bluuebunny/crossref_metadata_2025 huggingface dataset:
Phase II study of everolimus for recurrent or progressive pediatric ependymoma
Authors: Bowers Daniel C , Rajaram Veena , Karajannis Matthias A , Gardner Sharon L , Su Jack Meng-Fen , Baxter Patricia , Partap Sonia , Klesse Laura J
Published: February 2023

Background

Preclinical studies have suggested that mTOR pathway signaling may be a potential therapeutic target for childhood ependymoma.

Methods

A phase II clinical trial (ClinicalTrials.gov identifier: NCT02155920) of single-agent everolimus was performed to test the hypothesis that mTOR pathway inhibition would result in tumor responses for children with recurrent and/or progressive ependymomas.

Results

Eleven subjects [sex: 4 females (36.4%); median age: 8 years (range: 2-15 years); race: 9 white; prior therapies: median 6 (range: 3-9)] were enrolled on the study. Ten primary tumors were located in the posterior fossa and one primary tumor was located in the spinal cord. Eight of 9 tumors were PF-A subtype epenydmomas. All subjects were treated with oral everolimus 4.5 mg/m2/day (each cycle = 28 days) that was titrated to achieve serum trough levels of 5-15 ng/ml. Overall, everolimus was well tolerated; except for a single event of grade 3 pneumonia, all adverse events were grade 1-2. No objective tumor responses were observed. Participating subjects experienced tumor progression and discontinued therapy after a median of 2 cycles of therapy (1 cycle = 2; 2 cycles = 6; 3, 4, and 8 cycles = 1 each).

Conclusions

Everolimus does not appear to have activity for children with recurrent or progressive PF-A ependymoma.
Genomic decoding of breeding history to guide breeding-by-design in rice
Authors: Chen Zhuo , Bu Qingyun , Liu Guifu , Wang Maoqing , Wang Hongru , Liu Huazhao , Li Xiufeng , Li Hong , Fang Jun , Liang Yan , Teng Zhenfeng , Kang Sai , Yu Hong , Cheng Zhukuan , Xue Yongbiao , Liang Chengzhi , Tang Jiuyou , Li Jiayang , Chu Chengcai
Published: February 2023

Deciphering the intrinsic molecular logic of empirical crop breeding from a genomic perspective is a decisive prerequisite for breeding-by-design (BbD), but remains not well established. Here, we decoded the historical features of past rice breeding by phenotyping and haplotyping 546 accessions covering the majority of cultivars bred in the history of Northeast China (NEC). We revealed that three groups founded the genetic diversities in NEC rice with distinct evolution patterns and traced and verified the breeding footprints to known or genome-wide association study (GWAS)-detected quantitative trait loci (QTLs), or introgressions from indica sub-species with chronological changes in allele frequencies. Then we summarized a rice breeding trend/principle in NEC, and combined with the successful example in breeding and application of Zhongkefa5 to demonstrate the guiding value of our conclusion for BbD in practice. Our study provides a paradigm for decoding the breeding history of a specific crop to guide BbD, which may have implications in different crop breeding.
Eczema Monkeypoxicum in a Female Patient With Atopic Dermatitis
Authors: Napoli Emma , Frizzell Madeline , Gravell Clark , Vallejo Sergio , Theodore Shasta , Chen Karen , Siddiqui Huma , Dunn Justin , Marrufo Dora , Cadena Jose , Danaher Patrick J
Published: February 2023

A female patient with atopic dermatitis who had recently received a tattoo presented with severe right ear pain and several vesiculopustular lesions. Over 1 week, she developed approximately 80 widely distributed lesions. Laboratory testing confirmed mpox (previously monkeypox) virus, and no further lesions developed after initiation of oral tecovirimat.
Polysulfide metabolizing enzymes influence SqrR-mediated sulfide-induced transcription by impacting intracellular polysulfide dynamics
Authors: Shimizu Takayuki , Ida Tomoaki , Antelo Giuliano T , Ihara Yuta , Fakhoury Joseph N , Masuda Shinji , Giedroc David P , Akaike Takaaki , Capdevila Daiana A , Masuda Tatsuru
Published: February 2023

Sulfide plays essential roles in controlling various physiological activities in almost all organisms. Although recent evidence has demonstrated that sulfide is endogenously generated and metabolized into polysulfides inside the cells, the relationship between polysulfide metabolism and polysulfide-sensing mechanisms is not well understood. To better define this interplay between polysulfide metabolism and sensing in cells, we investigated the role of polysulfide-metabolizing enzymes such as sulfide:quinone oxidoreductase (SQR) on the temporal dynamics of cellular polysulfide speciation and on the transcriptional regulation by the persulfide-responsive transcription factor SqrR in Rhodobacter capsulatus. We show that disruption of the sqr gene resulted in the loss of SqrR repression by exogenous sulfide at longer culture times, which impacts the speciation of intracellular polysulfides of Δsqr vs. wild-type strains. Both the attenuated response of SqrR and the change in polysulfide dynamics of the Δsqr strain is fully reversed by the addition to cells of cystine-derived polysulfides, but not by glutathione disulfide (GSSG)-derived polysulfides. Furthermore, cysteine persulfide (CysSSH) yields a higher rate of oxidation of SqrR relative to glutathione persulfide (GSSH), which leads to DNA dissociation in vitro. The oxidation of SqrR was confirmed by a mass spectrometry-based kinetic profiling strategy that showed distinct polysulfide-crosslinked products obtained with CysSSH vs. GSSH. Taken together, these results establish a novel association between the metabolism of polysulfides and the mechanisms for polysulfide sensing inside the cells.
Vitamin D status in ANCA-associated vasculitis
Authors: Doubelt Irena , Cuthbertson David , Carette Simon , Khalidi Nader A , Koening Curry L , Langford Carol , McAlear Carol A , Moreland Larry W , Monach Paul , Seo Philip , Specks Ulrich , Warrington Kenneth J , Merkel Peter A , Pagnoux Christian
Published: February 2023

Objective

Vitamin D might participate in the pathogenesis of several immune-mediated diseases, but few related data are available for ANCA-associated vasculitis (AAV). In this study, we analysed the association between vitamin D status and disease in patients with AAV.

Methods

Serum levels of 25(OH)D2/3 were measured in 125 randomly selected patients with AAV [granulomatosis with polyangiitis (n = 50), eosinophilic granulomatosis with polyangiitis (n = 50) or microscopic polyangiitis (n = 25)] enrolled in the Vasculitis Clinical Research Consortium Longitudinal Studies at the time of enrolment and a subsequent relapse visit. Sufficient, insufficient and deficient vitamin D status were defined as 25(OH)D3 levels >30, 20–30 and ˂20 ng/ml, respectively.

Results

Seventy of 125 patients (56%) were female, with a mean age of 51.5 (16) years at diagnosis; 84 (67%) were ANCA positive. Mean 25(OH)D was 37.6 (16) ng/ml, with vitamin D deficiency in 13 (10.4%) and insufficiency in 26 (20.8%). In univariate analysis, lower vitamin D status was associated with male sex (P = 0.027) and disease activity (P = 0.047). In univariate and multivariate analyses, deficient vitamin D status was associated with disease activity (P = 0.015). Mean 25(OH)D status in the 21 patients with a subsequent relapse did not differ between baseline and relapse visit [37.8 (16) vs 38.0 (10) ng/ml, respectively; P = 0.92].

Conclusion

Most patients with AAV have sufficient 25(OH)D levels, although those with lower vitamin D status were more likely to be male and to have active disease. Whether optimization of vitamin D status alters disease manifestations or activity in AAV remains to be determined.

Trial Registration

Vasculitis Clinical Research Consortium (VCRC) Longitudinal Study (LS), NCT00315380, https://clinicaltrials.gov/ct2/show/NCT00315380
Surgical Site Infection After Primary Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis
Authors: Rudic Theodore N. , Althoff Alyssa D. , Kamalapathy Pramod , Bachmann Keith R.
Published: February 2023

Study Design.

Retrospective review.

Objective.

The purpose of this study was to quantify the incidence and factors associated with surgical site infection (SSI) in pediatric patients undergoing spinal fusion for adolescent idiopathic scoliosis (AIS).

Summary of Background Data.

Infection is a morbid complication after spinal fusion. The incidence of SSI after pediatric spinal fusion is likely underestimated; the use of a national database allows for a comprehensive assessment of this rare outcome.

Materials and Methods.

The PearlDiver Database was used to identify AIS patients who underwent primary instrumented spinal fusion between 2010 and 2019 and relevant patient records were queried to identify infections within 7, 30, and 90 postoperative days. Patients with nonidiopathic scoliosis were excluded. Logistic regression was used to evaluate risk factors associated with postoperative infection.

Results.

Out of 9801 patients who underwent primary fusion for AIS, 44 patients (0.4%) developed an infection within 7 postoperative days. The 30 days and 90 days incidences were 1.9% and 2.7%, respectively. Within 90 days, 154 (57.7%) of the patients with infection had undergone reoperation, of whom 72 underwent multiple reoperations. Obesity and male sex (P < 0.05) were significantly associated with postoperative infection. The length of fusion was not a significant factor in the development of SSI (P > 0.05). Eleven patients underwent an operation requiring hardware removal within 90 days. There were no significant factors associated with those undergoing hardware removal compared with those undergoing surgical debridement.

Conclusions.

The study identified a 2.7% 90 days incidence of SSI after posterior spinal fusion for AIS, with 57.7% of all infections requiring a return to the operating room. Preoperative patient-related characteristics associated with increased risk of postoperative SSI were male sex and obesity. The current study can be used to provide preoperative counseling regarding the risk of this postoperative complication.

Level of Evidence.

Level III.
Annexin A2 Loss After Cardiopulmonary Bypass and Development of Acute Postoperative Respiratory Dysfunction in Children
Authors: Hsing Deyin D. , Stock Arabela C. , Greenwald Bruce M. , Bacha Emile A. , Flynn Patrick A. , Carroll Sheila J. , Dayton Jeffrey D. , Prockop Susan E. , Qiu Yuqing , Almeida Dena , Tamura Shoran , Hajjar Katherine A.
Published: February 2023

IMPORTANCE AND OBJECTIVES:

The primary objective of this study was to determine whether expression of the multifunctional and adherens junction-regulating protein, annexin A2 (A2), is altered following cardiopulmonary bypass (CPB). A secondary objective was to determine whether depletion of A2 is associated with post-CPB organ dysfunction in children.

DESIGN:

In a prospective, observational study conducted over a 1-year period in children undergoing cardiac surgery requiring CPB, we analyzed A2 expression in peripheral blood mononuclear cells at different time points. We then assessed the relationship of A2 expression with organ function at each time point in the early postoperative period.

SETTING:

Twenty-three-bed mixed PICU in a tertiary academic center.

PARTICIPANTS:

Patients 1 month to 18 years old undergoing cardiac surgery requiring CPB.

MEAN OUTCOME MEASUREMENTS AND RESULTS:

We analyzed A2 expression in 22 enrolled subjects (n = 9, 1–23 mo old; n = 13, 2–18 yr old) and found a proteolysis-mediated decline in intact A2 immediately after bypass (p = 0.0009), reaching a median of 4% of baseline at 6 hours after bypass (p < 0.0001), and recovery by postoperative day 1. The degree of A2 depletion immediately after bypass in 1–23-month-olds correlated strongly with the extent of organ dysfunction, as measured by PICU admission Vasoactive-Ventilation-Renal (p = 0.004) and PEdiatric Logistic Organ Dysfunction-2 (p = 0.039) scores on postoperative day 1. A2 depletion immediately after bypass also correlated with more protracted requirement for both respiratory support (p = 0.007) and invasive ventilation (p = 0.013) in the 1–23-month-olds.

CONCLUSIONS AND RELEVANCE:

The degree of depletion of A2 following CPB correlates with more severe organ dysfunction, especially acute respiratory compromise in children under 2 years. These findings suggest that loss of A2 may contribute to pulmonary microvascular leak in young children following CPB.
Obesity Paradox and Functional Outcomes in Sepsis: A Multicenter Prospective Study
Authors: Yeo Hye Ju , Kim Tae Hwa , Jang Jin Ho , Jeon Kyeongman , Oh Dong Kyu , Park Mi Hyeon , Lim Chae-Man , Kim Kipoong , Cho Woo Hyun ,   on behalf of the Korean Sepsis Alliance (KSA) Investigators
Published: February 2023

OBJECTIVES:

In Asian populations, the correlation between sepsis outcomes and body mass is unclear. A multicenter, prospective, observational study conducted between September 2019 and December 2020 evaluated obesity’s effects on sepsis outcomes in a national cohort.

SETTING:

Nineteen tertiary referral hospitals or university-affiliated hospitals in South Korea.

PATIENTS:

Adult patients with sepsis (n = 6,424) were classified into obese (n = 1,335) and nonobese groups (n = 5,089).

MEASUREMENTS AND RESULTS:

Obese and nonobese patients were propensity score-matched in a ratio of 1:1. Inhospital mortality was the primary outcome. After propensity score matching, the nonobese group had higher hospital mortality than the obese group (25.3% vs 36.7%; p < 0.001). The obese group had a higher home discharge rate (70.3% vs 65.2%; p < 0.001) and lower median Clinical Frailty Scale (CFS) (4 vs 5; p = 0.007) at discharge than the nonobese group, whereas the proportion of frail patients at discharge (CFS ≥ 5) was significantly higher in the nonobese group (48.7% vs 54.7%; p = 0.011). Patients were divided into four groups according to the World Health Organization body mass index (BMI) classification and performed additional analyses. The adjusted odds ratio of hospital mortality and frailty at discharge for underweight, overweight, and obese patients relative to normal BMI was 1.25 (p = 0.004), 0.58 (p < 0.001), and 0.70 (p = 0.047) and 1.53 (p < 0.001), 0.80 (p = 0.095), and 0.60 (p = 0.022), respectively.

CONCLUSIONS:

Obesity is associated with higher hospital survival and functional outcomes at discharge in Asian patients with sepsis.
Obstructive sleep apnea and cardiovascular events in acute coronary syndrome: a meta-analysis
Authors: Tong Jiangtao , Yu Qian , Li Yuan , Du Jianbo , Qiu Jian
Published: February 2023

Objective

Obstructive sleep apnea (OSA) in patients with the acute coronary syndrome (ACS) were at high risk for cardiovascular events, but the results are currently inconclusive. We aimed to conduct a systematic review to determine the incidence of cardiovascular events among ACS patients with OSA by a meta-analysis of observational studies.

Methods

PubMed, Embase, and Cochrane Library were searched for studies related to the association between OSA and the risk of cardiovascular events in patients with ACS. Risk of bias in observational studies was assessed according to the Risk Of Bias In the Non-randomized Studies-Of Interventions tool.

We performed a meta-analysis using a random-effects model to calculate estimates of pooled hazard ratios (HR) with 95% confidence intervals (CI), and heterogeneity was assessed using the statistics.

Results

A total of 12 studies evaluating ACS patients with OSA were included in the meta-analysis. OSA was related to the increased risk of MACE (HR = 2.2; 95% CI, 1.274–3.805, I
2 = 76.1%). The effect of OSA on MACCE (HR = 1.921; 95% CI, 1.45–2.546; I
2 = 19.1%) and readmission for unstable angina (HR = 3.137, 95% CI, 1.06–9.283; I
2 = 52.4%) were statistically significant in the pooled analysis. All of the outcomes in the included studies had a serious risk of bias and the Grading of Recommendation, Assessment, Development, and Evaluation evidence level of all the evaluation results were very low.

Conclusions

OSA was associated with a significant increase in the risk of cardiovascular events for patients with ACS. Additional randomized controlled trial studies are required to confirm the results and to prove the treatment of OSA can change the prognosis.
Meta-analysis of the effect of colchicine on C-reactive protein in patients with acute and chronic coronary syndromes
Authors: Alam Mustafa , Kontopantelis Evangelos , Mamas Mamas A. , Savinova Olga V. , Jhaveri Amit , Siddiqui Emaad , Jhamnani Sunny
Published: February 2023

Objective

The anti-inflammatory drug colchicine has recently shown benefits in the prevention of major adverse cardiovascular events (MACE) in patients with the acute coronary syndrome (ACS) and chronic coronary syndromes (CCS). This meta-analysis focuses on understanding Colchicine’s effects on the high-sensitivity C-reactive protein (hs-CRP) to provide mechanistic insight to explain its clinical event reduction.

Methods

A computerized search of MEDLINE was conducted to retrieve journal articles with studies performed on humans from 1 January 2005 to 1 January 2022, using keywords: ‘Colchicine AND Coronary’, ‘Colchicine AND CRP’, and ‘Colchicine AND Coronary Artery Disease’. Studies were included if they measured hs-CRP changes from baseline, and colchicine or placebo were given to patients with ACS or CCS.

Results

Thirteen studies with a biomarker subgroup population of 1636 patients were included in the hs-CRP meta-analysis. Of those 13 studies, 8 studies with a total population of 6016 reported clinical events defined as myocardial infarction (MI), stroke, cardiovascular death, periprocedural MI, repeat angina after PCI and repeat revascularization. Multivariate analysis revealed a weak negative correlation of −0.1056 (P = 0.805) between change in CRP and clinical events. Overall, colchicine treatment resulted in a greater reduction in hs-CRP levels compared with placebo (Mean Difference: -1.59; 95% Confidence Interval, −2.40 to −0.79, P = 0.0001) and clinical events (Odds Ratio: 0.78; 95% Confidence Interval 0.64 to 0.95, P = 0.01)

Conclusion

Colchicine therapy is associated with a reduction in hs-CRP and clinical events in patients with ACS and CCS. This finding supports colchicine’s anti-inflammatory efficacy via CRP reduction to explain its clinical benefit.
Intracoronary thrombus assessment with cardiac computed tomography angiography in a deferred stenting strategy: the MATURE prospective study (MSCT to Assess ThrombUs REsolution)
Authors: Osinalde Eduardo Pozo , Bastante Teresa , Cecconi Alberto , Muñiz Álvaro Montes , García-Guimaraes Marcos , Rivero Fernando , Rojas-González Antonio , Olivera María José , Salamanca Jorge , de Isla Leopoldo Pérez , De Agustín Jose Alberto , Caballero Paloma , Torres Rio Aguilar , Jiménez-Borreguero Luis Jesús , Alfonso Fernando
Published: February 2023

Background

Cardiac computed tomography angiography (CCTA) is precise in noninvasive coronary atherosclerosis characterization but its value in the diagnosis of intracoronary thrombus remains unknown. Therefore, our aim was to evaluate CCTA for intracoronary thrombus and stenosis detection in patients with acute coronary syndromes with high thrombus burden selected for a deferred stenting strategy.

Methods

We systematically performed a CCTA in consecutive patients following a deferred stenting strategy, 24 h before the scheduled repeated coronary angiography including optical coherence tomography (OCT) imaging. Intracoronary thrombus and residual stenosis were blindly and independently evaluated by both techniques. Agreement was determined per lesion using the weighted Kappa (K) coefficient and absolute intraclass correlation coefficient (ICC). A stratified analysis according to OCT-detected thrombus burden was also performed.

Results

Thirty lesions in 28 consecutive patients were analyzed. Concordance between CCTA and repeated coronary angiography in thrombus detection was good (K = 0.554; P < 0.001), but both showed poor agreement with OCT. CCTA needed >11.5% thrombus burden on OCT to obtain adequate diagnostic accuracy. The lesions detected by angiography were more frequently classified as red thrombus (76.5 vs. 33.3%; P = 0.087) on OCT. CCTA showed an excellent concordance with coronary angiography in diameter measurement (ICC = 0.85; P < 0.001) and was able to identify all the patients with severe residual stenosis.

Conclusions

Although CCTA showed just a good concordance with angiography in intracoronary thrombus detection, the agreement in residual stenosis was excellent. Thus, in patients with a high-thrombus burden selected for a deferred stenting strategy CCTA may substitute repeat angiography.
Gut–lung crosstalk during critical illness
Authors: Nath Sridesh , Kitsios Georgios D. , Bos Lieuwe D.J.
Published: February 2023

Purpose of review

Study of organ crosstalk in critical illness has uncovered complex biological communication between different organ systems, but the role of microbiota in organ crosstalk has received limited attention. We highlight the emerging understanding of the gut–lung axis, and how the largest biomass of the human body in the gut may affect lung physiology in critical illness.

Recent findings

Disruption of healthy gut microbial communities and replacement by disease-promoting pathogens (pathobiome) generates a maladaptive transmitter of messages from the gut to the lungs, connected via the portal venous and the mesenteric lymphatic systems. Gut barrier impairment allows for microbial translocation (living organisms or cellular fragments) to the lungs. Host-microbiota interactions in the gut mucosa can also impact lung physiology through microbial metabolite secretion or host-derived messengers (hormones, cytokines or immune cells). Clinical examples like the prevention of ventilator-associated pneumonia by selective decontamination of the digestive tract show that the gut–lung axis can be manipulated therapeutically.

A growing body of evidence supports the pathophysiological relevance of the gut–lung axis, yet we are only at the brink of understanding the therapeutic and prognostic relevance of the gut microbiome, metabolites and host-microbe interactions in critical illness.
Ventilatory targets following brain injury
Authors: Taran Shaurya , Wahlster Sarah , Robba Chiara
Published: February 2023

Purpose of review

Recent studies have focused on identifying optimal targets and strategies of mechanical ventilation in patients with acute brain injury (ABI). The present review will summarize these findings and provide practical guidance to titrate ventilatory settings at the bedside, with a focus on managing potential brain-lung conflicts.

Recent findings

Physiologic studies have elucidated the impact of low tidal volume ventilation and varying levels of positive end expiratory pressure on intracranial pressure and cerebral perfusion. Epidemiologic studies have reported the association of different thresholds of tidal volume, plateau pressure, driving pressure, mechanical power, and arterial oxygen and carbon dioxide concentrations with mortality and neurologic outcomes in patients with ABI. The data collectively make clear that injurious ventilation in this population is associated with worse outcomes; however, optimal ventilatory targets remain poorly defined.

Although direct data to guide mechanical ventilation in brain-injured patients is accumulating, the current evidence base remains limited. Ventilatory considerations in this population should be extrapolated from high-quality evidence in patients without brain injury – keeping in mind relevant effects on intracranial pressure and cerebral perfusion in patients with ABI and individualizing the chosen strategy to manage brain-lung conflicts where necessary.
Brain monitoring after cardiac arrest
Authors: Sandroni Claudio , Skrifvars Markus Benedikt , Taccone Fabio Silvio
Published: February 2023

Purpose of review

To describe the available neuromonitoring tools in patients who are comatose after resuscitation from cardiac arrest because of hypoxic–ischemic brain injury (HIBI).

Recent findings

Electroencephalogram (EEG) is useful for detecting seizures and guiding antiepileptic treatment. Moreover, specific EEG patterns accurately identify patients with irreversible HIBI. Cerebral blood flow (CBF) decreases in HIBI, and a greater decrease with no CBF recovery indicates poor outcome. The CBF autoregulation curve is narrowed and right-shifted in some HIBI patients, most of whom have poor outcome. Parameters derived from near-infrared spectroscopy (NIRS), intracranial pressure (ICP) and transcranial Doppler (TCD), together with brain tissue oxygenation, are under investigation as tools to optimize CBF in patients with HIBI and altered autoregulation. Blood levels of brain biomarkers and their trend over time are used to assess the severity of HIBI in both the research and clinical setting, and to predict the outcome of postcardiac arrest coma. Neuron-specific enolase (NSE) is recommended as a prognostic tool for HIBI in the current postresuscitation guidelines, but other potentially more accurate biomarkers, such as neurofilament light chain (NfL) are under investigation.

Neuromonitoring provides essential information to detect complications, individualize treatment and predict prognosis in patients with HIBI.
Beyond intracranial pressure: monitoring cerebral perfusion and autoregulation in severe traumatic brain injury
Authors: Dietvorst Sofie , Depreitere Bart , Meyfroidt Geert
Published: February 2023

Purpose of review

Severe traumatic brain injury (TBI) remains the most prevalent neurological condition worldwide. Observational and interventional studies provide evidence to recommend monitoring of intracranial pressure (ICP) in all severe TBI patients. Existing guidelines focus on treating elevated ICP and optimizing cerebral perfusion pressure (CPP), according to fixed universal thresholds. However, both ICP and CPP, their target thresholds, and their interaction, need to be interpreted in a broader picture of cerebral autoregulation, the natural capacity to adjust cerebrovascular resistance to preserve cerebral blood flow in response to external stimuli.

Recent findings

Cerebral autoregulation is often impaired in TBI patients, and monitoring cerebral autoregulation might be useful to develop personalized therapy rather than treatment of one size fits all thresholds and guidelines based on unidimensional static relationships.

Today, there is no gold standard available to estimate cerebral autoregulation. Cerebral autoregulation can be triggered by performing a mean arterial pressure (MAP) challenge, in which MAP is increased by 10% for 20 min. The response of ICP (increase or decrease) will estimate the status of cerebral autoregulation and can steer therapy mainly concerning optimizing patient-specific CPP. The role of cerebral metabolic changes and its relationship to cerebral autoregulation is still unclear and awaits further investigation.
Efficacy of rational emotive behavior therapy for the improvement of knowledge and risk perception of hypertension among university lecturers in South East Nigeria: REBT for university lecturers’ hypertension improvement
Authors: Uwakwe Stephen Iro , Uwakwe Chinedozie , Edeh Nathaniel Ifeanyi , Chukwu Chukwuemeka Joseph , Enyi Chinwe , Irouwakwe Chidera , Chukwuemeka-Nworu Joyce Ijeoma , David Adeleye Olaide , Ezepue Evelyn Ijeoma , Aneke Mary Chioma , Nwankwo Benedict Chimezie , Isilebo Chidiebere Nwamara , Ezurike Chukwuemeka Alexander , Nweke Prince Onyemaechi
Published: February 2023

Background:

This study determined the effectiveness of a rational emotive behavioral therapy (REBT) intervention on knowledge of risks of hypertension among university lecturers in South-east geopolitical zone of Nigeria.

Methods:

The study used a group randomized controlled trial design to group the participants into treatment group and a waiting-list control group and the hypertension knowledge questionnaire and the Perceived Risks of Hypertension Questionnaire to collect a pretest, posttest, and follow-up data of this study. The sample of the study was 84 university lecturers in public universities in Southeast Nigeria (University of Nigeria, Nsukka, Enugu State, Nnamdi Azikiwe University, Awka, Anambra State) who satisfies the requirements to participate in the study. The study lasted for 10 weeks. The data collected for the study were analyzed using repeated measures ANOVA and t test statistics.

Results:

The findings of this study were that REBT health educational intervention effectively increased the education foundation and business education lecturers’ knowledge and perceived risk of hypertension compared to participants in waitlist group. Lastly, the outcomes of the follow-up measures indicate that the increased knowledge and perceived risks of hypertension acquired during the training program was sustained by the treatment group one month after the end of program.

Conclusion:

The REBT health educational intervention program could be utilized to increase knowledge and perceived risks of hypertension among university lecturers in public universities in Southeast Nigeria.
Allogeneic stem cell transplantation without preconditioning in a child with therapy-related myelodysplastic syndrome: A case report
Authors: Tung Yi-Ling , Wang Yi-Lun , Chang Tsung-Yen , Chiu Chia-Chi , Wen Yu-Chuan , Jaing Tang-Her
Published: February 2023

Rationale:

Infants with mixed-lineage leukemia (MLL)-rearranged leukemia are usually refractory to standard induction therapy and are not immediate candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chromosome 11q23 translocations, resulting in MLL rearrangement, have been well characterized in infant acute lymphoblastic leukemia (ALL). While t(4;11) ALL continues to have carry a bleak prognosis, patients with therapy-related myelodysplastic syndrome (t-MDS) have a shorter median overall survival than those compared with de novo MDS.

Patient concerns:

We describe a child with t-MDS who evolved from MLL-rearranged ALL and was successfully treated with HSCT without toxic preconditioning.

Diagnoses:

MDS diagnosis was based on morphological characteristics of bone marrow dysplasia in patients with clinical manifestations evidence of hematopoiesis impairments by different combinations of anemia, leukopenia, neutropenia, and thrombocytopenia.

Interventions:

Although the best donor for allo-HSCT is generally considered an human leukocyte antigen-matched sibling, only ~ 30% of patients have a suitable sibling. HSCT from an unrelated donor is a suitable option for patients with t-MDS who do not have matched sibling donors.

Outcomes:

Allo-HSCT without recipient preconditioning could be a promising treatment option for t-MDS, especially for patients with recurrent or persistent infections.

Lessons:

Cytogenetics, prognosis, and treatment of t-MDS are briefly discussed. Preconditioning before allo-HSCT seriously damages immune function. This work reviews our experience with a patient with t-MDS following ALL complicated by recurrent infections, and highlights our choice to omit preconditioning from allo-HSCT.
Overactive bladder with urodynamic study-induced bladder pain: An overactive bladder subtype with symptoms similar to those of interstitial cystitis/painful bladder syndrome
Authors: Mu Hsueh-Yu , Wu Ming-Ping , Wang I-Te , Wu Jeng-Cheng , Chin Hung-Yen
Published: February 2023

Overactive bladder (OAB) and interstitial cystitis/painful bladder syndrome (IC/PBS) are 2 lower urinary tract disorders with urgency and bladder pain for diagnosis and with several other shared symptoms. Because of their overlapping symptoms, precise differential diagnosis of OAB and IC/PBS remains difficult. Thus, we characterize a subgroup of OAB with bladder pain (OAB-BP) that can be differentiated from OAB alone by urodynamic study (UDS) findings. We also further examined the clinical presentations and urodynamic parameters of OAB alone, OAB-BP, and IC/PBS. Data were collected between September 2018 and April 2019. Patients were categorized into 3 groups, OAB-alone (no bladder pain during UDS, n = 39), OAB-BP (with bladder pain during UDS, n = 35), and IC/PBS (the comparator, n = 39). Chi-square tests were used to compare OAB alone, OAB-BP, and IC/PBS with respect to their clinical presentations and urodynamic parameters. Factors with P < .05 were further analyzed through post hoc comparisons with Bonferroni adjustment. An unique subgroup of OAB patients was identified (i.e., OAB-BP), bladder pain can only be induced at maximal cytometric capacity during UDS. We also identified that the case histories and UDS parameters (e.g., low first desire, normal desire, and maximum cytometric capacity) of the OAB-BP group were more similar to those of the IC/PBS group than to those of the OAB-alone group. The OAB-BP group and the IC/PBS group reported more intrusive, longer-lasting symptoms before their final diagnoses, more extensive family history of urinary tract disorder, and more associated comorbidities (e.g., irritable bowel syndrome, and myofascial pain) than the OAB-alone group. The UDS assessment induced bladder pain in the OAB-BP group to reveal their hidden symptoms. Careful attention to patient history and sophisticated UDS evaluation may help to identify this unique OAB group.
Construction of a pyroptosis-related lncRNAs signature for predicting prognosis and immunotherapy response in glioma
Authors: Huang Qianrong , Yan Jun , Jiang Qian , Guo Fangzhou , Mo Ligen , Deng Teng
Published: February 2023

Recent studies have proved that pyroptosis-related long non-coding RNAs (PRlncRNAs) are closely linked to tumor progression, prognosis, and immunity. Here, we systematically evaluated the correlation of PRlncRNAs with glioma prognosis. This study included 3 glioma cohorts (The Cancer Genome Atlas, Chinese Glioma Genome Atlas, and Gravendeel). Through Pearson correlation analysis, PRlncRNAs were screened from these 3 cohorts. Univariate Cox regression analysis was then carried out to determine the prognostic PRlncRNAs. A pyroptosis-related lncRNAs signature (PRLS) was then built by least absolute shrinkage and selection operator and multivariate Cox analyses. We systematically evaluated the correlation of the PRLS with the prognosis, immune features, and tumor mutation burden in glioma. A total of 14 prognostic PRlncRNAs overlapped in all cohorts and were selected as candidate lncRNAs. Based on The Cancer Genome Atlas cohort, a PRLS containing 7 PRlncRNAs was built. In all cohorts, the PRLS was proved to be a good predictor of glioma prognosis, with a higher risk score related to a poorer prognosis. We observed obvious differences in the immune microenvironment, immune cell infiltration level, and immune checkpoint expression in low- and high-risk subgroups. Compared with low-risk cases, high-risk cases had lower Tumor Immune Dysfunction and Exclusion scores and greater tumor mutation burden, indicating that high-risk cases can be more sensitive to immunotherapy. A nomogram combining PRLS and clinical parameters was constructed, which showed more robust and accurate predictive power. In conclusion, the PRLS is a potentially useful indicator for predicting prognosis and response to immunotherapy in glioma. Our findings may provide a useful insight into clinically individualized treatment strategies for patients.
The relationship between physical activity and diabetes in middle-aged and elderly people
Authors: Tian Ying , Li Cheng , Shilko Tatiana Alexandrovna , Sosunovsky Vadim Sergeevich , Zhang Yaqun
Published: February 2023

To investigate the association between diabetes symptoms and physical activity (PA) levels among middle-aged and older Chinese adults. Data for this study were obtained from 2018 Charles data. Z test, logistic regression analysis, and linear hierarchical regression analysis were performed in 5352 individuals aged ≥50 years with complete information. In terms of diabetes, 6.8% of the middle-aged and elderly people with diabetes were detected, and 93.2% of the middle-aged and elderly people without diabetes symptoms. The proportion of middle-aged and elderly people with high PA levels was 50.5%, and the proportion of middle-aged and elderly people with low PA was 49.5%. There was a significant positive correlation between low PA and diabetes (P < .05). After adjusting demographic characteristics (gender, registered permanent residence type, education level, age, widowhood) and health status characteristics (poor mood, asthma, hyperlipidemia, disability, memory disease, self-assessment of health status, hypertension, smoking, stroke, depression), there was still a statistical significance between PA level and diabetes (P < .05). The risk of diabetes of middle-aged and elderly people in China increases with age, while the risk of diabetes of middle-aged and elderly people with low level of PA is higher. The risk of diabetes is high among middle-aged and elderly people who are old, have poor self-evaluation health, suffer from hyperlipidemia, memory disease, and asthma. The middle-aged and old people should increase their PA levels to prevent and improve diabetes.
The relationship between depression, anxiety, e-health literacy, and health-promoting behavior in nursing students during COVID-19
Authors: Kwon Mihyoung , Oh Jihyun
Published: February 2023

The purpose of this study was to identify the correlation between depression, anxiety, e-health literacy (eHL), and health-promoting behaviors among nursing students during the coronavirus disease 2019 (COVID-19) pandemic, and to identify the factors affecting health-promoting behaviors. A cross-sectional study was conducted online, recruiting 301 nursing students recruited from 4 universities in the Chungcheng Province and Daejeon Metropolitan City in South Korea between May 28 and June 30, 2021. Data were analyzed using SPSS WIN 27.0. The general characteristics of the study participants were analyzed by frequency and percentage, and the degree of depression, anxiety, eHL, and health-promoting behaviors were calculated as averages and standard deviations. Differences in health-promoting behaviors according to general characteristics were analyzed using independent t tests and analysis of variance, and a post hoc Scheffe test was conducted. Correlations between depression, anxiety, eHL, and health-promoting behaviors were measured using Pearson correlation matrices. Stepwise multiple regression was performed to identify factors affecting health-promoting behaviors. During the COVID-19 pandemic, the average level of depression and anxiety was reported to be 3.93 (4.71) and 3.40 (4.30), respectively; 33.2% of nursing students experienced more than mild depression and 29.2% experienced anxiety. The average eHL level was 3.91 (0.56), and the average of health-promoting behaviors was 2.43 (0.45). Depression was positively correlated with anxiety (R = 0.734, P < .001) and negatively correlated with health-promoting behaviors (r = −0.198, P = .001), whereas eHL had a positive correlation with health-promoting behaviors (R = 0.347, P < .001). The factors affecting health-promoting behaviors were religion (β = −0.160, standard error [SE] = 0.048), current health status (β = −0.097, SE = 0.032), frequency of searching the Internet for health-related information in a week (β = −0.070, SE = 0.026), interest in health (β = −0.191, SE = 0.039), and critical eHL (β = 0.243, SE = 0.040); the explanatory power was 27.4%. Results demonstrate that during the COVID-19 pandemic, higher depression and anxiety among nursing students decreased health-promoting behaviors, while higher eHL increased health-promoting behaviors, and eHL was a major factor affecting health-promoting behaviors. These results contribute to the provision of basic data for the development of nursing intervention programs and educational strategies that can establish correct health-promoting behaviors by managing depression and anxiety among nursing students and improving eHL.
Percutaneous nephroscopy combined with the laser used for right kidney bullet extraction: A case report
Authors: Wang Baolong , Yang Lijun , Yuan Jianlin , Qin Weijun , Wu Peng , Yang Xiaojian , Hou Guangdong , Yu Ming , Gong Xue , Xu Zhicheng , Qin Jun , Gao Xuelin , Ma Shuaijun , Wang Fuli
Published: February 2023

Rationale:

Wounds caused by firearms are intractable problems in treating war traumas and clinical management. Conventional open surgery inflicts large injury and leads to slow recovery. At the same time, most patients suffer from compound injuries with the critical condition and poor operation tolerance. Thus, it is crucial to probe into the minimally invasive surgical removal of residual kidney bullets.

Patient concerns:

We report a case where a bullet remained in the right renal parenchyma on the patient, with penetrating injury in his liver.

Diagnosis:

Obviously the patient has suffered gunshot wound with a bullet stuck in his kidney, while his liver function was impacted.

Interventions:

Six months after the injury, we performed the minimally-invasive procedures on the patient with percutaneous nephroscope technology and laser technology under the guidance of ultrasound localization. The bullet and ammunition granulation and scar surrounding tissue were fully removed. Intraoperative bleeding was little, while the incision was small. The patient could leave the bed and walk on the 1st postoperative day. The drainage tube was removed on the 3rd postoperative day, after which the patient was discharged on the 4th postoperative day.

Outcomes:

The patient recovered well after surgery and was followed up for 5 years. The latest examination of his liver and kidney function was as follows: alanine aminotransferase 61IU/L, aspartate aminotransferase 33 IU/L, albumin/globulin 46.6/26.0, total bilirubin 19.1μmol/L, direct bilirubin 4.9μmol/L, indirect bilirubin 14.2μmol/L, alkaline phosphatase 111 IU/L, creatinine 57μmol/L, urea 5.16mmol/L, cystatin 0.73mg/L. The plain computed tomography scan showed a few calcifications in the liver and a patchy low-density shadow in the right kidney. It was proved that the liver and kidney function of the patient recovered well, and his living qualify has come back to the track, with no postoperative complications.

Lessons:

Innovative integration of percutaneous nephroscopy technology and laser was used to remove kidney foreign bodies and developed the optimal surgical plan, small trauma, fast recovery, and the treatment of kidney foreign bodies was newly explored.
Topical tranexamic acid in intramedullary nailing for the treatment of intertrochanteric fractures in the elderly: A protocol for systematic review and meta-analysis
Authors: Zhang Jiakai , Fan Xiaoyuan , Zheng Yi , Wu Junlong , Yuan Xinhua
Published: February 2023

Background:

Numerous studies have demonstrated that the use of tranexamic acid (TXA) intravenously minimizes bleeding, lowers transfusion rates, and does not raise the risk of complications during major orthopedic surgery. Concerning the effectiveness of the topical application, there are, nevertheless, inconsistent findings. We aimed to develop a protocol for systematic review and meta-analysis on the benefits and safety of topical TXA in intramedullary nailing for the treatment of intertrochanteric fractures in the elderly.

Methods:

PubMed, Embase, and the Cochrane Library will all be searched for randomized controlled trials published from the database inception to October 15, 2022. The primary outcomes will be intraoperative blood loss, hidden blood loss, total blood loss, transfusion rate, transfusion units, operative time, thromboembolic events, and mortality. The risk of bias will be evaluated using the Cochrane risk of bias assessment tool. Review Manager 5.3 will be used for the analysis.

Results:

The effects and safety of topical TXA in intramedullary nailing for the treatment of intertrochanteric fractures in the elderly will be quantified in this study.

Conclusions:

The study’s findings will assist doctors in determining if topical TXA use is secure and efficient.
Five-hub genes identify potential mechanisms for the progression of asthma to lung cancer
Authors: Yang Weichang , Li Zhouhua , Wang Wenjun , Wu Juan , Ye Xiaoqun
Published: February 2023

Previous studies have shown that asthma is a risk factor for lung cancer, while the mechanisms involved remain unclear. We attempted to further explore the association between asthma and non-small cell lung cancer (NSCLC) via bioinformatics analysis. We obtained GSE143303 and GSE18842 from the GEO database. Lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) groups were downloaded from the TCGA database. Based on the results of differentially expressed genes (DEGs) between asthma and NSCLC, we determined common DEGs by constructing a Venn diagram. Enrichment analysis was used to explore the common pathways of asthma and NSCLC. A protein–protein interaction (PPI) network was constructed to screen hub genes. KM survival analysis was performed to screen prognostic genes in the LUAD and LUSC groups. A Cox model was constructed based on hub genes and validated internally and externally. Tumor Immune Estimation Resource (TIMER) was used to evaluate the association of prognostic gene models with the tumor microenvironment (TME) and immune cell infiltration. Nomogram model was constructed by combining prognostic genes and clinical features. 114 common DEGs were obtained based on asthma and NSCLC data, and enrichment analysis showed that significant enrichment pathways mainly focused on inflammatory pathways. Screening of 5 hub genes as a key prognostic gene model for asthma progression to LUAD, and internal and external validation led to consistent conclusions. In addition, the risk score of the 5 hub genes could be used as a tool to assess the TME and immune cell infiltration. The nomogram model constructed by combining the 5 hub genes with clinical features was accurate for LUAD. Five-hub genes enrich our understanding of the potential mechanisms by which asthma contributes to the increased risk of lung cancer.
Nomograms for predicting overall survival and cancer-specific survival in patients with head and neck non-Hodgkin lymphoma: A population-based study
Authors: Peng Jing , Chen Jianming , Liu Yucheng , Lyu Jun , Zhang Bin
Published: February 2023

This study aimed to develop comprehensive nomograms for patients with head and neck non-Hodgkin lymphoma (H&NNHL) to determine their overall survival (OS) and cancer-specific survival (CSS). In this study, 602 H&NNHL patients were analyzed from the Surveillance, Epidemiology, and End Results database. The R software was used to randomly divide the patients into the training cohort (n = 421) and the validation cohort (n = 181) in a 7-to-3 ratio. To develop nomograms for projecting OS and CSS, multivariable Cox regression was used to acquire independent predictive factors. We have constructed nomograms to predict the 3-, 5-, and 8-year OS and CSS probabilities of H&NNHL patients. The consistency index of the nomograms for OS (CSS) was 0.74 (0.778) and 0.734 (0.775), in the training and validation cohort respectively, and was higher than that of the Ann Arbor staging system. Calibration plotting showed that our models have good calibration ability. Moreover, assessments of the area under the time-dependent receiver operating characteristics curve, net reclassification improvement, integrated discrimination improvement and decision curve analysis demonstrated that our nomograms performed better and were more clinically useful than the Ann Arbor staging system. This is the first research to establish comprehensive nomograms for predicting OS and CSS in patients with H&NNHL at 3-, 5-, and 8-year. The validation of the models demonstrated good performance. It can provide clinicians with reference information for determining customized clinical treatment options and providing personalized prognoses.

Indexes such as the concordance index, the area under the time-dependent receiver operating characteristics curve, calibration curves, the net reclassification improvement, the integrated discrimination improvement, and decision-curve analysis were used to compare new survival models to the classical Ann Arbor staging system.