bluuebunny/crossref_metadata_2025 huggingface dataset:
GLIM Achieves Best Diagnostic Performance in Non-Cancer Patients with Low BMI: A Hierarchical Bayesian Latent-Class Meta-Analysis
Authors: Wu Tiantian , Zhou Mingming , Xu Kedi , Zou Yuanlin , Zhang Shaobo , Cheng Haoqing , Guo Pengxia , Song Chunhua
Published: July 2024

Context

Global Leadership Initiative on Malnutrition (GLIM) and Patient-Generated Subjective Global Assessment (PG-SGA) are commonly used nutrition assessment tools, whose performance does not reach a consensus due to different and imperfect reference standards.

Objective

This study aimed to evaluate and compare the diagnostic accuracy of GLIM and PG-SGA, using a hierarchical Bayesian latent class model, in the absence of a gold standard.

Data Sources

A systematic search was undertaken in PubMed, Embase, and Web of Science from inception to October 2022. Diagnostic test studies comparing (1) the GLIM and/or (2) PG-SGA with “semi-gold” standard assessment tools for malnutrition were included.

Data Extraction

Two authors independently extracted data on sensitivity, specificity, and other key characteristics. The methodological quality of each included study was appraised according to the criteria in the Quality Assessment of Diagnostic Accuracy Studies-2.

Data Analysis

A total of 45 studies, comprising 20 876 individuals evaluated for GLIM and 11 575 for PG-SGA, were included. The pooled sensitivity was 0.833 (95% CI 0.744 to 0.896) for GLIM and 0.874 (0.797 to 0.925) for PG-SGA, while the pooled specificity was 0.837 (0.780 to 0.882) for GLIM and 0.778 (0.707 to 0.836) for PG-SGA. GLIM showed slightly better performance than PG-SGA, with a higher diagnostic odds ratio (25.791 vs 24.396). The diagnostic performance of GLIM was most effective in non-cancer patients with an average body mass index (BMI) of <24 kg/m2, followed by non-cancer patients with an average age of ≥60 years. PG-SGA was most powerful in cancer patients with an average age of <60 years, followed by cancer patients with an average BMI of <24 kg/m2.

Conclusion

Both GLIM and PG-SGA had moderately high diagnostic capabilities. GLIM was most effective in non-cancer patients with a low BMI, while PG-SGA was more applicable in cancer patients.

Systematic Review Registration

PROSPERO registration No. CRD42022380409.
Florence Nightingale
Authors: Strachey Lytton
Published: July 2024

FLORENCE NIGHTINGALE
II
Authors: Wharton Edith
Published: July 2024

Undine’s white and gold bedroom, with sea-green panels and old rose carpet, looked along Seventy-second Street toward the leafless tree-tops of the Central Park.

She went to the window, and drawing back its many layers of lace gazed eastward down the long brownstone perspective. Beyond...
VII
Authors: Wharton Edith
Published: July 2024

Some two months later than the date of young Marvell’s midnight vigil, Mrs Heeny, seated on a low chair at Undine’s knee, gave the girl’s left hand an approving pat as she laid aside her lapful of polishers.

‘There! I guess you can put your...
XIV
Authors: Wharton Edith
Published: July 2024

It was one of the distinctions of Mr Claud Walsingham Popple that his studio was never too much encumbered with the attributes of his art to permit the installing, in one of its cushioned corners, of an elaborately furnished tea-table flanked by the most...
XVIII
Authors: Wharton Edith
Published: July 2024

Undine stood alone on the landing outside her father’s office.

Only once before had she failed to gain her end with him—and there was a peculiar irony in the fact that Moffatt’s intrusion should have brought before her the providential result of her previous failure....
XX
Authors: Wharton Edith
Published: July 2024

Some six weeks later, Undine Marvell stood at the window smiling down on her recovered Paris.

Her hotel sitting-room had, as usual, been flowered, cushioned and lamp-shaded into a delusive semblance of stability; and she had really felt, for the last few weeks, that the...
XXIII
Authors: Wharton Edith
Published: July 2024

In the Adirondacks Ralph Marvell sat day after day on the balcony of his little house above the lake, staring at the great white cloud-reflections in the water and at the dark line of trees that closed them in. Now and then he got...
XXV
Authors: Wharton Edith
Published: July 2024

Undine Marvell, for the next few months, tasted all the accumulated bitterness of failure. After January the drifting hordes of her compatriots had scattered to the four quarters of the globe, leaving Paris to resume, under its low grey sky, its compacter winter personality....
XXVI
Authors: Wharton Edith
Published: July 2024

The next phase in the unrolling vision was the episode of her return to New York. She had gone to the Malibran, to her parents—for it was a moment in her career when she clung passionately to the conformities, and when the...
XXIX
Authors: Wharton Edith
Published: July 2024

The early spring found Undine once more in Paris.

She had every reason to be satisfied with the result of the course she had pursued since she had pronounced her ultimatum on the subject of Raymond de Chelles. She had continued to remain on the...
I
Authors: Wharton Edith
Published: July 2024

In a window of the long gallery of the château de Saint Désert the new Marquise de Chelles stood looking down the poplar avenue into the November rain. It had been raining heavily and persistently for a longer time than she could...
XL
Authors: Wharton Edith
Published: July 2024

After the Princess Estradina’s departure, the days at Saint Désert succeeded each other indistinguishably; and more and more, as they passed, Undine felt herself drawn into the slow strong current already fed by so many tributary lives. Some spell she could not have named...
III
Authors: Conrad Joseph
Published: July 2024

The first thing I saw down there was the upper part of a man’s body projecting backwards, as it were, from one of the doors at the foot of the stairs. His eyes looked at me very wide and still. In one hand he...
V
Authors: Conrad Joseph
Published: July 2024

I heard the clatter of the scissors escaping from his hand, noted the perilous heave of his whole person over the edge of the bunk after them, and then, returning to my first purpose, pursued my course on to the deck. The sparkle of...
Chapter VI
Authors: London Jack
Published: July 2024

BUT the time was rapidly drawing near when I was to begin my second series of bouts with John Barleycorn. When I was fourteen, my head filled with the tales of the old voyagers, my vision with tropic isles and far searims, I was sailing...
Chapter XVI
Authors: London Jack
Published: July 2024

THERE was nothing to drink on the Sophie Sutherland, and we had fifty-one days of glorious sailing, taking the southern passage in the northeast trades to Bonin Islands.* This isolated group, belonging to Japan, had been selected as the rendezvous of...
Chapter XXXII
Authors: London Jack
Published: July 2024

WHEN the Snark* sailed on her long cruise from San Francisco there was nothing to drink on board. Or, rather, we were all of us unaware that there was anything to drink, nor did we discover it for many a month. This...
Chapter XXXVIII
Authors: London Jack
Published: July 2024

THE foregoing is a sample roaming with the White Logic through the dusk of my soul. To the best of my power I have striven to give the reader a glimpse of a man’s secret dwelling when it is shared with John Barleycorn. And the...
CHAPTER V
Authors: Woolf Virginia
Published: July 2024

Denham had no conscious intention of following Katharine, but, seeing her depart, he took his hat and ran rather more quickly down the stairs than he would have done if Katharine had not been in front of him. He overtook a friend of his,...
CHAPTER XXIII
Authors: Woolf Virginia
Published: July 2024

When Ralph Denham entered the room and saw Katharine seated with her back to him, he was conscious of a change in the grade of the atmosphere such as a traveller meets with sometimes upon the roads, particularly after sunset, when, without warning, he...
CHAPTER XXXI
Authors: Woolf Virginia
Published: July 2024

The tray which brought Katharine’s cup of tea the next morning brought, also, a note from her mother, announcing that it was her intention to catch an early train to Stratford-on-Avon that very day.

‘Please find out the best way of getting there,’ the note...
Chapter VI
Authors: Conrad Joseph
Published: July 2024

At that time Nostromo had been already long enough in the country to raise to the highest pitch Captain Mitchell’s opinion of the extraordinary value of his discovery. Clearly he was one of those invaluable subordinates whom to possess is a legitimate cause of...
Chapter VIII
Authors: Conrad Joseph
Published: July 2024

Those of us whom business or curiosity took to Sulaco in these years before the first advent of the railway can remember the steadying effect of the San Tomé mine upon the life of that remote province. The outward appearances had not changed then...
Chapter VIII
Authors: Conrad Joseph
Published: July 2024

For a moment, before this extraordinary find, they forgot their own concerns and sensations. Señor Hirsch’s sensations as he lay there must have been those of extreme terror. For a long time he refused to give a sign of life, till at last Decoud’s...
Chapter IV
Authors: Conrad Joseph
Published: July 2024

Charles Gould turned towards the town. Before him the jagged peaks of the Sierra came out all black in the clear dawn. Here and there a muffled lépero whisked round the corner of a grass-grown street before the ringing hoofs of his horse. Dogs...
Chapter VI
Authors: Conrad Joseph
Published: July 2024

The declining sun had shifted the shadows from west to east amongst the houses of the town. It had shifted them upon the whole extent of the immense Campo, with the white walls of its haciendas on the knolls dominating the green distances; with...
Chapter VII
Authors: Conrad Joseph
Published: July 2024

At about that time, in the Intendencia of Sulaco, Charles Gould was assuring Pedrito Montero, who had sent a request for his presence there, that he would never let the mine pass out of his hand for the profit of a Government who had...
Chapter XII
Authors: Conrad Joseph
Published: July 2024

Nostromo had been growing rich very slowly. It was an effect of his prudence. He could command himself even when thrown off his balance. And to become the slave of a treasure with full self-knowledge is an occurrence rare and mentally disturbing. But it...
Chapter XIII
Authors: Conrad Joseph
Published: July 2024

On the day Mrs. Gould was going, in Dr. Monygham’s words, to “Give a tertulia,” Captain Fidanza went down the side of his schooner lying in Sulaco harbour, calm, unbending, deliberate in the way he sat down in his dinghy and took up his...
Poetry, Fiction and the Future
Authors: Woolf Virginia
Published: July 2024

Far the greater number of critics turn their backs upon the present and gaze steadily into the past. Wisely, no doubt, they make no comment upon what is being actually written at the moment; they leave that duty to the race of reviewers whose...
Craftsmanship
Authors: Woolf Virginia
Published: July 2024

The title of this series is ‘Words Fail Me,’ and this particular talk is called ‘Craftsmanship.’* We must suppose, therefore, that the talker is meant to discuss the craft of words—the craftsmanship of the writer. But there is something incongruous, unfitting, about...
Chapter 1
Authors: Lewis Wyndham
Published: July 2024

Paris hints of sacrifice. But here we deal with that large dusty facet known to indulgent and congruous kind: it is in its capacity of delicious inn and majestic Baedeker,* where western Venuses* twang its responsive streets and hush to...
Chapter 7
Authors: Lewis Wyndham
Published: July 2024

Impossible my poor old son! Five francs. Not a cent more! That’s the outside!’

Suzanne stood at attention before him in the hall of the Mont-de-Piété: if before she had been inexorable she was now doubly so beneath the eyes of the authentic officials. The...
Chapter 2
Authors: Lewis Wyndham
Published: July 2024

In a large fluid but nervous handwriting, the following letter lay, read, Bertha still keeping her large blue ox-eye* upon it from a distance:

‘Dear Bertha,—I am writing at the Gare St. Lazare,* on my way to England. You have...
Chapter 8
Authors: Lewis Wyndham
Published: July 2024

‘Who is that, then—Anass—what?’ Kreisler asked, after some moments of gradually changing silence, when Miss Vasek began to be mentioned by Bertha. He was stretched out in massive abandon and seemed interested in nothing in the world.

This meeting had been the only event...
Chapter 6
Authors: Lewis Wyndham
Published: July 2024

Already before a considerable pile of saucers, representing a considerable bill up-to-date for the accommodating Tarr, Kreisler sat quite still, his eyes very bright, smiling to himself. Tarr did not at once ask him ‘what Kreisler meant’ as he had intended; ‘Kreisler’ looked as...
Chapter XVIII
Authors: Lewis Sinclair
Published: July 2024

I

Though he saw them twice daily, though he knew and amply discussed every detail of their expenditures, yet for weeks together Babbitt was no more conscious of his children than of the buttons on his coat-sleeves.

The admiration of Kenneth Escott made him aware...
Chapter XXIX
Authors: Lewis Sinclair
Published: July 2024

I

The assurance of Tanis Judique’s friendship fortified Babbitt’s self-approval. At the Athletic Club he became experimental. Though Vergil Gunch was silent, the others at the Roughnecks’ Table came to accept Babbitt as having, for no visible reason, “turned crank.” They argued windily with...
Chapter XXXI
Authors: Lewis Sinclair
Published: July 2024

I

When he was away from her, while he kicked about the garage and swept the snow off the running-board and examined a cracked hose-connection, he repented, he was alarmed and astonished that he could have flared out at his wife, and thought fondly...
A Country Doctor
Authors: Kafka Franz
Published: July 2024

To my father
Walking to Ramses
Authors: Kafka Franz
Published: July 2024

In the little inn that Karl reached after a short walk, and that was really only a last station for trucks headed for New York and was therefore scarcely used for overnight accommodation, Karl asked for the cheapest bed they had, since he thought...
The Robinson Affair
Authors: Kafka Franz
Published: July 2024

Then someone tapped him on the shoulder. Karl, thinking of course that it was a guest, hurriedly put the apple in his pocket and hurried, scarcely looking at the man, over to the lift. But: ‘Good evening, Mr Rossmann,’ said the man, ‘it’s me,...
Was it the Ghost?
Authors: Leroux Gaston
Published: July 2024

On the evening which Messrs Debienne and Poligny, the Opera’s outgoing Directors, had chosen to present their last gala concert as a way of marking their departure, the dressing room of La Sorelli, one of the leading ballerinas, was suddenly invaded by half a...
In which Messrs Debienne and Poligny, for the first time, secretly make the Opera’s new Directors, Messrs Armand Moncharmin and Firmin Richard, party to their real, hidden reason for resigning from the National Academy of Music
Authors: Leroux Gaston
Published: July 2024

Meantime, the farewell ceremony was under way.

As I have explained, the evening’s magnificent concert had been arranged by Messrs Debienne and Poligny to mark their departure from the Opera. They wanted what we would now call a ‘first-class send-off’.

In choosing the ideal...
Box 5 (Continued)
Authors: Leroux Gaston
Published: July 2024

Having said this, M. Richard paid no further attention to the security officer and proceeded to settle a number of business matters with his general Administrator who had just come into the office. The security man thought he could slip away quietly, very quietly,...
Mme Giry’s amazing revelations of her personal dealings with the Phantom of the Opera
Authors: Leroux Gaston
Published: July 2024

Before following Inspector Mifroid into the Directors’ office, perhaps the reader will allow me to mention certain highly unusual events which had just occurred in the said office, to which Rémy, the secretary, and Mercier, the Administrator, had both tried and failed to gain...
In the Belly of the Opera
Authors: Leroux Gaston
Published: July 2024

‘Keep your hand up, ready to shoot!’ Raoul’s companion said again.

Behind them, the wall completed one full turn on its axis then closed softly behind them.

For a few moments, both men remained where they were, holding their breath.

The darkness was full...
Scorpion or Grasshopper? Which is it to be?
Authors: Leroux Gaston
Published: July 2024

The Persian’s Tale Concluded

And so, by descending to the lowest vaults of the Opera, I had also reached the lowest point of my darkest fears! Erik had not misled me with his vague threats against all those members of the human race!...
Epilogue
Authors: Leroux Gaston
Published: July 2024

So ends the true story of the Phantom of the Opera.

As I observed on the first page of this book, no one can doubt the reality of Erik’s existence. Too much irrefutable evidence is now so generally available that virtually anyone is in a...
Gibberellin dynamics governing nodulation revealed using GIBBERELLIN PERCEPTION SENSOR 2 in Medicago truncatula lateral organs
Authors: Drapek Colleen , Rizza Annalisa , Mohd-Radzman Nadiatul A , Schiessl Katharina , Dos Santos Barbosa Fabio , Wen Jiangqi , Oldroyd Giles E D , Jones Alexander M
Published: July 2024

During nutrient scarcity, plants can adapt their developmental strategy to maximize their chance of survival. Such plasticity in development is underpinned by hormonal regulation, which mediates the relationship between environmental cues and developmental outputs. In legumes, endosymbiosis with nitrogen-fixing bacteria (rhizobia) is a key adaptation for supplying the plant with nitrogen in the form of ammonium. Rhizobia are housed in lateral root-derived organs termed nodules that maintain an environment conducive to Nitrogenase in these bacteria. Several phytohormones are important for regulating the formation of nodules, with both positive and negative roles proposed for gibberellin (GA). In this study, we determine the cellular location and function of bioactive GA during nodule organogenesis using a genetically encoded second-generation GA biosensor, GIBBERELLIN PERCEPTION SENSOR 2 in Medicago truncatula. We find endogenous bioactive GA accumulates locally at the site of nodule primordia, increasing dramatically in the cortical cell layers, persisting through cell divisions, and maintaining accumulation in the mature nodule meristem. We show, through misexpression of GA-catabolic enzymes that suppress GA accumulation, that GA acts as a positive regulator of nodule growth and development. Furthermore, increasing or decreasing GA through perturbation of biosynthesis gene expression can increase or decrease the size of nodules, respectively. This is unique from lateral root formation, a developmental program that shares common organogenesis regulators. We link GA to a wider gene regulatory program by showing that nodule-identity genes induce and sustain GA accumulation necessary for proper nodule formation.
People believe political opponents accept blatant moral wrongs, fueling partisan divides
Authors: Puryear Curtis , Kubin Emily , Schein Chelsea , Bigman Yochanan E , Ekstrom Pierce , Gray Kurt
Published: July 2024

Efforts to bridge political divides often focus on navigating complex and divisive issues, but eight studies reveal that we should also focus on a more basic misperception: that political opponents are willing to accept basic moral wrongs. In the United States, Democrats, and Republicans overestimate the number of political outgroup members who approve of blatant immorality (e.g. child pornography, embezzlement). This “basic morality bias” is tied to political dehumanization and is revealed by multiple methods, including natural language analyses from a large social media corpus and a survey with a representative sample of Americans. Importantly, the basic morality bias can be corrected with a brief, scalable intervention. Providing information that just one political opponent condemns blatant wrongs increases willingness to work with political opponents and substantially decreases political dehumanization.
Perils and opportunities in using large language models in psychological research
Authors: Abdurahman Suhaib , Atari Mohammad , Karimi-Malekabadi Farzan , Xue Mona J , Trager Jackson , Park Peter S , Golazizian Preni , Omrani Ali , Dehghani Morteza
Published: July 2024

The emergence of large language models (LLMs) has sparked considerable interest in their potential application in psychological research, mainly as a model of the human psyche or as a general text-analysis tool. However, the trend of using LLMs without sufficient attention to their limitations and risks, which we rhetorically refer to as “GPTology”, can be detrimental given the easy access to models such as ChatGPT. Beyond existing general guidelines, we investigate the current limitations, ethical implications, and potential of LLMs specifically for psychological research, and show their concrete impact in various empirical studies. Our results highlight the importance of recognizing global psychological diversity, cautioning against treating LLMs (especially in zero-shot settings) as universal solutions for text analysis, and developing transparent, open methods to address LLMs’ opaque nature for reliable, reproducible, and robust inference from AI-generated data. Acknowledging LLMs’ utility for task automation, such as text annotation, or to expand our understanding of human psychology, we argue for diversifying human samples and expanding psychology’s methodological toolbox to promote an inclusive, generalizable science, countering homogenization, and over-reliance on LLMs.
The Trump Effect? Right-Wing Populism and Distrust in Voting by Mail in Canada
Authors: Wu Cary , Dawson Andrew
Published: July 2024

Do Donald Trump’s attacks on voting by mail influence how some Canadians view mail-in ballots? The Trump effect on views and behaviors surrounding voting by mail has been well documented in the United States. North of the border, more Canadians than ever voted by mail in the last general election. In this study, we consider how right-wing populism is associated with trust in voting by mail among Canadians. Specifically, we seek to test two main hypotheses. First, we consider whether Canadians holding populist views—and, in particular, those holding right-wing populist views (would-be Trump supporters)—are less trusting of voting by mail. Second, we consider whether political media exposure amplifies this association. We analyze data from both the 2021 Canadian Election Study and Democracy Checkup Survey. We find that those who hold populist views clearly have less trust in voting by mail. This is especially true among right-leaning individuals. Furthermore, as in the United States, this effect is moderated by one’s level of political media exposure, with higher levels of political media exposure amplifying the effect of populist views on trust in voting by mail. Our findings, therefore, suggest that the politicization of mail-in voting by President Trump has important implications for the legitimacy of the electoral system not only in the United States, but also in Canada and potentially in other parts of the world.
Distrusting the Process: Electoral Trust, Operational Ideology, and Nonvoting Political Participation in the 2020 American Electorate
Authors: Fitz Erin B , Saunders Kyle L
Published: July 2024

This article explores the relationships between electoral trust, operational ideology, and nonvoting political participation (NVP) during the 2020 US presidential election cycle. We hypothesize that: (1) more liberal operational ideology is associated with more NVP, (2) less electoral trust is associated with more NVP, and (3) operational ideology moderates the negative relationship between electoral trust and NVP. Using data from the 2020 American National Election Study (N = 8,280), our contribution is threefold: We first add to previous research that indicated liberals engage in more NVP than conservatives. We then provide some of the first evidence to suggest that electoral trust—in this case, trust prior to the 2020 election—is negatively associated with NVP. Results further indicate that the negative relationship between electoral trust and NVP is strongest among those with conservative operational ideology, such that the more trust those with conservative operational ideology have in the election, the less they engage in NVP. Given that electoral trust is crucial for a well-functioning democracy, the implication is that elites with a strategic incentive to express contempt for the election process can have direct and downstream consequences on political participation.
Where Are the Sore Losers? Competitive Authoritarianism, Incumbent Defeat, and Electoral Trust in Zambia’s 2021 Election
Authors: Kerr Nicholas , Krönke Matthias , Wahman Michael
Published: July 2024

How do electoral turnovers shape citizen perceptions of election quality in competitive authoritarian regimes? We argue that electoral outcomes are crucial for determining perceptions of electoral quality. While detailed evaluation of electoral trust is complex in competitive autocracies with institutional uncertainty and polarized electoral environments, turnovers send strong and unequivocal signals about election quality. Previous literature has noted a strong partisan divide in electoral trust in competitive authoritarian regimes, but turnovers can boost trust among both incumbent and opposition supporters. We test this argument in the case of Zambia’s 2021 election, a case where a ruling party lost despite electoral manipulation and strong control over the Election Management Body (EMB). Empirically, we leverage the first-ever panel survey carried out during Zambian elections. Comparing trust in elections before and after the election, we find that perceived election quality increased after the 2021 electoral turnover among both losers and winners. We find that trust in elections increased the most among winning opposition supporters. Moreover, despite the outgoing president’s attempt to portray the election as fraudulent, losing ruling-party supporters also increased their trust in elections after the turnover. The study has important implications for the literature on democratic consolidation and institutional trust.
Controllable self-assembly of tyrosine-rich triblock peptides into robust collagen mimetic bioscaffolds for aging skin rejuvenation
Authors: Yao Linyan , Ling Biyang , Huang Wenjie , Wang Qi , Cai Xiangdong , Xiao Jianxi
Published: July 2024

Skin aging, a complex physiological process characterized by alterations in skin structure and function, seriously affects human life. Collagen holds considerable potential in aging skin treatment, while animal-derived collagen poses risks of pathogen transmission. Self-assembled peptides have garnered increasing attention in creating collagen mimetic materials; however, previous reported self-assembled peptides rely on vulnerable non-covalent interactions or lack the capability of controlling morphology and incorporating functional motifs, limiting their ability to mimic collagen structure and function. We have herein created a controllable tyrosine-rich triblock peptide system capable of self-assembling into robust collagen mimetic bioscaffolds for rejuvenating aging skin. Through ruthenium-mediated crosslinking, these peptides self-assemble into well-defined nanospheres or collagen-mimetic scaffolds, precisely regulated by the triple-helical structure and tyrosine distribution. The self-assembled collagen mimetic scaffolds exhibit outstanding resistances to various solvents and pH conditions. The integrin-binding motif has been incorporated into the triple helical block without disrupting their assembly, while endowing them with superior bioactivities, effectively promoting cell adhesion and proliferation. In vivo studies demonstrated their efficacy in treating photoaging skin by accelerating collagen regeneration and activating fibroblasts. The self-assembled tyrosine-rich triblock peptides represent a versatile system for creating robust collagen mimetic biomaterials, providing great potential in skin rejuvenation and tissue regeneration.
Ferritin is a potential marker of cardiometabolic risk in adolescents and young adults with sleep-disordered breathing
Authors: Cheng Esther T W , Au Chun T , Chan Raymond N C , Chan Joey W Y , Chan Ngan Y , Wing Yun K , Li Albert M , Lam Ethan , Chan Kate C
Published: July 2024

Objective

To explore markers that reflect sleep-disordered breathing (SDB) severity and investigate their associations with cardiometabolic risk factors in adolescents and young adults.

Methods

Participants were recruited from our SDB epidemiological cohort. They underwent overnight polysomnography and ambulatory blood pressure (BP) monitoring. Complete blood count, ferritin, high-sensitivity C-reactive protein (hs-CRP), fasting blood glucose, and lipid profile were measured. Multiple linear regression was used to examine the association between red cell indices (RCIs), ferritin, and obstructive apnea-hypopnea index (OAHI). Subgroup analyses on participants with SDB were performed for the association of RCIs and ferritin with lipid profile, hs-CRP, and BP.

Results

There were 88 participants with SDB and 155 healthy controls aged 16–25 years. Hemoglobin (Hb; p < .001), hematocrit (HCT; p < .001), and ferritin (p < .001) were elevated with increasing SDB severity and were independently associated with OAHI (β=1.06, p < .001; β=40.2, p < .001; β=4.89 × 10−3, p = .024, respectively). In participants with SDB, after adjusting for age, sex, and BMI, significant associations were found between ferritin with low-density lipoprotein (LDL; β=0.936 × 10−3, p = .008) and triglyceride (TG; β =1.08 × 10−3, p < .001), as well as between Hb (β=1.40, p = .007), HCT (β=51.5, p = .010) and mean arterial pressure (MAP). Ferritin (β=0.091, p = .002), Hb (β=0.975, p = .005), and HCT (β=38.8, p = .004) were associated with hs-CRP independent of age, sex, BMI, plasma LDL, and MAP. OAHI was not associated with LDL and TG in the multivariable models.

Conclusions

Serum ferritin, but not OAHI, was associated with LDL and TG in participants with SDB, suggesting it is a potential marker of cardiometabolic risk in patients with SDB.
CBLL1 promotes endometrial stromal cell senescence via inhibiting PTEN in recurrent spontaneous abortion
Authors: Liu Xueqing , Wei Xiaowei , Wu Jiayi , Xu Yichi , Hu Jianing , Qin Chuanmei , Chen Cailian , Lin Yi
Published: July 2024

Recurrent spontaneous abortion (RSA) is a common pregnancy‐related disorder. Cbl proto‐oncogene like 1 (CBLL1) is an E3 ubiquitin ligase, which has been reported to vary with the menstrual cycle in the endometrium. However, whether CBLL1 is involved in the occurrence and development of RSA remains unclear. This study aimed to investigate the effects of CBLL1 on RSA. We analyzed the expression of CBLL1 in the decidua of RSA patients, as well as its functional effects on cellular senescence, oxidative stress, and proliferation of human endometrial stromal cells (HESCs). RNA sequencing was employed to identify a key downstream target gene regulated by CBLL1. We found that CBLL1 was upregulated in the decidua of RSA patients. Additionally, overexpression of CBLL1 promoted HESC senescence, increased oxidative stress levels, and inhibited proliferation. Phosphatase and tensin homolog located on chromosome 10 (PTEN) was identified as one of the important downstream target genes of CBLL1. In vivo experiments demonstrated that CBLL1 overexpression in the endometrium caused higher embryo absorption rate in mice. Consequently, elevated CBLL1 expression is a potential cause of RSA, representing a novel therapeutic target for RSA.
Novel PET tracers in breast cancer for treatment optimization: clinical utility and future perspectives
Authors: Gilardi Laura , Airò Farulla Lighea Simona , Bonatto Elena , Ceci Francesco
Published: July 2024

Purpose of review

There is a critical need for timely and accurate decisions in breast cancer management. This narrative review aims to clarify the potential role of novel PET tracers in optimizing treatment strategies for different breast cancer subtypes.

Recent findings

2-deoxy-2-[18F]-fluoro-D-glucose PET/computed tomography (FDG PET/CT) has a pivotal role in response assessment in metastatic breast cancer, despite its limitations in certain histological and molecular subtypes. Further PET radiopharmaceuticals have been proposed to address these clinical needing.

FES PET/CT demonstrates its usefulness in assessing ER expression and predicting response to therapy in luminal breast cancer, with implications for treatment optimization and monitoring. In HER2-positive and HER2-low breast cancer, HER2-targeted PET tracers show potential in assessing HER2 status, while their accuracy in predicting response to targeted therapies is still debated. PARP-targeted PET imaging holds potential for selecting patients for PARP inhibitors treatments, particularly in triple-negative breast cancer (TNBC), where imaging tools are crucial due to the absence of specific targets. Immunotherapy and antibody-drug conjugates (ADCs) are emerging treatment options for TNBC, and PET imaging targeting immune checkpoints could aid in treatment selection and response monitoring. The dynamic role of PET/CT imaging in tailoring breast cancer treatments requires further multidisciplinary research to validate the clinical utility of targeted tracers.
Controversies on chemotherapy for early HR+/HER2− breast cancer: the role of anthracyclines and dose intensification
Authors: Poggio Francesca , Molinelli Chiara , Giannubilo Irene , Lambertini Matteo , Blondeaux Eva
Published: July 2024

Purpose of review

Use of adjuvant chemotherapy significantly reduces the risk of recurrence and improves overall survival (OS) in patients with early-stage breast cancer. However, few data are available on the efficacy of different adjuvant chemotherapy regimens and schedules in patients with hormone receptor positive/HER2-negative (HR+/HER2−) breast cancer. We aim to summarize the available evidence on the efficacy of adjuvant anthracycline-based chemotherapy and of the dose-dense schedule in this specific patient population. Moreover, current controversies in the management of patients with early-stage HR+/HER2− breast cancer are discussed.

Recent findings

Patient-level meta-analysis evaluating the role of the addition of an anthracycline to taxane-based chemotherapy showed that recurrence rate was lower among patients receiving anthracycline-based treatment.

Patient-level meta-analysis evaluating the role of different schedules of chemotherapy administration showed that the use of adjuvant dose-dense chemotherapy is associated with significant reduction in breast cancer recurrences and breast cancer mortality. Less evidence is available in the neoadjuvant setting.

For patients with high-risk HR+/HER2− breast cancer, (neo) adjuvant anthracycline and taxane-based chemotherapy, and a dose-dense regimen should still be considered the standard of care. However, in patients with intermediate risk breast cancer candidates to chemotherapy, anthracycline-free regimens could be considered the preferred treatment option.
Limb Salvage Using Lateral Circumflex Femoral Artery Graft for a Hand Vibration Syndrome
Authors: Zhou Zhegang , Yu Longbiao , Meng Fanbin , Wen Jingjing , Xiao Yingfeng , Shan Huiming , Wan Shengxiang , Zeng Hui , Yu Fei
Published: July 2024

A 50-year-old man was admitted to the hospital with a chief complaint of long-standing cold-induced numbness in the fingers for more than a year, accompanied by persistent hand pain and fingertip ulceration for 3 months. On physical examination, radial and ulnar artery pulsation was absent in both limbs, and pale skin color, low skin temperature, and limited finger range of motion were noted. Gangrene was detected in the fingertips of the left index and middle fingers, and the right middle and ring fingers. The patient was diagnosed with bilateral arterial occlusion and vibration white finger. Upon admission, the patient underwent an intervention surgery on the right side. Subsequently, transplantation of the descending branches of the left and right lateral femoral circumflex arteries was performed to restore blood flow in the bilateral radial arteries. Additionally, debridement was conducted without shortening after the surgical procedure, the patient received anticoagulation, anti-inflammatory, and symptomatic treatment. The bilateral finger skin temperature increased by 3 °C postoperatively, and the accompanying pain and numbness were alleviated. The wound healed 1 month after surgery, and no recurrence of pain or ulcer was reported during the 1-year follow-up period. Eventually, his hand function recovered, without any impact on the vascular donor site.
Autologization of Exosomes with Deparenchymized Adipose Tissue: An Innovative Approach for Regenerative Medicine and Surgery
Authors: Copcu H. Eray
Published: July 2024

Background:

Among all regenerative applications developed in recent years, the use of exosomes has generated by far the greatest interest. Exosome products from allogeneic and xenogeneic sources are available on the market. A key challenge is controlling the effects of nonautologous exosomes. We hypothesized that combining exosomes with a patient’s own extracellular matrix (ECM) can create “autologization,” enabling control over their effects. This study aimed to provide the rationale and a guide for future research exploring the autologization of exosome applications using deparenchymized adipose tissue (DPAT).

Methods:

DPAT adipose tissue was achieved using 1200-, 400-, and 35-micrometer blades in an ultrasharp blade system (Adinizer), and then “autologization” was achieved by combining the obtained DPAT with allogeneic exosomes. DPAT was evaluated histochemically, and exosomes were counted and analyzed with the Nanosight device.

Results:

The DPAT process using ultrasharp blades is easily performed. DPAT obtained from adipose tissue was then combined with allogenic exosomes. It has been demonstrated histopathologically that adipocytes are eliminated in deparenchymized fat tissue, and only ECM and stromal cells remain. It has also been proven that the number of exosomes is not affected by the combination.

Conclusions:

This study introduces two novel concepts previously unknown in the literature, “deparenchymization” and “autologization,” representing an innovative approach in plastic surgery and regenerative medicine. Our novel approach enriches regenerative cells while preserving critical ECM signals, overcoming the limitations of existing isolation methods. Extensive research is still needed, but autologization using DPAT ECM holds great promise for translating exosome-based treatments into practice.
An integrated analysis of bile acid metabolism in humans with severe obesity
Authors: Aydin Ömrüm , Wahlström Annika , de Jonge Patrick A. , Meijnikman Abraham S. , Sjöland Wilhelm , Olsson Lisa , Henricsson Marcus , de Goffau Marcus C. , Oonk Stijn , Bruin Sjoerd C. , Acherman Yair I.Z. , Marschall Hanns-Ulrich , Gerdes Victor E.A. , Nieuwdorp Max , Bäckhed Fredrik , Groen Albert K.
Published: July 2024

Background and Aims:

Bile acids (BA) are vital regulators of metabolism. BAs are AQ6 secreted in the small intestine, reabsorbed, and transported back to the liver, where they can modulate metabolic functions. There is a paucity of data regarding the portal BA composition in humans. This study aimed to address this knowledge gap by investigating portal BA composition and the relation with peripheral and fecal BA dynamics in conjunction with the gut microbiome.

Approach and Results:

Thirty-three individuals from the BARIA cohort were included. Portal plasma, peripheral plasma, and feces were collected. BA and C4 levels were measured employing mass spectrometry. FGF19 was measured using ELISA. Gut microbiota composition was determined through metagenomics analysis on stool samples. Considerable diversity in the portal BA composition was observed. The majority (n = 26) of individuals had a 9-fold higher portal than peripheral BA concentration. In contrast, 8 individuals showed lower portal BA concentration compared with peripheral and had higher levels of unconjugated and secondary BA in this compartment, suggesting more distal origin. The altered portal BA profile was associated with altered gut microbiota composition. In particular, taxa within Bacteroides were reduced in abundance in the feces of these individuals.

Conclusions:

Characterization of the portal BA composition in relation to peripheral and fecal BA increased insight into the dynamics of BA metabolism in individuals with obesity. Peripheral BA composition was much more diverse due to microbial metabolism. About 24% of the portal samples was surprisingly low in total BA; the underlying mechanism requires further exploration.
Solitary Langerhans Cell Histiocytosis of the Palpebral Conjunctiva Presenting as Leukoplakia: Case and Review of Literature
Authors: Rubinstein Tal J. , Bennett Adam J. , Parekh Preeti H.
Published: July 2024

A 69-year-old male presented with a superior palpebral conjunctival white leukoplakic lesion. Excisional biopsy showed Langerhans cell histiocytosis. Positron emission tomography scanning revealed no lesions beyond this site. Native Langerhans cells are known to exist in the conjunctiva, yet only a few cases in the literature have described Langerhans cell histiocytosis of the conjunctiva, mostly in children. Conjunctival Langerhans cell histiocytosis has rarely been reported in an adult as leukoplakia. The authors advocate excisional biopsy for palpebral conjunctival Langerhans cell histiocytosis in older patients if the morbidity of closure is minimal, in addition to surveillance for multifocal disease.
Demographic Differences and Potential Bias From Automated Occupation Coding Among Mothers of Babies Born With or Without Cleft Lip and/or Cleft Palate in the Texas Birth Defects Registry
Authors: Oluwafemi Omobola O. , Agopian A. J. , Benjamin Renata H. , Gimeno Ruiz de Porras David , Shumate Charles J. , Patel Jenil
Published: July 2024

Objective

To compare maternal demographics based on occupation coding status and evaluate potential bias by excluding manually coded occupations.

Methods

This case-control study assessed cases with clefts obtained from the Texas Birth Defects Registry. The NIOSH Industry and Occupation Computerized Coding System automatically coded occupations, with manual coding for unclassified cases. Maternal demographics were tabulated by occupation coding status (manual vs. automatic). Logistic regression examined associations between major occupation groups and clefts.

Results

Automatic coding covered over 90% of all mothers. Building, grounds cleaning, and maintenance occupations, and office and administrative support occupations were significantly associated with cleft lip with or without cleft palate, even after excluding manually coded occupations.

Conclusion

We found consistent associations before and after excluding manually coded data for most comparisons, suggesting that machine learning can facilitate occupation-related birth defects research.
The efficacy of Hemospray in managing bleeding related to gastrointestinal tumors: systematic review and meta-analysis
Authors: Abosheaishaa Hazem , Abdallfatah Abdallfatah , Ahmed Omar T. , Elfert Khaled , Mohamed Islam , AlabdulRazzak Iyiad , Abdalla Monzer , Sethi Arshia , Abdelhalim Omar , Gayam Vijay Reddy , Eskaros Saphwat , Boulay Brian
Published: July 2024

Introduction

Gastrointestinal (GI) bleeding stemming from malignant tumors is increasingly recognized, due to advancements in oncology and detection methods. Traditional endoscopic hemostatic techniques have shown variable success rates in managing hemorrhagic GI neoplasms. Hemospray, an emerging endoscopic hemostatic powder, offers promise in treating upper GI bleeding, potentially extending its utility to neoplastic bleeding sites. This meta-analysis aims to evaluate Hemospray’s efficacy in managing bleeding related to GI tumors.

Methods

We searched Embase, Scopus, Web of Science, Medline/PubMed, and Cochrane. Inclusion criteria encompassed studies focusing on malignancy-related GI bleeding and interventions utilizing Hemospray. Comparative studies contrasted Hemospray with standard endoscopic treatments (SET), while noncomparative studies assessed Hemospray’s efficacy independently. The risk of bias was assessed using appropriate tools, and statistical analyses were performed using Review Manager and open Meta analyst software.

Results

We included 19 studies in our meta-analysis. Hemospray demonstrated higher rates of immediate hemostasis compared to SET (odds ratio: 17.14, 95% confidence interval: 4.27–68.86), with consistent outcomes across studies. Rebleeding rates at 14 and 30 days were comparable between Hemospray and SET groups, suggesting similar efficacy in long-term hemostasis. Hemospray showed a significantly lower need for nonendoscopic hemostasis compared to SET (odds ratio: 0.51, 95% confidence interval: 0.30–0.87), indicating a potential reduction in supplementary interventions. Safety assessments revealed no confirmed adverse events directly linked to Hemospray.

Conclusion

This meta-analysis highlights Hemospray’s efficacy in achieving immediate hemostasis in GI tumor-related bleeding, with potential benefits in reducing supplementary interventions and improving patient outcomes. Despite comparable rebleeding rates, Hemospray emerges as a valuable adjunctive therapy in managing malignant GI bleeding.
Radionuclide therapy of bevacizumab-based PNA-mediated pretargeting
Authors: Yan JingXuan , Zhao Peng , Li Yuanyuan , Wang Jing , Yang Xia , Li Hongbo , Zhuo Liangang , Liao Wei , Fan Wenqi , Jia Yaodan , Wei Hongyuan , Chen Yue
Published: July 2024

Background

The radionuclide-labeled bevacizumab (BV) is a potential therapeutic approach for vascular endothelial growth factor overexpressed tumors. Because of its large molecular weight, BV is cleared slowly in vivo, which caused damage to healthy tissues and organs. On account of this situation, using the pretargeting strategy with DNA/RNA analogs, such as peptide nucleic acid (PNA), is an effective way of treating solid tumors.

Methods

The BV-PNA conjugate (BV-PNA-1) was injected intravenously as the pretargeted probe, which was specifically accumulated in a solid tumor and gradually metabolically cleared. Then the [177Lu]Lu-labeled complementary PNA strand ([177Lu]Lu-PNA-2) as the second probe was injected, and bound with BV-PNA-1 by the base complementary pairing. In this study, the BV-based PNA-mediated pretargeting strategy was systematically studied, including stability of probes, specific binding ability, biodistribution in animal model, evaluation of single photon emission computed tomography/computed tomography imaging, and therapeutic effect.

Results

Compared with group A ([177Lu]Lu-BV), the group B (BV-PNA-1 + [177Lu]Lu-PNA-2) showed lower blood radiotoxicity (22.55 ±1.62 vs. 5.18 ± 0.40%, %ID/g, P < 0.05), and similar accumulation of radioactivity in tumor (5.32 ± 0.66 vs. 6.68 ± 0.79%, %ID/g, P > 0.05). Correspondingly, there was no significant difference in therapeutic effect between groups A and B.

Conclusion

The PNA-mediated pretargeting strategy could increase the tumor-to-blood ratio, thereby reducing the damage to normal tissues, while having a similar therapeutic effect to solid tumor. All the experiments in this study showed the potential and effectiveness of pretargeting radioimmunotherapy.