bluuebunny/crossref_metadata_2025 huggingface dataset:
Immunological profiling for short-term predictive analysis in PD-1/PD-L1 therapy for lung cancer
Authors: Wang Yun , Chen Rujia , Guo Zhenzhou , Wei Wei , Wang Ting , Ouyang Renren , Yuan Xu , Xing Yutong , Wang Feng , Wu Shiji , Hou Hongyan
Published: July 2024

Background

Immune checkpoint inhibitors, such as anti-programmed cell death-1 (PD-1) and PD-1 ligand-1 (PD-L1) antibodies, have achieved breakthrough results in improving long-term survival rates in lung cancer. Although high levels of PD-L1 expression and tumor mutational burden have emerged as pivotal biomarkers, not all patients derive lasting benefits, and resistance to immune checkpoint blockade remains a prevalent issue. Comprehending the immunological intricacies of lung cancer is crucial for uncovering the mechanisms that govern responses and resistance to immunomodulatory treatments. This study aimed to explore the potential of peripheral immune markers in predicting treatment efficiency among lung cancer patients undergoing PD-1/PD-L1 checkpoint inhibitors.

Methods

This study enrolled 71 lung cancer patients undergoing PD-1/PD-L1 inhibitor therapy and 20 healthy controls. Immune cell subsets (CD4 + T cells, CD8 + T cells, B cells, NK cells, and NKT cells), phenotypic analysis of T cells and B cells, and PMA/Ionomycin-stimulated lymphocyte function assay were conducted.

Results

Lung cancer patients exhibited significant alterations in immune cell subsets, notably an increased percentage of Treg cells. Post-treatment, there were substantial increases in absolute numbers of CD3 + T cells, CD8 + T cells, and NKT cells, along with heightened HLA-DR expression on CD3 + T and CD8 + T cells. Comparison between complete remission and non-complete remission (NCR) groups showed higher Treg cell percentages and HLA-DR + CD4 + T cells in the NCR group.

Conclusion

The study findings suggest potential predictive roles for immune cell subsets and phenotypes, particularly Treg cells, HLA-DR + CD4 + T cells, and naïve CD4 + T cells, in evaluating short-term PD-1/PD-L1 therapy efficacy for lung cancer patients. These insights offer valuable prospects for personalized treatment strategies and underscore the importance of immune profiling in lung cancer immunotherapy.
Combination of neoadjuvant and adjuvant chemotherapy with FOLFOX compared with adjuvant chemotherapy in management of locally advanced rectal cancers: a randomized trial of a promising therapeutic approach
Authors: Biniaz Mandana , Moradi Arash , Basit Manouchehr Ghorbanpour , Pashaki Abdol-Azim Seddighi , Dehghan Arash , Mohammadian Kamal
Published: July 2024

Background

Colorectal cancer (CRC) is a significant malignancy with widespread implications. Despite progress in surgical interventions for rectal cancer, improvements in overall prognosis remain disproportionate. Standard preoperative chemoradiation, while established as the standard treatment for the majority of rectal cancers, exhibits limited effectiveness in enhancing disease-free survival (DFS) and mitigating distant metastases, particularly in cases of locally advanced rectal cancer (LARC).

Methods

This randomised clinical trial assessed 286 patients with LARC in two paralleled groups. Group A underwent six courses of neoadjuvant MFOLFOX chemotherapy, chemoradiation, surgery, and six adjuvant chemotherapy cycles. Group B received concurrent chemoradiation, surgery, and twelve adjuvant chemotherapy cycles. Patient evaluations were achieved at multiple stages of treatment and follow-up.

Results

Group A had significantly lower local recurrence (11.64%) than Group B (21.74%, P = 0.025). The distant metastasis rate in Group A (8.90%) was lower than in Group B (20.29%) but was not significant (p = 0.143). More patients in Group A experienced downstaging (80.82% vs. 60.87%, p < 0.001). Specifically, 72.60% demonstrated downstaging of tumour invasion and 54.79% downstaging of lymph node involvement, compared to 57.25% and 41.30% in Group B (p = 0.009 and p = 0.025, respectively) as well as higher pCR rate (26.03% vs. 15.25%, p = 0.030) and three-year DFS rate (82.19% vs. 71.01%, p = 0.035) in group A compare to group B.

Conclusion

This innovative strategy for LARC showed promising results with lower local recurrence and higher rates of downstaging and pCR. Treatment side effects were similar in both groups but less frequent in Group A. Anaemia was the most common haematological side effect (A: 58%, B: 68%), and peripheral sensory neuropathy was the most common non-haematological complication (A: 63%, B: 64%). These findings suggest this regimen could be a valuable therapeutic approach for LARC.

Trial Registration

This trial was registered on 2023–12-08 within the IRCT.IR database under the number IRCT20210308050628N1.
The effect of adding physician recommendation in digitally-enabled outreach for COVID-19 vaccination in socially/economically disadvantaged populations
Authors: Sumar Kamal , Blue Lisa , Fatahi Gina , Sumar Mehek , Alvarez Stephanie , Cons Pedro , Valencia Nathalie , Williams Zachary , Bhatti Atiq , Parthasarathy Sairam , Doubeni Chyke A.
Published: July 2024

Introduction

People from backgrounds that are economically/socially disadvantaged experienced disproportionately high COVID-19 death rates and had lower vaccination rates. Effective outreach strategies for increasing vaccine uptake during the pandemic are not fully known. Among patients receiving care at a Federally Qualified Health Center, we tested whether community engaged digitally-enabled outreach from a trusted clinician messenger increased COVID vaccine uptake.

Study design, setting, and participants

A 3-parallel-arm randomized controlled trial with a hybrid effectiveness-implementation design was conducted among patients ≥ 18 years old on study enrollment during 2021 with 1,650 assigned in 3:10:20 ratio; 2,328 were later selected for two subsequent implementation rounds.

Interventions

From April 13 to June 10, 2021, patients were proactively sent a text-messaging invitation to make an appointment for vaccination as part of the routine practice with a link to frequently asked questions (Arm 1, n = 150) with added personalized clinician recommendation alone (Arm 2, n = 500) or with enabled 2-way SMS messaging feature (Arm 3, n = 1,000). Further implementation used messaging addressing vaccine hesitancy (n = 1,323) or adverse reactions to vaccines (n = 1,005).

Main outcomes and measures

The primary outcome was the completion of the first SARS-Cov-2 vaccine dose determined at 14, 30 and 90 days after outreach.

Results

Of 1,650 patients in effectiveness Arms, 61% was female. Vaccination rates for Arms 1, 2, and 3, were 6% (n = 9), 5.4% (n = 27) and 3.3% (n = 33) at 14 days, and 11.5% (n = 17), 11.6% (n = 58), and 8.5% (n = 85) at 90 days, respectively, which were similar in pairwise comparisons. At 90 days, vaccination rates were similar across the two implementation rounds (3.9% vs. 3.6%) and were similar to the rate (3.3%) among patients who were not selected for intervention arms or implementation rounds (n = 8,671).

Conclusions

Digitally-enabled outreach that included SMS messaging outreach augmented with clinician recommendations did not improve COVID-19 vaccination rates.

Trial registration

This study is registered at ClinicalTrails.gov Identifier: NC-T04952376.
Illegitimate work tasks: an investigation of psychometric properties of the Swedish version of the BITS instrument and its suitability in human versus ‘non-human’ service occupations
Authors: Stengård Johanna , Leineweber Constanze , Berthelsen Hanne
Published: July 2024

Background

Illegitimate tasks, i.e. working tasks that are perceived as unnecessary or unreasonable, are commonly measured by the Bern Illegitimate Tasks Scale (BITS). Despite a growing research attention paid to illegitimate tasks, the Swedish version of BITS needs yet to be properly evaluated. Moreover, previous multiorganizational studies in this field have taken for granted, without really testing it, that the instrument functions invariantly in different contexts; a prerequisite for meaningful comparisons.

Methods

Two occupational groups that differs hugely—966 human services workers (teachers and registered nurses) and 750 non-’human service’ workers (construction and IT-workers) were targeted utilizing questionnaires data collected 2018 within the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. Psychometric properties, i.e., reliability, dimensionality, and measurement invariance between the occupations were examined using confirmatory factor analyses and structural equation models. Also, the associations between the two dimensions of illegitimate tasks and job satisfaction and emotional exhaustion, respectively, were tested.

Results

Good reliability was supported and two- versus one-dimensionality showed better psychometric properties. Partial scalar measurement invariance was satisfactory supported with only 25% relaxed constraints of equal intercepts between groups. Examining the two subdimensions revealed different associations with emotional exhaustion, where the associations was more substantial for unreasonable tasks. Nevertheless, the findings point to potential improvements for future investigation.

Conclusions

This study shows that the Swedish version of BITS is working satisfactory and allows for meaningful comparisons of occupational groups. Furthermore, construct validity of the two dimensions was corroborated.
Association between lipoprotein(a), fibrinogen and their combination with all-cause, cardiovascular disease and cancer-related mortality: findings from the NHANES
Authors: Wang Zhenwei , Yan Xuejiao , Fang Lijuan , Tang Junnan , Zhang Jinying
Published: July 2024

Background

There is evidence indicating that both lipoprotein(a) [Lp(a)] and fibrinogen (FIB) are associated with mortality, However, the impact of their combination on mortality has not been determined. Thus, the aim of this study was to examine the association between the combination of Lp(a) and FIB with all-cause and cause-specific mortality.

Methods

This prospective cohort study enrolled 4,730 participants from the third National Health and Nutrition Examination Survey. The exposure variables included Lp(a), FIB and their combination, while the outcome variables consisted of all-cause, cardiovascular disease (CVD) and cancer-related mortality. Multivariate COX regression, subgroup analysis, sensitivity analysis and restricted cubic spline (RCS) were used to investigate the association between Lp(a), FIB and their combination with all-cause, CVD and cancer-related mortality.

Results

Over a median follow-up period of 235 months, 2,668 individuals died, including 1,051 deaths attributed to CVD and 549 deaths due to cancer. Multivariate Cox regression analyses revealed independent associations between both Lp(a) and FIB with all-cause, CVD, and cancer-related mortality. Compared to participants in the 1st to 50th percentiles of both Lp(a) and FIB, those in the 90th to 100th percentiles exhibited multivariable adjusted HRs of 1.813 (95% CI: 1.419–2.317, P < 0.001), 2.147 (95% CI: 1.483–3.109, P < 0.001) and 2.355 (95% CI: 1.396, 3.973, P = 0.001) for all-cause, CVD and cancer-related mortality, respectively. Subgroup and sensitivity analyses did not substantially attenuate the association between the combination of high Lp(a) and high FIB with the risk of all-cause and CVD-related mortality. Additionally, the RCS analysis showed that the relationship between Lp(a) and the risk of all-cause and cancer-related mortality, as well as the relationship between FIB and the risk of cancer-related mortality, were linear (P for nonlinearity > 0.05). Conversely, the relationship between Lp(a) and the risk of CVD-related mortality, as well as the relationship between FIB and the risk of all-cause and CVD-related mortality, were nonlinear (P for nonlinearity < 0.05).

Conclusions

High levels of Lp(a) and FIB together conferred a greater risk of mortality from all-cause, CVD and cancer.
Thoracic and vertebral deformities in lung transplantation: perioperative complications and long-term prognoses
Authors: Nikkuni Etsuhiro , Hirama Takashi , Ui Masahiro , Watanabe Toshikazu , Mukai Shunta , Watanabe Tatsuaki , Watanabe Yui , Oishi Hisashi , Ebihara Satoru , Okada Yoshinori
Published: July 2024

Background

Lung transplantation (LTx) is a crucial therapeutic strategy for patients suffering from end-stage respiratory diseases, necessitating precise donor-recipient size matching to ensure optimal graft function. While standard allocation protocols rely on predicted lung capacity based on factors such as sex, age, and height, a subset of patients with respiratory diseases presents an additional challenge – thoracic or vertebral deformities. These deformities can complicate accurate volume predictions and may impact the success of lung transplantation.

Methods

In this retrospective cohort study of patients who underwent LTx at Tohoku University Hospital between January 2007 and April 2022, with follow-up until October 2022, the primary objective was to assess the influence of thoracic and vertebral deformities on perioperative complications, emphasizing interventions, such as volume reduction surgery. The secondary objective aimed to identify any noticeable impact on long-term prognoses in recipients with these deformities.

Results

Of 129 LTx recipients analyzed, 17.8% exhibited thoracic deformities, characterized by pectus excavatum, while 16.3% had vertebral deformities. Perioperative complications, requiring delayed chest closure, tracheostomy, and volume reduction surgery, were more prevalent in the deformity group. Thoracic deformities were notably associated with the need for volume reduction surgery. However, long-term prognoses did not differ significantly between patients with deformities and those without. Vertebral deformities did not appear to significantly impact perioperative or long-term outcomes.

Conclusions

This study highlights the prevalence of thoracic deformities in LTx recipients, correlating with increased perioperative complications, particularly the potential need for volume reduction surgery. Importantly, these deformities do not exert a significant impact on long-term prognoses. Additionally, patients with vertebral deformities, such as scoliosis and kyphosis, appear to be manageable in the context of LTx.
Application of indocyanine green-labeled fluorescence technology in laparoscopic total extra-peritoneal inguinal hernia repair surgery:a preliminary study
Authors: Zhang Qi , Xu Xiujuan , Ma Jun , Ling Xinjian , Wang Yongsheng , Zhang Yaming
Published: July 2024

Background

Laparoscopic Total Extra-peritoneal Inguinal Hernia Repair(TEP) presents escalated risks of surgical complications, notably bleeding, particularly in European Hernia Society (EHS) types 3 and recurrent inguinal hernia. In this study, we introduced an innovative technique using indocyanine green-labeled fluorescence laparoscopy to mitigate intraoperative complications, including bleeding and rupture of the hernial sac.

Methods

This retrospective study reviewed records of 17 patients who underwent TEP repair at Anqing Municipal Hospital between July and August 2023. Intraoperatively, fluorescence imaging was utilized to trace the pathway of the spermatic vessels and outline the boundaries of the hernia sac to facilitate a thorough dissection.

Results

The procedure was successfully completed in all 17 patients, with a median operation time of 42 min (range: 30–51 min). Median intraoperative blood loss was 5 ml (range: 3–8 ml). Complete dissection of the hernia sac was achieved in each case without any incidents of sac rupture. Hemodynamic parameters of blood flow within the spermatic artery on postoperative day 1 showed no statistically significant deviations from the preoperative values. Furthermore, during the 7-month follow-up period, there were no cases of seroma formation or hernia recurrence.

Conclusion

Our findings suggest that employing indocyanine green-labeled fluorescence technology in TEP repair significantly reduces intraoperative complications, notably bleeding and rupture of the hernial sac. This technique demonstrated a negligible impact on the hemodynamic parameters of the spermatic artery and reduced the overall surgical time.
Artificial Intelligence to support ethical decision-making for incapacitated patients: a survey among German anesthesiologists and internists
Authors: Benzinger Lasse , Epping Jelena , Ursin Frank , Salloch Sabine
Published: July 2024

Background

Artificial intelligence (AI) has revolutionized various healthcare domains, where AI algorithms sometimes even outperform human specialists. However, the field of clinical ethics has remained largely untouched by AI advances. This study explores the attitudes of anesthesiologists and internists towards the use of AI-driven preference prediction tools to support ethical decision-making for incapacitated patients.

Methods

A questionnaire was developed and pretested among medical students. The questionnaire was distributed to 200 German anesthesiologists and 200 German internists, thereby focusing on physicians who often encounter patients lacking decision-making capacity. The questionnaire covered attitudes toward AI-driven preference prediction, availability and utilization of Clinical Ethics Support Services (CESS), and experiences with ethically challenging situations. Descriptive statistics and bivariate analysis was performed. Qualitative responses were analyzed using content analysis in a mixed inductive-deductive approach.

Results

Participants were predominantly male (69.3%), with ages ranging from 27 to 77. Most worked in nonacademic hospitals (82%). Physicians generally showed hesitance toward AI-driven preference prediction, citing concerns about the loss of individuality and humanity, lack of explicability in AI results, and doubts about AI’s ability to encompass the ethical deliberation process. In contrast, physicians had a more positive opinion of CESS. Availability of CESS varied, with 81.8% of participants reporting access. Among those without access, 91.8% expressed a desire for CESS.

Physicians' reluctance toward AI-driven preference prediction aligns with concerns about transparency, individuality, and human-machine interaction. While AI could enhance the accuracy of predictions and reduce surrogate burden, concerns about potential biases, de-humanisation, and lack of explicability persist.

Conclusions

German physicians frequently encountering incapacitated patients exhibit hesitance toward AI-driven preference prediction but hold a higher esteem for CESS. Addressing concerns about individuality, explicability, and human-machine roles may facilitate the acceptance of AI in clinical ethics. Further research into patient and surrogate perspectives is needed to ensure AI aligns with patient preferences and values in complex medical decisions.
Deletions of conserved extracytoplasmic function sigma factors-encoding genes in Streptomyces have a major impact on secondary metabolism
Authors: Sekurova Olga N. , Zehl Martin , Predl Michael , Hunyadi Peter , Rattei Thomas , Zotchev Sergey B.
Published: July 2024

Background

Ethanol shock significantly affects expression of over 1200 genes in Streptomyces venezuelae NRRL B-65,442, including those involved in secondary metabolite biosynthesis and a cryptic gene pepX, which encodes a 19-amino acid peptide with an unknown function.

Results

To establish a possible correlation between the PepX peptide and secondary metabolism in S. venezuelae, its gene was deleted, followed by analyses of the transcriptome and secondary metabolome of the mutant. Although the secondary metabolome of the pepX mutant was not strongly affected, pepX deletion, similar to ethanol shock, mostly resulted in downregulated expression of secondary metabolite biosynthesis gene clusters (BGCs). At the same time, there was a reverse correlation between the expression of certain extracytoplasmic function sigma factors (ECFs) and several BGCs. Individual deletions of three selected ECF-coding genes conserved in Streptomyces that were upregulated upon both pepX deletion and ethanol shock, had a profound positive effect on the expression of BGCs, which also correlated with the overproduction of specific secondary metabolites. Deletion of one such ECF-coding gene in a marine sponge-derived Streptomyces sp. also significantly altered the secondary metabolite profile, suggesting an important role of this ECF in the regulation of secondary metabolism.

Conclusions

These findings pave the way for the activation or upregulation of BGCs in Streptomyces bacteria harboring genes for ECFs homologous to those identified in this study, hereby assisting in the discovery of novel bioactive secondary metabolites.
Improvements in data completeness in health information systems reveal racial inequalities: longitudinal national data from hospital admissions in Brazil 2010–2022
Authors: Coelho Rony , Rocha Rudi , Hone Thomas
Published: July 2024

Background

Race and ethnicity are important drivers of health inequalities worldwide. However, the recording of race/ethnicity in data systems is frequently insufficient, particularly in low- and middle-income countries. The aim of this study is to descriptively analyse trends in data completeness in race/color records in hospital admissions and the rates of hospitalizations by various causes for Blacks and Whites individuals.

Methods

We conducted a longitudinal analysis, examining hospital admission data from Brazil’s Hospital Information System (SIH) between 2010 and 2022, and analysed trends in reporting completeness and racial inequalities. These hospitalization records were examined based on year, quarter, cause of admission (using International Classification of Diseases (ICD-10) codes), and race/color (categorized as Black, White, or missing). We examined the patterns in hospitalization rates and the prevalence of missing data over a period of time.

Results

Over the study period, there was a notable improvement in data completeness regarding race/color in hospital admissions in Brazil. The proportion of missing values on race decreased from 34.7% in 2010 to 21.2% in 2020. As data completeness improved, racial inequalities in hospitalization rates became more evident – across several causes, including assaults, tuberculosis, hypertensive diseases, at-risk hospitalizations during pregnancy and motorcycle accidents.

Conclusions

The study highlights the critical role of data quality in identifying and addressing racial health inequalities. Improved data completeness has revealed previously hidden inequalities in health records, emphasizing the need for comprehensive data collection to inform equitable health policies and interventions. Policymakers working in areas where socioeconomic data reporting (including on race and ethnicity) is suboptimal, should address data completeness to fully understand the scale of health inequalities.
Discriminative capacity of the Spanish version of the Inventory of Depression and Anxiety Symptoms-II (IDAS-II) for detecting DMS-5 specific disorders and poor quality of life in a clinical sample
Authors: Sanchez-Garcia Manuel , Díaz-Batanero Carmen , De la Rosa-Cáceres Ana
Published: July 2024

Background

Emotional problems can be evaluated using categorical approaches to guide treatment choices focused on targeting specific disorders, or dimensional approaches to reduce symptom severity. Moreover, recent evidence points out the need to intervene in patients’ quality of life (QoL), which often remains low even after the remission of emotional problems. Thus, assessment instruments are needed to provide information on diagnosis, symptom severity, and QoL. The present study aimed to provide diagnostic and QoL cutoffs for the Inventory of Depression and Anxiety Symptoms-II (IDAS-II).

Methods

273 patients recruited from mental health services in Huelva (Spain) completed the IDAS-II, Mini International Neuropsychiatric Interview, and Short Form-36 Health Survey. Receiver operating characteristic curve analyses were used to establish cutoff values. Diagnostic, balanced, and screening cutoffs were provided for each IDAS-II scale to detect corresponding diagnoses and poor QoL.

Results

The specific IDAS-II scales Suicidality, Panic, Social Anxiety, Claustrophobia, and Traumatic Intrusions showed adequate discrimination values for their corresponding diagnoses (suicidal behavior disorder, panic disorder, social anxiety disorder, agoraphobia, and post-traumatic stress disorder, respectively). Both the General Depression and Dysphoria scales showed adequate ability to detect major depressive disorder. The IDAS-II scales showed a higher discrimination ability for Mental Health-related QoL, than for General Health-related QoL.

Conclusions

The diagnostic and QoL cutoffs expand the clinical utility of the IDAS-II in clinical practice and research, making it a comprehensive, detailed, and versatile self-report tool. The IDAS-II allows for the assessment of emotional problems consistent with the dimensional, categorical, transdiagnostic, and QoL approaches.
The economic burden of bipolar disorder: a case study in Southern Iran
Authors: Shaker Zohreh , Goudarzi Zahra , Ravangard Ramin , Shaker Zinab , Hedayati Arvin , Keshavarz Khosro
Published: July 2024

Background

Bipolar Disorder (BD) imposes considerable economic and social burdens on the community. Therefore, the present study aimed to determine the economic burden of bipolar disorder in patients referred to single-specialty psychiatric hospitals at the secondary and tertiary care level in 2022.

Methods

This partial economic evaluation was conducted as a cross-sectional study in the south of Iran in 2022, and 916 patients were selected through the census method. The prevalence-based and bottom-up approaches were used to collect cost information and calculate the costs, respectively. The data on Direct Medical Costs (DMC), Direct Non-Medical Costs (DNMC), and Indirect costs (IC) were obtained using the information from the patients’ medical records and bills as well as the self-reports by the patients or their companions. The human capital approach was also used to calculate IC.

Findings

: The results showed that in 2022, the annual cost of bipolar disorder was $4,227 per patient. The largest share of the costs was that of DMC (77.66%), with hoteling and ordinary beds accounting for the highest expenses (55.40%). The shares of DNMC and IC were 6.37% and 15.97%, respectively, and the economic burden of the disease in the country was estimated at $2,799,787,266 as well.

Conclusion

In general, the costs of bipolar disorder treatment could impose a heavy economic burden on the community, the health system, the insurance system, and the patients themselves. Considering the high costs of hoteling and ordinary beds, it is suggested that hospitalization of BD patients be reduced by managing treatment solutions along with prevention methods to reduce the economic burden of this disease. Furthermore, in order to reduce the costs, proper and fair distribution of psychiatrists and psychiatric beds as well as expansion of home care services and use of the Internet and virtual technologies to follow up the treatment of these patients are recommended.
Association between sex hormone binding globulin and metabolic syndrome in US adults: insights from National Health and Nutrition Examination Survey (NHANES) 2013–2016
Authors: Yang Yang , Wang Jie , Huang Yi , Liu Yuhang , Liu Shuwan , Liu Huabao , Tan Meiao
Published: July 2024

Background

Metabolic syndrome (MetS) presents a notable public health challenge on a global scale, exerting a considerable impact on individuals’ health and quality of life. There is mounting evidence indicating a robust association between MetS and levels of sex hormones. Therefore, the study aims to explore the relationship between sex hormone binding-globulin (SHBG) and MetS, and to provide evidence that could inform the development of effective prevention strategies for MetS.

Methods

Data for this cross-sectional investigation were collected during the 2013–2016 cycle of the National Health and Nutrition Examination Survey (NHANES), from which 5,499 adults were sampled. The criteria established by the Adult Treatment Program III of the National Cholesterol Education Program were utilized to define MetS. SHBG levels were measured using a standardized technique. Multivariate-adjusted logistic regression, multivariate restricted cubic spline, and threshold effect analyses were utilized to investigate the association between SHBG levels and MetS. Moreover, the stratified analyses and interaction tests of covariables were presented in a forest plot. Finally, sensitivity analysis was utilized to ensure the robustness of the results.

Results

Overall, 1822 participants had MetS. After adjusting for possible confounders, SHBG levels were associated with MetS (Odds ratio [OR], 0.984; 95% confidence interval [CI], 0.981–0.986; P < 0.01). The multivariate restricted cubic spline analysis demonstrated a non-linear association between SHBG and MetS (P < 0.001). With two piecewise regression models, the adjusted OR of developing MetS was 0.964 (95% CI, 0.959–0.969; P < 0.001) among people with SHBG < 76.653 nmol/L, but there was no correlation between SHBG and MetS in participants with SHBG ≥ 76.653 nmol/L. The stability of the association between SHBG levels and MetS was confirmed using subgroup analysis and sensitivity analyses.

Conclusions

Our results suggest that reduced SHBG levels are associated with an increased prevalence of MetS in adults, particularly when SHBG levels are below 76.653 nmol/L. More investigation is required to understand comprehend the mechanisms underlying these results and to delve into their clinical implications.
Single-cell sequencing of facial adipose tissue unveils FKBP5 as a therapeutic target for facial infiltrating lipomatosis
Authors: Chen Hongrui , Sun Bin , Chang Shih-Jen , Yu Zhang , Qiu Yajing , Hua Chen , Lin Xiaoxi
Published: July 2024

Background

Facial infiltrating lipomatosis is characterized by excessive growth of adipose tissue. Its etiology is associated with somatic phosphatidylinositol 3-kinase catalytic subunit alpha (PIK3CA) variants, but the specific mechanisms are not yet fully understood.

Methods

We collected facial adipose tissue from both FIL patients and non-FIL individuals, isolated the stromal vascular fraction (SVF) and performed single-cell transcriptome sequencing on these samples.

Results

We mapped out the cellular landscape within the SVF, with a specific focus on a deeper analysis of fibro-adipogenic precursor cells (FAPs). Our analysis revealed that FAPs from FIL patients (FIL-FAPs) significantly overexpressed FK506 binding protein 51 (FKBP5) compared to FAPs from individuals without FIL. Further experiments indicated that FKBP5 is regulated by the PI3K-AKT signaling pathway. The overactivation of this pathway led to an increase in FKBP5 expression. In vitro experiments demonstrated that FKBP5 promoted adipogenic differentiation of FAPs, a process that could be hindered by FKBP5 knockdown or inhibition. Additionally, in vivo assessments confirmed FKBP5’s role in adipogenesis.

Conclusions

These insights into the pathogenesis of FIL underscore FKBP5 as a promising target for developing non-surgical interventions to manage the excessive adipose tissue growth in FIL.
Utilising systematic reviews to assess potential overtreatment and claim for better evidence-based research: an analysis of anticancer drugs versus supportive care in advanced esophageal cancer
Authors: Santero Marilina , Meade Adriana-Gabriela , Selva Anna , Savall-Esteve Olga , Bracchiglione Javier , Macías Ismael , Leache Leire , Cerdà Paula , Bonfill Cosp Xavier ,   Appropriateness of Systemic Oncological Treatments for Advanced Cancer (ASTAC-Study) Research Group, Acosta-Dighero Roberto , Antequera Alba , Auladell-Rispau Ariadna , Cantero-Fortiz Yahveth , Hernández Edgar D , Irassar Juan , Meinardi Pamela , Merchán-Galvis Angela , Meza Nicolas , Quintana María Jesús , Requeijo Carolina , Rodríguez-Grijalva Gerardo , Salas-Gama Karla , Salazar Josefina , Savall-Esteve Olga , Solà Ivan , Urrútia Gerard
Published: July 2024

Background

Highlighting the identified gaps in evidence-based research concerning advanced esophageal cancer (EC) treatment and care, this review evaluates the efficacy and safety of anticancer drugs compared to supportive care for advanced EC patients, aiming to assess the appropriateness of usual treatments and identify the gaps that need to be filled with primary research.

Methods

We searched (May 2022) MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Epistemonikos, and trial registries (ClinicalTrials.gov and PROSPERO) for randomised controlled trials (RCTs) comparing anticancer drugs (chemotherapy, immunotherapy, or biological/targeted therapy) with supportive care in advanced EC. The results were summarised using GRADE summary of finding tables.

Results

We included 15 RCTs. Most studies did not have a special focus on EC, did not detail the treatment lines in all patients, and did not evaluate all outcomes. Anticancer drugs may result in a slight increase in overall survival (OS) (HR 0.78; 95% CI 0.71, 0.86; MD 0.83 months) and better progression-free survival (PFS) (HR 0.56 95% CI 0.49, 0.64, MD 0.68 months), but also may increase toxicity (RR 1.37; 95% CI 1.13, 1.65), without a significant improvement in quality of life. The certainty of evidence was low or very low due to indirectness of results and lack of specific focus on EC in some studies.

Conclusion

RCTs on advanced EC lack specificity, detailed treatment line information, and evaluation of all relevant outcomes. Moreover, when they find any benefit, this is negligible. Therefore, the certainty to justify anticancer drug treatments instead of supportive care in advanced EC is low or very low, and this information should be actively shared with affected patients. More and better RCTs should be conducted to assess whether any old or new proposed treatment for advanced EC patients provides a better balance of benefits and harms than the supportive care.

Systematic review registration

The study protocol was registered in OSF (https://doi.org/10.17605/OSF.IO/7CHX6) on 2022–03-29.
Evaluation of traditional Chinese exercise for knee osteoarthritis (KOA): an overview of systematic reviews
Authors: Tao Tao , Shi Ming-peng , Tan Bo-yang , Zhang Xian-shuai , Sun Feng-ling , Liu Bao-ren , Li Shao-jun , Li Zhen-hua
Published: July 2024

Background

Knee osteoarthritis (KOA) has become a public health issue. Several systematic reviews (SRs) and meta-analyses (MAs) indicate that traditional Chinese exercise (TCE) may be an effective treatment for reducing pain and stiffness and improving physical function in people with knee osteoarthritis (KOA).

Objectives

To evaluate the literature quality and evidence for the systematic reviews of TCE for KOA and provide evidence to support the clinical application of TCE for KOA.

Methods

Eight databases were searched from their inception to January 3, 2023, to retrieve relevant literature, including China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journal Database (VIP), China Biology Medical literature database (CBM), PubMed, Embase, Web of Science and Cochrane Library, without restrictions on publication date or language. AMSTAR-2 and PRISMA 2020 assessed the methodological and reporting quality of included SRs/MAs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to evaluate the quality of evidence.

Results

A total of 18 SRs/MAs were included. The methodological quality was “very low” based on AMSTAR-2. The overall reporting quality was deficient based on PRISMA 2020. The quality of Chinese and English literature differed, with English literature being superior in methodological and reporting quality. Among 93 pieces of evidence obtained, 46 (49.46%) were of very low quality, 34 (36.56%) were of low quality, 13 (13.98%) were of moderate quality, and none were of high quality. TCE was supported by 76 pieces of evidence (81.72%).

Conclusion

TCE appears beneficial and safe for managing KOA. However, due to the relatively low methodological and evidentiary quality of included SRs/MAs, clinicians should interpret these findings cautiously.
Hope and its associations with academic-related outcomes and general wellbeing among college students: the importance of measurement specificity
Authors: Wong Wai-lap Lance , Cheung Sing-hang
Published: July 2024

Background

Hope has been extensively studied as a predictor of college students’ academic success. Most previous studies used domain-general, global hope measures to gauge the association between hope and academic performance among college students. However, a few studies have suggested that hope is domain-specific and domain-specific academic hope measures should be included in related research to better assess the influence of hope on academic outcomes. In this study, we aimed to further examine this issue to ascertain if there is value in including academic hope measures when studying the link between hope and academic outcomes in college students.

Methods

Two samples of Hong Kong college students (total N = 1321) were recruited. Each participant completed a set of self-reported online questionnaires.

Results

In both samples, global hope and academic hope emerged as related but separate factors in confirmatory factor analyses. Academic hope had consistently stronger unique explanatory power on academic performance and goal setting than global hope did. On the other hand, global hope explained more variance in general wellbeing than academic hope did, but its explanatory role in academic performance was not significant.

Conclusions

The findings support domain-specificity and show that hope measures explain more variance in outcomes in the matched domains. Therefore, academic hope measures should more routinely be included in related research to better evaluate the role of hope in academic pursuit among college students. Possible implications for hope interventions are also discussed.
The influence of resilience and social support on mental health of older adults living in community: a cross-sectional study
Authors: Upasen Ratchaneekorn , Saengpanya Weeraphol , Awae Wanida , Prasitvej Preedanan
Published: July 2024

Background

Mental health is an important fundamental element of health that influences different dimensions of an older individual’s life. There are various factors that affect the mental health of older adults, such as resilience and social support. However, the relationship between various factors and mental health is unclear. Purposes of the study were to investigates whether resilience and social support affect the mental health of older adults and to analyze the structural equation model of mental health among the older adults with resilience as a mediating variable.

Methods

A cross-sectional study was conducted among 964 older adults by multi-stage random sampling. The data were collected using the following questionnaires: Thai Elderly Resilience Scale, Social Support Scale, and Thai Geriatric Mental Health Assessment. Data analysis used descriptive statistics, Pearson’s correlation, and Path analysis.

Results

The older adults had a high level of resilience, social support, and mental health (MH). The best model we obtained demonstrated that social support and resilience had directly statistically significant influences the MH. Social support also had statistically significant indirect effect via resilience to the MH.

Conclusion

Understanding the factors that influence mental health of older adults can be beneficial for health professionals to provide appropriate social support and resilience, including helping the older adult can join with others, be confident in life, have necessities, live with spiritual security, and be able to de-stress and management problems were recommended.
Enhancing landslide susceptibility mapping using a positive-unlabeled machine learning approach: a case study in Chamoli, India
Authors: Zhang Danrong , Jindal Dipali , Roy Nimisha , Vangla Prashanth , Frost J. David
Published: July 2024

Introduction

The Indian Himalayas' susceptibility to landslides, particularly as a location where climate change effects may be event catalysts, necessitates the development of dependable landslide susceptibility maps (LSM).

Method

This study diverges from traditional binary classification models, framing LSM as a positive-unlabeled learning problem. This approach acknowledges that regions without recorded landslides are not necessarily at low risk but could simply have not experienced landslides yet. The study utilizes novel positive-unlabeled learning-enhanced algorithms—Random Forest, K-Nearest Neighbor, and Decision Tree—to create LSM for Chamoli district, India. Eleven causative factors for landslides are identified, including elevation, aspect, slope, geology, geomorphology, distance to lineament, lithology, NDVI, distance to river, distance to road and residential land use. To address spatial correlation biases, instead of randomly splitting the dataset, the study adopts spatial splitting to get the training and testing datasets.

Conclusion

The study reveals that positive-unlabeled learning substantially improves the Area Under Curve and recall, leading to a more conservative LSM compared to binary classification methods. Analysis shows that the southern region of Chamoli exhibits high recall but lower accuracy, suggesting a latent high landslide susceptibility despite a lack of historical landslides in this region. The study also quantifies the impact of human activity on landslide risk, indicating an elevated threat to life and the local economy, especially in Chamoli's southwestern areas.
Unveiling the influence of salinity on bacterial microbiome assembly of halophytes and crops
Authors: Abdelfadil Mohamed R. , Patz Sascha , Kolb Steffen , Ruppel Silke
Published: July 2024

Background

Climate change and anthropogenic activities intensify salinity stress impacting significantly on plant productivity and biodiversity in agroecosystems. There are naturally salt-tolerant plants (halophytes) that can grow and withstand such harsh conditions. Halophytes have evolved along with their associated microbiota to adapt to hypersaline environments. Identifying shared microbial taxa between halophyte species has rarely been investigated. We performed a comprehensive meta-analysis using the published bacterial 16S rRNA gene sequence datasets to untangle the rhizosphere microbiota structure of two halophyte groups and non-halophytes. We aimed for the identification of marker taxa of plants being adapted to a high salinity using three independent approaches.

Results

Fifteen studies met the selection criteria for downstream analysis, consisting of 40 plants representing diverse halophyte and non-halophyte species. Microbiome structural analysis revealed distinct compositions for halophytes that face high salt concentrations in their rhizosphere compared to halophytes grown at low salt concentrations or from non-halophytes. For halophytes grown at high salt concentrations, we discovered three bacterial genera that were independently detected through the analysis of the core microbiome, key hub taxa by network analysis and random forest analysis. These genera were Thalassospira, Erythrobacter, and Marinobacter.

Conclusions

Our meta-analysis revealed that salinity level is a critical factor in affecting the rhizosphere microbiome assembly of plants. Detecting marker taxa across high-halophytes may help to select Bacteria that might improve the salt tolerance of non-halophytic plants.
The Relational Approach to Treating Self-Harm (RELATE): study protocol for a feasibility randomised controlled trial study of cognitive analytic therapy for adults who self-harm versus treatment at usual
Authors: Taylor Peter James , Adeyemi Isabel , Marlow Katie , Cottam Sarah , Airnes Zerena , Hartley Samantha , Howells Victoria , Dunn Barnaby D. , Elliott Rachel A. , Hann Mark , Latham Cameron , Robinson Catherine , Turpin Clive , Kellett Stephen
Published: July 2024

Background

Self-harm is a prevalent behaviour that has a major detrimental impact on a person’s life. Psychological therapies have the potential to help, but evidence of effective interventions remains limited. Access and acceptability of interventions can also be a significant challenge, with individuals either being unable to access help or having to endure long waiting lists. Cognitive analytic therapy (CAT) is a time-limited and relationally-focused psychotherapy that may provide a valuable treatment option for people who self-harm. This protocol outlines the methodology for the first feasibility randomised controlled trial (RCT) of CAT for adults that self-harm. The trial will aim to determine the feasibility, acceptability and safety of undertaking larger-scale evaluations of CAT for self-harm within an RCT context.

Method

An RCT design with 1:1 allocation to CAT plus treatment as usual (TAU) or TAU alone. Participants will be adult outpatients with three or more instances of self-harm in the past year (target sample of n = 60). CAT will be 8 one-to-one weekly 60-min sessions plus a follow-up session up to 8 weeks after the last session. Assessments will occur at baseline, 12 weeks and 18 weeks after randomisation. Qualitative interviews with participants will gain insights into the feasibility and acceptability of CAT. Feasibility outcomes will be judged against progression criteria.

Discussion

CAT may be an effective and accessible treatment option for people who self-harm, providing a more relationally orientated alternative to more behavioural therapies. The proposed feasibility RCT is an important first step in evaluating CAT as a treatment for self-harm.

Trial registration

The trial was pre-registered (21/10/22) on ISR CTN (ISRCTN code: ISRCTN75661422).
Prognosis and characteristics of Corynebacterium exit site infection: a single-center retrospective study
Authors: Sugita Kazuya , Washida Naoki , Takahashi Jyunji , Tsunematsu Masashi , Hosoya Kozi , Ito Jun , Suzuki Yutaka , Uchiyama Kiyotaka
Published: July 2024

Background

Corynebacterium is a rare but important cause of peritoneal dialysis (PD)-associated infection. A previous study reported that continued antibiotic use at the exit site is associated with increased Corynebacterium exit site infection (ESI), although the latest International Society of Peritoneal Dialysis guideline recommends its use. This study aims to verify the prognosis of Corynebacterium-associated PD-related infections, focusing on ESI.

Methods

We conducted a single-center, retrospective study about ESI, tunnel infection (TI), and PD-associated peritonitis due to Corynebacterium between April 2018 and January 2023. We primarily examined the prognosis and characteristics of Corynebacterium ESI.

Results

In this study, we included 125 patients with PD (mean age at PD onset: 69.4 ± 13.7 years, 71.2% male, 48% diabetic, mean estimated glomerular filtration rate at the introduction of PD 7.4 ± 2.6 ml/min/1.73 m2, total follow-up 179.6 patient dialysis year). Between April 2018 and January 2023, 191 cases of ESI, 62 cases of Corynebacterium ESI in 24 patients, 10 cases of TI, and 32 cases of PD-associated peritonitis were detected. In total, 16 of 24 patients with Corynebacterium-associated ESI tested positive for Corynebacterium multiple times in cultures against the exit site, with a maximum of eight times. The estimated glomerular filtration rate during PD introduction was relatively lower in patients with Corynebacterium-associated ESI than in patients without ESI (6.4 versus 7.9 mL/min/1.73 m2, respectively; P = 0.052). Although three of the Corynebacterium ESI cases progressed to TI, there were no cases that progressed directly to PD-associated peritonitis.

Conclusions

Corynebacterium-associated ESI progresses to TI with a certain probability; however, it is thought that it rarely progresses to PD-associated peritonitis directly.