bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to Organochlorine Pesticides and Obesity in Rural Prediabetic Patients: Associations and Potential Mediation by Multiple Health Indicators
Authors: Mao Zhenxing , Shi Jiayu , Wei Dandan , Ma Cuicui , Geng Jintian , Zhao Mengzhen , Hou Jian , Huo Wenqian , Jing Tao , Chen Zhuo , Huang Shan , Zeng Xin , Wang Chongjian
Published: August 2024

Objective To lessen the burden of diabetes, we explored the relationship between obesity and single and mixed plasma organochlorine pesticides (OCPs) exposure and the mediating roles of 13 health indicators in the correlations mentioned above among 894 rural Chinese adults with prediabetes.Methods The effects of plasma OCPs on obesity and obese anthropometric measurements were assessed by generalized linear regression models for single exposure, and quantile g-computation (QGC) and LASSO regression for mixed exposure. The potential mediating roles of multiple health indicators were explored through mediation analyses.Results We discovered that β-BHC and p,p'-DDE were related to obesity for single exposure. QGC and LASSO demonstrated that OCPs were positively correlated with a higher likelihood of obesity for mixed exposure, with β-BHC being the primary contributor. Mediation analyses found that systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), high-density lipoprotein-Cholesterol (HDL-C), alanine aminotransferase (ALT), and aspartate aminotransferase / alanine aminotransferase (AST/ALT) played significantly mediating roles in the relationship of β-BHC on obesity, with the estimated mediation proportion ranging from 9.0–40.5%.Conclusions Our findings suggest that liver function damage and lipid metabolism disorders may be one of the biological pathways by which OCPs exposure induces obesity risk.
Comparative Analysis of Large Language Models against the NHS 111 Online Triaging for Emergency Ophthalmology
Authors: Khan Shaheryar , Gunasekera Chrishan
Published: August 2024

Background This study presents a comprehensive evaluation of the performance of various language models in generating responses for ophthalmology emergencies and compares their accuracy with the established NHS 111 online Triage system.Methods We included 21 ophthalmology related emergency scenario questions from the 111 triaging algorithm. These questions were based on four different ophthalmology emergency themes as laid out in the NHS 111 algorithm. The responses generated from NHS 111 online, were compared to the different LLM-chatbots responses. We included a range of models including ChatGPT-3.5, Google Bard, Bing Chat, and ChatGPT-4.0. The accuracy of each LLM-chatbot response was compared against the NHS 111 Triage using a two prompt strategy. Answers were graded separately by two different authors as following: −2 graded as “Very poor”, -1 as “Poor”, 0 as “No response”, 1 as “Good”, 2 as “Very good” and 3 graded as “Excellent”.Results Overall score of ≥ 1 graded as “Good” or better was achieved by 93% of responses of all LLMs. This refers to at least part of the answer having correct information and partially matching NHS 111 response, as well as the absence of any wrong information or advice which is potentially harmful to the patient’s health.Conclusions The high accuracy and safety observed in LLM responses support their potential as effective tools for providing timely information and guidance to patients. While further research is warranted to validate these findings in clinical practice, LLMs hold promise in enhancing patient care and healthcare accessibility in the digital age.
Manual Manipulation and Ex Vivo Flexible Ureteroscopic Lithotripsy to Salvage Deceased Donor Kidneys with Renal Stones: A Case Series
Authors: Xiong Lin , Kwan Kristine J.S. , Pan Jian-Yong , Lu Zhen-Quan , Fu Ying-Xin
Published: August 2024

Background:
Nephrolithiasis is a relative contraindication to kidney donation. This study aimed to determine the feasibility and effectiveness of a surgical technique that can salvage a deceased donor kidney with renal stone, which involves manual manipulation of the kidney harvested from a deceased donor combined with flexible ureteroscopic lithotripsy (MM-FURSL)
Case presentation:
A total of 9 kidneys were harvested from 6 deceased patients. The recipients (66.7% female; mean age 43.9 ± 12.2 years) previously received dialysis for a mean duration of 2.6 years before receiving renal transplantation with MM-FURSL. The number of stones in donor kidneys ranged between 1 – 4 (mean max. diameter 15.1 ± 10.6 mm; mean CT value 942.0 ± 106.6 HU). Mean duration of warm and cold ischemia for the donor kidneys were 5 min and 480 ± 108.2 min respectively. The mean total operative duration was 57.0 ± 63.4 min. The first patient that underwent MM-FURSL used a reusable FURS that was found to be damaged intraoperatively. Her operative time and donor cold ischemia duration was the longest. She was the only patient that suffered from acute tubular necrosis (ATN) but creatine levels recovered within 3 weeks. No other complication was observed during a mean follow-up of 11.7 ± 8.2 months.
Conclusion:
MM-FURSL is an effective method to remove renal stones in donor kidneys. Short-term outcomes were favorable, which may make a feasible method to expand the pool of donor kidneys by salvaging donor kidneys with nephrolithiasis. Prolonged cold ischemia may be associated with ATN and should be avoided.
Preoperative MRI features for predicting response to postoperative adjuvant anti-PD-1 therapy in hepatocellular carcinoma
Authors: Peng Zhenwei , He Xiaofang , Zhan Jie , Sun Yukun , Hu Shuifang
Published: August 2024

Biomarkers for predicting survival benefit of postoperative adjuvant anti-PD-1 therapy (PA-PD-1) in hepatocellular carcinoma (HCC) are scare and lack of clinical evidence currently. This study aimed to identify the value of preoperative MRI features for predicting response to PA-PD-1 in HCC. Between 2020 and 2023, 58 patients with PA-PD-1 and 110 without PA-PD-1 were retrospectively included after propensity-score matching. Patients with PA-PD-1 had significantly longer recurrence-free survival (RFS) than those without PA-PD-1 (29.50 versus 10.97 months, p = 0.005). Absence of hypointense halos and irregular rim-like hyper enhancement were identified as independent predictors for RFS. Subgroup analysis indicated that patients with absence of hypointense halos and irregular rim-like hyper enhancement achieved significantly longer RFS after PA-PD-1 compared with those without PA-PD-1. In conclusion, preoperative MRI features of absence of hypointense halos and irregular rim-like hyper enhancement were significantly associated with recurrence and potential predictors for response to PA-PD-1 in HCC.
A Study on Placental and Umbilical Cord Morphology in Mothers with Pre-Eclampsia and its Correlation with Fetal Outcome at Birth in a Tertiary Care Hospital
Authors: sinha Sweta , kumar Pravin , Chattopadhyay Nibedita , Sengupta Mini
Published: August 2024

INTRODUCTION
The placenta is a distinctive characteristic of higher mammals which is attached to the uterus and is connected to the foetus through the umbilical cord. The placenta is an organ of vital importance for the continuation of a pregnancy and fetal nutrition. In humans, after the birth of the infant, placenta is often disposed soon after parturition without adequate examination. It has been seen that many disorders of the pregnancy are associated with gross anatomical, physiological, and pathological changes in the placenta. Hypertension is one of the common complications met with in pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Of the few studies that have explored the subject, it has been seen that morphologically, the placentae of hypertensive disorders of pregnancy are smaller, with lesser weight, diameter, and thickness as compared to placentae of normal women. Even fewer studies have been done which have correlated these altered placental findings with foetal and neonatal outcomes.
OBJECTIVE
Here we did a study on placental and umbilical cord morphology in mothers with pre-eclampsia and its correlation with fetal outcome at birth in a tertiary care hospital.
MATERIAL AND METHODS
The study population consisted of women of gestational age > 34 weeks with diagnosed pregnancy induced hypertension or pre-eclampsia who were admitted to the labour room of the study institution for delivery.
CONCLUSION
Mothers with hypertensive disorders of pregnancy tend to have a high incidence of abnormal placental and umbilical cord morphology at delivery such as lower placental weight, diameter, thickness, lower umblical cord weight, diameter, and length
Excellent Electromagnetic Interference Shielding of Multi-layered Thermoplastic Poly- urethane Nanocomposites with CoFe 2 O 4 Nanoparticles and Graphite
Authors: Wilson Nithiya Hanna , N/A Anju , Masař Milan , Machovský Michal , Škoda David , Urbánek Pavel , Urbánek Michal , Pöschl Marek , Vilčáková Jarmila , Kuřitka Ivo , Yadav Raghvendra Singh
Published: August 2024

This work presents multi-layered polymer-based nanocomposites that effectively block electromagnetic (EM) radiation by including magnetic and conductive fillers. The sonochemical method produced CoFe2O4 nanoparticles with a high degree of purity. The melt mixing process followed by compression moulding was utilized to generate individual layers of thermoplastic polyurethane (TPU) containing conductive graphite (G-TPU) or magnetic CoFe2O4 spinel ferrite nanoparticles (F-TPU) at a thickness of around 0.8 mm. Additionally, to create TPU-based multi-layered nanocomposites, three mono-layers of either F-TPU or G-TPU were stacked in an identical and alternating fashion. These were designated as F-TPU/F-TPU/F-TPU, G-TPU/G-TPU/G-TPU, F-TPU/G-TPU/F-TPU, and G-TPU/F-TPU/G-TPU which were further briefly represented as F/F/F, G/G/G, F/G/F, and G/F/G, respectively. The electromagnetic interference (EMI) total shielding effectiveness (SET) in the X-band frequency range of 8.2–12.4 GHz was investigated and observed to be 3.7 dB, 33.8 dB, 23.9 dB, and 54.0 dB for F/F/F, G/G/G, F/G/F, and G/F/G, respectively. This research offers a guide for engineers looking to create superior EMI shielding polymer nanocomposites, which have potential uses in radar security and information communications.
Enhancing Economic Efficiency Through the Implementation of Home Parenteral Nutrition SOP with a Novel Training Module
Authors: Wang Jaw-Yuan , Su Wei-Chih , Chang Tsung-Kun , Chen Yen-Cheng , Huang Ching-Wen , Yeh Yung-Sung , Chen Po-Jung , Yin Tzu-Chieh , Tsai Hsiang-Lin , Sun Li-Chu
Published: August 2024

Background
Home parenteral nutrition (HPN) is essential in providing nutrition and hydration to appropriately selected patients who cannot receive adequate oral or enteral nutrition. This study investigated the implementation of HPN at our institution, following our standardized operating procedures (SOP) and the utilization of the Port-A auxiliary device model.
Methods
This was a retrospective observational study that enrolled adult and pediatric patients undergoing HPN. The patients were supervised by the Nutrition Therapy Team of a single institution from January 2020 to December 2022.
Results
Results indicated substantial improvements in operational efficiency and patient outcomes. Specifically, the integration of our hospital’s SOP and the use of the auxiliary device led to a notable reduction in nursing workload hours in terms of providing HPN education (mean reduction of 36.2 hours) and shortened patient hospital stays (mean reduction of 2.9 days), suggesting that these interventions can lead to a streamlined, efficient, and safe HPN administration. Furthermore, the HPN protocol of our institution led to significant direct and indirect cost savings, signifying its potential to alleviate the financial burden of Taiwan’s healthcare system. Lastly, HPN at our institution is safe, with the incidences of adverse events of special interest generally showing a decreasing trend during the study period.
Conclusions
The study demonstrates that integrating the SOP of Kaohsiung Medical University Hospital and using the Port-A auxiliary device for HPN therapy substantially enhances operational efficiency, cost savings, and patient outcomes.
Severe hypoglycemia with Hyperprolinemia and Pituitary Stalk Interruption Syndrome in a 5-year-old boy: A Case Report and Literature Review
Authors: Theodosiadi Aikaterini , Toulia Ilektra , Grammatikopoulou Maria G , Adamidou Fotini , Chourmouzi Danai , Evangeliou Athanasios E , Goulis Dimitrios G , Tsiroukidou Kyriaki
Published: August 2024

Background: Hyperprolinemia is a rare autosomal recessive disorder with two distinct types: I (HPI) and II (HPII). The clinical presentation varies widely, with some individuals remaining asymptomatic and others exhibiting neurological, renal or auditory defects and seizures. However, it has never been associated with hypoglycemia. The present case report describes a boy with HPII, with an episode of severe hypoglycemia and Pituitary Stalk Interruption Syndrome (PSIS) with isolated growth hormone (GH) deficiency (GHD).
Case presentation: A 5-year and 6/12-month-old boy presented to the Department of Pediatric Endocrinology for routine thyroid function assessment due to hypothyroidism. He was diagnosed as having HPII at the age of 2 years during an investigation for seizure episodes. Clinically, the boy exhibited attention deficit hyperactivity disorder (ADHD) and a reduction in growth velocity (1.6 cm/year). Hematological and biochemical analyses were within the reference range. Hormone profiling revealed lower-than-expected insulin-like growth factor-1 (IGF-1) concentrations, prompting a GH stimulation test, which, in turn, revealed GHD. Brain magnetic resonance imaging (MRI) showed features consistent with PSIS. Noteworthy is the occurrence of severe hypoglycemia during the evaluation, leading to hospitalization, eventually attributed to GHD. Following the exogenous administration of recombinant human GH, the boy exhibited increased growth velocity, with no adverse events over the follow-up period.
Conclusion: Hyperprolinemia is a rare condition; in this context, the occurrence of severe hypoglycemia accompanied by a low growth velocity poses a challenge for the clinical pediatrician.
Impact of Mechanical Ventilation and Anesthesia on PET Tracer Kinetics for Combined PET/fMRI Studies in Rats
Authors: Ma Yan , Kuebler Laura , Haas Sabrina , Maurer Andreas , Herfert Kristina
Published: August 2024

Purpose
Positron Emission Tomography (PET), a crucial tool in molecular brain imaging, has evolved into hybrid system through integration with functional MRI (fMRI). This advancement facilitates simultaneous recording of molecular and functional data in animal models, offering in-sights into neuroreceptor and neurotransmitter dynamics and their effects on brain function. While mechanical ventilation is often used in small animal fMRI to stabilize physiological blood gas levels, its effects on PET tracer kinetics remain underexplored.
Procedures:
This study examines the kinetics of [11C]raclopride, a dopamine-sensitive PET tracer targeting D2/D3 receptors, under various respiratory conditions and anesthesia protocols frequently used in small animal fMRI and PET.
Results
Results indicate significant variations in tracer kinetics: increased peak levels, a shorter time to peak, and a faster tracer equilibrium in the striatum-cerebellum distribution volume ratio were observed in spontaneously breathing animals versus those under mechanical ventilation. Anesthesia type also strongly influenced the tracer kinetics: α-chloralose anesthesia reduced brain uptake, whereas isoflurane led to a more rapid equilibrium.
Conclusions
These findings underscore the profound impact of mechanical ventilation and anesthesia selection on PET tracer kinetics in hybrid PET/fMRI studies. The study highlights that those protocols established for fMRI are not directly transferable to PET imaging in small animals, emphasizing the necessity for a careful investigation of the influence of anesthesia and ventilation techniques on tracer kinetics.
Acylcarnitines metabolism in depression: association with diagnostic status, depression severity and symptom profile in the NESDA cohort
Authors: milaneschi yuri , Montanari Silvia , Jansen Rick , Schranner Daniela , Kastenmüller Gabi , Arnold Matthias , Janiri Delfina , Sani Gabriele , Bhattacharyya Sudeepa , Dehkordi Siamak Mahmoudian , Dunlop Boadie , Rush Augustus , penninx brenda , Kaddurah-Daouk Rima
Published: August 2024

Acylcarnitines (ACs) are involved in bioenergetics processes that may play a role in the pathophysiology of depression. Previous genomic evidence identified four ACs potentially linked to depression risk. We carried forward these ACs and tested the association of their circulating levels with Major Depressive Disorder (MDD) diagnosis, overall depression severity and specific symptom profiles. The sample from the Netherlands Study of Depression and Anxiety included participants with current (n = 1035) or remitted (n = 739) MDD and healthy controls (n = 800). Plasma levels of four ACs (short-chain: acetylcarnitine C2 and propionylcarnitine C3; medium-chain: octanoylcarnitine C8 and decanoylcarnitine C10) were measured. Overall depression severity as well as atypical/energy-related (AES), anhedonic and melancholic symptom profiles were derived from the Inventory of Depressive Symptomatology. As compared to healthy controls, subjects with current or remitted MDD presented similarly lower mean C2 levels (Cohen’s d = 0.2, p ≤ 1e-4). Higher overall depression severity was significantly associated with higher C3 levels (ß=0.06, SE = 0.02, p = 1.21e-3). No associations were found for C8 and C10. Focusing on symptom profiles, only higher AES scores were linked to lower C2 (ß=-0.05, SE = 0.02, p = 1.85e-2) and higher C3 (ß=0.08, SE = 0.02, p = 3.41e-5) levels. Results were confirmed in analyses pooling data with an additional internal replication sample from the same subjects measured at 6-year follow-up (totaling 4141 observations). Small alterations in levels of short-chain acylcarnitine levels were related to the presence and severity of depression, especially for symptoms reflecting altered energy homeostasis. Cellular metabolic dysfunctions may represent a key pathway in depression pathophysiology potentially accessible through AC metabolism.
A Qualitative Study Exploring Patients Experience of Emergency Healthcare Utilisation during the Covid-19 Pandemic.
Authors: FitzGerald Christine , Bounds Megan , Barry Louise , Corey Gillian , Devlin Collette , Ryan Damian , Cummins Fergal , Galvin Rose , Cummins Niamh
Published: August 2024

Background
COVID-19 caused a global pandemic, disrupting healthcare services and contributing to significant mortality and morbidity worldwide. This necessitated high-quality care to be balanced with infection control in Emergency Department (ED) setting, compounding existing challenges for both healthcare professionals and patients. The aim of this study was to explore the experiences of adults who attended EDs across Ireland during the COVID-19 pandemic. Study findings will enhance understanding of patient’s experiences of ED attendance during COVID-19 and add to the evidence which explores the impact of Covid-19 on patient care.
Methods
This study utilises a subset of the Better Data Better Planning study [1] consisting of 46 interviews from 4 Regional Hospital Sites across Ireland. A qualitative research design comprising of semi-structured interviews was used for this study.
Results
Two key themes were produced from the data; Sense of reassurance in the ED during COVID-19 and COVID-19 impact on ED attendance and discharge experience.
Conclusions
This paper provides tangible insights into the experiences of ED patients during Covid-19 Notably, the importance of staff reassurance, where along with PPE use, reconfiguration of the ED environment and communication were found to alleviate patients concerns regarding exposure and transmission risks of Covid-19 while being present in the ED during the pandemic.
The influence of Lactobacillus johnsonii on tumor growth and lymph node metastasis in papillary thyroid carcinoma
Authors: Min Xiang , Xie Minghao , Yang Tingting , Liu Qiang , Ning Zhikun , Feng Lili
Published: August 2024

The presence of lymph node metastasis (LNM) is one of the most crucial factors in the prognosis of papillary thyroid carcinoma (PTC). The aim of this study was to investigate the influence of intratumoral bacteria on the LNM in PTC. The intrathyroidal microbiome was analyzed in 55 PTC patients by 16S rRNA gene sequencing. The CCK8 and Transwell assays were conducted to determine the impact of bacteria on the proliferation and migration abilities of PTC cells. Xenograft tumor and bacterial colonization experiments were carried out using nude mice. We showed that Lactobacillus was significantly decreased in PTC lesions from patients with LNM. Lactobacillus johnsonii (L. johnsonii) could suppress the proliferation and migration capability of PTC cells in vitro and in vivo. Bacterial gut colonization of L. johnsonii increased its abundance in tumors and inhibited PTC growth and LNM. These findings suggested that L. johnsonii could be harnessed for the development of innovative therapeutic strategies for PTC.
Protective and Risk Factors in Daily Life Associated with Cognitive Decline of Older Adults
Authors: Tong Fang , Yang Hao , Yu Hai-dong , Sui Le-wen , Yao Jing-yuan , Shi Chen-lei , Yao Qiao-yuan , Shi Mei-fang , Qian Cheng-lang , Li Gang , Zhao Chao , Wang Hui-jing
Published: August 2024

Background: Cognitive decline is a chronic condition which is characterized by a loss of the ability to remember, learn, and pay attention to complex tasks. Many older people are now suffering from cognitive decline, which decreases life quality and leads to disability. This study aimed to identify the risk and protective factors for cognitive decline of the older people from daily life and establish a predictive model using logistic regression.
Methods: We investigated 3,790 older people with health examination and questionnaires which included information associated with physical condition, lifestyle factors, and cognitive status. Single-factor comparison, principal component analysis with a Manova-Wilk test, and logistic regression were performed to filter the risk and protective factors regarding cognitive decline of older individuals.
Results: We found a significant separation along the coordinate axis between people with normal and declined cognition by principal component analysis, as confirmed by the Manover-Wilk test. Single-factor comparison and logistic regression demonstrated significant difference in gender, age, hypertension level, height, dietary habit, physical-exercise duration, physical-exercise history, and smoking history between the two groups. We also observed significant differences in height, physical exercise duration, physical-exercise years, and smoking years between the male and female of the participants. ROCs of the predictive model by logistic regression were plotted, with AUC values of 0.683 and 0.682 respectively for the training and testing sets.
Conclusion: The protective factors of cognitive decline for older people were male gender, height, keeping exercising, and nicotine stimulation, and the risk factors included age, female gender, vegetarianism, hypertension, and over-exercise. Except for the genetic factor, differences in lifestyle, such as smoking and exercise habits, may contribute to the observed differences in cognitive function between genders.
Transforming dementia research into practice: A multiple case study of academic research utilization strategies in Dutch Alzheimer Centers
Authors: Zhu Eden Meng , Buljac-Samardžić Martina , Ahaus Kees , Huijsman Robbert
Published: August 2024

Background
Non-pharmacological dementia research products generated in traditional university settings, such as social and behavioral interventions, often experience challenges to impact practices that they were developed for. The Netherlands established five specialized academic health science centers, referred to as Alzheimer Centers, to structurally coordinate and facilitate the utilization of dementia research knowledge. This study leverages implementation science to systematically explore the research utilization strategies used by academic researchers from each Alzheimer Center, based on the ‘knowledge-to-action’ (KTA) framework, which includes knowledge creation, adaptation, dissemination, and implementation.
Methods
Individual semi-structured qualitative interviews were conducted with 29 respondents across the five Alzheimer Centers in the Netherlands, selected through purposive (snowball) sampling. Interviews were conducted in-person and virtually through Microsoft Teams, and all were audio-recorded and transcribed verbatim. Data analysis was guided by the dimensions of the KTA framework.
Result
There was a high variation in the strategies used across the five Alzheimer Centers to bring non-pharmacological dementia research into practice, and selected strategies in each Center were influenced by the typology of research products produced and the Centers’ organizational heritage. The knowledge creation and adaptation phases were mainly facilitated by funders’ guidance toward research impact and research product co-creation with patients and implementing organizations. Dissemination and implementation phases were often facilitated through utilizing support from university-based technology transfer offices to facilitate implementation and valorization and establishing and strategically leveraging formal infrastructure, such as public-private partnerships and professional collaborative networks.
Conclusion
Successful research utilization requires evolving researcher competencies to meet environmental demands and facilitating co-creation with research end-users and implementing partners. Understanding external determinants influencing research utilization in the Dutch dementia research ecosystem is crucial for capacity-building and aligning cross-sector agendas. The KTA framework appears to reveal the intricacies of research utilization, guiding future studies to explore strategies employed across various contexts.
Effect of artesunate on the expression of ICAM-1 and MMP-9 in vascular endothelial cells under high glucose conditions
Authors: Ge Pengfei , Jiang Tao , Zong Yao , Lu Susu , Yang Xuejiao , Xu Xinyan , Fan Xiaojun , Song Liping , Yang Yunxiao , Sun Zhe
Published: August 2024

Background Diabetic retinopathy (DR) is the most common cause of diabetes-induced microvascular complications and it is the leading cause of blindness in working age worldwide. At the present stage,The main treatment for neovascularization and leakage in DR is anti-VEGF therapy, however, anti-VEGF therapy has its limitation,such as single target and short half-life of anti-VEGF drugs. Therefore, clarifying more therapeutic targets according to the molecular mechanism of neovascularization and leakage is needed, treating the disease by a drug which is multi-target and long-acting. Previous studies have shown that artesunate (ART) can inhibit retinal neovascularization and leakage through multiple targets. This study aimed to clarify the new mechanism of ART inhibiting retinal neovascularization and leakage.
Objective To investigate the new mechanism of retinal neovascularization and leakage inhibited by artesunate (ART) .
Methods Human Umbilical Vein Endothelial Cells (HUVEC) were divided into glucose (G) group, 40mmol/L G+ART(G40+ART)group, mannitol (M) control group, dimethyl sulfoxide (DMSO)control group. The concentration gradient of G group is 5.5mmol/L G (G5.5), 25mmol/L G (G25), 40mmol/L G (G40); The concentration gradient of M control group is 5.5 mmol / L G + 19.5 mmol / L M (M25), 5.5 mmol / L G + 34.5 mmol / L M (M40), The concentration gradient of ART of G40 + ART group is G40 + 10ug /ml ART(10A), G40+20ug/ml ART(20A), G40+40ug/ml ART(40A); the volume of DMSO in the DMSO control group is the same as it is in the 40A group. Western blot,and cell Immunofluorescence technique were used to detect the protein expression of ICAM-1 and MMP-9 in each group.
Results Western blot,and cell Immunofluorescence showed that the protein expression of Intercellular adhesion molecule-1（ICAM-1）and Matrix metalloproteinase-9（MMP-9）in G25 group was higher than that in G5.5 group (P<0.01), and it increased in G40 group compared with G25 group (P<0.01);The protein expression of ICAM-1 and MMP-9 in G25 group was higher than that of M25 group (P<0.01),and it increased in G40 group compared with M40 (P<0.01);the protein expression of ICAM-1 and MMP-9 of G40+ART group was lower than that of G40 group,in which,it was lower in 20A group than that of 10A group (P<0.01), and it was lower in 40A group compared with 20A group (P<0.01). The DMSO control group showed that the protein expression of ICAM-1 and MMP-9 in G40+ART was lower than that of G40+DMSO group (P<0.01).
Conclusion The two targets of ICAM-1 and MMP-9 may act as new therapeutic targets of ART to suppress the retinal neovascularization and leakage in DR,offering assistance for ART used in DR to treat the neovascularization and leakage.
Association between a lower T-CD4+/CD8+ lymphocyte ratio and cognitive impairment in older persons with HIV
Authors: Ruiz-Manriquez Carlos Alberto , Avila-Funes José Alberto , Brañas Fátima , Crabtree-Ramírez Brenda , Amieva Hélène , Hernández-Ruiz Virgilio
Published: August 2024

Purpose
to determine the association between a lower LT-CD4+/CD8 + ratio and cognitive impairment among people ≥ 50 years with HIV.
Methods
cross-sectional study, including 207 adults aged > 50 years with HIV, receiving care at a tertiary-care hospital in Mexico City. Participants underwent a standardized geriatric and neuropsychological assessment to establish the presence of HIV-associated neurocognitive disorder using validated criteria. Multivariate logistic regression models were performed to determine the association between T-CD4+/CD8 + lymphocyte ratio tercile values (0.57–0.91, and < 0.56; being > 0.91 the reference category) and cognitive impairment.
Results
Participants’ median age was 56 (IQR 53–62) years and 173 (83.6%) were men. The prevalence of any kind of cognitive impairment according to the Antinori criteria was 66.2% (n = 137); the highest proportion being asymptomatic neurocognitive impairment (n = 114, 83.2%). Adjusted logistic regression analyses showed that the lowest LT-CD4+/CD8 + ratio tercile values (< 0.56) were independently associated with the presence of cognitive impairment (OR 3.16; 95% CI: 1.22–8.16, p = 0.017).
Conclusion
lower LT-CD4+/CD8 + ratios are independently associated with cognitive impairment older persons with HIV, which represents another factor that could be addressed to modulate this outcome.
Flow Experiences across Multiple Performance Domains
Authors: Mauldin Kristin N. , Thompson Bailey A. , Rubio Andrea L. , Betancourt Yilena C. , Brana Gerardo , Hernandez Janeane , Gonzalez Lindsey , Batherson Matthew J. , Lewin Rachael E.
Published: August 2024

As the construct of flow is currently under revision, the nine dimensions of the Jackson-Marsh Model of flow have been examined more closely. The current study aims to add to this examination by comparing these dimensions across four performance domains: academic, individual sport, spectator sport, and team sport. Participants completed two different flow assessments within one hour following their specified performance activity. One of the assessments measured state specific flow [1]. A total of 118 performers participated: academic (n = 26), individual sport (n = 26), spectator sport (n = 32), and team sport (n = 34). Multivariate analysis of variance analyses conducted on the dimensions that represent antecedents of flow (challenge to skills match, clear goals, and unambiguous feedback) revealed less unambiguous feedback for the exam takers (academic) in comparison to the individual sport athletes, spectator sport athletes, and team sport athletes. A multivariate analysis of variance was then conducted comparing dimensions of the experience of flow between activity types. Individual sport athletes experienced higher levels of merging of action and awareness while spectator sport athletes experienced less loss of self-consciousness between the performance domains. Implications of these differences for the flow construct are discussed.
Peruvian Medical Residency Selection: A portrayal of scores, distribution, and predictors of 28,872 applicants between 2019 and 2023
Authors: Flores-Cohaila Javier A , Miranda-Chavez Brayan , Copaja-Corzo Cesar , Benavente-Chalco Xiomara C. , Rios-García Wagner , Moreno-Ccama Vanessa P. , Samanez-Obeso Angel , Rivarola-Hidalgo Marco
Published: August 2024

Background
Residency selection is crucial for enhancing the healthcare workforce. Most research on this topic arises from the global north, leaving a gap from the global south perspective. Hence, this study aimed to evaluate factors associated with the Peruvian National Residency Examination (ENARM) in Peruvian applicants.
Methods
A cross-sectional analytical study was conducted using data from applicants to the Peruvian ENARM from 2019 to 2023. The data were sourced from the National Council of Medical Residency's webpage and analyzed using descriptive statistics and linear mixed-effect models.
Results
The final population consisted of 28,872 (95.06%) of applicants between 2019 and 2023. The mean ENARM score was 11.69, with a pass rate of 61.6% if a standard setting was set at 11. The highest scores were seen in those who achieved scores above 13 in the ENAM and received honors in medical school, while the lowest in those who applied in the captive modality and did not take the ENAM. Most applicants were concentrated in Lima and applied to Surgery, Pediatrics, and Obstetric-Gynecology. The ENAM score was positively associated with the ENARM in the mixed model when adjusting for receiving, year, setting of application, modality, and application specialty.
Conclusions
ENAM scores and honors in medical school were most associated with ENARM; hypothetically, 4 out of 10 applicants would fail the ENARM. Moreover, We portrayed the disparities in Peruvian medical education that point toward the quality of medical education, its centralization in the Peruvian capital, and the power dynamics between specialties.
Genetics-informed new causal proteins in atopic dermatitis pathogenesis and treatment
Authors: Luo Chen , Zhang YaJing , Feng QiFan , Yao KaiXin , Zheng LeiLei , Yang Ye , Zheng WenXin , Li Feng , Lv YongQiang , Cai Yue
Published: August 2024

Atopic dermatitis (AD) is an immune-related skin disease with a genetic background. Numerous loci have been identified associated with AD to better comprehend its complicated genetic mechanisms by genome‑wide association studies (GWASs). However, current studies reveal the underlying mechanisms of these loci in the pathogenesis of AD inadequately. To explore the plasma proteins genetically correlated with AD via the GWAS data. Herein, we adopted recent AD GWAS data (N = 796,661) and the dataset of plasma protein quantitative trait loci (pQTLs), comprising 1,348 proteins from individuals of European descent. We first conducted the AD-related proteome-wide association studies (PWASs) (N = 7,213) by integrating pQTLs with the AD GWAS statistics and identified six significant plasma proteins by PWAS (P < 0.05). Then, the potential causal proteins of AD were identified via Mendelian randomization (MR), and four causal proteins of AD were discovered afterward. Following this, Bayesian colocalization analysis then explored proteins sharing the same causal variants. Three causal proteins strongly associated with the pathogenesis of AD were eventually pinpointed. Finally, we discovered drugs that could be repurposed for AD with the plasma proteins that might contribute to the pathogenesis of AD in the Drug Gene Interaction Database.
Knowledge and attitudes about rare diseases in the general population of Peru
Authors: Abarca-Barriga Hugo Hernán , Tello Rossana Alvariño , Laso-Salazar María Cristina , Serna-Infantes Jorge La , Mujica María del Carmen Castro
Published: August 2024

Background. Rare diseases (RD) affect up to 8% of the population. They present with variable and nonspecific phenotypes, and most of these conditions are genetically determined. Few studies have explored the knowledge of rare diseases in the general population.
Methods. The present research is a cross-sectional analytical study, where a modified and expert-verified survey was applied. The survey gathered data such as the level of knowledge of rare diseases, age, gender, profession, and years of professional practice; additionally, the attitude towards state financing, and insurance coverage were explored. We describe the absolute and relative frequencies, as well as the range of the proportion of qualitative variables; we assessed the difference in the average of the final score of rare diseases knowledge, multiple linear regression, and the crude and adjusted prevalence ratio based on the level of deficient or sufficient knowledge of rare diseases were determined.
Results. The average score of the final RD knowledge is low (53.9; DE = 14.45); where 85.4% have a deficient score. However, there is a positive attitude towards RD regarding financing and coverage (> 80%). The variables that cause a decrease in the final score include not having a profession, older age, having a negative attitude towards insurance coverage, not having a family member with an RD, and having a higher number of years of professional practice. Despite a deficient score on RD knowledge, there is a positive attitude towards coverage and financing of RD.
Conclusions. The study reveals a significant knowledge gap about rare diseases (RD) in the general population. Despite the low knowledge levels, there is a notably positive attitude towards the financing and insurance coverage of RD. Factors such as lack of a professional background, older age, negative attitudes towards insurance coverage, absence of family members with an RD, and longer professional practice are associated with lower knowledge scores. These findings highlight the need for targeted educational initiatives to enhance RD awareness while leveraging the positive attitudes towards financial support to advocate for improved healthcare policies and resources for RD patients.
The term cotwin with special pulmonary lesions and elevated maternal-neonatal D- dimer levels following single intrauterine fetal death in a monochorionic-monoamniotic twin pregnancy: a case report and literature review
Authors: Liu Haiyan , Zhang Xiaoyue , Liu Zhenzhen , Yu Yi , Gu Weirong
Published: August 2024

Background
Complications such as cerebral impairment, preterm delivery, and even intrauterine death can occur in monochorionic twins with singleton fetal death. The coagulation functions of the surviving fetus and mother are controversial.
Case presentation
We reported a case of spontaneous single intrauterine fetal death at 17 weeks of gestation in a monochorionic monoamniotic twin pregnancy followed by increased maternal-neonatal D-dimer levels and special pulmonary lesions in the surviving term cotwin without cerebral impairment. The mother was complicated with massive pelvic hematomas postpartum and recovered after conservative treatment.
Conclusions
Maternal-neonatal follow-up of D-dimer and detailed examination of the respiratory system as well as brain impairment of the surviving cotwin and newborn are recommended, especially in monochorionic monoamniotic twin pregnancies with placental arterio-arterial or veno-venous anastomoses and elevated maternal D-dimer.
Prediction of Prognosis, Efficacy of Lung Adenocarcinoma by Machine Learning Model Based on Immune and Metabolic Related Genes
Authors: Xue Cong , Dai Yi-Zhi , Li Gui-Long , Zhang Yi
Published: August 2024

Background
The aim of this study is to integrate immune and metabolism-related genes in order to construct a predictive model for predicting the prognosis and treatment response of LUAD(lung adenocarcinoma) patients, aiming to address the challenges posed by this highly lethal and heterogeneous disease.
Material and Methods
Using TCGA-LUAD as the training subset, differential gene expression analysis, batch survival analysis, Lasso regression analysis, univariate and multivariate Cox regression analysis were performed to construct prognostic related gene models. GEO queue as validation subsets, is used to validate build RiskScore. Then, we explore the RiskScore and mutation status, immune cell infiltration, the relationship between immune therapy and chemotherapy, and build the model of the nomogram.
Results
The RiskScore has been determined to be composed of seven gene. In the high-risk group defined by this score, both early-stage and advanced-stage LUAD patients exhibit a decreased overall survival rate. The mutation status of patients as well as immune cell infiltration show associations with the RiskScore value obtained from these genes' expression levels. Furthermore, there exist variations in response to immunotherapy as well as sensitivity to commonly used chemotherapy drugs among different individuals. Lastly, when using a column line plot model based on the calculated RiskScore values, we obtain a concordance index (C-index) was 0 .716 (95% CI: 0.671–0.762), and time-dependent ROC predicted probabilities of 1-, 3- and 5-year survival for LUAD patients were 0.752、0.725 and 0.654, respectively.
Conclusion
In summary, by combining immune- and metabolism-related genes, we successfully con-structed a novel model for predicting prognosis and treatment response in LUAD patients.
Different Types of Connections between the Thalamus and Vestibular Nucleus in the Human Brain
Authors: Yeo Sang Seok , Lee Sang Soo
Published: August 2024

This study investigated connections between vestibular and thalamic nuclei in the human brain using diffusion tensor imaging (DTI). We examined nine vestibulothalamic tracts (VTTs) by selecting three seed regions of interest (ROIs) in the vestibular nuclei (superior, medial, and lateral) and three target ROIs in the thalamic nuclei (ventral posterolateral, ventral posteromedial, and ventral intermediate). DTI tractography was performed on twelve healthy subjects. Results showed all three vestibular nuclei had connectivity with the thalamus, with varying reconstruction rates. The lateral vestibular nucleus demonstrated highest connectivity with ventral posterolateral and posteromedial nuclei, while the medial vestibular nucleus had highest connectivity with the ventral intermediate nucleus. All VTTs passed through the midbrain tegmentum, with some traversing the tectum. This study provides new insights into neural pathways involved in vestibular information processing and may serve as a foundation for understanding the central vestibular system's neurophysiology. These findings could have implications for diagnosing and treating vestibular disorders and related balance issues.
Clinical effect of abdominal Tuina on patients with generalized anxiety disorder: A randomized controlled study and evaluation of event-related potentials
Authors: He Yayong , Wu Yiming , Li Chenrui , Nan Shanzhu
Published: August 2024

Background
Generalized anxiety disorder (GAD) is a highly prevalent disorder that affects patients’ physical and mental health and overall quality of life. GAD is often accompanied by palpitations, chest tightness, muscle tension, restlessness, and other autonomic nervous disorders and symptoms, but its underlying mechanism is incompletely understood. Abdominal Tuina is effective in relieving the clinical symptoms of patients with GAD; therefore, to objectively evaluate the efficacy of abdominal Tuina, which is essential to make appropriate treatment decisions, we will use event-related potentials to assess cognitive function in patients with GAD.
Methods
We will enroll 114 patients diagnosed with GAD who will be randomly assigned to either the abdominal Tuina or drug group at a 1:1 ratio. The main outcome indicator will be the Hamilton Anxiety Scale (HAMA), while secondary outcome indicators will include the Self-rating Anxiety Scale (SAS), the Traditional Chinese Medicine (TCM) syndrome scale, the Chinese Attention to Positive and Negative Information Scale (APNI), attention to deviation index changes, negative potential (N1), vertex positive potential (VPP) amplitude, and latency. We will use the German Brain Products electroencephalogram (EEG) collection device to perform one EEG session before and after treatment for both the treatment and control groups. Through the changes in N1, VPP amplitude, and the latency of event-related potentials, we will analyze the specific neural mechanism by which abdominal Tuina affects the attention bias of negative stimuli in patients with GAD.
Discussion
The results of this randomized controlled clinical trial will help to demonstrate the efficacy of abdominal Tuina.
Trial registration:
ClinicalTrials.gov ChiCTR2300068257. Registered on February 13, 2023.
Impact of PI-RADS Score Combined with SII on Pathological Upgrading in Patients with Localized Prostate Cancer After Radical Prostatectomy
Authors: Zhiheng Huang , Haiyang WEI , Tianhe ZHANG , Changbao Xu , Junfeng GAO , Changhui Fan
Published: August 2024

Purpose
To investigate the combined effect of PI-RADS v2.1 scores and the systemic immune-inflammation index (SII) on predicting pathological upgrading in patients with localized prostate cancer after radical prostatectomy.
Methods
The study collected various clinical indicators, imaging examination results, serum inflammation marker levels, and pathological examination results of 76 patients with localized prostate cancer who underwent prostate biopsy followed by radical prostatectomy. Patients were divided into two subgroups based on changes in their International Society of Urological Pathology (ISUP) grades before and after surgery: the pathological upgrading group and the non-upgrading group. Univariate and multivariate logistic regression analyses were used to assess independent risk factors for pathological upgrading. The effectiveness of single indicators, imaging inflammation indicators, traditional clinical pathology indicators, and multi-indicator combined prediction models in predicting pathological upgrading was evaluated using receiver operating characteristic (ROC) curves.
Results
Univariate and multivariate logistic regression analyses revealed that PI-RADS scores, SII, percentage of free PSA (%PSA), and the proportion of tumor tissue in biopsy samples were independent predictors of ISUP grade upgrading after radical prostatectomy. The area under the curve (AUC) values for single indicators PI-RADS, SII, %PSA, and biopsy tumor tissue proportion were 0.607, 0.711, 0.618, and 0.778, respectively. The AUC for the model combining imaging inflammation indicators (PI-RADS and SII) was 0.914.
Conclusions
The PI-RADS v2.1 score and SII are valuable in predicting pathological upgrading after radical prostatectomy in prostate cancer patients. Combining these indicators with traditional clinical pathology indicators significantly improves predictive performance.