bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of long-term creep response characteristics of high rock slopes considering cumulative effects of earthquakes
Authors: Yu Meilin , Deng Hongyan
Published: December 2024

In mountain-gorge areas, the rock creep is the critical process for high rock slopes failure. During long-term creep, slopes might encounter earthquakes and form further creep after earthquakes, which can easily lead to the slope failure. Based on a high rock slope in the Nujiang River Basin, deformation and dynamic response characteristics are analyzed by FLAC3D software, considering combined effects of multiple earthquakes and long-term creep. Results show that when the amplitude increases, the shear strength of the slope decreases and the risk of instability increases under combined actions of creep and earthquakes. Earthquakes promote the development of creep and induce the accumulation of damage on the slope surface and in the slope. The ground motion response on the slope surface is stronger than that in the slope, with the peak occurring at the top of the slope. Earthquakes have a greater impact on the middle and top of the slope surface, where cumulative damage and crack development begin. Vertical ground motion has a great effect on the dynamic response. The slope resonance leads to a larger PGA amplification factor in the vertical direction than that in the horizontal direction. Nonlinear and damping characteristics of the slope and the frequency of seismic waves cause the PGA amplification factor to decrease with increasing amplitudes. This study could promote the development of high rock slope failure mechanism and provide references for the prevention of landslides in the Nujiang River Basin.
Association of the comorbidity of gestational diabetes mellitus and hypertension disorders of pregnancy with birth outcomes
Authors: Lin Xingxi , Zhou Luhan , Si Shuting , Cheng Haoyue , Alifu Xialidan , Qiu Yiwen , Zhuang Yan , Huang Ye , Zhang Libi , Ainiwan Diliyaer , Liu Hui , Yu Yunxian
Published: December 2024

Backgrounds

Many pregnant women suffer from more than one pregnancy complication. However, whether those women experienced a higher risk of adverse birth outcomes is unclear. This study aims to assess the association between the comorbidity of gestational diabetes mellitus (GDM) and hypertension disorders of pregnancy (HDP) and adverse birth outcomes.

Methods

The data was from the Zhoushan Maternal and Child Health Hospital electronic medical recorder system (EMRS) between 2015 and 2022. Multivariate linear regression model was used to analyze the association of GDM, HDP, and comorbidity with birth weight and gestational age, respectively. Multiple logistic regression model was used to analyze the association of GDM, HDP, and comorbidity with adverse birth outcomes.

Results

13645 pregnant women were included. GDM+HDP was significantly associated with a higher risk of composite adverse neonatal outcomes (OR=1.82, 95%CI: 1.02-3.04), including preterm birth, placenta previa, and/or neonatal jaundice, a higher risk of small for gestational age (SGA) (OR=2.2, 95% CI: 1.24 3.92) and large for gestational age (LGA) (OR=2.33, 95% CI: 1.64 3.31) compared with the normal group. Further analysis showed that HDP diagnosed in the 21-27th week comorbid with GDM had the lowest gestational age at delivery (β= -1.57, P=0.0002) and birth weight (β= -189.57, P=0.0138). Moreover, combined hyperglycemia (CH) comorbid with HDP had the strongest association with reduced gestational age (β= -0.83, P=0.0021).

Conclusion

Pregnant women suffering from both GDM and HDP had a higher risk of adverse neonatal outcomes; hence, the prevent and treatment of GDM and HDP, especially their comorbidity, are very important for pregnant women.
The diagnostic performance comparison between T2 mapping and Dixon against the activity of thyroid-associated ophthalmopathy: a systematic review and meta-analysis
Authors: Zhang Fuyi , Wang Pengcheng , Cao Chun , Pan Xinyu , Zhang Tao , Fan Meng , Guan Yu
Published: December 2024

Objective

The aim of this study was to compare the diagnostic performance of T2 mapping and Dixon in thyroid-associated ophthalmopathy’s disease activity.

Methods

Published studies were collected by systematically searching the databases PubMed, Embase, Cochrane Library, Google Scholar, Medline, Web of Science, CNKI, VIP, and WANFANG. The sensitivities, specificities, likelihood ratios, and diagnostic odds ratio (DOR) were confirmed. The symmetric receiver operator characteristic curve (SROC) was used to assess the threshold of T2 mapping and Dixon. Fagan’s nomogram was drawn. Meta-regression and subgroup analyses were applied to distinguish the sources of heterogeneity among the included studies. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement.

Results

A total of 17 studies were included, comprising 1,455 participants. The combined sensitivity of T2 mapping was 0.70 [95% CI (0.65–0.75)], specificity was 0.84 [95% CI (0.75–0.90)], area under the SROC curve (AUC) was 0.78 [95% CI (0.75–0.82)], and DOR was 12. The combined sensitivity of Dixon was 0.74 [95% CI (0.58–0.85)], specificity was 0.80 [95% CI (0.58–0.93)], AUC was 0.83 [95% CI (0.80–0.86)], and DOR was 11.66. The Deeks’ funnel plot showed no existing publication bias. The prospective design, partial verification bias, and blinding contributed to the heterogeneity in specificity and sensitivity. The post-test probability of T2 mapping in TAO patients’ disease activity was 75%, and the post-test probability of Dixon in TAO was 87%.

Conclusion

Compared with T2 mapping, Dixon presented a significantly higher sensitivity and AUC for detecting TAO disease activity. Dixon is expected to further improve the accuracy of diagnosis of TAO’s disease activity.
Health-related quality of life among patients with cirrhosis at a tertiary care center in Addis Ababa, Ethiopia: a cross-sectional study
Authors: Zewde Edgeit Abebe , Teklemariam Awgichew Behaile , Ayele Tesfaneh Shemeles , Agidew Melaku Mekonnen , Mulu Anemut Tilahun , Melaku Metages Damtie
Published: December 2024

Background

Health-related quality of life (HRQoL) reflects an individual’s perception of how disease and treatment affect their physical, functional, emotional, and social well-being. The burden of cirrhosis is high in Ethiopia but reports on HRQoL among cirrhosis patients are lacking. This study aimed to assess HRQoL and associated factors among patients with cirrhosis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

Methods

A cross-sectional study was conducted among 221 patients with cirrhosis at Tikur Anbessa Specialized Hospital. Data were coded and entered into Epi Data 4.6.0.2 and analyzed by STATA software version 17m/p. Bivariable and multivariable linear regression analyses were performed. A p-value lower than 0.05 was used to declare statistical significance.

Results

The mean ± SD age was 42.74 ± 12.25. In multivariable linear regression analysis, Mid Upper Arm Circumference (MUAC) (Standardized β.coff (Std.β.coff) = 0.12, 95% CI (0.06, 0.18), age ≥50 (Std.β.coff = -0.38, 95% CI (-0.68,-0.09), Child-Turcotte-Pugh (CTP) class B (Std.β.coff = -0.92, 95% CI (-1.28, -0.55), CTP class C (Std.β.coff = -1.69, 95% CI (-2.30,-1.07) were significantly associated with mean quality of life score.

Conclusion

Quality of life score was significantly associated with age, CTP class, and MUAC. Health-related quality of life should be taken into consideration in the assessment and treatment of patients with cirrhosis. Older patients, patients with decompensated cirrhosis, and patients with lower MUAC measurements should be given special attention.
Bibliometric analysis and visualization of the research on the relationship between RNA methylation and immune cell infiltration in tumors
Authors: Meng Sibo , Yang Guanghui , Yu Enhao , Li Jiaxin
Published: December 2024

Background

This research endeavors to delve into the research hotspots and trends concerning RNA methylation and tumor immune cells through the application of bibliometric analysis and visualization techniques.

Methods

A comprehensive search in WoSCC (2014-2023) for RNA methylation and tumor immune cell articles/reviews was conducted. Bibliometric analysis and visualization employed CiteSpace, Bibliometric, and VOSviewer tools.

Results

A total of 3295 articles were included in the analysis, with a continuously increasing number of publications linking RNA methylation to tumoral immune cells. Chinese authors and research institutions have demonstrated a sustained growth trend in both the number of publications and author influence. SUN YAT SEN UNIVERSITY, a Chinese institution, has published the highest number of articles in this field, while also demonstrating extensive international and inter-institutional collaborations. Meanwhile, HARVARD UNIVERSITY has also achieved impressive results. For instance, Frontiers in Immunology has published the largest number of articles in this category. Nature Communications has published articles that are most influential in this field, playing a pivotal role in disseminating research findings. The sustained vitality of this field is attributed to its solid research foundation, including the groundbreaking work published by Professor Chiappinelli KB in Cell and the widely cited paper by Professor Han DL in Nature. Analysis of research trend topics reveals that m5C, immunotherapy, and the immune microenvironment are current research focuses.

Conclusion

Future investigative efforts at the juncture of RNA methylation and tumor immune cells are anticipated to concentrate on domains including m5C, n7-methylguanosine, cuproptosis, prognosis assessment, immunotherapeutic strategies, and the tumor microenvironment.
Dynamics of invasive mosquitoes: introduction pathways, limiting factors, and their potential role in vector-borne pathogen transmission
Authors: Yan Jiayue , Mackay Andrew J. , Stone Chris M.
Published: December 2024

The blooming of global trade and travel and the intensification of global changes over the past decades are thought to be important drivers of accelerated range expansions of vector-borne pathogens (VBPs), with the potential to cause severe disease outbreaks around the world. As a bridge between hosts and pathogens, mosquitoes play a central role in the transmission of VBPs. With modern oversea/air transportation facilitating the introduction of different mosquito species into novel regions, there is concern that this may escalate the introduction and subsequent spread of introduced VBPs in those regions. Despite these potential impacts, there is still a lack of comprehensive understanding of the ecology of invasive mosquitoes and the consequences they have for VBP introductions and transmission intensity. Here we review common introduction pathways, limiting factors for the establishment and spread of invasive mosquito species and explore their role in the transmission of VBPs in invaded regions. We also highlight the major challenges in invasive mosquito surveillance and control and identify key research questions for advancing future control strategies and practices. This body of knowledge may contribute to the prevention of mosquito introductions, as well as risk assessment and risk management of VBPs.
Burden and clinical characteristics of recurrent Plasmodium vivax infections, and impact of primaquine for radical cure: a systematic scoping review in India
Authors: Kojom Foko Loick Pradel , Singh Vineeta
Published: December 2024

Background

India accounts for the bulk of Plasmodium vivax burden in South East Asia. Primaquine (PQ) is the only currently available drug for treating relapses in P. vivax malaria.

Methods

Here, we provide an overview of the epidemiology and clinical characteristics of P. vivax recurrent infections in India and discuss current knowledge gaps and priority research areas for further investigations, with emphasis on relapses and their radical cure with PQ.

Results and discussion

A total of 27 studies involving ~27,000 P. vivax infected patients were finally included. Recurrent infections with P. vivax malaria are common, especially in young males. The burden of P. vivax relapse greatly varies across Indian regions, with a proportion range of 1.47 to 6% based on the included studies which all used low (very low) PQ dose. There is a need for more empirical data on the effectiveness and safety of weekly administration of PQ at 0.75 mg/Kg for eight weeks in G6PD–deficiency patients in India, especially in children. Further research priorities should also be focused on the epidemiology of confounding factor, such as CQ-resistance, mixed infections, or Pv genetic diversity are needed. The clinical impact of P. vivax relapses (e.g., severe malaria, mortality) is also of valuable interest in upcoming studies. More studies addressing the above-mentioned missing links should be implemented to inform malariologists, clinicians, populations, and policy makers on real situation of P. vivax relapses and the clinical impact of PQ in India. All taken together, these would have important implications for P. vivax malaria control and elimination in endemic areas.
Fatigue damage analysis of plain and steel fiber-reinforced concrete material based on a stiffness degradation microplane model
Authors: Qin Changjin , Dong Xiaogang , Wu Biao , Cai Lidong , Wang Shaohua , Xia Qing
Published: December 2024

Steel fiber-reinforced concrete material has garnered significant attention in structure design due to its excellent resistance to fatigue damage. The application of the plain concrete microplane model is extended to steel fiber-reinforced concrete by modifying the stress-strain boundary conditions on the microplane and then extended to fatigue damage analysis by considering fatigue-related material stiffness, mainly concerned with tensile damage, mainly concerned with tensile damage. The normal positive strain on the micro-plane is regarded as the fatigue variable, and the fatigue history variable is the accumulation of the fatigue variable during the loading. The relationship between the fatigue history variable and the material stiffness fatigue degradation function is established. In the numerical implementation, the crack band model is combined to reduce the mesh sensitivity caused by strain localization. During the numerical simulation, the parameters of plain concrete, steel fiber-reinforced concrete, and the material fatigue degradation function can be calibrated sequentially, requiring only a few benchmark tests for accurate parameter calibration. The numerical results show that this model can be used for the fatigue damage analysis of plain concrete and steel fiber-reinforced concrete material. It is expected to be used for the refined analysis of concrete structures under complex loading conditions and structural forms in the future, providing convenience to engineering design, evaluation, and optimization.
Myopia prevalence, refractive status and uncorrected myopia among primary and secondary school students in Germany
Authors: Hönekopp Astrid , Tommes Lisa-Marie , Doebler Philipp , Weigelt Sarah
Published: December 2024

Introduction

The increasing prevalence of myopia worldwide is problematic because myopia can result in severe secondary pathologies, and is associated with considerable financial burden. With plenty of prevalence data available for some regions, current data for Europe remain sparse. Yet, information on myopia prevalence and associations is essential for monitoring, preventive and interventive purposes. Likewise, uncorrected refractive errors are also critical, as they can, e.g., affect educational outcomes, making information on uncorrected myopia valuable for diagnostics and health education.

Methods

We performed non-cycloplegic autorefraction on two samples in Germany. The younger sample included 489 primary school students (grades 3–4, mean age: 9.30 ± 0.78 years), the older sample 1,032 secondary school students (grades 8–10, mean age 14.99 ± 1.12 years). These samples mark the limits of the age range during which school myopia usually emerges.

Results

Myopia (spherical equivalent ≤ −0.75D) prevalence was 8.4% in the younger sample and 19.5% in the older sample. The prevalence was generally higher in higher grade levels, with the most notable difference between grades 8 and 9. Females were more myopic than males in all grades except grade 3, with the largest gender difference in grade 10. The older sample also exhibited a more myopic spherical equivalent than the younger sample. In the older sample, spherical equivalent was more myopic in females than in males, and in grade 9 and 10 participants more than in grade 8 participants. Rates of uncorrected myopia were extremely high: 51.2% in the younger sample and 43.3% in the older sample.

Discussion

The obtained myopia prevalence rates are generally consistent with other European studies, as is the higher prevalence in female than male adolescents, accelerating with age. The high rates of uncorrected myopia warrant further investigation and should inform public health policies, including the implementation of regular refractive screenings.
Tuberous sclerosis: a survey in the canton of Vaud, Switzerland
Authors: Hagon-Nicod Olivia , Fellmann Florence , Novy Jan , Lebon Sébastien , Wider Christian , Lazor Romain , Bonny Olivier
Published: December 2024

Aim of the study

Tuberous sclerosis complex (TSC) is a genetic and multisystemic disorder that affects between 1/6’000 and 1/10’000 of newborns. Clinical criteria and/or genetic analysis establish the diagnosis. The mechanistic target of rapamycin (mTOR) inhibitors everolimus or sirolimus reduce the severity of several TSC-related clinical traits. We report here on the epidemiology and management of TSC patients in a large Swiss canton: the canton of Vaud.

Method

We extracted patient files containing the diagnostic code TSC in 2015 at the Lausanne University hospital (tertiary reference center for a population of about 755’000 people) and in specialized neurological institutions of the same region.

Results

We identified 52 patients with a diagnosis of TSC. The majority of the patients with a pathologic result in genetic testing were positive for a pathogenic variant in the TSC2 gene, including five cases of contiguous gene deletion syndrome of TSC2 and PKD1 causing both polycystic kidney disease and TSC. The most frequent clinical manifestations encountered were affecting the skin (87% of patients), the brain (83%), the heart (46%) and the kidneys (46%). Neuropsychiatric disorders were described in 56% of cases. At the time of data collection (2015), there were 2 patients using systemic mTOR inhibitors and 16 patients using topical mTOR inhibitors for dermatological features. Next, we compared this data with those of large published cohorts. While we found fewer cases than expected for the screened population, demographic as well as genetic data were overall similar to the literature. However, we observed that some clinical manifestations (renal, lung and neuropsychiatric disorders) were less frequently described in our cohort.

Conclusion

This work indicates that TSC and some of its clinical manifestations is under-reported. It raises concern that patients with mild manifestations are often not referred to reference centers with dedicated multidisciplinary group. The follow-up by expert board is instrumental in offering systematic screening of all putatively affected organs and to assess the eligibility for targeted treatment.
The dynamics of microbial community structure and metabolic function in different parts of cigar tobacco leaves during air-curing
Authors: Li Wenlong , Yu Jun , Li Hao , Yang Chunlei , Peng Zheng , Zhang Juan
Published: December 2024

Air-curing is the initial step in the processing of cigar tobacco leaves. However, the dynamics of microbial community and metabolic functions in different parts of tobacco leaves during this process remain largely unclear. In this study, amplicon-based high-throughput sequencing revealed that Pseudomonas (9.0 to 29.9%) and Sphingomonas (0.5 to 13.8%) were the dominant bacterial genera in the early stages of air-curing, while Pantoea (1.7–90.4%) became predominant after air-curing. Microbial community diversity analysis indicated that species richness and diversity were significantly higher during the fresh leaf and withering periods. Functional prediction based on PICRUSt2 suggested that the microbial communities in the middle leaves exhibited higher abundances of metabolic pathways related to carbohydrates and amino acids than those in the upper leaves, potentially leading to the formation of more flavor compounds. The volatile flavor compounds were detected during the air-curing process by HS-SPME-GC–MS, with alkaloids and esters being the most prominent, although their accumulation periods differed across leaf parts. Furthermore, based on PLS-DA, 17 and 38 significantly changed flavor components were identified in the upper and middle leaves, respectively. Finally, the potential relationships between characteristic microbes and flavor components were explored based on Spearman correlation coefficient. It was found that multiple bacteria such as Rhodanobacter, Gemmatimonas, and Ramlibacter present in the middle leaves exhibited significant positive correlations with multiple flavor compounds such as 3,3-dimethylacrylic acid, phenylacetone, 2,3-butanedione, and geranylacetone, potentially promoting the flavor formation of cigar tobacco leaves during air-curing process. This study provides scientific insights into the role of microorganisms during the air-curing process of cigar tobacco leaves and offers a scientific basis for screening of specific functional microorganisms to improve and stabilize cigar tobacco flavor in the future.
Root-associated microbial diversity and metabolomics in maize resistance to stalk rot
Authors: Wang Liming , Jia Jiao , Su Qianfu , Cao Hongzhe , Jia Shiqi , Si Helong , Cao Zhiyan , Ma Shujie , Xing Jihong , Zhang Kang , Dong Jingao
Published: December 2024

As one of the three major food crops in the world, maize plays a significant role in alleviating the food crisis. Maize stalk rot can reduce maize yield and mechanical harvesting efficiency. In addition, mycotoxins such as Deoxynivalenol (DON) and Zearalenone (ZEN) produced by maize stalk rot pathogens can also harm livestock and human health. Maize stalk rot is an infection of the whole growth period, and there are no effective control measures at present. Therefore, it is of great significant to study the pathogenesis and control mechanism of stalk rot from multiple perspectives. In the present study, root and rhizosphere soil of disease-resistant inbred line Y853 and disease-susceptible inbred line Q478 were collected at the dough stage (R4) and maturity stage (R6) of maize, respectively. The effects of resistant/susceptible inbred line on soil microorganisms were analyzed by amplicon sequences and metabolomics. The results showed that there was different microbial community composition from different inbred lines in different growth stages. Specifically, the abundance of Arthrobacter, Streptomyces and Bacillus in R4 rhizosphere soil was higher than that of R6, while the rhizosphere fungal composition of LR853 was significantly different from that of the other three compartments. Co-occurrence network analysis showed that the pathogen Fusarium had the highest degree centrality and closeness centrality in the DR478. Moreover, metabolomics analysis showed that four main metabolic pathways were significantly enriched, and 15 metabolites were upgrade in resistant inbred line. Furthermore, microbes, especially fungi, also were related to these 15 metabolites. Our results revealed that maize resistance to stalk rot is closely related to root-associated microbiota and rhizospheric metabolites, which would be a new perspective of phytopathogenic biocontrol.
Identification and characterization of a novel chromosome-encoded aminoglycoside O-nucleotidyltransferase gene, ant(9)-Id, in Providencia sp. TYF-12 isolated from the marine fish intestine
Authors: Yu Yan , Zhang Runzhi , Pan Wei , Sheng Xinyi , Chen Susu , Wang Junjun , Lu Junwan , Bao Qiyu , Hu Yunliang , Jiang Pengfei , Huang Dawei
Published: December 2024

Background

The mechanisms underlying the resistance of the genus Providencia to aminoglycosides are complex, which poses a challenge for the efficient treatment of infectious diseases caused by these pathogens. To help clinicians treat infections more effectively, a more comprehensive understanding of antibiotic resistance mechanisms is urgently needed.

Methods

Plates were streaked to isolate bacteria from the intestinal contents of fish. The standard agar dilution method was used to determine the minimum inhibitory concentrations (MICs) of the antimicrobial agents. Molecular cloning was carried out to study the function of the novel antibiotic inactivation gene ant(9)-Id. The kinetic parameters of ANT(9)-Id were measured by a SpectraMax multifunctional microplate reader. Whole-genome sequencing and bioinformatic analysis were conducted to elucidate the sequence structure and evolutionary relationships of similar genes.

Results

The novel aminoglycoside O-nucleotidyltransferase gene ant(9)-Id was encoded on the chromosome of a species-unclassified isolate designated Providencia sp. TYF-12, which was isolated from the intestine of a marine fish. Among the 11 aminoglycosides tested, ant(9)-Id was resistant to only spectinomycin. The MIC of spectinomycin for the recombinant strain carrying ant(9)-Id (pUCP20-ant(9)-Id/DH5α) increased 64-fold compared with that of the control strain (pUCP20/DH5ɑ). ANT(9)-Id shares the highest amino acid (aa) identity of 46.70% with the known drug resistance enzyme ANT(9)-Ic. Consistent with the MIC results, ANT(9)-Id showed high affinity and catalytic efficiency for spectinomycin, with a Km of 8.94 ± 2.50 μM and a kcat/Km of 26.15 μM−1·s−1. This novel resistance gene and its close homologs are conserved in Providencia strains from various sources, including some of clinical significance. No mobile genetic elements (MGEs) surrounding the ant(9)-Id(−like) genes were identified.

Conclusion

This work revealed and characterized a novel spectinomycin resistance gene, ant(9)-Id, along with its biological features. Identifying novel resistance genes in pathogens can assist in rational medication use and the identification of additional antimicrobial resistance mechanisms in microbial populations.
Aloe-emodin plus TIENAM ameliorate cecal ligation and puncture-induced sepsis in mice by attenuating inflammation and modulating microbiota
Authors: Su Jingqian , Deng Xiaohui , Hu Shan , Lin Xinrui , Xie Lian , Ye Hui , Lin Congfan , Zhou Fen , Wu Shun , Zheng Liling
Published: December 2024

Despite the high sepsis-associated mortality, effective and specific treatments remain limited. Using conventional antibiotics as TIENAM (imipenem and cilastatin sodium for injection, TIE) is challenging due to increasing bacterial resistance, diminishing their efficacy and leading to adverse effects. We previously found that aloe-emodin (AE) exerts therapeutic effects on sepsis by reducing systemic inflammation and regulating the gut microbiota. Here, we investigated whether administering AE and TIE post-sepsis onset, using a cecal ligation and puncture (CLP)-induced sepsis model, extends survival and improves physiological functions. Survival rates, inflammatory cytokines, tissue damage, immune cell populations, ascitic fluid microbiota, and key signaling pathways were assessed. Combining AE and TIE significantly enhanced survival rates, and reduced inflammation and bacterial load in septic mice, indicating potent antimicrobial properties. Moreover, substantial improvements in survival rates of AE + TIE-treated mice (10% to 60%) within 168 h were observed relative to the CLP group. This combination therapy also effectively modulated inflammatory marker (interleukin [IL]-6, IL-1β, and tumor necrosis factor [TNF]-α) levels and immune cell counts by decreasing those of B, NK, and TNFR2+ Treg cells, while increasing that of CD8+ T cells; alleviated tissue damage; reduced bacterial load in the peritoneal cavity; and suppressed the NF-κB signaling pathway. We also observed a significantly altered peritoneal cavity microbiota composition post-treatment, characterized by reduced pathogenic bacteria (Bacteroides) abundance. Our findings underscore the potential of AE + TIE in treating sepsis, and encourage further research and possible clinical implementations to surmount the limitations of TIE and amplify the therapeutic potential of AE.
Identification of key factors for malnutrition diagnosis in chronic gastrointestinal diseases using machine learning underscores the importance of GLIM criteria as well as additional parameters
Authors: Rischmüller Karen , Caton Vanessa , Wolfien Markus , Ehlers Luise , van Welzen Matti , Brauer David , Sautter Lea F. , Meyer Fatuma , Valentini Luzia , Wiese Mats L. , Aghdassi Ali A. , Jaster Robert , Wolkenhauer Olaf , Lamprecht Georg , Bej Saptarshi
Published: December 2024

Introduction

Disease-related malnutrition is common but often underdiagnosed in patients with chronic gastrointestinal diseases, such as liver cirrhosis, short bowel and intestinal insufficiency, and chronic pancreatitis. To improve malnutrition diagnosis in these patients, an evaluation of the current Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria, and possibly the implementation of additional criteria, is needed.

Aim

This study aimed to identify previously unknown and potentially specific features of malnutrition in patients with different chronic gastrointestinal diseases and to validate the relevance of the GLIM criteria for clinical practice using machine learning (ML).

Methods

Between 10/2018 and 09/2021, n = 314 patients and controls were prospectively enrolled in a cross-sectional study. A total of n = 230 features (anthropometric data, body composition, handgrip strength, gait speed, laboratory values, dietary habits, physical activity, mental health) were recorded. After data preprocessing (cleaning, feature exploration, imputation of missing data), n = 135 features were included in the ML analyses. Supervised ML models were used to classify malnutrition, and key features were identified using SHapley Additive exPlanations (SHAP).

Results

Supervised ML effectively classified malnourished versus non-malnourished patients and controls. Excluding the existing GLIM criteria and malnutrition risk reduced model performance (sensitivity -19%, specificity -8%, F1-score -10%), highlighting their significance. Besides some GLIM criteria (weight loss, reduced food intake, disease/inflammation), additional anthropometric (hip and upper arm circumference), body composition (phase angle, SMMI), and laboratory markers (albumin, pseudocholinesterase, prealbumin) were key features for malnutrition classification.

Conclusion

ML analysis confirmed the clinical applicability of the current GLIM criteria and identified additional features that may improve malnutrition diagnosis and understanding of the pathophysiology of malnutrition in chronic gastrointestinal diseases.
Ovarian reserve modulates the impact of vitamin D deficiency on assisted reproductive outcomes in patients undergoing controlled ovarian hyperstimulation
Authors: He Lina , Xu Qing , Hao Li , Ran Xu , Qiu Yamin , Lin Jie , Chen Wei
Published: December 2024

Objective

The association between vitamin D deficiency and ovarian reserve-specific outcomes of assisted reproductive technology (ART) remains uncertain. This study aimed to investigate the role of ovarian reserve in the association between basal serum vitamin D levels and ART outcomes in patients undergoing controlled ovarian hyperstimulation (COH).

Methods

A total of 1,333 infertile women undergoing COH cycles were retrospectively analyzed. Patients were divided into a vitamin D deficiency group (serum vitamin D < 20 ng/mL) and a normal vitamin D group. Univariate and multivariate logistic regression analyses were performed to estimate the relationship between vitamin D deficiency and pregnancy outcomes including biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, and live birth rate in the overall cohort and subgroups with diminished ovarian reserve (DOR) or polycystic ovary syndrome (PCOS).

Results

In the entire participants’ cohort, no correlation between vitamin D deficiency and pregnancy results was observed (p > 0.05). However, in the DOR subgroup, vitamin D deficiency was associated with a lower biochemical pregnancy rate (adjusted OR 0.27; 95% CI 0.08–0.90; p < 0.01) and clinical pregnancy rate (adjusted OR 0.36; 95% CI 0.14–0.90; p < 0.01). No significant differences were observed in pregnancy outcomes among patients with PCOS (p > 0.05).

Conclusion

Vitamin D deficiency does not affect pregnancy outcomes in the overall patient population, but it may negatively impact women with DOR potentially leading to poorer pregnancy outcomes. Further studies are needed to clarify the mechanisms involved and the potential use of vitamin D screening and supplementation in specific populations.
Inflammation and nutritional status in relation to mortality risk from cardio-cerebrovascular events: evidence from NHANES
Authors: Hou Chengzhi , Huang Xuanchun , Wang Jie , Chen Cong , Liu Chao , Liu Shuyuan , Li Hongping
Published: December 2024

Objective

Inflammation and nutritional status are closely associated with the mortality risk of survivors of cardio-cerebrovascular events. This study aims to evaluate the relationship between inflammation and nutritional indices and mortality among, identifying the most predictive indices.

Methods

This study included cohort data of the survivors of major adverse cardiovascular and cerebrovascular events (MACCE) from the National Health and Nutrition Examination Survey (NHANES) in 1999–2010. MACCE is defined as a composite of myocardial infarction, heart failure and stroke, and at least one of the three events occurs. The main outcomes were all-cause mortality and cardiovascular mortality. Kaplan–Meier analysis and receiver operating characteristic curves were used to compare the correlation between seven inflammatory nutritional indices (such as Advanced Lung Cancer Inflammation Index, ALI) and mortality among the survivors. A multivariable-adjusted Cox regression and restricted cubic splines analysis identified the most predictive index, with the optimal number of nodes determined by the Akaike information criterion. Subgroup and sensitivity analyses were conducted to assess model stability.

Results

A total of 2,045 MACCE survivors were included. The higher levels of ALI and serum albumin were significantly associated with lower risks of all-cause and cardiovascular mortality among these individuals. Increases in C-reactive protein to Lymphocyte Ratio, Neutrophil to Serum Albumin Ratio, Neutrophil-to-Lymphocyte Ratio, Systemic Immune-Inflammation Index (SII), and C-reactive protein were similarly correlated with higher mortality risk. ALI outperformed other indices, displaying a distinct L-shaped nonlinear relationship with both all-cause and cardiovascular mortality among MACCE survivors, with an inflection point at 90 indicating the lowest risk. To the left of this inflection, each unit increase in ALI was associated with a 1.3% decrease in all-cause and cardiovascular mortality risk among MACCE patients. To the right, the risk might increase by 0.2%, although the change was not statistically significant. Subgroup analyses and sensitivity analyses showed that the association between ALI and risk of mortality remained stable in most MACCE survivor populations.

Conclusion

Routine and dynamic monitoring of ALI is helpful for clinicians to assess the mortality risk among MACCE survivors. Anti-inflammatory therapies and appropriate nutritional support are crucial for reducing mortality in these individuals.
Diagnosis and treatment experience of cecal diverticulitis in six pediatric patients
Authors: Li Xiao , Liu Wei , Zhang Shisong , Liu Hongzhen
Published: December 2024

Objective

This study aims to summarize the clinical characteristics, diagnostic methods, and treatment experience of cecal diverticulitis in children.

Method

The clinical data of six pediatric patients with cecal diverticulitis, treated at Children's Hospital Affiliated to Shandong University from November 2021 to May 2023, were retrospectively analyzed.

Result

All patients presented with abdominal pain primarily in the lower right abdomen. Two cases had fever with a maximum body temperature not exceeding 38.0°C. Three cases exhibited elevated inflammatory markers such as white blood cell count and C-reactive protein (CRP) upon admission. Three children were misdiagnosed with acute appendicitis based on preoperative color Doppler ultrasound. Two children were treated with third-generation cephalosporins and ornidazole for anti-inflammatory therapy and were cured after 6 and 9 days of hospitalization, respectively. Four children underwent laparoscopic surgery with excision of the cecal diverticulum and cecal repair, all of whom recovered well without postoperative complications. The operation duration ranged from 100 to 170 min, with an average of 140 min. Intraoperative blood loss ranged from 5 to 10 ml, averaging 6.75 ml. The overall length of hospital stay was 8–12 days, with an average stay of 9.5 days. All patients were followed up until December 2023, with no recurrences observed.

Conclusion

Children with cecal diverticulitis, especially complex cecal diverticulitis, are easily misdiagnosed as acute appendicitis. Acute simple cecal diverticulitis can be treated with anti-inflammatory therapy. Laparoscopic cecal diverticulectomy combined with cecal repair is a feasible and effective method for treating acute complex cecal diverticulitis.
Cross-sectional and prospective associations between children's eating behavior and visceral fat area and trunk fat mass
Authors: Wang Youxin , Shen Fangjing , Zhang Pingping , Xu Miao , Qiu Danqi , Wang Hui , Li Li
Published: December 2024

Background

Understanding children's eating behaviors is crucial for elucidating the etiology of childhood obesity. However, the relationship between these behaviors and abdominal fat accumulation remains poorly understood. This study aims to investigate this association in primary school children.

Methods

This study included 1,475 children aged 8–10 years in Ningbo, China. Body composition was measured both at baseline (September 2022) and after 9 months of follow-up (June 2023). Primary caregivers completed the Children's Eating Behavior Questionnaire (CEBQ). A mixed-effects linear model was applied to analyze the relationships between children's eating behaviors and body composition.

Results

Greater visceral fat area (VFA) was associated with greater slowness in eating [β = 0.25 (0.02, 0.49)], greater food responsiveness [β = 0.29 (0.14, 0.43)], increased emotional undereating [β = 0.35 (0.17, 0.54)], and more emotional overeating [β = 0.21 (0.02, 0.39)]. Children with greater trunk fat mass (TrFM) tended to have greater food responsiveness [β = 0.02 (0.01, 0.03)] and greater enjoyment of food [β = 0.01 (0.00, 0.03)], increased emotional undereating [β = 0.02 (0.01, 0.03)] and emotional overeating [β = 0.02 (0.00, 0.03)]. Prospectively, positive correlations were observed between VFA and food responsiveness [β = 0.18 (0.02, 0.35)], as were emotional undereating [β = 0.31 (0.10, 0.52)] and emotional overeating [β = 0.24 (0.03, 0.46)]. Similarly, TrFM was positively correlated with food responsiveness [β = 0.02 (0.00, 0.03)], enjoyment of food [β = 0.02 (0.00, 0.04)], emotional undereating [β = 0.02 (0.01, 0.04)] and emotional overeating [β = 0.02 (0.01, 0.04)].

Conclusions

Our findings suggest that eating behaviors are significantly associated with abdominal fat accumulation in primary school children. Addressing specific eating behaviors may be crucial in mitigating abdominal fat and its related health risks.
Predicting intra-abdominal candidiasis in elderly septic patients using machine learning based on lymphocyte subtyping: a prospective cohort study
Authors: Zhang Jiahui , Zhao Guoyu , Lei Xianli , Cui Na
Published: December 2024

Objective

Intra-abdominal candidiasis (IAC) is difficult to predict in elderly septic patients with intra-abdominal infection (IAI). This study aimed to develop and validate a nomogram based on lymphocyte subtyping and clinical factors for the early and rapid prediction of IAC in elderly septic patients.

Methods

A prospective cohort study of 284 consecutive elderly patients diagnosed with sepsis and IAI was performed. We assessed the clinical characteristics and parameters of lymphocyte subtyping at the onset of IAI. A machine-learning random forest model was used to select important variables, and multivariate logistic regression was used to analyze the factors influencing IAC. A nomogram model was constructed, and the discrimination, calibration, and clinical effectiveness of the model were verified.

Results

According to the results of the random forest and multivariate analyses, gastrointestinal perforation, renal replacement therapy (RRT), T-cell count, CD28+CD8+ T-cell count and CD38+CD8+ T-cell count were independent predictors of IAC. Using the above parameters to establish a nomogram, the area under the curve (AUC) values of the nomogram in the training and testing cohorts were 0.840 (95% CI 0.778-0.902) and 0.783 (95% CI 0.682-0.883), respectively. The AUC in the training cohort was greater than the Candida score [0.840 (95% CI 0.778-0.902) vs. 0.539 (95% CI 0.464-0.615), p< 0.001]. The calibration curve showed good predictive values and observed values of the nomogram; the DCA results showed that the nomogram had high clinical value.

Conclusion

We established a nomogram based on the T-cell count, CD28+CD8+ T-cell count, CD38+CD8+ T-cell count and clinical risk factors that can help clinical physicians quickly rule out IAC or identify elderly patients at greater risk for IAC at the onset of infection.

Clinical Trial Registration

[chictr.org.cn], identifier [ChiCTR2300069020].
JiangyaTongluo decoction ameliorates tubulointerstitial fibrosis via regulating the SIRT1/PGC-1α/mitophagy axis in hypertensive nephropathy
Authors: Zhao Yun , Jia Qi , Hao Gaimei , Han Lin , Gao Yushan , Zhang Xiaoyu , Yan Ziming , Li Boyang , Wu Yiping , Zhang Boya , Li Yubo , Qin Jianguo
Published: December 2024

Introduction

With the increasing prevalence of hypertension, the incidence of kidney diseases is also increasing, resulting in a serious public burden. Jiangya Tongluo decoction (JYTL), a recognized prescription in traditional Chinese medicine (TCM), is commonly used to calm an overactive liver and reduce excess yang, while also promoting blood flow to alleviate obstructions in the meridians. Previous research has indicated that JYTL may help mitigate kidney damage caused by hypertension; however, the underlying mechanisms have not been thoroughly assessed.

Methods

First, an amalgamation of UPLC-QE/MS and network pharmacology techniques was employed to pinpoint potential active components, primary targets, and crucial action mechanisms of JYTL in treating hypertensive nephropathy (HN). Then, we used spontaneous hypertensive rats (SHRs) and Wistar-Kyoto rats (WKYs) to evaluate the efficacy of JYTL on HN with valsartan as a positive reference. We also conducted DCFH-DA fluorescence staining in rat renal tissues to detect the level of ROS. Western blotting and immunohistochemistry were performed to investigate further the effect of JYTL decoction on key targets and signaling pathways.

Results

Through UPLC-QE/MS and network analysis, 189 active ingredients and 5 hub targets were identified from JYTL. GSEA in the MitoCarta3.0 database and PPI network analysis revealed that JYTL predominantly engages in the Sirt1-mitophagy signaling pathway. Tanshinone iia, quercetin, and adenosine in JYTL are the main active ingredients for treating HN. In vivo validation showed that JYTL decoction could improve kidney function, ameliorate tubulointerstitial fibrosis (TIF), and improve mitochondrial function by inhibiting ROS production and regulating mitochondrial dynamics in SHRs. JYTL treatment could also increase the expression of SIRT1, PGC-1α, Nrf1, and TFAM, and activate PINK1/Parkin-mediated mitophagy.

Conclusion

JYTL decoction may exert renal function protective and anti-fibrosis effects in HN by ameliorating mitochondrial function and regulating the SIRT1/PGC-1α-mitophagy pathway.
Nutrient allocation patterns in different aboveground organs at different reproductive stages of four introduced Calligonum species in a common garden in northwestern China
Authors: Liu Ji-Yuan , Zhang Xue-Lian , Jin Xin-Yue , Wang Meng-Ting , Zhang Yuan-Yuan , Wang Xi-Yong
Published: December 2024

Introduction

The Calligonum species is a typical shrub with assimilative branches (ABs) in arid regions in Central Asia. The nutrient distribution patterns at different reproductive stages are of great significance for further understanding the ecological adaptation and survival strategies of plants.

Methods

In the present study, a common garden experiment was employed to avoid interference by environmental heterogeneity. Furthermore, the nitrogen (N), phosphorus (P), and potassium (K) allocation characteristics in the supporting organs (mature branches), photosynthetic organs (ABs), and reproductive organs (flowers and fruits) of Calligonum caput-medusae (CC), Calligonum arborescens (CA), Calligonum rubicundum (CR), and Calligonum klementzii (CK) during the flowering, unripe fruit, and ripe fruit phases were systematically analyzed.

Results

Aboveground organs were the main factors affecting the variation of N, P, and K concentrations and their stoichiometric ratios, and the reproductive stages were secondary factors affecting N, P, and the P:K ratio and species were secondary factors affecting K and the N:P and N:K ratios. Meanwhile, significant interactions were found for all three of the aforementioned factors. The N and P concentrations in the ABs of the four species were highest during the flowering phase, while the N:P ratio was lowest, which then gradually decreased and increased, respectively, during plant growth. This result supported the growth rate hypothesis, i.e., that the growth rate is highest during the early growth stage. In the growth period, the N, P, and K concentrations in each organ of the four Calligonum species followed the power law, with the allocation rates of N and P being generally higher than K. There were differences among the species as the N−P scaling exponent in the ABs of CR was only 0.256; according to the scaling exponent law, this species was the least stressed and had the strongest environmental adaptability. Overall, the adaptability of the four species could be ranked as CR > CA > CC > CK. In conclusion, there were significant differences in nutrient traits among different aboveground organs, species, and reproductive stages.

Discussion

The results of this study contribute to a deeper understanding of the nutrient allocation strategies of different Calligonum species and provide scientific evidence for the ex-situ conservation and fixation application of these species.