bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitudes, and practice towards allergic rhinitis in patients with allergic rhinitis: a cross-sectional study
Authors: Gu Wenzhe , Yan Daonan , Yuan Zijiang , Jiang Xiaoting , Qian Yuhan , Dong Hongjun , Shen Zhengjie
Published: August 2023

Background

The knowledge, attitude, and practice (KAP) of Chinese patients with allergic rhinitis (AR) on AR is poorly known. This study investigated the KAP towards AR in patients with this disease and explored the factors associated with KAP.

Methods

This cross-sectional study enrolled patients with AR in Zhangjiagang Hospital of Traditional Chinese Medicine between October 2022 and March 2023.

Results

This study included 656 valid questionnaires. Most participants were 26–35 years old (36.13%) and were female (55.18%). The knowledge, attitude, and practice scores were 5.70 ± 2.88 (possible range: 0–12), 29.51 ± 3.52 (possible range: 9–45), and 34.13 ± 7.55 (possible range: 9–45), indicating poor knowledge, unfavorable attitudes, and proactive practice. AR history of 3–5 years (adjusted odds ratio (adjOR) = 1.62, 95% confidence interval (CI): 1.03–2.54, P = 0.037), AR history of > 6 years (adjOR = 1.64, 95%CI: 1.06–2.54, P = 0.027), and know their own allergens (adjOR = 2.34, 95%CI: 1.28–4.25, P = 0.005) were independently associated with the sufficient knowledge. AR history of ≥ 6 years (adjOR = 0.60, 95%CI: 0.37–0.96, P = 0.035), and liking sports (adjOR = 1.58, 95%CI = 1.07–2.33, P = 0.020) were independently associated with the positive attitude. The knowledge scores (adjOR = 1.14, 95%CI: 1.05–1.22, P = 0.001), attitude scores (adjOR = 1.24, 95%CI: 1.17–1.32, P < 0.001), age 36–45 (adjOR = 2.13, 95%CI: 1.19–3.82, P = 0.011), employed (adjOR = 0.59, 95%CI: 0.37–0.94, P = 0.026), and liking sports (adjOR = 2.11, 95%CI: 1.43–3.14, P < 0.001) were independently associated with the proactive practice.

Conclusions

Patients with AR have poor knowledge and unfavorable attitudes but good practice toward AR. Continuous quality teaching interventions and education on patients for AR were recommended.
Measuring deliberate reflection in residents: validation and psychometric properties of a measurement tool
Authors: Blum Richard H. , Mai Christine L. , Mitchell John D. , Saddawi-Konefka Daniel , Cooper Jeffrey B. , Shorten George , DunnGalvin Audrey
Published: August 2023

Purpose

Reflective capacity is “the ability to understand critical analysis of knowledge and experience to achieve deeper meaning.” In medicine, there is little provision for post-graduate medical education to teach deliberate reflection. The feasibility, scoring characteristics, reliability, validation, and adaptability of a modified previously validated instrument was examined for its usefulness assessing reflective capacity in residents as a step toward developing interventions for improvement.

Methods

Third-year residents and fellows from four anesthesia training programs were administered a slightly modified version of the Reflection Evaluation for Learners’ Enhanced Competencies Tool (REFLECT) in a prospective, observational study at the end of the 2019 academic year. Six written vignettes of imperfect anesthesia situations were created. Subjects recorded their perspectives on two randomly assigned vignettes. Responses were scored using a 5-element rubric; average scores were analyzed for psychometric properties. An independent self-report assessment method, the Cognitive Behavior Survey: Residency Level (rCBS) was used to examine construct validity. Internal consistency (ICR, Cronbach’s alpha) and interrater reliability (weighted kappa) were examined. Pearson correlations were used between the two measures of reflective capacity.

Results

46/136 invited subjects completed 2/6 randomly assigned vignettes. Interrater agreement was high (k = 0.85). The overall average REFLECT score was 1.8 (1–4 scale) with good distribution across the range of scores. ICR for both the REFLECT score (mean 1.8, sd 0.5; α = 0.92) and the reflection scale of the rCBS (mean 4.5, sd 1.1; α = 0.94) were excellent. There was a significant correlation between REFLECT score and the rCBS reflection scale (r = .44, p < 0.01).

Conclusions

This study demonstrates feasibility, reliability, and sufficiently robust psychometric properties of a modified REFLECT rubric to assess graduate medical trainees’ reflective capacity and established construct/convergent validity to an independent measure. The instrument has the potential to assess the effectiveness of interventions intended to improve reflective capacity.
Examination of the relationship between thanatophobia and resilience levels of nurses working in intensive care and palliative care units
Authors: Rashidi Mahruk , Karaman Funda , Yildirim Gülay , Kiskaç Neşe , Ünsal jafarov Gülşah , Saygin şahin Buse
Published: August 2023

Background

Nurses in critical care and palliative care units care for patients suffering from severe pain and suffering and at high mortality risk. For this reason, nurses working in these units should be psychologically resilient. However, nurses who are constantly exposed to the death process face the risk of thanatophobia. The aim of this study is to examine the relationship between thanatophobia levels and the psychological resilience of nurses working in intensive care and palliative care units.

Methods

The sample of this descriptive and cross-sectional study included 158 nurses working in intensive care and palliative care units. Personal information form for nurses, Thanatophobia Scale and Psychological Resilience Scale for Adults were used. Data were collected through an online questionnaire in the study. Percentage calculations, mean measurements, Kruskal Wallis test and Mann Whitney U test were used in the statistical evaluation of the data.

Results

The mean of thanatophobia scale and psychological resilience scale was found 31.74 ± 10.08 and 108.34 ± 7.12, respectively. There was a statistically significant difference between the tanatophobia total scale score and age, receiving training on psychological resilience (p < 0.05). A statistically significant difference was found between perseption of self, family cohesion and perception of future and the status of receiving training on psychological resilience (p < 0.05). A statistically negative significant correlation was determined between the thanatophobia scale and the psychological resilience scale total scores.

Conclusions

As a result, it was determined that as the thanatophobia of the nurses increased, their psychological resilience decreased. This situation may negatively affect nurses working in critical departments to provide quality health care to patients. Establishing and maintaining training programs to reduce thanatophobia and increase psychological resilience of nurses working in intensive care and palliative care units will ensure that nurses provide quality health care to the patient and reduce the physiological and psychological wear of nurses.
Analysis on EZH2: mechanism identification of related CeRNA and its immunoassay in hepatocellular carcinoma
Authors: Zhao Haoran , Liu Haishi , Kang Wenli , Zhan Chao , Man Yingchun , Qu Tong
Published: August 2023

Objective

To screen the possible potential signaling pathways related to enhancer of zeste homolog 2 (EZH2) based on ceRNA mechanism, and to analyze the correlation between E2H2 and depths of various immune cell infiltration depths. The relationship between different immune checkpoints were also analyzed.

Methods

First, the expression of EZH2 in pan-cancer (18 malignancies) was analyzed with the TCGA database. Hepatocellular carcinoma (HCC) tissues of 374 cases and normal tissues of 50 cases were analyzed in terms of the differential expression, overall survival (OS) and progression-free-survival (PFS). Then, we conducted GO and KEGG enrichment analysis on target gene. We also analyzed mRNA-miRNA and MicroRNA (miRNA)- long non-coding RNA (lncRNA) correlation with starbase databse, so as to determine the potential ceRNA mechanism associated with EZH2. Finally, immunoassay and drug-sensitivity analysis of EZH2 was performed.

Results

Seven potential EZH2-related ceRNA pathways were screened out, namely lncRNA: Small Nucleolar RNA Host Gene 1 (SNHG1), SNHG 3, and SNHG 6-miR-101-3p-EZH2; and lncRNA: Long Intergenic Non-Protein Coding RNA 1978 (LINC01978), SNHG12, Ring Finger Protein 216 Pseudogene 1 (RNF216P1), and Coiled-coil Domain Containing 18 Antisense RNA 1 (CCDC18-AS1)-let-7c-5p—EZH2. Finally, 4 potential EZH2-related ceRNA pathways were identified through qPCR.According to immune correlation analysis, EZH2 may be positively correlated with T cells follicular helper, T cells Cluster of differentiation (CD)4 memory activated, Macrophages M0, and B cells memory (P < 0.05, cof > 0.2); while be negatively correlated with T cells CD4 + memory resting (P < 0.05, cof < -0.2). And EZH2 is positively correlated with Programmed Cell Death 1 (PDCD1) (R = 0.22), CD274 (R = 0.3) and Cytotoxic T-Lymphocyte Associated Protein 4 (CTLA4) (R = 0.23). According to drug sensitivity analysis, patients in the high expression group were more susceptible to the effects of various drugs including Sorafenib, 5-Fluorouracil, Doxorubicin, Etoposide, Paclitaxel, and Vinorelbine than those with low expression.

Conclusion

This study revealed seven potential pathways of Enhancer of Zeste Homolog 2 (EZH2)-related ceRNA mechanisms: lncRNA (SNHG3, 6) -Mir-101-3P-ezh2; lncRNA (SNHG12, RNF216P1)-let-7c-5p—EZH2. We also analyzed the immunity and drug sensitivity of EZH2. Our study proves that EZH2 still has great research prospects in HCC.
5ʹ-Ectonucleotidase CD73/NT5E supports EGFR-mediated invasion of HPV-negative head and neck carcinoma cells
Authors: Shi Enxian , Wu Zhengquan , Karaoglan Birnur Sinem , Schwenk-Zieger Sabina , Kranz Gisela , Abdul Razak Nilofer , Reichel Christoph A. , Canis Martin , Baumeister Philipp , Zeidler Reinhard , Gires Olivier
Published: August 2023

Background

Epithelial-to-mesenchymal transition (EMT) of malignant cells is a driving force of disease progression in human papillomavirus-negative (HPV-negative) head and neck squamous cell carcinomas (HNSCC). Sustained hyper-activation of epidermal growth factor receptor (EGFR) induces an invasion-promoting subtype of EMT (EGFR-EMT) characterized by a gene signature (“‘EGFR-EMT_Signature’”) comprising 5´-ectonucleotidase CD73. Generally, CD73 promotes immune evasion via adenosine (ADO) formation and associates with EMT and metastases. However, CD73 regulation through EGFR signaling remains under-explored and targeting options are amiss.

Methods

CD73 functions in EGFR-mediated tumor cell dissemination were addressed in 2D and 3D cellular models of migration and invasion. The novel antagonizing antibody 22E6 and therapeutic antibody Cetuximab served as inhibitors of CD73 and EGFR, respectively, in combinatorial treatment. Specificity for CD73 and its role as effector or regulator of EGFR-EMT were assessed upon CD73 knock-down and over-expression. CD73 correlation to tumor budding was studied in an in-house primary HNSCC cohort. Expression correlations, and prognostic and predictive values were analyzed using machine learning-based algorithms and Kaplan–Meier survival curves in single cell and bulk RNA sequencing datasets.

Results

CD73/NT5E is induced by the EGF/EGFR-EMT-axis and blocked by Cetuximab and MEK inhibitor. Inhibition of CD73 with the novel antagonizing antibody 22E6 specifically repressed EGFR-dependent migration and invasion of HNSCC cells in 2D. Cetuximab and 22E6 alone reduced local invasion in a 3D-model. Interestingly, combining inefficient low-dose concentrations of Cetuximab and 22E6 revealed highly potent in invasion inhibition, substantially reducing the functional IC50 of Cetuximab regarding local invasion. A role for CD73 as an effector of EGFR-EMT in local invasion was further supported by knock-down and over-expression experiments in vitro and by high expression in malignant cells budding from primary tumors. CD73 expression correlated with EGFR pathway activity, EMT, and partial EMT (p-EMT) in malignant single HNSCC cells and in large patient cohorts. Contrary to published data, CD73 was not a prognostic marker of overall survival (OS) in the TCGA-HNSCC cohort when patients were stratified for HPV-status. However, CD73 prognosticated OS of oral cavity carcinomas. Furthermore, CD73 expression levels correlated with response to Cetuximab in HPV-negative advanced, metastasized HNSCC patients.

Conclusions

In sum, CD73 is an effector of EGF/EGFR-mediated local invasion and a potential therapeutic target and candidate predictive marker for advanced HPV-negative HNSCC.
Effect of semaglutide on major adverse cardiovascular events by baseline kidney parameters in participants with type 2 diabetes and at high risk of cardiovascular disease: SUSTAIN 6 and PIONEER 6 post hoc pooled analysis
Authors: Rossing Peter , Bain Stephen C. , Bosch-Traberg Heidrun , Sokareva Ekaterina , Heerspink Hiddo J. L. , Rasmussen Søren , Mellbin Linda G.
Published: August 2023

Background

Semaglutide is a glucose-lowering treatment for type 2 diabetes (T2D) with demonstrated cardiovascular benefits; semaglutide may also have kidney-protective effects. Thispost hocanalysis investigated the association between major adverse cardiovascular events (MACE) and baseline kidney parameters and whether the effect of semaglutide on MACE risk was impacted by baseline kidney parameters in people with T2D at high cardiovascular risk.

Methods

Participants from the SUSTAIN 6 and PIONEER 6 trials, receiving semaglutide or placebo, were categorised according to baseline kidney function (estimated glomerular filtration rate [eGFR] < 45 and ≥ 45–<60 versus ≥ 60 mL/min/1.73 m2) or damage (urine albumin:creatinine ratio [UACR] ≥ 30–≤300 and > 300 versus < 30 mg/g). Relative risk of first MACE by baseline kidney parameters was evaluated using a Cox proportional hazards model. The same model, adjusted with inverse probability weighting, and a quadratic spline regression were applied to evaluate the effect of semaglutide on risk and event rate of first MACE across subgroups. The semaglutide effects on glycated haemoglobin (HbA1c), body weight (BW) and serious adverse events (SAEs) across subgroups were also evaluated.

Results

Independently of treatment, participants with reduced kidney function (eGFR ≥ 45–<60 and < 45 mL/min/1.73 m2: hazard ratio [95% confidence interval]; 1.36 [1.04;1.76] and 1.52 [1.15;1.99]) and increased albuminuria (UACR ≥ 30–≤300 and > 300 mg/g: 1.53 [1.14;2.04] and 2.52 [1.84;3.42]) had an increased MACE risk versus those without. Semaglutide consistently reduced MACE risk versus placebo across all eGFR and UACR subgroups (interaction p value [pINT] > 0.05). Semaglutide reduced HbA1cregardless of baseline eGFR and UACR (pINT>0.05); reductions in BW were affected by baseline eGFR (pINT<0.001) but not UACR (pINT>0.05). More participants in the lower eGFR or higher UACR subgroups experienced SAEs versus participants in reference groups; the number of SAEs was similar between semaglutide and placebo arms in each subgroup.

Conclusions

MACE risk was greater for participants with kidney impairment or damage than for those without. Semaglutide consistently reduced MACE risk across eGFR and UACR subgroups, indicating that semaglutide provides cardiovascular benefits in people with T2D and at high cardiovascular risk across a broad spectrum of kidney function and damage.

Trial registrations

NCT01720446; NCT02692716.
Inhibiting NLRP3 inflammasome signaling pathway promotes neurological recovery following hypoxic-ischemic brain damage by increasing p97-mediated surface GluA1-containing AMPA receptors
Authors: Chen Yuxin , Li Xiaohuan , Xiong Qian , Du Yehong , Luo Man , Yi Lilin , Pang Yayan , Shi Xiuyu , Wang Yu Tian , Dong Zhifang
Published: August 2023

Background

The nucleotide-binding oligomeric domain (NOD)-like receptor protein 3 (NLRP3) inflammasome is believed to be a key mediator of neuroinflammation and subsequent secondary brain injury induced by ischemic stroke. However, the role and underlying mechanism of the NLRP3 inflammasome in neonates with hypoxic-ischemic encephalopathy (HIE) are still unclear.

Methods

The protein expressions of the NLRP3 inflammasome including NLRP3, cysteinyl aspartate specific proteinase-1 (caspase-1) and interleukin-1β (IL-1β), the α-amino-3-hydroxy-5-methyl-4-isoxazole-propionicacid receptor (AMPAR) subunit, and the ATPase valosin-containing protein (VCP/p97), were determined by Western blotting. The interaction between p97 and AMPA glutamate receptor 1 (GluA1) was determined by co-immunoprecipitation. The histopathological level of hypoxic-ischemic brain damage (HIBD) was determined by triphenyltetrazolium chloride (TTC) staining. Polymerase chain reaction (PCR) and Western blotting were used to confirm the genotype of the knockout mice. Motor functions, including myodynamia and coordination, were evaluated by using grasping and rotarod tests. Hippocampus-dependent spatial cognitive function was measured by using the Morris-water maze (MWM).

Results

We reported that the NLRP3 inflammasome signaling pathway, such as NLRP3, caspase-1 and IL-1β, was activated in rats with HIBD and oxygen-glucose deprivation (OGD)-treated cultured primary neurons. Further studies showed that the protein level of the AMPAR GluA1 subunit on the hippocampal postsynaptic membrane was significantly decreased in rats with HIBD, and it could be restored to control levels after treatment with the specific caspase-1 inhibitor AC-YVAD-CMK. Similarly, in vitro studies showed that OGD reduced GluA1 protein levels on the plasma membrane in cultured primary neurons, whereas AC-YVAD-CMK treatment restored this reduction. Importantly, we showed that OGD treatment obviously enhanced the interaction between p97 and GluA1, while AC-YVAD-CMK treatment promoted the dissociation of p97 from the GluA1 complex and consequently facilitated the localization of GluA1 on the plasma membrane of cultured primary neurons. Finally, we reported that the deficits in motor function, learning and memory in animals with HIBD, were ameliorated by pharmacological intervention or genetic ablation of caspase-1.

Conclusion

Inhibiting the NLRP3 inflammasome signaling pathway promotes neurological recovery in animals with HIBD by increasing p97-mediated surface GluA1 expression, thereby providing new insight into HIE therapy.
Pediatric-onset limited ANCA-associated vasculitis arising during pre-existing chronic recurrent multifocal osteomyelitis
Authors: Eloseily Esraa , Henrickson Michael
Published: August 2023

Background

Granulomatosis with polyangiitis (GPA) is an autoimmune disease characterized by chronic vasculitis involving small to medium sized arteries, granulomatous inflammation of the upper and lower respiratory tracts, pauci-immune necrotizing glomerulonephritis, as well as vasculitis of other organs. Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory syndrome characterized by sterile bone inflammation.

Case presentation

We report a case of CRMO that was doing well on non-steroidal anti-inflammatory drugs (NSAID for 6 years and then developed ANCA positive limited GPA presenting with pyoderma gangrenosum, persistent bilateral otalgia with serous otitis, otorrhea, then sensorineural hearing loss.

Conclusion

This is the first report of limited GPA initially presenting as pyoderma gangrenosum in a patient with underlying CRMO. It is unclear how the pathology of an autoimmune and an autoinflammatory condition can overlap.
Advances in single-cell RNA sequencing and its applications in cancer research
Authors: Huang Dezhi , Ma Naya , Li Xinlei , Gou Yang , Duan Yishuo , Liu Bangdong , Xia Jing , Zhao Xianlan , Wang Xiaoqi , Li Qiong , Rao Jun , Zhang Xi
Published: August 2023

Cancers are a group of heterogeneous diseases characterized by the acquisition of functional capabilities during the transition from a normal to a neoplastic state. Powerful experimental and computational tools can be applied to elucidate the mechanisms of occurrence, progression, metastasis, and drug resistance; however, challenges remain. Bulk RNA sequencing techniques only reflect the average gene expression in a sample, making it difficult to understand tumor heterogeneity and the tumor microenvironment. The emergence and development of single-cell RNA sequencing (scRNA-seq) technologies have provided opportunities to understand subtle changes in tumor biology by identifying distinct cell subpopulations, dissecting the tumor microenvironment, and characterizing cellular genomic mutations. Recently, scRNA-seq technology has been increasingly used in cancer studies to explore tumor heterogeneity and the tumor microenvironment, which has increased the understanding of tumorigenesis and evolution. This review summarizes the basic processes and development of scRNA-seq technologies and their increasing applications in cancer research and clinical practice.
Cell-free DNA 5-hydroxymethylcytosine is highly sensitive for MRD assessment in acute myeloid leukemia
Authors: Shao Jianming , Shah Shilpan , Ganguly Siddhartha , Zu Youli , He Chuan , Li Zejuan
Published: August 2023

Measurable residual disease (MRD) is an important biomarker in acute myeloid leukemia (AML). However, MRD cannot be detected in many patients using current methods. We developed a highly sensitive 5-hydroxymethylcytosine (5hmC) signature in cell-free DNA by analyzing 115 AML patients and 86 controls. The 5hmC method detected MRD in 20 of 29 patients with negative MRD by multiparameter flow cytometry and 11 of 14 patients with negative MRD by molecular methods. MRD detection by the 5hmC method was significantly associated with relapse-free survival. This novel method can be used in most AML patients and may significantly impact AML patient management.
Metabolites of Xenorhabdus bacteria are potent candidates for mitigating amphibian chytridiomycosis
Authors: Ujszegi János , Boros Zsófia , Fodor András , Vajna Balázs , Hettyey Attila
Published: August 2023

Chytridiomycosis, caused by the chytrid fungus Batrachochytrium dendrobatidis (Bd), has caused extreme losses in amphibian biodiversity. Finding bacteria that produce metabolites with antifungal properties may turn out to be invaluable in the fight against this devastating disease. The entomopathogenic bacteria, Xenorhabdus szentirmaii and X. budapestensis produce secondary metabolites that are effective against a wide range of fungal plant pathogens. To assess whether they may also be effective against Bd, we extracted cell-free culture media (CFCM) from liquid cultures of X. szentirmaii and X. budapestensis and tested their ability to inhibit Bd growth in vitro. As a second step, using juvenile common toads (Bufo bufo) experimentally infected with Bd we also tested the in vivo antifungal efficacy of X. szentirmaii CFCM diluted to 2 and 10% (v/v), while also assessing possible malign side effects on amphibians. Results of the in vitro experiment documented highly effective growth inhibition by CFCMs of both Xenorhabdus species. The in vivo experiment showed that treatment with CFCM of X. szentirmaii applied at a dilution of 10% resulted in infection intensities reduced by ca. 73% compared to controls and to juvenile toads treated with CFCM applied at a dilution of 2%. At the same time, we detected no negative side effects of treatment with CFCM on toad survival and development. Our results clearly support the idea that metabolites of X. szentirmaii, and perhaps of several other Xenorhabdus species as well, may prove highly useful for the treatment of Bd infected amphibians.
Relationship between dyslipidemia and diabetic retinopathy in patients with type 2 diabetes mellitus: a systematic review and meta-analysis
Authors: Li Zhaoping , Yuan Yuan , Qi Qianjin , Wang Qian , Feng Li
Published: August 2023

Background

Diabetic retinopathy (DR) affects more than 80% of patients with diabetes. However, literature on the association between serum lipids and DR in patients with type 2 diabetes mellitus (T2DM) is inconsistent. Hence, in this study, we aimed to investigate the relationship between baseline serum lipids and the incidence of DR in patients with T2DM.

Methods

We searched relevant articles in the PubMed, Embase databases, and the Cochrane Library up to February 7, 2022, and reviewed the reference lists of the included articles to identify appropriate cohort studies. The weighted mean difference (WMD) and the corresponding 95% confidence intervals (CIs) were calculated.

Results

Thirteen cohort studies, including 7459 participants, were included in the present study. Higher levels of total cholesterol (2.94 mg/dL, 95% CI 1.32, 4.56), triglycerides (8.13 mg/dL, 95% CI 5.59, 10.66), and low-density lipoprotein cholesterol (2.53 mg/dL, 95% CI 1.02, 4.04) at baseline were observed in patients with later onset of DR. However, no significant difference in the high-density lipoprotein cholesterol level (0.27 mg/dL, 95% CI − 0.91, 1.45) was observed between patients with DR and without DR.

Conclusion

The present results suggest that baseline triglyceride and cholesterol levels are significantly associated with the occurrence of DR in patients with T2DM. Thus, patients with T2DM may benefit from lowering serum lipids. Future studies exploring the relationship between longitudinal changes in serum lipids and DR occurrence are warranted.

Systematic review registration

PROSPERO CRD42022319978
Investigating years of life lost in Belgium, 2004–2019: A comprehensive analysis using a probabilistic redistribution approach
Authors: Devleesschauwer Brecht , Scohy Aline , De Pauw Robby , Gorasso Vanessa , Kongs Anne , Neirynck Elias , Verduyckt Peter , Wyper Grant M. A. , Van den Borre Laura
Published: August 2023

Introduction

Information on years of life lost (YLL) due to premature mortality is instrumental to assess the fatal impact of disease and necessary for the calculation of Belgian disability-adjusted life years (DALYs). This study presents a novel method to reallocate causes of death data.

Materials and methods

Causes of death data are provided by Statistics Belgium (Statbel). First, the specific ICD-10 codes that define the underlying cause of death are mapped to the GBD cause list. Second, ill-defined deaths (IDDs) are redistributed to specific ICD-10 codes. A four-step probabilistic redistribution was developed to fit the Belgian context: redistribution using predefined ICD codes, redistribution using multiple causes of death data, internal redistribution, and redistribution to all causes. Finally, we used the GBD 2019 reference life table to calculate Standard Expected Years of Life Lost (SEYLL).

Results

In Belgium, between 2004 and 2019, IDDs increased from 31 to 34% of all deaths. The majority was redistributed using predefined ICD codes (14–15%), followed by the redistribution using multiple causes of death data (10–12%). The total number of SEYLL decreased from 1.83 to 1.73 million per year. In 2019, the top cause of SEYLL was lung cancer with a share of 8.5%, followed by ischemic heart disease (8.1%) and Alzheimer’s disease and other dementias (5.7%). All results are available in an online tool https://burden.sciensano.be/shiny/mortality2019/.

Conclusion

The redistribution process assigned a specific cause of death to all deaths in Belgium, making it possible to investigate the full mortality burden for the first time. A large number of estimates were produced to estimate SEYLL by age, sex, and region for a large number of causes of death and every year between 2004 and 2019. These estimates are important stepping stones for future investigations on Disability-Adjusted Life Years (DALYs) in Belgium.
Digital innovation and entrepreneurship: a review of challenges in competitive markets
Authors: Kreiterling Christoph
Published: August 2023

This article presents a narrative review of seven selected studies investigating the impact of digital innovation on entrepreneurship and its outcomes within diverse sociopolitical contexts. Results show that improved innovation output scores and the ability to absorb innovative models are associated with higher GDP growth rates. Technological changes account for 35–40% of the dynamics, while regional factors account for 40%. Internet usage has led to decreased operational costs, increased sales, and better customer interaction for 88% of companies, enabling 83% to expand their markets and 78% to engage more effectively with suppliers. Digitalization fosters entrepreneurship expansion into new markets, creating a positive feedback loop between the two variables. Additionally, the study found that government roles have a more significant influence on entrepreneurship sustainability compared to electronic readiness. Digital technologies have been shown to enhance firm productivity, particularly in manufacturing and intensive industries.
Characterization of embroidered textile-based electrode for EMG smart wear according to stitch technique
Authors: Kim Hyelim , Rho Soohyeon , Lim Daeyoung , Jeong Wonyoung
Published: August 2023

This study fabricated and evaluated the textile-type electrodes for application to smartwear that can measure surface electromyography(sEMG). It was manufactured by lock stitch(LS) and moss stitch(MS), and the stitch distance was prepared as 1, 2, or 3 mm. The surface and compression property was measured by using the Kawabata evaluation system, and the sheet resistance and skin-electrode impedance were analyzed. The coefficient of friction(MIU) of the MS was larger than that of the LS. On the other hand, the geometrical roughness(SMD) showed a smaller value. When the same load was applied, the compressive range of the MS was larger than the LS. When it was manufactured as a leg sleeve and worn, the conductive path could be increased as the loops made of conductive yarn become flat as the loops adhere to the skin by the pressure of clothing. Accordingly, the skin-electrode impedance decreased by increasing the area in contact with the skin. As the results of the RMS(root-mean-square), the LS was higher than the MS in a stable. Nevertheless, the SNR(signal-to-noise ratio) value was lower than that of the MS because movement generated noise during operation. Therefore, more stable signal acquisition is possible when applying MS. It is expected that could be applied to producing smartwear for sEMG measurements with superior sEMG signal acquisition performance while having a softer touch and flexibility.
Health status analysis is comparable in HM3 patients with different preoperative grades of mitral regurgitation
Authors: Klaeske Kristin , Schreiber Constantin , Eifert Sandra , Dieterlen Tillmann , Jawad Khalil , Saeed Diyar , Semmig-Könze Sandra , Meyer Anna Lassia , Borger Michael Andrew , Dieterlen Maja-Theresa
Published: August 2023

Background

The guidelines for mechanical circulatory support of the International Society for Heart and Lung Transplantation do not recommend the routine replacement or repair of the mitral valve at the time point of left ventricular assist device (LVAD) implantation. We investigated different parameters of health status including exercise capacity, anxiety and depression after LVAD implantation in patients with different preoperative grades of mitral regurgitation (MR).

Methods

A single-center analysis of health status was performed including 45 patients with HeartMate 3 (HM 3) implantation using the 12-items Short Form Health Survey (SF-12) and the Hospital Anxiety and Depression Score (HADS) questionnaires. The study groups were classified according to echocardiographically defined preoperative grade of MR. The group without severe MR comprised 33 patients; the group with severe MR comprised 12 patients.

Results

Demographic and preclinical characteristics as well as LVAD complications such as thrombosis and bleeding events were comparable between LVAD patients with severe and not severe MR (p > 0.05). Severe MR resolved in all patients after LVAD implantation and improved to moderate, mild or no MR in both groups in a period ranging from 6 months until 2 years. The analyses of SF-12 questionnaire revealed that the physical (p = 0.44) and mental health (p = 0.64) was comparable. The grade of anxiety (p = 0.34) and depression (p = 0.44) was comparable between the groups. Exercise capacity measured by the 6 min walk test correlated positively with the SF-12-determined physical health (p < 0.01, r = 0.518) and negatively with the HADS anxiety (p = 0.01, r = −0.399) and depression (p < 0.01, r = −0.570) scores.

Conclusions

Our data showed that the health status is comparable in HM 3 patients with different preoperative MR severities in the post-LVAD period. Preoperative severe MR resolves in the majority of patients early after LVAD implantation and is not associated with concomitant mitral valve repair or replacement at the time of LVAD implantation.
An unusual presentation of severe preeclampsia presenting with maternal collapse in the post-cesarean section secondary to drug toxicity associated with pituitary hemorrhage: a case report
Authors: Kumar Krishna Mylavarapu , Madabushi Shyam , Lall Amit , Dwivedi Pranjali D.
Published: August 2023

Background

Severe preeclampsia presenting with maternal collapse post-cesarean section secondary to drug toxicity associated with pituitary hemorrhage is rare.

Case presentation

A 24-year-old primigravida 27 weeks of gestation presented with severe preeclampsia, and underwent emergency cesarean section; postoperatively, she had a sudden maternal collapse and cardiac arrest while on labetalol and magnesium infusion. Following the return of spontaneous circulation (ROSC), the patient was found to have severe bradycardia with prolonged QTc interval and recurrent hypoglycemic episodes. Investigations had revealed low serum cortisol with the brain showing pituitary hemorrhage with features of atypical Sheehan’s syndrome without lactation failure.

Conclusions

Drug toxicity is an important cause of maternal collapse and cardiac arrest. Pituitary hemorrhage needs to be suspected in maternal patients with recurrent hypoglycemic episodes with or without postpartum hemorrhage (PPH). Continuous monitoring, use of maternal early warning scoring systems (MEWS), and prudence in the perioperative period/labor room will help in reducing the complications.
High levels of pesticides found in illicit cannabis inflorescence compared to licensed samples in Canadian study using expanded 327 pesticides multiresidue method
Authors: Gagnon Mathieu , McRitchie Tyler , Montsion Kim , Tully Josée , Blais Michel , Snider Neil , Blais David R.
Published: August 2023

Background

As Cannabis was legalised in Canada for recreational use in 2018 with the implementation of the Cannabis Act, Regulations were put in place to ensure safety and consistency across the cannabis industry. This includes the requirement for licence holders to demonstrate that no unauthorized pesticides are used to treat cannabis or have contaminated it. In this study, we describe an expanded 327 multi-residue pesticide analysis in cannabis inflorescence to confirm if the implementation of the Cannabis Act is providing safer licensed products to Canadians in comparison to those of the illicit market.

Methods

An extensive multi-residue method was developed using a modified quick, easy, cheap, effective, rugged, and safe (QuEChERS) sample preparation method using a combination of gas chromatography—triple quadrupole mass spectrometry (GC–MS/MS) and liquid chromatography—triple quadrupole mass spectrometry (LC–MS/MS) for the simultaneous quantification of 327 pesticide active ingredients in cannabis inflorescence.

Results

Application of this method to Canadian licensed inflorescence samples revealed a 6% sample positivity rate with only two pesticide residues detected, myclobutanil, and dichlobenil, at the method’s lowest calibrated level (LCL) of 0.01 μg/g. Canadian illicit cannabis inflorescence samples analysed showed a striking contrast with a 92% sample positivity rate covering 23 unique pesticide active ingredients with 3.7 different pesticides identified on average per sample. Chlorpyrifos, imidacloprid, and myclobutanil were measured in illicit samples at concentrations up to three orders of magnitude above the method LCL of 0.01 μg/g.

Conclusion

These results demonstrate the need of an extensive multiresidue method capable of analysing hundreds of pesticides simultaneously, to generate data for future policy and regulatory decision-making, and to enable Canadians to make safe cannabis choices.
Immune cell infiltration-based prognosis in prostate cancer: a review of current knowledge
Authors: Apusiga Kingsley
Published: August 2023

Background

Despite the widespread use of tumor immune cell infiltrates as prognostic biomarkers in many cancers, their use in prostate cancer remains relatively unexplored. More recently, many studies are validating the use of tumor-infiltrating lymphocytes, macrophages and neutrophils for predicting cancer progression for other cancers. This review aims to identify what tumor-infiltrating immune cells have prognostic value for prediction prostate cancer progression.

Main body of the abstract

PubMed and Scopus were searched for eligible studies published from inception to May 31, 2023. Studies assessing tumor immune cell infiltrates were included. Twenty-six studies met the inclusion criteria. Infiltrating CD4+ and CD8+ T cell lymphocytes were prognostic and were associated with improved prostate cancer outcomes. Increased infiltration of M1 and M2 macrophages was prognostic and associated with worsening prostate cancer outcomes. High levels of infiltrating mast cells prognostically improve prostate cancer outcomes. Evidence of increased infiltration of neutrophils, monocytes and dendritic cells are conflicting and will require further studies to validate their role in prostate cancer prognosis.

Short conclusion

Despite the widespread use of tumor immune cell infiltrates for prediction outcome of many cancers, their use in prostate cancer is still limited. More evidence is required to help understand the landscape of immune cell infiltrates for predicting prostate cancer outcome.
Camera traps link population-level activity patterns with wildfire smoke events for mammals in Eastern Washington State
Authors: Ayars Jessalyn , Emmet Robert L. , Bassing Sarah B. , Sanderfoot Olivia V. , Raby Sierra , Karambelas Alexandra , James Eric P. , Ahmadov Ravan , Gardner Beth
Published: August 2023

Background

Due to anthropogenic climate change and historic fire suppression, wildfire frequency and severity are increasing across the western United States. Whereas the indirect effects of fire on wildlife via habitat change are well studied, less is known about the impacts of wildfire smoke on animal health and behavior. In this study, we explore the effects of wildfire smoke on the behavior of eight medium- to large-bodied mammalian species in a heterogenous study area in Washington, USA. We linked population-level activity metrics derived from camera trap data to concentrations of fire-specific fine particulate matter (PM2.5). We hypothesized that mammalian activity would decline during smoke events, as animals attempt to reduce potential health impacts of smoke inhalation. We used occupancy models and Poisson regression models to test the effect of fire-specific PM2.5levels on daily detection probability and the number of detections per day, respectively, for each study species.

Results

While we did not observe any significant responses to daily mean concentrations of PM2.5in the occupancy models, we found three species with significant responses in their rates of detections per day in the Poisson regression. Specifically, for each standard deviation increase in the daily mean concentration of PM2.5, there was a 12.9% decrease in the number of bobcat detections per day, an 11.2% decrease in the number of moose detections per day, and a 5.8% increase in the number of mule deer detections per day. In general, the effects of PM2.5were small compared to other relevant covariates.

Conclusions

We generally found little evidence to support our hypothesis that animals would reduce their activity in response to wildfire smoke. However, our study demonstrated that mammals exhibited species-specific behavioral responses to smoke, which are possibly adaptive responses to reduce health impacts from smoke inhalation. Though we found only a few immediate behavioral responses to smoke exposure, we note that longer-term health consequences of smoke exposure for wildlife are also likely and generally unknown. Our study shows how camera traps, which are already widely used to study wildlife, can also be used to investigate the impacts of wildfire smoke on animal behavior and provides a step towards developing methods to better understand this increasing source of environmental stress on wildlife.
The added value of using artificial intelligence in adult chest X-rays for nodules and masses detection in daily radiology practice
Authors: Farouk Suzan , Osman Ahmed M. , Awadallah Shrouk M. , Abdelrahman Ahmed S.
Published: August 2023

Background

Pulmonary nodule detection in CXR is challenging. Recently, the use of artificial intelligence (AI) has been a major attraction. The current study aimed to evaluate the diagnostic performance of the AI in the detection of pulmonary nodules or masses on CXR compared to the radiologist’s interpretation and to assess its impact on the reporting process. The current study included 150 patients who had CXR interpreted by radiologists and by AI software.

Results

CT detected pulmonary nodules in 99 cases (66%) while the visual model of analysis, as well as AI, detected nodules among 92 cases (61.3%) compared to 93 (62%) cases detected by combined visual/AI model. A total of 216 nodules were detected by CT (64.4% solid and 31.5% GG). Only 188 nodules were detected by the AI while 170 nodules were detected by visual analysis. As per case classification or nodule analysis, the AI showed the highest area under curve (AUC) (0.890, 95% CI) and (0.875, 95% CI), respectively, followed by the combined visual/AI model. Regarding the nodules’ texture, the AI model’s sensitivity for solid nodules was 91.4% which was greater than the combined visual/AI and visual models alone, while in GG nodules, the combined visual/AI model’s sensitivity was higher than the AI and visual models. The probability score using the combined visual/AI model was significantly higher than using the visual model alone (P value = 0.001).

Conclusions

The use of the AI model in CXR interpretation regarding nodules and masses detection helps in more accurate decision-making and increases the diagnostic performance affecting the patient’s morbidity and mortality.
RNA modification: mechanisms and therapeutic targets
Authors: Qiu Lei , Jing Qian , Li Yanbo , Han Junhong
Published: August 2023

RNA modifications are dynamic and reversible chemical modifications on substrate RNA that are regulated by specific modifying enzymes. They play important roles in the regulation of many biological processes in various diseases, such as the development of cancer and other diseases. With the help of advanced sequencing technologies, the role of RNA modifications has caught increasing attention in human diseases in scientific research. In this review, we briefly summarized the basic mechanisms of several common RNA modifications, including m6A, m5C, m1A, m7G, Ψ, A-to-I editing and ac4C. Importantly, we discussed their potential functions in human diseases, including cancer, neurological disorders, cardiovascular diseases, metabolic diseases, genetic and developmental diseases, as well as immune disorders. Through the “writing-erasing-reading” mechanisms, RNA modifications regulate the stability, translation, and localization of pivotal disease-related mRNAs to manipulate disease development. Moreover, we also highlighted in this review all currently available RNA-modifier-targeting small molecular inhibitors or activators, most of which are designed against m6A-related enzymes, such as METTL3, FTO and ALKBH5. This review provides clues for potential clinical therapy as well as future study directions in the RNA modification field. More in-depth studies on RNA modifications, their roles in human diseases and further development of their inhibitors or activators are needed for a thorough understanding of epitranscriptomics as well as diagnosis, treatment, and prognosis of human diseases.
Hemoptysis due to ruptured lung abscess successfully treated by exploratory thoracoscopy: report of a case
Authors: Miyano Yutaka , Oyama Kunihiro , Saito Yuka , Kanzaki Masato
Published: August 2023

Background

Ruptured lung abscess is rare and a serious medical concern. We reported a rare case of exploratory thoracoscopy for hemoptysis and empyema due to ruptured lung abscess.

Case

A 49-year-old man visited our hospital due to hemoptysis. Chest CT showed a left empyema due to ruptured lung abscess in the left lower lobe. Exploratory thoracoscopy revealed thoracic empyema with bronchopleural fistula, and thoracotomy was performed and curettage for empyema cavity, and closure of bronchopleural fistula was done. It was closed by sutures with polyglycolic-acid sheet as a pledget and covered with thickened pleura. A pneumonia and a small cavity, which seemed to be aspiration, were found on the healthy side, and the patient is being closely followed up.

Conclusion

We encountered a surgical case of ruptured lung abscess that is a cause of hemoptysis, and postoperative course was uneventful. Exploratory thoracoscopy was effective in confirming the fistula.
Long-term Outcomes of Testosterone Treatment in Men: A T4DM Postrandomization Observational Follow-up Study
Authors: Handelsman David J , Grossmann Mathis , Yeap Bu B , Stuckey Bronwyn G A , Shankara-Narayana Nandini , Conway Ann J , Inder Warrick J , McLachlan Robert I , Allan Carolyn , Jenkins Alicia J , Jesudason David , Bracken Karen , Wittert Gary A
Published: August 2023

Context

The T4DM study randomized 1007 men with impaired glucose tolerance or newly diagnosed diabetes to testosterone undecanoate (TU, 1000 mg) or matching placebo (P) injections every 12 weeks for 24 months with a lifestyle program with testosterone (T) treatment reducing diabetes diagnosis by 40%.

Background

The long-term effects on new diagnosis of diabetes, cardiovascular and prostate disease, sleep apnea, weight maintenance trajectory and androgen dependence were not yet described.

Methods

A follow-up email survey after a median of 5.1 years since last injection obtained 599 (59%) completed surveys (316 T, 283 P), with participants in the follow-up survey compared with nonparticipants in 23 anthropometric and demographic variables.

Results

Randomization to was TU associated with stronger belief in study benefits during (64% vs 49%, P < .001) but not after the study (44% vs 40%, P = .07); there is high interest in future studies. At T4DM entry, 25% had sleep apnea with a new diagnosis more frequent on TU (3.0% vs 0.4%, P = .03) during, but not after, the study. Poststudy, resuming prescribed T treatment was more frequent among TU-treated men (6% vs 2.8%, P = .03). Five years after cessation of TU treatment there was no difference in self-reported rates of new diagnosis of diabetes, and prostate or cardiovascular disease, nor change in weight maintenance or weight loss behaviors.

Conclusion

We conclude that randomized T treatment for 24 months in men with impaired glucose tolerance or new diabetes but without pathological hypogonadism was associated with higher levels of self-reported benefits and diagnosis of sleep apnea during, but not after, the study as well as more frequent prescribed poststudy T treatment consistent with androgen dependence in some men receiving prolonged injectable TU.