bluuebunny/crossref_metadata_2025 huggingface dataset:
A Relational Approach to Understanding Psychosocial Wellbeing, Including Suicidal Ideation, among MENA-background Adolescents
Authors: Meyer Sarah R. , Gillespie Alli , Seff Ilana , Bennouna Cyril , Qushua Najat , Tothezan Iulia , Boahen-Boaten Baffour Boaten , Allaf Carine , Stark Lindsay
Published: January 2024

Adolescent refugees from the Middle East and North Africa (MENA) region face significant acculturation challenges and stressors in the United States. This qualitative study draws upon the integrated motivational-volitional model to understand MENA-background adolescents’ psychosocial wellbeing and suicide risk in three U.S. cities. Local service providers served as key informants ( n = 27), sharing in-depth reflections on supporting newcomer students in education, mental health, and refugee services. Analysis also includes focus group discussions with MENA-background adolescents ( n = 11) who participated in a photovoice activity. Four key themes emerged: (1) acculturation stressors; (2) influence of family contexts; (3) community belonging, expectations, and support; and (4) school belonging. Service providers and students described adolescents’ challenges in navigating dual identities, conflicting expectations, and strong cultural norms surrounding gender and mental health. Implementation and evaluation of interventions to address both systemic and identity-based acculturative challenges are central to improving mental health and reducing suicide risk among this population.
Bear E. Drooley: Achieving Business Growth With the Help of Pets-In-Residence and Resort Mascots
Authors: Lelo de Larrea Gabriela , Smith Scott J.
Published: January 2024

With increasing pet ownership in the United States and the growing popularity of pet travel, lodging businesses have recognized the attractiveness of this niche market. As means to support the pet-friendliness of the lodging industry and achieve business growth, this case introduces students to two powerful concepts in hospitality marketing and branding and addresses their complementarity. These concepts are pets-in-residence and brand mascots. The case explores the benefits of using these as brand identity and customer engagement strategies and illustrates how a resort uses these to achieve business growth based on the identification of market changes and pet-friendliness trends. This case study focuses on FantasyWorld Resort in Kissimmee, FL. During the pandemic, this resort became pet-friendly and brought in a new key “employee” for the success of this strategy and its future growth. Bear E. Drooley is a St. Bernard dog who has been FantasyWorld Resort’s pet-in-residence and Chief Hospitality Officer since September 2020. So far, Bear has been highly beneficial to the resort, which has big plans for Bear to become its official resort mascot.
The Continuity of Adversity: Negative Emotionality Links Early Life Adversity With Adult Stressful Life Events
Authors: Brennan Grace M. , Moffitt Terrie E. , Bourassa Kyle J. , Harrington HonaLee , Hogan Sean , Houts Renate M. , Poulton Richie , Ramrakha Sandhya , Caspi Avshalom
Published: January 2024

Adversity that exhibits continuity across the life course has long-term detrimental effects on physical and mental health. Using 920 participants from the Dunedin Study, we tested the following hypotheses: (a) Children (ages 3–15) who experienced adversity would also tend to experience adversity in adulthood (ages 32–45), and (2) interim personality traits in young adulthood (ages 18–26) would help account for this longitudinal association. Children who experienced more adversity tended to also experience more stressful life events as adults, β = 0.11, 95% confidence interval [CI] = [0.04, 0.18], p = .002. Negative emotionality—particularly its subfacet alienation, characterized by mistrust of others—helped explain this childhood-to-midlife association (indirect effect: β = 0.06, 95% CI = [0.04, 0.09], p < .001). Results were robust to adjustment for sex, socioeconomic origins, childhood IQ, preschool temperament, and other young-adult personality traits. Prevention of early life adversity and treatment of young-adult negative emotionality may reduce vulnerability to later life stress and thereby promote the health of aging adults.
R&D Incentives with Uncertain Probability of Success
Authors: Chatterjee Rittwik , Chattopadhyay Srobonti , Kabiraj Tarun
Published: January 2024

A firm’s decision to invest in R&D depends on a number of factors such as the availability of funds, extent of R&D spillovers, market structure and success probability. However, the probability of success depends, to a large extent, on factors endogenous to a firm. This means that the success probability can be known to the firm undertaking R&D investment, but not to the rivals; hence, there is incomplete information about probability of success in R&D. There are also uncertainties about the rivals’ R&D decision and R&D status. In a duopoly, we show that there is a non-monotone relation between R&D incentives and the level of information.

JEL Classifications: D43, D82, LI3, O3I
Long-term Outcomes After Surgical Reconstruction of Multiligamentous Knee Injuries: Results at Minimum 10-Year Follow-up
Authors: Boos Alexander M. , Wang Allen S. , Hevesi Mario , Krych Aaron J. , Stuart Michael J. , Levy Bruce A.
Published: January 2024

Background:

Multiligamentous knee injuries (MLKIs) are devastating injuries with concomitant injuries that complicate treatment and recovery. Short-term studies have shown satisfactory patient outcomes after surgical treatment; however, evaluations of long-term outcomes remain scarce.

Purpose:

To evaluate long-term outcomes after surgically reconstructed MLKIs and further investigate the relationship between patient age on clinical outcomes.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 55 knees (age, 36 ± 11 years; 24% female subjects) who underwent surgical reconstruction for MLKI between 1992 and 2013 met the study inclusion criteria and were evaluated with postoperative patient-reported outcomes (PROs) including International Knee Documentation Committee (IKDC) score, Lysholm score, visual analog scale (VAS) for pain, Forgotten Joint Score, subjective improvement ratings and surgery satisfaction, and Tegner activity scores. PRO scores, revision, and conversion to arthroplasty were analyzed using descriptive statistics, linear regression, Wilcoxon rank-sum, and Fisher exact tests.

Results:

At final follow-up (mean, 15 ± 5 years; range, 10-31 years), 67% of the cohort reported subjective improvement in their knee, and 82% reported satisfaction with their surgery. Compared with preoperative scores, there were significant improvements in postoperative VAS pain at rest in the full cohort, age ≤30-year cohort, and age >30-year cohort (4 ± 1 vs 2 ± 2; 4 ± 1 vs 2 ± 3; 4 ± 1 vs 1 ± 2, respectively; P≤ .029 for all) but significant reductions in Tegner scores (6 ± 3 vs 4 ± 2; 7 ± 2 vs 5 ± 2; 5 ± 2 vs 3 ± 1; P≤ .003 for all). Younger patients had higher postoperative Tegner scores than older patients (5 ± 2 vs 3 ± 1, respectively; P = .003), but no other differences in PROs were observed based on age. At a mean 15-year follow-up, 3.6% of the cohort underwent revision ligament surgery and 10.9% required arthroplasty.

Conclusion:

The majority of the cohort reported modest subjective improvement and were satisfied with their surgery. Gradual but expected age-related decreases in Tegner scores were observed, and some patients demonstrated continued symptomatic and functional limitations, but mean PRO scores remained satisfactory. Revision surgery and conversion to arthroplasty were not commonly required.
Entrepreneurs with Disability: A Comprehensive Study in the Context of Uncertainty
Authors: Iytha Mallikarjuna , Tiwary Shivangi , Augustine Anoushka
Published: January 2024

The purpose of this research is to explore how disabled social entrepreneurs deal with uncertainty, the role of technology in entrepreneurial activities, and gendered implications on social entrepreneurship with uncertainty.

The data are from understanding different secondary research that already exists on social entrepreneurship and disability, and the use of technology for the disabled. The discourse on social entrepreneurship and uncertainty, a mixed method of narrative and thematic analysis was chosen. The qualitative data have been analysed from peer-reviewed research papers, newspaper articles, journals and quantitative data from the global UN websites, and government.

Entrepreneurs with disabilities (EwDs) have links to higher resilience in uncertainties and competencies that attribute to the development of their social enterprise. Technology also acts as a catalyst for EwDs in the face of uncertainty.

An overarching limitation that emerged is the lack of data, and literature available on the implication of uncertainty in the context of disabled entrepreneurs.

Information on disabled women is also limited.

A social implication of this article is the empowerment of EwDs. They are equipped with entrepreneurial skills despite their disabilities. Besides, advocacy of technology can serve as a boon for the disabled community in the face of uncertainty. This research paper has been written using authentic data emerging from secondary research.
Capturing planning: Politics of land based accumulation in Tehran
Authors: Taheri Tafti Mojgan
Published: January 2024

This paper contributes to the literature on the relationships between the state and other actors around the politics of the extraction of value from urban developments by focusing on one planning institution in the Tehran metropolitan area, the Tehran Point 5 Committee (TPC). Drawing from studies on state capture, the paper shows how this planning institution, initially established to make spatial plans flexible and implementable through deliberating on zoning relief requests, has been captured by strong political actors and their networks of front companies. By collecting and analyzing quantitative and qualitative data on the decisions of this institution from 2009 to 2019 and the corresponding spatial pattern of the projects with granted zoning relief, I examine how these actors cluster around the TPC to shape, expand, and exploit opportunities from urban development to their benefit while harming the public good. I argue that the explanatory frameworks of neoliberalism, elite informality, and corruption fail to adequately account for the political drivers that undergird the operation of this institution. The paper draws attention to the susceptibility of the planning systems, in particular those components with discretionary powers, to be a target of state capture under circumstances of political distortions, due to the role they can play in extracting and distributing significant economic returns from urban development.
Endoscopic retrograde cholangiopancreatography induced splenic injury: comprehensive analysis and new perspectives based on a case report
Authors: Kourdakis Dimitrios S. , Deftereos Savvas P.
Published: January 2024

Splenic injury is an extremely rare complication of endoscopic retrograde cholangiopancreatography (ERCP). There are only 34 cases reported in the literature up to now. Based on a case of a 72-year-old man, who after ERCP due to choledocholithiasis developed a large perisplenic and subcapsular hematoma, we carried out an extensive review of all cases of ERCP-induced splenic injury found in the literature. We searched PubMed/Medline and Google Scholar till 15 April 2023, for published case reports and series using the following terms: splenic injury after ERCP, ERCP-induced splenic injury, and post-ERCP splenic trauma. The case reports included were in English, Spanish, and German literature. We attempt to discuss the possible clinical image, the available diagnostic methods, the potential treatment alternatives, and predisposing factors related to this entity. Furthermore, a theory of a possible mechanism of this injury is discussed and supported schematically. The ERCP-induced splenic injury is rare and a high index of suspicion is needed for diagnosis. Therefore, we present two diagnostic algorithms, which according to our opinion may assist the evaluation of this complication and lead to early accurate diagnosis and appropriate management. Collectively, our findings support that although ERCP-induced splenic injury is an unexpected/unusual complication of ERCP, following the proper steps can be timely diagnosed and treated.
Quantitative evaluation of the damage to RC buildings caused by the 2023 southeast Turkey earthquake sequence
Authors: Pujol Santiago , Bedirhanoglu Idris , Donmez Cemalettin , Dowgala Jeffrey D , Eryilmaz-Yildirim Meltem , Klaboe Kari , Koroglu Fahri Baran , Lequesne Rémy D , Ozturk Baki , Pledger Liam , Sonmez Egemen
Published: January 2024

Data from 15 earthquakes that occurred in 12 different countries are presented showing that, without better drift control, structures built with building codes allowing large seismic drifts are likely to keep leaving a wide wake of damage ranging from cracked partitions to building overturning. Following the earthquake sequence affecting southeast Turkey in 2023, a team led by Committee 133 of the American Concrete Institute surveyed nearly 250 reinforced concrete buildings in the area extending from Antakya to Malatya. Buildings ranging from 2 to 16 stories were surveyed to assess their damage and evaluate the robustness of their structures in relation to overall stiffness, as measured by the relative cross-sectional areas of structural walls and columns. The majority of the buildings were estimated to have been built in the past 10 years. Yet, the structures surveyed were observed to have amounts of structural walls and columns comparable with amounts reported after the Erzincan (1992), Duzce (1999), and Bingol (2003) Earthquakes in Turkey. These amounts are, on average, much smaller than the wall and column amounts used in Chile and Japan. Because of that lack of robustness and given the intensities of the motions reported from Antakya to Malatya (with 10 stations with peak ground velocity (PGV) of 100 cm/s or more), it is concluded that structures in this region experienced large drifts. Excessive drift (1) exposed a myriad of construction and detailing problems leading to severe structural damage and collapse, (2) induced overturning caused by p-delta for some buildings, and (3) caused widespread damage to brittle masonry partitions. The main lesson is simple: ductility is necessary but not sufficient. It is urgent that seismic drift limits are tightened in high-seismicity regions worldwide.
Age-related decline in melatonin contributes to enhanced osteoclastogenesis via disruption of redox homeostasis
Authors: Wu Di-Zheng , Zhu Guo-Zheng , Zhao Kai , Gao Jia-Wen , Cai Gui-Xing , Li Hong-Zhou , Huang Yu-Sheng , Tu Chen , Zhuang Jing-Shen , Huang Zhi-Wei , Zhong Zhao-Ming
Published: January 2024

Background

Increased oxidative stress contributes to enhanced osteoclastogenesis and age-related bone loss. Melatonin (MT) is an endogenous antioxidant and declines with aging. However, it was unclear whether the decline of MT was involved in the enhanced osteoclastogenesis during the aging process.

Methods

The plasma level of MT, oxidative stress status, bone mass, the number of bone marrow-derived monocytes (BMMs) and its osteoclastogenesis were analyzed in young (3-month old) and old (18-month old) mice (n = 6 per group). In vitro, BMMs isolated from aged mice were treated with or without MT, followed by detecting the change of osteoclastogenesis and intracellular reactive oxygen species (ROS) level. Furthermore, old mice were treated with MT for 2 months to investigate the therapeutic effect.

Results

The plasma level of MT was markedly lower in aged mice compared with young mice. Age-related decline in MT was accompanied by enhanced oxidative stress, osteoclastogenic potential and bone loss. MT intervention significantly suppressed the receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis, decreased intracellular ROS and enhanced antioxidant capacity of BMMs from aged mice. MT supplementation significantly attenuated oxidative stress, osteoclastogenesis, bone loss and deterioration of bone microstructure in aged mice.

Conclusions

These results suggest that age-related decline of MT enhanced osteoclastogenesis via disruption of redox homeostasis. MT may serve as a key regulator in osteoclastogenesis and bone homeostasis, thereby highlighting its potential as a preventive agent for age-related bone loss.
A cautionary tale of low-pass sequencing and imputation with respect to haplotype accuracy
Authors: Wragg David , Zhang Wengang , Peterson Sarah , Yerramilli Murthy , Mellanby Richard , Schoenebeck Jeffrey J. , Clements Dylan N.
Published: January 2024

Background

Low-pass whole-genome sequencing and imputation offer significant cost savings, enabling substantial increases in sample size and statistical power. This approach is particularly promising in livestock breeding, providing an affordable means of screening individuals for deleterious alleles or calculating genomic breeding values. Consequently, it may also be of value in companion animal genomics to support pedigree breeding. We sought to evaluate in dogs the impact of low coverage sequencing and reference-guided imputation on genotype concordance and association analyses.

Results

DNA isolated from saliva of 30 Labrador retrievers was sequenced at low (0.9X and 3.8X) and high (43.5X) coverage, and down-sampled from 43.5X to 9.6X and 17.4X. Genotype imputation was performed using a diverse reference panel (1021 dogs), and two subsets of the former panel (256 dogs each) where one had an excess of Labrador retrievers relative to other breeds. We observed little difference in imputed genotype concordance between reference panels. Association analyses for a locus acting as a disease proxy were performed using single-marker (GEMMA) and haplotype-based (XP-EHH) tests. GEMMA results were highly correlated (r ≥ 0.97) between 43.5X and ≥ 3.8X depths of coverage, while for 0.9X the correlation was lower (r ≤ 0.8). XP-EHH results were less well correlated, with r ranging from 0.58 (0.9X) to 0.88 (17.4X). Across a random sample of 10,000 genomic regions averaging 17 kb in size, we observed a median of three haplotypes per dog across the sequencing depths, with 5% of the regions returning more than eight haplotypes. Inspection of one such region revealed genotype and phasing inconsistencies across sequencing depths.

Conclusions

We demonstrate that saliva-derived canine DNA is suitable for whole-genome sequencing, highlighting the feasibility of client-based sampling. Low-pass sequencing and imputation require caution as incorrect allele assignments result when the subject possesses alleles that are absent in the reference panel. Larger panels have the capacity for greater allelic diversity, which should reduce the potential for imputation error. Although low-pass sequencing can accurately impute allele dosage, we highlight issues with phasing accuracy that impact haplotype-based analyses. Consequently, if accurately phased genotypes are required for analyses, we advocate sequencing at high depth (> 20X).
Internal and external normalization of nascent RNA sequencing run-on experiments
Authors: Maas Zachary L. , Dowell Robin D.
Published: January 2024

In experiments with significant perturbations to transcription, nascent RNA sequencing protocols are dependent on external spike-ins for reliable normalization. Unlike in RNA-seq, these spike-ins are not standardized and, in many cases, depend on a run-on reaction that is assumed to have constant efficiency across samples. To assess the validity of this assumption, we analyze a large number of published nascent RNA spike-ins to quantify their variability across existing normalization methods. Furthermore, we develop a new biologically-informed Bayesian model to estimate the error in spike-in based normalization estimates, which we term Virtual Spike-In (VSI). We apply this method both to published external spike-ins as well as using reads at the $$3^\prime$$

3
′

end of long genes, building on prior work from Mahat (Mol Cell 62(1):63–78, 2016. https://doi.org/10.1016/j.molcel.2016.02.025) and Vihervaara (Nat Commun 8(1):255, 2017. https://doi.org/10.1038/s41467-017-00151-0). We find that spike-ins in existing nascent RNA experiments are typically under sequenced, with high variability between samples. Furthermore, we show that these high variability estimates can have significant downstream effects on analysis, complicating biological interpretations of results.
Evolutionary history of the cytochrome P450s from Colletotrichum species and prediction of their putative functional roles during host-pathogen interactions
Authors: Ortiz-Álvarez Jossue , Becerra Sioly , Baroncelli Riccardo , Hernández-Rodríguez César , Sukno Serenella A. , Thon Michael R.
Published: January 2024

The genomes of species belonging to the genus Colletotrichum harbor a substantial number of cytochrome P450 monooxygenases (CYPs) encoded by a broad diversity of gene families. However, the biological role of their CYP complement (CYPome) has not been elucidated. Here, we investigated the putative evolutionary scenarios that occurred during the evolution of the CYPome belonging to the Colletotrichum Graminicola species complex (s.c.) and their biological implications. The study revealed that most of the CYPome gene families belonging to the Graminicola s.c. experienced gene contractions. The reductive evolution resulted in species restricted CYPs are predominant in each CYPome of members from the Graminicola s.c., whereas only 18 families are absolutely conserved among these species. However, members of CYP families displayed a notably different phylogenetic relationship at the tertiary structure level, suggesting a putative convergent evolution scenario. Most of the CYP enzymes of the Graminicola s.c. share redundant functions in secondary metabolite biosynthesis and xenobiotic metabolism. Hence, this current work suggests that the presence of a broad CYPome in the genus Colletotrichum plays a critical role in the optimization of the colonization capability and virulence.
Effect of two different doses of nalbuphine for postoperative analgesia in children with cleft palate: a randomized controlled trial
Authors: Chen Zhan-ming , Gao Bao-hua , Wang Liang-shan
Published: January 2024

Background

Cleft palate repair surgery may result in severe pain in the immediate postoperative period. The aim of this study is to compare the effects of different doses of nalbuphine for postoperative analgesia in children with cleft palate.

Methods

From November 2019 to June 2021, 90 children (45 males and 45 females, age 9–20 months old, ASA class I—II) were selected for palatoplasty. They were randomly divided into three groups: the control group (Group C), the N1 group (postoperative analgesia with 0.05 mg/kg/h nalbuphine) and the N2 group (postoperative analgesia with 0.075 mg/kg/h nalbuphine). Each group had 30 cases. Nalbuphine was not continuously infused in Group C but was continuously infused in Groups N1 and N2 at rates of 0.05 mg/kg/h and 0.075 mg/kg/h, respectively, for 24 h for postoperative analgesia. The FLACC analgesia score and Ramsay Sedation score were recorded at 10 min (T1), 30 min (T2), 2 h (T3), 12 h (T4) and 24 h (T5) after the operation. Adverse reactions such as nausea, vomiting and respiratory depression were observed and recorded.

Results

Compared with those in Group C, the FLACC scores in the N1 and N2 groups decreased significantly at T1-T5 (p < 0.05); the Ramsay Sedation score in the N1 group was significantly higher at T3 and T4 (p < 0.05), and that in the N2 group was significantly higher at T1-T5 (p < 0.05). Compared with that in the N1 group, the FLACC score in the N2 group was not significantly different, and the Ramsay Sedation score increased significantly at T5 (p < 0.05).

Conclusion

Using 0.05 mg/kg/h Nalbuphine continuously for 24 h for postoperative analgesia in children with cleft palate has a better effect and fewer adverse reactions.

Trial registration

This study was registered at ChiCTR1900027385 (11/11/2019).
The influence of fears of perceived legal consequences on general practitioners’ practice in relation to defensive medicine – a cross-sectional survey in Germany
Authors: Goetz Katja , Oldenburg Dorothee , Strobel Christina Jana , Steinhäuser Jost
Published: January 2024

Background

Medical decisions are influenced by a variety of factors also by legal requirements and feelings of uncertainty, which results in the term defensive medicine. The aim of the study was to evaluate the influence of fears of perceived legal consequences on the practice of defensive medicine from the perspective of German general practitioners (GPs).

Methods

A cross-sectional study was performed from April to May 2022. GPs were invited via an e-mail newsletter of the Institute for Continuing Education in Family Medicine in the German Association of General Practitioners and via an online platform of the German College of General Practitioners and Family Physicians. The evaluation of legal fears, the general assessment of defensive medicine and reasons for and the frequency of defensive medical measures were surveyed in this study. Beside descriptive analyses, a stepwise linear regression analysis was used to explore potential associations between for the primary outcome variable ‘fears of legal consequences’ on the practice of defensive medicine.

Results

413 general practitioners with an average age of 50 years (51% female) responded. The majority rated their fears of legal consequences as low to average whereas for almost a third (27%, n = 113) the fears were strong to very strong. Regarding legal fears, the physician-patient-relationship played a fairly to very large role for 48% (n = 198) of the respondents. One third estimated the probability of being sued civilly in the next 10 years as rather high to very high. 47% (n = 193) of the participants assumed that the risk of being sued could mostly to very much be reduced by defensive medicine. Legal self-protection was for 38% of the responders (n = 157) quite frequently to very frequently a reason for acting defensively. Consequently, half of the respondents stated that they performed unnecessary laboratory tests at least once per week and 40% indicated that they referred patients for radiological diagnostics without medical indication once per month.

Conclusions

As legal fears have an influence on medical practice and legal self-protection being a frequent reason for defensive behaviour, understanding and knowledge of the law should be improved by legal education at university and further training of post-graduate trainees and practicing physicians should be implemented. Additionally, a more in-depth enlightenment of society about the phenomenon of Protective and Defensive Medicine and its consequences could be a possibility to decrease the perceived fears of legal consequences on the physicians’ side.
Uptake of COVID-19 and influenza vaccines in relation to preexisting chronic conditions in the European countries
Authors: Tang Shangfeng , Ji Lu , Bishwajit Ghose , Guo Shuyan
Published: January 2024

Background

The suboptimal uptake of COVID-19 and influenza vaccines among those with non-communicable chronic diseases is a public health concern, because it poses a higher risk of severe illness for individuals with underlying health conditions, emphasizing the need to address barriers to vaccination and ensure adequate protection for this vulnerable population. In the present study, we aimed to identify whether people with chronic illnesses are more likely to get vaccinated against COVID-19 and influenza in the European Union.

Methods

Cross-sectional data on 49,253 men (n = 20,569) and women (n = 28,684) were obtained from the ninth round of the Survey of Health, Ageing and Retirement in Europe (June – August, 2021). The outcome variables were self-reported COVID-19 and influenza vaccine uptake status. The association between the uptake of the vaccines and six preexisting conditions including high blood pressure, high blood cholesterol, chronic lung disease, diabetes, chronic bronchitis, and asthma was estimated using binary logistic regression methods.

Results

The vaccination coverage for COVID-19 ranged from close to 100% in Denmark (98.2%) and Malta (98.2%) to less than 50% in Bulgaria (19.1%) and Romania (32.7%). The countries with the highest percentage of participants with the influenza vaccine included Malta (66.7%), Spain (63.7%) and the Netherlands (62.5%), and those with the lowest percentage included Bulgaria (3.7%), Slovakia (5.8%) and Poland (9.2%). Participants with high blood pressure were 3% less likely [Risk difference (RD) = -0.03, 95% CI = -0.04, -0.03] to report taking COVID-19 and influenza [RD = -0.03, 95% CI= -0.04, -0.01] vaccine. Those with chronic lung disease were 4% less likely [RD = -0.04, 95% CI= -0.06, -0.03] to report taking COVID-19 and 2% less likely [RD= -0.02, 95% CI = -0.04, -0.01] to report taking influenza vaccine. Men and women with high blood pressure were 3% less likely to have reported taking both of the vaccines.

Conclusions

Current findings indicate a suboptimal uptake of COVID-19 and influenza vaccines among adult men and women in the EU countries. Those with preexisting conditions, including high blood pressure and chronic lung disease are less likely to take the vaccines.
Value of blood oxygenation level-dependent magnetic resonance imaging in early evaluation of the response and prognosis of esophageal squamous cell carcinoma treated with definitive chemoradiotherapy: a preliminary study
Authors: Zheng Huanhuan , Zhang Hailong , Zhu Yan , Wei Xiaolei , Liu Song , Ren Wei
Published: January 2024

Background

To find a useful hypoxia non-invasive biomarker for evaluating early treatment response and prognosis to definitive chemoradiotherapy (dCRT) in patients with esophageal squamous cell carcinoma (ESCC), using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI).

Methods

The R2* values were obtained pre- and 2–3 weeks post-dCRT in 28 patients with ESCC using BOLD MRI. Independent samples t-test (normality) or Mann-Whitney U test (non-normality) was used to compare the differences of R2*-related parameters between the complete response (CR) and the non-CR groups. Diagnostic performance of parameters in predicting response was tested with receiver operating characteristic (ROC) curve analysis. The 3-year overall survival (OS) was evaluated using Kaplan Meier curve, log rank test, and Cox proportional hazards regression analysis.

Results

The post-R2*, ∆R2*, and ∆%R2* in the CR group were significantly higher than those in the non-CR group (P = 0.002, 0.003, and 0.006, respectively). The R2*-related parameters showed good prediction of tumor response, with AUC ranging from 0.813 to 0.829. The 3-year OS rate in patients with ∆R2* >-7.54 s− 1 or CR were significantly longer than those with ∆R2* ≤ -7.54 s− 1 (72.37% vs. 0.00%; Hazard ratio, HR = 0.196; 95% confidence interval, 95% CI = 0.047–0.807; P = 0.024) or non-CR (76.47% vs. 29.27%; HR = 0.238, 95% CI = 0.059–0.963; P = 0.044).

Conclusions

The preliminary results demonstrated that the R2* value might be a useful hypoxia non-invasive biomarker for assessing response and prognosis of ESCC treated with dCRT. BOLD MRI might be used as a potential tool for evaluating tumor oxygenation metabolism, which is routinely applied in clinical practice and beneficial to clinical decision-making. A large sample size was needed for further follow-up studies to confirm the findings.
The impact of stress hyperglycemia ratio on short-term and long-term outcomes for acute basilar artery occlusion underwent endovascular treatment
Authors: Peng Zhouzhou , Tian Yan , Hu Jinrong , Yang Jie , Li Linyu , Huang Jiacheng , Kong Weilin , Guo Changwei , Liu Xiang , Yang Dahong , Yue Chengsong , Yu Nizhen , Li Fengli , Zi Wenjie , Song Jiaxing , Yang Qingwu
Published: January 2024

Background

Stress hyperglycemia ratio (SHR) reflects a true acute hyperglycemic state during acute basilar artery occlusion (ABAO). We aimed to investigate the association between SHR and short-term and long-term outcomes in patients with ABAO receiving endovascular treatment (EVT).

Methods

We selected patients treated with EVT from the BASILAR study, a nationwide prospective registry. A total 250 patients with documented glucose and glycated hemoglobin (HbA1C) values at admission were included. SHR was calculated as the ratio of glucose/HbA1C. All 250 patients completed 90 days of follow-up and 234 patients (93.6%) completed 1 year of follow-up. The primary outcome was the favorable outcome defined as modified Rankin Scale (mRS) score ≤ 3 at 90 days. Safety outcomes included mortality at 90 days and 1 year, and intracranial hemorrhage.

Results

Among the 250 patients included, patients with higher tertiles of SHR were associated with decreased odds of a favorable functional outcome at 90 days (adjusted OR, 0.26; 95% CI, 0.12–0.56; P = 0.001 and adjusted OR, 0.37; 95% CI, 0.18–0.80; P = 0.01; respectively) and 1 year (adjusted OR, 0.34; 95% CI, 0.16–0.73; P = 0.006 and adjusted OR, 0.38; 95% CI, 0.18–0.82; P = 0.01; respectively) after adjusting for confounding covariates. The mortality was comparable across tertiles of SHR groups at 90 days and 1 year.

Conclusions

Our study showed that SHR was associated with a decreased probability of favorable functional outcome both at 90 days and 1 year after EVT in patients with ABAO. The relationship was more pronounced in non-diabetes patients.

Trial registration

Clinical Trial Registry Identifier: ChiCTR1800014759 (November 12, 2013).
The effect of mother’s age on the neonatal cord serum’s oxidative stress index and maternal and neonatal outcomes: a case control study
Authors: Imanparast Fatemeh , Hashemi Bahman , Mokhtari Fatemeh , Mohaghegh Pegah , Azar Fereshteh Farzan , Mehvari Fatemeh
Published: January 2024

Background

One of the main challenges of many societies in reducing and ageing of the population is marriage at an advanced age in women and decrease of producing offspring due to the concern of increasing the probability of maternal and neonatal outcomes. The mother’s oxidative stress conditions during pregnancy affect mothers and their baby’s health. Aging is one of the increasing factors of oxidants in the body. Aim of this study is the compartion total antioxidant capacity (TAC), total oxidants status (TOS), oxidative stress index (OSI) values, and maternal and neonatal outcomes in three groups of mothers with different age ranges from 20 to 29, 30 to 34, and 35 to 45 years old.

Methods

164 pregnant women were grouped according to age into three groups: 25 to 30 (group I), 30 to 35 (group II), and 35 to 45 years old (group III). The umbilical cord blood samples were taken to the assay TAC, TOS, and OSI (TOS/TAC). The Kolmogorov-Smirnov test was employed to assess the normal distribution of countinus variables. The one-way ANOVA and Kruskal-Wallis test were used to compare anthropometric and biochemical factors between groups.

Results

TAC levels decreased non-significantly (438.2 ± 102; 431.7 ± 99.8; and 428.2 ± 100.26 for groups I, II, and III respectively, P value = 0.99), TOS levels increased significantly (23.93 ± 11.7; 25.4 ± 12.3; and 28.2 ± 12.7 for groups I, II, and III respectively, P value = 0.034), and OSI increased non-significantly with increasing maternal age (0.055 ± 0.044; 0.091 ± 0.031; 0.069 ± 0.005, for groups I, II, and III respectively, P value = 0.14). Increasing age did not significantly affects the maternal and infant birth outcomes.

Conclution

The results showed that the increasing the age of the mother up to 45 doesn’t have a significant effects on the value of OSI and the maternal and infant outcomes.
SARIFA as a new histopathological biomarker is associated with adverse clinicopathological characteristics, tumor-promoting fatty-acid metabolism, and might predict a metastatic pattern in pT3a prostate cancer
Authors: Enke Johanna S. , Groß Matthias , Grosser Bianca , Sipos Eva , Steinestel Julie , Löhr Phillip , Waidhauser Johanna , Lapa Constantin , Märkl Bruno , Reitsam Nic G.
Published: January 2024

Background

Recently, we introduced Stroma-AReactive-Invasion-Front-Areas (SARIFA) as a novel hematoxylin–eosin (H&E)-based histopathologic prognostic biomarker for various gastrointestinal cancers, closely related to lipid metabolism. To date, no studies on SARIFA, which is defined as direct tumor-adipocyte-interaction, beyond the alimentary tract exist. Hence, the objective of our current investigation was to study the significance of SARIFA in pT3a prostate cancer (PCa) and explore its association with lipid metabolism in PCa as lipid metabolism plays a key role in PCa development and progression.

Methods

To this end, we evaluated SARIFA-status in 301 radical prostatectomy specimens and examined the relationship between SARIFA-status, clinicopathological characteristics, overall survival, and immunohistochemical expression of FABP4 and CD36 (proteins closely involved in fatty-acid metabolism). Additionally, we investigated the correlation between SARIFA and biochemical recurrence-free survival (BRFS) and PSMA-positive recurrences in PET/CT imaging in a patient subgroup. Moreover, a quantitative SARIFA cut-off was established to further understand the underlying tumor biology.

Results

SARIFA positivity occurred in 59.1% (n = 178) of pT3a PCas. Our analysis demonstrated that SARIFA positivity is strongly associated with established high-risk features, such as R1 status, extraprostatic extension, and higher initial PSA values. Additionally, we observed an upregulation of immunohistochemical CD36 expression specifically at SARIFAs (p = 0.00014). Kaplan–Meier analyses revealed a trend toward poorer outcomes, particularly in terms of BRFS (p = 0.1). More extensive tumor-adipocyte interaction, assessed as quantity-dependent SARIFA-status on H&E slides, is also significantly associated with high-risk features, such as lymph node metastasis, and seems to be associated with worse survival outcomes (p = 0.16). Moreover, SARIFA positivity appeared to be linked to more distant lymph node and bone metastasis, although statistical significance was slightly not achieved (both p > 0.05).

Conclusions

This is the first study to introduce SARIFA as easy-and-fast-to-assess H&E-based biomarker in locally advanced PCa. SARIFA as the histopathologic correlate of a distinct tumor biology, closely related to lipid metabolism, could pave the way to a more detailed patient stratification and to the development of novel drugs targeting lipid metabolism in pT3a PCa. On the basis of this biomarker discovery study, further research efforts on the prognostic and predictive role of SARIFA in PCa can be designed.
Differential efficacy of tyrosine kinase inhibitors according to the types of EGFR mutations and agents in non-small cell lung cancer: a real-world study
Authors: Kim Tae-Hwan , Choi Jin-Hyuk , Ahn Mi Sun , Lee Hyun Woo , Kang Seok Yun , Choi Yong Won , Koh Young Wha , Sheen Seung-Soo
Published: January 2024

Background

Both first and second-generation EGFR-TKIs are recommended in advanced NSCLC with common EGFR mutations. However, there are few data on the difference in efficacy of EGFR-TKIs based on the type of EGFR mutation and agents.

Methods

This retrospective real-world study evaluated the outcomes and clinicopathologic characteristics, including the type of EGFR mutations, of 237 advanced NSCLC patients treated with first- or second-generation (afatinib) EGFR-TKIs as first-line therapy.

Results

The median progression-free survival (PFS) and overall survival (OS) of all patients were 11 months (M) and 25M, respectively. In the univariate analysis, patients with exon 19 deletion (del) (n=130) had significantly longer median OS compared to those with other mutations (L858R: 84, others: 23) (30 vs. 22 M, p=0.047), without a difference in PFS (p=0.138). Patients treated with afatinib (n=60) showed significantly longer median OS compared to those treated with first-generation TKIs (gefitinib: 159, erlotinib: 18) (30 vs. 23 M, p=0.037), without a difference in PFS (p=0.179). In patients with exon 19 del, there was no significant difference in median PFS (p=0.868) or OS (p=0.361) between patients treated with afatinib and those treated with first-generation TKIs, while significantly better PFS (p=0.042) and trend in OS (p=0.069) were observed in patients receiving afatinib in other mutations. Exon 19 del was independently associated with favorable OS (p=0.028), while age >70 years (p=0.017), ECOG performance status ≥2 (p=0.001), primary metastatic disease (p=0.007), and synchronous brain metastasis (p=0.026) were independent prognostic factors of poor OS.

Conclusions

The EGFR exon 19 del was associated with favorable OS in advanced NSCLC patients receiving first-line EGFR-TKIs. Moreover, in patients with exon 19 del, first-generation TKIs seem to be a reasonable treatment option if osimertinib is unavailable.
Survival outcome of different treatment sequences in patients with locally advanced and metastatic pancreatic cancer
Authors: Fan Mengjiao , Deng Guochao , Ma Yue , Si Haiyan , Wang Zhikuan , Dai Guanghai
Published: January 2024

Background

Despite some therapeutic advances, improvement in survival rates of unresectable and/or metastatic pancreatic ductal adenocarcinoma (PDAC) has been minimal over recent decade. We aimed to evaluate the impact of different treatment sequences on clinical outcomes of advanced PDAC at our academic institution.

Methods

In this single institution retrospective analysis, we assessed characteristics and survival rates of unresectable and/or metastatic pancreatic PDAC patients who started a systemic treatment between 01/2015 and 12/2021. Survival analyses were performed by Kaplan-Meier and Cox proportional hazards model.

Results

The number of 285 patients received at least two lines of treatment, but only 137 patients were suitable for third-line treatment. Subgroup analysis showed that thirty-seven patients received A line (gemcitabine/nab-paclitaxel or nab-paclitaxel combined therapy to FOLFIRINOX) therapy, 37 patients received B line (nab-paclitaxel combined therapy to gemcitabine combined therapy to FOLFIRINOX) therapy, 21 patients received C line (nab-paclitaxel combined therapy to gemcitabine combined therapy to oxaliplatin or irinotecan combined therapy) therapy. Survival rates for different treatment lines were significantly different and median overall survival (OS) was 14.00, 18.00, and 14.00 months, respectively (p<0.05).

Conclusion

Our study provides real-world evidence for the effectiveness of different treatment sequences and underscores the treatment sequences on survival outcome when considering the entire management in advanced PDAC.
An integrated model incorporating deep learning, hand-crafted radiomics and clinical and US features to diagnose central lymph node metastasis in patients with papillary thyroid cancer
Authors: Gao Yang , Wang Weizhen , Yang Yuan , Xu Ziting , Lin Yue , Lang Ting , Lei Shangtong , Xiao Yisheng , Yang Wei , Huang Weijun , Li Yingjia
Published: January 2024

Objective

To evaluate the value of an integrated model incorporating deep learning (DL), hand-crafted radiomics and clinical and US imaging features for diagnosing central lymph node metastasis (CLNM) in patients with papillary thyroid cancer (PTC).

Methods

This retrospective study reviewed 613 patients with clinicopathologically confirmed PTC from two institutions. The DL model and hand-crafted radiomics model were developed using primary lesion images and then integrated with clinical and US features selected by multivariate analysis to generate an integrated model. The performance was compared with junior and senior radiologists on the independent test set. SHapley Additive exPlanations (SHAP) plot and Gradient-weighted Class Activation Mapping (Grad-CAM) were used for the visualized explanation of the model.

Results

The integrated model yielded the best performance with an AUC of 0.841. surpassing that of the hand-crafted radiomics model (0.706, p < 0.001) and the DL model (0.819, p = 0.26). Compared to junior and senior radiologists, the integrated model reduced the missed CLNM rate from 57.89% and 44.74–27.63%, and decreased the rate of unnecessary central lymph node dissection (CLND) from 29.87% and 27.27–18.18%, respectively. SHAP analysis revealed that the DL features played a primary role in the diagnosis of CLNM, while clinical and US features (such as extrathyroidal extension, tumour size, age, gender, and multifocality) provided additional support. Grad-CAM indicated that the model exhibited a stronger focus on thyroid capsule in patients with CLNM.

Conclusion

Integrated model can effectively decrease the incidence of missed CLNM and unnecessary CLND. The application of the integrated model can help improve the acceptance of AI-assisted US diagnosis among radiologists.
Serum levels of interleukin-33 and mesencephalic astrocyte derived neurotrophic factors in patients with major depressive disorder: a cross-sectional comparative design
Authors: Nahar Zabun , Nowshin Delruba Tabassum , Roknuzzaman A. S. M. , Sohan Md. , Islam Salsabil , Qusar M. M. A. Shalahuddin , Islam Md. Rabiul
Published: January 2024

Background

Major depressive disorder (MDD) is a debilitating health condition that has significant morbidity and mortality rates. Depression can be caused due to social, biological, environmental, psychological, and genetic factors. A few biological processes have been proposed as the pathophysiological pathways of depression. Neurotrophic factors and inflammatory cytokines have been linked to depression. Thus, we aimed to investigate the serum interleukin-33 (IL-33) and mesencephalic astrocyte-derived neurotrophic factor (MANF) in MDD patients and corresponding healthy controls (HCs).

Method

This study involved the inclusion of 129 MDD patients and 125 HCs matched by sex and age. A psychiatrist evaluated the study participants following DSM-5 criteria. The severity of the illness was assessed utilizing the Hamilton Depression Rating Scale (Ham-D). The serum concentrations of IL-33 and MANF were measured using enzyme-linked immunosorbent assay (ELISA) kits.

Results

The mean serum levels of IL-33 were decreased (159.12 ± 6.07 pg/ml vs. 180.60 ± 8.64 pg/ml, p = 0.042), and the MANF levels were increased (5.40 ± 0.19 ng/ml vs. 4.46 ± 0.21 ng/ml, p = 0.001) in MDD patients when compared to HCs.

Conclusions

The current study proposes that lower IL-33 and higher MANF serum levels are associated with MDD progression and depression severity. These biomarkers could be used as risk assessment tools for MDD. We recommend more investigation, including a significant population, to determine the precise function of IL-33 and MANF in depression.