bluuebunny/crossref_metadata_2025 huggingface dataset:
Mobile-Enhanced Family-Integrated Care for Preterm Infants
Authors: Franck Linda S. , Hodgson Christine , Gay Caryl L. , Bisgaard Robin , Cormier Diana M. , Joe Priscilla , Lothe Brittany , Sun Yao
Published: November 2023

Background:

The mobile-enhanced family-integrated care (mFICare) model addresses inconsistencies in family-centered care (FCC) delivery, with an evidence-based bundle of staff training, parent participation in rounds, parent classes, parent peer mentors, expanded role for parents in infant caregiving, and a parent-designed app.

Purpose:

Our aim was to explore the views of neonatal intensive care unit (NICU) nurses and physicians about mFICare implementation, including what worked well and what could be improved.

Methods:

As part of a larger study to compare mFICare with FCC, we invited registered nurses, nurse practitioners, and fellow and attending physicians at the 3 study sites to participate in a survey about mFICare implementation. Data were analyzed with descriptive statistics and thematic analysis.

Results:

The majority of the 182 respondents with experience delivering mFICare positively rated parent-led rounds, parent classes, parent skills acquisition, and the nurse–family relationship resulting from participation in mFICare. Respondents were less familiar or neutral regarding the parent peer mentor and app components of mFICare. Most respondents agreed that the mFICare program improved parent empowerment, and they shared suggestions for optimizing implementation. Physicians experienced more challenges with parent participation in rounds than nurses. Three themes emerged from the free-text data related to emotional support for parents, communication between staff and parents, and the unique experiences of families receiving mFICare.

Implications for Practice and Research:

The mFICare program was overall acceptable to nurses and physicians, and areas for improvement were identified. With implementation refinement, mFICare can become a sustainable model to enhance delivery of FCC in NICUs.
CALCRL induces resistance to daunorubicin in acute myeloid leukemia cells through upregulation of XRCC5/TYK2/JAK1 pathway
Authors: Tang Shanhao , Li Shuangyue , Shi Xiaowei , Sheng Lixia , Mu Qitian , Wang Yi , Zhu Huiling , Xu Kaihong , Zhou Miao , Xu Zhijuan , Wu An , Ouyang Guifang
Published: November 2023

Chemotherapy is the main treatment option for acute myeloid leukemia (AML), but acquired resistance of leukemic cells to chemotherapeutic agents often leads to difficulties in AML treatment and disease relapse. High calcitonin receptor-like (CALCRL) expression is closely associated with poorer prognosis in AML patients. Therefore, this study was performed by performing CALCRL overexpression constructs in AML cell lines HL-60 and Molm-13 with low CALCRL expression. The results showed that overexpression of CALCRL in HL-60 and Molm-13 could confer resistance properties to AML cells and reduce the DNA damage and cell cycle G0/G1 phase blocking effects caused by daunorubicin (DNR) and others. Overexpression of CALCRL also reduced DNR-induced apoptosis. Mechanistically, the Cancer Clinical Research Database analyzed a significant positive correlation between XRCC5 and CALCRL in AML patients. Therefore, the combination of RT-PCR and Western blot studies further confirmed that the expression levels of XRCC5 and PDK1 genes and proteins were significantly upregulated after overexpression of CALCRL. In contrast, the phosphorylation levels of AKT/ PKCε protein, a downstream pathway of XRCC5/PDK1, were significantly upregulated. In the response study, transfection of overexpressed CALCRL cells with XRCC5 siRNA significantly upregulated the drug sensitivity of AML to DNR. The expression levels of PDK1 protein and AKT/PKCε phosphorylated protein in the downstream pathway were inhibited considerably, and the expression of apoptosis-related proteins Bax and cleaved caspase-3 were upregulated. Animal experiments showed that the inhibitory effect of DNR on the growth of HL-60 cells and the number of bone marrow invasions were significantly reversed after overexpression of CALCRL in nude mice. However, infection of XCRR5 shRNA lentivirus in HL-60 cells with CALCRL overexpression attenuated the effect of CALCRL overexpression and upregulated the expression of apoptosis-related proteins induced by DNR. This study provides a preliminary explanation for the relationship between high CALCRL expression and poor prognosis of chemotherapy in AML patients. It offers a more experimental basis for DNR combined with molecular targets for precise treatment in subsequent studies.
Mechanism of gemcitabine combined with lobaplatin in interventional treatment of locally advanced cervical cancer
Authors: Lin Yang , Yang Qiaoli
Published: November 2023

In order to investigate the mechanism of gemcitabine combined with lobaplatin in the interventional treatment of locally advanced cervical cancer (LACC), 90 patients with LACC were divided into control group (oxaliplatin + gemcitabine) and experimental group (lobaplatin + gemcitabine) according to different perfusion drugs and embolization drugs, 45 cases in each group. They were treated with arterial chemotherapy and arterial embolization. Postoperative recurrence, metastasis, and survival, as well as changes in serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) levels before and after treatment were observed in both groups. The results showed that the recurrence rate of cervical cancer at 0.5, 1, 2, 3, 4, and 5 years after operation in the experimental group was significantly lower than that in the control group, P < 0.05; there was no significant difference in the postoperative cervical cancer metastasis rate, P > 0.05. Before treatment, the serum VEGF in the experimental group and the control group were (642.76 ± 216.67) ng/ L and (626.30 ± 275.43) ng/ L, respectively, and MMP-9 were (580.61 ± 194.12) ng/ L and (575.28 ± 202.55) ng/ L, respectively. After treatment, the serum VEGF levels in the experimental group and the control group were (429.24 ± 132.69) ng/ L and (554.63 ± 178.11) ng/ L, respectively, and MMP-9 levels were (357.60 ± 123.11) ng/ L and (461.83 ± 144.45) ng/ L, respectively. There was no significant difference in the serum VEGF and MMP-9 levels between the two groups before treatment (P > 0.05); after treatment, the serum VEGF and MMP-9 levels in the experimental group were significantly lower than those in the control group, P < 0.05. Therefore, gemcitabine combined with lobaplatin interventional therapy can improve the cure rate of LACC by reducing VEGF and MMP-9 levels in the serum of patients.
Delayed immune-related hepatitis after 24 months of pembrolizumab treatment: a case report and literature review
Authors: Salazar González Fernando , Quiñones Palacios Cristel Andrea , Manzaneque Gordón Alba , Mazarico Gallego José María , Díaz Alba , Molas Ferrer Gloria
Published: November 2023

Immune checkpoint inhibitors targeting the programmed cell death protein 1 (PD-1) pathway have revolutionized cancer immunotherapy by enhancing the immune system’s ability to combat cancer cells. However, this innovative approach comes with a distinctive set of challenges, as these therapies can lead to immune-related adverse events (irAEs) due to their mechanism of action. The most common irAEs involve the skin, gastrointestinal tract, liver, endocrine system, and lungs. These events can range from mild skin rashes to severe colitis, pneumonitis, or even autoimmune organ damage. These adverse effects usually appear with an average of 5–15 weeks from the start of treatment depending on the affected organ. This article presents a case report of a delayed related-mediated hepatitis, after 24 months of treatment with pembrolizumab and almost 3 months after its termination, and a review of the scientific literature on cases of delayed immune-related hepatitis caused by anti-PD1. This case highlights the importance of monitoring patients treated with immune checkpoint inhibitors after cessation as a growing number of patients stop treatment due to achieving durable responses.
The Influence of Potential Organ Donors on Standardized Mortality Ratios and ICU Benchmarking*
Authors: Pölkki Anssi , Moser André , Raj Rahul , Takala Jukka , Bendel Stepani , Jakob Stephan M. , Reinikainen Matti
Published: November 2023

OBJECTIVES:

The standardized mortality ratio (SMR) is a common metric to benchmark ICUs. However, SMR may be artificially distorted by the admission of potential organ donors (POD), who have nearly 100% mortality, although risk prediction models may not identify them as high-risk patients. We aimed to evaluate the impact of PODs on SMR.

DESIGN:

Retrospective registry-based multicenter study.

SETTING:

Twenty ICUs in Finland, Estonia, and Switzerland in 2015–2017.

PATIENTS:

Sixty thousand forty-seven ICU patients.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We used a previously validated mortality risk model to calculate the SMRs. We investigated the impact of PODs on the overall SMR, individual ICU SMR and ICU benchmarking. Of the 60,047 patients admitted to the ICUs, 514 (0.9%) were PODs, and 477 (93%) of them died. POD deaths accounted for 7% of the total 6738 in-hospital deaths. POD admission rates varied from 0.5 to 18.3 per 1000 admissions across ICUs. The risk prediction model predicted a 39% in-hospital mortality for PODs, but the observed mortality was 93%. The ratio of the SMR of the cohort without PODs to the SMR of the cohort with PODs was 0.96 (95% CI, 0.93–0.99). Benchmarking results changed in 70% of ICUs after excluding PODs.

CONCLUSIONS:

Despite their relatively small overall number, PODs make up a large proportion of ICU patients who die. PODs cause bias in SMRs and in ICU benchmarking. We suggest excluding PODs when benchmarking ICUs with SMR.
Irritation, General and Pandemic-Related Demands, and the Importance of Workplace Health Promotion in Long-Term Care—Results From a Survey of Managers in Outpatient and Inpatient Long-Term Care Facilities in Germany
Authors: Schaps Valerie , Hower Kira Isabel , Pfaff Holger , Pförtner Timo-Kolja
Published: November 2023

Objective

This study examines the association between irritation and demands of long-term care managers during the COVID-19 pandemic, as well as the role of workplace health promotion (WHP).

Methods

Findings were derived from an online survey investigating long-term care managers as part of the employees in the COVID-19 pandemic (N = 207). Data analyses were performed with linear regression and interaction analyses.

Results

For managers in long-term care, there was found a significant positive association between pandemic-related and general demands and irritation. The irritation level was significantly lower among managers in facilities where WHP was offered whereas the association between irritation and demands did not significantly vary by WHP.

Conclusions

The presence of WHP was associated with lower average irritation levels among managers during the COVID-19 pandemic. Thus, the implementation of WHP can contribute to maintain the well-being of long-term care managers.
Combination of an Anti-Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitor and Immunotherapy as a Neoadjuvant Approach in Renal Cell Carcinoma With Associated Inferior Vena Cava Tumor Thrombus: A Single-Center Experience and Review of Literature
Authors: Candelario Nellowe C. , Kafer Ilana , Kim Simon P. , Kessler Elizabeth R.
Published: November 2023

Introduction:

Renal cell carcinoma (RCC) has a predisposition to vascular invasion that manifest as an inferior vena cava tumor thrombus (IVC TT). Radical nephrectomy with an IVC thrombectomy is associated with high morbidity. We present our single-center experience on the neoadjuvant use of the combination of anti-vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKI) and immune check point inhibitor (IO) for patients with RCC with IVC TT.

Patient and Methods:

Five patients with RCC and associated IVC TT received a neoadjuvant combination anti-VEGF TKI and IO. The IVC TT reduction was evaluated. The extent of tumor thrombus was defined based on the Mayo Classification, and TT volume was measured by the largest anteroposterior diameter. The safety of therapy, perioperative outcome, and number of patients who were able to undergo definitive surgery are described.

Results:

Two (40%) had a reduction in IVC TT based on the Mayo Classification. Tumor thrombus volume reduction was seen in all patients (100%). Four of 5 patients (80%) were able to have surgery.

Conclusion:

The neoadjuvant combination of an anti-VEGF TKI and IO is effective in reducing the extent of IVC TT. Prospective research is needed to characterize the safety, and long-term outcomes of this approach.
Large Intra-abdominal Testicular Neoplasm Involving the Bladder and Ureter in an Adult Male with Bilateral Cryptorchidism
Authors: Beal Pedro Rodrigues , Silva Tiago Aparecido , Buonfiglio Vitor Bonadia , Dal Col Luciana Saboya Brito , Junior Renato Meirelles Mariano Da Costa , Portari FIlho Luiz Henrique Correa , Sadi Marcus Vinicius
Published: November 2023

Cryptorchidism remains as one of the most significant risk factors for the development of testicular cancer (TC). The occurrence of TC in undescended testes can represent challenges to both diagnosis and management because the clinical presentation can delay a definitive diagnosis, and surgical management of intra-abdominal masses can be difficult. We present a case of an adult male with bilateral cryptorchidism diagnosed with a large intra-abdominal TC which was subjected to surgical resection.
Efficacy of cognitive behavioral therapy for reducing pain susceptibility and increasing social engagement in patients with chronic low back pain: A systematic review and meta-analysis
Authors: Zhang Qian , Xu Hongli , Wang Yuqi , Jiang Jiahui , Xue Qing , Qiu Zhengang
Published: November 2023

Background:

The objective of this study was to evaluate the efficacy of cognitive behavioral therapy in improving social engagement and pain susceptibility in patients with chronic low back pain (≥6 months duration).

Methods:

From the initial to January 2023, 5 databases were searched for randomized controlled trials, literature screening, quality evaluation, and data extraction were performed by 2 independent researchers throughout, Meta-analysis was performed using RevMan 5.4 software, standardized mean difference (SMD) was calculated for different indicators, and the combined experimental and control groups were calculated using random-effects models or fixed-effects models effect sizes, and forest plots were drawn to present the results.

Results:

A total of 16 studies containing 2527 patients with chronic nonspecific low back pain, all of whom had pain lasting longer than 6 months, were included, and after treatment, cognitive behavioral therapy (CBT) was superior to other treatments in improving social participation [SMD = −0.30, 95%CI (−0.60, −0.01), Z = 2.02, P = .04]. There was no significant difference from other treatments in improving patient depression [SMD = −0.07, 95%CI (−0.19, 0.05), Z = 1.11, P = .27] and anxiety [SMD = −0.07, 95%CI (−0.30, 0.16), Z = 0.52, P = .57]. Three papers describe the superiority of CBT over other treatments in improving sleep quality, but the metrics could not be combined due to too little literature.

Conclusion:

CBT can improve patients’ social participation and pain susceptibility to some extent, but it does not show advantages for managing negative emotions (depression, anxiety). Due to the limited number and low quality of included literature, the above findings still need to be validated by conducting a large sample of high-quality RCTs.
Investigating the levels of depression, anxiety, sexual disorders, and other influencing factors in breast cancer patients: Turkish radiation oncology integrative group study (TROD 12-05)
Authors: Karabulut Gul Sule , Tepetam Huseyin , Gursel Ozge Kandemir , Alanyali Senem , Oruc Ahmet Fatih , Tugrul Fuzuli , Ergen Sefika Arzu , Yavuz Berrin Benli , Kanyilmaz Gul , Altinok Pelin , Bolukbasi Yasemin , Alomari Omar , Akmansu Muge
Published: November 2023

The fear of death associated with cancer and the side effects of its treatments can have a detrimental psychological impact on breast cancer patients. Early detection and support services play a crucial role in alleviating the expected symptoms of depression, anxiety, and sexual dysfunction. The objective of our study is to assess the levels of depression, anxiety, and sexual dysfunction in breast cancer patients, as well as identify the factors that influence these conditions. The study involved 329 voluntarily participating breast cancer patients who had undergone surgery and were in the follow-up stage. Data were collected from 8 different centers after obtaining ethical approval. The assessment utilized tools such as the Sociodemographic Information Form, Beck Depression and Anxiety Scale, and Arizona Sexual Experiences Scale. Data analysis was performed using SPSS 20. The study included 329 breast cancer patients in the follow-up stage post-surgery. Their average age was 52.7 years (range: 27–83). Results indicated that 33.1% experienced moderate to severe depression, 18.2% reported severe anxiety, and 82.7% scored above 11 on the sexual scale. Factors linked to higher scores were mastectomy, surgical dissatisfaction, insufficient information on sexual side effects, and comorbidities like smoking and diabetes. The study emphasizes the importance of closely monitoring anxiety, depression levels, and sexual side effects in breast cancer treatment. It underscores the need to focus not only on reducing mortality rates but also on supporting patients’ psychological and sexual well-being, ultimately improving their overall quality of life.
Performance evaluation of the sterilization process with Bowie & Dick test and biological indicator in the quality control of a blood bank in Peru
Authors: Lagos-Palomino Lesdy , Rueda-Torres Lenin , Sanchez-Holguin Gloria , Soncco-Llulluy Fernando , Rosales-Rimache Jaime
Published: November 2023

Managing contaminated waste in blood banks is a crucial process that must end with the safe disposal of blood products. In this sense, practical methods and indicators must be used to guarantee the operability of autoclave equipment and the sterility of treated waste to mitigate the risk of biological exposure and hospital biosafety. We designed a cross-sectional study to evaluate the performance the autoclaving process with Bowie & Dick test and biological indicator at the Hemotherapy and Blood Bank Unit of the Cayetano Heredia Hospital in Peru. Fifty autoclaving processes were carried out independently for the Bowie & Dick tests and biological indicators based on Geobacillus stearothermophilus spores. Autoclaving was programmed at 134°C for 3.5 minutes for the Bowie & Dick test, while, for the biological indicator, it was programmed at 121°C for 5 minutes. Both in the presence of contaminated waste. The autoclaving process evaluated by the Bowie & Dick test had a compliance rate of 80% (CI95: 66.3%–90.0%), while, by the biological indicator, 90% (CI95: 78.2%–96.7%). We did not find significant differences between the results of both tests (P = .689; Fisher exact test). The compliance rate in the autoclaving process within the blood bank of a Peruvian Hospital is acceptable; however, there are actions for continuous improvement, especially at the vacuum level in the autoclaving process.
Cardiovascular anesthesia training: A single center survey among fellow doctors
Authors: Sun Yan-Ting , Wu Wei , Liang Jian-Qun , Yao Yun-Tai ,   the Evidence in Cardiovascular Anesthesia (EICA) Group
Published: November 2023

Despite the proliferation of research on anesthesiology training at all stages of medical education, there is relatively little published literature surveying the perspectives and concerns of anesthesiologists regarding cardiovascular anesthesia training. Therefore, we conducted a survey to investigate the attitudes, barriers, expectations, stress experiences, satisfaction, and future aspirations of anesthesiologists trained at a tertiary cardiovascular specialty hospital in China. A questionnaire survey was conducted among 260 anesthesiologists who received cardiovascular anesthesia training at departments of anesthesiology in a tertiary cardiovascular specialty hospital in China. After the study protocol was approved, electronic questionnaires were distributed to the target group through the online survey software “Wen Juan Xing.” Respondents were asked to complete an anonymous questionnaire on their smartphones through WeChat, with the restriction of one response per device enabled. Of the 260 trainees, 240 (98%) completed the questionnaire. The majority of the trainees were 31 years of age or above. A large majority had approximately 10 years of clinical anesthesia practice, and nearly one-third had never undertaken cardiovascular specialty anesthesia practice before. The most common reasons for attending the refresher training were the need to learn basic specialty theory and improve clinical skills. The barriers were mainly time constraints or staff shortages in the department. Sixty-one (93.8%) trainees described the experience as “stressful or highly stressful” and identified poor teacher interaction as the highest-ranking stressor. Anesthesiologists were most dissatisfied with job rewards, with a satisfaction rate of only 15%. Anesthesiologists are highly stressed during the refresher training. Poor teacher interaction and low job rewards were identified as the highest-ranking stressors during cardiovascular anesthesia training. Training providers need to pay more attention to these stressors to enhance the quality of cardiovascular anesthesia training.
Effects of the COVID-19 pandemic on mental health and sleep quality in the Chinese general populations during sporadic and outbreak periods
Authors: Zheng Doudou , Liu Yifei , Lu Yao , Qiu Yuying , Gao Ying , Li Meijuan , Li Jie
Published: November 2023

The different coronavirus disease 2019 (COVID-19) outbreak patterns may have different impact on the mental health, but there is no such report at present. This study was aimed to investigate general populations mental health and sleep quality during the sporadic and outbreak of COVID-19 in Tianjin of China. Two cross-sectional studies included 1090 participants during the COVID-19 sporadic period from 28th January to 28th February 2022 and 2036 participants during the COVID-19 outbreak period from 1st January to 1st February 2023. We used the propensity score matching method to match the 2 samples (sporadic and outbreak group) with a ratio of 1:1. Finally, 1087 participants were included in each group. The demographics, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, Connor–Davidson Resilience Scale, and Pittsburgh Sleep Quality Index were collected from all participants. There was a significant difference between the sporadic and outbreak groups for COVID-19-infected status, anxiety levels, sleep quality, and phycological resilience (all P < .05). Logistic regression analysis showed that female (P < .05) and depression status (P < .05) were the risk factors for the incidence rate of anxiety and poor sleep quality in sporadic group, and outbreak group, while phycological resilience were robust related to the sleep quality (P < .01). Poor sleep quality (P < .01) was related to the incidence of anxiety in sporadic group but not the outbreak group; anxiety levels (P < .01) were related to sleep quality in sporadic group but not the outbreak group. During the COVID-19 pandemic, general populations experienced high anxiety and poor sleep quality incidence rates, especially in the outbreak period. Different risk models for anxiety and sleep quality were found in the different outbreak patterns.
Combination treatment of transcatheter arterial chemoembolization, intensity-modulated radiotherapy, and sorafenib for hepatocellular carcinoma with macrovascular invasion
Authors: Yang Dan , Du Jiaojiao , Nie Weijie , Wang Chaozhi , Ma Zhufang
Published: November 2023

This study evaluated the therapeutic effects and toxic reactions of combining transcatheter arterial chemoembolization (TACE) and intensity-modulated radiotherapy (IMRT) with sorafenib for the treatment of advanced hepatocellular carcinoma (HCC) patients with macrovascular invasion (MVI). We retrospectively analyzed the clinical data of 82 HCC patients with MVI, among whom 35 were treated with TACE plus IMRT alone, and 47 were treated with the combined therapy of TACE, IMRT, and sorafenib. The progression-free survival (PFS), overall survival (OS), and adverse events were assessed. The baseline characteristics were comparable between the 2 groups (all P > .05). In the TACE plus IMRT plus sorafenib group, the median PFS was 17.2 months (95% confidence interval, 14.1–19.9), significantly longer than the 9.4 months (95% confidence interval, 6.8–11.2) observed in the TACE plus IMRT group (P < .001). Additionally, patients treated with the TACE plus IMRT plus sorafenib showed a longer median OS than those treated with TACE plus IMRT alone (24.1 vs 17.3 months; P < .001). The occurrence rates of grade 1 to 2 hand-foot syndrome, other skin reactions, diarrhea, and hair loss were higher in the TACE plus IMRT plus sorafenib group (all P < .05). There were no grade 4 or higher adverse events in either group. The combination of TACE plus IMRT with sorafenib provided substantial clinical benefits in the treatment of HCC patients with MVI, increasing the tumor response rate and prolonging both PFS and OS. This approach demonstrated a tolerable and manageable safety profile.
Infection with COVID-19 is a risk factor for poor prognosis in patients with intracranial hemorrhage: A prospective observational cohort study
Authors: Wang Jia , Chen Jin
Published: November 2023

This research aimed to explore the COVID-19 infection in the prognosis of patients with intracerebral hemorrhage (ICH), as well as analyzed the risk factors of the poor prognosis. This present prospective observational cohort study enrolled 136 patients with ICH who were admitted in our hospital during May 2020 to July 2022. The diagnosis of COVID-19 was confirmed by reverse transcriptase polymerase chain reaction. All patients were collected demographic and clinical data and were followed up for 3 months, and we used the modified Rankin scale (mRS) to assess the prognosis of ICH patients, mRS score ≥ 3 indicated a bad prognosis and mRS score ≤ 2 indicated a good prognosis. All data used SPSS 18.0 for statistical analyses. The mRS score after 3 months of patients in COVID-19 group were also remarkably elevated than that in the patients in control group (P < .05). The levels of fasting plasma glucose (FPG), D-dimer (D-D) were remarkably enhanced in the ICH patients in COVID-19 group compared to the control group (P < .05). The national institutes of health stroke scale scores, hematoma volume, the serum levels of white blood cell, FPG, D-D and the proportion of patients with diabetes were significantly higher while the Glasgow coma scale scores were significantly lower in bad prognosis group (P < .05). In addition, we found a significantly higher rate of COVID-19 infections in ICH patients with poor prognosis (P < .05). Infection of COVID-19, FPG, white blood cell, national institutes of health stroke scale, Glasgow coma scale and hematoma volume were the risk factors for poor prognosis in patients with ICH. This study showed that the proportion of patients with diabetes, the mRS score after 3 months and the levels of FPG, D-D were remarkably elevated in the ICH patients in COVID-19 group compared to the control group. This study may provide the effective preventive and treatment measures for the burden of ICH on families and society.
A two-year retrospective study on traumatic dental injury in the primary dentition
Authors: Zhang Jing-Lan , Peng Zhu-Li , Huang Jie , Pan Yan-Jun , Sun Zhi-Wen , Mai Zhi-Hui
Published: November 2023

The aim of this study was to analyze the causes, clinical characteristics, social factors, and current status of treatment of traumatic dental injury (TDI) in the primary dentition. A retrospective analysis was performed on 144 children (213 teeth) with TDI in the primary dentition from our hospital between December 2017 and June 2020. Data were analyzed using the chi-square test and the Mann–Withney–Wilcoxon test. Boys accounted for 68.1% (98/144) and girls for 31.9% (46/144) of all 144 children with TDI in the primary dentition, with a boy-girl ratio of 2.13:1. The primary age of TDI in deciduous teeth was 2 to 4 years old, accounting for 59% of all cases. Collision with others and fall were the 2 main causes of trauma to the deciduous teeth, making up 52.1% and 44.4% of all causes, respectively. Crown fracture injury was the most common type of TDI in the primary dentition, accounting for 37% of all cases (53/144). Of the 144 cases, 17.4% (25/144) was accompanied by soft tissue laceration, while 22.2% (32/144) by swelling or contusion of tissue. Maxillary teeth (92.4%) were more vulnerable to injury than mandibular teeth (7.5%), with maxillary incisor being the most vulnerable 1 (91.5%). The percentage of children arrived at the hospital for treatment 24 hours after the injury was the highest (57.0%, 82/144). After the hospital visit, 74.3% of children received treatment for the dental trauma. In terms of the treatment modalities, extraction of the traumatized teeth (27.1%) and pulpectomy + resin filling (or preformed crown) restoration were predominant. Approximately 28.5% (41/144) of cases were reviewed within 2 years, with the proportion of children with pulpitis or periapical infection being the highest (29.3%, 12/41). Age, gender, collision, and fall are the factors linked to a higher risk of TDI in the primary dentition in children under the age of 7. Resin filling (or preformed crown) restoration and pulpectomy are effective in preserving the affected tooth and controlling infection. However, the preservation of the affected tooth and the prevention of infection may be hampered by late visits and low follow-up rates.
One case of recurrent ST-segment elevation myocardial infarction in a patient with antiphospholipid syndrome complicated with severe thrombocytopenia within a short period of time: A case report
Authors: Qiu Zhongjue , Wang Yong , Xu Li , Zhou Zhou , Zhang Jiacheng , Wang Zhen
Published: November 2023

Introduction:

Acute myocardial infarction is an important arterial thrombotic event in patients with antiphospholipid syndrome (APS). Anticoagulation regimen might greatly affect the prognosis. Due to the lack of sufficient data and large prospective randomized controlled trials, there is no definite consensus among researchers on the optimal antithrombotic therapy for patients with APS after arterial events.

Patient concerns:

A 35-year-old male presented with sustained chest tightness and chest pain for 6 hours, accompanied with palpitation, sweating and headache.

Diagnosis:

The patients was diagnosed with acute ST-segment elevation myocardial infarctions with severe thrombocytopenia. Emergency coronary angiography showed that the posterior descending artery (PDA) was occluded, and a thrombus shadow was visible. An emergency coronary intervention was performed to open the occluded PDA. About 48 hours after hospitalization, the PDA was occluded again and percutaneous coronary intervention was performed again to open the blocked coronary artery. The lupus anticoagulant screen rate were positive during hospitalization and 12 weeks after discharge, meeting the diagnostic criteria of APS.

Interventions:

The patient received coronary intervention twice during hospitalization. After the second coronary intervention, a sequential therapy of bivalirudin, fondaparinux sodium, and warfarin was adopted as the anticoagulant regimen.

Outcomes:

The patient was discharged in stable condition without chest pain. One year later, during her follow-up, a repeat echocardiogram and electrocardiogram showed normal findings.

Conclusion:

It is the first report of severe thrombocytopenia and recurrent coronary thrombosis within a short period of time in an APS patient, and in this report the importance of anticoagulant therapy in thrombus management in patients with APS was present, also the importance of tracking thrombotic factors. This study proposes an anticoagulation regimen for patients suffering from antiphospholipid syndrome, experiencing recurrent atherothrombotic events, and presenting severe thrombocytopenia.
Endomyocardial fibrosis and apical calcification: A case report with unusual presentations of apical hypertrophic cardiomyopathy
Authors: Gao Man , Zhang Feifei , Xie Yuetao , Li Jialin , Hao Xiao , Liu Huiliang , Qi Xiaoyong , Dang Yi
Published: November 2023

Rationale:

Apical hypertrophic cardiomyopathy (ApHCM) is a phenotypic variant of hypertrophic cardiomyopathy. Endomyocardial fibrosis and endocardial calcification are especially rare in ApHCM.

Patient concerns:

The main symptoms was chest tightness, palpitation, shortness of breath, and fatigue. Echocardiography and imaging examinations found apical hypertrophy along with endocardial calcification and endomyocardial fibrosis. Abnormal structural changes led to thrombosis and made the left ventricle a flat shape resembling an “apple.”

Diagnoses:

The typical presentations, hypertrophic apex on echocardiography and an elevated N-terminal pro-brain natriuretic peptide level indicated the diagnosis of ApHCM and heart failure with preserved ejection fraction.

Interventions:

Optimal medical therapy including the administration of ApHCM, heart failure and atrial fibrillation to improve symptoms and life quality.

Outcomes:

Since discharge, the patient could perform normal daily activities and had no discomfort based on the optimal medical therapy.

Lessons:

We report a ApHCM patients with unusual presentations of endomyocardial fibrosis and apical calcification. This case highlights the importance of understanding the specific pathological changes of ApHCM for treatment and prognosis.
Splicing factor proline- and glutamine-rich regulates cytotoxic T lymphocytes-mediated cytotoxicity on non-small cell lung cancer by directly binding to PD-L1 3’UTR
Authors: Pan Yanming , Cheng Yongxia
Published: November 2023

Splicing factor proline- and glutamine-rich (SFPQ) can interact with RNAs to regulate gene expression. The function of SFPQ in the immunotherapy of non-small cell lung cancer (NSCLC) is investigated in this study. H1299 and A549 cells were transfected with shSFPQ plasmid. Cell counting kit-8 (CCK-8) and cell clone formation were utilized to detect survival and proliferation. Programmed death-ligand 1 (PD-L1) and SFPQ were detected in NSCLC patients treated with anti-PD-L1 antibody. Dual-luciferase assays, RNA immunoblotting, RNA pull-down, and mRNA stability assay were applied to verify the regulation of PD-L1 with SFPQ. Human peripheral blood mononuclear cells (PBMC)-derived dendritic cells were loaded with irradiated A549 and H1299 cells, which were cultured with autologous CD8+T cells and tumor cells to perform in vitro tumor-specific cytotoxic T lymphocytes (CTL) cytotoxicity analysis. SFPQ silencing inhibited the survival and proliferation of H1299 and A549 cells with down-regulated PD-L1 expression. PD-L1 and SFPQ expression were markedly higher in anti-PD-L1 antibody treatment responders compared to non-responders, which showed a positive Pearson correlation (R = 0.76, P < .001). SFPQ up-regulated the relative mRNA and protein expression of PD-L1 by binding to the PD-L1 3’UTR to slow the decay of PD-L1 mRNA. SFPQ silencing promoted the killing effect of CTL on A549 and H1299 cells. SFPQ up-regulates PD-L1 expression by binding with PD-L1 3’UTR to slow the decay of PD-L1 mRNA, and SFPQ silencing promotes CTL-mediated cytotoxicity on NSCLC cells.
Network pharmacology and molecular docking reveal potential mechanism of esculetin in the treatment of ulcerative colitis
Authors: Cai Ting , Cai Bin
Published: November 2023

Ulcerative colitis (UC) is a chronic inflammatory bowel disease of the colonic mucosa. Esculetin is a type of natural coumarin that has many pharmacological activities such as antioxidant, anticancer, anti-inflammatory, etc. A previous study showed that esculetin improved intestinal inflammation and reduced serum proinflammatory cytokines in UC. The present study aimed to utilize network pharmacology and molecular docking to explore the potential mechanism of esculetin against UC. The potential gene targets of esculetin were predicted through SwissTargetPrediction and Super-PRED web servers. UC-related genes were obtained from DisGeNet, OMIM, and GeneCards databases. The overlap between gene targets of esculetin and UC-related genes were identified as the potential targets of esculetin against UC. The interaction between these overlapping genes was analyzed by the STRING database and the core genes were identified by Cytoscape platform. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis of the core genes were then performed. And the results of these analyses were further confirmed through molecular docking. A total of 50 overlapping genes were identified as the potential action targets of esculetin against UC. Among them, 10 genes (AKT1, STAT1, CCND1, SRC, PTGS2, EGFR, NFKB1, ESR1, MMP9, SERPINE1) were finally identified as the core genes. The Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis results showed that the top signaling pathway associated with the core genes of esculetin against UC was the prolactin (PRL) signaling pathway. Molecular docking results showed that esculetin has a strong binding affinity to the core genes, as well as PRL and prolactin receptor. This study suggests that esculetin may have a crucial impact on UC through the PRL signaling pathway and provides insights into the potential mechanism of esculetin in the treatment of UC, which may shed light on the mechanism and treatment of UC.
The relationship between frailty, walking ability, and depression in elderly Chinese people
Authors: Yin Hang , Gao Caizhu , Quan Zhengri , Zhang Yaqun
Published: November 2023

To explore the relationship between depression symptoms, frailty, and walking ability in Chinese elderly people, and to provide new evidence for research on the prevention and treatment of depression in Chinese elderly people. The data of this study is sourced from the 2018 CHARLS data (China Health and Retirement Longitudinal Study). Z-test, logistic regression, and linear stratified regression were used to analyze the walking ability, frailty, and depressive symptoms of 2927 participants. Good walking ability and non frailty were significantly negatively correlated with depression symptoms in the elderly (P < .05). This important negative association persists even after adjusting for demographic, health condition, and lifestyle factors. (P < .05). Elderly women are at a higher risk of developing depression than men, while elderly people with good walking ability and no frailty are at a lower risk of developing depression. At the same time, elderly people with disabilities, hypertension, arthritis, and low levels of physical activity are more likely to experience depressive symptoms. It is recommended that elderly people pay attention to maintaining walking ability and avoiding frailty to reduce the risk of depression.
Identification of hub gene and lncRNA signature related to entotic cell death in cutaneous melanoma for prognostic and immune prediction
Authors: Zhang Chen , Shen Chenyang
Published: November 2023

Entotic cell death (ECD), a cell death program observed in cancer cell competition, predominantly occurs in an autophagy protein-dependent, non-apoptotic manner. However, the relationship between cutaneous melanoma (CM) and ECD-associated genes and lncRNAs has remained unclear. This study aimed to elucidate the role and mechanism of ECD-associated genes in CM. To achieve this, 4 mechanism learning algorithms and integrated bioinformatic analyses were employed to identify the core ECD-associated genes and lncRNAs. Subsequently, 2 risk signatures based on ECD-associated genes and hub lncRNAs were constructed for CM patients. As a result, we observed significant differential expression of ECD-associated genes in CM, indicating their potential as valuable predictors for CM patients. Moreover, RHOA was identified as a core ECD-associated gene in CM, and its expression was found to be associated with patients’ survival and immune infiltration, suggesting its relevance as a potential therapeutic target. Additionally, this study provided clarification on hub ECD-associated lncRNAs in CM, offering insights into their roles in the disease. Through bioinformatic analyses, we identified 2 risk signatures based on the expression of ECD-associated genes and hub ECD-associated lncRNAs, respectively. Both risk signatures were strongly linked to the prognosis and cancer growth of CM, underscoring their potential as valuable prognostic indicators. Furthermore, mechanistic analyses suggested a significant association between the risk signature and the immune microenvironment in CM, highlighting potential immune-related implications in disease progression. In conclusion, we propose that ECD-associated genes and lncRNAs hold promise as potential targets in CM. Moreover, our findings revealed a significant correlation between ECD and the immune microenvironment, providing crucial insights for guiding individualized treatment strategies in CM.
Machine learning methods for accurately predicting survival and guiding treatment in stage I and II hepatocellular carcinoma
Authors: Li Xianguo , Bao Haijun , Shi Yongping , Zhu Wenzhong , Peng Zuojie , Yan Lizhao , Chen Jinhuang , Shu Xiaogang
Published: November 2023

Accurately predicting survival in patients with early hepatocellular carcinoma (HCC) is essential for making informed decisions about treatment and prognosis. Herein, we have developed a machine learning (ML) model that can predict patient survival and guide treatment decisions. We obtained patient demographic information, tumor characteristics, and treatment details from the SEER database. To analyze the data, we employed a Cox proportional hazards (CoxPH) model as well as 3 ML algorithms: neural network multitask logistic regression (N-MLTR), DeepSurv, and random survival forest (RSF). Our evaluation relied on the concordance index (C-index) and Integrated Brier Score (IBS). Additionally, we provided personalized treatment recommendations regarding surgery and chemotherapy choices and validated models’ efficacy. A total of 1136 patients with early-stage (I, II) hepatocellular carcinoma (HCC) who underwent liver resection or transplantation were randomly divided into training and validation cohorts at a ratio of 3:7. Feature selection was conducted using Cox regression analyses. The ML models (NMLTR: C-index = 0.6793; DeepSurv: C-index = 0.7028; RSF: C-index = 0.6890) showed better discrimination in predicting survival than the standard CoxPH model (C-index = 0.6696). Patients who received recommended treatments had higher survival rates than those who received unrecommended treatments. ML-based surgery treatment recommendations yielded higher hazard ratios (HRs): NMTLR HR = 0.36 (95% CI: 0.25–0.51, P < .001), DeepSurv HR = 0.34 (95% CI: 0.24–0.49, P < .001), and RSF HR = 0.37 (95% CI: 0.26–0.52, P = <.001). Chemotherapy treatment recommendations were associated with significantly improved survival for DeepSurv (HR: 0.57; 95% CI: 0.4–0.82, P = .002) and RSF (HR: 0.66; 95% CI: 0.46–0.94, P = .020). The ML survival model has the potential to benefit prognostic evaluation and treatment of HCC. This novel analytical approach could provide reliable information on individual survival and treatment recommendations.
Meta-analysis of risk factors for cardiovascular disease in patients with rheumatoid arthritis
Authors: Lyu Qian , Ma Linxiao , Liu Huijie , Wang Jihong
Published: November 2023

Background:

Cardiovascular disease (CVD) is a common complication of rheumatoid arthritis (RA). We aimed to explore the risk factors for cardiovascular disease in patients with rheumatoid arthritis and provide a scientific basis on effective prevention and treatments for CVD in RA patients.

Methods:

We searched for a combination of the subject words and free words involved arthritis, rheumatoid, CVD, heart disease, vascular disease, risk factors, etc. from China Knowledge Network, Wanfang, Vip, China Biomedical Literature Database, Pubmed, Embase, Web of Science, Cochrane and other databases for documents published in public in 2000-October 2022.RevMan 5.3 and Stata14.0 analysis software was used to perform a meta-analysis of case-control and cohort studies on risk factors of CVDs in patients with RA published from 2000 to 2022.The Egger method was used to determine whether there was publication bias.

Results:

Seventeen pieces of literature were included in this meta-analysis. We explored the associations between CVD and different clinical characters such as DAS28 score, rheumatoid factor, triglyceride, age, sex, C-reactive protein, total cholesterol (TC), hypertension, and D dimer. High serum levels of C-reactive protein, TC, and D-dimer, as well as hypertension, are the main risk factors for CVD in patients with RA. The OR and 95% CI of C-reactive protein were 2.06 (1.91–2.23), RR and 95% CI of TC were 1.7 (1.49–1.93), RR and 95% CI of hypertension were 3.58 (2.37–5.40), as well as OR and 95% CI of D dimer were 2.83 (1.48–5.40).Our results performed by the meta-analysis were reliable, with low publication bias existed.

Conclusion:

C-reactive protein, TC, hypertension, and D dimer are the main risk factors for CVD in patients with RA. No protective factors were found.
Integrating multiple microarray datasets to explore the significance of ferroptosis regulators in the diagnosis and subtype classification of osteoarthritis
Authors: Huang Yue , Chen Lihua , Xiong Bo , Lu GuanYu , Chen Cai , Liu JinFu
Published: November 2023

Osteoarthritis (OA) is a chronic joint disease that reduces quality of life for patients. Ferroptosis plays a significant role in OA. However, its underlying mechanism remains unclear. In this study, we integrated 7 OA synovial datasets from the GEO database to screen for significant ferroptosis-related genes. The top 5 ferroptosis regulators were used to construct nomogram models to predict OA prevalence. Consensus clustering was applied to classify OA patients into different ferroptosis patterns based on significant ferroptosis-related genes. Subsequently, an immune cell infiltration study was performed to investigate the relationship between the significant ferroptosis regulators and immune cells. As a result, we screened 11 ferroptosis-related genes in OA patients. Five candidate ferroptosis regulators (SLC7A11, ALOX5, SLC1A5, GOT1, and GSS) were used to predict OA risk. The nomogram model based on these 5 genes is important for assessing the occurrence of OA. Consensus clustering analysis showed that OA patients could be classified into 2 ferroptosis patterns (Clusters A and B). Immune cell infiltration levels were higher in Cluster B than in Cluster A. Two subtypes, gene Clusters A and B, were classified according to the expression of ferroptosis-related DEGs among the ferroptosis patterns. Cluster A and gene Cluster A had higher ferroptosis scores than Cluster B or gene Cluster B, whereas the expression levels of the proinflammatory cytokines interleukin (IL)-1β, tumor necrosis factor, IL-6, IL-18, and IL-10 were higher in Cluster B or gene Cluster B than those in Cluster A or gene Cluster A. Different subtypes of ferroptosis play critical roles in OA. Furthermore, immunotherapy strategies for OA treatment may be guided by our study on ferroptosis patterns.