bluuebunny/crossref_metadata_2025 huggingface dataset:
Graphene/β-Tricalcium Phosphate Composite Scaffold Facilitates the Repairment of Cartilage Defect in Rabbit Knee Joint
Authors: Huang Wendong , Liao Yong , Yuan Xiaolu , Huang Jianhui , Chen Ya , Zhao Binxiu
Published: November 2023

Our research aims to evaluate the repairment of graphene/β-tricalcium phosphate (G/β-TCP) composite scaffold on cartilage defect in rabbit knee joints. The G/β-TCP composite material containing BMSCs was surgically implanted into the femoral condyle
of a full-thickness cartilage defect model in rabbits. XRD showed that no difference in the X-ray diffraction characteristics was observed between G/β-TCP and β-TCP. The biomechanical test claimed that the graphene doped β-TCP material processed higher mechanical
strength. Scanning electron microscopy showed that the surface of G/β-TCP material was smoother and the texture was denser. The scaffold combined with BMSCs was transplanted into the full-thickness cartilage defect rabbit model and the results showed that the serum CRP level increased
only 1 month after implantation, and the Cr level increased at 2 months after implantation, while G/β-TCP material showed rare significant pathological changes on the liver, spleen, kidney, brain, and soft tissue around the operation, which indicated a promising biocompatibility.
The expression of type I and II collagen in the cartilage tissue of G/β-TCP treated rabbits was dramatically elevated compared to β-TCP at 2 and 3 months after implantation. Collectively, the G/β-TCP composite scaffold facilitated the repairment of cartilage
defects in the rabbit knee joints.
Effects of Circ_0132269 on the Progression of Hepatocellular Carcinoma via Targeting miR-1248/MTO1
Authors: Yu Peng , Hu Xiongwei , Wang Sen , Yang Muyi
Published: November 2023

We investigated the role of circ_0132269 in hepatocellular carcinoma (HCC). We examined circ_0132269 levels in HCC tissues and cell lines using qRT-PCR. Survival analysis was performed to assess the correlation between circ_0132269 expression and HCC patient survival rates. Knockdown
of circ_0132269 was performed to evaluate its impact on HCC cell proliferation, migration, and invasion. Bioinformatics analysis predicted that circ_0132269 could interact with miR-1248. This interaction was confirmed using dual luciferase assays, and the correlation between circ_0132269 and
miR-1248 was analyzed. Further functional experiments investigated the effect of miR-1248 on circ_0132269-mediated malignant phenotypes. circ_0132269 was significantly upregulated in HCC tissues and cell lines. Higher circ_0132269 expression correlated with poorer overall and disease-free
survival in HCC patients. Silencing circ_0132269 suppressed HCC cell proliferation, migration, and invasion. Bioinformatics analysis revealed a binding site between circ_0132269 and miR-1248. miR-1248 expression was reduced in HCC, while its target MTO1 was highly expressed. miR-1248 levels
showed a negative correlation with circ_0132269 and MTO1 levels, while circ_0132269 and MTO1 exhibited a positive correlation. Overexpression of miR-1248 partially reversed the promotive effect of highly expressed circ_0132269 on HCC cell behaviors. circ_0132269 was significantly upregulated
in HCC and associated with poor prognosis. It interacts with miR-1248 to regulate HCC malignancy, highlighting its potential as a diagnostic and therapeutic target.
Coptisine Down-Regulates Soluble Intercellular Adhesion Molecule-1 by Inactivating Fas/FasL Signaling Pathway to Inhibit the Recurrence After Orthodontics
Authors: Song Bing , Gao Rui , Xu Xiaohui , Yan Weijun
Published: November 2023

In this study, by constructing a rat model of orthodontic recurrence and intervening with coptisine, the IL-6, IL-8, TNF-α and soluble intercellular adhesion molecule-1 (sICAM-1) content were analyzed to assess the regulatory mechanism of coptisine on the health status
of recurrent periodontal tissue after orthodontics and the occurrence of periodontal tissue inflammation. Male rats were assigned into three groups by constructing coptisine liposome nano-objects: blank group (Blank, 10 rats), orthodontic tooth movement model group (50 rats). The orthodontic
tooth movement model group was randomly divided into model group (module), model control group (control-free), model coptisine treatment group (treatment-free), model blank functional liposome group (control-lip) and model functional coptisine liposome group (treatment-lip). Rats in model
group were killed on the day after device was removed. Rats in other groups received equal doses of normal saline, coptisine, blank functional liposomes, and functional coptisine liposomes by intragastric administration on the day of device removal and then were killed after 7 days of continuous
treatment. Through Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, we found that Fas/FasL signaling pathway was enriched in pathways related to apoptosis, disease infection and inflammation. Western blot experiments confirmed that coptisine could inhibit Fas/FasL signaling
activation in the process of relapse after orthodontics. Lipopolysaccharides (LPS) treatment significantly increased inflammatory cytokines and sICAM-1, as well as the level of Fas and FasL. Coptisine treatment inhibited LPS-induced Fas/FasL signaling pathway in periodontal ligament cells.
Coptisine attenuated the relapsed inflammation after orthodontics by inhibiting Fas/FasL signaling.
A Rapid Integrated Detection Platform for Genes Related to Duck Muscle Tissue Development
Authors: Zhu Zhiming , Li Li , Miao Zhongwei , Xin Qingwu , Zhang Linli , Huang Qinlou , Zheng Nengzhu
Published: November 2023

In duck breeding, the growth and development of skeletal muscle is an important factor influencing the meat production performance of ducks. Therefore, the determination of Myod and Myf5 gene expression in poultry skeletal muscle tissues can help to understand the muscle
development of poultry, improve the production performance and feed conversion rate of animal organism, enhance the rapid protein deposition in animal organism, and obtain high quality and quantity of animal livestock products. In this study, a fluorescent PCR assay system for Myod
and Myf5 genes was developed, and a dual integrated rapid detection platform suitable for detecting Myod and Myf5 genes in poultry muscle tissue with a sensitivity of 10 copies/μL was constructed using a set of commercial, fully automated nucleic acid analyzer
with integrated detection based on magnetic bead method for nucleic acid extraction and PCR fluorescence detection. For 20 simulated samples, the integrated detection system was consistent with the results of qPCR experiments after conventional laboratory extraction, while the closed cassette-based
detection reduced the chance of contamination occurrence, making the results more reliable and accurate, which is ideal for immediate on-site rapid detection.
The Role of Climate Change in the Proliferation of Freshwater Harmful Algal Blooms in Inland Water Bodies of the United States
Authors: Wiley D. Yvette , McPherson Renee A.
Published: November 2023

Harmful algae and cyanobacteria blooms are increasing in frequency and intensity in freshwater systems due to anthropogenic impacts such as nutrient loading in watersheds and engineered alterations of natural waterways. There are multiple physical factors that affect the conditions in a freshwater system that contribute to optimal habitats for harmful algae and toxin-producing cyanobacteria. A growing body of research shows that climate change stressors also are impacting water-body conditions that favor harmful algae and cyanobacteria species over other phytoplankton. The overgrowth of these organisms, or a “bloom,” increases the opportunity for exposure to toxins by humans, companion animals, livestock, and wildlife. As waters warm and precipitation patterns change over time, exposure to these blooms is projected to increase. Hence, it is important that states and tribes develop monitoring and reporting strategies as well as align governmental policies to protect their citizens and ecosystems within their jurisdiction. Currently, the policies and approaches taken to monitor and report on harmful algae and cyanobacteria blooms vary widely among states, and it is undetermined if any tribes have specific policies on harmful algae blooms. This paper synthesizes research on algal blooms in inland freshwater systems of the United States. This review examines how climate change contributes to trends in bloom frequency or severity and outlines approaches that states and tribes may use to monitor, report, and respond to harmful algae and cyanobacteria blooms.

Significance Statement

Inland bodies of freshwater supply drinking water for humans and animals, water for irrigating crops, habitats for aquatic species, places of cultural significance for Indigenous peoples, and other important functions. Many of these bodies of water have been polluted with runoff from industry, including agriculture, and already support harmful algal blooms during warm conditions. Hot extremes associated with climate change are expected to increase the occurrence and duration of harmful algal blooms, and in some places, initiate blooms where none have been recorded previously. These toxic blooms are harmful to people, companion animals, livestock, and wildlife. It is important to review the interconnections among biological, climate, and water systems to monitor blooms and alert the public about their toxin production.
The War Years in Thebes: Ernest Mackay’s Work in Theban Tombs
Authors: Kaczanowicz Marta
Published: November 2023

The Mackay archive (now part of the larger manuscript collection of Alan H. Gardiner) kept at the Griffith Institute, University of Oxford, comprises excavation reports, photographs, and personal correspondence of Ernest Mackay, the British archaeologist who worked in the Theban necropolis from 1913–1916 on behalf of Robert Mond. Mackay’s notes fill in the gaps in the history of the exploration of Theban tombs, as well as add some additional information on the obscure years of the First World War in the Theban necropolis. The archive also sheds some light on the hitherto unknown beginning of the archaeological career of Dorothy Mackay.

[Formula: see text]
Pseudotumoral herpes genitalis in a woman living with HIV: Diagnosis and treatment challenges
Authors: Tomaino María V. , Sanchez Costantini Macarena , Alfaro Carmen T.
Published: November 2023

Herpes simplex virus (HSV) is the leading cause of genital ulcers worldwide. In rare cases, mostly among immunocompromised hosts, HSV infections can present as hypertrophic pseudotumoral forms simulating malignancies or often mistaken as other viral infections, usually resistant to conventional antiviral therapy and often requiring alternative therapeutic approaches. A high level of clinical suspicion is needed. We present a case of woman living with HIV with pseudotumoral vulvar herpes refractory to oral acyclovir, successfully treated with systemic foscarnet and topical imiquimod.
Export diversification and disaggregate energy consumption in BRICS economies: Does environmental degradation matter?
Authors: Rehman Faheem Ur , Noman Abul Ala , Islam Monirul , Wu Yan , Metwally Ahmad Sayed Mohammed
Published: November 2023

The role of exports as a catalyst for income growth necessitates the utilization of energy resources in manufacturing industries. Consequently, major exporting nations are embracing a dual approach, employing both renewable and non-renewable energy sources, to enhance export promotion while addressing environmental concerns. In this study, we examine the intricate relationship between export diversification and disaggregated energy consumption, specifically focusing on renewable and non-renewable energy, within the framework of the BRICS countries from 1990 to 2020. Notably, our investigation contributes significantly to the understanding of the moderating influence of environmental degradation, employing the Markov Chain Monte Carlo (MCMC) panel quantile regression method. Our findings reveal that initially, export diversification exerts a negative impact on renewable energy consumption. However, as countries attain a comparative advantage in diversification, this relationship transitions into a positive correlation. Additionally, we observe a significant positive association between export diversification and non-renewable energy consumption, which subsequently turns negative once the level of comparative advantage is reached. Moreover, we uncover that CO2 emissions, serving as a proxy for environmental degradation, partially moderate the link between export diversification and renewable energy consumption, while fully moderating the relationship with non-renewable energy consumption. Furthermore, we identify heterogeneous effects of outward foreign direct investment (FDI), innovation, human capital, and institutional quality on the disaggregated levels of energy consumption across the BRICS economies. In light of these findings, we propose the adoption of a prudent approach towards energy resource utilization, taking into account environmental safety considerations within the BRICS countries.
Culturally Safe Mentoring for American Indian Nursing Students
Authors: Kahn-John Michelle , Eddie Regina , Slaven Anna
Published: November 2023

Being the least-represented ethnic/racial group in college settings, American Indian students may experience loneliness and self-doubt related to the challenges of adapting to an environment that embodies values, norms, and culture so different from those represented in their traditional culture. Ongoing health disparities and psychosocial inequities, and persisting impacts of historical colonization, have led to additional hardships for these students that further complicate their academic experiences. Fostering culturally safe learning environments where compassionate and caring faculty provide culturally aligned teaching is important in addressing these complex disparities. Derived from American Indian values and teachings, we present a culturally safe intergenerational mentoring approach that emphasizes the nursing mentors’ responsibility to support the growth and success of American Indian nursing students. This approach, drawn from the wisdom of American Indian teachings, focuses on students’ strengths and culturally based protective factors. Culturally informed faculty who are aware of the historical impacts of colonization and who have adequate mentoring capacity (time, interest, and commitment) contribute to safe and effective learning environments. Culturally safe mentoring is one approach to promoting American Indian students’ potential for academic and professional success.
Digital encounters with microbial ecologies in a polluted urban river
Authors: Bradshaw Aaron
Published: November 2023

Despite their ubiquity and ecological heterogeneity, non-pathogenic microorganisms are often lacking in accounts of more-than-human and other-than-human urbanisms. This article focuses on the use of digital technologies as practice for sensing and encountering unglamorous microbial ecologies emerging in a polluted urban river in East London. The River Lea has a dense industrial history, but today it is a site of post-industrial disuse, uneven development and burgeoning urban ecologies. In an easily bypassed segment of this urban river, microbial ecosystems bloom in and out of existence, reflecting a confluence of urban political ecological, hydrological and microbiological dynamics. These ecosystems are generally overlooked in accounts of urban ecological value, and are often framed as uncharismatic, accidental or even invasive. The aim of this work is to provide an alternative rendering of these slimy micro-ecologies. To this end, two digital approaches are explored: deployment of in situ micro-videography and attention to historical satellite imagery of the urban ecosystem. Microscopic approaches configure embodied, sensory, aesthetic and speculative encounters with microbial ecologies in urban space. In their temporal configuration, historical satellite approaches glimpse the machinations of urban political ecological dynamics as they contribute to the emergence of, and intersect with, recombinant urban ecosystems. These methods provide tools for cultural geographers studying how urban organisation affects ecological diversity, and for expanding geographic investigation into the more-than-human cultures of overlooked, unglamorous and uncharismatic urban lifeforms.
Regulation of expression quantitative trait loci by SVA retrotransposons within the major histocompatibility complex
Authors: Kulski Jerzy K , Pfaff Abigail L , Marney Luke D , Fröhlich Alexander , Bubb Vivien J , Quinn John P , Koks Sulev
Published: November 2023

Genomic and transcriptomic studies of expression quantitative trait loci (eQTL) revealed that SINE-VNTR-Alu (SVA) retrotransposon insertion polymorphisms (RIPs) within human genomes markedly affect the co-expression of many coding and noncoding genes by coordinated regulatory processes. This study examined the polymorphic SVA modulation of gene co-expression within the major histocompatibility complex (MHC) genomic region where more than 160 coding genes are involved in innate and adaptive immunity. We characterized the modulation of SVA RIPs utilizing the genomic and transcriptomic sequencing data obtained from whole blood of 1266 individuals in the Parkinson’s Progression Markers Initiative (PPMI) cohort that included an analysis of human leukocyte antigen ( HLA) -A regulation in a subpopulation of the cohort. The regulatory properties of eight SVAs located within the class I and class II MHC regions were associated with differential co-expression of 71 different genes within and 75 genes outside the MHC region. Some of the same genes were affected by two or more different SVA. Five SVA are annotated in the human genomic reference sequence GRCh38.p14/hg38, whereas the other three were novel insertions within individuals. We also examined and found distinct structural effects (long and short variants and the CT internal variants) for one of the SVA ( R_SVA_24) insertions on the differential expression of the HLA-A gene within a subpopulation (550 individuals) of the PPMI cohort. This is the first time that many HLA and non-HLA genes (multilocus expression units) and splicing mechanisms have been shown to be regulated by eight structurally polymorphic SVA within the MHC genomic region by applying precise statistical analysis of RNA data derived from the blood samples of a human cohort population. This study shows that SVA within the MHC region are important regulators or rheostats of gene co-expression that might have potential roles in diversity, health, and disease.
Screening of Natural Compounds for CYP11A1 Stimulation Against Cell Renal Cell Carcinoma
Authors: Ong Hien Thi My , Ates Eda , Kwon Oh-Seung , Kang Min-Jung
Published: November 2023

Background

Renal cancer therapies are challenging owing to the extensive spreading of this cancer to other organs and its ability to pose resistance to current medications. Therefore, drugs targeting novel targets are urgently required to overcome these challenges. The cholesterol side-chain cleavage enzyme (CYP11A1) is closely associated with steroidogenesis, and its downregulation is linked to adrenal dysfunction and several types of carcinoma. We previously found that overexpression of CYP11A1 inhibited epithelial-mesenchymal transition and induced G2/M arrest in the kidney cancer Caki-1 cell line. In this context, natural compounds that exhibit potent CYP11A1 stimulation activity can be promising therpaeutic agents for kidney cancer.

Methods

We screened a panel of 1374 natural compounds in a wound-healing assay using CYP11A1-transfected Caki-1 cells. Of these, 167 promising biologically active compounds that inhibited cancer cell migration by more than 75% were selected, and their half-maximal inhibitory concentrations (IC50) were determined. The IC50 of 159 compounds was determined and 38 compounds with IC50 values less than 50 µM were selected for further analysis. Steroid hormones (cholesterol and pregnenolone) levels in cells treated with the selected compounds were quantitated using LC–MS/MS to determine their effect on CYP11A1 activity. Western blotting for CYP11A1, autophagy signaling proteins, and ferroptosis regulators were performed to ivestigate the mechanisms underlying the action of the selected compounds.

Results

We screened five promising natural lead compounds that inhibited cancer cell proliferation after three screening steps. The IC50 of these compounds was determined to be between 5.9 and 14.6 μM. These candidate compounds increased the expression of CYP11A1 and suppressed cholesterol levels while increasing pregnenolone levels, which is consistent with the activation of CYP11A1. Our results showed that CYP11A1 activation inhibited the migration of cancer cells, promoted ferroptosis, and triggered autophagy signaling.

Conclusions

This study indicates that the CYP11A1-overexpressing Caki-1 cell line is useful for screening drugs against kidney cancer. The two selected compounds could be utilized as lead compounds for anticancer drug discovery, and specifically for the development of antirenal cancer medication.
Genetic insights into the dissolution of dioecy in diploid persimmon Diospyros oleifera Cheng
Authors: Sun Peng , Nishiyama Soichiro , Li Huawei , Mai Yini , Han Weijuan , Suo Yujing , Liang Chengzhi , Du Huilong , Diao Songfeng , Wang Yiru , Yuan Jiaying , Zhang Yue , Tao Ryutaro , Li Fangdong , Fu Jianmin
Published: November 2023

Background

Dioecy, a sexual system of single-sexual (gynoecious/androecious) individuals, is rare in flowering plants. This rarity may be a result of the frequent transition from dioecy into systems with co-sexual individuals.

Results

In this study, co-sexual expression (monoecy and hermaphroditic development), previously thought to be polyploid-specific in Diospyros species, was identified in the diploid D. oleifeara historically. We characterized potential genetic mechanisms that underlie the dissolution of dioecy to monoecy and andro(gyno)monoecy, based on multiscale genome-wide investigations of 150 accessions of Diospyros oleifera. We found all co-sexual plants, including monoecious and andro(gyno)monoecious individuals, possessed the male determinant gene OGI, implying the presence of genetic factors controlling gynoecia development in genetically male D. oleifera. Importantly, discrepancies in the OGI/MeGI module were found in diploid monoecious D. oleifera compared with polyploid monoecious D. kaki, including no Kali insertion on the promoter of OGI, no different abundance of smRNAs targeting MeGI (a counterpart of OGI), and no different expression of MeGI between female and male floral buds. On the contrary, in both single- and co-sexual plants, female function was expressed in the presence of a genome-wide decrease in methylation levels, along with sexually distinct regulatory networks of smRNAs and their targets. Furthermore, a genome-wide association study (GWAS) identified a genomic region and a DUF247 gene cluster strongly associated with the monoecious phenotype and several regions that may contribute to andromonoecy.

Conclusions

Collectively, our findings demonstrate stable breakdown of the dioecious system in D. oleifera, presumably also a result of genomic features of the Y-linked region.
Whole-genome resequencing and transcriptome analyses of four generation mutants to reveal spur-type and skin-color related genes in apple (Malus domestica Borkh. Cv. Red delicious)
Authors: Ren Jiaxuan , Li Wenfang , Guo Zhigang , Ma Zonghuan , Wan Dongshi , Lu Shixiong , Guo Lili , Gou Huimin , Chen Baihong , Mao Juan
Published: November 2023

Background

Bud sport is a kind of somatic mutation that usually occurred in apple. ‘Red Delicious’ is considered to be a special plant material of bud sport, whereas the genetic basis of plant mutants is still unknown. In this study, we used whole-genome resequencing and transcriptome sequencing to identify genes related to spur-type and skin-color in the ‘Red Delicious’ (G0) and its four generation mutants including ‘Starking Red’ (G1), ‘Starkrimson’ (G2), ‘Campbell Redchief’ (G3) and ‘Vallee Spur’ (G4).

Results

The number of single nucleotide polymorphisms (SNPs), insertions and deletions (InDels) and structural variations (SVs) were decreased in four generation mutants compared to G0, and the number of unique SNPs and InDels were over 9-fold and 4-fold higher in G1 versus (vs.) G2 and G2 vs. G3, respectively. Chromosomes 2, 5, 11 and 15 carried the most SNPs, InDels and SVs, while chromosomes 1 and 6 carried the least. Meanwhile, we identified 4,356 variation genes by whole-genome resequencing and transcriptome, and obtained 13 and 16 differentially expressed genes (DEGs) related to spur-type and skin-color by gene expression levels. Among them, DELLA and 4CL7 were the potential genes that regulate the difference of spur-type and skin-color characters, respectively.

Conclusions

Our study identified potential genes associated with spur-type and skin-color differences in ‘Red Delicious’ and its four generation mutants, which provides a theoretical foundation for the mechanism of the apple bud sport.
Egg consumption and risk of cardiovascular disease: a PERSIAN cohort-based study
Authors: Mohseni Golsa khalatbari , Mohammadi Saeideh , Aghakhaninejad Zohreh , Tajadod Shirin , Abbasi Khadijeh , Askarpour Seyed Ali , Salimi Zahra , Shafaei Kachaei Hanieh , Rajabi Harsini Asma , Alami Farkhondeh , Bagheri Seyedeh Elaheh , Mosavi Jarrahi Seyed Alireza , Gohari Ali , Khoshdooz Sara , Doaei Saeid , Kooshki Akram , Gholamalizadeh Maryam
Published: November 2023

Background

Cardiovascular diseases (CVDs) are one of the main causes of death worldwide. Data on the effect of eggs consumption on the risk of CVDs are still unreliable. Therefore, this study aimed to investigate the association between CVDs and the consumption of eggs.

Methods

In this case-control study, the required data were extracted from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) cohort in Sabzevar, Iran. A total of 4241 adults participated including 1535 patients with CVDs as the case group and 2706 healthy people as controls. Egg consumption was assessed using a valid food frequency questionnaire (FFQ).

Results

A significant association was observed between eggs consumption and stroke after adjustment for physical activity, body mass index (BMI), smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), using alcohol, lipid profile, diabetes, and the intake of energy, lipid, protein, carbohydrate, and cholestrol (OR:1.007, 95% CI:1.001–1.013, P = 0.03). No association was found between egg consumption with hypertension, cardiac ischemia, and myocardial infarction.

Conclusions

There was a significant association between the consumption of eggs and stroke. However, more studies are needed to examine the effect of eggs on CVDs.
Relationship between obesity indicators and hypertension–diabetes comorbidity in an elderly population: a retrospective cohort study
Authors: Li Haojie , Shi Zhan , Chen Xuejiao , Wang Junjie , Ding Jiacheng , Geng Shuoji , Sheng Xinyuan , Shi Songhe
Published: November 2023

Background

The prevalence of obesity, hypertension and diabetes is increasing. Hypertension and diabetes are common complications. Additionally, obesity and hypertension–diabetes comorbidity (HDC) are both closely related to insulin resistance. The aim of this study was to determine the association of obesity indicators with HDC in elderly individuals.

Methods

This retrospective cohort study included 74,955 subjects aged ≥ 60 years living in Xinzheng, Henan Province, from January 2011 to December 2019. The data were collected from the annual health examination dataset. Cox proportional hazard regression models and competing-risk survival regression models were used to examine the relationships between the three indicators and HDC risk.

Results

After 346,504 person-years of follow-up, HDC developed in 9,647 subjects. After further adjustments for confounders and death competing risks, compared with a body mass index (BMI) of 18.5–23.9 kg/m2, the fully adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of BMI < 18.5, 24–27.9 and ≥ 28 kg/m2 for HDC morbidity were 0.651(0.538,0.788),1.00,1.396(1.336,1.459) and 1.769(1.666,1.878), respectively. Moreover, participants with abdominal obesity measured via waist circumference (WC) or waist-to-height ratio (WtHR) had a higher risk of HDC (HR:1.513; 95% CI: 1.45,1.578 and HR:1.412;95% CI: 1.353,1.473), respectively, than participants with low WC or with low WtHR. In the joint analyses, the highest risk was observed in participants who were overweight and who had central obesity (HR: 1.721; 95% CI: 1.635, 1.811) compared with the nonoverweight and noncentral obesity groups.

Conclusions

Increased BMI, WC and WtHR were associated with an increased risk of HDC. There was an additive interaction between general body adiposity (as measured via BMI) and central obesity (as measured via WC and WtHR) for HDC. Therefore, reasonable control of BMI, WC and WtHR may be an effective measure to prevent HDC among elderly individuals.
Cognitive decline as the main manifestation of diabetic striatal disease but without involuntary movements: a case report
Authors: Li He , Cheng YiRan , Tang Wei , Hu YiBin , Jia GeHui , Wu Tong , Wang KangFeng
Published: November 2023

Diabetic striatopathy (DS) is a rare central nervous system complication of diabetes mellitus, characterized mainly by non-ketotic hyperglycemia and lateralized involuntary movements. Patients with diabetic striatopathy manifested solely by subacute cognitive decline were rarely reported. In this paper, we report a patient with DS who presented solely with subacute cognitive decline without involuntary movements, and cranial CT showed bilateral high density in the basal ganglia. In contrast, SWI showed microhemorrhages in the right caudate nucleus head. After one week of treatment, including glycemic control, the patient showed significant improvement in cognitive function, while a repeat cranial CT showed improved hyperdensity in the right basal ganglia region. 1 month later, at telephone follow-up, the patient’s symptoms did not recur.
A national perspective on exposure to essential surgical procedures among medical trainees in Nigeria: a cross-sectional survey and recommendations
Authors: KingPriest Paul Tunde , Alayande Barnabas Tobi , Clement Emmanuel Walong , Muhammed Mustapha , Egbiri Joy Ohejem , Shanabo Miracle , Osayande Etinosa Kevin , Atunrase Abiodun Ayomide , Abubakar Jamiu Israel , Eze Daniel Chukwuma , Adekoya Stephen , Chiroma Gideon Bulus , Aikhuomogbe Onosegbe Moses , Gaila Fatima Shuwa , Yaga Dennis , Thomas Nomsu Noble , Chukwunta Chukwudi Anthony , Hey Matthew T. , Forbes Callum , Riviello Robert R. , Ismaila Bashiru O.
Published: November 2023

Background

In sub-Saharan Africa, recent graduates from medical school provide more direct surgical and procedural care to patients than their counterparts from the Global North. Nigeria has no nationally representative data on the procedures performed by trainees before graduation from medical school and their confidence in performing these procedures upon graduation has also not been evaluated.

Methods

We performed an internet-based, cross-sectional survey of recent medical school graduates from 15 accredited Federal, State, and private Nigerian medical schools spanning six geopolitical zones. Essential surgical procedures, bedside interventions and three Bellwether procedures were incorporated into the survey. Self-reported confidence immediately after graduation was calculated and compared using cumulative confidence scores with subgroup analysis of results by type and location of institution. Qualitative analysis of free text recommendations by participants was performed using the constant comparative method in grounded theory.

Results

Four hundred ninety-nine recent graduates from 6 geopolitical zones participated, representing 15 out of a total of 44 medical schools in Nigeria. Male to female ratio was 2:1, and most respondents (59%) graduated from Federal institutions. Students had greatest practical mean exposure to bedside procedures like intravenous access and passing urethral foley catheters and were most confident performing these. Less than 23% had performed over 10 of any of the assessed procedures.

They had least exposures to chest tube insertion (0.24/person), caesarean Sect. (0.12/person), and laparotomy (0.09/person). Recent graduates from Federal institutions had less procedural exposure in urethral catheterization (p < 0.001), reduction (p = 0.035), and debridement (p < 0.035).

Respondents that studied in the underserved North-East and North-West performed the highest median number of procedures prior to graduation. Cumulative confidence scores were low across all graduates (maximum 25/60), but highest in graduates from Northern Nigeria and private institutions. Graduates recommended prioritizing medical students over senior trainees, using simulation-based training and constructive individualized non-toxic feedback from faculty.

Conclusion

Nigerian medical students have poor exposure to procedures and low confidence in performing basic procedures after graduation. More attention should be placed on training for essential surgeries and procedures in medical schools.
How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada
Authors: Cherba Maria , Funk Laura , Scott Erin , Salman Bora , Rounce Andrea , Mackenzie Corey , Stajduhar Kelli , Dujela Carren , Krawczyk Marian , Cohen S. Robin
Published: November 2023

Objectives

In response to COVID-19’s first wave, provincial governments rapidly implemented several public health directives, including isolation measures and care facility visitor restrictions, which profoundly affected healthcare delivery at the end of life and dying experiences and perceptions. The objective of this study was to identify implications of early policy changes for dying at home.

Methods

Analysis of interviews with 29 key informants with expertise in the policy and practice context of dying at home and care for those dying at home was conducted as part of a larger mixed-methods study on dying at home in Canada.

Results

Initial pandemic policy responses, especially visitor restrictions and limitations to home care services, shaped dying at home in relation to three themes: (1) increasing preferences and demand for, yet constrained system ability to support dying at home; (2) reinforcing and illuminating systemic reliance on and need for family/friend caregivers and community organizations, while constraining their abilities to help people die at home; and (3) illuminating challenges in developing and implementing policy changes during a pandemic, including equity-related implications.

Conclusion

This study contributes to broader understanding of the multifaceted impacts of COVID-19 policy responses in various areas within Canadian healthcare systems. Implications for healthcare delivery and policy development include (1) recognizing the role of family/friend caregivers and community organizations in end-of-life care, (2) recognizing health inequities at the end of life, and (3) considering possible changes in future end-of-life preferences and public attitudes about dying at home and responsibility for end-of-life care.
Implementing PCR testing in general practice—a qualitative study using normalization process theory
Authors: Shahrzad Sinead , Balasubramaniam Kirubakaran , Kousgaard Marius Brostrøm , Thilsing Trine , Søndergaard Jens , Overbeck Gritt
Published: November 2023

Background

The COVID-19 pandemic brought attention to a need for rapid testing of large populations. Experiences from community-based testing settings show that there can be workload difficulties, logistical challenges and socioeconomic downsides to large scale Polymerase Chain Reaction (PCR) testing. Alternative testing arenas have therefore been considered. Rapid point-of-care (POC) PCR test methods have since been developed and could have potential to surveille viral respiratory infections. It is, however, unknown if PCR testing can be successfully implemented routinely in general practice. The aim of this study was to assess factors that enable and inhibit the implementation of point-of-care PCR testing for acute respiratory tract infection in general practice.

Methods

Fourteen general practices in the east Zealand area in Denmark were included in the study and given access to POC PCR testing equipment during a flu season. The participating clinics were initially trained in the use of a POC PCR testing device and then spent 6 weeks testing it. We conducted qualitative interviews with general practitioners (GPs) and their staff, before and after the testing period, specifically focusing on their clinical decision-making and internal collaboration in relation to POC PCR testing. We used normalization process theory to design the interview guides and to analyze the data.

Results

Professionals reported no clinical need for a POC PCR testing device in a non-pandemic clinical setting. Results were delivered faster, but this was only timesaving for the patient and not the GP, who had to perform more tasks.

Conclusion

In its current form, the added diagnostic value of using POC PCR testing in general practice was not sufficient for the professionals to justify the increased work connected to the usage of the diagnostic procedure in daily practice.

Trial registration

n/a.
Multi-classification model incorporating radiomics and clinic-radiological features for predicting invasiveness and differentiation of pulmonary adenocarcinoma nodules
Authors: Sun Haitao , Zhang Chunling , Ouyang Aimei , Dai Zhengjun , Song Peiji , Yao Jian
Published: November 2023

Purpose

To develop a comprehensive multi-classification model that combines radiomics and clinic-radiological features to accurately predict the invasiveness and differentiation of pulmonary adenocarcinoma nodules.

Methods

A retrospective analysis was conducted on a cohort comprising 500 patients diagnosed with lung adenocarcinoma between January 2020 and December 2022. The dataset included preoperative CT images and histological reports of adenocarcinoma in situ (AIS, n = 97), minimally invasive adenocarcinoma (MIA, n = 139), and invasive adenocarcinoma (IAC, n = 264) with well-differentiated (WIAC, n = 99), moderately differentiated (MIAC, n = 84), and poorly differentiated IAC (PIAC, n = 81). The patients were classified into two groups (IAC and non-IAC) for binary classification and further divided into three and five groups for multi-classification. Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) algorithm to identify the most informative radiomics and clinic-radiological features. Eight machine learning (ML) models were developed using these features, and their performance was evaluated using accuracy (ACC) and the area under the receiver-operating characteristic curve (AUC).

Results

The combined model, utilizing the support vector machine (SVM) algorithm, demonstrated improved performance in the testing cohort, achieving an AUC of 0.942 and an ACC of 0.894 for the two-classification task. For the three- and five-classification tasks, the combined model employing the one versus one strategy of SVM (SVM-OVO) outperformed other models, with ACC values of 0.767 and 0.607, respectively. The AUC values for histological subtypes ranged from 0.787 to 0.929 in the testing cohort, while the Macro-AUC and Micro-AUC of the multi-classification models ranged from 0.858 to 0.896.

Conclusions

A multi-classification radiomics model combined with clinic-radiological features, using the SVM-OVO algorithm, holds promise for accurately predicting the histological characteristics of pulmonary adenocarcinoma nodules, which contributes to personalized treatment strategies for patients with lung adenocarcinoma.
The role of extracellular vesicles in circulating tumor cell-mediated distant metastasis
Authors: Guo Siyin , Huang Jing , Li Genpeng , Chen Wenjie , Li Zhihui , Lei Jianyong
Published: November 2023

Current research has demonstrated that extracellular vesicles (EVs) and circulating tumor cells (CTCs) are very closely related in the process of distant tumor metastasis. Primary tumors are shed and released into the bloodstream to form CTCs that are referred to as seeds to colonize and grow in soil-like distant target organs, while EVs of tumor and nontumor origin act as fertilizers in the process of tumor metastasis. There is no previous text that provides a comprehensive review of the role of EVs on CTCs during tumor metastasis. In this paper, we reviewed the mechanisms of EVs on CTCs during tumor metastasis, including the ability of EVs to enhance the shedding of CTCs, protect CTCs in circulation and determine the direction of CTC metastasis, thus affecting the distant metastasis of tumors.
A step change model analysis of the establishment of pill testing in one Australian jurisdiction
Authors: Caldicott David , Makkai Toni , McLeod Malcolm , Tzanetis Stephanie , Vumbaca Gino
Published: November 2023

This paper applies the theory of change model (Kotter in Harv Bus Rev 2:59–67, 1995; Moore et al. in Viet Nam J Public Health 1(1):66–75, 2013) to describe the pathway that lead to Australia’s first pill testing/drug checking services in Canberra, in the Australian Capital Territory. The paper takes each step of the model and illustrates the key activities that largely occurred over an approximately 24 month period resulting in the service being operational on 29 April 2018. The paper demonstrates that leadership, advocacy and activism are key components, alongside evidence, to bringing about public policy change. It provides a unique insight to the extensive efforts undertaken to achieving the first legally sanctioned pill testing at festivals in Australia and provides a positive case study for those seeking to introduce contested harm reduction services in the drug and alcohol field.
A systematic literature review on direct and indirect costs of triple-negative breast cancer
Authors: Rezaei Sadeq , Babaei Majid
Published: November 2023

Background

Triple-negative breast cancer (TNBC) is an aggressive and therapy-resistant form of breast cancer with a significant economic burden on patients and healthcare systems. Therefore, we completed a systematic review to classify and synthesize the literature on the direct and indirect costs of TNBC.

Methods

Databases including ISI Web of Science, Scopus, PubMed, and Google Scholar were searched for all related articles assessing the economic burden of TNBC from 2010 until December 2022. The quality and eligibility assessments were done accordingly. We adjusted all costs to January 2023 $US.

Results

From 881 records, 15 studies were eligible. We found that studies are widely disparate in the timetable, study design, patient populations, and cost components assessed. The annual per-patient direct costs of metastatic TNBC (mTNBC) were about $24,288 to $316,800. For early TNCB patients (eTNBC) this was about $21,120 to $105,600. Cancer management anticancer therapy costs account for the majority of direct costs. Along with an increase in cancer stage and line of therapy, healthcare costs were increased. Moreover, the indirect costs of patients with mTNBC and eTNBC were about $1060.875 and about $186,535 for each patient respectively.

Conclusion

The results showed that the direct and indirect costs of TNBC, mainly those of mTNBC, were substantial, suggesting attention to medical progress in cancer prognosis and therapy approaches.
Distal aortic biomechanics after transcatheter versus surgical aortic valve replacement: a hypothesis generating study
Authors: Rong Lisa Q. , Zheng William , Martinez Andrew , Rahouma Mohammed , Devereux Richard B. , Kim Jiwon , Osman Bassam , Palumbo Maria C. , Redfors Björn , Girardi Leonard N. , Weinsaft Jonathan W. , Gaudino Mario
Published: November 2023

Background

Biomechanical effects of transcatheter (TAVR) versus surgical (SAVR) aortic valve interventions on the distal aorta have not been studied. This study utilized global circumferential strain (GCS) to assess post-procedural biomechanics changes in the descending aorta after TAVR versus SAVR.

Methods

Patients undergoing TAVR or SAVR for aortic stenosis were included. Transesophageal (TEE) and transthoracic (TTE) echocardiography short-axis images of the aorta were used to image the descending aorta immediately before and after interventions. Image analysis was performed with two-dimensional speckle tracking echocardiography and dedicated software. Delta GCS was calculated as: post-procedural GCS—pre-procedural GCS. Percentage delta GCS was calculated as: (delta GCS/pre-procedural GCS) × 100.

Results

Eighty patients, 40 TAVR (median age 81 y/o, 40% female) and 40 SAVR (median 72 y/o, 30% female) were included. The post-procedure GCS was significantly higher than the pre-procedural GCS in the TAVR (median 10.7 [interquartile range IQR 4.5, 14.6] vs. 17.0 [IQR 6.1, 20.9], p = 0.009) but not in the SAVR group (4.4 [IQR 3.3, 5.3] vs. 4.7 [IQR 3.9, 5.6], p = 0.3). The delta GCS and the percentage delta GCS were both significantly higher in the TAVR versus SAVR group (2.8% [IQR 1.4, 6] vs. 0.15% [IQR − 0.6, 1.5], p < 0.001; and 28.8% [IQR 14.6%, 64.6%] vs. 4.4% [IQR − 10.6%, 5.6%], p = 0.006). Results were consistent after multivariable adjustment for key clinical and hemodynamic characteristics.

Conclusions

After TAVR, there was a significantly larger increase in GCS in the distal aorta compared to SAVR. This may impact descending aortic remodeling and long-term risk of aortic events.
The use of checklists in the intensive care unit: a scoping review
Authors: Erikson Ethan J. , Edelman Daniel A. , Brewster Fiona M. , Marshall Stuart D. , Turner Maryann C. , Sarode Vineet V. , Brewster David J.
Published: November 2023

Background

Despite the extensive volume of research published on checklists in the intensive care unit (ICU), no review has been published on the broader role of checklists within the intensive care unit, their implementation and validation, and the recommended clinical context for their use. Accordingly, a scoping review was necessary to map the current literature and to guide future research on intensive care checklists. This review focuses on what checklists are currently used, how they are used, process of checklist development and implementation, and outcomes associated with checklist use.

Methods

A systematic search of MEDLINE (Ovid), Embase, Scopus, and Google Scholar databases was conducted, followed by a grey literature search. The abstracts of the identified studies were screened. Full texts of relevant articles were reviewed, and the references of included studies were subsequently screened for additional relevant articles. Details of the study characteristics, study design, checklist intervention, and outcomes were extracted.

Results

Our search yielded 2046 studies, of which 167 were selected for further analysis. Checklists identified in these studies were categorised into the following types: rounding checklists; delirium screening checklists; transfer and handover checklists; central line-associated bloodstream infection (CLABSI) prevention checklists; airway management checklists; and other. Of 72 significant clinical outcomes reported, 65 were positive, five were negative, and two were mixed. Of 122 significant process of care outcomes reported, 114 were positive and eight were negative.

Conclusions

Checklists are commonly used in the intensive care unit and appear in many clinical guidelines. Delirium screening checklists and rounding checklists are well implemented and validated in the literature. Clinical and process of care outcomes associated with checklist use are predominantly positive. Future research on checklists in the intensive care unit should focus on establishing clinical guidelines for checklist types and processes for ongoing modification and improvements using post-intervention data.