bluuebunny/crossref_metadata_2025 huggingface dataset:
A four-asset technology-based growth policy
Authors: Tassey Gregory
Published: August 2023

This paper presents the rationale for a four-asset growth policy model, which the US economy has executed only on a partial and intermittent basis over the past four decades. The need for such a model is driven by (1) growing global competition, (2) resulting slower gross domestic product and personal income growth, and (3) a consequent rise in income inequality. Without a more effective growth model to both broaden and deepen the role of technology, declining growth and its skewed distribution among income classes will perpetuate current social and political unrest. To achieve both broader and deeper technology-based growth across the economy, the proposed technology element model specifies the four major asset categories that characterize technology-based economic development, which combine to drive more effective growth policy analysis and development.
Policy Effects on Mixed-Citizenship, Same-Sex Unions: A Triple-Difference Analysis
Authors: Hoffmann Nathan I , Velasco Kristopher
Published: August 2023

After the U.S. Supreme Court struck down the Defense of Marriage Act (DOMA) in 2013, same-sex partners of U.S. citizens became eligible for spousal visas. Since then, the United States has seen a rapid rise in same-sex, mixed-citizenship couples. However, this effect varies greatly depending on the lesbian, gay, and bisexual (LGB) policy context of the noncitizen’s country of origin. Using waves 2008–2019 of the American Community Survey, this study employs a triple-difference design to examine how the policy environment of the origin country moderates the effect of the end of DOMA on incidence of mixed-citizenship, same-sex couples in the United States. Quasi-Poisson models with two-way fixed effects show that, after 2013, individuals in mixed-citizenship, same-sex couples coming from countries with progressive LGB policies saw a more than 60% increase in incidence relative to those in different-sex or same-citizenship couples. Meanwhile, those from countries with regressive laws experienced no significant increase. These results are corroborated by analyses of individual policies. We argue that the country-of-origin policy context affects and is affected by local norms and attitudes as well as individuals’ material circumstances. This nexus of factors leaves a lasting impact on immigrants that shapes migration decisions, union formation, and responses to policy shifts.
Seroepidemiology of Toxoplasma gondii infection in blood donors in a population from the northwestern region of São Paulo state, Brazil
Authors: Assoni Letícia Carolina Paraboli , Nakashima Fabiana , de Sousa Valquíria Pardo , Paduan Natália Juliana , Andreasse Isabela Rufino , Anghinoni Thelma Helena , de Faria Junior Geraldo Magela , Ricci Junior Octávio , Castiglioni Lilian , Brandão Cinara Cássia , de Mattos Luiz Carlos , Ayo Christiane Maria
Published: August 2023

Background

Toxoplasmosis is one of the most common parasitic infections worldwide with varying prevalence between human populations. These variations are mainly associated with human exposure to risk factors. In this article, the seroprevalence of Toxoplasma gondii infection and the risk factors associated with infection in 1729 blood donors from São José do Rio Preto, São Paulo, Brazil were analysed.

Methods

The serological tests for detecting immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-T. gondii were used. The risk factors associated with the infection were identified through the application of an epidemiological questionnaire.

Results

The prevalence of T. gondii infection was 48.0%. The following factors were identified in the final model after multiple logistic regression analysis: drinking raw milk (p=0.003; odds ratio [OR] 1.364 [confidence interval {CI} 1.1 to 1.7]), residing in a rural area (p<0.0001; OR 2.764 [CI 1.7 to 4.6]) and receiving a blood transfusion (p=0.015; OR 1.856 [CI 1.1 to 3.0]).

Conclusions

The data obtained in this study showed that the blood donor population is exposed to risk factors related to infection by T. gondii. These data allow the establishment of control programs to contribute to public health in northwestern São Paulo state.
20-year Clinical Outcomes of Cervical Disk Arthroplasty
Authors: Sasso Willa R. , Ye Jason , Foley David P. , Vinayek Sheetal , Sasso Rick C.
Published: August 2023

Study Design.

Prospective, randomized, controlled trial.

Objective.

To compare clinical outcomes of anterior cervical discectomy and fusion (ACDF) and cervical disk arthroplasty (CDA) at 20 years.

Summary of Background Data.

Concern for adjacent-level disease after ACDF prompted the development of CDA.

Materials and Methods.

Forty-seven patients with single-level cervical radiculopathy were randomized to either BRYAN CDA or ACDF for a Food and Drug Administration Investigational Device Exemption trial. At 20 years, patient-reported outcomes, including visual analog scales (VAS) for neck and arm pain, neck disability index (NDI), and reoperation rates, were analyzed.

Results.

Follow-up rate was 91.3%. Both groups showed significantly better NDI, VAS arm pain, and VAS neck pain scores at 20 years versus preoperative scores. Comparing CDA versus ACDF, there was no difference at 20 years in mean scores for NDI [11.1 (SD 14.1) vs. 19.9 (SD 17.2), P=0.087], mean VAS arm pain [0.9 (SD 2.4) vs. 2.3 (SD 2.8), P=0.095], or mean VAS neck pain [1.2 (SD 2.5) vs. 2.9 (3.3), P=0.073]. There was a significant difference between CDA versus ACDF groups in the change in VAS neck pain score between 10 and 20 years [respectively, −0.4 (SD 2.5) vs. 1.5 (SD 2.5), P=0.030]. Reoperations were reported in 41.7% of ACDF patients and 10.0% of CDA patients (P=0.039).

Conclusions.

Both CDA and ACDF are effective in treating cervical radiculopathy with sustained improvement in NDI, VAS neck and VAS arm pain at 20 years. CDA demonstrates lower reoperation rates than ACDF. There were no failures of the arthroplasty device requiring reoperation at the index level. The symptomatic nonunion rate of ACDF was 4.2% at 20 years. Despite a higher reoperation rate in the CDA group versus ACDF group, there was no difference in the 20-year NDI, VAS Neck, and VAS arm pain scores.
Applications of Near-Infrared Fluorescence Imaging and Angiography of Inferior Vesical Artery in Laparoscopic Lateral Lymph Node Dissection: A Prospective Non-randomized Controlled Study
Authors: Tang Bin , Zhou Sicheng , He Kunshan , Mei Shiwen , Qiu Wenlong , Guan Xu , Liu Fucheng , Chi Chongwei , Wang Xishan , Tian Jie , Liu Qian , Tang Jianqiang
Published: August 2023

BACKGROUND:

Near-infrared imaging with indocyanine green has been used to guide lateral lymph node dissection, yet its efficacy and benefits need further investigation.

OBJECTIVE:

To investigate the efficacy and feasibility of near-infrared fluorescence imaging and angiography of inferior vesical artery in laparoscopic lateral lymph node dissection.

DESIGN:

A prospective non-randomized controlled study.

SETTINGS:

Single center study

PATIENTS:

Patients with lower rectal cancer who underwent total mesorectal excision plus lateral lymph node dissection.

MAIN OUTCOME MEASURES:

A cohort of 108 patients was enrolled. After propensity score matching, 29 patients in near-infrared group and 50 patients in non-near-infrared group were matched. The total number of harvested lateral lymph nodes, positive lateral lymph nodes, inferior vesical artery preservation, and postoperative urinary function were compared.

RESULTS:

After propensity score matching, the baseline characteristics were similar in both groups. The total number of harvested lateral lymph nodes in the near-infrared group was significantly higher (12 vs 9, p = 0.013), but positive lateral lymph nodes were similar between the two groups (1 vs. 1, p = 0.439). The ratio of inferior vesical artery preservation was significantly increased with the aid of indocyanine green angiography (93.1% vs. 56.0%, p < 0.001). The non-near-infrared group required more days for urinary catheter removal than the near-infrared group (5 vs. 4, p = 0.046). Urinary recatheterization tended to occur more frequently in the non-near-infrared group, with a marginally significant trend (16% vs. 0%, p = 0.059). The non-near-infrared group tended to have more cases with residual urine volume ≥50 ml than that of the near-infrared group (20.0% vs. 3.4%, p = 0.087), especially in the bilateral dissection subgroup (41.2% vs. 0%, p = 0.041).

LIMITATIONS:

Small sample size.

CONCLUSIONS:

Near-infrared imaging increased the number of harvested lateral lymph nodes, while real-time indocyanine green fluorescence angiography ensured the preservation of inferior vesical artery and tended to improve postoperative urinary function.
Measurable Residual Disease Testing in Multiple Myeloma Routine Clinical Practice: A Modified Delphi Study
Authors: Ramasamy Karthik , Avet-Loiseau Hervé , Hveding Blimark Cecilie , Delforge Michel , Gay Francesca , Manier Salomon , Martinez-Lopez Joaquín , Mateos Maria Victoria , Mohty Mohamad , van de Donk Niels W.C.J. , Weisel Katja
Published: August 2023

We used a modified Delphi approach to establish areas of consensus and nonconsensus regarding the utility of determining measurable residual disease (MRD) to assess multiple myeloma (MM) treatment response, which may inform disease management and design of future clinical trials. This modified Delphi study incorporated 2 iterative rounds of surveys to evaluate the opinions of an expert panel of 61 practicing hematological oncologists from across 14 countries in Europe concerning the use of MRD testing in MM management. Survey 1 assessed experts’ opinions on MRD testing in different clinical situations and associated challenges. Survey 2 focused on the lack of consensus areas identified in survey 1. Consensus to an individual question was defined a priori as 75% agreement or disagreement by the panel. From the 2 rounds of surveys, the experts reached consensus agreement that MRD testing should be performed in newly diagnosed or relapsed patients who achieved complete response (CR) or better after transplantation. In transplant-ineligible patients, experts recommended MRD testing in those who are ≤70 years old and in CR. If a patient was previously positive on positron-emission tomography and computed tomography (PET/CT), both MRD and PET/CT should be assessed at CR. MRD testing should be performed ≤6 months after transplantation and every 6–12 months in continuously treated patients in CR. There was no consensus on making treatment decisions based on MRD status. MRD testing is an important component of clinical management in MM. Additional data will further clarify the role of MRD in guiding treatment decisions.
Calcification of an intraocular lens designed for sutureless scleral fixation in a patient with band keratopathy
Authors: Bundogji Nour , Filios Achilleas , Hawn Vivian S. , Crafoord Sven , Werner Liliana
Published: August 2023

Introduction:

A case of a calcified Carlevale intraocular lens (IOL), which was explanted or exchanged and underwent laboratory analyses, is reported.

Patient and Clinical Findings:

A 74-year-old pseudophakic man with a history of type 2 diabetes presented with progressive vision changes 2 years after undergoing vitrectomy and implantation of a Carlevale IOL in the right eye due to previous subluxation of a 3-piece lens. Slitlamp examination was significant for mild band keratopathy and a diffusely opacified Carlevale IOL.

Diagnosis, Intervention, and Outcomes:

The opacified IOL was explanted and exchanged for an Artisan IOL, with posterior enclavation. Grossly, the explanted IOL exhibited extensive and diffuse deposits/crusts throughout its surface, causing opacification. Scanning electron microscopy coupled with surface analysis confirmed that the deposits/crusts were composed of calcium/phosphate.

Conclusions:

To the authors' knowledge, this is the first reported case of an opacified Carlevale IOL that underwent laboratory analysis confirming calcification. Alteration in calcium homeostasis that may accompany the diabetic state may represent a contributing factor to the band keratopathy and IOL calcification in this case.
The Experiences of Black Students in Physical Therapy Education in Texas: A Qualitative Study
Authors: Bakouetila-Martin Mercia , Duke Brittney , Pantoja-Aming Andrea , Alfaro Sarah , Williams Stephanie , Mbah Nkechi , Marie Lucero-Schoenfeld Amy , Ossai Uchenna , Hale Jennifer
Published: August 2023

Introduction.

Racial or ethnic minorities are underrepresented in many health care professions, including physical therapy. Understanding the experiences of minority students in graduate education provides insight into how physical therapy educational programs can promote diversity, equity, and inclusion, which are factors that have been shown to improve patient outcomes. The purpose of this study is to qualitatively analyze and describe the lived experiences of Black student physical therapists (PT) in Texas.

Review of Literature.

Currently, there is a lack of qualitative research that investigates the experiences of Black students in physical therapy education in the United States.

Subjects.

Nineteen Doctor of Physical Therapy students from 8 different physical therapy educational programs in Texas.

Methods.

This qualitative study was conducted using a phenomenological approach. All participants took part in a focus group regarding their academic experiences. Students' dialogues were recorded and transcribed, and the researchers identified recurrent themes.

Results.

After the analysis of focus group content, it was determined that the following 5 themes characterized the students’ experiences: 1) Barriers to enrollment, 2) underrepresentation, 3) implicit and explicit racism, 4) code-switching, and 5) desired image.

Discussion and Conclusion.

There is evidence to suggest that Black or African American students are subject to unique pressures that negatively affect their experiences during their PT education. Efforts need to be made by higher education institutions and individuals to provide a more inclusive environment to best support those students. By gaining awareness of the results of this study, educators and students can begin dialogues on how to foster inclusivity and cultural understanding in physical therapy education. Ultimately, understanding the experiences of others can improve how individuals coexist in an increasingly diverse society, and how clinicians provide patient-centered, culturally aware care to patients and clients.
A Continuous Quality Improvement Framework for Sustainable Action and Advancement of Diversity, Equity, Inclusion, and Belonging in Physical Therapy
Authors: Kiami Sheri R. , Hayward Lorna , Goodgold Shelley
Published: August 2023

Background and Purpose.

To address racial and ethnic disparities, physical therapy organizations, educational institutions, and clinical practices seek to advance diversity, equity, inclusion (DEI), and social justice in health care. Although our professional organizations have crafted proclamations, resource lists, developed new accreditation standards, and strategic plans, we lack a unifying framework and action tools for substantial and sustained progress. In addition, the DEI acronym is missing the essential element of belonging (B), that is, sharing a sense of purpose and feeling safe to contribute opinions as a valued member of an organization. Therefore, the purpose of this position paper is to propose the utilization of a continuous quality-improvement (CQI) framework using Plan-Do-Study-Act (PDSA) cycles to advance DEI-B in physical therapy education and practice.

Position and Rationale.

The CQI framework and PDSA cycles are data-driven, iterative approaches for identifying areas for improvement, implementing interventions, collecting data, analyzing outcomes, and taking evidence-based next action steps. Application of this framework can enhance sustainability of DEI-B goals and foster progress toward the proposed accreditation criteria of the Commission on Accreditation in Physical Therapy Education in this critical area. Tenants for PDSA team success are presented, and PDSA cycles are described.

Discussion and Conclusion.

Addressing racism and advancing DEI-B efforts in the physical therapy profession requires bold, sustained, and intentional action that incorporates standards, strategies, and methods for measuring change. Examples of PDSA DEI-B initiatives, interventions, and outcomes are provided to illustrate how this approach can be implemented within a physical therapy education program. Using this CQI framework provides our profession with a DEI-B roadmap for advancing incremental and sustained progress.
Upper Gastrointestinal Neoplasia and Worrisome Thyroid Nodules are Common in Colonic Polyposis of Unknown Etiology (CPUE)
Authors: Hajj Ali Adel , Burke Carol A. , O’Malley Margaret , LaGuardia Lisa , Liska David , Macaron Carole
Published: August 2023

Background:

Colonic polyposis of unknown etiology (CPUE) is defined as ≥10 cumulative colonic adenomas without a detectable germline pathogenic variant. Surveillance for patients with >100 adenomas is recommended, similar to patients with familial adenomatous polyposis. The utility of extra-colonic screening in patients with 10 to <100 adenomas is not well established.

Methods:

All CPUE patients seen at our center between 2003 and 2022 were included. Patients were categorized based on the range of cumulative colorectal adenoma count: 10 to 19, 20 to 99, and ≥100.

Results:

In all, 150 patients were identified of which 20(13.3%) had 10 to 19 cumulative adenomas, 79(52.7%) had 20 to 99 adenomas, and 51(34.0%) had ≥100 adenomas. Compared with patients with 10 to 19 and 20 to 99, patients with ≥100 adenomas were younger (mean 51 vs. 52 vs. 42 y, respectively). Of patients who underwent esophagogastroduodenoscopy, duodenal adenomas were found in 33.3%, 10.1%, and 38% in the 3 groups, respectively, P=0.002. Ampullary adenomas were significantly more common in the ≥100 adenoma group (14.8%, P=0.019) compared with 8.3% and 2.9% in the 10 to 19 and 20 to 99 groups, respectively. Thyroid nodules ≥1 cm were not detected in patients with 10 to 19 adenomas but were found in 23.3% and 14.3% of patients with 20 to 99 and ≥100 adenomas, respectively (P=0.254).

Conclusion:

In our cohort, duodenal and gastric adenomas occurred in CPUE patients with adenoma count 10 to ≥100 at a relatively high proportion. We recommend a baseline esophagogastroduodenoscopy in all patients with CPUE. While clinically significant thyroid nodules were not detected in patients with 10 to 19 adenomas, they occurred in about one-fifth of the patients with ≥20 adenomas, indicating that thyroid ultrasound is prudent.
Perioperative management of Obstructive Sleep Apnoea: Present themes and future directions
Authors: Chambers Tom , Bamber Harry , Singh Nanak
Published: August 2023

Purpose of review

Obstructive sleep apnoea (OSA) is an increasingly common pathology that all those involved in perioperative care will come across. Patients with the condition present a challenge at many stages along the perioperative journey, not least because many patients living with OSA are unaware of their diagnosis.

Key interventions can be made pre, intra-, and postoperatively to improve outcomes. Knowledge of screening tools, diagnostic tests, and the raft of treatment options are important for anyone caring for these patients.

Recent findings

Recent literature has highlighted the increasing complexity of surgical patients and significant underdiagnosis of OSA in this patient population. Work has demonstrated how and why patients with OSA are at a higher perioperative risk and that effective positive airways pressure (PAP) therapy can reduce these risks, alongside evidencing how best to optimise adherence to therapy, a key issue in OSA.

OSA, and particularly undiagnosed OSA, presents a huge problem in the perioperative period. Perioperative PAP reduces the risk of postoperative complications but adherence remains an issue. Bespoke perioperative pathways should be developed to identify and optimise high risk patients, although at present evidence on how best to achieve this is lacking.
Efficacy of 3rd generation TKI in patients with EGFR mutation lung adenocarcinoma with bone metastases: A review of 3 case reports and literature
Authors: Guo Qiang , Feng Weiqiang , Hu Sheng , Ye Jiayue , Wang Silin , Su Lang , Zhang Yang , Zhang Deyuan , Zhang Wenxiong , Xu Jianjun , Wei Yiping
Published: August 2023

Rationale:

With the advancement of targeted therapies, epidermal growth factor receptor tyrosine kinase inhibitors have become the preferred initial treatment for patients with advanced epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer. Osimertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor, is effective against exon 19 and 21 mutations as well as the T790M mutation. It has been approved by both the food and drug administration and European Medicines Agency for the treatment of non-small cell lung cancer patients with locally advanced or metastatic EGFR-mutated tumors, including those who have acquired T790M mutations.

Patient concerns:

To evaluate the effectiveness of osimertinib in treating patients with EGFR-mutated advanced lung adenocarcinoma and bone metastases, we present the treatment outcomes of 3 patients with EGFR 19 deletion-mutated advanced lung adenocarcinoma and bone metastases who received osimertinib treatment in recent years. All 3 cases involved elderly female patients, aged 62, 62, and 54, respectively.

Diagnoses:

All 3 cases exhibited a diagnosis of pulmonary adenocarcinoma accompanied by osseous metastases, with genetic testing revealing the presence of an EGFR 19del mutation.

Interventions:

In the first case, following 17 months of gefitinib therapy, disease progression prompted a switch to osimertinib treatment. In the second case, bone metastases were detected after 20 months of pemetrexed-carboplatin chemotherapy, leading to a transition to osimertinib therapy. In the third case, after 11 months of erlotinib treatment, bone metastases were identified. Subsequent interventions, including radiation therapy, pemetrexed-carboplatin chemotherapy, pemetrexed-bevacizumab maintenance therapy, and docetaxel chemotherapy, failed to arrest the progression of bone metastases. As a result, a combination of osimertinib and anlotinib targeted therapy was administered.

Outcomes:

All 3 patients experienced relatively good and favorable survival outcomes, with a progression-free survival of 22.7 months, 12 months, and 17.7 months, respectively.

Lessons:

These cases suggest that osimertinib is a promising treatment option for patients with EGFR 19 deletion-mutated lung adenocarcinoma and bone metastases, although further clinical studies are needed to confirm its efficacy.
Treatment of filtration bleb dysfunction after glaucoma surgery by needle revision of filtration bleb combined with conbercept
Authors: Sun Zhonghua , Li Shanshan , Wang Wen , Zhang Miaomiao , Liu Wei , Ji Zhen , Wang Jianrong , Sun Yan , Liu Mingkun , Liu Cuijuan
Published: August 2023

Filtration surgery (Trabeculectomy) is the main treatment for glaucoma. The scarring of the filtration bleb and obstruction of the outflow of aqueous humor through the filtration channel are the main reasons of the surgery failure. The objective of this study was to determine the clinical efficacy of needle revision of filtration blebs combined with subconjunctival injection of conbercept on the functional bleb formation in glaucoma patients with eye pressure out of control after trabeculectomy. A total of 48 eyes with poor filtration bleb function after trabeculectomy for glaucoma were treated with needle revision of filtration bleb combined with subconjunctival injection of conbercept. After the treatment, the patients were followed up for 3 months during which visual acuity, intraocular pressure, slit lamp and ultrasound biomicroscope examinations were performed. Intraoperative and postoperative complications were recorded. The visual acuity and intraocular pressure were significantly improved after the needle revision of filtration blebs. Among the 48 eyes, 39 eyes still had functional blebs at the end of the follow-up period, and filtration blebs failed in 9 eyes 2 to 8 weeks after the removal of the needle. The survival rate of filtration blebs at 3 months after needle revision was (79.06 ± 3.42%), and 81.25% (39/48) of the eyes showed good formation rate of functional bleb at the last follow-up. Three months after needle revision, there was local scar formation in some filtration blebs. Part of the filtration blebs showed mild thickening of the local subconjunctival tissue, and the filtration bleb was slightly raised and diffuse, showing a multi-cavity and thin-walled shape in some blebs. Ultrasound biomicroscopy examination showed relative structural manifestations. Subconjunctival hemorrhage occurred in 43 patients during and after the operation. Low intraocular pressure occurred in 8 patients with the lowest pressure of 5 mm Hg. Choroidal edema was observed in 3 patients. Five patients had intraoperative conjunctival hemorrhage in the anterior chamber, and hyphema occurred. All complications were self-limited and resolved without surgical intervention. Needle revision of filtration bleb combined with anti-VEGF drugs is a safe and effective method for the treatment of filtration bleb dysfunction after surgery of glaucoma.
A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis
Authors: Liu Zhen , Luo Ling , Zhang Yunzhi , Chen Rong , Liu Anlin
Published: August 2023

Patients with decompensated cirrhosis, a symptomatic phase of cirrhosis, commonly experience multiple symptoms concurrently, referred to as symptom clusters. Effective self-management of symptoms is known to improve outcomes in various chronic diseases. However, a theory for self-management of symptom clusters in decompensated cirrhosis is lacking. In this study, we applied grounded theory research methodology to construct a new theory of self-management of symptom clusters in these patients. This qualitative study prospectively enrolled 20 patients with decompensated cirrhosis within 1 week after hospital admission. Data related to patients’ experiences, needs, perspectives, and abilities related to their symptoms were collected via a semi-structured, in-depth interview and analyzed with Nvivo version 20 software. Grounded theory methodology with 3 coding steps (open, axial, and selective coding) was applied to generate a theory of self-management of symptom clusters. From the step-by-step coding process, 2 core categories or major themes were identified: patients’ experiences with symptoms and coping with symptoms. The first major theme included symptom clustering, multidimensionality, recurrence, and specificity, while the second consisted of endogenous motivation, endogenous resistance, and external support needs. A new theory of self-management of symptom clusters was then constructed and delineated to enhance self-management among patients with decompensated cirrhosis. Using patient experience data, we developed a new theory of self-management of symptom clusters in patients with decompensated cirrhosis. Use of this theory has the potential to promote patient self-management and guide healthcare providers in planning optimal treatments and implementing timely interventions, ultimately improving in patient outcomes.
Identification of the key mechanisms of action of Si-Ni-San in uveitis using bioinformatics and network pharmacology
Authors: Zhang Dandan , Hong Liu , Zhang Rui Su , Zhang Qian , Yao Jing , Wang Jiadi , Zhang Ning
Published: August 2023

Background:

Uveitis is an eye disease with a high rate of blindness, whose pathogenesis is not completely understood. Si-Ni-San (SNS) has been used as a traditional medicine to treat uveitis in China. However, its mechanism of action remains unclear. This study explored the potential mechanisms of SNS in the treatment of uveitis through network pharmacology and bioinformatics.

Methods:

Using R language and Perl software, the active components and predicted targets of SNS, as well as the related gene targets of uveitis, were mined through the Traditional Chinese Medicine Systems Pharmacology, Therapeutic Target, Gene Expression Omnibus, GeneCards, and DrugBank databases. The network diagram of active components and intersection targets was constructed using Cytoscape software and the String database. The CytoNCA plug-in was used to conduct topological analysis on the network diagram and screen out the core compounds and key targets. The genes were analyzed for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment. Chemoffice, Pymol, AutoDock, and Vina were used to analyze the molecular docking of key targets and core compounds of diseases through the PubChem database.

Results:

JUN, RELA, and MAPK may play important roles in the treatment of uveitis by SNS. Kyoto encyclopedia of genes and genomes pathway enrichment analysis showed that core genes were mainly concentrated in MAPK, toll-like receptor, tumor necrosis factor, and nucleotide oligomerization domain-like receptor signaling pathways. In addition, molecular docking results showed that the bioactive compounds (kaempferol, luteolin, naringin, and quercetin) exhibited good binding ability to JUN, RELA, and MAPK.

Conclusion:

Based on these findings, SNS exhibits multi-component and multi-target synergistic action in the treatment of uveitis, and its mechanism may be related to anti-inflammatory and immune regulation.
Expression and prognostic value of AIM1L in esophageal squamous cell carcinoma
Authors: Zhou Lu , Gan Lanlan , Liu Zongwen
Published: August 2023

Background:

Absent in melanoma 1-like (AIM1L), also known as crystalline beta gamma domain containing 2. The relationship between AIM1L and tumors has not been fully investigated, and the biological function of AIM1L in different tumors is unknown, so we bioinformatically explored a possible relationship between AIM1L and esophageal squamous cell carcinoma (ESCC).

Methods:

AIM1L mRNA expression was detected by the Gene Expression Omnibus database (GSE20347, GSE161533, and GSE53625), and protein level expression was detected by immunohistochemistry. The correlation between AIM1L expression and clinical pathological characteristics was evaluated by the Wilcoxon signed rank test or chi-square test. Kaplan–Meier analysis and Cox proportional risk regression model were used to determine the prognostic value of AIM1L in ESCC patients and establish and verify a nomogram. Find genes highly related to the expression of AIM1L, conduct GO and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis, and conduct GSEA analysis on the gene set. The “CIBERSORT” R package was used to explore the relationship between AIM1L and immune infiltration, and the “OncoPredict” R package was used to explore the relationship between AIM1L and drug sensitivity.

Results:

Compared with the matched adjacent non-cancer tissues, the expression of AIM1L was down-regulated in ESCC tissues, and correlated with tumor grade. Kaplan–Meier survival analysis and Cox analysis showed that the low expression of AIM1L was related to the poor prognosis of ESCC patients. Enrichment analysis explained the possible function of AIM1L, GSEA determined the highly correlated signal pathway of AIM1L low expression phenotype, immune infiltration analysis determined that AIM1L was related to activated NK cells and macrophage M2, and drug sensitivity analysis determined that the low expression of AIM1L might be related to EGFR targeted drug resistance.

Conclusion:

AIM1L may be a candidate tumor suppressor gene for ESCC and an independent molecular biomarker for the prognosis of ESCC patients.
The practice of defensive medicine among physicians in the United Arab Emirates: A clinician survey
Authors: Al Awar Shamsa , Ucenic Teodora Elena , Elbiss Hassan
Published: August 2023

Defensive medicine, a term known since the 1960s, may lead to risks in healthcare provision. Reported to be prevalent in North America and Europe, it is thought to be spreading globally. This study aims to evaluate defensive medicine practice among physicians in the United Arab Emirates. A quantitative cross-sectional survey consisting of a twenty-three point questionnaire was conducted after obtaining ethics approval. The response data concerning the practice of defensive medicine were summarized as a percentage of the total. There were 562 respondents. Of these, 307 (54.6%) and 258 (45.9%) were aware of positive and negative defensive medicine practice respectively. Of the respondents, 285 (50.7%) agreed that they feared patients or their attendants and 177 (31.5%) were not willing to accept patients involved in previous legal prosecutions against doctors. Case referral to other colleagues as a form of defensive medicine was reported by 186 (31.1%) respondents. The majority, 339 (60.3%) of the respondents thought that their medical decisions were backed by the hospital’s managerial staff. The practice of defensive medicine is common among physicians working in the United Arab Emirates. It is a widespread practicing behavior in respondents who have more than fifteen years of working experience as compared to those with less experience.
Network pharmacology and molecular docking-based investigation on traditional Chinese medicine Astragalus membranaceus in oral ulcer treatment
Authors: Zhong Wan , Tao Si-Yu , Guo Xiang , Cheng Xiao-Fang , Yuan Qing , Li Chu-Xing , Tian Hong-Yuan , Yang Song , Sunchuri Diwas , Guo Zhu-Ling
Published: August 2023

To analyze the mechanism of Astragalus membranaceus (AM) in molecular level in the oral ulcer (OU) treatment with reference to network pharmacology. Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database was used in screening the AM active components and AM action targets; GeneCards database was used to screen OU targets; the common target were screened by Venny online tool; Cytoscape software was applied to construct the target gene regulation map of AM active components; STRING database was used to construct the protein–protein interaction network and the key targets were screened as per degree value; gene ontology enrichment and KEGG pathway enrichment of interactive genes were calculated through David database. There were 17 active ingredients and 429 target spots in Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database. There are 606 target genes for OU in GeneCards database. There are 67 common targets, including 10 key targets: IL10, IL6, TNF, IL1B, CXCL8, CCL2, TLR4, IL4, ICAM1, and IFNG. It involves 30 gene ontology terms and 20 KEGG signal channels. The molecular docking results showed that quercetin and kaempferol had a good binding activity with IL6, IL1B, TNF, and CCL2. Network pharmacological analysis shows that AM can regulate multiple signal pathways through multiple targets to treat OU.
Association among VKORC1 rs9923231, CYP4F2 rs2108622, GGCX rs11676382 polymorphisms and acute ischemic stroke
Authors: Iluţ Silvina , Vesa Ştefan Cristian , Văcăraş Vitalie , Şipoş-Lascu Diana , Bârsan Cristina , Pop Raluca Maria , Crişan Sorin , Macarie Antonia Eugenia , Coadă Camelia Alexandra , Perju-Dumbravă Lăcrămioara , Muresanu Dafin Fior , Buzoianu Anca Dana
Published: August 2023

Acute ischemic stroke is a major cause of morbidity and mortality worldwide, and genetic factors play a role in the risk of stroke. Single nucleotide polymorphisms (SNPs) in the VKORC1, CYP4F2, and GGCX genes have been linked to clinical outcomes, such as bleeding and cardiovascular diseases. This study aimed to investigate the association between specific polymorphisms in these genes and the risk of developing the first episode of acute ischemic stroke in patients without a known embolic source. This retrospective, cross-sectional, observational, analytical, case-control study included adult patients diagnosed with acute ischemic stroke. The SNPs in VKORC1 rs9923231, CYP4F2 rs2108622, GGCX rs11676382 genes were genotyped and analyzed together with the demographic and clinical factors of the 2 groups of patients. The presence of SNPs in VKORC1 or CYP4F2 genes significantly increased the risk of ischemic stroke in the context of smoking, arterial hypertension, and carotid plaque burden. The multivariate logistic model revealed that smoking (odds ratio [OR] = 3.920; P < .001), the presence of carotid plaques (OR = 2.661; P < .001) and low-density lipoprotein cholesterol values >77 mg/dL (OR = 2.574; P < .001) were independently associated with stroke. Polymorphisms in the VKORC1 and CYP4F2 genes may increase the risk of ischemic stroke in patients without a determined embolic source. Smoking, the presence of carotid plaques, and high low-density lipoprotein cholesterol levels were reconfirmed as important factors associated with ischemic stroke.
Efficacy and safety of human gut-derived multi-strain probiotics in patients with irritable bowel syndrome: A prospective open-label observation study
Authors: Oh Chang Kyo , Park Jae Keun , Kim Yu Jin , Kim Jin Bae
Published: August 2023

This study aimed to investigate the efficacy and safety of human gut-derived multi-strain probiotics in patients with irritable bowel syndrome (IBS). This was an open-label, prospective, observational study. Patients with IBS were administered human gut-derived multi-strain probiotics for 4 weeks. The primary and secondary outcomes were based on the overall responder rate of the total IBS severity scoring system (IBS-SSS) score (>50-point decrease) and the IBS quality of life (IBS-QOL) score and IBS-SSS1 subscore (>10-point decrease in both scores), respectively. The estimated response rate is 55%. Of 44 patients, the total IBS-SSS score responder rate was 18.2% and 63.6% of patients at 2 and 4 weeks, respectively (P = .018). Compared with baseline, a significant improvement in the IBS-QOL score was observed in 27.3% and 63.6% of patients at 2 and 4 weeks, respectively (P = .001). Overall improvement rates in the IBS-SSS1 subscore were observed in 29.5% and 61.4% of patients at 2 and 4 weeks, respectively (P < .001). Primary and secondary outcomes were higher at 4 weeks (total IBS-SSS score, 63.6%; IBS-QOL score, 63.6%; IBS-SSS1 subscore, 61.4%) than the estimated responder rate (55%). Human gut-derived multi-strain probiotics have the potential to become an effective and safe treatment option for IBS patients.
Effect of early rehabilitation nursing on neurological function and quality of life of patients with hemiplegia after stroke: A meta-analysis
Authors: Gu Minghuan , Huang Hong
Published: August 2023

Background:

Meta-analysis was used to systematically evaluate the effects of early rehabilitation nursing on neurological function and quality of life of patients with hemiplegia after stroke.

Methods:

Literature was searched from PubMed, Web of Science, cochrane library, China National Knowledge Infrastructure, and Wanfang Database. Relevant literature up to 2022 was screened, followed by data extraction and quality evaluation. Next, Stata17.0 was employed for meta-analysis.

Results:

A total of 18 articles, including 1631 subjects, were enrolled in this study. The control group subjects (n = 825) received routine nursing, and the observation group subjects (n = 806) underwent early rehabilitation nursing. The results of meta-analysis showed that early rehabilitation nursing could significantly improve neurological function the National Institute of Health Stroke Scale [standardized mean difference (SMD) = −1.623, 95% confidence interval (CI) (−2.280, −0.967), P < .001], Fugl-Meyer assessment [SMD = 2.688, 95% CI (1.767, 3.608), P < .001], cure rate [relative risk = 1.333, 95% CI (1.138, 1.562), P < .001], quality of life activity of daily living [SMD = 1.784, 95% CI (0.791, 2.777), P < .001], Barthel index [SMD = 1.617, 95% CI (1.138, 2.096), P < .001] and nursing satisfaction [relative risk = 1.191, 95% CI (1.091, 1.300), P < .001] in patients with hemiplegia after stroke. There was no obvious publication bias for the included articles in this research.

Conclusion:

Compared with the controls, early rehabilitation nursing can effectively improve neurological function and quality of life of patients with hemiplegia after stroke. This study provides a theoretical basis for the clinical application of early rehabilitation nursing in patients with hemiplegia after stroke.
Miller-Fisher syndrome with positive anti-GD1b and anti-GM1 antibodies combined with multiple autoimmune antibodies: A case report
Authors: Zhang Limei , Ma Linqing , Zhou Lihua , Sun Lu , Han Chunru , Fang Qi
Published: August 2023

Rationale:

Anti-ganglioside antibodies (AGA) play an essential role in the development of Miller-Fisher syndrome (MFS). The positive rate of ganglioside antibodies was exceptionally high in MFS, especially anti-GQ1b antibodies. However, the presence of other ganglioside antibodies does not exclude MFS.

Patient concerns:

We present a 48-year-old male patient who suddenly developed dizziness, visual rotation, nausea, and vomiting accompanied by unsteady gait and diplopia for 3 days before presentation to our clinic.

Diagnoses:

On physical examination, the patient’s right eye could not fully move to the right side and horizontal nystagmus was found. Coordination was also impaired in the upper and lower extremities with dysmetria and dysdiadochokinesia. The electromyography and cerebrospinal fluid examination results were normal. The serum anti-GQlb antibody test results were negative. However, serum anti-GD1b IgM and anti-GM1 IgM antibodies were positive. Meanwhile, the anti-thyroid peroxidase antibody was >600.00 IU/mL (0.00–34.00), and the anti-SS-A/Ro52 antibody was positive. He was diagnosed with MFS.

Interventions:

The patient received IVIg treatment for 5 days (0.4 g/kg/day) from day 2 to day 6 of hospitalization. On the 7th day of admission, the patient was administered intravenous methylprednisolone (500 mg/day), which was gradually reduced.

Outcomes:

The patient’s symptoms improved after treatment with immunoglobulins and hormones.

Lessons:

We report a case of MFS with positive anti-GD1b and anti-GM1 antibodies combined with multiple autoimmune antibodies. Positive ganglioside antibodies may be used as supporting evidence for the diagnosis; however, the diagnosis of MFS is more dependent on clinical symptoms.
Neoadjuvant chemoradiotherapy with capecitabine based regimen in locally advanced rectal cancer: A retrospective study
Authors: Li Fei , Zhang Chi , Xu Liping , Zhang Sheng , Zhang Dongsheng , Leng Yan , Wu Chenjiang , Chen Jiayan , Sun Xinchen
Published: August 2023

Capecitabine-based neoadjuvant chemoradiotherapy (nCRT) is the standard treatment for locally advanced rectal cancer. The objective of this study is to analyze overall survival (OS), disease-free survival (DFS) and prognostic factors of patients with stage II to III rectal cancer treated with nCRT in our institution. Between March 2014 to June 2020, 121 locally advanced rectal cancer patients were retrospectively reviewed and analyzed. All of the enrolled patients were treated with capecitabine-based nCRT (pelvic radiotherapy: 45–50.4 Gy, 1.8 Gy/d plus concomitant capecitabine-based chemotherapy), total mesorectal excision surgery (surgery was carried out 8–12 weeks after the end of CRT), and capecitabine-based adjuvant chemotherapy. We examined the pathological complete response rate, 3-year OS, 3-year DFS and the other prognostic factors. Kaplan–Meier method and Log-rank test were used to estimate and compare survival rate. With a median follow-up of 36 months, 3-year DFS and 3-year OS was 74.4% and 83.2%, respectively. Among the 121 patients, 24 achieved pathological complete remission (19.8%). After multivariate analysis, ypTNM stage (TNM stage after neoadjuvant therapy) was significantly associated with DFS. Positive mesorectal fasciae (MRF) status on magnetic resonance imaging and ypTNM stage were significantly related to OS. CRT with capecitabine based regimen provides high rates of survival and sphincter preservation with acceptable toxicity. YpTNM stage was significantly associated with DFS; magnetic resonance imaging MRF status and ypTNM stage were significant factors for OS after multivariate analysis. Distant metastasis is the dominant mode of treatment failure, and it is crucial to optimize systemic treatment for newly diagnosed patients.
Multimodal magnetic resonance imaging on brain network in amnestic mild cognitive impairment: A mini-review
Authors: Gao Sheng-Lan , Yue Jinhuan , Li Xiao-Ling , Li Ang , Cao Dan-Na , Han Sheng-Wang , Wei Ze-Yi , Yang Guanhu , Zhang Qinhong
Published: August 2023

Amnestic mild cognitive impairment (aMCI) is a stage between normal aging and Alzheimer disease (AD) where individuals experience a noticeable decline in memory that is greater than what is expected with normal aging, but dose not meet the clinical criteria for AD. This stage is considered a transitional phase that puts individuals at a high risk for developing AD. It is crucial to intervene during this stage to reduce the changes of AD development. Recently, advanced multimodal magnetic resonance imaging techniques have been used to study the brain structure and functional networks in individuals with aMCI. Through the use of structural magnetic resonance imaging, diffusion tensor imaging, and functional magnetic resonance imaging, abnormalities in certain brain regions have been observed in individuals with aMCI. Specifically, the default mode network, salience network, and executive control network have been found to show abnormalities in both structure and function. This review aims to provide a comprehensive understanding of the brain structure and functional networks associated with aMCI. By analyzing the existing literature on multimodal magnetic resonance imaging and aMCI, this study seeks to uncover potential biomarkers and gain insight into the underlying pathogenesis of aMCI. This knowledge can then guide the development of future treatments and interventions to delay or prevent the progression of aMCI to AD.
Social Cognition and Other Determinants of Perceived Social Support in Individuals With Serious Mental Illness
Authors: Howie J. Hunter , Faith Laura A. , Jarvis Stephen P. , Rempfer Melisa V.
Published: August 2023

Social support provides protective effects for those with serious mental illness (SMI), but these effects may be attenuated by factors that hinder positive perceptions of support. Improved understanding of social support and its determinants may hold relevance for clinical interventions and provide avenues to promote recovery and improve functioning. The present study is a cross-sectional, correlational analysis investigating the relationships among social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test–Managing Emotions subscale), social anxiety (Liebowitz Social Anxiety Scale), negative symptoms (Scale for the Assessment of Negative Symptoms), and perceived social support (Interpersonal Support Evaluation List) among individuals with SMI. Data were analyzed for 59 participants from a psychosocial rehabilitation treatment study at a public, urban academic-affiliated medical center in the Midwest. Bivariate Pearson correlations revealed statistically significant associations among perceived social support and social cognition (total perceived social support, p < 0.05; appraisal support, p < 0.01), negative symptoms (appraisal support, p < 0.05), and social anxiety (self-esteem support, p < 0.05). Further, multiple linear regression revealed social cognition remained a significant predictor of perceived social support (p < 0.05) when controlling for social anxiety and negative symptoms. Overall findings suggest a correlative relationship between social cognition and perceived social support. Conclusions, limitations, and future directions are discussed.