bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a machine learning model for predicting the expression of proteins associated with targeted therapy in endometrial cancer
Authors: Sun Chenwen , Li Qianling , Huang Ya'nan , Xia Yang , Li Meiping , Zhu Xiucong , Zhu Jinke , Zhao Zhenhua
Published: March 2024

Background: To develop a machine learning model integrates multi-parametric magnetic resonance imaging (MRI) radiomics features and clinicopathological features to predict the expression status of phosphatase and tension homolog (PTEN), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PI3KCA), and mammalian target of rapamycin (mTOR), which are frequently linked with targeted therapy for endometrial cancer (EC), in order to establish a dependable foundation for personalized adjuvant therapy for EC patients.
Methods: we retrospectively recruited 82 EC patients who underwent preoperative MRI and radical resection at two independent hospitals. 60 patients from Center 1 were utilized as the training set for constructing the machine learning model, while 22 patients from Center 2 served as an external validation set to assess the model's performance. We evaluated the performance of models predicted three proteins’ expression using receiver operating characteristic (ROC) analysis, calibration curve analysis, and decision curve analysis (DCA).
Result: To construct machine learning models for predicting the expression of PTEN, PI3KCA, and mTOR, we respectively screened 5 radiomic and 7 clinicopathologic features, 4 radiomic and 9 clinicopathologic features, and 3 radiomic and 10 clinicopathologic features. The area under the curve (AUC) values of the radscore, clinicopathology, and combination models predicting PTEN expression were 0.875, 0.703, and 0.891 in the training set, and 0.750, 0.844, and 0.833 in the validation set, respectively. The AUC values for the models predicted PI3KCA expression in the training set were 0.856, 0.633, and 0.880, respectively, in the validation set, they were 0.842, 0.667, and 0.825. The AUC of each model for mTOR were 0.896, 0.831, and 0.912 in the training set, and 0.729, 0.847, and 0.829 in the validation set. Calibration curve analysis and DCA showed that the combination models were both well calibrated and clinically useful.
Conclusion: Machine learning models integrating multi-parametric MRI radiomics and clinicopathological features can be a potential tool for predicting PTEN, PI3KCA, and mTOR expression status in EC patients.
Relationship between musculoskeletal body region pain complaints, depression and physical activity level in major hospitals of Abbottabad, Pakistan
Authors: Shah* Rizwan Ullah , Tanoli Maheen , Wajid Zawish , Khan Konain Bint , Khan* Najeeb Ullah
Published: March 2024

Introduction/Aim
The growing recognition of musculoskeletal disorders in the northern region of Pakistan, specifically Abbottabad, lacks contextually relevant data for devising effective prevention and intervention strategies in the mitigation of MSDs burden. This study aims to explore the relationship between musculoskeletal body region pain complaints, depression and physical activity of those visiting major hospitals in Abbottabad.
Methodology
The cross-sectional study design aimed to determine the incidence of MSDs (NMQ: Nordic Musculoskeletal complaints rating questionnaire) in 384 female participants in Abbottabad. Informed consent was obtained from all the subjects. Secondly, the relationship between MSD regions, depression (PHQ-9: patient depression questionnaire) and physical activity (IPAQ: International Physical Activity Questionnaire) was sought via phi value, Cramer's V value and logistic regression.
Results
The incidence of MSDs was noticeably higher in females above 40 years of age and who were employees. There was a significant (p < 0.05) negative weak to moderate correlation (Phi − 0.103 to -0.148) between employment and MSDs regions. In contrast, depression and physical activities had a significant (p < 0.05) positive correlation (Cramer's V: 0.129 to 0.225) with the upper back, shoulders and elbow. Individuals who were depressed were more likely to complain about their upper back and shoulders (OR 1.4, p < 0.01).
Conclusion
A significant relationship was observed between depression and MSDs. Higher musculoskeletal pain complaints were noticed in females who were not employees. The study suggested that awareness and multi-dimensional interventions addressing physical, psychological and social barriers are required for prevention and decrease in MSD complaints.
Onyx prevent the bleeding of ruptured aneurysms during interventional embolization
Authors: Yang Chenxing , Liao Yiwei , Peng Gang , Shen Chenfu
Published: March 2024

Endovascular treatment has been acknowledged as an effective treatment for intracranial aneurysms, showcasing favorable clinical outcomes and providing robust protection against rebleeding and rupture. Notably, during the endovascular procedure, significant complications include surgical aneurysm rupture induced by microcatheters, microguidewires, or spring coils, along with thromboembolic events, significantly escalating patient mortality and disability. Current approaches for treating intraprocedural aneurysmal rupture involve various strategies such as heparin reversal, compression of the common carotid artery or upstream soft guidewire to mitigate blood flow, management of intracranial pressure and blood pressure, and balloon-assisted or unassisted rapid dense embolization of the aneurysm. Nevertheless, these measures may prove insufficient in halting hemorrhage, especially in scenarios where additional coils cannot be added for dense embolization due to inherent limitations. In this context, we introduce a novel strategy for the prompt, safe, and effective cessation of aneurysm bleeding, which involves injecting an appropriate quantity of Onyx into the aneurysm through a microcatheter while safeguarded by an aneurysm-carrying arterial braided stent. Initially, we attempted dense embolization by filling multiple coils. However, in cases where continued coil filling proved unfeasible or failed to sufficiently prevent contrast agent extravasation, we opted for Onyx injection into the aneurysm. Utilizing Onyx effectively prevented further blood extravasation without adversely impacting the aneurysm-carrying artery or distal vessels, leading to favorable prognoses for all patients. This article delineates our surgical strategy, highlighting the efficacy and safety of Onyx injection as an alternative or complementary measure in managing complications arising from endovascular coil embolization.
Spectral quantization of discrete random walks on half-line, and orthogonal polynomials on the unit circle
Authors: Doliwa Adam , Siemaszko Artur
Published: March 2024

We define quantization scheme for discrete-time random walks on the half-line consistent with Szegedy's quantization of finite Markov chains. Motivated by the Karlin and McGregor description of discrete-time random walks in terms of polynomials orthogonal with respect to a measure with support in the segment [-1,1], we represent the unitary evolution operator of the quantum walk in terms of orthogonal polynomials on the unit circle. We find the relation between transition probabilities of the random walk with the Verblunsky coefficients of the corresponding polynomials of the quantum walk. We show that the both polynomials systems and their measures are connected by the classical Szegö map. Our scheme can be applied to arbitrary Karlin and McGregor random walks and generalizes the so called Cantero--Grünbaum--Moral--Velázquez method. We illustrate our approach on example of random walks related to the Jacobi polynomials. Then we study quantization of random walks with constant transition probabilities where the corresponding polynomials on the unit circle have two-periodic real Verblunsky coefficients. We present geometric construction of the spectrum of such polynomials (in the general complex case) which generalizes the known construction for the Geronimus polynomials. In the Appendix we present the explicit form, in terms of Chebyshev polynomials of the second kind, of polynomials orthogonal on the unit circle and polynomials orthogonal on the real line with coefficients of arbitrary period.
2010 Mathematics Subject Classification. 81P68, 05C81, 42C05, 94A11.
Examining immune-inflammatory mechanisms of probiotic supplementation in depression: secondary findings from a randomized clinical trial
Authors: Sempach Lukas , Doll Jessica , Limbach Verena , Marzetta Flavia , Schaub Anna-Chiara , Schneider Else , Kettelhack Cedric , Mählmann Laura , Schweinfurt Nina , Ibberson Mark , Lang Undine , Schmidt André
Published: March 2024

We recently indicated that four-week probiotic supplementation significantly reduced depression along with microbial and neural changes in people with depression. Here we further elucidated the biological modes of action underlying the beneficial clinical effects of probiotics by focusing on immune-inflammatory processes.
The analysis included a total of N=39 participants with depression, from which N=18 received the probiotic supplement and N=21 received a placebo over four weeks, in addition to treatment as usual. Blood and saliva were collected at baseline, at post-intervention (week 4) and follow-up (week 8) to assess immune-inflammatory markers (IL-1β, IL-6, CRP, MIF), gut-related hormones (ghrelin, leptin), and a stress marker (cortisol). Furthermore, transcriptomic analyses were conducted to identify differentially expressed genes (DEG). Finally, we analyzed the associations between probiotic-induced clinical and immune-inflammatory changes.
We observed a significant group x time interaction for the gut hormone ghrelin, indicative of an increase in the probiotics group. Additionally, the increase in ghrelin was correlated with the decrease in depressive symptoms in the probiotics group. Transcriptomic analyses identified 51 up- and 57 down-regulated genes, which were involved in functional pathways related to enhanced immune activity. We identified a probiotic-dependent upregulation of the genes ELANE, DEFA4 and OLFM4 associated to immune activation and ghrelin concentration.
These results underscore the potential of probiotic supplementation to produce biological meaningful changes in immune activation in patients with depression. Further large-scale mechanistic trials are warranted to validate and extend our understanding of immune-inflammatory measures as potential biomarkers for stratification and treatment response in depression.
Trial Registration: www.clinicaltrials.gov, identifier: NCT02957591.
The Effect of Nutrition, Physical Activity and Sleep Pattern on Success in Medical Students
Authors: Mutlu Serra Nur , Pasin Özge , Konar Naime Meriç
Published: March 2024

This study investigates the effects of nutrition, physical activity, and sleep patterns on the academic performance of medical students. A questionnaire-based survey involving 330 medical students from two universities was conducted to collect data on demographic characteristics, nutrition, sleep patterns, and physical activity. Academic performance was assessed by obtaining students’ grade point averages (GPAs) from the respective faculties' deanships. The relationship between lifestyle factors and academic success was examined using advanced statistical analysis methods: cluster analysis and biplot method. The correlation of the lifestyle factors and GPAs was visualized in a low-dimensional space with a biplot. The findings revealed that students residing with their families, without outside work commitments, engaging in daily walking, and maintaining regular sleep patterns achieved significantly higher GPAs. Students were divided into two distinct clusters based on lifestyle factors and differences in GPA to determine the factors with the greatest impact on academic performance including the impact of studying on physical activity, self-perception of nutritional quality, engagement in daily walking, and self-perception of physical activity. There was a significant statistical difference in GPA values between the clusters. This study highlights the impact of nutrition, physical activity, and sleep patterns on students’ GPAs, emphasizing the importance of a stable family life, regular sleep routines, and engagement in physical activity for better academic performance. Further research is needed to establish causal relationships and explore potential interventions to support medical students in achieving optimal lifestyle habits for academic success.
High standard uptake value on FDG-PET/CT of the primary lesion of hepatocellular carcinoma correlates with early recurrence after curative resection
Authors: Kato Kazuya , Noda Takehiro , Kobayashi Shogo , Yamanaka Chihiro , Sasaki Kazuki , Iwagami Yoshifumi , Yamada Daisaku , Tomimaru Yoshito , Takahashi Hidenori , Asaoka Tadafumi , Shimizu Junzo , Doki Yuichiro , Eguchi Hidetoshi
Published: March 2024

Purpose
Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful for detecting the presence of distant metastases in many types of cancer, including hepatocellular carcinoma (HCC). However, the clinical significance of the standard uptake value (SUV) in primary HCC lesions is unclear. Therefore, we investigated the relationship between the SUV, clinicopathological factors, and prognosis in HCC.
Methods
The retrospective analysis included 86 patients with HCC who underwent FDG-PET/CT prior to liver resection. The distribution of SUV was compared in three groups: no recurrence after surgery, recurrence within 2 years, and recurrence after 2 years. The optimal cut-off SUV were determined based on receiver operating characteristic curve analysis to detect the recurrence within 2 years. All patients were divided into two groups based on the cut-off: low and high SUV. Cox univariate and multivariate analyses were performed for disease-free survival.
Results
The SUV was significantly higher in patients with recurrence within 2 years. The optimal cut-off SUV was 5.0. The patients in the high SUV group had significantly higher des-γ-carboxy prothrombin, poorer differentiation, and larger tumor diameter than the low SUV group, and presented with pathologically positive intrahepatic metastases. Moreover, high SUV was a significant and independent prognostic factor. In a subgroup analysis, high SUV had a significantly lower 2-year disease-free survival rate than the low SUV group in tumors ≤ 3.5 cm.
Conclusion
High SUV (≥ 5) on FDG-PET/CT of the primary HCC lesion, especially tumors ≤ 3.5 cm, correlates with early recurrence after curative resection and is an independent prognostic factor.
Conventional versus high-voltage, long-term pulse Radiofrequency of ganglion impar in perineal pain with advanced rectal cancer: A Randomized, Double-Blind Controlled Trial
Authors: Li Qin , Wang Huaiming , Zhong Bo , Zhang Taomei , Wang Zhiqiang , Tao Ping , Zhang Hongwei , Zhang Aimin
Published: March 2024

Objective Advanced rectal cancer is a common cause of perineal pain and research on the use of radiofrequency therapy for the treatment of this pain is limited. In the present study, we aimed to compare the effectiveness and safety of conventional radiofrequency (CRF) and high-voltage long-term pulsed radiofrequency (H-PRF) of radiofrequency therapy in the management of perineal pain in advanced rectal cancer.
Methods A total of 72 patients with advanced rectal cancer experiencing perineal pain were enrolled and randomly assigned to either the group CRF or H-PRF in a double-blind trial. The primary focus was on assessing perineal pain using NRS scores at various time points. Secondary outcomes included the duration of maintaining a sitting position, depression scores, sleep quality, consumption of Oral Morphine Equivalent and Pregabalin, and the incidence of perineal numbness.
Results A total of 57 patients (28 patients in the group CRF and 29 patients in the H- group H-PRF) were investigated. At all observation time points postoperatively, both groups of patients exhibited significant reductions in pain, enhancements in depression, improvements in sleep quality, and increased duration of sitting compared to their baseline measurements (P＜0.05). During the 3 months and 6 months follow-up period, the group CRF exhibited significant reduction in pain, improvement in depression, sleep quality, and increased the time of keeping a sitting position compared with the group H-PRF. (P＜0.05). The consumption of oral morphine equivalent and Pregabalin as well as the incidence of perineal numbness were not significantly different between groups (P>0.05).
Conclusion Our results demonstrate that application of CRF and H-PRF in ganglion impar to reduce perineal pain and improve the quality of life of patients with advanced rectal cancer is safe and effective. However, the long-term effect of CRF is better compared with that of H-PRF.
Trial registration This study was registered was registered with the Chinese Clinical Trial Registry (ChiCTR2200061800, 07/02/2022).
Polarised human alveolar epithelia enable identification of dichloroacetate as an effective drug against respiratory viruses
Authors: de Iturrate Paula Martínez , Hernaez Bruno , Santos Patricia de los , García-Gómez Alba , Sánchez-Cruz Alonso , Hernández-Sánchez Catalina , Rivas Luis , Val Margarita del , Rial Eduardo
Published: March 2024

Respiratory viral infections are a significant cause of morbidity and mortality worldwide. COVID-19 pandemic highlighted the lack of chemotherapeutical tools to fight emerging viruses and the need to focus on preclinical models that better recapitulate the human disease. We performed a comparative analysis of inhibitors of the PI3K/AKT/mTOR pathway, involved in the virus-induced metabolic reprogramming, since strategies aimed to cellular targets should serve to combat diverse viruses and hamper the development of resistance. Tests were performed in two human cell lines, MRC5 lung fibroblasts and Huh7 hepatoma cells, and showed that the inhibitors had markedly different effects on energy metabolism and in antiviral activity. Thus, dichloroacetate (DCA) had a potent antiviral activity against HCoV-229E in MRC5 but not in Huh7 cells, implying that the screening model appears to be more critical than previously assumed. DCA was then tested in polarized human alveolar epithelia in air-liquid interface, a 3D model to study respiratory infections. DCA reduced the viral progeny of HCoV-229E, SARS-CoV-2 and the respiratory syncytial virus by 2–3 orders of magnitude, being effective even when applied once infection had been established. Although DCA has previously been shown to be effective against other viruses, suggesting it could be a broad-spectrum antiviral, our experiments reinforce the need to use physiologically appropriate disease models to screen antiviral compounds.
Analysis of clinical features, biochemical and inflammatory indexes in patients with acute pancreatitis
Authors: Han Minghua , Jiang Jun , Huang Lei
Published: March 2024

Background: Acute pancreatitis (AP) is an inflammatory process unpredictability occurring in the pancreas, imposing a substantial burden on healthcare systems. Herein,Exploring the clinical characteristics of patients with acute pancreatitis, biochemical tests and the role of inflammatory indexes in the disease, to predict the prognosis of acute pancreatitis.
Methods: We retrospectively analyzed the clinical data, biochemical and inflammatory indexes of 116 patients with acute pancreatitis diagnosed in Puren Hospital affiliated to Wuhan University of Science and Technology. They were divided into non-severe group and severe group. Counting data were expressed as rate (%), X2 test was used, and measurement data were expressed as mean±standard deviation. Comparison between the two groups was performed by t test, and comparison between the mean of more than two samples was performed by a one-way analysis of variance (ANOVA).P<0.05 was considered to be statistically significant.Receiver operating characteristic curve (ROC) analysis was performed according to the inflammatory indexes of the two groups, and the area under the curve (AUC) and the cut-off value (CUT-OFF) are calculated respectively.
Results: The mean age of patients in the severe group was older, and the proportion of underlying diseases was higher. The biochemical and inflammatory indexes in the severe group were higher than those in the non-severe group (P < 0.05). The area under the curve (AUC) and CUT-OFF value (cut-off) were obtained by ROC curve analysis of the inflammatory indexes of white blood cell count (WBC), neutrophil count (NEUT), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT) and interleukin-6 (IL-6).
Conclusion: Elderly patients with acute pancreatitis accompanied by underlying diseases are more likely to develop into severe disease. In severe patients, biochemical tests are obviously abnormal and inflammatory indexes are increased or even excessive, which is helpful to judge the condition and prognosis of patients with acute pancreatitis.
Monsoon Hysteresis reveals Atmospheric Memory
Authors: Katzenberger Anja , Levermann Anders
Published: March 2024

Within Earth’s climate system the ocean, cryosphere and vegetation exhibit hysteresis behaviour such that their state depends on their past and not merely on their current boundary conditions. The atmosphere’s fast mixing time scales were thought to inhibit the necessary memory effect for such multistability. Here we show that moisture accumulation within the atmospheric column generates hysteresis in monsoon circulation independent of oceanic heat storage and yields two stable atmospheric states for the same boundary conditions. Hysteresis is shown in observational data, reproduced in a general circulation model where it increases with decreasing oceanic memory and then reproduced in a mathematical formulation of the moisture-advection feedback. Thus moisture accumulation can generate bistability through an atmospheric memory that carries information across time scales much longer than those typical for mixing. This has implications for the future evolution of monsoon rainfall that is crucial for the agricultural productivity currently feeding more than two billion people.
DCE-MRI Based Machine Learning Predictor for HER2-Positive Breast Cancer: A Feasibility and Validation Multicenter Study
Authors: Kong Chunli , Lin Guihan , Chen Weiyue , Cheng Xue , Liu Shuang , Shen Di , Ding Jiayi , Hui Junguo , Chen Minjiang , Xia Shuiwei , Xu Min , Peng Zhiyi , Ji Jiansong
Published: March 2024

Background
Human epidermal growth factor receptor 2 (HER2) status of breast cancer plays a critical role in guiding clinical treatment. We aimed to develop and validate a predictive model for HER2 status using preoperative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).
Methods
A total of 570 patients (282, 121 and 167 patients for training, internal and external test sets, respectively) with pathologically confirmed breast cancer and known HER2 status were recruited. A total of 851 radiomics features for each patient were extracted from preoperative DCE-MRI images. VarianceThreshold, SelectKBest and least absolute shrinkage and selection operator (LASSO) regression were applied to identify the optimal predictive features. Logistic regression was adopted to incorporate the Rad-score and clinical predictors into a nomogram. The performance of the nomogram was evaluated by area under receiver operating characteristic curve (AUC), calibration curve and decision curve. Additionally, gene expression analysis based on the Cancer Image Archive database was conducted to validate the biological interpretability of the model.
Results
Twenty-three radiomics features were selected to calculate the Rad-score. The Rad-score, along with breast imaging reporting and data system (BI-RADS) parameter, were independent predictors for HER2 status and were incorporated into the predictive model. The combined model achieved AUCs of 0.881, 0.883, and 0.798 in the training, internal and external test sets, respectively. Calibration curves demonstrated well agreement between the model predictions and actual HER2 status. Decision curve analysis further confirmed the clinical utility of the model. Differentially expressed genes between HER2-positive and HER2-negative patients were primarily involved in signaling pathways such as PI3K-AKT, endocrine resistance, and p53.
Conclusions
The combined model, which incorporated the Rad-score and BI-RADS, representing a potential and efficient alternative tool to evaluate HER2 status in breast cancer.
Impact of Smoking on Immune Checkpoint Inhibitor Treatment Outcomes in Patients with Non-Squamous Non-Small Cell Lung Cancer with High PD-L1 Expression: A Real-World Observational Study
Authors: Kuo Yu-Chu , Cheng Wen-Chien , Chen Hsu-Yuan , Chen Chia-Hung , Liao Wei-Chih , Hsia Te-Chun , Tu Chih-Yen , Chen Hung-Jen
Published: March 2024

Background
Smoking history is increasingly recognized as a potential prognostic indicator for immune checkpoint inhibitor (ICI) efficacy in metastatic non-small-cell lung cancer (NSCLC). However, the findings of most studies have not reached statistical significance. Furthermore, no studies have evaluated the impact of smoking specifically on non-squamous cell NSCLC with high programmed cell death-ligand 1 (PD-L1) expression (≥ 50%).
Materials and Methods
Patients with stage IIIB to IV non-squamous cell NSCLC without epidermal growth factor receptor/anaplastic lymphoma kinase mutations and ≥ 50% PD-L1 expression were retrospectively recruited from August 2017 to December 2022. The enrolled patients were categorized into two groups based on their smoking status: smokers or nonsmokers.
Results
The final analysis included 53 patients, comprising 36 smokers and 17 nonsmokers. The partial response rates to ICI treatment were significantly higher in smokers (75.0%) than in nonsmokers (17.6%; p < 0.001). The median progression-free survival (PFS) was not reached in smokers, which is longer than the 1.4 months in nonsmokers (p < 0.001). Smokers also had a longer overall survival (OS) than nonsmokers (not reached vs. 8.1 months, p = 0.006). Multivariate regression analysis demonstrated that smoking independently predicted better PFS (p < 0.001) and OS (p = 0.003) in patients with non-squamous NSCLC with high PD-L1 expression receiving ICI therapy.
Conclusions
Our findings underscore the significant role of smoking in treatment outcomes among patients with non-squamous NSCLC with high PD-L1 expression undergoing ICI therapies. Smoking serves as an independent predictor of improved PFS and OS.
Network externality, environmental regulation and firms' technology strategy choice: An evolutionary game analysis in a competitive market
Authors: Ma Shengbiao , Li Shoude
Published: March 2024

Compared with existing literature, the feature of this article is to investigate the mechanism of influence between the choice of firms' production technology strategy choice (green-tech or dirty-tech) and the environmental tax rate set by government in a competitive market exhibiting network externality. By applying evolutionary game analysis, it is shown that if the environmental tax rate very high or very low, thefirms would extensively select dirty-tech, while if the environmental tax rate is moderate, the firms prefer to select green-tech. At the evolutionary stable point, the fraction of the population of firms adopting green-tech (dirty-tech) increases (decreases) not only with improvement in the strength of network externality but also with the magnitude of the green-tech innovation. Besides, the social welfare increases with the increase of the strength of network externality. Specially, when the strength of network externality is constant, the social welfare exhibits an inverted-U shape under the effect of the magnitude of the green-tech innovation.
Prognostic factors for gastric cancer patients aged ≥ 85 years
Authors: Endo Shunji , Higashida Masaharu , Furuya Kei , Yano Shuya , Okada Toshimasa , Yoshimatsu Kazuhiko , Fujiwara Yoshinori , Ueno Tomio
Published: March 2024

Background
As gastric cancer patients aged ≥ 85 years have a short life expectancy and often die from other diseases such as pneumonia, indications for surgery are controversial. In this study, we retrospectively analyzed the prognostic factors of elderly patients with gastric cancer who are candidates for curative gastrectomy.
Methods
Among 114 patients aged ≥ 85 years with gastric cancer at our hospital between 2010 and 2019, prognostic factors were examined using the Cox proportional hazards model in 76 patients excluding those with cStage IVB or endoscopic submucosal dissection. We also analyzed the factors of pneumonia death.
Results
cStage was I/IIA/IIB/III/IVA in 37/6/14/14/5 patients, respectively. Treatment included distal gastrectomy in 28 patients, total gastrectomy in 6, local resection in 9, others in 3, and no surgery in 30. In univariate analyses of overall survival, Eastern Cooperative Oncology Group Performance Status, physiological score of Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM), Onodera's prognostic nutritional index, cStage, and treatment were prognostic factors. In a multivariate analysis, POSSUM physiological score, cStage, treatment method {no surgery vs distal gastrectomy: hazard ratio (HR) 5.78, 95% confidence interval (CI) 2.33–14.3}, (total gastrectomy vs distal gastrectomy: HR 4.26, 95% CI 1.22–14.9) were independent prognostic factors. In univariate analyses of pneumonia-specific survival, treatment (total gastrectomy vs distal gastrectomy: HR 6.98, 95% CI 1.18–41.3) was the only prognostic factor.
Conclusions
The prognosis of distal gastrectomy was better than that of non-surgery even in patients aged ≥ 85 years. However, total gastrectomy was considered to be avoidable due to the high rate of postoperative pneumonia death.
Implantable Collamer Posterior Chamber Intraocular Lenses: Effectiveness, Safety and Perioperative problems in a sample of Lebanese population
Authors: Ghoch Marie Line , Romanos Marianne , Hallit Souheil , Schakkal Alexandre
Published: March 2024

Background:
The Implantable Collamer Lens (ICL) has gained recognition in refractive surgery for its stability and ability to achieve reversible refractive outcomes.
Aim:
Our study seeks to assess the safety and efficacy of the ICL with a central hole for vision correction procedures within the Lebanese population. Through this investigation, we aim to enhance our understanding of ICLs and their applicability in refractive surgeries, thus contributing valuable insights to the existing body of knowledge in this field.
Methods:
We conducted a prospective cohort study spanning two years. The study included 116 eyes of 58 patients who underwent surgical implantation of the Visian ICL V4c model. The participants were patients aged between 20 and 45 years, with a stable history of refraction and a medical history of myopia ranging from −2.00 to −20.0 diopters (D) and cylinder up to 3 D. Refractive outcomes, intraocular pressure, and corneal endothelial cell were evaluated one year and two years post operatively.
Results:
During the two years of follow-up, we observed a significant decrease in the UDVA (uncorrected distance visual acuity), CDVA (corrected distance visual acuity), SPH (sphere), CYL (cylinder), and SPH EQ (sphere equivalent). However, there was no variation in the IOP (intraocular pressure) recorded, and the ECC (endothelial cell count) remained stable during the first year following the surgery, but decreased slightly during the second year. Furthermore, we found that an increase in the anterior chamber depth value is associated with a decrease in ECC loss. Importantly, no complications were noted during the two years of postoperative follow-up.
Conclusion:
The implantation of the ICL is a safe and effective treatment for myopic astigmatism, improving visual acuity without complications.
SARS-CoV-2 Infection Related Hyperglycemia during hospitalization and three months post-discharge
Authors: Hosseini Mohsen , Rashid Rabeet , Homayoun Khadije , Hemmatabadi Mahboobeh , Ghaderkhani Sara , Sohrabi Marjan , Salami Arezoo , Ghiasvand Fereshteh
Published: March 2024

Hyperglycemia or diabetes mellitus during COVID-19 has always been a great concern and heralds severe forms of the disease, we also don’t know whether this condition will continue as diabetes mellitus even after convalescence. For this purpose we conducted a study to investigate this condition and factors related to it in hospitalized patients and even three months post-discharge we followed them up. We gathered data from 202 patients that fulfilled our inclusion criteria, among them 100 patients were hyperglycemic. Patients in hyperglycemic status experienced significantly longer duration of hospitalization than normoglycemic patients and significantly showed more severe forms of the disease. During their follow up three months post-discharge for the investigation of glycemic status, 46 out of 97 patients were diagnosed with diabetes mellitus and have been taking anti-diabetic drugs while 29 patients only had normal glycemic status.
Transplantaion of Parabacteroides distasonis mitigated Aβ-associated changes in APP/PS1 mice via gut-brain interactions by attenuating neuroinflammation
Authors: Jiang jingwen , He Yixi , Pan Hong , Xu Nanjie , Tan Yuyan , Sun dingya , Chen Shengdi
Published: March 2024

Background:
Alzheimer's Disease (AD) is a neuropathological condition marked by cognitive deterioration and chronic neuroinflammation. Previous investigations have unveiled a strong correlation between the gut microbiota and the progression of AD. In this study, our objective is to probe the effects of Parabacteroides distasonis (P.distasonis), previously found to be conspicuously diminished in AD patients, on the APP/PS1 mice model.
Methods:
To assess the impact of orally administered P.distasonis on gut microbiota and metabolites, we utilized 16s rDNA sequencing and GC-MS to analyze gut composition and short-chain fatty acids in APP/PS1 mice after one month of P.distasonis gavage. To investigate the effects of P.distasonis administration over a six-month period on APP/PS1 mice, we evaluated cognitive function using novel object recognition and Y-maze tests, assessed intestinal barrier integrity and AD-related pathological features with immunofluorescence, and analyzed immune cell subpopulations in intestine, blood, spleen, and brain tissues via flow cytometry. The Luminex assay was employed to detect inflammatory cytokine secretion in the same regions.
Results:
One-month oral administration of P.distasonis modulated the gut microbiota, elevated butyrate levels. Six-month oral administration of P.distasonis improved cognitive function in APP/PS1 mice, reducing Aβ deposition and inhibiting glial cell proliferation. It also amplified Treg cells within the gut, concomitant with the decreased Th1 proliferation and intestinal inflammation. Additionally, we observed the migration of peripheral CD4+ T cells to the brain through chemotaxis, accompanied by an increase in Treg cells and higher levels of anti-inflammatory factors such as IL-10 and TGF-β in the brain. Collectively, these multifaceted effects contributed to the alleviation of neuroinflammation.
Conclusion:
These findings underscore the potential of transplanting P.distasonis in alleviating AD-related pathology, suggesting a role for gut microbiota in neuroinflammation attenuation.
Comparative metabolomics revealed the effect of high altitude on the metabolic pattern of Polygonum viviparum L
Authors: Wei Na , Ci Don , Dai Yanna
Published: March 2024

As a main medicinal plants in Qinghai-Tibet Plateau, Polygonum viviparum L. could improve a range of disease. However, the effects of altitude changes in affecting the metabolic compositions in Polygonum viviparum L. was still unclear. Presently, we deployed comparative metabolomics analysis to investigate the metabolic variations in Polygonum viviparum L. from high and low altitudes (NQ and SN). We found that the medicinal activity and accumulation of bioactive metabolites in Polygonum viviparum L. were closely correlated with the region altitude. High altitude induced dramatic changes in metabolic compositions of Polygonum viviparum L.. And a variety of flavonoids, soluble sugar, amino acids and lipids were highly accumulated in Polygonum viviparum L. from high altitude region. The accumulation of these metabolites was mainly associated with the UVB exposure, which explained the adaptive mechanisms of Polygonum viviparum L. to numerous abiotic stresses represented by hypoxia and UV exposure at high altitude region. Additionally, Arachidonic acid, Stearidonic acid and Procyanidin B2 were identified as the hub upregulated metabolites that contributed to the medicinal value in Polygonum viviparum L. under NQ condition. And these metabolites could affect the expression level of numerous genes involved in hypoxia-related diseases and immune system, demonstrating the higher medicinal value of Polygonum viviparum L. from high altitude. Overall, our metabolic profiles gain insight into the effects of altitude in altering the medicinal value of Polygonum viviparum L., thus contributed to the usage of such medicinal plants in improving diseases in high altitude region.
Source identification and migration fate of heavy metals of soil-groundwater system in a thousand-year cultivation region
Authors: Zhu Shu , Li Shuyi , Shao Ming’an , Qiao Jiangbo , Zhu Yuanjun
Published: March 2024

Pollution of farmland by heavy metals threatens food security and human health. In addition, heavy metals in soil could infiltrate into groundwater to influence the water quality and safety of drinking water. However, the relationship between heavy metal pollution in soil and groundwater is still not clear. In this study, we investigated the soil and groundwater in the Guanzhong (GZ) Plain region, which is a significant grain production base in China, and determined the spatial distributions, ecological risk, sources, and migration fates of heavy metals (As, Cd, Cr, Cu, Ni, Pb, and Zn). The results showed that the mean values in the soil were 19.57 mg kg–1 for As, 0.71 mg kg–1 for Cd, 69.65 mg kg–1 for Cr, 21.97 mg kg–1 for Cu, 28.67 mg kg–1 for Ni, 17.54 mg kg–1 for Pb, and 73.77 mg kg–1 for Zn, and the corresponding mean values in groundwater were 1.2, 0.04, 4.69, 0.15, 0.07, 0.3, and 3.6 µg L–1, respectively. The mean values for As, Cd, Cr, Pb, and Zn in soil exceeded the background values, and the mean values for As, Cd and Pb exceeded those in groundwater. Positive matrix factorization (PMF) models identified five sources ( fertilizers and organic fertilizers, natural sources, pesticides and herbicides, industrial activities, and sedimentation caused by transportation) for heavy metal pollution in soil and four sources (industry activity, atmospheric sedimentation caused by transportation, natural sources, and agriculture) for heavy metal pollution in groundwater. The soil particle composition and soil organic carbon content were important factors that affected the vertical distribution of heavy metals in the soil. The migration modes were not found for all heavy metals. These results help to understand the relationships between heavy metals in soil and groundwater in farmland ecosystems.
Efficacy and safety of a Low-FODMAP combined with gluten-free diet in adult irritable bowel syndrome: a systematic review and meta-analysis
Authors: Zhang Jing , Yu Ping , Xu Yang , Lu Xiao Yun , Xu Yan , Hang Jun , Zhang Yu
Published: March 2024

Background: Irritable Bowel Syndrome (IBS) is a prevalent gastrointestinal disorder characterized by symptoms such as abdominal pain, bloating, and altered bowel habits. A Low-FODMAP diet combined with a gluten-free diet (LF-GFD) has been proposed as a potential treatment approach.
Objective: This study aimed to investigate the application of a low-FODMAP combined with gluten-free diet (LF-GFD) in patients with irritable bowel syndrome (IBS).
Methods: Clinical studies that evaluated the intervention of LF-GFD in the treatment of IBS patients were identified through strict inclusion and exclusion criteria from online databases. The outcomes assessed the efficacy of LF-GFD in IBS patients using the following measures: Visual Analog Scale (VAS) for bloating and pain, IBS Symptom Severity Scale (IBS-SSS), and IBS Quality of Life (IBS-QoL) scores. Additionally, the psychological intervention effect of LF-GFD on IBS patients was evaluated using the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS).
Results: 4 RCTs and 4 cohort studies were included which involving 437 patients (221 patients with LF-GFD diet and 216 with GFD). The pooled results showed LF-GFD Alleviated the VAS bloating scores (RR=-0.58, 95%CI: -0.92--0.23, P=0.0010, I2=83%) and VAS pain scores (RR=-0.42, 95%CI: -0.66--0.19, P=0.005, I2=58%). Besides that, LF-GFD showed significant improvement of IBS-SSS (MD=-1.42, 95%CI: -2.74--0.10, P=0.03, I2=24%) scores and IBS-QoL scores (MD=3.75, 95%CI: 0.98-6.53, P=0.008, I2=33%). Furthermore, SDS (MD=-2.56, 95%CI: -3.38--1.74, P<0.00001, I2=65%) and SAS(MD=-4.30, 95%CI: -6.53--2.24, P<0.0001, I2=0%) scores were significantly decreased in LF-GFD group compared to GFD group.
Conclusion: LF-GFD intervention effectively improves clinical symptoms and alleviates anxiety and depression in patients with irritable bowel syndrome.
Negative impact of steroids on the efficacy of immunotherapy in a multi- tumor cohort: time and dose-dependent
Authors: Albarrán Víctor , Guerrero Patricia , de Quevedo Coral García , González Carlos , Chamorro Jesús , Rosero Diana Isabel , Moreno Jaime , Calvo Juan Carlos , de Aguado Patricia Pérez , Alía Víctor , Sotoca Pilar , Barrill Ana María , Román María San , Álvarez-Ballesteros Pablo , Serrano Juan José , Soria Ainara , Olmedo María Eugenia , Saavedra Cristina , Cortés Alfonso , Gómez Ana , Lage Yolanda , Ruiz Álvaro , Ferreiro María Reyes , Longo Federico , Garrido Pilar , Gajate Pablo
Published: March 2024

Previous studies have suggested a negative impact of steroids on the efficacy of immune checkpoint inhibitors (ICI), but how this effect is modulated by the dosage and time of administration is yet to be clarified. We have performed a retrospective analysis of 475 patients with advanced solid tumors treated with ICI as monotherapy from 2015 to 2022. Data regarding immune-related adverse events (irAEs) and clinical outcomes were collected. For each patient, the daily steroid dose (in mg/kg of prednisone) was registered until disease progression or death. The impact of cumulative doses on response rates and survival outcomes was analyzed within different periods. The objective response rate (ORR) was significantly lower among patients exposed to steroids within 30 days before the first cycle of ICI (C1) (20.3% vs. 36.7%, p < 0.01) and within the first 90 days of treatment (25.7% vs. 37.7%, p = 0.01). This negative effect was confirmed by multivariable analysis. Higher mean steroid doses were observed among non-responders, and cumulative doses were inversely correlated with the disease control rate (DCR) around ICI initiation. Remarkably, poorer outcomes were observed even in patients belonging to the lowest dose quartile compared to the steroid-naïve population. The detrimental impact of steroids was not observed in long-term responders exposed to steroids after 6 months from C1. Our results suggest that the negative impact of steroids on ICI efficacy seems to be time-dependent, prevailing around ICI initiation, and may also be dose-dependent, with modulation of neutrophil-to-lymphocyte ratio as a potential underlying mechanism.
Exposure to Family Violence and Internalizing and Externalizing Symptoms: The Role of Sibling Abuse Among Adolescents
Authors: Lawrence Timothy I. , Merrin Gabriel J. , Fitzgerald Michael
Published: March 2024

Early childhood exposure to family violence increases the risk of aggression, depressive symptoms, and substance use. However, the mediating role of sibling abuse underlying these associations remain understudied. Therefore, utilizing data from the Bullying, Sexual, and Dating Violence Trajectories From Early to Late Adolescence in the Midwestern United States, 2007–2013) dataset (n = 1,051), this study first tested the associations between exposure to family violence and sibling abuse. Then using structural equation model, this study tested the extent to which sibling abuse was a potential mechanism by which exposure to family violence was associated with aggression, depression, and substance use while controlling for gender and race. Consistent with the theory of intergenerational transmission of violence and social information processing models, results suggest that exposure to family violence was positively associated with sibling abuse that was, in turn, associated with aggression, depression, and substance use. Findings highlight the pernicious effects of exposure to family violence on the progression of problem behavior, which leads to internalizing and externalizing symptoms.
The determinants of household fertility decisions in Burkina Faso
Authors: NANEMA Tinwendé Clémence Benjamine , POKOU Koffi , ZAHONOGO Pam
Published: March 2024

This paper examines the factors that influence household fertility decisions in Burkina Faso. A negative binomial regression model is used with survey data from the 2021 Demographic and Health Surveys (DHS), collected by National Institute of Statistics and Demography (INSD). The analysis reveals the following key findings. Education is a significant determinant of household fertility decisions, with varying effects depending on the area of residence. Specifically, education has a negative impact on fertility decisions in urban areas. Women's decision-making power within the household is negatively correlated with their fertility intentions. Women who marry before the age of 18 are likely to have fewer children. The household standard of living has a significant impact on fertility decisions. Women from high-income households tend to have greater fertility intentions than those from poor households. The use of contraceptive methods reduces household fertility. Therefore, fertility control programmes should focus on educating women, increasing their bargaining power, and disseminating contraceptive methods.
JEL codes: D1; J13; J16; R20