bluuebunny/crossref_metadata_2025 huggingface dataset:
Figure S1 from Determining the N-Glycan and Collagen/Extracellular Matrix Protein Compositions in a Novel Outcome Cohort of Prostate Cancer Tissue Microarrays Using MALDI-MSI
Authors: Hartig Jordan P. , Bejar Kaitlyn , Young Lyndsay E.A. , Grimsley Grace , Bethard Jennifer R. , Troyer Dean A. , Hernandez Javier , Wu Jennifer D. , Ippolito Joseph E. , Ball Lauren E. , Gelfond Jonathan A.L. , Johnson-Pais Teresa L. , Mehta Anand S. , Leach Robin J. , Angel Peggi M. , Drake Richard R.
Published: November 2024

H&E images of TMAs
Early Growth and Impacts on Long-Term Neurodevelopment and Human Capital
Authors: González-Fernández Doris , Williams Tricia S. , Vaivada Tyler , Bhutta Zulfiqar A.
Published: November 2024

Background:: Growth trajectories during the first 1,000 days from conception to 2 years influence human capital, predicting intelligence, skills and health in adults. Summary:: This review describes current evidence on the impacts of adverse pregnancy outcomes such as low birth weight, preterm birth, small for gestational age, and infant nutrition on long-term neurodevelopment and summarizes interventions that have proven to be effective in improving child development and further impact human capital. To date, no globally standardized measurements of child development in low-medium-income countries exist, and comparisons among studies using different developmental scales are challenging. In the perinatal period, birth weight, gestational age at delivery and elevated placental blood flow resistance have been identified as the main risk factors for global neurological delay, poor neurosensory development and cerebral palsy. Although these adverse neurological outcomes have decreased in developed settings, it is still a problem in low-resource populations. Nutritional deficiencies are the main drivers of developmental impairment, notably iron, iodine and folate deficiencies, and environmental stressors during pregnancy such as air pollution, exposure to chemicals, substance abuse, smoking, and maternal/parental psychiatric disorders can affect the developing brain. Interventions aiming to improve maternal macro- and micronutrient status, delayed cord clamping, exclusive breastfeeding and nurturing care have demonstrated to be effective strategies to prevent perinatal complications known to affect child development.
Impact of body mass index on outcomes of cervical cerclage: a systematic review and meta-analysis
Authors: Yang Lihua , Yang Hua
Published: November 2024

Introduction: The purpose of the review was to examine the impact of maternal body mass index (BMI) on outcomes of cervical cerclage for cervical insufficiency.
Methods: This prospectively registered review (CRD42024512436) searched PubMed, Embase, Scopus, and Web of Science for comparative studies published before 6th March 2024. Maternal and neonatal outcomes of females undergoing cerclage were compared based on BMI.
Results: Seven studies were included. Pooled data showed that the risk of preterm birth (<37 weeks) was significantly increased in the obese vs non-obese group (OR: 1.32 95% CI: 1.15, 1.51 I2=36%). Gestation age at delivery in weeks was also found to be significantly lower in the obese group (MD: -2.47 95% CI: -4.83, -0.12 I2=96%). There was no significant difference in the risk of preterm premature rupture of membranes and chorioamnionitis between the two groups. Still, the rate of cesarean sections was significantly higher in the obese group. Neonatal birth weight in grams was not found to be significantly different between obese and non-obese groups but the risk of NICU admission was significantly increased in the obese group.
Conclusion: Low-quality evidence indicates that obesity may lead to an increased risk of PTB in women undergoing cervical cerclage. The risk of cesarean section and NICU admission is also increased in obese females.
Estimation of invasion depth of early colorectal cancer using Endoscopic ultrasonography and Magnifying chromoendoscopy: a meta-analysis
Authors: Chen Runhua , Huang Yafang , Liu Fusheng
Published: November 2024

Introduction magnifying chromoendoscopy (MCE) and Endoscopic ultrasonograpty (EUS) are often used as diagnostic tools to estimate the depth of invasion in early colorectal cancers (CRCs). The aim of this study was to compare MCE with EUS in distinguishing between slight submucosal invasion (invasion depth <1000μm) and massively submucosal invasion in patients with early CRCs, since slight submucosal invasion is currently considered as an indication for endoscopic resection and submucosal cancer with massively submucosal invasion should be surgically treated due to an increased risk of lymph node metastasis.
Methods For this meta-analysis, relevant studies were identified from PubMed, Embase and the Cochrane Library databases between the time of the establishment and
April 2023.Data on the yield of tumors were extracted, pooled, and analyzed by stata15.0 software. The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio in differentiating massive submucosal invasion from slight submucosal invasion were calculated for both diagnostic modalities.
Results Twenty-six studies involving 1,2586 lesions were included: sixteen were studies on MCE and 7 were studies on EUS and 3 were studies on both MCE and EUS. The pooled sensitivity of MCE was 0.78(95%CI 0.72-0.83), the specificity was 0.95（0.95%CI 0.91-0.97）, the positive likelihood ratio was 15.4（0.95%CI 8.7-27.4) and the negative likelihood ratio was 0.23（0.95%CI 0.18-0.30).The pooled sensitivity of EUS was 0.88(95%CI 0.81-0.93), the specificity was 0.87（0.95%CI 0.80-0.91）, the positive likelihood ratio was 6.7（0.95%CI 4.4-10.3) and the negative likelihood ratio was 0.13（0.95%CI 0.08-0.23).
Conclusion The sensitivity tended to be higher in EUS than MCE for early CRCs with massively submucosal invasion, whereas the specificity was significantly lower in EUS than in MCE.
Feasibility of using continuous glucose monitoring to detect glycemic abnormalities in children with cystic fibrosis.
Authors: Leonard Amanda , Judware Isabel R. , Vanscoy Lori L. , Paranjape Shruti M. , Peeler Donna , Wu Malinda , Blackman Scott M. , Mogayzel Peter J.
Published: November 2024

Introduction: Cystic fibrosis-related diabetes (CFRD) is linked to worsening pulmonary function and increased mortality in people with cystic fibrosis (pwCF). Because of this correlation, early recognition of CFRD is important. Current recommendations for detecting glucose abnormalities using an oral glucose tolerance test (OGTT) can be difficult to achieve in a busy clinical setting.

Methods: We trialed a 10-day CGM (Dexcom G6Pro) session in patients seen in our pediatric CF clinic that could not do an OGTT (reasons include emesis with OGTT or fear of needles) or that had an abnormal OGTT (to gather additional data to make treatment decisions).

Results: Of the 36 sensors placed, 34 (94%) were returned. Devices were worn for a median of 10 days (range 4-10 days). Of the 34 CGMs returned, 20 (59%) met the criterion for referral to a
pediatric endocrinologist.

Conclusion: CGM placement is feasible in a busy CF clinic to detect glucose abnormalities in children.
Beyond the ʿUthmānic Codex: the Role of Self-Similarity in Preserving the Textual Integrity of the Qurʾān
Authors: Dawood Jawhar M.
Published: November 2024

Self-similarity is the most pervasive feature of the Qurʾān and demands an explanation. Western scholarship generally maintains that self-similarity indicates the Qurʾān’s oral origins. In contrast, this article argues that self-similarity is evidence of an initial written origin of the Qurʾān that played a crucial role in giving the text its distinct identity and safeguarding it from corruption. The article is divided into three sections. The first introduces the concept of self-similarity, briefly defining it and reviewing Western scholarship that has dealt with self-similarity. The second section examines how self-similarity functions within the Qurʾān by analyzing eleven samples of parallel passages, thereby substantiating the study’s central claim. The third section concludes that the Qurʾān was not subject to later editing and that the ʿUthmānic Codex was copied from an earlier written exemplar.
Description of a new species of the genus Aeromachus Nicéville (Lepidoptera, Hesperiidae, Hesperiinae) from Southwestern China
Authors: HUANG SI-YAO , CHANG ZHOU , HOU YONG-XIANG
Published: November 2024

A new species of the genus Aeromachus, A. angustifascia sp. nov. is described from western Guizhou Province, southwestern China. The new species is superficially similar to A. catocyanea (Mabille, 1876) but can be distinguished from the latter by the details in wing pattern and male genitalia as well as COI genetic difference. The adults and genitalia of the aforementioned taxa are illustrated.
A new species of Neohylomys (Eulipotyphla: Galericidae) from northern Vietnam
Authors: BANNIKOVA ANNA A. , LEBEDEV VLADIMIR S. , GORCHKHANOV DZHABRAIL , FEI LI , DUNG DINH THE , HAI BUI TUAN , KRUSKOP SERGEI V. , ROZHNOV VIATCHESLAV V. , ABRAMOV ALEXEI V.
Published: November 2024

A new species of gymnure of the genus Neohylomys is described from northern Vietnam based on morphological and molecular differences. The species Neohylomys vietnamensis sp. nov. differs from the closely related species N. hainanensis from Hainan Island, China, previously the only species of the genus Neohylomys, by morphological and morphometric traits and by the mitochondrial cytb (8% of divergence) and nuclear BRCA1 genes. To date, the new species is known to exist only in northern Vietnam.
Reexamination of the taxonomic status of Coladenia agni (de Nicéville, [1884]) from Hainan, China reveals a new subspecies (Lepidoptera, Hesperiidae)
Authors: LI HUA-ZHAO , LIU ZHE , LI JIA-LING
Published: November 2024

By reexamining the taxonomic status of Coladenia agni (de Nicéville, [1884]) from different localities, the insular population from Hainan Island is described as a new subspecies, i.e., C. a. huanghaoi Li & Liu ssp. nov., based on morphological and genetic distinctions. The habitus, distributional map, and molecular phylogeny of all subspecies of C. agni are provided with remarks on ssp. sundae de Jong & Treadaway, 1992. Furthermore, some less-discussed characteristics on the hind tibiae are also illustrated and discussed.
A new harvestman species of the genus Nelima (Opiliones: Sclerosomatidae) from Extremadura, Spain
Authors: WIJNHOVEN HAY
Published: November 2024

A new Nelima species from Extremadura, Spain, is described as Nelima monfraguense sp. nov. The male is characterised by its dark dorsal colour, robust pedipalps armed with denticles, short, robust legs with extremely short and enlarged femora I and III, and by its penial morphology; both sexes have trichomes on all leg femora and patellae. The species was found in an open woodland area, a ‘dehesa’ landscape near the Monfragüe National Park. A discussion on related Iberian species of the genus is included.
Słownik prasłowiański. T. X: Ka–Ko
Authors: Jakubowicz Mariola , Cząstka-Szymon Bożena , Kwoka Tomasz , Ostrowski Bogumił , Pogwizd Szymon , Raszewska-Żurek Beata , Swoboda Paweł , Zwolski Artur
Published: November 2024

Słownik prasłowiański [Proto-Slavic Dictionary] is a work which combines features of an etymological dictionary and a study on the comparative history of the Slavic languages. The aim of its authors, who based on source materials from all Slavic languages, is to reconstruct the full lexical resource of the language used by the Slavic peoples immediately before the disintegration of the Proto-Slavic language community into individual languages (c. 7th–8th century AD). The first eight volumes were prepared under the auspices of the Linguistics Committee of the Polish Academy of Sciences at the Institute of Slavic Studies, Polish Academy of Sciences. They were published in 1974–2001 by the Ossolineum publishing house in a print version (the electronic version is available in the RCIN repository at https://rcin.org.pl/dlibra/publication/6907). Their editor was Franciszek Sławski. The Institute of Slavic Studies published Volume 10 of the Dictionary, which contains a part of entries beginning with the letter K: Ka–Ko. It was prepared under the National Programme for the Development of Humanities (NPRH, Grant No. 11H 11 026480) at the Kraków centre of the Institute. Edited by a team led by Mariola Jakubowicz, this volume was published in a small number of print copies and in pdf format.
Automated High-Throughput Live Cell Monitoring of Scratch Wound Closure
Authors: Schmidt Kevin , Lerm Dominik , Schmidt Arne , Dickel Nicholas , Fiedler Jan , Thum Thomas , Kunz Meik
Published: November 2024

Background:

Angiogenesis and regenerative wound healing rely on the promotion of distinct endothelial cell phenotypes exhibiting increased migratory capacity. Monitoring of these hallmark events in vitro is invaluable for discovering novel therapeutics. However, respective methods often lack a high-throughput character or accurate analysis tools, which are essential for effective screening suitability.

Methods and results:

We stained nuclei of confluent human umbilical vein endothelial cells with Hoechst33342 prior to induction of an artificial scratch wound. Treatments with various growth factors and several concentrations of nintedanib were performed to microscopically evaluate impacts on wound closure. We developed 2 tools for automated analysis of wound closure image sets. Utilizing cell-free area measuring or cellular density evaluation, respectively, migration behavior was assessed well-wise for each time point. We identified pro-migratory effects of interleukin 1β as well as inhibitory actions of nintedanib. Hoechst33342 staining allowed for cell counting which was excluded as a contributing factor to wound closure in our assay.

Conclusion:

We developed a cost-effective, high-throughput pipeline for monitoring cell migration in vitro. We believe that our protocol will accelerate pre-clinical screenings not only for medications targeting endothelial wound closure but also drug discovery research in a broad range of diseases involving cellular migration.
‘No longer what you used to be’: Renegotiating relations between de facto states and their patrons
Authors: Caspersen Nina , Gueudet Sophie
Published: November 2024

The dependence of de facto states/breakaway-territories on external patrons is well-established, but we lack detailed knowledge of the dynamics of these hierarchical relationships, including opportunities for client agency. Through a comparative study of two patron–client relationships that had reached a crisis point, this article examines how the weaker client responds when at odds with its patron. Drawing on original data, including archival sources and interviews, it provides a bottom-up analysis of the relationship between Serbia and Republika Srpska after the signing of the Dayton Peace Agreement and between Armenia and Nagorno Karabakh immediately after the 2020 war. The out-of-equilibrium behaviour presents an opportunity for analysing the underlying mechanisms of patron–client relationships. In both cases, the crisis resulted in deep mistrust of the patron, but the de facto states were unable to sever links. They were constrained by a lack of reliable alternative supporters, continued patron dependence and powerful ethno-nationalist narratives. Non-recognition added to the client’s weakness, yet we still find clear examples of agency: external supporters were courted, and patrons were pressured through obstruction or appeals to its domestic forces. What resulted was a renegotiated, less hierarchical relationship. The article adds to our understanding of patron–client relationships, including those involving non-sovereign entities where an effective patronage monopoly still exists. It contributes to the existing literature with typologies of patron–client crises and client strategies for reclaiming autonomy, and with detailed empirical evidence of client agency and constraining factors, and by demonstrating the potential leverage of some of the weakest international actors.
The updated prevalence and risk factors of dementia in old adults in China: A cross-sectional study
Authors: Gan Jinghuan , Zeng Yan , Huang Guowei , Wang Xiao-Dan , Lü Yang , Niu Jianping , Meng Xinling , Cai Pan , Li Xia , Li Yang , Shen Lu , You Yong , Gang Baozhi , Tang Yanqing , Lv Yan , Ren Zhihong , Liu Shuai , Ji Yong
Published: November 2024

Background

The continuously increasing aging population and life expectancy have led to an inconsistent and underestimated dementia prevalence in China. An updated epidemiologic study is urgently needed.

Objective

To update the prevalence rate and risk factors of dementia in China.

Methods

For this national cross-sectional study, 20,438 participants aged ≥65 from 28 communities and 56 villages from 14 centers were recruited using a multistage cluster sampling design between May 2019 and December 2019. Participants were assessed with a series of clinical and neuropsychological measurements. The prevalence rates of dementia, Alzheimer's disease (AD), and vascular dementia (VaD), as well as the risk factors, were calculated using multivariate-adjusted models.

Results

The crude prevalence rates were 9.1% (95% CI, 8.7%–9.5%) for dementia, 6.0% (95% CI, 5.7%–6.3%) for AD, 1.4% (95% CI, 1.2%–1.5%) for VaD, and 1.8% (95% CI, 1.6%–2.0%) for other dementias in a population aged ≥65 years. The overall sex- and age-standardized prevalence was 8.8%. Apart from VaD, the prevalence rates of dementia and AD were higher in females than males (10.3% versus 7.7%, respectively). Moreover, the prevalence rates of dementia and AD increased significantly with age. Being unmarried and having fewer social activities increased the risks of dementia and main subtypes. Risk factors were not exactly the same for participants with AD and VaD.

Conclusions

The prevalence of dementia is increased and almost comparable with that of developed countries for individuals aged ≥65 years. These findings may serve as new evidence for government interventions in aging.
False Lumen Patency After Occlusion With Physician-Modified Candy-Plug in Aortic Dissections: A 2-Center Experience
Authors: Karaolanis Georgios I. , Kotelis Drosos , Jungi Silvan , D’Amico Rosalinda , Mujagic Edin , Makaloski Vladimir
Published: November 2024

Objective:

To evaluate the early and mid-term results of physician-modified candy-plug (pmCP) in patients with type-B or residual type-A aortic dissection (TBRAD).

Methods:

All patients with TBRAD who received false lumen (FL) occlusion with pmCP between September 2018 and May 2024 were analyzed. Primary outcomes were technical and clinical success, and overall mortality. Secondary outcomes were postoperative aortic remodeling and aortic reintervention.

Results:

Seventeen patients (88% male; mean age 69±12 years) underwent FL occlusion with a pmCP. Nine patients (53%) were emergently treated. The technical and clinical successes were 100% and 82%, respectively. One patient (6%) died postoperatively. Early complete FL occlusion was observed in 82% of the patients. One patient (6%) required an early pmCP-related reintervention. During a mean follow-up of 15±5 months, 75% of the patients had complete thoracic FL thrombosis while 13% of them aortic remodeling in the last computed tomography (CT) scan. Aneurysm size remained stable in 69% of the cases. There were no aortic-related re-interventions during follow-up.

Conclusions:

The pmCP technique is a feasible and promising alternative technique, with high primary technical and clinical success rate. Stable aortic diameters can be expected during follow-up, thus reducing the need for further aortic reintervention.

Clinical Impact:

Persistence of false lumen (FL) patency after thoracic endovascular aortic repair (TEVAR) for thoracic aortic dissection (TBAD) remains a significant challenge for physicians. Various strategies have been developed to address retrograde FL patency, including the candy-plug technique. This technique involves modifying thoracic stent grafts and placing an additional plug to occlude the reduced stent graft waist.Since its introduction, three generations of custom-made candy-plug devices (Cook Medical, Bloomington, IN, USA) have been developed. However, delivery times vary across countries and vascular surgery services, complicating procedural planning, particularly in symptomatic patients or cases of rapid FL diameter progression.In this study, we provide a step-by-step description of the physician-modified candy-plug technique and present our preliminary results.
Endovascular Management of Aortic Rupture Secondary to Thoracolumbar Spine Fracture From a Domestic Fall: A Case Report and Clinical Challenges
Authors: Pakeliani David , Ferrante Liborio , Indelicato Giuseppe , Tumbiolo Silvana , Finocchiaro Maurizio
Published: November 2024

Purpose:

Instances of aortic lesions combined with thoracolumbar spine fractures have been rarely described, primarily occurring in high-speed motor vehicle collisions and falls from heights.

Case Report:

We present a unique case of a 71-year-old woman with a thoracic aortic rupture caused by a thoracolumbar spine fracture during an accidental domestic fall. She experienced an injury at the level of the celiac trunk on the posterior aspect of the aorta. Hemorrhagic shock and profound hemodynamic instability prompted the swift initiation of a percutaneous endovascular approach, involving the use of REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) followed by the parallel graft technique in a sandwich configuration. Subsequently, thoracolumbar spinal fixation was carefully scheduled and performed 20 days after achieving clinical stabilization.

Conclusions:

This case underscores the importance of a multidisciplinary approach in managing complex aortic and spinal injuries. The combined use of REBOA and the sandwich graft technique can be life-saving in managing acute thoracic aortic injuries, allowing for the staged stabilization and repair of associated spinal fractures.

Clinical Impact

This case highlights a novel approach to managing a rare thoracic aortic rupture caused by an accidental domestic fall. The application of REBOA for immediate hemodynamic stabilization, combined with the use of a sandwich graft configuration, underscores the adaptability of advanced endovascular techniques in complex, life-threatening situations. These interventions demonstrate the importance of tailoring treatment strategies to individual patient needs, especially in cases involving atypical mechanisms of injury. The findings emphasize the value of early multidisciplinary collaboration and dynamic procedural planning, paving the way for improved outcomes and the refinement of clinical protocols in the management of similar trauma cases.
Direct and Gradual Electrical Testicular Shocks Stimulate Spermatogenesis and Activate Sperms in Infertile Men: A Randomized Controlled Trial
Authors: Hashim Hashim Talib , Varney Joseph , Qais Zanyar , Reda Abdallah , Qaderi Shohra , Chowdhury Nazmus Sakib , Murry Kimberly , Shah Jaffer , Alhaideri Adil , Ahmad Shoaib , Hashim Ali Talib , Rehman Rehana , Ahmed Naseer , Al-Jorani May Saad , Skuk Moatamn , Abdalhusain Mahdi , Khalafalla Kareim
Published: November 2024

Infertility was reported in approximately 15% of all heterozygous couples, with the male factor accounting for nearly half of the cases. This typically occurs due to low sperm production, sperm dysfunction, and sperm delivery obstruction. In this randomized controlled single-blind clinical trial, 90 infertile male subjects diagnosed with oligospermia, hypospermia, asthenozoospermia, or necrozoospermia were recruited. Semen samples were obtained with the masturbation method and an assessment of semen volume, sperm count, and motility was performed. Five milliamps of electrical shock was delivered to the participants through the fertility improvement device. Semen analysis was collected 4 months post-intervention from all subjects. Data were collected and an analysis of pre- and post-intervention results was performed. There was an improvement in the count, volume, and motility of the patient’s sperm after electrical shock treatment compared with the control group. By using the analysis of variance (ANOVA) test, there were statistically significant differences between the first and the second seminal analysis results (<.05). All other results were found to be independently correlated. This study demonstrated that using a painless, convenient at-home device, which is designed to contain all the testis tissue as a cup and then extend to include the scrotal roots reaching the penile root to include the epididymis, could significantly improve sperm motility and count. This device can be utilized to tackle the significant issue of infertility in a cost-effective, safe, and efficacious manner. An ultrasound was done before and after using the device as well as years after with no changes noted.

Clinical Trial’s Registration Number: NCT04173052
Diagnostic accuracy of strain cervical elastography as a predictor for preterm delivery: A single tertiary care centre study
Authors: Sharma Abhinash , Thakur Shruti , Tomar Ashwani , Mittal Rita , Surya Mukesh
Published: November 2024

Introduction:

Preterm delivery is a grave and demanding problem that accounts for the major cause of neonatal deaths and long-term morbidities. It remains an unresolved health issue of global dimensions. Cervical elastography is evolving as a useful diagnostic tool for its timely prediction so that individualised management can be done.

Aim:

To assess the diagnostic accuracy of transvaginal strain cervical elastography in prediction of preterm delivery.

Methods:

This prospective observational study was conducted from June 2021 to August 2022 in a tertiary care institute of North India. A total of 75 low-risk asymptomatic women were included. Transvaginal ultrasound was performed for the cervical length in the second and third trimesters. In addition, we collected strain elastography data such as colour codes from six regions of the cervix, that is, at the anterior and posterior lips of internal os, middle one-third of the cervix and the external os, and the strain ratios from these three cervical levels were also calculated. Then these parameters were compared with cervical length, second and third trimester groups and also with preterm and term delivery groups.

Result:

The red colour (soft colour) at the anterior lip of internal os was the best predictor of preterm delivery in our study with a sensitivity and specificity of 63.64% and 96.87%, respectively. The elastography strain ratio of >2 at the internal os and cervical length ⩽2.8 cm were the additional predictors for the same.

Conclusion:

Cervical elastography can serve as a potential and reliable predictor for preterm delivery.
Preoperative knee hyperextension is the most relevant predictor for ACL reconstruction objective failure: a machine learning analysis of 680 patients
Authors: Helito CP , Silva AGM , Pecora JR , Gobbi RG , Alaiti RK , Vallio CS
Published: November 2024

Objectives

To evaluate the predictive performance of different machine learning algorithms for the occurrence of objective failure in ACL reconstruction and to identify the most relevant predictors associated with this outcome.

Methods

We evaluated 680 patients submitted submitted to ACL reconstruction between January 2012 and July 2021. The study outcome was ACL objective failure, defined as a complete tear confirmed by MRI or arthroscopy evaluation or clinically ACL insufficiency. Routinely collected imaging, clinical, and demographic data were used to train 9 machine learning algorithms (k-nearest neighbors (KNN) classifier, decision tree classifier, random forest classifier, extra trees classifier, gradient boosting classifier, Light Gradient Boosting Machine (LightGBM), eXtreme Gradient Boosting (XGBoost), CatBoost classifier, and logistic regression). We used a random sample of 70% of patients to train the algorithms, and 30% were left for performance assessment, simulating new data. The performance of the models was evaluated with the area under the receiver operating characteristic curve (AUC).

Results

The predictive performance of all models was good, with AUC’s ranging from 0.81 to 0.88. The models with the best AUC metric were the Gradient Boosting Classifier (0.88 [95% CI, 0.81 to 0.92]) and Random Forest Classifier (0.88 [ 95% CI, 0.81 to 0.92). Knee hyperextension consistently emerged as the primary predictor across all models subjected to our analysis.

Conclusion

Machine learning algorithms demonstrated good performance to predict ACL reconstruction objective failure. Additionally, knee hyperextension consistently emerged as the primary predictor across all models subjected to our analysis.
Evaluation of the diagnostic performance of different criteria in identification of periprosthetic infection after knee arthroplasty
Authors: Corrêa VK , Mozella AP , Oliveira Filho NG , De Oliveira ACL
Published: November 2024

Objectives

The objective was to identify the best performance among the criteria most currently used for the diagnosis of PPI using the database of patients undergoing revision TKA surgery in a SUS hospital specializing in highly complex orthopedic surgeries.

Methods

A retrospective study was carried out by collecting data from patients undergoing TKA revision for PPI. Patients who did not have sufficient data to confirm or exclude the diagnosis of PJI and insufficient information that did not allow comparison of systems were exclude. An analysis of the variables of the study participants was carried out, the microbiological profile was evaluated and the different diagnostic systems were compared.

Results

A total of 188 participants were included, with 67 cases excluded. At the end, 121 cases of revisions due to chronic infection were analyzed. The average age of patients undergoing revision was 71 years, with the majority being women. The microbiological profile converged with previous literature. MSIS 2018 (standard) identified 39 cases of infection, with 10 (25%) culture-negative cases. The 2013 MSIS diagnosed 35 infections, with 6 (17%) showing no bacterial growth. EBJIS identified 47 cases of infection, of which 20 (38%) were culture-negative cases. Of the cases considered infected by MSIS 2018, all were also considered infected by EBJIS 2021. However, of the 47 cases considered confirmed infection by EBJIS, 39 patients were considered confirmed infection by MSIS 2018, 4 possibly infected and 4 not infected, which makes the european system positive a greater number of cases in addition to confirming more cases without bacterial growth.

Conclusion

EBJIS demonstrated more cases of infection when compared to MSIS 2018 and more inconclusive/possibly infected cases. MSIS 2013 would not change the management of all patients who confirmed infection.
Youth Soccer Players Undergoing Anterior Cruciate Ligament Reconstruction Demonstrate High Rates of Continuation of Sport and Progression to Professional Level Soccer: A Seven Season Analysis in Twenty-Nine Brazilian Professional Soccer Teams
Authors: DC Astur , M Moises Cohen
Published: November 2024

Objectives

To evaluate the progression of youth male soccer athletes who undergo ACL reconstruction and track their progression from youth up to professional level play

Methods

163 male players from 29 soccer teams underwent ACL reconstruction and were followed from 2015 to 2023. They were evaluated regarding category progression (under-13 to professional), type of graft used, presence of re- rupture, and return to sport/continuation of sport.

Results

Most injuries occurred in players in the under-17 (31.3%) and under-20 (47.2%) categories. A total of 111 patients continued playing after ligament reconstruction (68.1%), and 52 patients discontinued their careers (31.9%). Of the 163 athletes who underwent ACL reconstruction, 40 still play professionally (24.5%) and 71 are continuing participation in youth soccer and may still become professionals (43.6%). Among the professionals, 8 underwent an ACL revision reconstruction. The graft of choice in 77.3% of the reconstructions were the hamstring tendons.

Conclusion

Athletes from professional soccer teams who underwent ACL reconstruction while still playing in the youth teams of their clubs demonstrated a return to sport rate of 68.1%. Among players who returned to sport and became adult league professionals, 40 (83.3%) continued to play at the adult professional level, and 8 (16.7%) have discontinued their careers.
Transcriptomics of interstitial lung disease: a systematic review and meta-analysis
Authors: He Daniel , Guler Sabina A. , Shannon Casey P. , Ryerson Christopher J. , Tebbutt Scott J.
Published: November 2024

Objective

Gene expression (transcriptomics) studies have revealed potential mechanisms of interstitial lung disease (ILD), yet sample sizes of studies are often limited and between-subtype comparisons are scarce. The aim of this study was to identify and validate consensus transcriptomic signatures of ILD subtypes.

Methods

We performed a systematic review and meta-analysis of fibrotic ILD transcriptomics studies using an individual participant data approach, and included studies examining bulk transcriptomics of human adult ILD samples and excluding those focusing on individual cell populations. Patient-level data and expression matrices were extracted from 43 studies and integrated using a multivariable integrative algorithm to develop ILD classification models.

Results

Using 1459 samples from 24 studies, we identified transcriptomic signatures for idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis (HP), idiopathic nonspecific interstitial pneumonia (NSIP), and systemic sclerosis-associated ILD (SSc-ILD) against control samples, which were validated on 308 samples from 8 studies (area under receiver operating curve [AUC]=0.99 [95% CI: 0.99–1.00], HP AUC=0.91 [0.84–0.99], NSIP AUC=0.94 [0.88–0.99], SSc-ILD AUC=0.98 [0.93–1.00]). Significantly, meta-analysis allowed, for the first time, identification of robust lung transcriptomics signatures to discriminate IPF (AUC=0.71 [0.63–0.79]) and HP (AUC=0.76 [0.63–0.89]) from other fibrotic ILDs, and unsupervised learning algorithms identified putative molecular endotypes of ILD associated with decreased forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) % predicted. Transcriptomics signatures were reflective of both cell-specific and disease-specific changes in gene expression.

Conclusion

We present the first systematic review and largest meta-analysis of fibrotic ILD transcriptomics to date, identifying reproducible transcriptomic signatures with clinical relevance.
Association between e-cigarette exposure and ventilation homogeneity in young adults: A cross-sectional study
Authors: Stanojevic Sanja , Ha Yung Mei , Sahin Berke , Johnson Noah , Stewart Hanna , Laflamme Olivier D. , Maksym Geoffrey , Mateos-Corral Dimas , Asbridge Mark
Published: November 2024

Background

The number of young people who use electronic cigarettes (e-cigarettes) is rising. It remains unclear whether e-cigarettes use impairs lung function. We aimed to compare ventilation distribution between young adults exposed to e-cigarettes with an unexposed group.

Methods

Study participants included otherwise healthy young adults (18 to 24 years) who self-reported e-cigarette use, and participates who had no history of e-cigarette, tobacco or cannabis exposure. Exposure to e-cigarettes was defined using three measures 1) ever exposed, 2) daily use, and 3) puff frequency, which includes: none (unexposed), low (1–2 puffs/hour), moderate (3–4 puffs/hour) and heavy (5+ puffs/hour). Ventilation distribution was measured using the multiple breath washout test and reported as lung clearance index (LCI).

Results

A total of 93 participants were recruited, 38 unexposed and 41 exposed participants had LCI measures. The exposed group consisted predominately of participants who used flavoured e-liquids (94.5%) that contained nicotine (93.5%). The magnitude and direction of the difference in LCI across the exposure definitions was similar. Compared with the unexposed group, in the unadjusted models LCI was higher in those with any e-cigarette use (mean difference 0.16 units; 95% CI 0.004; 0.31), daily users (mean difference 0.11; 95% CI 0.06; 0.28) and heavy users (mean difference 0.22; 95% CI 0.03; 0.41).

Conclusion

This preliminary work suggests that LCI may be a useful biomarker to measure the effects of e-cigarette use on ventilation distribution and to track early functional impairment of the small airways.
Effect of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery: a randomized clinical trial
Authors: Karimi Mehdi , Ghaheri Ali , Saleh Kianmehr , Cheraghi Zahra , Farahanchi Afshin
Published: November 2024

Background

Muscle relaxants are used during surgery, but their impact on ECG may differ, potentially affecting cardiac safety. This study aimed to compare the effects of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery.

Method

This double-blind, parallel-group randomized clinical trial (RCT) was conducted in 2023 in Hamadan, Iran. A total of 80 patients undergoing cataract surgery under general anesthesia were randomly assigned to receive either Atracurium (n = 40) or Cisatracurium (n = 40). QT interval changes were measured at four time points to assess and compare the corrected QT interval (QTc) between the two groups. Data were analyzed using SPSS version 29, and a p-value < 0.05 was deemed significant.

Results

Cisatracurium demonstrated significant reductions in QTc from pre-anesthesia to post-anesthesia and through recovery, with values of -9.325 ms (P = 0.045), -9.925 ms (P = 0.038), and − 19.359 ms (P = 0.016), respectively. Atracurium also showed reductions but a notable increase in QTc after anesthesia to the end of surgery (32.322 ms, P = 0.0019). Throughout the procedure, Cisatracurium maintained shorter QTc intervals compared to Atracurium (e.g., T0: 420.07 ms vs. 434.75 ms, P = 0.03), but post-recovery, no significant differences were observed (Cisatracurium: 440.05 ms; Atracurium: 439.80 ms, P = 0.489).

Conclusions

Atracurium causes more QT prolongation than Cisatracurium. While both affect QTc intervals, Cisatracurium has a more stable impact on cardiac repolarization, making it safer for patients at risk of QT prolongation. Cisatracurium’s minimal impact on cardiovascular function, especially in patients with low ejection fraction, makes it the preferred choice for maintaining cardiac stability.

Trial registration

IRCT20120215009014N441.
Sociodemographic determinants of mobility decline among community-dwelling older adults: findings from the Canadian longitudinal study on ageing
Authors: Onyeso Ogochukwu Kelechi , Alumona Chiedozie James , Odole Adesola Christiana , Victor Janice , Doan Jon , Awosoga Oluwagbohunmi A.
Published: November 2024

Background

Mobility is fundamental to healthy ageing and quality of life. Mobility decline has been associated with functional impairment, falls, disability, dependency, and death among older adults. We explored the sociodemographic determinants of mobility decline among community-dwelling older Canadians.

Methods

This study was a secondary analysis of a six-year follow-up of the Canadian Longitudinal Study on Ageing (CLSA). Our analysis was based on 3882 community-dwelling older adults 65 years or older whose mobility was measured using timed-up and go (TUG) and 4-meter walk (4MWT) tests at baseline and follow-ups 1 and 2 after three- and six-year intervals, respectively. We analysed the cross-sectional and longitudinal association, main and interaction effects of the participants’ sociodemographic characteristics on mobility decline using chi-square, Pearson’s correlation, mixed-design repeated measures ANOVA, and bivariate and multivariate linear regression tests.

Results

At baseline, 52% of the participants were female, 70.4% were married, and the average age was 68.82 ± 2.78 years. Mean TUG and 4MWT scores were 9.59 ± 1.98 s and 4.29 ± 0.95 s, respectively. There was a strong positive longitudinal correlation between TUG and 4MWT (r = 0.65 to 0.75, p < 0.001), indicating concurrent validity of 4MWT. The multivariate linear regression (for TUG) showed that older age (β = 0.088, p < 0.001), being a female (β=-0.035, p < 0.001), retired (β=-0.058, p < 0.001), Canadian born (β=-0.046, p < 0.001), non-Caucasian (β=-0.063, p < 0.001), tenant (β = 0.050, p < 0.001), having no spouse/partner (β=-0.057, p < 0.001), household income of $50,000-$99,999 (β = 0.039, p < 0.001), wealth/investment lower than $50,000 (β=-0.089, p < 0.001), lower social status (β=-0.018,p = 0.025), secondary education and below (β = 0.043, p < 0.001), and living in certain provinces compared to others, were significant predictors of a six-year mobility decline.

Conclusion

Our study underscored the impact of modifiable and non-modifiable sociodemographic determinants of mobility trajectory. There is a need for nuanced ageing policies that support mobility in older adults, considering sociodemographic inequalities through equitable resource distribution, including people of lower socioeconomic backgrounds.
The relationship between ethnicity and place of birth in England: a mixed-methods study
Authors: Rivers Frances , Grollman Christopher , Khan Zahra , Daniele Marina A. S.
Published: November 2024

Background

UK maternity policy advocates a choice of birthplace in an obstetric-led unit (OU), a midwife-led unit (MLU) or at home. Although robust evidence supports the safety of birth in midwife-led settings, particularly for women with uncomplicated pregnancies, most births are in the OU. Women and babies from ethnic minority communities experience major health disparities and inequitable care, but there is limited research examining birthplace choices through an ethnicity lens. This study investigated the association between ethnicity and place of birth at an urban NHS Trust in England.

Methods

A mixed-methods sequential explanatory study. Analysis of births from 2014–2023 at a London NHS Trust included multivariable logistic regression analysis of birthplace by ethnicity. Planned or pre-labour Caesareans, pre-term, and multiple births were excluded. Significant disparities between White and South Asian women were identified which informed the focus of the qualitative study. Semi-structured interviews with 10 women of South Asian heritage who had given birth in the OU, the alongside MLU or at home were conducted and analysed thematically.

Results

More White women gave birth in midwife-led settings (27.5%) than all other ethnicities, particularly South Asian women (20.6%). South Asian women had fewer homebirths (0.8%) than White women (2.7%) and were much less likely to birth in a midwife-led setting after adjusting for parity, maternal age, BMI, previous Caesarean, presence of diabetes or hypertensive disorders and onset of labour (aOR 0.61, 95% CI 0.51–0.73, p < 0.001). Places of birth were similar for Black and White women, although the number of Black women in the population was too low to detect significant differences.

Themes generated from interviews included the assumption that birth is hospital-based and doctor-led; choosing a midwife-led birth setting went against the cultural norm, but felt safe – physically, psychologically and culturally.

Conclusions

There are ethnic disparities in place of birth. Cultural factors seem influential, but barriers to choice, such as limited evidence-sharing by midwives, may disproportionately affect women from ethnic minority communities, who may particularly benefit from midwife-led birth settings. Women need personalised information about options. Improving choice of birthplace is a step towards reducing health inequalities and promoting optimal health.
Remote school instruction in Fall 2020 and psychiatric emergencies among adolescents in Los Angeles County
Authors: Huo Shutong , Ro Annie , Du Senxi , Young Andrew , Bruckner Tim A.
Published: November 2024

Objective

Schools play an essential role in providing mental health care for adolescents. School closures during COVID-19, as well as re-opening to remote-only instruction in Fall 2020, may indirectly affect the utilization of emergency psychiatric care. We examine COVID-19-related changes in emergency psychiatric care among youth during the school closure and after school reopening (with remote instruction).

Methods

We use Box-Jenkins interrupted time series methods to analyze psychiatric emergency department (ED) visits among patients 10–19 years at LAC + USC Medical Center (LAC + USC) between January 5th, 2018, and December 31st, 2020. We control for the 1st societal shutdown in LA County (i.e., the nine weeks from March 13 to May 14, 2020) when analyzing the potential “return to remote school” shock.

Results

Youth psychiatric ED visits fell by 15.3 per week during the Spring 2020 school closure (p < .05). The “return to remote school” coefficient (i.e., August 14th to September 10, 2020), by contrast, is positive but does not reach statistical detection above expected values (p = .11). However, the proportion of psychiatric ED visits rises 38% among youth during the “return to remote school” period (p = 0.006).

Conclusion

The initiation of Fall 2020 remote instruction corresponded with a greater proportion of youth ED visits that are classified as psychiatric.
Association between tobacco smoking and prevalence of HIV, tuberculosis, hypertension and diabetes in rural South Africa: a cross-sectional study
Authors: Chidumwa Glory , Olivier Stephen , Ngubane Hloniphile , Zulu Thando , Sithole Mareca , Gunda Resign ,   The Vukuzazi Team, Sewpaul Ronel , Kruse Gina , Rigotti Nancy A. , Hanekom Willem A. , Siedner Mark J. , Reddy Krishna P. , Wong Emily B.
Published: November 2024

Background

South Africa is facing a convergence of communicable diseases (CDs) and non-communicable diseases (NCDs). There are limited data about how tobacco use contributes to the burden of these conditions, especially in rural populations.

Methods

We analyzed the associations between current tobacco smoking and four important CDs and NCDs in Vukuzazi, a cross-sectional study of individuals aged 15 years and older conducted between 2018–2020 in a demographic surveillance area in KwaZulu-Natal, South Africa. Data on HIV, active tuberculosis (TB), hypertension and diabetes mellitus were collected via direct measurement from participants.

Results

Of 18,024 participants (68% female, median age 37 years [interquartile range 23–56 years]), 1,301 (7.2%) reported current smoking. Prevalence of HIV infection was similarly high among people who currently smoked (34.6%) and people who had never smoked (33.9%). However, among people living with HIV (PLWH), there was a higher prevalence of detectable viremia in people reporting current smoking compared to people who reported never smoking (28.8% vs. 16.6%; p-value < 0.001). Active TB was more prevalent in people who currently smoked than in people who never smoked (3.1% vs 1.3%, p < 0.001). In contrast, the prevalence of hypertension and diabetes mellitus were lower in people reporting current smoking than in people reporting never smoking (17.1% vs 26.0% (p < 0.001), and 2.5% vs 10.2% (p < 0.001), respectively). In sex-stratified multiple logistic regression analyses that were adjusted for potential confounding factors (including body mass index for the NCDs), the magnitude of differences in CD prevalence between people who currently smoked and people who never smoked decreased, whereas the lower prevalence of NCDs among people reporting current smoking persisted.

Conclusions

In rural South Africa, smoking is associated with higher prevalence of active TB, and people with HIV who smoke have worse disease control. In contrast, hypertension and diabetes mellitus are less common in those who smoke. Interventions to screen for TB among those who smoke and to address smoking among people with HIV may be particularly impactful.