bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Different Localization Needles and Postures in Localization of Pulmonary Nodules
Authors: Wang Zengming , Li Bin , Hu Zhonghui , Zhao Qingtao , Zhang Xiaopeng , Zhao Huanfen , Xue Wenfei , Zhao Hongzhen , Duan Guochen , Xu Shun
Published: August 2024

Background
With advances in imaging testing and surgical procedures, more and more nodules with smaller diameters and deeper locations have been given surgical indications. The preoperative localization of those nodules is necessary. We conducted a retrospective single-center study comparing the effectiveness and comfort of the four-hook needle and hook-wire needle in terms of localization preoperative. We also compared the effect of different postures taken by patients on localization effectiveness.
Methods
We retrospectively analyzed the data of 692 patients following preoperative CT-guided localization. Patients were divided into different groups according to the different localization needles and the different postures taken during localization.
Results
There was no statistical difference in total complications between the four-hook needle group and the hook-wire needle group (P > 0.05). The chest pain score in the four-hook needle group was lower than the hook-wire needle group (P = 0.001). The incidence of decoupling in the four-hook needle group was significantly lower than the hook-wire needle group (P < 0.05). The four-hook needle group had better performance in terms of localization operation time, operation time, intraoperative bleeding and first-day drainage (P < 0.05). Compared with the supine and lateral groups, the prone posture group had better performance in total complications and localization operation time, and worse performance in decoupling and chest pain (P < 0.05).
Conclusions
The four-hook needle has better effectiveness on localization and comfort in patient than the hook-wire needle, which is worthy of clinical promotion and application. The patient's different postures during localization procedure may affect the localization results.
WITHDRAWN: Comparison of vacuum suction semirigid ureteroscopic laser lithotripsy and flexible ureteroscopic laser lithotripsy for upper ureteral calculi with a diameter ≥ 15mm: a retrospective study
Authors: Lai Longhui , Zhang Yuanfeng , Wang Yingru , Fan Guangrui , Chen Chaohu , Yao Kang , Zhang Wenzhao , Liu Yongfei , Zhu Kai , Xing Jinchun , Bai Peide , Wang Tao , Chen Bin , Wang Zhiping
Published: August 2024

Purpose
To compare the efficacy and safety of vacuum suction semirigid ureteroscopic (Sotn-URS) laser lithotripsy and flexible ureteroscopic (F-URS) laser lithotripsy for the treatment of unilateral upper ureteral calculi with a diameter ³ 15mm.
Methods
This study included 153 patients with upper ureteral calculi who met the criteria. Of these, Sotn-URS laser lithotripsy was performed on 96 patients, while F-URS laser lithotripsy was administered to 57 patients. The clinical data of the two groups were retrospectively analyzed and compared to the operative time, postoperative hospitalization time, stone-free rate (SFR), complication rate and success rate of ureteral sheath (UAS) placement of the two groups. Based on calculi computed tomography(CT) numerical value ≥1000 Hu, subgroup analysis was carried out for both groups.
Results
Surgery was successfully completed in both groups. In comparison to the F-URS group, the Sotn-URS group witnessed a reduced operative time (45.82±18.81 vs. 54.21±23.05 min; P = 0.036), a higher SFR of one day after operation (47.92% vs. 24.56%; P = 0.004), a higher SFR of one month after operation (87.50% vs. 73.68%; P = 0.030), and lower rate of complications (7.3% vs. 19.3%; P =0.026). When the success rate of UAS placement and postoperative hospitalization time were compared, there was no statistically significant difference between the two groups (P>0.05). Subgroup analyses revealed that the Sotn-URS group had a shorter operative time,a higher SFR of one day after operation, and fewer complications than the F-URS group. (P<0.05).
Conclusion
For the treatment of unilateral upper ureteral calculi with a diameter ³ 15mm, Sotn-URS presents advantages over F-URS, including shorter operative time, a greater SFR, and fewer complications.
The Vascular Supply to the Lateral Compartment of the Leg with Emphasis on Fibular Graft Harvesting
Authors: Apaydin Nihal , Balci Aybegum , Kendir Simel , Loukas Marios , Tubbs Richard S.
Published: August 2024

Purpose
The aim of this study is to determine the exact locations of vascular pedicles that supply the fibularis longus and brevis, to identify the morphometric features of those vessels in the lateral compartment of the leg, and to indicate the branching points of the pedicles from the main arteries.
Methods
The popliteal arteries of 40 lower limbs from 20 adult cadavers (12 males, eight females) were injected with colored latex bilaterally. Following dissection, the branches were counted, and the distances between the apex of the head of the fibula and the branching points of pedicles from the anterior tibial, fibular, and posterior tibial arteries that supply the fibularis longus and brevis were measured.
Results
In all cases, a single artery coursing in the lateral compartment of the leg was identified; it was a branch of the anterior tibial artery and it supplied the proximal and middle thirds of the fibular muscles anteriorly. The mean distance between the origin of this artery and the apex of the fibular head was 8.65 cm. Its mean length was 10.9 cm and the mean number of its branches was 4.7. In all specimens, the fibular artery supplied the proximal and distal portions of the fibular muscles posteriorly.
Conclusions
In this study, the morphometric properties and branching patterns of the axial pedicle of ATA, which runs longitudinally in the lateral compartment and branches to the FL and FB, are described in detail for the first time. We propose that this artery be named the lateral fibular artery. If this nomenclature is accepted, the fibular artery can be renamed the posterior fibular artery.
Wnt/BDNF pathway mediates autism-like behaviors induced by prenatal subclinical hypothyroidism in male neonatal rats
Authors: LIU DIJIE , Tao Kai , Sun Ying , Hao Jialin , Wang Shiyong
Published: August 2024

Epidemiological studies have illuminated that abnormal maternal thyroid function in early pregnancy escalates the risk of autism spectrum disorder (ASD) in offspring by nearly fourfold. However, the exact mechanism by which maternal thyroid dysfunction affects the risk of ASD in the offspring remains unknown. Early pregnancy emerges as a pivotal juncture for fetal brain development, with the fetus heavily reliant on maternal thyroid hormones for its neurological maturation. Our investigation unveils a striking correlation: mothers afflicted by perinatal subclinical hypothyroidism (SCH) tend to have male offspring displaying marked ASD-like behavioral anomalies, typified by conspicuous diminution in social interactions and repetitive behavioral patterns. Furthermore, we discerned a substantial reduction in neuron count within critical brain regions among offspring of SCH mothers, suggestive of underlying neurodegeneration or developmental impediments. Moreover, diminished levels of brain-derived neurotrophic factor (BDNF), cAMP response element binding protein (CREB), and Bcl-2 were noted in the hippocampal region of SCH offspring, juxtaposed with a noteworthy upregulation of mTOR expression and downregulation of Wnt. These findings coalesce to suggest that the Wnt-mediated signaling pathway, in concert with its interplay with the downstream target BDNF, might underpin one of the mechanisms by which maternal SCH predisposes offspring to autism-like behaviors.
The eGFR parameter model helps predict blood drug concentration of amisulpride in patients with schizophrenia
Authors: Wang Qi , Qu Kankan , Wang Shushan
Published: August 2024

Objective
This study aimed to examine inter-patient variability in amisulpride levels, using a multiple regression model with a dataset acquired from Chinese patients with schizophrenia.
Methods
Plasma concentrations of amisulpride (153 data from 128 patients) were analyzed by four-covariate model and eGFR model and were validated using goodness-of-fit and external prediction ability analyses. The amisulpride levels were detected by 2D-LC-UV system.
Results
The eGFR model adequately characterized amisulpride levels with adjusted R2 0.457. The dose and eGFR values significantly affected concentrations, as follows: amisulpride concentration = 838.561–9.169*eGFR + 1.273*dose. To remain below the laboratory alert level, recommended dose should remain below 300 mg/d, 500 mg/d, and 700 mg/d for patients with eGFR of 60 ml/min/1.73 m2, 90 ml/min/1.73 m2, and 120 ml/min/1.73 m2, respectively. Once and twice daily treatment regiments yielded comparable trough concentration values.
Conclusion
The eGFR model is simpler and more accurate in predicting the concentration of AMI, and provides an evaluation method for safe and individualized use of AMI.
Perceptions of using smartwatches for the early detection of cardiac arrhythmias
Authors: AlKhalaf Rabab A. , AlKhudair Abdullah M. , AlSheikh Eman , AlMousa Walaa H. , AlHadab Fatemah S. , Alshareet Fatimah Y. , AlSultan Norah H.
Published: August 2024

Background: As there is a growing trend toward a healthy lifestyle, wearable fitness trackers, such as smartwatches, are gaining interest in mentoring and detecting health issues earlier, particularly cardiac arrhythmia. Subsequently, there have been concerns about the accuracy of smartwatches and the results they generate. Therefore, this study was conducted to explore the public perception of using smartwatches for the early detection of cardiac arrhythmia, along with the current use of smartwatches among adults in five major regions of Saudi Arabia.
Methods: A cross-sectional study was conducted from May to October 2023. The study involved participants who were Saudi or non-Saudi, aged 22 or older, and who were willing to participate and share their perceptions of using smartwatches for the early detection of cardiac arrhythmia. The data were collected and recorded via a questionnaire that measures the current usage and public perceptions of wearable technology. The questionnaire was completed through face-to-face interviews with participants who met the inclusion and exclusion criteria.
Results: Our study revealed that the use of wearable fitness trackers is remarkably high. Nearly half of the participants (46.4%) reported actively using wearable technologies for health monitoring, with smartwatches being the most popular choice (42.0%). The factors affecting the use of these devices seem to be centered on age, education level, and income. Among 46.4% of users, 14.8% experienced the benefits of detecting irregular heartbeats. However, 49.5% of smartwatch users do not use an electrocardiogram (ECG) for monitoring.
Conclusion: There is growing interest in the use of wearable fitness trackers, especially smartwatches, for monitoring health issues such as cardiac arrhythmia. The positive perception of using this technology for the early detection of cardiac arrhythmia was significantly related to age and previous usage of these devices.
"To exercise sustainably" – Patients’ experiences of compulsive exercise in eating disorders and the CompuLsive Exercise Activity TheraPy as a treatment: a qualitative interview study.
Authors: Simón Emma Thell , Monell Elin , Lindstedt Katarina , Wiberg Anne-Charlotte , Mantilla Emma Forsén
Published: August 2024

Background: Compulsive exercise (CE) is common in eating disorders (EDs), but a systematic treatment model has been missing. The CompuLsive Exercise Activity TheraPy (LEAP) is a cognitive behavioral therapeutic (CBT) treatment for CE in EDs, aiming to promote healthy physical activity (PA). LEAP is currently evaluated in a randomized efficacy trial. In parallel, it is crucial to learn more about its acceptability and feasibility by qualitatively investigating participants’ experiences.
Methods: Nine patients with various EDs participating in the LEAP trial were interviewed about their experiences of taking part in LEAP and about CE as an ED symptom using a semi-structured interview guide. The interviews were analyzed according to thematic analysis.
Results: The informants expressed that CE had not been addressed in their standard ED treatment and that LEAP as such provided an important complement, spurring reflection, awareness, and changed feelings and behaviors in relation to CE. Initially, increased PA was triggered for some, but this side effect was transitory. A wish for more treatment time, in terms of longer or additional sessions, was expressed.
Conclusions: Overall, LEAP seemed to fill an important treatment need and seemed both acceptable and feasible to patients. However, treatment time and the initial increase in PA may need further investigation and attention in order to optimize this treatment.
Trial registration: The trial is registered with the ISRCTN registry (registration date 2020-03-25), trial ID: ISRCTN80711391.
The pupillary dark reflex in acute disorders of consciousness
Authors: Zarifkar Pardis , Othman Marwan H. , Hansen Karen Irgens Tanderup , Amiri Moshgan , Stückler Sarah Gharabaghi , Fabritius Maria Louise , Sigurdsson Sigurdur Thor , Hassager Christian , Birkeland Peter F. , Hauerberg John , Møller Kirsten , Kjaergaard Jesper , Larson Merlin D. , Kondziella Daniel
Published: August 2024

Background. In intensive care patients with disorders of consciousness (DoC), the pupillary light reflex is a measure of pupillary parasympathetic function. By contrast, the pupillary dark reflex leads to pupil dilation in response to darkness and primarily reflects the sympathetic function of the pupil. To our knowledge, this reflex has not been systematically investigated in DoC patients. We hypothesized that the pupillary dark reflex correlates with consciousness levels after acute brain injury, and that this correlation is not necessarily the same as that of the pupillary light reflex.
Methods. From November 2022 to March 2023, we enrolled 100 study participants: 25 clinically unresponsive (coma or unresponsive wakefulness syndrome) and 25 clinically low-responsive (minimally conscious state or better) patients from the intensive care units of a tertiary referral center, and 50 age- and sex-matched healthy controls. Exclusion criteria were active or chronic eye disease. We used automated pupillometry to assess the pupillary dark reflex and the pupillary light reflex of both eyes under scotopic conditions in all study participants.
Results. The pupillary dark reflex was strongly correlated with consciousness levels (r = 0.62, p < 0.001), the increase in pupillary diameters being smallest in unresponsive patients (mean ± SD: 20% ± 21%), followed by low-responsive patients (47% ± 26%) and healthy controls (67 % ± 17%; p < 0.001). Similar, yet less pronounced patterns were observed for the pupillary light reflex. Twenty-one of 25 unresponsive patients had preserved pupillary light reflexes, but only seven had preserved pupillary dark reflexes (p < 0.0001). Of these seven patients, five regained awareness.
Conclusion. The pupillary dark reflex is more sensitive to consciousness levels after brain injury than the pupillary light reflex. The clinical implications of this finding seem worthy of further investigation, particularly regarding possible benefits for neuromonitoring and prognostication after brain injury.
Anti-Synthetase Syndrome with Anti-PL-7 Antibody Positive in a Child: A Case Report and Literature Review
Authors: Liu Jia , Nie Nana , Zhang Ranran , Wang Dahai , Lin Yi , Chang Hong
Published: August 2024

Background: Anti-synthetase syndrome (ASS) is a rare autoimmune myopathy and forms part of the idiopathic inflammatory myopathies (IIMs). A distinctive feature of ASS is the presence of anti-aminoacyl tRNA synthase (ARS) antibodies, which target synthetases, leading to inflammation in muscles, lungs, and other tissues.
Case presentation: A case of a 12-year-old Chinese girl with recurrent fever, myalgia, and Gottron's papules is reported. Serum creatine kinase was markedly elevated, and chest CT revealed interstitial changes. Magnetic Resonance Imaging (MRI) of the left thigh indicated soft tissue swelling and interstitial fluid accumulation. Electromyography demonstrated myogenic injury. Pathological examination of a left thigh muscle biopsy revealed local edema, focal lymphocyte infiltration, and proliferation and dilation of interstitial small vessels. The myositis antibody spectrum test was positive for anti-PL-7 antibodies. Treatment with glucocorticoids and methotrexate led to significant improvement in her condition.
Conclusion: This case represents the youngest reported patient with PL-7 positive ASS to date.
Assessing the safety and performance of the easyEndoTM Universal Linear Cutting Stapler in laparoscopic gastric bypass surgery: a monocentric post-market observational study.
Authors: Pype Willem , Melsens Elodie , Aelst Pieter Van , Rycx Astrid , Haesen Dorien , Dillemans Bruno
Published: August 2024

Purpose: Laparoscopic Roux-en-Y gastric bypass (RYGB) is a key treatment for obesity. This study aimed to assess the safety and performance of the easyEndoTM Universal Linear Cutting Stapler and Reloads (EziSurg Medical CO., LTD, Shanghai, China) in laparoscopic RYGB.
Methods: Adult patients undergoing laparoscopic RYGB were recruited. The primary endpoint was to evaluate the occurrence of peri- and post-operative anastomotic leaks and intraluminal/intraperitoneal bleeding. Patient’s weight loss, primary technical success of the procedure, device performance, complications and re-interventions were evaluated as secondary outcomes.
Results: One hundred and fifty patients successfully underwent laparoscopic RYGB using the easyEndoTM Universal Linear Cutting Stapler. Mean weight pre-RYGB was 116.26±19.50 kg, body mass index (BMI) was 40.54±3.64 kg/m2 and mean excess weight was 44.77±13.70 kg. Pulsatile bleeding occurred in 3.3% of cases that could be clipped, and staple line disruption in 1.3% that was oversewn. Primary technical success was 90.7%. Regarding the primary endpoint, 1 post-operative bleeding occurred on the gastrojejunostomy created by a circular stapler. Post-operative melaena occurred in 3 patients. At 24 months, average BMI dropped to 25.91±4.07 kg/m2, with a percentage excess weight loss (%EWL) of 95.74±26.59% and a percentage total weight loss (%TWL) of 35.59±9.53%. Nineteen post-operative complications occurred in 15 patients (10.0%), mainly internal herniation and small bowel obstruction. Re-interventions were required in 11 patients (7.3%).
Conclusion: RYGB with the easyEndoTM Universal Linear Cutting Stapler and Reloads is safe and effective with significant weight loss and comparable complication rates to existing literature.
Prospectively registered at ClinicalTrials.gov (NCT03968757) in May2019.
Comparison of Laparoscopy without Use of Uterine Manipulator and Laparatomy for Staging Surgery for High Grade and Serous Endometrial Carcinoma Running Title: Laparoscopy and Laparatomy for Endometrial Carcinoma
Authors: Erkilinc Selcuk , Iscan Serhan Can , Ata Can , Atlıhan Ufuk , Cakir Ilker , Avsar Huseyin Aytug , Bildaci Tevfik Berk
Published: August 2024

Introduction: To Evaluate perioperative and oncological outcomes of laparoscopy without the use of uterine manipulators and laparatomy in high-grade and serous endometrial cancer
Material and Methods: The patients with grade III endometrioid adenocancer and serous carcinoma between 2018 and 2022 were included to the study. A preoperative staging with PET/CT or thoracoabdominal CT was performed. All patients underwent staging surgery including hysterectomy, bilateral salpingoopherectomy,peritoneal washing, omentectomy pelvic and paraaortic lymphadenectomy up to renal vein. Laparoscopic paraaortic lymphadenectomy was perofmed by extraperitoneal approach. No uterine manipulator was used for laparoscopic hysterectomy. Age, CA 125 level, BMI, accompanying diseases, pathologic data including stage, lymphovascular invasion, number of pelvic and paraaortic lymph nodes and surgical data including operative time, surgical complications and ajuvant therapies were collected from hospital database.
Results: Eighty-nine patients were included in the study: 34 underwent laparotomy and 55 underwent laparoscopy. Operation time were similar between groups. Mean pelvic lymph node count in LT and LS groups were 33 and 34 respectively. Mean paraaortic lymph node count was 23 and 22 respectively. Red blood cell transfusion, hemorrhage, urinary tract infection, postoperative fever, bladder atony, bladder injury, and chylous leakage showed no significant differences. However, ileus, intestinal injury and eviscerations were significantly higher in the LT group. Hospital stay was significantly loonger in LT compared to LS. Overall and recurrence-free survival were similar between the groups
Conclusion: Our study concluded that laparoscopic surgery, performed without manipulators, provides comparable oncological outcomes to open surgery in the treatment of high-grade endometrial cancer, while also offering improved perioperative results.
Appropriate timing for the removal of urinary catheters in gastrointestinal surgery with epidural anesthesia: A randomized controlled trial
Authors: Miyakawa Teppei , Honda Michitaka , Kawamura Hidetaka , Yamamoto Ryuya , Toshiyama Satoshi , Mashiko Ryutaro , Kakinuma Hirohito , Hori Soshi , Nakao Eiichi , Todate Yukitoshi , Takano Yoshinao , Kono Koji
Published: August 2024

Purpose: The purpose of this randomized controlled trial was to evaluate whether early urinary catheter removal is feasible during epidural anesthesia during gastrointestinal surgery in male patients at high risk for urinary retention.
Methods: Male patients who underwent radical surgery for gastric or colon cancer were enrolled in this randomized controlled trial. Patients were randomized 1:1 into 2 groups: the early group, in which the urinary catheter was removed before removal of the epidural catheter on the second or third postoperative day, and the late group, in which the urinary catheter was removed after removal of the epidural catheter. The randomization adjustment factors were age (≥ 65 or < 65 years) and operative site (gastric or colon). The primary endpoint was urinary retention. The secondary endpoints were the incidence of urinary tract infection and length of postoperative hospital stay.
Results: Seventy-three patients were enrolled between March 2020 and February 2024 and assigned to the Early (n=37) and Late (n=36) groups. Four patients withdrew their consent after randomization. The intention-to-treat analysis showed that urinary retention occurred in 4 patients (11.1%) in the early group and 1 patient (3.0%) in the late group (P = 0.20). Urinary tract infection occurred in 1 patient (3.0%) in the late group. The median postoperative hospital stay was 9 days in both groups.
Conclusion: Early urinary catheter removal in male patients undergoing gastrointestinal surgery with epidural anesthesia could increase urinary retention within the expected acceptable range.
Trial registration number:UMIN000040468
Date of registration: May 21, 2020
An innovative electrical neurostimulation approach to mimic reflective urination control in spinal cord injury models
Authors: Li Jun , Deng Guoxian , Li Xianping , Yin Lingxuan , Yuan Chunhui , Shao Wei , Chen Yuangui , Yan Junan , Yao Jiwei
Published: August 2024

Neurogenic lower urinary tract dysfunction (NLUTD) is a frequent consequence of spinal cord injury (SCI), leading to symptoms that significantly impact quality of life. However, existing treatment strategies for managing NLUTD exhibit limitations and drawbacks. The demand for a novel, effective approach to restore bladder function and re-establish urination control. In this study, we introduce a new electrical neuromodulation strategy involving electrical stimulation of the major pelvic ganglion (MPG) to initiate bladder contraction, in conjunction with innovative programmable (IPG) electrical stimulation on the pudendal nerve (PN) to induce external urethral sphincter (EUS) relaxation in freely moving or anesthetized SCI mice. Furthermore, we conducted the void spot assay and cystometry coupled with EUS electromyography (EMG) recordings to evaluate voiding function and monitor bladder pressure and EUS muscle activity. Our findings demonstrate that our novel electrical neuromodulation approach effectively triggers coordinated bladder detrusor contraction and EUS relaxation, effectively counteracting SCI-induced NLUTD. Additionally, this electrical neuromodulation method enhances voiding efficiency, closely resembling natural reflexive urination in SCI mice. Thus, our study offers a promising electrical neurostimulation approach aimed at restoring physiological coordination and potentially offering personalized treatment for improving voiding efficiency in individuals with SCI-associated NLUTD.
Association between air pollutants and blood cell counts in pediatric patients with asthma: A retrospective observational study
Authors: Huang Kuo-Chen , Pan Hsiu-Yung , Hsieh Ting-Min , Cheng Fu-Jen
Published: August 2024

Background
Asthma is a common respiratory disease in children, and air pollution is a risk factor for pediatric asthma. However, how air pollution affects blood cells in pediatric patients with asthma remains unclear.
Methods
This retrospective observational study, performed in 2007–2018 at a medical center, enrolled non-trauma patients aged < 17 years who visited the emergency department and had asthma. Medical records and blood cell counts, including absolute neutrophil count (ANC), eosinophil count, and platelet count were extracted. The concentrations of PM2.5, PM10, sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were measured from 11 air-monitoring stations in Kaohsiung City.
Results
One-unit increases in PM2.5 (regression coefficient = 0.098; S.E. =5.937; p < 0.001), PM10 (regression coefficient = 0.129; S.E. =3.541; p < 0.001), NO2 (regression coefficient = 0.110; S.E. =15.857; p < 0.001), SO2 (regression coefficient = 0.049; S.E. =30.339; p = 0.007), and O3 (regression coefficient = 0.048; S.E. =8.831; p = 0.022) on lag 0–6 (7 d average) correlated positively with ANC. One-unit increases in PM2.5 (regression coefficient = 0.055; S.E. =0.357; p = 0.016), PM10 (regression coefficient = 0.078; S.E. =0.213; p = 0.001), and SO2 (regression coefficient = 0.041; S.E. =1.811; p = 0.024) on lag 0–6 correlated positively with eosinophil count. Additionally, one-unit increases in PM2.5 (regression coefficient = 0.068; S.E. =0.101; p = 0.003) and PM10 (regression coefficient = 0.086; S.E. =0.06; p < 0.001) on lag 0–6 correlated positively with platelet count. In a two-pollutant model, the impacts of PM2.5 and PMC on ANC and platelet count remained statistically significant after adjusting for other air pollutants. Additionally, PMC correlated significantly with eosinophil count after adjusting for PM2.5, NO2, SO2, and O3. Quartile increases in PM2.5 and PMC levels correlated positively with ANC, eosinophil count, and platelet count, with differences of approximately 13.8% and 16.2%, 18.5% and 17.3%, and 4.4% and 4.6% between the upper and lower quartiles, respectively.
Conclusions
PM2.5, PMC, and NO2 were independently and positively associated with ANC, PMC was positively associated with eosinophil count, and PM2.5 and PMC were positively associated with platelet count in pediatric patients with asthma. Our results highlight the impact of air pollution on immunity and coagulation in pediatric patients with asthma.
WITHDRAWN: Deciphering PCSK9 and LDLR Gene Expression in Coronary Artery Disease Patients: Implications for Blood Lipid Regulation
Authors: Zahid Aqsa , Batool Andleeb , Khan Muhammad Ajmal , Ahmad Ajaz , Ullah Amin , Wajid Abdul
Published: August 2024

The main purpose of this study to calculate the frequency, risk factors, sedentary lifestyle, prevalence and expression of PCSK9 and LDLR genes showed a substantial role in cholesterol homeostasis involving in prognosis of coronary artery disease patients in Pakistan. Therefore, there is an urgent need to assess the frequency and risk factors involved and expression and regulation of a PCSK9 and LDLR in patients. A demographic survey involving CAD patients from different cardiac Hospitals in Pakistan was conducted and 100 CAD patients and 100 controls were included for the investigation of the expression level of PCSK9 and LDLR gene by using RT-PCR. CAD patients (males = 803, Females = 307) that participated in this study consisted of smokers (55%) and non-smokers (45%), the majority had a family history (62% positive, 38% negative). The participants also had diverse weight profiles (underweight 14%, active or normal 21%, overweight 27%, and obese 34%); while the majority claimed that they suffered stress (stress 85%, no stress 15%). Strong negative correlations (p < 0.01) were observed between CAD & gender, Diet, age of diagnosis, BMI, marital status, stress, different risk factors and family history. A negative correlation (p < 0.05) was seen between CAD and Sleep and with exercise also. The results indicated that the PCSK9 and LDLR expression level were considerably higher P was less than 0.05 in the patient group as compared to the healthy group. The AUC value of expression of PCSK9 (P = 6.58337E-4) and LDLR (P = 0.00111) were significant. The cox model result showed that high expression of LDLR and PCSK9 have significant effect, both the differences and overall survival rate were (P > 0.05) statistically significant. The findings of this study will help improve the management and treatment of CAD worldwide, the expression of PCSK9 and LDLR in CAD’s patient’s with specific implications in under developed countries.
Transcriptomic analysis reveals key molecular signatures across recovery phases of hemorrhagic fever with renal syndrome
Authors: Hu Yuanyuan , Wu Chao , Li Tuohang , Wu Yang , Yao Kun , Zhang Mengtian , Li Pan , Bian Xuzhao
Published: August 2024

Background
Hemorrhagic fever with renal syndrome (HFRS), a life-threatening zoonosis caused by hantavirus, poses significant mortality risks and lacks specific treatments. This study aimed to delineate the transcriptomic alterations during the recovery phases of HFRS.
Methods
RNA sequencing was employed to analyze the transcriptomic alterations in peripheral blood mononuclear cells from HFRS patients across the oliguric phase (OP), diuretic phase (DP), and convalescent phase (CP). Twelve differentially expressed genes (DEGs) were validated using quantitative real-time PCR in larger sample sets.
Results
Our analysis revealed pronounced transcriptomic differences between DP and OP, with 38 DEGs showing consistent expression changes across all three phases. Notably, immune checkpoint genes like CD83 and NR4A1 demonstrated a monotonic increase, in contrast to a monotonic decrease observed in antiviral and immunomodulatory genes, including IFI27 and RNASE2. Furthermore, this research elucidates a sustained attenuation of immune responses across three phases, alongside an upregulation of pathways related to tissue repair and regeneration.
Conclusion
Our research reveals the transcriptomic shifts during the recovery phases of HFRS, illuminating key genes and pathways that may serve as biomarkers for disease progression and recovery.
Long-term hot spring bathing on improving sleep quality with the decrease of TNF-α and increase of 5-HT
Authors: Yang Fen , Zou Yue , Zhang Ying-ying , Li Hong-xia , Xu Yi-hang , Zhang Bao-chao , Liao Lin-xuan , Cao Meng-xi , Wang Rui-xue , Yuan Yuan , Zhou Yun , Zeng Da-yong , Pei Xiaofang
Published: August 2024

Previous studies investigating the influence of hot spring bathing on sleep quality have predominantly focused on the short-term effects basically depending on questionnaire without blood collection for biochemical tests. In this study, we undertook comprehensive investigation on the long-term health effects of hot spring bathing among the residents of Hot Spring Village and collected their blood samples for biochemical tests, including inflammatory cytokines (TNF-α) and neurotransmitters (5-HT and BDNF) analysis as well. We found that hot spring bathing (OR=0.18, 95%CI: 0.05-0.68), with the length of more than 30 minutes (OR=0.10, 95%CI: 0.02-0.53), and the frequency of more than 3 times per week (OR=0.07, 95%CI: 0.01-0.32) were protective factors for sleep quality (P<0.05). Interestingly, we observed at the first time that the blood TNF-α significantly decreased (P<0.05), with an increasing trend of 5-HT and BDNF in the bathing group. Besides, participants with good sleep quality exhibited significantly lower levels of TNF-α compared to those of poor ones, and among good sleepers aged 65 and older, higher levels of 5-HT were observed. Further logistic analysis revealed that a decrease of TNF-α (OR=1.03, 95% CI: 1.01-1.06) and an increase of 5-HT (OR=0.98, 95% CI: 0.97-0.99) were associated with good sleep quality. Additionally, the trends of decreasing TNF-α and increasing 5-HT were also
observed in the hot spring bathing group with good sleep quality for the first time. These findings suggested that hot spring bathing might improve sleep quality with the alteration of TNF-α and 5-HT, which could serve as potential indicators for future studies on health benefits of bathing.
Estimation of the satellite-derived Leaf Area Index of spring wheat using machine learning approaches
Authors: Prakash Pratibha , Koley Swadhina , Kumar Soora Naresh , Harit Ramesh Chand , Gupta Jitender Kumar , Kumar Ravi
Published: August 2024

The study focuses on the estimation of Leaf Area Index (LAI) for smallholder farms less than 1 acre in semi-arid regions, particularly in Bundelkhand, India. Accurate LAI estimation is crucial for optimizing crop management practices, enhancing yield predictions, and improving the sustainability of agricultural operations. This study evaluates the efficiency of different machine learning algorithms in deriving LAI from Sentinel-2 and Landsat-8 data, with a focus on spring wheat across two growing seasons (2020–2021 and 2021–2022) in six villages in the Bundelkhand region of India. Three machine learning approaches—Random Forest (RF), Support Vector Machine (SVM), and XGBoost—were employed for LAI estimation. Validation against ground-truth LAI measurements was carried out using Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Pearson’s correlation coefficient (R), and Multiplicative Bias (MBias). Results indicate that RF and SVM with Radial Basis Function (SVM-RBF) achieved the highest accuracy for both Sentinel-2 and Landsat-8 data. For Sentinel-2, RF and SVM-RBF both achieved an R-value of 0.94, with RMSE of 0.40 and MAE of 0.29 and 0.30, respectively. RF showed a slight overestimation (MBias = 1.02), while SVM-RBF had a perfect MBias of 1.00. XGBoost also performed well (R = 0.94), though with slightly higher RMSE (0.43) and MAE (0.33), and an MBias of 0.88, indicating slight underestimation. SVM linear had lower performance metrics (R = 0.84, RMSE = 0.62, MAE = 0.48, MBias = 1.02). For Landsat-8, RF and SVM-RBF also showed strong performance (R = 0.94), with RF achieving RMSE of 0.38 and MAE of 0.28, and SVM-RBF achieving the lowest RMSE of 0.37 and MAE of 0.29. Both had near-perfect MBias values (RF = 1.00, SVM-RBF = 0.99). XGBoost displayed a high R-value (0.93) but higher error metrics (RMSE = 0.40, MAE = 0.30, MBias = 1.01). SVM linear underperformed (R = 0.78, RMSE = 0.69, MAE = 0.53, MBias = 0.98). Overall, RF and SVM-RBF consistently outperformed SVM linear and XGBoost across both satellite datasets.
Prognostic Accuracy of Blood Cell Count Ratios in Predicting Adverse Outcomes in Crush Syndrome Patients
Authors: Karlidag Taner , Bingol Olgun , Sarikaya Baran , Keskin Omer Halit , Durgal Atahan , Ozdemir Guzelali
Published: August 2024

Purpose
The rationale behind this study was the lack of an accurate predictor to facilitate treatment management and anticipate prognosis in crush syndrome. Our research aimed to investigate the following: 1) Is there a correlation between the ratios of blood cell counts upon admission and the adverse outcomes of crush syndrome? and 2) if such a correlation exists, what are the precise thresholds of blood cell count ratios for predicting these adverse outcomes?
Methods
In this single-centered and retrospective design study, we analyzed all patients admitted to our hospital after Kahramanmaras Earthquake.The data on length of stay in the ICU and mortality status were obtained using our hospital system. Ratios of blood cell count were calculated and recorded at the time of admission.
Results
The NLR values in admission were significantly higher in patients with amputation, patients who received intensive care unit (ICU) and patients who died. (p < 0.001, p < 0.001 and p = 0.001, respectively). The MLR values were found to be significantly increased in patients who underwent amputation and patients who received ICU (p < 0.001 and p = 0.003, respectively). NAR values in admission were significantly higher in patients with amputation, patients who received intensive care unit (ICU) and patients who died (p < 0.001, p < 0.001 and p = 0.002,respectively). In addition, according to binary logistic regression analysis, with a CLR value of > 109.844, the risk of amputation increases 8.188 fold; with a CLR value of > 64.518, the possibility of ICU admission requirement increases 10.117 fold, and with a CLR value of > 116.00, the risk of death increases 5.519 fold.
Conclusion
Ratios of blood cell count such as NLR, MLR, NAR, and CLR offer a reasonable prognostic accuracy in predicting adverse outcomes and mortality in patients with crush syndrome. Therefore, for better disaster management in the future, the determination of these values at admission should be used as an adjunct tool for predicting prognosis in patients with crush syndrome.
Cushing’s syndrome developing myasthenia gravis with Takotsubo cardiomyopathy after adrenalectomy: a case report
Authors: Yamamoto Ken , Kuroda Takeshi , Kubota Satomi , Matsuoka Kaoru , Kosuge Shota , Momma Yutaro , Miki Ayako , Murakami Hidetomo
Published: August 2024

Background
Several cases of autoimmune disease onset after treatment for Cushing’s syndrome have been reported.
Case presentation:
Herein, we report a case of myasthenia gravis crisis in a 51-year-old woman 2 months after adrenalectomy for adrenal Cushing’s syndrome accompanied by Takotsubo cardiomyopathy. The resolution of excessive endogenous cortisol after adrenalectomy may have triggered the onset of previously latent myasthenia gravis.
Conclusions
Observing the similarities in symptoms between myasthenia gravis and adrenal crisis, which can sometimes be challenging to differentiate, is essential. Moreover, the presence of Takotsubo cardiomyopathy as a non-motor manifestation of myasthenic crisis must be noted.
Establishing user centre design in developing a lung cancer self- management digital platform: Protocol Paper
Authors: Kirkpatrick Suriya , Wright Peter , Davey Zoe , Windsor Stanley , Henshall Catherine
Published: August 2024

Lung cancer exemplifies a significant global health challenge, characterised by pronounced mortality rates. An escalating incidence of new cases worldwide, coupled with comparatively diminished survival rates, distinguishes it from other prevalent malignancies. Physical activity can alleviate symptoms of breathlessness, cough, and depression, while also enhancing well-being in individuals with lung cancer. However, resources to support self-management through physical activity and exercise are limited. Our team proposes an innovative solution: a digital self-management platform designed for individuals with lung cancer. This paper reports on a protocol for the co-development of an exercise focused digital self-management platform. The principal objective of this platform is to offer people living with lung cancer an alternative approach to accessing relevant support to manage their health more independently, thereby fostering a more self-reliant approach to physical health self-management. The platform offers users with a secure internet connection, an individually tailored exercise plan, with features that facilitate the ongoing monitoring of their progress. Furthermore, the platform offers relevant guidance to users by directing them toward pertinent resources as required. The protocol describes a procedural framework for the platform's development and sets out a comprehensive strategy for the iterative co-development of the app with key stakeholders; lung cancer patients/survivors and their carers, health care professionals and other key decision makers. The platform's development is rooted in a user-centred, coproduction approach, aimed at accommodating the intricate demands of the targeted patient demographic and enhancing their overall physical functioning and wellbeing outcomes. A mixed methods study design is employed to collect both qualitative and quantitative data throughout the study.
Impact of sleep disturbances on outcomes in intensive care units
Authors: Marchasson Laura , Rault Christophe , Pape Sylvain Le , Arrivé François , Coudroy Rémi , Frat Jean-Pierre , Bironneau Vanessa , Jutant Etienne-Marie , Heraud Quentin , Drouot Xavier , Thille Arnaud W
Published: August 2024

Background
Sleep deprivation is common in ICUs and may alter respiratory performance. Few studies have assessed the role of sleep disturbances on outcomes in critically ill patients.
Objectives
We hypothesized that sleep disturbances may be associated with poor outcomes in ICUs.
Methods
Post-hoc analysis pooling 3 studies assessing sleep by complete polysomnography in 131 conscious and non-sedated patients included at different times of their ICU stay. Sleep was assessed early in patients admitted for acute respiratory failure while breathing spontaneously (n = 34), or under mechanical ventilation in patients with weaning difficulties (n = 45), or immediately after extubation (n = 52). Patients admitted for acute respiratory failure who required intubation, those under mechanical ventilation who had prolonged weaning, and those who required reintubation after extubation were considered as having poor clinical outcomes. Durations of deep sleep, rapid eye movement (REM) sleep, and atypical sleep were compared according to the timing of polysomnography and the clinical outcomes.
Results
While deep sleep remained preserved in patients admitted for acute respiratory failure whereas it was markedly reduced under mechanical ventilation and after extubation (p < 0.01). Atypical sleep was significantly more frequent in patients under mechanical ventilation than in those breathing spontaneously (p < 0.01). REM sleep was uncommon at any time of their ICU stay. Patients with complete disappearance of REM sleep (50% of patients) were more likely to have poor clinical outcomes than those with persistent REM sleep (24% vs. 9%, p = 0.03).
Conclusion
Complete disappearance of REM sleep was significantly associated with poor clinical outcomes in critically ill patients.
Knowledge, self-efficacy, satisfaction, and self-confidence of nursing students for stoma care using active learning methods: a controlled experimental study
Authors: Abselam-Ali Karima , Capilla-Díaz Concepcion , Reina-Prego Rocío , Parra-González Maria Elena
Published: August 2024

Background: An intestinal stoma is a surgery in which an artificial opening (stoma) is made in the abdomen to bypass the outflow of faeces. It is essential to provide training in stoma therapy as a core competency for nursing students to ensure optimal care for patients’ rehabilitation, occupational, social and family needs. While nursing skills are mainly taught through traditional teacher-centred lectures, the use of active learning methods can improve students’ competencies.
Objectives: To assess knowledge about stoma care in relation to the level of learning methods and to measure students' self-confidence, satisfaction and self-efficacy with the training received using different levels of fidelity, including simulation.
Design: Controlled experimental study involving three groups, with a pretest and post-test design. Settings: Faculty of Nursing of two Spanish public universities. Participants: Third-year nursing students during the academic year 2022-2023.
Methods: Group A received traditional teaching methods and low-fidelity simulation, group B received traditional teaching methods and high-fidelity simulation and group C received active learning methods and high-fidelity simulation. The instruments for data collection were the Nursing Outcomes Classification: "Knowledge: Ostomy Care [1829]” and its indicators, self-efficacy, and student satisfaction-self-confidence with learning. Results: Significant differences were found in 14 of the 15 NOC indicators measured between groups. The analysis of self-efficacy indicated notable differences in scores between the different groups after the intervention. For satisfaction and self-confidence, there were also significant differences, with group C (active learning methods and high-fidelity simulation) having the highest scores. Conclusions: Active learning methods are considered instruments that appear to improve ostomy knowledge and the degree of fidelity of the simulation impacts on student satisfaction and self-confidence in learning.