bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of prediabetes on the prognosis of patients with myocardial infarction: a meta-analysis
Authors: Zeng Mengya , Sun Eyu , Zhu Li , Deng Lingzhi
Published: July 2024

Background

Previous studies evaluating the association between prediabetes the prognosis of patients with acute myocardial infarction (AMI) showed inconsistent results. The aim of the meta-analysis was to compare the long-term incidence of major adverse cardiovascular events (MACEs) between AMI patients with prediabetes and normoglycemia.

Methods

Relevant prospective cohort studies were obtained by searching Medline, Web of Science, and Embase databases. Only studies with follow-up duration of at least one year were included. A random-effects model was utilized to pool the results by incorporating the influence of heterogeneity.

Results

Twelve studies with 6972 patients with AMI were included. Among them, 2998 were with prediabetes and 3974 were with normoglycemia. During a mean follow-up of 52.6 months, 2100 patients developed MACEs. Compared to those with normoglycemia, AMI patients with prediabetes were associated with a higher incidence of MACEs (risk ratio [RR]: 1.30, 95% confidence interval: 1.07 to 1.58, p = 0.008; I2 = 67%). Subgroup analysis showed a stronger association between prediabetes and MACEs in studies of patients with mean age ≥ 60 years compared to < 60 years (RR: 1.66 versus 1.10, p for subgroup difference = 0.04), with proportion of men < 75% compared to ≥ 75% (RR: 1.87 versus 1.08, p for subgroup difference = 0.01), and in prediabetes evaluated at or after discharge compared to that evaluated within three days of AMI onset (RR: 1.39 versus 0.78, p for subgroup difference = 0.01).

Conclusions

Prediabetes may be associated with a higher risk of MACEs in patients with AMI.
Cardiac rehabilitation in children and adolescents with long QT syndrome: the RYTHMO’FIT pilot study
Authors: Souilla Luc , Guillaumont Sophie , Auer Annie , Metzler Gael , Requirand Anne , Vincenti Marie , De La Villeon Gregoire , Pasquie Jean-Luc , Mottet Denis , Amedro Pascal
Published: July 2024

Background

To assess the feasibility, acceptability, safety, and short-term benefits of a tailored cardiac rehabilitation program for children and adolescents with long QT syndrome (LQTS).

Methods

Eight participants, aged between 6 and 18, with a positive LQTS genotype and impaired cardiorespiratory fitness, were enrolled in a 12-week centre-based cardiac rehabilitation program. The program included supervised exercise training group sessions (aerobic, resistance, and outdoor activities) and patient education workshops. Feasibility, acceptability, and safety of the program were prospectively monitored. Feedback from the parents, children, and professionals involved was collected from qualitative interviews. Short-term effects on cardiorespiratory fitness, muscle fitness, physical activity, and health-related quality of life (HRQoL) were measured between baseline and the end of the program.

Results

Retention (88% with one participant dropping out) and adherence (79%) rates were good, and no cardiac events occurred during the 12-week intervention period. Participants, parents, and healthcare professionals expressed a high level of satisfaction with the program. A significant increase between the beginning and the end of the program was observed for ventilatory anaerobic threshold (21.7±5.2 vs. 28.7±5.1 mL/kg/min, P=0.01, effect size=0.89), grip strength, (18±5.3 Kg vs. 20±4.7 Kg, P=0.02, effect size=0.90), lower limb explosive strength (142±36.5 cm vs. 148±24 cm, P=0.02, effect size=0.90), and parent-reported physical health dimension of HRQoL (65.6±9.75 vs. 84.4±20.35, P=0.03, effect size=0.87).

Conclusions

A 12-week tailored centre-based cardiac rehabilitation program was feasible, acceptable, and safe for children with LQTS. Cardiac rehabilitation for children with LQTS presents a new approach aligned with secondary prevention in youth with cardiac diseases.

Trial registration

The trial was registered at Clinicaltrials.gov (NCT05964322, registration date: 27/07/2023).
Robust error-state Kalman-type filters for attitude estimation
Authors: Bellés Andrea , Medina Daniel , Chauchat Paul , Labsir Samy , Vilà-Valls Jordi
Published: July 2024

State estimation techniques appear in a plethora of engineering fields, in particular for the attitude estimation application of interest in this contribution. A number of filters have been devised for this problem, in particular Kalman-type ones, but in their standard form they are known to be fragile against outliers. In this work, we focus on error-state filters, designed for states living on a manifold, here unit-norm quaternions. We propose extensions based on robust statistics, leading to two robust M-type filters able to tackle outliers either in the measurements, in the system dynamics or in both cases. The performance and robustness of these filters is explored in a numerical experiment. We first assess the outlier ratio that they manage to mitigate, and second the type of dynamics outliers that they can detect, showing that the filter performance depends on the measurements’ properties.
Healthcare delivery to patients from culturally and linguistically diverse backgrounds in emergency care: a scoping review protocol
Authors: Huang Ya-Ling , Thorning Sarah , Lin Chun-Chih , Lee Robert , Elder Elizabeth , Crilly Julia
Published: July 2024

Background

Worldwide, the culturally and linguistically diverse (CALD) population is increasing, and is predicted to reach 405 million by 2050. The delivery of emergency care for the CALD population can be complex due to cultural, social, and language factors. The extent to which cultural, social, and contextual factors influence care delivery to patients from CALD backgrounds throughout their emergency care journey is unclear. Using a systematic approach, this review aims to map the existing evidence regarding emergency healthcare delivery for patients from CALD backgrounds and uses a social ecological framework to provide a broader perspective on cultural, social, and contextual influence on emergency care delivery.

Methods

The Joanna Briggs Institute (JBI) scoping review methodology will be used to guide this review. The population is patients from CALD backgrounds who received care and emergency care clinicians who provided direct care. The concept is healthcare delivery to patients from CALD backgrounds. The context is emergency care. This review will include quantitative, qualitative, and mixed-methods studies published in English from January 1, 2012, onwards. Searches will be conducted in the databases of CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), SocINDEX (EBSCO), Scopus (Elsevier), and a web search of Google Scholar. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram will be used to present the search decision process. All included articles will be appraised using the Mixed Methods Appraisal Tool (MMAT). Data will be presented in tabular form and accompanied by a narrative synthesis of the literature.

Discussion

Despite the increased use of emergency care service by patients from CALD backgrounds, there has been no comprehensive review of healthcare delivery to patients from CALD backgrounds in the emergency care context (ED and prehospital settings) that includes consideration of cultural, social, and contextual influences. The results of this scoping review may be used to inform future research and strategies that aim to enhance care delivery and experiences for people from CALD backgrounds who require emergency care.

Systematic review registration

This scoping review has been registered in the Open Science Framework https://doi.org/10.17605/OSF.IO/HTMKQ
The cereal network: a baseline approach to current configurations of trade communities
Authors: Robu Raluca Georgiana , Alexoaei Alina Petronela , Cojanu Valentin , Miron Dumitru
Published: July 2024

This paper attempts to provide insights into the current network configurations of the food-trade system and to study the short-term effects of one of the ongoing and lasting global crises, the Ukraine War, on the link intensity. Towards this end, this analysis (1) reveals the pattern of countries’ network positions in two most traded subcategories of the cereal network: wheat and meslin, and maize or corn, and (2) discusses the characteristics of the global cereal networks over the 2021–2022 period. The results highlight several features of the trade networks: (1) the distribution of cereal trade is highly concentrated, with considerable dependency on a small number of exporters and a low import diversification, making the system rigid and prone to shocks; (2) a central role of several key developed countries that leave many developing countries outside the centre of the networks; (3) a high network heterogeneity which confirms the propensity to have hub nodes. Particular indicators show that the highest level of interconnectivity is specific to the cereals’ export network, the densest networks are the maize or corn ones, and the greatest heterogeneity appears for the cereals export network.
Sustainability challenges in the multi-tier crop agri-food sector: a systematic review
Authors: Khan Muhammad , Papadas Dimitrios , Arnold Lydia , Behrendt Karl
Published: July 2024

This systematic review identifies the potential sustainability challenges lower-tier suppliers and buying firms face in multi-tier crop agri-food supply chains. The first stage applied systematic mapping, and based on a sample of 487 academic articles from 6 databases, identified a less-researched area through empirical analysis. Secondly, a systematic evidence review synthesis methodology was used to synthesise the identified sustainability challenges from 18 qualitative studies focusing on the crop agri-food sector. A complex adaptive system, triple-bottom-line approach, and environmental, social, and governance sustainability models were applied to understand the nature of multi-tier supply chain structures and then identify sustainability challenges. Four major dimensions of sustainability challenges (social, economic, environmental and governance) for the lower-tier suppliers and buying firms were identified. Disintegration between buying firms and the lower-tier suppliers, predominantly due to their different locations, was found to be the primary reason for sustainability challenges in the crop agri-food sector. The review findings establish a theoretical framework that could serve as a roadmap for future research in multi-tier supply chains across various sectors and geographies, examining potential sustainability challenges and developing governance structures for sustainable development.
Lysine 2-hydroxyisobutyrylation levels determined adipogenesis and fat accumulation in adipose tissue in pigs
Authors: Yan Enfa , Tan Mingyang , Jiao Ning , He Linjuan , Wan Boyang , Zhang Xin , Yin Jingdong
Published: July 2024

Background

Excessive backfat deposition lowering carcass grade is a major concern in the pig industry, especially in most breeds of obese type pigs. The mechanisms involved in adipogenesis and fat accumulation in pigs remain unclear. Lysine 2-hydroxyisobutyrylation (Khib), is a novel protein post-translational modification (PTM), which play an important role in transcription, energy metabolism and metastasis of cancer cells, but its role in adipogenesis and fat accumulation has not been shown.

Results

In this study, we first analyzed the modification levels of acetylation (Kac), Khib, crotonylation (Kcr) and succinylation (Ksu) of fibro-adipogenic progenitors (FAPs), myogenic precursors (Myo) and mesenchymal stem cells (MSCs) with varied differentiation potential, and found that only Khib modification in FAPs was significantly higher than that in MSCs. Consistently, in parallel with its regulatory enzymes lysine acetyltransferase 5 (KAT5) and histone deacetylase 2 (HDAC2) protein levels, the Khib levels increased quadratically (P < 0.01) during adipogenic differentiation of FAPs. KAT5 knockdown in FAPs inhibited adipogenic differentiation, while HDAC2 knockdown enhanced adipogenic differentiation. We also demonstrated that Khib modification favored to adipogenic differentiation and fat accumulation by comparing Khib levels in FAPs and backfat tissues both derived from obese-type pigs (Laiwu pigs) and lean-type pigs (Duroc pigs), respectively. Accordingly, the expression patterns of KAT5 and HDAC2 matched well to the degree of backfat accumulation in obese- and lean-type pigs.

Conclusions

From the perspective of protein translational modification, we are the first to reveal the role of Khib in adipogenesis and fat deposition in pigs, and provided new clues for the improvement of fat accumulation and distribution as expected via genetic selection and nutritional strategy in obese-type pigs.
Evaluation of the effects of pandemic-related fears on anxiety and depression: the mediating roles of traumatic stress and loneliness
Authors: Bucaktepe Pakize Gamze Erten , Akgül Fethiye , Çelİk Sercan Bulut
Published: July 2024

Background

The detrimental mental health effects which emerged from COVID-19 have profoundly affected healthcare workers (HCWs) worldwide. The aim of this study was to investigate the mediating effects of traumatic stress and loneliness on the fears of contracting and dying from COVID-19, and anxiety and depression of HCWs during the pandemic.

Methods

A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software.

Results

Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (β = 0.244, p < 0.001) and depression (β = 0.135, p < 0.01) and that traumatic stress and loneliness mediated the relationships between the fear of contracting COVID-19 and anxiety (β = 0.435, p < 0.001; β = 0.235, p < 0.001, respectively) and depression (β = 0.365, p < 0.001; β = 0.294, p < 0.001, respectively). The fear of dying from COVID-19 was determined to be directly associated with anxiety (β = 0.190, p < 0.001) but not with depression (β = 0.066, p = 0.116), and traumatic stress and loneliness mediated the relationships between the fear of dying from COVID-19 and anxiety (β = 0.476, p < 0.001; β = 0.259, p < 0.001, respectively) and depression (β = 0.400, p < 0.001; β = 0.311, p < 0.001, respectively).

Conclusions

The study results demonstrated the important roles of traumatic stress and loneliness in exacerbating the negative consequences of fears of COVID-19 on anxiety and depression, and provide insights for identifying HCWs at greater risk.
Development and internal validation of a model for predicting cefoperazone/sulbactam-associated coagulation disorders in Chinese inpatients
Authors: Fu An , Ge Feng , Wang Yanwei , Guo Haili , Zhu Man , Li Shu , Gao Ao , Li Chao , Lu Jingchuan , Guo Daihong
Published: July 2024

Background and aim

The use of cefoperazone/sulbactam (CPZ/SAM) could commonly cause vitamin K-dependent coagulation disorders and even hemorrhage sometimes. However, there is a lack of prediction tools estimating the risk for this. This study aimed at developing and internally validating a model for predicting CPZ/SAM-associated coagulation disorders in Chinese inpatients.

Methods

A case-control study was conducted in 11,092 adult inpatients admitted to a Chinese general hospital between 2020 and 2021 and treated with CPZ/SAM. Patients with CPZ/SAM-associated coagulation disorders were identified through the Adverse Drug Events Active Surveillance and Assessment System-II and subsequent manual evaluation. Controls were selected from eligible patients who didn’t develop coagulation disorders after CPZ/SAM therapy, with a 1:1 propensity score matching. The final predictors were obtained by univariable and multivariable logistic regression analyses. Internal validation and calibration for the model were performed using 1000 bootstrap resamplings.

Results

258 patients were identified as CPZ/SAM-associated coagulation disorders in 2184 patients eligible for inclusions and exclusions and the incidence was 11.8%. A final population of 252 cases and 252 controls was included for model development and validation. Malnutrition (OR = 2.41 (1.56–3.77)), history of recent bleeding (OR = 1.95 (1.32–2.90)), treatment duration (OR = 1.10 (1.07–1.14)), combination with carbapenems (OR = 4.43 (1.85–11.88)), and serum creatinine (OR = 1.01 (1.00–1.01)) were identified as final predictors. The model showed good discrimination, calibration, and clinical practicality, with the validated area under the receiver operating characteristic curve being 0.723 (0.683–0.770).

Conclusions

The model with good performance quantifies the risk for CPZ/SAM-associated coagulation disorders, and may support individual assessment and interventions to mitigate the risk after external validation.
Effect of luteolin on oxidative stress and inflammation in the human osteoblast cell line hFOB1.19 in an inflammatory microenvironment
Authors: Peng Zhengjun , Zhang Wenyu , Hong Hong , Liu Lu
Published: July 2024

Background

Periapical lesions are characterized by periapical inflammation and damage to periapical tissues and eventually lead to bone resorption and even tooth loss. H2O2 is widely used in root canal therapy for patients with periapical inflammation. Luteolin possesses high anti-inflammatory, antioxidant, and anticancer potential. However, the underlying mechanism of the efficacy of H2O2 and luteolin on oxidative stress and inflammatory tissue has not been previously addressed. We aimed to investigate the anti-inflammatory and antioxidative effects of luteolin on H2O2-induced cellular oxidative inflammation.

Methods

After human osteoblasts (hFOB1.19) were treated with lipopolysaccharide (LPS), luteolin, or H2O2, cell proliferation was analysed by using a cell counting kit-8 (CCK-8), cell apoptosis was measured by using flow cytometry, the production of reactive oxygen species (ROS) was evaluated by using an oxidation-sensitive probe DCFH-DA ROS assay kit, and the expression of genes and proteins was detected by using reverse transcription quantitative polymerase chain reaction (RT‒qPCR), Western blotting, and enzyme-linked immunosorbent assay (ELISA).

Results

We demonstrated that inflammation is closely related to oxidative stress and that the oxidative stress level in the inflammatory environment is increased. Luteolin inhibited the H2O2-induced increase in the expression of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor α (TNF-α) and significantly repressed the H2O2-induced increase in ROS, as well as markedly strengthened superoxide dismutase (SOD) activity in hFOB1.19 cells. Moreover, we detected that luteolin may inhibit H2O2-induced hFOB1.19 cell injury by suppressing the NF-κB pathway.

Conclusion

We elucidated that luteolin protected human osteoblasts (hFOB1.19) from H2O2-induced cell injury and inhibited the production of proinflammatory cytokines by suppressing the NF-κB signalling pathway. Our findings provide a potential drug for treating H2O2-induced periodontitis and cell injury.
Early biomarkers in the presymptomatic phase of cognitive impairment: changes in the endocannabinoidome and serotonergic pathways in Alzheimer's-prone mice after mTBI
Authors: Guida Francesca , Iannotta Monica , Lauritano Anna , Infantino Rosmara , Salviati Emanuela , Verde Roberta , Luongo Livio , Sommella Eduardo Maria , Iannotti Fabio Arturo , Campiglia Pietro , Maione Sabatino , Di Marzo Vincenzo , Piscitelli Fabiana
Published: July 2024

Background

Despite extensive studies on the neurobiological correlates of traumatic brain injury (TBI), little is known about its molecular determinants on long-term consequences, such as dementia and Alzheimer’s disease (AD).

Methods

Here, we carried out behavioural studies and an extensive biomolecular analysis, including inflammatory cytokines, gene expression and the combination of LC-HRMS and MALDI-MS Imaging to elucidate the targeted metabolomics and lipidomics spatiotemporal alterations of brains from wild-type and APP-SWE mice, a genetic model of AD, at the presymptomatic stage, subjected to mild TBI.

Results

We found that brain injury does not affect cognitive performance in APP-SWE mice. However, we detected an increase of key hallmarks of AD, including Aβ1-42 levels and BACE1 expression, in the cortices of traumatized transgenic mice. Moreover, significant changes in the expanded endocannabinoid (eCB) system, or endocannabinoidome (eCBome), occurred, including increased levels of the endocannabinoid 2-AG in APP-SWE mice in both the cortex and hippocampus, and N-acylserotonins, detected for the first time in the brain. The gene expression of enzymes for the biosynthesis and inactivation of eCBs and eCB-like mediators, and some of their main molecular targets, also underwent significant changes. We also identified the formation of heteromers between cannabinoid 1 (CB1) and serotonergic 2A (5HT2A) receptors, whose levels increased in the cortex of APP-SWE mTBI mice, possibly contributing to the exacerbated pathophysiology of AD induced by the trauma.

Conclusions

Mild TBI induces biochemical changes in AD genetically predisposed mice and the eCBome may play a role in the pathogenetic link between brain injury and neurodegenerative disorders also by interacting with the serotonergic system.
A pathologic study of Perivascular pTDP-43 Lin bodies in LATE-NC
Authors: Shahidehpour Ryan K. , Nelson Peter T. , Bachstetter Adam D.
Published: July 2024

Background

TAR DNA-Binding Protein 43 (TDP-43) pathological inclusions are a distinctive feature in dozens of neurodegenerative pathologies, including limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC). Prior investigations identified vascular-associated TDP-43-positive micro-lesions, known as “Lin bodies,” located on or near the brain capillaries of some individuals with LATE-NC. This study aimed to investigate the relationship between the accumulation of Lin bodies and glial cells in LATE-NC and the potential co-localization with ferritin, a protein associated with iron storage. Using multiplexed immunohistochemistry and digital pathology tools, we conducted pathological analyses to investigate the relationship between Lin bodies and glial markers (GFAP for astrocytes, IBA1 for microglia) and ferritin. Analyses were conducted on post-mortem brain tissues collected from individuals with pathologically confirmed Alzheimer’s disease neuropathological changes (ADNC) and LATE-NC.

Results

As shown previously, there was a robust association between Lin bodies and GFAP-positive astrocyte processes. Moreover, we also observed Lin bodies frequently co-localizing with ferritin, suggesting a potential link to compromised vascular integrity. Subsequent analyses demonstrated increased astrocytosis near Lin body-positive vessels compared to those without Lin bodies, particularly in ADNC cases. These results suggest that the accumulation of Lin bodies may elicit an increased glial response, particularly among astrocytes, possibly related to impaired vascular integrity.

Conclusions

Lin bodies are associated with a local reactive glial response. The strong association of Lin bodies with ferritin suggests that the loss of vascular integrity may be either a cause or a consequence of the pTDP-43 pathology. The reactive glia surrounding the affected vessels could further compromise vascular function.
Research on the spatiotemporal distribution and factors influencing intangible cultural heritage in Fujian Province from a multiscale perspective
Authors: Han Qile , Tao Fei , Hong Zihan , Qin Guanghui , Wei Yuxin , Chen Yize , Zhou Tong
Published: July 2024

The spatiotemporal distribution of intangible cultural heritage in Fujian Province, China, and the factors that influence it were explored using multiple spatial scales. The samples include five batches of Chinese national-level and six batches of Chinese provincial-level intangible cultural heritage items, totaling 554. The samples involve city-scale, county-scale, and traditional dwellings, and the analysis uses various methods, such as gravity migration theory and the GeoDetector model. The results show that, in terms of historical timescales, the moving trajectory of the center of gravity of the intangible cultural heritage distribution in Fujian Province involves reciprocation from north to south, and the center moves south in time from the pre-Qin period to the modern period. Spatially, intangible cultural heritage in Fujian Province forms an overall aggregate pattern, among which traditional skills fall into an aggregate pattern; five categories, including traditional drama, fall into an aggregate-random pattern; and four categories, including traditional medicine, fall into a random pattern. The traditional art category and other intensive distribution areas are located in coastal areas, and the traditional dance category is scattered in northwestern Fujian Province. Experiments on the factors influencing intangible cultural heritage distribution were conducted at the city and county levels. At the city level, human geography factors, such as the resident population, urbanization rate, and gross domestic product, have a greater influence on distribution. At the county level, the influence of physical geographical factors clearly increases. The dominant factors for coastal cities are the normalized difference vegetation index (NDVI), average precipitation, and coastline, and that for inland cities is elevation. From the perspective of categories, the dominant factors of traditional music and Quyi are human geography factors, and those of other types of intangible cultural heritage are the synergistic effects of physical geography and human geography. The conclusions of this study are helpful for systematically protecting and developing the intangible cultural heritage industry and improving research theories and methodological systems of the spatiotemporal distribution and mechanism influencing intangible cultural heritage.
Peak Oxygen Uptake is Slope Dependent: Insights from Ground Reaction Forces and Muscle Oxygenation in Trained Male Runners
Authors: Lemire Marcel , Meyer Frédéric , Triguera Rosalie , Favret Fabrice , Millet Grégoire P. , Dufour Stéphane P.
Published: July 2024

Background

The aim of this study is to explore the effect of treadmill slope on ground reaction forces and local muscle oxygenation as putative limiting factors of peak oxygen uptake in graded maximal incremental running tests. Thirteen trained male runners completed five maximal incremental running tests on treadmill at − 15%, − 7.5%, 0%, 7.5% and 15% slopes while cardiorespiratory and local muscle oxygenation responses as well as ground reaction forces were continuously recorded. Blood lactate concentration and isometric knee extensor torque were measured before and after each test.

Results

Peak oxygen uptake was lower at − 15% slope compared to all other conditions (from − 10 to − 17% lower, p < 0.001), with no difference between − 7.5 and + 15% slope. Maximal heart rate and ventilation values were reached in all conditions. The negative external mechanical work increased from steep uphill to steep downhill slopes (from 6 to 92% of total external work) but was not correlated with the peak oxygen uptake reduction. Local muscle oxygenation remained higher in − 15% slope compared to level running (p = 0.003).

Conclusions

Similar peak oxygen uptake can be reached in downhill running up to − 7.5% slope. At more severe downhill slopes (i.e., − 15%), greater negative muscle work and limited local muscle deoxygenation occurred, even in subjects familiarized to downhill running, presumably preventing the achievement of similar to other condition’s peak oxygen uptake.

Key Points

Trained male runners can reach like level running V̇O2peak at moderate but not at severe negative slope.

Negative external mechanical work increases with increasing negative slope.

At maximal intensity Vastus Lateralis muscle oxygenation is higher in steep negative slope.

Knee extensor isometric muscle torque is preserved after maximal level and uphill running, but reduced after downhill running, despite lower blood lactate.

Progressive reduction of V̇O2 at maximal effort with increasing negative slope might be related to the metabolic consequences of increased lower limb negative external work (i.e., eccentric muscle actions).
A cognitive-behavioral treatment for suicide prevention among adults with schizophrenia spectrum disorders in community mental health: Study protocol for a pilot feasibility and acceptability randomized clinical trial
Authors: Bornheimer Lindsay A. , Verdugo Juliann Li , Brdar Nicholas M. , Im Vitalis , Jeffers Nakea , Bushnell Courtney B. , Hoener Katie , Tasker Melisa , DeWeese Krista , Florence Timothy , Jester Jennifer M. , King Cheryl A. , Taylor Stephan F. , Himle Joseph A.
Published: July 2024

Background

Suicide is among the leading causes of death for adults with schizophrenia spectrum disorders (SSDs), and there is a paucity of evidence-based suicide prevention-focused interventions tailored for this vulnerable population. Cognitive-Behavioral Suicide Prevention for psychosis (CBSPp) is a promising intervention developed in the UK that required modifications for delivery in community mental health (CMH) settings in the United States of American. This pilot trial evaluates the feasibility, acceptability, and preliminary effectiveness of our modified CBSPp intervention in comparison to services as usual (SAU) within a CMH setting in a Midwestern state of the USA.

Methods

This is a single-site randomized pilot trial with a planned enrollment of 60 adults meeting criteria for both SSD and SI/A. Eligible participants will be randomized 1:1 to either 10 sessions of CBSPp or SAU. Clinical and cognitive assessments will be conducted within a 4-waive design at baseline (prior to randomization and treatment) and approximately 1 month (mid-treatment), 3 months (post-treatment), and 5 months (follow-up) after baseline assessment. Qualitative interviews will also be conducted at post-treatment. The primary objective is to determine whether CBSPp is feasible and acceptable, involving examinations of recruitment rate, treatment engagement and adherence, retention and completion rates, and experiences in the CBSPp treatment and overall study. The secondary objective is to preliminarily evaluate whether modified CBSPp is associated with reductions in clinical (suicide ideation, suicide attempt, symptoms of psychosis, depression, and emergency/hospital service, hopelessness, defeat, and entrapment) and cognitive (information processing biases, appraisals, and schemas) outcomes in comparison to SAU from baseline to post-treatment assessment.

Discussion

This randomized pilot trial will provide clinically relevant information about whether CBSPp can improve SI/A, depression, and psychosis among adults with SSDs. Testing this modified cognitive-behavioral suicide prevention-focused intervention has the potential for a large public health impact by increasing the intervention’s utility and usability in CMH where many individuals with SSDs receive care, and ultimately working towards reductions in premature suicide death.

Trial registration

ClinicalTrials.gov NCT#05345184. Registered on April 12, 2022.
Development and validation of AI-derived segmentation of four-chamber cine cardiac magnetic resonance
Authors: Assadi Hosamadin , Alabed Samer , Li Rui , Matthews Gareth , Karunasaagarar Kavita , Kasmai Bahman , Nair Sunil , Mehmood Zia , Grafton-Clarke Ciaran , Swoboda Peter P. , Swift Andrew J. , Greenwood John P. , Vassiliou Vassilios S. , Plein Sven , van der Geest Rob J. , Garg Pankaj
Published: July 2024

Background

Cardiac magnetic resonance (CMR) in the four-chamber plane offers comprehensive insight into the volumetrics of the heart. We aimed to develop an artificial intelligence (AI) model of time-resolved segmentation using the four-chamber cine.

Methods

A fully automated deep learning algorithm was trained using retrospective multicentre and multivendor data of 814 subjects. Validation, reproducibility, and mortality prediction were evaluated on an independent cohort of 101 subjects.

Results

The mean age of the validation cohort was 54 years, and 66 (65%) were males. Left and right heart parameters demonstrated strong correlations between automated and manual analysis, with a ρ of 0.91−0.98 and 0.89−0.98, respectively, with minimal bias. All AI four-chamber volumetrics in repeatability analysis demonstrated high correlation (ρ = 0.99−1.00) and no bias. Automated four-chamber analysis underestimated both left ventricular (LV) and right ventricular (RV) volumes compared to ground-truth short-axis cine analysis. Two correction factors for LV and RV four-chamber analysis were proposed based on systematic bias. After applying the correction factors, a strong correlation and minimal bias for LV volumetrics were observed. During a mean follow-up period of 6.75 years, 16 patients died. On stepwise multivariable analysis, left atrial ejection fraction demonstrated an independent association with death in both manual (hazard ratio (HR) = 0.96, p = 0.003) and AI analyses (HR = 0.96, p < 0.001).

Conclusion

Fully automated four-chamber CMR is feasible, reproducible, and has the same real-world prognostic value as manual analysis. LV volumes by four-chamber segmentation were comparable to short-axis volumetric assessment.

Trials registration

ClinicalTrials.gov: NCT05114785.

Relevance statement

Integrating fully automated AI in CMR promises to revolutionise clinical cardiac assessment, offering efficient, accurate, and prognostically valuable insights for improved patient care and outcomes.

Key points

• Four-chamber cine sequences remain one of the most informative acquisitions in CMR examination.

• This deep learning-based, time-resolved, fully automated four-chamber volumetric, functional, and deformation analysis solution.

• LV and RV were underestimated by four-chamber analysis compared to ground truth short-axis segmentation.

• Correction bias for both LV and RV volumes by four-chamber segmentation, minimises the systematic bias.

Graphical Abstract
When it itches, dengue switches off: a retrospective case series
Authors: Kamble Niranjan , Kumar Vikram S. , Rangaswamy Darshan Rajatadri , Kavatagi Kiran
Published: July 2024

Background

Dengue fever (DF) is a viral illness caused by the dengue virus transmitted by Aedes aegypti mosquitoe. It manifests with a range of symptoms, from mild DF to severe forms like dengue hemorrhagic fever and dengue shock syndrome. Common symptoms include fever, headache, rash, muscle and joint pain, and itching. The relationship between itching and clinical improvement in dengue patients remains unclear.

Case presentation

A retrospective analysis was conducted on hospital data from a tertiary care centre in South India from April 2021 to April 2023. Patients diagnosed with dengue fever (confirmed by Immunoglobulin (Ig) M and Non-Structural protein (NS) 1 positivity) who experienced itching were included. Clinical details, age, sex, and laboratory findings were collected. A total of 261 patients were examined. Itching typically occurred around day eight from fever onset and was associated with improved platelet count and hematocrit levels.

Conclusions

Dengue fever, caused by the dengue virus, presents with various symptoms, including itching during the recovery phase. Studies suggest a correlation between itching and clinical improvement in dengue patients, indicating itching as a potential prognostic marker. Possible mechanisms for itching include direct viral infection of skin cells and cytokine release. However, further research is needed to understand this association fully. Despite limitations such as retrospective analysis, these findings highlight the significance of itching in dengue prognosis and emphasise the need for large-scale studies.
Atrial fibrillation fact sheet in Korea 2024 (part 1): epidemiology of atrial fibrillation in Korea
Authors: Lee So-Ryoung , Kim Daehoon , Lee Sung Ho , Lim Woo-Hyun , Chun Kwang Jin , Choe Won-Seok , Ahn Hyo-Jeong , Lee Kyung-Yeon , Choi JungMin , Kim Bong-Seong , Han Kyung-Do , Choi Eue-Keun
Published: July 2024

Background and objectives

This study aimed to analyze and present updated trends in atrial fibrillation (AF) epidemiology within the Korean population, providing a foundation for planning and implementing appropriate management and treatment strategies for patients with AF.

Patients and methods

We used the Korean National Health Insurance Service database to evaluate the prevalence, incidence, comorbidities, and clinical adverse outcomes of patients with AF in Korea between 2013 and 2022.

Results

AF prevalence in Korean adults aged ≥ 20 years doubled (1.1 to 2.2%) between 2013 and 2022, with significant increases observed across various sex and age groups. Similarly, the number of newly diagnosed patients with AF per year increased steadily, with the incidence rising from 184 to 275 per 100,000 person-years, particularly among older populations. Over this period, the mean age of patients with AF increased from 67.7 to 70.3 years, and comorbidities prevalence and CHA2DS2-VASc score rose significantly, indicating a higher stroke risk. Compared with patients without AF, AF was associated with an increased risk of mortality (hazard ratio [HR]: 1.78), ischemic stroke (HR: 2.39), major bleeding (HR: 2.10), myocardial infarction (HR: 1.44), and heart failure admission (HR: 2.42).

Conclusion

AF prevalence and incidence have steadily increased between 2013 and 2022, with a more pronounced increase in older patients. Patients with AF are increasingly becoming a high-risk population and are at increased risk of clinical adverse outcomes compared to non-AF patients. Therefore, a sustained national effort to improve AF awareness and comprehensive care quality for patients with AF is required.
Deep Learning-Based Dynamic Risk Prediction of Venous Thromboembolism for Patients With Ovarian Cancer in Real-World Settings From Electronic Health Records
Authors: Lee Dahhay , Kim Seongyoon , Lee Sanghee , Kim Hak Jin , Kim Ji Hyun , Lim Myong Cheol , Cho Hyunsoon
Published: July 2024

PURPOSE

Patients with epithelial ovarian cancer (EOC) have an elevated risk for venous thromboembolism (VTE). To assess the risk of VTE, models were developed by statistical or machine learning algorithms. However, few models have accommodated deep learning (DL) algorithms in realistic clinical settings. We aimed to develop a predictive DL model, exploiting rich information from electronic health records (EHRs), including dynamic clinical features and the presence of competing risks.

METHODS

We extracted EHRs of 1,268 patients diagnosed with EOC from January 2007 through December 2017 at the National Cancer Center, Korea. DL survival networks using fully connected layers, temporal attention, and recurrent neural networks were adopted and compared with multi-perceptron–based classification models. Prediction accuracy was independently validated in the data set of 423 patients newly diagnosed with EOC from January 2018 to December 2019. Personalized risk plots displaying the individual interval risk were developed.

RESULTS

DL-based survival networks achieved a superior area under the receiver operating characteristic curve (AUROC) between 0.95 and 0.98 while the AUROC of classification models was between 0.85 and 0.90. As clinical information benefits the prediction accuracy, the proposed dynamic survival network outperformed other survival networks for the test and validation data set with the highest time-dependent concordance index (0.974, 0.975) and lowest Brier score (0.051, 0.049) at 6 months after a cancer diagnosis. Our visualization showed that the interval risk fluctuating along with the changes in longitudinal clinical features.

CONCLUSION

Adaption of dynamic patient clinical features and accounting for competing risks from EHRs into the DL algorithms demonstrated VTE risk prediction with high accuracy. Our results show that this novel dynamic survival network can provide personalized risk prediction with the potential to assist risk-based clinical intervention to prevent VTE among patients with EOC.
Neoadjuvant Docetaxel, Oxaliplatin, and S-1 Plus Surgery and Adjuvant S-1 for Resectable Advanced Gastric Cancer: Updated Overall Survival Outcomes From Phase III PRODIGY
Authors: Kang Yoon-Koo , Kim Hyung-Don , Yook Jeong Hwan , Park Young-Kyu , Lee Jong Seok , Kim Young-Woo , Kim Jin Young , Ryu Min-Hee , Rha Sun Young , Chung Ik Joo , Kim In-Ho , Oh Sang Cheul , Park Young Soo , Cheong Jae-Ho , Jeong Oh , Heo Mi Hwa , Kim Hark Kyun , Park ChoHyun , Yoo Chang Hak , Kang Seok Yun , Zang Dae Young , Jang You Jin , Sul Ji Young , Kim Jong Gwang , Kim Beom Su , Beom Seung-Hoon , Hwang Jun-Eul , Ryu Seung Wan , Kook Myeong-Cherl , Ryoo Baek-Yeol , Kim Hyunki , Yoo Moon-Won , Lee Nam Su , Lee Sang Ho , Noh Sung Hoon
Published: July 2024

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in
JCO
or elsewhere, for which the primary end point has already been reported.

The phase III PRODIGY study demonstrated that neoadjuvant chemotherapy with docetaxel, oxaliplatin, and S-1 (DOS) followed by surgery and adjuvant S-1 chemotherapy (CSC) improved progression-free survival (PFS) compared with surgery followed by adjuvant S-1 (SC) for patients with resectable locally advanced gastric cancer (LAGC) with clinical T2-3N+ or T4Nany disease. The primary end point was PFS. Overall survival (OS) was the secondary end point. We herein report the long-term follow-up outcomes, including OS, from this trial. A total of 238 and 246 patients were randomly assigned to the CSC and SC arms, respectively, and were treated (full analysis set). As of the data cutoff (September 2022), the median follow-up duration of the surviving patients was 99.5 months. Compared with SC, CSC significantly increased the OS (adjusted hazard ratio [HR], 0.72; stratified log-rank
P
= .027) with an 8-year OS rate of 63.0% and 55.1% for the CSC and SC arms, respectively. CSC also significantly improved the PFS (HR, 0.70; stratified log-rank
P
= .016). In conclusion, neoadjuvant DOS chemotherapy, as part of perioperative chemotherapy, prolonged the OS of Asian patients with LAGC relative to patients treated with surgery and adjuvant S-1. It should be considered one of the standard treatment options for patients with LAGC in Asia.
Pituitary Complications of Checkpoint Inhibitor Use
Authors: Chamorro-Pareja Natalia , Faje Alexander T , Miller Karen K
Published: July 2024

Immune checkpoint inhibitors have revolutionized cancer therapy but are associated with a risk of endocrine immune-related adverse events, including pituitary complications. Autoimmune hypophysitis, traditionally a rare diagnosis, has become a more frequently encountered clinical entity with the emergence of antitumor immunotherapy. This mini-review aims to consolidate current knowledge, encompassing the epidemiology, pathophysiology, clinical presentation, diagnosis, and management of pituitary complications of immune checkpoint inhibitor use.
Insulin Mimicking Mystery: Decoding Recurrent Hypoglycemia
Authors: Sridhar Aarthi , Renzu Mahvish , Mehta Vidhi , Hubers Carly , Ruby Edward
Published: July 2024

Insulin antibody syndrome (IAS), also known as Hirata disease, is a rare condition characterized by spontaneous hypoglycemic episodes unrelated to exogenous insulin exposure. It is caused by elevated serum levels of insulin autoantibodies (IAA). IAS typically occurs when a triggering factor, such as medication or viral infection, interacts with a predisposing genetic background. Diagnosing IAS is challenging due to its rarity and the presence of multiple potential causes for hyperinsulinemic hypoglycemia. The presence of Whipple triad—symptoms of hypoglycemia, low plasma glucose concentration, and relief of symptoms after raising plasma glucose—strongly supports the diagnosis of IAS. However, the detection of IAA is considered the most reliable test. Timely diagnosis can facilitate appropriate treatment and prevent unnecessary imaging studies and invasive procedures, thereby reducing costs. Currently, no definitive guidelines exist for managing IAS. Most management strategies involve supportive measures due to the high rate of spontaneous remission, with hypoglycemia often managed through dietary interventions. However, a few medications have shown benefit. Although predominantly observed in the Japanese population, IAS cases have been reported in other ethnicities, including Caucasians. This report presents a unique case of IAS in an African American male.
The Rocker Technique for Atlantoaxial Dislocation With or Without Basilar Invagination: A Prospective Observational Study
Authors: Bajaj Jitin , Patidar Jayant , Bajaj Diya , Vikram Aditya , Yadav Omprakash , Yadav Nishtha , Sharma Mukesh , Hedaoo Ketan , Sinha Mallika , Ratre Shailendra , Parihar Vijay S. , Swamy M. N. , Yadav Y. R.
Published: July 2024

BACKGROUND AND OBJECTIVES:

Atlantoaxial dislocation (AAD) poses a complex surgical challenge. Surgical approaches vary for reducible and irreducible cases. Challenges persist in reducing the atlantodental interval, especially in cases with oblique or vertical C1-C2 joints. The Rocker instrument (MJ Surgical), a less-explored technique, seeks to simplify instrumentation, reduce complexity, and enhance translation and retroflection reduction of AAD.

METHODS:

This prospective observational study was conducted from January 2022 to July 2023 at a tertiary neurosurgical center. Inclusion criteria covered all age groups with AAD, with or without basilar invagination. Exclusions included medically unstable patients and severe osteoporotic spine conditions. Preoperative assessments included dynamic X-rays, magnetic resonance imaging, and computed tomography scans. The Rocker technique was used, and patients were followed up for 6 to 12 months.

RESULTS:

Fifty-five patients (30 males, 25 females) underwent surgery. The mean age was 40.41 ± 15.01 years. Successful Rocker technique application was observed in 53 cases. Functional outcomes, assessed using Modified Ranawat grading, showed improvement postoperatively. Radiological outcomes revealed a significant reduction in the anterior atlantodental interval (7.21 ± 0.94 to 2.98 ± 0.78). Basilar invagination was reduced in all cases, whenever present. The technique exhibited versatility, applicability in various joint orientations, and cost-effectiveness.

CONCLUSION:

The Rocker technique is a safe and effective alternative for managing both reducible and irreducible AADs, with or without basilar invagination. It simplifies the reduction process, offering advantages over established techniques. Further trials, especially in rotational deformities, are warranted for validation.