bluuebunny/crossref_metadata_2025 huggingface dataset:
A longitudinal study of the impacts of area-level social cohesion on multimorbidity in Scotland
Authors: Zheng C , Abubakar E , Dibben C , Marshall A , Pearce J
Published: October 2024

Background

Multimorbidity is a growing global public health challenge, commonly referring to the co-occurrence of 2+ conditions but with varying measurements. Prior evidence has linked social cohesion with single health conditions; however, its impact on multimorbidity remains unclear. This study aims to examine the association between area-level social cohesion and multimorbidity and to explore whether this association will vary across multimorbidity measurements and levels of urban-rural classification.

Methods

Using a dataset that links the Scottish Longitudinal Study (5.3% of the Scottish population) with hospitalisation records (2001-2019) and an index that reflects area-level social cohesion (2012), focused on the cohorts of adults aged 40+, we used 3-level logistic regression to account for the clustered data structure of diagnosed chronic conditions over time within individuals within neighbourhoods.

Results

Areas with the highest social cohesion were observed to have the lowest risks of multimorbidity (p < 0.001), even after adjusting for area-level income deprivation. Varying by multimorbidity measurements, an inverted U-shaped pattern was observed between reduced area-level social cohesion and increased risks of having 2+ co-occurring chronic conditions; while a linear pattern was found for mental-physical multimorbidity. Moderated by levels of urban-rural classification, as compared to rural residents, urban residents were more sensitive to the impact of social cohesion on the co-occurrence of 2+ conditions; however, for mental-physical multimorbidity, no interaction effects between area-level social cohesion and urban-rural classification were found.

Conclusions

Although varying patterns were seen for different multimorbidity measurements, people living in areas with the highest area-level social cohesion were less likely to be multimorbid. This study offers new insights for developing effective place-based public health interventions.

Key messages

• This is the first longitudinal study that analysed the association between area-level social cohesion and multimorbidity using a nationally representative dataset based on secondary care data.

• Area-level social cohesion affects multimorbidity, but its impact may vary by multimorbidity measurements and by urban-rural classification.
Static output feedback control for positive 2D discrete systems in Roesser model
Authors: Bolajraf Mohamed
Published: October 2024

This paper investigates the output stabilization problem for multi-input multi-output positive 2D systems described by a linear discrete-time Roesser system. This kind of systems have the property that the horizontal and vertical states take non-negative values whenever the initial boundaries are non-negative. Conditions for the existence of desired static output feedback controllers guaranteeing the resultant closed-loop system to be positive and asymptotically stable are obtained. Also, the synthesis of static output feedback controllers, including the requirement of positivity of the controllers, is solved. These results are then extended to the case of uncertain plants. All of the proposed conditions are expressed in terms of Linear Programming, which can be easily verified by using standard numerical software. Finally, several numerical examples are included to illustrate the validity and the effectiveness of the developed results.
Development of a large-scale horizontal curve inventory for safety analysis using open GIS data
Authors: Ge Hanzhang , Qiu Shi , Hou Qing , Wang Jin , Ai Chengbo
Published: October 2024

Horizontal curves are crucial for the safety and mobility of roadways. To enhance the understanding of these curves, transportation agencies are investigating methods to accurately determine their spatial locations, geometric attributes, and conditions within their extensive road networks. Leveraging the widespread availability of Global Positioning System (GPS) and Geographic Information System (GIS) data, significant advancements have been made in developing automated algorithms that identify horizontal curves from GPS trajectories and GIS basemaps. This study introduces a novel dataset—the Horizontal Curve Inventory—that encapsulates detailed features of horizontal curves. We employed a modified automated cycle regression algorithm designed for large-scale road network analysis to extract horizontal curve data. This method was applied nationally to process an expansive network utilizing open-source GIS basemaps, encompassing over 300,000 miles across interstate, U.S. highway, and state highway systems. The inventory includes comprehensive data on curve radius, rotation angle, start and end point coordinates, and the curve’s center points. These data are essential for supporting safety research pertaining to road alignment. Our approach demonstrated robust performance across various open GIS data sources and provides the first accurate, efficient, and comprehensive inventory of horizontal curves for all major highway systems in the United States. The dataset is available at http://aichengbo.com/research/national-horizontal-curve-inventory/.
A search for water vapor plumes on Europa by spatially resolved spectroscopic observation using Subaru/IRCS
Authors: Kimura Jun , Matsuo Taro , Kobayashi Hitomi , Ikeda Yuji , Yoshioka Kazuo , Takagi Seiko , Ida Shigeru
Published: October 2024

We present near-infrared high-dispersion spectroscopic observations of Europa using the Infrared Camera and Spectrograph (IRCS) onboard the Subaru Telescope, seeking direct evidence of water plumes on Europa and exploring spatial variations in plume activity. Using the high spectral/spatial resolution and sensitivity of Subaru/IRCS, our observations have enabled a spatially resolved search for water plumes on Europa. Within our detection limits and time of observation, we found no evidence for the presence of water emission. For a rotation temperature of 50 K, we derived an upper limit on the H$_{2}$O abundance of 9.46 $\times$ 10$^{19}$–5.92 $\times$ 10$^{20}$ m$^{-2}$ in each divided slit area and 4.61 $\times$ 10$^{19}$ m$^{-2}$ in the entire area covered by the slit. This upper limit lies below the inferred water abundance from previous UV observations by the Hubble Space Telescope, while being less sensitive by a factor of three compared to the Keck telescope and by one order of magnitude or more than the James Webb Space Telescope observations. Our results align with previous studies and demonstrate that using Subaru/IRCS is an effective strategy for searching for water plumes on Europa with high spatial resolution. Continued observations across different surface areas and orbital phases are essential to fully characterize Europa’s plume activity and complement upcoming space missions.
The cliff-edge of toxicological concern: highlighting the potential issues of an over-reliance on “less-than-lifetime” thresholds
Authors: Waine Christopher J , Watts Peter , Hopkins James
Published: October 2024

The Threshold of Toxicological Concern (TTC) is a very well-established concept in applied toxicology, and has become a key tool for the pragmatic human health risk assessment of data-poor chemicals. Within the pharmaceutical sector, regulatory guidance on genotoxins defaults to a TTC of 1.5 μg/day equating to a maximum lifetime cancer risk of 1 in 100,000. Higher doses for drug products where exposures are intermittent or otherwise “less-than-lifetime” (LTL) are also considered tolerable. This also allows substance-specific lifetime Acceptable Intakes (AIs) for known genotoxic carcinogens to be scaled up for shorter durations.

The default TTCs for assessing LTL exposures build in conservatism such that there is deviation from strict linearity. However, close to the boundaries between LTL categories there can be such a difference in the default tolerable intakes that a health risk assessment can yield conflicting results. We have presented a theoretical case study based on our recent work that illustrates this apparent “cliff-edge.” The total acceptable cumulative dose over a 56-day treatment is – in absolute terms – one third of that allowed over 28 days, despite the maximum cancer risk of the longer exposure being an order of magnitude higher. Our analysis suggests the need for careful consideration of what might represent tolerable exposures in the region of the category limits, rather than simply adopting the hardline default. Where a potential patient exposure is found to be above a default value, there is real value in refining the cancer risk estimates using the Lifetime Cumulative Dose approach.
GABAergic Neurons in the Central Amygdala Promote Emergence from Isoflurane Anesthesia in Mice
Authors: Zhang Jin-Sheng , Yao Wei , Zhang Lei , Li Zhang-Shu , Gong Xia-Ting , Duan Li-Li , Huang Zhi-Xian , Chen Tong , Huang Jin-Chuang , Yang Shu-Xiang , Yu Changxi , Cai Ping , Chen Li
Published: October 2024

Background:

Recent evidence indicates that general anesthesia and sleep–wake behavior share some overlapping neural substrates. γ-Aminobutyric acid–mediated (GABAergic) neurons in the central amygdala have a high firing rate during wakefulness and play a role in regulating arousal-related behaviors. The objective of this study was to investigate whether central amygdala GABAergic neurons participate in the regulation of isoflurane general anesthesia and uncover the underlying neural circuitry.

Methods:

Fiber photometry recording was used to determine the changes in calcium signals of central amygdala GABAergic neurons during isoflurane anesthesia in Vgat-Cre mice. Chemogenetic and optogenetic approaches were used to manipulate the activity of central amygdala GABAergic neurons, and a righting reflex test was used to determine the induction and emergence from isoflurane anesthesia. Cortical electroencephalogram (EEG) recording was used to assess the changes in EEG spectral power and burst–suppression ratio during 0.8% and 1.4% isoflurane anesthesia, respectively. Both male and female mice were used in this study.

Results:

The calcium signals of central amygdala GABAergic neurons decreased during the induction of isoflurane anesthesia and were restored during the emergence. Chemogenetic activation of central amygdala GABAergic neurons delayed induction time (mean ± SD, vehicle vs. clozapine-N-oxide: 58.75 ± 5.42 s vs. 67.63 ± 5.01 s; n = 8; P = 0.0017) and shortened emergence time (385.50 ± 66.26 s vs. 214.60 ± 40.21 s; n = 8; P = 0.0017) from isoflurane anesthesia. Optogenetic activation of central amygdala GABAergic neurons produced a similar effect. Furthermore, optogenetic activation decreased EEG delta power (prestimulation vs. stimulation: 46.63 ± 4.40% vs. 34.16 ± 6.47%; n = 8; P = 0.0195) and burst–suppression ratio (83.39 ± 5.15% vs. 52.60 ± 12.98%; n = 8; P = 0.0003). Moreover, optogenetic stimulation of terminals of central amygdala GABAergic neurons in the basal forebrain also promoted cortical activation and accelerated behavioral emergence from isoflurane anesthesia.

Conclusions:

The results suggest that central amygdala GABAergic neurons play a role in general anesthesia regulation, which facilitates behavioral and cortical emergence from isoflurane anesthesia through the GABAergic central amygdala–basal forebrain pathway.
Post-stroke osteoporosis: Mechanisms, treatments, and recent advances
Authors: Liu Zezhong , Liu Xiaoguang , Wang Congcong , Sun Quanxiang , Zhang Lan , Wang Jun
Published: October 2024

Post-stroke osteoporosis (PSO) is a common complication encountered in patients after stroke, characterized by a rapid decline in bone mass and disruption of bone microarchitecture, which significantly elevates the risk of fracture. The pathogenesis of PSO is multifaceted, encompassing factors, such as oxidative stress, inflammatory responses, neurological damage, extended immobilization, and hormonal imbalances, culminating in a dysregulation of bone metabolism. Treatment strategies encompass pharmacological interventions, nutritional supplementation, physical exercise, and rehabilitative training. Emerging therapies, such as stem cell therapy and exosome therapy, are being explored for their potential to promote cellular regeneration and modulate inflammatory responses in the treatment of PSO. Future therapeutic approaches should integrate a comprehensive understanding of the multifactorial pathogenesis of PSO to develop tailored treatment plans, aiming to optimize treatment efficacy and improve patients’ quality of life.
Investigating the link between coronary artery calcification and atrial fibrillation: A systematic review and meta-analysis
Authors: Tabesh Faezeh , Arjmand Zahra , Teimouri-Jervekani Zahra
Published: October 2024

Background:

Both coronary artery calcification (CAC) and atrial fibrillation (AF) are associated with common risk factors, such as age, hypertension, diabetes, and dyslipidemia. Investigating their association may provide insights into shared pathophysiological mechanisms and overlapping risk profiles.

Methods:

A systematically search was performed covering various data bases including PubMed, Scopus, ISI, and Google Scholar from January 2000 until December 2023 for English-published articles. We focused on observational studies—cohort, case–control, and cross-sectional—that involved adult participants (aged 18 and older) and provided data on the any association between CAC and AF. We excluded studies if the full text was unavailable, the publication was not in English, there was insufficient numerical data or relative risk information.

Results:

All the included articles (n = 14), were observational studies (n = 5 case–control and n = 9 cohort). All of the included papers (100%), reported a link between CAC and higher rate of major adverse cardiovascular events such as stroke and mortality in AF patients. The overall prevalence of AF across 5 studies was estimated to be 9.00% (95% confidence intervals [CI]: 2.00, 16.00), and 60% of the AF population were male. The overall proportion of AF in individuals with a coronary artery calcification score (CACS) of 0 is relatively high at 0.48 (95% CI: 0.32, 0.64), followed by CACS (1–99) which was 0.22 (95% CI: 0.16, 0.28), CACS (100–399) which was 0.17 (95% CI: 0.07, 0.28), and CACS (≥ 400) as 0.14 (95% CI: 0.07, 0.22).

Conclusion:

It can be concluded that there is a robust and consistent association between CAC and AF. Our systematic review underscores the importance of considering CAC as a potential factor in assessing the risk of AF, while also recognizing the multifactorial nature of this relationship.
The mediating impact of exercise frequency and duration on the relationship between digital health literacy and health among older adults: A cross-sectional study
Authors: Wei Ye , Zhou Yinting
Published: October 2024

Although several studies have discussed the relationships among digital health literacy, health, and exercise behavior, few have integrated these 3 factors into a single model. This study aims to address this research gap. This article aims to analyze the impact of digital health literacy on the health of older adults, as well as the mediating mechanisms related to exercise frequency and duration. A cross-sectional survey was conducted in Luoyang and Zhengzhou urban areas from December 2023 to January 2024. Utilizing random sampling methods, data were collected from 661 older adults through the “digital health literacy scale,” “health scale,” and “count of exercise duration and frequency” questionnaires. The data were processed by employing SPSS 20 and Process, v3.0, and analyzed through independent samples t test, 1-way ANOVA (F-test), and mediation testing methods. The results indicate that no statistical significance (P > .05) is observed in terms of the 3 dimensions of digital health literacy, exercise behavior, and health status among older adults with different genders, living conditions, educational backgrounds, and economic status. In contrast, statistical significance (P < .05) is observed in terms of exercise frequency and health status among older adults with varying levels of smoking and drinking. The 3 dimensions of digital health literacy among older adults statistically impact (P < .05) their exercise duration, frequency, and health. The dimension of access and assessment exerts the most significant influence on exercise duration (β = 0.415) and a considerable impact on health (β = 0.214). Furthermore, the impact of exercise duration and frequency on health status is statistically significant (P < .05). In terms of the interactive capability dimension, exercise frequency exerts the most significant influence (β = 0.199). Digital health literacy has a significant impact on the health of older adults. The duration and frequency of exercise play a partial mediating role between older adults’ digital health literacy and their physical health status. Digital health literacy can encourage older adults to increase the duration and frequency of exercise, which, in turn, promotes their physical health.
Lamotrigine associated extensive hyperpigmentation: A case report and literature review
Authors: Pei Keling , Wu Yuqian , Zhang Tao
Published: October 2024

Rationale:

Lamotrigine (LTG)-associated extensive hyperpigmentation is rare and may persist for a long time or even become permanent. LTG-associated cutaneous adverse reaction (CAR) manifests initially as mild maculopapular exanthema (MPE). The first step in CAR therapy is to immediately discontinue the offending LTG for predicting evolution to mild or severe forms not always possible. Here, we present a rare case of LTG-associated extensive hyperpigmentation for delaying the withdrawal of LTG.

Patient concerns:

We describe the case of a female adolescent with a history of depression managed with LTG, who developed a mild MPE. Unfortunately, the patient did not discharge LTG after the occurrence of MPE until 20 days later. Then she developed a residual extensive hyperpigmentation in her trunk and extremities.

Diagnoses:

After a series of physical examinations and retracing past medical history, she was diagnosed with LTG-associated extensive hyperpigmentation.

Interventions:

The patient refused any treatment.

Outcomes:

Nine months later, there still existed residual hyperpigmentation in her trunk and extremities, and the range and color of hyperpigmentation have not changed significantly.

Lessons:

This case suggests that LTG may cause not only MPE but also extensive hyperpigmentation. When a patient displays a mild MPE following the initiation of LTG in the outpatient clinic, LTG-associated CAR should not be overlooked as a diagnosis, and early withdrawal of LTG should be considered at first.
Coronary heart disease evaluation using PCAT radiomics model based on coronary CT angiography and pericoronary adipose tissue
Authors: Zhang Chuanmin
Published: October 2024

To explore the clinical application value of radiomics model based on pericoronary adipose tissue (PCAT) in predicting coronary heart disease. A retrospective analysis was performed for inpatients who had undergone coronary computed tomography angiography from January to December 2023, and 164 cases of coronary artery lesions were screened as the lesion group and 190 cases of normal coronary artery samples were selected as the control group. The clinical data and imaging data of all patients were collected, the radiomics features were extracted by relevant software, and the “region of interest” of pericoronary fat was delineated, and the selection operator and multivariate logistic regression were used to screen the radiomic features of pericoronary fat. A coronary heart disease evaluation model was constructed by the best radiomics features. Area under the curve values of the PCAT radiomics scoring model for predicting the receiver operating characteristic curve of coronary heart disease were 0.863 and 0.851 in training and test sets, respectively. After calibration curve analysis, PCAT radiomics scoring model has a high consistency between the predictive evaluation results and the actual results of coronary heart disease events. In addition, in the training set, the PCAT radiomics scoring model has a net benefit on all threshold probabilities. In the test set, the model has a negative net return with only a small number of threshold probabilities. After combining the clinical characteristics model, the evaluation accuracy of the model for coronary heart disease can reach 0.896. PCAT radiomics model based on coronary computed tomography angiography can effectively predict and evaluate coronary heart disease, which is of great value for the clinical diagnosis of coronary artery disease.
Network meta-analysis evaluating the impact of diverse exercise regimens on quality of life in women post-breast cancer surgery
Authors: Yao Lin-Xi , Zhou Yan-Bing , Yuan Yu-Xin , Li Xiao-Fei , Li Xiao-Fen
Published: October 2024

Background:

This study used network meta-analysis to compare the effects of various exercise interventions, with the aim of identifying the most effective intervention measures.

Methods:

Data were extracted from 8 databases, comprising of PubMed, Web of Science, EBSCO, and Embase. The Cochrane risk of bias assessment tool was used to assess the quality of the research. Network meta-analysis and meta-analysis were performed using STATA15.0 and Review Manager 5.4, respectively.

Results:

This analysis incorporated 58 research papers that had 4998 participants, of which 2480 were assigned to the test group and 2518 to the control group. As revealed by the data, the following is a descending order of the impact of various exercise regimens on the quality of life (QoL) of women who have undergone breast cancer surgery: For the MOS item short form health survey, the recommended sequence was as follows: aerobic + resistance exercise, football, baduanjin, walking, tai chi, yoga, resistance exercise, slow-moving qigong, aerobic exercise, and usual care; for functional assessment of cancer therapy for breast cancer, the sequence was as follows: aerobic + resistance exercise, resistance exercise, relaxation, baduanjin, square dance, aerobic exercise, tai chi, yoga, Pilates, mixer dance, aquatic sports, cycle ergometer, and usual care; and for European Organization for Research and Treatment of Cancer quality of life questionnaire, the sequence was aerobic + resistance exercise, aerobic + yoga, aerobic exercise, Pilates, yoga, muscle strengthening, resistance exercise, square dance, usual care, walking, and aerobic + edema massage.

Conclusion:

The majority of exercise interventions demonstrated a discernible impact on the QoL in women following breast cancer surgery. The effects of diverse exercise interventions on the 3 QoL outcome indicators in patients with breast cancer exhibited variability. However, irrespective of the QoL measurement technique used, aerobic and resistance exercise continue to be the most favorable choices.
Mitochondrial diabetes presenting with spontaneous abortion and ketoacidosis onset: A case report and literature review
Authors: Wu Baoyuan , Tao Yubing , Wu Qingqiang , Zou Caiyan , Liu Xuekui , Geng Houfa
Published: October 2024

Rationale:

Mitochondrial diabetes mellitus (MDM) is a rare form of diabetes characterized by mitochondrial dysfunction, leading to a diverse range of clinical manifestations that may result in misdiagnosis. Accurate identification of MDM is essential for proper management and reporting of diagnosed cases.

Patient concerns:

The patient was a young woman with a slender physique who presented with sensorineural hearing loss detected during auditory testing.

Diagnoses:

Auditory testing confirmed sensorineural hearing loss, and further evaluation revealed impaired pancreatic β-cell function, indicating reduced insulin secretion. Genetic testing of blood samples identified the A3243G mitochondrial DNA mutation. The patient’s family history was notable for hearing loss in her mother and maternal grandmother, who exhibited clinical features consistent with MDM.

Interventions:

Clinical management focused on monitoring and addressing the metabolic and clinical needs associated with MDM.

Outcomes:

The diagnosis of MDM was established, highlighting the importance of recognizing the diverse clinical manifestations, including a rare case of spontaneous abortion during pregnancy.

Lessons:

MDM presents with atypical clinical manifestations, and thorough physical examinations are crucial for its diagnosis. This case underscores the significance of genetic testing and family history in diagnosing MDM and the need for increased awareness among clinicians to prevent misdiagnosis.
Combined detection of serum adiponectin and pregnancy-associated plasma protein A for early prediction of gestational diabetes mellitus
Authors: Wang Xia , Sheng Yajun , Xiao Jinli , Hu Yaozong , Li Limin , Chen Kang
Published: October 2024

Early diagnosis of gestational diabetes mellitus (GDM) reduces the risk of adverse perinatal and maternal outcomes. At present, the value of serum adiponectin (ADP) and pregnancy-associated plasma protein A (PAPP-A) in clinical practice for the diagnosis of GDM in early pregnancy is unclear. To investigate the predictive value of serum ADP and PAPP-A in GDM. The electronic medical record data of all pregnant women from Zhongshan People’s Hospital from 2018 to 2021 were retrospectively collected and divided into GDM group and control group according to whether GDM occurred. ADP and PAPP-A levels of the 2 groups were detected in early pregnancy, and the related factors of GDM were analyzed by binary logistic regression analysis. Receiver operating characteristic (ROC) curves of ADP and PAPP-A in predicting GDM in the early pregnancy were plotted and their clinical predictive value was analyzed. The significance level for all statistical tests is 0.05. Compared with the non-GDM group, the ADP of the GDM group was significantly lower than that of the non-GDM group [(8.19 ± 2.24) vs. (10.04 ± 2.73)]mg/L, the difference between groups was statistically significant (P < .05), and the multiple of median (MoM) of PAPP-A was significantly lower than that of the non-GDM group (1.13 ± 0.52) versus (1.45 ± 0.61) (P < .05). Binary logistic regression analysis showed that elevated serum ADP and PAPP-A levels were negatively correlated with the subsequent development of GDM [odds ratio (OR) 95% confidence interval (95% CI)] was 0.626 (0.536, 0.816), 0.934 (0.908, 0.961), respectively, P < .05.ROC curve analysis showed that the sensitivity and specificity of ADP and PAPP-A in predicting gestational diabetes were79.1% and 58.6%, respectively, 92.7% and 73.1%, and respectively. The area under curve (AUC) is 0.755 for ADP and 0.770 for PAPP-A. The AUC of the combined detection was 0.867, both of which were higher than that of single index diagnosis, and the sensitivity and specificity of the combined detection were 0.958 and 0.853, respectively. In summary, PAPP-A and ADP levels are independent related factors affecting the occurrence of GDM. The combined detection of PAPP-A and ADP should be utilized in diagnosing GDM to improve pregnancy outcomes for pregnant women.
Female and diabetes are risk factors for alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II negative in hepatocellular carcinoma
Authors: Shi Yanhui , Yang Hongli , Bai Xue , Liu Xiaoyan , Li Qiang , Du Wenjun
Published: October 2024

Hepatocellular carcinoma (HCC) is a common type of tumor with a high incidence. Alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II or des-gamma-carboxy prothrombin) are proven effective biomarkers for HCC. Combining them can enhance detection rates. However, when both AFP and PIVKA-II are negative, clinical diagnosis may be missed. This study aims to explore the risk factors for AFP and PIVKA-II negativity in HCC, thereby reducing missed diagnoses. A retrospective study enrolled 609 HCC patients at Shandong Public Health Clinical Center Affiliated with Shandong University from January 2010 to March 2022. Patients with negative AFP and PIVKA-II were the observed group, and others with at least 1 positive were controls. Epidemiological, clinical, laboratory, and radiological data were collected and analyzed to identify the frequency and factors influencing AFP and PIVKA-II negativity. Receiver operating characteristic (ROC) curves were used to assess the prediction model’s ability to detect negative AFP and PIVKA-II in HCC. Gender (P = .045, 95% confidence interval [95%CI] = 1.013–3.277), diabetes mellitus (P = .018, 95%CI = 1.151–4.422), tumor size (P = .000, 95%CI = 0.677–0.841), glutamate transpeptidase (P = .003, 95%CI = 0.239–0.737), total bilirubin (P = .001, 95%CI = 0.235–0.705), and hepatitis B virus-associated infections (P = .007, 95%CI = 0.077–0.661) were significantly associated with AFP and PIVKA-II negativity in HCC. The prediction model had an area under curve of 0.832 (P < .001, 95%CI = 0.786–0.877), with a sensitivity of 81.2% and specificity of 75.5% in all HCC patients. Female diabetic patients with levels closer to normal for glutamate transpeptidase and total bilirubin are more likely to develop AFP and PIVKA-II-negative HCC. Imaging is crucial for screening liver cancer in these patients.
A bibliometric analysis and typology of drug pricing policies across the globe
Authors: Berthe Abdrahmane , Eljilany Islam , Kulkarni Amit , Diaby Vakaramoko
Published: October 2024

Background:

Limited research exists on pricing policies from a bibliometric and visualization perspective, and there is a lack of understanding of their typology. This study aims to address these gaps in knowledge and provide a deeper understanding of the research topics and development trends in this field.

Methods:

A bibliometric study was conducted on drug pricing approaches in healthcare literature, published between 2000 and June 2023. The literature was identified through an extensive search of healthcare databases and was then classified based on the year of publication, research topics, corresponding authors, location of corresponding authors, and journal titles. The citation data analysis was conducted using Bibliometrix, which consisted of descriptive, geographical, and time-series analyses and visualization.

Results:

Between 2000 and June 2023, 173 articles were disseminated across 98 distinct publication sources. During the analysis, we observed a significant and consistent rise in literature reports on drug pricing approaches in healthcare, especially in 2010. The research topics were distributed almost equally, discussing improvement or issues with drug pricing models and addressing drug pricing applications. Our analysis revealed that the top ten corresponding authors were responsible for 19% of the total articles, with those based in the United States being the most productive. Furthermore, the “Health Economics” journal ranked first among the top ten journals. These findings align with the overall publication trends of drug pricing methods reported in other fields.

Conclusions:

The current study offers a comprehensive overview of drug pricing techniques utilized in medicine through visualization and bibliometric techniques. Analysis of authors, journals, institutions, and countries could serve as a reference for new researchers and guide them differently. Researchers can also consider emerging trends when determining the focus of their studies.
Exploring the causal pathway from gut microbiota to polycystic ovary syndrome: A network Mendelian randomization study
Authors: Gao Xueyan , Zhao Huijuan , Shi Qingling , Zou Ting , Zhu Yidan
Published: October 2024

Polycystic ovary syndrome (PCOS) is a complicated endocrine and metabolic syndrome with unclear pathogenesis. The gut microbiota sheds light on the etiology and pathophysiology of PCOS. We used Mendelian randomization (MR) studies to systematically evaluate the pathological mechanism gut microbiota causally associated with PCOS risk. A network MR analysis was performed to estimate the causal effects of gut microbiota and risk factors on PCOS, as well as the mediation effect of risk factors linking gut microbiota to PCOS. The investigation of side effects for the important gut microbiota was subsequently broadened to include phenotypes by performing Phenowide-MR analysis for a range of diseases. Genus Sellimonas id.14369 were causally associated with reduced PCOS risk (odds ratio [OR] = 0.69, 95% confidence interval [CI]: 0.58–0.84, P = 1.22 × 10-4) after multiple testing correction. And Sellimonas retained consistent causal effect estimates after a series of sensitivity analyses. In addition, we observed an indirect effect of Sellimonas on PCOS through body mass index (BMI) using network MR (b = ‐0.05, 95% CI: ‐0.09 to ‐0.01), with a mediated proportion of 12.82% of the total effect. Further, Phenowide-MR analyses showed that the protective effects of Sellimonas on type 2 diabetes and depression (for type 2 diabetes: OR = 0.95, 95% CI: 0.90–0.99, P = .0366; for depression: OR = 0.99, 95% CI: 0.98–1.00, P = .0210). We summarized that the causal path between gut microbiota and type 2 diabetes are also jointly mediated by BMI. Sellimonas may be a protective factor of PCOS, which can affect the occurrence of PCOS through BMI, supporting future studies on the importance of addressing obesity and metabolic issues in preventing and managing PCOS.
Advances in clinical research on pharmacological management of chemotherapy-induced constipation in gastrointestinal tumor: A perspective
Authors: Zhang Jin-Qiang , Zhang Peng-Fei
Published: October 2024

Gastrointestinal tumors, including those of the stomach, colon, rectum, and esophagus, present significant global health challenges. Chemotherapy, essential for treating these cancers, often causes constipation, adversely affecting patients’ quality of life. This study examines the mechanisms behind chemotherapy-induced constipation, such as the direct impact of chemotherapeutic drugs on intestinal function, reduced fluid intake, decreased physical activity, opioid use, and psychological stress. While traditional treatments like stimulant and osmotic laxatives are commonly used, emerging therapies such as 5-HT4 receptor agonists and probiotics show promise. Traditional Chinese medicine offers additional strategies with herbal remedies and dietary adjustments. Future research should prioritize precision medicine, combining pharmacological and non-pharmacological approaches, and developing innovative therapeutics utilizing biologics and nanotechnology. Ongoing research is crucial for improving chemotherapy-induced constipation management, aiming to enhance treatment outcomes and the quality of life for chemotherapy patients with gastrointestinal tumors.
Serum non-high-density lipoprotein cholesterol predicts distant metastases following resection of stages I to III colorectal cancer
Authors: Fang Ronghua , Shi Aijun , Cong Hui , Shi Xiuying
Published: October 2024

The aim of this study was to examine the relationship between levels of non-high-density lipoprotein cholesterol (non-HDL-C) and postoperative distant metastasis for stages I to III colorectal cancer (CRC). Demographic, clinicopathological, and lipid data were collected from 588 patients, who were subsequently grouped according to their non-HDL-C levels. The primary endpoint was distant metastasis, survival without distant metastasis-free survival (DMFS). The association between non-HDL-C and pathological features, as well as postoperative distant metastasis, was assessed using a chi-square test, Mann–Whitney U test, and Cox proportional hazard regression model. The correlation between DMFS and non-HDL-C levels was analyzed employing the Kaplan–Meier method and log-rank test. The incidence of postoperative distant metastasis was significantly higher in the high non-HDL-C group (34.8%) compared to the low non-HDL-C group (18.2%) (P < .001). Non-HDL-C levels were significantly higher in the metastasis group than in the nonmetastasis group (P = .001). Multivariate Cox proportional hazards identified non-HDL-C ≥ 4.1mmol/L(HR: 2.604; 95% CI: 1.584–4.282; P = .001) as independent risk factors for postoperative distant metastasis. The high non-HDL-C group exhibited a higher rate of distant metastasis and a shorter duration of DMFS (HR: 2.133; 95% CI: 1.404–3.240; P < .001). Our study suggests that high levels of non-HDL-C (≥4.1 mmol/L) may potentially serve as predictors for postoperative distant metastasis in stages I to III CRC.
Association between nasal septal deviation and tinnitus: Insights from a 9-year nationwide cohort study
Authors: Yeo Cha Dong , Yeom Sang Woo , Lee Eun Jung , Kim Jong Seung
Published: October 2024

Tinnitus is a condition where sound is perceived in the ear or head when no external sound stimulation is present. To date, no study has explored the correlation between nasal septal deviation (SD) and tinnitus using large-scale real-world data. This study hypothesized a potential relationship between tinnitus and SD, which we investigated using a 9-year large-scale cohort study. Nationwide cohort observational study. The SD group was selected from 1 million individuals randomly extracted from the National Health Insurance Service database. The non-SD group was obtained through propensity score matching considering several variables. The primary endpoint was tinnitus diagnosis. The study (SD) group included 10,790 individuals, and the non-SD group (control group) included 21,580 individuals. The overall hazard ratio (HR) for tinnitus in the SD group was 1.74 (95% CI: 1.62–1.89). In the subgroup analysis, the HR was 0.73 (95% CI: 0.68–0.79) for tinnitus in the male group, 1.12 (95% CI: 1.04–1.21) in the group with high economic status, 0.81 (95% CI: 0.75–0.89) in the group living in metropolitan areas, and 0.45 (95% CI: 0.42–0.49) in the younger age group (<50 years). In the SD group, the HR for tinnitus after septoplasty significantly decreased to 0.75 (95% CI: 0.63–0.90). From long-term follow-up, the prevalence of tinnitus was 1.74 times higher in the SD group compared with the control group. This phenomenon significantly decreased after septoplasty.
Sex bias in FGFR3 somatic mutations in bladder cancer
Authors: Meng Xiangyu , Wang Qiaoli
Published: October 2024

Background

Strong sex disparities have been observed among patients with bladder cancer (BCa). FGFR3 is one of the most frequently mutated genes in bladder cancer, and there are inconsistencies in its frequency in male and female patients.

Methods

Here, we conducted a meta-analysis comparing the FGFR3 somatic mutation frequency in men and women among 7351 patients with BCa from 18 cohorts.

Results

We showed that female patients had a 1.32 times higher risk of having FGFR3 somatic mutations than males. This difference was attributed to mutations occurring at the 2 most frequently mutated sites, S249 and Y375. Additionally, nonsense mutations were more likely to be found in women, whereas indel/frameshift mutations were almost exclusively found in men; however, no difference was noted for missense mutations.

Conclusions

A female sex bias in FGFR3 somatic mutations was observed in BCa. Well-powered individual participant data analyses addressing the possible confounding effects of other factors (eg, age, ethnicity, smoking status, muscle invasiveness, and molecular subtype), as well as analyses integrating omics and functional investigations, are warranted to further validate and explain the mechanisms of the current findings.
Successful Collaborations that Resulted in Increased U.S. Diagnostic Testing During the 2022 Mpox Outbreak
Authors: Hutson Christina L. , Villanueva Julie , Stenzel Timothy , Olson Victoria A. , Gerald Noel , McNall Rebecca , Courtney Sean , Aden Tricia , Rager Stacy , Egan Christina , Blevins Patricia , Kuhnert Wendi , Davidson Whitni , Khan Theodora , Baird Nicolle , Kling Chantal , Van Meter Susan , Chaitram Jasmine , Salerno Reynolds M.
Published: October 2024

Context

The first case of mpox was detected in the United States in a Laboratory Response Network (LRN) laboratory at the Massachusetts Department of Public Health on May 17, 2022. Through previous years of smallpox preparedness efforts by the United States government, testing capacity in LRN laboratories across the United States utilizing the FDA-cleared Centers for Disease Control and Prevention (CDC) Non-variola orthopoxvirus (NVO) test was approximately 6000 tests weekly across the nation prior to the mpox outbreak. By early June 2022, the LRN laboratories had capacity to perform up to 8000 tests per week. As the outbreak expanded, cases were identified in every United States state, peaking at ~3000 cases per week nationally in August 2022.

Objective

Although NVO testing capacity in LRN laboratories exceeded national mpox testing demand overall, LRN testing access in some areas was challenged and test expansion was necessary.

Participants

CDC engaged with partners and select commercial laboratories early to increase diagnostic testing access by allowing these commercial laboratories to utilize the NVO test.

Setting

The expansion of testing to commercial laboratories increased testing availability, capacity, and volume nationwide. This was the first time that CDC shared an FDA 510k-cleared molecular test with commercial laboratories to support a public health emergency.

Design

Extensive efforts were made to ensure the CDC NVO test was used appropriately in the private sector and that the transfer process met regulatory requirements.

Main Outcome Measures, Results, Conclusions

These novel methods to expand NVO testing to commercial laboratories increased national testing capacity to 80 000 mpox tests/week. Test volumes among these laboratories never exceeded this expanded capacity. The rapid increase in the nation’s testing capacity, in conjunction and coordination with other public and private health efforts, helped to detect cases rapidly. These actions demonstrated the importance of highly functional and efficient public health and private sector partnerships for responding to public health emergencies.
Treatment of Posttraumatic Zygomatic Coronoid Ankylosis. Systematic Review
Authors: Requejo Stefania , García Guevara Henry , Viamonte Maria Daniela , Cicciu Marcos , Jensen Maria Dianella , Olate Sergio , Crimi Salvatore
Published: October 2024

Facial trauma is mostly associated with traffic accidents, fights, and sports accidents. The mandible, midface, and temporomandibular joint are usually the region’s most frequently affected. Coronoid process fractures are rare, representing ∼2% of facial fractures in the literature, usually being the result of direct trauma to the zygomatic region. Due to the anatomical relationship of the coronoid process, it may be associated with other facial fractures, such as fractures of the zygomatic bone. Zygomatic-coronoid ankylosis is a rare clinical entity with variable etiology. It is most commonly associated with trauma (13%–100%), local or systemic infection (0%–53%), or systemic diseases, such as ankylosing spondylitis, rheumatoid arthritis, or psoriasis. The aim of this research is to evaluate the different treatments for ankylosis from the coronoid process to the zygoma after trauma, allowing to determine the treatment to obtain the best results. A systematic review was carried out following PRISMA “preferred reports for systematic reviews and meta-analyses” search matrix, based on a PICO question; was used PubMed, Embase, Sciencedirect, Cochrane, Google Scholar, and manual search in high-impact journals between 1946 and 2023 publications in English or Spanish, including randomized and nonrandomized clinical trials, prospective and retrospective cohort studies, case-control studies, series, and case reports. A total of 1993 articles were obtained from the 4 databases. After corroborating duplicate articles, 847 articles were excluded. Another 1112 articles were excluded in the title evaluation, and an additional 1093 after the abstract review; a total of 19 articles eligible for full-text evaluation were established and 1 article was added as a result of the manual search. After the full-text review, it was decided to include 16 articles in the study that met the objectives of the systematic review. After evaluating the different treatments described in the literature, the authors can determine that coronoidectomy through an intraoral approach is the most appropriate treatment for zygomatic coronoid ankylosis, accompanied by postoperative physiotherapy to achieve greater oral opening without recurrences.
Symmetric, Bilateral Auricular Calcifications in Twins With Noonan Syndrome
Authors: Leonard Courtney , Abduljabbar Sarah , Lance Samuel
Published: October 2024

Noonan syndrome (NS) is a rare, genetic multisystem disorder often presenting with associated craniofacial abnormalities. The authors report an identical twin pair with classical features of NS including short stature, mild ptosis, hypertelorism, down-slanting palpebral fissures, low-set angulated ears, and giant cell tumors in the craniofacial skeleton. Interestingly, these patients also presented with bilateral, symmetric, dystrophic auricular calcifications. Genome sequencing revealed identical germline son of sevenless homolog 1 mutations and inversion of chromosome 2 (p11.2q13). Awareness of the association of auricular calcifications and NS may help guide clinical management for these patients, particularly if auricular procedures are indicated.
Simple Trocar Placement for Robotic Liver and Pancreatic Surgery: Multiple Access Devices at 5-cm Single Umbilicus Incision with 2 Robotic Ports
Authors: Kawaguchi Yoshikuni , Ito Kyoji , Abe Satoru , Nishioka Yujiro , Miyata Akinori , Ichida Akihiko , Akamatsu Nobuhisa , Hasegawa Kiyoshi
Published: October 2024

Background:

Robotic trocars are recommended to be placed 6–8 cm apart, and assistant trocars are placed 7 cm away from the horizontal line of the robotic trocar placement. However, adhering to these rules may be difficult, particularly in lean patients. This study aims to demonstrate our standardized simple trocar placement, 5-cm single umbilicus incision + 2 ports for robotic liver resection (RLR) and robotic pancreaticoduodenectomy (RPD).

Methods:

During 2022–2024, patients undergoing RLR and RPD at The University of Tokyo were identified from a prospectively maintained database. Our standardized trocar placement consisted of multiple access devices at the 5-cm umbilicus incision, including two robotic trocars and one assistant trocar, and two other robotic trocars inserted to shape a hemi-circle around the surgical object.

Results:

A total of 29 and 31 consecutive patients underwent RLR and RPD, respectively. The 5-cm single umbilicus incision + 2 ports method was used in 82.8% of patients undergoing RLR and 100% of patients undergoing RPD. No patients undergoing RLR developed hepatic insufficiency and bile leakage with the median postoperative hospital stay of 5 days. No patients undergoing RPD developed clinically relevant pancreatic fistula, delayed gastric emptying, and bile leakage with the median postoperative hospital stay of 8 days.

Conclusions:

Our standardized trocar placement technique is simple and widely feasible for lean-to-obese patients, allowing for RLR and RPD while minimizing incisions for patients.
Statistical relationships across epigenomes using large-scale hierarchical clustering
Authors: Kim Anastasiia , Lubbers Nicholas , Steadman Christina R. , Sanbonmatsu Karissa Y.
Published: October 2024

Environmental toxins and pathogens can influence epigenetic modifications on chromosomes, thereby leaving trace evidence of exposures. However, the avalanche of epigenomic data is difficult to parse for biological interpretation given non-linear complex patterns and relationships. This attractive challenge in epigenomic data lends itself to machine learning for discerning infectivity and susceptibility. In this study, we explore over 3,000 epigenomes of uninfected individuals and provide a comprehensive characterization of the relationships among epigenetic modifiers, their modifiers, and specific immune cell types across all chromosomes using hierarchical clustering.