bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Value of Baseline Skeletal Muscle Index in Colorectal Cancer Patients Treated with Fruquintinib：A multi-center real world analysis
Authors: Tang Wanfen , Li Fakai , Zheng Hongjuan , Zhao Jinglei , Wei Hangping , Xiong Xuerong , Chen Hailang , Zhang Cui , Xie Weili , Zhang Penghai , Gong Guangrong , Ying Mingliang , Guo Qiusheng , Wang Qinghua , Fu Jianfei
Published: October 2024

Background
The Skeletal Muscle Index (SMI) is an objective indicator for evaluating the nutritional status in malignant tumors. The baseline nutritional status may affect the efficacy and prognosis of targeted anti-tumor therapy, and growth factor tyrosine kinase inhibitors often lead to drug-related sarcopenia. Fruquintinib has been approved for metastatic colorectal cancer. In this study, we analyzed the prognostic value of baseline SMI in metastatic colorectal cancer treated with fruquintinib, and observed the incidence of SMI reduction after fruquintinib treatment to evaluate its impact on prognosis.
Methods
A retrospective multi-center analysis of metastatic colorectal cancer patients treated with fruquintinib in eight medical centers in China was performed. The muscle area of the third lumbar spine was evaluated, the baseline SMI and post-treatment SMI were calculated separately. The correlation with survival was analyzed.
Results
The median PFS of 105 patients was 4.2 months (95% CI, 3.7 months to 4.9 months), and the median OS was 10.2 months (95% CI, 9.0 months to 12.7 months). The baseline SMI before fruquintinib therapy was significantly correlated with OS (P = 0.0077). Multivariate analysis demonstrated that the baseline SMI was an independent prognostic factor for OS (P = 0.005). Twenty-eight point eight seven percent (28.87%) patients experienced sarcopenia after oral administration of fruquintinib. However, there was no significant difference in OS between the SMI reduced group and the SMI nonreduced group after treatment with fruquintinib.
Conclusion
The baseline SMI was an independent prognostic factor for OS and it could affect the survival of patients treated with fruquintinib in metastatic colorectal cancer. Although fruquintinib can cause sarcopenia, there is no correlation between post-treatment SMI changes and survival.
The Effectiveness of Physical Activity During Hemodialysis on Dialysis Adequacy in Hemodialysis Patients: A Clinical Trial Study
Authors: Mohamadizadeh Mahmoud , Sharifi Sharif , Motamed Niloufar , Shadman Mohamad amin , pouladi shahnaz
Published: October 2024

Background
In patients with chronic renal failure undergoing hemodialysis, activity, and rehabilitation are very important to prevent the reduction of muscle strength and performance of the patient undergoing dialysis. This study aims to determine the effectiveness of physical activity during hemodialysis on dialysis adequacy in hemodialysis patients.
Methods
This randomized controlled trial study investigated the impact of pedaling exercise on dialysis effectiveness in 84 hemodialysis patients at Bushehr hospitals. Participants were randomly assigned to either an experimental group (n = 42) that performed 30 minutes of pedaling exercise during their 4-hour dialysis sessions or a control group (n = 42) that received routine hemodialysis. Dialysis adequacy was assessed by comparing pre-and post-dialysis blood samples taken from the arterial line. The study utilized a standardized protocol for collecting blood samples and measured patient weight using a calibrated digital scale. Data analysis was performed using SPSS.ver24 software.
Results
The test and control groups were similar in demographic characteristics, except for age (X2= -3/84, p = 0.001) and education levels (X2 = 10/100, p = 0.006). While there was no significant difference in weight before and after the intervention between the groups (t = 0.223, p = 0.82 before; t = 0.203, p = 0.84 after), both groups showed a substantial weight reduction overall (p < 0.0001). There was no statistically significant difference in weight change (t = 0.80, p = 0.25), blood urea nitrogen (BUN) (t = 0.13, p = 1.52), or Kt/V (t = 1.62, p = 0.11) between the test and control groups.
Conclusion
This study found that incorporating pedaling exercise during hemodialysis did not significantly improve dialysis effectiveness, as measured by weight change, BUN levels, or Kt/V. While both groups showed weight loss, there were no statistically significant differences between them. However, the study had limitations due to its small sample size and the specific type of exercise used. Further research with larger cohorts and a wider variety of physical activities is needed to determine if physical activity during hemodialysis can benefit dialysis adequacy and overall patient outcomes.
Trial registration: IRCT code number 20150529022466N15 with registration date: 5.5.2020 and trial Code of Ethics IR.BPUMS.REC.1398.130
Protein design of two-component tubular assemblies like cytoskeletons
Authors: Suzuki Yuta , Noji Masahiro , Sugita Yukihiko , Yamazaki Yosuke , Miyazaki Makito
Published: October 2024

Recent advances in protein design have ushered in an era of constructing intricate higher-order structures. Nonetheless, orchestrating the assembly of diverse protein units into cohesive artificial structures akin to biological assembly systems, especially in tubular forms, remains elusive. To this end, here, we introduce the Nature-Inspired Protein Assembly Design (NIPAD), a novel methodology that utilises two distinct protein units to create unique tubular structures under carefully designed conditions. These structures demonstrate dynamic flexibility similar to that of actin filaments, with cryo-electron microscopy revealing diverse morphologies, like microtubules. By mimicking actin filaments, helical conformations were incorporated into tubular assemblies, thereby enriching their structural diversity. Notably, these assemblies can be reversibly disassembled and reassembled in response to environmental stimuli, including changes in salt concentration and temperature, mirroring the dynamic behaviour of natural systems. NIPAD combines rational protein design with biophysical insights, leading to the creation of biomimetic, adaptable, and reversible higher-order assemblies. This approach deepens our understanding of protein assembly design and complex biological structures. Concurrently, it broadens the horizons of synthetic biology and material science, holding significant implications for unravelling life’s fundamental processes and pioneering new applications.
Association of Triglyceride-Glucose Index with the Progression of Atherosclerosis and Impairment of Arterial Endothelial Function
Authors: Hu Yinqin , Xu Zhaohui , Wan Qiqi , Shi Tianyun , Yang Jiahui , Lu Cheng , Shao Qin , Wang Xiaolong , Liu Yongming
Published: October 2024

Aims
This study aims to investigate the correlation between the (TyG) index and the progression of atherosclerosis and endothelial dysfunction.
Methods
We retrospectively collected data from 150 adult inpatients with atherosclerosis who received consistent medical care at the Cardiovascular Department of Shuguang Hospital, affiliated with Shanghai University of Traditional Chinese Medicine, from January 2018 to December 2023. The TyG index was calculated by using the formula TyG = ln[triglyceride (TG) [mg/dL] × fasting blood glucose (FBG) [mg/dL]/2]. The relationship between TyG and the progression of atherosclerosis, Flow-Mediated Dilation (FMD), Brachial-Ankle Pulse Wave Velocity (baPWV), and Ankle-Brachial Index (ABI) was explored using SPSS 27.0 software and R (version 4.3.1, Austria) software.
Results
There was a significant correlation between the patient’s TyG index and the intima-media thickness (IMT) of both carotid and lower limb arteries (P < 0.05). There was also a noteworthy correlation between the TyG index and the peak systolic velocity (PSV) of the left femoral artery (P = 0.019), flow-mediated dilation (FMD), and brachial-ankle pulse wave velocity (baPWV) (P < 0.001). After adjusting for confounding factors, logistic regression analysis still showed that TyG is correlated with the progression of atherosclerosis (P < 0.0001). ROC curve analysis demonstrated that the TyG index possessed predictive value for the progression of atherosclerosis in carotid arteries (AUC = 0.774, P < 0.001) and lower limb arteries (AUC = 0.8, P < 0.001) comparable to the Framingham Risk Score.
Conclusion
The TyG index is closely correlated with the progression of atherosclerosis and arterial stiffness.
Computed tomography imaging for assessment at risk of development of MRONJ in oncological patients under antiresorptive drugs
Authors: Barros¹ Francisco Barbara Abreu , Yanaguizawa¹ Wellington Hideaki , Santos¹ Marcos Antônio Lima dos , Gimenez² Thais , Alves Fábio Abreu , Cavalcanti Marcelo Gusmao Paraiso
Published: October 2024

Background
Oncological patients subjected to bisphosphonate therapy may develop medication-related osteonecrosis of the jaw (MRONJ). This study compares the mandibular bone density of these patients with a control group, by using computed tomography (CT), and evaluated whether this imaging modality potentially detects early changes associated with bisphosphonate therapy in oncological patients.
Materials and Methods
This study included 32 patients treated with zoledronic acid and 43 patients in the control group. Two lower mandible regions of interest (total and medullary bone contours) were selected and standardized in patients under antiresorptive drug treatment (experimental group) and the control group. The intraclass correlation coefficient (ICC) test evaluated reproducibility and repeatability, the Shapiro-Wilk test analyzed sample normality, and the independent sample t-test indicated statistical significance.
Results
Inter- and intra-examiner analyses considered the indicators excellent, and dental extractions were the most associated with MRONJ development. Patients subjected to antiresorptive medication experienced higher density in the mandibular medullary bone (p = 0.009) than the control group.
Conclusions
CT was useful to show changes in bone densities in patients using bisphosphonates.
Evaluating the preventive impact of anthracycline-induced cardiotoxicity using natural language processing and electronic medical records
Authors: Kawazoe Yoshimasa , Tsuchiya Masami , Shimamoto Kiminori , Seki Tomohisa , Shinohara Emiko , Yada Shuntaro , Wakamiya Shoko , Imai Shungo , Aramaki Eiji , Hori Satoko
Published: October 2024

In this retrospective observational study, we evaluated the effects of angiotensin II receptor blockers/angiotensin-converting enzyme inhibitors (ARB/ACEI), beta blockers (BB), statins, and calcium channel blockers (CCB) on anthracycline-induced cardiotoxicity (AIC) using signals extracted from clinical texts via natural language processing (NLP). The study included 2,935 patients prescribed anthracyclines at a single hospital, with concomitant prescriptions of ARB/ACEI, BB, statins, and CCB. Using propensity score matching, groups with and without these medications were compared, and expressions suggestive of cardiotoxicity extracted via NLP were considered as the outcome. The hazard ratios were 0.47, 0.50, 0.48, and 0.57 for ARB/ACEI, BB, statin, and CCB, respectively, all indicating significant suppression of AIC. In conclusion, NLP-extracted signals from clinical texts reflected the known effects of these medications, demonstrating the feasibility of NLP-based drug repositioning. Further investigation is needed to determine whether similar results can be obtained from electronic medical records of other institutions.
Risk factors for postoperative thrombosis-related complications in patients who undergo meningioma surgery: A Chinese single-center, retrospective study
Authors: Kong Yingying , Jin Beibei , Zhang Yijie , Bu Xiaoning , Long Jianhai
Published: October 2024

ObjectiveTo explore the incidence and risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE) following surgical intervention for meningioma.
Methods In this retrospective, observational study, we enrolled 9067 patients with histologically confirmed meningiomas who underwent surgical resection at our institution between January 2019 and June 2024. Demographic data (including gender, age, and geographic region) and information on postoperative complications (e.g., intracerebral hemorrhage, DVT, and PE) were documented and analyzed. The incidences of postoperative DVT and PE were also recorded. Risk factors for DVT and PE were identified using univariate and multivariate logistic regression analyses and restricted cubic splines.
Results Among the 9067 included patients, 766 (8.4%) experienced DVT and 32 (0.35%) developed PE. Northeast China, North China, and East China were the top three regions with the highest prevalence of DVT/PE, and the three most affected provinces were Hebei, Shandong, and Inner Mongolia. Univariate logistic regression analysis and restricted cubic splines indicated that age was a significant contributing factor to the development of both DVT and PE. The risk of PE increased in patients aged 42–82 years, as follows: the odds ratio (OR) for PE increased from 1.001 (95% confidence interval [CI]: 1.000–1.002) at 42 years to 1.044 (95% CI: 1.001–1.088) at 82 years. The incidence of PE was 4.58 (95% CI: 1.37–15.33) times higher in patients aged ≥ 60 years vs < 40 years and 8.58 (95% CI, 1.02–72.03) times higher in those aged ≥ 80 years compared with the 40–60 years group. Multivariate logistic regression analysis identified age (OR: 1.07; 95% CI: 1.06–1.08) and intracerebral hemorrhage (OR: 6.98; 95% CI: 3.75–13.00) as independent risk factors for DVT. In comparison, age (OR: 1.05; 95% CI: 1.01–1.09) and DVT (OR: 20.21; 95% CI: 9.03–45.27) were risk factors for PE.
Conclusions The incidences of DVT and PE following meningioma surgery were 8.4% and 0.4%, respectively, from 2019 to 2024. In addition to the specific age threshold of > 60 years, a broader age range (42–82 years) is also a risk factor for postoperative PE.
Pythium Insidiosum Biological Characteristics and Treatment: A Strain Cured by Repurposing of Existing Drugs in China
Authors: Liu Xiaoyun , Diao Qiuyue , Li Mingliang , Yang Yuting , Liao Jiaoyin , Cui Zehua , Zhang Haiyan , He Huiling , Huang Jiaobao , Ren Hao , Zhou Fengli , Shan Tijiang , Liao Xiaopin , Sun Jian , Zhang Kouxing
Published: October 2024

Background
Pythiosis is an infectious disease caused by P. insidiosum that threatens humans and animals. The number of people being diagnosed with this disease has been increasing worldwide. Pythiosis has a high rate of morbidity and mortality. Early diagnosis and prompt treatment are crucial in determining the prognosis of patients. The character of P. insidiosum has geographical variants, and a comprehensive investigation of it is essential in China.
Methods
In this study, a strain of P. insidiosum was visually and genetically identified, and isolated from a patient at a hospital in Guangzhou. A novel sporulation technique was used to produce zoospores. Microscopic observation was employed to understand the biological properties of P. insidiosum. Drug susceptibility studies on the isolates were conducted in vitro and in vivo.
Results
Our results provide comprehensive evidence that this strain was P. insidiosum, supported by molecular biology, morphology, and biological processes. Drug susceptibility studies showed P. insidiosum was more sensitive to antibiotics than antifungals, with tetracyclines and macrolides being the most sensitive in vitro. In vivo, doxycycline and azithromycin were administered to immunodeficient mice infected with P. insidiosum subcutaneously. The treatment significantly increased the survival rate of infected mice (p < 0.05) and alleviated the histopathology while decreasing the fungal burden in infected mice.
Conclusion
Our study provides theoretical and technical support for effectively treating pythiosis in humans and animals in China.
An Exploration of Health Inequalities in a Tier 3 Specialist Weight Management Service
Authors: Sorrell Caitlin , Brough Grace , Savidge Caroline
Published: October 2024

Background:
Almost two thirds of the adult UK population is either overweight or obese, a condition associated with physical and psychological comorbidities. Evidence shows that engaging with specialist weight management services can lead to significant reductions in weight. However, little is known about how legally protected characteristics impact on access to services and on outcomes. The purpose of this evaluation was to explore any barriers and health inequalities related to patients’ age, gender, disability, ethnicity, and socio-economic background in access or outcomes within a Tier 3 specialist Weight Management service in the UK.
Methods:
The evaluation was conducted in a pragmatic paradigm. Mixed methods were used in an iterative design where findings informed action. The evaluation included a narrative literature review, a quantitative demographic analysis on equity of access to the service (n=1896), a quantitative analysis on patient pathways and outcomes (n=2148), a patient focus group and interview (n=3), staff interviews (n=7) and a survey amongst referring General Practitioners (n=9).
Results:
Both weight stigma and male gender are perceived as barriers to accessing and engaging with weight management. Fewer men than women are referred to and access the service. However, after 52 weeks, both genders have similar outcomes in terms of BMI reduction. Older adults are under-represented in the service due to a lower referral rate, but they achieve higher than average BMI reduction. People from areas with the highest levels of deprivation are over-represented at referral and as starters in the service, and whilst they have lower-than-average BMI reduction after six months, longer engagement (12 months) achieves above average outcomes. Mistrust and disempowerment can be barriers to access but support from staff can help build trust and empowerment, facilitating positive outcomes. Staff’s existing skills facilitate working with people with protected characteristics, yet skills gaps still exist that act as barriers.
Conclusions:
Individual, societal and structural factors intertwine to generate inequalities. Relationship-building and empathy skills from health professionals, combined with improved communication, practical information, and support may alleviate these inequalities. However, some sample sizes were small and generalisations may only be made with caution.
Tricuspid valve papillary fibroelastoma in an adult patient ： a case report and review of literature
Authors: Ji Zhenchun , Yu Changhui , Musha Kadeerjiang , Lin Liangqiang , Saimi Baihetiya , Abudurexiti Abudusalamu , Huang Haoyue , Shen Zhenya
Published: October 2024

Background
Tricuspid valve papillary fibroelastoma is a primary benign tumor of the heart located in the tricuspid valve. It has a risk of embolism.Here, we report a case of Tricuspid valve papillary fibroelastoma. The lesion was surgically removed, and a cure was finally achieved. There was no recurrence after telephone follow-up for 1 years.
Case presentation
This article reports on a 51-year-old female patient who was admitted to the hospital with chest tightness and shortness of breath for three years.Transthoracic echocardiography showed a mass of about 10*9 mm large at the root of the right atrial surface of the anterior tricuspid valve leaflet, which could be seen activities with valve opening and closing.The patient underwent resection. Histopathology revealed the mass to be a papillary fibroelastoma.
Conclusions
Tricuspid valve papillary fibroelastoma remains a very rare benign cardiac tumor, but its incidence has increased in recent years. Echocardiography can provide a reliable method for the diagnosis. Early resection combined with tricuspid valvuloplasty can prevent serious complications such as embolization.
Predicting Suicide Outcomes: An Analysis of Key Factors and Machine Learning Models
Authors: Bazrafshan Mohammad , Sayehmiri Kourosh
Published: October 2024

Background: Suicide attempts are lethal and self-destructive behaviors that, in some cases, lead to death or irreversible physical harm and are associated with various factors. This study aimed to identify suicide-related death risk factors.
Materials and Methods: This study utilized data recorded in the suicide registry system of hospitals in Ilam Province. The data were analyzed via the Chi-square test in SPSS software. After the factors influencing suicide-related death were identified, their significance was evaluated and compared via logistic regression via the Python programming language and SPSS software. Subsequently, models for predicting suicide outcomes were developed via support vector machine (SVM), logistic regression, K-nearest neighbors (KNN), decision tree (DT), and random forest (RF) methods. These models were compared based on accuracy, recall, F1 score, and area under the receiver operating characteristic (ROC) curve.
Results: Among 3,833 cases of suicide in various hospitals in Ilam Province, the results indicated that the method of suicide (P<0.001), reason for attempting suicide (P<0.001), age group (P<0.001), education level (P<0.001), marital status (P=0.008), and employment status (P=0.002) were significantly associated with suicide-related death. Variables such as the season of suicide attempt, sex, father's education level, and mother's education level were not significantly related to suicide-related death. Furthermore, the random forest model demonstrated the highest area under the ROC curve (0.79) and the highest classification accuracy and F1 score on both the training data (0.85 and 0.2, respectively) and test data (0.87 and 0.22, respectively) for predicting suicide outcomes among the models tested.
Conclusion: This study revealed that older age, lower education level, divorce or widowhood, retirement, the use of physical methods and tools for suicide, and socioeconomic problems were significantly associated with suicide-related deaths. Additionally, the random forest model showed the best performance among the models tested in predicting suicide outcomes when these factors were used.
Genome size variation in the Poaceae supertribe Poodae, the major grass lineage of temperate climates (tribes Aveneae, Festuceae and Poeae)
Authors: Tkach Natalia , Winterfeld Grit , Röser Martin
Published: October 2024

Nuclear DNA amounts were examined by flow cytometry for 70 genera and 214 species and subspecies taxonomically belonging to the supertribe Poodae of the grass subfamily Pooideae. This supertribe contains most of the grasses distributed in the temperate extratropical regions of the world and is important because of its many cultivated species (e.g., grains) and its prominence as a major component of grasslands. The majority of holoploid genome sizes (2C values) ranged from 5 to 10 pg, with the full range of values representing a 30-fold variation. Most monoploid genome sizes (1Cx values) were between 2 and 3 pg, with a total of 12.3-fold variation. The minimum values in Poodae are only about twice those of Brachypodium stacei, which has the smallest genome known for the subfamily Pooideae, and those of rice and some other species of the rice subfamily (Oryzoideae) and a few species of the subfamily Panicoideae with miniature genomes. The maximum values of our study group are among the largest found within the whole family Poaceae, only slightly surpassed by a some in the tribe Triticeae (wheat and related species). The effects of polyploidy and dysploidy, their association with genome “downsizing” as well as with cases of size increase, were analyzed in both autopolyploids and allopolyploids. The origin of the low chromosome number of only x= 2 in some Poodae species and the transition from perennial to annual life form were addressed in the light of genome sizes, which were also discussed in a phylogenetic framework.
10-Year Outcomes of Targeted Axillary Surgery after Neoadjuvant Chemotherapy in Breast Cancer
Authors: Lee Jeeyeon , Kang Byeongju , Kim Hye Jung , Kim Won Hwa , Chae Yee Soo , Lee Soo Jung , Lee In-Hee , Park Ji-Young , Park Nora Jee-Young , Park Ho Yong
Published: October 2024

Background: When pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is achieved, identifying traces of the previous tumor site or lymph nodes and performing accurate surgery becomes challenging. We conducted ultrasound-guided targeted axillary surgery (TAS) in patients with node-positive breast cancer treated with NAC. Survival outcomes were compared with those of patients who underwent conventional axillary lymph node dissection (ALND).
Methods: We conducted a retrospective analysis of 235 patients (TAS, n=78; ALND, n=157) with cT1-3N1-2 breast cancer who underwent NAC followed by surgery from 2012 to 2017. Patients were treated with standard treatments, and oncologic results, including locoregional recurrence-free survival, distant metastasis-free survival, and overall survival (OS), were assessed over a 10-year follow-up period.
Results: There was no significant difference in oncologic outcomes between two groups and based on subtypes, including hormone receptor (HR)-positive, HER2-positive, and triple-negative breast cancer (TNBC). In the HR-positive breast cancer group, the TAS and ALND groups showed very similar trends . In HER2-positive breast cancer, although not statistically significant, the survival outcomes were better in the TAS group than in the ALND group. However, the OS in the TAS group for TNBC was lower than that in the ALND group, though not significantly.
Conclusions and Relevance: This study demonstrates that TAS is comparable to ALND in terms of 10-year oncological outcomes across different types of node-positive breast cancer, suggesting its potential as a viable alternative.
DT4CCU – A Digital Twins framework for Critical Care Unit
Authors: Appuhamilage Gayan Dihantha Kuruppu Kuruppu , Hussain Maqbool , Zaman Mohsin , Khan Wajahat Ali
Published: October 2024

Digital twins, long utilized in industries for enhancing efficiency, maintenance, real-time monitoring, and sustainability, are now gaining traction in healthcare, particularly with a disease-focused approach. This paper presents our journey towards the realization of a Digital Twin framework specifically designed for Critical Care, emphasizing patient safety, operational efficiency, and sustainability. Our Digital Twin architecture is uniquely structured with a dual-layer approach: a physical twin monitors real-time activities, while a conceptual twin represents ideal workflows. In Phase 1 of our research work, we aim to establish a methodology for live activity tracking. Our findings indicate that by reviewing documentation alone, we could successfully track 72% of tasks performed by nursing staff and physicians in real time. These results underscore the potential of Digital Twins to transform critical care delivery by bridging the gap between actual and ideal clinical practices.
A study of the impact of social participation on the subjective well-being of low-vision older adults in western China in the context of healthy aging
Authors: Zhong Zhu , Luo Xu , Huang Jinyu , Li Yajiang , Luo Yu
Published: October 2024

Background Low vision represents a significant global health issue, and its effects on the physical and mental health of the elderly have been extensively researched. However, the relationship between social participation and the subjective well-being of elderly individuals with low vision in China remains underexplored. This study focuses on the elderly with low vision residing in the main urban area of Chongqing, Western China, to investigate the impact and pathways of subjective well-being at both subjective and objective levels of social participation.
Methods Purposive and convenience sampling methods were employed to select 274 elderly individuals with low vision who were monitored at the ophthalmology clinics of two tertiary hospitals in Chongqing, western China, as the subjects of this survey. The study utilized the Memorial University of Newfoundland Happiness Scale, the Social Participation Scale, and the Social Support Scale, along with a visual function-related quality of life scale to collect relevant data. Pearson correlation analysis was conducted to examine the relationships among the research variables. Based on the theoretical model, a multiple mediating effect prediction model was established to assess the impact of social participation on subjective well-being. Linear regression analysis and the Bootstrap method were applied to evaluate the mediating effects within the prediction model.
Results The overall average subjective well-being of elderly individuals with low vision in western China is measured at 24.75 ± 8.02 points, which indicates a lower-middle level of well-being. participation in social activities is a positive predictor of subjective well-being, whereas individuals' subjective feelings of social participation can negatively impact it. social support and quality of life related to visual functioning were identified as mediating factors influencing the relationships between social participation activities, feelings of social participation, and subjective well-being.
Conclusion This study highlights the subjective well-being of elderly individuals with low vision in western China, as well as the pathways influencing the relationship between social participation-both subjective and objective-and their subjective well-being. It is recommended that healthcare professionals prioritize long-term care strategies for elderly patients experiencing low vision.
Impact of nucleos(t)ide analogues on the risk of hepatocellular carcinoma in chronic hepatitis B patients: A time-dependent Cox regression analysis
Authors: Moriyama Makoto , Tateishi Ryosuke , Kinoshita Mizuki Nishibatake , Fukumoto Tsuyoshi , Yamada Tomoharu , Wake Taijiro , Nakagomi Ryo , Nakatsuka Takuma , Minami Tatsuya , Sato Masaya , Fujishiro Mitsuhiro , Koike Kazuhiko
Published: October 2024

Background and Aims:
The preventive effect of nucleos(t)ide analog (NA) use on HCC development in patients with chronic hepatitis B (CHB) is controversial due to the difficulty of conducting randomized controlled trials.
Approach and Results:
In this single-center, retrospective study, NA-naïve CHB patients without a history of HCC were enrolled and followed-up from the first visit on or after January 2000 to December 2020. Patients were categorized into the NA group, including those who started NA after study enrollment, and the non-NA group, including patients to whom NA was never administered during the follow-up period. After propensity score matching (PSM) to balance the confounding factors, we applied a multivariable time-dependent Cox proportional regression analysis with the initiation of NA as a time-dependent covariate. We further performed a subgroup analysis according to the presence or absence of cirrhosis. The baseline characteristics of 212 pairs of patients retrieved by PSM were comparable. During the mean follow-up of 12.9 and 6.8 years in the NA and non-NA groups, respectively, 25 and 28 patients developed HCC, respectively. Multivariable analysis with time-dependent covariates showed that NA did not affect HCC risk (HR, 0.68; 95% CI, 0.36–1.31; p = 0.25) after adjusting for other risk factors, including age, sex, and HBV viral load. Subgroup analysis showed that NA use significantly reduced the risk of HCC in cirrhotic patients (HR, 0.26; 95% CI, 0.08–0.85; p = 0.03).
Conclusions
The preventive effect of NA on hepatocarcinogenesis may be limited to cirrhotic patients.
Liver Tumor Imaging Staging: A Multi-Institutional Study of a Preoperative Staging Tool for Hepatocellular Carcinoma
Authors: Liu Qiupng , Li Xiang , Yang KaiLan , Sun ShuWen , Xu Xun , Qu Kai , Xiao Jiaqi , Liu Chenyue , Yu HangQi , Lu YinYing , Qu JinRong , Zhang YuDong , Zhang Yuelang
Published: October 2024

Background & Aims:
The current staging system has limitations in preoperatively assessing hepatocellular carcinoma (HCC) and in precise detailed treatment allocation. This study aims to propose a new Liver Tumor Imaging Staging (LTIS) method for HCC.
Methods
1295 patients who underwent CT or MRI and curative liver resection during January 2012 and October 2020 were retrospectively recruited from three independent institutions. LTIS was designed to discriminate low-grade (absence of microvascular invasion [MVI] and Edmondson-Steiner grade III/IV), intermediate (MVI + or Edmondson-Steiner grade III/IV but not both) and high-grade HCC (MVI + and Edmondson-Steiner grade III/IV) upon CT and MRI. Model was constructed in 578 derivation cohort (center 1) and validated in internal center 1 test cohort (n = 291), and external center 2 (n = 226) and center 3 (n = 200), respectively. Net clinical benefit of LTIS on recurrence-free survival (RFS) and overall survival (OS) was analyzed with a Cox proportional hazards model.
Results
In independent test, LTIS achieved agreement of 73.2% (281/384), 18.9% (100/528), and 69.2% (265/383) for determining low, intermediate, and high-grade HCCs with “ground truth” results. In the Cox analysis, LTIS was comparable to “ground truth” grade for predicting RFS (hazards ratio (HR), 1.30 vs ground truth grade, 1.36 and 1.56) and OS (HR, 1.76 vs ground truth grade, 2.00 to 3.03) of patients after surgery. In patients conventionally classified as having low-grade tumors (serum α-fetoprotein < 40 ng/mL, stage T1), 47.4% and 35.6% were reclassified as high-grade tumors upon LTIS restaging. The resulting LTIS subgroups showed a significant difference in RFS and OS at Kaplan-Meier analysis (Log-rank test, p < 0.001).
Conclusion
LTIS provides a potential noninvasive way to precisely stage HCC using CT and MRI.
Morphological, Cytological, and Molecular Characterization of Interspecific Cotton Hybrids Derived from Gossypium hirsutum and G. arboreum Crosses
Authors: Mondal Saptarshi , Pathak Dharminder , Jindal Salil , Agrawal Neha , Gupta Mehak , Rathore Pankaj
Published: October 2024

Diploid cotton Gossypium arboreum (2n = 2x = 26, AdAd) is a valuable genetic resource to improve widely cultivated American cotton G. hirsutum (2n = 4x = 52, AtAtDtDt). In this study, successful generation of four unique interspecific hybrids (G. hirsutum × G. arboreum) was confirmed through morphological, cytological, and molecular characterization. The morphological evaluation included different stem and leaf characters, trichome density, floral characters, and cotton leaf curl disease reaction. Interspecific hybrids were recorded with either complete dominance of some characters or an intermediate expression. However, variation among the F1s was observed for some traits, especially for pollen size and fertility. Two of the four F1s were found to possess relatively bigger pollen sizes with partial fertility which enabled their utilization as male parents in backcrosses. Mitotic analysis of already established F1s was made possible through the induction of fresh roots by air layering. Of the four hybrid plants, two were triploid (2n = 39) and the other two were tetraploids (2n = 52), the latter case probably was a result of the fusion of normal n (AtDt) gametes from female parent (G. hirsutum) and unreduced gametes 2n (AdAd) from male parent (G. arboreum). Meiotic irregularities in interspecific hybrids were also observed. Successful amplification of polymorphic parental bands in all four F1s using simple sequence repeat markers added another line of evidence supporting their hybridity. Results of this experiment provided useful insight and base material to introgress leaf-hopper tolerance from G. arboreum to G. hirsutum.
Persistence of dysfunctional immune response 12 months after SARS-CoV-2 infection and their relationship with pulmonary sequelae and long covid
Authors: Cruz Tamara , Albacar Núria , Ruiz Estibaliz , Lledo Gema M , Perea Lídia , Puebla Alba , Torvisco Alejandro , Mendoza Núria , Marrades Pau , Sellares Jacobo , Agustí Alvar , Viñas Odette , Sibila Oriol , Faner Rosa
Published: October 2024

Introduction
Most patients recover fully after an acute infection by SARS-CoV-2. Some, however, may develop pulmonary sequelae (PS) and/or long COVID (LC), However, whether these two clinical conditions have similar or different pathogenic mechanisms is unknown.
Methods.
The levels of autoantibodies and 184 inflammatory and organ damage associated proteins in plasma were determined (by immunofluorescence and Olink panels, respectively) 1 year after an acute infection by SARS-CoV-2 in 51 patients with PS (DLCO < 80% ref), 31 patients with LC and 31 patients fully recovered (Rec). PS was defined by the presence of reduced carbon monoxide diffusing capacity (DLCO) lower than 80% ref. LC was defined by the presence of chronic symptoms in the absence of an alternative diagnosis.
Results.
We found that patients with PS or LC both showed increased levels than Rec of anti-microbial, immune cell activation and recruitment related proteins. Patients with PS showed higher levels of anti-nuclear autoantibodies, whereas LC patients had increased levels of organ-damage associated proteins. In patients with PS most of the elevated proteins correlate with the impairment of lung function (DLCO). Finally, in PS we additionally performed the determinations at an earlier time point (6 months) and showed that the expression of CCL20 and IFN-ɣ was already higher at 6 months, while CCL3 and CCL19 increase from 6 to 12 months, suggesting a pathogenic role in PS persistence.
Conclusions.
Patients with PS or LC have abnormal but different persistent circulatory immune and organ damage biomarkers, suggesting different underlying biology of both post-COVID conditions.
Patterns of tuberculosis case notification and treatment outcomes in the context of COVID-19 pandemic: analysis of national surveillance data, January 2019 - June 2021
Authors: Masanja Veronicah , Majwala Robert Kaos , Turyahabwe Stavia , Nsubuga Edirisa Juniour , Gonahasa Doreen Nsimiire , Kwesiga Benon , Kadobera Daniel , Bulage Lilian , Ario Alex Riolexus
Published: October 2024

Background
Tuberculosis case notification is critical for TB control but can be disturbed by interruptions to normal health system functioning. The first major wave of COVID-19 in Uganda occurred during August-December 2020. The government-imposed lockdown measures during March-June 2021 which required residents to stay at home. We determined the effect of COVID-19 and associated lockdown on TB case notification rates (CNR) and treatment success rates (TSR).
Methods
We analysed TB CNR and TSR data for January 2019-June 2021 from the Uganda District Health Information Software version2 (DHIS2) and disaggregated them by region. We also compared data on the COVID-19 cases with the TSR, and CNR trends over the period. We computed the CNR per 100,000 population, defined as number of notified TB cases/100,000 population. TSR was defined as the proportion of patients initiated on TB treatment that successfully completed treatment or cured. We described the quarterly trends and distribution of CNR and TSR pre (January 2019-March 2020) and during COVID-19 (April 2020-June 2021). We used interrupted time series analysis to determine the significance of the trends before and during COVID-19. We defined time periods by year (2019, 2020, or 2021) and quarter.
Results
The overall TB CNR between January 2019 and June 2021, was 165/100,000; TSR was 79.4%. CNR ranged from 166.2/100,000 pre COVID-19 to 164/100,000 during COVID-19. CNR declined significantly by 22% (p = 0.042, CI= [-41.4, -1.1]) from January 2020 to April 2020, concurrent with the lockdown and rising COVID-19 cases and was primarily driven by the sharp decline from 426/100,000 to 265/100,000 in Kampala City. This was followed by a significant quarterly increase in the national CNR of 16/100,000 (p < 0.001, CI= [10.0,21.6]), and 39/100,000 (p = 0.01, CI= [15.66,62.32]) in Kampala. TSR increased significantly by 1.6% (p < 0.0001,95%CI 1.3–1.9%) quarterly.
Conclusion
CNR appeared to be affected by the initial lockdown but recovered quickly. However, this decline was heavily driven by declines in CNR in Kampala City whose trends are not reflective of the rest of the country. TSR increased over time but was still below the 90% target. There is need to focus on continuity of TB care interventions in areas heavily affected by lockdowns.
Recurrent Strokes As The Sole Manifestation of Antineutrophil Cytoplasmic Antibody Associated Vasculitis in a Patient with Panuveitis. A Case Report and review of literature
Authors: Seraj Hadeel , Alshalan Hanan A. , Alemam Reham , Omair Mohammed A.
Published: October 2024

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a heterogeneous group of rare, autoimmune conditions characterized by widespread, multisystemic inflammation of small to medium-sized blood vessels. We present a case report of a 46-year-old male with a history of prior ischemic strokes and recurrent bilateral non-granulomatous panuveitis associated with a strongly positive cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) titer. Initial treatment with steroids, methotrexate, and rituximab were ineffective, but the condition responded moderately to cyclophosphamide. This case underscores the importance of considering AAV in patients with unexplained ocular inflammation and highlights the role of c-ANCA testing in diagnosing and managing such cases, even in the absence of classic systemic symptoms.
Lancelot: Towards Efficient and Privacy-Preserving Byzantine-Robust Federated Learning within Fully
Homomorphic Encryption
Authors: Ma Chuan , Jiang Siyang , Yang Hao , Xie Qipeng , Wang Sen , Xiang Tao , Xing Guoliang
Published: October 2024

In sectors such as finance and healthcare, where data governance is subject to rigorous regulatory requirements, the exchange and utilization of data are particularly challenging. Federated Learning (FL) has risen as a pioneering distributed machine learning paradigm that enables collaborative model training across multiple institutions while maintaining data decentralization. This approach inherently heightens data privacy by sharing only model weights, rather than raw data. Despite its advantages, FL is vulnerable to adversarial threats, particularly poisoning attacks during model aggregation, a process typically managed by a central server. To counteract the vulnerabilities of traditional FL frameworks, Byzantine-robust federated learning (BRFL) systems have been introduced, which rely on robust aggregation rules to mitigate the impact of malicious attacks. However, in these systems, neural network models still possess the capacity to memorize and potentially expose individual training instances inadvertently. This presents a significant privacy risk, as attackers could reconstruct private data by leveraging the information contained in the model itself. Existing solutions fall short of providing a viable, privacy-preserving BRFL system that is both completely secure against information leakage and computationally efficient. To address these concerns, we propose Lancelot, an innovative and computationally efficient BRFL framework that employs fully homomorphic encryption (FHE) to safeguard against malicious client activities while preserving data privacy. Lancelot features a novel interactive sorting mechanism called masked-based encrypted sorting. This method successfully circumvents the multiplication depth limitations of ciphertext, ensuring zero information leakage.
Furthermore, we incorporate cryptographic enhancements, such as Lazy Relinearization and Dynamic Hoisting, alongside GPU hardware acceleration, to achieve a level of computational efficiency that makes Lancelot a viable option for practical implementation. Our extensive testing, including medical imaging diagnostics and widely used public image datasets, demonstrates that Lancelot significantly outperforms existing methods, offering more than a twenty-fold increase in processing speed while maintaining data privacy. The Lancelot framework thus stands as a potent solution to the pressing issue of privacy in secure, multi-centric scientific collaborations, paving the way for safer and more efficient federated learning applications.
Diversity and Dynamics of Seasonal Pool Vegetation in Nediyenga, Sreekandapuram, Kannur District, Kerala, India.
Authors: Abhijith Sarga , MV Jeeshna , T Sreelakshmi
Published: October 2024

The present study was conducted in the seasonal pond at Nediyenga, Sreekandapuram (Northern side of Kannur District), Kerala, India during June 2022 - October 2023. The pond is renowned for the range of microhabitats and temporal dynamics that support a broad diversity of vascular plants. A total of 53 plant species were recorded and herbs dominated with a share of about (48 spp.) Of these, 16 species were endemic and many highly threatened as per the IUCN Red List criteria. Results of soil analysis were high organic carbon, enough magnesium (Mg), copper (Cu) and zinc (Zn) low potassium (K), sulfur(S) and boron(B); there are above resistance iron(Fe) and above tolerance levels of manganese (Mn). It indicates the potential anthropogenic impacts. The water analysis revealed a pH that was slightly acidic, and total dissolved solids were low with moderate conductivity and nutrient levels of the irrigation solution. These findings underscore the ecological significance of the Nediyenga pond, highlighting the need for targeted conservation efforts to manage soil nutrient imbalances and maintain water quality to supports its unique biodiversity.
Attention Deficit Hyperactivity Disorder Risk Factors Assessment and Correlation with Symptomatology among Children in Al Dakahlya Governorate
Authors: Soliman Amir , Hamdy Reem , Hasan Judy
Published: October 2024

Background
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder that primarily manifests during childhood, characterized by persistent patterns of inattention, hyperactivity, and impulsivity that are inappropriate for the child's developmental level.
Objectives
to assess and investigates the relationship between sociodemographic factors, prenatal influences, and ADHD symptom severity among children in Al Dakahlya Governorate, Egypt.
Methods
This cross-sectional study included 375 children with ADHD in Al Dakahlya Governorate, data were collected using standardized questionnaires and diagnostic tools such as the DSM-V criteria and Conners’ Rating Scale.
Results
Significant correlations were found between ADHD severity and several factors, including socioeconomic status, parental education, paternal smoking, parental consanguinity, and maternal folic acid intake. Children from lower socioeconomic backgrounds and those with less educated parents exhibited more severe ADHD symptoms. Additionally, paternal smoking and parental consanguinity were associated with greater ADHD severity, while maternal folic acid intake showed a protective effect.
Conclusion
The findings underscore the importance of socioeconomic and prenatal factors in influencing ADHD symptomatology and highlight potential areas for public health interventions aimed at improving maternal nutrition and reducing exposure to harmful prenatal conditions.