bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-parametric MRI-based Peritumoral Radiomics for Stage IIA and IIB Classification of Cervical Cancer：A Multicenter Study
Authors: Wang Ying , Liu Weixiao , Chen Yulian , Wang Fei , Liang Xiaoyun , Zhang Xiao , Fang Jin
Published: August 2024

Objective: The aim of the study is to establish a multiparametric MRI (mpMRI)-based peritumoral radiomics nomogram for preoperatively predicting IIA and IIB classification of cervical Cancer preoperatively.
Methods: 208 patients with histologically confirmed cervical cancer from three institutions were enrolled in this study. All the cases were randomly divided into the training cohort (n=145) and the validation cohort (n=63). The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. The independent-sample t test and the Chi-squared test were conducted to assess the significance of clinical factors between the training cohort and the validation cohort. The Pearson correlation coefficient analysis and recursive feature elimination algorithm were adopted successively to obtain the well-representative features. Different classifiers were compared to develop the optimal radiomics signature across 5-fold cross validation. The calibration curves and decision curve analysis were conducted to evaluate the clinical utility of the optimal model. The radiomics model was constructed using logistic regression.
Results: The peritumoral radiomics models were superior to the intratumoral radiomics models, regardless of single sequence model or fusion model (all P <0.001*). DWI-based peritumoral radiomics model performed best with the AUCs of 0.975 (0.965−0.983) and 0.899 (0.880−0.916) in the training and validation cohort, respectively. There was no significant difference between the validation AUCs of DWI-based and fusion peritumoral radiomics model (0.899 vs. 0.895, P=0.566). In addition, 3 pixel peritumoral regions of radiomic signatures have a much better discrimination performance in distinguishing IIA and IIB stage by comparing the 2,4,5 pixels extension surrounding the tumor.
Conclusion: MRI-based radiomics model from peritumoral regions of cervical cancer outperformed radiologists for the preoperative diagnosis of IIA and IIB stage, which could provide a noninvasive and reliable way of individualized treatment plans for patients with cervical cancer.
Frailty and long-term outcomes in patients admitted to intensive care after surgery: a retrospective multicentre cohort study
Authors: Ueno Ryo , Chan Rachel , Ling Ryan Ruiyang , Slack Ryan , Lussier Sandra , Jones Daryl , Pilcher David , Subramaniam Ashwin
Published: August 2024

Purpose
As the global population ages and older patients undergo surgery, understanding the association between frailty and post-operative outcomes is crucial to informed decision-making and patient care. There is a lack of research assessing the association between frailty and long-term outcomes in patients admitted to intensive care units (ICUs) post-operatively.
Methods
We conducted a multicentre retrospective cohort study using Australian and New Zealand Intensive Care Society Adult Patient Database, linked with the Australian National Death Index. Adults aged ≥ 16 years admitted to the 175 ICUs in Australia between January 1st, 2018, and March 31st, 2022, following surgery were included. Frailty was assessed using the Clinical Frailty Scale (CFS), and patients with CFS ≥ 5 were considered frail. The primary outcome was survival time up to four years after ICU admission. Mixed-effects Cox regression models were used for adjusted analyses.
Results
Of 222,509 patients included, 14.1% were frail. Patients with frailty had shorter overall survival time (median: 16 vs 21 months) and lower survival rates at one, two, three, and four years compared to patients without frailty. After adjusting for confounders, frailty was associated with a shorter time to death (HR: 2.30, 95%-CI: 2.24–2.37). This association was consistent across sensitivity analyses and subgroups, including elective vs. emergency surgery, age groups, and various surgical categories. The association was more pronounced in younger patients (< 65 years), those undergoing elective surgery, and patients without treatment limitations.
Conclusions
In this multicentre study, frailty was associated with worse long-term outcomes amongst post-operative ICU patients. The trend was concordant across all subgroups.
Effects of mixed simulations-based interprofessional education in nursing students: A quasi-experimental study
Authors: Zhuo Yi-shang , Yang Shuai , Yang Qiao-hong , Dou Chun-xia , Liu Peng
Published: August 2024

Background: Mixed simulations-based interprofessional education provides opportunities for students of different majors to cooperate in simulated clinical scenarios. The purpose in this study was to investigate whether interprofessional mixed simulations may be helpful in teaching.
Methods: A quasi-experimental design with assessments conducted before and after the activity. 46 students were devided into 6 groups. Each group of students studied according to the mixed simulation sequence of case-based learning-virtual simulation-high-fidelity simulation. Effects were measured based on the Student Satisfaction and Self-Confidence in Learning Scale, Nurses Clinical Reasoning Scale, Chinese version of Assessment of Interprofessional Team Collaboration in Student Learning Scale, and Instructional Test Questionnaire before and after mixed simulations-based interprofessional education. The Wilcoxon test was used for statistical analysis, and α=0.05 revealed statistical significance.
Results: Significant improvements were shown in pre-and post-test total scores on the theory test, learning satisfaction, self-confidence, clinical reasoning ability, and mean item scores on overall interprofessional collaboration.
Conclusions: Mixed simulations-based interprofessional education may improve the clinical reasoning ability, interprofessional cooperation ability, learning satisfaction, and self-confidence of students.
RNA-binding protein PCBP1regulated dry eye disease via ferroptosis
Authors: Yang Li , Hu Shengjia , Yu Pingping , Chen Muzhi , Wang Xinchang
Published: August 2024

Background
Dry eye disease (DED) is a medical condition which is characterized by a wide range of symptoms and clinical signs related to insufficient or poor-quality of tears. In this study, we investigated a potential protein and related mechanisms involved in DED process.
Methods
Bioinformatics technology was conducted to find potential protein. PCR and Elisa assay were performed to detect gene and protein level in the tear samples collected from patients. Ex vivo DED model was built by hyperosmotic stress‑induced cell model and knockdown of aimed gene was achieved by lentivirus vector-mediated shRNA. CCK8 assay and flow cytometry was conducted to detect cell viability and apoptosis. Western blot was performed to detect oxidative stress-related proteins. Then ROS and iron level within cells were also detected by assay kit.
Results
The expression of PolyC-RNA binding protein 1 (PCBP1) of tear samples was higher in DED patients compared with non-DED controls both in gene and protein level. In ex vivo DED model, PCBP1 could decrease corneal epithelial cell proliferation and increase cell apoptosis. Moreover, PCBP1 also decreased oxidative stress-related protein level as well as increased ROS and iron level within cells.
Conclusion
PCBP1 could influence dry eye disease via ferroptosis by regulating cell viability and oxidative stress process.
AGD1/USP10/METTL13 complexes enhance cancer stem cells proliferation and diminish the therapeutic effect of docetaxel via CD44 m6A modification in castration resistant prostate cancer
Authors: Wang Hong , Cui Chunli , Li Weiyi , Wu Hui , Sha Jianjun , Pan Jiahua , Xue Wei
Published: August 2024

Background: Most patients with prostate cancer inevitably progress to castration-resistant prostate cancer (CRPC), at which stage chemotherapeutics like docetaxel become the first-line treatment. However, chemotherapy resistance typically develops after an initial period of therapeutic efficacy. Increasing evidence indicates that cancer stem cells confer chemotherapy resistance via exosomes. This study demonstrated that AGD1, derived from prostate cancer stem-like cells, enhances the stemness of prostate cancer cells and reduces the therapeutic effect of docetaxel in CRPC.
Methods: Quantitative real-time PCR (qPCR) was employed to determine the expression levels of AGD1 and METTL13 mRNAs in CRPC-like cells and exosomes. Protein expression levels were examined using Western blots and dot blots. The potential functions of AGD1 and METTL13 in CRPCs were investigated through CCK-8, Transwell, EDU incorporation assays, Annexin V-FITC/PI staining, and sphere formation assays. To uncover the underlying mechanisms of AGD1, RNA pull-down assay, RIP, Co-Immunoprecipitation (Co-IP), mass spectrometry (MS), and Methylated RNA immunoprecipitation (MeRIP) were performed. The effects of AGD1 and METTL13 on CRPC development and metastasis under docetaxel treatment were analyzed using a xenograft mouse model, an organoid model and liposomal-chitosan nanocomplex drug delivery systems. Additionally, liposomal-chitosan nanocomplex drug delivery systems were designed to explore AGD1's role in regulating docetaxel treatment resistance in CRPC.
Results: AGD1 expression was upregulated in CRPC-like cells and exosomes. Downregulating AGD1 enhanced the sensitivity of CRPCs to docetaxel treatment by inhibiting their stemness, with the reverse also being true. RNA pull-down, combined with mass spectrometry (MS), Co-IP, and RIP assays, demonstrated that AGD1 binds to METTL13 and USP10, forming a complex that facilitates METTL13 protein degradation through USP10-induced ubiquitination. MeRIP assays revealed that METTL13 transcriptionally controls the mRNA decay of CD44 via m6A methylation. Additionally, this process activates the pSTAT3/PI3K-AKT signaling pathway. Organoid models and liposomal-chitosan nanocomplex drug delivery systems showed that reducing AGD1 expression enhances the therapeutic effect of docetaxel in CRPC.
Conclusions: AGD1 mediates the stemness and apoptosis of PCSCs and promotes docetaxel treatment resistance by enhancing tumor growth and metastasis through USP10/METTL13-mediated CD44 mRNA decay in CRPC.
Does Capsulotomy in Closed Reduction of Femoral Neck Fractures Decrease Incidence of Avascular Necrosis?
Authors: Hamdy Mohamed Salama , Sabry Ahmed O. , Abdelazim Mahmoud , Ahmed Rana Ali , Morrah Ahmed , Eldin Alaa Eldin Mohy , Ghanem Mohamed
Published: August 2024

Background: Femoral neck fractures are commonly encountered injuries resulting from high-energy or low-energy indirect trauma. Healing of these fractures is often complicated by avascular necrosis (AVN) or non-union of the femoral head. This study aims to investigate the impact of performing capsulotomy before closed reduction and internal fixation on the incidence of complications and functional outcomes.
Methods: This randomized controlled trial allocated participants into two groups: the capsulotomy group (Group A) and the no capsulotomy group (Group B). We included skeletally mature patients with femoral neck fractures scheduled for urgent surgery within 48 hours. Both male and female patients of any Garden classification, aged 18-55 years, were included.
Results: Forty patients were randomized equally into Group A and Group B. The mean age was 37.35 ± 11.8 & 36.65 ± 12.4 years respectively. Seventy percent of patients sustained high-energy trauma, while thirty percent sustained low-energy trauma. Group B had significantly lower intraoperative blood loss and shorter operative times compared to Group A. However, Group A showed significantly higher Harris hip scores, indicating better functional outcomes. Additionally, Group A had a significantly lower incidence of complications, including AVN and non-union. Regarding fracture-to-surgery time, 18 patients were operated upon after 24 hours and 22 before 24 hours. Delays were due to associated fractures (2 patients), medical comorbidities (12 patients), and presentation after 48 hours of trauma (4 patients).
Conclusion: Our findings suggest that capsulotomy before internal fixation significantly reduces the risk of non-union and AVN. Furthermore, it is associated with improved functional outcomes, as evidenced by higher Harris hip scores in the capsulotomy group.
Assessment and Predictive Analysis of Health Professions Students' Proficiency in Health Economics and Pharmacoeconomics in Southwest China: A Cross-Sectional Study
Authors: Yang Jian , Wei Quanzhi , Yang Xin , Jiao Jingyi , Yang Zaixian , Li Fan
Published: August 2024

Background: This study assesses and predicts the proficiency of health professions students in health economics and pharmacoeconomics in Southwest China, focusing on their knowledge, attitudes, and educational needs.
Methods: A cross-sectional study was conducted from July to October 2023, involving medical and pharmaceutical programs across universities in Sichuan, Chongqing, Guizhou, and Yunnan. Data on students' knowledge, attitudes, and proficiency were captured using a structured questionnaire. Advanced statistical methods, including descriptive analysis, ANOVA, regression analysis, PCA, and Spearman correlation heatmaps, were employed for data analysis using IBM SPSS and Python. The sample consisted of 781 students, with the survey facilitated via the Questionnaire Star platform.
Results: The survey revealed moderate comprehension of health economics and pharmacoeconomics among 781 health-related students, with an average knowledge score of 2.9. The majority were pharmacy students (45.84%) and aged 21-24 years (65.81%) with a significant female majority (64.92%). Academic year significantly influenced understanding, while gender differences were minimal. Spearman correlation indicated a strong linkage (0.78) between Supply and Demand and Cost Effectiveness, with minimal correlations between knowledge and attitudes towards the educational importance of health economics. Multiple regression highlighted the impact of gender and academic progression on Supply and Demand comprehension and the influence of knowledge levels on educational attitudes. PCA indicated the complex structure of knowledge and attitudes.
Conclusions: The study highlights moderate knowledge levels in health economics among health professions students in Southwest China, suggesting the need for educational enhancements that consider gender and academic stages. These insights are essential for developing comprehensive educational frameworks to prepare future healthcare professionals for economic decision-making in healthcare.
The Relationship Between Physical Activity and Depression Among Middle-aged and Elderly Chinese: A Longitudinal Study
Authors: Yang Juxiang , Zheng Xi , Wang Yi , Wang Hongchu , Song Gang
Published: August 2024

Objective: This study aims to discuss the association between physical activity and the risk of depression using cross-sectional and longitudinal data respectively, in order to determine whether physical activity serves as a protective or risk factor for depression.
Methods: A total of 3,564 eligible middle-aged and elderly individuals from the China Health and Retirement Longitudinal Study (CHARLS) were included. Cross-sectional data from 2020 were analyzed to examine the dose-response relationship between physical activity and depression. Group-based trajectory model was used to identify trajectories of physical activity from 2011 to 2020, and multivariable logistic regression was employed to analyze the association between physical activity trajectories and depression symptoms in 2020.
Results: 1) Cross-sectional analysis revealed a U-shaped relationship between physical activity level and depression risk. 2) Longitudinal analysis of physical activity demonstrated that compared to the low-stable group (Group A), the moderate-stable group (Group B) had the lowest risk of depression, with a 47% decrease in risk (odds ratio [OR] 0.53, 95% confidence interval [CI] 0.39-0.71, P < 0.001), while the highest-stable group (Group E) had the highest risk of depression, with a 37% increase in risk (OR 1.37, 95% CI 1.02-1.82, P = 0.033). 3) The protective effect of physical activity trajectories was significant in both male and female groups, while the harmful effect was only significant in the female group.
Conclusion: Physical activity serves as both a protective factor and a risk factor for depression prevention in middle-aged and elderly Chinese populations. Both men and women can benefit from long-term moderate physical activity, but women are more susceptible to the harmful effects of excessive physical activity. Adequate physical activity is an effective measure for preventing depression, while early reduction of excessive physical activity may also be beneficial.
Variability of Loa loa microfilarial counts in successive blood smears and its potential implication in drug-related serious adverse events
Authors: Lepage Tristan M. , Campillo Jérémy T. , Louya Frédéric , Bikita Paul , Missamou François , Hemilembolo Marlhand C. , Pion Sébastien D. S. , Boussinesq Michel , Chesnais Cédric B.
Published: August 2024

Background: The standard method to diagnose Loa loa infection and quantify microfilarial density (MFD) is the microscopic examination of calibrated thick blood smears (TBS). In 1950, it was noticed that successive L. loa MFDs from a single capillary puncture could exhibit up to 20% variation. Although loiasis treatment allocation is based on MFD to prevent serious adverse events (SAE), data on this variability are scarce. There are also no guidelines supporting the collection and analysis of one or two TBS.
Methods: We assessed the variability of two successive L. loa MFDs (MFD1 and MFD2), collected from 255 patients. We analyzed the influence of sex, age, weight, heart rate, arterial pressure, body temperature, and sampling time on MFD variability, as well as variability’s impact on MFD thresholds relevant to loiasis treatment protocols.
Results: 63% (1145/1826) of TBS pairs exhibited an MFD2 increase, while only 37% (681/1826) exhibited a decrease. MFD2 were on average 28% higher than MFD1. These variations drove a total of 333 (17.4%) MFD class changes according to loiasis treatment protocol, including 210 (11.3%) class increases. TBS sampled from subjects with lower MFD (1-1 000 mf/mL), lower MAP (55-80 mmHg) and sampled at an earlier hour (10:00-10:59 am) were more subject to MFD2 variability in a multivariate analysis. The MFD relative change was not constant over time for a given person.
Conclusions: We observed a trend towards an increase in MFD2 with an important variability between samples that may impact loiasis treatment allocation. We suggest that systematically sampling at least two successive TBSs might allow better MFD assessments to prevent posttreatment SAEs. Further studies are needed to verify this variability in larger samples as well as confirm the potential explanatory variables identified.
Comparison of Robot-Assisted versus Fluoroscopically Guided Treatment of Atlantoaxial Dislocation in Combination with High-Riding Vertebral Artery: A Preliminary Study
Authors: Li Hou-Kun , Sun Kai , Duan Yong-Chao , Shan Le-Qun , Yan Liang , Yang Jun-Song , Zhang Ya-Dong , Huang Da-Geng , Hao Ding-Jun
Published: August 2024

BACKGROUND: Robotic-assisted surgery has emerged as an innovative approach widely adopted in the field of orthopedics. However, its application specifically for managing atlantoaxial dislocation with a high-riding vertebral artery (AAD-HVA) remains underreported in the existing literature.
OBJECTIVE: To compare the perioperative outcomes of robotic-assisted (RA) and fluoroscopic-guided (FG) techniques for atlantoaxial dislocation in combination with a high-riding vertebral artery (AAD-HVA).
STUDY DESIGN: This was a retrospective study.
SETTING: This research was performed at a single departmentof spine surgery.
METHODS: Data from patients who underwent atlantoaxial internal fixation between July 2018 and January 2022 at our hospital were retrospectively analyzed. Among the cases, 14 were performed using fluoroscopic guidance (FG) and 11 utilized robotic-assisted (RA) techniques. Data collected included case notes, imaging records, and follow-up data. The reliability of screw placement was evaluated based on the Gertzbein and Robbins scores, while treatment outcomes were assessed using the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS), neck disability index (NDI), and postoperative complication rate.
RESULTS: Baseline patient characteristics were comparable between the FG and RA groups. The mean blood loss was markedly lower in the RA group (157.3±49.7 ml) compared to the FG group (290.0±110.3 ml) (p=0.03). Although the average operative time was slightly higher in FG group than in RA group, this disparity did not achieve statistical significance (p=0.7588). Moreover, the radiation exposure dose was remarkably higher in FH group (32.7 ± 4.4 mGy) than in RA group (23.0 ± 3.2 mGy) (p<0.0001). The percentage of clinically acceptable screw placement was slightly lower in FH group (87.5%) than in RA group (97.8%), but the observed variance was not statistically meaningful (p=0.3669). Furthermore,the differences in JOA, VAS, and NDI scores between theFG and RA groups were not statistically significant. Additionally, no obvious differences were found in clinical outcomes or complications related to screw implantation between the two groups.
LIMITATIONS: This study has inherent limitations as it was retrospective in nature and conducted at a single center.
CONCLUSION: Robotic-assisted surgery for AAD-HVA patients offers a minimally invasive approach, reduced bleeding, lower radiation exposure, and enhanced accuracy of screw placement compared with traditional free-hand surgery.
A deep graph model for the signed interaction prediction in biological network
Authors: Jin Shuyi , Zhang Mengji , Wang Meijie , Yu Lun
Published: August 2024

In pharmaceutical research, the strategy of drug repurposing accelerates the development of new therapies while reducing R&D costs. Network pharmacology lays the theoretical groundwork for identifying new drug indications, and deep graph models have become essential for their precision in mapping complex biological networks. Our study introduces an advanced graph model that utilizes graph convolutional networks and tensor decomposition to effectively predict signed chemical-gene interactions. This model demonstrates superior predictive performance, especially in handling the polar relations in biological networks. Our research opens new avenues for drug discovery and repurposing, especially in understanding the mechanism of actions of drugs.
Silent witnesses: Unveiling the epidemic of femicides in Northwest Tshwane, South Africa – a decade of analysis.
Authors: Bismilla Yaseen
Published: August 2024

Background
Femicides, defined as the gender-based killing of women, are a pressing public health issue worldwide, with South Africa experiencing some of the highest rates globally. This study focuses on the North West region of Tshwane, particularly the Garankuwa area, aiming to address gaps in understanding the epidemiology, demographics, circumstances, and pathology associated with femicides. The Garankuwa mortuary serves as the primary site for this investigation, providing a detailed analysis over a ten-year period.
Objectives
The study had four main objectives: to analyse the demographics and incidence rates of femicides in the Northwest Tshwane area, to examine the circumstances surrounding femicides (including the time, location, and demographic risk factors), to identify the causes and pathological characteristics of femicides; and to observe trends in femicide rates over the ten-year study period.
Methods
This study was a retrospective cross-sectional descriptive analysis, focusing on all deceased females admitted to the Garankuwa mortuary from 2009 to 2018. The inclusion criteria comprised female cases at autopsy, with a suspected homicidal manner of death. Cases that were later identified as suicides, accidental, or natural deaths following ancillary investigations were excluded. Data was meticulously collected from various sources, including the National Injury Mortality Surveillance System (NIMSS), death registers, post-mortem reports, and police docket information.
Results
Over the ten-year period, the Garankuwa mortuary admitted an annual average of 1131 bodies, with approximately 23.5% (266) being female. Of these, 17.5% were identified as femicides. The average incidence rate of femicides was 11.2 per 100,000 female population, showing a general decline over the study period, except for notable increases in 2013 and 2016. The study found that the most common months for femicides were September and December, with most incidents occurring at home, followed by residential areas and medical facilities. The geographic analysis identified Temba, Rietgat, and Akasia as the areas with the highest number of femicide cases. Demographically, the majority of femicide victims were black, with the most affected age group being 18–39 years. The leading causes of death were gunshot wounds, sharp force injuries, and blunt force trauma, with significant incidences of strangulation and asphyxial deaths, primarily affecting the neck and head regions.
Conclusion
The study highlights the severity of femicides in the Northwest Tshwane region, confirming specific characteristics and trends that align with national patterns. The findings emphasize the necessity for targeted prevention programs, stricter firearm control measures, and community-based violence prevention strategies. The demographic data indicate that young black women are particularly vulnerable, necessitating protective and educational initiatives tailored to this group.
CST1 Interaction with RAB1B Modulates Tamoxifen resistance of Breast Cancer by Regulating Autophagy
Authors: Liu Li , Liu Yang , Chen Chenxi , Gao Shun , Shen Meiying , Peng Yang , Yu Haochen , Tang Zhenrong , Liu Shengchun
Published: August 2024

Background: Breast cancer (BC) is a leading cause of cancer-related death in women worldwide, with approximately 70% of cases being estrogen receptor alpha-positive (ER+). Expression of the CST1 associated with metastasis of breast cancer and is linked with poor prognosis and poor survival.
Methods: CST1 levels were measured using IHC, RT-qPCR, and Western Blot. Cell proliferation, invasion, and migration were evaluated using CCK-8 cell viability assays, colony formation assays, flow cytometry, Transwell assays, and TEM. Furthermore, the specific molecular mechanisms underlying CST1-mediated TAM resistance were elucidated through plasmid transfection, lentivirus infection, CO-IP, confocal microscopy, and Western Blot.
Results: Elevated CST1 promotes the proliferation and migration of ER+ BC cells. Additionally, CST1 positively correlated with autophagy in ER+ BC cells, affecting TAM sensitivity. Further investigation revealed that CST1 interact with RAB1B, promoting autophagy and TAM resistance.
Conclusion: These findings highlight CST1's regulatory role in modulating autophagy through its interaction with RAB1B, thereby increasing TAM resistance in ER+ BC.
The relationship between overparenting and young children’s problem behaviors in China: a moderated mediation model
Authors: Wang Yingjie , Yao Kemeng , Yao Yijie , Xia Qianqian , Li Yan
Published: August 2024

Problem behaviors are prevalent during the preschool stage and have significant adverse effects on children's future social and academic adjustment. Overparenting represents a crucial familial factor influencing young children's problem behaviors, so it is important to investigate the underlying mechanisms through which overparenting impacts the problem behaviors of young children. A total of 430 young children (Meanage =5.43 years, SD = 1.19) and their parents (Meanage=35.34 years, SD = 4.58) participated in this study. Parents filled the Overparenting Scale, Parent-Child Attachment Scale, Social Competence and Behavior Evaluation and Child Behavior Questionnaire. The results showed that (1) There was a significant positive correlation between parental overparenting and young children’s problem behaviors; (2) Parent-child attachment played a mediating role between parental overparenting and young children’s problem behavior; (3) Children’s negative affect temperament moderated the latter half path of the mediation model, that is, at high levels of negative affect, overparenting has a stronger effect on children’s problem behaviors through parent-child attachment. The results provided the basis for the intervention to alleviate the young children’s problem behavior from the perspective of parenting and child’s temperament.
Predictors of dropout from abemaciclib therapy in patients with breast cancer: a multicenter retrospective cohort study
Authors: Kataoka Noriaki , Hata Takeo , Hosomi Kouichi , Hirata Atsushi , Ota Ryosuke , Nishihara Masami , Kimura Kosei , Iwamoto Mitsuhiko , Ashida Akira , Neo Masashi
Published: August 2024

Objective: This study explored the predictors of dropping out from abemaciclib therapy, a cyclin-dependent kinase 4 and 6 inhibitor, in patients with breast cancer.
Material and Methods: Between November 2018 and March 2023, 147 patients with breast cancer treated with abemaciclib at Osaka Medical and Pharmaceutical University Hospital and Kindai University Nara Hospital were included. The exclusion criteria were as follows: lack of blood testing within 2 weeks prior to starting abemaciclib therapy, transfer to another facility after the commencement of abemaciclib therapy, and discontinuation of abemaciclib therapy due to the diagnosis of another cancer. The duration from the initiation of abemaciclib to dropout for any reason and to temporary suspension or dose reduction due to adverse events were analyzed as outcome variables using multivariate Cox regression analysis.
Results: Baseline weight <54 kg, bone metastases, and hemoglobin level ≤12.4 g/dL were independent predictors of dropout for any reason. The main adverse events leading to dropout were liver enzyme elevation and gastrointestinal symptoms. Additionally, focusing on the adverse event of abemaciclib, a baseline weight <54 kg was an independent predictor of temporary suspension or dose reduction due to adverse events. The most common adverse events leading to temporary suspension or dose reduction were neutropenia and diarrhea.
Conclusion: Patients with lower body weight are more susceptible to the adverse events of abemaciclib, increasing their risk of treatment dropout. In such patients, strict monitoring of adverse events and consideration of more frequent medical visits are necessary from the start of abemaciclib therapy.
An Ultrasound Image Segmentation Method for Thyroid Nodules Based on Dual-Path Attention Mechanism-Enhanced UNet++
Authors: Dong Peizhen , Zhang Ronghua , Li Jun , Liu Changzheng , Liu Wen , Hu Jiale , Yang Yongqiang , Li Xiang
Published: August 2024

Purpose: This study aims to design an auxiliary segmentation model for thyroid nodules to increase diagnostic accuracy and efficiency, thereby reducing the workload of medical personnel.
Methods: This study proposes a Dual-Path Attention Mechanism (DPAM)-UNet++ model, which can automatically segment thyroid nodules in ultrasound images. Specifically, the model incorporates dual-path attention modules into the skip connections of the UNet++ network to capture global contextual information in feature maps. The model's performance was evaluated using Intersection over Union (IoU), F1_score, accuracy, etc. Additionally, a new integrated loss function was designed for the DPAM-UNet++ network.
Results: Comparative experiments with classical segmentation models revealed that the DPAM-UNet++ model achieved an IoU of 0.7451, an F1_score of 0.8310, an accuracy of 0.9718, a precision of 0.8443, a recall of 0.8702, an Area Under Curve (AUC) of 0.9213, and an HD95 of 35.31. Except for the precision metric, this model outperformed the other models on all the indicators and achieved a segmentation effect that was more similar to that of the ground truth labels. Additionally, ablation experiments verified the effectiveness and necessity of the dual-path attention mechanism and the integrated loss function.
Conclusion: The segmentation model proposed in this study can effectively capture global contextual information in ultrasound images and accurately identify the locations of nodule areas. The model yields excellent segmentation results, especially for small and multiple nodules. Additionally, the integrated loss function improves the segmentation of nodule edges, enhancing the model’s accuracy in segmenting edge details.
Evaluation of Risk Factors for Recurrent Ventriculoperitoneal Shunt Infections in Adult
Authors: Elgormus Neval , Dogu Huseyin , Okuyan Omer , Bozkurt Fatma , Senyigit Abdulhalim , Uzun Hafize
Published: August 2024

Objective: The objective of this paper is to evaluate demographic, clinical, laboratory and microbiological features of ventriculoperitoneal shunt (VPS) infections in this 13 year retrospective study. VPS-related bacterial agents and their antibiotic sensitivity were also investigated in single VPS (SVPS) and recurrent VPS (RVPS) infections.
Methods: The study included 110 patients with SVPS infection and 55 patients with RVPS infection.
Results: In patients who developed multiple infections, gram-negative organisms were the most predominant (60%, 54/90). Resistance rates were 85.2% for third generation cephalosporins, 83.3% for Piperacillin-Tazobactam, and 10.4% for Carbapenem's. Forty-nine % of patients in the SVPS and 84.4% in the RVPS infection group were treated with combinations of carbapeneme. Central nervous system (CNS) tuberculosis as the etiology of hydrocephalus, short duration of antibiotics used for treatment, high cerebrospinal fluid (CSF) protein and blood C-reactive protein (CRP) levels, and prolonged use of prophylactic antibiotics was found related to increased rate of recurrent infection occurrence. Two-stage shunt change decreased the risk of recurrent infections.
Conclusions: VPS infection may be life-threating and its management rucial. Rational and appropriate use of antibiotics and treatment methods according to the algorithms can reduce recurrent infections. Gram-negative predominant bacterial colonization and its carbapenem sensitivity in RVPS infection has to be kept in mind to manage the infection effectively.
Prognosis of patients with breast cancer who underwent breast-conserving surgery using a 3D-printed surgical guide after neoadjuvant chemotherapy
Authors: Kim Ah Yoon , Lee Sae Byul , Yoo Tae Kyung , Kim Ji Sun , Chung Il Yong , Kim Hee Joung , Lee Jong Won , Son Byung Ho , Jeong Jae Ho , Lee Hee Jin , Kim Nam kug , Ko BeomSeok
Published: August 2024

In breast-conserving surgery (BCS), clear resection margins are crucial to prevent recurrence. Accurate imaging is vital for precise BCS, with MRI being the most accurate. However, MRI has limitations in identifying the exact extent of breast cancer in patients who have undergone neoadjuvant chemotherapy (NACT). A 3D-Printed Breast Surgical Guide (3DP-BSG) can address this issue by effectively pinpointing cancer extent in NACT patients, thus enhancing surgical accuracy. This retrospective single-institution cohort study focused on female patients diagnosed with invasive breast cancer who underwent NACT. Between November 2015 and October 2021, patients received BCS with the aid of a 3DP-BSG. Personalized 3DP-BSG targeted tumors by tracking changes in breast and tumor anatomy on MRI before and after NACT. 203 patients with invasive breast cancer were enrolled in the study. According to exclusion criteria, 197 patients were analyzed. The median follow-up period was 35.3 months (range: 2.2–96.8 months). 3 patients (1.5%) had positive resection margins. During the follow-up period, 17 patients (8.6%) experienced recurrence, with one patient (0.5%) confirmed local recurrences. The application of MRI-based 3DP-BSG is effective in achieving low positive margins and local recurrence in patients undergoing BCS after NACT, offering a promising approach for improving surgical outcomes.
A novel ATP-binding cassette protein (NoboABCG1.3) p lays a vital role in the proliferation of Nosema bombycis
Authors: He Shaogang , Zheng Shiyi , Zhu Honglin , Hu Yuanke , Yu Bin , Wei Junhong , Pan Gu oqing , Zhou Zeyang , Li Chunfeng
Published: August 2024

ATP-binding cassette (ABC) transporter proteins, one of the largest families of membrane transport proteins, participate in almost all biological processes and widely exist in living organisms. Microsporidia are intracellular parasites, they can reduce crop yields and pose a threat to human health. The ABC proteins are also present in microsporidia and plays a critical role in their proliferation and energy transport. In this study, a novel ABC transporter protein of Nosema bombycis named NoboABCG1.3 was identified. The NoboABCG1.3 protein is comprised of 640 amino acids, which contains six transmembrane domains and one nucleotide-binding domain. After N. bombycis infection of cells or tissues, quantitative reverse transcription polymerase chain reaction analysis revealed a progressive elevation in the transcript levels of NoboABCG1.3. Downregulation of NoboABCG1.3 expression significantly inhibited N. bombycis proliferation. Subsequently, a transgenic cell line stably expressing an interfering fragment of NoboABCG1.3 was established, which exhibited extreme inhibition on the proliferation of N. bombycis. These findings indicate that NoboABCG1.3 plays a crucial role in the proliferation of N. bombycis and holds promise as a target for developing N. bombycis-resistant silkworms.
Ascites-derived EpCAM+/CD45+ ovarian cancer stem cells unveil potential therapeutic targets
Authors: Meigooni Mohammad Reza Tayebizadeh , Kharkeshi Mahboubeh Safari , Daneshvari Sadra , Montazeri Hesam , Hossein Ghamartaj
Published: August 2024

Ascites-derived ovarian cancer stem cell (OCSC) populations may originate from the fallopian tube epithelium (FTE) or ovarian surface epithelium (OSE). Additionally, EpCAM/CD45 dual-positive OCSCs (DpOCSCs) may also result from the other origin. The distinctions between these two OCSC populations are not thoroughly understood. This study examines the transcriptome analysis of ascites-derived DpOCSC populations compared to ascites-derived OCSC populations with FTE/OSE origins. We observed that upregulated genes in DpOCSCs are primarily associated with inflammatory pathways, such as NFκB, TNF, Toll-like receptor, and IL-17 signaling pathways. Moreover, 14 out of 28 identified DpOCSCs-related hub genes were TCGA-validated at mRNA levels, among which SYK, CD74, and LCP1 were also validated at protein levels using the UALCAN dataset. SYK, in particular, stood out, displaying a noteworthy association with decreased progression-free survival. Notably, we found a significant positive correlation between DpOCSCs-related hub genes and immune checkpoint proteins, as well as with infiltrating immune-suppressive cells. Further examination of their relations with clinico-pathological features revealed that seven out of fourteen TCGA-validated hub genes were significantly linked to lymphatic and venous invasion, which were transcriptionally regulated by Wnt/β-catenin signaling pathway. Furthermore, SYK was significantly related to new neoplasm events type and primary therapy outcomes success. In conclusion, our findings suggest that hub genes associated with DpOCSC populations in ascites could be potential therapeutic targets due to their involvement in tumor progression and invasiveness.
Scrutinizing the LCC Hypothesis in ASEAN-5: An Innovative Exploration Integrating Energy Intensity, Global Trade Dynamics, and Financial Inclusion Using DKSE and Quantile Regression
Authors: Ridwan Mohammad , Aspy Nazhat Nury , Mahjabin Tasfia , Eleais Md. , Shaari Mohd Shahidan , Ridzuan Abdul Rahim , P Jaheer Mukthar K , Shah Mohd Asif
Published: August 2024

This study investigates how economic growth, energy intensity, financial inclusion, and trade globalization impact the load capacity factor in the ASEAN-5 region. Using data from 2000 to 2022 from reputable databases, the study analyzed the load capacity curve (LCC) hypothesis through comprehensive statistical analysis. Several diagnostic tests, such as cross-sectional dependence, slope homogeneity, unit root, and cointegration, to select a suitable long-run estimation model were conducted. The study utilized the Driscoll-Kraay standard error (DKSE) approach to address identified issues like cross-sectional dependence, heterogeneity, and unit root problems. DKSE estimation showed that the LCC hypothesis was not present in the ASEAN-5 region. It is worth noting that an inverted-U-shaped relationship between per capita income and the load capacity factor was found, emphasizing the complexity of economic dynamics in the region. Furthermore, the analysis revealed a strong correlation between energy intensity and the load capacity factor, with trade globalization having a significant negative effect. Surprisingly, financial inclusion did not show a significant correlation with the load capacity factor, highlighting the intricate role of financial accessibility in economic performance. To enhance the strength of the DKSE estimation, the study also utilized quantile regression analysis, which supported the results of the DKSE approach. The study confirmed that the LCC hypothesis is not applicable in the ASEAN-5 region and offered a more detailed analysis of the varying effects of energy intensity and trade globalization at different levels. Conclusively, this study provides valuable insights into the complex relationships among economic growth, energy intensity, financial inclusion, and trade globalization in the ASEAN-5 region. A thorough analytical approach enhances comprehension of sustainable development and economic resilience in the region, guiding policy decisions and future research efforts.
JEL: Q43, G21, F14, D24, F15
Windthrow disturbance impacts soil biogeochemistry and bacterial communities in a temperate forest
Authors: Waring Bonnie , Lancastle Lena , Bell Thomas , Bidartondo Martin I. , García-Díaz Pablo , Lambin Xavier , Vanguelova Elena , Windram Francis A.
Published: August 2024

Aims.
Forests across the world are subject to disturbance via wind, wildfire, and pest and disease outbreaks. Yet we still have an incomplete understanding of how these stressors impact forest biota - particularly the soil microbes, which govern forest carbon and nutrient cycling.
Methods.
Here, we investigated the impact of windstorms on soil bacterial communities in Kielder Forest, a temperate coniferous forest in the north of England. Within ten individual sites, defined by common stand composition and topography, we established 50 m2 plots in undisturbed stands, and in nearby stands that were moderately and/or severely disturbed by windthrow. Soils were sampled within each of the 22 study plots, and analysed for changes in carbon and nitrogen content, pH, root biomass, and bacterial community structure. We separately sequenced bacteria from bulk soils, rhizosphere soils, and root tissues to assess whether disturbance impacts varied based on the proximity of microbiota to tree roots.
Results.
Less than a year after the storm, we found that the most severely disturbed stands had lower canopy cover, lower soil carbon content, higher soil pH, and a smaller fine root biomass than the undisturbed stands. Disturbance also impacted bacterial community beta-diversity, but the effects were subtle and did not vary among assemblages in bulk vs. rhizosphere soils.
Conclusions.
Impacts of aboveground disturbance on soil biogeochemistry can be significant, but soil bacterial communities are relatively well-buffered against these changes. However, altered patterns of root growth and carbon cycling may have longer-term implications for forest recovery after windthrow disturbances.
Fecal metabolomics to understand intestinal dysfunction in male dairy beef calves at arrival to the rearing farm
Authors: Bassols Anna , Amigó Núria , Pérez-Rodado Marc , Saco Yolanda , Peña Raquel , Pato Raquel , Pisoni Lucia , Devant Maria , Martí Sònia
Published: August 2024

Fecal biomarkers are becoming an important analytical tool since feces are in direct contact with the inflamed intestine and site for the gut microbiome. The objective of this study was the identification of potential fecal biomarkers by means of 1H-NMR to evaluate management of male dairy beef calves. Holstein calves were subjected to a protocol aimed to simulate real conditions of the dairy beef market. Three groups were studied: Control (CTR: high colostrum, no transport, milk replacer), LCMR (low colostrum, transport, milk replacer) and LCRS (low colostrum, transport, rehydrating solution). Fecal lactoferrin was determined as marker of intestinal inflammation, and metabolomic profiling was performed in feces collected the day after arrival to the farm. 41 polar and 10 non-polar metabolites were identified, of which proline, formate and creatine increased in the LCRS group, whereas butyrate and uracil decreased. Less differences were found in non-polar metabolites. Multivariate analysis indicated that most differences are found between the LCRS group and the others. In conclusion, this study indicates that feed restriction has a more important effect at this age than colostrum uptake and transport. These results should help to identify robust fecal biomarkers to assess calf intestinal health and improve management protocols.
Modeling and analysis of hybrid bonded-bolted joining in large-scale aircraft assembly
Authors: Eliseev Artem , Lupuleac Sergey , Shinder Julia , Grigor'ev Boris , Khashba Valeriia
Published: August 2024

Hybrid Bonded-Bolted (HBB) joining is a common method used in aircraft assembly, particularly for critical junctions such as the wing-to-fuselage joint, to ensure both quality and durability. Accurate simulation of HBB joining presents a significant challenge, as it requires proper description of contact interaction of the assembled parts, the flow of adhesive used for bonding and their mutual influence. In this paper, the process of HBB joining of the upper wing panel and fuselage of a commercial aircraft is simulated. The utilized mathematical model is comprehensive in several ways. Firstly, it covers all most important physical phenomena determining the intermediate and final result of the assembly process, notably including the two-way fluid-structure interaction and a presence of a free surface in the fluid part. Secondly, the finite element model of the joint has dimensions and level of detail comparable to models used in industrial applications. Finally, the complete sequence of assembly stages is reproduced during the simulation, including installation of temporary fasteners and their replacement by permanent ones. The paper focuses on investigating the problem of permanent fasteners loosening, a critical issue in aircraft assembly. The state-of-the-art aircraft assembly technologies typically include requirements intended to prevent significant loosening of permanent fasteners by the end of the assembly process. The validity of these requirements is studied using a series of numerical tests with specially developed simulation tool.