bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional connectome fingerprinting and stability in multiple sclerosis
Authors: Mantwill Maron , Asseyer Susanna , Chien Claudia , Kuchling Joseph , Schmitz-Hübsch Tanja , Brandt Alexander U , Haynes John-Dylan , Paul Friedemann , Finke Carsten
Published: August 2023

Background

Functional connectome fingerprinting can identify individuals based on their functional connectome. Previous studies relied mostly on short intervals between fMRI acquisitions.

Objective

This cohort study aimed to determine the stability of connectome-based identification and their underlying signatures in patients with multiple sclerosis and healthy individuals with long follow-up intervals.

Methods

We acquired resting-state fMRI in 70 patients with multiple sclerosis and 273 healthy individuals with long follow-up times (up to 4 and 9 years, respectively). Using functional connectome fingerprinting, we examined the stability of the connectome and additionally investigated which regions, connections and networks supported individual identification. Finally, we predicted cognitive and behavioural outcome based on functional connectivity.

Results

Multiple sclerosis patients showed connectome stability and identification accuracies similar to healthy individuals, with longer time delays between imaging sessions being associated with accuracies dropping from 89% to 76%. Lesion load, brain atrophy or cognitive impairment did not affect identification accuracies within the range of disease severity studied. Connections from the fronto-parietal and default mode network were consistently most distinctive, i.e., informative of identity. The functional connectivity also allowed the prediction of individual cognitive performances.

Conclusion

Our results demonstrate that discriminatory signatures in the functional connectome are stable over extended periods of time in multiple sclerosis, resulting in similar identification accuracies and distinctive long-lasting functional connectome fingerprinting signatures in patients and healthy individuals.
Three Approaches to Platform Studies: Cobweb, Billiard Balls, and Ant Societies
Authors: Qiu Jack Linchuan
Published: August 2023

Digital media platforms are becoming increasingly subject to the sway of geopolitics, as seen during the Russian invasion of Ukraine and the US-China trade war. How are platforms becoming geopoliticized? What perspectives shall we use to make sense of the process? This theoretical paper reformulates conceptual apparatuses of liberalism, realism, and constructivism, each represented by a metaphor: the cobweb, billiard balls, and ant societies, respectively. The approaches are introduced, critiqued, and compared to understand platform geopoliticization more historically and imaginatively on global as well as regional and local scales. The discussions propel platform studies to be grounded and multi-layered, concerning not only the apex of politico-economic power but also grassroots and communal praxis, for example, metis. While the pendulum is swinging from transnational capital to nation-states, it is insufficient to restrict our thinking to (neo)realism vis-à-vis (neo)liberalism. A moderate version of constructivism—the “ant societies” model—hence needs articulation, which holds important conceptual and methodological implications.
Sports Marketing and Conceptual Evolution: A Bibliometric Analysis
Authors: Shekhar Suraj Kushe , Shah Mohd Asif
Published: August 2023

Sports marketing is a branch of marketing that focuses on promoting sporting events and teams and advertising other products and services concerning sports. This study employs a bibliometric analysis of sports marketing based on Biblioshiny, a web interface for bibliometric analysis. Through a bibliometric examination of the existing literature in sports marketing, this study analyses the literature by addressing existing and emerging areas and advocating for more attention to the thriving sports sector. Results are interpreted under different sections like dataset, sources, authors, documents, clustering, conceptual structure, intellectual structure, and social structure. It is reported that sports marketing had piqued the interest of various marketing publications since its widespread adoption. The majority of the criteria and collaboration were found to be led by the USA. However, there was seldom any coordination among the several continents. More cooperation between continents is required to take advantage of sports marketing tactics around the world as there are numerous top leagues taking place in sports like football, cricket, and so on. It is suggested that to increase the visibility of sports marketing initiatives, more work is required in niche areas like sponsorship, attitude, image, sports knowledge, and so on. The limitations, implications, and future search areas are also suggested in the paper.
The Influence of Internship Year on Nursing Students’ Perceived Clinical Competence: A Multi-Site Study
Authors: Albloushi Monirah , Innab Adnan , Mofdy Almarwani Abdulaziz , Alqahtani Naji , Anazi Maryam , Roco Irene , Alzahrani Naif S.
Published: August 2023

This study aimed to explore the level of perceived clinical competence among undergraduate nursing students. This was a cross-sectional, comparative, study. Data were collected using the Clinical Competence Questionnaire. Study participants included fourth year and internship nursing students attending 1 of 39 public and private nursing programs in Saudi Arabia. A total of 244 nursing students completed the clinical competence questionnaire. Students reported the ability to perform some clinical skills in clinical settings under supervision. Intern students had higher clinical competence than fourth year students ( t = 2.792, p < .01). Year of education (β = .148, p < .05) and gender (β = .190, p < .01) were statistically significant to the prediction of perceived clinical competence level. The internship year facilitates the translation of theory into practice, which eventually may improve students’ clinical competence skills. Improving perceived clinical competencies might improve actual clinical competencies. Lastly, more qualitative research studies are needed to investigate the decreased perceived clinical competencies among male students compared female students.
Research on the Spatial Correlation and Influence Factors of Regional Internet Finance in China
Authors: Yu Haihua , Zhuo Zhiyi , Zhang Jing
Published: August 2023

Based on the Internet Finance development index developed by Peking University in investigating 31 provinces, we use social network analysis to investigate the spatial correlation and influencing factors of the Internet Finance of China’s provinces. The research shows that the spatial correlation of Internet Finance of China’s provinces has significant characteristics of a regional gradient. The correlation among their correlation is moderate, more closely related, smooth, or weak. All provinces gather to form four plates; they play their respective functional advantages and have different statuses, functions, and roles. The differences between provinces in industrial structure, degree of marketization, infrastructure, degree of informatization, and geographical distance significantly affect the spatial correlation of Internet finance development in China, and the degree of influence decreases in turn. Our results might positively affect policymakers in promoting the coordinated development of regional Internet finance in China.
Making Informed Decisions in the Volatile Crypto Market: An Analysis of Portfolio Risk and Return
Authors: Nuhiu Artor , Aliu Florin , Horák Jakub , Peci Bedri
Published: August 2023

Despite widespread skepticism linked to cryptocurrencies, they are constantly gaining the interest of scholars, investors, media, and regulators. Recognizing the importance that portfolio risk maintains for crypto participants, this study attempts to shed light on this issue. We investigate the risk-return tradeoffs of the most tradable cryptocurrencies based on portfolio diversification techniques. Three different crypto portfolios containing a diverse number of cryptocurrencies were created to analyze the diversification risk from a historical perspective. Data concerning daily prices and their trade volume was collected from the Coin Market Cap database and covered the period from 1 January 2016 to 31 December 2022. The results regarding the risk-reward tradeoff stand in line with the portfolio theory, where higher expected returns offset higher risk. On average, the portfolio composed of 10 cryptocurrencies offers better optimization than the one with five, as it generates the same returns with lower risk. The year 2018 reflects the maximum diversification benefits in the three portfolios, corresponding to the period when cryptocurrencies gained massive popularity. From the managerial perspective, results inform crypto and institutional investors of the possible diversification benefits of the 15 most traded cryptocurrencies.
Measurement and Analysis of the Scientific and Technological Innovation Efficiency of Industrial Enterprises above a Designated Scale in China
Authors: Lan Ma , Qi Wang , Dalei Wang
Published: August 2023

To explore the technological innovation efficiency of industrial enterprises above designated size and its influencing factors under the China’s economic census industry classification, using the stochastic frontier approach to estimates the innovation efficiency of the 34 industry from 2008 to 2018. Taking the sales revenue of new products as the dependent variable, R&D capital stock and R&D personnel equivalent are taken as the independent variable, control variables are reasonably selected. The characteristics and influencing factors of innovation efficiency between industries are analyzed. The results show that the innovation efficiency of all industries in China is steadily improving, and the difference between industries is gradually narrowing. Industries with high innovation efficiency are related to future competition and national economy and people’s livelihood, while industries with low innovation efficiency are concentrated in mining and supply industry. The low input and low output industries are in the majority. The influence of innovation capital input on output is greater than that of personnel input. The proportion of state-owned property rights and capital constraints have a negative effect on innovation output, while the sales income has a positive effect on innovation output. Therefore, China should further improve the innovation efficiency of industrial industries, adopt classified policies, and increase the number of industries with low input and high output. The conclusion of the paper is of reference value to the development of China’s 14th five-year industry and the medium and long term planning.
Still Separate and Unequal: Persistent Racial Segregation and Inequality in Subsidized Housing
Authors: Howell Junia , Whitehead Ellen , Korver-Glenn Elizabeth
Published: August 2023

Initially, U.S. federally funded low-income rental housing was racially segregated and unequal. Activists decried this injustice and pressured legislators to introduce new practices and procedures. Since the passage of these initiatives in the 1960s, scholars have repeatedly documented ongoing racial inequality in housing at large. Yet rarely have researchers investigated whether racial inequality persists within governmentally subsidized housing units. By merging the restricted American Housing Survey with the American Community Survey at a Federal Statistical Research Data Center, the authors find that low-income renter subsidies are effective and beneficial but disproportionately grant White residents access to cheaper and higher quality units. Moreover, subsidized renters remain racially segregated across program type and neighborhoods. The authors discuss the implications of these findings for future research and policy decisions.
Small vessel disease burden and risk of recurrent cerebrovascular events in patients with lacunar stroke and intracerebral haemorrhage attributable to deep perforator arteriolopathy
Authors: Goeldlin Martina B , Vynckier Jan , Mueller Madlaine , Drop Boudewijn , Maamari Basel , Vonlanthen Noah , Siepen Bernhard M , Hakim Arsany , Kaesmacher Johannes , Jesse Christopher Marvin , Mueller Mandy D , Meinel Thomas R , Beyeler Morin , Clénin Leander , Gralla Jan , Z’Graggen Werner , Bervini David , Arnold Marcel , Fischer Urs , Seiffge David J
Published: August 2023

Introduction:

Deep perforator arteriolopathy (DPA) causes intracerebral haemorrhage (ICH) and lacunar strokes (LS). We compare patient characteristics, MRI findings and clinical outcomes among patients with deep ICH and LS.

Patients and methods:

We included patients with MRI-confirmed LS or ICH in the basal ganglia, thalamus, internal capsule or brainstem from the Bernese Stroke Registry. We assessed MRI small vessel disease (SVD) markers, SVD burden score, modified Rankin Scale (mRS) and ischaemic stroke or ICH at 3 months.

Results:

We included 716 patients, 117 patients (16.3%) with deep ICH (mean age (SD) 65.1 (±15.2) years, 37.1% female) and 599 patients (83.7%) with LS (mean age (SD) 69.7 (±13.6) years, 39.9% female). Compared to LS, deep ICH was associated with a higher SVD burden score (median (IQR) 2 (1–2) vs 1 (0–2)), aORshift 3.19, 95%CI 2.15–4.75). Deep ICH patients had more often cerebral microbleeds (deep ICH: 71.6% vs LS: 29.2%, p < 0.001, median count (IQR) 4(2–12) vs 2(1–6)) and a higher prevalence of lacunes (deep ICH: 60.5% vs LS: 27.4% p < 0.001). At 3 months, deep ICH was associated with higher mRS (aORshift 2.16, 95%CI 1.21–3.87). Occurrence of ischaemic stroke was numerically but not significantly higher in deep ICH (4.3% vs 2.9%; p = 0.51). One patient (1.1%) with ICH but none with LS suffered ICH recurrence.

Discussion/Conclusion:

DPA manifesting as ICH is associated with more severe MRI SVD burden and worse outcome compared to LS. The short-term risks of subsequent ischaemic stroke and recurrent ICH are similar in ICH and LS patients. This implies potential consequences for future secondary prevention strategies.
Investigating the Correlation Between Clinical and Laboratory Findings With the Degree of the Fatty Liver Using Sonography in Pediatric Patients
Authors: Akhoundi Neda , Naseri Zahra , Hazara Reza , Siami Alireza , Hazara Sara , Ghadiri Asli Seyed Mohammadsadegh , Hazara Kobra
Published: August 2023

Objective:

The prevalence of fatty liver disease is increasing among children. The aim of this study was to investigate a possible association between clinical and laboratory findings with the degree of fatty liver deposition, in pediatric patients.

Materials and Methods:

This study enrolled 323 pediatric patients with suspected fatty liver disease, who underwent a liver sonogram. The amount of fatty infiltration, within the liver, was assessed. The clinical data include age and body mass index (BMI), which were collected from their medical records.

Results:

The liver sonogram revealed fatty infiltration in 212 (66%) of the patients. Of those patients, 120 (38%) displayed mild infiltration, 65 (20%) exhibited moderate infiltration, and 27 (8%) demonstrated severe infiltration. Patients with severe fatty infiltration had significantly higher levels of alanine aminotransferase (ALT). The different levels of aspartate aminotransferase (AST), among patients, with varied degrees of fatty infiltration, were not statistically significant.

Conclusion:

A liver sonogram can be utilized to assess liver damage and inflammation, in pediatric patients, with fatty liver disease. Sonographers should prioritize evaluating the liver size, hepatic vasculature, and liver parenchyma for signs of fatty infiltration. Monitoring ALT levels appears to be crucial in managing pediatric patients, with nonalcoholic fatty liver disease (NAFLD).
Dorsal visual stream and LIMK1: hemideletion, haplotype, and enduring effects in children with Williams syndrome
Authors: Kippenhan J. Shane , Gregory Michael D. , Nash Tiffany , Kohn Philip , Mervis Carolyn B. , Eisenberg Daniel P. , Garvey Madeline H. , Roe Katherine , Morris Colleen A. , Kolachana Bhaskar , Pani Ariel M. , Sorcher Leah , Berman Karen F.
Published: August 2023

Background

Williams syndrome (WS), a rare neurodevelopmental disorder caused by hemizygous deletion of ~ 25 genes from chromosomal band 7q11.23, affords an exceptional opportunity to study associations between a well-delineated genetic abnormality and a well-characterized neurobehavioral profile. Clinically, WS is typified by increased social drive (often termed “hypersociability”) and severe visuospatial construction deficits. Previous studies have linked visuospatial problems in WS with alterations in the dorsal visual processing stream. We investigated the impacts of hemideletion and haplotype variation of LIMK1, a gene hemideleted in WS and linked to neuronal maturation and migration, on the structure and function of the dorsal stream, specifically the intraparietal sulcus (IPS), a region known to be altered in adults with WS.

Methods

We tested for IPS structural and functional changes using longitudinal MRI in a developing cohort of children with WS (76 visits from 33 participants, compared to 280 visits from 94 typically developing age- and sex-matched participants) over the age range of 5–22. We also performed MRI studies of 12 individuals with rare, shorter hemideletions at 7q11.23, all of which included LIMK1. Finally, we tested for effects of LIMK1 variation on IPS structure and imputed LIMK1 expression in two independent cohorts of healthy individuals from the general population.

Results

IPS structural (p < 10−4 FDR corrected) and functional (p < .05 FDR corrected) anomalies previously reported in adults were confirmed in children with WS, and, consistent with an enduring genetic mechanism, were stable from early childhood into adulthood. In the short hemideletion cohort, IPS deficits similar to those in WS were found, although effect sizes were smaller than those found in WS for both structural and functional findings. Finally, in each of the two general population cohorts stratified by LIMK1 haplotype, IPS gray matter volume (pdiscovery < 0.05 SVC, preplication = 0.0015) and imputed LIMK1 expression (pdiscovery = 10−15, preplication = 10−23) varied according to LIMK1 haplotype.

Conclusions

This work offers insight into neurobiological and genetic mechanisms responsible for the WS phenotype and also more generally provides a striking example of the mechanisms by which genetic variation, acting by means of molecular effects on a neural intermediary, can influence human cognition and, in some cases, lead to neurocognitive disorders.
Mass spectrometry-based proteomics as an emerging tool in clinical laboratories
Authors: Birhanu Alemayehu Godana
Published: August 2023

Mass spectrometry (MS)-based proteomics have been increasingly implemented in various disciplines of laboratory medicine to identify and quantify biomolecules in a variety of biological specimens. MS-based proteomics is continuously expanding and widely applied in biomarker discovery for early detection, prognosis and markers for treatment response prediction and monitoring. Furthermore, making these advanced tests more accessible and affordable will have the greatest healthcare benefit.

This review article highlights the new paradigms MS-based clinical proteomics has created in microbiology laboratories, cancer research and diagnosis of metabolic disorders. The technique is preferred over conventional methods in disease detection and therapy monitoring for its combined advantages in multiplexing capacity, remarkable analytical specificity and sensitivity and low turnaround time.

Despite the achievements in the development and adoption of a number of MS-based clinical proteomics practices, more are expected to undergo transition from bench to bedside in the near future. The review provides insights from early trials and recent progresses (mainly covering literature from the NCBI database) in the application of proteomics in clinical laboratories.
Haplotype based testing for a better understanding of the selective architecture
Authors: Chen Haoyu , Pelizzola Marta , Futschik Andreas
Published: August 2023

Background

The identification of genomic regions affected by selection is one of the most important goals in population genetics. If temporal data are available, allele frequency changes at SNP positions are often used for this purpose. Here we provide a new testing approach that uses haplotype frequencies instead of allele frequencies.

Results

Using simulated data, we show that compared to SNP based test, our approach has higher power, especially when the number of candidate haplotypes is small or moderate. To improve power when the number of haplotypes is large, we investigate methods to combine them with a moderate number of haplotype subsets. Haplotype frequencies can often be recovered with less noise than SNP frequencies, especially under pool sequencing, giving our test an additional advantage. Furthermore, spurious outlier SNPs may lead to false positives, a problem usually not encountered when working with haplotypes. Post hoc tests for the number of selected haplotypes and for differences between their selection coefficients are also provided for a better understanding of the underlying selection dynamics. An application on a real data set further illustrates the performance benefits.

Conclusions

Due to less multiple testing correction and noise reduction, haplotype based testing is able to outperform SNP based tests in terms of power in most scenarios.
Outcome of interventions to improve the quality of intrapartum care in Nigeria’s referral hospitals: a quasi-experimental research design
Authors: Okonofua Friday , Ntoimo Lorretta Favour , Ekezue Bola , Ohenhen Victor , Agholor Kingsley , Imongan Wilson , Ogu Rosemary , Galadanci Hadiza
Published: August 2023

Background

Evidence indicates that Nigeria’s high maternal mortality rate is attributable primarily to events that occur during the intrapartum period. This study determines the effectiveness of multifaceted interventions in improving the quality of intrapartum care in Nigeria’s referral hospitals.

Methods

Data collected through an exit interview with 752 women who received intrapartum care in intervention and control hospitals were analyzed. The interventions were designed to improve the quality indicators in the WHO recommendations for positive childbirth and assessed using 12 quality indicators. Univariate, bivariate, Poisson, and logistic regression analyses were used to compare twelve quality indicators at intervention and control hospitals.

Results

The interventions showed a 6% increase in composite score of quality of care indicators at intervention compared with control hospitals. Five signal functions of intrapartum care assessed were significantly (< 0.001) better at intervention hospitals. Quality scores for segments of intervention periods compared to baseline were higher at intervention than in control hospitals.

Conclusions

We conclude that multiple interventions that address various components of the quality of intrapartum care in Nigeria’s referral hospitals have demonstrated effectiveness. The interventions improved five of ten quality indicators. We believe that this approach to developing interventions based on formative research is important, but a process of integrating the implementation activities with the normal maternal health delivery processes in the hospitals will enhance the effectiveness of this approach.

Trial registration

The study was registered at the Nigeria Clinical Trials Registry. Trial Registration Number NCTR No: 91,540,209 (14/04/2016) http://www.nctr.nhrec.net/ and retrospectively with the ISRCTN. Trial Registration Number 64 ISRCTN17985403 (14/08/2020) https://doi.org/10.1186/ISRCTN17985403.
Uterus-preserving surgical management of placenta accreta spectrum disorder: a large retrospective study
Authors: Pan Wenxia , Chen Juan , Zou Yinrui , Yang Kun , Liu Qingfeng , Sun Meiying , Li Dan , Zhang Ping , Yue Shixia , Huang Yuqiang , Wang Zhaoxi
Published: August 2023

Background

The two-child policy implemented in China resulted in a surge of high-risk pregnancies among advanced maternal aged women and presented a window of opportunity to identify a large number of placenta accreta spectrum (PAS) cases, which often invoke severe blood loss and hysterectomy. We thus had an opportunity to evaluate the surgical outcomes of a unique conservative PAS management strategy for uterus preservation, and the impacts of magnetic resonance imaging (MRI) in PAS surgical planning.

Methods

Cross-sectional study, comparing the outcomes of a new uterine artery ligation combined with clover suturing technique (UAL + CST) with the existing conservative surgical approaches in a maternal public hospital with an annual birth of more than 20,000 neonates among all placenta previa cases suspecting of PAS between January 1, 2015 and December 31, 2018.

Results

From a total of 89,397 live births, we identified 210 PAS cases from 400 singleton pregnancies with placenta previa. Aside from 2 self-requested natural births (low-lying placenta), all PAS cases had safe cesarean deliveries without any total hysterectomy. Compared with the existing approaches, the evaluated UAL + CST had a significant reduction in intraoperative blood loss (β=-312 ml, P < .001), RBC transfusion (β=-1.08 unit, P = .001), but required more surgery time (β = 16.43 min, P = .01). MRI-measured placenta thickness, when above 50 mm, can increase blood loss (β = 315 ml, P = .01), RBC transfusion (β = 1.28 unit, P = .01), surgery time (β = 48.84 min, P < .001) and hospital stay (β = 2.58 day, P < .001). A majority of percreta patients resumed normal menstrual cycle within 12 months with normal menstrual fluid volume, without abnormal urination or defecation.

Conclusions

A conservative surgical management approach of UAL + CST for PAS is safe and effective with a low complication rate. MRI might be useful for planning PAS surgery.

Clinical trial registration number

: ChiCTR2000035202.
Clinical presentations and outcomes of pancreaticobiliary maljunction in different pediatric age groups
Authors: Mao Hui-min , Huang Shun-gen , Yang Yang , Cai Tian-na , Fang Lin , Guo Wan-liang
Published: August 2023

Background

Pancreaticobiliary maljunction (PBM) is a congenital defect, with risk of developing various pancreaticobiliary and hepatic complications. The presentations of PBM in children and adults are believed to be different, but studies on PBM children of different age groups are limited. This study was to evaluate clinicopathologic characteristics and outcomes in PBM children of different ages.

Methods

A total of 166 pediatric patients with PBM were reviewed retrospectively. Clinicopathological, imaging, laboratory, surgical, and follow-up data were collected and analyzed. The patients were divided into three age groups, namely, group A (< 1 year, n = 31), group B (1–3 years, n = 63), and group C (> 3 years, n = 72).

Results

The major clinical manifestation was jaundice in group A and abdominal pain and vomiting in groups B and C. Acute pancreatitis was more often seen in group C than group A. The length of common channel was significantly longer in group C than group A, while the maximum diameter of common bile duct in group C was smaller than that in group A. Cholangitis and cholecystitis were more commonly performed in groups B and C, while hepatic fibrosis in group A. Whether preoperatively or postoperatively, group C was more likely to have elevated serum amylase, while groups A and B were more likely to present with abnormal liver function indicators, including the increase of aspartate transaminase, alanine transaminase, and gamma-glutamyl transpeptidase.

Conclusion

Presentation of PBM varies among different pediatric age groups, thus suggesting that targeted management should be carried out according to these differences.
The potential of cystatin C as a predictive biomarker in pulmonary hypertension
Authors: Duan Anqi , Huang Zhihua , Zhao Zhihui , Zhao Qing , Jin Qi , Yan Lu , Zhang Yi , Li Xin , Zhang Sicheng , Hu Meixi , Gao Luyang , An Chenhong , Luo Qin , Liu Zhihong
Published: August 2023

Background

Cystatin C is a novel biomarker to identify renal dysfunction and cardiovascular risk.

Objective

The aim of this study was to investigate the role of cystatin C in non-invasive risk prediction in a large cohort of patients with pre-capillary pulmonary hypertension (PH).

Method

We retrospectively analyzed pre-capillary PH patients with available cystatin C and hemodynamic data derived from right heart catheterization.

Results

A total of 398 consecutive patients with confirmed pre-capillary PH were recruited from Fuwai Hospital between November 2020 and November 2021. Over a median duration of 282 days, 72 (18.1%) of these patients experienced clinical worsening. Cystatin C levels significantly correlated with cardiac index (r = -0.286, P < 0.001), mixed venous oxygen saturation (r = -0.216, P < 0.001), and tricuspid annular plane systolic excursion (r = -0.236, P < 0.001), and high cystatin C levels independently predicted a poor prognosis after adjusting potential confounders in different models (all P < 0.05). A three-group non-invasive risk model was constructed based on the combined assessment of the cystatin C and WHO-FC using dichotomous cut-off value. Those patients with higher cystatin C (≥ 1.0 mg/L) and a worse WHO-FC experienced the highest risk of endpoint occurrence. The predictive capacity of this model was comparable to that of an existing invasive risk stratification model (area under curve: 0.657 vs 0.643, P = 0.619).

Conclusions

Cystatin C levels were associated with disease severity and prognosis in patients with pre-capillary PH. A combination of high cystatin C and advanced WHO-FC identifies patients at particularly high risk of clinical deterioration.
Assessing lateral femoral condyle cartilage prior to medial UKA: MRI vs. Valgus stress radiograph
Authors: Jiao Xufeng , Cao Guanglei , Wu Jiangpeng , Li Zheng , An Shuai , Huang Jiang
Published: August 2023

Background

The cartilage quality of the lateral compartment needs to be clarified prior to medial unicompartmental knee arthroplasty (UKA). Valgus stress radiograph has been recommended as the preferred tool. Some studies also show that magnetic resonance imaging (MRI) has a higher diagnostic value. So, we conducted this study to compare whether valgus stress radiographic lateral joint space width (LJSW) and MRI grading can accurately reflect cartilage quality and its screening value for UKA-suitable patients.

Methods

One hundred and thirty eight knees proposed for UKA were enrolled prospectively. Valgus stress radiograph was taken to measure LJSW. LJSW > 4 mm was considered normal and suitable for UKA. For weight-bearing area cartilage of lateral femoral condyle, Recht grade was assessed by MRI preoperatively. Recht grades ≤ 2 were treated as non-high-grade injuries while Recht grades > 2 were treated as high-grade injuries. Outerbridge grade was the gold standard and was assessed intraoperatively. Patients with Outerbridge grades 0–2 (non-high-grade injuries) underwent UKA, and patients with Outerbridge grades 3–4 (high-grade injuries) underwent total knee arthroplasty (TKA). The diagnostic parameters of valgus stress radiograph and MRI for the selection of UKA candidates were calculated, and receiver operating characteristic curves were drawn. P < 0.05 was considered significant.

Results

Of 138 knees, 120 underwent UKAs, and 18 underwent TKAs. In terms of selecting UKA candidates, the sensitivity was close between MRI (95.0%) and valgus stress radiograph (96.7%), and the specificity, accuracy, positive predictive value and negative predictive value of MRI (94.4%, 94.9%, 99.1%, 73.9%, respectively) were higher than that of valgus stress radiograph (5.9%, 85.5%, 88.0%, 20.0%, respectively). The difference in area under the curve (AUC) between MRI (0.950) and LJSW (0.602) was significant (P = 0.001).

Conclusion

Compared with valgus stress radiograph, MRI has excellent evaluation value in diagnosing lateral weight-bearing cartilage injuries and can be used as a reliable tool for selecting suitable UKA patients.
Extrusion of the medial meniscus under a weight-loading condition in early knee osteoarthritis: an investigation using special upright magnetic resonance imaging
Authors: Shimozaki Kengo , Nakase Junsuke , Kanayama Tomoyuki , Yanatori Yusuke , Ishida Yoshihiro , Ohno Naoki , Miyati Tosiaki , Tsuchiya Hiroyuki
Published: August 2023

Background

Whether the medial meniscus morphology and movement occur under upright loading conditions in early knee osteoarthritis (OA) or medial meniscus posterior root tear (MMPRT) remains unknown. This study aimed to evaluate the medial and anteroposterior extrusion of the medial meniscus under unloaded and upright-loaded conditions in patients with early knee OA.

Methods

Twelve patients with early knee OA and 18 healthy adult volunteers participated in this study. Magnetic resonance imaging using special equipment was performed with the participants in the unloaded and upright-loaded conditions. Medial, anterior, and posterior extrusions of the medial meniscus against the tibial edge were evaluated and compared between the early knee OA and healthy adult control groups. Additionally, 12 patients in the early knee OA group were divided into 2 subgroups based on whether MMPRT was observed, and the extrusion of the medial meniscus was compared.

Results

The amount of medial extrusion of the medial meniscus in both the unloaded and upright-loaded conditions was significantly greater in the early knee OA group than in the control group (unloaded: 2.6 ± 1.0 mm vs 0.7 ± 0.5 mm; upright-loaded: 3.7 ± 0.9 mm vs 1.8 ± 0.8 mm). Similarly, the anterior and posterior extrusion of the medial meniscus in the upright-loaded condition was significantly larger in the early knee OA group (anterior: 4.6 ± 1.0 mm vs 3.7 ± 1.1 mm; posterior: -3.4 ± 1.1 mm vs -4.6 ± 1.6 mm). However, no difference was observed in meniscal extrusion between unloaded and upright-loaded conditions. The posterior extrusion of the medial meniscus in the upright-loaded condition was significantly greater in MMPRT cases than in non-MMPRT cases in the early knee OA group (MMPRT: -2.7 ± 1.1 mm; non-MMPRT -4.1 ± 1.5 mm).

Conclusions

In early knee OA, significantly large meniscal extrusions of the medial meniscus in both unloaded and upright-loaded conditions were found compared with healthy adults. Among patients with early knee OA, those with MMPRT showed a large posterior extrusion of the medial meniscus in the upright-loaded condition compared with those without MMPRT.

Level of evidence

Level IV.
Re-investigation of functional gastrointestinal disorders utilizing a machine learning approach
Authors: Mousavi Elahe , Keshteli Ammar Hasanzadeh , Sehhati Mohammadreza , Vaez Ahmad , Adibi Peyman
Published: August 2023

Background

Functional gastrointestinal disorders (FGIDs), as a group of syndromes with no identified structural or pathophysiological biomarkers, are currently classified by Rome criteria based on gastrointestinal symptoms (GI). However, the high overlap among FGIDs in patients makes treatment and identifying underlying mechanisms challenging. Furthermore, disregarding psychological factors in the current classification, despite their approved relationship with GI symptoms, underlines the necessity of more investigation into grouping FGID patients. We aimed to provide more homogenous and well-separated clusters based on both GI and psychological characteristics for patients with FGIDs using an unsupervised machine learning algorithm.

Methods

Based on a cross-sectional study, 3765 (79%) patients with at least one FGID were included in the current study. In the first step, the clustering utilizing a machine learning algorithm was merely executed based on GI symptoms. In the second step, considering the previous step's results and focusing on the clusters with a diverse combination of GI symptoms, the clustering was re-conducted based on both GI symptoms and psychological factors.

Results

The first phase clustering of all participants based on GI symptoms resulted in the formation of pure and non-pure clusters. Pure clusters exactly illustrated the properties of most pure Rome syndromes. Re-clustering the members of the non-pure clusters based on GI and psychological factors (i.e., the second clustering step) resulted in eight new clusters, indicating the dominance of multiple factors but well-discriminated from other clusters. The results of the second step especially highlight the impact of psychological factors in grouping FGIDs.

Conclusions

In the current study, the existence of Rome disorders, which were previously defined by expert opinion-based consensus, was approved, and, eight new clusters with multiple dominant symptoms based on GI and psychological factors were also introduced. The more homogeneous clusters of patients could lead to the design of more precise clinical experiments and further targeted patient care.
Identification and prediction model of placenta-brain axis genes associated with neurodevelopmental delay in moderate and late preterm children
Authors: Zhu Yumin , Zhang Yimin , Jin Yunfan , Jin Heyue , Huang Kun , Tong Juan , Gan Hong , Rui Chen , Lv Jia , Wang Xianyan , Wang Qu’nan , Tao Fangbiao
Published: August 2023

Background

Moderate and late preterm (MLPT) birth accounts for the vast majority of preterm births, which is a global public health problem. The association between MLPT and neurobehavioral developmental delays in children and the underlying biological mechanisms need to be further revealed. The “placenta-brain axis” (PBA) provides a new perspective for gene regulation and risk prediction of neurodevelopmental delays in MLPT children.

Methods

The authors performed multivariate logistic regression models between MLPT and children’s neurodevelopmental outcomes, using data from 129 MLPT infants and 3136 full-term controls from the Ma’anshan Birth Cohort (MABC). Furthermore, the authors identified the abnormally regulated PBA-related genes in MLPT placenta by bioinformatics analysis of RNA-seq data and RT-qPCR verification on independent samples. Finally, the authors established the prediction model of neurodevelopmental delay in children with MLPT using multiple machine learning models.

Results

The authors found an increased risk of neurodevelopmental delay in children with MLPT at 6 months, 18 months, and 48 months, especially in boys. Further verification showed that APOE and CST3 genes were significantly correlated with the developmental levels of gross-motor domain, fine-motor domain, and personal social domain in 6-month-old male MLPT children.

Conclusions

These findings suggested that there was a sex-specific association between MLPT and neurodevelopmental delays. Moreover, APOE and CST3 were identified as placental biomarkers. The results provided guidance for the etiology investigation, risk prediction, and early intervention of neurodevelopmental delays in children with MLPT.
Insulin resistance estimated by estimated glucose disposal rate predicts outcomes in acute ischemic stroke patients
Authors: Lu Zhengzhao , Xiong Yunyun , Feng Xueyan , Yang Kaixuan , Gu Hongqiu , Zhao Xingquan , Meng Xia , Wang Yongjun
Published: August 2023

Background

Estimated glucose disposal rate (eGDR), a simple and noninvasive measure of insulin resistance, has been proven to be an independent risk factor for first-time stroke and all-cause mortality. In this study, we aimed to investigate the associations between eGDR and the stroke outcome in patients with first-time acute ischemic stroke (AIS).

Methods

We included first-time AIS patients with available data on eGDR in the China National Stroke Registry III (CNSR-III), and divided the subjects into lower eGDR group (eGDR ≤ 6 mg/kg/min) and higher eGDR group (eGDR > 6 mg/kg/min). The primary outcome was excellent functional outcome (modified Rankin Scale score 0–1) at 3 months. Secondary outcomes included stroke recurrence and favorable functional outcome (modified Rankin Scale score 0–2) at 3 months, and functional outcome and combined vascular event at one year. Univariate and multivariate analyses were performed to evaluate the association between eGDR and outcomes.

Results

A total of 6,271 patients with AIS were included in this study. The median values of eGDR in lower and higher eGDR group were 5.0 mg/kg/min (interquartile range, 4.2–5.6) and 7.6 mg/kg/min (interquartile range, 6.8–9.6), respectively. Patients with higher eGDR were significantly associated with higher incidence of excellent functional outcome (adjusted odds ratio, 1.24; 95% confidence interval, 1.06–1.45; P < 0.01) at 3 months and favorable (adjusted odds ratio, 1.55; 95% confidence interval, 1.24–1.93; P < 0.01) and excellent (adjusted odds ratio, 1.28; 95% confidence interval, 1.08–1.51; P < 0.01) functional outcome at one year. However, there was no significant difference in stroke recurrence between these two groups at 3 months (adjusted odds ratio, 0.81; 95% confidence interval, 0.61–1.06; P = 0.12) and one year (adjusted odds ratio, 0.91; 95% confidence interval, 0.73–1.14; P = 0.41).

Conclusion

eGDR is a predictor of functional outcome in patients with AIS, independent of traditional cardiovascular predictors.
Advances in preparation and application of antibacterial hydrogels
Authors: Tang Yixin , Xu Huiqing , Wang Xue , Dong Shuhan , Guo Lei , Zhang Shichen , Yang Xi , Liu Chang , Jiang Xin , Kan Mujie , Wu Shanli , Zhang Jizhou , Xu Caina
Published: August 2023

Bacterial infections, especially those caused by drug-resistant bacteria, have seriously threatened human life and health. There is urgent to develop new antibacterial agents to reduce the problem of antibiotics. Biomedical materials with good antimicrobial properties have been widely used in antibacterial applications. Among them, hydrogels have become the focus of research in the field of biomedical materials due to their unique three-dimensional network structure, high hydrophilicity, and good biocompatibility. In this review, the latest research progresses about hydrogels in recent years were summarized, mainly including the preparation methods of hydrogels and their antibacterial applications. According to their different antibacterial mechanisms, several representative antibacterial hydrogels were introduced, such as antibiotics loaded hydrogels, antibiotic-free hydrogels including metal-based hydrogels, antibacterial peptide and antibacterial polymers, stimuli-responsive smart hydrogels, and light-mediated hydrogels. In addition, we also discussed the applications and challenges of antibacterial hydrogels in biomedicine, which are expected to provide new directions and ideas for the application of hydrogels in clinical antibacterial therapy.
Biomimetic nanovesicle co-delivery system impairs energy metabolism for cancer treatment
Authors: Zhao Yongmei , Zhu Yan , Ding Kai , Li Shanshan , Liu Tianqing
Published: August 2023

Metabolic reprogramming in cancer cells plays a crucial role in cancer development, metastasis and invasion. Cancer cells have a unique metabolism profile that could switch between glycolysis and oxidative phosphorylation (OXPHOS) in order to satisfy a higher proliferative rate and enable survival in tumor microenvironment. Although dietary-based cancer starvation therapy has shown some positive outcomes for cancer treatment, it is difficult for patients to persist for a long time due to the adverse effects. Here in this study, we developed a specific M1 macrophage-derived membrane-based drug delivery system for breast cancer treatment. Both metformin and 3-Bromopyruvate were loaded into the engineered cell membrane-based biomimetic carriers (Met-3BP-Lip@M1) for the shutdown of energy metabolism in cancer cells via simultaneous inhibition of both glycolysis and oxygen consumption. The in vitro studies showed that Met-3BP-Lip@M1 had excellent cancer cell uptake and enhanced cancer cell apoptosis via cell cycle arrest. Our results also demonstrated that this novel biomimetic nanomedicine-based cancer starvation therapy synergistically improved the therapeutic efficiency against breast cancer cells by blocking energy metabolic pathways, which resulted in a significant reduction of cancer cell proliferation, 3D tumor spheroid growth as well as in vivo tumor growth.
Application of biomedical materials in the diagnosis and treatment of myocardial infarction
Authors: Zhang Jiahui , Guo Yishan , Bai Yu , Wei Yumiao
Published: August 2023

Myocardial infarction (MI) is a cardiovascular emergency and the leading cause of death worldwide. Inflammatory and immune responses are initiated immediately after MI, leading to myocardial death, scarring, and ventricular remodeling. Current therapeutic approaches emphasize early restoration of ischemic myocardial reperfusion, but there is no effective treatment for the pathological changes of infarction. Biomedical materials development has brought new hope for MI diagnosis and treatment. Biomedical materials, such as cardiac patches, hydrogels, nano biomaterials, and artificial blood vessels, have played an irreplaceable role in MI diagnosis and treatment. They improve the accuracy and efficacy of MI diagnosis and offer further possibilities for reducing inflammation, immunomodulation, inhibiting fibrosis, and cardiac regeneration. This review focuses on the advances in biomedical materials applications in MI diagnosis and treatment. The current studies are outlined in terms of mechanisms of action and effects. It is addressed how biomedical materials application can lessen myocardial damage, encourage angiogenesis, and enhance heart function. Their clinical transformation value and application prospect are discussed.
Diagnostic value of the combination of DAPK methylation in urinary sediment and B ultrasound for recurrent urinary bladder cancer
Authors: Wang Dawen , Qiu Zhilei , Wu Changli
Published: August 2023

Background

Urinary bladder cancer (UBC) is the most common malignancy affecting the urinary system. This study aimed to investigate the diagnostic value of combining DAPK methylation in urinary sediment and B ultrasound in the detection of recurrent UBC.

Methods

A total of 1021 cases with primary UBC who underwent electrocision of bladder tumor through urethra were included in this study and followed up. Various parameters including B ultrasound, DAPK methylation in urinary sediment, examination of exfoliated cells in the urine, and cystoscopy were performed. The data collected was analyzed using the Kappa test, and receiver operating characteristic (ROC) curve was constructed to assess the diagnostic role in recurrent UBC.

Results

Among the 1021 patients, 115 patients experienced recurrence confirmed by cystoscopy and biopsy within two years and were excluded from the study, resulting in an effective sample size of 906 primary UBC cases. The results of cystoscopy showed agreement with B ultrasound (Kappa = 0.785, P < 0.05), as well as with DAPK methylation in urinary sediment, and the combination of B ultrasound and DAPK methylation (Kappa = 0.517, P < 0.05, Kappa = 0.593, P < 0.05). The combination of B ultrasound with DAPK methylation yielded an area under the curve of 0.922, with a sensitivity of 92.86%, specificity of 91.63%, and a negative predictive value of 99.4%, suggesting that a negative result indicates a low risk of recurrence.

Conclusion

The combination of DAPK methylation in urinary sediment with B ultrasound demonstrates high diagnostic performance for recurrent UBC.