bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients with acute decompensated heart failure in an area with a super-aging society; A single- center, retrospective cohort study
Authors: Tanabe Junya , Sasaki Hiroyuki , Okazaki Kouichi , Maeda Atsuyoshi , Endo Akihiro , Nakazawa Yoshio , Tanabe Kazuaki
Published: March 2024

Background
In recent years, the population of very elderly heart failure (HF) patients has been rising, but there are few reports on their characteristics, treatment, and prognosis.
Methods This study included patients aged 18 years or older with acute HF admitted to a single hospital between April 1, 2016, and March 31, 2021. Patients were classified into three groups according to their echocardiographic left ventricular ejection fraction (LVEF): HF with reduced LVEF (LVEF < 40%: HFrEF), HF with mildly reduced LVEF (LVEF between 40% and 49%: HFmrEF), and HF with preserved LVEF (LVEF ≥ 50%: HFpEF).
Results
Of 524 admitted patients, 437 were discharged, including 124 with HFrEF, 62 with HFmrEF, and 251 with HFpEF. The median age was 86 years, and patients with HFmrEF and HFpEF were older than those with HFrEF. Overall, the in-hospital mortality rate was 14.1%, the 1-year composite event rate of cardiac death and heart failure readmission was 37.7%, and the 1-year all-cause death rate was 19.7%. In particular, the composite event rate was higher in patients with HFrEF than in those with HFpEF (44.0% vs. 32.8%, P = 0.03).
Conclusions
The high incidence of in-hospital mortality, composite events, and all-cause mortality in this very elderly population warrants prospective consideration of appropriate treatment choices and goal setting for these patients.
Timing of magnetic resonance imaging in pregnancy for congenital diaphragmatic hernia
Authors: Dütemeyer Vivien , Cannie Mieke , Schaible Thomas , Weis Meike , Persico Nicola , Borzani Irene , Badr Dominique , JANI Jacques
Published: March 2024

Purpose: To evaluate the impact of the timing of MRI on the prediction of survival and morbidity in patients with CDH, and whether serial measurements have a beneficial value.
Methods: This retrospective cohort study was conducted in two perinatal centers, in Germany and Italy. It included 354 patients with isolated CDH having at least one fetal MRI. The severity was assessed with the observed to expected total fetal lung volume (o/e TFLV) measured by two experienced double-blinded operators. The cohort was divided into three groups according to the gestational age (GA) at which the MRI was performed (<27, 27-32 and >32 weeks gestation [WG]). The accuracy for the prediction of survival at discharge and morbidity was analyzed with receiver operating characteristic (ROC) curves. Multiple logistic regression analyses and propensity score matching examined the population for balance. The effect of repeated MRI was evaluated in ninety-seven cases.
Results: There were no significant differences in prediction of survival when the o/e TFLV was measured before 27, between 27 and 32, and after 32 WG (area under the curve [AUC]: 0.77, 0.79, and 0.77, respectively). After adjustment for confounding factors, it was seen, that GA at MRI was not associated with survival at discharge, but the risk of mortality was higher with an intrathoracic liver position (adjusted odds ratio [aOR]: 0.30, 95% confidence interval [95%CI]: 0.12-0.78), lower GA at birth (aOR 1.48, 95%CI: 1.24-1.78) and lower o/e TFLV (aOR 1.13, 95%CI: 1.06-1.20). ROC curves showed comparable prediction accuracy for the different timepoints in pregnancy for pulmonary hypertension, the need of extracorporeal membrane oxygenation, and feeding aids. Serial measurements revealed no difference in change rate of the o/e TFLV according to survival.
Conclusion: The timing of MRI does not affect the prediction of survival rate or morbidity as the o/e TFLV does not change during pregnancy. Clinicians could choose any gestational age starting mid second trimester for the assessment of severity and counseling.
Fabrication of Gutta-percha points derived from the Latex of Manilkara zapota for Obturation treatment in root canal therapy
Authors: Madan Shivam , Geetha R. V. , Gopal Rajesh Kanna
Published: March 2024

The Gutta-percha (GP) points are filling material used in the obturation treatments in endodontic root canal therapy. The GP points are manufactured from the latex of a Malaysian tree called a Percha Tree (Palaquium gutta, family: Sapotaceae). However, in this study, an attempt has been made to fabricate an alternative GP points from the latex of a tree Manilkara zapota from the same plant family Sapotaceae. The latex was obtained by wounding the tree trunk using a sterile blade and collected in a sterile container. Then the latex was vigorously mixed with a 3.5:6.5 ratio of latex and zinc oxide respectively. The MZ-GP points were made by hand-rolling method and characterized for their radiopacity, and tensile strength. Simultaneously, the latex was tested for its antibacterial activity against Pseudomonas aeruginosa, Enterococcus faecalis, Streptococcus mutans, Staphylococcus aureus, and Methicillin-resistance Staphylococcus aureus (MRSA). The hand-rolled MZ-GP points have a similar structure to a commercial GP point, are white and also have good filling capability during obturation with natural radioopaque properties. The average tensile stress at the break for the control was 1.59 MPa, whereas, the same was 0.09 MPa for the MZ-GP points. However, the displacement was 3 mm for the control and 0.6 mm for the MZ-GP points. The latex of M. zapota has limited antibacterial activity showing very little zone of inhibitions (< 8 mm) on all the bacterial strains tested. The latex of M. zapota is an alternative to the latex of P. gutta for the manufacturing of GP points for Obturation treatments. However, the formulation may be modified to improve the properties of the MZ-GP points.
An improved method to study Phytophthora cinnamomi Rands zoospores interactions with host
Authors: Lucía Lucía Del Castillo-González , Serine Serine Soudani , Noelia Noelia de la Cruz-Gómez , Antonio José Antonio Manzanera José , Marta Marta Berrocal-Lobo
Published: March 2024

The pathogen Phytophthora cinnamomi Rands (Pc) is one of the ten most widespread phytopathogens in the world causing crown rot, canker and root rot in multi-functional land plants. Pc has a disastrous impact on the surrounding environment and biodiversity of flora, fauna and soil. Pc infects more than 5,000 species, including Quercus suber, Quercus ilex, Castanea sativa, Eucalyptus globulus, Persea americana (avocado), Zea mays (maize) and Solanum lycopersicon (tomato). The efficient spread of Pc depends on the short survival of asexually motile zoospores (Zs), which move through water currents until they penetrate the host roots. Due to the complexity of the life cycle, the management of Zs in the laboratory has remained quite complex for decades. The production of Zs requires mimicking nature by following a complex protocol of circular steps of growth, drought and flooding. Similar to other pathogens, the artificial growth conditions induce a rapid loss of virulence, making it necessary to add additional steps of plant infection in between these other steps. In this work, the study of the survival of Zs under different conditions has allowed us to obtain a "ready-to-use" stable stock of Zs with a high capacity to infect the host by direct freezing in liquid nitrogen. Obtaining this stock prevents the loss of virulence of Pc between cultures, thus greatly simplifying the process of inoculating plants and studying Pc with their host.
A justice-based framework to determine countries’ fair warming contributions to Paris Agreement
Authors: Rogelj Joeri , Li Mingyu , Pelz Setu , Lamboll Robin , Wang Can
Published: March 2024

Equity is a cornerstone of global climate policy, yet no international agreement has managed to agree on how to allocate mitigation efforts across countries. While a rich literature informs these deliberations, there remains a gap in approaches that appropriately consider non-CO2 emissions and their warming contributions. In this study, we define a global warming budget applicable to all anthropogenic greenhouse gases and allocate it to countries based on equity principles drawn from international environmental law. We find that by 2021 up to 85 countries, including all major developed countries, exhausted their budget compatible with keeping warming to 1.5°C under all allocation approaches considered in this study. A similar picture emerges for 2°C. A large group of countries will hence exceed their fair shares even if their updated pledges under the Paris Agreement represent the deepest possible reductions. Considerations of fairness should therefore start to include aspects beyond domestic emissions reductions only.
Overdiagnosis of atypical lipomatous tumors/well-differentiated liposarcomas by morphological diagnosis using only HE stained specimens: A case-control study with MDM2/CDK4 immunostaining and MDM2/CDK4 fluorescence in situ hybridization
Authors: Nomura kentaro , Tomita Masato , Kuroda Kishio , Souda Masakazu , Chiba Ko , Yonekura Akihiko , Osaki Makoto
Published: March 2024

Background
Lipomatous tumors represent the most common type of soft tissue neoplasms. Mouse double minute 2 homolog (MDM2)/cyclin-dependent kinase 4 (CDK4) immunostaining is considered effective in differentiating between benign lipomas and intermediate malignant atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLPSs). However, these tumors have traditionally been diagnosed histopathologically using hematoxylin and eosin-stained specimens, which is referred to here as morphological diagnosis. In this study, the accuracy of morphological diagnoses that had been made before MDM2/CDK4 immunostaining became available for distinguishing between lipoma and ALT/WDLPS was examined.
Methods
The study participants were 109 patients with a morphological diagnosis of lipoma (68 patients) or ALT/WDLPS (41 patients) who had undergone surgical resection of the tumor in our hospital between 2009 and 2012. Tissue samples from all patients were used for MDM2/CDK4 immunostaining and the confirmation of MDM2/CDK4 amplification by fluorescence in situ hybridization (FISH).
Results
Of the 41 patients with a morphological diagnosis of ALT/WDLPS, only 17 were positive for MDM2 FISH. In addition, one of the 68 patients with a morphological diagnosis of lipoma showed MDM2 amplification by FISH. When the definitive diagnosis of ALT/WDLPS was made by the positive results of MDM2 FISH, the sensitivity and specificity of morphological diagnosis were 41.5% and 98.5%, respectively. The sensitivity of MDM2 and CDK4 immunostaining was 55.6% and 40.0%, respectively, and their specificity was 87.0% and 84.6%, respectively. This indicates that the diagnostic accuracy of these immunostaining assays was not particularly high. The clinical features suggesting ALT/WDLPS were: patient age (older), maximum tumor diameter (large, cut-off value of 125 mm), tumor location (lower limb), and tumor depth (deep-seated).
Conclusions
Morphological diagnosis alone can accurately diagnose lipomas. However, it has a propensity to overdiagnose ALT/WDLPS. Thus, MDM2 FISH should be used more proactively, not only for lesions with obvious morphological abnormalities, but also for lipomatous tumors that are clinically suggestive of ALT/WDLPS.
Atmospheric Microplastic Particulate in Urban Roadside: Case of Bandar Lampung City, Indonesia
Authors: Sari Novi Kartika , Mawaddah Nurul , Shiddiq Muhammad Daffa , Alam Firdha Cahya , Fajar Mutiara
Published: March 2024

Atmospheric microplastics (AMPs) have been a growing concern in the past decade, yet still research remains limited and at an early stage. The research aids in presenting the current level of AMPs in Bandar Lampung City, Indonesia. A study was conducted to investigate roadside microplastics in urban areas using a High Volume Air Sampler (HVAS) over eight hours. The sampling locations were purposely chosen in representative areas of industrial zones, residential areas, busy roads, and city centers. Visual observations combined with needle tests, were employed to assess the abundance and morphology of microplastics. Additionally, some samples were identified its polymer by Raman. The Total Suspended Particulate (TSP) concentrations ranged from 16.96 to 427.8 μg/m3, with industrial areas showing the highest concentrations. Microplastic abundance varied between 0.0021 and 0.0199 particles/m3, with fibrous microplastics being the predominant type and only few fragment found. Among the observed colors, blue and grey (faded black) were the most prevalent across all sampling sites. Microplastic size distribution showed a range of 500-1000 µm as the foremost category (42%), followed by 100-500 µm (29%). Raman analysis presented PET (Polyethylene terephthalate). In S4 (city center), 3,388±270 vehicles/day were identified as the highest, whereas in S2 (residential area), the lowest number of vehicles/day was 1166±99. There is no significant relationship between TSP-MPs and MPs-vehicle numbers. The Northwest and Northeast directions were identified as common sources for almost all sites, suggesting that microparticles may originate from these directions.
Datawiz-IN: Summer Research Experience for Health Data Science Training
Authors: Afreen Sadia , Krohannon Alexander , Purkayastha Saptarshi , Janga Sarath Chandra
Published: March 2024

Background:
Good science necessitates diverse perspectives to guide its progress. This study introduces Datawiz-IN, an educational initiative that fosters diversity and inclusion in AI skills training and research. Supported by a National Institutes of Health R25 grant from the National Library of Medicine, Datawiz-IN provided a comprehensive data science and machine learning research experience to students from underrepresented minority groups in medicine and computing.
Methods:
The program evaluation triangulated quantitative and qualitative data to measure representation, innovation, and experience. Diversity gains were quantified using demographic data analysis. Computational projects were systematically reviewed for research productivity. A mixed-methods survey gauged participant perspectives on skills gained, support quality, challenges faced, and overall sentiments.
Results:
The first cohort of 14 students in Summer 2023 demonstrated quantifiable increases in representation, with greater participation of women and minorities, evidencing the efficacy of proactive efforts to engage talent typically excluded from these fields. The student interns conducted innovative projects that elucidated disease mechanisms, enhanced clinical decision support systems, and analyzed health disparities.
Conclusion:
By illustrating how purposeful inclusion catalyzes innovation, Datawiz-IN offers a model for developing AI systems and research that reflect true diversity. Realizing the full societal benefits of AI requires sustaining pathways for historically excluded voices to help shape the field.
The relationship between maternal anxiety due to the COVID-19 pandemic and children's anxiety following school reopening in the post-pandemic era: an analytical cross-sectional study
Authors: Ghasemi Fatemeh , Valizadeh Fatemeh , Mohammadi Rasool , Goodarzi Hanieh
Published: March 2024

Background
Although infection rates and mortality have decreased, COVID-19-related anxiety persists in families, especially among mothers, even in the post-pandemic period. Maternal mental health issues may jeopardize various aspects of children's development. This study aims to explore the correlation between maternal COVID-related anxiety and their children's anxiety following the reopening of primary schools in the post-pandemic era.
Methods
This analytical cross-sectional study involved the selection of 305 pairs of mothers and children. Data collection instruments comprised demographic questionnaires as well as assessments for COVID-related anxiety and manifest anxiety. Statistical analyses encompassed independent t-tests, one-way analysis of variance (ANOVA), and multivariate regression.
Results
Children's manifest anxiety was predicted by maternal anxiety related to COVID-19 (B = 0.907, P < 0.001). Moreover, significant associations were observed between the mean difference in mothers' COVID anxiety scores and their educational attainment and occupation, as well as their children's education and age, residential area, and their husbands' education and occupation (P < 0.001). Conversely, no significant differences were detected in maternal COVID anxiety scores concerning maternal age, spouse's age, and child's gender (P > 0.05).
Conclusions
Given the study's findings, it is recommended that nurses and psychologists provide educational interventions for mothers who need psychological support.
A genotype-phenotype approach to discriminate Central European spelt landraces from modern wheat-spelt intercrosses in the Swiss context
Authors: Stefan Laura , Sanchez-Martin Javier , Kurth Thomas , Keller Beat , Herren Gerhard , Krattinger Simon , Strebel Silvan , Kragten Silvia Ampuero , Camp Karl-Heinz , Häner Lilia Levy
Published: March 2024

Marketed as a healthier alternative to soft wheat, spelt (Triticum aestivum ssp. spelta) is in increasing demand from consumers and bakers in Switzerland. The Swiss spelt landscape is currently dominated by two varieties – Ostro and Oberkulmer Rotkorn – considered as references for Swiss “typical” spelt. However, these two varieties are rather old and deliver low yields; the market therefore needs improved spelt varieties with higher agronomic potential while keeping the essential attributes of typical spelt. As spelt and winter wheat can be interbred, modern spelt varieties often result from crosses between the two. It has therefore become increasingly difficult to distinguish between typical spelt and modern wheat-spelt intercrosses. This project aims to clarify the phenotypic distinction between typical spelt and modern wheat-spelt intercrosses in the Swiss context. To do this, we performed field trials with 50 spelt varieties, including typical and modern cultivars from Switzerland and Central Europe. We measured agronomic, rheological and nutritional parameters of each variety. In addition, these cultivars were genotyped using a 25K Illumina Wheat SNP array. This allowed us to identify which phenotypic parameters were associated with genetic proximity to typical spelt. Swiss typical spelt varieties were characterized by highly extensible doughs, later phenology, low harvest index, high thousand kernel weights, and lower Zeleny/protein ratio. By linking phenotypic characteristics, easily measurable in fields, to the underlying genetic information of each variety, these results will help to better classify spelt varieties in Switzerland and pave the way for more clarity and transparency on the Swiss spelt market.
Video Game Play and Mental Health During the COVID-19 Pandemic: A Meta-Analysis of Global Findings
Authors: Kaczmarek Łukasz , Chwiłkowska Patrycja , Behnke Maciej , Drążkowski Dariusz
Published: March 2024

During the COVID-19 pandemic, video gaming was often suggested as a way to help maintain physical distancing by encouraging people to stay indoors and play games instead of seeking social activities. However, there was concern about whether the increased time spent on video gaming could negatively affect players' mental health. In our meta-analysis, we synthesized studies to quantify changes in gaming time during the pandemic and examine its association with positive and negative mental health metrics. We searched databases for studies published from March 2020 to December 2021 reporting gaming time and mental health positive (e.g., happiness, positive affect, relaxation) or negative (e.g., depression, anxiety, stress, loneliness, anger) indicators during the pandemic. We employed random effects meta-analyses with robust variance estimates. We accounted for potential moderators (e.g., world region). In 17 studies (26 effects, n = 18026), we found a small increase in time spent gaming during the pandemic versus pre-pandemic, d = 0.26, 95% CI [0.14, 0.37], p = .0004). In 22 studies (100 effects, n = 19752), gaming time was not associated with mental health (r = -0.03, 95% CI [-0.08, 0.02], p = .22), regardless of whether it was for well-being or ill-being measures. Moderator analyses indicated negligible differences across study characteristics (d< 0.20). These findings challenge the simplistic view that more gaming time automatically leads to worse (or better) mental health during pandemics. They provide important insights for researchers, policymakers, educators, and caregivers about the role of digital technologies in easing the impact of pandemics and lockdowns. This research is vital for developing evidence-based public health policies and recommendations regarding video gaming in the event of future pandemics and lockdowns.
De novo transcriptome assembly of the oak processionary moth Thaumetopoea processionea
Authors: Zicola Johan , Dasari Prasad , Hahn Katharina Klara , Ziese-Kubon Katharina , Meurer Armin , Buhl Timo , Scholten Stefan
Published: March 2024

Objectives
The oak processionary moth (OPM) (Thaumetopoea processionea) is a species of moth (order: Lepidoptera) native to parts of central Europe. However, in recent years, it has become an invasive species in various countries, particularly in the United Kingdom and the Netherlands. The larvae of the OPM are covered with urticating barbed hairs (setae) causing irritating and allergic reactions at the three last larval stages (L3-L5). The aim of our study was to generate a de novo transcriptomic assembly for OPM larvae by including one non-allergenic stage (L2) and two allergenic stages (L4 and L5). A transcriptomic assembly will help identify potential allergenic peptides produced by OPM larvae, providing valuable information for developing novel therapeutic strategies and allergic immunodiagnostic assays.
Data
Transcriptomes of three larval stages of the OPM were de novo assembled and annotated using Trinity and Trinotate, respectively. A total of 145,251 transcripts from 99,868 genes were identified. Bench-marking universal single-copy orthologues analysis indicated high completeness of the assembly. About 19,600 genes are differentially expressed between the non-allergenic and allergenic larval stages. The data provided here contribute to the characterization of OPM, which is both an invasive species and a health hazard.
A coastal karstic aquifer response to contamination. Puerto Morelos, Mexico
Authors: Cepeda Mario Humberto Cortazar , Herrera Roger Amilcar Gonzalez
Published: March 2024

A contaminant transport model for a coastal karstic aquifer of Puerto Morelos, in Mexico was developed in this study. The aquifer is under constant environmental stress due to intensive discharge of domestic wastewater by means of poorly constructed septic systems and the leachate from unregulated open dumpsites within and nearby Puerto Morelos town. Based on the results of a previously implemented groundwater flow model in the local aquifer, a subsequent contaminant transport model and particle tracking was developed. The presence of arsenic on groundwater samples lead to the assumption of the dumpsites being the main source but particle tracking did not back up this claim, mainly due to the presence of a groundwater dome in the urban area that influences the flows and gradients in the immediate area; the possible existence of very local arsenic contamination in the aquifer are likely the cause of the concentrations found. From contaminant plume simulation it was evidenced the high dilution capacity of the aquifer as chlorine concentrations greatly reduced to background concentration levels at a distance no greater than 300 meters away from the pollution sources (dumpsites and septic systems); this dilution is likely the consequence of high hydraulic conductivities in the regional aquifer and the presence of the groundwater dome. The use of septic tanks represents the main pollution risk for the aquifer and jeopardizes the well-being of the community of Puerto Morelos who consume water from local shallow wells.
Burden of Portal Hypertension Complications is Greater in Patients with Decompensated Cirrhosis and Type 2 Diabetes Short title: Impact of Diabetes on Outcomes In Cirrhosis
Authors: Yakubu Idris , Flynn Sean , Khan Hiba , Nguyen Madison , Razzaq Rehan , Patel Vaishali , Kumaran Vinay , Sharma Amit , Siddiqui Mohammad Shadab
Published: March 2024

Background and aims:Impact of type 2 diabetes mellitus (T2DM) in patients with decompensated cirrhosis awaiting liver transplantation (LT) remains poorly defined. The current study hypothesizes, that the presence of T2DM will be associated with worse LT waitlist outcomes that include greater burden of portal hypertension related complications, hospitalizations, and mortality.
Methods: In this retrospective study, 593 patients evaluated for LT between 1/2010 to 1/2017 were included in the analysis. The impact of T2DM on portal hypertension, survival, and likelihood of receiving LT were evaluated.
Results: The baseline prevalence of T2DM was 32% (n=191). At baseline, patients with T2DM were more likely to have esophageal varices (61% vs. 47%, p=0.002) and history of variceal hemorrhage (23% vs. 16%, p=0.03). T2DM was associated with increase risk of incident ascites (OR 1.91, 95% CI 1.11, 3.28, p=0.019). Patients with T2DM were more likely to require hospitalizations (56% vs. 49%) over 12 months of follow up, however, this did not reach statistical significance (p=0.06). Patients with diabetes were more likely to be hospitalized with portal hypertension related complications (22% vs. 14%; p=0.026) and require renal replacement therapy during their hospitalization. Patients with T2DM were less likely to receive a LT (37% vs. 45%; p=0.03) and had significantly lower bilirubin at each follow up. No differences in INR and creatinine were noted.
Conclusion:
Patients with T2DM are at increased risk of portal hypertension complications. This risk is not captured in MELD score, which may potentially negatively affect their likelihood of receiving LT.
Evaluation of Foveal Avascular Region and Macular Blood Vessel Density in Prediabetic Patients with OCT-A Findings
Authors: UTLU BAHADIR , UTLU Elif Sedanur , ÇİNİCİ Emine , Akgöz Hasan , BAYRAKÇEKEN Kemal , KOZAN Betül DERTSİZ
Published: March 2024

Purpose: This study aimed to compare the macular layer thickness, macular vessel density and Foveal avascular zone (FAZ) perimetric and areal OCT-A measurements of prediabetic patients with normoglycemic healthy subjects.
Material - Methods: Thirty patients (Group A) with fasting plasma glucose (between 100-125 mg/dl), postprandial plasma glucose (between 140-199 mg/dl) and HbA1C (between 5.7-6.4%) values within the defined limits were included in the study. In addition, 30 healthy normoglycemic patients (Group B) were included as a control group. All participants underwent OCT-A to measure macular superficial capillary plexus (inner) and deep capillary plexus vessel density (outer) and foveal avascular zone width. Participants with poor image quality, refractive error, glaucoma, intraocular surgery, chorioretinal atrophy-like fundus findings and comorbid comorbidities were excluded from the study.
Results: The perfusion density of the SCP and DCP decreased in the patient group compared to the control group and this difference was statistically significant in the inferior and temporal quadrants in the deep plexus and the temporal quadrant in the superficial plexus (p<0.05). Although there were changes around the foveal avascular zone and FAZ area between the groups, the difference was not statistically significant (p >0.05). Macular thickness was thicker in all quadrants in Group A, while the difference between nasal and inferior was statistically significant (p<0.05).
Conclusion: Prediabetic patients showed increased macular thickness, decreased macular perfusion density and increased width of the FAZ in some patients. Although the results show that the disease affects ocular structures, more large-scale studies are needed to better understand the associated complications.
The impact of the national centralized drug procurement on the use of original and generic targeted anti- tumor drugs in Hohhot, China: an interrupted time-series analysis
Authors: Wu Rihan , Gong Zhaotang , Wang Weisong , Zhu Benben , SiRi GuLeng
Published: March 2024

Objectives: In December 2022, the implementation of the seventh round of national centralized drug procurement(NCDP) in China, encompassing a range of targeted anti-tumor drugs. This study aims to assess the explored the different effect of the NCDP on three original and generic targeted anti-tumor drugs use in clinical practice.
Method: Clinical drug volume data was collected covering 18 months before, during, and after the the seventh round of the National Centralized Drug Procurement in Inner Mongolia. Three targeted anti-tumor drugs associated with the seventh round of NCDP were chosen for investigation and categorized into original and generic products based on bidding outcomes. Interrupted time-series method was employed to estimate the net effect of policy impact.
Results: After the implementation of national centralized drug procurement (NCDP), there has been a significant increase in the utilization of generic targeted antineoplastic drugs. The volume of generic afatinib(30mg) increased by 25.78DDDs, the expenditures decreased by 3641.14 yuan (95 % CI: -5581.16 to -1701.12, p=0.001), and the DDDc decreased by 124.35 yuan (95 % CI: -128.23 to -120.46, p<0.001). The volume of generic afatinib(40mg) increased by 65.19DDDs (95 % CI: 35.38 to 96.43, p<0.001), the expenditures increased by 1304.93 yuan (95 % CI: 700.55 to 1909.31, p<0.001), and the DDDc decreased by 120.2 yuan (95 % CI: -120.2 to -120.2, p<0.001). The volume of generic sunitinib increased by 75.79DDDs (95 % CI: 37.99 to 112.46, p<0.001), the expenditures decreased by 15869.78 yuan (95 % CI: -23275.57 to -8463.98, p<0.001) , and the DDDc decreased by 243.28 yuan. There was no significant change trend in volume, expenditures and DDDc of the three original targeted drugs after NCDP intervention.
Conclusions: After the policy intervention, generic afatinib (40mg) successfully aligned with the objectives of NCDP by reducing drug costs and enhancing patient affordability; however, the desired outcomes were not achieved for generic afatinib (30mg) and generic sunitinib. This discrepancy may be attributed to the inherent clinical efficacy and safety profiles of these drugs. Therefore, in implementing NCDP, it is necessary to enhance the clinical efficacy and safety of generic targeted anti-tumor drugs while considering economic efficiency.
Protocol of the Reformation study: a prospective, multicenter, randomized controlled trial on the improvement of rheolytic thrombectomy for acute deep vein thrombosis of the whole lower limb by primary popliteal vein thrombosis clearance
Authors: Ni Qihong , Ye Xiande , He Chunshui , Zhao Hui , Lou Wensheng , Zhuang Hui , Sang Hongfei , Wu Ziheng , Ye Meng
Published: March 2024

Introduction: Pharmacomechanical thrombectomy (PMT) can be a useful treatment for restoring vein patency quickly especially for extensive acute deep vein thrombosis (DVT). However, previous evidence failed to validate the effectiveness of PMT in reducing the incidence of post-thrombotic syndrome (PTS). To address this controversy, the Reformation study aims to improve rheolytic thrombectomy for acute deep vein thrombosis of the lower limb through primary popliteal vein thrombosis clearance.
Method and analysis: Reformation is a prospective randomized multicenter trial. It has 160 patients in two groups: the modified access group (80 patients) and the traditional access group (80 patients). The purpose of this study is to assess whether the modified access approach for removing inflow thrombus in a one-stage procedure is more effective in enhancing the success rate of the procedure and reducing the incidence of post-thrombotic syndrome during a 24-month follow-up period, for patients with acute whole limb DVT.
Ethics and dissemination: The Reformation study has been registered at www.clinicaltrials.gov (registration number: NCT05286710). The study protocol has been approved by the Institutional review board and Human Research Ethics Committee of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (Approved number: KY2021-067-A). The results will be disseminated by publication in a peer-reviewed journal.
Trial registration number: NCT05286710
Protocol version and date: V.1.2, 20 August 2022
Transcriptome profiling on Euphorbia kansui elicited with methyl jasmonate
Authors: Li Peng , Liang Xiaoqing , Zhang Min , Fang Xiaoai , Cai Xia
Published: March 2024

Euphorbia kansui Liou of Euphorbia (Euphorbiaceae) is an endemic traditional
medicine in China, and exerted effective antitumor activity due to its specific metabolic
composition, especially terpenoid.This study was designed to illustrate the detailed effects of MeJA on E. kansui through transcriptome before and after MeJA treatment. 96,040 unigenes with an average length of 812 bp were identified, among which 53,822 unigenes were annotated according to function database. Of note, we noted that MeJA treatment significantly altered the transcription pattern of E. kansui, especially at 24 hat of MeJA treatment. MeJA treatment mainly altered the expression of genes that functioned in biosynthesis of cutin, wax, flavonoid and terpenoid represented by MVA pathway in E. kansui. Typically, MeJA treatment mainly activated the expression of genes for terpenoid biosynthesis in EK at 36 hat. Further qRT-PCR verified that exogenous application of 20 μM MeJA greatly upregulate the expression levels of genes encoding enzymes in the terpenoid biosynthesis in E. kansui at 36 hat. Importantly, the contents of total terpenoid in E. kansui at 36 hat of MeJA treatment were promoted to 2.80 times of those without MeJA treatment. our results highlighted that MeJA could promoted the accumulation of terpenoid in E. kansui, which provided basis for cultivating high quality of E. kansui with higher levels of
bioactive compounds.
Unmasking of molecular players: Proteomic profiling of vitreous humor in pathologic myopia
Authors: Wen Yue , Ren Chi , Zhu Li , Huang Lvzhen , Qi Huijun , Yu Wenzhen , Wang Kai , Zhao Mingwei , Xu Qiong
Published: March 2024

Background: The purpose of this study was to examine the differentially expressed proteins in the vitreous humor (VH) of eyes with and without pathologic myopia (PM).
Methods: This was a cross-sectional, observational study. Patients with idiopathic epiretinal membrane (ERM), macular holes (MH), or myopic retinoschisis (MRS) who underwent vitrectomy provided VH samples. The differentially expressed proteins were identified using a label-free quantitative proteomic analysis, and the expression of three of the differentially expressed proteins was validated using ELISA.
Results: The expression of tubulin alpha 1A (TUBA1A) and eukaryotic translation elongation factor 1 alpha 1 (EEF1A1) was substantially greater in the PM group (MH-PM, MRS-PM) than in the control group (MH, ERM), although xylosyltransferase 1 (XYLT1) was significantly less expressed. While XYLT1 concentrations were lower in PM patients than in controls, EEF1A1 and TUBA1A concentrations in the vitreous were greater in PM patients.
Conclusions: Our research offers novel insights into the molecular alterations in PM patients' VH, EEF1A1, TUBA1A, and XYLT1 might be important for chorioretinal cell apoptosis, scleral extracellular matrix (ECM) synthesis, and scleral remodeling as well as potential new targets for PM treatment.
Associations between high-sensitivity C-reactive protein and hypertension base on NHANES 2017-2018
Authors: Wang Shihong , Lv Deliang , Wu Xiaobing , Xie Fengzhu , Shang Qinggang , Xie Wei , Zhao Zhiguang
Published: March 2024

Background: High-sensitivity C-reactive protein (hsCRP) is a systemic inflammation marker. Currently, the relationship between hsCRP and hypertension is still controversial. The purpose of this study is to further investigate the possible link between hsCRP and hypertension.
Methods: The cross-sectional data was obtained from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. We used multiple logistic regression models to examine the possible relationship between hsCRP and hypertension. Restricted cubic spline (RCS) models were used to further detect thenonlinear dose-response relationship between hsCRP and hypertension.
Results: A total of 4307 participants were enrolled in this study, including 2085 (48.4%) males and 2222 (51.6%) females. 1453 (33.7%) participants were over 60 years old and 1584 (36.8%) participants had hypertension. After adjusting for all potential confounders, the positive association between hsCRP and hypertension was statistically significant (OR=1.017; 95%CI: 1.006~1.028). Besides, compared to the lowest quartile of hsCRP, the highest quartile was associated with a higher risk of hypertension (OR=1.572; 95%CI: 1.237~1.997). Furthermore, the restricted cubic spline (RCS) model also showed a nonlinear relationship between hsCRP and hypertension (P for nonlinear < 0.001).
Conclusions: The cross-sectional population based study demonstrates the significant positive association between hsCRP and hypertension. Early screening for hsCRP and initiation of treatment may be helpful in preventing hypertension.
Rapid and convenient detection of Weissella ceti with loop-mediated isothermal amplification
Authors: Fang Huahua , Pan Jiankun , Wang Yingfei , Tao Ye , Zheng Chaoli , Wang Minghao , Qian Dandan , Sun Yanling
Published: March 2024

Weissella ceti, one of Gram-positive lactic‐acid bacteria, as a newly emerging pathogen can cause the rainbow trout (Oncorhynchus mykiss) with Weissellosis. Until now, it is not easy to identify W. ceti from other pathogens by symptoms of the fish infected especially at the primary stage of infection, and thus a method of identification was needed to determine conveniently and quickly this pathogen. In this study, loop-mediated isothermal amplification (LAMP) detection has higher specificity and sensitivity for W. ceti. The primers according to the hemolysin A gene were designed, and the LAMP detection was accomplished within 30 min at 63 ℃. The mimimum concentration of LAMP detection for W. ceti was 5.9*10− 6 ng/µl, which was 100 times more sensitive than traditional PCR. The LAMP detection confirmed the high specificity for detecting W. ceti, whereas the other six pathogens used were all negative reactions. In addition, it was validated that the LAMP detection was also effective in simulated clinical samples. Based on the results, the LAMP detection was rapid and convenient for point-of-care testing diagnosis of W. ceti.
Utilization of breakthrough curve for Estimation of Dispersion Coefficients of Subsurface Aquifer using Machine Learning
Authors: Ayaz Md , Ali Md. Shaheer
Published: March 2024

To forecast the future direction of pollutant movement, the advection dispersion equation is employed with positive time increments. Solving the Advection-dispersion equation necessitates prior knowledge of the dispersion coefficient, posing the challenge of estimating these coefficients within a subsurface aquifer. The task of deducing longitudinal and transverse coefficients for the subsurface aquifer emerges as an inverse problem. In this study, an innovative approach using Artificial Neural Network (ANN) modeling technique is introduced to estimate the dispersion coefficient of the subsurface aquifer. Training data is based on pollutant concentration over time, commonly referred to as a breakthrough curve. By focusing solely on the section of the breakthrough curve near the peak concentration, the required sampling duration are minimized. This is in contrast to previous research where the complete breakthrough curve was employed to estimate dispersion coefficients. Notably, both longitudinal and transverse dispersion coefficients are concurrently estimated in this study. The developed ANN model is trained using the Levenberg-Marquardt algorithm and is assessed under two and three-dimensional scenarios, incorporating both error-free and error-prone concentration data with a margin of up to 10%. The outcome of the performance evaluation underscores the robustness and efficacy of the ANN model in predicting longitudinal and transverse dispersion coefficients for subsurface aquifers.
Genetic landscape of nodular goiter, thyroid nodules with intermediate features between nodular goiter and follicular adenoma
Authors: Duan Ting , Ren Dingyuan , Jin Yanling , Lu Xiaming , Guo Zhenying
Published: March 2024

Background
Nodular goiters (NG) and follicular adenoma (FA) are common thyroid benign nodules and thyroid nodules with intermediate features between nodular goiter and follicular (ING) is used to describe the disease with borderline features. The genetic landscape of these three diseases is poorly investigated comparatively.
Methods
Clinical information of NG, ING and FA was retrieved and reviewed. Cytology and histology of the pathologic archives were reviewed to confirm the diagnosis. DNA and RNA were extracted to be submitted to qPCR assay to detect BRAF, TERT, RET, RAS, PAX8 and NTRK genetic aberration.
Results
The demographic, clinical, image and cytologic features in NG and ING are similar. Most disease presents a benign clinical and cytologic behavior, causing no diagnostic difficulty. Low frequency (< 10%) RAS gene was found in NG and ING. Patients with FA are older than whom with NG or ING. FA lesion size is smaller than ones in NG or ING. Although sonography demonstrated most FA nodules as benign category, the cytologic evaluation demonstrated a considerable percentage (45%) of atypia disease. Additionally, much higher frequency of RAS gene abnormality has been found in FA. And PAX8-PPARG gene is found in 17.9% FA and in no NG/ING cases.
Conclusion
NG/ING and FA is in the same spectrum and represents two ends of the spectrum of thyroid benign nodular condition. Differentiation of ING from NG has little clinical significance and would not be recommended. FA is devoid from NG/ING clinically and genetically. Interpretation of genetic abnormality should be cautious.
Safety and efficacy of covered self-expandable metallic stent for choledochojejunal anastomotic stricture: A multi-center retrospective cohort study
Authors: Iwasa Yuhei , Iwashita Takuji , Iwata Keisuke , Okuno Mitsuru , Shimojo Kota , Uemura Shinya , Tezuka Ryuichi , Senju Akihiko , Iwata Shota , Shimizu Masahito
Published: March 2024

Background
Benign choledochojejunal anastomotic stricture (CJS) is a complication of pancreaticoduodenectomy and choledochojejunostomy. Typically managed with endoscopic balloon dilatation, CJS has a high recurrence rate. Covered metallic stent (CMS) placement is a potential alternative; however, a comprehensive evaluation is lacking.
Objectives
The aim of this study was to evaluate the treatment outcomes of CMS placement in patients with CJS.
Methods
We retrospectively analyzed 46 patients who underwent balloon dilation via endoscopic retrograde cholangiopancreatography using a double-balloon endoscope for CJS between October 2010 and October 2023. The study outcomes included technical and clinical success rates, adverse event rates, choledochojejunal anastomotic stricture recurrence rates, and time to recurrence for balloon dilation and CMS treatment for CJS.
Results
The technical and clinical success rates were 100% for both treatments. Recurrence of CJS was observed in 35% (14/40) of the patients in the balloon dilation group. The recurrence rate was significantly higher in the balloon dilatation group than in the CMS group (35% vs. 0%, p = 0.006). The time to CJS recurrence was significantly shorter in the balloon dilatation group than in the covered metallic stent group (NR vs. NR, p = 0.03).
Conclusion
Placement of CMS for treating patients with CJS was demonstrated to be an effective and safe method with a lower recurrence rate than balloon dilation.
Long-Term Survival Outcomes Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis of Hepatocellular Carcinoma patients
Authors: Yan Guojun , Zhang Kai , Yan Lijun , Zhang Yanbin
Published: March 2024

Background: Patients with hepatocellular carcinoma with peritoneal metastasis (HCC-PM) have a poor prognosis. Traditional treatments have limited effects on survival. The safety and efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) have been shown in other peritoneal cancers. This study evaluated the role of CRS+HIPEC in HCC-PM.
Methods: A retrospective analysis of HCC-PM patients treated with CRS+HIPEC at Beijing Shijitan Hospital from March 2017 to December 2023 was conducted to assess clinical features, severe adverse events (SAEs), and overall survival (OS) rates.
Results: The study population comprised 10 HCC-PM patients who underwent CRS+HIPEC. The median peritoneal cancer index (PCI) was 25, and complete cytoreduction (CC0 ~ 1) was achieved in half of the patients. Three patients experienced SAEs within 30 days postoperatively. The 1-year, 3-year, and 5-year OS rates were 89.0%, 89.0%, and 21.0%, respectively, with a median OS1 of 107.8 months and OS2 of 49.9 months. The median progression-free survival (PFS) was 5.0 months.
Conclusion: CRS+HIPEC offers significant benefits to patients with HCC-PM. A selected group of patients may achieve prolonged PFS. Incorporating CRS+HIPEC into the treatment paradigm can thus be considered a strategic therapeutic option for patients with HCC-PM.
Research on Lane Line Detection Method Based on Cross Attention Mechanism
Authors: Huang Bingqiang , Wang Shiqian , Fei Zhenshun , Xiang Xinjian , Tian Shaohua , Tang Fuying , Yuan Tianshun
Published: March 2024

Lane detection is a key technical challenge in autonomous driving and advanced driving assistance systems. The current lane detection system has insufficient robustness and low detection accuracy problem in complex and harsh environmental conditions, and lacks research on visual cues without information. In order to accurately and effectively detect multiple lanes in challenging scenarios and meet the real-time requirements of actual driving, a lane detection method based on cross attention mechanism is proposed in this paper. Firstly, by embedding a cross attention mechanism in the feature extraction module, the contextual information of surrounding pixels on the intersection path is obtained, and useful information is collected from other regions for accurate lane detection; Secondly, anchor point detection is selected based on the prior position of the designed lane starting position; Finally, combining mixed anchor points to represent lane coordinates, using row and column anchors to learn lane coordinates and improve the real-time performance of lane detection models. The detection model RCCLaneNet designed in this paper was evaluated on the TuSimple and CULane datasets. The experimental results showed that the F1 of this method can reach 97.05% on the TuSimple dataset, 78.5% on the CULane dataset, and the real-time inference speed index FPS can reach +150. The proposed model achieves advanced performance in lane detection tasks in complex scenes while maintaining real-time detection efficiency, and has good universality in actual driving scenarios.