bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Approaches to Intraflap Anastomosis: Navigating Conjoined DIEP Flap Reconstruction—A Comprehensive Roadmap
Authors: Parikh Janak A. , Bombardelli Joao , Doval Andres , Spiegel Aldona J.
Published: February 2024

Background:

For patients desiring autologous breast reconstruction without adequate abdominal tissue volume, the deep inferior epigastric perforator (DIEP) flap may be stacked or combined with other flaps for bilateral reconstruction. Various combinations of anastomoses have been described in the literature. We sought to describe a framework for intraflap anastomoses.

Methods:

A retrospective review of 17 patients who underwent conjoined DIEP flaps with intraflap anastomoses with a single surgeon was performed. Patient demographics, comorbidities, operative details, and complications were reviewed. A framework scheme was developed for the type of intraflap anastomosis performed.

Results:

Between 2016 and 2020, 17 patients underwent conjoined DIEP flaps for unilateral breast reconstruction. Fourteen patients had delayed reconstruction. Eleven patients underwent an intraflap anastomosis in which a medial perforator on the left hemiabdomen flap was anastomosed with a distal lateral row perforator in the right hemiabdomen flap (type A). Four patients underwent an intraflap anastomosis in which a left lateral perforator was anastomosed to a right distal lateral row perforator (type B). Two patients underwent an intraflap anastomosis in which the left superficial inferior epigastric vessel was anastomosed to a right lateral row perforator (type C). Complications included reoperation (11.8%), partial flap loss (5.9%), seroma (23.5%), and hematoma (11.8%).

Conclusions:

We report a detailed framework for intraflap anastomoses of conjoined DIEP flap reconstruction including superficial inferior epigastric artery/superficial inferior epigastric vessel options. Knowledge of this comprehensive framework will allow surgeons to identify the type of intraflap anastomoses required for the anatomy they encounter and will standardize reporting of surgical technique in the literature.
Immediately sequential bilateral cataract surgery
Authors: Nowrouzi Ali , Alió Jorge L.
Published: February 2024

Purpose of review

This review aims to clarify the advantages and disadvantages of immediately sequential bilateral cataract surgery (ISBCS) based on recent studies, illustrate the safety of this approach, the cost-effectiveness, and present the importance of inclusion protocols for the best results.

Recent findings

In recent studies, the authors found no evidence of an increased risk of bilateral devastating complications such as endophthalmitis with ISBCS based on descriptive evidence compared to delayed sequential bilateral cataract surgery (DSBCS). Furthermore, recent studies on cost analyses showed that ISBCS resulted in fewer costs and significant cost savings to third-party payers, patients, and society compared to DSBCS.

The ISBCS surgical approach decreases hospital visits, reduces costs, and provides rapid visual rehabilitation and neuro adaptation. The risk of bilateral simultaneous complications is now recognized to be very rare with intracameral antibiotics and compliance with correct protocols. With new generations of optical biometry and lens calculation formulas, refractive surprises are occasional for normal eyes. However, refractive surprise is controversial, especially in the implantation of presbyopia correction intra-ocular lenses, which must be evaluated carefully in the ISBCS approach.
The role of neutrophil to lymphocyte ratio with wound healing in open tibial fracture grade IIIA
Authors: Johan Muhammad P. , Putra Luky T. , Yurianto Henry , Usman Muhammad A. , Arifin Jainal , Abidin Mohammad A. , Putro Yuni A.P. , Kennedy Dave , Singjie Leonard C.
Published: February 2024

Introduction:

Open fractures of the tibia are challenging injuries to treat. The neutrophil-lymphocyte ratio (NLR) has been used to predict poor prognosis in various orthopedic conditions. This study aims to analyze the role of NLR in the wound healing of patients with open fractures.

Methods:

This is a retrospective study with data taken from all patients with grade IIIA open tibial fractures admitted to the hospital for treatment between January 2018 and June 2023. The initial NLR value and wound healing state were recapped after 6 weeks of follow-up. A statistical analysis between NLR values and wound healing state was done to measure the significance between variables.

Results:

There were 49 participants included in this study. Our current study found a significant difference between the mean NLR value of the healed and nonhealed wound (12.59±11.2 vs 10.46±7.9, P =0.015). The mean NLR in the healed group was significantly higher than in the nonhealed group. Calculating NLR involves dividing the absolute count of neutrophils by the total count of lymphocytes, which can be obtained through a complete blood count test. This ratio offers valuable insights into the balance between inflammatory and anti-inflammatory responses in the body.

Conclusion:

The NLR was significantly higher in the healed group than in the nonhealed group. Further research with higher-quality studies might be needed to prove its prognostic factor.
Validation of the Raycome model M2 ambulatory blood pressure monitor in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Universal Standard (ISO 81060-2:2018)
Authors: Yang Shijie , Zhou Zhanyang , Miao Huanhuan , Zhang Hongye , Zhou Qiong , Zhai Mei , Zhang Yuqing
Published: February 2024

Objective

The aim of this study was to evaluate the accuracy of the Raycome model M2 oscillometric upper-arm blood pressure (BP) monitor developed for ambulatory BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060-2:2018) at rest and during dynamic exercise.

Method

Subjects were recruited to fulfill the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in the general population using the same arm sequential BP measurement method. Three cuffs of the test device were used for arm circumference 18–22 cm (small), 22–32 cm (medium) and 32–42 cm (large).

Results

For the general validation study, 106 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 0.5 ± 6.2/−0.2 ± 5.1 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.23/4.50 mmHg (systolic/diastolic). In the ambulatory validation study (N = 35), the mean difference was 0.4 ± 5.9/−1.1 ± 5.8 mmHg. The Raycome model M2 performed well against the standard in both the general and ambulatory validations and the Bland–Altman plots did not show any systematic variation in the error.

Conclusion

These data show that the Raycome model M2 monitor meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018) and in the ambulatory setting, indicating its suitability for measuring BP in the general population.
Novel dietary strategies to manage sarcopenia
Authors: Cailleaux Pierre-Emmanuel , Déchelotte Pierre , Coëffier Moïse
Published: February 2024

Purpose of review

Sarcopenia is a wasting disease, mostly age-related in which muscle strength and mass decline, such as physical performance. With aging, both lower dietary protein intake and anabolic resistance lead to sarcopenia. Moreover, aging and sarcopenia display low-grade inflammation, which also worsen muscle condition. In this review, we focused on these two main targets to study dietary strategies.

Recent findings

The better understanding in mechanisms involved in sarcopenia helps building combined dietary approaches including physical activity that would slow the disease progression. New approaches include better understanding in the choice of quality proteins, their amount and schedule and the association with antioxidative nutrients.

First, anabolic resistance can be countered by increasing significantly protein intake. If increasing amount remains insufficient, the evenly delivery protein schedule provides interesting results on muscle strength. Quality of protein is also to consider for decreasing risk for sarcopenia, because varying sources of proteins appears relevant with increasing plant-based proteins ratio. Although new techniques have been developed, as plant-based proteins display a lower availability, we need to ensure an adapted overall amount of proteins. Finally, specific enrichment with leucine from whey protein remains the dietary combined approach most studied and studies on citrulline provide interesting results. As cofactor at the edge between anabolic and antioxidative properties, vitamin D supplementation is to recommend. Antioxidative dietary strategies include both fibers, vitamins, micronutrients and polyphenols from various sources for positive effects on physical performance. The ω3-polyunsaturated fatty acids also display positive modifications on body composition. Gut microbiota modifiers, such as prebiotics, are promising pathways to improve muscle mass and function and body composition in sarcopenic patients. Nutritional interventions could be enhanced by combination with physical activity on sarcopenia. In healthy older adults, promoting change in lifestyle to get near a Mediterranean diet could be one of the best options. In sarcopenia adults in which lifestyle changes appears u

nprobable, specific enrichement potentialized with physical activity will help in the struggle against sarcopenia. Longitudinal data are lacking, which makes it hard to draw strong conclusions. However, the effects of a physical activity combined with a set of nutrition interventions on sarcopenia seems promising.
A literature review of a meta-analysis of BRAF mutations in non-small cell lung cancer
Authors: Chimbangu Clint Taonaishe , Xi Li , Ya Zhou , Jiayue Zhao , Xiao Meng , Ying Wang , Xingxu Yu , Liu Xiaomei
Published: February 2024

Background:

The research on the relationship between the Braf Proto-oncogene (BRAF) mutation and lung cancer has generated conflicting findings. Nevertheless, there is an argument suggesting that assessing the BRAF status could offer benefits in terms of managing and prognosing individuals with non-small cell lung cancer (NSCLC). To present a comprehensive overview of this subject, we undertook an up-to-date meta-analysis of pertinent publications.

Methods:

We conducted an extensive literature search utilizing Medical Subject Headings keywords, namely “BRAF”, “mutation”, “lung”, “tumor”, “NSCLC”, and “neoplasm”, across multiple databases, including PubMed, EMBASE, ISI Science Citation Index, and CNKI. For each study, we calculated and evaluated the odds ratio and confidence interval, focusing on the consistency of the eligible research.

Results:

The meta-analysis unveiled a noteworthy correlation between BRAF mutation and lung cancer. No significant evidence was found regarding the connection between smoking and staging among individuals with BRAF mutations. Furthermore, a substantial disparity in the rate of BRAF mutations was observed between males and females.

Conclusion:

Our meta-analysis revealed a significant correlation between BRAF mutations and NSCLC. Moreover, we observed a higher incidence of BRAF lung mutations in females compared to males. Additionally, the BRAFV600E mutation was found to be more prevalent among female patients and nonsmokers.
PD-L1 expression and its correlation with clinicopathological and molecular characteristics in Chinese patients with non-small cell lung cancer
Authors: Guo Jindong , Yuan Haibin , Zhu Yimin , Che Zhiyuan , Zhang Bei , Zhang Ding , Zhou Ying , Xiong Liwen
Published: February 2024

Little is known about the relationship between programmed cell death-ligand 1 (PD-L1) expression and histologic and genetic features in real-world Chinese non-small cell lung cancer patients. From November 2017 to June 2019, tumor tissues were collected from 2674 non-small cell lung cancer patients. PD-L1 expression was detected with immunohistochemistry using the 22C3 and SP263 antibodies, and patients were stratified into subgroups based on a tumor proportion score of 1%, 1% to 49%, and ≥ 50%. Genetic alterations were profiled using targeted next-generation sequencing. In the total population, 50.5% had negative PD-L1 expression (tumor proportion score < 1%), 32.0% had low-positive expression (1%–49%), and 17.5% had high-positive expression (≥50%). The PD-L1 positive rate was 39.0% in squamous cell carcinomas and 53.6% in adenocarcinomas. PD-L1 expression was higher in squamous cell carcinomas (P < .001) and lower in adenocarcinomas (P < .001). Of the overall patient population, 11.2% had Kirsten rat sarcoma viral oncogene (KRAS) mutations, 44.9% had epidermal growth factor receptor (EGFR) mutations, 2.1% had BRAF V600E mutations, 0.3% had MET exon 14 skipping mutations, 5.4% had anaplastic lymphoma kinase translocations, and 0.9% had ROS proto-oncogene 1 translocations. Patients carrying ROS proto-oncogene 1 translocations (P = .006), KRAS (P < .001), and MET (P = .023) mutations had significantly elevated expression of PD-L1, while those harboring EGFR (P < .001) mutations had lower PD-L1 expression. In our study, PD-L1 expression was significantly higher in squamous cell carcinomas and lower in adenocarcinomas, and was positively associated with MET and KRAS mutations, as well as the wild-type EGFR gene state. Nonetheless, additional studies are needed to further validate those associations and determine the clinical significance for immune checkpoint inhibitors of these factors.
Patient self-reported experience and satisfaction with golimumab and etanercept treatments for rheumatic diseases: A cohort study
Authors: Xia Wenjie , Zhou Lvjiong , Gao Weiqin , Zhang Yating , Si Fangyuan , Bai Fengmin , Zhang Zhanming , Wang Weifeng , Chen Guangjie , Gao Chenxin , Li Xiaotong , Yue Tao
Published: February 2024

Golimumab and etanercept both exhibit good efficacy in treating rheumatic diseases, while the patient self-reported measurement of treatment improvement and injection experience lacks sufficient evidence. Hence, this study aimed to compare the satisfaction with disease improvement and injection experience and the level of injection site reactions (ISRs) between golimumab-treated and etanercept-treated patients with rheumatic diseases. A total of 312 patients with rheumatic diseases were serially enrolled. Among them, 158 patients received golimumab (golimumab group); the other 154 patients were treated with etanercept (etanercept group) according to the actual disease status, physician advice, and patient willingness. Satisfaction with disease improvement was assessed using the 7-point Likert scale; satisfaction with injection experience and level of ISRs were both determined by the 5-point Likert scale. Satisfaction degrees with global injection experience (P = .025), injection device (P = .008), injection frequency (P = .010), and injection convenience (P = .003) were superior in the golimumab group to the etanercept group, while satisfaction degrees with global disease improvement, symptom relief, and speed of action did not vary (all P > .050) between the 2 groups. Discomfort (P = .005), swelling (P < .001), pain (P = .028), and burning (P = .035) levels were lower in the golimumab group than in the etanercept group. In addition, among 56 patients with a history of tumor necrosis factor inhibitor treatment before golimumab, 40 (71.4%) patients preferred golimumab to other tumor necrosis factor inhibitor. After switching to golimumab treatment, the level of ISRs in most patients was reduced or comparable. Golimumab achieves a satisfying injection experience and relieves the level of ISRs over etanercept in patients with rheumatic diseases.
Fatty acid metabolism-related lncRNAs are potential biomarkers for survival prediction in clear cell renal cell carcinoma
Authors: Zhang Ming-Qing , Yang Bai-Zhi , Wang Zhi-Qiang , Guo Shanchun
Published: February 2024

Metabolic reprogramming of energy is a newly recognized characteristic of cancer. In our current investigation, we examined the possible predictive importance of long noncoding RNAs (lncRNAs) associated to fatty acid metabolism in clear cell renal cell carcinoma (ccRCC). We conducted an analysis of the gene expression data obtained from patients diagnosed with ccRCC using the Cancer Genome Atlas (TCGA) database and the ArrayExpress database. We performed a screening to identify lncRNAs that are differentially expressed in fatty acid metabolism. Based on these findings, we developed a prognostic risk score model using these fatty acid metabolism-related lncRNAs. We then validated this model using Cox regression analysis, Kaplan–Meier survival analysis, and principal-component analysis (PCA). Furthermore, the prognostic risk score model was successfully validated using both the TCGA cohort and the E-MTAB-1980 cohort. We utilized gene set variation analysis (GSVA) and gene set enrichment analysis (GSEA) to determine the correlation between fatty acid metabolism and the PPAR signaling pathway in patients with ccRCC at various clinical stages and prognoses. We have discovered compelling evidence of the interaction between immune cells in the tumor microenvironment and tumor cells, which leads to immune evasion and resistance to drugs. This was achieved by the utilization of advanced techniques such as the CIBERSORT method, ESTIMATE R package, ssGSEA algorithm, and TIMER database exploration. Ultimately, we have established a network of competing endogenous RNA (ceRNA) that is related to fatty acid metabolism. The findings of our study suggest that medicines focused on fatty acid metabolism could be clinically significant for individuals with ccRCC. The utilization of this risk model, which is centered around the lncRNAs associated with fatty acid metabolism, could potentially provide valuable prognostic information and hold immunotherapeutic implications for patients with ccRCC.
Therapeutic efficacy of high-dose chemotherapy with autologous stem-cell transplantation in 44 relapsed or refractory germ-cell tumor patients: A retrospective cohort study
Authors: Ferhatoglu Ferhat , Paksoy Nail , Khanmammadov Nijat , Yildiz Anil , Ahmed Melin Aydan , Gülbas Zafer , Basaran Mert
Published: February 2024

Despite having a higher mortality risk than conventional chemotherapeutics, high-dose chemotherapy (HDCT) has the potential to be curative in relapsed/refractory germ-cell tumors. Therefore, selecting the best patient group for this treatment is critical. This study aimed to determine the factors that affect survival in our relapsed/refractory GCT cohort who received HDCT and autologous stem-cell transplantation. Between September 2010 and 2020, we included in the study 44 relapsed/refractory male patients with GCT treated with HDCT plus autologous stem-cell transplantation. The patients’ demographic features, clinical characteristics, and treatment outcomes were evaluated. Statistical analyses were performed to identify risk factors associated with survival. The median age of all cohorts was 28 years. Thirty-six patients had nonseminomatous tumors, and 8 patients had seminomatous tumors. The most common primary tumor sites were the gonads (75%), followed by the mediastinum (15.9%) and the retroperitoneum (9.1%). After HDCT, 11 patients had a complete response, 12 patients had a partial response, and 17 patients had a progressive disease, respectively. About 23 patients (52.3%) experienced at least 1 treatment-related grade 3 to 4 nonhematological toxicity. About 4 patients (10%) died due to HDCT-related toxicity. The total group’s median progression-free survival (PFS) was 7 months, and the median overall survival (OS) was 14.9 months. Primary tumor site (hazard ratio [HR]: 1.84; P = .028), type of HDCT regimen (HR: 0.35; P = .010), and best response to HDCT (HR: 11.0; P < .0001) were independent prognostic risk factors for PFS. The only independent prognostic risk factor associated with OS was the best response to HDCT (HR: 6.62; P = .001). The results of the study promise the best response to HDCT as a primary measure for predicting survival in relapsed/refractory GCT. In contrast, primary mediastinal GCT is not a good candidate for HDCT. Furthermore, a carboplatin–etoposide regimen in combination with cyclophosphamide and paclitaxel may improve PFS.
Laparoscopic repair of perineal hernia and unilateral inguinal hernia after rectal cancer surgery: A case report
Authors: Li Chuan-Ying , Zhao Hao-Jun , Zhou Yuan , Xu Jia-You
Published: February 2024

Introduction:

Perineal hernia (PH) is a rare complication that can occur after abdominoperineal resection for rectal cancer. Laparoscopic repair of PHs has gained increasing popularity compared to open approaches due to advantages such as superior visualization, decreased invasiveness, and faster recovery. This case report highlights the successful use of laparoscopic tension-free mesh repair for concurrent perineal and inguinal hernias after rectal cancer surgery.

Case Description:

A 51-year-old man underwent laparoscopic-assisted abdominoperineal resection for rectal cancer. About 2 months postoperatively, he developed reducible masses in the perineal and left groin regions, associated with urinary symptoms and sensation of prolapse. Physical exam revealed protruding masses that enlarged with Valsalva. Pelvic CT confirmed PH and left inguinal hernia.

Interventions:

Laparoscopic tension-free repair of the PH and inguinal hernia was performed on this patient. The repair was completed by the steps of adhesion separation, mesh placement, and fixation.

Outcomes:

The 98-minute surgery was successful without complications. The patient recovered well, ambulating on postoperative day 2 and getting discharged on day 6.

Conclusion:

This case demonstrates that laparoscopic tension-free repair with mesh is an effective approach for treating PH and concurrent inguinal hernia following rectal cancer surgery, resulting in successful outcomes and low recurrence rates. The laparoscopic technique provides benefits of minimal invasiveness and rapid recovery.
Association of systemic inflammation index with psoriasis risk and psoriasis severity: A retrospective cohort study of NHANES 2009 to 2014
Authors: Guo Huan-huan , Chen Ruo-xi
Published: February 2024

To investigate the association of systemic inflammation index (SII) with psoriasis risk and psoriasis severity. This is a retrospective cohort study based on data from the National Health and Nutrition Examination Survey database from 2009 to 2014. The psoriasis information was obtained from the questionnaire data, and the SII was calculated as neutrophil × platelet/lymphocyte. We performed matching by controlling age and gender to reach a 1:2 ratio for better statistical power. Weighted logistic regression analysis, subgroup analysis, restricted cubic spline analysis, and threshold analysis were used to evaluate the association of SII with psoriasis risk. Besides, mediation analysis was conducted to assess the possible regulatory path. Finally, the receiver operating characteristic curve was plotted to analyze the predictive value of SII for psoriasis severity. The study involved 16,466 participants including 16,020 no-psoriasis participants and 446 psoriasis participants. After matching, psoriasis and non-psoriasis individuals were 446 and 892, respectively. SII was significantly higher in the psoriasis group than the non-psoriasis group (P < .05). Additionally, white blood cells and monocytes were significantly linked to psoriasis risk and SII scores (P < .05). Besides, SII elevation was an independent predictor for upregulated psoriasis risk (P < .05). There was a nonlinear relationship between SII and psoriasis risk (P nonlinear < .05), which was not mediated by white blood cells and monocytes. Unexpectedly, SII had no significance in predicting SII severity (P > .05). SII can independently predict psoriasis risk but has no impact on psoriasis severity. Further, SII serves as a potential and robust biomarker for identifying high-risk psoriasis individuals.
Intercostal hemangiomas coexisting with multiple hepatic hemangiomas: Clinical and imaging findings in a single case report with a review of the literature
Authors: Li Xiangui , Wen Xing , Yang Lin
Published: February 2024

Rationale:

Intercostal hemangioma (IH) is an extremely rare disease, with only 18 cases reported in the past 30 years. Herein, we report the first case of IH coexisting with multiple hepatic hemangiomas, which recurred 32 months after surgery with rib erosion. IHs are invasive and difficult to distinguish from other intercostal tumors on imaging. To date, there have been no review articles on the imaging findings of IHs. We hope that this article will help clinicians improve their ability to diagnose and treat IH.

Patients concerns:

A 58-year-old male came to our hospital with gastrointestinal disease. Chest tumors were accidentally discovered on routine chest computed tomography (CT). The patient had no chest symptoms. The patient also had multiple liver tumors that had been present for 2 years but with no remarkable changes.

Diagnosis:

Plain chest CT revealed 2 adjacent masses protruding from the left chest wall into the thoracic cavity. Neurogenic tumors or hamartomas were suspected on enhanced CT scans. Abdominal contrast-enhanced computed tomography scan indicated multiple liver tumors as MMHs, which was consistent with the 2 previous Doppler ultrasound findings.

Interventions:

Surgeons removed the chest tumors by video-assisted thoracoscopic surgery. No treatment was provided for the MMHs.

Outcomes:

Two tumors of the chest wall were diagnosed as the IHs. There were no significant changes in the hepatic tumors after 32 months of follow-up. Unfortunately, the IH recurred, and the left 5th rib was slightly eroded.

Lessons:

It is necessary to include IHs as a potential differential diagnosis for chest wall tumors because early clinical intervention can prevent tumor growth and damage to adjacent structures. The imaging findings of IH show special characteristics. Preoperative imaging evaluation and diagnosis of IH are helpful for safe and effective surgery. Because of the high recurrence rate, complete surgical resection of IH with a sufficient tumor-free margin is recommended. It should be noted that the ribs should also be removed when the surrounding ribs are suspected to have been violated.
Research progress on microcirculatory disorders in septic shock: A narrative review
Authors: Wang Hui , Ding Hong , Wang Zi-Yan , Zhang Kun
Published: February 2024

Hemodynamic coherence plays a critical role in the outcomes of septic shock. Due to the potential negative consequences of microcirculatory disorders on organ failure and clinical outcomes, the maintenance of a balance between the macrocirculation and microcirculation is a topic of significant research focus. Although physical methods and specialized imaging techniques are used in clinical practice to assess microcirculation, the use of monitoring devices is not widespread. The integration of microcirculation research tools into clinical practice poses a significant challenge for the future. Consequently, this review aims to evaluate the impact of septic shock on the microcirculation, the methods used to monitor the microcirculation and highlight the importance of microcirculation in the treatment of critically ill patients. In addition, it proposes an evaluation framework that integrates microcirculation monitoring with macrocirculatory parameters. The optimal approach should encompass dynamic, multiparametric, individualized, and continuous monitoring of both the macrocirculation and microcirculation, particularly in cases of hemodynamic separation.
Clinical characteristics and outcomes of acute bacterial meningitis in adults at a tertiary university hospital in Thailand
Authors: Sirijatuphat Rujipas , Rungrotsakhon Attasit , Leelaporn Amornrut
Published: February 2024

The epidemiology of acute bacterial meningitis varies among settings, areas, and times. This study aimed to determine the clinical characteristics, the causative organisms and their antibiotic susceptibility, and the outcomes of patients with acute bacterial meningitis in Thai adults. This retrospective study included hospitalized patients aged ≥18 years diagnosed with acute bacterial meningitis at Siriraj Hospital during January 2002–December 2016. Of 390 patients, the median age was 48 years, 51% were male, and 80% had at least 1 underlying illness. Over half (54%) of patients had community-acquired bacterial meningitis (CBM), and 46% had nosocomial bacterial meningitis (NBM). The triad of acute bacterial meningitis (fever, headache, and neck stiffness) was found in 46% of CBM and 15% of NBM (P < .001). The causative organisms were identified in about half (53%) of patients. Most study patients (73%) received antibiotic treatment before the CSF collection. Causative organisms were identified more frequently in CBM (P < .001). Gram-positive cocci were more prevalent in CBM (P < .001), whereas Gram-negative bacilli were more common in NBM (P < .001). Streptococcus agalactiae (29%), Streptococcus pneumoniae (12%), and Streptococcus suis (11%) were most common in CBM, and all of them were sensitive to third-generation cephalosporins. Acinetobacter baumannii (19%), Klebsiella pneumoniae (16%), and Staphylococcus aureus (11%) were the most common organisms in NBM, and antibiotic-resistant isolates were frequently found among these organisms. Ceftriaxone monotherapy and meropenem plus vancomycin were the most common empiric antibiotic in CBM and NBM, respectively. Mortality was 19% among CBM and 23% among NBM (P = .338). HIV infection, alcoholism, pneumonia, shock, and disseminated intravascular coagulation were independent predictors of mortality. Mortality remains high among adults with acute bacterial meningitis in Thailand. A clinical practice guideline for acute bacterial meningitis should be developed that is based on local epidemiology and microbiology data.
Managing lymphoedema following treatment for head and neck cancer: is complete decongestive therapy an effective intervention to improve dysphagia outcomes?
Authors: Smith Alison
Published: February 2024

Purpose of review

The purpose of this review is to summarize current evidence regarding management of head and neck lymphoedema (HNL) to improve dysphagia outcomes following head and neck cancer (HNC) treatment. This review aims to support complete decongestive therapy (CDT) comprising compression, manual lymphatic drainage (MLD), exercises and skincare as an adjunct of dysphagia rehabilitation.

Recent findings

Research in the limbs supports the use of CDT to improve lymphoedema outcomes. Emerging evidence supports the use of CDT for the head and neck, though, there is no consensus on optimal treatment required to improve dysphagia outcomes. Current evidence is limited due to a paucity of randomized controlled trials, case series or cohort studies with small participant numbers, and a lack of functional and instrumental dysphagia outcome measures. This provides a foundation to design and test an individually tailored programme of HNL intervention to evaluate swallowing outcomes post CDT.

As the incidence of HNC is increasing with HPV, with patients living for longer with late effects of HNC treatment, it is vital to understand how the presence of HNL impacts on the swallow, and if functional dysphagia outcomes improve following treatment of HNL. Prospective, longitudinal research with objective and functional outcome measures are required to help determine optimal management of HNL and its impact on the swallow.
Disease Duration Affects the Clinical Phenotype of Primary Sjögren Syndrome
Authors: Zhang Yan , Yang Jian-Ying , Chen Jia-Qi , Liao Jia-He , Huang Zi-Wei , Wu Tzu-Hua , He Qian , Yu Xin-Bo , Wang Qin , Song Wei-Jiang , Luo Jing , Tao Qing-Wen
Published: February 2024

Objectives

To investigate the impact of disease duration on clinical phenotypes in Chinese patients with primary Sjögren syndrome (pSS) and examine the correlation between clinical phenotypes and onset age, age at diagnosis, and disease duration.

Methods

Data from 952 patients diagnosed with pSS in China between January 2013 and March 2022 were analyzed based on medical records. Patients were categorized into 3 groups based on disease duration: short (<5 years), moderate (≥5 and <10 years), and long (≥10 years) group. Clinical characteristics were compared among the 3 groups, and pSS patients with a long disease duration were compared with the other patients after matching age at diagnosis and age at onset.

Results

Among the patients, 20.4% had a disease duration over 10 years. After matching for age at onset and age at diagnosis, pSS patients with a long disease duration exhibited a significantly higher prevalence of dry mouth (p <0.001), dry eyes (p <0.001), fatigue (p <0.001), arthralgia (p <0.001), and dental caries (p <0.001) and higher rates of anti-Sjögren syndrome A (p < 0.05), anti-Ro52 (p < 0.05), and anti-SSB (p < 0.05) positivity than their control groups, with prevalence increasing with disease duration (p
trend < 0.001). However, no differences were noted in the prevalence of interstitial lung disease and leukopenia between different disease duration groups after matching for age at onset, although differences were shown when matching for age at diagnosis.

Conclusion

Longer disease duration in pSS patients correlates with increased prevalence of sicca symptoms, fatigue, and arthralgia and higher positivity of autoantibodies associated with pSS. However, the prevalence of interstitial lung disease and leukopenia did not correlate with disease duration after matching for age at onset.
Monitoring Dual-Cancer Treatment in a Patient With Prostate and Hepatocellular Carcinoma Using Prostate-Specific Membrane Antigen-Directed PET/CT
Authors: Reiter Florian P. , Weich Alexander , Higuchi Takahiro , Serfling Sebastian E. , Kickuth Ralph , Werner Rudolf A.
Published: February 2024

We report on a 70-year-old man affected with prostate carcinoma (PC) scheduled for prostate-specific membrane antigen (PSMA) PET/CT using 18F-PSMA1007. Because of uptake in the liver and corresponding findings on magnetic resonance, diagnosis of hepatocellular carcinoma (HCC, G1) was established. The patient was then scheduled for antihormonal treatment for PC and locoregional therapy due to HCC. On follow-up PSMA-targeted PET/CT, we observed durable response to PC-associated therapy, whereas hepatic lesions showed progressive disease. As such, we herein report on a dual-cancer targeting molecular imaging strategy to determine disease extent in a patient affected with both PC and HCC, along with potential of monitoring both systemic and locoregional treatment.
Differentiating Brown Tumor From Bone Metastasis in Parathyroid Cancer Using 18F-FDG PET and 99mTc-MIBI SPECT
Authors: Tsukamoto Suzune , Kawabata Kazuna , Kawamura Hitomi , Takata Kuniaki , Hosono Makoto
Published: February 2024

A 69-year-old woman presented with a right clavicle pain. CT revealed a pathological fracture of the right clavicle, multiple osteolytic lesions, and a left cervical mass. 18F-FDG PET/CT demonstrated a marked FDG uptake in the cervical mass and osteolytic lesions indicative of metastatic parathyroid cancer. 99mTc-MIBI SPECT/CT revealed either faint or no uptake in the osteolytic lesions. However, a histopathological analysis after a parathyroidectomy and right clavicle biopsy confirmed the diagnosis of parathyroid cancer and the presence of benign brown tumors secondary to hyperparathyroidism. Postoperative imaging showed sclerotic change and a decreased FDG uptake in the bone lesions.
Struma Ovarii With Extensive Peritoneal Implants Metastasis Revealed by 99mTcO4 SPECT/CT
Authors: Xie Hangyu , Huang Rui , Lei Jianyong , Li Lin
Published: February 2024

Struma ovarii is a rare form of ovarian teratoma composed entirely or mainly of mature thyroid tissue. A 55-year-old woman with persistent hypogastric pain for 4 months was admitted to our hospital. She had undergone resection of struma ovarii 4 years ago. Contrast-enhanced CT shows multiple significantly enhanced nodules scattered in the abdominopelvic cavity. Pathological examination of the nodule in the left pararenal region demonstrated thyroid-like follicular epithelium. Herein, we present the 99mTcO4 whole-body scintigraphy SPECT/CT findings of a case of struma ovarii with extensive peritoneal implants metastasis. Then, she was treated with total thyroidectomy and 131I therapy.
Myocardial Infarction and Cardiac Arrest During Acquisition of 18F-FDG PET/CT
Authors: Omery Bilal M. , Kalirao Amitjeet S.
Published: February 2024

An 83-year-old man with multiple myeloma and history of coronary artery disease and ischemic cardiomyopathy experienced cardiac arrest during the 18F-FDG PET/CT examination. The patient had not yet been treated for multiple myeloma. The PET/CT demonstrated focal FDG uptake about the left anterior descending coronary artery. Diffuse intense FDG uptake in the liver and less than normal uptake in other organs of usual FDG distribution were also present, likely due to altered hemodynamics and heart failure in the setting of an acute coronary syndrome.
A Hangover Under 177Lu-PSMA-617 Therapy
Authors: Poterszman Nathan , Somme Laura , Bund Caroline , Hutt Emilie , Somme François
Published: February 2024

Leptomeningeal carcinomatosis in prostate cancer is extremely rare. Because of the low overall penetration of drugs into the brain and the prolonged survival of castration-resistant prostate cancer (CRPC) patients, a special attention should be paid to the appearance of neurological symptoms in long-term CRPC survivors. A patient suffering from a CRPC with bone metastases underwent 4 cycles of 177Lu-PSMA (prostate-specific membrane antigen)-617. Starting from the third cycle, he reported an increasing feeling of a permanent hangover. A 68Ga-PSMA-11 brain PET/MRI was carried out after the fourth cycle. It revealed intraparenchymatous brain metastases with intense uptake and evidences of leptomeningeal carcinomatosis.
Trends in End-of-Life Care and Satisfaction Among Veterans Undergoing Surgery
Authors: Dualeh Shukri H.A. , Anderson Maia S. , Abrahamse Paul , Kamdar Neil , Evans Emily , Suwanabol Pasithorn A.
Published: February 2024

Objective:

To examine trends in end-of-life care services and satisfaction among Veterans undergoing any inpatient surgery.

Summary Background Data:

The Veterans Health Administration has undergone system-wide transformations to improve end-of-life care yet the impacts on end-of-life care services use and family satisfaction are unknown.

Methods:

We performed a retrospective, cross-sectional analysis of Veterans who died within 90 days of undergoing inpatient surgery between 01/2010 and 12/2019. Using the Veterans Affairs (VA) Bereaved Family Survey (BFS), we calculated the rates of palliative care and hospice use and examined satisfaction with end-of-life care. After risk and reliability adjustment for each VA hospital, we then performed multivariable linear regression model to identify factors associated with the greatest change.

Results:

Our cohort consisted of 155,250 patients with a mean age of 73.6 years (standard deviation 11.6). Over the study period, rates of palliative care consultation and hospice use increased more than two-fold (28.1% to 61.1% and 18.9% to 46.9%, respectively) while the rate of BFS excellent overall care score increased from 56.1% to 64.7%. There was wide variation between hospitals in the absolute change in rates of palliative care consultation, hospice use and BFS excellent overall care scores. Rural location and ACGME accreditation were hospital-level factors associated with the greatest changes.

Conclusions:

Among Veterans undergoing inpatient surgery, improvements in satisfaction with end-of-life care paralleled increases in end-of-life care service use. Future work is needed to identify actionable hospital-level characteristics that may reduce heterogeneity between VA hospitals and facilitate targeted interventions to improve end-of-life care.
Stenotrophomonas riyadhensis sp. nov., isolated from a hospital floor swab
Authors: Macori Guerrino , Al-Qahtani Ahmed Ali , Koolman Leonard , Althawadi Sahar , Mutabaqani Maysoon , Bashtawi Rustom , Aljumaa Sulaiman , Almaghrabi Reem Saad , Fanning Séamus
Published: February 2024

During the analysis of a collection of Pseudomonas strains linked to an outbreak in an intensive care unit at King Faisal Specialist Hospital and Research Center in 2019, one isolate (CFS3442T) was identified phenotypically as Pseudomonas aeruginosa. However, whole-genome sequencing revealed its true identity as a member of the genus Stenotrophomonas, distinct from both P. aeruginosa and Stenotrophomonas maltophilia. The isolate demonstrated: (i) a significant phylogenetic distance from P. aeruginosa; (ii) considerable genomic differences from several S. maltophilia reference strains and other Stenotrophomonas species; and (iii) unique phenotypic characteristics. Based on the combined geno- and phenotypic data, we propose that this isolate represents a novel species within the genus Stenotrophomonas, for which the name Stenotrophomonas riyadhensis sp. nov. is proposed. The type strain is CFS3442T (=NCTC 14921T=LMG 33162T).
One-loop evolution of twist-2 generalized parton distributions
Authors: Bertone Valerio , del Castillo Rafael F. , Echevarria Miguel G. , del Río Óscar , Rodini Simone
Published: February 2024

We revisit the evolution of generalized parton distributions at the leading order in the strong coupling constant αs for all of the twist-2 quark and gluon operators. We rederive the relevant one-loop evolution kernels, expressing them in a form suitable for implementation, and check analytically that some basic properties, such as Dokshitzer-Gribov-Lipatov-Altarelli-Parisi/Efremov-Radyushkin-Brodsky-Lepage limits and polynomiality conservation, are fulfilled. We also present a number of numerical results obtained with a public implementation of the evolution in the library ++ and available within the framework.

Published by the American Physical Society
2024
Unitarity bound on dark matter in low-temperature reheating scenarios
Authors: Bernal Nicolás , Konar Partha , Show Sudipta
Published: February 2024

The model-independent theoretical upper bound on the thermal dark matter (DM) mass can be derived from the maximum inelastic DM cross section featuring the whole observed DM abundance. We deploy partial-wave unitarity of the scattering matrix to derive the maximal thermally averaged cross section for general number-changing processes r→2 (with r≥2), which may involve standard model particles or occur solely within the dark sector. The usual upper limit on the DM mass for s-wave annihilation is around 130 TeV (1 GeV) for r=2 (3) and only applies in the case of a freeze-out occurring in the standard cosmological scenario. We consider the effects of two nonstandard cosmological evolutions, characterized by low-temperature reheating: (i) a kinationlike scenario and (ii) an early matter-dominated scenario. In the first case, early freeze-out strengthens the unitarity bound to a few TeVs for weakly interacting massive particles (WIMPs); while in the second case, the WIMP DM can be as heavy as ∼1010  GeV due to a large entropy dilution.

Published by the American Physical Society
2024
Flipped
SU(6)
unification of the sequential
SU(3)c×SU(3)L×U(1)X
model
Authors: Wang Fei
Published: February 2024

We propose to partially unify the sequential SU(3)c×SU(3)L×U(1)X model (with β=1/3) into the flipped SU(6) model with the gauge group SU(6)×U(1)K. Gauge anomaly cancellation can easily be satisfied. We discuss the relevant Higgs sector, the low energy model spectrum, and the unification of SU(3)c and SU(3)L gauge couplings. Neutrino mass generation and successful gauge coupling unification can set lower/upper bounds on the breaking scale. The partial proton decay lifetime of various channels, for example, the p→e+π0 channel, in flipped SU(6) GUT are discussed. We find that certain parameter region with M331∼1015  GeV of case II (for case with M331 scale H˜3,8 Higgs field) can predict a partial proton lifetime of order 1034  years for p→e+π0 mode, which can be tested soon by future DUNE and Hyper-Kamiokande experiments.

Published by the American Physical Society
2024
Current fluctuations in a partially asymmetric simple exclusion process with a defect particle
Authors: Lobaskin Ivan , Evans Martin R. , Mallick Kirone
Published: February 2024

We study an exclusion process on a ring comprising a free defect particle in a bath of normal particles. The model is one of the few integrable cases in which the bath particles are partially asymmetric. The presence of the free defect creates localized or shock phases according to parameter values. We use a functional approach to Bethe equations resulting from a nested Bethe ansatz to calculate exactly the mean currents and diffusion constants. The results agree very well with Monte Carlo simulations and reveal the main modes of fluctuation in the different phases of the steady state.

Published by the American Physical Society
2024
Performance of ChatGPT on the test of understanding graphs in kinematics
Authors: Polverini Giulia , Gregorcic Bor
Published: February 2024

The well-known artificial intelligence-based chatbot ChatGPT-4 has become able to process image data as input in October 2023. We investigated its performance on the test of understanding graphs in kinematics to inform the physics education community of the current potential of using ChatGPT in the education process, particularly on tasks that involve graphical interpretation. We found that ChatGPT, on average, performed similarly to students taking a high-school level physics course, but with important differences in the distribution of the correctness of its responses, as well as in terms of the displayed “reasoning” and “visual” abilities. While ChatGPT was very successful at proposing productive strategies for solving the tasks on the test and expressed correct reasoning in most of its responses, it had difficulties correctly “seeing” graphs. We suggest that, based on its performance, caution and a critical approach are needed if one intends to use it in the role of a tutor, a model of a student, or a tool for assisting vision-impaired persons in the context of kinematics graphs.

Published by the American Physical Society
2024