bluuebunny/crossref_metadata_2025 huggingface dataset:
How is digital technology used to facilitate shared decision-making between healthcare professionals and patients in cardiovascular care? A scoping review
Authors: Leysen Dirk , Propst Eva , McGowan Hannah , Pfannerstill Franziska , Crutzen Rik , Kulnik Stefan Tino
Published: February 2025

Aims

To (1) identify characteristics of digital technologies (DTs) used to facilitate shared decision-making (SDM) within the field of cardiovascular care, (2) examine conceptualizations of SDM underpinning these DTs, and (3) summarize designs and outcomes of evaluation studies concerning these DTs.

Methods and results

We conducted a scoping review following methodological guidelines by the Joanna Briggs Institute. Ten scientific databases were searched. We selected peer-reviewed articles in cardiovascular care, with SDM and DT in the title and/or abstract published between January 2000 and March 2023. We extracted data on the type of DT, intended user(s), timepoint and mode of use, purpose, decision topic, underlying SDM model, and designs and outcomes of evaluation studies. Data were analyzed descriptively in a narrative synthesis.

From 4,432 search results, 48 articles reporting on 31 DTs were included. Half of the articles were published after 2018, with most published in 2022. Most DTs are web-based applications for interactive use before and during the encounter between patient and healthcare professional, to convey information on cardiovascular care, calculate personal risk and/or recommend treatment options. SDM conceptualizations refer to the International Patient Decision Aid Standards and authors in the field. Thirty-seven evaluation studies report on 31 DTs, with heterogeneous results related to variation in intervention designs, measurement timepoints, and outcome measures.

Conclusion

A recent increase in the reporting of DTs to facilitate SDM in cardiovascular care indicates their potential. This scoping review offers researchers, developers, and clinicians a comprehensive overview of this literature.

Registration

Open Science Framework, https://doi.org/10.17605/OSF.IO/TRGQ5
Allometry of sound reception structures and evidence for a mandibular middle ear in non-mammalian synapsids
Authors: Olroyd Savannah L , Kopperud Bjørn T
Published: February 2025

The origin of sensory structures provides an excellent framework for studying how constraints and selective pressures affect the evolution of complex features. The evolution of the mammalian middle ear from the jaw hinge of non-mammalian synapsids offers a deep-time perspective on sensory evolution but is limited by a poor understanding of early synapsid hearing. This work tests the hypothesis that the size of the reflected lamina of the angular bone in non-mammalian synapsids followed a strict, negative allometric trend that may be expected for a sound receiver. Allometry is first investigated in the pterygoid bone of chameleons, which was co-opted for hearing in some species and represents a possible analog for the synapsid reflected lamina. Results indicate that chameleons with a pterygoid ear exhibit a similar allometric slope, while species without a pterygoid ear have variable slopes, suggesting an optimum allometric pattern in sound receivers. In the reflected lamina, we find reduced variation around the allometric trend in therocephalians and non-bidentalian anomodonts, and evolutionary modeling suggests constraint in these groups. These results are consistent with a mandibular middle ear in non-mammalian synapsids, adding valuable new insights to the hypothesis that selective pressures for hearing ability were present long before the evolution of the mammalian middle ear.
Dynamic Changes in Gene Expression Through Aging in Drosophila melanogaster Heads
Authors: Hanson Katherine M , Macdonald Stuart J
Published: February 2025

Work in many systems has shown large-scale changes in gene expression during aging. However, many studies employ just two, arbitrarily-chosen timepoints at which to measure expression, and can only observe an increase or a decrease in expression between “young” and “old” animals, failing to capture any dynamic, non-linear changes that occur throughout the aging process. We used RNA sequencing to measure expression in male head tissue at 15 timepoints through the lifespan of an inbred Drosophila melanogaster strain. We detected >6,000 significant, age-related genes, nearly all of which have been seen in previous Drosophila aging expression studies, and which include several known to harbor lifespan-altering mutations. We grouped our gene set into 28 clusters via their temporal expression change, observing a diversity of trajectories; some clusters show a linear change over time, while others show more complex, non-linear patterns. Notably, re-analysis of our dataset comparing the earliest and latest timepoints – mimicking a two-timepoint design – revealed fewer differentially-expressed genes (around 4,500). Additionally, those genes exhibiting complex expression trajectories in our multi-timepoint analysis were most impacted in this re-analysis; their identification, and the inferred change in gene expression with age, was often dependent on the timepoints chosen. Informed by our trajectory-based clusters, we executed a series of gene enrichment analyses, identifying enriched functions/pathways in all clusters, including the commonly seen increase in stress- and immune-related gene expression with age. Finally, we developed a pair of accessible Shiny apps to enable exploration of our differential expression and gene enrichment results.
Longitudinal trajectories of psychological resilience and cognitive impairment among older adults: Evidence from a national cohort study
Authors: Wang Peicheng , Li Ruihua , Chen Yanhua
Published: February 2025

Objectives

The relationship between resilience trajectories and cognitive health is not well understood. This study aimed to identify clusters of psychological resilience trajectories in a national sample of older adults and to examine the association with cognitive impairment over time.

Methods

This study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, and 2,788 respondents were included in this prospective analysis. Using a group-based trajectory modeling approach, we identified resilience trajectory groups over a 6-year period. Cox proportional hazards models were used to assess the relationship between the resilience trajectory groups and cognitive impairment.

Results

Three distinct trajectories of psychological resilience, including decreasing resilience group (n=131, 4.7%), persistent middle resilience group (n=1,808, 64.8%), and persistent high resilience group (n=849, 30.5%). During the 6-year follow-up, compared to those with persistent high resilience, participants with persistent middle resilience (HR=1.40, 95%CI=1.11-1.75) and decreasing resilience (HR=2.31, 95%CI=1.65-3.23) remained consistently associated with a higher risk of cognitive impairment. The associations between resilience trajectories and cognitive impairment varied by lifestyle and health conditions.

Discussion

Psychological resilience is a relatively stable trait among older adults in China, with most individuals maintaining a persistently high or middle level of resilience throughout the follow-up period; however, declining psychological resilience was significantly associated with the risk of cognitive impairment. Therefore, developing targeted interventions to strengthen psychological resilience in older adults is crucial for promoting cognitive health and successful aging.
Validation of the German registry of acute aortic dissection type A score for predicting 30-day mortality after acute type A aortic dissection surgery in a single Japanese aortic center
Authors: Kotani Shinsuke , Sakaguchi Genichi
Published: February 2025

OBJECTIVES

This study evaluated the applicability of the German Registry of Acute Aortic Dissection Type A (GERAADA) score in predicting 30-day mortality in Japanese patients undergoing surgery for acute type A aortic dissection (ATAAD) and compared its predictive performance with that of the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II).

METHODS

This single-center retrospective study involved 154 patients who underwent emergency surgery for ATAAD between January 2019 and April 2024. The GERAADA and EuroSCORE II were calculated for each patient. Predictive accuracy for 30-day mortality was assessed using the area under the receiver operating characteristic curve (AUC). A multivariate logistic regression identified independent predictors of mortality, and long-term outcomes were evaluated using Kaplan–Meier analysis.

RESULTS

The 30-day mortality rate was 11.0%. The GERAADA score showed an AUC of 0.80, indicating good discriminatory ability, while the EuroSCORE II demonstrated moderate performance with an AUC of 0.67 (P = 0.07). The GERAADA score significantly overestimated mortality in this cohort, whereas the EuroSCORE II underestimated it. Independent predictors of mortality included the use of catecholamines at referral. Kaplan–Meier analysis revealed a 1-year survival rate of 79.4% with an AUC of 0.72, demonstrating the GERAADA score’s utility as a predictor of long-term survival.

CONCLUSIONS

The GERAADA score provides accurate predictions of 30-day mortality in Japanese patients undergoing ATAAD surgery, comparable to the EuroSCORE II. This score demonstrates robust predictive ability for short- and long-term outcomes and may serve as a practical tool for risk stratification in ATAAD surgery.
Parametric finite element approximation of two-phase Navier–Stokes flow with viscoelasticity
Authors: Garcke Harald , Nürnberg Robert , Trautwein Dennis
Published: February 2025

In this work we present a parametric finite element approximation of two-phase Navier–Stokes flow with viscoelasticity. The free boundary problem is given by the viscoelastic Navier–Stokes equations in the two fluid phases, connected by jump conditions across the interface. The elasticity in the fluids is characterized using the Oldroyd-B model with possible stress diffusion. The model was originally introduced to approximate fluid-structure interaction problems between an incompressible Newtonian fluid and a hyperelastic neo-Hookean solid, which are possible limit cases of the model. We approximate a variational formulation of the model with an unfitted finite element method that uses piecewise linear parametric finite elements. The two-phase Navier–Stokes–Oldroyd-B system in the bulk regions is discretized in a way that guarantees unconditional solvability and stability for the coupled bulk–interface system. Good volume conservation properties for the two phases are observed in the case where the pressure approximation space is enriched with the help of an extended finite element method function. We show the applicability of our method with some numerical results.
cGAS-STING Aggravates Cartilage Degradation by Promoting Glycolysis in TMJOA
Authors: Dong Yanhua , Zhou Xueman , Zhang Zhenzhen , Liu Jiaqi , Wu Xiayanran , Xiang Jie , Zheng Yingcheng , Xiong Xin , Yi Yating , Liu Jin , Wang Jun
Published: February 2025

The abnormal mechanical stress has been considered as a major contributor of temporomandibular joint osteoarthritis (TMJOA), but the mechanism by which it leads to the degeneration of condylar cartilage remains elusive. The double-stranded (dsDNA)-sensing cGAS/STING pathway serves as a response mechanism in many sterile inflammatory responses. In the present study, we found that mechanical stress exerted on condyle chondrocytes induced dsDNA leakage from mitochondria to cytoplasm to activate STING. Upon activation, STING exacerbated cartilage degradation by suppressing the anabolism of cartilage extracellular matrix (ECM) and accelerating the catabolic activity. Furthermore, the promoted glycolysis in chondrocytes was identified as a central mechanism in the onset of TMJOA, with critical rate-limiting enzymes downstream of STING. Our study not only establishes an important link between the intrinsic TMJOA suppressor activity of STING and chondrocyte metabolism, but also has critical implications for the development of STING-targeted therapeutic modalities of TMJOA.
Sex-related adaptive responses in the carbon balance to diurnal variation in the dioecious species Morus alba
Authors: Huang Xudong , Wang Yixia , Wang Yaman , Yan Meijing , Zhang Chunyan , Xu Xiao , Dong Tingfa
Published: February 2025

The carbon balance processes of plants in response to diurnal environmental changes are critical for their growth and survival. While sex-specific responses in photosynthesis to environmental stress have been observed in several dioecious plant species, the diurnal dynamics of carbon balance in male and female individuals remain unexplored. Here, we investigated the diurnal variations of photosynthetic rate (A), dark respiration rate (Rd), A/Rd, and the concentration, pool, and allocation of non-structural carbohydrates (NSC) of male and female mulberry (Morus alba) seedlings. Males exhibited the highest A at 09:00, while females had the highest A and Rd at 13:00. Male A was higher than female A at 09:00, whereas male Rd was lower than female Rd at 13:00. The A/Rd was higher in males than in females. The peak of NSC concentration in males was earlier than in females, and the NSC concentration and storage in the whole plant, leaves, and bark were generally higher in males than in females across most time points. The average NSC allocation followed the leaves > roots > bark ≈ trunk trend, but its dynamic changes over the daily cycle were more pronounced in females than in males. These findings suggest that carbon balance processes in mulberry seedlings exhibit sex-specific responses to diurnal changes, with females displaying greater sensitivity to these variations. This study is the first to explore such responses in woody plants and suggests that future carbon cycle models for terrestrial plants should incorporate plant sex.
Fungal Infections in People Who Use Drugs
Authors: Portugal Gonzales Jose , Ostrosky-Zeichner Luis
Published: February 2025

Illicit drug use in the United States continues to rise, alongside an increasing number of severe infections associated with drug use. Surveillance studies report that 28–34% of candidemia cases are linked to intravenous drug use, with Candida albicans being the most commonly isolated species, followed by Candida parapsilosis and Candida glabrata. Marijuana use is associated with lung infections caused by Aspergillus and the Mucorales, showing a 3.5-fold increased risk of mold infections and a 2.2-fold increased risk for other fungal infections. Intravenous drug use also presents a recognized risk factor for Aspergillus and Mucorales infections. Additionally, substances like cannabis, methamphetamines, and opioids share metabolic pathways with triazoles, a class of antifungal, and terbinafine through the CYP enzyme system. These antifungal drugs strongly inhibit CYP3A4 and CYP2D6, leading to potential drug interactions, adverse effects, overdose risks, and even death.
EEG slow oscillations and overnight spatial navigational memory performance in CPAP-treated obstructive sleep apnea
Authors: Mullins Anna E , Parekh Ankit , Kam Korey , Valencia Daphne I , Schoenholz Reagan , Fakhoury Ahmad , Castillo Bresne , Roberts Zachary J , Wickramaratne Sajila , Tolbert Thomas M , Hwang Jeongyeon , Blessing Esther M , Bubu Omonigho M , Rapoport David M , Ayappa Indu , Osorio Ricardo S , Varga Andrew W
Published: February 2025

Obstructive sleep apnea (OSA) exerts pathogenic effects through a combination of sleep fragmentation (SF) and intermittent hypoxia (IH). The mechanisms through which sleep disruption impacts memory might arise by investigating disruption of specific sleep stages and, when such disruption occurs through OSA, by evaluating the individual contributions of SF and IH. Given region-specific EEG slow activity during non-REM sleep has been associated with overnight declarative, motor and spatial memory formation, we investigated the effects of disrupting slow wave sleep (SWS) on a virtual maze navigation task. Thirty three participants (24 male, 56 years old [range 28-68 years] with OSA (baseline AHI4%>20/hour) who were habitually well-treated and adherent to CPAP completed 3 timed trials on a 3D spatial maze before and after polysomnographically (PSG) recorded sleep. We restricted CPAP withdrawal to SWS through real-time monitoring of the PSG under three conditions: 1) stable-SWS on therapeutic CPAP, 2) SWS-CPAP withdrawal containing SF and IH, and 3) SWS-CPAP withdrawal with supplemental oxygen containing SF with reduced IH. SWS-specific CPAP withdrawal (with or without supplemental oxygen) did not significantly impact EEG slow oscillation or spatial navigational memory, despite effectively reducing %SWS and SWS bout length. Greater regional EEG slow oscillation (0.6-1Hz), but not delta (1-4Hz) activity, was associated with improvements in overnight memory during stable SWS in the CPAP condition. These observations suggest that slow oscillations may be important for overnight memory processing, and sleep disruptions of sufficient magnitude to reduce slow oscillations may be required to capture demonstrable change in spatial navigation performance.
Performance Metrics of Cucumber Cultivars: Yield, Marketability, and Disease Susceptibility, Georgia, 2024
Authors: Kumari Manisha , Dutta Bhabesh , Kaur Navjot , McAvoy Theodore
Published: February 2025

Anthracnose, caused by Colletotrichum orbiculare, is a devastating disease affecting cucumber (Cucumis sativus) production, characterized by water-soaked lesions that eventually turn into brown spots. This study, conducted at the University of Georgia Tifton Campus in 2024, assessed eight cucumber cultivars for anthracnose resistance, total, marketable, unmarketable, and percent marketable yields. ‘Marketer’ was the susceptible check, while ‘H-19’ was used as the resistant check. Statistically significant differences were observed in yield metrics, with ‘Python’ exhibiting the highest total and marketable yields, and ‘H-19’ having the highest marketable percentage. No significant differences in anthracnose severity were found, indicating similar levels of disease resistance among the cultivars. Thus, the strategic selection of cultivars is paramount for optimizing cucumber production and effective disease management.
Assessment of Occupational Exposure in Some Radiology Departments in Ghana
Authors: Akyea-Larbi K.O. , Gbeddy Gustav , Amoatey Edith , Manteaw Philip , Otoo F.
Published: February 2025

Introduction: Medical workers account for about 75% of all workers exposed to ionizing radiation; therefore, occupational radiation protection is still a challenge in clinical practices and, consequently, measures should be put in place to optimize radiation in clinical practice. Objective: The aim of this study was to assess the occupational radiation dose for staff in some selected radiology departments in Ghana as a precursor for optimization studies. Methods: A total of 68 occupationally exposed workers (OEWs) radiation dose history for 5 facilities have been analyzed. This study is a retrospective study that involves the assessment of the dose records of occupational exposed workers in five radiology departments in the Greater Accra region of Ghana from the Radiation Protection Institute of the Ghana Atomic Energy Commission (GAEC) dose records history. The OEWs included in the study were radiographers/technologists, radiologist, physicians, medical physicists, and nurses. These records were collected and assessed for a period of 5 years (2019-2023). TLDs are worn under the lead aprons to estimate Hp (10) or deep dose and on aprons for Hp (0.07) or skin dose. Results: A total of 68 OEWs’ dose histories for 5 facilities have been analyzed. It was observed that the average annual effective dose for all workers throughout the study period ranged from 0.29 ± 0.07 mSv to 0.41 ± 0.05 mSv. The variations in the mean annual dose for the OEWs for the facilities in the study could be due to the number of OEWs that were monitored and the type and quantity of equipment at the facility during the year under review. Conclusion: The occupational radiation dose for OEWs in some selected radiological departments in Ghana have been evaluated. The facility with the highest number of OEWs recorded relatively higher mean annual effective dose. The annual effective doses were lesser than the yearly occupational dose limit of 20 mSv as recommended by national and international guidelines.
Assessing gastrointestinal system dysfunction in intensive care
Authors: Bachmann Kaspar F. , Asrani Varsha M. , Reintam Blaser Annika
Published: February 2025

Purpose of review

To summarize the current knowledge on the assessment of gastrointestinal dysfunction.

Recent findings

Clinical assessment is becoming more structured but remains largely subjective. Some instrumental tools to assess gastrointestinal motility have been developed but not yet widely applied in clinical practice. Imaging techniques offer a good method for static (i.e. nonfunctional) diagnostics but a standardized dynamic assessment at the bedside is currently unavailable. Recent studies on biomarkers have not provided convincing results for accurate evaluation of gastrointestinal function.

Clinical assessment remains the main tool for assessing gastrointestinal dysfunction. A single sign or symptom does not reflect gastrointestinal dysfunction adequately, and a set of variables might be needed. Studies on tools reflecting gastrointestinal motility and biomarkers for response to enteral nutrients, including absorption, are warranted.
Novel minimally invasive strategies for achieving source control in intra-abdominal infections
Authors: Wyland Clayton , Zeng Desmond , Sawyer Robert G.
Published: February 2025

Purpose of review

To provide an overview of recent advancements in minimally invasive intra-abdominal source control techniques.

Recent findings

There have been multiple recent advances in minimally invasive techniques for managing intra-abdominal infection or sepsis. Endoscopic based interventions include stenting, suturing, clip placement, and endoscopic vacuum therapy. Robotic surgery is becoming progressively more popular in emergency general surgery and offers comparable results compared to laparoscopic surgery with lower rates of conversion to open.

Endoscopic based interventions and minimally invasive surgery offer comparable outcomes to more invasive interventions with less morbidity for patients, though the ability to perform these techniques may not be limited to tertiary and quaternary health centers. Providers must use their clinical judgment to determine the best course of action.
Update on the management of acute liver failure
Authors: Nilsen Oliver , Fisher Caleb , Warrillow Stephen
Published: February 2025

Purpose of review

Acute liver failure (ALF) is a rare, life-threatening but potentially reversible clinical syndrome characterized by multiple organ failure secondary to the rapid loss of liver function. Key management challenges include severe cerebral oedema and complex treatments to support multiple organ failure. This review focuses on the fundamental principles of management and recent treatment advances.

Recent findings

Identifying the cause of ALF is key to guiding specific therapies. The early commencement of continuous renal replacement therapy (CRRT) to control hyperammonaemia can now be considered an important standard of care, and plasma exchange may have a role in the sickest of ALF patients; however, other blood purification modalities still lack supporting evidence. Close monitoring, regular investigations, careful attention to neuroprotective measures, as well as optimizing general physiological supports is essential. Where possible, patients should be transferred to a liver transplant centre to achieve the best chance of transplant-free survival, or to undergo emergency liver transplantation if required.

This review outlines current principles of ALF management, emerging treatment strategies, and a practical approach to management in the ICU. These recommendations can form the development of local guidelines, incorporating current best evidence for managing this rare but often lethal condition.
Efficacy of levothyroxine on growth and development in children with congenital hypothyroidism: A meta-analysis
Authors: Liang Wenguan , Tu Lin
Published: February 2025

Background:

The aim of this study is to systematically assess the efficacy of levothyroxine (L-T4) in the treatment of growth and development among children diagnosed with congenital hypothyroidism (CH) through meta-analysis, with the ultimate goal to provide clinicians with a more robust and effective evidence-based foundation for treatment decisions.

Methods:

We conducted a comprehensive search of relevant literature from both domestic and international resources, and meticulously screened out clinical studies which meet our inclusion criteria, that is without any time restrictions and the deadline was September 25, 2024, and the language was limited to English and Chinese only. Subsequently, we integrated and analyzed the data using standard meta-analysis methodologies under the Preferred Reporting Items for Systematic reviews and Meta-Analyses rules, aiming to derive more precise and reliable conclusions by summarizing and comparing the findings of multiple studies.

Results:

A total of 17 studies with 5 diagnostic indexes of IQ, height, weight, head circumference, and bone age were included, and these studies collectively reported on 1934 patients, with 951 and 983 patients, respectively being divided into the experimental and control group. The included studies were of high quality, and the results of our meta-analysis showed that L-T4 treatment could effectively promote the physical development of children with CH. Specifically, children in the experimental group had a higher level of IQ [mean difference [MD] = 8.38, 95% confidence intervals [CI] (6.89, 987)], height [MD = 6.71, 95% CI (6.08, 7.35)], weight [MD = 1.31, 95% CI (1.14, 1.49)], head circumference [MD = 3.83, 95% CI (3.52, 4.13)], and bone age [OR = 3.49, 95% CI (2.15, 5.68)] compared to those in the control group.

Conclusion:

L-T4 is an effective drug for the treatment with CH in children, which significantly promote their growth and development while improving thyroid function. This finding provides strong evidence and support for clinicians, contributing to the progress and advancement in the field of CH treatment.
Strongyloides stercoralis infection in a DLBCL patient treated with rituximab and BTK inhibitor: A case report and literature review
Authors: Liu Wanyi , Wang Zechuan , Wu Huiqiang , Zeng Lili , Cai Nina , Zhuang Weihuang , Guo Jianxin
Published: February 2025

Rationale:

Diffuse large B-cell lymphoma (DLBCL) is a common subtype of non-Hodgkin’s lymphoma characterized by high malignancy, rapid onset and aggressive clinical behavior. The disease exhibits considerable heterogeneity, which influences clinical and immunophenotypic characteristics, which in turn affect treatment outcomes and prognosis. Recently, targeted therapies have been introduced, offering improved therapeutic efficacy but with risks such as immunosuppression and opportunistic infections.

Patient concerns:

We report a case of a patient diagnosed with DLBCL who experienced immunosuppression as a result of treatment with rituximab and a Bruton’s tyrosine kinase inhibitor, which subsequently led to Strongyloides stercoralis infection.

Diagnoses:

The patient was diagnosed with S. stercoralis infection, confirmed by appropriate diagnostic tests after the onset of clinical symptoms suggestive of parasitic infection.

Interventions:

The patient was treated with a combination of rituximab and a Bruton’s tyrosine kinase inhibitor as part of her DLBCL therapy. Antiparasitic treatment was started after diagnosis of S. stercoralis infection.

Outcomes:

The patient’s infection was successfully managed with antiparasitic therapy, although the case highlights the need for vigilant monitoring of immunosuppressive therapy in patients with DLBCL due to the risk of opportunistic infections.

Lessons:

This case highlights the potential complications of targeted therapies in DLBCL, particularly the risk of opportunistic infections such as S. stercoralis. It highlights the importance of careful patient monitoring and prompt intervention to effectively manage such infections.
Job involvement in heavy manual or physical work associated with epigenetic age: A Mendelian randomization study
Authors: Sun Xiqiao
Published: February 2025

Engaging in heavy manual or physical work has been linked to various health outcomes, but its effect on physiological aging, as measured by epigenetic clocks, remains unclear. This study aims to analyze the causal relationship between heavy manual or physical work and epigenetic age acceleration using Mendelian randomization (MR). In this study, we explored the causal link between job involvement in heavy manual or physical work and epigenetic age acceleration measured by 4 different epigenetic clocks using 2-sample MR. Our analytical approach included inverse-variance weighting (IVW), MR-Egger, weighted median, and weighted mode methods. The primary analyses utilized IVW with random effects, supplemented by sensitivity and heterogeneity tests using both IVW and MR-Egger. MR-Egger was also applied for pleiotropy testing. Additionally, a leave-one-out analysis helped identify potentially impactful single-nucleotide polymorphisms. The analysis revealed a positive association between heavy manual or physical work and epigenetic clock acceleration. There statistically significant associations between heavy manual or physical work with a higher PhenoAge and HannumAge acceleration (β = 1.692, 95% CI [0.349 to 3.035], P = .013 for PhenoAge; β = 0.917, 95% CI [0.024 to 1.809], P = .044 for HannumAge, respectively). The heterogeneity test revealed that our IVW analysis exhibited minimal heterogeneity (P > .05), and the pleiotropy test findings confirmed the absence of pleiotropy within our IVW analysis (P > .05). Our study provides partial evidence for a causal effect between heavy manual or physical work and epigenetic age acceleration. Further experimental research is required to confirm these findings.
Gut microbiota and male fertility: A two-sample Mendelian randomization study
Authors: Wang Zhi-hong , Kang Yi-fan
Published: February 2025

Previous studies have reported that alterations in gut microbiota composition are associated with male fertility. However, it is unclear and difficult to establish whether these associations reflect a causal relationship. We assessed genome-wide association study summary statistics for gut microbiota and male fertility to perform MR analysis. Independent single nucleotide polymorphisms closely associated with 211 gut bacterial taxa (N = 122,110) were identified as instrumental variables. The summary statistic data for male infertility (N = 733,479), abnormal spermatozoa (N = 209,921) and erectile dysfunction (N = 223,805) were obtained from the latest release from the FinnGen consortium as the outcome of interest. Two-sample MR was performed to evaluate the causal effect of gut microbiota on male fertility, including inverse-variance-weighted (IVW) method, weighted median method, MR-Egger, mode-based estimation and MR-PRESSO. A series of sensitivity analyses was performed to validate the robustness of the results. The robustness of the estimation was tested by a series of sensitivity analyses including Cochran’s Q test, MR-Egger intercept analysis, leave-one-out analysis and funnel plot were used to assess the causal association. Combining the results from the discovery and replication stages, we identified 3 causal bacterial genus. Ruminiclostridm6 (OR = 0.537, 95%CI = 0.292–0.987, P = .045, PFDR = 0.234) was found to be closely associated with male infertility, and the decrease in its quantity increased the risk of male infertility. Decreased Prevotella9 (OR = 0.670, 95% CI = 0.452–0.992, P = .046, PFDR = 0.175) was found to be closely related to abnormal sperm. Lachnospiraceae NC2004 group (OR = 1.173, 95% CI = 1.008–1.366, P = .078, PFDR = 0.530) was found to be closely related to male erectile dysfunction, and there was a positive correlation between them. No heterogeneity and pleiotropy were detected. This study implied a causal relationship between the Ruminiclostridm6 genus, Prevotella9 genus, Lachnospiraceae NC2004 group genus and male fertility, thus providing novel insights into the gut microbiota-mediated development mechanism of ADs. Nevertheless, future studies are warranted to dissect the underlying mechanisms of specific bacterial taxa’s role in the pathophysiology of male fertility.
Associations between systemic inflammation response index and femur bone mineral density in adults: The NHANES 2005–2010, 2013–2014, and 2017–2018
Authors: Ye Xiaoang , Li Xinru , Zhu Chaojin , Cui Longkang , Shen Zhe , Xu Kuangying , Shen Gaobo , Wu Lianguo , Zhang Bingbing
Published: February 2025

A unique measure of inflammatory evaluation, the systemic inflammation response index (SIRI) may offer useful data for the diagnosis and risk assessment of a number of diseases. The aim of this study was to investigate the relationship between SIRI and femur bone mineral density (BMD) in US adults. The association between SIRI and femur BMD was examined using multivariate logistic regression, sensitivity analysis, and smoothing curve fitting using data from the National Health and Nutrition Examination Survey (NHANES) 2005–2010, 2013–2014, and 2017–2018. Subgroup analysis and interaction tests were employed to examine the population-level stability of this connection. This present study included 18,022 participants older than 20 years from NHANES (2005–2010, 2013–2014, and 2017–2018). The present study showed a negative association between SIRI and femur BMD (including total femur BMD, femoral neck BMD, trochanter BMD, and intertrochanter BMD). In the fully adjusted model, we found a negative association between the SIRI and total femur BMD (Beta = −0.0032, 95% CI: −0.0053 to −0.0012), a negative association between the SIRI and femoral neck BMD (Beta = −0.0025, 95% CI: −0.0045 to −0.0005), a negative association between the SIRI and trochanter BMD (Beta = −0.0032, 95% CI: −0.0050 to −0.0013), a negative association between the SIRI and intertrochanter BMD (Beta = −0.0031, 95% CI: −0.0056 to −0.0007). This negative association was more pronounced in older adults > 65 years of age. In addition, we found a U-shaped association between SIRI and femur BMD by further smoothing curve-fitting methods. SIRI was negatively associated with femur BMD in US adults, and this association was more significant in older adults over 65 years. SIRI may be a useful, convenient, and practical indicator of inflammation. Moreover, older adults with high SIRI levels are likely to have low femur BMD.
Examining the frequency of artificial intelligence generated content in anesthesiology and intensive care journal publications: A cross sectional study
Authors: Erel Selin , Erkocak Arabaci Ozge , Pampal Hasan Kutluk
Published: February 2025

The emergence of artificial intelligence (AI)-based linguistic models has revolutionized academic writing, prompting concerns about integrity. In response, AI-powered text authenticity detectors have been developed. This study examines AI tool usage in anesthesiology and intensive care journals. 1268 articles from 86 journals in “Anesthesiology” and “Anesthesiology and Intensive Care” were analyzed using Copyleaks and ZeroGPT. English abstracts published between April 18 and May 18, 2023, were scrutinized. ZeroGPT and Copyleaks found average AI usage at 25.1% ± 27.5 and 10.5% ± 15.9, respectively. 16.8% of articles were “human-written,” while 83.2% were “AI-assisted”. AI assistance correlated positively with abstract length and was more common among nonnative English speakers (P < .001). It was also prevalent in high-impact and science citation index-indexed journals (P < .01; P < .001). This study underscores the widespread adoption of AI tools in academic writing, particularly among nonnative English authors and in high-impact journals, emphasizing the need for improved detection mechanisms and regulatory guidelines.
Awareness of environmental risk factors contributing to asthma exacerbations among asthmatic patients in the Jazan region, Saudi Arabia
Authors: Alhazmi Luai , Oraibi Omar , Areeshi Areej , Alhazmi Nirmin , Hakami Alyaj , Kariri Talal , Akish Eyas , Alamer Abdullah , Sayed Ahmed , Madkhali Mohammed Ali , Somaili Mohammed , Altherwi Tawfeeq , Alhazmi Ahmed , Madkhali Mohammed A. , Hakami Abdulrahman
Published: February 2025

Bronchial asthma is a common chronic airway disease marked by reversible obstruction and bronchial hyperresponsiveness. Effective management relies on patient understanding of the condition and available treatments. This study aimed to assess awareness of asthma risk factors, exacerbations, and disease severity among the population in the Jazan region of Saudi Arabia. A cross-sectional observational study was conducted through social media platforms, targeting individuals from various cities in the Jazan region. A total of 633 participants completed structured questionnaires designed to assess their knowledge of asthma and its environmental risk factors. Data were analyzed using Statistical Package for the Social Sciences software. Out of the 633 participants, 506 (79.9%) demonstrated good awareness of the relationship between environmental risk factors and asthma exacerbations, while 127 (20.1%) exhibited poor awareness. Nearly all participants (99.2%) had prior knowledge of asthma, and 437 (69%) were aware of the link between environmental factors and exacerbations, making efforts to reduce exposure. House dust mites were identified as the most frequently reported cause of asthma exacerbations (69.5%), followed by respiratory infections (67.1%). A significant association was found between educational level and awareness of asthma’s environmental triggers (P = .020), with participants holding bachelor’s and diploma degrees showing higher levels of awareness compared to other educational groups. The overall level of awareness regarding environmental risk factors associated with asthma exacerbations was satisfactory, though gaps remain in understanding specific triggers such as respiratory infections, cold weather, and exercise. Educational attainment and a formal asthma diagnosis were significantly associated with greater awareness. Targeted educational interventions may help bridge these knowledge gaps, enhancing asthma management, and reducing exacerbations in the region.
Hybrid iterative reconstruction in ultra-low-dose CT for accurate pulmonary nodule assessment: A Phantom study
Authors: Chen Li-Guo , Kao Hung-Wen , Wu Ping-An , Sheu Ming-Huei , Tu Hsing-Yang , Huang Li-Chuan
Published: February 2025

This study evaluated hybrid iterative reconstruction in ultra-low-dose computed tomography (ULDCT) for solid pulmonary nodule detection. A 256-slice CT machine operating at 120 kVp imaged a chest phantom with 5 mm nodules. The imaging process involved adjusting low-dose computed tomography (LDCT) settings and conducting 3 ULDCT scans (A–C) with varied minimum and maximum mA settings (10/40 mA). Images were processed using iDose4 iterative reconstruction at levels 5 to 7. Measurements were taken for noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), noise power spectrum (NPS), and detectability index (D’) to assess image quality, noise texture, and detectability. Analysis of variance (ANOVA) was used to compare the protocols. Noise levels varied significantly across iDose4 iterative reconstruction levels, with the highest noise at 178 HU in iDose4 L5 (protocol C) and the lowest at 54.85 HU in level 7 (protocol A). ULDCT scans showed noise increases of 38.5%, 104.2%, and 118.7% for protocols A, B, and C, respectively, compared to LDCT. Protocol A (iDose4 level 7) significantly improved SNR and CNR (P < .001). The mean volume CT dose index was 2.4 mGy for LDCT and 2.0 mGy, 1.2 mGy, and 0.7 mGy for ULDCT protocols A, B, and C, respectively. Increasing iDose4 levels reduced noise magnitude in the NPS and improved the D’. ULDCT with iDose4 level 7 provides diagnostically acceptable image quality for solid pulmonary nodule assessment at significantly reduced radiation doses. This approach, supported by advanced metrics like NPS and D’, demonstrates a potential pathway for safer, effective lung cancer screening in high-risk populations. Further clinical studies are needed to validate these findings in diverse patient populations.
Warming with a composite warming strategy reduces intraoperative hypothermia in patients undergoing open hepatectomy for liver cancer: A randomized controlled study
Authors: Yi Nianxun , Wang Zhangling , Cui Ran
Published: February 2025

Background:

This study investigated the application of a composite warming strategy in the perioperative care of patients who underwent open hepatectomy for liver cancer. The clinical efficacy of the composite warming strategy was observed and analyzed, and the factors causing hypothermia were discussed.

Methods:

From January 2020 to December 2021, 80 patients were selected for the study. The control group adopted perioperative forced-air warming measures, while the experimental group implemented a composite warming strategy. The clinical data of the 2 groups of patients were compared, and the factors influencing intraoperative hypothermia were explored.

Results:

The incidence of hypothermia in the composite warming strategy group was significantly lower than that in the forced-air warming group (P = .015). There were no significant differences in sex, age, BMI, stage of liver cancer, presence of liver cirrhosis, chronic hepatitis, history of alcohol consumption, PLT, PT, pain score, length of hospital stay, etc, between the 2 groups (P > .05). However, there were significant differences in intraoperative fluid volume, anesthesia time, intraoperative blood loss, and PACU observation time (P < .05). Multivariate analysis revealed that intraoperative blood loss, intraoperative fluid replacement volume, and operation time were factors influencing intraoperative hypothermia (P < .05).

Conclusion:

The composite warming strategy plays a role in preventing hypothermia during open hepatectomy for liver cancer. The occurrence of hypothermia during open hepatectomy for liver cancer patients is related to intraoperative blood loss, intraoperative fluid replacement volume, and anesthesia time.
Causal association between gastroesophageal reflux disease and sepsis, and the mediating role of gut bacterial abundance, a Mendelian randomization study
Authors: Fu Zengyan , Jiang Zhenhong , Zhao Fei , Gou Tao , Jiang Le
Published: February 2025

Gastroesophageal reflux disease (GERD), akin to sepsis, is mediated by inflammatory reactions and exhibits a strong correlation with intestinal dysbiosis. We sought to examine whether these associations reflect causality using the Mendelian randomization (MR) mediation analysis. Genetic data were obtained from genome-wide association studies. Two-sample MR were performed to evaluate the causal association, accompanied by sensitivity analyses. Reverse direction MR was undertaken to assess the potential for reverse causation. Then, mediation analysis was performed to evaluate the mediating effect of gut bacterial pathway abundance in this relationship. Genetic predisposition to GERD was significantly associated with sepsis [inverse variance weighting: odds ratio = 1.366, P = 2.13E-09, 95% confidence interval [CI] 1.233–1.513] and sepsis-related 28-day mortality (inverse variance weighting: odds ratio = 1.412, P = 6.64E-03, 95% CI 1.101–1.812). There is no convincing evidence for reverse causation. Gut bacterial pathway abundance (ARO.PWY..chorismate.biosynthesis.I) mediates the effect of GERD on sepsis (β = 0.036, 95% CI 0.004–0.067, P = .025), accounting for 11.406% of the total effect; Gut bacterial pathway abundance (PWY.7219..adenosine.ribonucleotides.de.novo.biosynthesis) mediates the effect of GERD on sepsis (β = 0.026, 95% CI −0.003 to 0.056, P = .083), accounting for 8.486% of the total effect; gut bacterial pathway abundance (ARO.PWY..chorismate.biosynthesis.I) mediates the effect of GERD on sepsis (28-day death) (β = 0.079, 95% CI 0.005–0.153, P = .036), accounting for 22.890% of the total effect; gut bacterial pathway abundance (TRNA.CHARGING.PWY..tRNA.charging) mediates the effect of GERD on sepsis (28-day death) (β = −0.066, 95% CI −0.140 to 0.007, P = .078), accounting for −19.171% of the total effect. The present MR study supported GERD as a causal risk factor of sepsis and sepsis-related 28-day mortality. Three specific gut bacterial pathway abundances were identified that played a partial mediating role in the aforementioned causal relationship between GERD and sepsis.
Coronavirus disease 2019 vaccination and menstrual cycle changes: A cross-sectional study on females of reproductive age in Saudi Arabia
Authors: Eskandar Mamdoh , Alassim Alshaima , Riaz Fatima , Mahmood Syed Esam , Alshehri Nouf Khaled , Asim Ahmed Ali Al , Almodeer Mohamed , Ahmad Ausaf
Published: February 2025

Data supporting the evidence of changes in the menstrual cycle and premenstrual symptoms associated with coronavirus disease (COVID-19) is quite scarce. To determine the association between COVID-19 vaccination and menstrual cycle changes and its relationship with different types of vaccines among women of reproductive age in Abha City, Saudi Arabia. A cross-sectional study was conducted from January 2022 to June 2022, among participants from Asser region of Saudi Arabia by using a self-administered questionnaire through an electronic survey. Data analysis was performed using SPSS version 16.0. Among 1208 study subjects, majority (66.9%) of females had menarche at the age of <13 years, 17.2% had irregular periods, and 24.8% reported an average regularity of periods (23–35 days). A statistically significant association was found among females who experienced a change in their menstrual cycle after receiving COVID-19 vaccine. Mood swings and lower back pain were common symptoms of premenstrual syndrome symptoms. Only 15% females reported a delay in conception. Out of 176 females, 40% showed 6 month delay in conception after receiving vaccine. Multivariate logistic regression analysis showed that age, regularity of periods, and usual volume of bleeding were significantly associated with changes in the menstrual cycle after vaccination. The relationship between COVID-19 vaccine and associated changes on the menstrual cycle and premenstrual syndrome was established in our study. Further research is needed to produce concrete evidence regarding its relationship to eliminate vaccine hesitancy among women.