bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the cobia (Rachycentron canadum) genome: unveiling putative male heterogametic regions and identification of sex-specific markers
Authors: Shen Xueyan , Hu Jie , Yáñez José M , Bastos Gomes Giana , Poon Zhi Weng Josiah , Foster Derick , Alarcon Jorge F , Shao Libin , Guo Xinyu , Shao Yunchang , Huerlimann Roger , Li Chengze , Goulden Evan , Anderson Kelli , Fan Guangyi , Domingos Jose A
Published: July 2024

Background

Cobia (Rachycentron canadum) is the only member of the Rachycentridae family and exhibits considerable sexual dimorphism in growth rate. Sex determination in teleosts has been a long-standing basic biological question, and the molecular mechanisms of sex determination/differentiation in cobia are completely unknown.

Results

Here, we reported 2 high-quality, chromosome-level annotated male and female cobia genomes with assembly sizes of 586.51 Mb (contig/scaffold N50: 86.0 kb/24.3 Mb) and 583.88 Mb (79.9 kb/22.5 Mb), respectively. Synteny inference among perciform genomes revealed that cobia and the remora Echeneis naucrates were sister groups. Further, whole-genome resequencing of 31 males and 60 females, genome-wide association study, and sequencing depth analysis identified 3 short male-specific regions within a 10.7-kb continuous genomic region on male chromosome 18, which hinted at an undifferentiated sex chromosome system with a putative XX/XY mode of sex determination in cobia. Importantly, the only 2 genes within/between the male-specific regions, epoxide hydrolase 1 (ephx1, renamed cephx1y) and transcription factor 24 (tcf24, renamed ctcf24y), showed testis-specific/biased gene expression, whereas their counterparts cephx1x and ctf24x, located in female chromosome 18, were similarly expressed in both sexes. In addition, male-specific PCR targeting the cephx1y gene revealed that this genomic feature is conserved in cobia populations from Panama, Brazil, Australia, and Japan.

Conclusion

The first comprehensive genomic survey presented here is a valuable resource for future studies on cobia population structure and dynamics, conservation, and evolutionary history. Furthermore, it establishes evidence of putative male heterogametic regions with 2 genes playing a potential role in the sex determination of the species, and it provides further support for the rapid evolution of sex-determining mechanisms in teleost fish.
Mid-term outcomes of tricuspid annuloplasty using the Tri-Ad Adams tricuspid annuloplasty ring
Authors: Lee Heemoon , Kim Jihoon , Jung Ji-Hyun , Yoo Jae Suk
Published: July 2024

OBJECTIVES

The Tri-Ad Adams tricuspid annuloplasty ring is a recent innovative prosthesis characterized by a semi-rigid central component and fully flexible extremities. The goal of this study was to assess the short-term and mid-term results following implantation of the Tri-Ad Adams ring.

METHODS

A retrospective analysis was conducted on patients who underwent tricuspid annuloplasty using the Tri-Ad Adams ring between August 2016 and October 2021.

RESULTS

Our study enrolled a total of 248 participants. The median age was 64.0 (interquartile range: 56.0–71.5) years. The median EuroSCORE II was 4.3% (2.7–7.5%), with 37 patients (14.9%) having a history of cardiac operations. Tricuspid regurgitation of grade 2–3 was observed in 63.7% of cases, and the median tricuspid annular diameter was 3.3 (2.8–3.6) cm. Concurrent procedures included mitral valve replacement (n = 160, 64.5%), mitral valve repair (n = 75, 30.2%), aortic valve replacement (n = 72, 29.0%) and the maze procedure (n = 170, 68.5%). Immediate postoperative tricuspid regurgitation≥moderate was present in 1 patient (0.4%). Early death occurred in 14 patients (5.6%). Major complications included low cardiac output syndrome (n = 18, 0.3%), acute kidney injury (n = 14, 5.6%) and permanent pacemaker placement (n = 15, 6.0%). According to the Kaplan–Meier analysis, the 4-year rates of freedom from overall mortality and moderate-to-severe tricuspid regurgitation were 96.9% and 91.6%, respectively. There were no incidents of tricuspid valve reoperations, ring detachment or significant tricuspid stenosis (trans-tricuspid valve gradient ≥ 5 mmHg).

CONCLUSIONS

Tricuspid annuloplasty utilizing the Tri-Ad Adams ring demonstrated favourable outcomes in both the early and midterm periods. Further studies are warranted to confirm the long-term results.
The antiherpetic and anti-inflammatory activity of the frog-derived peptide Hylin-a1
Authors: Chianese Annalisa , Giugliano Rosa , Palma Francesca , Nastri Bianca M , Monti Alessandra , Doti Nunzianna , Zannella Carla , Galdiero Massimiliano , De Filippis Anna
Published: July 2024

Aim

The high incidence of virus-related infections and the large diffusion of drug-resistant pathogens stimulate the search and identification of new antiviral agents with a broad spectrum of action. Antivirals can be designed to act on a single target by interfering with a specific step in the viral lifecycle. On the contrary, antiviral peptides (AVPs) are known for acting on a wide range of viruses, with a diversified mechanism of action targeting virus and/or host cell. In the present study, we evaluated the antiviral potential of the peptide Hylin-a1 secreted by the frog Hypsiobas albopunctatus against members of the Herpesviridae family.

Methods and Results

The inhibitory capacity of the peptide was evaluated in vitro by plaque assays in order to understand the possible mechanism of action. The results were also confirmed by real-time PCR and Western blot evaluating the expression of viral genes. Hylin-a1 acts to block the herpetic infection interfering at the early stages of both herpes simplex virus type 1 (HSV-1) and type 2 infection. Its mechanism is mainly directed on the membrane, probably by damaging the viral envelope. The same effect was also observed against HSV-1 strains resistant to acyclovir.

Conclusions

The data presented in this study, such as the increased activity of the peptide when combined to acyclovir, a weak hemolytic profile, an anti-inflammatory effect, and a tolerable half-life in serum, indicates Hylin-a1 as a novel antiherpetic molecule with promising potential in the clinical setting.
Gas-phase hydrogenation processes of cationic carbon clusters
Authors: Dong Zhenru , Hu Xiaoyi , Liu Jia , Zhen Junfeng , Qin Liping
Published: July 2024

In this work, the gas-phase ion–atom collision reaction between large cationic carbon clusters and H-atoms is investigated. The carbon cluster cations (C$_{48-2*n}$$^+$, n = [0$-$8]) are produced from the photo-fragmentation processes of large PAH (dicoronylene, DC, C$_{48}$H$_{20}$) cations. The hydrogenated carbon cluster cations are efficiently formed (e.g. C$_{44/46}$H$_{9}$$^+$), and no even–odd hydrogenated mass patterns are observed. The hydrogenation behaviour and hydrogenation rate for these carbon cluster cations are the same. With theoretical calculations, the formation and bending processes of carbon cluster cations, the structure of these newly formed hydrogenated carbon cluster cations, and the bonding energies for the hydrogenation pathways are investigated. During the formation process of carbon clusters, the zigzagged edges gradually increase, and the planar configuration tends towards a bent and folded molecular configuration, i.e. from graphene to fullerene structures. The bending process with higher exothermic energies provides a reasonable explanation for the formation of the ‘magic numbers’ (e.g. C-atoms = 44) carbon clusters and their greater stability. The exothermic energy for each hydrogenation reaction pathway is relatively high; consequently, the forms and the hydrogenated states of carbon clusters are complex. The hydrogenation ability of edge carbon sites is higher than that of internal carbon sites; after bending and folding, the hydrogenation ability of these originally internal carbon sites becomes higher due to structural caged. As a result, under the co-evolution interstellar chemistry network, the (hydrogenation) states and forms of carbon compounds are complicated and diverse in the ISM.
Playing with the Canon: Ḥanafī Legal Riddles of the Mamluk Period
Authors: Mauder Christian
Published: July 2024

The article investigates the history of the genre of Ḥanafī legal riddles (alghāz fiqhiyya) during the Mamluk period (648/1250–923/1517). It argues that legal riddles did not constitute ‘useless’ knowledge as earlier scholarship on Islamicate learned riddles had assumed. In contrast, the article shows that the Ḥanafī texts under investigation fulfilled important functions in the transmission of canonized legal scholarship, the performance of madhhab identities, the establishment and maintenance of scholarly prestige and patronage relationships, and the legitimation of political rule. The article demonstrates that in order to fully understand processes of transmission and the canonization of legal knowledge, we must broaden our focus to encompass more than the bodies of knowledge used in qāḍī courts and taught in institutions of higher learning such as madrasas. Instead, we should be open to the possibility that Islamic legal learning and its textual tradition were also shaped by institutions and practices that catered at least as much to the curiosity and aesthetic expectations of the people involved in them as to their desire for practically useful knowledge.
A mechanohydraulic model supports a role for plasmodesmata in cotton fiber elongation
Authors: Hernández-Hernández Valeria , Marchand Olivier C , Kiss Annamaria , Boudaoud Arezki
Published: July 2024

Plant cell growth depends on turgor pressure, the cell hydrodynamic pressure, which drives expansion of the extracellular matrix (the cell wall). Turgor pressure regulation depends on several physical, chemical, and biological factors, including vacuolar invertases, which modulate osmotic pressure of the cell, aquaporins, which determine the permeability of the plasma membrane to water, cell wall remodeling factors, which determine cell wall extensibility (inverse of effective viscosity), and plasmodesmata, which are membrane-lined channels that allow free movement of water and solutes between cytoplasms of neighboring cells, like gap junctions in animals. Plasmodesmata permeability varies during plant development and experimental studies have correlated changes in the permeability of plasmodesmal channels to turgor pressure variations. Here, we study the role of plasmodesmal permeability in cotton fiber growth, a type of cell that increases in length by at least three orders of magnitude in a few weeks. We incorporated plasmodesma-dependent movement of water and solutes into a classical model of plant cell expansion. We performed a sensitivity analysis to changes in values of model parameters and found that plasmodesmal permeability is among the most important factors for building up turgor pressure and expanding cotton fibers. Moreover, we found that nonmonotonic behaviors of turgor pressure that have been reported previously in cotton fibers cannot be recovered without accounting for dynamic changes of the parameters used in the model. Altogether, our results suggest an important role for plasmodesmal permeability in the regulation of turgor pressure.
Enabling science from the Rubin alert stream with Lasair
Authors: Williams Roy D , Francis Gareth P , Lawrence Andy , Sloan Terence M , Smartt Stephen J , Smith Ken W , Young David R
Published: July 2024

Lasair is the UK Community Broker for transient alerts from the Legacy Survey of Space and Time from the Vera C. Rubin Observatory. We explain the system’s capabilities, how users can achieve their scientific goals, and how Lasair is implemented. Lasair offers users a kit of parts that they can use to build filters to concentrate their desired alerts. The kit has novel light-curve features, sky context, watchlists of special sky objects and regions of the sky, dynamic cross-matching with catalogues of known astronomical sources, and classifications and annotations from other users and partner projects. These resources can be shared with other users, copied, and modified. Lasair offers real-time machine-to-machine notifications of filtered transient alerts. Even though the Rubin Observatory is not yet complete, Lasair is a mature system: it has been processing and serving data from the similarly formatted stream of the Zwicky Transient Facility alerts.
A review on molecular scissoring with CRISPR/Cas9 genome editing technology
Authors: Irfan Muskan , Majeed Hammad , Iftikhar Tehreema , Ravi Pritam Kumar
Published: July 2024

Genome editing is a technology to make specific changes in the DNA of a cell or an organism. It has significantly altered the landscape of life sciences, facilitating the establishment of exceedingly customized genetic modifications. Among various genome editing technologies, the CRISPR/Cas9 system, a specific endonuclease induces a double stranded DNA break and enabling modifications to the genome, has surfaced as a formidable and adaptable instrument. Its significance cannot be overstated, as it not only allows for the manipulation of genomes in model organisms but also holds great potential for revolutionary advances in medicine, particularly in treating genetic diseases. This review paper explores the remarkable journey of CRISPR/Cas9, its natural function, mechanisms, and transformative impact on genome editing and finally the use of artificial intelligence and other intelligent manufacturing tools used. The introduction provides the background on genome editing, emphasizing the emergence and significance of CRISPR/Cas9. Subsequent sections comprehensively elucidate its natural function, disease modeling, agriculture, and biotechnology, address therapeutic applications, and ongoing clinical trials while also discussing prospects and ethical implications. We summarized the key findings, indicating that CRISPR/Cas9 has empowered the creation of disease-specific animal models. This provides invaluable insights into pathogenic mechanisms and opens new avenues for drug discovery, reaffirming the transformative impact of CRISPR/Cas9 on genome editing. Finally we discussed the importance of continued research and collaboration for comprehensive utilization of the inherent capabilities of this molecular precision tool in shaping forthcoming advancements.
Insights into brominated flame retardant neurotoxicity: mechanisms of hippocampal neural cell death and brain region-specific transcriptomic shifts in mice
Authors: Kramer Naomi E , Fillmore Courtney E , Slane Elizabeth G , Barnett Lillie M A , Wagner John J , Cummings Brian S
Published: July 2024

Brominated flame retardants (BFRs) reduce flammability in a wide range of products including electronics, carpets, and paint, but leach into the environment to result in continuous, population-level exposure. Epidemiology studies have correlated BFR exposure with neurological problems, including alterations in learning and memory. This study investigated the molecular mechanisms mediating BFR-induced cell death in hippocampal cells and clarified the impact of hexabromocyclododecane (HBCD) exposure on gene transcription in the hippocampus, dorsal striatum, and frontal cortex of male mice. Exposure of hippocampus-derived HT-22 cells to various flame retardants, including tetrabromobisphenol-A (current use), HBCD (phasing out), or 2,2',4,4'-tetrabromodiphenyl ether (BDE-47, phased out) resulted in time, concentration, and chemical-dependent cellular and nuclear morphology alterations, alterations in cell cycle and increases in annexin V staining. All 3 BFRs increased p53 and p21 expression; however, inhibition of p53 nuclear translocation using pifthrin-α did not decrease cell death. Transcriptomic analysis upon low (10 nM) and cytotoxic (10 μM) BFR exposure indicated that HBCD and BDE-47 altered genes mediating autophagy-related pathways. Further evaluation showed that BFR exposure increased LC3-II conversion and autophagosome/autolysosome formation, and co-exposure with the autophagy inhibitor 3-methyladenine (3-MA) attenuated cytotoxicity. Transcriptomic assessment of select brain regions from subchronically HBCD-exposed male mice demonstrated alteration of genes mediating vesicular transport, with greater impact on the frontal cortex and dorsal striatum compared with the dorsal and ventral hippocampus. Immunoblot analysis demonstrated no increases in cell death or autophagy markers, but did demonstrate increases in the SNARE binding complex protein SNAP29, specifically in the dorsal hippocampus. These data demonstrate that BFRs can induce chemical-dependent autophagy in neural cells in vitro and provide evidence that BFRs induce region-specific transcriptomic and protein expression in the brain suggestive of changes in vesicular trafficking.
Association between Intraoperative Hypotension and Postoperative Delirium: A Retrospective Cohort Analysis
Authors: Zarour Shiri , Weiss Yotam , Abu-Ghanim Maher , Iacubovici Liat , Shaylor Ruth , Rosenberg Omer , Matot Idit , Cohen Barak
Published: July 2024

Background

Intraoperative hypotension might contribute to the development of postoperative delirium through inadequate cerebral perfusion. However, evidence regarding the association between intraoperative hypotension and postoperative delirium is equivocal. Therefore, the hypothesis that intraoperative hypotension is associated with postoperative delirium in patients older than 70 yr having elective noncardiac surgery was tested .

Methods

This was a retrospective cohort analysis of patients older than 70 yr who underwent elective noncardiac surgery in a single tertiary academic center between 2020 and 2021. Intraoperative hypotension was quantified as the area under a mean arterial pressure (MAP) threshold of 65 mmHg. Postoperative delirium was defined as a collapsed composite outcome including a positive 4 A’s test during the initial 2 postoperative days, and/or delirium identification using the Chart-based Delirium Identification Instrument. The association between hypotension and postoperative delirium was assessed using multivariable logistic regression, adjusting for potential confounding variables. Several sensitivity analyses were performed using similar regression models.

Results

In total, 2,352 patients were included (median age, 76 yr; 1,112 [47%] women; 1,166 [50%] American Society of Anesthesiologists Physical Status III or greater; 698 [31%] having high-risk surgeries). The median [interquartile range] intraoperative area under the curve below a threshold of MAP less than 65 mmHg was 28 [0, 103] mmHg · min. The overall incidence of postoperative delirium was 14% (327 of 2,352). After adjustment for potential confounding variables, hypotension was not associated with postoperative delirium. Compared to the first quartile of area under the curve below a threshold of MAP less than 65 mmHg, patients in the second, third, and fourth quartiles did not have more postoperative delirium, with adjusted odds ratios of 0.94 (95% CI, 0.64 to 1.36; P = 0.73), 0.95 (95% CI, 0.66 to 1.36; P = 0.78), and 0.95 (95% CI, 0.65 to 1.36; P = 0.78), respectively. Intraoperative hypotension was also not associated with postoperative delirium in any of the sensitivity and subgroup analyses performed.

Conclusions

To the extent of hypotension observed in our cohort, our results suggest that intraoperative hypotension is not associated with postoperative delirium in elderly patients having elective noncardiac surgery.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Skin Barrier Function of Black African and White Nursing Students
Authors: Young Monica , Franken Anja , du Plessis Johannes Lodewykus
Published: July 2024

Aims

Assessment of skin biophysical parameters in a South African nursing population may provide insight in long-term changes in their skin condition in a practical setting. This study aimed to investigate changes in skin barrier function parameters over a period of 2 years, in nursing students completing their tertiary education.

Methods

Transepidermal water loss, stratum corneum (SC) hydration, and skin surface pH were measured in female nursing students (63 white, 42 Black African) three times a year and repeated for 2 years. Linear mixed models and Bonferroni post hoc tests were performed to test changes over time in skin barrier function parameters.

Results

Transepidermal water loss and SC hydration significantly (p< .001) decreased over 2 years in first-year students, whereas only specific differences were established for senior students. Skin surface pH significantly (p< .001) varied over the 2 years with significant increases (p< .031) in the winter months. The only significant difference (p< .001) between white and Black African students was established in skin surface pH.

Conclusion

This study demonstrated the variability of skin barrier function parameters, specifically seasonal variation in skin surface pH. This study also revealed possible long-term changes in skin condition through the recovery of the SC in a practical setting.
Latent class analysis of healthcare workers’ knowledge, attitudes, and practice levels, and risk factors regarding associated with occupational exposure to antineoplastic drugs: A multicenter cross-sectional study
Authors: Cheng Jintao , Yuan Meng , Zhang Shuangfei , Xiao Qingqing , Zhou Qian , Huang Xiaohong
Published: July 2024

The study investigated the health care workers’ knowledge, attitudes, and practice levels regarding occupational protection against antineoplastic drugs (ADs) via analysis of latent classes and their influencing factors. A convenience sampling method was used to select healthcare workers from 7 hospitals in southern China between April and August 2023. A questionnaire based on literature analysis, brainstorming, and Delphi method was used to investigate the knowledge, practice, and attitudes of healthcare workers exposed to ADs for appropriate occupational protection intervention, followed by latent class analysis. The factors influencing latent classes were identified via single-factor analysis and multiple logistic regression. A total of 322 healthcare workers from departments using ADs were surveyed. The knowledge score associated with occupational protection against ADs was 31.95 ± 7.38. The attitude score was 21.08 ± 2.729, while the practice score was 36.54 ± 9.485. The overall score was 89.57 ± 15.497. The healthcare workers were divided into 4 latent classes based on their knowledge, attitude, and practice associated with occupational protection measures against ADs. Healthcare workers in the 4 categories showed significance differences based on professional title, marital status, educational background, and frequency of exposure to ADs (P < .05). The knowledge, attitude, and practice levels of healthcare workers engaged in ADs at work can be divided into 4 latent classes. Despite their increased awareness of the hazards associated with ADs and their attitudes toward protection, the healthcare workers displayed poor knowledge and implementation of occupational protection measures.
Research trends and hotspots in exercise interventions for liver cirrhosis: A bibliometric analysis via CiteSpace
Authors: Wei Tao , Jin Qiguan
Published: July 2024

Cirrhosis is a chronic liver disease with severe consequences for a patient’s health and survival. Exercise is an essential therapeutic strategy for both cirrhosis prevention and treatment. On the other hand, information regarding the present status of exercise-related research in cirrhosis is limited. Therefore, this study seeks to close the information gap in the scientific literature by using bibliometric techniques to analyze the trends, focal points, and cutting-edge research areas on exercise and cirrhosis. On September 22, 2023, research articles and reviews on exercise intervention for cirrhosis were obtained and downloaded from the Web of Science Core Collection (WoSCC). Subsequently, we employed CiteSpace (version 6.1.R6) to conduct bibliometric and knowledge graph analyses. 588 papers in 301 scholarly journals were written by 673 authors from 460 institutions spread over 63 countries and regions. The most productive nation among them is the United States. Not only is Zobair M. Younossi 1 of the most prolific writers, but he also receives the most co-citations. Most articles were published by the University of Michigan in the US, with the University of Alberta in Canada coming in second. Meanwhile, the WORLD JOURNAL OF GASTROENTEROLOGY has the most published articles, whereas HEPATOLOGY has the greatest number of co-citations. Apart from the theme words, the most frequently utilized keywords were “quality of life,” “insulin resistance,” and “mortality.” Future research may concentrate on “obesity,” “sarcopenia,” and “Mediterranean diet,” according to the analysis of keyword emergence. CiteSpace is used in this work to visually represent the topic of exercise intervention in cirrhosis, offering valuable information to researchers regarding the field’s current status and possible future direction.
Perihippocampal failure after hippocampal-avoidance brain radiotherapy in small cell lung cancer patients: Cases report and literature review
Authors: Ho Yi-Chia , Shieh Li-Tsun , Lin Chia-Hui , Chen Chia-Chun , Ho Sheng-Yow
Published: July 2024

Rationale:

Brain metastasis is a major concern, and may occur in roughly 50% of patients during the clinical course of small cell lung cancer (SCLC). Because prophylactic cranial irradiation reduces the incidence of brain metastases and improves overall survival, prophylactic cranial irradiation is recommended for SCLC patients without distant metastases or an extensive stage and have responded well to systemic therapy. Hippocampal-avoidance whole-brain radiotherapy (HA-WBRT) is preferred to preserve hippocampal function while minimizing negative cognitive effects.

Patient concerns:

Reducing the dose delivered to the hippocampus below the therapeutic brain dose may increase the risk of hippocampal progression; thus, HA-WBRT may be associated with a risk of perihippocampal recurrence.

Diagnosis:

Three patients with SCLC received HA-WBRT and developed intracranial failure during clinical follow-up; 3 relapsed with intracranial failure in the perihippocampal region after 12, 13, and 7 months, respectively.

Intervention and outcomes:

Compared to the therapeutic brain dose of cases and the underdose region around the HA region, we matched MRI scans of intracranial failure and previous planning scans of simulation and found a deviation of the underdosed region within the perihippocampal failure of approximately 55% to 63%.

Lessons:

Perihippocampal failure is a rare clinical outcome in SCLC patients following HA-WBRT. Perihippocampal failure could be caused by an underdose of radiation or by the aggressiveness of the cancer itself. More research into this topic is encouraged.
Anterior quadratus lumborum block provided superior pain control and reduced opioid consumption in kidney transplantation: A randomized controlled trial
Authors: Theeraratvarasin Cheevathun , Jirativanon Tachawan , Taweemonkongsap Tawatchai , Liangkobkit Karn , Aussavavirojekul Pubordee , Jitpraphai Siros , Chotikawanich Ekkarin , Woranisarakul Varat , Hansomwong Thitipat
Published: July 2024

Background:

The research aimed to assess the effectiveness of inside-out anterior quadratus lumborum (QL3) block and local wound infiltration in managing postoperative pain and total morphine dosage following kidney transplantation.

Methods:

In this prospective, randomized, double-blind study; 46 end-stage renal disease patients undergoing kidney transplantation were randomly allocated into 2 groups: a QL group (n = 23) receiving 20 mL of 0.25% bupivacaine using the ultrasound-assisted inside-out technique before wound closure, while the local wound infiltration (LA) group (n = 23) receiving the same dose around the surgical wound and drain at the time of skin closure. The primary outcome measure was the numerical pain rating scale, with secondary outcomes including amount of morphine consumption at various postoperative time points (2nd, 4th, 6th, 12th, 18th and 24th hours).

Results:

Patients in the QL group had significantly lower numerical rating scale scores at the 2nd and 4th hours, both at rest and during movement (P < .05). Although pain scores at rest and during movement at later time points were lower in the QL group compared to the LA group, these differences were not statistically significant. Cumulative morphine consumption at postoperative 4th, 6th, 12th, 18th and 24th hours was significantly lower in the QL group (P < .05). No patients experienced complications from the QL3 block.

Conclusion:

Ultrasound-assisted inside-out QL3 block significantly reduced postoperative pain levels at the 2nd and 4th hours, both at rest and during movement, and led to a reduction in cumulative morphine consumption from the 4th hour postoperatively, and persisting throughout the 24-hour period.
Hip and pelvic geometry as predictors of knee osteoarthritis severity
Authors: Mirahmadi Alireza , Kouhestani Emad , Farrokhi Mehrdad , Kazemi Seyed Morteza , Noshahr Reza Minaei
Published: July 2024

Malalignment is one of the most critical risk factors for knee osteoarthritis (KOA). Biomechanical factors such as knee varus or valgus, hip–knee–ankle angle, and femoral anteversion affect KOA severity. In this study, we aimed to investigate KOA severity predictive factors based on hip and pelvic radiographic geometry. In this cross-sectional study, 125 patients with idiopathic KOA were enrolled. Two investigators evaluated the knee and pelvic radiographs of 125 patients, and 16 radiological parameters were measured separately. KOA severity was categorized based on the medial tibiofemoral joint space widths (JSW). Based on JSW measurements, 16% (n = 40), 8.8% (n = 22), 16.4% (n = 41), and 56.8% (n = 147) were defined as grades 0, 1, 2, 3, respectively. There were significant differences between the JSW groups with respect to hip axis length, femoral neck-axis length, acetabular width, neck shaft angle (NSA), outer pelvic diameter, midpelvis–caput distance, acetabular–acetabular distance, and femoral head to femoral head length (P < .05). Two different functions were obtained using machine learning classification and logistic regression, and the accuracy of predicting was 74.4% by using 1 and 89.6% by using both functions. Our findings revealed that some hip and pelvic geometry measurements could affect the severity of KOA. Furthermore, logistic functions using predictive factors of hip and pelvic geometry can predict the severity of KOA with acceptable accuracy, and it could be used in clinical decisions.
Risk factors for empty follicle syndrome in diminished ovarian reserve patients undergoing intracytoplasmic sperm injection cycles: A retrospective observational analysis
Authors: Devranoğlu Belgin , Yilmaz Müşerref Banu , Peker Gamze , Özay Özlen Emekçi , Özay Ali Cenk , Güzel Ali İrfan
Published: July 2024

The aim of this study is to evaluate the risk factors for empty follicle syndrome (EFS) in patients with diminished ovarian reserve (DOR) undergoing an intracytoplasmic sperm injection cycle. In this retrospective study, patients with DOR were divided into 2 groups according to the presence of empty follicles on the day of oocyte retrieval. Patient age, body mass index (BMI), anti-Müllerian hormone (AMH), baseline follicle stimulating hormone (FSH) and estradiol (E2) levels, basal antral follicle count (AFC), total gonadotropin dose, and day of stimulation were recorded as risk factors. The association between EFS and these variables was assessed using the logistic regression method and ROC curve analysis. Increased BMI, low AMH, higher baseline FSH, low baseline AFC, higher gonadotropin dose, and longer day of ovulation induction were independent risk factors for EFS in patients with DOR. ROC curve analysis showed that BMI, AMH, baseline FSH, baseline AFC, higher gonadotropin dose, and longer ovulation induction days were predictive parameters in this group. According to the current study, higher BMI, lower AMH, higher baseline FSH, lower baseline AFC, higher gonadotropin dose and longer ovulation induction days were independent risk factors for EFS in patients with reduced ovarian reserve.
Rupture risk of intracranial aneurysms: Comparison between small ruptured intracranial aneurysms and large unruptured intracranial aneurysms
Authors: Peng Min-jie , Zeng Lu , Liu Lan-lan , Wen Li , Wang Guang-xian
Published: July 2024

To compare the differences in clinical and morphological features between small ruptured intracranial aneurysms and large unruptured intracranial aneurysms to evaluate the risk factors for the rupture of IAs. The clinical data of 189 consecutive patients with 193 IAs were reviewed. The patients and IAs were divided into ruptured (<5 mm) and unruptured groups (>10 mm). The characteristics of the patients and the intracranial aneurysms (IAs) were compared between the 2 groups, and the risk factors for rupture of IAs were assessed using multiple logistic regression. Patient age (odds ratio [OR], 0.955), IA located at the internal carotid artery (ICA, OR, 0.202), irregular shape (OR, 0.083) and parent vessel diameter (OR, 0.426) were negatively correlated with the risk of IA rupture. IAs located at bifurcations (OR, 6.766) were positively correlated with the risk of IA rupture. In addition to the size of the IAs, regardless of IAs shape, other factors, such as younger age (<63.5 years), location at a bifurcation, IAs located at the ICA and a small parent vessel diameter (<3.25 mm), can influence the risk of IA rupture.
Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials
Authors: Deng Yun-Peng , Zhou Yan-Li , Wei Teng-Teng , He Guang-Shuai , Zhu Zhi-Xin , Zhang Shu-Ning , Liu Mei-Jun , Xue Jing-Jing , Zhang Wei-Xing , Yang Xu-Guang
Published: July 2024

Background:

Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA).

Methods:

In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0.

Results:

This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate.

Conclusion:

The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.
Injection, hematoma, abscess, systemic inflammatory response syndrome, stairway to hell: Case report
Authors: Gokkus Kemal , Sargin Baris , Haberal Bahtiyar , Sahin Mehmet Sukru
Published: July 2024

Rationale:

Intramuscular injections are routine outpatient procedure performed at healthcare institutions worldwide. In the current literature, there have been very few reports of gluteal superior artery injuries due to incorrect injection techniques. However, no one has ever reported a healthy middle-aged man with systemic inflammatory response syndrome with possible injection-related bleeding from the gluteus superior artery, followed by a hematoma, and then a deep abscess after 3 weeks of not receiving treatment.

Patient concerns:

A 40-year-old man presented with pain in his buttock, a fever of 40°, and a lump after a dorso-gluteal injection. (November, 2022) The patient was diagnosed with systemic inflammatory response syndrome due to a deep abscess related to a hematoma caused by a possible superior gluteal artery branch injury.

Diagnoses:

He was admitted to our institution with a lump, pain in his buttock, and a fever of 40° after a dorso-gluteal injection. The patient had diffuse swelling and tenderness in the upper-posterior aspect of the gluteal region. Systemic examination revealed yellow sclera and icteric skin appearance. Blood tests showed low hemoglobin levels and increased pre-sepsis parameters (procalcitonin and indirect bilirubin). Pelvic MRI and ultrasonography revealed a gluteal abscess.

Interventions:

The patient was transferred to the operating theater, where a curved incision was made behind the trochanter. The gluteus maximus was bluntly dissected, and abscess fluid was drained from the muscle. Continuous bleeding was detected, suggesting iatrogenic superior gluteal artery branch injury at the time of the injection.

Outcome:

After drainage and antibiotic treatment, the patient’s parameters normalized within 5 days, and the patient was discharged. The patient’s weekly follow-up examinations were normal, and he was able to walk without a limp. A postoperative visit to the outpatient clinic 2 months after the operation and a telephone call 17 months later showed that the patient was completely healthy and able to work.

Lessons:

The dorso-gluteal technique has potential risks, including possible injury to the sciatic nerve and superior gluteal artery and irritation of the subcutaneous adipose tissue. This article aims to highlight the potential risks of a particular technique and advocate the use of the ventrogluteal technique instead of the traditional dorso-gluteal technique.
Efficacy of corticosteroid therapy for oxygen-free coronavirus disease 2019-derived pneumonia
Authors: Saito Zentaro , Kanai Osamu , Okamoto Natsumi , Watanabe Isao , Tsukino Mitsuhiro
Published: July 2024

Corticosteroid therapy for oxygen-free coronavirus disease 2019 (COVID-19) is not recommended due to its negative prognostic impact, but the efficacy of corticosteroids when limited to COVID-19 pneumonia is unclear. We aimed to evaluate the efficacy of corticosteroid monotherapy for patients with COVID-19 pneumonia without supplemental oxygen. We retrospectively reviewed patients with oxygen-free COVID-19 pneumonia at our institute between September 2020 and August 2021 and assessed the use of corticosteroids and the timing of initiation. We classified the patients into the following 2 groups: those who were initiated corticosteroids without developing respiratory failure (early steroid group) and those who were not (standard of care [SOC] group). We used inverse probability of treatment weighting (IPW) to balance between the groups. The primary outcome was the incidence of respiratory failure. A total of 144 patient records were reviewed; 63 patients were in the early steroid group and 81 patients were in the SOC group. Of all patients, 14 (22.2%) and 27 (33.3%) patients in the early steroid and SOC group, respectively, required supplemental oxygen (P = .192). After adjusted by the IPW method, 10 (16.0%) and 32 (40.1%) patients in the early steroid and SOC groups, respectively, required supplemental oxygen (P = .004). The logistic regression analysis indicated that early corticosteroid use was significantly associated with a decreased incidence of respiratory failure (odds ratio; 0.17, 95% confidence intervals; 0.06–0.46, P < .001). Corticosteroid monotherapy may suppress the development of exacerbation requiring oxygen supply in patients with oxygen-free COVID-19 pneumonia.
Assessing the predictive value of the suppressed 1 mg overnight dexamethasone suppression test in success of bariatric surgery
Authors: Şirikçi Vehbi , Kiraç Cem Onur , Findikli Hüseyin Avni , Muhammedoğlu Bahtiyar
Published: July 2024

Bariatric surgery has been proven to be a successful intervention for managing obesity. There are numerous studies in the literature aiming to predict the factors influencing the success of bariatric surgery. Our study aims to determine whether preoperative 1 mg overnight dexamethasone suppression test (1 mg-DST) serum cortisol levels can serve as predictors of the effectiveness of bariatric surgery in severe obese patients without Cushing syndrome. A total of 98 patients who underwent bariatric surgery were included in the study. The preoperative 1 mg-DST levels, insulin levels, thyroid function tests, and lipid profiles of the patients were recorded. The patients’ preoperative, postoperative 3rd, and 6th month weights were recorded and the percent total weight loss (%TWL) is calculated. Patients were categorized into 2 groups based on their TWL at 6 months. The 1 mg-DST results were significantly lower in the high-TWL-6 group (0.93 ± 0.37 μg/dL) compared to the low-TWL-6 group (1.09 ± 0.36 μg/dL, P = .040). Similarly, Homeostatic Model Assessment for Insulin Resistance values were lower in the high-TWL-6 group (5.63 ± 2.21) compared to the low-TWL-6 group (6.63 ± 2.55, P = .047). The optimal cutoff value found for 1 mg-DST level was 0.97 µg/dL, providing 50% sensitivity and 70% specificity. This study is the first to examine the predictive role of suppressed 1 mg-DST levels on postoperative weight loss in nondiabetic patients. The most prominent result of this study was that we observed a negative correlation between 1 mg-DST levels and %TWL.
Effects of obesity on clinical outcomes in diminished ovarian reserve patients undergoing intracytoplasmic sperm injection cycles
Authors: Devranoğlu Belgin , Yilmaz Müşerref Banu , Peker Gamze , Emekçi Özay Özlen , Özay Ali Cenk , Güzel Ali İrfan
Published: July 2024

The aim of this study is to evaluate the effects of obesity on clinical outcomes in diminished ovarian reserve (DOR) patients undergoing intracytoplasmic sperm injection cycles. In this retrospective observational cross-sectional study, women admitted to current clinic with DOR undergoing intracytoplasmic sperm injection were divided into 2 groups according to the obesity. Patient age, body mass index, anti-mullerian hormone, baseline follicle stimulating hormone and baseline estradiol levels, antral follicle count, total gonadotropin dose, day of stimulation, number of mature (MII) oocytes, and clinical pregnancy were evaluated. There were no statistically significant differences between groups in terms of age, anti-mullerian hormone, baseline follicle stimulating hormone, baseline estradiol levels, antral follicle count, and clinical pregnancy (P > .05). Total gonadotropin dose, the days of ovarian stimulation were higher and number of MII oocyte were less in the obese group (P < .05). Logistic regression analyses also revealed that the days of ovarian stimulation and number of MII oocyte were significant factors in the study group. ROC curve analysis showed obesity is a negatively affecting factor in DOR patients. Obesity causes more gonadotropin dose longer days of stimulation, and less number of MII oocyte. However clinical pregnancy rate is not negatively affected by obesity according to the current study.
Value of MRI signal intensity in evaluation of allergic fungal rhinosinusitis compared with CT Hounsfield units: Retrospective study
Authors: Alsalem Seham , Almontashri Ali , Alsalem Mohammed , Altamimi Fahad , Alyami Nasher , Hajjaf Shaker , Ahmed Faisal
Published: July 2024

“Allergic fungal sinusitis (AFS)” is typically diagnosed using radiologic images like computed tomography (CT) scans and magnetic resonance imaging (MRI), with the “Hounsfield unit (HU)” in CT scans and T2-weighted images (T2WI) in MRI serving as reliable objective parameters. However, diagnosing AFS might be difficult because of possible signal changes and densities caused by variations in the secretion concentration in the sinus. Few studies have compared the diagnostic performance of MRI and CT scans. This study aimed to investigate the value of MRI signal intensity in evaluating AFS compared with CT HUs. This retrospective study included 111 patients with pathologically confirmed AFS who underwent CT imaging followed by MRI evaluation at King Saud Medical City, Riyadh, Saudi Arabia, from January 2012 to December 2022. Radiographic densities of sinus opacities on CT scan, including the mean HU values, and MRI findings, including signal voids on T1-weighted images and T2WI, were gathered and analyzed. To determine the efficacy of these radiographic characteristics in predicting the disease and the best cutoff value, we employed receiver operator characteristic curves. The mean age was 31.9 ± 15.6 years, and most patients were 74 females (66.7%). The main symptom was nasal obstruction in 73 patients (65.8%). In comparison, between HU and signal void on T2WI, there was moderate predictive performance [area under the curve: 0.856, P = .001]. An ideal HU cutoff value of 69.50 HU was obtained with a sensitivity of 100% and a specificity of 44.7%. However, the receiver operator characteristic for T1-weighted images could not be plotted, as no signal was avoided to predict AFS and it was not statistically significant (area under the curve: 0.566; P = .287). The study found a CT HU of 69.5 can predict MRI T2WI signal values with a void signal, aiding in diagnostic workup and evaluation for AFS.