bluuebunny/crossref_metadata_2025 huggingface dataset:
Selective Default Expectations
Authors: Accominotti Olivier , Albers Thilo N H , Oosterlinck Kim
Published: December 2023

This paper explores how selective default expectations affect the pricing of sovereign bonds in a historical laboratory: the German default of the 1930s. We analyze yield differentials between identical government bonds traded across various creditor countries before and after bond market segmentation. We show that, when secondary debt markets are segmented, a large selective default probability can be priced in bond yield spreads. Selective default risk accounted for one-third of the yield spread of German external bonds over the risk-free rate during the 1930s. Selective default expectations arose from differences in the creditor countries’ economic power over the debtor.
The evaluation of vascular flow in clubfoot: a resistive index and peak systolic velocity study
Authors: Bozkurt Celal , Bekin Sarikaya Pelin Zeynep , Karayol Sunay Sibel , Sarikaya Baran , Sipahioğlu Serkan , Kaptan Ahmet Yiğit , Orhan Özlem
Published: December 2023

Resistive index (RI) and peak systolic velocity (PSV) are important Color doppler ultrasonography (CDU) parameters indicating the microcirculation and flow velocity in tissues. We aim to determine the changes in vascular flow characteristics in clubfoot after Ponseti treatment. There were three groups: the clubfoot group, the healthy group (the unaffected feet with unilateral deformities) and the control group. The Pirani severity scoring and CDU examinations of the foot were performed at initial admission and the 6th-month follow-up after Ponseti treatment. A total of 34 feet of 24 patients were included in the study. The mean age at initial treatment was 20.9 ± 22.5 days. The RI and PSV values of the clubfeet and the healthy group were similar. Resistive index values were significantly lower, and PSV values were significantly higher in the control group. After Ponseti treatment, only RI of the dorsalis pedis artery decreased, but PSV increased for all of the arteries. Recurrence of the deformity deteriorates the improvement in vascular development. Resistive index and PSV values were not related to the initial severity of the deformity. The RI values were higher, and PSV values were lower in clubfoot patients compared with the normal control group. Vascular pathology is a component of clubfoot, and treatment success improves vascular development. The improvement of microcirculation and blood flow velocity together was detected only in the dorsalis pedis artery. The effect of vascular flow change on prognosis was not detected.
Physeal Migration During Knee-guided Growth With Tension Band Plates: Influence of Implant Position
Authors: Galán-Olleros María , Sánchez del Saz Jaime , Miranda-Gorozarri Carlos , Serrano Jose Ignacio , Egea-Gámez Rosa M. , Garríguez-Pérez Daniel , Alonso-Hernández Javier , Martínez-Caballero Ignacio
Published: December 2023

Objective:

Physeal migration during guided growth with tension band plates (TBPs) has been poorly described. The positioning factors associated with this phenomenon and its clinical implications are unknown. Our aim is to determine the influence of implant position on the risk of physeal migration during knee-guided growth with TBP.

Methods:

Retrospective study of 491 patients who underwent temporary hemi or epiphysiodesis with TBP around the knee between 2007 and 2019. We identified 29 patients who presented physeal migration during follow-up. Demographic and clinical data were collected, and the following measures were obtained from the immediate postoperative radiographs: epiphyseal screw base–physis distance/epiphyseal screw tip–physis distance, interscrew angle, epiphyseal screw-physis angle(ES-PHa)/metaphyseal screw–physis angle, plate–physis angle, epiphyseal screw–plate angle/metaphyseal screw–plate angle, and epiphyseal screw–physis length ratio. Using follow-up radiographs, the type of physeal migration of the epiphyseal screw (touch, occupy, or traverse) and the status of the physis after implant removal (unaltered, physeal bar, and skeletal maturity) were also recorded. A descriptive analysis of the cases and a case-control comparison of imaging studies were performed.

Results:

The median patient age at intervention was 12.2 years (interquartile range: 11.3 to 14.1), and 76% were males. A statistically significant difference between cases and controls was obtained for epiphyseal screw base–physis distance (3.7 vs 6.3; P = 0.029), epiphyseal screw tip–physis distance (3.6 vs 7.85; P = 0.002), ES-PHa (–0.1 vs 7.45; P = 0.007), and plate–physis angle (85.45 vs 88.60; P = 0.012). In a categorical analysis, a significant difference was found for the ES-PHa categories (P = 0.002) and for the ES-PHa/metaphyseal screw–physis angle categorical pair (P = 0.018). In 16, 17, and 12 cases the physis was touched, occupied, or traversed, respectively, although we found no physeal alterations after plate removal.

Conclusions:

In our study, physeal migration of TBP is not an uncommon phenomenon, although no physeal abnormalities were detected. Convergent placement of the epiphyseal screw with the base or tip close to the physis should be avoided as this position is associated with a higher risk of physeal migration.

Level of Evidence

Level III—case-control study.
Predictors of Survival in Patients With Hepatocellular Cancer Receiving Atezolizumab and Bevacizumab
Authors: Ledenko Matthew , Mercado Lydia , Patel Tushar
Published: December 2023

Objectives:

In randomized clinical trials in patients with hepatocellular cancer (HCC), combination therapy with atezolizumab and bevacizumab (Atezo-Bev) prolonged survival, and these treatments have become the standard first-line therapy for advanced HCC. However, clinical trials may not reflect real-life clinical practice due to treatment selection criteria. Thus, our aim was to understand predictors of HCC outcomes with these treatments in a real-world, multicenter setting.

Methods:

A retrospective review of all patients 18 years of age or older treated for advanced primary liver cancer between February 2020 and August 2022 was conducted to assess the relationship between overall survival and clinical and biochemical variables before or during treatment. Univariate and multivariate Cox regression survival analyses were performed to identify predictors of survival following treatment.

Results:

One hundred and eleven eligible patients with unresectable HCC received Atezo-Bev over a consecutive 30-month period. Cox regression identified several significant (P<0.05) predictors of survival, including pretreatment albumin (hazard ratios [HR]: 0.2; CI: 0.1-0.4), total bilirubin (HR: 1.3; CI: 1.2-1.5), and international normalized ratio (HR: 5.6; CI: 2.5-12.5). In multivariate analyses, these were significantly associated as predictors of mortality, and patients with pretreatment albumin <3.5 mg/dL had significantly lower survival than those ≥3.5 (153 vs. 522 d, P<0.0001).

Conclusions:

Pretreatment hypoalbuminemia, high bilirubin, and biochemical tests indicative of hepatic or renal dysfunction can independently predict short-term mortality in advanced HCC patients receiving Atezo-Bev.
Fractional CO2 Laser Combined With Autologous Nanofat Injection Versus Fractional CO2 Laser Combined With Platelet-Rich Plasma in the Treatment of Atrophic Acne Scars: A Split-Face Comparative Study With Optical Skin Imaging
Authors: Rageh Mahmoud A. , Tawfik Abeer Attia , Abdallah Noha , Ibrahim Shady Mahmoud Attia
Published: December 2023

BACKGROUND

Atrophic acne scarring is a common problem. If left untreated, its implications can impair the quality of life. Various treatments, with differing degrees of success, are used to alleviate atrophic scars.

OBJECTIVE

To assess the efficacy of nanofat versus platelet-rich plasma (PRP) as an adjuvant therapy to fractional CO2 laser (FCL) for atrophic acne scars.

METHODS

This study included 35 patients with atrophic acne scars who received 3 sessions of FCL at 1-month intervals on both sides of the face, followed by intradermal PRP injection on the left side. A single session of nanofat was injected into the right side of the face 2 weeks before the laser sessions. The evaluation was conducted 3 months after the final treatment session.

RESULTS

After treatment, the right side of the face showed a significant reduction in Goodman scores and the indentation index of the Antera camera. The left side showed a significant difference in Goodman scores, yet the Antera camera showed a nonsignificant improvement. Nonetheless, the difference between the 2 sides was statistically insignificant.

CONCLUSION

Atrophic acne scars improved with both modalities. As a result, cotreatment with these techniques may synergistically affect atrophic acne scars in efficacy and safety.
Characterizing Gender and Leadership Trends Among Mohs Micrographic Surgery Fellowship Directors
Authors: Chen Caroline , Pulavarty Akshay , Lopez Adriana
Published: December 2023

BACKGROUND

Fellowship directors (FDs) play a key role in shaping Mohs micrographic surgery (MMS). Studies characterizing director trends are lacking and may provide a framework for improving gender diversity.

OBJECTIVE

To explore characteristics of FDs and trends in gender of both fellows and FDs over time.

MATERIALS AND METHODS

The authors compiled a comprehensive list of FDs and fellows for all Accreditation Council for Graduate Medical Education–accredited Micrographic Surgery & Dermatologic Oncology programs from 1996 to 2023. Publicly available data from various internet sources from February 1, 2023 to May 30, 2023 were used to assess characteristics of MMS FDs.

RESULTS

The percentage of female FDs increased from 6% to 25% from 1996 to 2023. Female directors were more likely to select female fellows than male directors (p= .0002) and had fewer years between fellowship completion and FD appointment (9.1 ± 4.7 years) compared with male directors (13.6 ± 8.8 years;p= .036). H-index, program type, and academic rank were similar between male and female directors.

CONCLUSION

Although gender parity among MMS trainees has been achieved, discrepancies remain in the gender composition of FDs. Further studies are required to determine why women are underrepresented as FDs.
Pure and Mixed Variants of Desmoplastic Melanoma: A Single-Center, Retrospective, Clinicopathologic Review
Authors: Light Jeremy G. , Freeman Timothy , Russell Aaron J. , Council M. Laurin , Michalski Basia M.
Published: December 2023

BACKGROUND

Desmoplastic melanoma (DM) is a rare melanoma variant. Prognostic indicators and survival vary widely and are further confounded by the histopathologic distinction between pure DM (pDM) and mixed DM (mDM) subtypes. The utility of current treatment guidelines is limited by the lack of evidence-based recommendations.

OBJECTIVE

To compare the clinicopathologic characteristics of pure and mixed subtypes of DMs.

METHODS

All cases of DM were identified from the Washington University in St Louis institutional pathology database between January 2000 and September 2022. Fifty-two cases were identified and subsequently categorized as pure (n = 26) or mixed (n = 26). Clinical and histopathologic data were collected and compared.

RESULTS

There were no differences in demographics or tumor location between pure and mixed subtypes. Patients with mDM were more likely to have mitoses present (p = .03). There were no differences in Breslow depth, tumor diameter, level of invasion, ulceration, and lymphovascular or perineural invasion. The utilization of sentinel lymph node biopsy (p = .17) and sentinel lymph node positivity (p = .67) were also similar.

CONCLUSION

Despite histopathologic distinction between pDM and mDM, these subtypes were found to have similar clinicopathologic characteristics, including similar rates of sentinel lymph node metastasis.
Determinants of clinical response to empirical antibiotic treatment in patients with cirrhosis and bacterial and fungal infections—Results from the ICA “Global Study” (EABCIR-Global Study)
Authors: Maiwall Rakhi , Piano Salvatore , Singh Virendra , Caraceni Paolo , Alessandria Carlo , Fernandez Javier , Soares Elza Cotrim , Kim Dong Joon , Kim Sung Eun , Marino Monica , Vorobioff Julio , Ribeiro Barea Rita de Cassia , Merli Manuela , Elkrief Laure , Vargas Victor , Krag Aleksander , Singh Shivaram Prasad , Lesmana Laurentius Adrianto , Toledo Claudio , Marciano Sebastian , Verhelst Xavier , Wong Florence , Intagliata Nicolas , Rabinowich Liane , Colombato Luis , Kim Sang Gyune , Gerbes Alexander , Durand Francois , Roblero Juan Pablo , Bhamidimarri Kalyan Ram , Maevskaya Marina , Fassio Eduardo , Kim Hyoung Su , Hwang Jae Seok , Gines Pere , Bruns Tony , Gadano Adrian , Angeli Paolo , Sarin Shiv Kumar ,   on behalf of the International Club of Ascites Global Study Group
Published: December 2023

Background:

The administration of an appropriate empirical antibiotic treatment is essential in cirrhosis and severe bacterial infections. We aimed to investigate the predictors of clinical response of empirical antibiotic treatment in a prospective cohort of patients with cirrhosis and bacterial and fungal infections included in the International Club of Ascites “Global Study.”

Methods:

Patients hospitalized with cirrhosis and bacterial/fungal infection were prospectively enrolled at 46 centers. Clinical response to antibiotic treatment was defined according to changes in markers of infection/inflammation, vital signs, improvement of organ failure, and results of cultures.

Results:

From October 2015 to September 2016, 1302 patients were included at 46 centers. A clinical response was achieved in only 61% of cases. Independent predictors of lack of clinical response to empirical treatment were C-reactive protein (OR = 1.16; 95% CI = 1.02–1.31), blood leukocyte count (OR = 1.39;95% CI = 1.09–1.77), serum albumin (OR = 0.70; 95% CI = 0.55–0.88), nosocomial infections (OR = 1.96; 95% CI = 1.20–2.38), pneumonia (OR = 1.75; 95% CI = 1.22–2.53), and ineffective treatment according to antibiotic susceptibility test (OR = 5.32; 95% CI = 3.47–8.57). Patients with a lack of clinical response to first-line antibiotic treatment had a significantly lower resolution rate of infections (55% vs. 96%; p < 0.001), a higher incidence of second infections (29% vs. 15%; p < 0.001), shock (35% vs. 7%; p < 0.001) and new organ failures (52% vs. 19 %; p < 0.001) than responders. Clinical response to empirical treatment was an independent predictor of 28-day survival ( subdistribution = 0.20; 95% CI = 0.14–0.27).

Conclusions:

Four out of 10 patients with cirrhosis do not respond to the first-line antibiotic therapy, leading to lower resolution of infections and higher mortality. Broader-spectrum antibiotics and strategies targeting systemic inflammation may improve prognosis in patients with a high degree of inflammation, low serum albumin levels, and severe liver impairment.
Meta-analysis for the relationship between circulating pregnancy-associated plasma protein A and placenta accreta spectrum
Authors: Li Yan , Meng Yizi , Chi Yang , Li Ping , He Jin
Published: December 2023

Background:

Changes in circulating pregnancy-associated plasma protein A (PAPP-A) have been observed in women with a placenta accreta spectrum (PAS). However, no consensus has been reached according to the previous studies. Our study investigated the relationship between circulating PAPP-A and PAS risk through a systematic review and meta-analysis.

Methods:

Studies comparing the circulating level of PAPP-A between pregnant women with and without PAS were obtained by searching the Medline, Cochrane Library, Embase, CNKI, and Wanfang databases from the inception of the databases until February 12, 2023. Heterogeneity was considered in the pooling of results via a random-effects model.

Results:

Eight observational studies were obtained for the meta-analysis, which included 243 pregnant women with PAS and 1599 pregnant women without PAS. For all these women, the first-trimester circulating level of PAPP-A was measured by immunoassay and reported as multiples of the median (MoM) values. The pooled results showed that compared to those who did not develop PAS, women with PAS had significantly higher first-trimester serum level PAPP-A (mean difference: 0.43 MoM, 95% confidence interval [CI]: 0.30 to 0.56, P < .001; I2 = 32%). Furthermore, a high first-trimester serum PAPP-A level was related to a high PAS risk (odds ratio: 2.89, 95% CI: 2.13 to 3.92, P < .001; I2 = 0%). Sensitivity analysis which excluded one study at a time, also obtained similar results (p all < 0.05).

Conclusion:

Pregnant women with a high serum PAPP-A level in the first trimester may be at an increased risk for PAS.
Small bowel diaphragm disease with multiple cluster lesions in one segment of the small bowel mimicking an adhesion band: A case report
Authors: Jeong Youseok , Chung Jae Hun , Lim Dong Won , Lee Si Hak , Hwang Sun-Hwi , Shin Dong Hoon
Published: December 2023

Rationale:

Small bowel diaphragm disease (SBDD) is a rare case, caused by long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs). The circumferential diaphragm in the lumen of small bowel causing mechanical obstruction is the characteristic finding.

Patient concerns:

A 74-year-old male was transferred to Pusan National University Yangsan Hospital (PNUYH) due to abdominal pain lasting for 2 months. He was treated in the local medical center (LMC) with Levin tube insertion and Nil Per Os (NPO) but showed no improvement.

Diagnosis:

According to abdomen-pelvis computed tomography (CT) result, small bowel obstruction due to the adhesion band was identified, showing dilatation of the small bowel with abrupt narrowing of the ileum.

Interventions:

Laparoscopic exploration was done but failed to find an adhesion band. An investigation of the whole small bowel was done with mini-laparotomy. At the transitional zone, the intraluminal air could not pass so the segmental resection of small bowel including the transitional zone and end-to-end anastomosis was done.

Outcomes:

After surgery, every laboratory finding recovered to the normal range in 4 days, but the patient’s ileus lasted for 8 days. The patient’s symptoms were relieved after defecation, he was discharged on postoperative day 10.

Lessons:

For patients who show mechanical obstruction without an operation history but with long-term administration of NSAIDs, the clinicians should suspect small bowel diaphragm disease.
Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis
Authors: Ding Chaowei , Wang Runlu , Gong Xiaowei , Yuan Yadong
Published: December 2023

Objective:

Chronic obstructive pulmonary disease (COPD) is closely related to the development and progression of cardiovascular disease. The purpose of this study is to clarify the answers to the following questions through systematic evaluation: the risk of stroke in COPD patients; the risk of stroke in acute exacerbations of COPD (AECOPD) patients; and the risk of death after stroke in COPD patients.

Methods:

Two reviewers independently searched EMbase, PubMed, and the Cochrane Library for relevant literature from the date of creation to February 17, 2023, for studies relating COPD to stroke patients. Of the 8039 publications retrieved, we identified 27 articles that met our selection criteria. Fixed-effects or random-effects models were used to calculate ORs and 95% confidence intervals for the combined risk.

Results:

combining studies on stroke risk in COPD patients by random-effects model suggested that COPD was an independent risk factor for stroke-associated pneumonia (OR 1.40, 95% CI: 1.24–1.59, I
2 = 98.4%, P = .000), with significant heterogeneity in the results, and subgroup analysis did not find a source of heterogeneity. In the combined 7 AECOPD studies, a significantly higher risk of stroke was found (OR 1.53, 95% CI: 1.44–1.63, I
2 = 49.2%, P = .066). In the combined 6 short- term prognostic studies, the relationship between COPD and risk of death was not highly significant (OR 1.12, 95% CI: 1.08–1.16, I
2 = 37.4%, P = .131). In 10 long-term observational prognosis studies, COPD was suggested to be associated with death after stroke by combining data using a random-effects model (OR 1.20, 95% CI: 1.13–1.27, I
2 = 56.8%, P = .014), and there was moderate heterogeneity in the combination, with subgroup analysis showing that stroke type may be a source of heterogeneity and the risk of death from ischemic stroke: OR 1.23, 95% CI: 1.17–1.29, I
2 = 45.0%, P = .191 and the risk of death from both types of stroke: OR 1.12, 95% CI: 1.07–1.18, I
2 =18.9%, P = .291.

Conclusion:

COPD is an independent risk factor for stroke. The risk of stroke is significantly increased, especially during AECOPD. In addition, the association between COPD and short-term death in stroke patients is insignificant, while it is more associated with fatal events in the long-term prognosis.
Novel mutation in RPGRIP1L gene causing Joubert syndrome: A case report
Authors: Duque-Cordoba Paola Andrea , Diaz-Ordoñez Lorena , Gutierrez-Medina Juan David , Pachajoa Harry
Published: December 2023

Introduction:

Joubert syndrome is a rare disease of genetic origin with autosomal recessive inheritance and extreme genetic heterogeneity with more than 40 causative genes. Joubert syndrome 7 is caused by mutations in the RPGRIP1L gene.

Patient concerns:

Our report describes a pediatric patient with clinical features compatible with JS type 7 such as hypotonia, developmental delay and aplasia of the cerebellar vermis.

Diagnosis:

The clinical features and the MRI of the head and neck which showed alterations at the level of the posterior fossa, with absence of the vermis and horizontal disposition of the cerebellar peduncles, were compatible with Joubert syndrome. Whole exome sequencing detected the variants RPGRIP1L (NM_015272.2) c.697A > T (p. Lys233Ter) and RPGRIP1L (NM_015272.2) c.3545 del (p.Pro1182LeufsTer25).

Interventions:

Resection was performed to correct the polydactyly. At age 2 years umbilical hernia, adenoid surgery and ventilatory tubes surgery were performed. Renal biopsy confirmed interstitial fibrosis and focally accentuated mild tubular atrophy with focal tubular hypertrophy, compatible with the clinical suspicion of Joubert syndrome. Congenital hip dislocation surgery was performed. The patient underwent surgery for correction of concomitant divergent strabismus and continued with glasses for astigmatism and hyperopia.

Outcomes:

Sanger sequencing confirmed the patient´s results and the father was found to be a carrier of RPGRIP1L (NM_015272.2) c.697A > T (p. Lys233Ter) and the mother and maternal grandmother as carriers of RPGRIP1L (NM_015272.2) c.3545del (p.Pro1182LeufsTer25). RPGRIP1L:c.3545del novel variant is a deletion which changes the reading frame, altering the RPGR1_C terminal domain and giving rise to an incomplete protein whose functions will be altered.

Conclusion:

This is the first genetically confirmed case of JS in Colombia, the first carrier of biallelic RPGRIP1L gene mutations with hip dislocation and incomplete glottic closure and the first report of the novel c.3545del likely pathogenic variant causing JS.
Takayasu arteritis and hyperthyroidism: A secondary hypertension case report
Authors: He Lian-Man , Liu Min , Dong Wen-Yong , Sun Xiao-Lin
Published: December 2023

Introduction:

Renovascular disease and hyperthyroidism are secondary hypertension. Takayasu arteritis (TAK) is a chronic, progressive, nonspecific great vasculitis involving the aorta and its major branches. It is one of the causes of renal artery stenosis. Hyperthyroidism is an endocrine disease caused by improper continuous synthesis and secretion of excessive thyroid hormone by the thyroid gland. Both diseases can raise blood pressure (BP).

Case presentation:

we present a case of 18-year-old. Female, after exercise, fatigue palpitations. The maximum BP was 190/87 mm Hg, ankle-brachial index was <0.9. C-reactive protein and erythrocyte sedimentation rate were elevated. Imaging revealed multiple vascular stenosis. Triiodothyronine, tetraiodothyroxine, serum-free triiodothyronine, serum-free thyroxine, thyroid peroxidase antibody and thyroid stimulating receptor antibody were elevated. TSH reduced. She was diagnosed with TAK and hyperthyroidism. After treatment, the BP was normal, the thyroid function gradually returned to normal, and the symptoms improved.

Conclusion:

It is suggested that the BP of both upper limbs should be measured in newly diagnostic hypertension. If BP is not measured in both upper limbs, it is likely to be missed diagnosis. The cause of vascular stenosis needs to be identified, otherwise interventional treatment may lead to aggravation of the condition. Few cases of TAK complicated with hyperthyroidism have been reported. Both diseases are related to the immune system, whether there is any correlation between the 2 diseases, further research is needed. Early diagnosis, early treatment, the earlier intervention, the better prognosis.
Risk factors and prevention of liver cancer: A bibliometric and visual analysis
Authors: Yang Min , Zhang Huiqin , Zhang Jieqiu , Yao Xiaopeng
Published: December 2023

Liver cancer has become an important public health problem. In this study, bibliometrics and visual analysis were performed on the literature related to the risk factors and prevention of liver cancer, in order to understand the latest research progress of the risk factors and prevention of liver cancer. The Web of Science database was used as a retrieval platform to retrieve the published research results from 2012 to 2023. CiteSpace and VOSviewer were utilized for bibliometrics and visual analysis. A total of 2388 articles were screened according to exclusion criteria. Between 2012 and 2018, the number of articles published fluctuated. From 2018 to 2023, the number of published documents showed a steady upward trend. The 3 journals with the most publications are World Journal of Gastroenterology, PLOS ONE, and Hepatology. The United States and China are the countries with the most publications, while Harvard University, the National Institutes of Health and the University of Texas System are the 3 institutions with the most publications. Keywords such as hepatitis B virus, hepatitis C virus, alcohol, obesity, recrudescence rate, global burden are hot words in the field of liver cancer risk factors and prevention. The current research mainly focuses on the influence of environmental factors, behavioral lifestyle and biological factors on liver cancer, as well as the primary and secondary prevention of liver cancer, but there are still many undetermined factors to be explored.
Clinical study of low-frequency acupoint electrical stimulation to improve thumb-to-finger movements after stroke: A randomized controlled trial
Authors: Xia Xue , Dong Xu , Huo Hong , Zhang Ying , Song Jing , Wang Dongyan
Published: December 2023

Objective:

To examine the effect of low-frequency acupoint electrical stimulation (LFES) on the surface electromyographic (sEMG) signals of the thumb-to-finger movement muscles in stroke patients, and to evaluate the clinical efficacy of LFES on hand function recovery after stroke.

Methods:

Sixty patients who met the inclusion criteria were randomly assigned to a LFES group or an electroacupuncture (EA) group, with 30 patients in each group. Both groups received conventional treatment, and the EA group was treated with acupoints from the book of Acupuncture and Moxibustion, while the LFES group was treated with acupoints from a previous study. The sEMG characteristic values (maximum value and RMS), Chinese Stroke Clinical Neurological Deficit Scale (CSS), Brunnstrom Motor Function Evaluation, Modified Ashworth Scale (MAS), Lindmark Hand Function Score and Lovett Muscle Strength Classification were measured before and after treatment.

Results:

After treatment, both groups showed improvement in sEMG characteristic values, Brunnstrom motor function score, Lindmark hand function score, and Lovett muscle strength classification compared with before treatment, and the improvement in the LFES group was significantly better than that in the EA group (P < .05). The CSS score and MAS classification of both groups decreased compared with before treatment, and the decrease in the LFES group was significantly better than that in the EA group (P < .05). The total effective rate of the LFES group was 92.86%, and that of the EA group was 79.31%. The difference between the 2 groups was statistically significant (P < .05).

Conclusion:

Both LFES and EA were effective in restoring thumb-to-finger movement function after stroke, as evidenced by the increased maximum value and root mean square values of the first dorsal interosseous muscle and the extensor pollicis brevis muscle, the decreased CSS score, the increased Brunnstrom motor function score, the decreased MAS classification, the increased Lindmark hand function score, and the increased Lovett muscle strength classification. However, LFES showed more obvious improvement and better efficacy than EA, which is worthy of clinical promotion.
Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial
Authors: Pathan Farhan Khan M. , Pandian Joseley Sunderraj , Shaikh Anis I. , Ahsan Mohammad , Nuhmani Shibili , Iqbal Amir , Alghadir Ahmad H.
Published: December 2023

Purpose:

The present study aims to investigate the combined effect of slow breathing exercise (SBE) and progressive muscle relaxation (PMR) technique on blood pressure (BP), heart rate (HR), respiratory rate (RR), and anxiety in patients diagnosed with essential hypertension.

Trial design:

This study was based on a 4-arm parallel-group, randomized control design.

Methods:

Sixty-four participants diagnosed with essential hypertension were randomly allocated into SBE, PMR, SBE-PMR, and Control groups, with 16 subjects each. All 3 groups received different treatments according to their name; however, the Control group received no treatment. Systolic and diastolic BP (SBP and DBP), HR, RR, and anxiety were all evaluated as the study outcomes using a digital sphygmomanometer and perceived stress scale (PSS) at baseline (pretest), 2nd week and 4th weeks post-intervention. A repeated measure analysis of variance test assessed intra-group comparison (overall) analyses across multiple time points. Bonferroni multiple comparison tests were used to analyze the mean differences between the groups. The confidence interval was kept at 95% for all the statistical analyses, that is, P < .05 is considered significant.

Results:

There was a significant change in the HR (F = 239.04, P = .0001), RR (F = 167.74, P = .0001), SBP (F = 266.64, P = .0001), DSP (F = 279.80, P = .0001), and PSS (F = 473.42, P = .0001) as an outcome of baseline measurements versus (vs) the following weeks. There were significant (F = 48.57, P = .001) differences among different training on HR. The SBE vs SBE-PMR showed an insignificant difference (F = 48.54, P = 1.000). The RR showed significant differences (F = 32.05, 0.0001) between the SBE vs PMR, SBE vs Control, PMR vs Control, and SBE-PMR vs Control groups and insignificant differences for the SBE vs SBE-PMR and PMR vs SBE-PMR groups. The SBE vs SBE-PMR groups showed insignificant differences for DPP and SBP. However, PSS showed significant differences (F = 67.12, P = .0001) among the intervention groups except for the PMR and SBE-PMR groups.

Conclusions:

The combined interventions of SBEs and progressive muscle relaxation techniques can effectively reduce the heart rate, respiratory rate, BP, and anxiety in essential hypertensive patients compared to both techniques when given alone.
Risk factor analysis for infection and bleeding after lateral decubitus percutaneous nephrolithotomy
Authors: Han Yangjun , Gao Wenzhi , Wang Bing , Gao Zihui , Diao Mingxin , Zuo Chao , Zhang Minghua , Diao Yingzhi , Wang Chunji , Liu Honglei , Gu Yaming
Published: December 2023

This study aimed to explore the risk factors for infection and bleeding after lateral decubitus percutaneous nephrolithotomy procedures to prevent their occurrence and improve surgical outcomes. A retrospective analysis was conducted on 356 patients who underwent lateral decubitus percutaneous nephrolithotomy for the treatment of kidney stones and upper ureteral stones from January 2015 to August 2022. Among them, 290 patients had complete clinical data. General clinical data, perioperative data, and stone characteristics were collected for each patient. Univariate and multivariate logistic regression analyses were performed to identify risk factors for infection and bleeding after lateral decubitus percutaneous nephrolithotomy. The postoperative infection rate after lateral decubitus percutaneous nephrolithotomy was 19.31%, and the postoperative bleeding rate was 12.07%. Independent risk factors for postoperative infection were multiple stones (P < .001), stone size (P < .001), and stone co-infection (P = .012). Independent risk factors for postoperative bleeding were multiple stones (P = .008) and stone size (P = .014). Multiple stones, stone size, and stone co-infection are independent risk factors for postoperative infection after lateral decubitus percutaneous nephrolithotomy. Multiple stones and stone size are independent risk factors for postoperative bleeding after lateral decubitus percutaneous nephrolithotomy.
Vertebral artery dissection aneurysm in a pediatric patient: A rare case with unusual clinical manifestations, diagnostic, and management challenges
Authors: Oshi Mohammed A. M. , Aljabri Mohammed Fahad , Alotaibi Saad , Alzahrani Yahea , Alfaifi Jaber , Abosabie Salma A. S. , Abosabie Sara A. , Algethami Samaher S. , Younes Alaa E. , Almanjoomi Raid K. , Babkour, Bashar , Kamal Naglaa M.
Published: December 2023

Vertebral artery aneurysm is a rare condition with diverse clinical manifestations in pediatric patients. We present the case of a 12-year-old male who presented with diplopia, vomiting, ataxia, and severe headache. Diagnostic evaluation revealed an extracranial vertebral artery dissection with an associated aneurysm at the C3–C4 level. Despite the absence of recurrent ischemic strokes, the aneurysm posed challenges in differentiating the symptoms from other inflammatory demyelinating disorders, particularly internuclear ophthalmoplegia. Diagnosis relied on a thorough history, physical examination, and imaging studies. Magnetic resonance imaging with magnetic resonance angiography confirmed the diagnosis and played a crucial role in assessing the size, location, and extent of the aneurysm. Additionally, the imaging findings helped guide treatment decisions and determine the need for anticoagulation therapy. Regular follow-up imaging was initiated to monitor for late complications and evaluate the effectiveness of the management approach. This case highlights the atypical presentation of vertebral artery aneurysm in a pediatric patient, underscoring the importance of clinical suspicion and the role of advanced imaging techniques in facilitating accurate diagnosis and guiding appropriate management. Prompt diagnosis and optimal utilization of imaging modalities are essential in preventing severe morbidity and mortality. Further research is warranted to enhance our understanding of this condition and refine imaging and management protocols in pediatric population.
Effect of Dolutegravir regimen against other regimens on some hematological parameters, CD4 count and viral load of people living with HIV infection in South Eastern Nigeria
Authors: Echefu Stella N. , Udosen Joseph E. , Akwiwu Euphoria C. , Akpotuzor Josephine O. , Obeagu Emmanuel Ifeanyi
Published: December 2023

Background:

Appropriate usage of highly active antiretroviral therapy (HAART) suppresses human immunodeficiency virus (HIV) replication. One of such HAART is dolutegravir (DTG) containing regimen which Nigeria included in her national protocol, as the preferred first-line option, with particularly fixed dose combination of tenofovir/lamivudine/dolutegravir (TLD) in 2018.

Aim:

To access the impact of this regimen as against other regimens on some hematological parameters as well as cluster of differentiation 4 (CD4) count and viral load on people living with HIV infection

Methods:

The study site is a health facility center supported by President Emergency Plan for acquired immunodeficiency syndrome (AIDS) Relief where people living with HIV infection (PLWHIV) visit for their routine management in Abakaliki, Ebonyi State. A hundred and twenty-two (122) subjects participated, 58 PLWHIV and 64 control subjects. CD4 + count by partec cyflow auto analyzer, while the Viral load assay was by Roche COBAS Ampriplep/COBAS TaqMan molecular systems. Full blood count determination was by Sysmex XE-2100 hematology auto analyzer, while the detection of antibody to HAART was by Petz and direct Coombs tests.

Results:

Mean values of hemoglobin (Hb), Total white cell count, Lymphocytes, Monocytes and CD4 + counts of people living with HIV infection (PLWHIV) were significantly (P = .0001) lower than the control subjects. The Hb level of PLWHIV on Efavirenz combination (TDF/3TC/EFV) are comparable 123 ± 32g/l with those on Ritonavir combination (TDF/3TC/LPV/R) 136 ± 16g/l and Dolutegravir (TLD)134 ± 20.0g/l (P = .307). On the other hand, total white cell count (4.55 ± 1.99 × 109/L) of those on Efavirenz combination (TDF/3TC/EFV) and Dolutegravir (TLD) (4.53 ± 1.31 × 109/L) were significantly higher than those on Ritonavir combination (TDF/3TC/LPV/R) (4.09 ± 1.15 × 109/L). The Viral Load of PLWHIV on Dolutegravir (TLD) was significantly lower 171.57 ± 4.56 copies/mL than those on Efavirenz combination (TDF/3TC/EFV) (86,395.91 ± 27,476.57copies/mL) and Ritonavir combination (TDF/3TC/LPV/R) (81,188.83 ± 13,393.47 copies/mL), respectively.

Conclusion:

Some hematological parameters (such as Hb, total white cell counts and CD4 + count) were lower in people living with HIV than values seen in control group. The 3 regimens used in the management of HIV infection in the locality revealed comparable Packed cell volume and Hemoglobin levels. Total white cell count of those on Efavirenz and DTG is comparable with higher values than those on Ritonavir.
Efficacy and safety of Aprepitant-containing triple therapy for the prevention and treatment of chemotherapy-induced nausea and vomiting: A meta-analysis
Authors: Zhang Min , Guo Qing-Li , Zhang Ting-Ting , Fu Min , Bi Heng-Tai , Zhang Jun-Yao , Zou Kai-Li
Published: December 2023

Background:

Most cancer patients suffer from the pain of chemotherapy-induced nausea and vomiting (CINV). This meta-analysis was performed to evaluate the efficacy and safety of a regimen consisting of aprepitant, dexamethasone, and 5-HT3 receptor antagonists in the prevention and treatment of CINV.

Methods:

A systematic literature search was conducted across multiple databases, including PubMed, EMbase, Cochrane Library, MEDLINE, CENTRAL, HEED, CNKI, Wanfang, and VIP, to identify randomized controlled trials (RCTs) investigating the use of triple therapy (aprepitant, 5-HT3 receptor antagonist, and dexamethasone) to prevent and treat CINV. Meta-analysis was performed using RevMan 5.4 and Stata17 software, employing either a fixed-effect or random-effect model based on statistical heterogeneity.

Results:

A meta-analysis of 23 randomized controlled trials (RCTs) involving 7956 patients was conducted. Efficacy: Results showed significantly improved complete responses (CRs) for CINV in the test group versus the control group in the overall, acute, and delayed phases. Furthermore, in the test group, substantial alleviation of nausea symptoms was observed in the delayed and overall phases but not in the acute phase. Safety: There was no statistically significant difference in the incidence of febrile neutropenia, diarrhea, anorexia, and headache between the 2 groups. The incidence of fatigue and hiccups in the test group was higher than that in the control group; however, the incidence of constipation was significantly lower.

Conclusions:

Aprepitant-containing triple therapy is highly effective in the prevention and treatment of CINV, with reliable medication safety.
A bibliometric analysis of cardiomyocyte apoptosis from 2014 to 2023: A review
Authors: Wang Rui , Luo Xu , Li Songyun , Wen Xin , Zhang Xin , Zhou Yunxiang , Xie Wen
Published: December 2023

Cardiomyocyte apoptosis is an important factor in cardiac function decline observed in various cardiovascular diseases. To understand the progress in the field of cardiomyocyte apoptosis research, this paper uses bibliometrics to statistically analyze publications in this field. A total of 5939 articles were retrieved from the core Web of Science database, and then VOSviewer and Citespace were used to conduct a scientometric analysis of the authors, countries, institutions, references and keywords included in the articles to determine the cooperative relationships between researchers that study cardiomyocyte apoptosis. At present, the research hotspots in this field mainly include experimental research, molecular mechanisms, pathophysiology and cardiac regeneration of cardiomyocyte apoptosis-related diseases. NOD-like receptor thermal protein domain associated protein 3 inflammasome, circular RNA, and sepsis are the research frontiers in this field and are emerging as new areas of research focus. This work provides insight into research directions and the clinical application value for the continued advancement of cardiomyocyte apoptosis research.
Exploring the mechanism of Dahuang-Tusizi drug pair in the treatment of diabetes nephropathy based on network pharmacology and immune infiltration analysis
Authors: Liu Wenjing , Yuan Ling , Che Mengying , Hou Shaozhang , Meng Fandi , Xu Duojie , Nan Yi
Published: December 2023

The study aimed to explore the key targets and molecular mechanisms of Dahuang-Tusizi drug pair (DTDP) in the treatment of diabetes nephropathy (DN) based on the GEO database by using network pharmacology combined with molecular docking and immune infiltration. The active components of the DTDP were screened using the Traditional Chinese Medicine Systems Pharmacology database and the Swiss Target Prediction database. The differential genes of DN were retrieved from GEO databases. Next, the intersecting targets of drug and disease were imported into the String database for protein–protein interactions network analysis, and the core targets were identified through topological analysis. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed with the help of the Metascape database and gene set enrichment analysis database. Subsequently, molecular docking was performed to verify the binding activity of the key component and the key target. The Nephroseq V5 database was used to verify the clinical relevance of DN and core genes. Finally, the Using CIBERSORT Algorithm to analyze the immune Infiltration of DN Gene Chip. The network analysis showed that 25 active ingredients of DTDP were associated with 22 targets in DN. The key active ingredients (Sesamin, quercetin, EUPATIN, matrine, beta-sitosterol, isorhamnetin, etc.) and the core targets (JUN, EGF, CD44, FOS, KDR, CCL2, PTGS2, and MMP2) were further identified. Enrichment analysis revealed signaling pathways including TNF, MAPK, and IL-17 signaling pathway. Molecular docking results showed that there was a strong affinity between the key components and core targets. The results of immune infiltration found that the proportion of macrophages in DN tissues was significantly increased. Our findings demonstrated that the characteristics of DTDP in treating DN are “multiple components, multiple targets and multiple pathways.” We predicted that DTDP may inhibit inflammation related pathways by regulating key genes, reducing macrophage infiltration. Thus, inhibiting inflammatory response to reduce glomerular damage and delay the development of DN.
Case report: A case of posterior reversible encephalopathy in postpartum preeclampsia
Authors: Rho Joong-Dong , Kim Yeon-Hee , Shin Jae-Ho , Kim Tae Ki
Published: December 2023

Rationale:

Posterior reversible encephalopathy syndrome is a neurological condition characterized by headache, convulsions, altered consciousness, and visual disturbance with specific radiological features, which is characterized by contrast enhancement in the occipital lobe on T2-weighted image. We report a case of sudden visual impairment of both eyes 6 days after childbirth diagnosed as postpartum preeclampsia and posterior reversible encephalopathy syndrome (PRES) through radiological examination.

Patient concerns:

A 31-year-old female patient with headache and visual disturbance visited the clinic.

Diagnosis:

Visual acuity was light perception in the right eye and hand motion in the left eye; pupillary light reflections of both eyes were normal. In the field of view test, the waveform was not observed in the defect pattern visual field power test, and the amplitude was greatly reduced in the visual field test. 1+ proteinuria was observed on urine test and magnetic resonance imaging showed contrast enhancement under both parietal and occipital cortex.

Interventions:

Hospitalization was done for blood pressure control and examination of related disease under suspicion of PRES caused by postpartum preeclampsia.

Outcomes:

Four weeks after diagnosis, vision and visual field defects recovered to normal, and the previously observed lesion on magnetic resonance imaging completely improved 3 months after the initial visit, and it was diagnosed as PRES.

Lessons:

PRES in postpartum preeclampsia can cause rapid vision and symptoms, visual field loss, and accurate follow-up diagnosis with relevant imaging and clinical patterns can improve vision.
Visual analysis of autoimmune dry eye studies based on bibliometrics
Authors: Zhou Zhenfeng , Long Hui , Zhou Li , Xu Xing , Zhang Rong , Tu Ning , Liu Fen , Xiong Jing
Published: December 2023

Background:

Dry eye is a chronic ocular surface disease caused by the instability of tear film or the imbalance of the ocular surface microenvironment which can lead to a diverse range of ocular discomfort symptoms. At present, the relevant mechanism of autoimmunity and treatment of dry eye is still unclear. Due to the proliferation of research papers in this field, visual analysis of existing papers can provide reference for future research.

Methods:

The academic papers of Web of Science were searched with the topics of “autoimmunity” and “dry eye,” and the countries, institutions and keywords of the literatures selected in this domain were visualized by Citespace and Vosviewer software.

Results:

A total of 787 valid international papers were detected, and the publication count exhibited a consistent upward trend year by year. Within this field, the US has produced the highest number of papers (363), with Baylor College of Medicine being the most prolific institution (28 publications). High-producing authors in this field include Artemis P. Simopoulos and Stephen C. Pflugfelder.

Conclusion:

International research in this field has focused on the pathogenesis, symptoms, and treatment of dry eye. It is predicted that the future international research hotspots will be the pathophysiology of autoimmune dry eye disease, data analysis of artificial intelligence-related diseases, and research on improving patients’ quality of life.