bluuebunny/crossref_metadata_2025 huggingface dataset:
Aesthetic Perspective of Forest Experience in the Age of Forest Boom
Authors:   The Korean Society of Culture and Convergence, Choi Junho
Published: December 2023

The purpose of this paper is to explore the issues underlying the forest boom, and to provide insights into the forest understanding based on ecological perspective and corresponding practical activities by providing a aesthetic perspective on forest experience. The core of the research content is as follows. Forest experience is an aesthetic experience in which the forest experiencer feels the unique atmosphere of the forest and at the same time senses his or her own being with the body. It can be summarized in three aspects as follows. First, the experience is a multi-sensory experience in which all five senses are simultaneously exerted, which cannot be imitated by any other aesthetic experience. Second, forest experience involves falling into a unique ecstasy, namely a calm ecstasy. Finally, forest experience is an aesthetic experience in which one's “being” is much more keenly felt in front of the silent cry calling for a departure from the anthropocentric view of nature than in the aesthetic experience of other natural phenomena.
The Factors Affecting Unmet Medical Needs in Those Who Feel Future Anxiety
Authors:   The Korean Society of Culture and Convergence, Bea Sangsook
Published: December 2023

This study employed SPSS Window version 23.0 for hierarchical logistic regression analysis on 2018 KMP data to evaluate the impact of unmet medical services on future anxiety and confirm contributing factors. Using the Anderson Model, I adjusted factors influencing healthcare utilization and validated variables contributing to unmet healthcare needs. Results showed significant associations between unmet healthcare needs and factors such as age, education, marital status, understanding of doctor's explanations, smoking, self-perceived health, activity limitations, and thoughts of suicide. To manage future anxiety and reduce unmet healthcare needs, need assessment models that systematically evaluate interactions, including social anxiety symptoms. To address this, psychiatry and government agencies must collaborate to improve public understanding of anxiety disorders and coping abilities.
Structural Analysis of Changes in Yield Correlation of Events KOSDAQ before and after COVID-19
Authors:   The Korean Society of Culture and Convergence, Han Hyeji , Kim GwangIl , Jun Doobae
Published: December 2023

In this study, the Minimum spanning tree (MST) method was applied to daily price data of KOSDAQ stocks to conduct a structural analysis of changes in each graph and degree based on before and after COVID-19 occurred and at the start of each pandemic. As a result, it was confirmed that the minimum height tree graph and order change were the greatest before and after the outbreak of COVID-19 and at the beginning of the first and second pandemic, and stock market stabilized as of the start of the third pandemic as COVID-19 entered a prolonged period. These results confirmed that the change in the correlation between stocks increased at a time when social turmoil was the biggest, and that the stock market gradually stabilized at some point when the situation caused by social confusion entered a prolonged period.
A Study on the Utilization of ChatGPT to Secure Competitiveness of the Banking Sector
Authors:   The Korean Society of Culture and Convergence, Kim Yeji , Jun Doobae , Kim Minhwan , Park Hyewon , Hong Sohyeon
Published: December 2023

Recently, the banking industry has been implementing AI bankers utilizing artificial intelligence on-site. However, the application of AI bankers has revealed various technical issues, prompting efforts by banks to address and improve them. In this paper, we propose the combination of AI bankers and ChatGPT as one method of improvement. It is anticipated that this combination will alleviate some of the identified issues and bring about diverse changes in banking services. Specifically, we suggest enabling AI bankers to handle customer interactions by leveraging ChatGPT's ability to store and recall previous conversation context. Additionally, we propose expanding the scope of AI bankers by combining them with ChatGPT trained on regional dialects to recognize and incorporate regional expressions. This approach is expected to enhance productivity and efficiency by bankers focusing on other core tasks. Moreover, the introduction of ChatGPT for employees is expected to improve the quality of banking services through accurate task processing, ultimately increasing customer satisfaction.
Implementasi Model Pentahelix dalam Pengembangan Badan Usaha Milik Desa (BumDes) di Kabupaten Lampung Selatan
Authors: Rosalia Feni , Makhya Syarief , Budiono Pitojo
Published: December 2023

Tujuan penulisan yang diangkat adalah (1) Untuk mendeskripsikan apakah model pentahelix sudah terimplementasikan dalam pengelolaan Badan Usaha Milik Desa (BumDes)  di Kabupaten Lampung Selatan, dan (2) Untuk mendeskripsikan hambatan implementasi model pentahelix dalam pengelolaan  Badan Usaha Milik Desa (BumDes) di Kabupaten Lampung Selatan. Tujuan penulisan berkaitan dengan optimalisasi pembangunan desa dalam rangka meningkatkan kesejahteraan masyarakat desa sebagaimana dinyatakan dalam UU Nomor 6 Tahun 2014 tentang Desa.  Demikian pula sejalan dengan tujuan pendirian BumDes di antaranya yaitu meningkatkan perekonomian dan meningkatkan pendapatan masyarakat desa. Metode penelitian yang digunakan adalah Melalui pendekatan kualitatif peneliti melakukan representasi objektif mengenai gejala-gejala yang terdapat di dalam masalah penelitian yaitu implementasi model pentahelix dalam pengelolaan BumDes di Kabupaten  Lampung Selatan Data diperoleh dari teknik wawancara, observasi dan dokumentasi. Selanjutnya analisis data dengan reduksi data, penyajian data dan verifikasi/penarikan kesimpulan. Hasil penelitian memaparkan bahwa implementasi model pentahelix telah di Implementasikan dengan baik dalam Pengelolaan BumDes di Kabupaten Lampung Selatan hanya di Kecamatan Sidomulto yang telah menerapkan model Pentahelix berkolaborasi dengan 5 stakeholder, yaitu Media, Komunitas Pelaku usaha, Akademisi, dan Pemerintah sebagai leading sektor. Bentuk kerjasama yang dilakukan adalah dengan mengadakan kegiatan bersama di mana stakeholder masih terbatas menjadi fasilitator dan sponsor dari kegiatan tersebut. Karena itu pada masa mendatang diharapkan kerjasama stakeholder dengan BumDes dapat lebih ditingkatkan dalam bentuk yang lebih konkrit yaitu pengembangan BumDes, peningkatan kapasitas sumber daya BumDes dan upaya peningkatan modal BumDes.
Biomechanics and finite element analysis comparing posterior T-plates with LCP for fixation of posterolateral tibial plate fractures
Authors: Hu Zhenghui , Ren Weizhi , Peng Jian , Gu Zenghui , Wu Chenying , Wu Weicheng , Zhang Wen , Xu Wei , Li Liubing
Published: December 2023

Objective: The treatment for posterolateral tibial plateau fractures (PTPF) have been subjects of controversy. We conducted a study to improve the fixation of PTPF through a lateral approach.

Methods: We utilized 40 synthetic tibias and categorized the fracture models into five groups based on the locking compression plate (LCP) and T-distal radius plate (TPP) via various forms of fixation with screws through the posterolateral (PL) fracture fragments. I: Two-screw fixation using two locking screws (LPTL). Ⅱ: Two-screw fixation with both variable angle locking screws (LPTV). Ⅲ: One-screw fixation with one locking screw (LPOL). Ⅳ: One-screw fixation with one locking screw and two anteroposterior lag screws (LPOLTL). Ⅴ: a distal radius plate with three locking screws (TPP). Biomechanical tests were conducted to observe the axial compression displacement of the PL fracture fragments at force levels of 250 N, 500 N, and 750 N, as well as to determine the failure load and the axial stiffness for each respective group.

Results: Under a 750 N load condition, the displacements within the five experimental groups exhibited the following trend: Ⅴ < Ⅱ < Ⅰ< Ⅳ < Ⅲ. However, there were no significant differences between Group V and Group II, Group I and Group IV (p > 0.05), and only Group Ⅲ demonstrated a displacement exceeding 3 mm. The failure load and the axial stiffness exhibited the same trend. Conversely, statistical significance was identified among the remaining group compared with Group Ⅲ (p < 0.05). Regarding the finite element analysis, the maximum displacements for the five models under the load of 750 N exhibited the following trend: Ⅴ < Ⅱ < Ⅰ< Ⅳ < Ⅲ. The following trends were observed in maximum von Mises stresses for these models under the load of 750 N: Ⅴ < Ⅱ < Ⅳ< Ⅰ < Ⅲ.

Conclusion: It is crucial to address the inadequate mechanical strength associated with single screw fixation of LCP for fixing PL fractures in a clinical setting. The biomechanical strength of two-screw fixation surpasses that of single-screw fixation. Introducing variable-angle screws can further enhance the fixation range. Furthermore, the addition of two lag screws threaded from anterior to posterior can compensate the mechanical stability, when PL fracture is fixed with single screw in clinic.
Gallium-doped thermochemically treated titanium reduces osteoclastogenesis and improves osteodifferentiation
Authors: Piñera-Avellaneda David , Buxadera-Palomero Judit , Ginebra Maria-Pau , Rupérez Elisa , Manero José María
Published: December 2023

Excessive bone resorption is one of the main causes of bone homeostasis alterations, resulting in an imbalance in the natural remodeling cycle. This imbalance can cause diseases such as osteoporosis, or it can be exacerbated in bone cancer processes. In such cases, there is an increased risk of fractures requiring a prosthesis. In the present study, a titanium implant subjected to gallium (Ga)-doped thermochemical treatment was evaluated as a strategy to reduce bone resorption and improve osteodifferentiation. The suitability of the material to reduce bone resorption was proven by inducing macrophages (RAW 264.7) to differentiate to osteoclasts on Ga-containing surfaces. In addition, the behavior of human mesenchymal stem cells (hMSCs) was studied in terms of cell adhesion, morphology, proliferation, and differentiation. The results proved that the Ga-containing calcium titanate layer is capable of inhibiting osteoclastogenesis, hypothetically by inducing ferroptosis. Furthermore, Ga-containing surfaces promote the differentiation of hMSCs into osteoblasts. Therefore, Ga-containing calcium titanate may be a promising strategy for patients with fractures resulting from an excessive bone resorption disease.
Recent developments in ionization techniques for single-cell mass spectrometry
Authors: Zeng Qingli , Xia Meng-Chan , Yin Xinchi , Cheng Simin , Xue Zhichao , Tan Siyuan , Gong Xiaoyun , Ye Zihong
Published: December 2023

The variation among individual cells plays a significant role in many biological functions. Single-cell analysis is advantageous for gaining insight into intricate biochemical mechanisms rarely accessible when studying tissues as a whole. However, measurement on a unicellular scale is still challenging due to unicellular complex composition, minute substance quantities, and considerable differences in compound concentrations. Mass spectrometry has recently gained extensive attention in unicellular analytical fields due to its exceptional sensitivity, throughput, and compound identification abilities. At present, single-cell mass spectrometry primarily concentrates on the enhancement of ionization methods. The principal ionization approaches encompass nanoelectrospray ionization (nano-ESI), laser desorption ionization (LDI), secondary ion mass spectrometry (SIMS), and inductively coupled plasma (ICP). This article summarizes the most recent advancements in ionization techniques and explores their potential directions within the field of single-cell mass spectrometry.
Mortality patterns of patients with tonsillar squamous cell carcinoma: a population-based study
Authors: Wang Jia , Li Xiaolin , Niu Dongdong , Huang Jiasheng , Ye Enlin , Zhao Yumei , Yue Suru , Hou Xuefei , Wu Jiayuan
Published: December 2023

Objective

Tonsillar squamous cell carcinoma (TSCC) and second primary malignancies (SPMs) are the most common causes of mortality in patients with primary TSCC. However, the competing data on TSCC-specific death (TSD) or SPM-related death in patients with TSCC have not been evaluated. This study aimed to analyze the mortality patterns and formulate prediction models of mortality risk caused by TSCC and SPMs.

Methods

Data on patients with a first diagnosis of TSCC were extracted as the training cohort from the 18 registries comprising the Surveillance, Epidemiology, and End Results (SEER) database. A competing risk approach of cumulation incidence function was used to estimate cumulative incidence curves. Fine and gray proportional sub-distributed hazard model analyses were performed to investigate the risk factors of TSD and SPMs. A nomogram was developed to predict the 5- and 10-year risk probabilities of death caused by TSCC and SPMs. Moreover, data from the 22 registries of the SEER database were also extracted to validate the nomograms.

Results

In the training cohort, we identified 14,530 patients with primary TSCC, with TSCC (46.84%) as the leading cause of death, followed by SPMs (26.86%) among all causes of death. In the proportion of SPMs, the lungs and bronchus (22.64%) were the most common sites for SPM-related deaths, followed by the larynx (9.99%), esophagus (8.46%), and Non-Melanoma skin (6.82%). Multivariate competing risk model showed that age, ethnicity, marital status, primary site, summary stage, radiotherapy, and surgery were independently associated with mortality caused by TSCC and SPMs. Such risk factors were selected to formulate prognostic nomograms. The nomograms showed preferable discrimination and calibration in both the training and validation cohorts.

Conclusion

Patients with primary TSCC have a high mortality risk of SPMs, and the competing risk nomogram has an ideal performance for predicting TSD and SPMs-related mortality. Routine follow-up care for TSCC survivors should be expanded to monitor SPMs.
Changes in serum tumor markers in type 2 diabetes mellitus with microalbuminuria
Authors: Chen Lina , Du Shichun , Li Yan Bo , Su Qing , Zhang Jiangrong , Zhang Hongmei
Published: December 2023

Objectives

The objective of this study was to investigate changes in serum tumor markers in type 2 diabetes mellitus (T2DM) with microalbuminuria and analyze the relationship between tumor markers and microalbuminuria.

Methods

A total of 956 T2DM patients aged 40–70 years hospitalized in the Department of Endocrinology, Xinhua Hospital, China, affiliated with Shanghai Jiaotong University School of Medicine, were enrolled from January 2018 to December 2020. The sample comprised 313 T2DM patients with microalbuminuria and 643 T2DM patients with normal urinary microalbumin levels. After assessing the changes in serum tumor markers in T2DM with microalbuminuria, we analyzed the risk of microalbuminuria by the serum tumor marker category using multiple logistic regression analysis.

Results

Serum CEA, CA199, CA125, CA153, CA211, SCC, CA242, and CA50 levels were significantly higher in T2DM patients with microalbuminuria than in those without microalbuminuria, while serum AFP levels were lower in the microalbuminuria group (P < 0.05). Following adjustment of confounders, serum CEA, CA211, and SCC were independently associated with microalbuminuria in T2DM. An ROC curve was used to estimate the cutoff point of tumor markers for microalbuminuria. Taking the values under the cutoff points as a reference, values for CEA, CA211, and SCC above the cutoff points indicated a significantly high risk of microalbuminuria. The OR of increased CEA for microalbuminuria was 2.006 (95%CI 1.456–2.765), the OR of increased CA211 for microalbuminuria was 1.505 (95%CI 1.092–2.074), and the OR of increased SCC for microalbuminuria was 1.958 (95%CI 1.407–2.724).

Conclusion

Several serum tumor markers were related to microalbuminuria in T2DM. Serum tumor markers such as CEA, SCC, and CA211 may indicate early diabetic nephropathy, particularly when elevated in combination.
GCM2 p.Tyr394Ser variant in Ashkenazi Israeli patients with suspected familial isolated hyperparathyroidism
Authors: Szalat Auryan , Shpitzen Shoshana , Pollack Rena , Mazeh Haggi , Durst Ronen , Meiner Vardiella
Published: December 2023

Context

A germline mutation can be identified in up to 10% of patients with primary hyperparathyroidism (PHPT). In 2017, a high frequency of the GCM2 [(NM_ 004752.4) c.1181A> C; p.Tyr394Ser; rs142287570] variant was reported in PHPT Ashkenazi Jews (AJ).

Objective

To evaluate the presence of the GCM2 p.Tyr394Ser variant in Israeli patients addressed for genetic evaluation to characterize their phenotype and clinical management.

Method

Patients with PHPT who underwent addressed for genetic screening for suspected familial hypocalciuric hypercalcemia (FHH), a family history of isolated hyperparathyroidism (FIHP), or failed parathyroidectomy with persistent PHPT were recruited. Those with normal initial selected gene sequencing or hyperparathyroid genetic panel completed the GCM2 p.Tyr394Ser variant sequencing. The prevalence of this variant was evaluated using our local genomic database.

Results

A total of 42 single individuals from unrelated kindreds were evaluated. A disease-causing mutation was found in 11 (26.1%) patients: 10 were diagnosed with FHH (eight CASR and two AP2S1 mutations), and one patient had a CKN2B mutation. In 28 of the remaining patients, the GCM2 p.Tyr394Ser variant was positive in three (10.7%), and all were AJ. Within AJ (15/28, 53.5%), the rate of the p.Tyr394Ser variant was 3/15 (20%), and of those, two had a history of familial isolated hyperparathyroidism. Multi-glandular parathyroid adenoma/hyperplasia was also observed in two of these patients. No clinical or laboratory findings could discriminate patients with the GCM2 p.Tyr394Ser variant from those with FHH. Cinacalcet normalized the calcium levels in one patient. The prevalence of the GCM2 p.Tyr394Ser variant in 15,407 tests in our local genomic database was 0.98%.

Conclusion

In contrast to previous observations, the GCM2 p.Tyr394Ser variant-associated phenotype may be mild in AJ with FIHP, sometimes mimicking FHH. Because surgery may be curative, surgeons should be aware of the possibility of multiple gland diseases in these patients. The clinical spectrum and clinical utility of screening for this variant warrant further investigation.
KLF14 activates the JNK-signaling pathway to induce S-phase arrest in cervical cancer cells
Authors: Du Ying , Ye Hui , Lin Mei , Cao Lili
Published: December 2023

Objective

To explore the role of Krüppel-like factor 14 (KLF14) and its underlying mechanism(s) of action in cell-cycle regulation in cervical cancer.

Methods

Lentiviral infection was used to construct KLF14, KLF14 zinc-finger structural mutations, and empty vector controls in SiHa and HeLa cervical cancer cells. The effect of KLF14 on cervical cancer cell cycle was detected by flow cytometry. The effect of KLF14 on the expression of cyclin-dependent kinase 2 (CDK2), cyclin A2 (CCNA2), and MAPK signalling pathway-related molecules was detected by fluorescence quantitative RT-PCR (qRT-PCR) and western blot. Cervical cancer cells were treated with JNK-pathway inhibitors/agonists before we assessed changes in the cell cycle and the expression of the CDK2, CCNA2, and p-JNK/JNK. Subcutaneous xenograft studies to explore the effects of KLF14 on cervical cancer cell proliferation in vivo, and western blotting was implemented to measure the expression of CCNA2, CDK2, and the activation levels of the MAPK-signaling pathway proteins in tumours.

Results

The proportion of cells in the S phase was increased in the KLF14-overexpressing group compared with the control group (P<0.001); CDK2, CCNA2, and p-JNK/JNK expression levels were elevated in the KLF14-overexpressing group relative to the control group (all P<0.05). When JNK-pathway activation was inhibited/promoted, the proportion of cells in the S phase was reduced/increased (P<0.05) and CDK2 and CCNA2 expression levels were reduced/decreased, respectively (all P<0.05). Vivo experiments revealed that KLF14 inhibited cervical cancer cell proliferation (P<0.01) and that p-JNK/JNK, CDK2, and CCNA2 expression levels were augmented in tumours in the overexpression group (P<0.01).

Conclusion

KLF14 induced S-phase arrest in cervical cancer cells and inhibited the proliferation of cervical cancer cells in vivo; the induction of S-phase arrest was related to its zinc-finger structure. KLF14 also activated the JNK pathway to induce S-phase arrest and promote the expression of CDK2 and CCNA2. In summary, KLF14 activates the JNK-signaling pathway to induce S-phase arrest in cervical cancer cells
Immunologic barriers in liver transplantation: a single-cell analysis of the role of mesenchymal stem cells
Authors: Li Haitao , Yu Saihua , Liu Haiyan , Chen Lihong , Liu Hongzhi , Liu Xingwen , Shen Conglong
Published: December 2023

Background

This study aimed to analyze the biomarkers that may reliably indicate rejection or tolerance and the mechanism that underlie the induction and maintenance of liver transplantation (LT) tolerance related to immunosuppressant or mesenchymal stem cells (MSCs).

Methods

LT models of Lewis-Lewis and F344-Lewis rats were established. Lewis-Lewis rats model served as a control (Syn). F344-Lewis rats were treated with immunosuppressant alone (Allo+IS) or in combination with MSCs (Allo+IS+MSCs). Intrahepatic cell composition particularly immune cells was compared between the groups by single-cell sequencing. Analysis of subclusters, KEGG pathway analysis, and pseudotime trajectory analysis were performed to explore the potential immunoregulatory mechanisms of immunosuppressant alone or combined with MSCs.

Results

Immunosuppressants alone or combined with MSCs increases the liver tolerance, to a certain extent. Single-cell sequencing identified intrahepatic cell composition signature, including cell subpopulations of B cells, cholangiocytes, endothelial cells, erythrocytes, hepatic stellate cells, hepatocytes, mononuclear phagocytes, neutrophils, T cells, and plasmacytoid dendritic cells. Immunosuppressant particularly its combination with MSCs altered the landscape of intrahepatic cells in transplanted livers, as well as gene expression patterns in immune cells. MSCs may be included in the differentiation of T cells, classical monocytes, and non-classical monocytes.

Conclusion

These findings provided novel insights for better understanding the heterogeneity and biological functions of intrahepatic immune cells after LT treated by IS alone or in combination with MSCs. The identified markers of immune cells may serve as the immunotherapeutic targets for MSC treatment of liver transplant rejection.
Diversity and distribution of yeasts in intertidal zones of China
Authors: Zhu Hai-Yan , Han Da-Yong , Guo Liang-Chen , Li Jun-Ning , Wei Xu-Yang , Zhang Ri-Peng , Wang Qi-Ming , Shang Yu-Jie , Luo Lu-Jun , Wei Yu-Hua , Liu Xin-Zhan , Bai Feng-Yan
Published: December 2023

China has the second greatest extent of intertidal zones in the world. The intertidal zone is the most dynamic environments in the biosphere and potentially supports high biodiversity. Marine yeasts show excellent performance in various industrial, environmental and medical applications, however, the marine yeast diversity has rarely been studied in China. In this study, we collected 1241 samples including marine sediments, marine water, plants, and benthos at 161 GPS sites in different types of intertidal zones along the Chinese coastline from north to south. A total of 4436 strains were isolated from these samples using different methods and 286 species including 39 potential novel species were identified from these strains based on the internal transcribed spacer (ITS) region or the D1/D2 domain of the large subunit rRNA gene sequence analysis. The majority of the yeast species in different geographical locations belong to the five orders Serinales, Saccharomycetales, Tremellales, Sporidiobolales, and Pichiales. The yeast species diversity varied depending on sample types, depth of marine sediments, intertidal zone types and geographical locations. Mean annual temperature (MAT), salinity and pH had the greatest effect on the community structures of the yeasts isolated from the intertidal zones. This study represents one of the most comprehensive surveys of marine yeasts in China to date and provides a better understanding of marine yeast diversity and distribution.
Factors contributing to emotional distress when caring for children with imperforate anus: a multisite cross-sectional study in China
Authors: Lv Meng , Feng-Fang Ya , Wang Yi , Zhen-Xu Hong
Published: December 2023

Background

Imperforate anus (IA) has a life-long impact on patients and their families. The caregivers of children with IA (CoCIA) might experience distress, which could be detrimental to them physically and mentally. However, there are limitations in the related studies. This study aimed to investigate the prevalence of IA and the associated factors contributing to the distress experienced by CoCIA.

Methods

A cross-sectional study was conducted in three tertiary children's hospitals from November 2018 to February 2019. Distress was assessed using the Chinese version of the Kessler Psychological Distress Scale, and possible determinants were assessed by the Caregiver Reaction Assessment, the Parent Stigma Scale, the Parent Perception of Uncertainty Scale, and the Social Support Scale. Demographic and clinical information was also collected. Multiple regression analysis was performed to explore the association between variables.

Results

Out of 229 CoCIA, 52.9% reported experiencing a high level of distress or above. The data analysis revealed that health problems associated with caregiving, stigma, uncertainty, social support, and children who underwent anal reconstruction surgery 1 year before or earlier could significantly predicate caregivers' distress, and these factors could explain 50.1% of the variance.

Conclusions

The majority of the caregivers of children with IA experience high levels of distress, particularly when their children undergo anal reconstruction surgery 1 year before or earlier. Additionally, health problems related to caregiving, stigma, uncertainty, and low social support could significantly predicate caregivers' distress. It is important for clinical staff to be aware of the prevalent situation of caregivers' distress and to make targeted interventions focused on addressing modifiable factors that should be carried out in family-based care.
Gender gap–Gender-specific development in the field of obstetrics and gynecology in Germany in the last 20 years
Authors: Hertling Stefan , Kaiser Mario , Schleußner Ekkehard , Loos Franziska Maria , Eckhardt Niklas , Graul Isabel
Published: December 2023

Background

Gender Gap refers to differences between men and women in terms of access to medical education, career development, and leadership positions in medical practice and research. Although women now make up most medical school graduates in many countries, they are often underrepresented in higher positions.

Objective

The aim of this study is therefore to analyze the gender-specific development in the field of Obstetrics and Gynecology in Germany over the past 20 years and to survey the current status quo.

Materials and methods

An narrative review was carried out on the development of female graduates of human medicine, the proportion of women in contract medical care and clinical care, as well as the gender-specific evaluation of obtaining a gynecological/obstetric additional qualification. habilitation figures in the field of Obstetrics and Gynecology were evaluated about gender distribution. All data were received from federal institutes.

Results

A total of 46.7% (n = 95,234) of all inpatient doctors were female. A total of 46.7% (n = 95,234) of the physicians in hospitals were female. A total of 46% (1,832/3,958) were the portion of females as assistant physicians, 39.8% (n = 45.551) as specialists, 35.3% (n = 18789) as senior physicians, 25.1% (n = 2394) as first senior physicians and 25% (n = 10) as chief physicians in hospital. A total of 64.6% (n = 3958) of the physicians in Obstetrics and Gynecology were female. A total of 46% (1,832/3,958) were the portion of females as assistant physicians, 64.6% (n = 3958) as specialists, 65.0% (n = 1919) as senior physicians, 26.4% (n = 207) first senior physicians and 25% (n = 10) as chief physicians in Obstetrics and Gynecology.

Discussion

The problem with the gender gap in medicine, does not seem to be access to teaching or starting a residency. But in the functions with increasing responsibility and management functions, e.g., as senior physicians, women are already rarely seen. In Obstetrics and Gynecology, too, there is a shortage of women in leading positions, despite the relatively high numbers, for example as senior physicians. Factors like maternity and establishing a family are points mentioned therefore, but also stereotypes seem to be considerable facts.

Conclusion

However, it is important to recognize the need for more women in higher positions in medicine and actively work to encourage more women to choose a career in medicine.
Predicting type 2 diabetes risk before and after solid organ transplantation using polygenic scores in a Danish cohort
Authors: dos Santos Quenia , Leung Preston , Thorball Christian W. , Ledergerber Bruno , Fellay Jacques , MacPherson Cameron R. , Hornum Mads , Terrones-Campos Cynthia , Rasmussen Allan , Gustafsson Finn , Perch Michael , Sørensen Søren S. , Ekenberg Christina , Lundgren Jens D. , Feldt‐Rasmussen Bo , Reekie Joanne
Published: December 2023

Type 2 diabetes mellitus (T2DM) can be multifactorial where both genetics and environmental factors play a role. We aimed to investigate the use of polygenic risk scores (PRS) in the prediction of pre-transplant T2DM and post-transplant diabetes mellitus (PTDM) among solid organ transplant (SOT) patients. Using non-genetic risk scores alone; and the combination with PRS, separate logistic regression models were built and compared using receiver operator curves. Patients were assessed pre-transplant and in three post-transplant periods: 0–45, 46–365 and >365 days. A higher PRS was significantly associated with increased odds of pre-transplant T2DM. However, no improvement was observed for pre-transplant T2DM prediction when comparing PRS combined with non-genetic risk scores to using non-genetic risk scores alone. This was also true for predictions of PTDM in all three post-transplant periods. This study demonstrated that polygenic risk was only associated with the risk of T2DM among SOT recipients prior to transplant and not for PTDM. Combining PRS with a clinical model of non-genetic risk scores did not significantly improve the predictive ability, indicating its limited clinical utility in identifying patients at high risk for T2DM before transplantation, suggesting that non-genetic or different genetic factors may contribute to PTDM.
Acute stress modulates hippocampal to entorhinal cortex communication
Authors: Nasretdinov Azat , Jappy David , Vazetdinova Alina , Valiullina-Rakhmatullina Fliza , Rozov Andrei
Published: December 2023

Feed-forward inhibition is vital in the transfer and processing of synaptic information within the hippocampal–entorhinal loop by controlling the strength and direction of excitation flow between different neuronal populations and individual neurons. While the cellular targets in the hippocampus that receive excitatory inputs from the entorhinal cortex have been well studied, and the role of feedforward inhibitory neurons has been attributed to neurogliafom cells, the cortical interneurons providing feed-forward control over receiving layer V in the entorhinal cortex remain unknown. We used sharp-wave ripple oscillations as a natural excitatory stimulus of the entorhinal cortex, driven by the hippocampus, to study the function of synaptic interactions between neurons in the deep layers of the entorhinal cortex. We discovered that CB1R-expressing interneurons in the deep layers of the entorhinal cortex constitute the major relay station that translates hippocampal excitation into efficient inhibition of cortical pyramidal cells. The impact of inhibition provided by these interneurons is under strong endocannabinoid control and can be drastically reduced either by enhanced activity of postsynaptic targets or by stress-induced elevation of cannabinoids.
A bidirectional Mendelian randomization study investigating the causal role between gut microbiota and insomnia
Authors: Yang Jie , Su Tengfei , Zhang Yating , Jia Menghan , Yin Xiang , Lang Yue , Cui Li
Published: December 2023

Background

It has emerged that disturbances of the gut microbiota (GM) are linked to insomnia. However, the causality of the observed associations remains uncertain.

Methods

We conducted a two-sample Mendelian randomization analysis based on genome-wide association study data to explore the possible causal link between GM and insomnia. The GM data were from the MiBioGen consortium, while the summary statistics of insomnia were obtained from the FinnGen consortium R9 release data. Cochran’s Q statistics were used to analyze instrumental variable heterogeneity.

Results

According to the inverse variance weighted estimates, the family Ruminococcaceae (odds ratio = 1.494, 95% confidence interval:1.004–2.223, p = 0.047) and the genus Lachnospiraceae (odds ratio = 1.726, 95% confidence interval: 1.191–2.501, p = 0.004) play a role in insomnia risk. In contrast, the genus Flavonifractor (odds ratio = 0.596, 95% confidence interval: 0.374–0.952, p = 0.030) and the genus Olsenella (odds ratio = 0.808, 95% confidence interval: 0.666–0.980, p = 0.031) tended to protect against insomnia. According to the reverse MR analysis, insomnia can also alter GM composition. Instrumental variables were neither heterogeneous nor horizontal pleiotropic.

Conclusion

In conclusion, our Mendelian randomization study provides evidence of a causal relationship between GM and insomnia. The identified GM may be promising gut biomarkers and new therapeutic targets for insomnia. This investigation also provides a foundation for future studies examining the influence of GM on sleep disorders beyond insomnia, with potential implications for redefining the mechanisms governing sleep regulation.
Percutaneous uniportal full-endoscopic surgery for treating symptomatic lumbar facet joint cysts under local anesthesia combined with monitored anesthesia care: a preliminary report of eight cases with at least 1 year follow-up
Authors: Tan Haining , Yu Lingjia , Li Xiang , Yang Yong , Zhu Bin
Published: December 2023

Background

Lumbar facet joint cysts (FJCs) are a relatively rare clinical pathology that can result in radiculopathy or neurogenic claudication. Various treatments such as percutaneous aspiration and surgery have been reported to have good clinical outcomes. However, few clinical studies have aimed to treat symptomatic lumbar FJCs by using uniportal full-endoscopic (UFE) surgery. This study aimed to investigate the preliminary clinical outcomes of UFE surgery for the treatment of lumbar FJCs under local anesthesia combined with monitored anesthesia care (MAC).

Methods

Eight patients (five males and three females) with symptomatic lumbar FJCs who underwent UFE surgery under local and MAC anesthesia were enrolled in this study between January 2018 and April 2022. The clinical characteristics, radiological features, operative information, visual analog scale (VAS) score, Oswestry disability index (ODI), and overall outcome rating based on the modified MacNab criteria were retrospectively analyzed.

Results

Of the eight patients, four underwent a transforaminal approach and four underwent an interlaminar approach. Postoperatively, the mean VAS score for leg pain decreased from 6.1 before surgery to 0.6 after surgery, and the ODI decreased from 74.5% to 14.7%. All patients were followed up for more than 1 year, and the good-to-excellent rate based on the modified MacNab criteria remained 100% at the last follow-up. No complications occurred during the follow-up period.

Conclusion

Lumbar FJCs can cause severe radiating leg pain and/or neurogenic claudication due to the dural sac compression and nerve roots. As an alternative treatment, UFE decompression under local and MAC anesthesia may provide effective clinical outcomes for symptomatic lumbar FJCs.
Abnormalities of cerebral blood flow and the regional brain function in Parkinson’s disease: a systematic review and multimodal neuroimaging meta-analysis
Authors: Xie Hao , Yang Yang , Sun Qian , Li Ze-Yang , Ni Min-Hua , Chen Zhu-Hong , Li Si-Ning , Dai Pan , Cui Yan-Yan , Cao Xin-Yu , Jiang Nan , Du Li-Juan , Yu Ying , Yan Lin-Feng , Cui Guang-Bin
Published: December 2023

Background

Parkinson’s disease (PD) is a neurodegenerative disease with high incidence rate. Resting state functional magnetic resonance imaging (rs-fMRI), as a widely used method for studying neurodegenerative diseases, has not yet been combined with two important indicators, amplitude low-frequency fluctuation (ALFF) and cerebral blood flow (CBF), for standardized analysis of PD.

Methods

In this study, we used seed-based d-mapping and permutation of subject images (SDM-PSI) software to investigate the changes in ALFF and CBF of PD patients. After obtaining the regions of PD with changes in ALFF or CBF, we conducted a multimodal analysis to identify brain regions where ALFF and CBF changed together or could not synchronize.

Results

The final study included 31 eligible trials with 37 data sets. The main analysis results showed that the ALFF of the left striatum and left anterior thalamic projection decreased in PD patients, while the CBF of the right superior frontal gyrus decreased. However, the results of multimodal analysis suggested that there were no statistically significant brain regions. In addition, the decrease of ALFF in the left striatum and the decrease of CBF in the right superior frontal gyrus was correlated with the decrease in clinical cognitive scores.

Conclusion

PD patients had a series of spontaneous brain activity abnormalities, mainly involving brain regions related to the striatum-thalamic-cortex circuit, and related to the clinical manifestations of PD. Among them, the left striatum and right superior frontal gyrus are more closely related to cognition.

Systematic review registration

https://www.crd.york.ac.uk/ PROSPERO (CRD42023390914).
Primary squamous cell carcinoma of the pancreas: an update on a rare neoplasm from the SEER database
Authors: Ford Jacob A. , Bhatt Arjun , Kim Rachel C. , Larkins Michael , Burke Aidan M.
Published: December 2023

Introduction

Pancreatic squamous cell carcinoma is a rare type of pancreatic cancer of ductal origin, composing an estimated 0.5 - 5% of pancreatic ductal malignancies. As a result, epidemiology, treatment options, and associated outcomes are poorly understood and understudied. Our aim was two-fold: to evaluate demographic trends and analyze overall survival (OS) associated with different treatment modalities for this rare malignancy.

Methods

Patients with pancreatic squamous cell carcinoma diagnosed between 1992 and 2019 were eligible and reviewed utilizing the Surveillance, Epidemiology, and End Results Registry (SEER) database. Data was analyzed using SPSS and python packages lifelines and pandas. Variables of interest included stage at diagnosis as well as the receipt of surgery, radiotherapy, and/or chemotherapy. Five-year OS curves were analyzed using Kaplan-Meier probability stratified by treatment modality.

Results

Of 342 cases of pancreatic squamous cell carcinoma, 170 (49.7%) were females and 172 (50.3%) were males. 72 (21.1%) of patients received radiotherapy, 123 (35.9%) patients received chemotherapy, and 47 (13.7%) received surgery. Patients who were diagnosed under the age of 50 had prolonged survival time compared to those diagnosed over the age of 50 (12 vs 8 months, respectively, p < 0.001). This trend was evident despite the lack of a significant association between age at diagnosis and presence of metastases (p = 0.524). The median OS was 3 months for the entire cohort and there was a significant difference in median survival time noted across treatment modalities: OS was prolonged in those receiving surgery compared to those receiving chemotherapy or radiotherapy alone (30 vs 2 months, respectively, (p<0.001)). Receipt of radiotherapy was not associated with a significant difference in OS compared to those who did not receive radiotherapy.

Conclusion

Pancreatic squamous cell carcinoma is a rare subtype of pancreatic cancer and typically portends a poor prognosis. As demonstrated by our study, surgery offers prolonged overall survival compared to other treatment modalities. Age at diagnosis and presence of metastatic disease are also important prognostic factors likely related to patients‘ ability to tolerate surgery or physician willingness to offer surgery. Given the importance of surgery on outcomes, it may be reasonable to offer it in the oligometastatic setting in patients who are otherwise a good candidate. Future research on larger cohorts is warranted to investigate the role that modality selection plays in overall survival rates in this understudied malignancy.
Does surgery affect systemic immune response? a perioperative analysis of TGF-β, IL-8 and CD45RO
Authors: Trumet Leah , Ries Jutta , Ivenz Niclas , Sobl Philip , Wehrhan Falk , Lutz Rainer , Kesting Marco , Weber Manuel
Published: December 2023

Background

The options of (neo-)adjuvant immunotherapy in addition to surgery in the treatment of oral squamous cell carcinoma (OSCC) are steadily increasing, but patients do not always respond to therapy as intended. The objectives of this study were to investigate the systemic perioperative course of the biomarkers CD45RO, TGF-β, and IL-8 in non-tumor-related minor and tumor-related major maxillofacial surgery and to perform association analyses with demographic and histomorphologic parameters. A deeper understanding of surgery-related changes in various of different immune biomarkers could help to better understand the immunologic consequences of surgery which could influence immunotherapeutic protocols.

Methods

Peripheral whole blood from 38 patients was analyzed by real-time quantitative polymerase chain reaction (RT-qPCR) at five different timepoints before and after maxillofacial surgery to detect changes in mRNA expression of the biomarkers TGF-β, IL-8 and CD45RO. All patients underwent general anesthesia to undergo either resection and free flap reconstruction for OSCC or minor maxillofacial surgery (controls). Statistical analysis was done using Mann-Whitney-U test, Wilcoxon test, and Spearman’s correlation.

Results

Compared to the preoperative expression, there was a significant postoperative downregulation of CD45RO, TGF-β and IL-8 until the 4th postoperative day (p ≤ 0.003) in OSCC patients. For TGF-β and IL-8, the reduction in expression was significant (p ≤ 0.004) compared to controls. By postoperative day 10, all analyzed parameters converged to baseline levels. Only CD45RO still showed a significant downregulation (p=0.024). Spearman analysis revealed a significant correlation between increased duration of surgery and perioperative reduction in peripheral blood expression of CD45RO, TGF-β and IL-8 (p ≤ 0.004). Perioperative changes in TGF-β and PD-L1 expression were shown to be not correlated. Preoperative TGF-β expression was significantly lower in patients with lymph node metastases (p=0.014).

Conclusion

With regard to the analyzed parameters, major oncologic head-and-neck surgery does not seem to have long-lasting systemic immunologic effects. Reduced CD45RO might be an expression of transient systemic immunosuppression in response to major surgery. The association of duration of surgery with expression changes of immunologic markers supports efforts to keep the duration of surgery as short as possible. As perioperative TGF-β and PD-L1 expression changes are not associated, these results support further investigation of a combined perioperative anti-PD-1 and anti-TGF-β immunotherapy.
Approach to multidrug resistant infections in pediatric transplant recipients
Authors: Dong Sara W. , Sharma Tanvi S. , Sue Paul K.
Published: December 2023

Introduction

There is increasing recognition of infections due to multidrug-resistant Gram negative (MDRGN) bacterial infections among children undergoing solid organ and hematopoietic cell transplantation, which may be associated with morbidity and mortality.

Methods

We present two vignettes that highlight the clinical challenges of evaluation, management, and prevention of MDRGN bacterial infections in children prior to and after transplantation. The goal of this discussion is to provide a framework to help develop an approach to evaluation and management of these infections.

Results

Source control remains the utmost priority in management of MDR infections and is paired with antibiotic selection guided by in vitro susceptibilities, adverse effect profiles, and clinical response. Identification and confirmation of resistance can be challenging and often requires additional testing for recognition of complex mechanisms. Current antimicrobial approaches to MDRGN infections include use of novel agents, prolonged infusion, and/or combination therapy. We also discuss preventative efforts including infection control, antimicrobial stewardship, targeted pre-emptive or prophylactic treatment, and decolonization.

Discussion

The impact of MDRGN infections on patient and graft survival highlights the need to optimize treatment and prevention strategies.