bluuebunny/crossref_metadata_2025 huggingface dataset:
cfDNA Fragmentation Patterns Correlates with Tumor Burden Measured via PSMA PET/CT Volumetric Parameters in Patients with Biochemical Recurrence of Prostate Cancer
Authors: Amseian Gary , Figueras Marcel , Mases Joel , Mengual Lourdes , Ribal Maria-Jose , Quintero Katherine , Pages Rita , Ingelmo-Torres Mercedes , Roldan Fiorella-Lizzeth , Fuster David , Alcaraz Antonio , Izquierdo Laura , Paredes Pilar , Medicine CBNM Group Clinic Barcelona Nuclear
Published: October 2024

Background
Prostate cancer recurrence following primary treatment poses a significant clinical challenge, particularly when detected through biochemical recurrence at low PSA levels. Conventional imaging modalities often fail to localize the disease at this early stage. PSMA PET has demonstrated superior sensitivity in detecting recurrent lesions, even in patients with low PSA. Concurrently, liquid biopsy, through analysis of cell-free DNA (cfDNA), offers a minimally invasive approach for monitoring disease. There is scarce evidence about the association between liquid biopsy and PSMA PET/CT findings. This study aimed to assess the correlation between liquid biopsy and tumor burden assessed by PSMA PET/CT in early recurring prostate cancer patients.
Results
PSMA PET/CT and liquid biopsies of 32 patients in biochemical recurrence were analyzed. 12 patients (37.5%) had no PSMA PET-measurable disease. Four patients (12.5%) presented local recurrence, seven (21.9%) had recurrence in pelvic lymph nodes, one of whom also had local recurrence. Nine patients (28.1%) presented metastatic recurrence, with or without local or nodal recurrence. PSA levels correlated with molecular imaging data (p < 0.05), including wbPSMA-TV40, wbTL-PSMA40, wbSUVmean and wbSUVmax. The mean cfDNA fragment size fraction was inversely correlated with tumour burden measured with wbPSMA-TV, with a Spearman correlation coefficient of -0.451 and a p-value of 0.009. No correlation was found between cfDNA concentration and PET-PSMA data.
Conclusion
This prospective study demonstrated a statistically significant negative correlation between cfDNA fragmentation patterns and PSMA PET/CT volumetric parameters in localized prostate cancer patients with early biochemical recurrence. These findings underscore the potential of liquid biopsy as a biomarker and a complementary tool to PSMA PET/CT to assess disease progression during the follow-up of these patients.
Assessment of gingival blood flow changes due to orthodontic force using laser speckle contrast imaging: A randomized controlled trial
Authors: Yin Fan , Zhao Junwei , Zhang Hao , Wang Shusi , An Qi , Wei Xiaojiao , Tang Chenxin , Han Shuang
Published: October 2024

Background
This study aimed to measure gingival blood flow under different orthodontic forces using laser speckle contrast imaging (LSCI).
Methods
Forty eligible individuals were recruited and randomly assigned into two groups:50 g group and 150 g group. According to the groups, forces of 50 g or 150 g were applied from the maxillary canines to the first molars on the left or right sides of each participant. The canine area's blood flow (regions of interest (ROIs) 1, 2, 3, and 4) was measured using LSCI at different time intervals (baseline, 30 minutes, 1, 3, 7, and 14 days).
Results
Evaluation of blood flow between the groups revealed significant differences at ROI 1 at 1 day and 3 days; and at ROI 4 at 1 day and 3 days. Intra-group comparisons showed significant differences in blood flow within each group for each region at each time point (P<0.05). After applying orthodontic forces, blood flow reached its nadir within 30 minutes to 1 day. The 150 g group exhibited a more significant decrease compared to the 50 g group. Blood flow peaked at 3 days in the 50 g group and at 7 days in the 150 g group. Both groups finally returned to baseline at day 14. In the resting state without force loading, statistically significant differences in blood flow were observed among the marginal gingiva, attached gingiva, and interdental papilla. The marginal gingiva exhibited lower blood flow compared to other regions.
Conclusions
Laser speckle contrast imaging is a reliable tool for monitoring gingival blood flow in orthodontic treatment. Gingival blood flow decreased after force application, reaching peak values in 3 to 7 days and eventually returning to baseline within 14 days.
Trial registration
The trial was registered in Chinese Clinical Trial Registry (ChiCTR2400082438) on 29/03/2024.
How Do International Medical Students Make Sense of Internal and External Feedback to Improve Their Dutch Communication Skills?
Authors: Yu Hao , Li Zhien , Köhler S. Eleonore , Merriënboer Jeroen J. G. van , Asoodar Maryam
Published: October 2024

Background:
Feedback is crucial in medical education for developing communication skills and fostering comprehensive learning. Despite its importance, medical students often face challenges in effectively leveraging feedback. This study investigates how students make sense of internal and external feedback in a 2nd language (L2) medical Dutch course.
Methods:
Sixteen third-year international medical students (mean age = 23) participated in a medical Dutch course that included six structured sessions. Each session encompassed a briefing, simulated patient consultations (SPCs), and a debriefing. The curriculum integrated internal feedback from self-reflections and external feedback from peers, teachers, and simulated patients. Data were gathered through a students’ feedback perception survey and semi-structured interviews and analyzed via inductive thematic analysis.
Results:
Survey data indicated a trend where the preference, satisfaction, and trust in external feedback were higher than those for internal feedback. However, both types of feedback were regarded as equally effective in facilitating learning progress. Through thematic analysis, we identified five crucial themes that show how students perceive and make sense of various forms of feedback: proactive, dialogue and integration, holistic view on performance, value from diverse perspectives, and moment-specific and actionable feedback.
Conclusions:
This study underscores the vital roles of internal and external feedback in enhancing medical Dutch communication skills among medical students. Internal feedback encourages self-reflection and growth, essential for complex medical communications, while external feedback provides clear, specific and supportive guidance and experience from teachers, simulated patients and peers. These feedback mechanisms together improve students' skill in medical Dutch communication, leading to better doctor-patient interactions. Future research should focus on adapting these feedback strategies across diverse educational settings to further support the development of medical L2 communication skills in global medical contexts.
Predictors of Successful Erectile Function Using Intracavernosal Injection in Post-Prostatectomy Men with Erectile Dysfunction
Authors: Veredgorn Yotam , Savin Ziv , Marom Ron , Herzberg Haim , Nevo Amihay , Yossepowitch Ofer , Dekalo Snir
Published: October 2024

Intracavernosal injections (ICI) are commonly used to treat erectile dysfunction in men following radical prostatectomy (RP). Predictors of treatment success are still unclear.
Our objective is to explore the relationship between various clinical and pathological parameters and the achievement of satisfactory erections with ICI following RP.
A prospective study of men following RP with bilateral neurovascular bundle preservation who experienced erectile dysfunction refractory to treatment with phosphodiesterase type 5 inhibitors (PDE5I) at a minimum of 6 months after surgery. Three escalating dosages of TRIMIX were used consecutively (5mg Papaverine, 0.5 mg Phentolamine, 10mcg Alprostadil; 10mg Papaverine, 1 mg Phentolamine, 20 mcg Alprostadil; 17mg Papaverine, 1mg Phentolamine, and 30mcg Alprostadil). Erection Hardness Scale (EHS) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were used for functional assessments.
Thirty four patients were stratified by their EHS scores and Trimix dosages: low dose full responders (N=12), intermediate dose full responders (N=10), high dose partial responders (N=7), high dose failures (N=5). Twenty nine (85%) of the patients reported on satisfactory erectile function with ICI. The ICIQ-SF scores were the only parameter that correlated significantly with successful erectile response with mean scores of 2.58, 4.7, 9.57, and 14.8 for the respective groups above (p=0.001). Multivariate analysis identified ICIQ-SF as the only independent predictor of success (OR 0.74, p=0.002).
ICI is an efficient therapy for achieving satisfactory erections following RP in PDE5I-resistant men. Sustainable urinary incontinence is a strong predictor of poor response to therapy.
Integrate analysis of bulk and single-cell RNA sequencing demonstrates a transcriptional pattern characterized by GDF15 of tumor cells that predicts immunotherapy efficacy in non-small cell lung cancer
Authors: Zhang Xianfei , Yin Zhenxin , Chen Xueyu , Zhang Nengchong , Yu Shengjia , Zhu Congcong , Zhu Lianggang , Shao Liulan , Jin Runsen , Li Hecheng
Published: October 2024

The advent of immunotherapy has transformed the landscape of lung cancer treatment. Nevertheless, the question of which populations may benefit from this approach remains unsolved. In this study, we designed a pipeline based on machine learning for processing the RNA-sequencing data from lung cancer patients treated with immune check point blockade therapy to identify the most important genes that predict the prognosis. The final model was developed by accelerated oblique random forests (AORSF) for its best performance on the training, test and 10-cross validation set. An intriguing phenomenon revealed by single-cell RNA sequencing data was that the prognostically unfavorable genes were predominantly expressed by a specific tumor cell that was characterized by GDF15, while CXCL9-positive macrophages expressed the most favorable genes. The specific tumor cell with the highest score of unfavorable genes, as calculated by the AUCell package, not only exhibited the feature of epithelial cell migration but also possessed a transcription factor indicating proliferation and the highest potency score of differentiation. Furthermore, the higher level of expression of GDF15 and the proportion of this specific tumor cell can both predict a worse overall survival in an external validation melanoma cohort treated with immune checkpoint blockade therapy. In conclusion, our study identified a specific tumor cell and its hub genes that affect the efficacy of immunotherapy and may represent a target for improving the outcomes of patients.
Frontal Alpha Asymmetry Reveals a Relationship Between Human Approach Motivation and the Propensity to Take the Altercentric Perspective
Authors: Zappullo Isa , Cecere Roberta , Lauro Anna , Trojano Luigi , Esposito Anna , Cordasco Gennaro , Albano Mariaelisabetta , Nacca Renata , Romano Antonietta , Conson Massimiliano
Published: October 2024

Frontal asymmetry in the EEG alpha frequency allows to distinguish greater left activation relating to approach motivation from greater right activation relating to withdrawal motivation. It has been mostly studied in the context of affective empathy. Instead, it remains unknown whether it can be specifically related to one key component of the cognitive dimension of empathy, i.e., visuospatial perspective-taking (VSPT). In the present study, we intended to bridge this gap. To this aim, we administered an implicit VSPT task in which participants were presented with scenes of an agent grasping an object, gazing at it, or both, or neither, and were required to judge the left/right location of the object, without receiving any instruction about the perspective to take. The same participants underwent a resting state EEG recording to obtain an index of frontal alpha asymmetry. Correlational analyses showed a positive relationship between left frontal activation and the spontaneous tendency to take the agent’s perspective (altercentric propensity) when the agent behaved ambiguously, grasping the object while not gazing to it. These results suggest that the onlooker’s spontaneous altercentric propensity implies the approach motivation in the effort to understand what another individual is intending to do.
The association between caffeine intake and mortality among patients with chronic kidney disease: A population-based study
Authors: Cao Wenlong , Zhang Jianduan , Xiong Jing
Published: October 2024

Background The benefits of caffeine to human health have been widely reported, but the association between caffeine intake and mortality among patients with chronic kidney disease (CKD) has been rarely studied in large epidemiologic studies. Thus, we aimed to investigate the association between caffeine intake and mortality among CKD patients.Methods Our study was based on non-dialysis CKD patients in 2003–2016 National Health and Nutrition Examination Survey (NHANES). Weighted COX regression analysis was applied to explore the linear relationship between caffeine intake and mortality (including all-cause mortality, cardiovascular mortality, cancer mortality, cerebrovascular mortality, nephropathy mortality and influenza and pneumonia mortality). Restricted cubic spline analysis was performed to explore the nonlinear relationship. Finally, threshold effects were analyzed with two-piecewise linear regression.Results In the fully adjusted model, there was no significant linear association between caffeine intake and mortality. However, a U-shaped nonlinear association between caffeine intake and all-cause mortality (inflection point = 277mg) was identified. Moreover, there was a J-shaped association between caffeine intake and cardiovascular mortality (inflection point = 252mg) and cancer mortality (inflection point = 79mg).Conclusion Moderate caffeine intake shows a protective effect on the prognosis of CKD patients. However, excessive caffeine intake was associated with increased all-cause mortality, cardiovascular mortality and cancer mortality.
" Solar energy radiation predication based in regional satellite images and data"
Authors: Attya Mohamed , Abo-Seida OM , Abdulkader H. M. , Mohammed Amgad M.
Published: October 2024

Accurate solar radiation prediction is crucial for optimizing solar energy systems. There are two types of data can be used to predict the solar radiation such as the satellite images and the tabular satellite data. This research aims to create a more comprehensive picture of the factors influencing solar radiation. This research presents a hybrid methodology to predict the solar radiation from both satellite images and satellite data. The methodology basis on two datasets; the first data set contains tabular data, and the second dataset contains satellite images. The framework divides into two paths; the first path take the input as the satellite images; this stages contains three steps; the first step is removing noise using latent diffusion model, the second step is about pixel imputation using a modified RF + Identity GAN (this model contains two modification the first modification is adding the identity block to solve mode collapse problem in the GANs and the second modification is to add the 8-connected pixel to generate a value of missing pixel near to the real missed pixel. The third step in the first path is about using the self-organizing map to identify the special informative in the satellite image. The second path take the input as tabular data and use the diffusion model to impute the missing data in the tabulated data. Finally, we merge the two path and use feature selection to be as input for the LSTM for solar radiation predictions. The experiments done prove the efficiency of the used stage such as missing pixel imputation, removing noise, missing data imputation and prediction using LSTM when compared with other available techniques. The experiments also prove the enhancement of all prediction model after adding two paths before the prediction step.
Serum Glial Fibrillary Acidic Protein (GFAP) as a Potential Biomarker for Monitoring Postoperative Complications in Deep Brain Stimulation Surgery
Authors: Frank Anika , Arjomand Jonas , Bendig Jonas , Delfs Mia , Klingelhöfer Lisa , Polanski Witold H. , Akgün Katja , Ziemssen Tjalf , Falkenburger Björn , Schnalke Nils
Published: October 2024

Deep brain stimulation (DBS) is an efficient treatment for movement disorders, most commonly Parkinson’s Disease (PD), dystonia and essential tremor. DBS surgery carries risks, e.g. the risk of delayed peri-lead edema (PLE) and the risk of postoperative cognitive decline. The mechanisms of these complications are not fully understood and there is no established biomarker to screen for these complications after DBS surgery. To assess whether serum glial fibrillary acid protein (sGFAP) might constitute a potentially useful biomarker to detect complications after DBS surgery, we measured sGFAP and serum neurofilament light chain (sNfl) in 58 patients undergoing DBS at our center. Both serum markers increased transiently after surgery. Serum GFAP returned to baseline after weeks, whereas sNfl only returned to baseline after months. Patients with poorer preoperative cognitive performance had higher postoperative sGFAP values, and the relationship of sGFAP with preoperative patient characteristics was closer than for sNfl. These properties suggest that sGFAP can be a valuable biomarker to monitor patients for delayed complications after DBS surgery.
Measuring pH in insulin secretory granules using phasor fluorescence lifetime imaging of a genetically encoded sensor
Authors: Cardarelli Francesco , De Lorenzi Valentina , Ghignoli Samuele , Bernardi Mario , Matteoli Giulia , Storti Barbara , Bizzarri Ranieri
Published: October 2024

It is widely accepted that the pH of insulin granules is acidic, and that its active regulation during granule maturation plays a role in the process of insulin secretion by β-cells. Yet, a calibrated measurement of the absolute granule pH with organelle specificity is still lacking. To tackle this issue, we used the genetically encoded E1GFP pH reporter inserted into the C-peptide of proinsulin and expressed in Insulinoma 1E cells. Following verification of correct targeting of the E1GFP reporter in the insulin granules, phasor-based Fluorescence Lifetime Imaging Microscopy (FLIM) was applied to obtain a calibrated and probe-concentration-independent measurement of insulin-granule pH. Our results confirmed the acidic nature of insulin granules under maintenance cell-culturing conditions, with an average luminal pH of ~ 5.8, and showed that acidity is actively maintained, as evidenced by its near-neutralization upon treatment with the vacuolar H+-ATPase inhibitor Concanamycin. Additionally, by exploiting the intrinsic spatial resolution of FLIM, we highlighted that granules which are proximal to the plasma membrane are slightly more acidic (~ 0.1 pH units) than those which are distal, a difference preserved even during the early phase of glucose-induced insulin secretion. This study lays the foundations for future investigations of granule pH in physiology and disease.
China’s National Continuing Medical Education Program for General Practitioners: A Cross-Sectional Survey(2016–2023)
Authors: You Conglei , Wang Lingling , Zhang Jian , Yao Mi
Published: October 2024

Background: Pursuing excellence in the healthcare delivery system is an ongoing process. In this process, continuing medical education (CME) is essential for medical professionals to maintain high standards of patient care. In China, where the healthcare sector is undergoing considerable reforms and faces challenges owing to socioeconomic development and demographic shifts, an effective CME system is vital for general practitioners (GPs).
Methods:The external characteristics of CME programs between 2016 and 2023 were systematically gathered and statistically analyzed. Subsequently, the programs were subjected to a competency-based assessment by using the six core competencies outlined by the American Board of Medical Specialties and the Accreditation Council for Graduate Medical Education as a framework. Furthermore, keywords were extracted for the CME program names based on the International Classification of Primary Care. Visual analysis was performed using VOSviewer software, facilitating a content-based evaluation of the programs.
Results: 6,607 items were obtained by comprehensively retrieving CME programs between 2016 and 2023. After rigorous screening and evaluation, 3,815 CME programs were subjected to statistical analysis, and 2,895 CME programs were comprehensively evaluated for content and capability. A diverse range of CME providers were identified, with hospitals and publishing/education companies being the primary providers. Since 2019, a significant increase in online CME offerings has been noted. By 2023, the proportion of online CME reached 50.3%. However, the regional distribution of the CME programs was uneven, with Shanghai, Zhejiang, and Beijing leading, but western regions lagging. Furthermore, most programs focused on patient care and medical knowledge in competency-based CME evaluations, with less emphasis on interpersonal and communication skills. Content-based CME evaluations revealed that the teaching focus is the diagnosis, treatment, and primary care management of elderly patients and chronic diseases such as diabetes, and hypertension.
Conclusions: In this cross-sectional study, we comprehensively reviewed the national CME program for GPs in China between 2016 and 2023, focusing on CME programs at the national level. Our study findings underscore the essential role of CME in equipping GPs with the competencies required to navigate the evolving landscape of medical knowledge and practice, advocating for a more systematic, relevant, and individualized approach to training GPs. Therefore, there is an opportunity to enhance the quality of primary care and contribute to the Healthy China 2030 Plan.
TFE3 and HIF1a regulates the expression of SHMT2 isoforms via alternative promoter utilization in ovarian cancer cells
Authors: Wang Siqi , Liu Ning , Li Baiqiang , Zhao Fuying , Li Chao , Wang Huaqin , liu chuan
Published: October 2024

Ovarian cancer ranks first lethally among gynecological malignancies. Platinum-based chemotherapy constitutes the first-line therapeutic regime. However, primary or acquired resistance seriously affects the survival rate of patients with ovarian cancer. Serine hydroxy methyltransferase (SHMT) catalyzes conversion of serine to glycine and is responsible for production of S-adenosylmethionine (SAM) for methylation. There are cytosolic SHMT1 and mitochondrial SHMT2 in human. Alternative promoter usage is a proteome-expanding mechanism that allows multiple pre-mRNAs to be transcribed from a single gene. The current study demonstrated that cisplatin-sensitive and cisplatin-resistant ovarian cancer cells expressed discrete SHMT2 isoforms, which was ascribed to the selective utilization of SHMT2 alternative promoters. SHMT2 isoforms exerted somewhat paradoxical roles in ovarian cancer cells, with tumor-suppressive role of isoform 1, and tumor-promotive role of isoform 3. In addition, the current study demonstrated that SHMT2 alternative promoter usage mediated by HIF1α and TFE3 might represent adaptive response of ovarian cancer cells to metabolic stress. Collectively, regulation of SHMT2 isoform expression via alternative promoter usage by transcription factors HIF1α and TFE3 provides a novel basis and potential drug targets for the clinical treatment of platin-resistant ovarian cancer.
Social and sexual networks of newly diagnosed people living with HIV: a qualitative social network analysis
Authors: Landeghem Ella Van , Bulcke Charlotte Vanden , Rotsaert Anke , Deblonde Jessika , Verhofstede Chris , Nöstlinger Christiana
Published: October 2024

Background A better understanding of HIV transmission dynamics is needed to further reduce the number of new HIV diagnoses in Belgium. As environmental and social context play an important role in explaining HIV acquisition despite the availability of effective HIV prevention, this study investigated the role of social and sexual networks in HIV prevention and risk behavior among people newly diagnosed with HIV, including their perceptions of how they acquired HIV and their ability to disclose their HIV status.Methods This qualitative study used an ego-centric social network approach, through in-depth interviews generating sociograms of social and sexual networks with 20 participants newly diagnosed with HIV.Results Friends, family members, regular sex partners and HIV physicians were placed closest to the ego on the sociogram. Self-identified gay men did not consider their casual sex partners as emotionally close enough to be included in the sociogram, even though these partners were often participants’ primary source of information about sexual health. HIV acquisition among this group was often attributed to increased sexual risk-taking under influence of drugs. Heterosexual and bisexual men who have sex with men (MSM), who had more diverse networks, often did not consider themselves at risk for HIV. Awareness of PrEP was higher among gay-identified MSM than among heterosexuals and heterosexual MSM, partly attributed to community-based prevention efforts. Most participants only disclosed HIV to those closest to them, and the anticipated and perceived lack of social support influenced HIV acceptance. Feelings of internalized HIV stigma and homophobia prevented HIV disclosure, especially among heterosexuals and heterosexual and bisexual MSM.Conclusion This study revealed important differences in the networks of gay-identified MSM, heterosexuals and hetero- and bisexual identified MSM influencing sexual risk taking and prevention behavior. Future prevention initiatives should be inclusive and mainstreamed to ensure to also address those who do not identify as the established transmission groups. Awareness of biomedical prevention should be raised in the general population, providing a base on which more tailored promotion can be built. Involving family physicians and social empowering people living with HIV may help to decrease (anticipated) HIV stigma.
Risk-factors associated with new-onset temporomandibular joint disorder syndrome in patients who underwent mandibular fracture surgery : A retrospective study
Authors: Wang Honghao , Xie Fei , Hou Jun , Huang Zhao , Chi Yifan , Lin Lisong
Published: October 2024

Objective: To study the incidence and related risk factors for new-onset temporomandibular joint disorder after mandibular surgery to provide clinical guidance.
Materials and methods: The medical records of patients who underwent open reduction and internal fixation formandibular fractures between September 2020 andJune 2023 were retrospectively analysed, and their personal information and the incidence and pathogenic factors of temporomandibular joint disorder before surgery were recorded. Patients were followed up at 3 months, 6 months, and 1 year after surgery to investigate the incidence and pathogenic factors of postoperative temporomandibular joint disorder.
Results: A total of 121 patients were included in this study, 33 of whomdeveloped temporomandibular joint disorder, accounting for 27.27% of the study population, and 88 patients who did not develop temporomandibular joint disorder, accounting for 72.73% of the study population. Univariate analysis revealed significant differences in abnormal occlusion and healing rates, unilateral chewing rates, and deep overbite of the anterior teeth rates (P <0.05). There was no significantdifference in age, sex, fracture area, cause of trauma, infection rate, bruxism rate, empty chewing rate, or postoperative anxiety rate between the two groups (P >0.05). Binary logisticregression analysis revealed that abnormal occlusion and healing (OR=0.044) and unilateral chewing (OR=0.142) may be risk factors for new-onset temporomandibular joint disorder after maxillofacial fracture surgery.
Conclusion: During the follow-up period, long-term postoperative occlusal habits should be established, and attention should be given the patients’ postoperative psychological state. Accurate digital reconstruction of the occlusal relationship is needed fortreating mandibular fractures.
Experiences of early parenthood in and beyond the Coronavirus pandemic/outbreak
Authors: Celik Filiz , Harrad Rachel , Keasley Rob , Bennett Paul
Published: October 2024

The term ‘Perinatal’ incorporates pregnancy, birth and the postnatal period. The perinatal period is a milestone event in both the individual and familial life cycle, an experience shared by the wider social network and community. Yet, it can be a period where the impact of pre-existing and emerging mental health problems during this time could necessitate specialist Perinatal Mental Health Services (PMHS) support via the NHS. COVID-19 pandemic is considered to have exacerbated the adversity for Perinatal Mental Health (PMH), yet questions on the lived experience remain unanswered. Interviews with expectant and new mothers were analysed using Reflexive Thematic Analysis (RTA) establishing themes of 1- Perinatal Medical Care during COVID-19 Pandemic, 2- Becoming a Parent within social isolation, iii- Managing the Perinatal Period with the Support of Perintal Mental Health Services (PMHS) and iv- Parenthood beyond the COVID-19 Pandemic. Findings indicated that the COVID-19 Pandemic caused concerns and worries amongst pregnant, birthing, and post-partum women and that diminished opportunities for social support during the perinatal period created an adverse mental health impact upon them. Overall, COVID-19 appears to have a ripple effect on women and their families experiencing the perinatal period during COVID-19. Although participants largely did not link their poor mental well-being during the perinatal period to the COVID-19 Pandemic, they attributed the causes of their poorer experiences to the COVID-19 Pandemic, identifying the pandemic as contributor to their heightened perinatal mental distress and at times as sole cause for their referral to Perinatal Mental Health Services.
Use of a Self-Screening Tool and Patient Alert Cards to Help Patients Identify and Manage Severe Adverse Drug Reactions
Authors: Srisuriyachanc Warisara , Foocharoen Chingching , Mahakkanukrauh Ajanee , Cox Anthony R , Jarernsiripornkul Narumol
Published: October 2024

Background
Few studies have examined the use of self-screening tools and patient alert cards (PAC) for screening adverse drug reactions (ADRs).
Aim To examine the efficacy of self-screening tools and PAC for screening ADRs.
Methods A cross-sectional survey of outpatients was conducted at a tertiary care teaching hospital. The sample included patients over 18 years of age who were currently taking one of four prescription medicines—methotrexate, sulfasalazine, cyclosporine, or prednisolone. A self-screening tool was distributed to patients in either hard copy or on-line format depending on patient preference. Simple random sampling was used to assign patients to either receive a PAC or not.
Results A total of 922 self-screening tools were distributed with 709 returned (71.5%). Over half (n=388) of the respondents reported a total of 3437 symptoms that they credited to their medication. The most commonly reported symptom was angioedema (15.8%). The majority of patients (76.7%) used the temporal relationship between the onset of symptoms and the administration of the drug to decide if their ADR was associated with the drug and this proportion was higher in respondents who selected the online self-screening tool (70.7% and 83.2%, p=0.040). Half of the patients reported high satisfaction with their PACs.
Conclusions Providing patients with a self-screening tool and a PAC supported patients to report more ADRs compared to rates for spontaneous reporting alone. We propose that they should be provided to all patients to increase ADR reporting and to encourage HCPs to provide drug information, thereby improving patient medication safety.
Value of MRI-based VBQ scores in screening for osteoporosis in postmenopausal women and diagnositic differences from those of DXA
Authors: Chen Ang , Feng Shangyong , She Dunmin , Yan Caifeng
Published: October 2024

Background
To investigate the value of the vertebral bone quality score (VBQ) in osteoporosis screening in postmenopausal women and the difference in the diagnosis between VBQ and dual-energy X-ray absorptiometry (DXA).
Methods
A total of 601 postmenopausal women who underwent lumbar MRI and DXA throughout the year 2022 were selected to obtain data to calculate the predictive value of the VBQ for osteoporosis via receiver operating characteristic (ROC) curve analysis, and used the cut-off value was used as the criterion to compare the ability of the VBQ and DXA to detect osteoporosis. We also analyzed the correlation between the VBQ and T-values at each site.
Results
The mean age of the 601 menopausal women was 68.18 years, the prediction accuracy of the VBQ score for osteoporosis was 93.1%, and the cut-off value was 2.979. There were strong negative correlations between the VBQ score and T-value at each site; the detection rate of osteoporosis was higher than that of DXA according to the VBQ score; the VBQ score and DXA were comparable in 519 patients (86.4%), and they were incompatible in 82 patients (13.6%).
Conclusion
The VBQ score could distinguish osteoporosis from non-osteoporosis in postmenopausal women. It was superior to DXA in detecting osteoporosis.
Clinical Characteristics And Risk Factors For Pruritus In Patients With Neuromyelitis Optica Spectrum Disorders
Authors: Shao Ruo-Chen , Sun Ya-Ting , Fu Min , Ren Shi-Qing , Li Xiao-Hui
Published: October 2024

Objective This study aimed to investigate the clinical characteristics and risk factors for pruritus in patients with neuromyelitis optica spectrum disorders (NMOSD) and evaluate its impact on patient quality of life.
Methods Patients with NMOSD at the Department of Neurology of our hospital from December 2021 to August 2023 were followed up by outpatient visits or telephone interviews. The 5-D itch scale was used to evaluate pruritus intensity, the course of pruritus and pruritus-related interference in daily life during the entire disease course. We explored the factors correlated with pruritus by comparing the clinical features of patients with NMOSD with and without pruritus.
Results A total of 112 patients with NMOSD were enrolled. 32(28.6%) patients had pruritus. All of these patients had myelitis. 22 (68.8%) patients had pruritus for less than 6 hours/day, 26 (81.2%) had moderate or severe pruritus intensity, 16 (50%) had complete pruritus relief, and 30 (93.8%) had never or occasionally affected daily life. Compared with patients without pruritus, patients with pruritus were more common in males (P=0.030), younger in age (P=0.018), with a shorter course of disease (P=0.000), and with cervical cord lesions and longitudinally extensive transverse myelitis (P=0.013 and 0.022, respectively). Multivariate logistic regression analysis revealed that younger age (OR=0.031, 95% CI=0.002-0.421, P=0.009), short disease duration (OR=0.810, 95% CI=0.721-0.909, P=0.000), longitudinally extensive transverse myelitis (OR=7.346, 95% CI=1.172-46.052, P=0.033), and cervical lesions (OR=8.023, 95% CI=1.501-42.852, P=0.015) were independent factors correlated with pruritus in patients with NMOSD.
Conclusions Pruritus is a common clinical feature in patients with NMOSD, and it can be the initial symptom in some patients. A short disease course, younger age, cervical cord involvement and longitudinally extensive transverse myelitis are risk factors for NMOSD with pruritus. Pruritus has a minor effect on the quality of life for the majority of NMOSD patients.
Distinct Microbial Signatures and Their Predictive Value in Recurrent Acute Pancreatitis: Insights from 5-region 16S rRNA Gene Sequencing
Authors: Wang Qiwen , Zheng Haorui , Du Zengkan , Chang Xinyao , Hang Zining , Liao Zhuan
Published: October 2024

Background
The recurrent acute pancreatitis (RAP) poses significant clinical challenges, and the underlying microbial factors contributing to RAP remain poorly understood. This study aims to identify the microbial profiles associated with RAP and explore the potential microbial predictors for RAP.
Methods
Ninety patients were classified into non-recurrent acute pancreatitis (NRAP, n = 68) and RAP (n = 22) groups based on the number of pancreatitis episodes. Clinical characteristics were documented, and the microbial composition of serum samples was analyzed using 5-region (5R) 16S rRNA gene sequencing. Key microbial taxa and functional predictions were made. Additionally, a random forest model was used to assess the predictive value of microbial features for RAP. The impact of Staphylococcus hominis (S. hominis) on RAP was further evaluated in an experimental mouse model.
Results
Microbial analysis revealed specific taxa were differentially abundant between the groups. LefSE analysis highlighted significant microbial differences, with Paracoccus aminovorans, Corynebacterium glucuronolyticum and S. hominis being prominent in RAP. Functional predictions indicated enrichment of metabolic pathways in the RAP group. Random forest analysis identified key microbial taxa with an AUC value of 0.759 for predicting RAP. Experimental validation showed that S. hominis exacerbates pancreatic inflammation in mice.
Conclusions
This study identifies distinct clinical and microbial features associated with RAP, emphasizing the role of specific bacterial taxa in pancreatitis recurrence. The findings suggest that microbial profiling could enhance the diagnosis and management of RAP, paving the way for personalized therapeutic approaches.
Antisense oligonucleotides as a targeted therapeutic approach in model of acute myeloid leukemia
Authors: Macečková Diana , Vaňková Lenka , Bufka Jiří , Hošek Petr , Moravec Jiří , Pitule Pavel
Published: October 2024

Background
The genetic and epigenetic alterations observed in acute myeloid leukemia (AML) contribute to its heterogeneity, influencing disease progression, response to therapy, and patient outcomes. The use of antisense oligonucleotide (AONs) technology allows the design of oligonucleotide inhibitors based on gene sequence information alone, enabling precise targeting of key molecular pathways or specific genes implicated in AML.
Methods and Results
Midostaurin, an FLT3-specific inhibitor and AONs targeting specific genes, exons, or mutations were evaluated using AML models. This AON treatment was designed to bind to exon 7 of the muscleblind-like (MBNL1) gene. Another target was the FLT3 gene, focusing on two aspects: (a) FLT3-ITD (internal tandem duplication), to inhibit the expression of this aberrant gene and (b) the FLT3 in general. Treated and untreated cells were analyzed using quantitative PCR, dot blotting, and Raman spectroscopy. This study compared midostaurin with AONs, which inhibit FLT3 protein production or its isoforms via mRNA degradation. Increased FLT3 expression was observed in midostaurin-treated cells, whereas AON-treated cells showed decreased expression; however, these changes were not statistically significant.
Conclusions
In AML, exon 7 of MBNL1 is involved in several cellular processes. In this study, exon 7 of MBNL1 was targeted for method optimization, with the highest block of the exon 7 gene variant observed 48 h post-transfection. Midostaurin, a multi-targeted kinase inhibitor, acts against the receptor tyrosine kinase FLT3, a critical molecule in AML pathogenesis. While midostaurin blocks the FLT3 signaling pathway, it paradoxically increases FLT3 expression.
Association of preoperative low circulating basophil counts with the prognostic factor in gastric cancer
Authors: Kawano Makiko , Oshima Yoko , Shiratori fumiaki , Suzuki Takashi , Yajima Satoshi , Funahashi Kimihiko , Shimada Hideaki
Published: October 2024

Purpose
Basophils play a crucial role in immunoglobulin E-mediated allergic reactions and parasitic infections. Recently, a low basophil count was reported to be a poor prognostic indicator in patients with malignant tumors. This study aimed to investigate the cut-off value to evaluate the clinicopathological and prognostic significance of the basophil count in patients with gastric cancer.
Methods
This study enrolled 1192 consecutive gastric cancer surgically treated between 2001 and 2020. The cut-off values were fixed at 26/µl based on the receiver of characteristics curves for overall survival, and 606 patients were classified as the low basophil group. The clinicopathological and prognostic significance of the low basophil count was assessed by univariate and multivariate analyses
Results
Elderly age (p = 0.009), high C-reactive protein level (p < 0.001), and low neutrophil count (p < 0.001), are independently associated with low basophil count. The low basophil group demonstrated a significantly worse overall survival than the high basophil group (p = 0.005). Although there was no significant difference in stage I, the low basophil group demonstrated poor overall survival in stage II/III/IV. The low basophil count was an independent risk factor for poor overall survival (p = 0.042).
Conclusion
Low basophil count was significantly associated with elderly age, high C-reactive protein level, and low neutrophil count (< 26/µl). And, low basophil count was an independent poor prognostic factor in patients with gastric cancer. Thus, preoperative circulating basophil count assessment may be useful for predicting the postoperative survival of patients with gastric cancer.
Correlation of the Triglyceride-Glucose-Body Mass Index with All-cause and Cardiovascular Mortality in Patients Undergoing Peritoneal Dialysis: A Retrospective Cohort Study
Authors: Li Jinping , Wang Xichao , Zhang Wenyu , Sun Na , Han Yingying , Chang Wenxiu
Published: October 2024

Background
Triglyceride-glucose-body mass index (TyG-BMI) is a simple indicator of insulin resistance and is linked to an elevated risk of mortality. Nevertheless, limited research has explored the associations between the TyG-BMI and all-cause and cardiovascular mortality in patients undergoing peritoneal dialysis (PD).
Methods
Patients initiating PD treatment at Tianjin First Central Hospital’s nephrology department from July 2013 to February 2024 had triglycerides, fasting blood glucose, height, and weight measured at baseline and monthly during follow-up. TyG-BMI was calculated, dividing PD patients into high, middle, or low TyG-BMI groups using tri-quantile method. Cox regression analysis assessed hazard ratios (HRs) for all-cause and cardiovascular mortality among these groups.
Results
A total of 865 patients were included. The mean TyG-BMI value for the entire study population was 212.27 ± 46.64. Patients in the high group had a higher proportion of patients whose primary kidney disease was diabetic nephropathy and the greatest proportion of patients with comorbid diabetes mellitus. During the follow-up, 266 (30.75%) deaths occurred, with CVD being the dominant cause in 110 (41.35%) patients. Univariate and multivariate Cox regression analyses showed that middle group patients had a significantly lower risk of all-cause mortality compared to other groups. For CVD mortality, high group patients had a significantly greater hazard ratio than middle group, while there was no significant difference between low and middle groups. Restricted cubic spline regression revealed U-shaped association between TyG-BMI and all-cause mortality risk, as well as J-shaped association with CVD mortality, inflection points were identified at 209.73 and 206.64 respectively.
Conclusion
The TyG-BMI shows U-shaped and J-shaped relationships with all-cause and CVD mortality risk, respectively, in PD patients. Additionally, significant sex differences were observed in these associations.
Cerebrolysin, Hemorrhagic Transformation, and Anticoagulation Timing after Reperfusion Therapy in Stroke: Secondary Analysis of the CEREHETIS Trial
Authors: Kalinin Mikhail N. , Khasanova Dina R.
Published: October 2024

Background
Evidence supports Cerebrolysin’s efficacy in reducing hemorrhagic transformation (HT), but its impact on the timing of resuming anticoagulation therapy in stroke patients remains unclear.
Methods
A post hoc survival analysis of the CEREHETIS trial (ISRCTN87656744) was conducted. Patients with middle cerebral artery infarction (n = 238) were categorized into low-risk (HTI = 0) and high-risk (HTI > 0) groups based on HTI scores. The 14-day follow-up included any HT and symptomatic HT as failure events. Hazard deceleration (HD) curves were generated using the Gompertz model to estimate changes in the hazard function over time. The inception point, defined as when the HD curve dropped below the 5% threshold, indicated a constant hazard function. Timing of restarting anticoagulation therapy was inferred from the inception points using the HD curves and the lower limit of their 95% confidence intervals (CI).
Results
In the HTI > 0 cohort, Cerebrolysin reduced the risk of symptomatic HT and any HT, with hazard ratios of 0.245 (95% CI 0.072–0.837; p = 0.020) and 0.543 (95% CI 0.297–0.991; p = 0.032), respectively. Inception points for resuming anticoagulation therapy occurred on days 2–3 for the Cerebrolysin group and days 4–5 for the control group. In the HTI = 0 cohort, Cerebrolysin was ineffective, with inception points for both groups at the two-day mark.
Conclusion
Cerebrolysin may reduce the risk of HT and allow for a 1-2-day earlier resumption of anticoagulation therapy in patients at high risk of HT. However, its benefit is limited in those with initially low HT risk.