bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of clinicopathologic characteristics and prognosis of gastric cancer in patients <40 years
Authors: Liu Lifeng , Lin Jina , Zhao Jingrun , Yan Peng
Published: August 2023

An increase trend and a bad prognosis toward gastric cancer (GC) in individuals <40 years have been observed over the past few decades. GC in Young adult needs further evaluation to identify clear risk factors for early screening and better prognosis. A total of 126 young adult patients with gastric cancer (individuals <40 years) (YG) were collected in Liaocheng hospital in China from Jan 2003 to Dec 2019. The overall median follow-up was 96.5 months (rang 1–192 months). Survival was determined by the Kaplan–Meier method and the difference in survival among different subgroups were assessed using the log-lank test. Correlations between risk factors and overall survival were assessed by univariate and multivariate Cox proportional hazards regression analysis. Advanced stage cancer at onset and undifferentiated histologic tumor type were the prominent clinicopathological features of YG. The 5-year overall survival of the YG was 31.7%. The 5-year survival of the YG differed from tumor staging and treatment methods. The 5-year survival was 100% in stage I group, 58.8% in stage II group, 22.6% in stage III group, and 8.3% in stage IV group respectively. The 5-year survival was 52.1% in the curative resection group versus 3.8% in the non-curative resection group. Multivariate analysis displayed that tumor staging (P = .002) and treatment method (P = .034) were 2 independent prognostic predictors for survival. GC in young adult patients have unique clinicopathological features. Upper gastrointestinal endoscopy should regularly perform for young adult especially those symptomatic patients. Early diagnosis and then proceed to a successful curative resection are vital for a better prognosis.
Real-world treatment patterns and survival for locally advanced esophageal squamous cell carcinoma
Authors: Luo Hua-Chun , Wu Jing-Jing , Zhu Li-Jun , Cai Lv-Juan , Feng Jing , Shen Zhi-Yong , Wu Meng-Jing , Chen Fei-Fan , Fu Zhi-Chao , Xie Fang-Wei
Published: August 2023

The “real world” treatment mode and clinical efficacy of locally advanced esophageal squamous cell carcinoma (LAESCC) are unclear. Meanwhile, the role of immunotherapy in the clinical practice is also puzzling. We conducted the research to investigate the statue of “real world” LAESCC. The clinical data of patients with locally advanced esophageal squamous cell carcinoma which met the criteria from January 2010 to December 2019 have been retrospectively analyzed, and the distribution of clinical treatment patterns has been analyzed. They cover such aspects as dfferences in survival time and further analysis of the differences in overall survival (OS) and progression-free survival (PFS) between patients who received immunotherapy and those who did not receive immunotherapy. What is more, Cox risk regression model has also been used to evaluate the risk factors affecting the prognosis of LAESCC. The cases of a total of 5328 newly diagnosed patients with esophageal cancer were collected, and a total of 363 patients were included in the study, with a median age of (46.2 ± 7.8) years old; 84 (23.1%) and 279 (76.9%) patients received 1L and ≥ 2L, respectively; Concurrent chemoradiotherapy (74.1%) and paclitaxel combined with platinum-based chemotherapy (14.3%) were the main first-line treatment options; fluorouracil combined with cisplatin regimen-based chemotherapy (63.8%) was the main treatment option for ≥ 2L, of which 69 patients (25.3%) received immunization treatment; OS of patients with 1 line of therapy and ≥ 2L were (22.4 ± 7.2) months and (38.7 ± 8.5) months, respectively, and the comparison between groups was statistically significant (P < .05); among 69 patients with ≥ 2L who received immunotherapy, PFS and The OS was (14.6 ± 6.9) and (45.3 ± 9.7) respectively, and the comparison between the groups was statistically significant (all P < .05). Cox multivariate analysis has shown that clinical stage, immunotherapy, concurrent chemoradiotherapy, and ≥ 2L are the main factors affecting OS. and immunotherapy, concurrent chemoradiotherapy, and ≥ 2L are independent factors affecting PFS. Concurrent chemoradiotherapy is currently one of the standard treatments for LAESCC, and most patients are still willing to receive second-line or above treatments. Adding immunotherapy to standard treatment modalities may further optimize clinical treatment modalities and improve patient outcomes.
Changes of health-related quality of life after initiating basal insulin treatment among people with type 2 diabetes
Authors: Zhang Puhong , Bao Yuqian , Chen Minyuan , Zhang Heng , Zhu Dongshan , Ji Linong , Li Xian , Ji Jiachao , Zhao Fang , Fisher Edwin B. , Zhao Yang , Duolikun Nadila , Wang Du , Jia Weiping
Published: August 2023

To assess the association between insulin regimens and health-related quality of life (HRQoL) after the introduction of basal insulin (BI) among people with type 2 diabetes in real-world clinical settings. 16,339 registered people with diabetes who had inadequate glycaemic control by oral agents initiated BI (either single BI or Basal-bolus) and completed a 6-month follow-up from 209 hospitals were included in the analyses. At the end of the follow-up, the switches of insulin regimens, change of HRQoL (EQ-5D-3L) and their associations were assessed. Initial insulin regimens of single BI and of basal-bolus (BI included Glargine, Detemir, and Neutral Protamine Hagedorn) accounted for 75.6% and 24.4%, respectively. At 6 months, regimens used were BI alone (65.2%), basal-bolus (10.4%), and premixed (6.4%), whereas 17.9% stopped all insulin therapy. The visual analogue scale score increased by 5.46 (P < .001), and the index value increased slightly by 0.02 (P < .001). Univariate analysis showed that people with diabetes taking basal-bolus regimen had the greatest improvement on HRQoL in all dimensions, especially in the reduction of the percentage of Pain/Discomfort (by 10.03%) and Anxiety/Depression (by 11.21%). In multivariable analysis, single BI or premixed insulin at 6 months was associated with more improvement of visual analogue scale score compared with stopping all insulin. Improved HRQoL was observed after initiating BI in people with type 2 diabetes . If the same achievement on HbA1c control can be guaranteed, single BI is preferred to other regimens from the viewpoint of HRQoL. Basal-bolus has the most significant potential to increase HRQoL, however, the people with diabetes characteristics differ from those initiating BI alone. Further longitudinal cohort study with a longer study period might be necessary to evaluate the certain effect.
The association between albumin and C-reactive protein in older adults
Authors: Jiang Yiqian , Yang Zhenli , Wu Qinghua , Cao Jianhua , Qiu Tiefeng
Published: August 2023

Albumin had been found to be a marker of inflammation. The purpose of our study was to investigate the relationship between albumin and C-reactive protein (CRP) in 3579 participants aged 60 to 80 years from the National Health and Nutrition Examination Survey (NHANES). In order to evaluate the association between albumin and CRP, We downloaded the analyzed data (2015–2018) from the NHANES in the United States, and the age of study population was limited to 60 to 80 years (n = 4051). After exclusion of subjects with missing albumin (n = 456) and CRP (n = 16) data, 3579 subjects aged 60 to 80 years were reserved for a cross-sectional study. All measures were calculated accounting for NHANES sample weights. We used the weighted χ2 test for categorical variables and the weighted linear regression model for continuous variables to calculate the difference among each group. The subgroup analysis was evaluated through stratified multivariable linear regression models. Fitting smooth curves and generalized additive models were also carried out. We found albumin negatively correlated with CRP after adjusting for other confounders in model 3 (β = −0.37, 95% CI: −0.45, −0.28, P < .0001). After converting albumin from a continuous variable to a categorical variable (quartiles), albumin level was also negatively associated with serum CRP in all groups (P for trend < .001 for each). In the subgroup analysis stratified by gender, race/ethnicity, smoking, high blood pressure, the negative correlation of albumin with CRP was remained. We also found that the level of CRP further decreased in other race (OR: −0.72, 95% CI: −0.96, −0.47 P < .0001) and participants with smoking (OR: −0.61, 95% CI: −0.86, −0.36 P < .0001). Our findings revealed that albumin levels was negatively associated with CRP levels among in USA elderly. Besides, CRP level decreased faster with increasing albumin level in other race and participants with smoking. Considering this association, hypoalbuminemia could provide a potential predictive biomarker for inflammation. Therefore, studying the relationship between albumin and CRP can provide a screening tool for inflammation to guide therapeutic intervention and avoid excessive correction of patients with inflammation.
Research on the psychological status of medical staff during the COVID-19 epidemic in China: A longitudinal study
Authors: Li Shanshan , Shang Shasha , Wang Junrong , Yang Boyi , Jiang Wei
Published: August 2023

An online questionnaire, including the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), was used to assess the psychological status of medical staff in Wuhan during the COVID-19 epidemic. Lasso-Logistic regression analysis was performed to analyze the risk factors of abnormal psychological status (anxiety or depression). 36.6% of the study subjects experienced anxiety, and 41.5% experienced depression. Female (OR [odds ratio] = 7.22, 95% CI [confidence interval]: 0.58–89.33), basic diseases (OR = 17.95, 95% CI: 1.59–202.49), suspected exposure history (OR = 9.63, 95% CI: 1.40–66.29), smoking (OR = 6.07, 95% CI: 0.38–96.78) were risk factors for anxiety. Female (OR = 5.00, 95% CI: 0.45–55.91), basic diseases (OR = 37.19, 95% CI: 2.70–512.73), suspected exposure history (OR = 5.10, 95% CI: 0.78–33.10), drinking wine (OR = 6.27, 95% CI: 0.38–103.85) were risk factors for depression. The results of the re-sampling evaluation after 2 years showed that some medical staff still showed anxiety (42.4%) and depression (27.3%), and the proportion of females was higher. Early intervention should be carried out, and short-term and long-term intervention plans should be formulated.
Long-term outcomes of large balloon dilatation for benign anastomotic stricture following surgical resection of esophageal cancer
Authors: Bi Yonghua , Ren Jianzhuang , Han Xinwei
Published: August 2023

Surgical resection of esophageal cancer may result in benign anastomotic strictures, which are usually treated by balloon dilatation. Here we reported the long-term outcomes of large balloon dilatation for benign anastomotic strictures secondary to esophagectomy for esophageal cancer. From February 2011 to December 2016, 27 esophageal cancer patients underwent large balloon dilatation for benign strictures following surgical resection. Clinical success rate, number of dilatation sessions, complication rate, and mortality rate were evaluated. A total of 27 patients developed a benign stricture at the esophagectomy site. A total of 50 dilatation sessions of large balloon were performed, with a mean of 1.8 sessions per patients (range 1.0–5.0). Only 1 perforation was observed (2.0% per dilatation session), and required no surgery. No procedure-related deaths were recorded. Large balloon dilation was technically successful in the remained 26 patients (96.3%). Dysphagia score and stricture index decreased significantly (P < .0001). Proximal diameter of stricture, stricture diameter and length decreased significantly. Patients were followed up for 36.3 ± 7.1 months, and 14 patients survived without dysphagia. The survival rates were 95.0%, 69.1%, 34.5% for 1, 5, and 9 years, respectively. The median survival was 96.0 months. Large balloon dilatation can be a safe and feasible treatment for benign anastomic strictures following surgical resection of esophageal cancer, with a low perforation rate. However, further study compared with small balloon dilatation is warranted.
Causal association between psycho-psychological factors, such as stress, anxiety, depression, and irritable bowel syndrome: Mendelian randomization
Authors: Diao Zhihao , Xu Wenchang , Guo Danyang , Zhang Jingzhi , Zhang Ruiyu , Liu Fengzhao , Hu Yufei , Ma Yuxia
Published: August 2023

Background:

Pathogenesis, diagnosis, and treatment of irritable bowel syndrome (IBS) have been reported to be challenging hotspots in clinical practice. Previous observational studies have found that stress, anxiety, depression, and other mental and psychological diseases are closely associated with IBS. This study aimed to further explore the causal relationships of these associations through Mendelian randomization (MR).

Methods:

The data needed for MR were obtained from publicly published genome-wide association databases. We performed a bidirectional, 2-sample MR analysis using instrumental variables (IV) associated with stress, anxiety, and depression, and other mental and psychological factors as exposures and IBS as the outcome. A reverse MR analysis with IBS as exposure and stress, anxiety, depression, and other mental and psychological factors as the outcomes was also performed. The inverse variance weighting (IVW) method was adopted as the main method of MR, and the causal effect between stress, anxiety, depression, and other mental and psychological factors and IBS was evaluated as the main result of the study. In addition, a series of sensitivity analyses was conducted to comprehensively evaluate the causal relationship between them.

Results:

Stress, anxiety, depression, and other mental and psychological factors were the underlying etiologies for IBS (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.03–1.08), and they were positively correlated. Univariate analysis further supported the above conclusions (Depression, [OR = 1.31, 95% CI: 1.05–1.63, P = .016], Anxiety, [OR = 1.53, 95% CI: 1.16–2.03, P = .003]). However, in reverse MR analysis, we found that IBS did not affect stress, anxiety, depression, or other mental and psychological factors and that there was no causal relationship between IBS and stress, anxiety, depression, or other mental and psychological factors (P > .05).

Conclusion:

This study demonstrates that mental and psychological factors are the underlying etiologies for IBS. These findings may provide important information for physicians regarding the clinical treatment of IBS.
Comparative analysis of the effectiveness difference of SARS-COV-2 mRNA vaccine in different populations in the real world: A review
Authors: Cai Sihui , Chang Chunyan , Zhang Xiuhong , Qiao Weizhen
Published: August 2023

Coronavirus disease 2019 (COVID-19) has ravaged the world since December 2019. Up to now, it is still prevalent around the world. Vaccines are an important means to prevent the spread of COVID-19 and reduce severe disease and mortality. Currently, different types of novel coronavirus vaccines are still being developed and improved, and the relevant vaccines that have been approved for marketing have been widely vaccinated around the world. As vaccination coverage continues to grow, concerns about the efficacy and safety of vaccines after real-world use have grown. Some clinical studies have shown that vaccine effectiveness is closely related to antibody response after vaccination. Among them, the advantages of COVID-19 messenger ribonucleic acid (mRNA) vaccine, such as better adaptability to variant strains and better immune response ability, have attracted great attention. However, different populations with different genders, ages, previous COVID-19 infection history, underlying diseases and treatments will show different antibody responses after mRNA vaccination, which will affect the protection of the vaccine. Based on this, this paper reviews the reports related severe acute respiratory syndrome Coronavirus 2 mRNA vaccines, and summarizes the effectiveness of vaccines in different populations and different disease states and looked forward to the precise vaccination strategy of the vaccine in the future.
The association of hemodynamic markers of right ventricular dysfunction with SII index and clinical outcomes in reduced ejection fraction heart failure
Authors: Balci Kevser , Erbay İlke , Demirkan Burcu , Balci Mustafa Mücahit , Temizhan Ahmet
Published: August 2023

Heart failure (HF) is a clinical syndrome with various etiologies and presentations. The role of the inflammatory pathway in HF prognosis is not fully understood. We investigated the association between the systemic immune-inflammation index (SII) and HF complicated by right ventricular dysfunction (RVD) and whether the SII is related to compromised hemodynamic volume status. A total of 235 patients with HF with reduced ejection fraction (HFrEF) were enrolled and divided into 2 groups according to the presence of RVD. The relationship between the SII score, hemodynamic parameters, and clinical endpoints was evaluated. Higher SII scores and neutrophil counts (P < .001 and P = .017, respectively) were observed in the RVD group (n = 120). In the high SII score group (≥590.4), hospitalization and the need for positive inotrope treatment were significantly higher (P = .026 and P = .009, respectively), and left ventricular ejection fraction (LVEF) was significantly lower (P = .015). In addition, in the high SII score group, right heart catheterization values, including cardiac output and index, were significantly impaired compared with those in the lower SII score group. There was a significant negative correlation between the SII score and the LVEF, cardiac output, and cardiac index in the correlation analyses. A significant relationship was observed between indirect inflammation and RVD in patients with HFrEF. The hemodynamic volume status and functional capacity were impaired in patients with high SII scores. These results indicated that advanced HF with worse outcomes may be related to the inflammatory process.
Application of ultrasound in the management of TRASH (the radiographic appearance seemed harmless) fractures in preschool children: A review
Authors: Jia Guoqiang , Sun Jun
Published: August 2023

Elbow fracture is one of the most common fractures in preschool children, and the secondary ossification center appears regularly with age increasing. Transphyseal separation of the distal humerus, medial humeral condyle fracture, lateral humeral condyle fracture, radial head osteochondral separation, and Monteggia fracture (minimal ulnar bow type) are difficult to diagnose based on X-ray films alone because of the unossified secondary ossification center or a suspicious non-alignment of the anatomical cartilage of the elbow joint in preschool children. These 5 fractures above are defined as The Radiographic Appearance Seemed Harmless fractures in preschool children (TRASH-PS). The TRASH-PS fractures must be taken into consideration when there is swelling at the injured site without fracture feature on X-ray. Additionally, relevant misdiagnosis or unsuitable management can lead to elbow dysfunction and deformity. Therefore, this work reviews the application of ultrasound in the management of TRASH-PS fractures.
Predicting acute pulmonary embolism in COVID-19
Authors: Koc Ibrahim , Deniz Olgun , Ozmen Sevda Unalli , Bulut Sertan
Published: August 2023

Acute pulmonary embolism (PE) is a life-threatening condition in patients with Coronavirus disease-2019 (COVID-19). Computed tomography pulmonary angiography is the preferred test to confirm the diagnosis. However, computed tomography pulmonary angiography is expensive and is not available in every clinic. This study aimed to determine whether clinical findings, symptoms, and parameters that are cost-effective and available in many clinics such as C-reactive protein (CRP) lymphocyte ratio (CLR), and ferritin CRP ratio (FCR) can be used in the diagnosis of PE in patients with COVID-19. Out of the reviewed files, 127 patients were diagnosed with PE, whereas 105 patients had no PE. At the first admission, laboratory parameters, complaints, respiratory rate, and percent oxygen saturation in the blood (SpO2) with a pulse oximeter were recorded for each patient. Eosinophil levels remained lower, whereas ferritin lymphocyte ratio and CLR were higher in the PE group. Patients with more elevated ferritin, CRP, and CLR had an increased mortality risk. Shortness of breath and tiredness was more common in the PE group. A decrease in eosinophil levels, whereas an increase in CLR, D-dimer, and CRP may predict PE. Elevated CLR is highly predictive of PE and is associated with increased mortality risk. COVID-19 patients with a CLR level above 81 should be investigated for PE.
Mechanism, application and effect evaluation of nerve mobilization in the treatment of low back pain: A narrative review
Authors: Chen Quanzheng , Wang Zhenshan , Zhang Shuna
Published: August 2023

Lower back pain is a prevalent condition affecting people across all age groups and causing significant personal and societal burdens. While numerous treatments exist, nerve mobilization has emerged as a promising approach for managing lower back pain. Nerve mobilization involves applying gentle and rhythmic movements to the affected nerves, promoting normal nerve function and releasing tension. It has been well documented that nerve mobilization can be effective in reducing pain and improving function in patients with lower back pain, but the underlying mechanisms have not been clarified. This study aims to review the mechanisms of nerve mobilization in the management of lower back pain, its application, and effectiveness evaluation, and provide a potential solution for managing lower back pain.
A Retrospective Chart Review of Patients with Reactive RPRs in the Emergency Department of an Urban Safety Net Southern Hospital
Authors: Sweitzer Stephanie , Sharp Joseph , Gruen Judah
Published: August 2023

Emergency departments (EDs) are a critical access point to care in safety net health systems. A retrospective chart review of patients with reactive RPRs collected in the ED of an Atlanta safety net hospital from 5/01/2020 to 10/31/2020 found suboptimal rates of syphilis treatment completion and linkage to PrEP services.
The Immediate Contraction of the Expanded Forehead Flap
Authors: Song Zhen , Zhang Xulong , Xu Yihao , You Jianjun , Wang Huan , Zheng Ruobing , Tian Le , Guo Junsheng , Fan Fei
Published: August 2023

Introduction:

Flaps contract immediately after harvest, which added difficulty to flap design. This study aims to investigate the immediate contraction rate of the expanded forehead flap used in nasal reconstruction.

Methods:

Patients undergoing nasal reconstruction with expanded forehead flaps from September 2021 to January 2023 were included. Objective measurements of the pedicle width, maximum width, maximum length, and flap size of the expanded forehead flap before and after harvest were conducted.

Results:

Fourteen patients, including 9 males and 5 females, were included. The average expansion period was 4.6 months, and the mean injection volume was 658.6 ml. The average retraction rate of pedicle width, maximum width, maximum length, and size of the flap after harvest were 16.15%, 30.26%, 26.86%, and 50.89%, respectively.

Conclusion:

This study presents the contraction rate of the expanded forehead flap used for nasal reconstruction. The data from the measurement will help surgeons to design the expanded forehead flap.

Level of Evidence:

Level—Level IV
Classification of Skeletal Phenotypes of Preadolescent Patients With Isolated Cleft Palate Using Principal Component Analysis and Cluster Analysis
Authors: Baek Seung-Hak , Hong Hyunseung , Yang II-Hyung , Chung Jee Hyeok , Choi Jin-Young , An Jung-Sub
Published: August 2023

This study aimed to classify the skeletal phenotypes of preadolescent patients with isolated cleft palate using principal component analysis and cluster analysis. Sixty-four preadolescent female patients with isolated cleft palate (incomplete hard palate and complete soft palate cleft group, n=51; complete cleft of the hard and soft palate group, n=13; the mean age when lateral cephalograms were taken, 7.08±0.76 y) were included. Ten angular and 2 ratio cephalometric variables were measured on a lateral cephalogram. Cluster analysis was performed using 3 representative variables obtained from principal component analysis (SN-GoMe, SNA, and SNB). The differences in the variables among the clusters were characterized using the Kruskal–Wallis test. As a result of the analysis, 6 clusters were obtained from 3 groups: the retrusive maxilla and mandible group: cluster 3 (14.1%, moderately hyperdivergent pattern), cluster 5 (17.2%, severely hyperdivergent pattern); the normal maxilla and mandible group: cluster 1 (23.4%, normodivergent pattern), cluster 4 (12.5%, moderately hyperdivergent pattern), cluster 6 (20.3%, severely hyperdivergent pattern); the normal maxilla and protrusive mandible group: cluster 2 (12.5%, normodivergent pattern). The distribution of isolated cleft palate types did not differ among the 6 clusters (P>0.05). Two thirds of the patients (68.7%, clusters 1, 2, 4, and 6) had a normal anteroposterior position of the maxilla, while one third of the patients (31.3%, clusters 3 and 5) showed a retrusive mandible. These results indicate that isolated cleft palate patients have diverse maxillo-mandibular growth patterns compared with patients with cleft lip and palate.
Occlusal Plane Angle as a Key Factor for Chin Protrusion After Mandibular Osteotomy in Skeletal Class III
Authors: Shido Rena , Morita Yukiko , Nishioka-Sakamoto Kie , Narahara Shun , Koga Takamitsu , Yoshida Noriaki , Asahina Izumi , Ohba Seigo
Published: August 2023

There is no treatment algorithm to decide whether maxillomandibular or mandibular osteotomy alone should be performed in borderline cases. This study assessed the factors that affect the changes in soft tissue after mandibular setback. Patients who underwent mandibular osteotomy alone to correct mandibular protrusion were included in this study. Hard and soft tissue analyses were performed on lateral cephalograms before and 12±3 months after surgery. The popular points were set for referencing hard and soft tissues on the lateral cephalogram. Nasolabial, labiomental, and soft tissue facial plane angles were measured for the soft tissue assessment. To assess the mandibular setback amount, SNB was calculated. Twenty-one patients were included in this study. The nasolabial angle was increased after surgery and its change significantly correlated with the change in SNB (P=0.00815). The change in soft tissue facial plane angle after surgery per change in SNB significantly correlated with the occlusal plane angle (P=0.0009). An occlusal plane angle of at least 15.45 degrees was required for the SNB and soft tissue facial plane angle to change to the same degree. The occlusal plane angle (whether or not it was ≥15.45 degrees) may help in determining the surgical approach in borderline cases, specifically on whether maxillomandibular or mandibular osteotomy alone should be performed if the mandibular setback is simple.
A Clinical Observation Study for Transnasal Endoscopic Marsupialization in the Treatment of Maxillary Cyst
Authors: Xu Dapeng , Han Maoqiang , Cao Rongyu , Liu Dianwei , Zhang Qingquan , Sun Chao
Published: August 2023

The aim of this study was to investigate the feasibility and evaluate the clinical effects of transnasal marsupialization of maxillary cyst under nasal endoscope. Twenty patients with maxillary bone cysts were treated with endoscopic marsupialization. According to the location of the maxillary bone cyst, the opening window was selected in the nasal base or the inferior or middle nasal meatus. The cyst wall of the window was removed, and the fluid was drained out. The diameter of the opening window was more than 1 cm, so that the cyst and the maxillary sinus can be fused into a cavity. This ensured nasal drainage through the cyst cavity and nasal cavity or maxillary sinus. The patients were followed up for 6 to 18 months. No serious complications occurred. The cyst wall epithelialized 2 or 3 months after the operation, and the cyst cavity drained well with no recurrence. Intranasal marsupialization under a nasal endoscope is a feasible alternative for the treatment of maxillary cysts. It makes the procedure simple, safe, less traumatic, has definite clinical effects, and low recurrence rate. Especially suitable for maxillary cysts protruding into the nasal floor or maxillary sinus.
Hemophagocytic lymphohistiocytosis due to Burkholderia pseudomallei in a primigravida.
Authors: al Waseem Shaikh Mohammed Haroon , Antony Tessa , Suresh Suchitra , Gopalan Sowmya
Published: August 2023

Introduction: Melioidosis is caused by Burkholderia pseudomallei, a gram-negative, saprophytic bacilli, commonly found in soil or contaminated water. As infection with this bacterium produces a wide variety of clinical manifestations the organism is aptly called the “great mimicker”. Even though it is non-fastidious and an easily cultivable organism, it can be misidentified in the automated identification systems.
Case report: A 24-year-old primigravida presented with complaints of fever and myalgia of 45 days duration. She was diagnosed to have hemophagocytic lymphohistiocytosis (HLH) based on clinical and laboratory parameters. Blood and bone marrow culture sent to the microbiology laboratory grew non fermenting gram negative bacilli which was misidentified as Burkholderia cepacia by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) technology . It was further identified as B.pseudomalleiby 16S ribosomal RNA sequencing. Patient was commenced on intensive phase therapy with intravenous ceftazidime for 2 weeks, followed by maintenance therapy with oral  trimethoprim and sulfamethoxazole for 3 months. In view of HLH, she was treated with intravenous dexamethasone for 2 weeks which was later switched over to oral dexamethasone for a period of 6 weeks.  She responded well to the treatment, but had to undergo medical termination of pregnancy as there was severe intrauterine growth restriction of the foetus.
Conclusion: Prognosis of melioidosis is excellent if early diagnosis and appropriate antibiotic treatment is provided. In this era of automation, it is important to find out if the suspected pathogen is listed in the database of the automated identification system.
Monitoring the battleground: Exploring Antimicrobial Resistance, Antibiofilm Trends, and Virulence Factors in Wound Bacterial Isolates.
Authors: Awuor Silas Onyango , Omwenga Eric O. , Mariita Richard M. , Musila Jonathan , Musyoki Stanslaus
Published: August 2023

There is an alarming increase in antibiotic resistance especially on common bacterial infections that could be attributed to extensive unregulated use of antibiotics.   Continuous strategic monitoring of antibiotic use and AMR trends becomes imperative. This serves as a motivation to a thorough evaluation of wound isolates for relevant bacteria and assessing their drug susceptibility patterns, which we report herein. This cross-sectional study aimed to decipher antibacterial resistance by examining samples collected from patients with chronic wounds seeking medication at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Standard microbiological methods were employed to identify and characterize the bacterial pathogens. Analysis of the wound isolates revealed a significant presence of microbial growth, with a higher prevalence of59% isolates in male patients. Staphylococcus aureus 20.7%emerged as the most predominant pathogen, followed by Klebsiella spp.14.8%, P. aeruginosa spp. 14.8%, and E. coli 4.4% in the wound samples. Notably, Cotrimoxazole exhibited the highest antibacterial resistance 48.1%, followed by Clindamycin 25.9% and Erythromycin 25.9%, affecting both Gram-positive and Gram-negative bacteria. Furthermore, among the isolates, 75% were capable of producing haemolysin and protease, while 50% produced lipase and phospholipase, factors that enhance virulence and survival. These findings provide crucial insights into antimicrobial resistance in chronic wounds, emphasizing the importance of responsible antibacterial use in wound management. Additionally, they shed light on the need for developing more potent antibiotics for effectively treating chronic wounds.
Inter-laboratory Variability of Caspofungin Minimum Inhibitory Concentrations for Nakaseomyces glabrata isolates – An Irish Tertiary Hospital Experience
Authors: Ali Saied , Collison Meadhbh , McNicholas Sinead , McDermott Sinead
Published: August 2023

Background:
Nakaseomyces glabrata, formerly Candida glabrata, is an opportunistic yeast and emerging cause of human infections. The use of broth microdilution (BMD) methodologies for caspofungin (CSP) antifungal susceptibility testing (AFST) against N. glabrata is reported to be prone to high inter-laboratory variation. We aimed to compare CSP minimum inhibitory concentrations (MICs) of N. glabrata isolates from our institution with those obtained by the Reference Laboratory for the same isolates.
 
Methods:
All clinically significant N. glabrata isolates from 2019-2021 inclusive were reviewed. AFST was performed locally using the VITEK2 system with the AST-YS08 card, while E-tests were performed at Mycology Reference Laboratory (MRL), and agreement between these two methods was evaluated – categorical and essential.
 
Results:
41 isolates were reviewed during the study period – 30 from blood cultures, seven from intra-operative theatre specimens and four from sterile site drain fluids. Despite an essential agreement of 100% within ±2 log2 dilutions, marked discrepancies were noted in interpretative breakpoints between assays with 17 Minor and 16 Major category errors. Categorical agreement was 19.5%, with the VITEK2 over-estimating resistance. A Mann-Whitney U Test assessed the relationship of MICs across the AFST modalities, and a statistically significant difference was noted, p<0.01, with a higher mean rank for VITKEK2 outputs. 
 
Conclusion:
While the VITEK2 system is highly applicable, its performance for CSP AFST is unreliable and potentially results in the mis-classification of susceptible isolates as highlighted in our study. The use of VITEK2 AST-YS08 micafungin as a sentinel echinocandin should be explored and/or the evaluation of CSP-specific E-tests as utilised by the MRL. These methods appear more consistent and less prone to the variation seen with BMD for CSP.
Participation Questionnaire for Preschoolers with Autism Spectrum Disorder: Item Development
Authors: Nakamura Takuto , Koyama Sakumi , Nagayama Hirofumi , Sasada Satoshi
Published: August 2023

Occupational therapists need to comprehensively assess participation of children with autism spectrum disorder (ASD) in daily activities and evaluate the effectiveness of relevant interventions. Several participation measurement tools have been developed for children with ASD, but these tools require expert involvement, which is a barrier to large-scale surveys. To address these concerns, a caregiver-administered questionnaire—the Participation Questionnaire for Preschoolers (PQP)—was developed. However, this tool could be improved due to its narrow age range of 48–72 months and because the item development process does not reflect the perspectives of children and caregivers. Therefore, we expanded the PQP’s target age range to 36–83 months and developed new items that reflect the perspectives of professionals and caregivers. Interviews were conducted with eight experts in supporting children with ASD and 11 caregivers of children with ASD. The interviews were transcribed, and a content analysis was performed. The number of questions was reduced from 51 to 36, and the order of items was changed for clarity. Two of the eight sub-domains were removed to clarify the conceptual difference between activity and participation. The updated version of the PQP has two unique features: (1) it can be administered without expert involvement, and (2) it includes items specific to the challenges faced by children with ASD. Future development of the scale and validation of its measurement properties are needed.
Single-cell analysis of Rohon-Beard neurons implicates Fgf signaling in axon maintenance and cell survival
Authors: Tuttle Adam M. , Miller Lauren N. , Royer Lindsey J. , Wen Hua , Kelly Jimmy J. , Calistri Nicholas L. , Heiser Laura M. , Nechiporuk Alex V.
Published: August 2023

Peripheral sensory neurons are a critical part of the nervous system that transmit a multitude of sensory stimuli to the central nervous system. During larval and juvenile stages in zebrafish, this function is mediated by Rohon-Beard somatosensory neurons (RBs). RBs are optically accessible and amenable to experimental manipulation, making them a powerful system for mechanistic investigation of sensory neurons. Previous studies provided evidence that RBs fall into multiple subclasses; however, the number and molecular make up of these potential RB subtypes have not been well defined. Using a single-cell RNA sequencing (scRNA-seq) approach, we demonstrate that larval RBs in zebrafish fall into three, largely non-overlapping classes of neurons. We also show that RBs are molecularly distinct from trigeminal neurons in zebrafish. Cross-species transcriptional analysis indicates that one RB subclass is similar to a mammalian group of A-fiber sensory neurons. Another RB subclass is predicted to sense multiple modalities, including mechanical stimulation and chemical irritants. We leveraged our scRNA-seq data to determine that the fibroblast growth factor (Fgf) pathway is active in RBs. Pharmacological and genetic inhibition of this pathway led to defects in axon maintenance and RB cell death. Moreover, this can be phenocopied by treatment with dovitinib, an FDA-approved Fgf inhibitor with a common side effect of peripheral neuropathy. Importantly, dovitinib-mediated axon loss can be suppressed by loss of Sarm1, a positive regulator of neuronal cell death and axonal injury. This offers a molecular target for future clinical intervention to fight neurotoxic effects of this drug.
pyScoMotif: Discovery of similar 3D structural motifs across proteins
Authors: Cia Gabriel , Kwasigroch Jean Marc , Stamatopoulos Basile , Rooman Marianne , Pucci Fabrizio
Published: August 2023

Motivation

The fast and accurate detection of similar geometrical arrangements of protein residues, known as 3-dimensional (3D) structural motifs, is highly relevant for many applications such as binding region and catalytic site detection, drug discovery and structure conservation analyses. With the recent publication of new protein structure prediction methods, the number of available protein structures is exploding, which makes efficient and easy-to-use tools for identifying 3D structural motifs essential.

Results

We present an open-source Python package that enables the search for both exact and mutated motifs with position-specific residue substitutions. The tool is fast, accurate and suitable to run both on computer clusters and personal laptops. Successful application of pyScoMotif to catalytic site identification is showcased.

Availability

The pyScoMotif package can be installed from the PyPI repository and is also available athttps://github.com/3BioCompBio/pyScoMotif. It is free to use for non-commercial purposes; for commercial purposes, please contact us.
Mechano-signaling of prostate tumor initiating cells facilitates their tropism to stiff metastatic niche
Authors: Chen Lanpeng , Zhao Gangyin , De Menna Marta , Coppola Stefano , Landman Nick , Schieven Sebastiaan , Groenewoud Arwin , Thalmann George N. , Schmidt Thomas , de Vries Jelle , Kruithof-de Julio Marianna , Snaar-Jagalska Ewa B.
Published: August 2023

Analysis of clinical datasets indicate that cancer stem-like cells/tumor-initiating cells (CSCs/TICs) derived from prostate cancer (PCa) patients display an elevated expression of genes for cell-matrix interactions, cell adhesion proteins and of the putative mechanotransducer TAZ. Here we combined measurements on the cellular mechano-responses to matrix stiffness, including cell-generated forces, zebrafish and PDX-derived organoid models, to show that mechanotransduction serves as a key determinant for PCa CSC maintenance during metastatic onset. The β1-integrin-ILK-CDC42-N-Wasp dependent cytoskeletal tension and TAZ nucleus-translocation mediate this mechano-signaling axis. As a result, expression of the stemness genes NANOG and OCT4 are induced, leading to metastatic tumor initiation. It is further demonstrated that pharmaceutical perturbation of this mechano-signaling using a novel YAP/TAZ inhibitor K975 constrains PCa metastasis in zebrafish, and development of PDX-derived organoids. Our data highlights the essential role of mechanotransduction in PCa aggressiveness, thereby underlying this pathway as a therapeutic target for future studies.
Glyco-Engineering Cell Surfaces by Exo-Enzymatic Installation of GlcNAz and LacNAz Motifs
Authors: De León González Fabiola V. , Boddington Marie E. , Prindl Martha I. , Capicciotti Chantelle J.
Published: August 2023

Exo-enzymatic glyco-engineering of cell-surface glycoconjugates enables the selective display of well-defined glyco-motifs bearing bioorthogonal functional groups which can be used to study glycans and their interactions with glycan-binding proteins. While the installation of monosaccharides and their derivatives using glycosyltransferase enzymes has rapidly evolved, similar strategies to introduce chemical-reporter functionalized Type 2 LacNAc motifs have not been reported. Herein, we report the chemo-enzymatic synthesis of unnatural UDP-GlcNAc and UDP-GalNAc nucleotide-sugars, and the donor and acceptor substrate tolerance of the human glycosyltransferases B3GNT2 and B4GalT1, respectively, to form derivatized LacNAc moieties. We also demonstrate that B3GNT2 can be used to exo-enzymatically install GlcNAc and GlcNAz onto cell-surface glycans. GlcNAc- or GlcNAz-engineered cells can be further extended by B4GalT1, producing LacNAc or LacNAz-engineered cells. Our glyco-engineering labeling strategy is amenable to different cell types and our work expands the exo-enzymatic glycan editing toolbox to selectively introduce unnatural Type 2 LacNAc motifs.
SIMVI reveals intrinsic and spatial-induced states in spatial omics data
Authors: Dong Mingze , Su David , Kluger Harriet , Fan Rong , Kluger Yuval
Published: August 2023

Spatial omics technologies enable the analysis of gene expression and interaction dynamics in relation to tissue structure and function. However, existing computational methods may not properly distinguish cellular intrinsic variability and intercellular interactions, and may thus fail to capture spatial regulations for further biological discoveries. Here, we present Spatial Interaction Modeling using Variational Inference (SIMVI), an annotation-free framework that disentangles cell intrinsic and spatial-induced latent variables for modeling gene expression in spatial omics data. We derive theoretical support for SIMVI in disentangling intrinsic and spatial-induced variations. By this disentanglement, SIMVI enables estimation of spatial effects (SE) at a single-cell resolution, and opens up various opportunities for novel downstream analyses. To demonstrate the potential of SIMVI, we applied SIMVI to spatial omics data from diverse platforms and tissues (MERFISH human cortex, Slide-seqv2 mouse hippocampus, Slide-tags human tonsil, spatial multiome human melanoma, cohort-level CosMx melanoma). In all tested datasets, SIMVI effectively disentangles variations and infers accurate spatial effects compared with alternative methods. Moreover, on these datasets, SIMVI uniquely uncovers complex spatial regulations and dynamics of biological significance. In the human tonsil data, SIMVI illuminates the cyclical spatial dynamics of germinal center B cells during maturation. Applying SIMVI to both RNA and ATAC modalities of the multiome melanoma data reveals potential tumor epigenetic reprogramming states. Application of SIMVI on our newly-collected cohort-level CosMx melanoma dataset uncovers space-and-outcome-dependent macrophage states and the underlying cellular communication machinery in the tumor microenvironments.
Dysregulation of extracellular vesicle protein cargo in female ME/CFS cases and sedentary controls in response to maximal exercise
Authors: Giloteaux Ludovic , Glass Katherine A. , Germain Arnaud , Zhang Sheng , Hanson Maureen R.
Published: August 2023

In healthy individuals, physical exercise improves cardiovascular health and muscle strength, alleviates fatigue, and reduces risk of chronic diseases. Although exercise is suggested as a lifestyle intervention to manage various chronic illnesses, it negatively affects people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), who suffer from exercise intolerance. We hypothesized that altered extracellular vesicle (EV) signaling in ME/CFS patients after an exercise challenge may contribute to their prolonged and exacerbated negative response to exertion (post-exertional malaise). EVs were isolated by size exclusion chromatography from the plasma of 18 female ME/CFS patients and 17 age- and BMI-matched female sedentary controls at three time points: before, 15 minutes, and 24 hours after a maximal cardiopulmonary exercise test. EVs were characterized using nanoparticle tracking analysis and their protein cargo was quantified using Tandem Mass Tag-based (TMT) proteomics. The results show that exercise affects the EV proteome in ME/CFS patients differently than in healthy individuals and that changes in EV proteins after exercise are strongly correlated with symptom severity in ME/CFS. Differentially abundant proteins in ME/CFS patients vs. controls were involved in many pathways and systems, including coagulation processes, muscle contraction (both smooth and skeletal muscle), cytoskeletal proteins, the immune system, and brain signaling.
Sex-dependent effects of stress on insular cortex-to-nucleus accumbens synaptic plasticity
Authors: Gauthier Manon , Dugast Emilie , Lardeux Virginie , Letort Kevin , Belnoue Laure , Balado Eric , Solinas Marcello , Belujon Pauline
Published: August 2023

Stress is an important risk factor for the development of psychiatric disorders and men and women tend to react differently to stress. Sex differences are also observed in many stress-related psychiatric disorders such as depression, anxiety disorders or addiction. Therefore, identifying specific neuroadaptations induced by stress, in males and females, is a necessary step to the understanding of stress-related sex dimorphism in these disorders. Here, we tested the hypotheses that acute stress could affect plasticity in the anterior insular cortex (aIC)-nucleus accumbens core (NAcC) pathway, two structures involved in the stress response, in a sex-dependent manner. Usingin vivoextracellular recordings in anesthetized rats, we show that synaptic plasticity in the aIC-NAcC pathway is different between male and female rats. Whereas in males, long-term potentiation and long-term depression were equally induced, in females, there was mostly a long-term potentiation induced. Moreover, stress affected synaptic plasticity in the aIC-NAcC differently in male and female rats. In males, stress induced a loss of long-term-depression that lasted for at least 24h, whereas in females, stress induced less neurons displaying LTP, which did not last.

These results demonstrate that integration of aIC information to NAcC is different between males and females. This study provides mechanistic support for differential reactivity to stress between males and females that may relate to stress-related psychiatric disorders and sex dimorphism in these disorders.