bluuebunny/crossref_metadata_2025 huggingface dataset:
Health assessment of mangrove ecosystem of natural protected areas in Guangdong Province, China
Authors: Yang Xitao , Wen Rushu , Qu Ming , Zhang Chunxia , Luo Jianing , Zhu Weidong , Jiang Tong , Liu Xihui , Liu Xinke
Published: September 2024

Introduction

Multiple factors, including human disturbance and environmental change, have caused a significant global mangrove resource loss. Therefore, the Chinese government has restructured mangrove habitats and restored the ecosystem functionality through establishing naturally protected mangrove areas. Despite efforts spanning several years, over 90% of mangrove forests in China have been now integrated into the natural protected area system, with the health status and influencing factors of mangrove ecosystem remaining a pertinent subject for further exploration. Given the intricacies of mangrove ecosystems with complex nonlinear relationships among evaluation factors, it is imperative to adopt scientific methodologies to assess their health status.

Methods

To illustrate this, we conducted a mangrove ecosystem health assessment of natural protected areas of Guangdong Province, China. By employing a fuzzy comprehensive evaluation method and establishing an index system for mangrove ecosystem health assessment.

Results

The results revealed the following findings. (1) Various factors exert differing degrees of influence on mangrove ecosystem health. Notably, the mangrove habitat pattern (weight 47.95%), bird diversity (weight 20.97%), mangrove community (weight 14.31%), water environment (weight 11.76%), and soil sedimentary environment (weight 5.01%) were identified. (2) Overall, the mangrove ecosystem within protected areas of Guangdong exhibited unhealthy signs. There were 4 healthy protected areas (20.00%), 4 areas classified as sub-healthy (20.00%), and 12 were deemed unhealthy (60.00%). (3) Key factors contributing to the compromised health of mangrove ecosystems included the homogenization of mangrove plants, decreased habitat diversity, and exogenous pollution.

Discussion

By planting local mangrove species, scientifically managing the ratio of mangrove cover area to mudflat area, and controlling pollution sources and treating pollutants, the structure of the mangrove ecosystem can be optimized, and the quality of mangrove forest can be improved. These findings can enhance mangrove ecosystem management practices, assist mangrove natural reserve managers in performing targeted mangrove ecological protection and restoration, promote effective management, and contribute to the realization of “harmonious symbiosis” between humanity and nature within mangrove ecosystems.
Comparison of objective visual quality between SMILE and FS-LASIK in moderate-to-high myopia
Authors: Zou Huaxian , Wei Xianxian , Li Lili , Wei Diefeng , Mao Hejuan , Huang Yanyan , Lu Pengfei , Li Ziyu , Zhong Dedong , Chen Qi
Published: September 2024

Purpose

This study aims to compare the changes in the corneal wavefront aberrations and the objective visual quality resulting from two types of eye surgery—small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK)—in patients with moderate-to-high myopia.

Methods

A prospective analysis was performed on 98 eyes of 51 patients who underwent SMILE. Additionally, 88 eyes of 45 patients who underwent FS-LASIK were analyzed. All patients underwent ocular examination preoperatively and at 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal aberrations and objective visual quality were measured using the Optical Quality Analysis System II (OQAS II) and Optical Path Difference Scan III (OPD-Scan III).

Results

At postoperative 1 day and 1 week, there was a statistically significant difference in uncorrected distance visual acuity (UDVA) between SMILE and FS-LASIK (P < 0.05). Postoperative spherical (S), cylinder (C) and spherical equivalent refraction (SE) were similar between the two groups (P > 0.05). In both groups, the absolute magnitude of total higher-aberrations (tHOA), piston, vertical tilt, vertical coma, and spherical aberration (SA) increased after surgery compared to preoperative values (P < 0.05). There was no significant difference in Δhorizontal tHOA, Δhorizontal tilt, Δhorizontal coma, and Δhorizontal trefoil between the two groups (P > 0.05), and the FS-LASIK had higher Δvertical trefoil and ΔSA (P < 0.05) but lower Δpiston, Δvertical tilt, and Δvertical coma than the SMILE group (P < 0.05). There was a rise in objective scattering index (OSI) and a decline in both modulation transfer function (MTF) cutoff and Strehl ratio (SR) after surgery compared to preoperative values in both groups (P < 0.05). There was a statistically significant difference in the OSI at 1 day and 3 months between the two groups (P < 0.05). Postoperative MTF cutoff and SR were similar between the two groups (P > 0.05). Postoperative OSI was positively correlated with corneal tHOA (0.261 ≤ R ≤ 0.483, P < 0.05) and was negatively correlated with vertical tilt and vertical coma (−0.315 ≤ R ≤ −0.209, P < 0.05) in both groups.

Conclusion

While both SMILE and FS-LASIK can effectively correct moderate-to-high myopia, there is an increase in corneal aberrations and a postoperative delay in objective visual quality. The cornea may require a longer recovery period in the SMILE. OPD-Scan III combined with OQAS II is a useful supplementary inspection for assessing the optical quality following refractive surgery.
Autologous serum eye drops for patients with dry eye disease: a systematic review and meta-analysis of randomized controlled trials
Authors: He Chang-Zhu , Zeng Zhao-Jun , Liu Jun Qiao , Qiu Qin , He Yu
Published: September 2024

Background

Dry eye disease (DED) is highly prevalent worldwide, leading to increased medical costs, economic burdens on families and society, and a diminished quality of life for patients. The utilization of autologous serum eye drops (ASEDs) for the treatment of DED is progressively rising.

Objective

To further evaluate the efficacy and safety of ASEDs in the treatment of DED.

Methods

A thorough search for randomized controlled trials (RCTs) was conducted across eight databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, SinoMed, and VIP. This search encompassed the inception of each database up to April 1, 2024, with a specific focus on identifying RCTs evaluating the efficacy and safety of ASEDs for the treatment of DED. Data analysis was conducted utilizing Stata 15.0 software and the Cochrane Risk of Bias Assessment Tool was utilized to appraise the literature’s quality.

Results

The study encompassed 12 RCTs. In comparison to the use of artificial tears (AT), patients diagnosed with DED who utilized ASEDs displayed elevated the Schirmer test (ST) scores [WMD = 2.35, 95% CI (1.45, 3.24), p < 0.001] and tear-film breakup time (TBUT) scores [WMD = 2.83, 95% CI (2.27, 3.39), p < 0.001], decreased Corneal fluorescence staining (CFS) scores [SMD = −2.11, 95% CI (−3.07, −1.15), p < 0.001] and the Ocular Surface Disease Index (OSDI) scores [WMD = −10.54, 95% CI (−13.31, −7.77), p < 0.001], and experienced a reduced frequency of adverse events [RR = 0.36, 95% CI (0.13, 0.99), p = 0.048].

Conclusion

In this study, ASEDs had been shown to enhance tear secretion, extend tear film break-up time, mitigate corneal epithelial damage, ameliorate OSDI scores, and exhibit greater safety compared to AT.
The landscape of perioperative nursing education in Africa: a scoping review
Authors: Wong Maddie , Banda Zione , Nabulime Josephine , Matunda Nira , Nkangala Edina , Silvers Rebecca
Published: September 2024

Background

Not everyone across the globe has access to safe surgical care. There exist stark disparities in surgical mortality between high-income and low-and middle-income countries. Quality perioperative care across the surgical care continuum can mitigate these disparities. Nurses play a vital role in providing quality perioperative care and their competency in perioperative nursing directly impacts surgical outcomes. Across Africa, formal educational opportunities for nurses in perioperative care is not well understood.

Methods

This is an informal scoping review of the existing literature investigating the current state of perioperative nursing education across the African continent. Ten articles were included in the analysis.

Results

Few programs exist across Africa that provide specialized training for nurses in perioperative medicine. Programs that have been formally evaluated show improved knowledge and clinical skills among nurses.

Conclusion

Greater research is necessary to establish a more robust evidence base in support of increasing access to perioperative nursing education to improve patient outcomes. Obstacles remain to designing, implementing, and evaluating new educational programs.
Oral propranolol for the treatment of hemangiomas in high-risk infants: safety and cost analysis of outpatient-initiated therapy
Authors: Su Rina , Qian Hua , Hu Cui , Li Wei , Li JiBin , Wu Bo , Gu Yang , Zhang Ting , Wu YaFen , Qian YingYing , Lu Hui
Published: September 2024

Objectives

To investigate the safety and cost analysis of oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting.

Methods

A total of 41 high-risk infantile hemangioma patients from outpatient settings and 43 from inpatient settings were selected for the study. After routine pre-treatment examinations, patients were administered propranolol in a stepwise incremental dosing regimen over three consecutive days in the outpatient clinic. Changes in heart rate, blood pressure and PR interval before and after medication were compared. On the 10th day post-medication, liver and kidney functions, fasting blood glucose, tumor ultrasonography, and electrocardiogram were re-evaluated. The costs of treatment starting from the outpatient clinic (including pre-treatment examinations and the first three days of treatment) were calculated and compared with those of similarly managed inpatient cases.

Results

The majority of patients exhibited a reduction in heart rate and blood pressure, as well as an extended PR interval after treatment of medication (P < 0.05), which remained within normal limits without clinical symptoms. On the 10th day post-medication, statistical differences in blood biochemistry and electrocardiograms were observed when compared to pre-treatment values (P < 0.05), but all values remained within normal ranges. No severe adverse reactions such as hypoglycemia occurred. Additionally, the cost of treatment from the outpatient clinic was significantly lower than that of inpatient care.

Conclusion

Oral propranolol treatment for high-risk infantile hemangiomas starting from the outpatient setting is associated with few adverse reactions and significantly reduced treatment costs. It is worthy of broader application in hospitals without dermatology wards.
Machine learning for identifying risk of death in patients with severe fever with thrombocytopenia syndrome
Authors: He Qionghan , You Zihao , Dong Qiuping , Guo Jiale , Zhang Zhaoru
Published: September 2024

Background

Severe fever with thrombocytopenia syndrome (SFTS) has attracted attention due to the rising incidence and high severity and mortality rates. This study aims to construct a machine learning (ML) model to identify SFTS patients at high risk of death early in hospital admission, and to provide early intensive intervention with a view to reducing the risk of death.

Methods

Data of patients hospitalized for SFTS in two hospitals were collected as training and validation sets, respectively, and six ML methods were used to construct the models using the screened variables as features. The performance of the models was comprehensively evaluated and the best model was selected for interpretation and development of an online web calculator for application.

Results

A total of 483 participants were enrolled in the study and 96 (19.88%) patients died due to SFTS. After a comprehensive evaluation, the XGBoost-based model performs best: the AUC scores for the training and validation sets are 0.962 and 0.997.

Conclusion

Using ML can be a good way to identify high risk individuals in SFTS patients. We can use this model to identify patients at high risk of death early in their admission and manage them intensively at an early stage.
Analysis of genomic and characterization features of Luteolibacter soli sp. nov., isolated from soil
Authors: An Jing , Xuan Xiaoqi , Wang Yanan , Wu Linwei , Zhou Jizhong , Mu Dashuai
Published: September 2024

The strain designated as Y139T is a novel Gram-stain-negative, aerobic, and non-motile bacterium, was isolated from a soil sample in McClain County, Oklahoma, United States. The cells of strain Y139T were a rod-shaped, with the width of 0.4–0.7 μm and the length of 1.5–2.0 μm. Growth occurred at 20–37°C (optimum, 30°C), pH 5.5–9.5 (optimum, pH 7.0), and 0–1.0% NaCl (w/v) (optimum, 0%). The polar lipid profiles included phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol, phosphatidyldimethylethanolamine, and an unidentified lipid. The major fatty acids included C16:0, iso-C14:0, and C16:1ω9c. Menaquinone-9 (MK-9) was recognized as the only respiratory quinone. Strain Y139T showed the highest 16S rRNA gene sequence similarity to Luteolibacter flavescens MCCC 1K03193T (98.3%). Phylogenetic analysis positioned it within the genus Luteolibacter. The draft genome of strain Y139T consisted of 7,106,054 bp, and contained 5,715 open reading frames (ORFs), including 5,656 coding sequences (CDSs) and 59 RNA genes. The genomic DNA G + C content was found to be 62.5%. Comparing strain Y139T with L. flavescens MCCC 1K03193T and Luteolibacter arcticus CCTCC AB 2014275T, the average nucleotide identity (ANI) values were 80.6 and 82.1%, respectively. Following phylogenetic, physiological, biochemical, and chemotaxonomic analyses, a novel species within the genus Luteolibacter, designated as Luteolibacter soli sp. nov., was proposed for strain Y139T, which was also assigned as the type strain (=KCTC 92644T = MCCC 1H01451T). Further analysis of core genes across 9 Luteolibacter species uncovered significant genomic divergence, particularly in those related to cofactor, vitamin, and energy metabolism. Analysis of biogeographic distribution suggested that lake and soil were the main habitats for the genus Luteolibacter. Additionally, the genus Luteolibacter was sensitive to climate warming and precipitation.
Changes of regional brain activity following Tuina therapy for patients with painful cervical spondylosis: a resting-state fMRI study
Authors: Song Shilong , Fang Yun , Wan Xing , Shen Lili , Hu Yidan , Lu Chao , Yue Tao , Chen Lu , Chen Jianhuai , Xue Mingxin
Published: September 2024

Background

The effectiveness of Tuina therapy has been confirmed in treating pain of patients with cervical spondylosis (CS), however, its therapeutic mechanism is still unclear. This study aimed to observe the changes of regional brain activity following Tuina therapy in patients with painful CS based on resting-state functional magnetic resonance imaging (rs-fMRI) data.

Methods

A total of 27 patients with CS and 27 healthy subjects (HCs) were enrolled in this study. All patients received Tuina therapy every 2 days for 2 weeks. The clinical manifestations of patients were evaluated by the Visual Analog Scale (VAS) and Neck Disability Index (NDI) before and after treatment. In addition, rs-fMRI data were collected and preprocessed in all patients before and after treatment, as well as HCs. HCs underwent a 1-time rs-fMRI scan, whereas CS patients underwent 2-times of rs-fMRI scan. The measure of regional homogeneity (ReHo) was calculated and compared between groups. Finally, relationships between altered brain regions and clinical characteristics were evaluated by Pearson’s correlation analysis.

Results

After Tuina therapy, VAS and NDI scores of patients decreased. Before treatment, CS patients showed higher ReHo values in the left middle temporal gyrus, left thalamus, right anterior and posterior cingulate gyrus, left inferior parietal gyrus and lower ReHo values in the right gyrus rectus when compared with HCs. After treatment, CS patients exhibited higher ReHo values in the left inferior temporal gyrus, right anterior and posterior cingulate gyrus, left inferior parietal gyrus and lower ReHo values in the right rectus gyrus when compared with HCs. CS patients after treatment demonstrated higher ReHo values in the left inferior occipital gyrus when compared with those before treatment. Positive correlations were found between ReHo values of the right rectus gyrus and VAS, NDI scores in CS patients before treatment. Differences of VAS scores between before and after treatment were negatively correlated with ReHo values of the left inferior temporal gyrus in CS patients after treatment.

Conclusion

This study demonstrated the presence of asynchronous activity in certain brain regions in CS patients, which might be associated with pain and cervical spine dysfunction. Tuina therapy might modulate asynchronous activity of abnormal brain regions, which might contribute to the effectiveness of Tuina therapy in alleviating pain and cervical spine dysfunction in CS patients.
Metabolomics and gut microbiota analysis reveal the differential efficacy of areca nut and charred areca nut in treating constipation
Authors: Wang Li-sha , Wu Jiao-xia , Zhang Fang , Huang Yan , Jiang Yue-xia , Li Yong-hui
Published: September 2024

Background

Areca nut (AN) is a traditional Chinese herbal medicine used for centuries to treat gastrointestinal (GI) disorders. Charred AN (CAN) is a processed product of AN with similar therapeutic effects. This study aimed to investigate the therapeutic mechanisms of AN and CAN for constipation via metabolomics and gut microbiota analysis.

Methods

In this study, the rats were randomly divided into 5 groups (n = 6): control, constipation model, positive drug, AN treatment, and CAN treatment groups. Constipation was induced by intragastric administration of loperamide hydrochloride, followed by 14-day treatment with mosapride, AN, or CAN. The efficacy difference between AN and CAN was assessed by evaluating the weight gain, fecal water content, GI transit rate, colonic histopathology, serum levels of GI hormones, gut microbiota, and fecal metabolites.

Results

The results demonstrated that both AN and CAN could alleviate loperamide-induced constipation. Furthermore, they significantly elevated the serum levels of motilin, vasoactive intestinal peptide, substance P, and acetylcholine. 16S rRNA analysis revealed that AN regulated the relative abundance of Bacillus, UCG-005, norank_f_Muribaculaceae, Candidatus_Saccharimonas, and Ruminococcus, whereas CAN modulate the relative abundance of Lactobacillus, Bacillus, norank_f_Muribaculaceae, Ruminococcus, unclassified_f_Oscillospiraceae, and unclassified_f_Prevotellaceae. Moreover, the metabolic profile of AN- and CAN-treated rats was also different, where AN treatment involved pathways of citrate cycle (TCA) and tyrosine, alanine, aspartate, and glutamate metabolisms. Whereas CAN treatment involved pathways of steroid and primary bile acid biosynthesis, as well as pyrimidine and purine metabolisms. Spearman correlation analysis indicated a close relationship between gut microbiota and fecal metabolites.

Conclusion

In summary, this study revealed that AN may protect GI mucosa, enhance GI motility, and alleviate constipation symptoms by regulating the relative abundance of specific gut microbiota (Bacillus, UCG-005, norank_f_Muribaculaceae, Candidatus_Saccharimonas, Ruminococcus) as well as citrate cycle or tyrosine, alanine, aspartate, and glutamate metabolic pathways. Furthermore, CAN was observed to promote gastric emptying and intestinal propulsion, thereby alleviating constipation, by modulating the relative abundance of specific gut microbiota (Lactobacillus, Bacillus, norank_f_Muribaculaceae, Ruminococcus, unclassified_f_Oscillospiraceae, unclassified_f_Prevotellaceae) as well as steroid and primary bile acid biosynthesis, as well as pyrimidine and purine metabolic pathways.
Establishing a risk stratification model to identify clinically high-risk N0 breast cancer who could benefit from regional nodal irradiation: a single institute analysis
Authors: Qi Wei-Xiang , Cao Lu , Ou Dan , Li Shuyan , Xu Cheng , Cai Rong , Xu Haoping , Cai Gang , Chen Jiayi
Published: September 2024

Background

The purpose of this real-world study was to investigate the risk factors for developing recurrence among patients with pathological T1-3N0 breast cancer (BC) treated with breast-conserving surgery (BCS) followed by whole breast irradiation alone (WBI) and identify those clinically high-risk BCs who could benefit from regional nodal irradiation (RNI).

Materials and methods

Female BC patients treated at Shanghai Ruijin hospital from 2009 to 2016 were retrospectively reviewed. The disease-free survival (DFS), breast cancer specific survival (BCSS) and overall survival (OS) were estimated by the Kaplan-Meier method, and survival differences were compared with the log-rank test. Univariate and multivariate analysis was performed using Cox proportional hazards regression analysis. An external validation was conducted by using SEER database.

Results

A total of 622 BC patients treated with BCS+WBI alone were included. With a median follow-up of 82 months, the 7-year OS, BCSS and DFS for the entire cohort was 97%, 99% and 91%, respectively. Multivariable Cox analysis indicated that tumor size (p=0.006), tumor location (p=0.033), lymphovascular invasion (LVI) status (p=0.0028) and Ki-67 index (p=0.051) were independent risk factors for DFS. A scoring system was developed using these four factors and the 7-year DFS and OS were 97% and 96% for patients with 0-1 risk factors, 95% and 82% for patients with ≥2 risk factors (p<0.0001 for DFS, and p=0.0063 for OS). Based on tumor size and tumor location, an external validation by demonstrated that the 7-year OS was 90% and 88% for patients with 0-1 risk factor, which was significantly better than those defined as high-risk BC patients (82%, p<0.0001).

Conclusion

By using our institute database, we establish a risk stratification system for identifying sub-group of pN0 BC patients, who are at high risk for developing recurrence. The results of our study support tailored RT decision-making according to individual risks, which needed to be confirmed in further studies.
DSP-0509, a TLR7 agonist, exerted synergistic anti-tumor immunity combined with various immune therapies through modulating diverse immune cells in cancer microenvironment
Authors: Ota Yosuke , Inagaki Ryosaku , Sumida Kentaro , Nakamura Megumi , Nagai Yasuhiro , Yamamoto Setsuko
Published: September 2024

Toll-like receptor 7 (TLR7) acts as a crucial component of the innate immune system. Upon TLR7 binding to its ligand, myeloid cells, including dendritic cells (DCs) and macrophages, are activated and play vital roles in initiating adaptive immunity. Consequently, TLR7 agonists have been employed in cancer immunotherapy. We have synthesized DSP-0509, a systemic injectable TLR7 agonist, and in this investigation, we examined the effects of DSP-0509 on tumor-infiltrating lymphocytes (TILs) utilizing single-cell RNA sequencing (scRNA-seq) in a mouse model bearing tumors. Our results demonstrated that DSP-0509 induced an expansion of immune cell populations, such as Natural Killer (NK) cells, CD4+ T cells, and CD4+ regulatory T cells (Tregs). Subsequently, we combined an Indoleamine 2,3-dioxygenase 1 (IDO1) inhibitor with DSP-0509 to enhance the antitumor efficacy by reducing Tregs, as DSP-0509 led to an increase in Treg presence within tumors. Our findings demonstrated that this combination therapy effectively reduced Treg infiltration within the tumor, leading to enhanced antitumor activity. To further prevent CD8+ T cell exhaustion, we combined DSP-0509 with an anti-PD-1 antibody and assessed the alterations in TILs using scRNA-seq. Our results indicated that the combination treatment significantly increased the cluster of CD8+ T cells expressing Gzmb, Prf1, Ctla4, and Icos, when compared to the administration of DSP-0509 alone. Additionally, we observed a marked rise in the M1-like macrophage cluster in the combination treatment group compared to the group receiving only DSP-0509. To validate the potential of modulating myeloid cells within the tumor to enhance antitumor efficacy, we combined DSP-0509 with an inhibitor targeting the receptor tyrosine kinase AXL. In bone marrow derived macrophages (BMDMs), the AXL inhibitor further amplified DSP-0509-stimulated TNFα secretion while reducing IL-10 secretion. As a final step, we evaluated the antitumor activity by combining DSP-0509 and the AXL inhibitor in an in vivo tumor model, which demonstrated increased efficacy. In summary, our study elucidated the effects of DSP-0509 on immune activity within the tumor microenvironment. These findings provided valuable insights that pave the way for the development of novel combination immunotherapy strategies.
Disitamab vedotin (RC48) long-term regimen in a post-nephroureterectomy patient with metastases: a case report
Authors: Li Weiping , Jing Suoshi , Zhao Bo , Jiang Wei , Zhang Bin
Published: September 2024

Background

For patients with metastatic upper tract urothelial carcinoma (UTUC), the preferred first-line treatment is platinum-based chemotherapy. Immunotherapy can be considered a subsequent treatment if the chemotherapy is ineffective or the disease progresses. However, how should treatment be administered if immunotherapy is useless and the patient cannot take chemotherapy? Especially in patients who have metastasized after radical nephroureterectomy (RNU).

Case presentation

A 68-year-old woman was admitted to the hospital due to left flank pain for two weeks and was diagnosed with metastatic UTUC after RNU. The patient underwent systemic chemotherapy with gemcitabine and cisplatin (GC), as well as reduced-dose GC, but developed myelosuppression. Immunotherapy was ineffective, so Disitamab vedotin (RC48) was chosen.

Results

Disitamab vedotin (RC48) monotherapy was administered for 13 cycles, during which thyroid function remained normal, the patient responded well to the treatment, and the disease was controlled well. In the subsequent two years of follow-up, there was no disease recurrence.

Conclusion

The long-term treatment regimen with RC48 is feasible for metastatic UTUC after RNU, and RC48 monotherapy is suitable as first-line therapy for selected patients.
Defining intra-tumoral and systemic immune biomarkers for locally advanced head-and-neck cancer – detailed protocol of a prospective, observatory multicenter trial (ImmunBioKHT) and first results of the immunophenotyping of the patients’ peripheral blood
Authors: Donaubauer Anna-Jasmina , Frey Benjamin , Weber Manuel , Allner Moritz , Vogl Christoph , Almajali Omar , Kuczera Lukas , Tamse Henriette , Balk Matthias , Müller Sarina , Eckstein Markus , Zülch Lilli , Mogge Lia , Weissmann Thomas , Fietkau Rainer , Kesting Marco , Iro Heinrich , Gaipl Udo S. , Hecht Markus , Gostian Antoniu-Oreste
Published: September 2024

The approval and effectiveness of immune checkpoint inhibitors in head-and-neck squamous cell carcinoma (HNSCC) highlights the role of the immune system in this tumor entity. HNSCCs not only interacts with the immune system in the tumor tissue, but also induce systemic effects that may be additionally influenced by further factors such as the microbiome. Nonetheless, reliable immunological biomarkers that predict treatment response and outcome in HNSCC patients are lacking. The currently available biomarkers are mainly limited to analyses from tumor biopsies, while biomarkers from liquid biopsies, such as peripheral blood are not well-established. Thus, the here presented trial aims to identify interactions of intra-tumoral and systemic immune responses and to define prognostic immune signatures. Consequently, not only samples from the tumor tissue, but also from peripheral blood and the microbiome will be studied/are being evaluated and correlated with the clinical outcome. In this prospective, multi-center trial, 1000 HNSCC patients and 100 patients in the control cohort with non-tumor head-and-neck surgery will be enrolled. The local immune status from of the tumor and the microbiome will be sampled before treatment. In addition, the systemic immune status from peripheral blood will be analyzed before and after surgery and after the adjuvant and definitive radio-chemotherapy (RCT). Clinical baseline characteristics and outcome will additionally be collected. Data mining and modelling approaches will finally be applied to identify interactions of local and systemic immune parameters and to define prognostic immune signatures based on the evaluated immune markers. Approval from the institutional review board of the Friedrich-Alexander-Universität Erlangen-Nürnberg was granted in December 2021 (application number 21-440-B). By now, 150 patients have been enrolled in the intervention cohort. The results will be disseminated to the scientific audience and the general public via presentations at conferences and publication in peer-reviewed journals.
Case Report: A case of thoracoscopic mediastinal tumor resection in a child with ROHHAD syndrome
Authors: Ma Yangwei , Gao Jia , Huo Lianghong , Wang Fang
Published: September 2024

Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is an exceptionally rare condition. This case report highlights a child diagnosed with ROHHAD syndrome, presenting with a mediastinal tumor. ROHHAD syndrome is characterized by early onset obesity, hypothalamic dysfunction, autonomic dysfunction, inadequate ventilation, suspected seizures, and abnormal behavior. The presence of a mediastinal tumor necessitated surgical intervention. Key considerations during surgery included hypernatremia due to hypothalamic dysfunction, potential airway challenges, preoperative anemia, and hemodynamic fluctuations during the removal of the sizable mediastinal tumor. Comprehensive preparations ensured a safe operation. Notably, some children with this syndrome may exhibit symptoms such as decreased gastrointestinal function, polyuria, and thermoregulatory disturbances. Vigilance is essential during anesthesia assessment in these patients. Anesthesiologists should enhance their knowledge of this condition and tailor their management strategies based on individual clinical presentations and the specific planned surgical procedures.
Flavonoids as therapeutic agents for epilepsy: unveiling anti-inflammatory and antioxidant pathways for novel treatments
Authors: Zhang Ya , Hu Xizhuo , Zou Li-Qun
Published: September 2024

Epilepsy, a chronic neurological disorder affecting millions globally, is often exacerbated by neuroinflammation and oxidative stress. Existing antiepileptic drugs primarily manage symptoms, leaving the disease’s progression largely unaddressed. Flavonoids, ubiquitous plant metabolites with potent anti-inflammatory and antioxidant properties, show promise in epilepsy treatment. Unlike conventional therapies, they target multiple pathophysiological processes simultaneously, offering a comprehensive approach to this complex neurological disorder. This review explores the dual role of flavonoids in mitigating neuroinflammation and reducing oxidative stress through various molecular pathways. By inhibiting key inflammatory mediators and pathways such as NF-κB, MAPK, JNK, and JAK, flavonoids offer neuronal protection. They enhance the body’s natural antioxidant defenses by modulating enzyme activities, including superoxide dismutase, catalase, and glutathione peroxidase. Moreover, flavonoids influence crucial antioxidant response pathways like PI3K/AKT, Nrf2, JNK, and PKA. Despite their therapeutic promise, the low bioavailability of flavonoids poses a considerable challenge. However, cutting-edge strategies, including nanotechnology and chemical modifications, are underway to improve their bioavailability and therapeutic efficacy. These advancements support the potential of flavonoids as a valuable addition to epilepsy treatment strategies.
A kinetic study of fusion burn waves in compressed deuterium–tritium and proton–boron plasmas
Authors: Lavell Michael J. , Kish Ayden J. , Sexton Andrew T. , Evans Eugene S. , Mohammad Ibrahim , Gomez-Ramirez Sara , Scullin William , Borscz Marcus , Pikuz Sergey , Mehlhorn Thomas A. , Tabak Max , Ainsworth Greg , Sefkow Adam B.
Published: September 2024

We present particle-in-cell simulations with Monte Carlo collisions of fusion burn waves in compressed deuterium–tritium and proton–boron plasmas. We study the energy balance in the one-dimensional expansion of a hot-spot by simulating Coulomb collisions, fusion reactions, and bremsstrahlung emission with a Monte Carlo model and inverse bremsstrahlung absorption using a new PIC model. This allows us to self-consistently capture the alpha particle heating and radiative losses in the expanding hot-spot and surrounding cold fuel. After verifying our model in a code-to-code comparison with both kinetic and fluid codes for the case of a deuterium–tritium hot-spot, we simulate the expansion of a proton–boron hot-spot initialized at 200 keV and 1,000 g/cm3. Our model predicts that energy radiated by the hot-spot is recaptured by the surrounding high-density opaque fuel reducing the expansion work done by the propagating burn wave. As a result, we find the net fusion energy produced over the course of $20$∼ps is twice the initial hot-spot energy independent of whether radiation physics is included.
Therapeutics for sickle cell disease intravascular hemolysis
Authors: Xue Jianyao , Li Xiang-An
Published: September 2024

Sickle cell disease (SCD) is a genetic disorder predominantly affecting individuals of African descent, with a significant global health burden. SCD is characterized by intravascular hemolysis, driven by the polymerization of mutated hemoglobin within red blood cells (RBCs), leading to vascular inflammation, organ damage, and heme toxicity. Clinical manifestations include acute pain crises, hemolytic anemia, and multi-organ dysfunction, imposing substantial morbidity and mortality challenges. Current therapeutic strategies mitigate these complications by increasing the concentration of RBCs with normal hemoglobin via transfusion, inducing fetal hemoglobin, restoring nitric oxide signaling, inhibiting platelet-endothelium interaction, and stabilizing hemoglobin in its oxygenated state. While hydroxyurea and gene therapies show promise, each faces distinct challenges. Hydroxyurea’s efficacy varies among patients, and gene therapies, though effective, are limited by issues of accessibility and affordability. An emerging frontier in SCD management involves harnessing endogenous clearance mechanisms for hemolysis products. A recent work by Heggland et al. showed that CD-36-like proteins mediate heme absorption in hematophagous ectoparasite, a type of parasite that feeds on the blood of its host. This discovery underscores the need for further investigation into scavenger receptors (e.g., CD36, SR-BI, SR-BII) for their possible role in heme uptake and detoxification in mammalian species. In this review, we discussed current SCD therapeutics and the specific stages of pathophysiology they target. We identified the limitations of existing treatments and explored potential future developments for novel SCD therapies. Novel therapeutic targets, including heme scavenging pathways, hold the potential for improving outcomes and reducing the global burden of SCD.
The therapeutic potential of exercise for improving mobility in multiple sclerosis
Authors: Locatelli Giuseppe , Stangel Martin , Rooks Daniel , Boesch Julian , Pierrel Eliane , Summermatter Serge
Published: September 2024

Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation and demyelination in the central nervous system (CNS) with subsequent axonal and neuronal degeneration. These changes are associated with a broad range of symptoms including skeletal muscle dysfunction. Importantly, musculoskeletal impairments manifest in various ways, compromise the quality of life and often precede the later development of mobility disability. As current standard disease modifying therapies for MS predominantly act on neuroinflammation, practitioners and patients face an unmet medical need for adjunct therapies specifically targeting skeletal muscle function. This review is intended to detail the nature of the skeletal muscle dysfunctions common in people with MS (pwMS), describe underlying intramuscular alterations and outline evidence-based therapeutic approaches. Particularly, we discuss the emerging role of aerobic and resistance exercise for reducing the perception of fatigue and increasing muscle strength in pwMS. By integrating the most recent literature, we conclude that both exercise interventions should ideally be implemented as early as possible as they can address MS-specific muscle impairments. Aerobic exercise is particularly beneficial for pwMS suffering from fatigue and metabolic impairments, while resistance training efficiently counters muscle weakness and improves the perception of fatigue. Thus, these lifestyle interventions or possible pharmacological mimetics have the potential for improving the general well-being and delaying the functional declines that are relevant to mobility.
PagSOD2a improves poplar salt tolerance by elevating superoxide dismutase activity and decreasing malondialdehyde contents
Authors: Zhou Lieding , Yu Changhong , Nan Siyuan , Li Yajing , Hu Jia , Zhao Kai , Guo Jinping , Wang Shengji
Published: September 2024

Superoxide dismutase (SOD) is widely present in plants and plays a crucial role in defending against oxidative stress and preventing tissue damage. This study discovered that the PagSOD2a gene in 84K poplar (Populus alba × P. glandulosa) exhibits a distinct capacity to be induced in response to salt stress. To delve into the pivotal role of PagSOD2a in conferring salt tolerance, the entire PagSOD2a fragment was successfully cloned from 84K poplar and the potential function of PagSOD2a was explored using bioinformatics and subcellular localization. PagSOD2a was found to encode a CuZn-SOD protein localized in chloroplasts. Furthermore, six CuZn-SOD family members were identified in poplar, with closely related members displaying similar gene structures, indicating evolutionary conservation. Morphological and physiological indexes of transgenic 84K poplar overexpressing PagSOD2a (OE) were compared with non-transgenic wild-type (WT) plants under salt stress. The OE lines (OE1 and OE3) showed improved growth performance, characterized by increased plant height and fresh weight, along with reduced malondialdehyde (MDA) content and electrolyte leakage rate under salt stress. Meanwhile, overexpression of PagSOD2a significantly augmented CuZn-SOD and total SOD enzyme activities, leading to a reduction in superoxide anion accumulation and an enhancement of salt tolerance. Additionally, co-expression and multilayered hierarchical gene regulatory network (ML-hGRN) mediated by PagSOD2a constructed using transcriptome data revealed that PagSOD2a gene may be directly regulated by SPL13, NGA1b and FRS5, as well as indirectly regulated by MYB102 and WRKY6, in response to salt stress. These findings provide a theoretical and material foundation for further elucidating the function of PagSOD2a under salt stress and for developing salt-tolerant poplar varieties.
Gender differences in relation of gender role attitudes and happiness—a mixed-methods research from China
Authors: Chen Yanan , Zhang Xubin
Published: September 2024

The gender equality movement represents a monumental advancement in human civilization, liberating countless women worldwide politically, socially, and economically. Intuitively, women are expected to experience greater happiness from the concept of gender equality, while men may see diminished benefits as gender oppression fades away. However, in China, the data indicates a surprising trend: men seem to derive more happiness from gender equality than women. This phenomenon often occurs in countries where gender equality has been achieved, known as the gender equality paradox, while it is relatively rare in countries in transition. In response to this contradiction, a mixed-methods research approach was adopted, utilizing cross-sectional data from the Chinese General Social Survey (CGSS) and conducting interviews with 10 participants. In the context of China, happiness increases with gender-egalitarian attitudes, with men experiencing a more pronounced boost. Upon investigation, Women with egalitarian values, unlike traditional counterparts, are less tolerant of sexual unfairness, limiting women’s happiness growth. Conversely, Chinese men with an equality mindset find greater happiness through benefits like economic relief, reduced family responsibilities, and positive emotional values. To address this incongruity, The government and society should collaborate to overcome the resistance encountered in the practical realization of gender equality, eliminate gender discrimination and opposition, and ensure alignment between the concept and practice of gender equality.
Mental health of individuals at increased suicide risk after hospital discharge and initial findings on the usefulness of a suicide prevention project in Central Switzerland
Authors: Werdin Sophia , Fink Günther , Rajkumar Sarah , Durrer Michael , Gurtner Caroline , Harbauer Gregor , Warnke Ingeborg , Wyss Kaspar
Published: September 2024

Background

Supporting individuals in managing their suicidality can prevent suicidal behavior. This study evaluated the suicide prevention project SERO, which was launched in Central Switzerland in 2021. SERO comprises four components: the suicide risk assessment technique PRISM-S, a personal safety plan, mental health first aid courses for relatives, and a self-management app. We assessed the mental health of individuals at increased suicide risk after hospital discharge and evaluated the usage and usefulness of SERO components.

Methods

A cross-sectional study targeted former patients of Lucerne Psychiatry with an increased suicide risk. Between March 2023 and March 2024, we collected data from 24 individuals through a questionnaire administered six months post-discharge. Descriptive statistics characterized sociodemographics, assessed self-efficacy, self-management, and health literacy, and analyzed the usage and usefulness of SERO components. Associations between the usage of SERO components and mental health outcomes were investigated using Wilcoxon rank sum tests.

Results

Mental health assessments indicated, on average, low to moderate levels of self-efficacy, self-management, and health literacy, with substantial variations across individuals. Participants’ exposure to SERO components varied: 83% used PRISM-S for suicide risk assessment, 67% developed a personal safety plan, 38% used the SERO app, and 8% reported that their relatives participated in a mental health first aid course. 50% of safety plan users and 44% of SERO app users found the tools helpful before or during a suicidal crisis. 78% of SERO app users would recommend the app to others.

Conclusion

Low to moderate levels of self-efficacy, self-management, and health literacy underscore the need for targeted interventions to support individuals at suicide risk. Positive feedback on the personal safety plan and the SERO app suggests their potential effectiveness in helping individuals manage their suicidality. Therefore, integrating structured measures for promoting self-management into standard care protocols in psychiatric hospitals and into patients’ lives may contribute to preventing suicides. The main limitation of our study is its small sample size. Future larger-scale studies should investigate user experiences in detail, assess the causal effects of SERO components on specific mental health and suicide outcomes, and evaluate the cost-effectiveness of each component separately and in combination.
Exploring the neural link between childhood maltreatment and depression: a default mode network rs-fMRI study
Authors: Lin Jian , Huang Jialing , Wu Yun , Zhou Linqi , Qiao Changyuan , Xie Jian , Hu Changchun
Published: September 2024

Background

Childhood maltreatment (CM) is increasingly recognized as a significant risk factor for major depressive disorder (MDD), yet the neural mechanisms underlying the connection between CM and depression are not fully understood. This study aims to deepen our understanding of this relationship through neuroimaging, exploring how CM correlates with depression.

Methods

The study included 56 MDD patients (33 with CM experiences and 23 without) and 23 healthy controls. Participants were assessed for depression severity, CM experiences, and underwent resting-state functional MRI scans. Independent Component Analysis was used to examine differences in functional connectivity (FC) within the Default Mode Network (DMN) among the groups.

Results

MDD patients with CM experiences exhibited significantly stronger functional connectivity in the left Superior Frontal Gyrus (SFG) and right Anterior Cingulate Cortex (ACC) within the DMN compared to both MDD patients without CM experiences and healthy controls. FC in these regions positively correlated with Childhood Trauma Questionnaire scores. Receiver Operating Characteristic (ROC) curve analysis underscored the diagnostic value of FC in the SFG and ACC for identifying MDD related to CM. Additionally, MDD patients with CM experiences showed markedly reduced FC in the left medial Prefrontal Cortex (mPFC) relative to MDD patients without CM experiences, correlating negatively with Childhood Trauma Questionnaire scores.

Conclusion

Our findings suggest that increased FC in the ACC and SFG within the DMN is associated with CM in MDD patients. This enhanced connectivity in these brain regions is key to understanding the predisposition to depression related to CM.
Promoting menstrual health and hygiene—insights from the 2023 World Menstrual Hygiene Day celebration events in the Hohoe municipality in Ghana
Authors: Gbogbo Sitsofe , Wuresah Israel , Addo Phyllis , Klomegah Senam , Gbogbo Emmanuel , Axame Wisdom , Klutse Priscilla , Makam Christopher , Dowou Robert Kokou , Nelson Paramount Eli , Boateng Ishmael , Mantey Sarah Odi , Kugbey Nuworza , Doku Victor Christian Korley , Hennegan Julie , Baiden Frank E. , Aziato Lydia , Binka Fred N.
Published: September 2024

The 2023 World Menstrual Hygiene Day (WMHD) celebration at the University of Health and Allied Sciences (UHAS) sought to create awareness about menstruation. Toward normalizing menstruation, the 3-day event brought together key stakeholders and engaged community members on various topics relating to menstruation. Among the stakeholders were basic school teachers (13), school children (155), in a 2:1 female vs. male ratio within the ages of 10–17 years, School Health and Education Program Coordinators (2), Health Officers (4), Academicians (15), University students (35), Media representatives (3), and Civil society representatives (130). Particular among these discussions were the biology of menstruation, nutrition related facts during menstruation, sociocultural, and mental health issues surrounding menstruation. These discussions were intended to incite more conversations about menstruation, and contribute toward the agenda 2030 goal of making menstruation a normal fact of life. The paper describes activities conducted to improve menstrual health, reduce period poverty, and involve men in breaking the stigma around menstruation. This contributes to creating supportive environments for menstruating individuals. Meanwhile, the lessons from the activities to celebrate WMHD in Ghana are relevant for other communities to consider replicating with consideration for contextual differences.