bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the bidirectional relationship between metabolic syndrome and thyroid autoimmunity: a Mendelian randomization study
Authors: Chen Kefan , Sun Wei , He Liang , Dong Wenwu , Zhang Dalin , Zhang Ting , Zhang Hao
Published: March 2024

Background

Observational studies have reported a possible association between metabolic syndrome (MetS) and thyroid autoimmunity. Nevertheless, the relationship between thyroid autoimmunity and MetS remains unclear. The objective of this research was to assess the causal impact of MetS on thyroid autoimmunity through the utilization of Mendelian randomization (MR) methodology.

Methods

We performed bidirectional MR to elucidate the causal relationship between MetS and their components and thyroid autoimmunity (positivity of TPOAb). Single nucleotide polymorphisms (SNPs) of MetS and its components were obtained from the publicly available genetic variation summary database. The Thyroidomics Consortium conducted a genome-wide association analysis, which provided summary-level data pertaining to thyroid autoimmunity. The study included several statistical methods, including the inverse variance weighting method (IVW), weighted median, simple mode, weight mode, and MR-Egger methods, to assess the causal link. In addition, to ensure the stability of the results, a sensitivity analysis was conducted.

Results

IVW showed that MetS reduced the risk of developing thyroid autoimmunity (OR = 0.717, 95% CI = 0.584 - 0.88, P = 1.48E−03). The investigation into the causative association between components of MetS and thyroid autoimmune revealed a statistically significant link between triglycerides levels and the presence of thyroid autoimmunity (IVW analysis, OR = 0.603, 95%CI = 0.45 -0.807, P = 6.82E−04). The reverse analysis did not reveal any causal relationship between thyroid autoimmunity and MetS, including its five components.

Conclusions

We have presented new genetic evidence demonstrating that MetS and its triglyceride components may serve as potential protective factors against thyroid autoimmunity.
Anaerobic biodegradation of brown grease and its potential as a source of renewable energy
Authors: Heindel Amy , Lee Ross , Spracklin Dan , Duran Metin
Published: March 2024

The purpose of the study was twofold. The first was to study the anaerobic digestibility and the biochemical methane potential (BMP) of brown grease (BG)–fats and oils collected from restaurants and similar food production facilities. The second objective was to investigate the effects of adding dry, food waste derived hydrochar to enhance the digestion process, specifically as a possible in situ agent to improve biogas quality. The BMP tests involved various BG loadings between 3 and 30 g BG/L. The results indicate that BG is highly digestible under anaerobic conditions with 354 mL CH4/g COD equivalent of BG at 1 atm and 35°C testing conditions, which translates into 28 million gasoline gallon equivalent (GGE) potential energy that could be recovered by anaerobically digesting or co-digesting BG. The particular hydrochar investigated in this study did not show any potential to increase biogas CH4 content.
Non-structural carbohydrate dynamics of Pinus yunnanensis seedlings under drought stress and re-watering
Authors: Xiao Jiandong , Zhao Zhijuan , Deng Xin , Hu Haocheng , Liu Yuanxi , Sun Jianli , Fu Xiaoyong , Wu Junwen
Published: March 2024

Non-structural carbohydrates (NSC) are an important “buffer” for maintaining plant physiological functions under drought conditions; however, our understanding of the dynamics of NSC at the organ level during sustained drought of varying intensities and re-watering remains poor. In this study, two-year-old Pinus yunnanensis seedlings were subjected to drought and re-watering trials. Plants were subjected to three drought intensities (light drought, moderate drought, and severe drought) as well as control conditions (suitable moisture) for 51 days, including 30 days of drought followed by 21 days of re-watering for drought-treated seedlings, to study the dynamics of NSC in the leaves, stems, coarse roots, and fine roots. Changes in the distribution of NSC concentrations in the organ of P. yunnanensis seedlings under drought stress varied; in the early drought stages, the drought resistance of P. yunnanensis seedlings was enhanced by increasing soluble sugar concentrations; in later stages of drought, the stored starch in organs, stems, and coarse roots was consumed. Drought inhibited the growth of P. yunnanensis seedlings, but the maximum limit of drought tolerance was not reached under the different drought treatments after 30 days. P. yunnanensis seedlings in all treatment groups resumed growth after re-watering, and the growth of seedlings was actually promoted during re-watering in the moderate drought treatment group, indicating that drought induced the compensatory growth of seedlings. The growth of P. yunnanensis seedlings during re-watering was inhibited in the severe drought treatment group, and NSC continued to be regulated in seedlings in this group. Given that P. yunnanensis seedlings maintain growth through the consumption of coarse root starch in the late stages of drought, seedlings with a larger root-to-shoot ratio should be selected for cultivation in actual production. Based on our findings, exposure to moderate drought stress can enhance the drought tolerance of P. yunnanensis seedlings and promote the compensatory growth of seedlings.
Indigenous engagement challenges and carbon mitigation activities in Malaysian forest policy
Authors: Guglyuvatyy Evgeny
Published: March 2024

Malaysia’s commitment to achieving net-zero emissions by 2050 hinges on its ability to protect its abundant carbon sinks, notably its natural forests. However, several challenges impede effective forest protection, including the undervaluation of forested land, the absence of regulatory safeguards against land use changes, and the insufficient protection of land rights of indigenous communities. This paper examines these challenges and their implications for Malaysia’s net-zero emissions goal. It argues that remedial action is necessary, including the development of carbon credit mechanisms that recognize indigenous communities as integral stakeholders and the implementation of regulatory reforms to address the undervaluation of forested land and to strengthen the protection of land rights of indigenous communities.
“…He’s not beating me”—Socio-cultural construction of intimate partner violence and traditional birth attendants: implications for maternal & child health in rural communities in Hohoe, Ghana
Authors: Okoror Titilayo A. , Nyamuame Bless M. , Martin-Ikpe Cordelia , Gilani Yasmeen , Nyamuame Samuel Elikem
Published: March 2024

Introduction

Most research on Intimate Partner Violence (IPV) focuses on the physical, sexual and psychological abuse, with less focus on the financial abuse. This study explores nursing mothers' experiences and perceptions of financial and material support from their significant others and traditional birth attendants' (TBA) observations of support to nursing mothers in their communities.

Methods

Using purposive sampling, focus groups and interviews were conducted primarily in Ewe language among nursing mothers and TBAs in rural communities in Hohoe, Volta region, Ghana. All discussions were audio-recorded and transcribed for analysis. Thematic analysis guided by the social constructivist framework was used in data analysis.

Results

Twenty-seven women participated in the study, ranging in ages from 19 to 82 (20 nursing mothers; 7 TBAs). Most participants were married (19) and about 65% reported working outside the home (10 nursing mothers; 7 TBAs). Two themes emerged from the data analysis: Lack of support from partners for housekeeping chores and finances; and TBAs as mediators. Nursing mothers who reported lack of financial support did not perceive it as abuse, rather as hinderance to their efforts to care for their children. TBAs act as mediators interceding on behalf of nursing mothers with their husbands and fathers of their children, while also seeking resources to support them.

Discussion

Understanding the perceptions and socio-cultural meanings women attached to IPV experience is essential for effective intervention to reduce IPV. In addition, TBAs can be a resource in intervening to alleviate IPV in their communities, thereby improving maternal and child health.
Optimizing PEEK implant surfaces for improved stability and biocompatibility through sandblasting and the platinum coating approach
Authors: Faadhila Afrah , Taufiqurrakhman Mohamad , Katili Puspita Anggraini , Rahman Siti Fauziyah , Lestari Delly Chipta , Whulanza Yudan
Published: March 2024

Polyether–ether–ketone (PEEK) is a commonly employed biomaterial for spinal, cranial, and dental implant applications due to its mechanical properties, bio-stability, and radiolucency, especially when compared to metal alloys. However, its biologically inert behavior poses a substantial challenge in osseointegration between host bone and PEEK implants, resulting in implant loosening. Previous studies identified PEEK surface modification methods that prove beneficial in enhancing implant stability and supporting cell growth, but simultaneously, those modifications have the potential to promote bacterial attachment. In this study, sandblasting and sputter coating are performed to address the aforementioned issues as preclinical work. The aim is to investigate the effects of surface roughness through alumina sandblasting and a platinum (Pt) sputtered coating on the surface friction, cell viability, and bacterial adhesion rates of PEEK material. This study reveals that a higher average surface roughness of the PEEK sample (the highest was 1.2 μm obtained after sandblasting) increases the coefficient of friction, which was 0.25 compared to the untreated PEEK of 0.14, indicating better stability performance but also increased bacterial adhesion. A novelty of this study is that the method of Pt coating after alumina sandblasting is seen to significantly reduce the bacterial adhesion by 67% when compared to the sandblasted PEEK sample after 24 h immersion, implying better biocompatibility without changing the cell viability performance.
Artificial intelligence and skin cancer
Authors: Wei Maria L. , Tada Mikio , So Alexandra , Torres Rodrigo
Published: March 2024

Artificial intelligence is poised to rapidly reshape many fields, including that of skin cancer screening and diagnosis, both as a disruptive and assistive technology. Together with the collection and availability of large medical data sets, artificial intelligence will become a powerful tool that can be leveraged by physicians in their diagnoses and treatment plans for patients. This comprehensive review focuses on current progress toward AI applications for patients, primary care providers, dermatologists, and dermatopathologists, explores the diverse applications of image and molecular processing for skin cancer, and highlights AI’s potential for patient self-screening and improving diagnostic accuracy for non-dermatologists. We additionally delve into the challenges and barriers to clinical implementation, paths forward for implementation and areas of active research.
Case report: A rare case of bilateral Leber’s idiopathic stellate neuroretinitis
Authors: He Wei , Tang Panli , Lv Hongbin , Qiao Lifeng
Published: March 2024

Background

Leber’s idiopathic stellate neuroretinitis (LISN) is a rare disease characterized by disk edema, peripapillary and macular hard exudates, and often, the presence of vitreous cells. To enhance clinical understanding of the disease, a retrospective analysis was conducted on a patient diagnosed with LISN at our hospital, and discussions were held regarding its diagnosis and treatment.

Methods

We reviewed the medical records of a 26-year-old male patient whose main complaint was a decrease in visual acuity of both eyes for 4 days, which had worsened over the last day. After systemic examination, fundus fluorescein angiography, and indocyanine green angiography, the patient was diagnosed with LISN in both eyes. After treatment with glucocorticoids, the patient’s vision showed a significant improvement.

Results

Upon admission, the visual acuity of both eyes was: VOD 0.05, VOS 0.25. After 5 days of treatment, the visual acuity of both eyes was: VOD 0.25, VOS 0.4. After 1 month of follow-up, the visual acuity of both eyes was: VOD 0.4, VOS 0.6. After 5 months of follow-up, the patient’s vision improved to VOD 0.6, VOS 0.8.

Conclusion

The cause of LISN remains unidentified. It is essential to rule out diseases exhibiting similar clinical signs but possessing a clear etiology. The primary treatment approach involves glucocorticoid-based anti-inflammatory therapy, potentially supplemented with antibiotics, antivirals, vasodilators, and traditional Chinese medicine. This disease is usually self-limiting and generally carries a favorable prognosis.
Global research trends and hotspots in patellofemoral pain syndrome from 2000 to 2023: a bibliometric and visualization study
Authors: Xu Jie , Cai Zijuan , Chen Meng , Wang Xin , Luo Xiaobing , Wang Yanjie
Published: March 2024

Background

Patellofemoral pain syndrome (PFPS) is a prevalent condition in sports medicine, and as sports competitions become more popular, the incidence of sports injuries is on the rise. Despite the increasing research on PFPS, there remains a lack of bibliometric analyses on this topic. The aim of this study was to identify the research hotspots and trends in the field of PFPS by reviewing 23 years of literature in this field.

Methods

By analyzing the literature on PFPS research from 2000 to 2023 in the core dataset of the Web of Science database and utilizing bibliometric tools like CiteSpace 6.1, VOSviewer 1.6.18, R-bibliometrix 4.6.1, Pajek 5.16, and Scimago Graphica 1.0.26, our aim was to gain insights into the current status and key areas of PFPS research. The study examined various aspects including the number of publications, countries, institutions, journals, authors, collaborative networks, keywords, and more. Through the visualization of relevant data, we also attempted to forecast future trends in the field.

Results

There were 2,444 publications were included in this visualization study, published in 322 journals by 1,247 authors from 818 institutions in 67 countries. The Journal of Orthopaedic and Sports Physical Therapy had the highest number of publications, with the USA leading in article count. La Trobe University contributed the most articles, while Rathleff MS and Barton CJ emerged as the most prolific authors. Hip and knee strength and core strength, lower extremity kinematics and biomechanics, females (runners), muscle activation, risk factors, gait retraining, clinical practice guidelines, and rehabilitation were research hotspot keywords.

Conclusion

Current research suggests that there is still significant potential for the development of PFPS research. Key areas of focus include the clinical effectiveness of combined hip and knee strengthening to address PFPS, characterization of lower limb kinematics and biomechanics, gait retraining, risk factors, and clinical practice guidelines. Future research could explore the effectiveness of innovative exercise therapies such as blood flow restricting training, gait retraining, and neuromuscular control training for PFPS improvement. Further investigation into gait retraining for runners, particularly females, and clinical efficacy study of a novel PRP formulation for the treatment of PFPS.
Different fat-to-fiber ratios by changing wheat inclusion level impact energy metabolism and microbial structure of broilers
Authors: Jiang Qiuyu , Zhao Lihua , Ban Zhibin , Zhang Bingkun
Published: March 2024

Introduction

Dietary nutrient content is crucial for energy metabolism and development of gut microbiota. Herein, this study aimed to explore the effects of fat-to-fiber ratios on nutrient transporter, energy metabolism and gut microbiota when ingredients composition was altered.

Methods

A total of 240 as-hatched broiler chickens were randomly assigned into three groups including low fat-high dietary fiber (LF-HD), medium fat-medium dietary fiber (MF-MD) and high fat-low dietary fiber (HF-LD), with diets being iso-protein, and broilers were offered the same commercial diets from 21 to 42 d. The data were analyzed using one-way ANOVA of SPSS.

Results and Discussion

Results showed that HF-LD diet significantly increased glucose content and decreased triglyceride in serum of broilers (p < 0.05). The mRNA abundance of jejunal gene involved in glucose transporter and tricarboxylic acid (TCA) cycle was significantly increased in broilers fed with HF-LD diets. Compared with LF-HD, HF-LD had a lower abundance of Anaerofilum and CHKCI001, and an increased proportion of beneficial bacteria such as Alistipes, Catenibacillus, Intestinimonas, Lactobacillus, and Peptococcus (p < 0.05). Functional prediction of these microbial changes indicated that HF-LD diet drove caecal microbiota to participate in carbohydrate metabolism and TCA cycle (p < 0.05). Dietary HF-LD-induced microbiota changes were positively correlated with growth performance of broilers (p < 0.05). Therefore, HF-LD diet increased glucose transporters and energy metabolism in intestine and shaped microbial structure and metabolic pathways, which may benefit the growth performance of broilers.
It’s time to shed some light on the importance of fungi in neonatal intensive care units: what do we know about the neonatal mycobiome?
Authors: Wojciechowska Dobrochna , Salamon Sylwia , Wróblewska-Seniuk Katarzyna
Published: March 2024

The 21st century, thanks to the development of molecular methods, including DNA barcoding, using Sanger sequencing, and DNA metabarcoding, based on next-generation sequencing (NGS), is characterized by flourishing research on the human microbiome. Microbial dysbiosis is perceived as a new pathogenetic factor for neonatal diseases. Fungi are crucial, but neglected, components of the neonatal microbiome, which, despite their low abundance, significantly impact morbidity and mortality rates of premature infants hospitalized in Neonatal Intensive Care Units (NICUs). The neonatal mycobiome’s composition and effect on health remain poorly studied research areas. Our knowledge about neonatal mycobiome, composed of limited genera, is mainly based on research on the bacterial microbiome. We presume it is influenced by clinical factors, including prematurity, antibiotic therapy, and type of delivery. Understanding these risk factors may be useful in prevention strategies against dysbiosis and invasive fungal infections. Despite the methodological challenges resulting from the biology of the fungal cell, this topic is an attractive area of research that may contribute to more effective treatment, especially of newborns from risk groups. In this mini review, we discuss the current state of knowledge, research gaps, study difficulties, and future research directions on the neonatal mycobiome, concerning potential future clinical applications.
Deep learning-based identification of esophageal cancer subtypes through analysis of high-resolution histopathology images
Authors: Aalam Syed Wajid , Ahanger Abdul Basit , Masoodi Tariq A. , Bhat Ajaz A. , Akil Ammira S. Al-Shabeeb , Khan Meraj Alam , Assad Assif , Macha Muzafar A. , Bhat Muzafar Rasool
Published: March 2024

Esophageal cancer (EC) remains a significant health challenge globally, with increasing incidence and high mortality rates. Despite advances in treatment, there remains a need for improved diagnostic methods and understanding of disease progression. This study addresses the significant challenges in the automatic classification of EC, particularly in distinguishing its primary subtypes: adenocarcinoma and squamous cell carcinoma, using histopathology images. Traditional histopathological diagnosis, while being the gold standard, is subject to subjectivity and human error and imposes a substantial burden on pathologists. This study proposes a binary class classification system for detecting EC subtypes in response to these challenges. The system leverages deep learning techniques and tissue-level labels for enhanced accuracy. We utilized 59 high-resolution histopathological images from The Cancer Genome Atlas (TCGA) Esophageal Carcinoma dataset (TCGA-ESCA). These images were preprocessed, segmented into patches, and analyzed using a pre-trained ResNet101 model for feature extraction. For classification, we employed five machine learning classifiers: Support Vector Classifier (SVC), Logistic Regression (LR), Decision Tree (DT), AdaBoost (AD), Random Forest (RF), and a Feed-Forward Neural Network (FFNN). The classifiers were evaluated based on their prediction accuracy on the test dataset, yielding results of 0.88 (SVC and LR), 0.64 (DT and AD), 0.82 (RF), and 0.94 (FFNN). Notably, the FFNN classifier achieved the highest Area Under the Curve (AUC) score of 0.92, indicating its superior performance, followed closely by SVC and LR, with a score of 0.87. This suggested approach holds promising potential as a decision-support tool for pathologists, particularly in regions with limited resources and expertise. The timely and precise detection of EC subtypes through this system can substantially enhance the likelihood of successful treatment, ultimately leading to reduced mortality rates in patients with this aggressive cancer.
Exploring an innovative decellularization protocol for porcine nerve grafts: a translational approach to peripheral nerve repair
Authors: Muratori Luisa , Crosio Alessandro , Ronchi Giulia , Molinaro Debora , Tos Pierluigi , Lovati Arianna B. , Raimondo Stefania
Published: March 2024

Introduction

Peripheral nerves are frequently affected by lesions caused by traumatic or iatrogenic damages, resulting in loss of motor and sensory function, crucial in orthopedic outcomes and with a significant impact on patients’ quality of life. Many strategies have been proposed over years to repair nerve injuries with substance loss, to achieve musculoskeletal reinnervation and functional recovery. Allograft have been tested as an alternative to the gold standard, the autograft technique, but nerves from donors frequently cause immunogenic response. For this reason, several studies are focusing to find the best way to decellularize nerves preserving either the extracellular matrix, either the basal lamina, as the key elements used by Schwann cells and axons during the regenerative process.

Methods

This study focuses on a novel decellularization protocol for porcine nerves, aimed at reducing immunogenicity while preserving essential elements like the extracellular matrix and basal lamina, vital for nerve regeneration. To investigate the efficacy of the decellularization protocol to remove immunogenic cellular components of the nerve tissue and to preserve the basal lamina and extracellular matrix, morphological analysis was performed through Masson’s Trichrome staining, immunofluorescence, high resolution light microscopy and transmission electron microscopy. Decellularized porcine nerve graft were then employed in vivo to repair a rat median nerve lesion. Morphological analysis was also used to study the ability of the porcine decellularized graft to support the nerve regeneration.

Results and Discussion

The decellularization method was effective in preparing porcine superficial peroneal nerves for grafting as evidenced by the removal of immunogenic components and preservation of the ECM. Morphological analysis demonstrated that four weeks after injury, regenerating fibers colonized the graft suggesting a promising use to repair severe nerve lesions. The idea of using a porcine nerve graft arises from a translational perspective. This approach offers a promising direction in the orthopedic field for nerve repair, especially in severe cases where conventional methods are limited.
Prediction of tissue outcome in acute ischemic stroke based on single-phase CT angiography at admission
Authors: Palsson Frosti , Forkert Nils D. , Meyer Lukas , Broocks Gabriel , Flottmann Fabian , Maros Máté E. , Bechstein Matthias , Winkelmeier Laurens , Schlemm Eckhard , Fiehler Jens , Gellißen Susanne , Kniep Helge C.
Published: March 2024

Introduction

In acute ischemic stroke, prediction of the tissue outcome after reperfusion can be used to identify patients that might benefit from mechanical thrombectomy (MT). The aim of this work was to develop a deep learning model that can predict the follow-up infarct location and extent exclusively based on acute single-phase computed tomography angiography (CTA) datasets. In comparison to CT perfusion (CTP), CTA imaging is more widely available, less prone to artifacts, and the established standard of care in acute stroke imaging protocols. Furthermore, recent RCTs have shown that also patients with large established infarctions benefit from MT, which might not have been selected for MT based on CTP core/penumbra mismatch analysis.

Methods

All patients with acute large vessel occlusion of the anterior circulation treated at our institution between 12/2015 and 12/2020 were screened (N = 404) and 238 patients undergoing MT with successful reperfusion were included for final analysis. Ground truth infarct lesions were segmented on 24 h follow-up CT scans. Pre-processed CTA images were used as input for a U-Net-based convolutional neural network trained for lesion prediction, enhanced with a spatial and channel-wise squeeze-and-excitation block. Post-processing was applied to remove small predicted lesion components. The model was evaluated using a 5-fold cross-validation and a separate test set with Dice similarity coefficient (DSC) as the primary metric and average volume error as the secondary metric.

Results

The mean ± standard deviation test set DSC over all folds after post-processing was 0.35 ± 0.2 and the mean test set average volume error was 11.5 mL. The performance was relatively uniform across models with the best model according to the DSC achieved a score of 0.37 ± 0.2 after post-processing and the best model in terms of average volume error yielded 3.9 mL.

Conclusion

24 h follow-up infarct prediction using acute CTA imaging exclusively is feasible with DSC measures comparable to results of CTP-based algorithms reported in other studies. The proposed method might pave the way to a wider acceptance, feasibility, and applicability of follow-up infarct prediction based on artificial intelligence.
Guideline for standardized approach in the treatment of the Mal de Debarquement syndrome
Authors: Schoenmaekers Catho , Jillings Steven , De Laet Chloë , Zarowski Andrzej , Wuyts Floris L.
Published: March 2024

Introduction

Mal de Debarquement Syndrome (MdDS) is a debilitating neuro-otological disorder. Patients experience almost continuously a perception of self-motion. This syndrome can be motion-triggered (MT-MdDS), such as on a boat, or occur spontaneously or have other triggers (SO-MdDS) in the absence of such motion. Because the pathophysiological mechanism is unknown, treatment options and symptom management strategies are limited. One available treatment protocol involves a readaptation of the vestibular ocular reflex (VOR). This study assesses the effectiveness of vestibulo-ocular reflex (VOR) readaptation in 131 consecutive patients with a fixed protocol.

Methods

We administered 131 treatments involving optokinetic stimulation (OKS) paired with a fixed head roll at 0.167 Hz over two to five consecutive days. Each day, four-minute treatment blocks were scheduled twice in the morning and afternoon. Treatment effectiveness was evaluated through questionnaires and posturography.

Results

We observed significant improvements in the visual analog scale (VAS), MdDS symptom questionnaire, and posturography measures from pre- to post-treatment. No significant differences were found in outcome variables between MT- and SO-MdDS onsets.

Conclusion

Symptoms improved subjectively and objectively in patients’ post-treatment. The overall success rate was 64.1%, with no significant difference between MT (64.2%) and SO (63.3%). This study supports the conclusion that VOR readaptation treatment provides relief for two-thirds of MdDS patients, irrespective of the onset type. Based on consistency in the findings, we propose a standardized method for treatment of MdDS based on the OKS with head roll paradigm.
Construction and application of a time-saving mode in China for the treatment of acute ischemic stroke
Authors: Yan Yazhou , Du Li , Shangguan Xiu , Li Lujun , Chi Yuxiang , Wang Yu , Cheng Shuai , Huang Qinghai , Pan Yuan , Xin Tao
Published: March 2024

Objective

To explore the construction and application in the practice of green channel in No. 971 Naval Hospital of PLA (No. 971 Hospital mode) for the treatment of acute ischemic stroke (AIS).

Methods

This retrospective study involved a cohort of 694 suspected stroke patients from December 2022 to November 2023 undergoing emergency treatment for stroke at our institution. Among them, 483 patients were treated with standard green channel (the control group), and 211 patients adopted the No. 971 Hospital mode for treatment (the study group). The biggest difference between the two groups was that the treatment process started before admission. We compared the effectiveness of the emergency treatment between the two groups and the thrombolysis treatment.

Results

Compared with control group, the accuracy rate of determining stroke and the rate of thrombolysis were significantly higher (p = 0.002, 0.039) and the door to doctor arrival time (DAT) and the door to CT scan time (DCT) of the study group was significantly shorter (all p < 0.001). There were 49 patients (10.1%) and 33 patients (15.6%) from the control group and study group receiving thrombolysis, respectively. The DAT, DCT, imaging to needle time (INT), and door to needle time (DNT) of patients receiving thrombolysis in the study group were significantly shorter than that in the control group (all p < 0.01). The NIHSS in the study group after the thrombolysis was lower than that in the control group (p = 0.042).

Conclusion

No. 971 Hospital model can effectively shorten DAT, DCT, INT, and DNT, and improve the effectiveness of thrombolysis and prognoses of AIS patients.
The effect of conjugated linoleic acid supplementation in comparison with omega-6 and omega-9 on lipid profile: a graded, dose–response systematic review and meta-analysis of randomized controlled trials
Authors: Akhgarjand Camellia , Tavakoli Aryan , Samavat Simin , Bagheri Amir , Anoushirvani Aliarash , Mirzababaei Atieh , Amini Mohammad Reza , Ghorbi Mahmoud Dehghani , Valisoltani Neda , Mansour Asieh , Sajjadi-Jazi Sayed Mahmoud , Ansar Hastimansooreh , Rezvani Hamid
Published: March 2024

Conjugated linoleic acid (CLA) is a geometrical isomer of linoleic acid, which has anti-inflammatory, anti-diabetic, anti-cancer, and anti-obesity properties. However, the studies reported inconstant results about the CLA-related effects on lipid profiles. As a result, meta-analysis and systematic review were performed to survey the CLA supplementation-related effect on lipid profile including high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG). To identify the relevant research, a systematic comprehensive search was initiated on the medical databases such as Scopus and PubMed/Medline until December 2022. The overall effect size was estimated by weighted mean difference (WMD) and 95% confidence interval (CI) in a random effect meta-analysis. In the final quantitative analysis, the meta-analysis considered 35 randomized controlled trials (RCTs) with 1,476 participants (707 controls and 769 cases). The pooled results demonstrated that CLA supplementation, compared with olive oil, significantly increased serum TG levels (WMD: 0.05 mmol/L; 95% CI: 0.01 to 0.1; p = 0.04; I2 = 0.0%, p = 0.91). With regard to TC level, CLA supplementation compared with placebo significantly reduced TC concentrations (WMD: −0.08 mmol/L; 95% CI: −0.14 to −0.02; p < 0.001; I2 = 82.4%). Moreover, the non-linear dose–response analysis indicated a decreasing trend of TC serum level from the 15th week of CLA supplementation compared with olive oil (Pnon-linearity = 0.01). The present meta-analysis and systematic review of 35 RCTs showed that the CLA intervention was able to raise the level of TG in comparison to olive oil; however, it can decrease TC level compared with placebo and olive oil.
Association between amino acids and recent osteoporotic fracture: a matched incident case-control study
Authors: Liang Bing , Shi Xinyan , Wang Xinwei , Ma Chao , Leslie William D. , Lix Lisa M. , Shi Xianbao , Kan Bo , Yang Shuman
Published: March 2024

Context

Osteoporotic fracture is a major public health issue globally. Human research on the association between amino acids (AAs) and fracture is still lacking.

Objective

To examine the association between AAs and recent osteoporotic fractures.

Methods

This age and sex matched incident case-control study identified 44 recent x-ray confirmed fracture cases in the Second Hospital of Jilin University and 88 community-based healthy controls aged 50+ years. Plasma AAs were measured by high performance liquid chromatography coupled with mass spectrometry. After adjusting for covariates (i.e., body mass index, milk intake >1 time/week, falls and physical activity), we conducted conditional logistical regression models to test the association between AAs and fracture.

Results

Among cases there were 23 (52.3%) hip fractures and 21 (47.7%) non-hip fractures. Total, essential, and non-essential AAs were significantly lower in cases than in controls. In the multivariable conditional logistic regression models, after adjusting for covariates, each standard deviation increase in the total (odds ratio [OR]: 0.304; 95% confidence interval [CI]: 0.117–0.794), essential (OR: 0.408; 95% CI: 0.181–0.923) and non-essential AAs (OR: 0.290; 95%CI: 0.107–0.782) was negatively associated with recent fracture. These inverse associations were mainly found for hip fracture, rather than non-hip fractures. Among these AAs, lysine, alanine, arginine, glutamine, histidine and piperamide showed the significantly negative associations with fracture.

Conclusion

There was a negative relationship between AAs and recent osteoporotic fracture; such relationship appeared to be more obvious for hip fracture.
Case report: Incidental MALT lymphoma of the left adrenal gland mimicking a metastatic spread within durvalumab maintenance treatment in inoperable stage III non-small cell lung cancer
Authors: Käsmann Lukas , Degerli Esra , El-Marouk Karim , Manapov Farkhad
Published: March 2024

Durvalumab after chemotherapy in non-operable stage III non-small cell lung cancer (NSCLC) is the standard of care worldwide. We present a patient with the incidental discovery of a unilateral MALT lymphoma of the adrenal gland and adrenalitis during durvalumab maintenance treatment detected by 18F-FDG-PET/CT. We assessed the clinical and histopathological findings, radiological examinations and overall treatment. Our work emphasizes the significance of considering other differential diagnoses and the importance of multidisciplinary treatment of the findings, especially within clinical trials.
Plasma metabolomics reveals risk factors for lung adenocarcinoma
Authors: Yu Mengjie , Wen Wei , Wang Yue , Shan Xia , Yi Xin , Zhu Wei , Aa Jiye , Wang Guangji
Published: March 2024

Background

Metabolic reprogramming plays a significant role in the advancement of lung adenocarcinoma (LUAD), yet the precise metabolic changes remain incompletely understood. This study aims to uncover metabolic indicators associated with the progression of LUAD.

Methods

A total of 1083 subjects were recruited, including 670 LUAD, 135 benign lung nodules (BLN) and 278 healthy controls (HC). Gas chromatography-mass spectrometry (GC/MS) was used to identify and quantify plasma metabolites. Odds ratios (ORs) were calculated to determine LUAD risk factors, and machine learning algorithms were utilized to differentiate LUAD from BLN.

Results

High levels of oxalate, glycolate, glycine, glyceric acid, aminomalonic acid, and creatinine were identified as risk factors for LUAD (adjusted ORs>1.2, P<0.03). Remarkably, oxalate emerged as a distinctive metabolic risk factor exhibiting a strong correlation with the progression of LUAD (adjusted OR=5.107, P<0.001; advanced-stage vs. early-stage). The Random Forest (RF) model demonstrated a high degree of efficacy in distinguishing between LUAD and BLN (accuracy = 1.00 and 0.73, F1-score= 1.00 and 0.79, and AUC = 1.00 and 0.76 in the training and validation sets, respectively). TCGA and GTEx gene expression data have shown that lactate dehydrogenase A (LDHA), a crucial enzyme involved in oxalate metabolism, is increasingly expressed in the progression of LUAD. High LDHA expression levels in LUAD patients are also linked to poor prognoses (HR=1.66, 95% CI=1.34-2.07, P<0.001).

Conclusions

This study reveals risk factors associated with LUAD.
Molecular aspects of cervical cancer: a pathogenesis update
Authors: Vallejo-Ruiz Verónica , Gutiérrez-Xicotencatl Lourdes , Medina-Contreras Oscar , Lizano Marcela
Published: March 2024

Cervical cancer (CC) is a significant health problem, especially in low-income countries. Functional studies on the human papillomavirus have generated essential advances in the knowledge of CC. However, many unanswered questions remain. This mini-review discusses the latest results on CC pathogenesis, HPV oncogenesis, and molecular changes identified through next-generation technologies. Interestingly, the percentage of samples with HPV genome integrations correlates with the degree of the cervical lesions, suggesting a role in the development of CC. Also, new functions have been described for the viral oncoproteins E5, E6, and E7, resulting in the acquisition and maintenance of cancer hallmarks, including proliferation, immune response evasion, apoptosis, and genomic instability. Remarkably, E5 oncoprotein affects signaling pathways involved in the expression of interferon-induced genes and EGFR-induced proliferation, while E6 and E7 oncoproteins regulate the DNA damage repair and cell cycle continuity pathways. Furthermore, next-generation technologies provide vast amounts of information, increasing our knowledge of changes in the genome, transcriptome, proteome, metabolome, and epigenome in CC. These studies have identified novel molecular traits associated with disease susceptibility, degree of progression, treatment response, and survival as potential biomarkers and therapeutic targets.
Anti-angiogenic therapy or immunotherapy? A real-world study of patients with advanced non-small cell lung cancer with EGFR/HER2 exon 20 insertion mutations
Authors: Li Jiaqi , Xie Mengqing , Zhao Ruiying , Qiang Huiping , Chang Qing , Qian Jialin , Lu Haijiao , Shen Yinchen , Han Yuchen , Su Chunxia , Chu Tianqing
Published: March 2024

Background

For patients with EGFR/HER2 exon20 insertions, platinum-containing double-drug chemotherapy is still the standard treatment method. First-generation TKIs have almost no therapeutic activity against EGFR exon 20 insertions. The efficacy of second-and third-generation TKIs is still controversial. Immunotherapy research is scarce, and there is an urgent need for more evidence and new treatment options for this group of patients.

Methods

We reviewed patients with advanced NSCLC with EGFR/HER2 exon 20 insertion mutations treated in Shanghai Chest Hospital and Shanghai Pulmonary Hospital from 2015 to 2022 and assessed the efficacy of receiving chemotherapy, anti-angiogenic therapy and immunotherapy, including objective response rate (ORR) and disease control rate (DCR), and compared progression-free survival (PFS) and overall survival (OS).

Results

Of the 126 patients included in the study, 51 patients had EGFR20ins mutations and 7 5 patients had HER2-20ins mutations. In the first-line treatment, bevacizumab + chemotherapy (Beva+Chemo), ICI+chemotherapy (ICI+Chemo), compared with chemotherapy alone (Chemo), ORR: 40% vs 33.3% vs 15% (p=0.0168); DCR: 84% vs 80.9% vs 67.5% (p=0.1817); median PFS: 8.3 vs 7.0 vs 4.6 months (p=0.0032), ICI+Chemo has a trend of benefiting on OS. Stratified analysis showed that compared with chemotherapy, ICI+Chemo was more effective for EGFR20ins mutation with median PFS: 10.3 vs. 6.3m (P=0.013); Beva+Chemo was more effective for HER2-20ins mutation, with a median PFS: 6.6 vs. 4.3m (p=0.030). In the second-line treatment of EGFR20ins mutation, bevacizumab + chemotherapy has a significant advantage in PFS compared with targeted therapy, median PFS:10.8 vs 4.0 months (P=0.016).

Conclusion

For patients with EGFR20ins mutation, compared to chemotherapy, ICI+Chemo prolongs PFS, and after chemotherapy progression, bevacizumab combined with chemotherapy seems better than Furmonertinib-based targeted therapy on PFS. For HER2-20ins mutation, Beva+Chemo may be a better choice.
Clinical and radiomics integrated nomogram for preoperative prediction of tumor-infiltrating lymphocytes in patients with triple-negative breast cancer
Authors: Hu Ling , Jin Peile , Xu Wen , Wang Chao , Huang Pintong
Published: March 2024

Objectives

The present study aimed to develop a radiomics nomogram based on conventional ultrasound (CUS) to preoperatively distinguish high tumor-infiltrating lymphocytes (TILs) and low TILs in triple-negative breast cancer (TNBC) patients.

Methods

In the present study, 145 TNBC patients were retrospectively included. Pathological evaluation of TILs in the hematoxylin and eosin sections was set as the gold standard. The patients were randomly allocated into training dataset and validation dataset with a ratio of 7:3. Clinical features (age and CUS features) and radiomics features were collected. Then, the Rad-score model was constructed after the radiomics feature selection. The clinical features model and clinical features plus Rad-score (Clin+RS) model were built using logistic regression analysis. Furthermore, the performance of the models was evaluated by analyzing the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results

Univariate analysis and LASSO regression were employed to identify a subset of 25 radiomics features from a pool of 837 radiomics features, followed by the calculation of Rad-score. The Clin+RS integrated model, which combined posterior echo and Rad-score, demonstrated better predictive performance compared to both the Rad-score model and clinical model, achieving AUC values of 0.848 in the training dataset and 0.847 in the validation dataset.

Conclusion

The Clin+RS integrated model, incorporating posterior echo and Rad-score, demonstrated an acceptable preoperative evaluation of the TIL level. The Clin+RS integrated nomogram holds tremendous potential for preoperative individualized prediction of the TIL level in TNBC.
Eosinophilic esophagitis improved by the discontinuation of sublingual immunotherapy for aeroallergens: a case report
Authors: Monzani Alice , Cerutti Marta , Curto Sara , Lovaste Sara , Coppola Marta , Mercalli Francesca , Saettone Silvia , Rabbone Ivana
Published: March 2024

Introduction

Eosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammation of the esophagus, characterized by symptoms related to esophageal dysfunction, resulting from severe eosinophilic infiltration of the esophageal mucosa. It is common in atopic subjects and food antigens have been identified as the most common triggers. However, a seasonal variation in EoE prevalence, correlated with air pollen levels, is reported, suggesting that also aeroallergens may play a role. Little is known about the interplay between EoE and concomitant atopy treatment for aeroallergens.

Case presentation

We describe the case of an 11-year-old boy who presented dysphagia, vomiting, drooling, and chest pain while eating meat, developed 15 months after receiving sublingual immunotherapy (SLIT) for Alternaria (SUBLIVAC®). He underwent esophagogastroduodenoscopy (EGD) revealing severe eosinophilic predominant inflammation (100 eos/HPF), consistent with the diagnosis of EoE, not improving at the EGDs performed after both omeprazole and topical corticosteroids treatment, despite symptom improvement. Afterward, immunotherapy was switched from sublingual to injective form. At the EGD performed 1 month later, macroscopic examination of the esophageal mucosa was normal and eosinophilic infiltration was significantly decreased (5–10 eos/HPF).

Conclusions

SLIT may induce EoE by chronic antigenic exposure of oral mucosa in patients with a robust allergic susceptibility: while attenuating the IgE-mediated immune reactions, the progressive contact with the causative allergen might induce a chronic stimulation of the immune system with the consequent activation of tissue eosinophils. Our data suggest monitoring patients receiving SLIT for EoE symptoms and to discontinue SLIT on their earlier appearance, possibly as a first-line treatment.
Emerging insights into the impacts of heavy metals exposure on health, reproductive and productive performance of livestock
Authors: Afzal Ali , Mahreen Naima
Published: March 2024

Heavy metals, common environmental pollutants with widespread distribution hazards and several health problems linked to them are distinguished from other toxic compounds by their bioaccumulation in living organisms. They pollute the food chain and threaten the health of animals. Biologically, heavy metals exhibit both beneficial and harmful effects. Certain essential heavy metals such as Co, Mn, Se, Zn, and Mg play crucial roles in vital physiological processes in trace amounts, while others like As, Pb, Hg, Cd, and Cu are widely recognized for their toxic properties. Regardless of their physiological functions, an excess intake of all heavy metals beyond the tolerance limit can lead to toxicity. Animals face exposure to heavy metals through contaminated feed and water, primarily as a result of anthropogenic environmental pollution. After ingestion heavy metals persist in the body for an extended duration and the nature of exposure dictates whether they induce acute or chronic, clinical or subclinical, or subtle toxicities. The toxic effects of metals lead to disruption of cellular homeostasis through the generation of free radicals that develop oxidative stress. In cases of acute heavy metal poisoning, characteristic clinical symptoms may arise, potentially culminating in the death of animals with corresponding necropsy findings. Chronic toxicities manifest as a decline in overall body condition scoring and a decrease in the production potential of animals. Elevated heavy metal levels in consumable animal products raise public health concerns. Timely diagnosis, targeted antidotes, and management strategies can significantly mitigate heavy metal impact on livestock health, productivity, and reproductive performance.