bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proteomic profiling of neutrophils and plasma in community-acquired pneumonia reveals crucial proteins in diverse biological pathways linked to clinical outcome
Authors: Michels Erik H. A. , Chouchane Osoul , de Brabander Justin , de Vos Alex F. , Faber Daniël R. , Douma Renée A. , Smit Eva R. , Wiersinga W. Joost , Biggelaar Maartje van den , Poll Tom van der , Hoogendijk Arie J. 
Published: October 2024

IntroductionNeutrophils play a dichotomous role in community-acquired pneumonia (CAP), providing protection and potentially causing damage. Existing research on neutrophil function in CAP relies on animal studies, leaving a gap in patient-centered investigations.MethodsWe used mass spectrometry to characterize the neutrophil proteome of moderately ill CAP patients at general ward admission and related the proteome to controls and clinical outcomes.ResultsWe prospectively included 57 CAP patients and 26 controls and quantified 3482 proteins in neutrophil lysates and 386 proteins in concurrently collected plasma. The extensively studied granule-related proteins in animal models did not drive the neutrophil proteome changes associated with human CAP. Proteome alterations were primarily characterized by an increased abundance of proteins related to (aerobic) metabolic activity and (m)RNA translation/processing, concurrent with a diminished presence of cytoskeletal organization-related proteins (all pathways p&lt;0.001). Higher and lower abundances of specific proteins, primarily constituents of these pathways, were associated with prolonged time to clinical stability in CAP. Moreover, we identified a pronounced presence of platelet-related proteins in neutrophil lysates of particularly viral CAP patients, suggesting the existence of neutrophil-platelet complexes in non-critically ill CAP patients. Of the proteins measured in neutrophils, 4.3% were detected in plasma.DiscussionOur study presents new perspectives on the neutrophil proteome associated with CAP, laying the groundwork for forthcoming patient-centred investigations. Our results could pave the way for targeted strategies to fine-tune neutrophil responses, potentially improving CAP outcomes.
Exploring the mechanism of action of Modified Simiao Powder in the treatment of osteoarthritis: an in-silico study
Authors: Xu Zhouhengte , Su Pingping , Zhou Xiahui , Zheng Zhihui , Zhu Yibo , Wang Qinglai 
Published: October 2024

IntroductionOsteoarthritis (OA) is the most common form of arthritis and the leading musculoskeletal disorders in adults. Modified Simiao Powder (MSMP) has been widely used in the treatment of OA with remarkable clinical ecaciousness.ObjectiveThis study aimed to elucidate underlying mechanisms of MSMP in OA by employing network pharmacology, molecular docking, and molecular dynamics simulations, due to the unclear mode of action.MethodsBioinformatic analysis was used to evaluate the major chemical constituents of MSMP, determine prospective target genes, and screen genes associated with OA. Network pharmacology methods were then applied to identify the crucial target genes of MSMP in OA treatment. Further analyses included gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. These key targets within the pertinent pathways was further confirmed by molecular docking, binding energy evaluation, and molecular dynamics simulations.ResultsNetwork pharmacology analysis identified an MSMP component–target–pathway network comprising 11 central active compounds, 25 gene targets, and 12 biological pathways.DiscussionThese findings imply that the therapeutic effects of MSMP was potentially mediated by targeting several pivotal genes, such as androgen receptor (AR), NFKB1, AKT1, MAPK1, and CASP3, and regulating some pathways, including lipid metabolism and atherosclerosis, the AGE–RAGE signaling pathway in diabetic complications, the PI3K–Akt signaling pathway, fluid shear stress, atherosclerosis, and Kaposi's sarcoma-associated herpesvirus infection. Molecular docking assessments demonstrated that these compounds of MSMP, such as berberine, kaempferol, quercetin, and luteolin, exhibit high binding anities to AR and AKT1. Molecular dynamics simulations validated the interactions between these compounds and targets.ConclusionThe therapeutic effect of MSMP likely attributed to the modulation of multiple pathways, including lipid metabolism, atherosclerosis, the AGE-RAGE signaling pathway, and the PI3K-Akt signaling pathway, by the active components such as berberine, kaempferol, luteolin, and quercetin. Especially, their actions on target genes like AR and AKT1 contribute to the therapeutic benefits of MSMP observed in the treatment of OA.
Effects of peer-led education on knowledge, attitudes, practices of stoma care, and quality of life in bladder cancer patients after permanent ostomy
Authors: Ding Juan-Ying , Pan Ting-Ting , Lu Xu-Jing , You Xiao-Ming , Qi Jia-Xian 
Published: October 2024

ObjectiveTo investigate the effects of peer-led intervention on knowledge, attitudes, and practices (KAP) of stoma care, as well as quality of life in bladder cancer patients post-permanent ostomy.MethodsA series of 340 eligible bladder cancer patients who underwent permanent ostomy from January 2019 to December 2022 were enrolled in this study. These participants were randomly assigned to the intervention group (peer-led intervention) and the control group (routine health intervention) using random number table, with 170 cases in each group. A 30-item questionnaire was used to evaluate knowledge, healthy attitudes, and healthy practices (KAP) of disease; the WHO Quality of Life-100 (WHOQOL-100) was utilized to assess the quality of life among patients; and the incidence of complications in two groups were also recorded during six-month intervention. For the comparison of continuous variables within and between groups, paired sample and independent t-test were applied. The categorical variables analyzed using x2 test or rank-sum test.ResultsAfter six-month intervention, 144 participants in the intervention group and 151 participants in the control group were finally retained in this study. The scores of the 20 items in KAP (including basic knowledge of disease, basic knowledge of ostomy, observation of stoma, etc.) in the intervention group were significantly higher than those in the control group (all p &lt; 0.05); the scores of 12 items in WHOQOL-100 (including the positive feelings, thinking, learning, memory and concentration, etc.) in the intervention group were markedly higher than those in the control group, while negative feelings and dependence on medical support in the intervention group were significantly lower than those in the control group (all p &lt; 0.05); the total rate of complications in the intervention group was significantly lower than that in the control group (18.31% vs. 31.13%, p &lt; 0.05).ConclusionThe peer-led intervention has a positive effect on improving patients’ KAP of stoma care and quality of life and reducing the rate of complications, which enables it to be a favorable intervention approach for patients with permanent ostomy.
Practical exploration of BOPPPS model combined with situational teaching method in clinical training of intensive medicine: novel pedagogy and perception
Authors: Liu Yanquan , Lian Xiaolan , Chen Xiaojun , Zeng Minjuan , Yin Yue , Lin Jie 
Published: October 2024

ObjectiveTo explore the application value of bridge-in, learning objective, pre-assessment, participatory learning, post-assessment, and summary (BOPPPS) model combined with situational teaching method in the clinical teaching of intensive care unit (ICU), and to provide experience for the reform of ICU clinical teaching and standardized training of intensive medicine.MethodsA randomized trial was conducted using a multi-center, prospective cohort study. A total of 293 residential physicians in ICU of Fujian Medical University Union Hospital, the Affiliated Hospital of Putian University and the First Affiliated Hospital of Gannan Medical University from January 2021 to December 2023 were selected as subjects, and the residential physicians in ICU in each medical center were divided into control group and experimental group using random number table method. The control group adopted bedside teaching and demonstration teaching method, and the experimental group adopted BOPPPS model combined with situational teaching method. Clinical teaching performance was evaluated by ICU admission examination, and study process questionnaire (SPQ) and the critical thinking disposition inventory-Chinese version (CTDI-CV) was used to evaluate the learning motivation and critical thinking ability of the two groups. At the same time, the effect evaluation and satisfaction questionnaire of ICU training (EESQ) was used to evaluate the teaching satisfaction.ResultsThe scores of the experimental group in ICU theoretical knowledge, clinical thinking and skills, and the treatment of clinical critical cases were higher than those of the control group [(87.31 ± 13.15), (92.86 ± 12.35), (81.45 ± 11.28)] vs. [(83.94 ± 12.73), (88.37 ± 12.61), (78.83 ± 10.47)], the difference between the two groups was statistically significant (p &lt; 0.05). The scores of surface motivation, deep motivation, achievement motivation and SPQ total scores of the experimental group were all higher than those in control group (p &lt; 0.05), and the scores of seek truth, open mind, analytical ability, systematic ability, self-confidence of critical thinking and intellectual curiosity of the experimental group were also higher than those in the control group, and the CTDI total score was statistically significant (p &lt; 0.05). In addition, the results of the questionnaire showed that the experimental group was better than the control group in terms of learning interest in ICU, improvement of humanistic care and doctor-patient communication ability, improvement of teamwork ability, improvement of job identity, ICU training harvest and satisfaction with teacher style (p &lt; 0.05).ConclusionThe combination of BOPPPS model and situational teaching method is likely a more effective and helpful which may improve the clinical comprehensive ability and training quality of residential physicians, and it may be worth learning and promoting.
Distribution diversity and expression regulation of class 1 integron promoters in clinical isolates of Morganella morganii
Authors: Yang Ye , Zhang Hui , Zhao Rongqing , Qiu Xuedan , Ye Jinglu , Lu Wenjun , Li Qingcao , Wu Guangliang 
Published: October 2024

BackgroundMorganella morganii is an emerging nosocomial opportunistic pathogen with increasing multidrug resistance. Antibiotic resistance, driven primarily by the horizontal transfer of resistance genes, has become a global health crisis. Integrons, mobile genetic elements, are now understood to facilitate the transfer of these genes, contributing to the rapid proliferation of resistant strains. Understanding the regulatory role of integrons in drug resistance gene expression is crucial for developing novel strategies to combat this pressing public health issue.ObjectiveTo investigate the distribution of promoter types in the variable regions of class 1 integrons isolated from clinical isolates of M. morganii and their regulatory role in the expression of downstream drug resistance gene cassettes.MethodsNinety seven clinical isolates of M. morganii were screened for the presence of class 1 integrons (intI1) using polymerase chain reaction (PCR). Gene cassettes within the variable regions of positive isolates were characterized, and the gene cassette promoter Pc variants and downstream auxiliary promoter P2 were identified. Enterobacterial repetitive intergenic consensus (ERIC)-PCR was employed for homology analysis. Recombinant plasmids containing different variable region promoters and gene cassettes were constructed to evaluate drug resistance genes and integrase (intI1) expression levels using reverse transcription-quantitative PCR (RT-qPCR) and antimicrobial susceptibility testing.ResultsOf the clinical isolates, 28.9% (n = 28/97) were positive for class 1 integrons. 24.7% (n = 24/97) of these isolates carried gene cassettes encoding resistance to aminoglycosides and trimethoprim. Three Pc promoter types (PcH1, PcS, and PcW) were identified, while all P2 promoters were inactive with a 14-base pair spacing between the −35 and −10 regions. ERIC-PCR analysis classified the integron-positive strains into 6 genotypes, with high consistency in promoter types and gene cassettes within each genotype. RT-qPCR and antimicrobial susceptibility testing demonstrated that strong promoters significantly enhanced the expression of downstream drug resistance gene cassettes compared to weak promoters. Additionally, RT-qPCR revealed a negative correlation between intI1 expression and Pc promoter strength.ConclusionClass 1 integrons are prevalent in M. morganii. The promoter types within these integrons are diverse, and promoter strength is closely linked to downstream gene cassette expression. Integron-positive strains exhibit high homology, suggesting horizontal gene transfer and dissemination in clinical settings.
Functional correlates of executive dysfunction in primary progressive aphasia: a systematic review
Authors: Thomsen Kristin , Keulen Stefanie , Arslan Seçkin 
Published: October 2024

IntroductionRecent research has recognized executive dysfunction as another component affected in Primary Progressive Aphasia (PPA). This systematic review aimed to examine what information distinctive neurophysiological markers can provide in the evaluation of executive function (EF) deficits in PPA, and to what effect executive function deficits can be assessed through the characteristics of functional markers.MethodsWe conducted a systematic literature search following the PRISMA guidelines across studies that employed neuropsychological assessments and neurophysiological imaging techniques (EEG, MEG; PET, SPECT, fMRI, fNIRS) to investigate executive dysfunction correlates in PPA.ResultsFindings from nine articles including a total number of 111 individuals with PPA met our inclusion criteria and were synthesized. Although research on the neural correlates of EF deficits is scarce, MEG studies revealed widespread oscillatory slowing, with increased delta and decreased alpha power, where alterations in alpha, theta, and beta activities were significant predictors of executive function deficits. PET findings demonstrated significant correlations between executive dysfunction and hypometabolism in frontal brain regions. fMRI results indicated elevated homotopic connectivity in PPA patients, with a broader and more anterior distribution of abnormal hippocampal connections of which were associated with reduced executive performance.ConclusionOur study provides indirect support for the assumption regarding the significance of the frontal regions and inferior frontal junction in executive control and demonstrates that neurophysiological tools can be a useful aid to further investigate clinical-neurophysiological correlations in PPA.
Association between serum calcium and in-hospital mortality in intensive care unit patients with cerebral infarction: a cohort study
Authors: Meng Kaiwu , Lei Xiaoyang , He Dian 
Published: October 2024

BackgroundThe relationship between serum calcium levels and the prognosis of cerebral infarction remains controversial.PurposeThis study aims to investigate the correlation between serum calcium levels and in-hospital mortality in critically ill patients with ischemic stroke admitted to the intensive care unit (ICU).MethodsA retrospective cohort study was conducted using data from the MIMIC-IV database. Demographic and clinical data of all participants were collected including gender, age, hypertension, diabetes, myocardial infarction, heart failure, chronic obstructive pulmonary disease, hemoglobin, potassium, sodium, anion gap, platelets, white blood cells, glucose, creatinine, Glasgow coma score (GCS), IV-tPA administration (rt-PA), and mechanical thrombectomy (MT). The outcome measure was in-hospital death. Multivariable-adjusted logistic regression analysis, curve fitting, interaction analysis, and threshold effect analysis were employed to evaluate the relationship between serum calcium levels and in-hospital mortality among ICU patients with cerebral infarction.ResultsA total of 2,680 critically ill patients with cerebral infarction were enrolled, with a mean serum calcium level of 8.6 ± 0.8 mg/dL. The overall in-hospital mortality rate was 19.5%, where Group 1 (serum calcium &lt; 8.0 mg/dL) had a mortality rate of 27.7%, Group 2 (serum calcium 8–9 mg/dL) had a rate of 19.8%, and Group 3 (serum calcium ≥ 9 mg/dL) had a rate of 13.9%. There was a non-linear, S-shaped relationship between serum calcium levels and in-hospital mortality. Serum calcium levels within the range of 7.70–9.50 mg/dL were found to be independently associated with increased in-hospital mortality in ICU patients with cerebral infarction. No significant interactions were detected in subgroup analyses, and the results of sensitivity analyses remained stable.ConclusionSerum calcium levels are independently associated with in-hospital mortality in critically ill patients with cerebral infarction in the ICU setting. Within the range of 7.70–9.50 mg/dL, lower serum calcium levels increase the risk of in-hospital death among these patients, emphasizing the importance of close monitoring by ICU physicians.
Surgical site infections after sarcoma resections in the peripelvic region: do we need perioperative antibiotic prophylaxis?
Authors: Klein Alexander , Chudamani Chataut , Wieser Andreas , Goller Sophia S. , Berclaz Luc M. , Di Gioia Dorit , Holzapfel Boris M. , Dürr Hans Roland 
Published: October 2024

IntroductionSurgical site infections (SSI) are one of the most common complications after extensive sarcoma resections and represent a daily challenge. SSI occur in up to 50% of cases particularly in the peripelvic area. One possible approach to reduce infection rate is perioperative antibiotic prophylaxis. The aim of this study therefore was to investigate the influence of perioperative antibiotic prophylaxis on the infection rate and the possible influence of location-specific antibiotic prophylaxis with ampicillin/sulbactam.MethodsThis monocentric retrospective study included 366 patients who underwent sarcoma resections in the groin, proximal thigh, or gluteal region. All patients were operated on by 2 surgeons after neoadjuvant pretreatment if necessary. 3 groups of patients were defined. Group 1: In 60.4% of all cases, antibiotic prophylaxis was administered with cephalosporins (also clindamycin in case of penicillin allergy). Group2: In 9.8% of cases, ampicillin/sulbactam was used. Group 3: 29.8% of patients did not receive any antibiotic prophylaxis.ResultsIn 31.1% of treated cases, antibiotic therapy was prolonged due to extended tumor resections. Postoperative infections occurred in 23.2% (85 cases), in 77 cases within the first 90 days (on average after 20 days). The median operating time, blood loss was higher, and tumor size were significantly larger in cases with infections, compared to patients without infection. In group 1 and 2 with perioperative single-shot prophylaxis, infection occurred in 24.1% of cases, compared to 13.5% of cases without prophylaxis (group 3) (p= 0.032). In the patients with prolonged antibiotic therapy, infection occurred in 31.6% of cases, compared to 16.3% of cases without prolongation (p&lt; 0.001). In the group 2, infection occurred in 19.4% of cases compared to 24.9% of cases in the group 1 (p= 0.479). In the multivariate analysis, surgery time longer 80 min, blood substitution, neoadjuvant radio- and chemotherapy proved to be a risk factor for SSI.DiscussionRegion adapted perioperative antibiotic prophylaxis may reduce the risk of infection after extended sarcoma resection in the peripelvic area. However, the particular bacterial spectrum of this anatomic region should be taken into account when deciding which antibiotics to use.
Immune-related toxic epidermal necrolysis affecting trachea mucosal epithelium: a case report and literature review
Authors: Zhang Mingbo , Fu Yang , Song Yuxiao , Gao Xia , Wang Jun , Zhang Bicheng 
Published: October 2024

BackgroundMonoclonal antibodies against programmed cell death protein-1 (PD-1)/programmed death-ligand-1 (PD-L1) have emerged as critical tools in cancer treatment. However, concerns regarding their potential cutaneous and mucosal toxicity, along with severe complications, have drawn clinical attention. Further research is warranted to investigate the adverse reactions and treatment strategies associated with PD-1 monoclonal antibodies.MethodsWe present a detailed case report of a laryngeal cancer patient who developed toxic epidermal necrolysis (TEN) after treatment with PD-1 monoclonal antibody. We analyzed the etiology, diagnosis, and treatment approaches by integrating clinical manifestations, pathological examinations, and literature research.ResultsAfter PD-1 monoclonal antibody therapy, the patient exhibited systemic rash, bullae, and epidermal detachment, which subsequently involved the tracheal and bronchial mucosa, resulting in dyspnea. The patient recovered after treatments with steroids, macrolides, immunoglobulins, and etanercept, along with repeated removal of scabs via bronchoscopy. Literature reviewing suggests a potential association between PD-1 monoclonal antibodies and the pathogenesis of Steven Johnson’s Syndrome (SJS) and Toxic epidermal necrolysis (TEN), possibly due to immune dysregulation. Treatment consists of immediate discontinuation of suspicious drugs, essential supportive therapy, and systemic corticosteroid administration, with the addition of immunosuppressants and/or immunoglobulins needed.ConclusionThe mucocutaneous toxicity induced by PD-1 monoclonal antibodies is not limited to the surface of the skin but also in deep mucosal layers, potentially leading to life-threatening complications. Therefore, when using PD-1 monoclonal antibodies, clinicians should closely monitor adverse events and apply appropriate treatments as soon as possible to prevent severe complications.