bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and implementation of evidence-based, nurse-leading early warning model and healthcare quality improvement project for transplant-associated thrombotic microangiopathy: a mixed-methods, before-and-after study
Authors: Zhou Xiaoyu , Ye Yishan , Jin Aiyun , Pan Zhengwen , Xu Zhe , Ding Shuyi , Yan Jiali , Cheng Yin , Huang Yixuan , Cao Kai , Xie Wei , Zhang Jianli , Xu Liwei , Zhou Weiwei , Huang Lihua
Published: August 2024

Objective

The early identification and diagnosis of transplant-associated thrombotic microangiopathy (TA-TMA) are essential yet difficult in patients underwent hematopoietic stem cell transplantation (HSCT). To develop an evidence-based, nurse-leading early warning model for TA-TMA, and implement the healthcare quality review and improvement project.

Methods

This study was a mixed-methods, before-and-after study. The early warning model was developed based on quality evidence from literature search. The healthcare quality review and improvement project mainly included baseline investigation of nurse, improvement action and effectiveness evaluation. The awareness and knowledge of early parameter of TA-TMA among nurses and the prognosis of patients underwent HSCT were compared before and after the improvement.

Results

A total of 1 guideline, 1 evidence synthesis, 4 expert consensuses, 10 literature reviews, 2 diagnostic studies, and 9 case series were included in the best evidence. The early warning model including warning period, high-risk characteristics and early manifestation of TA-TMA was developed. The improvement action, including staff training and assessment, suspected TA-TMA identification and patient education, was implemented. The awareness and knowledge rate of early parameter of TA-TMA among nurses significantly improved after improvement action (100% vs. 26.7%, P < 0.001). The incidence of TA-TMA was similar among patients underwent HSCT before and after improvement action (2.8% vs. 1.2%, P = 0.643), while no fall event occurred after improvement action (0 vs. 1.2%, P < 0.001).

Conclusion

The evidence-based early warning model and healthcare quality improvement project could enhance the awareness and knowledge of TA-TMA among healthcare providers and might improve the prognosis of patients diagnosed with TA-TMA.
Life on a leaf: the epiphyte to pathogen continuum and interplay in the phyllosphere
Authors: Thomas Graham , Kay William T. , Fones Helen N.
Published: August 2024

Epiphytic microbes are those that live for some or all of their life cycle on the surface of plant leaves. Leaf surfaces are a topologically complex, physicochemically heterogeneous habitat that is home to extensive, mixed communities of resident and transient inhabitants from all three domains of life. In this review, we discuss the origins of leaf surface microbes and how different biotic and abiotic factors shape their communities. We discuss the leaf surface as a habitat and microbial adaptations which allow some species to thrive there, with particular emphasis on microbes that occupy the continuum between epiphytic specialists and phytopathogens, groups which have considerable overlap in terms of adapting to the leaf surface and between which a single virulence determinant can move a microbial strain. Finally, we discuss the recent findings that the wheat pathogenic fungus Zymoseptoria tritici spends a considerable amount of time on the leaf surface, and ask what insights other epiphytic organisms might provide into this pathogen, as well as how Z. tritici might serve as a model system for investigating plant–microbe-microbe interactions on the leaf surface.
History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study
Authors: Wang Yue , Ge Fenfen , Aspelund Thor , Ask Helga , Hauksdóttir Arna , Hu Kejia , Jakobsdóttir Jóhanna , Zoega Helga , Shen Qing , Whalley Heather C. , Pedersen Ole Birger Vesterager , Lehto Kelli , Andreassen Ole A. , Fang Fang , Song Huan , Valdimarsdóttir Unnur A.
Published: August 2024

Background

Childhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association.

Methods

We included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes.

Results

The mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31–1.81]), particularly after physical neglect (2.04 [1.57–2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01–1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13–1.29]).

Conclusions

Our results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.
Predicting disease recurrence in patients with endometriosis: an observational study
Authors: Holdsworth-Carson Sarah J. , Chung Jessica , Machalek Dorothy A. , Li Rebecca , Jun Byung Kyu , Griffiths Meaghan J. , Churchill Molly , McCaughey Tristan , Nisbet Debbie , Dior Uri , Donoghue Jacqueline F. , Montgomery Grant W. , Reddington Charlotte , Girling Jane E. , Healey Martin , Rogers Peter A. W.
Published: August 2024

Background

Despite surgical and pharmacological interventions, endometriosis can recur. Reliable information regarding risk of recurrence following a first diagnosis is scant. The aim of this study was to examine clinical and survey data in the setting of disease recurrence to identify predictors of risk of endometriosis recurrence.

Methods

This observational study reviewed data from 794 patients having surgery for pelvic pain or endometriosis. Patients were stratified into two analytic groups based on self-reported or surgically confirmed recurrent endometriosis. Statistical analyses included univariate, followed by multivariate logistic regression to identify risk factors of recurrence, with least absolute shrinkage and selection operator (Lasso) regularisation. Risk-calibrated Supersparse Linear Integer Models (RiskSLIM) and survival analyses (with Lasso) were undertaken to identify predictive features of recurrence.

Results

Several significant features were repeatedly identified in association with recurrence, including adhesions, high rASRM score, deep disease, bowel lesions, adenomyosis, emergency room attendance for pelvic pain, younger age at menarche, higher gravidity, high blood pressure and older age. In the surgically confirmed group, with a score of 5, the RiskSLIM method was able to predict the risk of recurrence (compared to a single diagnosis) at 95.3% and included adenomyosis and adhesions in the model. Survival analysis further highlighted bowel lesions, adhesions and adenomyosis.

Conclusions

Following an initial diagnosis of endometriosis, clinical decision-making regarding disease management should take into consideration the presence of bowel lesions, adhesions and adenomyosis, which increase the risk of endometriosis recurrence.
Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0–3: a nationwide prospective cohort study
Authors: Li Weipeng , Shen Chaonan , Kong Weiya , Zhou Xiaohui , Fan Huimin , Zhang Yuzhen , Liu Zhongmin , Zheng Liang
Published: August 2024

Background

The American Heart Association (AHA) has recently introduced the concept of Cardiovascular-Kidney-Metabolic (CKM) syndrome, which is the result of an increasing emphasis on the interplay of metabolic, renal and cardiovascular diseases (CVD). Furthermore, there is substantial evidence of a correlation between the triglyceride glucose-body mass index (TyG-BMI ) and CVD as an assessment of insulin resistance (IR). However, it remains unknown whether this correlation exists in population with CKM syndrome.

Methods

All data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The exposure was the participants’ TyG-BMI at baseline, which was calculated using a combination of triglycerides (TG), fasting blood glucose (FBG) and body mass index (BMI). The primary outcome was CVD, which were determined by the use of a standardised questionnaire during follow-up. To examine the relationship between TyG-BMI and CVD incidence in population with CKM syndrome, both Cox regression analyses and restricted cubic spline (RCS) regression analyses were performed.

Results

A total of 7376 participants were included in the final analysis. Of these, 1139, 1515, 1839, and 2883 were in CKM syndrome stages 0, 1, 2, and 3, respectively, at baseline. The gender distribution was 52.62% female, and the mean age was 59.17 ± 9.28 (years). The results of the fully adjusted COX regression analyses indicated that there was a 6.5% increase in the risk of developing CVD for each 10-unit increase in TyG-BMI,95% confidence interval (CI):1.041–1.090. The RCS regression analyses demonstrated a positive linear association between TyG-BMI and the incidence of CVD in the CKM syndrome population (P for overall < 0.001, P for nonlinear = 0.355).

Conclusions

This cohort study demonstrated a positive linear association between TyG-BMI index and increased CVD incidence in a population with CKM syndrome stage 0–3. This finding suggests that enhanced assessment of TyG-BMI index may provide a more convenient and effective tool for individuals at risk for CVD in CKM syndrome stage 0–3.
Effect of rosuvastatin versus atorvastatin on new-onset diabetes mellitus in patients treated with high-intensity statin therapy for coronary artery disease: a post-hoc analysis from the LODESTAR randomized clinical trial
Authors: Hong Sung-Jin , Lee Yong-Joon , Kang Woong Chol , Hong Bum-Kee , Lee Jong-Young , Lee Jin-Bae , Yang Tae-Hyun , Yoon Junghan , Lee Seung-Jun , Ahn Chul-Min , Kim Jung-Sun , Kim Byeong-Keuk , Ko Young-Guk , Choi Donghoon , Jang Yangsoo , Hong Myeong-Ki ,   for the LODESTAR investigators
Published: August 2024

Background

The impact of rosuvastatin versus atorvastatin on new-onset diabetes mellitus (NODM) among patients treated with high-intensity statin therapy for coronary artery disease (CAD) remains to be clarified. This study aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial.

Methods

In the LODESTAR trial, patients with CAD were randomly assigned to receive either rosuvastatin or atorvastatin using a 2-by-2 factorial randomization. In this post-hoc analysis, the 3-year incidence of NODM was compared between rosuvastatin and atorvastatin treatment in the as-treated population with high-intensity statin therapy as the principal population of interest.

Results

Among 2932 patients without diabetes mellitus at baseline, 2377 were included in the as-treated population analysis. In the as-treated population with high-intensity statin therapy, the incidence of NODM was not significantly different between the rosuvastatin and atorvastatin groups (11.4% [106/948] versus 8.8% [73/856], hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 0.98 to 1.77, P = 0.071). When the risk of NODM with rosuvastatin versus atorvastatin was assessed according to the achieved low-density lipoprotein cholesterol (LDL-C) level, the risk of NODM began to increase at a LDL-C level below 70 mg/dL. The incidence of NODM was significantly greater in the rosuvastatin group than it was in the atorvastatin group when the achieved LDL-C level was < 70 mg/dL (13.9% versus 8.0%; HR = 1.79, 95% CI 1.18 to 2.73, P = 0.007).

Conclusions

Among CAD patients receiving high-intensity statin therapy, the incidence of NODM was not significantly different between rosuvastatin and atorvastatin. However, a drug effect of the statin type on NODM was observed when the achieved LDL-C level was < 70 mg/dL.

Trial registration

ClinicalTrials.gov, Identifier: NCT02579499.

Graphical abstract
Shear-wave elastography as a supplementary tool for axillary staging in patients undergoing breast cancer diagnosis
Authors: Togawa Riku , Riedel Fabian , Feisst Manuel , Fastner Sarah , Gomez Christina , Hennigs André , Nees Juliane , Pfob André , Schäfgen Benedikt , Stieber Anne , Wallwiener Markus , Heil Jörg , Golatta Michael
Published: August 2024

Background

Preoperative evaluation of axillary lymph node status is crucial for the selection of both systemic and surgical treatment in early breast cancer. This study assessed the particular role of additional shear wave elastography (SWE) in axillary staging in patients undergoing initial breast cancer diagnostics.

Methods

One hundred patients undergoing axillary lymph node biopsy due to a sonographically suspicious axillary lymph node were prospectively evaluated with SWE using virtual touch tissue imaging quantification (VTIQ). Mean values of tissue stiffness for axillary tissue and lymph node tissue were measured prior to core-cut biopsy of the lymph node. All lymph nodes were clip-marked during the biopsy. Cut-off values to differentiate between malignant and benign lymph nodes were defined using Youden’s index.

Results

Lymph nodes with evidence of malignant tumor cells in the final pathological examination showed a significantly higher velocity as measured by SWE, with a mean velocity of 3.48 ± 1.58 m/s compared to 2.33 ± 0.62 m/s of benign lymph nodes (p < 0.0001). The statistically optimal cutoff to differentiate between malignant and benign lymph nodes was 2.66 m/s with a sensitivity of 69.8% and a specificity of 87.5%.

Conclusions

Lymph node metastases assessed with SWE showed significantly higher elasticity values compared to benign lymph nodes. Thus, SWE provides an additional useful and quantifiable parameter for the sonographic assessment of suspicious axillary lymph nodes in the context of pre-therapeutic axillary staging in order to differentiate between benign and metastatic processes and support the guidance of definitive biopsy work-up.

Critical relevance statement

Shear-wave elastography provides an additional useful and quantifiable parameter for the assessment of suspicious axillary lymph nodes in the context of pre-therapeutic axillary staging in order to differentiate between benign and metastatic processes and support guiding the definitive biopsy work-up.

Key Points

SWE is a quantifiable ultrasound parameter in breast cancer diagnosis.

SWE shows a significantly higher velocity in malignant lymph nodes.

SWE is useful in improving the sensitivity and specificity of axillary staging.

Graphical Abstract
Shunt dysfunction and mortality after transjugular intrahepatic portosystemic shunt (TIPS) in patients with portal hypertension
Authors: Büttner Laura , Pick Lisa , Jonczyk Martin , Fehrenbach Uli , Collettini Federico , Auer Timo Alexander , Schnapauff Dirk , De Bucourt Maximilian , Wieners Gero , Gebauer Bernhard , Aigner Annette , Böning Georg
Published: August 2024

Objectives

Transjugular intrahepatic portosystemic shunt (TIPS) is a catheter-based, minimally invasive procedure to reduce portal hypertension. The aim of the study was to investigate dysfunction and mortality after TIPS and to identify factors associated with these events.

Methods

A retrospective analysis of 834 patients undergoing TIPS implantation in a single center from 1993–2018 was performed. Cumulative incidence curves were estimated, and frailty models were used to assess associations between potentially influential variables and time to dysfunction or death.

Results

1-, 2-, and 5-year mortality rates were 20.9% (confidence interval (CI) 17.7–24.1), 22.5% (CI 19.1–25.8), and 25.0% (CI: 21.1–28.8), 1-year, 2-year, and 5-year dysfunction rates were 28.4% (CI 24.6–32.3), 38.9% (CI 34.5–43.3), and 52.4% (CI 47.2–57.6). The use of covered stents is a protective factor regarding TIPS dysfunction (hazard ratio (HR) 0.47, CI 0.33–0.68) but does not play a major role in survival (HR 0.95, CI 0.58–1.56). Risk factors for mortality are rather TIPS in an emergency setting (HR 2.78, CI 1.19–6.50), a previous TIPS dysfunction (HR 2.43, CI 1.28–4.62), and an increased Freiburg score (HR 1.45, CI 0.93–2.28).

Conclusion

The use of covered stents is an important protective factor regarding TIPS dysfunction. Whereas previous TIPS dysfunction, emergency TIPS implantation, and an elevated Freiburg score are associated with increased mortality. Awareness of risk factors could contribute to a better selection of patients who may benefit from a TIPS procedure and improve clinical follow-up with regard to early detection of thrombosis/stenosis.

Critical relevance statement

The use of covered stents reduces the risk of dysfunction after transjugular intrahepatic portosystemic shunt (TIPS). TIPS dysfunction, emergency TIPS placement, and a high Freiburg score are linked to higher mortality rates in TIPS patients.

Key Points

The risk of dysfunction is higher for uncovered stents compared to covered stents.

Transjugular intrahepatic portosystemic shunt dysfunction increases the risk of instantaneous death after the intervention.

A higher Freiburg score increases the rate of death after the intervention.

Transjugular intrahepatic portosystemic shunt implantations in emergency settings reduce survival rates.

Graphical Abstract
How do deep-learning models generalize across populations? Cross-ethnicity generalization of COPD detection
Authors: D. Almeida Silvia , Norajitra Tobias , Lüth Carsten T. , Wald Tassilo , Weru Vivienn , Nolden Marco , Jäger Paul F. , von Stackelberg Oyunbileg , Heußel Claus Peter , Weinheimer Oliver , Biederer Jürgen , Kauczor Hans-Ulrich , Maier-Hein Klaus
Published: August 2024

Objectives

To evaluate the performance and potential biases of deep-learning models in detecting chronic obstructive pulmonary disease (COPD) on chest CT scans across different ethnic groups, specifically non-Hispanic White (NHW) and African American (AA) populations.

Materials and methods

Inspiratory chest CT and clinical data from 7549 Genetic epidemiology of COPD individuals (mean age 62 years old, 56–69 interquartile range), including 5240 NHW and 2309 AA individuals, were retrospectively analyzed. Several factors influencing COPD binary classification performance on different ethnic populations were examined: (1) effects of training population: NHW-only, AA-only, balanced set (half NHW, half AA) and the entire set (NHW + AA all); (2) learning strategy: three supervised learning (SL) vs. three self-supervised learning (SSL) methods. Distribution shifts across ethnicity were further assessed for the top-performing methods.

Results

The learning strategy significantly influenced model performance, with SSL methods achieving higher performances compared to SL methods (p < 0.001), across all training configurations. Training on balanced datasets containing NHW and AA individuals resulted in improved model performance compared to population-specific datasets. Distribution shifts were found between ethnicities for the same health status, particularly when models were trained on nearest-neighbor contrastive SSL. Training on a balanced dataset resulted in fewer distribution shifts across ethnicity and health status, highlighting its efficacy in reducing biases.

Conclusion

Our findings demonstrate that utilizing SSL methods and training on large and balanced datasets can enhance COPD detection model performance and reduce biases across diverse ethnic populations. These findings emphasize the importance of equitable AI-driven healthcare solutions for COPD diagnosis.

Critical relevance statement

Self-supervised learning coupled with balanced datasets significantly improves COPD detection model performance, addressing biases across diverse ethnic populations and emphasizing the crucial role of equitable AI-driven healthcare solutions.

Key Points

Self-supervised learning methods outperform supervised learning methods, showing higher AUC values (p < 0.001).

Balanced datasets with non-Hispanic White and African American individuals improve model performance.

Training on diverse datasets enhances COPD detection accuracy.

Ethnically diverse datasets reduce bias in COPD detection models.

SimCLR models mitigate biases in COPD detection across ethnicities.

Graphical Abstract
Nocardamine mitigates cellular dysfunction induced by oxidative stress in periodontal ligament stem cells
Authors: He Hai-Peng , Zhao Mei-Zhen , Jiao Wei-Hua , Liu Zhi-Qiang , Zeng Xian-Hai , Li Quan-Li , Hu Tian-Yong , Cheng Bao-Hui
Published: August 2024

Background

The role of periodontal ligament stem cells (PDLSCs) in repairing periodontal destruction is crucial, but their functions can be impaired by excessive oxidative stress (OS). Nocardamine (NOCA), a cyclic siderophore, has been shown to possess anti-cancer and anti-bacterial properties. This study aimed to investigate the protective mechanisms of NOCA against OS-induced cellular dysfunction in PDLSCs.

Methods

The cytotoxicity of NOCA on PDLSCs was assessed using a CCK-8 assay. PDLSCs were then treated with hydrogen peroxide (H2O2) to induce OS. ROS levels, cell viability, and antioxidant factor expression were analyzed using relevant kits after treatment. Small molecule inhibitors U0126 and XAV-939 were employed to block ERK signaling and Wnt pathways respectively. Osteogenic differentiation was assessed using alkaline phosphatase (ALP) activity staining and Alizarin Red S (ARS) staining of mineralized nodules. Expression levels of osteogenic gene markers and ERK pathway were determined via real-time quantitative polymerase chain reaction (RT-qPCR) or western blot (WB) analysis. β-catenin nuclear localization was examined by western blotting and confocal microscopy.

Results

NOCA exhibited no significant cytotoxicity at concentrations below 20 µM and effectively inhibited H2O2-induced OS in PDLSCs. NOCA also restored ALP activity, mineralized nodule formation, and the expression of osteogenic markers in H2O2-stimulated PDLSCs. Mechanistically, NOCA increased p-ERK level and promoted β-catenin translocation into the nucleus; however, blocking ERK pathway disrupted the osteogenic protection provided by NOCA and impaired its ability to induce β-catenin nuclear translocation under OS conditions in PDLSCs.

Conclusions

NOCA protected PDLSCs against H2O2-induced OS and effectively restored impaired osteogenic differentiation in PDLSCs by modulating the ERK/Wnt signaling pathway.
The impact of targeted local outreach clinics to improve COVID-19 vaccine uptake: controlled interrupted time series in South West England
Authors: Jones Tim , Adamali Huzaifa , Redaniel Maria Theresa , de Vocht Frank , Tilling Kate , Kenward Charlie , Ben-Shlomo Yoav , Creavin Sam
Published: August 2024

Background

Outreach clinics were part of efforts to maximise uptake in COVID-19 vaccination.

Methods

We used controlled interrupted time series, matching on age, sex, deprivation and vaccination eligibility date, to determine the effect of outreach clinics on time to first COVID-19 vaccine, using a population-based electronic health record database of 914,478 people, from December 2020 to December 2021; people living within 1 mile of each outreach clinics were exposed.

Results

50% of 288,473 exposed citizens were white British, and 71% were aged 0–49 years. There was no evidence for an overall statistically significant increase in cumulative percentage vaccinated due to the outreach clinic at 6 weeks, with an overall pooled effect estimate of -0.07% (95% CI: -1.15%, 1.02%). The pooled estimate for increased cumulative vaccine uptake varied slightly depending on how the analysis was stratified; by ethnic group it was − 0.12% (95% CI: -0.90%, 0.66%); by age group it was − 0.06% (95% CI: -0.41%, 0.28%); and by deprivation it was 0.03% (95% CI: -0.74%, 0.79%).

Conclusions

Living within a mile of an outreach clinic was not associated with higher vaccine uptake. Evaluation of future outreach clinics should consider the relative importance of travel amongst other barriers to accessing vaccines.
Peri-urban dynamics: assessing expansion patterns and influencing factors
Authors: Haldar Subrata , Chatterjee Uday , Bhattacharya Subhasis , Paul Suman , Bindajam Ahmed Ali , Mallick Javed , Abdo Hazem Ghassan
Published: August 2024

Background

Peri-urbanization, the expansion of large metropolitan centers into adjacent peri-urban regions, is a growing concern due to land scarcity and escalating housing costs. These zones, a blend of rural and urban features, blur the line between urban and rural areas, creating new landscapes. This study examines historical, present, and potential growth trends in the peri-urban area surrounding Durgapur Municipal Corporation (DMC). Analytical techniques and spatial metrics are used to track development intensity changes over time, including built-up density, Shannon’s entropy, Landscape expansion index, Average Weighted Mean Expansion Index, Annual Built-Up Expansion Rate, Built-Up Expansion Intensity Index, and Built-Up Expansion Difference Index. Landscape indices like Patch Density, Edge Density, Landscape Shape Index, Largest Patch Index, Ratio of Open Space, and Area Weighted Mean Patch Fractal are used to understand fragmentation, connectivity, and spatial relationships. The Logistic Regression Model (LRM) is used to identify influencing factors and CA-Markov modeling for future built-up areas.

Results

Between 1991 and 2001, built-up area in the region increased significantly, primarily due to urban development near industrial zones, roadways, and mining areas. The growth was primarily concentrated in the western sector and near National Highway-2 (NH-2). Urban sprawl was a continuous trend, with the highest built-up density in the South-South-East (SSE) direction from 1991 to 2011. Additionally, a key determinant of built-up development was the distance to the city core. By 2031, the built-up area is expected to concentrate in the western and southeast regions, reaching 177.90 km2.

Conclusions

This expansion is attributed to urban development near industrial zones, roadways, mining areas, and other infrastructure. The study identifies distance to the city center as a significant influencing factor for built-up development. The results emphasize the need for inclusive urban planning methods prioritizing sustainable development principles and prudent resource management for future growth and efficient management in the DMC’s peri-urban area.
Transcriptomic changes and gene fusions during the progression from Barrett’s esophagus to esophageal adenocarcinoma
Authors: Fu Yusi , Agrawal Swati , Snyder Daniel R. , Yin Shiwei , Zhong Na , Grunkemeyer James A. , Dietz Nicholas , Corlett Ryan , Hansen Laura A. , Waddah Al-Refaie , Nandipati Kalyana C. , Xia Jun
Published: August 2024

The incidence of esophageal adenocarcinoma (EAC) has surged by 600% in recent decades, with a dismal 5-year survival rate of just 15%. Barrett’s esophagus (BE), affecting about 2% of the population, raises the risk of EAC by 40-fold. Despite this, the transcriptomic changes during the BE to EAC progression remain unclear. Our study addresses this gap through comprehensive transcriptomic profiling to identify key mRNA signatures and genomic alterations, such as gene fusions. We performed RNA-sequencing on BE and EAC tissues from 8 individuals, followed by differential gene expression, pathway and network analysis, and gene fusion prediction. We identified mRNA changes during the BE-to-EAC transition and validated our results with single-cell RNA-seq datasets. We observed upregulation of keratin family members in EAC and confirmed increased levels of keratin 14 (KRT14) using immunofluorescence. More differentiated BE marker genes are downregulated during progression to EAC, suggesting undifferentiated BE subpopulations contribute to EAC. We also identified several gene fusions absent in paired BE and normal esophagus but present in EAC. Our findings are critical for the BE-to-EAC transition and have the potential to promote early diagnosis, prevention, and improved treatment strategies for EAC.
Evidence-based scientific thinking and decision-making in everyday life
Authors: Dawson Caitlin , Julku Hanna , Pihlajamäki Milla , Kaakinen Johanna K. , Schooler Jonathan W. , Simola Jaana
Published: August 2024

In today’s knowledge economy, it is critical to make decisions based on high-quality evidence. Science-related decision-making is thought to rely on a complex interplay of reasoning skills, cognitive styles, attitudes, and motivations toward information. By investigating the relationship between individual differences and behaviors related to evidence-based decision-making, our aim was to better understand how adults engage with scientific information in everyday life. First, we used a data-driven exploratory approach to identify four latent factors in a large set of measures related to cognitive skills and epistemic attitudes. The resulting structure suggests that key factors include curiosity and positive attitudes toward science, prosociality, cognitive skills, and openmindedness to new information. Second, we investigated whether these factors predicted behavior in a naturalistic decision-making task. In the task, participants were introduced to a real science-related petition and were asked to read six online articles related to the petition, which varied in scientific quality, while deciding how to vote. We demonstrate that curiosity and positive science attitudes, cognitive flexibility, prosociality and emotional states, were related to engaging with information and discernment of evidence reliability. We further found that that social authority is a powerful cue for source credibility, even above the actual quality and relevance of the sources. Our results highlight that individual motivating factors toward information engagement, like curiosity, and social factors such as social authority are important drivers of how adults judge the credibility of everyday sources of scientific information.
Exploring the association of serum prolactin with serum glucose levels and clinical findings in a cohort of patients with early rheumatoid arthritis
Authors: Bandeira de Santana Lidiana , de Souza Lima Thomas Alves , Costa Amanda Rodrigues , Sandoval Leticia Assad Maia , de Souza Talita Yokoy , da Mota Licia Maria Henrique , Naves Luciana Ansaneli
Published: August 2024

Background

In the context of rheumatoid arthritis and its systemic inflammatory implications, there is an increasing interest in investigating the role of prolactin in the clinical and metabolic aspects of the disease. This study aimed to explore the potential links between serum prolactin levels, serum glucose levels, and the clinical manifestations of arthritis.

Methods

This exploratory, cross-sectional, observational study focused on women diagnosed with rheumatoid arthritis. The research involved assessing prolactin and blood glucose concentrations, alongside specific clinical traits such as disease-related inflammation, morning stiffness, and fatigue intensity. The presence of changes in serum prolactin (PRL) was initially compared among the groups based on disease activity intensity. Using a multinomial regression analysis, the study analyzed the impact of predetermined clinical and metabolic factors on various categories of prolactin concentration.

Results

Out of the 72 participants included in the study, hyperprolactinemia was detected in 9.1% of the sample. No differences in serum PRL were identified among the evaluated groups based on disease activity. Following multivariate analysis, no statistically significant differences were identified for the outcomes of inflammatory activity and morning stiffness within each PRL category when compared to the reference category for PRL. There was no increased likelihood of encountering blood glucose levels below 100 mg/dl among individuals with higher prolactin concentrations compared to those in the lowest prolactin category (OR 5.43, 95% CI 0.51–58.28). The presence of clinically significant fatigue revealed a higher likelihood of encountering this outcome among patients with intermediate PRL values (prolactin categories 7.76–10.35 with OR 5.18, 95% CI 1.01–26.38 and 10.36–15.29 with OR 6.25, 95% CI 1.2–32.51) when compared to the reference category.

Conclusions

The study found no discernible correlation between prolactin concentrations and worse scores for inflammatory activity of the disease, nor between prolactin concentrations and serum glucose levels. The findings regarding fatigue should be approached with caution given the exploratory nature of this study.
The many MRI faces of invasive lobular carcinoma: a pictorial essay
Authors: Jerković Kristian , Vuković Danica , Budimir Mršić Danijela , Ordulj Ivan
Published: August 2024

Background

Invasive lobular cancer is the second most common subtype of invasive breast cancer. Due to the wide diversity of histopathological, clinical, and radiological presentations, it can provide diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI) has the highest sensitivity for its detection and the most accurate determination of invasive lobular cancer extent. The aim of our pictorial review was to demonstrate the different presentations of invasive lobular cancer on MRI and thus facilitate the interpretation of imaging findings for radiologists.

Main body of the abstract

The pictorial essay carefully extracted six different MRI presentations of an invasive lobular cancer with brief histopathological and clinical patient data. We showed that invasive lobular cancer presentation on MRI varied, ranged from a single focus to single and multiple lesions, non-mass enhancements of various distributions, and in some cases with nonspecific enhancement curves.

Conclusions

This pictorial essay presented a spectrum of MRI findings of invasive lobular cancer, showing the variety of their appearances. Considering the variety of MRI imaging, the radiologist sometimes has to look for other diagnostic methods for the final interpretation of the imaging findings. We believe that the presentation of different cases will educate radiologists and help in making appropriate diagnostic and therapeutic decisions.
Factors influencing limb movements in post-stroke patients
Authors: Theppan Kwunchanok , Suphunnakul Pattama
Published: August 2024

Background

Stroke is the leading cause of long-term disability impacting patients’ daily lives. Adequate and ongoing rehabilitation is a necessity. Due to disability problems, rehabilitation in the health care system is limited. Traditional medicine has been promoted in Thailand for stroke rehabilitation, with physical therapy as the primary treatment plan. However, despite more options, many patients still receive inadequate rehabilitation. The development of an appropriate rehabilitation model is still necessary. This study aims to study factors influencing limb movements in post-stroke patients.

Methods

This cross-sectional study comprised 120 ischemic stroke patients obtained by multi-stage sampling in Muang district, Phitsanulok province. The data were collected using questionnaires with Cronbach’s alpha coefficient of 0.89. The ability to move the muscles of the limbs of the patients was assessed using the motor power assessment form, and binary logistic regression statistics analyzed the factors influencing limb movements.

Result

Data analysis shows that 76% of the stroke patients were female, 39.3% aged 61–70 years had a mean of 62 years and a standard deviation (S.D.) of 8.9, 4.6% of stroke patients had a duration of illness of 6–12 months, and 94.2% had a caregiver. 53.1% received rehabilitation once a week, and 92.5% received Thai massage. Thai traditional medicine utilization methods consist of Thai massage, herbal compresses, herbal steam, and taking herbal medicines. There are two factors influencing the ability to move the limb muscles of stroke patients as follows: (1) the massage with the Thai traditional medicine rehabilitation method (Adj OR = 28.917, p-value = 0.006) and (2) the number of rehabilitation sessions per week (Adj OR = 2.465, p-value < 0.001). These two variables explain the variance of regaining limb movement among post-stroke patients of 42.5% at a significance level of 0.05. In this analysis, the predictive accuracy was 70%.

Conclusion

Rehabilitation using Thai massage, together with the number of rehabilitation sessions per week, influenced the ability of limb movement in post-stroke patients. In other words, increasing the number of rehabilitation times per week and using Thai massage in rehabilitation will help stroke patients move their limbs better.
Rapid production of monoclonal antibodies from single mouse B cells against FMDV
Authors: Yang Zhengxin , Li Fangtao , Zhang Mengjia , Li Yan , Zhao Qizu , Wang Chunyan , Xu Lu , Liu Yebing , Li Wentao , Zhu Yuanyuan
Published: August 2024

Single B-cell antibody generation technology is an advanced method that offers several advantages, including rapid production, high efficiency, and high yield. The antibodies generated via this technique retain their natural conformation and are well suited for applications in pathogen diagnosis, disease treatment, and investigations of virus cross-species transmission mechanisms. Our study aimed to establish a platform for generating single B-cell antibodies specifically targeting the foot-and-mouth disease virus (FMDV) 146S antigen in mice. Female BALB/c mice were immunized with inactivated O-type FMDV 146S antigen, and spleen cells were collected for further analysis. Flow cytometric sorting was performed using a biotin-labeled O-type FMDV 146S antigen as a decoy to identify and select CD19 + /CD21/35 + /CD43-/IgM-/Biotin + antigen-specific individual B cells. The gene sequences encoding the variable regions of the heavy and light chains of the murine IgG antibodies were obtained via single-cell nested PCR amplification. Separate constructs were created for the heavy and light chain plasmids to ensure the proper expression of intact IgG antibodies. These plasmids were cotransfected into human embryonic kidney 293T (HEK293T) cells, leading to the successful production and purification of 15 specific monoclonal antibodies (mAbs), 10 which exhibited activity in ELISA tests, and six antibodies that displayed activity in IFA tests. These findings highlight the successful development of a method for generating mouse-derived single B-cell antibodies that target FMDV. This achievement provides a solid foundation for diagnostic techniques and the analysis of antigenic structural variations.
Economic Burden of Endometrial Cancer Associated With Polycystic Ovary Syndrome
Authors: Pace Lauren , Markovic Daniela , Buyalos Richard , Bril Fernando , Azziz Ricardo
Published: August 2024

Context

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged females, and women with PCOS are at increased risk for endometrial cancer (EndoCA), the most common gynecological malignancy.

Objective

Our study sought to assess the economic burden associated with EndoCA in PCOS.

Method

Using PRISMA systematic review guidelines, we evaluated studies on EndoCA rates in patients with PCOS. Excluded studies were reviews and case reports, those with nonhuman subjects, without controls, without full text available, or reporting solely on other conditions. Selected studies were assessed for quality using the Newcastle-Ottawa Scale. Meta-analysis used DerSimonian-Laird random effects model to assess pooled risk ratio (RR). Excess cost was assessed in US dollars (USD).

Result

Of 98 studies screened, 9 were included. Pooled RR for EndoCA in PCOS was 3.46 (95% CI, 2.28-5.23), P ≤ .001. In the United States, prevalence of EndoCA in patients with PCOS in 2020 was 1.712%, compared with a baseline estimated prevalence in all women of 0.489%. The excess prevalence of EndoCA attributable to PCOS was 1.223%, approximately 98 348 affected women. A population attributable fraction of EndoCA for PCOS was 24.4%. Given estimated costs of EndoCA exceeding $1.9 billion (in 2023 USD), the economic burden of EndoCA attributable to PCOS exceeds $467 million/year.

Conclusion

The excess annual US healthcare cost for EndoCA attributable to PCOS exceeds $467 million/year (2023 USD). Although a concerning morbidity of PCOS, it is notable that the economic burden of EndoCA attributable to the disorder represents only a small fraction of its total healthcare burden.
Insulin Sensitivity and Insulin Secretion in Adults With Friedreich's Ataxia: The Role of Skeletal Muscle
Authors: Tamaroff Jaclyn , Nguyen Sara , Wilson Neil E , Stefanovski Darko , Xiao Rui , Scattergood Theresa , Capiola Christopher , Schur Gayatri Maria , Dunn Julia , Dedio Anna , Wade Kristin , Shah Hardik , Sharma Rohit , Mootha Vamsi K , Kelly Andrea , Lin Kimberly Y , Lynch David R , Reddy Ravinder , Rickels Michael R , McCormack Shana E
Published: August 2024

Introduction

Friedreich's ataxia (FRDA) is a multisystem disorder caused by frataxin deficiency. FRDA-related diabetes mellitus (DM) is common. Frataxin supports skeletal muscle mitochondrial oxidative phosphorylation (OXPHOS) capacity, a mediator of insulin sensitivity. Our objective was to test the association between skeletal muscle health and insulin sensitivity and secretion in adults with FRDA without DM.

Methods

Case-control study (NCT02920671). Glucose and insulin metabolism (stable-isotope oral glucose tolerance tests), body composition (dual-energy x-ray absorptiometry), physical activity (self-report), and skeletal muscle OXPHOS capacity (creatine chemical exchange saturation transfer magnetic resonance imaging) were assessed.

Results

Participants included 11 individuals with FRDA (4 female), median age 27 years (interquartile range 23, 39), body mass index 26.9 kg/m2 (24.1, 29.4), and 24 controls (11 female), 29 years (26, 39), 24.4 kg/m2 (21.8, 27.0). Fasting glucose was higher in FRDA [91 vs 83 mg/dL (5.0 vs 4.6 mmol/L), P < .05]. Individuals with FRDA had lower insulin sensitivity (whole-body insulin sensitivity index 2.8 vs 5.3, P < .01), higher postprandial insulin secretion (insulin secretory rate incremental area under the curve 30-180 minutes, 24 652 vs 17,858, P < .05), and more suppressed postprandial endogenous glucose production (−.9% vs 26.9% of fasting endogenous glucose production, P < .05). In regression analyses, lower OXPHOS and inactivity explained some of the difference in insulin sensitivity. More visceral fat contributed to lower insulin sensitivity independent of FRDA. Insulin secretion accounting for sensitivity (disposition index) was not different.

Conclusion

Lower mitochondrial OXPHOS capacity, inactivity, and visceral adiposity contribute to lower insulin sensitivity in FRDA. Higher insulin secretion appears compensatory and, when inadequate, could herald DM. Further studies are needed to determine if muscle- or adipose-focused interventions could delay FRDA-related DM.
Effects of Exercise on Bone Marrow Adipose Tissue in Children With Overweight/Obesity: Role of Liver Fat
Authors: Labayen Idoia , Cadenas-Sánchez Cristina , Idoate Fernando , Gracia-Marco Luis , Medrano María , Alfaro-Magallanes Víctor Manuel , Alcantara Juan M A , Rodríguez-Vigil Beatriz , Osés Maddi , Ortega Francisco B , Ruiz Jonatan R , Cabeza Rafael
Published: August 2024

Context

Exercise reduces adiposity, but its influence on bone marrow fat fraction (BMFF) is unknown; nor is it known whether a reduction in liver fat content mediates this reduction.

Objectives

This work aimed to determine whether incorporating exercise into a lifestyle program reduces the lumbar spine (LS) BMFF and to investigate whether changes in liver fat mediate any such effect.

Methods

Ancillary analysis of a 2-arm, parallel, nonrandomized clinical trial was conducted at primary care centers in Vitoria-Gasteiz, Spain. A total of 116 children with overweight/obesity were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). The compared interventions consisted of a family-based lifestyle program (two 90-minute sessions/month) and the same program plus supervised exercise (three 90-minute sessions/week). The primary outcome examined was the change in LS-BMFF between baseline and 22 weeks, as estimated by magnetic resonance imaging. The effect of changes in hepatic fat on LS-BMFF were also recorded.

Results

Mean weight loss difference between groups was 1.4 ± 0.5 kg in favor of the exercise group. Only the children in the exercise group experienced a reduction in LS-BMFF (effect size [Cohen d] −0.42; CI, −0.86 to −0.01). Importantly, 40.9% of the reductions in LS-BMFF were mediated by changes in percentage hepatic fat (indirect effect: β=−0.104; 95% CI, −0.213 to −0.019). The effect of changes in hepatic fat on LS-BMFF was independent of weight loss.

Conclusion

The addition of exercise to a family-based lifestyle program designed to reduce cardiometabolic risk improves bone health by reducing LS-BMFF in children with overweight or obesity. This beneficial effect on bone marrow appears to be mediated by reductions in liver fat.