bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of M2 with early-stage hepatocellular carcinoma based on Nomogram
Authors: Xia Guoyi , Yu Zeyan , Lu Shaolong , Wang Xiaobo , Zhao Yuanquan , chen jie
Published: October 2024

Background
Microvascular invasion (MVI) is a crucial factor for early recurrence and poor outcomes in hepatocellular carcinoma (HCC). However, there are few studies on M2 classification. We aimed to build a predictive model for M2 in early-stage HCC, assisting clinical decision-making.
Methods
We retrospectively enrolled 451 patients with early-stage HCC and employed multiple machine learning algorithms to identify the risk factors influencing the robustness of M2. Model performance was evaluated using receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC).
Results
There were 363 M0-1 and 88 M2 cases. Differences in recurrence-free survival(RFS) and overall survival(OS) between the M0-1 and M2 groups were statistically significant (P < 0.0001). Complement C3, tumor size > 5cm, incomplete tumor capsule, and Edmondson-Steiner stage III-IV were independent risk factors for M2.The prediction model showed an area under the receiver operating characteristic curve(AUROC) of 0.765 and 0.807 in the training and validation groups, respectively. Calibration curves showed good agreement between actual and predicted M2 risks, and the DCA and CIC showed a significant clinical efficacy.
Conclusion
The nomogram-based model had a good predictive effect for M2 in patients with early-stage HCC ,providing guidance for treatment decisions.
Intracranial Dural Arteriovenous Fistulas with Deep Venous Drainage: A Single-Center Retrospective Cohort Study
Authors: Su Xin , Song Zihao , Chen Yiguang , Huang Mingyue , Liu Huiwei , Zhang Chao , Pang Huishen , Sun Liyong , Ye Ming , Hong Tao , Ma Yongjie , Zhang Hongqi , Zhang Peng
Published: October 2024

Objective
Dural arteriovenous fistulas (DAVFs) with deep venous drainage (DVD) (DAVFs-DVD) are characteristically associated with nonhemorrhagic neurological deficits, most notably cognitive impairment. Large studies have yet to thoroughly characterize these DAVFs. We conducted an analysis of the largest cohort of DAVFs-DVD to provide a comprehensive characterization of this specific subset.
Methods
This study was a retrospective cohort analysis of 207 patients with DAVFs-DVD who were hospitalized at a single medical center between 2002 and 2022. Logistic regression was employed to identify angiographic features specific to DAVFs associated with cognitive impairment. Additionally, post-treatment outcomes were evaluated.
Results
DAVFs-DVDs can be classified into two categories: the Galenic group, where arterial feeders drain directly into the vein of Galen (VoG), and the non-Galenic group, where arterial feeders drain into other veins or venous sinuses and indirectly flow into the VoG. Cognitive impairment accounting for 15.9% of all clinical presentations. We found that the overall rate of complete occlusion was 86.6%, while the overall rate of complications was 16.4%. Moreover, patients with DAVFs-DVD presenting with cognitive impairment were more likely to have straight sinus stenosis or occlusion, as well as DAVFs located at the midline.
Conclusion
DAVFs-DVDs can be classified into two categories: the Galenic group and the non-Galenic group. Patients with DAVFs-DVD presenting with cognitive impairment were more likely to have straight sinus stenosis or occlusion, as well as DAVFs located at the midline. Venous hypertension of the deep venous system is a key angiographic feature of DAVFs associated with thalamic cognitive impairment.
Dietary patterns trends of US adults with undiagnosed and diagnosed hyperlipidemia and their relationship with long-term mortality: NHANES 2007-2018
Authors: Xu Liang , Yu Wenjie , Que Dongdong , Yan Jing , Zhang Xiuli , Zhu Yingqi , Wang Yuxi , Yang Yashu , Song Xudong , Yang Pingzhen
Published: October 2024

Background
Dietary intervention is an important component of treating hyperlipidemia. There are many people with undiagnosed hyperlipidemia, and the dietary patterns of population with undiagnosed and diagnosed hyperlipidemia in US have not been studied. The purpose of this study was to explore the dietary pattern trends of the population with undiagnosed and diagnosed hyperlipidemia in the past decade and their correlation with mortality.
Methods
The sample data came from the National Health and Nutrition Examination Survey from 2007 to 2018. The dietary patterns were assessed using Dietary Inflammatory Index (DII) and Healthy Eating Index (HEI). The relationship between DII and HEI and mortality in individuals with hyperlipidemia were evaluated by Cox proportional hazards model. We conducted subgroup analysis to evaluate the potential relationship between DII and HEI and covariates.
Results
Of 29897 individuals included, 9815 without hyperlipidemia (age: weighted mean [WM] 39.91 years; 95% confidence interval [CI] 39.31–40.51; male: weighted proportion 49.4%), 9815 with undiagnosed hyperlipidemia (age: WM 45.65 years; 95% CI 45.08–46.23; male: weighted proportion 55.3%), and 10817 with diagnosed hyperlipidemia (age: WM 57.33 years; 95% CI 56.82–57.83; male: weighted proportion 50%). The proportion of population with undiagnosed hyperlipidemia shown an upward trend. The DII of each group showed an increasing trend, while the HEI showed a decreasing trend. Compared with participants with diagnosed hyperlipidemia, the participants with undiagnosed hyperlipidemia had higher DII (WM: 1.11; 95% CI: 1.04–1.18 versus WM: 0.94; 95% CI: 0.86–1.02) and lower HEI (WM: 50.26; 95% CI: 49.71–50.81 versus WM: 52.38; 95% CI: 51.84–52.93). The median follow-up time for survival analysis was 9.7 years, and high DII (hazard ratio [HR]: 1.09; 95% CI: 1.03–1.15) and low HEI (HR per 1 SD increase: 0.89; 95% CI: 0.81–0.98) were associated with an increased risk of all-cause mortality in individuals with hyperlipidemia.
Conclusions
From 2011 to 2018, the dietary health and inflammatory potential of US adults were deteriorating, especially those with undiagnosed hyperlipidemia. High DII and Low HEI are associated with an increased risk of all-cause mortality.
Characteristics of Genetically Confirmed Familial Hypercholesterolemia in Chinese Patients with Coronary Heart Disease
Authors: Wang Yihan , Li Chuang , Zhao Wenshu , Dong Ying , Wang Peijia
Published: October 2024

Background
Familial hypercholesterolemia (FH) is a genetically inherited disorder caused by monogenic mutations or polygenic deleterious variants. Patients with FH innate with significantly elevated risks for coronary heart disease (CHD). FH prevalence based on genetic testing in Chinese CHD patients is missing. Whether classical index of coronary atherosclerosis severity can be used as indicators of FH needs to be explored. To investigate the FH prevalence in Chinese CHD patients and the association of SYNTAX I score with FH genotype.
Methods
The monogenic and polygenic FH related genes were genotyped in 400 consecutively enrolled CHD patients. The clinical characteristics and SYNTAX I scores were analyzed in a retrospective nested case-control study.
Results
The prevalence of genetically confirmed FH in our CHD cohort was 8.75%. The cLDL-C level, SYNTAX I scores and incidences of triple vessel lesions in FH patients were significantly higher, while cLDL-C and SYNTAX I scores were independent risk factors for FH. Furthermore, cLDL-C levels of polygenic FH were significantly lower than monogenic FH, while their severity of coronary atherosclerosis was comparable.
Conclusions
Our study revealed a genetically confirmed FH prevalence of 8.75% in a Chinese CHD cohort. Additionally, the SYNTAX I score was an independent risk factor for FH. Besides, polygenic origin of FH should be taken into consideration for CHD patients suspected of FH.
The discovery and molecular mechanism of the subversion of human E3 ligase RNF213 by the Shigella effector IpaH1.4
Authors: Pan Lifeng , Zhou Xindi , Zhang Huijing , Wang Yaru , Wang DanNi , Lin Zhiqiao , Zhang Yuchao , Tang Yubin , Liu Jianping , Yao Yu-Feng , Zhang Yixiao
Published: October 2024

Ubiquitination plays vital roles in modulating pathogen-host cell interactions. RNF213, a unique E3 ligase, can catalyze the ubiquitination of lipopolysaccharide (LPS) and is crucial for antibacterial immunity in mammals. Shigella flexneri, an LPS-containing pathogenic bacterium, has developed mechanisms to evade host antibacterial defenses during infection. However, the precise strategies by which S. flexneri circumvents RNF213-mediated antibacterial immunity remain poorly understood. Here, through comprehensive biochemical, structural and cellular analyses, we reveal that the E3 effector IpaH1.4 of S. flexneri can directly target human RNF213 via a specific interaction between the IpaH1.4 LRR domain and the RING domain of RNF213, and mediate the ubiquitination and proteasomal degradation of RNF213 in cells. Furthermore, we determine the cryo-EM structure of human RNF213 and the crystal structure of the IpaH1.4 LRR/RNF213 RING complex, elucidating the molecular mechanism underlying the specific recognition of RNF213 by IpaH1.4. Finally, our cell-based function asaays demonstrate that the targeting of host RNF213 by IpaH1.4 promotes S. flexneri proliferation within infected cells. In summary, our work uncovers a novel strategy employed by S. flexneri to subvert the key host immune factor RNF213, thereby facilitating bacterial proliferation during invasion.
Exploring Nurse Perspectives on AI-Based Shift Scheduling for Fairness, Transparency, and Work-Life Balance
Authors: Gerlach Maisa , Fabienne Josefine Renggli , Jannic Stefan Bieri , Murat Sariyar , Golz Christoph
Published: October 2024

Introduction
Work-life balance (WLB) is critical to nurse retention and job satisfaction in healthcare. Traditional shift scheduling, characterised by inflexible hours and limited employee control, often leads to stress and perceptions of unfairness, contributing to high turnover rates. AI-based scheduling systems offer a promising solution by enabling fairer and more transparent shift distribution. This study explored the perspectives of nurse managers, permanent nurses, and temporary nurses on the perceived fairness, transparency, and impact on work-life balance of AI-based shift scheduling systems.
Methods
A qualitative study design was used, with focus group (FG) interviews conducted between May and June 2024. The sample consisted of 21 participants from different healthcare settings, including acute hospitals, home care services and nursing homes in German-speaking Switzerland. The interviews were analysed using the knowledge mapping method, which allowed for a visual representation of key discussion points, highlighting consensus among participants. The focus group discussions revolved around five main themes, such as experiences with current scheduling systems, expectations of AI-based scheduling, and its potential advantages and disadvantages.
Results
Participants reported that current scheduling practices often lacked fairness and transparency, leading to dissatisfaction, particularly among permanent nurses. While temporary staff appreciated the flexibility in their schedules, permanent nurses expressed a desire for more autonomy and fairness in shift allocation. AI-based scheduling has the potential to improve shift equity by objectively managing shifts based on pre-defined criteria, thereby reducing bias and administrative burden. However, participants raised concerns about the depersonalisation of scheduling, emphasising the need for human oversight to consider the emotional and contextual factors that AI systems may overlook.
Conclusion
AI-based scheduling systems could offer significant benefits in improving fairness, transparency and work-life balance for caregivers. However, the integration of these systems must be accompanied by careful consideration of the human element and ongoing collaboration with healthcare professionals to ensure that the technology is aligned with organisational needs. By striking a balance between AI-driven efficiency and human judgement, healthcare organisations can improve nurse satisfaction and retention, ultimately benefiting patient care and organisational efficiency.
Cemento-osseous dysplasia: a multi-centre analysis of surgical management
Authors: Titinchi Fadi , Alturki Naser , Morkel Jean , Alkaabi Salem , Taylor Kathryn
Published: October 2024

Purpose
Cemento-osseous dysplasia (COD) is a fibro-osseous lesion whose management is highly controversial in the literature. Due to scarcity of comprehensive studies on its management, the aim of this study was to analyse its management and develop a treatment protocol.
Methods
A multi-centre retrospective cohort analysis was conducted at two tertiary referral hospitals on 124 patients diagnosed with COD from 2005–2023. Demographic, clinical, and radiological data were analysed and correlated with treatment methods. Post-operative complications such as osteomyelitis or pathological fracture were documented along with follow-up visits to evaluate the need for further treatment. Data was analysed using Student’s t-test and Fisher’s exact test. Statistical significance was set at P < 0.05
Results
The patients’ ages ranged from 22–78 years (mean: 48.5 years), with majority being females (90.4%) and of African descent (95.9%). Radiopaque CODs presented significantly higher rate of symptoms compared to radiolucent or mixed lesions (p = 0.02). The majority of incidental CODs were managed through observation (72%), while six incidental CODs underwent biopsy due to suspicion of more sinister lesions. Symptomatic lesions were mainly treated by curettage (29.7%) or local excision (48.6%), while only one symptomatic case was managed with observation and antibiotics (p = 0.0001).
Conclusion
Biopsy of asymptomatic COD should only be reserved for cases with inconclusive clinico-pathological features. The decision to surgically treat COD should be based on the presence of symptoms and infection. Early curettage or excision of infected COD is the most effective approach to eradicate the disease and prevent progression into osteomyelitis.
Effects of Six Weeks of Watermelon Juice supplementation on Total Antioxidant Capacity in Elite Taekwondo Athletes
Authors: aghabeighiamin parvin , Azizi Mohammad , tahmasebi worya
Published: October 2024

Introduction and objective:The natural product watermelon contains a high concentration of antioxidants that have the potential to mitigate the oxidative damage resulting from the generation of free radicals post-exercise. As such, this study aims to explore the impact of six weeks of watermelon juice supplementation on the antioxidant capacity of elite female taekwondo athletes.
Methods: In a study involving twenty-five young female elite taekwondo players with a mean age of 21.84±2.26 years, participants were randomly assigned to either the watermelon juice group (n=15) or the placebo group (n=10). Over six weeks, subjects consumed 500 ml of watermelon juice or placebo 45 minutes before each of their three weekly training sessions. The Total Antioxidant Capacity (TAC) index was measured in selected athletes undergoing training at the Taekwondo House in Kermanshah, located in western Iran.
Results: The study found that following six weeks of intervention, watermelon juice supplementation led to a significant increase in total antioxidant capacity (TAC) (p=0.001), while the TAC levels in the placebo (PLA) group remained relatively unchanged (p=0.490). Moreover, participants in the watermelon juice group demonstrated higher VO2max compared to the placebo group, and experienced significantly lower levels of muscle soreness at 24 and 48 hours post-exercise (p>0.05).
Conclusions: A six-week regimen of watermelon juice supplementation has been found to enhance overall antioxidant capacity and alleviate muscle soreness.
Mental Health from Childhood to Early Adolescence and its impact on School Attendance Problems: A Latent Transition Analysis
Authors: Sharpe Jane , Heary Caroline , Bunting Brendan
Published: October 2024

Despite concerted efforts among policy makers and practitioners, School Attendance Problems (SAPs) are increasing, with post covid figures indicating higher than ever rates of absenteeism. The aim of this paper was to examine how the developmental trajectory of emotional and behavioural difficulties from childhood to early adolescence might impact the frequency of chronic absenteeism and truancy at 13 years. Using a sample (N = 8570) from the Longitudinal Growing Up In Ireland Study (GUI’98), the research used Latent Class Analysis (LCA) and Latent Transition Analysis (LTA) to examine combinations of mental health symptoms at 9 and 13 years and their developmental impact on SAPs. The Strengths and Difficulty Questionnaire (SDQ) was used to measure a range of emotional and behavioural difficulties at both time points, yielding four mental health classes. Children who remained in High Risk classes, had higher odds of chronic absenteeism and/or truancy. Movement between classes significantly altered the odds of truancy, but not chronic absenteeism, highlighting the importance of differentiating between SAPs and early intervention. A secondary aim was to investigate how family, school and socio-demographic risk factors impacted those trajectories. Family factors were significantly linked to transitions into the co-morbid class, indicating that family risk factors can negatively impact the trajectory of emotional and behavioural difficulties between childhood and adolescence. This paper contributes to current knowledge on the complexities of mental health difficulties in primary school children and their impact on SAPs in early adolescence.
Electrochemical immunosensing of Crohn´s disease biomarkers using diazonium salt grafted - crystalline nanocellulose / carbon nanotubes modified electrodes
Authors: García-Rodrigo Lorena , Ramos-López Claudia , Sánchez-Tirado Esther , Agüí Lourdes , González-Cortés Araceli , Yáñez-Sedeño Paloma , Pingarrón José M.
Published: October 2024

This work reports the first dual immunosensor for the determination of IL-12 and IL-23, two relevant biomarkers of Crohn’s disease (CD). The strategy relies on the selective capture of the targets by the respective antibodies which were covalently immobilized onto SPCEs modified with crystalline nanocellulose (CNC) and multi-walled carbon nanotubes (MWCNTs) followed by conjugation with a detector antibody labelled with poly-HRP-Strept and amperometric transduction using the H2O2/HQ system. The developed bioplatform exhibits a high reproducibility and selectivity allowing the simultaneous determination of both biomarkers using a lower sample volume and lasting a much shorter assay time than those reported for each target with commercially available ELISA kits. It is worth highlighting the storage stability of the bioconjugates, which lasts at least 71 days. This excellent performance is probably due to the combination of the CNC properties, mainly its biocompatibility and hydrophilicity, the high surface area and open pore structure, together with the electrochemical properties of MWCNTs, which provide a nanocomposite excellent for biomolecules immobilization onto the transducer surface and electrochemical detection. The suitability and applicability of the dual immunosensor were demonstrated by analyzing raw serum and faeces spiked with IL-12 and IL-23 at the levels that can be found in samples from patients suffering severe CD.
Suppressing DBNDD2 promotes neuron growth and axon regeneration in adult mammals
Authors: Zhang Lan , Dai WenYu , Wu Yucong , Chen Tianyun , Qian Yuyue , Tang Yiming , Yang Peng , Yi Sheng , Gong Leilei
Published: October 2024

Effective axon regeneration is essential for the successful recovery of nerve functions in patients with axon injury-associated neurological diseases. Certain self-regeneration occurs in injured peripheral axonal branches of dorsal root ganglion (DRG) neurons but does not occur in their central axonal branches. By performing rat sciatic nerve or dorsal root axotomy, we determined the expression of the dysbindin domain containing 2 (DBNDD2) in the DRGs after the regenerative peripheral axon injury or the non-regenerative central axon injury, respectively, and found that DBNDD2 is down-regulated in the DRGs after peripheral axon injury but up-regulated after central axon injury. Moreover, we found that DBNDD2 expression differs in neonatal and adult rat DRGs and is gradually increased during development. DBNDD2 knockdown promotes the outgrowth of neurites in both neonatal and adult rat DRG neurons and stimulates robust axon regeneration in adult rats after sciatic nerve crush injury. Bioinformatic analysis data showed that transcription factor estrogen receptor 1 (ESR1) interacts with DBNDD2, exhibits a similar expression trend as DBNDD2 after axon injury, and may targets DBDNN2. These studies indicate that reduced level of DBNDD2 after peripheral axon injury and low abundance of DBNDD2 in neonates contribute to axon regeneration and thus suggest the manipulation of DBNDD2 expression as a promising therapeutic approach for improving recovery after axon damage.
A novel nomogram based on PET/CT to predict CT-negative lymph nodal metastasis for patients with lung adenocarcinoma
Authors: Zhu Xinyu , Jia Xinyu , Teng Shibing , Fu Kai , Chen Jiawei , Zhao Jun , Li Chang
Published: October 2024

Purpose
A precise assessment of lymph nodal status is essential for guiding an individualized treatment plan in lung adenocarcinoma patients. A novel nomogram using easily accessible indicators was developed and validated in this study to predict CT-negative lymph nodal metastasis.
Methods
Between September 2020 and December 2023, data from 132 consecutive patients diagnosed with lung adenocarcinoma who underwent lung resection with systemic lymph node dissection or sampling were retrospectively reviewed. Risk factors associated with lymph nodal metastasis were identified using univariable and multivariable logistic regression analyses. Subsequently, a nomogram was developed on basis of these identified parameters. The performance and validity of the nomogram were evaluated using the area under the receiver operating characteristic (ROC) curve, calibration curve, and bootstrap resampling techniques.
Results
Four predictors (primary tumor location, primary tumor SUVmax value, N1 lymph node SUVmax, and N2 lymph node SUVmax) were identified and incorporated into the nomogram. The nomogram exhibited notable discrimination, evidenced by an area under the receiver operating characteristic (ROC) curve of 0.825 (95% CI: 0.749–0.886, P < 0.001). Excellent concordance between the predicted and observed probabilities of lymph nodal involvement was demonstrated by the calibration curve. Furthermore, decision curve analysis indicated a net benefit associated with the use of our nomogram.
Conclusion
The nomogram demonstrated efficacy and practicality in predicting CT-negative lymph node metastasis for lung adenocarcinoma patients. It holds potential to offer valuable treatment guidance for clinicians.
Empirical Evidence for a Process-Based Model of Health-Related Quality of Life Using Network Analysis
Authors: Stogios Nicolette , Francis Troy , Peiris Rachel G. , Stanimirovic Aleksandra , Rac Valeria , Nolan Robert P.
Published: October 2024

Background
Health-related quality of life (HRQL) is the perceived impact of a medical condition on one’s overall well-being. While contemporary assessments are structured to evaluate an individual’s HRQL state, we propose a complementary process-based model, which is defined as an appraisal that evolves over time as it reflects and informs a self-regulatory process of adapting to dynamic changes in bio-psycho-social life domains. In support of this approach, we developed a novel HRQL assessment tool called the EUROIA: EvalUation of goal-diRected activities to prOmote well-beIng and heAlth, which uses self-report data to assess the frequency with which individuals engage in a sample of goal-directed activities in pursuit of living well.
Methods
We conducted a network analysis to evaluate the hypothesis that the EUROIA subscales would demonstrate a meaningful pattern of associations with an established HRQL measure and associated indices of psychosocial functioning and efficacy in self-managing a chronic medical condition.
Results
The EUROIA is associated with established indices of HRQL in a manner that is theoretically consistent with our process-based model. Stability coefficients (i.e., betweenness, closeness, and strength) of the analysis revealed high reliability for the network.
Conclusion
This analysis provides support for the validation of a process-based approach to HRQL assessment, which is represented, in part, by the EUROIA. A process-based approach complements and expands conventional measures of HRQL by focusing on how a patient’s capacity to engage in goal-directed activities for living well is affected by their medical condition.
Identification of Comorbidities and Genomic Associations of Biochemically Analogous Retinal and Brain Tissues Using Bioinformatics Approaches
Authors: Bhosale Rohan P. , Perianayagam Rajesh
Published: October 2024

The human retina and brain share similar biochemical compositions, primarily containing docosahexaenoic acid (DHA), an omega-3 fatty acid crucial to neurological functions. Scientific reports indicate that DHA is essential for brain and retinal development, aging, memory formation, synaptic membrane function, photoreceptor biogenesis, and neuroprotection. Epidemiologic studies suggest that diets rich in DHA can slow cognitive impairments, aid in the progression of Alzheimer’s disease, and promote ocular health. In this study, we identified comorbidities and genomic associations between retinal and brain tissues using bioinformatics approaches. This involved several key steps: data collection, bioinformatic analysis, comorbidity identification, and studying genomic associations. The project aimed to investigate the connection between retinal and brain disorders by examining altered genetic compositions using automated mutation discovery platforms such as DisGeNET, Cytoscape, and Karyosoft. The hypothesis is that similar biochemical compositions will lead to commonalities in genetic variations and phenotypic expressions. The data helped to understand genomic diseases affecting both the retina and the brain, such as Alzheimer’s disease and age-related macular degeneration.
Comparison of pediatric temporal bone computed tomography at 100kVp with tin filtration versus conventional protocol
Authors: Wang Yiting , Tong Tianfang , Xu Shuming
Published: October 2024

Background
Reducing the radiation dose of pediatric temporal bone computed tomography (CT) has always been a challenge.
Objective
To compare radiation doses and conspicuity of anatomic landmarks of the pediatric temporal bone between the CT protocol using spectral beam shaping at 100 kVp with a dedicated tin filter (Sn100 kVp) and the conventional protocol (100 kVp).
Matetials and Methods
: In total 100 children who had undergone head CT for diagnostic purposes and were found to have normal anatomical inner and middle ear structures were included in this study, of these, 50 children were examined with the Sn100kVp protocol and 50 with the conventional protocol. Subjective and objective image qualities, including visualization of temporal bone structures, image quality, image noise, and radiation doses, were compared between the two groups.
Results
The mean dose length product and effective dose (ED) of the Sn100 kVp scans (ED:0.03 ± 0.01 mSv) were significantly lower than those of the 100kVp scans ( ED: 0.50 ± 0.14 mSv, p < 0.001). The signal-to-noise ratio was slightly lower in the Sn100kVp scans than in the 100kVp scans, except for the squamous bone. However, the subjective evaluation of anatomic landmarks was not significantly different between the two groups, except for the labyrinth.
Conclusion
Temporal bone CT performed at 100 kVp with an additional tin fifilter for spectral shaping markedly reduced radiation dose and maintained good anatomic conspicuity in pediatric patients compared with conventional temporal bone CT .
Characterising processing conditions that artifactually bias human brain tissue transcriptomes
Authors: Stratton Jo Anne , Yaqubi Moein , Thomas Michael , Talbot-Martin Jonathan , Mohammadnia Abdulshakour , Allot Alexis , Groh Adam , Petrecca Kevin , Fancy Nurun , Papageorgopoulou Marianna , Zhang Xiaowen , McGarry Aisling , Matthews Paul , Jackson Johanna
Published: October 2024

Autopsy-derived brain tissue analysis is vital for exploring the complex landscape of neurobiology in health and disease but processing conditions during post-mortem handling can lead to significant technical artifacts affecting data interpretation. Here, we define brain transcriptomic signatures from healthy adult human brain tissue that was snap frozen in under 1 hour (Mean: 31min, Min: 10min, Max 55min) of extraction (hereafter referred to as ~ 0 hours) and compared it to brain autopsy tissue with either typical shorter (Mean: 6 hours, Min: 4h, Max: 14h) or longer (Mean: 36 hours, Min: 17h, Max: 70h) post-mortem intervals. We found a large number of differentially expressed genes in post-mortem tissue compared to snap frozen tissue, even with the shorter post-mortem intervals. These differences allowed us to define a general “artifactual” gene signature from adult human brain autopsies that arise as a result of post-mortem processing (termed Brain Artifact Gene (BAG) Signatures). We subjected the snap frozen brain samples to different times and temperatures mimicking those typical with autopsy material to determine how these common variables influence brain gene expression. Using this approach, we discovered a set of regulated genes that we defined as “Time and Temperature Response genes Underlying Transcriptional Heterogeneity (TTRUTH)” genes. Using deep learning approaches, we then developed a model capable of modelling the extent to which individual brain autopsy samples from non-neurological disease control donors express artifactual transcripts associated with post-mortem interval time and temperature. This allowed us to assign TTRUTH scores to each individual brain autopsy sample. Moreover, using single nuclear RNA sequencing on paired samples, we identified that neuronal populations are the initial expressers of these artifactual transcripts. As tissue remains at room temperature for extended periods, oligodendrocytes emerge as the predominant cell types expressing artifactual genes. Finally, we provide an Open Science website tool for others to use to determine whether their samples are subject to similar artifacts. Using this tool, the brain autopsy research community can now assign TTRUTH scores to human brain autopsy RNAseq datasets, to provide an additional quality control measure to better standardise datasets, allow additional sample stratification across experimental groups and enhance data interpretation.
Distinctive Hobnail Variant of Papillary Thyroid Carcinoma: A Case Series From a Tertiary Referral Center
Authors: Yadav Vishal , Lahiri Anupam , Pasricha Sunil , Dewan Ajay Kumar
Published: October 2024

Introduction: The hobnail variant of papillary thyroid carcinoma (HVPTC) is a rare and aggressive subtype, comprising 1-2% of all PTC cases. It is characterized by poor prognosis, frequent BRAF and p53 mutations, and a high recurrence rate. Given the limited data on HVPTC, especially in the Indian population, this case series aims to provide valuable insights into its clinical behavior, mutational profile, and treatment outcomes.
Materials and Methods: A retrospective analysis was conducted from January 2021 to December 2023. Histological reports were reviewed for cases with ≥5% hobnail features, and molecular testing was performed for BRAF and p53 mutations. Patient demographics, tumor characteristics, and follow-up data were collected. Follow-up included clinical exams, thyroid function tests, thyroglobulin, anti-thyroglobulin antibody levels, and imaging when necessary.
Results: Among 600 PTC cases, 4 were identified as HVPTC (0.67% incidence). The median follow-up was 40 months. Mean tumor size of 3.3 cm. BRAF and p53 positivity were found in 75%. Lymphovascular invasion (LVI) was present in 50% of patients. Recurrence occurred in two patients, both with LVI, despite receiving radioactive iodine and radiotherapy. The largest tumor (6 cm) did not show lymph node metastasis, while smaller tumors (2.2 cm, 2.3 cm) were metastatic. Neither BRAF nor p53 positivity correlated with thyroglobulin levels.
Conclusion: HVPTC exhibits aggressive behavior, particularly in cases with LVI. While BRAF and p53 mutations are common and cause aggressiveness. Risk stratification, early, aggressive management and molecular characterization are essential to improve treatment and outcomes.
The Role of Adjuvant Radiotherapy in Low-Risk Elderly Male Breast Cancer: Is Omission Justified?
Authors: Xu Chang , Zeng Cheng , Meng Hanheng , Ma Fei
Published: October 2024

Background
The aim of our study is to evaluate the net survival benefit of adjuvant radiotherapy following breast-conserving surgery (BCS) in elderly male patients with early-stage, low-risk breast cancer (node-negative, hormone receptor-positive [HR+]) and to assess whether omitting radiotherapy might be a viable option based on observed survival outcomes.
Methods
We conducted a retrospective cohort study using data from SEER-17 registries (2000–2021), identifying 9,695 male breast cancer (MBC) patients. After applying inclusion criteria and PSM, a total of 360 patients were included. Early-stage, low-risk patients were categorized into radiotherapy (RT) and non-radiotherapy (NRT) groups. A 1:3 nearest neighbor propensity score matching (PSM; caliper = 0.05) was used to adjust for confounders. Estimate the net survival benefit of RT by using overall survival (OS), relative survival (RS), standardized mortality ratio (SMR), and transformed Cox regression, while controlling for background mortality.
Results
In early-stage, low-risk MBC patients underwent BCS, RT did not confer a significant survival benifit compared to those who omitted RT. After PSM adjustment, the 15-year OS, RS, and SMR for the RT group were 31.8%, 1.05, and 2.14, respectively, with no statistically significant differences observed when compared to the NRT group (34.1%, 1.03, and 2.25; p = 0.36, 0.35, and 0.81, respectively). Furthermore, the cumulative incidence of breast cancer-related death (BCRD) and non-BCRD did not differ significantly between the RT and NRT groups. The 15-year cumulative incidences of BCRD and non-BCRD were 7.0% and 61.2% in the RT group, and 12.4% and 53.5% in the NRT group (p = 0.06 and 0.75, respectively). Additionally, compared to the NRT group, the RT group demonstrated a lower risk for both OS and RS within the first 10 years following diagnosis, although this survival benefits gradually diminished over time.
Conclusions
In MBC patients over 65 with T1 − 2N0M0, hormone receptor-positive tumors, radiotherapy showed no significant improvement in overall, disease-specific, or net survival. Therefore, omitting radiotherapy may be justified for early-stage, low-risk patients, aligning treatment with individualized risk assessments.
Trend Analysis and Cross Nations Inequality Analysis of Infectious Skin Diseases from 1990 to 2021
Authors: Yu Bing , Liang Xiaofeng , Wan Gexiao , Nie Hanhui , Liu Hongfang , Xie Lingfeng , He Liya , Yuan Juanna , Chen Xinsheng , Mo Dongdong , Fan Ruiqiang , Xie Ting
Published: October 2024

Background
The skin serves as a crucial barrier against microbial invasion, but breaches in this barrier can lead to infectious skin diseases (ISD). ISD, including bacterial (BSD), fungal (FSD) and viral Skin Disease (VSD), pose significant global health challenges.
Methods
Age-standardized and age specific incidence, prevalence, and lived with disability (YLDs) data for ISD were sourced from the Global Burden of Disease Study 2021 (GBD 2021) and demographic data from the United Nations. We utilized linear regression to analyze prevalence trends and Average Annual Percentage Change (AAPC) for BSD, FSD and VSD. Log transformation of prevalence rates addressed heteroscedasticity. Cross-national inequality was assessed using concentration and slope indices based on SDI.
Result
From the prevalence perspective, FSD continues to rank first, with a prevalence rate of 7,789.55 (95% CI: 7,059.28 to 8,583.54) in 2021. Interestingly, VSD overtakes BSD, with a prevalence rate of 1,781.31 (95% CI: 1,733.08 to 1,835.16), while BSD has a prevalence rate of 473.98 (95% CI: 463.37 to 484.64). Next, looking at YLDs, VSD rises to the first position in 2021, with YLDs rate of 54.77 (95% CI: 34.83 to 81.77). FSD comes next, with YLDs rate of 43.39 (95% CI: 17.79 to 89.10). Lastly, BSD has YLDs rate of 4.21 (95% CI: 2.36 to 7.20). The rate of YLDs for FSD is primarily concentrated among the elderly, while VSD are concentrated among children. There is no significant difference for BSD. The burden is greater for males than females. The prevalence of BSD and FSD is negatively correlated with the Socio-demographic Index (SDI), with the burden primarily concentrated in low SDI countries. VSD shows a positive correlation, mainly concentrated in high SDI countries.
Conclusion
We discovered that the global impact of ISD remains significant. Both BSD and FSD are increasing, while VSD are decreasing. FSD is more common among the elderly, whereas VSD predominantly affects children. BSD and FSD are primarily found in less developed areas such as Africa, whereas VSD is more prevalent in developed regions like Europe and North America. ISD cases are also increasing in the Middle East and South America. To reduce the burden of ISD, it is crucial to improve global hygiene standards, boost vaccination rates against viruses, and strictly regulate the use of antimicrobial drugs.
A Malaysian Study on COVID-19 (SARS-CoV-2) Vaccination Immune Response in Haemodialysis patients: A prospective, multicenter, cohort study
Authors: FANG TAN XUE
Published: October 2024

Background: Patients with end-stage renal disease (ESRD) have compromised immune systems, possibly reducing their vaccine-induced antibody responses compared to the general population. This study aims to determine the immunogenicity of this group to the COVID-19 vaccine.
Methods: Haemodialysis patients receiving the Pfizer-BioNTech mRNA vaccine were followed for at least 13 months. Blood samples were collected prior to every vaccine dose and at multiple intervals thereafter. Neutralising antibodies (nAb) against SARS-CoV-2 were measured. Patients voluntarily reported any COVID-19 infection.
Results: Between April 2021 and January 2023, 271 patients received at least one dose of the vaccine; 212 of these had at least one blood sample tested for nAb. Booster doses were given 26.2 weeks after the second dose. nAbs were detected in 16.8% of patients before vaccination. The nAb levels were higher than the non-convalescent patients after the first dose, but it was not statistically significant. Breakthrough infections occurred in 29.3% patients. They were not associated with history of COVID-19 infection (p=0.188). There were 34 deaths (16.0%); 2 related to COVID-19. Younger age was associated with higher nAb reactivity post-first dose, but this difference diminished after the second dose.
Conclusion: Almost complete seropositivity (98.4%) was achieved after two doses of vaccine. Sustained antibody levels after the third dose underscore the importance of a booster dose in protecting this vulnerable population. However, the occurrence of breakthrough infections highlights the need for continued monitoring, preventive measures, and further research to optimize vaccination strategies in haemodialysis patients.
A systemic review of economic challenges in Bangladesh
Authors: Akter Bilkish , Bepari Sapan
Published: October 2024

Bangladesh suffers enormous economic issues, such as inflation, unemployment, corruption, and poor infrastructure. These concerns limit the country's potential to achieve long-term economic growth and stability. The goal of this research is to investigate how these factors interact with and affect Bangladesh's economy, providing an in-depth examination of their consequences. A systematic review methodology was used to analyse a variety of papers concentrating on Bangladesh's economic issues.
The findings show that inflation weakens economic stability by increasing living costs and lowering household welfare, whereas unemployment, particularly among young people, limits the country's economic potential. Corruption further stifles the economy by discouraging foreign direct investment (FDI) and causing inefficiencies in both the public and private sectors. Furthermore, poor infrastructure, particularly in energy and transportation, discourages investment and hampers industrial development.
On the basis of these findings, the research advises extensive reforms such as anticorruption campaigns, job creation techniques, and considerable infrastructure investment. These steps are critical to stabilizing the economy and realizing Bangladesh's full potential for long-term growth.
Einfluss der systemischen Inflammation für die portalvenöse und systemische Hämodynamik bei Patienten mit Leberzirrhose - Implikationen für hepatische Dekompensation
Authors:   , Bothou Christina
Published: October 2024

Systemic inflammation is known to be a key player in the pathogenesis of the development of cirrhosis and consequent liver failure. However, the role of inflammation in the cascade of classical liver decompensation is not fully understood. This research project, part of a series of projects investigating hepatic decompensation in a large cohort of patients, aims to elucidate the interplay between systemic inflammation, hemodynamics, and anemia in decompensation in cirrhosis. The study population consisted of consecutively followed outpatients with advanced liver fibrosis or cirrhosis. We approached our research question by performing a post hoc analysis for potential parameters associated with liver decompensation and/or hospitalization. In total, we analyzed data from 338 patients, with 50/338 (15%) hospitalized for decompensated cirrhosis during a median follow-up of six months. In a first step, we performed a univariate analysis, which showed that active alcoholism (p = 0.002), Model of End-Stage Liver Disease (MELD) score (p = 0.00002), serum IL-6 concentration (p = 0.006), heart rate (p = 0.03), low arterial blood pressure (p < 0.05), maximal portal venous flow (p = 0.008), and low hemoglobin concentration (p < 0.00001) were associated with hospitalization during follow-up. Subsequent multivariate analysis showed an independent association of low hemoglobin (OR = 0.62, 95% CI = 0.51-0.78, p = 0.001) and serum IL-6 concentration (OR = 1.02, 95% CI = 1.01-1.04, p = 0.03), but not hemodynamic parameters, with liver decompensation. An inverse correlation between hemoglobin concentration and portal venous flow (R = -0.362, p < 0.0001) was observed in non-hospitalized patients. The accuracy of baseline hemoglobin levels in predicting hospitalization (area under the curve-AUC = 0.84, p < 0.000001) was high. In conclusion, our study showed that anemia and systemic inflammation, but not arterial circulatory dysfunction, are strong and independent predictors of liver decompensation in outpatients with cirrhosis.
Telemedicine-assisted cardiac rehabilitation: A controlled cohort clinical trial
Authors: Mishina I. E. , Berezina E. V. , Blinova K. A. , Parfenov A. S. , Lebedeva O. V. , Khoroshilova O. V. , Gudukhin A. A. , Zhaburina M. V. , Dovgaluk Yu. V.
Published: October 2024

Introduction. The traditional method of cardiac rehabilitation (CR) recommends continuing physical training at home, but many patients do not follow these instructions and the effectiveness of the rehabilitation program decreases. Thanks to the use of telemedicine technologies, the doctor can remotely monitor the patient’s condition, ensuring the safety and effectiveness of training. Aim. To test the method of organizing telemedicine support for CR of patients who have suffered a myocardial infarction.

Materials and methods. During the study, 27 patients underwent CR with telemedicine support, and 26 patients underwent traditional CR. To assess the effectiveness of using telemedicine technologies in CR, the results of the six-minute walk test under the control of an electrocardiogram were assessed using the Accordix telemedicine system (Neurosoft LLC, Ivanovo) before and after the rehabilitation program.

Results. After the end of the CR, in the group of patients with telemedicine support, during the six-minute walk test, reliable indicators of an increase in the distance covered were revealed compared to the results of patients in the control group (72 [52; 99.5] m vs. 45 [0.75; 51] m, p < 0.05), restoration of tolerance to physical activity (the ratio of the distance covered to the expected 15 [11.5; 18.5]% vs. 3 [-1.75; 8.75]%, p < 0.05), as well as an increase in the time the pulse stays in the training corridor (15% vs. 0.04%, p < 0.05). Also, in patients in the telemedicine CR group, the number of workouts was significantly higher (14.5 [12.5; 17] vs. 8.5 [4.5; 11.5], p < 0.05).

Conclusion. The presented method of conducting CR using telemedicine technologies has shown greater efficiency compared to the traditional approach. Changes recorded using ECG are analyzed by the telemedicine system, ensuring control and safety of physical activity. The use of telemedicine technologies allows the patient to reduce the fear of repeated myocardial infarction and increase adherence to CR.
JOSÉ P. CASTIANO
Authors: Domingos Maulana Maulana , Chingore Tiago Tendai
Published: October 2024

Este texto é recensão do livro de José Paulino Castiano, intitulado: Do Espírito da Tradição ao Espírito da Reconciliação, 1ª Edição, 2021. No entanto, trata-se dum exercício hermenêutico de busca por compreensão a partir do pensamento do autor, no sentido de se estabelecer uma análise mais ampla sobre o Espírito da Tradição e o Espírito da Reconciliação. O objectivo é mesmo problematizar o título deste livro especificamente, será uma transição dum “Espírito” ao outro? O que vai ser Espírito da Tradição e o da Reconciliação na concepção de Castiano? A Covid-19 representa o possível fim da humanidade? O que se pretende reconciliar de facto? Ora, a África e os africanos são por natureza agentes/sujeitos da Reconciliação, tanto que ao longo de vários ciclos de história conturbada, esse Espírito se manteve resistente e firme. Não obstante, segundo Castiano (2021) não se trata somente de buscar uma Reconciliação com o nosso passado colonizado e suas espiritualidades cristã e instituições modernas. Trata-se também, agora e doravante, de buscar uma Reconciliação que dê conta das manifestações deste espírito nas suas vertentes de religião, politica, cultura e da própria filosofia. A Covid-19 abalou profundamente a humanidade, tanto que se chegou a pensar que seria o fim. Todavia, o sujeito da reconciliação esteve como sempre apto para encontrar soluções locais a esse problema global e, por acaso, resistiu e cá estamos.
SONHO COMO REALIZAÇÃO DO DESEJO INCONSCIENTE DE BRANQUITUDE DA PESSOA NEGRA COM O IDEAL DE EGO BRANCO.
Authors: De Pina Hedy Carlos
Published: October 2024

O artigo visa discutir sobre o desejo inconsciente da pessoa negra de tornar-se branca em uma sociedade que lhe impõe um ideal de ego segundo modelo branco. Para tanto, segue a análise de dois psiquiatras negros que atendiam pacientes que manifestavam, de certa forma, um desejo de embranquecimento: A análise que Neusa Souza Santos, na obra Tornar-se Negro, faz sobre os efeitos desse modelo ideal de ego na vida psíquica do sujeito negro; e análise dos sonhos de pacientes negras que Franz Fanon traz nos seus escritos Pele Negra, Máscara Branca. Considerando que os sonhos são manifestações de desejo inconsciente, ao analisá-los, busca refletir sobre as implicações clínicas da imposição de um ideal inatingível sobre as pessoas negras dentro de uma estrutura social constituída predominantemente por ideais da branquitude.