bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and predictors of acute kidney injury after elective surgery for lumbar degenerative disease: A 13-year analysis of the US Nationwide Inpatient Sample
Authors: Hsieh Yueh-Ying , Wu Lien-Chen , Chen I-Chun , Chiang Chang-Jung
Published: February 2024

Background:

Acute kidney injury (AKI) is a severe postoperative complication associated with poor clinical outcomes, including the development of chronic kidney disease (CKD) and death. This study aimed to investigate the incidence and determinants of AKI following elective surgeries for degenerative lumbar spine disease.

Methods:

All patient data were extracted from the US Nationwide Inpatient Sample database. After surgery, AKI’s incidence and risk factors were identified for lumbar degenerative disease. ICD-9 and ICD-10 codes defined lumbar spine degenerative disease, fusion, decompression, and AKI. The study cohort was categorized by type of surgery, that is, decompression alone or spinal fusion. Regression analysis was used to identify associations between AKI and risk factors organized by surgery type.

Results:

The incidence of AKI after decompression or fusion was 1.1% and 1.8%, respectively. However, the incidence of AKI in the United States is rising. The strongest predictor of AKI was underlying CKD, which was associated with an 9.0- to 12.9-fold more significant risk of AKI than in subjects without comorbid CKD. In this setting, older age, congestive heart failure, anemia, obesity, coagulopathy and hospital-acquired infections were also strong predictors of AKI. In contrast, long-term aspirin/anticoagulant usage was associated with lowered AKI risk.

Conclusion:

Findings of this study inform risk stratification for AKI and may help to optimize treatment decisions and care planning after elective surgery for lumbar degenerative disease.
Creating Shared Perspectives for Worker Well-being
Authors: Schaefer Camie , Ahonen Emily
Published: February 2024

Objectives

This study aimed to highlight the utility of a new certificate program in Total Worker Health® (TWH) designed for health professionals in other community health settings (OCHS).

Methods

Stakeholder needs assessment, priority setting, and comparison with existing core competencies in TWH approaches were performed to identify learning objectives and curricular threads in alignment with adult learning principles. Faculty-student pairings were conducted for content and assessment development.

Results

A free six-module training course that prepares OCHS professionals to collaborate with occupational safety and health (OSH) professionals.

Conclusions

TWH can be advanced through collaboration between OSH and OCHS professionals. In service of shared ground, OCHS professionals should articulate the influence of work on health, TWH principles, and OSH vocabulary and concepts. Such training is a necessary step toward facilitating groups for the benefit of all work and workers.
Air pollution impede ALT normalization in chronic hepatitis B patients treated with nucleotide/nucleoside analogues
Authors: Jang Tyng-Yuan , Ho Chi-Chang , Wu Chih-Da , Dai Chia-Yen , Chen Pau-Chung
Published: February 2024

Biochemical response is an important prognostic indicator in chronic hepatitis B (CHB) patients receiving nucleotide/nucleoside analogues (NAs). However, the effects of air pollution in alanine aminotransferase (ALT) normalization remain elusive. This longitudinal study recruited 80 hepatitis B e antigen–negative CHB patients who received NAs. ALT levels were measured during the first year of anti-hepatitis B virus therapy. Normal ALT levels were defined as <19 U/L for females and <30 U/L for males, and the risk factors associated with ALT abnormalities were analyzed. The daily estimations of air pollutants (particulate matter ≤2.5 µm in diameter (PM2.5), nitrogen dioxide, ozone (O3), and benzene) were aggregated into the mean estimation for the previous month based on the date of recruitment (baseline) and 1 year later. Sixteen patients (20.0%) had a baseline ALT > 40 U/L; overall, 41 (51.6%) had an abnormal ALT (≥19 U/L for females and ≥ 30 U/L for males). After 1 year of NA therapy, 75 patients (93.8%) had undetectable hepatitis B virus DNA levels. Mean post-treatment ALT levels were significantly lower than mean pretreatment levels (21.3 vs 30.0 U/L, respectively; P < .001). The proportion of patients with a normal ALT was also significantly higher after versus before treatment (71.2% vs 51.2%, respectively; P = .001). The strongest factors associated with ALT abnormality after 1 year of NA treatment were body mass index (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.05–1.54; P = .01) and ozone level (OR, 1.11; 95% CI, 1.02–1.22; P = .02). Among hepatitis B e antigen-negative CHB patients with relatively low viral loads, 1 year of NA treatment improved ALT levels after the adjustment for confounding factors and increased the proportion of patients with normal ALT levels. Air pollution affects the efficacy of ALT normalization.
Herpes Zoster virus infection and the risk of developing dementia: A systematic review and meta-analysis
Authors: Elhalag Rowan H. , Motawea Karam R. , Talat Nesreen Elsayed , Rouzan Samah S. , Reyad Sarraa M. , Elsayed Soliman M. , Chébl Pensée , Abowafia Marwan , Shah Jaffer
Published: February 2024

Background:

Herpes Zoster, commonly known as shingles, is a viral infection that affects a significant portion of the adult population; however, its potential role in the onset or progression of neurodegenerative disorders like dementia remains unclear.

Methods:

We searched the following databases: PubMed, Scopus, Cochrane library, and Web of Science. We included any randomized control trials and controlled observational studies as Cross-sectional, prospective, or retrospective cohort and case-control studies that investigated the prevalence of dementia in Herpes Zoster Virus (HZV)-infected patients and HZV-free control group or if the study investigated the prevalence of HZV in demented patients. Also, if the studies measured the levels of dementia biomarkers in patients with HZV compared with a healthy control group.

Results:

After the complete screening, 9 studies were included in the meta-analysis. In the outcome of the incidence of HZV, the pooled analysis showed no statistically significant difference between the dementia group and the No dementia group (RR = 1.04% CI = 0.86–1.25, P = .70). In the outcome of incidences of dementia and Alzheimer’s disease, the pooled analysis showed no statistically significant difference between the HZV group and the incidence of dementia (RR = 0.99, 95% CI = 0.92–1.08, P = .89), (RR = 3.74, 95% CI = 0.22–62.70, P = .36) respectively. In the outcome of incidences of Herpes Zoster ophthalmicus (HZO), the generic inverse variance showed a statistically significant association between patients who have HZO and increased incidence of dementia (RR = 6.26, 95% CI = 1.30–30.19, P = .02).

Conclusion:

Our study showed no significant association between HZV and the incidence of dementia or Alzheimer’s disease, but it shows a significant association between HZO and the incidence of dementia. More multicenter studies are needed to establish the actual association between the HZV and dementia.
ANRGs impact on gastric cancer progression and drug efficacy: A comprehensive study
Authors: Zhang Zhijing , Zhu Yeqing
Published: February 2024

Gastric cancer (GC) is a significant contributor to cancer-related mortality globally, with the heterogeneity of metastasis and treatment impacting patient prognosis. Currently, the treatment of GC still relies on early surgical resection, and comprehensive treatment is needed for patients with metastatic GC. Anikis-related genes (ANRGs) have been shown to affect tumor metastasis. Exploring the role of ANRGs in GC will help us understand the mechanism of tumor metastasis; screening precise targets and selecting appropriate chemotherapeutics will help individualize the treatment of GC patients. In this study, we established a prognostic scoring model based on ANRGs and explored their association with GC patient prognosis, immune microenvironment, chemotherapeutic drug sensitivity, and small molecule compounds. Our findings revealed that a gene signature composed of ANXA5, CCN1, EGF, VTN, and ZBTB7A accurately predicted GC patient prognosis. Patients in the low-risk group had better outcomes, higher macrophage M1 infiltration, and higher tumor mutation burden. The half maximal inhibitory concentration (IC50) values of Ponatinib (ap.24534), Motesanib (amg.706), and Navitoclax (abt.263) were lower in the high-risk group, indicating that patients in the high-risk group were more sensitive to these chemotherapy drugs, meaning with better clinical outcomes. In addition, we screened the small molecule compound SGC-CBP30 that can inhibit ANXA5 and CCN1, and these results help individualized treatment of GC patients. Our study identified key genes based on ANRGs and developed a novel gene signature for predicting the prognosis of GC patients and understanding the relationship between immunity and tumor mutation burden. Additionally, we identified chemotherapeutic drugs that can guide GC treatment and elucidated the binding affinity between specific targeted drugs and distinct protein sites, providing novel insights for the precise treatment of GC patients.
Novel echocardiographic parameters in pulmonary hypertension assessment and the relationship between echocardiography and 6-minute walking test
Authors: Bigdelu Leila , Alimi Hedieh , Fazlinezhad Afsoon , Ghaderi Fereshteh , Poorzand Hoorak , Vakilian Farveh , Keihanian Faeze , Abbasi Shaye Zahra , Afshar Sara
Published: February 2024

Pulmonary artery stiffness (PAS) has been shown to be related to pulmonary artery pressure in patients with pulmonary artery hypertension (PAH). The aim of this study was to determine the correlation between functional capacity and echocardiographic indices of PAS in patients with PAH. This cross-sectional study was performed on patients with PAH who were confirmed by right heart catheterization and referred to Imam Reza PAH clinic for routine follow-up between November 2019 and January 2020. All patients underwent echocardiography and the maximum Doppler frequency shift, pulmonary acceleration time, peak velocity of the pulmonary flow, and velocity time integral, as well as PAS, were measured. All patients performed a 6-minute walk test. Fifty patients with a mean age of 41.90 ± 14.73 years old participated in this study. The majority of the patients were female (74%). The most common cause of PAH was idiopathic (74%). There was a significant correlation between PAS and pulmonary artery systolic pressure (r = 0.302, P = .041), second pulmonary valve pulse Doppler velocity (V2) (r = −0.461, P = .003), time from onset of pulmonary flow ejection to V2/first pulmonary valve pulse Doppler velocity (r = −0.311, P = .037) and Z3 ratio (r = −0.346, P = .023). There was no significant correlation between PAS and 6-minute walk test, pulmonary vascular resistance, and tricuspid annular plane systolic excursion (P > .05). There was a significant correlation between V2 and pulmonary vascular resistance (r = 0.359, P = .049). PAS and first pulmonary valve pulse Doppler velocity are simple, noninvasive, available tools for the evaluation of pulmonary vascular beds and diagnosis of presymptomatic clinical status in patients with PAH.
Hypoxia-mediated activation of hypoxia-inducible factor-1α in triple-negative breast cancer: A review
Authors: Liu Lihui , Bai Jie , Hu Lanxin , Jiang Daqing
Published: February 2024

Triple-negative breast cancer (TNBC) is a subtype of breast cancer (BC) that is highly aggressive and hypoxic compared with other subtypes. The role of hypoxia-inducible factor 1α (HIF-1α) as a key hypoxic transcription factor in oncogenic processes has been extensively studied. Recently, it has been shown that HIF-1α regulates the complex biological processes of TNBC, such as glycolysis, angiogenesis, invasion and metastasis, BC stem cells enrichment, and immune escape, to promote TNBC survival and development through the activation of downstream target genes. This article discusses the expression of the HIF-1α transcription factor in TNBC and the Hypoxia-mediated activation of hypoxia-inducible factor-1α in triple-negative BC. It offers a fresh approach to clinical research and treatment for TNBC.
Neuralgic amyotrophy: sensitivity and specificity of magnetic resonance neurography in diagnosis: A retrospective study
Authors: Duan Luyao , Zhao Liyang , Liu Ying , Zhang Yizhe , Zheng Wensong , Yu Xiaoman , Liu Hongran , Li Zequn , Peng Zhigang , Li Xiaona
Published: February 2024

Background:

Neuralgic amyotrophy (NA) is a clinically acute or subacute disease. To study the characteristics of brachial plexus magnetic resonance neurography (MRN) in patients with NA, and to explore the clinical application value of MRN combined with electromyography (EMG) in the diagnosis of NA.

Methods:

Brachial plexus MRN images of 32 patients with NA were retrospectively analyzed, and their characteristics were investigated. The accuracy, sensitivity and specificity of MRN, EMG, and the combination of the 2 methods for NA diagnosis were compared.

Results:

Among the 32 patients with NA, 28 (87.5%) cases of unilateral brachial plexus involvement, 18 (56.3%) cases of multiple nerve roots involvement. In 10 cases, C5 nerve roots were involved alone, and in 9 cases, C5 to C6 nerve roots were involved together. The T2 signal intensity of the affected nerve increased, and 19 cases showed thickened and smooth nerve root edges. Twelve cases showed uneven thickening and segmental stenosis of the involved nerve roots. The diagnostic accuracy, sensitivity, and specificity of MRN for NA were higher than those of EMG. Combining MRN and EMG could improve the sensitivity and specificity of diagnosis.

Conclusion:

The main feature of MRN in patients with NA was that it was unilateral brachial plexus asymmetric involvement. The diagnostic effect of MRN was better than that of EMG. The combined diagnosis of MRN and EMG can help clinicians diagnose NA accurately.
Effects of Baduanjin exercise on patients with chronic nonspecific low back pain and surface electromyography signs of erector spinal muscle: A randomized controlled trial
Authors: Yang Dan , Huang Hai , Xu Dan Dan , Zhao Yan
Published: February 2024

Background:

Chronic nonspecific low back pain (CNLBP) is a common disease usually with lower back muscle fatigue and injuries that may contribute to lumbar muscle imbalance and pain recurrence. This study aimed to examine the effectiveness of Baduanjin exercise on patients of CNLBP and to assess its impact on the surface electromyographic signals of the lumbar erector spinae muscle.

Methods:

A total of 60 patients diagnosed with CNLBP were admitted from the Hubei Provincial Hospital of Traditional Chinese Medicine from March 2022 to December 2022. Those patients were randomly allocated into the Baduanjin group (n = 30) or the walking group (n = 30). Both groups received a 4-week intervention, with 5 training sessions per week. The numeric pain rating scale (the minimal clinically important difference = 2.4) and Oswestry Disability Index (the minimal clinically important difference = 13.4), electromyogram signals during lumbar flexion (FLEXAEMG), lumbar extension (EXTAEMG), and maximum lumbar flexion (MAEMG), the ratios of FLEXAEMG to MAEMG and EXTAEMG to MAEMG were collected at Baseline and posttreatment and compared using the Wilcoxon signed-rank test or Mann–Whitney U test.

Results:

After treatment, the numeric pain rating scale score in the Baduanjin group exhibited a significant decrease compared to baseline (P < .05) and was found to be lower than that of the Walking group (mean difference 2.36; CI 95% −2.323 to −1.742; P = .001). Similarly, the Oswestry disability index in the Baduanjin group demonstrated a reduction compared to baseline (P < .05) and was lower than that of the Walking group (the mean difference 7.59; CI 95% −8.861 to −6.312; P = .001). The FLEXAEMG and EXTAEMG of both groups had a significant increase (P < .05), with the Baduanjin group demonstrating higher levels compared to the Walking group (P < .05). Conversely, the MAEMG of both groups displayed a significant decrease (P < .05), with the Baduanjin group exhibiting lower levels than the Walking group (P < .05). The FLEXAEMG to MAEMG and EXTAEMG to MAEMG in the Baduanjin group increased (P < .05) and were significantly higher than the Walking group (P < .05).

Conclusion:

Baduanjin exercise has shown to be highly effective in reducing low back pain and in promoting lumber dysfunction, due to its ability to improve the strength and flexibility of the lumbar erector spinae muscle.
Blood coagulation, risk factors and associated complications in COVID-19 patients in Saudi Arabia: A retrospective cohort study
Authors: Al Nafea Haifa Mohammed , Al-Qahtani Mohammed Tahani , Al Gahtani Farjah Hassan , Tabassum Hajera
Published: February 2024

A good understanding of the possible risk factors for coronavirus disease 19 (COVID-19) severity could help clinicians in identifying patients who need prioritized treatment to prevent disease progression and adverse outcomes. COVID-19-linked coagulopathy is one of the life-threatening severe acute respiratory syndrome coronavirus 2 infections. Growing evidence indicates a correlation between abnormal coagulation and increased risk of venous thromboembolism; in COVID-19-infected patients, yet a clear understanding of the role of coagulopathy in the severity of COVID-19 illness is still unresolved. This retrospective cohort study was thus undertaken to investigate the role of coagulation dysfunction with COVID-19 mortality/severity. Blood samples from 1000 hospitalized patients with COVID-19 pneumonia were collected. The study participants were both male and female in equal ratios with a mean age of 48.94. Patients were followed-up until discharge either for recovery or death. All biochemical investigations-complete blood count and coagulation profile including D-dimers, prothrombin time, partial prothrombin time, and international normalized ratio was performed in COVID-19 survivors and in non-survivors admitted in intensive care unit. In the survivor group, all coagulation parameters were within normal limits, and 8.7% had a low red blood count. The most common risk factors associated with COVID-19 patients were diabetes mellitus (2.8%), hypertension (10.8%), and heart disease (3%). In the non-survivor group, the coagulation parameters were above the normal range (prothrombin in 31.5%, PTT in 10.5%, international normalized ratio in 26.3%, D-dimer in 36.8%) with thrombocytopenia in 21.04% of patients. Other complications were pulmonary embolism in 21.05% and venous thromboembolism in 15.7% of non-survivors. A significant association was found between increased markers of coagulopathy and the severity of SARS-CoV2 infection. Furthermore, the severity of infection was observed to increase with risk factors such as age, heart disease, hypertension, and DM eventually affecting COVID-19 prognosis and mortality.
Trends and bibliometric analysis on pediatric anesthesia from 2002 to 2022: A review
Authors: Ruan Dijiao , Tang Xu , Li Xiaoli , Li Lianlian , Hua Jing
Published: February 2024

Pediatric anesthesia is one of the most concerning topics in our society. However, there is still a lack of a comprehensive overview of the research base and of future trends. This study aimed to guide beginners quickly learn the academic research on pediatric anesthesia and do their own studies by analyzing the articles of this field in the latest 21 years through bibliometric analysis. Literature scanning was conducted with the Web of Science database. Microsoft Excel, SPSS, VOSviewer, and CiteSpace were in this review. There was an increasing trend of articles on pediatric anesthesia, based on the analysis of 11,591 included articles. The top 3 most productive countries were the United States of America (4538), Canada (730) and Turkey (688). The most productive institutions were Boston Childrens hospital, Childrens Hospital Philadelphia and Ohio State University. Tobias, Joseph D (141), Kim, Hee-Soo (40) and Curley, Martha A Q (38) were the most active authors. Habre W (2017), Gross JB (2002) and Cravero JP (2009) are the articles cited more than 100 times during the analysis years. Anesthesia and Analgesia, Anesthesiology, Pediatric Anesthesia, were the core journals in this field. Cohort, simulation, sleep, postoperative complication are strongest burst keywords in recent years. This article summarizes the authoritative institutions, authors, literatures and frontier hotspots on pediatric anesthesia. Itwill be a valuable literature review and help beginners to quickly get started in the field, reduce unnecessary clueless and aimless learning, and greatly improve learning efficiency.
Impaired consciousness and unilateral limb movement due to acute limb ischemia complicated by acute cerebral infarction: A case report
Authors: Sato Jun , Yagi Tsukasa , Ishii Yusuke , Hinoura Rei , Kajimoto Ryuta , Kuwana Tsukasa , Chiba Nobutaka , Saito Takeshi , Kinoshita Kosaku
Published: February 2024

Rationale:

The symptoms of impaired consciousness and unilateral motor impairments are a perfect scenario for cerebral infarction, and a physician can easily miss the findings of limb ischemia on the patient paralyzed side even if acute limb ischemia (ALI) occurs on that side. The purpose of this case report is to reiterate the need to suspect ALI in patients with impaired consciousness who cannot complain of symptoms such as abnormal limb paresthesia or pain.

Patient concerns:

An 89-year-old woman with impaired consciousness and motor impairment of the left upper and lower extremities was transported to our hospital.

Diagnoses:

Brain magnetic resonance imaging showed a suspected cerebral infarction in the posterior circulation; contrast-enhanced computed tomography showed occlusion of the left axillary artery and left femoral artery; and ultrasonography showed occlusion of the right popliteal artery.

Interventions:

Cerebral angiography was performed simultaneously with surgical thrombectomy to treat the ALI. Mechanical thrombectomy was not performed for cerebral infarction.

Outcomes:

Although motor impairment of the left upper and lower extremities persisted, the patient successfully underwent limb salvage.

Lessons:

Both cerebral infarction and ALI require early diagnosis and treatment. This rare case of cerebral infarction complicated by ALI emphasizes the need to avoid missing the signs of ALI in patients with impaired consciousness.
The determination of acetabular parameters in a Turkish population sample: CT-based retrospective analysis of side and gender differences
Authors: Hassa Ercan , Kosehan Dilek , Ulu Ozturk Funda , Alic Taner
Published: February 2024

Determination of the acetabular morphology and orientation is important for the total hip arthroplasty applications. In general, preoperative planning for these patients is done on true hip X-rays in orthopedics clinics. But those evaluations may not represent the acetabular architecture in detail, because of 2 dimensional images. The aim of this study is to determine the acetabular morphology of a healthy Turkish adult population sample through examination of acetabular parameters on 3-dimensional computed tomography (CT)-based images according to side and gender. A retrospective evaluation was made of acetabulum CT scans taken for various reasons in a healthy Turkish population sample. The examination parameters were defined as measurements of the acetabular anteversion angle, acetabular abduction angle, lateral center edge angle, acetabular width, acetabular depth, sagittal acetabular angle, and medial wall thickness values. The CT scans including the bone structure were examined of a total of 252 hips of 126 patients. The acetabular index was calculated as depth/width × 100. Lateral center edge angle of < 20° with medial wall thickness > 5 mm was accepted as a criterion of dysplasia of the acetabulum. Evaluation was made of the acetabular CT scans of 73 females and 53 males with a mean age of 44.64 ± 12.31 (19–68) years. A statistically significant difference was determined between the sides in respect of acetabular anteversion angle (P = .007) and between the genders in respect of acetabular depth and acetabular width (P = .001, P = .001). The prevalence of dysplasia was determined to be 1.6% for the whole study group, as 1.9% in males and 1.4% in females. In the current study sample there were parametric differences between sides and genders in terms of acetabulum morphology and orientation. Further studies of larger series will be able to provide a better representation of the Turkish population.
Peripherally inserted central catheter related pericardial effusion/cardiac tamponade in neonates: Analysis of two cases and literature review
Authors: Liu Yucen , Li Maojun , Shi Wei , Tang Binzhi
Published: February 2024

Rationale:

Peripherally inserted central catheter (PICC)-related pericardial effusion/cardiac tamponade is a rare but fatal complication which cause a high mortality if not timely diagnosed and treated. However, the atypical manifestations and the rapid deterioration present challenges for neonatologists, and there has been limited investigation reported globally to date. Furthermore, a systematic review and comprehensive summary of clinical management are lacking. The significance of this article lies in emphasizing the importance of maintaining vigilance in high-risk neonates and implementing effective management strategies for PICC-related pericardial effusion/cardiac tamponade, thereby contributing to saving more lives.

Patient concerns:

In the current report, we discuss 2 cases of neonatal pericardial effusion/cardiac tamponade following PICC catheterization.

Diagnosis:

The first case was diagnosed based on forensic autopsy and the second case was diagnosed by bedside echocardiography.

Interventions and outcomes:

The first case was treated conservatively and the second case underwent pericardiocentesis, unfortunately both were died.

Lessons:

Once sudden hemodynamic or respiratory abnormalities are detected in neonates with PICC placement, particularly in the preterm infants, prompt diagnosis by cardiac ultrasound is required to verify pericardial effusion/cardiac tamponade and immediate pericardiocentesis or pericardiotomy is necessary to improve survival.
Association of anxiety, depression symptoms and sleep quality with chronic kidney disease among older Chinese
Authors: Huang Jing , Mao Yanyan , Zhao Xuetao , Liu Qiaomei , Zheng Tao
Published: February 2024

This study aimed to explore the association of anxiety, depression symptoms and sleep quality with chronic kidney disease (CKD) among older Chinese adults. A total of 1025 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2011–2012) were included in our study. The Generalized Anxiety Disorder scale was used to assess anxiety and the Center for Epidemiologic Studies Depression Scale was used to evaluate depressive symptoms. Logistic regression models were conducted to explore the odds ratios (ORs) and 95% confidential intervals (CIs). We found that anxiety, depression symptoms and poor sleep quality were positively associated with albuminuria, impaired estimated glomerular filtration (eGFR) and CKD, after adjusting for other covariates. For anxiety symptom, the ORs and 95% CIs were 1.20 (1.15–1.38) for albuminuria, 1.16 (1.12–1.35) for impaired eGFR and 1.18 (1.12–1.36) for CKD, respectively. For depression symptom, the ORs and 95% CIs were 1.15 (1.05–1.23) for albuminuria, 1.14 (1.05–1.20) for impaired eGFR and 1.14 (1.05–1.22) for CKD, respectively. Compared with good sleep quality, the OR and 95% CI of poor sleep quality were 1.12 (1.04–1.35) for albuminuria, 1.10 (1.02–1.30) for impaired eGFR and 1.11 (1.03–1.32) for CKD, respectively. And the positive association was more evident among females, body mass index ≥ 28, smoking and drinking adults. Anxiety, depression symptoms and poor sleep quality are positively associated with CKD. Future cohort studies are needed to confirm the results.
Anticoagulant therapy likely increases risk of bleeding in Gynura segetum-induced hepatic sinus obstruction syndrome
Authors: Tan Youwen , Zhou Xingbei
Published: February 2024

This study aimed to analyze the clinical characteristics of Gynura segetum (Tusanqi)-induced hepatic sinusoidal obstruction syndrome (HSOS) and the benefits and risks of anticoagulant therapy for Tusanqi-induced HSOS. This was a retrospective analysis of 49 patients with Tusanqi-induced HSOS who were treated with anticoagulation or standard therapy between July 2006 and December 2022. Clinical manifestations included abdominal pain (n = 47) and peritoneal or pleural effusion (n = 46); 2 patients died. Nineteen patients requested standard medical treatment, while 30 were treated with anticoagulants. HSOS resolved within 6 months in 22 patients but did not resolve in 27 patients. The resolution rate was higher in the anticoagulant than standard treatment group (P = .037). Logistic regression analysis revealed that a history of chronic liver disease or treatment increased the risk of poor outcomes. Bleeding complications occurred in 6 patients in the anticoagulant treatment group. Early diagnosis and anticoagulant treatment are beneficial for rapid recovery after Tusanqi-induced HSOS. However, anticoagulant treatment is associated with the risk of multisite bleeding.
Primary clostridium difficile infection in patients with ulcerative colitis: Case report and literature review
Authors: Gao Xizhuang , Zhou Huihui , Hu Zongjing , Wang Quanyi , Chen Yun , Zh Fengqin , Zhou Guangxi
Published: February 2024

Rationale:

Inflammatory bowel disease (IBD), including Crohn disease (CD) and ulcerative colitis (UC), is a chronic immune-mediated disorder characterized by inflammation of the gastrointestinal tract. Patients with IBD are susceptible to various complications, including the coexistence of Clostridioides difficile infection (CDI). The incidence of IBD combined with difficile infection is higher in patients with compromised immune function, which can lead to increased mortality.

Patient concerns:

A 43-year-old male presented with recurrent episodes of mucus and bloody stools persisting for more than a month without any identifiable triggering factors. Initially, the stool consistency was normal, but it progressively shifted to a loose and watery texture, with up to 8 occurrences daily.

Diagnoses:

This case underscores the diagnosis of severe UC through colonoscopy and colonic biopsy, along with the supplementary identification of a positive result for Clostridioides difficile in the fecal sample.

Interventions:

The patient initiated infliximab therapy alongside a full vancomycin course, demonstrating the potential effectiveness of this intervention in managing early-stage ulcerative colitis with concurrent Clostridioides difficile infection.

Outcomes:

Following the completion of a full vancomycin course, the patient initiated infliximab therapy. The patient was free from significant discomfort, exhibited no fever, and had no mucopurulent bloody stools. A follow-up blood test indicated reduced inflammatory markers compared to the preoperative period, and the stools were normal.

Lessons:

We illustrate the potential effectiveness of this medication by presenting an in-depth case report of a patient with early-stage UC. The report outlines the patient inclusion of infliximab to better manage UC inflammation alongside an adjunct vancomycin regimen, given the ineffectiveness of mesalazine therapy and the concurrent presence of Clostridium difficile infection. This case prompts consideration of therapeutic approaches for complex UC and contributes to advancing both research and clinical practice. Nonetheless, we should remain attentive to the variations and potential risks unique to each patient in order to formulate personalized treatment strategies.
SQLE is a promising prognostic and immunological biomarker and correlated with immune Infiltration in Sarcoma
Authors: Shao Mengwei , Wang Mingbo , Wang Xiliang , Feng Xiaodong , Zhang Lifeng , Lv Huicheng
Published: February 2024

Squalene epoxidase (SQLE) is an essential enzyme involved in cholesterol biosynthesis. However, its role in sarcoma and its correlation with immune infiltration remains unclear. All original data were downloaded from The Cancer Genome Atlas (TCGA). SQLE expression was explored using the TCGA database, and correlations between SQLE and cancer immune characteristics were analyzed via the TISIDB databases. Generally, SQLE is predominantly overexpressed and has diagnostic and prognostic value in sarcoma. Upregulated SQLE was associated with poorer overall survival, poorer disease-specific survival, and tumor multifocality in sarcoma. Mechanistically, we identified a hub gene that included a total of 82 SQLE-related genes, which were tightly associated with histone modification pathways in sarcoma patients. SQLE expression was negatively correlated with infiltrating levels of dendritic cells and plasmacytoid dendritic cells and positively correlated with Th2 cells. SQLE expression was negatively correlated with the expression of chemokines (CCL19 and CX3CL1) and chemokine receptors (CCR2 and CCR7) in sarcoma. In conclusion, SQLE may be used as a prognostic biomarker for determining prognosis and immune infiltration in sarcoma.
Usage, knowledge and perception of the ketogenic diet and associated factors in Saudi adults: A cross-sectional study
Authors: Alhassani Ameerah A. , Noorwali Essra A.
Published: February 2024

The ketogenic diet (KD) is a popular weight management method. However, knowledge, perceptions, and use of KD have not been studied in the Saudi population. This cross-sectional study aims to assess the knowledge, perceptions, and use of the KD in Saudi Arabia, to compare medical and nonmedical students in their awareness of KD, and to determine factors associated with knowledge and perception of KD. A total of 1071 Saudis aged ≥ 18 years old were included. Participants were excluded if they were younger than 18, non-Saudi, pregnant, breastfeeding, had chronic illnesses, were using any medication, or were diagnosed with psychiatric conditions. Knowledge, perception, and use of KD were collected between 2021 and 2022 in Saudi Arabia using a prevalidated tool and its scoring protocol; higher scores indicated higher level of knowledge or perception. Among Saudi adults, 24% (n = 253) and 55% of them (n = 138/253) followed the KD for 1 month or less, respectively. The KD knowledge score was mean ± SD: 7.95 ± 3.97 and half of the participants (49.5%) had a low knowledge level. Students had a significantly lower knowledge score (mean ± SD: 7.69 ± 3.85) compared to nonstudents (mean ± SD: 8.68 ± 4.19). Students in medical majors had a higher knowledge score compared to nonmedical major students (P < .001). The KD perception score was mean ± SD: 28.74 ± 4.83 and 76% of the participants had moderate perception level. Males had a significantly higher perception score compared to females (P < .001). Students in medical majors had a lower perception score compared to nonmedical major students. Age and body mass index had a significantly weak positive correlation with knowledge and perception scores. Half of the sample had low knowledge and moderate level of perception about KD. Students with medical majors had higher knowledge but lower perception scores compared to nonmedical majors. Dieticians may measure the knowledge and perception of the KD diet in outpatient clinics to lose weight. Educational institutions may increase students’ knowledge and perception of the KD in all majors. Future experimental studies examining the efficacy of the KD are needed to provide recommendations of the KD as a strategy for weight loss.
GLIM criteria represent a more suitable tool to evaluate the nutritional status and predict postoperative motor functional recovery of older patients with hip fracture: A retrospective study
Authors: Wu Weicheng , Guo Zhening , Gu Zenghui , Mao Yongtao , She Chang , Gu Jun , Lv Bo , Xu Wei , Li Liubing
Published: February 2024

Early recognition of malnutrition is essential to improve the prognosis of older patients with hip fracture. The Nutritional Risk Screening 2002 (NRS-2002), the Short-Form Mini Nutritional Assessment (MNA-SF) and the Global Leadership Initiative on Malnutrition (GLIM) are widely used in malnutrition diagnosis. However, criteria for predicting postoperative hip joint motor function in older patients with hip fractures are still necessary. The objective of this study was to select the most appropriate criteria from the NRS-2002, the MNA-SF and the GLIM in predicting the postoperative hip joint motor function recovery 1 year after surgery. This retrospective observational study included 161 patients aged ≥ 65 years with hip fractures. The nutritional status of patients was determined by the NRS-2002, MNA-SF and GLIM. The Harris hip joint score (HHS), the primary outcome of this study, was used to evaluate hip joint motor function. HHS was classified as excellent (HHS > 75) or non-excellent outcomes (HHS ≤ 75). Logistic regression models for hip joint motor function recovery were constructed. Both the receiver operating characteristic curve and the decision curve analysis were used to select the most predictive criteria. The overall mean age of the 161 patients was 77.90 ± 8.17. As a result, NRS-2002 (OR:0.06, 95%CI [0.01, 0.17]), MNA-SF (OR:0.05, 95%CI [0.00, 0.23]) and GLIM (OR of moderate: 0.03, 95%CI [0.01, 0.11]; OR of severe: 0.02 [0.00, 0.07]) were predictive for recovery of hip joint motor function. Additionally, both the area under curve of the receiver operating characteristic curve (NRS-2002: 81.2 [73.8, 88.6], MNA-SF: 76.3 [68.5, 84.2], GLIM: 86.2 [79.6,92.8]) and the decision curve analysis showed the GLIM was better than others. Compared with NRS-2002 and MNA-SF, GLIM was a more suitable nutritional assessment criteria to predict the postoperative recovery of hip joint motor function for older patients with hip fracture 1 year after surgery.
Duodenal malignant melanoma: Primary and metastatic case series and literature review
Authors: Zhou Bing , Li Xiaohua , Liu Jincai , Peng Lizi , Liu Xianwei
Published: February 2024

Rationale:

Duodenal malignant melanoma is rare, and its early clinical symptoms are insidious, making it difficult to diagnose in its early stages. Combined with previous literature, We explored the clinicopathological characteristics and v-raf murine sarcoma viral oncogene homolog B1 mutations in primary and metastatic duodenal malignant melanoma, in order to provide some experience on its differential diagnosis and treatment.

Patient concerns:

The 2 patients (a 63-year-old female [Patient 1] and a 54-year-old male [Patient 2]) experienced pain and discomfort in their upper abdomen. Additionally, one of them had a history of skin malignant melanoma.

Diagnoses:

Patient 1 was diagnosed with primary duodenal malignant melanoma; and Patient 2 was diagnosed with metastatic duodenal malignant melanoma.

Interventions:

Patient 1 underwent pancreaticoduodenectomy; and patient 2 underwent complete surgical resection and lymph node dissection.

Outcomes:

After surgery, Patient 1 survived after 26 months follow-up, and Patient 2 died of systemic multi-organ circulatory failure after 1 month follow-up.

Lessons:

Primary and metastatic cases should be diagnosed through previous medical history analysis and detailed physical and auxiliary examinations. This would enable a diagnosis based on characteristic histomorphology and immunohistochemical markers. An early diagnosis and surgical treatment can prolong patient survival and the molecular inspection of v-raf murine sarcoma viral oncogene homolog B1 mutations can guide follow-up treatment.
A case report of refractory amebic colitis and literature review
Authors: Shao Yupei , Lv Hong , Zhou Weixun , Zhou Baotong , Jiang Qingwei , Qian Jiaming
Published: February 2024

Rationale:

Amebic colitis has been less prevalent in recent times in China, and the similarity of its symptoms to those of inflammatory bowel disease (IBD) results in the difficulty of early identification and diagnosis.

Patient concerns:

A 31-year-old male who exhibited intermittent diarrhea and hematochezia was highly suspected as IBD initially. Despite the partial relief of symptoms following the administration of mesalamine, the endoscopic ulcers remained largely unchanged.

Diagnoses:

Two years after the onset of mesalamine therapy, amebic cysts were detected in stool microscopy and trophozoites were found on the surface of cecal ulcers. The patient was then diagnosed with amebic colitis.

Interventions:

After 2 rounds of standardized metronidazole treatment, amebic colitis remained refractory until diloxanide was administered.

Outcomes:

The patient remained asymptomatic, and the mucosa of colon was normal during the annual follow-up.

Lessons:

Individuals newly diagnosed with IBD should undergo essential screening for amebiasis. And the use of steroids should be taken with caution, especially in cases where the effect of mesalamine is limited. For symptomatic intestinal amebiasis, even after the administration of tissue amebicides, the continued use of luminal amebicides is necessary to prevent recurrence.
“Being a Good Parent” During Times of Illness as Defined by Chinese Children With Cancer, Their Parents, and Providers
Authors: Zhang Zihe , Huang Haiying , Duan Mingxia , Yu Ling , Cheng Lei
Published: February 2024

Background

Identifying the definition of “being a good parent” facilitates the understanding of parents’ personal beliefs and deeds regarding their ill child.

Objective

The aim of this study was to explore the concept of “being a good parent to my ill child” during pediatric cancer treatment from the perspective of Chinese children, parents, and providers.

Methods

A descriptive qualitative study was conducted with 6 children, 18 parents, 5 doctors, 19 nurses, and 3 social workers by semistructured interviews at 3 Chinese hospitals.

Results

Except for “letting the Lord lead,” 7 themes from the original conceptual model were validated, for example, “being there for my child” (n = 51, 100.0%); “doing right by my child” (n = 38, 74.5%), “being an advocate for my child” (n = 27, 52.9%), “conveying love to my child” (n = 26, 51.0%), “making my child healthy” (n = 18, 35.3%), “being a good life example” (n = 13, 25.5%), and “not allowing suffering” (n = 13, 25.5%). A new theme, “rebuilding myself” (n = 39, 76.5%), emerged in the Chinese context. “Being a good parent to my ill child” is perceived differently among stakeholders. Healthcare professionals’ facilitation to fulfill the concept included “recognizing the individualized good-parent definition,” “providing best available care” and “establishing a supportive environment.”

Conclusion

“Being a good parent to my ill child” is meaningfully expressed by Chinese parents and recognized by children and providers during pediatric cancer treatment.

Implications for Practice

It is important to support parents in conveying their internal good parent definition and sharing it with stakeholders. Attention should be paid to related cultural influencers, a supportive family-friendly environment, and shared decision making involving the child’s voice.
An Evaluation of ChatGPT and Bard in the Context of Biological Knowledge Retrieval
Authors: Caspi Ron , Karp Peter D.
Published: February 2024

ChatGPT and Bard, two conversational AI models developed by OpenAI and Google AI, respectively, have garnered considerable attention for their ability to engage in natural language conversations and perform various language-related tasks. While the versatility of these chatbots in generating text and simulating human-like conversations is undeniable, we wanted to evaluate their effectiveness in retrieving biological knowledge for curation and research purposes. To do so we asked each chatbot a series of questions and scored their answers based on their quality. Out of a maximal score of 24, ChatGPT scored 5 and Bard scored 11. The encountered issues included missing information, incorrect answers, and instances where responses combine accurate and inaccurate details. Notably, both tools tend to fabricate references to scientific papers, undermining their usability.
In light of these findings, we recommend that biologists continue to rely on traditional sources while periodically assessing the reliability of ChatGPT and Bard. As ChatGPT aptly suggested, for specific and up-to-date scientific information, established scientific journals, databases, and subject-matter experts remain the preferred avenues for trustworthy data.
The Pseudogene RPS27AP5 Reveals Novel Ubiquitin and Ribosomal Protein Variants Involved in Specialised Ribosomal Functions
Authors: Meller Anna , Lévesque Dominique , Raisch Jennifer , Fafard-Couture Etienne , Scott Michelle , Roucou Xavier , Boisvert Francois-Michel
Published: February 2024

Pseudogenes, traditionally considered non-functional gene copies resulting from evolutionary mutations, have garnered attention due to recent transcriptomics and proteomics revealing their unexpected expressions and consequential cellular functions. Ubiquitin, transcribed from UBA52 and RPS27A genes, fused to ribosomal proteins eL40 and eS31, and polyubiquitin precursors encoded by UBB and UBC genes, has additional pseudogenes labeled as non-functional. However, recent evidence challenges this notion, demonstrating that these pseudogenes produce ubiquitin variants with minimal differences from the canonical sequence, suggesting a new regulatory dimension in ubiquitin-mediated cellular processes. To systematically catalogue possible Ubiquitin (Ub) and Ubiquitin-like (Ubl) variants from pseudogenes, expression data was compiled, identifying potential functional variants. Among these pseudogenes, RPS27AP5 expresses both Ubiquitin variant (UbP5) and ribosomal protein variant (S27aP5), with precursor proteins maturing through cleavage and exhibiting behavior similar to their counterparts post-translation. Notably, S27aP5 integrates into translating ribosomes, increasing the 80S monosomal ribosomal fraction and indirectly influencing p16INK4A transcriptional activation. The discovery of a functional S27a pseudogene supports the concept that a subset of ribosomes may incorporate diverse subunits for specific translational functions.
Dual Targeting of Histone Deacetylases and MYC as Potential Treatment Strategy for H3-K27M Pediatric Gliomas
Authors: Algranati Danielle , Oren Roni , Dassa Bareket , Fellus-Alyagor Liat , Plotnikov Alexander , Barr Haim , Harmelin Alon , London Nir , Ron Guy , Furth Noa , Shema Efrat
Published: February 2024

Diffuse midline gliomas (DMG) are aggressive and fatal pediatric tumors of the central nervous system that are highly resistant to treatments. Lysine to methionine substitution of residue 27 on histone H3 (H3-K27M) is a driver mutation in DMGs, reshaping the epigenetic landscape of these cells to promote tumorigenesis. H3-K27M gliomas are characterized by deregulation of histone acetylation and methylation pathways, as well as the oncogenic MYC pathway. In search of effective treatment, we examined the therapeutic potential of dual targeting of histone deacetylases (HDACs) and MYC in these tumors. Treatment of H3-K27M patient-derived cells with Sulfopin, an inhibitor shown to block MYC-driven tumorsin-vivo, in combination with the HDAC inhibitor Vorinostat, resulted in substantial decrease in cell viability. Moreover, transcriptome and epigenome profiling revealed synergistic effect of this drug combination in downregulation of prominent oncogenic pathways such as mTOR. Finally,in-vivostudies of patient-derived orthotopic xenograft models showed significant tumor growth reduction in mice treated with the drug combination. These results highlight the combined treatment with PIN1 and HDAC inhibitors as a promising therapeutic approach for these aggressive tumors.