bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the use of small-area models on estimation of attributable mortality at a regional level
Authors: Rey-Brandariz Julia , Santiago-Pérez María I , Candal-Pedreira Cristina , Varela-Lema Leonor , Ruano-Ravina Alberto , López-Vizcaíno Esther , Guerra-Tort Carla , Ahluwalia Jasjit S , Montes Agustín , Pérez-Ríos Mónica
Published: June 2024

The objective of this study is to assess the impact of applying prevalences derived from a small-area model at a regional level on smoking-attributable mortality (SAM). A prevalence-dependent method was used to estimate SAM. Prevalences of tobacco use were derived from a small-area model. SAM and population attributable fraction (PAF) estimates were compared against those calculated by pooling data from three national health surveys conducted in Spain (2011–2014–2017). We calculated the relative changes between the two estimates and assessed the width of the 95% CI of the PAF. Applying surveys-based prevalences, tobacco use was estimated to cause 53 825 (95% CI: 53 182–54 342) deaths in Spain in 2017, a figure 3.8% lower obtained with the small-area model prevalences. The lowest relative change was observed in the Castile-La Mancha region (1.1%) and the highest in Navarre (14.1%). The median relative change between regions was higher for women (26.1%), population aged ≥65 years (6.6%), and cardiometabolic diseases (9.0%). The differences between PAF by cause of death were never greater than 2%. Overall, the differences between estimates of SAM, PAF, and confidence interval width are small when using prevalences from both sources. Having these data available by region will allow decision-makers to implement smoking control measures based on more accurate data.
First Chromosome-Level Genome Assembly of a Ribbon Worm from the Hoplonemertea Clade, Emplectonema gracile, and Its Structural Annotation
Authors: Valero-Gracia Alberto , Roberts Nickellaus G , Yap-Chiongco Meghan , Capucho Ana Teresa , Kocot Kevin M , Matschiner Michael , Struck Torsten H
Published: June 2024

Genome-wide information has so far been unavailable for ribbon worms of the clade Hoplonemertea, the most species-rich class within the phylum Nemertea. While species within Pilidiophora, the sister clade of Hoplonemertea, possess a pilidium larval stage and lack stylets on their proboscis, Hoplonemertea species have a planuliform larva and are armed with stylets employed for the injection of toxins into their prey. To further compare these developmental, physiological, and behavioral differences from a genomic perspective, the availability of a reference genome for a Hoplonemertea species is crucial. Such data will be highly useful for future investigations toward a better understanding of molecular ecology, venom evolution, and regeneration not only in Nemertea but also in other marine invertebrate phyla. To this end, we herein present the annotated chromosome-level genome assembly for Emplectonema gracile (Nemertea; Hoplonemertea; Monostilifera; Emplectonematidae), an easily collected nemertean well suited for laboratory experimentation. The genome has an assembly size of 157.9 Mb. Hi-C scaffolding yielded chromosome-level scaffolds, with a scaffold N50 of 10.0 Mb and a score of 95.1% for complete BUSCO genes found as a single copy. Annotation predicted 20,684 protein-coding genes. The high-quality reference genome reaches an Earth BioGenome standard level of 7.C.Q50.
The influence of stress on the fracture and elastic properties of carbonate rocks controlled by strike-slip faults: a novel rock-physics modelling perspective
Authors: Song Yichen , Gong Fei , Zeng Lianbo , Zhang Zhaoji , Mao Zhe , Huang Cheng , Yao Yingtao , Tan Xiaolin , Lin Bo
Published: June 2024

The fine-scale fractures within strike-slip faults substantially impact the flowing capacity. However, effective methods for their characterization are still lacking, making it challenging to predict hydrocarbon accumulation patterns. In this study, we conducted microscopic statistics, ultrasonic experiments and theoretical modelling to analyse the fracture density and elastic characteristics within the strike-slip fault and investigated the impact of stress. Our findings reveal that the fracture density in the fault core is 3–4 times higher than that in the damage zone, and the acoustic velocity is 13–18 per cent lower under atmospheric pressure. With the rising confining pressure, the fracture density initially decreases rapidly and then slowly, while the acoustic velocity follows the same increasing trend. The gradually slowing trend indicates that the majority of fractures close within the range of 0–20 MPa. Moreover, the stress sensitivity of the bulk modulus is higher than that of the shear modulus. The stress sensitivity is higher in the fault core than in the damage zone, which correlates strongly with the variation in fracture density. These indicate that the stress sensitivity in the fault-controlled rock is attributed to stress-induced fracture deformation, predominantly manifested as volumetric compression deformation. During the geological evolution, differences in tectonic faulting, fluid filling and compaction within the fault zone contribute to present heterogeneity in fracture density. Finally, our research demonstrates a strong correlation between theoretical prediction results and underground logging, drilling and core data. These findings can help predict the underground fracture distribution and elastic response of carbonate reservoirs controlled by strike-slip faults.
Opt-Out Implied Licenses in Copyright Law: From Search Engines to GPAI Models
Authors: Zhang Hongjiao , Li Yahong
Published: June 2024

Traditionally, the doctrine of implied license is consistent with the default of copyright law, because it requires evidence of a clear grant. Currently, US and German courts have implicitly applied an extended doctrine of implied licenses in the search engine context: opt-out implied licenses. This article calls for legislative recognition of opt-out implied licenses and identifies the unique mechanism and independent position in copyright law. Furthermore, two criteria, i.e. efficiency and balance, are proposed to assess the applicability of the doctrine. The proposed criteria can guide legislators in crafting legal norms that the opt-out implied license applies in specific contexts. On this basis, this article makes the case that opt-out implied licenses have some implications for training general-purpose AI models (hereinafter ‘GPAI models’) using copyrighted materials and that the proposed criteria can help better design and improve the law.
Multi-ancestry polygenic risk scores for venous thromboembolism
Authors: Jee Yon Ho , Thibord Florian , Dominguez Alicia , Sept Corriene , Boulier Kristin , Venkateswaran Vidhya , Ding Yi , Cherlin Tess , Verma Shefali Setia , Faro Valeria Lo , Bartz Traci M , Boland Anne , Brody Jennifer A , Deleuze Jean-Francois , Emmerich Joseph , Germain Marine , Johnson Andrew D , Kooperberg Charles , Morange Pierre-Emmanuel , Pankratz Nathan , Psaty Bruce M , Reiner Alexander P , Smadja David M , Sitlani Colleen M , Suchon Pierre , Tang Weihong , Trégouët David-Alexandre , Zöllner Sebastian , Pasaniuc Bogdan , Damrauer Scott M , Sanna Serena , Snieder Harold ,   Lifelines Cohort Study, Aguirre-Gamboa Raul , Deelen Patrick , Franke Lude , Kuivenhoven Jan A , Lopera Maya Esteban A , Nolte Ilja M , Sanna Serena , Snieder Harold , Swertz Morris A , Visscher Peter M , Vonk Judith M , Wijmenga Cisca , Wray Naomi , Kabrhel Christopher , Smith Nicholas L , Kraft Peter ,   INVENT Consortium
Published: June 2024

Venous thromboembolism (VTE) is a significant contributor to morbidity and mortality, with large disparities in incidence rates between Black and White Americans. Polygenic risk scores (PRSs) limited to variants discovered in genome-wide association studies in European-ancestry samples can identify European-ancestry individuals at high risk of VTE. However, there is limited evidence on whether high-dimensional PRS constructed using more sophisticated methods and more diverse training data can enhance the predictive ability and their utility across diverse populations. We developed PRSs for VTE using summary statistics from the International Network against Venous Thrombosis (INVENT) consortium genome-wide association studies meta-analyses of European- (71 771 cases and 1 059 740 controls) and African-ancestry samples (7482 cases and 129 975 controls). We used LDpred2 and PRS-CSx to construct ancestry-specific and multi-ancestry PRSs and evaluated their performance in an independent European- (6781 cases and 103 016 controls) and African-ancestry sample (1385 cases and 12 569 controls). Multi-ancestry PRSs with weights tuned in European-ancestry samples slightly outperformed ancestry-specific PRSs in European-ancestry test samples (e.g. the area under the receiver operating curve [AUC] was 0.609 for PRS-CSx_combinedEUR and 0.608 for PRS-CSxEUR [P = 0.00029]). Multi-ancestry PRSs with weights tuned in African-ancestry samples also outperformed ancestry-specific PRSs in African-ancestry test samples (PRS-CSxAFR: AUC = 0.58, PRS-CSx_combined AFR: AUC = 0.59), although this difference was not statistically significant (P = 0.34). The highest fifth percentile of the best-performing PRS was associated with 1.9-fold and 1.68-fold increased risk for VTE among European- and African-ancestry subjects, respectively, relative to those in the middle stratum. These findings suggest that the multi-ancestry PRS might be used to improve performance across diverse populations to identify individuals at highest risk for VTE.
Polynomial Representations of the Witt Lie Algebra
Authors: Sam Steven V , Snowden Andrew , Tosteson Philip
Published: June 2024

The Witt algebra  ${\mathfrak{W}}_{n}$ is the Lie algebra of all derivations of the $n$-variable polynomial ring $\textbf{V}_{n}=\textbf{C}[x_{1}, \ldots , x_{n}]$ (or of algebraic vector fields on $\textbf{A}^{n}$). A representation of ${\mathfrak{W}}_{n}$ is polynomial if it arises as a subquotient of a sum of tensor powers of $\textbf{V}_{n}$. Our main theorems assert that finitely generated polynomial representations of ${\mathfrak{W}}_{n}$ are noetherian and have rational Hilbert series. A key intermediate result states polynomial representations of the infinite Witt algebra are equivalent to representations of $\textbf{Fin}^{\textrm{op}}$, where $\textbf{Fin}$ is the category of finite sets. We also show that polynomial representations of ${\mathfrak{W}}_{n}$ are equivalent to polynomial representations of the endomorphism monoid of $\textbf{A}^{n}$. These equivalences are a special case of an operadic version of Schur–Weyl duality, which we establish.
Ethics of research engagement with Deaf people. A qualitative evidence synthesis
Authors: Krawczyk Tomasz , Piasecki Jan , Wasylewski Mateusz , Waligora Marcin
Published: June 2024

In this article, we explore ethical issues of Deaf people’s engagement in research. To focus on the perspectives of Deaf people, we investigated existing qualitative and mixed methods research within a qualitative evidence synthesis. Our synthesis is based on a systematic database search (Scopus, PubMed) and reference check of included papers which resulted in 27 eligible papers. We analyzed the data using thematic synthesis and developed 5 analytical themes. The results present research as a struggle for Deaf people and emphasize the need for changes regarding recognition of Deaf research in a cross-cultural context, maintaining equal and partner relations, and provision of accessible communication. Our research contributes to understanding what the ethical inclusion of Deaf people in research implies. It may also support the development of evidence-based normative recommendations and scientific cooperation between Deaf and hearing people.
Optimism, pessimism, and physical health among youth: a scoping review
Authors: Fairbank Eloïse J , Borenstein-Laurie James , Alberts Nicole M , Wrosch Carsten
Published: June 2024

Objective

High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions.

Methods

We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized.

Results

Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk.

Conclusions

The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.
A cesarean section scar dehiscence during the first trimester of an intrauterine pregnancy: a rare case report and literature review
Authors: Alhalak Fadi , Haddad Sultaneh , Nasseh Gabriel , Nasseh Mira , Marroush Joud , Abaza Rami , AlSafadi Aya , Hani Majd Jehad Dakhalalah Bani , Kabbabe George Michael
Published: June 2024

Uterine rupture is specified as a complete laceration of the uterine wall, including its serosa, leading to a connection between the endometrial and peritoneal chambers. It can occur in any stage of pregnancy and is considered a severe and perhaps fatal complication. A 35-year-old woman at 9 weeks of gestation with a medical history of five prior cesarean sections presented with lower abdominal pain that had lasted for 5 hr. We detected small amounts of free fluid in the Douglas pouch using ultrasound. Subsequently, a laparotomy revealed a cesarean scar dehiscence from a non-cesarean scar pregnancy. Patients who experience a uterine rupture may have vague symptoms, severe abdominal discomfort, abnormal uterine bleeding, and severe hemorrhagic shock, depending on their gestational age. Ultrasound imaging can be used to diagnose this fatal condition in addition to laparoscopy to immediately identify and treat the issue in urgent cases.
Plunging region emission in the X-ray binary MAXI J0637−430
Authors: Mummery Andrew , Jiang Jiachen , Fabian Andrew
Published: June 2024

On 2019 November 2, the black hole X-ray binary MAXI J0637−430 went into outburst, at the start of which it was observed in a thermal ‘disc-dominated’ state. High photon energy (extending above 10 keV) observations taken by the NuSTAR telescope reveal that this thermal spectrum cannot be fit by conventional two-component (disc plus corona) approaches that ignore disc emission sourced from within the plunging region of the black hole’s space–time. Instead, these models require a third ‘additional’ thermal component to reproduce the data. Using new disc solutions that extend classical models into the plunging region, we show that this ‘additional’ thermal emission can be explained self-consistently with photons emitted from the accretion flow at radii within the innermost stable circular orbit of the black hole. This represents the second low-mass X-ray binary, after MAXI J1820+070, with a detection of plunging region emission, suggesting that signatures of this highly relativistic region may well be widespread but not previously widely appreciated. To allow for a detection of the plunging region, the black hole in MAXI J0637−430 must be at most moderately spinning, and we constrain the spin to be $a_\bullet \lt 0.86$ at 99.9 ${{\ \rm per\ cent}}$ confidence. We finish by discussing the observational requirements for the robust detection of this region.
Autocatalytic bifunctional supramolecular hydrogels for osteoporotic bone repair
Authors: Han Zhihui , Gao Xiang , Wang Yuanjie , Huang Cheng , Song Hao , Cheng Shuning , Yang Xiaoyuan , Cui Xiaoliang , Wu Jie , Wei Kailu , Cheng Liang
Published: June 2024

Conventional bone scaffolds, which are mainly ascribed to highly active osteoclasts and an inflammatory microenvironment with high levels of reactive oxygen species and pro-inflammatory factors, barely satisfy osteoporotic defect repair. Herein, multifunctional self-assembled supramolecular fiber hydrogels (Ce–Aln gel) consisting of alendronate (Aln) and cerium (Ce) ions were constructed for osteoporotic bone defect repair. Based on the reversible interaction and polyvalent cerium ions, the Ce–Aln gel, which was mainly composed of ionic coordination and hydrogen bonds, displayed good injectability and autocatalytic amplification of the antioxidant effect. In vitro studies showed that the Ce–Aln gel effectively maintained the biological function of osteoblasts by regulating redox homeostasis and improved the inflammatory microenvironment to enhance the inhibitory effect on osteoclasts. Ribonucleic acid (RNA) sequencing further revealed significant downregulation of various metabolic pathways, including apoptosis signaling, hypoxia metabolism and tumor necrosis factor-alpha (TNF-α) signaling via the nuclear factor kappa-B pathway after treatment with the Ce–Aln gel. In vivo experiments showed that the clinical drug-based Ce–Aln gel effectively promoted the tissue repair of osteoporotic bone defects by improving inflammation and inhibiting osteoclast formation at the defect. Notably, in vivo systemic osteoporosis was significantly ameliorated, highlighting the strong potential of clinical translation for precise therapy of bone defects.
Enhanced stiffness in peri-cancerous tissue: a marker of poor prognosis in papillary thyroid carcinoma with lymph node metastasis
Authors: Hu Lei , Ye Lei , Pei Chong , Sun Chunlei , Zhang Chaoxue , Jiang Fan , He Nianan , Lv Weifu
Published: June 2024

Background

The prognostic significance of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) remains controversial. Notably, there is evidence suggesting an association between tissue stiffness and the aggressiveness of the disease. We therefore aimed to explore the effect of tissue stiffness on LNM-related invasiveness in PTC patients.

Method

A total of 2492 PTC patients from 3 hospitals were divided into an LNM group and a non-LNM group based on their pathological results. The effects of interior lesion stiffness (E) and peri-cancerous tissue stiffness (Eshell) on the LNM-related recurrence rate and mortality in each patient with PTC subgroup were analyzed. The activation of cancer-associated fibroblasts (CAFs) and extracellular matrix component type 1 collagen (COL-I) in the lesion were compared and analyzed across different subgroups. The underlying biological basis of differences in each subgroup was identified using RNA sequencing (RNA-seq) data.

Results

The Eshell value and Eshell/E in the LNM group were significantly higher than those in the non-LNM group of patients with PTC (Eshell: 72.72 ± 5.63 vs 66.05 ± 4.46; Eshell/E: 1.20 ± 1.72 vs 1.09 ± 1.10, P < .001). When Eshell/E > 1.412 and LNM were both present, the recurrence rate and mortality were significantly increased compared to those of group of patients with LNM (91.67% and 7.29%, respectively). The CAF activation and COL-I content in the Eshell/E+ group were significantly higher than those in the Eshell/E− group (all P < .001), and the RNA-seq results revealed significant extracellular matrix (ECM) remodeling in the LNM-Eshell/E+ group.

Conclusions

Stiff peri-cancerous tissue induced CAF activation, COL-I deposition, and ECM remodeling, resulting in a poor prognosis for PTC patients with LNM.
Computational Reproducibility in Finance: Evidence from 1,000 Tests
Authors: Pérignon Christophe , Akmansoy Olivier , Hurlin Christophe , Dreber Anna , Holzmeister Felix , Huber Jürgen , Johannesson Magnus , Kirchler Michael , Menkveld Albert J , Razen Michael , Weitzel Utz
Published: June 2024

We analyze the computational reproducibility of more than 1,000 empirical answers to 6 research questions in finance provided by 168 research teams. Running the researchers’ code on the same raw data regenerates exactly the same results only 52% of the time. Reproducibility is higher for researchers with better coding skills and those exerting more effort. It is lower for more technical research questions, more complex code, and results lying in the tails of the distribution. Researchers exhibit overconfidence when assessing the reproducibility of their own research. We provide guidelines for finance researchers and discuss implementable reproducibility policies for academic journals.
Diabetes mellitus and female sexual response: what do animal models tell us?
Authors: Hernández-Munive Abigail Karina , Molina-Leonor Mildred Berenice , Ayala-González Brenda Denisse , Vázquez-Andrade Joanna , Medina-Nieto Alberto , Fernández-Guasti Alonso
Published: June 2024

Background

One of the less explored effects of diabetes mellitus (DM) is female sexual dysfunction. Females of different species have been used as models.

Aim

To analyze the information of animal models of DM and female sexual response (FSR).

Methods

The literature of FSR in models of DM was reviewed.

Outcomes

Paradigm- and diabetes-dependent changes have been found in various aspects of the FSR.

Results

Females in a type 1 DM (DM1) model show a decrease in the number of proestrus events, and ovariectomized females treated with sex hormones have been used. In these females, a reduction in lordosis has been reported; in proceptivity, the data are contradictory. These females present a decrease in sexual motivation that was restored after exogenous insulin. In the type 2 DM (DM2) model, females show regular estrous cycles, normal levels of lordosis behavior, and, depending on the paradigm, decreased proceptivity. These females display normal preference for sexually active males or their olfactory cues when having free physical contact; they lose this preference when tested in paradigms where physical interaction is precluded.

Clinical Translation

Preclinical data showing the high deleterious effects of a DM1 model and the less drastic effects under a DM2 model are in accordance with clinical data revealing a much higher prevalence of sexual dysfunction in women with DM1 than DM2.

Strengths and Limitations

The main strength is the analysis of the changes in various components of FSR in 2 models of DM. The main limitation is the difficulty in extrapolating the data on FSR from rats to women and that most studies focus on evaluating the impact of severe or chronic-moderate hyperglycemia/hyperinsulinemia on the sexual response, without considering other pathophysiologic alterations generated by DM.

Conclusion

Females with severe hyperglycemia have a decrease in FSR, while those with moderate hyperglycemia show much less drastic effects.
Role of anxiolytic medications in maintaining perioperative blood pressure in total hip arthroplasty surgeries: case-control retrospective study
Authors: Elifranji Zuhdi O. , Al-Ajlouni Jihad M. , Al-Saber Munther G. , Karam Abdulrahman M. , Alshrouf Hadeel A. , Alshrouf Mohammad Ali
Published: June 2024

Background:

Elevated blood pressure (BP) measurements seen in patients having total hip arthroplasty (THA), pose a significant issue for surgeons. The study objective was to investigate the effectiveness of preoperative anxiolytic medications in the maintenance of blood pressure and reduction of total blood loss in patients undergoing THA surgeries.

Methods:

A retrospective case-control cohort study in a tertiary care university hospital included patients who had THA and had either primary managed hypertension or were non-hypertensive. 190 patients who underwent primary THR; 103 controls and 87 treatment group (Oral 3 mg Bromazepam). Pearson’s chi-square, independent sample t-test, paired samples t-test, and a two- way repeated measures analysis of variance (ANOVA) was utilized in the analysis.

Results:

Bromazepam group had a significantly lowered ratio of systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP) in the morning of the surgery (P<0.05). Bromazepam also reduced the ratio of SBP and MAP in theaters before anesthesia (P<0.05). A repeated measures ANOVA showed significant treatment effects for SBP and MAP but not DBP (P<0.001 for both). SBP, DBP, and MAP showed a significant time-treatment effect (P<0.001, 0.019, and<0.001, respectively).

Conclusions:

Oral bromazepam (anxiolytic) aids in the regulation of blood pressure in individuals with well-managed hypertension and in healthy patients having total hip arthroplasty without apparent adverse effects related to the medication. This could potentially reduce the number of uncontrolled hypertension-related surgery delays and patients on the surgical waiting list.
Unveiling the Potential of AI in Plastic Surgery Education: A Comparative Study of Leading AI Platforms’ Performance on In-training Examinations
Authors: DiDonna Nicole , Shetty Pragna N. , Khan Kamran , Damitz Lynn
Published: June 2024

Background:

Within the last few years, artificial intelligence (AI) chatbots have sparked fascination for their potential as an educational tool. Although it has been documented that one such chatbot, ChatGPT, is capable of performing at a moderate level on plastic surgery examinations and has the capacity to become a beneficial educational tool, the potential of other chatbots remains unexplored.

Methods:

To investigate the efficacy of AI chatbots in plastic surgery education, performance on the 2019–2023 Plastic Surgery In-service Training Examination (PSITE) was compared among seven popular AI platforms: ChatGPT-3.5, ChatGPT-4.0, Google Bard, Google PaLM, Microsoft Bing AI, Claude, and My AI by Snapchat. Answers were evaluated for accuracy and incorrect responses were characterized by question category and error type.

Results:

ChatGPT-4.0 outperformed the other platforms, reaching accuracy rates up to 79%. On the 2023 PSITE, ChatGPT-4.0 ranked in the 95th percentile of first-year residents; however, relative performance worsened when compared with upper-level residents, with the platform ranking in the 12th percentile of sixth-year residents. The performance among other chatbots was comparable, with their average PSITE score (2019–2023) ranging from 48.6% to 57.0%.

Conclusions:

Results of our study indicate that ChatGPT-4.0 has potential as an educational tool in the field of plastic surgery; however, given their poor performance on the PSITE, the use of other chatbots should be cautioned against at this time. To our knowledge, this is the first article comparing the performance of multiple AI chatbots within the realm of plastic surgery education.
Reappraisal of the Parenchyma-Sparing Resections for Pancreatic Neuroendocrine Tumors: A Chinese High-volume Center Experience
Authors: Zhang Haoqi , Tan Chunlu , Liu Xubao , Wang Xing
Published: June 2024

Background:

Parenchyma-sparing resections (PSRs) are increasingly used for small pancreatic neuroendocrine neoplasms (PNENs) to preserve the function of the gland. However, the data are extremely limited due to the rarity of this tumor.

Aims:

This study sought to describe the indications, operative technique, short and long-term outcomes of PSRs for PNENs, with a focus on postoperative pancreatic fistula (POPF) and oncologic outcomes.

Methods:

From 2008 to 2018, data collected retrospectively from 113 PNENs that underwent PSRs (113/421, 27%) were reviewed. A comparison was conducted of PSRs of PNENs without (group1, n=101) or with pancreatic transection (group 2, n=12).

Results:

Of the 113 patients, the most common indication for PSRs was insulinoma (80%), followed by NF-PNEN (20%). The majority of lesions were WHO G1 grade (80/113, 71%). The mean maximum diameter of the tumors was 19 mm. Patients who underwent PSRs had a low rate of severe postoperative morbidity (7/113, 6%). Pancreatic endocrine and exocrine insufficiency occurred in only 1% and 7% of patients respectively. And there was no evidence of tumor recurrence after PSRs detected during follow-up. Age was identified as the only independent positive risk factor of POPF in group 1. Patients in group 2 had significantly higher rates of POPF (p=0.002), overall morbidity (p=0.002), severe morbidity (p=0.026) and readmission (p=0.004).

Conclusions:

PSRs of PNENs appear to be feasible and safe, preserving the endocrine and exocrine function of the gland with no increased risk of recurrence or metastasis. In contrast, PSRs involving transection of the pancreas should be performed more cautiously.
Reliability and Validity of the Korean version of the Center for Neurologic Study Bulbar Function Scale (K-CNS-BFS): An observational study
Authors: Park Bu Kyung , Oh Seong-il , Kang Minsung , Seok Hung Youl , Park Jin-Mo , Kim Sohyeon , Kim Hye-In , Kim Ji-Ah , Park Jin-Sung
Published: June 2024

Bulbar dysfunction in amyotrophic lateral sclerosis (ALS) significantly affects daily life, leading to weight loss and reduced survival. Methods for evaluating bulbar dysfunction, including videofluoroscopic swallowing studies and the bulbar component of the ALS Functional Rating Scale-Revised (ALSFRS-R), have been employed; however, Korean-specific tools are lacking. The Center for Neurologic Study Bulbar Function Scale (CNS-BFS) comprehensively evaluates bulbar symptoms. This study aimed to develop and validate the Korean version of the CNS-BFS (K-CNS-BFS) to assess bulbar dysfunction in Korean patients with ALS. Twenty-seven patients with ALS were recruited from a tertiary hospital in South Korea based on revised El Escorial criteria. Demographic, clinical, and measurement data were collected. The K-CNS-BFS was evaluated for reliability and validity. Reliability assessment revealed strong internal consistency (Cronbach alpha) for the K-CNS-BFS subscales and total score. Test–retest reliability showed significant correlation. Content validity index was excellent, and convergent validity demonstrated significant correlations between the K-CNS-BFS and relevant measures. Discriminant validity was observed between the K-CNS-BFS and motor/respiratory subscores of the ALSFRS-R. Construct validity demonstrated significant correlations between the K-CNS-BFS subscales and total score. This is the first study to investigate the reliability and validity of the Korean version of the CNS-BFS, which showed consistent and reliable scores that correlated with tests for bulbar or general dysfunction. The K-CNS-BFS effectively measured bulbar dysfunction similar to the original CNS-BFS. The K-CNS-BFS is a reliable and valid tool for assessing bulbar dysfunction in patients with ALS in South Korea.
Mechanism of polygonum capitatum intervention in pulmonary nodule based on network pharmacology and molecular docking technology
Authors: Tang Yilian , Pu Xiang , Fan Zhiliang , Kong Xiangyan , Zhang Chen , Li Lailai
Published: June 2024

The present study utilizes network pharmacology and molecular docking methodologies to investigate the mechanism of action behind the intervention of Polygonum capitatum Buch.-Ham.ex D. Don (THL) in treating pulmonary nodules (PN). This research aims to provide a theoretical foundation for broadening the clinical application of THL. Active components of THL were identified and screened through an extensive literature review and the PharmMapper database, followed by an analysis of their target interactions. Relevant targets associated with PN were selected using databases such as OMIM and GeneCards, with an intersection of the two sets being determined. STRING11.5 facilitated the acquisition of protein-protein interaction data, which was then imported into Cytoscape 3.7.2 to establish a protein interaction network topology. This enabled the identification of pivotal targets affected by THL intervention in PN. The study further employed the Metascape database to conduct GO and KEGG bioinformatics enrichment analyses, which illuminated core pathways involved in THL’s therapeutic effects on PN. A comprehensive component-target-pathway diagram was constructed utilizing Cytoscape 3.7.2 software, with molecular docking validations carried out via Maestro software. A total of 49 active THL ingredients were discerned, implicating 67 PN-relevant targets. Subsequent software analysis pinpointed 10 key targets, including ALB, EGFR, and SRC. Molecular docking studies indicated strong binding affinities for most protein-compound pairs, with 44 out of 60 docking results exhibiting binding energies below −5 kcal/mol. Enrichment analysis highlights that key targets are mainly involved in pathways such as cancer, lipid metabolism and atherosclerosis, estrogen signaling, IL-17 signaling, complement and coagulation cascades, and chemical carcinogenesis through receptor activation. Through comprehensive network pharmacological approaches, this research delineates the synergy of THL’s multiple components, targets, and pathways in mitigating PN. It posits that primary active ingredients of THL – quercetin, salidroside, and oleanolic acid – may exert effects on targets like ALB, EGFR, SRC, potentially modulating pathways associated with cancer, lipid and atherosclerosis, and IL-17 signaling in the context of PN intervention.
Bioinformatic analysis combined with immune infiltration to explore osteoarthritis biomarkers and drug prediction
Authors: Liu Yan , Jiang Wei , Huang Juan , Zhong Li
Published: June 2024

Along with global aging, osteoarthritis (OA) appears to have a high incidence and disability rate, which seriously affects the quality of life of patients, making age a major risk factor. However, the pathology of OA is under-researched, and there is no obvious and effective treatment. Research has demonstrated the importance of aging, inflammation, and immunology in the onset and course of OA. This study aims to anticipate therapeutic drugs based on critical genes associated with OA and to elucidate the roles of genes and possible biomarkers associated with inflammation, immunology, and cellular senescence in OA. The OA gene expression matrix was first obtained from the Gene Expression Omnibus database. Screening for OA significant differentially expressed genes by bioinformatics identification. Specific biological processes and related signaling pathways of the differential genes were enriched. Then elucidate the status of immune cell involvement in OA based on immune infiltration analysis. Finally predict therapeutic agents based on pivotal genes. A total of 198 differentially expressed genes were identified in OA, and TP53, EGFR, TGFB1, LEP, CD4, MAPK8, SCARB1, ADIPOQ, JAK2, and SERPINE1 were further identified as important hub genes. The enrichment results showed that the development of arthritis was mainly related to immune cell differentiation, amino acid metabolism and cellular senescence process. The validation of immune infiltration results indicated that NK_cells, CD4_Tcells, Macrophages, Monocytic_lineage, Dendritic_cells, Basophils, CD8+_naive_T-cells may play an important role in the immune process of OA. Key Drug Prediction of Hub Genes found that Halicin, Ruxolitinib, Tofacitinib, Clenoliximab, Baricitinib may be a key drug or component in the treatment of OA.
Association between obstructive sleep apnea and risk of Benign vocal fold lesions: A nationwide 9-year follow-up cohort study
Authors: Hong Yong Tae , Kang Min Gu , Lee Min Gyu , Yeom Sang Woo , Kim Jong Seung
Published: June 2024

Since obstructive sleep apnea (OSA) affects various parts of the body, there has been little interest about the effect of OSA on voice. The objective of this study was to evaluate the risk of benign vocal fold lesions (BVFL) in OSA patients. This study used data from the National Health Insurance Service (NHIS) database. The study group was defined as the group diagnosed with OSA between 2008 and 2011. Non-OSA groups were selected based on propensity score (PS) matching. Incidence of BVFL among participants during the follow-up was analyzed. Cox proportional hazard regression analyses were performed to evaluate the association between OSA and incident BVFL. The HR value of the OSA group calculated by considering 8 variables indicates that the risk of developing BVFL is 79% higher than that of the control group. Further, among OSA patients, patients with a history of OP had a 35% lower risk of developing BVFL. The relationships between BVFL and 7 individual variables considered were as follows: For age, HR for the 40 to 59 years group was 1.20 (95%CI, 1.09–1.32). For sex, the HR in the female group was 1.22 (95%CI, 1.10–1.35). For residential areas, the HR values for “Seoul” 1.39 (95%CI, 1.23–1.59). In the high economic status group, the HR was 1.10 (95%CI, 1.01–1.21). This observational study indicated that OSA is associated with an increased incidence of BVFL. The incidence of BVFL increased with older age, female sex, and high SES.
The association between serum uric acid and low birth weight in advance maternal age women with hypertension: An observational study
Authors: Luo Yanlan , Mo Yeping , Xiong Yingzhu , Huang Sulan
Published: June 2024

In China, the implementation of 2-child policy since 2015 entitles increasing number of advanced maternal age. Recently, Chinese hypertensive disorders of pregnancy (HDP) in advanced-age women have attracted significant clinical and epidemiological research interest. Previous studies have shown an association between serum uric acid (SUA) levels and low birth weight (LBW) in children. Several studies have reported that advanced maternal age is a risk factor for many complications in pregnancy, including LBW. However, it remains unclear whether SUA affects LBW risk in advanced maternal age mothers with hypertensive diseases. The study was observational in nature. A total of 692 advanced maternal age with hypertension were enrolled in our study. A variety of demographic and vital sign data, laboratory test results, and pregnancy outcomes were collected. Children born with LBW served as the clinical endpoint. On admission, blood samples were taken, and women with advanced maternal ages were divided into 2 groups based on their SUA levels. In order to investigate the association between SUA and LBW, a logistic regression model was used. E-value analysis was used to determine the residual unmeasured confounding. The mean SUA level was increased in advanced maternal age patients with HDP. Of 692 newborns, 244 (35.26%) have LBW. With possible confounders adjusted, high SUA levels were independent risk factors for LBW (odds ratio [OR]2.88, 95% confidence intervals [CI]1.22–6.81), multivariate logistic regression analysis using SUA as a continuous variable recapitulated the pattern (OR 1.01, 95% CI 1.00–1.01). In addition, SUA levels in women with advanced maternal age and hypertension were linearly related to LBW incidence. According to this study, SUA levels in patients with advanced maternal age and HDP are associated with LBW incidence.
Assessing parental comprehension of online resources on childhood pain
Authors: Ocmen Elvan , Erdemir Ismail , Aksu Erdost Hale , Hanci Volkan
Published: June 2024

We aimed to examine the patient education materials (PEMs) on the internet about “Child Pain” in terms of readability, reliability, quality and content. For our observational study, a search was made on February 28, 2024, using the keywords “Child Pain,” “Pediatric Pain,” and “Children Pain” in the Google search engine. The readability of PEMs was assessed using computer-based readability formulas (Flesch Reading Ease Score [FRES], Flesch-Kincaid Grade Level [FKGL], Automated readability index (ARI), Gunning Fog [GFOG], Coleman-Liau score [CL], Linsear Write [LW], Simple Measure of Gobbledygook [SMOG]). The reliability and quality of websites were determined using the Journal of American Medical Association (JAMA) score, Global Quality Score (GQS), and DISCERN score. 96 PEM websites included in our study. We determined that the FRES was 64 (32–84), the FKGL was 8.24 (4.01–15.19), ARI was 8.95 (4.67–17.38), GFOG was 11 (7.1–19.2), CL was 10.1 (6.95–15.64), LW was 8.08 (3.94–19.0) and SMOG was 8.1 (4.98–13.93). The scores of readability formulas showed that, the readability level of PEMs was statistically higher than sixth-grade level with all formulas (P = .011 for FRES, P < .001 for GFOG, P < .001 for ARI, P < .001 for FKGL, P < .001 for CL and P < .001 for SMOG), except LW formula (P = .112). The websites had moderate-to-low reliability and quality. Health-related websites had the highest quality with JAMA score. We found a weak negative correlation between Blexb score and JAMA score (P = .013). Compared to the sixth-grade level recommended by the American Medical Association and the National Institutes of Health, the readability grade level of child pain-related internet-based PEMs is quite high. On the other hand, the reliability and quality of PEMs were determined as moderate-to-low. The low readability and quality of PEMs could cause an anxious parent and unnecessary hospital admissions. PEMs on issues threatening public health should be prepared with attention to the recommendations on readability.
Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades
Authors: Ashraf Hamza , Nadeem Aimen , Ashfaq Haider , Fatima Tehniat , Ahmed Sophia , Nadeem Zain Ali , Saleh Aalaa
Published: June 2024

Approximately 38 million people worldwide are affected by human immunodeficiency virus (HIV), with 4000 new infections daily. While literature explores HIV mortality among the elderly in the US, there is an underrepresentation of mortality data for adults. By scrutinizing mortality trends based on demographic factors such as gender, race or ethnicity, age groups, and geographic location, the study seeks to uncover patterns that may facilitate a longitudinal perspective for tailoring interventions and allocating resources effectively. Crude death rates and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated using HIV mortality data (ICD-10 Codes B20–24) from CDC WONDER database. Permutation test was used to calculate annual percentage changes in AAMR with 95% confidence interval. Average annual percentage changes were computed as weighted average of annual percentage changes. Between 1999 to 2020, US adult HIV deaths totaled 225,396 (AAMR: 5.03), with a significantly decreasing average annual percentage changes (‐5.94). Males exhibited a 3-fold higher AAMR (7.50) than females (2.67). Non-Hispanic Blacks had the highest AAMR (21.82), while Non-Hispanic Asians had the lowest (0.67). The South and Northeast regions had the highest AAMRs (6.91 and 6.33, respectively). Notably, the District of Columbia had an alarmingly high mortality rate of 39.9, while North Dakota had the lowest (0.7). Urban regions (5.47) had double the mortality rates of rural regions (2.70). Mortality rate peaked in age groups 45 to 54 (8.65) and 35 to 44 (7.42). While overall HIV mortality is declining, disparities persist among demographics. Targeted interventions are crucial to improve preventive measures and healthcare access for disproportionately affected groups.
Optimizing the connection of CRRT and ECMO lines with additional pressure regulator on the therapeutic effect, filter life, and incidence of complications
Authors: Huang Xihua , Gao Yongxia , Chen Xufeng , Mei Yong , Zhang Hui , Tian Yali , Wu Juan
Published: June 2024

Background:

Extracorporeal membrane oxygenation (ECMO) is used for severe cardiopulmonary failure, with veno-arterial ECMO for cardiogenic shock and veno-venous ECMO for acute respiratory failure. ECMO’s application has expanded to ICUs, emergency departments, and operating rooms. ECMO patients are at high risk for complications, including acute kidney injury (AKI), often requiring renal replacement therapy (RRT), posing significant management challenges.

Methods:

From August 2015 to June 2022, 120 patients were cured with veno-venous ECMO (n = 60) or veno-arterial ECMO (VA-ECMO, n = 60) combined with CRRT in our hospital. In the control group (n = 60), the input end (arterial end) of CRRT was connected to the ECMO oxygenator. The reinfusion end (venous end) of CRRT was connected to the oxygenator of ECMO for CRRT + ECMO treatment. In the experimental group (n = 60), the input end (arterial end) of CRRT was connected to the oxygenator of ECMO, and an additional pressure regulating device was installed on the connection of the 2 lines. The observation indexes including clinical therapeutic effect, clinical therapeutic effect, the incidence of complications, and the incidence of complications were compared.

Results:

There was a notable decrease in serum creatinine, and the differences in blood urea nitrogen, procalcitonin, and C-reactive protein after operation were statistically significant (P < .05). The filter use time in the study group was notably longer (P < .01). There exhibited no remarkable difference in the incidences of bleeding, thrombosis, numbness of hands and feet, metabolic alkalosis, disseminated intravascular coagulation, organ dysfunction syndrome, hyperbilirubinemia, and infection.

Conclusion:

This study demonstrates that additional pressure regulation devices are installed at the line connection between the CRRT input end and the CRRT return end to ensure that the flow rate of ECMO does not affect the CRRT treatment. ECMO and CRRT provide a safe pressure range so that the ECMO line can be safely connected to the CRRT machine at physiological pressure, reducing the occurrence of complications related to CRRT machine interruption and improving the efficiency of CRRT without affecting the efficiency of ECMO, ensuring patient safety.