bluuebunny/crossref_metadata_2025 huggingface dataset:
Causal association between immune cells and lung cancer risk: a two-sample bidirectional Mendelian randomization analysis
Authors: Xu Shengshan , Fang Huiying , Shen Tao , Zhou Yufu , Zhang Dongxi , Ke Yongwen , Chen Zhuowen , Lu Zhuming
Published: June 2024

Background

Previous studies have highlighted the crucial role of immune cells in lung cancer development; however, the direct link between immunophenotypes and lung cancer remains underexplored.

Methods

We applied two-sample Mendelian randomization (MR) analysis, using genetic variants as instruments to determine the causal influence of exposures on outcomes. This method, unlike traditional randomized controlled trials (RCTs), leverages genetic variants inherited randomly at conception, thus reducing confounding and preventing reverse causation. Our analysis involved three genome-wide association studies to assess the causal impact of 731 immune cell signatures on lung cancer using genetic instrumental variables (IVs). We initially used the standard inverse variance weighted (IVW) method and further validated our findings with three supplementary MR techniques (MR–Egger, weighted median, and MR-PRESSO) to ensure robustness. We also conducted MR–Egger intercept and Cochran’s Q tests to assess heterogeneity and pleiotropy. Additionally, reverse MR analysis was performed to explore potential causality between lung cancer subtypes and identified immunophenotypes, using R software for all statistical calculations.

Results

Our MR analysis identified 106 immune signatures significantly associated with lung cancer. Notably, we found five suggestive associations across all sensitivity tests (P<0.05): CD25 on IgD- CD24- cells in small cell lung carcinoma (ORIVW =0.885; 95% CI: 0.798–0.983; PIVW =0.022); CD27 on IgD+ CD24+ cells in lung squamous cell carcinoma (ORIVW =1.054; 95% CI: 1.010–1.100; PIVW =0.015); CCR2 on monocyte cells in lung squamous cell carcinoma (ORIVW =0.941; 95% CI: 0.898–0.987; PIVW =0.012); CD123 on CD62L+ plasmacytoid dendritic cells (ORIVW =0.958; 95% CI: 0.924–0.992; PIVW =0.017) as well as on plasmacytoid dendritic cells (ORIVW =0.958; 95% CI: 0.924–0.992; PIVW =0.017) in lung squamous cell carcinoma.

Conclusion

This study establishes a significant genomic link between immune cells and lung cancer, providing a robust basis for future clinical research aimed at lung cancer management.
Awareness and analysis: concurrent and predictive roles of two morphological processes in early reading comprehension
Authors: Zinger Katharine , Kruk Richard S.
Published: June 2024

Introduction

We examine how awareness and analysis of morphemes contribute to children's reading comprehension and its development. A multidimensional perspective on reading comprehension posits morphological awareness and morphological analysis play distinct roles in reading comprehension. Assuming individual differences in growth in these aspects of morphological processing, their concurrent influences can vary depending on children's reading comprehension abilities, and predictive influences can change as children's reading comprehension abilities improve.

Method

The current longitudinal study examined the concurrent and predictive influences of awareness and analysis on children's reading comprehension from Grades 1 to 3. Data from 171 public school children, with diverse reading comprehension abilities, were collected across five waves and were analyzed using cross-lagged panel structural equation modeling.

Results

Results showed concurrent relationships among morphological awareness, analysis, and reading comprehension in Grades 1 and 2, and morphological analysis having a concurrent relationship with reading comprehension at the end of Grade 3. Morphological awareness in all waves but Wave 3, at the end of Grade 2, predicted subsequent reading comprehension. Morphological analysis did not predict subsequent reading comprehension.

Discussion

Findings support the multidimensional conceptualization of awareness and analysis as distinct morphological processes that play early-wave concurrent and across-wave predictive roles in children's reading comprehension development.
Looking beyond literacy and phonology: word learning and phonological cue use in children with and without dyslexia
Authors: van Viersen Sietske , Kerkhoff Annemarie , de Bree Elise H.
Published: June 2024

Introduction

This study investigated whether children with and without dyslexia differ in word learning and whether phonological cues to word class play a role. If children with dyslexia have difficulties with implicit learning, they might be less sensitive to such cues.

Methods

A group of 89 Dutch primary school children from Grades 3 to 6 participated in a word learning experiment, consisting of children with dyslexia (n = 44) and typically developing children (n = 45). Test items were four monosyllabic ‘verb-like' nonwords (e.g., voek) and four bisyllabic ‘noun-like' nonwords (e.g., banijn). They were presented as novel verbs or nouns in a two word sentence frame (e.g., “I voek” or “a voek”), paired with pictures of unfamiliar actions or objects. Nonwords were either consistent (e.g., “I voek,” “a banijn”) or inconsistent (e.g., “I banijn,” “a voek”) with word class. The word learning experiment consisted of a repetition, identification, and naming phase.

Results

Children with dyslexia showed lower word learning outcomes in the naming phase. However, phonological cues did not affect word learning in either group. Regression analyses indicated that phoneme awareness, receptive vocabulary, and nonword reading were predictors of word learning for all children.

Discussion

These findings indicate that Dutch children with dyslexia have more difficulty in recalling novel words, fitting in with their phonological difficulties. Phonological cues to word class did not contribute to word learning in either group.
Fabrication of electrically conductive microparts by constructing carbon black-rich network under high shear conditions in microinjection molding
Authors: Lei Xue , Gong Xiaoxi , Li Jixiang , Shi You , Liang Mei , Zou Huawei , Zhou Shengtai
Published: June 2024

Microinjection molding (μIM) is an important technique to fabricate microparts for applications in the fields of automotive and microelectromechanical systems. However, the prevailing high shear conditions in μIM are unfavorable for constructing intact electrically conductive networks because the added fillers tend to be preferentially aligned along the melt flow direction. In this work, a series of polypropylene/polyamide 6/carbon black (PP/PA6/CB) composites with a selective localization of CB in the PA6 phase were used as the model system to prepare electrically conductive microparts. The prevailing high shearing and extensional flow effects in μIM were utilized to deform CB-rich phase with an aim to in situ construct electrically conductive network, thereby improving the electrical conductivity (σ) of subsequent moldings. The results indicated that a higher σ was achieved for PP/PA6/CB microparts when compared with their PP/CB and PA6/CB counterparts, at a lower filler content (<10 wt%). The influence of blending sequence of various components (i.e., PP, PA6, and CB) and annealing treatment on the σ of microparts was also studied. This work provided an approach to the design and preparation of electrically conductive microparts that can be potentially used in high-tech sectors.
Segmentation of retinal microaneurysms in fluorescein fundus angiography images by a novel three-step model
Authors: Li Jing , Ma Qian , Yao Mudi , Jiang Qin , Wang Zhenhua , Yan Biao
Published: June 2024

Introduction

Microaneurysms serve as early signs of diabetic retinopathy, and their accurate detection is critical for effective treatment. Due to their low contrast and similarity to retinal vessels, distinguishing microaneurysms from background noise and retinal vessels in fluorescein fundus angiography (FFA) images poses a significant challenge.

Methods

We present a model for automatic detection of microaneurysms. FFA images were pre-processed using Top-hat transformation, Gray-stretching, and Gaussian filter techniques to eliminate noise. The candidate microaneurysms were coarsely segmented using an improved matched filter algorithm. Real microaneurysms were segmented by a morphological strategy. To evaluate the segmentation performance, our proposed model was compared against other models, including Otsu's method, Region Growing, Global Threshold, Matched Filter, Fuzzy c-means, and K-means, using both self-constructed and publicly available datasets. Performance metrics such as accuracy, sensitivity, specificity, positive predictive value, and intersection-over-union were calculated.

Results

The proposed model outperforms other models in terms of accuracy, sensitivity, specificity, positive predictive value, and intersection-over-union. The segmentation results obtained with our model closely align with benchmark standard. Our model demonstrates significant advantages for microaneurysm segmentation in FFA images and holds promise for clinical application in the diagnosis of diabetic retinopathy.

Conclusion

The proposed model offers a robust and accurate approach to microaneurysm detection, outperforming existing methods and demonstrating potential for clinical application in the effective treatment of diabetic retinopathy.
Effectiveness of psychological interventions for reducing depressive symptomatology and overload and improving quality of life in informal caregivers of non-institutionalized dependent elderly: a systematic review
Authors: Barrero-Mejias Marco Antonio , Gómez-Martínez Sandra , González-Moreno Jesús , Rueda-Extremera María , Izquierdo-Sotorrio Eva , Cantero García María
Published: June 2024

Introduction

The phenomenon of aging is distinguished by profound life transformations, with the most dependent group being constituted by elderly individuals. The responsibility for their care primarily falls on the figure of the informal caregiver. The scarcity of time, the stress associated with caregiving, the financial, work-related, and personal difficulties it entails, make it a collective with high probabilities of experiencing various psychological disorders. Interventions that have shown the best results are those of multiple components, composed of various techniques that seek to adapt to the reality of the informal caregiver.

Method

The purpose of this study is a systematic review of effective interventions on depressive symptoms, emotional wellbeing, burden, or quality of life in informal caregivers of non-institutionalized dependents from 2018 to the present. A search was conducted in November 2023, on Pubmed, Pubmed Central, Proquest, and Scielo. The final review was conducted on 11 articles.

Results

The results indicate that multiple component interventions including cognitive behavioral techniques and psychoeducation in combination with stress coping techniques and social support are more effective on depressive symptoms, burden, quality of life, and increasing the social support network.

Discussion

Results on web-based programs demonstrate their efficacy and effectiveness, but require a greater number of trials to adjust their methodological quality and content to the idiosyncrasies of the informal caregiver.
Myocardial protection in cardiac surgery: a comprehensive review of current therapies and future cardioprotective strategies
Authors: Chiari Pascal , Fellahi Jean-Luc
Published: June 2024

Cardiac surgery with cardiopulmonary bypass results in global myocardial ischemia–reperfusion injury, leading to significant postoperative morbidity and mortality. Although cardioplegia is the cornerstone of intraoperative cardioprotection, a number of additional strategies have been identified. The concept of preconditioning and postconditioning, despite its limited direct clinical application, provided an essential contribution to the understanding of myocardial injury and organ protection. Therefore, physicians can use different tools to limit perioperative myocardial injury. These include the choice of anesthetic agents, remote ischemic preconditioning, tight glycemic control, optimization of respiratory parameters during the aortic unclamping phase to limit reperfusion injury, appropriate choice of monitoring to optimize hemodynamic parameters and limit perioperative use of catecholamines, and early reintroduction of cardioprotective agents in the postoperative period. Appropriate management before, during, and after cardiopulmonary bypass will help to decrease myocardial damage. This review aimed to highlight the current advancements in cardioprotection and their potential applications during cardiac surgery.
Gut microbiota and serum metabolomic alterations in modulating the impact of fecal microbiota transplantation on ciprofloxacin-induced seizure susceptibility
Authors: Zou Shangnan , Li Yinchao , Zou Qihang , Yang Man , Li Huifeng , Niu Ruili , Lai Huanling , Wang Jiaoyang , Yang Xiaofeng , Zhou Liemin
Published: June 2024

Introduction

The gut microbiota and the microbiota-gut-brain axis have gained considerable attention in recent years, emerging as key players in the mechanisms that mediate the occurrence and progression of many central nervous system-related diseases, including epilepsy. In clinical practice, one of the side effects of quinolone antibiotics is a lower seizure threshold or aggravation. However, the underlying mechanism remains unclear.

Methods

We aimed to unravel the intrinsic mechanisms through 16S rRNA sequencing and serum untargeted metabolomic analysis to shed light on the effects of gut microbiota in ciprofloxacin-induced seizure susceptibility and lithium pilocarpine-induced epilepsy rat models.

Results

We observed that ciprofloxacin treatment increased seizure susceptibility and caused gut dysbiosis. We also found similar changes in the gut microbiota of rats with lithium pilocarpine-induced epilepsy. Notably, the levels of Akkermansia and Bacteroides significantly increased in both the ciprofloxacin-induced seizure susceptibility and lithium pilocarpine-induced epilepsy rat models. However, Marvinbryantia, Oscillibacter, and Ruminococcaceae_NK4A214_group showed a coincidental reduction. Additionally, the serum untargeted metabolomic analysis revealed decreased levels of indole-3-propionic acid, a product of tryptophan-indole metabolism, after ciprofloxacin treatment, similar to those in the plasma of lithium pilocarpine-induced epilepsy in rats. Importantly, alterations in the gut microbiota, seizure susceptibility, and indole-3-propionic acid levels can be restored by fecal microbiota transplantation.

Conclusion

In summary, our findings provide evidence that ciprofloxacin-induced seizure susceptibility is partially mediated by the gut microbiota and tryptophan-indole metabolism. These associations may play a role in epileptogenesis, and impacting the development progression and treatment outcomes of epilepsy.
Comparative genomics analysis to explore the biodiversity and mining novel target genes of Listeria monocytogenes strains from different regions
Authors: Zhang Bo , Ren Honglin , Wang Xiaoxu , Han Cheng , Jin Yuanyuan , Hu Xueyu , Shi Ruoran , Li Chengwei , Wang Yuzhu , Li Yansong , Lu Shiying , Liu Zengshan , Hu Pan
Published: June 2024

As a common foodborne pathogen, infection with L. monocytogenes poses a significant threat to human life and health. The objective of this study was to employ comparative genomics to unveil the biodiversity and evolutionary characteristics of L. monocytogenes strains from different regions, screening for potential target genes and mining novel target genes, thus providing significant reference value for the specific molecular detection and therapeutic targets of L. monocytogenes strains. Pan-genomic analysis revealed that L. monocytogenes from different regions have open genomes, providing a solid genetic basis for adaptation to different environments. These strains contain numerous virulence genes that contribute to their high pathogenicity. They also exhibit relatively high resistance to phosphonic acid, glycopeptide, lincosamide, and peptide antibiotics. The results of mobile genetic elements indicate that, despite being located in different geographical locations, there is a certain degree of similarity in bacterial genome evolution and adaptation to specific environmental pressures. The potential target genes identified through pan-genomics are primarily associated with the fundamental life activities and infection invasion of L. monocytogenes, including known targets such as inlB, which can be utilized for molecular detection and therapeutic purposes. After screening a large number of potential target genes, we further screened them using hub gene selection methods to mining novel target genes. The present study employed eight different hub gene screening methods, ultimately identifying ten highly connected hub genes (bglF_1, davD, menE_1, tilS, dapX, iolC, gshAB, cysG, trpA, and hisC), which play crucial roles in the pathogenesis of L. monocytogenes. The results of pan-genomic analysis showed that L. monocytogenes from different regions exhibit high similarity in bacterial genome evolution. The PCR results demonstrated the excellent specificity of the bglF_1 and davD genes for L. monocytogenes. Therefore, the bglF_1 and davD genes hold promise as specific molecular detection and therapeutic targets for L. monocytogenes strains from different regions.
Composition and distribution of bacterial communities and potential radiation-resistant bacteria at different elevations in the eastern Pamirs
Authors: Zhu Jing , Wang Hui-Nan , Tang Qi-Yong , Gu Mei-Ying , Zhang Zhi-Dong
Published: June 2024

Altitude and ultraviolet (UV) radiation may affect the community composition and distribution of microorganisms in soil ecosystems. In this study, 49 soil samples from 10 locations were collected from different elevations on the eastern Pamir Plateau and analyzed for soil microbial community structure and function using high-throughput sequencing. The results showed that soil samples from different elevations of the eastern Pamir Plateau contained 6834 OTUs in 26 phyla and 399 genera. The dominant phyla common to different elevations were Actinobacteria, Proteobacteria, Bacteroidota, Acidobacteriota, and Gemmatimonadota. The dominant genera were Rubrobacter, Sphingomonas, Nocardioides, and Solirubrobacter. Species richness increased slightly with elevation, and there were significant differences in community composition between the elevations. Elevation and UV exposure are important factors that drive changes in bacterial communities. The results of the KEGG pathway showed that drug resistance, antineoplastic, aging, replication, and repair were enhanced and then slightly decreased with increasing elevation. Bacterial communities at different elevations were rich in radiation-resistant microorganisms, and the main genera were Rubrobacter, Sphingomonas, Nocardioides, Pontibacter, and Streptomyces. The findings have shown the composition and distribution of bacterial communities at different elevations on the Eastern Pamir Plateau. Potentially radiation tolerant microbial species were also examined. The results are of considerable importance for the succession of bacterial microorganisms in the plateau region, the study of radiation tolerant bacterial germplasm resources, and the application of biofunctionality.
Seasonal and anthropogenic influences on bacterioplankton communities: ecological impacts in the coastal waters of Qinhuangdao, Northern China
Authors: Wang Qiuzhen , Yu Jia , Li Xiaofang , Zhang Yong , Zhang Jianle , Wang Jianyan , Mu Jiandong , Yu Xinping , Hui Ruixue
Published: June 2024

Marine bacterioplankton play a crucial role in the cycling of carbon, nitrogen, and phosphorus in coastal waters. And the impact of environmental factors on bacterial community structure and ecological functions is a dynamic ongoing process. To systematically assess the relationship between environmental changes and bacterioplankton communities, this study delved into the spatiotemporal distribution and predicted metabolic characteristics of bacterioplankton communities at two estuarine beaches in Northern China. Coastal water samples were collected regularly in spring, summer, and autumn, and were analyzed in combination with environmental parameters and bacterioplankton community. Results indicated significant seasonal variations in bacterioplankton communities as Bacteroidetes and Actinobacteria were enriched in spring, Cyanobacteria proliferated in summer. While Pseudomonadota and microorganisms associated with organic matter decomposition prevailed in autumn, closely linked to seasonal variation of temperature, light and nutrients such as nitrogen and phosphorus. Particularly in summer, increased tourism activities and riverine inputs significantly raised nutrient levels, promoting the proliferation of specific photosynthetic microorganisms, potentially linked to the occurrence of phytoplankton blooms. Spearman correlation analysis further revealed significant correlations between bacterioplankton communities and environmental factors such as salinity, chlorophyll a, and total dissolved phosphorus (TDP). Additionally, the metabolic features of the spring bacterioplankton community were primarily characterized by enhanced activities in the prokaryotic carbon fixation pathways, reflecting rapid adaptation to increased light and temperature, as well as significant contributions to primary productivity. In summer, the bacterial communities were involved in enhanced glycolysis and biosynthetic pathways, reflecting high energy metabolism and responses to increased light and biomass. In autumn, microorganisms adapted to the accelerated decomposition of organic matter and the seasonal changes in environmental conditions through enhanced amino acid metabolism and material cycling pathways. These findings demonstrate that seasonal changes and human activities significantly influence the structure and function of bacterioplankton communities by altering nutrient dynamics and physical environmental conditions. This study provides important scientific insights into the marine biological responses under global change.
Case report: Dementia sensitivity to altitude changes and effective treatment with hyperbaric air and glutathione precursors
Authors: Fogarty Edward F. , Harch Paul G.
Published: June 2024

A 78-year-old man with dementia experienced waxing and waning of symptoms with changes in altitude as he traveled from his home in the Rocky Mountains to lower elevations and back. To replicate the improvement in his symptoms with travel to lower elevations (higher pressure), the patient was treated with a near-identical repressurization in a hyperbaric chamber using compressed air. With four 1-h treatments at 1.3 Atmospheres Absolute (ATA) and concurrent administration of low-dose oral glutathione amino acid precursors, he recovered speech and showed improvement in activities of daily living. Regional broadcast media had documented his novel recovery. Nosocomial COVID-19 and withdrawal of hyperbaric air therapy led to patient demise 7 months after initiation of treatment. It is theorized that hyperbaric air therapy stimulated mitochondrial biochemical and physical changes, which led to clinical improvement.
Repetitive transcranial magnetic stimulation impacts the executive function of patients with vascular cognitive impairment: a systematic review and meta-analysis
Authors: Wang Xu , Ding Qixin , Li Yuefang , Li Tianshu , Li Yakun , Yin Jialin , Zhuang Weisheng
Published: June 2024

Objective

Executive dysfunction is a core symptom of vascular cognitive impairment (VCI), which seriously affects patients’ prognosis. This paper aims to investigate the effectiveness of rTMS on executive function in VCI.

Methods

The databases selected for this study included Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and China Biology Medicine Disc (CBM). The screening times were conducted from the time of library construction until August 23, 2023. The inclusion criteria for this meta-analysis were randomized controlled trials (RCTs) on rTMS for VCI, which include executive function scores. The primary metrics were executive subscale scores of the Cognitive Comprehensive Scale and total scores of the Executive Specificity Scale. The secondary metrics were subscale scores of the Executive Specificity Scale. The quality of each eligible study was assessed using the Cochrane Risk of Bias tool. Meta-analysis and bias analysis were performed using Stata (version 16.0) and RevMan (version 5.3).

Results

A total of 20 high-quality clinical RCTs with 1,049 samples were included in this paper. The findings from the primary outcomes revealed that within the rTMS group, there were significantly higher scores observed for the executive sub-item on the cognitive composite scale (SMD = 0.93, 95% CI = 0.77–1.08, p < 0.00001, I2 = 14%) and the total score on the executive specific scale (SMD = 0.69, 95% CI = 0.44–0.94, p < 0.00001, I2 = 0%) compared to the control group. As for the secondary outcome measures, as shown by the Trail Making Test-A (time) (MD = −35.75, 95% CI = −68.37 to −3.12, p = 0.03, I2 = 55%), the Stroop-C card (time) (SMD = −0.46, 95% CI = −0.86 to −0.06, p = 0.02, I2 = 0%) and the Stroop-C card (correct number) (SMD = 0.49, 95% CI = 0.04–0.94, p = 0.03, I2 = 0%), the experimental group shorts time and enhances accuracy of executive task in comparison to the control group. Subgroup analysis of the main outcome demonstrated that intermittent theta burst stimulation (iTBS), higher frequency, lower intensity, longer duration, and combined comprehensive therapy exhibited superior efficacy.

Conclusion

rTMS is effective in the treatment of the executive function of VCI. The present study has some limitations, so multi-center, large-sample, objective indicators and parameters are needed to further explore in the future.

Systematic review registration:https://www.crd.york.ac.uk/prospero/, CRD42023459669.
A simple and effective machine learning model for predicting the stability of intracranial aneurysms using CT angiography
Authors: Luo Sha , Wen Li , Jing Yang , Xu Jingxu , Huang Chencui , Dong Zhang , Wang Guangxian
Published: June 2024

Background

It is vital to accurately and promptly distinguish unstable from stable intracranial aneurysms (IAs) to facilitate treatment optimization and avoid unnecessary treatment. The aim of this study is to develop a simple and effective predictive model for the clinical evaluation of the stability of IAs.

Methods

In total, 1,053 patients with 1,239 IAs were randomly divided the dataset into training (70%) and internal validation (30%) datasets. One hundred and ninety seven patients with 229 IAs from another hospital were evaluated as an external validation dataset. The prediction models were developed using machine learning based on clinical information, manual parameters, and radiomic features. In addition, a simple model for predicting the stability of IAs was developed, and a nomogram was drawn for clinical use.

Results

Fourteen machine learning models exhibited excellent classification performance. Logistic regression Model E (clinical information, manual parameters, and radiomic shape features) had the highest AUC of 0.963 (95% CI 0.943–0.980). Compared to manual parameters, radiomic features did not significantly improve the identification of unstable IAs. In the external validation dataset, the simplified model demonstrated excellent performance (AUC = 0.950) using only five manual parameters.

Conclusion

Machine learning models have excellent potential in the classification of unstable IAs. The manual parameters from CTA images are sufficient for developing a simple and effective model for identifying unstable IAs.
Cerebral air embolism: neurologic manifestations, prognosis, and outcome
Authors: Červeňák Vladimír , Všianský Vít , Cviková Martina , Brichta Jaroslav , Vinklárek Jan , Štefela Jakub , Haršány Michal , Hájek Michal , Herzig Roman , Kouřil Dávid , Bárková Veronika , Filip Pavel , Aulický Petr , Weiss Viktor
Published: June 2024

Background

Cerebral air embolism (CAE) is an uncommon medical emergency with a potentially fatal course. We have retrospectively analyzed a set of patients treated with CAE at our comprehensive stroke center and a hyperbaric medicine center. An overview of the pathophysiology, causes, diagnosis, and treatment of CAE is provided.

Results

We retrospectively identified 11 patients with cerebral venous and arterial air emboli that highlight the diversity in etiologies, manifestations, and disease courses encountered clinically. Acute-onset stroke syndrome and a progressive impairment of consciousness were the two most common presentations in four patients each (36%). Two patients (18%) suffered from an acute-onset coma, and one (9%) was asymptomatic. Four patients (36%) were treated with hyperbaric oxygen therapy (HBTO), high-flow oxygen therapy without HBOT was started in two patients (18%), two patients (18%) were in critical care at the time of diagnosis and three (27%) received no additional treatment. CAE was fatal in five cases (46%), caused severe disability in two (18%), mild disability in three (27%), and a single patient had no lasting deficit (9%).

Conclusion

Cerebral air embolism is a dangerous condition that necessitates high clinical vigilance. Due to its diverse presentation, the diagnosis can be missed or delayed in critically ill patients and result in long-lasting or fatal neurological complications. Preventative measures and a proper diagnostic and treatment approach reduce CAE’s incidence and impact.
Decoding Wilson disease: a machine learning approach to predict neurological symptoms
Authors: Yang Yulong , Wang Gang-Ao , Fang Shuzhen , Li Xiang , Ding Yufeng , Song Yuqi , He Wei , Rao Zhihong , Diao Ke , Zhu Xiaolei , Yang Wenming
Published: June 2024

Objectives

Wilson disease (WD) is a rare autosomal recessive disorder caused by a mutation in the ATP7B gene. Neurological symptoms are one of the most common symptoms of WD. This study aims to construct a model that can predict the occurrence of neurological symptoms by combining clinical multidimensional indicators with machine learning methods.

Methods

The study population consisted of WD patients who received treatment at the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from July 2021 to September 2023 and had a Leipzig score ≥ 4 points. Indicators such as general clinical information, imaging, blood and urine tests, and clinical scale measurements were collected from patients, and machine learning methods were employed to construct a prediction model for neurological symptoms. Additionally, the SHAP method was utilized to analyze clinical information to determine which indicators are associated with neurological symptoms.

Results

In this study, 185 patients with WD (of whom 163 had neurological symptoms) were analyzed. It was found that using the eXtreme Gradient Boosting (XGB) to predict achieved good performance, with an MCC value of 0.556, ACC value of 0.929, AUROC value of 0.835, and AUPRC value of 0.975. Brainstem damage, blood creatinine (Cr), age, indirect bilirubin (IBIL), and ceruloplasmin (CP) were the top five important predictors. Meanwhile, the presence of brainstem damage and the higher the values of Cr, Age, and IBIL, the more likely neurological symptoms were to occur, while the lower the CP value, the more likely neurological symptoms were to occur.

Conclusions

To sum up, the prediction model constructed using machine learning methods to predict WD cirrhosis has high accuracy. The most important indicators in the prediction model were brainstem damage, Cr, age, IBIL, and CP. It provides assistance for clinical decision-making.
Rapid axial roll test outperforms alternative positional tests in identifying the affected ear in HSC-BPPV: an observational cohort study
Authors: Xing Juanli , Yun Yanning , Zhang Shu , Yang Pan , Bai Xiongxiong , Zhang Leyi , Zhang Ming
Published: June 2024

Purpose

To evaluate the utility of supine roll test (SRT) and alternative positional tests, such as head-shaking test (HST), seated supine positioning test (SSPT), bow and lean test (BLT), and rapid axial roll test (RART) in determining the affected semicircular canal of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV).

Methods

In an observational cohort study, 553 patients diagnosed with HSC-BPPV were divided into five groups in terms of different positional tests received: SRT group (n = 110), HST+ SRT (n = 112), BLT + SRT (n = 114), SSPT+SRT (n = 108) and RART+SRT (n = 109). The same method was used for the last four groups: The patients were first subjected to different alternative positional tests and then to SRT, and the nystagmus was observed separately to determine the affected side. The primary outcomes compared included the accuracy and sensitivity of these tests in the determination of the affected semicircular canal in HSC-BPPV.

Results

Patients with nystagmus elicited by positional tests accounted for 84.99% (470/553). The elicitation rate of nystagmus of SRT was lowest, being 77.27% (85/110). The elicitation rate of nystagmus were higher in the test groups than in the control group, and RART+SRT group yielded the highest elicitation rate of nystagmus (95.41%, 104/109). Among the alternative positional tests, RART attained the highest elicitation rate of nystagmus (101/109, 92.66%). Comparison between alternative positional tests and SRT, RART and SRT showed obviously better agreement in determining the affected semicircular canal (85.45%, 96/109) and eliciting nystagmus (95.41%, Kappa = 0.642), but no difference was found in curative effect when the affected side was accurately determined (χ2 = 1.618, p = 0.655).

Conclusion

All alternative positional tests are helpful for eliciting nystagmus in patients with HSC-BPPV, and the significant advantages of RART include high-sensitivity in eliciting nystagmus and high accuracy in determining the affected semicircular canal, which provided objective support for the correct diagnosis of HSC-BPPV and the successful reduction of otolith.
An investigation of association between human milk mineral patterns and infant growth
Authors: Sun Han , Xie Qinggang , Zhou Yalin , Liu Yang , Pan Jiancun , Xu Yajun , Jiang Shilong , Li Kaifeng
Published: June 2024

Introduction

Human milk is widely acknowledged as the optimal food for infant aged 0 ~ 6 months. While there has been extensive documentation on the mineral and trace element composition of human milk, results on the relationship between mineral content and infant growth remain mixed. This cross-sectional study aims to explore human milk mineral patterns and to investigate associations between human milk mineral patterns, human milk metabolomic profile and infant growth.

Methods

A total of 200 breast milk samples from seven cities in China was included. Human milk mineral and trace elements was detected by inductively coupled plasma mass spectrometer (ICP-MS). K-means cluster analysis was utilized to derived human milk mineral patterns. Untargeted human milk metabolomic profiles was determined using high performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS). Differences of infant growth rate and metabolomic profiles were then compared across patterns identified.

Results

Three human milk mineral patterns were identified. Cluster I was characterized as the highest levels of potassium, magnesium and calcium, while the lowest levels of copper, zinc, manganese and selenium. Cluster II showed the most abundant sodium, iron, zinc, manganese and selenium. Cluster III had the lowest levels of sodium, potassium, magnesium, iron and calcium. Infants of cluster I showed significantly higher length-for-age z score (0.60 ± 2.03, p = 0.03). Compared with other clusters, samples of cluster I showed lower expression of metabolites of arachidonic acid (ARA) and nicotinate and nicotinamide metabolism pathway.

Discussion

A human milk mineral pattern was identified which is related to increased infant growth rate and altered metabolic signature. Future work is needed to understand these human milk patterns in terms of biologic mechanisms and generalization to other populations.
Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: a narrative review
Authors: Wu Haoxiang
Published: June 2024

Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas (UCOGCP) is a rare pancreatic tumor that accounts for less than 1% of all pancreatic malignancies. The characteristic pathological manifestation of UCOGCP is the presence of osteoclast-like giant cells (OGCs) distributed among pleomorphic undifferentiated tumor cells. UCOGCP can occur either alone or in association with other types of pancreatic tumors. At present, there is no unified consensus or guideline for the diagnosis and treatment of UCOGCP, and most of the literature are individual case reports. With the accumulation in the number of clinical cases and the development of precision medicine technology, the understanding of UCOGCP is also deepening. Researchers have begun to recognize that UCOGCP is a pancreatic tumor with distinctive clinical and molecular characteristics. In this review, we focus on the latest research status and future exploration directions in the diagnosis, treatment, and prognosis of UCOGCP.
Electroencephalographic insights into the pathophysiological mechanisms of emergence delirium in children and corresponding clinical treatment strategies
Authors: Gao Xin , Li Zhichao , Chai Jun , Li Si , Pan Xuanyuan , Liu Jie , Li Linxing , Qin Shangyuan , Kang Yihan , Zhu Youzhuang
Published: June 2024

Emergence delirium is a common postoperative complication in patients undergoing general anesthesia, especially in children. In severe cases, it can cause unnecessary self-harm, affect postoperative recovery, lead to parental dissatisfaction, and increase medical costs. With the widespread use of inhalation anesthetic drugs (such as sevoflurane and desflurane), the incidence of emergence delirium in children is gradually increasing; however, its pathogenesis in children is complex and unclear. Several studies have shown that age, pain, and anesthetic drugs are strongly associated with the occurrence of emergence delirium. Alterations in central neurophysiology are essential intermediate processes in the development of emergence delirium. Compared to adults, the pediatric nervous system is not fully developed; therefore, the pediatric electroencephalogram may vary slightly by age. Moreover, pain and anesthetic drugs can cause changes in the excitability of the central nervous system, resulting in electroencephalographic changes. In this paper, we review the pathogenesis of and prevention strategies for emergence delirium in children from the perspective of brain electrophysiology—especially for commonly used pharmacological treatments—to provide the basis for understanding the development of emergence delirium as well as its prevention and treatment, and to suggest future research direction.
Natural products for Gut-X axis: pharmacology, toxicology and microbiology in mycotoxin-caused diseases
Authors: Li Kaiqi , Wang Shiqi , Qu Wuyi , Ahmed Abdelkareem A. , Enneb Wael , Obeidat Mohammad Diya’ , Liu Hao-Yu , Dessie Tadelle , Kim In Ho , Adam Saber Y. , Cai Demin
Published: June 2024

Introduction: The gastrointestinal tract is integral to defending against external contaminants, featuring a complex array of immunological, physical, chemical, and microbial barriers. Mycotoxins, which are toxic metabolites from fungi, are pervasive in both animal feed and human food, presenting substantial health risks.

Methods: This review examines the pharmacological, toxicological, and microbiological impacts of natural products on mycotoxicosis, with a particular focus on the gut-x axis. The analysis synthesizes current understanding and explores the role of natural products rich in polysaccharides, polyphenols, flavonoids, and saponins.

Results: The review highlights that mycotoxins can disrupt intestinal integrity, alter inflammatory responses, damage the mucus layer, and disturb the bacterial balance. The toxins' effects are extensive, potentially harming the immune system, liver, kidneys, and skin, and are associated with serious conditions such as cancer, hormonal changes, genetic mutations, bleeding, birth defects, and neurological issues. Natural products have shown potential anticancer, anti-tumor, antioxidant, immunomodulatory, and antitoxic properties.

Discussion: The review underscores the emerging therapeutic strategy of targeting gut microbial modulation. It identifies knowledge gaps and suggests future research directions to deepen our understanding of natural products' role in gut-x axis health and to mitigate the global health impact of mycotoxin-induced diseases.
A systematic review and meta-analysis assessing the efficacy of Tuina for nocturnal enuresis in children
Authors: Chen Xin , Sun Wei-jie , Wang Jing-rong , Cai Ying-ying , Yu Xiao-dan
Published: June 2024

Background: Desmopressin acetate (DDAVP) and behavioral interventions (BI) are cornerstone treatments for nocturnal enuresis (NE), a common pediatric urinary disorder. Despite the growing body of clinical studies on massage therapy for NE, comprehensive evaluations comparing the effectiveness of Tuina with DDAVP or BI are scarce. This study aims to explore the efficacy of Tuina in the management of NE.

Methods: A systematic search of international databases was conducted using keywords pertinent to Tuina and NE. The inclusion criteria were limited to randomized controlled trials (RCTs) that evaluated NE treatments utilizing Tuina against DDAVP or BI. This meta-analysis included nine RCTs, comprising a total of 685 children, to assess both complete and partial response rates.

Results: Tuina, used as a combination therapy, showed enhanced clinical efficacy and improved long-term outcomes relative to the control group. The therapeutic efficacy of Tuina was not directly associated with the number of acupoints used. Instead, employing between 11 and 20 acupoints appeared to have the most significant effect.

Conclusion: The findings of this meta-analysis support the potential of Tuina as an adjunct therapy to enhance the sustained clinical efficacy of traditional treatments for NE. However, Tuina cannot completely replace DDAVP or BI in the management of NE. While this study illuminates some aspects of the effective acupoint combinations, further research is crucial to fully understand how Tuina acupoints contribute to the treatment of NE in children.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=442644, identifier CRD42023442644.
Thermal conductivity of nonunitary triplet superconductors: application to UTe2
Authors: Mishra Vivek , Wang Ge , Hirschfeld P. J.
Published: June 2024

Considerable evidence shows that the heavy fermion material UTe2 is a spin-triplet superconductor, possibly manifesting time-reversal symmetry breaking, as measured by Kerr effect below the critical temperature, in some samples. Such signals can arise due to a chiral orbital state or possible nonunitary pairing. Although experiments at low temperatures appear to be consistent with point nodes in the spectral gap, the detailed form of the order parameter and even the nodal positions are not yet determined. Thermal conductivity measurements can extend to quite low temperatures, and varying the heat current direction should be able to provide information on the order parameter structure. Here, we derive a general expression for the thermal conductivity of a spin-triplet superconductor and use it to compare the low-temperature behavior of various states proposed for UTe2.
Quantum private comparison for the socialist millionaire problem
Authors: Hou Min , Sun Shi-Yao , Zhang Wei
Published: June 2024

The socialist millionaire problem aims to compare the equality of two inputs from two users while keeping their inputs undisclosed to anyone. Quantum private comparison (QPC), whose security relies on the principles of quantum mechanics, can solve this problem and achieve the information-theoretic security of information processing. The current QPC protocols mainly utilize the bitwise XOR operation to implement the comparison, leading to insufficient security. In this paper, we propose a rotation operation-based QPC protocol to solve the socialist millionaire problem, which utilizes Bell states as quantum resources and rotation operations for classical calculations. The proposed protocol only utilizes easy-to-implement technologies such as Bell states, rotation operations, and Bell-basis measurements, making it more practical. The analysis demonstrates that our protocol can meet both the correctness and security requirements. Compared with the existing QPC protocols, our protocol has improved performance in terms of practicability and security.
Genome-wide transcript expression analysis reveals major chickpea and lentil genes associated with plant branching
Authors: Basso Marcos Fernando , Girardin Giacomo , Vergata Chiara , Buti Matteo , Martinelli Federico
Published: June 2024

The search for elite cultivars with better architecture has been a demand by farmers of the chickpea and lentil crops, which aims to systematize their mechanized planting and harvesting on a large scale. Therefore, the identification of genes associated with the regulation of the branching and architecture of these plants has currently gained great importance. Herein, this work aimed to gain insight into transcriptomic changes of two contrasting chickpea and lentil cultivars in terms of branching pattern (little versus highly branched cultivars). In addition, we aimed to identify candidate genes involved in the regulation of shoot branching that could be used as future targets for molecular breeding. The axillary and apical buds of chickpea cultivars Blanco lechoso and FLIP07–318C, and lentil cultivars Castellana and Campisi, considered as little and highly branched, respectively, were harvested. A total of 1,624 and 2,512 transcripts were identified as differentially expressed among different tissues and contrasting cultivars of chickpea and lentil, respectively. Several gene categories were significantly modulated such as cell cycle, DNA transcription, energy metabolism, hormonal biosynthesis and signaling, proteolysis, and vegetative development between apical and axillary tissues and contrasting cultivars of chickpea and lentil. Based on differential expression and branching-associated biological function, ten chickpea genes and seven lentil genes were considered the main players involved in differentially regulating the plant branching between contrasting cultivars. These collective data putatively revealed the general mechanism and high-effect genes associated with the regulation of branching in chickpea and lentil, which are potential targets for manipulation through genome editing and transgenesis aiming to improve plant architecture.