bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of axillary lymph node metastasis with the ultrasound and Magnetic Resonance Imaging features in breast cancer
Authors: Shang Qiu Jing , Li Yan Qin , Lang Man Lin , Chen Xu Wei , Li De Xin , Yu Jie , Liang Ping
Published: August 2024

Purpose
The prediction of axillary lymph node metastasis (ALNM) in patient with breast cancer before surgery is of great value. We aim to develop a preoperative nomogram by integrating clinical-pathological variables with ultrasound (US)and magnetic resonance imaging (MRI) features to forecast axillary lymph node metastasis, and to evaluate whether the diagnostic performance of a combined US-MRI model outperforms that of standalone imaging modalities.
Method
In this retrospective study, 1481 women with breast cancer who underwent surgery were identified from the hospital between November 2009 and April 2022. According to inclusion and exclusion criteria,885women were classified at 6:4 ratio into training and validation set. MRI and US scans before surgery and clinical-pathologic data were reviewed. The prediction models were developed in the training set by using logistic regression and LASSO regression and then tested in the validation set.
Result
Our training set included 535 women, aged 52 ± 11 years, with 165 cases of axillary lymph node metastases. The validation set comprised 356 women, aged 54 ± 11 years, including 113 cases with metastases. Variables such as the number, size, and location of nodes, morphology, calcification, ADC, pathological patterns, molecular subtypes, and minor-axis dimensions, along with cortical thickness, were significantly associated with an increased risk of axillary lymph node involvement (all P < 0.05). Our predictive model, integrating ultrasound (US) and MRI-based clinical-pathological features (CPUM), showed better performance (AUC = 0.795 for ALNM) in predicting axillary lymph node metastases than the individual models based solely on US features (CPU) (AUC = 0.766 for ALNM; P = 0.0192) or MRI features (CPM) (AUC = 0.760 for ALNM; P = 0.0088) in the validation set.
Conclusion
The preoperative nomogram, in combination with clinical-pathologic variables and US and MRI features, demonstrated superior predictive performance for axillary lymph node metastasis in patients with breast cancer compared to the use of US or MRI features alone.
Analysis of the Surprise Question as a tool for predicting death in neonates
Authors: Asenjo Silvia , Soler-Garcia Aleix , Palomo Ana Morillo , Jordana Anna Habimana , Guillen Montserrat , Bolancé Catalina , Vilarrubí Sergi Navarro
Published: August 2024

Purpose
The Surprise Question (SQ) "Would you be surprised if the patient died in the next 12 months?" lacks pediatric research, particularly in neonatal patients. Our study aims to analyze the SQ’s predictive ability in neonates and explore pediatricians’ views on palliative care (PC) patient identification.
Methods
A prospective cross-sectional study was conducted from February 2021 to June 2023, including all newborns admitted to the Neonatal Intensive Care Unit of a pediatric tertiary hospital and its pediatricians. Patients with less than a year since admission were excluded from final analyses.
Recorded variables included patient demographics and condition, pediatricians’ profile and opinions regarding the SQ and PC patient identification. The SQ was formulated to one or more pediatricians per neonate at admission, 7 days and 28 days of life, with patient status recorded after twelve months to elaborate a confusion matrix of prognostic test results.
Results
A total of 51 pediatricians participated. Most felt they had limited criteria for identifying PC patients (55%), believed the SQ could be useful (77%) and predict death (75%).
The SQ was answered at least in one out of the three moments for 262 neonates (61% male and at least 35,5% preterm), with sufficient sample at each moment to study its predictive ability. High negative predictive values were consistent, with higher positive predictive value at 7 days (25,7%).
Conclusions
The SQ is a promising tool for predicting neonatal outcome and could guide professionals in initiating PC discussions. The 7-day mark appears more suitable for its application.
Exploring the Pathogenesis of NAFLD: A Study of the Correlation of Gut Microbes and Metabolites in Humanized Mouse Gut Microbiota
Authors: Cheng Yuanzhi , Yang Yun , Guo Yaxi , Shi Yang , Feng Jianghao , Jiang Xiaoliang , Yang Zhiwei , Zhu Hua , Liu Xing
Published: August 2024

There is mounting scientific evidence indicating a robust association between gut microbiota and nonalcoholic fatty liver disease (NAFLD). Exposure to commensal microbiota in germ-free mice has a significant impact on the regulatory mechanisms of gut genes, in contrast to those conventionally raised. In this study, we have successfully inoculated the gut microbiota from healthy individuals and NAFLD patients into germ-free mice, with the objective of developing a humanized mouse model that accurately replicates the gut microenvironment of NAFLD patients. Changes in blood composition and liver pathology in these mice were systematically measured. Furthermore, we have conducted a det ailed analysis of the variations in fecal microbiota and differential metabolites in the blood composition. Our findings indicate a high degree of similarity in disease characteristics between mice colonized with microbiota and humans suffering from NAFLD. Notably, we have observed a strong correlation between alterations in serum differential metabolites and gut microbiota in these mice.
Novel Donor–Acceptor Based 4-Nitrophenol luminophors as a Yellow-Orange Fluorescent Material for Optoelectronic Applications
Authors: Mane K. G. , Pujari S. R. , Shahabade V. , Nagore P. B.
Published: August 2024

A new category of 4-nitrophenol (4-NP) luminophores, infused with differing quantities of Pyrene (Py), was synthesized using the standard solid-state reaction method to explore novel luminophores emitting at longer wavelengths. Their optical and electrochemical properties were analyzed through fluorimetry and Cyclic Voltammetry techniques, respectively. The fluorescence spectrum of Py-doped 4-NP exhibited a broad fluorescence band peaking at 599 nm for a Py concentration of 1x10− 3 mol, confirming exciplex formation between 4-NP and Py in the excited state. Based on electrochemical data, the energy levels of the Highest Occupied Molecular Orbital (HOMO) and Lowest Unoccupied Molecular Orbital (LUMO) were determined for the prepared luminophores, falling in between 5.72–5.73 eV and 3.01–3.08 eV, respectively. Thermal stableness was assessed via TGA analysis, while SEM images revealed crystal sizes of approximately 115 nm. Consequently, this comprehensive investigation suggests the potential utility of these newly developed yellow-orange fluorescent luminophores in optoelectronic applications.
Whole grain oat attenuates high-fat and high-cholesterol diet-induced dyslipidemia by modulating non-12OH bile acid ratio via the gut-liver axis
Authors: Pan Da , Xia Hui , Wang Yuanyuan , Wang Pei , Fu Bingmeng , Yin Shiyu , Wang Yin , Qu Xuefeng , Zhang Yangjunna , Hu Jingjin , Sun Guiju , Xu Dengfeng
Published: August 2024

Background
Dyslipidemia is a chronic, metabolic disease characterized by elevated level of serum total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C), and acts as a key contributor to the development of cardiovascular diseases (CVDs). Our previous work has shown that whole grain oat supplementation exerted cholesterol-lowering properties by modulating gut microbiota in individuals with hyperlipidemia. However, it is not clear that whether the cholesterol-lowering effect of whole grain oat depends on gut microbiota and its metabolites. In this study, we leverage a high-fat and high-cholesterol (HFHC) diet induced model of dyslipidemia that exhibits significant remission following whole grain oat intervention, to conduct an animal experiment that integrates clinical parameters, 16S rRNA sequencing, targeted metabolomic profiling and fecal microbiota transplantation (FMT) to investigate the relationship between whole grain oat diet, gut microbiota, and dyslipidemia.
Results
We demonstrated that the improvements in blood circulating TC and LDL-C level induced by a whole grain oat diet is accompanied by alterations in gut microbiota diversity and structure marked by increased abundance of probiotics (e.g., Bifidobacterium and Parabacteroides). Targeted metabolomic profiling analysis showed that whole grain oat supplementation increases the ratio of non-12OH/12-OH bile acid (BA), level of HDCA, GCDCA-3S, IDCA, and propionate acid. Correlation analysis showed that the alteration in the metabolic profiles is closely related to the changed microbial taxa. Consistently, the expression level of proteins involved in BAs synthesis (especially the alternative pathway) was significantly activated by whole grain oat supplementation. Subsequently, FMT treatment attenuated the abnormal increase of serum lipid in the model rat. Finally, when HDCA was administered to rats for 8 weeks, the circulating TC and LDL-C level were significantly ameliorated.
Conclusions
These data revealed that whole grain oat supplementation ameliorated the dyslipidemia in a gut microbiota-dependent manner, via promoting the production of short-chain fatty acids (SCFAs), activating the alternative pathway of BAs metabolism and increase the ratio of non-12OH/12-OH BAs. Our findings provide a promising, and novel therapeutic strategy for gut microbiota to prevent and treat dyslipidemia.
Integrated Analysis of POL Family Gene Mutations in AML: Clinical Features, Prognosis, and Bioinformatics Insights
Authors: Wu Jianrong , wang chaoban , Tang Wenhao , Gao Ju , Guo Xia
Published: August 2024

Introduction:
The long-term prognosis of acute myeloid leukemia (AML) is challenging due to limited understanding of the molecular markers involved in its development. This study investigates the role of DNA polymerases in AML to offer new insights for diagnosis and treatment.
Methods
A retrospective study on pediatric AML patients with POL gene family mutations from 2021 to 2024 was conducted. Patients were categorized based on risk stratification criteria, and the DAH regimen was used for induction chemotherapy. Bioinformatics analysis integrated data from various databases to identify key genes and develop survival analysis plots and AUC curves.
Results
The study included 59 pediatric AML patients, revealing no significant differences in demographic or clinical characteristics between those with and without POL family gene mutations. However, patients with POL gene mutations showed higher complete remission rates after initial DAH chemotherapy (91.67% vs. 59.57%, P = 0.03607), indicating a potential treatment benefit. High expression of four POL genes (POLD1, POLE, POLG, POLQ) in bone marrow and immune cells suggests their crucial role in hematopoiesis and immune response. Survival analysis across different datasets indicated that AML patients with overexpressed POL family genes had significantly worse outcomes, proposing these genes as potential prognostic biomarkers for AML.
Discussion
This study on pediatric AML demonstrates that POL gene family mutations are associated with higher remission rates post-chemotherapy, indicating their potential as prognostic markers. Bioinformatics analysis emphasizes the significance of these mutations in AML, highlighting their impact on disease prognosis.
A Case of Bilateral Mirror Movements secondary to Unilateral Closed Lip Schizencephaly
Authors: Dao Kevin Trong , Ipe Jennifer , Hart Spencer , Veedu Hari Kunhi
Published: August 2024

Schizencephaly is a very unique disease due to an abnormal migration of fluid-filled clefts that communicate between the lateral ventricles and cerebrum. Due to these abnormal migrations, neurological abnormalities can occur to varying degrees. In fact, in some instances, mirror movements, which are a form of involuntary movement where intentional movements of one side result in unintentional movements of the opposing side, can occur. However, these cases are rare since the incidence of either one of these diseases separately is very low. Here we would like to present a very rare case of a 23-year-old male with right-sided closed-lip schizencephaly resulting in bilateral mirror movements. A discussion regarding how this patient has a bilateral motor dysfunction despite having unilateral biological and neurological disease will also be held.
First identification and whole genome characterization of rotavirus C in pigs in Zambia
Authors: Harima Hayato , Qiu Yongjin , Sasaki Michihito , Ndebe Joseph , Penjaninge Kapila , Simulundu Edgar , Kajihara Masahiro , Ohnuma Aiko , Matsuno Keita , Nao Naganori , Orba Yasuko , Takada Ayato , Ishihara Kanako , Hall William W , Hang’ombe Bernard , Sawa Hirofumi
Published: August 2024

Background
Rotavirus C (RVC) is a causative agent of gastroenteritis in suckling neonatal piglets. The increased prevalence of RVC infection in pig populations, and the higher genetic diversity of porcine RVC strains influence the productivity in the pig industry. Despite the clinical importance, the distribution and prevalence of RVC infection in pigs in most African countries remains unknown. In this study, we investigated the prevalence of RVC infection in pigs in Zambia.
Results
RVC genomes were detected in fecal samples from pigs in Zambia by metagenomic analyses. The full genome sequence of the RVC revealed two different sequences of the VP4 gene segment, implying that two different RVC strains (ZP18-77-c1 and ZP18-77-c2) were present in the same sample. Genetic analyses revealed that all segments of ZP18-77-c1 and ZP18-77-c2 showed high nucleotide sequence identities (87.7–94.5%) to reported porcine RVC strains in Asia, Africa, Europe, and North America. ZP18-77-c1 and ZP18-77-c2 strains were assigned to genotype constellations, G1-P[4]-I13-R5-C5-M1-A7-N9-T10-E5-H1 and G1-P[14]-I13-R5-C5-M1-A7-N9-T10-E5-H1, respectively, according to the whole genome classification for RVC. We further screened RVC genomes among fecal samples collected from pigs in Zambia (n = 147) by RT-qPCR. Of these, 78 samples (53.1%) were positive, and RVC genomes were detected in all the examined farms, suggesting widespread infection in Zambia.
Conclusions
This study demonstrated the first full genome sequence of RVC strains in Africa with a relatively high prevalence of RVC in the pig populations in Zambia. Considering the limited genetic and epidemiological information of RVC infection in African countries, further RVC surveillance is required to improve productivity in pig industry as well as to assess the potential zoonotic risk to humans and animals.
Determinants and Sequelae of Smoking: Prevalence, Incidence, and Cessation Among Male Adults in Abu Dhabi, United Arab Emirates. A Retrospective Cohort Study
Authors: AlKetbi Latifa Baynouna , AlKetbi Fatima Ali , Nagelkerke Nico , AlDhaheri Alreem Abdulla , AlNeyadi Amna Matar , AlKalbaani Sanaa , Humaid Ahmed , AlAzeezi AlYazia , AlDobaee Muna Galal , AlMansoori Mohammed , Mahmoud Esraa , AlKetbi Rudina , Aleissaee Hamda , AlAlawi Noura , Shuaib Fatima , Fahmawee Toqa , AlHashaikeh Basil
Published: August 2024

Objectives
The study aimed to determine the prevalence and the cumulative risk of smoking among national male adults in Abu Dhabi, and to assess the determinants of starting, quitting, maintaining cessation, and continuing smoking among them.
Methods
This retrospective cohort study has an average follow-up period of 9 years. The study population was national males aged 18 years and above. Data was initially collected from the medical electronic records of individuals who participated in a comprehensive screening program (Weqaya) performed in Abu Dhabi ambulatory healthcare services in 2011–2013.
Results
The prevalence of smoking among male adults was 21%. The cumulative risk of smoking was 45%, with the highest risk observed in adults aged 30–39. Young age and lower cholesterol level were the main determinants of starting smoking. The predictors of quitting smoking were younger age, lower systolic blood pressure, higher cholesterol, lower high-density lipoprotein (HDL), lower glomerular filtration rate (GFR), and vitamin D level. History of acute coronary syndrome (ACS) was a determinant for maintaining smoking cessation. Continuing smoking is associated with a higher risk of developing diabetes mellitus (DM), stroke, acute coronary syndrome (ACS), psychiatric illness, non-alcoholic fatty liver disease (NAFLD), and peripheral artery disease (PAD), while smoking cessation is associated with a reduced risk of those conditions.
Conclusions
The study confirms smoking's health burden in Abu Dhabi and its association with various health risks.
Nudging COVID-19 vaccination with an inferior option: an online experimental study testing the asymmetric dominance effect
Authors: Grimani Aikaterini , Stoffel Sandro , von Wagner Christian , Sniehotta Falko , Vlaev Ivo
Published: August 2024

Optimising vaccine uptake is a public health challenge and requires effective strategies. The asymmetric dominance (or decoy) effect describes the increasing likelihood of choosing an alternative when an inferior alternative is offered. Therefore, we aimed to test the impact of offering decoy alternatives, less convenient vaccination appointments, on vaccination intentions. Participants aged 18–33, living in England, who did not intend to get vaccinated, undertook three online experiments. They were randomly assigned to a control or an experimental condition in each experiment. The asymmetrically dominated options were an appointment in two weeks-time at a distant location (experiment 1); at a later time at the participant’s local GP, pharmacy, or community centre (experiment 2); and at a later time at a distant location (experiment 3). Vaccination intention was the primary outcome. Secondary outcomes included an active interest in reading additional information about the vaccination procedure, perceived difficulty and cognitive effort. Initial analysis showed no asymmetric dominance effect. However, further subgroup analysis indicated that ensuring the decoy alternatives are perceived as inferior through formative research could enhance the effectiveness of this approach for some individuals.
Rare Case of Multiple Rhabdomyomas in a Newborn without Tuberous Sclerosis Complex
Authors: Alsuliman Raghad Mahmoud , Hossin Huda , kababeh karam , Saleh Heba Haj , Achmeh Bassel , takkem Saleh
Published: August 2024

The case of a pregnant woman who presented at 16 weeks of gestation for routine pregnancy monitoring. Despite being in good health, the patient had a history of cardiac anomalies in previous births. A fetal echocardiogram revealed the presence of multiple rhabdomyomas tumors, associated with tuberous sclerosis complex in the fetus. The patient delivered a male infant via cesarean section at 39 weeks of gestation, and postnatal ultrasound imaging confirmed the presence of the tumors. Detailed genetic and pediatric studies revealed no valvular disorders or hemodynamic abnormalities. The infant's cardiac functions were normal, and follow-up visits are planned for the regression of the condition over the next two years. Since cardiac rhabdomyomas can be an early indication of tuberous sclerosis. Hence, comprehensive fetal screening for the complex should be conducted after the diagnosis of multiple cardiac tumors to ensure thorough evaluation and appropriate management
Prevalence of Lateral Epicondylitis among Housewives in Lahore: A Cross-sectional Study
Authors: Akbar Hira , Akbar Seher , Saddique Muhammad Nabeel
Published: August 2024

Background
Lateral epicondylitis (LE) is characterized by pain, inflammation and local tenderness over the bony prominence of lateral epicondyle and is exacerbated under stressful and repetitive movements such as prolonged supination and pronation movements, twisting and rolling activities. Lateral Epicondylitis ranks as the second most commonly diagnosed musculoskeletal condition. Females, especially housewives, are more affected by LE. It can lead to persistent elbow pain, reduced grip strength, limited arm movement, and difficulty performing daily tasks
Results
All of our 150 participants were women aged 25–50 years. We found that 17% (26 of 150) housewives have severe type of pain, 43% (65 of 150) have moderate pain, 30% (45 of 150) have mild pain, 9% (14 of 150) reported no pain at all according to PRTEE questionnaire. We also found that most affected part of body by pain was arm (68%) (102 of 150) while 26% (39 of 150) reported pain in both arms. Only 30.7% of women (46 of 150) reported functional limitations during specific activities, 26% (29 of 150) during usual activities, while the remaining 43.3% (65 of 150) were pain-free.
Conclusion
We found a high prevalence of patient-reported lateral epicondylitis among housewives with arms affected by pain most hindering functional mobility of body. Robust studies with larger sample size are needed to establish conclusive evidence.
Pitfalls in using ML to predict cognitive function performance
Authors: Kuhles Gianna , Hamdan Sami , Heim Stefan , Eickhoff Simon , Patil Kaustubh R. , Camilleri Julia , Weis Susanne
Published: August 2024

Machine learning analyses are widely used for predicting cognitive abilities, yet there are pitfalls that need to be considered during their implementation and interpretation of the results. Hence, the present study aimed at drawing attention to the risks of erroneous conclusions incurred by confounding variables illustrated by a case example predicting executive function performance by prosodic features. Healthy participants (n = 231) performed speech tasks and EF tests. From 264 prosodic features, we predicted EF performance using 66 variables, controlling for confounding effects of age, sex, and education. A reasonable model fit was apparently achieved for EF variables of the Trail Making Test. However, in-depth analyses revealed indications of confound leakage, leading to inflated prediction accuracies, due to a strong relationship between confounds and targets. These findings highlight the need to control confounding variables in ML pipelines and caution against potential pitfalls in ML predictions.
The Association between the Presence of Kidney Stones and the Risk of Developing Osteoporosis: A NHANES-based Cross-sectional Study and Mendelian Randomization Analysis
Authors: Dong Juefei , Hou Weibin , Yin Guangming , Wang Jinrong , Wang Long , Liu Jianye , Jiang Xianzhen , Tan Jing
Published: August 2024

Background Kidney stone disease is thought to be a risk factor
for osteoporosis, but the causality between the conditions remains
unknown.. Thus, we implemented a NHANES-based cross-sectional study
and mendelian randomization
to investigate whether the presence of kidney stones increases the risk of developing osteoporosis.
Methods
First, we performed an observational study on the basis of data from the National Health and Nutrition Examination Survey (NHANES; 2007–2020). Kidney stone patients were identified on the basis of their affirmative response to the question "Have you ever experienced kidney stones?" (KIQ026). Participants whose T score at the femoral neck was <-2.5 were defined as osteoporosis patients. Multivariable-adjusted logistic regression was used to assess the correlation between the presence of kidney stones and the risk of developing osteoporosis. Second, Mendelian randomization (MR) was applied to further investigate the causal relationship between the presence of kidney stones and the risk of developing osteoporosis. Genetic instruments were obtained from large genome-wide association studies (GWASs) from the UK Biobank and FinnGen Biobank. Inverse-variance weighting (IVW) was the primary analytical method used.
Results
After adjustment for demographic and other covariates, a significant association between the presence of kidney stones and the risk of developing osteoporosis was detected (OR 1.778, CI: 1.345–2.351, P < 0.001). The MR results further revealed that genetically speaking, the presence of kidney stones was causally associated with a greater risk of developing osteoporosis (IVW: OR 1.088, CI: 1.015–1.167, P < 0.05).
Conclusion
The presence of kidney stones is associated with an increased risk of developing osteoporosis. Further prospective cohort studies are needed to validate our results.
Infantile Injury and Its Recurrence: A Nationwide Longitudinal Survey in Japan
Authors: Hiraoka Tomohiro , Obara Takafumi , Matsumoto Naomi , Tsukahara Kohei , Hongo Takashi , Nojima Tsuyoshi , Hisamura Masaki , Yumoto Tetsuya , Nakao Atsunori , Yorifuji Takashi , Naito Hiromichi
Published: August 2024

Injury recurrence in young children is a significant public health concern, as it may indicate an unfavorable home environment. This study evaluates whether infantile injuries increase recurrence during preschool years, contributing to more effective prevention strategies for vulnerable families. The study included 20,191 children from "The Longitudinal Survey of Babies in the 21st Century," a representative sample of infants born in Japan between May 10 and 24, 2010. We conducted a logistic regression analysis to compare injury recurrence risk between children aged 18 months to seven years with and without infantile injury histories. The study revealed that infants with a history of injuries had a higher risk of subsequent hospital visits for injuries during preschool years (crude Odds Ratio (cOR) 1.52, 95% CI, 1.41–1.64, adjusted OR (aOR) 1.48, 95% CI 1.37–1.60). Specific injuries, such as falls (aOR 1.34, 95% CI, 1.26–1.43), pinches (aOR 1.22, 95% CI, 1.15–1.29), drowning (aOR 1.29, 95% CI, 1.19–1.40), ingestion (aOR 1.35, 95% CI, 1.17–1.55), and burns (aOR 1.47, 95% CI, 1.31–1.65), independently increased the risk of future injuries. Our findings highlight the necessity of universal safety measures in the home environment and targeted interventions for families with a history of high-risk injuries.
Contextualizing abortion opinions in Kenya: A vignette-based national survey
Authors: Ushie Boniface Ayanbekongshie , Akuku Isaiah G , Mutuku Esther , Juma Kenneth
Published: August 2024

Objectives: Abortion is a deeply controversial public health issue, evoking diverse opinions regardless of the legal context. Policymaking on abortion often relies on generalized public opinion surveys lacking contextual nuance. We examined public opinions in Kenya towards abortion in circumstances of rape, health risks, and fetal anomalies.
Methods: We used a nationally representative sample of 8,942 adults in Kenya, drawn from a database of 12 million phone users in Kenya. Using a two-stage sampling approach with random digit dialing, the sample was stratified by location, sex, and age to facilitate proportional representation. We utilized a questionnaire adopted from a vignette-based tool, with scenarios describing threats to the life or health of the pregnant woman, fetal anomaly, and rape. The tool had 14 opinion statements corresponding to each vignette and three questions on whether respondents support women’s abortion rights in these circumstances. Trained interviewers administered the questionnaire through telephone between October and November 2022. We employed multivariable-adjusted linear regression to assess factors influencing abortion opinions.
Results: Most respondents (>61%) favored women’s right to abortion when pregnancies threaten their life or health, compared to 29% and 44% who supported it in cases of rape or fetal anomaly. There was significant support for abortion to be performed by the public health system, compared to abortion as a woman’s right. Generally, the liberal constructs had higher mean scores than the conservative constructs, and the women’s reproductive autonomy had the highest mean score (3.44±1.07) among all the constructs, suggesting widespread agreement that abortion decisions should rest solely with the pregnant woman. Conversely, among conservative constructs, the sanctity of life had the highest mean score (2.40±0.89), showing a strong belief in the sanctity of life among abortion opponents.
Conclusion: Abortion opinions vary depending on the circumstances, with significant support for legal abortion under diverse contexts. Public policy should reflect these contextualized opinions and address specific impediments to support, especially towards legalization as a public health, gender equality and human rights imperative.
Clinical and Pharmacogenomic Predictors of Survival in Tamoxifen Treated Breast Cancer Female Patients: A Real-World Study
Authors: Al-Matrafi Abdullah R. , Bedair Khalid F. , Sriniva Sundar , Palmer Colin , Campbell Archie , Hayward Caroline , Pearson Ewan R. , Petty Russell D.
Published: August 2024

Aim
To investigate the impact of tamoxifen treatment coverage, CYP2D6 inhibitors, CYP2D6*4 genotype, and non-genetic parameters on the outcomes of tamoxifen treated female breast cancer patients.
Method
We retrospectively included 3218 female patients who initiated tamoxifen following a diagnosis of breast cancer with long-term follow-up (median 7.5 years). A subgroup analysis of 303 genotyped patients with a median follow-up of 9.7 years was also conducted. The outcomes of interest were overall survival (OS) and breast-cancer-specific survival (BCS).
Results
In the whole cohort, a 10% increase in tamoxifen coverage over a six-month period was associated with a 27% increase in OS (HR: 0.73, 95% CI: 0.71–0.0.75, P < 0.001) and a 30% increase in BCS (HR: 0.7, 95% CI: 0.67–0.73, P < 0.001). In the genotyped subgroup, CYP2D6*4 heterozygotes had a 76% greater risk of all-cause mortality than *4 non-carriers (HR: 1.76, 95% CI: 1.07–2.9, P = 0.025). For breast cancer-specific mortality, CYP2D6*4 heterozygotes and homozygotes had increased risk by 3.7-fold (HR: 3.7, 95% CI: 1.32–10.6, P = 0.01) and 11.6-fold (HR: 11.6, 95% CI: 1.3–103.5, P = 0.03), respectively.
Conclusion
Our study demonstrates that carriers of CYP2D6*4 have a higher risk of both all-cause and breast cancer-specific mortality and indicates that longer follow-up time may be crucial to determining impact. The shorter follow-up in previous studies may be a key reason for the conflicting results. A large real-world pharmacogenomic study with long-term follow-up is warranted to determine the impact of CYP2D6 genotyping and its implications for clinical decision making.
Tumor distribution type help distinguish the prognosis of HCC patients with multiple tumors in BCLC-A stage: A multicenter retrospective study
Authors: Ding Wenzhen , Tian Xueqin , Xu Haokai , Cheng Zhigang , Zheng Lin , Liu Fangyi , Yu Jie , Liang Ping
Published: August 2024

Background:
Hepatocellular carcinoma (HCC) patients with multiple tumors have a poor prognosis and need more attention. Therefore, we aim to find an easy-available radiologic indicator that can differentiate prognosis for BCLC-A patients with multiple tumors.
Methods:
Magnetic resonance imaging (MRI) of patients received thermal ablation, laparoscopic hepatectomy, or laparoscopic hepatectomy combined with thermal ablation from five tertiary hospitals were collected. Tumor distribution (TD) was classified into three types: same-segment, different-segments and different-lobes, and three junior doctors (< 5year-experience) were invited to classified classification. We compared disease-free survival (DFS) and overall survival (OS) among different TD types, and performed pathological consistency and classification analysis to explicate. Six pathological indicators (tumor differentiation, AFP, Arg-1, HepPar1, CK-19 and VEGF) were included.
Results:
373 patients were included with a 36.0-month median follow-up. Fleiss' kappa among three doctors was 0.803. Patients with same-segment type had better DFS and OS than different-segments (p < 0.001) and different-lobes (p < 0.001) type, so same-segment was defined as concentrated distribution. Different-segments and different-lobes type had comparable DFS (p = 0.072) and OS (p = 0.83), and were defined as dispersed distribution. Patients in concentrated group had higher pathological consistency in tumor-differentiation (96.2%vs86.7%, p = 0.003), AFP (95.3%vs84.4%, p = 0.005), Arg-1 (96.7%vs83.3%, p = 0.001) and CK-19 (96.0%vs82.4%, p = 0.004), and better tumor-differentiation (23.3%vs41.7%, p < 0.001) and lower expression rate in AFP (36.8%vs49.5%, p = 0.035), CK-19 (9.3%vs24.3%, p = 0.008) and VEGF (17.0%vs39.3%, p = 0.004) than dispersed group.
Conclusion:
MRI can accurately classify tumor distribution type of multiple tumors for patients in BCLC-A stage, and patients with concentrated distribution tumors have better prognosis than patients with dispersed distribution.
Association of Upper Urinary Tract and Renal Vasculature Anatomical Variations: Evidence From Northern Nigeria
Authors: UMAR Ahmad Bashir , ISYAKU Kabir , AJI Sani A. , ISMAIL Anas
Published: August 2024

Background
The knowledge of anatomical variations as they relate to the urinary system is valuable, especially in the proper evaluation and conduction of surgical as well as interventional procedures of the urinary tract. The study aimed to determine the prevalence and possible association between anatomical variations of the upper urinary tract and renal vasculature.
Methodology
: A total of 200 computed tomograms were generated with Toshiba Aquilion Prime 160-slice scanner and analyzed for the presence of potential anatomical variations using a Vitrea multimodality work station capable of image post processing by two expert radiologists.
Results
The most common anatomical variation of the upper urinary tract found on the right was extra-renal bifid pelvis at 25 (12.5%) while on the left it was baggy extra-renal pelvis at 27 (13.5%). Early branching hilar renal artery and accessory superior polar renal artery both at 19 (9.5%) were the most common renal vasculature variations on the right and left respectively. There was statistically significant association between anatomical variations of the upper urinary tract and renal vasculature with a p-value of < 0.001.
Conclusion
This study showed that anatomical variations of the upper urinary tract are commoner on the right side while for renal vasculature they are commoner on the left. There was a statistically significant association between the anatomical variations of the upper urinary tract and that of the renal vasculature indicating an increasing likelihood of one occurring if the other is present.
Efficacy of Ocrelizumab Versus Rituximab in Patients With Relapsing-remitting Multiple Sclerosis
Authors: Mounir Nesma , Shalaby Nevin , Hegazy Mohamed I. , Kishk Nirmeen , Shehata Hatem , Abdalgeleel Shaimaa abdalaleem , Abdulrahman Ahmed Mohammed , Merghany Nahla
Published: August 2024

Background
Ocrelizumab (OCR) and rituximab (RTX) are monoclonal antibodies binding to CD20, inducing B-cell depletion. The randomized controlled trials that compare their effectiveness in people with Multiple sclerosis (pwMS) are still ongoing. This study aims at comparing the efficacy of ocrelizumab (OCR) and rituximab (RTX) in treating pwMS.
Methods
We conducted a retrospective cohort study in patients with relapsing remitting multiple sclerosis (RRMS) treated with either OCR or RTX. Patients were recruited from the Kasr Al-Ainy MS research unit (KAMSU) at Cairo University, Egypt. Data were collected at least one year of the first anti-CD20 infusion. The primary outcome was the time to 3-month confirmed disability worsening (3 month-CDW). Secondary outcomes were time to first relapse (TTFR), 3-month confirmed disability improvement (CDI), annualized relapse rate (ARR), and magnetic resonance imaging (MRI) activity.
Results
126 patients were included in the analysis: 64 (50.8%) received OCR, and 62 (49.2%) received RTX. There was no significant difference between patients receiving OCR and RTX in CDW (9.37% vs. 11.29%), CDI (21.87% vs. 30.64%), mean ARR (0.21 vs. 0.29). There was no significant difference in TTFR, cumulative hazard of relapses or time to 3 months-CDW between both groups.
Conclusion
No difference in efficacy between ocrelizumab and rituximab in treating RRMS
Serum Uric acid level as an estimated parameter predicts all-cause mortality in patients with hemodialysis
Authors: Niu Sheng-Wen , Kuo I-Ching , Zhen Yen-Yi , Chang Eddy Essen , Ting Cheng-Chung , Lin Hugo You-Hsien , Chiu Yi-Wen , Chang Jer-Ming , Hwang Shang-Jyh , Hung Chi-Chih
Published: August 2024

Background: Serum uric acid (UA) level in end stage renal disease (ESRD) patients is an important physiological index for nutrition and inflammation. Serum UA displays a U-shape associated with all-cause mortality in ESRD patients. In this study, we evaluated relevance of serum UA level with survival rate in ESRD patients according to Charlson comorbidity index (CCI).
Methods: Our cohort of2615 subjects suffer from ESRD with CCI < 4 and ≥ 4. Of the 2615 subjects, 1107 subjects are CCI < 4 and others are CCI ≥ 4. The two independent groups were individually marked by serum UA sextiles.
Results: With Cox regression, serum UA levels higher than 8.6 mg/dl in the ESRD with CCI < 4 denoted as risk factor for all-cause mortality (hazard ratio (HR): 1.61, 95% CI: 1.01–2.38), compared to these subjects with UA of 7.1-7.7 mg/dl. In contrast, serum UA levels < 5.8 mg/dl represent risk factor for all-cause mortality in subjects with CCI ≥ 4 (HR: 1.53, 95% CI: 1.20–1.95) compared with UA > 8.6 mg/dl.
Conclusion: Higher serum UA in ESRD subjects with high comorbidities is hardly a risk factor. Profoundly, low UA should be prevented in all ESRD patients.
Efficacy and safety of neoadjuvant therapy with tislelizumab plus axitinib for nonmetastatic renal cell carcinoma with inferior vena cava tumor thrombus: a retrospective study
Authors: Zhao Zhongjie , Liu Zhengsheng , Zhang Kaiyan , Li Wei , Zhang Lijian , Jiang Bingliang , Chen Bin , Xing Jinchun , Wang Xuegang
Published: August 2024

Background: In renal cell carcinoma (RCC) patients with inferior vena cava (IVC) tumor thrombus, neoadjuvant therapy could alleviate the burden of tumor thrombus, enhance the safety and feasibility of surgical resection, and improve patient prognosis. The combination of tislelizumab and axitinib has demonstrated efficacy in the treatment of advanced RCC. Our study aimed to evaluate the efficacy and safety in the neoadjuvant therapy setting of tislelizumab and axitinib in RCC patients with IVC tumor thrombus.
Methods: In this retrospective study, seven patients of nonmetastatic RCC with IVC tumor thrombus who received 3 cycles of neoadjuvant therapy with tislelizumab plus axitinib at the First Affiliated Hospital of Xiamen University from May 2020 to December 2023 were included. The main outcomes included objective response rate (ORR), reduction of tumor thrombus size and level, surgical outcomes, and adverse events (AEs).
Results: The median age was 66 (range, 50-72) years, and five (71.4%) patients were male. Five (71.4%) patients were diagnosed with clear cell carcinoma, and two (28.6%) patients were papillary type I carcinoma. Four (57.1%) patients had level II tumor thrombus and three (42.9%) patients had level III. The ORR of patients was 57.1%. The mean decrease in thrombus diameter and length was 5.8 (1.8-17.2) mm and 18.5 (4.4-41.5) mm, respectively. All patients showed a decrease in IVC tumor thrombus. The mean time from the end of neoadjuvant therapy to radical nephrectomy and thrombectomy was 31.7(range, 22-45) days. No intraoperative complications or postoperative Clavien-Dindo grade＞3 complications occurred. The most common AEs were all grade 1-2, and only one patient had grade 4 hepatic impairment. No AEs delayed the surgery schedule.
Conclusions: This study of RCC patients receiving neoadjuvant combination with tislelizumab and axitinib effectively reduced primary tumor and IVC tumor thrombus with the absence of serious AEs, demonstrating a promising neoadjuvant therapy.
Associations between multiple immune-response-related proteins and neonatal infection: A proximity extension assay based proteomic study using cord plasma of twins
Authors: Chen Ruoqing , Tan Weiri , Zheng Yeqi , Wu Feng , Ye Xiaomin , Liang Hui , Chen Youmei , Liu Xian , Fang Fang , Zhang Rui , Zhang Quanfu , Chen Xu
Published: August 2024

Neonates are highly susceptible to infection given their immature immune system. Previous studies on proteins related to neonatal infection mainly focused on certain antibodies or proteins, but without comprehensive studies on multiple immune-response-related proteins associated with neonatal infection. We conducted a nested case-control study within SZBBTwin cohort, 92 immune-response-related proteins in cord plasma of 149 twins (including 34 discordant twin pairs) were measured by proximity extension assay. All twins were followed for diagnoses of infection from birth until 27 days of age. Wilcoxon rank-sum test was used to determine differentially expressed proteins (DEPs), the predictive performance was evaluated by receiver operating characteristic curve, and their functions and pathways were annotated through enrichment analysis. Logistic regression was used to assess the associations between level of proteins and risk of neonatal infection. Five DEPs (ITGA11, FCRL6, DDX58, SH2D1A, and EDAR) were identified for neonatal infection, and the area under curve achieved 0.835, which were mainly enriched in the NF-κB pathway. A higher level of ITGA11 was associated with an increased risk of neonatal infection in both all twins and discordant twin pairs. This study suggests that multiple immune-response-related proteins in cord plasma, particularly ITGA11, are associated with neonatal infection in twins.
Reaction of a Molten Cr-Si-Base Alloy with Ceramics and a High Entropy Oxide
Authors: Pelchen Lucas , Schenker Manuel , Lepple Maren , Ulrich Anke Silvia
Published: August 2024

Due to their higher thermal and chemical stability than other high-temperature materials, chromium-silicon-base (Cr-Si-base) alloys are among the most promising materials for future gas turbines and other high-temperature applications operating under harsh conditions. To enable near-net-shape casting of Cr-Si-base alloys, a compatibility of the alloy melt with the ceramic crucibles and molds is necessary. Additionally, a metal-ceramic contact exists at the interface between thermal barrier coating (TBC) and alloy, where metallic may melts play a role in the case of coating failure and overheating. In this study, molten Cr92Si8 (in at. %) alloy is brought into contact with powders of ceramics commonly used for casting molds or crucibles (e.g. ZrSiO4, Al2O3, 3YSZ), to investigate liquid metal corrosion, interdiffusion, and stabilities. Additionally, the high entropy oxide (Sm0.2Gd0.2Dy0.2Er0.2Yb0.2)2Zr2O7 (HEO), a potential future TBC material, is investigated. Before melting using an electric arc furnace the powders of the investigated ceramics were mixed with pulverized Cr92Si8 and pressed to alloy-ceramic pairs, to maximize the contact area between molten metal and ceramic. For microstructural investigations and phase analysis the materials were assessed using scanning electron microscopy (SEM) equipped with energy dispersive X-ray spectroscopy (EDS), and X-ray diffraction (XRD). The widely used mold material ZrSiO4 and the coating BN were found to decompose, while reaction products of SiO2 and CoAl2O4 with the melt were detected. Al2O3, 3YSZ, and the HEO did not show decomposition or corrosion by the melt. Al2O3, 3YSZ, and the HEO are therefore considered as promising crucible, mold, and TBC materials for Cr-Si-base alloys.
Prevalence of problem drinking in the Swedish workforce: Differences between labour market industries based on gender composition and main job activity
Authors: Tareq Hasan , Nyberg Anna , Wennberg Peter , Redmalm David , Toivanen Susanna , Mensah Aziz
Published: August 2024

Background: Identifying problem drinking patterns across industries is essential for addressing drinking problems in the workforce. Still, it is not well understood how problem drinking differs across industries and whether it is associated with industry gender composition. This study aimed to measure the prevalence of problem drinking (PPD) across Swedish industries and investigate possible associations between gender-typed industries and problem drinking.
Methods: 9,155 current workers were selected from the Swedish Longitudinal Occupational Survey of Health (SLOSH) data collected in 2020. Participants' work industries were identified through the Swedish Standard Industrial Classification (SNI) codes. Seven gender-typed industry categories were created based on gender composition and main job activity in each industry. Self-reported problem drinking was measured using a slightly modified Cut-Annoyed-Guilty-Eye (CAGE) questionnaire, and a cutoff score ≥2 was used to determine problem drinking. Poisson regression with robust standard errors was used to investigate the association between gender-typed industries and problem drinking.
Results:PPD in the workforce was 6.6%. Men (8.5%) had a higher prevalence than women (5.3%). Across industries, PPD varied from 2.3% in Water supply and waste management to 15.4% in Mining and quarrying. The highest prevalence for men was in Mining and quarrying (18.2%), whereas for women it was in Construction (11.1%). Within gender-typed industries, the highest PPD was in male-dominated Goods and Energy Production (7.7%), and the lowest was in female-dominated Health and Social Care (4.7%). In the regression analysis, both Education (aPR: 1.39, p = 0.03) and Labour-intensive Services (aPR: 1.39, p = 0.02) had higher adjusted prevalence ratios (aPR) compared with Health and Social Care. However, there was no significant difference in aPR among gender-typed industries when considering the gender composition of industries only.
Conclusions: PPD in the Swedish workforce varied significantly across industries, with differences observed between men and women. Problem drinking differed between industries when categorized by gender composition and main job activity, but not when categorized by gender composition only. Future research should investigate how industry-specific psychosocial factors influence individual alcohol consumption.
Benign Pericholecystic Regeneration Mimicking Hepatocellular Carcinoma: A Potential Pitfall in Imaging of Cirrhosis
Authors: Borhani Amir A. , Patel Naishal , Patel Vedang , Haghshomar Maryam , Grimaldi Gregory , miller frank H. , McGinty Katrina
Published: August 2024

Several pseudolesions mimicking malignancy have been reported in cirrhotic and non-cirrhotic livers. Pericholecystic regeneration is among those pseudolesions and can occasionally mimic malignancy. To our knowledge, this entity has not been previously described or systematically studied. Herein we present a case series comprised of 10 cirrhotic patients (majority due to alcoholic liver disease [ALD] or metabolic dysfunction associated steatotic liver disease [MASH]) with pericholecystic observations initially categorized as highly suspicious for HCC (LR-4 and LR-5) according to LI-RADS criteria which were later proven to be benign based on biopsy, transplantation or imaging criteria (stability of size and morphology on serial CT or MRI for > 2 years). These observations ranged 2-6.3 cm in size, were multiple in most patients and universally resulted in indentations of gallbladder. Arterial phase hyperenhancement and washout, features usually attributed to hepatocellular carcinoma (HCC), were seen in most patients. However, ancillary features of malignancy such as diffusion restriction, increased T2 signal, and hypointensity on hepatobiliary phase MRI were not present. Pericholecystic observations, in particular in the setting of ALD and MASLD, should be carefully assessed and possibility of pseudolesion should be considered especially when the observations are multiple, cause indentation of gallbladder, and lack ancillary features of malignancy.