bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Validation of a Risk Prediction Model for ADL Dysfunction in the Elderly
Authors: Lin Fangbo , Liu Chao
Published: December 2024

Background: Aging populations have led to increased chronic diseases, economic challenges, and labor shortages, significantly impacting China's public health. The elderly often seek to maintain independence, making research crucial to understand factors that lead to daily life dysfunction. This study aimed to develop and validate a predictive tool to identify risks of daily life dysfunction in the elderly.
Methods: Data from 5081 participants aged 60 to 80 in the China Health and Retirement Longitudinal Survey(CHARLS) wave 3 was analyzed. Participants were divided into training and testing groups. Predictive factors were identified using Least Absolute Shrinkage and Selection Operator(LASSO) and multivariable logistic regression, resulting in a nomogram model. The model's performance was evaluated using Receiver Operating Characteristic(ROC) curves, the calibration plots, and Decision Curve Analysis(DCA).
Results: It identified 12 factors as risk factors for daily life dysfunction in the elderly, which were integrated into the final model. The nomogram's predictive performance was deemed acceptable, with ROC curve values of 0.788 (95% CI: 0.771-0.804) for the training set and 0.794 (95% CI: 0.773-0.814) for the testing set. The calibration curve confirmed the model's accuracy, and the DCA showed it had good clinical utility.
Conclusions: Twelve key factors were chosen to create a nomogram predicting daily life dysfunction in the elderly. This nomogram demonstrates strong evaluation performance and serves as a dependable tool for forecasting daily life dysfunction in the elderly.
How to pre-evaluate the risk of systemic inflammatory response syndrome in patients undergoing one-stage flexible ureteroscopy lithotripsy？
Authors: Zhou Yuan , Zhang Haiyan , Zhang Rentao , Ding Yinman , Wang Zhengquan , Lin Changming
Published: December 2024

Background Flexible ureteroscopy lithotripsy (FURL) is widely used to treat Upper urinary tract stone (UUTS). Evaluating whether a patient develops systemic inflammatory response syndrome (SIRS) during and after surgery is one of the most important factors in determining whether a ureteral stent should be placed before FURL. Materials and methods A total of 340 patients with UUTS who underwent one-stage FURL from April 2021 to May 2024 were analyzed retrospectively. Least absolute shrinkage and selection regression and multivariate logistic regression analysis were used to screen out independent risk factors and then developed a nomogram. Concordance index (C-index), receiver operating characteristic curve and calibration curve were used to internal evaluated the predictive ability. We further evaluated the risk of SIRS in one-stage FURL based on the influence of available variables. Results Age, urinary white blood cells, urine bacterial culture and systemic immune-inflammation index (SII) were combined to establish nomogram for prediction the risk of SIRS in one-stage FURL. The SII had the highest odds ratio (OR = 30.356) to SIRS. The C-index (0.964, 95%CI = 0.932–0.996), area under curve (0.935), and calibration curve demonstrated the favourable predictive ability of nomogram prediction. We further developed a scoring system and classified the risk of SIRS into four grades. Conclusion The established nomogram and risk scoring system have favourable predictive ability and clinical serviceability to personalize predict the SIRS risk in UUTS patients undergoing one-stage FURL. A ureteral stent should be placed before FURL in patients with SII greater than 1300 and one of the following: age>60 years, urinary white blood cell 1+/2+/3+, or urine bacterial culture positive. We present the first study to evaluate the value of preoperative SII on FURL. The proposed new insights may help clinicians select safer treatment for UUTS patients.
White Matter Integrity Abnormalities in 1-to 5-Year-Olds with Global Developmental Delays: A Diffusion Study Utilizing Tract-Based Spatial Statistics and ROI-Based Analysis
Authors: Yang Jinze , Shen Yanyong , Wang Kaiyu , Cheng Meiying , Lu Lin , Zhou Liang , Liu Shipeng , Lu Yu , Feng Liujuan , Li Sike , Zhang Xiaoan , Zhao Xin
Published: December 2024

Objects We aimed to use diffusion kurtosis imaging (DKI) and its derived white matter integrity metrics to characterize white matter integrity in children with global developmental delay（GDD） and explore the relationship between diffusion parameters and development quotient（DQ）.
Methods and Materials Thirty-four children with GDD and 44 healthy control children were included in this study, and MRI images were acquired. Diffusion parameters were preprocessed and obtained by Pydesigner and FSL software, including fractional anisotropy (FA), mean diffusivity (MD), axonal diffusivity (AD), radial diffusivity (RD), anisotropy (MO), mean kurtosis (MK), axial kurtosis (AK), kurtosis fractional anisotropy (FAK), radial kurtosis (RK), and WMTI parameters: the axial diffusivity of the extra-axonal space (EAS_AD), the radial diffusivity of the extra-axonal space (EAS_RD), the diffusivity of the intra-axonal space (IAS_DA), the axonal water fraction (AWF), and the tortuosity of the extra-axonal space (EAS_TORT). Afterward, the Tract-based spatial statistics analysis was used to compare the diffusion parameters of the whole brain. We also performed covariance analysis to compare the diffusion parameters in the genu, body, and splenium of the corpus callosum. Lastly, we used partial correlation analysis to assess the correlation between diffusion parameters and DQ.
Results In the results of TBSS, we found that FA, AD, MO, MK, RK, and EAS_TORT were significantly reduced(P＜0.05); RD, AK, KFA, AWF, EAS_AD, and EAS_RD significantly increased in children with GDD compared to healthy controls (P<0.05). In the corpus callosum, FA, MO, IAS_DA, and EAS_TORT were significantly reduced(P＜0.05); AK, KFA, and AWF were significantly increased (P<0.05). In the correlation analysis, fine motor skills DQ was negatively correlated with AK and AWF(P<0.05) and positively correlated with MO(P<0.05). In addition, Adaptability DQ was negatively correlated with AWF(P<0.05).
Conclusion DKI and its derived WMTI parameters can characterize the white matter integrity of children with GDD and have a certain correlation with the DQ, which helps understand the specific pathological changes inside and outside axons and assists clinical diagnosis.
Evaluation of Mechanical Ventilation Modes in the Laparoscopic Perioperative Period with Electrical Impedance Tomography
Authors: Li Zhiwei , Wu Yang , Yu Yao , Liu Kai , Tian Hang , Yao Jiafeng , Cheng Qiuju
Published: December 2024

Purpose: The lung protective ventilation strategy has been advocated during the laparoscopic perioperative period. However, uncertainty remains as to which mode of mechanical ventilation is more appropriate in the laparoscopic perioperative period. We hypothesized the pressure controlled ventilation - volume guaranteed (PCV-VG) mode is a better option than the volume controlled ventilation (VCV) mode in the laparoscopic perioperative period.
Method: The trial was a self-controlled study. The laparoscopic perioperative period is divided into five phases: before induction of anesthesia (AWAKE), after induction of anesthesia (BEGIN), the first phase of the surgery (MIDDLE-1), the second phase of the surgery (MIDDLE-2), and before postoperative wakefulness (END). The BEGIN phase and MIDDLE-1 phase use the VCV mode, and the MIDDLE-2 phase and END phase use the PCV-VG mode. EIT data are recorded at each phase and the parameters of EIT were calculated to quantify the performance of pulmonary ventilation in space and time.
Results: During the non-surgical period, compared with VCV mode, PCV-VG mode had a significant increase in CoV (48.7 ± 2.6 vs. 47.0 ± 3.7, P < 0.01*), a significant decrease in RVDI (8.5 ± 3.1 vs. 10.1 ± 3.9) and no significant difference in GI (0.80 ± 0.10 vs.0.77 ± 0.08, P = 0.067). During the surgical period, compared with VCV mode, PCV-VG mode had a significant increase in CoV (46.0 ± 3.6 vs. 42.5 ± 3.3, P < 0.001*), a significant decrease in GI (0.87 ± 0.15 vs. 1.03 ± 0.28; P < 0.01*) and a significant decrease in RVDI (11.1 ± 3.8 vs. 15.4 ± 5.1; P < 0.001*)
Conclusion: EIT ventilation parameters between VCV mode and PCV-VG mode have significant differences in the laparoscopic perioperative period. The PCV-VG mode could improve ventilation inhomogeneity and elevated ventilation delay due to changes in position and pneumoperitoneum during surgery. The PCV-VG mode might be better used to meet the changing demands for ventilation at different surgical stages. We believe that PCV-VG is a more alternative during laparoscopic surgery.
Penguin guano: an important source of climate-relevant aerosol in Antarctica
Authors: Boyer Matthew , Quéléver Lauriane , Brasseur Zoé , McManus J , Herndon Scott , Agnese Mike , Nelson David , Roscioli Joseph , Weis Frederik , Sel Sergej , Marincovich Giselle , Quarin Francisco , Buchholz Angela , Xavier Carlton , Perchivale Pablo , Kerminen Veli-Matti , Kulmala Markku , Petäjä Tuukka , He Xu-Cheng , Sofieva Svetlana , Timonen Hilkka , Aurela Minna , Barriera Luis , Virkkula Aki , Asmi Eija , Worsnop Douglas , SIPILA Mikko
Published: December 2024

Gaseous ammonia, while influential in atmospheric processes, is critically underrepresented in atmospheric measurements. This limits our understanding of key climate-relevant processes, such as new particle formation, particularly in remote regions. Here, we present highly sensitive, online observations of gaseous ammonia from a coastal site in Antarctica, which allows us to constrain the mechanism of new particle formation in this region in unprecedented detail. Our observations show that penguin colonies are a large source of ammonia in coastal Antarctica, whereas ammonia originating from the Southern Ocean is, in comparison, negligible. In conjunction with sulfur compounds sourced from oceanic microbiology, ammonia initiates new particle formation and is an important source of cloud condensation nuclei. Dimethyl amine, likely originating from penguin guano, also participates in the initial steps of particle formation, effectively boosting particle formation rates up to 10000 times. These findings emphasize the importance of local fauna (penguin/bird colonies and oceanic phytoplankton/bacteria) on climate-relevant aerosol processes in coastal Antarctica. This demonstrates an important connection between ecosystem and atmospheric processes that impact the Antarctic climate, which is crucial given the current rate of environmental changes in the region.
A single-center 9-year experience in pediatric continuous kidney replacement therapy
Authors: Puspitasari Henny Adriani , Hidayati Eka Laksmi , Fahlevi Reza , Yuniar Irene , Pardede Sudung O. , Aryadevi Ni Nyoman Berlian
Published: December 2024

Background
Acute kidney injury (AKI) is a commonly found complication found in critically ill children. One of the key treatments in these children is continuous kidney replacement therapy (CKRT), especially in those who are hemodynamically unstable. However, due to its costly and complex procedure, there has been some challenges in implementing this treatment in developing countries. Therefore, the aim of this study is to present a comprehensive analysis of clinical profiles of our pediatric patients during a 9-year CKRT experience at our center.
Methods
We conducted a retrospective analysis of medical records from January 2015 to June 2023. Demographic data; clinical and laboratory profiles; hospitalization duration; use of inotropic support and mechanical ventilation; and the presence of sepsis, AKI, acute lung injury (ALI), acute respiratory distress syndrome (ARDS), and encephalopathy were recorded and compared between survivors and non-survivors.
Results
Fifty-six critically ill children received CKRT. The median age was 7.4 years, while the median body weight was 22.2 kg. CKRT was more commonly indicated in those with sepsis-associated AKI (41.1%), non-sepsis AKI (23.2%), and acute-on-chronic kidney disease (21.4%). The median CKRT duration was 52.2 hours, with median total delivered dose and mean blood flow rate per kg of 22.2 (5.8–71.7) and 3.1 ± 0.9 mL/kg/min, respectively. The survival rate was 25%.
Conclusion
Although we have similar patient demographics and CKRT prescription compared to other center, we have lower survival due to notable challenges we encountered with limited resources. Despite its challenges, CKRT remains a preferred treatment option for critically ill children.
Management of Challenging Post-hepatectomy Bile Leakage with Concurrent Bile Duct Stenosis
Authors: Matsuo Yasuko , Yasuda Satoshi , Nagai Minako , Nakamura Kota , Terai Taichi , Doi Shunsuke , Kohara Yuichiro , Sakata Takeshi , Sho Masayuki
Published: December 2024

Purpose
Bile leakage remains a serious complication following hepatic resection, with particularly high incidence in procedures involving hilar manipulation. Such cases are often complicated by bile duct strictures, presenting unique management challenges. This study evaluated our institutional experience in managing post-hepatectomy bile leakage, focusing on high-risk procedures and complex cases with concurrent bile duct stenosis.
Methods
We retrospectively analyzed patients who underwent liver resection without biliary reconstruction between January 2008 and December 2023. Based on established risk factors, patients were stratified into high- and low-risk procedure groups. Treatment approaches and outcomes were compared between groups, with detailed analysis of cases complicated by bile duct stenosis.
Results
Of 894 patients, 73 (8.0%) developed bile leakage: 45 in the low-risk and 28 in the high-risk group. Approximately 75% of low-risk cases resolved with drainage alone, compared to 52.0% in the high-risk group (P = 0.041). Among patients requiring endoscopic intervention, bile duct stenosis was significantly more common in the high-risk group (63.6% vs. 0%, P = 0.013). Five high-risk cases with concurrent stenosis required complex management, presenting with both proximal and peripheral leakage. These cases were successfully managed using a combination of surgical resection, transarterial embolization, and advanced interventional techniques.
Conclusion
Post-hepatectomy bile leakage management is particularly challenging in high-risk procedures, frequently complicated by bile duct stenosis. Successful outcomes require accurate characterization of leakage patterns and appropriate selection of therapeutic interventions. Our proposed algorithm emphasizes systematic evaluation and stepwise intervention, including bridging stent placement and alternative approaches for complex cases.
Comprehensive Analysis of the NF1 gene Using Long-Read Sequencing Improved Neurofibromatosis type 1 Molecular Diagnosis
Authors: Zheng Yu , Chen Miaomiao , Zhang Shuju , Peng Yu , Wu Xinghan , Guo Danni , Liu Yaoxi , Mao Aiping , Li Danhua , Xie Tiantian , Mei Haibo , Zhu Guanghui , Wang Hua
Published: December 2024

Clinical diagnosing Neurofibromatosis type 1 (NF1) in pediatrics are facing challenges because of limited presence of age-dependent phenotypes, and the limited detection rate by current approaches for the complexity of the NF1 gene. Here we developed a comprehensive analysis of NF1 (CANF1) combining 14 long-range locus-specific PCR, 25 gap primers and long-read sequencing (LRS) for sequence analysis of the NF1 gene. In this blind retrospective study, the clinical utility of CANF1 was evaluated in 191 samples (181 pediatric probands, 10 NF1 parents) by comparing to the control methods, mainly next generation sequencing (NGS). The results exhibited 176 probands (176/181 = 97.2%) having concordant results, and the other 5 probands (2.8%) with improved findings including: one was established a new diagnosis (c.5812 + 332A > G in deep intron) and four were improved with precise CNV breakpoints. In 127 pediatric NF1 probands with limited clinical manifestations, this assay received a detection rate of 92.9%, which is higher than NGS. In conclusion, this study constructed a comprehensive analysis of NF1 employing LRS, which can reliably identify various type variants of the NF1 gene in one assay. This CANF1 assay can help in screening NF1 with more precise molecular diagnosis than conventional methods, particularly for individuals with unfulfilling NF1 diagnosis solely by clinical phenotypes.
Factors Affecting Inflammatory Changes in Congenital Lung Malformations
Authors: Zulli Andrea , Tocchioni Francesca , Oreglio Chiara , Caporalini Chiara , Buccoliero Anna Maria , Morabito Antonino , Morini Francesco
Published: December 2024

AIM OF THE STUDY
Patients with congenital lung malformation (CLM) may present pulmonary inflammatory changes. However, little is known about the factors influencing local inflammation. Aim of this study was to evaluate the factors that may affect inflammatory changes in CLM.
METHODS
Patients with CLM operated upon between 2005 and 2021 were included. The grade of inflammation was defined with a purpose-made inflammatory score (IS) ranging from 0 to 5. The association of type of CLM and age at surgery with IS was analyzed. Results are means (standard deviation).
MAIN RESULTS
Data from 105 patients with CLM were collected, 56 had congenital pulmonary airways malformation (CPAM), 24 bronchopulmonary sequestration (BPS), and 25 congenital lobar emphysema (CLE). 91 patients (87%) had inflammatory changes. IS was 2.1 (1.5), 1.2 (1.0), and 1.3 (1.5) in CPAM, BPS, and CLE respectively (One-way ANOVA p=0.0101). CPAM showed a significantly higher IS as compared with BPS (p = 0.0242) and CLE (p = 0.0495). Age at operation significantly correlated to IS (r2=0.14; p <0.0001). Patients aged below 6 months at operation had lower IS [1.4 (1.2)] as compared to those over 6 months [2.0 (1.6)] (p =0.018). Age at operation significantly correlated with the IS in CPAM (r2=0.17; p=0.0016) and CLE (r2=0.47; p<0.0001) patients.
CONCLUSIONS
Patients with CLMs often present inflammatory changes in their lungs. Grade of inflammation significantly correlates with age at surgery and type of anomaly, with CPAMs having the highest grade. These findings support early resection in patients with CLM, especially in case of CPAM.
Reduced Folate Carrier 1 (RFC1/Slc19a1) Suppression Exacerbates Blood-Brain Barrier Breakdown in Experimental Ischemic Stroke in Adult Mice
Authors: Gurler Gokce , Bozanoglu Dilan , Leon Christelle , Belder Nevin , Sever‐Bahcekapili Melike , Bolbos Radu , Karatas Hulya , Wiart Marlene , Chauveau Fabien , Yemisci Muge , Soylu Kadir Oguzhan
Published: December 2024

The Reduced Folate Carrier 1 (RFC1), also called solute carrier family 19 member 1 (SLC19A1/SLC19a1), is recognized for transporting folates across the blood-brain barrier (BBB). RFC1 has recently been defined as a hypoxia-immune related gene whose expression levels were induced by acute retinal ischemia, suggesting that RFC1 may have a role in the response of the brain to ischemic injury. Despite a recent human meta-analysis suggesting an association between certain RFC1 polymorphisms and the risk of silent brain infarctions, preclinical evidence concerning the potential role of RFC1 in acute ischemic stroke has yet to be presented. To investigate this, we first characterized RFC1 protein expression in mouse microvessels and pericytes which play significant roles in stroke pathophysiology. Then, we examined the temporal (1-h, 24-h, and 48-h) and spatial (infarct, periinfarct, contralateral) expression of RFC1 protein in the intraluminal transient middle cerebral artery occlusion mouse model. Finally, we knocked down RFC1 protein with RFC1-siRNA in the potential periinfarct region before induction of ischemia and investigated BBB integrity and infarct size in vivo via 7T-MRI. Moreover, we utilized a pharmacological modulation -methotrexate, a non-covalent inhibitor of RFC1- to further investigate the role of RFC1 in maintaining BBB integrity. Our study revealed that, i) RFC1 protein levels were dynamic throughout the acute phases of ischemic stroke, ii) RFC1 suppression aggravated the BBB leakage during ischemia. These results emphases the role of RFC1 in the pathophysiology of ischemic stroke and supports the evidence from human studies.
Microglia aggregates define distinct immune and neurodegenerative niches in Alzheimer's disease hippocampus.
Authors: Fixemer Sonja , Maza Mónica Miranda de la , Hammer Gaël Paul , Jeannelle Félicia , Schreiner Sophie , Gérardy Jean-Jacques , Mechawar Naguib , Mittelbronn Michel , Bouvier David S.
Published: December 2024

In Alzheimer's disease (AD), microglia show strong associations with amyloid-β (Aβ) and tau pathology, forming cellular aggregates such as Aβ plaque-associated microglia (PaM). Using high-content neuropathology, we found another type of microglial aggregates, morphologically distinct and not associated with Aβ plaques, mainly localised in the pyramidal layer of the CA2/CA1 human hippocampal subfields of AD patients, namely Coffin-like microglia (CoM). This study aims to define the morphological, pathological and molecular signatures of hippocampal PaM and CoM in AD patients and their implication in disease progression. We mapped and profiled PaM, CoM and their neuropathological and astrocytic microenvironment using Nanostring GeoMx Deep Spatial Profiling (DSP), multiplex chromogenic and confocal microscopy in AD hippocampal post-mortem samples. Key markers and results were validated in a collection of AD, DLB and age-matched control samples. CoM, found attached to tau tangles and neurons with phosphorylated α-synuclein accumulations, displayed specific protein and transcriptomic signatures associated with STING, protein degradation, TGF-β, and NF-κB signalling pathways. In contrast, PaM and PaM-astrocyte signatures were associated with complement system pathways, ErbB signalling, metabolic and neurodegenerative activities. While no direct association of CD8 + T cells with either PaM or CoM was observed, CD163 + perivascular macrophages were frequently found incorporated into PaM. This study provides new insights into the molecular characteristics of microglia and their association with astrocytes and infiltrating immune cells to delineate specific neurodegenerative hotspots in AD and related dementia and highlights their prominent role in hippocampal deterioration.
Unravelling the decision matrix: factors shaping small-scale aquaculture sustainability and choice of interventions in Lake Victoria basin communities, Uganda
Authors: Byabasaija Syliver , Limuwa Moses , semyalo Ronald
Published: December 2024

Fishing is crucial for food security and economic stability in Uganda, supporting over 1.8 million people. However, unsustainable practices and declining fish stocks threaten livelihoods, necessitating strategic interventions in small-scale aquaculture. This study aimed to investigate the factors influencing small-scale aquaculture intervention choices among farmers in the Lake Victoria Basin. A mixed-methods approach was employed, involving a cross-sectional survey conducted across three purposively selected districts: Buikwe, Wakiso, and Mpigi. Data were collected from 169 respondents in November 2023 using quantitative surveys and qualitative interviews. Data were analyzed using STATA and thematic methods, including multinomial logistic regression to examine choice patterns of pond farming (69.6%), cage farming (22.8%), and aquaponics (7.6%). The findings reveal a significant male predominance (83.6%) among fish farmers and highlight that education level, household size, and location and resource access influence small scale aquaculture intervention choice. Specifically, higher education levels were associated with a greater likelihood of choosing cage farming and aquaponics, while larger household sizes influenced preferences for pond farming due to resource allocation dynamics and limited access to resources constrains aquaculture diversification. To promote sustainable aquaculture, it is essential to implement programs aimed at empowering women, developing educational initiatives to enhance farmers' knowledge, and improving access to financial services. Additionally, advocating for supportive policy frameworks is critical for ensuring that aquaculture development in Uganda is sustainable and responsive to community needs.
PD-1/L1 immune checkpoint inhibitors for KRAS-mutant non-small cell lung cancer: a multicenter retrospective real-world study
Authors: Wei Kunchen , Sun Tiansheng , Feng Xiao , Chen Yang , Liu Qingzhong , Tang Hao
Published: December 2024

Background
KRAS (Kirsten rat sarcoma viral oncogene homolog) gene mutation is one of the common driver gene mutations in non-small cell lung cancer (NSCLC) with poor prognosis. There are limited effective treatments for advanced NSCLC patients with KRAS mutation. This study aimed to evaluate the effectiveness of PD-1/L1 immune checkpoint inhibitors (ICIs) as a first-line immunotherapy for advanced NSCLC patients harboring KRAS oncogene mutation.
Methods
This multicenter retrospective real-world study was conducted from 2019 to 2024 at Shanghai Changzheng Hospital and Shanghai Municipal Hospital of Traditional Chinese Medicine, including 78 patients who received immunotherapy using PD-1/L1 ICIs, and 29 patients who received traditional platinum-doublet chemotherapy. Their Clinical outcomes and prognostic factors for advanced NSCLC patients with KRAS oncogene mutation were analyzed.
Results
No significant difference in the objective response rate (ORR) and disease control rate (DCR) was observed between the two groups. The median progression-free survival (PFS) in immunotherapy group was longer than that in chemotherapy group [7.9 months (95% CI: 5.3–10.5) vs. 6.0 months (95% CI: 3.8–8.2), P = 0.030].
Conclusion
The first-line treatment with PD-1/PD-L1 ICIs showed numerically better clinical efficacy than the traditional double-agent chemotherapy in patients with KRAS-mutated NSCLC, especially in PFS. Additionally, PD-L1 expression, C reactive protein, CEA, and the neutrophil-to-lymphocyte ratio could serve as markers for predicting the efficacy of immunotherapy in patients with KRAS-mutated NSCLC.
Application of neck/chest CT to establish the evaluation perforation model of esophageal foreign body
Authors: Zhai Jianhua , Meng Haohao , Tang Sha , Zhang Yining , Guo Ruichang , Lin Lin , Wu Chao , Guo Ying , Wang Bangmao
Published: December 2024

Objective:Establish a predictive model with the perforation risk of esophageal foreign bodies (EFBs)--jujube pit, based on the structure of jujube pit and the relevant diameter of neck/chest computed tomography (CT).
Methods: A 6-year retrospective study enrolled 162 patients from November 2016 and October 2021, who were diagnosed as esophageal foreign bodies with jujube pits, proved by neck/chest CT and endoscopy. Clinical characters contained age, gender, and the time from ingestion to perforation. Neck/chest CT were collected for analysis. Those patients with incomplete clinical data or no imaging data have been eliminated. The jujube pit section (Intermediate Sheet Separator) has been stretched to maximum after 3D reconstruction, the longest diameter of jujube pit is defined as jujube pit size. The impaction angle was the angle between the longest diameter and the esophagus wall. Multifactor logistic regression and Receiver operating characteristic (ROC) curve analysis were used to calculate the predictive model of perforation risk of jujube pits.
Results:
There are 48 cases complicated with perforation among the 162 cases with complete data. Patients in the perforated group had higher age, jujube pit size and impaction angle than those in the non-perforated group (P<0.05). Multifactorial logistic regression analysis showed that patients age, jujube pit size, impaction angle were the risk factors for concomitant perforation in patients with EFBs (OR=0.926, 95%Cl: 0.886-0.968, P=0.001; OR=0.075, 95%Cl: 0.020-0.281, P=0.000; OR=0.926, 95%Cl: 0.899-0.954, P=0.000) and based on this result the regression equation of the risk assessment model was established Logit(p)=15.919-0.077*patients age-2.586*jujube pit size-0.077*impaction angle. ROC curve analysis revealed that the areas under the ROC curve (AUC) values of patient age, jujube pit size, impaction angle and comprehensive prediction model were 0.65,0.73,0.82 and 0.89, with a sensitivity of 54%,79%,92% and 81%, and a specificity of 68%,58%,68% and 82%, respectively.
Conclusion:
In patients with EFBs, those who experienced perforation were significantly older and had larger jujube pit sizes and greater impaction angles compared to those without perforation. These factors were identified as risk factors for the development of perforation in EFBs patients. A risk assessment model that incorporates these variables can effectively predict the likelihood of perforation.
An original strategy to promote Sleeping Sickness diagnostic participation in Guinea: How did the Football World Cup 2022 help to target the refractory young male population during an active screening Door-to-Door survey?
Authors: Gassama Mohamed , Camara Oumou , Soumah Aissata , Kagbadouno Moise , Vedovi François-Xavier Bart , Courtin Fabrice , Bucheton Bruno , Camara Mamadou , Bessell Paul , Bart Jean-Mathieu
Published: December 2024

Background. The study aimed to evaluate the effectiveness of sensitization events targeting young males to improve their participation in active screening campaigns for Human African Trypanosomiasis (HAT), also known as sleeping sickness, in Guinea. Despite progress towards eliminating HAT as a public health problem, challenges remain in detecting the last remaining cases, particularly among individuals, especially young men, who work in mangroves and are highly exposed to the tsetse fly vector.
Method. During the 2022 Football World Cup, coinciding with a door-to-door screening campaign in the Boffa focus of Guinea, football matches were used as an opportunity to sensitize the population. Twenty-seven villages were selected for screening, and four villages with recently diagnosed HAT cases were chosen to broadcast World Cup matches followed by a 30-minute sensitization movie about HAT in the local language. Demographic data were collected using an Open Data Kit system.
Results. The results indicated significant interest in the sensitization events, with over 500 attendees at all during the four days of broadcasting. A comparison of participation rates between World Cup villages (WCV) and non-WCV villages showed a higher proportion of males aged 8 to 27 participating in the WCV (17.7%) compared to non-WCV villages (14.6%). This difference was not observed for females of the same age group. Furthermore, compared to data from the previous year, there was an increase in the relative participation of young males from 16.4% to 19.6%.
Conclusion. Innovative strategies, such as using football matches for sensitization, are essential for reaching at-risk populations and identifying remaining HAT cases. Football holds significant cultural and social importance in Guinean villages, making it an effective platform for HAT sensitization efforts. Scaling up such strategies could further enhance awareness and participation in screening campaigns, ultimately aiding in the elimination of HAT transmission.
Identifying Factors that Influence Pediatric Echo Lab Image Quality: Development and Validation of a New Assessment Tool
Authors: Hill Garick D. , Hahn Eunice , Block Joseph R. , Chaves Alicia H. , Cumbermack Kristopher , Lipinski Joan , Natarajan Shobha , Parra David A. , Robinson Joshua D. , Soriano Brian D. , Walsh Michael J. , Seo JangDong , Frommelt Peter
Published: December 2024

Background
No method of evaluating transthoracic echocardiograms (TTE) image quality (IQ) has been validated. Furthermore, structural echo lab elements impacting IQ are unknown. We sought to develop and validate a TTE IQ grading tool and determine patient and echo lab features associated with IQ.
Methods
Ten pediatric echo labs each submitted 50 consecutive new patient TTEs without complex heart disease. For each study, 3 sonographers independently rated IQ and performed routine measurements. IQ scoring used the American College of Cardiology Quality Network (ACC QNet) tool plus a novel echo IQ tool. IQ scores were validated against the ability to make measurements and, when all measurements were made, variation between sonographers. After validation, patient and lab factors, from a previously published survey, associated with improved TTE IQ were determined by linear regression.
Results
Total IQ score (R2 = 0.64), ACC QNet (R2 = 0.29) and the novel IQ component (R2 = 0.52) correlated with the total number of measurements made (p < 0.001). For the 236 (52%) TTEs with all measurements, the novel IQ component (OR 0.9, 95% CI 0.82–0.99, p = 0.037) was associated with lower measurement variability. Factors significantly associated with worse novel IQ scores were higher patient weight, performance by a traveling sonographer, lower annual and inpatient TTE volume, less dedicated teaching/administrative sonographer time, and full-day sessions for reading physicians.
Conclusions
A novel TTE IQ scoring tool was created and validated for pediatric TTE. Modifiable structural components of echo labs associated with TTE IQ were identified. This novel IQ tool should guide IQ beyond the ACC QNet score.
A role for DICAM+ mononuclear phagocytes in controlling neuroinflammation in multiple sclerosis
Authors: von Essen Marina Rode , Hansen Marie Mathilde , Mahdaoui Sahla El , Hvalkof Victoria Hyslop , Hansen Malene Bredahl , Buhelt Sophie , Sellebjerg Finn
Published: December 2024

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). In MS, CNS-infiltrating monocytes differentiate to tissue resident macrophages which are found in large numbers within the injured areas of the brain where they play a central role in driving disease progression through demyelination and tissue destruction. However, infiltrating monocytes and their derivative macrophages can also serve protective functions. In this study we investigated a possible role of intrathecal mononuclear phagocytes (infiltrating monocytes and macrophages) expressing dual immunoglobulin domain-containing cell adhesion molecule (DICAM) in neuroinflammation. Compared to symptomatic controls, treatment-naïve patients with relapsing-remitting MS had a reduced prevalence of DICAM+ mononuclear phagocytes in CSF. When patients were treated with natalizumab, an antibody blocking migration of blood leukocytes to the CNS, we observed that DICAM+ monocytes were still recruited to the CSF and that the level of soluble DICAM (sDICAM) in CSF was significantly increased compared to untreated patients. sDICAM and the prevalence of DICAM+ mononuclear phagocytes in CSF furthermore correlated negatively with concentrations of various cytokines, including TNFa. Analysing the functional properties of DICAM showed that LPS-induced TNFa-production in mononuclear phagocytes was effectively reduced by signalling through surface-bound DICAM. This discovery, together with the observation of a high prevalence of infiltrating DICAM+ mononuclear phagocytes in individuals with no disease or in which disease was kept under control, suggests an immunomodulatory role of DICAM+ mononuclear phagocytes. Also, DICAM can engage in homophilic interaction with DICAM on other cells, suggesting that the increased intrathecal sDICAM of natalizumab-treated patients may help regulate inflammation in a paracrine way. Overall, our data suggest that DICAM+ mononuclear phagocytes play a role in controlling neuroinflammation.
Open Versus Endoscopic Surgery with Helmet Molding Therapy in Non-syndromic Patients with Craniosynostosis: An Updated Systematic Review and Meta-Analysis of Clinical Outcomes and Treatment-Related Costs
Authors: Ortega-Ruiz Omar R. , Torres-Martínez Mauricio , Villafranca-Cantú Mariana , Ávila-Cañedo Rebeca Alejandra , PiñeyroCantú Emilio , Menchaca-Welsh Eduardo , Shimony Nir , Jallo George I. , Terrazo-Lluch Javier , Cuéllar-Hernández J. Javier
Published: December 2024

Objective There is an ongoing debate regarding the optimal treatment for craniosynostosis as diverse factors influence the election between endoscopic and open surgery. Previous evidence favors endoscopic procedures; However, evidence remains unfulfilled by a limited number of patients and clustered in very few centers worldwide making it difficult to define it as a replicable technique in different populations. In recent years, evidence regarding endoscopic-assisted procedures has gone through a considerable spurt showing an increased interest among surgeons globally showing optimal outcomes in different populations and centers. In this systematic review and meta-analysis, we performed an updated analysis of previous reviews, including only non-syndromic patients. We also seek to provide a summary of the tendency of treatment observed in the literature. Similarly, this is the first study to include total costs within its analysis.
Material and Methods Three previous meta-analyses published in 2018 yielded 11 eligible papers. We performed a systematic review and meta-analysis of the literature in MEDLINE and EMBASE databases through PubMed, Scopus, and Ovid to fill the gap of information between 2018 and 2024. 23 total articles were included in the final analysis.
Results Variables analyzed were baseline characteristics, length of stay, blood loss, transfusion rates and volume, operative time, and costs. Analysis of data concluded a younger age at surgery in patients undergoing endoscopic surgery (p= <0.00001). Blood loss, transfusion rates, and volumes depicted favored outcomes for endoscopy with less blood loss during surgery (p = <0.00001), operative time (p=<0.00001), and transfusion rates (p=<0.00001) as well as lower transfused volumes (p = <0.00001).
Conclusion Endoscopic surgery carries fewer complications than open surgery. Treatment-related costs are highly decreased in endoscopic procedures after including costs related to outpatient care. Open surgery can be considered in older children if no endoscope or experienced surgeons in endoscopic procedures are available.
Post-stroke Central Neuropathic Pain: Prevalence and Associated Risks Factors
Authors: Yacouba Yacouba MAPOURE NJANKOUO , MAGNEROU Annick Melanie , Njoya Ahmed Vessah , Massi Daniel Gams , Kenmegne Caroline , Tegueu Callixte Kuate
Published: December 2024

Introduction: Stroke can lead to complications such as post-stroke central neuropathic pain (PSCNP), which is often underdiagnosed in Sub-Saharan Africa.
Objective: to determine the frequency and predicting factors of PSCNP at the Douala General Hospital.
Methods: This hospital-based, cross-sectional analytic study was conducted in the neurology unit from January 1 to May 31, 2019. Two patient groups were included: Group 1 (stroke+), consisting of confirmed stroke patients with a stroke onset of over one month, no PSCNP symptoms prior to the stroke, and no other causes of central or peripheral neuropathic pain; and Group 2 (stroke-), comprising patients with no history of stroke, matched by age, sex, and cerebrovascular risk factors with Group 1. The “Douleur neuropathique 4” (DN4) questionnaire was used to diagnose PSCNP. Logistic regression was performed to identify PSCNP predictors.
Results: A total of 301 patients (100 stroke+ and 201 stroke-) were included. The prevalence of PSCNP was 27% in stroke+ and 8.95% in stroke- [p <0.001; OR = 3.760; 95% CI: 1.953-7.241]. Independent predictors of PSCNP were alcoholism [p = 0.001, OR = 9.704, 95% CI = 2.630 - 35.805], hemorrhagic stroke [p = 0.003, OR = 8.534, 95% CI = 2.068 - 35.214], and obesity [p = 0.001, OR = 9.324, 95% CI = 2.487 - 34.963].
Conclusion: Stroke increases the risk of developing PSCNP by fourfold. Alcohol use, hemorrhagic stroke, and obesity are significant predictors and should be carefully monitored in PSCNP assessments.
Sub-nanosecond all-optically reconfigurable photonics in optical fibres
Authors: Ji Kunhao , Richardson David , Wabnitz Stefan , Guasoni Massimiliano
Published: December 2024

We introduce a novel all-optical platform in multimode and multicore fibres. By using a low-power probe beam and a high-power counter-propagating control beam, we achieve advanced and dynamic control over light propagation within the fibres. This setup enables all-optical reconfiguration of the probe, which is achieved by solely tuning the control beam power. Key operations such as fully tuneable power splitting and mode conversion, core-to-core switching and combination, along with remote probe characterization, are demonstrated at the sub-nanosecond time scale. Our experimental results are supported by a theoretical model that extends to fibres with an arbitrary number of modes and cores. The implementation of these operations in a single platform underlines its versatility, a critical feature of next-generation photonic systems. These results represent a significant shift from existing methods that rely on electro-optical or thermo-optical modulation for tunability. They pave the way towards a fast and energy-efficient alternative through all-optical modulation, a keystone for the advancement of future reconfigurable optical networks and optical computing. Scaling these techniques to highly nonlinear materials could underpin ultrafast all-optically programmable integrated photonics.
Human transporter de-oligomerization regulates copper uptake into cells
Authors: Chen Tai-Yen , Wen Meng-Hsuan , Chen Huanhuan , Yan Guangjie , Zhang Yuteng , Chen Wenkai , Dokholyan Martin , Wang Jian , Dokholyan Nikolay
Published: December 2024

Copper is an essential element involved in various biochemical processes, such as mitochondrial energy production and antioxidant defense, but improper regulation can lead to cellular toxicity and disease. Copper Transporter 1 (CTR1) plays a key role in copper uptake and maintaining cellular copper homeostasis. Although CTR1 endocytosis was previously thought to reduce copper uptake when levels are high, it was unclear how rapid regulation is achieved. Using single-molecule localization microscopy and single-molecule neighbor density assays, we discovered that excess copper induces monomerization of the wild-type trimeric CTR1 prior to endocytosis, a response blocked in the endocytosis-deficient CTR1 (M150L) mutant. This monomerization rapidly halts copper uptake and prevents copper overload. These findings reveal changes in protein oligomerization as a new paradigm of metal transport regulation, linking CTR1's structural changes to its endocytosis and copper homeostasis.
Discovery and language model-guided design of hyperactive transposase
Authors: Güell Marc , Ivančić Dimitrije , Agudelo Alejandro , Lindstrom-Vautri Jonathan , Jaraba-Wallace Jessica , Gallo Maria , Ragel Alejandro , Higueras Irene , Billeci Federico , Sanvicente Marta , Petazzi Paolo , Ferruz Noelia , Sánchez-Mejías Avencia , Das Ravi
Published: December 2024

The PiggyBac transposase gene writing system has been efficiently used across biotechnological applications, however its diversity and biochemical potential remain largely unexplored. By developing a eukaryotic transposon mining pipeline, we expand the known diversity by two orders of magnitude and experimentally validate a subset of highly divergent PiggyBacs. We then fine tune a protein language model to further expand PiggyBac sequence space and discover transposons with improved activity, compatible with T-cell engineering and Cas9-guided programmable transposition. Our work illustrates how combining bioprospecting and AI-driven sequence exploration can accelerate the discovery of novel eukaryotic gene writing tools.
Design of robust networks via reinforcement learning prompt the emergence of multilayer backbones
Authors: Li Daqing , Zhu Bingyu , Zhu Tianchen , Gao Jianxi , Havlin Shlomo
Published: December 2024

Network robustness design is a significant engineering task in complex systems including urban planning, communication programming, and chip designing. With the embedded vulnerability of complex networks, the relationship between network topology and its robustness remains unknown, presenting a significant challenge in designing robust networks. Existing approaches—ranging from empirical manual designs, statistically-driven rules to optimization via Monte Carlo simulations, struggle to meet the design demands of large-scale networks under multidimensional attacks. Here, we introduce a general framework for designing robust networks based on AI reinforcement learning. This framework establishes an interactive environment between network attack strategies and design models, enabling the learning of effective robustness design strategies against specific attacks. Our framework enables efficient design of robust large-scale networks for a given cost, surpassing existing methods. Notably, we find that during the design process, the network may develop suitable multilayer backbones that mitigate its current vulnerability, offering insight into higher-order relations in real-world networks. Our approach can be adopted to various network design scenarios, which provides an integrative intelligent solution for designing robust complex systems.
Association of KRAS and TERT Genetic Variants with Opioid Dependence in a Large Clinical Cohort
Authors: Cuomo Raphael E.
Published: December 2024

Introduction:
The present exploratory study seeks to showcase an approach to uncover potential genetic associations predisposing individuals to opioid dependence, in which a large clinical database is utilized to compare results of testing for genetic variants with clinical diagnoses of opioid dependence.
Methods
Employing a STROBE-compliant study design, this research leveraged the UC Health Data Warehouse, an OMOP CDM-compliant database with EHR data from six University of California academic health centers. Utilizing SQL queries embedded in Python scripts with the Spark framework, the study extracted genetic data, focusing on individuals tested for specific genetic variants.
Results
Rates of detection for nine genes were evaluated between 222 patients with opioid dependence and 20141 patients without, revealing significantly decreased odds of opioid dependence for individuals with the TERT gene (OR = 0.61, p = 0.010) and significantly increased odds for individuals with the KRAS gene (OR = 1.45, p = 0.014). Significant associations persisted after adjusting for demographics.
Conclusions
The discovery of KRAS and TERT associations with opioid dependence in our study highlights the intricate genetic landscape of this condition. This study, in triangulation with findings from GWAS and other designs, may pave the way for more personalized approaches to prevention and treatment of opioid dependence.