bluuebunny/crossref_metadata_2025 huggingface dataset:
Intentional replantation and dental autotransplantation of mandibular posterior teeth: Two case reports
Authors: Wang Yao , Hofmann Maria , Ruf Sabine , Zhang Jian , Huang Qiuju
Published: November 2023

Background:

Intentional replantation and dental autotransplantation are 2 similar techniques both involving atraumatic tooth extraction, visualization of the root, and replantation. They are considered as the last resort for unsalvageable teeth. The author aims to describe 2 mandibular posterior teeth with serious periapical lesions which are resolved by intentional replantation and dental autotransplantation, respectively.

Case summary:

In case 1, a 45-year-old male patient received root canal treatment because of a cracked mandible right first molar with periapical lesions. An endodontic file was separated in the apical third of the mesiolingual root canal. After conventional canal filling of the other root canals, the molar was atraumatically extracted. The separated instrument was removed, the mesiolingual root received a retrograde filling and the molar was replanted. At the 3-month follow up, the patient was asymptomatic and the X-ray picture showed no detectable root resorption and ankylosis. In case 2, a 29-year-old woman reported discomfort during occlusal loading after a root canal treatment and a coronal restoration of the mandibular right first molar. Radiographs showed a low-density shadow in the mesial apical and in the root furcation area of the mandibular first molar so the patient was diagnosed as chronic periapical periodontitis. After the removal of the affected tooth, the extraction socket was thoroughly debrided and irrigated. The intact mandibular right third molar with similar dimensions was extracted by minimally invasive procedure and transplanted. The donor tooth was fixed by a fiber-splint for 1 month and a root canal treatment was performed 2 weeks after surgery. After 1 year, clinical and radiographical examination revealed functional and periodontal healing.

Conclusions:

These 2 reports present the successful management of intentional replantation and dental autotransplantation. Both procedures are recommended after nonsurgical endodontic treatment, especially when apical microsurgery is not an option, for example because of difficult accessibility or patient preference.
Vitamin B12 status among asymptomatic young adult females and its association with some anthropometric and biochemical parameters: A cross-sectional study from Makkah (cobalamin deficiency in young adult females)
Authors: Basalamah Mohammad A. , Ibrahim Mohammed O. , Qutob Maysoun S. , Jazar Abdelelah S. , Bakr El-Sayed H. , Alazzeh Awfa Y. , Al-Slaihat Abed H. , Azzeh Firas S.
Published: November 2023

This study was designed to measure the prevalence of vitamin B12 deficiency among young adult females in Makkah City and study its correlation with some anthropometric and biochemical indicators. A cross-sectional study and a detailed questionnaire were used to collect information from 402 young women aged 19 to 22 years, who were university students. Moreover, dietary assessments using a validated food frequency questionnaire and anthropometric measurements were performed. The mean values of serum vitamin B12, serum folate, hemoglobin, and body mass index (BMI) were 343.29 ± 148.16 pg/mL, 12.72 ± 2.62 ng/mL, 12.69 ± 1.41 g/dL, and 22.64 ± 4.24 kg/m2, respectively. About three-quarters of the study sample had normal vitamin B12 levels, while the rest had vitamin B12 deficiency. Meanwhile, a significant negative association (r = −0.201, P = .048) was found between abdominal fat and serum vitamin B12 levels. This study concluded that the young adult females’ population from Makkah City is among the risk groups for vitamin B12 deficiency, which is highly correlated with inappropriate values of weight, body fat, and some blood indices. Appropriate dietary interventions and awareness are needed for this population.
Prediction of leg-length discrepancy in pediatric femoral shaft fracture using bone SPECT/CT: A case report
Authors: Wang Sung Il , Jeong Hwan-Jeong , Lim Seok Tae , Han Yeon-Hee
Published: November 2023

Rationale:

Children’s bones are in the process of growing in both length and width. Therefore, evaluating whether fractures affect the growth plate or not is very crucial. However, even in cases of lower limb fractures where the growth plate remains unaffected, overgrowth or shortening of the affected limb are encountered.

Patient concerns:

An 11-year-old boy was admitted to the emergency department after a passenger car accident.

Diagnoses:

A comminuted fracture of the right femoral shaft was diagnosed by X-ray image.

Interventions:

Closed reduction and internal fixation were performed using intramedullary titanium elastic nails. Six months after the operation, bone union was achieved and the nails were removed.

Outcomes:

Nine months after nail removal, the right leg was unexpectedly noticed 5 mm shorter than the left one. On the initial and follow-up bone single-photon emission computed tomography/computed tomography images with a 9-month interval, radioactivity of growth plate in the right proximal femur was much lower than that of the left femur, suggesting a further increasing of leg-length discrepancy (LLD) in the future. As we expected, LLD had progressively increased up to 20 mm. Epiphysiodesis was finally decided for the left distal femur. Twenty-two months after the length equalization operation, LLD decreased to 5 mm.

Lessons:

This case emphasizes that quantitative analysis of growth plate activity using bone single-photon emission computed tomography/computed tomography could predict LLD and help us decide when and which limb should be operated on for pediatric patients with lower limb fractures.
Comparison of UPDRS III score between young and late onset Parkinson disease after deep brain stimulation: A meta-analysis
Authors: Lee Jae Meen , Pak Kyoungjune
Published: November 2023

Purpose:

Parkinson disease (PD) is a common age-related neurodegenerative disease. Subthalamic nucleus deep brain stimulation (DBS) is a safe and effective surgical treatment for medically resistant advanced PD. However, the relationship between the age at PD onset and the efficacy of subthalamic nucleus DBS surgery remains unclear. Thus, we conducted a meta-analysis to compare motor symptom improvements after DBS for the treatment of young-onset and late-onset PD.

Methods:

We systematically searched the Medline and Embase databases (from inception to March 2023) for English publications. All published studies comparing the outcomes (Unified Parkinson’s Disease Rating Scale part III [UPDRS III] scores) of DBS between the young-onset Parkinson disease (YOPD) and late-onset Parkinson disease (LOPD) groups were identified. The effect size was defined as the standardized mean difference (Hedge g) with 95% confidence intervals. The standardized mean difference was calculated by dividing the difference in UPDRS III scores between old and young patients by the pooled and weighted standard deviations. The meta-analysis was performed using R Statistical Software version 4.2.2 (The R Foundation for Statistical Computing).

Results:

Six studies were eligible for inclusion. The standardized mean difference of UPDRS III score between young and old patients ranged from −0.54 to 1.43 with a pooled difference of 0.0932 (95% confidence intervals: − 0.4666 to 0.6530, I
2 = 86.77%). Subgroup analyses were performed with a cutoff age of 65 years and did not show a significant difference in UPDRS III scores between patients with YOPD and LOPD (0.1877, −0.6663 to 1.0417).

Conclusions:

The efficacy of DBS in patients with YOPD and LOPD showed similar improvements in the UPDRS score; hence, DBS should be considered, if necessary, regardless of the onset age of PD.
The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke
Authors: Tutal Gürsoy Görkem , Görgülü Ümit , Tengirşenk Zeynep , Bektas Hesna
Published: November 2023

Especially in recent years, temporal muscle thickness has been used as an important parameter for sarcopenia in neurological disorders. In addition, triglyceride glucose index was evaluated separately in studies conducted in terms of coronary diseases, diabetes, high blood pressure, body mass index and acute stroke. In this clinical study, unlike the others, both temporal muscle thickness and triglyceride glucose index were evaluated together in acute stroke patients in terms of sarcopenia. We aimed to investigate the relationship between temporal muscle thickness and triglyceride glucose index, which is atherosclerotic index, with mortality and 3rd month functional outcomes in acute stroke patients. In this retrospective study, 147 patients admitted to Ankara City Hospital with the diagnosis of acute ischemic stroke between January 2021 and September 2022 were evaluated. Fasting triglyceride glucose indexes of the patients were calculated. The temporal muscle thickness measurement of the patients was performed by the radiologist using computed tomography images. Those who scored 3 or higher on the modified Rankin Scale (mRS) at the third month were considered to have poor functional outcome. A significant cutoff point was found for estimating mortality for the temporal muscle thickness parameter [area under the curve for a receiver operating characteristic curve (AUC) = 0.636; P = .012]. The cutoff point was obtained as ≤ 5.2. Sensitivity value was 65%, specificity value was 65%, the positive predictive value (PPV) value was 42.62% and the negative predictive value (NPV) value was 82.28%. Similarly, for the triglyceride glucose index parameter, there was a significant cutoff point in estimating mortality (AUC = 0.673; P = .003). The cutoff point was obtained as ≥ 8.23. Sensitivity value was 91.18%, specificity value was 13%, PPV value was 26.96% and NPV value was 81%. Temporal muscle thickness and triglyceride glucose index parameters were found to be statistically important parameters of sarcopenia. It was concluded that the evaluation of these 2 parameters in terms of both mortality and sarcopenia in acute stroke patients is important in the evaluation of neurological and cardiac disorders.
Application of functional magnetic resonance imaging for evaluation of cartilage injury effect on knee joint function by recurrent patellar dislocation
Authors: Chen Yanbo , Wang Zijie , Zhang Shenlu , Jin Chengzhe
Published: November 2023

Explore the therapeutic effect of vastus medialis oblique plasty and the reliability and applicability of functional magnetic resonance imaging as a diagnostic method for early cartilage degeneration and injury diagnosis. From July 2020 to July 2022, there were 53 patients with recurrent patellar dislocation who met the inclusion criteria for surgery, including 34 women and 19 men, aged 11 to 53 years, with an average age of 24.4 years. After patient selection, functional magnetic resonance imaging was performed before surgery. According to the presence or absence of cartilage injury, they were divided into cartilage injury group (n = 28) and non-cartilage injury group (n = 25), and underwent vastus medialis oblique plasty. Preoperative patellar axial radiographs were performed in both groups of patients to measure the patellar tilt angle and lateral patellofemoral angle. The Lysholm, Kujala, and VAS (visual analogue scale) scores were applied to assess changes in knee joint function and anterior knee pain. All patients were postoperatively followed up. The patellar tilt angle and lateral patellofemoral angle of the 2 groups were significantly improved postoperatively (P < .05), with no statistical difference between the 2 groups (P > .05). Significant differences were observed in the VAS changes between the cartilage injury group and the non-cartilage injury group before and after operation (P < .05). There was a statistical difference in VAS score between the groups (P < .05). The changes in the Lysholm and Kujala scores before and after the operation in the cartilage injury and the non-cartilage injury groups were statistically different (P < .05). There was statistical difference between the 2 groups in Lysholm score and Kujala score after operation (P < .05). Vastus medialis oblique plasty significantly improved knee joint function and pain. Patients with cartilage injury had worse preoperative and postoperative knee function than patients without cartilage injury. Functional magnetic resonance imaging can reflect the early-stage changes in the biochemical cartilage components caused by recurrent patellar dislocation.
Establishment of a 6-signature risk model associated with cellular senescence for predicting the prognosis of breast cancer
Authors: Zhang Xiu-Xia , Yu Xin , Zhu Li , Luo Jun-Hua
Published: November 2023

This study focused on screening novel markers associated with cellular senescence for predicting the prognosis of breast cancer. The RNA-seq expression profile of BRCA and clinical data were obtained from TCGA. The pam algorithm was used to cluster patients based on senescence-related genes. The weighted gene co-expression network analysis was used to identify co-expressed genes, and LASSO-Cox analysis was performed to build a risk prognosis model. The performance of the model was also evaluated. We additionally explored the role of senescence in cancer development and possible regulatory mechanism. The patients were clustered into 2 subtypes. A total of 5259 genes significantly related to senescence were identified by weighted gene co-expression network analysis. LASSO-Cox finally established a 6-signature risk model (ADAMTS8, DCAF12L2, PCDHA10, PGK1, SLC16A2, and TMEM233) that exhibited favorable and stable performance in our training, validation, and whole BRCA datasets. Furthermore, the superiority of our model was also observed after comparing it to other published models. The 6-signature was proved to be an independent risk factor for prognosis. In addition, mechanism prediction implied the activation of glycometabolism processes such as glycolysis and TCA cycle under the condition of senescence. Glycometabolism pathways were further found to negatively correlate with the infiltration level of CD8 T-cells and natural killer cells but positively correlate with M2 macrophage infiltration and expressions of tissue degeneration biomarkers, which suggested the deficit immune surveillance and risk of tumor migration. The constructed 6-gene model based on cellular senescence could be an effective indicator for predicting the prognosis of BRCA.
Duodenal ulcer bleeding from a branch of the middle colic artery: A case report
Authors: Shishido Yutaka , Mitsuoka Eisei , Tanigawa Yuma , Ooki Hodaka , Shio Seiji , Monzawa Shuichi , Ishii Masayuki , Fujimoto Koji
Published: November 2023

Rationale:

Duodenal ulcer bleeding is a potentially life-threatening condition commonly caused by the erosion of the duodenal arteries.

Patient concerns:

A 55-year-old male was referred to our hospital with abdominal pain for the past 3 days. Contrast-enhanced computed tomography of the abdomen revealed wall thickening in the descending part of the duodenum and a cystic lesion (27 × 19 mm) contiguous with the duodenum, with an accumulation of fluid. An esophagogastroduodenoscopy showed the significantly stenotic duodenum, which prevented passage of the endoscope and evaluation of the main lesion. Based on these findings, duodenal ulcer perforation and concomitant abscess formation were suspected. Two days after admission, he had massive hematochezia with bloody drainage from the nasogastric tube.

Diagnoses:

Emergency angiography revealed duodenal ulcer bleeding from the gastroduodenal artery and the branch artery of the inferior pancreaticoduodenal artery and middle colic artery (MCA).

Interventions:

The patient was treated with transcatheter arterial embolization (TAE) of the gastroduodenal artery, the branch vessel of the inferior pancreaticoduodenal artery, and the main trunk of the MCA.

Outcomes:

Hemostasis was achieved with TAE. The patient recovered uneventfully and undergone a gastro-jejunal bypass surgery for the duodenal stenosis 2 weeks after TAE. He was discharged without any abnormal complaints on postoperative day 12.

Lessons:

We have experienced a rare case of duodenal ulcer bleeding from a branch of the MCA. In patients with refractory upper gastrointestinal bleeding, careful evaluation of bleeding sites is recommended considering unexpected culprit vessels.
Effective resection of dermatofibrosarcoma protuberans using the novel Saturn’s rings technique
Authors: Kim Geon Woo , Bae Yong Chan , Hong Jung Hyun , Kim Hoon-Soo , Yi Changryul Claud
Published: November 2023

Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade sarcoma with locally infiltrative characteristics. A wide excision is made with a 5 cm gross margin. However, recently, Mohs micrographic surgery has emerged as an alternative. In this study, we evaluate a novel method (Saturn’s Rings technique) for removing tumors that combines the advantages of wide excision and Mohs micrographic surgery. Between September 2001 and March 2020, 29 patients with DFSP, excluding the head and neck, were treated using Saturn’s rings technique. Frozen biopsies were performed at regular intervals under various conditions and depths. If the biopsy was positive, a negative margin was obtained through an additional session. The depth and breadth of excision, reconstruction method, and postoperative recurrence were analyzed. The breadth of excision was evaluated at 1 cm intervals. Only 1 session was required in 12 cases, 2 sessions were needed in 13 cases, and 3 or more sessions were performed in 4 cases. In 24 cases, the depth of excision was limited to above the superficial fascia, with a negative biopsy of the superficial fascia. Local flaps were the most common reconstruction method (n = 21, 72.4%). No cases of recurrence were observed at follow-up (average, 45.7 months). Saturn’s rings technique for DFSP maximized the preservation of normal tissue with minimal resection, was advantageous for reconstruction, and yielded good results without recurrence.
Thematic maps with scatter and 4-quadrant plots in R to identity dominant entities on schizophrenia in psychiatry since 2017: Bibliometric analysis
Authors: Jang Fong-Lin , Chien Tsair-Wei , Chou Willy
Published: November 2023

Background:

Schizophrenia affects more than 21 million people worldwide. There have been a number of articles published in the literature regarding schizophrenia. It is unclear which authors contributed the most to the field of schizophrenia. This study examines which article entities (affiliated countries, institutes, journals, and authors) earn the most research achievements (RAs) and whether keywords in articles are associated with the number of article citations.

Methods:

As of August 25, 2022, 20,606 abstracts published on schizophrenia in psychiatry since 2017 were retrieved from the WoS core collection (WoSCC). RAs were measured using the category, JIF, authorship, and L-index (CJAL) score. The follower-leading cluster algorithm (FLCA) was used to examine clusters of keywords associated with core concepts of research. There were 7 types of visualizations used to report the study results, including Sankey diagrams, choropleth maps, scatter charts, radar plots, and cluster plots. A hypothesis was examined that the mean number of citations for keywords could predict the number of citations for 100 top-cited articles(T100SCHZ).

Results:

The results indicate that the US (18861), Kings College London (U.S. (2572), Psychiatry (14603), and Kolanu Nithin (Australia) (9.88) had the highest CJAL scores in countries, institutes, departments, and authors, respectively. The journal of Schizophrenia Res had higher citations (19,017), counts (1681), and mean citations (11.31) in journals. There was a significant correlation between article citations and weighted keywords (F = 1471.74; P < .001).

Conclusion:

Seven visualizations were presented to report the study results, particularly with thematic maps using scatter and 4-quadrant plots produced in R programming language. We recommend that more future bibliographical studies utilize CAJL scores and thematic maps to report their findings, not restrict themselves solely to schizophrenia in psychiatry as done in this study.
Incidence, mortality and survival of transitional cell carcinoma in the urinary system: A population-based analysis
Authors: Tang Xiaofeng , Zhan Xiangpeng , Chen Xiaomin
Published: November 2023

The goal of this study is exploring the disparity of incidence, mortality and survival outcome among transitional cell carcinomas (TCCs) in the 4 parts of urinary system. This study comprehensively evaluates these disparities using the Surveillance, Epidemiology, and End Results (SEER) (2000–2018) database. According to the SEER database, the urinary tract is divided into 4 parts: urinary bladder, renal pelvis, ureter, and urethra. The joinpoint regression was used to analyze the secular trend of incidence and incidence-based mortality (IBM). The Kaplan–Meier method with the log-rank test is performed to evaluate survival outcomes. The bladder TCC has the highest age-adjusted incidence and mortality rate compared with TCC in other 3 locations. A slight decrease in incidence is shown in the both bladder and urethra TCCs during 2000–2018. The age-adjusted mortality rate similarly presents an initial increase among 4 locations TCCs at the beginning of study period. The survival curves demonstrate that patients with bladder TCCs have better overall survival (OS) and cancer-specific survival (CSS), whereas those with renal pelvis TCCs have the worse OS and CSS. In addition, patients with bladder TCC have the highest 1-year, 3-year, 5-year relative survival rate, and those with renal pelvis TCC have the lowest. These disparities are especially essential when we explore tumor characteristics and treatment, extrapolated from the literature on bladder TCC for upper tract urothelial carcinoma (UTUC). Notably, patients with bladder TCC especially for localized stage have better survival outcomes than those with UTUC.
Prognostic significance of a five-factor modified frailty index in patients with gastric cancer undergoing curative-intent resection: A cohort study
Authors: An Soomin , Eo Wankyu , Lee Sookyung
Published: November 2023

The 5-factor modified frailty index (mFI-5) evaluates frailty based on variables including functional status, diabetes, chronic obstructive pulmonary disease, congestive heart failure, and hypertension requiring medication. Despite its effectiveness in predicting surgical risk, the potential of mFI-5 as a predictor of long-term survival in patients with gastric cancer (GC) has not been investigated. This study aims to assess the prognostic significance of mFI-5 in patients with GC who have undergone curative-intent gastric resection. Among the 494 patients diagnosed with stage I to III GC, multivariate analysis revealed that age, tumor–node–metastasis (TNM) stage, geriatric nutritional risk index, mFI-5, and the type of gastrectomy were significant predictors for both overall survival (OS) and disease-free survival (DFS). We assessed 3 models: Baseline model (BM, TNM stage only), interim model (IM, all significant variables except mFI-5), and full model (FM, all significant variables including mFI-5). FM outperformed BM for OS (C-index 0.818 vs 0.683; P < .001) and DFS (C-index 0.805 vs 0.687; P < .001). Similarly, IM outperformed BM for OS (C-index 0.811 vs 0.683; P < .001) and DFS (C-index 0.797 vs 0.687; P < .001). Multiple metrics consistently supported the improved discriminative capacity of FM and IM compared to BM. However, while FM exhibits enhanced predictive capacity over IM, this improvement lacks statistical significance across key metrics. In conclusion, our study highlights the clinical significance of the mFI-5, along with age, TNM stage, geriatric nutritional risk index, and type of gastrectomy, as valuable predictors of long-term survival in GC patients. The FM consistently demonstrates enhanced predictive accuracy compared to the BM. However, it is important to note that while the FM improves predictive power over the IM, this enhancement does not achieve statistical significance across multiple metrics. These findings collectively emphasize the potential clinical value of the FM as a robust tool for surgeons in predicting long-term survival outcomes before surgery in patients with GC.
Causal relationship between dried fruit intake and frozen shoulder: Two-sample Mendelian randomization
Authors: Deng Guang-Hua
Published: November 2023

To investigate the causal relationship between dried fruit intake and frozen shoulder using Mendelian randomization (MR). Genome wide association studies were conducted to pool data and select genetic loci independently associated with dried fruit intake and frozen shoulder in people of European ancestry as instrumental variables. Three MR analyses, inverse variance weighting, weighted median and MR-Egger, were used to investigate the causal relationship between dried fruit intake and frozen shoulder. Heterogeneity and multiplicity tests were used, and sensitivity analyses were conducted using the leave-one-out method to explore the robustness of the results. The inverse variance weighting results showed an OR (95 % CI) of 0.52 (0.34–0.80), P = .003, suggesting that there is a causal relationship between dried fruit intake and frozen shoulder. And no heterogeneity and multiplicity were found by the test and sensitivity analysis also showed robust results. The present study used a two-sample MR analysis, and by analyzing and exploring the genetic data, the study showed that too little intake of dry fruits is a risk factor for developing frozen shoulder.
Mechanism of action of Huangbaichen Sanwei formulation in treating T2DM based on network pharmacology and molecular docking
Authors: Li Chunnan , Shen Jiaming , Jing Xiaolong , Zhang Kaiyue , Liu Lu , Wang Yuelong , Zhang Hui , Sun Jiaming
Published: November 2023

Huangbaichen Sanwei formulation (HBCS) has been reported to have a good hypoglycemic effect, but its pharmacological mechanism of action remains unclear. We used network pharmacology and molecular docking to explore the potential mechanism of action of HBCS against type-2 diabetes mellitus (T2DM). Fifty-five active components from HBCS interfered with T2DM. Twenty-five core targets, such as AKT1, INS, INSR, MAPK1 were identified. Enrichment analyses showed that HBCS was involved mainly including insulin receptor signaling pathway, extracellular region, and insulin-like growth factor receptor binding and other biological processes; common targets had roles in treating T2DM by regulating diabetic cardiomyopathy and insulin resistance. Molecular docking verified that components combined with core targets. HBCS play a part in treating T2DM through multiple components and targets at the molecular level, which lays a theoretical foundation for research using HBCS to treat T2DM. The components, predicted targets, and T2DM targets of HBCS were searched through databases, and common targets were determined. Further screening of the core targets was conducted through the establishment of a protein -protein interaction network. The core targets were analyzed by Gene Ontology (GO) annotation utilizing the DAVID platform. And the enrichment of signaling pathways was explored by employing the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Cytoscape 3.9.1 was employed to construct a “TCM-components-core target-pathway” network. Autodock Vina was used to dock molecules to compare the binding activity of active molecules with targets.
Preference between Chinese and Western medicines for hypertension treatment: Evidences based on Chinese population aged ≥ 45 years
Authors: Zhang Hangjing , Ding Ye , Qin Shangren
Published: November 2023

Hypertension is one of the chronic diseases that threaten the health of the elderly population. This study aims to explore the treatment and medication preferences in Chinese elderly patients (≥45 years old) with hypertension, and to investigate the relevant influencing factors. A cross-sectional design was adopted. Utilizing the data from the public database CHARLS 2018, the factors influencing the treatment and medication preference among the elderly hypertensive patients were explored with multinomial logistic regression models. A total of 6588 hypertensive patients aged ≥ 45 years were included in this study, of which 5135 (77.94%) received treatment. Besides, 4939 (96.18%) chose oral medication, which was the most preferred treatment for these patients. The proportion of patients who chose “oral medication only” increased with age, but decreased with educational level and self-reported health. Patients with higher educational levels were more likely to choose other modalities of treatment. In particular, patients with better self-reported health were more willing to try traditional Chinese medication (TCM). Lower income group without medical insurance preferred to choose “Chinese medicine only.” Patients aged ≥ 75 years, urban residents, and those with 2 or more chronic diseases were more willing to try combined Chinese and Western medicines. Patients’ preference for TCM therapy was correlated positively with the provincial economic welfare factor, and negatively with the provincial medical and social welfare factors. During treatment of patients with hypertension, clinicians should pay attention to their preferences and formulate personalized regimens for them, in order to improve their compliance with treatment. Additionally, the government should steadily improve the local medical benefits, thereby facilitating the promotion and application of local TCM services.
Preimplantation genetic testing and prenatal diagnosis in a family with pseudovaginal perineoscrotal hypospadias: A case report
Authors: Chen Jiayao , Zhang Zhiping , Shi Wenjing , Yan Qin , Bi Xingyu , Zhu Pengfei , Zhang Dongdong , Wu Xueqing
Published: November 2023

Rationale:

Pseudovaginal perineoscrotal hypospadias (PPSH) is a rare autosomal recessive disorder of sex development caused by biallelic mutations in SRD5A2. PPSH is characterized by a vaginal-like blind ending perineal opening, penoscrotal hypospadias, and impaired masculinization.

Patient concerns:

We reported preimplantation genetic testing and prenatal diagnosis in a family with PPSH.

Diagnosis:

Whole-exome sequencing of the family identified 2 SRD5A2 pathogenic variants (c.578A>G and c.607G>A). Haplotype analysis showed that the variants were inherited from the previous generation of this family.

Interventions:

During subsequent in vitro fertilization, preimplantation genetic testing was performed on 9 embryos. One unaffected embryo was transferred, resulting in a singleton pregnancy.

Outcomes:

The prenatal diagnosis at 20 weeks’ gestation confirmed the fetus was unaffected. A healthy female infant weighing 3100 g and measuring 50 cm was delivered vaginally at 39+5 weeks of gestation.

Lessons subsections:

This case highlights the use of preimplantation genetic testing and prenatal diagnosis to prevent the transmission of PPSH in families at risk. Our approach provides an effective strategy for identification and management of families with autosomal recessive disorders like PPSH.
Anesthetic management for surgery in a nemaline myopathy patient with difficult airway: A CARE-compliant case report
Authors: Jung Hoon , Kim Hyunjee , Lee See Woo
Published: November 2023

Rationale:

Nemaline myopathy (NM) is a congenital disease characterized by nonprogressive or slowly progressing muscle weakness and may increase the risk of anesthesia in case of respiratory muscle or cardiac involvement. Care should be taken to prevent respiratory failure after surgery.

Patient concerns:

A 35-year-old man with NM, who had difficult airway, restrictive ventilatory pattern, and pulmonary hypertension, required general anesthesia for surgery because of limited mouth opening.

Diagnoses:

The patient was diagnosed with NM (ACTA1 mutation) and coronoid hyperplasia.

Interventions:

Awake fiberoptic nasal intubation was performed following preparations for analgesia. General anesthesia was maintained using inhalational anesthetics and opioids without using neuromuscular blocking agents.

Outcomes:

General anesthesia remained well maintained during surgery, with no movement or spontaneous breathing of the patient and he recovered from anesthesia uneventfully without complications.

Lessons:

This report highlights the safe performance of anesthesia induction and recovery in a case where anesthesia management is necessary for surgery in a patient of NM at a high risk of anesthesia-related complications.
Development and validation of multi-omic prognostic signature of anoikis-related genes in liver hepatocellular carcinoma
Authors: Ding, Dongxiao , Wang, Dianqian , Qin Yunsheng
Published: November 2023

Liver hepatocellular carcinoma (LIHC) is characterized by high morbidity, rapid progression and early metastasis. Although many efforts have been made to improve the prognosis of LIHC, the situation is still dismal. Inability to initiate anoikis process is closely associated with cancer proliferation and metastasis, affecting patients’ prognosis. In this study, a corresponding gene signature was constructed to comprehensively assess the prognostic value of anoikis-related genes (ARGs) in LIHC. Using TCGA-LIHC dataset, the mRNA levels of the differentially expressed ARGs in LIHC and normal tissues were compared by Student t test. And prognostic ARGs were identified through Cox regression analysis. Prognostic signature was established and then externally verified by ICGC-LIRI-JP dataset and GES14520 dataset via LASSO Cox regression model. Potential functions and mechanisms of ARGs in LIHC were evaluated by functional enrichment analyses. And the immune infiltration status in prognostic signature was analyzed by ESTIMATE algorithm and ssGSEA algorithm. Furthermore, ARGs expression in LIHC tissues was validated via qRT-PCR and IHC staining from the HPA website. A total of 97 differentially expressed ARGs were detected in LIHC tissues. Functional enrichment analysis revealed these genes were mainly involved in MAP kinase activity, apoptotic signaling pathway, anoikis and PI3K-Akt signaling pathway. Afterward, the prognostic signature consisting of BSG, ETV4, EZH2, NQO1, PLK1, PBK, and SPP1 had a moderate to high predictive accuracy and served as an independent prognostic indicator for LIHC. The prognostic signature was also applicable to patients with distinct clinical parameters in subgroup survival analysis. And it could reflect the specific immune microenvironment in LIHC, which indicated high-risk group tended to profit from ICI treatment. Moreover, qRT-PCR and IHC staining showed increasing expression of BSG, ETV4, EZH2, NQO1, PLK1, PBK and SPP1in LIHC tissues, which were consistent to the results from TCGA database. The current study developed a novel prognostic signature comprising of 7 ARGs, which could stratify the risk and effectively predict the prognosis of LIHC patients. Furthermore, it also offered a potential indicator for immunotherapy of LIHC.
Lumbosacral Paravertebral Tophaceous Gout on an Adolescent Mimicking Malignant Neoplasm in 18F-FDG PET/CT
Authors: Jiao Benzheng , Liu Shanshan , Zhuang Yuying , Zhao Shuangyan , Zhao Hongguang
Published: November 2023

Contrast-enhanced MRI was performed on a 17-year-old adolescent boy with chronic lumbar and lower-limb pain, which had worsened over the past 3 days. It revealed a suspicious malignant mass adjacent to right appendage of L5–S1 vertebrae, with mixed signals and heterogeneous and obvious enhancement. 18F-FDG PET/CT was subsequently performed for staging. It showed an FDG-avid mass with mixed density in right psoas major muscle, involving adjacent appendage of L5–S1 vertebrae. Histopathological examination confirmed the mass to be gouty tophus, characterized by nodular homogeneous pink amorphous deposits around the cartilage tissue, surrounded by histiocytes and multinucleated giant cells.
68Ga-PSMA Uptake in Solar Elastosis
Authors: Calderon Tobar Merve Nida , Önner Hasan , Yavuz Cahit
Published: November 2023

68Ga–prostate specific membrane antigen (PSMA) PET/CT scan for staging revealed increased 68Ga-PSMA uptake in solar elastosis in a patient with prostate cancer. Solar elastosis is a degenerative condition of elastic tissue in the dermis caused by prolonged sun exposure. A few studies have demonstrated 68Ga-PSMA uptake in cutaneous lesions. This case illustrates another instance of a benign cutaneous lesion accompanied by increased 68Ga-PSMA uptake.
Osteonecrosis of the Femoral Head as a Potential Pitfall in 18F-PSMA-1007 PET
Authors: Bailly Matthieu , Ibrahim Nada , Champeaux-Orange Elise , Metrard Gilles
Published: November 2023

PSMA-targeted PET agents are mainly involved for prostate cancer; however, unspecific bone uptakes can be challenging for the clinician. We report the case of a 71-year-old man with history of recurrent prostate cancer initially treated by surgery and radiation therapy. 18F-PSMA 1007 PET/CT was performed. Beside hyperfixing lymph nodes, focal uptake was found in right femoral head with shell subchondral hypofixation and no morphologic correlate on CT. MRI found bilateral osteonecrosis of the femoral head. This case emphasizes that osteonecrosis of the femoral head can mimic a metastasis uptake, even with normal CT, without however the fixation being constant.
Regional White Matter Hyperintensities Relate to Specific Cognitive Abilities in Older Adults Without Dementia
Authors: Membreno Rachel , Thomas Kelsey R. , Calcetas Amanda T. , Edwards Lauren , Bordyug Maria , Showell Maya , Stanfill Morgan , Brenner Einat K. , Walker Kayla S. , Rotblatt Lindsay J. , Brickman Adam M. , Edmonds Emily C. , Bangen Katherine J. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: November 2023

Introduction:

White matter hyperintensities (WMHs) are magnetic resonance imaging markers of small vessel cerebrovascular disease that are associated with cognitive decline and clinical Alzheimer disease. Previous studies have often focused on global or total WMH; less is known about associations of regional WMHs and cognitive abilities among older adults without dementia.

Methods:

A total of 610 older adults with normal cognition (n=302) or mild cognitive impairment (n=308) from the Alzheimer’s Disease Neuroimaging Initiative underwent neuropsychological testing and magnetic resonance imaging. Linear regression models examined associations between regional WMH volumes and cognition, adjusting for age, sex, education, apolipoprotein E ε4 allele frequency, and pulse pressure.

Results:

Among all participants, greater regional WMH volume in all lobes was associated with poorer performance on memory and speed/executive functioning. Among participants with normal cognition, greater temporal and occipital WMH volumes were associated with poorer memory, whereas no regional WMH volumes were associated with speed/executive function.

Discussion:

Results show that greater regional WMH volume relates to poorer cognitive functioning—even among those with normal cognition. Together with results from previous studies, our findings raise the possibility that WMH may be a useful therapeutic target and/or important effect modifier in treatment or prevention dementia trials.
Marinitoga aeolica sp. nov., a novel thermophilic anaerobic heterotroph isolated from a shallow hydrothermal field of Panarea Island in the Aeolian archipelago, Italy
Authors: Postec Anne , Galès Grégoire , Prime Anne-Hélène , Bartoli Manon , Price Roy E. , Vandecasteele Céline , Erauso Gaël
Published: November 2023

A novel thermophilic strain, designated BP5-C20AT, was isolated from the shallow hydrothermal field of the Panarea island in the Aeolian archipelago close to Sicily, Italy. Cells are motile rods surrounded with a ‘toga’, Gram-stain-negative and display a straight to curved morphology during the exponential phase. Strain BP5-C20AT is thermophilic (optimum 55 °C), moderately acidophilic (optimum pH 5.6) and halotolerant (optimum 25 g l−1 NaCl). It can use yeast extract, peptone and tryptone. It uses the following carbohydrates: cellobiose, fructose, glucose, maltose, starch, sucrose and xylan. Elemental sulphur is used as an electron acceptor and reduced to hydrogen sulphide. The predominant cellular fatty acid is C16 : 0. Phylogenetic analysis showed that strain BP5-C20AT shared 97.3 % 16S rRNA gene sequence identity with the closest related species

Marinitoga lauensis

LG1T. The complete genome of strain BP5-C20AT is 2.44 Mb in size with a G+C content of 27.3 mol%. The dDDH and ANI values between the genomes of strains BP5-C20AT and

M. lauensis

LG1T are 31.0 and 85.70% respectively. Finally, from its physiological, metabolic and genomic characteristics, strain BP5-C20AT (=DSM 112332T=JCM 39183 T) is proposed as representative of a novel species of the genus

Marinitoga

named Marinitoga aeolica sp. nov. and belonging to the order

Petrotogales

, in the phylum

Thermotogota

.
Actin cytoskeleton remodeling disrupts physical barriers to infection and presents entry receptors to respiratory syncytial virus
Authors: Kieser Quinten J. , Granoski Madison J. , McClelland Ryley D. , Griffiths Cameron , Bilawchuk Leanne M. , Stojic Aleksandra , Elawar Farah , Jamieson Kyla , Proud David , Marchant David J.
Published: November 2023

RSV is the leading cause of infant hospitalizations and a significant cause of paediatric and geriatric morbidity worldwide. Recently, we reported that insulin-like growth factor 1 receptor (IGF1R) was a receptor for respiratory syncytial virus (RSV) in airway epithelial cells and that activation of IGF1R recruited the coreceptor, nucleolin (NCL), to the cell surface. Cilia and mucus that line the airways pose a significant barrier to viral and bacterial infection. The cortical actin cytoskeleton has been shown by others to mediate RSV entry, so we studied the roles of the RSV receptors and actin remodelling during virus entry. We found that IGF1R expression and phosphorylation were associated with the ability of RSV to infect cells. Confocal immunofluorescence imaging showed that actin projections, a hallmark of macropinocytosis, formed around viral particles 30 min after infection. Consistent with prior reports we also found that virus particles were internalized into early endosome antigen-1 positive endosomes within 90 min. Inhibiting actin polymerization significantly reduced viral titre by approximately ten-fold. Inhibiting PI3 kinase and PKCζ in stratified air-liquid interface (ALI) models of the airway epithelium had similar effects on reducing the actin remodelling observed during infection and attenuating viral entry. Actin projections were associated with NCL interacting with RSV particles resting on apical cilia of the ALIs. We conclude that macropinocytosis-like actin projections protrude through normally protective cilia and mucus layers of stratified airway epithelium that helps present the IGF1R receptor and the NCL coreceptor to RSV particles waiting at the surface.
Seizure forecasting by tracking cortical response to electrical stimulation
Authors: Laiou Petroula , Kraljevic Zeljko , Valentin Antonio , Jewell Sharon , Viana Pedro F. , Mehra Chirag , Dobson Richard J.B. , Schulze-Bonhage Andreas , Dümpelmann Matthias , Denison Timothy J. , Winston Joel S. , Richardson Mark P.
Published: November 2023

Background

Seizure unpredictability is a significant burden in the lives of people with epilepsy. Previously published approaches to seizure forecasting analysed intracranial electroencephalographic recordings (iEEG) and showed that seizures can be forecast above chance levels. Although passive observation of the brain might provide some insights, repeated active perturbation of the cortex and measuring the cortical response may provide more direct information about time-varying cortical excitability.

Objective

The aim of this study is to investigate whether seizures can be forecast by stimulating the cortex via intracranial electrodes and measuring cortical response from the iEEG.

Methods

We studied a cohort of eight patients with treatment-resistant epilepsy who were admitted to King’s College Hospital for presurgical evaluation with iEEG. During their stay, they underwent prolonged single pulse electrical stimulation for approximately one day. Stimuli were delivered every 5 minutes to a constant pair of electrodes and all patients experienced at least one clinical seizure during the period of stimulation. We extracted quantitative features from the iEEG post-stimulus response and developed a logistic regression algorithm to estimate the seizure likelihood at each stimulus. To evaluate the algorithm’s performance, we used improvement over chance (IoC), sensitivity, time spent in warning and Brier Skill score. We also compared performance with seizure prediction based on passive observation of iEEG.

Results

In seven out of eight patients, seizures could be forecast using the post-stimulus response above chance levels (average IoC: 0.74). In comparison, the seizure forecasting performance based on passive (unstimulated) iEEG was less good (average IoC: 0.54).

Conclusions

These results suggest that cortical response to electrical stimulation may aid in the development of seizure forecasting algorithms as well as in the design of novel implantable devices that deliver electrical stimulation to control seizures.
Reduced Achilles tendon stiffness in aging persists at matched activations and associates with higher metabolic cost of walking
Authors: Franz Jason R. , Krupenevich Rebecca L. , Gray Aubrey J. , Batsis John A. , Sawicki Gregory S.
Published: November 2023

The mechanisms responsible for increased walking metabolic cost among older adults are poorly understood. We recently proposed a theoretical premise by which age-related reductions in Achilles tendon stiffness (kAT) can disrupt the neuromechanics of calf muscle behavior and contribute to faster rates of oxygen consumption during walking. The purpose of this study was to objectively evaluate this premise. We quantified kATat a range of matched activations prescribed using electromyographic biofeedback and walking metabolic cost in a group of 15 younger (age: 23±4 yrs) and 15 older adults (age: 72±5 yrs). Older adults averaged 44% less kATthan younger adults at matched triceps surae activations (p=0.046). This effect appeared to arise not only from altered tendon length-tension relations with age, but also from differences in the operating region of those length-tension relations between younger and older adults. Older adults also walked with a 17% higher net metabolic power than younger adults (p=0.017). In addition, we discovered empirical evidence that lesser kATexacts a metabolic penalty and was positively correlated with higher net metabolic power during walking (r=-0.365, p=0.048). These results pave the way for interventions focused on restoring ankle muscle-tendon unit structural stiffness to improve walking energetics in aging.