bluuebunny/crossref_metadata_2025 huggingface dataset:
Corneal scar after ulcer in a young patient demanding visual restoration in a timely fashion treated with PTK + topo-guided PRK
Authors: Santhiago Marcony R. , Morgado Claudia R. , Koo Ellen , Iyer Geetha , Srinivasan Bhaskar , Berrospi Ruben , Ghanem Ramon
Published: November 2024

A 23-year-old woman was referred for low visual acuity in the left eye after a corneal ulcer associated with contact lens use 2 years previously. The patient had a history of contact lens use, reported use of antibiotic eye drops with improvement of infection, and subsequent scarring. There were no comorbidities. The manifest refraction was −3.25 −2.25 × 180 (20/20) in the right eye and was −2.00 esf −2.00 × 165 (20/80) in the left eye. The patient demands a solution in a reasonable time because of the need for functional vision and possible restoration of her binocular functions.

The slitlamp examination revealed a corneal scar partially affecting the visual axis (Figure 1

JOURNAL/jcrs/04.03/02158034-202412000-00016/figure1/v/2025-01-16T220450Z/r/image-tiff

). Corneal topography revealed an irregular pattern and spectral-domain optical coherence tomography (OCT) examinations revealed scarring in the anterior stroma (Figures 2 and 3

JOURNAL/jcrs/04.03/02158034-202412000-00016/figure2/v/2025-01-16T220450Z/r/image-tiff

JOURNAL/jcrs/04.03/02158034-202412000-00016/figure3/v/2025-01-16T220450Z/r/image-tiff

).

Given the patient's refraction, corneal scar, and visual demands, would you perform photorefractive keratectomy (PRK) treatment to correct ametropia and partially remove the anterior stroma? Would you perform excimer laser treatment for therapeutic purposes guided by topography? Would you opt for a 2-stage treatment, regularizing the cornea with neutral phototherapeutic keratectomy (PTK) or PRK treatment guided by topography and then correcting the ametropia? Considering the OTC maps, would you perform a femtosecond laser-assisted anterior lamellar keratoplasty (FALK), deep anterior lamellar keratoplasty (DALK), or even penetrating keratoplasty? Would you consider any other surgical step to prevent delayed cornea healing-persistent epithelial defect?
Complementary, integrative, and standard rehabilitative therapies in a military population with chronic predominantly musculoskeletal pain: a pragmatic clinical trial with SMART design
Authors: Flynn Diane M. , Ransom Jeffrey C. , Steffen Alana D. , Orr Kira P. , McQuinn Honor M. , Snow Tyler J. , Burke Larisa A. , Wi Dahee , Doorenbos Ardith Z.
Published: November 2024

There is growing acceptance for combining complementary and integrative health (CIH) therapies with standard rehabilitative care (SRC) for chronic pain management, yet little evidence on the best sequence of therapies. We investigated whether starting with CIH therapies or SRC is more effective in reducing pain impact. Participants were 280 service members with predominantly (88%) musculoskeletal chronic pain referred to an interdisciplinary pain management center who were randomized to a twice weekly program of either CIH therapies (n = 140) or SRC (n = 140) for the 3-week first stage of treatment. The composition of a second 3-week treatment stage depended upon response to the first stage. The primary outcome measure was the impact score (range 8-50) from the NIH Task Force on Research Standards for Chronic Low-Back Pain. Outcomes were measured after 3 and 6 weeks of treatment and at 3- and 6-month follow-ups. Most participants were men (76.8%) and mean age was 34.7 years (SD 8.0). At end of stage 1, pain impact decreased significantly more in the CIH group (29.8 points [SD 7.2] at baseline to 26.3 points [SD 7.9], change of −3.3 points [95% confidence interval, −4.2 to −2.5]) than in the SRC group (30.8 [SD 7.6] to 29.4 [SD 7.8], change of −0.9 points [95% confidence interval, −1.8 to −0.1]; P < 0.001). No significant between-group differences were observed after 6 weeks of treatment nor at 3- or 6-month follow-ups. Complementary and integrative health therapies may provide earlier improvement in pain impact than SRC, but this difference is not sustained.
Depression and Quality of Life in Patients With Chronic Kidney Disease: A Mediation Analysis of Handgrip Strength and Demoralization
Authors: LEE Szu-Ying , FANG Yu-Wei , LIU Chieh-Yu
Published: November 2024

Background

Chronic kidney disease (CKD) is a progressive disease impacting the physical function and mental health of sufferers. Depression is known to negatively impact quality of life, whereas handgrip strength and demoralization are important factors affecting physical and mental health. Lower handgrip strength has been associated with sarcopenia and higher risk of hospitalization in patients and higher workloads for nurse caregivers. Few studies have investigated the complex relations among these factors in patients with CKD.

Purpose

This study was designed to investigate the mediating effects of grip strength and demoralization on the relationship between depression and quality of life in patients with CKD.

Methods

Two hundred fifty patients with CKD comprised the study sample. The hypotheses were tested using the PROCESS macro.

Results

Depression was found to be negatively associated with handgrip strength and quality of life but positively associated with demoralization. The results indicate that both handgrip strength and demoralization mediate the association between depression and quality of life. Moreover, the results of multiple mediation model analysis showed handgrip strength and demoralization both play important roles in the link between depression and quality of life.

Conclusions

The results of this study indicate that handgrip strength and demoralization mediate the relationship between depression and quality of life in patients with CKD. Thus, increasing handgrip strength and decreasing demoralization levels may mitigate the impact of depression on quality of life. Therefore, nurses should better appreciate the importance of handgrip strength for patients with CKD and evaluate handgrip strength. Nurses should also develop physical and mental interventions to increase handgrip strength and decrease demoralization.
Smoking and outcomes in candidates for liver transplantation: Analysis of the Pulmonary Vascular Complications of Liver Disease 2 (PVCLD2)
Authors: Cecil Colleen R. , Moutchia Jude , Krowka Michael J. , Dubrock Hilary M. , Forde Kimberly A. , Krok Karen L. , Fallon Michael B. , Kawut Steven M. , Al-Naamani Nadine
Published: November 2024

Patients with chronic liver disease commonly have abnormal lung function; however, the impact of smoking on outcomes in these patients is unknown. We hypothesized current or past smoking would be associated with worse survival in patients with advanced liver disease. The Pulmonary Vascular Complications in Liver Disease Study 2 (PVCLD2) was a prospective cohort of patients with advanced liver disease undergoing evaluation for liver transplantation (LT). Patients were classified by self-report as a “non-smoker,” “past smoker,” or “current smoker.” We used Cox proportional hazards models and Fine-Gray models with LT as a competing risk. Models were adjusted for age, sex, body mass index, race, family income, liver disease etiology, and Model for End-Stage Liver Disease-Sodium score. Of the 410 patients included, most (65%) were male and the mean age at enrollment was 56.5 years. One hundred sixty (39%) patients were nonsmokers, 183 (45%) were past smokers, and 67 (16%) were current smokers. In total, 151 (37%) patients received an LT, and 88 (20%) patients died. When compared to nonsmokers, current smokers had a 2.17-fold increase in risk of death overall (95% CI: 1.12–4.18, p = 0.02). There was a 7% increase in overall risk of death for every 5 pack-years increase (95% CI: 1.01–1.13, p = 0.02). With LT as a competing risk, the subdistributional HR of current smokers versus nonsmokers for death was 2.45 (95% CI: 1.31–4.60, p = 0.005). In this model, past smokers displayed a nonsignificant increase in the risk of death compared to nonsmokers (subdistributional HR: 1.58, 95% CI: 0.91–2.72, p = 0.10). Patients with advanced liver disease undergoing evaluation for LT who smoke have an increased risk of death. Smoking cessation could lead to improved overall survival with or without LT.
Advances in achieving lung and diaphragm-protective ventilation
Authors: van den Berg Maarten J.W. , Heunks Leo , Doorduin Jonne
Published: November 2024

Purpose of review

Mechanical ventilation may have adverse effects on diaphragm and lung function. Lung- and diaphragm-protective ventilation is an approach that challenges the clinician to facilitate physiological respiratory efforts, while maintaining minimal lung stress and strain. Here, we discuss the latest advances in monitoring and interventions to achieve lung- and diaphragm protective ventilation.

Recent findings

Noninvasive ventilator maneuvers (P0.1, airway occlusion pressure, pressure-muscle index) can accurately detect low and excessive respiratory efforts and high lung stress. Additional monitoring techniques include esophageal manometry, ultrasound, electrical activity of the diaphragm, and electrical impedance tomography. Recent trials demonstrate that a systematic approach to titrating inspiratory support and sedation facilitates lung- and diaphragm protective ventilation. Titration of positive-end expiratory pressure and, if available, veno-venous extracorporeal membrane oxygenation sweep gas flow may further modulate neural respiratory drive and effort to facilitate lung- and diaphragm protective ventilation.

Achieving lung- and diaphragm-protective ventilation may require more than a single intervention; it demands a comprehensive understanding of the (neuro)physiology of breathing and mechanical ventilation, along with the application of a series of interventions under close monitoring. We suggest a bedside-approach to achieve lung- and diaphragm protective ventilation targets.
Monitoring respiratory muscles effort during mechanical ventilation
Authors: van Oosten Julien P. , Akoumianaki Evangelia , Jonkman Annemijn H.
Published: November 2024

Purpose of review

To summarize basic physiological concepts of breathing effort and outline various methods for monitoring effort of inspiratory and expiratory muscles.

Recent findings

Esophageal pressure (Pes) measurement is the reference standard for respiratory muscle effort quantification, but various noninvasive screening tools have been proposed. Expiratory occlusion pressures (P0.1 and Pocc) could inform about low and high effort and the resulting lung stress, with Pocc outperforming P0.1 in identifying high effort. The pressure muscle index during an inspiratory hold could unveil inspiratory muscle effort, however obtaining a reliable inspiratory plateau can be difficult. Surface electromyography has the potential for inspiratory effort estimation, yet this is technically challenging for real-time assessment. Expiratory muscle activation is common in the critically ill warranting their assessment, that is, via gastric pressure monitoring. Expiratory muscle activation also impacts inspiratory effort interpretation which could result in both under- and overestimation of the resulting lung stress. There is likely a future role for machine learning applications to automate breathing effort monitoring at the bedside.

Different tools are available for monitoring the respiratory muscles’ effort during mechanical ventilation – from noninvasive screening tools to more invasive quantification methods. This could facilitate a lung and respiratory muscle-protective ventilation approach.
Epidemiology of Early-onset Colorectal Cancer in a Safety-net Hospital System in Texas
Authors: Tran Vinh , Spezia-Lindner Nathaniel , Millien Valentine O. , Bilal Mohammad , Liu Yan , Montealegre Jane , Gould-Suarez Milena
Published: November 2024

Goals:

We aimed to characterize risk factors for early versus advanced-stage early-onset colorectal cancer (eoCRC) at our safety-net hospital system.

Background:

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Rates of CRC diagnosis in young adults (age below 50) have been rising despite an overall decrease in CRC. CRC in this group is often detected late due to screening historically being for persons 50 years and older. Etiologies for the increase in rates of eoCRC remain unclear, as do the risk factors for advanced-stage, defined as stage III or IV, at presentation.

Study:

We conducted a retrospective cohort study of 556 adults younger than 50 years of age with an ICD-10 diagnosis of malignant neoplasm of the colon or rectum within a 10-year span. Data collected included demographics, age at diagnosis, time to diagnosis, and cancer stage at diagnosis. Multivariable analysis was used to determine factors associated with advanced-stage CRC.

Results:

A total of 279 patients met the inclusion criteria. Most were Hispanic (67.03%), followed by non-Hispanic Black (NHB, 24.01%). Most had advanced-stage CRC at diagnosis (85.7%, n=239), despite 67.7% (n=189) being diagnosed within 3 months of symptom onset. When compared with non-Hispanic White (NHW) patients, NHB (OR: 2.02, CI: 0.59-6.96) and Hispanic (OR: 1.68, CI: 0.57-4.95) patients had higher odds of advance-stage CRC, albeit not statistically significant.

Conclusions:

Most patients were diagnosed with advanced-stage disease. NHB and Hispanic patients had a nonstatistically significant higher odds of presenting at advanced-stage CRC compared with NHW patients. System-wide quality improvement interventions may be needed to screen for eoCRC in safety-net hospital systems.
Evaluating the GALAD Score for Detection of Hepatocellular Carcinoma in Patients With Cirrhosis
Authors: Vo Thong Duy , Mai Sang Hoai , Lam Huong Tu
Published: November 2024

Introduction:

Early diagnosis of hepatocellular carcinoma (HCC) is crucial but challenging, and late detection limits its treatment and prognosis. We aimed to evaluate the GALAD score as a novel yet highly accurate and promising diagnostic tool for HCC.

Methods:

A prospective and retrospective cohort study was conducted in 196 adult patients with cirrhosis, including 102 with HCC and 94 without. The diagnostic performance of the GALAD score for HCC detection was compared with that of single biomarkers.

Results:

In patients with cirrhosis with HCC, the GALAD score was 2.5 (95% CI: −2.43 to 11.09), which was significantly higher than the GALAD score of −2.46 (95% CI: −6.15 to 2.04) in patients with cirrhosis without HCC (P<0.001). Patients with multiple tumors had a significantly higher GALAD score than those with a single tumor (P=0.0081). There was a moderate correlation between the GALAD score and tumor size in patients with cirrhosis (r=0.44; P<0.001). The GALAD score had an area under the receiver operating characteristic curve of 0.91, higher than that of all single biomarkers used to diagnose HCC (all P<0.001). The optimal cutoff for diagnosing HCC using the GALAD score was −0.518, achieving a sensitivity of 87.25%, specificity of 82.98%, positive predictive value of 84.62%, and negative predictive value of 84.78%. At this cutoff, the GALAD score demonstrated superior sensitivity compared with single or combined biomarkers.

Conclusions:

The GALAD score shows promise in detecting HCC in patients with cirrhosis. The GALAD score could be applied in clinical practice to diagnose HCC in patients with cirrhosis, and calculating the GALAD score in clinical settings may help predict tumor size and quantity before imaging results become available.
High Rate of Seroprotection With Heplisav-B in Patients With Inflammatory Bowel Disease
Authors: Hegde Yash , Lazarus Sarah K. , Farraye Francis A. , Hollnagel Fauzia , Hayney Mary S. , Caldera Freddy
Published: November 2024

Objective:

Patients with inflammatory bowel disease (IBD) are commonly treated with immunosuppressive therapies that increase the risk for infections, including hepatitis B (HepB) virus. Adult patients with IBD have suboptimal seroprotection rates after vaccination with a 3-dose recombinant recombinant HepB vaccine. Heplisav-B is an adjuvanted 2-dose HepB series that is more immunogenic in the general adult population. Herein, we evaluated the immunogenicity of Heplisav-B in adult patients with IBD.

Patients and Methods:

We conducted a prospective observational study of adult patients with IBD who were not seroprotected to HepB virus and received a Heplisav-B series with postimmunization HepB surface antibody (anti-HBs) serologic testing. Postimmunization anti-HBs ≥10 IU/mL was considered seroprotection. The primary outcome was the rate of seroprotection. Secondary outcomes were rates of seroprotection in different age groups, those on immunosuppressive therapy, and previous HepB vaccine nonresponders using a univariate analysis.

Results:

Eighty-five patients met the inclusion criteria with the majority (72%) achieving seroprotection with a median anti-HBs level of 48.7 IU/mL and 28 patients (33%) having an anti-HBs level >100 IU/mL. Those on immunosuppressive therapy [49 (58%), 18 nonresponders, odds ratio: 0.34, 95% CI: 0.12-0.99] and primary nonresponders to a previous HepB series [22 (26%), 11 nonresponders, odds ratio: 0.26, 95% CI: 0.09-0.73] were less likely to achieve seroprotection. Seven patients who did not respond received a third dose of Heplisav-B, and 2 achieved seroprotection.

Conclusions:

Heplisav-B achieved higher rates of seroprotection than those seen with 3-dose recombinant HepB vaccines in patients with IBD and may be the preferred option.
Association Between Indices of Thyroid Hormone Resistance and Constipation Prevalence in the US Population
Authors: Li Cheng , Wu Ruozhen , Xie Diya
Published: November 2024

Background:

Chronic constipation is a common and complex condition that significantly impairs the quality of life and health care costs. Identifying the underlying cause is crucial for effective management, and hypothyroidism is frequently implicated. Nevertheless, extensive studies are scarce regarding this correlation. The research aims to examine the association between indices of thyroid hormone resistance, particularly the Thyroid Feedback Quantile-based Index of Free Thyroxine (TFQIFT4), and the occurrence of constipation among the population of the United States.

Methods:

The analysis examined data collected from 6354 participants in the National Health and Nutrition Examination Survey (NHANES) conducted between 2007 and 2010. Chronic constipation was determined as the Bristol Stool Form Scale (BSFS) types of 1 to 2 or <3 bowel movements weekly. Thyroid hormone resistance was assessed using various indices. The statistical analysis comprised weighted logistic regression, restricted cubic splines (RCS), subgroup analysis, and sensitivity analysis.

Results:

Chronic constipation was diagnosed in 10% of participants, displaying distinct characteristics. A nonlinear association between TFQIFT4 and constipation was observed, with inflection points at −0.25 and 0.376. Above a TFQIFT4 value of −0.25, a significantly negative association with constipation was found, primarily in females (OR=0.21; 95% CI: 0.10-0.44). No such association was found in males.

Conclusions:

The study elucidates a complex correlation between thyroid hormone resistance, particularly TFQIFT4, and constipation. Gender-specific correlations were evident, with TFQIFT4 demonstrating a negative association with constipation, primarily in females. These findings underscore the need for further investigation into the underlying mechanisms involving central thyroid resistance and constipation across genders.
The effectiveness of vasodilators on chronic obstructive pulmonary disease: A systematic review and meta-analysis
Authors: Han Ningxin , Qi Hui , Yin Yujie , Liu Yi , Jin Peipei , Hou Yunlong , Jia Zhenhua
Published: November 2024

Background:

Chronic obstructive pulmonary disease (COPD) is a complex progressive disease. Some vasodilators have been reported with therapeutic potential to protect vascular function therefore may delay the progression of COPD.

Methods:

We searched PubMed, Embase, Cochrane Library, Web of Science, OVID and Clinicaltrials.gov database for eligible randomized controlled trials (RCTs) published before January 1, 2024. RCTs which treatment with vasodilators to COPD patients were included. Gas-blood exchange indicators were the primary outcomes, and ventilation function and quality of life indicators were the secondary outcomes. Mean differences with 95% confidence intervals were extracted. Subgroup analysis of vasodilator category and COPD complicated with or without pulmonary hypertension (PH) were performed. The risk of bias was assessed using Cochrane risk of bias tool, and the meta-analysis was conducted.

Results:

Twenty studies with a total sample size of 986 were included. The results showed that the 2 types of drugs in vasodilators included PDE-5 inhibitors could improve DLCO (MD = 6.56 [95% CI (1.74, 11.39)], P = .008) and iNO could reduce PaCO2 (MD = −0.10 [95% CI (−0.17, −0.03)], P = .006). Vasodilators could reduce PaCO2 in COPD complicated with PH (COPD-PH) (MD = −0.10 [95% CI (−0.17, −0.03)], P = .006). There were no statistically significant differences in FEV1 (MD = 0.02 [95% CI (−0.11, 0.16)], P = .74), FEV1% predicted (MD = 0.07 [95% CI (−1.90, 2.05)], P = .94), FEV1/FVC (MD = 0.70 [95% CI (−4.02, 5.42)], P = .77) and V

E

/V

CO2
(MD = −0.17 [95% CI (−2.39, 2.05)], P = .88) levels. The total SGRQ score was significantly lower in vasodilator groups (MD = −5.53 [95% CI (−9.81, −1.24)], P = .01).

Conclusions:

The therapeutic effects of vasodilators for COPD are controversial. In this meta-analysis, vasodilators have benefits in improving gas-blood exchange function and quality of life in COPD patients. However, vasodilators may have a limited capacity to improve pulmonary function.
Current status and hotspots in breast cancer patient self-management research: A bibliometric and visual analysis via CiteSpace
Authors: Chen Xinyue , Cao Yan , Huang Shan , Chen Yanyan , Zhang Cui-ping
Published: November 2024

Background:

Breast cancer remains a leading cause of cancer-related mortality worldwide. Patient self-management plays a pivotal role in enhancing outcomes and quality of life for individuals affected by this disease. This study employed bibliometric and visual analysis techniques utilizing CiteSpace to elucidate the current status and research hotspots in breast cancer patient self-management from January 1, 2005, to August 31, 2023.

Methods:

A comprehensive search was conducted in the Web of Science Core Collection (WoSCC). The retrieved literature was subjected to visualization and analysis using CiteSpace, focusing on publication timeline, article count, geographical distribution, institutional affiliations, journal sources, reference co-citation networks, and keyword analysis.

Results:

The analysis encompassed 1413 English-language documents. The United States emerged as the most prolific contributor, while the University of Toronto demonstrated the highest institutional output. The two-map overlay revealed prominent citation paths, indicating strong interconnections between publications in “Medicine, Medicine, Clinical” and “Health, Nursing, Medicine,” as well as “Psychology, Education, Health” and “Health, Nursing, Medicine.” The most frequently co-cited reference was “Self-Management: Enabling and Empowering Patients Living with Cancer as a Chronic Illness.” High-frequency keywords identified included quality of life, chronic disease, self-management, patient education, randomized controlled trials, education, and intervention. These keywords formed 11 distinct clusters related to intervention content, methodologies, outcome indicators, and emerging research trends. Keyword burst analysis predicted future research hotspots focusing on patient needs, psychological distress, Internet technology, and mobile applications.

Conclusions:

Research in breast cancer self-management is experiencing significant growth. Enhanced collaboration between countries, regions, and institutions is imperative. Further investigation is warranted, particularly in the domains of “quality of life,” “patient education,” and “mobile health.” These findings provide valuable insights to guide future research directions in this critical field.
Does the intervention for adhesive capsulitis in patients with diabetes differ from that for patients without diabetes?: A systematic review
Authors: Tang Shuquan , Tan Xiaoya
Published: November 2024

Background:

Adhesive capsulitis (AC) is often accompanied by pain and restriction in range of movement, which long lasting symptoms often have negative impact on patients’ work and lives. Since diabetes mellitus (DM) is an independent risk factor for developing AC, and AC with DM have more limitations of joint motion than general people.

Aims:

The aim of the present study is to evaluate the difference of clinical efficacy between diabetes and non-diabetes, and to explore whether AC with diabetes need special intervention compared to non-diabetes.

Methods:

Pubmed NCBI and Embase were searched for studies published in the last 30 years. We conducted a literature search for terms regarding AC and DM on Pubmed NCBI and Embase.

Results:

A total of 9 studies eligible for inclusion. The affected shoulders in these studies ranged from 26 to 135, 460 shoulders (551 participants) in total, including 166 shoulders in diabetic group and 394 shoulders in non-diabetic/idiopathic group. Interventions included shock wave therapy, hydrodilatation, arthroscopic capsular release, manipulation under cervical nerve root block. Evaluation indicators included pain, certain shoulder questionnaires, range of motion. Positive clinical efficacy were emerged after interventions between the 2 groups. The studies that better improvement of pain in non-diabetic/idiopathic group were 2 of 6, that of certain shoulder questionnaires were 4 of 8, that of range of motion were 3 of 6.

Conclusions:

Whether AC combined with DM or not, the current treatment could achieve positive clinical effectiveness and there is some statistical evidence show that the curative effect of AC combined with DM is worse than non-diabetic. In other words, the available evidence suggests that patients with DM might require additional rehabilitation measures with routine glycemic control.
Traditional Chinese medicine combined with chemotherapy for breast cancer after operation: A systematic review and meta-analysis
Authors: Zhang Yanran , Shi Lihui
Published: November 2024

Background:

This systematic review aims to explore the effect of traditional Chinese medicine combined with chemotherapy on the clinical efficacy of breast cancer postoperative patients, providing theoretical basis for the treatment of breast cancer postoperative patients with traditional Chinese medicine.

Methods:

A comprehensive search was conducted on databases such as China National Knowledge Infrastructure, Wanfang Database, VIP Database, Chinese Biomedical Literature Database, PubMed, and the Cochrane Library from their inception to August 2023 to screen RCTs comparing the effect of traditional Chinese medicine combined with chemotherapy with that of chemotherapy alone on the clinical efficacy of breast cancer postoperative patients. The included literature was systematically reviewed.

Results:

A total of 22 RCTs involving 1834 breast cancer postoperative patients were finally included, with 918 patients in the traditional Chinese medicine combined with chemotherapy group (treatment group) and 916 patients in the chemotherapy alone group (control group). Meta-analysis showed that compared with the control group, therapeutical effective rate, CD3, CD4, CD4/CD8, and adverse reactions in the treatment group were all improved, and the incidence of leukopenia and thrombocytopenia after chemotherapy were all reduced, with statistically significant differences.

Conclusion:

Traditional Chinese medicine combined with chemotherapy is superior to chemotherapy alone in improving the therapeutical effective rate after breast cancer surgery, reducing chemotherapy adverse reactions, and enhancing immune function.
Comparative efficacy and safety of second-line medications for status epilepticus: A network meta-analysis
Authors: Zhang Qishun , Peng Shaokang , Wei Ziyi , Cheng Xiangshu
Published: November 2024

Background:

To systematically review the efficacy and safety of second-line medications for status epilepticus (SE).

Methods:

Electronic searches were conducted in PubMed, Embase, and The Cochrane Library for randomized controlled trials of second-line medications for SE from inception to January 2024. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was performed using R 4.2.2 software.

Results:

A total of 23 randomized controlled trials were analyzed, examining the efficacy of 5 different treatment regimens: levetiracetam (LEV), phenytoin (PHT), fosphenytoin (FPHT), valproate (VPA), and phenobarbital (PHB). The results of the network meta-analysis indicated that the seizure control rate ranking was as follows: PHB (98.1%) > LEV (60.7%) > FPHT (40.3%) > PHT (33.0%) > VPA (17.8%). The surface under the cumulative ranking (SUCRA) values revealed that PHB had the highest ranking (SUCRA, 91.8%), followed by VPA (SUCRA, 69.3%), PHT (SUCRA, 56.1%), and FPHT (SUCRA, 5.9%) for the recurrence of seizures within 24 hours. Subgroup analysis revealed that PHB was most effective for seizure control in both pediatric and adult populations, VPA demonstrated superior efficacy in children across various indicators, LEV was deemed the safest option for children and elderly individuals, and VPA was identified as the safest choice for adult patients.

Conclusions:

PHB continues to be a prominent option for managing SE, although its safety profile warrants careful consideration. Meanwhile, both VPA and LEV offer distinctive advantages in the treatment of SE, with each demonstrating commendable safety profiles.
Exploring the causal relationships between type 2 diabetes and neurological disorders using a Mendelian randomization strategy
Authors: Wei Yongfang , Xu Shuling , Wu Zhaoquan , Zhang Mengling , Bao Meihua , He Binsheng
Published: November 2024

While there is ample evidence indicating an increased occurrence of general neurological conditions among individuals with diabetes, there has been limited exploration into the cause-and-effect connection between type 2 diabetes (T2D) and specific neurological disorders, including conditions like carpal tunnel syndrome and Bell’s palsy. We used Mendelian randomization (MR) approach to investigate the causal effects of T2D on 67 neurological diseases. We primarily utilized the inverse-variance weighted method for the analysis, and also employed the weighted median and MR-Egger methods in our study. To detect and correct potential outliers, MR-PRESSO analysis was used. Heterogeneity was assessed using Cochrane Q-values. The MR analyses found a possible relationship between T2D and a risk increase of 8 diseases at suggestive level of evidence (P < .05). Notably, among the positive findings that met the false discovery rate threshold, nerve, nerve root, and plexus disorders (odds ratio [OR] = 1.11; 95% confidence interval [CI] = 1.08–1.15); neurological diseases (OR = 1.05; 95% CI = 1.03–1.07) and carpal tunnel syndrome (OR = 1.10; 95% CI = 1.05–1.16) were identified. Our findings affirm a cause-and-effect association between T2D and certain neurological disorders.
Development and validation of a risk score for detecting non-alcoholic fatty liver disease
Authors: Jiang Zhili , Li Xiang , Yang Duo , Qu Chao , Yi Jiayi , Gao Hai
Published: November 2024

The development of an easy-to-use noninvasive model to screen nonalcoholic fatty liver disease (NAFLD) is warranted. This study aimed to develop and validate a simple noninvasive NAFLD risk score (NARS). We used the National Health and Nutrition Examination Survey 2017 to March 2020 cycle data. The sample size of derivation and validation cohort were 4056 and 2502, separately. The NAFLD was determined by FibroScan® measured controlled attenuation parameter scores of >285 dB/m in the absence of excessive alcohol use, steatogenic medications use, and viral hepatitis. The NARS was derived from a multivariable logistic regression model and variables were selected based on Boruta analysis. The performance of NARS was internally validated and compared with previous models using receiver-operating characteristics curve and C-statistics. The NARS was established using waist circumference, triglycerides, alanine aminotransferase, and fasting glucose, and the total score ranges from 0 to 8, with an increasing risk of NAFLD. NARS demonstrated ideal discrimination in the validation cohort, with C-statistics of 0.832 (95% confidence interval, 0.801–0.824), and was not inferior to any existing models. The optimal cutoff point for predicting NAFLD was obtained at 4 scores with a sensitivity of 82% and specificity of 69%. We reported the derivation and internal validation of a novel and easy-to-use risk score for detecting the presence of NAFLD. NARS demonstrated ideal discrimination performance and was practical in clinical practice for selecting individuals at higher risk of NAFLD for further examination or intervention.
Selinexor in combination with pomalidomide and dexamethasone for the treatment of primary plasma cell leukemia with 1q21+ abnormality: A case report
Authors: Fan Wenxia , Wang Lei , Wang Xinyou , Liu Ying , Sun Mingling , Abduklimu Nadia , Zhang Rui , Jiang Ming , Guo Xinhong
Published: November 2024

Rationale:

Primary plasma cell leukemia is a rare and highly aggressive malignancy of the blood system, with rapid disease progression and a high early mortality rate. Currently, there is no recognized therapeutic regimen, leading to the adoption of strategies typically utilized for multiple myeloma, which, however, exhibit limited efficacy. Selinexor is considered effective in treating relapsed/refractory multiple myeloma, but there are currently no reports on its application in primary plasma cell leukemia. Here, we reported a case of primary plasma cell leukemia with multiple high-risk genetic factors (including 1q21+, 17p‐, and 13q‐) who received a chemotherapy regimen including selinexor, pomalidomide, and dexamethasone.

Patient concerns:

This case was a 58-year-old male presenting with lower back pain, abdominal pain, and various systemic symptoms.

Diagnoses:

The initial diagnosis of intestinal obstruction at a local hospital was followed by a referral to our emergency department due to abnormal blood test results indicative of a hematologic disorder. Further investigations confirmed a rare diagnosis of primary plasma cell leukemia of the IgA-k light chain subtype.

Interventions:

The patient was promptly treated with a chemotherapy regimen comprising selinexor, pomalidomide, and dexamethasone in addition to supportive care.

Outcomes:

Subsequent assessments showed a significant response to treatment, with improvement in symptoms, normalization of blood parameters, and achievement of very good partial response. However, due to financial constraints, the patient declined hematopoietic stem cell transplantation and eventually opted to discontinue treatment, leading to disease progression.

Lessons:

The combination of selinexor with pomalidomide and dexamethasone has shown good efficacy in primary plasma cell leukemia with high-risk genetic abnormalities. Our case may provide evidence for developing an effective selinexor-based regimen for treating primary plasma cell leukemia with high-risk genetic abnormalities.
Visualize the time dynamics and research trends of macrophage associated periodontitis research from 2004 to 2023: Bibliometrix analysis
Authors: Zheng Hu , Cai Yuhang , Liu Keyi , Xiang Junwei , Han Wenjia , Wang Yuanyin , Chen Ran
Published: November 2024

Background:

Macrophages play an important role in the symptoms and structural progression of periodontitis, and are receiving increasing attention. In recent years, research has shown significant progress in macrophage associated periodontitis. However, there is still lack of comprehensive and methodical bibliometric analysis in this domain. Therefore, this research aims to describe the state of the research and current research hotspots of macrophage associated periodontitis from the perspective of bibliometrics.

Methods:

This study collected and screened a total of 1424 articles on macrophage associated periodontitis retrieved between 2004 and 2023 from Web of Science Core Collection database. Use Citespace (6.1. R6), Bibliometrix-R (4.1.3), VOSviewer (1.6.19), and Graphpad Prism8 software to analyze and plot countries/regions, institutions, journals, authors, literature, and keywords to explore the research hotspots and development trends of macrophage associated periodontitis.

Result:

After analysis, the amount of macrophage associated periodontitis publications has been rising consistently over time, with China having the most publications (29.32%). 3 countries accounted for 65.57% of the total publications: the United States, China, and Japan, occupying a dominant position in this research field. China publications have the fastest growth rate and played a driving role. The most productive institution is the Sichuan University in China. Journal of Periodontal Research is highly popular in the field of macrophage associated periodontitis, with the highest number of publications. Grenier, Daniel is the most prolific author. Inflammation and Bone Loss in Periodontal Disease are the most cited literature. “Biological pathogenic factors,” “immune regulation,” “mechanism research,” “susceptibility factor research,” “pathological processes and molecular correlation,” “pathological characteristics,” “inflammatory response” are the main keyword groups in this field.

Conclusion:

This study systematically analyzes and describes the development process, direction, and hotspots of macrophage associated periodontitis using bibliometric methods, providing a reference for future researchers who continue to study macrophage associated periodontitis.
Clinical efficacy of Crinone on pregnancy outcomes in frozen embryo transfer: A retrospective study in the Chinese population
Authors: Xu Lishuang , Xiong Fang , Chen Jie , Jin Xin , Zeng Huiming , Weng Meiling
Published: November 2024

Background:

The aim of this study was to retrospectively investigate the effect of Crinone vaginal gel on pregnancy outcomes in women undergoing natural cycle (NC) frozen embryo transfer (FET) and to obtain the most suitable population for its routine application.

Methods:

The 1613 women who underwent FET in the NC regimen [including the controlled ovulation stimulation protocol for the natural cycle, or the controlled ovulation stimulation protocol for the natural cycle (NC-COS)] from 2017 to 2021 were included. All patients were divided into 2 groups including Control group and Crinone group, which administered with or without Crinone vaginal gel. The key clinical information and between the 2 groups was recorded in detail.

Results:

The results indicated that there were no statistical differences in blood β human chorionic gonadotropin (HCG) positive rate, clinical pregnancy, live birth, abortion (spontaneous and induced) and stillbirth between Control group and Crinone group. Moreover, Crinone could prevent spontaneous abortion. The spontaneous abortion rate in the Crinone group was 5.93% while this in control group was 8.32%. In the cohort exposed to Femoston, the preventive result was more significant (0/32 vs 5/15, P = .001). Furthermore, Crinone exhibited a significant protective effect on spontaneous abortion in 1520 patients who received no human menopausal gonadotropin (HMG) treatment.

Conclusion:

This study demonstrated that the Crinone could protect women against spontaneous abortion, especially in patients who do not need HMG or in combination with Femoston.
Association between hospital characteristics and rate of prophylactic antibiotic use over 1 day for clean surgery: A nationwide cohort study
Authors: Huang Chun-Che , Chen Chia-Yu
Published: November 2024

The timing of prophylactic antibiotic use has become a hospital’s surgical quality indicator. This study aims to assess the association of hospital characteristics with rate of prophylactic antibiotic use over 1 day for clean surgery. The retrospective cohort study was conducted using open government data, and hospitals must legally disclose to Taiwan’s National Health Insurance Administration (NHIA). We identified 278 hospitals that reported 9491 records of prophylactic antibiotic use over 1 day for clean surgery from the 2009 first quarter to the 2019 fourth quarter. Regression models with generalized estimating equations were estimated. Overall, the median rate of prophylactic antibiotic use over 1 day for clean surgery in hospitals was 11.1% (interquartile range: 1.9% to 30%). Multivariable analyses showed that regional (coefficient [B] = 9.45, 95% confidence interval [CI]: 6.02–12.87, P < .001) and local hospitals (B = 15.04, 95% CI: 9.61–20.47, P < .001) had higher rates of prophylactic antibiotic use more than 1 day for clean surgery than medical centers. Moreover, public (B = 4.94, 95% CI: 0.61–9.28, P = .025) and medical care corporation hospitals (B = 8.17, 95% CI: 0.85–15.49, P = .029) experienced significantly greater proportions of antibiotic use over 1 day for clean surgery than medical care foundation hospitals after adjustments. This study revealed that low-level, public, and medical care corporation hospitals had higher rates of prophylactic antibiotic use over 1 day for clean surgery. These findings may represent a quality improvement opportunity for postoperative antibiotic use.
The application of sphingomyelin in mediating the causal role of the T-cell surface glycoprotein CD5 in Crohn’s disease: A two-step Mendelian randomization study
Authors: Li Xiao , Yao Xin , Wen Jieying , Chen Qiaoling , Zhu Ziming , Zhang Xinyue , Wang Song , Lan Weixuan , Huang Yunsi , Tang Shanneng , Zhou Xuan , Han Xuedong , Zhang Tao
Published: November 2024

To examine the possible causative association between Crohn disease (CD) and the T-cell surface glycoprotein CD5 and to ascertain whether sphingomyelin (SM) functions as a mediator. We conducted a two-step Mendelian randomization (MR) study to further explore the pathogenesis of Crohn and its related targets. MR study was performed on CD5 and CD using summary-level data from a genome-wide association study. Additionally, by employing a two-step MR study method, we determined that SM might mediate the causal effect of CD5 on CD. There was a favorable correlation between the surface glycoprotein CD5 on T cells and vulnerability to CD, and SM mediated the causal effect of CD5 on CD (the mediating effect accounts for 9.2%). Our study revealed that CD5 and CD are causally related, with SM mediating a small fraction of the impact (approximately 9.2%). The mediating function of SM in the link between CD5 and CD is anticipated to be realized through the regulation of immune cell transportation, apoptosis of intestinal barrier cells, and maintenance of the intestinal microenvironment.
Research hotspots and trends related to pain in gouty arthritis from 2014 to 2024: A bibliometric analysis
Authors: Lu Chengyin , Guo Yuxing , Luo Zhiqiang , Hu Xiaomei , Xiong Hui , Xiang Yang , Shu Yang , Jian Gonghui
Published: November 2024

Background:

Gouty arthritis is a metabolic condition caused by disordered purine metabolism and elevated uric acid levels. This study adopts a bibliometric approach to analyze current research on pain in gouty arthritis and forecast future research trends.

Methods:

Retrieve relevant research on gouty arthritis pain in the Web of Science core collection database, screen literature, and use visualization software such as CiteSpace, Vosviewers, and R package “Bibliometrix” for analysis.

Results:

The total number of documents included was 1133, with 909 articles and 224 reviews. Between 2014 and 2024, there was an overall upward trend in the number of publications about pain in gouty arthritis, with the United States of America and China ranking first and second, respectively, in terms of publication volume. The UNIVERSITY OF ALABAMA BIRMINGHAM had the most publications, and Professor DALBETH N played a key role in this field. According to the keyword analysis, disease management and treatment, particularly methods for enhancing patients’ quality of life and reducing symptoms, are research hotspots. For a deeper understanding, attention is also being paid to the epidemiology and pathological mechanisms of the disease. Emerging keywords such as “gut microbiota” and “urate-lowering therapies” indicate growing interest in the interrelationship between gut microbiota and gout, and the development of new treatment methods.

Conclusion:

This bibliometric study reveals that research on gouty arthritis pain is actively developing. Current hot topics reflect investigations into the deeper pathological mechanisms of gouty arthritis and the development of new treatment methods, including urate-lowering therapies. There is also increasing attention on the role of gut microbiota in the disease. Despite limitations such as the preliminary nature of research methods and insufficient interdisciplinary collaboration, future research directions aim to improve the rigor of research design, strengthen international cooperation, promote unified treatment guidelines, and optimize the diagnosis and treatment of gouty arthritis with new technologies like artificial intelligence, precision medicine, and nanomedicine. This will drive the field towards a deeper scientific understanding, more effective treatment methods, and more comprehensive disease management, ultimately improving patients’ prognosis and quality of life.