bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the clinical outcomes and molecular characteristics of Acinetobacter baumannii bloodstream infections: a study of sequence types, capsular types, and drug resistance in China
Authors: Chen Jiao , Shao Yanting , Cheng Zhibin , Li Guanghui , Wan Fen , Gao Chenyan , Wu Danqin , Wei Dandan , Liu Yang , Li Rong
Published: February 2025

Background

Bloodstream infections (BSIs) caused by Acinetobacter baumannii have been associated with high mortality. To improve the outcomes of patients, this study explored the clinical characteristics and outcomes of patients with BSIs, as well as the phenotypic and genomic characteristics of these isolates.

Methods

A retrospective cohort study was conducted involving A. baumannii BSIs cases from 2020 to 2023 in a tertiary hospital. The clinical characteristics of all A. baumannii isolates were evaluated. Virulence phenotypes of all isolates were evaluated using the growth curve, biofilm-forming assay, antiserum complement killing, and G.mellonella killing assay. Furthermore, whole-genome sequencing (WGS) was utilized to analyze genomic characteristics.

Results

The 30-day mortality rate of 67 patients with BSIs was 55.22%. Patients in the death group had significantly lower platelet counts and higher CRP levels than those in the survival group. Additionally, higher rates of antibiotic use (≥2 classes) and greater carbapenem exposure were observed. Among the isolates, CRAb accounted for 80.6%, ST2 accounted for 76.12%, and KL2/3/7/77/160 accounted for 65.67%. The predominant KL type was KL3, found in 19.4% of the isolates. All ST2 and KL2/3/7/77/160 isolates were CRAb. Among the isolates, 90.7% of the CRAb isolates coharbored blaOXA-23 and blaOXA-66, while one coharbored blaNDM-1 and blaOXA-23. Compared with non-ST2 and non KL2/3/7/77/160 infections, ST2 and KL2/3/7/77/160 infections had higher mortality rates (66.0% vs. 23.5%, P=0.002; 65.90% vs. 34.78%, P=0.015). Patients with ST2 and KL2/3/7/77/160 infections underwent more invasive procedures, received two or more antibiotics and carbapenem therapy before isolation, and had lower serum albumin levels. These isolates exhibited significantly higher resistance to antimicrobial agents. No significant differences in virulence phenotypes were observed between the two groups, except for biofilm formation between the ST2 and non-ST2 groups (P=0.002). However, these isolates harbored more virulence genes related to iron uptake and biofilm formation.

Conclusion

The mortality rate associated with BSIs caused by A. baumannii is high. It is of great significance for clinicians to pay attention to the risk factors of the clinical characteristics of patients and to identify the ST and KL types of the strains causing the infection at an early stage.
Relationship between estimated pulse wave velocity and the risk of future sarcopenia in middle-aged and older Chinese adults: evidence from the China Health and Retirement Longitudinal Study
Authors: Song Dingding , Miao Jianghu , Zhang Yunzhu , Zhu Aiguo
Published: February 2025

Objective

Sarcopenia, common among older adults, is associated with adverse health outcomes. This study explores the relationship between estimated pulse wave velocity (ePWV), a marker of arterial stiffness, and sarcopenia to support the early diagnosis and prevention strategies.

Methods

Using data from two waves (2011 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS), we conducted a nationally representative cohort study. ePWV was calculated at baseline, and sarcopenia was identified based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. We used multivariate logistic regression and restricted cubic spline (RCS) analyses to investigate the ePWV-sarcopenia relationship.

Results

Among 6,639 participants followed for 4 years, 11.1% were diagnosed with sarcopenia. Initial analyses indicated a positive correlation between ePWV and sarcopenia (β = 1.35), which weakened after adjusting for confounders. RCS analysis demonstrated a non-linear relationship (P-non-linear <0.001), with sarcopenia risk peaking at an ePWV of 9.430 m/s. The highest ePWV quartile showed the lowest grip strength, the longest chair stand test time, and the highest sarcopenia prevalence (P < 0.0001).

Conclusions

In middle-aged and elderly Chinese adults, ePWV variations may be linked to sarcopenia risk, potentially serving as a predictive marker. The non-linear relationship indicates complex underlying mechanisms, meriting further research.
Optimal dispatch of integrated energy system considering time-space dimensional demand response based on time-of-use electricity price
Authors: Cheng Tingli , Zeng Liqiang , Tang Hao , Zhang Yingying
Published: February 2025

Demand response has significant potential for enhancing energy utilization, thereby contributing to the advancement of integrated energy systems (IES). In this paper, an optimal IES dispatch model fully incorporating flexible loads on the demand sides is established. Firstly, based on time-of-use (ToU) electricity pricing, a flexible two-dimensional integrated demand response (IDR) model is presented, which is characterized by considering tightly spatial-temporal coupling characteristics of different loads. Subsequently, a day-ahead dispatch model for IES, incorporating ToU-based IDR, is developed to minimize the total operational cost. In this model, the optimal ToU pricing scheme is determined by comparing their economic efficiencies. The Particle Swarm Optimization (PSO) algorithm is then applied to solve the complex dispatch problem. Finally, the case study is conducted and the comparative results confirm that: 1) implementation of the IDR in time-space dimension can flatten the loads curves; 2) the time-space IDR significantly promotes the economic benefits of IES dispatch; 3) the proposed dispatch model is able to coordinate and optimize various types of energy and flexible loads.
A short overview of the physicochemical properties of cold-bonded alkali-activated lightweight aggregates and preliminary examinations of their usability for plant growth
Authors: Frohmüller Max O. , Wichmann Isabelle , Stephan Dietmar
Published: February 2025

Introduction

A novel way to upcycle fine concrete or brick demolition waste (<2 mm) to akaliactivated lightweight aggregates (ALA) was described recently. As pollutant burdens in these precursors are closely controlled by federal law in Germany, the aggregates produced in this study could be used in direct contact with the environment.

Methods

Therefore, different parameters of ALA, lightweight expanded clay aggregates (LECA), and plant granulate were measured and compared, such as pH buffering, heavy metal leaching, pH, and conductivity in solution, pore size distribution, available water content (AWC), and dissolvable macronutrients. Additional plant growth experiments assessed the aggregate’s feasibility as a substrate compared to or as an improvement for lightly acidic soil, with different mixing ratios between LUFA reference soil and ALA.

Results

These investigations showed high phytotoxicity, which might be explained by salinization (∼3.6 or 4.6 times higher conductivities than plant granulate) and by ALA’s elevated pH (>12). The latter may be used for soil improvements like liming, but a neutralization capacity of only ∼1.7% compared to pure CaO was reached. Similar to this, ALA’s AWC stayed below 1/6 of LECA’s AWC. Both brick or concrete powder aggregates (BPA or CPA) provided comparable or higher amounts of Ca, K, and P relative to plant granulate and exhibited heavy metal loads below the German federal limit values.

Discussion

While these findings hinted that ALA could act as soil improvements in the future, this use case is not feasible without significant improvements to either ALA’s production process or post-treatment.
State-of-the-art virtualisation technologies for the centralised automotive E/E architecture
Authors: Guo Zixuan , Koufos Konstantinos , Dianati Mehrdad , Woodman Roger
Published: February 2025

The automotive industry is undergoing profound changes, driven by the need for safer, more environmentally friendly, and more accessible future mobility and transport systems for goods and people. Enabling technologies include electrification, digitalisation, and automation of future vehicles. These technologies are powered by a multitude of onboard Electronic Control Units (ECUs). A typical modern vehicle has about 100 physical ECUs to enable various aspects of its function. These legacy many-ECU electronic/electrical (E/E) architecture models, known as distributed E/E architecture, are deemed inefficient as the number of ECUs and their processing power requirements keep increasing. In contrast, emerging centralised E/E architectures propose using fewer physical high-performance onboard processors on which an almost unlimited number of virtual ECUs can be created to handle various legacy and modern applications. As a result, virtualisation techniques, which enable multiple virtual ECUs with different operating systems to run concurrently on a single hardware platform, are promising models for modern centralised E/E architectures. Motivated by this trend, this paper provides a structured and comprehensive state-of-the-art review of virtualisation techniques for automotive applications, covering areas such as resource allocation, AUTOSAR, peripheral I/O interfaces, and in-vehicle communication networks. We comprehensively review the literature and identify research gaps in virtualisation techniques for cache management, paravirtualsation, software-defined networking for in-vehicle networks, and virtualisation for enhanced prototyping and testing in the context of modern E/E architectures for modern vehicles.
Exploring genetic loci linked to COVID-19 severity and immune response through multi-trait GWAS analyses
Authors: Meng Ziang , Zhang Chumeng , Liu Shuai , Li Wen , Wang Yue , Zhang Qingyi , Peng Bichen , Ye Weiyi , Jiang Yue , Song Yingchao , Guo Miao , Chang Xiao , Shao Lei
Published: February 2025

Introduction

COVID-19 severity has been linked to immune factors, with excessive immune responses like cytokine storms contributing to mortality. However, the genetic basis of these immune responses is not well understood. This study aimed to explore the genetic connection between COVID-19 severity and blood cell traits, given their close relationship with immunity.

Materials and methods

GWAS summary statistics for COVID-19 and blood cell counts were analyzed using Linkage Disequilibrium Score Regression (LDSC) to estimate genetic correlations and heritabilities. For traits with significant correlations, a Multi-Trait GWAS Analysis (MTAG) was performed to identify pleiotropic loci shared between COVID-19 and blood cell counts.

Results

Our MTAG analysis identified four pleiotropic loci associated with COVID-19 severity, five loci linked to hospitalized cases, and one locus related to general patients. Among these, two novel loci were identified in the high-risk population, with rs55779981 located near RAVER1 and rs73009538 near CARM1. In hospitalized patients, two previously unrecognized loci were detected, namely, rs115545251 near GFI1 and rs3181049 near RAVER1, while in general patients, rs11065822 near CUX2 emerged as a newly identified locus. We also identified potential target genes, including those involved in inflammation signaling (CARM1), endothelial dysfunction (INTS12), and antiviral immune response (RAVER1), which may require further investigation.

Conclusion

Our study offers insights into the genetic overlap between COVID-19 and immune factors, suggesting potential directions for future research and clinical exploration.
Role of innate immune cells in multiple sclerosis
Authors: Prado Carolina , Herrada Andrés A. , Hevia Daniel , Goiry Lorna Galleguillos , Escobedo Noelia
Published: February 2025

Multiple sclerosis (MS) is a chronic autoimmune, inflammatory and neurodegenerative disease affecting the central nervous system (CNS). MS is associated with a complex interplay between neurodegenerative and inflammatory processes, mostly attributed to pathogenic T and B cells. However, a growing body of preclinical and clinical evidence indicates that innate immunity plays a crucial role in MS promotion and progression. Accordingly, preclinical and clinical studies targeting different innate immune cells to control MS are currently under study, highlighting the importance of innate immunity in this pathology. Here, we reviewed recent findings regarding the role played by innate immune cells in the pathogenesis of MS. Additionally, we discuss potential new treatments for MS based on targets against innate immune components.
Hydrodynamic performance testing of artificial textures using a novel pin-on-disc test method
Authors: Pusterhofer Michael , Maier Michael , Scharf Raphael , Haumer Florian , Grün Florian
Published: February 2025

In times of global climate change, the reduction in friction in technical applications is of crucial significance. Surface textures are one possibility for reducing friction in lubricated contacts. To provide a deeper understanding of the effects of surface textures on the tribological performance, this study analyzes wedge-shaped, textured lubrication gaps using a novel test rig with an in situ lubrication gap height measurement. Using this experimental pin-on-disc setup, chevron-shaped and cylindrical textures with two different heights (ht = 10 and 50 µm) were tested under full-film lubrication conditions. The pin was tilted in a very precise way to generate a convergent lubrication gap. The test results show the potential for friction reduction using textures. In general, it can be stated that the investigated textures show clearly different behavior compared to the smooth reference specimens. Mostly, a reduction in friction force was measured for the texture specimens, which was accompanied by a reduction in the lubrication gap height. The system still operates in full-film lubrication, but there is a higher risk of entering the mixed-friction regime. In summary, no universal performance trend for single textures can be stated; it needs to be checked for each specific operating point which texture provides the best enhancement.
Parameter optimization of the notched blade spiral fertilizer discharger for pineapple orchards based on DEM
Authors: Dun Guoqiang , Sheng Quanbao , Ji Xinxin , Li Hailiang , Ma Chunyu , Li Xinming , Sun Haitian , Wang Luhan , Ma Chao , Yu Zhenzhen , Wang Hongxuan
Published: February 2025

Introduction

In order to improve the fertilizer-discharging uniformity of the traditional spiral fertilizer distributor and achieve precise and controllable fertilization, based on the agronomic characteristics of fertilization in pineapple orchards, a notched-blade spiral fertilizer discharger with the mechanism of discontinuous-blade sliding-cutting and pushing-pore fertilization is innovatively designed.

Methods

Based on parametric modelling and determining the volume of fertilizer accommodation of the spiral, the theoretical fertilizer-discharging amount of the fertilizer discharger is determined in combination with theoretical analysis. The main factors influencing the fertilization performance of the spiral fertilizer discharger are analyzed using theoretical calculation formulas. The discrete element method is used to simulate the fertilizer-discharging process. By comparing simulation experiments, it is determined that the notched-blade spiral fertilizer discharger has better uniformity than the traditional one. The effects of the number and shape of periodic notched blades on the fertilizer-discharging uniformity are analyzed through single-factor experiments. The L9 (3⁴) orthogonal table is adopted for conducting orthogonal simulation tests.

Results

The test results show that the primary and secondary order of the influence of test factors on test indexes is blade notch shape and periodic blade notch number. When the blade notch is a sector, and the periodic blade has three notches, the fluctuation coefficient of fertilizer discharge uniformity is 27.01%. The results of the bench test show that the uniformity fluctuation coefficient of the notched blade spiral fertilizer discharger is 27.42% when the rotating speed is 60r/min. The experimental and simulation values are consistent. Moreover, the fluctuation coefficient of the spiral fertilizer discharger is reduced by 64.86 percentage points compared with that of the spiral fertilizer discharger under the same conditions. Moreover, the fluctuation coefficient of the notched blade spiral is 64.86% lower than that of the spiral fertilizer discharger under the same conditions. Based on different rotational speeds, the fitting curve of fertilizer discharge is y = 2.02x + 23.02.

Conclusion

The fertilizer discharge can be controlled by adjusting the rotating speed. It improves the controlled accuracy and uniformity of fertilizer application and achieves the goal of green and sustainable development of the pineapple industry in the tropics. The research results can provide a reference for designing and optimizing spiral fertilizer dischargers.
Enhanced efficacy of aprepitant-based triple prophylaxis in preventing postoperative nausea and vomiting following metabolic bariatric surgery: a single-center, retrospective cohort study
Authors: Shan Xiaodong , Yang Yidi , Xiao Xiaoao , Zhang Mingchuang , Chen Rui , Huang Qingqiu , Gao Yuanqing , Sun Xitai
Published: February 2025

Background

Metabolic bariatric surgery (MBS) is associated with high risk of postoperative nausea and vomiting (PONV). We aimed to investigate the impact of aprepitant-based triple prophylaxis on PONV after MBS.

Methods

We reviewed a retrospective cohort of patients who underwent primary MBS between December 28, 2023 and May 31, 2024. The eligible patients were divided into two groups based on whether receiving additional oral single 125 mg dose of aprepitant preoperatively to the dual prophylaxis (ondansetron 8 mg and dexamethasone 10 mg). Multivariable and propensity score-adjusted analyses were performed to compare the composite PONV endpoints between the groups.

Results

A total of 207 patients were included in the study. Of these, 129 patients received dual prophylaxis, while the remaining 78 patients received additional single 125 mg dose of aprepitant. Similar to multivariable logistic regression analysis, propensity-adjusted logistic regression analysis revealed that the aprepitant-based triple prophylaxis group had a significantly higher complete response rate (82.1% vs. 24.0%, adjusted OR 10.312, 95% CI 4.186–25.399, p < 0.001), a lower incidence of PONV (59.0% vs. 85.3%, adjusted OR 0.287, 95% CI 0.125–0.663, p = 0.004), and required fewer rescue antiemetics (7.7% vs. 37.2%, adjusted OR 0.155, 95% CI 0.052–0.457, p < 0.001) compared to the dual prophylaxis group. Propensity score-adjusted analysis demonstrated that the addition of aprepitant to dual prophylaxis significantly reduced the incidence of PONV, vomiting frequency, and both the Nausea VAS and Nausea Subscale scores (all p < 0.05).

Conclusion

Our findings indicate that the addition of a single preoperative dose of aprepitant to a dual antiemetic prophylaxis of dexamethasone and ondansetron might be associated with a further improve outcomes related to composite PONV endpoints in patients undergoing metabolic bariatric surgery.
Impending sepsis-induced coagulopathy (SIC) is associated with increased disease severity in SIC-negative patients: a secondary analysis of a prospective exploratory study
Authors: Schmoch Thomas , Möhnle Patrick , Nusshag Christian , Feisst Manuel , Weigand Markus A. , Brenner Thorsten
Published: February 2025

Due to the intense crosstalk between the coagulation and immune systems, coagulation disorders are an integral part of the disturbed host response to infection that defines sepsis. These so-called sepsis-induced coagulopathies (SIC) are associated with increased morbidity and mortality. However, we still do not know enough about the prevalence and risk factors for SIC in different patient groups. In this study, we present a secondary analysis of a prospective, observational study. The objectives of this secondary analysis were (1) to estimate the prevalence of SIC at the onset of sepsis, (2) to assess the prevalence of SIC throughout the intensive care unit (ICU) stay using a previously described modified SIC score, and (3) to evaluate the association between SIC and morbidity and mortality. The prevalence of SIC at the onset of sepsis was 15.0% (95% confidence interval [CI]: 9.3–23.3%). A total of 24 additional patients who were SIC-negative at the onset of sepsis developed SIC according to the modified SIC score during their ICU stay. In total, we estimated that 39.0% (95% CI: 30.0–48.8%) of patients experienced relevant SIC during their ICU stay. Septic shock, a high lactate level, and a high Sequential Organ Failure Assessment (SOFA) score at the onset of sepsis in SIC-negative patients were associated with SIC development during the course of the disease. These findings need to be verified in larger cohorts and may represent a starting point for the development of a new screening tool for the identification of patients with sepsis at high risk of developing SIC.
Global, regional, and national burden of chronic kidney disease due to diabetes mellitus type 2 from 1990 to 2021, with projections to 2036: a systematic analysis for the Global Burden of Disease Study 2021
Authors: Hu Ruikang , Zhao Zhifeng , Xie Luze , Ma Zhenjie , Wu Wen , Li Shuangxi
Published: February 2025

Background

Chronic kidney disease (CKD) due to type 2 diabetes mellitus (T2DM) has emerged as a significant global health burden, with rising incidence and prevalence rates observed over the past decades.

Methods

We utilized the latest data from the Global Burden of Disease Study (GBD) 2021. Firstly, we reported the number of incidence, prevalence, deaths, and Disability-Adjusted Life Years (DALYs) attributed to CKD due to T2DM, accompanied by their respective Age-Standardized Rates (ASRs), for the year 2021. This analysis encompassed a global perspective and was further stratified by various subtypes. Moreover, we examined trends globally and within specified sub-types to investigate the temporal dynamics of the ASRs. We estimated the percentage change in ASRs, providing a quantitative measure of the rate of change in the burden over the study period. Moreover, we utilized the Bayesian age-period-cohort (BAPC) model to forecast the future burden.

Results

Globally, the ASRs of CKD due to T2DM all have witnessed a notable rise except for age-standardized prevalence rate (ASPR). The trends observed in both sexes and nearly all age groups were found to be congruent with those of the overall population. The increase in disease burden being greatest in the middle and lower SDI regions. The predicted results showed that the ASRs would still increase from 2022 to 2036.

Conclusion

This study highlights the critical importance of addressing the growing burden of T2DM-related CKD on global health. Effective prevention and management strategies, including improvements in diabetes care, renal health promotion, and access to healthcare services, are urgently needed to mitigate the future impact of T2DM-related CKD.
The value of heparin-binding protein in bronchoalveolar lavage fluid in acute respiratory distress syndrome
Authors: Liu Yang , Zhou Wei , Xu Wei , Lv Xing-ping , Wang Fei-fei , Wang Xue-bin , Ma Shao-lin
Published: February 2025

Background

Heparin-binding protein (HBP) is recognized as a significant factor in the development of Acute Respiratory Distress Syndrome (ARDS). Although plasma levels of HBP have been identified as a predictive biomarker for ARDS, the role and value of HBP in bronchoalveolar lavage fluid (BALF) remain unexplored.

Methods

Our study utilized a cecum ligation and puncture (CLP) method to induce an ARDS model in mice, examining the correlations between plasma and BALF HBP levels, lung injury severity, lung wet-to-dry (WD) ratio, and BALF total protein levels. Additionally, we conducted a comparative analysis of BALF and plasma HBP levels in 44 ARDS patients and 38 patients with cardiogenic pulmonary edema (CPE), investigating their correlations.

Results

In the animal study, CLP-induced mice demonstrated significantly higher lung WD ratios, BALF protein, BALF HBP, and plasma HBP levels compared to the control group. Notably, both BALF and plasma HBP levels were significantly correlated with lung injury severity. In human subjects, significant differences in BALF HBP, BALF protein, and plasma HBP levels were observed between ARDS and CPE patients, along with notable correlations between these markers and the severity of lung injury. Particularly, BALF HBP levels exhibited a stronger correlation with lung injury compared to plasma HBP levels.

Conclusion

The study indicates that both BALF and plasma HBP levels are significantly elevated in the context of lung injury in both animal models and human ARDS patients. More importantly, BALF HBP levels show a stronger correlation with the severity of lung injury, suggesting that BALF HBP could serve as a valuable biomarker for diagnosing and guiding the treatment of ARDS.
Gene manipulation in Oenococcus oeni based on a newly applicable gene gun technology
Authors: Chen Mengrong , Chen Qiling
Published: February 2025

Oenococcus oeni is an important engineering microbe in winemaking. Detailed knowledge of its growth and metabolism in harsh wine environments could contribute to breeding elite O. oeni varieties. However, further studies on this topic do not appear to be sustained due to the lack of stable and reproducible technology to perform gene manipulation on O. oeni. Therefore, this research was designed to study gene function by exploring a newly applicable transformation technique that could perform stably and reproducibly on O. oeni. By using gene gun technology with detonation nanodiamonds as a plasmid DNA carrier, we achieved stable and reproducible plasmid DNA transformation in O. oeni. In addition, the plasmid with the chloramphenicol resistance gene allowed O. oeni SX-1b to thrive in chloramphenicol medium.
Artificial intelligence in stroke risk assessment and management via retinal imaging
Authors: Khalafi Parsa , Morsali Soroush , Hamidi Sana , Ashayeri Hamidreza , Sobhi Navid , Pedrammehr Siamak , Jafarizadeh Ali
Published: February 2025

Retinal imaging, used for assessing stroke-related retinal changes, is a non-invasive and cost-effective method that can be enhanced by machine learning and deep learning algorithms, showing promise in early disease detection, severity grading, and prognostic evaluation in stroke patients. This review explores the role of artificial intelligence (AI) in stroke patient care, focusing on retinal imaging integration into clinical workflows. Retinal imaging has revealed several microvascular changes, including a decrease in the central retinal artery diameter and an increase in the central retinal vein diameter, both of which are associated with lacunar stroke and intracranial hemorrhage. Additionally, microvascular changes, such as arteriovenous nicking, increased vessel tortuosity, enhanced arteriolar light reflex, decreased retinal fractals, and thinning of retinal nerve fiber layer are also reported to be associated with higher stroke risk. AI models, such as Xception and EfficientNet, have demonstrated accuracy comparable to traditional stroke risk scoring systems in predicting stroke risk. For stroke diagnosis, models like Inception, ResNet, and VGG, alongside machine learning classifiers, have shown high efficacy in distinguishing stroke patients from healthy individuals using retinal imaging. Moreover, a random forest model effectively distinguished between ischemic and hemorrhagic stroke subtypes based on retinal features, showing superior predictive performance compared to traditional clinical characteristics. Additionally, a support vector machine model has achieved high classification accuracy in assessing pial collateral status. Despite this advancements, challenges such as the lack of standardized protocols for imaging modalities, hesitance in trusting AI-generated predictions, insufficient integration of retinal imaging data with electronic health records, the need for validation across diverse populations, and ethical and regulatory concerns persist. Future efforts must focus on validating AI models across diverse populations, ensuring algorithm transparency, and addressing ethical and regulatory issues to enable broader implementation. Overcoming these barriers will be essential for translating this technology into personalized stroke care and improving patient outcomes.
Development and validation of a predictive model for the risk of symptomatic adjacent segmental degeneration after anterior cervical discectomy and fusion
Authors: Liang Xiao , Ran Lijing , Zhang Zhenyu , Xiao Xin , Wang Congyang , Du Yuwang , Jiang Hua
Published: February 2025

Background

To investigate the risk factors for symptomatic adjacent segment degeneration (ASD) 5 years after anterior cervical discectomy and fusion (ACDF) and develop and evaluate predictive models.

Methods

A total of 655 patients who underwent ACDF were randomly assigned to the training set (n = 393) or validation set (n = 262) at a ratio of 6:4. Independent predictors of ASD were selected by LASSO regression and logistic regression analysis. A calibration curve, ROC curve and DCA curve were used to evaluate the model performance.

Results

LASSO regression combined with logistic regression analysis revealed that age, cervical canal stenosis, smaller T1S and smaller cervical lordosis (CL) were risk factors for ASD 5 years after surgery. Nomographic analysis using appeal factors was used to predict the risk of ASD. The area under the ROC curve was 0.711 (95% CI: 0.643–0.780) in the training set and 0.701 (95% CI: 0.618–0.785) in the validation set. The calibration curve showed no significant bias in either set. The DCA indicated that using the nomogram to predict the risk of ASD would be more accurate when the risk threshold probability was 12–53% in the training set and 6–43% in the validation set.

Conclusion

Age, cervical spinal stenosis, a smaller T1S, and a smaller CL are independent risk factors for ASD 5 years after ACDF surgery. Based on these four indicators, we constructed a new clinical prediction model that has a certain predictive effect and is conducive to clinical decision-making and treatment planning.
Alterations in neutrophil mRNA profiles in multiple sclerosis and identification of candidate genes for further investigation
Authors: Zhang Huining , Guo Ruoyi , Han Yusen , Yao Zhichao , Quan Moyuan , Li Bin , Guo Li
Published: February 2025

Introduction

Multiple sclerosis (MS) is a chronic and debilitating inflammatory disease of the central nervous system (CNS), characterized by demyelination and neurodegeneration. Emerging evidence implicates neutrophils in MS pathogenesis, particularly through processes like neutrophil extracellular traps (NETs) formation and degranulation, which may exacerbate inflammation and autoimmunity.

Methods

RNA sequencing of peripheral blood neutrophils from MS patients and healthy controls identified differentially expressed genes (DEGs). Pathway enrichment and protein–protein interaction (PPI) analyses highlighted potential biomarkers, validated using reverse transcription quantitative PCR (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA).

Results

Our analysis identified 1,968 DEGs in neutrophils from MS patients, comprising 1,068 upregulated and 900 downregulated genes. Pathway enrichment analysis revealed significant involvement of immune processes, including antigen presentation, B and T cell receptor signaling, intracellular signaling cascades, and neutrophil degranulation. Notably, KEGG analysis highlighted a pivotal role for upregulated genes in neutrophil extracellular traps (NETs) formation, a process increasingly associated with autoimmunity. PPI network analysis pinpointed five key hub genes—LCN2, LTF, ELANE, CAMP, and CTSG—as central players in neutrophil-mediated immune modulation. Protein-level validation using ELISA confirmed elevated levels of LCN2, ELANE, CAMP, and CTSG, consistent with transcriptomic findings, further supporting their role as biomarkers. Subsequent RT-qPCR validation demonstrated robust diagnostic potential for these genes, with area under the curve (AUC) values of 0.952 (LCN2), 0.827 (LTF), 0.968 (ELANE), 0.950 (CAMP), and 0.862 (CTSG).

Discussion

These findings uncover a previously underappreciated role for neutrophils in MS pathogenesis, driven by alterations in gene expression linked to immune modulation and NET formation. The identified biomarkers, particularly ELANE and LCN2, demonstrate strong diagnostic potential, offering a new avenue for non-invasive MS diagnostics. Beyond clinical utility, this study highlights the importance of neutrophil-driven immune responses in MS, providing mechanistic insights into the complex interplay between innate and adaptive immunity in demyelinating diseases. Furthermore, these findings suggest that targeting neutrophil-specific processes, such as NETs formation and degranulation, could mitigate inflammatory damage and provide novel therapeutic approaches for MS treatment. These results lay the groundwork for future studies exploring therapeutic strategies targeting neutrophil functions in MS.
Impacts of night shift on medical professionals: a pilot study of brain connectivity and gut microbiota
Authors: Yao Tengmao , Chao Yi-Ping , Huang Chih-Mao , Lee Hsin-Chien , Liu Chi-Yun , Li Kuan-Wei , Hsu Ai-Ling , Tung Yu-Tang , Wu Changwei W.
Published: February 2025

Night shift is a prevalent workstyle in medical hospitals, demanding continuous health monitoring and rapid decision making of medical professionals. Night shifts may cause serious health problems to medical staff, including cognitive impairments, poor sleep, and inflammatory responses, leading to the altered gut-brain axis. However, how night shifts impact gut-brain axis and how long the impact lasts remain to be studied. Hence, we investigated the dynamic changes of brain-microbiota relations following night shifts and subsequent recovery days among medical shift workers. Young medical staffs were recruited for the 3-session assessments over the scheduled night shifts (pre-shift, post-shift, and recovery) by measuring (a) sleep metrics, (b) brain functions, (c) gut bacteriome compositions, and (d) cognitive assessments. Participants experienced partial sleep deprivation only during the 5-day night shifts but rapidly returned to baseline after the 4-day recovery, so as the elevated brain fluctuations in the superior frontal gyrus after night shifts. Meanwhile, the night shifts caused elongated connectivity changes of default-mode and dorsal attention networks without recovery. Nevertheless, we did not find prevailing night-shift effects on cognition and gut bacteriome compositions, except the Gemellaceae concentration and the multi-task performance. Collectively, night shifts may induce prolonged alterations on brain connectivity without impacts on gut bacteriome, suggesting the vulnerable brain functions and the resilient gut bacteriome to the short-term night shifts among medical shift workers.
Prediction of right recurrent laryngeal nerve lymph node metastasis in esophageal cancer based on computed tomography imaging histology
Authors: Huang Xiaoli , Jiang Shumin , Li Zhe , Lin Xiong , Chen Zhipeng , Hu Chao , He Jianbing , Yan Chun , Duan Hongbing , Ke Sunkui
Published: February 2025

Purpose

This study aimed to identify risk factors for right recurrent laryngeal nerve lymph node (RRLNLN) metastasis using computed tomography (CT) imaging histology and clinical data from patients with esophageal squamous cell carcinoma (ESCC), ultimately developing a clinical prediction model.

Methods

Data were collected from 370 patients who underwent surgical resection at the Department of Thoracic Surgery, Zhongshan Hospital of Xiamen University, from December 2014 to December 2020. Subsequently, the venous-stage chest-enhanced CT images of the patients were imported into 3DSlicer 4.11 software, allowing for the extraction of imaging histological features. Additionally, by combining the clinical data of the patients, single- and multifactor analyses were conducted to screen the risk factors and build a predictive model in the form of a nomogram. The area under the curve (AUC) was used as a discriminant for model accuracy, while differentiation and calibration methods were applied to further evaluate the model’s accuracy. Finally, the Bootstrap resampling method was employed to repeat sampling 2,000 times to draw calibration curves, while the K-fold crossvalidation method was used for the internal validation of the prediction model.

Results

The RRLNLN lymph node metastasis rate was 17.3%. Four significant factors—Maximum2DDiameterSlice, Mean, Imc1, and Dependence Entropy—were identified. Alignment diagrams were subsequently constructed, yielding an AUC of 0.938 and a C-index of 0.904 during internal validation.

Conclusion

The model demonstrates high predictive accuracy, making it a valuable tool for guiding the development of preoperative protocols.
Almonertinib-induced interstitial lung disease in an NSCLC patient co-harboring EGFR Ex19del mutation and MET de novo amplification: a case report and literature review
Authors: Yang Wenjing , Shi Lin , Wang Hao , Li Ying , Ji Xingyu , Li Hongjin , Yang Guowang , Xu Weiru
Published: February 2025

Lung cancer patients co-harboring EGFR Ex19del mutation and MET de novo amplification is extremely uncommon. Thus, the optimal therapeutic strategies, treatment-related complications, and prognosis for such patients remain unclear. Herein, we describe a case of patient co-harboring EGFR Ex19del mutation and MET de novo amplification who presented targeted (almonertinib)-induced interstitial lung disease (ILD). We propose that patients with EGFR Ex19del mutation and MET de novo amplification may benefit more from dual-targeted therapy than pemetrexed and carboplatin chemotherapy along with bevacizumab. However, dual-targeted therapy may increase the risk of ILD, so it is important to be alert to targeted-induced ILD, and unexplained fever may be an early warning signal for targeted-induced ILD, especially almonertinib-induced ILD. Timely intervention is needed to avoid greater harm when ILD occurs and, when ILD is effectively controlled, seize the opportunity to rechallenge the dual-targeted therapy may contribute to a better prognosis. In addition, the patients with targeted-induced ILD in the past need more rigorous monitoring and follow-up in the process of rechallenging the targeted drug therapy.
Bisphenol A and DDT disrupt adipocyte function in the mammary gland: implications for breast cancer risk and progression
Authors: Bernhardt Sarah M. , House Carrie D.
Published: February 2025

As breast cancer incidence continues to rise worldwide, there is a pressing need to understand the environmental factors that contribute to its development. Obesogens, including Bisphenol A (BPA) and Dichlorodiphenyltrichloroethane (DDT), are highly prevalent in the environment, and have been associated with obesity and metabolic dysregulation. BPA and DDT, known to disrupt hormone signaling in breast epithelial cells, also promote adipogenesis, lipogenesis, and adipokine secretion in adipose tissue, directly contributing to the pathogenesis of obesity. While the adipose-rich mammary gland may be particularly vulnerable to environmental obesogens, there is a scarcity of research investigating obesogen-mediated changes in adipocytes that drive oncogenic transformation of breast epithelial cells. Here, we review the preclinical and clinical evidence linking BPA and DDT to impaired mammary gland development and breast cancer risk. We discuss how the obesogen-driven mechanisms that contribute to obesity, including changes in adipogenesis, lipogenesis, and adipokine secretion, could provide a pro-inflammatory, nutrient-rich environment that promotes activation of oncogenic pathways in breast epithelial cells. Understanding the role of obesogens in breast cancer risk and progression is essential for informing public health guidelines aimed at minimizing obesogen exposure, to ultimately reduce breast cancer incidence and improve outcomes for women.
Longitudinal study of cognitive and mental functions among adult Hodgkin-lymphoma survivors, based on data from a primary treatment center in Hungary
Authors: Virga István , Kósa Karolina , Illés Anna , Miltényi Zsófia , Ivánka Tibor , Berecz Roland , Égerházi Anikó , Illés Árpád , Magyari Ferenc
Published: February 2025

Introduction

Due to risk and response-adapted treatment strategies, more than 80% of newly diagnosed adult classical Hodgkin lymphoma (HL) patients at any stage can be cured and become long-term survivors. A well-known side effect is cognitive dysfunction that appears in HL patients after chemotherapy (chemobrain). In the present longitudinal study, we measured cognitive function in our HL patients, in search of potential correlations between patient-related factors, the signs and symptoms of their diseases, and therapeutic factors.

Methods

Patients underwent a computer-assisted assessment (CANTAB) of cognitive function (especially domains of visual memory, attention, working memory, and planning) and filled out psychological questionnaires (standardized, self-administered and validated for Hungarian language) before treatment (n=30, T1) and after the first-line treatment (n=25, T2), and 8.6 years after the end of chemotherapy (n=19, T3).

Results

The median age of 16 females and 14 males was 35 years (20-69), 35 years (21-63) after chemotherapy, and 43 years (29-70) at the end of the long-term follow-up, when the study was completed. 77% of all patients showed cognitive impairment before treatment. A close correlation was found between attention and unfavorable prognostic factors (III-IV. stage, age, bulky) baseline comorbidities (T2DM, psoriasis, HTN) and place of residence. Visual memory was affected by comorbidities and the place of residence. Working memory and planning was influenced by single marital status, and bulk disease. Post-treatment cognitive impairment was evaluated in 77% of the HL patients. In the working memory and planning domain, the Stockings of Cambridge (SOC) subtest significantly improved after treatment, while visual memory and attention remained unchanged. The cumulative dose of bleomycin associated with SOC.

Conclusion

The study highlights the fact that cognitive functions of HL patients were already impaired before treatment, especially attention, working memory, and planning. Long-term improvement in cognitive function was observed post-treatment. Employment status, place of residence and unfavorable prognosis have an impact on cognitive domains. Early diagnosis and intervention are essential to maintain patients’ quality of life throughout and after treatment.
Epidemiological trends and age-period-cohort effects on lip and oral cavity cancer burden across the BRICS from 1992 to 2021
Authors: Yu Zhengrong , Wu Yuhang , Cao Yu , Cheng Peiyu
Published: February 2025

Background

Lip and oral cavity cancer (LOC) is one of the common malignant tumors of the head and neck, posing significant health and economic burdens. The BRICS, including Brazil, Russia, India, China, and South Africa, represent a large global population, presenting unique public health challenges. This study aims to evaluate the epidemiological trends and variations in the burden of LOC across BRICS in a timely manner.

Methods

Data on the number, all-age rate, age-standardized rate, and relative change in LOC incidence from 1992 to 2021 within BRICS were obtained from the Global Burden of Disease study (GBD) 2021, and we analyzed global and BRICS-specific LOC incidence trends over 30 years. Furthermore, age-period-cohort model was applied to estimate net drift, local drift, age, period and cohort effects between 1992 and 2021.

Results

In 2021, the BRICS nations reported 194.74 thousand new LOC cases, constituting 46.2% of the global total. From 1992 to 2021, all BRICS countries witnessed a significant rise in LOC cases, with China leading at 259.06%. The age-standardized incidence of LOC increased by over 20% in the Russian Federation, India, and China, while Brazil and South Africa exhibited marginal changes (Brazil: 0.75%; South Africa: -7.87%). Rising LOC trends were prevalent across most age groups in China, India, and the Russian Federation, particularly affecting older adults (60-94 years). Age, period, and cohort effects were deteriorating in China and India, contrasting with improvements in Brazil and South Africa.

Conclusion

LOC incidence has increased across BRICS, with temporal trends not consistently aligning with economic growth and exhibiting significant variation among countries. Brazil’s experience highlights the efficacy of oral health and tobacco control measures in mitigating LOC, especially in fast-developing nations. Prevention should target men and elderly in China and India, and women in other areas.
Extracellular vesicles and preterm infant diseases
Authors: Chen Wenqain , Kongsomros Supasek , Thorman Alexander , Esfandiari Leyla , Morrow Ardythe L. , Chutipongtanate Somchai , Newburg David S.
Published: February 2025

With the continuous improvement in perinatal care, the number of viable preterm infants is gradually increasing, along with the rise in preterm-related diseases such as necrotizing enterocolitis, bronchopulmonary dysplasia, perinatal brain injury, retinopathy of prematurity, and sepsis. Due to the unique pathophysiology of preterm infants, diagnosing and treating these diseases has become particularly challenging, significantly affecting their survival rate and long-term quality of life. Extracellular vesicles (EVs), as key mediators of intercellular communication, play an important regulatory role in the pathophysiology of these diseases. Because of their biological characteristics, EVs could serve as biomarkers and potential therapeutic agents for preterm-related diseases. This review summarizes the biological properties of EVs, their relationship with preterm-related diseases, and their prospects for diagnosis and treatment. EVs face unique challenges and opportunities for clinical applications.