bluuebunny/crossref_metadata_2025 huggingface dataset:
One-Bag 8-Step Ferric Carboxymaltose Desensitization Protocol for Patients with a History of Hypersensitivity Reactions to Iron Preparations
Authors: Özden Şeyma , Tepetam Fatma Merve , Atik Özge
Published: January 2024

Introduction: Iron deficiency is the most common cause of anemia in both sexes, although it is more common in women. Intravenous (IV) iron replacement is preferred in patients who cannot tolerate oral treatment or when iron stores need to be replenished rapidly. In this study, we wanted to share the ferric carboxymaltose (FCM) desensitization protocol that we self-created and successfully applied. Methods: This retrospective cross-sectional study included patients with a history of hypersensitivity reactions (HSRs) to IV or oral iron replacement and patients who were planned to receive IV iron replacement but were referred to the allergy clinic because of have risk factors (atopic diseases, history of HSR to other drugs, high serum tryptase levels, etc.) for HSRs. Before desensitization, some of the patients underwent skin tests (skin prick test and intradermal test) with FCM, and the results were recorded. Skin tests were not performed in patients with a history of drug use (antihistamine, systemic steroid, omalizumab, etc.) that affected the results of skin tests. All patients underwent a one-bag 8-step desensitization protocol with 500 mg FCM and were observed for 2 h after desensitization. Results: A total of 15 patients (14 females and 1 male) with a mean age of 41.13 ± 11.18 years were included in the study. When the patients were evaluated in terms of the risk of allergic reactions according to their clinical history, 8 patients had a history of anaphylaxis with iron preparations (FCM, n = 4; ferric hydroxide sucrose, n = 2; iron [II] glycine sulfate, n = 1; and iron [III] hydroxide polymaltose, n = 1), and 7 patients had a history of HSR other than anaphylaxis with iron preparations (urticaria, n = 6 [FCM, n = 2; iron (II) glycine sulfate, n = 2; and iron (III) hydroxide polymaltose, n = 2] and urticaria + angioedema [ferric hydroxide sucrose, n = 1]). Desensitization was successfully completed in all patients. No HSR was observed during or after the procedure in any of the patients. Conclusion: IV iron replacement is a very effective method, especially in cases where iron stores need to be replenished more rapidly. In patients with a history of iron HSR or at risk of developing HSR, replacement can be safely performed without an allergic reaction with successful desensitization protocols.
One-Day Peer-Delivered Cognitive Behavioral Therapy-Based Workshops for Postpartum Depression: A Randomized Controlled Trial
Authors: Babiy Zoryana , Layton Haley , Savoy Calan D. , Xie Feng , Brown June S.L. , Bieling Peter J. , Streiner David L. , Ferro Mark A. , Van Lieshout Ryan J.
Published: January 2024

Introduction: Myriad treatment barriers prevent birthing parents with postpartum depression (PPD) from receiving timely treatment. We aimed to determine whether a peer-delivered online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual (TAU) improves PPD and its comorbidities and is more cost-effective than TAU alone. Methods: This parallel-group, randomized controlled trial took place in Ontario, Canada (June 7, 2021, to February 18, 2022). Participants were ≥18 years old, had an infant ≤12 months old, and an Edinburgh Postnatal Depression Scale (EPDS) score ≥10. Participants were allocated to receive the workshop plus TAU (n = 202) or TAU and waitlisted to complete the workshop 12 weeks later (n = 203). The primary outcome was change in PPD (EPDS score) from enrollment to 12 weeks later. The secondary outcome was cost-effectiveness and tertiary outcomes included anxiety, social support, partner relationship quality, the mother-infant relationship, parenting stress, and infant temperament. Results: Participants had a mean age of 32.3 years (SD = 4.30) and 65% were White. The workshop led to a significant reduction in EPDS scores (15.95–11.37; d = 0.92, p < 0. 01) and was associated with higher odds of exhibiting a clinically significant decrease in EPDS scores (OR = 2.03; 95% CI: 1.26–3.29). The workshop plus TAU was more cost-effective than TAU alone. It also led to improvements in postpartum anxiety, infant-focused anxiety, parenting stress, and infant temperament. Conclusions: Peer-delivered 1-day CBT-based workshops can improve PPD and are a potentially scalable low-intensity treatment that could help increase treatment access.
Profibrotic VEGFR3-Dependent Lymphatic Vessel Growth in Autoimmune Valvular Carditis
Authors: Osinski Victoria , Yellamilli Amritha , Firulyova Maria M. , Zhang Michael J. , Peck Alyssa L. , Auger Jennifer L. , Faragher Jessica L. , Marath Aubyn , Voeller Rochus K. , O’Connell Timothy D. , Zaitsev Konstantin , Binstadt Bryce A.
Published: January 2024

BACKGROUND:

Rheumatic heart disease is the major cause of valvular heart disease in developing nations. Endothelial cells (ECs) are considered crucial contributors to rheumatic heart disease, but greater insight into their roles in disease progression is needed.

METHODS:

We used a
Cdh5
-driven EC lineage-tracing approach to identify and track ECs in the K/B.g7 model of autoimmune valvular carditis. Single-cell RNA sequencing was used to characterize the EC populations in control and inflamed mitral valves. Immunostaining and conventional histology were used to evaluate lineage tracing and validate single-cell RNA-sequencing findings. The effects of VEGFR3 (vascular endothelial growth factor receptor 3) and VEGF-C (vascular endothelial growth factor C) inhibitors were tested in vivo. The functional impact of mitral valve disease in the K/B.g7 mouse was evaluated using echocardiography. Finally, to translate our findings, we analyzed valves from human patients with rheumatic heart disease undergoing mitral valve replacements.

RESULTS:

Lineage tracing in K/B.g7 mice revealed new capillary lymphatic vessels arising from valve surface ECs during the progression of disease in K/B.g7 mice. Unsupervised clustering of mitral valve single-cell RNA-sequencing data revealed novel lymphatic valve ECs that express a transcriptional profile distinct from other valve EC populations including the recently identified PROX1 (Prospero homeobox protein 1)+ lymphatic valve ECs. During disease progression, these newly identified lymphatic valve ECs expand and upregulate a profibrotic transcriptional profile. Inhibiting VEGFR3 through multiple approaches prevented expansion of this mitral valve lymphatic network. Echocardiography demonstrated that K/B.g7 mice have left ventricular dysfunction and mitral valve stenosis. Valve lymphatic density increased with age in K/B.g7 mice and correlated with worsened ventricular dysfunction. Importantly, human rheumatic valves contained similar lymphatics in greater numbers than nonrheumatic controls.

CONCLUSIONS:

These studies reveal a novel mode of inflammation-associated, VEGFR3-dependent postnatal lymphangiogenesis in murine autoimmune valvular carditis, with similarities to human rheumatic heart disease.
Association of Mean Upper Cervical Spinal Cord Cross-Sectional Area With Cerebral Small Vessel Disease: A Community-Based Cohort Study
Authors: Meng Yufei , Wang Suying , Zhu Wanlin , Wang Tingting , Liu Dandan , Wang Mengxing , Pi Jingtao , Liu Yaou , Zhuo Zhizheng , Pan Yuesong , Wang Yilong
Published: January 2024

BACKGROUND:

The purpose of this study was to investigate the association between the mean upper cervical spinal cord cross-sectional area (MUCCA) and the risk and severity of cerebral small vessel disease (CSVD).

METHODS:

Community-dwelling residents in Lishui City, China, from the cross-sectional survey in the PRECISE cohort study (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) conducted from 2017 to 2019. We included 1644 of 3067 community-dwelling adults in the PRECISE study after excluding those with incorrect, incomplete, insufficient, or missing clinical or imaging data. Total and modified total CSVD scores, as well as magnetic resonance imaging features, including white matter hyperintensity, lacunes, cerebral microbleeds, enlarged perivascular spaces, and brain atrophy, were assessed at the baseline. The Spinal Cord Toolbox was used to measure the upper cervical spinal cord cross-sectional area of the C1 to C3 segments of the spinal cord and its average value was taken as MUCCA. Participants were divided into 4 groups according to quartiles of MUCCA. Associations were analyzed using linear regression models adjusted for age, sex, current smoking and drinking, medical history, intracranial volume, and total cortical volume.

RESULTS:

The means±SD age of the participants was 61.4±6.5 years, and 635 of 1644 participants (38.6%) were men. The MUCCA was smaller in patients with CSVD than those without CSVD. Using the total CSVD score as a criterion, the MUCCA was 61.78±6.12 cm
2
in 504 of 1644 participants with CSVD and 62.74±5.94 cm
2
in 1140 of 1644 participants without CSVD. Using the modified total CSVD score, the MUCCA was 61.81±6.04 cm
2
in 699 of 1644 participants with CSVD and 62.91±5.94 cm
2
in 945 of 1644 without CSVD. There were statistical differences between the 2 groups after adjusting for covariates in 3 models. The MUCCA was negatively associated with the total and modified total CSVD scores (adjusted β value, −0.009 [95% CI, −0.01 to −0.003] and −0.007 [95% CI, −0.01 to −0.0006]) after adjustment for covariates. Furthermore, the MUCCA was negatively associated with the white matter hyperintensity burden (adjusted β value, −0.01 [95% CI, −0.02 to −0.003]), enlarged perivascular spaces in the basal ganglia (adjusted β value, −0.005 [95% CI, −0.009 to −0.001]), lacunes (adjusted β value, −0.004 [95% CI, −0.007 to −0.0007]), and brain atrophy (adjusted β value, −0.009 [95% CI, −0.01 to −0.004]).

CONCLUSIONS:

The MUCCA and CSVD were correlated. Spinal cord atrophy may serve as an imaging marker for CSVD; thus, small vessel disease may involve the spinal cord in addition to being intracranial.
Disentangling the neural correlates of semantic and domain-general control: The roles of stimulus domain and task process
Authors: Hodgson Victoria J. , Ralph Matthew A. Lambon , Jackson Rebecca L.
Published: January 2024

Control processes are critical for the context-appropriate use of meaningful stimuli. Similar definitions have been adopted in two distinct literatures focusing on identifying the neural correlates of “semantic control” and of executive control across domains (the “multiple demand network”). Surprisingly, despite their proposed functions varying only in relation to domain-specificity, these networks appear to differ anatomically. However, prior comparisons are confounded by variations in task design. To what extent might varying task requirements drive differences in activation patterns that are typically attributed to stimulus domain? Here, for the first time, we use functional MRI to disentangle the effects of task process and stimulus domain during cognitively demanding tasks. Participants performed an odd-one-out task requiring rule-switching, inhibition and selection processes, and an n-back working memory task, each with meaningful semantic and non-semantic stimuli, in a factorial design. Both stimulus domain and task process affected the control regions activated, indicating that task process is indeed a key factor confounding prior studies. However, core semantic control regions (left inferior frontal gyrus, left posterior temporal cortex) also showed a preference for semantic stimuli even with matched task processes, while more peripheral semantic control regions, overlapping the multiple demand network (dorsomedial prefrontal cortex, right inferior frontal gyrus), showed little preference across task or stimulus. Conversely, most multiple demand network regions were preferentially engaged for non-semantic stimuli. These results highlight the mutual importance of stimulus domain and task process in driving variation in control region engagement, both across and between semantic control and multiple demand networks.
Allah, God, YHWH, Gott*: Language-Aware Perspectives on References to God in Religious and Worldview Education. A Comparative Study of Finnish and German School Textbooks
Authors: Putkonen Niina , Tacke Lena
Published: January 2024

Language awareness is part of religious and worldview education. In this study, we understand religious and worldview education as language-sensitive and argue that it is necessary to investigate the perspectives on religious language in language-aware school pedagogy. In our view, religious language can be an identity marker which navigates and reflects one’s position. We analysed the language used in Finnish and German secondary school textbooks for the Lutheran religion, the Roman Catholic religion and for Islam as well as for the subject culture, worldview and ethics (Finland) and practical philosophy (Germany). Using discourse analysis, we examined the representations of God in the textbooks’ chapters about Judaism, Christianity and Islam, which are characterized as monotheistic religions. According to the findings in this study, representations of God in the textbooks refer to the self-understanding of the studied religion in RE. This study also shows that the use of the name of God in textbooks illustrates similarities and differences in Abrahamic religions. We argue that inter-worldview learning in the context of religious and worldview education enables participation, dialogue and encounter, and that language awareness is part of inter-worldview learning.
Collating and Interpreting the Medical Bamboo Slips Excavated from the Han Tombs in Tianhui Town
Authors: Gu Man
Published: January 2024

In July 2012 through August 2013, four earthen shaft pit tombs with timber chambers were excavated in a cemetery located in Tianhui Town, Jinniu District, Chengdu City. The tombs, which had been looted, were of similar size and aligned in the same south–north orientation. Tomb M3 contained 951 bamboo slips distributed across two compartments of its lower chambers: North II and South II. Most of the texts they contain are of medical interest, though twenty fragments appear to be from legal documents. Based on the content of the discovered slips, it has been suggested that the tomb’s occupant was a physician or medical official. Six of the M3–121 manuscripts found in North II concern medical theory, the causes and symptoms of disease, the nature of the channels of the body (mai 脈), diagnosis, acupuncture, and possibly moxibustion therapy. The dates the texts were transcribed fall within the period when Empress Lü 呂后 (187–181 BCE) was effectively in power and the reign of Emperor Wendi (r. 180–157 BCE) of the Western Han dynasty. The M3–137 manuscripts found in South II include two texts entitled the Book of Treating Horses and the Book of the Classic Channels. The dates the texts were copied were earlier than those assigned to the M3–121 manuscripts.
Investigating the Clan Affiliations of the Occupants of the Laoguanshan 老官山 Han Tombs in Chengdu
Authors: Xie Tao , Yang Dolly
Published: January 2024

Inscriptions on funerary objects excavated from the Han tombs of Laoguanshan in Chengdu are key to unraveling the identities of the tombs’ occupants. Our analysis of these inscriptions, considered alongside the varying configurations of the tombs, the excavated objects, the earliest dates when the tombs were ransacked, and the physical characteristics revealed by the bones of the tomb occupants, together suggest that they were aristocrats from different regions. They were “out of state” officials who had immigrated to Chengdu. Identifying their clan affiliations provides an important clue for determining the clan affiliations of occupants of other high-specification tombs found in the Chengdu plain.
Practitioner Responses to the Tianhui Laoguanshan Medical Manuscripts and Artifacts
Authors: Neal Edward , He George
Published: January 2024

In the process of editing this special double issue of Asian Medicine we were keen to print the responses of practitioners of Chinese medicine currently still in practice. We therefore sent colleagues the article by Gu Man, Zhou Qi, and Liu Changhua, “Techniques for Piercing the Mai Recorded in the Laoguanshan Han Tomb Bamboo Slips” and the article by Zhou Qi, “Research on the Lacquered Channel Figurine Excavated from a Han Tomb in Tianhui” while they were in preparation. We are very grateful to Edward Neal and George He for their generous responses. —Eds.
Preliminary Report on the Tianhui Bamboo Manuscript Methods of Decoctions with Blended Formulas to Treat Sixty Ailments
Authors: Luo Qiong , Gu Man , Liu Changhua , Yang Dolly
Published: January 2024

Among the medical manuscripts excavated in 2012–13 from the Han tombs at Tianhui Township in Sichuan Province is a collection of recipes for treating sixty ailments. Under each ailment heading are one or more recipes, making 106 recipes in total. Because its content focuses on “combining, blending and producing formulas,” the authors decided to name this collection the Methods of Decoctions with Blended Formulas to Treat Sixty Ailments after a title of a manuscript transmitted to Cang Gong as recorded in the “Biographies of Bian Que and Cang Gong” chapter of the Records of the Grand Historian, circa 100 BCE. The key phrase in this title, “methods of decoctions with blended formulas,” refers to methods of blending and harmonizing formulas optimally. This Tianhui manuscript preserves ancient medical recipes that had been long lost, including grain decoctions, alcoholic decoctions, and “fire formulas.” It is an invaluable source for charting the emergence of a genre of “classical formularies” in Han times that resulted in texts such as the Classical Methods of Decoctions, the title of which was noted in an ancient bibliography but until recently was thought to be entirely lost.
Plasmin-cleaved von Willebrand factor as a biomarker for microvascular thrombosis
Authors: El Otmani Hinde , Frunt Rowan , Smits Simone , Barendrecht Arjan D. , de Maat Steven , Fijnheer Rob , Lenting Peter J. , Tersteeg Claudia
Published: January 2024

von Willebrand factor (VWF) is an essential contributor to microvascular thrombosis. Physiological cleavage by ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) limits its prothrombotic properties, explaining why ADAMTS13 deficiency leads to attacks of microthrombosis in patients with thrombotic thrombocytopenic purpura (TTP). We previously reported that plasminogen activation takes place during TTP attacks in these patients. Furthermore, stimulation of plasminogen activation attenuates pathogenesis in preclinical TTP models in vivo. This suggests that plasmin is an endogenous regulator of VWF thrombogenicity, in particular when ADAMTS13 falls short to prevent microvascular occlusions. VWF cleavage by plasmin is biochemically distinct from cleavage by ADAMTS13. We hypothesized that plasmin-cleaved VWF (cVWF) holds value as a biomarker of microvascular thrombosis. Here, we describe the development of a variable domain of heavy-chain-only antibody (VHH)-based bioassay that can distinguish cVWF from intact and ADAMTS13-cleaved VWF in plasma. We validate this assay by tracking cVWF release during degradation of microthombi in vitro. We demonstrate that endogenous cVWF formation takes place in patients with TTP during acute attacks of thrombotic microangiopathy but not in those in remission. Finally, we show that therapeutic plasminogen activation in a mouse model of TTP amplifies cVWF formation, which is accompanied by VWF clearance. Our combined findings indicate that cVWF is released from microthrombi in the context of microvascular occlusion.
Differential gene expression and microRNA profile in corpora allata-corpora cardiaca of Aedes aegypti mosquitoes with weak juvenile hormone signalling
Authors: Qi Zhi , Etebari Kayvan , Nouzova Marcela , Noriega Fernando G. , Asgari Sassan
Published: January 2024

The corpora allata-corpora cardiaca (CA-CC) is an endocrine gland complex that regulates mosquito development and reproduction through the synthesis of juvenile hormone (JH). Epoxidase (Epox) is a key enzyme in the production of JH. We recently utilized CRISPR/Cas9 to establish an epoxidase-deficient (epox−/−) Aedes aegypti line. The CA from epox−/− mutants do not synthesize epoxidated JH III but methyl farneosate (MF), a weak agonist of the JH receptor, and therefore have reduced JH signalling. Illumina sequencing was used to examine the differences in gene expression between the CA-CC from wild type (WT) and epox−/− adult female mosquitoes. From 18,034 identified genes, 317 were significantly differentially expressed. These genes are involved in many biological processes, including the regulation of cell proliferation and apoptosis, energy metabolism, and nutritional uptake. In addition, the same CA-CC samples were also used to examine the microRNA (miRNA) profiles of epox−/− and WT mosquitoes. A total of 197 miRNAs were detected, 24 of which were differentially regulated in epox−/− mutants. miRNA binding sites for these particular miRNAs were identified using an in silico approach; they target a total of 101 differentially expressed genes. Our results suggest that a lack of epoxidase, besides affecting JH synthesis, results in the diminishing of JH signalling that have significant effects on Ae. aegypti CA-CC transcriptome profiles, as well as its miRNA repertoire.
Association of changes in frailty status with the risk of all-cause mortality and cardiovascular death in older people: results from the Chinese Longitudinal Healthy Longevity Survey (CLHLS)
Authors: Wang Ziqiong , Ruan Haiyan , Li Liying , Song Ningying , He Sen
Published: January 2024

Background

Few studies have investigated the association between changes in frailty status and all-cause mortality, inconsistent results were reported. What’s more, studies that evaluated the effect of changes of frailty on cardiovascular death in older population are scanty. Therefore, the present study aims to investigate the association of such changes with the risk of all-cause mortality and cardiovascular death in older people, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Methods

A total of 2805 older participants from two consecutive waves (i.e. 2011 and 2014) of the CLHLS were included for analysis. Based on the changes in frailty status from wave 2011 to wave 2014, participants were categorized into 4 subgroups, including sustained pre/frailty, robustness to pre/frailty, pre/frailty to robustness and sustained robustness. Study outcomes were all-cause mortality and cardiovascular death, and Cox regression analysis examined the association of changes in frailty status with outcomes.

Results

From wave 2011 to wave 2014, 33.2% of the participants had frailty transitions. From wave 2014 to wave 2018, there were 952 all-cause mortalities and 170 cardiovascular deaths during a follow-up of 9530.1 person-years, and Kaplan-Meier analysis demonstrated that cumulative incidences of the two outcomes were significantly lower in more robust participants (all log-rank p < 0.001). Compared with the subgroup of sustained pre/frailty, the fully adjusted HRs of all-cause mortality were 0.61 (95% CI: 0.51–0.73, p < 0.001), 0.51 (95% CI: 0.42–0.63, p < 0.001) and 0.41 (0.34–0.49, p < 0.001) in the subgroup of robustness to pre/frailty, the subgroup of pre/frailty to robustness, and the subgroup of sustained robustness, respectively. The fully adjusted HRs of cardiovascular death were 0.79 (95% CI: 0.52–1.19, p = 0.256) in the subgroup of robustness to pre/frailty, 0.45 (95% CI: 0.26–0.76, p = 0.003) in the subgroup of pre/frailty to robustness and 0.51 (0.33–0.78, p = 0.002) in the subgroup of sustained robustness when comparing to the subgroup of sustained pre/frailty, respectively. Stratified analysis and extensive sensitivity analyses revealed similar results.

Conclusions

Frailty is a dynamic process, and improved frailty and remaining robust are significantly associated with lower risk of all-cause mortality and cardiovascular death in older people.
Characteristics of renal pathology and coagulation function in IgA nephropathy and IgA vasculitis associated nephritis
Authors: Wang Yinhong , Wang Hao , Ma Xiaotao , Zhu Zikun , Tian Xuefei , Fu Rongguo , Jia Lining
Published: January 2024

Background

The objective of this study is to investigate the clinical and pathological differences between patients with IgA nephropathy (IgAN) and IgA vasculitis associated nephritis (IgAVN).

Methods

A total of 253 patients with IgAN and 71 patients with IgAVN were retrospectively included in the study, and clinical and laboratory data were collected and analysed.

Results

Compared with IgAVN group, months from onset to kidney biopsy were significantly prolonged in IgAN patients because of the lack of obvious symptoms such as rash, abdominal symptoms, and joint pain (13.5 ± 26.6 vs. 10.2 ± 31.6 months, P = 0.007), and the levels of serum creatinine (92.3 ± 94.7 vs. 68.9 ± 69.2 µmol/L, P = 0.015) was higher and eGFR (99.1 ± 35.2 vs. 123.4 ± 41.8 mL/min/1.73m2, P < 0.001) was lower in IgAN group. The pathological results revealed that patients with IgAN have a greater degree of chronic kidney injury compared to patients with IgAVN. In addition, the levels of plasma D-Dimers (1415.92 ± 1774.69 vs. 496.78 ± 711.91 ng/mL, P < 0.001) and fibrinogen degradation products (FDP) (3.92 ± 4.73 vs. 1.63 ± 2.46 µg/mL, P = 0.001) were significantly higher in IgAVN patients than in IgAN patients. The deposition of fibrinogen in the renal tissues was more severe and the cumulative partial remission rate was higher in patients with IgAVN as compared to those with IgAN (P = 0.001).

Conclusions

In comparison, IgAN patients had poorer renal function, whereas IgAVN patients had more severe coagulation abnormalities. These findings provide a basis for the differentiation of the two diseases at an early stage.
Development of a risk assessment model for cardiac injury in patients newly diagnosed with acute myeloid leukemia based on a multicenter, real-world analysis in China
Authors: Ma Linlu , Wang Qian , Li Xinqi , Shang Yufeng , Zhang Nan , Wu Jinxian , Liang Yuxing , Chen Guopeng , Tan Yuxin , Liu Xiaoyan , Yuan Guolin , Zhou Fuling
Published: January 2024

Background

Studies have revealed that acute myeloid leukemia (AML) patients are prone to combined cardiac injury. We aimed to identify hematological risk factors associated with cardiac injury in newly diagnosed AML patients before chemotherapy and develop a personalized predictive model.

Methods

The population baseline, blood test, electrocardiogram, echocardiograph, and genetic and cytogenetic data were collected from newly diagnosed AML patients. The data were subdivided into training and validation cohorts. The independent risk factors were explored by univariate and multivariate logistic regression analysis respectively, and data dimension reduction and variable selection were performed using the least absolute shrinkage and selection operator (LASSO) regression models. The nomogram was generated and the reliability and generalizability were verified by receiver operating characteristic (ROC) curves, the area under the curve (AUC) and calibration curves in an external validation cohort.

Results

Finally, 499 AML patients were included. After univariate logistic regression, LASSO regression and multivariate logistic regression analysis, abnormal NT-proBNP, NPM1 mutation, WBC, and RBC were independent risk factors for cardiac injury in AML patients (all P < 0.05). The nomogram was constructed based on the above four variables with high accuracy. The area under the curve was 0.742, 0.750, and 0.706 in the training, internal validation, and external validation cohort, respectively. The calibration curve indicated that the model has good testing capability. The Kaplan-Meier curve showed that the higher the risk of combined cardiac injury in AML patients, the lower their probability of survival.

Conclusions

This prediction nomogram identifies hematological risk factors associated with cardiac injury in newly diagnosed AML patients and can help hematologists identify the risk and provide precise treatment options.
All-cause, premature, and cardiovascular death attributable to socioeconomic and ethnic disparities among New Zealanders with type 1 diabetes 1994–2019: a multi-linked population-based cohort study
Authors: Yu Dahai , Cai Yamei , Osuagwu Uchechukwu Levi , Pickering Karen , Baker John , Cutfield Richard , Orr-Walker Brandon J. , Sundborn Gerhard , Wang Zheng , Zhao Zhanzheng , Simmons David
Published: January 2024

Background

New Zealand (NZ) research into type 1 diabetes mellitus (T1DM) mortality can inform policy and future research. In this study we aimed to quantify the magnitude to which ethnicity and socioeconomic disparities influenced mortality at the population level among people with Type 1 diabetes (T1DM) in Auckland, New Zealand (NZ).

Methods

The cohort data were derived from the primary care diabetes audit program the Diabetes Care Support Service (DCSS), and linked with national primary care, pharmaceutical claims, hospitalisation, and death registration databases. People with T1DM enrolled in DCSS between 1994–2018 were included. All-cause, premature, and cardiovascular mortalities were estimated by Poisson regression models with adjustment for population-level confounders. The mortality rates ratio (MRR) was standardized against the DCSS type 2 diabetes population. Mortality rates were compared by ethnic group (NZ European (NZE) and non-NZE) and socioeconomic deprivation quintile. The population attributable fraction (PAF) was estimated for ethnic and socioeconomic disparities by Cox regression adjusting for demographic, lifestyle, and clinical covariates. The adjusted slope index inequality (SII) and relative index of inequality (RII) were used to measure the socioeconomic disparity in mortalities.

Results

Overall, 2395 people with T1DM (median age 34.6 years; 45% female; 69% NZE) were enrolled, among whom the all-cause, premature and CVD mortalities were 6.69 (95% confidence interval: 5.93–7.53), 3.30 (2.77–3.90) and 1.77 (1.39–2.23) per 1,000 person-years over 25 years. The overall MRR was 0.39 (0.34–0.45), 0.65 (0.52–0.80), and 0.31 (0.24–0.41) for all-cause, premature and CVD mortality, respectively. PAF attributable to ethnicity disparity was not significantly different for mortality. The adjusted PAF indicated that 25.74 (0.84–44.39)% of all-cause mortality, 25.88 (0.69–44.69)% of premature mortality, 55.89 (1.20–80.31)% of CVD mortality could be attributed to socioeconomic inequality. The SII was 8.04 (6.30–9.78), 4.81 (3.60–6.02), 2.70 (1.82–3.59) per 1,000 person-years and RII was 2.20 (1.94–2.46), 2.46 (2.09–2.82), and 2.53 (2.03–3.03) for all-cause, premature and CVD mortality, respectively.

Conclusions

Our results suggest that socioeconomic disparities were responsible for a substantial proportion of all-cause, premature and CVD mortality in people with T1DM in Auckland, NZ. Reducing socioeconomic barriers to management and self-management would likely improve clinical outcomes.
A comparative study of bronchodilator response: utilizing pre-bronchodilator versus predicted normal values
Authors: Alexis Afe , Punjabi Naresh M. , Grealis Kyle , Wanner Adam
Published: January 2024

Background

A positive bronchodilator response has been defined as a 12% increase in the forced expiratory volume in one second (FEV1) or forced vital capacity (FVC) from their respective pre-bronchodilator values, combined with at least a 0.2 L absolute change. Recent recommendations suggested the use of the percent change in FEV1 and FVC relative to their predicted normal values without having applied them in patients with airflow obstruction. The aim of the current study was to compare the two approaches over a wide range of pre-bronchodilator FEV1 and FVC values.

Methods

A retrospective review of consecutive patients undergoing spirometry and bronchodilator testing was completed. The change in FEV1 and FVC with a bronchodilator was expressed relative to the pre-bronchodilator and predicted normal FEV1 and FVC.

Results

In 1,040 patients with a non-paradoxical change in FEV1, 19.0% had a ≥ 12% change in FEV1 using their pre-bronchodilator value compared to 5.7% using their predicted normal value. For FVC, the respective values were 12.7% vs. 5.8%. The difference was retained in patients with a ≥ 0.2 L change in FEV1 or FVC. In unobstructed patients, the upper threshold (two standard deviations above the mean) of the bronchodilator response was 14% for FEV1 and 10% for FVC using predicted normal values.

Conclusions

Expressing the percent change in FEV1 and FVC relative to predicted normal values reduces the over-estimation of the bronchodilator response, especially in patients with a very low pre-bronchodilator FEV1, including in those with a ≥ 0.2 L change in FEV1. Irrespective of pre-bronchodilator values, a ≥ 14% change in FEV1 and ≥ 10% change in FVC relative to the predicted normal values could be considered a positive bronchodilator response.
Oral health-related quality of life among people living with HIV and HIV-negative adults in Kigali, Rwanda: a comparative cross-sectional study
Authors: Murererehe Julienne , Malele-Kolisa Yolanda , Niragire François , Yengopal Veerasamy
Published: January 2024

Background

Assessing health-related quality of life has become integral to people living with HIV (PLHIV) follow-up. However, there is a lack of data regarding the impact of oral health on quality of life, known as Oral health-related quality of life (OHRQoL) among PLHIV compared to HIV-negative individuals in Rwanda.

Aim

The study aimed to assess OHRQoL among PLHIV compared to HIV-negative counterparts in Kigali, Rwanda.

Methods

The Oral Health Impact Profile short version (OHIP-14) questionnaire was interviewer-administered to 200 PLHIV and 200 HIV-negative adults (≥ 18 years old) at an HIV clinic of Kigali Teaching Hospital (CHUK). Socio-demographic characteristics, including age, sex, occupation, and socioeconomic status (SES) of participants, were collected using a survey questionnaire. A 4-point Likert scale was used to assess the frequency of oral impacts for all 14 items within 7 domains of the OHIP tool. The descriptive statistics were used to see frequencies and percentages of OHRQoL among PLHIV and HIV-negative persons, respectively. The Chi-square test was used to determine the association of OHRQoL with caries (DMFT) and periodontal disease (CPITN) among PLHIV compared to HIV-negative individuals.

Results

The results revealed a higher prevalence of PLHIV with poor OHRQoL than HIV-negative individuals in 5 domains and almost all items of OHIP-14 except for the OHIP 3 (found it uncomfortable to eat any foods because of problems with teeth or mouth) and OHIP-14 (being totally unable to function because of problems with teeth or mouth). The findings showed statistically significant results (p ≤ 0.05) for the OHIP1 item “trouble pronouncing any word,” with a prevalence of 2.5% (n = 11) and 2.25% (n = 9) in PLHIV and HIV-negative, respectively. Also, PLHIV had a significantly higher prevalence, 2.75% (n = 11) for the OHIP 13 item “life not satisfying due to teeth and mouth problems compared to HIV-negative individuals 2% (8) p ≤ 0.05. Moreover, dental caries was significantly associated with poor OHRQoL among PLHIV and HIV-negative adults and for all 14 items of the OHIP tool. Periodontal disease was not significantly associated with OHRQoL among PLHIV and HIV-negative adults.

Conclusion

This study revealed poor OHRQoL among PLHIV compared to HIV-negative adults. There is a need for further longitudinal studies to investigate the OHRQoL in Rwanda, especially among PLHIV. It is essential to include oral health care as one of the components of the medical health care programs for PLHIV in Rwanda.
Delayed vs. immediate placement of restorative materials over Biodentine and RetroMTA: a micro-shear bond strength study
Authors: Celiksoz Ozge , Irmak Ozgur
Published: January 2024

Background

The aim of the present study was to investigate the micro-shear bond strength (µSBS) of various restorative materials applied on two different fast-setting calcium silicate-based materials and to evaluate the effect of restoration time on µSBS.

Methods

A total of 180 acrylic blocks with a cavity in the center were randomly divided into 2 main groups according to the capping material to be used (Biodentine or RetroMTA). The specimens were also randomly divided into 3 groups according to the restoration time (3 min, 12 min, 24 h). After the specified waiting periods, glass hybrid material (EQUIA Forte HT), resin composite (Filtek Z550) and light-cured calcium silicate material (Theracal LC) were placed on the specimens with tygon tubes. The specimens were kept for 24 h and then subjected to µSBS test. Statistical analysis was performed by 3-way ANOVA followed by Tukey test for pairwise comparisons (α = 0.05).

Results

There is a statistically significant difference (p < 0.05) between the µSBS values obtained by applying resin composite on RetroMTA after different setting times (24 h > 12 min > 3 min). The µSBS obtained for the Biodentine-resin composite at the end of the 3 min setting time is significantly lower (p < 0.05) than the µSBS values at 12 min and 24 h. For both calcium silicate cements, at the end of all time periods, the µSBS obtained when resin composite was applied at the end was higher than the other materials (p < 0.05).

Conclusions

For Biodentine-resin composite bonding, the manufacturer’s recommendation of 12 min can be considered an appropriate time, whereas for RetroMTA-resin composite bonding, the µSBS increased as the waiting time increased. Regardless of the waiting time, it is recommended to prefer direct composite resin restoration over Biodentine and RetroMTA.
Clinical nurses’ work-life balance prediction due to patient safety incidents using classification and regression tree analysis: a secondary data analysis
Authors: Kang Jiwon , Kwon Soon-Sun , Lee Youngjin
Published: January 2024

Background

Patient safety incidents lead to performance difficulties for nurses when providing nursing practice. This affects work-life balance and causes second and third-victimization. This study predicts factors affecting clinical nurses’ work-life balance due to patient safety incidents using classification and regression tree analysis techniques.

Methods

This study was a secondary analysis of data from a cohort research project, which used a descriptive survey for data collection. Participants comprised 372 nurses. Data were collected using SurveyMonkey, a mobile-based survey software solution, from January to September 2021. Data included the general characteristics of clinical nurses, second damage, second damage support, third damage, and work-life balance. The specific variables included in the analysis chosen through rigorous Lasso analysis form the foundation for predicting work-life balance. Variables with low explanatory power were excluded, thereafter, the variables selected by Lasso were analyzed with a classification and regression tree model to predict work-life balance.

Results

A regression tree was applied to predict work-life balance using seven variables—education level, marital status, position, physical distress, second-victim support, turnover intentions, and absenteeism (selected through Lasso analysis). After pruning, at tree size four, when turnover intentions were < 4.250, physical distress < 2.875, and second-victim support < 2.345, the predicted work-life balance was 3.972. However, when turnover intentions were < 4.250, physical distress < 2.875, and second-victim support ≥ 2.345, then the predicted work-life balance was 2.760.

Conclusions

This study's insights offer crucial groundwork for crafting targeted workforce risk management strategies and fostering a conducive organizational culture to mitigate nursing occupational stress, potentially curbing the recurrence of patient safety incidents and improving nursing practice while enhancing patient outcomes. Future research should explore second and third victim experiences across various healthcare settings globally to understand their impact on WLB and patient safety outcomes.
The neurosurgical outpatient clinic: comparison between accesses in public and private activities
Authors: Menegatti Marta , Del Villano Nunzia , Scerrati Alba , Travaglini Francesco , Ricciardi Luca , Lofrese Giorgio , Cavallo Michele Alessandro , De Bonis Pasquale
Published: January 2024

Background

Neurosurgical clinic assesses presence and extent of pathologies of central and peripheral nervous system or disorders affecting the spine, to identify most effective treatment and possible recourse to surgery. The aim of the study is to evaluate the appropriateness of request for a neurosurgical consult both in private and in public outpatient clinics.

Materials and methods

We collected and analyzed all the reports of outpatient visits of public and private clinic over a period between January and December 2018.

Results

There were 0.62% real urgent visits in the public sector and 1.19% in the private sector (p = 0.05). Peripheral pathologies represented 12.53% and 6.21% of pathologies evaluated in public and private sector respectively (p < 0.00001). In addition, 15.76% of visits in public lead to surgery, while they represented 11.45% in private (p = 0.0003).

Conclusions

No study is available comparing accesses of patients in neurosurgical outpatient clinics. In public clinic, visits are booked as urgent on the prescription of the general practitioner: in reality, only 5% of these visits were really confirmed as urgent by the specialist. Peripheral pathologies are more frequent in public clinic, while cranial pathologies are more frequent in private one. Patients with cranial pathologies prefer to choose their surgeon by accessing private clinic.
Preliminary study of the effect of gut microbiota on the development of prostatitis
Authors: Shen Cheng , Chen Zhan , Zhang Wei , Chen Xinfeng , Zheng Bing , Shi Chunmei
Published: January 2024

Background

Dysbacteriosis of intestinal tract may cause systemic inflammation, making distant anatomical locations more susceptible to illness. Recent research has demonstrated that the microbiome can affect both prostatitis and the inflammation of the prostate that is linked to prostate cancer. It is still unclear, though, whether this relationship indicates causation. We conducted a Mendelian randomization investigation on two samples to fully uncover gut microbiota’s potential genetic causal role in prostatitis.

Method

Prostatitis (1859 prostatitis cases and 72,799 controls) was utilized as the outcome, while SNPs highly linked with 196 microbial taxa (18 340 people) were chosen as instrumental factors. Random effects, inverse variance weighting, weighted medians, and MR-Egger were used to analyze causal effects. The Cochran’s Q test, funnel plot, leave-one-out analysis, and MR-Egger intercept test were all used in the sensitivity analysis.

Results

A causal effect in lowering the incidence of prostatitis is anticipated for five gut microorganisms (Methanobacteria, Methanobacteriaceae, Erysipelatoclostridium, Parasutterella, and Slackia; P < 0.05). Four gut bacteria, including Faecalibacterium, LachnospiraceaeUCG004, Sutterella, and Gastranaerophilales, are predicted to play a causal role in increasing the risk of prostatitis (P < 0.05). There were no discernible estimates of pleiotropy or heterogeneity.

Conclusion

Our investigation established the genetic links between nine gut microorganisms and prostatitis, which may offer fresh perspectives and a theoretical framework for the future prevention and management of prostatitis.
Blood FOLR3 methylation dysregulations and heterogeneity in non-small lung cancer highlight its strong associations with lung squamous carcinoma
Authors: Qu Yunhui , Zhang Xiuzhi , Qiao Rong , Di Feifei , Song Yakang , Wang Jun , Ji Longtao , Zhang Jie , Gu Wanjian , Fang Yifei , Han Baohui , Yang Rongxi , Dai Liping , Ouyang Songyun
Published: January 2024

Background

Non-small cell lung cancer (NSCLC) accounts for the vast majority of lung cancers. Early detection is crucial to reduce lung cancer-related mortality. Aberrant DNA methylation occurs early during carcinogenesis and can be detected in blood. It is essential to investigate the dysregulated blood methylation markers for early diagnosis of NSCLC.

Methods

NSCLC-associated methylation gene folate receptor gamma (FOLR3) was selected from an Illumina 850K array analysis of peripheral blood samples. Mass spectrometry was used for validation in two independent case–control studies (validation I: n = 2548; validation II: n = 3866). Patients with lung squamous carcinoma (LUSC) or lung adenocarcinoma (LUAD), normal controls (NCs) and benign pulmonary nodule (BPN) cases were included. FOLR3 methylations were compared among different populations. Their associations with NSCLC clinical features were investigated. Receiver operating characteristic analyses, Kruskal–Wallis test, Wilcoxon test, logistics regression analysis and nomogram analysis were performed.

Results

Two CpG sites (CpG_1 and CpG_2) of FOLR3 was significantly lower methylated in NSCLC patients than NCs in the discovery round. In the two validations, both LUSC and LUAD patients presented significant FOLR3 hypomethylations. LUSC patients were highlighted to have significantly lower methylation levels of CpG_1 and CpG_2 than BPN cases and LUAD patients. Both in the two validations, CpG_1 methylation and CpG_2 methylation could discriminate LUSC from NCs well, with areas under the curve (AUCs) of 0.818 and 0.832 in validation I, and 0.789 and 0.780 in validation II. They could also differentiate LUAD from NCs, but with lower efficiency. CpG_1 and CpG_2 methylations could also discriminate LUSC from BPNs well individually in the two validations. With the combined dataset of two validations, the independent associations of age, gender, and FOLR3 methylation with LUSC and LUAD risk were shown and the age-gender-CpG_1 signature could discriminate LUSC and LUAD from NCs and BPNs, with higher efficiency for LUSC.

Conclusions

Blood-based FOLR3 hypomethylation was shown in LUSC and LUAD. FOLR3 methylation heterogeneity between LUSC and LUAD highlighted its stronger associations with LUSC. FOLR3 methylation and the age-gender-CpG_1 signature might be novel diagnostic markers for the early detection of NSCLC, especially for LUSC.
Single-cell N6-methyladenosine-related genes function within the tumor microenvironment to affect the prognosis and treatment sensitivity in patients with gastric cancer
Authors: Wang Zehua , Chen Chen , Shu Jiao , Ai Jiaoyu , Liu Yihan , Cao Haoyue , Jia Yongxu , Qin Yanru
Published: January 2024

Background

Gastric cancer (GC) ranks fifth for morbidity and third for mortality worldwide. The N6-methyladenosine (m6A) mRNA methylation is crucial in cancer biology and progression. However, the relationship between m6A methylation and gastric tumor microenvironment (TME) remains to be elucidated.

Methods

We combined single-cell and bulk transcriptome analyses to explore the roles of m6A-related genes (MRG) in gastric TME.

Results

Nine TME cell subtypes were identified from 23 samples. Fibroblasts were further grouped into four subclusters according to different cell markers. M6A-mediated fibroblasts may guide extensive intracellular communications in the gastric TME. The m6A-related genes score (MRGs) was output based on six differentially expressed single-cell m6A-related genes (SCMRDEGs), including GHRL, COL4A1, CAV1, GJA1, TIMP1, and IGFBP3. The protein expression level was assessed by immunohistochemistry. We identified the prognostic value of MRGs and constructed a nomogram model to predict GC patients’ overall survival. MRGs may affect treatment sensitivity in GC patients.

Conclusion

Our study visualized the cellular heterogeneity of TME at the single-cell level, revealed the association between m6A mRNA modification and intracellular communication, clarified MRGs as an independent risk factor of prognosis, and provided a reference for follow-up treatment.