bluuebunny/crossref_metadata_2025 huggingface dataset:
Explorations of preferred and maximum booking windows among U.S. national park campers: Implications for improved fairness
Authors: Rice William L. , Taff B. Derrick , Morris Sophie A. , Pan Bing , Parkinson Colby , Newman Peter
Published: March 2024

The purpose of this research note is to inform national park management regarding the strategies in rationing campsites in popular U.S. national park campgrounds and provide data-driven guidance for the design of more fair and equitable methods for distributing limited, highly demanded campsites. To explore preferences in campsite rationing techniques and preferred and maximum campsite booking windows, we collected survey data among randomly sampled onsite visitors in Grand Canyon National Park at scenic viewpoints and Mather Campground in 2023. The rationing technique with the highest level of positive support was advance reservation, followed by a combination of time frames for booking window (e.g., 6-month, 2- month, and 2-week) and a combination of rationing techniques (e.g., advance reservation and first-come, first-serve). Concerning fairness and equity, we found that respondents in higher annual household income groups had a longer maximum booking window, on average, than those in lower income groups. Thus, we discuss the merits of offering a diversity of booking windows to meet the needs of multiple groups, each with constrained booking horizons.
Excellent 2-Year Outcomes of a Midlevel Constrained Liner Used in Stemless Primary TKA
Authors: Hawes Joseph , Ast Michael , Mayman David , Bostrom Mathias , Haas Steven , Chalmers Brian
Published: March 2024

Introduction:

Instability after total knee arthroplasty (TKA) remains a leading cause of revision TKA and can lead to patient dissatisfaction. While many companies have developed midlevel constrained (MLC) polyethylene inserts in primary TKAs, there is little data on their outcomes.

Purpose:

We sought to analyze short-term outcomes including survivorship, rates of manipulation under anesthesia (MUA), and improvements in patient-reported outcome measures (PROMs) preoperatively to postoperatively in one design of MLC TKA.

Methods:

We prospectively followed consecutive primary TKA patients who received constrained inserts (Journey II or Legion Genesis II, Smith and Nephew) from 5 surgeons, 2019 to 2020, at a single academic institution. We analyzed revision-free survivorship, MUA rates, and PROMs, preoperatively to postoperatively.

Results:

A total of 356 patients were included with a mean age of 64 years; 49% were male and the mean body mass index (BMI) was 31 kg/m2. Sixteen patients (4.5%) underwent MUA and 3 patients (0.8%) underwent revision. Two patients underwent polyethylene exchange and patellar resection for patellar loosening. One patient underwent liner exchange for instability. The 2-year revision-free survivorship was 98.5% (95% confidence interval [CI]: 96.6%–100%). Survivorship free from revision for tibial or femoral aseptic loosening was 100% at 2 years. The 2-year survivorship free from MUA was 92.3% (95% CI: 88.6%–96.1%). The mean Knee Osteoarthritis and Injury Outcomes Score Joint Replacement (KOOS JR) was 81 at 2 years follow-up, while the Lower Extremity Activity Score (LEAS) score was 10.5.

Conclusion:

At a mean of 3 years follow-up, 2 types of MLCs used in primary TKA were associated with a low rate of early revision, low rate of MUA, and reliable improvement in functional outcomes. These MLCs were not associated with early loosening or unique failure modes.
Enabling equitable and ethical research partnerships in crisis situations: Lessons learned from post-disaster heritage protection interventions following Nepal’s 2015 earthquake
Authors: Coningham Robin , Lewer Nick , Acharya Kosh Prasad , Weise Kai , Kunwar Ram Bahadhur , Joshi Anie , Parajuli Khanal Sandhya
Published: March 2024

The earthquakes which struck Nepal’s capital in 2015 were humanitarian disasters. Not only did they inflict tragic loss of life and livelihoods, they also destroyed parts of the Kathmandu Valley’s unique UNESCO World Heritage site. These monuments were not just ornate structures but living monuments playing central roles in the daily lives of thousands, representing portals where the heavens touch earth and people commune with guiding deities. Their rehabilitation was also of economic importance as they represent a major source of tourist income and employment. Unfortunately, the social and political desire for rapid reconstruction resulted in the swift removal of many traditionally constructed foundations and their replacement with modern materials without assessments of whether they contributed towards the collapse of individual monuments. These actions, combined with the wholesale removal, mixing and dumping of modern and historic debris, contributed to a second, equally destructive, cultural catastrophe – irreversible damage to Kathmandu’s Medieval fabric, in a process which frequently excluded local communities and custodians. This case study draws from our collective reflections and lessons learned from our attempts to enable equitable and ethical research partnerships between UK and Nepali colleagues as well as local communities in the debris of the Kasthamandap, Kathmandu’s eponymous monument. After briefly describing the potential of mobilising archaeologists in post-disaster contexts and outlining the challenges of undertaking research in such a setting, our case study utilises the TRUST Code to assess the character and success of our multidisciplinary collaboration in a time of crises.
Antecedents of Corruption Perception in Guyana
Authors: Thomas Troy D. , Abts Koen , Stroeken Koen
Published: March 2024

Regardless of its utility as a measure of actual corruption, perceived corruption is related to many political attitudes and other variables which makes it an important phenomenon to understand. This paper explores demographic variables, ideological orientations, socioeconomic status, interpersonal trust, political attitudes and feelings of resentment as explanations for corruption perception with response styles controlled within a structural equation modelling framework using survey data collected in Guyana where corruption is salient and thought to be pervasive. It finds that the categories of variables jointly explain 31.5% of the variance in corruption perception and that there is explanatory utility for each category of variables evaluated except socioeconomic status with demographics and ideological orientations accounting for the largest changes in explained variance. It also finds that political cynicism attenuates an initial effect of interpersonal trust and concludes that ethnicity appears to function as partisan orientation in its relationship with corruption perception.
“It’s All About US vs THEM!”: Comparing Chinese Populist Discourses on Weibo and Twitter
Authors: Zhang Yuan , Schroeder Ralph
Published: March 2024

The recent resurgence of populism has led to renewed interest in the phenomenon, but it remains unclear how this phenomenon has manifested itself in non-Western settings like China. This article analyses Chinese populism and provides a systematic categorization of online discourses related to this phenomenon, including ideas about “the people,” “corrupt elites,” and “enemies.” The article is based on a collection of more than 100,000 Chinese online posts, collected from both Weibo and Twitter, that were classified as populist or not using natural language processing (NLP) models. We show how populism has manifested itself in Chinese online venues, and how populist discourses on Weibo and Twitter differ in topics, semantic content, and in who posts (agenda setters) and shares posts (audiences). The comparison demonstrates that different Chinese netizens take competing approaches to define the place of a rising China, and this also puts populism into the context of the peculiar Chinese way of rallying “the people” on behalf of the nation. Findings from this study contribute new insights into understanding populism in Chinese cyberspaces and provide a cross-platform perspective for understanding populist discourses in national and transnational contexts. The study also adds to computational methods in empirical research of populism in a comparative perspective.
Insights into the Purification of C1-esterase Inhibitor from Human Plasma
Authors: Verma Sachin , Dolia Sheetal , Makadia Savan , Kumar Narendra
Published: March 2024

Hereditary angioedema (HAE) is a rare but often life-threatening genetic disorder caused by either lack of or dysfunctional C1-esterase inhibitor (C1-I3NH). C1-INH is a high-cost therapy for HAE. Because plasma-derived C1-INH has a higher half-life than other therapeutics, it may be considered a suitable treatment option for HAE. However, the high cost of plasma-derived C1-INH may make the therapy unaffordable to some patients. Herein, we review the C1-INH purification processes used to date to identify the reasons for the high costs of this therapy and assess the scope of improvements in the purification processes to develop a cost-effective product. A literature search was conducted in PubMed and Google Scholar in January 2023 to identify the relevant articles. The following keywords were used: “C1 esterase inhibitor,” “hereditary angioedema,” and “C1 esterase inhibitor purification from human plasma.” All English-language articles published from 1960 to February 2021 were included. Several plasma products can be purified using the Cohn fractionation process; this decreases the cost of individual products. However, many C1-INH purification strategies developed to date fail to purify other products from the unused plasma fraction (ie, the fraction remaining after C1-INH purification) because of changes in the physical characteristics of the plasma, such as pH and ionic strength; as a result, it is unavailable for the Cohn fractionation process, leading to the high cost of C1-INH. Using cutting-edge purification technologies and more efficient virus removal steps can decrease manufacturing costs, thereby increasing the affordability and safety of the product.
Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries – a cadaveric study
Authors: Privalov Maxim , Junge Malte , Jung Matthias Karl , Vetter Sven Yves , Franke Jochen , Hetjens Svetlana , Grützner Paul Alfred , Stadthalter Holger
Published: March 2024

Background

Type C pelvic fractures (AO/OTA) are severe injuries that frequently lead to bleeding and hemodynamic instability. Pelvic binders play a crucial role in their initial management. Placement at the correct level in the prehospital setting is challenging. The aim of this study was to compare two pelvic binders regarding their effectiveness in reducing intrapelvic volume and increasing intrapelvic pressure in patients with type C pelvic fractures (AO/OTA) when applied at three different levels.

Methods

Rotationally and vertically unstable pelvic injuries (AO/OTA classification 61-C1.1) were produced in five fresh-frozen human cadaveric specimens. Intrapelvic volume, vesical pressure and compression pressure within the pubic symphysis and the sacroiliac joint were measured when applying a SAM Pelvic Sling II and a T-POD at the level of the greater trochanter as well as levels higher and lower than recommended.

Results

Comparison of the two pelvic binders positioned at the recommended level (greater trochanter) showed no significant difference in volume reduction (13.85 ± 31.37 cm3, p = 0.442), however, increase in vesical pressure was significantly higher when using the T-POD (5.80 ± 3.27 cmH2O, p = 0.017). When positioned at the level of the iliac crest, vesical pressure increase and intrapelvic volume reduction were significantly greater with the T-POD (14.00 ± 8.57 cmH2O, p = 0.022 and 10.45 ± 5.45 cm3, p = 0.031 respectively). Application of the SAM Pelvic Sling II below the greater trochanter led to a significantly greater decrease in volume (-32.26 ± 7.52 cm3, p = 0.003) than the T-POD. Comparison of the recommended attachment level with incorrect positioning led to no significant differences for the T-POD, while the SAM Pelvic Sling II achieved a significantly lower volume reduction when placed at the iliac crest (40.15 ± 14.57 cm3, p = 0.012) and a significantly lower increase in vesical pressure when applied below the greater trochanter (3.40 ± 1.52 cmH2O, p = 0.007).

Conclusion

Direct comparison of the two pelvic binders showed that the T-POD achieved significantly greater results when applied at the recommended level and was less susceptible to incorrect positioning. These outcomes support the preferred use of the T-POD for prehospital emergency pelvic stabilisation.
Determining the environmental effect of Chinese FDI on the Belt and Road countries CO2 emissions: an EKC-based assessment in the context of pollution haven and halo hypotheses
Authors: Liu Peiqian , Ur Rahman Zia , Jóźwik Bartosz , Doğan Mesut
Published: March 2024

This work aims to examines the effect of Chinese outward foreign direct investment (CoFDI), renewable energy, and energy intensity on CO2 emissions in 46 Belt and Road Initiative (BRI) nations divided into: Panel A, consisting of 16 European countries, and Panel B, comprising 30 Asian and MENA countries. This analysis used data from 2005 to 2018, applying second-generation econometric techniques. The empirical outcomes, obtained using Driscoll–Kraay methods, confirmed the pollution halo effect in Panel A, suggesting that FDI flows in these countries are environmentally friendly. In contrast, the results indicated a positive impact of CoFDI on CO2e in Panel B, supporting the pollution haven hypothesis that FDI may add to pollution. In addition, the study found an inverted-U-shaped association between per capita income and CO2e, validating the environmental Kuznets curve (EKC) hypothesis in both panels. The findings also revealed that energy intensity positively affects CO2e, whereas renewable energy has a significant negative effect in both panels, while the interaction terms of renewable and energy intensity are heterogenous in both panels. Based on these findings, the study recommends policy makers of these countries to attract clean FDI, particularly in renewable sectors, and shift from fossil fuel-based energy to renewable sources to control pollution by enacting energy-saving initiatives via lowering energy intensity.
BSXplorer: analytical framework for exploratory analysis of BS-seq data
Authors: Yuditskiy Konstantin , Bezdvornykh Igor , Kazantseva Anastasiya , Kanapin Alexander , Samsonova Anastasia
Published: March 2024

Background

Bisulfite sequencing detects and quantifies DNA methylation patterns, contributing to our understanding of gene expression regulation, genome stability maintenance, conservation of epigenetic mechanisms across divergent taxa, epigenetic inheritance and, eventually, phenotypic variation. Graphical representation of methylation data is crucial in exploring epigenetic regulation on a genome-wide scale in both plants and animals. This is especially relevant for non-model organisms with poorly annotated genomes and/or organisms where genome sequences are not yet assembled on chromosome level. Despite being a technology of choice to profile DNA methylation for many years now there are surprisingly few lightweight and robust standalone tools available for efficient graphical analysis of data in non-model systems. This significantly limits evolutionary studies and agrigenomics research. BSXplorer is a tool specifically developed to fill this gap and assist researchers in explorative data analysis and in visualising and interpreting bisulfite sequencing data more easily.

Results

BSXplorer provides in-depth graphical analysis of sequencing data encompassing (a) profiling of methylation levels in metagenes or in user-defined regions using line plots and heatmaps, generation of summary statistics charts, (b) enabling comparative analyses of methylation patterns across experimental samples, methylation contexts and species, and (c) identification of modules sharing similar methylation signatures at functional genomic elements. The tool processes methylation data quickly and offers API and CLI capabilities, along with the ability to create high-quality figures suitable for publication.

Conclusions

BSXplorer facilitates efficient methylation data mining, contrasting and visualization, making it an easy-to-use package that is highly useful for epigenetic research.
Evaluation of aphid resistance on different rose cultivars and transcriptome analysis in response to aphid infestation
Authors: Dong Wenqi , Sun Lei , Jiao Bo , Zhao Pu , Ma Chunhong , Gao Junping , Zhou Shuo
Published: March 2024

Background

The rose is one of the most important ornamental flowers in the world for its aesthetic beauty but can be attacked by many pests such as aphids. Aphid infestation causes tremendous damage on plant tissues leading to harmed petals and leaves. Rose cultivars express different levels of resistance to aphid infestation yet the information remains unclear. Not only that, studies about the transcriptional analysis on defending mechanisms against aphids in rose are limited so far.

Results

In this study, the aphid resistance of 20 rose cultivars was evaluated, and they could be sorted into six levels based on the number ratio of aphids. And then, a transcriptome analysis was conducted after aphid infestation in one high resistance (R, Harmonie) and one highly susceptibility (S, Carefree Wonder) rose cultivar. In open environment the majority of rose cultivars had the highest aphid number at May 6th or May 15th in 2020 and the resistance to infestation could be classified into six levels. Differential expression analysis revealed that there were 1,626 upregulated and 767 downregulated genes in the R cultivar and 481 upregulated and 63 downregulated genes in the S cultivar after aphid infestation. Pathway enrichment analysis of the differentially expressed genes revealed that upregulated genes in R and S cultivars were both enriched in defense response, biosynthesis of secondary metabolites (phenylpropanoid, alkaloid, and flavonoid), carbohydrate metabolism (galactose, starch, and sucrose metabolism) and lipid processing (alpha-linolenic acid and linolenic acid metabolism) pathways. In the jasmonic acid metabolic pathway, linoleate 13S-lipoxygenase was specifically upregulated in the R cultivar, while genes encoding other crucial enzymes, allene oxide synthase, allene oxide cyclase, and 12-oxophytodienoate reductase were upregulated in both cultivars. Transcription factor analysis and transcription factor binding search showed that WRKY transcription factors play a pivotal role during aphid infestation in the R cultivar.

Conclusions

Our study indicated the potential roles of jasmonic acid metabolism and WRKY transcription factors during aphid resistance in rose, providing clues for future research.
De novo assembly and annotation of the Patagonian toothfish (Dissostichus eleginoides) genome
Authors: Ryder David , Stone David , Minardi Diana , Riley Ainsley , Avant Justin , Cross Lisa , Soeffker Marta , Davidson Deborah , Newman Andrew , Thomson Peter , Darby Chris , van Aerle Ronny
Published: March 2024

Background

Patagonian toothfish (Dissostichus eleginoides) is an economically and ecologically important fish species in the family Nototheniidae. Juveniles occupy progressively deeper waters as they mature and grow, and adults have been caught as deep as 2500 m, living on or in just above the southern shelves and slopes around the sub-Antarctic islands of the Southern Ocean. As apex predators, they are a key part of the food web, feeding on a variety of prey, including krill, squid, and other fish. Despite its importance, genomic sequence data, which could be used for more accurate dating of the divergence between Patagonian and Antarctic toothfish, or establish whether it shares adaptations to temperature with fish living in more polar or equatorial climes, has so far been limited.

Results

A high-quality D. eleginoides genome was generated using a combination of Illumina, PacBio and Omni-C sequencing technologies. To aid the genome annotation, the transcriptome derived from a variety of toothfish tissues was also generated using both short and long read sequencing methods. The final genome assembly was 797.8 Mb with a N50 scaffold length of 3.5 Mb. Approximately 31.7% of the genome consisted of repetitive elements. A total of 35,543 putative protein-coding regions were identified, of which 50% have been functionally annotated. Transcriptomics analysis showed that approximately 64% of the predicted genes (22,617 genes) were found to be expressed in the tissues sampled. Comparative genomics analysis revealed that the anti-freeze glycoprotein (AFGP) locus of D. eleginoides does not contain any AFGP proteins compared to the same locus in the Antarctic toothfish (Dissostichus mawsoni). This is in agreement with previously published results looking at hybridization signals and confirms that Patagonian toothfish do not possess AFGP coding sequences in their genome.

Conclusions

We have assembled and annotated the Patagonian toothfish genome, which will provide a valuable genetic resource for ecological and evolutionary studies on this and other closely related species.
Identification and validation of RNA-binding protein SLC3A2 regulates melanocyte ferroptosis in vitiligo by integrated analysis of single-cell and bulk RNA-sequencing
Authors: Zhang Jingzhan , Xiang Fang , Ding Yuan , Hu Wen , Wang Hongjuan , Zhang Xiangyue , Lei Zixian , Li Tingting , Wang Peng , Kang Xiaojing
Published: March 2024

Background

The pathogenesis of vitiligo remains unclear. The genes encoding vitiligo-related RNA-binding proteins (RBPs) and their underlying pathogenic mechanism have not been determined.

Results

Single-cell transcriptome sequencing (scRNA-seq) data from the CNCB database was obtained to identify distinct cell types and subpopulations and the relative proportion changes in vitiligo and healthy samples. We identified 14 different cell types and 28 cell subpopulations. The proportion of each cell subpopulation significantly differed between the patients with vitiligo and healthy groups. Using RBP genes for unsupervised clustering, we obtained the specific RBP genes of different cell types in vitiligo and healthy groups. The RBP gene expression was highly heterogeneous; there were significant differences in some cell types, such as keratinocytes, Langerhans, and melanocytes, while there were no significant differences in other cells, such as T cells and fibroblasts, in the two groups. The melanocyte-specific RBP genes were enriched in the apoptosis and immune-related pathways in the patients with vitiligo. Combined with the bulk RNA-seq data of melanocytes, key RBP genes related to melanocytes were identified, including eight upregulated RBP genes (CDKN2A, HLA-A, RPL12, RPL29, RPL31, RPS19, RPS21, and RPS28) and one downregulated RBP gene (SLC3A2). Cell experiments were conducted to explore the role of the key RBP gene SLC3A2 in vitiligo. Cell experiments confirmed that melanocyte proliferation decreased, whereas apoptosis increased, after SLC3A2 knockdown. SLC3A2 knockdown in melanocytes also decreased the SOD activity and melanin content; increased the Fe2+, ROS, and MDA content; significantly increased the expression levels of TYR and COX2; and decreased the expression levels of glutathione and GPX4.

Conclusion

We identified the RBP genes of different cell subsets in patients with vitiligo and confirmed that downregulating SLC3A2 can promote ferroptosis in melanocytes. These findings provide new insights into the pathogenesis of vitiligo.
Defined co-cultures of glutamatergic and GABAergic neurons with a mutation in DISC1 reveal aberrant phenotypes in GABAergic neurons
Authors: Heider Johanna , Stahl Aaron , Sperlich Denise , Hartmann Sophia-Marie , Vogel Sabrina , Breitmeyer Ricarda , Templin Markus , Volkmer Hansjürgen
Published: March 2024

Background

Mutations in the gene DISC1 are associated with increased risk for schizophrenia, bipolar disorder and major depression. The study of mutated DISC1 represents a well-known and comprehensively characterized approach to understand neuropsychiatric disease mechanisms. However, previous studies have mainly used animal models or rather heterogeneous populations of iPSC-derived neurons, generated by undirected differentiation, to study the effects of DISC1 disruption. Since major hypotheses to explain neurodevelopmental, psychiatric disorders rely on altered neuronal connectivity observed in patients, an ideal iPSC-based model requires accurate representation of the structure and complexity of neuronal circuitries. In this study, we made use of an isogenic cell line with a mutation in DISC1 to study neuronal synaptic phenotypes in a culture system comprising a defined ratio of NGN2 and ASCL1/DLX2 (AD2)-transduced neurons, enriched for glutamatergic and GABAergic neurons, respectively, to mimic properties of the cortical microcircuitry.

Results

In heterozygous DISC1 mutant neurons, we replicated the expected phenotypes including altered neural progenitor proliferation as well as neurite outgrowth, deregulated DISC1-associated signaling pathways, and reduced synaptic densities in cultures composed of glutamatergic neurons. Cultures comprising a defined ratio of NGN2 and AD2 neurons then revealed considerably increased GABAergic synapse densities, which have not been observed in any iPSC-derived model so far. Increased inhibitory synapse densities could be associated with an increased efficiency of GABAergic differentiation, which we observed in AD2-transduced cultures of mutant neurons. Additionally, we found increased neuronal activity in GABAergic neurons through calcium imaging while the activity pattern of glutamatergic neurons remained unchanged.

Conclusions

In conclusion, our results demonstrate phenotypic differences in a co-culture comprising a defined ratio of DISC1 mutant NGN2 and AD2 neurons, as compared to culture models comprising only one neuronal cell type. Altered synapse numbers and neuronal activity imply that DISC1 impacts the excitatory/inhibitory balance in NGN2/AD2 co-cultures, mainly through increased GABAergic input.
Preventive and therapeutic effects of rifaximin on hepatic encephalopathy with differential application dosages and strategies: a network meta-analysis
Authors: Fang Guihua , Liu Shuna , Liu Bin
Published: March 2024

Background

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome that affects the prognosis of patients with liver disease and is considered an independent risk factor for hospitalization and death. Rifaximin has been approved for HE treatment. This review will analyze the effect of rifaximin on different stages of HE with differential application dosages and strategies by traditional and network meta-analyses.

Methods

We performed a systematic search of PubMed, EmBase, and Cochrane Library databases up to February 26, 2023, to identify randomized controlled trials (RCTs) about rifaximin for the prevention and treatment of HE. The outcomes included incidence of HE and HE progression, HE reversal, mortality, and adverse effects.

Results

A total of 21 studies were included. In the primary prevention of HE, rifaximin significantly reduced the incidence of HE (OR: 0.66; 95% CI: 0.45, 0.96; p = 0.032). In secondary prevention, rifaximin significantly reduced the risk of recurrence in patients who were in remission (OR: 0.38; 95% CI: 0.28, 0.52; p < 0.001). In the treatment of minimal HE, rifaximin significantly reduced the breakthrough of MHE to OHE (OR: 0.17; 95% CI: 0.04,0.63; p = 0.008). Rifaximin also significantly improved the clinical symptoms of MHE and OHE patients (OR: 3.76; 95% CI: 2.69, 5.25; p < 0.001). However, rifaximin did not reduce mortality at any stage in HE patients (OR: 0.79; 95% CI: 0.58, 1.08; p = 0.133). Additionally, rifaximin did not increase the risk of adverse effects (OR: 0.96; 95% CI: 0.74, 1.24; p = 0.749). In the network meta-analysis, the 400 mg T.I.D. intervention had a relative advantage for HE risks in primary and secondary prevention. In the treatment of MHE, 600 mg b.i.d. was superior in preventing the breakthrough from MHE to OHE.

Conclusion

Rifaximin prevented HE risks and progression and improved clinical symptoms in patients with MHE but did not reduce mortality. For primary and secondary prevention, 400 mg t.i.d. could be considered. 600 mg b.i.d. could be considered in patients with MHE.
Prediction of survival and analysis of prognostic factors for patients with AFP negative hepatocellular carcinoma: a population-based study
Authors: Liu Chengyu , Li Zikang , Zhang Zhilei , Li Jinlong , Xu Congxi , Jia Yuming , Zhang Chong , Yang Wuhan , Wang Wenchuan , Wang Xiaojuan , Liang Kuopeng , Peng Li , Wang Jitao
Published: March 2024

Purpose

Hepatocellular carcinoma (HCC) has a poor prognosis, and alpha-fetoprotein (AFP) is widely used to evaluate HCC. However, the proportion of AFP-negative individuals cannot be disregarded. This study aimed to establish a nomogram of risk factors affecting the prognosis of patients with AFP-negative HCC and to evaluate its diagnostic efficiency.

Patients and methods

Data from patients with AFP-negative initial diagnosis of HCC (ANHC) between 2004 and 2015 were collected from the Surveillance, Epidemiology, and End Results database for model establishment and validation. We randomly divided overall cohort into the training or validation cohort (7:3). Univariate and multivariate Cox regression analysis were used to identify the risk factors. We constructed nomograms with overall survival (OS) and cancer-specific survival (CSS) as clinical endpoint events and constructed survival analysis by using Kaplan-Meier curve. Also, we conducted internal validation with Receiver Operating Characteristic (ROC) analysis and Decision curve analysis (DCA) to validate the clinical value of the model.

Results

This study included 1811 patients (1409 men; 64.7% were Caucasian; the average age was 64 years; 60.7% were married). In the multivariate analysis, the independent risk factors affecting prognosis were age, ethnicity, year of diagnosis, tumor size, tumor grade, surgery, chemotherapy, and radiotherapy. The nomogram-based model related C-indexes were 0.762 (95% confidence interval (CI): 0.752–0.772) and 0.752 (95% CI: 0.740–0.769) for predicting OS, and 0.785 (95% CI: 0.774–0.795) and 0.779 (95% CI: 0.762–0.795) for predicting CSS. The nomogram model showed that the predicted death was consistent with the actual value. The ROC analysis and DCA showed that the nomogram had good clinical value compared with TNM staging.

Conclusion

The age(HR:1.012, 95% CI: 1.006–1.018, P-value < 0.001), ethnicity(African-American: HR:0.946, 95% CI: 0.783–1.212, P-value: 0.66; Others: HR:0.737, 95% CI: 0.613–0.887, P-value: 0.001), tumor diameter(HR:1.006, 95% CI: 1.004–1.008, P-value < 0.001), year of diagnosis (HR:0.852, 95% CI: 0.729–0.997, P-value: 0.046), tumor grade(Grade 2: HR:1.124, 95% CI: 0.953–1.326, P-value: 0.164; Grade 3: HR:1.984, 95% CI: 1.574–2.501, P-value < 0.001; Grade 4: HR:2.119, 95% CI: 1.115–4.027, P-value: 0.022), surgery(Liver Resection: HR:0.193, 95% CI: 0.160–0.234, P-value < 0.001; Liver Transplant: HR:0.102, 95% CI: 0.072–0.145, P-value < 0.001), chemotherapy(HR:0.561, 95% CI: 0.471–0.668, P-value < 0.001), and radiotherapy(HR:0.641, 95% CI: 0.463–0.887, P-value:0.007) were independent prognostic factors for patients with ANHC. We developed a nomogram model for predicting the OS and CSS of patients with ANHC, with a good predictive performance.
Age- and sex-specific associations of frailty with mortality and healthcare utilization in community-dwelling adults from Ontario, Canada
Authors: Verschoor Chris P. , Theou Olga , Ma Jinhui , Montgomery Phyllis , Mossey Sharolyn , Nangia Parveen , Saskin Refik , Savage David W.
Published: March 2024

Background

Understanding how health trajectories are related to the likelihood of adverse outcomes and healthcare utilization is key to planning effective strategies for improving health span and the delivery of care to older adults. Frailty measures are useful tools for risk stratification in community-based and primary care settings, although their effectiveness in adults younger than 60 is not well described.

Methods

We performed a 10-year retrospective analysis of secondary data from the Ontario Health Study, which included 161,149 adults aged ≥ 18. Outcomes including all-cause mortality and hospital admissions were obtained through linkage to ICES administrative databases with a median follow-up of 7.1-years. Frailty was characterized using a 30-item frailty index.

Results

Frailty increased linearly with age and was higher for women at all ages. A 0.1-increase in frailty was significantly associated with mortality (HR = 1.47), the total number of outpatient (IRR = 1.35) and inpatient (IRR = 1.60) admissions over time, and length of stay (IRR = 1.12). However, with exception to length of stay, these estimates differed depending on age and sex. The hazard of death associated with frailty was greater at younger ages, particularly in women. Associations with admissions also decreased with age, similarly between sexes for outpatient visits and more so in men for inpatient.

Conclusions

These findings suggest that frailty is an important health construct for both younger and older adults. Hence targeted interventions to reduce the impact of frailty before the age of 60 would likely have important economic and social implications in both the short- and long-term.
Transfer learning–based PET/CT three-dimensional convolutional neural network fusion of image and clinical information for prediction of EGFR mutation in lung adenocarcinoma
Authors: Shao Xiaonan , Ge Xinyu , Gao Jianxiong , Niu Rong , Shi Yunmei , Shao Xiaoliang , Jiang Zhenxing , Li Renyuan , Wang Yuetao
Published: March 2024

Background

To introduce a three-dimensional convolutional neural network (3D CNN) leveraging transfer learning for fusing PET/CT images and clinical data to predict EGFR mutation status in lung adenocarcinoma (LADC).

Methods

Retrospective data from 516 LADC patients, encompassing preoperative PET/CT images, clinical information, and EGFR mutation status, were divided into training (n = 404) and test sets (n = 112). Several deep learning models were developed utilizing transfer learning, involving CT-only and PET-only models. A dual-stream model fusing PET and CT and a three-stream transfer learning model (TS_TL) integrating clinical data were also developed. Image preprocessing includes semi-automatic segmentation, resampling, and image cropping. Considering the impact of class imbalance, the performance of the model was evaluated using ROC curves and AUC values.

Results

TS_TL model demonstrated promising performance in predicting the EGFR mutation status, with an AUC of 0.883 (95%CI = 0.849–0.917) in the training set and 0.730 (95%CI = 0.629–0.830) in the independent test set. Particularly in advanced LADC, the model achieved an AUC of 0.871 (95%CI = 0.823–0.919) in the training set and 0.760 (95%CI = 0.638–0.881) in the test set. The model identified distinct activation areas in solid or subsolid lesions associated with wild and mutant types. Additionally, the patterns captured by the model were significantly altered by effective tyrosine kinase inhibitors treatment, leading to notable changes in predicted mutation probabilities.

Conclusion

PET/CT deep learning model can act as a tool for predicting EGFR mutation in LADC. Additionally, it offers clinicians insights for treatment decisions through evaluations both before and after treatment.
Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage of both eyes after COVID-19 infection: a case report
Authors: Wang Yifan , Chen Hong , Yuan Lifei , Fan Yijia , Liang Yilei , Zhang Haiyu , Dang Ziyao , Wang Lifei
Published: March 2024

Background

Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage is commonly observed in myopia with tilted optic disc. It presents with typical features on the fundus and follows a self-limiting course. However, due to its complex etiology, clinicians sometimes lack sufficient understanding of it which can easily lead to misdiagnosis or overtreatment. In this case report, we describe a rare case of intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage in both eyes.

Case presentation

An 18-year-old female who has no past medical history experienced sudden black shadow blocking of her right eye in the right eye for the past 2 days after a 5-day history of COVID-19 infection. The best corrected visual acuity is 0.5 in the right eye and 0.6 in the left eye. Optical coherence tomography (OCT) showed tilted optic discs in both eyes, bulged nasal optic discs, and the presence of strong reflective material under the parafoveal retina of the optic discs. Fundus fluorescein angiography (FFA) showed subretinal fluorescence occlusion above and nasolateral to the optic disc in the right eye, with hypofluorescence below the optic disc; the subretinal below the optic disc was obscured by vitreous hemorrhage; hypofluorescence was seen in the optic disc region of the left eye.COVID-19 antigen was positive. The patient was in the early stage of the third COVID-19 infection when the disease occurred. We speculate that it may be related to it. After 5 months of conservative treatment, the patient’s hemorrhage disappeared in both eyes and her best corrected visual acuity returned to normal.

Conclusions

Intrapapillary hemorrhage with adjacent peripapillary subretinal hemorrhage usually occurs in myopia with tilted optic disc. In most patients, the cause of the bleeding is unknown, but it can gradually resolve under clinical observation or conservative treatment.
Supporting social emotional learning and wellbeing of displaced adolescents from the middle east: a pilot evaluation of the ‘forward with peers’ intervention
Authors: Seff Ilana , Stark Lindsay , Ali Ali , Sarraf Danielle , Hassan Wafa , Allaf Carine
Published: March 2024

Background

A growing literature points to the critical role schools can play in promoting improved psychosocial wellbeing and resilience among first- and second-generation Arab immigrant and refugee adolescents, but few evaluations have examined the effectiveness of culturally adapted, school-based interventions.

Methods

We conducted a pilot evaluation of a culturally adapted social and emotional learning and life skills program, Forward with Peers (FwP), and examined its potential effectiveness for this population. FwP was evaluated across three high schools in the Detroit Metropolitan Area. Within each school, one Arabic class was randomly assigned to receive FwP programming and another served as a control. The pilot evaluation sought to examine changes in several mental health and psychosocial outcomes of interest.

Findings

Improvements in overall perceived social support (P = 0.045) and perceived social support from someone special in one’s life (0.042) were statistically significant in the treatment as compared to the control group. Comparative improvements were also marginally significant for resilience (P = 0.095) and perceived social support from family (P = 0.074).

Conclusions

Findings highlight the potential of FwP and support the growing interest in establishing efficacy of school-based, culturally appropriate SEL programming to improve psychosocial wellbeing among Arab refugee and immigrant adolescents. FwP’s demonstrated improvements in resilience and social support have the potential to prevent mental health disorders and bolster coping mechanisms to minimize adverse consequences in this vulnerable population. Employing a strengths-based approach, FwP offers an alternative intervention to traditional treatment-oriented supports for the proliferation of mental health disorders within this vulnerable population.
A causal relationship between panic disorder and risk of alzheimer disease: a two-sample mendelian randomization analysis
Authors: Tian Yueqin , Ye Qiuping , Qiao Jia , Wang Lian , Dai Yong , Wen Hongmei , Dou Zulin
Published: March 2024

Background

Observational studies have suggested a link between panic disorder (PD) and Alzheimer disease (AD). This study aimed to identify the underlying association of PD with the risk of AD using Mendelian randomization.

Methods

Genetic instrumental variables (IVs) were retrieved in the genome-wide association study between PD and AD. Then, five different models, namely inverse variance weighting (IVW), weighted median, weighted mode, MR-Egger and MR-robust adjusted profile scores (MR-RAPS), were used for MR Analysis. Finally, the heterogeneity and pleiotropy of identified IVs were verified by multiple sensitivity tests.

Results

The Cochran’s Q test based on MR Egger and IVW showed that no evidence of heterogeneity was found in the effects of instrumental variables, so a fixed-effect model was used. IVW analysis (OR 1.000479, 95% CI [1.000147056, 1.000811539], p = 0.005) indicated that PD was associated with an increased risk of AD, and a causal association existed between them. Meanwhile, weighted median (OR 1.000513373, 95% CI [1.000052145, 1.000974814], p = 0.029) and MR-RAPS (OR 1.000510118, 95% CI [1.000148046, 1.00087232], p = 0.006) also showed the similar findings. In addition, extensive sensitivity analyses confirmed the robustness and accuracy of these results.

Conclusion

This investigation provides evidence of a potential causal relationship between PD and the increased risk of AD. Based on our MR results, when diagnosing and treating patients with PD, clinicians should pay more attention to their AD-related symptoms to choose therapeutic measures or minimize comorbidities. Furthermore, the development of drugs that improve both PD and AD may better treat patients with these comorbidities.
Female university students’ fertility intentions and their psychosocial factors
Authors: Qiao Penghao , Li Yiming , Song Yixuan , Tian Xi
Published: March 2024

Background

Raising the birth rate can effectively increase the resulting labour supply and minimise the adverse impact of an ageing population on high-quality economic development since the demographic dividend is rapidly declining. The Chinese government has a “three-child” policy in place, yet the fertility rate is still falling. This study intends to investigate the present fertility intentions of female university students and assess the extent to which feminism has affected their intentions. It will next investigate the degree to which and the mechanisms by which the psychosocial factors have an impact on those intentions.

Methods

A cross-sectional survey of female university students was conducted in Nanjing, China, from February to March 2023. To assure the representativeness of the sample, a technique of stratified proportional sampling, PPS sampling, and convenience sampling was utilized. A total of 1124 valid samples were acquired from female university students in 15 comprehensive universities. The data were mined and analysed by SPSS (version 24.0) and AMOS (version 24.0) software.

Results

Overall female university students’ fertility intentions are low at this stage, with more than half (53.55%) of them having no clear desire to have children. The level of feminist identity significantly negatively affected the Intensity of desire to have children (-0.32) and child-number desires (-0.7). Psychosocial factors had a greater degree of influence on fertility intentions. The direct effect of the level of feminist identity and the perception of fertility hindrances on childbearing desires was -0.63 and -0.50 respectively, and the direct effect of the perception of fertility supports on childbearing intentions was 0.79.

Conclusion

The level of feminist identity is significantly and negatively related to childbearing desires. Psychosocial factors have a greater degree of influence on fertility intentions, with the level of feminist identity, the perception of fertility hindrances and the perception of fertility supports all significantly impacting fertility intentions. The findings of this study emphasise the importance of the government providing a full range of social security and employers providing better employee benefits to promote a fertility-friendly society.
Continuum of care for maternal and child health and child undernutrition in Angola
Authors: Saito Akiko , Kondo Masahide
Published: March 2024

Background

Continuum of care (CoC) for maternal and child health provides opportunities for mothers and children to improve their nutritional status, but many children remain undernourished in Angola. This study aimed to assess the achievement level of CoC and examine the association between the CoC achievement level and child nutritional status.

Methods

We used nationally representative data from the Angola 2015–2016 Multiple Indicator and Health Survey. Completion of CoC was defined as achieving at least four antenatal care visits (4 + ANC), delivery with a skilled birth attendant (SBA), child vaccination at birth, child postnatal check within 2 months (PNC), and a series of child vaccinations at 2, 4, 6, 9 and 15 months of child age. We included under 5 years old children who were eligible for child vaccination questionnaires and their mothers. The difference in CoC achievement level among different nutritional status were presented using the Kaplan-Meier method and examined using the Log-Lank test. Additionally, the multivariable logistic regression analysis examined the associations between child nutritional status and CoC achievement levels.

Results

The prevalence of child stunting, underweight and wasting was 48.3%, 23.2% and 5.9% respectively. The overall CoC completion level was 1.2%. The level of achieving CoC of mother-child pairs was 62.8% for 4 + ANC, 42.2% for SBA, 23.0% for child vaccination at birth, and 6.7% for PNC, and it continued to decline over 15 months. The Log-Lank test showed that there were significant differences in the CoC achievement level between children with no stunting and those with stunting (p < 0.001), those with no underweight and those with underweight (p < 0.001), those with no wasting and those with wasting (p = 0.003), and those with malnutrition and those with a normal nutritional status (p < 0.001). Achieving 4 + ANC (CoC1), 4 + ANC and SBA (CoC 2), and 4 + ANC, SBA, and child vaccination at birth (CoC 3) were associated with reduction in child stunting and underweight.

Conclusions

The completion of CoC is low in Angola and many children miss their opportunity of nutritional intervention. According to our result, improving care utilization and its continuity could improve child nutritional status.