bluuebunny/crossref_metadata_2025 huggingface dataset:
‘It was a challenge to look at things from a perpetrator perspective’. The problem of holding domestically abusive men to account in multi-agency partnership work
Authors: Davies Pamela , Barlow Charlotte , Fish Rebecca
Published: March 2024

One of the most challenging aspects of multi-agency partnership work aimed at reducing domestic abuse is the problem of holding perpetrators to account. Drawing on findings from our recent mixed methods evaluation of a revised approach to multi-agency policing of domestic abuse, this article explores this problem from the perspective of the multi-agency practitioner stakeholders. We present evidence attesting to the challenge these stakeholders are experiencing as they strive to ensure they play their part in ensuring the perpetrator is accountable for their behaviour. We review what is known about male perpetrators and perpetrator programmes and examine our findings in the context of the wider challenges of engaging perpetrators in behavioural change. We argue that the perpetrator is the elusive stakeholder in multi-agency partnership work to reduce domestic abuse and that the web of accountability requires strengthening if domestically abusive men are to be held to account.
Intermittently Scanned Continuous Glucose Monitoring Performance in Patients With Liver Cirrhosis
Authors: Rigon Fernanda Augustini , Ronsoni Marcelo Fernando , Hohl Alexandre , Vianna André Gustavo Daher , Sande-Lee Simone van de , Schiavon Leonardo de Lucca
Published: March 2024

Aim:

To evaluate the use of intermittently scanned continuous glucose monitoring (isCGM) in patients with liver cirrhosis (LC).

Methods:

Observational study including 30 outpatients with LC (Child-Pugh B/C): 10 without diabetes (DM) (G1), 10 with newly diagnosed DM by oral glucose tolerance test (G2), and 10 with a previous DM diagnosis (G3). isCGM (FreeStyle Libre Pro) was used for 56 days (four sensors/patient). Blood tests were performed at baseline and after 28 and 56 days.

Results:

No differences were found in the baseline characteristics, except for higher age in G3. There were significant differences between G1, G2 and G3 in glucose management indicator (GMI) (5.28 ± 0.17, 6.03 ± 0.59, 6.86 ± 1.08%, P < .001), HbA1c (4.82 ± 0.39, 5.34 ± 1.26, 6.97 ± 1.47%, P < .001), average glucose (82.79 ± 7.06, 113.39 ± 24.32, 149.14 ± 45.31mg/dL, P < .001), time in range (TIR) (70.89 ± 9.76, 80.2 ± 13.55, 57.96 ± 17.96%, P = .006), and glucose variability (26.1 ± 5.0, 28.21 ± 5.39, 35.31 ± 6.85%, P = .004). There was discordance between GMI and HbA1c when all groups were considered together, with a mean difference of 0.35% (95% SD 0.17, 0.63). In G1, the mean difference was 0.46% (95% SD 0.19, 0.73) and in G2 0.69% (95% SD 0.45, 1.33). GMI and HbA1c were concordant in G3, with a mean difference of −0.10 % (95% SD [−0.59, 0.38]).

Conclusion:

Disagreements were found between the GMI and HbA1c levels in patients with LC. isCGM was able to detect abnormalities in glycemic control that would not be detected by monitoring with HbA1c, suggesting that isCGM can be useful in assessing glycemic control in patients with LC.
Control-IQ Technology Use in Individuals With High Insulin Requirements: Results From the Multicenter Higher-IQ Trial
Authors: Carlson Anders L. , Graham Timothy E. , Akturk Halis K. , Liljenquist David R. , Bergenstal Richard M. , Sulik Becky , Shah Viral N. , Sulik Mark , Zhao Peter , Briggs Peter , Sassan-Katchalski Ravid , Pinsker Jordan E.
Published: March 2024

Background:

Control-IQ technology version 1.5 allows for a wider range of weight and total daily insulin (TDI) entry, in addition to other changes to enhance performance for users with high basal rates. This study evaluated the safety and performance of the updated Control-IQ system for users with basal rates >3 units/h and high TDI in a multicenter, single arm, prospective study.

Methods:

Adults with type 1 diabetes (T1D) using continuous subcutaneous insulin infusion (CSII) and at least one basal rate over 3 units/h (N = 34, mean age = 39.9 years, 41.2% female, diabetes duration = 21.8 years) used the t:slim X2 insulin pump with Control-IQ technology version 1.5 for 13 weeks. Primary outcome was safety events (severe hypoglycemia and diabetic ketoacidosis (DKA)). Central laboratory hemoglobin A1c (HbA1c) was measured at system initiation and 13 weeks. Participants continued using glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose transport protein 2 (SGLT-2) inhibitors, or other medications for glycemic control and/or weight loss if on a stable dose.

Results:

All 34 participants completed the study. Fifteen participants used a basal rate >3 units/h for all 24 hours of the day. Nine participants used >300 units TDI on at least one day during the study. There were no severe hypoglycemia or DKA events. Time in range 70-180 mg/dL was 64.8% over the 13 weeks, with 1.0% time <70 mg/dL. Hemoglobin A1c decreased from 7.69% at baseline to 6.87% at 13 weeks (−0.82%, P < .001).

Conclusions:

Control-IQ technology version 1.5, with wider range of weight and TDI input and enhancements for users with high insulin requirements, was safe in individuals with T1D in this study.
Source Matters? Exploring the Effects of Source Congeniality on Corrections of False Information on Twitter
Authors: Wang Luxuan , Feldman Lauren
Published: March 2024

This study examines the impact of source congeniality and its interaction with partisanship on the effectiveness of debunking false information on Twitter in the United States. Conducted in February 2022, a survey experiment revealed that most respondents paid little attention to correction source information. Politically congenial sources failed to enhance the effectiveness of corrective tags, whereas politically uncongenial sources and Twitter as the correction source weakened debunking’s persuasiveness, especially among Democrats. Republicans consistently exhibited higher misperception levels, unaffected by the correction source. The study highlights the persistent influence of belief-consistent false information and inattention as challenges in using corrective tags to counter false information on social media. The results underscore the need for more compelling corrections and increased public trust in debunking efforts in the United States.
Attention-assisted hybrid CNN-BILSTM-BiGRU model with SMOTE–Tomek method to detect cardiac arrhythmia based on 12-lead electrocardiogram signals
Authors: Chopannejad Sara , Roshanpoor Arash , Sadoughi Farahnaz
Published: March 2024

Objectives

Cardiac arrhythmia is one of the most severe cardiovascular diseases that can be fatal. Therefore, its early detection is critical. However, detecting types of arrhythmia by physicians based on visual identification is time-consuming and subjective. Deep learning can develop effective approaches to classify arrhythmias accurately and quickly. This study proposed a deep learning approach developed based on a Chapman–Shaoxing electrocardiogram (ECG) dataset signal to detect seven types of arrhythmias.

Method

Our DNN model is a hybrid CNN-BILSTM-BiGRU algorithm assisted by a multi-head self-attention mechanism regarding the challenging problem of classifying various arrhythmias of ECG signals. Additionally, the synthetic minority oversampling technique (SMOTE)–Tomek technique was utilized to address the data imbalance problem to detect and classify cardiac arrhythmias.

Result

The proposed model, trained with a single lead, was tested using a dataset containing 10,466 participants. The performance of the algorithm was evaluated using a random split validation approach. The proposed algorithm achieved an accuracy of 98.57% by lead II and 98.34% by lead aVF for the classification of arrhythmias.

Conclusion

We conducted an analysis of single-lead ECG signals to evaluate the effectiveness of our proposed hybrid model in diagnosing and classifying different types of arrhythmias. We trained separate classification models using each individual signal lead. Additionally, we implemented the SMOTE–Tomek technique along with cross-entropy loss as a cost function to address the class imbalance problem. Furthermore, we utilized a multi-headed self-attention mechanism to adjust the network structure and classify the seven arrhythmia classes. Our model achieved high accuracy and demonstrated good generalization ability in detecting ECG arrhythmias. However, further testing of the model with diverse datasets is crucial to validate its performance.
Sandwich Generation and Ever-married Women’s Perceived Stress: Do “Gone Lovers” Matter?
Authors: Liu Shuangshuang , Delaruelle Katrijn , Bracke Piet
Published: March 2024

Building on the stress process model and adopting an intersectionality framework, this study highlights the formation of a stronger intergenerational family symbiosis system in China. It offers a systematic understanding of the association between multigenerational caregiving and sandwich women’s stress, extending prior research by exploring the mitigating effect of husbands. Drawing upon China Health and Nutrition Survey data, findings indicate that sandwich women experience less stress than non-sandwich women. Particularly among sandwich women, upward care has a stress-reducing impact, while downward care has a stress-enhancing impact compared with carefree sandwich women. Providing active dual care has no significant effect, but when active help shifts to passive need, sandwich women’s stress reaches a peak. Husbands living at home could not buffer wives’ stress. These analyses depict the vulnerability of Chinese sandwich women under the revival of patriarchy and the imbalanced population structure and warrant a sounder public care system.
Cumulative Exposure to Social Isolation and Longitudinal Changes in Life Satisfaction among Older Adults
Authors: Kim Jinho , Park Gum-Ryeong
Published: March 2024

This study examines the longitudinal association between cumulative exposure to social isolation and life satisfaction and whether this association differs by gender. Using seven waves of the Korean Longitudinal Study of Aging from 2006 to 2018 (3,543 adults aged 65 or older), fixed effects models were estimated. Cumulative social isolation was longitudinally associated with a decline in life satisfaction in older adults. Gender-specific analyses revealed that older women exposed to cumulative social isolation continued to experience a decline in life satisfaction up to the fourth and subsequent waves of exposure (relative to the initial wave in which there was no social isolation; b = −13.038, p < .001). In contrast, a decline in life satisfaction associated with cumulative social isolation was less pronounced among older men ( b = −6.200 for the fourth and subsequent waves of exposure, p < .05). Cumulative social isolation can be a persistent risk factor for life satisfaction in older adults, particularly older women. The study’s findings hold important implications for programs aimed at reducing social isolation and improving psychological well-being among older adults.
Intermediate Outcomes of Medial Ulnar Collateral Ligament Reconstruction Using Gracilis Allograft in Adolescent Patients
Authors: Campbell Leonie , Bryan Tracey P. , Edmonds Eric W.
Published: March 2024

Background:

Autograft palmaris has been the primary choice for the reconstruction of the medial ulnar collateral ligament (UCL) in the elbow. Agenesis of the palmaris tendon is not rare, and outcomes of allograft reconstruction in the breadth of athlete types found in the adolescent population are lacking.

Hypothesis:

Allograft tendon reconstruction of the medial UCL in the young elbow would have low failure rates and satisfactory outcome scores.

Study Design:

Case series; Level of evidence, 4.

Methods:

The records of patients who underwent allograft medial UCL reconstruction (UCLR) by a single surgeon between 2009 and 2019 were reviewed. Patient-reported outcome scores in adolescent patients obtained at a minimum 4-year follow-up (for intermediate assessment) were recorded, with no exclusion according to sex or sport type. Outcomes included the Timmerman-Andrews score, the Single Assessment Numeric Evaluation (SANE), and the Conway-Jobe score.

Results:

Of 29 patients who underwent allograft UCLR, 10 adolescents (40% women; mean age at surgery, 15.8 years [age range, 15-17 years]) met the inclusion criteria and were included in the study. The mean follow-up was 8 years (range, 4.3-11.9 years). There were 4 overhead athletes (baseball, water polo) and 6 impact sports athletes (motocross, gymnastics, wrestling, and soccer). The mean SANE score was 86.3, and the mean subjective Timmerman-Andrews score was 92.5. The Conway-Jobe score was “excellent” in 7 of 10 participants; nonetheless, 3 elected not to return to sport (2 for reasons unrelated to the elbow). No patients experienced loss of range of motion, contracture, or ulnar nerve neuropathy. There was 1 patient with early failure (10%) who required revision reconstruction .

Conclusion:

Allograft reconstruction for medial UCL instability in adolescent patients from sport and trauma mechanisms demonstrated excellent patient-reported functional scores in this study. If the patient and surgeon desire to avoid autograft morbidity or agenesis of the palmaris longus, allograft tendon UCLR appears viable for both the throwing and the high-impact adolescent athlete, regardless of sex.
Relationship Between Hip Capsular Thickness and Instability After Previous Hip Arthroscopic Surgery: A Matched-Cohort Analysis
Authors: Ohlsen Suzanna M. , Metz Allan K. , Froerer Devin L. , Mortensen Alexander J. , Smith Tyler R. , Featherall Joseph , Rosenthal Reece M. , Aoki Stephen K.
Published: March 2024

Background:

Thinner anterior hip capsules are associated with hip laxity, but there is little known about the impact of capsular thickness on the development of instability after primary hip arthroscopic surgery.

Purpose:

To investigate the relationship between hip capsular thickness as measured on preoperative magnetic resonance imaging (MRI) and the development of hip instability after hip arthroscopic surgery for femoroacetabular impingement.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

We reviewed revision hip arthroscopic procedures performed between January 1, 2019, and May 1, 2021, at a single institution. Inclusion criteria were preoperative MRI/magnetic resonance arthrography, completion of the study traction protocol, and asymmetric distraction between the hips of ≥3 mm on examination under anesthesia. A comparison group of patients treated for femoroacetabular impingement with primary hip arthroscopic surgery who did not develop capsular instability were matched 1:1 to the patients with instability. Superolateral hip capsular thickness was measured on MRI before index surgery. Analysis was conducted using independent-samples t tests and multivariable linear regression.

Results:

A total of 44 patients were included, with 22 patients each in the instability and no-instability groups. The mean capsular thickness was lower in the patients with hip instability than in those without (1.9 ± 0.6 vs 3.4 ± 1.1 mm, respectively; P < .001). Decreased capsular thickness was significantly associated with hips with instability versus no-instability (β = −1.468 [95% CI, –2.049 to −0.887]; P < .001).

Conclusion:

Thinner preoperative hip capsules in the region of the iliofemoral ligament were seen in patients who subsequently underwent revision arthroscopic surgery for hip instability compared to patients who underwent primary hip arthroscopic surgery without subsequent revision. Patients at a higher risk for the development of postoperative hip instability had a superolateral hip capsular thickness of <2 mm.
An integrated action plan to fund and support drug development for Dup15q syndrome: a patient organization perspective
Authors: Rogers-Hammond Ryan , Howell Carrie
Published: March 2024

Maternal 15q11.2-13.1 duplication syndrome, or Dup15q syndrome (Dup15q), is a rare neurodevelopmental disorder affecting as many as 1 in 5000 to 1 in 20,000 children worldwide. Autism and seizures are two of the most commonly observed phenotypes in Dup15q, with intellectual disability, hypotonia, gastrointestinal distress, and substantial fine and gross motor deficits also commonly reported. The community that is now known as the Dup15q Alliance started in 1994 as a small group of families raising children with chromosome 15q duplications. Originally named IsoDicentric 15 Exchange, Advocacy and Support (IDEAS), the group received official nonprofit organization status 10 years later and rebranded to its current name, Dup15q Alliance, shortly thereafter. Today, there are over 2200 families affiliated with Dup15q Alliance, with an average intake of 10 new families each month. Historically, Dup15q Alliance has provided the community with access to family and caregiver resources in addition to serving as a repository for basic educational information about Dup15q and research developments. The recent installation of a dedicated director of scientific and clinical initiatives alongside other infrastructural changes has now primed the Dup15q Alliance to expand its scientific footprint by funding cutting-edge research, supporting clinical sites and trials, and investing in novel therapeutics that have the potential to change the reality of a Dup15q syndrome diagnosis. To do this, we have developed the LEARN. TREAT. CURE. program to align initiatives, fast-track progress, and bring hope and reality into coexistence. Briefly, we seek to learn as much as we can about the syndrome through cutting-edge research, natural history studies, and patient registry utilization, identify and develop methods to treat the symptoms of our patient community, with the ultimate goal of developing a cure for the disease-causing symptoms of the syndrome.
Complementary ways of seeing “the Nature”: Integrating varieties of knowledge practices in the management of local environmental conflicts in Colombia
Authors: Amador-Jimenez Mónica , Ramos Baron Pablo Andres , Richter Solveig
Published: March 2024

The complex pathways of armed conflict and its consequences for ecosystem transformations and environmental change have been well established in the literature. However, despite recent progress in this subject area, there is still a lack of integrative transdisciplinary research in this context, limiting our potential to fully understand the scalar interwoven processes of armed conflict, societal transformation, and ecological consequences. We address this desideratum by suggesting an alternative way of understanding the dynamics of environmental peacebuilding (EP) that integrates local narratives about “nature” and “conflict” with “real-world” data. By this, we aim to first foster a transdisciplinary heuristic linking environmental and earth system science with political ecology and social science. Second, we base our heuristic on a decolonial understanding of knowledge production, thus integrating complementary ways of seeing from above and from below into an interactive and relational practice of knowing. Our paper is based on research and intervention projects, combining both statistical and quantitative human geographical data with ethnographic field research to understand deforestation. With this paper, we hope to encourage academic discussions on alternative ontologies and epistemic practices and inform contextualized EP efforts.
Modernity's Antillean ecologies: Dispossession, disasters, justice, and repair across the Caribbean archipelago
Authors: Moulton Alex A.
Published: March 2024

The Caribbean region has been (re)shaped by colonial transformations of Amerindian ecologies, enslavement of Africans, and Indenture of Asians on plantations designed for European profit. Yet longstanding practices of resistance to human­–environmental domination and ecocidal violence have enabled Caribbean people to (re)create and sustain affirmative socio-ecologies. This report reflects on four axes characterizing the contestations over Caribbean environmental geographies: resistance to extractivism and dispossession, denaturalization of disaster, theorizing global ecological justice, and pursuit of repair. The article suggests how Caribbean environmental philosophy and ecocriticism offer analytics for mapping relational geographies beyond Western epistemes of progress and spatial imaginaries that peripheralize the region.
A systematic review and meta-analysis of the association between exposure to potentially toxic elements and gestational diabetes mellitus
Authors: Lefta Ridha M. , Hjazi Ahmed , Skakodub Alla A. , Dham Ammar , Sapaev I. B. , Khlewee Ibrahim Hammoud , Alawadi Ahmed Hussien , Alsaalamy Ali , Habash Ruqayah Taher , Lari Najafi Moslem
Published: March 2024

Potentially toxic elements (PTEs), including heavy metal exposures, have been associated with numerous negative pregnancy and birth outcomes. However, the association between PTE exposure and gestational diabetes mellitus (GDM) has not yet undergone a comprehensive systematic review. Consequently, this study undertook the first-ever systematic review and meta-analysis of observational studies concerning this association. All relevant articles published in English were searched in Scopus, PubMed, and Web of Science until November 6, 2023, adhering to the MOOSE guidelines. The quality of retrieved studies was evaluated based on the Gascon et al. method. The meta-analysis of association estimates was performed using random effects meta-analysis. Egger’s regression was employed to evaluate publication bias. In total, 16 articles (n = 116,728 participants) were included in our review, with 11 eligible for meta-analysis. Quality assessment categorized five studies (31%) as excellent, nine studies (56%) as good, and two studies (13%) as fair. Maternal high levels of Hg during pregnancy were associated with an increased risk of GDM (for each one-quartile increase in Hg: 1.20, 95% CI 1.08, 1.31), while serum Cd levels during the second trimester were associated with a lower risk of GDM (for each one-quartile increase in Cd: 0.76, 95% CI 0.65, 0.87). Furthermore, exposure to Pb was not associated with higher risk of GDM. In summary, our comprehensive review and meta-analysis underscore the possible negative influence of Hg exposure on GDM.
tRigon: an R package and Shiny App for integrative (path-)omics data analysis
Authors: Hölscher David L. , Goedertier Michael , Klinkhammer Barbara M. , Droste Patrick , Costa Ivan G. , Boor Peter , Bülow Roman D.
Published: March 2024

Background

Pathomics facilitates automated, reproducible and precise histopathology analysis and morphological phenotyping. Similar to molecular omics, pathomics datasets are high-dimensional, but also face large outlier variability and inherent data missingness, making quick and comprehensible data analysis challenging. To facilitate pathomics data analysis and interpretation as well as support a broad implementation we developed tRigon (Toolbox foR InteGrative (path-)Omics data aNalysis), a Shiny application for fast, comprehensive and reproducible pathomics analysis.

Results

tRigon is available via the CRAN repository (https://cran.r-project.org/web/packages/tRigon) with its source code available on GitLab (https://git-ce.rwth-aachen.de/labooratory-ai/trigon). The tRigon package can be installed locally and its application can be executed from the R console via the command ‘tRigon::run_tRigon()’. Alternatively, the application is hosted online and can be accessed at https://labooratory.shinyapps.io/tRigon. We show fast computation of small, medium and large datasets in a low- and high-performance hardware setting, indicating broad applicability of tRigon.

Conclusions

tRigon allows researchers without coding abilities to perform exploratory feature analyses of pathomics and non-pathomics datasets on their own using a variety of hardware.
Vitamin a potentiates sheep myoblasts myogenic differentiation through BHLHE40-modulated ID3 expression
Authors: Song Pengkang , Zhao Jiamin , Zhang Weipeng , Li Xuying , Ji Bingzhen , Zhao Junxing
Published: March 2024

Background

Vitamin A and retinoic acid (RA, a metabolite of vitamin A), are inextricably involved to the development of skeletal muscle in animals. However, the mechanisms regulating skeletal muscle development by vitamin A remain poorly reported. The current study designed to investigate the underlying mechanism of vitamin A affecting myogenic differentiation of lamb myoblasts through transcriptome sequencing (RNA-Seq) and gene function validation experiments. It provides a theoretical basis for elucidating the regulation of vitamin A on skeletal muscle development as well as for improving the economic benefits of the mutton sheep industry.

Results

Newborn lambs were injected with 7,500 IU vitamin A, and longissimus dorsi (LD) muscle tissue was surgically sampled for RNA-Seq analysis and primary myoblasts isolation at 3 weeks of age. The results showed that a total of 14 down-regulated and 3 up-regulated genes, were identified between control and vitamin A groups. Among them, BHLHE40 expression was upregulated in vitamin A group lambs. Furthermore, BHLHE40 expression is significantly increased after initiation of differentiation in myoblasts, and RA addition during differentiation greatly promoted BHLHE40 mRNA expression. In vitro, RA inhibited myoblasts proliferation and promoted myoblasts myogenic differentiation through BHLHE40. Moreover, BHLHE40 was proved to inhibit the expression of the DNA binding inhibitor 3 (ID3), and meanwhile, ID3 could effectively promote myoblasts proliferation and inhibit myoblasts myogenic differentiation.

Conclusions

Taken together, our results suggested that vitamin A inhibited myoblasts proliferation and promoted myoblasts myogenic differentiation by inhibiting ID3 expression through BHLHE40.
The first Cyclospora cayetanensis lineage A genome from an isolate from Mexico
Authors: Santin Monica , Molokin Aleksey , Orozco-Mosqueda Guadalupe E. , Almeria Sonia , Maloney Jenny
Published: March 2024

Background

Cyclospora cayetanensis is a protozoan parasite that causes intestinal illness in humans worldwide. Despite its global distribution, most genomic data for C. cayetanensis has been obtained from isolates collected in the United States, leaving genetic variability among globally distributed isolates underexplored.

Results

In the present study, the genome of an isolate of C. cayetanensis obtained from a child with diarrhea living in Mexico was sequenced and assembled. Evaluation of the assembly using a lineage typing system recently developed by the Centers for Disease Control and Prevention revealed that this isolate is lineage A.

Conclusions

Given that the only other whole genome assembly available from Mexico was classified as lineage B, the data presented here represent an important step in expanding our knowledge of the diversity of C. cayetanensis isolates from Mexico at the genomic level.
Bioinformatics analysis of the microRNA genes associated with type 2 cardiorenal syndrome
Authors: Zong Yani , Hu Yuexin , Zheng Mengdi , Wang Zhi
Published: March 2024

Background

MicroRNAs (miRNAs) are important regulatory factors in the normal developmental stages of the heart and kidney. However, it is currently unclear how miRNA is expressed in type 2 cardiorenal syndrome (CRS). This study aimed to detect the differential expression of miRNAs and to clarify the main enrichment pathways of differentially expressed miRNA target genes in type 2 CRS.

Methods

Five cases of healthy control (Group 1), eight of chronic heart failure (CHF, Group 2) and seven of type 2 CRS (Group 3) were enrolled, respectively. Total RNA was extracted from the peripheral blood of each group. To predict the miRNA target genes and biological signalling pathways closely related to type 2 CRS, the Agilent miRNA microarray platform was used for miRNA profiling and bioinformatics analysis of the isolated total RNA samples.

Results

After the microarray analysis was done to screen for differentially expressed circulating miRNAs among the three different groups of samples, the target genes and bioinformatic pathways of the differential miRNAs were predicted. A total of 38 differential miRNAs (15 up- and 23 down-regulated) were found in Group 3 compared with Group 1, and a total of 42 differential miRNAs (11 up- and 31 down-regulated) were found in Group 3 compared to Group 2. According to the Gene Ontology (GO) function and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway analysis, the top 10 lists of molecular functions, cellular composition and biological processes, and the top 30 signalling pathways of predicted gene targets of the differentially expressed miRNAs were discriminated among the three groups.

Conclusion

Between the patients with CHF and type 2 CRS, miRNAs were differentially expressed. Prediction of target genes of differentially expressed miRNAs and the use of GO function and KEGG pathway analysis may reveal the molecular mechanisms of CRS. Circulating miRNAs may contribute to the diagnosis of CRS, and further and larger studies are needed to enhance the robustness of our findings.
Single-pool model urea clearance index is associated with sarcopenia and nutritional status in patients undergoing maintenance hemodialysis: a cross-sectional study
Authors: Li Yan , Xing Tingting , Xu Rong , Liu Yan , Zhong Xiaoshi , Liu Yun , Tan Rongshao
Published: March 2024

Background

The single-pool model urea clearance index (single-pool Kt/Vurea; spKt/V) is the most commonly used method for dialysis adequacy assessment. However, only a few studies have examined the relationship between spKt/V values and parameters related to sarcopenia and nutritional status. This study aimed to evaluate whether the spKt/V is an indicator of sarcopenia and nutritional status in patients undergoing maintenance hemodialysis (MHD).

Methods

A total of 142 patients were included in this single-center, cross-sectional study. Venous blood samples were collected shortly before the hemodialysis session. The adequacy of dialysis in patients receiving MHD was assessed using spKt/V. Sarcopenia was identified according to the Asian Working Group for Sarcopenia (2019) definition. Receiver operating characteristic curve and area under the curve were used to evaluate the predictive value of spKt/V in sarcopenia. Univariate and multivariate binary logistic regression analyses were used to determine the association between spKt/V and sarcopenia and nutritional status.

Results

The mean spKt/V level was 1.3 ± 0.2, the prevalence of sarcopenia was 15.5% in patients on MHD. The best cutoff value of spKt/V in sarcopenia was 1.45 for both sexes, 1.33 and 1.45 for men and women, respectively (P < 0.05). The multivariate binary logistic regression shown that the spKt/V was independently positively associated with sarcopenia (OR = 122.88, 95% CI = 0.64–0.87, P = 0.002). Grouping spKt/V by the best cutoff value, when spKt/V ≥ 1.45, the OR of sarcopenia was 11.75 (95% CI = 3.16–43.67, P < 0.001). Subgroup analyses showed that when spKt/V ≥ 1.33 in men and spKt/V ≥ 1.45 in woman, the OR of sarcopenia was 9.73 (95% CI = 2.25–42.11, P = 0.002) and 14.52 (95% CI = 1.06–199.67, P = 0.045), respectively.

Conclusions

The present study showed that spKt/V was an important influencing factor of sarcopenia and malnutrition in Asian patients on MHD.
COVID-19 and cancer risk arising from ionizing radiation exposure through CT scans: a cross-sectional study
Authors: Mahmoudi Golshan , Toolee Heidar , Maskani Reza , Jokar Farzaneh , Mokfi Milad , Hosseinzadeh Ali
Published: March 2024

Background

The surge in the utilization of CT scans for COVID-19 diagnosis and monitoring during the pandemic is undeniable. This increase has brought to the forefront concerns about the potential long-term health consequences, especially radiation-induced cancer risk. This study aimed to quantify the potential cancer risk associated with CT scans performed for COVID-19 detection.

Methods

In this cross-sectional study data from a total of 561 patients, who were referred to the radiology center at Imam Hossein Hospital in Shahroud, was collected. CT scan reports were categorized into three groups based on the radiologist’s interpretation. The BEIR VII model was employed to estimate the risk of radiation-induced cancer.

Results

Among the 561 patients, 299 (53.3%) were males and the average age of the patients was 49.61 ± 18.73 years. Of the CT scans, 408 (72.7%) were reported as normal. The average age of patients with normal, abnormal, and potentially abnormal CT scans was 47.57 ± 19.06, 54.80 ± 16.70, and 58.14 ± 16.60 years, respectively (p-value < 0.001). The average effective dose was 1.89 ± 0.21 mSv, with 1.76 ± 0.11 mSv for males and 2.05 ± 0.29 mSv for females (p-value < 0.001). The average risk of lung cancer was 3.84 ± 1.19 and 9.73 ± 3.27 cases per 100,000 patients for males and females, respectively. The average LAR for all cancer types was 10.30 ± 6.03 cases per 100,000 patients.

Conclusions

This study highlights the critical issue of increased CT scan usage for COVID-19 diagnosis and the potential long-term consequences, especially the risk of cancer incidence. Healthcare policies should be prepared to address this potential rise in cancer incidence and the utilization of CT scans should be restricted to cases where laboratory tests are not readily available or when clinical symptoms are severe.
Subthreshold micropulse laser therapy for early postoperative macular thickening following surgical removal of epiretinal membrane
Authors: Lin Hongjie , Huang Zijing , Huang Dingguo , Zheng Dezhi , Lin Peimin , Lin Yangxuan , Chen Weiqi
Published: March 2024

Background

This study aimed to investigate the functional and anatomical outcomes of subthreshold micropulse laser (SMPL) therapy in eyes with early postoperative macular thickening after idiopathic epiretinal membrane (iERM) removal.

Methods

This was a prospective and interventional study. Forty-eight eyes from 48 patients with macular edema at 1 month after iERM removal were randomly divided into two groups. Patients in the SMPL group (n = 24) received SMPL therapy while no special intervention was used for the observation group (n = 24). Baseline demographic data and clinical findings before and at 1 and 3 months after SMPL treatment or observation, including best-corrected visual acuity (BCVA) and the changes in central subfield thickness (CST) and average macular thickness (AMT), were analyzed.

Results

An improvement in BCVA with a decrease in CST and AMT from baseline to the 3-month follow-ups were observed in both SMPL and observation groups. No significant difference in BCVA was observed between the SMPL group and observation group either in the 1-month (0.26 [0.15, 0.52] vs. 0.26 [0.15, 0.39],P = 0.852) or the 3-month (0.15 [0.10, 0.30] vs. 0.23 [0.15, 0.30],P = 0.329) follow-up. There was a greater reduction in CST in the SMPL group versus observation group between baseline and the 3-month follow-up (-77.8 ± 72.3 μm vs. -45.0 ± 46.9 μm,P = 0.049). The alteration in AMT did not differ between the two groups in either 1-month (-16.5 ± 20.1 μm vs. -19.7 ± 16.3 μm,P = 0.547) or 3-month (-36.9 ± 26.9 μm vs. -34.0 ± 20.1 μm,P = 0.678) follow-up.

Conclusions

SMPL therapy led to a significant decrease in CST at the 3-month follow-up while did not significantly improve the visual acuity in patients with postoperative macular thickening following iERM surgery.

Trial registration

The study was registered on Aug 27, 2020 (Trial Registration Number: ChiCTR 2000037227).
Prediction of coronary artery lesions in children with Kawasaki syndrome based on machine learning
Authors: Tang Yaqi , Liu Yuhai , Du Zhanhui , Wang Zheqi , Pan Silin
Published: March 2024

Objective

Kawasaki syndrome (KS) is an acute vasculitis that affects children < 5 years of age and leads to coronary artery lesions (CAL) in about 20-25% of untreated cases. Machine learning (ML) is a branch of artificial intelligence (AI) that integrates complex data sets on a large scale and uses huge data to predict future events. The purpose of the present study was to use ML to present the model for early risk assessment of CAL in children with KS by different algorithms.

Methods

A total of 158 children were enrolled from Women and Children’s Hospital, Qingdao University, and divided into 70–30% as the training sets and the test sets for modeling and validation studies. There are several classifiers are constructed for models including the random forest (RF), the logistic regression (LR), and the eXtreme Gradient Boosting (XGBoost). Data preprocessing is analyzed before applying the classifiers to modeling. To avoid the problem of overfitting, the 5-fold cross validation method was used throughout all the data.

Results

The area under the curve (AUC) of the RF model was 0.925 according to the validation of the test set. The average accuracy was 0.930 (95% CI, 0.905 to 0.956). The AUC of the LG model was 0.888 and the average accuracy was 0.893 (95% CI, 0,837 to 0.950). The AUC of the XGBoost model was 0.879 and the average accuracy was 0.935 (95% CI, 0.891 to 0.980).

Conclusion

The RF algorithm was used in the present study to construct a prediction model for CAL effectively, with an accuracy of 0.930 and AUC of 0.925. The novel model established by ML may help guide clinicians in the initial decision to make a more aggressive initial anti-inflammatory therapy. Due to the limitations of external validation and regional population characteristics, additional research is required to initiate a further application in the clinic.
Psychometric properties of the Perceived Stress Scale (PSS-10) in silica-exposed workers from diverse cultural and linguistic backgrounds
Authors: Hore-Lacy Fiona , Gwini StellaMay , Glass Deborah C. , Dimitriadis Christina , Jimenez-Martin Javier , Hoy Ryan F. , Sim Malcolm R. , Walker-Bone Karen , Fisher Jane
Published: March 2024

Background

The Perceived Stress Scale (PSS-10) has been used in a range of occupational cohorts, but only recently in stone benchtop workers undergoing screening for silicosis. The aim of this study was to compare psychometric properties of the PSS-10 in stone benchtop workers amongst those born overseas or who used an interpreter.

Methods

Stone benchtop workers in Melbourne, Australia completed the PSS-10 as part of their occupational screening for silicosis. Internal consistency was assessed with Cronbach’s α for the total score and the positive and negative subscales. Validity was assessed using confirmatory factor analysis (CFA). Analysis was performed for the total group and for subgroups according to sex, interpreter use, overseas-born, and language spoken at home.

Results

The results of 682 workers with complete PSS-10 scores were included in analysis. Most participants were male (93%), with mean age 36.9 years (SD 11.4), with just over half (51.6%) born in Australia, 10.1% using an interpreter, and 17.5% using a language other than English at home. Cronbach’s α for the overall group (α = 0.878) suggested good internal consistency.

Discussion

CFA analysis for validity testing suggested PSS-10 performance was good for both sexes, moderate for country of birth and language spoken at home categories, but poorer for those who used an interpreter. Whilst professional interpreters provide a range of benefits in the clinical setting, the use of translated and validated instruments are important, particularly in cohorts with large numbers of migrant workers.

Conclusion

This study describes the psychometric properties of the PSS-10 in a population of stone benchtop workers, with good internal consistency, and mixed performance from validity testing across various subgroups.
Population mortality before and during the COVID-19 epidemic in two Sudanese settings: a key informant study
Authors: AbuKoura Rahaf , Checchi Francesco , Abdalla Omama , Ibrahim Omnia , Hemeadan Ahmed Tom , Eldirdiri Ahmed Ali Ahmed , Mohamed Direeg Ismail , Ahmed Aljaile , Ahmed Abd Elhameed , Abdelmagid Nada , Pepe Pasquale , Dahab Maysoon
Published: March 2024

Background

Population mortality is an important metric that sums information from different public health risk factors into a single indicator of health. However, the impact of COVID-19 on population mortality in low-income and crisis-affected countries like Sudan remains difficult to measure. Using a community-led approach, we estimated excess mortality during the COVID-19 epidemic in two Sudanese communities.

Methods

Three sets of key informants in two study locations, identified by community-based research teams, were administered a standardised questionnaire to list all known decedents from January 2017 to February 2021. Based on key variables, we linked the records before analysing the data using a capture-recapture statistical technique that models the overlap among lists to estimate the true number of deaths.

Results

We estimated that deaths per day were 5.5 times higher between March 2020 and February 2021 compared to the pre-pandemic period in East Gezira, while in El Obeid City, the rate was 1.6 times higher.

Conclusion

This study suggests that using a community-led capture-recapture methodology to measure excess mortality is a feasible approach in Sudan and similar settings. Deploying similar community-led estimation methodologies should be considered wherever crises and weak health infrastructure prevent an accurate and timely real-time understanding of epidemics’ mortality impact in real-time.
Analysis of the association between urinary glyphosate exposure and fatty liver index: a study for US adults
Authors: Han Kexing , Gao Long , Xu Honghai , Li Jiali , Han Lianxiu , Shen Jiapei , Sun Weijie , Gao Yufeng
Published: March 2024

Background

Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition that often goes unrecognized in the population, and many risk factors for this disease are not well understood. Glyphosate (GLY) is one of the most commonly used herbicides worldwide, and exposure to this chemical in the environment is significant. However, studies exploring the association between GLY exposure and NAFLD remain limited. Therefore, the aim of this study was to assess the association between urinary glyphosate (uGLY) level and fatty liver index (FLI) using data from the National Health and Nutrition Examination Survey (NHANES), which includes uGLY measurements.

Methods

The log function of uGLY was converted and expressed as Loge(uGLY) with the constant “e” as the base and used for subsequent analysis. The association between Loge(uGLY) (the independent variable) level and FLI (the dependent variable) was assessed by multiple linear regression analysis. Smoothing curve fitting and a generalized additive model were used to assess if there was a nonlinear association between the independent and the dependent variables. A subgroup analysis was used to find susceptible individuals of the association between the independent variable and the dependent variable.

Results

A final total of 2238 participants were included in this study. Participants were categorized into two groups (< -1.011 and ≥ -1.011 ng/ml) based on the median value of Loge(uGLY). A total of 1125 participants had Loge(uGLY) levels ≥ -1.011 ng/ml and higher FLI. The result of multiple linear regression analysis showed a positive association between Loge(uGLY) and FLI (Beta coefficient = 2.16, 95% CI: 0.71, 3.61). Smoothing curve fitting and threshold effect analysis indicated a linear association between Loge(uGLY) and FLI [likelihood ratio(LLR) = 0.364]. Subgroup analyses showed that the positive association between Loge(uGLY) and FLI was more pronounced in participants who were female, aged between 40 and 60 years, had borderline diabetes history, and without hypertension history. In addition, participants of races/ethnicities other than (Mexican American, White and Black) were particularly sensitive to the positive association between Loge(uGLY) and FLI.

Conclusions

A positive linear association was found between Loge(uGLY) level and FLI. Participants who were female, 40 to 60 years old, and of ethnic backgrounds other than Mexican American, White, and Black, deserve more attention.
Longitudinal assessment of the relationship between frailty and social relationships among Japanese older adults: a random intercept cross-lagged panel model
Authors: Cui Mingyu , Jiao Dandan , Liu Yang , Zhu Yantong , Li Xiang , Zhu Zhu , Zhang Jinrui , Alpona Afsari Banu , Wang Yanlin , Qian Meiling , Sawada Yuko , Miura Kumi Watanabe , Watanabe Taeko , Tanaka Emiko , Anme Tokie
Published: March 2024

Objectives

This study aimed to explore the bidirectional association between frailty and social relationships in older adults while distinguishing between interpersonal and intrapersonal effects.

Methods

A prospective cohort study of community-dwelling older adults was conducted in Japan in three waves spanning six years with follow-ups in every three years. Random intercept cross-lagged panel model was used to explore temporal associations between frailty and social relationships.

Results

Data for 520 participants (mean age 73.02 [SD 6.38] years, 56.7% women) were analyzed. Across individuals, frailty was associated with social relationships (β = -0.514, p < 0.001). At the interpersonal level, frailty was cross-sectionally associated with social relationships separately at T1(β = -0.389, p < 0.01), T2 (β = -0.343, p < 0.001) and T3 (β = -0.273, p < 0.05). Moreover, social relationships were associated with subsequent increases in symptoms of frailty in all measurement waves (β = -0.332, p < 0.001; β = -0.169, p < 0.01) and vice versa (β = -0.149, p < 0.05; β = -0.292, p < 0.001).

Conclusions

The results suggest that frailty was associated with lower levels of social relationships. Frailty improvement programs can be combined with interventions to enhance social relationships, which will be beneficial in preventing frailty. The results emphasize the importance of combining clinical treatments of frailty with interventions to improve social relationships.
Presentation and treatment of two cases of malignant struma ovarii
Authors: Obeidat Rawan A. , Alshwayyat Sakhr , Alshwayyat Tala Abdulsalam , Rjoop Anwar , Sharqiah Qosay Mahmoud
Published: March 2024

Background

Malignant Struma Ovarii (MSO) is a rare type of germ cell tumour which is diagnosed postoperatively on surgical pathology specimens by the presence of differentiated thyroid cancer in mature cystic teratomas in the ovaries. Treatment and follow-up procedures are not clearly established due to the paucity of MSO cases.

Case 1

A 44-year-old multiparous female presented with an irregular period. Ultrasound showed a left ovarian lesion mostly a dermoid cyst, however, CT showed a 3.8 × 2.7 × 4 cm complex cystic lesion with thick septation and enhancing soft tissue component. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed a follicular variant of papillary thyroid carcinoma arising in a mature cystic teratoma. Peritoneal cytology was positive for malignancy. A thyroid function test was normal before surgery. Total thyroidectomy was performed followed by radioactive (RAI) iodine therapy. Later, a total laparoscopic hysterectomy and right salpingo-oophorectomy were performed. There is no evidence of recurrent disease during the 26-months follow-up.

Case 2

A 46-year-old single female presented with left lower abdominal pain that had persisted for 2 months. Imaging revealed an 8 × 9 × 9.5 cm left ovarian mass. Laparoscopic left salpingo-oophorectomy was performed and histopathology showed mature cystic teratoma with small papillary thyroid cancer. CT showed no evidence of metastatic disease. Later, the patient had a total thyroidectomy followed by radioactive (RAI) iodine therapy. She was started on thyroxine and later had total abdominal hysterectomy and right salpingo-oophorectomy.

Conclusion

MSO is a very rare tumour. Preoperative diagnosis is very difficult because of the nonspecific symptoms and the lack of specific features in imaging studies. Also, there is no consensus on the optimal treatment of women with MSO. Our two cases add to the limited number of MSO cases.