bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Wnt Signaling Pathway Aberrations in Metastatic Prostate Cancer
Authors: Choi Sharon H. , Pan Elizabeth , Elliott Andrew , Beltran Himisha , Panian Justine , Jamieson Christina , Bagrodia Aditya , Rose Brent , Herchenhorn Daniel , Heath Elisabeth , Nabhan Chadi , Antonarakis Emmanuel S. , McKay Rana R.
Published: June 2024

Wnt (wingless-type) signaling pathway (WSP) alterations have been identified in patients with prostate cancer and are implicated in disease progression and hormonal resistance. In this study, we utilized a multi-institutional dataset to characterize molecular alterations in the canonical and noncanonical WSPs in prostate cancer. Patients with prostate cancer who underwent tissue-based genomic sequencing were investigated. Tumors with somatic activating mutations in CTNNB1 or RSPO2 or inactivating mutations in either APC or RNF43 were characterized as having aberrant canonical Wnt signaling (WSP-activated). Overall survival analyses were restricted to microsatellite-stable (MSS) tumors lacking RNF43 G659fs* mutations. We also investigated noncanonical WSP by evaluation of ROR1, ROR2, and WNT5 in WSP-activated versus WSP wild-type (WSP-WT) tumors. Of 4,138 prostate cancer samples, 3,684 were MSS. Among MSS tumors, 42.4% were from metastatic sites, of which 19.1% were WSP activated, and 57.6% were from the prostate, of which 10.1% were WSP activated. WSP-activated tumors were more prevalent in metastatic sites than in primary prostate cancer. WSP-activated prostate cancer exhibited more SPOP mutations and higher expression of canonical WSP activators than WSP-WT tumors. ROR1 gene expression was elevated in WSP-activated tumors from both primary and metastatic sites. M2 macrophages predominated the tumor microenvironment in WSP-activated tumors. There was no significant difference in overall survival between patients with WSP-activated and WSP-WT prostate cancer. WSP-activated prostate cancer demonstrated a more immunosuppressed tumor microenvironment and a pronounced upregulation of ROR1 gene expression, underscoring its potential involvement in the crosstalk between canonical and noncanonical WSPs.

Implications: Our findings may provide a rationale for developing novel therapeutic strategies targeting Wnt-activated prostate cancer.
Figure 2 from Cancer-Related Fatigue and the Additive Effect of Treatment in the Context of Lymphoma: An Analysis of the Lymphoma Coalition’s 2022 Global Patient Survey
Authors: Kalloger Steve E. , Watson Amanda , Sajkowski Shawn , Warwick Lorna
Published: June 2024

The effect of age and biological sex on the probability of experiencing CRF as a symptom, side effect, or both. A and B, For patients with DLBCL, the probability of experiencing CRF as both a symptom and side effect increases by a factor of 1.37 for females relative to males given a static age of 50 years. C and D, Similar but milder phenomenon for patients with follicular lymphoma. Increasing age was also associated with experiencing CRF as both a symptom and side effect. In contrast, the way CRF was experienced by patients with mantle cell lymphoma was not influenced by biological sex but rather age. A 30-year increase in age saw the increase in the probability of experiencing CRF as both a symptom and a side effect by a factor of 2.21 (E and F).
FIGURE 2 from Cancer-related Fatigue and the Additive Effect of Treatment in the Context of Lymphoma: An Analysis of the Lymphoma Coalition's 2022 Global Patient Survey
Authors: Kalloger Steve E. , Watson Amanda , Sajkowski Shawn , Warwick Lorna
Published: June 2024

The effect of age and biological sex on the probability of experiencing CRF as a symptom, side effect or both. Panels A and B demonstrate that for patients with DLBCL, the probability of experiencing CRF as both a symptom and side effect increases by a factor of 1.37 for females relative to males given a static age of 50 years. Panels C and D demonstrate a similar but milder phenomenon for patients with follicular lymphoma. Increasing age was also associated with experiencing CRF as both a symptom and side effect. In contrast, the way CRF was experienced by patients with mantle cell lymphoma was not influenced by biological sex but rather age. A 30 year increase in age saw the probability of experiencing CRF as both a symptom and a side-effect increase by a factor of 2.21 (E and F).
Differential Deep RNA Sequencing for Diagnostic Detection of Microbial Infections in Inflammatory Cardiomyopathy
Authors: Huang Weihua , Yin Changhong , Lento Patrick A. , Adem Patricia V. , Dimitrova Nevenka , Fallon John T.
Published: June 2024

BACKGROUND:

Inflammatory heart disease can be triggered by a variety of causes, both infectious and noninfectious in nature. We hypothesized that inflammatory cardiomyopathy is potentially related to microbial infection.

METHODS:

In this retrospective study, we used deep RNA sequencing on formalin-fixed paraffin-embedded heart tissue specimens to detect pathogenic agents. We first investigated 4 single-sample cases to test the feasibility of this diagnostic protocol and further 3 control-sample paired cases to improve the protocol with differential metatranscriptomics next-generation sequencing (mtNGS) analysis.

RESULTS:

We demonstrate that differential mtNGS allows identification of various microbials as potentially pathogenic, for example,
Cutibacterium acnes
,
Corynebacterium aurimucosum
, and
Pseudomonas denitrificans
, which are usually commensal in healthy individuals. Differential mtNGS also allows characterization of human host response in each individual by profiling alterations of gene expression, networked pathways, and inferred immune cell compositions, information of which is beneficial for us to understand different etiologies and immunity roles in each case. Additionally, differential mtNGS allows the identification of genetic variants in patients that may contribute to their susceptibility to particular microbial infections.

CONCLUSIONS:

The demonstrated power of differential mtNGS in simultaneous capture of both the infectious microbial(s) and the status of human host immune response could help us better understand the pathogenesis of complex inflammatory cardiomyopathy, if conducted on a larger scale of the population. The developed differential mtNGS method could also shed light on its translation and adoption of such a laboratory test in clinic practice, allowing for a more effective diagnosis to guide therapeutic treatment of the disease.
A new species in the Cyrtodactylus intermedius (Squamata: Gekkonidae) group from an isolated limestone karst formation in southwestern Cambodia
Authors: CHHIN SOPHEA , NEANG THY , CHAN SOMALY , KONG KIMSRENG , OU RATANAK , IN VISATHA , SAMORN VIREAK , SOR RATHA , LOU VANNY , SIN SOPHA , CHHIM MENG , STUART BRYAN L. , GRISMER L. LEE
Published: June 2024

The gekkonid lizard Cyrtodactylus intermedius was formerly considered to be a single widespread species in hilly areas across eastern Thailand through southern Vietnam but has recently been partitioned into a complex of 12 nominal species across its range. A population belonging to the C. intermedius group was recently found in an isolated limestone karst block in Kampot Province in southwestern Cambodia, part of which lies within the recently designated Phnom Preah Kuhear Loung Natural Heritage Site. Comparisons of morphometric, meristic, qualitative morphological and color pattern data, as well as a molecular analysis using the mitochondrial ND2 gene, revealed that this population differs from all other named members of the C. intermedius group, and so is described here as a new species. The karst-dwelling C. regicavernicolus sp. nov. was recovered as the sister species to C. laangensis, the most geographically proximate member of the complex and one that is also restricted to a small limestone karst habitat.
On the subgenus Eurysunius Reitter of Turkey IX. Three new species from central northern Anatolia, with an identification key to Turkish species (Coleoptera: Staphylinidae: Paederinae, Astenus)
Authors: ANLAŞ SİNAN
Published: June 2024

In this study, three new species belonging to the subgenus Eurysunius Reitter of the genus Astenus Dejean (Coleoptera: Staphylinidae: Paederinae) are described and illustrated from central northern Anatolia, in Turkey, and compared with the related species: Astenus corumensis sp. n. and A. hititicus sp. n. (Çorum province), and A. kaspareki sp. n. (Amasya province). A improved key to Turkish species of Eurysunius is provided as well. The distributions of 28 species in Turkey are mapped.
Strong Skin Cooling and Its Impacts on Lake Thermal Processes in a Large Lake on the Tibetan Plateau
Authors: Ma Xiaogang , Yang Kun , Wang Binbin , Li Zhaoguo , Lazhu  , Lu Hui , Yao Xiangnan , Chen Xin
Published: June 2024

Skin cooling, wherein the surface temperature of a water body Tskin is lower than the temperature below the surface, is a widespread phenomenon. Previous studies have almost ignored this effect on the Tibetan Plateau (TP), despite the presence of thousands of lakes on the TP and the fact that extraordinary solar heating leads to very strong energy exchanges on the lake surfaces. This study utilizes in situ observations and MODIS-derived Tskin data at Lake Nam Co, one of the largest lakes on the TP, to quantify the skin cooling effect. The observed nighttime skin cooling is approximately 0.52°C on average, with the maximum of about 1°C, during the lake water turnover period (from October to mid-November), which obviously surpasses reported values for oceans (less than 0.4°C). To understand the impact of the skin cooling on the lake thermal processes, a skin cooling parameterization is validated and incorporated into the WRF-lake model. Simulations with the updated model show that accounting for the skin cooling process systematically lowers sensible and latent heat fluxes by a few watts per square meter, which yields an increase in water temperature by 0.45°C at the end of December and may delay the onset of lake freeze. Finally, we show that the inclusion of the skin cooling process in a lake model needs simultaneous adjustment of the parameterization of heat/water vapor transfer.

Significance Statement

Skin cooling is a widespread phenomenon for a water surface, and its intensity depends on the energy flux exchange of the water surface. The Tibetan Plateau possesses the presence of thousands of lakes, but early studies have ignored the skin cooling effect. We found that the nighttime skin cooling magnitude during the lake water turnover period in this region obviously exceeds reported values for oceans, due to the strong surface energy exchange in the Tibetan Plateau. Neglecting the skin cooling process may lead to systematic overestimation of turbulent heat fluxes and underestimation of water temperature. We highlight that accounting for this skin cooling process is crucial to select appropriate parameterization schemes for heat/water vapor transfer in lake thermal process modeling.
Distilling the Fundamentals of Evidence-Based Public Health Policy
Authors: Kelly Megan A. , Puddy Richard W. , Siddiqi Sameer M. , Nelson Christopher , Ntazinda Alexandra H. , Kucik James E. , Hall Diane , Murray Christian T. , Tomoaia-Cotisel Andrada
Published: June 2024

Public health policy interventions are associated with many important public health achievements. To provide public health practitioners and decision makers with practical approaches for examining and employing evidence-based public health (EBPH) policy interventions, we describe the characteristics and benefits that distinguish EBPH policy interventions from programmatic interventions. These characteristics include focusing on health at a population level, focusing on upstream drivers of health, and involving less individual action than programmatic interventions. The benefits of EBPH policy interventions include more sustained effects on health than many programs and an enhanced ability to address health inequities. Early childhood education and universal preschool provide a case example that illustrates the distinction between EBPH policy and programmatic interventions. This review serves as the foundation for 3 concepts that support the effective use of public health policy interventions: applying core component thinking to understand the population health effects of EBPH policy interventions; understanding the influence of existing policies, policy supports, and the context in which a particular policy is implemented on the effectiveness of that policy; and employing a systems thinking approach to identify leverage points where policy implementation can have a meaningful effect.
Finite time non-singular terminal synergistic control of hydraulic servo system considering time-varying disturbance
Authors: Zhou Xin , Xu Zhangbao , Yang Xu
Published: June 2024

This paper introduces a novel control strategy combining a hybrid nonlinear disturbance observer with a finite-time synergistic control approach for hydraulic servo systems, focusing on compensating time-varying disturbances and suppresses chattering. Recognizing the critical challenges posed by these disturbances and the chattering phenomenon in hydraulic servo systems, our work offers significant advancements in enhancing system robustness and control precision. Through meticulous classification and handling of matched and unmatched disturbances, the study unveils a dual-channel finite-time disturbance observer capable of simultaneously addressing both disturbance types with high accuracy, particularly focusing on the often overlooked and challenging to observe friction effects. Key contributions include the pioneering integration of cooperative control theory with sliding mode control, employing fractional-order terms to minimize chattering, thereby improving system stability. The experimental evaluation underlines the proposed controller’s superior performance over traditional control strategies, including PID, TSMC, and SMC, under both low and high-frequency operational conditions. Notably, the proposed FTNTSC controller demonstrates exceptional robustness and effectiveness, with significantly lower performance degradation when transitioning from low to high-frequency conditions compared to its counterparts.
Computational thinking through the lens of biological evolution learning: enhancing understanding through the levels of biological organization and computational complexity
Authors: Christensen Dana , Lombardi Doug
Published: June 2024

Research on exploring the relationship between computational thinking and domain specific knowledge gains (i.e. biological evolution) are becoming more common in science education research. The mechanisms behind these relationships are not well understood, particularly between computational practices and biological evolution content knowledge. Increased computational complexity (i.e. simple to complex) may support a greater comprehension of scales or levels of biological organization (i.e. micro to macro) within the context of biological evolution learning. We made use of quantitative methods from qualitative work in the form of coding and relational analysis to identify which biological levels of organization students addressed, how students made connections between these levels and the level of computational complexity displayed during evolution learning with the use of two computational interventions. The aim of this study was not only exploring the biological levels and biological level connections made during the computational thinking interventions, but also analysis of the differences between these two interventions. The results illuminated that use of specific biological levels, biological level connections and differences in computational complexity were distinguishable and there were significant differences between the interventions. These factors may contribute to better understanding of biological evolution knowledge gains.
Association between metal exposures and periodontitis among U.S. adults: the potential mediating role of biological aging
Authors: Dai Zhida , Fu Yingyin , Tan Yuxuan , Yu Xinyuan , Cao Yixi , Xia Yian , Jing Chunxia , Zhang Chunlei
Published: June 2024

Background

This study aimed to investigate the associations between metal exposures and periodontitis among U.S. adults, as well as the mediated effect of biological aging.

Methods

Using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014, we explored the single and mixed impacts of metal exposures on periodontitis through adjusted weighted logistic regression, robust Poisson regression, restricted cubic spline regression, and Bayesian kernel machine regression models. This study included 2,393 participants, with 46.9% experiencing periodontitis. Concentrations of nine urinary metals, including barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), thallium (Tl), tungsten (Tu), and uranium (Ur), were measured using inductively coupled plasma-mass spectrometry. In addition, we analyzed the association between metals and periodontitis, stratified by age, body mass index, gender, and smoking status. Mediation models were also applied to investigate the mediated effects of biological aging between metal exposures and periodontitis.

Results

Weighted logistic and robust Poisson regression identified positive associations between Cd, Pb and periodontitis (P < 0.05). BKMR analyses indicated that mixed metal exposures were significantly associated with periodontitis, particularly among smokers, second-hand smokers, and males, with Cd, Pb, Tl, and Ba contributing the most. Furthermore, subgroup analyses observed a modifying effect on the associations between urinary Cd, Pb and periodontitis in stratified gender and BMI subgroups in robust Poisson regression. Phenotype age was found to mediate the association between metals and periodontitis.

Conclusions

This study identified significant positive associations between metal exposures and periodontitis in the U.S. adults. In addition, the association between metal exposures and periodontitis could vary in different gender, BMI and smoking subgroups. These associations were likely partly mediated by biological aging, suggesting that metals may potentially increase the risk of periodontitis by promoting cell senescence and overall aging of the body.

Graphical Abstract
A metagenomic investigation of the faecal RNA virome structure of asymptomatic chickens obtained from a commercial farm in Durban, KwaZulu-Natal province, South Africa
Authors: Nwokorogu Vivian C. , Pillai Santhosh , San James E. , Pillay Charlene , Nyaga Martin M. , Sabiu Saheed
Published: June 2024

Background

Virome studies on birds, including chickens are relatively scarce, particularly from the African continent. Despite the continuous evolution of RNA viruses and severe losses recorded in poultry from seasonal viral outbreaks, the information on RNA virome composition is even scantier as a result of their highly unstable nature, genetic diversity, and difficulties associated with characterization. Also, information on factors that may modulate the occurrence of some viruses in birds is limited, particularly for domesticated birds. Viral metagenomics through advancements in sequencing technologies, has enabled the characterization of the entire virome of diverse host species using various samples.

Methods

The complex RNA viral constituents present in 27 faecal samples of asymptomatic chickens from a South African farm collected at 3-time points from two independent seasons were determined, and the impact of the chicken’s age and collection season on viral abundance and diversity was further investigated. The study utilized the non-invasive faecal sampling method, mRNA viral targeted enrichment steps, a whole transcriptome amplification strategy, Illumina sequencing, and bioinformatics tools.

Results

The results obtained revealed a total of 48 viral species spanning across 11 orders, 15 families and 21 genera. Viral RNA families such as Coronaviridae, Picornaviridae, Reoviridae, Astroviridae, Caliciviridae, Picorbirnaviridae and Retroviridae were abundant, among which picornaviruses, demonstrated a 100% prevalence across the three age groups (2, 4 and 7 weeks) and two seasons (summer and winter) of the 27 faecal samples investigated. A further probe into the extent of variation between the different chicken groups investigated indicated that viral diversity and abundance were significantly influenced by age (P = 0.01099) and season (P = 0.00099) between chicken groups, while there was no effect on viral shedding within samples in a group (alpha diversity) for age (P = 0.146) and season (P = 0.242).

Conclusion

The presence of an exceedingly varied chicken RNA virome, encompassing avian, mammalian, fungal, and dietary-associated viruses, underscores the complexities inherent in comprehending the causation, dynamics, and interspecies transmission of RNA viruses within the investigated chicken population. Hence, chickens, even in the absence of discernible symptoms, can harbour viruses that may exhibit opportunistic, commensal, or pathogenic characteristics.
Store-and-forward teledermatology in a Spanish health area significantly increases access to dermatology expertise
Authors: Sánchez-Martín Elena , Moreno-Sánchez Isabel , Morán-Sánchez Marta , Pérez-Martín Miguel , Martín-Morales Manuel , García-Ortiz Luis
Published: June 2024

Introduction

Teledermatology is the practice of dermatology through communication technologies. The aim of this study is to analyze its implementation in a Spanish health area during its first two years.

Methods

Cross-sectional descriptive study. It included interconsultations between dermatologists and family physicians in the Salamanca Health Area (Spain) after the implementation of the non-face-to-face modality over a period of two consecutive years. A total of 25,424 consultations were performed (20,912 face-to-face and 4,512 non-face-to-face); 1000 were selected by random sampling, half of each modality. Main measures: referral rate, response time and resolution time, type of pathology, diagnostic concordance, and quality of consultation.

Results

The annual referral rate was 42.9/1000 inhabitants (35.3 face-to-face and 7.6 non-face- to-face). The rate of face-to-face referrals was higher in urban areas (37.1) and the rate of non- face-to-face referrals in rural areas (10.4). The response time for non-face-to-face consultations was 2.4 ± 12.7 days and 56 ± 34.8 days for face-to-face consultations (p < 0.001). The resolution rate for non-face-to-face consultations was 44%. Diagnostic concordance, assessed by the kappa index, was 0.527 for face-to-face consultations and 0.564 for non-face-to-face consultations. Greater compliance with the quality criteria in the non-attendance consultations.

Conclusions

Teledermatology appears to be an efficient tool in the resolution of dermatological problems, with a rapid, effective, and higher quality response for attention to skin pathologies.

Registry

ClinicalTrials.gov Identifier: NCT05625295. Registered on 21 November 2022 (https://clinicaltrials.gov/ct2/show/ NCT05625295).
Deciphering the role of KLRB1: a novel prognostic indicator in hepatocellular carcinoma
Authors: Fang Siting , Zhou Yinglu
Published: June 2024

Background

Hepatocellular carcinoma (HCC) represents a significant global health challenge with high incidence and mortality rates. T cells and natural killer (NK) cells are pivotal in this context, yet HCC can evade immune surveillance. CD161 (KLRB1), a C-type lectin receptor, modulates immune responses and is expressed on NK cells and a subset of T cells. Its relevance in HCC remains poorly understood, with conflicting findings regarding its impact on patient prognosis.

Methods

Utilizing TCGA data and single-cell analysis, we investigated the biological functions of KLRB1 in HCC. Peripheral blood samples from 126 HCC patients were collected to assess KLRB1 expression on NK and T cells. The diagnostic performance of KLRB1 on NK and CD8 + T cells was evaluated using receiver operating characteristic curve (ROC) analysis, while its prognostic significance was assessed using Kaplan-Meier analysis and COX regression models.

Results

Analysis of TCGA data revealed a significant correlation between KLRB1 expression and immune activation, particularly T cell activation. Single-cell data further demonstrated elevated KLRB1 expression in tissue-resident NK and T cells within HCC, which co-expressed markers of immune activation. Clinical data showed downregulated KLRB1 expression on NK and T cells in HCC patients compared to health individuals, with lower expression levels correlating with poorer prognosis.

Conclusion

KLRB1 emerges as a promising biomarker in HCC, with its downregulation on peripheral blood NK and T cells suggesting potential prognostic value. Further elucidation of KLRB1’s role in HCC may pave the way for the development of targeted immunotherapies and the improvement of patient outcomes.
Hypertension and immune activation in antiretroviral therapy naïve people living with human immunodeficiency virus
Authors: Mwakyandile Tosi M. , Shayo Grace A. , Sasi Philip G. , Mugusi Ferdinand M. , Barabona Godfrey , Ueno Takamasa , Lyamuya Eligius F.
Published: June 2024

Background

The pathogenesis of hypertension (HTN) in people living with HIV/AIDS (PLHIV) is complex and remains not fully understood. Chronic immune activation (IA) is postulated to be one of the culprits. This notion is derived from studies in HIV-uninfected populations and/or animals while data on HTN and how it relates to IA in PLHIV remains scarce. We determined the relationship between HTN and IA among antiretroviral therapy (ART) naïve PLHIV.

Methods

We analysed baseline data of 365 out of 430 clinical trial participants whose main aim was to investigate the effect of low-dose aspirin on HIV disease progression in PLHIV starting ART. Soluble CD14 (sCD14), T cells co-expressing CD38 and HLA-DR, and PD-1 were the IA and exhaustion markers, respectively studied and were analysed by flow cytometry. Mann-Whitney U-test was used for comparison of the markers by HTN status. A robust Poisson regression model was used to determine the predictors for HTN.

Results

A quarter of the 365 were hypertensive (25.3%, 95% CI 20.9–29.8%), and, had higher median (IQR) body mass index (kg/m2) (23.4 (19.6, 28.0) versus 21.9 (19.3, 25.1)) and lower median (IQR) estimated glomerular filtration rate (mL/min/1.73m2) (101.2 (79.4, 126.9) versus 113.6 (92.7, 138.8)) than normotensive participants (p < 0.05). Participants with HTN had higher median frequencies of all markers of IA and exhaustion but lower sCD14 (p > 0.05). None of these markers significantly predicted the occurrence of HTN.

Conclusion

Studied markers of IA and exhaustion were higher in PLHIV with HTN than those without but were unpredictive of HTN. Larger multicentre studies with a wider range of markers are needed to confirm the role of IA in HIV-associated HTN.
International multicenter real-world REGistry for patients with metastatic renAL cell carcinoma – Meet-URO 33 study (REGAL study)
Authors: Rebuzzi Sara Elena , Fornarini Giuseppe , Signori Alessio , Buti Sebastiano , Procopio Giuseppe , De Giorgi Ugo , Pignata Sandro , Naglieri Emanuele , Maruzzo Marco , Banna Giuseppe Luigi , Rescigno Pasquale , Messina Carlo , Mattana Alvise , Basso Umberto , Bimbatti Davide
Published: June 2024

Background

Nowadays, different therapeutic options are available for the first-line treatment of metastatic renal cell carcinoma (mRCC). Immuno-combinations are the standard first-line therapy in all mRCC patients regardless of the International Metastatic RCC Database Consortium (IMDC) risk category, even though TKI monotherapy is still a therapeutic option in selected patients. However, comparisons between the different first-line treatment strategies are lacking and few real-world data are available in this setting. For this reason, the regimen choice represents an important issue in clinical practice and the optimal treatment sequence remains unclear.

Methods

The REGAL study is a multicentric prospective observational study enrolling mRCC patients treated with first-line systemic therapy according to clinical practice in a real-world setting. A retrospective cohort of mRCC patients who received first-line systemic therapy from the 1st of January 2021 will also be included. The primary objective is to identify potential prognostic and predictive factors that could help guide the treatment choice; secondary objectives included the assessment of the prognostic performance of the novel prognostic Meet-URO score (IMDC score + neutrophil-to-lymphocyte ratio + bone metastases) compared with the IMDC score and the comparison between treatment strategies according to response and survival outcomes and toxicity profile.

Discussion

Considering the high number of therapeutic first-line strategies available for mRCC, the identification of clinical prognostic and predictive factors to candidate patients to a preferable systemic therapy is still an unmet clinical need. The Meet-URO 33 study aims to provide a large-scale real-world database on mRCC patients, to identify the clinical predictive and prognostic factors and the different performances between the ICI-based combinations according to response, survival and toxicity.

Trial Registration

CESC IOV 2023-78.
The impact of apparent temperature on the emergency visits for traumatic fractures in Hangzhou, China
Authors: Li Feng , Liu Xuejiao , Niu Yanlin , Gao Jinghong , Li Maoqiang , Zhao Yipin , Ji Cheng , Pan Guobiao , Zhao Mingxing , Wu Boliang , Tang Xiaoxiang , Wu Gang , Tian Jun , Chen Jianwei , Yan Shiyu , Tan Jianlu , Li Yunqing , Zhao Wentao , Li Lingyun , Qiu Yinmiao , Yao Wangxiang , Zhu Liulong
Published: June 2024

Background

Traumatic fractures occur frequently worldwide. However, research remains limited on the association between short-term exposure to temperature and traumatic fractures. This study aims to explore the impact of apparent temperature (AT) on emergency visits (EVs) due to traumatic fractures.

Methods

Based on EVs data for traumatic fractures and the contemporary meteorological data, a generalized Poisson regression model along with a distributed lag nonlinear model (DLNM) were undertaken to determine the impact of AT on traumatic fracture EVs. Subgroup analysis by gender and age and sensitivity analysis were also performed.

Results

A total of 25,094 EVs for traumatic fractures were included in the study. We observed a wide “J”-shaped relationship between AT and risk of traumatic fractures, with AT above 9.5 °C positively associated with EVs due to traumatic fractures. The heat effects became significant at cumulative lag 0–11 days, and the relative risk (RR) for moderate heat (95th percentile, 35.7 °C) and extreme heat (99.5th percentile, 38.8 °C) effect was 1.311 (95% CI: 1.132–1.518) and 1.418 (95% CI: 1.191–1.688) at cumulative lag 0–14 days, respectively. The cold effects were consistently non-significant on single or cumulative lag days across 0–14 days. The heat effects were higher among male and those aged 18–65 years old. The sensitivity analysis results remained robust.

Conclusion

Higher AT is associated with cumulative and delayed higher traumatic fracture EVs. The male and those aged 18–65 years are more susceptible to higher AT.
The relationship between air pollutants and preterm birth and blood routine changes in typical river valley city
Authors: Li Jimin , Gu Jiajia , Liu Lang , Cao Meiying , Wang Zeqi , Tian Xi , He Jinwei
Published: June 2024

Objective

To collect maternal maternity information on preterm births in two tertiary hospitals in the urban area of Baota District, Yan'an City, from January 2018 to December 2020, to explore the long-term and short-term effects of air pollutants (PM2.5, PM10, SO2, NO2, CO and O3) and preterm births, and to explore changes in blood cell counts due to air pollutants.

Methods

Daily average mass concentration data of six air pollutants in the urban area of Yan'an City from January 1, 2017 to December 31, 2020 were collected from the monitoring station in Baota District, Yan'an City. Meteorological information was obtained from the Meteorological Bureau of Yan'an City, including temperature,relative humidity and wind speed for the time period. The mass concentration of air pollutants in each exposure window of pregnant women was assessed by the nearest monitoring station method, and conditional logistic regression was used to analyze the relationship between air pollutants and preterm births, as well as the lagged and cumulative effects of air pollutants. Multiple linear regression was used to explore the relationship between air pollutants and blood tests after stepwise linear regression was used to determine confounders for each blood test.

Results

The long-term effects of pollutants showed that PM2.5, PM10, SO2, NO2and CO were risk factors for preterm birth. In the two-pollutant model, PM2.5, PM10, SO2 and NO2 mixed with other pollutants were associated with preterm birth. The lagged effect showed that PM2.5, PM10, SO2, NO, and CO were associated with preterm birth; the cumulative effect showed that other air pollutants except O3 were associated with preterm birth. The correlation study between air pollutants and blood indicators showed that air pollutants were correlated with leukocytes, monocytes, basophils, erythrocytes, hs-CRPand not with CRP.

Conclusion

Exposure to air pollutants is a risk factor for preterm birth. Exposure to air pollutants was associated with changes in leukocytes, monocytes, basophils and erythrocytes and hs-CRP.
Development and psychometric testing of a questionnaire for the Korea Youth risk behavior survey to assess physical activity behaviors
Authors: Park Bomi , Lee Hye Ah , Shin Yoonhee , Kim Yeonjae , Park Hyunjin , Jun Seunghee , Kim Ui Jeong , Oh Kyungwon , Choi Sunhye , Kim Yangha , Park Hyesook
Published: June 2024

Background

Physical activity is essential for physical, mental, and cognitive health. Providing evidence to develop better public health policies to encourage increased physical activity is crucial. Therefore, we developed an in-depth survey as part of the Korea Youth Risk Behavior Survey to assess the current status and determinants of physical activity among Korean adolescents.

Methods

We developed an initial version of the questionnaire based on a review of validated questionnaires, recent trends and emerging issues related to adolescent physical activity, and the national public health agenda pertaining to health promotion. Content validity was confirmed by a panel of 10 experts. Face validity was confirmed through focus group interviews with 12 first-year middle school students. The test-retest reliability of the questionnaire was evaluated by administering it twice, approximately two weeks apart, to a sample of 360 middle and high school students. Additionally, the frequency or average number of responses was analyzed in a sample of 600 students who participated in the initial test-retest reliability evaluation of the questionnaire developed in this study.

Results

Through item pool generation and content and face validity test, the final 15 questionnaire items were developed across five themes: levels of physical activity, school sports club activities, transportation-related physical activity, physical activity-promoting environments, and factors mediating physical activity. The test-retest reliability ranged from fair to substantial. Results from the newly developed survey reveal that only a minority of adolescents engage in sufficient physical activity, with only 17.2% and 21.5% participating in vigorous and moderate-intensity activities, respectively, for at least five days per week. Among school-based activities, 44.3% of students do not participate in school sports clubs due to reasons including absence of clubs and disinterest in exercise. The major motivators for physical activity are personal enjoyment and health benefits, whereas preferences for other leisure activities and academic pressures are the predominant barriers.

Conclusions

This study developed valid and reliable in-depth survey items to assess physical activity among Korean youths. It will hopefully enhance our understanding of adolescent physical activity, offering essential preliminary evidence to inform the development of public health strategies aimed at promoting adolescent health.
Learning and depicting lobe-based radiomics feature for COPD Severity staging in low-dose CT images
Authors: Zhao Meng , Wu Yanan , Li Yifu , Zhang Xiaoyu , Xia Shuyue , Xu Jiaxuan , Chen Rongchang , Liang Zhenyu , Qi Shouliang
Published: June 2024

Background

Chronic obstructive pulmonary disease (COPD) is a prevalent and debilitating respiratory condition that imposes a significant healthcare burden worldwide. Accurate staging of COPD severity is crucial for patient management and treatment planning.

Methods

The retrospective study included 530 hospital patients. A lobe-based radiomics method was proposed to classify COPD severity using computed tomography (CT) images. First, we segmented the lung lobes with a convolutional neural network model. Secondly, the radiomic features of each lung lobe are extracted from CT images, the features of the five lung lobes are merged, and the selection of features is accomplished through the utilization of a variance threshold, t-Test, least absolute shrinkage and selection operator (LASSO). Finally, the COPD severity was classified by a support vector machine (SVM) classifier.

Results

104 features were selected for staging COPD according to the Global initiative for chronic Obstructive Lung Disease (GOLD). The SVM classifier showed remarkable performance with an accuracy of 0.63. Moreover, an additional set of 132 features were selected to distinguish between milder (GOLD I + GOLD II) and more severe instances (GOLD III + GOLD IV) of COPD. The accuracy for SVM stood at 0.87.

Conclusions

The proposed method proved that the novel lobe-based radiomics method can significantly contribute to the refinement of COPD severity staging. By combining radiomic features from each lung lobe, it can obtain a more comprehensive and rich set of features and better capture the CT radiomic features of the lung than simply observing the lung as a whole.
Yoga as an adjunct treatment for eating disorders: a qualitative enquiry of client perspectives
Authors: O’Brien Jennifer , McIver Shane , Evans Subhadra , Trethewey Eleanor , O’Shea Melissa
Published: June 2024

Background

This qualitative enquiry explores the experiences and perspectives of individuals with an eating disorder (ED) regarding their perceptions of yoga as an adjunct intervention to psychotherapy. It also explores the feasibility, acceptability, and safety of yoga from their perspectives.

Methods

This study used a practice-based evidence framework and employed semi-structured interviews with 16 females with an ED. Participants were asked about their perspectives on the use of yoga as an adjunct intervention in ED recovery, perceived risks and what factors supported or hindered engagement. Thematic template analysis was used.

Results

Three topic areas were elaborated. The first included participants’ perceptions of how yoga enhanced their ED recovery. The second included how and when participants came to find yoga in their ED recovery. The final topic explored factors that supported participants with ED to engage in yoga. These resulted in the development of guiding principles to consider when designing a yoga intervention for EDs.

Conclusions

This study adds further to the emerging evidence that yoga can bring complementary benefits to ED recovery and provides a biopsychosocial-spiritual framework for understanding these. Findings provide an understanding of how yoga programs can be adapted to improve safety and engagement for people with an ED. Yoga programs for people with EDs should be co-designed to ensure that the physical, social, and cultural environment is accessible and acceptable.
The relationships between precarious employment, having a calling, and occupational well-being among young nurses: a cross-sectional study
Authors: Pesonen Tanja , Nurmeksela Anu , Hult Marja
Published: June 2024

Background

Working in the healthcare sector seems less interesting than other sectors: the salary is low relative to the demands of the labour involved, and working conditions as well as management are perceived as poor. These factors may have an impact on the well-being of nurses in the healthcare sector. This study aims to explore the relationship between precarious employment and occupational well-being, in addition to the moderating effect of having a calling in this relationship among younger and older nurses.

Methods

Cross-sectional survey data were collected among Finnish nurses (n = 5867) between October and November 2020. Data were collected on demographics, occupational well-being, precarious employment, and having a calling in the field. Multiple linear regression analyses were used to explore the associations.

Results

Younger nurses perceived lower levels of occupational well-being and calling, and higher levels of precarious employment compared to older nurses. Precarious employment had a negative relationship with occupational well-being, and having a calling showed a positive relationship with regard to occupational well-being. No interaction effect of precarious employment and having a calling with occupational well-being was found.

Conclusions

Young nurses’ occupational well-being, precarious employment, and calling should be studied further because they are in a weaker position in working life. Using a qualitative approach should be considered in order to obtain more in-depth information.
Role of inflammation in a rat model of radiation retinopathy
Authors: Lebon Cécile , Malaise Denis , Rimbert Nicolas , Billet Manon , Ramasamy Gabriel , Villaret Jérémie , Pouzoulet Frédéric , Matet Alexandre , Behar-Cohen Francine
Published: June 2024

Radiation retinopathy (RR) is a major side effect of ocular tumor treatment by plaque brachytherapy or proton beam therapy. RR manifests as delayed and progressive microvasculopathy, ischemia and macular edema, ultimately leading to vision loss, neovascular glaucoma, and, in extreme cases, secondary enucleation. Intravitreal anti-VEGF agents, steroids and laser photocoagulation have limited effects on RR. The role of retinal inflammation and its contribution to the microvascular damage occurring in RR remain incompletely understood. To explore cellular and vascular events after irradiation, we analyzed their time course at 1 week, 1 month and 6 months after rat eyes received 45 Gy X-beam photons. Müller glial cells, astrocytes and microglia were rapidly activated, and these markers of retinal inflammation persisted for 6 months after irradiation. This was accompanied by early cell death in the outer retina, which persisted at later time points, leading to retinal thinning. A delayed loss of small retinal capillaries and retinal hypoxia were observed after 6 months, indicating inner blood‒retinal barrier (BRB) alteration but without cell death in the inner retina. Moreover, activated microglial cells invaded the entire retina and surrounded retinal vessels, suggesting the role of inflammation in vascular alteration and in retinal cell death. Radiation also triggered early and persistent invasion of the retinal pigment epithelium by microglia and macrophages, contributing to outer BRB disruption. This study highlights the role of progressive and long-lasting inflammatory mechanisms in RR development and demonstrates the relevance of this rat model to investigate human pathology.
The effect of hyperlipidemia on overall survival in patients with cancer was differentiated by BMI and hyperlipidemia type
Authors: Tian Hai-Ying , Yang Ming , Xie Hai-Lun , Ruan Guo-Tian , Ge Yi-Zhong , Zhang Xiao-Wei , Zhang He-Yang , Liu Chen-An , Liu Tong , Shi Han-Ping
Published: June 2024

Background and aims

The impact of lipids on the overall survival (OS) of patients with malignancy has not yet been clarified. This study aimed to evaluate the effect of hyperlipidemia on the OS among Chinese patients based on Body Mass Index (BMI) stratifications and hyperlipidemia types.

Method

The patients in this study were derived from the Investigation of the Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) trial. Kaplan–Meier was used to draw the survival curve, and the log-rank test was used to estimate the survival rates between each group. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI).

Results

A total of 9054 patients were included in the final study, with a median age of 59 years, and 55.3% (5004) of them were males. Regarding types of hyperlipidemia, only low high-density lipoprotein was an independent risk factor for the prognosis of all patients (HR = 1.35, 95% CI: 1.25–1.45, P < 0.001), while high total cholesterol (HR = 1.01, 95% CI: 0.90–1.15, P = 0.839) and high low-density lipoprotein (HR = 1.03, 95%CI: 0.91–1.16, P = 0.680) were not. In terms of BMI stratification, the effect of triglycerides on prognosis varied; high triglycerides were an independent risk factor for the prognosis of underweight patients (HR = 1.56, 95% CI:1.05–2.32, P = 0.027) and a protective factor for overweight patients (HR = 0.75, 95% CI: 0.63–0.89, P = 0.001). However, for normal-weight patients, there was no significant statistical difference (HR = 0.88, 95%CI: 0.75–1.03, P = 0.108).

Conclusions

The impact of hyperlipidemia on the OS among patients with cancer varied by different BMI and hyperlipidemia types. BMI and hyperlipidemia type ought to be considered in combination to estimate the prognosis of patients with malignancy.
Development of a risk prediction model for radiation dermatitis following proton radiotherapy in head and neck cancer using ensemble machine learning
Authors: Lee Tsair-Fwu , Liu Yen-Hsien , Chang Chu-Ho , Chiu Chien-Liang , Lin Chih-Hsueh , Shao Jen-Chung , Yen Yu-Cheng , Lin Guang-Zhi , Yang Jack , Tseng Chin-Dar , Fang Fu-Min , Chao Pei-Ju , Lee Shen-Hao
Published: June 2024

Purpose

This study aims to develop an ensemble machine learning-based (EML-based) risk prediction model for radiation dermatitis (RD) in patients with head and neck cancer undergoing proton radiotherapy, with the goal of achieving superior predictive performance compared to traditional models.

Materials and methods

Data from 57 head and neck cancer patients treated with intensity-modulated proton therapy at Kaohsiung Chang Gung Memorial Hospital were analyzed. The study incorporated 11 clinical and 9 dosimetric parameters. Pearson’s correlation was used to eliminate highly correlated variables, followed by feature selection via LASSO to focus on potential RD predictors. Model training involved traditional logistic regression (LR) and advanced ensemble methods such as Random Forest and XGBoost, which were optimized through hyperparameter tuning.

Results

Feature selection identified six key predictors, including smoking history and specific dosimetric parameters. Ensemble machine learning models, particularly XGBoost, demonstrated superior performance, achieving the highest AUC of 0.890. Feature importance was assessed using SHAP (SHapley Additive exPlanations) values, which underscored the relevance of various clinical and dosimetric factors in predicting RD.

Conclusion

The study confirms that EML methods, especially XGBoost with its boosting algorithm, provide superior predictive accuracy, enhanced feature selection, and improved data handling compared to traditional LR. While LR offers greater interpretability, the precision and broader applicability of EML make it more suitable for complex medical prediction tasks, such as predicting radiation dermatitis. Given these advantages, EML is highly recommended for further research and application in clinical settings.