bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the Characteristics of Flash Drought and the Response Regularity of Photosynthesis to Flash Drought in Different Vegetation Ecosystems in the Middle and Lower Reaches of the Yangtze River Basin.
Authors: Zhan Yunjun , Ma Chuanqi , Yan Yan , Luo Yongsi , Wang Xueting , Wang Senrong , Rong Yuejing
Published: October 2024

In recent decades, flash drought events have frequently occurred in the humid regions of southern China. Due to the sudden onset and rapid intensification of these droughts, they often cause severe damage to vegetation photosynthesis. Our current understanding of the spatiotemporal evolution characteristics of flash droughts across different vegetation types remains limited. Moreover, insufficient consideration of the early stress of vegetation during flash droughts has constrained our understanding of the response regularity of vegetation photosynthesis to flash drought events. This study analyzes the spatial and temporal evolution characteristics of flash drought for different vegetation types in the middle and lower reaches of the Yangtze River Basin from 2000 to 2023. Using the flash drought event of 2013 as a case study, solar-induced chlorophyll fluorescence (SIF) and fluorescence yield (ΦF) were employed to further explore the Response Regularity of vegetation photosynthesis to flash drought. The results show that, over the past 24 years, the frequency of flash drought for different vegetation types in the middle and lower reaches of the Yangtze River Basin has decreased, but the total duration has increased, with forests experiencing a higher frequency of flash drought. Cropland photosynthesis is the most sensitive to flash drought, responding on the 10th day after the onset and reaching a negative anomaly by the 26th day. Forests and grasslands respond later, beginning on the 20th day and showing a negative anomaly by the 36th day. The findings of this study contribute to a deeper understanding of vegetation photosynthesis responses to flash drought and provide a reference for developing effective flash drought management strategies.
Mindfulness-integrated Cognitive Behavior Therapy reduces pain and psychological distress, and improves equanimity, hope and post-traumatic growth during breast cancer treatment
Authors: Arefian Mohsen , Asgari-Mobarake Karim
Published: October 2024

Background Chemotherapy is associated with many side effects, including pain and psychological discomforts, which affect patients' physical and psychological health.
Objectives. The objective of this study was to evaluate the effectiveness of a shortened version of Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) in managing pain and psychological distress (including depression, anxiety, and stress), improving equanimity, hope, and post-traumatic growth in patients with Stage I-III breast cancer undergoing chemotherapy.
Methods A total of 62 women were randomly assigned to either an intervention group (n=21) or a treatment-as-usual (TAU) control group (n=21), with 9 women lost to follow-up. All participants completed a battery of assessments for pain, emotional distress, hope, equanimity, and post-traumatic growth before and after the intervention, as well as at the 2-month follow-up. The intervention consisted of a short (4-week) version of the MiCBT program, which involved progressive muscle relaxation, mindfulness of breath, body scanning, and the mindfulness-based interoceptive exposure task (MIET) for pain.
Results The MiCBT program was conducted over four consecutive weeks with an emphasis on the mindfulness-based interoceptive exposure task (MIET) for pain. Compared with the TAU group, at post-treatment, the MiCBT group experienced larger and significant reductions in pain, psychological distress, depression, anxiety, and stress, and large improvements in equanimity and hope. These differences remained significant at 2-month follow-up.
Conclusion This study provides preliminary evidence that a four-week MiCBT intervention can improve the daily experiences of women with BC undergoing chemotherapy. Further research using larger samples and active control is needed to determine the generalizability of the results.
Trial registration This study was registered in the Iranian Clinical Trial Registry (registry ID: IRCT20220903055860N1, registration date: 2022-09-29).
Exploring the double-edged sword effect of unreasonable tasks on employee creativity from cognitive and behavioral perspectives: A moderated dual-chain mediation model
Authors: Li Fangfang , Dou Cunfang , Li Zhen , Liao Qianyi
Published: October 2024

Background
Over the past two years, the emergence of new quality productive forces has drawn significant academic interest in China, with employee creativity identified as its core driver. Previous research has confirmed the relationship between illegitimate tasks and employee creativity. However, the double-edged effect of unreasonable tasks on employee creativity remains unexplored. To bridge the gap, this research constructed a moderated dual-chain mediation model based on the perseverative cognition theory and the COR theory. The aim was to systematically examine the potential mechanisms and boundary conditions between unreasonable tasks and employee creativity.
Methods
Using the questionnaire method, a total of 353 participants took part in the four-phase survey.
Results
The findings indicated that unreasonable tasks enhanced employee creativity by prompting problem-solving pondering, and they also inhibited employee creativity by inducing affective rumination. Additionally, problem-solving pondering encouraged feedback-seeking behavior, whereas affective rumination led to feedback-avoiding behavior. These results supported the chain mediation effect of “unreasonable tasks → work-related rumination → feedback behavior → employee creativity.” Furthermore, the organizational climate for creativity strengthened the link between unreasonable tasks and problem-solving pondering, as well as reinforced the chain mediation of problem-solving pondering and feedback-seeking behavior. Conversely, the organizational climate for creativity weakened the connection between unreasonable tasks and affective rumination, as well as diminished the chain mediation of affective rumination and feedback-avoiding behavior.
Conclusion
The research suggests that unreasonable tasks have a double-edged effect on employee creativity. These findings provide advice and guidance for management practices.
Utility of Airway Fluoroscopy as a Diagnostic Test in Children with Stridor
Authors: Frank Samantha , Pion Tyler , Kavanagh Katherine , Lee Subin , Hughes Amy
Published: October 2024

Background
Stridor is a high-pitched airway sound that can be produced from static or dynamic lesions along the upper airway. Airway fluoroscopy (AF) has been utilized as a diagnostic test to evaluate pediatric stridor, but prior studies have shown limitations.
Objectives
We aim to assess the reliability of airway fluoroscopy as compared to direct laryngoscopy and bronchoscopy (DLB) in evaluating pediatric stridor, with stratification of airway subsite.
Materials and Methods
A retrospective chart review was performed. 184 patients were evaluated who had undergone both AF and DLB within one year of each other. Sensitivity and specificity were calculated at each airway subsite, including supraglottis, glottis, subglottis, trachea, and bronchi. Receiver operating characteristics (ROC) area under the curve (AUC) testing was performed at each subsite.
Results
Sensitivity and specificity were 12%/99%, 12%/98%, 44%/96%, and 39%/100% respectively for pathology at the level of the supraglottis, subglottis, trachea, and bronchi. ROC AUC was 0.558 (p < 0.05) for supraglottic pathology, 0.695 (p < 0.001) for tracheal pathology, and 0.676 (p < 0.001) for bronchial pathology.
Conclusion
Airway fluoroscopy has poor sensitivity, but excellent specificity as a diagnostic test. Based on low ROC AUC values, airway fluoroscopy may not be a reliable screening test for the majority of stridulous patients; however, given its high specificity, low cost, and low risk profile it may be useful as an adjunct test in higher anesthetic risk populations or in patients where there is specific concern for tracheal or bronchial pathology.
Comparison of the detection performance of [18F]FDG PET/CT with CT on bone metastases: randomized controlled clinical trial
Authors: Chang Yujie , Gu Yifeng , Ruan Shunyi , Xu Shengyu , Sun Jing , Jiang Zhiyuan , Yao Guangyu , Wang Zhiyu , Zhao Hui
Published: October 2024

Background
Bone biopsy is the gold standard for diagnosing bone metastases. However, there is no clinical consensus regarding the optimal imaging test for locating the puncture site.
Methods
We compared the performance of [18F]FDG PET/CT with CT in detecting bone metastases to achieve the highest biopsy efficiency. This registered prospective study enrolled 273 patients with bone lesions who were treated between January 2020 and March 2021. Patients were randomly assigned to undergo [18F]FDG PET/CT or CT to locate the puncture site before bone biopsy. The accuracy, sensitivity, specificity, second biopsy rate, diagnostic time and cost-effectiveness of the two imaging tests were compared.
Results
The accuracy and sensitivity of [18F]FDG PET/CT group in the diagnosis of bone metastases were significantly higher than CT group(97.08% vs. 90.44%, 98.76% vs. 92.22%, P<0.05). The second biopsy rate was significantly lower in the PET/CT group (2.19% vs. 5.15%; P < 0.05). The diagnostic time of PET/CT was 18.33 ± 2.08 days, which was significantly shorter than 21.28 ± 1.25 days in CT group ( P< 0.05). The cost of [18F] FDG PETCT is 11428.35 yuan, and the cost of CT is 13287.52 yuan; the incremental cost is 1859.17 yuan. SUVmax > 6.3 combined with ALP > 103 U/L showed a tendency for tumor metastases with an AUC of 0.901 (95%CI 0.839 to 0.946, P<0.001).
Conclusion
[18F]FDG PET/CT is more effective and less costly than CT in locating optimal bone biopsy site. Thus, [18F]FDG PET/CT should be considered the optimal imaging test for locating the optimal puncture site for bone biopsy.
Trial registration
The prospective study was registered on 20180410, and the registration number is ChiCTR1800015540.
Efficacy of Dupilumab in CRSwNP treatment: A systematic review and meta-analysis
Authors: Hashim Hashim Talib , Khan Nashmiya , Umar Muhammad , Al-Ghuraibawi Mohammedbaqer Ali , Zubaidi Mustafa Sabeeh Lafta , Basalilah Ashraf Fhed Mohammed , Al-Mukhtar Mahmoud Mussleh
Published: October 2024

Objective
to evaluate efficacy of dupilumab in the treatment of CRSwNP.
Background
Chronic rhinosinusitis with nasal polyps (CRSwNP) represents an inflammation of the nasal and sinus mucosa, it is not uncommon disease. Patient with CRSwNP is presented nasal obstruction, facial pain, recurrent sinus infections, and anosmia. Dupilumab is an inhibitor of interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling pathways.
Method
A systematic review was conducted, strictly following the PRISMA guidelines. Search went through many databases including PubMed, Cochrane Library, Consensus, and Google scholar. 60 studies were acquired from the search and only four study included in this systematic review. Risk of biases were evaluated with acceptable results.
Results
Four studies included in this systematic review, primary outcomes including Lund-Mackay CT total score, Loss-of-smell score, Smell test (UPSIT) score, SNOT-22 total score, Bilateral endoscopic nasal polyp score, and Nasal congestion or obstruction score have shown a non-significant difference between placebo and dupilumab groups. Dupilumab group is associated. With higher level of blood eosinophils when compared with placebo group.
Conclusion
Dupilumab has shown a beneficial use in treating CRSwNP, its works on inhibiting the signaling pathways of interleukin-4 (IL-4) and interleukin-13 (IL-13).
Ghrelin increases cis-platinum resistance and promotes aggressiveness of osteosarcoma by activating AKT and Wnt/β- catenin pathways
Authors: Cong Menglin , Li Shufeng , Fu Yu , Wang Ting , Wei Huizhen , Ma Xiaojie , Liu Fangming , Sheng XieHuang , Long Kehan , Hou Haocheng , Sun Xuecheng , Li Weiwei , Zhang Lei
Published: October 2024

Osteosarcoma (OS) is the most common primary bone malignancy because of its extra high tendency of metastasis. In-depth research is needed to uncover the pathogenesis of patients with OS cells. We collected 74 tissue samples from patients with OS cells and measured the expression levels of ghrelin by immunohistochemistry. Ghrelin was added into OS cell lines in CCK8 assays, JC-1 staining and Western blot analysis were performed to explore its effect on the aggressiveness of OS cells and drug resistance. To determine its function, ghrelin was overexpressed or knocked down in OS cells and then detect cell proliferation in the xenograft mouse model and orthotopic model. Western blot analysis was performed to explore ghrelin-regulated signal pathways. In this work, we identified the relation between the level of ghrelin expression and poor prognosis of OS patients. As well as promoting proliferation, migration, and invation, ghrelin promotes the survival of OS in vitro as well as in vivo, and reduces the apoptosis of OS cells. What’s more, ghrelin increases the resistance of cis-platinum by changing mitochondrial function and decreases the expression of MRP-1. Above all, these results demonstrated ghrelin exerts tumorigenic and metastatic effects and may be a potential therapeutic target.
Identification of Quasi-specific binding sites of Cro-, λ- and Gal- repressor proteins within Escherichia coli bacterial and Enterobacteria phage λ viral Genomes
Authors: Kumar Mahendra , Saw Satish , Chandra Navin , Gupta Kishore Kumar
Published: October 2024

Binding of Proteins with DNA molecules is one of the fundamental bases of life. A protein may have one or more natural binding site within its cognate genome. There may be some other sites within a genome which have slightly lower binding affinity for the protein than its binding affinity with the natural binding site. These sites are quasi-specific binding sites of the proteins. Very little is known about the presence and role of such quasi-specific binding sites within a genome. In the present work we have predicted large number of quasi-specific sites for Cro-Repressor & λ-repressor within foreign E. coli genome. For Gal-repressor we find only one such site within foreign Bacteriophage λ genome. While in case of the cognate genomes of the three repressor proteins we found very less number of quasi-specific binding sites for the three proteins. This indicates that quasi-specific sites may be behaving as close competitors for protein’s binding hence nature have evolved in such a way that a protein can have only very less number of quasi-specific sites within its cognate genome. Because large number of such quasi-specific sites of a protein within its cognate genome will increase the competition during target search by the protein and eventually cause interference in natural binding of the protein through slowing down the binding process of the protein to its natural sites. Whereas in case of a foreign genome a protein does not have its natural binding site within the genome hence it may have any number of quasi-specific binding sites within it.
Preclinical evaluation of CAR20(NAP)-T cells for B cell lymphoma
Authors: Ma Jing , Sarén Tina , Jin Chuan , Kim Hyeong Su , Pineda Paola Donaji Contreras , Bernard Marina , Amini Rose-Marie , Enblad Gunilla , Yu Di , Essand Magnus
Published: October 2024

CD19-targeted CAR-T cell therapy has shown striking results against B cell malignancies, which has led to the approval of four CD19CAR-T cell products in the USA and EU. However, in long-term follow up evaluations it has become evident that many patients relapse after CD19CAR-T cell treatment and then in many cases present with CD19-negative tumors. In that case renewed CAR-T cell therapy targeting CD20 could be an option for lymphoma patients. Our previous study showed that CAR-T cells armed with immunomodulatory neutrophil-activating protein (NAP) from Helicobacter pylori (termed CAR(NAP)-T) can trigger the endogenous T-cell mediated immune response and further eliminate “CAR-target-antigen-negative” tumor cells. Here, we report the development of CD20-targeted (targeting moiety from Rituximab) CAR-T cells (CAR20-T cells), as well as the NAP-armed CAR20(NAP)-T cells and their pre-clinical evaluations in a murine lymphoma model. CAR20-T cells displayed efficient and specific cytotoxic potential against multiple human B cell lymphoma cell lines in vitro. In addition, primary mantle cell lymphoma cells isolated from a patient who relapsed after Rituximab treatment were also killed by CAR20-T cells. CAR20(NAP)-T cell treated mice showed delayed tumor growth and prolonged survival and NAP did not induce any severe toxicity. Human blood from healthy volunteers was exposed to recombinant NAP protein in an ex vivo human whole blood loop assay, without resulting in excessive cytokine release of immune cell activation, indicating a safe profile as a therapeutic transgene. CAR20(NAP)-T cells are worth further investigation especially in patients relapsing with CD19-negative tumors after CD19CAR-T cell therapy.
People Living With HIV have a prolonged virus shedding duration even with anti-SARS-CoV-2 treatment：a retrospective cohort study in Wuhan, China
Authors: Du Qian , Xu Li , Chen Qianhui , Wu Songjie , Liu Jie , Tan Yuting , Song Shihui , Tan Miao , Guo Wei , Ke Hengning , Zou Shi , Liang Ke
Published: October 2024

Objective
This study aimed to investigate the clearance of SARS-CoV-2 in people living with HIV (PLWH) after receiving anti-SARS-CoV-2 treatment and the relevant factors.
Methods
A retrospective investigation was conducted based on clinical data of patients with anti-SARS-CoV-2 treatment between December 2022 and June 2023. The patients were categorized into PLWH and HIV-negative groups. Basic information, comorbidity, COVID-19 severity, white blood cell count, lymphocyte count, anti-SARS-CoV-2 medicine, steroid usage, and SARS-CoV-2 virus shedding duration were collected. The Kaplan-Meier curve was employed to compare virus shedding rates, and multivariate logistic regression and Cox regression analyses were utilized to identify factors influencing SARS-CoV-2 virus shedding duration.
Results
A total of 149 patients with COVID-19 (32 PLWH and 117 HIV-negative individuals) were enrolled in the study. The median estimated virus shedding duration for PLWH group and HIV-negative group are 21 days and 14 days, respectively (P < 0.001). The virus shedding rates at the 5th day were 15.63% and 60.68% (P < 0.001), and at the 28th day were 87.50% and 97.44% (P = 0.019) for PLWH and HIV-negative groups, respectively. Multivariate logistic regression analysis showed that HIV infection (OR = 0.026, 95% CI: 0.004–0.159) and lymphocyte count at admission (OR = 4.341, 95% CI: 1.536–12.265) were independent factors influencing virus shedding at 5th day (P < 0.05). Compared to the mild COVID-19 group, the moderate and severe groups had significant impacts on virus shedding at both the 5th and the 28th day (P < 0.05). Multivariate Cox regression analysis revealed that age (OR = 0.977, 95% CI: 0.963–0.991), HIV infection (OR = 0.351, 95% CI: 0.197–0.626), duration of anti-SARS-CoV-2 therapy initiation (OR = 0.827, 95% CI: 0.786–0.871), and lymphocyte count (OR = 1.999, 95% CI: 1.372–2.914) were independent factors influencing SARS-CoV-2 virus shedding duration at the 28th day (P < 0.05). Compared to the mild COVID-19 group, the moderate, severe, and critically ill groups had statistically significant impacts on nucleic acid conversion (P < 0.001).
Conclusion
PLWH with COVID-19 had a prolonged virus shedding duration even with anti-SARS-CoV-2 treatment, which could lead to more opportunities to accumulate multiple mutations and induce resistance to anti-SARS-CoV-2 medicines.
Clinical implications of early blood transfusion after kidney transplantation
Authors: Kang Minyu , Koh Hwa-Hee , Yim Seung Hyuk , Choi Mun Chae , Kim Hyun Jeong , Kim Hyung Woo , Yang Jaeseok , Kim Beom Seok , Huh Kyu Ha , Kim Myoug Soo , Lee Juhan
Published: October 2024

Background
Pre-transplantation red blood cell transfusion (RBCT) is a well-recognized cause of allosensitization. However, the effects of RBCT after kidney transplantation remain controversial. This study evaluates the impacts of RBCT within the first 30 days post-transplantation (early RBCT) with regard to long-term patient and graft outcomes.
Methods
We retrospectively analyzed 785 patients who underwent HLA- and ABO-compatible kidney transplantation between 2014 and 2020. Patients were categorized based on whether they received early RBCT.
Results
Overall, 18.9% of patients received early RBCT. On multivariable analysis, early RBCT was independently associated with increased risks of all-cause mortality (hazard ratio, 2.264; 95% CI, 1.186–4.324; P = 0.013) and death-censored graft loss (hazard ratio, 1.995; 95% CI, 1.045–3.810; P = 0.036). Cumulative incidence of antibody-mediated rejection was significantly higher in the early RBCT group (P = 0.024). In the sensitivity analysis, the early RBCT significantly increased the risk of patient mortality (P = 0.017), death-censored graft loss (P = 0.018) and antibody-mediated rejection (P = 0.05), regardless of the donor profile.
Conclusions
Early post-transplantation RBCT was associated with increased risks of all-cause mortality, graft loss, and antibody-mediated rejection, highlighting the need for reconsideration of transfusion practices following kidney transplantation.
Global burden of bacterial skin diseases from 1990 to 2045: An analysis based on Global Burden Disease data
Authors: Gu Jiaxu , Wang Jiaming , Li Yannan , Li Lianjie , Zou Yanfen , Guo Yang , Yu Bo
Published: October 2024

Background The global burden of bacterial skin diseases has not been well evaluated.Objective We aimed to describe the burden and trend of bacterial skin diseases, to explore potential associated factors, and to predict the burden up to 2045.Methods Data on incidence and disability-adjusted life years (DALYs) of bacterial skin diseases were obtained from Global Burden of Disease 2021. We used average annual percent change (AAPC) by Joinpoint Regression to quantify the temporal trends. We conducted decomposition analysis to understand the contribution of aging, epidemiological changes, and population growth. Bayesian Age-Period-Cohort model was used to predict burden up to 2045.Results Global incidence rate of bacterial skin diseases increased from 8,988.74 per 100,000 in 1990 to 10,823.88 per 100,000, with AAPC of 0.62% (0.61 ~ 0.63%). The highest incidence rate was in low Socio-demographic Index (SDI) region and population aged < 35. The DALY rate increased from 20.82 per 100,000 in 1990 to 25.45 per 100,000 in 2021, with AAPC of -0.11% (-0.34 ~ 0.13%). The highest increase of DALY was in high SDI region and population aged > 85. The major drivers of incident case rise were population growth, followed by epidemiological changes; the major drivers of DALY case rise were population growth, followed by aging. Increasing trends were seen in prediction of incidence rate, incident cases and DALY cases; decreasing trend of DALY rate prediction was seen.Conclusion The incidence of bacterial skin diseases increased and varied considerably. The targeted prevention and treatment are needed to reduce burden of bacterial skin disease.
Knowledge, attitude and practice among adult Lebanese patients with epilepsy and impact on seizure control: a cross sectional descriptive study
Authors: Kassem Nada , Houssein Soumaya , Fahs Iqbal , Lahoud Nathalie , Akel Marwan
Published: October 2024

Purpose: Epilepsy is the fourth most prevalent neurological disorder accounting for more than 50 million cases worldwide. Religious and sociocultural beliefs influence the nature of treatment and care received by epileptic patients. According to the World Health Organization (WHO), almost 94% of epileptic patients in developing nations are not taking the appropriate therapy to control their seizure leading to a higher incidence of lifelong active epilepsies in these regions. With no related data in Lebanon, this study sought to assess the knowledge, the attitude, and the practice towards epilepsy among adult Lebanese epileptic patients and the associated factors
Methods:This was a cross-sectional descriptive study approved by the ethical committee at the Lebanese international university. The sample was drawn randomly from community pharmacies based on stratified cluster sampling and the strata were the six districts of Lebanon. Sixty community pharmacies constituted the primary sampling units, and ten pharmacies were randomly selected from the districts using the Research Randomizer computer program. Patients aged eighteen years and above with at least two years of diagnosis with epilepsy, who came for normal medications or para-pharmaceuticals were enrolled in the study. The enrolled participants were directly interviewed by the clinical pharmacists after providing their oral informed consent. The data collection sheet was established based on validated and standardized questionnaires including The Epilepsy Patient Knowledge Profile (EPQK) and The Kilifi Epilepsy Beliefs and Attitudes tool (KEBAS). Data were analysed using the Statistical Package of the Social Sciences software (SPSS, version 21).
Results: A Total of 134 epileptic patients (53% females, 47% males) with a mean age of 36.53 ± 13.15 years were included in this study. Most respondents had attained a minimum of secondary school education (91.3%). The most-reported seizure type was generalized seizure (26%). Approximately 64% of the studied patients had good seizure control. Most of the patients had good knowledge (82%) and a positive attitude (98%) toward their disease with almost two-thirds having a good practice (63%) as well. There were no statistically significant associations between the level of knowledge, attitude, or practice with seizure control (p= 0.14, p=1 and p=0.25, respectively). However, a statistically significant association was identified between the knowledge and educational level (p<0.001), Knowledge and Occupation, and between Practice and the educational levels of patients (P=0.015).
Palliative care of proximal femur metastatic disease and osteolytic lesions: results following surgical and radiation treatment
Authors: Mehnert Elisabeth , Möller Fränze Sophie , Hofbauer Christine , Weidlich Anne , Winkler Doreen , Troost Esther G.C. , Jentsch Christina , Kamin Konrad , Mäder Marcel , Schaser Klaus-Dieter , Fritzsche Hagen
Published: October 2024

Background
Femoral bone metastases (FBM) or lesions (FBL) can lead to loss of mobility and independence due to skeletal-related events (SRE), e.g. pain, deformity and pathological fractures. Aim of this study was to analyze effects of radiotherapy and surgery, different surgical techniques and complications on disease-specific survival (DSS).
Methods
Patients who underwent palliative therapy for FBM or FBL between 2014–2020 were retrospectively analyzed. Chi-square test was used to detect intergroup differences. Survival was calculated using Kaplan-Meier method, Cox regression and compared using log-rank test. Complications were evaluated using Chi-Square test.
Results
145 patients were treated for proximal femoral BM/OBL or pathologic fractures (10 bilaterally). Three groups were classified: surgery only (S, n = 53), surgery with adjuvant radiation (S/RT, n = 58), and primary radiation only (RT, n = 44). Most common primary tumors were breast (n = 31), prostate (n = 27), and non-small cell lung cancer (n = 27). 47 patients underwent surgery for an impending, 61 for a manifest pathological fracture. There were no significant differences in DSS between the 3 groups (S = 29.8, S/RT = 32.2, RT = 27.1 months), with the S + RT group having the longest one-year survival. Local complications occurred in 25 of 145 patients after a mean interval of 9.9 months.
Conclusion
Due to the steadily increasing incidence and survival of patients with FBM/FBL, indication for prevention and treatment of painful and immobilizing SREs should be critically assessed. Surgical treatment should always be performed with maximum stability and, whenever possible, adjuvant RT.
IGF2 confers genetic susceptibility to the risk of ischemic stroke with differential mRNA expression in leukocytes
Authors: Xie Haining , Chen Changying , Han Xu , Wang Jing , Wei Lai , Ren Zhanyun , Li Jie , Gu Shiyuan , Wu Nan , Du Mengxue , Fei Suhai , Chen Yan , Jin Yuelong , Zhu Lijun , Fang Zhengmei , Yao Yingshui , Shen Chong
Published: October 2024

Background
Insulin-like growth factor 2 (IGF2), has been proven to be involved in vascular health, neuroprotection, and inflammation modulation which are relevant to the mechanism of ischemic stroke (IS). This study aimed to investigate the effect of IGF2 variants and mRNA expression on IS.
Method Three tag SNPs rs3741211, rs10770125, rs2585 were genotyped in a case-control study and two cohorts to evaluate the genetic effect on the incidence and prognosis of IS. IGF2 mRNA expression in leukocytes was measured.
Results In the case-control study, the variations of rs3741211 and rs2585 were significantly associated with the increased risk of IS and odds ratios (ORs) of dominant model were 1.130 and 1.151. The association of rs3741211 and IS remains significant in hypertension group (adjusted OR: 1.268; P = 0.003) with additive interactions of hypertension (P < 0.05). IGF2 mRNA expression of IS cases were significantly lower than controls (fold change = 0.740, P = 0.002) and there was a nonlinear relationship between IGF2 mRNA expression of IS (P < 0.05). Furthermore, the variations of rs3741211, rs10770125, and rs2585 are significantly associated with increased expression levels of IGF2 mRNA (P < 0.05). Additionally, a negative correlation was observed between IGF2 mRNA level and both National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (mRS) scores in IS patients after discharge (P < 0.05).
Conclusions The study reveals that IGF2 gene is associated with the susceptibility of IS and rs3741211, rs10770125, and rs2585 may affect the expression levels of IGF2 mRNA. Furthermore, IGF2 mRNA level was downregulated in IS patients and negatively correlate with poor prognosis.
Incidence and risk factors for osteoporosis in people with type 2 diabetes mellitus in Thailand
Authors: Sribenja Dueanchonnee , Looareesuwan Panu , Siriyotha Sukanya , Srit Chanika , Amnuaywattakorn Sasithorn , Ongphiphadhanakul Boonsong , Thakkinstian Ammarin , Nimitphong Hataikarn
Published: October 2024

Background: Type 2 diabetes mellitus (T2DM) is documented to alter bone structure and increase fracture risk. This study aimed to determine the risk factors and incidence rate of osteoporosis in Thai adults with T2DM.
Methods:A retrospective cohort study was conducted at Ramathibodi Hospital. People aged 18 or above whom were diagnosed with T2DM between January 2010 and December 2019 and started diabetic medication were included. Participants with a history of osteoporosis were excluded. Osteoporosis was diagnosed by BMD T-score ≤ -2.5, ICD10 for osteoporosis, ICD9 for fragility fracture, or prescription of osteoporosis medication. The participants that did not meet the criteria would be categorized as non-osteoporosis. Univariate and multivariate Cox regression analyses were used to determine risk factors for osteoporosis.
Results:25,635 participants were recruited. 772 participants were diagnosed with osteoporosis during the study period. The incidence rate was 57/10,000 person-year. Older age and female sex were associated with a greater risk for osteoporosis with hazard ratios (HR) of 1.07 (1.06-1.08) and 4.30 (3.48-5.30) respectively, while higher BMI was associated with a reduction in osteoporosis [HR 0.95 (0.94-0.97)]. For Diabetes-related risk factors, dipeptidyl peptidase-4 inhibitors (DPP4-inhibitors), insulin, sulfonylureas, and thiazolidinediones were related with an increased risk of osteoporosis, HR were 1.41 (1.09-1.81), 1.34 (1.07-1.69), 1.22 (1.01-1.48) and 1.45 (1.05-1.99)respectively. Dyslipidemia is also associated with osteoporosis [HR 1.36 (1.12-1.66)].
Conclusion:Older women with T2DM and dyslipidemia had a significantly higher risk of osteoporosis. Furthermore, insulin, sulfonylureas, thiazolidinediones, and DPP4-inhibitors are associated with increased fracture risk when compared to metformin.
Time Analysis of Hospital Costs for Respiratory Diseases in Brazil, 1998-2021
Authors: Santos Maryelli Laynara Barbosa de Aquino , Fonseca Luiza Gabriela de Araújo , Silva João Pedro de Santana , Gualdi Lucien Peroni , Neto Saint-Clair Gomes Bernardes , Lima Íllia Nadinne Dantas Florentino
Published: October 2024

Background: Respiratory diseases (RD) affect individuals of all age groups, negatively impacting patients' quality of life and incurring significant costs to healthcare services. If not managed properly, they can also lead to mortality. Information provided by DATASUS on RD can be utilized to facilitate professional decision-making, set targets for approach and treatment, and support the creation of public policies aimed at this population.
Objective: To assess the financial costs of hospital admissions in the Brazilian population caused by respiratory diseases from 1998 to 2021.
Methods: This is a descriptive, longitudinal, and quantitative study, with data properly recorded in the Hospital Information System of the Unified Health System (SIH/SUS), regarding the costs generated by respiratory diseases in Brazil, including individuals aged 0 to 80 years. The data were analyzed using GraphPad Prism software version 5.0, and the significance level was set at 5%.
Results: A total of 34,749,023 hospital admissions were observed, representing a total cost of R$23,653,000,000.00 and an average cost of R$760.62 per hospital admission during the study period. The age group between 20 and 80 years showed the highest indices related to the number of admissions. Regarding the list of morbidities, pneumonia presented the highest costs to the public health system (R$11,415,000,000.00 - 48.3%). The Southeast region showed the highest financial support (R$9,192,000,000.00), the highest number of deaths (n= 907434 - 49%), and the highest average hospital stay (5.9 days).
Conclusion: Respiratory diseases, in addition to representing a public health problem, have a significant financial impact on the SUS. It is essential to prioritize strategy plans and actions to combat these diseases, especially pneumonia, targeting the male population and the Southeast region, aiming to reduce inequalities in public health.
Chronic stress increased intolerance of risk but decreased intolerance of ambiguity
Authors: Chen Wangxiao , Xi Yu , Deng Leyou , Yi Wei , Wu Jianhui
Published: October 2024

Chronic stress could influence decision-making under uncertain scenarios and cause maladaptation to stressors, ultimately leading to mental illness. Converging evidence distinguished uncertainty between risk and ambiguity, and suggested that risk mainly recruited reward and cognitive systems but ambiguity most likely activated affect-relative regions. However, limited evidence has investigated the relationship between chronic stress and uncertainty attitudes distinguished between risk and ambiguity. To bridge this gap, eighty-six undergraduates preparing for the National Postgraduate Entrance Examination (NPEE) participated in this study, and the perceived stress scale (PSS) was applied to measure their chronic stress levels. They performed a Gambling task wherein an economic model was applied to fit their intolerance of risk (1-α) and ambiguity (β). The results showed that participants’ intolerance of risk was decreased as reward probability increased and intolerance of ambiguity was augmented as the ambiguity level increased. More importantly, as chronic stress levels increased, participants’ intolerance of risk increased but intolerance of ambiguity decreased. These results suggest that chronic stress may blunt reward responsiveness and cognitive systems, leading to augmented intolerance of risk. However, prolonged stress exposure altered cognitive measures of the affective state in the Gambling task, leading to a lower level of intolerance of ambiguity.
Wideband Near-Infrared Absorber with high manufacturing tolerance utilizing MXene Metasurface for industrial thermal applications
Authors: Armghan Ammar , Alsharari Meshari , Baqir Muhammad Abuzar , Wu Xiaohu , saqlain Muhammad , Aliqab Khaled
Published: October 2024

This study presents a polarization-insensitive, wideband solar absorber and thermal emitter made of plus-shaped fractal MXene metasurface. The proposed structure shows a high average absorption rate and photon-to-thermal energy conversion efficiency of above 90% from 750 to 3300 nm. The result findings reveal that wideband high absorption and excellent photothermal conversion efficiency is a result of localized surface plasmon resonance (LSPR) exists within the design structure. Besides that, the proposed structure also shows incident wave angular stability over the wide angular range up to 600. Moreover, the proposed structure shows high manufacturing tolerance when different parameters of unit cell design varies up to ± 10–15%. The understanding of high absorption characteristics is explored by surface electric field at various operating wavelengths. The proposed wideband absorption would be useful for energy harvesting applications, thermophotovoltaic, high power electronics devices, and infrared imaging.
Variations of SPI during outpatient laparoscopic cholecystectomy without muscle relaxants using ANI-guided remifentanil
Authors: Boselli Emmanuel , Allaouchiche B.
Published: October 2024

Purpose: This study compared ANI and SPI during outpatient laparoscopic cholecystectomy without muscle relaxants.
Methods: Adult patients were included in this prospective observational study. Induction was performed using propofol, ketamine and remifentanil. All patients received bilateral TAP block. Maintenance of anesthesia was performed using remifentanil targeted to ANI 50-80 and desflurane targeted to MAC 0.8-1.2 without muscle relaxants. The ANI and SPI values were collected at different time-points and analyzed using repeated-measures ANOVA. The relationship between ANI and SPI were analyzed by linear regression.
Results: All procedures were performed without muscle relaxants. The mean ± SD ANI values significantly decreased from 70 ± 12 at induction to 57 ± 15 at intubation and 56 ± 17 at extubation and were maintained in the 50-80 target range throughout incision to exsufflation. The mean ± SD SPI values significantly decreased from 60 ± 15 at induction to 38 ± 16 at intubation, increased at 73 ± 14 at extubation and were in the 20-50 target range throughout incision to exsufflation. There was a poor but significant negative linear relationship (r2 = 0.053, p<0.001) between SPI and ANI values.
Conclusion: During laparoscopic cholecystectomy without muscle relaxants, remifentanil titrated to achieve a target ANI range of 50-80 provides SPI values with poor correlation ranging from 20 to 50, corresponding to adequate nociception-antinociception balance. Other studies comparing ANI and SPI guided remifentanil administration are required to determine the effect of each strategy on patient outcomes during laparoscopic cholecystectomy or other types of surgery.
Associations of healthy aging index with dementia: a prospective cohort study of 305,566 individuals
Authors: Tan Shanyuan , Huang Xiaxuan , Ling Yitong , Yuan Shiqi , Bai Zihong , Cheng Hongtao , Xu Anding , Lyu Jun
Published: October 2024

Purpose: To prospectively assess whether Healthy Aging Index (HAI) is associated with the risk of dementia, and to investigate the potential relationship between HAI and genetic susceptibility in the development of Alzheimer's disease (AD).
Methods: The study included 305,566 participants from the UK Biobank, with a median follow-up of 14.01 years. HAI components were systolic blood pressure, reaction time, forced vital capacity, serum cystatin c, and serum glucose. Cox proportional hazard regression models assessed the associations between HAI and dementia risk.
Results: Adjusted analyses showed that each one-point increase in HAI was associated with a 15% higher risk of all-cause dementia (HR 1.15, 95% CI 1.13-1.17), a 10% higher risk of AD (HR 1.10, 95% CI 1.07-1.13), and a 29% higher risk of VD (HR 1.29, 95% CI 1.24-1.34). Restricted cubic spline (RCS) analyses confirmed these results. Further, the combined effects of HAI and AD genetic risk score (AD-GRS) were assessed. Participants with HAI scores of 7-10 had a higher risk of AD at intermediate (HR 1.68, 95% CI 1.16-2.44) and high AD-GRS levels (HR 2.43, 95% CI 1.66-3.56).
Conclusion: Our study indicates that a higher HAI score is associated with an increased risk of dementia. Early intervention to lower HAI scores in early adulthood, such as adopting a healthy lifestyle, can attenuate these associations.
Structural reconfiguration of multi-particle systems through parametric pumping
Authors: Mao Qinghao , Wu Brady , VanSaders Bryan , Jaeger Heinrich
Published: October 2024

Processes from crystallization to protein folding to robot self-assembly rely on achieving specific configurations of interacting particles. However, precise manipulation of even a small number of particles into more than one configuration without the use of feedback control is still challenging when controlled externally without feedback loops, especially if the interactions are non-conservative. Here we show how one can select, and switch between, specific structures without relying on tuning the energetic landscape of the system. Exploiting that different particle configurations have different mechanical resonances, we use parametric pumping to selectively excite and destroy undesired structures, making the targeted one an absorbing state. We demonstrate this approach with an acoustically levitated five-particle system in the Rayleigh limit, where the interactions are not only non-reciprocal and thus non-conservative, but also non-pairwise. With results from experiments and simulations on three additional systems ranging up to hundreds of particles, we demonstrate the generality of this method, providing a new path for non-invasive structure control of multi-particle systems.
Myofibre-specific knockout of TGF-β type I receptors triggers muscle hypertrophy and promotes contraction and oxidative metabolism
Authors: Jaspers Richard , Shi Andi , Hillege Michèle , Noort Wendy , Offringa Carla , Wu Gang , Forouzanfar Tim , Hoogaars Willem , Wüst Rob
Published: October 2024

Transforming growth factor-β (TGF-β) signaling is associated with progressive skeletal muscle wasting and fibrosis, while double knockout of TGF-β type I receptors Acvr1b and Tgfbr1 results in hypertrophy. Gaining insights in how myofibre-specific knockout of these receptors affects muscle transcriptome, strength and mitochondrial activity could aid in the development of therapeutic interventions to improve muscle function. Here, we show that 3 months of myofibre-specific knockout of both receptors (dKO) in mice induced a 1.6-fold increase in gastrocnemius medialis mass and a 1.3-fold increase in maximal force. Soleus muscle mass and maximal force both increased 1.2-fold in dKO mice. Muscle hypertrophy in dKO mice was accompanied by a proportional increase in succinate dehydrogenase enzyme activity. Single receptor knockout caused minor phenotypical alterations. Transcriptome analyses revealed that gastrocnemius medialis had 1811 and soleus had 295 differentially expressed genes, mainly related to muscle contraction, hypertrophy, filament organization and oxidative metabolism. Hgf and Sln genes were strongly upregulated in both muscles of dKO mice, while Sntb1 was downregulated. This in combination of transcriptional changes are associated with muscle hypertrophy and increased mitochondrial biosynthesis. Our study highlights that myofibre-specific interference with both TGF-β type I receptors concurrently stimulates myofibre hypertrophy and mitochondrial activity.
Tip Optofluidic Immunoassay: Evaluating COVID-19 Antibody Protection with 1μL Fingertip Blood
Authors: Tan Xiaotian , Chai Yujuan , Li Ruihan , Zhang Binmao , Li Hao , zhang Jie , Zhu Tianen , Wu Weishu , An Lixiang , Hu Shi , Yang Bin , Wang Li , Cao Zhenqiu , Zhang Hongjiu , Wang Peng , Yu Lingling , Yin Shan , Li Xingyu , Shao Fei , Huang Jianheng , Li Jinze , Yang Fan , Zhao Chao , Guo Jiajia , Zeng Lin , Liang Dong , Zou Zhengting , Zheng Hairong , Fan Xudong , xie Liangzhi , Cao Yunlong , Yang Hui
Published: October 2024

Infectious diseases such as COVID-19 pose continuous threats to global health. Effective re-infection management relies heavily on maintaining high circulating binding and neutralizing antibody levels. Traditional methods for antibody protection evaluation such as ELISA and VNT face significant challenges including complicated sample preparation, long assay time, and large sample consumption, hindering their applications in timely and routine disease control. This study introduces a house-developed Tip Optofluidic Immunoassay (TOI), featuring industrial-grade micro-fabricated immuno-reactors and a portable chemiluminescent imaging station, capable of evaluating humoral immunity comprehensively within 20 minutes. The system quantifies SARS-CoV-2 binding and neutralizing antibodies efficiently, offering a large dynamic range (3-4 orders of magnitude), extremely high signal-to-noise ratio (approximately 10,000), and high sensitivity for IgG binding assays. It also integrates an updated version of the Rapid In-Vitro Inhibition Assay for SARS-CoV-2 neutralizing antibody assessment, significantly reducing the sample-to-answer time and cost. In a study, TOI was utilized for quantifying antibody protection for multiple SARS-CoV-2 strains using just 1 µL of fingertip blood, from both binding, affinity, and neutralization perspectives. With TOI, individuals with broad-spectrum antibody protection against the WT and XBB strains, as well as those with strong immune imprints were identified. The precision, efficiency, and minimal sample requirement make TOI a valuable tool for decentralized surveillance, and infectious disease risk prediction, supporting the development of disease control and personalized immunization strategies.
The ‘Hidden Cost’ of Sustainable Debt Financing in Emerging Markets
Authors: Rickman Jamie , Kothari Sumit , Ameli Nadia
Published: October 2024

International sustainable debt markets are a critical source of capital for EMDEs progressing sustainable development and climate goals. However, finance provided in ‘hard’ currencies preferred by international investors, rather than local currencies in which borrowers earn revenue, transfers currency risk from developed country lenders to EMDE borrowers. This shift amplifies financial vulnerabilities at both the micro and macroeconomic level. Here we investigate the risk factors influencing the currency composition of EMDE sustainable corporate debt over the past two decades. We show that EMDE borrowers choose hard currency financing as the price for market access during volatile periods, creating a ‘hidden cost’ of sustainable debt. In addition to currency risk, global uncertainty depresses access to local currency financing in a ‘flight-to-safety’ phenomenon. A ‘ratings trap’ further develops whereby improved sovereign credit ratings increase foreign currency borrowing with potentially negative feedback effects on sovereign credit stability and ongoing access to debt markets.