bluuebunny/crossref_metadata_2025 huggingface dataset:
Interleukin 1β receptor blocker (Anakinra) and regenerative stem cell therapy: two novel approaches effectively ameliorating diabetic cardiomyopathy
Authors: Mahmoud Lamiaa Mohamed , Mageed Aya Aly Ashraf Abdel , Saadallah Jackline Moawad , Youssef Mira Farouk , Rashed Liala Ahmed , Ammar Hania Ibrahim
Published: May 2024

Diabetic cardiomyopathy (DCM) is a serious common complication of diabetes. Unfortunately, there is no satisfied treatment for those patients and more studies are in critical need to cure them. Therefore, we aimed to carry out our current research to explore the role of two novel therapeutic approaches: one a biological drug aimed to block inflammatory signaling of the IL 1beta (IL1β) axis, namely, anakinra; the other is provision of anti-inflammatory regenerative stem cells. Wistar male rats were allocated into four groups: control group: type 2 diabetes mellitus (DM) induced by 6-week high-fat diet (HFD) followed by a single-dose streptozotocin (STZ) 35 mg/kg i.p., then rats were allocated into: DM: untreated; DM BM-MSCs: received a single dose of BM-MSCs (1 × 106 cell/rat) into rat tail vein; DM-Anak received Anak 0.5 μg/kg/day i.p. for 2 weeks. Both therapeutic approaches improved cardiac performance, fibrosis, and hypertrophy. In addition, blood glucose and insulin resistance decreased, while the antioxidant parameter, nuclear factor erythroid 2–related factor 2 (Nrf2) and interleukin 10 (IL10), and anti-inflammatory agent increased. Furthermore, there is a significant reduction in tumor necrosis factor alpha (TNFα), IL1β, caspase1, macrophage marker CD 11b, inducible nitric oxide synthase (iNOS), and T-cell marker CD 8. Both Anak and BM-MSCs effectively ameliorated inflammatory markers and cardiac performance as compared to non-treated diabetics. Improvement is mostly due to anti-inflammatory, antioxidant, anti-apoptotic properties, and regulation of TNFα/IL1β/caspase1 and Nrf2/IL10 pathways.
Thermotolerant acetic acid bacteria in the production of a red wine vinegar by surface culture at different temperatures: volatile and polyphenolic composition
Authors: Chanivet Marina , Es-sbata Ikram , Astola Antonio , Durán-Guerrero Enrique , Castro Remedios
Published: May 2024

This work aims to determine the effect on the aromatic profile and phenolic content of red wine vinegars produced by surface culture at two different temperatures (30 °C and 37 °C) and using different inocula of acetic acid bacteria (Acetobacter malorum, Gluconobacter oxydans and a mixture of bacteria isolated from a Sherry vinegar). Fifty-seven volatile compounds and 23 polyphenolic and furfural compounds were identified. Vinegars obtained at 37 °C had poorer volatile profiles, with no significant influence of the strain of acetic bacteria. For polyphenolic content, temperature was also the most significant variable, so that the vinegars produced at higher temperatures had lower total anthocyanin contents, while no clear trend was observed regarding the influence of temperature on the low-molecular-weight phenolic constituents. The total tannin content in the vinegars obtained experienced slight increases after acetification, although this was not affected by temperature, and it was observed that when using the mixture of acetic acid bacteria from the Sherry vinegar, the total tannin content was significantly higher than when individual bacteria cultures of Acetobacter malorum or Gluconobacter oxydans were used. Temperature appears as a key parameter for the volatile and phenolic composition of red wine vinegar versus the use of different acetic acid bacteria.
Asymptotic behavior of the overlap gap between infinite words
Authors: Costa J. C. , Nogueira C. , Teixeira M. L.
Published: May 2024

We proceed with the study of ultimate periodicity properties related to overlaps between the suffixes of a left-infinite word $$\lambda $$
λ
and the prefixes of a right-infinite word $$\rho $$
ρ
. For a positive integer n, let g(n) be n minus the maximum length of overlaps between the suffix of $$\lambda $$
λ
and the prefix of $$\rho $$
ρ
of length n. In a recent publication we have shown that the function g has finite image if and only if $$\lambda $$
λ
and $$\rho $$
ρ
are ultimately periodic words with a same root. In this paper we give an asymptotic characterization of words $$\lambda $$
λ
and $$\rho $$
ρ
for which the function g has finite image. We prove that this condition is true if and only if the sequence $$\big (g(n)/n\big )_n$$

(

g

(
n
)

/
n

)

n

tends to zero
NP, OP and Derivatives in Freshwater Sediment Downstream of Textile Associated Municipal Wastewater Discharges
Authors: Lalonde Benoit , Garron Christine
Published: May 2024

Alkylphenol ethoxylates comprise of many anthropogenic chemicals such as nonylphenol (NP), octylphenol (OP) and nonylphenol ethoxylates (NPEOs). The objectives of this study were to assess the frequency and magnitude of detections of 4-NP, OP and NPEOs in Canadian sediment downstream of textile associated municipal wastewater treatment plants (MWWTPs) to determine if regulatory actions have had a beneficial impact on the receiving environment. Surficial sediments were obtained in four locations in the province of Québec (Canada) and were analyzed for nonylphenol, nonylphenol monoethoxylates (NP1EO), nonylphenol diethoxylates (NP2EO) and octylphenol from 2015 to 2018. Individual concentrations of the compounds varied from non detect to 419 ng/g. Of the four compounds analyzed, NP was detected the most frequently with a 75% detection rate while OPs were not detected in any of the samples. Since the Canadian regulatory actions have drastically reduced NP/NPEOs usage in textile mill factories and manufactured products, the potential source of these compounds in sediment for this study could stem from the outfall from the MWWTPs but not related to textile mills as well as from the usage of these compounds as formulants in pesticide products. Lastly, there were no exceedances to the Canadian Sediment Quality guideline toxic equivalency approach (TEQ) of 1400 ng/g or the 1310 ng/g guideline for NP in freshwater sediment from the European Scientific Committee on Health, Environmental and Emerging Risks. We hypothesize that the significant concentrations of these compounds in sediment may be a relevant and continuous source of 4NP in surface waters due to resuspension of sediment in the water column.
Shear wave elastography and dispersion imaging for hepatic veno-occlusive disease prediction after pediatric hematopoietic stem cell transplantation: a feasibility study
Authors: Lee Seul Bi , Lee Seunghyun , Cho Yeon Jin , Choi Young Hun , Cheon Jung-Eun , Hong Kyung Taek , Choi Jung Yun , Kang Hyoung Jin
Published: May 2024

Background

Non-invasive imaging modalities are warranted for diagnosing and monitoring veno-occlusive disease because early diagnosis and treatment improve the prognosis.

Objective

To evaluate the usefulness of liver shear wave elastography (SWE) and shear wave dispersion (SWD) imaging in diagnosing and monitoring veno-occlusive disease in pediatric patients.

Materials and methods

We conducted a prospective cohort study at a single tertiary hospital from March 2021 to April 2022. The study protocol included four ultrasound (US) sessions: a baseline US and three follow-up US after hematopoietic stem cell transplantation. Clinical criteria, including the European Society for Blood and Marrow Transplantation criteria, were used to diagnose veno-occlusive disease. We compared clinical factors and US parameters between the veno-occlusive disease and non-veno-occlusive disease groups. The diagnostic performance of US parameters for veno-occlusive disease was assessed by plotting receiver operating characteristic (ROC) curves. We describe temporal changes in US parameters before and after veno-occlusive disease diagnosis.

Results

Among the 38 participants (mean age 10.7 years), eight developed veno-occlusive disease occurring 17.0 ± 5.2 days after hematopoietic stem cell transplantation. Liver stiffness, as measured by SWE (15.0 ± 6.2 kPa vs. 5.8 ± 1.8 kPa; P<0.001), and viscosity, as assessed with SWD (17.7 ± 3.1 m/s/kHz vs. 14.3 ± 2.8 m/s/kHz; P=0.015), were significantly higher in the veno-occlusive disease group compared to the non-veno-occlusive disease group at the time of diagnosis. Liver stiffness demonstrated the highest area under the ROC (AUROC) curves at 0.960, with an optimal predictive value of >6.5 kPa, resulting in sensitivity and specificity of 100% and 83.3%, respectively. Viscosity demonstrated an AUROC of 0.783, with an optimal cutoff value of 13.9 m/s/kHz for predicting veno-occlusive disease, with a sensitivity of 100% and specificity of 53.3%, respectively. Liver stiffness increased with disease severity and decreased during post-treatment follow-up.

Conclusion

SWE may be a promising technique for early diagnosis and severity prediction of veno-occlusive disease. Furthermore, liver viscosity assessed by SWD may serve as an additional marker of veno-occlusive disease.

Graphical abstract
Gut Microbial Composition of Cyprinella lutrensis (Red Shiner) and Notropis stramineus (Sand Shiner): Insights from Wild Fish Populations
Authors: Starr Krista , Montesanto Federica , Perisho Esther , Aluthge Nirosh , Pegg Mark , Fernando Samodha C.
Published: May 2024

The gut microbiome is a highly intricate ecosystem that exerts a pivotal influence on the host’s physiology. Characterizing fish microbiomes is critical to understanding fish physiology and health, but little is known about the ecology and colonization dynamics of microorganisms inhabiting fish species. In this study, we investigated the bacterial communities of two small-bodied fish species, Cyprinella lutrensis (red shiner) and Notropis stramineus (sand shiner), two fish species where gut microbiomes have not been investigated previously and surrounding waters, collected from rivers in Nebraska, USA. Our study focused on evaluating microbial diversity in small-bodied fish and identifying autochthonous microbes present within these species irrespective of location to better understand bacterial community composition and possible roles of such bacterial species. Our results revealed that both red shiner and sand shiner exhibited gut bacterial communities dominated by typical bacterial phyla found in freshwater fish. The phylum Bacteroidota was minimally abundant in both species and significantly lower in relative abundance compared to the surrounding water microbial community. Furthermore, we found that the gut microbiomes of red shiner and sand shiner differed from the microbial community in the surrounding water, suggesting that these fish species contain host-associated bacterial species that may provide benefits to the host such as nutrient digestion and colonization resistance of environmental pathogens. The fish gut bacterial communities were sensitive to environmental conditions such as turbidity, dissolved oxygen, temperature, and total nitrogen. Our findings also show bacterial community differences between fish species; although they shared notable similarities in bacterial taxa at phyla level composition, ASV level analysis of bacterial taxa displayed compositional differences. These findings contribute to a better understanding of the gut bacterial composition of wild, freshwater, small-bodied fish and highlight the influence of intrinsic (host) and environmental factors on shaping the bacterial composition.
Turn Your Vision into Reality—AI-Powered Pre-operative Outcome Simulation in Rhinoplasty Surgery
Authors: Knoedler Samuel , Alfertshofer Michael , Simon Siddharth , Panayi Adriana C. , Saadoun Rakan , Palackic Alen , Falkner Florian , Hundeshagen Gabriel , Kauke-Navarro Martin , Vollbach Felix H. , Bigdeli Amir K. , Knoedler Leonard
Published: May 2024

Background

The increasing demand and changing trends in rhinoplasty surgery emphasize the need for effective doctor–patient communication, for which Artificial Intelligence (AI) could be a valuable tool in managing patient expectations during pre-operative consultations.

Objective

To develop an AI-based model to simulate realistic postoperative rhinoplasty outcomes.

Methods

We trained a Generative Adversarial Network (GAN) using 3,030 rhinoplasty patients’ pre- and postoperative images. One-hundred-one study participants were presented with 30 pre-rhinoplasty patient photographs followed by an image set consisting of the real postoperative versus the GAN-generated image and asked to identify the GAN-generated image.

Results

The study sample (48 males, 53 females, mean age of 31.6 ± 9.0 years) correctly identified the GAN-generated images with an accuracy of 52.5 ± 14.3%. Male study participants were more likely to identify the AI-generated images compared with female study participants (55.4% versus 49.6%; p = 0.042).

Conclusion

We presented a GAN-based simulator for rhinoplasty outcomes which used pre-operative patient images to predict accurate representations that were not perceived as different from real postoperative outcomes.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Longitudinal effects of affective distress on disease outcomes in rheumatoid arthritis: a meta-analysis and systematic review
Authors: Sweeney Melissa , Adas Maryam A. , Cope Andrew , Norton Sam
Published: May 2024

Patients with rheumatoid arthritis have higher rates of mental health conditions compared to the general population. It is believed that affective distress and rheumatoid arthritis have a bi-directional relationship. This review will examine the associations between affective distress and rheumatoid arthritis outcomes over time. Several disease outcomes are included covering disease activity, function, and disability to provide a broad picture of the various ways patients are impacted. A quality assessment was also conducted. There were 71 studies included in the review. Three measures (disease activity, disability, and mortality) had enough data to complete meta-analyses of odds ratios or hazard ratios. The outcomes included were disease activity, tender joint count, swollen joints, pain, physician global assessment, patient global assessment, physical disability, acute phase reactants, stiffness, fatigue, work disability, and mortality. Numerous measures were included for most of the outcomes due to the variability across studies of measures used. Patients with affective distress had lower rates of remission according to the DAS-28, greater disability, and higher mortality. All of the outcomes covered had studies with mixed results, but swollen joint count, tender joint count, patient global assessment, and physician global assessment had the strongest evidence that they were associated with mental health longitudinally. The relationships between affective distress and disease outcomes are complex and vary depending on the measures. Overall, the effects fade over time. It is important for clinicians to be aware of the differing manifestations of the relationship between affective distress and rheumatoid arthritis outcomes.
Gene identification, expression analysis, and molecular docking of SAT and OASTL in the metabolic pathway of selenium in Cardamine hupingshanensis
Authors: Chen Yushan , Li Yao , Luo Guoqiang , Luo Cihang , Xiao Zhijing , Lu Yanke , Xiang Zhixin , Hou Zhi , Xiao Qiang , Zhou Yifeng , Tang Qiaoyu
Published: May 2024

Key message

Identification of selenium stress-responsive expression and molecular docking of serine acetyltransferase (SAT) and O-acetyl serine (thiol) lyase (OASTL) in Cardamine hupingshanensis.

A complex coupled with serine acetyltransferase (SAT) and O-acetyl serine (thiol) lyase (OASTL) is the key enzyme that catalyzes selenocysteine (Sec) synthesis in plants. The functions of SAT and OASTL genes were identified in some plants, but it is still unclear whether SAT and OASTL are involved in the selenium metabolic pathway in Cardamine hupingshanensis. In this study, genome-wide identification and comparative analysis of ChSATs and ChOASTLs were performed. The eight ChSAT genes were divided into three branches, and the thirteen ChOASTL genes were divided into four branches by phylogenetic analysis and sequence alignment, indicating the evolutionary conservation of the gene structure and its association with other plant species. qRT-PCR analysis showed that the ChSAT and ChOASTL genes were differentially expressed in different tissues under various selenium levels, suggesting their important roles in Sec synthesis. The ChSAT1;2 and ChOASTLA1;2 were silenced by the VIGS system to investigate their involvement in selenium metabolites in C. hupingshanensis. The findings contribute to understanding the gene functions of ChSATs and ChOASTLs in the selenium stress and provide a reference for further exploration of the selenium metabolic pathway in plants.
Pre-operative lung ablation prediction using deep learning
Authors: Keshavamurthy Krishna Nand , Eickhoff Carsten , Ziv Etay
Published: May 2024

Objective

Microwave lung ablation (MWA) is a minimally invasive and inexpensive alternative cancer treatment for patients who are not candidates for surgery/radiotherapy. However, a major challenge for MWA is its relatively high tumor recurrence rates, due to incomplete treatment as a result of inaccurate planning. We introduce a patient-specific, deep-learning model to accurately predict post-treatment ablation zones to aid planning and enable effective treatments.

Materials and methods

Our IRB-approved retrospective study consisted of ablations with a single applicator/burn/vendor between 01/2015 and 01/2019. The input data included pre-procedure computerized tomography (CT), ablation power/time, and applicator position. The ground truth ablation zone was segmented from follow-up CT post-treatment. Novel deformable image registration optimized for ablation scans and an applicator-centric co-ordinate system for data analysis were applied. Our prediction model was based on the U-net architecture. The registrations were evaluated using target registration error (TRE) and predictions using Bland-Altman plots, Dice co-efficient, precision, and recall, compared against the applicator vendor’s estimates.

Results

The data included 113 unique ablations from 72 patients (median age 57, interquartile range (IQR) (49–67); 41 women). We obtained a TRE ≤ 2 mm on 52 ablations. Our prediction had no bias from ground truth ablation volumes (p = 0.169) unlike the vendor’s estimate (p < 0.001) and had smaller limits of agreement (p < 0.001). An 11% improvement was achieved in the Dice score. The ability to account for patient-specific in-vivo anatomical effects due to vessels, chest wall, heart, lung boundaries, and fissures was shown.

Conclusions

We demonstrated a patient-specific deep-learning model to predict the ablation treatment effect prior to the procedure, with the potential for improved planning, achieving complete treatments, and reduce tumor recurrence.

Clinical relevance statement

Our method addresses the current lack of reliable tools to estimate ablation extents, required for ensuring successful ablation treatments. The potential clinical implications include improved treatment planning, ensuring complete treatments, and reducing tumor recurrence.
Dual-Energy CT muscle fat fraction as a new imaging biomarker of body composition and survival predictor in critically ill patients
Authors: Erley Jennifer , Roedl Kevin , Ozga Ann-Kathrin , de Heer Geraldine , Schubert Niklas , Breckow Julia , Burdelski Christoph , Tahir Enver , Kluge Stefan , Huber Tobias B. , Yamamura Jin , Adam Gerhard , Molwitz Isabel
Published: May 2024

Objective

To analyze changes in the muscular fat fraction (FF) during immobilization at the intensive care unit (ICU) using dual-energy CT (DECT) and evaluate the predictive value of the DECT FF as a new imaging biomarker for morbidity and survival.

Methods

Immobilized ICU patients (n = 81, 43.2% female, 60.3 ± 12.7 years) were included, who received two dual-source DECT scans (CT1, CT2) within a minimum interval of 10 days between 11/2019 and 09/2022. The DECT FF was quantified for the posterior paraspinal muscle by two radiologists using material decomposition. The skeletal muscle index (SMI), muscle radiodensity attenuation (MRA), subcutaneous-/ visceral adipose tissue area (SAT, VAT), and waist circumference (WC) were assessed. Reasons for ICU admission, clinical scoring systems, therapeutic regimes, and in-hospital mortality were noted. Linear mixed models, Cox regression, and intraclass correlation coefficients were employed.

Results

Between CT1 and CT2 (median 21 days), the DECT FF increased (from 20.9% ± 12.0 to 27.0% ± 12.0, p = 0.001). The SMI decreased (35.7 cm2/m2 ± 8.8 to 31.1 cm2/m2 ± 7.6, p < 0.001) as did the MRA (29 HU ±  10 to 26 HU ± 11, p = 0.009). WC, SAT, and VAT did not change. In-hospital mortality was 61.5%. In multivariable analyses, only the change in DECT FF was associated with in-hospital mortality (hazard ratio (HR) 9.20 [1.78–47.71], p = 0.008), renal replacement therapy (HR 48.67 [9.18–258.09], p < 0.001), and tracheotomy at ICU (HR 37.22 [5.66–245.02], p < 0.001). Inter-observer reproducibility of DECT FF measurements was excellent (CT1: 0.98 [0.97; 0.99], CT2: 0.99 [0.96–0.99]).

Conclusion

The DECT FF appears to be suitable for detecting increasing myosteatosis. It seems to have predictive value as a new imaging biomarker for ICU patients.

Clinical relevance statement

The dual-energy CT muscular fat fraction appears to be a robust imaging biomarker to detect and monitor myosteatosis. It has potential for prognosticating, risk stratifying, and thereby guiding therapeutic nutritional regimes and physiotherapy in critically ill patients.

Key Points

The dual-energy CT muscular fat fraction detects increasing myosteatosis caused by immobilization.

Change in dual-energy CT muscular fat fraction was a predictor of  in-hospital morbidity and mortality.

Dual-energy CT muscular fat fraction had a predictive value superior to established CT body composition parameters.
Standalone deep learning versus experts for diagnosis lung cancer on chest computed tomography: a systematic review
Authors: Wang Ting-Wei , Hong Jia-Sheng , Chiu Hwa-Yen , Chao Heng-Sheng , Chen Yuh-Min , Wu Yu-Te
Published: May 2024

Purpose

To compare the diagnostic performance of standalone deep learning (DL) algorithms and human experts in lung cancer detection on chest computed tomography (CT) scans.

Materials and methods

This study searched for studies on PubMed, Embase, and Web of Science from their inception until November 2023. We focused on adult lung cancer patients and compared the efficacy of DL algorithms and expert radiologists in disease diagnosis on CT scans. Quality assessment was performed using QUADAS-2, QUADAS-C, and CLAIM. Bivariate random-effects and subgroup analyses were performed for tasks (malignancy classification vs invasiveness classification), imaging modalities (CT vs low-dose CT [LDCT] vs high-resolution CT), study region, software used, and publication year.

Results

We included 20 studies on various aspects of lung cancer diagnosis on CT scans. Quantitatively, DL algorithms exhibited superior sensitivity (82%) and specificity (75%) compared to human experts (sensitivity 81%, specificity 69%). However, the difference in specificity was statistically significant, whereas the difference in sensitivity was not statistically significant. The DL algorithms’ performance varied across different imaging modalities and tasks, demonstrating the need for tailored optimization of DL algorithms. Notably, DL algorithms matched experts in sensitivity on standard CT, surpassing them in specificity, but showed higher sensitivity with lower specificity on LDCT scans.

Conclusion

DL algorithms demonstrated improved accuracy over human readers in malignancy and invasiveness classification on CT scans. However, their performance varies by imaging modality, underlining the importance of continued research to fully assess DL algorithms’ diagnostic effectiveness in lung cancer.

Clinical relevance statement

DL algorithms have the potential to refine lung cancer diagnosis on CT, matching human sensitivity and surpassing in specificity. These findings call for further DL optimization across imaging modalities, aiming to advance clinical diagnostics and patient outcomes.

Key Points

Lung cancer diagnosis by CT is challenging and can be improved with AI integration.

DL shows higher accuracy in lung cancer detection on CT than human experts.

Enhanced DL accuracy could lead to improved lung cancer diagnosis and outcomes.
Contribution of motile rubble-dwelling cryptofauna to the diet of invertivorous coral reef fishes
Authors: Kamen Zebilon F. , Mumby Peter J. , Wolfe Kennedy
Published: May 2024

One of the least understood trophic pathways on coral reefs is the linkage between highly productive cryptic motile invertebrates (herein: cryptofauna) and the predatory vertebrates that underpin reef fisheries. As cryptofauna are difficult to observe and quantify, particularly in coral rubble where they proliferate, the diets of invertivores that forage in rubble have largely been determined through relative gut content analyses. Without congruent quantification of prey diversity, biomass, and rates of predation specific to rubble, it remains challenging to develop models of productivity and energy transfer. We calculated bite rates of six wrasses (Labridae) and a goatfish (Mullidae) commonly found foraging in rubble, using in situ videography on a coral reef in Palau, Western Micronesia. Consumption rates (i.e. individuals consumed) and prey preferences were determined using tank-based feeding experiments, where individual fish were presented with a diverse rubble community characterised before and after 2 h feeding trials. The motile cryptofauna community and invertivore diet consisted predominantly of Arthropoda (83% and > 58%, respectively), with calanoid copepods and mysids positively selected and harpacticoids, decapods and ostracods negatively selected. The interspecific mean (± standard error) rate of consumption was 3.5 ± 0.2 ind. min−1 from rubble, estimated to equal 9.5 ± 0.9 mg min−1 of invertebrate biomass consumed per fish, with biased uptake of small fauna. Bite and consumption rates varied among species with the greatest efficiency in biomass uptake evident in Halichoeres melanurus. This study provides a first attempt at characterising diverse cryptofauna communities pre- and post-trial to identify feeding rates and preferences of coral reef invertivores from the rubble benthos, and highlights the importance of addressing the bioavailability of lower trophic entities in energy pathways.
Staged urethroplasty with groin full-thickness skin graft for managing complex anterior urethral strictures: surgical outcomes and predictive factors
Authors: Cho Min Chul , Lee Jooho , Kim Soo Woong
Published: May 2024

Purpose

To describe outcomes of staged-urethroplasty in complex anterior urethral strictures using full-thickness-skin-graft (FTSG) harvested from the hairless groin area, and to identify factors influencing successful outcomes.

Methods

Through retrospective chart review, we identified a total of 67 men who underwent the first-stage operation (grafting) using groin-FTSG for staged-urethroplasty to treat complex anterior urethral strictures unsuitable for one-stage urethroplasty. Among these, 59 underwent the second-stage operation (tubularization) at a median duration of 5.1-months after grafting. Patients were assessed for outcomes as scheduled after tubularization outcomes were analyzed only for 48 patients for whom ≥ 1-year follow-up data after tubularization were available. Their mean follow-up duration was 27.1 months. Success was defined as achieving physiologic voiding without requiring further procedures.

Results

Median stricture-length was 5.5 cm in all 67 patients. After grafting, neourethral-opening-narrowing occurred in 18. Partial graft-loss occurred in 8, of whom only 3 underwent re-grafting. The percentage of patients who achieved successful outcomes was 81.3%. Improvements in maximum-urine-flow-rate and post-void-residual-urine-volume were maintained until the last follow-up visit. A urethrocutaneous-fistula occurred in one patient, while meatal-stenosis occurred in two. On multivariate-regression-analysis, the presence of neourethral-opening-narrowing was the only predictor of non-success after tubularization. Furthermore, the presence of hypertension, longer stricture-length, and a history of prior direct-vision-internal-urethrotomy were predictors of the occurrence of neourethral-opening-narrowing.

Conclusion

Staged-urethroplasty using groin-FTSG is well worth considering as a useful therapeutic option for complex anterior urethral strictures, with an acceptable success rate and low morbidity. The absence of neourethral-opening-narrowing after the first-stage operation leads to success.
Ophthalmologische Forschung in Deutschland: Evaluation durch ein internationales Expertengremium
Authors: Ader Marius , Cursiefen Claus , Fauser Sascha , Gliem Martin , Helbig Horst , Lagrèze Wolf , Marshall John , Roesky Christian , Sahel José-Alain , Schlötzer-Schrehard Ursula , Sieving Paul , Ueffing Marius
Published: May 2024

Ziel

Die Forschungsleistung in der Augenheilkunde in Deutschland auf der Grundlage der Ergebnisse der aktuellen DOG-Analyse (Forschungslandkarte der Deutschen Ophthalmologischen Gesellschaft [DOG]) zu bewerten und der DOG sowie der Politik Strategien für zukünftige Verbesserungen auf nationaler Ebene vorzuschlagen. Der Fokus liegt dabei auf der präklinischen und translationalen, klinischen Forschung.

Methoden

Internationale Expertenpanelauswertung und Diskussion, organisiert von dem Arbeitskreis Forschung der Deutschen Ophthalmologischen Gesellschaft (DOG).

Ergebnisse

Die deutsche Forschungslandschaft in der Ophthalmologie ist international gut anerkannt. Das Preis-Leistungs-Verhältnis wurde als sehr gut bewertet. Da Deutschland mit einer alternden Gesellschaft konfrontiert ist und Sehbehinderungen eine immer größere sozioökonomische Belastung darstellen werden, schlugen die Gutachter mehrere Ziele für zukünftige Aktivitäten vor: eine verstärkte Aktivität zur Sicherung des geistigen Eigentums, mehr Lobbyarbeit mit Patientenvertretern, eine intensivere nationale Zusammenarbeit und der Aufbau einer kritischen Masse zwischen den „Leuchttürmen“ der ophthalmologischen Forschung in Deutschland sowie die Einrichtung eines „Deutschen National Eye Institutes“.

Schlussfolgerung

Die ophthalmologische Forschungsleistung in Deutschland wurde von einem internationalen Expertengremium als sehr gut bewertet. Dennoch wurden deutliche Verbesserungen in den Bereichen Translation (klinische Studien, IP), Synergie zwischen spezialisierten Einrichtungen und die staatliche Förderung eines deutschen Zentrums für Gesundheitsforschung zum Thema Augenheilkunde gefordert.
Atypical atrial flutter ablation: follow-up and predictors of arrhythmia recurrence
Authors: Michał Peller , Bartosz Krzowski , Kacper Rutkowski , Michał Marchel , Cezary Maciejewski , Karolina Mitrzak , Grzegorz Opolski , Marcin Grabowski , Paweł Balsam , Piotr Lodziński
Published: May 2024

Background: Ablation techniques have evolved greatly with advances in high-density 3D mapping systems over the last few years. Some patients develop atypical atrial flutter (AAFL) after pulmonary vein isolation (PVI). The data regarding follow-up after AAFL ablation as well as predictors of arrhythmia recurrence are lacking. This analysis aims to report procedure success rates and establish predictors of long-term success. Methods and Results: This retrospective cohort study included 45 patients (median age: 69 years; 40% female) who qualified for their first AAFL after PVI. The procedures were performed with the use of conventional ablation-index-guided ThermoCool Smarttouch SF and QDOT MICRO catheters. Freedom from arrhythmia recurrence was used as a primary end point. After 52 weeks of follow-up, 60% of patients suffered from arrhythmia recurrence, but over 70% of the studied cohort reported symptom improvement. In multivariate analysis, class I antiarrhythmics prescription (HR = 0.24 [95% CI 0.06–0.94], p = 0.04) was associated with the lack of arrhythmia recurrence during the follow-up, while cardioversion during procedure was associated with increased risk of arrhythmia recurrence (HR = 7.05 [95% CI 2.09–23.72], p = 0.002). Conclusions: Long-term success of AAFL ablation procedures is not satisfactory despite improvement in symptoms. Class I antiarrhythmics prescription at the discharge contributes to higher chances of sinus rhythm maintenance, whereas cardioversion during the procedure is related to increased risk of arrhythmia recurrence.
Evaluation of foreign national cases applied to Tokat Gaziosmanpasa University Hospital Forensic Medicine Department, 2014–2022
Authors: Çetin Selçuk , Gedikbaş Mete , Gedikbaş Şule Sinem
Published: May 2024

Introduction/aim

Turkey has experienced a heavy migration burden in recent years due to its location and benevolent policies. This study aimed to retrospectively examine and discuss the reports prepared for foreign nationals who requested assistance at the Forensic Medicine Department of Tokat Gaziosmanpaşa University Hospital in Tokat, which is located in the Middle Black Sea Region of Turkey, between 2014 and 2022.

Materials and methods

This study retrospectively evaluated reports prepared between 2014 and 2022 in the outpatient clinics of Forensic Medicine at Tokat Gaziosmanpaşa University Hospital.

Results

Based on the files reviewed, 219 cases were included in the study, of which 70.8% (n = 155) were male and 29.2% (n = 64) were female. Among the 75 cases referred by judicial authorities, 34.6% (n = 26) involved assault, 28% (n = 21) involved determination of the ability to understand the legal significance and consequences of the act, 16% (n = 12) involved traffic accidents, 8% (n = 6) involved poisoning, 9.3% (n = 7) involved abuse, and 4% (n = 3) involved age determinations.

Discussion

Problems with immigrants, which have always been a reality due to Turkey’s location on migration routes, have increased significantly in recent years. For this reason, we believe that studies with multicenter and larger series should be conducted to determine the current situation that foreigners create for themselves and Turkey to facilitate necessary arrangements, determine proposed solutions, increase the quality of services offered, and develop plans for the future.
A novel subtype based on driver methylation–transcription in lung adenocarcinoma
Authors: Wang Xin , Xu Zhenyi , Zhao Shuang , Song Jiali , Yu Yipei , Yang Han , Hou Yan
Published: May 2024

Aims

To identify driver methylation genes and a novel subtype of lung adenocarcinoma (LUAD) by multi-omics and elucidate its molecular features and clinical significance.

Methods

We collected LUAD patients from public databases, and identified driver methylation genes (DMGs) by MethSig and MethylMix algrothms. And novel driver methylation multi-omics subtypes were identified by similarity network fusion (SNF). Furthermore, the prognosis, tumor microenvironment (TME), molecular features and therapy efficiency among subtypes were comprehensively evaluated.

Results

147 overlapped driver methylation were identified and validated. By integrating the mRNA expression and methylation of DMGs using SNF, four distinct patterns, termed as S1-S4, were characterized by differences in prognosis, biological features, and TME. The S2 subtype showed unfavorable prognosis. By comparing the characteristics of the DMGs subtypes with the traditional subtypes, S3 was concentrated in proximal-inflammatory (PI) subtype, and S4 was consisted of terminal respiratory unit (TRU) subtype and PI subtype. By analyzing TME and epithelial mesenchymal transition (EMT) features, increased immune infiltration and higher expression of immune checkpoint genes were found in S3 and S4. While S4 showed higher EMT score and expression of EMT associated genes, indicating S4 may not be as immunosensitive as the S3. Additionally, S3 had lower TIDE and higher IPS score, indicating its increased sensitivity to immunotherapy.

Conclusion

The driver methylation-related subtypes of LUAD demonstrate prognostic predictive ability that could help inform treatment response and provide complementary information to the existing subtypes.
Serum cytokines and creatinine/cystatin C ratio as prognostic biomarkers in advanced cancer patients treated with anti-PD-1/PD-L1 therapy
Authors: Jin Shan-xiu , Liu Bo-Na , Ji Hong-juan , Wu Jing-ran , Li Bao-lei , Gao Xiao-li , Li Na , Zheng Zhen-dong , Du Cheng
Published: May 2024

Objective

Immune checkpoint inhibitors (ICIs), specifically targeting the programmed cell death protein-1 or its ligand (PD-1/PD-L1), have been extensively used in the treatment of a spectrum of malignancies, although the predictive biomarkers remain to be elucidated. This study aims to investigate the association between baseline circulating levels of cytokines and the creatinine/cystatin C ratio (CCR) with the treatment outcomes of ICIs in patients with advanced cancer.

Methods

The pre-treatment circulating levels of 10 cytokines (PD-L1, CTLA4, CXCL10, LAG3, HGF, CCL2, MIG, GRANB, IL-18, and IL-6) were measured via automated capillary-based immunoassay platform in the serum of 65 advanced cancer patients treated with anti-PD-1/PD-L1-based systemic therapy and 10 healthy volunteers. The levels of cytokines and CCR were quantified and categorized into high and low groups based on the median value. The associations of serum cytokines and CCR with response to treatment, survival, and immune-related adverse events were assessed.

Results

Elevated circulating levels of 6 cytokines (PD-L1, CXCL10, HGF, CCL2, MIG, and IL-6) were observed in cancer patients compared with that in healthy volunteers. The correlation coefficients between cytokines, CCR and nutritional risk index were also calculated. In the cancer cohort (N = 65), low circulating HGF (P = 0.023, P = 0.029), low IL-6 (P = 0.002, P < 0.001), and high CCR (P = 0.031, P = 0.008) were associated with significantly improved progression-free survival (PFS) and overall survival (OS). Multi-variable COX analyses adjusted for clinicopathological factors revealed that low HGF, low IL-6, and high CCR were independent favorable prognostic factors for PFS (P = 0.028, P = 0.010, and P = 0.015, respectively) and OS (P = 0.043, P = 0.003, and P = 0.026, respectively). Grade 2 irAEs occurred more frequently in patients with low levels of circulating CCL2 and LAG3.

Conclusions

Pre-treatment circulating levels of serum IL-6, HGF, and CCR may serve as independent predictive and prognostic biomarkers in advanced cancer patients treated with ICIs-based systemic therapy. These findings might help to identify potential patients who would benefit from these therapies.
Cognition in children with arachnoid cysts – A five-year follow-up after microneurosurgical fenestration
Authors: Adolfsson Tomas , Edström Erik , Tedroff Kristina , Sandvik Ulrika
Published: May 2024

Background and Purpose

In recent years there has been a re-evaluation regarding the clinical implications of temporal lobe arachnoid cysts (temporal arachnoid cysts) in children. These cysts have often been considered asymptomatic, or if symptomatic, only causing focal neurological symptoms or signs of increased intracranial pressure. However, several studies have more recently reported on cognitive symptoms improving after surgery. This study aimed to evaluate if reported cognitive improvement after surgery of temporal arachnoid cysts were stable after five years.

Method

Ten consecutive children (m = 14.65; range 12.1–19.415 were assessed cognitively five years after micro-neurosurgical fenestration of a temporal arachnoid cyst. Results were compared to results from their pre- and post-surgical evaluations. Evaluations included the Wechsler-scales, Boston Naming Test (BNT), Rey Auditory Verbal Learning Test (RAVLT), verbal fluency test (FAS) and Rey Complex Figure Test (RCFT).

Results

The analysis revealed significant postsurgical improvement compared to baseline on the Wechsler-scales measures of general intelligence (FSIQ), verbal abilities (VCI) and processing speed (PSI). Mean differences after surgery were 8.3 for FSIQ, (p = 0.026), 8.5 for VI (p =  < .01) and 9.9 for PSI (p = 0.03). There were no significant differences in mean test results when comparing postsurgical scores with scores five years after surgery, indicating long-term stability of improvements.

Conclusion

The results indicate that affected cognitive functions in children with temporal arachnoid cysts improve after surgery and that the improvements remain stable five years later. The improvements and long term stability were also consistent with the experience of both parents and children. The findings provide a strong argument for neurosurgical fenestration of temporal arachnoid cysts in children.
Dynamics of serum levels of TNF-α in a longitudinal follow-up study in 98 patients with juvenile idiopathic arthritis treated with anti-TNF-α biological drugs
Authors: Morozova N. , Avramovič M. Zajc , Markelj G. , Toplak N. , Avčin T.
Published: May 2024

Objective

To determine the dynamics of serum levels of TNF-α in patients with juvenile idiopathic arthritis (JIA) treated with anti-TNF-α biological drugs and investigate their association with the disease activity.

Methods

We conducted a single-centre, observational cohort study in 98 patients with JIA (30 boys, 68 girls, mean age 11.3 years) treated with anti-TNF-α biological drugs. Clinical examinations and laboratory assessments of serum levels of TNF-α were performed before starting therapy with biological drug and at 6-month intervals afterwards up to 2.5 years.

Results

The analysis of serum levels of TNF-α in relation to the disease activity states showed the highest mean serum levels of TNF-α in patients on etanercept who had low disease activity states and in patients on adalimumab who had inactive disease. The correlation analysis in patients with JIA treated with etanercept or adalimumab showed a weak negative correlation between the serum levels of TNF-α and JADAS10 scores (p = 0.007), (r =  − 0.177).

Conclusion

The assessment of serum levels of TNF-α in children with JIA during treatment with etanercept or adalimumab is not a reliable biomarker of disease activity or immunological remission. Longitudinal measurement of TNF-α has no added clinical value in patients with JIA treated with anti-TNF-α biological drugs.

Key Points• There is limited evidence regarding the effect of anti-TNF therapy on serum concentrations of TNF-α in patients with juvenile idiopathic arthritis• Our study showed an increase in the serum level of TNF-α after the initiation of therapy with either etanercept or adalimumab, which was more significant in patients with inactive or low disease activity• Serum TNF-α is most likely not biologically active during therapy with TNF-α inhibitors and therefore not a reliable biomarker of disease activity or immunological remission in patients with juvenile idiopathic arthritis
On the Timing of Marriage and Childbearing: Family Formation Pathways Among Immigrants in Switzerland
Authors: Lacroix Julie , Mikolai Júlia , Kulu Hill
Published: May 2024

This paper examines childbearing in and outside of marriage as a manifestation of the Second Demographic Transition among immigrant populations in Switzerland. Based on full-population register data, we simultaneously analyse fertility and partnership changes at different stages of the migration process. Results from a multistate event history model show that most of the differences in family formation patterns between migrant groups and natives are in the sequencing of marriage and first birth among childless unmarried women. Out of wedlock family trajectories prove to be a common experience for European migrants, but a sustainable family pathway only among natives, as well as among immigrants from France, and Sub-Saharan Africa. Among married women, it is the risk of a third birth that marks the differences between groups; first and second birth rates are relatively similar across migrant groups. Distinguishing between the transition patterns of newly arrived immigrants and settled immigrants (characterised by various residence durations) support the disruption hypothesis among EU migrants and the interrelated life events hypothesis among non-EU groups. Family size and the partnership context of fertility highlight which family regime prevails in different population subgroups and the role that immigrants play in the Second Demographic Transition and family transformation in Europe.
Analyzing the impact of fiscal conditions on private health expenditures in OECD countries: a quantile ARDL investigation
Authors: Silva Nuno , Tavares Aida Isabel , Koengkan Matheus , Fuinhas José Alberto
Published: May 2024

Organization for Economic Co-operation and Development (OECD) countries have embraced the aim of universal health coverage, as established in Sustainable Development Goal (SDG) 3.8. This goal guarantees access to quality healthcare services without financial hardship or poverty. Additionally, it requires correct and adequate financing sources. A country with weak protection for its population tends to spend less on healthcare and experiences a high share of out-of-pocket payments (OOPs), increasing the likelihood of people falling into poverty. This study aims to understand the relationship and causal effects between macroeconomic and public fiscal conditions and private health expenditure in OECD countries between 1995 and 2019. We retrieved OECD data for 26 OECD countries for the period 1995–2019. Panel AutoRegressive Distributed Lag (PARDL) and panel quantile AutoRegressive Distributed Lag (PQARDL) models were estimated to examine the relationship between private health expenditures and macroeconomic and public fiscal variables. Our results reveal a positive influence of government debt and economic freedom on private health expenditures. They also show a negative influence of the government budget balance, government health expenditures, and economic growth on private health expenditures. These results collectively suggest that public fiscal conditions will likely impact private health expenditures. The findings of this study raise concerns about the equity and financial protection objectives of universal health coverage in OECD countries.
Antimony Trisulfide with Graphene Oxide Coated Titania Nanotube Arrays as Anode Material for Lithium-ion Batteries
Authors: Anwar Tauseef , Manzoor Tareq , Hussain Naveed , Shah Syed Nasir , Perveen Shazia , Asif Sana Ullah , Nosheen Farhat , Khan Abdul Jabbar , Manzoor Habib Ullah
Published: May 2024

The performance of the Lithium Ion Batteries (LiBs) is significantly influenced with the synergetic chemical properties of two different materials in a composite form. The specific capacity of both titanium dioxide arrays (TNAs) and Antimony trisulfide (Sb2S3) bottleneck the performance of LiB due to the low conductivity after the implantation as anode material. Herein, a novel multifunctional composite composed of highly dispersed Sb2S3 on freestanding tubular TNAs host via chemical bath deposition method (CBD) for use as anode material in lithium-ion batteries (LIBs). The loading quantity of Sb2S3 with reduced graphene oxide (rGO) was regulated to achieve adjustable outcomes. The composite anode consisting of TNAs/ Sb2S3/G in lithium-ion batteries (LIBs) has a specific capacity that is three times greater than conventional anodes. Furthermore, this composite anode maintains stable cyclic performance even after undergoing 300 cycles. The initial coulombic efficiency of the composite electrode is 100%, whereas the bare TNAs had a coulombic efficiency of 45%. The cycle performance analysis demonstrated that the TNAs/ Sb2S3/G composite has superior specific capacity and efficiency, even under high current density conditions of 500 µA/cm2. The rate performance is greatly improved, indicating the efficacy of this innovative composite anode material for high-performance LIBs.