bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheumatoid Arthritis and Risk of Nontuberculous Mycobacterial Pulmonary Disease: A Nationwide Longitudinal Cohort Study
Authors: Yang Bumhee , Han Kyungdo , Jung Jin-Hyung , Jung Wonyoung , Kim Bo-Guen , Eun Yeonghee , Kim Hyungjin , Shin Dong Wook , Lee Hyun
Published: August 2024

Background
In this study, we aimed to evaluate the risk of incident nontuberculous mycobacteria pulmonary disease (NTM-PD) in subjects with rheumatoid arthritis (RA) versus age- and sex-matched controls, while focusing on the impact of RA serologic status on this association.
Methods
From the Korean National Health Insurance Service data from 2010 to 2017, we identified 60,315 participants aged ≥ 20 years with RA and 301,575 without RA who were age- and sex-matched 1:5. The participants were followed up from 1 year after RA diagnosis (or the corresponding index date for matched controls) to the date of NTM-PD diagnosis, censored date, or December 31, 2019, whichever occurred first.
Results
During a median 4.5 (interquartile range, 2.6–6.4)-year follow-up, NTM-PD occurred in 0.23% and 0.06% of the RA and matched cohort (incidence: 0.54 and 0.14 per 1,000 person-years), respectively. Compared to controls, participants with RA had a 3.11-fold (95% confidence interval [CI]: 2.50–3.88) higher risk of NTM-PD. In the subgroup analysis stratified by seropositivity, seropositive patients with RA had a 3.77-fold (95% CI: 3.00–4.73) higher risk of NTM-PD than controls whereas participants with seronegative RA did not have a significantly higher risk (adjusted hazard ratio: 1.18, 95% CI: 0.68–2.04). Stratified analyses showed a more prominent association of RA with NTM-PD in males, alcohol drinkers, and obese individuals (p < 0.05).
Conclusion
The risk of incident NTM-PD was approximately 3-fold higher in participants with RA than in matched controls, although the association was significant only for patients with seropositive RA.
Impact of mixing and shaking on mRNA-LNP drug product quality characteristics
Authors: Matthessen Roman , Pottelberge Robbe Van , Goffin Ben , De Winter Giel
Published: August 2024

Since the COVID-19 pandemic, the interest in RNA - lipid nanoparticle (LNP) based drug products has increased drastically. While one RNA-LNP drug product, Onpattro, was already on the market in 2018, high volume manufacturing was only initiated end of 2020 with the approval of the mRNA-LNP vaccines, Comirnaty and Spikevax. As such, deep product knowledge for RNA-LNPs is continuously increasing. In this article the effect of large-scale mixing and lab-scale shaking on mRNA-LNP drug product quality characteristics is investigated. It is shown that mixing and shaking can have a profound impact on both LNP size distribution and mRNA encapsulation, suggesting a direct correlation between both quality characteristics, and further supported by a proposed underlying mechanism. An in-depth investigation of different drug product (DP) presentations reveals a consistent effect of headspace volume and LNP content on the shaking stress sensitivity. Results reported in this study are of utter importance for both small- and large-scale manufacturers but also for care givers and patients using these products.
Impact of Surgical Revascularization on Regression of Enlarged Perivascular Spaces in Adult Moyamoya Disease
Authors: Yamamoto Shusuke , Akai Takuya , Kashiwazaki Daina , Maruyama Kunitaka , Hori Emiko , Akioka Naoki , Noguchi Kyo , Kuroda Satoshi
Published: August 2024

Objective
Previous studies have suggested that enlarged perivascular spaces (EPVSs) are potential radiological markers of cerebral ischemia in moyamoya disease (MMD). However, serial changes in EPVSs after surgical revascularization have not yet been clarified. In the present study, we evaluated the change of EPVSs after surgical revascularization in adult patients with MMD.
Methods
This was a single-center study. We counted the EPVSs in the basal ganglia (BG) and centrum semiovale (CSO) in each hemisphere on T2-weighted MRI performed upon admission. EPVSs were also quantified three months and two years after combined bypass surgery in surgically treated patients and compared with the number of EPVSs before surgery. We performed multivariate logistic regression analysis to identify the clinical and radiological factors associated with the number of EPVSs.
Results
This study included 120 hemispheres of 65 adults with MMD. Older age (P = 0.04) and hypertension (P = 0.04) were significantly associated with a larger baseline number of EPVSs in the BG. Older age (P < 0.01), posterior cerebral artery (PCA) involvement (P < 0.01), and cerebral blood flow (CBF) impairment (P = 0.02) were significantly associated with a large number of EPVSs in the CSO. The number of EPVSs only in the CSO markedly decreased at three months and two years after surgery compared with that before surgery (P < 0.01).
Conclusions
The number of EPVSs in the CSO was closely associated with age, PCA involvement, and CBF impairment in adult patients with MMD, which remarkably regressed after surgical revascularization. EPVSs are reversible radiological markers reflecting impaired cerebral hemodynamics in adult patients with MMD.
Comprehensive Assessment of Cardiovascular Risk Factors among Long-Haul Truck Drivers in South Brazil and its Impact on 3-year follow-up of Cardiovascular Events
Authors: Sangaleti Carine Teles , Brügge Joelson , Santos Jordana Canestraro , Gonçalves Wyndson Ribeiro , Trincaus Maria Regiane , Baratieri Tatiane , Lentsck Maicon Henrique , Pelazza Bruno Bordin , Silveira João Vicente , Irigoyen Maria Claudia , Consolim-Colombo Fernanda
Published: August 2024

Background
Cardiovascular diseases are a significant concern among truck drivers due to their profession's nature, involving long hours of sedentary work and exposure to various risk factors. Prevalence of risk factors associated with cardiovascular health in long-haul truck drivers and their impact on incidence of cardiovascular events are less studied.
Methods
A prospective cohort study was conducted among long-haul truck drivers traveling on BR 277, a major federal highway in Brazil. Truck drivers aged 18 years and above were recruited from four strategically selected locations along the route and were sequentially invited to participate while waiting to load and unload cargo. Clinical evaluations, including socio-demographic information, occupational factors, chronic disease history, medication use, lifestyle habits, and screening for obstructive sleep apnea, were performed. Physical measurements, blood glucose levels, lipid profile, ultrasensitive protein C-reactive, ankle-brachial index, left ventricular hypertrophy and heart rate variability were assessed. Participants were followed up for three years to detect the incidence of major cardiovascular events.
Results
The study revealed that obesity, diabetes and smoking were highly prevalent among long-haul truck drivers. A significant proportion of drivers met the criteria for metabolic syndrome and had a high-risk score for cardiovascular events. Moreover, subclinical inflammation, vascular stiffness, left ventricular overload and increased cardiac sympathetic modulation were also highly prevalent. The presence of multiple risk factors and medical conditions was associated with an increased likelihood of a major cardiovascular event.
Conclusion
The findings emphasize the need for targeted interventions to improve the cardiovascular health of truck drivers and promote roadway safety.
Modification on PBS using epoxy-functionalized core-shell starch particles
Authors: Liu Qiang , Ren Liang , Li Xinyang , Sui Xinyan , Shen Yunda , Wang Y.B. , Li Y.Q , Zhang Mingyao
Published: August 2024

Polybutylene succinate (PBS) is an aliphatic linear polyester that is known for its excellent biodegradability and biocompatibility, making it one of the most promising application polymers. However, its disadvantages of poor toughness, low thermostability, and high crystallinity limit its large-scale commercial applications. In this article, a novel epoxy-functionalized core-shell starch particle (CSP-GMA) is successfully synthesized by virtue of soap-free emulsion polymerization, which consists of a "hard" starch (St) core and a "soft" ethyl acrylate (EA) shell grafted with glycidyl methacrylate (GMA). A binary blend of biodegradable polymers is prepared via a melt blend process with CSP-GMA as a core-shell particle modifier and PBS as a polymer matrix. The mechanical properties, thermal behavior, crystallization properties, stability and microscopic morphology of PBS/CSP-GMA blends are thoroughly studied. The incorporation of 20 wt% CSP-GMA into the PBS blend promotes an increase in the impact strength by 55% and the elongation at break by 173% higher than that of pure PBS respectively, which indicates that our work proposes an efficient strategy for fabricating PBS blends with good comprehensive properties and low cost. The DSC testing shows that the crystallinity of PBS blend is reduced in comparison to PBS, while the crystallization temperature is also decreased, confirming that CSP-GMA can facilitate the crystallization of PBS. The SEM observation reveals that owing to the compatibility arising between two phases interface due to the presence of epoxy group on core-shell starch particle surface, CSP-GMA is better dispersed in the PBS matrix, resulting in the improvement for performance of PBS blends.
Concurrent Acute Cystitis, Pancolitis, and Tubo-Ovarian Abscess Following Laparoscopic Ovarian Cystectomy: A Case Report
Authors: AlHabil Yazan , Owda Anas N. , Zaid Basil J. , Hameedi Seema , Saadeddin Liza , Awad Mohammad A.A.
Published: August 2024

Background
Inadequate surgical interventions can lead to serious complications such as tubo-ovarian abscesses in the upper female genital system, often resulting from untreated pelvic inflammatory disease. Pelvic inflammatory disease, caused by infections like Chlamydia trachomatis and Neisseria gonorrhoeae, leads to scarring and adhesions in the reproductive organs, with common risk factors including intrauterine device use and multiple sexual partners. Pelvic inflammatory disease primarily affects sexually active young women and can manifest with varied symptoms, potentially leading to complications like ectopic pregnancy, infertility, and chronic pelvic pain if untreated.
Case presentation
This case report presents a unique scenario involving a 17-year-old sexually inactive female who experienced concurrent tubo-ovarian abscess, acute cystitis, and pancolitis following laparoscopic ovarian cystectomy. Pelvic inflammatory disease and its complications are well-documented, but the simultaneous occurrence of acute cystitis and pancolitis in this context is unprecedented in the medical literature. The patient’s presentation, clinical course, and management are detailed, highlighting the importance of considering diverse and severe complications in individuals with a history of gynecological surgeries.
Conclusions
Our case report highlights the need for healthcare professionals to remain vigilant for atypical presentations of gynecological complications and emphasizes the value of interdisciplinary collaboration for optimal patient care. We encourage further research and awareness to enhance understanding and recognition of complex clinical scenarios associated with gynecological procedures.
Alcoholic Drinking Practices During the Late Neolithic Longshan Culture in the Central Plains, North China
Authors: Li Lina , Liu Chunyang , Cao Yanpeng , Zhu Shuzheng , Wei Jiyin , Liu Li
Published: August 2024

Neolithic China witnessed a major sociopolitical transition during the third millennium BC in the Yellow River valley. One notable development was the exchange and dispersal of objects associated with ritual activities and ideology at an interregional level. This is exemplified by diverse pottery types linked to fermented beverages discovered at many walled regional centers of the late Longshan culture. To delve into the drinking practices intertwined with ritualistic activities, we undertook a comprehensive examination of microfossil remains (starch, phytolith, and fungi) on pottery vessels excavated from the Pingliangtai site, a walled settlement in eastern Henan (ca. 2300 − 2000 cal. BC). Our analyses revealed the functions of diverse vessel types, demonstrating that most vessel forms were associated with the production and consumption of fermented alcoholic beverages. The fermentation method involved the use of a qu starter compound containing mainly Monascus mold, yeast, and cereals to brew cereal-based beer. The drinking rituals involved several sequential steps, from heating and pouring, to serving individualized drinks to the living and deities. This form of ritual feasting emphasized individual status, differing sharply from the group drinking tradition of the previous local Yangshao culture. This practice originated in the east coast region and dispersed to the Central Plains as a component of the regional interaction sphere. This research provides fresh insights into the functionality of pottery and the significance of alcohol-related rituals as societies evolved towards greater complexity and stratification, setting the stage for the emergence of early dynastic states in the Central Plains.
Spectrum of Morphological Changes in the Placenta of Women with Preeclampsia/Eclampsia and Correlation with Neonatal Morbidity
Authors: Oluwasegun Folaranmi Olaleke , Olayinka Buhari Mikhail , Kazeem Ibrahim Olatunde , Muibat Ibiyeye Kehinde , Olayinka Fodeke Isreal , Salman Isa Abdulazeez , Lukman Abdulkadir
Published: August 2024

Background
Preeclampsia/eclampsia is a leading cause of maternal and perinatal mortality; the prevailing theory is that it is a consequence of disordered placentation with the resultant underperfusion of the placenta triggering release of cytokines and vascular factors which cause widespread endothelial damage. The placental changes are manifested as vascular and villous abnormalities with consequences in the developing foetus. The objective of this study was to compare the gross and microscopic changes in the placentas of women with preeclampsia/eclampsia and healthy mothers.
Methods
146 pregnant women were recruited; 73 were normotensive (control group) while 73 were diagnosed with preeclampsia/eclampsia (study group). The macroscopic and microscopic placental changes in the two groups were further examined.
Results
34% of the women in the study group had mild-moderate preeclampsia, 44% had severe preeclampsia and 22% had eclampsia. The placental weights were lower in the study group than the controls (556.82 grams ± 169.72 vs. 649.93 grams ± 116.38, p < 0.001). The major pathologic lesions with strong associations with preeclampsia/eclampsia in this study were decidual vasculopathy, infarction, increased syncytial knots (Tenney-Parker changes), accelerated villi maturity, stromal fibrosis and microcalcifications (p < 0.001). There was also a strong association between disease severity and Apgar scores in the 1st minute. The study group had 11% neonatal mortality.
Conclusion
There were distinct microscopic changes consistent with maternal vascular malperfusion changes in the placentas of mothers with preeclampsia/eclampsia and demonstrable neonatal morbidity depicted by high incidence of preterm birth and low birth weights.
Effectiveness of Salivary Sampling for the Detection and Quantification of Aggregatibacter actinomycetemcomitans and its JP2 Genotype in Periodontitis Patients
Authors: Khzam Nabil , Kujan Omar , Haubek Dorte , Arslan Aysen , Johansson Anders , Oscarsson Jan , Razooqi Zeinab , Miranda Leticia Algarves
Published: August 2024

Aim
The objective of this study was to evaluate the use of unstimulated saliva in detecting Aggregatibacter actinomycetemcomitans and its JP2 genotype, and to compare the saliva, subgingival and mucosa membrane occurrence of this periopathogen in patients diagnosed with advanced periodontitis.
Materials and Methods
One hundred and fifty-six patients (mean age: 54.03 ± 03 years) with advanced forms of periodontitis (stage-III/IV) were sampled. Unstimulated saliva, buccal cheek mucosa and pooled subgingival plaque samples were collected. Identification of A. actinomycetemcomitans and its JP2 genotype was performed using polymerase chain reaction. A descriptive analysis and chi-square test evaluation were performed.
Results
A. actinomycetemcomitans was isolated from 32% of the subjects. A total of 468 samples were obtained, 156 from unstimulated saliva, buccal cheek mucosa surfaces, and pooled subgingival plaque samples. A. actinomycetemcomitans was isolated from 23.07% of unstimulated saliva samples, 19.87% of buccal cheek swab samples, and 17.30% of subgingival samples. The total 468 samples were negative for the JP2 genotype of A. actinomycetemcomitans in this cohort of patients.
Conclusions
These results suggest that in advanced periodontitis, unstimulated saliva is representative of pooled subgingival plaque/buccal cheek samples and its use is adequate in the oral detection of A. actinomycetemcomitans in a cohort of patients with stage-III and IV periodontitis.
Clinical Relevance:
Data related to the oral colonization of periopthogens can be crucial to the diagnosis, vaccination, maintenance, and treatment of advanced forms of periodontitis. A. actinomycetemcomitans is a key periopathogen implicated in the pathogenesis of periodontitis. In the presence of inflammation, advanced bone loss and deep periodontal pocketing, saliva samples seem to be an effective and conservative alternative to other methods of sampling in detecting the presence of A. actinomycetemcomitans.
Neutrophile-to-Ferritin Ratio: A Potential Tool for Identifying Hematological Causes of Fever of Unknown Origin
Authors: Öztop Hikmet , Hunutlu Fazıl Çağrı
Published: August 2024

Despite advancements in diagnostic modalities, delineating the etiology of Fever of Unknown Origin (FUO) remains a significant challenge for clinicians. Notably, cases with hematological malignancies often have a poor prognosis due to delayed diagnosis. This study investigated the potential of readily obtainable laboratory markers to differentiate hematological causes from other etiologies during the early stages of FUO. A retrospective analysis was conducted on the medical records of 100 patients who fulfilled the modified FUO criteria between January 2010 and April 2023. Hematological etiologies were identified in 26 of the 100 patients. Peripheral blood neutrophil, lymphocyte, platelet counts, and the systemic immune inflammation (SII) index, were significantly lower in the hematological group compared to the non-hematological group. Conversely, serum ferritin levels were demonstrably higher in the hematological group. ROC analysis identified a neutrophil-to-ferritin ratio (NFR) cutoff value of <8.53 as optimal for predicting hematological etiology. Subsequent multivariate analysis demonstrated that the NFR was the sole independent predictor of hematological etiology (p=0.013).This study proposes a novel approach for early diagnosis of a potentially life-threatening subset of FUO patients. The NFR presents as an inexpensive and readily available marker for predicting hematological etiology in FUO cases.
Mediated Factors Associated with Metabolic Health among Obese Adolescents
Authors: Lev Hadar , Sternfeld Ron , Lazmi Rotem , Ohayon Rivka , Dudi Rivka , Brener Avivit , Sagi Shira Zelber , Cohen Shlomi , Lubetzky Ronit , Gepner Yftach
Published: August 2024

background
Obesity is highly associated with metabolic risk. Yet, subset of individuals maintains metabolic health despite obesity. This study aims to identify key factors potentially associated with a metabolically healthy obese (MHO) status in adolescents.
Methods
Cross-sectional study included 31 adolescents with obesity [median age:14 y, median body mass index (BMI) Z-score:2.58] categorized into MHO (n = 16) and metabolically unhealthy obese (MUO, n = 15), based on the presence of at least one metabolic syndrome criteria. A comprehensive evaluation included assessments of abdominal adipose tissue distribution, physiological performance, blood markers, prenatal and sociodemographic characteristics, and dietary habits.
Results
Compared to the MUO, MHO individuals exhibited significantly lower hepatic fat content (HFC, 14.0 ± 9.8% vs. 6.1 ± 3.2%, p = 0.01), liver enzymes (p = 0.004), and experienced a lower risk of complications during birth (p = 0.03). MHO participants consumed fewer total calories (p = 0.04), animal protein (p = 0.005), red meat (p = 0.02), sodium (p = 0.027), palmitic acid (p = 0.04), stearic acid (p = 0.029), arachidonic acid (p = 0.005) and calories from ultra-processed grains (p = 0.049) compared to their MUO counterparts.
Conclusion
HFC emerges as a primary mediator of metabolic health, suggesting its potential as a valuable tool for early risk assessment in adolescents with obesity. In addition, dietary composition exerts a notable influence on metabolic health during early stages of life.
Trial registration:
NCT06032312.
Correlation between the upregulation of circulating FABP4 and prognosis of joint replacement in patients with osteoarthritis
Authors: Lin Silong , Zhang Xianqi , Xia Xishang , Xu Guishui , Pan Hong
Published: August 2024

Objective
The aim of this study was to investigate the potential significance of FABP4 in predicting prognosis following total hip arthroplasty (THA) or total knee arthroplasty (TKA).
Method
This study selected patients undergoing THA/TKA aged >18 years who were hospitalized in Anqing First People’s Hospital of Anhui Medical University. A total of 400 patients and 100 healthy subjects were finally included. Based on the results of 90-day follow-up data were included in the complication group, otherwise, they were classified as the no complications group. The demographic and clinical data of the two groups were compared, and the clinical characteristics and risk factors of local complications within 90 days of TKA/THA were evaluated.
Results
FABP4 concentration (odds ratio (OR)=1.521 95% confidence interval (CI)=1.190–1.944, P =0.001), ASA class (OR=0.064 95% CI=0.005–0.811, P =0.034) and estimated intraoperative blood loss (OR=1.070, 95% CI=1.008–1.135, P=0.027) were found to be predictors of 90-Day Local Complications.
Conclusions
Higher FABP4 concentration is very common in patients with adverse events occurring locally within the 90 days of TKA/THA and the prevalence of adverse events occurring locally within the 90 days of TKA/THA was higher in patients combined with higher FABP4 concentration, higher ASA class or EIBL. FABP4 concentration, ASA class and EIBL are risk factors for the development of adverse events occurring locally within the 90 days of TKA/THA, but validation in larger sample studies is still needed.
The HMGCS2-associated hub genes as promising targets for ulcerative colitis patients
Authors: Yan Jing , Guo Mingxiao , Nie Jiao , Zhang Jinming , Shao Shuai , Lu Lin , Du Chao
Published: August 2024

Ulcerative colitis (UC) is a chronic inflammatory disease of colon with unclear pathogenesis. Studies have shown that 3-hydroxy-3-methylglutaryl-CoAsynthase 2 (HMGCS2) may play an important role in inflammation, but its role in UC especially those in remission phase has not been investigated. The transcriptional profile of normal and UC patients was extracted from the Gene Expression Omnibus database (GEO), and the results revealed that HMGCS2 was significantly downregulated in both inflamed and remission samples of UC patients as compared to controls. We generated Caco-2 and HT-29 cells lacking HMGCS2 by lentivirus shRNA vectors. The analysis of RNA-seq data of the cells showed that knockdown of HMGCS2 significantly downregulated fatty acid (FA)-metabolism pathway by KEGG analysis, and HMGCS2-associated FA-metabolism-related hub genes (HubHMGCS2−FA) were retrieved. Further validation in GEO datasets showed that the HubHMGCS2−FA panel were significantly correlated with FA-metabolism pathway. The risk score modelHMGCS2−FA was then established, and its prediction effect in distinguishing UC patients in active as well as remission phase from normal controls is good (AUC:0.85-1). Therefore, HMGCS2 plays an important role in patients with UC in not only active but also remission phase and may serve as promising biomarkers and therapeutic targets in the future.
Poor sleep quality, cardiometabolic risk factors and physical activity, among paramedical staff in Douala,Cameroon
Authors: Ndongo Jerson Mekoulou , Lele Elysée Claude Bika , Njoya Emmanuel Guilou Njimongna , Manga Léon Jules Owona , Tabunguia Ange Ulrich LeRoi , Mbian William Mbang , Guessogo William Richard , Ahmadou . , Foko Pradel Loick Kojom , Bilog Nadine Carole , Guyot Jessica , Ayina Clarisse Noel Ayina , Mandengue Samuel Honoré , Bongue Bienvenu , Ndemba Peguy Brice Assomo
Published: August 2024

Background: Paramedical personnel used to night shift predisposing them to poor sleep (PS) and its health consequences. Their work requests an important physical demand associated to physical activity (PA).
Objectives: This study aimed at determining prevalence of PS, its association with cardiometabolic risk factors (CFRs), and PA among paramedical staff.
Methods: A cross-sectional study was conducted among nurses and medical-health technicians (MTH) in reference hospitals of Douala, Cameroon. PS and PA were assessed with standard questionnaires. CFRs included overweight, obesity, waist circumference (WC), Waist-to-height ratio (WhtR), Waist-to-hip ratios (WhR), hyperglycemia and sedentary behaviors.
Results: A total of 331 participants were enrolled, including 53.4% nurses. The overall prevalence of PS was 68.3% (95%CI:63.01-73.01). PS was higher in women (73.5%,95%CI:67.3-78.8, p=0.04) and nurses (58.8%; 95%CI: 52.3-65.1, p=0.01). Among participants with PS, more than half more affected were overweight and obese (39.9% and 34% respectively) with abnormal WC (55.8%), abnormal WhR (78.2%), and sedentary behaviors (65.5%). However, 28.4% had abnormal WhtR, 40.6% had hyperglycemia, and 47.7% had low moderate level of PA. Among nurses with poor sleep, ponderal status appeared more normal among those with moderate PA (64.7%, p=0.009). Nurses with low and high levels were more overweight and obese (48.5%, p=0.009; 15.2%, p=0.009 respectively). Still among paramedical staff with poor sleep, it was noted that nurses with low levels of activity had more abnormal WhR (50.9%, p=0.0008), while WhR was more abnormal among nurses with moderate (51.9%, p=0.0008) and high (29.6%, p=0.0008) levels of PA. MTH were less in risk to suffer from PS quality (OR: 0.48.95%CI: 0.29-0.80; p= 0.004) but in risk of short sleep duration (OR= 2.4; 95%CI: 1.45-3.8; p=0.0006). Paramedical personnel with work seniority more than 5 years were at risk of PS (OR= 1.67, 95%CI :1.04-2.70, p=0.03). Eventhose aged under 30 years were protected against sleep duration (OR=0.50, 95%CI: 0.31-0.94; p=0.03). No association was found between PA level and PS and cardiometabolic risk cluster factors.
Conclusion: PS is a reality with alarming prevalence among paramedical staff, with high value in females and nurses. No associations were found with CRFs and PA.
Evaluation of High-Dose Chemotherapy and Autologous Stem Cell Transplant in Salvage Treatment of Extragonadal Germ Cell Tumours
Authors: TOPAL Alper , ERTURK Ismail , KOSEOGLU Caglar , DUMLUDAG Aysegul , KUZU Ömer Faruk , KARADURMUS Berkan , TUZUN Esmanur KAPLAN , ATACAN Huseyin , MAMMADZADA Nurlan , YILDIRIM Gizem , ACAR Ramazan , KARADURMUS Nuri
Published: August 2024

Background
We aimed to evaluate the survival analysis, response rates and factors affecting response to high-dose chemotherapy (HDCT) and autologous stem cell transplantation (OSCT) in patients with relapsed/refractory extragonadal germ cell tumours.
Methods
The study included patients diagnosed with extragonadal germ cell tumors who underwent HDCT + ASCT between November 2016 and January 2023 at Gülhane Training and Research Hospital. Clinical characteristics and follow-up data were retrospectively analyzed from patient records and the hospital electronic system. Patients under 18 years of age and those without medical records were excluded. Patient characteristics, post-HDCT progression-free survival (PFS), overall survival (OS) data, factors affecting survival, and treatment-related mortality (TRM) were examined. The relationship between clinical factors and OS/PFS was analyzed.
Results
Twenty-five patients were included. After HDCT + ASCT, complete response (CR) was observed in 6 patients (24%), partial response (PR) in 15 patients (60%) and progressive disease (PD) in 4 patients (16%). TRM was observed in 1 (4%) patient. Median follow-up was 25.4 months. Median PFS and OS after HDCT + ASCT were calculated to be 4.9 months and 12.2 months, respectively.
Conclusions
Salvage HDCT + ASCT is an option in the treatment of extragonadal germ cell tumours, offering the potential for prolonged survival and cure.
A higher shadow ratio of the living environment on the remote sensing digital image is possibly protective for adolescent myopia
Authors: Zhang Hanze , Zhang Ningyuan , Li Zeyu , Yang Jingyuan , Zhu Yucheng , Liu Zhao , Chen Li
Published: August 2024

This study aims to assess how the construction patterns within residential communities influence the adolescent myopia using cluster sampling. In a private high school from a megacity in mid-west China, a questionnaire gathered data on the 10th-grade students' level of myopia, home address, and some potential confounding factors. Additionally, satellite digital images were utilized to calculate the proportion of shadow area (PSA) and the proportion of greenness area (PGA) within a 500m×500m area centered on each student's home address. Correlations between myopia levels and PSA, along with other variables, were analyzed. The prevalence of mild, moderate, and high myopia were 39.2%, 32.5%, and 8.3%, respectively. A negative correlation was observed between myopia levels and PSA, albeit marginally significant (r=-0.189*, P = 0.05). Upon dividing the sample into higher and lower PSA groups using a cut-off point of 20%, a significant difference in myopia levels was evident (χ2 = 8.361, P = 0.038), while other confounding factors remained comparable. In conclusion, high-rise apartment constructions, which often cast more shadows on digital satellite maps, may not exacerbate myopia progression. Instead, they could potentially serve as a protective factor against adolescent myopia in densely populated megacities, as they allow for more ground space allocation.
Computational identification of PDL1 inhibitors and their cytotoxic effects with silver and gold nanoparticles
Authors: Ali Syed Hammad , Ali Hiba , Aziz Mohammad Azhar
Published: August 2024

Background
Immunotherapy is a promising treatment for cancer that aims to boost the immune system's response to cancer cells. This can be achieved by blocking PD1(Programmed cell death 1)/PDL1(Programmed death-ligand 1), which activates T cells. In this work, the aim was to find high-affinity drugs against PDL1 using computational tools and conjugate them with nanoparticles. The cytotoxic activity of the drug-conjugated nanoparticles was then tested.
Methods
The screening of one hundred thousand drugs from the ZINC database and FDA-approved drugs was done computationally. The physicochemical properties and toxicity of the drugs were analyzed using SwissADME and ProTox-II respectively. AgNPs and AuNPs were synthesized using extracts of Catharanthus roseus flowers and Juglans regia shells, respectively. The characterization of AgNPs and AuNPs was performed using UV-Vis spectroscopy, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR). Their conjugation with the drugs Irinotecan, Imatinib, and Methotrexate was also confirmed using UV-Vis, FTIR, and Dynamic light scattering (DLS).
Results
The top screened drugs were ZINC1098661 and three FDA-approved drugs (Irinotecan, Imatinib, and Methotrexate). Docking studies revealed that Irinotecan had the highest binding affinity towards PDL1 when conjugated with silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs). The Irinotecan-PDL1 complex was confirmed as the most stable through molecular dynamics simulations. The result of methylthiazol tetrazolium (MTT) assay showed that conjugated AgNPs and AuNPs with Irinotecan had a high toxic effect on A549 cancer cell line than Imatinib conjugated with AgNPs and AuNPs.
Conclusion:
This study provides a promising avenue for further investigation and development of nanoparticle-drug conjugates as a potential cancer immunotherapy strategy.
Evaluating the acceptability of water, sanitation and hygiene interventions, with the case of a portable hygiene intervention (The Spatap) in three Fijian communities, a mixed-methods study.
Authors: Hosking Rose , Richardson Alice , Gray Darren , Hales Simon , Batikawai Suliasi Mekerusa , Lal Aparna
Published: August 2024

Background The implementation of water, sanitation, and hygiene (WASH) interventions in low-resource communities can improve health outcomes. Acceptability evaluations can increase the uptake and sustainability of WASH interventions, but there is limited literature on how to conduct them. We developed a theory-based acceptability evaluation using mixed-methods and applied it to conduct the first acceptability evaluation the Spatap, a portable, water-saving hygiene intervention, in three Fijian communities. Methods We conducted a mixed-methods study in three Fijian communities aiming to evaluate the acceptability of the Spatap. We conducted a baseline household survey (n = 207) on WASH access, environmental conditions, and acceptability. We asked seven questions on acceptability aligned with Sekhon et al. (2017)’s Theoretical Framework of Acceptability (TFA) for healthcare interventions component constructs. We calculated a total acceptability score and modelled it against sociodemographic predictors using multiple linear modelling in R. In December 2022, we conducted three focus group discussions (FGD) with community members (n = 22) on experienced acceptability. We inductively and deductively coded transcripts using NVIVO (ver 12) and analysed the data using thematic analysis. Results Baseline acceptability scores out of 35 were high (med 29, min 18, Q1: 28, Q3: 35, max 35) and few barriers were reported, indicating the Spatap was initially accepted by the communities. Burden and cost scored lower than the other component constructs. Sociodemographic factors (age, gender, education, employment) did not significantly affect acceptability scores. The Spataps were still in use and acceptable five months later. Overall, convenient location and timesaving promoted acceptance of the Spatap. In some larger households, time spent re-filling the bottle was as a burden, but the costs of larger bottles were prohibitive. Challenging environmental conditions (water insecurity and climate events) promoted acceptance of the Spatap as a water saving device, and it fit with existing adaptations to water insecurity. Conclusions The TFA was useful to frame the acceptability evaluation, but qualitative methods are more appropriate than the score-based method. For future Spatap implementations in low-resource communities, the accessibility of bottles, local-language instruction, provision of Spataps per head rather than household and water availability should be considered. Promotion of the convenient location and ease of use for children may increase initial acceptance. Further research on the acceptability of the Spatap in other contexts, and its efficacy to reduce infectious disease is required.
Comparing the Impact of Different Motion Modes on Dentin Cracking: A Meta-Analysis
Authors: Du Shasha , Shi Dongye , Cui Weiwei , Liu Yingqi , Li Lei , Lu Lixian , Chen Jingyi , Zheng Xiangming
Published: August 2024

Objective: We aim to compare the effects of different exercise modes of single file on dentin cracks.
Methods: A literature search was conducted in PubMed and other databases to conduct meta-analysis on randomized controlled trials published before March 22, 2024, and subgroup analysis was performed on WaveOne and Reciproc single file. After preparing the root canal of a single file with reciprocating and rotational motion, the dentin cracks were evaluated under a stereomicroscope on the 3mm, 6mm, and 9mm sections of the root apex.
Results: A literature search yielded 264 records, and 8 randomized clinical trials were finally included in this study. We found that both reciprocating and rotating single files may cause dentin cracks, but there was no significant difference in the incidence of dentin cracks (RR=1.03; 95% CL, 0.89-1.18; P=0.72).
HTR2A DNA Methylation as a Diagnostic Biomarker for Rheumatoid Arthritis: A Validation Study Using Targeted Sequencing and Machine Learning Algorithms
Authors: Zhao Jianan , He Binghen , Li Yunshen , Shan Yu , Wei Kai , Jiang Ping , Shi Yiming , Chang Cen , Zheng Yixin , Zhao Fuyu , Yang Guizhen , Li Qianqian , Zhou Mi , Guo Shicheng , Lv Liangjing , Zheng Yuejuan , Jiao Juan , Wang Rongsheng
Published: August 2024

Objectives
To validate the potential of HTR2A cg15692052 DNA methylation as a diagnostic biomarker for RA and its subtypes.
Methods
MethylTarget™ targeted region methylation sequencing technology was employed to analyze the DNA methylation levels of HTR2A cg15692052 in RA, HC, ankylosing spondylitis (AS), psoriatic arthritis (PSA), gout, systemic lupus erythematosus (SLE), dermatomyositis (DM), and primary Sjögren's syndrome (SS) patients within the region of chr13:46898190 ~ chr13:46897976, spanning a total of 215bp. Logistic regression, LASSO, random forests, and Xgboost algorithms were used in R software to screen for significant variables, construct models, visualize results, and perform statistical analysis. Multiple imputation was applied to handle missing values, and Spearman's method was used to calculate correlations.
Results
Compared to the HC group, RA patients and four serological subtypes of RA (RF-negative RA, RF/CCP double-positive, RF/CCP double-negative, and CCP-negative RA) exhibited significantly higher levels of HTR2A cg15692052 methylation at positions 75/125/143/149/163/185/187 and in average methylation (P < 0.05). Methylation levels at all positions and average methylation in RA patients and its four serological subtypes were significantly positively correlated with erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) (P < 0.05). HTR2A cg15692052 displayed various haplotypes with differential proportions, among which the CCCCCCC haplotype was significantly elevated in RA (P < 0.05) and positively correlated with ESR and CRP (r = 0.13 and 0.21, P = 0.001 and P < 0.001). Conversely, the TTTTTTT haplotype was significantly decreased in RA (P < 0.05) and negatively correlated with CRP (r=-0.15, P = 0.002). Predictive models constructed using different machine learning algorithms, incorporating methylation levels of HTR2A cg15692052 at various positions combined with different clinical features, were able to significantly distinguish RA patients with AUCs ranging from 0.672 to 0.757, RF/CCP double-negative patients with AUCs from 0.825 to 0.966, RF/CCP double-positive RA patients with AUCs from 0.714 to 0.846, and RF-negative RA patients with AUCs from 0.928 to 0.932.
Conclusions
The DNA methylation level of HTR2A cg15692052 is associated with RA and can serve as a diagnostic biomarker for RA and its subtypes.
Barriers and Facilitators to Physical Activity, Screen time and Sleep in 3- to 4-year-olds living in Scotland
Authors: Dalziell Andrew , Janssen Xanne , Muirhead Fiona
Published: August 2024

Background
This study evaluated the barriers and facilitators that families experience in adhering to the 24-Hour Movement behaviours guidelines as outlined by World Health Organisation (WHO).
Methods
Twenty-four families from low- and high-income families living in Scotland were recruited. This cross-sectional study used a mixed-methods approach which included: 1) an online questionnaire for parents, 2) objectively measured physical activity (PA), sedentary behaviour and sleep, 3) online focus groups with parents. For the quantitative part, children wore an Actigraph (GT3X+) accelerometer to measure physical activity, sedentary behaviour, and sleep. Parents/guardians kept an activity diary outlining when their child had to remove the device (i.e., showering, bathing, swimming) and record the child’s screen time each day. Once the data had been analysed, a unique activity profile chart was sent to each family illustrating their child’s 24-hour movement behaviours (i.e., time spent active, time spent sedentary and on screens, time spent sleeping). The activity profile provided a day-by-day output as well as a weekly average for each of the 24-hour movement behaviours. Qualitative data was collected using the Asynchronous Remote Communities method (ARC) via private groups on a social media platform.
Results
The results showed most of the children in this sample adhere to the sleep and MVPA guidelines (71% and 86% respectively). However, adherence to the total PA guideline and ST guideline is much lower (50% and 21% respectively). Qualitative results in this study provide insights into the experiences of low-income and high-income families when adhering to the 24hMB guidelines. The results have shown different sub-themes affecting family’s adherence to each of the guidelines both positively and negatively. Results did not appear to differ substantially between low-income and high-income families.
Conclusions
This study has identified that there are numerous factors on all levels of the socio-ecological framework that need to be considered when promoting, supporting, and encouraging family’s adherence to the 24hMB guidelines.
Prognostic value of the preoperative prognostic nutritional and systemic immunoinflammatory indexes in patients with colorectal cancer
Authors: Li Haifeng , Sun Wei , Fu Shengfeng , Wang Junfeng , Jin Bin , Zhang Shuo , Liu Yujun , Zhang Qinyang , Wang Honggang
Published: August 2024

Background
Colorectal cancer (CRC) is a common malignant tumor of the digestive tract. Although many prognostic indicators are currently available, it remains unclear which indicators are the most beneficial for patients with CRC. Therefore, there is a critical need to identify a simple, convenient and accurate prognostic indicator.
Purpose
To investigate the clinical significance of the systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) as prognostic indicators for the survival of patients with CRC.
Methods
The clinical data of CRC patients admitted to the general surgery ward of Taizhou People's Hospital affiliated to Nanjing Medical University from January 2015 to January 2018 were retrospectively analyzed. Two prognostic indicators (SII and PNI) were compared to evaluate their prognostic value in CRC patients.
Results
Based on these variables, we constructed a LASSO prediction model. The AUC value and 95% CI of the training group were 0.917 (0.858–0.976) compared to 0.932 (0.846–1.000) in the validation group. We found that CEA > 5 ng/mL, tumor stage, pathological type, postoperative complications, and PNI were associated with the five-year survival rate of CRC patients. Receiver Operating Characteristic Curves (ROC) were drawn to assess the prediction accuracy of the model. The AUC and 95% CI of the training group were 0.913 (0.854–0.972), while the AUC and 95% CI of the validation group were 0.954 (0.899–1.000).
Conclusions
PNI is an independent risk factor for postoperative complications associated with CRC and a powerful tool for predicting survival outcomes in CRC patients.
Marker assisted improvement of super fine grain rice variety, VGD 1 for bacterial blight resistance
Authors: Rangu Sairachana , Ragulakollu Sravanthi , Rajendran Priyanka , Krishnaswamy Suji , Chellappan Gopalakrishnan , Ramasamy Saraswathy , Jegadeesan Ramalingam
Published: August 2024

Background
Super fine grain rice variety, VGD 1 (ADT 43 x Seeragasamba) is land mark variety in India for its grain quality traits. However, it is highly susceptible to bacterial blight (BB) disease. It is pertinent to improve the disease resistance without altering grain quality traits and high yielding capacity. We introgressed broad spectrum BB resistance genes, xa5, xa13 and Xa21 into VGD1 through marker assisted selection. Genome wide SSR markers were used to recover the recurrent genome contribution. Foreground selection was carried out at BC1F1, BC2F1, BC2F2 to BC2F4. Background screening was performed for RPG recovery at BC1F1, and BC2F1 generations.
Results
True breeding lines in BC2F4 were confirmed for targeted genes; screened for bacterial blight disease; and they were evaluated for agronomic and grain quality traits. Foreground selection of BC1F1 revealed four positive plants (Plant-7, plant-18, plant-36, and plant-58) for targeted bacterial blight R genes which were subjected to background selection and genotype (Plant-18) with high RPG (78.44%) was backcrossed to obtain BC2F1. In BC2F1 generation, two positive plants (Plant 10 and Plant 12) were screened for polymorphic SSR markers where plant-12 with RPG of 86.20% was advanced to BC2F2. Phenotypic screening of BC2F4 breeding lines for bacterial blight disease revealed that the seven lines with three genes pyramided were resistant showing the mean lesion length ranging from 0.76 ± 0.18 to 2.26 ± 0.04.
Conclusion
The superfine variety, VGD 1 was enhanced with xa5, xa13 and Xa21 genes for bacterial blight resistance. Seven pyramided lines were identified with high resistant to BB and grain quality similar to VGD1. The line 56 is promising with all desired agronomic and quality traits with improved resistance and higher yield than VGD1 was identified.
A mitigation strategy for the thermal stability threshold of nitrocellulose with additives
Authors: Li Mi , Gao Xu , Das Oisik , Jiang Lin
Published: August 2024

Nitrocellulose is a widely used energetic material known for its high flammability and explosiveness. To enhance the thermal stability threshold of nitrocellulose during storage, three stabilizers were evaluated: N-methyl-4-nitroaniline (MNA), N,N'-dimethyl-N,N'-diphenylurea (C2), and Na2CO3. This study involved conducting Differential Scanning Calorimetry (DSC) experiments on pure NC and NC/stabilizer (97:3 weight ratio) under both of non-isothermal and isothermal conditions. In non-isothermal tests, the results indicated that the stabilizers effectively reduced the onset temperature, peak temperature, reaction rate, and maximum heat flow during pyrolysis. Among the stabilizers, C2 demonstrated the most significant stabilizing effect. For the isothermal tests, thermal properties of all samples were examined at four temperatures, containing 150, 152, 154, and 156℃. The kinetic triplets of isothermal decomposition were determined using kinetic methods. The findings revealed that the three stabilizers did not alter the thermal decomposition reaction mechanism of nitrocellulose, but did increase the stability threshold during the decomposition process. Based on the calculations, the optimal form for the isothermal decomposition reaction of all samples was identified. This study provides valuable insights for developing strategies to enhance the thermal stability of nitrocellulose during storage and usage.