bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation of Hyaluronic Acid (HA), Syndecan-1 (SDC-1), Heparan Sulfate (HS) With Early Stage End Organ Dysfunction in Sepsis Patients
Authors: Li Zhengchao , Jiang Xingpeng , Li Jinghui , Wang Yuzhu
Published: November 2024

The aim of this study was to explore the relationship between the changes in early degradation products of polysaccharide coatings [such as hyaluronic acid (HA), syndecan-1 (SDC-1), and heparan sulfate (HS)] and the development of organ dysfunction in sepsis patients. We conducted a retrospective analysis on 140 sepsis patients admitted from January 2021 to June 2022, who formed the study group; 100 healthy individuals who underwent health checks during the same period were included as the control group. The study found that the expression levels of HA, SDC-1, and HS on admission and within 24 hours of admission in sepsis patients, as well as the early change rates, were positively correlated with organ dysfunction (P < 0.05). Through receiver operating characteristic curve analysis, we discovered that the early change rates of HA, SDC-1, and HS have high predictive value for organ dysfunction in sepsis patients, with the combined predictive value being the most significant. The study conclusion points out that the increased levels of HA, SDC-1, HS, and other degradation products of polysaccharide coatings in the early stage of sepsis are positively associated with the occurrence of organ dysfunction. Clinicians can use the early expression changes of these biomarkers to predict the risk of organ dysfunction in sepsis patients, enabling timely implementation of preventive measures that may improve patient outcomes.
Planned Y-shaped Muscle Wrapping for Salvaging Aortic Graft Infection: Latissimus Dorsi and Reverse Serratus Anterior Muscles
Authors: Tsuge Itaru , Saito Susumu , Takatoku Kazuhiro , Matsuo Takehiko , Minatoya Kenji , Morimoto Naoki
Published: November 2024

Aorta-related infections are life threatening. Aggressive replacement surgery using artificial aortic grafts should be performed using well-vascularized tissue wrapping to avoid reinfection. An omental flap is the first choice; however, a history of abdominal surgery necessitates other methods. In a cadaveric study in 2021, we verified the distal tight attachment area between the latissimus dorsi (LD) muscle and serratus anterior (SA) muscle to apply a Y-shaped combined flap consisting of the LD and reverse SA. We used this procedure to treat a 79-year-old man who underwent stent-graft insertion in the descending thoracic aorta. Descending aortic graft replacement was performed with a left anterior lateral thoracotomy. Then, we elevated the LD and SA combined flap by “posterior-to-anterior elevation” based on the previous cadaveric study. After blocking blood flow from the SA branch with a microvascular clip, blood flow from the LD branch of the thoracodorsal artery to the distal part of the SA muscle across the distal attachment area was evaluated using indocyanine green fluorescence. Fluorescence had spread throughout the distal part of the SA muscle. Postoperative computed tomography and the clinical course indicated successful regulation of infection. We established a novel surgical technique for the complete muscle wrapping of the descending thoracic aorta, including the aortic arch. The accumulation of further cases is needed to determine whether the blood flow of the distal connection area from the LD to the SA has individual variations; however, we hope this technique improves the mortality and morbidity associated with aorta-related infections.
INCIDENCE OF CENTRAL SEROUS CHORIORETINOPATHY AND ITS ASSOCIATION WITH GYNECOLOGICAL DISEASES IN WOMEN
Authors: Lee Ju-Yeun , Noe Eunbee , Yoon Chang Ki , Lee Eun Kyoung , Park Un Chul , Bae Kunho
Published: November 2024

Purpose:

Although the exact pathogenesis of central serous chorioretinopathy (CSC) remains unclear, some factors are known to be sex-specific. We aimed to investigate the incidence and systemic associations for CSC in women.

Methods:

This population-based nested case–control study included East Asian women whose medical claims data were obtained from the Korean National Health Insurance Service database. Patients newly diagnosed with CSC between 2017 and 2019 were assigned to the CSC group and matched to healthy controls in a 1:4 ratio by age, gender, and index date. The incidence of CSC in women and its association with gynecologic comorbidities and corticosteroid use before the index date (2008–2017) were analyzed.

Results:

The study matched 3,789 patients with CSC with 15,156 controls. The 3-year cumulative incidence of CSC in women was 27.13 (95% confidence interval [CI], 27.06–27.19) per 100,000 people. Multivariate logistic analysis showed a significantly increased association of CSC in patients with pre-eclampsia (adjusted odds ratio, 2.66; 95% CI, 1.86–3.81) (P < 0.001), endometriosis (adjusted odds ratio, 1.19; 95% CI, 1.03–1.38) (P < 0.001), steroid injections alone (adjusted odds ratio, 1.29; 95% CI, 1.16–1.43) (P < 0.001), and combination use of oral and injected steroid (adjusted odds ratio, 1.34; 95% CI, 1.23–1.47) (P < 0.001) compared with the controls.

Conclusion:

This study provides nationwide population-based data on the incidence of CSC in Asian women and suggests that exposure to specific gynecological comorbidities and intensive corticosteroid use are associated with the development of CSC in women.
CHRONIC RETINAL DETACHMENT
Authors: Dimakopoulou Ioanna , Mylonas Georgios , Kanata Aliki , Reiter Gregor S. , Schranz Markus , Lisy Marcus , Georgopoulos Michael
Published: November 2024

Purpose:

To elucidate the management of individuals with chronic retinal detachment, considering both surgical intervention and observation. The authors specifically focus on the long-term anatomical and functional outcomes, with a particular emphasis on optical coherence tomography follow-up.

Methods:

Data from 24 consecutive patients presenting with a chronic retinal detachment between 2014 and 2023 at the Department of Ophthalmology and Optometry, Medical University of Vienna, Austria, were retrospectively analyzed. The study used optical coherence tomography scanning with the Heidelberg Spectralis optical coherence tomography device's integrated measurement tool to assess the stability of chronic retinal detachment, potentially introducing optical coherence tomography as a follow-up tool for these patients.

Results:

The study included 27 eyes of 24 patients with an average age of 41.8 ± 13 years, and the mean follow-up time was 34 ± 27 months. Among the cases, 11 (41%) progressed and required surgery. Of these surgeries, 4 (37%) were scleral buckling and 7 (63%) were pars plana vitrectomy. After surgery, 64% experienced improved or stable vision, whereas 36% experienced a decrease in visual acuity. In the subgroup that had pars plana vitrectomy, two eyes (29%) had a redetachment, necessitating a second surgery. Meanwhile, 94% of untreated patients maintained stable 20/20 best-corrected visual acuity throughout the entire follow-up period.

Conclusion:

A cautious observation strategy could lead to superior outcomes when contrasted with more invasive management approaches in patients with chronic retinal detachment. Furthermore, when surgical intervention becomes imperative, the study suggests a preference for the adoption of a scleral buckling procedure in phakic patients without posterior vitreous detachment.
PNEUMATIC DISPLACEMENT AND INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR, WITH OR WITHOUT INTRAVITREAL TISSUE PLASMINOGEN ACTIVATOR, INJECTION FOR SUBMACULAR HEMORRHAGE
Authors: Chotikkakamthorn Patraramon , Bhurayanontachai Patama , Jirarattanasopa Pichai , Tsutsumi Wantanee Dangboon , Tantisarasart Thada , Ratanasukon Mansing
Published: November 2024

Purpose:

To evaluate the outcomes of intravitreal gas and anti–vascular endothelial growth factor (anti-VEGF), with or without tissue plasminogen activator (tPA), injection for submacular hemorrhage (SMH).

Methods:

The authors retrospectively enrolled patients with SMH treated with intravitreal gas and anti-VEGF, with or without tPA (tPA and non-tPA groups, respectively), injection between 2014 and 2021, and data were collected at the preoperative visit and at 1-, 3-, 6-, and 12-month follow-ups. The primary outcome was the final best-corrected visual acuity, and the secondary outcomes were central subfield thickness, degree of blood displacement, and incidence of vitreous hemorrhage.

Results:

Herein, 38 eyes received intravitreal gas, anti-VEGF, and tPA injections, whereas 89 eyes received intravitreal gas and anti-VEGF injections. At 12 months, no significant intergroup difference was detected (P = 0.94), except the slightly greater central subfield thickness change in the non-tPA group (P = 0.03). Complete SMH displacement occurred in 35 (tPA = 92.1%) and 89 (non-tPA = 89.9%) eyes, with higher vitreous hemorrhage incidence in the non-tPA group (odds ratio 7.03, P = 0.004).

Conclusion:

In pneumatic displacement combined with anti-VEGF therapy in SMH, adjunctive tPA use did not alter the visual and anatomical outcomes, although the vitreous hemorrhage risk in large SMH was reduced.
Impacts of immersive 3D videos on students’ surgical learning compared to 2D videos: a randomized controlled trial
Authors: Favier Amelia , Jaafar Eya , L’Hote Raphael , Gauthier Philippe , Avellino Ignacio , Canlorbe Geoffroy
Published: November 2024

Background:

Unlike other medical specialties, surgery is primarily learned through apprenticeship, by observing surgeons in action during operations. However, the increasing number of medical students and work-hour restrictions limit opportunities for learning in the operating room (OR). These circumstances call for novel technologies, such as immersive video. The objective of this study is to compare knowledge retention, preparedness, and content engagement for surgical learning when watching a surgical video in 3D through a Head-Mounted Display (HMD) versus in 2D video on a conventional screen.

Materiel and Methods:

This randomized controlled trial includes 231 fourth-year medical students. Participants watched the same 12 min surgical video, narrated by an expert, presented either in immersive 3D form through an HMD, or in 2D form through a conventional screen. The students completed three questionnaires (previewing, postviewing, and 1 month later), which included questions on knowledge retention, expected preparedness, content engagement, tool engagement, and self-assessment. Statistical analyses were adjusted by including the confounding factors.

Results:

Immediately after the video, the 3D immersive video group showed a significantly lower knowledge retention score compared to the classic video group (P<0.01). Nonetheless, the 3D immersive video group demonstrated better-expected preparedness as a future resident (P=0.019), greater satisfaction (P=0.033), better stimulation (P<0.001), higher involvement (P<0.001), and a greater perceived ability to identify anatomical structures (P<0.001). After 1 month, participants in the immersive video group reported feeling more prepared (P=0.016), more self-confident (P=0.020), more at ease (P=0.023), and less overwhelmed (P<0.01) than those in the 2D video group.

Conclusion:

Our results showed that 3D surgical immersive video vs. 2D surgical video, enhances the sense of stimulation, satisfaction, involvement, and the perception of having better identified anatomical structures. For early medical school students where access to the OR is limited, this tool appears to a significant step forward in surgical pedagogy. However, the precise understanding of its pedagogical value required further investigation and refinement.
Educational interventions improve disparities in patient access to kidney transplantation: a network meta-analysis of randomized controlled trials
Authors: Godoi Amanda , Koimtzis Georgios , Felix Nicole , Mora Maria M.R. , Graziani e Sousa Augusto , Soares Giulia A.R. , Carvalho Pedro E.P. , Ilham Mohamed A. , Stephens Michael R. , Khalid Usman
Published: November 2024

Background:

Transplantation significantly improves the quality of life for patients with chronic kidney disease. Despite various educational strategies being assessed, the optimal approach to overcome barriers to kidney transplantation remains unclear.

Materials and Methods:

The authors conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing educational interventions to improve kidney transplantation access. The authors searched Medline, Embase, Cochrane Central, and Clinicaltrials.gov up until June 2024. Outcomes included rate of transplantation, living donor inquiries, waitlisting, evaluation, and knowledge level. Frequentist random-effects models and p-scores were used to rank strategies. The protocol was registered in PROSPERO.

Results:

The authors included 24 RCTs with a total of 116 054 patients. Of these, 57 996 (49.97%) received educational interventions and 58 058 (50.03%) received standard-care. Educator-guided and home-based strategies were associated with a higher rate of transplantation to multilevel interventions (RR 1.63; 95% CI: 1.07–2.48; P=0.023 | RR 1.85; 95% CI: 1.11–3.08; P=0.019) and standard-care (RR 1.56; 95% CI: 1.00–2.45; P=0.049 | RR 1.78; 95% CI: 1.17–2.70; P=0.007). According to the P-scores ranking, home-based interventions were the most likely strategy to improve transplantation access.

Conclusion:

In this NMA of 24 RCTs, home-based and educator-guided interventions were the most beneficial for improving access to kidney transplantation. Future studies should focus on their applicability for minority populations with challenges in health literacy and transplant access.
Conservative Concussion Management in Youth Athletes Can Avoid Increased Injury Rates After Return to Sport: Initial Evidence
Authors: Adams Sarah N. , Mueske Nicole M. , Katzel Mia J. , Zaslow Tracy , Wren Tishya A. L.
Published: November 2024

Objective:

To evaluate whether injury rates are elevated after return to sport after concussion clearance in youth athletes and examine differences between concussed athletes who sustain injury after return to play and those who remain uninjured.

Design:

Prospective cohort study.

Setting:

Large metropolitan hospital.

Participants:

Twenty-four youth athletes cleared for return to play after a concussion and 84 pediatric athletes without concussion.

Independent Variables/Interventions:

Concussion (with return to play clearance) versus no concussion; age, sex, hours of sleep, and sports participation.

Main Outcome Measures:

Injury for a 12-week period.

Results:

Injury rates were similar between the concussed (5/24 = 21%) and nonconcussed (15/84 = 18%) athletes (P = 0.77). Within the concussion group, there was no significant difference between the noninjured and injured participants in time to return to play, time from concussion to initial evaluation, age, sex, hours of sleep per night, or hours of sports participation per week (P ≥ 0.19). The median time to clearance for the concussed athletes was 34 (range: 18–61) days.

Conclusions:

This study provides preliminary evidence suggesting that when current guidelines for return to play are followed, concussed pediatric athletes can resume activity without facing an elevated risk of injury. Time to achieve clearance in pediatric and adolescent athletes can be expected to be longer than the 7 to 14 days typical for older athletes.
A Systematic Review of Sports-Related Concussion Education Programs: Design, Outcomes, and Recommendations
Authors: Hussain Abid , Malcolm Dominic , Tausif Muhammad
Published: November 2024

Objective:

This systematic literature review was undertaken to identify the main design features of sport-related concussion (SRC) education programs, examine their outcomes, and consider the relationship between design and effectiveness.

Design:

Systematic review.

Main Outcome Measures:

Studies which report on educational interventions (a dedicated in-person or online teaching session) that purport to change knowledge, attitudes, and/or behavior toward sports-related concussion. Searches were performed across 5 databases.

Results:

Out of the 9192 records that were initially screened, 28 retrieved studies were identified. The review found considerable diversity in the content, mode of delivery, and aims of SRC education programs. Sport-related concussion programs were largely successful in increasing recipients' knowledge, but these gains were often transitory, and stronger among adults than among children. There was little evidence of a tangible impact on behavior.

Conclusions:

We recommend that future research should (1) seek to clarify what constitutes achievable goals for education programs, (2) move toward better intervention standardization through greater consolidation and coordination of the field, (3) feature explicit attempts to tailor interventions to specific target audiences, and (4) ensure the greater involvement of participants in the creation and design of SRC educational interventions.
Characteristics and outcomes of patients with acute coronary syndrome who present with atypical symptoms: a systematic review, pooled analysis and meta-analysis
Authors: Kwok Chun Shing , Bennett Sadie , Holroyd Eric , Satchithananda Duwarakan , Borovac Josip A. , Will Maximilian , Schwarz Konstantin , Lip Gregory Y. H.
Published: November 2024

How frequent and whether outcomes are worse for patients with atypical presentation in acute coronary syndrome (ACS) across the literature is not known. We conducted a systematic review of the literature on patients with ACS or acute myocardial infarction who reported whether their symptoms were atypical or typical. We determined the proportion of patients with atypical or no chest pain and used meta-analysis to evaluate predictors of atypical presentation and mortality associated with atypical presentation. A total of 43 studies were included with 1 691 401 patients (mean age: 65.4 years, 63.8% male). The proportion of patients with atypical presentation ranged from 4.6 to 74.2% while for those with no chest pain it ranged from 1.4 to 35.5%. Atypical presentation occurred in 11.6% of patients (28 studies) and no chest pain occurred in 33.6% of patients (16 studies). The three strongest factors associated with increased odds of atypical presentation or no chest pain presentation were non-ST-elevation myocardial infarction [odds ratio (OR): 2.38, 95% confidence interval (CI): 1.55–3.64], greater Killip class (OR: 2.22, 95% CI: 1.84–2.67), and prior heart failure (OR: 1.79, 95% CI: 1.76–1.82). There is a two-fold increase in odds of mortality with atypical or no chest pain presentation in ACS compared with the typical presentation (OR: 2.07, 95% CI: 1.71–2.50, I
2 = 9%). Atypical presentation occurs in approximately 1 in 10 patients with ACS but can be as high as 1 in 3 in some populations. Patients who present atypically are at two-fold increased risk of mortality.
Acupotomy therapy for knee osteoarthritis: An overview of systematic reviews
Authors: Zhang Jiangchun , Pang Tingting , Yao Junjie , Li Ailin , Dong Li , Wang Yueting , Wang Yufeng
Published: November 2024

Background:

This study aimed to evaluate the methodological quality, report quality, and evidence quality of a meta-analysis (MA) and systematic review (SR) of the efficacy of acupotomy in the treatment of knee osteoarthritis (KOA), and provided a reference for clinical decision-making.

Methods:

We searched 8 databases to collect systematic reviews and meta-analyses on the efficacy of acupotomy in the treatment of KOA from January 30, 2018, to January 31, 2023. The methodological quality of the studies was assessed using the assessment of multiple systematic reviews (AMSTAR) 2 scale, the quality of the literature reports was scored using the Preferred Reporting Items for Systems Reviews and Meta-Analyses 2020 Version (PRISMA 2020),and the quality of the evidence was graded using the grading of recommendations assessment, development, and evaluation (GRADE) scale.

Results:

Nine systematic reviews including 35 outcome indicators were included. AMSTAR 2 evaluated the methodological quality of the included studies, and 1 was of low quality, 8 were of very low quality, and the entries with poor scores were 2, 3, 4, 8, 10, 12, and 13. By PRISMA 2020, there were some reporting deficiencies, and quality problems were mainly reflected in the abstract, information sources, search strategy, synthesis methods, reporting bias assessment, certainty assessment, reporting biases, certainly of evidence, registration and protocol. The GRADE classification results showed that there were 2 medium-quality evidences, 7 low-quality evidences, and 26 very low-quality evidences. The main factors of degradation were limitations, imprecision, and publication bias.

Conclusion:

Acupotomy had been a promising complementary treatment for KOA. However, due to the low quality of the SRs/MAs supporting these results, high-quality studies with rigorous study designs and larger samples were needed before widespread recommendations could be made.
Impact of comprehensive thermal insulation on stress response and immune function in hysteroscopy patients: A retrospective study
Authors: Huang Xiaoqing , Ao Yumin , Zhang Liulian , Yang Lin
Published: November 2024

This retrospective study explores the impact of comprehensive thermal insulation measures on the stress response of patients undergoing hysteroscopy surgery. A total of 600 patients who underwent hysteroscopy at our hospital from January 2018 to December 2022 were included. Participants were randomly assigned to an observation group (n = 305) and a control group (n = 295). The control group received standard nursing care, whereas the observation group received additional comprehensive thermal insulation measures. We compared body temperature and stress response indicators, including heart rate, diastolic blood pressure, systolic blood pressure, blood glucose, adrenaline, norepinephrine, and C-reactive protein, at 3 time points: before surgery (T0), 30 minutes into surgery (T1), and after surgery (T2). A comparative analysis of immune competence, focusing on the variations in CD3+, CD4+, CD8+ T lymphocyte populations, and CD4+/CD8+ ratios, was conducted between the groups preoperatively and at a 24-hour postoperative juncture. The occurrence of intraoperative complications after surgery was analyzed. The central body temperature in the observation group at T1 and T2 was higher than that of the control group (P < .001). The levels of heart rate, diastolic blood pressure, systolic blood pressure, blood glucose, adrenaline, norepinephrine, and C-reactive protein in the observation group at T1 and T2 were lower than those in the control group (P < .05). The percentage of CD3+, CD4+, CD4+/CD8+ cells in the observation group at 1 day after surgery was higher than those in the control group (P < .05). The incidence of intraoperative and postoperative complications in the observation group after surgery was lower than that in the control group (P < .001). Implementing a comprehensive thermal insulation protocol for patients undergoing hysteroscopy may help maintain core temperature and support immune response following surgery, potentially contributing to a smoother recovery process. Further research is warranted to confirm these findings and better understand the implications for patient care.
Causal associations between telomere length and pulmonary arterial hypertension: A two-sample Mendelian randomization study
Authors: Lyu Ting-Ting , Wang Jing-Yang , Tan Jiang-Shan , Yang Yan-Min , Wang Yi-Meng , Zhao Jing , Qing Ping , Wu Ling-Min , Wang Xiao-Jian
Published: November 2024

Pulmonary arterial hypertension (PAH) is a life-threatening condition characterized by elevated pulmonary artery pressure, leading to right heart failure, and mortality. The role of telomere length, a marker of biological aging, in PAH remains unclear. We utilized summary-level data from genome-wide association studies for various measures of telomere length and PAH. Single nucleotide polymorphisms associated with telomere length at a genome-wide significance level were used as instrumental variables. The inverse variance weighted method was the primary analysis, with sensitivity analyses including the weighted median and Mendelian randomization-Egger regression. The odds ratios and 95% confidence intervals (CI) were calculated to estimate the causal effect of telomere length on PAH risk. The Mendelian randomization analyses revealed no significant causal association between overall telomere length and PAH (odds ratios per standard deviation increase = 1.229, 95% CI: 0.469–3.222, P = .676). Similar null findings were observed for granulocyte, lymphocyte, naive T-cell, memory T-cell, B-cell, and natural killer-cell telomere lengths. Sensitivity analyses confirmed the robustness of the results, with no evidence of horizontal pleiotropy or significant influence of individual single nucleotide polymorphisms on the overall estimates. This Mendelian randomization study didn’t support a causal association between telomere length and PAH.
Effects of 3-month liraglutide treatment on oxidative stress and inflammation in type 2 diabetes patients with different urinary albumin-to-creatinine ratio categories
Authors: Chen Shumei , He Meiqing , Qin Yufan , Tian Jing , Liang Zerong , Li Ying , Wang Peihua , Zhang Youzhi , Zhou Cui , Xiao Juan
Published: November 2024

This study evaluates the effects of liraglutide on albuminuria, oxidative stress, and inflammation in type 2 diabetes (T2D) patients with different urinary albumin-to-creatinine ratio (UACR) categories. We enrolled 107 patients with T2D who were initiating liraglutide for glycemic control. Patients were categorized into 3 groups: group I (UACR < 30 mg/g); group II (30 mg/g ≤ UACR ≤ 300 mg/g); group III (UACR > 300 mg/g). We observed the changes in body mass index, fasting plasma glucose, glycated hemoglobin, lipid profile, serum liver enzymes, creatinine, uric acid, cystatin C, UACR, as well as oxidative stress and inflammation biomarkers such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase before and after 3 months of liraglutide treatment. After 3-month liraglutide treatment, fasting plasma glucose, glycated hemoglobin, and body mass index significantly decreased in all 3 groups regardless of the baseline UACR (all P < .05). UACR significantly decreased in groups II (P = .005) and III (P = .001). Patients with higher UACR at baseline showed significantly greater albuminuria reduction (P < .001). Compared with baseline, TNF-α, IL-6, MCP-1, and MDA were remarkably decreased, while SOD and glutathione peroxidase were significantly increased in all 3 groups (P < .05). UACR at baseline showed a positive correlation with TNF-α, IL-6, and MDA, and a negative correlation with SOD at baseline. The change in UACR was negatively correlated with UACR, TNF-α, and MDA at baseline, while it was positively correlated with SOD at baseline, and also positively correlated with the change in MCP-1. Liraglutide ameliorated albuminuria in T2D patients with microalbuminuria and macroalbuminuria. The renoprotective effect of liraglutide was associated with the alleviation of oxidative stress and inflammation. These findings may provide new therapeutic strategies for patients with diabetic kidney disease.
Psychological factors, lifestyle habits, and their association with gastroesophageal reflux disease among Egyptian university students: A cross-sectional study
Authors: Ahmed Hebatalla Abdelmaksoud Abdelmonsef , Yousef Ahmed , El-Kurdy Rania , Murad Manal Abdulaziz , Abdelwahab Shady Mohamed , Shiba Hoda Ali Ahmed
Published: November 2024

Gastroesophageal reflux disease (GERD) is a common condition among university students that is associated with various lifestyle and psychological factors. The study aims to evaluate the association of psychological factors, physical activity, and dietary habits with the prevalence of GERD among university students in Egypt. An analytical cross-sectional study was conducted from March 2024 to May 2024, selecting students from different universities in Egypt. A self-administered questionnaire covered sociodemographic characteristics, and GERD assessment using the Gerd Q questionnaire. Generalized Anxiety Disorder-2, Perceived Stress Scale 4, Nordic Physical Activity Questionnaire, and short dietary habits questions were used to assess anxiety, perceived stress, physical activity, and dietary habits, respectively. Statistical analysis included descriptive statistics, correlation analysis, and hierarchical logistic regression, which were employed to identify significant predictors of GERD. Among the 2241 university students, 22.6% had GERD (GerdQ score > 8), 86.3% had high perceived stress, and 62.2% had high anxiety levels. Hierarchical logistic regression analysis identified old age, high weight, short height, frequent consumption of fried/fast food, and high anxiety levels as significant predictors of GERD. The study underscores the importance of considering psychological factors and dietary habits alongside traditional risk factors in understanding and addressing GERD among university students in Egypt. Public health interventions targeting psychological well-being and healthier dietary habits will play a pivotal role in reducing this population’s GERD burden.
Phantom evaluation of feasibility and applicability of artificial intelligence based pulmonary nodule detection in chest radiographs
Authors: El-Gedaily Mona , Euler André , Guldimann Mike , Schulz Bastian , Aghapour Zangeneh Foroud , Prause Andreas , Kubik-Huch Rahel A. , Niemann Tilo
Published: November 2024

The aim of our study was to evaluate the specific performance of an artificial intelligence (AI) algorithm for lung nodule detection in chest radiography for a larger number of nodules of different sizes and densities using a standardized phantom approach. A total of 450 nodules with varying density (d1 to d3) and size (3, 5, 8, 10 and 12 mm) were inserted in a Lungman phantom at various locations. Radiographic images with varying projections were acquired and processed using the AI algorithm for nodule detection. Computed tomography (CT) was performed for correlation. Ground truth (detectability) was established through a human consensus reading. Overall sensitivity and specificity of 0.978 and 0.812, respectively, were achieved for nodule detection. The false-positive rate was low with an overall rate of 0.19. The overall accuracy was calculated as 0.84 for all nodules. While most studies evaluating AI performance in the detection of pulmonary nodules have evaluated a mix of varying nodules, these are the first results of a controlled phantom-based study using a balanced number of nodules of all sizes and densities. To increase the radiologist’s diagnostic performance and minimize the risk of decision bias, such algorithms have an obvious benefit in a clinical scenario.
Predictive impact of clinical factors on chemosensitivity in advanced high-grade serous ovarian carcinoma according to chemotherapy response score
Authors: Park Mia , Shin Won Kyo , Lim Myong Cheol , Park Sang-Yoon , Yoo Chong Woo , Kim Kyung-Hee , Suh Kwang-Sun , Yoo Heon Jong
Published: November 2024

The use of neoadjuvant chemotherapy (NAC) as a first-line therapy for advanced high-grade serous ovarian carcinoma (HGSOC) has increased. However, several studies have reported NAC-induced platinum resistance. This study aimed to evaluate the predictive impact of clinical factors on chemotherapy response score (CRS) and to select patients who would respond well to NAC. This multicenter retrospective (study included patients treated between January 2016 and December 2021). International Federation of Gynecology and Obstetrics stage IIIC and IV HGSOC patients were eligible. Institutionally strict complete resectability criteria were used in the present study. Pathological slides were scored according to the CRS criteria. Among 172 patients with HGSOC, 87 (50.6%) had stage IIIC disease and 85 (49.4%) had stage IV disease. And 35 (20.4%) had CRS1, 103 patients were CRS2 (59.9%), and 34 patients were CRS3 (19.7%). Compared with CRS1, simultaneous metastases to distant lymph nodes and solid organs confirmed by imaging were associated with a 75% reduction in CRS2 (odds ratio = 0.25; 95% confidence interval: 0.09–0.70; P = .008). And breast cancer susceptibility gene 1/2 mutation was positively (odds ratio = 8.41; 95% confidence interval: 2.25–31.52; P = .002) associated with CRS3 compared to CRS1. Patients with CRS3 had significantly longer progression-free survival (PFS), with median PFS of 9.8, 14.8, and 27.0 months for CRS of 1, 2, and 3, respectively (P < .001). Overall survival was also prolonged in patients with CRS3 (P < .001). Germline breast cancer susceptibility gene 1/2 mutation was a predictor of CRS3 and a good prognostic factor for the survival rate. Simultaneous metastasis to distant lymph nodes and solid organs is a predictor of CRS1. CRS inversely correlated with PFS and overall survival.
Metabolic factors for liver cirrhosis: A Mendelian randomization study
Authors: Wang Xiaobing , Ni Yu , Wang Ziwen , Li Changhui , Hui Xinyu , Xu Hongyu
Published: November 2024

Liver cirrhosis is a chronic disease caused by long-term inflammation and fibrosis of the liver. Early identification and intervention in liver cirrhosis have become an important goal for researchers to explore the influence of some metabolic factors on the risk of liver cirrhosis in terms of genetic susceptibility. Data from genome-wide association studies (GWASs) of fourteen metabolic factors and liver cirrhosis were obtained from publicly available databases. To make the results more credible, we selected 2 GWASs for liver cirrhosis to be validated separately. The causal effect of metabolic factors on liver cirrhosis was assessed separately using 2-sample Mendelian Randomization (MR). The inverse variance weighted (IVW) method was used as the main analysis method. The present MR analysis confirmed that fasting insulin level (IVW-OR = 2.89, 95% CI: 1.36–6.15, P = .006) and ALT (IVW-OR = 1.42, 95% CI: 1.11–1.80, P = .004) were positively causally associated with the risk of liver cirrhosis, and there was a negative causal relationship between hypertension and the risk of liver cirrhosis (IVW-OR = 0.40, 95% CI: 0.23–0.72, P = .002) in 1 liver cirrhosis GWAS. In replication analysis, our MR proved the positive causal effect between ALT (IVW-OR = 2.09, 95% CI: 1.61–2.72, P < .001) and BMI (IVW-OR = 1.44, 95% CI: 1.17–1.77, P < .001) and the risk of liver cirrhosis. A causal relationship between other metabolic factors and the risk of liver cirrhosis could not be established in the current selection of data. Our MR study revealed a causal and positive association between ALT and the risk of liver cirrhosis, suggesting an important role of effective control of ALT in liver cirrhosis prevention. The causal relationship between thirteen other metabolic factors and the risk of liver cirrhosis remains to be further verified.
Exploring the gut-inflammation connection: A Mendelian randomization study on gut microbiota, inflammatory factors, and uterine fibroids risk
Authors: Peng Shaoyi , Liu Miao , Zeng Yuhao , Wang Lei , Man Yilong
Published: November 2024

This study employs Mendelian randomization (MR) approach to investigate the potential causal association between genetic variants associated with gut microbiota, inflammatory factors, and the risk of uterine fibroids development. We extracted data on 211 types of gut microbiota, 91 inflammatory factors, and uterine fibroids occurrence from genome-wide association studies and applied the inverse-variance weighted (IVW) method for analysis. To further assess the robustness of our MR analysis, we conducted sensitivity tests including Cochrane’s Q test, the MR-Egger intercept test, the MR-PRESSO global test, and a leave-one-out analysis. IVW analysis identified a potential causal association between 14 types of gut microbiota and 8 inflammatory factors with the risk of uterine fibroids. When using 91 inflammation-related proteins as the outcome variable, 13 proteins demonstrated a potential causal association with uterine fibroids risk (IVW, all P < .05). Additionally, the MR-Egger intercept and MR-PRESSO global tests indicated no evidence of horizontal pleiotropy (P > .05), and the leave-one-out analysis confirmed the robustness of the results. This MR approach suggests that specific gut microbiota and inflammatory factors may have a causal association with the development of uterine fibroids, shedding light on the pathogenesis of uterine fibroids and potentially identifying targets for future therapeutic interventions.
Molecular docking and network pharmacology research on the Danggui Sini Decoction’s mechanism of action for treating erectile dysfunction
Authors: Yan Xinyu , Zhang Yiyi , Mo Jingwen , Xu Lindong , Shi Keyu , Zhou Yi
Published: November 2024

Utilizing network pharmacology and molecular docking, we evaluated the possible pharmacological mechanism of Danggui Sini Decoction (DGSND) for treating erectile dysfunction (ED). DGSND’s chemical components and targets were found utilizing the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Disease-related genes associated with ED were identified through GeneCards, OMIM, TTD, DrugBank, and DisGeNET databases. These datasets intersected to identify possible DGSND targets for treating ED. We developed an interactive visual network that linked herbs, active components, diseases, and targets using Cytoscape 3.7.1. The protein–protein interactions (PPI) were analyzed using the STRING database. The DAVID database was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment studies to determine the mechanism of action of the discovered genes. The pathways most strongly associated with ED were analyzed through histograms and bubble maps. From the PPI network, the 6 promising targets were selected for molecular docking with the top ranked compounds in terms of degree value. DGSND contains 7 Chinese herbal medicines, 142 main components, and 73 latent targets for treating ED. GO and KEGG analyses suggest that DGSND may have the ability to modulate oxidative stress, apoptosis, and inflammatory responses. Through the PPI network and topology analysis, 6 core genes were pinpointed. Molecular docking revealed that beta-sitosterol exhibited the lowest binding energy with BCL2, indicating a more stable structure. This study demonstrates that DGSND’s compounds stimulate NO synthesis and reduce inflammation and cell apoptosis to improve ED by acting on AKTI, ALB, IL6, TNF, TP53, and BCL2. The findings show that DGSND’s compounds These findings offer a valuable scientific foundation for further understanding the mechanism of DGSND in treating ED.
Impact of sodium-glucose cotransporter inhibitors in acute coronary syndrome patients on endothelial function and atherosclerosis related-biomarkers: ATH-SGLT2i pilot study
Authors: Mghaieth Zghal Fathia , Abbassi Manel , Silini Ahlem , Ben Halima Manel , Jebberi Zeynab , Daly Foued , Ouali Sana , Farhati Abdeljelil , Ben Mansour Nadia , Boudiche Selim , Mourali Mohamed Sami
Published: November 2024

Little is known about the effects of sodium-glucose co-transporter 2 inhibitors (SGLT2i) on atherosclerosis. We aimed to determine if a 90-day intake of Dapagliflozin could improve atherosclerosis biomarkers (namely endothelial function assessed by flow-mediated dilatation [FMD] and carotid intima-media thickness [CIMT]) in diabetic and non-diabetic acute coronary syndrome (ACS) patients when initiated in the early in-hospital phase. ATH-SGLT2i was a prospective, single-center, observational trial that included 113 SGLT2i naive patients who were admitted for ACS and who were prescribed Dapagliflozin at a fixed dose of 10 mg during their hospital stay for either type 2 diabetes or for heart failure. After 90 days of follow-up, subjects who had a continuous intake of Dapagliflozin formed the SGLT2i group, while patients who did not take Dapagliflozin formed the non-SGLT2i group. In each of these main study groups, we considered diabetic and non-diabetic subgroups. The primary endpoint was the difference in between baseline and 90 days in FMD (∆FMD) and in FMD rate (∆FMD%). The secondary outcome was change in CIMT (∆CIMT). We enrolled 54 patients in the SGLT2i group aged 59 ± 9 years (70.4% males) which 30 were diabetics, and 59 in the non-SGLT2i group aged 63 ± 11 years (78% males) which 34 were diabetics. After 90 days, ∆FMD and ∆ FMD% were higher in the SGLT2i group in comparison with the non-SGLT2i group (0.05 ± 0.15 vs −0.05 ± 0.11, P < .001 and 1.78 ± 3.63 vs −0.88 ± 4, P < .001). Within the SGLT2i group, the improvement of FMD% was higher in non-diabetic patients (2.85 ± 3.46 vs 0.9 ± 3.59, P = .05). Multivariate analysis showed that Dapagliflozin intake was independently associated with FMD% improvement (HR = 2.24). After 90 days, CIMT showed no significant difference between the SGLT2i and the non-SGLT2i groups. In this pilot study, a 90-day intake of Dapagliflozin at the fixed dose of 10 mg started in the acute phase of an ACS, was associated with endothelial function improvement in diabetic and non-diabetic patients.
Causal effect of primary sclerosing cholangitis on diffuse large B-cell lymphoma: A two-sample Mendelian randomized study
Authors: Miao Zhengyang , Chen Hailin , Zhou Yongming
Published: November 2024

The connection between Primary sclerosing cholangitis (PSC) and lymphoma remains uncertain. To address this, Mendelian randomization (MR) was utilized to investigate the potential causal links between PSC and lymphoma. A 2-sample MR analysis was conducted utilizing summary-level data obtained from genome-wide association study datasets. Four complementary MR methods were performed, including inverse-variance weighting (IVW), MR-Egger, weighted median, and MR-robust adjusted profile score (MR-RAPS). Several sensitivity analyses were also employed to further validate the results. The results of IVW estimates showed that there was a potential causal association between PSC and diffuse large B-cell lymphoma (DLBCL) risk (OR = 1.138, 95% CI = 1.052–1.230, P = .001). No causal association was observed between PSC and other lymphoma subtypes. No horizontal and directional pleiotropy was observed in the MR studies. This study represents the inaugural utilization of MR analysis to investigate the causal associations between PSC and DLBCL. Further investigation is warranted to elucidate the underlying mechanism of this causal relationship.
Identification of mutation of MYOC (c.1099G>A), a pedigree pathogenic gene of juvenile open angle glaucoma (JOAG): A case report
Authors: Zheng Juan , Zhao Dongdong , Li Zhen , Feng Changjun , Song Zhaona , Li Rongrong , Wang Bo , Liang Yaxin , Tian Xiufen , Qianqian Zhang , Gao Jianlu
Published: November 2024

Rationale:

The MYOC gene is associated with juvenile open-angle glaucoma (JOAG). This study aims to provide genetic counseling for a Chinese JOAG family by detecting MYOC mutations to identify high-risk individuals for early JOAG intervention. It also supplements the clinical characteristics of glaucoma patients with MYOC gene mutations.

Patient concerns:

A 43-year-old presented sought medical attention in a local hospital due to a 6-month decline in binocular vision. He was diagnosed as JOAG and underwent glaucoma surgery. The patient also had 11 family members with a history of JOAG.

Diagnoses:

After sequencing the polymerase chain reaction products of the patient, MYOC c.1099 G > A (p.G367R) mutation was observed. That is consistent with a diagnosis of JOAG.

Intervention:

Polymerase chain reaction analyses of 9 patients and 42 healthy family members were performed to explore potential mutations associated with familial JOAG.

Outcomes:

JOAG assisted in diagnosing the III-5 proband. Genetic detection indicated that III-5 was exposed to a novel heterozygous missense mutation of MYOC (c.1099 G > A [p.G367R]). The co-segregation of this gene with the trait observed in the pedigree was verified. All 10 participants exhibiting this mutation had JOAG phenotypes, whereas other participants did not show this mutation. In terms of MYOC mutation c.1099 G > A (p.G367R), this mutation occurred when the 1099th nucleotide in the encoding zone of MYOC changed from G to A. Moreover, the 367th amino acid coded by this base got mutated from glycine to arginine. DNAMAN sequence homology results showed that the G residues of MYOC: 367 were significantly conserved among different species. In addition, 3D protein conformation predicted that these mutations could decrease protein stability.

Lessons:

MYOC c.1099 G > A was identified as a pathogenic gene of JOAG in this pedigree. The addition of the MYOC mutant spectrum to JOAG in the Chinese population facilitates a complete understanding of the molecular pathogenesis and clinical diagnosis of MYOC.
Single-cell and bulk RNA sequencing-based screening and identification of extracellular trap network-related genes in neutrophils in acute myocardial infarction
Authors: Li Wei , Yang Jun
Published: November 2024

Background:

The neutrophil-mediated generation of neutrophil extracellular traps (NETs) results in an augmented inflammatory response and cellular tissue injury during acute myocardial infarction (AMI). Through the analysis of public database information, we discovered and confirmed putative critical genes involved in NETs-mediated AMI.

Methods:

The AMI dataset GSE66360 and the single-cell dataset GSE163465 were downloaded from the Gene Expression Omnibus database. Key genes were screened by bioinformatics. Quantitative real-time PCR (qRT-PCR) was used to verify the key genes, and then a Mendelian randomization (MR) study was conducted on the basis of the genome-wide association study to determine the causal relationship between key genes and AMI. Dimensionality reduction clustering, pseudo-time series, and cell communication were performed on the single-cell dataset to analyze the key genes screened by bulk RNA sequencing and the dynamic evolution of NETs in the AMI process. Immunohistochemistry and Western blot were used to verify the key genes

Results:

Six key genes, IL1β, S100A12, TLR2, CXCL1, CXCL2, and CCL4, were screened out through bioinformatics. qRT-PCR results showed that compared with the control group, the expression of 5 key genes was upregulated in the AMI group. In the MR study, CXCL1 and CCL4 were observed to have a causal relationship with AMI. Single-cell analysis showed that NETs-related genes CCL4, CXCL2, and IL1β were highly expressed. Combining single cells, qRT-PCR and MR, gene CCL4 was selected as the focus of the study. H9c2 cardiomyocytes simulated myocardial infarction under hypoxia, and the results showed that the expression of gene CCL4 was increased. The immunohistochemical results of gene CCL4 showed that the expression was upregulated in the AMI group.

Conclusions:

We found 6 key genes related to NETs-mediated cell damage during AMI. The results of MR showed that CXCL1 and CCL4 were causally related to AMI. Combining single cells, qRT-PCR and MR, gene CCL4 may play an important role in the AMI process. Our results may provide some insights into neutrophil-mediated cell damage during AMI.