bluuebunny/crossref_metadata_2025 huggingface dataset:
Soil microbial drought history affects tree physiology of select species
Authors: Spanier Nicole M. , Phillips Richard P.
Published: October 2024

Soil microbes aid in the drought tolerance of plants, yet the extent to which a microbial community’s previous drought exposure can affect plant responses to contemporary drought is largely unknown. We used a greenhouse experiment to investigate whether microbes exposed to reduced moisture in the past affect the sensitivity of trees to future water-stress. We planted saplings of 3 species in field soils exposed to experimentally-induced drought or ambient moisture from adjacent forest plots, and then altered the watering regime of the saplings to induce contemporary drought. When trees were grown in ambient soils with no drought history, contemporary drought reduced C assimilation rates, stomatal conductance, and leaf water potential in all species. However, when Prunus virginiana were grown in soils with a drought history, they were buffered from the effects of contemporary drought, as physiological performance was mostly unchanged by water stress. P. virginiana grown in drought history soils also increased soluble sugars during contemporary drought to a lesser extent than those in soils with no drought history, suggesting the plants experienced less water stress. Sterilized soils confirmed the “soil drought history effect” likely resulted from drought-adapted microbes in soils exposed to drought previously. None of these effects were apparent in Liriodendron tulipifera and Quercus rubra, which reduced their physiological performance when water-stressed regardless of soil drought history. To the extent mature tree responses to environmental stress are similar, our results suggest that forest sensitivity to drought may depend, in part, on plant-microbial interactions shaped by past stress exposures.
Effects of rhomboid intercostal nerve, serratus anterior plane, and paravertebral block on the quality of recovery after breast cancer surgery: A randomized controlled clinical trial
Authors: Yu Jiali , Qi Yi , Wang Dan , Chen Qi , An Ran , Liu Hongliang
Published: October 2024

Nerve blocks are among the most important methods of postoperative analgesia in breast cancer surgery. We used a randomized controlled clinical trial to compare the effects of rhomboid intercostal nerve block (RIB), serratus anterior plane block (SAPB), and paravertebral block (PVB) on the postoperative quality of recovery and postoperative analgesia in modified radical mastectomy. A total of 132 breast cancer surgery patients were randomized 1:1:1 into three groups. 0.375% ropivacaine 20 ml for ultrasound-guided RIB (RIB group, n = 44), SAPB (SAPB group, n = 44), and PVB (PVB group, n = 44). The primary outcome was the QoR-40 score at 24 hours after surgery. The postoperative 24-hour QoR-40 scores of the RIB (median: 186; interquartile range: 177, 190.5) and PVB (median: 186.5; interquartile range: 176.25, 190.5) groups were higher than those of the SAPB group (median: 168; interquartile range: 163.25, 172) (P < 0.001). In addition, the intraoperative sufentanil consumption (P < 0.001), number of intraoperative sufentanil users (P < 0.001), and postintubation NRS scores (P = 0.01) of the RIB and PVB groups were significantly lower than those of the SAPB group, but there was no statistically significant difference between the RIB and PVB groups. Compared with SAPB, RIB and PVB improve the quality of postoperative recovery, reduce intraoperative opioid use, and improve early postoperative analgesia. RIB may be one of the best alternatives to PVB as a facial plane block.
Association between non-high-density lipoprotein cholesterol and coronary artery disease in patients with acute coronary syndrome: a single-centre retrospective cross-sectional analysis
Authors: Yang Xueyuan , Li Kui , Xu Guanxue , Wen Jiaojiao , Xiao Hong , Chen Lei , Yang Changlong , Chen Yuxuan , Liu Yanmiao , Zhao Yongchao , Shi Bei , Ma Yi
Published: October 2024

Background
A significant relationship exists between atherosclerotic cardiovascular disease (ASCVD) and non-high-density lipoprotein cholesterol (non-HDL-C). However, the relationship between non-HDL cholesterol levels and coronary artery disease in patients with acute coronary syndrome (ACS) remains under-researched and poorly understood. Therefore, this study aimed to explore the association between non-HDL-C and coronary artery disease in individuals with ACS.
Methods
This single-centre retrospective cross-sectional study included 1695 patients with ACS who underwent percutaneous coronary intervention at Zunyi Medical University's Affiliated Hospital from May 2019 to May 2023. The patients were categorised into three groups based on non-HDL cholesterol tertiles. The severity of coronary artery disease was assessed using the Gensini score, and patients were categorised into high and low Gensini score groups. Logistic regression models, including multifactorial adjustments, were used to analyse the association between non-HDL-C levels and high Gensini scores.
Results
After adjusting for potential risk factors, multifactorial logistic regression (odds ratio [OR] = 1.20; 95% confidence interval [CI] = 1.10–1.31; p < 0.001) revealed that non-HDL-C was an independent risk factor for high Gensini scores. After subgrouping based on age, sex, and glucose metabolic status, non-HDL-C remained an independent risk factor for high Gensini scores in these subgroups. Restricted cubic spline analysis revealed that a higher non-HDL-C level was associated with a greater the risk of having a high Gensini score. Receiver operating characteristic curve analysis revealed that non-HDL-C was incrementally predictive of high Gensini scores in patients with ACS.
Conclusions
Non-HDL-C is dose-dependently associated with the severity of coronary artery disease in patients with ACS. These findings suggest the potential of non-HDL-C in predicting its severity, supporting its use as a cost-effective and accessible marker for assessing coronary artery disease risk.
Hydrogeomorphological dynamics and erosion of the soft coasts in tropical Africa, the case study of the Wouri estuary, Cameroon
Authors: Fendoung Mbevo , Hubert-Ferrari Aurélia
Published: October 2024

Coastal erosion affects all countries along Africa's Atlantic coast, with flooding being the second most significant threat after erosion. In Cameroon, this phenomenon is particularly alarming, especially along the Kribian coast and in the Wouri estuary. Cape Cameroon in the Wouri estuary is experiencing severe erosion. The question arises whether the current erosion in the Wouri estuary is due to internal factors or part of a broader dynamic affecting all Atlantic African coasts. This inquiry aims to understand the causes of coastal erosion in the Wouri estuary. To address this, we used a large-scale map based on Landsat images (30m spatial resolution) covering the entire Wouri estuary and a smaller-scale map based on Pleiades images (0.5m spatial resolution) focusing on Cape Cameroon. The Digital Shoreline Analysis System (DSAS) in ArcGis 10.7.1 facilitated this analysis. Aerial photographs from 1916 to 2016 helped assess changes in Douala and their impact on mangroves over time. Diachronic land cover analysis employed Landsat images and the maximum likelihood algorithm. The Landsat results indicate that coastal erosion affects over 75% of the Wouri estuary's coastline, with average recession rates ranging from ± 3m to ± 11m between 1975 and 2020. Hotspots of regression include Cape Cameroon, the coastal spit around Manoka Island, and the area near the APD. High-resolution images from Pleiades and Google Earth confirm the severity of coastal erosion. The northern tip of Cape Cameroon is retreating at an estimated rate of + 15m/year, with the most significant recession measured at the tip of Cape Cameroon, estimated at 53 meters. A small accretion of + 5m is visible at Toubé, spanning no more than 100 meters.
Representational drawing ability is associated with the syntactic language comprehension phenotype in autistic individuals
Authors: Vyshedskiy Andrey , Venkatesh Rohan , Khokhlovich Edward
Published: October 2024

The relationship between symbolic thinking and language abilities is a topic of intense debate. We have recently identified three distinct language comprehension phenotypes: command, modifier and syntactic (Vyshedskiy et al., 2024). Individuals in the command phenotype were limited to comprehension of simple commands, while those in the modifier phenotype showed additional comprehension of color, size, and number modifiers. Finally, individuals in the most-advanced syntactic phenotype added comprehension of spatial prepositions, verb tenses, flexible syntax, possessive pronouns, complex explanations, and fairytales. In this report we analyzed how these three language phenotypes differed in their symbolic thinking as evidenced by their drawing abilities. In a cohort of 39,654 autistic individuals 4- to 21-years-of-age, parents reported that ‘drawing, coloring and art’ was manifested by 36.0% of participants. Among these individuals, representational drawing was manifested by 54.1% of individuals with syntactic-phenotype, 27.7% of those with modifier-phenotype, and 10.1% of those with command-phenotype (all pairwise differences between the phenotypes were statistically significant, p < 0.0001). The ability to draw a novel image per parent’s description (e.g. a three-headed horse) was reported by 34.6% of individuals with syntactic-phenotype, 7.9% of those with modifier- phenotype, and 1.9% of individuals with command-phenotype (all pairwise differences between the phenotypes were statistically significant, p < 0.0001). These results demonstrate strong association between representational drawing ability and the syntactic-language-comprehension-phenotype, suggesting a potential benefit of drawing interventions in language therapy.
Gut commensal Alistipes as a potential pathogenic factor in colorectal cancer
Authors: Fu Jingjing , Li Guangyao , Li Xiaoping , Song Shasha , Cheng Lijuan , Rui Beibei , Jiang Lei
Published: October 2024

Although previous research has shown that inflammation is associated with development of colorectal cancer (CRC), questions remain about whether inflammatory factor-secreting bacteria play a crucial role in CRC development. The potential role of gut microbiota in secreting inflammatory factors involved in the development of CRC among Chinese patients was explored in this study. 16S rRNA sequencing was utilized to evaluate the distinct microbial characteristics between patients with CRC and colorectal adenoma. Serum levels of inflammatory factors and the expression level of LRG1 tissue protein were studied. The correlation between gut microbiota and inflammatory signaling was analyzed to explore potential molecular mechanisms of CRC. Compared with the adenoma group, CRC patients exhibit distinct pathologies. Moreover, elevated levels of CEA, erythrocytes and haemoglobin in the blood of CRC patients were found. In addition, CRC patients have significantly higher levels of TNF-α, IL-6, IL-10, LRG1 and TGF-β1 when compared with adenoma patients. Spearman correlation analysis revealed that LRG1 was positively related to IL-6 and TNF-α, respectively. The correlation analysis result of TGF-β1 was consistent with the above. Furthermore, we found that the relative abundance of gut commensal Alistipes was significantly elevated in CRC patients. Moreover, a positive correlation between Alistipes and inflammatory signaling was also found. The results suggest that gut commensal Alistipes is a key bacterium with pro-inflammatory properties in the development of CRC. TNF-α and IL-6 associated with Alistipes might activate LRG1-TGF-β1 signaling which contributed to the pathogenesis of CRC.
Optimal Time for Collateral Channel Wiring in Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention
Authors: Lee Kyusup , Kim Tae Oh , Kwon Woojin , Yoon Yong-Hoon , Kwon Osung , Lee Jong-Young , Lee Pil Hyung , Kang Soo-Jin , Kim Young-Hak , Lee Cheol Whan , Lee Seung-Whan
Published: October 2024

Collateral channel wiring (CCW) is important in a retrograde chronic total occlusion (CTO) procedure. However, the guidance is insufficient. To investigate the optimal CCW time, patients who had received retrograde CTO procedures were enrolled. The optimal CCW time was derived by Receiver Operating Characteristic curves regarding success rates or complications. The clinical outcomes in terms of success and complication rates were addressed by cutoff value of optimal CCW time. With cutoff values of 25 minutes, 191 (54.9%) had shorter CCW times and 157 (45.1%) had longer CCW times. The success rates were significantly higher in the group with shorter CCW times than in the group with longer CCW times (p < 0.05). Procedure-related myocardial infarction (MI) and collateral channel (CC) related complications were more frequently observed in longer CCW times group than shorter group. The CCW time less than 25 minutes was more likely to result in a technical success (adjusted odds ratio [aOR]: 3.69) and the odds of CC perforation decreased by approximately 80% (aOR: 0.20). A CCW time of less than 25 minutes may facilitate the success results and minimize the risk of complications in retrograde CTO procedures.
Development for a novel phantom for evaluating image quality in small-animal single photon emission computed tomography and positron emission tomography.
Authors: Shibutani Takayuki , Onoguchi Masahisa , Kannno Takayuki
Published: October 2024

Objectives
The National Electrical Manufacturers Association (NEMA) has released guidelines delineating the performance of positron emission tomography (PET) devices designed for small animals. However, the NEMA NU 4 image quality phantom could not measure the known contrasts of the hot rod images and the recovery coefficient (RC) of cold rod images due to the structure of the phantom. Thus, we have devised novel hot rod and cold rod phantoms capable of evaluating uniformity and RCs for both hot rod and cold rod images. This study aimed to assess uniformity, image contrasts, and RCs in hot rod and cold rod images of single photon emission computed tomography (SPECT) and PET using the newly developed phantom.
Methods
The new physical phantom consisted of rod and pool sections. To assess image uniformity, the pool section, designed in a cylindrical shape, was utilized. Conversely, the rod section was created in hot rod and cold rod shapes and integrated into a cylindrical phantom with the same design as the pool section. Hot rod and cold rod phantoms were designed with six different 1–6 mm diameter rods. The rod and pool sections of the hot rod phantom were separately filled with 99mTc and 18F solutions. In the rod section, the cylindrical part was defined as the background (BG), with a radioactive concentration ratio of 4:1 for the hot rod and BG. The cylindrical part containing the cold rod was separately filled with 99mTc and 18F solutions. The 99mTc and 18F phantoms were acquired separately over 30 min. A transverse image with a cubic voxels of 0.8 mm length was reconstructed using a pixel-based ordered subset expectation maximization algorithm.
Results
The contrast of the hot rod for 99mTc and 18F showed lower values with a decreasing rod diameter. Furthermore, the 99mTc image demonstrated a higher contrast than the 18F image and approached the true contrast. The cold rod contrasts with 99mTc and 18F followed a similar trend as the hot rod contrast. The RCs for the hot rods with 4–6 mm diameters were similar, whereas hot rods with diameters ≤ 3 mm revealed lower values as the rod diameter decreased. The inverse RC was lower with a decreasing cold rod diameter. Moreover, the cold rod image with 18F demonstrated a lower inverse RC than with the 99mTc. The percent coefficient of variation (%CV) for the 99mTc and 18F images was 4% and 7%, respectively, with the 99mTc image displaying a lower %CV compared to the 18F image.
Conclusion
We have developed a new phantom that allows physical phenomenon evaluation in small animal SPECT and PET images, and can evaluate the image contrast, RC, and uniformity of both hot rod and cold rod images.
Usefulness of monitoring Mycophenolic Acid Exposure in Systemic Sclerosis- Related Interstitial Lung Disease: A Retrospective Cohort Study
Authors: Milesi Jules , Sampol Emmanuelle , Benyamine Audrey , Diai Shani , Coiffard Benjamin , Nieves Ana , Granel Brigitte , Reynaud-Gaubert Martine , Bermudez Julien
Published: October 2024

Background: Systemic sclerosis-related interstitial lung disease (SSc-ILD) represents a significant cause of morbidity and mortality in Systemic Sclerosis (SSc). Mycophenolate mofetil (MMF) is currently the first line treatment for SSc-ILD. There is no recommendation on the dosage of mycophenolic acid (MPA) blood concentrations, so we aimed to study the correlation between MPA exposure and respiratory outcomes in this population.
Methods: We conducted a retrospective cohort study of SSc-ILD patients treated with MMF in our center. According to our policy, a complete patient evaluation was performed approximately one year after MMF initiation, during which the mycophenolic acid (MPA) residual rate (RR) was measured. We analyzed the association between RR and changes in forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLCO) over time.
Results: Forty-three SSc-ILD patients were included. Patients with higher RR levels (1.5 mg/L) had a significantly better FVC evolution with a higher proportion of stabilization and lower proportion of FVC decrease (p= 0.024). RR above 1.5 mg/L was a predictive factor of reduced FVC decline compared with lower RR levels adjusting for MMF dose and duration of MMF exposure (p= 0.008). There was no difference regarding DLCO outcome.
Conclusion: Our study suggests that optimal MPA exposure, as indicated by RR levels, may better protect against FVC decline in SSc-ILD patients treated with MMF. Routine monitoring of MPA exposure could be beneficial in optimizing treatment outcomes. Prospective, multicenter studies are needed to further explore the relationship between MPA exposure and clinical outcomes in SSc-ILD.
Characteristics and outcomes of patients hospitalized for infection with Influenza A, SARS-CoV-2 or respiratory syncytial virus in the season 2023/2024 in a large German primary care centre
Authors: Wiechert Lukas , Fischer Carolina , Jörres Rudolf A. , Engelhardt Sebastian , Alter Peter , Kahnert Kathrin , Budweiser Stephan
Published: October 2024

Background
In addition to the persistence of SARS-CoV-2 infections, those with Influenza A/B and RSV have reappeared in 2022/23. To compare the development of prevalence, clinical outcomes and risk factors, we analysed data of the season 2023/24 from the same region/hospital as for 2022/23.
Methods
Patients covering the whole age range with a positive polymerase chain reaction (PCR) test for SARS-CoV-2, Influenza A/B, RSV were included from the internal, neurological and paediatric units of the RoMed hospital Rosenheim, Germany/Bavaria, from August 1st 2023 to 29th February 2024.
Results
Of 932 patients included, 912 showed single infections with SARS-CoV-2, Influenza A or RSV (47.9% female, median age 68.0 years; 52.9% SARS-CoV-2, 23.2% Influenza A, 21.8% RSV). Co-infections (2.0%) and Influenza B (0.1%) were negligible. In patients of age ≥ 18 years (n = 628, 68.5% SARS-CoV-2, 26.0% Influenza A, 5.6% RSV), patients with Influenza A were younger compared to SARS-CoV-2 (p < 0.001), with RSV similar to SARS-CoV-2. Heart failure and asthma were the most prevalent comorbidities for RSV, immunosuppression for Influenza A. Admission to Intensive Care Unit (ICU) occurred in 111 patients (17.0% of SARS-CoV-2, 17.2% Influenza A, 28.6% RSV), and 59 patients died (8.8% SARS-CoV-2, 8.6% Influenza A, 20.0% RSV). Low-flow oxygen supplementation and non-invasive ventilation (NIV) were most frequent for RSV (68.6% and 20.0%, respectively), oxygen demand upon admission for Influenza A (39.3%), without differences in high-flow oxygen supply or length of hospital stay. Among patients aged < 18 years (n = 284, 21.4% SARS-CoV-2, 18.0% Influenza A, 57.1% RSV), 15 were admitted to ICU (4.8% SARS-CoV-2, 3.8% Influenza A, 6.0% RSV); none of them died. Oxygen supply via high-flow, low-flow or upon admission was highest for RSV (23.8%, 70.2%, 21.4%, respectively), as well as the length of hospital stay.
Conclusion
In the season 2023/24, a large population of patients hospitalized due to respiratory tract infection, showed relative contributions of SARS-CoV-2, Influenza A or RSV similar to those in 2022/23. The findings underline that in both, adults and children, RSV posed a relatively higher clinical risk than Influenza A and SARS-CoV-2, though absolute numbers remained highest for SARS-CoV-2.
Posterior lumbar interbody fusion for degenerative spondylolisthesis; slippage reduction can be a risk factor for adjacent segment disease.
Authors: Saito Sosuke , Nakanishi Kazuyoshi , Sawada Hirokatsu , Matsumoto Koji , Oshima Masashi , Uei Hiroshi , Sato Kentaro , Suzuki Satoshi , Furuya Tomohiro , Miyanaga Yuya
Published: October 2024

Several risk factors for adjacent segment disease (ASD) after posterior lumbar interbody fusion (PLIF) have been reported. However, the reducing the slipped vertebra has not been investigated as a risk factor for ASD. The objective of this study is to identify the risk factors for ASD following single-segment PLIF in patients with L4 spondylolisthesis, with a particular focus on the reduction of vertebral body slippage. Fifty-two patients who underwent PLIF at the L4-L5 level for L4 degenerative spondylolisthesis were investigated. Patients were divided into two groups: the ASD group and the non-ASD group. The ASD group consisted of 12 of the 52 patients (23.1%). %Slip before surgery and at follow-up, Δ%Slip (Δ%Slip = %Slip before surgery - %Slip at follow-up), L4-L5 interbody height, and L4-L5 lordosis angle were evaluated. Stepwise multivariate regression analysis revealed Δ%Slip to be a risk factor for ASD (odds ratio: 1.22, 95% confidence interval: 1.04–1.43, p = 0.015). In the receiver operating characteristic analysis, the cutoff value for Δ%Slip was 7.3% (sensitivity: 75.0%, specificity: 67.5%, area under the curve = 0.725). Our findings suggest that the reduction of L4 slippage may contribute to the development of ASD in patients with L4 spondylolisthesis.
Development of ethyl cellulose and lecithin nanoparticles: Permeability enhancement for berberine topical application
Authors: Luong Anh Quang , Le Thu Uyen , Nguyen Thao Phuong , Tran Hiep Tuan , Tran Bao Ngoc
Published: October 2024

Introduction: Berberine chloride (BER), a well-known medicine for treating gastroenteritis, was renovated into topical application by using nanoparticle platform with ethyl cellulose (EC) and lecithin (LEC).
Method: BER was prepared into nanoparticles by solvent evaporation method, the effects of LEC, BER, EC were analyzed by JMP artificial neural network. The structure and permeation mechanism of nanoparticle system were predicted based on effects of inputs on particle size, polydispersity index (PDI), encapsulation efficiency. The optimal sample was analyzed with infrared and DSC spectra, TEM images. Obtained nanoparticle system was loaded into (i) ionic Sepimax Zen gel and non—ionic hydroxyethy Cellulose (HEC) gel for drug permeation study (in-vitro and ex-vivo).
Results: The average particle size of obtained nanoparticles were less than 200 nm with a negative Zeta potential. Data analysis showed that while EC proportions affected Z (nm) values, it did not have a significant impact on EE (%). Based on results from IR, DSC, and TEM analysis, the structure of nanoparticles was illustrated with EC as the core structure, whereas BER or LEC are more water-soluble compounds that are more dynamic in the nanosuspension. Despite a low EE %, the ex-vivo data confirmed that nanoparticle-gel provided a better permeation for BER than raw-suspension gel. In addition, two distinct gelling types pre-neutralized Sepimax ZEN and hydroxyl ethyl cellulose (HEC) were proposed. While Sepimax exhibited a higher drug retention and HEC gel offered better permeability.
Conclusion: This BER-EC-LEC nanoparticle provided an interesting platform for topical application.
Willingness to pay for rabies vaccination services and associated factors among communities in Geita District, Tanzania
Authors: George Janeth , Mbunde Mourice , Kimaro Loveness , Sam Given , Chachage Mkunde , Mohamed Hussein , Kakoko Deodatus , Killewo Japhet
Published: October 2024

Background: Rabies remains a significant public health and economic problem in Tanzania, causing a high economic burden due to medical costs and productive lives lost due to premature deaths. Despite all the effort put into rabies vaccination campaigns, there are still new cases all the time, and vaccination coverage is still low. Therefore, this study aimed to explore the willingness to pay for rabies vaccination services and associated factors among communities in Geita district, Tanzania.
Methods: A cross-sectional study was conducted among 312 respondents in Geita district from August to September 2023. The study deployed a willingness-to-pay (WTP) technique using a bidding game to elicit the maximum values respondents were willing to pay for rabies dog vaccination and human post-exposure prophylaxis. An interviewer-administered questionnaire was used to collect all the necessary data. Linear regression models were used to evaluate the WTP and associated factors.
Results: The results suggest that people are willing to pay slightly more for dog vaccination services ($0.3 above the prevailing price) compared to human post-exposure prophylaxis (PEP), in which the average WTP is the same as the prevailing price. 62% of the respondents were willing to pay above the prevailing price ($1.2) for dog vaccines compared to 32% for PEP ($20). In dog vaccination and human PEP services, men are more willing to pay than women.
Conclusion: This study highlights the significance of economic consideration in rabies vaccination decisions. In addition to awareness, availability, and access to vaccines, it is crucial to consider socioeconomic factors and financial values individuals place on the welfare of animals.
Trial registration: Not Applicable
Microbiology, Antibiotic Resistance, and Risk Factors Associated with Infectious Complications in Patients Undergoing Transrectal Prostate Biopsy.
Authors: Lagos-Beitz Horst Emanuel , Martínez-Delgado Guillermo H , González-Sosa Wolfgang , Trujillo-Martínez Guillermo , Escalante-Armenta Rodrigo , Tena-González-Méndez Gerardo , Castillejos-Molina Ricardo Alonso , Feria-Bernal Guillermo , Garza-Gangemi Adrian Mauricio
Published: October 2024

Purpose: Urinary tract infections (UTI) are a potentially fatal complication in men undergoing transrectal prostate biopsy (TRPB). Antibiotic prophylaxis is indicated for every patient and recommendations are vastly empiric or based on older epidemiological data. Adequate antibiotic stewardship tailored to local data is essential to reduce the incidence of MDR bacteria. The aim of this study is to investigate the microbiology in our population and to identify risk factors associated with infectious complications after prostate biopsy.
Methods: A retrospective analysis of prospectively collected data from 531 patients undergoing a TRPB biopsy at a tertiary care center in Mexico City between 2017-2023 was performed. Baseline characteristics, clinica and microbiological data were compared between patients with and without protoperative UTIs. Biniary logistic regression was used to identify risk factors for infectious compliations.
Results: Of the 531 patients, 44 (8.3%) developed UTIs, with 9 (1.7%) requiring hospitalization due to sepsis. Significant risk factors included Diabetes Mellitus (DM), dyslipidemia, and previous abdominal radiotherapy. DM was the only independent risk factor (OR 2.82, CI 95% 1.48-5.39). E. coli was the most common isolate (85.7%), with high antibiotic resistance.
Conclusions: Postoperative UTIs were observed in 8.3% of patients, with DM being the sole independent risk factor. High antibiotic resistance rates in E. coli isolates suggest a need for alternative prophylactic strategies.
Triorchidism: A Case Report
Authors: Nazir Fatima , Khawaja Muhammad Athar , Nazir Farhan , Naeem Wahaj , Iqbal Laiba , Javed Tariq
Published: October 2024

Background :
A very uncommon congenital anomaly of the genitourinary tract called polyorchidism is characterized by more than two testicles. Triorchidism, which has three testes, is the most prevalent form of polyorchidism. Triorchidism is most often asymptomatic and is found incidentally. An affordable diagnostic tool is an ultrasound.
Case presentation:
In our case, a patient presented with an extra testicle on the left side of the scrotum with its own separate epididymis and vas deference, which represents type 4 polyorchidism based on Leung's classification, and an ultrasound of the scrotum was used for diagnosis. The patient was conservatively managed and was advised of regular follow-up.
Conclusion:Polyorchidism should be taken into consideration when evaluating any mass in the scrotum or inguinal region. Ultrasound is a diagnostic tool for polyorchidism, as most of the time it is asymptomatic. The management of polyorchidism is still debatable. If there is any suspicion of neoplastic transformation, it should be resected. However, if there is any suspicion of neoplastic transformation, it should be resected.
Effect of therapeutic plasma exchange on tissue factor and tissue factor pathway inhibitor in septic shock
Authors: Stahl Klaus , Lehner Georg F , Wendel-Garcia Pedro David , Seeliger Benjamin , Pape Thorben , Schmidt Bernhard MW , Schenk Heiko , Schmitt Julius , Sauer Andrea , Wild Lennart , Peukert Konrad , Putensen Christian , Bode Christian , Joannidis Michael , David Sascha
Published: October 2024

Background:Coagulopathy is part of the pathological host response to infection in sepsis. Higher plasma concentrations of both tissue factor (TF) and tissue factor pathway inhibitor (TFPI) are associated with occurrence of disseminated intravascular coagulation (DIC), multi-organ dysfunction and increased mortality in patients with sepsis. Currently no treatment approaches specifically targeting this axis are available. We hypothesize that therapeutic plasma exchange (TPE) might limit this coagulopathy by restoring the balance of plasma proteins.
Methods: Fifty-one patients with early (shock onset < 24 hrs) and severe (norepinephrine dose > 0.4 mg/kg/min) septic shock were either receiving standard of care treatment (SOC, n=14) or SOC + one single TPE (n=37). Plasma concentrations of TF and TFPI were measured both at- and 6 hrs after study inclusion. The effect of TPE on concentrations of TF and TFPI was investigated and compared to SOC patients. Further, baseline TF and TFPI concentrations were used to modulate and predict clinical response to adjunctive TPE, indicated by longitudinal reduction of lactate concentrations over the first 24 hours following study inclusion.
Results: TPE led to a significant reduction in circulating concentrations of both TF and TFPI while no difference was observed in the SOC group. Relative change of TF within 6 hrs was +14 (-0.8 to +30.4) % (p=0.089) in the SOC and -18.3 (-32.6 to -2.2) % (p<0.001) in the TPE group (between group p<0.001). Similarly, relative change of TFPI was +14.4 (-2.3 to +30.9) % (p=0.076) in the SOC and -20 (-32.8 to -7.9) % (p<0.001) in the TPE group (between group p=0.022). The ratio of TF to TFPI remained unchanged in both SOC and TPE groups. SOC patients exhibited an increase in lactate over the initial 24 hrs when TF and TFPI concentrations were higher at baseline. In contrast, patients undergoing TPE experienced a sustained longitudinal reduction of lactate concentrations across all levels of baseline TF and TFPI elevations. In a multivariate mixed-effects model, higher baseline TF (p=0.003) and TFPI (p=0.053) levels led to greater longitudinal lactate concentration reduction effects in the TPE group.
Conclusions: Adjunctive TPE in septic shock is associated with a significant removal of both TF and TFPI, which may contribute to the early hemodynamic improvement observed in septic shock patients receiving TPE. Higher baseline TF (and TFPI) plasma concentrations were identified as a putative predictor of treatment response that could be useful for predictive enrichment strategies in future clinical trials.
Silibinin Induces Apoptosis and Suppresses Cell Migration by Targeting the Transforming growth factor-β Signaling Pathway in Osteosarcoma Cells
Authors: S Nancy sheela , G Gnanamathy , R Jeevitha , P Elumalai , M Sridevi
Published: October 2024

Osteosarcoma is the most common primary malignant bone tumor in children and teenagers, followed by lymphomas and brain tumors. Silibinin, a flavonolignan mix from milk thistle, has anticancer, neuroprotective, and anti-diabetic properties. It induces apoptosis in MG-63 cells.; Silibinin treatment of MG-63 cells resulted in a dose-dependent inhibition of cell viability; for the MG-63 cell line, the growth-dependent rate peaked at 40μM/ml and 60μM/ml. Although studies involving Silibinin in various cancers were reported, the anticancer activity of Silibinin in human osteosarcoma has not been reported. Utilising MTT assay, morphological studies, and mode of cell death. Acridine orange (AO)/ethidium bromide (EtBr) dual labeling at the ideal dosage is followed by morphological examinations and a fluorescence microscopy examination of the labeled cells to identify apoptotic alterations and the mode of cell death. Utilising LDH assay, Scratch wound healing assay, and molecular docking. Silibinin promotes apoptosis in MG-63 cell lines and may be a target for treatment in people with osteosarcoma and it may also have a role in the development of osteosarcoma. At 60μM/ml of Silibinin concentration, the prevention of cell division and cell cycle arrest in MG-63 cells was examined. In the MG-63 cells, the impact of Silibinin on the apoptotic genes p53, Bcl-2, Bax, and caspase-3 was assessed. Silibinin promotes apoptosis in MG-63 cell lines and may be a target for treatment in people with osteosarcoma and it may also have a role in the development of osteosarcoma.
Intra-individual comparison of long-term outcomes between combined and indirect bypass surgery in adult moyamoya disease
Authors: Chung Yuwhan , Kim Jeong Eun , Kang Hyun-Seung , Kim Tae Young , Paeng Jin Chul , Cho Won-Sang , Lee Sung Ho , Ha Eun Jin , Kim Kangmin
Published: October 2024

PURPOSE
Bypass surgery is regarded as the standard treatment option for symptomatic and hemodynamically unstable moyamoya disease (MMD), but controversy exists regarding which type of bypass surgery is most effective. We aimed to analyze the long-term outcomes of combined and indirect bypasses for MMD patients through intra-individual comparisons.
METHODS
Of the 896 patients who underwent 1084 bypass surgeries between 2007 and 2021, 24 patients with MMD who underwent combined bypass on one side and indirect bypass on the other side were ultimately enrolled in this study. Clinical, angiographic and hemodynamic outcomes were retrospectively evaluated.
RESULTS
Three asymptomatic strokes (12.5%) occurred within 30 postoperative days in each group. Postoperative strokes after 30 days occurred in 3 patients (12.5%) with 3 hemorrhagic events and 1 cerebral infarction, only in indirect bypass, while no stroke occurred in hemispheres treated with combined bypass. The revascularization area relative to supratentorial area was significantly greater in combined bypass than in indirect bypass, both in short-term and long-term periods (64.9% versus 43.9% in short-term and 75.7% versus 54.9% in long-term; P < 0.001, respectively). Hemodynamic outcomes showed significantly greater increases in acetazolamide-challenged cerebral blood flow (CBFacz) during short-term follow-up (P = .04) and in both basal CBF (CBFbas) and CBFacz during long-term follow-up (P = .014 and P = .009, respectively) in combined bypass than in indirect bypass.
CONCLUSION
Combined bypass may be a more effective treatment option for MMD based on its higher revascularization area and favorable hemodynamic results compared to indirect bypass in the same patient.
How much does it cost to retain antiretroviral therapy (ART) clients in their first year? Routine financial costs of retention interventions at Lighthouse Trustin Lilongwe, Malawi
Authors: Weldemariam Hiwot , Thawani Agness , Kiruthu-Kamamia Christine , Huwa Jacqueline , Chipanda Mirriam , Tweya Hannock , Feldacker Caryl
Published: October 2024

Introduction
Antiretroviral therapy (ART) improves the health of people living with HIV (PLHIV). However, a high loss to follow-up, particularly in the first year after ART initiation, is problematic. The financial expenses related to client retention in low- and middle-income countries (LMICs) in sub-Saharan Africa are not well understood. This study aimed to comprehensively assess and quantify the financial costs associated with routine ART retention services for clients in their first 12 months in care at Lighthouse Trust’s (LT) Martin Preuss Centre (MPC), a large, public ART clinic in Lilongwe, Malawi.
Methods
We performed activity-based microcosting using routine data to assess the expenses related to routine ART retention services at the MPC for 12 months, from January to December 2021. MPC provides an “ART Buddy” from ART initiation to 12 months. The MPC’s Back-to-Care (B2C) program traces clients who miss ART visits by at least 14 days. Clients may be traced and return to care multiple times per year. We assessed client retention costs for the first 12 months of treatment with ART and conducted a sensitivity analysis.
Results
The total annual cost of ART retention interventions at MPC was $237,564. The proactive Buddy phase incurred $108,504; personnel costs contributed $97,764. In the reactive B2C phase, the total cost was $129,060, with personnel expenses remaining substantial at $73,778. The Buddy unit cost was $34 per client. The reactive B2C intervention was $17 per tracing event. On average, the unit cost for ART retention in the first year of ART averaged $22 per client.
Conclusion
This study sheds light on the financial dimensions of ART retention during the first year on ART among clients in a routine public setting. ART retention is both costly and critical for helping clients adhere to visits and remain in care. Continued investment in the human resources needed for both proactive and reactive retention efforts is critical to engaging and retaining patients on lifetime ART.
The Effect of an Educational and Supportive Intervention on Health Performance, Self-Efficacy and Maternal/Neonatal Outcomes in Pregnant Adolescents with presence of close relative as a continuous companion support: Study Protocol for a Randomized Controlled Trial (RCT)
Authors: Nourimand firoozeh , Salehin Shahrbanoo , Mirrezaie Seyed Mohammad , Keramat Afsaneh
Published: October 2024

Background: Early motherhood (EM) has been identified as a major challenge for women's health in most developing countries and is associated with adverse outcomes in babies and mothers.
This study will examine the effect of educational and supportive intervention in pregnant teenagers and close relative as a Continuous Companion Support (CCS) on health performance, self-efficacy and maternal/neonatal outcomes.
Methods: The present protocol is introduced a parallel randomized clinical trial study with 136 adolescences pregnant woman under 19 years who will be randomly assigned to 2 groups (intervention and control group). Participants will be recruited from Comprehensive Health Service Centers (CHSCs) in Fasa city. The intervention group will receive six weekly sessions of educational and supportive courses.
Primary and secondary outcomes will be the assessed through the questionnaires (Self-Efficacy and Health Performance) and the maternal/neonatal outcomes, respectively. To follow the participants, we will evaluate the teenage pregnant by the follow up checklist to collect the data including participating in Educational/supportive courses, receiving complete routine care from CHSCs and presence of close relative as a CCS during pregnancy/labor, high-risk pregnancy symptoms, Apgar at first and 5Th minute, type of delivery, delivery complications. Data will be analyzed using SPSS software version 18. The level of significance in all tests have two-sided and 5%.
Discussion: The results of the present research could determine the appropriate method to increase Health Performance and self-efficacy in pregnant teenagers. It is obvious that the presence of close relative as a CCS improves the quality care of the teenage pregnant to reduces the Maternal/Neonatal complications and the costs borne by the pregnant teenagers and their families.
Trial registration: IRCT20230816059157N1 at 2023.08.28, prospectively registered.
Safety and Effectiveness of Ultrasound-Guided Artificial Ascites-Assisted Puncture and Sclerotherapy for Ovarian Cysts
Authors: Meng Bin , Wang Xiaotao , Li Qian , Xu Mingmin
Published: October 2024

Background
Ovarian cysts are a common gynecological condition that can cause significant morbidity. Ultrasound-guided sclerotherapy is a minimally invasive treatment option. This study aims to assess the safety and effectiveness of ultrasound-guided artificial ascites-assisted puncture and sclerotherapy for ovarian cysts.
Methods
A retrospective analysis was conducted on 100 ovarian cyst patients treated from January 2019 to June 2023 at Zhejiang Rongjun Hospital. Patients were divided into observation (44 cases) and control (56 cases) groups based on the use of artificial ascites. The primary endpoints included the incidence of pain and vagal reflex during and after surgery, and the cure rate and effective rate of sclerotherapy assessed by ultrasound at 3, 6, and 12 months post-treatment.
Results
The observation group experienced significantly lower rates of pain (11.36%) and vagal reflexes (4.55%) compared to the control group (35.71% and 25.00% respectively, P < 0.01). The cure rate was 93.18% in the observation group and 82.14% in the control group (P < 0.05). The effective rate was 100% in the observation group, while it was 91.07% in the control group (P < 0.05). No post-operative infections were observed in either group.
Conclusion
Ultrasound-guided artificial ascites-assisted puncture and sclerotherapy significantly enhances the safety and efficacy of sclerotherapy for ovarian cysts, reducing complications during and after the procedure. It is recommended for widespread clinical use.
Decision Support Guided Fluid Challenges and Stroke Volume Response during High-Risk Surgery: A Post Hoc Analysis of a Randomized Controlled Trial
Authors: Coeckelenbergh Sean , Rinehart Joseph , Desebbe Olivier , Rogoz Nicolas , Mastouri Amira Dagachi , Maghen Bryan , Cannesson Maxime , Vincent Jean-Louis , Duranteau Jacques , Joosten Alexandre
Published: October 2024

Purpose
Intravenous fluid is administered during high-risk surgery to optimize stroke volume (SV). To assess ongoing need for fluids, the hemodynamic response to a fluid bolus is evaluated using a fluid challenge technique. The Acumen Assisted Fluid Management (AFM) system is a decision support tool designed to ease the application of fluid challenges and thus improve fluid administration during high-risk surgery. In this post hoc analysis of data from a randomized controlled trial, we compared the rates of fluid responsiveness (defined as an increase in SV of ≥ 10%) after AFM-guided or clinician-initiated (control) fluid challenges.
Methods
Patients undergoing high-risk abdominal surgery were randomly allocated to AFM-guided or clinician-initiated groups for fluid challenges titration, which consisted of 250-mL boluses of crystalloid or albumin given over 5 mins. The fluid responsiveness rates and the mean SV increase in the two groups were compared.
Results
The original study included 86 patients (44 in the AFM group and 42 in the clinician-initiated group) and this sub-study analysed 85 patients with a total of 448 fluid challenges. The median rate of fluid responsiveness was greater in the AFM than in the control group (50 [44–71] % vs 33 [20–40] %, p < 0.001). The mean increase in SV after fluid challenge was also higher in the AFM than in the control group (12 [9–16] % vs 6 [3–10] %, p < 0.001).
Conclusion
AFM-initiated fluid challenges were more often associated with the desired increase in SV than were clinician-initiated fluid challenges, and absolute SV increases were greater.
Clinical effect of treating hyperextension injuries of the thoracolumbar spine in patients with ankylosing spondylitis, without active intervention on the anterior distraction defect
Authors: Ye Zhiyuan , Yang Jian , Zhao Xushen , Bai Jinyu , Song Fanglong , Dai Jun , Zhou Zhentao , Shan Bingchen , Zhou Xiaozhong
Published: October 2024

Background
To observe the treatment effect of hyperextension fracture on thoracolumbar in patients with ankylosing spondylitis (AS) and determine whether anterior distraction defect can achieve union without active intervention.
Methods
From 2013 to 2023, we retrospectively searched our database to identify all individuals who had experienced extension-type fractures in the thoracolumbar region. The patients received either surgical or conservative management for treatment. The assessment of the extent of the anterior distraction defect was conducted in all patients. The evaluation of clinical effectiveness mainly involves the utilization of the visual analogue scale (VAS) to measure the severity of back pain and the Oswestry Disability Index (ODI) to assess functional limitations. Computed tomography imaging is used to assess the progress of fracture healing.
Results
A total of 32 individuals diagnosed with AS received medical treatment for thoracolumbar hyperextension fractures at our institution and met the inclusion criteria. All patients were followed up for a minimum of 12 months, with an average age of 58.7 ± 13.1 years. The mean extent of the anterior distraction defect was 10.3 (5.4, 16.1) mm, with 18 (56.3%) patients exhibiting an anterior defect extent exceeding 10 mm. All the patients expressed satisfaction with the outcomes, and all patients exhibited successful healing of their fractures. The mean VAS and ODI values were recorded as 1 (0, 2) and 9 (4, 9) %, respectively, during the final follow-up. Compared to surgery patients, the anterior defect was smaller in patients who received conservative treatment (P > 0.05). The anterior defect was larger after the operation compared to preoperative, but there was no statistically significant difference (P > 0.05). No significant complications or deaths occurred during the treatment, except for one patient who experienced a delayed neurologic deficit.
Conclusion
Both surgical and conservative treatments can achieve favorable outcomes in patients with AS accompanied by thoracolumbar hyperextension fracture. Regarding the anterior distraction defect resulting from hyperextension, fracture healing can be achieved without active intervention.