bluuebunny/crossref_metadata_2025 huggingface dataset:
The ASCENT Trial: a phase 2 study of induction and consolidation afatinib and chemoradiation with or without surgery in stage III EGFR-mutant NSCLC
Authors: Chang Allison E B , Piper-Vallillo Andrew J , Mak Raymond H , Lanuti Michael , Muzikansky Alona , Rotow Julia , Jänne Pasi A , Mino-Kenudson Mari , Swanson Scott , Wright Cameron D , Kozono David , Marcoux Paul , Piotrowska Zofia , Sequist Lecia V , Willers Henning
Published: May 2024

Background

The role of tyrosine kinase inhibitors (TKIs) in early-stage and metastatic oncogene-driven non–small cell lung cancer (NSCLC) is established, but it remains unknown how best to integrate TKIs with concurrent chemoradiotherapy (cCRT) in locally advanced disease. The phase 2 ASCENT trial assessed the efficacy and safety of afatinib and cCRT with or without surgery in locally advanced epidermal growth factor receptor (EGFR)-mutant NSCLC.

Patients and Methods

Adults ≥18 years with histologically confirmed stage III (AJCC 7th edition) NSCLC with activating EGFR mutations were enrolled at Mass General and Dana-Farber/Brigham Cancer Centers, Boston, Massachusetts. Patients received induction afatinib 40 mg daily for 2 months, then cisplatin 75 mg/m2 and pemetrexed 500 mg/m2 IV every 3 weeks during RT (definitive or neoadjuvant dosing). Patients with resectable disease underwent surgery. All patients were offered consolidation afatinib for 2 years. The primary endpoint was the objective response rate (ORR) to induction TKI. Secondary endpoints were safety, conversion to operability, progression-free survival (PFS), and overall survival (OS). Analyses were performed on the intention-to-treat population.

Results

Nineteen patients (median age 56 years; 74% female) were enrolled. ORR to induction afatinib was 63%. Seventeen patients received cCRT; 2/9 previously unresectable became resectable. Ten underwent surgery; 6 had a major or complete pathological response. Thirteen received consolidation afatinib. With a median follow-up of 5.0 years, median PFS and OS were 2.6 (95% CI, 1.4-3.1) and 5.8 years (2.9-NR), respectively. Sixteen recurred or died; 6 recurrences were isolated to CNS. The median time to progression after stopping consolidation TKI was 2.9 months (95% CI, 1.1-7.2). Four developed grade 2 pneumonitis. There were no treatment-related deaths.

Conclusion

We explored the efficacy of combining TKI with cCRT in oncogene-driven NSCLC. Induction TKI did not compromise subsequent receipt of multimodality therapy. PFS was promising, but the prevalence of CNS-only recurrences and rapid progression after TKI discontinuation speak to unmet needs in measuring and eradicating micrometastatic disease.
Mandalas and Monarchs
Authors: Chemburkar Swati
Published: May 2024

From 7th to 13th centuries, network of Buddhist monks stretched from the Ganges Valley to Japan and from the Himalayan snows to the Maritime Sea routes. It became responsible for bringing the new esoteric form of Buddhism that was geared towards the representation of royal power than the earlier monastic version. The esoteric Buddhism attracted many kings, as it promised direct engagement with cosmic Buddhas and gods otherwise inaccessible to human conceptual powers. It was based on (1) ritual initiations prescribed in tantras; (2) recitation of magical formulas—mantras; and (3) architectural development of the model of the Buddhist cosmos—mandalas. Mandalas became valuable tools for Buddhist monks for reorganizing the religious/political landscapes. This study finds that the tantric Garbhadhātu and Vajradhātu manddalas along with their modified versions were wide spread than formerly thought and can be traced in the architecture of monuments from the Ganges valley to the island of Java.
To Mix or Not to Mix: Details of Magma Storage, Recharge, and Remobilization during the Pacheco Stage at Misti Volcano, Peru (≤21–2 ka)
Authors: Takach Marie K , Tepley Frank J , Harpel Christopher J , Aguilar Rigoberto , Rivera Marco
Published: May 2024

We investigate ten of the most recent tephra-fall deposits emplaced between ≤21 and 2 ka from the Pacheco stage of Misti volcano, Peru, to elucidate magma dynamics and explosive eruption triggers related to magma storage, recharge, and remobilization. Whole-rock, glass, and mineral textures and compositions indicate the presence of broadly felsic, intermediate, and mafic magmas in a chemically and thermally stratified magma storage system (Zones 1–3) that interact to differing extents prior to eruption. Intermediate magmas are defined by plagioclase + amphibole + two-pyroxenes + Fe-Ti oxides and phase equilibria indicate they formed at ~300 to 600 MPa and ~950°C to 1000°C. Intermediate magmas dominate the Pacheco stage and either erupted alone as hybridized magmas or mingled with minor volumes of cool felsic magmas (~800°C) in which only plagioclase + Fe-Ti oxides are stable. Felsic magmas do not exclusively comprise any tephra-fall deposit emplaced during the Pacheco stage but were remobilized by recharge and mixing with intermediate magmas in order to erupt. Furthermore, felsic-hosted amphibole cognate to the intermediate magmas are reacted despite the felsic magmas being water saturated, which suggests they are staged above the amphibole stability limit (≤200 MPa). The cryptic presence of mafic magmas is indicated by high-An plagioclase cores (An74–88), rare anhedral olivine (Fo77–80), and possibly high Mg# augite and amphibole (up to Mg# 84 and 77, respectively). The dearth of basalt to basaltic andesite melts recorded in erupted glasses and exclusivity of high-An plagioclase to crystal cores signals mafic magmas are staged deeper in the crust than the intermediate magmas. Periodic interactions between these magmas tracked via glass compositions and crystal exchange reveal an alternation between the production of mingled magmas and their eruption shortly after a recharge event, followed by a period of homogenization and eruption of hybridized magmas. As such, we identify magma recharge as a key mechanism by which half of the explosive eruptions were triggered in the Pacheco stage. A >100°C increase in Misti’s fumarole temperatures from 1967 to 2018 coincident with changes in fumarolic gas compositions is consistent with degassing of a mafic recharge magma, signaling that Misti could produce similar explosive eruptions in the future.
The Volcanism of the Meseta del Lago Buenos Aires, Patagonia: the Transition from Subduction to Slab Window
Authors: Guest Imani A , Saal Alberto E , Mallick Soumen , Gorring Matthew L , Kay Suzanne M
Published: May 2024

The Meseta del Lago Buenos Aires (MLBA) in southern Patagonia, a volcanic plateau formed from ~12 Ma to present, provides an opportunity to investigate the temporal evolution in volcanism as this region transitions from the subduction of the Nazca plate to the formation of the slab window produced by the collision of the Chile Ridge and the Andean subduction zone. Here, we report new major, minor, and trace element contents, as well as Sr, Nd, Pb, and Hf isotopes of the MLBA lavas. Three distinct geochemical endmembers can be distinguished in the MLBA basalts: a subduction-influenced endmember, a transitional component similar to the South Atlantic enriched mid-ocean ridge basalts, and an enriched component akin to the EM1 mantle composition. Lavas older than ~1.5 Ma define a compositional continuum between the subduction-influenced and transitional endmembers; this trend is also present in many other southern Patagonian plateaus regardless of their distance to the trench, eruption age, and the composition of the continental blocks where they are located. In contrast, MLBA basalts younger than ~1.5 Ma uniquely define a transition into the EM1 mantle component at the time when this region was affected by the slab window. The estimated pressures and temperatures of mantle-melt equilibration for the MLBA basalts indicates an increase in both parameters after the formation of the slab window that roughly correlate with the changes in lava composition. The basalts’ composition from all southern Patagonia plateaus points to the presence of the South Atlantic mid-ocean ridge basalt mantle influenced by the Discovery, Shona, and Bouvet hotspots rather than the sub-slab mantle, as represented by the Chile Ridge basalts. This observation challenges the hypothesis that the sub-slab mantle within the slab window has had an important role in the composition of the erupted lavas. Instead, it suggests the presence of a South Atlantic mantle beneath southern Patagonia either within the mantle wedge, consistent with a long-lasting South Atlantic convection cell beneath South America, or in the subcontinental lithospheric mantle metasomatized before or just after the opening of the South Atlantic basin, as demonstrated by the composition of southern Patagonia mantle xenoliths. Although it is difficult to precisely distinguish the contributions of the asthenosphere from that of the metasomatized subcontinental lithospheric mantle beneath this region, our work suggests significant contributions from the latter in the composition of the MLBA lavas.
The Application of Australian Rights Protections to the Use of Hepatitis C Notification Data to Engage People ‘Lost to Follow Up’
Authors: Saich Freya , Walker Shelley , Hellard Margaret , Stoové Mark , Seear Kate
Published: May 2024

Hepatitis C is a global public health threat, affecting 56 million people worldwide. The World Health Organization has committed to eliminating hepatitis C by 2030. Although new treatments have revolutionised the treatment and care of people with hepatitis C, treatment uptake has slowed in recent years, drawing attention to the need for innovative approaches to reach elimination targets. One approach involves using existing notifiable disease data to contact people previously diagnosed with hepatitis C. Within these disease surveillance systems, however, competing tensions exist, including protecting individual rights to privacy and autonomy, and broader public health goals. We explore these issues using hepatitis C and Australia’s legislative and regulatory frameworks as a case study. We examine emerging uses of notification data to contact people not yet treated, and describe some of the ethical dilemmas associated with the use and non-use of this data and the protections that exist to preserve individual rights and public health. We reveal weaknesses in rights protections and processes under Australian public health and human rights legislation and argue for consultation with and involvement of affected communities in policy and intervention design before notification data is used to increase hepatitis C treatment coverage.
Role of Machine Learning and Artificial Intelligence in Arrhythmias and Electrophysiology
Authors: Riaz Gondal Muhammad Umer , Atta Mehdi Hassan , Khenhrani Raja Ram , Kumari Neha , Ali Muhammad Faizan , Kumar Sooraj , Faraz Maria , Malik Jahanzeb
Published: May 2024

Machine learning (ML), a subset of artificial intelligence (AI) centered on machines learning from extensive datasets, stands at the forefront of a technological revolution shaping various facets of society. Cardiovascular medicine has emerged as a key domain for ML applications, with considerable efforts to integrate these innovations into routine clinical practice. Within cardiac electrophysiology, ML applications, especially in the automated interpretation of electrocardiograms, have garnered substantial attention in existing literature. However, less recognized are the diverse applications of ML in cardiac electrophysiology and arrhythmias, spanning basic science research on arrhythmia mechanisms, both experimental and computational, as well as contributions to enhanced techniques for mapping cardiac electrical function and translational research related to arrhythmia management. This comprehensive review delves into various ML applications within the scope of this journal, organized into 3 parts. The first section provides a fundamental understanding of general ML principles and methodologies, serving as a foundational resource for readers interested in exploring ML applications in arrhythmia research. The second part offers an in-depth review of studies in arrhythmia and electrophysiology that leverage ML methodologies, showcasing the broad potential of ML approaches. Each subject is thoroughly outlined, accompanied by a review of notable ML research advancements. Finally, the review delves into the primary challenges and future perspectives surrounding ML-driven cardiac electrophysiology and arrhythmias research.
Quality of ChatGPT Responses to Frequently Asked Questions in Carpal Tunnel Release Surgery
Authors: Amen Troy B. , Torabian Kaveh A. , Subramanian Tejas , Yang Brian W. , Liimakka Adriana , Fufa Duretti
Published: May 2024

Background:

Although demonstrating remarkable promise in other fields, the impact of artificial intelligence (including ChatGPT in hand surgery and medical practice) remains largely undetermined. In this study, we asked ChatGPT frequently asked patient-focused questions surgeons may receive in clinic from patients who have carpel tunnel syndrome (CTS) and evaluated the quality of its output.

Methods:

Using ChatGPT, we asked 10 frequently asked questions that hand surgeons may receive in the clinic before carpel tunnel release (CTR) surgery. Included questions were generated from the authors’ own experiences regarding conservative and operative treatment of CTS.

Results:

Responses from the following 10 questions were included: (1) What is CTS and what are its signs and symptoms? (2) What are the nonsurgical options for CTS? (3) Should I get surgery for CTS? (4) What is a CTR and how is it preformed? (5) What are the differences between open and endoscopic CTR? (6) What are the risks associated with CTR and how frequently do they occur? (7) Does CTR cure CTS? (8) How much improvement in my symptoms can I expect after CTR? (9) How long is the recovery after CTR? (10) Can CTS recur after surgery?

Conclusions:

Overall, the chatbot provided accurate and comprehensive information in response to most common and nuanced questions regarding CTS and CTR surgery, all in a way that would be easily understood by many patients. Importantly, the chatbot did not provide patient-specific advice and consistently advocated for consultation with a healthcare provider.
Mitochondrial antiviral signaling protein enhances MASLD progression through the ERK/TNFα/NFκβ pathway
Authors: Nóvoa Eva , da Silva Lima Natália , Gonzalez-Rellan Maria J. , Chantada-Vazquez Maria D.P. , Verheij Joanne , Rodriguez Amaia , Esquinas-Roman Eva M. , Fondevila Marcos F. , Koning Mirja , Fernandez Uxia , Cabaleiro Alba , Parracho Tamara , Iglesias-Moure Jose , Seoane Samuel , Porteiro Begoña , Escudero Adriana , Senra Ana , Perez-Fernandez Roman , López Miguel , Fidalgo Miguel , Guallar Diana , Martinez-Chantar Maria L. , Dieguez Carlos , Varela-Rey Marta , Prevot Vincent , Schwaninger Markus , Meijnikman Abraham , Bravo Susana B. , Frühbeck Gema , Nogueiras Ruben
Published: May 2024

Background and Aims:

Mitochondrial antiviral signaling protein (MAVS) is a critical regulator that activates the host’s innate immunity against RNA viruses, and its signaling pathway has been linked to the secretion of proinflammatory cytokines. However, the actions of MAVS on inflammatory pathways during the development of metabolic dysfunction–associated steatotic liver disease (MASLD) have been little studied.

Approach and Results:

Liver proteomic analysis of mice with genetically manipulated hepatic p63, a transcription factor that induces liver steatosis, revealed MAVS as a target downstream of p63. MAVS was thus further evaluated in liver samples from patients and in animal models with MASLD. Genetic inhibition of MAVS was performed in hepatocyte cell lines, primary hepatocytes, spheroids, and mice. MAVS expression is induced in the liver of both animal models and people with MASLD as compared with those without liver disease. Using genetic knockdown of MAVS in adult mice ameliorates diet-induced MASLD. In vitro, silencing MAVS blunts oleic and palmitic acid–induced lipid content, while its overexpression increases the lipid load in hepatocytes. Inhibiting hepatic MAVS reduces circulating levels of the proinflammatory cytokine TNFα and the hepatic expression of both TNFα and NFκβ. Moreover, the inhibition of ERK abolished the activation of TNFα induced by MAVS. The posttranslational modification O-GlcNAcylation of MAVS is required to activate inflammation and to promote the high lipid content in hepatocytes.

Conclusions:

MAVS is involved in the development of steatosis, and its inhibition in previously damaged hepatocytes can ameliorate MASLD.
Pharmacokinetics of Generic Pediatric Dolutegravir Dispersible Tablet in Thai Young Children Living With HIV Weighing Below Twenty Kilograms
Authors: Rungsapphaiboon Athiporn , Wacharachaisurapol Noppadol , Anugulruengkitt Suvaporn , Sirikutt Pugpen , Phasomsap Chayapa , Tawan Monta , Saisaengjan Chutima , Na Nakorn Yossawadee , Paiboon Nantika , Songtaweesin Wipaporn Natalie , Tawon Yardpiroon , Cressey Tim R. , Puthanakit Thanyawee ,   on behalf of DTGkids Study Team
Published: May 2024

Introduction:

Dolutegravir (DTG) dispersible tablet (DTG-DT) is a pediatric-friendly formulation. We aimed to describe the pharmacokinetics and virologic responses of generic DTG-DT in children weighing <20 kg.

Methods:

Children living with HIV-1 and <7 years of age weighing 6 to <20 kg were eligible. A generic 10-mg scored DTG-DT was administered to children using 3 weight bands (WB): WB1 (6 to <10 kg), WB2 (10 to <14 kg) and WB3 (14 to <20 kg), at doses of 20 mg (higher than World Health Organization recommendation of 15 mg), 20 mg and 25 mg, respectively. Steady-state intensive pharmacokinetics (PK) was performed in fasting condition with blood sampling at predose and 1, 2, 3, 4, 6 and 24 hours postdose. DTG PK parameters were estimated using a noncompartmental analysis, and DTG trough concentrations (C24) and 24-hour area under the concentration-time curve were calculated. Comparisons were made with ODYSSEY and IMPAACT 2019. And 90% effective concentration of 0.32 mg/L was used as a reference individual DTG C24 concentration.

Results:

From August 2021 to March 2023, 29 Thai children with a median (interquartile range) age of 3.2 (1.5–4.8) years were enrolled; 8 in WB1, 9 in WB2 and 12 in WB3. All children were treatment experienced and 59% had HIV RNA <200 copies/mL. Overall geometric mean (coefficient of variation percentage) DTG C24 was 1.0 (46%) mg/L [WB1, 0.9 (53%); WB2, 0.9 (27%); WB3, 1.2 (51%)]. Geometric mean (coefficient of variation percentage) 24-hour area under the concentration-time curve was 83.2 (24%) mg h/L [WB1, 84.3 (31%); WB2, 76.9 (16%); WB3, 87.6 (25%)]. At weeks 24 and 48, 90% and 92% of participants had plasma HIV RNA <200 copies/mL.

Conclusions:

Generic DTG-DT provided adequate drug exposure in children weighing 6 to <20 kg. The exploratory dose of DTG 20 mg for children weighing 6 to <10 kg showed similar PK parameters to World Health Organization doses in the other WB.
Virtual Access to Quality Dermatology Care: Challenges and Promises
Authors: Ashouri Diana , Fonseca Allene S.
Published: May 2024

Teledermatology is the treatment of skin disease via the electronic transfer of medical information to a provider in a distant location. There are two primary forms of teledermatology, namely, store-and-forward and live/real-time interactive, which are both discussed in this article. During the COVID-19 pandemic, teledermatology has emerged as a powerful tool for inpatient and outpatient care of dermatology patients. This article provides updates on the best approach to optimize the utilization of teledermatology and discusses its benefits, disadvantages, and financial and ethical challenges in the post-COVID-19 era.
Recurring Hidradenocarcinoma of the Lower Extremity
Authors: Dhinsa Harpinder , Bashir Amani , Rajan Anand , Miller Benjamin , Powers Jennifer Gloeckner
Published: May 2024

Hidradenocarcinomas are rare adnexal tumor of the sweat glands. They are typically found on the head and neck with a high rate of recurrence and metastasis. Here, we present a case of a 67-year-old woman who presented with long-standing subcutaneous mass over her right knee. She underwent initial surgical excision with positive margins, and histopathology of the resection specimen was consistent with hidradenocarcinoma. The patient completed 60-Gray adjuvant radiation to the surgical bed postoperatively. Eight months later, the patient returned with a concern for recurrence of the hidradenocarcinoma at the same site. Biopsy confirmed the recurrence, and the malignancy was excised with 2-cm margins along with surgical reconstruction with a local muscle flap. She has not had recurrence at follow-up 1 year after the reconstructive flap. This case highlights the histopathologic nature of hidradenocarcinomas and that, despite local excision and large-dose radiation, malignancy can recur.
Development of a CT-Based comprehensive model combining clinical, radiomics with deep learning for differentiating pulmonary metastases from noncalcified pulmonary hamartomas: a retrospective cohort study
Authors: Liu Yunze , Ren Hong , Pei Yanbin , Shen Leilei , Guo Juntang , Zhou Jian , Li Chengrun , Liu Yang
Published: May 2024

Background:

Clinical differentiation between pulmonary metastases and noncalcified pulmonary hamartomas (NCPH) often presents challenges, leading to potential misdiagnosis. However, the efficacy of a comprehensive model that integrates clinical features, radiomics, and deep learning (CRDL) for differential diagnosis of these two diseases remains uncertain.

Objective:

This study evaluated the diagnostic efficacy of a CRDL model in differentiating pulmonary metastases from NCPH.

Methods:

The authors retrospectively analyzed the clinical and imaging data of 256 patients from the First Medical Centre of the General Hospital of the People’s Liberation Army (PLA) and 85 patients from Shanghai Changhai Hospital, who were pathologically confirmed pulmonary hamartomas or pulmonary metastases after thoracic surgery. Employing Python 3.7 software suites, the authors extracted radiomic features and deep learning (DL) attributes from patient datasets. The cohort was divided into training set, internal validation set, and external validation set. The diagnostic performance of the constructed models was evaluated using receiver operating characteristic (ROC) curve analysis to determine their effectiveness in differentiating between pulmonary metastases and NCPH.

Results:

Clinical features such as white blood cell count (WBC), platelet count (PLT), history of cancer, carcinoembryonic antigen (CEA) level, tumor marker status, lesion margin characteristics (smooth or blurred), and maximum diameter were found to have diagnostic value in differentiating between the two diseases. In the domains of radiomics and DL. Of the 1130 radiomics features and 512 DL features, 24 and 7, respectively, were selected for model development. The area under the ROC curve (AUC) values for the four groups were 0.980, 0.979, 0.999, and 0.985 in the training set, 0.947, 0.816, 0.934, and 0.952 in the internal validation set, and 0.890, 0.904, 0.923, and 0.938 in the external validation set. This demonstrated that the CRDL model showed the greatest efficacy.

Conclusions:

The comprehensive model incorporating clinical features, radiomics, and DL shows promise for aiding in the differentiation between pulmonary metastases and hamartomas.
Regulatory patterns of Chinese patent medicine for lipid metabolism disorders in patients with type 2 diabetes mellitus complicated by ischemic stroke: A systematic review and network meta-analysis
Authors: Lu Zhenkai , Zhang Xuming , Xie Yanming
Published: May 2024

Background:

To investigate the regulatory patterns of Chinese patent medicine (CPM) interventions on lipid metabolism disorders in patients with type 2 diabetes mellitus (T2DM) complicated by ischemic stroke.

Methods:

Two researchers independently searched 8 major databases and created a comprehensive database containing all randomized controlled trials (RCTs) that investigated the application of “blood-activating and stasis-removing” CPM in the treatment of stroke combined with T2DM until October 1, 2022. The collected data were compiled and organized in Excel. Quality assessment was performed using the Cochrane 5.3 bias risk assessment tool, and the network meta-analysis was conducted using R software.

Results:

A total of 12 articles were included in the final analysis, covering 4 types of CPM: Naoxintong Capsules (NXT), Tongmai Jiangtang Capsules, Tongxinluo Capsules (TXL), and Yindan Xinnaotong Soft Capsules. Among these, CPM formulations containing herbs with blood-activating and stasis-removing properties were the most commonly used. The results of the network meta-analysis are as follows: (1) the combination of 3 CPM formulations showed superior efficacy in improving total cholesterol levels compared to conventional Western medicine treatment (CT). In particular, Yindan Xinnaotong Soft Capsules + CT (surface under the cumulative ranking curve [SUCRA] = 97.24%) demonstrated the highest efficacy, followed by NXT + CT (SUCRA = 66.23%), and then TXL + CT (SUCRA = 55.16%). (2) TXL + CT treatment exhibited the most promising efficacy in improving triglyceride levels (P < .05), while the effects of the other 3 CPM formulations were not statistically significant. (3) In terms of improving low-density lipoprotein levels, NXT + CT (SUCRA = 82.27%) showed better efficacy than TXL + CT (SUCRA = 73.99%), while the effects of the other 2 CPM formulations were not statistically significant. (4) The combination of CPM formulations and CT resulted in a lower incidence of adverse reactions compared to CT (P < .05).

Conclusion:

The treatment of patients with T2DM complicated by ischemic stroke commonly involved the use of “blood-activating and stasis-removing” herbal medicines. These herbal medicines have shown effectiveness in regulating patients’ blood lipid levels. However, it is crucial to acknowledge that the analysis was influenced by variations in the number and quality of RCTs involving different CPM formulations. Therefore, additional validation through large-scale, high-quality RCT studies is required.
A urethral leiomyoma presenting with dysuria: A rare case report
Authors: Wu Shuo , Min Zhichao , Wu Lingyan , Zhang Mengsi , Wu Lejun
Published: May 2024

Rationale:

Leiomyoma is a benign smooth muscle tumor which is rarely found in urethra. We hereby report a case of a 44-year-old female who presented with complaints of dysuria.

Patient concerns:

A 44-year-old female patient presented to the urology outpatient clinic with symptoms of dysuria. The patient described the presence of a protrusion from the urethra during urination.

Diagnosis:

Urethral leiomyoma.

Interventions:

Physical examination confirmed a solid urethral mass. CT scan and USG reports indicated that the mass originated from the mid-urethra with vascularity at the base. We performed a complete resection of the urethral mass. The patient was discharged after 3 days of observation.

Outcome:

During a follow-up after 1 month, the patient reported improved urinary flow and no occurrence of hematuria. The patient recovered well after discharge.

Lesson:

Urethral leiomyoma is a rare benign tumor that is often misdiagnosed in clinical practice. Diagnosis requires careful clinical examination. Surgical removal usually works well. It is important to remember that in some cases of acute urinary retention, it can be caused by a complete obstruction of a mass in the urethra. Urologists should be more cautious and experienced in handling such cases.
A mini-review on safeguarding global health amidst a “Pandemic” of armed conflicts
Authors: Kokori Emmanuel , Olatunji Gbolahan , Yusuf Ismaila Ajayi , Isarinade Timilehin , Moradeyo Akanmu Abdulrahmon , Olatunji Doyin , Akinmoju Olumide , Aderinto Nicholas
Published: May 2024

The year 2022 witnessed an alarming surge in state-based armed conflicts globally, reaching a staggering 56, with major hostilities in Ukraine, Myanmar, and Nigeria resulting in over 10,000 estimated conflict-related deaths. This trend continued with the onset of a significant conflict between Israel and Hamas in October 2023. The escalating frequency of armed conflicts, reaching the highest number since 1946, poses a critical threat to global health. This paper explores the multifaceted health impacts of armed conflicts, encompassing physical injuries, infectious diseases, malnutrition, and profound mental health consequences. Healthcare systems in conflict zones face severe strain, and achieving Sustainable Development Goals by 2030 becomes increasingly challenging. The surge in armed conflicts globally is characterized as a “pandemic,” justifying urgent attention. The paper identifies and discusses strategies to safeguard public health in conflict zones, emphasizing humanitarian response, protecting healthcare workers and infrastructure, building preparedness and resilience, and promoting mental health support. In navigating this “pandemic” of armed conflicts, comprehensive strategies are imperative to address the intricate challenges and secure a healthier global future.
Influence of continuous 4C nursing on quality of life and self-care ability of patients with diabetes retinopathy: An observational study
Authors: Wufuer Ayixianmuguli , Ma Jiamei , Ainiwa Pazilaiti , Zhou Qi
Published: May 2024

This study aims to investigate the impact of continuous 4C nursing on patients with diabetes retinopathy (DR) and its influence on self-care ability. A total of 100 DR patients admitted to our hospital from October 2020 to October 2022 were randomly divided into a control group and an observation group, with 50 cases in each group. The control group received routine care, while the observation group received continuous 4C care. The nursing effects of both groups were compared. After nursing, the observation group showed a lower self-rating anxiety scale score and a higher self-care ability scale score compared to the control group (P < .05). The SQQL-VI scores for all social activities were also higher in the observation group (P < .05). Additionally, the observation group had lower levels of fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin than the control group (P < .05). Moreover, the observation group had higher visual acuity and lower intraocular pressure than the control group (P < .05). The visual impairment rate was lower and the overall compliance rate was higher in the observation group compared to the control group (P < .05). After nursing, both groups showed improvements in symptoms, visual function, physical function, psychological and social activity scores, visual acuity, and patient satisfaction scores. The observation group showed greater improvements compared to the control group (P < .05). The application of continuous 4C nursing in DR patients has shown positive effects, including improved patient compliance and satisfaction, enhanced patient quality of life and visual acuity. These findings suggest that continuous 4C nursing should be widely promoted and applied in clinical practice.
Therapeutic effectiveness analysis of tenofovir alafenamide and tenofovir disoproxil fumarate on the treatment for chronic hepatitis B
Authors: Liu Rui , Qiao Jin , Zhang Lin , Dou Zhihua
Published: May 2024

To explore the therapeutic effectiveness of tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) on the treatment for chronic hepatitis B (CHB). Retrospectively analyzing 241 cases of chronic hepatitis B patients admitted to our hospital from January 2020 to December 2021, they were divided into a TAF group of 180 cases and a TDF group of 61 cases. The liver function, serum virus markers, clinical efficacy, adverse reactions and cost-effectiveness ratio (CER) analysis of 2 groups were compared. Two groups of patients had no statistically significant difference in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) before treatment. After treatment, the levels of ALT, AST and TBIL were lower than before treatment in both groups (P < .05), but the inter-group difference was not statistically significant (P > .05). After treatment, Hepatitis B surface antigen (HBsAg) conversion rate and Hepatitis B virus DNA (HBV-DNA) conversion rate in the 2 groups had no statistically significant difference. After treatment, the difference in total clinical cure rate between the 2 groups has no statistical significance (P > .05), adverse reactions rate of TAF group was lower than that of TDF group (P < .05). The drug cost median of TAF group was higher than that of TDF (P < .05), but Cost-effectiveness analysis showed the CER of TAF group was similar of TDF group. TAF or TDF therapy can both improve liver function and promote recovery in patients with CHB, achieving the goal of treatment. TAF have more cost but have similar CER to TDF. Moreover, TAF therapy has a higher safety profile.
Incretin-based drugs decrease the incidence of prostate cancer in type 2 diabetics: A pooling-up analysis
Authors: Lin Yuxiang , Xu Guangyong , Li Liangyu , Xiang Jingyi , Zhai Lingyun
Published: May 2024

Incretin-based drugs, a class of Antidiabetic medications (ADMs) used in the treatment of type 2 diabetes, may affect the incidence of prostate cancer (PCa). But real-world evidence for this possible effect is lacking. Therefore, the aim of this study is to assess the effect of incretin-based drugs on the incidence of PCa, including glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase-4 (DPP-4) inhibitors. We searched PubMed, Embase, and Cochrane Library databases for eligible studies through September 2023. Two independent reviewers performed screening and data extraction. We used the Cochrane Handbook for Systematic Reviews and the Newcastle-Ottawa Scale (NOS) to assess the quality of included randomized controlled trials (RCTs) and cohort studies. We did a meta-analysis of available trial data to calculate overall risk ratios (RRs) for PCa. A total of 1238 articles were identified in our search. After screening for eligibility, 7 high-quality studies met the criteria for meta-analysis, including 2 RCTs and 5 cohort studies, with a total of 1165,738 patients. Compared with the control group, we found that incretin-based drugs reduced the relative risk of PCa by 35% (95% confidence interval (CI), 0.17–0.49; P = .0006). In subgroup analysis, the RR values for GLP-1 receptor agonists and DPP-4 inhibitors were 62% (95% CI, 0.45–0.85; P = .003) and 72% (95% CI, 0.46–1.12; P = .14), respectively. Incretin-based drugs are associated with lower incidence of prostate cancer and may have a preventive effect on prostate cancer in patients with type 2 diabetes.
Deciphering the progression of fine-needle aspiration: A bibliometric analysis of thyroid nodule research
Authors: Liu Tengfei , Yang Fei , Qiao Junli , Mao Mengxuan
Published: May 2024

This study aims to dissect the evolution and pivotal shifts in Fine-Needle Aspiration (FNA) research for thyroid nodules over the past 2 decades, focusing on delineating key technological advancements and their impact on clinical practice. A comprehensive bibliometric analysis was conducted on 5418 publications from the Web of Science Core Collection database (2000–2023). Publications were rigorously selected based on their contributions to the advancement of FNA techniques and their influence on thyroid nodule management practices. Our analysis uncovered significant breakthroughs, most notably the incorporation of ultrasound and molecular diagnostics in FNA, which have markedly elevated diagnostic accuracy. A pivotal shift was identified towards minimally invasive post-FNA treatments, such as Radiofrequency Ablation, attributable to these diagnostic advancements. Additionally, the emergence of AI-assisted cytology represents a frontier in precision diagnostics, promising enhanced disease identification. The geographical analysis pinpointed the United States, Italy, and China as key contributors, with the United States leading in both publication volume and citation impact. This bibliometric analysis sheds light on the transformative progression in FNA practices for thyroid nodules, characterized by innovative diagnostic technologies and a trend towards patient-centric treatment approaches. The findings underscore the need for further research into AI integration and global practice standardization. Future explorations should focus on the practical application of these advancements in diverse healthcare settings and their implications for global thyroid nodule management.
Exploration of the molecular linkage between endometriosis and Crohn disease by bioinformatics methods
Authors: Zhou Weijie , Su Peizhu , Wang Yilin , Li Zhaotao , Liu Liu
Published: May 2024

Background:

Endometriosis (EMT) is a common disease in reproductive-age woman and Crohn disease (CD) is a chronic inflammatory disorder in gastrointestinal tract. Previous studies reported that patients with EMT had an increased risk of CD. However, the linkage between EMT and CD remains unclear. In this study, we aimed to investigate the potential molecular mechanism of EMT and CD.

Methods:

The microarray data of EMT and CD were downloaded from Gene Expression Omnibus. Common genes of EMT and CD were obtained to perform the Gene Ontology and Kyoto Encyclopedia of Gene Genomes enrichments. The protein-protein interaction network was constructed by Cytoscape software and the hub genes were identified by CytoHubba plug-in. Finally we predicted the transcription factors (TFs) of hub genes and constructed a TFs-hub genes regulation network.

Results:

A total of 50 common genes were identified. Kyoto Encyclopedia of Gene Genomes enrichment showed that the common genes mainly enriched in MAPK pathway, VEGF pathway, Wnt pathway, TGF-beta pathway, and Ras pathway. Fifteen hub genes were collected from the protein-protein interaction network, including FMOD, FRZB, CPE, SST, ISG15, EFEMP1, KDR, ADRA2A, FZD7, AQP1, IGFBP5, NAMPT, PLUA, FGF9, and FHL2. Among them, FGF9, FZD7, IGFBP5, KDR, and NAMPT were both validated in the other 2 datasets. Finally TFs-hub genes regulation network were constructed.

Conclusion:

Our findings firstly revealed the linkage between EMT and CD, including inflammation, angiogenesis, immune regulation, and cell behaviors, which may lead to the risk of CD in EMT. FGF9, FZD7, IGFBP5, KDR, and NAMPT may closely relate to the linkage.
Assessing the clinical utility of abdominal computed tomography in sepsis patients with unknown origin: A retrospective cohort study
Authors: Ho Pei-Hsuan , Lee Yi-Chih , Ng Chip-Jin , Chaou Chung-Hsien , Chen Shou-Yen
Published: May 2024

Early identification of the sources of infection in emergency department (ED) patients of sepsis remains challenging. Computed tomography (CT) has the potential to identify sources of infection. This retrospective study aimed to investigate the role of CT in identifying sources of infection in patients with sepsis without obvious infection foci in the ED. A retrospective chart review was conducted on patients with fever and sepsis visiting the ED of Linkou Chang Gung Memorial Hospital between July 1, 2020 and June 30, 2021. Data on patient demographics, vital signs, clinical symptoms, underlying medical conditions, laboratory results, administered interventions, length of hospital stay, and mortality outcomes were collected and analyzed. Of 218 patients included in the study, 139 (63.8%) had positive CT findings. The most common sources of infection detected by CT included liver abscesses, acute pyelonephritis, and cholangitis. Laboratory results showed that patients with positive CT findings had higher white blood cell and absolute neutrophil counts and lower hemoglobin levels. Positive blood culture results were more common in patients with positive CT findings. Additionally, the length of hospital stay was longer in the group with positive CT findings. Multivariate logistic regression analysis revealed that hemoglobin levels and positive blood culture results independently predicted positive CT findings in patients with fever or sepsis without an obvious source of infection. In patients with sepsis with an undetermined infection focus, those presenting with leukocytosis, anemia, and elevated absolute neutrophil counts tended to have positive findings on abdominal CT scans. These patients had high rates of bacteremia and longer lengths of stay. Abdominal CT remains a valuable diagnostic tool for identifying infection sources in carefully selected patients with sepsis of undetermined infection origins.
Diagnostic and prognostic significance of mast cell markers in HIV/AIDS: Current insights and future directions
Authors: Obeagu Emmanuel Ifeanyi
Published: May 2024

Human immunodeficiency virus (HIV) infection continues to pose significant global health challenges, necessitating advancements in diagnostic and prognostic approaches to optimize disease management. While primarily recognized for their roles in allergic responses, mast cells have emerged as potential markers with diagnostic and prognostic significance in the context of HIV/AIDS. This paper aims to synthesize current insights and delineate future directions regarding the utility of mast cell markers in diagnosing HIV infection, predicting disease progression, and guiding therapeutic strategies. Mast cells, equipped with distinct markers such as tryptase, chymase, carboxypeptidase A3, and c-kit/CD117 receptors, exhibit tissue-specific expression patterns that offer potential as diagnostic indicators for HIV infection. Understanding the dynamics of these markers in different tissues and body fluids holds promise for accurate HIV diagnosis, disease staging, and monitoring treatment responses. Moreover, the prognostic significance of mast cell markers in HIV/AIDS lies in their potential to predict disease progression, immune dysregulation, and clinical outcomes. The integration of mast cell markers into clinical applications offers promising avenues for refining diagnostic assays, patient monitoring protocols, and therapeutic strategies in HIV/AIDS. Future research directions involve the development of novel diagnostic tools and targeted therapies based on mast cell-specific markers, potentially revolutionizing clinical practice and enhancing patient care in the management of HIV/AIDS. Continued investigations into mast cell markers’ diagnostic and prognostic implications hold immense potential to advance our understanding and improve outcomes in HIV/AIDS management.
Global research landscape and trends of cancer stem cells from 1997 to 2023: A bibliometric analysis
Authors: Chen Yuxian , Qu Baozhen , Zheng Keke , Liu Yanhao , Lu Linlin , Zhang Xiaotao
Published: May 2024

Cancer stem cells (CSCs) are a subset of cells with self-renewal ability and tumor generating potential. Accumulated evidence has revealed that CSCs were shown to contribute to tumorigenesis, metastasis, recurrence and resistance to chemoradiotherapy. Therefore, CSCs were regarded as promising therapeutic targets in cancer. This study is the first to reveal the development process, research hotspots, and trends of entire CSCs research field through bibliometric methods. All relevant publications on CSCs with more than 100 citations (notable papers) and the 100 most cited papers (top papers) during 1997 to 2023 were extracted and analyzed. Cancer research published the largest number of papers (184 papers). The USA accounted for the most publications (1326 papers). Rich, JN was the author with the most publications (56 papers) and the highest M-index (3.111). The most contributive institution was the University of Texas System (164 papers). Before 2007, research mainly focused on the definition and recognition of CSCs. Between 2007 and 2016, with the emergence of the terms such as “sonic hedgehog,” “metabolism,” “oxidative phosphorylation,” and “epithelial mesenchymal transition,” research began to shift toward exploring the mechanisms of CSCs. In 2016, the focus transitioned to the tumor microenvironment and the ecological niches. The analysis of papers published in major journals since 2021 showed that “transcription,” “inhibition,” and “chemoresistance” emerged as new focused issues. In general, the research focus has gradually shifted from basic biology to clinical transformation. “Tumor microenvironment” and “chemo-resistance” should be given more attention in the future.
Management of work stress among arts and science school administrators in Nigeria using rational emotive occupational health coaching: A randomized controlled trial evaluation
Authors: Chinweuba Ngozi Hope , Chigbu Baptista Chinyere , Aham Assumpta C. , Onyi Ifeoma E. , Ezeugo Nneka Chinyere , Anakpua Blessing C. , Enebechi Regina Ijeamasi , Kalu Ijeoma Awa , Eze Nneka Justina , Ugwuanyi Christian Sunday
Published: May 2024

Background:

The working circumstances of the administrators are appalling due to the nature of education in Nigeria. These administrators put in a lot of overtime to fulfill the expectations of their positions, which stresses them out. But there is no information in the literature about how administrators of science schools deal with their demanding environments. Therefore, the aim of this study was to evaluate how administrators of secondary scientific schools in the Southeast could manage work-related stress by using rational and emotive occupational health coaching.

Methods:

A randomized controlled trial (RCT) experimental design was used for the investigation, with 106 people divided into 2 groups–one for the intervention and one for the control. A selection of these participants came from southeast Nigerian special scientific schools. The Occupational Stress Index (OSI) and the Perceived Stress Scale (PSS) served as the foundation for our data collection procedure. A posttest was given following the 12-week intervention, and then there was a 2-month follow-up assessment. Repeated analysis of variance (ANOVA) was utilized to ascertain the effects both within and across groups.

Results:

It was revealed that rational emotive occupational health coaching had significant effect on the management of work stress among southeast secondary arts and science school administrators, F (2, 208) = 1452.484, P = <.050, ŋ2 = .933, and F (1, 104) = 18076.988, P = <.050, ŋ2 = .994).

Conclusion:

The management of work stress among southeast secondary arts and science school administrators was significantly improved through rational emotive occupational health coaching.
A rare case report of bilateral vestibulopathy due to otosyphilis
Authors: Gu Huanhuan , Xu Yixin , Xu Jin , Zhuang Jianhua
Published: May 2024

Rationale:

Bilateral vestibulopathy is an important cause of imbalance. There are multiple etiologies of bilateral vestibulopathy (BVP), but reports of BVP due to otosyphilis are rare.

Patient concerns:

A 39-year-old male was referred to our medical center due to vertigo, persistent dizziness and gait disturbance for 2 months.

Diagnoses:

Bilateral vestibulopathy due to otosyphilis was considered in this case, as confirmed through analyses of vestibular function, laboratory tests, and penicillin treatment.

Interventions:

The patient was was treated with a high dose of penicillin G (24 × 106 IU/d) for 14 days.

Outcomes:

The patient’s symptoms had improved greatly following treatment, with dizziness and gait disturbance having completely resolved at 3 months following hospital discharge.

Lessons:

Bilateral vestibulopathy should be considered when evaluating patients with acute or subacute persistent dizziness. Clinicians should also be aware of the potential for otosyphilis among patients who report BVP.