bluuebunny/crossref_metadata_2025 huggingface dataset:
Funder strategies for promoting research addressing societal challenges: thematic, impact, and collaboration targeting
Authors: Norn Maria Theresa , Aagaard Kaare , Bjørnholm Josefine , Stage Andreas Kjær
Published: June 2024

Research funding instruments are increasingly targeted towards research that can contribute to solutions of complex societal challenges. How funders in practice seek to steer research towards addressing such challenges is, however, not well understood. This study explores how public, challenge-oriented funding instruments from three Northern European countries have been designed and deployed to steer funded research in desired directions. Our findings shed light on the practical levers that public funders use to influence research. The study also illustrates how these efforts are influenced by differences in their governance as well as in the choices they make about how to balance aims of promoting research excellence with aims of steering research towards other desired means and ends (e.g. economic and societal impact). Our findings highlight dilemmas and trade-offs in funders’ targeting efforts to influence the direction and outcomes of research, which ultimately influence the success of such efforts.
Concealed exchanges: relational work in racially segregated housing markets
Authors: Jang-Trettien Christine
Published: June 2024

How do real-estate investors make decisions about where to purchase properties? In recent years, an increasing share of the market has gone to investors, making it critical that we understand the behaviors of these important actors. This study examines investment as a relational process. Through 74 interviews with real estate investors, as well as additional interviews with homeowners and renters in low- to middle-income neighborhoods in Baltimore, I find that strategic interactions and intimate relational work among professional and amateur investors are key to understanding how properties are sold. Professional investors cultivate bonds with new investors by identifying common goals and obstacles. They also use concealment strategies to sell homes, including: legal concealment, concealment through bundling, and concealment through brokers. Legal concealment involves using legal vehicles to transfer properties between owners. Concealment through bundling occurs when properties are bundled together to be sold in bulk. Finally, concealment through brokers entails finding brokers who can connect sellers to investors from other markets. These strategies obscure not only the nature of the relationship between buyers and sellers but also the quality of products being sold. The series of exchanges resemble how products are sold within direct-selling organizations and other predatory industries, which rely on a pyramid-like structure of sponsors and distributors. Furthermore, concealment strategies are more likely to happen in weaker markets and poorer neighborhoods where investor behavior is less constrained—this suggests that concealment has potential to increase urban inequality.
Looking for a rhyme, looking for a reason: reasonableness and the trustee
Authors: Holme Natasha , Sherwin Timothy , Steen Peter
Published: June 2024

This article examines the standard of reasonableness required of trustees in the execution of their duties, particularly in light of the case of Perez v Equiom Trust Corporation (UK) Ltd & Anor. It explores the objective test for reasonableness, the heightened expectations placed on professional trustees, and the consequences of unreasonableness, including the impact on the trustee’s indemnity. The discussion delves into the nuances of trustee decision-making, the court’s role in intervening, and the implications of the Perez case on trust law and trustee conduct. The authors provide a critical analysis of the trustee’s obligation to act reasonably and the legal standards applied.
Loss of endogenous estrogen alters mitochondrial metabolism and muscle clock‐related protein Rbm20 in female mdx mice
Authors: Timpani Cara A. , Debrincat Didier , Kourakis Stephanie , Boyer Rebecca , Formosa Luke E. , Steele Joel R. , Zhang Haijian , Schittenhelm Ralf B. , Russell Aaron P. , Rybalka Emma , Lindsay Angus
Published: June 2024

Female carriers of a Duchenne muscular dystrophy (DMD) gene mutation manifest exercise intolerance and metabolic anomalies that may be exacerbated following menopause due to the loss of estrogen, a known regulator of skeletal muscle function and metabolism. Here, we studied the impact of estrogen depletion (via ovariectomy) on exercise tolerance and muscle mitochondrial metabolism in female mdx mice and the potential of estrogen replacement therapy (using estradiol) to protect against functional and metabolic perturbations. We also investigated the effect of estrogen depletion, and replacement, on the skeletal muscle proteome through an untargeted proteomic approach with TMT‐labelling. Our study confirms that loss of estrogen in female mdx mice reduces exercise capacity, tricarboxylic acid cycle intermediates, and citrate synthase activity but that these deficits are offset through estrogen replacement therapy. Furthermore, ovariectomy downregulated protein expression of RNA‐binding motif factor 20 (Rbm20), a critical regulator of sarcomeric and muscle homeostasis gene splicing, which impacted pathways involving ribosomal and mitochondrial translation. Estrogen replacement modulated Rbm20 protein expression and promoted metabolic processes and the upregulation of proteins involved in mitochondrial dynamics and metabolism. Our data suggest that estrogen mitigates dystrophinopathic features in female mdx mice and that estrogen replacement may be a potential therapy for post‐menopausal DMD carriers.
Adverse Cardiovascular Effects of COVID-19 Vaccination: A Systematic Review
Authors: Huang Jen-Hung , Ju Ke-Shiuan , Liao Tzu-Wei , Lin Yung-Kuo , Yeh Jong-Shiuan , Chen Yi-Jen
Published: June 2024

Several vaccines against coronavirus disease 2019 (COVID-19)—caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)—have been developed since the COVID-19 pandemic began. Of these, 7 have been approved in the World Health Organization’s Emergency Use Listing. However, these vaccines have been reported to have rare or serious adverse cardiovascular effects. This review presents updated information on the adverse cardiovascular effects of the approved COVID-19 vaccines—including inactivated vaccines, protein subunit vaccines, virus-like particles, nucleic acid vaccines, and viral vector vaccines—and the underlying mechanisms.
Pathological Mechanism and Treatment of Calcified Aortic Stenosis
Authors: Chen Si-Yu , Kong Xiang-Quan , Zhang Jun-Jie
Published: June 2024

Calcified aortic stenosis (AS) is one of the most common valvular heart diseases worldwide, characterized by progressive fibrocalcific remodeling and thickening of the leaflets, which ultimately leads to obstruction of blood flow. Its pathobiology is an active and complicated process, involving endothelial cell dysfunction, lipoprotein deposition and oxidation, chronic inflammation, phenotypic transformation of valve interstitial cells, neovascularization, and intravalvular hemorrhage. To date, no targeted drug has been proven to slow down or prevent disease progression. Aortic valve replacement is still the optimal treatment of AS. This article reviews the etiology, diagnosis, and management of calcified aortic stenosis and proposes novel potential therapeutic targets.
Exploring CYP2D6 polymorphisms and angiotensin receptor blocker response in the Bai hypertensive population
Authors: Yang Canbiao , Zhang Guoqiang , Shu Chang , Lv Linxi , Liu Zhengxing , Tian Yan , Tan Qi , Wang Zhaobin , Hu Songnian , Yang Libo , Sun Ningling
Published: June 2024

Objective

The CYP2D6 enzyme is crucial for the metabolism and disposition of a variety of drugs. This study was conducted to examine the relationship between CYP2D6 gene polymorphisms and the response to angiotensin receptor blocker (ARB)-based treatment in patients of Chinese Bai ethnicity with hypertension.

Methods

Seventy-two hypertensive adults from the Chinese Bai ethnic group, exhibiting systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, were recruited. Targeted regional sequencing was utilized to genotype single nucleotide polymorphisms in the CYP2D6 gene, aiming to assess their frequency and to evaluate their influence on the therapeutic efficacy of ARB medications.

Results

Our research identified nine significant CYP2D6 polymorphisms associated with the efficacy of ARB treatment in the Bai hypertensive cohort. Specifically, patients possessing certain mutant genotype at rs111564371 exhibited substantially greater reductions in SBP and DBP, with P-values of 0.021 and 0.016, respectively, compared to those carrying the wild genotype. Additionally, these mutant genotype at rs111564371 and rs112568578 were linked to approximately 20% higher overall efficacy rates and a 10% increased achievement rate relative to the wild genotype.

Conclusion

Our research with the Bai hypertensive group shows that certain CYP2D6 polymorphisms significantly influence ARB treatment outcomes. Mutations at rs111564371 led to better blood pressure control (P-values: 0.021 for SBP, 0.016 for DBP), improving ARB efficacy by appromixately 20% and increasing treatment goal achievement by 10% over the wild-type genotype.

Statements

Our investigation into CYP2D6 polymorphisms within the Bai hypertensive cohort marks a substantial advancement towards personalized healthcare, underscoring the pivotal influence of genetic constitution on the effectiveness of ARB therapy.
Public Perception of Scrub Color and Style in Plastic Surgery
Authors: Firouzbakht Peter K. , Zhang Andi , Nguyen David C. , Slovacek Cedar , Daytz Anna E. , Tanna Neil , Chen Kevin
Published: June 2024

Background:

Scrubs have become widespread office attire for plastic surgeons. The purpose of this study is to evaluate the public perception of scrub color and style for plastic surgeons.

Methods:

A crowdsourced survey was performed via MTurk. Respondents were asked to rate images of a surgeon dressed in black, navy, blue, and green scrubs as well as traditional or fitted scrubs. Qualities including representativeness, skill, trustworthiness, knowledge, and compassion were rated on a Likert scale across all images. Analysis of variance and one-sided t test were used to analyze differences in means.

Results:

In total, 562 responses were collected. For female plastic surgeons, navy and blue scrubs were perceived to be superior to those wearing black for skill, representativeness, trustworthiness, and compassion (P < 0.05). For male plastic surgeons, navy and blue scrubs were superior to black for knowledge, skill, representativeness, trustworthiness, and compassion (P < 0.05). For skill and representativeness, navy was superior to green (P < 0.05). For representativeness, blue was superior to green (P < 0.05). For trustworthiness and compassion, green was superior to black (P < 0.05). Fitted scrubs were significantly preferred (P < 0.05) across all characteristics with the exception of representativeness in the subgroup of male plastic surgeons.

Conclusions:

Black scrubs are associated with more negative characteristics than navy or blue scrubs, which were found to be the most positively perceived. Fitted scrubs were associated with positive characteristics for both male and female surgeons. The purchase of fitted scrubs may be a worthwhile purchase to maximize the patient–physician relationship.
Re-exploration for bleeding and long-term survival after adult cardiac surgery: a meta-analysis of reconstructed time-to-event data
Authors: Jr Soletti Giovanni , Cancelli Gianmarco , Dell’Aquila Michele , Caldonazo Tulio , Harik Lamia , Rossi Camilla , Tasoudis Panagiotis , Leith Jordan , An Kevin R. , Dimagli Arnaldo , Demetres Michelle , Gaudino Mario
Published: June 2024

Background:

Postoperative bleeding requiring re-exploration is a serious complication that occurs in 2.8–4.6% of patients undergoing cardiac surgery. Re-exploration has previously been associated with a higher risk of short-term mortality. However, a comprehensive analysis of long-term outcomes after re-exploration for bleeding has not been published.

Materials and methods:

The authors performed a systematic, three databases search to identify studies reporting long-term outcomes in patients who required re-exploration for bleeding after cardiac surgery compared to patients who did not, with at least 1-year of follow-up. Long-term survival was the primary outcome. Secondary outcomes were operative mortality, myocardial infarction, stroke, renal and respiratory complications, and hospital length of stay. Random-effects models was used. Individual patient survival data was extracted from available survival curves and reconstructed using restricted mean survival time.

Results:

Six studies totaling 135 456 patients were included. The average follow-up was 5.5 years. In the individual patient data, patients who required re-exploration had a significantly higher risk of death compared with patients who did not [hazard ratio (HR): 1.21; 95% CI: 1.14–1.27; P<0.001], which was confirmed by the study-level survival analysis (HR: 1.32; 95% CI: 1.12–1.56; P<0.01). Re-exploration was also associated with a higher risk of operative mortality [odds ratio (OR): 5.25, 95% CI: 4.74–5.82, P<0.0001], stroke (OR: 2.05, 95% CI: 1.72–2.43, P<0.0001), renal (OR: 4.13, 95% CI: 3.43–4.39 P<0.0001) respiratory complications (OR: 3.91, 95% CI: 2.96–5.17, P<0.0001), longer hospital length of stay (mean difference: 2.69, 95% CI: 1.68–3.69, P<0.0001), and myocardial infarction (OR: 1.85, 95% CI: 1.30–2.65, P=0.0007).

Conclusion:

Postoperative bleeding requiring re-exploration is associated with lower long-term survival and increased risk of short-term adverse events including operative mortality, stroke, renal and respiratory complications, and longer hospital length of stay. To improve both short-term and long-term outcomes, strategies to prevent the need for re-exploration are necessary.
Prevalence of Acute on Chronic Liver Failure in Autoimmune Hepatitis, Treatment Response and Mortality Burden Assessment
Authors: Patil Amol N. , Shamim Muhammad Aaqib , Roy Akash , Hegde Naveen C. , Khatri Pankaj , Sharma Shivam , Rathi Sahaj , De Arka , Duseja Ajay , Taneja Sunil
Published: June 2024

Acute-on-chronic liver failure (ACLF) is a global health problem. Little scientific evidence exists on its prevalence in autoimmune hepatitis. Treatment response and mortality outcomes have also been reported differently. The study was conducted to estimate the overall prevalence of ACLF among patients with autoimmune hepatitis (AIH) and determine the associated treatment response and mortality. We scrutinized wide literature in Scopus, PubMed, Embase, Web of Science, and Cochrane, and assessed published articles completely, studies performed and reported from around the globe, until December 07, 2023, according to the PROSPERO registered protocol (CRD42023412176). Studies (retrospective and prospective cohort study type) that stated the ACLF development among established AIH cases were considered. Features of the study, duration of follow-up, and numeric patient information were retrieved from the studies included. The research paper quality was checked for risk of bias. Random effect meta-analysis with metaregression and subsection scrutinies were performed with R. The main outcome was the collective prevalence of ACLF in the AIH patients, whereas treatment response and mortality in AIH-associated ACLF were secondary outcomes. Six studies were involved with confirmed diagnoses in 985 AIH patients for the data synthesis. The pooled prevalence of ACLF in the explored patients was 12% (95% CI: 8-17) (P=0.01). Heterogeneity was found to be high in the present meta-analysis (I
2 =72%; P < 0.01). For the secondary endpoint analysis, the pooled prevalence of complete remission at 1-year follow-up was 71% (0.52; 0.85), and mortality from the ACLF-AIH patient population was 32% (95% CI: 18-50). Sensitivity analysis showed no influence on the overall estimations of the pooled prevalence of ACLF by omitting studies one by one. One in 10 AIH patients likely present with ACLF. The response to treatment is seen in two-thirds of patients, and mortality is high.
Crohn disease but not ulcerative colitis increases the risk of acute pancreatitis: A 2-sample Mendelian randomization study
Authors: Fu Xuewei , Wu Hao , Shu Yufeng , Yang Bocheng , Deng Chao
Published: June 2024

Accumulating evidence has indicated an increased risk of acute pancreatitis in individuals with inflammatory bowel disease (IBD); however, the establishment of a clear and direct causal connection between IBD and acute pancreatitis remains uncertain. Utilizing genetic data from publicly accessible genome-wide association studies (GWAS), we conducted a 2-sample MR analysis to identify the associations between IBD, ulcerative colitis (UC), Crohn disease (CD), and acute pancreatitis risk. Rigorous quality control steps ensured the selection of eligible single nucleotide polymorphisms (SNPs) with strong associations to IBD. The primary estimation used the inverse-variance weighted method. We also assessed heterogeneity, potential pleiotropy, and conducted sensitivity analyses. The direction of causality was confirmed using the Steiger test. The MR analysis showed that IBD increased the risk of acute pancreatitis (IVW: OR = 1.032, 95% CI: 1.006–1.06, P = .015). Among the subgroup of IBD, CD (IVW: OR = 1.034, 95% CI: 1.008–1.06, P = .007) indicates a significant increase in the risk of acute pancreatitis compared to UC (IVW: OR = 1.02, 95% CI: 0.99–1.051, P = .189). The MR analysis assessing the association between CD and acute pancreatitis showed no evidence of heterogeneity or horizontal pleiotropy. Likewise, the leave-one-out (LOO) method indicated no significant influence of any individual SNP on the overall findings. In addition, the Steiger direction test revealed that CD was the cause for increased risk of acute pancreatitis, but not vice versa. In summary, this research pioneers in proposing a causal relationship between CD and acute pancreatitis among the European population.
Femoral anteversion linked to the inability to squat: Analysis of CT images in the patient and control groups
Authors: Lee Dong Hwan , Kim Yun Hwan , Baek Jaeyoon , Kim Seon Ae , Kim Seok Jung
Published: June 2024

Many patients who cannot squat well in a neutral toe position can only squat in an excessively out-toeing position. This excessive out-toeing squat is thought to be caused by rotational problems of the lower extremities. In this study, we aimed to identify the cause for the inability to squat by measuring and comparing femoral and tibial torsion between an excessive out-toeing squat patient group and a control group representing the general population. Between 2008 and 2022, a patient group comprising 50 lower extremities with excessive out-toeing squats was established. A control group representing the general population was selected from patients aged 0 to 29 years, who underwent lower-extremity CT angiography between 2012 and 2022, using the Clinical Data Warehouse with exclusion criteria applied. A total of 94 lower extremities were included in the control group. The femoral torsional angle (FTA) and tibial torsional angle (TTA) of both groups were measured and compared using Student t test. Additionally, 30 each of those with the highest and lowest 30 FTA values were selected from the patient and control groups, and the TTA was compared between the high- and low-FTA groups using Student t test. The mean FTA was 0.34° (SD, 11.11°) in the patient group and 10.14° (SD, 11.85°) in the control group, with a mean difference of 9.8° and P < .001. The mean TTA was 27.95° (SD, 7.82°) in the patient group and 32.67 ° (SD, 7.58°) in the control group, with a mean difference of 4.72° (P = .001). The mean TTA was 34.3° (SD, 7.72°) in the high-FTA group and 28.17° (SD, 8.35°) in the low-FTA group, with a mean difference of 6.13° (P = .005). Patients with excessive out-toeing squat showed lower FTA and TTA values than the general population. Furthermore, although a correlation between FTA and TTA was not established through Pearson correlation analysis, a tendency was observed where a decrease in FTA was associated with a decrease in TTA. Based on these results, decreased FTA was demonstrated to be one of the major causes of excessive out-toeing squats.
Risk factors and major adverse cardiovascular events of isolated coronary artery ectasia: An observational study
Authors: Yang Xiuchun , Zong Yijun , Zhang Zhentian , Yin Hongning , Zhang Xuqian , Miao Yajing , Xiao Bing
Published: June 2024

To evaluate the cardiac index and major adverse cardiovascular events (MACE) events between isolated coronary artery ectasia (CAE) and control groups over 1 year period from diagnosis. A total of 18 patients who were diagnosed with isolated CAE in the Second Hospital of Hebei Medical University from December 2020 to December 2021 were included in CAE group. About 36 patients with non-obstructive coronary artery lesions were included in the control group. All patients in 2 groups completed dobutamine stress echocardiography (DSE) during hospitalization. The chamber size, wall thickness, left ventricular ejection fraction, and left ventricular diastolic function indicators (including E/A ratio, e’, and E/e’ ratio) were measured. MACE and all-cause death were measured during follow-up after discharge. Interventricular septum thickness (IVSd), left ventricular posterior wall (LVPW) thickness in diastole and E/e’ in CAE group were significantly higher than control group (P < .05). No significant differences were found in prognosis including angina, myocardial ischemia (MI), patient readmission and cardiovascular death (P > .05). In CAE group, coronary angiography showed dilation of left anterior descending (LAD) in 1 case, left circumflex (LCX) in 3 cases and right coronary artery (RCA) in 14 cases. Multivariate logistic regression analysis showed that BMI and IVSd were independent risk factors for CAE. IVSd, LVPW thickness in diastole and E/e’ in CAE group were significantly higher than control group. BMI and IVSd were independent risk factors for isolated CAE, and had a good predictive value for isolated CAE.
Blood metabolites mediate the causal relationship between circulating CX3CL1 levels and prostate cancer: A 2-step Mendelian randomization study
Authors: Zhou Yinshu , Chen Zheng , Guo Zexiong , Gao Guie , Duan Yiping , Wang Haoyu , Sun Luping , Huang Wanwei , Zhuo Yumin
Published: June 2024

Chemokines influence the progression of prostate cancer (PCa) through multiple mechanisms. However, the effect of C-X3-C chemokine ligand 1 (CX3CL1) on PCa risk remains controversial. Our study aimed to investigate whether circulating CX3CL1 is causally associated with PCa and to identify metabolites that have mediating effects using the 2-step bidirectional Mendelian randomization (MR) analysis process. Inverse variance weighting (IVW) results were used as the primary observations, while additional sensitivity analyses were conducted. For each standard deviation increase exhibited by the circulating CX3CL1 levels, the risk of PCa was reduced by 0.4% (IVW: OR = 0.996, [95% CI = 0.994–0.998], P < .001), and blood alliin levels increased by 19% (IVW: OR = 1.185, [95% CI = 1.01–1.54], P = .003). For each standard deviation increase in the blood alliin levels, the risk of PCa was reduced by 0.1% (IVW: OR = 0.999, [95% CI = 0.997–0.999], P = .03). Therefore, the protective effect of circulating CX3CL1 on PCa may be mediated by blood alliin levels (mediated proportion = 6.7%). The results supported the notion that high levels of circulating CX3CL1 indicate a lower PCa risk and the idea that the food-derived antioxidant alliin may mediate this association. We emphasize that the use of CX3CL1 as a protective factor against PCa may provide new strategies for PCa prevention and care in the future.
Impact of TYMS gene polymorphism on the outcome of methotrexate treatment in a sample of Iraqi rheumatoid arthritis patients – identification of novel single nucleotide polymorphism: Cross-sectional study
Authors: Mutlak Qassim Mahdi , Kasim Ali Abdulhussain , Aljanabi Ali Saleh
Published: June 2024

The current work aims to evaluate the association between genetic mutations in thymidylate synthetase (TYMSgene in exon1 and partial regions of promotor and intron 1 [877 bp, 657,220–658,096 bp]) and the therapeutic outcomes for rheumatoid arthritis (RA) Iraqi patients. An observational cross-sectional study involving 95 RA patients with established RA patients based on their methotrexate treatment responsiveness. Genetic sequencing of the TYMS gene was performed for all patients according to the instruction manuals of the sequencing company (Macrogen Inc. Geumchen, South Korea). Four polymorphisms were identified by sequencing 95 randomly selected patients in the noncoding region of TYMS. Three of these polymorphisms were found in the NCBI database’s dbSNP (rs2853741, rs2606241, and rs2853742 SNPs), and one SNP polymorphism is novel (657334). The CTAT (657334, rs2853741, rs2606241, and rs2853742 SNPs) haplotype was significantly associated with responder with odd ratio, 95% confidence interval: 0.506, 0.281–0.912 (Pvalue = .022). In contrast, the other haplotypes were not associated with MTX responsiveness. In the multivariate analysis, after adjusting to the effect of age, sex, smoking, and disease duration, the TCrs2853741genotype was associated with non-responders (Pvalue = .030). In contrast, the ACrs260641genotype, after adjusting to the effect of age, sex, and smoking, was associated with non-responders (Pvalue = .035). Genetic polymorphism of the TYMS gene, especially in TCrs2853741and ACrs260641, predicts non-responder to MTX treatment in RA, while the presence of the CTAT haplotype predicts a good response to MTX treatment.
Analysis of the efficacy of retrodiscal approach percutaneous epidural adhesiolysis with WHIP catheter® in patients with lumbar radiculopathy: A retrospective study
Authors: Kim Sunmin , Nahm Francis , Cho Eun joo , Lee Pyung Bok
Published: June 2024

Percutaneous epidural adhesiolysis (PEA) is an effective treatment for patients with lumbar radiculopathy unresponsive to single steroid injections. Various approaches and instruments have been developed to access these lesions. This study aimed to evaluate the utility of a retrodiscal approach for epidural adhesiolysis using a WHIP catheter®. This retrospective study was conducted at Bundang Seoul National University Hospital, reviewing cases from January to December 2022. Forty-seven patients diagnosed with lumbar radiculopathy, aged 20 to 80 years, who underwent PEA with the WHIP catheter® were included. Outcomes assessed Numeric Rating Scale (NRS) for pain, Patients’ Global Impression of Change (PGIC) scores, and the incidence of procedure-related complications. Follow-up evaluations occurred at 1, 3, and 6 months post-procedure. Among 47 patients, 41 completed the study, showing significant pain reduction at all follow-up points: 1 month (N = 41, 1.32 ± 1.68, P < .001), 3 months (N = 31, 1.90 ± 2.14, P < .001), and 6 months (N = 30, 2.50 ± 2.30, P < .001). PGIC scores indicated that 40% of the patients reported substantial improvement at one-month post-procedure. The complications were minimal, with only one case of intradiscal injection and 2 cases of vascular uptake. The retrodiscal approach PEA using the WHIP catheter® demonstrated significant efficacy in pain reduction with minimal safety concerns for patients with lumbar radiculopathy. These findings suggest that this procedure is a viable option for patients who are unresponsive to conservative treatment. However, the retrospective nature of this study and its small sample size necessitate further prospective controlled studies to confirm our results and establish long-term outcomes.
Bile acid profiles and classification model accuracy for inflammatory bowel disease diagnosis
Authors: Xu Run-Hao , Shen Jia-Nan , Lu Jing-Bo , Liu Yi-Jing , Song Yan , Cao Yun , Wang Zhen-Huan , Zhang Jie
Published: June 2024

To investigate the utility of serum bile acid profiling for the diagnosis of inflammatory bowel disease (IBD). We analyzed 15 specific bile acids in the serum of 269 IBD patients, 200 healthy controls (HC), and 174 patients with other intestinal diseases (OID) using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Serum bile acid levels were compared between IBD group, HC group, and OID group. Binary logistic regression-based models were developed to model the bile acids and diagnose IBD. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic accuracy of each bile acid and the model. Compared to HC group, IBD group exhibited significantly lower levels of chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), glycodeoxycholic acid (GDCA), taurodeoxycholic acid (TDCA), lithocholic acid (LCA), glycolithocholic acid (GLCA), taurolithocholic acid (TLCA), and an elevated primary-to-secondary bile acid ratio. DCA had an area under the curve (AUC) of 0.860 for diagnosing IBD, with a sensitivity of 80.67% and a specificity of 82.50%. A model Y0 combining DCA and CDCA to distinguish between IBD group and HC group further improved accuracy (AUC = 0.866, sensitivity = 76.28%, specificity = 89.37%). Compared to non-IBD group (which combined healthy controls and those with other intestinal diseases), IBD group had significantly lower levels of DCA, GDCA, TDCA, LCA, GLCA, and TLCA, and elevated levels of glycocholic acid (GCA) and glycochenodeoxycholic acid (GCDCA). A model Y1 incorporating GCDCA, DCA and TLCA to distinguish between IBD group and non-IBD group yielded an AUC of 0.792, with a sensitivity of 77.67% and specificity of 71.91%. IBD patients exhibit decreased serum secondary bile acid levels and an elevated primary-to-secondary bile acid ratio. Serum bile acid alterations are associated with the onset of IBD. A model consisting of CDCA and DCA has potential for distinguishing between IBD group and HC group, while a model incorporating GCDCA, DCA and TLCA may be suitable for distinguishing between IBD group and non-IBD group.
Serial changes in anxiety levels related to corticosteroid use: A single-center prospective study
Authors: Koyama Katsumasa , Ohgami Ayaka , Nawata Takashi , Sato Kana , Fujinaka Masafumi , Shibuya Masaki , Kitahara Takashi , Yano Masafumi
Published: June 2024

Patients with autoimmune diseases treated with corticosteroids sometimes display feelings of anxiety regarding corticosteroid use. In this single-center prospective study, we aimed to evaluate the serial changes in anxiety levels related to corticosteroid use in 18 patients with autoimmune diseases. The degree of anxiety toward corticosteroid use was assessed using the visual analogue scale. Comprehension of drug characteristics and use was assessed using the Likert scale. To assess the patients’ levels of depression and anxiety we used the State-Trait Anxiety Inventory. These surveys were conducted immediately before the initiation of corticosteroid therapy and just before discharge from the hospital. We observed a decrease in anxiety levels related to corticosteroid use and State-Trait Anxiety Inventory scores before discharge. However, we did not detect a correlation between these score changes. Additionally, we found that patients who had a poor understanding of the drugs showed little or no changes in their anxiety levels related to corticosteroid use at discharge. These results suggest that some aspects of anxiety related to corticosteroids might be groundless and substantiated by assumptions without a complete understanding of corticosteroid functioning. Patient education regarding corticosteroid use may lead to reductions in anxiety levels and improvement in quality of life of the patients.
Evaluation of a 12-hole clock model for improving bronchoscopic skills in simulated normal and difficult airways among anesthesia residents: A randomized controlled study
Authors: Zhou Zhiqiang , Zhang Kaiwen , Zhao Xu , Hu Yingjie , He Yuqin , Wan Li , Yao Wenlong
Published: June 2024

Background:

Simulation-based training is used to improve fiberoptic bronchoscopic skills for novices. We developed a nonanatomical task trainer (named 12-hole clock model) that focused on training manipulation of bronchoscopes. The aim of this study was to evaluate the training effect of this model on bronchoscopic skills and learning interests in simulated normal and difficult airways among anesthesia residents.

Methods:

Forty-three anesthesia residents without experience in bronchoscopic intubation were randomly divided into control (n = 22) and intervention groups (n = 21). All participants received standard multimedia learning and a baseline test using a normal airway manikin. Then, the control and intervention groups engaged in 60 minutes of training via a traditional airway manikin or the clock model, respectively. After training, the participants completed bronchoscopic performance assessments in simulated normal and difficult airways, as well as an electronic questionnaire related to the course.

Results:

During training, the total hands-on time of bronchoscopic practice recorded by trainees’ themselves was longer in the intervention group than in the control group (1568 ± 478 seconds vs 497 ± 172 s, P < .0001). Posttraining, the time required to visualize the carina in simulated normal airways was longer in the intervention group than in the control group (22.0 [18.0, 29.0] vs 14.0 [10.8, 18.3], P < .0001), while it was shorter for simulated difficult airways (24.0 [16.0, 32.0] s vs 27.0 [21.0, 35.5] s, P = .0425). The survey results indicated that confidence in bronchoscopic intubation increased in both groups, without significant differences in satisfaction, acceptance, or perceived difficulty between the groups. However, the interest ratings were higher in the intervention group than in the control group.

Conclusions:

The 12-hole clock model is a simple and feasible method for improving bronchoscopic skills and promoting interest among trainees.

Trial registration:

NCT05327842 at Clinicaltrials.gov.
Proactive consultation of laboratory medicine increased diagnostic rate of multiple myeloma: One single center’s 12-year experience
Authors: Chang Chih-Chun , Ho Jung-Li , Lin Pei-Chin , Lin Chao-Pei , Tsai Wei-Ting , Huang Huei-Ling , Yu Yuan-Bin , Chen Wei-Chi , Chu Fang-Yeh
Published: June 2024

Multiple myeloma (MM) was one of the hardest cancers to diagnose because of numerous nonspecific symptoms, leading to diagnostic delay. Proactive consultation of laboratory medicine (PCLM) could help timely diagnosis of blood cancers, avoiding diagnostic delay. This study aimed to evaluate the effect of PCLM on diagnosis and outcomes in MM. This retrospective study was conducted in newly diagnosed MM patients from 2011 to 2022. Implementation of PCLM initiated in 2015 with a laboratory-oriented algorithm. The annual diagnostic rate, patient demographics, the time intervals from symptom onset to diagnosis and to treatment, and clinical outcomes were analyzed. A total of 134 patients were newly diagnosed during the study interval. The diagnostic rate increased from 4.65 ± 1.59 to 7.43 ± 1.52 per million patient-visits after implementation of PCLM. The median time interval from symptom onset to diagnosis was significantly shortened after implementation of PCLM (50 days with interquartile range [IQR]: 24–136 days vs 150 days with IQR: 41–385 days, P = .003). Besides, the 1-year survival was significantly higher in patients diagnosed as MM after implementation of PCLM (72.4% vs 51.7%, P = .035). Implementation of PCLM not only increased diagnostic rate of MM and improved outcomes, but also raise awareness for MM and promote multidisciplinary collaboration in healthcare.
Effect of oral tranexamic acid on postoperative bleeding in spinal surgery: a randomized controlled trial
Authors: Kargar-soleimanabad Saeed , khormali Aynoor , Godazandeh Farnaz , Najafi Sajjad
Published: June 2024

Background and objective:

This study aimed to investigate the effect of oral administration of tranexamic acid (TXA) on reducing intraoperative bleeding during spinal surgeries.

Method:

The study was a single-center, double-blind, randomized, placebo-controlled clinical trial. Participants were individuals over 20 years old who underwent spinal surgery. Patients received 1.5 g of TXA orally, 2 h before surgery. Intraoperative bleeding volume, blood volume in the drain after surgery, length of hospital stays after surgery, incidence of nausea or vomiting, decrease in hemoglobin (Hb) level, and postoperative coagulation test results were evaluated in each group.

Results:

In this study, patients were assigned to each study group based on inclusion and exclusion criteria. The mean age of patients was 69.6±6.47 years, and 65% were male. There was no significant difference in age, sex, pre and postoperative Hb levels, prothrombin time (PT), or international normalized ratio (INR) between the study groups. Intraoperative bleeding volume and blood volume in the drain after surgery were significantly lower in the TXA group. Additionally, the length of hospital stay after surgery was significantly shorter in the TXA group. The incidence of nausea or vomiting was significantly higher in the TXA group. Furthermore, postoperative partial thromboplastin time (PTT) was significantly higher in the TXA group compared to the placebo group.

Conclusion:

Oral administration of TXA before spinal surgery leads to a significant reduction in intraoperative and postoperative bleeding without significant adverse effects and also reduces the length of hospital stay.
Pediatric cardiac hydatid cysts: a diagnostic odyssey: a rare case report
Authors: Zahri Soukaina , Ettagmouti Yassine , Zagdan Soukaina , Belhakim Mehdi , Haboub Meriem , Drighil Abdenasser , Habbal Rachida
Published: June 2024

Introduction:

Hydatidosis, caused by the Echinococcus tapeworm, typically manifests with hepatic and pulmonary symptoms, but cardiac involvement, especially in pediatric cases, poses a rare challenge. This overview emphasizes the diagnostic complexities and potential complications associated with this uncommon parasitic disease.

Case presentation:

A 4-year-old child was presented with epigastric pain after an abdominal impact trauma. Clinical examination revealed tachycardia, fever, and pericardial effusion with an intramyocardial cyst. Hydatid serology confirmed the diagnosis, and subsequent imaging ruled out additional localizations. Treatment involved albendazole, pericardial drainage, and cyst removal, resulting in a favorable outcome.

Discussion

Cardiac hydatid cysts, comprising only 0.5–-2% of visceral cases, often occur in underdeveloped regions. The authors’ case, affecting the right ventricle in a pediatric patient, contributes to the understanding of varied presentations. Diagnosis relies on echocardiography, computed tomography scans, and MRI, with surgery being the mainstay treatment. Symptomatic cases demand prompt intervention due to potential complications.

Conclusion:

This case underscores the intricate diagnostic journey and management challenges posed by cardiac hydatid cysts, particularly in pediatric populations. Collaboration between medical disciplines is crucial for timely diagnosis and effective treatment, emphasizing the importance of ongoing research in endemic regions.
Aortic ulcerated plaque discovery following mesenteric infarction in a 60-year-old patient: a case report
Authors: Almohamed Ahmad , Takkem Saleh , Karaja Saja , Marina Sliman , Zoukar Sham , Rahhal Rema
Published: June 2024

Introduction:

A penetrating aortic ulcer (PAU), which accounts for 2–7% of all acute aortic syndromes, is the ulceration of an aortic atherosclerotic plaque that passes through the internal elastic lamina and into the aortic medium. Although PAUs are frequently seen in the middle and lower descending thoracic aortas, it is rare for them to arise in the ascending aorta. Atherosclerotic vascular illnesses and isolated peripheral arterial illnesses are associated with similar risk factors, such as male sex, advanced age, a history of tobacco use, hypertension, hyperlipidemia, and coronary artery disease. Just 20–54% of people with PAU first exhibit symptoms, suggesting that the condition might sometimes present as an asymptomatic phenomenon.

Case presentation:

A 60-year-old male came to the emergency department due to severe abdominal pain and abdominal contractures, which were diagnosed as mesenteric infarction with a relatively small infarcted intestinal segment. A part of the intestine was resected. Then he was referred to request a cardiac consultation to search for the source of the mesenteric infarction, which turned out to be an embolus.

Clinical discussion:

The patient was referred to cardiac surgery to perform aortic grafting.

Conclusion:

Aortic ulcer and mesenteric infarction together provide a challenging clinical picture that has to be recognized and treated right away. A high index of suspicion is necessary due to the possibility of fast deterioration, particularly in individuals who have risk factors like arteriosclerosis. Improving outcomes depends critically on early diagnostic imaging and intervention.
Meckel’s diverticulum complicated by acute intestinal obstruction: a case report
Authors: Niasse Abdou , Ndiaye Abdoulaye , Dieng Papa Souleymane , Dieng Mactar , Ndong Abdourahmane , Cissé Mamadou , Dieng Madieng , Konaté Ibrahima
Published: June 2024

Introduction and importance:

Meckel’s diverticulum is a rare congenital intestinal anomaly that can sometimes cause serious complications. The authors’ aim is to review the literature on this condition by reporting the clinical case of a young adult with Meckel’s diverticulum complicated by acute intestinal obstruction.

Case presentation:

This was a 24-year-old young man, operated on for open bladder stones received for occlusive syndrome. Abdominal computed tomography (CT) suggested a flange occlusion. Surgical exploration found a Meckel’s diverticulum creating a flange around the last one. An intestinal resection was performed with direct anastomosis with simple consequences.

Clinical discussion:

Meckel’s diverticulum is a rare congenital intestinal anomaly. It is discovered incidentally or in the face of serious complications such as intestinal obstruction. Intestinal resection with one-stage anastomosis emerges as a standard and safe management approach.

Conclusion:

A Meckel’s diverticulum can be complicated by acute intestinal obstruction mimicking a postoperative flange that can err the diagnosis.
Low Dose Aspirin Initiation 18 Hours After Thrombolytic Therapy in Acute Ischemic Stroke
Authors: Murphy Aubrey , Hamilton Leslie A. , Farley Kalene , Rowe Shaun A. , Christianson Thomas , Medenwald Brittny
Published: June 2024

Objectives:

To investigate the safety of administering low-dose aspirin (81 mg) 18 hours after intravenous thrombolytic therapy.

Methods:

This is a retrospective cohort investigation. Individuals received either alteplase or tenecteplase for acute ischemic stroke followed by aspirin 81 mg (after follow-up imaging). An institutional change moved follow-up post-thrombolytic CT scans to 18 hours, and qualifying patients were grouped based on whether they received aspirin ≤24 hours or >24 hours. Chart reviews were conducted to assess the primary outcome of new or worsening intracranial hemorrhage, as well as secondary outcomes of change in stroke scale scores at discharge and 3 months, lengths of stay, favorable outcomes at 3 months, hospital readmission, and mortality.

Results:

Out of 350 patients screened, 130 qualified for inclusion—50 of whom received aspirin ≤24 hours (mean 21.1 hours, SD±6.2), and 80 who received aspirin >24 hours (mean 34 hours, SD±8.2). Only 1 new intracranial bleed occurred following aspirin administration in the >24-hour group. No statistically significant differences were observed in any of the secondary outcomes, although there was higher mortality (3/50 vs. 2/80, P=0.372) and shorter hospital length of stay (median difference −1.0 day, P=0.0336) in the <24 hours group.

Conclusions:

Low-dose aspirin administration sooner than 24 hours following thrombolytic therapy did not increase bleeding events. Sooner aspirin administration after ischemic stroke can potentially enhance the prevention of secondary embolization and did not demonstrate worse clinical outcomes; however, further randomized controlled trials are needed.
Nutritional Experiences of Patients Undergoing Total Gastrectomy Surgery
Authors: Şayır Derya , Karacabay Kevser
Published: June 2024

The aim of this study was to determine the nutritional experiences of patients who underwent total gastrectomy surgery. This qualitative study was conducted using the phenomenological research design. The sample consisted of 18 individuals who underwent total gastrectomy surgery. The research data were collected using the semistructured in-depth interview method. Interviews were conducted and recorded using audio/visual tools during the COVID-19 pandemic. Data analysis was carried out by two researchers according to the hermeneutic phenomenological approach. The nutritional experiences of the informants were organized under three themes, namely, First Feeding Experiences may remain, Gastrointestinal Problems, and Coping Methods. It was determined that individuals face various problems after total gastrectomy, both physical and psychological. They have developed coping methods to deal with the nutritional problems they experience. Development of a patient-specific nutrition program is recommended to support adaptation to new eating habits after total gastrectomy.
TAD hierarchy restricts poised LTR activation and loss of TAD hierarchy promotes LTR co-option in cancer
Authors: Wong Elissa W. P. , Sahin Merve , Yang Rui , Lee UkJin , Zhan Yingqian A. , Misra Rohan , Tomas Fanny , Alomran Nawaf , Polyzos Alexander , Lee Cindy J. , Trieu Tuan , Fundichely Alexander M. , Wiesner Thomas , Rosowicz Andrew , Cheng Shuyuan , Liu Christina , Lallo Morgan , Merghoub Taha , Hamard Pierre-Jacques , Koche Richard , Khurana Ekta , Apostolou Effie , Zheng Deyou , Chen Yu , Leslie Christina S. , Chi Ping
Published: June 2024

Transposable elements (TEs) are abundant in the human genome, and they provide the sources for genetic and functional diversity. The regulation of TEs expression and their functional consequences in physiological conditions and cancer development remain to be fully elucidated. Previous studies suggested TEs are repressed by DNA methylation and chromatin modifications. The effect of 3D chromatin topology on TE regulation remains elusive. Here, by integrating transcriptome and 3D genome architecture studies, we showed that haploinsufficient loss ofNIPBLselectively activates alternative promoters at the long terminal repeats (LTRs) of the TE subclasses. This activation occurs through the reorganization of topologically associating domain (TAD) hierarchical structures and recruitment of proximal enhancers. These observations indicate that TAD hierarchy restricts transcriptional activation of LTRs that already possess open chromatin features. In cancer, perturbation of the hierarchical chromatin topology can lead to co-option of LTRs as functional alternative promoters in a context-dependent manner and drive aberrant transcriptional activation of novel oncogenes and other divergent transcripts. These data uncovered a new layer of regulatory mechanism of TE expression beyond DNA and chromatin modification in human genome. They also posit the TAD hierarchy dysregulation as a novel mechanism for alternative promoter-mediated oncogene activation and transcriptional diversity in cancer, which may be exploited therapeutically.