bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of uptake of sulphadoxine-pyrimethamine for intermittent preventive treatment among pregnant women in Osun State, Nigeria
Authors: Adegbola Adebanjo J , Ogboye Ruth M , Ijarotimi Omotade A , Ubom Akaninyene E , Adesoji Bukola A , Bolaji Oluseye O
Published: October 2024

Background

About 32 million pregnant women are at the risk of malaria infection yearly in malaria-endemic sub-Saharan Africa. To mitigate the risks associated with malaria in pregnancy, the WHO recommends ≥3 doses of intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP), covering from the second trimester of pregnancy until delivery.

Methods

This cross-sectional study assessed the uptake and extent of adherence with IPTp-SP among pregnant women in Osun State, Nigeria, from October 2020 to March 2021. Assessment of the uptake was done by extracting information from the validated case report forms. Venous blood samples were obtained to assess the levels of sulphadoxine in plasma through HPLC-UV.

Results

In total, 49.24%, 38.17% and 12.58% of the study participants obtained 1, 2 and ≥3 doses of IPTp-SP, respectively. In assessing the extent of adherence, 46.67% obtained their last dose within 28 d before sample collection. Uptake of IPTp-SP is not associated with gravidity (p=0.603), but is weakly associated with the age of the study participants (p=0.04). The median (IQR) plasma sulphadoxine concentration was 10.6248 (2.8124–27.1242) ug/mL.

Conclusions

Utilisation of the intervention is still very low and adherence appears to be inadequate among the study population, suggesting that more advocacy on the IPTp-SP strategy and the implementation of directly observed therapy is necessary.
TMEM182 inhibits myocardial differentiation of human iPS cells by maintaining the activated state of Wnt/β‐catenin signaling through an increase in ILK expression
Authors: Morihara Hirofumi , Yokoe Shunichi , Wakabayashi Shigeo , Takai Shinji
Published: October 2024

Transmembrane protein 182 (TMEM182) is notably abundant in muscle and adipose tissue, but its role in the heart remains unknown. This study examined the contribution of TMEM182 in the differentiation of human induced pluripotent stem cells (hiPSCs) into cardiomyocytes. For this, we generated hiPSCs overexpressing TMEM182 in a doxycycline‐inducible manner and induced their differentiation into cardiomyocytes. On Day 12 of differentiation, expression of the cardiomyocyte markers, TNNT2 and MYH6, was significantly decreased in TMEM182‐overexpressing cells. Additionally, we found that phosphorylation of GSK‐3β (Ser9) and β‐catenin (Ser552) was increased during TMEM182 overexpression, suggesting activation of Wnt/β‐catenin signaling. We further focused on integrin‐linked kinase (ILK) as the mechanism by which TMEM182 activates Wnt/β‐catenin signaling. Evaluation showed that ILK expression was increased in cells overexpressing TMEM182. These results suggest that TMEM182 maintains Wnt/β‐catenin signaling in an activated state after mesoderm formation by increasing ILK expression, thereby suppressing hiPSCs differentiation into cardiomyocytes.
Plasma membrane repair defect in Alzheimer's disease neurons is driven by the reduced dysferlin expression
Authors: Bulgart Hannah R. , Lopez Perez Miguel A. , Tucker Alexis , Giarrano Gianni N. , Banford Kassidy , Miller Olivia , Bonser Sidney W. G. , Wold Loren E. , Scharre Douglas , Weisleder Noah
Published: October 2024

Alzheimer's disease (AD) is the most common neurodegenerative disease, and a defect in neuronal plasma membrane repair could exacerbate neurotoxicity, neuronal death, and disease progression. In this study, application of AD patient cerebrospinal fluid (CSF) and recombinant human Aβ to otherwise healthy neurons induces defective neuronal plasma membrane repair in vitro and ex vivo. We identified Aβ as the biochemical component in patient CSF leading to compromised repair capacity and depleting Aβ rescued repair capacity. These elevated Aβ levels reduced expression of dysferlin, a protein that facilitates membrane repair, by altering autophagy and reducing dysferlin trafficking to sites of membrane injury. Overexpression of dysferlin and autophagy inhibition rescued membrane repair. Overall, these findings indicate an AD pathogenic mechanism where Aβ impairs neuronal membrane repair capacity and increases susceptibility to cell death. This suggests that membrane repair could be therapeutically targeted in AD to restore membrane integrity and reduce neurotoxicity and neuronal death.
Surgical Outcomes After Preoperative Embolization in Hypervascular Spinal Metastases
Authors: Pierik Robertus J.B. , Amelink Jantijn J.G.J. , Groot Olivier Q. , Som Avik , van Munster Bram T. , de Reus Daniël C. , Chua Theresa L. , Zijlstra Hester , Verlaan Jorrit-Jan , Shin John H. , Rabinov James D. , Tobert Daniel G.
Published: October 2024

Study Design.

Retrospective propensity-score matched, case control study at 2 academic tertiary care centers.

Objective.

To assess the effect of PE on (1) intraoperative blood loss, defined as conventional estimates of blood loss (EBL) and hemoglobin mass loss, and (2) secondary outcomes in patients with spinal metastases from hypervascular histologies.

Background Context.

Preoperative embolization (PE) intends to reduce blood loss during surgery for spinal metastases of hypervascular tumors such as renal cell carcinoma. However, studies investigating the effect of PE in hypervascular tumors often consist of small cohorts, do not correct for confounding factors, and have conflicting results.

Methods.

After propensity score matching (PSM), 46 PE patients were matched to 46 non-PE patients without baseline differences. The constraints of PSM did not allow analysis of patients with tumor volumes>9 cm3. Multiple linear regression models were fitted for EBL and hemoglobin mass loss. Poisson regression models were fitted for both intraoperative and postoperative transfusions.

Results.

There was no difference in EBL (948 mL [IQR 500−1750] vs. 1100 mL [IQR 388−1925], P=0.68) and hemoglobin mass loss (201g [IQR 119–307] vs. 232g [IQR 173–373], P=0.18) between PE and non-PE patients. Other than higher 1-year survival rates (65% vs. 43%, P=0.05) in PE-patients, there were no differences in secondary outcomes. In multiple regression analyses, PE was not associated with decreased intraoperative blood loss, hemoglobin mass loss or perioperative blood transfusions.

Conclusions.

Our study demonstrated that, for tumors <9 cm3, PE did not reduce EBL, hemoglobin mass loss or perioperative blood transfusions in patients undergoing spine surgery for metastases from hypervascular histologies. These findings suggest that urgent spine surgeries indicated for hypervascular histologies should not be delayed based on the availability of PE and accurate detection of pre-operative hypervascularity, beyond histology, will likely be an important determination of future PE utilization for spinal metastases.

Level of Evidence.

Treatment Benefits, Level III
Efficacy and Safety of Cardiac Myosin Inhibitors in Hypertrophic Cardiomyopathy: A Meta-Analysis of Randomized Controlled Trials
Authors: Ahsan Areeba , Ahmed Mushood , Shafiq Aimen , Tariq Muhammad Daoud , Arif Fariha , Hassan Ali , Ramphul Kamleshun , Liu Alexander , Ahmed Raheel , Behary Paray Nitish Kumar
Published: October 2024

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by structural and functional abnormalities. Current management strategies, such as medications and septal reduction therapies, have significant limitations and risks. Recently, cardiac myosin inhibitors (CMIs) like mavacamten and aficamten have shown promise as noninvasive treatment options. This meta-analysis aims to evaluate the efficacy and safety of CMIs in HCM patients. PubMed/MEDLINE, Embase, the Cochrane Library, Ovid, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) that compared CMIs to control treatments in HCM patients from inception till June 15, 2024. A random-effects model was used to pool odds ratios (ORs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes along with the corresponding 95% confidence intervals (CIs). Heterogeneity was assessed using the χ2 test and Higgins I
2 statistic, and sensitivity and subgroup analyses were performed. Six RCTs involving 826 patients were included. CMI therapy significantly reduced resting left ventricular outflow tract (LVOT) gradient (MD, −37.64; 95% CI, −46.71 to −28.56), Valsalva LVOT gradient (MD, −46.04; 95% CI, −57.60 to −34.48), post-exercise LVOT peak gradient (MD, −48.64; 95% CI, −68.20 to −28.88), N-terminal pro-b-type natriuretic peptide levels (MD, −1.05; 95% CI, −1.64 to −0.47), and cardiac troponin I levels (MD, −7.96; 95% CI, −12.84 to −3.07). Improvements were observed in peak oxygen consumption (MD, 1.20; 95% CI, 0.23–2.17) and patient-reported outcomes (Kansas City Cardiomyopathy Questionnaire Clinical Summary Score: MD, 6.44; 95% CI, 3.50–9.37), with more patients achieving New York Heart Association class improvement >1 (OR, 4.05; 95% CI, 2.61–6.30). Treatment-emergent adverse events were higher with CMI therapy (OR, 1.45; 95% CI, 1.02–2.05), but serious adverse events and other safety outcomes were comparable in both groups. CMIs, including mavacamten and aficamten, significantly improve clinical outcomes in HCM patients with a manageable safety profile. These results indicate that CMIs offer a promising noninvasive alternative to septal reduction therapies.
Accelerated Takedown of Melolabial Interpolation Flaps at 1 to 2 Weeks, Indications and Safety for Improved Patient Experience
Authors: Prasad Smriti , Neill Brett , Yu Wesley , Leitenberger Justin J. , Bar Anna
Published: October 2024

BACKGROUND

The melolabial interpolation flap is an effective surgical technique for reconstructing defects in the nasal ala and tip regions. Traditionally, this technique involves waiting for the standard 3-week period before pedicle division.

OBJECTIVE

To evaluate whether accelerated takedown at 1- or 2-week postflap creation is possible while maintaining the flap's viability and functionality.

METHODS

Retrospective cohort study at Oregon Health and Science University from 2018 to 2023.

RESULTS

The authors examined 67 patients who underwent reconstruction with a melolabial interpolation flap surgery, of which 50 had their flap takedown at <21 days and 17 had their takedown at 21 or more days. This analysis revealed similar complication rates for both groups. There were no increased rates of infection, necrosis, or hematoma formation in the earlier takedown group. Those undergoing earlier takedown were more likely to have a history of hypertension but less likely to have a history of diabetes, immunosuppression, and smoking, though the differences were not statistically significant.

CONCLUSION

This study provides valuable insights into the safety and feasibility of early melolabial interpolation flap takedown. This approach has the potential to enhance the quality of life for patients undergoing this flap by decreasing the amount of time with a pedicle.
Long-term comparative outcomes in patients undergoing transcatheter aortic valve implantation with self-expanding valves versus balloon-expandable valves
Authors: Hoo Chee Eng , Chen Po-Lin , Chen Ying-Hwa , Chen I-Ming , Wu Nai-Yuan , Chang Hsiao-Huang
Published: October 2024

Background

This study aimed to compare long-term clinical outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) with self-expanding (SEV) valve versus balloon-expandable valve (BEV), with a minimum follow-up period of five years.

Materials and Methods

Utilizing a prospectively maintained database, this observational study identified patients who underwent TAVI using either SEV or BEV for severe aortic stenosis and were followed for at least five years. Clinical outcomes encompassed both 30-day post-TAVI outcomes and long-term outcomes, including all-cause mortality, cardiovascular mortality, structural valve deterioration (SVD), heart failure related hospitalization, bioprosthetic valve failure, and valve related hospitalization and complications.

Results

A total of 74 patients were included in this study, with 64 patients in the SEV group and 10 patients in the BEV group. The median follow-up duration was 6.8 years, ranging from 5.0 to 10.2 years. Throughout the post-TAVI period, the SEV group consistently demonstrated a lower mean pressure gradient than the BEV group. No significant differences were observed between the two groups in terms of short-term or long-term outcomes. Within the study, four patients encountered moderate or severe SVD and one experienced thrombosis, and no cases of bioprosthetic valve failure or endocarditis were observed.

Conclusions

This study revealed that SEV and BEV demonstrated comparable long-term outcomes in patients undergoing TAVI, including all-cause and cardiovascular mortality, as well as the risk of SVD.
Efficacy of Extranasal Neurostimulation for Patients With Neuropathic Corneal Pain: A Pilot Study
Authors: Olcucu Onur , de Leeuw Anya , Lamazales Luiz Luciano , Mallone Fabiana , Hamrah Pedram
Published: October 2024

Purpose:

Neuropathic corneal pain (NCP) has been recognized as a distinct disease, yet treatment options remain limited. The aim of this pilot study was to explore the effectiveness of extranasal neurostimulation (EXNS) as a potential pain relief strategy for individuals with the peripheral component of NCP.

Methods:

A retrospective study was performed to identify patients who were diagnosed with refractory peripheral or mixed NCP and subsequently underwent a single session of EXNS. Visual analog scale (VAS) was used to evaluate pain intensities in the office before and after 60 seconds of EXNS. Demographic information, changes in pain scores, and comorbidities were recorded, and their correlations with pain score changes were analyzed.

Results:

Twenty-two patients with a mean age of 48.91 ± 3.32 years were included. The average VAS score before EXNS was 5.59 ± 0.41, which was reduced to 2.59 ± 0.43 after EXNS, indicating a 54.88% reduction (P < 0.001). EXNS reduced VAS scores from 4.90 ± 0.72 to 1.60 ± 0.42 (68.40%) for 10 patients with peripheral NCP and from 6.17 ± 0.42 to 3.42 ± 0.62 (43.61%) for 12 patients with mixed (peripheral and central) NCP (P = 0.005 for both groups). Fourteen patients (63.63%) experienced an improvement of at least 50% in their pain scores, 2 patients (9.09%) showed an improvement between 30% and 49.9%, while 6 patients (27.27%) experienced an improvement of less than 30%. No correlations between the change in pain scores and patient demographics, as well as comorbidities were detected.

Conclusions:

EXNS may be used as an adjuvant therapy to ameliorate pain among patients with NCP with the peripheral pain component.
Regenerative medicine for spinal cord injury using induced pluripotent stem cells: from animals to humans
Authors: Nagoshi Narihito , Hashimoto Shogo , Okano Hideyuki , Nakamura Masaya
Published: October 2024

Spinal cord injury (SCI) results in permanent neurological dysfunction and neuropathic pain. To address this pathology, we recently conducted a clinical study in which we transplanted neural precursor cells (NPCs) derived from human induced pluripotent stem cells into patients during the subacute phase of SCI. One of the therapeutic mechanisms of cell transplantation is the formation of synaptic connections with the host's neural tissues, which we demonstrated using a chemogenetic tool. In addition, we have developed innovative strategies to enhance the effectiveness of cell transplantation through gene therapy. Moreover, our current study is focused on developing cell therapy for chronic SCI, a more challenging pathology characterized by the formation of cavities and scar tissue. In such situations, transplanting NPCs with neurogenic properties could effectively penetrate scar tissue and form functional synapses with the host neurons. To improve the outcomes of cell transplantation alone, we have found that incorporating rehabilitation is beneficial. In animal models of SCI, we have established an effective rehabilitative training program in which NPCs were transplanted during the chronic phase. Robotic rehabilitation has demonstrated improvements in gait ability and trunk function in clinical situations. Therefore, regenerative medicine shows promise for chronic SCI, particularly when rehabilitation strategies are incorporated.
Evaluation of problem-based learning for pharmacology based on a comprehensive analysis in undergraduate students
Authors: Yang Xiding , Yang Zehua , Ma Sijia , Yan Miao , Yang Yongyu
Published: October 2024

Background:

Problem-based learning (PBL) has been widely employed in pharmacology teaching. However, the benefits of PBL for undergraduate students have not been clearly demonstrated. We performed a meta-analysis to compare the effects of PBL and lecture-based learning (LBL) in undergraduate pharmacology education.

Methods:

We systematically searched literature databases for comparative studies related to PBL pedagogy in the undergraduate pharmacology curriculum from the inception of the databases to December 2023. The obtained literature was screened according to the selection criteria, and Review Manager 5.4 was used for the meta-analysis of the included studies.

Results:

A total of 33 comparative studies involving 4425 undergraduate students were enrolled. The standardized mean differences (95% confidence intervals) of the examination scores and students’ self-rated scores on learning interest, comprehension of knowledge and thinking ability between PBL and LBL were calculated to be 2.03 (1.53–2.53), 0.50 (0.26–0.74), 0.69 (0.46–0.92), and 1.65 (1.21–2.09), respectively. The risk ratios of the proportion of satisfaction on improving students’ learning interest, comprehension of knowledge, thinking ability, self-study ability, and communication skills were calculated to be 2.08 (1.17–3.71), 1.84 (1.26–2.67), 1.42 (1.19–1.69), 1.44 (1.16–1.79), and 1.66 (1.22–2.27), respectively.

Conclusions:

The current evidence indicates that PBL is more effective than LBL in improving examination scores and student satisfaction in undergraduate pharmacology education.
Expression of interleukin-8 and integrin β3 predicts prognosis of patients with hepatocellular carcinoma after hepatectomy
Authors: Zhang Jiao , Yin Yi , Tang Jiliang , Ma Mingze , Shen Huimin , Zhang Yingrong , Sun Fengkai
Published: October 2024

As important components in the tumor microenvironment, interleukin-8 (IL-8) and integrin β3 play a key role in the progression and metastasis of hepatocellular carcinoma (HCC). This study aimed to determine the expression of IL-8 and integrin β3 and their prognostic value in patients with HCC after hepatectomy. We investigated the expression of IL-8 and integrin β3, their clinical significance, as well as their correlation in the cancer tissue of 130 patients with HCC using immunohistochemistry. The prognostic value of IL-8 and integrin β3 was investigated through the follow-up of patients with HCC after hepatectomy. In HCC, IL-8 expression had a positive correlation with integrin β3 expression. Increased expressions of IL-8 and integrin β3 were indicators of tumor progression and poor prognosis in patients with HCC after hepatectomy. IL-8 positive specimens exhibited a higher proportion of macrovascular invasion, larger tumor size, poor differentiation, and advanced tumor-node-metastasis (TNM) stage (P < .05, respectively). Integrin β3 positive group exhibited a higher proportion of TNM III-staged tumors (P < .05). The results indicated that macrovascular invasion, advanced TNM stage, and integrin β3 expression were independent unfavorable prognostic factors in HCC after hepatectomy. Integrin β3 expression was proved to be an independent unfavorable prognostic factor in HCC after hepatectomy. Targeting integrin β3 might be a potential therapeutic approach in preventing tumor progression in HCC.
Effect of nursing care based on goal-oriented mind mapping model on the prognosis of patients with severe brain injury
Authors: Zhang Jingxue , Jiao Xin'an , Ma Xianjun , Yu Ruizhao , Pan Jing , Yuan Meiling , Wang Shuaihui , Hua Changbao , Pan Hongmei
Published: October 2024

The objective of this study was to observe the effect of nursing care based on goal-oriented mind-mapping on the prognosis of patients with severe brain injury. Clinical data of 116 patients with severe brain injury admitted to Qinghe County Central Hospital between March 2021 and August 2023 were retrospectively analyzed. Based on the nursing mode the patients received, they were divided into an Observation group (n = 58, patients received nursing based on the goal-oriented mind mapping mode) and a Control group (n = 58, patients received routine care). Data on length of hospital stay, complications, functional recovery, cerebral oxygen metabolism, and quality of life scores of the 2 groups were collected and analyzed. The length of hospital stay of the Observation group was shorter than that of the Control group (P < .05). The total incidence of complications in the Observation group was lower than that in the Control group (P < .05). After intervention, neurological function, cerebral oxygen metabolism indicators, and quality of life of the 2 groups improved significantly compared with those before the intervention; furthermore, the neurological function and cerebral oxygen metabolism indexes of the Observation group were better than those of the Control group (P < .05). The nursing care based on goal-oriented mind-mapping model for patients with severe brain injury can effectively shorten the length of hospital stay, reduce the occurrence of prognostic complications, and improve the recovery of neurological and limb motor functions, and ultimately achieve the goal of improving the quality of life.
Physical activity modified the association of blood cadmium and lead with Helicobacter pylori infection: A cross-sectional analysis with NHANES data
Authors: Wang Wei-Feng , Liu Yu-Xiang , Li Chao-Qun , Liu Xian-Yong
Published: October 2024

Cadmium (Cd) and lead (Pb) exposure have been identified as risk factors for Helicobacter pylori seropositivity, possibly due to the immune suppression by Cd and Pb. Physical activity (PA) can induce an immune response. However, whether PA can reduce the effect of Cd and Pb on H pylori infection remains elusive. This study aims to investigate the association of blood Cd and Pb levels with H pylori infection and explore the intermediary effects of PA. This cross-sectional survey was conducted using the National Health and Nutrition Examination Survey (NHANES) of the 1999 to 2000 cycle (n = 9965). Participants without clear serological testing data, or absent in PA, blood Cd, and Pb information were excluded. Collinearity analysis was performed to remove the variables with high collinearity. Restricted cubic spline curve analysis was adopted to assess the nonlinear association of Cd and Pb with H pylori infection. The logistic regression analysis, generalized linear models, sensitivity analysis, and P for trend test were used to further analyze their relationship. Then, we analyzed the association of Cd and Pb with H pylori infection in 2 PA groups. Totally 3638 participants were divided into H pylori-negative (n = 2545) and H pylori-positive group (n = 1093). Pb exhibited a linear relationship but Cd had a nonlinear relationship with H pylori infection. Besides, the elevation of Cd and Pb both independently predicted H pylori infection after adjusting various variables (P < .05). The robust relationship was confirmed by the P for trend test (P for trend < .05). Under Cd exposure, the risk of H pylori infection was lower in the active PA group than in the inactive group (P < .05). A reverse result was found under the Pb exposure (P < .05). Exposure to Cd and Pb are positively linked to H pylori infection. PA may alleviate the effect of Cd on H pylori infection but may enhance H pylori infection under Pb exposure. Therefore, PA should be recommended in the appropriate season or region.
An investigation of machine learning algorithms for prediction of temporomandibular disorders by using clinical parameters
Authors: Yıldız Nazim Tolgahan , Kocaman Hikmet , Yıldırım Hasan , Canlı Mehmet
Published: October 2024

This study aimed to predict temporomandibular disorder (TMD) using machine learning (ML) approaches based on measurement parameters that are practically acquired in clinical settings. 125 patients with TMD and 103 individuals without TMD were included in the study. Pain intensity (with visual analog scale), maximum mouth opening (MMO) and lateral excursion movements (with millimeter ruler), cervical range of motion (with goniometer), pressure pain threshold (PPT; with algometer), oral parafunctional behaviors (with Oral Behaviors Checklist), psychological status (with Hospital Anxiety and Depression Scale), and quality of life (with Oral Health Impact Profile) were evaluated. The measurements were analyzed via over 20 ML algorithms, taking into account an extensive parameter tuning and cross-validation process. Results of variable importance were also provided. Bagging algorithm using Multivariate Adaptive Regression Spline (MARS) algorithm (accuracy = 0.8966, area under receiver operating characteristic curve = 0.9387, F1-score = 0.9032) was the best performing model regarding the performance criteria. According to this model, the 5 most important variables for predicting TMD were pain intensity, MMO, lateral excursion and PPT values of masseter and temporalis anterior muscles, respectively. The Bagging algorithm using the MARS algorithm is a robust model that, in combination with clinical parameters, assists in the detection of patients with TMD in settings with limited capabilities. The clinical parameters and ML algorithm proposed in this study may assist clinicians inexperienced in TMD to make a preliminary detection of TMD in clinics where diagnostic imaging tools are limited.
Retrospective analysis of venous thromboembolism, arterial thromboembolism, and microthrombosis incidence at a single center during the COVID-19 pandemic
Authors: Mei Wenjun , Zhu Yuefeng , Nie Zongjie , Fang Canjun , Zhang Zheng , Qiu Haijun , Bai Xia , Pan Lisheng
Published: October 2024

The coronavirus disease 2019 (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 has posed a significant threat to global health since its outbreak in early 2020. Various thrombotic complications have been reported in COVID-19 cases. This study aims to investigate the incidence of various types of thromboses during the COVID-19 pandemic, and explore the potential correlation between the number of COVID-19 infections and occurrence of thrombosis. The present retrospective, single-center study recorded the number of new cases with various types of thromboembolism among all hospital admissions between 2019 and 2023 in a single center. The correlation between the number of total thromboembolism cases and number of inpatients who tested positive for COVID-19 was assessed using Spearman rank correlation coefficient. A total of 3926 thromboembolism cases were recorded in men, while 3657 cases were reported in women. The total number of new thromboembolism cases among all inpatients annually increased from 2019 to 2022, and reached a peak during the “full liberalization” period from December 2022 to January 2023. The most substantial increase was observed in microthrombosis cases, followed by venous and arterial thrombosis cases. In addition, thromboembolism primarily occurred in the lower extremities, followed by the abdomen. The fewest cases were observed in the upper extremities. Furthermore, the correlation coefficient between the total number of thromboembolism cases and number of COVID-19-positive patients between January 2020 and June 2023 was 0.501 (P = .001). The number of thromboembolism cases among all inpatients was correlated to the number of COVID-19-positive patients during the pandemic. Early thromboembolism prophylaxis and thrombotic complications monitoring should be considered for hospitalized patients, when necessary.
Unveiling the pan-cancer landscape of S100A16: A comprehensive analysis of prognostic significance, drug sensitivity, and immunomodulatory roles
Authors: Shang Shixuan , Hu Ling , Wu Chengbi , Wu Jin , Chen Meixiang , Zhu Guoqiang , Xu Wang-yang , Zhang Yunzhi , Sun Ge , Wei Zexiong
Published: October 2024

Accumulating evidence supports the notion that S100A16 exhibits differential expression in many human cancers, affecting cellular functions associated with tumorigenesis through various signaling pathways. While extensive research has been conducted on S100A16 in specific cancer types, a comprehensive evaluation of its role across diverse cancers remains lacking. To explore the prognostic significance, drug sensitivity, and immunomodulatory roles of S100A16, a thorough analysis was conducted at a pan-cancer level using multiple databases. Our findings revealed high expression of S100A16 RNA in various human cancers. Importantly, this elevated expression was linked to disease prognosis and drug sensitivity across a spectrum of cancers. Genetic alterations in S100A16 were characterized across multiple cancer types, and a confirmed correlation was observed in the prognosis of skin cutaneous melanoma (SKCM). Furthermore, our study demonstrated a significant association between S100A16 expression and the infiltrating levels of diverse cell types in the tumor microenvironment (TME), suggesting its potential as a prognosis predictor for immunotherapy. Novel collections of miRNAs, such as has-miR-423-5p, has-miR-769-5p, has-miR-151a-3p, and has-miR-550a-5p, targeting S100A16 at a pan-cancer level were predicted through various databases. These findings contribute to a comprehensive understanding the role of S100A16 in prognosis prediction, chemotherapy, and immunotherapy, providing valuable insights for identifying novel targets in cancer treatment.
Effect of needle types and diameters using in spinal anesthesia on optic nerve sheath diameter: Prospective randomized study
Authors: Kumaş Solak Sezen , Demirgan Serdar , Karali Elif , Selcan Ayşin
Published: October 2024

Background:

This prospective randomized study aimed to investigate the impact of needle types and diameters used in spinal anesthesia (SA) on optic nerve sheath diameter (ONSD) in patients undergoing lower extremity orthopedic surgery.

Methods:

Patients were randomly assigned to 3 groups based on the needle type and size used for SA: Group 25w (25 gauge Whitacre needle), Group 27q (27 gauge Quincke needle), and Group 25q (25 gauge Quincke needle). Initially, 165 patients (55 in each group) were enrolled, with 146 patients ultimately included in the analysis (Group 25w, n = 49; Group 27q, n = 48; Group 25q, n = 49). ONSD measurements were conducted using ultrasound guidance at 5 time points: T0 (pre-SA), T1 (5 minutes post-SA), T2 (5 minutes post-tourniquet inflation), T3 (5 minutes post-tourniquet deflation), and T4 (24 hours post-operation). Additionally, oxygen saturation, systolic arterial pressure, mean arterial pressure, diastolic arterial pressure, and heart rate were recorded at these time points.

Results:

Analysis of ONSD measurements revealed no significant differences among the groups at time points T0,T1,T2, and T4 (P = .7293, P = .4428, P = .3676, and P = .3667, respectively). However, at T3, ONSD values were significantly higher in Group 27q compared to Group 25q (P = .0325). Across all groups, the mean ONSD values measured post-tourniquet release (T3) were higher than those at T0,T2, and T4 (P < .001 for all). The incidence of nausea was similar among the groups, and no cases of headache or visual impairment were reported within the initial 24 hours post-surgery.

Conclusion:

In conclusion, our study suggests that while subarachnoid injection and tourniquet inflation do not impact intracranial pressure (ICP), tourniquet deflation leads to an increase in ICP during lower limb surgery under SA. Therefore, caution should be exercised when using a tourniquet in patients at risk of elevated ICP.
The association between triglyceride glucose index and suicidal ideation in American adults: Results from NHANES 2005 to 2018
Authors: Lu Yuqiu , Zhou Tianmei , Shen Yueqian , Zhou Manxing
Published: October 2024

Previous studies have shown a significant association between the triglyceride glucose index (TyG) and suicidal ideation in Korean women. However, this association has not yet been examined among American adults. This study aims to investigate the association between TyG and suicidal ideation using data from the National Health and Nutrition Examination Survey. The National Health and Nutrition Examination Survey database from 2005 to 2018 was used, including samples ≥20 years old. Suicidal ideation was assessed through questionnaires, and the TyG was derived from fasting triglyceride and glucose measurements. Weighted logistic regression models were used to analyze the relationship between the TyG and suicidal ideation. Generalized additive model curves explored the nonlinear relationship, while stratified and sensitivity analyses assessed potential interactions and the robustness of the findings. A significance level of P < .05 was considered statistically significant. A total of 15,694 participants were enrolled, of whom 3.67% participants showed suicidal ideation. The mean TyG index for participants with or without suicidal ideation was 8.82 ± 0.76, 8.65 ± 0.68, respectively (P < .001). Multivariable logistic regression showed that a higher level of TyG were associated with a higher likelihood of suicidal ideation (OR = 1.20; 95% CI, 1.05–1.38) after full adjustment. Subgroup analysis and interaction tests showed no significant correlation between gender, age, race, marital status, education, body mass index, poverty income ratio, smoking status, drinking status, diabetes, hypertension, stroke, and cancer (P > .05 for all interactions). Our findings confirm a significant and positive association between the TyG and suicidal ideation among American adults. Further large-scale prospective studies are needed to analyze the role of TyG in suicidal ideation.
Treatment of microvascular angina pectoris by activating blood circulation to remove blood stasis: A systematic review and meta-analysis
Authors: Yang Ruitong , Bai Zelin , Liang Chao , Qi Feng
Published: October 2024

Background:

To systematically evaluate the clinical efficacy of using the method of activating blood circulation and removing blood stasis in the treatment of microvascular angina (MVA) based on the meta-analysis method.

Methods:

A comprehensive search of randomized controlled trials on the treatment of MVA using the method of activating blood circulation and removing blood stasis in Chinese and English databases such as China National Knowledge Infrastructure Database, Wanfang Data Knowledge Service Platform, Vipshop Journal Resource Integration Service Platform, PubMed, Cochrane Library, Embase, Web of Science, and CBM was conducted, and the search time limit was from the establishment of each database to February 2023. All retrieved literature was screened, and data extracted according to the specified inclusion and exclusion criteria, and data analysis was completed using Revman 5.4 software.

Results:

Fifteen studies with a total of 1031 patients were finally included, and the results of the meta-analysis showed that the treatment with the method of activating blood circulation and removing blood stasis was more advantageous compared with the group of Western medicine alone. Among them, clinical effect of activating blood circulation and removing blood stasis (relative risk = 1.20, 95% confidence intervals [CI] [1.11, 1.31], P < .0001) and electrocardiographic efficacy (relative risk = 1.32, 95% CI [1.15, 1.51], P < .0001) were more effective, concentration levels of endothelin-1 (standardized mean difference = −2.14, 95% CI [−2.97, −1.31], P < .00001) and high sensitivity C-reactive protein (mean difference = −0.84, 95% CI [−0.93, −0.75], P < .00001) were lower, concentration levels of nitric oxide (standardized mean difference = 0.61, 95% CI [0.33, 0.89], P < .0001) was higher, and ST-segment depression range (mean difference = −0.07, 95% CI [−0.09, −0. 04], P < .00001) was smaller.

Conclusion:

Compared with the treatment with Western medicine alone, the treatment of MVA is more effective by choosing the method of activating blood circulation and removing blood stasis.
Identification of a potential sialylation-related pattern for the prediction of prognosis and immunotherapy response in small cell lung cancer
Authors: Yu Yao , Shang Yu , He Yaowu , Shi Si , Wang Qi , Ma Jing , Wang Menghan , Shi Wenchao , Chen Hong
Published: October 2024

Our study aimed to establish a novel system for quantifying sialylation patterns and comprehensively analyze their relationship with immune cell infiltration (ICI) characterization, prognosis, and therapeutic sensitivity in small cell lung cancer (SCLC). We conducted a thorough assessment of the sialylation patterns in 100 patients diagnosed with SCLC. Our primary focus was on analyzing the expression levels of 7 prognostic sialylation-related genes. To evaluate and quantify these sialylation patterns, we devised a sialylation score (SS) using principal component analysis algorithms. Prognostic value and therapeutic sensitivities were then evaluated using multiple methods. The GSE176307 was used to verify the predictive ability of SS for immunotherapy. Our study identified 2 distinct clusters based on sialylation patterns. Sialylation cluster B exhibited a lower level of induced ICI therapy and immune-related signaling enrichment, which was associated with a poorer prognosis. Furthermore, there were significant differences in prognosis, response to targeted inhibitors, and immunotherapy between the high and low SS groups. Patients with high SS were characterized by decreased immune cell infiltration, chemokine and immune checkpoint expression, and poorer response to immunotherapy, while the low SS group was more likely to benefit from immunotherapy. This work showed that the evaluation of sialylation subtypes will help to gain insight into the heterogeneity of SCLC. The quantification of sialylation patterns played a non-negligible role in the prediction of ICI characterization, prognosis and individualized therapy strategies.
Concurrent EGFR mutation and SMARCA4 deficiency in non-small cell lung cancer: A case report and literature review
Authors: Dai Weiping , Li Taidong , Li Yujiao , Chen Chaopeng , Zhang Xiang , Zhou Pingan , Qi Bin
Published: October 2024

Rationale:

SMARCA4-deficient non-small cell lung cancer (NSCLC) represents a highly aggressive subtype with poor prognosis. While clinical studies have identified common co-mutations in TP53, LRP1B, STK11, KEAP1, and KRAS, actionable driver mutations such as EGFR or ALK are rarely reported in conjunction with SMARCA4 deficiency. This case presents a rare instance of NSCLC featuring both an EGFR exon 21 L858R mutation and SMARCA4 deficiency, highlighting the challenges in treatment and the need for novel therapeutic strategies.

Patient concerns:

A 79-year-old female patient presented with concerns of a lung mass, suspected to be peripheral lung cancer based on diagnostic imaging.

Diagnoses:

Histopathological evaluation confirmed SMARCA4-deficient NSCLC. Molecular genetic analysis further revealed an EGFR exon 21 L858R mutation.

Interventions:

The patient was initially treated with osimertinib, an EGFR tyrosine kinase inhibitor. Upon disease progression, treatment was adjusted to include anlotinib in combination with ongoing osimertinib.

Outcomes:

The initial treatment with osimertinib led to partial remission. However, disease progression necessitated a change in therapy. The combination treatment stabilized the disease temporarily, achieving a stable disease status.

Lessons:

This case underscores the transient efficacy of targeted therapy in SMARCA4-deficient NSCLC with concurrent EGFR mutations. It highlights the need for continuous therapeutic adjustments and emphasizes the importance of further research into effective strategies for treating this complex and challenging subset of NSCLC, as current modalities have limitations in sustained efficacy.
A review of exercise interventions for reducing anxiety symptoms: Insights and implications
Authors: Ewuzie Zimakor , Ezeano Chimezirim , Aderinto Nicholas
Published: October 2024

Generalized anxiety disorder (GAD) is a prevalent mental health condition affecting a significant proportion of the adult population. Despite the availability of pharmacological treatments, their long-term efficacy and potential side effects necessitate exploring alternative interventions. Aerobic exercise has emerged as a promising non-pharmacological approach for managing anxiety symptoms in individuals with GAD. This narrative review examines the efficacy of aerobic exercise interventions in alleviating symptoms of anxiety disorders, drawing on a comprehensive analysis of relevant literature. The review synthesizes findings from studies investigating various forms of aerobic exercise, including high-intensity interval training, resistance training, Pilates, and walking. The results indicate that aerobic exercise interventions demonstrate efficacy in reducing anxiety symptoms and improving overall well-being across diverse populations, including primary care patients, individuals with coronary heart disease, and older adults with cancer undergoing chemotherapy. The review discusses the neurobiological and psychological mechanisms underlying the anxiolytic effects of aerobic exercise. It highlights the implications of these findings for clinical practice, public health initiatives, and future research directions. Despite the promising evidence, limitations in study methodologies and heterogeneity across interventions warrant a cautious interpretation of the results. Further research is needed to elucidate optimal exercise modalities, dosages, and long-term effects on anxiety outcomes.
Effects of Inc parameter on quality of VMAT radiotherapy plans for right breast cancer based on dosimetric study
Authors: Shen Chong , Liao Hailong , Wang Qi , Liu Hai , Sun Xiaonan
Published: October 2024

This study aimed to investigate the influence of gantry angle increment (Inc) parameters on the Monaco treatment planning system for volumetric modulated arc therapy (VMAT) in right breast cancer, and to determine the optimal Inc parameters. Twenty-three patients with right breast cancer at the Sir Run Run Shaw Hospital from August 2022 to August 2023 were retrospectively selected. Four VMAT plans were generated for each patient incorporating Inc of 10°, 20° (control group), 30°, and 40°, while the other optimization parameters and constraint functions remained constant. The D98 and conformity index were lower in the Inc30 and Inc40 groups than in the Inc20 group. As Inc increased from 10° to 30°, the irradiated dose to the ipsilateral lung, including the V20, V5, and Dmax, mean dose, gradually increased. There were no statistically significant differences in the irradiated dose to the contralateral breast, contralateral lung, heart, esophagus, and brachial plexus. The number of monitor units and control points decreased with increasing Inc. Smaller Inc values can achieve higher target coverage and lower irradiated dose to the ipsilateral lung, but will reduce delivery efficiency. Considering the plan quality and delivery efficiency, an Inc of 10° or 20° is recommended for right breast cancer VMAT plans.
Clinical research perspective on moxibustion treatment for urinary incontinence: A perspective review
Authors: Yu Xi-Wen , Wang Cheng-Si , Wu Jia-Mei
Published: October 2024

This study provides an in-depth perspective of moxibustion as a treatment option for urinary incontinence (UI), focusing on its clinical efficacy, underlying mechanisms, and potential integration into standard care practices. Moxibustion, rooted in traditional Chinese medicine, involves the targeted application of heat from burning moxa at specific acupoints. Analyzing data from randomized controlled trials and retrospective studies, the study suggests that moxibustion effectively reduces UI symptoms and improves quality of life with minimal adverse effects. The therapeutic benefits are attributed to enhanced blood circulation, improved neurological functions, and hormonal balance, facilitating tissue repair, and urinary system functionality. Despite encouraging outcomes, existing research exhibits limitations, including small sample sizes, and inconsistent methodologies. Future research should aim to address these gaps by conducting larger, standardized multicenter trials to provide more definitive evidence of moxibustion’s effectiveness. Additionally, integrating moxibustion into comprehensive treatment strategies for UI and promoting its inclusion in clinical guidelines could enhance its acceptance and application in modern medical practice. This study underscores the potential of moxibustion as a non-alternative in the management of UI, warranting further exploration and validation in clinical settings.
Is detrusor underactivity the urodynamic characteristic of long-COVID in patients with benign prostate hyperplasia?
Authors: Xiao Ning , Xiao Jinhua , Tang Qi , Pan Gaoyu , Wei Kailu , Zhao Huasheng , Wang Jianfeng
Published: October 2024

Although coronavirus disease 19 (COVID-19) was reported to involve with multiple organs, COVID-19 reports focusing on urinary system mostly evaluated the association between lower urinary tract symptoms and COVID-19 using questionnaire score. In this study, sonography video urodynamic studies was first conducted to explore the effects of COVID-19 on contractility of bladder detrusor of patients with benign prostate hyperplasia (BPH). Clinical data was respectively reviewed and compared between BPH patients with previous COVID-19 infection (COVID-19 group) and without previous COVID-19 (non-COVID-19 group). The incidence of detrusor underactivity (DU) was compared between 2 groups. Comparison of age and noninvasive parameters was conducted between BPH patients with DU and without DU in COVID-19 group. Correlation coefficient between noninvasive parameters and detrusor contractility was determined and receiver operating characteristic curve of noninvasive parameters was used to choose the most appropriate cutoff for detection of DU in COVID-19 group. Beside a significant increase in the incidence of DU in BPH patients of COVID-19 group, a lower detrusor contractility and a greater bladder wall thick was detected compared to that of patients in non-COVID-19 group. Post-voiding residual urine was found to have a linear correlation with detrusor contractility in COVID-19 group. It was suggested that COVID-19 infection would further exacerbate impairment of detrusor previously resulted from bladder outlet obstruction in BPH patients. DU may be a urodynamic characteristic of long-COVID.