bluuebunny/crossref_metadata_2025 huggingface dataset:
MicroRNA-1 Deficiency Is a Primary Etiological Factor Disrupting Cardiac Contractility and Electrophysiological Homeostasis
Authors: Yang Dandan , Wan Xiaoping , Schwieterman Neill , Cavus Omer , Kacira Ege , Xu Xianyao , Laurita Kenneth R. , Wold Loren E. , Hund Thomas J. , Mohler Peter J. , Deschênes Isabelle , Fu Ji-Dong
Published: December 2023

BACKGROUND:

MicroRNA-1 (miR1), encoded by the genes
miR1-1
and
miR1-2
, is the most abundant microRNA in the heart and plays a critical role in heart development and physiology. Dysregulation of miR1 has been associated with various heart diseases, where a significant reduction (>75%) in miR1 expression has been observed in patient hearts with atrial fibrillation or acute myocardial infarction. However, it remains uncertain whether miR1-deficiency acts as a primary etiological factor of cardiac remodeling.

METHODS:

miR1-1
or
miR1-2
knockout mice were crossbred to produce 75%-miR1-knockdown (75%KD;

miR1-1
+/−
:miR1-2
−/−

or

miR1-1
−/−
:miR1-2
+/−

) mice. Cardiac pathology of 75%KD cardiomyocytes/hearts was investigated by ECG, patch clamping, optical mapping, transcriptomic, and proteomic assays.

RESULTS:

In adult 75%KD hearts, the overall miR1 expression was reduced to ≈25% of the normal wild-type level. These adult 75%KD hearts displayed decreased ejection fraction and fractional shortening, prolonged QRS and QT intervals, and high susceptibility to arrhythmias. Adult 75%KD cardiomyocytes exhibited prolonged action potentials with impaired repolarization and excitation-contraction coupling. Comparatively, 75%KD cardiomyocytes showcased reduced Na
+
current and transient outward potassium current, coupled with elevated L-type Ca
2+
current, as opposed to wild-type cells. RNA sequencing and proteomics assays indicated negative regulation of cardiac muscle contraction and ion channel activities, along with a positive enrichment of smooth muscle contraction genes in 75%KD cardiomyocytes/hearts. miR1 deficiency led to dysregulation of a wide gene network, with miR1’s RNA interference–direct targets influencing many indirectly regulated genes. Furthermore, after 6 weeks of bi-weekly intravenous tail-vein injection of miR1 mimics, the ejection fraction and fractional shortening of 75%KD hearts showed significant improvement but remained susceptible to arrhythmias.

CONCLUSIONS:

miR1 deficiency acts as a primary etiological factor in inducing cardiac remodeling via disrupting heart regulatory homeostasis. Achieving stable and appropriate microRNA expression levels in the heart is critical for effective microRNA-based therapy in cardiovascular diseases.
Magnesium and Hematoma Expansion in Intracerebral Hemorrhage: A FAST-MAG Randomized Trial Analysis
Authors: Liotta Eric M. , Maas Matthew B. , Prabhakaran Shyam , Shkirkova Kristina , Sanossian Nerses , Liebeskind David S. , Sharma Latisha , Stratton Samuel , Conwit Robin , Saver Jeffrey L. ,   for the FAST-MAG Investigators and Coordinators
Published: December 2023

BACKGROUND:

Observational studies suggest that magnesium may have hemostatic effects. FAST-MAG (Field Administration of Stroke Therapy-Magnesium) was a pragmatic clinical trial of magnesium sulfate administered prehospital for acute clinical stroke syndromes and included patients with intracerebral hemorrhage. Exploratory secondary analysis by the treatment group found no reduction in hematoma expansion (HE) associated with magnesium treatment in intracerebral hemorrhage but did not consider serum magnesium levels achieved. We analyzed FAST-MAG intracerebral hemorrhage data for associations between serum magnesium level, HE, and early neurological deterioration, accounting for groupwise biases.

METHODS:

HE was defined as hematoma volume increase ≥3 mL within 24 hours and early neurological deterioration as ≥1-point Glasgow Coma Scale decline from arrival to hospital day 4. Comparing treatment and placebo groups confirmed biased availability of neuroimaging data. Therefore, HE and neurological deterioration were analyzed and stratified by treatment and placebo groups using univariate tests and adjusted logistic regression.

RESULTS:

Spontaneous intracerebral hemorrhage was present in 381 patients. Placebo patients had fewer serial neuroimaging studies available (123 [65.4%] versus 145 [75.1%];
P
=0.038). Necessary data were available in 104 magnesium- and 85 placebo-treated patients (age, 64.9 [13.0] years; 67.7% male). In the magnesium group, higher magnesium level was associated with less HE (adjusted odds ratio, 0.64 per mg/dL [95% CI, 0.42–0.93]) and less neurological deterioration (adjusted odds ratio, 0.54 per mg/dL [95% CI, 0.33–0.82]). In the placebo group, magnesium level was not associated with either HE or neurological deterioration.

CONCLUSIONS:

Magnesium may exhibit a hemostatic effect that was only observable in the FAST-MAG magnesium treatment group. Equipoise should be maintained, and specific trials are needed.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT00059332.
Removing Backdoors in Pre-trained Models by Regularized Continual Pre-training
Authors: Zhu Biru , Cui Ganqu , Chen Yangyi , Qin Yujia , Yuan Lifan , Fu Chong , Deng Yangdong , Liu Zhiyuan , Sun Maosong , Gu Ming
Published: December 2023

Recent research has revealed that pre-trained models (PTMs) are vulnerable to backdoor attacks before the fine-tuning stage. The attackers can implant transferable task-agnostic backdoors in PTMs, and control model outputs on any downstream task, which poses severe security threats to all downstream applications. Existing backdoor-removal defenses focus on task-specific classification models and they are not suitable for defending PTMs against task-agnostic backdoor attacks. To this end, we propose the first task-agnostic backdoor removal method for PTMs. Based on the selective activation phenomenon in backdoored PTMs, we design a simple and effective backdoor eraser, which continually pre-trains the backdoored PTMs with a regularization term in an end-to-end approach. The regularization term removes backdoor functionalities from PTMs while the continual pre-training maintains the normal functionalities of PTMs. We conduct extensive experiments on pre-trained models across different modalities and architectures. The experimental results show that our method can effectively remove backdoors inside PTMs and preserve benign functionalities of PTMs with a few downstream-task-irrelevant auxiliary data, e.g., unlabeled plain texts. The average attack success rate on three downstream datasets is reduced from 99.88% to 8.10% after our defense on the backdoored BERT. The codes are publicly available at https://github.com/thunlp/RECIPE.
Revision of the fern genus Diplazium (Polypodiales: Athyriaceae) in Thailand
Authors: PONGKAI PUTTAMON , ZHANG LI-BING , BOONKERD THAWEESAKDI , POLLAWATN ROSSARIN
Published: December 2023

The genus Diplazium in Thailand is revised. Thirty-one species are recognized, of which D. thailandicum is new to science, and two species, D. bellum and D. pallidum are new to Thailand. These species are described and illustrated. The lectotypes of D. dilatatum, D. leptophyllum, D. petolotii and D. petrii are designated here. A key to the species, descriptions, line drawings, and ecological and distributional information are provided.
Description of five new species of the subgenus Tachycines (Gymnaeta) (Rhaphidophoridae: Aemodogryllinae: Aemodogryllini) from caves in Guizhou, China
Authors: LIN CHUN , HUANG SHIHUI , LUO CHANGQING
Published: December 2023

The genus Tachycines contains two subgenera: T. (Tachycines) and T. (Gymnaeta), and the species of this genus occur mainly in Southeast and East Asia, including Myanmar, Philippines, Vietnam, India, and China. Many species of the subgenus Tachycines (Gymnaeta) are cavernicolous. In this study, five new cave species of this subgenus, namely Tachycines (Gymnaeta) lingulatus sp. nov., Tachycines (Gymnaeta) multispinus sp. nov., Tachycines (Gymnaeta) microtuberculatus sp. nov., Tachycines (Gymnaeta) ovalius sp. nov., and Tachycines (Gymnaeta) conicus sp. nov., from Guizhou Province, China are identified and described. Morphological information of males and females of the five new species are provided.
Sepsis-induced Coagulopathy: The Different Prognosis in Severe Pneumonia and Bacteremia Infection Patients
Authors: Liufu Rong , Chen Yan , Wan Xi-Xi , Liu Rui-Ting , Jiang Wei , Wang ChYao , Peng Jin-Min , Weng Li , Du Bin
Published: December 2023

Sepsis-induced coagulopathy (SIC) is a critical condition in sepsis patients, with varying outcomes depending on the type of infection. This study aims to analyze the prognosis of different infections in SIC cohort. A retrospective cohort study was conducted on 525 patients diagnosed with SIC in the intensive care unit from December 2013 to December 2022. These patients were divided into four groups: a non-pneumonia or bacteremia group, a severe pneumonia group, a bacteremia group, and a severe pneumonia concomitant with bacteremia group. The 28-day mortality was 18% (49/271) in the other infections group, 31% (33/106) in the lung infections group, 23% (29/126) in the blood infections group and 36% (8/36) in the lung and blood co-infections group, respectively. Pearson correlation analysis showed that procalcitonin (PCT) correlated strongly with all detected hemostatic markers ( p < 0.001). The 28-day mortality rate in Lung infections group was significantly higher ( p = 0.019), while Blood infections group had a higher incidence of disseminated intravascular coagulation ( p = 0.011). By multivariable model analyses, longer duration of ventilation ( p = 0.039) and severe pneumonia ( p = 0.040) are risk factors associated with mortality. Different infections, including Lung and Blood infections, indicated different conditions in vivo. Longer duration of ventilation is associated with mortality, while Lung infections indicated higher 28-day mortality rate.
Drug therapy problems in patients with schizophrenia: A cross-sectional study
Authors: Temtem Gubae , Woldu Minyahil , Berha Alemseged , Shibeshi Workineh , Teferra Solomon , Engidawork Ephrem
Published: December 2023

Introduction

Fifty percent of people living with schizophrenia do not receive proper treatments, and adherence level has been reported as low as 65%. Furthermore, the level of satisfaction has been reported to be very low in this population.

Objective

The purpose of this study was to evaluate treatment satisfaction, adherence, and the prevalence of drug therapy problems (DTPs).

Methods

A hospital-based cross-sectional study was carried out on 118 patients with schizophrenia. DTPs, adherence, and treatment satisfaction were determined using the Cipolle, Morisky, Green, and Levine, and Treatment Satisfaction with Medicines Questionnaire tools. The data were then entered using Epi-Info™ version 7.2.1 and SPSS version 22 was used for analysis. Descriptive statistics were used to summarize patients’ characteristics. Univariate and bivariate logistic regressions, with a significance threshold of P < .05, were used to analyze the associations.

Results

DTPs were found in 52.5% ( P < .001) of the participants. The most often detected DTPs were ‘adverse drug reaction', (26.1%); ‘dose-too-low', (20.5%); and ‘ineffective-medicine therapy', (20.5%). Risperidone was the most prevalent medication (79, 47%) found in DTPs. DTPs were associated with age ≥ 65 years [AOR = .044, 95% CI (.003-.741); P < .030], drug-source [AOR = .774, 95% CI (.070-.826); P = .241], treatment duration [AOR = 5.820, 95% CI (1.451-23.342), P = .013], and the number of drugs taken [AOR = 5.936, 95% CI (1.623-21.71), P = .007]. Adherence status revealed that 69 (58.5%) of the participants were poorly adherent to their treatment. Overall, 68.8% of those who took part in the study were satisfied according to satisfaction ratings.

Conclusions

There is a high burden of DTPs in the study setting in the form of Adverse drug reactions, low dose schedules, and ineffective treatment associated with poor medication adherence; even though two-third of the participants were found to be satisfied with the clinical services given at the clinic.
Intensive care risk and long-term outcomes in pediatric allogeneic hematopoietic cell transplant recipients
Authors: Zinter Matt S. , Brazauskas Ruta , Strom Joelle , Chen Stella , Bo-Subait Stephanie , Sharma Akshay , Beitinjaneh Amer , Dimitrova Dimana , Guilcher Greg , Preussler Jaime , Myers Kasiani , Bhatt Neel S. , Ringden Olle , Hematti Peiman , Hayashi Robert J. , Patel Sagar , De Oliveira Satiro Nakamura , Rotz Seth , Badawy Sherif M. , Nishihori Taiga , Buchbinder David , Hamilton Betty , Savani Bipin , Schoemans Hélène , Sorror Mohamed , Winestone Lena , Duncan Christine , Phelan Rachel , Dvorak Christopher C.
Published: December 2023

Allogeneic hematopoietic cell transplantation (HCT) can be complicated by life-threatening organ toxicity and infection necessitating intensive care. Epidemiologic data have been limited by single-center studies, poor database granularity, and a lack of long-term survivors. To identify contemporary trends in intensive care unit (ICU) use and long-term outcomes, we merged data from the Center for International Blood and Marrow Transplant Research and the Virtual Pediatric Systems databases. We identified 6995 pediatric patients with HCT aged ≤21 years who underwent first allogeneic HCT between 2008 and 2014 across 69 centers in the United States or Canada and followed patients until the year 2020. ICU admission was required for 1067 patients (8.3% by day +100, 12.8% by 1 year, and 15.3% by 5 years after HCT), and was linked to demographic background, pretransplant organ toxicity, allograft type and HLA-match, and the development of graft-versus-host disease or malignancy relapse. Survival to ICU discharge was 85.7%, but more than half of ICU survivors required ICU readmission, leading to 52.5% and 42.6% survival at 1- and 5-years post-ICU transfer, respectively. ICU survival was worse among patients with malignant disease, poor pretransplant organ function, and alloreactivity risk factors. Among 1-year HCT survivors, those who required ICU in the first year had 10% lower survival at 5 years and developed new dialysis-dependent renal failure at a greater rate (P<.001). Thus, although ICU management is common and survival to ICU discharge is high, ongoing complications necessitate recurrent ICU admission and lead to a poor 1-year outcome in select patients who are at high risk.
Klebsiella pneumoniae invasive syndrome with liver, lung, and brain abscesses complicated with pulmonary fungal infection: a case report and review of the literature
Authors: Luo Yunhao , Hu Wen , Wu Lingna , Duan Shijie , Zhong Xingmei
Published: December 2023

Background

Klebsiella pneumoniae invasion syndrome (KPIS) is a severe multi-site infection that is usually caused by hypervirulent Klebsiella pneumoniae. The bacteria are relatively common in Asian diabetics and can cause organ abscesses or sepsis. When patients develop intracranial infection, the prognosis is poor. After anti-infective treatment, the Klebsiella pneumoniae-induced liver and lung abscesses and pulmonary fungal infection were relieved, but the brain abscesses worsened. Such complex and severe infection cases are rarely reported. Early identification of intracranial infection, selection of antibiotics with high concentrations in cerebrospinal fluid, and active treatment of complications such as diabetes and fungal infection are of great significance for the prognosis of patients.

Case presentation

A 71-year-old patient diagnosed with liver abscess in another hospital was transferred to our hospital due to a worsening condition. On day 1 (day of admission), the patient was given invasive mechanical ventilation, continuous renal replacement therapy combined with endotoxin adsorption, antimicrobial treatment with imipenem-cilastatin, and percutaneous catheter drainage for liver abscess. Metagenomic next-generation sequencing in bronchoalveolar lavage fluid indicated Klebsiella pneumoniae (K. pneumoniae), Candida albicans, and Aspergillus flavus complex, and no viruses were detected. Blood and pus cultures revealed K. pneumoniae that was sensitive to piperacillin/tazobactam. The anti-infection therapy was adjusted to piperacillin/tazobactam combined with voriconazole. On day 14, a head computed tomography (CT) scan showed no significant changes, and a chest CT scan showed absorption of multiple abscesses in both lungs. The patient was still unconscious. After the endotracheal tube was removed, cranial magnetic resonance imaging (MRI) showed multiple brain abscesses. Finally, his family gave up, and the patient was discharged and died in a local hospital.

Conclusion

In cases of K. pneumoniae infection, the possibility of intracranial, liver, lung, or other site infections should be considered, and physicians should be vigilant for the occurrence of KPIS. For patients suspected of developing an intracranial infection, cerebrospinal fluid should be tested and cultured as soon as possible, a head MRI should be performed, and antibiotics with high distribution in cerebrospinal fluid should be used early. When patients are complicated with diabetes, in addition to glycemic control, vigilance for concurrent fungal infections is also needed.
IgMAT: immunoglobulin sequence multi-species annotation tool for any species including those with incomplete antibody annotation or unusual characteristics
Authors: Dorey-Robinson Daniel , Maccari Giuseppe , Hammond John A.
Published: December 2023

Background

The advent and continual improvement of high-throughput sequencing technologies has made immunoglobulin repertoire sequencing accessible and informative regardless of study species. However, to fully map dynamic changes in polyclonal responses precise framework and complementarity determining region annotation of rearranging genes is pivotal. Most sequence annotation tools are designed primarily for use with human and mouse antibody sequences which use databases with fixed species lists, applying very specific assumptions which select against unique structural characteristics. For this reason, data agnostic tools able to learn from presented data can be very useful with new species or with novel datasets.

Results

We have developed IgMAT, which utilises a reduced amino acid alphabet, that incorporates multiple HMM alignments into a single consensus to automatically annotate immunoglobulin sequences from most organisms. Additionally, the software allows the incorporation of user defined databases to better represent the species and/or antibody class of interest. To demonstrate the accuracy and utility of IgMAT, we present analysis of sequences extracted from structural data and immunoglobulin sequence datasets from several different species.

Conclusions

IgMAT is fully open-sourced and freely available on GitHub (https://github.com/TPI-Immunogenetics/igmat) for download under GPLv3 license. It can be used as a CLI application or as a python module to be integrated in custom scripts.
Integrated analysis of HSP20 genes in the developing flesh of peach: identification, expression profiling, and subcellular localization
Authors: Zhang Chunhua , Zhang Yanping , Su Ziwen , Shen Zhijun , Song Hongfeng , Cai Zhixiang , Xu Jianlan , Guo Lei , Zhang Yuanyuan , Guo Shaolei , Sun Meng , Li Shenge , Yu Mingliang
Published: December 2023

Background

Plant HSP20s are not only synthesized in response to heat stress but are also involved in plant biotic and abiotic stress resistance, normal metabolism, development, differentiation, survival, ripening, and death. Thus, HSP20 family genes play very important and diverse roles in plants. To our knowledge, HSP20 family genes in peach have not yet been characterized in detail, and little is known about their possible function in the development of red flesh in peach.

Results

In total, 44 PpHSP20 members were identified in the peach genome in this study. Forty-four PpHSP20s were classified into 10 subfamilies, CI, CII, CIII, CV, CVI, CVII, MII, CP, ER, and Po, containing 18, 2, 2, 10, 5, 1, 1, 2, 1, and 2 proteins, respectively. Among the 44 PpHSP20 genes, 6, 4, 4, 3, 7, 11, 5, and 4 PpHSP20 genes were located on chromosomes 1 to 8, respectively. In particular, approximately 15 PpHSP20 genes were located at both termini or one terminus of each chromosome. A total of 15 tandem PpHSP20 genes were found in the peach genome, which belonged to five tandemly duplicated groups. Overall, among the three cultivars, the number of PpHSP20 genes with higher expression levels in red flesh was greater than that in yellow or white flesh. The expression profiling for most of the PpHSP20 genes in the red-fleshed ‘BJ’ was higher overall at the S3 stage than at the S2, S4-1, and S4-2 stages, with the S3 stage being a very important period of transformation from a white color to the gradual anthocyanin accumulation in the flesh of this cultivar. The subcellular localizations of 16 out of 19 selected PpHSP20 proteins were in accordance with the corresponding subfamily classification and naming. Additionally, to our knowledge, Prupe.3G034800.1 is the first HSP20 found in plants that has the dual targets of both the endoplasmic reticulum and nucleus.

Conclusions

This study provides a comprehensive understanding of PpHSP20s, lays a foundation for future analyses of the unknown function of PpHSP20 family genes in red-fleshed peach fruit and advances our understanding of plant HSP20 genes.
Comparison of different Pancreatic cancer treatments: a three-year retrospective study in the oncology center of Tangier university hospital, Morocco
Authors: Abrini Houda , Amzerin Mounia , El Baaboua Aicha , Aboulaghras Sara , Bouhda Alia , El Mrabet Fatima Zahra
Published: December 2023

Background

Pancreatic cancer is among the most lethal malignancies, with a 5-year overall survival (OS) of less than 10% for all stages. The present study aims to evaluate the epidemiological and clinical characteristics, as well as the results of different treatments of patients diagnosed and treated between 2019 and 2021 in the Oncology Center of Tangier, University Hospital, Morocco.

Methods

To compare the evolution of the pancreatic cancer between the different chemotherapy regimens, a retrospective study was performed using data collected over a period of 3 years. For each patient, the data were described and statistically analyzed in the dedicated operating sheet.

Results

55 pancreatic cancer patients were included in this study, and the median follow up was 3 months. The mean age of patients was 59.5 ± 10.3 years (extremes 34–79) and the sex ratio male/female was 0.9. Most patients were diagnosed with adenocarcinoma (92.3%), but metastatic stage was the most frequent (56.4%). The surgery was applied to 16.36% of patients. 10.9% of patients have received adjuvant chemotherapy and 76.4% received palliative chemotherapy. Chemotherapy regimens included mainly Gemcitabine and Folfirinox. The median OS was significantly longer for patients treated with Folfirinox versus Gemcitabine (6 months versus 3 months, p-value < 0.016). The median OS for patients that received Folfirinox and Gemcitabine successively (19.7 months) was significantly longer compared to patients that received a monotherapy with either Folfirinox or Gemcitabine alone (p-value < 0.016).

Conclusion

These findings reinforce the use of advanced methods for earlier detection of pancreatic cancer and the development of effective immunotherapies or more targeted therapies.
Recurrent exercise-induced acute kidney injury associated with hypouricemia: a case report and literature review
Authors: Zhou Jie , Zhang Min , Xie Qionghong , Xu Ningxin , Li Mingxin , Zhang Ming , Hao Chuanming
Published: December 2023

Background

Hereditary renal hypouricemia (RHUC) is a heterogenous disorder characterized by defective uric acid (UA) reabsorption resulting in hypouricemia and increased fractional excretion of UA. RHUC is an important cause of exercise-induced acute kidney injury (EIAKI), nephrolithiasis and posterior reversible encephalopathy syndrome (PRES). We present here an unusual case of a patient with RHUC who presented with recurrent EIAKI and had two heterozygous mutations in the SLC2A9 gene.

Case presentation

A 43-year old man was admitted to our clinic because of bilateral loin pain, nausea and sleeplessness for 3 days after strenuous exercise. The laboratory results revealed increased levels of blood urea nitrogen (BUN) (15 mmol/l) and serum creatinine (Scr) (450 μmol/l), while the UA level was extremely low at 0.54 mg/dl, and his fractional excretion of urate (FE-UA) was 108%. The patient had an episode of acute kidney injury after playing soccer approximately 20 years ago, and on routine physical examination, his UA was less than 0.50 mg/dl. In view of the marked hypouricemia and high FE-UA, a diagnosis of RHUC was suspected, which led us to perform mutational screening of the SLC22A12 and SLC2A9 genes. DNA sequencing revealed no mutation in SLC22A12 gene, but two heterozygous mutations in the SLC2A9 gene.

Conclusions

This is a rare report of a patient with RHUC2 due to the mutation of SLC2A9. And this unique symptom of EIAKI and decreased or normal serum concentrations of UA warrant more attention as an early cue of RHUC.
Neo-adjuvant chemotherapy plus immunotherapy in resectable N1/N2 NSCLC
Authors: Du Chengli , Chen Yunhao , Zhou Yuwei , Zheng Difang , Zhao Jiangang , Tang Jie , Wu Yihe , Tu Zhengliang
Published: December 2023

Background

Locally advanced non-small cell lung cancer (NSCLC) with N1/N2 lymph node metastasis is challenging with poor survival. Neo-adjuvant chemo-immunotherapy has gained benefits in a proportion of these patients. However no specific biomarker has been proved to predict the effect before therapy. In addition, the relationship of nodal status and survival after neo-adjuvant chemo-immunotherapy is still not well stated.

Methods

A total of 75 resectable NSCLC patients with N1/N2 stage who received neo-adjuvant chemo-immunotherapy plus surgery were retrospectively studied. The clinical characteristics, surgical information and safety parameters were collected. The correlations of major pathological response (MPR) and pathological complete response (pCR) with clinical data were analyzed. The progression free disease(PFS) and overall survival(OS) were evaluated with pathological response and nodal status.

Results

Of the 75 patients, 69 (92%) patients experienced treatment related adverse effects, while grade 3–4 adverse effects occurred in 8 (10%) patients. All the patients received surgical R0 resection with a MPR rate of 60% and a pCR rate of 36%. 67% of N1 patients and 77% of N2 patients had nodal clearance after neo-adjuvant treatment. A significant difference was observed between pathological response with age, histology and multiple lymph node metastasis. The PFS was better in the MPR cohort. The PFS was 90.1% and 83.6% at the nodal clearance group at the time of 12 and 18 months, compared with 70.1% and 63.7% at the nodal residual group.

Conclusions

The neo-adjuvant chemo-immunotherapy for locally advanced NSCLC with nodal positive was safe and feasible. The patients with elder age and squamous-cell carcinoma (SCC) were more likely to have better pathological response, while multiple nodal metastasis was a negative predictor. The clearance of lymph node resulted in significantly longer PFS and OS.
Incidence and pattern of childhood cancer in Addis Ababa, Ethiopia (2012–2017)
Authors: Belay Amanuel , Ali Ahmed , Ayele Wondimu , Assefa Mathewos , Jemal Ahmedin , Kantelhardt Eva J.
Published: December 2023

Background

Cancer is becoming a major public health problem globally and a leading cause of death in children in developed countries. However, little is known about the epidemiology of childhood cancer in Ethiopia. This study, therefore, assessed childhood cancer incidence patterns in Addis Ababa using the Addis Ababa city population-based cancer registry data from 2012 to 2017.

Methods

Invasive cancer cases diagnosed in ages 0–14 years from 2012 to 2017 were obtained from the Addis Ababa City population-based Cancer Registry. Cases were grouped according to the International Classification of Childhood Cancer, 3rd edition (ICCC-3) based on morphology and primary anatomic site. Age-standardized incidence rates (ASR) were calculated by the direct method using the world standard population.

Results

The overall average annual incidence rate during 2012–2017 in children was 84.6 cases per million, with rates higher in boys (98.97 per million) than in girls (69.7 per million). By age, incidence rates per million increased from 70.8 cases in ages 0–4 years to 88.4 cases in ages 5–9 years to 110.0 cases 10–14 years. Leukaemia was the most common childhood cancer in both boys (29.1%) and girls (26.8%), followed by lymphoma in boys (24.7%) and renal tumours (13.1%) in girls. The overall cancer incidence rate decreased from 87.02 per million in 2012 to 51.07 per million in 2017.

Conclusion

The burden of childhood cancer is considerably high in Addis Ababa. The observed distribution of childhood cancer in Addis Ababa differs from other African countries. This study highlights the need for further research and understanding of the variations in cancer patterns and risk factors across the region.
Twenty-seven-gauge vitrectomy: a consecutive, single-centre case series with exclusive use over a 4-year period
Authors: Ng Eugene , Masalkhi Mouayad , Steel David H. , Pavičić-Astaloš Jasna , Nolan Claire , Mernagh Sarah , Ankamah Emmanuel
Published: December 2023

Background

To assess the safety and effectiveness of the exclusive use of 27-gauge instruments for all vitreoretinal diseases requiring vitrectomy.

Methods

In this retrospective study, 1020 consecutive surgeries were performed on 958 eyes of 848 patients using 27-gauge instruments from March 2017 to June 2021. Patients with a minimum follow-up of 3 months were included. Surgical case-mix, best-corrected visual acuity (BCVA), intraocular pressure (IOP), intra- and post-operative complications, and surgery times were recorded.

Results

The study patients were followed up for averagely 11 months. Of the 1020 vitrectomies, 958 were primary procedures. Of the 148 retinal detachment (RD) cases, 138 (93%) required a single vitrectomy. Primary macular hole closure was achieved in 143 of 145 (99%) cases. The average surgical times were 55 and 38 min for RD surgeries and for all other indications, respectively. BCVA improved significantly at the final visit (20/49) compared with the pre-operative visit (20/78) (p < 0.01). IOP was similar at the pre-operative (14.8mmHg) and final (14.3mmHg) visits. Complications recorded include transient hypotony in 39 eyes, iatrogenic retinal breaks in 2 eyes, and a vitreous bleed in 1 other eye.

Conclusion

This study revealed that 27-gauge vitrectomy instruments can be used for a wide range of indications, with exclusive use in certain settings. The outcomes were similar to other gauges, including for rhegmatogenous retinal detachment, with minimal complications.
Prevalence and determinants of opioid use disorder among long-term opiate users in Golestan Cohort Study
Authors: Alvand Saba , Amin-Esmaeili Masoumeh , Poustchi Hossein , Roshandel Gholamreza , Sadeghi Yasaman , Sharifi Vandad , Kamangar Farin , Dawsey Sanford M. , Freedman Neal D. , Abnet Christian C. , Rahimi-Movaghar Afarin , Malekzadeh Reza , Etemadi Arash
Published: December 2023

Background

Number of opiate users worldwide has doubled over the past decade, but not all of them are diagnosed with opioid use disorder. We aimed to identify the prevalence and risk factors for OUD after ten years of follow-up.

Methods

Among 8,500 chronic opiate users at Golestan Cohort Study baseline (2004–2008), we recalled a random sample of 451 subjects in 2017. We used three questionnaires: a questionnaire about current opiate use including type and route of use, the drug use disorder section of the Composite International Diagnostic Interview lifetime version, and the validated Kessler10 questionnaire. We defined opioid use disorder and its severity based on the DSM-5 criteria and used a cutoff of 12 on Kessler10 questionnaire to define psychological distress.

Results

Mean age was 61.2 ± 6.6 years (84.7% males) and 58% were diagnosed with opioid use disorder. Starting opiate use at an early age and living in underprivileged conditions were risk factors of opioid use disorder. Individuals with opioid use disorder were twice likely to have psychological distress (OR = 2.25; 95%CI: 1.44–3.52) than the users without it. In multivariate regression, former and current opiate dose and oral use of opiates were independently associated with opioid use disorder. Each ten gram per week increase in opiate dose during the study period almost tripled the odds of opioid use disorder (OR = 3.18; 95%CI: 1.79–5.63).

Conclusions

Chronic opiate use led to clinical opioid use disorder in more than half of the users, and this disorder was associated with psychological distress, increasing its physical and mental burden in high-risk groups.
Association between body weight misperception and snacking patterns among adolescents: a population-based cross-sectional study
Authors: Jiang Ke , Zhang Yu , Xie Changxiao , Wang Tiankun , Zhao Lingxi , Zhao Wen , Shi Zumin , Sharma Manoj , Zhao Yong
Published: December 2023

Background

Unhealthy snacking behaviors and body weight misperception are both significant concerns in adolescent health. Weight misperception are common among youth and may influence their motivation to engage in health-related behaviors, however, the effect on snacking patterns choice remains unclear. Our study aimed to examine the relationship between body weight misperception and snacking pattern choice among school adolescents.

Methods

A cross-sectional study was conducted using an online survey platform. Body weight misperception was defined based on perceived body weight and true weight. Snack intake was measured using a qualitative food-frequency questionnaire. Factor analysis was used to identify snacking patterns, and multiple linear regression was employed to examine the association between body weight misperception and snacking patterns.

Results

190,296 students with the average age of 13.3 ± 1.0 years was included, and 44.5% of students misperceived their weight. Overestimation was more prevalent than underestimation. Two snacking patterns, namely a high-calorie snacking pattern and a healthy snacking pattern, were identified with eigenvalues > 1. Weight underestimation was positively linked to high-calorie snacking pattern scores for both normal weight students (β: 0.16, 95% CI: 0.11, 0.21) and students with overweight/obesity (β: 0.44, 95% CI: 0.35, 0.52), and to healthy snacking scores for students with overweight/obesity (β: 0.28, 95% CI: 0.22, 0.33), but negatively linked to healthy snacking pattern scores for normal weight students (β: -0.12, 95% CI: -0.15, -0.09). Conversely, weight overestimation was negatively linked to both high-calorie and healthy snacking pattern scores for normal weight students (β: -0.07, 95% CI: -0.11, -0.04 and β: -0.13, 95% CI: -0.15, -0.10), but positively linked to healthy snacking scores for underweight students (β: 0.15, 95% CI: 0.08, 0.21). Interactions were found between sex, grade, accommodation, only child, primary guardians, parental education level and weight misperception to snacking patterns.

Conclusions

Adolescents with normal weight and overweight/obesity who misperceived their weight exhibited less healthy snacking patterns, whereas underweight students who misperceived their weight displayed healthier snacking patterns. Comprehensive programs are crucial to educate and guide adolescents in understanding their weight status and making healthier snack choices, involving families, schools, and society.
New prediction equations for knee isokinetic strength in young and middle-aged non-athletes
Authors: Zhang Ye , Chen Kang , Liu Kun , Wang Qingliang , Ma Yuhui , Pang Bo , Huang Lihua , Ma Yanhong
Published: December 2023

Background

This study aimed to develop alternative prediction equations to predict isokinetic muscle strength at 60°/s based on anthropometric characteristics, including body mass, height, age, and sex for young and middle-aged non-athlete populations.

Methods

Three hundred and thirty-two healthy non-athletic participants (174 females, 158 males) between 20 and 59 years underwent a 60°/s isokinetic knee joint concentric contraction test. Forty people were randomly selected for retesting to assess the reliability of the isokinetic instrument. Multivariate linear regression was used to establish extension peak torque (EPT) and flexion peak torque (FPT) prediction equations. Sixty extra participants were used individually to validate the prediction equations, and Bland Altman plots were constructed to assess the agreement of predicted values with actual measurements.

Results

The result demonstrated that the instrument we used has excellent reliability. The multivariable linear regression model showed that body mass, age, and sex were significant predictors of PT (EPT: Adjusted R2 = 0.804, p < 0.001; FPT: Adjusted R2 = 0.705, p < 0.001). Furthermore, the equations we established had higher prediction accuracy than those of Gross et al. and Harbo et al.

Conclusion

The equations developed in this study provided relatively low bias, thus providing a more suitable reference value for the knee isokinetic strength of young and middle-aged non-athletes.
Inside the ‘imperfect mosaic’: Minority ethnic women’s qualitative experiences of race and ethnicity during pregnancy, childbirth, and maternity care in the United Kingdom
Authors: Silverio Sergio A. , Varman Nila , Barry Zenab , Khazaezadeh Nina , Rajasingam Daghni , Magee Laura A. , Matthew Jacqueline
Published: December 2023

Background

Persistent, high rates of maternal mortality amongst ethnic minorities is one of the UK’s starkest examples of racial disparity. With greater risks of adverse outcomes during maternity care, ethnic minority women are subjected to embedded, structural and systemic discrimination throughout the healthcare service.

Methods

Fourteen semi-structured interviews were undertaken with minority ethnic women who had recent experience of UK maternity care. Data pertaining to ethnicity and race were subject to iterative, inductive coding, and constant comparison through Grounded Theory Analysis to test a previously established theory: The ‘Imperfect Mosaic’.

Analysis & findings

A related theory emerged, comprising four themes: ‘Stopping Short of Agentic Birth’; ‘Silenced and Stigmatised through Tick-Box Care’; ‘Anticipating Discrimination and the Need for Advocacy’; and ‘Navigating Cultural Differences’. The new theory: Inside the ‘Imperfect Mosaic’, demonstrates experiences of those who received maternity care which directly mirrors experiences of those who provide care, as seen in the previous theory we set-out to test. However, the current theory is based on more traditional and familiar notions of racial discrimination, rather than the nuanced, subtleties of socio-demographic-based micro-aggressions experienced by healthcare professionals.

Conclusions

Our findings suggest the need for the following actions: Prioritisation of bodily autonomy and agency in perinatal physical and mental healthcare; expand awareness of social and cultural issues (i.e., moral injury; cultural safety) within the NHS; and undertake diversity training and support, and follow-up of translation of the training into practice, across (maternal) health services.
Effect of subsequent bladder cancer on survival in upper tract urothelial carcinoma patients post-radical nephroureterectomy: a systematic review and meta-analysis
Authors: Hu Haopu , Lai Shicong , Wang Mingrui , Tang Xinwei , Lai Chin-hui , Xu Kexin , Xu Tao , Hu Hao
Published: December 2023

Background

Radical nephroureterectomy (RNU) is the primary treatment strategy for upper tract urothelial carcinoma (UTUC). However, the intravesical recurrence occurs in 20–50% of all patients. The specific effect of subsequent bladder cancer (SBCa) on survival remains unclear. Therefore, we investigated the effect of SBCa following RNU in patients with UTUC.

Methods

PubMed, EMBASE, and Cochrane Library were exhaustively searched for studies comparing oncological outcomes between SBCa and without SBCa. Standard cumulative analyses using hazard ratios (HR) with 95% confidence intervals (CI) were performed using Review Manager (version 5.3).

Results

Five studies involving 2057 patients were selected according to the predefined eligibility criteria. Meta-analysis of cancer-specific survival (CSS) and overall survival (OS) revealed no significant differences between the SBCa and non-SBCa groups. However, subgroup analysis of pT0-3N0M0 patients suggested that people with SBCa had worse CSS (HR = 5.13, 95%CI 2.39–10.98, p < 0.0001) and OS (HR = 4.00, 95%CI 2.19–7.31, p < 0.00001).

Conclusions

SBCa appears to be associated with worse OS in patients with early stage UTUC. However, caution must be taken before recommendations are made because this interpretation is based on very few clinical studies and a small sample size. Research sharing more detailed surgical site descriptions, as well as enhanced outcome data collection and improved reporting, is required to further investigate these nuances.
Umbilical artery cord blood glucose predicted hypoglycemia in gestational diabetes mellitus and other at-risk newborns
Authors: Wang Yuan , Liu Huahua , Zhang Leilei , Wang Xin , Wang Mingbo , Chen Zhifang , Zhang Feng
Published: December 2023

Background

To explore the value of umbilical artery cord blood glucose (UACBG) in predicting hypoglycemia in gestational diabetes mellitus (GDM) and other at-risk newborns, and to provide a cut-off UACBG value for predicting hypoglycemia occurrence.

Methods

In this prospective study, we enrolled at-risk infants delivered vaginally, including neonates born to mothers with GDM, premature, macrosomic, and low birth weight. We separated the infants into GDM group and other at-risk group. All subjects underwent UACBG measurement during delivery. Neonatal peripheral blood glucose measurement was performed at 0.5 and 2 h after birth. The predictive performance of UACBG for neonatal hypoglycemia was assessed using receiver operating characteristic curve (ROC), area under curve (AUC), sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV).

Results

916 newborns were included, with 538 in GDM group and 378 in other at-risk group. 85 neonates were diagnosed hypoglycemia within 2 h after birth, including 36 belonging to GDM group and 49 to other at-risk group. For hypoglycemia prediction within 2 h, the best cut-off of UACBG was 4.150 mmol/L, yielding an AUC of 0.688 (95% CI 0.625–0.751) and a NPV of 0.933. In detail, the AUC was 0.680 in GDM group (95% CI 0.589–0.771), with the optimal cut-off of 4.150 mmol/L and a NPV of 0.950. In other at-risk group, the AUC was 0.678(95% CI 0.586–0.771), the best threshold was 3.950 mmol/L and the NPV was 0.908. No significant differences were observed between GDM group and other at-risk group in AUC at 0.5 h, 2 h and within 2 h.

Conclusions

UACBG has a high NPV for predicting neonatal hypoglycemia within 2 h after birth. It was implied that individuals with cord blood glucose levels above the threshold were at lower risk for hypoglycemia. UACBG monitoring provides evidence for subsequent classified management of hypoglycemia.
Lymphadenectomy and optimal excise lymph nodes count for early-stage primary fallopian tube cancer: a SEER-based study
Authors: Liu Yuexi , Huang Fanfan , Gu Qiuying , Wang Jinlong , Wang Qingmiao , Wu Yuyang , Li Lijuan , Xiao Yao
Published: December 2023

Backgrounds

There is still no consensus on the significance of Lymphadenectomy (LD) and the number of lymph nodes that need to be excised (ELNs) for adequate LD in patients with early-stage primary fallopian tube cancer (PFTC). Our endeavor is geared towards deepening comprehension of LD in early-stage PFTC and identify the optimal cut-off of ELNs.

Methods

This SEER-based study analyzed the clinical data of patients with early-stage PFTC between 2000 and 2018. X-tile was employed to confirm the optimal cut-off of ELNs. The survival data between groups were analyzed by the Kaplan-Meier estimates, Log-rank test and Cox proportional hazards model.

Results

There was significant improvement in both mean cancer-specific survival (CSS, p < 0.001) and overall survival (OS, p < 0.001) in LD group. Regardless of matched or not, LD was identified as an independent protective factor of CSS and OS. The optimal 3-year CSS-based cutoff of ELNs was 11 (p = 0.026) as determined by X-tile. Both the mean CSS (p = 0.001) and mean OS (p = 0.002) in adequate LD group (ELNs > 11, n = 574) were significantly longer than these in inadequate LD group (ELNs ≤ 11, n = 738). Adequate LD, FIGO stage, tumor grade and histology were significant prognostic factors for CSS and OS.

Conclusion

LD is an independent protective prognostic factor of patients with early-stage PFTC. The association between ELNs > 11 and an improved prognosis is evident. Future studies are needed to further clarify the results above.
How older adults recovering from substance use problems experience mattering
Authors: Bahl Nina Kavita Heggen , Nafstad Hilde Eileen , Blakar Rolv Mikkel , Øversveen Emil , Brodahl Morten , Ness Ottar , Prilleltensky Isaac
Published: December 2023

Aim

Mattering (to feel valued and add value to self and others) is a fundamental human experience and mechanism in recovery. In this paper, we concern ourselves with the recovery of older adults with substance problems. This population is on the rise in many Western countries. To offer mattering enhancing programs for this group, more knowledge about later life mattering in service-assisted recovery processes is needed. This study aims to explore experiences of mattering in older adults receiving services to recover from substance use problems.

Methods

A collaborative and deductive reflexive thematic approach was applied in analysing 23 interviews with participants using substance use services. Participants were recovering from different substance use problems: alcohol, medication and illegal substances. The participants were recruited from three different Norwegian social contexts: two urban and one medium size municipality. The age of the sample ranged from 65–80 years, with approximately equal numbers for those aged 60–69 (12 participants) and 70–80 (11 participants). Seven participants were women and 16 men.

Results

Three main themes were identified in the analysis: “relational experiences of mattering and not mattering”, “service-related experiences of mattering and not mattering” and “recovery and psychological sense of community as interrelated phenomena to experiences of mattering”. The findings illustrate various nuanced experiences of mattering and not mattering in later life recovery processes.

Conclusions

Overall, the participants’ mattering experiences rested on fair, healthy and positive community relationships and fair and attentive services, where participants could feel valued and also have a chance to add value to others. Experiences of not mattering were precipitated by lack of support, disrespect, devaluation and loss of relationships, and also by being ignored and not receiving fair treatment and help by professionals. Importantly, reciprocal and enhancing relations between mattering, recovery and relational PSOC seem to exist and to be significant for the older adults’ access to substance use services. Several practical implications are suggested to promote the therapeutic and preventive potentials of later life mattering in recovery.