bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic effect of mifepristone combined with misoprostol in early missed miscarriage and prediction of incomplete abortion
Authors: Bai Xue , Li Tianjie , Lin Qing
Published: July 2024

Objective
This study aimed to evaluate the efficacy of mifepristone combined with misoprostol in first-trimester missed miscarriages. We also aimed to determine ideal cutoff values of clinical indicators to predict the need for surgical intervention for an incomplete abortion.
Methods
A cohort of 702 consecutive women diagnosed with missed miscarriages between January 2020 and May 2023 was retrospectively analyzed. Demographic and ultrasound parameters such as endometrial thickness, mean diameter of the mass, hCG levels before and 24 h, 1 week, 2 weeks, and 1 month after treatment were measured and compared. ROC was used to determine cut-off values for incomplete abortion.
Results
Overall, 146 patients were treated with mifepristone and misoprostol (medication group), and 556 patients underwent curettage (surgical group). The endometrial thickness and postoperative vaginal bleeding duration of the medication group were greater than those of the surgical group one month post-treatment (P < 0.05), and the menstrual volume reduction rate in the medication group was significantly lower than that in the surgical group (23.56%). Sixteen patients experienced incomplete abortion (2.88%) in the surgical group and underwent another curettage procedure, while 25 patients (17.12%) in the medication group had incomplete abortion. Fourteen patients (9.59%) in the medication group underwent curettage because of incomplete abortion, which was a significantly higher rate than that in the surgical group. Eleven patients with incomplete abortion in the medication group received long-term medication, and the residual tissue in the uterine cavity disappeared after 1–2 menstrual cycles. The ultrasound cutoff values indicating the need for surgical intervention for an incomplete abortion were an endometrial thickness > 1.21 cm at 24 h after medication abortion and a uterine residual diameter > 0.95 cm at 7 days after surgical abortion.
Conclusion
The efficacy of mifepristone combined with misoprostol for first-trimester missed miscarriages is equivalent to that of curettage. Ultrasonography should be periodically reviewed after treatment. Patients with an endometrial thickness > 1.21 cm 24 h after a medication abortion and postoperative residual uterine diameter > 0.95 cm 7 days should be vigilant against incomplete abortion.
A Systematic Review and Meta-analysis of the effect of Hyperglycemia on Admission for Acute Myocardial Infarction in Diabetic and non-Diabetic patients
Authors: Alawaji Reem , Musslem Mohammed , Alshalahi Emtenan , Alanzan Abdaluziz , Sufyani Albarra , Alhati Maram , Almutairi Alhanouf , Alqaffas Mahdi , Alattas Batool , Alselmi Adhari
Published: July 2024

Introduction:
Regarding a potential relationship between diabetes and the prognostic significance of hyperglycemia in patients presenting with acute myocardial infarction (AMI), there is still debate. Therefore, we aimed in this study to demonstrate the effect of hyperglycemia on different outcomes in AMI patients whether they are diabetic or not.
Methods
Using the following search strategy: “Diabetes” or “Diabetic” AND “Acute myocardial infarction” OR “AMI” AND “hyperglycemia” OR “glucose level”, we searched PubMed, Web of Science, and Scopus for eligible articles that should undergo the screening process to determine its ability to be included in our study. Using Review Manager version 5.4 software, we conducted the meta-analysis of the included studies by pooling the mean difference in continuous variables, number and total of dichotomous variables to measure the odds ratio (OR), and generic inverse variance of OR or hazard ratio (HR) as they were reported in the included studies.
Results
The difference between the diabetes and non-diabetes patients regarding blood glucose level was found to be statistically significant with SMD of 1.39 (95%CI: 1.12, 1.66, p < 0.00001). Hyperglycemia in diabetic patients was statistically significant associated with mortality with HR of 1.92 (95%CI: 1.45, 2.55, p < 0.00001) and OR of 1.76 (95%CI: 1.15, 2.7, p = 0.01). In non-diabetic patients admitted with AMI, hyperglycemia was statistically significant associated with mortality with HR of 1.56 (95%CI: 1.31, 1.86, p < 0.00001), and OR of 2.89 (95%CI: 2.47, 3.39, p < 0.00001). Moreover, hyperglycemia in diabetic patients admitted with AMI was statistically significant associated with occurrence of MACE with HR of 1.9 (95%CI: 1.19, 3.03, p = 0.007) and hyperglycemia in non-diabetic AMI patients was statistically significant associated with occurrence of MACE with HR of 1.6 (95%CI: 1.15, 2.23, p = 0.006).
Conclusion
Hyperglycemia in AMI patients is a predictor of worse outcomes including MACE, and mortality whether these patients are diabetic or not. Some factors act as predictors for mortality in these patients including older age, higher glucose levels on admission, and high Killip class.
Neuromodulation and Mindfulness as Therapeutic Treatment in Detoxified Patients with Alcohol Use Disorder
Authors: Rosenthal Annika , Haslacher David , Garbusow Maria , Pangratz Elisabeth , Apfel Björn , Soekadar Surjo , Romanczuk-Seiferth Nina , Beck Anne
Published: July 2024

Background
Alcohol use disorder (AUD) poses a significant global health challenge. Traditional management strategies often face high relapse rates, leading to a need for innovative approaches. Mindfulness-based relapse prevention (MBRP) has emerged as a promising intervention to enhance cognitive control, reduce cue-related craving and improve interoceptive processing. Neuroimaging studies suggest that mindfulness training can modulate brain networks associated with these factors, potentially improving treatment outcomes for AUD. Neuroimaging studies suggest that mindfulness training can modulate brain networks linked to these brain functions, potentially improving treatment outcomes for AUD. However, it is unclear how MBRP links to neurophysiological measures such as frontal midline theta oscillations (FMΘ) and whether the beneficial effects of MBRP can be increased by enhancing FMΘ. Here, we will use two different forms of neuromodulation to target and enhance these oscillations, and evaluate their impact on the effectiveness of MBRP.
Methods
This study will employ a four-arm randomized controlled trial to evaluate the synergistic effects of MBRP augmented with transcutaneous vagus nerve stimulation (tVNS) or closed-loop amplitude-modulated transcranial alternating current stimulation (CLAM-tACS) on cognitive control, cue reactivity and interoceptive processing in AUD patients. Participants will undergo six weekly group MBRP sessions and daily individual mindfulness practices. Assessments will include an inhibition task, cue-induced craving task, and heartbeat discrimination task, alongside heart rate variability and 32-channel EEG recordings. Participants will be assessed pre and post treatment, with a three-month follow-up to evaluate long-term effects on abstinence and alcohol consumption.
Discussion
This study will not only elucidate the causal link between FMΘ and efficacy of MBRP, but contribute to a better understanding of how combined psychological and neuromodulation interventions can improve treatment outcomes for AUD, potentially leading to more effective therapeutic strategies. This study also seeks to explore individual differences in response to treatment, which could inform future approaches to AUD management.
Trial registration
This study received approval by the Charité—Universitätsmedizin Berlin Institutional Review Board (EA1/030/23, 10.11.2023). It was registered on ClinicalTrials.gov (NCT06308484).
Maternal Factors Promoting Normal Linear Growth of Children from Impoverished Rwandan Households
Authors: Habimana Jean Dieu , Noel Korukire , Jewett Sara , Matsiko Eric , Umugwaneza Maryse , Rugema Lawrence , Munyanshongore Cypreien
Published: July 2024

Background
Linear growth faltering remains a pervasive public health concern, considering its persistent prevalence and repercussions. This study aimed to investigate potential maternal factors promoting normal linear growth among children from impoverished Rwandan households.
Methods
We used a multi-stage cluster sampling procedure. A structured questionnaire helped to collect data from 807 mother-child dyads selected. The primary outcome variable was height-for-age Z-scores. The main predictors were maternal income-generating activity, maternal education, maternal depression, household decision-making (HHDM), number of ANC visits, use of family planning method, family planning types, and mode of delivery. The potential confounding variables were child age, parents working, good handwashing practice, owning a vegetable garden, and the total number of livestock. We used univariate analysis to establish means, frequencies, and percentages. Additionally, we used the Kruskal-Wallis, Mann-Whitney U, and Spearman Rank Correlation tests for bivariate analysis and robust linear regression for multivariable analysis.
Results
Maternal factors promoting normal linear growth of children were the presence of the mother's income-generating activity (ꞵ=0.640 [0.0269 − 1.253], p-value = 0.041), mother’s involvement in household decision-making (ꞵ=0.147 [0.080 − 0.214], p-value < 0.001), and higher frequency of ANC consultations (ꞵ=0.189 [0.025 − 0.354], p-value = 0.024). Additionally, a combination of household decision-making with ANC visit numbers predicted an increase in child linear growth (ꞵ=0.032 [0.019 − 0.045], p-value < 0.001).
Conclusion
Maternal factors such as maternal income-generating activity, maternal involvement in household decision-making, and increased number of ANC visits were found to promote normal child linear growth and can provide valuable information for shaping interventions and policies to promote child growth in the Rwandan community.
Vascular Insult in Neonatal Retinal Hemorrhage
Authors: Lam Matthew R. , Colmenarez Jose A. , Dong Pengfei , Gu Linxia , Suh Donny W.
Published: July 2024

Common hypotheses for the biomechanical cause underlying neonatal retinal hemorrhage include elevated intracranial pressure (ICP) inducing venous outflow obstruction and retinal deformation. A finite element computational model of the eye, optic nerve, and orbit was simulated with particular attention to the retinal vessels to analyze stress and strain on these structures during external head compression associated with normal vaginal delivery. Pressure from maternal contractions displaced the eye backward into the orbit, and the stiff optic nerve sheath provided localized resistance to this posterior displacement at its insertion point, resulting in tensile strain of 2.5% in the peripapillary (central) retina. Correspondingly, retinal vessels experienced tensile stress of up to 2.3 kPa near the optic nerve insertion point and opposing compressive stress of up to 3.2 kPa further away. The optic nerve was longitudinally compressed and experienced a mean radial tensile strain of 2.0%. Overall, forces associated with maternal labor resulted in a pattern of eye deformation that stretched the central retina in this simulation, mirroring the classical posterior localization of neonatal retinal hemorrhage. The optic nerve increased modestly in diameter despite rising ICP, suggesting retinal deformation is a more likely mechanism for retinal hemorrhage than occlusion of the central retinal vein.
“Art is just something that makes people heal” - A Qualitative Investigation of Tattoo Artists’ Perspectives on Cancer Survivorship Therapeutic Tattoos
Authors: Daly Adam , Karl Johannes , Dunne Simon
Published: July 2024

Purpose
Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists’ (TAs’) perspectives on the types, impacts, barriers and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves.
Methods
Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analysed thematically.
Results
The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos.
Conclusion
This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs’ perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, a reduction in barriers to the practice and greater collaboration between HPs and TAs.
Implications for Cancer Survivors:
Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.
The impact of variant annotations on the diagnostic yield of exome sequencing for rare pediatric neurological diseases
Authors: Komatsu Kazuyuki , Kato Mitsuhiro , Kubota Kazuo , Fukumura Shinobu , Yamada Keitaro , Hori Ikumi , Shimizu Kenji , Miyamoto Sachiko , Yamoto Kaori , Hiraide Takuya , Watanabe Kazuki , Aoki Shintaro , Furukawa Shogo , Hayashi Taiju , Isogai Mayu , Harasaki Takuma , Nakashima Mitsuko , Saitsu Hirotomo
Published: July 2024

Variant annotations are crucial for the efficient identification of pathogenic variants. In this study, we retrospectively evaluated the impact of various annotations on identifying 273 pathogenic single nucleotide and small insertion/deletion variants (SNVs/small indels) from 242 patients. Although variant filtering based on allele frequency is essential for narrowing down candidate variants, we found that 13 de novo pathogenic variants in autosomal dominant or X-linked dominant genes had been registered in gnomADv4.0 or 54KJPN with an allele frequency of less than 0.001%, suggesting that very rare variants in large cohort data can be pathogenic de novo variants. Strikingly, 38.1% candidate SNVs/small indels had been registered in the ClinVar database as pathogenic or likely pathogenic, highlighting great utility of this database. SpliceAI can detect candidate variants affecting RNA splicing, leading to the identification of four variants located at 11 to 50-bp away from the exon-intron boundary. Prioritization of candidate genes by patients’ phenotypes using PhenoMatcher module revealed that approximately 95% of the candidate genes had a maximum PhenoMatch score of ≥ 0.6, suggesting the utility of variant prioritization using phenotypes. This study suggests that a combination of multiple annotations and the appropriate evaluation can improve the diagnostic yield of rare diseases.
Immunotherapy in advanced esophageal squamous cell cancer: earlier or later?
Authors: Wei Shuang , Li Zuoji , Liu Tingting , Sun Guizhen , Sun Hongfu , Huang Wei
Published: July 2024

Background and objective: Several large-scale phase III clinical trials have confirmed the survival benefit of immunotherapy in patients with locally advanced or metastatic esophageal cancer. The aim of this study is to investigate whether early use of immunotherapy can improve long-term survival.
Methods: Patients with locally advanced or metastatic esophageal squamous cell cancer (ESCC) diagnosed from January 2018 to December 2021were retrospectively analyzed. According to the time of immunotherapy, patients were divided into early immunotherapy group (EIT group, first-line immunotherapy ) and late immunotherapy group (LIT group, second-line immunotherapy) . A 1:1 propensity score matching (PSM) was applied to balance the observable potential confounding factors between the two groups. The primary outcome was overall survival (OS).
Results: A total of 359 patients were enrolled, after propensity score matching, the clinical features were well balanced between two groups included 107 patients each. The median OS was 15.7 months (95%CI: 12.81-18.59) in the EIT group and 17.7 months (95%CI: 14.89-20.57) in the LIT group, respectively. (P=0.185, HR=1.25). The PFS1 of patients were 8.7 months (95%CI: 7.53-9.87) and 7.6 months (95%CI: 5.90-9.30),respectively, and the difference was statistically significant (P=0.032, HR=0.72). The PFS2 of patients were 12.97months (95%CI: 11.37-14.58) and 12.93 months (95%CI: 11.65-14.21), respectively, and the difference was statistically significant(P=0.045,HR=0.73). Subgroup analysis showed that male patients with middle thoracic esophageal cancer, younger than 65 years old, only one site of metastasis, only lymph node progression, no combined radiotherapy after progression and TP (paclitaxel plus platinum) regimen chemotherapy may have greater benefits. COX multivariate analysis showed that the EIT group and the differentiation degree of tumor had an impact on overall survival (P：0.03、0.04, HR: 0.73、0.70).
Conclusions: For patients with locally advanced or metastatic advanced ESCC, earlyimmunotherapy can improve PFS without improving OS.
Exacerbated Hepatotoxicity in Non-alcoholic Fatty Liver by Copper Sulfide Nanoparticles
Authors: Cui Jinbin , Zhao Gang , Xie Wei , Yang Yang , Fu Xing , Meng Hezhang , Liu He , Tan Mengfei , Chen Dandan , Rong Chao , Wang Yangyun , Wang Yong , Zhang Leshuai W.
Published: July 2024

Background
Copper sulfide nanoparticles represent a promising photothermal agent with significant commercial potential. Despite these advantages, the safety assessment of copper sulfide NPs, particularly for tumor patients with liver diseases, remains insufficient. Non-alcoholic fatty liver (NAFL) is a condition characterized by the accumulation of excess fat in the liver, potentially leading to increased sensitivity to foreign substances and progression to more severe liver disease.
Results
To explore the differential hepatotoxicity of copper sulfide NPs in NAFL conditions, we synthesized and characterized large-sized (LNPs, 15.1 nm) and small-sized (SNPs, 3.5 nm) BSA@Cu2 − xS NPs. A NAFL rat model fed with high fat diet (HFD) was successfully established for a 14-day subacute toxicity study by daily repeated administration of BSA@Cu2 − xS NPs. Our findings from serum biochemistry and histopathological examinations revealed that copper sulfide at both sizes NPs induced more pronounced liver damage in NAFL rats compared to rats fed with normal diet. Additionally, LNPs exhibited significantly higher intrahepatic accumulation than SNPs, leading to more severe hepatotoxicity. Transcriptome sequencing analysis showed that LNPs activated inflammation and DNA damage repair pathways in the livers of NAFL rats, while SNPs displayed minimal inflammation. In vitro 3D NAFL spheroids experiments demonstrated that LNPs, but not SNPs, triggered a distinct release of inflammatory factors and increased reactive oxygen species through Kupffer cells.
Conclusions
These results highlight that NAFL condition exacerbated the hepatotoxicity of BSA@Cu2 − xS NPs, with SNPs emerging as relatively safer photothermal agents compared to LNPs, suggesting superior potential for clinical applications.
Outcomes of fertility treatment after radical trachelectomy for early stage cervical cancer
Authors: Kamijo Shintaro , Matsuda Risa , Yamada Mitsutoshi , Nishio Hiroshi , Iwata Takashi , Yamgami Wataru , Tanaka Mamoru
Published: July 2024

Background
Perinatal outcomes including miscarriage, chorioamnionitis, preterm premature rupture of membranes, and premature birth in patients who undergo radical trachelectomy (RT) are correlated with cervical stenosis, bleeding, and shortening; infertility treatment is necessary, and a relatively high proportion of patients achieve pregnancy post-RT. A decreased response to ovarian stimulation in in vitro fertilization (IVF) and decreased pregnancy rates per embryo transfer (ET) have been reported in patients post-RT. This study aimed to investigate clinical characteristics and IVF outcomes of patients post-RT.
Results
This retrospective cohort study included 41 patients who underwent IVF among 297 individuals who underwent RT for early-stage cervical cancer between January 2009 and December 2022. Participants were referred to our reproductive center for IVF after undergoing RT for early-stage cervical cancer at our gynecology department at Keio University. All patient medical records were analyzed for the following variables: tumor characteristics, postoperative treatment, intraperitoneal infection post-surgery, age at operation and initial oocyte retrieval, body mass index, serum anti-Müllerian hormone level, ovarian stimulation protocol, gonadotropin dose, trigger type, number of oocytes retrieved and cryopreserved, fertilization rate, number of frozen embryos, pregnancy outcomes, presence of cervical stenosis and cervical dilation, endometrial thickness at ET, and Towako® method utilization. Of 41 patients who underwent IVF, 68% achieved clinical pregnancies with 59% live births. Age at initial oocyte retrieval and number of oocytes retrieved were significantly different between clinical-pregnancy and non-clinical pregnancy groups and between live-birth and non-live birth groups. The live-birth group had fewer cases of cervical stenosis. Endometrial thickness at ET was also significantly different between live-birth and non-live birth groups, with an optimal 9.2-mm threshold for predicting pregnancy and live birth and an additional 7.5-mm threshold for live births.
Conclusions
Age at initial oocyte retrieval, endometrial thickness at ET with an optimal 9.2-mm threshold for predicting pregnancy and live birth and an additional 7.5-mm threshold for live births, and presence of cervical stenosis are factors potentially influencing IVF outcomes post-RT. These findings may serve as a reference for considering IVF post-RT and support the use of endometrial thickness as a predictive marker in assisted reproductive technology.
The level of non-adherence and its associated factors among adult HIV patients on antiretroviral therapy in Nyamasheke district, Rwanda: a cross-sectional study, 2023
Authors: Nkundabaza Christophe , Stamatakis Caroline , Mukamurigo Judith , Ndagijimana Albert
Published: July 2024

Background
Antiretroviral therapy (ART) has been crucial in managing HIV, but its success heavily relies on patient adherence. In sub-Saharan African countries, including Rwanda, adherence remains a challenge. Moreover, adults living with HIV (ALHIV) account for the majority of clients on ART in Rwanda, with 3.80% of them in Nyamasheke district. However, information regarding adherence to ART among these ALHIV is limited. This study aimed to assess the level of non-adherence to ART and its associated factors among ALHIV in Nyamasheke district.
Methods
A cross-sectional study was conducted in 22 randomly selected health facilities and included 416 participants. Data were collected through medical record reviews and interviews. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with non-adherence. Adherence was measured based on pill count. Odds ratio, 95% confidence interval and p-value were reported. Data were managed using MS Excel and analysed using Stata version 16.
Results
Of the 416 participants, 92.50% had past-month ART adherence level of 95% or higher. The following factors; age of 15–24 years (adjusted odds ratio [AOR]: 5.76, 95% CI: 1.68–19.73), shorter duration on ART (< 5 years) (AOR: 3.10, 95% CI: 1.11– 8.68), those who had treatment interruption (AOR: 4.08, 95% CI: 1.54–10.83), alcohol consumption (AOR: 4.42, 95% CI: 1.79–10.9), and forgetfulness (AOR: 4.53, 95% CI: 1.34–15.22) were significantly associated with non-adherence among ALHIV in Nyamasheke district.
Conclusion
The overall level of adherence was lower than the World Health Organization (WHO) standard, highlighting the importance of addressing the associated factors to improve adherence rates and treatment outcomes. The study emphasizes the need for more intensive counselling and regular follow-up, particularly for younger HIV patients, patients during their early stages on medication, ALHIV with treatment interruption, forgetfulness, and those who consume alcohol.
Transcriptomic and bioinformatic analyses in the sacral ligament tissue of postmenopausal women have revealed the pathogenesis of pelvic organ prolapse disease
Authors: yang yanfeng , rui bingjie , xia ZhiJun , zhu jing
Published: July 2024

Background
Pelvic organ prolapse (POP) is a prevalent gynecological disorder, characterized by anomalies in the function or position of the pelvic organs, frequently manifesting as prolapse of the uterus and both the anterior and posterior vaginal walls. POP is primarily linked to damage to both the pelvic floor muscles and connective tissue, with the majority of molecules and genetic mutations associated with POP pertaining to the synthesis and degradation of pelvic support tissues. Recently, the significant role of non-coding RNA (ncRNA) in epigenetic regulation has garnered extensive attention. However, the functions of various RNAs including microRNA (miRNA), long non-coding RNA (lncRNA), circular RNA (circRNA), and messenger RNA (mRNA) in the pathogenesis of POP remain elusive.
Results
This study collected uterosacral ligament tissue from five POP patients and three age-matched controls for Illumina PE150 sequencing, identifying 60 mRNAs, 176 miRNAs, 29 lncRNAs, and 176 circRNAs with statistically significant differences in abundance between the POP and control groups. The accuracy of the high-throughput next-generation sequencing results was further validated through qRT-PCR analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses demonstrated that differentially expressed genes were predominantly involved in the MAPK, Erk1/2, rap1, FOXO, and ErbB signaling pathways. KEGG disease analysis indicated that these genes are closely associated with inflammation, adhesion plaques, cellular aging, apoptosis, and the cytoskeleton. Utilizing the competitive endogenous RNA (ceRNA) regulatory mechanism, we constructed a lncRNA/circRNA-miRNA-mRNA network. Finally, from the RNAs identified in the high-throughput whole transcriptome sequencing, we randomly selected ENSG00000254531 and confirmed that this molecule influences fibroblast proliferative capacity.
Conclusion
Our comprehensive transcriptome study reveals the gene expression characteristics in the uterosacral ligament tissues of postmenopausal women with POP. This study provides essential data support for identifying key mRNAs and non-coding RNAs associated with the potential molecular mechanisms of POP. We screened differentially expressed miRNAs, lncRNAs, circRNAs, and mRNAs, evaluated their functional enrichments, and constructed ceRNA network to elucidate potential regulatory mechanisms and their corresponding functions. Finally, we validated the differential expression of a critical lncRNA in tissues and cells through in vitro experiments. Our findings demonstrate that the dysregulated lncRNA significantly impacts fibroblast proliferation. The identification of key lncRNAs in our study provides valuable insights into POP-related lncRNAs and may serve as important factors in the diagnosis and treatment of pop. This research introduces new candidate markers for exploring the pathogenesis of pelvic organ prolapse.
Ranking the Attribution of High-Risk Genotypes among Women with Cervical Precancers and Cancers: A Cross-Sectional Study in Ningbo, China
Authors: Chen Shimin , Shangying HU , Jian YIN , Wenying YU , ZHANG Xun , DENG Xi , Huaxin DING , ZHANG Jinyu , Yan SONG , Qiming WANG , Liang CHEN , Feng GUO , Susanne HARTWIG , Fanghui ZHAO
Published: July 2024

Background:
The region-specific importance of carcinogenic HPV genotypes is required for optimizing HPV-based screening and promoting appropriate multivalent HPV prophylactic vaccines. This information is lacking for Ningbo, one of the first cities of China's Healthy City Innovation Pilot Program for Cervical Cancer Elimination. Here, we investigated high-risk HPV (HR-HPV) genotype-specific distribution and attribution to biopsy-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) before mass vaccination in Ningbo, China.
Methods:
A total of 1393 eligible CIN2+ archived blocks (including 161 CIN2, 1107 CIN3, and 125 invasive cervical cancers [ICC]) were collected from 2017 to 2020 in Ningbo. HR-HPV DNA was genotyped using the SPF10-DEIA-LiPA25 version 1 detection system and the SureX HPV 25X Genotyping Kit. Genotype-specific attribution to CIN2+ was estimated using a fractional contribution approach.
Results:
Ranking by the attributable proportions, HPV16 remained the most important genotype in both cervical precancers and cancers, accounting for 36.8% of CIN2, 53.2% of CIN3, and 73.3% of ICC cases. Among cervical precancers, HPV52 (17.3% in CIN2, 12.7% in CIN3) and HPV58 (13.9%, 14.9%) ranked second and third, while HPV33 (8.3%, 7.9%) and HPV31 (6.5%, 4.1%) ranked fourth and fifth, respectively. However, among ICCs, HPV18 (5.7%) accounted for the second highest proportion, followed by HPV33 (5.4%), HPV58 (4.0%), and HPV45 (3.2%). HPV18/45 together accounted for 46.8% of adenocarcinomas, which was slightly lower than that of HPV16 (47.7%). The remaining HR-HPV genotypes (HPV35/39/51/56/59/66/68) combined accounted for only 6.7% of CIN2, 2.9% of CIN3, and 4.2% of ICC.
Conclusions:
With Ningbo’s strong medical resources, it will be important to continue HPV16/18 control efforts, and could broaden to HPV31/33/45/52/58 for maximum health benefits. However, different strategies should be proposed for other HR-HPV genotypes based on their lower carcinogenic risks.
On the detection of population heterogeneity in causation between two variables: Finite mixture modeling of data collected from twin pairs.
Authors: Vinh Philip , Verhulst Brad , Dolan Conor V , Neale Michael C , Maes Hermine HM
Published: July 2024

Causal inference is inherently complex, often dependent on key assumptions that are sometimes overlooked. One such assumption is the potential for unidirectional or bidirectional causality, while another is population homogeneity, which suggests that the causal direction between two variables remains consistent across the study sample. Discerning these processes requires meticulous data collection through an appropriate research design and the use of suitable software to define and fit alternative models. In psychiatry, the co-occurrence of different disorders is common and can stem from various origins. A patient diagnosed with two disorders might have one recognized as primary and the other as secondary, suggesting the existence of two types of comorbidity within the population. For example, in some individuals, depression might lead to substance use, while in others, substance use could lead to depression. Identifying the primary disorder is crucial for developing effective treatment plans. This article explores the use of finite mixture models to depict within-sample heterogeneity. We begin with the Direction of Causation (DoC) model for twin data and extend it to a mixture distribution model. This extension allows for the calculation of the likelihood of each individual’s data for the two alternate causal directions. Given twin data, there are four possible pairwise combinations of causal direction. Through simulations, we investigate the Direction of Causation Twin Mixture (mixCLPM) model’s potential to detect and model heterogeneity due to varying causal directions.
Association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with gout prevalence: a cross-sectional study
Authors: Guo Xia , Chu Haoxuan , Xu Hanchi , Wang Shipeng , He Jiahuan , Wang Yushi
Published: July 2024

Background
The non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio (NHHR), which stands for the proportion of non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C), is a strong lipid marker that is linked to atherogenic features. The aim of the research was to investigate the potential association between NHHR and the prevalence of gout.
Methods
This study investigated the correlation between NHHR levels and gout by analyzing information gathered by the National Health and Nutrition Examination Survey (NHANES), a research study conducted in the United States from 2007 to 2018. NHHR is a mathematical formula that calculates the ratio of non-HDL-C to HDL-C. Gout assessment was conducted through a questionnaire. Multifactorial logistic regression analysis, subgroup analysis, and smoothed curve fitting were employed in this study.
Results
The study included 30,482 subjects. The fully adjusted models showed that for each unit rise in NHHR in continuous variables, there was an 11% higher likelihood of gout prevalence (OR: 1.11, 95% CI: 1.07–1.15). The analysis of the NHHR quartile variable revealed that those in the highest quartile of NHHR had a notably greater risk of developing gout in comparison to with people in the lowest quartile. (Q4 vs. Q1, OR: 1.43, 95% CI: 1.21–1.68). The subgroup analyses yielded consistent results across categories, indicating a substantial positive correlation between NHHR and gout. Interaction tests showed that gender, race, level of education, marital relationship, PIR, hypertension, BMI, smoking habits, and diabetes had no discernible effect on this association. The p-values for all the interactions were more than 0.05. Nevertheless, the relationship between NHHR and gout was substantially affected by the age of the participants (interaction p-value < 0.05).
Conclusion
Among adults in the United States, elevated NHHR levels are correlated with an increased odds of gout prevalence. Effectively managing NHHR levels may reduce the occurrence of gout.
Hubert-LSTM: A Hybrid Model for Artificial Intelligence and Human Speech
Authors: BAIAS Antonio-Cristian
Published: July 2024

Speech emotion recognition (SER) is a critical component of human-computer interaction, facilitating seamless communication between individuals and machines. In this paper, we propose a hybrid model, integrating Hubert, a cutting-edge speech recognition model, with LSTM (Long Short-Term Memory), known for its effectiveness in sequence modeling tasks, to enhance emotion recognition accuracy in speech audio files. We explore the Ryerson Audio-Visual Database of Emotional Speech and Song (RAVDESS) for our investigation, drawn by its complexity and open accessibility. Our hybrid model combines the semantic features extracted by Hubert with LSTM’s ability to capture temporal relationships in audio sequences, thereby improving emotion recognition performance. Through rigorous experimentation and evaluation on a subset of actors from the RAVDESS dataset, our model achieved promising results, outperforming existing approaches, with a maximum accuracy of 89.1%.
Exploring CHIT1 and YKL-40 in tuberculous pleural effusion: insights and implications
Authors: Przysucha Natalia , Paplińska-Goryca Magdalena , Górska Katarzyna , Misiukiewicz-Stępień Paulina , Mlącki Michał , Cyran Agata , Krenke Rafal
Published: July 2024

Background and objective: Chitinases and chitinase-like proteins are thought to be involved in the pathophysiology of lung diseases. The study was designed to evaluate the significance of chitotriosidase (CHIT1) and YKL-40 in tuberculous pleural effusion (TPE), to identify the cellular sources of these proteins in pleural fluid, and to assess the diagnostic performance of chitinases as potential biomarkers of TPE.
Methods: This retrospective, single-centre study included 66 patients with pleural effusion of different origins: malignant pleural effusion (MPE), TPE, parapneumonic pleural effusion (PPE), and pleural transudate (TE). YKL-40 and CHIT1 protein levels were measured in pleural effusions, while YKL-40 and CHIT1 expression was evaluated by the immunohistochemical staining in tuberculoid granulomas.
Results: The highest levels of CHIT1 and YKL-40 were found for TPE 70.51 ng/ml (49.65-136.98 ng/ml) and 569.84 ng/ml (530.32-706.01 ng/ml), respectively. The amount of YKL-40 in TPE was significantly higher than in PPE [387.98 ng/ml (262.94-539.09 ng/ml),(p<0.01)] and TE [(254.95 ng/ml (188.93-334.1 ng/ml), (p<0.001)]. A strong positive correlations between YKL-40 level in TPE and the percentage of macrophages (r=0.73, p=0.003) and adenosine deaminase activity (r=0.82, p<0.001) were demonstrated. Pleural YKL-40 (higher than 500 ng/ml) could be helpful in differentiating between tuberculosis vs. non-tuberculosis effusions (sensitivity 78.85%, specificity 85.7%, and AUC of 0.85). We revealed a clearly detectable expression of YKL-40 in the tuberculoid granulomas, whereas the presence of CHIT1 in this material was negligible.
Conclusion: Our study showed that YKL-40 but not CHIT-1 may contribute to the pleural inflammatory response associated with tuberculosis.
Neutrophil chemotaxis score and chemotaxis-related genes have the potential for clinical application to prognosticate the survival of patients with tumours
Authors: Yang Yunxi , Yang Jun , Li Linbin , Shao Yiming , Liu Lu , Sun Bingwei
Published: July 2024

As frontline cells, the precise recruitment of neutrophils is crucial for resolving inflammation and maintaining the homeostasis of the organism. Increasing evidence suggests the pivotal role of neutrophil chemotaxis in cancer progression and metastasis. Here, we collected clinical data and peripheral blood samples from patients with tumours to examine the alterations in the neutrophil quantity and chemotactic function using the Cell Chemotaxis Analysis Platform (CCAP). Transcriptome sequencing data of pan-cancer were obtained from The Cancer Genome Atlas (TCGA). Using the least absolute shrinkage and selection operator (LASSO) Cox regression model, a total of 29 genes were selected from 155 neutrophil- and chemotaxis-related genes to construct the ChemoScore model. Meanwhile, nomogram-based comprehensive model was established for clinical application. Furthermore, immunofluorescence staining was employed to assess the relationship between the neutrophils infiltrating and the survival outcomes of tumours. In this observational study, the chemotactic function of neutrophils in patients was notably diminished. The establishment and validation of ChemoScore suggested neutrophil chemotaxis to be a risk factor in most tumours, whereby higher scores were associated with poorer survival outcomes and were correlated with various immune cells and malignant biological processes. Moreover, IF staining of tumour tissue substantiated the adverse correlation between neutrophil infiltration and the survival of patients with lung adenocarcinoma (P = 0.0002) and colon adenocarcinoma (P = 0.0472). Taken together, patients with tumours demonstrated a decrease in chemotactic function. ChemoScore potentially prognosticates the survival of patients with tumours. Neutrophil chemotaxis provides novel directions and theoretical foundations for anti-tumour treatment.
Which voxel-wise resting state fMRI metric is the most discriminatory for concussion? A secondary analysis.
Authors: Sharma Bhanu , Nowikow Cameron , Zhu Calvin , Noseworthy Michael D
Published: July 2024

Background Concussions are among the most common sport-related injuries. While symptoms remain the most widely studied outcome, other measures such as resting state functional magnetic resonance imaging (rsfMRI) are being increasingly studied to better understand the neurophysiology of concussion. The basis for rsfMRI is the temporal blood oxygen level dependent (BOLD) signal, which shows complex changes in brain activity over the course of a scan. The BOLD signal can be operationalized in many ways, which effects how the data are analyzed and interpreted. It is therefore important for neuroimaging researchers to understand which rsfMRI metric is most discriminatory between concussion subjects and healthy controls, as such knowledge may aid in the design of future studies. The primary purpose of our study was to employ a random forest approach to determine which BOLD signal metric (of which we selected six) was most discriminatory between concussion subjects and healthy controls. As a secondary objective, we aimed to understand which anatomical regions of interest in the brain were most discriminatory between these two groups.Methods We performed a secondary data analysis of prospectively collected concussion data (n = 28), alongside healthy control data retrieved through an open-source neuroimaging repository (n = 379). After pre-processing data in CONN 21a, six BOLD metrics were computed: mean, standard deviation, Lyapunov exponent, sample entropy, amplitude of low frequency fluctuations (ALFF), and fractional ALFF (fALFF). Using a 60/20/20 (training/testing/validation) split of the data, random forest models were built using 'scikit-learn' and 'imbalanced-learn' to determine which metrics and anatomical regions of interest were most discriminatory between concussion and healthy subjects.Results We found that ALFF was the most discriminatory BOLD metric, with an ROC AUC = 0.993. With respect to regions of interest, we found that the BOLD signal from the cerebellum, vermis, and putamen (left) were most often discriminatory.Conclusions Our study provides concussion neuroimaging researchers with insight into which rsfMRI metrics may be discriminatory between groups, as well as which anatomical regions may help distinguish between concussion and healthy subjects. This may inform the design of new research studies that take aim at assessing or monitoring concussion using rsfMRI.Trial registration: Not applicable.
A nested case-control study of plasma-based extracellular vesicles biomarkers of Alzheimer’s disease
Authors: Yang Li , He Liang , Wang Yali , Xuan Cheng , Yu Caiyan , Yan Jing
Published: July 2024

Determining a non-invasive, serum-based diagnostic panel for early diagnosis of Alzheimer’s disease (AD) will play a significant role in the prevention and treatment of AD. The emerging role of extracellular vesicles (EVs) in intercellular communication has stimulated renewed interest in exploring the potential application of EVs as tools for early diagnosis in AD. We retrospectively identified 2 diagnostic groups of 50 individuals, 25 AD and 25 were healthy controls. Plasma neuron-derived extracellular vesicles (NDEVs) were isolated, characterization and high throughput analysis were conducted. ROC curve analysis was used to determine the performance of the EVs biomarkers and diagnosis models. In the screening of significantly different proteins, the expression change (FC) > 2.0 times (up-regulated greater than 2.0 times or down-regulated less than 0.5 times) and P value < 0.05 (T-test) were used as criteria to obtain the up-regulated and down-regulated EVs proteins between comparison groups. In this study, 8 EVs protein biomarkers were screened, including Fibrinogen-like protein 1 (FGL1), Glucosidase 2 subunit beta (PRKCSH), Phosphatidylinositol 5-phosphate 4-kinase type-2 alpha (PIP4K2A), cDNA FLJ78516 (FLJ78516), Ras GTPase-activating protein 3 (RASA3), Nck-associated protein 1 (NCKAP1), Hematopoietic progenitor cell antigen CD34 (CD34), and Angiopoietin-1 (ANGPT1). Among them, FGL1, PRKCSH and PIP4K2A are up-regulated EVs biomarkers, and the other 5 are down-regulated ones. Our study developed an approach including of EVs protein biomarkers, that could be used to distinguish AD from control candidates, thus providing an additional approach that can be used to complement classical diagnosis methods.
Simulation and Training for Pediatric Colorectal Surgery and Anorectal Malformation: A Scoping review
Authors: Sharma Shilpa , Sarkar Asia
Published: July 2024

Purpose: To study the published literature for various models used for simulation and training in the field of pediatric colorectal surgery.
Method: A PubMed search was conducted for studies of simulation models in anorectal malformation on 24 March 2024 with the search words ‘simulation pediatric colorectal surgery’ followed by another search on ‘simulation AND anorectal malformation’ that gave 22 and 14 results respectively (total 36). After removing 4 duplicate publications, 12 were found relevant to simulation and training in colorectal diseases. One publication relevant to the topic was added from literature, 13 articles were studied.
Results: Of these 5;1;4;3 were on Inanimate models; Animate model; 3D reconstructions; Training. Simulation models are available for Posterior sagittal anorectoplasty. The same inanimate model was used in 5 articles. The animate model was based on a chicken cadaver. 3D models have been made for personalized preoperative assessment and to understand the imaging in anorectal malformation. One 3D model was made by regeneration of organoid epithelium. Training modules were made to evaluate surgical dissection, standardize surgical techniques and improve proficiency.
Conclusions:Simulation models are an important tool for teaching the steps of surgery and discussing the nuances of operative complications amongst mentors and peers. With advances in this field, the development of high-fidelity models, more training modules and consensus on surgical techniques will benefit surgical training.
BANGKIT DARI BADAI: TRANSFORMASI INDUSTRI WISATA KULINER KOPI DAN KOMUNITAS PETANI DI ACEH TENGAH PASCA PANDEMI
Authors: Usrah Cut Rizka Al , Kembaren Emmia Tambarta
Published: July 2024

Abstrak: Potensi dan popularitas wisata kuliner kopi, khususnya kopi Arabika Gayo, telah meraih pengakuan baik secara lokal maupun internasional karena keunikan aroma dan citarasanya. Namun, dampak luas pandemi COVID-19 terhadap sektor pariwisata di Indonesia telah memberikan tantangan serius, termasuk bagi industri wisata kuliner kopi di Aceh Tengah. Penurunan kunjungan wisatawan telah mengganggu berbagai aspek bisnisnya. Oleh karena itu, penelitian dilakukan untuk mengidentifikasi dampak tersebut dan menemukan solusi yang tepat guna menghidupkan kembali industri ini. Melalui metode penelitian yang melibatkan observasi, wawancara mendalam, dan FGD, upaya dilakukan untuk mengoptimalkan potensi wisata kuliner kopi di wilayah tersebut. Hasil analisis menunjukkan bahwa pembatasan jam operasional bisnis kuliner kopi merupakan salah satu dampak terbesar dari pandemi COVID-19 di Aceh Tengah, menyebabkan penurunan pendapatan dan kesulitan dalam ekspor. Meskipun demikian, potensi pariwisata di daerah tersebut tetap tinggi meskipun terjadi penurunan jumlah wisatawan akibat adanya pembatasan aktivitas.
Kata Kunci: Pariwisata Kuliner Kopi; Arabika Gayo; Dampak COVID-1; Strategi pemulihan.
 
Abstract: The potential and popularity of coffee culinary tourism, particularly Arabica Gayo coffee, have garnered recognition both locally and internationally for its unique aroma and flavor profile. However, the widespread impact of the COVID-19 pandemic on the tourism sector in Indonesia has posed serious challenges, including to the coffee culinary tourism industry in Central Aceh. Decreased tourist visits have disrupted various aspects of the business. Hence, research is conducted to identify these impacts and find suitable solutions to revitalize this industry. Through research methods involving observation, in-depth interviews, and group discussions, efforts are made to optimize the potential of coffee culinary tourism in the region. The analysis reveals that operational hour restrictions on coffee culinary businesses are among the major impacts of the COVID-19 pandemic in Central Aceh, resulting in revenue decline and export difficulties. Nevertheless, the tourism potential in the area remains high despite the decrease in tourist numbers due to activity restrictions.
Keywords: Coffee Culinary Tourism; Arabica Gayo; COVID-19 Impact; Recovery strategies