bluuebunny/crossref_metadata_2025 huggingface dataset:
The FAN score predicts prognosis after platinum-based first-line chemotherapy in patients with metastatic urothelial carcinoma
Authors: Ishizuya Yu , Kawashima Atsunari , Horibe Yuki , Yamamoto Akinaru , Tani Masaru , Yoshimura Akihiro , Liu Yutong , Sassi Nesrine , Oka Toshiki , Okuda Yohei , Uemura Toshihiro , Yamamichi Gaku , Hayashi Takuji , Yamamoto Yoshiyuki , Kato Taigo , Hatano Koji , Nonomura Norio
Published: December 2024

We have reported that the FAN score, which consists of the fibrosis-4 (Fib-4) index, albumin–bilirubin (ALBI) score, and neutrophil-lymphocyte ratio (NLR), is a prognostic marker for patients receiving pembrolizumab for metastatic urothelial carcinoma (mUC). However, the insight into whether the FAN score is a prognostic factor for platinum-based first-line chemotherapy. We included 126 patients with mUC who received platinum-based first-line chemotherapy. The median PFS and overall survival (OS) were 6.3 months (95% confidence interval [CI]: 4.5 – 8.0) and 14.0 months (95% CI: 11.1 – 16.9), respectively. Multivariate analysis showed that Fib-4 index (HR 3.85, 95% CI 1.09 – 13.58, p = 0.036), ALBI score (HR 1.53, 95% CI 1.01 – 2.31, p = 0.045), and NLR (HR 1.76, 95% CI 1.14 – 2.71, p = 0.010) were independently associated with PFS. The FAN score was also associated with PFS (HR 2.52, 95% CI 1.60 – 3.98, p < 0.001). The median PFS for patients with low FAN score (≤1) and those with high FAN score (≥2) were 7.8 (95% CI 5.0 – 9.0) months and 3.0 (95% CI 1.6 – 5.8) months, respectively. In conclusion, the FAN score is a prognostic factor in patients with mUC treated with platinum-based first-line chemotherapy.
WITHDRAWN: Exploring the Molecular Mechanism of Estrogen Therapy Effectiveness after TCRA in IUA Patients at single-cell level
Authors: Du Yue , Shuai Ruzhen , Luo Sang , Jin Yiran , Xu Fengjuan , Zhang Jingyi , Liu Dan , Feng Limin
Published: December 2024

Background
Intrauterine adhesion (IUA) is a common cause of clinically refractory infertility, and there exists significant heterogeneity in the treatment outcomes among IUA patients with the similar severity after transcervical resection of adhesion(TCRA). The underlying mechanism of different treatment outcomes occur remains elusive, and the precise contribution of various cell subtypes in this process remains uncertain.
Results
Here, we performed single-cell transcriptome sequencing on 10 human endometrial samples to establish a single-cell atlas differences between patients who responded to estrogen therapy and those who did not. The results showed increased infiltration of immune cells such as monocyte macrophages, T cells, and natural killer (NK) cells in patients who did not respond to estrogen therapy. Our findings indicate that distinct fibroblast subsets are implicated in the modulation of the Wnt, Hippo, and Hedgehog signaling pathways, as evidenced by functional enrichment analyses. This may have implications for the therapeutic efficacy in patients with IUA. Furthermore, we delineated the markers and transcriptional status of different macrophage subsets and identified two cell clusters, CXCL10high and CCL4L2high macrophage subsets, which are intimately associated with inflammation and fibrosis. The state of fibrosis and inflammatory response in human endometrial tissues with disparate treatment outcomes is revealed, and providing evidence to clarify the underlying determinants of sensitivity to estrogen therapy.
Conclusions
We described the transcriptional status of different cell subtypes in the two groups of patients, providing new ideas for exploring the molecular mechanism of the difference in the effectiveness of estrogen therapy in patients, and providing theoretical basis for providing precise and individualized treatment plans for IUA patients.
Associations between C-reactive protein-triglyceride glucose index and Endometriosis: the NHANES 1999-2006
Authors: Ren Yanan , Xu Ren , Zhang Junqin , Jin Ying , Zhang Di , Wang Yazhuo , Su Luyang
Published: December 2024

Background: The C-reactive protein-triglyceride glucose index (CTI), a promising new marker, could evaluate the extent of inflammation. Endometriosis is a prevalent chronic inflammatory condition that is influenced by estrogen and primarily impacts individuals of reproductive age. However, no investigated have shown association of the CTI with endometriosis.
Methods: In total, 2235 women in National Health and Nutrition Examination Survey from the 1999-2006 were included. The CTI was deﬁned as 0.412 × ln (CRP) + ln [T.G. (mg/dL) × FPG (mg/dL)/2]. Multivariate logistic regression, restricted cubic splines, and subgroup analyses were employed to examine the association of CTI with endometriosis.
Results：Totally 2235 women were included, of whom 175 (7.82%) had endometriosis and 2060(92.18%) did not have endometriosis (named control). In comparison to the control group, patients exhibited a tendency toward higher CTI levels (P =0.005). CTI levels were positive associated with the prevalence of endometriosis (P =0.011). In Model 1, 1 mg/dL increment in CTI was associated with a 56% higher prevalence of endometriosis (OR: 1.563, 95% CI: 1.295–1.885, P < 0.001). This association in Model 2 (OR: 1.609, 95% CI: 1.334-1.941, P ＜ 0.001) and Model 3 (OR: 1.565, 95% CI: 1.246–1.966, P < 0.001) remained significant. Notably, individuals in the uppermost RC tertial exhibited a notably greater prevalence of endometriosis than those in the lowest tertial (OR = 3.029, P for trend = 0.051). The results from the restricted cubic splines indicated a nonlinear positive association between CTI and the prevalence of endometriosis. In addition, the higher endometriosis prevalence with CTI in >40 years (OR = 1.57, 95% CI:1.16 , 2.13), BMI ≥25 kg/m2 (OR =1.38, 95% CI: 1.06,1.80), smoking ≥ 100 cigarettes (OR =1.43, 95% CI: 1.06, 1.96), married or living with partner (OR =1.41, 95% CI: 1.09, 1.85) and taking oral contraceptives (OR =1.35, 95% CI: 1.07, 1.69) was observed.
Conclusions: CTI is positively associated with endometriosis in US women. Therefore, the use of CTI as a new indicator of inflammation may help provide new insights into the prevention and management of endometriosis.
Evaluating the Risk of Comorbidity Onset in Elderly Patients After a Cancer Diagnosis
Authors: Islam Md Tamzid , Saif Md Saiful Islam , Alam Naima , Pepper Sam , Ratnayake Isuru , Mudaranthakam Dinesh Pal
Published: December 2024

Background: Cancer is a critical disease that affects a person physically, mentally, socially, and in many other aspects. During the treatment stage of cancer, patients suffer from various health complexities, especially elderly people, which might result in the onset of other diseases development of a comorbid condition. Several studies have shown comorbidity plays a crucial role in cancer survival. However, there remains a lack of comprehensive statistical techniques at the national level studies to assess the significance of comorbidities development in cancer. Our research aims to address this gap by comparing cancer and non-cancer individuals over four years’ time period.
Methods: The Health Retirement Study (HRS) data was used to extract information from 6651 participants aged more than 50. Within a 4-year time span, cross-sectional observations were created whether comorbidities or not based on the development of diseases such as high blood pressure, diabetes, heart disease, stroke, lung disease, and psychological disease.
Results: The multivariable logistic regression model, we observe higher chances of developing comorbidity (OR=1.321, p-value 0.0051) among the cancer group compared to the non-cancer group, adjusting the socio-economic factors. Moreover, the socio-economic factors were found to be significantly associated with cancer leading to applying the propensity score matching with (1:3 matching). Finally, the balanced data also showed significantly higher chances of developing comorbidity (OR=1.294, p-value 0.0207) among cancer patients.
Conclusions: The above findings demonstrated the imperative development of enhanced treatment protocols, which prioritize the overall health of cancer patients, thereby reducing their susceptibility to additional illnesses.
Evaluation of renal oxidative stress in patients with chronic kidney disease using 64 Cu-ATSM PET/MRI
Authors: Huang Ya’nan , Nishikawa Yudai , Mori Tetsuya , Nogami Munenobu , Makino Akira , Kiyono Yasushi , Toyama Tadashi , Okazawa Hidehiko
Published: December 2024

The purpose of the study was to investigate renal oxidative stress (OS) and its relationship with disease severity in patients with chronic kidney disease (CKD) using positron emission tomography coupled with magnetic resonance imaging (PET/MRI), employing 64Cu-diacetyl-bis(N4-methylthiosemicarbazonate) (64Cu-ATSM) as the PET tracer for OS imaging. Thirty patients with CKD (66.4 ± 8.2 y.o.) and seven healthy controls (HC) subjects (58.3 ± 3.8 y.o.) underwent 64Cu-ATSM PET/MRI. Participants were categorized into three groups based on their estimated glomerular filtration rate (eGFR): HC, mild CKD (stages 2-3a), and advanced CKD (stages 3b-5). All subjects underwent 30-min dynamic PET/MRI starting with the injection of 64Cu-ATSM to evaluate renal blood flow (RBF) and OS levels. RBF (mL/min/100g) images were calculated from the first 3 min PET data, and standardized uptake value (SUV) images were obtained from delayed frames of 15–30 min after injection. The 64Cu-ATSM SUV images were corrected using individual RBF images to estimate the OS levels of individual kidneys using the following equation: OS index = (SUV/RBF)x100. Significant correlation was observed between eGFR and RBF (r = 0.81, P < 0.001). RBF in patients with advanced CKD is significantly lower than that in HC (P < 0.001) and patients with mild CKD (P = 0.004). 64Cu-ATSM SUV did not differ significantly among the three groups (P = 0.171). 64Cu-ATSM SUVs did not correlate with creatinine in the HC subjects or in the patients with CKD. However, these values did correlate with eGFR (r = 0.33, P = 0.049) in all subjects, whereas the CKD patients showed no significant correlation. Following RBF correction, the OS index demonstrated significant correlations with creatinine (r = 0.75, P < 0.001), eGFR (r= -0.65, P < 0.001), and CKD stages (r = 0.57, P < 0.001) in all subjects. This preliminary study has revealed that 64Cu-ATSM PET may provide a reasonable estimate of renal OS reasonably in CKD patients noninvasively. Increased OS index values were correlated with the CKD stages and creatinine levels, suggesting that OS increases with the severity of renal dysfunction.
Efficacy of Nutrient Supplements in Managing Malnutrition and Sarcopenia in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Protocol for Systematic Review and Meta-Analysis
Authors: Zheng Hong Yan , Zhang Hao-yu , Wu Kuang-hao , Cai Wen-jie , Li Zhou-zhou , Song Xin-yu
Published: December 2024

Background: COPD patients suffering from malnutrition or sarcopenia often incur higher healthcare costs and experience adverse clinical outcomes. Despite this, the effectiveness of nutrient supplements in this population remains uncertain.
Methods and analysis: Two reviewers will independently search seven databases—PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database, and the Cochrane Library—for randomized controlled trials (RCTs) published before August 31, 2024. These RCTs should compare the effects of nutrient supplements against either a standard diet or placebo supplements in patients with COPD. The risk of bias in the included studies will be evaluated using the modified Jadad scale and the Cochrane Collaboration's risk of bias tool. Data synthesis will be conducted using RevMan software. Trial sequential analysis (TSA) will be applied to the primary outcomes. Additionally, subgroup and sensitivity analyses will be performed to assess the robustness of the findings.
Ethics and dissemination: Ethical approval is not required because this study is a secondary analysis of existing data. We will disseminate the findings through peer- reviewed publications.
PROSPERO registration number: CRD42024585694.
How can China achieve a territorial spatial governance path that synergizes development and protection? A solution based on the harmonious coexistence of humans and nature
Authors: Ou Dinghua , Ruan Kun , Yang Ziheng , Shu Chang , Yan Zijia , Zhou Rui , Qin Jing , Gao Xuesong , Xia Jianguo
Published: December 2024

The contradiction between economic development and ecological protection has become a common problem faced by the territorial space governance of developing countries or regions around the world. The reconstruction of the territorial spatial functional pattern (TSFP) can provide a spatial governance path for coordinated development and protection. However, existing research has not given enough attention to the coupling and symbiotic relationship between humans and nature when restructuring of the TSFP, resulting in significant functional conflicts, weak stability, and a lack of balance between ecological and economic benefits. This has not effectively achieved synergy between development and protection. How to achieve the reconstruction of the TSFP of harmonious coexistence between humans and nature? It is still a challenge for synergizing development and protection through the path of TSFP reconstruction. This study innovatively applies game theory and real variable function theory to establish a territorial spatial functional pattern reconstruction (TSFPR) model for harmonious coexistence between humans and nature, and has been validated in Qionglai City, China. Empirical evidence shows that compared with conventional methods, the functional conflicts in the TSFP established by the TSFPR model have been significantly alleviated, stability has been significantly improved, and ecological and economic benefits have been significantly enhanced, achieving the expected harmonious coexistence between humans and nature. Further analysis confirms that the established territorial spatial functional conflict coordination (TSFCC) index provides a reliable criterion for identifying superior territorial spatial functions (TSFs). The proposed TSFPR model extends the theory of spatial optimization modeling and provides a tool for the TSFP reconstruction of harmonious coexistence between humans and nature. In short, using the TSFPR model to reconstruct TSFP of harmonious coexistence between humans and nature provides a new implementation solution for the territorial spatial governance path of the coordinated development and protection.
Choroid Plexus Free-Water Correlates with Glymphatic function and Neurodegeneration in Alzheimer’s Disease
Authors: Li Binyin , Xu Xiaomeng , Yang Xinyuan , Zhang Junfang , Wang Yan , Selim Magdy , Zheng Yingting , Shen Ruinan , Sun Lipeng , Huang Qi , Wang Wenjing , Xu Wei , Guan Yihui , Liu Jun , Deng Yulei , Xie Fang
Published: December 2024

Free-water imaging of the choroid plexus (CP) is an index revealing components of the CP, which may improve the evaluation of Alzheimer's disease (AD). Our study evaluated free water fraction (FWf) of CP in 216 participants (133 Aβ+ participants and 83 Aβ- controls) continuously enrolled in the Ruijin NeuroBank of Alzheimer's Disease and Dementia (RJNB-D) cohort. The ADNI dataset was used for external validation. Assessments of AD neurodegeneration included Aβ-PET, Tau-PET, synaptic vesicle glycoprotein 2A-PET scans, and blood biomarkers included glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), neurogranin (NRGN), and Tumor Necrosis Factor-α (TNF-α). The CP FWf and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index were independently associated with Aβ positivity in both RJNB-D and ADNI datasets. Within the Aβ+ group, the negative correlation between CP FWf and DTI-ALPS was validated by two datasets. Furthermore, we observed a partial mediation effect of DTI-ALPS between CP FWf and periventricular white matter hyperintensity (pWMH). Elevated CP FWf was linked to worse Mini-Mental State Examination, increased Tau accumulation, reduced synaptic density, and elevated levels of NFL, GFAP, NRGN, and TNF-α. Longitudinally, CP FWf increased faster in Aβ+ participants than Aβ- controls (time × group interaction effect p = 0.046). The growth of CP FWf was associated with a reduction in DTI-ALPS (ρ = -0.42, p = 0.006), and the growth rate of CP FWf surpassed that of pWMH, Tau, and GFAP. Overall, our findings suggest that elevated CP FWf indicates impaired glymphatic function and AD neurodegeneration.
Trial registration
The study is registered on ClinicalTrials.gov (NCT05623124).
Correlation of Social Ages and BMI Centiles among Children Aged 5 to 15 Years with and without Disability from a Rural Community in Karnataka, India.
Authors: Jacob Ankeeta Menona , Pruthvish Sreekantaiah , Shastry Nanda Kumar Bidare , Shankarappa Mohanraju , Kunnavil Radhika
Published: December 2024

Background:
Vineland Adaptive Behavioural Scales have been used to evaluate and diagnose social quotients in children. The study aimed to correlate social ages and quotients in children aged 5-15 with and without disabilities in a rural community in Karnataka, India, using Vineland Adaptive Behavioural Scales.
Methods and Material:
A cross-sectional analytical study was conducted on 145 children with disabilities and 145 children without disabilities, aged 5-15 years, in a rural community in Karnataka.
The Bharath Raj’s Indian Adaptation Vineland Social Maturity scale was used for interviews between February 2014 and February 2015. Two scoring methods, "Total correct score match method (TCSM)" and "Add months to year-wise (AMTY)," were employed.The data was analysed in MS Excel using SPSS v 21. BMI centiles were correlated with social age and quotient using Spearman's correlation, with results reported at a significance level of P < 0.05.
Results: Children with disabilities exhibited lower social ages compared to their non-disabled counterparts using both TCSM and AMTY methods. Social ages of both groups correlated positively and significantly with age. Additionally, children with disabilities displayed a significant positive correlation between BMI centiles and social ages using both methods.
Conclusion:
Social quotients children aged 5-15 using both methods on the Vineland Social Maturity Scales exhibited similar results and a strong correlation with actual ages for disabled and non-disabled children. Children with disabilities showed a positive correlation between social age and BMI centiles using both assessment methods.
Neutrophil-lymphocyte ratio predicts all-cause and cardiovascular mortality in a pan- vascular disease population: a nationally representative study
Authors: Yang Xueyuan , Chen Lei , Xiao Hong , Li Kui , Yang Changlong , Liang Jiafei , Ma Yi
Published: December 2024

Background
A novel medical specialty, pan-vascular medicine, has recently emerged for atherosclerosis treatment. Its objective is the integrated management of pan-vascular diseases, including coronary artery cerebrovascular, and peripheral artery diseases. This study aimed to examine the correlation between neutrophil-lymphocyte ratio (NLR) and mortality in a population with pan-vascular disease, to assess its predictive value.
Methods
This retrospective cohort study comprised 1,767 individuals with pan-vascular disease sourced from the NHANES database (2001–2016). Study endpoints were all-cause and cardiovascular mortality. The relationship among NLR, all-cause mortality, and cardiovascular mortality was examined in a population with a broad range of vascular diseases. Weighted Cox regression analyses and restricted cubic spline (RCS) analyses were conducted. Discrepancies in survival rates between the three groups classified according to NLR were investigated using Kaplan-Meier survival analysis. Prognostic accuracy of the NLR model for mortality in the pan-vascular disease population was evaluated using time-dependent receiver operating characteristic curves and calibration curves.
Results
The median follow-up period for this study was 90 months, during which a total of 832 patients died, including 269 who died of cardiovascular causes. Neutrophil-to-lymphocyte ratio (NLR) was an independent predictor of all-cause mortality [hazard ratio (HR) = 1.13, 95% confidence interval (CI) (1.07–1.20), p < 0.001] and cardiovascular mortality [HR = 1.14, 95% CI (1.05–1.24), p = 0.001] in individuals with pan-vascular disease. RCS analysis indicated a linear association between NLR and all-cause mortality (p-value for nonlinearity = 0.108) and cardiovascular mortality (p-value for nonlinearity = 0.149) in the population with pan-vascular disease. Risk of all-cause mortality and cardiovascular mortality was elevated among individuals with higher levels of NLR. NLR model exhibited favorable predictive efficacy for all-cause mortality and cardiovascular mortality in the pan-vascular disease population. Furthermore, the calibration curve illustrated the high predictive accuracy of the NLR model for all-cause mortality in the pan-vascular disease population at 3 and 5 years.
Conclusions
NLR is an independent risk factor for cardiovascular mortality and all-cause mortality in pan-vascular disease populations, and is linearly associated with all-cause mortality and cardiovascular mortality in pan-vascular disease populations and has some predictive value.
Impact of Land Use Change on Seasonal Water Quality, Case Study in Chi-Mun River Basin in Thailand
Authors: Pakoksung Kwanchai , Inseeyong Nantawoot , Chawaloesphonsiya Nattawin , Punyapalakul Patiparn , Chaiwiwatworakul Pichet , Xu Mengzhen , Chuenchum Pavisorn
Published: December 2024

This study investigates the correlation between land use changes and water quality in the Chi-Mun River Basin, Thailand, from 2007 to 2021. It is the first of its kind in the region and the Mekong River Basin, providing critical insights for global river basin management. The research analyzes spatial and temporal land use changes and their multi-scale impacts on water quality, utilizing land use change estimation, water quality index analysis, and redundancy analysis (RDA). The results showed that stream water quality variables displayed highly temporal variations, with pH, Biochemical Oxygen Demand (BOD), Total Coliform Bacteria (TCB), Fecal Coliform Bacteria (FCB), Total Phosphorus (TP), Nitrate Nitrogen (NO3-N), Ammonia-nitrogen (NH3-N), Suspended Solids (SS) all generally displaying higher levels in the wet season, while there were higher concentrations of Dissolved Oxygen (DO), Electrical Conductivity (EC), and Water Quality Index (WQI) in the dry season. The water samples were collected once in January, March, May, and August from 2007 to 2024. The water quality in wet season is represented in May and August, while in dry season is represented in January and March. The total contribution of land use patterns on overall water quality was stronger during the wet season. It shows a decline in paddy and forest areas alongside an expansion of urban, agricultural, and aqua agricultural land. Water quality displayed significant seasonal variations, with forests and water bodies contributing to purification, while agricultural and urban areas degraded water quality. The findings offer recommendations for water quality protection and land management policies that align with the basin’s natural and socio-economic characteristics, promoting coordinated regional development.
Serum biochemical markers and rheumatoid arthritis: Insights from observational study and Mendelian randomization analysis
Authors: Fan Fangzhou , Tan Hao , Xie Yuxin , Qin Hao , Zhang Chengxuan , Wang Huaao , Yan Wenlong , Zhou Aiguo , Liu Lei , Lian Chengjie
Published: December 2024

Objectives: To identify the specific serum biochemical markers that exhibit causal associations with the risk rheumatoid arthritis (RA)
Methods: A cross-sectional study based on the NHANES database was conducted to investigate which serum biochemical markers were significantly associated with RA. Two-sample Mendelian randomization (MR) and Generalized summary data-based Mendelian randomization (GSMR) analysis were employed to analyze the causal relationships between biomarkers exhibiting differential expression identified within the NHANES database. The primary MR analysis utilized the inverse variance weighted (IVW) method. Restricted cubic spline (RCS) regression was conducted to explore non-linear associations between variables.
Results: The NHANES cohort included 1,416 participants with clinically diagnosed RA and 3,744 control participants without RA. GSMR analysis revealed a significant causal relationship between serum albumin and RA risk (OR = 0.80, 95% CI: 0.72-0.89, P = 3.67×10−5). The IVW meta-analysis also confirmed that decreased albumin expression significantly associated with decreased risk of RA (P = 0.002). A four-node RCS model demonstrated non-linear correlations between albumin, uric acid, and RA (all P non-linear < 0.05), while calcium, globulin, and lactate dehydrogenase (LDH) exhibited linear relationships (all P non-linear > 0.05). However, multiple MR methods did not show any significant causal association between calcium, LDH, urate, and RA risk.
Conclusion: This study found a linear association between calcium, globulin, LDH, and RA risk, while a U-shaped non-linear relationship between albumin, uric and RA was observed. MR analysis revealed a significant causal association between albumin and RA. However, the molecular mechanisms by which albumin affects the risk of RA remain to be further elucidated.
Supplementation with Essential Amino Acids in the Early Stage of Carbohydrate Reintroduction after a Very-Low Energy Ketogenic Therapy (VLEKT) Improves Body Cell Mass, Muscle Strength and Inflammation.
Authors: Annunziata Giuseppe , Verde Ludovica , D’Orsi Vincenzo , Caprio Massimiliano , Gorini Stefania , Savastano Silvia , Colao Annamaria , Muscogiuri Giovanna , Barrea Luigi
Published: December 2024

Background
Although little is yet known about the long-term maintenance of very low-energy ketogenic therapy (VLEKT) effects on body composition, muscle strength and inflammation, it is plausible to assume that changes may occur, particularly during the steps following the ketogenic step, due to the loss of the protective effects of ketones and the concomitant reintroduction of carbohydrates. For this reason, the present study aimed to evaluate the effects of supplementation with 8 g per day of essential amino acids (EAAs) on these parameters.
Methods
A total of 68 women of reproductive age and with grade I obesity who had completed 45 days of the ketogenic phase with VLEKT (KeNuT protocol) and 40 days of non-ketogenic phase of KeNuT protocol with VLEKT (phase 3, fruit reintroduction) were included in the study. Half of them (n = 34) followed this first step of the re-educational phase of KeNuT protocol with VLEKT with supplementation with EAAs (Aminotrofic®: 4 g twice daily). Anthropometric parameters, body composition via bioelectrical impedance analysis and high-sensitivity C-reactive protein (hs-CRP) levels were assessed at baseline, pre- and post both dietary interventions.
Results
At the end of 45 days of ketogenic phase with VLEKT (before fruit reintroduction and EAA supplementation), the two groups did not differ in any of the parameters assessed. At the end of the fruit reintroduction phase, the supplemented group showed greater magnitudes of reduction in weight, waist circumference, fat mass (FM) and hs-CRP (p < 0.001 for all) and of increase in muscle strength (p < 0.001), phase angle (p < 0.001), body cell mass (BCM) (p = 0.001), and muscle mass (%) (p < 0.001).
Conclusion
These results underline the usefulness of supplementation with EAAs during the first transitional phase post VLEKT to improve body composition (specifically reduction in FM and increase in BCM), muscle strength, and inflammatory status.
A national study on knowledge of child language development, self-efficacy, and the professional development of childcare providers in Saudi Arabia
Authors: Alaslani Khadeejah , Almohammadi Alaa , Alroqi Haifa , Aljahlan Yara , Alsulaiman Roaa , Albeeshi Aalya , Murad Abdullah , Alnemary Fahad
Published: December 2024

This country-wide study explores the landscape of childcare providers (CPs) in Saudi Arabia, illuminating their pivotal role in fostering children’s language skills. While fundamental, our understanding of their status in Saudi Arabia remains limited. This study provides a comprehensive profile of CPs, exploring their knowledge of child language development, self-efficacy, and their interplay with work experience, education, and training. Key findings indicate that merely a quarter of CPs hold a degree in early childhood education. A significant positive association was found between CPs’ knowledge of child language development and their perceived self-efficacy, and a moderately significant positive association was found between CPs’ knowledge of language development and professional training received. CPs’ self-efficacy was significantly predicted by their knowledge of language development and the training received. The implications underscore the urgency of targeted professional development initiatives to enhance the quality of early childhood education in Saudi Arabia. Policymakers should address the concerning trend where a significant portion of entrusted professionals lacks specialization in early childhood, raising critical questions about the alignment of educational qualifications with the demands of early childhood education. These insights offer a compelling basis for policymakers to advocate evidence-based practices and guide future research in the field.
Chronic Phase Nasal Intermittent Ventilation in Neonates with Grade 3 Bronchopulmonary Dysplasia
Authors: Weems Mark , Lamba Vineet , Chilakala Sandeep , Murdock L. Brooke , Rana Divya , Sakaria Rishika , Zaveri Parul , Ramanathan Rangasamy
Published: December 2024

Objective
We describe a novel strategy of chronic-phase nasal intermitted positive pressure ventilation (cNIPPV) to support patients with bronchopulmonary dysplasia (BPD) and avoid tracheostomy.
Study Design
This is a retrospective study of Grade 3 BPD patients discharged from a single center January 2020 to May 2024. Patients were divided into groups treated with cNIPPV or with tracheostomy. Groups were assessed for clinical differences, and the cNIPPV strategy was described.
Result
There were 28 cNIPPV and 20 tracheostomy patients. There were no differences between groups for gestational age, birthweight, or respiratory severity score at key dates. Tracheostomy patients were more likely to have subglottic stenosis (55 vs 3.6%, p < 0.0001). Tracheostomy patients were older at discharge home [median 447 (411–514) vs 252 (184–309) days, p < 0.0001].
Conclusion
A subset of Grade 3 BPD patients can be supported with cNIPPV and avoid tracheostomy. This strategy may be associated with decreased length of hospital stay.
Optimisation of thermal characteristics of buried composite phase change energy storage walls
Authors: Diao Rongdan , Cao Yinqiu , chi congwen , Michel Mushagalusa Murhambo , Guan Yajuan , Guerrero Josep M
Published: December 2024

Improving the thermal insulation performance of building walls is the most effective way to save energy in buildings. In this paper, multiple construction forms of embedded composite phase change energy storage wall are proposed to study the heat transfer characteristics of the wall and its influence on the indoor thermal environment. The heat transfer law and mechanism of wall influence on indoor thermal environment are revealed. The results show that the error between the measured results and the numerical simulation results is less than 10%, which verifies the feasibility of studying the heat transfer performance of the phase-change wall by numerical simulation method. Under the condition that water does not flow, the temperature difference at the base of ordinary wall, S font, U font and back font phase change energy storage wall is 8.70℃, 8.80℃, 8.83℃ and 8.94℃, respectively. Under the working condition of water flow, the temperature difference of S-font, U-font and back-font phase change energy storage wall base is 5.00℃, 5.18℃ and 6.51℃, respectively. The smaller the coil spacing, the better the heat storage performance of the phase change wall. The phase-change energy storage wall can reduce the maximum indoor air temperature by 3.2℃, and effectively improve the indoor thermal comfort.
Research Hotspots and Cutting-edge Trends in Intertrochanteric Femur Fracture from 1999 to 2024: A Bibliometric Analysis
Authors: deng xin , su yun , fu yutian , zhang haochun , zhang yongkun , meng xiangjun
Published: December 2024

Purpose The objective of this study was to uncover the current primary research topics within the field of IFF through a comprehensive statistical analysis of available literature sources, while also providing insights into potential future advancements.Methods Literature on IFF, published from the establishment of the database until April 2024 was retrieved from the Web of Science database. Statistical analyses were performed using Microsoft Office Excel 2021 and a bibliometric online analysis platform. Literature visualization analysis was performed using a citespace.6.3. R1 software.Results A total of 3424 articles were retrieved, including 3211 research articles and 213 review articles. Literature on IFF has consistently shown an annual increase in quantity. Articles pertaining to this field have been published by 80 countries or regions globally, with the United States leading in both publication volume and total citations. J ORTHOP TRAUMA had the highest number of publications (138 articles), while the University of California System emerged as the most prolific institution with 64 articles. Professor Yingze Zhang has made significant contributions to the literature in this domain. Co-occurrence analysis revealed three primary categories for relevant keywords associated with IFF: clinical classification research, treatment, and complications.Conclusions The incidence and number of patients with IFF are expected to continue increasing, leading to subsequent growth in the volume of literature on this topic over the next decade. Future research should focus on investigating risk factors and treatment methods for IFF, particularly within the realm of treatment strategies.
Identification and validation of PANoptosis-based HNSCPAN-index as a prognostic model for head and neck squamous cell carcinoma
Authors: Feng Yekai , Tang Qinglai , Tang Xiaojun , Zeng Miao , Zang Yuming , Li Shisheng
Published: December 2024

PANoptosis, a recently characterized form of programmed cell death, remains incompletely understood in the context of Head and Neck Squamous Cell Carcinoma (HNSCC). In this study, we identified a prognostically relevant set of PANoptosis genes within The Cancer Genome Atlas (TCGA) database for HNSCC and uncovered three molecular subtypes based on their expression profiles. Each subtype exhibited distinct prognostic outcomes and immune cell infiltration patterns. To further elucidate the clinical relevance, we constructed a PANoptosis risk score model, termed the HNSCPAN-index, using least absolute shrinkage and selection operator (LASSO) Cox regression based on differentially expressed genes across the subtypes. Patients were stratified into high-risk and low-risk groups according to the HNSCPAN-index. The predictive power of the model was evaluated using Kaplan-Meier analysis, ROC, nomogram and validated using an external dataset. A lower HNSCPAN-index correlated with longer overall survival and enhanced immunotherapy responses, whereas a higher HNSCPAN-index indicated increased sensitivity to small-molecule targeted therapies. Moreover, the HNSCPAN-index demonstrated a strong correlation with chemotherapeutic drug sensitivity. Finally, DSCAM was identified as a key regulator in HNSCC, where silencing DSCAM expression enhanced cell death mediated by pyroptosis inducers. In conclusion, we constructed a risk model of PANoptosis in HNSCC and revealed its potential role in prognosis, TME, chemotherapy. These findings may provide a deeper understanding of PANoptosis in HNSCC and pave the way for the development of more personalized therapeutic strategies.
Epithelial Cell Adhesion Molecule accurately identifies pulmonary carcinoma metastases in lymph nodes
Authors: McGovern Kelly A. , Welch Katherine O. , Krouse Ryan , Brown Michael , Chen Lydia , Guo Kevin , Huang Jeffrey , Mlakar Jake , Delikatny Jim , Gruev Viktor , Zhang Paul , Singhal Sunil
Published: December 2024

Lymph node (LN) excision is critical in oncologic surgery to provide important therapeutic and diagnostic information. LN evaluation helps in staging cancers, predicting prognosis and improving survival. The ultimate wish of a surgical oncologist would be to localize and dissect all pathologically positive LNs while avoiding the morbidity of removing true negative LNs. The goal of our study was to identify a reliable marker for clinical prediction of LNs with cancer cells from non-small cell lung cancer (NSCLC) versus a LN without. We identified Epithelial Cell Adhesion Molecule (EpCAM), a membrane protein normally expressed in epithelial tissues including in lung. We used human specimens immunostained with anti-EpCAM monoclonal antibody. EpCAM was expressed in NSCLC metastasis to LNs as shown in 74 positive LNs from patients with resected primary NSCLC. Among pathologically negative LNs, regardless of PET avidity, EpCAM was absent; whereas among pathologically positive LNs, all PET uptake groups exhibited high EpCAM positivity. Together, this biomarker had a 100% accuracy. There was no difference in expression between hilar and mediastinal LNs, nor between primary tumor histology. EpCAM may be useful for the surgical oncologist for preoperative or intraoperative detection of positive LNs from NSCLC.
Classification of childhood obesity using longitudinal clinical body mass index and its validation
Authors: Thaker Vidhu , Ebrahim Nia , Khadegi Apurva , Deng Shuliang , Qian Kun , Yao Zonghui , Thaker Shaleen , May Benjamin , Patibandala Nandan , Lopez-Pintado Sara
Published: December 2024

Objective: Persistence of childhood adiposity is known to be associated with long-term adverse cardiometabolic risks. Yet, cross-sectional body mass index (BMI) is often used to classify obesity in clinical care and research. This study aimed to develop and validate a childhood obesity classification system using longitudinal clinical data.
Methods: This observational study used electronic health record data from a tertiary care hospital, with replication in an independent cohort. For individuals with ≥ 3 BMI measurements, the median BMI percentile and persistence in the obesity class were used for longitudinal classification. The association between longitudinal BMI class and early onset obesity, socioeconomic status (SES), and adverse cardiometabolic risk was analyzed.
Results: Height, weight, and cardiometabolic risk measures were obtained for 22 352 children from 2014-18 in the primary cohort and 24 444 children in the replication cohort. Obesity (BMI ≥ 95th percentile [BMIpct95]) was observed in 24.1% and severe obesity (BMI ≥ 120% of BMIpct95) in 10.6%. Individuals with early onset obesity (age ≤ 6 years) remained in the same or higher obesity class; those in the high-SES group had lower odds of obesity. The proportion of individuals with cardiometabolic risk increased with increasing obesity severity (p-value 0.01 - < 0.001). The AUC for cardiometabolic risk by longitudinal BMI class was higher compared to that for cross-sectional BMI (80.0% vs. 75.8%, p < 0.001).
Conclusions: The Longitudinal BMI classification may better reflect long-term cardiometabolic risk in children. This classification can be useful for focused intervention strategies and for profiling of individuals for genetic testing.
Disrupted topological organization of brain connectome in patients with chronic low back-related leg pain and correlations with clinical characteristics
Authors: Ji Yuqi , Liang Xiao , Pei Yixiu , Zuo Xiaoying , Zhu Yanyan , Xu Jie , Kuang Qinmei , Yang Ziwei , Zhou Fuqing , Zhang Yong
Published: December 2024

Chronic pain is associated with persistent alterations in brain structure and function. However, existing research has not fully explored the relationship between brain network topological properties and clinical symptoms in patients with chronic low back-related leg pain (cLBLP). In this study, we collected resting-state functional and structural magnetic resonance imaging (MRI) data, along with clinical symptom evaluation data, from 32 cLBLP patients and 31 healthy controls. A large-scale complex network analysis was conducted to evaluate the global and nodal topological properties of functional and structural brain networks. Statistical analyses were performed to determine the associations between network properties and clinical variables. The results showed significant alterations in both global and nodal topological properties of functional and structural brain networks in cLBLP patients compared to healthy controls. Notably, nodal properties of functional brain networks were also altered in patients. Additionally, a direct correlation was found between structural network properties and spatial discrimination ability, measured by two-point tactile discrimination (2-PD) values, while no significant association was observed between functional connectivity and spatial discrimination. This study demonstrates that alterations in the structural connectome, rather than the functional connectome, play a more significant role in deterioration of foot tactile spatial acuity in cLBLP patients.
Cytomegalovirus DNA doubling time for early identification of clinically significant infection episodes in allogeneic hematopoietic stem cell transplant recipients undergoing primary Letermovir prophylaxis: A multicenter study
Authors: Navarro David , Giménez Estela , García-Cadenas Irene , Piñana Jose Luis , Albert Eliseo , Vázquez Lourdes , Avendaño Alejandro , Cabrero Mónica , Esqu Albert , Martino Rodrigo , Jimenez Javier Lopez , Cuesta Marian , Humala Karem , Villar Sara , Rovira Montse , Heras Inmaculada , Ripa María Zudaire , Arroyo Ignacio , Zabalza Amaya , Aguado Beatriz , Solano Carlos
Published: December 2024

We evaluated the potential of Cytomegalovirus (CMV) DNA doubling time (dt) in plasma to distinguish between clinically significant CMV infection (CsCMVi) and abortive CMV infection in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients on primary letermovir (LMV) prophylaxis. Data from the Spanish Hematopoietic Transplantation and Cell Therapy Group multicenter registry included 296 allo-HSCT patients receiving LMV prophylaxis. Participating centers used a plasma CMV DNA threshold of ≥ 1,000 IU/ml for initiating preemptive antiviral therapy (PET). The CMV DNA dt was calculated from the first two or three positive PCR results based on pre-established criteria. CMV DNAemia developed in 64 recipients (21.6%) with a total of 88 episodes, of which CsCMVi occurred in 9 recipients (3.04%) and included 10 episodes (one patient had confirmed CMV gastrointestinal disease). A non-calculable CMV DNA dt had a negative predictive value (NPV) of 94% for CsCMVi. For initial episodes with calculable CMV DNA dts (4/7 CsCMVi and 8/57 no-CsCMVi), a threshold of ≤ 2.35 days had a positive predictive value of 100% for CsCMVi. CMV DNA dt could optimize CMV infection management in allo-HSCT patients under LMV prophylaxis, independent of the PCR platform used.
Risk Factors for Lymphatic Leakage Following Radical Cystectomy and Pelvic Lymph Node Dissection in Patients with Muscle-Invasive Bladder Cancer
Authors: Xue Zixuan , Yan Ye , Chen Huiying , Mao Hai , Ma Tianwu , Wang Guoliang , Zhang Hongxian , Ma Lulin , Zhang Shudong , Ye Jianfei , Kai Hong , Zhang Fan
Published: December 2024

Background
Lymphatic leakage is a common complication after radical cystectomy and pelvic lymph node dissection (PLND) for muscle-invasive bladder cancer (MIBC).This study aimed to investigate the risk factors contributing to postoperative lymphatic leakage in patients with MIBC.
Materials and Methods
A total of 534 patients undergoing radical cystectomy and PLND were enrolled in the retrospective study at Peking University Third Hospital from January 2010 to July 2023. Patients were categorized into lymphatic leakage(n = 254)and non-leakage groups (n = 280) and compared demographic, preoperative, intraoperative, pathological, and postoperative factors. Multivariate logistic regression found factors that predict lymphatic leakage. Spearman correlation was used to analyze the relationship between lymph leakage ratio and risk factors.
Results
Patients with lymphatic leakage had significantly higher rates of receiving extended PLND (19.7% vs 11.4%, p = 0.008), higher number of total lymph nodes removed (median 11 vs 8, p < 0.001), longer hospital stays (median 13 vs 11 days, p < 0.001), higher rates of postoperative hypoalbuminemia (56.7% vs 36.4%, p < 0.001) and fever (14.2% vs 8.6%, p = 0.04) compared to the non-leakage group. On multivariate analysis, higher number of lymph nodes removed (OR 3.278, 95% CI 1.135–9.471, p = 0.028) were found to be significant independent risk factors for lymphatic leakage. A significant positive correlation was observed between the number of lymph nodes excised and lymphatic leakage rate (R = 0.456, p = 0.013).
Conclusions
The increased number of lymph nodes dissected is associated with a heightened risk of lymphatic leakage following radical cystectomy for MIBC.
Recurrent brain abscess due to pulmonary arteriovenous fistula:a case report and literature review
Authors: Wu Rui , He Xin , Hu Xueqian , Zan Chunshu , Li Yang , Wei Zhenqing
Published: December 2024

Background
Brain abscesses are critical infections of the central nervous system, resulting from various pathogens. Common causes of recurrent brain abscesses include immunodeficiency, chronic otitis media, sinusitis, and intracranial infection spread. Although rare, pulmonary arteriovenous fistula (PAVF) is a significant risk factor for brain infections, as it allows pathogens to bypass pulmonary filtration and directly enter systemic circulation via abnormal vascular connections.
Case Presentation:
We report a case of a patient who developed two episodes of brain abscesses over a 35-year period following surgery for pulmonary arteriovenous fistula. The patient was ultimately diagnosed with hereditary hemorrhagic telangiectasia, suggesting a potential link between PAVF and recurrent brain abscess formation.
Conclusions
This case highlights the need to consider PAVF as a possible underlying cause in cases of recurrent brain abscesses. Additionally, we reviewed the literature on brain abscesses associated with pulmonary arteriovenous fistulas to provide a more comprehensive understanding of this rare but impactful association.