bluuebunny/crossref_metadata_2025 huggingface dataset:
Breastfeeding, first-food systems and corporate power: a case study on the market and political practices of the transnational baby food industry in Brazil
Authors: Robles Cindy Alejandra Pachón , Mialon Mélissa , Mais Laís Amaral , Neri Daniela , Silva Kimielle Cristina , Baker Phillip
Published: February 2024

Background

The exploitative marketing of commercial milk formula (CMF) reduces breastfeeding, and harms child and maternal health globally. Yet forty years after the International Code of Marketing of Breast-Milk Substitutes (The Code) was adopted by WHO member states, many countries are still to fully implement its provisions into national law. Furthermore, despite The Code, worldwide CMF markets have markedly expanded. In this paper, we adopt Brazil as a case study to understand the power of the baby food industry’s marketing and corporate political activity, and how this influences the country’s ‘first-food system’ in ways that promote and sustain CMF consumption.

Methods

We used a case study design, drawing data from from documents and key informant interviews (N = 10).

Results

Breastfeeding rates plummeted in Brazil to a historic low in the 1970s. A resurgence in breastfeeding from the mid-1980s onwards reflected strengthening political commitment for a national policy framework and breastfeeding protection law, resulting in-turn, from collective actions by breastfeeding coalitions, advocates, and mothers. Yet more recently, improvements in breastfeeding have plateaued in Brazil, while the industry grew CMF sales in Brazil by 750% between 2006 and 20. As regulations tightened, the industry has more aggressively promoted CMF for older infants and young children, as well as specialised formulas. The baby food industry is empowered through association with powerful industry groups, and employs lobbyists with good access to policymakers. The industry has captured the pediatric profession in Brazil through its long-standing association with the Brazilian Society of Pediatrics.

Conclusion

Brazil illustrates how the baby food industry uses marketing and political activity to promote and sustain CMF markets, to the detriment of breastfeeding. Our results demonstrate that this industry requires much greater scrutiny by regulators.
Periarticular blast wounds without fracture a prospective case series
Authors: Covey Dana C. , Gentchos Christopher E.
Published: February 2024

Background

During the wars in Afghanistan and Iraq most injuries to service members involved the musculoskeletal system. These wounds often occurred around joints, and in some cases result in traumatic arthrotomy—a diagnosis that is not always clear, especially when there is no concomitant articular fracture. The aim of the present study is to evaluate the diagnosis and treatment of peri-articular blast injuries without fracture.

Methods

The study cohort included 12 consecutive patients (12 involved extremities) who sustained peri-articular blast wounds of the extremities without fractures. The diagnosis of penetrating articular injury was based on clinical examination, radiographic findings, or aspiration. A peri-articular wound was defined as any wound, or radio-opaque blast fragment, within 5 cm of a joint. The New Injury Severity Score (NISS) was calculated for each patient. Four patients had upper, and 8 patients had lower extremity injuries. Nine of 12 patients had joint capsular penetration and underwent joint irrigation and debridement.

Results

Two patients had retained intra-articular metal fragments. One patient had soft tissue blast wounds within 5 cm of a joint but did not have joint capsule penetration. There were no significant differences (p = 0.23) between the distribution of wounds to upper versus lower extremities. However, there were a significantly greater number of blast injuries attributed to Improvised Explosive Devices (IEDs) than from other blast mechanisms (p = 0.01).

Conclusion

Extremity blast injuries in the vicinity of joints involving only soft tissues present a unique challenge in surgical management. A high index of suspicion should be maintained for joint capsular penetration so that intra-articular injuries may be appropriately treated.
Coronary pseudoaneurysm with a superficial mass and accompanying Brucella infection
Authors: Mi Chuanxiao , Zhang Xiangxi , Wang Liyuan , Yun Yan , Li Fang , Li Yi , Liu Yuxin , Zhang Shouji , Zou Chengwei , Zhang Haizhou , Ma Xiaochun
Published: February 2024

Background and aims

To our knowledge, no previously reported clinical data of a coronary artery fistula forming a pseudoaneurysm and presenting as a anterior chest wall lump. We reported a rare case of Coronary pseudoaneurysm with a superficial mass and accompanying Brucella infection. The patient was successfully treated with surgery.

Materials and methods

The patient case data was extracted from hospital records.

Results

A 64-year-old male presented with a history of paroxysmal left-sided chest pain and painful anterior chest wall lump. Coronary computed tomography (CT) angiography revealed the RCA pseudoaneurysm that showed a peripherally calcified soft-tissue mass in the anterior mediastinum and communicated with the chest wall lump through intercostal spaces. The patient underwent the resection of chest lump and RCA pseudoaneurysm under cardiopulmonary bypass, along with a combined antimicrobial therapy. The patient was discharged successfully after the surgery.

Discussion and conclusion

We report this rare case and highlight the possible origin of the anterior mediastinal mass and anterior chest wall lump as a pseudoaneurysm formed by a coronary artery fistula.
Predictive values of ultrasonic diaphragm thickening fraction combined with integrative weaning index in weaning patients with mechanical ventilation: a retrospective study
Authors: Lin Hai , Yao Mingming , Qin Ziwen , Fu Shilin , Wang Hongyou
Published: February 2024

Objective

We aimed to explore the predictive values of ultrasonic diaphragm thickening fraction (DTF) combined with integrative weaning index (IWI) in weaning patients with mechanical ventilation.

Methods

Patients with mechanical ventilation who received oral endotracheal intubation from September 2020 to September 2021 were included in this retrospective study. Before the start of the spontaneous breathing test (SBT), IWI was calculated according to the blood gas analysis parameters and parameters read in volume control mode. After the start of SBT, DTF was calculated according to the end-expiratory thickness and end-inspiratory thickness of the right diaphragm. The receiver operating curve (ROC) was used to evaluate the predictive value of DTF and IWI for successful weaning, and the sensitivity and specificity were calculated according to the best critical value.

Results

The sensitivity, specificity, and best cutoff value of DTF to predict successful weaning was 0.772, 0.727, and 0.293, respectively, and the area under the curve (AUC) was 0.72 (95%CI 0.59–0.86, p = 0.003). The sensitivity, specificity, and best cutoff value of IWI to predict successful weaning was 0.614, 0.909, 53.00, respectively, and AUC was 0.82 (95%CI 0.72–0.91, p < 0.001). The sensitivity, specificity, and best cutoff value of the combination of DTF and IWI to predict successful weaning was 0.614, 0.909, 17.848, respectively, and AUC was 0.84 (95%CI 0.75–0.93, p < 0.001).

Conclusion

DTF and IWI can guide the selection of weaning, while DTF combined with IWI can improve the effect of weaning prediction and provide support for patients’ weaning safety.
Body measurement changes in adults with pectus excavatum after the Nuss procedure: a study of 272 patients
Authors: Htut Nay , Tzeng I-Shiang , Fan Yu-Jiun , Cheng Yeung-Leung
Published: February 2024

Background

Pectus excavatum (PE) is the most common congenital abnormality of the chest wall. Most patients with PE have slim bodies. Some studies have been conducted on the physical growth of children and adolescents who underwent the Nuss procedure. This study aimed to evaluate body measurement changes in adult patients with PE after the Nuss procedure.

Methods

A total of 272 adult PE patients, who underwent the Nuss procedure and pectus bars removal from August 2014 to December 2020, were evaluated retrospectively. Body measurement [body height (BH), body weight (BW), and body mass index (BMI)] of the patients were collected before Nuss repair and after bar removal. We used the interquartile range (IQR) to identify and exclude outliers. Associations between changes in body measurement and clinical and radiological features were evaluated.

Results

The BH, BW and BMI showed significantly increased after pectus bar removal, compared to pre-Nuss procedure parameters (BH 173.8 ± 5.9 cm vs. 173.9 ± 5.9 cm, P < 0.001; BW 60.3 ± 8.1 kg vs. 61.1 ± 8.8 kg, P = 0.005; BMI 19.9 ± 2.2 kg/m2 vs. 20.1 ± 2.4 kg/m2, P = 0.02). The same result were observed in the male subgroup, the HI ≥ 4 group and the male subgroup within the HI ≥ 4 group.

Conclusions

The BH, BW and BMI were significantly increased after completing surgical correction of PE using the Nuss procedure, particularly in young males and patients with more pronounced deformities.
Comparative transcriptome analysis and identification of candidate R2R3-MYB genes involved in anthraquinone biosynthesis in Rheum palmatum L.
Authors: Zhao Xia , Yan Feng , Li Yi-min , Tang Jing , Hu Xiao-chen , Feng Zhao , Gao Jing , Peng Liang , Zhang Gang
Published: February 2024

Background

Rheum palmatum L. has important medicinal value because it contains biologically active anthraquinones. However, the key genes and TFs involved in anthraquinone biosynthesis and regulation in R. palmatum remain unclear.

Methods

Based on full length transcriptome data, in this study, we screened the differentially expressed genes in the anthraquinone biosynthesis pathway. The R2R3-MYB family genes of R. palmatum were systematically identified based on full-length transcriptome sequencing followed by bioinformatics analyses. The correlation analysis was carried out by using co-expression analysis, protein interaction analysis, and real-time fluorescence quantitative analysis after MeJA treatment. The RpMYB81 and RpMYB98 genes were amplified by RT-PCR, and their subcellular localization and self-activation characteristics were analyzed.

Results

Comparative transcriptome analysis results revealed a total of 3525 upregulated and 6043 downregulated DEGs in the CK versus MeJA group; 28 DEGs were involved in the anthraquinone pathway. Eleven CHS genes that belonged to the PKS family were differentially expressed and involved in anthraquinone biosynthesis. Twelve differentially expressed MYBs genes were found to be co-expressed and interact with CHS genes. Furthermore, 52 MYB genes were identified as positive regulators of anthraquinone biosynthesis and were further characterized. Three MYB genes including RpMYB81, RpMYB98, and RpMYB100 responded to MeJA treatment in R. palmatum, and the levels of these genes were verified by qRT-PCR. RpMYB81 was related to anthraquinone biosynthesis. RpMYB98 had an interaction with genes in the anthraquinone biosynthesis pathway. RpMYB81 and RpMYB98 were mainly localized in the nucleus. RpMYB81 had self-activation activity, while RpMYB98 had no self-activation activity.

Conclusion

RpMYB81, RpMYB98, and RpMYB100 were significantly induced by MeJA treatment. RpMYB81 and RpMYB98 are located in the nucleus, and RpMYB81 has transcriptional activity, suggesting that it might be involved in the transcriptional regulation of anthraquinone biosynthesis in R. palmatum.
Implementation of thyroid eye disease registry in Iran: rationale and research protocol
Authors: Akbarian Shadi , Sheikhtaheri Abbas , Khorrami Farid , Ghahvechian Hossein , Karimi Nasser , Kashkouli Mohsen Bahmani
Published: February 2024

Background

To describe the implementation of a registry system for patients with thyroid eye disease (TED) in Iran to obtain more information about its nature, prevalence, and annual incidence, as well as extend insight into the etiology, pathogenesis, and eventually make an accurate prognosis of different medical or surgical treatment methods.

Methods

After receiving approval from the Disease Registry Committee of Iran University of Medical Sciences (IUMS) in 2019 and the Ministry of Health and Medical Education (MOHME) in 2020, the protocol was introduced in three consecutive phases at regional, provincial and national levels. The establishment of a registry committee in Rassoul Akram Hospital, one of the medical centers affiliated to IUMS, was the first step to organizing the registry project's main core. The steering committee included six subgroups of required subject fields. The members are experts in developing a guideline, providing a new dataset, drawing an outline for the next steps, and structuring user-friendly software through several panel discussion meetings. The data is collected from clinical and para-clinical/imaging findings, laboratory evaluations, and their selected treatment strategy, retrospectively and prospectively.

Results

The purpose is to broaden our knowledge about the profile of TED; accordingly, data related to patients’ demographics, thyroid gland disease (status, duration, treatments, and function tests), general medical and ocular history, along with visual/ocular exams resulting TED status are collected and recorded in a 2- language software. The web-based software system is accessible at https://orc.iums.ac.ir. To maintain data security, prioritized user access was defined for different members. Furthermore, diverse methods, such as employing trained staff and utilizing software validation rules, were implemented to control data quality in every step of data collection, entry, and registration. Medical records of retrospective subjects were also evaluated and entered after accuracy verification.

Conclusion

Iran's TED registry provides practitioners with comprehensive data on natural history and phenotype variations in clinical features and outcomes. It facilitates patient recruitment and, consequently, earlier diagnosis on a large scale which helps improve treatment and quality of life for patients.
Low 25-hydroxyvitamin D concentrations in wild rabbits (Oryctolagus cuniculus) in southern Finland
Authors: Mäkitaipale Johanna , Hietanen Pinja , Grönthal Thomas
Published: February 2024

Background

Diet and endogenous vitamin D synthesis are possible sources of vitamin D in wild rabbits. Higher 25-hydroxyvitamin D (25(OH)D) concentrations have been reported in rabbits after artificial UVB light exposure than in rabbits without this exposure, suggesting that endogenous vitamin D synthesis occurs in the former group. In Finnish pet rabbits, diet was reported as main source of vitamin D, while outdoor access was not. Finland’s northern location only enables endogenous synthesis from mid-March to mid-October in people with light skin type. Living conditions during winter are challenging for Finnish wild rabbits. This study aimed to measure serum 25(OH)D concentrations and possible natural seasonal variation of vitamin D concentrations in Finnish wild rabbits.

Results

Post-mortem blood samples (n = 78) were collected between 2013 and 2021 from wild rabbits hunted for reduction of the wild rabbit population. Separated sera were stored at − 80 °C until 25(OH)D concentrations were measured by enzyme immunoassay. Data regarding sex were available from 50 rabbits, 29 (58%) of which were females. Mean 25(OH)D concentration was 3.3 (range 0.3–7.1) ng/ml. 25(OH)D concentration was statistically similar between season (autumn, winter, summer), month or year of sample collection, and sex.

Conclusions

Wild rabbits living in Finland have very low serum 25(OH)D concentrations. This is far below the previously suggested threshold of vitamin D deficiency in rabbits (17 ng/mL) or the mean 25(OH)D concentration reported in Finnish pet rabbits (26.0 ng/mL). Seasonal variation was not observed in 25(OH)D concentrations between winter and summer months. Even though rabbits are crepuscular animals and may spend the mid-day in underground burrows, the very low observed 25(OH)D concentrations raise doubt about whether vitamin D synthesis occurs efficiently in the skin of rabbits and whether the diet of wild rabbits provides adequate amounts of vitamin D. Cutaneous vitamin D synthesis, possible long-term consequences of low 25(OH)D concentrations, and the association of low vitamin D status with other health disorders warrant further investigations in rabbits.
PARD3 drives tumorigenesis through activating Sonic Hedgehog signalling in tumour-initiating cells in liver cancer
Authors: Wu Junyu , Tan Hor-Yue , Chan Yau-Tuen , Lu Yuanjun , Feng Zixin , Yuan Hongchao , Zhang Cheng , Feng Yibin , Wang Ning
Published: February 2024

Background

Par-3 Family Cell Polarity Regulator (PARD3) is a cellular protein essential for asymmetric cell division and polarized growth. This study aimed to study the role of PARD3 in hepatic tumorigenesis.

Methods

The essential role of PARD3 in mediating hepatic tumorigenesis was assessed in diet-induced spontaneous liver tumour and syngeneic tumour models. The mechanism of PARD3 was delineated by bulk and single-cell RNA sequencing. The clinical significance of PARD3 was identified by tissue array analysis.

Results

PARD3 was overexpressed in tumour tissues and PARD3 overexpression was positively correlated with high tumour stage as well as the poor prognosis in patients. In models of spontaneous liver cancer induced by choline-deficient, amino acid-defined (CDAA) and methionine-choline-deficient (MCD) diets, upregulation of PARD3 was induced specifically at the tumorigenesis stage rather than other early stages of liver disease progression. Site-directed knockout of PARD3 using an adeno-associated virus 8 (AAV8)-delivered CRISPR/Cas9 single-guide RNA (sgRNA) plasmid blocked hepatic tumorigenesis, while PARD3 overexpression accelerated liver tumour progression. In particular, single-cell sequencing analysis suggested that PARD3 was enriched in primitive tumour cells and its overexpression enhanced tumour-initiating cell (TICs). Overexpression of PARD3 maintained the self-renewal ability of the CD133+ TIC population within hepatocellular carcinoma (HCC) cells and promoted the in vitro and in vivo tumorigenicity of CD133+ TICs. Transcriptome analysis revealed that Sonic Hedgehog (SHH) signalling was activated in PARD3-overexpressing CD133+ TICs. Mechanistically, PARD3 interacted with aPKC to further activate SHH signalling and downstream stemness-related genes. Suppression of SHH signalling and aPKC expression attenuated the in vitro and in vivo tumorigenicity of PARD3-overexpressing CD133+ TICs. Tissue array analysis revealed that PARD3 expression was positively associated with the phosphorylation of aPKC, SOX2 and Gli1 and that the combination of these markers could be used to stratify HCC patients into two clusters with different clinicopathological characteristics and overall survival prognoses. The natural compound berberine was selected as a potent suppressor of PARD3 expression and could be used as a preventive agent for liver cancer that completely blocks diet-induced hepatic tumorigenesis in a PARD3-dependent manner.

Conclusion

This study revealed PARD3 as a potential preventive target of liver tumorigenesis via TIC regulation.
Thiamine administration in septic shock: a post hoc analysis of two randomized trials
Authors: Vine Jacob , Lee John H. , Kravitz Max S. , Grossestreuer Anne V. , Balaji Lakshman , Leland Shannon B. , Berlin Noa , Moskowitz Ari , Donnino Michael W.
Published: February 2024

Background

This is a post hoc analysis of combined cohorts from two previous Phase II clinical trials to assess the effect of thiamine administration on kidney protection and mortality in patients with septic shock.

Methods

Patient-level data from the Thiamine in Septic Shock Trial (NCT01070810) and the Thiamine for Renal Protection in Septic Shock Trial (NCT03550794) were combined in this analysis. The primary outcome for the current study was survival without the receipt of renal replacement therapy (RRT). Analyses were performed on the overall cohort and the thiamine-deficient cohort (thiamine < 8 nmol/L).

Results

Totally, 158 patients were included. Overall, thiamine administration was associated with higher odds of being alive and RRT-free (adjusted odds ratio [aOR]: 2.05 [95% confidence interval (CI) 1.08–3.90]) and not needing RRT (aOR: 2.59 [95% CI 1.01–6.62]). In the thiamine-deficient group, thiamine administration was associated with higher odds of being alive and RRT-free (aOR: 8.17 [95% CI 1.79–37.22]) and surviving to hospital discharge (aOR: 6.84 [95% CI 1.54–30.36]). There was a significant effect modification by baseline thiamine deficiency for alive and RRT-free (interaction, p = 0.016) and surviving to hospital discharge (p = 0.019).

Conclusion

In the combined analysis of two previous randomized trials, thiamine administration was associated with higher odds of being alive and RRT-free at hospital discharge in patients with septic shock. This signal was stronger in patients with thiamine deficiency.
qSOFA combined with suPAR for early risk detection and guidance of antibiotic treatment in the emergency department: a randomized controlled trial
Authors: Adami Maria Evangelia , Kotsaki Antigone , Antonakos Nikolaos , Giannitsioti Efthymia , Chalvatzis Stamatios , Saridaki Maria , Avgoustou Christina , Akinosoglou Karolina , Dakou Konstantina , Damoraki Georgia , Katrini Konstantina , Koufargyris Panagiotis , Lekakis Vasileios , Panagaki Antonia , Safarika Asimina , Eugen-Olsen Jesper , Giamarellos-Bourboulis Evangelos J.
Published: February 2024

Background

Sepsis guidelines suggest immediate start of resuscitation for patients with quick Sequential Organ Failure Assessment (qSOFA) 2 or 3. However, the interpretation of qSOFA 1 remains controversial. We investigated whether measurements of soluble urokinase plasminogen activator receptor (suPAR) may improve risk detection when qSOFA is 1.

Methods

The study had two parts. At the first part, the combination of suPAR with qSOFA was analyzed in a prospective cohort for early risk detection. At the second part, the double-blind, randomized controlled trial (RCT) SUPERIOR evaluated the efficacy of the suPAR-guided medical intervention. SUPERIOR took place between November 2018 and December 2020. Multivariate stepwise Cox regression was used for the prospective cohort, while univariate and multivariate logistic regression was used for the RCT. Consecutive admissions at the emergency department (ED) with suspected infection, qSOFA 1 and suPAR ≥ 12 ng/mL were allocated to single infusion of placebo or meropenem. The primary endpoint was early deterioration, defined as at least one-point increase of admission Sequential Organ Failure Assessment (SOFA) score the first 24 h.

Results

Most of the mortality risk was for patients with qSOFA 2 and 3. Taking the hazard ratio (HR) for death of patients with qSOFA = 1 and suPAR < 12 ng/mL as reference, the HR of qSOFA = 1 and suPAR ≥ 12 ng/mL for 28-day mortality was 2.98 (95% CI 2.11–3.96). The prospective RCT was prematurely ended due to pandemia-related ED re-allocations, with 91 patients enrolled: 47 in the placebo and 44 in the meropenem arm. The primary endpoint was met in 40.4% (n = 19) and 15.9% (n = 7), respectively (difference 24.5% [5.9–40.8]; odds ratio 0.14 [0.04–0.50]). One post hoc analysis showed significant median changes of SOFA score after 72 and 96 h equal to 0 and − 1, respectively.

Conclusions

Combining qSOFA 1 with the biomarker suPAR improves its prognostic performance for unfavorable outcome and can help decision for earlier treatment.

Trial registration EU Clinical Trials Register (EudraCT, 2018-001008-13) and Clinical-Trials.gov (NCT03717350). Registered 24 October 2018.
Molecular monitoring of insecticide resistance in major disease vectors in Armenia
Authors: Paronyan Lusine , Babayan Lilit , Vardanyan Haykuhi , Manucharyan Arsen , Papapostolou Kyriaki Maria , Balaska Sofia , Vontas John , Mavridis Konstantinos
Published: February 2024

Background

Armenia is considered particularly vulnerable to life-threatening vector-borne diseases (VBDs) including malaria, West Nile virus disease and leishmaniasis. However, information relevant for the control of the vectors of these diseases, such as their insecticide resistance profile, is scarce. The present study was conducted to provide the first evidence on insecticide resistance mechanisms circulating in major mosquito and sand fly populations in Armenia.

Methods

Sampling sites were targeted based mainly on previous historical records of VBD occurrences in humans and vertebrate hosts. Initially, molecular species identification on the collected vector samples was performed. Subsequently, molecular diagnostic assays [polymerase chain reaction (PCR), Sanger sequencing, PCR-restriction fragment length polymorphism (RFLP), quantitative PCR (qPCR)] were performed to profile for major insecticide resistance mechanisms, i.e. target site insensitivity in voltage-gated sodium channel (vgsc) associated with pyrethroid resistance, acetylcholinesterase (ace-1) target site mutations linked to organophosphate (OP) and carbamate (CRB) resistance, chitin synthase (chs-1) target site mutations associated with diflubenzuron (DFB) resistance and gene amplification of carboxylesterases (CCEs) associated with resistance to the OP temephos.

Results

Anopheles mosquitoes were principally represented by Anopheles sacharovi, a well-known malaria vector in Armenia, which showed no signs of resistance mechanisms. Contrarily, the knockdown resistance (kdr) mutations V1016G and L1014F/C in the vgsc gene were detected in the arboviral mosquito vectors Aedes albopictus and Culex pipiens, respectively. The kdr mutation L1014S was also detected in the sand fly, vectors of leishmaniasis, Phlebotomus papatasi and P. tobbi, whereas no mutations were found in the remaining collected sand fly species, P. sergenti, P. perfiliewi and P. caucasicus.

Conclusions

This is the first study to report on molecular mechanisms of insecticide resistance circulating in major mosquito and sand fly disease vectors in Armenia and highlights the need for the establishment of systematic resistance monitoring practices for the implementation of evidence-based control applications.

Graphical Abstract
Associations between cardiometabolic multimorbidity and cerebrospinal fluid biomarkers of Alzheimer’s disease pathology in cognitively intact adults: the CABLE study
Authors: Li Qiong-Yao , Hu He-Ying , Zhang Gao-Wen , Hu Hao , Ou Ya-Nan , Huang Liang-Yu , Wang An-Yi , Gao Pei-Yang , Ma Li-Yun , Tan Lan , Yu Jin-Tai
Published: February 2024

Background

Cardiometabolic multimorbidity is associated with an increased risk of dementia, but the pathogenic mechanisms linking them remain largely undefined. We aimed to assess the associations of cardiometabolic multimorbidity with cerebrospinal fluid (CSF) biomarkers of Alzheimer’s disease (AD) pathology to enhance our understanding of the underlying mechanisms linking cardiometabolic multimorbidity and AD.

Methods

This study included 1464 cognitively intact participants from the Chinese Alzheimer’s Biomarker and LifestylE (CABLE) database. Cardiometabolic diseases (CMD) are a group of interrelated disorders such as hypertension, diabetes, heart diseases (HD), and stroke. Based on the CMD status, participants were categorized as CMD-free, single CMD, or CMD multimorbidity. CMD multimorbidity is defined as the coexistence of two or more CMDs. The associations of cardiometabolic multimorbidity and CSF biomarkers were examined using multivariable linear regression models with demographic characteristics, the APOE ε4 allele, and lifestyle factors as covariates. Subgroup analyses stratified by age, sex, and APOE ε4 status were also performed.

Results

A total of 1464 individuals (mean age, 61.80 years; age range, 40–89 years) were included. The markers of phosphorylated tau-related processes (CSF P-tau181: β = 0.165, P = 0.037) and neuronal injury (CSF T-tau: β = 0.065, P = 0.033) were significantly increased in subjects with CMD multimorbidity (versus CMD-free), but not in those with single CMD. The association between CMD multimorbidity with CSF T-tau levels remained significant after controlling for Aβ42 levels. Additionally, significantly elevated tau-related biomarkers were observed in patients with specific CMD combinations (i.e., hypertension and diabetes, hypertension and HD), especially in long disease courses.

Conclusions

The presence of cardiometabolic multimorbidity was associated with tau phosphorylation and neuronal injury in cognitively normal populations. CMD multimorbidity might be a potential independent target to alleviate tau-related pathologies that can cause cognitive impairment.
A patient with multiple primary malignant neoplasms with high variant allele frequencies of RB1, TP53, and TERT
Authors: Ma Mingyang , Shang Kun , Wang Jiewei , Teng Xiaojing , Li Peng , Wang Jing
Published: February 2024

Multiple primary malignant neoplasms are a rare disease with tumors of different histology or morphology arising in various sites. Next-generation sequencing is essential in the etiology, diagnosis, treatment, and surveillance of this disease. No eight primary malignant neoplasm cases with high variant allele frequencies of RB1, TP53, and TERT have been reported. Herein, we report a 65-year-old male who exhibited eight primary malignancies of the vocal cord, pharynx, kidney, mouth floor, esophagus, and urinary bladder with different pathological types. The first seven tumors were early-stage tumors; the last tumor, small cell carcinoma of urinary bladder, showed liver metastasis at diagnosis. Next-generation sequencing results revealed extremely high somatic variant allele frequencies of RB1 c.1472 T > C, TP53 c.576A > G, and TERT c.-58-u66C > T (95.5%, 95.1%, and 51.0%, respectively). No germline mutations were detected. These findings denoted a heavy tumor burden and poor prognosis. This is the first report of eight primary malignant neoplasm cases with high variant allele frequencies of RB1, TP53, and TERT.
FaultSSL: Seismic fault detection via semisupervised learning
Authors: Dou Yimin , Li Kewen , Dong Minghui , Xiao Yuan
Published: February 2024

The prevailing methodology in data-driven fault detection leverages synthetic data for training neural networks. However, it grapples with challenges when it comes to generalization in surveys exhibiting complex structures. To enhance the generalization of models trained on limited synthetic data sets to a broader range of real-world data, we introduce FaultSSL, a semisupervised fault detection framework. This method is based on the classical mean teacher structure, in which its supervised part uses synthetic data and a few 2D labels. The unsupervised component relies on two meticulously devised proxy tasks, allowing it to incorporate vast, unlabeled field data into the training process. The two proxy tasks are panning consistency (PNC) and patching consistency (PTC). PNC emphasizes feature consistency in overlapping regions between two adjacent views in predicting the model. This allows for the extension of 2D slice labels to the global seismic volume. PTC emphasizes the spatially consistent nature of faults. It ensures that the predictions for the seismic data, whether made on the entire volume or individual patches, exhibit coherence without any noticeable artifacts at the patch boundaries. Although the two proxy tasks serve different objectives, they uniformly contribute to the enhancement of performance. Experiments showcase the exceptional performance of FaultSSL. In surveys wherein other mainstream methods fail to deliver, we present reliable, continuous, and clear detection results. FaultSSL reveals a promising approach for incorporating large volumes of field data into the training and promoting model generalization across broader surveys.
Reflective mode conversions between extensional and flexural waves by ultrathin oblique anisotropic tri-component resonators
Authors: Chen Fengyi , Du Qiujiao , Liu Fengming , Peng Pai
Published: February 2024

In this letter, we report a theoretical study for the conversions between extensional and flexural modes for Lamb waves. The incident extensional waves can be completely converted into reflected flexural waves, or vice versa. The used structure is oblique anisotropic tri-component resonators with locally dipolar resonators. Without special optimization designs, the thickness of conversion device is much smaller than the working wavelengths (1/150 and 1/15 for the extensional and flexural waves, respectively). Our proposed design is more feasible for low-frequency application scenarios.
Thermal transport in Yb-based 1-2-20 materials
Authors: Ekuma C. E.
Published: February 2024

Lattice thermal-transport properties of heavy-fermion YbT2Zn20-based (T = Co, Rh, and Ir) 1-2-20 compounds are calculated with the single-mode relaxation-time approximation and the full solution of the linearized phonon Boltzmann transport equation from first-principles anharmonic phonon calculations. We predict low lattice thermal conductivity κ

L
with a maximum value of ∼24.16

 ·K at 85.14 K, 137.29

 ·K at 9.67 K, and 23.55

 ·K at 67.50 K and ∼12.02, 40.04, and 10.30

 ·K at room temperature for YbCo2Zn20, YbRh2Zn20, and YbIr2Zn20, respectively. Based on the analysis of the cumulative κ

L
as a function of the phonon mean free path and the frequency-dependent joint density of states at various temperatures, we attribute the low κ

L
to a rattling mode with an average characteristic rattling frequency

that enhanced phonon scattering processes, which reduced the phonon mean free paths, suppressed the phonon lifetime, and enhanced the probability of three-phonon scattering events. The predicted low κ

L
, especially in YbCo2Zn20 and YbIr2Zn20, makes them promising candidate materials for thermoelectric applications and thermal management.
The Endocrine Phenotype Induced by Pediatric Adrenocortical Tumors Is Age- and Sex-Dependent
Authors: Kunstreich Marina , Dunstheimer Desiree , Mier Pascal , Holterhus Paul-Martin , Wudy Stefan A , Huebner Angela , Redlich Antje , Kuhlen Michaela
Published: February 2024

Context

Adrenocortical carcinomas are very rare malignancies in childhood associated with poor outcome in advanced disease. Most adrenocortical tumors (ACT) are functional, causing signs and symptoms of adrenal hormone excess. In most studies, endocrine manifestations were reported 4 to 6 months prior to diagnosis.

Objective

We sought to extend knowledge on endocrine manifestations with regard to age and sex to facilitate early diagnosis.

Methods

We retrospectively analyzed features of adrenal hormone excess in children and adolescents with ACT registered with the GPOH-MET studies between 1997 and 2022. Stage of puberty was defined as prepubertal in females < 8 years of age and males < 9 years.

Results

By December 2022, 155 patients (110 female, 45 male) with data on endocrine manifestations had been reported. Median age at ACT diagnosis was 4.2 years [0.1-17.8], median interval from first symptoms was 4.2 months [0-90.7]. In 63 girls of prepubertal age, the most frequently reported manifestations were pubarche (68.3%), clitoral hypertrophy (49.2%), and weight gain (31.7%); in 47 pubertal female patients, the most frequent manifestations were excessive pubic hair (46.8%), acne (36.2%), and hypertension (36.2%). Leading symptoms in 34 boys of prepubertal age were pubarche (55.9%), penile growth (47.1%), and acne (32.4%), while in 11 pubertal male patients, leading symptoms were weight gain (45.5%), hypertension (36.4%), excessive pubic hair (27.3%), and cushingoid appearance (27.3%). In pubertal patients, symptoms of androgen excess were mainly unrecognized as part of pubertal development, while symptoms of Cushing syndrome were more frequently apparent.

Conclusion

The endocrine phenotype induced by pediatric ACT is age- and sex-dependent.
The Effect of perioperative forced air warming blanket on older adult patients undergoing spinal surgery with general anesthesia
Authors: Shin Youngduck , Lee Jooyong , Seo Haewon , Park Sanghi
Published: February 2024

Objective: As the population of patients aged 65 years and older increases, the number of older adult patients undergoing surgery also increases. Older adults are vulnerable to hypothermia due to age-related changes in the thermoregulatory center, which leads to reduced subcutaneous fat tissue, vasomotor response, and heat production. Thus, they are more likely to suffer complications, including cardiovascular changes, blood coagulation disorders, infections, and delayed recovery from surgery. The study investigated the effect of preventive active warming.

Methods: This retrospective cohort study conducted at Chungbuk National University Hospital investigated clinical data from older adult patients undergoing spinal surgery from January 1, 2020, to December 13, 2022. In this study, we explored the use of prophylactic active warming during anesthesia induction and post-surgery warming in older adult patients (≥65 years) who experienced hypothermia during and after surgery under general anesthesia.

Results: The control group of patients who experienced hypothermia increased from 20% after 10 minutes to 80% after 30 minutes and 100% after 60 minutes. The percentage of patients in the treatment group who initially experienced hypothermia increased from 10% after 30 min to 40% after 60 minutes. However, notably, 90% of these patients had returned to a normal body temperature upon their arrival at the recovery room. The difference in the percentage of patients who developed hypothermia was statistically significant between the two groups.

Conclusions: Hypothermia prevention via an air-forced warming blanket was effective for older adult patients undergoing spinal surgery under general anesthesia.

doi: https://doi.org/10.12669/pjms.40.4.7886

How to cite this: Shin Y, Lee J, Seo H, Park S. Effect of perioperative forced air warming blanket on older adult patients undergoing spinal surgery with general anesthesia. Pak J Med Sci. 2024;40(4):706-710. doi: https://doi.org/10.12669/pjms.40.4.7886

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effect of fascia iliaca compartment block combined with ropivacaine on post-operative outcomes in elderly patients undergoing hip fracture repair
Authors: Li Junshi , Chen Hui , Zuo Jianfeng , Zhang Xiping
Published: February 2024

Objective: To explore the effect of fascia iliaca compartment block (FICB) in combination with ropivacaine on post-operative outcomes in elderly patients undergoing hip fracture (HF) repair.

Methods: Retrospective analysis included data of 111 elderly patients who underwent HF surgery with FICB in Changxing County People’s Hospital from October 2018 to October 2022. Observation group received 0.25% ropivacaine combined with FICB (n=52), and the control group was administered an intravenous injection of parecoxib sodium (n=59). Baseline characteristics of the patients, and indexes such as mean arterial pressure (MAP), heart rate (HR), and visual analogue scale (VAS) pain scores, were collected at one-, six-, 12- and 24-hours past surgery, both at rest and after passive movement.

Results: VAS scores, MAP and HR at rest and after a passive movement in both groups were comparable before the surgery. VAS sores were significantly lower in the observation group at one-, six-, 12- and 24-hours after the surgery (P<0.05). Postoperative MAP in the observation group (80.83 ± 8.31) was significantly lower compared to the control group (95.29 ± 8.45 (t = -9.0659, p < 0.0001). Similarly, HR of the observation group was significantly lower one-hour post-surgery both at rest (t = -2.0468, p = 0.0431) and after passive movement (t = -6.0625, p < 0.001), and at all subsequent time intervals after the passive movement (P<0.05).

Conclusions: Ropivacaine combined with FICB was associated with improved post-operative outcomes such as lower post-surgery VAS scores, MAP and HR compared to the intravenous injection of parecoxib sodium.

doi: https://doi.org/10.12669/pjms.40.4.8283

How to cite this: Li J, Chen H, Zuo J, Zhang X. Effect of fascia iliaca compartment block combined with ropivacaine on post-operative outcomes in elderly patients undergoing hip fracture repair. Pak J Med Sci. 2024;40(4):757-762. doi: https://doi.org/10.12669/pjms.40.4.8283

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The effect of budesonide combined with bifidobacteria and lactobacilli on lung function and gut microbiota of patients with chronic obstructive pulmonary disease
Authors: Liu Yan , Ye Feng , Ma Long
Published: February 2024

Objective: To explore the effects of budesonide combined with Bifidobacteria and Lactobacilli on the lung function and intestinal microbiota of patients with chronic obstructive pulmonary disease (COPD).

Methods: Clinical data of 124 COPD patients admitted to Fengcheng Hospital, Fengxian District, Shanghai from February 2021 to February 2023 were retrospectively analyzed. Patients either received budesonide treatment alone (n=59, control group) or budesonide combined with Bifidobacteria and Lactobacilli (n=65, observation group). Levels of lung function indicators, symptom relief time, gut microbiota levels, and quality of life were compared between the two groups before and after the treatment.

Results: After two weeks of treatment, the improvement of lung function in the observation group was better than that in the control group (P<0.05). Compared to budesonide treatment alone, combined budesonide, Bifidobacteria, and Lactobacilli treatment were associated with shorter symptom relief time (P<0.05), and with more significant improvement of intestinal microbiota level (P<0.05) and the quality of life (P<0.05).

Conclusions: Budesonide combined with Bifidobacteria and Lactobacilli can effectively alleviate clinical symptoms, regulate intestinal microbiota, improve lung function and the quality of life of COPD patients.

doi: https://doi.org/10.12669/pjms.40.4.8514

How to cite this: Liu Y, Ye F, Ma L. The effect of budesonide combined with bifidobacteria and lactobacilli on lung function and gut microbiota of patients with chronic obstructive pulmonary disease. Pak J Med Sci. 2024;40(4):695-700. doi: https://doi.org/10.12669/pjms.40.4.8514

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Refining the Occurrence of Viral Encephalopathy and Retinopathy, Photobacteriosis, and Vibriosis in Connection with Seawater Physicochemical Parameters: A Five-Year Case Study
Authors: SPINOS EFTHIMIOS , KATSELIS GEORGE , VALSAMIDIS MICHAIL AGGELOS , WHITE MARI DANIELLA , BAKOPOULOS VASILEIOS
Published: February 2024

The marine environment and its physicochemical parameters play a pivotal role in the context of fish farming. Fundamental physicochemical factors of water, including temperature (T°C), salinity (S psu), dissolved oxygen (D.O. mg/l), and pH, exert a profound influence on the physiology of farmed aquatic animals and the composition of microbial communities. This study aimed to establish correlations between documented disease occurrences in sea bass intensive rearing and the prevailing physicochemical parameters of water. The objective was to analyse the significance of these parameters in disease outbreaks and develop a predictive model for the outbreak risk of key diseases. To this end, real-time physicochemical data were collected daily over five years (2011-2015) from two fish farms (A and B) located in the Gulf of Argostoli, island of Cephalonia, Western Greece. The focus was on incidences of Viral Encephalopathy and Retinopathy (VER), Photobacteriosis caused by Photobacterium damselae subsp. piscicida (PHDP) and Vibriosis caused by Vibrio anguillarum serotype O1 (VAO1). Statistically significant correlations were found between increasing water temperature and salinity and the occurrence of VER, PHDP, and VAO1 diseases. The reduction of dissolved oxygen, when combined with other parameters, synergistically triggered the manifestation of these three diseases. The study’s findings were discussed within the context of their potential to predict disease outbreaks based on fluctuations in the physicochemical parameters of water and anticipated climate change scenarios.
Europe's economic geology generates exploitable critical mineral resources enabling to reduce its geopolitical dependence- Progress beyond state-of-the-art.
Authors: Arvanitidis Nikolaos
Published: February 2024

Mineral raw materials were for many years the missing link in the climate debate. It is now evident that climate goals can’t be met without them. Mineral-based lithium battery and neodymium magnets value chains are not in balance between upstream-downstream efforts e.g. electric vehicles boom when energy transition mineral resources are yet not secured, Considering the long period of time (from exploration to mining takes about 15 years) needed for the mineral value chains to be fully operational, the technologies addressing the implementation plan of climate change goals might not always readily available due to lack of the mineral resources needed. However, Europe’s opportunity to become self-sufficient in mineral raw materials supply from own sources and resources, is strongly favored by its geological setting and metallogenetic evolution. Critical and strategic mineral raw materials from European primary and secondary resources produced in Europe can be taken as a guarantee for high standards in social, environmental, and economic terms. Elements and practices related to circular economy, responsible sourcing and resource efficiency addressed by the new EU industrial strategy, should be particularly considered. Major European mineral belts, such as Fennoscandian, Iberian, Carpathian-Balkan, host highly potential exploration targets challenging the likelihood for discovery of new resources and feasible mining prospects. At this stage recycling is not significant resource provider for some of the critical and strategic mineral raw materials. For the EU and the rest of the world to develop mineral supply chains, less dependent on China, strengthening key technology value chains, including processing, refining and metallurgy facilities, seems to be a dominant target.