bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of on-site cardiac surgical backup on clinical outcomes of acute coronary syndrome—analysis of the ACSIS national registry
Authors: Moady Gassan , Ovdat Tal , Rubinshtein Ronen , Eitan Amnon , Daud Elias , Arow Ziad , Atar Shaul
Published: September 2023

Background

The availability of advanced technologies for mechanical support in hospitals with on-site cardiac surgery (CS), along with the ability to perform urgent coronary artery bypass graft (CABG) surgery, may result in improved clinical outcomes in patients with acute coronary syndrome (ACS).

Methods

We conducted a retrospective analysis of the bi-annually Acute Coronary Syndrome Israeli Survey (ACSIS) registry from the year 2000 to 2020, performed in hospitals with and without CS. Mortality rates and major adverse cardiac and cerebrovascular events (MACCE) rates are reported. We evaluated two periods of the study—early (2000–2010) vs. late (2011–2020). Propensity score matching was performed to reduce bias between the two groups.

Results

The study included 16,979 patients (52.3% in the on-site CS group). Patients in the on-site CS group were more likely to undergo percutaneous coronary intervention (PCI), (odds ratio [OR], 1.26 [95% CI, 1.18–1.35]; p < 0.001) and CABG [OR, 1.91 (95%CI, 1.63–2.24); P < 0.001], and patients in hospitals without on-site CS had higher 30-day MACCE [OR, 1.17 (95% CI, 1.07–1.27); p < 0.0005]. Overall, there was no difference in 1-year mortality (hazard ratio [HR], 0.98 [95% CI, 0.89–1.08]; p = 0.71) between the groups. During the late period of the study, patients in the group without on-site CS had lower 30-day mortality [OR, 0.69 (95% CI, 0.49–0.97); P = 0.04], yet with no difference in 1-year mortality [HR, 0.81 (95% CI, 0.65–1.01); p = 0.07].

Conclusions

The availability of on-site CS resulted in variations in treatment modality, yet it did not affect the clinical outcomes of ACS. A trend to a better short-term outcomes was noted in hospitals without CS during the late period of the study, which warrants further investigation.
Breathing pattern and pulmonary gas exchange in elderly patients with and without left ventricular dysfunction—modification with exercise-based cardiac rehabilitation and prognostic value
Authors: Eser Prisca , Marcin Thimo , Prescott Eva , Prins Leonie F. , Kolkman Evelien , Bruins Wendy , van der Velde Astrid E. , Gil Carlos Peña , Iliou Marie-Christine , Ardissino Diego , Zeymer Uwe , Meindersma Esther P. , Van’t Hof Arnoud W. J. , de Kluiver Ed P. , Wilhelm Matthias
Published: September 2023

Background

Inefficient ventilation is an established prognostic marker in patients with heart failure. It is not known whether inefficient ventilation is also linked to poor prognosis in patients with left ventricular dysfunction (LVD) but without overt heart failure.

Objectives

To investigate whether inefficient ventilation in elderly patients with LVD is more common than in patients without LVD, whether it improves with exercise-based cardiac rehabilitation (exCR), and whether it is associated with major adverse cardiovascular events (MACE).

Methods

In this large multicentre observational longitudinal study, patients aged ≥65 years with acute or chronic coronary syndromes (ACS, CCS) without cardiac surgery who participated in a study on the effectiveness of exCR in seven European countries were included. Cardiopulmonary exercise testing (CPET) was performed before, at the termination of exCR, and at 12 months follow-up. Ventilation (VE), breathing frequency (BF), tidal volume (VT), and end-expiratory carbon dioxide pressure (PETCO2) were measured at rest, at the first ventilatory threshold, and at peak exercise. Ventilatory parameters were compared between patients with and without LVD (based on cardio-echography) and related to MACE at 12 month follow-up.

Results

In 818 patients, age was 72.5 ± 5.4 years, 21.9% were women, 79.8% had ACS, and 151 (18%) had LVD. Compared to noLVD, in LVD resting VE was increased by 8%, resting BF by 6%, peak VE, peak VT, and peak PETCO2 reduced by 6%, 8%, and 5%, respectively, and VE/VCO2 slope increased by 11%. From before to after exCR, resting VE decreased and peak PETCO2 increased significantly more in patients with compared to without LVD. In LVD, higher resting BF, higher nadir VE/VCO2, and lower peak PETCO2 at baseline were associated with MACE.

Conclusions

Similarly to patients with HF, in elderly patients with ischemic LVD, inefficient resting and exercise ventilation was associated with worse outcomes, and ExCR alleviated abnormal breathing patterns and gas exchange parameters.
Clinical presentation and neurovascular manifestations of cardiac myxomas and papillary fibroelastomas: a retrospective single-institution cohort study
Authors: Mathavan Akshay , Mathavan Akash , Krekora Urszula , Mathavan Mohit , Rodriguez Vanessa , Altshuler Ellery , Nguyen Brianna , Ruzieh Mohammed
Published: September 2023

Background

Primary cardiac tumors are often benign and commonly present as cardiac myxomas (CMs) or papillary fibroelastomas (CPFEs). There is a paucity of prognostic indicators for tumor burden or potential for embolic cerebrovascular events (CVEs). This study was performed to address these gaps.

Methods

Medical records at the University of Florida Health Shands Hospital between 1996 and 2021 were screened to identify patients with CMs or CPFEs. Clinical features, echocardiographic reports, and CVE outcomes were quantitatively assessed.

Results

A total of 55 patients were included in the study: 28 CM (50.9%) and 27 CPFE (49.1%) patients. Baseline patient characteristics were similar among patients. The neutrophil–lymphocyte ratio was correlated (p < 0.005 in all cases) to three metrics of tumor size in both CM (r = 64–67%) and CPFE (r = 56–59%). CVEs were the presenting symptom in 30 (54.5%) patients. CVE recurrence was high; the 5-year CVE recurrence rate in patients with tumor resection was 24.0% compared to 60.0% without resection. No baseline patient characteristics or tumor features were associated with an initial presentation of CVEs compared to any other indication. Univariate analysis indicated that prolonged duration to surgical resection, left atrial enlargement, male sex, and a neutrophil–lymphocyte ratio >3.0 at the follow-up were significantly associated with 5-year CVE recurrence. Left atrial enlargement and a neutrophil–lymphocyte ratio >3.0 at the follow-up remained significantly associated with 5-year CVE recurrence in multivariate analysis.

Conclusion

The neutrophil–lymphocyte ratio may prognosticate tumor size and recurrence of neurologic events. An increased risk of CVE within 5 years of mass resection is almost exclusive to patients initially presenting with CVEs.
Bathymetries of proglacial lakes: a new data set from the northern Tien Shan, Kazakhstan
Authors: Kapitsa Vassiliy , Shahgedanova Maria , Kasatkin Nikolay , Severskiy Igor , Kasenov Murat , Yegorov Alexandr , Tatkova Mariya
Published: September 2023

Between 2009 and 2020, 74 bathymetric surveys of 57 glacial lakes were conducted in the northern Tien Shan using the ecosounding technique. The surveys provided data on lake depths and other parameters characterising the three-dimensional lake geometry, and bathymetrically derived lake volumes. The sample included 21 glacier-connected lakes, 27 lakes formed on the young moraines without glacier-connected with glacier tongue, eight lakes formed on the older moraines and one rock-dammed lake. The lakes’ volumes ranged between 0.029x105 and 53.89x105 m3 with the largest value of mean depth was 23 m. There is a statistically significant correlation between lake depth and width, length and area, best approximated by the power, linear, and polynomial models, with coefficients of determination ranging between 0.50 and 0.78 for the glacier-connected lakes. The power equations underestimated both depths and volumes of larger lakes but the second-order polynomial model provided a closer approximation in the study region. The obtained data were combined with the bathymetrically derived depth and volume data published in the literature extending the global data set of bathymetries of lakes with natural dams. The area-depth scaling equations derived from the combined data set showed a considerable improvement in correlation between area and depth in comparison with the earlier studies. The measured bathymetries of the glacier-connected lakes were compared with bathymetries of the same lakes simulated using GlabTOP2 model and published simulated ice thickness data. There is generally a good agreement between the measured and simulated bathymetries although GlabTOP2 tends to overestimate lake depths. The data from the bathymetric surveys and GlabTOP2 model are used by the practitioners to reduce and avoid risks associated with glacier lake outburst floods and are important instruments of the regional strategy of adaptation to climate change.
Genome-wide identification and characterization of ADH gene family and the expression under different abiotic stresses in tomato (Solanum lycopersicum L.)
Authors: Zhu Qingdong , Han Yading , Yang Wentao , Zhu Hang , Li Guangtong , Xu Ke , Long Mingxin
Published: September 2023

The SlADH gene plays a key role in environmental stress response. However, limited studies exist regarding the tomato SlADH gene. In this study, we identified 35 SlADH genes in tomato by genome-wide identification. Among the 12 chromosomes of tomato, SlADH gene is distributed on 10 chromosomes, among which the 7th and 10th chromosomes have no family members, while the 11th chromosome has the most members with 8 family members. Members of this gene family are characterized by long coding sequences, few amino acids, and introns that make up a large proportion of the genetic structure of most members of this family. Moreover, the molecular weight of the proteins of the family members was similar, and the basic proteins were mostly, and the overall distribution was relatively close to neutral (pI = 7). This may indicate that proteins in this family have a more conserved function. In addition, a total of four classes of cis-acting elements were detected in all 35 SlADH promoter regions, most of which were associated with biotic and abiotic stresses. The results indicate that SlADH gene had a certain response to cold stress, salt stress, ABA treatment and PEG stress. This study provides a new candidate gene for improving tomato stress resistance.
Representation of mental illness in video games beyond stigmatization
Authors: Kasdorf Ruth
Published: September 2023

The representation of mental illness is part of many video games; however, it is often accompanied by stigmatization of and discrimination against those who are affected. Recently, a more positive approach has been found, including a dimensional representation of mental disorders such as depression or anxiety, especially in games developed by independent developers. The study examined the most popular video games of 2018 and 2019 based on their representation of mental illness in a mixed-methods approach. A quantitative coding process examining general aspects of the games, the characters affected, and the illness representation is followed by a qualitative video game analysis of the games in the sample with a dimensional representation of mental illness. It was found that 16 of the 74 games examined included characters who were affected by mental illnesses. For the most part, mental illness is an essential aspect of the games analyzed in the sample represented by the main characters. However, the depiction of mental illness often lacks depth and dimensionality. Two examples in the study offer a dimensional representation that includes mental illness as characters, as part of the environment and atmosphere, and provides illness-related advice as part of the gameplay. These findings can be helpful for developing games with the potential to reduce discrimination and stigmatization of mental illness and those affected in the future by pointing out aspects leading to a more dimensional and empathetic portrayal of mental illness in existing games. Additionally, the category system used in this study is adaptable to future qualitative research on mental illness representation in video games.
Low-illumination underwater image enhancement based on non-uniform illumination correction and adaptive artifact elimination
Authors: Ning Yu , Jin Yong-Ping , Peng You-Duo , Yan Jian
Published: September 2023

High-quality underwater images are used to extract information for a variety of purposes, including habitat characterization, species monitoring, and behavioral analysis. However, due to the limitation of non-uniform illumination environment and equipment, these images often have the problem of local over- or underexposure due to non-uniform illumination. Conventional methods cannot fully correct for this, and the dark area artifacts generated in the process of enhancing a low-light image cannot be readily fixed. Therefore, we describe a low-illumination underwater image enhancement method based on non-uniform illumination correction and adaptive artifact elimination. First, to eliminate the influence of non-uniform illumination on underwater images, an illumination equalization algorithm based on non-linear guided filtering corrects the non-uniform bright and dark regions of underwater images, and the dark channel prior algorithm and contrast-limited adaptive histogram equalization algorithm are introduced to prevent excessive enhancement of images and generation of dark regions. Then, in order to adaptively eliminate the dark area artifacts generated during the enhancement process, an adaptive multi-scale Retinex color fidelity algorithm with color restore is proposed to improve the color of the image and adaptively eliminate the dark area artifacts of the image. Then, the gray world white balance algorithm is used to adjust the color distortion caused by the attenuation of light. Finally, a multi-scale Retinex model parameter estimation algorithm is proposed to obtain the illumination component and reflection component of the image, and then, the enhanced image is obtained according to the Retinex model. The results show that the proposed method is superior to other algorithms regarding contrast, color restoration, and comprehensive effect, and improves low-illumination image enhancement technology.
A state-of-the-art review of functional magnetic resonance imaging technique integrated with advanced statistical modeling and machine learning for primary headache diagnosis
Authors: Li Ming-Lin , Zhang Fei , Chen Yi-Yang , Luo Han-Yong , Quan Zi-Wei , Wang Yi-Fei , Huang Le-Tian , Wang Jia-He
Published: September 2023

Primary headache is a very common and burdensome functional headache worldwide, which can be classified as migraine, tension-type headache (TTH), trigeminal autonomic cephalalgia (TAC), and other primary headaches. Managing and treating these different categories require distinct approaches, and accurate diagnosis is crucial. Functional magnetic resonance imaging (fMRI) has become a research hotspot to explore primary headache. By examining the interrelationships between activated brain regions and improving temporal and spatial resolution, fMRI can distinguish between primary headaches and their subtypes. Currently the most commonly used is the cortical brain mapping technique, which is based on blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI). This review sheds light on the state-of-the-art advancements in data analysis based on fMRI technology for primary headaches along with their subtypes. It encompasses not only the conventional analysis methodologies employed to unravel pathophysiological mechanisms, but also deep-learning approaches that integrate these techniques with advanced statistical modeling and machine learning. The aim is to highlight cutting-edge fMRI technologies and provide new insights into the diagnosis of primary headaches.
Ex-utero third trimester developmental changes in functional brain network organization in infants born very and extremely preterm
Authors: Cook Kevin M. , De Asis-Cruz Josepheen , Basu Sudeepta K. , Andescavage Nickie , Murnick Jonathan , Spoehr Emma , du Plessis Adré J. , Limperopoulos Catherine
Published: September 2023

Introduction

The latter half of gestation is a period of rapid brain development, including the formation of fundamental functional brain network architecture. Unlike in-utero fetuses, infants born very and extremely preterm undergo these critical maturational changes in the extrauterine environment, with growing evidence suggesting this may result in altered brain networks. To date, however, the development of functional brain architecture has been unexplored.

Methods

From a prospective cohort of preterm infants, graph parameters were calculated for fMRI scans acquired prior to reaching term equivalent age. Eight graph properties were calculated, Clustering Coefficient (C), Characteristic Path Length (L), Modularity (Q), Local Efficiency (LE), Global Efficiency (GE), Normalized Clustering (λ), Normalized Path Length (γ), and Small-Worldness (σ). Properties were first compared to values generated from random and lattice networks and cost efficiency was evaluated. Subsequently, linear mixed effect models were used to assess relationship with postmenstrual age and infant sex.

Results

A total of 111 fMRI scans were acquired from 85 preterm infants born at a mean GA 28.93 ± 2.8. Infants displayed robust small world properties as well as both locally and globally efficient networks. Regression models found that GE increased while L, Q, λ, γ, and σ decreased with increasing postmenstrual age following multiple comparison correction (r2Adj range 0.143–0.401, p < 0048), with C and LE exhibited trending increases with age.

Discussion

This is the first direct investigation on the extra-uterine formation of functional brain architecture in preterm infants. Importantly, our results suggest that changes in functional architecture with increasing age exhibit a different trajectory relative to in utero fetus. Instead, they exhibit developmental changes more similar to the early postnatal period in term born infants.
Defining the lipid profiles of human milk, infant formula, and animal milk: implications for infant feeding
Authors: George Alexandra D. , Paul Sudip , Wang Tingting , Huynh Kevin , Giles Corey , Mellett Natalie , Duong Thy , Nguyen Anh , Geddes Donna , Mansell Toby , Saffery Richard , Vuillermin Peter , Ponsonby Anne-Louise , Burgner David , Burugupalli Satvika , Meikle Peter J. ,   Barwon Infant Study Investigator Team
Published: September 2023

Background

Breastfed infants have lower disease risk compared to formula-fed infants, however, the mechanisms behind this protection are unknown. Human milk has a complex lipidome which may have many critical roles in health and disease risk. However, human milk lipidomics is challenging, and research is still required to fully understand the lipidome and to interpret and translate findings. This study aimed to address key human milk lipidome knowledge gaps and discuss possible implications for early life health.

Methods

Human milk samples from two birth cohorts, the Barwon Infant Study (n = 312) and University of Western Australia birth cohort (n = 342), were analysed using four liquid chromatography-mass spectrometry (LC–MS) methods (lipidome, triacylglycerol, total fatty acid, alkylglycerol). Bovine, goat, and soy-based infant formula, and bovine and goat milk were analysed for comparison. Composition was explored as concentrations, relative abundance, and infant lipid intake. Statistical analyses included principal component analysis, mixed effects modelling, and correlation, with false discovery rate correction, to explore human milk lipidome longitudinal trends and inter and intra-individual variation, differences between sample types, lipid intakes, and correlations between infant plasma and human milk lipids.

Results

Lipidomics analysis identified 979 lipids. The human milk lipidome was distinct from that of infant formula and animal milk. Ether lipids were of particular interest, as they were significantly higher, in concentration and relative abundance, in human milk than in formula and animal milk, if present in the latter samples at all. Many ether lipids were highest in colostrum, and some changed significantly through lactation. Significant correlations were identified between human milk and infant circulating lipids (40% of which were ether lipids), and specific ether lipid intake by exclusively breastfed infants was 200-fold higher than that of an exclusively formula-fed infant.

Conclusion

There are marked differences between the lipidomes of human milk, infant formula, and animal milk, with notable distinctions between ether lipids that are reflected in the infant plasma lipidome. These findings have potential implications for early life health, and may reveal why breast and formula-fed infants are not afforded the same protections. Comprehensive lipidomics studies with outcomes are required to understand the impacts on infant health and tailor translation.
Deep learning techniques for imaging diagnosis of renal cell carcinoma: current and emerging trends
Authors: Wang Zijie , Zhang Xiaofei , Wang Xinning , Li Jianfei , Zhang Yuhao , Zhang Tianwei , Xu Shang , Jiao Wei , Niu Haitao
Published: September 2023

This study summarizes the latest achievements, challenges, and future research directions in deep learning technologies for the diagnosis of renal cell carcinoma (RCC). This is the first review of deep learning in RCC applications. This review aims to show that deep learning technologies hold great promise in the field of RCC diagnosis, and we look forward to more research results to meet us for the mutual benefit of renal cell carcinoma patients. Medical imaging plays an important role in the early detection of renal cell carcinoma (RCC), as well as in the monitoring and evaluation of RCC during treatment. The most commonly used technologies such as contrast enhanced computed tomography (CECT), ultrasound and magnetic resonance imaging (MRI) are now digitalized, allowing deep learning to be applied to them. Deep learning is one of the fastest growing fields in the direction of medical imaging, with rapidly emerging applications that have changed the traditional medical treatment paradigm. With the help of deep learning-based medical imaging tools, clinicians can diagnose and evaluate renal tumors more accurately and quickly. This paper describes the application of deep learning-based imaging techniques in RCC assessment and provides a comprehensive review.
Phenotypic characteristics of circulating tumor cells and predictive impact for efficacy of chemotherapy in patients with pancreatic cancer: a prospective study
Authors: Lee Hee Seung , Jung Eun Hye , Shin Hyejung , Park Chan Su , Park Soo Been , Jung Dawoon E. , Leem Galam , Kim So Jung , Jo Jung Hyun , Chung Moon Jae , Park Jeong Youp , Bang Seungmin , Park Seung Woo , Song Si Young
Published: September 2023

Objective

Early chemoresistance and tumor mass progression are associated with poor prognosis in pancreatic ductal adenocarcinoma (PDAC). Circulating tumor cells (CTCs) have been studied as potential predictors of treatment response and prognosis in PDAC; however, this approach has yet to be applied in clinical practice. The aim of our study was to investigate the phenotypic characteristics of CTCs and determine their predictive value for PDAC progression.

Methods

We prospectively enrolled 40 patients who were pathologically diagnosed with PDAC and collected blood samples at diagnosis, 2 months after diagnosis, and during disease progression or recurrence. We used a microfabricated filter-based enrichment system to retrieve and analyze CTCs, which were classified using immunofluorescence staining (CD45, EpCAM, and vimentin).

Results

Our study included 20 women and 20 men (median age, 66 years). Overall, 45% of the patients (18/40) had disseminated disease, and 77.5% (31/40) received chemotherapy. Multivariate analysis revealed that the total CTC count and carbohydrate antigen 19-9 level at 2 months after diagnosis were associated with disease progression (P<0.05). Linear mixed model analysis revealed that the total CTC count and vimentin-positive CTCs were significantly correlated with treatment response during chemotherapy (P=0.024 and 0.017, respectively). Kaplan–Meier analysis showed that total CTC positivity at 2 months was significantly associated with poor progression-free survival (P=0.038).

Conclusion

Our study’s findings suggest that CTCs can serve as predictive biomarkers of clinical outcomes in patients with PDAC receiving palliative chemotherapy. In particular, the total CTC count and vimentin-positive CTCs showed changes associated with the chemotherapy response.
Current status of clinical trial research and application of immune checkpoint inhibitors for non-small cell lung cancer
Authors: Wang Fuli , Xia Teng , Li Zhiqiang , Gao Xuzhu , Fang Xinjian
Published: September 2023

Immunotherapy has emerged as a hot topic in the treatment of non-small cell lung cancer (NSCLC) with remarkable success. Compared to chemotherapy patients, the 5-year survival rate for immunotherapy patients is 3-fold higher, approximately 4%–5% versus 15%–16%, respectively. Immunotherapies include chimeric antigen receptor T-cell (CAR-T) therapy, tumor vaccines, immune checkpoint inhibitors, and so forth. Among them, immune checkpoint inhibitors are in the spotlight. Common immune checkpoint inhibitors (ICIs) currently in clinical use include programmed death receptor-1(PD-1)/programmed death ligand-1(PD-L1) and cytotoxic T lymphocyte-associated antigen 4(CTLA-4). This article focuses on monotherapy and combination therapy of CTLA-4 and PD-1/PD-L1 immune checkpoint inhibitors. In particular, the combination therapy of ICIs includes the combination of ICIs and chemotherapy, the combination therapy of dual ICIs, the combination of ICIs and anti-angiogenic drugs, the combination of ICIs and radiotherapy, and the combination of ICIs inhibitors and tumor vaccines and so forth. This article focuses on the combination therapy of ICIs with chemotherapy, the combination therapy of dual ICIs, and the combination therapy of ICIs with anti-angiogenic drugs. The efficacy and safety of ICIs as single agents in NSCLC have been demonstrated in many trials. However, ICIs plus chemotherapy regimens offer significant advantages in the treatment of NSCLC with little to no dramatic increase in toxicity, while combined dual ICIs significantly reduce the adverse effects (AEs) of chemotherapy. ICIs plus anti-angiogenic agents regimen improves anti-tumor activity and safety and is expected to be the new paradigm for the treatment of advanced NSCLC. Despite some limitations, these agents have achieved better overall survival rates. In this article, we review the current status and progress of research on ICIs in NSCLC in recent years, aiming to better guide the individualized treatment of NSCLC patients.
Evaluation of CT features for differentiating consolidation pattern of pulmonary MALT lymphoma from pneumonic-type lung adenocarcinoma
Authors: Dong Congsong , Xia Peng , Qiu Wenli , Dai Zhenyu , Wang Zhongqiu
Published: September 2023

Purpose

In clinical practice, the consolidation pattern of pulmonary mucosa-associated lymphoid tissue (C-MALT) was often misdiagnosed as pneumonic-type lung adenocarcinoma (P-LADC). However, the mainstay of treatment and prognosis of these two diseases are different. The purpose of this study was to distinguish C-MALT from P-LADC by pre-treatment chest computed tomography (CT) features.

Patients and methods

A total of 31 patients with C-MALT (15 men and 16 women; mean age, 61.1 ± 11.2 years) and 58 patients with P-LADC (34 men and 24 women; mean age, 68.6 ± 7.4 years) confirmed by pathology who underwent contrast-enhanced chest CT were retrospectively enrolled from September 2014 to February 2023. Detailed clinical and CT characteristics of the two groups were evaluated. Logistic regression analysis was used to assess the effectiveness of statistically significant variables in distinguishing C-MALT from P-LADC.

Results

The average age of C-MALT was younger than P-LADC patients (p<0.001). With regard to CT features, bronchiectasis within the consolidation was more common in the C-MALT group than the P-LADC group [83.87% (26 of 31) vs 20.69% (12 of 58), p<0.001]; whereas lymph nodes enlargement [75.86% (44 of 58) vs 9.68% (3 of 31), p<0.001] and pleural effusion [43.10% (25of 58) vs 19.35% (6 of 31), p=0.025] were more frequently observed in the P-LADC group than C-MALT group. The predictors with p<0.05 (age, bronchiectasis, lymph node enlargement, and pleural effusion) were used to construct a logistic regression model in discriminating C-MALT from P-LADC, the area under curve (AUC), positive predictive value (PPV), negative predictive value (NPV), specificity, sensitivity, and accuracy were 0.9555, 86.67%, 91.53%, 83.87%, 93.10%, and 89.89%, respectively.

Conclusion

C-MALT and P-LADC have differential clinical and CT features. An adequate understanding of these different characteristics can contribute to the early accurate diagnosis of C-MALT and provide an appropriate therapeutic strategy.
An improvement in the reconstruction of digestive tract after total gastrectomy: ultra-short cecum
Authors: Ding Shikang , Yang Xin , Li Yibo , Zheng Xiaohao , Song Yanyang , Xie Yibin
Published: September 2023

Aim

This study aimed to evaluate the utility and complications of ultra-short cecum (USC) in the reconstruction of digestive tract after total gastrectomy (TG) for the alleviation of reflux esophagitis and to determine its effect on long-term nutritional status.

Methods

Patients who underwent TG with USC or normal cecum (NC) at a single institution between June 2018 and December 2020 were included in this study. The inclusion and exclusion criteria were defined, and the primary endpoints were reflux esophagitis, anastomotic leakage and postoperative nutritional status. The long-term nutritional status was evaluated by the change trend of laboratory blood tests, including total protein, prealbumin, hemoglobin, and total leukocytes.

Results

Totally 240 cases were included in the final analysis out of 496 patients who received TG with USC or NC. Postoperative reflux esophagitis was significantly higher in the NC group than in the USC group (24.7% versus 7.7%, P = 0.001), and the NC group had a higher incidence of severe esophagitis symptoms compared to the USC group (13.6% versus 0.00%, P < 0.001), and the incidence of anastomotic leakage in the USC group was similar to that in the NC group (9.0% versus 6.2%, P = 0.6). There was no significant difference in long-term nutritional status between the USC and NC groups in the two years following the surgery (P > 0.05).

Conclusion

Ultra-short cecum after total gastrectomy should be more actively recommended due to its significant reduction in reflux esophagitis and similar incidence of anastomotic leakage and nutritional status compared with normal cecum after total gastrectomy.
Efficacy and safety of anlotinib plus XELOX regimen as first-line therapy for mCRC: a single-arm, multicenter, phase II study (ALTER-C-001)
Authors: Song Bo , Hu Hai , Zhang Li , Ye Su-Juan , Jin Yong-Dong , Shang Chang-Ling , Zhang Jun , Sun Hao , Zhang Ke , Yi Bo , Han Yun-Wei , Yan Jin
Published: September 2023

Background

Anlotinib showed encouraging anti-tumor activity in metastatic colorectal cancer (mCRC). This study was designed to assess the efficacy and safety of anlotinib plus XELOX as first-line therapy in mCRC patients.

Materials and Methods

Eligible patients aged ≥18 with mCRC were enrolled in this multicenter, single-arm, phase II, exploratory study. Patients received at least 6 cycles of anlotinib, oxaliplatin, and capecitabine as initial therapy. Subsequently, patients received anlotinib monotherapy as maintenance therapy until tumor progression or intolerable toxicity. The primary endpoint was progression-free survival (PFS).

Results

Thirty-one patients were included between December 2019 and March 2022. The median follow-up was 17.5 (95% CI, 3.0-17.5) months. The median PFS was 8.3 (95% CI, 6.3-10.0) months, with 6- and 12-month PFS rates of 82.3% (95% CI, 59.2%-93.0%) and 18.9% (95% CI, 4.8%-40.1%), respectively. Fifteen (48.4%) achieved partial response for an ORR of 48.4% (95% CI, 30.2%-66.9%). The disease control rate was 71.0% (95% CI, 52.0%-85.8%) due to 7 (22.6%) stable diseases. The median duration of response was 6.0 (95% CI, 3.6-8.0) months and 1 patient had the longest ongoing response of 17.3 months. Of 24 patients with evaluable imaging, 23 (74.2%) obtained tumor shrinkage. The median PFS (11.0 vs. 6.9 months) and ORR (66.7% vs. 60.0%) for patients with RAS/BRAF wild-type were numerically better than those with mutation. Three patients are still ongoing treatment. The grade 3 or more treatment-emergent adverse events (TEAEs) were mainly hypertension (12.9%) and decreased neutrophil count (12.9%). Four (12.9%) had serious TEAEs, primarily including abdominal pain and incomplete intestinal obstruction.

Conclusion

Anlotinib plus XELOX as first-line therapy in patients with mCRC showed anti-tumor activity and safety profile, which is worth further investigation.

Clinical Trial Registration

chictr.org.cn, identifier ChiCTR1900028417.
Untargeted plasma metabolome identifies biomarkers in patients with extracranial arteriovenous malformations
Authors: Fan Xueqiang , Gao Xixi , Deng Yisen , Ma Bo , Liu Jingwen , Zhang Zhaohua , Zhang Dingkai , Yang Yuguang , Wang Cheng , He Bin , Nie Qiangqiang , Ye Zhidong , Liu Peng , Wen Jianyan
Published: September 2023

Objective: This study aimed to investigate the plasma metabolic profile of patients with extracranial arteriovenous malformations (AVM).

Method: Plasma samples were collected from 32 AVM patients and 30 healthy controls (HC). Ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) was employed to analyze the metabolic profiles of both groups. Metabolic pathway enrichment analysis was performed through Kyoto Encyclopedia of Genes and Genomes (KEGG) database and MetaboAnalyst. Additionally, machine learning algorithms such as Least Absolute Shrinkage and Selection Operator (LASSO) and random forest (RF) were conducted to screen characteristic metabolites. The effectiveness of the serum biomarkers for AVM was evaluated using a receiver-operating characteristics (ROC) curve.

Result: In total, 184 differential metabolites were screened in this study, with 110 metabolites in positive ion mode and 74 metabolites in negative mode. Lipids and lipid-like molecules were the predominant metabolites detected in both positive and negative ion modes. Several significant metabolic pathways were enriched in AVMs, including lipid metabolism, amino acid metabolism, carbohydrate metabolism, and protein translation. Through machine learning algorithms, nine metabolites were identify as characteristic metabolites, including hydroxy-proline, L-2-Amino-4-methylenepentanedioic acid, piperettine, 20-hydroxy-PGF2a, 2,2,4,4-tetramethyl-6-(1-oxobutyl)-1,3,5-cyclohexanetrione, DL-tryptophan, 9-oxoODE, alpha-Linolenic acid, and dihydrojasmonic acid.

Conclusion: Patients with extracranial AVMs exhibited significantly altered metabolic patterns compared to healthy controls, which could be identified using plasma metabolomics. These findings suggest that metabolomic profiling can aid in the understanding of AVM pathophysiology and potentially inform clinical diagnosis and treatment.
Physiological response and molecular regulatory mechanism reveal a positive role of nitric oxide and hydrogen sulfide applications in salt tolerance of Cyclocarya paliurus
Authors: Zhang Lei , Liu Yang , Zhang Zijie , Fang Shengzuo
Published: September 2023

As a multifunctional tree species, Cyclocarya paliurus leaves are rich in bioactive substances with precious healthy values. To meet the huge requirement of C. paliurus leaf production, sites with some environmental stresses would be potential land for developing its plantations due to the limitation of land resources in China. Nitric oxide (NO) and hydrogen sulfide (H2S) are common gas messengers used to alleviate abiotic stress damage, whereas the mechanism of these messengers in regulating salt resistance of C. paliurus still remains unclear. We performed a comprehensive study to reveal the physiological response and molecular regulatory mechanism of C. paliurus seedlings to the application of exogenous NO and H2S under salt stress. The results showed that the application of sodium hydrosulfide (NaHS) and sodium nitroprusside (SNP) not only maintained the photosynthetic capacity and reduced the loss of leaf biomass, but also promoted endogenous NO synthesis and reduced oxidative damage by activating antioxidant enzyme activity and increasing the content of soluble protein and flavonoids. Moreover, transcriptome and metabolome analysis indicated the expression of genes encoding phenylalanine ammonia lyase (PAL), cytochromeP450 (CYP), chalcone synthase (CHS), dihydroflavonol 4-reductase (DFR) and flavonol synthase (FLS) in flavonoid biosynthesis pathway was all up-regulated by the application of NO and H2S. Meanwhile, 15 transcriptional factors (TFs) such as WRKY, ERF, bHLH and HY5 induced by NO were found to regulated the activities of several key enzymes in flavonoid biosynthesis pathway under salt stress, via the constructed co-expression network. Our findings revealed the underlying mechanism of NO and H2S to alleviate salt stress and regulate flavonoid biosynthesis, which provides a theoretical basis for establishing C. paliurus plantations in the salt stress areas.
Validity and reliability of the WHOQOL-BREF in the measurement of the quality of life of Sickle disease patients in Bahrain
Authors: Almarabheh Amer , Salah Afif Ben , Alghamdi Manal , Al Saleh Aseel , Elbarbary Abdulla , Al Qashar Ahmed , Alserdieh Faisal , Alahmed Fatema , Alhaddar Hasan , Alsada Lulwa , Yosri Mohamed , Omran Mahmood , Khudhair Mina , Salih Motasem , Fuad Noora , Chlif Sadok
Published: September 2023

Background

Limited attention is devoted to the improvement of the quality of life of patients suffering from the negative consequences of Sickle cell disease (SCD). Our study focuses on the evaluation of the performance of the WHOQOL-BREF as a tool to measure the quality of life of SCD Patients in Bahrain.

Methods

We conducted a cross-sectional study that enrolled 273 SCD patients selected using a simple random sampling technique from primary health-care centers in Bahrain in 2019. A designed questionnaire including the WHOQOL-BREF was filled by the patients in the health centers. The reliability of the WHOQOL-BREF was assessed by standardized Cronbach’s alpha coefficient, and the validity was measured by convergent validity, principal component analysis and confirmatory factor analysis.

Results

The WHOQOL-BREF had good internal consistency as Cronbach’s alpha coefficient for the overall scale was 0.91. The convergent validity results indicated that the correlation coefficients values for all scale domains are significantly correlated at α < 0.01. Confirmatory factor analysis found that the four-domain structure produced a robust fit to the data.

Conclusion

The WHOQOL-BREF tool has high internal consistency and validity in assessing the quality of life of Sickle Disease patients in Bahrain.
Increased risk of postpartum depression in women with lactational mastitis: a cross-sectional study
Authors: Shen Fuyi , Zhou Xianjin , Guo Fei , Fan Kechen , Zhou Yilu , Xia Jianhua , Xu Zhendong , Liu Zhiqiang
Published: September 2023

Background

A high incidence of lactational mastitis mainly occurs during the first month of breastfeeding. It may cause severe pain, frustration, fatigue, stress, and breastfeeding concerns. However, few studies investigated the effects of lactational mastitis on postpartum depression. This study investigated the potential association between lactational mastitis and postpartum depression.

Methods

We examined the associations of lactational mastitis with postpartum depression in 1,551 Chinese women. Lactational mastitis was diagnosed by breast specialists. The presence of depression symptoms was evaluated by the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire 9 (PHQ9) at 6 weeks after delivery. Multiple linear regression analysis and multivariable log-binomial regression analysis were performed to estimate the association between lactational mastitis and postpartum depression.

Results

Among the 1,551 mothers, 147 (9.5%) experienced lactational mastitis diagnosed by breast specialists during the postpartum period. Compared with women without lactational mastitis, the proportion of women with depression symptoms was significantly higher (38.1% vs. 27.4%, p = 0.008), and the risk of postpartum depression increased by 68% (RR = 1.68, 95% CI, 1.18, 2.40) in women who had experienced lactational mastitis. In addition, the risk of self-harm or suicidal ideation increased by 89% (RR = 1.89, 95% CI, 1.08, 3.29) in women who experienced lactational mastitis. In stratified analysis, the associations of lactational mastitis with postpartum depression appeared stronger among women aged ≥35 years, with maternal comorbidities, and who delivered a female neonate.

Conclusion

The study results suggest that lactational mastitis is a risk factor for depression during the postpartum period. The impact of lactational mastitis on maternal mental health requires further attention.

Clinical trial registration

chictr.org.cn, ChiCTR2000041519.
Deaths from tuberculosis: differences between tuberculosis-related and non-tuberculosis-related deaths
Authors: Jeong Yun-Jeong , Park Jae Seuk , Kim Hyung Woo , Min Jinsoo , Ko Yousang , Oh Jee Youn , Lee Eun Hye , Yang Bumhee , Lee Min Ki , Kim Yun Seong , Chang Jung Hyun , Jegal Yangjin , Lee Sung Soon , Kim Ju Sang , Koo Hyeon-Kyoung
Published: September 2023

Objective

Tuberculosis (TB) is a major cause of ill health and one of the leading causes of death worldwide. The first step in developing strategies to reduce TB mortality is to identify the direct causes of death in patients with TB and the risk factors for each cause.

Methods

Data on patients with TB systemically collected from the National Surveillance System of South Korea from January 2019 to December 2020 were included in this study. We analyzed the clinical characteristics associated with TB and non-TB-related deaths, including TB-related symptoms, comorbidities, and radiographic and microbiological findings.

Results

Of the total of 12,340 patients with TB, 61% were males with a mean age of 61.3 years. During the follow-up period, the overall mortality rate was 10.6%, with TB-related deaths accounting for 21.3% of all TB deaths. The median survival time in the TB-related death group was 22 days. TB-related death was associated with older age, lower body mass index (BMI), dyspnea, fever, general weakness, bilateral radiographic patterns, and acid-fast bacilli (AFB)-positive smears. Non-TB-related deaths were associated with older age, male sex, lower BMI, comorbidities of heart, liver, kidney, and central nervous system (CNS) diseases, CNS TB involvement, the presence of dyspnea, general weakness, and bilateral radiographic patterns.

Conclusion

Patients with high-risk TB must be identified through cause-specific mortality analysis, and the mortality rate must be reduced through intensive monitoring of patients with a high TB burden and comorbidities.
Child and youth mental health and wellbeing before and after returning to in-person learning in secondary schools in the context of COVID-19
Authors: Qian Lei , McWeeny Robert , Shinkaruk Cheryl , Baxter Andrew , Cao Bo , Greenshaw Andy , Silverstone Peter , Pazderka Hannah , Wei Yifeng
Published: September 2023

Background

As children reintegrate with in-person classroom learning after COVID-19, health and education institutions should remain mindful of students’ mental health. There is a paucity of data on changes in students’ mental health before, during and after their return to in-person classroom learning.

Methods

We collected and analyzed data on self-reported wellbeing, general mental health, perceived stress, and help-seeking attitudes from grade 7–12 students in a Catholic school division in Canada (n = 258 at baseline; n = 132 at follow-up). Outcomes were compared according to demographic differences such as gender, grade level, experience accessing mental health services, and presence of support staff between baseline and follow-up. Effects of time points and each demographic variable on each outcome and on the prediction of students’ mental health were also analyzed.

Results

No significant differences were apparent for outcomes between baseline and follow-up. However, specific subgroups: junior high students, male students, students who had not accessed mental health services, and students who had access to support-staff had better outcomes than their counterparts. From baseline to follow-up, male students reported mental health decline [Mean = 11.79, SD = 6.14; Mean = 16.29, SD = 7.47, F(1, 333) = 8.36, p < 0.01]; students who had not accessed mental health services demonstrated greater stress [Mean = 20.89, SD = 4.09; Mean = 22.28, SD = 2.24, F(1, 352) = 6.20, p < 0.05]; students who did not specify a binary gender reported improved general mental health [Mean = 19.87, SD = 5.89; Mean = 13.00, SD = 7.40, F(1, 333) = 8.70, p < 0.01], and students who did not have access to support-staff improved help-seeking attitudes [Mean = 22.32, SD = 4.62; Mean = 24.76, SD = 4.81; F(1, 346) = 5.80, p < 0.05]. At each time point, students indicated parents, guardians, and close friends as their most-preferred help-seeking sources. High stress predicted lower wellbeing at baseline, but higher wellbeing at follow-up.

Conclusion

Students presented stable mental health. Subgroups with decreased mental health may benefit from extra mental health support through building capacity among teachers and health care professionals to support students following public health emergencies.
The COVID-19 pandemic reveals the wide-ranging role of biobanks
Authors: Juozapaitė Dovilė , Minkauskas Mantas , Laurinaitytė Inga , Simutytė Martyna , Griškevičius Laimonas , Naumovas Daniel
Published: September 2023

The pandemic of COVID-19 reached an unprecedented scale in terms of spread and deaths, its mitigation required a joint effort of governments, hospitals, private companies and other organizations. One type of organization that could undertake a major role in the process is biobank – a mediator between clinical practice and research. Naturally, biobanks are well equipped to alleviate the burden of a pandemic with their expertise in biospecimen and health information collection, sample preparation and storage, bioethics and project management. Here, we present the participation of Vilnius Santaros Klinikos Biobank (BB VSK), Lithuania in the overall management of the pandemics on the national level. We further discuss the role of biobanks in preparation and management of future pandemics.