bluuebunny/crossref_metadata_2025 huggingface dataset:
Gallium-68 citrate PET/CT for diagnosis and treatment response assessment of infections - Prospective study.
Authors: Johnson Hanna Elizabeth , Sunny Saumya Sara , Hephzibah Julie , Mathew David , Oommen Regi , Shanthly Nylla , Rupali Priscilla , Thomas Regi , Sundaresan Rajan , Samuel Sumant , Oommen Anil , Krishnan Venkatesh , K. Reka
Published: October 2024

The objective of this study was to evaluate the utility of Ga-68 citrate PET/CT imaging for diagnosing infection and for the assessment of treatment response. The scan interpretation was based on visual comparison of uptake of Ga-68 citrate in the region of interest which was compared to the normal side / adjacent soft tissue / blood pool. Semi-quantitative parameter maximum standardized uptake value (SUVmax) was retrospectively analysed as well. The PET/CT findings were correlated with tissue diagnosis, clinical symptoms, biochemical parameters like C- reactive protein (CRP), Erythrocyte sedimentation rate (ESR), and Total leucocyte count (TLC) and other imaging modalities with a statistically significant association with inflammatory markers CRP (p = 0.001) and ESR (p = 0.07). Tissue diagnosis was considered the gold standard and out of the 43 patients included in the study, 28 had a tissue diagnosis. Sensitivity, specificity, positive, and negative predictive values were calculated at 100%, 66.6%, 85%, and 100%. Ga-68 citrate is a promising tool for assessing the presence of skeletal/soft tissue infections for diagnosis and treatment response assessment, significantly impacting clinical decision-making in accurately treating patients and surgical planning.
CT imaging using variable helical pitch scanning for lower extremity arterial disease: reduced contrast medium dose, improved image quality and diagnostic accuracy
Authors: Li Xiao-Shi , Geng Ji-Gang , Zhu Yin-Hu , Liu Li-Yao , Qiao Yan-Qiang , Ma Yong-Li , Lu Lu , Song Chang-Rui , Qin Yue , Chen Guo-Ping , Xu Min , Wang Ya-Rong
Published: October 2024

Objectives
This study aimed to explore the feasibility of reducing contrast medium (CM) volume, improving image quality and diagnostic accuracy using variable helical pitch (VHP) scanning for patients with lower extremity arterial disease (LEAD).
Materials and Methods
Eighty patients who underwent lower extremity CT angiography (CTA) were prospectively enrolled and randomly assigned to either the VHP group (n = 40) or the conventional group (n = 40). Quantitative parameters and qualitative scores were compared between the two groups. Additionally, out of these patients, 72 arteries from 18 patients had DSA as the reference standard, and the diagnostic accuracy for the degree of vessel stenosis was assessed and compared.
Results
In the VHP group, the contrast volume was significantly lower than in the conventional group (79.55 ± 11.87 mL vs. 89.63 ± 10.03 mL, p < 0.001), showing a reduction of 12.7%. For all image quality characteristics, scores in VHP group were significantly superior to those to those in the conventional groups (all p < 0.05). Quantitative analysis revealed that images from the VHP group exhibited superior CT enhancement, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in the anterior tibial arteries (ATA) and dorsali pedis arteries (DPA) compared to the conventional group (all p < 0.001). Moreover, the VHP group demonstrated significantly higher positive predictive value (PPV) and accuracy than the conventional group (PPV: 100% vs. 76.19%, p = 0.01; accuracy: 100% vs. 84.38%, p = 0.01, respectively).
Conclusions
The implementation of the VHP protocol led to a 12.7% decrease in contrast medium dosage compared to the conventional lower extremity CTA scanning protocol. Furthermore, it improved image quality and diagnostic accuracy, particularly for arteries below the knee.
Artificial Intelligence Support Improves Diagnosis Accuracy in Anterior Segment Eye Diseases
Authors: Maehara Hiroki , Ueno Yuta , Yamaguchi Takefumi , Kitaguchi Yoshiyuki , Miyazaki Dai , Nejima Ryohei , Inomata Takenori , Kato Naoko , Chikama Tai-ichiro , Ominato Jun , Yunoki Tatsuya , Tsubota Kinya , Oda Masahiro , Suzutani Manabu , Sekiryu Tetsuju , Oshika Tetsuro
Published: October 2024

CorneAI, a deep learning model designed for diagnosing cataracts and corneal diseases, was assessed for its impact on ophthalmologists' diagnostic accuracy. In the study, 40 ophthalmologists (20 specialists and 20 residents) classified 100 images, including iPhone 13 Pro photos (50 images) and diffuser slit-lamp photos (50 images), into nine categories (normal condition, infectious keratitis, immunological keratitis, corneal scar, corneal deposit, bullous keratopathy, ocular surface tumor, cataract/intraocular lens opacity, and primary angle-closure glaucoma). The iPhone and slit-lamp images represented the same cases. After initially answering without CorneAI, the same ophthalmologists responded to the same cases with CorneAI 2–4 weeks later. With CorneAI's support, the overall accuracy of ophthalmologists increased significantly from 79.2–88.8% (P < 0.001). Specialists' accuracy rose from 82.8–90.0%, and residents' from 75.6–86.2% (P < 0.001). Smartphone image accuracy improved from 78.7–85.5% and slit-lamp image accuracy from 81.2–90.6% (both, P < 0.001). In this study, CorneAI's own accuracy was 86%, but its support enhanced ophthalmologists' accuracy beyond the CorneAI's baseline. This study demonstrated that CorneAI, despite being trained on diffuser slit-lamp images, effectively improved diagnostic accuracy, even with smartphone images.
Application of Santulli enterostomy in the treatment of neonatal necrotizing enterocolitis: a retrospective cohort study
Authors: Fu Zhe , Zhang Jingmin , Qin Fanyue , Wang Xinru , Huang Hua , Huang Hongwei , Zheng Mingjun , Wang Peng , Zhang Weibo , Shi Hongguang
Published: October 2024

The Santulli enterostomy (SE) has been used as a clinical surgical treatment of necrotizing enterocolitis (NEC) in few studies which enrolled small number cases or lacked control group. Our study aimed to compare the clinical safety and efficacy of Santulli enterostomy with single- or double-lumen enterostomy in neonatal NEC through a retrospective cohort study. 110 patients met the criteria were divided into the SE group with 64 cases and the conventional enterostomy group with 46 cases who underwent single- or double-lumen enterostomy. There were no significant differences in complications and prognoses between the two groups after enterostomy. The stoma location in the SE group was higher (20 [11,37] cm vs 10 [4.5,15,5] cm), but the unused small intestine (USI) length was not significantly different (13 [5,20] cm vs 10 [4.5,15,5] cm). Multivariate analysis showed that USI length was the influence factor of malnutritional status after enterostomy (OR=1.103, P<0.001). The operation time, intestinal recovery time, fasting time, hospitalization time and intraoperative blood loss were all significantly less and the incidence of complications was lower in the SE group after stoma closure. Multivariate analysis showed that SE was a protective factor for complications after stoma closure (OR=0.036, P=0.006). Santulli enterostomy is a safe treatment option for NEC and can increase the effective utilization length of the small intestine after enterostomy, thereby improving the postoperative nutritional status. In addition, it enhances the recovery process and reduces the incidence of complications after stoma closure.
Predicting new-onset persistent conduction block following transcatheter aortic valve replacement: The usefulness of FEOPS finite element analysis
Authors: Wang Maode , Wang Yong , Debusschere Nic , Rocatello Giorgia , Jin Jun , Yu Shiyong
Published: October 2024

Background: Despite the frequency of persistent new-onset conduction blocks after transcatheter aortic valve replacement (TAVR), few preoperative methods of prediction exist.
Methods: Patients who underwent TAVR in the Department of Cardiology of the Second Affiliated Hospital of the Army Medical University from December 2020 to September 2021 and postoperative aortic root modeling via the FEOPS finite element analysis were included in this single-center case-control study, divided into persistent conduction blocks (PCB)and non-PCB groups according to their pre- and postoperative electrocardiograms in the first month post-surgery. Risk factors affecting PCB were identified by comparing the baseline data of these two groups, including echocardiograms, computed tomography angiography of the aortic root, surgical decision-making, and FEOPS data. Independent risk factors were screened using logistic regression modeling, and the receiver operating characteristic (ROC) curve was used to test the predictive ability.
Results: A total of 56 patients were included in this study, 37 with bicuspid aortic valve (BAV) and 19 with trileaflet aortic valve (TAV), with 17 cases of PCB. FEOPS of the contact pressure index (CPI), valve oversize ratio, differences between membranous interventricular septum length and implantation depth (ΔMSID), valve implantation depth were statistically different (P < 0.05). CPI could be used as an independent risk factor for PCB (P < 0.05), and the ROC curve comparison showed that the CPI was more predictive (AUC = 0.806, 95% CI: 0.684-0.928, P = 0.001).
Conclusions: FEOPS has better predictive value for new-onset conduction block after TAVR compared to other known predictors.
Enhancing Pediatric Emergency Training: The Impact of Virtual Reality- Simulations on Medical Student Knowledge and Learning Experience
Authors: Keicher Franca , Müller Mirja , Ruf Katharina , Härtel Christoph , König Sarah , Mühling Tobias
Published: October 2024

Background
Pediatric emergencies present significant risks, and medical students often have limited exposure to these situations, hindering the development of clinical skills. Virtual reality (VR) simulations offer a solution by providing high-fidelity experiences for practicing clinical reasoning and procedures. This study aimed to assess knowledge gain and gather student perspectives following a pediatric emergency VR simulation.
Methods
A 45-minute VR case scenario involving a newborn with late-onset sepsis was developed and implemented as part of the clinical rotation for medical students. Students' knowledge was assessed before and after the seminar using open text questions. Additionally, a post-seminar questionnaire was employed to gather feedback on estimated learning success, the efficiency of the simulation, and the didactic concept.
Results
Students demonstrated a significant enhancement in objective knowledge, with average scores increasing from 7.80 ± 2.1 points before the seminar to 10.90 ± 1.2 points after (out of a maximum of 12 points). Knowledge of nearly all individual diagnostic and therapeutic measures showed a significant increase. Accordingly, participants reported a high level of estimated learning success within the VR scenario. They also appreciated the utilization of VR simulations for instructing pediatric emergencies. The presence of a clinician expert throughout the seminar was well-received as integral part of the didactic concept.
Conclusions
VR simulations for pediatric emergencies offer a practical means for students to link theoretical knowledge with practical skills. They prove to be a motivating educational tool that leads to a quantifiable enhancement in students' knowledge.
Role of corrective feedback as a learning tool in dental education.
Authors: Pateel Deepak Gowda Sadashivappa , Gunjal Shilpa , Zain Rosnah Binti Mohd
Published: October 2024

Background
Formative assessment is believed to be an integral part of the learning process and plays an essential role in medical and dental education. Feedback is an integral part of formative assessment and, to some extent, supports and helps close the gaps between expected and actual performance, thus determining the formative assessment's success and purpose. The present study assesses the role of corrective feedback in dental education.
Methods
A Randomized, controlled, single-blinded, cross-over quasi-experimental study was conducted on all year three dental students of MAHSA University. The students were randomly divided into two groups, with 52 in each group. After the case-based formative assessment was conducted for all the students, the study group received corrective feedback, and the control group did self-study for the same period. A post-learning assessment was conducted for both groups, and the results were compared between the study and control groups. The data was analyzed using GraphPad Prism version 9.2.0 for Windows, GraphPad Software, San Diego, California, USA. The normality of data was checked using the D'Agostino & Pearson test with p > 0.05, indicating fulfilment of the normality assumption. The p < 0.05 was considered as statistical significance.
Results
The mean age for the study and control groups was approximately 22 years. Two-way repeated-measures ANOVA revealed no statistically significant difference between corrective feedback and self-study groups in the post-learning assessment (F = 0.3604, P = 0.5509).
Conclusions
The present preliminary study throws light on the role of corrective feedback after assessment as an educational learning tool in dental education. Although it has a lesser impact during the initial stages of the learning process, the study triggers further exploration of such education methods.
Pediatric Terrible Elbow Tetrad: A Case Report and Systematic Review
Authors: Galán-Olleros María , Garlito-Díaz Hugo , Martínez-Álvarez Sergio , Picazo-Belinchón Joaquín , Suárez-Betancor Marta , Mascaraque-Ortiz Rocío , Vara-Patudo Isabel , Martínez-Caballero Ignacio
Published: October 2024

A 6-year-old girl presented with a complex elbow injury, involving a posterior transolecranon fracture-dislocation and a radial neck fracture. Surgical intervention, performed through a posterior elbow approach, revealed an additional fracture of the coronoid process. Stabilization included a retrograde crossed K-wire for the radial neck fracture and a tension band construct (comprising K-wires and suture wire) for the olecranon fracture extending into the coronoid process. This combination of olecranon, radial neck, and coronoid fractures, coupled with a posterior elbow dislocation, constitutes a rare and intricate entity that may be regarded as a “terrible elbow tetrad”.
Acute Intestinal Obstruction Caused by Gastrointestinal Foreign Bodies in Children: A Comparison of Laparoscopic Treatment and Open Surgery
Authors: Wu Wei , Dong Min , Zhang Wanli , zheng Lulu , Sun Jun , Lv Zhibao
Published: October 2024

Objective
This study aims to explore the appropriate surgical treatment method for acute intestinal obstruction caused by gastrointestinal foreign bodies in children through a comparison of clinical characteristics in patients treated via laparoscopic and open surgery.
Methods
This study retrospectively analyzed 12 children with acute intestinal obstruction caused by gastrointestinal foreign bodies treated at Shanghai Children's Hospital and Huzhou Maternity and Child Care Hospital from June 2019 to June 2024. Basic information, treatment methods, and prognoses of the patients were collected. General data, operation time, postoperative fasting time, postoperative hospital stay, and intraoperative and postoperative complications were compared between the two groups. Categorical data were compared using Fisher’s exact test. Normally distributed continuous data were expressed as mean ± standard deviation and analyzed using an independent samples t-test; non-normally distributed data were expressed as M (P25, P75) and analyzed using the non-parametric Mann-Whitney U test.
Results
Six cases underwent laparoscopic transumbilical extended incision, successfully extracting the intestines and removing the foreign bodies without converting to open surgery. Compared to Six cases undergoing traditional open surgery during the same period, the postoperative fasting time and postoperative hospital stay in the laparoscopic group were 4 (5 ± 3.65) days and 5.5 (5 ± 7.5) days, respectively, while in the traditional open surgery group, they were 5 (4.25 ± 6) days and 6 (5 ± 8.6) days, respectively; the differences were statistically significant (P < 0.05). The laparoscopic group had significantly shorter operation time and faster postoperative recovery. The acceptance of the laparoscopic treatment by the families was significantly higher than that of the open surgery treatment.
Conclusion
The method of extracting obstructed intestines and removing foreign bodies via laparoscopic-assisted transumbilical extended incision has advantages over open surgery for treating acute intestinal obstruction caused by gastrointestinal foreign bodies, such as shortening hospital stay and operation time. However, for children with secondary gastrointestinal perforation caused by magnetic foreign bodies, open surgery, due to its broader exploration scope, is more advantageous for detecting occult perforations.
Transcriptomic Analysis of Identical Twins with ALD and Different Onset Ages
Authors: Chen Yinglian , Fu Chuhua , Zhang Yonghui , Zhang Yan , Cao Ying , Wang Xinggang , Zeng Zhiming , Liu Chen , Yin Changlin , Tan Liang
Published: October 2024

Background
Adrenoleukodystrophy (ALD) is a rare X-linked neurogenetic disease caused by mutations in the ABCD1 gene. Currently, the molecular mechanisms underlying the onset and severity of ALD still remain unclear. Therefore, the aim of this paper is to mine information on candidate genes associated with onset and severity of ALD by transcriptome sequencing of whole blood samples from monozygotic twin families with ALD disease.
Method
The identifying of differentially expressed genes (DEGs), set theory analysis, gene enrichment analysis, and classification statistics of expression trend had been executed to identify potential candidate genes inducing the onset and severity of ALD in patients. And, eight ALD patients, which constituted by two normal children, two ALD child twins, twins’ mother, twins’ adult uncle with ALD, twins’ grandmother, and a normal adult had been used.
Result
In the present, five distinct sets of differentially expressed genes (DEGs) were identified via using whole blood samples from a family of identical twins with different onset ages and ABCD1 exon 2 deletion. Then, 39 DEGs of A∩B∩C-D and A∩B-D as well as 425 DEGs of C∩E had been considered as relating genes with the onset and severity of ALD. Especially, C4BPA, TPBG, CEP112, CHST15, SMAD1, IL-26, and LRRC69 had shown more important than others about ALD onset. Meanwhile, KEGG and GO enrichment further suggested the role of Ca2+ homeostasis and plasma membrane for ALD onset and severity. Finally, expression pattern analysis further demonstrated the pivotal role of the selected DEG sets.
Conclusion
The information on candidate genes of this research had been considered as the crucial for preliminarily exploring the molecular mechanisms relating to the onset and severity of ALD, which offered novel insights and research directions for mitigating and treating the development of ALD.
Perspectives on Implementation of Point of Care Ultrasound in Prehospital Patient Care
Authors: Toole Austin , Dhillon Dev , Meeker Scott , Padilla Ricardo , Vaezazizi Reza , Pennington Troy , Archambeau Benjamin , Patterson Stephen , Dong Fanglong , Neeki Michael M.
Published: October 2024

Background:
Handheld point-of-care ultrasound (POCUS) devices offer potential benefits for enhancing patient care without causing delays in transporting patients to definitive care. This current study aims to assess the safety and effectiveness of POCUS used by paramedics in the prehospital setting alongside their standard assessment tools.
Methods:
This is a prospective longitudinal study from January 2022 and March of 2023. Eligible patients 18 years and older were categorized into two main groups: trauma or cardiac arrest. Trauma patients included those suspected of tension pneumothorax or intra-abdominal bleeding, while cardiac arrest patients were included regardless of etiology. Paramedics assessed and performed ultrasound exams based on their clinical judgment. Images were subsequently reviewed by an emergency physician trained in ultrasound interpretation, who evaluated the image quality and provided agreement or disagreement with the paramedics' interpretations.
Results:
In total, 92 patients were evaluated, and 41 patients with complete records were included for analysis. There are 24 cardiac arrest cases, which included 10 were noted to have cardiac activity on POCUS and the other 14 patients did not have cardiac activities on POCUS, and 17 were trauma. The agreement between paramedics’ interpretation and reviewing physicians’ interpretation ranged from 60% for those cardiac arrests with cardiac activities on POCUS, 78.6% for cardiac arrests without cardiac activities on POCUS, and 70.6% for trauma cases.
Conclusions:
These findings underscore the potential for paramedics, with appropriate training, to utilize ultrasound effectively in improving patient care for individuals suffering from traumatic injuries or in cardiac arrest.
Clinical trial number:
Not applicable. This is a prospective observational study. No intervention was applied to human subjects. This study was approved by the Institutional Review Board at Arrowhead Regional Medical Center (ARMC) with approval number 20-35.
Preoperative Serum Creatinine Levels as a Prognostic Indicator in Upper Urinary Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Retrospective Clinical Study
Authors: Zhao Yu , Zhang Xin
Published: October 2024

Objective
This study aimed to elucidate the prognostic significance of preoperative serum creatinine (SCr) levels on oncologic outcomes in patients undergoing radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UUT-UC).
Methods
We retrospectively analyzed clinical data from 227 patients treated for UUT-UC with RNU at Beijing Chaoyang Hospital, Capital Medical University between 2009 and 2020. Patients were stratified into groups based on optimal SCr thresholds identified via receiver operating characteristic (ROC) curve analysis. We compared baseline characteristics across these groups and assessed the impact of preoperative SCr on intravesical recurrence-free survival (IVRFS), extra-urinary recurrence-free survival (EURFS), recurrence-free survival (RFS), and overall survival (OS) using Kaplan-Meier survival plots and Cox proportional hazards regression models.
Results
Our cohort included 227 patients who fulfilled the study's inclusion and exclusion criteria. Pathologic T stage was identified as a predictor of IVRFS. Both pathologic T stage and preoperative SCr levels were significant predictors of EURFS and RFS. Additionally, age, pathologic T stage, neural invasion, and preoperative SCr were all significant prognostic factors for OS.
Conclusion
Elevated preoperative SCr levels are associated with poorer prognoses in patients with UUT-UC undergoing RNU, particularly impacting EURFS, RFS, and OS. Conversely, preoperative SCr levels did not correlate with IVR.
From Mammary Mystery to Parasitic Surprise: A Rare Case of Primary Breast Hydatid Cyst
Authors: Nezhad Nazanin Zeinali , Nezhad Hamid Zeinali , Shahpar Amirhossein , Shahrebabak Aazam Gholami , Shahrebabak Maryam Gholami
Published: October 2024

Primary breast hydatid cyst is an exceedingly rare manifestation of echinococcosis, with an incidence of less than 0.27% among all hydatid cyst cases. This report presents a unique case of a 51-year-old multiparous female who initially presented with a painless left breast mass. Initial imaging studies, including ultrasonography and mammography, revealed a 4.5 x 4 cm cyst classified as BI-RADS 3. The cyst was initially managed with fine-needle aspiration and conservative treatment. However, it recurred twice over a six-month period, necessitating surgical excision. Preoperative blood work revealed eosinophilia, a finding initially overlooked but later recognized as significant. Histopathological examination of the excised specimen confirmed the diagnosis of a hydatid cyst. Post-surgical management included albendazole therapy, regular imaging follow-ups, and patient education on hygiene practices to prevent reinfection. This case highlights the importance of considering parasitic etiologies in the differential diagnosis of breast masses, particularly in endemic regions. It also underscores the value of a multidisciplinary approach in managing such rare cases. The unexpected diagnosis of a primary breast hydatid cyst in this case serves as a reminder of the diverse presentations of echinococcosis and the need for heightened clinical suspicion in atypical breast lesions.
Association between age-based interpregnancy interval and adverse perinatal outcomes in the context of China's comprehensive two-child policy:A real-world based study
Authors: Xiu Siqin , Tang Li , Qin Chengjie , Tian Di , Chen Yuhong , Gu Lingling , Yang Liu , Sun Yuhao , Liu Xinghui , Lin Yonghong , Wang Yumei
Published: October 2024

Background
Since the implementation of China’s comprehensive two-child policy, the prevalence of long interpregnancy intervals (IPI) and advanced maternal age has increased. However, previous studies in China have mostly focused on the relationship between short IPIs and adverse perinatal outcomes, while neglecting maternal age as a potential confounder.
METHODS
We conducted a retrospective cohort study of 23,899 pregnant women who delivered between January 1, 2017 and December 31, 2019 at Chengdu Women's and Children's Central Hospital and West China Second Hospital of Sichuan University. IPIs were categorized as < 18 months, 18–23 months, 24–59 months, 60–119 months, and ≥ 120 months. Their relationships with clinical characteristics and pregnancy outcomes were analyzed using chi-square tests. Logistic regression modeling, incorporating restricted cubic spline (RCS), was used to assess association between IPI and adverse perinatal outcomes, including full-term low birthweight (LBW), preterm birth (PTB), small-for-gestational age (SGA) and adverse neonatal composite (very low birthweight, very preterm birth, severe neonatal asphyxia or death).
RESULTS
Women with longer IPIs (≥ 120 months) were more likely to be older (≥ 35 years) and had higher rates of gestational diabetes and hypertensive disorders of pregnancy (p < 0.05). Compared to an IPI of 24–59 months, the risk of PTB was significantly higher with an IPI of ≥ 120 months for women aged ≥ 35 years (aRR,1.39; 95% CI, 1.07–1.80) and 30–34 years (aRR 2.32; 95% CI, 1.72–3.13), but not for those aged ≤ 29 years (aRR 1.33; 95% CI, 0.28–6.43). The risk of SGA increased with an IPI of ≥ 120 months for women aged 30–34 years (aRR, 2.35; 95% CI, 1.13–4.89) and with an IPI of 60–119 months for women aged ≤ 29 years (aRR, 2.87; 95% CI, 1.47–5.60). Full-term LBW risk was elevated among women aged ≤ 29 years with an IPI of 60–119 months (aRR, 11.68; 95% CI, 1.41–97.19). However, there were no significant differences in the risk of adverse neonatal composite across different IPI groups with each age category (p > 0.05).
CONCLUSION
A long IPI increased the risk of SGA, full-term LBW and PTB, regardless of maternal age. Medical professionals should advise women an optimal IPI to mitigate these risks. With China’s shift from a “one-child” to a “three-child” policy, future research will focus on analyzing this new fertility pattern to refine IPI recommendations.
Proteomic analysis of plasma total exosomes and placenta-derived exosomes in patients with gestational diabetes mellitus in the first and second trimesters
Authors: Lin Jing , Zhao Danqing , Liang Yi , Liang Zhiyuan , Wang Mingxian , Tang Xiaoxiao , Zhuang Hongbin , Wang Hanghang , Yin Xiaoping , Huang Yuhan , Yin Li , Shen Liming
Published: October 2024

Gestational diabetes mellitus (GDM) is the first spontaneous hyperglycemia during pregnancy. Early diagnosis and intervention are important for the management of the disease. This study compared and analyzed the proteins of total plasma exosomes (T-EXO) and placental-derived exosomes (PLAP-EXO) in pregnant women who subsequently developed GDM (12–16 weeks), GDM patients (24–28 weeks) and their corresponding controls to investigate the pathogenesis and biomarkers of GDM associated with exosomes. The exosomal proteins were extracted and studied by proteomics approach, then bioinformatics analysis was applied to the differentially expressed proteins (DEPs) between the groups. At 12–16 and 24–28 weeks of gestation, 36 and 21 DEPs were identified in T-EXO, while 34 and 20 DEPs were identified in PLAP-EXO between GDM and controls, respectively. These proteins are mainly involved in complement pathways, immunity, inflammation, coagulation and other pathways, most of them have been previously reported as blood or exosomal proteins associated with GDM. The findings suggest that the development of GDM is a progressive process and that early changes promote the development of the disease. Maternal and placental factors play a key role in the pathogenesis of GDM. These proteins especially Hub proteins have the potential to become predictive and diagnostic biomarkers for GDM.
Am I attached? A patient-partnered approach to creating infographics about attachment to primary care in Ontario, Canada
Authors: MacNeil Maggie , Tagami Aya , Sheffield Peter , Ramsden Vivian R , Barker Joan , Boyle Jennifer , Cruickshank Clare , Frymire Eliot , H Glazier Richard , Hill Anita Gombos , Green Michael E , Huang Mary , Jurriaans Marijke , Leid Caron , McCallum Melissa , Precious Sarah , Stans JoAnn , Vizza Julie , Walz Murray , Wilkins Sue , Ganann Rebecca
Published: October 2024

Background: Having a primary care provider is associated with better care experiences and lower care costs. In 2021, INSPIRE-PHC released Primary Care Data Reports (PCDR) - publicly available summaries of administrative billing data about how populations in each of Ontario’s 60 health teams engage with primary care. Given the characterization of Canadian primary care systems as ‘in crisis’, publicly available data about primary care at the regional level presented a significant opportunity for knowledge mobilization. An understandable resource could ground the public conversation about primary care access in data. Recognizing the role that lived experience plays in ensuring the public understands research findings, a partnership between patient advisors, Ontario Health Team (OHT) representatives, researchers, and trainees was established to co-produce public-facing infographics of PCDR data.
Methods: Evidence-based guidelines for public health infographic creation and elements of transformative action research guided a six-meeting process to engage up to 14 patient advisors, three OHT staff and two primary care trainees. Patient advisors were affiliated with a provincial patient-oriented primary health care research group or a Hamilton-based OHT. Ninety-minute meetings were conducted virtually, and notes were shared with attendees to ensure they accurately reflected the conversation. Two consultations with OHT-affiliated primary care providers provided direction and ensured project outputs aligned with local priorities.
Results: Project partners shared feedback on draft infographics, audience identification, priority elements from PCDR to include in the infographics, and aesthetic features (e.g., headings, colour scheme, charts). Project partners felt the most important metrics to convey to the public were those that simultaneously reinforced the benefits of primary care on individual health outcomes and health system costs.
Conclusions: Patient engagement in research is becoming widespread, but co-developing knowledge products with patient and health system partners is less common. Our approach to engaging patients prevented both oversimplification and unnecessary complexity in a public-facing visual about attachment to primary care.
The effects of local delivery of laurus nobilis extract and adipose derived stem cells via electrospun gelatin scaffold on spinal cord injury inflammatory response and its regeneration
Authors: Zhang Chong , Xie Daotao , Guo Gang , Jalili saman
Published: October 2024

When subjected to injury, the spinal cord's inherent complexity poses significant challenges for effective healing. In this study, gelatin nanofibers loaded with laurus nobilis extract were developed to serve as a delivery system for adipose-derived stem cells (ASCs), aiming to explore its potential immunomodulatory effects in a rat model of spinal cord injury. Through a series of in vitro assessments including scanning electron microscopy imaging, cell viability, anti-inflammatory, cell adhesion, biodegradation, and hemocompatibility assays, the characteristics of the delivery system were thoroughly evaluated. The in vitro studies revealed both the biocompatibility of the scaffolds and their notable anti-inflammatory properties, laying the groundwork for further investigation. Subsequent in vivo experiments demonstrated that rats treated with laurus nobilis extract and ASCs loaded scaffolds exhibited heightened functional recovery and histological restoration at the 8-week mark post-injury. Notably, ELISA assay results revealed a significant reduction in tissue expression levels of key pro-inflammatory cytokines, including TNF-a, IL-1β, and IL-6, suggesting a pronounced immunomodulatory effect of the laurus nobilis extract-loaded scaffolds. These findings underscore the potential of this novel delivery system as a promising therapeutic approach for spinal cord injury, with implications for advancing clinical treatment strategies and improving patient outcomes. Further research is warranted to optimize and validate the efficacy of this approach in larger animal models and, ultimately, in human clinical trials.
Association of topical clotrimazole and oral potassium iodide for the treatment of mycotic rhinitis caused by Aspergillus fumigatus in a Quarter Horse mare
Authors: Alonso Juliana de Moura , Watanabe Marcos Jun , Bosco Sandra de Moraes Gimenes , Apolonio Emanuel Vitor Pereira , de Vasconcelos Artur Bibiano , Prado Ana Carolina do , Alves Ana Liz Garcia , Rodrigues Celso Antonio , Hussni Carlos Alberto
Published: October 2024

Fungal rhinitis in horses is rare, although severe, due to the progressive nasal obstruction. Aspergillus spp. is one of the fungi most often involved in these cases. A 7-year-old Quarter Horse mare weighing 325 kg was admitted with a history of recurrent nasal discharge and bleeding, foul smell, reluctance to exercise and abortion. Laboratory and imaging examinations revealed eosinophilia, scarring and erosion areas in the nasal mucosa, purulent and bloody secretions, and remarkable yellowish plaques. Histopathological examination revealed fungal rhinitis and bacterial culture revealed the presence of β-hemolytic Streptococcus and Staphylococcus spp. Fungal culture and molecular diagnosis confirmed Aspergillus fumigatus as the etiological agent. A tracheostomy was necessary due to the patient's dyspnea. For the treatment, topical application of clotrimazole ointment was carried out in the rostral portion of the nasal cavity once a day and in the caudal portion of the nasal cavity, endoscopic guided every 48 hours. In the fifth endoscopy-guided application, a significant improvement was noticed; however, the animal exhibited a hypersensitivity reaction, and the treatment was discontinued. Thus, potassium iodide therapy was initiated (67 mg/kg, VO, SID, 14 days). The patient demonstrated favorable clinical improvement, achieved resolution of the fungal infection, and was discharged after 25 days of hospitalization. The isolated topical use of clotrimazole was an effective treatment. However, the occurrence of a hypersensitivity reaction has constrained the advancement of the therapy and the monitoring of case resolution. The treatment period for fungal rhinitis caused by Aspergillus spp. in horses was shorter than previously described.
Characteristics, spatiotemporal distribution, and risk assessment of Cu and Ni pollution in a farmland soil-corn system of arid oasis city in Northwest China
Authors: Xu Shenghui , Wu Ao , Liu Jingjing , Gao Guowen , Liu Kaiwang , Su Yanfang , Jin Cheng , Li Changhao , Yang Yahong
Published: October 2024

The rapid development of mining resources in the northwest oasis industrial and mining cities has brought many environmental problems. Previous research on heavy metals in cities in the Northwest Oasis mainly focused on the soil-wheat system, lacking research on the soil-corn system. As one of the main crops grown in the Northwest region, the pollution of heavy metals in corn grains is closely related to the physical health of the people in the Northwest region. The results show that the average content of Cu and Ni in the soil of the study area were 124.00 mg kg− 1 and 136.80 mg kg− 1, respectively, which are both higher than the background value of the area. The content of various heavy metals varies among the various organs of corn, The contents of Cu and Ni were the highest in tassel. The spatial distribution characteristics of heavy metals show that Cu and Ni have similarities in spatial distribution and may have the same source. The average Bio-concentration and translocation factors of corn plants are Cu > Ni. The hazard quotient (HQ) value of both children and adults are less than 1, indicating that Cu and Ni have no significant health risks for both adults and children.
Impact of cancer cachexia on chemotherapeutic efficacy in patients with metastatic colorectal cancer who are treated with trifluridine/thymidine phosphorylase inhibitor + bevacizumab
Authors: Shibutani Masatsune , Tanda Hideki , Seki Yuki , Kashiwagi Shinichiro , Nishiyama Tsuyoshi , Fukui Yasuhiro , Imanishi Daiki , Kasashima Hiroaki , Fukuoka Tatsunari , Maeda Kiyoshi
Published: October 2024

In later-line treatment of metastatic colorectal cancer (mCRC), there may be large differences in treatment efficacy depending on cancer cachexia. Recently, the cachexia index (CXI), which was calculated from the skeletal muscle mass index (SMI), serum albumin concentration, and neutrophil-to-lymphocyte ratio, was developed to evaluate cancer cachexia. We retrospectively examined the CXI of 80 patients who were treated with trifluridine/thymidine phosphorylase inhibitor (FTD/TPI) + bevacizumab (Bmab) therapy as a later-line treatment for mCRC and assessed the impact of cancer cachexia on chemotherapeutic efficacy using the CXI. Progression-free and overall survival rates were significantly worse in the low CXI group than in the high CXI group. As the cross-sectional area of the iliopsoas muscle was significantly associated with that of the skeletal muscle, the accuracy of the CXI based on the psoas mass index (P-CXI), which is easier to calculate than the SMI, in predicting treatment outcomes was equivalent to that of the CXI based on the SMI (S-CXI). Cancer cachexia is an important factor related to treatment efficacy in later-line treatments, such as FTD/TPI + Bmab therapy.
Prognostic Role of Androgen Receptor Splice Variant 7 (AR-V7) in the Pathogenesis of Breast Cancer
Authors: Srivast Tryambak Pratap , Ajmeriya Swati , Goel Isha , Talukdar Joyeeta , Srivast Anurag , Parshad Rajinder , Deo SVS , Mathur Sandeep R. , Gogia Ajay , Rai Avdhesh , Dhar Ruby , Karmakar Subhradip
Published: October 2024

Background:
The Androgen Receptor (AR) has emerged as an endocrine therapy target in Breast Cancer, exhibiting up to 80% expression in clinical cases. AR-V7, a constitutively activated splice variant of AR with a truncated ligand-binding domain (LBD), demonstrates ligand-independent transcriptional activity and resistance to nonsteroidal antiandrogens like Bicalutamide or Enzalutamide, targeting the LBD. In metastatic prostate cancer, elevated AR-V7 levels lead to therapeutic resistance and increased metastasis.
Methods:
In this study, we evaluated the expression of AR and AR-V7 in cell lines and a cohort of 89 patients undergoing surgical intervention for treatment-naïve breast cancer. Further clinicopathological correlations and survival analysis were performed to evaluate the relationship between the AR and AR-V7 expression and clinical outcomes.
Results:
AR-V7/AR-FL ratio was elevated in the TNBC cell line and downregulation of AR-FL upon AR antagonists’ treatment led to a compensatory increase in AR-V7. Clinical samples showed significantly elevated expression of AR and AR-V7 in tumors compared to control cases. Further clinicopathological correlation revealed aggressive clinical traits, higher pathological grades, and poor survival with AR-V7 expression.
Conclusions:
Our study unravels AR-V7 as a marker for poor clinical outcomes, predicting breast cancer aggressiveness, and encourages consideration of AR-V7 as a probable target for therapeutic intervention.
Brazilian Registry of Sjögren’s Disease (BRAS): a full picture of Sjögren’s disease
Authors: Valim Valéria , Miyamoto Samira Tatiyama , de Oliveira Fabiola Reis , Serrano Érica Vieira , Santos Laura Caldas dos , Pernambuco Roberta de Almeida , Appenzeller Simone , Markus Juliana , Tanure Leandro Augusto , Lopes Maria Lúcia Lemos , Coradin Rafael , Pinheiro Aysa César , Hax Vanessa , Fedrigo Aiessa Zanchett , Ribeiro Sandra Lúcia Euzébio , Capobianco Karina Gatz , Petterle Giovanna Sant’Ana , Pugliesi Alisson , Zampirolli Maria Clara , Machado Ketty Lisie Libardi , Santos Paula Regina Toche dos , Sacilotto Nathalia de Carvalho , Migueletto Anna Maria de Senna , Cantali Diego Ustárroz , Barbosa Vitalina de Souza , Xavier Ricardo Machado , Trevisani Virgínia Fernandes Moça
Published: October 2024

The Brazilian Registry on Sjögren's Disease (BRAS) is a prospective, national cohort registry. To date, 16 centers from all Brazilian regions are engaged in collaborative research, with the potential for additional centers to be included over time. The BRAS project started in 2021 and has the support of the Brazilian Society of Rheumatology (SBR). The primary objective of BRAS is to generate a set of Brazilian epidemiological data on patients with SjD who meet the 2002 AECG and/or 2016 ACR-EULAR classification criteria, and to promote high-quality clinical research. The Research Electronic Data Capture (REDCap) platform is being used for the entry of clinical data. In addition to demographic and laboratory data, clinical data are being collected, including disease activity (EULAR Sjögren's Syndrome Disease Activity Index - ESSDAI), disease damage (Sjögren's Syndrome Disease Damage Index-SSDDI), comorbidities, cardiovascular risk (Framingham), labial salivary gland biopsy, salivary gland ultrasound, and pharmacological and non-pharmacological treatment. Additionally, patient-reported outcome measures (PROMs) are being incorporated, including the EULAR Sjögren's Syndrome Patient-Reported Index (ESSPRI), Profile of Fatigue and Discomfort (PROFAD), Hospital Anxiety and Depression Scale (HADS), Epworth sleepiness scale (ESE), International Physical Activity Questionnaire-short form (IPAQ-SF), and EuroQol-5 Domain (EQ-5D). The study is currently enrolling 1,010 patients. The mean age of the 1,010 SjD patients is 55.6 ± 13.6 years, with 96.5% of women. Ninety-three percent of patients present with xerostomia, 93.7% xerophthalmia, 78.9% anti-Ro/SSA, and 41.8% anti-La/SSB. Ninety-four percent and 90% of patients have met the 2002 AECG and 2016 ACR-EULAR classification criteria, respectively. There is a potential for future studies to investigate the clinical and laboratory profile, predictors of systemic involvement and cardiovascular risk; prevalence of anxiety and depression and associations, level of physical activity and associations, comorbidities and polypharmacy; in addition, treatment response, follow-up of disease activity and mortality. The next step is to create a biorepository for biological specimens.
Anatomic Interpretability in Neuroimage Deep Learning: Saliency Approaches for Typical Aging and Traumatic Brain Injury
Authors: Guo Kevin , Chaudhari Nikhil , Jafar Tamara , Chowdhury Nahian , Bogdan Paul , Irimia Andrei
Published: October 2024

The black box nature of deep neural networks (DNNs) makes researchers and clinicians hesitant to rely on their findings. Saliency maps can enhance DNN explainability by suggesting the anatomic localization of relevant brain features. This study compares seven popular attribution-based saliency approaches to assign neuroanatomic interpretability to DNNs that estimate biological brain age (BA) from magnetic resonance imaging (MRI). Cognitively normal (CN) adults (N = 13,394, 5,900 males; mean age: 65.82 ± 8.89 years) are included for DNN training, testing, validation, and saliency map generation to estimate BA. To study saliency robustness to the presence of anatomic deviations from normality, saliency maps are also generated for adults with mild traumatic brain injury (mTBI, \(\:N\) = 214, 135 males; mean age: 55.3 ± 9.9 years). We assess saliency methods’ capacities to capture known anatomic features of brain aging and compare them to a surrogate ground truth whose anatomic saliency is known a priori. Anatomic aging features are identified most reliably by the integrated gradients method, which outperforms all others through its ability to localize relevant anatomic features. Gradient Shapley additive explanations, input × gradient, and masked gradient perform less consistently but still highlight ubiquitous neuroanatomic features of aging (ventricle dilation, hippocampal atrophy, sulcal widening). Saliency methods involving gradient saliency, guided backpropagation, and guided gradient-weight class attribution mapping localize saliency outside the brain, which is undesirable. Our research suggests the relative tradeoffs of saliency methods to interpret DNN findings during BA estimation in typical aging and after mTBI.
Functional Connectivity Changes in the Prefrontal-thalamic- cerebellar Circuit in Adolescents with First-Episode Schizophrenia
Authors: Song Yichen , Zhu Hanyu , Wu Zhaoyang , Hu Wenyan , Zhang Sen , Zhou Youqi , Peng Yue , Yang Yongfeng , Li Wenqiang , Shi Han , Yang Ge , Zhang Yan , Lv Luxian
Published: October 2024

Background
The role of functional connectivity (FC) changes in the prefrontal-thalamic-cerebellar circuit in schizophrenia has received widespread attention. Currently, domestic and international studies on this circuit have focused on adults, while the FC of this circuit in the brains of adolescent patients with schizophrenia (AOS) has been less reported.
Methods
We recruited 124 subjects who underwent resting-state functional magnetic resonance imaging scans at baseline, using key brain regions in the prefrontal-thalamic-cerebellar circuit as seed regions, to investigate the FC in AOS versus healthy controls. The FC of this loop was compared with that of the whole brain in healthy controls.
Results
Compared to healthy controls, patients with AOS had reduced FC between the medial prefrontal cortex (mPFC) and precuneus and between the posterior cerebellar lobe and middle temporal gyrus. Reduced FC in patients with AOS was associated with positive symptom scores and with some cognitive scales.
Conclusions
There are FC abnormalities in the prefrontal-thalamic-cerebellar circuit, precuneus, and temporal lobe in AOS. These abnormalities appear in the early stages of schizophrenia, independent of medication, and are characteristic of the disorder.