bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Forest Quality on Carbon Emission: A Study of China based on Environmental Kuznets Curve
Authors: Zhang Yuwen , Wu Xiaolan , Wang Shengyuan
Published: September 2024

Forest quality has a significant impact on carbon emissions of the economic system. This paper, based on an analysis of the Environmental Kuznets Curve (EKC) of Forest quality and carbon emission of economic systems, explores effective carbon emission reduction paths from the perspective of symbiosis between Forest quality and economic growth system. This paper carries out empirical analysis based on the provincial-level regional data of China and EKC panel data analysis for several major geographic regions in China. The correlation statistical test shows that the model considering Forest quality is more consistent with the test requirements. It is found that the overall EKC curve of China as a whole shows an inverted U-shape. In light of geographic differences, the EKC curve in the northwest also shows an inverted U-shape; it shows a U-shaped curve in North, Northeast, and East China. Meanwhile, in South Central and Southwest China, there is an approximately linear increasing curve. The data simulation of the symbiotic system of Forest quality and economic growth suggests that simultaneously increasing the proportion of forestry output value and the systematic carbon inhibition coefficient is the most effective pathway for carbon emission reduction. Choosing an appropriate carbon reduction pathway can contribute to the sustainable development of Forest quality and economic growth. The main research highlight of this paper is the application of the symbiotic system model to the EKC analysis of carbon emissions from the economic system with Forest quality.
Kreasi pertunjukan teater berbasis etnomatematika terintegrasi nilai-nilai islam di sekolah dasar
Authors: Nurmeta Irna Khaleda , Maula Luthfi Hamdani , Agustri Synta , Ramadhan Marisha Amelia , Husni Fauziah
Published: September 2024

This research is entitled Garap Performing Arts Ethnomathematics Theater Integrated with Islamic Values in Elementary Schools, which aims to describe the performance process that is part of the Art Work Degree program at SD Negeri Cicadas Cisaat Kab. Sukabumi. To explore the data, the Project Based Research method is used, namely research based on previous projects that have been carried out by the school and then become special notes for researchers to improve and package the project to be made.  The findings of the research consisted of four aspects, namely diagnosing the problem found that the previous performance was held in the classroom and packaged by dubbing. Planning was made by researchers by recommending Children's Theater performances that combine several branches of art (drama, music, dance). Implementation of the plan took the form of a partial and combined training process. The evaluation of the activity was the presentation of a Children's Theater performance in front of a public audience.
Kent Yurttaşlığı ve Yerel Katılım: SDÜ SBKY Öğrencileri Üzerinden Bir İnceleme
Authors: Negiz Nilüfer , Yalçın Özkan
Published: September 2024

Yurttaşlık, kent yurttaşlığı gibi antik dönemde ortaya çıkan kavramlar 18. 19. ve 20. Yüzyılda yaşanan sosyo-ekonomik değişimlere bağlı olarak geniş toplumsal kesimler için yasal düzlemde bir hak olarak görülmeye başlanmıştır. Yurttaşlık bir topluluğa veya ulusa ait olma duygusunu, paylaşılan bir kimlik olarak nitelendirilmiş ve ayrıca bu topluluğa aktif olarak katılma taahhüdünü kapsamıştır. Yurttaşlığın bir gereği olarak katılım, kişinin topluluğuyla ilişki kurmasını ve katkıda bulunmasını içerdiği için temel bir hak ve bileşen olarak görülmüştür. Çalışmada günümüzde kentsel yaşamın önemli bir parçası olarak kabul edilen katılım hakkının bilinirliği ve kullanımı yurttaşlık bağlamıyla ele alınmıştır. Çalışma bu yönüyle bir saha araştırmasını içerecek biçimde kurgulanmış ve hedef evren olarak da üniversite öğrencileri seçilmiştir. Nicel araştırma yönteminin kullanıldığı çalışmada SDÜ Siyaset Bilimi ve Kamu Yönetimi Bölümü öğrencilerinin yerel katılım mekanizmalarına yönelik algıları ve davranışları incelenmiştir. Çalışmanın sonucunda bu örneklemde yer alan gençlerin yerel katılım mekanizmaları konusunda eksikliklerinin olduğu, bazı katılım mekanizmalarını bilmedikleri görülmüştür. Ayrıca, bildikleri katılım mekanizmalarını da yeterli düzeyde kullanmadıkları verisine ulaşılmıştır.
How to analyze digital content?
Authors: Sánchez López Iván , Gifreu Castells Arnau , García Claro Jaime
Published: September 2024

In recent years there has been an exponential multiplication of media content, platforms and uses. After contextualizing the decline of the great theoretical currents of communication and exposing the linguistic bias of semiotics, this article proposes a review and characterization of the referential instruments and methodologies for the analysis of textual, multimodal and transmedia objects, with special emphasis on those of a connected digital nature. For this purpose, an integrative review of 75 documents that address the issue is carried out, leaving the final sample composed of the 25 most relevant for the purposes of the research. The epistemological-instrumental route goes from the Structural Analysis of the Story to Computer Vision, passing through Digital Ethnography and Multimodal Discourse Analysis. The conclusions include a sketch of an analysis instrument that synthesizes the study carried out, previously revealing the axiom put forward by several authors that there is no single invariable method for the study of this type of objects. The tendency, on the contrary, points to the atomization of research on specific aspects, rather than to a search for the generalization of results and the consolidation of theoretical bodies and universalizable techniques. It is also noted that quantitative turn and algorithmic programming for the study of digital objects open up a new analytical dimension with transhuman capabilities that is still far from being accessible to the international scientific community.
Nanoscale C–H/C–D mapping of organic materials using electron spectroscopy
Authors: Senga Ryosuke , Hagita Katsumi , Wang Hsiao-Fang , Mayumi Koichi , Miyata Tomohiro , Jinnai Hiroshi , Suenaga Kazu
Published: September 2024

Atomic-scale imaging and spectroscopy are essential for distinguishing hydrogen from deuterium, crucial in identifying structures and properties of organic materials with designed isotopic functionalities. However, conventional structural analysis techniques for materials containing both isotopes, likeneutron scattering, provide only averaged information across the beam area. In our study, we utilized vibrational spectroscopy with a monochromated transmission electron microscope, achievingdiscrete imaging of hydrogen and deuterium in organic polymers at single-nanometre resolution. This method's key advantage lies in its capability to distinguish between carbon-hydrogen (C–H) and carbon-deuterium (C–D) stretches by detecting slight differences in vibrational energy. The technique allowed for C–H/C–D mapping, which uncovered surface segregation of the deuterated polystyrene (dPS) component within a block copolymer film composed of dPS and poly(2-vinylpyridine). Moreover, it enabled the clear visualization of the spatial distribution of hydrogenated and deuterated polystyrene (hPS and dPS) on a molecular scale in a bulk block copolymer specimen containing both components.
Versatile and potent insecticide scavengers based on locust cell membrane-adapted mesoporous silicon microparticles to protect managed pollinators
Authors: Chen Jing , Huang Zuliang , Guo Jiakun , Lv Suhui , Gui Jie , Zhong Zhiyuan Zhong Zhiyuan , Deng Chao
Published: September 2024

Sustainable agriculture highly relies on pollinators which affect the production and diversity of around 75% of foodcrops worldwide. However, the population and fitness of pollinators are showing sharp declining trends for years. Exposure to insecticides especially during crop pollination together with lacking effective management method has been reported as a dominant factor. Here, we have developed versatile and potent insecticide scavengers based on locust cell membrane and tannic acid (TA)-coated mesoporous silicon microparticles (MTSM) to prevent pollinators from a broad-spectrum insecticides including organophosphorus, pyrethroids, and neonicotinoids. Leveraging the π-π stacking with TA and specific binding by the acetylcholinesterases, nicotine receptors of acetylcholine, or voltage-gated sodium channels on locust cell membrane, MTSM presented enormously high removal efficiency of various insecticides while minimum nonspecific clearance of favorable enzymes mainly exsisting in gastrointestinal system of bees. Notably, MTSM exhibited over 12 h residency in gastrointestinal tract of bumblebees to facilitate insecticide scanvenging, and could be almost entirly excreted from bees within 48 h, causing no death of bees even at a high concentration of 50 mg/mL. In microcolonies of bumblebee fed with insecticide-contaminated impatien pollen patties, MTSM revealed dose-dependent detoxicification capacity towards organophosphorus and neonicotinoids insecticides. In sharp constrast to complete death of bumblebees fed with triazophos at a dose of 98 ng/bee within 5 days, the survival rate of bumblebees was significantly elevated to 75% and 90% by MTSM at doses of 1.0 and 20 mg/mL within 10 days, respectively. Overall, MTSM combining the merits of good safety, facile construction, and efficient and broad-spectrum detoxification presents versatile and potent scavengers to protect managed pollinators from multiclass insecticides.
Spatial Pattern and Coupling Analysis of County Traffic Superiority and New Urbanization Levels: A Case Study of 88 Counties in Guizhou Province
Authors: Yao YAO , yang yuanyuan
Published: September 2024

The overall level of transportation infrastructure and the level of new urbanization are two coupled systems that complement each other. The balanced development of a region benefits from the efficient synergy of these two systems. Using methods such as the Gini coefficient and Lorenz curve, spatial autocorrelation and hotspot analysis, and models for evaluating traffic superiority and new urbanization levels, we analyzed the balance and spatial distribution characteristics of these two developments and their coupling coordination levels in 88 counties of Guizhou Province in 2020. The results indicate that the levels of traffic superiority and new urbanization are not high. Traffic superiority shows a "multi-core" ring differentiation, radiating outward from the advanced road nodes located in Guiyang, Zunyi, and Southeast Guizhou. The new urbanization level presents a "dual-core" spatial differentiation with the urban area of Guiyang as the main core, and the main urban area of Zunyi and Renhuai as the secondary cores. The overall balance of traffic superiority is better than that of new urbanization levels, but the balance of traffic superiority in type II areas is relatively low. The coupling coordination degree between traffic superiority and new urbanization levels in Guizhou Province is generally low. About 80.68% of the counties are in the periods of extreme incoordination and basic coordination, while the counties in the high coordination period are mainly concentrated in the economically better-off municipal (prefectural) seats and surrounding counties. In-depth exploration of the coupling coordination relationship between regional traffic superiority and new urbanization levels provides important insights for leveraging transportation support to promote rapid and balanced regional new urbanization development.
Activation of central cannabinoid type 2 receptors, but not on peripheral immune cells, is required for endocannabinoid-mediated neuroprotection in Parkinson´s disease
Authors: Ayerra Leyre , Abellanas Miguel Angel , Vidaurre Clara , Basurco Leyre , Tavira Adriana , Luquin Esther , Clavero Pedro , Mengual Elisa , Collantes Maria , Peñuelas Ivan , de Martin-Esteban Samuel Ruiz , Grether Uwe , Hillard Cecilia J , Romero Julian , Hervás-Stubbs Sandra , Aymerich Maria S.
Published: September 2024

Background
Neuroinflammation is a key feature of Parkinson´s disease (PD), a neurodegenerative disease for which there is no cure. The cannabinoid receptor type 2 (CB2R) is expressed by cells of the innate and adaptive immune systems. Inhibition of monoacylglycerol lipase increases the levels of the endocannabinoid 2-arachidonoylglycerol (2-AG), which is neuroprotective in an experimental model of PD. We hypothesize that the beneficial effect of MAGL inhibition with JZL184 is mediated by the activation of CB2R on specific immune cell populations.
Methods
Experimental parkinsonism was induced by chronic administration of MPTP and probenecid for 5 weeks in wild-type (WT), CB2R transgenic and knockout (KO) mice. Motor behavior and histological techniques were used to determine the status of the nigrostriatal pathway. Myeloid and lymphoid subpopulations and their TNFα+ production were analyzed by low cytometry in the striatum and ventral midbrain. To distinguish whether a central or peripheral CB2R activation is required for neuroprotection, mice were treated with the CB2R agonists JWH133 and RO304. In addition, WT mice were irradiated and transplanted with CB2R KO hematopoietic stem cells to generate chimeric animals lacking CB2R in the peripheral immune system. Finally, we analyzed the transcriptomic profile of the endocannabinoid system in midbrain microglia and astrocytes from PD patients.
Results
Parkinsonian mice experimented a specific increase in CD4+ T cell infiltration in the midbrain. The neuroprotective effect of JZL184 was accompanied by a reduction in CD4+ T cell infiltration, these effects were abolished in CB2R KO mice. CB2R expression was restricted to myeloid cells and lymphocytes, and increased in microglia under parkinsonian conditions. Administration of JWH133, but not RO304, exerted a neuroprotective and immunomodulatory effect similar to that of JZL184. Using chimeric mice, we demonstrated that central CB2R activation is required for neuroprotection. Transcripts related to 2-AG biosynthesis are downregulated in the midbrain microglia from PD patients.
Conclusions
Activation of CB2R in the brain prevents nigrostriatal degeneration, CD4+ T cell infiltration and TNFα production in the midbrain of parkinsonian mice. The reduced 2-AG signaling in microglia from PD patients suggests that activation of microglial CB2R may be an interesting strategy for the treatment of PD.
Clinical prognosis analysis of 54 pediatric patients with T-cell acute lymphoblastic leukemia
Authors: qi hai-xiao , kuai wen-xia
Published: September 2024

Background: T-cell acute lymphoblastic leukemia (T-ALL) is a rare and highly malignant neoplastic disease in children. Studying of its prognostic factors and clinical characteristics will bring certain reference value to clinical practice.
Procedure: The clinical data of 54 children with T-ALL admitted to our hospital were retrospectively analyzed, and the Kaplan-Meier method was used for analysis.
Results: The median survival time of the 54 children was 43.5 months. The complete remission rate after two courses was 90.74%, and the 3-year overall survival and disease-free survival rates were 81.48% and 77.78%, respectively. Ten(18.51%) of the 54 cases died, with six (11.11%) of them succumbing to recurrence. Univariate analysis revealed that age, gender, the initial count of white blood cells, remission status of day 19(D19) and day 35(D35), newly diagnosed lactate dehydrogenase levels, presence of a mediastinal mass, spleen infiltration, and adequacy of asparaginase treatment were statistically significant factors affecting the 3-year overall survival(OS) rate (P<0.05). Multivariate analysis revealed that age (P=0.004), D35 bone marrow remission (P<0.001), D35 MRD (P<0.001), and LDH (P=0.019) were independent risk factors influencing the 3-year os.
Conclusion: The overall efficacy of SCMC-ALL-2015(Shanghai Children's Medical Center-Acute Lymphoblastic Leukemia-2015) on pediatric T-ALL is good, and the death of a small number of children is mainly due to disease recurrence. Lactate dehydrogenase levels at the initial diagnosis, age, and remission status of D35 are independent risk factors.
Shock-induced perioperative complications in Gitelman syndrome: a case study and review of the literature
Authors: Peng Weijie , Zhang Xin , Qian Yiming , Gu Ruibin , Xie Siyuan , Yu Tianhe , Jie Ligang
Published: September 2024

Gitelman syndrome (GS) is an autosomal recessive disorder characterized by hypokalaemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria. Little research has been done on the association between GS and hemodynamic abnormalities. In the present case report, a 58-year-old female patient developed refractory vasodilatory shock after undergoing lumbar spine surgery and died after resuscitation, which was considered to be related to hemodynamic instability complicated by GS.
Odor exposure causes long-lasting effects on resting-state networks in the human brain
Authors: Kupers Ron , Dousteyssier Océane , Delforge Jérôme , Gonnot Vanessa , Kantono Kevin , Blerot Bernard , de Broqueville Quentin , Pêtre Arnaud , Dricot Laurence , Heinecke Armin
Published: September 2024

Most brain imaging studies on olfaction focus on short-term odorant stimuli, with few examining long-lasting odor exposure or its after-effects. This study utilized resting-state fMRI (rsfMRI) to investigate the effects of prolonged odorant exposure on brain activity and whether these effects persist post-exposure. Fourteen healthy females underwent two fMRI sessions on different days in a randomized order. Each session included rsfMRI scans before, during, and up to two hours after a 14-minute exposure to either lavender essential oil or a non-odorant control. Independent Component Analysis identified the salience network (SN) and default mode network (DMN) as the most consistent resting-state networks. A two-factorial ANOVA revealed significant time-varying interaction effects between SN and DMN. During odor exposure, functional connectivity (FC) within the SN increased, and a negative correlation with the DMN appeared, which intensified immediately after exposure. Two hours post-exposure, the FC between SN and DMN turned positive. These findings demonstrate that prolonged odorant exposure induces long-lasting brain effects detectable up to two hours afterward, suggesting new possibilities for exploring aromatherapy or odor exposure interventions on brain activity.
Exploration of health information needs of persons affected by complex cancers and evaluation of co-designed video-assisted health education.
Authors: Coyne Elisabeth , Winter Natalie , Carlini Joan , Robertson Julia , Halkett Georgia , Dieperink Karin
Published: September 2024

Purpose Persons with cancer and their families are given a range of complex information (written and verbal) to assist them in managing treatment and side effects at home. This study explored the health information needs of patients and family members and investigated whether video-assisted health education improved understanding of information for persons with complex cancers. Method A co-design framework with health consumers and clinicians was used to identify concepts and create videos. Qualitative interviews and thematic analysis of participant demographics explored the health information needs and acceptability of the videos. Persons affected by brain, head and neck and gastrointestinal cancer were included. Results Eleven interviews were conducted with patients and family members, aged between 39 to 82 years. The health literacy levels reported by participants highlighted the need for help with medical information and forms. Four themes were developed: sorting through information, acceptability of videos, balance of caring, and information presentation. Conclusion Information provided in different formats and tailored to meet the individuals’ health literacy levels can reinforce key points from the health professionals and improve health outcomes. Video-assisted health education improves the patients’ and families’ understanding of information and ability to make informed decisions regarding their cancer treatment and self-care at home. Digital resources may provide a way to improve the understanding of health information, although digital literacy levels influence access, but this requires further investigation.
Construction and Validation of a Combined Anoikis and Autophagy Prognostic Signature for Hepatocellular Carcinoma
Authors: Li Zengjun , wang hao , cui kai , he mingang , gao yang , ren bingbing , yan changsheng
Published: September 2024

Given the poor prognosis of patients with hepatocellular carcinoma (HCC), it is crucial to investigate possible new biomarkers to aid in prognostication and customised treatment. Accordingly, we analysed differentially expressed anoikis- and autophagy-related genes (DE-AARGs) associated with poor outcomes in actual cases of HCC. Analysis of differentially expressed genes (DEGs) was performed based on mRNA expression patterns and clinicopathological information found in the Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) database. Further validation of TCGA results was performed using the International Cancer Genome Consortium database. AARGs signatures were constructed by applying Univariate COX regression and the Least Absolute Shrinkage and Selection Operator method. We identified 13 AARGs, of which 9 showed significant associations with overall survival. Three AARGs (BIRC5, MAPK3, and BAK1) were selected to establish an AARGs signature. We assessed the prognostic capacity of the AARGs signature through various statistical methods. The molecular mechanisms underpinning this phenomenon were further studied using Gene Set Enrichment Analyses (GSEA). The prognostic ability of the signature was also examined in terms of clinical characteristics, immune landscape, immune checkpoint-blocking response, stemness, and chemotherapy response. Immunohistochemical staining was used to compare the protein expression levels of AARGs between normal liver tissue and HCC tissues. The high-risk group had higher tumour staging, shorter survival time, and worse prognosis than the low-risk group. In addition, high-risk patients showed inhibition of anoikis, a high autophagy index, and a suppressed immune system. The nomogram showed a strong prognostic capability for predicting overall survival in patients with HCC. With this study, a new AARGs-based signature has been developed to reliably predict patient prognosis for HCC.
T-Cell Exhaustion-Related Gene Signatures Predict Clinical Outcomes and Immunotherapy Response in Kidney Renal Clear Cell Carcinoma
Authors: Zou Chengyu , Huang Jiawen , Rao Zehui , Zhang Yida
Published: September 2024

T-cell exhaustion (TEX) is a crucial immune escape mechanism and a pathway of resistance in cellular immunotherapy, yet its prognostic role in kidney renal clear cell carcinoma (KIRC) remains unclear. This study analyzed 518 KIRC patients from the TCGA dataset, identifying TEX-related genes through Gene Set Variation Analysis (GSVA) and Weighted Gene Co-Expression Network Analysis (WGCNA). Using survival random forest and LASSO-Cox analyses, eight differentially expressed genes (RUFY4, NOD2, IL15RA, CXCL13, GBP5, DERL3, SPIB, and SLCO5A1) were selected to construct a TEX risk model. Functional analyses, including GO, KEGG, GSEA, CIBERSORT, and ssGSEA, explored the relationship between TEX risk scores and signaling pathways and immune cell infiltration. The IMvigor210 dataset evaluated the correlation between TEX risk scores and immunotherapy response, while single-cell data analysis and qRT-PCR validated the expression of a key TEX gene. The TEX risk model demonstrated accurate prognostic prediction for KIRC patients, serving as a new independent prognostic factor. GSEA results highlighted the enrichment of tumor proliferation, migration, and immunity functions within the model. TEX features were associated with immune cell infiltration and specific immune checkpoints, effectively predicting clinical responses to immunotherapy. Thus, TEX signatures are pivotal in clinical decision-making for KIRC, helping to distinguish patients and guide treatment strategies for maximum benefit.
Effects of different anesthesia methods on patients undergoing laparoscopic radical resection of rectal cancer: a retrospective study
Authors: He Xue , Li Lin , Luo Yonggang , Liu Min
Published: September 2024

To compare the effect of different surgical methods on the prognosis of patients with colon cancer. 360 patients undergoing laparoscopic radical resection of rectal cancer werei ncluded. Patients' general information, hospital moriality and surgical complications were recorded. The immunological indexes and inflammatory factor levels of patients were dynamically recorded before surgery, and at the first, third and fifth days after surgery. Compared with groups A and C, the intraoperative dosage of propofol, remifentanil and cisatracurium in group B was lower (p < 0.05), the number of vasoactive drug users and the incidence of postoperative chills were lower (p< 0.05), the probability of vomiting was lower in group B and group C; The cell counts of CD3 + T, CD4 + T, CD4/CD8 and NK in group B were higher than those in group A and C on day 1 and day 3 after surgery (p < 0.05), the CD3 + T, CD4 + T and NK cell counts of group C were higher than those of group A on the first and third days after surgery, while the IL-6, CRP, WBC and IFN-a counts of group B and C were lower than those of group A. Groups B and C had lower postoperative pain scores, lower use of postoperative analgesics, and shorter hospital times. General anesthesia combined epidural block can reduce postoperative immunosuppression and inflammatory response in patients with rectal cancer, and reduce intraoperative anesthetic drug dosage and adverse anesthesia reactions.
Effectiveness of a delegated primary care model in rural areas: design and methodology of a longitudinal observational study
Authors: Bräuer Julia , Lörzing Romina , Nagel Eckhard , Emmert Martin , Hofmann Reiner
Published: September 2024

Background: The shortage of general practitioners (GPs) in Germany, particularly in rural areas, is a pressing issue that requires innovative and sustainable solutions. One promising approach is the integration of trained medical assistants to support GPs by handling specific tasks, thus enhancing the efficiency of healthcare delivery. Delegated home visits can be carried out by healthcare professionals (HPs) with a well-defined range of tasks.
Methods: This quasi-experimental, non-randomised longitudinal observational study runs from January 2023 to June 2025. The study participants are patients cared for by participating GPs, selected based on defined inclusion criteria, who receive regularly delegated home visits. Health-related quality of life (HRQoL) and satisfaction is assessed at three data collection points (t0 as baseline before starting the intervention, t1 after the first testing and data collection phase, and t2 after the second data collection phase). For assessing the HRQoL, we use the Short-Form-Health Survey (SF-12), and satisfaction is being measured using the patient satisfaction questionnaire ZUF-8. These parameters, as well as the continuously collected parameters (kilometers driven, travel and setup time), are analysed statistically (descriptive statistics, paired t test, Wilcoxon test, ANOVA). At t1 and t2, focus group interviews are conducted with the assistants on their satisfaction. They allow to identify the potential for concept improvement by qualitative content analysis.
Discussion: The "VERSORGT am ORT" (VaO, engl. “PROVIDED on SITE”) project aims to optimise healthcare by using scarce resources in a more efficient way, maintaining patient-professional trust, and extending delegation. It seeks to implement care plans with minimal location changes and generate real-world evidence. Due to geographical and policy limitations, the study will have comparatively few participants and will use a repeated measures design instead of a control group to assess patient HRQoL and satisfaction over time. Changes in HRQoL cannot be directly linked to the new care model due to unclear causalities. Mergenthal et al. reported that 59 % of GPs in rural areas delegate home visits to healthcare professionals, saving time. The VaO project aims to further relieve GPs, increasing efficiency without compromising care quality.
Trial registration: DRKS00033915 – Registration Date 19/03/2024
Urinary Biomarkers for Disease Detection
Authors: Matov Alexandre
Published: September 2024

The current healthcare system relies largely on a passive approach toward disease detection, which typically involves patients presenting a “chief complaint” linked to a particular set of symptoms for diagnosis. Since all degenerative diseases occur slowly and initiate as changes in the regulation of individual cells within our organs and tissues, it is inevitable that with the current approach to medical care we are bound to discover some illnesses at a point in time when the damage is irreversible and meaningful treatments are no longer available. There exist organ-specific sets (or panels) of nucleic acids, such as microRNAs (miRNAs), which regulate and help to ensure the proper function of each of our organs and tissues. Thus, dynamic readout of their relative abundance can serve as a means to facilitate real-time health monitoring. With the advent and mass utilization of next-generation sequencing (NGS), such a proactive approach is currently feasible. Because of the computational complexity of customized analyses of “big data”, dedicated efforts to extract reliable information from longitudinal datasets is key to successful early detection of disease. Here, we present our preliminary results for the analysis of healthy donor samples and drug-naïve lung cancer patients.
Learning curve for double-port video-assisted thoracoscopic lung segmentectomy: a propensity score matching study
Authors: Yan Bixin , Yao Xiao , Zhao Zhihong , Sun Tianhao , Zhao Yiming , Zou Wenbiao , Wu Duofu , Chang Hao
Published: September 2024

Objective To determine the learning curve for double-port video-assisted thoracoscopic (VATS) lung segmentectomy performed by the same surgical team in our center.
Methods We retrospectively collected clinical data from 193 patients who underwent double-port video-assisted thoracoscopic lung segmentectomy from March 2017 to March 2023. The operative time (OT) was analyzed using the cumulative sum (CUSUM) method, and two stages of the learning curve were obtained. Propensity score matching (PSM) was performed for age, sex, underlying disease, and single-segment resection via radius matching. The OT, estimated amount of intraoperative blood loss, and other complications were analyzed.
Results We generated a graph of the CUSUM of the OT and found that the learning curve could be differentiated into two stages: the learning stage (1st to 95th surgery) and the proficiency stage (96th to 193rd surgery). Before PSM, there were significant differences in the OT, number of staples used, extent of lymph node station cleaning, amount of drainage on the day of surgery, amount of drainage on the first postoperative day, estimated amount of intraoperative blood loss, and length of hospital stay after surgery. There were no significant differences in the average amount of drainage 3 days after surgery, postoperative tube time, or number of intraoperative revolutions. However, after PSM, there were significant differences in the OT, number of staplers used, number of lymph node stations removed, amount of drainage on the day of surgery, and amount of drainage on the first postoperative day. There were no significant differences in the estimated amount of intraoperative blood loss, length of hospital stay after surgery, average amount of drainage for 3 days after surgery, postoperative tube time, or number of intraoperative revolutions.
Conclusion In our center, the learning curve for double-port video-assisted thoracoscopic lung segmentectomy transitions from the learning stage to the proficiency stage when the number of surgical cases reaches 95. There were significant differences in the OT, number of staplers used, number of lymph node stations removed, amount of drainage on the day of surgery, and amount of drainage on the first postoperative day.
[Can prostate biopsy be replaced?] Feasibility of mpMRI combined with 18F-PSMA PET/CT in the diagnosis of prostate cancer
Authors: Yang Yunkai , Zhao Changfeng , Wang Zhida , Miu Jia , Zhang Xinyu , Zhang Qi , Qi Xiaolong , Bai Yuchen , Zhang Dahong
Published: September 2024

Objective
To investigate whether multiparameter magnetic resonance imaging (mpMRI) combined with 18F-Prostate-specific membrane antigen (PSMA) PET/CT can replace prostate biopsy in the diagnosis of prostate cancer.
Materials and methods
This is a prospectively Three-arm Clinical Trial which enrolled 150 patients with suspected prostate cancer (PI-RADs ≥ 3 score) from Zhejiang Provincial People's Hospital between September 2020 to January 2023. Patients were screened and divided into three cohorts to undergo the PSMA-PET procedure, transperineally MRI-targeted biopsy (TB-TRUS), and conventional transrectal ultrasound-guided systematic biopsy (SB-TRUS). All patients required radical prostatectomy according to the treatment procedure and perioperative information was collected. Comparison of baseline patient characteristics, detection and omission rates for various screening methods, and perioperative information between the three groups.
Results
A total of 109 patients were included in this study. The median age was 68.4 (64.0-73.5) years old. The median PSA was 13.0 (7.1–15.0) ng/ml, the median prostate volume was 42.0 (24.6–53.8) ml, and the median PSA density (PSAD) was 0.36 (0.19–0.47) ng/ml2. 48 patients had PI-RADS scores of 3, 41 patients had scores of 4, and 20 patients had scores of 5. The median SUVmax of 18F-PSMA PET/CT was 15.41 (12.18–17.58). There were no significant differences in baseline characteristics among the three cohorts. The detection rate of prostate cancer in the Sa cohort was much lower than that in the Pa and Ma cohorts (P<0.001), and the missed diagnosis rate in the Sa cohort was much higher than that in the other two groups (P<0.001). The Intraoperative bleeding, surgery time and Hospitalization days in the Pa cohort were much higher than those in the other two cohorts (P<0.001).
Conclusion
MpMRI combined with 18F-PSMA PET/CT has high accuracy in the diagnosis of prostate cancer. For patients with highly suspected localized prostate cancer, radical prostatectomy without biopsy is safe, and can be attempted on the premise of adequate communication.
Predictive Value of the Systemic Immune-Inflammation Index for Periprocedural Complications in Flow Diverter Treatment for Patients with Intracranial Aneurysms
Authors: Huang Jiwan , Huang Yaxian , Feng Xin , Huang Chi , Huang Mengshi , Wen Zhuohua , Xu Anqi , Ge Runze , Yuan Hao , Shi Hongyu , Ma Gengwu , Li Can , Lin Jiancheng , Yi Ruizhe , Hu Yuqi , Jin Yuheng , Liang Shuyin , Bi Yiming , Su Shixing , Zhang Xin , Li Xifeng , Duan Chuanzhi
Published: September 2024

Flow-diverter devices (FDs) are effective in treating intracranial aneurysms (IAs) but carry substantial periprocedural risks, particularly ischemic complications. This study aimed to determine if elevated Systemic Immune-Inflammation Index (SII) can independently predict these risks and assess the impact of age and dual antiplatelet therapy on this association. We conducted a retrospective analysis of patients treated with FDs between February 2016 and August 2023, using blood samples taken within six days before surgery to calculate SII. Logistic regression and decision tree analyses assessed the link between SII and periprocedural complications, with subgroups exploring influencing factors. Multivariable analysis identified high SII as an independent predictor of periprocedural complications (OR=5.306, 95% CI: 1.367-18.455; P=0.009). The decision tree model confirmed SII > 0.437 as a critical threshold. Subgroup analysis showed a pronounced association of SII with periprocedural complications in patients ≥65 years (OR=36.979, 95% CI: 2.103-650.134; P=0.014) and in those on clopidogrel therapy (OR=16.921, 95% CI: 2.733-104.746; P=0.002). An elevated Systemic Immune-Inflammation Index (SII) >0.437 significantly correlates with increased periprocedural complications (6.5% vs. 1.8%, P=0.017). Although not statistically significant, higher SII is associated with a greater rate of ischemic events (3.9% vs. 0.9%). Elevated preoperative SII independently predicts periprocedural complications, particularly ischemic events, in patients undergoing FDs treatment for intracranial aneurysms. This association is especially significant in older patients and those on clopidogrel therapy.
Trial Registration: ClinicalTrials.gov (NCT06446778). Registered on May 22, 2024.
GDF15 propeptide promotes bone metastasis of castration-resistant prostate cancer by augmenting the bone microenvironment
Authors: Yamamichi Gaku , Kato Taigo , Arakawa Noriaki , Ino Yoko , Ujike Takeshi , Nakano Kosuke , Koh Yoko , Motoyama Yuichi , Outani Hidetatsu , Myoba Shohei , Ishizuya Yu , Yamamoto Yoshiyuki , Hatano Koji , Kawashima Atsunari , Fukuhara Shinichiro , Uemura Hiroji , Okada Seiji , Morii Eiichi , Nonomura Norio , Uemura Motohide
Published: September 2024

Background
Bone metastasis (BM) is a common and fatal condition in patients with castration-resistant prostate cancer (CRPC). However, there are no useful blood biomarkers for CRPC with BM, and the mechanism underlying BM is unclear. In this study, we investigated precise blood biomarkers for evaluating BM that can improve the prognosis of patients with CRPC.
Methods
We comprehensively examined culture supernatants from four prostate cancer (PCa) cell lines using Orbitrap mass spectrometry to identify specific proteins secreted abundantly by PCa cells. The effects of this protein to PCa cells, osteoblasts, osteoclasts were examined, and BM mouse model. In addition, we measured the plasma concentration of this protein in CRPC patients for whom bone scan index (BSI) by bone scintigraphy was performed.
Results
A total of 2,787 proteins were identified by secretome analysis. We focused on GDF15 propeptide (GDPP), which is secreted by osteoblasts, osteoclasts, and PCa cells. GDPP promoted the proliferation, invasion, and migration of PC3 and DU145 CRPC cells, and GDPP aggravated BM in a mouse model. Importantly, GDPP accelerated bone formation and absorption in the bone microenvironment by enhancing the proliferation of osteoblasts and osteoclasts by upregulating individual transcription factors such as RUNX2, OSX, ATF4, NFATc1, and DC-STAMP. In clinical settings, including a total of 386 patients, GDPP was more diagnostic of BM than prostate-specific antigen (PSA) (AUC = 0.92 and 0.78) and the seven other blood biomarkers (alkaline phosphatase, lactate dehydrogenase, bone alkaline phosphatase, tartrate-resistant acid phosphatase 5b, osteocalcin, procollagen I N-terminal propeptide and mature GDF15) in patients with CRPC. The changes in BSI over time with systemic treatment were correlated with that of GDPP (r = 0.63) but not with that of PSA (r = -0.16).
Conclusions
GDPP promotes a vicious cycle in the BM microenvironment and is a novel blood biomarker of BM in CRPC, which could lead to early treatment interventions in patients with CRPC.
Exploring the Role of Refined White Matter Segmentation in Head Finite Element Models for Studying Repetitive Subconcussive Head Impacts
Authors: Bouvette Véronique , Guay Samuel , Beaumont Louis , Petit Yvan , Vinet Sophie-Andrée , Wagnac Eric
Published: September 2024

Head finite element models (hFEMs) are instrumental in understanding injury mechanisms in head impacts. Personalizing hFEMs is crucial for capturing individualized brain responses, with brain volume scaling proving effective. However, the role of refined white matter (WM) segmentation in hFEMs for studying repetitive subconcussive head impacts (rSHIs) in American football remains underexplored. This study evaluated the effect of refined WM segmentation of 34 WM segments on responses variability due to brain volume variations, using peak maximum principal strain (95MPS) and strain rate (95MPSr) as injury predictive metrics. Data from diffusion-weighted imaging (DWI) of 21 Canadian varsity football players were utilized to personalize 21 hFEMs. Simulating four different head impacts, representing 50th and 99th percentile resultant accelerations in frontal and top-right directions, refined WM segmentation better captured variability of strain responses compared to baseline segmentation. Up to 94.76% of 95MPS and 99.05% of 95MPSr responses were significantly different across refined WM segments for players, compared to a maximum of 12.86% of responses with baseline segmentation. This highlights the necessity of refined WM segmentation for capturing player-specific responses. Both impact direction and intensity influenced strain response variations, with lower intensity and frontal impacts showing greater player-specificity. These findings emphasize the importance of refined WM segmentation in hFEMs for comprehensively evaluating strain responses under rSHI. Detailed WM segmentation in hFEMs is crucial for comprehensive injury assessment, enhancing the alignment of hFEMs with imaging studies evaluating changes in WM integrity across segments. The simple and straightforward method presented herein to achieve player-specific strain response is promising for future rSHI studies.
The 1,7-malaria reactive community-based testing and response (1,7-mRCTR) approach in Tanzania: a cost-effectiveness analysis
Authors: Tampi Radhika Pradip , Wang Duoquan , Abdulla Salim , Mahende Muhidin Kassim , Gavana Tegemeo , Msuya Hajirani M , Kuwawenaruwa Augustine , Mihayo Michael , Brown Felix , Msuya Hajirani , Anthony Wilbald , Bruxvoort Katia , Kihwele Fadhila , Chila Godlove , Chang Wei , Castro Marcia , Ning Xiao , Chaki Prosper P , Mlacha Yeromin P , Cohen Jessica , Menzies Nicolas Alan
Published: September 2024

Background: Reactive case detection (RACD) for malaria control has been found effective in low transmission settings, but its impact and cost-effectiveness in moderate-high transmission settings are unknown. We conducted an economic evaluation alongside an empirical trial of a modified RACD strategy (1,7-mRCTR) in three high malaria transmission districts in Tanzania.
Methods: The costs and cost-savings associated with the intervention to passive case detection alone were estimated, and a simulation model was utilized to assess cost-effectiveness in terms of incremental cost-effectiveness ratios (ICERs) for multiple endpoints. Empirical cost data were collected using household surveys. Only intervention-related programmatic costs were included in this analysis. The incremental costs of the intervention were calculated from under a societal perspective. Costs are reported in 2022 US dollars.
The proximal health effects of the intervention were calculated using trial data and malaria registers. OpenMalaria, an open-source microsimulation model, was used to simulate unobserved and distal health effects of the intervention. The model was fit to baseline malaria prevalence and estimated percentage point decline in malaria prevalence from the corresponding impact evaluation.
Cost-effectiveness endpoints include the incremental cost per: (i) person treated, (ii) additional malaria case detected using a combination of passive and reactive case detection, (iii) incident malaria case averted, (iv) malaria death averted, and (v) DALY averted. Propagated uncertainty was assessed via 2nd-order Monte Carlo simulation, including bootstrapping of empirical data distributions. Incremental costs per DALY averted were compared to a willingness-to-pay threshold based on estimated opportunity costs of healthcare spending in Tanzania.
Results: The programmatic cost of the 1,7-mRCTR intervention was $5327 per 1000 population. The combination of reactive and passive case detection in the intervention arm resulted in an additional 445 malaria cases detected per 1000 compared to passive detection alone, yielding an incremental cost per additional case detected of $11.97. For distal health outcomes, the ICER associated with the 1,7-mRCTR intervention is $14,887 per death averted and $163 per DALY averted.
Conclusions: The 1,7-mRCTR intervention appears to be cost-effective under a willingness-to-pay threshold of $417 per DALY averted, showing that modified RACD strategies can provide value for money in high transmission settings.
Engaging Australian adolescents to prevent non-communicable diseases: participation their way
Authors: Partridge Stephanie R. , Mandoh Mariam , Todd Allyson R. , Wardak Sara , Mautner Dominik , Yan Fulin , Phongsavan Philayrath , Redfern Julie , Cheng Hoi Lun , Lee Annabel , Fang Jie , Bower Marlee , Donohoe-Bales Amarina , Mihrshahi Seema , Raeside Rebecca
Published: September 2024

Background
Non-communicable diseases (NCDs) are a major global health burden, particularly affecting adolescents due to preventable risk factors. However, adolescents are frequently overlooked in NCD prevention efforts that directly impact them. This study aimed to evaluate adolescents' perspectives, experiences, perceptions, and preferences regarding their participation in NCD prevention activities.
Methods
A mixed-methods study design comprising cross-sectional survey and focus groups, underpinned by community-based participatory research approach. Participants were 13–18 years and residing in Australia. Methodological integration through merging quantitative and qualitative data was employed. A weaving approach through narrative was used to report the findings. Adolescent researchers were actively engaged throughout all phases.
Results
501 survey participants (mean 16.0 years, SD 1.2) and 19 focus group participants (mean 17.0 years, SD 0.9) contributed to this study. Mental health disorders were identified as the most significant health concern. Those with prior volunteer experience showed greater engagement in health-promoting activities. Participants recognised their pivotal role in NCD prevention, highlighting ‘influence’ as crucial for health improvements. They emphasised the importance of visibility, flexibility, and authenticity in engagement methods. Despite a strong willingness to participate in future NCD prevention activities, participants cited barriers such as limited opportunities.
Conclusion
This study highlights the importance of adolescent involvement in NCD prevention and suggests strategies to overcome participation barriers. Recommendations include promoting meaningful engagement, improving accessibility, and fostering collaboration with decision makers. These insights are crucial for guiding future efforts to tackle NCD challenges among adolescents.