bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in tuberculosis burden and its associated risk factors in Guizhou Province of China during 2006–2020: an observational study
Authors: Wang Yun , Chen Huijuan , Zeng Xiaoqi , Liao Long , Lu Xiaolong , Zhang Aihua
Published: February 2024

Background

Understanding the trends of tuberculosis (TB) burden and its risk factors at the provincial level in the context of global End TB targets is crucial to identify the progress and challenges in TB control. We aimed to estimate the burden of TB and risk factors for death from 2006 to 2020 for the first time in Guizhou Province, China.

Methods

Data were collected from the national TB surveillance system. Four indicators of TB burden and their corresponding age-standardized rates (ASRs), including incidence (ASIR), prevalence (ASPR), mortality (ASMR) and disability-adjusted life years (DALYs) (ASDR), were estimated and stratified by year, age, gender and prefecture. Temporal trends of ASRs were presented by locally weighted regression, and the annual percentage change was calculated. The correlation between gross domestic product (GDP) per capita and ASRs was evaluated by Pearson correlation analysis. The associated risk factors for death in PTB patients were determined using logistic regression models.

Results

A total of 557,476 pulmonary TB (PTB) cases and 11,234 deaths were reported, including 2233 (19.9%) TB specific deaths and 9001 (80.1%) deaths from other causes. The 15-year average incidence, prevalence and mortality rates were 94.6, 102.6 and 2.1 per 100,000 population, respectively. The average DALY rate was 0.60 per 1000 population. The ASIR and ASPR have shown downward trends since 2012, with the largest percentage decrease in 2020 (ASIR: -29.8%; ASPR: -30.5%). The number in TB specific deaths consistently decreased during the study period (P<0.001), while the increase in deaths from other causes drove the overall upward trend in ASMR and ASDR. Four ASRs remained high in males and 5 prefectures. GDP per capita was negatively associated with the ASIR, ASPR and ASDR (P<0.05). Among PTB patients, men, patients with no fixed job, those with a low GDP level, patients with increasing age, those previously treated, those with severe symptoms, those transferred in and those receiving directly observed treatment were more likely to suffer death.

Conclusion

Guizhou has made progress in reducing PTB cases and TB specific deaths over the last 15 years. Targeted interventions are needed to address these risk factors for death in PTB patients and high-risk areas.
Fatigue in taxi drivers and its relationship with traffic accident history and experiences: a cross-sectional study in the north of Iran
Authors: Rad Enayatollah Homaie , Hosseinnia Marjan , Mousavi Nima , Shekari Arian , Kouchakinejad-Eramsadati Leila , Khodadadi-Hassankiadeh Naema
Published: February 2024

Background

The monotonous nature of work, long driving duration, and working overload hours cause frequent fatigue in taxi drivers. A high prevalence of fatigue is associated with traffic accidents. However, the risk factors associated with taxi driver fatigue are unclear. Therefore, the present study aims to determine the rate of fatigue in taxi drivers and its relationship to their traffic accident experience.

Methods

In this descriptive-analytical study, 400 taxi drivers in the city of Rasht were registered in Taxi association selected through random sampling and entered into the study based on inclusion criteria. Data was collected through a researcher-made questionnaire reliable and valid by two medical students. The statistical analysis used ordinal data and a Poisson regression model with SPSS software version 21, with a significance level set at 5%.

Results

The driver fatigue self-reported was directly and significantly related to alcohol consumption (OR = 3.43, 95% CI 1.01–11.62) and had a significant and inverse relationship with smoking (OR = 0.50, 95% CI 0.32–0.76), being married (OR = 0.08, 95% CI 0.01–0.40) and driving experience there was (OR = 0.96, 95% CI 0.94–0.98). Drivers’ sense of quality of life (QOL) was directly and significantly related to smoking (IRR = 1.43, 95% CI 1.28–1.59), education level under diploma (IRR = 2.41, 95% CI 1.43–4.06) diploma (IRR = 2.06, 95% CI 1.21–3.48) and bachelor (IRR = 2.42, 95% CI 1.36–4.29) and there was a significant and inverse relationship with age (IRR = 0.98, 95%CI 0.98–0.99). There was a significant relationship between the number of traffic accidents in the past year with the level of bachelor’s degree (IRR = 3.10, 95% CI 1.43–6.76) and driving experience (IRR = 1.03, 95% CI 1.02–1.04 and inverse relationship between the number of traffic accidents in the past year and the QOL sense (IRR = 0.96, 95% CI 0.93–0.99) and the working hours (IRR = 0.96, 95% CI 0.94–0.99).

Conclusion

Legislators and policymakers should pay more attention to fatigue in single and inexperienced taxi drivers. Regarding the QOL, pay attention to drivers with high education and older. To reduce the number of crashes, pay more attention to drivers with a bachelor’s degree and less driving experience and improve the feeling of QOL.
The association between mammographic density and breast cancer risk in Chinese women: a systematic review and meta-analysis
Authors: Bai Song , Song Di , Chen Ming , Lai Xiaoshu , Xu Jinfeng , Dong Fajin
Published: February 2024

Purpose

Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women.

Methods

The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases.

Results

Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I.

Conclusions

For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.
A novel estimator for the two-way partial AUC
Authors: Chaibub Neto Elias , Yadav Vijay , Sieberts Solveig K. , Omberg Larsson
Published: February 2024

Background

The two-way partial AUC has been recently proposed as a way to directly quantify partial area under the ROC curve with simultaneous restrictions on the sensitivity and specificity ranges of diagnostic tests or classifiers. The metric, as originally implemented in the R package, is estimated using a nonparametric estimator based on a trimmed Mann-Whitney U-statistic, which becomes computationally expensive in large sample sizes. (Its computational complexity is of order$$O(n_x n_y)$$O(nxny), where$$n_x$$nxand$$n_y$$nyrepresent the number of positive and negative cases, respectively). This is problematic since the statistical methodology for comparing estimates generated from alternative diagnostic tests/classifiers relies on bootstrapping resampling and requires repeated computations of the estimator on a large number of bootstrap samples.

Methods

By leveraging the graphical and probabilistic representations of the AUC, partial AUCs, and two-way partial AUC, we derive a novel estimator for the two-way partial AUC, which can be directly computed from the output of any software able to compute AUC and partial AUCs. We implemented our estimator using the computationally efficient R package, which leverages a nonparametric approach using the trapezoidal rule for the computation of AUC and partial AUC scores. (Its computational complexity is of order$$O(n \log n)$$O(nlogn), where$$n = n_x + n_y$$n=nx+ny.). We compare the empirical bias and computation time of the proposed estimator against the original estimator provided in the package in a series of simulation studies and on two real datasets.

Results

Our estimator tended to be less biased than the original estimator based on the trimmed Mann-Whitney U-statistic across all experiments (and showed considerably less bias in the experiments based on small sample sizes). But, most importantly, because the computational complexity of the proposed estimator is of order$$O(n \log n)$$O(nlogn), rather than$$O(n_x n_y)$$O(nxny), it is much faster to compute when sample sizes are large.

Conclusions

The proposed estimator provides an improvement for the computation of two-way partial AUC, and allows the comparison of diagnostic tests/machine learning classifiers in large datasets where repeated computations of the original estimator on bootstrap samples become too expensive to compute.
The association between the AIP and undiagnosed diabetes in ACS patients with different body mass indexes and LDL-C levels: findings from the CCC-ACS project
Authors: Xu Shuwan , Liu Jun , Zhao Dong , Yang Na , Hao Yongchen , Zhou Yan , Zhu Dan , Cui Ming ,   the CCC Investigators
Published: February 2024

Background

The atherogenic index of plasma (AIP) has been demonstrated to be significantly associated with the incidence of prediabetes and diabetes. This study aimed to investigate the association between the AIP and undiagnosed diabetes in acute coronary syndrome (ACS) patients.

Methods

Among 113,650 ACS patients treated with coronary angiography at 240 hospitals in the Improving Care for Cardiovascular Disease in China-ACS Project from 2014 to 2019, 11,221 patients with available clinical and surgical information were included. We analyzed these patients’ clinical characteristics after stratification according to AIP tertiles, body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C) levels.

Results

The AIP was independently associated with a greater incidence of undiagnosed diabetes. The undiagnosed diabetes was significantly greater in the T3 group than in the T1 group after adjustment for confounders [T3 OR 1.533 (1.199–1.959) p < 0.001]. This relationship was consistent within normal weight patients and patients with an LDL-C level ≥ 1.8 mmol/L. In overweight and obese patients, the AIP was significantly associated with the incidence of undiagnosed diabetes as a continuous variable after adjustment for age, sex, and BMI but not as a categorical variable. The area under the receiver operating characteristic curve (AUC) of the AIP score, triglyceride (TG) concentration, and HDL-C concentration was 0.601 (0.581–0.622; p < 0.001), 0.624 (0.603–0.645; p < 0.001), and 0.493 (0.472–0.514; p = 0.524), respectively. A nonlinear association was found between the AIP and the incidence of undiagnosed diabetes in ACS patients (p for nonlinearity < 0.001), and this trend remained consistent between males and females. The AIP may be a negative biomarker associated with undiagnosed diabetes ranging from 0.176 to 0.738.

Conclusion

The AIP was significantly associated with the incidence of undiagnosed diabetes in ACS patients, especially in those with normal weight or an LDL-C level ≥ 1.8 mmol/L. A nonlinear relationship was found between the AIP and the incidence of undiagnosed diabetes, and this trend was consistent between male and female patients. The AIP may be a negative biomarker associated with undiagnosed diabetes and ranges from 0.176 to 0.738.
Incorporating an intersectional gender approach to improve access to maternal and child health screening services
Authors: Arrivillaga Margarita Rivera , Gold Marina , Rivera Elizabeth Pellecer , Juárez Jose Guillermo
Published: February 2024

Background

In the Americas, the Pan American Health Organization (PAHO) has promoted initiatives that aim at the elimination of mother-to-child transmitted diseases for over two decades. Although Guatemala has assumed the commitment to improve access and coverage of reproductive and perinatal services, the goals have not yet been reached. Often, the implementation of these efforts is hampered by complexities rooted in social, cultural, and environmental intersections. The objective of this work is to share our experience applying gender intersectionality as a methodological and analytical tool in a participatory research project that aims to improve access to maternal and child health screening services. The study shows the novel strategy that incorporates intersectionality contributing to evidence on how it can be applied to strengthen public health efforts around the implementation of the EMTCT Plus (Elimination of mother-to-child transmission of HIV, Syphilis, Hepatitis B, and Chagas disease) framework, in the mostly rural municipality of Comapa, in Guatemala.

Methods

We applied a participatory methodology, integrating theoretical and methodological frameworks to have an intersectional understanding of health services delivered by both, midwives, and the public health institution, for the prevention, diagnosis, treatment, and follow-up of HIV, Syphilis, Hepatitis B, and Chagas. The data was collected by conducting interviews, focus groups, workshops, and reviewing laboratory databases, guided by five strategies from a cultural appropriateness framework.

Results

The intersectional analysis shed light on the synergies and gaps of the current efforts and protocols implemented by both the midwives and the Ministry of Health. The services offered for the four diseases were often delivered independently from each other, and a comprehensive educational and communication material strategy was absent. However, our findings will be used to inform consistent, locally relevant, and culturally appropriate educational content for the local population, also following the national policy guidelines.

Conclusions

Using intersectionality as a method and as an analytical tool allowed us to understand the (1) interrelation of diverse social, cultural, and environmental determinants which influence the delivery of health services, as well as (2) the dynamics between the traditional and institutional health systems. (3) Community engagement and the participation of different stakeholders in a consultative process have been fundamental for the conceptual and methodological tenets of this research. (4) Finally, giving a more prominent role to midwives can strengthen sustainability and cultural appropriateness, which is complementary to the delivery of institutional health services.
Xylazine co-occurrence with illicit fentanyl is a growing threat in the Deep South: a retrospective study of decedent data
Authors: Bradford William , Figgatt Mary , Scott Karen S. , Marshall Stacy , Eaton Ellen F. , Dye Daniel W.
Published: February 2024

Background

Xylazine is a dangerous veterinary sedative found mainly in illicit fentanyl in the Northeast and Midwest. Its role in the Deep South overdose crisis is not well-characterized.

Methods

We conducted a retrospective review of autopsy data in Jefferson County, Alabama to identify trends in xylazine prevalence among people who fatally overdosed from June 2019 through June 2023.

Results

165 decedents met inclusion criteria. While the first identified xylazine-associated overdose was in June 2019, xylazine has become consistently prevalent since January 2021. All cases of xylazine-associated fatal overdoses were accompanied by fentanyl, and most (75.4%) involved poly-drug stimulant use. The average age was 42.2, and most decedents were white (58.8%) and male (68.5%). Overall, 18.2% of people were unhoused at the time of death.

Discussion

Xylazine is prevalent in the Deep South. Efforts to promote harm reduction, publicly viewable drug supply trends, and legalization of drug checking and syringe service programs should be prioritized.
“Superheroes? No, thanks.” Accepting vulnerability in healthcare professionals
Authors: Morera Dolores , Delgado Janet , Lorenzo Elena , de Castro-Peraza María Elisa , Delgado Naira
Published: February 2024

In this commentary, we develop a conceptual proposal aimed to explain why a discourse of praise and admiration for healthcare professionals´ limitless dedication can trigger a general indifference to the burnout and suffering they experience. Ultimately, this can lead to the justification of the lack of resources dedicated to preventing these problems. We first start by pointing out the stigmatisation of healthcare professionals suffering from burnout and showing their vulnerability, highlighting the complex interactions that occur in the healthcare context and that increase the risk of perpetuating their suffering. Then, we appeal to the recognition of one’s own vulnerability as a key element towards the creation of a culture more focused on the duty of care for those who care for others. We conclude with several proposals for action to cope with burnout-related stigma, trying to change the superhuman image of health personnel and incorporating the vulnerability inherent to human beings.
Characterizing hub biomarkers for post-transplant renal fibrosis and unveiling their immunological functions through RNA sequencing and advanced machine learning techniques
Authors: Niu Xinhao , Xu Cuidi , Cheuk Yin Celeste , Xu Xiaoqing , Liang Lifei , Zhang Pingbao , Rong Ruiming
Published: February 2024

Background

Kidney transplantation stands out as the most effective renal replacement therapy for patients grappling with end-stage renal disease. However, post-transplant renal fibrosis is a prevalent and irreversible consequence, imposing a substantial clinical burden. Unfortunately, the clinical landscape remains devoid of reliable biological markers for diagnosing post-transplant renal interstitial fibrosis.

Methods

We obtained transcriptome and single-cell sequencing datasets of patients with renal fibrosis from NCBI Gene Expression Omnibus (GEO). Subsequently, we employed Weighted Gene Co-Expression Network Analysis (WGCNA) to identify potential genes by integrating core modules and differential genes. Functional enrichment analysis was conducted to unveil the involvement of potential pathways. To identify key biomarkers for renal fibrosis, we utilized logistic analysis, a LASSO-based tenfold cross-validation approach, and gene topological analysis within Cytoscape. Furthermore, histological staining, Western blotting (WB), and quantitative PCR (qPCR) experiments were performed in a murine model of renal fibrosis to verify the identified hub genes. Moreover, molecular docking and molecular dynamics simulations were conducted to explore possible effective drugs.

Results

Through WGCNA, the intersection of core modules and differential genes yielded a compendium of 92 potential genes. Logistic analysis, LASSO-based tenfold cross-validation, and gene topological analysis within Cytoscape identified four core genes (CD3G, CORO1A, FCGR2A, and GZMH) associated with renal fibrosis. The expression of these core genes was confirmed through single-cell data analysis and validated using various machine learning methods. Wet experiments also verified the upregulation of these core genes in the murine model of renal fibrosis. A positive correlation was observed between the core genes and immune cells, suggesting their potential role in bolstering immune system activity. Moreover, four potentially effective small molecules (ZINC000003830276-Tessalon, ZINC000003944422-Norvir, ZINC000008214629-Nonoxynol-9, and ZINC000085537014-Cobicistat) were identified through molecular docking and molecular dynamics simulations.

Conclusion

Four potential hub biomarkers most associated with post-transplant renal fibrosis, as well as four potentially effective small molecules, were identified, providing valuable insights for studying the molecular mechanisms underlying post-transplant renal fibrosis and exploring new targets.
Ectopic colloid goiter in mediastinum with normal thyroid gland
Authors: Kolwalkar Jagannath , Samant Dattaprasad , Borkar Shirish , Vidyasagar M. Sunil Chandra , Vaggar Jagadeesh N.
Published: February 2024

Ectopic thyroid tissue is a rare developmental abnormality involving aberrant embryogenesis of the thyroid gland during passage from the primitive foregut to the pretracheal position. The most frequent position is the base of the tongue (lingual thyroid); however, it has been described in other sites, such as the submandibular region, trachea, mediastinum, and subdiaphragmatic regions.

Here, we report a case of an adenomatous goiter that developed in mediastinal thyroid tissue without any connection to the pretracheal thyroid gland.
16S rRNA sequencing analysis of the oral and fecal microbiota in colorectal cancer positives versus colorectal cancer negatives in Iranian population
Authors: Rezasoltani Sama , Azizmohammad Looha Mehdi , Asadzadeh Aghdaei Hamid , Jasemi Seyedesomayeh , Sechi Leonardo Antonio , Gazouli Maria , Sadeghi Amir , Torkashvand Shirin , Baniali Reyhaneh , Schlüter Hartmut , Zali Mohammad Reza , Feizabadi Mohammad Mehdi
Published: February 2024

Background

Colorectal cancer (CRC) poses a significant healthcare challenge, accounting for nearly 6.1% of global cancer cases. Early detection, facilitated by population screening utilizing innovative biomarkers, is pivotal for mitigating CRC incidence. This study aims to scrutinize the fecal and salivary microbiomes of CRC-positive individuals (CPs) in comparison to CRC-negative counterparts (CNs) to enhance early CRC diagnosis through microbial biomarkers.

Material and methods

A total of 80 oral and stool samples were collected from Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, encompassing both CPs and CNs undergoing screening. Microbial profiling was conducted using 16S rRNA sequencing assays, employing the Nextera XT Index Kit on an Illumina NovaSeq platform.

Results

Distinct microbial profiles were observed in saliva and stool samples of CPs, diverging significantly from those of CNs at various taxonomic levels, including phylum, family, and species. Saliva samples from CPs exhibited abundance of Calothrix parietina, Granulicatella adiacens, Rothia dentocariosa, and Rothia mucilaginosa, absent in CNs. Additionally, Lachnospiraceae and Prevotellaceae were markedly higher in CPs' feces, while the Fusobacteria phylum was significantly elevated in CPs' saliva. Conversely, the non-pathogenic bacterium Akkermansia muciniphila exhibited a significant decrease in CPs' fecal samples compared to CNs.

Conclusion

Through meticulous selection of saliva and stool microbes based on Mean Decrease GINI values and employing logistic regression for saliva and support vector machine models for stool, we successfully developed a microbiota test with heightened sensitivity and specificity for early CRC detection.
Free and open-source QSAR-ready workflow for automated standardization of chemical structures in support of QSAR modeling
Authors: Mansouri Kamel , Moreira-Filho José T. , Lowe Charles N. , Charest Nathaniel , Martin Todd , Tkachenko Valery , Judson Richard , Conway Mike , Kleinstreuer Nicole C. , Williams Antony J.
Published: February 2024

The rapid increase of publicly available chemical structures and associated experimental data presents a valuable opportunity to build robust QSAR models for applications in different fields. However, the common concern is the quality of both the chemical structure information and associated experimental data. This is especially true when those data are collected from multiple sources as chemical substance mappings can contain many duplicate structures and molecular inconsistencies. Such issues can impact the resulting molecular descriptors and their mappings to experimental data and, subsequently, the quality of the derived models in terms of accuracy, repeatability, and reliability. Herein we describe the development of an automated workflow to standardize chemical structures according to a set of standard rules and generate two and/or three-dimensional “QSAR-ready” forms prior to the calculation of molecular descriptors. The workflow was designed in the KNIME workflow environment and consists of three high-level steps. First, a structure encoding is read, and then the resulting in-memory representation is cross-referenced with any existing identifiers for consistency. Finally, the structure is standardized using a series of operations including desalting, stripping of stereochemistry (for two-dimensional structures), standardization of tautomers and nitro groups, valence correction, neutralization when possible, and then removal of duplicates. This workflow was initially developed to support collaborative modeling QSAR projects to ensure consistency of the results from the different participants. It was then updated and generalized for other modeling applications. This included modification of the “QSAR-ready” workflow to generate “MS-ready structures” to support the generation of substance mappings and searches for software applications related to non-targeted analysis mass spectrometry. Both QSAR and MS-ready workflows are freely available in KNIME, via standalone versions on GitHub, and as docker container resources for the scientific community. Scientific contribution: This work pioneers an automated workflow in KNIME, systematically standardizing chemical structures to ensure their readiness for QSAR modeling and broader scientific applications. By addressing data quality concerns through desalting, stereochemistry stripping, and normalization, it optimizes molecular descriptors' accuracy and reliability. The freely available resources in KNIME, GitHub, and docker containers democratize access, benefiting collaborative research and advancing diverse modeling endeavors in chemistry and mass spectrometry.
Hybrid cubic and hyperbolic b-spline collocation methods for solving fractional Painlevé and Bagley-Torvik equations in the Conformable, Caputo and Caputo-Fabrizio fractional derivatives
Authors: Barzehkar Nahid , Jalilian Reza , Barati Ali
Published: February 2024

In this paper, we approximate the solution of fractional Painlevé and Bagley-Torvik equations in the Conformable (Co), Caputo (C), and Caputo-Fabrizio (CF) fractional derivatives using hybrid hyperbolic and cubic B-spline collocation methods, which is an extension of the third-degree B-spline function with more smoothness. The hybrid B-spline function is flexible and produces a system of band matrices that can be solved with little computational effort. In this method, three parameters m, η, and λ play an important role in producing accurate results. The proposed methods reduce to the system of linear or nonlinear algebraic equations. The stability and convergence analysis of the methods have been discussed. The numerical examples are presented to illustrate the applications of the methods and compare the computed results with those obtained using other methods.
Integrated meta-omics reveals the regulatory landscape involved in lipid metabolism between pig breeds
Authors: Sun Jiajie , Xie Fang , Wang Jing , Luo Junyi , Chen Ting , Jiang Qingyan , Xi Qianyun , Liu George E. , Zhang Yongliang
Published: February 2024

Background

Domesticated pigs serve as an ideal animal model for biomedical research and also provide the majority of meat for human consumption in China. Porcine intramuscular fat content associates with human health and diseases and is essential in pork quality. The molecular mechanisms controlling lipid metabolism and intramuscular fat accretion across tissues in pigs, and how these changes in response to pig breeds, remain largely unknown.

Results

We surveyed the tissue-resident cell types of the porcine jejunum, colon, liver, and longissimus dorsi muscle between Lantang and Landrace breeds by single-cell RNA sequencing. Combining lipidomics and metagenomics approaches, we also characterized gene signatures and determined key discriminating markers of lipid digestibility, absorption, conversion, and deposition across tissues in two pig breeds. In Landrace, lean-meat swine mainly exhibited breed-specific advantages in lipid absorption and oxidation for energy supply in small and large intestinal epitheliums, nascent high-density lipoprotein synthesis for reverse cholesterol transport in enterocytes and hepatocytes, bile acid formation, and secretion for fat emulsification in hepatocytes, as well as intestinal-microbiota gene expression involved in lipid accumulation product. In Lantang, obese-meat swine showed a higher synthesis capacity of chylomicrons responsible for high serum triacylglycerol levels in small intestinal epitheliums, the predominant characteristics of lipid absorption in muscle tissue, and greater intramuscular adipcytogenesis potentials from muscular fibro-adipogenic progenitor subpopulation.

Conclusions

The findings enhanced our understanding of the cellular biology of lipid metabolism and opened new avenues to improve animal production and human diseases.
CT whole lung radiomic nomogram: a potential biomarker for lung function evaluation and identification of COPD
Authors: Zhou Tao-Hu , Zhou Xiu-Xiu , Ni Jiong , Ma Yan-Qing , Xu Fang-Yi , Fan Bing , Guan Yu , Jiang Xin-Ang , Lin Xiao-Qing , Li Jie , Xia Yi , Wang Xiang , Wang Yun , Huang Wen-Jun , Tu Wen-Ting , Dong Peng , Li Zhao-Bin , Liu Shi-Yuan , Fan Li
Published: February 2024

Background

Computed tomography (CT) plays a great role in characterizing and quantifying changes in lung structure and function of chronic obstructive pulmonary disease (COPD). This study aimed to explore the performance of CT-based whole lung radiomic in discriminating COPD patients and non-COPD patients.

Methods

This retrospective study was performed on 2785 patients who underwent pulmonary function examination in 5 hospitals and were divided into non-COPD group and COPD group. The radiomic features of the whole lung volume were extracted. Least absolute shrinkage and selection operator (LASSO) logistic regression was applied for feature selection and radiomic signature construction. A radiomic nomogram was established by combining the radiomic score and clinical factors. Receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were used to evaluate the predictive performance of the radiomic nomogram in the training, internal validation, and independent external validation cohorts.

Results

Eighteen radiomic features were collected from the whole lung volume to construct a radiomic model. The area under the curve (AUC) of the radiomic model in the training, internal, and independent external validation cohorts were 0.888 [95% confidence interval (CI) 0.869–0.906], 0.874 (95%CI 0.844–0.904) and 0.846 (95%CI 0.822–0.870), respectively. All were higher than the clinical model (AUC were 0.732, 0.714, and 0.777, respectively, P < 0.001). DCA demonstrated that the nomogram constructed by combining radiomic score, age, sex, height, and smoking status was superior to the clinical factor model.

Conclusions

The intuitive nomogram constructed by CT-based whole-lung radiomic has shown good performance and high accuracy in identifying COPD in this multicenter study.
A smartphone application to reduce problematic drinking: a feasibility trial
Authors: Lukas Christian Aljoscha , Blechert Jens , Berking Matthias
Published: February 2024

Background

Problematic drinking is common among college students and associated with various somatic and mental health problems. Given significant evidence for the efficacy of smartphone-based interventions and the frequent use of smartphones among college students, it can be assumed that such interventions have great potential to facilitate access to evidence-based interventions for students suffering from problematic drinking. Thus, we developed a brief intervention that combined a counseling session with an app that utilizes approach-avoidance modification training to reduce alcohol consumption.

Methods

To test the feasibility and explore the potential efficacy of the intervention, we conducted a before-after single-arm study with N = 11 participants reportedly engaging in problematic drinking, who were instructed to practice with the app for 14 days. Feasibility was assessed with the System Usability Scale (SUS). Outcomes included the reduction of self-reported problematic drinking behavior, dysfunctional attitudes about alcohol, and craving, as well as implicit associations between alcohol and self during the training period. Additionally, self-reported problematic drinking behavior was assessed at a 4-week follow-up.

Results

On average, participants rated app usability on the SUS (possible range: 0 to 100) with M = 84.32 (SD = 6.53). With regard to efficacy, participants reported a significant reduction of problematic drinking behavior (dpre vs. post = 0.91) which was sustained at follow-up (dfollow-up vs. baseline = 1.07). Additionally, participants reported a significant reduction of dysfunctional attitudes about alcohol (dpre vs. post = 1.48). Results revealed no significant changes in craving nor in implicit associations regarding alcohol.

Conclusions

Findings from this feasibility study provide preliminary evidence that smartphone-based interventions might help reduce problematic drinking in college students. Further research needs to replicate these findings with larger samples in randomized controlled trials.

Trial registration

DRKS00014675 (retrospectively registered).
Study on deep learning-based detection of viable cell count in dialysis fluid images
Authors: Kawasaki Michihiro , Shimozawa Toshiki , Suzuki Satoshi
Published: February 2024

Background and aims

Control of dialysate fluid quality is critical to secure the safety of dialysis treatment. The number of colonies is manually counted when determining viable cell count in dialysis fluid, but errors and subjective interpretation on the part of the measurer can be problematic. This prompted us to examine the potential for using deep learning to detect viable cells and count their numbers.

Methods

In this study we prepared 5360 images for detecting viable cell count and classified them into four categories using the VGG-16 model. These images were resized to 224 × 224 px; 90% of them were used for learning, and 10% were used for validation. In an alternative approach, we also created 110 annotated images from images to detect viable cell count in dialysis fluid and subjected them to learning using the YOLOv5 model.

Results

VGG-model had a detection accuracy using the test data was 43%. YOLOv5 model had a mAP (Mean Average Precision) was 0.842. The detection accuracy using the test data was 90%.

Conclusions

The method using the VGG-16 model had problems with overfitting, suggesting that the model was not sufficiently expressive. The detection of viable cells using the YOLOv5 model showed high accuracy.
How patients with insomnia interpret and respond to the consensus sleep diary: a cognitive interview study
Authors: Bini Christina , Hjelm Carina , Hellström Amanda , Årestedt Kristofer , Broström Anders , Sandlund Christina
Published: February 2024

Objective/Background

The Consensus Sleep Diary (CSD) is widely used to assess subjective sleep. Psychometric evaluations and focus-groups support its validity and clinical usefulness, but further research into its validity is needed. The aim of the study was to evaluate a Swedish translation of the CSD regarding test content and response processes in patients with insomnia.

Patients/Methods

In connection with translating the CSD into Swedish, we used cognitive interviewing to evaluate test content and the response process, that is, how people make decisions when responding to survey items. Cognitive interviews were conducted with 13 primary health care patients with insomnia disorder (mean age, 49 years; SD 15.5). Iterative, reparative analysis was used to investigate test content. Descriptive deductive analysis was used to investigate interview transcripts for the themes of the cognitive model: comprehension, retrieval, decision process, and judgement. Together, the themes explain the response process when responding to a patient-reported outcome measure.

Results

The overall comprehension of the CSD could be affected by poor adherence to the instructions (comprehension). Patients had difficulty with recall if they did not complete the diary immediately in the morning and just before bedtime (retrieval). They could have problems deciding how to respond to certain items because they imbued sleep-related concepts with extra meaning (decision process), and had trouble finding response alternatives nuanced enough to describe their experience of sleep and tiredness (judgement).

Conclusions

This study contributes knowledge on how the instrument is perceived and used by care-seeking patients with insomnia. In this context, the CSD exhibits known flaws such as memory lapses if the diary is not filled in directly in the morning. To increase the accuracy of patients’ responses, therapists should support patients in reading the instructions.
New-onset seizures misdiagnosed as psychogenic non-epileptic seizures: a case of paraneoplastic limbic encephalitis with primary testicular cancer
Authors: Rivas Axel , Levine Daniel , Nichols Cory , Merritt Mckenzie , Janda Paul , Vickers Aroucha
Published: February 2024

Background

Behavioral psychiatric symptoms can be the only warning signs of more serious conditions such as paraneoplastic limbic encephalitis. Differentiating between primary psychiatric disorders and paraneoplastic neurological syndromes is crucial as they require distinct treatment approaches. In this case report, we provide an overview of paraneoplastic encephalitis and introduce a unique case that showcases a misdiagnosis of psychogenic non-epileptic seizures (PNES) in a male as the primary symptom of paraneoplastic encephalitis due to pure seminoma. This case highlights the underlying pathophysiology of antibody-mediated paraneoplastic encephalitis and its significance.

Case presentation

A 31-year-old male with no known past medical history presented due to recurrent seizures. There was no prior history of epilepsy or exposure to seizure-triggering agents. Imaging and electroencephalogram findings during his initial hospitalizations pointed to a potential diagnosis of PNES. The patient continued to experience seizures following discharge, leading to repeat hospitalizations. During the fourth hospitalization, the patient received mood-stabilizing anti-seizure medications and benzodiazepines, but he deteriorated and required intubation. It was during this time that the patient was transferred to our facility. Magnetic resonance imaging of the brain revealed multifocal areas of hyperintensity and restricted diffusion with avid enhancement. Immunotherapy was initiated with improvement of non-epileptic spells and encephalopathy. Outpatient workup uncovered malignant pure seminoma with metastases to the retroperitoneum. The authors theorize that paraneoplastic neurological disorders stemming from testicular cancer led to the neurological symptoms seen in this case.

Conclusion

This report highlights a rare occurrence of paraneoplastic limbic encephalitis associated with pure testicular seminoma, clinically manifested as PNES. The diagnostic challenge posed by variability of presenting symptoms in paraneoplastic encephalitis emphasizes the importance of accurate differentiation from conditions such as autoimmune encephalitis. Current diagnostic approaches for paraneoplastic and autoimmune etiologies involve detection of known antibodies, as well as brain imaging. Notable antibodies associated with psychogenic non-epileptic seizures symptoms include anti-GAD-65, anti-Ma2, KLH11-antibodies, anti-Hu, and NMDA receptor antibodies. Recognizing paraneoplastic limbic encephalitis symptoms is challenging and often leads to misdiagnosis or overlooking of malignancies highlighting the need for awareness, comprehensive evaluation and timely treatment. Through this comprehensive case analysis, we enhance the understanding of underlying mechanisms, associated symptoms, and treatment options.
GhWDL3 is involved in the formation and development of fiber cell morphology in upland cotton (Gossypium hirsutum L.)
Authors: Chen Baojun , Tian Zailong , Fu Guoyong , Zhang Ai , Sun Yaru , Wang Jingjing , Pan Zhaoe , Li Hongge , Hu Daowu , Xia Yingying , He Shoupu , Du Xiongming
Published: February 2024

Background

Cotton fiber is a model tissue for studying microtubule-associated proteins (MAPs). The Xklp2 (TPX2) proteins that belong to the novel MAPs member mainly participate in the formation and development of microtubule (MT). However, there is a lack of studies concerning the systematic characterization of the TPX2 genes family in cotton. Therefore, the identification and portrayal of G. hirsutum TPX2 genes can provide key targets for molecular manipulation in the breeding of cotton fiber improvement.

Result

In this study, TPX2 family genes were classified into two distinct subclasses TPXLs and MAP genes WAVE DAMPENED2-LIKE (WDLs) and quite conservative in quantity. GhWDL3 was significantly up-regulated in 15 days post anthesis fibers of ZRI-015 (an upland cotton with longer and stronger fiber). GhWDL3 promotes all stem hairs to become straight when overexpressed in Arabidopsis, which may indirectly regulate cotton fiber cell morphology during fiber development. Virus induced gene silencing (VIGS) results showed that GhWDL3 inhibited fiber cell elongation at fiber development periods through regulating the expression of cell wall related genes.

Conclusion

These results reveal that GhWDL3 regulated cotton fiber cell elongation and provide crucial information for the further investigation in the regulatory mechanisms/networks of cotton fiber length.
Egyptian evidence-based consensus on clinical practice recommendations for the management of systemic sclerosis
Authors: El Miedany Yasser , El Hadidi Khaled , El Menyawi Manal Mohamed , El Gaafary Maha , Abdel-Nasser Ahmed , Abdel Azim Atef , Hassan Waleed , Mortada Mohamed , Tabra Samar Abd Alhamed , Saber Sally , Amer Ibrahim , Shaker Engi Seif E. , Maria Dina , Abu-Zaid Mohamed Hassan
Published: February 2024

Background

This work aims to develop clinical practice recommendations for the management of systemic sclerosis (SSc).

Results

Fourteen expert panels had completed the two rounds of surveys. After the end of round 2, recommendations were released and distributed on 11 domains. The percentage of the agreement on the recommendations was 92.3% to 100%. All 11 key questions were answered at the end of the second round with agreement.

Conclusion

This guideline tried to tackle the gaps in research that limit treatment options. Stratifying the patients according to their disease domains has helped to set up sequential management pathways for each domain.
Study of serum Ykl-40 level and its relationship to BODE index in patients with chronic obstructive pulmonary disease
Authors: Farrag Aya Elsayed , Elganady Anwar Ahmed , Mohammed Enas Elsaid , ElHadidi Abeer Shawky , Eshmawey Heba Ahmed
Published: February 2024

Background

Chronic obstructive pulmonary disease (COPD) is a significant global health concern characterized by growing rates of mortality and morbidity. The purpose of this work was to evaluate the serum YKL-40 level and its relationship to body mass index (BMI), obstruction of airflow, dyspnea, exercise capacity (BODE) index, and the extent of COPD.

Methods

This prospective work was carried out on 70 adult male patients, allocated into three groups: group A—36 smokers with stable COPD with different degrees of severity; group B—19 smokers without COPD; and group C—15 healthy non-smokers as a control group.

Results

The BODE index was 5.56 ± 2.52. Prebronchodilator forced expiratory volume in 1 s (FEV1) and FVC were substantially decreased in group A contrasted to group B and group C (P value < 0.001). Prebronchodilator forced expiratory volume in 1/forced vital capacity (FEV1/FVC) ratio was substantially decreased in group A contrasted to groups B and C and lower in group B than in group C (P value < 0.001).

Chest X-ray (CXR) signs of COPD and mMRC Dyspnea Scale were significantly higher in group A than in groups B and C (P value < 0.001). The 6-min walking test was substantially decreased in group A than in groups B and C and lower in group B than in group C (P value < 0.001 and 0.006 correspondingly). Serum YKL-40 was substantially greater in group A contrasted to group C (P value = 0.005). There was no correlation between serum YKL-40 and (BODE index, O2 saturation, or smoking index) in group A. A substantial positive association existed among serum YKL-40 and [degree of severity and white blood cells (WBCs)] in group A. Serum YKL-40 cannot predict the severity of COPD (P = 0.227 and AUC = 0.584) at cut-off > 0.394 with 80.65% sensitivity, 41.03% specificity, 52.1% PPV, and 72.7% NPV.

Conclusions

Serum YKL-40 level was substantially greater in the COPD group contrasted to healthy non-smokers, no substantial association existed between serumYKL-40 and BODE index, O2 saturation, or smoking index. A substantial positive association existed between SerumYKL-40 and the degree of severity and WBCs.
Performance of Aldosterone-to-renin Ratio Before Washout of Antihypertensive Drugs in Screening of Primary Aldosteronism
Authors: Liu Xinyu , Hao Sufang , Bian Jin , Lou Ying , Zhang Huimin , Wu Haiying , Cai Jun , Ma Wenjun
Published: February 2024

Objective

The aim of this study is to evaluate performance of aldosterone-to-renin ratio (ARR) before washout of antihypertensive drugs as a screening test for primary aldosteronism (PA).

Methods

This retrospective analysis included consecutive patients screening for secondary hypertension during a period from January 2017 to May 2022 at the authors’ institute. For inclusion in the final analysis, ARR had to be available prior to as well as after discontinuation of antihypertensives. Patients with ARR ≥2.4(ng/dL)/(μIU/mL) after washout proceeded to confirmatory tests. Diagnosis of PA was established based on a positive result of the confirmatory test. The diagnostic accuracy of ARR prior to the washout in predicting PA is shown as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results

The analysis included a total of 1306 patients [median age of 50.2 (41.0-59.0) years, 64.0% male]. Confirmatory tests showed PA in 215(16.5%) patients and essential hypertension (EH) in the remaining 1091(83.5%) patients. In comparison to the second screening test, the first screening test (before washout of antihypertensives) yielded lower plasma aldosterone and higher renin and consequently lower ARR in both the PA and EH groups. At a cutoff of .7(ng/dL)/(μIU/mL), ARR before washout had 96.3% sensitivity, 61.2% specificity, .33 PPV, and .99 NPV. At a lower cutoff of .5(ng/dL)/(μIU/mL), the sensitivity, specificity, PPV, and NPV were 97.7%, 52.0%, .29, and .99, respectively.

Conclusion

ARR prior to washout of antihypertensives is a sensitive screening test for PA. Washout of antihypertensives could be omitted and further investigation for PA is not warranted if ARR is ≤ .7(ng/dL)/(μIU/mL) before washout.