bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cavernosal venous occlusive dysfunction caused by enhanced sympathetic activity of cavernous smooth muscle: Identification and exploratory study
Authors: Chen Huirong , Meng Zizhou , Bai Haowei , Zhi ER lei , Tian Ruhui , Yao Chencheng , LI Peng , Huang yuhua , Zhao Fujun , Li Zheng 
Published: October 2024

Abstract

Cavernosal venous occlusive dysfunction (CVOD) accounts for the most common etiology of erectile dysfunction (ED) among non-responders to phosphodiesterase type 5 inhibitors (PDE5is). How to identify CVOD caused by hypersympathetic activity of cavernous smooth muscle (HS-CVOD) and effectively treat HS-CVOD non-responded to PDE5is have not been fully studied. A total of 166 patients with ED were assessed and grouped by nocturnal penile tumescence rigidity test (NPTR) and color duplex Doppler ultrasound (CDDU). The sympathetic activity of cavernous smooth muscle (amplitude and duration) were determined by corpus cavernosum electromyography (CC-EMG). Patients diagnosed with CVOD by CDDU and with psychological ED by NPTR were considered as HS-CVOD. HS-CVOD patients non-responded to PDE5is were treated by PDE5is combined trazodone for 4 weeks. There were 27 cases of HS-CVOD were considered. The CC-EMG amplitude of HS-CVOD group (302.65 ± 195.01 uv) were significantly greater than that of psychological ED combined with non-vascular ED group (183.71 ± 112.42 uv), organic ED combined CVOD group (162.67 ± 91.17 uv), organic ED combined CVOD group (162.67 ± 91.17 uv), and organic ED combined arterial or mixed ED group (145.67 ± 75.29 uv), respectively. 8 in 11 patients with HS-CVOD non-responded to PDE5is were successfully treated by PDE5is combined trazodone. These findings underscore that HS-CVOD can be preliminary considered by NPTR and CDDU, and assessed by CC-EMG with enhanced sympathetic activity of cavernous smooth muscle. The therapy of PDE5is combined trazodone could be an effective treatment strategy for HS-CVOD non-responded to PDE5is.
Uterine rupture and intestinal injury resulting from postpartum penetrating placental implantation: a case report
Authors: Zhang Qingge , Liu Zongyu , Zhao Ruimin , Wu Fei , Fan Limei 
Published: October 2024

Abstract

Background
The refractory obstetric hemorrhage that can occur as a result of placental implantation remains a major cause of maternal mortality. Abnormal placental implantation rates have risen markedly in recent years, with the increasing frequency of cesarean sections and other procedures such as myomectomy having contributed to uterine scarring. Penetrating placental implantation resulting in uterine rupture, however, is far less common. This report describes a case of postpartum penetrating placenta implantation leading to uterine rupture and intestinal injury.
Case:
A 38-year-old G2P1 female presented to the hospital 34 days following a normal delivery with symptoms including 10 days of irregular vaginal bleeding and a 1-day history of fever. She had previously undergone surgical treatment for multiple smooth muscle uterine tumors. Ultrasound and magnetic resonance imaging findings were indicative of myometrial occupancy, prompting speculation that placental implantation may have occurred. Following anti-infection treatment and the correction of anemia, open exploratory surgery was performed. During this procedure, the placenta was found to have penetrated the uterus and caused small bowel erosion. A subtotal hysterectomy and partial small bowel resection were performed, and postoperative pathology confirmed a case of penetrating placenta implantation.
Conclusion
Penetrating placenta implantation is a rare complication for which few additional testing options are available, complicating the diagnostic process. Greater awareness of this condition should thus be emphasized to minimize the incidence of adverse pregnancy outcomes.
Genomic Surveillance and Evolutionary Dynamics of Influenza A Virus in Sri Lanka
Authors: Jayadas Tibutius , Jeewandara Chandima , Senadheera Bhagya , Kuruppu Heshan , Wickramanayaje Rivindu , Bary Farha , Wijewickrama Ananda , Manilgama Suranga , Gamage Manouri , Perera Nilanka , Ogg Graham , MALAVIGE Gathsaurie 
Published: October 2024

Abstract

Background
Influenza A has been named as a priority pathogen by the WHO due to the potential to cause pandemics. Genomic sequencing of influenza strains is important to understand the evolution of the influenza strains and also to select the appropriate influenza vaccines to be used in the different influenza seasons in Sri Lanka. Therefore, we sought to understand the molecular epidemiology of the influenza viruses in the Western Province of Sri Lanka, including mutational analysis to investigate the evolutionary dynamics.
Methods
A total of 349 individuals presenting with fever and respiratory symptoms were enrolled in this study from November 2022 to May 2024. Nasopharyngeal and oropharyngeal specimens were collected and screened using quantitative PCR to detect Influenza A, Influenza B, and SARS-CoV-2. Subtyping and genomic sequencing was carried out on influenza A strains using Oxford Nanopore Technology.
Results
Influenza A was detected in 49 (14%) patients, influenza B in 20 (5.7%) and SARS-CoV-2 in 41 (11.7%). Co-infections were observed in five participants. The phylogenetic analysis assigned the H1N1 HA gene sequences within the 6B.1A.5a.2a clade. The HA gene of the H1N1 sequences in 2023 were assigned as belonging to the subclades C.1, C.1.2, and C.1.8, while the 2024 sequences were assigned to subclades C.1.8 and C.1.9. The H3N2 sequences from 2023 were assigned to the 3C.2a1b.2a.2a.1b clade and subclade G.1.1.2, while the 2024 sequences were assigned to the 3C.2a1b.2a.2a.3a.1 clade and subclade J.2. The K54Q, A186T, Q189E, E224A, R259K, K308R, I418V, and X215A amino acid substitutions were seen in the H1N1 in the 2023 and 2024 sequences. The 2024 H1N1 sequences additionally exhibited further substitutions, such as V47I, I96T, T120A, A139D, G339X, K156X, and T278S.
Conclusion
In this first study using genomic sequencing to characterize the influenza A strains in Sri Lanka, which showed different influenza A viruses circulating in an 18-month period. As the Sri Lankan strains also had certain mutations of unknown significance, it would be important to continue detailed surveillance of the influenza strains in Sri Lanka to choose the most suitable vaccines for the population and the timing of vaccine administration.
Six-Day Extreme Challenge: Can ECMO with Axillary Artery Cannulation Truly Reduce Cardiac Afterload? A Case Report A Case Report and minireview
Authors: Zhang Zhou-xing , Zeng Xiao-Kang , Qiu Chen-hui , Hu Wei , Zhu Ying , Yang Jing 
Published: October 2024

Abstract

Objective
The use of axillary artery cannulation in extracorporeal membrane oxygenation (ECMO) for patients with cardiogenic shock is gaining traction due to its potential to reduce cardiac afterload. However, clinical outcomes often diverge from theoretical expectations. This article presents a case study of a patient who experienced cardiac arrest and initiated veno-arterial ECMO (V-A ECMO) support 2 hours and 40 minutes after undergoing cardiopulmonary resuscitation (CPR). Despite ECMO intervention, the patient's aortic valve remained closed for up to six days. Transitioning from femoral to axillary artery cannulation did not yield a marked improvement in cardiac afterload. In the absence of abilities for atrial septostomy, conservative management was implemented, ultimately resulting in the normalization of aortic valve function and the patient's regained consciousness. This article seeks to examine the potential benefits and limitations of axillary artery cannulation in the context of ECMO for cardiogenic shock.
Methods
Following prolonged CPR, the patient experienced severe myocardial dysfunction and an impaired ability to open the aortic valve. The transition from femoral to axillary artery cannulation did not result in a significant reduction in cardiac afterload. However, through the optimization of ECMO parameters, intra-aortic balloon pump (IABP) support, improved fluid management, and tailored anticoagulation therapy, the patient’s cardiac function gradually recovered.
Results
After six days of therapeutic interventions, the patient's aortic valve function returned to normal, and consciousness was restored.
Whole genome transcriptional analysis of intestinal biopsies and blood cells indicate genes involved in antioxidant defense systems and antigen presentation in the pathogenesis of celiac disease
Authors: Naluai Åsa Torinsson , Sabbag Shafir , Abrahamsson Sanna , Gudjónsdóttir Audur H , Arnell Henrik , Agardh Daniel 
Published: October 2024

Abstract

Background: Celiac disease is closely linked to HLA-risk haplotypes, but non-HLA genes also play a significant role in disease susceptibility. In this study, we explore the molecular pathways involved in celiac disease by analyzing the differential expression of genes in both the gut and peripheral blood across various celiac disease phenotypes.
Methods: Whole genome RNA sequencing was performed on 298 samples from intestinal mucosa and peripheral blood from 81 children with celiac disease and 68 disease controls. Enrichr pathway analysis of top differentially expressed genes were performed.
Results: Overall, 7151 genes in intestinal biopsies and 532 genes in blood samples were differentially expressed between celiac cases and controls. Compared with controls, GBP1 (p=1.05×10-14) and TGM2 (p= 5.92×10-8), encoding for the protein tissue transglutaminase (TG2), the main autoantigen in celiac disease, were two of top up-regulated genes in intestinal biopsies from celiac cases. In contrast, PRKCD, encoding for the protein PKC-δ, also reported as an autoantigen in celiac disease, was down-regulated in intestinal biopsies of celiac cases compared with controls (p=4.61×10-5). The topmost differentially expressed genes in peripheral blood were HLA-DQB1 and HLA-DQB2. Among pathways identified as transcriptionally differentiated were antioxidant defense systems (e.g., Nrf2, glutathione, ergothioneine and caffeic acid metabolism), MHC class 1 antigen presentation, amino acid transport, mTORC1, bile secretion, liver homeostasis, the complement system and interferon signaling.
Conclusions: The differential expression of numerous genes across various molecular pathways suggests a complex molecular network related to liver metabolism and immunity, playing a role in the pathogenesis of celiac disease.
Pre-treatment prediction of response to neoadjuvant chemotherapy in breast cancer patients using a nomogram based on findings from cone-beam breast computed tomography
Authors: Zhang Yu-jiao , Liang Zhu-ming , Huang Xiang-yang , Yu Yan-jing , Mo Ya-nan , Luo Ning-bin , Ji Yi-nan 
Published: October 2024

Abstract

Background
Cone-beam breast computed tomography (CBBCT) can provide detailed information about breast tissue, but whether such information can help predict treatment response is unclear.
Purpose
To develop a nomogram based on findings from CBBCT as well as conventional clinical variables to predict pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in patients with breast cancer.
Materials and Methods
Medical data were retrospectively analyzed for a consecutive series of women with breast cancer who underwent NAC followed within three months by resection surgery at our hospital between September 2019 and March 2022. Patients were randomized into a development cohort and validation cohort. A nomogram to predict pCR after chemotherapy was formulated based on uni- and multivariate logistic regression of pre-treatment data from the development cohort, and it was tested against data from the validation cohort. The performance of the nomogram was evaluated in terms of the area under receiver operating characteristic curves (AUC), calibration plots and decision curve analysis.
Results
Of the 215 breast cancer patients in this study, 69 (32.1%) achieved pCR after NAC. Multivariate logistic regression of the development cohort linked such response independently to absence of estrogen receptor (ER) expression, expression of human epidermal growth factor receptor 2 (HER-2), small tumor diameter and non-mass enhancement (NME) on CBBCT. The resulting nomogram predicted response with AUCs of 0.841 (95% CI: 0.78–0.90) in the development cohort (n = 150) and 0.836 (95% CI: 0.74–0.94) in the validation cohort (n = 65), and it was efficient against data from both cohorts based on calibration curves. Decision curve analysis suggested that the nomogram is clinically useful.
Conclusion
A nomogram incorporating molecular biomarkers and findings from CBBCT may help predict breast cancer patients more likely to respond to NAC.
The completeness, accuracy and impact on alerts, of wearable vital signs monitoring in hospitalised patients
Authors: Wilson Anthony Joseph , Parker Alexander J , Kitchen Gareth B , Martin Andrew , Hughes-Noehrer Lukas , Nirmalan Mahesh , Peek Niels , Martin Glen , Thistlethwaite Fiona 
Published: October 2024

Abstract

Background
Use of wearable vital signs sensors to monitor hospitalised patients is growing but uncertainty exists about completeness of data capture and accuracy of measurements. Implications for track and trigger systems are unclear.
Methods
In this observational study, adult inpatients with Covid-19 wore four wearable sensors recording heart rate/respiratory rate (HR/RR), oxygen saturation (SpO2), axillary temperature and blood pressure (BP). Wearable vitals were paired with traditional vitals recorded concurrently. The accuracy of the wearable vitals was assessed using traditional vitals as the reference. National early warning (NEWS2) scores were calculated using wearable and traditional vitals.
Results
48 patients were monitored for 204 days with the sensors. Median sensor wear was 3.9(IQR:1.7-5.9), 3.9(IQR:1.6-5.9) and 3.8(IQR:0.9-5.9) days for HR/RR, temperature and SpO2 respectively. The BP cuff was worn for median 1.9(IQR:0.9-3.8) days in 33 patients. Length of hospital stay was 8(IQR:6-13) days. Completeness of data capture was 84% for HR/RR, 98% for temperature, 72% for SpO2 and 36% for BP.
There were 1632 HR, 1613 RR, 1411 temperature, 1294 SpO2 and 51 BP wearable-traditional measurement pairs. 59.7% of HR pairs were within ±5bpm, 38.5% of RR pairs within ±3breaths/min, 24.4% of temperature pairs within ±0.3oC, 32.9% of SpO2 pairs within ±2% and 39.0% of BP pairs within ±10mmHg. Agreement between wearable and traditional RRs was poor at high RRs.
613 NEWS2 scores were calculated using wearable-traditional HR, RR, temperature and SpO2 pairs. The median NEWS2traditional was 1(IQR:1-2) and the median NEWS2wearable was 4(IQR:3-6). Using traditional NEWS2 alerts as a reference, 86% (225/262) of wearable NEWS2 5+ alerts and 89% (82/92) of wearable NEWS2 7+ alerts were false positives.
Conclusions
Agreement between vital signs recorded by wearable sensors and concurrent traditional vitals is poor. Data from wearable sensors should not be used in existing track and trigger systems.
Increased Left Ventricular Mass As A Marker Of Left Ventricular Hypertrophy In Normotensive Type2 DM Patients
Authors: Saad Moustafa Kamal Eldin Ibrahim Khalil , Gomaa Mohamed Saleh , Ewais Abdelrahman Ahmed , Alamir Maher Abobaker , Mahmoud Mohamed Shaban Hashem 
Published: October 2024

Abstract

BACKGROUND: Diabetes is one of the most important metabolic conditions responsible for left ventricular (LV) dysfunction including LV hypertrophy. Increased left ventricular mass (LVM) and left ventricular mass index (LVMI) are strong predictive factors of LV hypertrophy.
Aims: This study aims to illustrate the clinical significance of using echocardiography in detecting left ventricular hypertrophy in normotensive patients with type 2 Diabetes mellitus.
Materials and Methods: our study included one hundred participants who were distributed into two groups ;Group A which included normotensive patients with type 2 DM & Group B which included normotensive non-diabetic patients as a control group.
RESULTS: LVM values were significantly higher in diabetic cases than controls (187.11 ± 60.83 vs. 119.15 ± 41.87, p<0.001). As well as, LVMI values were significantly higher in diabetic cases than controls (96.64 ± 29.84 vs. 63.17 ± 20.38, p<0.001), Proportion of abnormal LVMI was higher in diabetic cases than controls (56% vs. 6%, p<0.001), There was a statistically significant positive correlation between LVM and several study parameters including mainly disease duration (r=0.369, p=0.008), FBS (r=0.478, p<0.001), 2HPP (0.400, p=0.004), HA1C (%) (r=0.589, p=0.003), LVEDD (r=0.790, p<0.001), LVESD (r=0.388, p=0.005), SWT (r=0.897, p<0.001), PWT (r=0.808, p<0.001), and LA (r=0.322, p=0.022).
CONCLUSION: Left ventricular mass is significantly higher in normotensive type 2 DM patients when compared to controls. LVM is a good marker of LVH among normotensive diabetics and is markedly correlated with DM control and duration.
Repeated monochromatic low-level red-light versus 0.01% atropine therapy for slowing myopia progression in children—a randomized controlled trial
Authors: Fu Aicun , Wang Weiqun , Zhong Mei , Shang Lili , Chang Minghang , Zheng Guangying , Jin Xuemin 
Published: October 2024

Abstract

Purpose
This research was designed to compare the effectiveness of repeated monochromatic low-level red-light (RMLRL) and 0.01% atropine in controlling myopia and axial elongation in myopic children.
Methods
We conducted a prospective, randomized, and single-blind controlled trial. A total of ninety-one children with myopia between the ages of 6 and 12 were selected for this study. These children had a cycloplegic spherical equivalent refraction (SER) ≥-5.00 D and ≤-0.75 D for each eye. The participants underwent random assignment in a 1:1 ratio between two experimental groups: the RMLRL group (n = 46, exposed to 650 nm red light passing through the pupil to the fundus, twice daily for 3 min with a minimum 4 h interval between each session) and 0.01% atropine group (n = 45, applied a single drop of 0.01% atropine bilaterally every night). The primary measured outcomes comprised alterations in SER and axial length (AL) after a duration of six months, while the secondary outcomes included changes in the subfoveal choroidal thickness(SFChT) and choroidal vessel volume (CVV).
Results
At the six-month follow-up, there were 45 children (97.8%) in the RMLRL group and 42 children (93.3%) in the 0.01% atropine group. The SER change was 0.24 ± 0.30 D compared to -0.29 ± 0.38 D (p < 0.001), and the change in AL was − 0.09 ± 0.14 mm compared to 0.15 ± 0.16 mm (p < 0.001) in the RMLRL and 0.01% atropine groups. The change in SFChT was 41.47 ± 34.27 um compared to 2.38 ± 16.69 µm (p < 0.001) in the RMLRL and 0.01% atropine groups. The CVV change was 0.01 ± 0.01 compared to 0.00 ± 0.01 (p < 0.001) in the corresponding two groups. No serious adverse events were reported in either the RMLRL or 0.01% atropine groups.
Conclusions
After six months of treatment, RMLRL had better effects than 0.01% atropine in preventing myopic progression and axial elongation among children with myopia in the central region of Mainland China.
Assessment the Contribution of the Major Quality Influencing Factors on the Measurements of TLS Scan
Authors: Mala Bakhtyar , Al-Shrafany Dleen Muhammed Salih 
Published: October 2024

Abstract

Surface qualities, range detectors, and measuring travel time are all major quality-influencing factors that affect the position accuracy of the measured point clouds by the terrestrial laser scanner (TLS). We conducted experimental tests using ScanStation2 TLS to investigate the accuracy of the scanned point clouds at various incident angles and ranges, and then examined the influence of different scanned surfaces on roughness and reflectivity. In this study, we selected four distinct surface properties from various materials (glass, steel, wood, ekoplast, and adhesive total station (TS) target), and painted three of these materials in five different colors to investigate the influence of colored surfaces on the reflected measured point clouds. During the experiment, approximately 250 scans were recorded, as the chosen materials were scanned at six scan angles (0, 15, 30, 45, 60, and 75) and ranges of 5m, 20m, 40m, and 60m. The experiment's findings show that, at various incident angles, smooth surfaces have a greater impact on the accuracy of the measured 3D points than do rough surfaces. Conversely, the total RMSEs of the red and black colors were greater than those of the blue, green, and white colors. At 0˚ incident angle, the TS target reflects approximately 20 cm closer to the TLS than the other materials; this difference decreases as the scan angle increases. In comparison to the other materials, the difference becomes about 2 mm at a 75˚ incidence angle. With the exception of the 30˚ scan angle of wood material, the maximum RMSE of rough materials is less than 1 cm, while the highest RMSE for smooth surfaces at 45˚ glass material is 4 cm. Moreover, the intensity of different materials varies significantly. For example, smooth materials like steel and glass have varying degrees of accuracy because of their respective properties. We have created a best-fit patch for all the scanned points to detect their deviation and characterize a suitable correction method. Due to the huge number of point clouds that resulted from those hundreds of scans at different conditions, it is very difficult and complex to directly apply a point position correction for all those complicated scanning conditions. Therefore, in this study, a comprehensive and intensive Python programming code was developed to correct a large number of point cloud positions within a standard processing time. This, in turn, contributes to the process's time and cost savings. Interestingly, this developed code is a novel procedure for correcting TLS point clouds at different measurement conditions, so it will be a good suggestion to add it to the Cyclone software.
Pseudocapsule Thickness is Positively Associated with Prognosis in Patients with Clear Cell Renal Cell Carcinoma
Authors: Xi Wei , Hou Yingyong , Hou Jun , Guo Jianming 
Published: October 2024

Abstract

Background
Tumour pseudocapsule shows plasticity, whose representative indicator- pseudocapsule thickness- was little studied in clear cell renal cell carcinoma (ccRCC).
Methods
We enrolled 1037 ccRCC patients who underwent surgery between 2006 and 2013 at our institution. The patients did not receive therapy before surgery and were confirmed to have a pathological pseudocapsule. The associations of pseudocapsule thickness with overall survival and progression-free survival were studied using multivariable Cox regression analyses. Patients were stratified using points of maximum separation. Influential factors were examined with logistic regression.
Results
The average thickness was 0.47 mm (median: 0.43, interquartile range: 0.28–0.6). The average follow-up was 92.1. In multivariable analyses, every 0.1-mm increase in thickness resulted in a decreased risk of death (hazard ratio (HR) 0.906, p = 0.011) but not progression (HR 0.948, p = 0.105). The estimated 10-year overall survival rates were 74.9%, 83.3%, 87.8%, 90.1% and 91.0%, respectively, and the 10-year progression-free survival rates were 69.6%, 76.6%, 80.8%, 83.1% and 84.1%, respectively, with the best cut-off value being approximately 0.37 mm. The results of logistic regression revealed that female sex (p < 0.001), age (p = 0.002), a higher neutrophil count (p = 0.011), large tumour size (p < 0.001) and necrosis (p = 0.011) were independently associated with a thin pseudocapsule (≤ 0.37 mm).
Conclusions
Pseudocapsule thickness is heterogeneous in clear cell renal cell carcinoma. Generally, increased thickness is associated with improvement in long-term survival. A pseudocapsule being 0.37mm or thinner is mostly influenced by both systematic and tumor-related parameters.