bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic-Based Tools for Investigating Causal Associations between Immune Cells, Blood Metabolites, and Lung Cancer Risk: A Two-Sample Mendelian Randomization Study
Authors: Huang Yang Yu , Chen Guan Xu , Hurlstone Adam
Published: September 2024

Background
Previous observational studies have suggested a potential link between immune cell and blood metabolite levels and lung cancer risk, but the causality remains unclear. We aimed to investigate this relationship using a two-sample Mendelian randomization (MR) study and to explore the potential mediation by blood metabolites.
Methods
Genome-wide association study (GWAS) exposure data were extracted from immune cell levels in 3757 Europeans and blood metabolite levels in 8192 Europeans and ultimately analyzed in integration with the GWAS dataset of European lung cancer cases containing 492,803 samples. The inverse variance weighting (IVW) method was mainly applied for MR analysis, and MR-Egger regression with MR residuals was used to assess the potential level pleiotropy. Heterogeneity was detected using Cochran's Q test. Reverse MR analyses were also performed to assess reverse causality.
Results
MR analysis conclusively identified 5 immune cell and 20 metabolite profiles as strongly causally associated with lung cancer risk (p < 0.01). In addition, reverse MR analysis and mediated Mendelian analysis revealed that one type of immune cell may mitigate the risk of developing lung cancer by influencing a specific blood metabolite-related metric: CD39 + secreting Tregs (OR: 0.958, 95% CI: 0.931–0.985, p = 0.002) and sphingomyelin (d18:2/14:0, d18:1/14:1) levels (OR: 1.176, 95% CI: 1.041–1.329, p = 0.009).
Conclusions
Our study confirmed a causal relationship between immune cells and lung cancer risk, which may be mediated by blood metabolites. These findings provide a basis for future investigations into targeted prevention strategies.
Understanding the Impact of Vitamin B12 Deficiency on the Nervous System in the Population of Riyadh, Saudi Arabia
Authors: Abdulrahman Khalid A. Bin , Alshehri Abdulelah Faiz , Almutairi Faisal Marzouq , Almahayawi Faisal Ali , Alzahrani Rayan Saleh , Al-Ahmari Osama Thamer , Alshammari Khalid Ghadban , Aljuhani Turki Ahmed , Alkadi Yazeed Yahya , Alisi Mohammed Atiah
Published: September 2024

Background
Cobalamin, also referred to as vitamin B12, is important for the proper functioning of the nervous system and the production of red blood cells. An insufficiency of vitamin B12 can result in anemia, peripheral neuropathy, visual impairments, ataxia, and neurological harm. This paper aimed to examine the level of awareness regarding the effects of cobalamin deficiency on the nervous system in the population of Riyadh city.
Methods
A population-based cross-sectional survey was performed in March 2024 among the residents of Riyadh city. Respondents who were older than 18 years were eligible to participate in the survey. Subjects were contacted through various social media sites and provided with a hyperlink to access the survey questionnaire.
Results
One thousand three hundred thirty-seven (1337) participants completed the survey. The majority of the patients were female (62.3%). Two-thirds (65.6%) were aware of the importance of vitamin B12. A total of 38.7% indicated knowledge of a food source for vitamin B12. Approximately one-third (29.9%) consumed vitamin B12 supplements. Ultimately, 63.4% of the participants were aware of the consequences of vitamin B12 deficiency. Compared with their male counterparts, females displayed a greater understanding of B12 (P = .0001). Occupation was an important factor; employed individuals and those in 'Other' occupational categories demonstrated greater awareness than did students (P = 0.001).
Conclusion
This study assessed individuals' knowledge of the significance of vitamin B12, the symptoms associated with vitamin B12 insufficiency, and strategies for its prevention. Consequently, the group being studied showed a notably elevated level of knowledge of B12 deficiency.
Response to weekly oral dose vitamin D in obese vs non-obese vitamin D deficient children
Authors: Lal Kanhaiya , Mittal Medha , Sharma Shikha , Khadgawat Rajesh , Mishra Kirtisudha , Rai Anuradha , Sreeni V
Published: September 2024

Purpose- To compare the change in serum 25(OH)D level 30 days after supplementation with weekly vitamin D3 doses (60,000 IU for 5 doses) in obese and overweight vs normal BMI children of 5 to 12 years age. The secondary objectives were to compare the change from baseline to day 90 post intervention in the two groups, to evaluate the correlation of the change with fat mass, and to assess the safety profile of the intervention. Method-Sixty children of 5 to 12 years age (30 overweight/obese and 30 normal BMI) with vitamin D deficiency were administered oral vitamin D3 60, 000IU weekly for 5 doses in an open labelled non randomized controlled trial. Serum 25(OH)D levels were measured before intervention and at day 7, 30 and 90 post intervention. Serum and urine calcium at each visit. Results-The change/rise in serum 25(OH)D levels was significantly less in the overweight/obese at day 7, 30 and 90. At day 30, the rise in levels was 25% lower as compared to normal BMI children. The rise from baseline to day 30 had significant negative correlation with BMI (r=-0.412, P = 0.001), fat mass (r= -0.452, P = 0.0020, fat mass index (r= -0.428, P = 0.004) and waist circumference (r=-0.388, P = 0.003). The mean circulating levels were about 20% lower in the overweight/obese at day 30 and day 90. On calculating the area under curve of the 25(OH)D profile in the two groups, there was a significant difference between the groups (3776.9 ± 780.0 in overweight/obese vs 4857.9 ± 1267.8 in normal BMI, P = 0.0002). Transient hypervitaminosis (without hypercalcemia or hypercalciuria) was seen in 2/28 of overweight/ obese and 10/30 of normal BMI group only at day 7. Conclusion—The overweight/obese children had 25% lower rise in serum 25(OH)D levels, as compared to the normal BMI children, when administered similar weekly doses of vitamin D. CTRI Number- CTRI/ REF/2020/11/038481. Date – 29 Dec 2020
Reducing soft tissue artefacts through projection of markers and microwave imaging: An exploratory study
Authors: Radhakrishnan Vignesh , Robinson Martin , Fiorentino Niccolo M , Patil Samadhan , Pelah Adar
Published: September 2024

Soft tissue artefacts (STA) are widely considered the most critical source of error in skin-mounted marker-based biomechanics, negatively impacting the clinical usability of skin-mounted marker-based data. Amongst the numerous solutions proposed to ameliorate STA, incorporating true bone movement – acquired using adaptive constraints, projection of markers, or various imaging modalities - has been reported to improve kinematic accuracy. However,efficacy of these proposed solutions reduced for different investigated motions and participants. In this study, we propose two novel marker projection schemes, wherein a cluster of markers are projected onto the bone surface during motion. Additionally, we investigate the feasibility of applying a novel, safe and cost-effective imaging modality - microwave imaging - to detect the location of the bone from the skin surface. Our results indicate that the novel marker projection schemes reduce kinematic errors significantly (by 50%) and improve the quality of computed kinematics (95% correlation to true bone movement). In addition, our results show that microwave imaging was able to detect the bone from the skin surface in both male and female anatomical models of varying body mass index scores and poses. We believe our findings underscore the generalisability and applicability of our proposed solution to reduce STA.
Risk Factors for Iliac Limb Migration after Endovascular Aortic Repair
Authors: Lee Byung Chan , Park Chan , Kim Hyoung Ook , Yoon Woong , Jeong Yong Yeon , Choi Soo Jin Na , Lee Ho Kyun , Jung Hong Sung , Yoo Youngsup
Published: September 2024

This study investigated anatomical and procedural factors influencing iliac limb migration and its correlation with late type 1b and type 3 endoleaks. We analyzed 141 iliac limbs from 91 patients who underwent endovascular aneurysm repair for abdominal aortic aneurysm between 2005 and 2017. Iliac limb migration was measured using initial and follow-up computed tomography angiography scans conducted at least three years post-procedure, with significant migration defined as a change of ≥ 5 mm. The iliac limbs were categorized based on the presence of significant migration, and statistical analyses were conducted to compare anatomical and procedural factors between the groups. Significant migration was associated with larger preoperative common iliac artery (CIA) diameters, more acute iliac angles, lower iliac seal degrees, and smaller iliac limb oversizing. Multivariable analysis confirmed that significant migration correlated with larger CIA diameters and lower iliac limb oversizing. Significant iliac limb migration was associated with a higher risk of type 1b endoleak development, while type 3 endoleaks were not observed. Our findings suggest that careful iliac limb oversizing is essential for patients with a CIA diameter > 20 mm, and vigilant monitoring of the iliac landing zone is crucial during postoperative surveillance.
Epidemiology and laboratory testing of Brucella spondylitis
Authors: Lu Yan-peng , Qiu Wei-qi , Zhang Tao , Cheng Qian-xi , Wang Yizhe , Li Song-kai , Chen Long , Tan Xingguo , Huang Dashuai
Published: September 2024

The average age of patients with BS was 52.29±9.46 years, comprising 136 males and 31 females. Risk factors for BS include close contact with cattle and sheep and consumption of unpasteurized food. The positive detection rate using combined Rose Bengal Test (RBT) and Standard Agglutination Test (SAT) was 94.6%, whereas the positive rate for blood culture was only 7.8%. The most common clinical manifestations were fever (81.4%), back pain (88.6%), sweating (61.1%), fatigue (69.5%), and anorexia (65.3%). Hematological examinations often revealed decreased hemoglobin (18.0%), increased platelets (18.0%), elevated erythrocyte sedimentation rate (ESR) (88.0%), elevated C-reactive protein (CRP) (78.4%), elevated Alanine aminotransferase (ALT) (18.6%), and decreased K+(23.4%). The imaging examinations revealed that the lumbar spine, particularly L4/5 (41.3%), is the most frequently affected vertebral level in BS. After treatment, the overall recurrence rate was 3.0%. In endemic areas, clinicians should be vigilant for BS in patients presenting with back pain and unexplained fever, particularly those with a history of close contact with cattle and sheep. The RBT and SAT tests show a high positivity rate of 94.6%, establishing them as the preferred diagnostic methods. This study enhances clinicians' comprehension of BS characteristics and lays a robust theoretical groundwork for disease prevention and monitoring.
Evaluating and Optimizing NBR-Modified Bituminous Mixes: A Rheological and RSM based Study
Authors: Khan Inamullah , Khan Zahoor Ahmad , Khan Muhammad Imran , Ali Mujahid , Khan Nasir , Paulraj Manidurai , Avudaiappan Siva
Published: September 2024

Bitumen shows visco-elastic behavior in nature. It exhibits the property of elastic behavior and viscous behavior predicted by Dynamic response (E*) and phase angle (δ). Today’s modern world is facing the problem of early-stage fatigue cracks, rutting, and permanent deformations of asphalt bituminous pavements due to low temperature cracking, high-temperature deformation, moisture susceptibility, and overloading. The aforementioned pavement distresses result in the formation of potholes, alligator cracks, and certain types of deformations which result in early-stage cracking of bituminous pavements which accelerates the rehabilitation and maintenance cost. To properly address these issues, this study focused on the utilization of a waste source derived from surgical gloves named Nitrile Butadiene Rubber (NBR) as an additive to conventional asphalt pavement to study its effect in terms of stiffness. For this purpose, NBR was added in the intervals of 2%, 4%, 6%, and 8% to conventional bituminous pavement and rheological properties, marshall properties, dynamic modulus and phase angle was evaluated for varying NBR, temperature, and frequency. The dynamic response |E*| was determined using a simple performance tester (SPT) at four different temperatures 4.4°C, 21.1°C, 37.8°C, and 54.4°C and six different frequencies ranging from 0.1, 0.5, 1, 5, 10, and 25 Hz. Response surface methodology (RSM) was adopted to develop the relation between input and output and to optimize the amount of NBR in the mix based on dynamic modulus and phase angle. Based on the study it was concluded that the addition of NBR up to 6% increased the marshall stability while any further addition resulted in stability reduction. Similar behavior was observed in the case of dynamic modulus where the maximum dynamic modulus was observed as a result of 6% NBR addition irrespective of frequency and temperature. Based on the developed RSM model, it was concluded that coupling the NBR percentage with frequency increases the dynamic modulus for the same temperature and resulted highest dynamic modulus for 4.4°C while the dynamic modulus decreased as a result of increasing the temperature for the same combinations of NBR % and frequencies. From the numerical optimization, it was concluded that a maximum of 5.9% NBR could be added if it is intended to achieve the highest dynamic modulus and lowest phase angle.
High Schistosoma mansoni Co-Infection in Tuberculosis Patients with or without Human Immunodeficiency Virus: A Prospective Cohort Study
Authors: Baya Bocar , Diarra Bassirou , Dabitao Djeneba Koumba , Somboro Amadou , Traore Fah Gaoussou , Goita Drissa , Coulibaly Gagni , Sanogo Moumine , Wague Mamadou , Kone Bourahima , Kone Drissa , Ouattara Khadidia , Soumare Dianguina , Kanoute Tenin , Toloba Yacouba , Maiga Almoustapha I , Maiga Mamoudou , Diallo Souleymane , Murphy Robert L , Doumbia Seydou
Published: September 2024

Background
People with Latent tuberculosis infection (LTBI) remain the reservoir of tuberculosis. One-third to 1/4 of the world's population is infected. Its reactivation is due to factors that disrupt the host’s immune response. Recent findings showed that Schistosoma mansoni coinfection leads to a Th2/Th1 profile which results in an immune modulation that favors the escape of the Mycobacteria. Schistosoma mansoni may contribute to TB incidence in endemic regions. We aimed to investigate the coinfection rate and patient outcomes.
Methods
A prospective cohort study was conducted between 2020–2022 at University Clinical Research Center (UCRC), including culture-confirmed active pulmonary TB patients and tested for Schistosoma mansoni in stools using Kato-Katz Technique. After descriptive analysis a logistic regression was performed to determine risk factors associated with TB and Schistosoma mansoni co-infection.
Results
Data of 174 tuberculosis-confirmed patients, Kato-Katz tested were analyzed. Males represented 62.6%, mean age was 34.9 ± 13.8 years, 29.9% were smokers, alcohol consumption 13.8%, TB contact history 26.4%, HIV coinfection 11.5%, diabetes 6.3%, undernourished 55.7%. Schistosoma mansoni prevalence was 28.7%. The co-infection was associated with less lung cavitation [aOR = 0.24 [95% CI (0.06–0.85), p = 0.028], unfavorable treatment result [aOR = 2.95 (1.23–7.08), p = 0.015] and death [aOR = 3.43 (1.12–10.58), p = 0.032].
Conclusions
Despite Kato-Katz's low sensitivity, Schistosoma mansoni coinfection was found in one-third of the TB patients; 2.5-fold higher than that of HIV. The coinfection was associated with poor treatment results and death.
Huaier promotes sensitivity of colorectal cancer to oxaliplatin by inhibiting METTL3 to regulate the Wnt/β-catenin signaling pathway
Authors: Huo Mingyi , Gao Zhixu , Wang Guizhen , Hou Zhiping , Zheng Jining
Published: September 2024

Objective
Colorectal cancer (CRC) ranks in the top five in terms of incidence rate and mortality among malignant tumors in China. Oxaliplatin (OXA) is a first-line drug for the clinical treatment of CRC, but its antitumor effect is limited due to the development of drug resistance. The aim of this study was to investigate whether the traditional Chinese medicine Huaier can regulate the Wnt/β-catenin signaling pathway by affecting the expression of METTL3, thereby promoting the sensitivity of HCT-8/L cells to OXA.
Methods
We analyzed the expression of METTL3 based on the UCSC Xena database and Gene Expression Omnibus (GEO) database. We constructed silent METTL3 and overexpression METTL3 models, and used CCK-8 and flow cytometry to detect the effects of Huaier on the viability and apoptosis of HCT-8/L cells. Western blot, qRT-PCR, nuclear cytoplasmic separation, and immunofluorescence were used to detect the effects of Huaier on the expression of METTL3, Pgp, Wnt/β-catenin signaling pathway–related proteins, apoptosis-related proteins, and related mRNA.
Results
Patients with high expression levels of METTL3 had a shorter overall survival period. The expression level of METTL3 significantly increased in drug-resistant CRC cells. Silencing METTL3 promoted apoptosis of CRC cells and increased their sensitivity to OXA by inhibiting the Wnt/β-catenin signaling pathway. Huaier downregulated the expression of METTL3, thereby promoting apoptosis of drug-resistant CRC cells and increasing their sensitivity to OXA by inhibiting the Wnt/β-catenin signaling pathway.
Bariatric Surgery and Kidney Stone Disease: Does the Procedure Matter? Prospective Single Centre Experience
Authors: Iossa Angelo , Pastore Antonio Luigi , Coluzzi Ilenia , Valenzi Fabio Maria , De Angelis Francesco , Bellini Davide , Lelli Giulio , Cavallaro Giuseppe
Published: September 2024

Background: Numerous epidemiological studies demonstrate the correlation between obesity and urolithiasis. Bariatric Surgery is effective in significant weight loss, reducing mortality rates, and lowering the incidence of obesity-related comorbidities. However, it may be associated with long-term complications such as urolithiasis, with an estimated increase of 7.6% in bariatric patients. This study investigates the impact of various bariatric surgical techniques and personal and nutritional habits on post-operative urolithiasis.
Material and method: 185 patients were prospectively enrolled in the study. All patients underwent nutritional assessment two years after surgery, and urinary stone disease was evaluated through urinalysis. Patients with urinary crystals were subsequently sent to the division of Urology to evaluate the possible presence of urinary stones through an abdominal CT scan.
Results: Kidney stone disease was present in 12 female patients (6.49%) out of the 25 with urinary crystals. Among the various surgical techniques, 8 patients underwent SG, 2 patients each for OAGB and RYGB, without a proven significant correlation. Hypertension, Dyslipidemia, and OSAS were significantly correlated with the incidence of urolithiasis (p-value < 0.05). BMI > 30 kg/m2 was significantly correlated with urinary stone formation (p-value < 0.05).
Conclusion: Patients undergoing bariatric surgery should receive counseling about the risk of developing urolithiasis, highlighting the necessity of adhering to nutritional guidelines. Evaluation for urinary stones could be recommended during follow-up, especially for patients with a BMI > 30 kg/m².
Successful Conservative Management of Traumatic Pancreatic Duct Injury: A Case Report of Blunt Pancreatic Trauma and Management Clinical Update
Authors: Ferreira Ana , Martins Daniela , Tavares Carolina , Louro Hugo , Malta Wilson , Costa Alexandre , Mendes Miguel , Santos Jorge , Pereira Bela , Oliveira Manuel
Published: September 2024

Introduction: Pancreatic trauma without injuries to other organs is uncommon and the integrity of the main pancreatic duct is the crucial point in the management and outcome of these patients. Severe injuries or hemodynamic instability require emergent surgical intervention. In contrast, conservative strategy demand close monitoring and regular reassessment to detect any deterioration or complications that may need a change in the treatment plan. We present a case of a Grade III pancreatic trauma in a stable and very young patient, successfully treated conservatively. Case Presentation: A 25-year-old male patient presented to the Emergency Department in context of thoracic and abdominal trauma, due to blunt trauma caused by machine compression. Patient’s symptoms were not severe. On physical examination, his vital signs were within normal limits, with complains of upper quadrants pain but no peritoneal signs. Computed tomography scan showed a complete laceration of the proximal region of the head of the pancreas, with minimum free fluid. Conservative treatment was decided. Magnetic Resonance Cholangiopancreatography was also performed, revealing two pancreatic fractures with an imperceptible Wirsung duct in practically the entire pancreas, probably collapsed, calling into question the hypothesis of sectioning. Between fractures, there is a segment of necrotic pancreas. The patient remained asymptomatic, with favorable laboratory and imaging evolution. After 5 months, Magnetic Resonance Cholangiopancreatography showed a scar in the body of the pancreas, with no collections. Conclusions: Nonoperative approach plays a crucial role in the conduct of pancreatic trauma, aiming to preserve function while minimizing the risks associated with surgical interventions.
Mature Teratoma Mimicking as an Aspergilloma: A case report
Authors: Faiz Zohaa , Khalid Abdullah , Safdar Nabeel , Arshad Anaum , Khalid Mahnoor , Fatimi Saulat
Published: September 2024

Introduction: Teratoma is a neoplasm composed of tissues derived from more than one germ layer (ectoderm, mesoderm, and endoderm). Teratomas occur in 1 in 4000 live births and are most commonly found in the sacrococcygeal, ovarian, and testicular regions, as well as in the brain and mediastinum. Mediastinal teratomas are rare, accounting for 8-13% of mediastinal tumors.
Case Presentation: A 35-year-old woman presented with left shoulder pain radiating to the shoulder for nine months and dry cough for one month. She experienced sharp chest pain worsened by inspiration and had two episodes of mild hemoptysis a month prior to presentation. A significant history included lower-segment cesarean section in 2012. Imaging revealed a left globular mass in the anterior left hemithorax. Intraoperatively, a large, firm, globular mass was found attached to the lingular segments of the left upper lobe, left pulmonary artery, and pericardium. En-bloc resection of the mass along with left upper lobectomy was performed.
Discussion: Teratomas are classified as mature or immature, and malignancy is determined by the presence of immature tissue. Symptoms arise from the compression of mediastinal structures, presenting as cough, dyspnea, chest pain, or pulmonary infections. Trichoptysis is unique to mediastinal teratomas (trichoptysis. The diagnosis is primarily based on CT imaging, which shows heterogeneous, sharply marginated masses with tissue fluid, fat, and calcium attenuation. Complete surgical removal is the treatment of choice, which is essential for confirming diagnosis and preventing complications. Histopathology confirmed a mature teratoma with benign characteristics and no malignant components.
Conclusion: This case report highlights a rare case of mature mediastinal teratoma mimicking an aspergilloma. Despite being benign, early diagnosis and surgical excision are crucial to prevent compressive symptoms and potential complications. Patients with mature teratomas typically have excellent prognoses and appropriate management.
Efficacy and safety of multi-day antiemetic treatment for patients undergoing multi-day chemotherapy: A systematic review of Clinical Practice Guidelines for Antiemesis 2023 from Japan Society of Clinical Oncology
Authors: Nakashima Kazuhisa , Harashima Saki , Kaneko Rena , Tanaka Ryuhei , Abe Masakazu , Wada Makoto , Iino Keiko , Akechi Tatuso , Iihara Hirotoshi , Imamura Chiyo K. , Okuyama Ayako , Ozawa Keiko , Kim Yong-il , Satomi Eriko , Takeda Masayuki , Nakajima Takako Eguchi , Nakamura Naoki , Nishimura Junichi , Noda Mayumi , Hayashi Kazumi , Higashi Takahiro , Boku Narikazu , Matsumoto Koji , Matsumoto Yoko , Okita Kenji , Yamamoto Nobuyuki , Aogi Kenjiro , Sasaki Hidenori
Published: September 2024

Background
A standardized multi-day antiemetic regimen for multi-day chemotherapy remains elusive. This systematic review evaluated the efficacy and safety of multi-day antiemetic regimens in patients undergoing undergoing multi-day intravenous chemotherapy
Methods
We conducted a comprehensive search of PubMed, Cochrane Library, and Ichushi-Web databases for relevant studies published from January 1990 to December 2020. We included studies comparing multi-day and single-day antiemetic regimens for preventing chemotherapy-induced nausea and vomiting.
Results
No studies directly comparing multi-day versus single-day antiemetic regimens were found. Despite expanding control group criteria beyond “single-day antiemetic therapy” limited high-quality studies and variations in cancer types, chemotherapy regimens, and antiemetic treatments precluded meta-analysis. Among the included studies, some randomized controlled trials (RCTs) focused on complete response and vomiting rates. Two studies comparing two- and three-drug combinations reported higher complete response and no-vomiting rates with the three-drug regimen. Limited RCTs explored “nausea control” and “cost,” and assessing “adverse events” proved challenging due to inconsistent reporting.
Conclusion
Research on multi-day antiemetic therapy is limited, necessitating further investigation. Nonetheless, our findings suggest that three-drug combination therapy, including aprepitant, may offer superior antiemetic efficacy compared to two-drug regimens. Multi-day antiemetic therapy is strongly recommended during multi-day intravenous administration of cytotoxic anticancer drugs.
Differences of left ventricular hemodynamic forces in athletes and patients with hypertension: A feature-tracking cardiac magnetic resonance study.
Authors: Jumadilova Dinara , Rakhmanov Yeltay , Khissamutdinov Nail , Zhankorazova Aizhan , Toktarbay Bauyrzhan , Khamitova Zaukiya , Zholshybek Nurmakhan , Bekbossynova Makhabbat , Dautov Tairkhan , Gaipov Abduzhappar , Tonti Giovanni , Salustri Alessandro
Published: September 2024

By assessing left ventricular hemodynamic forces (HDF) during different phases of the cardiac cycle, we aimed to provide insights into the cardiac adaptations in athletes as compared to patients with hypertension. Sixty athletes and 48 hypertensive patients were studied using cardiac magnetic resonance. HDF were measured during the entire cardiac cycle, the systolic phase (including systolic impulse and elastic rebound), suction, early LV filling, and atrial thrust. Statistical comparisons of HDF parameters were made between athletes and hypertensive patients, and between endurance and strength athletes. The slope of the systolic ejection was significantly higher in athletes compared to hypertensive patients (541.5 vs 435 1/sec; p = 0.033). Athletes showed higher HDF during the first phase of systole (4.53 vs 3.86; p = 0.047) and the systolic impulse (11.2 vs 8.7; p = 0.045), and a higher peak value (62.9 vs 46.8; p = 0.001). Compared to hypertensive patients, the elastic rebound in athletes was shorter (51.6 vs 70.1 ms; p < 0.001) and the hemodynamic work during this phase was lower (-0.31 vs -0.44; p = 0.011). Moreover, hypertensive patients had an abnormal suction phase as revealed by a divergent direction (apex-to-base) of the HDF (0.09). The atrial thrust component was significantly higher in hypertensive patients than in athletes (-0.31 vs -0.05; p < 0.001). Compared to endurance athletes, strength athletes had a shorter duration of the systolic impulse (250 vs 280 ms; p = 0.019) and higher hemodynamic work during the early left ventricular filling (1.65 vs 0.97; p = 0.016). The assessment of HDF allows distinction between the hemodynamic patterns of athletes and patients with hypertension. Athletes were able to generate higher pressure gradients in a shorter period of time, and had a shorter and softer elastic rebound. In hypertensive patients, the suction mechanism is lost. Higher atrial thrust indicates the importance of the active LV filling during diastole in hypertensive patients. This study was funded by a grant of the Ministry of Education and Science of the Republic of Kazakhstan, № AP14869730.
Validating a clinically based MS-MLPA threshold through comparison with Sanger sequencing in glioblastoma patients
Authors: Lhotska Halka , Janečkova Karolina , Cechova Hana , Macoun Jaromir , Aghova Tatiana , Lizcova Libuse , Svobodova Karla , Hodanova Lucie , Konecna Dora , Soukup Jiri , Kramar Filip , Netuka David , Zemanova Zuzana
Published: September 2024

Background
Glioblastoma is the commonest malignant brain tumor and has a very poor prognosis. Reduced expression of the MGMT gene (10q26.3), influenced primarily by the methylation of two differentially methylated regions (DMR1 and DMR2), is associated with a good response to temozolomide treatment. However, suitable methods for detecting the methylation of the MGMT gene promoter and setting appropriate cut-off values are debated.
Results
A cohort of 108 patients with histologically and genetically defined glioblastoma was retrospectively examined with methylation-specific Sanger sequencing (sSeq) and methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) methods. The DMR2 region was methylated in 29% of samples, whereas DMR1 was methylated in 12% of samples. Methylation detected with the MS-MLPA method using probes MGMT_215, MGMT_190, and MGMT_124 from the ME012-A1 kit (located in DMR1 and DMR2) correlated with the methylation of the corresponding CpG dinucleotides detected with sSeq (p = 0.005 for probe MGMT_215; p < 0.001 for probe MGMT_190; p = 0.016 for probe MGMT_124). The threshold for methylation detection with the MS-MLPA method was calculated with a ROC curve analysis and principal components analysis of the data obtained with the MS-MLPA and sSeq methods, yielding a weighted value of 0.362. Thus, methylation of the MGMT gene promoter was confirmed in 36% of samples. These patients had statistically significantly better overall survival (p = 0.003).
Conclusions
Our results show that the threshold for methylation detection with the MS-MLPA method determined here is useful from a diagnostic perspective because it allows the stratification of patients who will benefit from specific treatment protocols, including temozolomide. Detailed analysis of the MGMT gene promoter enables the more-precise and personalized treatment of patients with glioblastoma.
Craving Induction through Virtual Reality Cue-Exposure for Patients with Alcohol Dependence in Rehabilitation Treatment
Authors: Tsamitros Nikolaos , Gutwinski Stefan , Beck Anne , Mussons Sofia Lange , Sebold Miriam , Schöneck Robert , Wolbers Thomas , Bermpohl Felix , Heinz Andreas , Lütt Alva
Published: September 2024

New therapeutic approaches for Alcohol Dependence (AD) include Virtual Reality (VR)-based treatments offering scalable options for Cue Exposure (CE), a well-established strategy in Cognitive Behavioral Therapy. This study aimed to evaluate the feasibility and tolerability of a new VR-CE intervention. On an explorative basis, factors influencing the induction of craving were examined. This single-arm monocentric clinical study included n = 21 patients with AD in inpatient rehabilitation treatment, that completed one VR-CE session including confrontation with alcohol-associated stimuli. Measurements of subjective craving before, during and after exposure, affective states, VR side effects as cybersickness and the sense of presence in VR were conducted. Craving levels during and directly after VR-CE were significantly higher than before the intervention. Craving levels 20 min after VR-CE did not significantly differ compared to those before VR-CE. Patients described a pronounced sense of presence and only mild symptoms of cybersickness. Craving was significantly correlated with cybersickness. While positive affect decreased throughout the VR exposure, negative affect did not differ significantly in pre-post-comparisons. This study shows that craving induction through our VR-CE paradigm is feasible and well-tolerated by patients with AD in long-term rehabilitation. These results contribute to the development and future research of therapeutic VR-CE approaches.
Bio-inspired Optimisation Design Strategy of Graded Hemp Core for Hybrid Carbon/Hemp Sandwich Laminates
Authors: Boccarusso Luca , De Fazio Dario , Myronidis Konstantinos , Durante Massimo , Pinto Fulvio
Published: September 2024

Composite sandwich structures incorporating foams or honeycombs as core materials have been widely researched and employed in various fields. Traditional cores often face limitations such as poor impact resistance, sustainability issues, and the inability to provide graded properties along their thickness. This paper explores the production and mechanical analysis of hemp bi-grid cores designed for use in sandwich structures, by using an ad-hoc continuous manufacturing process. Both graded cores, with varying fibre content through their thickness and non-graded cores were produced. The mechanical properties of these cores were evaluated under flexural and compressive testing. Additionally, to assess their impact performance in sandwich panels, hybrid panels with CFRP skins were fabricated and subjected to Low Velocity Impact tests. The resulting damage was examined using CT-Scan. The results indicate that the possibility of customising failure modes and tailor energy absorption capabilities of the proposed structures open the way for new, exciting perspectives for the development of innovative sandwich structures, broadening the application of natural fibres in various industrial sectors.
Tonsillectomy reverses arterial stiffness in children with obstructive sleep-disordered breathing: three years follow up
Authors: Monteiro Eduardo Machado Rossi , Paiva Alan Rodrigues de Almeida , Canuto Nayane Oliveira Pio , Silva Rebeca Carolina Campos e Almeida , Rodrigues-Machado Maria da Gloria , Navarro Tulio Pinho , Bittencourt Juliana Cabral , Pinto Daniel Mendes
Published: September 2024

Purpose
This study investigated vascular, hemodynamic and arterial stiffness parameters in children with Obstructive Sleep-Disordered Breathing (oSDB) due to adenotonsillar hypertrophy and compared them before and three years after tonsillectomy and adenoidectomy (T&A).
Methods
Mixed study, cross-sectional and longitudinal, conducted in a tertiary hospital from June/2018 to September/2022. The longitudinal study compared cardiovascular parameters and quality of life (OSA-18 questionnaire) in children with oSDB before (T1, n = 48) and three years after T&A (T2, n = 36). The cross-sectional study compared T2 with a control group, matched by sex and age. Cardiovascular parameters were measured non-invasively by brachial artery oscillometry with a portable device.
Results
Children with oSDB had a reduction in the augmentation index normalized to heart rate of 75 bpm (AIx@75) 3 years after T&A. Quality of life significantly improved after T&A and was maintained throughout follow-up. Although within adequate levels, the T2 group had higher systolic, diastolic and mean blood pressure. Systolic volume increased and heart rate decreased. When comparing the oSDB and control groups, it was observed that the AIx@75 did not differ between the groups. The higher T2 pulse wave velocity compared to control was within the expected progression.
Conclusions
Children treated for oSDB with T&A showed improvement in AIx@75, an independent predictor of cardiovascular complications. The improvement in this index suggests that early treatment of oSDB may be a modifiable factor in reducing cardiovascular risk in children.
Microbiome in Early Childhood Caries: Caries Severity-Dependent Insights
Authors: Gong Siew-Ging , Switzer J. , Nainar S. M.H. , Lévesque C. M.
Published: September 2024

Objectives: Children with early childhood caries (ECC) show different caries severities and susceptibility in different tooth types and location in the oral cavity. The study aimed to investigate changes in the oral microbiome in ECC subjects stratified according to the severity of caries and types of teeth and tooth surfaces involved.
Materials and Methods: Supragingival plaque from the upper and lower anterior regions in the oral cavity of subjects were collected in 3 groups of increasing caries severity (G1-Molar (M) caries only; G2- Molar and Upper Anterior (UA) caries; and G3-M + UA + lower anterior (LA) caries were obtained followed by microbiome analysis.
Results: Alpha-diversity analyses showed inter- but no intra-individual statistically significant differences between the UA and LA (p-value ˂ 0.001, LA˃UA), and a significant difference between the microbiome of the three caries groups (p-value ˂ 0.001). There were significant beta-diversity differences between G1 and G2 (p < 0.05) and in the composition and diversity among the three groups (p-value ˂ 0.001). Actinomyces, Saccharibacteria_genera_inserta_sedis and Eikenella had increased differential abundance in G1 vs G3 and Fusobacterium was less abundant in G2 compared to the other groups.
Conclusions: There were clear distinct differences in tooth-site specific and caries-severity microbiome diversity patterns and bacterial abundance profiles in S-ECC children.
Clinical Relevance: This study provides new information towards the refinement of an ECC clinical phenotype stratification, a step that will contribute to increased uniformity in future microbiome studies of children with ECC.
Comparative Study of Percutaneous Retrograde Screw Fixation and Minimally Invasive Plate Fixation for Acetabular Anterior Column Fractures
Authors: Fang Tao , Wu Qianqian , Liu Zhicheng , Meng Juan , Song Feng
Published: September 2024

Objective
To explore the surgical techniques and compare the treatment outcomes of percutaneous retrograde screw fixation and minimally invasive ilioinguinal approach plate internal fixation in the management of acetabular anterior column fractures.
Methods
A retrospective analysis of clinical data from 32 patients with acetabular anterior column fractures treated at Qingdao Municipal Hospital from August 2019 to November 2023 was conducted. Fifteen cases were treated with percutaneous retrograde screw fixation (denoted as the screw group), and 17 cases were treated with minimally invasive ilioinguinal approach plate internal fixation (denoted as the plate group). The average surgical time, intraoperative blood loss, fluoroscopy frequency, pre- and postoperative VAS scores, and postoperative complications were compared between the two groups. Fracture reduction quality was assessed using the Matta standard, and functional scores were evaluated using the Majeed functional scoring scale.
Results
Both groups of patients were followed up for 8–15 months, with an average of 11.84 months. There was no statistically significant difference in average surgical time and hospital stay between the two groups (P > 0.05). Intraoperative blood loss in the screw group was significantly less than that in the plate group (P < 0.05). The fluoroscopy frequency in the screw group was significantly higher than that in the plate group (P < 0.05). There was no statistically significant difference in postoperative complications between the two groups (P > 0.05). The VAS scores at 3 days and 1 month postoperatively were significantly better than those at admission in both groups. There was no statistically significant difference in the VAS scores at admission between the two groups (P > 0.05), but the screw group had better VAS scores at 3 days and 1 month postoperatively compared to the plate group. Matta evaluation of the fracture reduction quality and the Majeed clinical efficacy results showed no statistically significant differences between the two groups (P > 0.05).
Conclusion
Both surgical methods achieved good treatment outcomes. Minimally invasive ilioinguinal approach plate internal fixation required fewer fluoroscopy sessions and exhibited a wider range of indications. On the other hand, percutaneous retrograde screw fixation resulted in less trauma, more pronounced pain relief, and demonstrated superior clinical advantages with broad application prospects.
Identification of hub genes and potential molecular mechanisms related to chemotherapy sensitivity in bladder cancer: A Comprehensive Analysis
Authors: Sun Peng , Chen Shao-yong , Chen Cui
Published: September 2024

Chemotherapy resistance drives bladder cancer (BC) recurrence and metastasis, but the biomarkers and mechanisms of chemotherapy sensitivity are not fully known. We identified differentially expressed genes (DEGs) in chemo-resistant and -sensitive BC patients from TCGA and GEO databases. Analyses like GO, KEGG, random survival forest were conducted. We studied the relationships of hub genes with immune cell infiltration, pathways, drug sensitivity, prognosis, regulation, and cellular heterogeneity using multiple methods. A total of 4042 up-regulated and 1355 down-regulated DEGs were included in the analysis. Four hubs, RNF19A, PCGF5, UNC5CL, and CCDC146, were identified and linked to tumor immune infiltration, immune-related genes, sensitivity to chemotherapeutic drugs, and the expression of disease-related genes like APC and EGFR. GSVA and GSEA analysis revealed varying expression levels of these genes impacting cancer-related signaling pathways. A nomogram and calibration curves based on these hub genes showed excellent prognosis predictive performance. We identified key binding motifs and transcription factors for hub genes using RcisTarget. Our mRNA-miRNA regulatory network and single cell analysis revealed cellular heterogeneity in hub gene expression. Therefore, up-regulation of RNF19A, PCGF5, UNC5CL, and CCDC146 in BC is associated with chemotherapy response and various cellular functions, making them potential predictive biomarkers for chemotherapy sensitivity and prognosis.
Perspectives of health professions students on using virtual reality as a teaching tool: a cross-sectional study in 10 Ugandan Medical schools
Authors: Wekha Godfrey , Ssewante Nelson , Ebiju Isaac , Nabaweera Rebecca , Atau Pius , Kihumuro Bernard Raymond , Nakandi Racheal , Banturaki Davis , Natukunda Ferguson , Babuya Jonathan , Nabisere Vivian , Musoke Phillip , Buyana David , Atuhaire Arnold , Magala Primrose , Ddungu Jethro Tendo , Lubwama James , Muwanga Richard David , Ayesiga Innocent , Kiyimba Blaise , Bongomin Felix
Published: September 2024

Background
Virtual reality (VR), a simulation modality for skills acquisition, has been used as a teaching alternative in several professions globally with reportedly excellent practical experience. This makes it one of the few potential solutions for the daily increasing overcrowding in most training classes, including those of medical schools. However, scant data exists on the perceptions of Health Professions Students (HPS), one of the most likely suitable VR users to be once this teaching modality is officially adopted. We aimed to find out Ugandan HPS's perspective on using VR as a teaching tool.
Methods
We conducted a cross-sectional study among undergraduate health professions students (HPS) aged 18 years and above across ten Ugandan Medical schools. The data was collected through an online survey and analyzed using STATA version 16.
Results
Overall, 361 HPS, with a mean age of 24.2 (standard deviation, SD = 3.8) years, and a male preponderance (217, 60.1%) participated in this study. A majority (215, 59.6%) were students for Bachelor of Medicine and Surgery (MBChB). Three-hundred and sixteen (87.5%) participants had prior knowledge of VR. Of these, only 56(18%) had acquired this knowledge through class settings, and 136 (37.8%) had used a VR modality before this survey. Of these 136, Seventy-five (54.4%) had used VR in official academic training. A majority (306, 85%) of participants believed that VR would be an important upgrade in modern medicine if introduced as a teaching tool, would be open to using VR if trained to do so (338,94%), and would recommend their adoption in medical training and healthcare (319, 89%). Participants who had prior VR knowledge (p < 0.001) and those who had been formally introduced to the concept of VR (p = 0.032) were likely to accept VR as a learning model.
Conclusion
Despite the participants' high awareness and positive attitude towards VR, less than one-third have used it in their academic settings. The gradual incorporation of VR in the existing teaching modalities by Ugandan medical schools could create better learning environments and skill acquisition for HPS to produce more competent healthcare professionals.
Safe Water Handling Practice and Its Associated Factors Among Rural Communities in South East Zone of Tigray Region, North Ethiopia, 2024: a Cross-sectional Study
Authors: Gebremedhin Haftay , Angaw Yonas , Abay Teame
Published: September 2024

Background
Safe drinking water is a vital to health and survival of individuals and families. Access of safe drinking water to individuals prevents at least 9% of the global disease burden and 6.3% of all deaths. Therefore this study aimed to assess practice of safe water handling and its associated factors among rural communities in Southeast zone of Tigray, North Ethiopia.
Methods & Materials:
A community based cross-sectional study was conducted in rural households of enderta and seharti samere districts, South East zone of Tigray from November 2023-February 2024. A total of 570 head of households were selected for this study using a multi-stage sampling technique. Descriptive, bivariate and multivariate logistic regression analysis was performed using SPSS version 20 and a variable having P ≤ 0.05 was considered as significantly associated with the outcome variable.
Results
A total of 559 head of households were included in this study and making a response rate of 98.1%. Of these, 60.5% were females and more than half of 334(59.7%) the respondents were practicing safe water handling. Almost half (51.5%) of the study participants were used different methods of water treatments to make water safe for drinking at home. Being farmer on occupational status [AOR = 2.674, 95%CI (1.769–4.041)] and having information on water handling [AOR = 0.401, 95%CI (0.186–0.867)] were determinant factors for practice of safe water handling.
Conclusion
Behavior change in practice of safe water handling, water treatment at home and hand washing practice at critical time did not show remarkable changes. Strengthening of the health education, frequency of home visit by health extension workers and appropriate technical support are the key factors to improve the utilization of safe water handling.
Reducing risk of CO2 storage in regional aquifers – plume migration in flat layer
Authors: Vulin Domagoj , Močilac Iva Kolenković , Jukić Lucija , Logarušić Božo
Published: September 2024

In order to show that in certain circumstances the presence of a structural trap is not required for CO2 storage, a set of conceptual models for CO2 injection in a deep saline aquifer represented by a horizontal, laterally infinite layer, i.e., without structural or stratigraphic trap, was developed. This is theoretically supported by the assumed gravitational migration of a CO2 plume towards cap-rock. The hypothesis was tested by varying injection depths and rock permeability to analyse the influence of these parameters on time and radius of CO2 plume lateral spreading. After running 30 simulation cases, an analytical term has been proposed and it was found that a logarithmic function is satisfactory for describing the relationship between time and maximum spreading radius from the injection well. Subsequently, a generalized analytical multi-parameter correlation was found to describe CO2 plume movement with time within the spread radius. After establishing such a fitted correlation, it is possible to predict the extent of the CO2 saturation zone, justifying less frequent 4D seismic measurements.