bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction and validation of a diagnostic model for high-risk papillary thyroid microcarcinoma
Authors: Liang Yu , Fan ErXi , Zhang Jing , Xu Tong , Song Jun , Huang Fuhong , Wang Dong
Published: October 2024

Objective

The purpose of this study was to construct a diagnostic model by exploring the potential predictors of high-risk Papillary Thyroid Microcarcinoma (PTMC) and verifying its reliability.

Methods

A retrospective analysis of PTMC patients who underwent surgical treatment from 2004 to 2015 in the SEER database (training set) and the clinical pathological ultrasound information of PTMC patients at the Sichuan Provincial People's Hospital from 2020 to 2022 (external validation set) was conducted. In the training set, univariate and multivariate logistic regression analyses were used to screen independent predictive factors for high-risk PTMC patients in pathology. A nomogram diagnostic model was further constructed. Additionally, ROC curves and calibration curves were drawn to evaluate the efficiency of the model. In the external validation set, the diagnostic model was indirectly evaluated based on preoperative ultrasound imaging features to explore the feasibility and reliability of diagnosing high-risk PTMC through preoperative ultrasound imaging features.

Results

A total of 1628 patients were included in the training set, and 530 patients were included in the test set. The independent risk factors for pathological high-risk PTMC were sex, age, tumor maximum diameter, tumor invasive, and cervical lymph nodes (P<0.05). The C-index of the nomogram constructed based on these five factors was 0.947, with an optimal sensitivity of 96.7% and a specificity of 86.0%. The calibration curve showed that the model had high consistency. The area under the curve (AUC) value of the ROC curve for high-risk PTMC predicted by the risk score based on ultrasound features was 0.824 [95% CI (0.789, 0.860)], which was highly consistent with the risk score based on pathological features (κ= 0.758, P<0.05).

Conclusion

Indirect evaluation of a high-risk PTMC diagnostic model based on preoperative ultrasound imaging features had high predictive efficiency and potential value for clinical application.
Patient satisfaction and operator proficiency in gasless transaxillary endoscopic thyroidectomy under IONM: a retrospective cohort study
Authors: Zhang Yushuai , Zhao Yishen , Tang Hong , Zou Hongrui , Li Yang , Bian Xuehai
Published: October 2024

Background

This study aims to evaluate the surgical safety and effectiveness of gasless transaxillary endoscopic thyroidectomy (GTET), assess patients’ short-term perceptions and long-term outcomes, and delineate the learning curve and key surgical techniques of the operators.

Materials and methods

Clinicopathological and postoperative follow-up data from patients with unilateral thyroid cancer in the same period were collected. These patients were divided into the GTET group and the traditional open surgery group to compare and analyze the differences and explore the factors affecting the learning curve of GTET.

Results

Patients who chose GTET had better general health and thyroid conditions than those in the open group, and the quality of postoperative life was better in the GTET group than in the open group, with the main differences between the two groups being appearance and neck and shoulder function. The GTET learning curve in this study peaked at 19 cases, with slight differences between left and right, and a larger sample size is still needed to explore the factors affecting the learning curve.

Conclusions

GTET has a reliable safety and efficacy profile for patients with unilateral thyroid cancer. Intraoperative nerve monitoring (IONM) techniques require some adaptation in GTET. In some respects, patients’ postoperative experience and quality of life are superior to those of conventional open surgery. There is a learning curve for GTET, but large samples are still needed to explore its true significance.
Exploring lipodystrophy gene expression in adipocytes: unveiling insights into the pathogenesis of insulin resistance, type 2 diabetes, and clustering diseases (metabolic syndrome) in Asian Indians
Authors: Saxena Aditya , Tiwari Pradeep , Gupta Shalu , Mandia Rajendra , Banshiwal Ramesh C. , Lamoria Ravinder Kumar , Anjana Ranjit Mohan , Radha Venkatesan , Mohan Viswanathan , Mathur Sandeep Kumar
Published: October 2024

Background

Studying the molecular mechanisms of lipodystrophy can provide valuable insights into the pathophysiology of insulin resistance (IR), type 2 diabetes (T2D), and other clustering diseases [metabolic syndrome (MetS)] and its underlying adipocentric disease (MetS disease).

Methods

A high-confidence lipodystrophy gene panel comprising 50 genes was created, and their expressions were measured in the visceral and subcutaneous (both peripheral and abdominal) adipose depots of MetS and non-MetS individuals at a tertiary care medical facility.

Results

Most lipodystrophy genes showed significant downregulation in MetS individuals compared to non-MetS individuals in both subcutaneous and visceral depots. In the abdominal compartment, all the genes showed relatively higher expression in visceral depot as compared to their subcutaneous counterpart, and this difference narrowed with increasing severity of MetS. Their expression level shows an inverse correlation with T2D, MetS, and HOMA-IR and with other T2D-related intermediate traits. Results also demonstrated that individualization of MetS patients could be done based on adipose tissue expression of just 12 genes.

Conclusion

Adipose tissue expression of lipodystrophy genes shows an association with MetS and its intermediate phenotypic traits. Mutations of these genes are known to cause congenital lipodystrophy syndromes, whereas their altered expression in adipose tissue contributes to the pathogenesis of IR, T2D, and MetS.
Exploring carbon footprints and carbon intensities of Indonesian provinces in a domestic and global context
Authors: Rum Irlan A. , Tukker Arnold , Hoekstra Rutger , Koning Arjan de , Yusuf Arief. A.
Published: October 2024

Within Indonesia, the structure of consumption and production differs significantly across provinces. This implies that carbon footprints and intensities between provinces are also diverse. This paper calculates historical consumption- and production-based carbon emissions at the provincial level using a multi-scale input-output (IO) database for 2010, in which an environmentally extended multi-regional IO (EE MRIO) table for 34 Indonesian provinces is integrated in the global EE MRIO EXIOBASE with data for 43 countries and 5 rest of the world regions. Emissions from consumption are detailed by product and their points of origin, while emissions from production are detailed by industry and their destinations. Our results show the heterogeneity of Greenhouse Gas (GHG) emissions under both sides. The Java region is a net importer of carbon emission, while Sumatra and Kalimantan are net exporters. In the global context, the Asia Pacific region plays important role in national GHG emissions. Services product contributed 57.1% of national consumption-based GHG emissions, followed by manufacture (30.6%), and agriculture (12.3%). On the national level, 63.5% of national GHG emissions are related to household consumption. There is a high disparity across provinces in Indonesia in carbon footprints. Provincial average per capita carbon footprints vary from 2 t CO2e/capita in East Nusa Tenggara to 13.84 t CO2e/capita in East Kalimantan. Carbon intensity also varies from 0.83 kt CO2e/M Euro in Jakarta to 2.37 kt CO2e/M Euro in North Kalimantan. Agriculture and food products dominate household carbon footprints, while construction leads in government carbon footprints. Utilities and transportation services play important roles on national carbon intensities. We further correlated the Human Development Index (HDI) with per capita carbon footprints and expenditure, and find that provinces with similar GHG emissions and expenditure per capita income as Java, tend to have a lower HDI. Understanding development status and province-level characteristics is important for selecting policy strategies.
Linking individual experiments and multiscale models to simulate physiological perturbations on aquatic food webs
Authors: Bourdaud Pierre , Niquil Nathalie , Araignous Emma , Cabral Henrique , Carpentier Alexandre , Drouineau Hilaire , Lobry Jérémy , Pecquerie Laure , Saint-Béat Blanche , Lassalle Géraldine , Vagner Marie
Published: October 2024

Numerous threats affect aquatic ecosystems at different biological organizational levels from individuals to ecosystems. Stresses occurring on the metabolism and physiological functions of individuals can have repercussions on the individual behavior, its ability to survive and reproduce, also known as the individual fitness, which may then influence the demography and spatial distribution of populations, and ultimately modify trophic flows and ecosystem functioning. In a context of a globally changing environment, predicting the life history traits and fitness of individuals can be relevantly performed with the association of laboratory experiments with Dynamic Energy Budget (DEB) theory, while modeling species interactions have proven to be an efficient tool to understand aquatic food webs using mass-balanced models such as linear inverse models (LIMs) or Chance and Necessity (CaN) models. However, while predictive results obtained on individuals can be provided with a thorough mechanistic interpretation, the propagation of the effects is most often limited to the closest biological hierarchical level, i.e., the population, and rarely to the food-web level. Furthermore, there is a need to understand how to avoid misleading approaches and interpretations due to the simplicity of experiments. For the moment, no clear methodology has stood out yet to do so. In this study, we provide a new methodology based on a combination of models (i.e., DEB, LIM, and CaN) aiming at upscaling information from laboratory experiments on individuals to ecosystems to address multiple ecological issues. This framework has a potential to enhance our understanding of higher-scale consequences of the effect of stressors measured at the sub-individual scale. This combination of models was chosen for the convergence of their framework but also their ability to consider a substantial portion of the projected uncertainty. The description of this methodology can help experimenters and modelers to jointly address a specific question involving upscaling from individual to ecosystem, proposes approaches, and gives tips on the pitfalls to avoid along the upscaling process.
How to measure outcomes in forest restoration? A European review of success and failure indicators
Authors: Menéndez-Miguélez María , Rubio-Cuadrado Álvaro , Cañellas Isabel , Erdozain Maitane , de Miguel Sergio , Lapin Katharina , Hoffmann Johanna , Werden Leland , Alberdi Icíar
Published: October 2024

Restoration involves the recovery and repair of environments because environmental damage is not always irreversible, and communities are not infinitely resilient to such harm. When restoration projects are applied to nature, either directly or indirectly these may take the form of ecological, forestry or hydrological restoration, for example. In the current scenario of global climate change and increasing intensity of disturbances the importance of restoration in all types of ecosystems in order to adapt to the new conditions (so called prestoration) is evident. Whatever the objective of the restoration initiative, there is a lack of consensus as regards common indicators to evaluate the success or failure of the different initiatives implemented. In this study, we have carried out an extensive meta-analysis review of scientific papers aiming to evaluate the outcomes of restoration projects. We have done a review and selected 95 studies implemented in Europe. We explored the main pre-restoration land cover in which restoration initiatives have been implemented, the main causes of degradation, the objective of the restoration action and the indicators selected to analyze the success or failure of the action. We identified a total of 84 indicators in the analyzed papers and compared with the ones proposed for forest in the recent Nature Restoration Law. The analysis revealed five indicators commonly used for the evaluation of restoration initiatives (abundance, coverage, density, Ellenberg indicator, and richness), even where the initial objective has not yet been achieved. Our findings underscore both the benefits and challenges associated with a specific set of harmonized indicators for evaluating the success or failure of restoration initiatives.
Soil available phosphorus and pH are key factors affecting the site index of Larix kaempferi plantations in China
Authors: Wei Hongyang , Chen Dongsheng , Wu Chunyan , Sun Xiaomei , Zhang Shougong
Published: October 2024

Assessing the quality of forest sites is crucial for evaluating the potential productivity of forests and formulating effective management strategies. Therefore, it is essential to understand how environmental variables affect the site quality. This study focuses on quantifying the effects of 44 different environmental variables including climate, topography, and soil properties on the site index of Larix kaempferi plantations in three different climate regions in China, utilizing the random forest algorithm. L. kaempferi site index was determined from stem analysis data by felling dominant trees from 51 even-aged stands. The results indicated that the proposed random forest model explained ~59.47% of site index variations. Among many environmental variables, available phosphorus, pH, degree-days above 5°C (DD5), and spring mean maximum temperature (Tmax_MAM) had significant effects on the site index (P < 0.05), and the importance of soil chemical properties generally exhibits relatively larger effects on the site index than climate variables and topography variables. The partial dependence analysis revealed that the L. kaempferi plantations had maximum values at ~30 mg/kg of available phosphorus in the first soil layers, 30 mg/kg of available phosphorus in the second soil layers, 20 mg/kg of available phosphorus in the third soil layers, the DD5 between 2,600and 3,000°C, and Tmax_MAM ~15°C. Our findings attempt to provide a better understanding of the site–growth relationship.
Genetic investigation and diagnosis in adults with congenital heart disease with or without structural or neurodevelopmental comorbidity: a retrospective chart review
Authors: Edwards Moriah , Zhang Xue , Opotowsky Alexander R. , Brown Nicole , Shikany Amy R. , Weaver Kathryn Nicole
Published: October 2024

Introduction

Genetic evaluation is indicated for individuals with congenital heart disease (CHD), especially if extracardiac anomalies are also present. Timely recognition of genetic diagnoses can facilitate medical management and as well as provide assessment of reproductive risk. At least 20% of the pediatric population with CHD has a syndrome or genetic diagnosis. Further, at least 30% have extracardiac congenital malformations and/or neurodevelopmental differences (NDD), and this is known to increase the likelihood of a genetic/syndromic diagnosis. However, little is known regarding whether these statistics also apply to the current population of adults living with CHD, many of whom were born prior to currently available genetic testing.

Methods

The primary aim of this study was to determine the prevalence of documented genetic and syndromic diagnoses in a cohort of adults with CHD followed by a dedicated adult CHD (ACHD) clinic. The secondary aims were to describe genetic testing and genetic referral patterns in this population and identify the presence of extracardiac comorbidities which are known to be indicative of an underlying genetic diagnosis in the pediatric CHD population. To answer these questions, we performed a retrospective chart review on a sample of adults with CHD (excluding those with isolated bicuspid aortic valve) seen at Cincinnati Children’s Hospital in the ACHD clinic between 2010–2021.

Results

Among 233 adult CHD patients, 36 (14%) had a documented genetic or syndromic diagnosis but only 29 (13.7%) had received genetic testing, while 27 (11.6%) had received genetic referrals. Furthermore, of 170 patients without any documented genetics related care (defined as genetic testing, genetic referrals, or genetic diagnosis), 35 (20%) had at least one congenital and/or neurodevelopmental comorbidity. Factors associated with individuals having received genetics related care included younger age (<40), male sex, and presence of extracardiac comorbidities.

Discussion

Our results indicate important gaps in genetics-related care for adults living with CHD. The subset of our cohort with congenital and/or neurodevelopmental comorbidities who received no genetic-related care, represent a population of adults with CHD who may have unrecognized genetic diagnoses.
Implications of vitamin D levels or status for mortality in rheumatoid arthritis: analysis of 2001-2018 data from the National Health and Nutrition Examination Survey
Authors: Feng Yalin , Zhu Ping , Yan Dandan , Wang Xu , Chen Caiyun , Zhang Zhongyuan , Tian Yian , Wang Jiajia , Liu Shanshan , Li Ju , Meng Deqian , Wang Kai
Published: October 2024

Background

Inadequate levels of vitamin D (VitD) have been linked to increased rates of various health conditions and mortality. However, little is known about the relationship between mortality outcomes and 25-hydroxyvitamin D [25(OH)D] levels in individuals with rheumatoid arthritis (RA). This study aimed to examine this association using data from the National Health and Nutrition Examination Survey.

Methods

A cohort of 2,290 individuals aged 20 to 85 years with RA was analyzed. Lower 25(OH)D levels were inversely associated with all-cause mortality, with a hazard ratio (HR) of 0.91 (0.87 to 0.96) per 10 nmol/L increase. Comparatively, the HR for the VitD insufficiency group was 0.64 (0.50 to 0.83), and for the VitD sufficiency group, it was 0.60 (0.44 to 0.80), both compared to the VitD deficiency group. Cause-specific analysis showed that higher 25(OH)D levels were associated with reduced mortality from heart disease (HR: 0.88, 0.82 to 0.95) and malignant neoplasms (HR: 0.86, 0.79 to 0.94). No significant correlation was found between 25(OH)D levels and cause-specific mortalities for other conditions.

Results

Stratified by gender, the HR for males was 0.92 (0.85 to 0.99) and for females was 0.91 (0.86 to 0.98) per 10 nmol/L increase in 25(OH)D levels. Among individuals aged 20-59 years, no significant correlation was observed, while for those aged 60 years and older, the HR was 0.86 (0.82 to 0.90) per 10 nmol/L increase. Nonlinear analysis identified a sharp increase in HR below 59.95 nmol/L, while HR remained below 1 for 25(OH)D levels above 59.95 nmol/L.

Conclusion

This study reveals a strong negative correlation between 25(OH)D levels and overall mortality in individuals with RA. Notably, this association is particularly significant for mortality related to heart disease and malignant neoplasms. Targeted VitD supplementation should be emphasized, especially in individuals aged 60 years and older with RA. The proposed minimum threshold for adequate 25(OH)D levels in the RA population is 60 nmol/L.
IDEIS: a tool to identify PTPRC/CD45 isoforms from single-cell transcriptomic data
Authors: Michalik Juraj , Niederlova Veronika , Stepanek Ondrej
Published: October 2024

Single-cell RNA sequencing (scRNA-seq) methods are widely used in life sciences, including immunology. Typical scRNA-seq analysis pipelines quantify the abundance of particular transcripts without accounting for alternative splicing. However, a well-established pan-leukocyte surface marker, CD45, encoded by the PTPRC gene, presents alternatively spliced variants that define different immune cell subsets. Information about some of the splicing patterns in particular cells in the scRNA-seq data can be obtained using isotype-specific DNA oligo-tagged anti-CD45 antibodies. However, this requires generation of an additional sequencing DNA library. Here, we present IDEIS, an easy-to-use software for CD45 isoform quantification that uses single-cell transcriptomic data as the input. We showed that IDEIS accurately identifies canonical human CD45 isoforms in datasets generated by 10× Genomics 5’ sequencing assays. Moreover, we used IDEIS to determine the specificity of the Ptprc splicing pattern in mouse leukocyte subsets.
Comparative analysis of iPSC-derived NK cells from two differentiation strategies reveals distinct signatures and cytotoxic activities
Authors: Huyghe Matthias , Desterke Christophe , Imeri Jusuf , Belliard Nathan , Chaker Diana , Oudrirhi Noufissa , Bezerra Hudson , Turhan Ali G. , Bennaceur-Griscelli Annelise , Griscelli Frank
Published: October 2024

Purpose

The ability to generate natural killer (NK) cells from induced pluripotent stem cells (iPSCs) has given rise to new possibilities for the large-scale production of homogeneous immunotherapeutic cellular products and opened new avenues towards the creation of “off-the-shelf” cancer immunotherapies. However, the differentiation of NK cells from iPSCs remains poorly understood, particularly regarding the ontogenic landscape of iPSC-derived NK (iNK) cells produced in vitro and the influence that the differentiation strategy employed may have on the iNK profile.

Methods

To investigate this question, we conducted a comparative analysis of two sets of iNK cells generated from the same iPSC line using two different protocols: (i) a short-term, clinically compatible feeder-free protocol corresponding to primitive hematopoiesis, and (ii) a lymphoid-based protocol representing the definitive hematopoietic step.

Results and discussion

Our work demonstrated that both protocols are capable of producing functional iNK cells. However, the two sets of resulting iNKs exhibited distinct phenotypes and transcriptomic profiles. The lymphoid-based differentiation approach generated iNKs with a more mature and activated profile, which demonstrated higher cytotoxicity against cancer cell lines compared to iNK cells produced under short-term feeder-free conditions suggesting that the differentiation strategy must be considered when designing iNK cell–based adoptive immunotherapies.
Application of novel CAR technologies to improve treatment of autoimmune disease
Authors: Cheever Abigail , Kang Chloe C. , O’Neill Kim L. , Weber K. Scott
Published: October 2024

Chimeric antigen receptor (CAR) T cell therapy has become an important treatment for hematological cancers, and its success has spurred research into CAR T cell therapies for other diseases, including solid tumor cancers and autoimmune diseases. Notably, the development of CAR-based treatments for autoimmune diseases has shown great progress recently. Clinical trials for anti-CD19 and anti-BCMA CAR T cells in treating severe B cell-mediated autoimmune diseases, like systemic lupus erythematosus (SLE), have shown lasting remission thus far. CAR T cells targeting autoreactive T cells are beginning clinical trials for treating T cell mediated autoimmune diseases. Chimeric autoantigen receptor (CAAR) T cells specifically target and eliminate only autoreactive B cells, and they have shown promise in treating mucosal pemphigus vulgaris and MuSK myasthenia gravis. Regulatory CAR T cells have also been developed, which show potential in altering autoimmune affected areas by creating a protective barrier as well as helping decrease inflammation. These new treatments are only the beginning of potential CAR T cell applications in treating autoimmune disease. Novel CAR technologies have been developed that increase the safety, potency, specificity, and efficacy of CAR T cell therapy. Applying these novel modifications to autoimmune CARs has the potential to enhance the efficacy and applicability of CAR therapies to autoimmune disease. This review will detail several recently developed CAR technologies and discuss how their application to autoimmune disease will improve this emerging field. These include logic-gated CARs, soluble protein-secreting CARs, and modular CARs that enable CAR T cell therapies to be more specific, reach a wider span of target cells, be safer for patients, and give a more potent cytotoxic response. Applying these novel CAR technologies to the treatment of autoimmune diseases has the potential to revolutionize this growing application of CAR T cell therapies.
Application of a risk score model based on glycosylation-related genes in the prognosis and treatment of patients with low-grade glioma
Authors: Zou Binbin , Li Mingtai , Zhang Jiachen , Gao Yingzhen , Huo Xiaoya , Li Jinhu , Fan Yimin , Guo Yanlin , Liu Xiaodong
Published: October 2024

Introduction

Low-grade gliomas (LGG) represent a heterogeneous and complex group of brain tumors. Despite significant progress in understanding and managing these tumors, there are still many challenges that need to be addressed. Glycosylation, a common post-translational modification of proteins, plays a significant role in tumor transformation. Numerous studies have demonstrated a close relationship between glycosylation modifications and tumor progression. However, the biological function of glycosylation-related genes in LGG remains largely unexplored. Their potential roles within the LGG microenvironment are also not well understood.

Methods

We collected RNA-seq data and scRNA-seq data from patients with LGG from TCGA and GEO databases. The glycosylation pathway activity scores of each cluster and each patient were calculated by irGSEA and GSVA algorithms, and the differential genes between the high and low glycosylation pathway activity score groups were identified. Prognostic risk profiles of glycosylation-related genes were constructed using univariate Cox and LASSO regression analyses and validated in the CGGA database.

Results

An 8 genes risk score signature including ASPM, CHI3L1, LILRA4, MSN, OCIAD2, PTGER4, SERPING1 and TNFRSF12A was constructed based on the analysis of glycosylation-related genes. Patients with LGG were divided into high risk and low risk groups according to the median risk score. Significant differences in immunological characteristics, TIDE scores, drug sensitivity, and immunotherapy response were observed between these groups. Additionally, survival analysis of clinical medication information in the TCGA cohort indicated that high risk and low risk groups have different sensitivities to drug therapy. The risk score characteristics can thus guide clinical medication decisions for LGG patients.

Conclusion

Our study established glycosylation-related gene risk score signatures, providing new perspectives and approaches for prognostic prediction and treatment of LGG.
Targeting STING signaling for the optimal cancer immunotherapy
Authors: Xu Yan , Xiong Ying
Published: October 2024

Despite the transformative impact of anti-PD-1/PD-L1 therapies, challenges such as low response rates persist. The stimulator of interferon genes (STING) pathway, a crucial element of innate immunity, emerges as a strategic target to overcome these limitations. Understanding its multifaceted functions in cancer, including antigen presentation and response to DNA damage, provides valuable insights. STING agonists, categorized into cyclic dinucleotides (CDNs) and non-CDNs, exhibit promising safety and efficacy profiles. Innovative delivery systems, including antibody-drug conjugates, nanocarriers, and exosome-based therapies, address challenges associated with systemic administration and enhance targeted tumor delivery. Personalized vaccines, such as DT-Exo-STING, showcase the adaptability of STING agonists for individualized treatment. These advancements not only offer new prospects for combination therapies but also pave the way for overcoming resistance mechanisms. This review focuses on the potential of targeting STING pathway to enhance cancer immunotherapy. The integration of STING agonists into cancer immunotherapy holds promise for more effective, personalized, and successful approaches against malignancies, presenting a beacon of hope for the future of cancer treatment.
Characteristics of measured typhoon waves on the central coast of Zhejiang province
Authors: Yang Zhongliang , Ye Qin , Yang Bin , Shi Weiyong , Zhang Junbiao
Published: October 2024

The risk of typhoon disasters is high in the Zhejiang coastal areas; however, it has been difficult to characterize waves generated by these typhoons, particularly in shallow waters. In this study, the characteristics of nearshore typhoon waves were analyzed using data from 14 typhoon processes from a wave station on the central coast of Zhejiang Province for three consecutive years from 2016 to 2018. According to their paths, these typhoons were divided into landing and non-landing steering types. Wave parameters were evaluated using statistical analyses and linear regression. Variations in wave parameters and spectra are discussed. We obtained several key results: (1) The dominant wave direction was E-SE and the strong wave direction was SE. (2) There were strong correlations between characteristic wave heights and between characteristic periods. (3) Single-peak spectra were dominant, with a frequency of 92.33%. The minimum peak frequency was 0.06–0.1 Hz and the maximum peak period was 17.7 s. The typhoon waves were mainly composed of swells with a frequency of 94.54%. (4) Affected by Typhoon Maria (No. 201808), a maximum wave height of 8.20 m was observed at 04:00 on July 11, 2018. This study provides an important reference for the design of offshore structures and disaster prevention and mitigation.
Prevalence and associated factors of self-medication among pregnant women in Sodo Town, Southern Ethiopia
Authors: Abebe Mesfin , Gashaw Silenat , Getahun Dinkalem , Wassu Wudit , Menshaw Tiruye , Lakew Serawit
Published: October 2024

Background

Self-medication is a widespread practice among pregnant women worldwide, with 44.55% practicing it. However, it may lead to incorrect diagnosis, inappropriate treatment, and failure to recognize contraindications. The adverse effects of self-medication are often unknown, and they pose potential risks to maternal and fetal health. This study aimed to address the gap in research on the prevalence and associated factors of self-medication among pregnant women in Southern Ethiopia, and to promote effective strategies and interventions.

Methods

A community-based cross-sectional study was conducted among 425 pregnant women in Sodo Town from April to June 2021. Participants were enrolled using a two-stage sampling technique. Data were collected using a structured questionnaire and face-to-face interviews. The association between the outcome and independent variables was assessed through bivariate logistic regression analysis. Additionally, multivariable logistic regression analysis was carried out, including variables with an adjusted odds ratio (AOR) accompanied by a 95% confidence interval (CI) and a p-value of less than 0.05, which was considered statistically significant.

Results

In this study, pregnant women aged 18–39 years participated with a 100% response rate. The study found that the prevalence of self-medication during pregnancy was 20.5%, with 8.2% using herbal medicine and 12.3% using conventional medicine. A history of self-medication and first-and second-trimester pregnancy were significantly associated with self-medication. A history of self-medication (AOR = 6.31, 95% CI: 4.89, 9.91) and being in the first trimester of pregnancy (AOR = 3.47, 95% CI: 1.63, 7.38) or second trimester of pregnancy (AOR = 2.14, 95% CI: 1.12, 4.08) were associated with a higher likelihood of self-medication.

Conclusion

The study found that 20.5% of pregnant women engaged in self-medication. It also identified that a previous history of self-medication and gestational age were factors associated with self-medication. These findings underscore the need for targeted educational programs and policy interventions to mitigate the risks associated with self-medication during pregnancy, particularly in the early stages of gestation.
Dry age-related macular degeneration classification from optical coherence tomography images based on ensemble deep learning architecture
Authors: Yang Jikun , Wu Bin , Wang Jing , Lu Yuanyuan , Zhao Zhenbo , Ding Yuxi , Tang Kaili , Lu Feng , Ma Liwei
Published: October 2024

Background

Dry age-related macular degeneration (AMD) is a retinal disease, which has been the third leading cause of vision loss. But current AMD classification technologies did not focus on the classification of early stage. This study aimed to develop a deep learning architecture to improve the classification accuracy of dry AMD, through the analysis of optical coherence tomography (OCT) images.

Methods

We put forward an ensemble deep learning architecture which integrated four different convolution neural networks including ResNet50, EfficientNetB4, MobileNetV3 and Xception. All networks were pre-trained and fine-tuned. Then diverse convolution neural networks were combined. To classify OCT images, the proposed architecture was trained on the dataset from Shenyang Aier Excellence Hospital. The number of original images was 4,096 from 1,310 patients. After rotation and flipping operations, the dataset consisting of 16,384 retinal OCT images could be established.

Results

Evaluation and comparison obtained from three-fold cross-validation were used to show the advantage of the proposed architecture. Four metrics were applied to compare the performance of each base model. Moreover, different combination strategies were also compared to validate the merit of the proposed architecture. The results demonstrated that the proposed architecture could categorize various stages of AMD. Moreover, the proposed network could improve the classification performance of nascent geographic atrophy (nGA).

Conclusion

In this article, an ensemble deep learning was proposed to classify dry AMD progression stages. The performance of the proposed architecture produced promising classification results which showed its advantage to provide global diagnosis for early AMD screening. The classification performance demonstrated its potential for individualized treatment plans for patients with AMD.
Preferences of patients with multiple chronic diseases for medication in rural areas of an Eastern Province China: a discrete choice experiment
Authors: Li Xiaona , Ma Dongping , Feng Zhiqiang , Gao Min , Dong Ping , Shi Yongli , Li Ziyuan , Li Runmin , Yin Wenqiang , Chen Zhongming
Published: October 2024

Background

Multiple Chronic Diseases (MCD) are the co-occurrence of two or more chronic conditions within an individual. Compared to patients with a single chronic disease, those with MCD face challenges related to polypharmacy, which increases the risk of adverse drug events, side effects, and drug–drug interactions. Understanding the specific medication preferences of patients with MCD is crucial to optimize treatment plans and enhance treatment safety.

Objective

This study aims to evaluate the medication preferences among patients with multiple chronic diseases in rural areas of an eastern province of China.

Methods

A discrete choice experiment (DCE) was used to measure patients’ medication preferences. According to literature research, expert panel discussions, and in-depth patient interviews, we identified six attributes: monthly out-of-pocket cost, onset speed of action, adverse effects, whether it is covered by health insurance, origin of medications, and types of medications. The conditional logit models (CLM) and mixed logit models (MIXL) were used to evaluate the choice data. Willingness to pay (WTP) was used to reflect the monetary value that patients were willing to pay or receive reimbursement after changes in different attribute levels.

Results

A total of 956 respondents were included in the analysis. Of which, 68.62% were female, with an average age of 68 years, and 65.89% had a Body Mass Index (BMI) greater than or equal to 24. Statistical significance was observed for all attributes (p < 0.001). The preferred medication for patients encompassed low monthly out-of-pocket costs, rapid onset of action, rare adverse effects, and a preference for Western medicine, health insurance-covered medication and domestic medication. The onset speed of action was a primary consideration for patients, who demonstrated a willingness to pay an additional CNY151.37 per month for a medication with a rapid onset of action.

Conclusion

Rural patients with multiple chronic diseases preferred medications with rapid onset, rare adverse, Western medications, domestic medication, and health insurance-covered medication. Medical staff can effectively combine the Health Belief Model (HBM) to help patients with multiple chronic diseases improve their confidence and understanding of medication selection, to improve their health management.
Efficacy of Direct Acting Antivirals (DAA) therapy in patients with recurrent hepatitis C after liver and kidney transplantation: a cross-sectional study
Authors: Kashani Mehdi , Karimi Mehdi , Sharifi Rayeni Alireza , Azizi Nadian Mohammad Ali , Mortezazadeh Masoud , Parsaei Amirhossein , Abolghasemi Nooshin , Shirsalimi Niyousha , Mofidi Abbas , Seyyed Mahmoudi Seyyed Taher
Published: October 2024

Background and objectives

Direct-acting antiviral (DAA) agents are now widely used to treat patients with hepatitis C infection (HCV) and effectively increase their sustained virologic response (SVR). However, the literature seems to lack or deficient evidence of DAA efficacy in more complicated patients, especially those with HCV reinfection after liver transplantation (LT) or liver-kidney (hepatorenal) transplantation (LKT). This study aimed to retrospectively evaluate the effectiveness of two different DAA regimens in LT and LKT patients with HCV reinfection.

Methods

This cross-sectional study was conducted at three hospitals in Tehran, Iran, from 2014 to 2020, enrolling 53 patients with recurrent HCV infection after LT (n = 35) or LKT (n = 18). Patients were treated for 12 weeks with one of two DAA regimens: 37 patients (70%) received Daclatasvir and Sofosbuvir (SOF + DCV), while 16 patients (30%) received Sofosbuvir and Ledipasvir (SOF + LDV). Ribavirin (RBV) was added as an adjunct antiviral in 28 patients (52.8%). To assess the SVR, all patients were followed for 12 weeks after treatment.

Results

Both DAA regimens were well-tolerated and effective, with 94.6% (35 of 37) achieving SVR-12 in the SOF + DCV group and 93.8% (15 of 16) in the SOF + LDV group. Additionally, SVR-12 rates were promising across treatment durations, with 93.9% (31 of 33) in the 12-week group and 95% (19 of 20) in the 24-week group achieving undetectable HCV RNA. No significant difference in SVR was observed between the two regimens (p = 0.439).

Conclusion

The DAA-based therapeutic regimen was well tolerated and showed significant effectiveness in achieving the virologic response in patients with HCV reinfection after LT or LKT.
Extraordinary therapeutic effect of PSMA radioligand therapy in treatment-refractory progressive metastatic prostate cancer with the transketolase inhibitor benfo-oxythiamine as a radiosensitizer—A case report
Authors: Kramer Carsten S. , Zhang Jingjing , Baum Richard P.
Published: October 2024

Herein we report, for the first time, the therapeutic response of a prostate cancer patient with the thiamine antagonist benfo-oxythiamine (B-OT) added to prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (PRLT). The patient was initially diagnosed as pT3b pN0 (0/7) M0 L0 V0 R0 G3, Gleason score 5 + 5 = 10, with an initial prostate-specific antigen (PSA) level of 4.05 ng/ml. Shortly after radical prostatectomy, 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) revealed PSMA-positive lymph node metastases. Despite treatment with androgen deprivation therapy, external beam radiation therapy, palliative chemotherapy, and five cycles of PRLT (177Lu-PRLT or TANDEM-PRLT, respectively), the patient experienced progression in PSA levels as well as in PSMA PET/CT. Due to the intense PSMA expression, 177Lu-PRLT with 177Lu-PSMA-I&T was resumed for another 4 cycles (cycles 6th to 9th) and the patient was additionally treated with the thiamine antagonist benfo-oxythiamine. It was hypothesized that B-OT acts as a radiosensitizer by interfering with the repair of damaged DNA. B-OT-PRLT was well-tolerated and no substantial changes in laboratory results were observed. Additionally, the patient reported significant improvement in clinical symptoms. Post-treatment 177Lu-PSMA single-photon computed tomography (SPECT)/CT after the 7th cycle (and after 2 cycles of B-OT-PRLT) revealed regression of metastases compared to the post-treatment SPECT/CT after the 6th cycle. Before the 8th cycle, PSMA PET/CT showed a mixed response following prior uncontrollable cancer progression. Moreover, the PSA level showed a significant decline after one cycle of B-OT-PRLT. Although the patient had experienced massive progression before the first cycle of B-OT-PRLT, he survived for an additional 12 months. This case supports the hypothesis that B-OT-PRLT could overcome radiation resistance in prostate cancer patients who do not initially respond to 177Lu- or 225Ac-PRLT.
Dietary diversity contributes to delay biological aging
Authors: Liao Wen , Li Meng-ying
Published: October 2024

Aims

As aging is a major risk factor for chronic diseases, strategies to promote healthy aging are essential. Dietary diversity has been reported to be beneficial for human health, however, the role in the biological aging process remains underexplored. Our aim was to analyse the potential link between diet diversity and aging.

Methods

Twenty-two thousand six hundred participants from the National Health and Nutrition Examination Survey (NHANES) were included in this study. Dietary diversity was assessed by the dietary diversity score (DDS), which aggregated data on participants’ self-reported dietary categories for the 5 major food groups (18 subgroups) over 2 rounds. Biological age was determined using the phenotypic age, with the residual between biological age and chronological age, phenotypic age acceleration, representing biological aging advance. Weighted multivariate regressions analysis were used to examine the relationship between DDS and phenotypic age acceleration. Sensitivity, subgroup interaction and mediation analyses were employed for further analysis.

Results

Higher DDS was consistently associated with slower phenotypic age acceleration (β < 0, p < 0.001). Subgroup analyses revealed that the inverse relationship persisted across categories, with minimal interaction effects. Sensitivity analyses confirmed the robustness of results. The oxidative stress indicator glutamyltransferase partially mediated the relationship between DDS and aging [4.9% (3.6, 6.0%), p < 0.001].

Conclusion

Dietary diversity is associated with a slower rate of biological aging, which may be due in part to reduced oxidative stress. These findings underscore the potential of a rich, broad-spectrum diet to promote healthy aging and reduce the burden of age-related diseases.
Liver cirrhosis is a risk-factor for Pneumocystis jirovecii associated mortality
Authors: Peschel Georg , Happ Nils , Bornschein Jan , Weis Florian , Schmid Stephan , Mueller Martina , Selgrad Michael
Published: October 2024

Background

Pneumocystis jirovecci pneumonia (PCP) is a life threating disease in immunodeficient patients. Liver cirrhosis itself can lead to immunodefiency, however little is known if Pneumocystis jirovecci infection affects the outcome of patients with liver cirrhosis.

Aim

We aimed to assess the predictors for Pneumocystis jirovecci-associated mortality in patients with Pneumocystis jirovecci infection treated at intensive care units.

Methods

A total of 151 patients hospitalized between January 2013 and November 2019 with a PCR-confirmed Pneumocystis jirovecci infection were retrospectively included in this study and analysed for clinical predictors for PCJ associated mortality.

Results

The overall mortality in our patient cohort was 60%. Out of 151 patients included in the analysis, 67 (44%) patients suffered from liver cirrhosis. Patients with an advanced liver cirrhosis (Child-Pugh class C) showed the highest mortality rate of 84.7%. The presence of a liver cirrhosis was associated with a significant increased risk of mortality (OR: 4.809) ([95%-CI: 2.32–9.97]; p < 0.001). There was a significant correlation of Meld score and mortality (r = 0.612, p < 0.001).

Discussion

To our knowledge, this study represents the largest evaluation of Pneumocystis jirovecci infection in patients with advanced liver cirrhosis. Cirrhosis associated immune dysfunction (CAID) describes the spectrum of immunological disturbances in patients with cirrhosis, which is linked to a heightened vulnerability to bacterial infections. Our data indicate a heightened susceptibility to fungal infections. Understanding the phenotypic manifestations of CAID could lead to immune-targeted therapies aimed at reducing infection susceptibility and decreasing CAID-associated mortality in cirrhosis patients.
Advancements in sarcopenia diagnosis: from imaging techniques to non-radiation assessments
Authors: Lavalle Salvatore , Scapaticci Rosa , Masiello Edoardo , Messina Carmelo , Aliprandi Alberto , Mario Salerno Valerio , Russo Arcangelo , Pegreffi Francesco
Published: October 2024

Sarcopenia is a prevalent condition with significant clinical implications, and it is expected to escalate globally, demanding for effective diagnostic strategies, possibly at an early stage of the disease. Imaging techniques play a pivotal role in comprehensively evaluating sarcopenia, offering insights into both muscle quantity and quality. Among all the imaging techniques currently used for the diagnosis and follow up of sarcopenia, it is possible to distinguish two classes: Rx based techniques, using ionizing radiations, and non-invasive techniques, which are based on the use of safe and low risk diagnostic procedures. Dual-energy x-ray Absorptiometry and Computed Tomography, while widely utilized, entail radiation exposure concerns. Ultrasound imaging offers portability, real-time imaging, and absence of ionizing radiation, making it a promising tool Magnetic Resonance Imaging, particularly T1-weighted and Dixon sequences, provides cross- sectional and high-resolution images and fat-water separation capabilities, facilitating precise sarcopenia quantification. Bioelectrical Impedance Analysis (BIA), a non-invasive technique, estimates body composition, including muscle mass, albeit influenced by hydration status. Standardized protocols, such as those proposed by the Sarcopenia through Ultrasound (SARCUS) Working Group, are imperative for ensuring consistency across assessments. Future research should focus on refining these techniques and harnessing the potential of radiomics and artificial intelligence to enhance diagnostic accuracy and prognostic capabilities in sarcopenia.