bluuebunny/crossref_metadata_2025 huggingface dataset:
Mapping associations between anxiety and sleep problems among outpatients in high-altitude areas: a network analysis
Authors: Jin Yu , Li Jiaqi , Ye Jing , Luo Xianyu , Wilson Amanda , Mu Lanxue , Zhou Pinyi , Lv Yunhui , Wang Yuanyuan
Published: May 2023

Background

Anxiety and sleep problems are common comorbidities among outpatients living in high-altitude areas. Network analysis is a novel method to investigate the interaction and the association between symptoms across diverse disorders. This study used network analysis to investigate the network structure symptoms of anxiety and sleep problems among outpatients in high-altitude areas, and to explore the differences in symptom associations in various sex, age, educational levels and employment groups.

Methods

The data was collected from the Sleep Medicine Center of The First People’s Hospital of Yunnan Province from November 2017 to January 2021 with consecutive recruitment (N = 11,194). Anxiety and sleep problems were measured by the Chinese version of the seven-item Generalized Anxiety Disorder Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) respectively. Central symptoms were identified based on centrality indices and bridge symptoms were identified with bridge indices. The difference of network structures in various sex, age, educational levels and employment groups were also explored.

Results

Among all the cases, 6,534 (58.37%; 95% CI: 57.45-59.29%) reported experiencing anxiety (GAD-7 total scores ≥ 5), and 7,718 (68.94%; 95% CI: 68.08-69.80%) reported experiencing sleep problems (PSQI total scores ≥ 10). Based on the results of network analysis, among participants, “Nervousness”, “Trouble relaxing”, “Uncontrollable worry” were the most critical central symptoms and bridge symptoms within the anxiety and sleep problems network structure. The adjusted network model after controlling for covariates was significantly correlated with the original (r = 0.75, P = 0.46). Additionally, there were significant differences in edge weights in the comparisons between sex, age and educational levels groups (P < 0.001), while the employed and unemployed groups did not show significant differences in edge weights (P > 0.05).

Conclusions

In the anxiety and sleep problems network model, among outpatients living in high-altitude areas, nervousness, uncontrollable worry, and trouble relaxing were the most central symptoms and bridge symptoms. Moreover, there were significant differences between various sex, age and educational levels. These findings can be used to provide clinical suggestions for psychological interventions and measures targeting to reduce symptoms that exacerbate mental health.
Considerations for the design of overdose education and naloxone distribution interventions: results of a multi-stakeholder workshop
Authors: Sellen Kate , Markowitz Benjamin , Parsons Janet A. , Leece Pamela , Handford Curtis , Goso Nick , Hopkins Shaun , Klaiman Michelle , Shahin Rita , Milos Geoffrey , Wright Amy , Charles Mercy , Morrison Laurie , Strike Carol , Orkin Aaron ,   SOONER Investigators
Published: May 2023

Introduction

Opioid overdose epidemic is a public health crisis that is impacting communities around the world. Overdose education and naloxone distribution programs equip and train lay people to respond in the event of an overdose. We aimed to understand factors to consider for the design of naloxone distribution programs in point-of-care settings from the point of view of community stakeholders.

Methods

We hosted a multi-stakeholder co-design workshop to elicit suggestions for a naloxone distribution program. We recruited people with lived experience of opioid overdose, community representatives, and other stakeholders from family practice, emergency medicine, addictions medicine, and public health to participate in a full-day facilitated co-design discussion wherein large and small group discussions were audio-recorded, transcribed and analysed using thematic approaches.

Results

A total of twenty-four participants participated in the multi-stakeholder workshop from five stakeholder groups including geographic and setting diversity. Collaborative dialogue and shared storytelling revealed seven considerations for the design of naloxone distribution programs specific to training needs and the provision of naloxone, these are: recognizing overdose, how much naloxone, impact of stigma, legal risk of responding, position as conventional first aid, friends and family as responders, support to call 911.

Conclusion

To create an naloxone distribution program in emergency departments, family practice and substance use treatment services, stigma is a central design consideration for training and naloxone kits. Design choices that reference the iconography, type, and form of materials associated with first aid have the potential to satisfy the need to de-stigmatize overdose response.
Turning the tide on inequity through systematic equity action-analysis
Authors: Plamondon Katrina M. , Dixon Jenna , Brisbois Ben , Pereira Rodrigo Curty , Bisung Elijah , Elliott Susan J. , Graham Ian D. , Ndumbe-Eyoh Sume , Nixon Stephanie , Shahram Sana
Published: May 2023

Background

Collective agreement about the importance of centering equity in health research, practice, and policy is growing. Yet, responsibility for advancing equity is often situated as belonging to a vague group of ‘others’, or delegated to the leadership of ‘equity-seeking’ or ‘equity-deserving’ groups who are tasked to lead systems transformation while simultaneously navigating the violence and harms of oppression within those same systems. Equity efforts also often overlook the breadth of equity scholarship. Harnessing the potential of current interests in advancing equity requires systematic, evidence-guided, theoretically rigorous ways for people to embrace their own agency and influence over the systems in which they are situated. ln this article, we introduce and describe the Systematic Equity Action-Analysis (SEA) Framework as a tool that translates equity scholarship and evidence into a structured process that leaders, teams, and communities can use to advance equity in their own settings.

Methods

This framework was derived through a dialogic, critically reflective and scholarly process of integrating methodological insights garnered over years of equity-centred research and practice. Each author, in a variety of ways, brought engaged equity perspectives to the dialogue, bringing practical and lived experience to conversation and writing. Our scholarly dialogue was grounded in critical and relational lenses, and involved synthesis of theory and practice from a broad range of applications and cases.

Results

The SEA Framework balances practices of agency, humility, critically reflective dialogue, and systems thinking. The framework guides users through four elements of analysis (worldview, coherence, potential, and accountability) to systematically interrogate how and where equity is integrated in a setting or object of action-analysis. Because equity issues are present in virtually all aspects of society, the kinds of ‘things’ the framework could be applied to is only limited by the imagination of its users. It can inform retrospective or prospective work, by groups external to a policy or practice setting (e.g., using public documents to assess a research funding policy landscape); or internal to a system, policy, or practice setting (e.g., faculty engaging in a critically reflective examination of equity in the undergraduate program they deliver).

Conclusions

While not a panacea, this unique contribution to the science of health equity equips people to explicitly recognize and interrupt their own entanglements in the intersecting systems of oppression and injustice that produce and uphold inequities.
Pulmonary benign metastasizing leiomyoma in patients aged 45 years and younger: clinical features and novelty in treatment
Authors: Su Hao , Fan Rong , Yang Hua , You Yan , Zhu Lan , Feng Fengzhi
Published: May 2023

Background

Pulmonary benign metastasizing leiomyoma (PBML) is the most common extrauterine spread of uterine leiomyoma, and its biological behavior is traditionally thought to be hormone dependent. Studies on older PBML patients have been previously reported, but limited literature has been published regarding the clinical features and treatment of PBML in young women.

Methods

A total of 65 cases of PBML in women aged 45 years and younger were reviewed, including 56 cases selected from PubMed and 9 cases from our hospital. The clinical characteristics and management of these patients were analyzed.

Results

The median age of all the patients at diagnosis was 39.0 years. PBML most commonly presented as bilateral solid lesions (60.9%), with other rare imaging manifestations. The median interval time from a pertinent gynecologic procedure to diagnosis was 6.0 years. A total of 16.7% of patients received careful observation, and all achieved stable status in a median follow-up time of 18.0 months. A total of 71.4% of patients were administered anti-estrogen therapies, including surgical castration (33.3%), gonadotropin-releasing hormone analog (23.8%) and anti-estrogen drugs (14.3%). Eight of 42 patients underwent surgical resection of metastatic lesions. Patients who underwent curative surgery for the removal of pulmonary lesions combined with adjuvant anti-estrogen therapies had favorable outcomes compared with those who only underwent surgical resection. The disease control rates of surgical castration, gonadotropin-releasing hormone analog, and anti-estrogen drugs were 85.7%, 90.0%, and 50.0%, respectively. For two patients, sirolimus (rapamycin) achieved successful relief of symptoms and control of pulmonary lesions without lowering hormone levels and causing estrogen deficiency symptoms.

Conclusions

In the absence of standard treatment guidelines for PBML, maintaining a low-estrogen environment using different kinds of antiestrogen therapies has been the mainstream strategy and has satisfying curative effects. A wait-and-see strategy might be an option, but therapeutic approaches must be contemplated when complications or symptoms progress. For PBML in young women, the negative effect on ovarian function of anti-estrogen treatment, especially surgical castration, should be considered. Sirolimus might be a new treatment option for young PBML patients, especially for those who want to preserve ovarian function.
Association between the triglyceride glucose index and in-hospital and 1-year mortality in patients with chronic kidney disease and coronary artery disease in the intensive care unit
Authors: Ye Zixiang , An Shuoyan , Gao Yanxiang , Xie Enmin , Zhao Xuecheng , Guo Ziyu , Li Yike , Shen Nan , Zheng Jingang
Published: May 2023

Objective

This study aimed to explore the association between the triglyceride glucose index (TyG) and the risk of in-hospital and one-year mortality in patients with chronic kidney disease (CKD) and cardiovascular disease (CAD) admitted to the intensive care unit (ICU).

Methods

The data for the study were taken from the Medical Information Mart for Intensive Care-IV database which contained over 50,000 ICU admissions from 2008 to 2019. The Boruta algorithm was used for feature selection. The study used univariable and multivariable logistic regression analysis, Cox regression analysis, and 3-knotted multivariate restricted cubic spline regression to evaluate the association between the TyG index and mortality risk.

Results

After applying inclusion and exclusion criteria, 639 CKD patients with CAD were included in the study with a median TyG index of 9.1 [8.6,9.5]. The TyG index was nonlinearly associated with in-hospital and one-year mortality risk in populations within the specified range.

Conclusion

This study shows that TyG is a predictor of one-year mortality and in-hospital mortality in ICU patients with CAD and CKD and inform the development of new interventions to improve outcomes. In the high-risk group, TyG might be a valuable tool for risk categorization and management. Further research is required to confirm these results and identify the mechanisms behind the link between TyG and mortality in CAD and CKD patients.
Association between the triglyceride-glucose index and the presence and prognosis of coronary microvascular dysfunction in patients with chronic coronary syndrome
Authors: Zhang Wen , Liu Lu , Chen Huiying , Li Siqi , Wan Minying , Mohammed Abdul-Quddus , Xu Bin , Yin Guoqing , Lv Xian , Shi Tingting , Galip Jassur , Mohammed Ayman A. , Mareai Redhwan M. , Xu Yawei , Abdu Fuad A. , Che Wenliang
Published: May 2023

Background

Coronary microvascular dysfunction (CMD) is a strong determinant of prognosis in patients with chronic coronary syndrome (CCS). The triglyceride-glucose index (TyG index), an alternative method to evaluate insulin resistance, is positively correlated with the incidence and adverse outcomes of cardiovascular diseases. However, the relationship between the TyG index and the presence and prognosis of CMD in CCS patients has not been investigated. Therefore, we aimed to evaluate the association between the TyG index and the presence and clinical outcomes of CMD among CCS patients.

Methods

CCS patients who underwent coronary angiography between June 2015 to June 2019 were included. The TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Coronary angiography‑derived index of microvascular resistance (caIMR) was used to measure microvascular function, and CMD was defined as caIMR ≥ 25U. Patients with CMD were divided into three groups (T1, T2, and T3 groups) according to TyG tertiles. The primary endpoint was major adverse cardiac event (MACE).

Results

Of 430 CCS patients, 221 patients had CMD. CMD patients had significantly higher TyG index than those without CMD. Sixty-three MACE was recorded during the follow-up duration among CMD patients, and the incidence rate of MACE was higher in the T3 group compared to T1/T2 groups (39.2% vs. 20.5% vs. 25.7%; P = 0.035). Multivariable logistic regression analysis showed that the TyG index was an independent predictor of CMD (OR, 1.436; 95% CI, 1.014–2.034; P = 0.042). Compared to the T1 group, the T3 group strongly correlated with the risk of MACE in CMD patients even after adjusting for additional confounding risk factors (HR, 2.132; 95%CI, 1.066–4.261; P = 0.032).

Conclusion

TyG index is significantly associated with the risk of CMD, and it is an independent predictor of MACE among CMD patients with CCS. This study suggests that the TyG index has important clinical significance for the early prevention and risk stratification of CMD.
Effects of metabolic parameters’ variability on cardiovascular outcomes in diabetic patients
Authors: Lim Subin , Chung Se Hwa , Kim Ju Hyeon , Kim Yong Hyun , Kim Eung Ju , Joo Hyung Joon
Published: May 2023

Background

Metabolic abnormalities such as dyslipidemia, glucose and high blood pressure are common in diabetic patients. Visit-to-visit variabilities in these measures have been reported as potential residual cardiovascular risk factors. However, the relationship between these variabilities and their effects on cardiovascular prognosis have not been studied.

Methods

A total of 22,310 diabetic patients with ≥ 3 measurements of systolic blood pressure (SBP), blood glucose, total cholesterol (TC), and triglyceride (TG) levels during a minimum of three years at three tertiary general hospitals were selected. They were divided into high/low variability groups for each variable based on the coefficient of variation (CV) values. The primary outcome was the incidence of major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, and stroke.

Results

All high CV groups had a higher incidence of MACE than those with low CV (6.0% vs. 2.5% for SBP-CV groups, 5.5% vs. 3.0% for TC-CV groups, 4.7% vs. 3.8% for TG-CV groups, 5.8% vs. 2.7% for glucose-CV groups). In multivariable Cox regression analysis,, high SBP-CV (HR 1.79 [95% CI 1.54–2.07], p < 0.01), high TC-CV (HR 1.54 [95% CI 1.34–1.77], p < 0.01), high TG-CV (HR 1.15 [95% CI 1.01–1.31], p = 0.040) and high glucose-CV (HR 1.61 [95% CI 1.40–1.86], p < 0.01) were independent predictors of MACE.

Conclusion

Variability of SBP, TC, TG and glucose are important residual risk factors for cardiovascular events in diabetic patients.
The FLURESP European commission project: cost-effectiveness assessment of ten public health measures against influenza in Italy: is there an interest in COVID-19 pandemic?
Authors: Beresniak Ariel , Napoli Christian , Oxford John , Daruich Alejandra , Niddam Laurent , Duru Gérard , Tozzi Alberto E. , Atti Marta Ciofi degli , Dupont Danielle , Rizzo Caterina , Bremond-Gignac Dominique
Published: May 2023

Background

The FLURESP project is a public health research funded by the European Commission, with the objective to design a methodological framework to assess the cost-effectiveness of existing public health measures against human influenza pandemics. A dataset has been specifically collected in the frame of the Italian health system. As most of interventions against human influenza are relavant against other respiratory diseases pandemics, potential interests in COVID-19 are discussed.

Methods

Ten public health measures against human influenza pandemics pandemic were selected to be also relevant to other respiratory virus pandemics such as COVID 19: individual (hand washing, using masks), border control (quarantine, fever screening, border closure), community infection (school closure, class dismissal, social distancing, limitation of public transport), reduction of secondary infections (implementation of antibiotic therapy guidelines), pneumococcal vaccination for at-risk people, development of Intensive Care Unit (ICU) capacity, implementation of life support equipments in ICU, screening interventions, vaccination programs targeting health professional and targeting general population.

Results

Using mortality reduction as effectiveness criteria, the most cost-effective strategies are “reduction of secondary infections” and “implementation of life support equipment in ICU”. The least cost-effective option whatever the level of pandemic events are screening interventions and mass vaccination.

Conclusions

A number of intervention strategies against human influenza pandemics appears relevant against every respiratory virus, including the COVID-19 event. Measures against pandemics should be considered according to their expected effectiveness but also their costs for the society because they impose substantial burden to the population, confirming the interest of considering cost-effectiveness of public health measures to enlighten decision making.
Association of soft drinks and 100% fruit juice consumption with risk of cancer: a systematic review and dose–response meta-analysis of prospective cohort studies
Authors: Pan Bei , Lai Honghao , Ma Ning , Li Dan , Deng Xiyuan , Wang Xiaoman , Zhang Qian , Yang Qiuyu , Wang Qi , Zhu Hongfei , Li Mengting , Cao Xiao , Tian Jinhui , Ge Long , Yang Kehu
Published: May 2023

Background

Studies of the associations between soft drinks and the risk of cancer showed inconsistent results. No previous published systematic reviews and meta-analysis has investigated a dose–response association between exposure dose and cancer risk or assessed the certainty of currently available evidence. Therefore, we aim to demonstrate the associations and assessed the certainty of the evidence to show our confidence in the associations.

Methods

We searched Embase, PubMed, Web of Science, and the Cochrane Library from inception to Jun 2022, to include relevant prospective cohort studies. We used a restricted cubic spline model to conduct a dose–response meta-analysis and calculated the absolute effect estimates to present the results. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of the evidence.

Results

Forty-two articles including on 37 cohorts enrolled 4,518,547 participants were included. With low certainty evidence, increased consumption of sugar-sweetened beverages (SSBs) per 250 mL/day was significantly associated with a 17% greater risk of breast cancer, a 10% greater risk of colorectal cancer, a 30% greater risk of biliary tract cancer, and a 10% greater risk of prostate cancer; increased consumption of artificially sweetened beverages (ASBs)re per 250 mL/day was significantly associated with a 16% greater risk of leukemia; increased consumption of 100% fruit juice per 250 mL/day was significantly associated with a 31% greater risk of overall cancer, 22% greater risk of melanoma, 2% greater risk of squamous cell carcinoma, and 29% greater risk of thyroid cancer. The associations with other specific cancer were no significant. We found linear dose–response associations between consumption of SSBs and the risk of breast and kidney cancer, and between consumption of ASBs and 100% fruit juices and the risk of pancreatic cancer.

Conclusions

An increment in consumption of SSBs of 250 mL/day was positively associated with increased risk of breast, colorectal, and biliary tract cancer. Fruit juices consumption was also positively associated with the risk of overall cancer, thyroid cancer, and melanoma. The magnitude of absolute effects, however, was small and mainly based on low or very low certainty of evidence. The association of ASBs consumption with specific cancer risk was uncertain.

Trial registration

PROSPERO: CRD42020152223
The sclerosing sertoli cell tumor of the testis: a case report
Authors: Tang Xueyao , Hu Yifan , Zhou Hong , Zhou Yang
Published: May 2023

Background

Testicular Sertoli cell tumor (SCT) is very rare sex cord-gonadal stromal tumor, and sclerosing SCT (SSCT) is even rarer. So far, no more than 50 cases of SSCT have been reported. 80% of SSCTs are less than 2 cm in diameter, large volume mass is pretty unusual. SSCT is usually benign with very low malignant potential. However, it is easily misdiagnosed as a malignant tumor resulting in the removal of the entire testicle.

Case presentation

A 55-year-old Chinese male patient presented with a six months’ history of right testis progressively enlargement and negative tumor markers. The physical examination was nothing special except for swelling in the right testicle. Imaging identified a large mass in right testicle with rich blood. A right radical orchiectomy was performed on suspicion of malignancy. However, the tumor was postoperatively diagnosed as SSCT, which pathologically consisted of a tubular pattern with regular nuclei and embedded in a densely collagenous stroma, as well as diffusely positive for vimentin, β-catenin and synaptophysin. After 7 months of follow up, no evidence of local recurrence and metastasis has been observed.

Conclusion

This rare case is helpful to expand the knowledge of the testicular tumor and alert us fully understand the rare variant of SCTs in order to choose the optimal management when they encounter SSCT.
Efficient strategies for controlled release of nanoencapsulated phytohormones to improve plant stress tolerance
Authors: Sampedro-Guerrero Jimmy , Vives-Peris Vicente , Gomez-Cadenas Aurelio , Clausell-Terol Carolina
Published: May 2023

Climate change due to different human activities is causing adverse environmental conditions and uncontrolled extreme weather events. These harsh conditions are directly affecting the crop areas, and consequently, their yield (both in quantity and quality) is often impaired. It is essential to seek new advanced technologies to allow plants to tolerate environmental stresses and maintain their normal growth and development. Treatments performed with exogenous phytohormones stand out because they mitigate the negative effects of stress and promote the growth rate of plants. However, the technical limitations in field application, the putative side effects, and the difficulty in determining the correct dose, limit their widespread use. Nanoencapsulated systems have attracted attention because they allow a controlled delivery of active compounds and for their protection with eco-friendly shell biomaterials. Encapsulation is in continuous evolution due to the development and improvement of new techniques economically affordable and environmentally friendly, as well as new biomaterials with high affinity to carry and coat bioactive compounds. Despite their potential as an efficient alternative to phytohormone treatments, encapsulation systems remain relatively unexplored to date. This review aims to emphasize the potential of phytohormone treatments as a means of enhancing plant stress tolerance, with a specific focus on the benefits that can be gained through the improved exogenous application of these treatments using encapsulation techniques. Moreover, the main encapsulation techniques, shell materials and recent work on plants treated with encapsulated phytohormones have been compiled.
Traffic-related air pollution and supplemental folic acid intake in relation to DNA methylation in granulosa cells
Authors: Gaskins Audrey J. , Hood Robert B. , Ford Jennifer B. , Hauser Russ , Knight Anna K. , Smith Alicia K. , Everson Todd M.
Published: May 2023

Background

Higher exposure to traffic-related air pollution (TRAP) is related to lower fertility, with specific adverse effects on the ovary. Folic acid may attenuate these effects. Our goal was to explore the relation of TRAP exposure and supplemental folic acid intake with epigenetic aging and CpG-specific DNA methylation (DNAm) in granulosa cells (GC). Our study included 61 women undergoing ovarian stimulation at a fertility center (2005–2015). DNAm levels were profiled in GC using the Infinium MethylationEPIC BeadChip. TRAP was defined using a spatiotemporal model to estimate residence-based nitrogen dioxide (NO2) exposure. Supplemental folic acid intake was measured with a validated food frequency questionnaire. We used linear regression to evaluate whether NO2 or supplemental folic acid was associated with epigenetic age acceleration according to the Pan-tissue, mural GC, and GrimAge clocks or DNAm across the genome adjusting for potential confounders and accounting for multiple testing with a false discovery rate < 0.1.

Results

There were no associations between NO2 or supplemental folic acid intake and epigenetic age acceleration of GC. NO2 and supplemental folic acid were associated with 9 and 11 differentially methylated CpG sites. Among these CpGs, only cg07287107 exhibited a significant interaction (p-value = 0.037). In women with low supplemental folic acid, high NO2 exposure was associated with 1.7% higher DNAm. There was no association between NO2 and DNAm in women with high supplemental folic acid. The genes annotated to the top 250 NO2-associated CpGs were enriched for carbohydrate and protein metabolism, postsynaptic potential and dendrite development, and membrane components and exocytosis. The genes annotated to the top 250 supplemental folic acid-associated CpGs were enriched for estrous cycle, learning, cognition, synaptic organization and transmission, and size and composition of neuronal cell bodies.

Conclusions

We found no associations between NO2, supplemental folic acid, and DNAm age acceleration of GC. However, there were 20 differentially methylated CpGs and multiple enriched GO terms associated with both exposures suggesting that differences in GC DNAm could be a plausible mechanism underlying the effects of TRAP and supplemental folic acid on ovarian function.
Conceptual framework of hybrid style in fashion image datasets for machine learning
Authors: An Hyosun , Lee Kyo Young , Choi Yerim , Park Minjung
Published: May 2023

Fashion image datasets, in which each fashion image has a label indicating its design attributes and styles, have contributed to the achievement of various machine learning techniques in the fashion industry. Computer vision studies have investigated labeling categories (such as fashion items, colors, materials, details, and styles) to create fashion image datasets for supervised learning. Although a considerable number of fashion image datasets has been developed, different style classification criteria exist because of a lack of understanding concerning fashion style. Since fashion styles reflect various design attributes, multiple styles can often be included in a single outfit. Thus, this study aims to build a Hybrid Style Framework to develop a fashion image dataset that can be efficiently applied to supervised learning. We conducted focus group interviews with six fashion experts to determine fashion style categories with which to classify hybrid styles in fashion images. We developed 1,206,931K-fashion image datasets and analyzed the hybrid style convergence. Finally, we applied the datasets to the machine learning model and verified the accuracy of the computer’s ability to recognize style. Overall, this study concludes that the Hybrid Style Framework and developed K-fashion image datasets are helpful, as they can be applied to data-driven fashion services to offer personalized fashion design solutions.
Serum Midkine for AFP-negative hepatocellular carcinoma diagnosis: a systematic review and meta-analysis
Authors: Thokerunga Erick , Kisembo Peter , FangFang Huang , Zi Wang , Yu Zhang , Bongolo Christian Cedrick , Tu Jiancheng
Published: May 2023

Introduction

To date, alpha-feto protein (AFP) remains the most widely used serum biomarker for hepatocellular carcinoma (HCC) diagnosis and prognosis. However, its role has become controversial as close to 30% of early stage HCC patients are AFP negative. Different studies on the diagnostic performance of novel AFP-negative HCC biomarkers have shown inconsistent results of sensitivity, specificity, and area under the receiver operating curve (AUROC). Here, we conducted a systematic review and meta-analysis to resolve this inconsistency.

Methods

Relevant studies were systematically searched from PubMed, Embase, Cochrane library, Scopus, and the China National Knowledge Infrastructure (chkd-cnki) databases up to the 20th October 2022. The Newcastle–Ottawa Scale was used to assess the methodological quality of included studies. Sensitivity, specificity, and area under the curve were pooled using the random effect model.

Results

Five studies, with a total of 286 patients, were included. Serum Midkine was assessed using enzyme-linked immunosorbent assay (ELISA) in all the studies, at diagnostic thresholds varying from 0.387 to 5.1 ng/ml. The summary estimates for serum Midkine were 76% (95% CI 70–81%) sensitivity, 85% (95% CI 82–87%) specificity, and 91% area under the receiver operating characteristic curve (AUC), while the pooled diagnostic odds ratio (DOR) was 27.64 (95% CI 4.95–154.17).

Conclusion

Based on these findings, serum Midkine is a very promising diagnostic biomarker for AFP-negative HCC and should be validated further in large cohort studies.
Coexistence of pulmonary tuberculosis with pulmonary sarcoidosis and skin sarcoidosis: a case report
Authors: Yusuf Khalifa Abdulrahman , Kanhosh Shadi Fayez , Al-Madani Abdulrahman Hasan
Published: May 2023

Background

Necrotising granulomatous diseases of the lungs exhibit a narrow range of differential diagnoses. Tuberculosis accounts for most of these cases, while sarcoidosis is an uncommon entity in this group but both possess similar clinical and radiological similarities. One must consider a diagnosis of sarcoidosis once the standard anti-mycobacterial medications fail to achieve a clinical improvement. The case described highlights the coexistence of tuberculosis and sarcoidosis which is a rare entity in the medical literature.

Case presentation

A 57-year-old male presented with respiratory symptoms and was diagnosed with tuberculosis (TB) demonstrating a polymerase chain reaction (PCR) test positive showing microbial DNA in bronchial washing. The patient started standard anti-TB treatment; however, he did not respond initially. Further investigations led us to diagnose pulmonary followed by skin sarcoidosis, based on histology. After confirmation of sarcoidosis, administered corticosteroids for 6 months simultaneously along with anti-TB treatment; however, anti-TB treatment was prolonged for a total of 9 months. The patient was found clinically symptomless after the completion of treatment during subsequent follow-ups.

Conclusion

The use of corticosteroids as an adjunct with standard anti-TB treatment proves beneficial effects on the recovery of patients having a coexistence of pulmonary mycobacterium tuberculosis and sarcoidosis disease conditions.
Delayed post-traumatic intractable epistaxis due to pseudoaneurysms in concha bullosa: a case report
Authors: Jain Shraddha , Murali Mithula , Hande Vaidehi , Ranjan Aditya , Banode Pankaj , Shekawat Rupesh
Published: May 2023

Background

Delayed post-traumatic bleeding at various sites is known due to vascular abnormalities related to structural changes in the vessel walls, in the form of pseudo aneurysms and arteriovenous malformations. Delayed epistaxis following facial trauma is a distinct entity that presents as recurrent episodes of bleeding from the nose. History of trauma is important to differentiate it from idiopathic intractable epistaxis, the management of which is less dramatic in the beginning in the form of endoscopy and electrocauterization. However, uncontrolled post-traumatic delayed epistaxis usually requires embolization. We report a rare case of intractable epistaxis associated with multiple pseudoaneurysms (PA), due to bleeding inside concha bullosa, where even embolization was unsuccessful.

Case presentation

A 25-year-old male patient presented to casualty and was referred to the Otorhinolaryngology department for recurrent profuse bleeding from left nasal cavity, where conservative measures like nasal packing, and electrocauterization did not help. Patient had a history of fall from height with facial bone fractures 1 month back. Angiography revealed blush with dilatation (pseudoaneurysms) in the nasal branches of internal maxillary arteries, ascending pharyngeal and labial arteries and embolization was done in the Interventional Radiology Department. Post-embolization, the patient again developed massive epistaxis. The patient was explored under general anaesthesia, to find out the site of bleed by nasal endoscopy. Collected blood was found in the left concha bullosa. Conchoplasty of the left middle turbinate was done with cauterization of bleeding vessels. The patient had no further epistaxis and was discharged in stable condition. He is asymptomatic for the last 6 months.

Conclusion

Post-traumatic pseudoaneurysms is a rare cause of delayed epistaxis following nasal trauma. Angiography helps in the localization of the source of bleeding inside nasal cavity and can identify pseudoaneurysmal dilatations of vessels. Our case highlights the importance of hidden bleeding points inside concha bullosa as a source of intractable epistaxis unresponsive to embolization.
Dynamical approach to shortcuts to adiabaticity for general two-level non-Hermitian systems
Authors: Luan T. Z. , Sun J. Y. , Shen H. Z.
Published: May 2023

In this Letter, we apply a class of general two-level non-Hermitian Hamiltonians whose off-diagonal elements are neither equal nor conjugate of each other to study the dynamical approach to shortcut to adiabaticity which is based on engineering the Hamiltonian and dynamical properties of the system to remove any unwanted probability amplitude or implant the desired probability amplitude. Using the special characteristics that one of the eigenvalues of the general two-level non-Hermitian Hamiltonian is real and the other is complex, we can decay (amplify) the population exponentially in the undesired (desired) eigenstate, and maintain the conservation of probability amplitude of the other eigenstate. Applying this approach to general two-level non-Hermitian systems, we find that the efficient population transfer can be achieved by our method, which works even in almost instantaneous manner and has a lower cost compared with the common approach of shortcut to adiabaticity.
Occurrence of connected clusters in motility-induced phase-separated states of persistent active particles at zero temperature
(a)
Authors: Schmiedeberg M.
Published: May 2023

To study the interplay of the formation of clusters of overlapping particles and motility-induced phase separation in the zero temperature limit in two dimensions, we consider a simple model system consisting of a bidisperse mixture of disks that are only subject to a repulsion force in case of overlaps and an active force. The orientation of the disks is chosen randomly in the beginning and does not change anytime during the simulation thus corresponding to an infinite persistence length. Simulations with our model system reveal that clusters of overlapping particles occur in the dense phase of a phase-separated state in case of intermediate values of the ratio of active to repulsive force. However, for smaller activities there are only a few overlaps between the particles in the dense phase and the coexistence region ends at a packing fraction below the onset of the formation of clusters with overlapping particles. For large activities small clusters corresponding to small patches of the dense phase are found that are unstable due to the activity. Finally, the occurrence of connected clusters affects the phase separation. Our findings on how cluster formation and phase separation are related are relevant to many active particle systems as after adding thermal noise our model system corresponds to a system of active Brownian particles that have been intensely studied in recent years. Further extensions by adding friction, inertia, or more complex interactions are possible.
A zebrafish model of combined saposin deficiency identifies acid sphingomyelinase as a potential therapeutic target
Authors: Zhang Tejia , Alonzo Ivy , Stubben Chris , Geng Yijie , Herdman Chelsea , Chandler Nancy , Doane Kim P. , Pluimer Brock R. , Trauger Sunia A. , Peterson Randall T.
Published: May 2023

Sphingolipidoses are a subcategory of lysosomal storage diseases (LSDs) caused by mutations in enzymes of the sphingolipid catabolic pathway. Like many LSDs, neurological involvement in sphingolipidoses leads to early mortality with limited treatment options. Given the role of myelin loss as a major contributor toward LSD-associated neurodegeneration, we investigated the pathways contributing to demyelination in a CRISPR-Cas9-generated zebrafish model of combined saposin (psap) deficiency. psap knockout (KO) zebrafish recapitulated major LSD pathologies, including reduced lifespan, reduced lipid storage, impaired locomotion and severe myelin loss; loss of myelin basic protein a (mbpa) mRNA was progressive, with no changes in additional markers of oligodendrocyte differentiation. Brain transcriptomics revealed dysregulated mTORC1 signaling and elevated neuroinflammation, where increased proinflammatory cytokine expression preceded and mTORC1 signaling changes followed mbpa loss. We examined pharmacological and genetic rescue strategies via water tank administration of the multiple sclerosis drug monomethylfumarate (MMF), and crossing the psap KO line into an acid sphingomyelinase (smpd1) deficiency model. smpd1 mutagenesis, but not MMF treatment, prolonged lifespan in psap KO zebrafish, highlighting the modulation of acid sphingomyelinase activity as a potential path toward sphingolipidosis treatment.
In a marine teleost, the significance of oxygen supply for acute thermal tolerance depends upon the context and the endpoint used
Authors: Nati Julie J. H. , Blasco Felipe R. , Rodde Charles , Vergnet Alain , Allal François , Vandeputte Marc , McKenzie David J.
Published: May 2023

Eight juvenile European seabass were exposed to two thermal ramping protocols with different levels of aerobic activity and tolerance endpoint: the critical thermal maximum for swimming (CTSmax) while exercising aerobically until fatigue and the critical thermal maximum (CTmax) under static conditions until loss of equilibrium (LOE). In the CTSmax protocol, warming caused a profound increase in the rate of oxygen uptake (ṀO2), culminating in a gait transition from steady aerobic towards unsteady anaerobic swimming, then fatigue at 30.3±0.4°C (mean±s.e.m.). Gait transition and fatigue presumably indicate an oxygen limitation, which reflects the inability to meet the combined demands of swimming plus warming. The CTmax protocol also elicited an increase in ṀO2, culminating in LOE at 34.0±0.4°C, which is significantly warmer than fatigue at CTSmax. The maximum ṀO2 achieved in the CTmax protocol was, however, less than 30% of that achieved in the CTSmax protocol. Therefore, the static CTmax did not exploit full cardiorespiratory capacity for oxygen supply, indicating that LOE was not caused by systemic oxygen limitation. Consequently, systemic oxygen supply can be significant for tolerance of acute warming in seabass but this depends upon the physiological context and the endpoint used.
A diminutive snake species can maintain regional heterothermy in both homogeneous and heterogeneous thermal environments
Authors: Cox Christian L. , Chung Albert K. , Davoll Myles E. , DeHart Steph A. , Gerardi Samuel T. , Ly Tony K. , Moxley Kyle , Nipper Preston T. , Novak Delaney R. , Reeves Phillip F. , Williams Becky J. , Logan Michael L.
Published: May 2023

Regional heterothermy is a pattern whereby different body regions are maintained at different temperatures, often to prioritize the function of certain body parts over others, or to maximize the function of organs and tissues that vary in thermal sensitivity. Regional heterothermy is relatively well understood in endotherms, where physiological mechanisms maintain heterogeneity. However, less is known about regional heterothermy in ectotherms, where behavioral mechanisms are more important for generating thermal variation. In particular, whether small and elongate ectotherms with high surface area to volume ratios such as diminutive snakes can maintain regional heterothermy, despite rapid thermal equilibration, is not yet known. We measured regional variation in body temperature and tested whether environmental heterogeneity is used to generate regional heterothermy in the ring-necked snake (Diadophis punctatus) using both field and laboratory studies. We found that ring-necked snakes have robust regional heterothermy in a variety of contexts, despite their small body size and elongate body shape. Temperature variation along the length of their bodies was not detectable when measured externally. However, snakes had higher mouth than cloacal temperatures both in the field and in laboratory thermal gradients. Further, this regional heterothermy was maintained even in ambient laboratory conditions, where the thermal environment was relatively homogeneous. Our results indicate that regional heterothermy in ring-necked snakes is not solely driven by environmental variation but is instead linked to physiological or morphological mechanisms that maintain regional variation in body temperature irrespective of environmental context.
Ultra-low radiation dose and contrast volume CT protocol and TAVI-CT score for TAVI planning and outcome
Authors: Fogante Marco , Esposto Pirani Paolo , Cela Fatjon , Balardi Liliana , Piva Tommaso , Argalia Giulio , Schicchi Nicolò
Published: May 2023

Objective:

To investigate the feasibility of an ultra-low radiation dose and contrast volume protocol using third-generation dual-source (DS) CT for transcatheter aortic valve implantation (TAVI) planning with coronary artery disease (CAD) assessment, coronary artery calcium score (CACS) and aortic valve calcium score (AVCS) quantification and to evaluate their relationship with TAVI outcome.

Methods:

In this retrospective study were selected 203 patients (131 males, 79.4 ± 5.4 years) underwent to TAVI and at 30- and 90-day follow-up. All patients had performed a third-generation 2 × 192-slices DSCT. The CT protocol included a non-contrast and a contrast high-pitch aortic acquisition for TAVI planning and CAD assessment. Semi-qualitative and quantitative image analysis were performed; the performance in CAD assessment was compared with ICA; the relationship between AVCS and CACS and paravalvular aortic regurgitation (PAR) and major cardiovascular events (MACEs) were evaluated. Mean radiation dose were calculated. Non-parametric tests were used.

Results:

Semi-qualitative image analysis was good. Contrast enhancement >500 Hounsfield unit (HU) and contrast-to-noise ratio <20 were obtained in all segments. The diagnostic accuracy in CAD was 89.0%. AVCS was significantly higher in patients with 30-day severe PAR. AVCS and CACS were higher in patients with 90-day MACE complications, respectively, 1904.5 ± 621.3 HU (p < 0.0001) and 769.2 ± 365.5 HU (p < 0.0230). Mean radiation dose was 2.8 ± 0.3 mSv.

Conclusion:

A TAVI planning ultra-low radiation dose and contrast volume protocol using third-generation DSCT provides highly diagnostic images with CAD assessment, AVCS and CACS quantification and these latter were related with TAVI outcomes.

Advances in knowledge:

The proposed protocol using third-generation 2 × 192-slices DSCT allows with an ultra-low radiation dose and contrast volume the TAVI planning and the coronary artery assessment.
ChatGPT from radiologists’ perspective
Authors: Şendur Halit Nahit , Şendur Aylin Billur , Cerit Mahi Nur
Published: May 2023

ChatGPT is a newly developed technology created by the OpenAI company. It is an artificial-intelligence-based large language model (LLM) and able to generate human-like text. The potential roles of ChatGPT in clinical decision support and academic writing have led to intense criticism of this technology in the scientific community. Therefore, radiologists also need to be familiar with LLMs such as ChatGPT.