bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol and research program of the European registry and biobank for interstitial lung diseases (eurILDreg)
Authors: Krauss Ekaterina , Tello Silke , Naumann Jennifer , Wobisch Sandra , Ruppert Clemens , Kuhn Stefan , Mahavadi Poornima , Majeed Raphael W. , Bonniaud Philippe , Molina-Molina Maria , Wells Athol , Hirani Nik , Vancheri Carlo , Walsh Simon , Griese Matthias , Crestani Bruno , Guenther Andreas ,   on behalf of further eurILDreg investigators, Borie Raphael , Kannengiesser Caroline , Poletti Venerino , Behr Juergen , Drakopanagiotakis Fotios , Bastos Helder , Ravaglia Claudia , Hurley Killian ,   RARE-ILD investigators, Eils Roland , Gut Ivo , Haick Hossam , Broza Yoav Y.
Published: November 2024

Background and Aims

Interstitial lung diseases (ILDs), encompassing both pediatric and adult cases, present a diverse spectrum of chronic conditions with variable prognosis. Despite limited therapeutic options beyond antifibrotic drugs and immunosuppressants, accurate diagnosis is challenging, often necessitating invasive procedures that may not be feasible for certain patients.

Drawn against this background, experts across pediatric and adult ILD fields have joined forces in the RARE-ILD initiative to pioneer novel non-invasive diagnostic algorithms and biomarkers. Collaborating with the RARE-ILD consortium, the eurILDreg aims to comprehensively describe different ILDs, analyze genetically defined forms across age groups, create innovative diagnostic and therapeutic biomarkers, and employ artificial intelligence for data analysis.

Methods

The foundation of eurILDreg is built on a comprehensive parameter list developed and adopted by clinical experts, encompassing over 1,800 distinct parameters related to patient history, clinical examinations, diagnosis, lung function and biospecimen collection. This robust dataset is further enriched with daily assessments captured through the patientMpower app, including handheld spirometry and exercise tests, conducted on approximately 350 patients over the course of a year. This approach involves app-based daily assessments of quality of life, symptom tracking, handheld spirometry, saturation measurement, and the 1-min sit-to-stand test (1-STST). Additionally, pediatric data from the ChILD-EU registry will be integrated into the RARE-ILD Data Warehouse, with the ultimate goal of including a total of 4.000 ILD patients and over 100.000 biospecimen.

Discussion

The collaborative efforts within the consortium are poised to streamline research endeavors significantly, promising to advance patient-centered care, foster innovation, and shape the future landscape of interstitial lung disease research and healthcare practices.

Trial Registration

EurILDreg is registered in the German Clinical Trials Register (DRKS 00028968, 26.07.2022), and eurIPFreg is registered in ClinicalTrials.gov (NCT02951416).
Menstrual cycle related depressive symptoms and their diurnal fluctuations – an ambulatory assessment study
Authors: Klusmann Hannah , Brose Annette , Schulze Lars , Engel Sinha , Laufer Sebastian , Bücklein Elise , Knaevelsrud Christine , Schumacher Sarah
Published: November 2024

Background

Reproductive mood disorders indicate that within-person variation in depressive symptoms across the menstrual cycle can be related to ovarian hormone changes. Until now, such cycle-related symptom changes have been measured once daily, even though depression research indicates systematic diurnal changes in symptoms. Further, previous research often focused on aggregated depression scores. This study examined whether three daily assessments of depressive symptoms follow similar trajectories across the menstrual cycle and investigated within-person cyclical fluctuation of all individual symptoms and the aggregated score.

Methods

77 naturally-cycling participants (35 with and 42 without depressive disorder) provided three daily ratings of depressive symptoms across one menstrual cycle to evaluate individual and summarized symptoms.

Results

Reliability estimates (w) of the three diurnal measurements ranged from 0.56 to 0.78. Cyclicity showed statistically significant interindividual differences for all symptoms, and individual symptoms differed significantly from each other in their magnitude of cyclicity.

Limitations

Only one menstrual cycle was assessed to reduce participant burden. Further, ovulation testing dates were based on self-reported cycle lengths, and only LH (luteinizing hormone) peaks were tested without subsequent progesterone rises.

Conclusions

The results highlight the need for a symptom-specific approach to assess individual variance in cyclicity of depressive symptoms. Reliability for one daily assessment can be improved by using the afternoon value, a sum score for depressiveness, or multiple items per symptom. Furthermore, this study emphasizes, that depressive symptoms can systematically change across the menstrual cycle, and it is, therefore, important to include it in depression research. Exploring female-specific risk factors of depression will enable the development of person-tailored treatments.

Trial registration

The study was preregistered at ClinicalTrials.gov (NCT04086316) with the first registration on 27/08/2019.
Exploring alternative practice placement models in occupational therapy and physiotherapy: perspectives and experiences of learners and practice educators: a qualitative systematic review
Authors: Deaves Amanda , Matson Rebecca , Rushe Edwina , Rees Anna , Edwards David , Trainor Kate , Seddon Joanne
Published: November 2024

Within physiotherapy and occupational therapy practice placements, there is a predominance of the one-to-one supervision model which creates limitations for placement capacity expansion. Alternative placement models must be explored to meet training requirements for these professions and ensure the availability of a future workforce. The aim of this review is to explore the experiences and perceptions of practice educators and learners regarding alternative placement models, to inform future planning and the adoption of these opportunities. This qualitative systematic review followed the Joanna Briggs Institute methodology. A comprehensive search was conducted across six databases (CINAHL, MEDLINE, PubMed, Scopus, ERIC, PsycINFO), covering the period from January 2010 to December 2022. Meta-aggregation was used to synthesise the findings from the included studies. A total of 16 articles were included within this review. The learner voice was represented in 14 categories aggregated to five synthesised findings: professional growth and development, personal and psychological adaptation, alliances within collaborative learning, educational and learning process, and managing professional relationships. The practice educator voice was represented in 11 categories aggregated into four synthesised findings: providing the right support; professional identity; peer relationships and levels of satisfaction. This review highlights positive aspects associated with skill development, personal growth, and the formation of professional identity following alternative placement experiences. However, it also reveals concerns including uncertainty and anxiety related to role clarity, expectations, and the structure within these environments. This understanding of the perceptions and experiences of both learners and practice educators can inform the development of targeted support and guidance from universities, addressing these challenges and enhancing overall satisfaction. Further adoption of alternative placement models has the potential to expand practice placement capacity for learners offering a promising environment for healthcare education. These models provide learners with invaluable experiences and skills essential for their future careers.
Forecasting the future of smart hospitals: findings from a real-time delphi study
Authors: Jovy-Klein Florian , Stead Susan , Salge Torsten Oliver , Sander Jil , Diehl Anke , Antons David
Published: November 2024

Background

In concert with other digital technologies, artificial intelligence (AI) is shaping the vision of smart hospitals. The transformation into smart hospitals, however, is all but trivial due to the lack of financial and human resources, digital skills, and supporting policies. Thus, the extent to which the vision of smart hospitals will eventually become reality is uncertain. In this context, our study provides a multidimensional conceptualization of the immediate future of smart hospitals to 2042.

Methods

This study employs an iterative mixed-methods approach, including expert workshops and a Delphi study. We conducted a real-time Delphi study to forecast the evolution of smart hospitals in 5-year steps from 2027 to 2042. A total of 39 experts in healthcare, artificial intelligence, and management participated.

Results

Our understanding of a technology-enabled smart hospital in this study includes four dimensions: artificial intelligence (AI), sustainability, ecosystems, and human-centeredness. Our findings underscore the critical need to address the shortage of hospital staff and general practitioners that models predict will peak by 2032. Additionally, our results show a significant shift to individualized medicine and home care. This shift indicates that smart hospitals are expected to leverage AI and digital technologies to tailor care to each patient. Furthermore, the roles and responsibilities of hospital staff will undergo significant changes. Healthcare personnel will have to adapt to new technologies that facilitate more efficient workflows and improve patient engagement in evolving healthcare environments. The results of our study suggest a shift in care to individualized medicine and home care, with corresponding changes in the roles and responsibilities of hospital staff who will employ new technologies.

Conclusions

The findings from our real-time Delphi study suggest that the vision of smart hospitals is gradually becoming reality over the next 20 years. Advancements in artificial intelligence should enhance operational efficiency and patient-centric care, while facilitating the integration of sustainability practices and fostering collaborative ecosystems. However, addressing challenges such as staff shortages, ethical considerations, and the need for robust digital skills will be essential. A deep pool of expert healthcare practitioners, clear ethical guidelines, and robust digital skills are essential to fully realize this vision and ensure that smart hospitals can meet the evolving needs of healthcare delivery.
Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia
Authors: Simangolwa Warren Mukelabai , Govender Kaymarlin , Mbonigaba Josue
Published: November 2024

Background

Health technology assessment uses explicit economic evaluation evidence to support health benefits package design. However, the limited availability of technical expertise, data, and methods has restricted the production of economic evaluation evidence in low- and middle-income countries. Zambia has initiated a roadmap to support its policy of reviewing and implementing its national benefits package. This study characterises economic evaluation evidence to support this process's evidence mapping, synthesis, and appraisal stages.

Methods

This systematic review applies deductive analysis and the preferred reporting items for systematic review and meta-analyses. Four databases were searched to identify studies from 1993 that coincided with Zambia's health benefits package reform.

Results

A total of 61 studies met the inclusion criteria. Most of the studies were first authored by nonlocal authors, and the number of local-based authors in each study was low. Almost all funding for economic evaluation research was not local, and only a few studies sought local ethical clearance to conduct research. Infectious diseases were the highest disease control priority for the studies, with HIV research having the highest output. Most of the studies were cost-effectiveness studies that utilised trial-based data and a combination of program, published, and unpublished data for analysis. The studies generally utilised direct cost and applied the ingredient-based costing approach. Natural units were predominantly used for outcomes alongside DALYs. Most studies reported using a 3% discount rate for both costs and outcomes, with only a few reporting methods for sensitivity analysis.

Conclusion

Economic evaluation evidence in Zambia has increased, revealing limited local research leadership, methodological inconsistencies, and a focus on infectious diseases. These findings are crucial for revising Zambia's benefits package and may guide researchers and decision-makers in improving the transparency and quality of future research.
An update on the pathogenesis and ethnopharmacological therapeutic approaches of vulvovaginal candidiasis
Authors: Chauhan Vidushi , Kumar Amit , Tripathi Shweta , Jha Madhulika , Kumar Navin , Poluri Krishna Mohan , Gupta Payal
Published: November 2024

In the era of globalization, the concept of world health needs to be practiced where a significant consideration should be given to women health. Of many issues, the most common and under-rated is vulvovaginal candidiasis (VVC); a superficial to invasive mucosal infection of lower reproductive tract in women, primarily caused by commensal yeast Candida. The inability of conventional drugs in triumphing the VVC has made researchers to review the potential of traditional medicines. The present review aimed to highlight the problem and concerns of women related to VVC, covering all aspects of disease development, host response, conventional drug failure, and possibilities of formulating phytomolecule based VVC therapy. The health and disease issues in women are considerably severe, especially for those living in impoverished conditions. Any dysbiosis in vaginal microbiome disturbs the harmony between residing microbes and leads to commencement of VVC. Lactobacillus is key care-taker microbe that keeps check on over growth of Candida by various means. However, Candida have evolved numerous virulence traits to overcome the governance of Lactobacillus as well as host immune system. The present review comprehensively outlined the virulence, and pathogenicity of Candida along with its interaction with host immune system. The review has also highlighted the current conventional drugs and their drawbacks, along with potential of ethnopharmacological phytoactive molecules as future therapies for defining the therapeutic management of the disease.

Graphical Abstract
Comparative analysis of nutritional and mineral compositions of Farfantepenaeus notialis and Macrobrachium vollenhovenii for dietary planning and food industry applications
Authors: Ibitoye Oluwatosin , Ayanniyi Oluwadamilola , Ayeni Olabisi , Kolejo Oluwatobi , Arabambi Israel , Ademola Oluwafunke , Adetola Olusegun , Onafurume Ono
Published: November 2024

This study compares the nutritional composition of two commercially important crustaceans, Farfantepenaeus notialis and Macrobrachium vollenhovenii, to assess their dietary suitability. Proximate and mineral analyses were performed on dried samples of each species, evaluating fat, protein, ash, moisture, and mineral concentrations. Results reveal significant differences. F. notialis showed higher fat (1.79% ± 0.001%) and protein (6.69% ± 0.2%) compared to M.vollenhovenii (fat: 1.54% ± 0.001%; protein: 5.34% ± 0.4%), making it a more energy-dense protein source. Conversely, M. vollenhovenii had higher ash (5.38% ± 0.002%) and moisture (22.12% ± 0.004%), with higher calcium (256.24 mg/g ± 0.74) and potassium (71.02 mg/g ± 0.76) content, key for bone health and cardiovascular function. F. notialis was richer in iron (5.18 mg/g ± 0.03), useful for preventing iron deficiency. Both species had substantial zinc levels (~ 0.8 mg/g), essential for immune health. T-tests confirmed significant differences in nutritional parameters and minerals. The findings highlight the benefits of including both species in diets for improved nutritional diversity, especially in regions with limited food options.

Graphical Abstract
Feasibility and acceptability of a web-intervention to prevent alcohol and cannabis-impaired driving among adolescents in driver education
Authors: Nameth Katherine , Ueland Elizabeth , D’Amico Elizabeth J. , Osilla Karen Chan
Published: November 2024

Background

Adolescents increasingly view cannabis as a substance with limited harm. Their propensity to engage in risky driving, combined with their relative driving inexperience, places adolescents at heightened risk for harm resulting from impaired driving. Driver education provides an opportunity to help prevent and reduce these risks, yet few interventions address cannabis-impaired driving, especially impairment from simultaneous use of both cannabis and alcohol.

Methods

We adapted a single-session primary care brief intervention (CHAT) for driver education programs. First, we conducted two focus groups with adolescents aged 15–17 years (n = 6; n = 5) enrolled in driver education programs in Michigan and Colorado. Their feedback was integrated into a prototype of an online intervention called webCHAT that focuses on preventing alcohol and cannabis-impaired driving. Next, we recruited a new sample of adolescents who user tested webCHAT (n = 8) and provided qualitative and survey feedback. We analyzed qualitative data using classic content analysis and grouped themes according to the feasibility and acceptability of webCHAT.

Results

Participants suggested that webCHAT should have adolescent narrators in short, informal, and interactive videos. In satisfaction surveys (n = 8), 88% of participants would recommend webCHAT to a friend and 88% reported that they learned helpful skills regarding impaired driving. General acceptability was also reflected in interviews (n = 6; 100% would recommend the intervention to a friend, 100% indicated overall positive impressions, and 67% stated it was easy to use). Participants reported that it was helpful to learn about the negative effects of both cannabis and alcohol on driving behavior, voicing that webCHAT would help adolescents make more informed decisions.

Conclusions

Soliciting adolescent perspectives is critical when developing interventions targeting cannabis use because of increasingly permissive attitudes and perceptions of minimal risk associated with use. The current study highlights how feedback can help increase both the feasibility and acceptability of interventions.
Analysis of public perceptions on the use of artificial intelligence in genomic medicine
Authors: Harrison Jack E. , Lynch Fiona , Stark Zornitza , Vears Danya F.
Published: November 2024

Purpose

Next generation sequencing has led to the creation of large pools of genomic data with analysis rather than data generation now the limiting factor. Artificial intelligence (AI) may be required to optimize the benefits of these data, but little is known about how the public feels about the use of AI in genomics.

Methods

We conducted focus groups with members of the Australian public. Participants were recruited via social media advertisements. We explored potential uses of AI in genomic medicine, the benefits, risks, and the possible social implications of its use.

Results

Participants (n = 34) largely felt comfortable with AI analysing their own genomic data and generally agreed about its benefits. Concerns were raised over data security, the potential for misdiagnosis, and bias AI may perpetuate. Many participants wanted checking mechanisms for when results were generated using AI.

Conclusions

The insights gained from these discussions help to understand public concerns around the use of AI in genomic medicine. Our findings can help to inform both policies around genomic AI and how to educate the public on its use.

Graphical abstract
Relationships between emotional labor, job burnout, and emotional intelligence: an analysis combining meta-analysis and structural equation modeling
Authors: Chen Yin-Che , Huang Zhi-Ling , Chu Hui-Chuang
Published: November 2024

The present study adopted a meta-analysis design that incorporated structural equation modeling to explore the relationships between emotional labor (EL), job burnout (JB), and emotional intelligence (EI), and enable model validation. The results revealed that EL and JB were significantly and positively correlated, that EI was significantly and positively correlated with EL, and that EI was significantly and negatively correlated with JB. The SEM parameter estimation values were all positive, reaching the level of significance and meeting the basic fit criteria. The total effect size of EL on JB was 0.289, which was equal to the sum of the direct and indirect effect sizes (0.371–0.082). This result indicated that EL affected JB through EI, validating the presence of a moderating effect. Finally, the results were discussed, and practical suggestions were proposed.
Mycological evaluation of the visible deterioration symptoms on the Spectatius family marble tomb (Slovenia)
Authors: Kosel Janez , Tomšič Nejc , Mlakar Mojca , Žbona Nina , Ropret Polonca
Published: November 2024

Our objective, as part of the planned conservation work, was to identify culturable fungi related to the formation of various deterioration symptoms occurring on the Spectatius family marble tomb, the largest monument of the Roman Necropolis in Šempeter, Slovenia. By using fluorescent microscopy, microbial cultivation methods and standard DNA sequencing we were able to identify 21 fungal isolates, 16 being filamentous moulds, primarily dominated by xerophilic Cladosporium spp. (mainly Cladosporium langeronii RN 28) and some Alternaria species; and 5 yeast or yeast like species namely Torula fici, Filobasidium wieringae, Rhodotorula babjevae and Blastobotrys peoriensis. Locations on the tomb, which are well sheltered against rainfall, contained higher concentrations of xerophilic fungi to those, which are completely or partially exposed to rain. The black fungal species of Cladosporium spp. and Alternaria spp. formed the bulk of melanized-greyish patina present on the bottom reliefs and within the cracks of the inner dome of the Spectacius tomb. Moreover, the red coloured yeast R. babjevae caused a thick red pigmentation right under the top roof of the monument’s left side. The obtained results indicated that not only moulds but also yeasts can cause significant biodeterioration. Lastly we isolated indigenous mycoparasitic strains of F. wieringae (RN 37 and RN 38) that could potentially be used in biocontrol formulations applicable in situ for the sustainable preservation of the Spectatius family tomb monument.
Clinical significance of visual cardiac 18F-FDG uptake in advanced non-small cell lung cancer
Authors: Hashimoto Kosuke , Kaira Kyoichi , Imai Hisao , Yamaguchi Ou , Mouri Atsuto , Shiono Ayako , Miura Yu , Kobayashi Kunihiko , Kagamu Hiroshi , Kuji Ichiei
Published: November 2024

Background

Two-deoxy-2-[fluorine-18]-fluoro-d-glucose (18F-FDG) positron emission tomography (PET) is useful for detecting malignant lesions; however, the clinical significance of cardiac 18F-FDG uptake in patients with cancer remains unclear. This preliminary study explored the relationship between cardiac 18F-FDG uptake and advanced diseases such as cancer cachexia in non-small cell lung cancer (NSCLC).

Methods

Forty-three patients with advanced NSCLC who underwent 18F-FDG PET and complained of weight loss before the first-line systemic therapy were retrospectively included in this study. Visual assessment using a 5-point scale based on 18F-FDG uptake was performed; a cut-off score of 3 was determined, a low score was 1, 2, or 3, and a high score was 4 or 5).

Results

High and low visual cardiac 18F-FDG uptakes were observed in 27 (62.8%) and 16 (37.2%) patients, respectively. Of the 43 patients, 17 (39.5%) definitely had cachexia, and 26 (60.5%) did not. A low visual score and standardized uptake valuemax for cardiac 18F-FDG uptake were significantly associated with high metabolic tumor activity (p = 0.009, and p = 0.009, respectively) and a high neutrophil-to-lymphocyte ratio (p = 0.016, and p = 0.047, respectively), whereas a low visual score for cardiac 18F-FDG uptake and high metabolic tumor activity were significantly associated with cachexia (p = 0.004). The amount of cardiac 18F-FDG accumulation depicted a close relationship with body mass index, low weight loss, and inflammation. The combination of cachexia and low visual cardiac 18F-FDG uptake was identified as a significant predictor for poor overall survival (OS) (p = 0.034).

Conclusion

Decreased visual cardiac 18F-FDG uptake was associated with poor nutritional status and OS, and cachexia in patients with advanced NSCLC.
Selenium alters the gene content but not the taxonomic composition of the soil microbiome
Authors: Bennett Alison E. , Kelsey Scott , Saup Casey , Wilkins Mike , Malacrinò Antonino
Published: November 2024

Background

Microbiomes, essential to ecosystem processes, face strong selective forces that can drive rapid evolutionary adaptation. However, our understanding of evolutionary processes within natural systems remains limited. We investigated evolution in response to naturally occurring selenium in soils of different geological parental materials on the Western Slope of Colorado. Our study focused on examining changes in gene frequencies within microbial communities in response to selenium exposure.

Results

Despite expectations of taxonomic composition shifts and increased gene content changes at high-selenium sites, we found no significant alterations in microbial diversity or community composition. Surprisingly, we observed a significant increase in differentially abundant genes within high-selenium sites.

Conclusions

These findings are suggestive that selection within microbiomes primarily drives the accumulation of genes among existing microbial taxa, rather than microbial species turnover, in response to strong stressors like selenium. Our study highlights an unusual system that allows us to examine evolution in response to the same stressor annually in a non-model system, contributing to understanding microbiome evolution beyond model systems.
Controls of sedimentary-diagenetic evolution on rock-physics properties in the Precambrian-Lower Paleozoic ancient carbonate reservoirs
Authors: Wang Jiaqing , Deng Jixin , Xia Hui , Yan Longlong
Published: November 2024

The Precambrian-Lower Paleozoic ancient carbonate reservoirs are pivotal for onshore hydrocarbon exploration in China. Nevertheless, their intricate diagenetic history leads to apparent inter- and intrareservoir heterogeneity, strongly impacting the physical responses. Deciphering the rock-physical characteristics compatible with geologic processes is imperative for interpreting the geophysical responses of these reservoirs. To address this, rock-physical experiments under reservoir conditions are conducted for carbonate rocks formed in different sedimentary systems from a geologic perspective. The results illustrate that sedimentary-diagenetic evolution determines the material composition, dolomite genesis, and pore evolution, ultimately defining the two most critical parameters, the load-bearing frame and pore structure, and thereby controlling the physical properties of ancient carbonate rocks. Reservoir properties (porosity and permeability) are enhanced by strong hydrodynamic conditions that facilitate primary pore development, a penecontemporaneous dissolution leading to secondary dissolved pores, an early-stage dolomitization preserving preexisting pores, and the multistage tectonic movement forming microcracks (at the plug scale) with superior transport capacity. Concerning seismic properties, the slight decrease in P-wave velocity reflects the fact that dissolution shapes the pores into a larger but stiffer shape. The significant decrease in P-wave velocity could be attributed to two factors, including weaker crystal contact boundary types formed due to different provenances, strong evaporation and silicification, and microcracks developed in regions with intense tectonic activities. Furthermore, these crystal contact boundary and pore structure types can be effectively identified by the difference in the [Formula: see text]/[Formula: see text] ratio. This study enhances the understanding of rock physics in ancient carbonate reservoirs, which is relevant to the exploration of such reservoirs.
Coulomb impurities in graphene driven by fast ions
Authors: Rakhmanov Saparboy , Egger Reinhold , Jumanazarov Doniyor , Matrasulov Davron
Published: November 2024

We provide a theoretical model for electronic transitions in a two-dimensional (2D) artificial atom in a graphene monolayer. The artificial atom is due to the presence of a charged adatom (Coulomb impurity) in the layer and interacts with a fast ultrarelativistic ion moving parallel to the layer. We compute the probability and cross-sections for the corresponding electronic transitions by means of an exact solution of the time-dependent 2D Dirac equation describing the interaction of the planar atom with the electromagnetic field of the ultrarelativistic projectile.
Association Between Per- and Polyfluoroalkyl Substance Exposures and Thyroid Homeostasis Parameters
Authors: Yu Xinwen , Liu Yufei , Wang Meiying , Jia Peng , Yang Shuo , Sun Fei , Jin Yuxin , Wang Xin , Guo Zixin , Zhao Guohong , Gao Bin
Published: November 2024

Context

Prevailing studies have shown the disruption effect of per- and polyfluoroalkyl substances (PFAS) on thyroid homeostasis. However, most studies have focused on individual thyroid hormones.

Objective

To explore the associations between PFAS exposures and thyroid homeostasis parameters.

Methods

A total of 2386 adults from National Health and Nutrition Examination Survey (2007-2008 and 2011-2012) were included. Thyroid homeostasis parameters included central and peripheral thyroid hormone sensitivity, calculated by thyroid hormones. Multivariable survey-weighted linear regressions were performed to determine the association between PFAS exposure and thyroid homeostasis parameters. The weighted quantile sum (WQS) and the quantile g-computation (QGC) models were used to estimate the mixed effects of coexposures to PFAS.

Results

The ratio of free T3/free T4 (FT3/FT4) and the sum activity of peripheral deiodinases (SPINA-GD) were positively associated with perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid, perfluorononanoic acid, and perfluorohexane sulfonic acid, respectively. However, no significant associations were observed between PFAS exposure and central thyroid sensitivity parameters. PFAS coexposure was positively associated with FT3/FT4 (β = 0.013, P < .001) and SPINA-GD (β = 1.230, P < .001) in WQS models. Consistently, PFAS concentrations per quantile were linked to an increase in FT3/FT4 (β = 0.004, P = .002) and SPINA-GD (β = 0.392, P = .008) in QGC models, with PFOA having the highest weight in all models.

Conclusion

This study revealed that PFAS exposures may affect peripheral thyroid hormone sensitivity instead of central among US general adults, enhancing our understanding of the correlation between PFAS exposure and thyroid hormones and providing insights into potential health implications.
Clinical and Sonographic Differences Between RET Fusion-positive and BRAFV600E in Papillary Thyroid Carcinoma
Authors: Chen Zixian , Sun Wenyu , Fei Mengjia , Qian Kai , Shi Yuan , Guo Kai , Wang Zhuoying
Published: November 2024

Purpose

This study aimed to describe the ultrasound characteristics of papillary thyroid carcinoma (PTC) harboring RET gene fusion and explore its clinical significance.

Methods

A retrospective study was conducted on 209 patients with PTC diagnosed between August 2021 and January 2024. All patients underwent ultrasound examination and were confirmed to be positive for RET fusion or BRAFV600E by pathological results. The differences in clinical characteristics and ultrasonography features between the 2 groups were analyzed.

Results

Among all PTCs (n = 209), we detected 30 RET fusions and 179 BRAFV600E. RET-fusion PTCs showed younger age [38.5 (16.0-69.0) vs 42.9 (20.0-74.0) years, P < .05], larger tumor size [1.09 (0.5-4.0) vs 0.77 (0.1-4.0) cm, P < .005], and more advanced N stage (P < .001) than BRAFV600E PTCs. RET-fusion PTCs were mainly classical and diffuse sclerosing subtypes. In terms of ultrasound performance, RET-fusion PTCs were mainly manifested as heterogeneous echogenicity (43.3%), ill-defined tumor margin (90.0%), irregular shape (83.3%), and intranodular microcalcification (83.3%), characterized by scattered microcalcification around the tumor/within thyroid gland (40.0%). In comparison, BRAFV600E PTCs were mainly characterized by hypoechogenicity (95.5%), round/oval shape (80.4%), and intranodular noncalcification (54.2%). Multivariate logistic regression analysis revealed that scattered microcalcification around the tumor/within the normal gland was an independent risk factor for lateral lymph node metastasis (LLNM) in RET-fusion PTCs (odds ratio 9.79, 95% confidence interval 1.31-72.93, P = .026).

Conclusion

Patients diagnosed with PTC harboring RET fusion presented with distinctive clinical characteristics and sonographic patterns, underscoring the unique diagnostic value of ultrasound examination. It can provide a preoperative noninvasive primary screening method for RET-fusion diagnosis, thus facilitating targeted patients with purposeful molecular sequencing to improve treatment outcomes.
Increased Risk of Fracture Among Patients With Iron Overload: A Population-based Matched Cohort Study
Authors: Burden Andrea Michelle , Martinez-De la Torre Adrian , Burkard Theresa , Immoos Maria , Hofbauer Lorenz Christian , Steinbicker Andrea Ulrike , Rauner Martina
Published: November 2024

Introduction

Iron overloading disorders are associated with decreased bone mineral density. However, evidence on fracture risk is scarce. Therefore, we evaluated the risk of fracture associated with iron overload disorders compared to matched controls.

Methods

Using The Healthcare Improvement Network, a Cegedim database of UK general practice data, we identified patients >18 years with elevated iron (ferritin value >1000 µg/L) or an eligible diagnosis code for iron overloading disorders between 2010 and 2022. The first date of elevated iron or a diagnosis code defined the index date for iron overload patients, who were matched with up to 10 controls. Time-varying confounder-adjusted Cox proportional hazard models estimated the hazard ratios (HRs) and 95% confidence intervals. Analyses were stratified by osteoporotic fracture site (hip, vertebral, humerus, forearm) and evidence of elevated serum ferritin at baseline (ferritin >1000 µg/L), and sex.

Results

We identified 20 264 eligible patients and 192 956 controls. Overall, there was a 55% increased risk of any fracture among iron overload patients (HR 1.55 [1.42-1.68]). Fracture risk was increased at all sites, with the highest risk observed for vertebral fractures (HR 1.97 [1.63-2.10]). Patients with ferritin >1000 µg/L had a 91% increased risk of any fracture (HR 1.91 [1.73-2.16]) and a 2.5-fold increased risk of vertebral fractures (HR 2.51 [2.01-3.12]). There was no increased risk among patients without elevated serum ferritin at any site. Fracture risk was similar between sexes.

Discussion

This large population-based cohort study found a 55% increased risk of fracture associated with iron overload. The risk was highest among patients with laboratory-confirmed iron overload, highlighting the importance for clinicians to consider initiating osteoporosis therapy in patients with serum ferritin >1000 µg/L to minimize fracture risk.
Glycemic Control and Adult Height: A Nationwide Swedish Cohort Study on Childhood Type 1 Diabetes
Authors: Smew Awad I , Lundholm Cecilia , Gong Tong , Lichtenstein Paul , Sävendahl Lars , Almqvist Catarina
Published: November 2024

Context

Normal growth throughout childhood and adolescence is considered an indicator of adequate glycaemic control in patients with type 1 diabetes. While it has been suggested that growth in type 1 diabetes is reduced, the literature is conflicting and differences in final adult height and the risk of short stature depending on glycaemic control remain largely unexplored.

Objective

This work aims to assess adult height outcomes across levels of glycemic control in children and adolescents with type 1 diabetes, as well as to investigate the effect of sex, age at disease onset, and timing of glycemic control in relation to puberty.

Methods

In this population-based Swedish cohort study, we collected data on glycemic control and height from specialist health-care visits of all individuals with childhood-onset type 1 diabetes in the National Diabetes Register. Using linear and logistic regression, we compared suboptimal (glycated hemoglobin A1c [HbA1c] 53-75 mmol/mol [7.0-9.0%]) and poor (HbA1c > 75 mmol/mol [>9.0%]) to optimal (HbA1c < 53 mmol/mol [<7.0%]) glycemic control in relation to final adult height and the risk of short stature.

Results

Poor glycemic control was associated with lower final adult height (−2.91 cm [95% CI, –3.48 to −2.33] for males, −1.83 cm [−2.42 to −1.23] for females) as well as a higher risk of short stature in males (odds ratio 1.90 [1.07-3.35]) but not in females (0.73 [0.36-1.51]). For females, adult height was lower only among those with type 1 diabetes since before puberty and if the poor glycemic control occurred before puberty. For males, adult height was lower irrespective of their age at diabetes onset, but only if they had poor glycemic control during or after puberty.

Conclusion

Poor glycemic control after the onset of type 1 diabetes, compared to optimal control, is associated with lower adult height in males and females. The prepubertal period seems to be more critical for females than males.
Comparison of Efficacy of Romosozumab With Denosumab and Risedronate in Patients Newly Initiating Glucocorticoid Therapy
Authors: Kawazoe Mai , Kaneko Kaichi , Masuoka Shotaro , Yamada Soichi , Yamada Zento , Muraoka Sei , Furukawa Karin , Sato Hiroshi , Watanabe Eri , Koshiba Keiko , Irita Izumi , Kanaji Miwa , Sugihara Takahiko , Nishio Junko , Nanki Toshihiro
Published: November 2024

Context

Wnt/β-catenin signaling pathway is one of the pathogenic mechanisms of glucocorticoid-induced osteoporosis (GIOP). We previously reported the potential of inhibiting sclerostin as a treatment for GIOP.

Objective

To compare the efficacy of romosozumab (ROMO), a monoclonal antibody against sclerostin, with existing therapy for GIOP.

Methods

Patients with rheumatic diseases who had not previously received treatment for osteoporosis and were newly treated with prednisolone 15 mg/day or more were randomly assigned to receive ROMO, denosumab (DMAb), or bisphosphonates (BP). After the initiation of glucocorticoid therapy, we measured the bone mineral density (BMD) of the lumbar spine, femoral neck, and total hip every 6 months and bone turnover markers every 3 months for 12 months.

Results

Eleven patients were assigned to the ROMO group, 14 to the DMAb group, and 14 to the BP group. The median [25th to 75th percentile] percent change in lumbar spine BMD from baseline at 12 months was the greatest in the ROMO group (ROMO: 8.6 [3.1-12.4]%, DMAb: 3.3 [1.5-6.2]%, BP: −0.4 [−3.4-1.1]%). Among bone formation markers, serum levels of bone alkaline phosphatase were slightly elevated in the ROMO group, whereas those of N-terminal propeptide of type I procollagen and osteocalcin decreased in all 3 groups; however, these changes were smaller in the ROMO group. Serum levels of bone resorption markers and a urine bone quality marker decreased in all groups.

Conclusion

Treatment with ROMO significantly increased lumbar spine BMD in glucocorticoid-treated patients, suggesting that ROMO is effective for GIOP.

Clinical trial number

UMIN000037239
Comparison of Phenylephrine Bolus and Infusion Regimens on Maternal and Fetal Outcomes During Cesarean Delivery: A Systematic Review and Meta-Analysis
Authors: Garg Heena , Narayanan M R. Vishnu , Khanna Puneet , Yalla Bharat
Published: November 2024

BACKGROUND:

A systematic review and meta-analysis was conducted to compare phenylephrine boluses versus prophylactic infusion in parturients undergoing cesarean delivery under spinal or combined spinal-epidural anesthesia on feto-maternal outcomes.

METHODS:

Medline, Embase, Cochrane, and US Clinical registry databases were searched. Studies comparing phenylephrine boluses (both therapeutic and prophylactic) with infusion (both fixed- and variable-rate) assessing various feto-maternal outcomes were included. The primary outcome was the incidence of maternal hypotension. Secondary maternal outcomes included the incidence of reactive hypertension, bradycardia, nausea, or vomiting; secondary neonatal outcomes included umbilical arterial pH, partial pressure of oxygen (paO2), umbilical venous pH, fetal acidosis, Apgar Scores at 1 and 5 minutes. All outcomes were quantitatively analyzed using the random effects model. Risk of bias was assessed using the Cochrane Collaboration R0B 2.0 tool.

RESULTS:

We included 15 studies with 2153 parturients. The parturients receiving phenylephrine bolus during cesarean delivery under spinal or combined spinal-epidural anesthesia had a significant increase in the incidence of predelivery hypotension compared to phenylephrine infusion (risk ratio [RR], 2.34, 95% confidence interval [CI], 1.72–3.18). Reactive hypertension (RR, 0.48, 95% CI, 0.29–0.79) and bradycardia (RR, 0.57, 95% CI, 0.41–0.79) were less common in the parturients receiving phenylephrine bolus; whereas, vomiting (RR, 2.15, 95% CI, 1.53–3.03) was more common compared to the infusion group. No statistically significant difference was observed in the incidence of nausea or any fetal outcomes (umbilical artery pH, paO2, umbilical venous pH, fetal acidosis, and Apgar scores at 1 and 5 minutes) between either of the groups. Three studies had a high risk of bias.

CONCLUSIONS:

A prophylactic phenylephrine infusion significantly reduces the incidence of predelivery hypotension in parturients undergoing cesarean delivery under neuraxial anesthesia in comparison to the therapeutic or prophylactic phenylephrine bolus group. A prophylactic phenylephrine infusion may be considered in all parturients without preexisting hypertensive disorder or cardiovascular disorders to reduce the risk of predelivery hypotension. More evidence is needed to guide optimal hemodynamic management for patients with hypertensive or cardiovascular disorders.
Clinical Evaluation of the NaviNetics Stereotactic System Using Intraoperative Portable Surgical Imaging System in DBS Surgery
Authors: Shin Jee Won , Scheitler Kristen M. , Sharaf Basel , Mandybur Ian , Hussein Sara , Klassen Bryan T. , Gregg Nick , Grewal Sanjeet S. , Miller Kai J. , Shin Hojin , Chang Jin-Woo , Oh Yoonbae , Vansickle David , Lee Kendall H.
Published: November 2024

BACKGROUND AND OBJECTIVES:

A typical workflow for deep brain stimulation (DBS) surgery consists of head frame placement, followed by stereotactic computed tomography (CT) or MRI before surgical implantation of the hardware. At some institutions, this workflow is prolonged when the imaging scanner is located far away from the operating room, thereby increasing workflow times by the addition of transport times. Recently, the intraoperative O-arm has been shown to provide accurate image fusion with preoperative CT or MR imaging, suggesting the possibility of obtaining an intraoperative localization scan and postoperative confirmation. In this article, we aim to evaluate the compatibility of the stereotactic frame system with the intraoperative O-arm system regarding lead accuracy and surgical flow.

METHODS:

A total of 17 patients undergoing DBS surgery for movement disorders were evaluated. One patient underwent both the stereotactic CT and O-arm localization, while 16 patients underwent only intraoperative O-arm localization. Following lead placement, intraoperative O-arm imaging was obtained to evaluate the accuracy of the lead placement. Accuracy was defined as the error measured as the distance from the center of the planned trajectory to the cannula.

RESULTS:

Less than 0.1 mm difference was found between the O-arm imaging technique and CT image localization of the NaviNetics stereotactic head frame in DBS surgery. Of the 16 patients who underwent the intraoperative O-arm imaging alone, the targets included bilateral ventral intermediate nucleus (16 leads), bilateral globus pallidus internus (4 leads), and subthalamic nucleus (12 leads). The mean ± SD radial error in the probe's eye view was 0.71 ± 0.33 mm for n = 32 leads. No tract hemorrhage was observed.

CONCLUSION:

Intraoperative O-arm imaging can be used safely and effectively for stereotactic registration and lead placement confirmation with the stereotactic system in both awake and asleep DBS surgery.
Early autonomous patterning of the anteroposterior axis in gastruloids
Authors: Anlaş Kerim , Gritti Nicola , Nakaki Fumio , Salamó Palau Laura , Tlili Sham Leilah , Oriola David , Arató Krisztina , Le Lim Jia , Sharpe James , Trivedi Vikas
Published: November 2024

Minimal in vitro systems composed of embryonic stem cells (ESCs) have been shown to recapitulate the establishment of the anteroposterior (AP) axis. In contrast to the native embryo, ESC aggregates – such as gastruloids – can break symmetry, which is demarcated by polarization of the mesodermal marker T, autonomously without any localized external cues. However, associated earliest patterning events, such as the spatial restriction of cell fates and concomitant transcriptional changes, remain poorly understood. Here, we dissect the dynamics of AP axis establishment in mouse gastruloids, particularly before external Wnt stimulation. Through single-cell RNA sequencing, we identify key cell state transitions and the molecular signatures of T+ and T− populations underpinning AP polarization. We also show that this process is robust to modifications of aggregate size. Finally, transcriptomic comparison with the mouse embryo indicates that gastruloids develop similar mesendodermal cell types, despite initial differences in their primed pluripotent populations, which adopt a more mesenchymal state in lieu of an epiblast-like transcriptome. Hence, our findings suggest the possibility of alternate ESC states in vivo and in vitro that can converge onto similar cell fates.
Distinct fingerprints of tRNA-derived small non-coding RNA in animal models of neurodegeneration
Authors: Baindoor Sharada , Gibriel Hesham A. Y. , Venø Morten T. , Su Junyi , Morrissey Elena Perez , Jirström Elisabeth , Woods Ina , Kenny Aidan , Alves Mariana , Halang Luise , Fabbrizio Paola , Bilen Maria , Engel Tobias , Hogg Marion C. , Bendotti Caterina , Nardo Giovanni , Slack Ruth S. , Kjems Jørgen , Prehn Jochen H. M.
Published: November 2024

Transfer RNA-derived small RNAs (tsRNAs) – categorized as tRNA-derived fragments (tRFs), tRNA-derived stress-induced RNAs (tiRNAs) and internal tRF (itRF) – are small non-coding RNAs that participate in various cellular processes such as translation inhibition and responses to cellular stress. We here identified tsRNA profiles within susceptible tissues in animal models of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD) and Parkinson's disease (PD) to pinpoint disease-specific tsRNAs and those shared across neurodegenerative diseases. We performed small RNA sequencing in the SOD1G93A and TDP43A315T mouse models of ALS (spinal cord), the TauP301S model of FTD (hippocampus), and the parkin/POLG model of PD (substantia nigra). Bioinformatic analysis showed higher expression of 5′ tiRNAs selectively in the two ALS models, lower expression of 3′ tRFs in both the ALS and FTD mouse models, and lower expression of itRF Arg in the PD model. Experimental validation confirmed the expression of tsRNAs. Gene Ontology analysis of targets associated with validated 3′ tRFs indicated functions in the regulation of synaptic and neuronal pathways. Our profiling of tsRNAs indicates disease-specific fingerprints in animal models of neurodegeneration, which require validation in human disease.