bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Huangqi Guizhi Wuwu decoction combined with rehabilitation training for shoulder hand syndrome after stroke: A systematic review and meta-analysis
Authors: Shi Zhenyu , Wang Shuxuan , Wu Fuping , Liu Zhenhang , Wang Yaqun
Published: December 2023

Background:

Shoulder hand syndrome (SHS) is a common complication of stroke. This meta-analysis aimed to evaluate the effectiveness of Huangqi Guizhi Wuwu decoction (HGWD) combined with rehabilitation training in managing it, as its efficacy remains inconclusive.

Methods:

Seven databases, including PubMed, EMBASE, Cochrane Library, SinoMed, Chinese National Knowledge Infrastructure, Wanfang Data, and VIP database were searched in this study. The search deadline was April 30, 2023. Randomized controlled trials that included either standalone rehabilitation training or HGWD combined with rehabilitation training were included, and data were independently extracted by 2 reviewers who assessed the risk of bias.

Results:

Thirteen studies involving 1270 patients were included in this study. Meta-analysis showed that the combined treatment was significantly more effective than standalone rehabilitation therapy (odds ratio = 4.49; 95%CI: 2.98–6.76; Z = 7.17; P < .00001). Compared with the control group, the intervention group had a lower visual analog scale score (mean difference [MD] = −2.80, 95%CI (−3.15, −2.45), Z = 15.84, P < .00001). In addition, the Fugl-Meyer assessment scale score improved (MD = 9.69, 95%CI (7.60, 11.78), Z = 9.08, P < .00001). The SHS score in the intervention group decreased more compared to the control group (standard mean difference = −2.27, 95%CI (−3.19, −1.34), Z = 4.79, P < .00001). Serum biomarkers related to SHS decreased, including serum substance P (MD = −7.52, 95%CI (−8.55, −6.48), Z = 14, P < .00001) and bradykinin (MD = −1.81, 95%CI (−2.68, −0.95), Z = 4.1, P < .00001). Although there was no statistical difference in joint mobility score (MD = −4.19, 95%CI (−8.16, −0.22), Z = 4.79, P = .28), sensitivity analysis after excluding one study still suggested that the joint mobility score of the combined treatment group was higher than that of the standalone rehabilitation treatment group.

Conclusion:

The results of this study indicate that HGWD combined with rehabilitation training may be more effective in treating SHS after stroke compared to standalone rehabilitation therapy.
Middle mediastinal paraganglioma: A case report and review of the literature
Authors: Xu Shaopeng , Hu Gawei , Du Jinchen , Ma Linchong , Zou Lei , Li Qingxin
Published: December 2023

Rational:

Paragangliomas are rare and can occur in many places throughout the body, but mediastinal paragangliomas are even rarer, accounting for less than 0.3% of mediastinal masses. Extremely susceptible to misdiagnosis and mistreatment, which may lead to the death of the patient.

Patient concerns:

We report a case of a giant paraganglioma of the middle mediastinum. A 40-year-old woman was admitted to the hospital with a rib fracture and a chest computed tomography suggesting a giant occupying tumor in the middle mediastinum.

Diagnosis:

Immunohistochemistry revealed positive for S100 fraction and Syn, focally positive for CgA, while negative for CKp and succinate dehydrogenase complex iron sulfur subunit B gene, and Ki67index ≈ 5%. The imaging and immunohistochemical features suggested a final diagnosis of Paragangliomas.

Interventions:

This patient underwent lateral open heart surgery to remove a mediastinal mass.

Outcomes:

One month after being discharged, the patient was contacted by phone for a follow-up visit and reported feeling OK. Unfortunately, as of the date of submission, the patient did not come to our hospital for review.

Lessons:

Mediastinal paraganglioma as a rare and potentially malignant tumor susceptible to misdiagnosis and mistreatment. Organ pathology examination is the gold standard for diagnosis, and surgery is an important treatment method. A clear diagnosis and thorough preoperative examination are important guarantees for the success of surgery.
Bibliometric analysis of trends in research of Tripterygium wilfordii Hook F for treating rheumatoid arthritis
Authors: Li Wenyuan , Yan Chuanzhu , Du Dongqing , Ma Yuxia
Published: December 2023

Tripterygium wilfordii Hook F (TwHF) has been widely used to relieve rheumatoid arthritis (RA) in many countries. However, a bibliometric analysis of published articles discussing this treatment has not been conducted. This study aimed to explore the current status and trends of TwHF for treating RA. Literature was extracted from the Science Citation Index Expanded Database of the Web of Science from January 1, 2013 to December 31, 2022. CiteSpace and the “bibliometrix” package were adopted to analyze the number of publications, countries, institutions, journals, authors, and keywords and to draw collaborative network maps. One hundred sixty-seven articles were identified. China has the most articles, followed by the United States. The China Academy of Chinese Medical Science had the study’s most significant publications and the highest centrality. The author analysis combined with the analysis of the cited authors, the rank of Lin Na is in an important position. The Journal of Ethnopharmacology, Frontiers in Pharmacology has published the most relevant articles and is the hottest related journal. For keyword analysis, “classification,” “criteria,” “mechanism,” and “methotrexate” were still being researched hot until 2022. Further investigation showed that “TNF-α,” “proliferation,” “endothelial growth factor,” “NF-κB,” and “collagen-induced arthritis” also remains research hotspot. Our results provide information on the research status, institutions, countries, authors, published journals, keywords related to using TwHF to treat RA, and theoretical support for further research.
Clinical characteristics and outcomes of patients hospitalized with heart failure with preserved ejection fraction and low NT-proBNP levels
Authors: Chen Yu-Yi , Liang Lin , Tian Peng-Chao , Feng Jia-Yu , Huang Li-Yan , Huang Bo-Ping , Zhao Xue-Mei , Wu Yi-Hang , Wang Jing , Guan Jing-Yuan , Li Xin-Qing , Zhang Jian , Zhang Yu-Hui
Published: December 2023

The aim of this study was to investigate the clinical characteristics and prognosis of patients hospitalized with heart failure with preserved ejection fraction (HFpEF) and low N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. Seven hundred ninety consecutive patients hospitalized with HFpEF from 2006 to 2017 were enrolled. Clinical characteristics and outcomes were compared between low NT-proBNP group (<300 ng/L) and elevated NT-proBNP group (≥300 ng/L). 108 HFpEF patients (13.7%) presented with low NT-proBNP levels. Age, body mass index, atrial fibrillation, New York Heart Association functional class, and albumin were independent predictors of low NT-proBNP levels in HFpEF patients. During the median follow-up duration of 1103 days, 11 patients (10.2%) in low NT-proBNP group suffered from primary endpoint event. Elevated NT-proBNP group had a higher risk of all-cause death or heart transplantation than low NT-proBNP group (adjusted HR [95%CI]: 2.36 [1.24,4.49], P = .009). Stratified analyses showed that the association between NT-proBNP (elevated NT-proBNP group vs low NT-proBNP group) and risk of all-cause death or heart transplantation was stronger in non-atrial fibrillation patients than in atrial fibrillation patients (P value for interaction = .025). Furthermore, the associations between NT-proBNP and risk of all-cause death or heart transplantation were stronger in younger and male patients than in older and female patients. However, both subgroups only reached borderline significant (P values for interaction = .062 and .084, respectively). Our findings suggest that low NT-proBNP levels were common in patients hospitalized with HFpEF. Patients with HFpEF and low NT-proBNP levels had a better prognosis than those with elevated NT-proBNP levels, particularly in younger, male, and non-atrial fibrillation patients.
A case report of giant malignant schwannoma of the sciatic nerve associated with neurofibromatosis-1: A CARE-compliant article
Authors: Gokkus Kemal , Saylik Murat , Birtay Tayfun , Sahin Mehmet Sukru
Published: December 2023

Rationale:

Neurofibromatosis type 1 (NF1) is an autosomal dominant neurocutaneous syndrome that causes multiple central and peripheral nerve sheath tumors. People with NF1 have a 10% chance of developing malignant peripheral nerve sheath tumors (MPNSTs). Here we report a unique instance of a malignant schwannoma that has remained free of metastasis since its initial removal a decade ago. The malign schwannoma has been infrequently documented in the literature, and remarkably, no instances of such an extensive postoperative time without metastases have ever been described.

Patient concerns:

A 46-year-old male patient with NF had multiple neurofibromas in different parts of his body, underwent surgery about 10 years ago (2013), and was diagnosed histopathologically as MPNST.

Diagnoses:

He was admitted to our institution with a recurrent mass in the posterior third of the proximal thigh and severe pain radiating to the left lower extremity, which presented as sciatic pain (2021). A magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography examination revealed that the tumor was likely malignant.

Interventions:

Surgical excision was performed.

Outcome:

A 10-year follow-up revealed no metastases or neurologic impairment.

Lessons:

When articles about benign schwannomas are placed in a separate category, little is written about NF-1-related malignant schwannomas of the sciatic nerve. MPNSTs are high-grade, aggressive sarcomas with a high risk of local recurrence (40%–65%) and metastasis to other body parts. Therefore, among the various benign peripheral nerve sheath tumors in NF-1 patients, the diagnosis of MPNST is crucial.

Orthopedic surgeons should be aware that neurofibromas in NF-1 have a significant risk of developing MPNSTs. This study reports the successful treatment of a giant malignant sciatic nerve schwannoma with a long follow-up period without metastasis.
A case report of autoimmune glial fibrillary acidic protein astrocytopathy presenting as an isolated spinal cord lesion
Authors: Liu Qing , Ma Hongmei , Yang Dan , Bian Tingting , Ji Jinyuan , Duan Huijie , Yan Heli , Wang Xiangbo
Published: December 2023

Introduction:

Autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) is a group of neurological syndromes involving the meninges, brain, spinal cord, and optic nerves and is characterized by sensitivity to steroid therapy. Due to the diverse clinical presentation and lack of uniform diagnostic criteria, GFAP-A can easily be overlooked or diagnosed as another disease. It is even rarer when presenting as an isolated spinal cord lesion.

Case Report:

We report the case of a 70-year-old man with initial symptoms of numbness and weakness in both lower limbs, followed by difficulty in urination and defecation, and progression of numbness upward to the hands. Magnetic resonance imaging (MRI) showed a lesion in the spinal cord from cervical level 2 to thoracic 7 in a T2-weighted image. T1-weighted image showed a punctate, lamellar strengthening lesion with significant spinal strengthening. GFAP immunoglobulin G (IgG) was detected in the cerebrospinal fluid and blood. After treatment with intravenous gamma globulin (IVIG), the patient symptoms improved and spinal cord enhancement was reduced.

Conclusion:

Long segment cases with punctate and patchy enhancement of the spinal cord are difficult to distinguish from CLAPPERS, so GFAP-A antibody detection is very important. This atypical case also increases neurologists’ understanding of GFAP-A.
Advances in the investigation of the role of autophagy in the etiology of chronic obstructive pulmonary disease: A review
Authors: Wang Qianxinhong , Su Wenlong , Liu Junnan , Zhao Dongkai
Published: December 2023

Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory illness. It arises from emphysema and chronic bronchitis and is characterized by progressive and irreversible airflow limitation and chronic inflammation of the lungs, which eventually progresses to pulmonary hypertension, chronic pulmonary heart disease and respiratory failure. Autophagy is a highly conserved cellular homeostasis maintenance mechanism that involves the transport of damaged organelles and proteins to lysosomes for destruction. Dysregulation of autophagy is one of the pathogenic mechanisms of many diseases and is strongly associated with the development of COPD, although the precise mechanisms are unknown. In this paper, we focus on macroautophagy, a type of autophagy that has been thoroughly studied, and describe the characteristics, processes, regulatory pathways, and functions of autophagy, and discuss its relationship with COPD from the perspectives of inflammation, emphysema, mucus hypersecretion, cilia structure and function, airway remodeling, vascular remodeling, and bacterial infections, with a view to searching for the therapeutic targets of COPD from the perspective of autophagy, which is hoped to be helpful for the clinical treatment.
The incidence and predisposing factors for irritable bowel syndrome following COVID-19: a systematic review and meta-analysis
Authors: Wang Yi-nuo , Zhou Li-ying , Huang Yu-Hong , Jiang Min , Dai Cong
Published: December 2023

Background:

Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder. Several studies have analyzed the long-term GI symptoms and IBS following coronavirus disease 2019 (COVID-19). The purpose of this study is to evaluate the incidence and predisposing factors for IBS following COVID-19 by a systematic review and meta-analysis.

Methods:

Electronic databases were searched to identify relevant studies. Primary outcomes were the pooled incidence rate of IBS following COVID-19 and the pooled relative risk (RR) for IBS in the COVID-19 group compared to the non-COVID-19 group. Secondary outcomes were the pooled RR and the standardized mean difference (SMD) for predisposing factors in the IBS group compared to the non-IBS group. Heterogeneity was evaluated using Cochran’s Q test and I
2 statistics.

Results:

Ten studies were included in this study. The pooled incidence rate of IBS in COVID-19 patients was 12%. The pooled incidence rate of IBS-D, IBS-C and IBS-M was 5%, 2% and 1%. The pooled incidence rate of IBS in 6 and 12 months was 10% and 3%. The pooled RR for IBS in COVID-19 patients was 1.23 [95% confidence interval (CI) = 0.50–3.01] compared to non-COVID-19 patients. The pooled RR or SMD for mild, moderate, and severe disease activity, procalcitonin (PCT), depression or anxiety in IBS patients following COVID-19 was 0.94 (95% CI = 0.74–1.21), 1.19 (95% CI = 0.65–2.21), 1.30 (95% CI = 0.63–2.66), 6.73 (95% CI = 6.08–7.38) and 3.21 (95% CI = 1.79–5.75).

Conclusion:

The incidence of IBS following COVID-19 was 12%. But it was not higher than the general population. We also found some predisposing factors for IBS including depression or anxiety, PCT.
Extracorporeal Cardiopulmonary Resuscitation for Amniotic Fluid Embolism
Authors: Sundin Courtney Stanley , Gomez Laura , Chapman Brian
Published: December 2023

Amniotic fluid embolism (AFE) is a rare, sudden, and catastrophic complication of pregnancy that can result in cardiopulmonary arrest, potentially leading to death. The pathophysiology of an AFE includes an inflammatory and coagulopathic response due to fetal materials entering maternal circulation with the hallmark triad of symptoms: acute respiratory distress, cardiovascular collapse, and coagulopathy. Management of AFE should include high-quality cardiopulmonary resuscitation, immediate delivery of the fetus if applicable, early intubation to provide adequate oxygenation and ventilation, fluid volume resuscitation, and ongoing evaluation of coagulopathy. Priorities include thromoboelastography interpretation if available, control of hemorrhage and coagulopathy with blood component therapy, and cardiovascular support through inotropes and vasopressor administration. More recent approaches include implementing the A-OK (atropine, ondansetron, and ketorolac) protocol for suspected AFE protocol, extracorporeal cardiopulmonary resuscitation (ECPR), and extracorporeal membrane oxygenation (ECMO) therapies to increase survival and decrease complications. Venoarterial ECMO is the highest form of life support that provides support in patients with pulmonary and cardiac failure. ECPR is the application of Venoarterial ECMO during cardiopulmonary resuscitation in cases where the cause of arrest is believed to be reversible. Early implementation of ECPR during the acute phase of AFE can provide support for end-organ perfusion in place of the weakened and recovering heart while optimizing oxygenation, making venoarterial ECMO an ideal adjunctive therapy. Because of the rarity of AFE, many obstetrical teams may have limited prior experience in managing these catastrophic cases; however, with ongoing education and simulation, teams can be better prepared in the recognition and management of these life-threatening events.
NIPBL::NACC1 Fusion Hepatic Carcinoma
Authors: Hissong Erika , Al Assaad Majd , Bal Munita , Reed Katelyn A. , Fornelli Adele , Levine Max F. , Gundem Gunes , Semaan Alissa , Orr Christine E. , Sakhadeo Uma , Manohar Jyothi , Sigouros Michael , Wilkes David , Sboner Andrea , Montgomery Elizabeth A. , Graham Rondell P. , Medina-Martínez Juan S. , Robine Nicolas , Fang Jiayun M. , Choi Eun-Young K. , Westerhoff Maria , Delgado-de la Mora Jesús , Caudell Patricia , Yantiss Rhonda K. , Papaemmanuil Elli , Elemento Olivier , Sigel Carlie , Jessurun José , Mosquera Juan Miguel
Published: December 2023

Several reports describing a rare primary liver tumor with histologic features reminiscent of follicular thyroid neoplasms have been published under a variety of descriptive terms including thyroid-like, solid tubulocystic, and cholangioblastic cholangiocarcinoma. Although these tumors are considered to represent histologic variants, they lack classic features of cholangiocarcinoma and have unique characteristics, namely immunoreactivity for inhibin and NIPBL::NACC1 fusions. The purpose of this study is to present clinicopathologic and molecular data for a large series of these tumors to better understand their pathogenesis. We identified 11 hepatic tumors with these features. Immunohistochemical and NACC1 and NIPBL fluorescence in situ hybridization assays were performed on all cases. Four cases had available material for whole-genome sequencing (WGS) analysis. Most patients were adult women (mean age: 42 y) who presented with abdominal pain and large hepatic masses (mean size: 14 cm). Ten patients had no known liver disease. Of the patients with follow-up information, 3/9 (33%) pursued aggressive behavior. All tumors were composed of bland cuboidal cells with follicular and solid/trabecular growth patterns in various combinations, were immunoreactive for inhibin, showed albumin mRNA by in situ hybridization, and harbored the NIPBL::NACC1 fusion by fluorescence in situ hybridization. WGS corroborated the presence of the fusion in all 4 tested cases, high tumor mutational burden in 2 cases, and over 30 structural variants per case in 3 sequenced tumors. The cases lacked mutations typical of conventional intrahepatic cholangiocarcinoma. In this report, we describe the largest series of primary inhibin–positive hepatic neoplasms harboring a NIPBL::NACC1 fusion and the first WGS analysis of these tumors. We propose to name this neoplasm NIPBL:NACC1 fusion hepatic carcinoma.
Combination of Intranasal Dexmedetomidine and Midazolam for Sedation in Pediatric Magnetic Resonance Imaging
Authors: Palmese Salvatore , Bilancio Giancarlo , Caterino Vittorio , De Anseris Anna Giulia , Perciato Stanislao , Siglioccolo Antonio , Gammaldi Renato
Published: December 2023

Background

Intranasal dexmedetomidine associated with midazolam has been used for pediatric magnetic resonance imaging studies because immobility is a fundamental requirement for correct execution. Many studies have shown dexmedetomidine to be a good option for non-operating room sedation. However, identifying the optimal dose remains a key challenge, especially for pediatric patients.

Methods

All medical records of 139 pediatric patients who underwent sedation for magnetic resonance imaging studies between September 2021 and November 2022 at the University Hospital of Salerno, Italy, were retrospectively reviewed about success rate and adverse events. Our protocol required dosing 30 minutes before the procedure. Patients weighing up to 40 kg received intranasal dexmedetomidine (3 μg/kg) with intranasal midazolam (0.2 mg/kg). Those weighing more than 40 kg received intranasal dexmedetomidine (2 μg/kg) with midazolam orally (0.3 mg/kg; maximum dose, 15 mg).

Results

A total of 139 pediatric patients, with age range between 2 months and 16 years, median (95% confidence interval) of 3 (3–5) years, and weight range between 4 and 70 kg, median (95% confidence interval) of 19 (15–24) kg, were reviewed.

The procedure was satisfactorily completed in 93.5% (130 patients) (P < 0.01). Only 9 (6.5%) patients completed the procedure with general anesthesia; there are hot adverse events.

Conclusions

Our experience with association of intranasal dexmedetomidine and midazolam has a high success rate, with high effectiveness and safety.
Clinical and Pathological Validation of CT-Based Regional Harmonization Methods of Amyloid PET
Authors: Kim Soo-Jong , Jang Hyemin , Yoo Heejin , Na Duk L. , Ham Hongki , Kim Hee Jin , Kim Jun Pyo , Farrar Gill , Moon Seung Hwan , Seo Sang Won
Published: December 2023

Purpose

The CT-based regional direct comparison Centiloid (dcCL) method was developed to harmonize and quantify regional β-amyloid (Aβ) burden. In the present study, we aimed to investigate correlations between the CT-based regional dcCL scales and Aβ pathological burdens and to validate the clinical utility using thresholds derived from pathological assessment.

Patients and Methods

We included a pathological cohort of 63 cases and a clinical cohort of 4062 participants, and obtained modified Consortium to Establish a Registry for Alzheimer’s Disease criteria (mCERAD) scores by assessment of neuritic plaque burdens in multiple areas of each cortical region. PET and CT images were processed using the CT-based regional dcCL method to calculate scales in 6 distinct regions.

Results

The CT-based regional dcCL scales were correlated with neuritic plaque burdens represented by mCERAD scores, globally and regionally (r = 0.56~0.76). In addition, striatum dcCL scales reflected Aβ involvement in the striatum (P < 0.001). The regional dcCL scales could predict significant Aβ deposition in specific brain regions with high accuracy: area under the receiver operating characteristic curve of 0.81–0.97 with an mCERAD cutoff of 1.5 and area under the receiver operating characteristic curve of 0.88–0.93 with an mCERAD cutoff of 0.5. When applying the dcCL thresholds of 1.5 mCERAD scores, the G(−)R(+) group showed lower performances in memory and global cognitive functions and had less hippocampal volume compared with the G(−)R(−) group (P < 0.001). However, when applying the dcCL thresholds of 0.5 mCERAD scores, there were no differences in the global cognitive functions between the 2 groups.

Conclusions

The thresholds of regional dcCL scales derived from pathological assessments might provide clinicians with a better understanding of biomarker-guided diagnosis and distinguishable clinical phenotypes, which are particularly useful when harmonizing different PET ligands with only PET/CT.
Clinical Implications of Adding SPECT/CT to Radioiodine Whole-Body Scan in Patients With Differentiated Thyroid Cancer
Authors: Chong Ari , Seo Youngduk , Bang Ji-In , Park Sohyun , Kim Keunyoung , Hong Chae Moon , Choi Miyoung , Oh So Won , Lee Sang-Woo
Published: December 2023

Purpose

This study aimed to determine the usefulness of adding SPECT/CT to radioiodine whole-body scans (WBSs) for the treatment of differentiated thyroid cancer (DTC).

Patients and Methods

A systematic review and meta-analysis were performed following the PRISMA guidelines (PROSPERO registration: CRD42022341732) to compare the feasibility of conclusive readings and the frequency of changes in treatment plans in patients with DTC undergoing WBS + SPECT/CT versus WBS. MEDLINE, EMBASE, and Cochrane databases were searched to identify relevant articles concerning thyroid cancer, radioactive iodine, and SPECT/CT or SPECT, published before August 16, 2023. Studies not comparing WBS + SPECT/CT with WBS, those lacking target outcomes, and those not involving human subjects were excluded. The risk of bias was assessed using the RoBANS 2.0 (Risk of Bias Assessment Tool for Nonrandomized Studies) tool. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system was used to evaluate the quality of evidence and strength of recommendations.

Results

A total of 30 studies (prospective n = 9, retrospective n = 21) were included in the meta-analyses. Adding SPECT/CT to WBS was shown to increase conclusive readings for cervical lesions, extracervical lesions, and all regions. Lesion-based analyses showed improvements of 14%, 20%, and 18%, respectively, whereas scan-based analyses showed improvements of 27%, 9%, and 34%. The addition of SPECT/CT to WBS led to changes in 30% of treatment plans after diagnostic scans and 9% of treatment plans after posttherapeutic scans. The quality of evidence and strength of recommendations were low.

Conclusions

Compelling evidence demonstrates that the addition of SPECT/CT to WBS improves lesion localization, diagnostic performance, and therapy plan for patients with DTC.
Cure Probabilities After Resection of Pancreatic Ductal Adenocarcinoma: A Multi-Institutional Analysis of 2554 Patients
Authors: Crippa Stefano , Malleo Giuseppe , Langella Serena , Ricci Claudio , Casciani Fabio , Belfiori Giulio , Galati Sara , Ingaldi Carlo , Lionetto Gabriella , Ferrero Alessandro , Casadei Riccardo , Ercolani Giorgio , Salvia Roberto , Falconi Massimo , Cucchetti Alessandro
Published: December 2023

Objective:

To assess the probability of being cured of pancreatic ductal adenocarcinoma (PDAC) by pancreatic surgery.

Background:

Statistical cure implies that a patient treated for a specific disease will have the same life expectancy as if he/she never had that disease.

Methods:

Patients who underwent pancreatic resection for PDAC between 2010 and 2021 were retrospectively identified using a multi-institutional database. A nonmixture statistical cure model was applied to compare disease-free survival to the survival expected for a matched general population.

Results:

Among 2554 patients, either in the setting of upfront (n=1691) or neoadjuvant strategy (n=863), the cure model showed that the probability that surgery would offer the same life expectancy (and tumor-free) as the matched general population was 20.4% (95% CI: 18.3, 22.5). Cure likelihood reached the 95% of certainty (time to cure) after 5.3 years (95% CI: 4.7, 6.0). A preoperative model was developed based on tumor stage at diagnosis (P=0.001), radiologic size (P=0.001), response to chemotherapy (P=0.007), American Society of Anesthesiology class (P=0.001), and preoperative Ca19-9 (P=0.001). A postoperative model with the addition of surgery type (P=0.015), pathologic size (P=0.001), tumor grading (P=0.001), resection margin (P=0.001), positive lymph node ratio (P=0.001), and the receipt of adjuvant therapy (P=0.001) was also developed.

Conclusions:

Patients operated for PDAC can achieve a life expectancy similar to that of the general population, and the likelihood of cure increases with the passage of recurrence-free time. An online calculator was developed and available at https://aicep.website/?cff-form=15.
Risk Factors for Surgical-Site Infections After Liver Transplant: Does Perioperative Antibiotic Regimen Matter?
Authors: Rolak Stacey C. , Yetmar Zachary A. , Lahr Brian D. , Beam Elena , Razi Samrah , Watt Kymberly , Yang Liu , Aqel Bashar A. , Mahmood Maryam
Published: December 2023

Background.

Surgical-site infections (SSIs) are common in liver transplant recipients. The optimal SSI antimicrobial prophylaxis agent and duration are not established. We aimed to explore risk factors for SSIs after transplant, with a particular interest in the impact of perioperative antibiotic regimen on the development of SSIs.

Methods.

Retrospective study of adults undergoing liver transplant across 3 transplant programs between January 1, 2020, and June 01, 2021.

Results.

Of 557 patients included in the study, 32 (5.7%) were infected or colonized with a multidrug-resistant organism (MDRO) within 1 y before liver transplant. Narrow-spectrum SSI prophylaxis with ceftriaxone or cefazolin alone was administered in 488 of 577 patients (87.6%); the remaining 69 patients (12.4%) received broad-spectrum prophylaxis with vancomycin and aztreonam (n = 40), piperacillin–tazobactam (n = 11), carbapenems (n = 8), ceftriaxone and another antibiotic (n = 7), and others. Patients with pretransplant MDRO were more likely to receive broad-spectrum coverage than those without pretransplant MDROs (28.1% versus 11.4%, P = 0.005). SSIs were identified in 40 patients (7.2%); 25 (62.5%) were organ–space infections, 3 (7.5%) were deep incisional infections, and 12 (30.0%) were superficial incisional infections. The median time from liver transplant to SSIs was 14 d (interquartile range, 10–20.2). MDROs were identified in 12 SSIs (30%). Multivariable analysis revealed no significant association between antimicrobial spectrum and risk of SSIs (P = 0.5), whereas surgical leak (P<0.001) and reoperation (P = 0.017) were independently associated with increased risk of SSIs. SSIs were not significantly associated with composite risk of death or liver allograft failure.

Conclusions.

The spectrum of antimicrobial prophylaxis did not impact the development of SSIs in liver transplant recipients.
Spin–orbit coupling and Jahn–Teller effect in
T

d

symmetry: an
ab initio
study on the substitutional nickel defect in diamond
Authors: Thiering Gergő , Gali Adam
Published: December 2023

We analyse the spin–orbit and Jahn–Teller interactions in

T
d

symmetry that are relevant for substitutional transition metal defects in semiconductors. We apply our theory to the substitutional nickel defect in diamond and compute the appropriate fine-level structure and magneto-optical parameters by means of hybrid density functional theory. Our calculations confirm the intepretations of previous experimental findings that the 2.56 and 2.51 eV optical centres are associated with this defect. Our analysis of the electronic structure unravels possible mechanisms behind the observed optical transitions and the optically detected magnetic resonance signal, too.

This article is part of the Theo Murphy meeting issue ‘Diamond for quantum applications’.
Ab initio
study of defect interactions between the negatively charged nitrogen vacancy centre and the carbon self-interstitial in diamond
Authors: Kirkpatrick Andrew R. , Chen Guangzhao , Witkowska Helen , Brixey James , Green Ben L. , Booth Martin J. , Salter Patrick S. , Smith Jason M.
Published: December 2023

Fabrication techniques for nitrogen-vacancy centres in diamond require the creation of Frenkel defects (vacancy-interstitial pairs) the components of which can interact with formed NV centres affecting their photophysical properties. Here we use Density Functional Theory simulations of inter-defect electronic and strain interactions to explore how the NV centre and carbon self-interstitial interact in different configurations. We find that hybridization occurs between the NV centre e-orbitals and the carbon self-interstitial when an interstitial is present on the vacancy side of the NV centre. We propose that this phenomenon may explain the fluorescence blinking of NV centres observed during annealing.

This article is part of the Theo Murphy meeting issue ‘Diamond for quantum applications’.
Bone Health Status of Children with Spinal Muscular Atrophy
Authors: Tung Joanna Yuet-Ling , Chow Tsz-Kit , Wai Monique , Lo Jasmine , Chan Sophelia Hoi Shan
Published: December 2023

Background: Spinal muscular atrophy (SMA) is a group of rare, inherited neuromuscular disorders. Bone health is often a neglected issue in children with SMA. This study aimed to evaluate the bone health status of children with SMA in Hong Kong.Methods: This retrospective study included children with SMA who were managed in the Neuromuscular Disorder Clinics of 2 quaternary centers in Hong Kong. Bone health status was assessed by fracture history, bone mineral density (BMD) measured by dual energy X-ray absorptiometry, and serum 25-hydroxy-vitamin D (25[OH]D) level.Results: Thirty-two children were included (males, 12). The median age was 10.8 years. BMD assessments were performed in 17 patients (SMA type 1=2, type 2=8, type 3=7). Low BMD was observed in 16 out of 17 patients. Four had a history of long bone fractures and were started on bisphosphonates. SMA types, age at last visit, sex, ambulation, and 25(OH)D level were not associated with fracture history or BMD Z-scores. Only one fulfilled the 2019 International Society for Clinical Densitometry (ISCD) pediatric definition of osteoporosis, with both low BMD and a history of clinically significant fracture.Conclusions: Children with SMA on disease-modifying treatments commonly had Low BMD and a history of fractures, but osteoporosis was uncommon according to the 2019 ISCD pediatric definition. A special definition of osteoporosis may be needed for this high-risk group.
Knowledge, Attitude, and Behavior Levels of Postmenopausal Women about Osteoporosis
Authors: Saltık Hazal , Öztürk Furkan , Emiroğlu Canan , Hekimoğlu Baki , Aypak Cenk
Published: December 2023

Background: Osteoporosis can be delayed by providing accurate and adequate information to people at risk. Therefore, we aimed to determine the knowledge, attitude, and behavior levels of women in the postmenopausal period, which is the largest group at risk.Methods: The study was conducted in a tertiary Training and Research Hospital between 1 December 2018 and 1 May 2019 in 225 postmenopausal women who applied to the Family Medicine outpatient clinic and bone mineral density (BMD) outpatient clinics for BMD measurement or had previously had this measurement at least once. A questionnaire evaluating the knowledge, attitudes, and behavior levels related to osteoporosis was applied to all patients included in the study.Results: The mean age was 58.05±9.1 years. The median osteoporosis knowledge score was 7 out of 19 points. A total of 119 (52.9%) had low knowledge scores and 106 (47.1%) had higher knowledge scores. Of the individuals with high scores, 40 (37.7%) were smoking, 64 (60.4%) did not sunbathe, 89 (84%) did not consume the recommended daily amount of calcium, and 58 (54.7%) were not exercising in the recommended time. It was seen that those who were university graduates, who had previously learned about osteoporosis from a health professional, and who had a family history of osteoporosis had higher knowledge levels.Conclusions: Even in postmenopausal women who are aware that they are in the risk group and that they should have BMD, their knowledge, attitude, and behavior levels on osteoporosis were found to be quite low.
Distinct gradients of cortical architecture capture visual representations and behavior across the lifespan
Authors: Chen Xiayu , Liu Xingyu , Hoyos Patricia Maria , Daniel Hertz Edan , Yao Jewelia K. , Zhen Zonglei , Gomez Jesse
Published: December 2023

The microstructure of cells within human cerebral cortex varies across the cortical ribbon, where changes in cytoarchitecture and myeloarchitecture are thought to endow each region of cortex with its unique function. While fine-scale relative to a cell, these changes at population level impact architectural properties of cortex measurable in vivo by noninvasive MRI, such as the thickness and myelin content of cortex. This raises the question of whether or not we can use these in vivo architectural measures to understand cortical organization, function, and development more broadly. Using human visual cortex as a test bed, we demonstrated two architectural gradients, one in which cytoarchitecture and myeloarchitecture converge and another in which they diverge. These two gradients underlie the structural and functional topography of visual cortex, even predicting the presence of new visual field maps. Moreover, the two gradients show distinct visual behavior relevance and lifespan trajectory. These findings provide a more general framework for understanding human cortex, showing that architectural gradients are a measurable fingerprint of functional organization and ontogenetic routines in the human brain.
Association between recovering from tempo perturbations and reading measurements
Authors: Wei Yi , Hancock Roeland
Published: December 2023

A strong correlation between auditory temporal processing and reading proficiency has been consistently observed across clinical and nonclinical populations, spanning various age groups and languages. Specifically, rhythm sensitivity in both the music and speech domains has been considered to be fundamental for accurately tracking the hierarchical acoustic components in speech, playing a central role in the development of reading skills. However, the empirical validation of this hypothesis has primarily utilized stimuli with an isochronous underlying beat structure, which is limited in its ability to capture the nonlinearity inherent in the perception of timing within the speech and music domains. In our current study, we introduced perturbation stimuli and demonstrated a relationship between sensorimotor synchronization performance and reading measurements in the neurotypical adult population. Specifically, the current study highlighted that sensorimotor synchronization during the post-perturbation time window yields notably superior predictive value across a wide array of reading measurements when compared to the pre-perturbation time window, which, in contrast, did not predict reading measurements. Furthermore, our novel curve fitting analysis effectively captured the nonlinear aspects of participants’ sensorimotor synchronization performance when recovering from tempo perturbation, providing further insight into their auditory temporal processing abilities when responding to timing changes in auditory signals—a phenomenon commonly encountered in both speech and music contexts.
Ivermectin increases striatal cholinergic activity to facilitate dopamine terminal function
Authors: Wadsworth Hillary A. , Warnecke Alicia M.P. , Barlow Joshua C. , Kayden Robinson J. , Steimle Emma , Ronström Joakim , Williams Pacen , Galbraith Christopher , Baldridge Jared , Jakowec Michael W. , Davies Daryl L. , Yorgason Jordan T.
Published: December 2023

Ivermectin (IVM) is a commonly prescribed antiparasitic treatment with pharmacological effects on invertebrate glutamate ion channels resulting in paralysis and death of invertebrates. However, it can also act as a modulator of some vertebrate ion channels and has shown promise in facilitating L-DOPA treatment in preclinical models of Parkinson’s disease. The pharmacological effects of IVM on dopamine terminal function were tested, focusing on the role of two of IVM’s potential targets: purinergic P2X4 and nicotinic acetylcholine receptors. Ivermectin enhanced electrochemical detection of dorsal striatum dopamine release. Although striatal P2X4 receptors were observed, IVM effects on dopamine release were not blocked by P2X4 receptor inactivation. In contrast, IVM attenuated nicotine effects on dopamine release, and antagonizing nicotinic receptors prevented IVM effects on dopamine release. IVM also enhanced striatal cholinergic interneuron firing. L-DOPA enhances dopamine release by increasing vesicular content. L-DOPA and IVM co-application further enhanced release but resulted in a reduction in the ratio between high and low frequency stimulations, suggesting that IVM is enhancing release largely through changes in terminal excitability and not vesicular content. Thus, IVM is increasing striatal dopamine release through enhanced cholinergic activity on dopamine terminals.
Reduction of low-frequency oscillations in cerebral circulation correlates with pupil dilation during cognition: an fNIRS study
Authors: Moreno-Castillo Mayra , Manjarrez Elias
Published: December 2023

Numerous studies have utilized functional near-infrared spectroscopy (fNIRS) to investigate brain hemodynamics during diverse cognitive tasks. However, although these studies have consistently reported increased oxygenation levels in the prefrontal cortex, they have not explored their effects on the amplitude of brain low-frequency oscillations (LFO). Additionally, other reports have shown that pupil dilation occurs during cognitive tasks, which may indicate a correlation between LFO amplitude and pupil dilation. However, no study has demonstrated such a correlation. Our research has two aims: firstly, to analyze the impact of cognitive tasks on the amplitude of LFO using oxyhemoglobin (HbO2) fNIRS signals, and secondly, to assess the relationship between the amplitude of these LFO and pupil diameters during such cognitive tasks. We found that during arithmetic tasks, the brain LFOs recorded on the prefrontal cortex were temporarily reduced while pupil diameter increased. These findings offer new insights into the physiological functions of reactivity of LFO in cerebral circulation. Additionally, combining fNIRS signals to track LFO on the prefrontal cortex with pupil measurement shows the feasibility of developing efficient hybrid brain-computer interfaces of LFO-pupil detection capable of predicting the initiation and ending of cognitive processes.

Significant statement

Inspired by the Berger effect, which demonstrates alpha wave reactivity with eye-opening, our study investigated reactivity in other physiological oscillations related to brain hemodynamics during cognition. Our findings revealed a novel phenomenon: a temporary reduction in the amplitude of low-frequency oscillations (LFOs) of oxyhemoglobin (HbO2) in the brain’s prefrontal cortex, concurrent with increased pupil diameter during arithmetic tasks. This discovery expands our knowledge of LFO in cerebral circulation and creates new avenues for studying fNIRS-LFO reactivity during cognitive tasks in healthy individuals and patients.
iTraNet: A Web-Based Platform for integrated Trans-Omics Network Visualization and Analysis
Authors: Sugimoto Hikaru , Morita Keigo , Li Dongzi , Bai Yunfan , Mattanovich Matthias , Kuroda Shinya
Published: December 2023

ABSTRACT

A major goal in biology is to comprehensively understand molecular interactions within living systems. Visualization and analysis of biological networks play crucial roles in understanding these biochemical processes. Biological networks include diverse types, from gene regulatory networks and protein–protein interactions (PPIs) to metabolic networks. Metabolic networks include substrates, products, and enzymes, which are regulated by allosteric mechanisms and gene expression. Given this complexity, there is a pressing need to investigate trans-omics networks that include these various regulations to understand living systems. However, analyzing various omics layers is laborious due to the diversity of databases and the intricate nature of network analysis. We developed iTraNet, a user-friendly interactive web application that visualizes and analyzes trans-omics networks involving four major types of networks: gene regulatory networks (including transcription factor, microRNA, and mRNA); PPIs; metabolic networks (including enzyme, mRNA, and metabolite); and metabolite exchange networks (including transporter, mRNA, and metabolite). Using iTraNet, we found that in wild-type mice, hub molecules within the network tended to respond to glucose administration, whereas inob/obmice, this tendency disappeared. With its ability to facilitate network visualization and analysis, we anticipate that iTraNet will help researchers gain insights into biological systems. iTraNet is available at (https://transomics.streamlit.app/).

GRAPHICAL ABSTRACT
Translating from mice to humans: using preclinical blood-based biomarkers for the prognosis and treatment of traumatic brain injury
Authors: Lisi Ilaria , Moro Federico , Mazzone Edoardo , Marklund Niklas , Pischiutta Francesca , Kobeissy Firas , Mao Xiang , Corrigan Frances , Helmy Adel , Nasrallah Fatima , Pietro Valentina Di , Ngwenya Laura B , Portela Luis , Semple Bridgette , Smith Douglas H. , Wellington Cheryl , Loane David J , Wang Kevin , Zanier Elisa R ,   the InTBIR Fundamental & Translational Working Group
Published: December 2023

Rodent models are important research tools for studying the pathophysiology of traumatic brain injury (TBI) and developing potential new therapeutic interventions for this devastating neurological disorder. However, the failure rate for the translation of drugs from animal testing to human treatments for TBI is 100%, perhaps due, in part, to distinct timescales of pathophysiological processes in rodents versus humans that impedes translational advancements. Incorporating clinically relevant biomarkers in preclinical studies may provide an opportunity to calibrate preclinical models to human TBI biomechanics and pathophysiology. To support this important translational goal, we conducted a systematic literature review of preclinical TBI studies in rodents measuring blood levels of clinically used NfL, t-Tau, p-Tau, UCH-L1, or GFAP, published in PubMed/MEDLINE up to June 13th, 2023. We focused on blood biomarker temporal trajectories and their predictive and pharmacodynamic value and discuss our findings in the context of the latest clinical TBI biomarker data. Out of 369 original studies identified through the literature search, 71 met the inclusion criteria, with a median quality score on the CAMARADES checklist of 5 (interquartile range 4-7). NfL was measured in 17 preclinical studies, GFAP in 41, t-Tau in 17, p-Tau in 7, and UCH-L1 in 19 preclinical studies. Data in rodent models show that all blood biomarkers exhibited injury severity-dependent elevations, with GFAP and UCH-L1 peaking within hours after TBI, NfL peaking within days after TBI and remaining elevated up to 6 months post-injury, whereas t-Tau and p-Tau levels were gradually increased many weeks after TBI. Blood NfL levels emerges as a prognostic indicator of white matter loss after TBI, while both NfL and GFAP hold promise for pharmacodynamic studies of neuroprotective treatments. Therefore, blood-based preclinical biomarker trajectories could serve as important anchor points that may advance translational research in the TBI field. However, further investigation into biomarker levels in the subacute and chronic phases will be needed to more clearly define pathophysiological mechanisms and identify new therapeutic targets for TBI.