bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive risk factors for distant metastasis in pediatric differentiated thyroid cancer from Saudi Arabia
Authors: Parvathareddy Sandeep Kumar , Siraj Abdul K. , Annaiyappanaidu Padmanaban , Siraj Nabil , Al-Rasheed Maha , Al-Haqawi Wael , Qadri Zeeshan , Siddiqui Khawar , Al-Sobhi Saif S. , Al-Dayel Fouad , Al-Kuraya Khawla S.
Published: October 2023

Background

Despite their excellent prognosis, children and young adults (CAYA) with differentiated thyroid cancer (DTC) tend to have more frequent occurrence of distant metastasis (DM) compared to adult DTC. Data about DM in CAYA from Middle Eastern ethnicity is limited.

Methods

Medical records of 170 patients with DTC ≤18 years were retrospectively reviewed. Clinico-pathological factors associated with lung metastasis in CAYA, their clinical presentation and outcome were analyzed. Rick factors related to distant metastasis-free survival (DMFS) for the whole cohort were evaluated.

Results

DM was observed in 27 patients and all were lung metastasis. Lung metastasis was significantly associated with younger age (≤15 years), extrathyroidal extension (ETE), multifocal tumors, bilaterality, presence of lymph node (LN) disease and high post-operative stimulated thyroglobulin (sTg). Highest negative predictive values were seen with low post-operative sTg (97.9%), absence of LN disease (93.8%), absence of ETE (92.2%) and age older than 15 years (92.9%). Post-therapy whole body scan (WBS) identified most of the lung metastasis (21 of 27; 77.8%). Upon evaluating patients response according to ATA guidelines, excellent response was seen in only one patient, while biochemical persistence and structural persistence were seen in 11.1% (3/27) and 77.8% (21/27), respectively. Elevated post-operative sTg (>10ng/ml) was the only risk factor found to be significantly associated with both biochemical persistence (with or without structural persistence (p = 0.0143)) and structural persistence (p = 0.0433). Cox regression analysis identified age and post-operative sTg as independent risk factors related to DMFS. Based on these two risk factors for DMFS, patients were divided into 3 groups: low risk (no risk factors), intermediate risk (1 risk factor) and high risk (both risk factors). 20-year DMFS rates in the low-, intermediate- and high-risk groups were 100.0%, 81.3% and 23.7% respectively (p < 0.0001).

Conclusion

Higher suspicion for metastatic pediatric DTC should be considered in patients who are young, have LN disease, extrathyroidal extension and elevated post-operative sTg. Persistent disease, despite therapy, is very common and it appears to be related to post-operative sTg level. Hence, risk adaptive management is desirable in CAYA with DTC.
The role of the interferon/JAK-STAT axis in driving islet HLA-I hyperexpression in type 1 diabetes
Authors: Russell Mark A. , Richardson Sarah J. , Morgan Noel G.
Published: October 2023

The hyperexpression of human leukocyte antigen class I (HLA-I) molecules on pancreatic beta-cells is widely accepted as a hallmark feature of type 1 diabetes pathogenesis. This response is important clinically since it may increase the visibility of beta-cells to autoreactive CD8+ T-cells, thereby accelerating disease progression. In this review, key factors which drive HLA-I hyperexpression will be explored, and their clinical significance examined. It is established that the presence of residual beta-cells is essential for HLA-I hyperexpression by islet cells at all stages of the disease. We suggest that the most likely drivers of this process are interferons released from beta-cells (type I or III interferon; possibly in response to viral infection) or those elaborated from influent, autoreactive immune cells (type II interferon). In both cases, Janus Kinase/Signal Transducer and Activator of Transcription (JAK/STAT) pathways will be activated to induce the downstream expression of interferon stimulated genes. A variety of models have highlighted that HLA-I expression is enhanced in beta-cells in response to interferons, and that STAT1, STAT2 and interferon regulatory factor 9 (IRF9) play key roles in mediating these effects (depending on the species of interferon involved). Importantly, STAT1 expression is elevated in the beta-cells of donors with recent-onset type I diabetes, and this correlates with HLA-I hyperexpression on an islet-by-islet basis. These responses can be replicated in vitro, and we consider that chronically elevated STAT1 may have a role in maintaining HLA-I hyperexpression. However, other data have highlighted that STAT2-IRF9 may also be critical to this process. Thus, a better understanding of how these factors regulate HLA-I under chronically stimulated conditions needs to be gathered. Finally, JAK inhibitors can target interferon signaling pathways to diminish HLA-I expression in mouse models. It seems probable that these agents may also be effective in patients; diminishing HLA-I hyperexpression on islets, reducing the visibility of beta-cells to the immune system and ultimately slowing disease progression. The first clinical trials of selective JAK inhibitors are underway, and the outcomes should have important implications for type 1 diabetes clinical management.
Optimization algorithms for light pollution management based on TOPSIS-non-linear regularization model
Authors: Zhou Ze-Han , Cao Hui-Ling , Feng Tong-Yue , Zhu Jia-Ming
Published: October 2023

Rapid urbanization and economic development have inevitably led to light pollution. However, currently the world has not yet formed a unified technical standard for light pollution, and light pollution cannot be effectively controlled when the environmental protection department is unable to operate. To effectively solve this problem, this paper establishes a combined weight ideal point method evaluation model based on TOPSIS evaluation method to obtain comprehensive index weights to evaluate the light pollution risk levels of four different land types in urban, suburban, rural and nature reserve areas in Beijing, China, and uses one-way ANOVA to test the differences among the four regions. Based on the Random Forest algorithm to determine the three variables with the top three feature importance weights, and based on the nonlinear optimization algorithm, using the SLSQP method, the optimal parameter combinations with the smallest cost are obtained after iteration, so as to put forward three feasible intervention strategies such as adjusting the design of the nightscape lighting, reducing the time of nonessential lighting, and rationally planning the layout of the city’s lighting, etc., to solve the light pollution problem, which effectively promote the urban nightscape lighting’s it effectively promotes the healthy and sustainable development of urban nightscape lighting.
Experimental analysis of energy consumption of building roof energy-saving technologies based on time difference comparison test
Authors: Zhao Shanguo , Hai Guangmei , Ma Hongtao , Zhang Xiaosong
Published: October 2023

The roof plays a pivotal role as it directly engages with solar radiation absorption and external heat exchange, significantly influencing the building’s overall energy dynamics. To assess the performance of green roofs and cool roofs, a roof performance test facility was established in Nanjing. Time-difference comparison experiments were conducted to measure and analyze the energy-saving effects of cool roofs, green roofs, and conventional roofs during both summer and winter conditions. The study aimed to investigate how their thermal performance impacts building energy consumption. The study’s findings reveal that under summer conditions, the incorporation of a cool roof system leads to a substantial enhancement in energy efficiency, achieving an impressive 13.2% energy savings compared to conventional roofing solutions. In contrast, the implementation of a green roof system results in a more modest energy-saving rate of 4.1%. Transitioning to winter conditions, the adoption of a cool roof system shows a marginal increase of 2.8% in energy consumption compared to conventional roofs. Interestingly, the green roof system stands out as an energy-efficient option during winter, demonstrating a significant 4.9% reduction in energy consumption. This approach ensured reliable and valid results to provide a comprehensive view of how different roof types respond to varying climatic conditions.
The great tit abdominal stripe contains a sexually dichromatic colour patch hidden from the human eye
Authors: Laczi Miklós , Herczeg Gábor , Szabó Gyula , Gyarmathy Helga , Sarkadi Fanni , Török János , Hegyi Gergely
Published: October 2023

Information on the exact nature of sexual dichromatism might be incomplete, often leading to the treatment of dichromatic species as monochromatic. This error is evident when the two sexes of a species look identical to the human eye, as in the great tit (Parus major). We measured reflectance in three sections (throat, breast, belly) of the abdominal black stripe of great tits during the pairing and nestling feeding periods and assessed differences between patch sections, sexes, and seasons using visual models. We found that the stripe, which had previously been considered a single, contiguous patch, consists of multiple patches. In males, the breast section differed markedly from the throat and belly sections in having higher total brightness and ultraviolet chroma, while the female’s breast seemed to be less bright than the two other regions, resulting in strong sexual dichromatism hidden from the human eye. Colouration was more pronounced in winter, but dichromatism was present in both periods. The hidden breast ultraviolet patch we discovered in males may act as a sexual ornament or a signal amplifier.
Nucleotide-level prediction of CircRNA-protein binding based on fully convolutional neural network
Authors: Shen Zhen , Liu Wei , Zhao ShuJun , Zhang QinHu , Wang SiGuo , Yuan Lin
Published: October 2023

Introduction: CircRNA-protein binding plays a critical role in complex biological activity and disease. Various deep learning-based algorithms have been proposed to identify CircRNA-protein binding sites. These methods predict whether the CircRNA sequence includes protein binding sites from the sequence level, and primarily concentrate on analysing the sequence specificity of CircRNA-protein binding. For model performance, these methods are unsatisfactory in accurately predicting motif sites that have special functions in gene expression.

Methods: In this study, based on the deep learning models that implement pixel-level binary classification prediction in computer vision, we viewed the CircRNA-protein binding sites prediction as a nucleotide-level binary classification task, and use a fully convolutional neural networks to identify CircRNA-protein binding motif sites (CPBFCN).

Results: CPBFCN provides a new path to predict CircRNA motifs. Based on the MEME tool, the existing CircRNA-related and protein-related database, we analysed the motif functions discovered by CPBFCN. We also investigated the correlation between CircRNA sponge and motif distribution. Furthermore, by comparing the motif distribution with different input sequence lengths, we found that some motifs in the flanking sequences of CircRNA-protein binding region may contribute to CircRNA-protein binding.

Conclusion: This study contributes to identify circRNA-protein binding and provides help in understanding the role of circRNA-protein binding in gene expression regulation.
Protein modification by short-chain fatty acid metabolites in sepsis: a comprehensive review
Authors: Zhang Liang , Shi Xinhui , Qiu Hongmei , Liu Sijia , Yang Ting , Li Xiaoli , Liu Xin
Published: October 2023

Sepsis is a major life-threatening syndrome of organ dysfunction caused by a dysregulated host response due to infection. Dysregulated immunometabolism is fundamental to the onset of sepsis. Particularly, short-chain fatty acids (SCFAs) are gut microbes derived metabolites serving to drive the communication between gut microbes and the immune system, thereby exerting a profound influence on the pathophysiology of sepsis. Protein post-translational modifications (PTMs) have emerged as key players in shaping protein function, offering novel insights into the intricate connections between metabolism and phenotype regulation that characterize sepsis. Accumulating evidence from recent studies suggests that SCFAs can mediate various PTM-dependent mechanisms, modulating protein activity and influencing cellular signaling events in sepsis. This comprehensive review discusses the roles of SCFAs metabolism in sepsis associated inflammatory and immunosuppressive disorders while highlights recent advancements in SCFAs-mediated lysine acylation modifications, such as substrate supplement and enzyme regulation, which may provide new pharmacological targets for the treatment of sepsis.
Bacterium-like particles derived from probiotics: progress, challenges and prospects
Authors: Zhou Xinyao , Gao Mingchun , De Xinqi , Sun Tong , Bai Zhikun , Luo Jilong , Wang Fang , Ge Junwei
Published: October 2023

Bacterium-like particles (BLPs) are hollow peptidoglycan particles obtained from food-grade Lactococcus lactis inactivated by hot acid. With the advantage of easy preparation, high safety, great stability, high loading capacity, and high mucosal delivery efficiency, BLPs can load and display proteins on the surface with the help of protein anchor (PA), making BLPs a proper delivery system. Owning to these features, BLPs are widely used in the development of adjuvants, vaccine carriers, virus/antigens purification, and enzyme immobilization. This review has attempted to gather a full understanding of the technical composition, characteristics, applications. The mechanism by which BLPs induces superior adaptive immune responses is also discussed. Besides, this review tracked the latest developments in the field of BLPs, including Lactobacillus-derived BLPs and novel anchors. Finally, the main limitations and proposed breakthrough points to further enhance the immunogenicity of BLPs vaccines were discussed, providing directions for future research. We hope that further developments in the field of antigen delivery of subunit vaccines or others will benefit from BLPs.
Case Report: Durable complete response of metastatic hepatocellular carcinoma with asymptomatic hyperamylasemia to combined immunotherapy of anti-cytotoxic T lymphocyte-associated antigen 4 plus anti-programmed cell death-1 antibodies
Authors: Gao Han , Chang Rui-zhi , Chen Xiao-ping , Zhang Wan-guang , Zhang Bixiang , Luo Xin , Ding Ze-yang
Published: October 2023

Background

Combined immunotherapy has shown promising results in the treatment of advanced HCC, whereas the priority population that would respond to the combined immunotherapy is still elusive. In addition, HCC with asymptomatic hyperamylasemia was not reported previously.

Case presentation

An aged patient was diagnosed as HCC with BCLC stage C (bone metastasis). Notably, this patient showed asymptomatic hyperamylasemia. The patient was then enrolled in a trial evaluating combined immunotherapy of anti-PD-1 antibody sintilimab (IBI308) plus anti-CTLA-4 antibody (IBI310) in advanced HCC. After being treated with combined immunotherapy, this patient rapidly achieved complete response (CR) according to mRECIST criteria or immune partial response (iPR) according to iRECIST criteria and maintain the CR state for more than 12 months. Interestingly, serum levels of amylase and lipase in this patient were reduced after treatment.

Conclusion

We reported, for the first time, a case of metastatic HCC with asymptomatic hyperamylasemia, and suggested that HCC patients with asymptomatic hyperamylasemia may benefit from combined immunotherapy of anti-CTLA-4 and PD-1 antibodies.
New depth records and novel feeding observations of three elasmobranchs species in the Eastern Red Sea
Authors: Frappi Sofia , Williams Collin , Pilcher Nicolas , Rodrigue Mattie , Marshall Paul , Pieribone Vincent , Qurban Mohammed , Duarte Carlos M.
Published: October 2023

Understanding the vertical distribution of elasmobranch species and associated ecological dynamics can be a crucial component of developing effective conservation strategies, particularly in light of their global population decline. Previous studies have primarily focused on horizontal extent and movement patterns of elasmobranchs, with limited knowledge about their vertical distribution. This knowledge gap stems from limited access to technological advancements and reliance on surface data from fisheries operations. Today, advancements in observing platforms such as electronic tracking, remotely operated vehicles and submersibles, and reductions in costs for drop cameras and BRUVs, allow for direct observation of animals at great depths, facilitating improved understanding of their ecological and trophic niches. This study reports new global depth records for three elasmobranch species observed in the Saudi Arabian Red Sea (Carcharhinus altimus, Rhinobatos punctifer, Iago omanensis), also presenting ethological evidence on Iago omanensis feeding behavior. Our findings have significant implications for conservation strategies and the development of targeted conservation measures. The provisioning of data on new depth ranges allows places like NEOM to better manage and protect deep sea habitats, due to the presence of species occurring at those depths.
Fabrication and characterization of net-shaped iron nitride-amine-epoxy soft magnetic composites
Authors: Hoyt Melinda R. , Falcon Gillian I. , Pearce Charles J. , Delaney Robert E. , Stevens Tyler E. , Johnson Emily M. , Szenderski Thomas M. , Sorenson Nathan R. , Fultz-Waters Sydney F. , Rodriguez Mark A. , Whalen Lisa J. , Monson Todd C.
Published: October 2023

Soft magnetic composites (SMCs) offer a promising alternative to electrical steels and soft ferrites in high performance motors and power electronics. They are ideal for incorporation into passive electronic components such as inductors and transformers, which require a non-permanent magnetic core to rapidly switch magnetization. As a result, there is a need for materials with the right combination of low coercivity, low magnetic remanence, high relative permeability, and high saturation magnetization to achieve these goals. Iron nitride is an attractive soft magnetic material for incorporation into an amine/epoxy resin matrix. This permits the synthesis of net-shaped SMCs using a “bottom-up” approach for overcoming the limitations of current state-of-the-art SMCs made via conventional powder metal processing techniques. In this work we present the fabrication of various net-shaped, iron nitride-based SMCs using two different amine/epoxy resin systems and their magnetic characterization. The maximum volume loading of iron nitride reached was ∼77% via hot pressing, which produced SMCs with a saturation magnetic polarization (Js) of ∼0.9 T, roughly 2–3 times the Js of soft ferrites.
Case report: A case of pulmonary mucormycosis caused by Rhizopus azygosporus infection complicated by type 2 diabetes mellitus
Authors: Wang Lu , Qu Yuanqing , Tang Lu , Li Yanmei , Liu Lu , Liu Yuan
Published: October 2023

A case of pulmonary mucormycosis (PM) caused by Rhizopus azygosporus infection complicated by type 2 diabetes mellitus is reported. An adult male patient had a productive cough for more than 10 days, aggravated by blood in the sputum for 9 days. Laboratory examination confirmed that he had had type 2 diabetes mellitus and diabetic ketosis for more than 3 years, and his chest computed tomography (CT) scan showed lesions, cavities, and a small effusion in the right lower lobe. The lavage fluid was taken by bronchoscope for bacterial culture and mNGS, which indicated Rhizopus azygosporus growth. Mucormycosis was diagnosed. The patient was given amphotericin B cholesterol sulfate complex for 30 days, and his renal function was closely monitored. After that, his right lower lobe was resected. To date, the patient has recovered well.
Development of functional gastrointestinal disorder symptoms following laparoscopic cholecystectomy: a prospective cohort study
Authors: Chang Ji Young , Jung Hye-Kyung , Moon Chang Mo , Kim Seong-Eun , Shim Ki-Nam , Jung Sung-Ae , Min Seog Ki
Published: October 2023

Background

The casual relationship between the role of cholecystectomy and functional gastrointestinal disorders (FGIDs) are a controversial clinical challenge. This study aimed to investigate: (1) the overlap of FGIDs before cholecystectomy and its long-term outcome after surgery in patients with symptomatic cholelithiasis, and (2) the incidence of new-onset FGIDs after cholecystectomy.

Methods

Patients with symptomatic gallstone disease who underwent elective, laparoscopic cholecystectomy were prospectively enrolled. Healthy populations who underwent medical check-ups were selected as age- and sex-matched controls. Questionnaires regarding sociodemographic characteristics, gastrointestinal symptoms and a somatization symptom checklist (SSC) were completed at baseline and 12 months thereafter.

Results

The prevalence of all FGID symptoms before cholecystectomy were significantly higher in the group of patients with symptomatic cholecystolithiasis compared to the control group. In cholecystectomy group, the preoperative FGID symptoms improved after surgery, except for chronic diarrhea. Compared to the controls, the new-onset FGIDs, including functional dyspepsia (14.8% vs. 6.9%; p = 0.040), functional diarrhea (6.6% vs. 0.2%; p < 0.001), and chronic abdominal pain (11.9% vs. 4.4%; p = 0.024), were more common at 1 year after cholecystectomy. Somatization was independent predictors of new-onset dyspepsia and abdominal pain, while newly occurring diarrhea was not realted to somatization.

Conclusion

Overlap of FGIDs was common in patients with symptomatic cholelithiasis before surgery and at follow-up 1 year after cholecystectomy. Furthermore, new-onset FGIDs could be occurred after cholecystectomy. Therefore, a delicate diagnostic approaches and appropriate treatments about co-existent FGIDs should be given in patients with cholelithiasis before and after cholecystectomy.
Automated evaluation of retinal hyperreflective foci changes in diabetic macular edema patients before and after intravitreal injection
Authors: Wang Xingguo , Zhang Yanyan , Ma Yuhui , Kwapong William Robert , Ying Jianing , Lu Jiayi , Ma Shaodong , Yan Qifeng , Yi Quanyong , Zhao Yitian
Published: October 2023

Purpose

Fast and automated reconstruction of retinal hyperreflective foci (HRF) is of great importance for many eye-related disease understanding. In this paper, we introduced a new automated framework, driven by recent advances in deep learning to automatically extract 12 three-dimensional parameters from the segmented hyperreflective foci in optical coherence tomography (OCT).

Methods

Unlike traditional convolutional neural networks, which struggle with long-range feature correlations, we introduce a spatial and channel attention module within the bottleneck layer, integrated into the nnU-Net architecture. Spatial Attention Block aggregates features across spatial locations to capture related features, while Channel Attention Block heightens channel feature contrasts. The proposed model was trained and tested on 162 retinal OCT volumes of patients with diabetic macular edema (DME), yielding robust segmentation outcomes. We further investigate HRF’s potential as a biomarker of DME.

Results

Results unveil notable discrepancies in the amount and volume of HRF subtypes. In the whole retinal layer (WR), the mean distance from HRF to the retinal pigmented epithelium was significantly reduced after treatment. In WR, the improvement in central macular thickness resulting from intravitreal injection treatment was positively correlated with the mean distance from HRF subtypes to the fovea.

Conclusion

Our study demonstrates the applicability of OCT for automated quantification of retinal HRF in DME patients, offering an objective, quantitative approach for clinical and research applications.
A study on the correlation between the prognosis of HPV infection and lesion recurrence after cervical conization
Authors: Lu Junling , Han Shichao , Li Ya , Na Jing , Wang Jun
Published: October 2023

Introduction

Persistent human papillomavirus infection is an important factor in the development of cervical cancer, which is usually a long process evolving from the development of squamous intraepithelial lesions (SIL), also referred to as cervical intraepithelial neoplasia (CIN). Local treatment of advanced squamous intraepithelial lesions, also regarded as High-Grade Squamous Intraepithelial Lesion, may be effective in preventing cancer.

Objective

To promptly identify high-risk patients with a tendency to recurrence.

Methods

We retrospectively analyzed the clinical data of 300 patients with high-grade squamous intraepithelial lesions of the cervix admitted to the Second Affiliated Hospital of Dalian Medical University from 2019 to 2020 to investigate the relationship between recurrence of cervical lesions and postoperative regression of HPV infection, as well as other related risk factors.

Results

We found that the HPV-negative rates were 81.81, 85.71, and 90.91% at 6, 12, and 24 months, respectively, and the average lesion recurrence rate was 8.16%, with a median time to recurrence of 14 months in patients undergoing CKC for HSIL. The risk of cervical squamous intraepithelial lesions was highest in patients with HPV16. Patients over 61 years of age had the lowest postoperative HPV-negative rate. The conversion rate was significantly lower in patients with multiple HPV genotypes than in those with single HPV infection (p < 0.05). The probability of recurrence was higher in patients with the same HPV infection genotype before and after surgery than in patients with different infection genotypes before and after surgery (p < 0.05).

Conclusion

Combined with the literature review, we believe that patients aged ≥50 years, with ≥3 pregnancies and births, a history of smoking, and consistent genotypes of preoperative and postoperative HPV infection in cervical conization have more HPV re-infection or persistent infection, and that these factors may be high-risk factors for lesion recurrence. For patients with possible potential high-risk factors, we need to carry out individualized follow-up and focused management, take timely and effective management measures, optimize the treatment plan, reduce the recurrence rate, prevent HSIL and cervical cancer, improve the quality of patient’s survival, and improve the prognosis.
An integrated neuroimaging-omics approach for the gut-brain communication pathways in Alzheimer’s disease
Authors: Sheng Can , Du Wenying , Liang Yuan , Xu Peng , Ding Qingqing , Chen Xue , Jia Shulei , Wang Xiaoni
Published: October 2023

A key role of the gut microbiota in the pathogenesis of neurodegenerative diseases, such as Alzheimer’s disease (AD), has been identified over the past decades. Increasing clinical and preclinical evidence implicates that there is bidirectional communication between the gut microbiota and the central nervous system (CNS), which is also known as the microbiota-gut-brain axis. Nevertheless, current knowledge on the interplay between gut microbiota and the brain remains largely unclear. One of the primary mediating factors by which the gut microbiota interacts with the host is peripheral metabolites, including blood or gut-derived metabolites. However, mechanistic knowledge about the effect of the microbiome and metabolome signaling on the brain is limited. Neuroimaging techniques, such as multi-modal magnetic resonance imaging (MRI), and fluorodeoxyglucose-positron emission tomography (FDG-PET), have the potential to directly elucidate brain structural and functional changes corresponding with alterations of the gut microbiota and peripheral metabolitesin vivo. Employing a combination of gut microbiota, metabolome, and advanced neuroimaging techniques provides a future perspective in illustrating the microbiota-gut-brain pathway and further unveiling potential therapeutic targets for AD treatments.
Effect of newly developed scissors-attached micro-forceps on the recipient clamp time and occurrence of anastomotic site infarction after bypass surgery for moyamoya disease
Authors: Yomo Munetaka , Kitai Ryuhei , Tada Hiroyuki , Isozaki Makoto , Higashino Yoshifumi , Matsuda Ken , Yamauchi Takahiro , Akazawa Ayumi , Kawajri Satoshi , Oiwa Mizuki , Yamada Shintaro , Tsubota Tadahiro , Watanabe Akifumi , Okazawa Hidehiko , Kiyono Yasushi , Arishma Hidetaka , Kikuta Kenichiro
Published: October 2023

Introduction

This study aimed to examine the effect of newly developed scissors-attached micro-forceps in superficial temporal artery-to-middle cerebral artery (STA-MCA) anastomosis for moyamoya disease (MMD).

Materials and methods

Of 179 consecutive STA-MCA anastomoses on 95 hemispheres of 71 MMD patients at the University of Fukui Hospital between 2009 and 2023, 49 anastomoses on 26 hemispheres of 21 patients were enrolled in this retrospective cohort clinical trial intraoperative indocyanine green video-angiography did not demonstrate bypass patency in three anastomoses in two patients who were excluded. Twenty-one anastomosis in 19 hemispheres of 16 patients were performed using the conventional micro-forceps (conventional group, CG), and 25 anastomoses in 22 hemispheres of 19 patients were performed using scissors-attached micro-forceps (scissors group, SG). A small infarction near the anastomotic site detected using postoperative diffusion-weighted imaging was defined as anastomotic site infarction (ASI). Factors affecting the occurrence of ASI were examined by univariate, logistic regression, and receiver operating curve (ROC) analysis.

Results

There were no significant differences in clinical parameters such as age, sex, number of sacrificed branches, number of sacrificed large branches, and number of sutures between the CG and SG. However, the clamp time and occurrence of ASI were significantly lower in the SG than in the CG. Logistic regression analysis revealed that the clamp time was the only significant factor predicting the occurrence of ASI. A receiver operating curve analysis also revealed that the clamp time significantly predicted the occurrence of ASI (area under the curve, 0.875; cutoff value, 33.2 min).

Conclusion

The newly developed scissors-attached micro-forceps could significantly reduce the clamp time and occurrence of ASI in STA-MCA anastomosis for MMD.
Modality-specific brain representations during automatic processing of face, voice and body expressions
Authors: Vaessen Maarten , Van der Heijden Kiki , de Gelder Beatrice
Published: October 2023

A central question in affective science and one that is relevant for its clinical applications is how emotions provided by different stimuli are experienced and represented in the brain. Following the traditional view emotional signals are recognized with the help of emotion concepts that are typically used in descriptions of mental states and emotional experiences, irrespective of the sensory modality. This perspective motivated the search for abstract representations of emotions in the brain, shared across variations in stimulus type (face, body, voice) and sensory origin (visual, auditory). On the other hand, emotion signals like for example an aggressive gesture, trigger rapid automatic behavioral responses and this may take place before or independently of full abstract representation of the emotion. This pleads in favor specific emotion signals that may trigger rapid adaptative behavior only by mobilizing modality and stimulus specific brain representations without relying on higher order abstract emotion categories. To test this hypothesis, we presented participants with naturalistic dynamic emotion expressions of the face, the whole body, or the voice in a functional magnetic resonance (fMRI) study. To focus on automatic emotion processing and sidestep explicit concept-based emotion recognition, participants performed an unrelated target detection task presented in a different sensory modality than the stimulus. By using multivariate analyses to assess neural activity patterns in response to the different stimulus types, we reveal a stimulus category and modality specific brain organization of affective signals. Our findings are consistent with the notion that under ecological conditions emotion expressions of the face, body and voice may have different functional roles in triggering rapid adaptive behavior, even if when viewed from an abstract conceptual vantage point, they may all exemplify the same emotion. This has implications for a neuroethologically grounded emotion research program that should start from detailed behavioral observations of how face, body, and voice expressions function in naturalistic contexts.
Targeting mitophagy for depression amelioration: a novel therapeutic strategy
Authors: Xu Wangjun , Gao Weiping , Guo Yukun , Xue Feng , Di Lulu , Fang Shaojie , Fan Linlin , He Yangyang , Zhou Yunfeng , Xie Xinmei , Pang Xiaobin
Published: October 2023

Major depressive disorder is a global psychiatric condition characterized by persistent low mood and anhedonia, which seriously jeopardizes the physical and mental well-being of affected individuals. While various hypotheses have been proposed to explicate the etiology of depression, the precise pathogenesis and effective treatment of this disorder remain elusive. Mitochondria, as the primary organelles responsible for cellular energy production, possess the ability to meet the essential energy demands of the brain. Research indicated that the accumulation of damaged mitochondria is associated with the onset of depression. Mitophagy, a type of cellular autophagy, specifically targets and removes excess or damaged mitochondria. Emerging evidence demonstrated that mitophagy dysfunction was involved in the progression of depression, and several pharmacological interventions that stimulating mitophagy exerted excellent antidepressant actions. We provided an overview of updated advancements on the regulatory mechanism of mitophagy and the mitophagy abnormality in depressed patients and animals, as well as in cell models of depression. Meanwhile, various therapeutic strategies to restore mitophagy for depression alleviation were also discussed in this review.
Mid-upper arm circumference as a screening tool for identifying underweight adolescents
Authors: Musa Imad R. , Omar Saeed M. , AlEed Ashwaq , Al-Nafeesah Abdullah , Adam Ishag
Published: October 2023

Background

Mid-upper arm circumference (MUAC) is a potentially credible alternative method for body mass index (BMI) to assess nutritional status. We aimed to assess the correlation between MUAC and BMI- Z-score and to identify a reliable MUAC cut-off point to detect underweight (BMI- Z-score of < −2 standard deviation) Sudanese adolescents.

Methods

A cross-sectional study was conducted in eastern Sudan. After obtaining adolescents’ age and sex, their weight, height, and MUAC were measured using the standard procedures. The MUAC (cm) cut-off corresponding to underweight was calculated using receiver operating characteristic (ROC) curve analysis.

Results

In total, 390 adolescents were enrolled in the study and 205 (52.6%) of them were females. The median (interquartile range, IQR) age was 15.1 (14.0–16.3) years. The medians (IQR) of MUAC and BMI- Z-score were 22.0 (20.0–24.0) cm and − 0.62 (−1.5–0.3), respectively. MUAC was positively correlated with BMI Z-score in all participants (r = 0.534, p < 0.001), in females (r = 0.715, p < 0.001), and in males (r = 0.404, p < 0.001). Of the 390 enrolled adolescents, 61(15.6%) were underweight. The MUAC cut-off for underweight was ≤21.2 cm in all participants (Youden’s Index, YI = 0.50; sensitivity = 82.0%; specificity = 68.0%, AUROCC = 0.78), in females (YI = 0.66, sensitivity = 86.0%, specificity = 80.0%, AUROCC = 0.87), and in males (YI = 0.32, sensitivity = 80.0%, specificity = 52.0%, AUROCC = 0.69).

Conclusion

MUAC has good accuracy results and can be adopted for community-based screening of underweight adolescents.
Prevalence and effect on survival of pre-treatment sarcopenia in patients with hematological malignancies: a meta-analysis
Authors: Xiong Jianzhu , Chen Kangkang , Huang Wen , Huang Mingang , Cao Feiyan , Wang Yiwen , Chen Qifeng
Published: October 2023

Background & aims

Evidence regarding the prevalence of pre-treatment sarcopenia and its impact on survival in patients with hematological malignancies (HM) varies across studies. We conducted a systematic review and meta-analysis to summarize this discrepancy.

Methods

PubMed, Embase and Cochrane library were systematically searched for relevant studies. Outcomes assessed were: prevalence of pre-treatment sarcopenia, overall survival (OS), progression-free survival (PFS) and complete response (CR). Weighted mean proportion, odds ratios (ORs) and hazard ratios (HRs) were estimated using a fixed-effects and a random-effects model.

Results

A total of 27 retrospective cohort studies involving 4,991 patients were included in this study. The prevalence of pre-treatment sarcopenia was 37.0% (95% CI: 32.0%-42.0%) in HM patients <60 years and 51.0% (95% CI: 45.0%-57.0%) in≥60 years. Patients with leukemia had the lowest prevalence, compared with those with other HM (38.0%; 95% CI: 33.0%-43.0%; P = 0.010). The presence of sarcopenia was independently associated with poor OS (HR = 1.57, 95% CI = 1.41-1.75) and PFS (HR = 1.50, 95% CI = 1.22-1.83) throughout treatment period, which may be partially attributed to decreased CR (OR = 0.54, 95% CI = 0.41-0.72), particularly for BMI ≥ 25 (P = 0.020) and males (P = 0.020).

Conclusion

Sarcopenia is highly prevalent in patients with HM and an adverse prognostic factor for both survival and treatment efficacy. HM and sarcopenia can aggravate each other. We suggest that in future clinical work, incorporating sarcopenia into risk scores will contribute to guide patient stratification and therapeutic strategy, particularly for the elderly.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier (CRD42023392550).
Placental weights of neonates born with symptomatic congenital syphilis
Authors: Pillay Shakti , Horn Alan R. , Tooke Lloyd
Published: October 2023

Background

Syphilis during pregnancy remains an important global health concern causing miscarriage, stillbirth, preterm birth and neonatal death. As part of the fetal infection, placental changes occur which may include a heavier placenta than expected.

Methods

A cohort of 50 neonates with symptomatic congenital syphilis has previously been described. This cohort was admitted to Groote Schuur neonatal unit in Cape Town South Africa from 2011 to 2013. For this study, the placental weights of the neonates were analyzed and compared to population based placental centiles.

Results

There was data for 37 placentae. Heavy placentae (>90th centile) occurred in 76% of placentae in the study. All 6 infants with birth weights ≥2,500 g had heavy placentae. There was no correlation between placental centile and death.

Conclusion

Heavy placenta are an important and frequent finding with symptomatic congenital syphilis, especially in the larger neonates.
Preterm birth and exercise capacity: what do we currently know?
Authors: O’Dea Christopher A. , Beaven Michael L. , Wilson Andrew C. , Smith Elizabeth F. , Maiorana Andrew , Simpson Shannon J.
Published: October 2023

Objectives

The long-term cardiopulmonary outcomes following preterm birth during the surfactant era remain unclear. Respiratory symptoms, particularly exertional symptoms, are common in preterm children. Therefore, cardiopulmonary exercise testing may provide insights into the pathophysiology driving exertional respiratory symptoms in those born preterm. This review aims to outline the current knowledge of cardiopulmonary exercise testing in the assessment of children born preterm in the surfactant era.

Design

This study is a narrative literature review.

Methods

Published manuscripts concerning the assessment of pulmonary outcomes using cardiopulmonary exercise testing in preterm children (aged <18 years) were reviewed. Search terms related to preterm birth, bronchopulmonary dysplasia, and exercise were entered into electronic databases, including Medline, PubMed, and Google Scholar. Reference lists from included studies were scanned for additional manuscripts.

Results

Preterm children have disrupted lung development with significant structural and functional lung disease and increased respiratory symptoms. The association between these (resting) assessments of respiratory health and exercise capacity is unclear; however, expiratory flow limitation and an altered ventilatory response (rapid, shallow breathing) are seen during exercise. Due to the heterogeneity of participants, treatments, and exercise protocols, the effect of the aforementioned limitations on exercise capacity in children born preterm is conflicting and poorly understood.

Conclusion

Risk factors for reduced exercise capacity in those born preterm remain poorly understood; however, utilizing cardiopulmonary exercise testing to its full potential, the pathophysiology of exercise limitation in survivors of preterm birth will enhance our understanding of the role exercise may play. The role of exercise interventions in mitigating the risk of chronic disease and premature death following preterm birth has yet to be fully realized and should be a focus of future robust randomized controlled trials.
Evaluation of NAVA-PAP in premature neonates with apnea of prematurity: minimal backup ventilation and clinically significant events
Authors: Protain Alison , Firestone Kimberly , Hussain Saima , Lubarsky Daniel , Stein Howard
Published: October 2023

Background

Neonates with apnea of prematurity (AOP) clinically deteriorate because continuous positive airway pressure (CPAP) provides inadequate support during apnea. Neurally adjusted ventilatory assist (NAVA) provides proportional ventilator support from the electrical activity of the diaphragm. When the NAVA level is 0 cmH2O/mcV (NAVA-PAP), patients receive CPAP when breathing and backup ventilation when apneic. This study evaluates NAVA-PAP and time spent in backup ventilation.

Methods

This was a prospective, two-center, observational study of preterm neonates on NAVA-PAP for AOP. Ventilator data were downloaded after 24 h. The number of clinically significant events (CSEs) was collected. A paired t-test was used to perform statistical analysis.

Results

The study was conducted on 28 patients with a gestational age of 25 ± 1.8 weeks and a study age of 28 ± 23 days. The number of CSEs was 4 ± 4.39/24 h. The patients were on NAVA-PAP for approximately 90%/min, switched to backup mode 2.5 ± 1.1 times/min, and spent 10.6 ± 7.2% in backup.

Conclusion

Preterm neonates on NAVA-PAP had few CSEs with minimal time in backup ventilation.
Modeling the protein binding non-linearity in population pharmacokinetic model of valproic acid in children with epilepsy: a systematic evaluation study
Authors: Zhang Lina , Liu Maochang , Qin Weiwei , Shi Dandan , Mao Junjun , Li Zeyun
Published: October 2023

Background: Several studies have investigated the population pharmacokinetics (popPK) of valproic acid (VPA) in children with epilepsy. However, the predictive performance of these models in the extrapolation to other clinical environments has not been studied. Hence, this study evaluated the predictive abilities of pediatric popPK models of VPA and identified the potential effects of protein binding modeling strategies.

Methods: A dataset of 255 trough concentrations in 202 children with epilepsy was analyzed to assess the predictive performance of qualified models, following literature review. The evaluation of external predictive ability was conducted by prediction- and simulation-based diagnostics as well as Bayesian forecasting. Furthermore, five popPK models with different protein binding modeling strategies were developed to investigate the discrepancy among the one-binding site model, Langmuir equation, dose-dependent maximum effect model, linear non-saturable binding equation and the simple exponent model on model predictive ability.

Results: Ten popPK models were identified in the literature. Co-medication, body weight, daily dose, and age were the four most commonly involved covariates influencing VPA clearance. The model proposed by Serrano et al. showed the best performance with a median prediction error (MDPE) of 1.40%, median absolute prediction error (MAPE) of 17.38%, and percentages of PE within 20% (F20, 55.69%) and 30% (F30, 76.47%). However, all models performed inadequately in terms of the simulation-based normalized prediction distribution error, indicating unsatisfactory normality. Bayesian forecasting enhanced predictive performance, as prior observations were available. More prior observations are needed for model predictability to reach a stable state. The linear non-saturable binding equation had a higher predictive value than other protein binding models.

Conclusion: The predictive abilities of most popPK models of VPA in children with epilepsy were unsatisfactory. The linear non-saturable binding equation is more suitable for modeling non-linearity. Moreover, Bayesian forecasting with prior observations improved model fitness.
“Bet hedging” against climate change in developing and adult animals: roles for stochastic gene expression, phenotypic plasticity, epigenetic inheritance and adaptation
Authors: Burggren Warren W. , Mendez-Sanchez Jose Fernando
Published: October 2023

Animals from embryos to adults experiencing stress from climate change have numerous mechanisms available for enhancing their long-term survival. In this review we consider these options, and how viable they are in a world increasingly experiencing extreme weather associated with climate change. A deeply understood mechanism involves natural selection, leading to evolution of new adaptations that help cope with extreme and stochastic weather events associated with climate change. While potentially effective at staving off environmental challenges, such adaptations typically occur very slowly and incrementally over evolutionary time. Consequently, adaptation through natural selection is in most instances regarded as too slow to aid survival in rapidly changing environments, especially when considering the stochastic nature of extreme weather events associated with climate change. Alternative mechanisms operating in a much shorter time frame than adaptation involve the rapid creation of alternate phenotypes within a life cycle or a few generations. Stochastic gene expression creates multiple phenotypes from the same genotype even in the absence of environmental cues. In contrast, other mechanisms for phenotype change that are externally driven by environmental clues include well-understood developmental phenotypic plasticity (variation, flexibility), which can enable rapid, within-generation changes. Increasingly appreciated are epigenetic influences during development leading to rapid phenotypic changes that can also immediately be very widespread throughout a population, rather than confined to a few individuals as in the case of favorable gene mutations. Such epigenetically-induced phenotypic plasticity can arise rapidly in response to stressors within a generation or across a few generations and just as rapidly be “sunsetted” when the stressor dissipates, providing some capability to withstand environmental stressors emerging from climate change. Importantly, survival mechanisms resulting from adaptations and developmental phenotypic plasticity are not necessarily mutually exclusive, allowing for classic “bet hedging”. Thus, the appearance of multiple phenotypes within a single population provides for a phenotype potentially optimal for some future environment. This enhances survival during stochastic extreme weather events associated with climate change. Finally, we end with recommendations for future physiological experiments, recommending in particular that experiments investigating phenotypic flexibility adopt more realistic protocols that reflect the stochastic nature of weather.