presents with a wide range of symptoms, including neck pain. Current diagnostic methods employ a range of clinical and radiographic features, but diagnostic challenges remain due to missed indications on static imaging and a lack of standardized measurement values and normalized variance.

Methods:

Seventy-two healthy patients with cervical imaging were analyzed. Surgimap software was used to annotate supine computed tomography images, flexion, extension, and neutral x-ray images for measurement. These measurements included the atlanto-dental interval, clival-axial angle, basion-dens interval, basion-axis interval, perpendicular basion to the inferior aspect of C2, also known as Grabb Oakes measurement, and the hard palate to C1 and hard palate to C2. Statistical analysis assessed differences among imaging modalities, and coefficients of variation were calculated for each measurement.

Results:

Our cohort consisted of a total of 72 patients with a mean age of 64 (SD: 13.54). All measurements except for the basion-axial interval and atlanto-dental interval demonstrated a significant difference between extension and flexion x-ray measurements. clivo-axial angle, hard palate to C1, and hard palate to C2 demonstrated the lowest coefficients of variance across imaging modalities.

Conclusion:

Understanding normal variance in cervical measurements is invaluable for accurate CCI diagnosis. Using a cohort of healthy patients, this study delineates the distribution and spread of 7 cervical measurements, delineating reference values and variability in these key measurements and highlighting their potential for use as imaging markers for CCI.

Level of Evidence:

Level III.
The Use of NovoSorb BTM for Trauma Reconstruction: Illustrative Cases and a Proposed Decision-making Tool
Authors: Hendrickson Susan A. , Flod Sara , Misky Adam T. , Senarath-Yapa Kshemendra , Hettiaratchy Shehan
Published: October 2024

Achieving a functional and aesthetic reconstruction following complex trauma is a challenge. Skin substitutes, including acellular dermal matrices, and newer, synthetic options such as NovoSorb biodegradable temporizing membrane (BTM) have given the reconstructive surgeon a useful tool where autologous options have been exhausted, are inappropriate, or would present a suboptimal reconstruction. This case series describes 6 patients admitted to an urban level I major trauma center between July and December 2022. All patients underwent complex reconstructive lower limb surgery using BTM as either a primary or salvage option. In each case, this approach was chosen on a case-by-case basis where it was felt BTM would offer a reconstructive advantage, or where primary reconstructive options had been exhausted. Data were collected retrospectively from case notes. Three patients received BTM as a primary reconstructive option. BTM integrated successfully in all 3. Three patients received BTM as a salvage option. In 1, the exposed fracture site was successfully bridged, and in another, BTM was successfully reapplied over exposed fracture site where BTM had previously failed to incorporate. Although BTM is a relatively new tool in the reconstructive surgeon’s armamentarium, requiring further research into long-term outcomes, cost-effectiveness, and patient satisfaction, it can be a useful and versatile tool.
Hypertension and its determinants in Abu Dhabi population: a retrospective cohort study
Authors: Alketbi Latifa Baynouna , Al Hashaikeh Basil , Fahmawee Toqa , Sahalu Yusra , Alkuwaiti Mouza Hamad Helal , Nagelkerke Nico , Almansouri Mohammad , Humaid Ahmad , Alshamsi Noura , Alketbi Rudina , Aldobaee Muna , Alahbabi Nayla , Alnuaimi Jawaher , Mahmoud Esraa , Alazeezi AlYazia , Shuaib Fatima , Alkalbani Sanaa , Saeed Ekram , Alalawi Noura , Alketbi Fatima , Sahyouni Mohammad
Published: October 2024

Background:

Preventing high blood pressure and its complications requires identifying its risk factors. This study assessed predictors of hypertension and its associated complications among Emirati adults in Abu Dhabi, United Arab Emirates (UAE).

Methods:

This retrospective cohort study was conducted by retrieving data from the Electronic Medical Records (EMR) of Emiratis who participated in a national cardiovascular screening program between 2011 and 2013. The study cohort comprised 8456 Emirati adults (18 years and above): 4095 women and 4361 men. The average follow-up period was 9.2 years, with a maximum of 12 years.

Results:

The age-adjusted hypertension prevalence in Abu Dhabi increased from 24.5% at baseline to 35.2% in 2023. At baseline, 61.8% of hypertensive patients had controlled blood pressure, which increased to 74.3% in 2023. Among those free from hypertension at screening, 835 patients (12.3%) were newly diagnosed during the follow-up period. Using Cox regression, the hypertension prediction model developed included age [P value <0.001, hazard ratio 1.051, 95% confidence interval (CI) 1.046–1.056], SBP (P value <0.001, hazard ratio 1.017, 95% CI 1.011–1.023) and DBP (P value <0.001, hazard ratio 1.029, 95% CI 1.02–1.037), glycated hemoglobin (P < 0.001, hazard ratio 1.132, 95% CI 1.077–1.191), and high-density lipoprotein cholesterol (HDL-C) (P value <0.001, hazard ratio 0.662, 95% CI 0.526–0.832). This prediction model had a c-statistic of 0.803 (95% CI 0.786–0.819). Using survival analysis (Kaplan–Meier), higher blood pressure was associated with more cardiovascular events and mortality during follow-up.

Conclusion:

Targeting population-specific predictors of hypertension can prevent its progression and inform healthcare professionals and policymakers to decrease the incidence, complications, and mortality related to hypertension.
Improving joy at work and reducing burnout in health care workers in Victoria, Australia using the Institute for Healthcare Improvement joy in work framework: A mixed-methods study
Authors: Jordan Joanne E. , Garner Kerryn , Bones Kate , McKenzie Lisa , Linzer Mark , Rathert Cheryl , Goelz Elizabeth , McCall Jesse , Sawyer Eleanor , Baass Briana , Herco Fiona
Published: October 2024

Background

Burnout in health care workers (HCWs) has serious ramifications for individual well-being, patients, organizations, and health systems. Global evidence demonstrates the COVID-19 pandemic has amplified the risk of burnout. Scalable interventions to address burnout are critical to protect HCW well-being.

Purpose

Underpinned by the Conservation of Resources theory, this study examines the impacts of a statewide improvement initiative (the Initiative), using the Institute for Healthcare Improvement Joy in Work (JiW) Framework, to reduce burnout and increase joy at work across participating health care organizations in Victoria, Australia.

Methodology/Approach

An impact evaluation was undertaken utilizing a mixed-methods design. Quantitative outcomes included burnout and joy at work measured using an adapted Mini Z tool. In-depth interviews with implementation teams sought insights into the effectiveness of interventions.

Results

Overall, 20 teams from 17 organizations across diverse health care settings and geographical locations participated. At a statewide level, outcomes in burnout and joy at work were inconclusive due to limited data. However, five out of eight teams reporting sufficient data achieved measurable improvements in one or more outcomes. Qualitative data revealed the Initiative increased workplace resources and supports such as providing “permission” for HCWs to prioritize well-being at work, improved communications between management and HCWs, and increased HCWs' teamwork and camaraderie, resulting in safer and more positive workplaces.

Conclusion and Practice Implications

The JiW Framework, implemented across diverse settings, provided organizations with a structured process to develop multifaceted improvements that resulted in enhanced resources that appeared to improve HCW well-being. Compared to individual well-being support, this approach offers organization-level change and scalability potential.
TikTok as a Source of Education and Misinformation in Lichen Sclerosus
Authors: Foster Jennifer , Sarlashkar Priya , Abraham Olivia , Negris Olivia , Lanthier Jaclyn , Krapf Jill , Mauskar Melissa M.
Published: October 2024

Objectives

The purpose of this study is to evaluate the content, delivery, and quality of medical information for vulvar lichen sclerosus on the social media platform TikTok.

Materials and Methods

This is a descriptive, cross-sectional study. Using the third-party data scraping tool Apify, TikTok videos tagged with #lichensclerosus or “lichen sclerosus” were identified and sorted by view count. A sample of 100 videos was reviewed by 2 independent reviewers, excluding those not discussing lichen sclerosus. Videos were assessed using a coding document, the Patient Educational Materials Assessment Tool, and the DISCERN instrument. Interrater reliability was measured, and statistical analyses included Fleiss' kappa, intraclass correlation coefficient, t tests, and Wilcoxon rank sum test with Holm-Bonferroni correction.

Results

Content creators included patients (46%), health care professionals (30%), and others. Topics focused on clinical disease (52%) and treatment (48%). Evidence-based medicine was discussed in 71.7% of treatment-related videos, while 51.7% included nonevidence-based approaches, with a neutral or positive sentiment. Videos discussing topical steroids often had negative sentiments. Quality assessment revealed 61% of videos were understandable, 27% actionable, and 46% contained misinformation. Videos by health care professionals had less misinformation and higher quality scores compared to patient-generated content. Commercially biased videos were more understandable but contained more misinformation.

Conclusions

TikTok serves as a significant platform for sharing information on lichen sclerosus, but nearly half of the content contains misinformation. Health care professionals need to engage in social media to provide accurate information and counteract misinformation. Enhanced collaboration with patient advocates and careful resource sharing can improve the quality and reliability of medical information available online.
Comparison on clinical efficacy and adverse reactions between TPICC and ultrasound-guided PICC for advanced tumors: A retrospective study
Authors: Zheng Yingshan , Xiang Xia , Li Lixiang , Zhang Li , He Shaoli
Published: October 2024

Comparing the differences in efficacy and adverse reactions on the application between tunnel peripherally inserted central catheter (TPICC) and ultrasound-guided peripherally inserted central catheter (PICC) in patients with advanced tumors. A retrospective investigation was conducted to collect treatment data. We randomly selected 200 patients with advanced tumors who were admitted to our hospital from January 2020 to January 2022 as the research subjects. The observation group consisted of 100 cases of tunnel PICC catheterization, while the control group consisted of 100 cases of PICC catheterization. We observed and compared the catheterization time, PICC puncture success rate, intraoperative blood loss, pain degree, comfort level, and postoperative complication rate between the 2 groups. Compared with the control group, there was no significant difference at the distribution of PICC indwelling time in the observation group, and the difference was not statistically significant (P > .05). The success rate on PICC puncture in the observation group was higher than that on the control group (P < .05). Intraoperative bleeding volume and numerical rating scale (NRS) of the observation group were lower than those of the control group (P < .05). At 1 month postoperatively, comfort ratings in the observation group and the control group were lower than those of their same groups at 1 week postoperatively (P < .05); At 1 week and 1 month postoperatively, comfort rating in the observation group were lower than that in the control group (P < .05). The incidence of postoperative complication in the observation group was lower than that in the control group (P < .05). TPICC improves the success rate on puncture and the post-catheterization comfort, it reduces NRS and the risks on complications, which owns high safety.
Efficacy and safety of different oral anticoagulants for stroke prevention in older patients with atrial fibrillation: A network meta-analysis
Authors: Zhang Han , Liu Feng , Lu Xueli
Published: October 2024

Background:

Various oral anticoagulants have been used for stroke prevention in older patients with atrial fibrillation (AF). However, the optimal anticoagulants for stroke prevention has not yet been developed. We performed a systematic review and network meta-analysis to determine the optimal instructions.

Methods:

We searched for randomized controlled trials (RCTs) from PubMed, Embase, and the Cochrane Library without restriction for publication date or language at January 2024. Any RCTs that compared the effectiveness of a direct oral anticoagulant and a vitamin K antagonist (VKA) for stroke prevention in older patients with AF were included in this network meta-analysis. The Bayesian network meta-analysis used a random effects model and surface under the cumulative ranking curve analysis to rank results. All analyses were done using R software with gemtc package, with statistical significance set at P < .05.

Results:

We included 7 RCTs (79,003 patients) comparing 8 different instructions including Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, Edoxaban 60 mg, Rivaroxaban 15 mg, Rivaroxaban 20 mg, and VKA. Apixaban 5 mg, Dabigatran 110 mg, and Dabigatran 150 mg was more effective than the VKA for reducing stroke or systemic embolism risks, and the difference was statistically significant (P < .05). Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, and Edoxaban 60 mg was associated with a reduction of the intracranial hemorrhage rate than the VKA (P < .05). The surface under the cumulative ranking curve shows that Dabigatran 110 mg ranked first for reducing stroke or systemic embolism risks. Edoxaban 60 mg ranked first for major bleeding. Dabigatran 110 mg ranked first for intracranial hemorrhage. Apixaban 5 mg ranked first for all bleeding events.

Conclusions:

Direct oral anticoagulants were found to have lower rates of thromboembolic events compared to VKAs in older patients with AF. Apixaban 5 mg, Dabigatran 110 mg, Dabigatran 150 mg, Edoxaban 30 mg, and Edoxaban 60 mg were also associated with a reduction of intracranial hemorrhage than VKA.
Exploring the role of aggrephagy-related signatures in immune microenvironment, prognosis, and therapeutic strategies of breast cancer
Authors: Ye Chenbo
Published: October 2024

Breast cancer (BC) is 1 of the most common malignant tumors among women globally. This study aimed to develop a prognostic signature based on aggrephagy-related genes (ARGs). Transcriptomic and clinical data for BC patients were downloaded from the cancer genome atlas and GEO databases. Differential expression analysis, univariate Cox proportional hazards regression and least absolute shrinkage and selection operator Cox regression were employed to construct a prognostic signature. Consensus clustering, evaluation of immune infiltration and drug sensitivity, and gene set enrichment analysis, and development of nomogram were performed. The expression of ARGs was validated using data from the Cancer Cell Line Encyclopedia and clinical samples. Eleven ARGs were abnormally expressed in BC, with 5 showing significant correlations with BC prognosis. Consensus clustering identified 2 molecular subtypes with distinct prognoses. A prognostic signature including 5 ARGs (VIM, TUBB1, TUBA3E, TUBA3D, TUBA1C) was developed, which showed high performance in predicting BC prognosis. The low-risk group showed enrichment in extracellular matrix organization and cell migration processes while chromosome separation was suppressed. Additionally, patients in this group also show activation in several signaling pathways including MAPK, PI3K-AKT, and cAMP pathways, whereas cell cycle and neutrophil extracellular trap formation were significantly inhibited. The signature was also associated with immune infiltration and drug sensitivity. A nomogram incorporating the risk signature, clinical stage and chemotherapy was constructed, demonstrating excellent performance in predicting prognosis. The expression of signature-related genes were validated in patients with BC. This study successfully constructed molecular subtypes and a prognostic signature based on ARGs in BC, and developed a nomogram.
Effect of small dose esketamine on perioperative neurocognitive disorder and postoperative depressive symptoms in elderly patients undergoing major elective noncardiac surgery for malignant tumors: A randomized clinical trial
Authors: Huang Cuifang , Yang Ruimin , Xie Xianlong , Dai Huijun , Pan Linghui
Published: October 2024

Background:

Perioperative neurocognitive disorder and postoperative depressive symptoms are significant complications after surgery. Studies have indicated that esketamine possesses neuroprotective and antidepressant qualities.

Methods:

This trial included 209 patients aged 60 to 86 years undergoing tumor resection who received esketamine (Group E) or not (Group C) during and after surgery. In group E, patients were given an intravenous dose of 0.5 mg/kg of esketamine 10 minutes after induction of general anaesthesia. In addition, esketamine (2 mg/kg) in combination with sufentanil was used for PCIA during 48 hours postoperatively. On the other hand, saline was used as a substitute for esketamine in group C. Cognitive function was evaluated using neuropsychological tests and telephone interview for cognitive status-modified, and symptoms of depression were assessed using Hamilton Depression Rating Scale 17.

Results:

Compared to Group C, patients in Group E exhibited lower rates of depressive symptoms at 3, 7, and 90 days post-surgery (53.9% vs 67.7%, 26.3% vs 47.9%, and 13.3% vs 28.4%). Group E also showed decreased time for Trail Making Test on days 7 and 90. However, there were no significant differences in the incidence of delirium 1 to 5 days post-surgery or cognitive impairment 90 days post-surgery between the 2 groups (12.1% vs 10.9% and 8.4% vs 9.7%).

Conclusions:

Intraoperative low-dose esketamine and postoperative low-dose esketamine combined with sufentanil for patient-controlled intravenous analgesia has been shown to improve postoperative analgesia, alleviate postoperative depressive symptoms, and aid in the recovery of social executive ability. However, this approach did not reduce the incidence of postoperative delirium or postoperative cognitive dysfunction.
The causal association between immune cells and gout: A bidirectional two-sample Mendelian randomization study
Authors: Zeng Yuanyuan , Huang Mu , Zeng Wen , Lei Ling
Published: October 2024

Gout, a metabolic disorder, is increasingly being linked to immune cells. However, the causal relationships between these factors remain unclear. Our study aimed to elucidate the causal relationship between immune cells and gout. Our study used 2-sample Mendelian randomization (MR) to explore the causal relationship between immune cells and gout. It is noteworthy that we utilized 5 methods MR-Egger, weighted median, inverse variance weighted, weighted mode, and simple mode to ensure the reliability of the results. Comprehensive sensitivity analyses were performed to verify the robustness, heterogeneity, and horizontal pleiotropy of the results. After false discovery rate correction (P
FDR <0.20), 3 immunophenotypes were identified: one in the B cell panel, one in the regulatory T cells panel, and another in the T lymphocytes, B lymphocytes, Natural Killer cells panel. Among them, 2 immunophenotypes (CD4-CD8-T cell absolute count and CD25 on IgD + CD24 + B cell) increased the risk of developing gout, whereas the other one immunophenotype (CD45RA + CD28- CD8 + T cell %T cell) decreased the risk of gout. Subsequently, we did not observe heterogeneity and horizontal pleiotropy stable in these data through comprehensive sensitivity analyses. Furthermore, we identified some positive results in reverse MR analysis, but after false discovery rate correction (P
FDR <0.20), no significant results were detected. Our study revealed causal relationships between immune cells and gout, providing novel insights into the prevention and treatment of gout.
Reversible elevation of creatine kinase and creatinine caused by sintilimab-induced hypothyroidism: A case report
Authors: Liu Shu-Rong , Zhao Zhen-Guang , Zhai Rui-Ren , Wang Li-Juan , Yang Chen , Ma Quan-Bin , Wang Li
Published: October 2024

Rationale:

Programmed cell death (PD) -1 inhibitors has significantly improved the prognosis of cancer patients by enhancing antitumor immune responses. However, PD-1 inhibitors are associated with immune-related adverse events, some of which are rare and potentially life-threatening. Thus far, elevated creatine kinase (CK) and creatinine caused by a novel PD-1 inhibitor (sintilimab)-induced hypothyroidism has not yet been reported.

Patient concerns:

A 63-year-old male patient with esophageal cancer who developed hypothyroidism accompanied by unexplained increases in CK and creatinine after sintilimab treatment.

Diagnosis:

Since the increases in CK and creatinine paralleled the decrease in thyroxine, after excluding other potential conditions, we speculated that the muscular and renal dysfunction might be caused by sintilimab-induced hypothyroidism.

Interventions and outcomes:

As the patient’s thyroid function improved with levothyroxine replacement therapy, the levels of CK and creatinine concomitantly returned to normal.

Conclusion and lessons:

The elevated CK and creatinine levels in this patient were caused by sintilimab-induced hypothyroidism. Our case highlights the importance of keeping PD-1 induced hypothyroidism in mind when patients present with unexplained increased levels of CK and creatinine. Hypothyroidism-related muscular and renal dysfunctions, which can be restored with thyroid hormone replacement, need to be identified early and treated promptly so that unnecessary examinations and treatments can be avoided in these patients.
The value of postoperative contrast-enhanced ultrasound parameters in lymph node metastasis, tumor node metastasis, and treatment response evaluation of resected hepatocellular carcinoma
Authors: Ying Chenhao , Yao Yefei , Yang Binjun , Song Haijing
Published: October 2024

To explore the application value of postoperative contrast-enhanced ultrasound (CEUS) parameters for lymph node metastasis (LNM), tumor, node, metastasis staging, and treatment response evaluation of resected hepatocellular carcinoma (HCC). We retrospectively analyzed 100 patients with liver cancer who underwent liver CEUS at our hospital between October 2020 and October 2022. The patient’s LNM, pathological staging, and therapeutic effects were recorded based on the histopathological results. CEUS parameters were analyzed and compared CEUS parameters between different lymph node metastases, pathological stages, and therapeutic effects. Twenty-three patients experienced LNM, 77 patients did not experience LNM; and the rise time (RT), peak intensity (PI), and area under the curve (AUC) of the metastatic group were significantly smaller than those of the nonmetastatic group (P < .05). 44 cases were classified into groups I to II by pathological staging, and 56 cases were classified into groups III to IV. The RT, PI, and AUC of groups III to IV were significantly lower than those of groups I–II (P < .05). Seventy-nine cases were complete necrosis, 21 cases were residual or recurrent; The RT, PI, and AUC of the residual or recurrent group were significantly lower than those of the complete necrosis group (P < .05). The receiver operating characteristic curve shows that RT, PI, and AUC have a certain value in evaluating LNM, pathological staging, and treatment response of HCC, and the combined evaluation/evaluation value of these 3 factors is relatively high. The postoperative CEUS parameters RT, PI, and AUC can be used for LNM, pathological staging evaluation, and treatment response evaluation of HCC. Moreover, the combination of the 3 parameters is feasible and valuable in evaluating LNM, tumor, node, metastasis staging, and treatment response of HCC.
Risk stratification model for foreseeing overall survival in Chinese patients with initially metastatic small-cell lung cancer
Authors: Fu Rong , Jing Chuanqing , Zhang Wei
Published: October 2024

The study was outlined to develop and approve a nomogram and chance stratification demonstrate for foreseeing overall survival of Chinese patients with at first metastatic small-cell lung cancer (SCLC). We collected information from the Surveillance, Epidemiology, and End Results (SEER) database approximately Chinese SCLC patients with at first distant metastases between 2010 and 2015. Patients with incomplete data about the follow-up time or clinicopathological information were excluded. The included patients were randomized into the training and validation set. Univariate and multivariate Cox proportional hazard regression models were performed. By integrating the significant variables screened, a prescient nomogram and risk stratification model were developed. In addition, we collected 198 small-cell lung cancer patients with metastasis at diagnosis from the case database of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine as an external validation cohort. In all, 421 patients were screened from the SEER database. Multivariate examination showed that age (P = .049), sex (P = .001), grade (P = .008), chemotherapy (P = .001), liver metastasis (P = .001), and pleural invasion (P = .012) were independent prognostic factors. The C-indicator of the nomogram to anticipate overall survival was higher than that of the eighth edition of the American Joint Committee on Cancer Tumor Node Metastasis classification system (0.75 vs 0.543; P < .001). A risk stratification model was encouraged to be created to precisely classify patients into 2 prognostic bunches. The survival rates anticipated by the nomogram appeared to have critical qualifications from the Kaplan–Meier curves in the entire SEER cohort. Calibration curves and survival predictions also showed strong accuracy and consistency in the external validation cohort. The nomogram provided a clear prognostic superiority over the traditional Tumor Node Metastasis system. It could help clinicians make individual risk predictions for initially metastatic Chinese SCLC cancer patients and give necessary treatment recommendations.
Serum pentraxin-3 expression varies according to polycystic ovary syndrome phenotypes
Authors: Tanılır Çağıran Fatma , Mavral Nihal , Kalı Zercan , Ecin Seval Müzeyyen
Published: October 2024

Pentraxin-3 (PTX-3) is a multibiological protein involved in cumulus cell expansion, fertilization, and implantation. This study was designed to analyze how circulating PTX-3 levels change in women with polycystic ovary syndrome (PCOS). A total of 50 Turkish participants, 35 of whom had PCOS and 15 of whom were fertile, were included in the study. Patients in the PCOS group were divided into 4 different phenotypes according to the NIH criteria (phenotypes A–D). The number of patients in phenotype A was the highest 13 (37.1%). In the calculations made without phenotyping, the serum ptx3 levels of the PCOS group were found to be significantly lower compared to the fertile control group (3.32 ± 0.73 ng/mL vs 4.97 ± 1.29 ng/mL; P < .001). The ptx3 value of phenotypes A and B was significantly lower than phenotype D (P = .008 and P = .009, respectively). When the phenotypes were compared with the fertile control group, the PTX-3 levels of phenotypes A and B were significantly lower than the fertile group. Although the ptx3 levels of phenotypes C and D were lower than the fertile group, the difference did not reach statistical significance. This is the first study to investigate serum ptx3 levels by phenotype in PCOS. While serum PTX-3 levels decreased in phenotypes A and B, ptx3 levels in phenotypes C and D were similar in fertile patients.
Cervical angiofibroma of soft tissue: A rare case report with literature review
Authors: Shi Yaoqi , Xu Yuhong , Li Minhua , Zheng Weiping , Shan Jiangjing
Published: October 2024

Rationale:

Angiofibroma of soft tissue (AFST) is a rare benign fibrous tumor recently included in the 2020 WHO classification of soft tissue and bone tumors. Currently, there are limited reports on AFST, and pathologists lack sufficient understanding of its clinical and pathological characteristics. There is scarce literature available on AFST in the cervical region.

Patient concerns:

We presented a case of a 49-year-old woman who was admitted to our hospital for emergency treatment due to vaginal bleeding and fatigue. Ultrasound revealed a 63 × 27 mm hypoechoic mass extending from the cervical opening to the external opening, with a hemoglobin level of 58.0 g/L on blood routine.

Diagnoses:

The tissue exhibited a pale-yellow mucinous appearance with distinct tissue boundaries and a fibrous capsule under a microscope. HE staining revealed spindle-shaped fibroblast-like cells with a consistent morphology, thin-walled branching small blood vessels, and dilated blood vessels. Regions with abundant cells and areas with sparse cells were alternately distributed and migrated gradually. Immunohistochemical analysis indicated positive expression of P53, desmin, progesterone receptor, estrogen receptor, epithelial membrane antigen, vimentin, CD68, CD163 in the tumor, but negative expression of P16, S-100, smooth muscle actin, CD117, CD10, STAT-6. CD34 was negative in the tumor cells but positive in the vascular endothelium. The Ki-67 index value was 5%. Pathological examination confirmed a soft tissue angiofibroma of the cervix.

Interventions:

Emergency hysteroscopic surgery was performed following infusion of 3 units of packed red blood cells. A local excision of the cervical mass was performed.

Outcomes:

A 1-month follow-up ultrasound showed no abnormal mass in the cervical canal, and there have been no signs of recurrence to date.

Lessons:

Cervical angiofibroma of soft tissue is a rare tumor with a benign clinical manifestation, minimal local recurrence, and no significant metastatic potential. Treatment primarily involves local resection with a focus on achieving negative surgical margins. By presenting this case, we aim to enhance the diagnostic and differential diagnostic capabilities of pathologists in identifying uterine tumors and preventing misdiagnosis.
International Multicenter Retrospective Study From the Ultra-rare Sarcoma Working Group on Low-grade Fibromyxoid Sarcoma, Sclerosing Epithelioid Fibrosarcoma, and Hybrid Forms
Authors: Giani Claudia , Salawu Abdulazeez , Ljevar Silva , Denu Ryan A. , Napolitano Andrea , Palmerini Emanuela , Connolly Elizabeth A. , Ogura Koichi , Wong Daniel D. , Scanferla Roberto , Rosenbaum Evan , Bajpai Jyoti , Li Zola Chia-Chen , Bae Susie , D’Ambrosio Lorenzo , Bialick Steve , Wagner Andrew J. , Lee Alexander T.J. , Koseła-Paterczyk Hanna , Baldi Giacomo G. , Brunello Antonella , Lee Yeh Chen , Loong Herbert H. , Boikos Sosipatros , Campos Fernando , Cicala Carlo M. , Maki Robert G. , Hindi Nadia , Figura Costanza , Almohsen Shahd S. , Patel Sheyaskumar , Jones Robin L. , Ibrahim Toni , Karim Rooshdiya , Kawai Akira , Carey-Smith Richard , Boyle Richard , Taverna Silvia M. , Lazar Alexander J. , Demicco Elizabeth G. , Bovee Judith V.M.G. , Dei Tos Angelo P. , Fletcher Christopher , Baumhoer Daniel , Sbaraglia Marta , Schaefer Inga-Marie , Miceli Rosalba , Gronchi Alessandro , Stacchiotti Silvia
Published: October 2024

The aim of the study was to report the outcome of primary localized low-grade fibromyxoid sarcoma (LGFMS), sclerosing epithelioid fibrosarcoma (SEF), and hybrid LGFMS/SEF (H-LGFMS/SEF). Patients with primary localized LGFMS, SEF, or H-LGFMS/SEF, surgically treated with curative intent from January 2000 to September 2022, were enrolled from 14 countries and 27 institutions. Pathologic inclusion criteria were predefined by expert pathologists. The primary endpoint was overall survival (OS). Secondary endpoints were crude cumulative incidence (CCI) of local recurrence (LR), CCI of distant metastases (DM), and post-metastases OS (p-OS). Two hundred ninety-four patients (239 LGFMS, 32 SEF, and 23 H-LGFMS/SEF) were identified. At a median(m-) follow-up (FU) of 57.1 months, 12/294 patients died. The 5- and 10-year OS were 99.0% and 95.9% in LGFMS, 86.2% and 67.0% in SEF, and 84.8% and 84.8% in H-LGFMS/SEF, respectively. Predictors of worse OS included pathology, age at surgery, systemic therapy, and radiotherapy. LR developed in 13/294 (4.4%) patients. The observed m-time to LR was 10.7 months. The 5- and 10-yr CCI-LR were 4.7% in LGFMS and 6.6% in SEF, respectively. There were no LR events in H-LGFMS/SEF. The sole predictor of higher risk of LR was histology. DM developed in 23/294 (7.8%) patients. The observed m-time to DM was 28.2 months. The 5- and 10-yr CCI-DM were 1.3% and 2.7% in LGMFS, 29.9% and 57.7% in SEF, 48.9% and 48.9% in H-LGFMS/SEF, respectively. Predictors of higher risk of DM were histology, systemic therapy, and radiotherapy. Primary localized LGFMS treated with complete surgical resection has an excellent prognosis, while about 50% of H-LGFMS/SEF and SEF develop DM within 5 to 10 years. Very long-term FU is needed to understand absolute cure rates.
Discontinuation of Alzheimer Disease Medications in Patients Receiving Home Care Medicine
Authors: Kidana Kiwami , Yamaga Ryonosuke , Fujii Hiroko , Akishita Masahiro , Yamanaka Takashi
Published: October 2024

There is no consensus on how long antidementia medications should be administered to patients with Alzheimer disease (AD). To clarify this issue, we investigated the discontinuation of antidementia medications in Japanese home care settings, including community-dwelling and institutionalized patients. Using medical records from April 2017 to March 2022 at 3 clinics in Tokyo and Chiba prefectures, we selected patients with AD who started receiving home care medicine. Forty-nine patients discontinued antidementia medications during the observation period, there was no apparent deterioration in cognitive function or new occurrence of behavioral and psychological symptoms of dementia caused by the discontinuation of medications. More aggressive discontinuation of AD medications probably is recommended for patients with activities of daily living dysfunction, such as those receiving home care medicine.
Validation of Artificial Intelligence-Based POTTER Calculator in Emergency General Surgery Patients Undergoing Laparotomy: Prospective, Bi-Institutional Study
Authors: Panossian Vahe S , Argandykov Dias , Arnold Suzanne C , Gebran Anthony , Paranjape Charudutt N , Hwabejire John O , DeWane Michael P , Velmahos George C , Kaafarani Haytham MA ,   for the POTTER Validation Group
Published: October 2024

BACKGROUND:

The Predictive Optimal Trees in Emergency Surgery Risk (POTTER) calculator, a widely used interpretable artificial intelligence risk calculator, has been validated in population-based studies and shown to predict outcomes in patients who underwent emergency general surgery better than surgeons. We sought to prospectively validate POTTER.

STUDY DESIGN:

Patients undergoing an emergency exploratory laparotomy for nontrauma indications at 2 academic medical centers between June 2020 and March 2022 were included. POTTER preoperative risk calculations and postoperative outcomes were systematically recorded. POTTER’s performance in predicting 30-day postoperative mortality, septic shock, respiratory failure, bleeding, and pneumonia was assessed using the c-statistic methodology.

RESULTS:

A total of 361 patients were included. The median age was 63 years (interquartile range 51 to 72 years), 45.4% were women, and the overall mortality and morbidity were 24.1% and 51.4%, respectively. POTTER predicted mortality accurately with a c-statistic of 0.90. POTTER also accurately predicted the occurrence of individual postoperative complications, with c-statistics ranging between 0.80 and 0.89.

CONCLUSIONS:

This is the first prospective validation of the artificial intelligence-enabled POTTER calculator. The superior accuracy, user-friendliness, and interpretability of POTTER make it a useful bedside tool for preoperative patient and family counseling.