bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing emergency department visits 10-year apart at a tertiary care center in Lebanon
Authors: El Zahran Tharwat , Ghandour Lara , Chami Anwar , Saliba Najat , Hitti Eveline
Published: September 2023

Presentations to the emergency department (ED) are growing worldwide. With the increasing risk factors of non-communicable disease (NCD) and communicable diseases (CD) in low- and middle-income countries, it is crucial to understand how ED presentations are changing with time to meet patients’ needs and allocate acute care resources. The aim of this study is to compare the changes in patient and diseases characteristics over 2 time periods 10 year apart at the largest tertiary care center in Lebanon. This was a retrospective descriptive study of patients presenting to the ED at a large tertiary care center in 2009/2010 and 2018/2019. The discharge diagnoses were coded into Clinical Classification Software codes. We used descriptive statistics, odds ratios (OR), and non-parametric test to compare the different diagnoses. The total number of ED visits increased by 33% from 2009/2010 to 2018/2019. The highest increase rate was among patients older than 65 years (2.6%), whereas the percentage of pediatric patients decreased from 30.8% to 25.3%. ED presentations shifted from NCD to CD. A shift in the discharge diagnoses was also noted within age groups, specifically a shift in cardiovascular diseases to a younger age. Our study suggests that the role of the ED is changing and moving towards treating the aging population and CD. There is a need to invest and mitigate CD, better allocate resources to accommodate the aging population, focus on awareness campaigns targeting early detection of cardiovascular diseases and modifying its risk factors.
Staphylococcal enterotoxin C as a novel strategy for treating lumbar spondylolysis in adolescents: Description of technique
Authors: Zhou Hongdian , Deng Kaiwen , Wang Nan , Li Hua , Xu Zujian
Published: September 2023

Lumbar spondylolysis is one of the most common causes of low back pain and primarily affects children and adolescents. Traditional posterior lumbar fixation and interbody fusion surgery has always been the most effective method to treat spondylolysis. However, traditional surgical management has limitations of large trauma, complex operation, high cost, postoperative biomechanical deterioration, and resulting complications. In order to avoid the trauma and complications of surgical treatment, and reduce the cost of treatment. Based on the successful clinical experience of using staphylococcal enterotoxin C (SEC) to treat nonunion after a limb fracture, we identified a minimally invasive method to effectively treat lumbar spondylolysis. A novel minimally invasive therapeutic approach is presented herein of an SEC injection guided by C-arm fluoroscopy to treat lumbar spondylolysis. We describe a novel technique applied in a patient with lumbar spondylolysis, who showed significantly improved low back pain symptoms and a computed tomography scan, including osseous fusion of the bilateral isthmus at L4 after SEC therapy. This is the first reported case description of using an SEC injection to treat lumbar spondylolysis with a successful clinical outcome.
A pilot study of stereotactic body radiotherapy combined with pelvic radiotherapy and GTVp boost based on multiparameter magnetic resonance image in patients with high-risk prostate cancer
Authors: Wang Fang , Yao Jin , Chen Junru , Zeng Hao , Wang Xin
Published: September 2023

This pilot study aimed to explore the preliminary effects and safety of stereotactic body radiotherapy (SBRT) combined with preventive pelvic radiotherapy and primary gross tumor volumes (GTVp) boost in patients with high-risk prostate cancer based on multiparameter magnetic resonance image (mpMRI). Tumors were contoured as GTVp based on mpMRI. The prostate and proximal seminal vesicles were considered as the clinical target volume1. The pelvic lymphatic drainage area constituted clinical target volume 2. Radiation doses were 40Gy or 45Gy/5fractions to planning target volume of primary tumor, 37.5Gy/5f to prostate, seminal vesicle, and positive pelvic lymph nodes, and 25Gy/5f to pelvic synchronously. The treatment was delivered 3 times per week. Volumetric modulated arc radiotherapy and intensity-modulated radiotherapy were used to complete SBRT. The genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated. Quality of life data was also captured. A total of 15 patients were enrolled in this study with a median age of 78 (56–87) from 2017 to 2020. All patients received SBRT. At 3 months after radiotherapy, the proportion of PSA < 0.006 ng/mL was 66.7% (10/15). The 2-year biochemical relapse-free survival was 93.3%. The incidence of grade 1 acute GU side effects was 80% (12/15); the incidence of acute grade 1 GI toxicity was 66.7% (10/15); and no grade 2 or higher acute GU and GI side effects was observed. Two patients presented with temporary late grade 2 GI toxicity. International Prostatic System Score increased rapidly after a transient increase at 1 week (P = .001). There were no significant differences in EORTC quality of life scores in all domains except global health status. In this pilot study, it was revealed that SBRT combined with preventive pelvic radiotherapy and GTVp boost based on mpMRI image was effective and well tolerated for patients with high-risk prostate cancer.
Progressive multifocal leukoencephalopathy without overt immunosuppression
Authors: Jain Varun , Branstetter Hannah , Savaram Srikar , Vasquez Matthew , Swords Gabriel , Aghili-Mehrizi Sina , Rees John , Rivera-Zengotita Marie , Montalvo Mayra , Chuquilin Miguel , Patterson Addie , Rempe Torge
Published: September 2023

Progressive multifocal leukoencephalopathy (PML) is a central nervous system disease caused by the human polyomavirus 2 that usually occurs in a setting of immunodeficiency. PML without overt immunosuppression is considered a rare occurrence but has been described in multiple previous case reports and series. Its prevalence, overall frequency, and prognosis are largely unknown. This is a single-center retrospective review of all University of Florida cases with the ICD10 PML diagnosis code (A81.2). PML without overt immunosuppression was defined as absence of human immunodeficiency virus (HIV) infection, hematological malignancy, immunomodulatory/-suppressive medications, autoimmune conditions with a propensity for PML (sarcoidosis, systemic lupus erythematosus). Cases that did not fulfill criteria for clinically or histologically definite PML were excluded. Of 52 patients with the ICD10 code A 81.2, 17 fulfilled definite diagnostic criteria for PML. Overt immunosuppression was identified in 15/17 (88.2%) cases (10/17 (58.8%): human immunodeficiency virus; 5/17 (29.4%): immunomodulatory/-suppressive medication). Two/seventeen (11.8%) cases were consistent with PML without overt immunosuppression. Possible contributing factors were a preceding dog bite and mild hypogammaglobulinemia M (39 mg/dL) in case 1 and significant alcohol use without evidence for liver disease in case 2. Both cases were fatal within 6 (case 1) and 2 (case 2) months. The results suggest that PML without overt immunosuppression may be more common than previously described. Therefore, PML should be considered even in the absence of overt immunosuppression if clinical and radiographic findings are suggestive of the diagnosis.
Elastic stable intramedullary nail fixation versus submuscular plate fixation of pediatric femur shaft fractures in school age patients: A PRISMA-compliant systematic review and meta-analysis
Authors: Hu Donglai , Xu Zihang , Shi Tao , Zhong Hui , Xie Yuting , Chen Junjie
Published: September 2023

Background:

Studies of clinical outcomes that compare the elastic stable intramedullary nail (ESIN) with the submuscular plate (SMP) were controversial. The meta-analysis was performed to summarize existing evidence, aiming to determine whether ESIN was superior to SMP in pediatric femur shaft fractures.

Methods:

Search strategies followed the recommendations of the Cochrane collaboration. Electronic searches such as PubMed, Embase, Web of Science, Cochrane were systematically searched for publications concerning ESIN and SMP from the inception date to March 2023. Two investigators independently searched, screened, and reviewed the full text of the article. Disagreements generated throughout the process were resolved by consensus, and if divergences remain, they were arbitrated by a third author.

Results:

This study included 8 articles, comprising a total of 561 patients with a similar baseline. Compared to the SMP, the ESIN had shorter operation time (mean difference = −16.16; 95% CI = −22.83 to −9.48, P < .00001), and less intraoperative blood loss (mean difference = −53.62; 95% CI = −58.89 to −48.36, P < .00001), but had a higher incidence of implant irritation (odds ratio [OR] = 6.49; 95% CI = 3.01 to 13.98, P < .0001), lower limb malalignment (OR = 2.60; 95% CI = 1.12 to 6.04, P = .96) and overall complications(OR = 4.14; 95% CI = 2.51 to 6.84, P < .0001). And there was no significant difference in radiation time, length of hospital stay, limb length discrepancy, infection rate, delayed union rate and unplanned revised surgery rate (P > .05).

Conclusions:

Compared to the SMP, the ESIN offers shorter operative time, and less blood loss. However, the SMP is superior to ESINs in complication rates, especially regarding implant irritation and malalignment. Both methods could achieve excellent satisfactory functional outcomes. Thus, the SMP is an alternative choice in the pediatric femur shaft fracture.
Small intestinal adenocarcinoma accompanied by lynch syndrome: A case report
Authors: Yoon Kyoung Won , Jo Jaemin , Lee Donghyoun
Published: September 2023

Rationale:

Lynch syndrome is caused by germline mutations of DNA mismatch repair genes. A significant risk increase for several types of cancer is one of the characteristics of lynch syndrome.

Patient concerns:

A 45-year-old female presented to the emergency department with abdominal pain that had persisted for a month.

Diagnoses:

The abdominal and pelvic computed tomography scan showed edematous and thickening of the proximal small bowel wall, as well as dilatation of the proximal bowel and stomach.

Interventions:

Tumor resection of the small bowel was performed, and adenocarcinoma was confirmed pathologically. Microsatellite instability was also confirmed.

Outcomes:

Postoperative imaging revealed soft tissue lesions with potential for tumor seeding. Two months after the first surgery, a secondary surgery was performed as a result of cancer recurrence. The patient received chemotherapy with capecitabine. The latest computed tomography scan, performed 19 months after the cessation of chemotherapy, did not show any recurrence.

Lessons:

In the rare incidence of small bowel cancer genetic mutation testing and detailed family history should be actively considered.
Association between injury severity scores and clinical outcomes in patients with traumatic spinal injury in an aging Japanese society
Authors: Tsukuda Manami , Kumagai Gentaro , Wada Kanichiro , Asari Toru , Nitobe Yohshiro , Tsuda Eiichi , Ishibashi Yasuyuki
Published: September 2023

The Injury Severity Score (ISS) is widely used to evaluate patients with multiple injuries. This study investigated the association between ISS and clinical outcomes of patients with spinal cord injury (SCI) in an aging Japanese population. This retrospective cohort study investigated patients admitted to a Japanese university hospital. In the study, 89 patients with traumatic SCI were included. Traumatic SCI was categorized as monotrauma or polytrauma, and the ISS was used to evaluate trauma severity. Spearman’s correlation coefficient was used to estimate the correlation between ISS and the American Spinal Injury Association (ASIA) motor score, Barthel Index (activities of daily living assessment), and the European Quality of Life (QOL) scale (EQ5d) as an assessment of QOL at admission or the last follow-up with the adjustment for age, sex, and body mass index. Return to home and work were analyzed using the chi-squared test after the ISS was divided into three groups (<14, 14–19, and 20). The mean ISS was significantly higher for polytrauma than monotrauma. Significant negative correlations between the ISS and ASIA motor scores at the first visit (P < .001, r = −0.37) and the last follow-up (adjusted, P = .007, r = −0.30) were observed. The Barthel Index was also negatively correlated with ISS at the first visit (P = .04, r = −0.21) and at the last follow-up period (P < .001, r = −0.35). Moreover, ISS was significantly negatively correlated with EQ5d score at the last follow-up (P = .01, r = −0.28). The chi-squared test demonstrated that patients with an ISS of < 14 returned home (P = .03), while those with an ISS of < 19 returned to work (P = .02). ISS is associated with paralysis, activities of daily living, QOL, and lifestyle in patients with SCI and is an important initial injury assessment method.
Research trends and hotspots of exosomes in respiratory diseases
Authors: Fu Jinjie , Song Wenjie , Hao Zheng , Fan Mengzhen , Li Yang
Published: September 2023

Currently, theoretical studies on exosomes in respiratory diseases have received much attention from many scholars and have made remarkable progress, which has inestimable value and potential in future clinical and scientific research. Unfortunately, no scholar has yet addressed this field’s bibliometric analysis and summary. We aim to comprehensively and profoundly study and explore the present situation and highlights of exosome research at the stage of respiratory diseases and to provide meaningful insights for the future development of this field. The WOSCC literature was gathered for the study using bibliometrics, and the data were collected and analyzed using CiteSpace, VOSviewer, Microsoft Excel, and Endnote software. The publication language is “English,” and the search strategy is TS = (exosome OR exosomes OR exosomal) AND TS = (respiratory OR lung). The search time is from the beginning of the WOS construction, and the deadline is July 11, 2022, at 22:00 hours. The literature types selected were dissertation, review paper, and online published paper. The analysis includes 2456 publications in 738 journals from 76 countries, 2716 institutions, and 14,568 authors. The field’s annual publications have been rising, especially in recent years. China and the US lead research, and prominent universities, including Harvard Medical School, Shanghai Jiao Tong University, and Fudan University, are essential research institutes. Takahiro Ochiya, whose research focuses on exosomes and lung cancer, and Clotilde Théry, a pioneering exosome researcher, are the most cited authors in this field. The key terms include lung cancer, non-small cell lung cancer, mesenchymal stem cells, intercellular communication, exosomal miRNAs, and oncology. Cell biology, biochemistry & biotechnology, and oncology are related fields. The final summary of research hotspots is exosomes and lung cancer, mesenchymal stem cell-derived exosomes and lung inflammation, and miRNAs in exosomes as biomarkers for respiratory illnesses. The present research situation and relevant hotspots of the area were analyzed through bibliometric studies on exosomes in respiratory diseases. The research development in this field has a considerable upside, and the exosome’s function in diagnosing, treating, monitoring, and prognosis of respiratory illnesses cannot be taken lightly. Moreover, we believe the research results will bring the gospel to many patients with clinical respiratory diseases shortly.
Biological functions and molecular subtypes regulated by miR-142-3p in colon cancer
Authors: Dai Liang , Guo Weiyan , Xuan Xingwei , Wang Baohua , Chai Haixia , Yang Guanghua , Chen Jianli , Meng Xiaodong , Wang Yinhua , Pu Jianyi
Published: September 2023

MicroRNA-142-3p (miR-142-3p) has been reported to be implicated in colon cancer; however, the possible regulatory mechanisms and molecular subtypes regulated by miR-142-3p have not been fully elucidated. This study aimed to investigate the biological functions and regulatory mechanism of miR-142-3p in colon cancer. The expression level of miR-142-3p in colon cancer was analyzed based on the mRNA and miRNA expression datasets of colon cancer retrieved from The Cancer Genome Atlas. Target genes of miR-142-3p were also predicted. Based on these target genes, the functions and subtypes of miR-142-3p were investigated. The metabolic and tumor-related pathways, immune microenvironment, and target gene expression between the 2 subtypes were analyzed. MiR-142-3p was upregulated in tumor tissues, and its high expression indicated a poor prognosis. A total of 39 target genes were predicted, which were significantly involved in autophagy- and metabolism-related functions and pathways. Based on these target genes, the colon cancer samples were clustered into 2 subtypes. There were 35 metabolism-related pathways that were significantly different between the 2 clusters. The immune and stromal scores in cluster 2 were higher than those in cluster 1, whereas the tumor purity of cluster 2 was significantly lower than that of cluster 1. TP53INP2 expression in cluster 2 was higher than that in cluster 1. MiR-142-3p may promote colon cancer progression via autophagy- and metabolism-related pathways. MiR-142-3p may be served as a candidate target for the treatment of colon cancer.
Role of hypoxia-inducible factor in postoperative delirium of aged patients: A review
Authors: Shen Hu , Yang Jianyin , Chen Xu , Gao Yu , He Baoming
Published: September 2023

Postoperative delirium is common, especially in older patients. Delirium is associated with prolonged hospitalization, an increased risk of postoperative complications, and significant mortality. The mechanism of postoperative delirium is not yet clear. Cerebral desaturation occurred during the maintenance period of general anesthesia and was one of the independent risk factors for postoperative delirium, especially in the elderly. Hypoxia stimulates the expression of hypoxia-inducible factor-1 (HIF-1), which controls the hypoxic response. HIF-1 may have a protective role in regulating neuron apoptosis in neonatal hypoxia-ischemia brain damage and may promote the repair and rebuilding process in the brain that was damaged by hypoxia and ischemia. HIF-1 has a neuroprotective effect during cerebral hypoxia and controls the hypoxic response by regulating multiple pathways, such as glucose metabolism, angiogenesis, erythropoiesis, and cell survival. On the other hand, anesthetics have been reported to inhibit HIF activity in older patients. So, we speculate that HIF plays an important role in the pathophysiology of postoperative delirium in the elderly. The activity of HIF is reduced by anesthetics, leading to the inhibition of brain protection in a hypoxic state. This review summarizes the possible mechanism of HIF participating in postoperative delirium in elderly patients and provides ideas for finding targets to prevent or treat postoperative delirium in elderly patients.
Knowledge mapping of immunotherapy for thyroid cancer from 1980 to 2022: A review
Authors: Ding Ran , Jiao Hongguan , Piao Yuanlin , Tian Weiyi
Published: September 2023

With the gradual development of immunotherapy for thyroid cancer, relevant research has increased. To better understand the current situation, development trend, evolution process, and research hotspots of this field, we conducted this comprehensive bibliometrics visual analysis. We retrieved papers published from 1980 to 2022 from Web of Science Core Collection on January 31, 2023. CiteSpace, Pajek, VOSviewer, R-Bibliometrix, and Scimago Graphics are the tools to perform the analysis. Analysis methods mainly include co-occurrence analysis and cluster analysis. Analysis objects are countries or regions, institutions, authors, journals, and keywords, etc. In terms of publication number, the recent decade has witnessed rapid growth. USA was the most prolific country and has the most influence in the cooperation team. Sweden took the lead in focus on this research field and lasted for 21 years. Garden State Cancer Center was released most papers (28). INSERM played a major role in institutional cooperation. Goldenberg DM published the most papers (48), with H-Index 25 and G-Index 43. Journal of Nuclear Medicine has the greatest papers published (41). The average impactor factor of the top 10 journals is 7.2058. The top keywords with high burst strength are: radioimmunotherapy (14.85), monoclonal antibody (13.78), non hodgkins lymphoma (12.54). The research field of immunotherapy for thyroid cancer will be further developed. This study provides a valuable reference for future research in the field.
Association of Pooled Fecal Microbiota on Height Growth in Children According to Enterotypes
Authors: Park Sunmin , Kang Suna
Published: September 2023

Objectives:

The association between fecal microbiota and height in children has yielded conflicting findings, warranting further investigation into potential differences in fecal bacterial composition between children with short stature and those of standard height based on enterotypes (ETs).

Methods:

According to the height z score for age and gender, the children were categorized into normal-stature (NS; n = 335) and short-stature (SS; n = 152) groups using a z score of −1.15 as a separator value. The human fecal bacterial FASTA/Q files (n = 487) were pooled and analyzed with the QIIME 2 platform with the National Center for Biotechnology Information alignment search tool. According to ETs, the prediction models by the machine learning algorithms were used for explaining SS, and their quality was validated.

Results:

The proportion of SS was 16.4% in ET Enterobacteriaceae (ET-E) and 68.1% in Prevotellaceae (ET-P). The Chao1 and Shannon indexes were significantly lower in the SS than in the NS groups only in ET-P. The fecal bacteria related to SS from the prediction models were similar regardless of ETs. However, in network analysis, the negative correlations between fecal bacteria in the NS and SS groups were much higher in the ET-P than in the ET-E. In the metagenome function, fecal bacteria showed an inverse association of biotin and secondary bile acid synthesis and downregulation of insulin/insulin-like growth factor-1-driven phosphoinositide 3-kinase Akt signaling and AMP-kinase signaling in the SS group compared with the NS group in both ETs.

Conclusion:

The gut microbial compositions in children were associated with height. Strategies to modify and optimize the gut microbiota composition should be investigated for any potential in promoting height in children.
Nulliparous Women's Expectations and Experiences of Early Labor
Authors: Heelan-Fancher Lisa , Moore Simas Tiffany A. , Mazzawi Julianne , Dumont Tina , Edmonds Joyce K.
Published: September 2023

Purpose:

To describe the expectations of early labor by nulliparous pregnant women in their third trimester and first-time mothers' experiences of early labor after they had given birth.

Study Design and Methods:

A descriptive qualitative approach involving semi-structured, video-call interviews conducted between September 2020 and April 2021. Data were analyzed using content analysis.

Results:

Twenty-two women took part in this study. Only 3 of the 10 nulliparous pregnant participants reported pain as an expected symptom of early labor. There were two themes identified from interviews with pregnant participants: Desire to stay at home in early labor and Lack of knowledge and two themes from interviews from postpartum participants: Expectations didn't match experiences and Feelings of anxiety and uncertainty during early labor.

Clinical Implications:

Nulliparous women lack knowledge of and skills to effectively cope with pain during early labor while at home. There is a need for an innovative labor support program for childbearing women to remain safely at home in early labor.
Clinical, Morphologic, and Molecular Features of Benign and Intermediate-grade Melanocytic Tumors With Activating Mutations in MAP2K1
Authors: Fumero-Velázquez Mónica , Hagstrom Michael , Dhillon Soneet , Geraminejad Tara , Olivares Shantel , Donati Michele , Nosek Daniel , Waldenbäck Pia , Kazakov Dmitry , Sheffield Brandon S. , Tron Victor A. , Gerami Pedram
Published: September 2023

Activating mutations in MAP2K1 can be seen in benign and intermediate-grade melanocytic neoplasms with spitzoid morphology. We analyzed the clinical, histopathologic, and genetic features for 16 cases of benign and intermediate-grade melanocytic tumors harboring activating MAP2K1 mutations. We compared them to Spitz neoplasms with characteristic Spitz fusions or HRAS mutation. We also compared the mutational pattern of benign and intermediate-grade MAP2K1-mutated neoplasms and melanomas with activating MAP2K1 mutations. Among the 16 cases, the favored morphologic diagnosis was Spitz nevus (8/16), atypical Spitz tumors (6/16), and deep penetrating nevus (2/16). The 2 most common architectural patterns seen included a plaque-like silhouette with fibroplasia around the rete reminiscent of a dysplastic nevus (n=7) or a wedge-shaped or nodular pattern with the plexiform arrangement of the nests aggregating around the adnexa or neurovascular bundle (n=8). The cases with dysplastic architecture and spitzoid cytology resembled dysplastic Spitz nevi. Compared with true Spitz neoplasms, MAP2K1-mutated neoplasms occurred in older age groups and had more frequent pagetosis and a lower average mitotic count. The most common type of mutation in the benign and intermediate-grade cases in the literature involves an in-frame deletion, while, in melanomas, missense mutations are predominant. Benign and intermediate-grade melanocytic neoplasms with activating mutations in MAP2K1 can have morphologic overlap with Spitz neoplasms. A significant proportion of melanomas also have activating MAP2K1 mutations. In-frame deletions are predominantly seen in the benign and intermediate-grade cases, and missense mutations are predominantly seen in melanomas.
Restoring Function of the Flexor Tendons of the Hand: State of the Science in Kazakhstan
Authors: Kazantayev Kymbat E. , Mukhamedkerim Kanat B. , Muradov Mismil I. , Nabiyev Yergali , Turdalieva Botagoz S.
Published: September 2023

We conducted a literature review to highlight the diagnosis and treatment of hand flexor tendon injuries and discuss the current state of the science of hand surgery in the Republic of Kazakhstan. We reviewed the Google Scholar, PubMed, Web of Science, Elsevier, and National Center for Biotechnology Information databases and other printed sources for open access articles in three languages. We accepted relevant scientific articles that reflected the peculiarities of restoring function of the tendon flexors of the hand. We reviewed articles from the present to the previous 20 years and included 31 of these sources in our literature review. The medical examination of a patient who has sustained a flexor tendon injury should be thorough and gradual, supported by ultrasound and X-ray examination. For effective restoration of hand function following a hand injury, it is important for the surgeon to conduct a step-by-step assessment of the damage that has occurred to soft tissues, superficial and deep tendons, bones, nerves, and blood vessels. The main goal of tendon repair is to preserve tendon function. It is also known that early postoperative tendon movement leads to faster healing. The most frequent complications associated with flexor tendon repair include the development of adhesions, wound infection, tendon rupture, impaired hand function, and scar formation. Relative to the state of the science in the Republic of Kazakhstan, we conclude that hand surgery should be performed by highly skilled specialists in the field of microsurgery in a specialized department with microsurgical equipment.
Using Ginger Oil to Treat Nausea and Vomiting Following Breast Augmentation Surgery
Authors: Sforza Marcos , Sidhu Manu , Okhiria Renee , Okhiria Terrell , Saghir Reyan , Saghir Norman , Husein Rodwan , Poojary Manoj , Seifalian Amelia
Published: September 2023

We conducted a double-blind, randomized, placebo-controlled, single-center study involving 30 women undergoing breast augmentation surgery with silicone breast implants. All patients had an A cup breast size and a similar body mass index. We placed the same type of implant in a subpectoral dual plane in each patient. We randomly allocated the study participants to receive either three drops of ginger oil (110 mg Zingiber officinale) or three drops of a placebo control oil placed on their laryngeal mask before insertion. We used a postoperative nausea and vomiting (PONV) and a visual analog scale (VAS) scores as outcome measures and compared the scale results with the dose of morphine used by the patient. The results of the multivariate analysis of variance showed that the ginger oil had a significant effect on PONV/VAS scores, V = 0.87, F(3, 16) = 34.78, p < .001. The results of the univariate analysis of variance showed that using the ginger oil provided significant treatment effects on PONV, F(1, 18) = 73.05, p < .001. These results are also reflected in the descriptive statistics. The mean PONV score for the experimental group and the control group was 1.70 ± 0.48 and 4.20 ± 0.79, respectively. The mean VAS score for the experimental group and the control group was 5.0 ± 1.63 and 5.9 ± 2.33, respectively. The results of our study showed that ginger oil has an important role in preventing PONV and reducing the use of postoperative opioids in women who have undergone breast augmentation surgery.
Contrast Agent Reflux in Transvaginal 4-D Hysterosalpingo-Contrast Sonography
Authors: Yang Ping , Zhong Yue , Zhang Chao , Zhang Yaping , Fan Xu , Shi Hong
Published: September 2023

Transvaginal 4-D hysterosalpingo-contrast sonography (TV 4-D HyCoSy) plays an important role in the detection and diagnosis of clinical female infertility. The purposes of this study were to analyze the influencing factors of TV 4murD HyCoSy complicated with contrast agent reflux and to provide evidence for clinical diagnosis and treatment. Female patients diagnosed as infertility by transvaginal hysterosalpingography from January 2021 to December 2022 were included. The characteristics of patients with and without contrast agent reflux were evaluated. Pearson correlation and logistic regression were conducted to analyze the related factors affecting the occurrence of contrast reflux. A total of 416 patients undergoing TV 4-D HyCoSy were included, and the incidence of contrast agent reflux in patients undergoing TV 4-D HyCoSy was 38.94%. Pearson correlation analysis results indicated that history of uterine cavity operation (r = 0.556), adenomyosis of uterus (r = 0.584), examination on less than 5 days after menstruation (r = 0.602), endometrial thickness (r = 0.566), and endometrial polyps (r = 0.575) are all correlated with contrast agent reflux in patients undergoing 4-D HyCoSy (all P < 0.05). Logistic regression analysis showed that history of uterine cavity operation (odds ratio [OR], 1.109; 95% confidence interval [CI], 1.012–1.872), adenomyosis of uterus (OR, 2.026; 95% CI, 1.864–2.425), examination on less than 5 days after menstruation (OR, 2.465; 95% CI, 2.118–2.851), endometrial thickness less than 6 mm (OR, 2.866; 95% CI, 2.095–2.957), and endometrial polyps (OR, 1.587; 95% CI, 1.137–1.744) were the influencing factors of contrast agent reflux in patients undergoing (all P < 0.05). The incidence of contrast agent reflux in TV 4-D HyCoSy is high, and there are many influencing factors. Clinical medical workers should take early measures based on these influencing factors to reduce the contrast agent reflux.
Efficacy of probiotics, prebiotics and synbiotics in irritable bowel syndrome: a systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials
Authors: Zhang Wen Xue , Shi Lu Bo , Zhou Min Si , Wu Jing , Shi Hai Yun
Published: September 2023

Introduction. Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the quality of life of numerous people worldwide.

Gap statement. The therapeutic role of gut microbiota modulation in IBS remains controversial.

Aim. We aimed to assess the efficacy of probiotics, prebiotics or synbiotics in patients with IBS.

Methodology. We searched MEDLINE and EMBASE up to 1 August 2023, to identify the randomized, double-blind, placebo-controlled trials investigating the effectiveness of probiotics, prebiotics or synbiotics among patients with IBS. Pooled analyses of the effects of probiotics in relieving IBS symptoms were calculated using a random-effects model. Further subgroup analyses were performed by different genera, doses and duration of treatment.

Results. Our final analysis included 52 trials involving 6289 IBS patients. Probiotics significantly increased the overall response rate (RR:1.64; P<0.00001), subjective relief rate (RR:1.50; P=0.0002) and abdominal pain relief rate (RR:1.69; P<0.00001). As for specific genera, mixed probiotics (RR:1.41; P=0.0001),

Bifidobacterium

(RR:1.76; P<0.00001),

Lactobacillus

(RR:1.97; P=0.0004) and Saccharomyces (RR:1.31; P=0.0004) markedly relieved IBS symptoms. Mixed probiotics (RR:1.31; P=0.005),

Lactobacillus

(RR:2.22; P=0.04) and

Bifidobacterium

(RR:1.62; P<0.0001) elevated patients’ subjective relief rate. Besides, probiotics effectively relieved the abdominal pain in IBS patients (RR:1.69; P<0.00001). Probiotics appeared to show a remarkable beneficial role at a dose of 109 c.f.u./day or above (RR:1.662; P<0.0001) and started to work at 4 weeks (RR 1.72; P<0.00001). Efficacy of prebiotics and synbiotics in IBS remained uncertain, due to the deficiency of available RCTs.

Conclusions. Probiotics have a therapeutic role in IBS. However, the effect of different probiotics varies. The minimal effective dose of probiotics may be 109 c.f.u./day. With appropriate probiotic formula, the therapeutic effect can occur at 4 weeks. These data provide a basis for further research on the optimal probiotic therapy in IBS.
Estimating limit of detection of M.tuberculosisDNA as an analyte released from a chemically coated solid matrix and using a WHO-approved CB-NAAT platform
Authors: Goyani Krishna H. , Mukhopadhyaya Pratap N.
Published: September 2023

The limit of detection of Mtb (Mycobacterium tuberculosis) bacilli was evaluated by detection of released DNA from a chemically treated cellulose matrix. Loopful of the Mtb cells were suspended in phosphate buffer (pH 6.8), DNA extracted from it and quantified using a commercial Mtb real time PCR quantitation kit. Synthetic sputum, prepared using acrylamides as the matrix of choice was mixed with defined number of Mtb bacilli and spotted onto the cellulose matrix. Mtb DNA from the matrix was released into a DNA-release buffer and detected using a WHO-approved CB-NAAT detection platform. One hundred and fifty, 500 and 1000 but not 10 Mtb bacilli/mL of synthetic sputum could be detected by this protocol. The result underlined the potential of cellulose matrix as a potent, room temperature, Mtb-infected sputum transportation, storage and DNA-release device for sensitive detection of Mtb usingMtb Xpert Ultra CB-NAATas the WHO-approved Mtb test of choice.
Integrating Shear Flow and Trypsin Treatment to Assess Cell Adhesion Strength
Authors: Patel Antra , Bhavanam Bhavana , Keenan Trevor , Maruthamuthu Venkat
Published: September 2023

Cell adhesion is of fundamental importance in cell and tissue organization, and for designing cell-laden constructs for tissue engineering. Prior methods to assess cell adhesion strength for strongly adherent cells using hydrodynamic shear flow either involved the use of specialized flow devices to generate high shear stress or used simpler implementations like larger height parallel plate chambers that enable multi-hour cell culture but generate low shear stress and are hence more applicable for weakly adherent cells. Here, we propose a shear flow assay for adhesion strength assessment of strongly adherent cells that employs off-the-shelf parallel plate chambers for shear flow as well as simultaneous trypsin treatment to tune down the adhesion strength of cells. We implement the assay with a strongly adherent cell type and show that shear stress in the 0.07 to 7 Pa range is sufficient to dislodge the cells with simultaneous trypsin treatment. Imaging of cells over a square centimeter area allows cell morphological analysis of hundreds of cells. We show that the cell area of cells that are dislodged, on average, does not monotonically increase with shear stress at the higher end of shear stresses used and suggest that this can be explained by the likely higher resistance of high circularity cells to trypsin digestion. The adhesion strength assay proposed can be easily adapted by labs to assess the adhesion strength of both weakly and strongly adherent cell types and has the potential to be adapted for substrate stiffness-dependent adhesion strength assessment in mechanobiology studies.
Reducing the vicissitudes of heterologous prochiral substrate catalysis by alcohol dehydrogenases through machine learning algorithms
Authors: Ghatak Arindam , Shanbhag Anirudh P. , Datta Santanu
Published: September 2023

Alcohol dehydrogenases (ADHs) encompass three distinctive superfamilies: medium-chain dehydrogenase (MDRs), short-chain dehydrogenase (SDRs), and iron-containing alcohol dehydrogenases. MDRs and SDRs have pivotal roles in converting pro-pharmaceutical ketones into chiral alcohols, serving as active pharmaceutical intermediate catalysts in industries. Nevertheless, the pursuit of aligning enzymes to a one enzyme-one substrate paradigm is intricate and resource-intensive. This study undertook the catalysis of 284 antibacterial ketone intermediates, yielding distinct patterns for both MDRs and SDRs. We endeavored to leverage machine learning to discriminate between compounds subjected to the influence of these superfamilies. To this end, we curated a dataset comprising 33 features, encompassing 4 descriptors for each compound. Subsequently, an ensemble of machine learning techniques, including Partial Least Squares (PLS) regression, k-Nearest Neighbors (kNN) regression, and Support Vector Machine (SVM) regression, was harnessed. Furthermore, the assimilation of Principal Component Analysis (PCA) augmented precision and accuracy, refining compound classification and intensifying differentiation and demarcation within diverse compound classes. As such, this classification strategy emerged as a potent approach for discerning substrates amenable to diverse alcohol dehydrogenases, thereby mitigating the reliance on high-throughput screening in identifying the optimal enzyme for specific substrate preferences.
“My doctor self and my human self”: A qualitative study of physicians’ presentation of self on social media
Authors: Maggio Lauren A. , Céspedes Lucía , Fleerackers Alice , Royan Regina
Published: September 2023

Introduction

When using social media, physicians are encouraged and trained to maintain separate professional and personal identities. However, this separation is difficult and even undesirable, as the blurring of personal and professional online presence can influence patient trust. Thus, to develop policies and educational resources that are more responsive to the blurring of personal and professional boundaries on social media, this study aims to provide an understanding of how physicians present themselves holistically online.

Methods

28 physicians based in the United States that use social media were interviewed. Participants were asked to describe how and why they use social media, specifically Twitter (rebranded as “X” in July 2023), which is especially popular among physicians. Interviews were complimented by data from participants’ Twitter profiles. Data were analyzed using reflexive thematic analysis guided by Goffman’s theory of presentation of self. This theory uses the metaphor of a stage to characterize how individuals attempt to control the aspects of the identities—orfaces—they display during social interactions.

Results

We identified seven faces presented by the participants. Participants crafted and maintained these faces through discursive choices in their tweets and profiles, which were motivated by their perceived audience. We identified overlaps and tensions that arise at the intersections of faces, which posed professional and personal challenges for participants.

Conclusions

Physicians strategically emphasize their more professional or personal faces according to their objectives and motivations in different communicative situations, and tailor their language and content to better reach their target audiences. While tensions arise in between these faces, physicians still prefer to project a rounded, integral image of themselves on social media. This suggests a need to reconsider social media policies and related educational initiatives to better align with the realities of these digital environments.
Effects of Six Weeks of Supervised Telerehabilitation on Pulmonary Function, Functional Capacity, and Dyspnoea among individuals with Long COVID
Authors: Al Mheiri Alya , Girish Srilatha , Amaravadi Sampath Kumar
Published: September 2023

Background

Long COVID, characterized by persistent symptoms post-COVID-19, presents challenges like reduced functional capacity, pulmonary function, and dyspnea. Telerehabilitation, a remote healthcare approach, is gaining attention for its potential to address these issues

Objectives

The study aims to determine the effect of telerehabilitation on functional capacity by six-minute walk test (MWT), pulmonary function by pulmonary function test (PFT), dyspnea by modified medical research council (mMRC) and level of physical activity by Global physical activity questionnaire (GPAQ) in individuals with long COVID.

Materials and Methods

At Al Ain Hospital, UAE, a 6-week telerehabilitation program for Long COVID patients aged 18-75 was studied using single-group pretest-posttest quasi-experimental design. Pre and post assessments included 6MWT, PFT, mMRC, and GPAQ. The study also monitored technical issues and session adherence.

Results

Participants had an average age of 49.30 ± 15.46, height of 163.80 ± 9.76, and weight of 78.70 ± 15.58, with a gender ratio of 12 females to 8 males. After six weeks of telerehabilitation, significant improvements were seen in the 6MWT (21% improvement) and PFT (4% FVC increase, 8% FEV1 increase, 1% FEV1/FVC increase, and 11% PEF increase). mMRC scale scores post-rehabilitation were significantly lower, indicating substantial improvement in dyspnea levels with clinical significance.

Conclusion

This approach has shown tangible benefits in enhancing functional capacity, pulmonary function, reducing dyspnea, and improving physical activity levels among individuals with Long COVID. The results of the study demonstrate the feasibility and effectiveness of implementing a telerehabilitation program for individuals with Long
Engineered retrons generate genome-independent protein-binding DNA for cellular control
Authors: Lee Geonhu , Kim Jongmin
Published: September 2023

DNA-protein interactions are core components of myriad natural and synthetic gene networks. Despite the potential new design space, DNA-protein interactions remain underexploited in vivo due to challenges in controlling specific DNA segments, including protein-binding sequences, independently of the genome. Here we engineer retrons, prokaryotic retroelements, to intracellularly generate genome-independent programmable small DNA for sequence-specific protein-binding. Using reprogrammed retron-derived DNA for allosteric transcription factor, we demonstrated dynamic regulation of synthetic gene networks and construction of automated feedback circuits for signal amplification, adaptation, and memory. Furthermore, we developed a new class of stimuli-responsive molecular “bait and prey” that enable modular, rapid, and post-translational control of protein subcellular localization. This work substantially expands possible application area of DNA-protein interactions, laying the foundation for technical advances in synthetic biology.

One-Sentence Summary

We demonstrate new ways to control, design, and exploit DNA-protein interactions in living cells using engineered retron-generated small DNA.
A telomere-to-telomere genome assembly of Zhonghuang 13, a widely-grown soybean variety from the original center of Glycine max
Authors: Zhang Anqi , Kong Tangchao , Sun Baiquan , Qiu Shizheng , Guo Jiahe , Ruan Shuyong , Guo Yu , Guo Jirui , Zhang Zhishuai , Liu Yue , Hu Zheng , Jiang Tao , Liu Yadong , Cao Shuqi , Sun Shi , Wu Tingting , Hong Huilong , Jiang Bingjun , Yang Maoxiang , Yao Xiangyu , Hu Yang , Liu Bo , Han Tianfu , Wang Yadong
Published: September 2023

Soybean (Glycine max) stands as a globally significant agricultural crop, and the comprehensive assembly of its genome is of paramount importance for unraveling its biological characteristics and evolutionary history. Nevertheless, previous soybean genome assemblies have harbored gaps and incompleteness, which have constrained in-depth investigations into soybean. Here, we present the first Telomere-to-Telomere (T2T) assembly of the Chinese soybean cultivar “Zhonghuang 13” (ZH13) genome, termed ZH13-T2T, utilizing PacBio Hifi and ONT ultralong reads. We employed a multi-assembler approach, integrating Hifiasm, NextDenovo, and Canu, to minimize biases and enhance assembly accuracy. The assembly spans 1,015,024,879 bp, effectively resolving all 393 gaps that previously plagued the reference genome. Our annotation efforts identified 50,564 high-confidence protein-coding genes, 707 of which are novel. ZH13-T2T revealed longer chromosomes, 421 not-aligned regions (NARs), 112 structure variations (SVs), and a substantial expansion of repetitive element compared to earlier assemblies. Specifically, we identified 25.67 Mb of tandem repeats, an enrichment of 5S and 48S rDNAs, and characterized their genotypic diversity. In summary, we deliver the first complete Chinese soybean cultivar T2T genome. The comprehensive annotation, along with precise centromere and telomere characterization, as well as insights into structural variations, further enhance our understanding of soybean genetics and evolution.