bluuebunny/crossref_metadata_2025 huggingface dataset:
High order shallow water equations: application to dam break problems
Authors: Ndengna Ngatcha Arno Roland
Published: December 2024

The majority of shallow flows that occur in sediment transport are turbulent, and as a result, cannot be described by shallow water equations. This paper introduces a set of shallow water equations based on the long-wave second-order approximation. The set of equations is employed in the modeling of sediment transport in coastal zones, thereby facilitating the consideration of a diverse array of civil engineering problems. The derived sediment transport model is capable of representing the coupling of sediment transport phenomena with turbulent flow in shallow regions. The proposed models utilize the concept of two-velocity vectors (comprising a mean velocity and a distortion velocity due to turbulence) in the primary flow directions. To demonstrate the efficacy of the model, a numerical scheme is employed to solve a number of dam-break problems that are well-known in the field.
The Effect of Nirmatrelvir-Ritonavir on Short- and Long-term Adverse Outcomes From COVID-19 Among Patients With Kidney Disease: A Propensity Score–Matched Study
Authors: Strohbehn Ian A , Ouyang Tianqi , Lee Meghan D , Zhao Sophia , Harden Destiny , Mejia Sherley M , Cao Andrew , Bhattacharyya Roby P , Sise Meghan E
Published: December 2024

Background

Patients with kidney disease are at high risk for adverse outcomes after coronavirus disease 2019 (COVID-19) despite vaccination. Because patients with advanced chronic kidney disease (CKD) and kidney failure were excluded from registrational trials, the impact of the protease inhibitor nirmatrelvir-ritonavir in patients with kidney disease is unknown.

Methods

This was a cohort study evaluating adverse outcomes in patients with kidney disease who developed COVID-19. Patients prescribed nirmatrelvir-ritonavir for COVID-19 between March 16, 2022, and November 30, 2022, were propensity score–matched to comparators diagnosed with COVID-19 between July 15, 2021, and March 15, 2022 (before the use of nirmatrelvir-ritonavir in our health care network). We determined the association between nirmatrelvir-ritonavir and short- and long-term outcomes using Fine-Gray subdistribution hazard and Cox proportional hazard models, adjusting for potential confounders. Outcomes included 30-day risk of hospitalization and 1-year risk of a major adverse cardiovascular event (MACE), CKD progression, and death.

Results

A total of 1095 nirmatrelvir-ritonavir-treated patients were matched to 584 comparators. Patients who received nirmatrelvir-ritonavir patients were less likely to be hospitalized within 30 days of diagnosis (adjusted subdistribution hazard ratio [sHR], 0.44; 95% CI, 0.26–0.73; P < .01). At 1 year, nirmatrelvir-ritonavir-treated patients had a lower risk of hospitalization for MACE (adjusted sHR, 0.49; 95% CI, 0.36–0.67; P < .01) and death (adjusted hazard ratio, 0.37; 95% CI, 0.21–0.65; P < .01). Use of nirmatrelvir-ritonavir was not associated with decreased risk of CKD progression or attenuation of estimated glomerular filtration rate decline slope in the year following infection.

Conclusions

Nirmatrelvir-ritonavir was associated with decreased risk of hospitalization within 30 days and 1-year risk of MACE and death in patients with CKD and kidney failure.
The concepts of irreversibility and reversibility in research on anthropogenic environmental changes
Authors: Buhr Lorina , Lenzi Dominic S , Pols Auke J K , Brunner Claudia E , Fischer Andrea , Staal Arie , Hofbauer Benjamin P , Bovenkerk Bernice
Published: December 2024

The concept of “irreversibility” and its counterpart “reversibility” have become prominent in environmental and ecological research on human-induced changes, thresholds, climate tipping points, ecosystem degradation, and losses in the cryosphere and biosphere. Through a systematic literature review, we show that in these research fields, these notions are not only descriptive terms, but can have different semantic functions and normative aspects. The results suggest that, in the context of environmental and ecological research the concepts of irreversibility and reversibility have taken on additional usages in comparison to their contexts in theoretical thermodynamics and mechanics. Irreversible as a classification of anthropogenic environmental change can be used categorically, in the sense of a finite end, or relatively, i.e. on time or spatial scales of interest. Surprisingly, most of the analyzed scientific articles that use the terminology of (ir)reversibility substantively do not provide an explicit conceptualization or definition (74.7%). The research on potential (ir)reversibility of environmental change may affect the social and political willingness to bear the costs of interventions to mitigate or prevent undesirable environmental change. In particular, classifying a change as reversible or irreversible and determining the timescale(s) and spatial scale(s) involved has implications for policy and ecosystem management decisions, as suggested by its use in several high-level scientific and policy reports on ecosystem and climate change. Therefore, it is important to explicitly present a clear definition of irreversibility or reversibility for the readers from other fields, even if it could be the case that within a specific community an implicit definition was considered to be sufficient. We propose further recommendations for inter- and transdisciplinary reflection and conceptual use in the context of environmental, ecological, and sustainability research.
Collegial Virtues and Vises
Authors: Hume Robert J
Published: December 2024

This review essay of The Elevator Effect, by Morgan L. W. Hazelton, Rachael K. Hinkle, and Michael J. Nelson, considers the authors' premise that collegiality is a central determinant of judicial behavior, on par with other leading influences such as attitudes, the law, and strategy. The authors make a strong case that judges on collegial courts forge relationships when they serve in close contact with one another over long careers and that these relationships influence the choices judges make. This review essay engages the authors' theory and highlights the areas in which it seems to offer the most explanatory power: notably, the decision by judges to write separately (e.g., dissent, concur) on the U.S. Courts of Appeals. The essay also reflects on the limitations of collegiality and how the theory may be less helpful in accounting for behavior in other contexts, such as the U.S. Supreme Court. Among the topics explored are the decision to reverse, citation practices, and the use of discourteous rhetoric by federal judges.
Use of Practices to Reduce of Sudden Unexpected Infant Death among Caregivers of Opioid Exposed Newborns
Authors: Parker Margaret G. , Rice Fiona , Peguero Chanel , Evans Ariana , Schiff Davida M. , Colvin Bryanne , Friedman Hayley , Harer Katherine , Kerr Stephen M. , Corwin Michael J. , Heeren Timothy C. , Colson Eve R. , Wachman Elisha M.
Published: December 2024

Objectives

Sudden unexpected infant death (SUID) occurs disproportionately among opioid exposed newborns (OENs) compared to those unexposed. The extent that primary caregivers of OENs adhere to SUID-reducing infant care practices is unknown. We examined rates of SUID-reducing practices (smoking cessation, breastfeeding, and safe sleep [supine sleep, room-sharing not bed-sharing, nonuse of soft bedding or objects]) in a pilot sample of caregivers of OENs.

Methods

We surveyed 50 English-speaking mothers and other primary caregivers of OENs 1–6 months old between 02/2022 and 10/2023. We examined prenatal and postnatal cigarette smoking exposure, breastfeeding initiation and duration, and sleep position (side, back, or stomach), sleep location (bed-sharing, room-sharing not bed-sharing, or separate room), and soft bedding or objects in the infant sleep space.

Results

Thirty-six (72%) of 50 respondents were birth mothers and 14/50 (28%) were other caregivers. Sixty-one percent of infants were exposed to cigarette smoking prenatally (mothers only) and 34% postnatally (41% mothers vs 14% other caregivers). Sixty percent of infants received breast milk ≤4 weeks. Among respondents, 32% placed infants in nonsupine sleep position (36% mothers vs 21% other caregivers), 38% shared a bed with their infant for sleep (47% mothers vs 14% other caregivers), and 30% used soft bedding in the infant sleep space (33% among mothers vs 21% among other caregivers).

Conclusions

Infant care practices associated with SUID were highly prevalent in our pilot sample of OENs and differed among mothers versus other caregivers. Further investigation and tailored approaches to this population are needed.
Direct Immunofluorescence in Dermatomyositis and Lupus Erythematosus: Cross-Sectional Diagnostic Accuracy and Correlation With Serologies and Other Features of Systemic Disease
Authors: Jacobson Rebecca , Kazmi Maha , Vaughan Heidi , Agnihothri Ritesh , North Jeffrey P. , Connolly M. Kari , Haemel Anna
Published: December 2024

This is a retrospective cross-sectional diagnostic test accuracy study of direct immunofluorescence (DIF) performed on a group of potential lupus erythematosus (LE)/dermatomyositis (DM) skin biopsies from 2015 to 2020 at a large, academic medical center. For purposes of this study, which was focused primarily on detection of LE/DM-related interface dermatitis, DIF was considered positive for a LE/DM pattern if it showed granular deposition of immunoglobulin G, with or without C3, at the basement membrane zone on the final pathology report. Blinded clinicopathologic correlation was the reference standard. One thousand fifty-eight sequential pairs of skin biopsies obtained from adults and submitted for both DIF and routine histology were screened. Cases were excluded if histopathology did not demonstrate features that could be consistent with LE/DM (broadly predefined as interface dermatitis and/or neutrophilic dermatosis), resulting in 254 cases of possible LE/DM eruptions for further analysis. Sensitivity of DIF with an immunoglobulin G granular pattern at the basement membrane zone was 71.4% (confidence interval 55.4%–84.3%) in LE-related and 59.3% (confidence interval 38.8%–77.6%) in DM-related eruptions. No statistically significant difference was found in sensitivities of DIF between LE and DM (P = 0.3). DIF positivity did not correlate with available key demographic, clinical, and serologic features.
Intramuscular Cellular Nodules in a Congenital Large Plaque-Like Blue Nevus: Melanoma or Not?
Authors: Tirumalae Rajalakshmi , Correa Marjorie , Manjunath Suraj
Published: December 2024

Introduction:

Melanoma arising in blue nevus (BN) is usually evident on histopathology. However, there are cases in the gray zone where neither morphology nor immunostains and molecular studies are conclusive.

Case Report:

A 33-year-old man presented with greenish discoloration of the abdominal skin at birth. Over time, the lesion increased in size to involve the entire left half of the abdomen, extending to the back and chest wall. He noticed nodules beneath the lesion, which were enlarging. Magentic resonanace imaging showed a lesion within the left external oblique measuring 8.3 × 6 × 4 cm and smaller lesions in the adjacent muscular planes. Gross examination of the excision showed an 8 × 6.5 × 5 cm brown-black, intramuscular nodule. Histopathology showed a BN of the overlying skin extending into the subcutis. The intramuscular nodule showed infiltrative, cellular areas with nonpigmented, plump spindle cells in nests and pseudorosettes with focal necrosis. There was minimal pleomorphism and prominent eosinophilic nucleoli. Mitoses were scarce. The neoplastic cells expressed Melan A, S100, and HMB45 with a low proliferative index (<1%). The lack of atypia and mitoses, despite clinically suspicious for melanoma, lead us to perform comparative genomic hybridization, which showed an abnormality suggesting malignancy. The patient remains with localized disease 6 years after surgery and no distant metastases.

Conclusions:

Cellular nodules in a plaque-like blue nevus presenting as an intramuscular mass is hitherto unreported. It is prudent to follow-up such cases like a melanoma, despite lacking overt atypia and mutations, because metastases have been reported as late as 16 years after diagnosis.
Association of Early-life Trauma With Gestational Diabetes and Hypertensive Disorders of Pregnancy
Authors: Lovett Sharonda M. , Woo Jennifer M. P. , O’Brien Katie M. , Parker Samantha E. , Sandler Dale P.
Published: December 2024

Background:

Early-life trauma (before age of 18 years) is hypothesized to increase the risk for adverse pregnancy outcomes through stress pathways, yet epidemiologic findings are mixed.

Methods:

Sister Study participants (US women aged 35–74 years enrolled 2003–2009) completed an adapted Brief Betrayal Trauma Survey at the first follow-up visit. Lifetime history of gestational diabetes mellitus (GDM) or hypertensive disorders of pregnancy (HDP: pregnancy-related high blood pressure, pre-eclampsia/toxemia, or eclampsia) in pregnancies lasting ≥20 weeks was self-reported. We used log–binomial regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for the association between early-life trauma (modeled using conventional measures [e.g., any experience, substantive domains, individual types] and latent classes of co-occurring traumas) and GDM or HDP among 34,879 parous women.

Results:

Approximately, 4% of participants reported GDM and 11% reported HDP. Relative to no early-life trauma, the RRs for any were 1.1 (95% CI = 1.0, 1.3) for GDM and 1.2 (95% CI = 1.2, 1.3) for HDP. Women reporting physical trauma had the highest risk of GDM and HDP in comparison to other substantive domains. In analyses using latent classes of early-life trauma, high trauma was associated with an elevated risk of both GDM (RR = 1.9, 95% CI = 1.5, 2.6) and HDP (RR = 1.7, 95% CI = 1.4, 2.0) compared with low trauma.

Conclusions:

Women experiencing high levels of trauma in early life were at higher risk of GDM and HDP, adding to a growing evidence base for this association.
Associations of Traumatic Brain Injury and Hearing: Results From the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)
Authors: Schneider Andrea L.C. , Kamath Vidyulata , Reed Nicholas S. , Mosley Thomas , Gottesman Rebecca F. , Sharrett A. Richey , Lin Frank R. , Deal Jennifer A.
Published: December 2024

Objective:

To examine associations of traumatic brain injury (TBI) with self-reported and clinical measures of hearing function.

Setting:

Four US communities.

Participants:

A total of 3176 Atherosclerosis Risk in Communities Study participants who attended the sixth study visit in 2016-2017, when hearing was assessed.

Design:

Prospective cohort study. TBI occurring prior to the hearing assessment was defined using self-reported questions and “International Classification of Diseases-9th/10th Edition” (ICD-9/10) codes.

Main Measures:

Hearing function was assessed by self-reported questionnaires and clinically measured indices (audiometry [4-frequency pure tone average for each ear] and speech-in-noise testing). Linear, logistic, and multinomial logistic models adjusted for sociodemographics, vascular risk factors, and occupational noise exposure were used to examine associations.

Results:

Participants were a mean age of 79 years, 59% were female, 21% were of self-reported Black race, and 33% had a history of TBI (median time from first TBI to hearing assessment: 39 years (25th-75th percentile = 19-63 years). Compared to participants without TBI, participants with prior TBI had higher age-adjusted prevalence of self-reported hearing loss (42.3% vs 35.3%), tinnitus (28.0% vs 23.8%), hearing aid use (23.4% vs 17.8%), pure tone average > 40 dB (30.6% vs 24.8%), and presence in the lowest quartile of speech-in-noise performance (27.6% vs 22.8%). With further adjustment, and particularly with adjustment for occupational noise exposure, associations with hearing measures were largely no longer statistically significant. In secondary analyses of associations of TBI frequency and severity with hearing function, results were similar to our main analyses, without evidence of dose-dependent associations.

Conclusions and Relevance:

In this community-based cohort, prior TBI was associated with impaired hearing on both self-reported and clinically measured assessments, but these associations were attenuated after adjustment for occupational noise exposure. These results underscore the importance of the consideration of loud noise exposures, which may confound associations of TBI with hearing, in future studies.
Ultrasound-Guided Intraosseous Injection of Bone Marrow Aspirate Concentrate for a Basketball Player With Bilateral Tibial Nonunion Fractures
Authors: Hussain Farah S. , Olufade Oluseun A.
Published: December 2024

We present a case of a professional basketball player who suffered from nonunion bilateral chronic tibial fractures, successfully treated with ultrasound-guided intraosseous injection with bone marrow aspirate concentrate. The patient was able to return to play full time after recovery from the procedure.
Influence of phytosomal curcumin on anthropometric indices for nonalcoholic fatty liver disease: A meta-analysis
Authors: Liu Nana , Li Hongting
Published: December 2024

Background:

Phytosomal curcumin may have some potential in improving anthropometric indices for nonalcoholic fatty liver disease, and this meta-analysis aims to study the effect of phytosomal curcumin on anthropometric indices for nonalcoholic fatty liver disease.

Methods:

We have searched several databases including PubMed, EMbase, Web of science, EBSCO and Cochrane library databases, and selected the randomized controlled trials (RCTs) comparing phytosomal curcumin with placebo for nonalcoholic fatty liver disease. This meta-analysis was conducted using the random-effect or fixed-effect model based on the heterogeneity.

Results:

Seven RCTs were included in this meta-analysis. Compared with placebo in nonalcoholic fatty liver disease, phytosomal curcumin was associated with substantially reduced body mass index (BMI, mean difference [MD] = −0.72; 95% confidence interval [CI] = −1.11 to −0.33; P = .0003), body fat percent (MD = −2.04; 95% CI = −3.10 to −0.98; P = .0002), weight (MD = −2.15; 95% CI = −3.78 to −0.53; P = .01) and waist circumference (MD = −2.09; 95% CI = −4.05 to −0.12; P = .04), but showed no influence on hip circumference (MD = −0.06; 95% CI = −0.59 to 0.47; P = .83) or waist/hip ratio (MD = 0; 95% CI = −0.01 to 0.01; P = 1).

Conclusions:

Phytosomal curcumin is effective to improve anthropometric indices for patients with nonalcoholic fatty liver disease.
How much is too much?: A retrospective causal analysis of the 7-day fluid balance for septic critical care patients
Authors: Yang Zheng , Shi Zhanli , Song Wenwen
Published: December 2024

Many studies have provided significant evidence to suggest that early aggressive fluid resuscitation strategies are acutely beneficial in patients with sepsis. However, most of these studies did not follow up to determine the long-term impacts on patients’ fluid and electrolyte balance after high-volume resuscitation strategies. This study sought to investigate the results of the aggressive fluid resuscitation measures used on patients with sepsis over the course of 7 days following resuscitation. An initial 3528 adult patients with sepsis who met inclusion criteria from the Medical Information Mart for Intensive Care IV database were collected. The total 7-day fluid balance of each patient was calculated and categorized into quartiles. Univariate Cox regression, lasso regression, backward stepwise elimination, and multivariate Cox regression were performed to search for variables related to survival during hospitalization. To determine the critical point of patients’ fluid balance over 7 days, a restricted cubic spline regression model with 4 knots was performed. In addition, an inverse probability of treatment weighting analysis was conducted to confirm our findings. The median 7-day fluid balance is 5321.4 (interquartile range, 848.5–10,404.0) mL. The observed 28-day mortality in this cohort was 21.6%. Both before and after the inverse probability of treatment weighting analysis, the first 7-day fluid balance in the intensive care unit was significantly related to mortality during hospitalization (P < .001). A restricted cubic spline regression analysis indicated when the 7-day fluid balance was equal to 5243.3ml, the heart rate value was ≈1. A 7-day fluid balance < 5243.3 mL was considered a protective factor, while a balance > 5243.3 mL was considered a risk factor for patient mortality. To be clear, this study does not advocate against aggressive fluid resuscitation in patients with sepsis. However, clinicians walk a fine line with the extent of the resuscitation volume given to patients with sepsis. As a result of this study, it is highly advised that fluid resuscitation in patients with sepsis be limited to ≈5200-mL 7-day fluid balance for optimal clinical benefit.
Effect of sodium zirconium cyclosilicate on hyperkalemia after parathyroidectomy in secondary hyperparathyroidism patients with maintenance hemodialysis: A randomized trial
Authors: Kang Jing , Li Sijia , Su Jinglin , Xiao Zhixue , Zhang Siyi , Liu Shuangxin , Ge Pingjiang
Published: December 2024

Background:

Postoperative hyperkalemia is 1 common complication after parathyroidectomy (PTX), which requires close monitoring and prompt treatment. This study aimed to determine whether using sodium zirconium cyclosilicate (SZC) would lower the risk of hyperkalemia in patients with maintenance hemodialysis after PTX.

Methods:

Sixty-two patients with secondary hyperparathyroidism (SHPT) were randomly divided into the experimental and control groups. Patients in the experimental group were required to take 10 g of SZC before PTX. Laboratory chemistries were obtained before and after surgery.

Results:

Parathyroid hormone (PTH) decreased dramatically in the experimental and control groups after PTX. There were no significant differences in serum potassium ion (K+) between the 2 groups at 6 am on the day of surgery and immediately after surgery. However, serum potassium in the experimental group at 9 pm on the day of surgery was significantly lower than in the control group. Three patients with severe hyperkalemia in the control group received emergency hemodialysis or insulin and glucose treatment, while none in the experimental group required hemodialysis. Serum calcium levels declined immediately after the operation, but no significant differences were found between these 2 groups at all time points.

Conclusion:

SZC has the potential to reduce the occurrence of hyperkalemia and avoid urgent hemodialysis after PTX. We recommended that SZC could be used routinely in SHPT patients on the day of PTX surgery.
Hemorrhagic liver cyst misdiagnosed as echinococcosis in a Tibetan woman: A case report
Authors: Wang Shuang , He Yan , He Xuchang , Wang Jun
Published: December 2024

Rationale:

We describe a case of hepatic cyst with intracystic bleeding that was preoperatively misdiagnosed as hepatic echinococcosis. Pain in the right upper quadrant of the abdomen was the first symptom to appear. In addition to highlighting the significance of imaging in distinguishing hepatic cyst with intracystic bleeding from other cystic liver tumors, we also talk about the difficulties and obstacles encountered throughout the diagnosis and treatment of this case. More imaging evidence for the diagnosis of hepatic cyst with intracystic bleeding is anticipated in this patient.

Patient concerns:

A 24-year-old Tibetan female was admitted to the hospital due to swelling and pain in the right upper abdomen for more than 1 month.

Diagnoses:

The patient had a history of living in the epidemic area, serum echinococcosis antibody was positive, and abdominal computed tomography plain enhanced scan showed a low-density cystic space-occupying lesion in the right lobe of the liver, with a high-density mass in the cyst, which was misdiagnosed as cystic hepatic echinococcosis before operation. Postoperative pathological examination confirmed old hemorrhage in hepatic cysts, and no parasitic infectious lesions such as Echinococcus granulosus were found.

Interventions:

After perfecting the relevant preoperative preparation, the patient underwent right hemihepatectomy plus portal vein and vena cava repair.

Outcomes:

The patient was discharged from the hospital 5 days after operation.

Lessons:

The differential diagnosis of individuals with a history of residing in an epidemic region and liver space-occupying lesions on imaging should take into account more than only the probability of hepatic echinococcosis, as this case highlights. When making a differential diagnosis of different types of cystic liver tumors, imaging testing is crucial.
Lobular endocervical glandular hyperplasia: Two case report and literature review
Authors: Tang Shenglan , Jiang Xuelu , Wang Xue
Published: December 2024

Rationale:

Lobular endocervical glandular hyperplasia is a rare proliferative lesion of the endocervical glands with an unclear pathogenesis. The condition lacks specific clinical manifestations and signs and often leading to clinical underdiagnosis and misdiagnosis.

Patient concerns:

A 27-year-old female patient presented with a history of abnormal vaginal bleeding over the previous 3 months. An ultrasound examination revealed the presence of a cystic solid structure in the posterior wall of the cervix.

The second patient is a 25-year-old woman who has undergone 3 cervical cystectomies over the past 9 years due to recurrent cervical cysts. It is regrettable to report that the cyst has now recurred.

Diagnoses:

Lobular endocervical glandular hyperplasia.

Interventions:

In consideration of the fertility needs of both patients, the gynecologists conducted a comprehensive imaging evaluation and detailed preoperative discussion, and performed ultrasound-guided hysteroscopic excision of cervical lesions and transvaginal excision of cervical lesions.

Outcomes:

Following treatment, the 2 patients exhibited a complete resolution of their clinical symptoms. Subsequent follow-up examinations demonstrated that both patients were exhibiting favorable outcomes.

Lessons:

The objective of this study is to present 2 cases of lobular endocervical glandular hyperplasia in order to facilitate a greater understanding of this rare disease among gynecologists. Furthermore, this study will describe the potential use of ultrasound-guided hysteroscopic excision of cervical lesions and transvaginal hysteroscopic excision of cervical lesions as a treatment modality for lobular endocervical glandular hyperplasia patients with fertility needs.
Anti-sulfatide antibody-positive Guillain–Barré syndrome in adults following off-craniotomy for cerebellar contusion: A case report
Authors: Min Xiaobin , Feng Haoye , Zhao Riguang , Guo Zhigang , Su Hongjun
Published: December 2024

Rationale:

Gullain–Barré syndrome (GBS) is a rare autoimmune condition primarily presenting with symmetrical progressive limb weakness. It is frequently associated with sensory and autonomic symptoms and autonomic disturbances and often manifests seropositivity for anti-ganglioside antibodies. Infections are considered major precipitants; however, GBS post-craniotomy for severe traumatic brain injury is a rarity.

Patient concerns:

A 79-year-old female underwent craniotomy for a cerebellar contusion sustained from severe traumatic brain injury, leading to quadriplegia, autonomic dysfunction, dilated pupils, and respiratory failure. However, the patient’s GBS manifested slightly differently. Her limb weakness was asymmetric and progressed from 1 upper limb to the other.

Diagnoses:

The diagnosis of GBS was confirmed based on clinical presentation, cerebrospinal fluid analysis showing albuminocytologic dissociation, and the detection of anti-sulfatide antibodies in serum.

Interventions:

The patient received intravenous immunoglobulin (IVIG) therapy at 2 g/kg daily, along with supportive measures including mechanical ventilation and rehabilitation.

Outcomes:

The patient demonstrated significant improvement within 5 days of IVIG treatment, achieving near-complete functional recovery with grade 4 muscle strength at discharge 6 weeks post-intervention.

Lessons:

This case highlights the need to consider GBS in postoperative patients with acute limb weakness, even in atypical presentations. Early recognition and timely IVIG treatment are critical for favorable outcomes.
Predictors of high-grade atherosclerotic renal artery stenosis in patients with CKD
Authors: Ouyang Jun , Chen Kequan , Wang Hui , Huang Jiangnan
Published: December 2024

This study aims to explore predictors of high-grade atherosclerotic renal artery stenosis (ARAS) in patients with chronic kidney disease (CKD). This was a retrospective study, and univariate analysis such as independent-sample t test or nonparametric test where appropriate was used to explore variables with significant difference between patients with high-grade ARAS and patients with low-grade ARAS. Then, multivariate logistic regression and receiver operating characteristic curve (ROC) analysis were performed for further research. In univariate analysis, we found that there was a significant difference in smoking history, estimated glomerular filtration rate (eGFR), cystatin C, fasting blood glucose and lymphocyte-to-monocyte ratio (LMR) between the 2 groups. Multivariate logistic regression analysis showed that eGFR (OR = 0.979, 95% CI: 0.962–0.996, P = .017), cystatin C (OR = 2.123, 95% CI: 1.118–4.030, P = .021) and LMR (OR = 0.639, 95% CI: 0.421–0.969, P = .035) were still associated with high-grade ARAS in patients with CKD. ROC analysis showed that eGFR (AUC: 0.681; sensitivity: 64.1%, specificity: 65.1%), cystatin C (AUC: 0.658; sensitivity: 74.6%, specificity: 53.85%) and LMR (AUC: 0.650; sensitivity: 66.70%, specificity: 62.00%). In patients with CKD, eGFR, and cystatin C and LMR were predictive parameters of high-grade ARAS, and among them, eGFR and LMR held the greatest predictive value for high-grade ARAS in patients with CKD.
The value of pelvic peritoneal reconstruction during abdominoperineal resection for rectal cancer: A systematic review and meta-analysis
Authors: Wang Jian , Yang Xingwen , Hao Mengdi
Published: December 2024

Background:

To systematically evaluate the significance of pelvic peritoneal reconstruction during abdominoperineal resection for rectal cancer, specifically focusing on its impact on the incidence of postoperative complications, in order to provide recommendations for clinical medical practice.

Methods:

We performed a thorough literature search using multiple databases, including PubMed, Web of Science (which includes MEDLINE), the Chinese National Knowledge Infrastructure database, and the Wan-Fang database. The search was updated until May 20, 2023, and included articles published from the earliest available dates. The selected literature was assessed for quality, and data extraction was conducted. The extracted data were then subjected to meta-analysis using RevMan 5.4 software.

Results:

A total of 16 cohort studies were included, with publication dates ranging from 2012 to 2021, including 9 prospective cohort studies and 7 retrospective cohort studies. These studies consisted of both a pelvic peritoneal closure (PPC) group and a non-closure group. The meta-analysis revealed that patients in the PPC group had significantly lower incidence rates of the following postoperative complications compared to the non-PPC group, with statistical significance observed (P < .05): intestinal obstruction (odds ratio [OR] = 0.22, 95% confidence intervals [CI]: 0.14–0.36, P < .01), surgical site infection (OR = 0.36, 95% CI: 0.24–0.55, P < .01), pelvic and abdominal cavity infection (OR = 0.20, 95% CI: 0.05–0.79, P < .05), pelvic and abdominal cavity infection (OR = 0.17, 95% CI: 0.07–0.39, P < .01).

Conclusion:

Our findings indicate that pelvic peritoneal reconstruction during the surgical procedure holds promise in reducing the occurrence of adverse postoperative events and may have substantial clinical implications for the management of rectal cancer.
Construction and validation of a nomogram prediction model for factors affecting hip functional recovery after PFNA internal fixation of intertrochanteric femur fractures in the elderly
Authors: Jiang Wan-Zhong
Published: December 2024

A nomogram prediction model was developed with the aim of identifying and analyzing which independent risk factors affect the recovery of hip function in elderly patients with intertrochanteric femur fractures after undergoing proximal femoral anti-rotation intramedullary nailing (PFNA) internal fixation. We collected detailed data on elderly patients with intertrochanteric femur fractures from January 2018 to December 2022 in a tertiary hospital in China. By applying univariate and multivariate logistic regression analysis, we systematically screened and identified the independent risk factors affecting the recovery of hip function after PFNA internal fixation. Based on these risk factors, we further constructed a corresponding nomogram prediction model. In order to comprehensively evaluate the predictive performance of the model, we not only plotted the receiver operating characteristic curve and calculated the area under the curve, but also produced the calibration curve and decision curve. Of the total 646 patients included, 510 patients had good hip function recovery and were categorized as the excellent hip function group, while the other 136 patients had poor hip function recovery and were categorized as the poor hip function group. After rigorous unifactorial and multifactorial logistic regression analyses, we identified 5 key risk factors, which were: fracture instability, posterolateral wall type III, posterolateral wall thickness less than or equal to 2 cm, cusp distance >25 mm, and delayed postoperative weight-bearing. Together, these factors constitute the main risk factors affecting the recovery of hip function after PFNA internal fixation of intertrochanteric femur fractures in the elderly. In this study, a nomogram prediction model for the recovery of hip function after PFNA internal fixation of intertrochanteric femur fractures in the elderly was successfully constructed, and the model demonstrated good prediction accuracy. This not only provides a powerful tool for orthopedic surgeons so that they can identify and intervene in advance with risk factors that may affect patients’ hip functional recovery, but also provides a scientific basis for developing more precise and personalized treatment strategies.
Roles of WDR12 and MRTO4 genes in colorectal cancer
Authors: Luo Huanping
Published: December 2024

Colorectal cancer refers to malignant tumors occurring in the walls of the colon or rectum. The roles of WD Repeat Domain 12 (WDR12) and mitochondrial ribosome-associated tumor suppressor 4 (MRTO4) genes in colorectal cancer remain unclear. The colorectal cancer dataset GSE113513 configuration file was downloaded from the gene expression omnibus database generated from GPL15207. Differentially expressed genes screening, functional enrichment analysis, gene set enrichment analysis, Weighted Gene Co-expression Network Analysis, construction and analysis of protein–protein interaction networks, survival analysis, and gene expression heatmap plotting were conducted. Comparative toxicogenomics database analysis was performed to find diseases most relevant to core genes. TargetScan was used to screen miRNAs regulating core genes. A total of 3106 differentially expressed genes were identified. According to gene ontology analysis, they mainly enriched in organic acid metabolic processes, condensed chromosome kinetochore, oxidoreductase activity, and cell cycle. In Kyoto encyclopedia of genes and genomes analysis, they primarily concentrated in the cell cycle, TGF-β signaling pathway, Jak-STAT signaling pathway, PI3K-Akt signaling pathway, Ras signaling pathway, TNF signaling pathway, p53 signaling pathway, NF-kB signaling pathway, and WNT signaling pathway. Weighted Gene Co-expression Network Analysis with a soft thresholding power set to 12 generated 29 modules. The protein–protein interaction network identified 6 core genes (DDX27, NAT10, WDR12, DKC1, MRTO4, and NOP56). Survival analysis showed core genes (POSTN, MYH11, LUM, COL6A3, and COL4A1) as risk factors. Gene expression heatmap revealed high expression of core genes (WDR12 and MRTO4) in colorectal samples. Comparative toxicogenomics database analysis linked core genes (WDR12 and MRTO4) with local tumor infiltration, bowel obstruction, abdominal pain, and colorectal neoplasms. WDR12 and MRTO4 genes are highly expressed in colorectal cancer, potentially influencing its progression.
Lemierre syndrome: case presentation of a life-threatening septic pneumonia with complicated parapneumonic effusion: A case report
Authors: Kim Tae Hun , Youn Seong Hwan , Kim Mi-Ae , Kim Hyun Jung , Kwon Yong Shik , Park Jae Seok , Park Sun Hyo
Published: December 2024

Rationale:

Lemierre syndrome is a rare, life-threatening complication of oropharyngeal infections.

Patient concerns:

A 35-year-old man started with an upper respiratory infection but worsened the clinical course with sepsis and acute respiratory failure with complicated bilateral pleural effusion.

Diagnoses:

The patient was diagnosed with typical Lemierre syndrome with lung complications.

Interventions:

Antibiotic therapy with bilateral pleural percutaneous drain with fibrinolysis.

Outcomes:

The patient improved and was discharged without oxygen therapy after antibiotics were covered and active lung care with complicated parapneumonic effusion. After discharge, lung function showed restrictive lung defect but improved compared to the initial exam.

Lessons:

Lemierre syndrome, which might begin as a mild upper respiratory infection, can progress to a critically ill disease accompanied by sepsis and metastatic septic embolus. The patient suffered septic lung emboli with bilateral complicated parapneumonic effusion but was successfully treated with percutaneous drainage with pleural fibrinolysis, appropriate antibiotics, and anticoagulants. Early suspicion of the disease and active treatment are necessary to treat rare syndromes like Lemierre syndrome.
Efficacy and safety of red ginseng extract powder (KGC05pg) in achieving glycemic control in prediabetic Korean adults: A 12-week, single-center, randomized, double-blind, parallel-group, placebo-controlled study
Authors: Jeong Yoonseon , Lee Seung Ho , Shim Sung Lye , Jang Kyoung Hwa , Kim Jong Han
Published: December 2024

Background:

This study was conducted to assess the efficacy and safety of Red Ginseng Extract Powder (RGEP) (KGC05pg; Korea Ginseng Corporation, Daejeon, Korea) in achieving glycemic control in prediabetic Korean adults.

Methods:

The patients of the RGEP group (n = 49) and those of the placebo group (n = 49) were orally given 2 tablets of RGEP and its matching placebo, respectively, at a dose of 500 mg/day twice daily in the morning and the evening within 30 min after meal during a 12-week treatment period. The patients were assessed for glycemic control parameters, such as fasting blood glucose levels, 30-, 60-, 90-, and 120-min blood glucose levels on an oral glucose tolerance test, Hb1Ac levels and glucose area under the curve, insulin resistance parameters, such as homeostasis model assessment of insulin resistance, c-peptide and insulinogenic index, and hormone parameters, such as glucagon, adiponectin and glucagon-like peptide-1. Moreover, the patients were also assessed for time-dependent changes in dipeptidyl peptidase-4 levels. Finally, the patients were also assessed for incidences of treatment-emergent adverse events and serious adverse events.

Results:

There were significant differences in changes in fasting blood glucose and 30-, 60-, 90-, and 120-min blood glucose levels on an oral glucose tolerance test, Hb1Ac levels, glucose area under the curve, homeostasis model assessment of insulin resistance, c-peptide levels and insulinogenic index, glucagon, adiponectin, and glucagon-like peptide-1 levels at 12 weeks from baseline between the 2 groups (P < .05). There was a significant time-dependent decrease in dipeptidyl peptidase-4 levels in the RGEP group (P = .001). There were no cases of treatment-emergent adverse events and serious adverse events in each treatment arm.

Conclusion:

RGEP might be effective in achieving glycemic control in prediabetic Korean adults.
Refining of cancer-specific genes in microsatellite-unstable colon and endometrial cancers using modified partial least square discriminant analysis
Authors: Na Woong , Lee Sung Hak , Lee Seunghee , Kim Jong-Seok , Han Seung Yun , Kim Yong Min , Kwon Mihye , Song Young Soo
Published: December 2024

Despite similarities in microsatellite instability (MSI) between colon and endometrial cancer, there are many clinically important organ-specific features. The molecular differences between these 2 MSI cancers are underexplored because the usual differentially expressed gene analysis yields too many noncancer-specific normally expressed genes. We aimed to identify cancer-specific genes in MSI colorectal adenocarcinoma (CRC) and MSI endometrial carcinoma (ECs) using a modified partial least squares discriminant analysis. We obtained a list of cancer-specific genes in MSI CRC and EC by taking the intersection of the genes obtained from tumor samples and normal samples. Specifically, we obtained publically available 1319 RNA sequencing data consisting of MSI CRCs, MSI ECs, normal colon including the rectum, and normal endometrium from The Cancer Genome Atlas and genome-tissue expression sites. To reduce gene-centric dimensions, we retained only 3924 genes from the original data by performing the usual differentially expressed gene screening for tumor samples using DESeq2. The usual partial least squares discriminant analysis was performed for tumor samples, producing 625 genes, whereas for normal samples, projection vectors with zero covariance were sampled, their weights were square-summed, and genes with sufficiently high values were selected. Gene ontology (GO) term enrichment, protein–protein interaction, and survival analyses were performed for functional and clinical validation. We identified 30 cancer-specific normal-invariant genes, including Zic family members (ZIC1, ZIC4, and ZIC5), DPPA2, PRSS56, ELF5, and FGF18, most of which were cancer-associated genes. Although no statistically significant GO terms were identified in the GO term enrichment analysis, cell differentiation was observed as potentially significant. In the protein–protein interaction analysis, 17 of the 30 genes had at least one connection, and when first-degree neighbors were added to the network, many cancer-related pathways, including MAPK, Ras, and PI3K-Akt, were enriched. In the survival analysis, 16 genes showed statistically significant differences between the lower and higher expression groups (3 in CRCs and 15 ECs). We developed a novel approach for selecting cancer-specific normal-invariant genes from relevant gene expression data. Although we believe that tissue-specific reactivation of embryonic genes might explain the cancer-specific differences of MSI CRC and EC, further studies are needed for validation.
The value of red blood cell distribution width in perioperative cardiac function assessment in children with congenital heart disease: A retrospective cohort study
Authors: Wang Qingsong , Yin Jun , Wang Xianmin , Luo Tongyong , Wei Min , Zhang Xiaomeng , Ou Huimin , Wan Weiyi , Li Fuyan , Zhang Yundong , Guo Caiyu
Published: December 2024

Congenital heart disease (CHD) is the leading cause of birth defects in children, with high morbidity and mortality rates. Despite advances in surgical and interventional treatments, perioperative management of CHD remains challenging, particularly in complex cases and neonates. Effective perioperative assessment of cardiac function is essential for optimizing surgical outcomes and improving postoperative prognosis. This study investigates the association between red blood cell distribution width (RDW) and perioperative cardiac function in children with CHD. Specifically, we aim to determine whether RDW can serve as a reliable biomarker for assessing perioperative cardiac risk in this patient population. This retrospective cohort study included 107 pediatric patients aged 0 to 18 years who underwent surgical or interventional treatment for CHD at Sichuan Provincial Maternity and Child Health Hospital between March 2022 and March 2023. Patients were classified into 3 groups based on their cardiac function (Class I–III) according to the European Society of Cardiology guidelines. Clinical and imaging data, as well as RDW levels, were analyzed to assess their relationship with perioperative cardiac function. Both preoperative and postoperative RDW-coefficient of variation (RDW-CV) and RDW-standard deviation (RDW-SD) levels were significantly higher with increasing severity of cardiac dysfunction, with statistically significant differences observed among the 3 cardiac function groups (P < .001). Preoperative RDW-CV values were 13.26 ± 1.44%, 15.07 ± 2.13%, and 19.87 ± 3.62%, and RDW-SD values were 39.84 ± 4.04%, 45.02 ± 6.33%, and 56.12 ± 9.61% (all P < .001). Postoperative RDW-CV values were 14.05 ± 2.14%, 15.98 ± 2.29%, and 20.36 ± 4.42%, and RDW-SD values were 43.99 ± 4.73%, 48.21 ± 6.23%, and 58.33 ± 9.71% (all P < .001). Patients with heart failure had significantly higher RDW-CV and RDW-SD levels compared to non-heart failure patients, both preoperatively and postoperatively (P < .001). RDW is strongly associated with perioperative cardiac function in children with CHD. RDW levels increase with the severity of cardiac dysfunction and are clinically valuable in identifying heart failure in these children. As a simple and effective biomarker, RDW can assist in the perioperative assessment of cardiac function in this patient population.