bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of Salt-Inducible Kinase 2 (SIK2) and its Correlation with Immune Cell Infiltration and Prognosis in Thyroid Papillary Carcinoma
Authors: wang sisi , li yilin , deng jian , zhong yangyan , deng junjie , deng lufeng , li dan , feng haigang , wang youquan , cao hong
Published: August 2024

Background
Thyroid cancer(THCA) is the most common malignancy of the endocrine system, with papillary carcinoma being the most prevalent histopathological type. In recent years, its incidence has been continuously increasing, making it one of the fastest-growing malignancies in multiple countries. This study aims to investigate the relevance of Salt-Inducible Kinase 2 (SIK2) to this disease.
Methods
In this study,Reverse Transcription Quantitative Polymerase Chain Reaction(RT-qPCR),Enzyme-Linked Immunosorbent Assay (ELISA),Western Blotting (WB), Immunohistochemistry (IHC), and other experimental methods were employed to investigate the expression of SIK2 in thyroid cancer and adjacent tissues. WB, (Cell Counting Kit-8)CCK8 assay, Transwell assay, scratch test, and flow cytometry were used to analyze the activity of thyroid papillary carcinoma cells after SIK2 silencing. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analysis were conducted to guide further research directions. Immune infiltration was investigated using the Tumor Immune System Interaction Database (TISIDB), and prognosis-related analyses were performed using the Kaplan-Meier plotter and TIMRE2.0 databases.
Results
The protein level of SIK2 was significantly elevated in thyroid papillary carcinoma tissues compared to adjacent tissues. Silencing of SIK2 resulted in a significant reduction in the viability of thyroid papillary carcinoma cells, indicating its prognostic value. Additionally, using bioinformatics methods, the relationship between SIK2, immune cell infiltration, and prognosis in thyroid cancer was explored. Analysis using the TISIDB database showed a negative correlation between SIK2 expression and immune cell infiltration in thyroid cancer, suggesting a potential role of SIK2 dysregulation in tumor immune evasion. Kaplan-Meier plotter database analysis revealed different survival rates associated with different levels of immune cell infiltration, demonstrating clinical relevance. In patients with high SIK2 expression in thyroid cancer, decreased infiltration of B cells, CD8 + cells, macrophages, and regulatory T cells was associated with poorer prognosis, while increased infiltration of CD4 + T cells, eosinophils, mesenchymal stem cells, natural killer T cells, and Th1 cells was associated with better prognosis (all P < 0.05). TIMER2.0 analysis demonstrated that SIK2 was associated with better prognosis in males, stage 1, stage 2, and low tumor burden populations, and after 5 years of follow-up, the important outcome measure Overall Survival (OS) began to show statistical significance.
Conclusion
SIK2 is highly expressed in thyroid papillary carcinoma tissues and regulates cancer cell activity, likely through modulation of the surrounding immune microenvironment to influence disease progression.
Semantic segmentation of coronary arteries in computed tomography angiograph: A multi-center, multi-vendor and multi disease study
Authors: Triki Meriem , AMMAR MOHAMMED , Mahmoudi Said , Gkontra Polyxeni , Kincl Vladimir , Holeček Tomáš , lekadir Karim
Published: August 2024

Coronary artery disease (CAD) is one of the primary causes of death worldwide accountings for almost 25% of all deaths worldwide each year. Accurate diagnosis and assessment of CAD and stenosis require the semantic segmentation of the coronary arteries and aorta in coronary computed tomography angiography (CCTA) images, which is of great significance. Nonetheless, producing semantic segmentations is particularly challenging due to the anatomical similarity between various surrounding areas, the branching of the arteries which includes numerous bifurcations, and the presence of smaller vessels that add to the complexity. Reducing the resolution of a 3D image to fit within the constraints of available GPU memory can result in a loss of detail, which is often undesirable. Instead, using patches of the image as input can help mitigate this issue. In this study, we propose a novel semantic segmentation method based on the 3D U-Net that uses three different datasets consisting of multi-center, multi-vendor, and multi-continent data CCTA images. We achieved accuracies of 91.2%, 93.9%, and 97.3%, respectively. The outcomes of the study demonstrate the efficacy of the method for accurately segmenting the aorta and/or the coronary arteries.
Epidemiological, clinical characterization and treatment patterns of migraine patients in a Colombian cohort from 2018 to 2022.
Authors: Rubio Andrea , Arciniegas Jair Alberto , Bolanos Jhon Edward , Gonzalez Farley Johanna , Gomez Diana , Mesa Alejandro , Bello Carlos Jose , Garcia Monica , Perez Luz Eugenia , Reyes Juan Manuel
Published: August 2024

Background
To describe the epidemiology and clinical characteristics of migraine and the status of treatment in Colombia. Additionally, the use of health resources by patients was measured.
Methods
This was a non-interventional, retrospective, descriptive study conducted in one Colombian Health Management Organization (HMO) from 2018 to 2022 with a follow-up period of 5 years. Migraine patients were identified using the International Code Disease 10th version G43, and the diagnosis was confirmed by a neurologist. The first recorded migraine diagnosis was defined as the index date. Medical records, claim databases and other electronic databases from the HMO were used to determine the clinical characteristics, treatments, and health care services.
Results
A total of 89,227 patients were included in the study. The mean follow-up period was 3.7 years (standard deviation 1.2). Most of them were women (84.9%). Many patients were first seen by a general practitioner (82.6%), and only 8.9% were first seen by a neurologist. The prevalence of migraine during follow-up was between 1.69 and 2.42 patients in 100 HMO affiliates in 2020, the year with the highest prevalence (2.42 [95% CI 2.41–2.44]), and the incidence ranged from 0.032 to 1.72 per 100 patient-year at risk of developing migraine. Hypertension (21.3%), arrythmia (4.1%) and structural heart disease (3.4%) were the most common cardiovascular diseases. The annual mean number of outpatient consultations in 2018 was 1.43 consultations per patient, which decreased to 0.68 in 2022. The most frequent treatments for acute events were nonsteroidal anti-inflammatory drugs (NSAIDs) (range 37%-42%) in monotherapy, combinations of analgesics (range 14%-35%), and corticosteroids (range 10%-15%). Triptans were used in 4% of patients in the first medication record, reaching a maximum of 16% of patients. Among preventive treatments, beta-blockers (24%-49%) and antiepileptics (29%-41%) were the most common.
Conclusion
The prevalence of migraine in Colombia according to health electronic databases was lower than that reported in previous studies conducted in the country. The treatment patterns for acute and preventive treatment of migraine follow the recommendations of different guidelines. Cardiovascular disease is relevant for the management of migraine.
Prognostic Factors in Patients with Gastrointestinal Perforation under the Acute Care Surgery Model : A retrospective cohort study
Authors: Sung Kiyoung , Hwang Sanguk , Lee Jaeheon , Cho Jinbeom
Published: August 2024

Background
Gastrointestinal perforation (GIP) is a life-threatening condition that necessitates immediate surgical intervention. This study aims to identify prognostic factors in patients with GIP treated within a standardized acute care surgery (ACS) framework.
Materials and methods
This single center retrospective cohort study analyzed patients diagnosed with GIP who underwent emergent surgery and were admitted to the intensive care unit between January 2013 and March 2023.
Results
Among 354 patients, the mortality was 11%, and 38% of survivors experienced significant complications (Clavien-Dindo class III or higher). Independent prognostic factors for mortality included initial sequential organ failure assessment (SOFA) scores (at the time of admission or ACS activation), postoperative SOFA scores, and postoperative body temperatures. For morbidity, independent predictors were the extent of peritonitis, the surgical approach (open versus laparoscopic), postoperative albumin levels, and postoperative SOFA scores. These factors showed significant predictive accuracy for patient outcomes, as evidenced by the area under the receiver operating characteristic curve.
Conclusion
It is crucial to establish a system that ensures rapid preoperative work-up, accurate surgical intervention, and evidence-based postoperative critical care. Implementing such a system and assessing patient outcomes after surgery using the identified factors could provide a more detailed evaluation.
The Histone Acetylation-Related Gene Signature for Prediction of Prognosis and Immunotherapy Efficacy in Stomach Adenocarcinoma and Verification in vitro
Authors: Dai Chen , Su Rishun , Zhao Zhenzhen , Guo Yangyang , Yin Songcheng , Zhou Jingyao , He Yulong , Zhang Changhua
Published: August 2024

Background
Gastric cancer (GC) is a very aggressive, with extreme heterogeneity and rapid growth, most frequently manifested histologically as stomach adenocarcinoma (STAD). Current evidence suggests that histone acetylation is critical for the origin and development of tumors. However, the significance of histone acetylationrelated gene signatures for prognosis of STAD patients and mechanisms of histone acetylation in STAD therapy remains unclear.
Methods
We identified histone acetylationrelated genes in STAD from TCGA and constructed eight-gene signatures by utilizing a univariate Cox regression model with the Least Absolute Shrinkage and Selection Operator (LASSO). In addition, a nomogram was plotted to predict the prognostic significance of the established risk model. We examined associations between our gene signature and somatic mutation, immune subtype, clinicopathological features, tumor microenvironment, immune cell infiltration and immune activity, immunotherapy prediction and drug sensitivity. Cell-based assays were performed to determine the relationship between Doublecortin Like Kinase 1 (DCLK1) and the proliferation, migration and oxaliplatin resistance of GC cells in vitro.
Results
A prognostic model composed of eight histone acetylationrelated genes in STAD was developed. Based on median risk score, the STAD patients were equally assigned into two groups of high- and low-risk, where high-risk represented a less favorable prognosis than low-risk. The two groups showed significant differences with respect to somatic mutation, immune subtype, clinicopathological features, tumor microenvironment, immune cell infiltration and immune activity, immunotherapy prediction and drug sensitivity. The results generated during Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggested that Differentially Expressed Genes (DEGs) in the two groups were involved in cancer-related processes and pathways. Cell-based assays indicated that DCLK1 is a promoting factor in gastric cancer and can promote oxaliplatin resistance in gastric cancer cells.
Conclusions
A novel histone acetylationrelated gene signature, which possesses potential value in predicting the prognosis and immunotherapy effectiveness regarding STAD patients, was developed. This signature may serve as a reliable biomarker for prognosis of STAD and promote the identification of novel treatment targets for STAD. Furthermore, DCLK1 exhibited oncogenic roles and may be a new target for STAD therapy.
Association between physical activity and pulmonary function among middle-aged and older adults
Authors: Lim Jae Hyeok , Jang Yun Seo , Kim Dan Bi , Park Eun-Cheol , Jang Sung-In
Published: August 2024

Objective: Regular physical activity has several health benefits, and it is critical to investigate whether it also has advantages in pulmonary function for the general population. Therefore, this study aimed to explore the association between regular physical activity and the decline in pulmonary function among middle-aged and older South Korean population.
Methods: Data from 2014 to 2019 of Korean National Health and Nutrition Examination Survey were analyzed. Physical activity was measured using Global Physical Activity Questionnaire, and it was defined as sufficiently active groups and performing more than 2 days per week of muscle-strengthening exercisesaccording to guidelines. Pulmonary function was measured based on spirometry results. Using multiple logistic regression analyses, adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated.
Results: Of the 16,014 population over the age of 40, 7,177 were male and 8,837 were female participants, with 36.3% male and15.8% of female having pulmonary functional defects. After adjusting all covariates, the male population who performed physical activity had significantly lower likelihoods of pulmonary function defect (OR: 0.86, CI: 0.75–0.97) than inactivity group. This association was prominent in recreation-related and muscle-strengthening activity. However, the results of female population were not significant (OR: 1.04, CI: 0.88–1.23).
Conclusions:Engaging in physical activity were associated with lower likelihoods of pulmonary dysfunction in male population. Regular physical activities might be recommended for improved pulmonary function in this group, with more emphasis on recreation-related, muscle strengthening activities.
Investigating Coaggregation Between Human Intestinal and Oral Bacteria: Effects on the Structure and Stability of the Microbiota
Authors: Mohammed Waleed K. , Warwar Abdul Nasser H , johan Younus. H.
Published: August 2024

Coaggregation is a process that occurs when different types of bacteria bind to each other, an important step in biofilm formation, especially in dental bacteria. It is important to note that there is a shortage of equipment available for accurately measuring and quantifying the distribution of various cell types in either coaggregates or biofilm. Therefore, this project aims to look at the interactions between different types of oral and intestinal bacteria during assembly. The coaggregation of oral bacteria was investigated by standardized methods, indicating a high synergistic effect in species such as Actinomyces oris, Fusobacterium nucleatum, and Streptococcus gordonii. The results indicated adsorption about themselves more and like to form groups when interact to each other. Overall and according to the findings, the coaggregation between oral strains was more significant than coaggregation between oral and intestinal strains. to investigate coaggregation between oral and intestinal bacteria a variety of imaging techniques have been used to enable visualisation of the detailed structure of co-aggregates among bacteria that are include, fluorescence labelling and confocal scanning laser microscopy (CLSM) techniques. New insights of the three-dimensional structure of the coaggregate was established, allowing researchers insight into the bacteria within the coaggregate of spatial planning. Notably, this study contributes to the understanding of bacterial interactions in the oral and gut environments, with consequences for dental plaque and disease further in-depth studies will need to be explored.
High platelet - lymphocyte ratio may predict poor therapeutic response in breast cancer patients treated with neoadjuvant chemotherapy
Authors: Wang Wei , Chen Hao , Zhao Ruoyan , Zhang Weijie , Yao Yongzhong
Published: August 2024

In this study, our aim was to explore the correlation between blood inflammatory markers (BIMs), including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR) and platelet to lymphocyte ratio (PLR), and the efficacy of neoadjuvant chemotherapy (NACT) in BC patients. Besides, the relationship between tumor infiltrating inflammatory cells (TIIs) and BIMs has also been preliminarily studied. A total of 315 BC patients between January 2018 and September 2022 were analyzed. Receiver operating characteristic curve was used to determine the cut-off value of each BIM. Logistic regression analysis were used to evaluated the predictive power of BIMs for pathological complete response (pCR). TIIs were assessed by immunohistochemistry, and their relationships with BIMs also were analyzed. The results showed that NLR, MLR, PLR in the pCR group were significantly lower than those in the non-pCR group after NACT (p ≤ 0.05). PLR had the largest area under the curve (AUC) (0.73) compared to NLR (0.57) and MLR (0.67) (p < 0.01). Univariate analysis showed ER, PR, HER2, NLR, MLR, PLR were significantly associated with pCR, but multivariate analysis found only HER2 and PLR were independently predictors for pCR (p < 0.01). PLR was positively correlated with the expression of P-selectin in tumor tissue (r: 0.26, p < 0.01). Survival analysis showed that NLR, MLR, PLR had no significant correlation with disease prognosis. In conclusion, PLR after NACT could serve as a predictor for pCR, and it correlated with the imbalance of the tumor-infiltrating platelet to lymphocyte ratio, which might cause drug resistance.
Correlation analysis between carotid atherosclerosis and post-stroke cognitive impairment
Authors: Nie GuanHua , Wei ZhiHong , Su Zhan , Zhang Haining
Published: August 2024

Background
Post-stroke cognitive impairment (PSCI) significantly impacts the quality of life and recovery of stroke survivors. An indicator capable of identifying the risk of cognitive decline upon admission can facilitate early identification and management of stroke patients.
Objective
Carotid ultrasound, being a low-cost, widely accessible, and easily measurable diagnostic tool, has drawn the interest of researchers. Consequently, we aimed to investigate the link between carotid atherosclerosis markers and PSCI in patients with mild ischemic stroke (AIS), with the goal of improving early identification and diagnosis of PSCI in patients.
Methods
We enrolled 181 patients diagnosed with acute ischemic stroke within seven days. Data analysis was conducted using baseline demographics, clinical risk factors, and carotid ultrasound parameters. Binary logistic regression was utilized to analyze the independent factors influencing PSCI. The receiver operating characteristic curve(ROC) was employed to assess the predictive value of carotid atherosclerosis indexes and models combining various independent influencing factors for PSCI.
Results
A total of 181 participants completed the 6-month follow-up, among whom 75 patients (41.1%) were diagnosed with PSCI. Logistic regression analysis revealed that carotid plaque Crouse score (OR = 1.111, 95% CI = 1.016–1.216) and severe stenosis of the carotid artery (OR = 2.774, 95% CI = 1.148–6.705) were independently associated with PSCI at 6–12 months. The predictive model for post-stroke cognitive impairment included carotid plaque Crouse score (AUC = 0.667) and degree of carotid artery stenosis (AUC = 0.596), along with other covariates, with an overall Area Under the Curve (AUC) of 0.818 (95% CI: 0.758–0.877). There were significant differences in the scores of AVLT-I, AVLT-II, VFT, TMT-B, CDT, and MoCA subdomains between PSCI and post-stroke non-cognitive impairment (PSNCI) patients at 6 months (P < 0.05).
Conclusion
The carotid atherosclerosis index in the acute phase of AIS is independently correlated with PSCI, and both the carotid plaque Crouse score and severe stenosis of the common carotid artery hold diagnostic value for PSCI.
Patients’ Knowledge, Attitude, and Practice of Heart Failure: A web-based cross-sectional study
Authors: Jin Ping , Shu Zhisong , Cui Kun , Ou Zhenhong , Li Hongping , Luo Yuhui
Published: August 2024

There is a lack of comprehensive research on the topic of knowledge, attitude, and practice (KAP) among heart failure patients. This study aimed to investigate the patients’ KAP toward heart failure (HF). This web-based cross-sectional study was conducted among HF patients, using a self-administered questionnaire. A total of 483 valid questionnaires were enrolled, including 254 (52.59%) males. The mean KAP scores were 10.75 ± 3.44 (possible range: 0–20), 22.93 ± 2.43 (possible range: 8–40), 32.21 ± 4.34 (possible range: 8–40), respectively. Multivariate logistic regression showed that knowledge and heart failure mid-range ejection fraction were independently associated with proactive practice. The SEM analysis showed that education exhibited a positive effect on knowledge, while medical insurance showed a notable negative effect on knowledge. Furthermore, left ventricular ejection fraction #10 score demonstrated a positive effect on knowledge, and marital status had a significant positive effect on knowledge. Additionally, kidney disease emerged as a positive effect on practice, while attitude was found to have a negative effect on practice. HF patients had inadequate knowledge, negative attitude and proactive practice towards HF. Targeted educational initiatives, mental health support, and interventions addressing comorbidities and lifestyle changes are recommended to be integrated into HF management protocols.
What we can and cannot see from the surveillance for drug-resistant Pseudomonas aeruginosa - Findings from the evaluation of surveillance system for multidrug-resistant P. aeruginosa infections in Japan
Authors: Otake Shogo , Yamagishi Takuya , Shiomoto Takayuki , Nakashita Manami , Kurosu Hitomi , Ikenoue Chiaki , Kato Hirofumi , Fukusumi Munehisa , Shimada Tomoe , Takahashi Takuri , Suzuki Motoi , Kirikae Teruo , Arakawa Yoshichika , Nozu Kandai , Sunagawa Tomimasa , Sugai Motoyuki
Published: August 2024

IntroductionAntimicrobial resistance ofPseudomonas aeruginosais a global health concern, and some countries and regions have been monitoring drug resistance inP. aeruginosawith various surveillance systems.Japan has a national sentinel surveillance for multidrug-resistantP. aeruginosa(MDRP) infections, the sites of which are designated by prefectures, and we are seeing a decreasing trend in the number of MDRP reports in recent years. We evaluated the national surveillance system to verify whether this decreasing trend is true and discussed future directions of the surveillance.MethodsWe conducted a cross-sectional study to evaluate the surveillance system for MDRP infections and discussed its usefulness in 2023. We used a quantitative method to analyze characteristics of reports on MDRP infections from designated sentinel sites (DSSs) between 2013–2022. Additionally, we sent a questionnaire to identifiable DSSs (target DSSs) requesting data on accurate numbers of MDRP infections between 2018–2022. We conducted face-to-face interviews with surveillance system stakeholders as a qualitative method.ResultsIn total, 1,666 cases of MDRP infections were reported by 463 target DSSs between 2013-2022. We obtained valid responses to the questionnaire survey from 229 target DSSs (49.5%). From 2018 to 2022, these sites reported 275 cases as MDRP infections, of which 182 were accurate cases of MDRP infection, with both numbers decreasing over time. False reporting or underreporting of MDRP infections was common, resulting in a positive predictive value of 0.44 and sensitivity of 0.65 for reports in the national sentinel surveillance. The interviews highlighted the difficulties this surveillance system has in timely detection, accurate reporting, and international comparison of surveillance data.ConclusionOur evaluation indicated that current sentinel surveillance for MDRP infections fairly captured the true decreasing trend in Japan. As the epidemiology of drug-resistantP. aeruginosais changing, the direction of the national policy may differ according to the public health needs. The surveillance system also needs to be modified based on the policy, the candidates of which may be a notifiable disease surveillance for MDRP infections to respond to outbreaks, or sentinel surveillance for carbapenem-resistantP. aeruginosainfections to facilitate antimicrobial stewardship and international comparison.
Post-Synthetic Modification of Zr-Based Metal Organic Framework by Schiff Base Zinc Complex for Catalytic Applications in a Click Reaction
Authors: Rezaie Mohammad-Aqa , Khojastehnezhad Amir , Shiri Ali
Published: August 2024

A novel nanocatalyst, denoted as UiO-66/Sal-ZnCl2, has been synthesized and systematically characterized employing a range of analytical techniques, including Fourier-transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), thermogravimetric analysis (TGA), Brunauer-Emmett-Teller (BET) surface area analysis, and inductively coupled plasma (ICP) analysis. The comprehensive analyses collectively affirm the effective coordination of zinc chloride onto the functionalized UiO-66. Subsequently, the catalytic efficacy of UiO-66/Sal-ZnCl2 was assessed in a one-pot, three-component click reaction involving terminal alkynes, alkyl halides, and sodium azide, conducted in an aqueous medium. The catalyst demonstrated remarkable catalytic activity, showcasing the capability to facilitate the reaction with high yields and exceptional regioselectivity. Noteworthy attributes of this nanocatalyst and the method include its elevated efficiency, recyclability, convenient product workup, and, significantly, the utilization of a sustainable solvent medium. The synthesis, characterization, and catalytic performance of this catalyst collectively contribute to its potential as an innovative and reusable nanocatalyst for diverse synthetic transformations.
Family-Related Quality of Life and Burden in Caregivers of Patients with Chronic Skin Diseases
Authors: Elaidy Asmaa M. , Elsheikh Asmaa Abdelghany , Abdellateef Aisha Ghanem , Elsadek Hala M.
Published: August 2024

Background: Skin diseases significantly impact the psychological well-being, social functioning, and daily activities of patients, which in turn can severely affect the quality of life of their family caregivers. Objectives: To assess burnout prevalence among caregivers of patients with chronic skin diseases (vitiligo, psoriasis, and alopecia areata) and its impact on their quality of life.
Methods: A cross-sectional study using self-assessment questionnaires was conducted on 213 caregivers, utilizing the Zarit Burden Interview (ZBI) and the Family Dermatology Life Quality Index (FDLQI). The caregivers were equally divided among those caring for patients with psoriasis, alopecia areata, and vitiligo.
Results: The study found that 29.5% of caregivers reported "not having enough time" due to caregiving, especially those caring for patients with psoriasis and vitiligo. Additionally, 37.1% of caregivers experienced stress balancing caregiving with other responsibilities, particularly those caring for patients with alopecia areata and psoriasis.We found that caregivers of psoriasis patients experienced the highest burden, followed by those of patients with alopecia areata and vitiligo. Positive correlation was found between ZBI scores and caregiver age, duration of patient care, FDLQI scores, and disease severity. Similarly, FDLQI scores correlated positively with caregiver age, time spent caregiving, duration, and disease severity.
Conclusion: Caregivers of patients with chronic skin diseases face significant burdens that adversely affect their quality of life. It is crucial to spotlight these caregivers, as addressing their challenges can lead to better support systems and improved quality of life for both caregivers and patients.
Predictive Nomogram of Ultrasound Indicators for the Termination Outcome of Cesarean Scar Pregnancy
Authors: Xiao Xiaoyi , Feng Zhichao , Li Ting , Qiao Hong , Zhu Yun
Published: August 2024

Purpose
To construct and validate a nomogram to predict the risk of adverse events (intraoperative massive hemorrhage or retained products of conception) during the termination of Cesarean scar pregnancy (CSP).
Method
Data from patients diagnosed with CSP who underwent Dilation and Curettage (D&C) at two hospitals were retrospectively collected. This data formed both internal and external cohorts for analysis. The internal cohort was split randomly, with 70% of the data allocated to a training set and 30% to an internal validation set. The external cohort was used exclusively as the external validation set. LASSO and logistic regression were utilized to select variables and construct a nomogram. The nomogram's performance was assessed using various methods including C-index, calibration curve, decision curve analysis (DCA), and clinical impact curve analysis (CICA) to evaluate its ability for identification, calibration, and clinical effectiveness.
Results
The prediction nomogram incorporated several predictors, including scar thickness, type of CSP, gestational sac diameter, and blood flow. This nomogram exhibited strong discrimination, as evidenced by a C-index of 0.829 (95% confidence interval: 0.770–0.887). Moreover, even in the interval validation set, a high C-index value of 0.784 was achieved, and in the external validation set, it reached 0.833. Further assessment through calibration curve analysis, DCA, and CICA revealed a robust agreement between the nomogram's predictions and actual observations, underscoring its utility and reliability.
Conclusion
The validated nomogram effectively predicts adverse events in CSP, showing good discrimination and calibration, making it useful in clinical settings.
Prognostic Value of Lymphocyte Subset Levels in Hepatocellular Carcinoma Following Conventionally Fractionated vs. Stereotactic Body Radiotherapy
Authors: Wang Si-tong , Chen Yi-xing , Gao Yu-nan , Yang Ping , Zhao Qian-Qian , Zhuang Yuan , Zeng Zhao-chong
Published: August 2024

Background and aim:
Radiotherapy (RT)-induced lymphopenia is associated with poor prognosis. This study aimed to compare the effects of conventionally fractionated radiotherapy (CFRT) and stereotactic body radiotherapy (SBRT) on lymphocyte subpopulations in hepatocellular carcinoma (HCC) patients and to evaluate the prognostic value of lymphocyte subset levels.
Materials and Methods
A retrospective analysis was conducted on 137 HCC patients who underwent CFRT or SBRT between July 2011 and January 2018. Variables were obtained within 1 week before RT, and at 1 day and 2 months post-RT, respectively. Univariate and multivariate Cox regression analyses were conducted to investigate independent prognostic factors for overall survival (OS).
Results
The one-year and two-year OS rates were 80.0% and 55.0%, respectively. Multivariate analysis identified tumor size > 4.5cm, multiple tumors, and post-RT CD4 + T cell count < 231/µL and CD8 + T cell count < 179/µL as independent factors associated with inferior OS in HCC patients. Severe RT-induced lymphopenia (< 0.5*10^9/L) occurred in 70.0% of patients following CFRT compared to 23.0% in SBRT patients. Patients receiving SBRT exhibited higher total lymophocyte counts and subset levels at 1 day and 2 months post-treatment compared to those receiving CFRT (P < 0.05). Further analysis revealed that CD19 + B cells were predominantly depleted and recovered more slowly than other populations while CD8 + T cells demonstrated rapid recovery. In the SBRT group, patients with OS > 2 years exhibited higher levels of CD4 + T cell and CD8 + T cell counts compared to those with OS < 2 years (P < 0.05).
Conclusion
SBRT induced less severe lymphopenia than CFRT. Peripheral lymphopenia of CD4 + and CD8 + T cells post-SBRT may independently predict survival for HCC patients.
Psychometric evaluation of an Arabic language version of the Short Form of Preferences for Routines Scale (PRS-S) in Community-dwelling Older Adults
Authors: Khalil Marwa Ibrahim Mahfouz , Shaala Reem Said , Elnakeeb Mayar , Mousa Enas Fouad Sayed , Fekih-Romdhane Feten , Hallit Souheil
Published: August 2024

Background
There is a growing acknowledgment within the scientific community of the importance of preferences for routines (PR) in structuring the daily lives of older adults, as it reliably can serve as either a coping mechanism or contribute to emotional, cognitive, and functional vulnerabilities in its indeclinable form. Therefore, it is crucial to have a reliable, concise, easily administered, and cost-effective tool to assess this concept in clinical practice. The present study aims to evaluate the psychometric properties of the Arabic translation of the Preferences for Routines Scale- Short Form (PRS-S) in older Arabic-speaking adults living in the community.
Method
This study involved 539 older Arabic-speaking adults residing in the Egyptian community. Participants were provided with the 5-item Arabic-translated versions of the PRS-S, the 13-item Older People Quality of Life-Brief (OPQOL-brief), and the 15-item Resilience Scale of Older Adults (RSOA).
Results
Confirmatory factor analyses revealed that, after introducing a correlation between the residuals of items 1 and 2 due to a high modification index, the one-factor model of the PRS-S demonstrated excellent fit indices and a reliability of ω = .70; α = .69. Measurement consistency of the Arabic PRS-S was established across males and females at the configural, metric, and scalar levels; no significant difference in PRS-S scores between genders was found. Lastly, PRS-S scores showed significant and appropriate patterns correlations with the Arabic versions of RSOA and OPQOL-Brief scores in our sample, indicating adequate concurrent validity.
Conclusion
This study presents significant psychometric insights into the PRS-S based on CFA results and other analyses among older adults from a distinct cultural context. Providing the PRS-S in Arabic could be valuable for clinicians working with Arabic-speaking older adults in the community, enhancing the understanding of the prevalence and features of preferences for routines and its relevance to Gero-psychology.
Brain activity during intraoperative general anesthesia using resting-state functional magnetic resonance imaging ~Feasibility study~
Authors: Wakabayashi Junji , Oshiro Yoshitetsu , Kan Shigeyuki , Kohta Masaaki , Taniguchi Masaaki , Obata Norihiko , Okada Masako , Kohmura Eiji , Sasayama Takashi , Mizobuchi Satoshi
Published: August 2024

Electroencephalogram (EEG) monitors are widely used to evaluate depth of anesthesia. However, EEG monitors have problems such as differences in evaluation depending on the type of anesthetic and influences from drugs other than anesthetic agents. Monitoring of brain activity using intraoperative resting-state functional MRI (rs-fMRI) would be expected to improve evaluation of the depth of anesthesia in EEG monitoring. We examined the feasibility of evaluating the effects of general anesthesia with sevoflurane using rs-fMRI during neurosurgery. We enrolled 20 adult patients scheduled for transsphenoidal surgery. We compared differences between before and during general anesthesia in terms of brain functional connectivity of the thalamus by seed-to-voxel correlation analysis and local neural activity using fractional amplitude of low-frequency fluctuations (fALFF) analysis. An exclusion mask was applied to exclude brain areas showing intraoperative spatial artifacts and correct for differences in the magnitude of intra- and preoperative head movements. We analyzed 16 patients. Functional connectivity of the thalamus to the contralateral thalamus, bilateral caudate nuclei and globi pallidi was significantly decreased during anesthesia. The precuneus and posterior cingulate cortex showed significantly decreased fALFF values during anesthesia. These findings were consistent with previous studies and indicate the feasibility of intraoperative rs-fMRI during deep anesthesia.
Risk Factors for Renal Function Progression in Patients with CKD Complicated by COPD
Authors: Zhu Fan , Gan Wenyuan , Liu Hui , Chen Wenli , Zeng Xingruo
Published: August 2024

Background
Chronic diseases rarely occur in isolation, and chronic kidney disease (CKD) is no exception. There has been considerable research on the interplay between the heart and kidneys, but studies on the relationship between the lungs and kidneys are less common. The interaction between pulmonary and renal functions in areas such as acid-base metabolism, chronic inflammation, and bone metabolism is increasingly gaining clinical attention.
Method
In this cohort study, we examined 480 patients with stages 3–4 CKD and COPD (GOLD stages 1 and 2) to identify risk factors that contribute to the progression of renal function to a composite endpoint, which includes a 40% decline in estimated glomerular filtration rate (eGFR) and the onset of end-stage renal disease during follow-up periods. A Cox proportional hazards regression model was used to investigate the risk factors associated with the timing of renal event endpoints in the study population. Additionally, the restricted cubic spline method was used to explore the relationship between quantitative variables and survival risk.
Results
Our study included 480 eligible patients with an average follow-up period of 21.41 ± 14.90 months, during which 224 individuals (46.7%) experienced the composite renal endpoints. Multivariable Cox regression analysis revealed that systolic blood pressure (SBP) [1.10 (1.04–1.18), p = 0.002], hemoglobin (Hb) [HR 0.89 (0.83–0.96), p = 0.002], albumin (Alb) [0.96 (0.93–0.99), p = 0.009], and edema [1.73 (1.29–2.33), p < 0.001] were independent risk factors for the renal endpoints.
Conclusion
The adjusted multivariable Cox regression analysis demonstrated that elevated SBP and edema were factors that promoted the occurrence of composite endpoints, while higher levels of Hb and Alb were protective factors.
Isolation Method of Brain Microvessels from Minimal Frozen Human Brain Tissue for Blood-Brain Barrier Protein Expression Analysis
Authors: Ogata Seiryo , Ito Shingo , Masuda Takeshi , Ohtsuki Sumio
Published: August 2024

Background Protein expression analysis of isolated brain microvessels provides valuable insights into the function of the blood-brain barrier (BBB). However, the isolation of brain microvessels from human brain tissue, particularly in small amounts, poses significant challenges. This study presents a method for isolating brain microvessels from a minimal amount of frozen human brain tissue, using techniques from an established mouse brain capillary isolation method.Methods The human brain microvessel fraction was obtained from approximately 0.3 g of frozen human brain (frontal cortex) using a bead homogenizer for homogenization and a combination of cell strainer and glass beads for purification. Protein expression in human microvessel fractions and whole-brain lysates was analyzed by western blot and proteomic analysis.Results Microscopic images showed successful isolation of brain microvessels from a frozen human brain. Protein assays indicated that sufficient protein was extracted from the microvessel fraction for detailed expression analysis. Western blot analysis showed enrichment of BBB-selective proteins (MDR1/ABCB1, GLUT1/SLC2A1, and CLDN5) in the brain microvessel fraction compared to whole-brain lysates. In addition, multiple reaction monitoring quantification of six BBB-selective proteins (MDR1, BCRP/ABCG2, GLUT1, MCT1/SLC16A1, transferrin receptor, and CLDN5) revealed expression levels consistent with those observed in larger human brain samples. Sequential Window Acquisition of all Theoretical Mass Spectra (SWATH-MS)-based quantitative proteomics further revealed significant enrichment of human microvascular endothelial cells within the isolated fraction, mirroring the findings in mouse models.Conclusions The developed method successfully isolated brain microvessels from a small volume of frozen human brain tissue, facilitating the study of BBB proteome changes due to aging or pathological conditions. This technique provides valuable insights into BBB dysfunction in central nervous system disorders and may improve drug delivery strategies in the brain.
Short and mid-term outcomes of ductal graft with bilateral pulmonary banding in hypoplastic left heart syndrome and variants
Authors: Oktay Ayla , Arnaz Ahmet , Ayabakan Canan , Sarioglu Tayyar , Yalcinbas Yusuf Kenan
Published: August 2024

Objectives
This study evaluates a novel surgical technique inspired by the hybrid Norwood procedure, which involves ductal graft placement and bilateral pulmonary artery banding. This technique is designed to avoid the high risk classical Norwood stage 1 operation and to avoid the need for first stage invasive catheter interventions and interstage catheter interventions when ductal stent placement is not feasible in developing countries with limited resources.
Methods
Between June 2015 and December 2022, 14 patients with hypoplastic left heart syndrome and variants were treated using this procedure at our center. Polytetrafluoroethylene graft was used for ductal graft procedure and polytetrafluoroethylene bands were used for bilateral pulmonary banding. Atrial septectomy was done selectively. Patients with adequate left heart growth underwent biventricular repair and pulmonary debanding. Patients without left heart growth underwent cavopulmonary anastomosis or necessary intermediate surgical revisions.
Results
Seven patients out of 14 reached the second stage. Two received biventricular repair, three underwent bidirectional cavopulmonary anastomosis, and two required repeat palliations other than bidirectional cavopulmonary anastomosis.
Conclusions
Modifications of the Norwood procedure is an ongoing process due to the complex nature of hypoplastic left heart syndrome and variants. As experience grows, the mortality associated with ductal graft and bilateral pulmonary banding procedure may decrease, making this technique an alternative for centers where classical Norwood operation or hybrid palliation is not possible, especially in developing countries with limited resources. We might predict promising outcomes, especially for patients with hypoplastic left heart complex where biventricular repair is expected.
Association of Robotic Surgery with Early Discharge, Readmission, and Complications in Elective Colectomy: An Analysis of NSQIP Data from 2012-2021
Authors: Hsu Angela Ting-Wei , Zion Mofi , Powell Jocelyn , D’Adamo Christopher R. , Feinman Marcie , Felton Jessica , Wolf Joshua H.
Published: August 2024

Background: Early discharge (ED) after colectomy has become a target outcome for multiple reasons, but the factors associated with ED are not well characterized. This study investigated the factors associated with ED and evaluated the impact of ED on overall outcome.
Methods: Data from ACS-NSQIP were used to identify patients who underwent non-emergent colectomy from 2012 to 2021. ED was defined as length of stay ≤2 days. Unpaired t-tests, chi-square tests and adjusted multivariate logistic regression modeling were used to estimate associated factors for ED. Bounceback readmission was defined as readmission within 7 days of discharge.
Results: In this cohort of 282,490 patients, 43,137 (15.3%) met the criteria for ED. Robotic colectomy (OR 14.35; 95%CI [13.63-15.12]) was more strongly associated with ED than any other patient characteristic, including laparoscopic colectomy (6.82 [6.51-7.14], ref open colectomy). ED vs. non-ED patients had lower rates of 30-day (5.84 vs. 10.37%, P<0.01) and bounceback (3.56 vs. 5.75%, P<0.01) readmissions, overall complications (5.65 vs. 18.63%, P<0.01) and post-discharge complications (4.21 vs. 7.49%, P<0.01).
Conclusions: Robotic surgery was the variable most strongly associated with ED, and had twice the odds of ED compared to laparoscopic colectomy. Patients who had ED after robotic surgery had lower rates of complications and readmission compared to non-ED patients.
Prevalence, severity, and determinants of depressive disorder among patients with low back pain in Al-Qassim Region, Saudi Arabia
Authors: Naif Abdullah
Published: August 2024

Background: Low back pain (LBP) is a widespread health problem that poses a severe economic burden on both affected patients and their societies. A bidirectional relationship between depression and other chronic illnesses, including chronic LBP, has been suggested. However, the exact association between them remains unclear.
Objectives: To investigate the association between depressive disorder and low back pain and its impact on disability of patients.
Patients and methods: A cross-sectional study carried out in the orthopedic clinics of AlBadaya General Hospital, Qassim Region, Saudi Arabia, among a sample of patients with LBP throughout the period of the study (April-June 2024,). An interview questionnaire composed of four parts was utilized: personal information, medical history, and habits, the Arabic-validated version of the Roland-Morris Disability Questionnaire (RMDQ), and the Patient Health Questionnaire (PHQ)-9 to assess depression.
Results: A total of 365 patients were included in this study. Their age ranged between 18 and 85 years, with an arithmetic mean of 47.9 and a standard deviation (SD) of 10.4 years. Females represented 55.6% of them. The overall prevalence of depressive disorder among the participants was 56.2%, being mild in 40.3% of patients and moderately severe or severe among 2.7% of them. The disability score ranged between 0 and 24 with an arithmetic mean of 10.7 and SD of 6.2, while its median 1 value was 11, and its interquartile range was 6-15.5. Patients with moderately severe/severe depression had the highest disability score (median value was 15 and the mean rank was 243.25), while those with no depression had the lowest disability score (median value was seven and mean rank was 130.62), p<0.001. Multivariate logistic regression analysis revealed that with each unit increase in disability score, there was a 20% increase in depression (Adjusted odds ratio "AOR" =1.20; 95% confidence interval "CI": 1.14-1.26), p<0.001.
Conclusion: Depression is very commonly associated with chronic LBP, although it is mostly mild. Disability is a serious complication of chronic LBP, and its severity is associated with the degree of depression. Therefore, patients with chronic LBP should be screened for depression.
Oxidative stress controls lncRNA-mediated granulosa cell functions in a FoxO1-dependent manner
Authors: Sheng Wenmin , Wang Miaomiao , Li Yuqi , Sun Zhenyu , Du Xing , Li Qifa
Published: August 2024

Background
Oxidative stress (OS) is intensely involved in female low fertility by altering the multi-omics such as transcriptome, miRome, and lncRNome in follicular cells and follicular fluid. However, the mechanism by which OS affects multi-omics dynamics is largely unknown. Here, we report that OS induces lncRNome dynamics in sow granulosa cells (sGCs) partially depending on the transcription factor activity of its effector FoxO1.
Results
2283 putative FoxO recognition elements (FREs) were identified in the promoters of 394 lncRNAs, accounting for 91.20% (394/432) of the lncRNAs stimulated by OS. ChIP and reporter assays showed that effector FoxO1 mediates OS regulation of the transcription activity of lncRNAs in a transcription factor activity-dependent manner. In sGCs, OS induces the transcription of NORSF, a nuclear lncRNA involved in sGCs functions and its mediated cell apoptosis via FoxO1. Furthermore, FoxO1 was identified as a transcription activator of NORSF in sGCs by interacting with the FRE motif of its promoter. Meanwhile, OS reduces the transcription of CYP19A1, which encodes an essential enzyme for estrogen synthesis, and 17β-estradiol (E2) release by sGCs via the FoxO1 and NORSF axis. Phenotypically, transcriptional dysregulation of NORSF transcription caused by two novel adjacent transitions in the promoter leads to decreased sow fertility.
Conclusion
These results suggest a model of OS-stimulated lncRNome dynamics of sGCs, and a new signaling pathway of OS influences sGC functions and sow fertility.