bluuebunny/crossref_metadata_2025 huggingface dataset:
Human-centered design and evaluation of AI-empowered clinical decision support systems: a systematic review
Authors: Wang Liuping , Zhang Zhan , Wang Dakuo , Cao Weidan , Zhou Xiaomu , Zhang Ping , Liu Jianxing , Fan Xiangmin , Tian Feng
Published: June 2023

Introduction

Artificial intelligence (AI) technologies are increasingly applied to empower clinical decision support systems (CDSS), providing patient-specific recommendations to improve clinical work. Equally important to technical advancement is human, social, and contextual factors that impact the successful implementation and user adoption of AI-empowered CDSS (AI-CDSS). With the growing interest in human-centered design and evaluation of such tools, it is critical to synthesize the knowledge and experiences reported in prior work and shed light on future work.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review to gain an in-depth understanding of how AI-empowered CDSS was used, designed, and evaluated, and how clinician users perceived such systems. We performed literature search in five databases for articles published between the years 2011 and 2022. A total of 19874 articles were retrieved and screened, with 20 articles included for in-depth analysis.

Results

The reviewed studies assessed different aspects of AI-CDSS, including effectiveness (e.g., improved patient evaluation and work efficiency), user needs (e.g., informational and technological needs), user experience (e.g., satisfaction, trust, usability, workload, and understandability), and other dimensions (e.g., the impact of AI-CDSS on workflow and patient-provider relationship). Despite the promising nature of AI-CDSS, our findings highlighted six major challenges of implementing such systems, including technical limitation, workflow misalignment, attitudinal barriers, informational barriers, usability issues, and environmental barriers. These sociotechnical challenges prevent the effective use of AI-based CDSS interventions in clinical settings.

Discussion

Our study highlights the paucity of studies examining the user needs, perceptions, and experiences of AI-CDSS. Based on the findings, we discuss design implications and future research directions.
Cardiovascular health and potential cardiovascular risk factors in young athletes
Authors: Grabitz Carl , Sprung Katharina M. , Amagliani Laura , Memaran Nima , Schmidt Bernhard M. W. , Tegtbur Uwe , von der Born Jeannine , Kerling Arno , Melk Anette
Published: June 2023

Introduction

Cardiovascular disease remains the most common cause of death worldwide, and early manifestations are increasingly identified in childhood and adolescence. With physical inactivity being the most prevalent modifiable risk factor, the risk for cardiovascular disease is deemed low in people engaging in regular physical exercise. The aim of this study was to investigate early markers and drivers of cardiovascular disease in young athletes pursuing a career in competitive sports.

Methods

One hundred and five athletes (65 males, mean age 15.7 ± 3.7 years) were characterized by measurement of body impedance to estimate body fat, blood pressure (BP), carotid femoral pulse wave velocity (PWV) to evaluate arterial elasticity, ergometry to assess peak power output, echocardiography to calculate left ventricular mass, and blood tests.

Results

Systolic BP was elevated in 12.6% and thereby more than twice as high as expected for the normal population. Similarly, structural vascular and cardiac changes represented by elevated PWV and left ventricular mass were found in 9.5% and 10.3%. Higher PWV was independently associated with higher systolic BP (β = 0.0186, p < 0.0001), which in turn was closely correlated to hemoglobin levels (β = 0.1252, p = 0.0435). In this population, increased left ventricular mass was associated with lower resting heart rate (β = −0.5187, p = 0.0052), higher metabolic equivalent hours (β = 0.1303, p = 0.0002), sport disciplines with high dynamic component (β = 17.45, p = 0.0009), and also higher systolic BP (β = 0.4715, p = 0.0354).

Conclusion

Despite regular physical exercise and in the absence of obesity, we found an unexpected high rate of cardiovascular risk factors. The association of PWV, systolic BP, and hemoglobin suggested a possible link between training-induced raised hemoglobin levels and altered vascular properties. Our results point toward the need for thorough medical examinations in this seemingly healthy cohort of children and young adults. Long-term follow-up of individuals who started excessive physical exercise at a young age seems warranted to further explore the potential adverse effects on vascular health.
Intestinal fatty acid binding protein is associated with cardiac function and gut dysbiosis in chronic heart failure
Authors: Nendl Andraž , Raju Sajan C. , Broch Kaspar , Mayerhofer Cristiane C. K. , Holm Kristian , Halvorsen Bente , Lappegård Knut Tore , Moscavitch Samuel , Hov Johannes Roksund , Seljeflot Ingebjørg , Trøseid Marius , Awoyemi Ayodeji
Published: June 2023

Background

The gut microbiota in patients with chronic heart failure (HF) is characterized by low bacterial diversity and reduced ability to synthesize beneficial metabolites. These changes may facilitate leakage of whole bacteria or bacterial products from the gut into the bloodstream, which may activate the innate immune system and contribute to the low-grade inflammation seen in HF. In this exploratory cross-sectional study, we aimed to investigate relationships between gut microbiota diversity, markers of gut barrier dysfunction, inflammatory markers, and cardiac function in chronic HF patients.

Methods

In total, 151 adult patients with stable HF and left ventricular ejection fraction (LVEF) < 40% were enrolled. We measured lipopolysaccharide (LPS), LPS-binding protein (LBP), intestinal fatty acid binding protein (I-FABP), and soluble cluster of differentiation 14 (sCD14) as markers of gut barrier dysfunction. N-terminal pro-B-type natriuretic peptide (NT-proBNP) level above median was used as a marker of severe HF. LVEF was measured by 2D-echocardiography. Stool samples were sequenced using 16S ribosomal RNA gene amplification. Shannon diversity index was used as a measure of microbiota diversity.

Results

Patients with severe HF (NT-proBNP > 895 pg/ml) had increased I-FABP (p < 0.001) and LBP (p = 0.03) levels. ROC analysis for I-FABP yielded an AUC of 0.70 (95% CI 0.61–0.79, p < 0.001) for predicting severe HF. A multivariate logistic regression model showed increasing I-FABP levels across quartiles of NT-proBNP (OR 2.09, 95% CI 1.28−3.41, p = 0.003). I-FABP was negatively correlated with Shannon diversity index (rho = −0.30, p = <0.001), and the bacterial genera Ruminococcus gauvreauii group, Bifidobacterium, Clostridium sensu stricto, and Parasutterella, which were depleted in patients with severe HF.

Conclusions

In patients with HF, I-FABP, a marker of enterocyte damage, is associated with HF severity and low microbial diversity as part of an altered gut microbiota composition. I-FABP may reflect dysbiosis and may be a marker of gut involvement in patients with HF.
Hypoxia-inducible factor activation promotes osteogenic transition of valve interstitial cells and accelerates aortic valve calcification in a mice model of chronic kidney disease
Authors: Csiki Dávid Máté , Ababneh Haneen , Tóth Andrea , Lente Gréta , Szöőr Árpád , Tóth Anna , Fillér Csaba , Juhász Tamás , Nagy Béla , Balogh Enikő , Jeney Viktória
Published: June 2023

Introduction

Valve calcification (VC) is a widespread complication in chronic kidney disease (CKD) patients. VC is an active process with the involvement of in situ osteogenic transition of valve interstitial cells (VICs). VC is accompanied by the activation of hypoxia inducible factor (HIF) pathway, but the role of HIF activation in the calcification process remains undiscovered.

Methods and result

Using in vitro and in vivo approaches we addressed the role of HIF activation in osteogenic transition of VICs and CKD-associated VC. Elevation of osteogenic (Runx2, Sox9) and HIF activation markers (HIF-1α and HIF-2α) and VC occurred in adenine-induced CKD mice. High phosphate (Pi) induced upregulation of osteogenic (Runx2, alkaline-phosphatase, Sox9, osteocalcin) and hypoxia markers (HIF-1α, HIF-2α, Glut-1), and calcification in VICs. Down-regulation of HIF-1α and HIF-2α inhibited, whereas further activation of HIF pathway by hypoxic exposure (1% O2) or hypoxia mimetics [desferrioxamine, CoCl2, Daprodustat (DPD)] promoted Pi-induced calcification of VICs. Pi augmented the formation of reactive oxygen species (ROS) and decreased viability of VICs, whose effects were further exacerbated by hypoxia. N-acetyl cysteine inhibited Pi-induced ROS production, cell death and calcification under both normoxic and hypoxic conditions. DPD treatment corrected anemia but promoted aortic VC in the CKD mice model.

Discussion

HIF activation plays a fundamental role in Pi-induced osteogenic transition of VICs and CKD-induced VC. The cellular mechanism involves stabilization of HIF-1α and HIF-2α, increased ROS production and cell death. Targeting the HIF pathways may thus be investigated as a therapeutic approach to attenuate aortic VC.
The impact of an interaction-based classroom program on executive function development in low-SES preschoolers: first support for effectiveness
Authors: Kellens Silke , Dieusaert Fren , De Wilde Johan , Spilt Jantine L. , Baeyens Dieter
Published: June 2023

Studies have shown that children from a low socioeconomic status (SES) family are likely to have lower academic scores, indicating an SES-achievement gap. This inequality already starts in preschool and persists throughout children’s lives. Since executive functions (EFs) have been put forward as contributing factors in this SES-achievement gap, it is crucial to target early EF development to remediate the adverse effects of poverty. In this quasi-experimental study, a classroom program delivered by teachers (i.e., “Put your EF glasses on”) was implemented to strengthen preschoolers’ EFs, consistent with the idea that well-developed EFs can foster school readiness and prevent school failure. The program aimed to boost children’s EFs through high-quality teacher-child interactions, EF-supporting activities (e.g., games), and a supportive classroom structure. Teachers (n = 24) and children (n = 224, Mage = 52.61 months) from 8 Belgian schools participated in this quasi-experimental pilot study and were divided into experimental and control groups. Teachers in the experimental group carried out the program (receiving materials and coaching to support implementation), whereas teachers in the control group practiced teaching as usual. Before and after the program, all teachers filled out the BRIEF-P, a questionnaire about daily executive problems in preschool children. We compared the effect of the classroom program in low-SES versus middle-to-high-SES children on EF problem scores. Results revealed that all low-SES children started with significantly higher EF problems (total problem score, working memory, inhibition, and planning and organizing) scores than middle-to-high-SES children. A positive effect of the program was found among low-SES children. More specifically, EF problems (total problem score, working memory, shifting, and planning and organizing) remained stable over time in the low-SES group in the experimental group, but there was no program effect on emotional control and inhibition. In the control group, these EF problems increased for low-SES children, expanding the gap between low and middle-to-high-SES children. There were no program effects for middle-to-high-SES children. These results show that a teacher-mediated classroom program can support EF development, especially in preschoolers at sociodemographic risk.
Application of carbon nanoparticles combined with refined extracapsular anatomy in endoscopic thyroidectomy
Authors: Wang Zheng , Bo Hongguang , Xu Yufa , Bi Zilin , Yin Zhaocai , Yu Changsheng , Luo Enxi , Shi Xiaomeng , Chen Bin , Wang Yabing , Sha Rui
Published: June 2023

Objective

To evaluate the value of refined extracapsular anatomy combined with carbon nanoparticle suspension tracing technology for protecting parathyroid function and the thoroughness of lymph node dissection in the central region during endoscopic thyroid cancer surgery.

Patients and methods

Retrospective clinical data analysis was performed on 108 patients who underwent endoscopic thyroid cancer surgery at the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from November 2019 to November 2022. Before surgery, thyroid function tests, color Doppler ultrasounds and neck-enhanced CT scans were performed on all patients. Cytopathological diagnosis obtained via ultrasound-guided fine-needle aspiration served as confirmation for the primary diagnosis. It was determined whether to perform a total thyroidectomy or a hemithyroidectomy (HT) together with preventive unilateral (ipsilateral) central neck dissection. Follow-up times were 1 to 34 months.

Results

Transient neuromuscular symptoms were present in 3.70% (4/108) cases, with no permanent neuromuscular symptoms or permanent hypoparathyroidism. Regarding transient hypoparathyroidism, the patients recovered after three months and did not need long-term calcium supplementation. The number of harvested LNs (mean± SD) was 5.54 ± 3.84, with ≤5 in 57.41% (62/108) and >5 in 42.59% (46/108) cases. The number of patients with metastatic LNs was 37.96% (41/108), with ≤2 in 65.85% (27/41) and >2 in 34.15% (14/41) cases.

Conclusions

Fine extracapsular anatomy combined with carbon nanoparticle suspension tracing is effective in endoscopic thyroid cancer surgery. It can improve the thoroughness of prophylactic central neck dissection and recognition of the parathyroid gland and avoid parathyroid injury and other complications to effectively protect parathyroid function.
Brain alterations associated with overweight evaluated by body mass index or body fat index in an elderly population: the PROOF study
Authors: Kassir Radwan , Gimet Pierre , Hupin David , Boutet Claire , Barthélémy Jean-Claude , Roche Frédéric , Celle Sébastien
Published: June 2023

Background/objectives

Obesity is a complex health issue in which the brain plays a role yet to be determined, especially in the elderly. Indeed, in the ageing population, the balance between fat and lean mass is different; thus, the co-influence between the brain and obesity may differ between the elderly and younger subjects. Our main goal is thus to explore the relationship between the brain and obesity using two different approaches to measure obesity: body mass index (BMI) and an index centred on fat mass, the body fat index (BFI).

Subjects/methods

Among the 1,011 subjects of the PROOF population, 273 subjects aged 75 years underwent 3D magnetic resonance imaging as well as dual-energy X-ray absorptiometry to assess fat mass. Voxel-based morphometry was used to explore the local differences in brain volume with obesity.

Results

Higher BMI and BFI were associated with higher grey matter (GM) volume in the left cerebellum. Higher BMI and BFI were mainly associated with higher white matter volume in the left and right cerebellum and near the right medial orbital gyrus. Higher BMI was also associated with higher GM volume in the brainstem, whereas higher BFI was associated with higher GM volume in the left middle temporal gyrus. No decrease in white matter was associated with BMI or BFI.

Conclusion

In the elderly, the relationship between the brain and obesity does not depend on the marker of obesity. Supra-tentorial brain structures seem to be slightly associated with obesity, whereas the cerebellum seems to be one of the key structures related to obesity.
Normal glucose tolerant women with low glycemia during the oral glucose tolerance test have a higher risk to deliver a low birth weight infant
Authors: Raets Lore , Van Doninck Lore , Van Crombrugge Paul , Moyson Carolien , Verhaeghe Johan , Vandeginste Sofie , Verlaenen Hilde , Vercammen Chris , Maes Toon , Dufraimont Els , Roggen Nele , De Block Christophe , Jacquemyn Yves , Mekahli Farah , De Clippel Katrien , Van Den Bruel Annick , Loccufier Anne , Laenen Annouschka , Devlieger Roland , Mathieu Chantal , Benhalima Katrien
Published: June 2023

Background

Data are limited on pregnancy outcomes of normal glucose tolerant (NGT) women with a low glycemic value measured during the 75g oral glucose tolerance test (OGTT). Our aim was to evaluate maternal characteristics and pregnancy outcomes of NGT women with low glycemia measured at fasting, 1-hour or 2-hour OGTT.

Methods

The Belgian Diabetes in Pregnancy-N study was a multicentric prospective cohort study with 1841 pregnant women receiving an OGTT to screen for gestational diabetes (GDM). We compared the characteristics and pregnancy outcomes in NGT women according to different groups [(<3.9mmol/L), (3.9-4.2mmol/L), (4.25-4.4mmol/L) and (>4.4mmol/L)] of lowest glycemia measured during the OGTT. Pregnancy outcomes were adjusted for confounding factors such as body mass index (BMI) and gestational weight gain.

Results

Of all NGT women, 10.7% (172) had low glycemia (<3.9 mmol/L) during the OGTT. Women in the lowest glycemic group (<3.9mmol/L) during the OGTT had compared to women in highest glycemic group (>4.4mmol/L, 29.9%, n=482), a better metabolic profile with a lower BMI, less insulin resistance and better beta-cell function. However, women in the lowest glycemic group had more often inadequate gestational weight gain [51.1% (67) vs. 29.5% (123); p<0.001]. Compared to the highest glycemia group, women in the lowest group had more often a birth weight <2.5Kg [adjusted OR 3.41, 95% CI (1.17-9.92); p=0.025].

Conclusion

Women with a glycemic value <3.9 mmol/L during the OGTT have a higher risk for a neonate with birth weight < 2.5Kg, which remained significant after adjustment for BMI and gestational weight gain.
Industrial steam consumption analysis and prediction based on multi-source sensing data for sustainable energy development
Authors: Yang Mingxia , Xu Xiaojie , Cheng Huayan , Zhan Zhidan , Xu Zhongshen , Tong Lianghuai , Fang Kai , Ahmed Ahmedin M.
Published: June 2023

Centralized heating is an energy-saving and environmentally friendly way that is strongly promoted by the state. It can improve energy utilization and reduce carbon emissions. However, Centralized heating depends on accurate heat demand forecasting. On the one hand, it is impossible to save energy if over producing, while on the other hand, it is impossible to meet the heat demand of enterprises if there is not enough capacity. Therefore, it is necessary to forecast the future trend of heat consumption, so as to provide a reliable basis for enterprises to reasonably deploy fuel stocks and boiler power. At the same time, it is also necessary to analyze and monitor the steam consumption of enterprises for abnormalities in order to monitor pipeline leakage and enterprise gas theft. Due to the nonlinear characteristics of heat load, it is difficult for traditional forecasting methods to capture data trend. Therefore, it is necessary to study the characteristics of heat loads and explore suitable heat load prediction models. In this paper, industrial steam consumption of a paper manufacturer is used as an example, and steam consumption data are periodically analyzed to study its time series characteristics; then steam consumption prediction models are established based on ARIMA model and LSTM neural network, respectively. The prediction work was carried out in minutes and hours, respectively. The experimental results show that the LSTM neural network has greater advantages in this steam consumption load prediction and can meet the needs of heat load prediction.
A dynamic framework for assessing and managing risks to ecosystems from fisheries: demonstration for conserving the krill-based food web in Antarctica
Authors: Constable Andrew J. , Kawaguchi So , Sumner Michael , Trathan Philip N. , Warwick-Evans Victoria
Published: June 2023

The ecosystem approach to fisheries has been discussed since the 1980s. It aims to reduce risks from fisheries to whole, or components of, ecosystems, not just to target species. Precautionary approaches further aim to keep the risk of damage to a low level. Here, we provide a dynamic framework for spreading the ecosystems risk of fisheries in space and time, a method that can be used from the outset of developing fisheries and continually updated as new knowledge becomes available. Importantly, this method integrates qualitative and quantitative approaches to assess risk and provides mechanisms to both spread the risk, including enabling closed areas to help offset risk, and adjust catch limits to keep regional risk to a baseline level. Also, the framework does not require uniform data standards across a region but can incorporate spatially and temporally heterogeneous data and knowledge. The approach can be coupled with the conservation of biodiversity in marine protected areas, addressing potential overlap of fisheries with areas of high conservation value. It accounts for spatial and temporal heterogeneity in ecosystems, including the different spatial and temporal scales at which organisms function. We develop the framework in the first section of the paper, including a simple illustration of its application. In the framework we include methods for using closed areas to offset risk or for conserving biodiversity of high conservation value. We also present methods that could be used to account for uncertainties in input data and knowledge. In the second section, we present a real-world illustration of the application of the framework to managing risks of food web effects of fishing for Antarctic krill in the Southern Ocean. Last, we comment on the wider application and development of the framework as information improves.
Coupled biological and hydrological processes shape spatial food-web structures in riverine metacommunities
Authors: Ho Hsi-Cheng , Altermatt Florian , Carraro Luca
Published: June 2023

Introduction

Understanding how species are distributed in space and how they interact with each other is central for scientific and conservation purposes. Species' distributions and interactions result from a complex interplay of local trophic dynamics, dispersal processes, resource availability, and abiotic factors governed by the landscape matrix, which also determines the spatial connectivity for organisms' dispersal and resource fluxes. River networks not only exhibit universal spatial structures, but their dendritic landscape structure is tightly linked to species and metacommunity processes therein.

Methods

Here, using a mechanistic model of spatially connected food webs integrating both essential biological and hydrological aspects, we investigate how food-web properties vary in space, and how these patterns are influenced by key model parameters. We then contrast our predictions with a suite of null models, where different aspects (such as spatial structure or trophic interactions) of the spatial food-web model are alternatively relaxed.

Results

We find that species richness is highest in areas where local nutrient load is maximal (lowland headwaters, according to our default assumption). Overall, species richness is positively associated with link density, modularity and omnivory, and negatively related to connectance, nestedness, and niche overlap. However, for metrics such as connectance and omnivory, stochasticity of trophic interactions is a much stronger predictor than spatial variables such as distance to outlet and drainage area. Remarkably, relationships between species richness and food-web metrics do not generally hold in null models, and are hence the outcome of coupled biological and physical (i.e., hydrological) processes characteristic to river networks.

Discussion

Our model generates realistic patterns of species richness and food-web properties, shows that no universal food-web patterns emerge as a result of the riverine landscape structure, and paves the way for future applications aimed at disentangling metacommunity dynamics in river networks.
ANN-based prediction of ammonia nitrogen for wastewater discharge indicators under carbon neutral trend
Authors: Liu Hongbo , Jian Haoran
Published: June 2023

Introduction

With the rapid development of society and urbanization, greenhouse gas emissions have increased, leading to environmental problems such as global warming. The rise in urban water consumption has also resulted in increased sewage discharge, exacerbating freshwater scarcity and water pollution. Understanding the current status and spatial distribution of greenhouse gas emissions in China's sewage treatment industry is crucial for emission reduction measures and controlling ammonia nitrogen pollution.

Methods

This study comprehensively investigates greenhouse gas emissions from sewage treatment plants, analyzing influencing factors and predicting future spatial and temporal distributions. The uncertainty of ammonia nitrogen emissions is calculated using the IPCC's error propagation method, considering uncertainty ranges of variables. Additionally, an artificial neural network is employed to predict ammonia nitrogen content in sewage discharge, aiming to prevent excessive levels in wastewater.

Results and discussion

The proposed model outperforms others with an R-Squared score of 0.926, demonstrating its superior accuracy in predicting ammonia content in wastewater. These findings contribute to better emission reduction strategies and control of ammonia nitrogen emissions. This model can effectively prevent excessive ammonia nitrogen content in discharged wastewater, contributing to water pollution control. In conclusion, this study highlights the importance of understanding greenhouse gas emissions from sewage treatment plants and their impact on water pollution. The research provides valuable insights into emission reduction measures, emission prediction, and technological innovations suitable for China's specific conditions. By effectively managing ammonia nitrogen emissions and adopting the proposed predictive model, the goals of carbon neutrality and environmental sustainability can be better achieved.
Identification of diagnostic hub genes related to neutrophils and infiltrating immune cell alterations in idiopathic pulmonary fibrosis
Authors: Lin Yingying , Lai Xiaofan , Huang Shaojie , Pu Lvya , Zeng Qihao , Wang Zhongxing , Huang Wenqi
Published: June 2023

Background

There is still a lack of specific indicators to diagnose idiopathic pulmonary fibrosis (IPF). And the role of immune responses in IPF is elusive. In this study, we aimed to identify hub genes for diagnosing IPF and to explore the immune microenvironment in IPF.

Methods

We identified differentially expressed genes (DEGs) between IPF and control lung samples using the GEO database. Combining LASSO regression and SVM-RFE machine learning algorithms, we identified hub genes. Their differential expression were further validated in bleomycin-induced pulmonary fibrosis model mice and a meta-GEO cohort consisting of five merged GEO datasets. Then, we used the hub genes to construct a diagnostic model. All GEO datasets met the inclusion criteria, and verification methods, including ROC curve analysis, calibration curve (CC) analysis, decision curve analysis (DCA) and clinical impact curve (CIC) analysis, were performed to validate the reliability of the model. Through the Cell Type Identification by Estimating Relative Subsets of RNA Transcripts algorithm (CIBERSORT), we analyzed the correlations between infiltrating immune cells and hub genes and the changes in diverse infiltrating immune cells in IPF.

Results

A total of 412 DEGs were identified between IPF and healthy control samples, of which 283 were upregulated and 129 were downregulated. Through machine learning, three hub genes (ASPN, SFRP2, SLCO4A1) were screened. We confirmed their differential expression using pulmonary fibrosis model mice evaluated by qPCR, western blotting and immunofluorescence staining and analysis of the meta-GEO cohort. There was a strong correlation between the expression of the three hub genes and neutrophils. Then, we constructed a diagnostic model for diagnosing IPF. The areas under the curve were 1.000 and 0.962 for the training and validation cohorts, respectively. The analysis of other external validation cohorts, as well as the CC analysis, DCA, and CIC analysis, also demonstrated strong agreement. There was also a significant correlation between IPF and infiltrating immune cells. The frequencies of most infiltrating immune cells involved in activating adaptive immune responses were increased in IPF, and a majority of innate immune cells showed reduced frequencies.

Conclusion

Our study demonstrated that three hub genes (ASPN, SFRP2, SLCO4A1) were associated with neutrophils, and the model constructed with these genes showed good diagnostic value in IPF. There was a significant correlation between IPF and infiltrating immune cells, indicating the potential role of immune regulation in the pathological process of IPF.
A nomogram diagnostic cardiovascular disease in patients with erythrodermic psoriasis in Chinese
Authors: Zou Yue-Min , Zhou Dong-Mei , Wu Man-Ning , Zhao Xin-Yuan
Published: June 2023

Objective

Patients with erythrodermic psoriasis (EP) are associated with an increased risk of cardiovascular disease (CVD), because of the more severe inflammation in the skin areas. This study aimed to develop a diagnostic model for the risk of CVD in EP patients based on the available features and multidimensional clinical data.

Methods

A total of 298 EP patients from Beijing Hospital of Traditional Chinese Medicine were retrospectively included in this study from May 5th, 2008, to March 3rd, 2022. Of them, 213 patients were selected as the development set by random sampling, and clinical parameters were analyzed by univariate and backward stepwise regression. Whereas the remaining 85 patients were randomly selected as the validation set. The model performance was later assessed in terms of discrimination, calibration, and clinical usefulness.

Results

In the development set, the CVD rate was 9%, which was independently correlated with age, glycated albumin (GA>17%), smoking, albumin (ALB<40 g/L), and lipoprotein(a) (Lp(a)>300 mg/L). The area under the ROC curve (AUC) value was 0.83 (95% confidence interval CI, 0.73,0.93). For the validation set of EP patients, the AUC value was 0.85 (95%CI, 0.76,0.94). According to decision curve analysis, our model exhibited favorable clinical applicability

Conclusion

EP patients with age, GA>17%, smoking, ALB<40 g/L, and Lp(a)>300 mg/L are associated with a higher risk of CVD. The nomogram model performs well in predicting the probability of CVD in EP patients, which may help improve perioperative strategies and good treatment outcomes.
The value of Interferon β in multiple sclerosis and novel opportunities for its anti-viral activity: a narrative literature review
Authors: Bellucci Gianmarco , Albanese Angela , Rizzi Caterina , Rinaldi Virginia , Salvetti Marco , Ristori Giovanni
Published: June 2023

Interferon-beta (IFN-β) for Multiple Sclerosis (MS) is turning 30. The COVID-19 pandemic rejuvenated the interest in interferon biology in health and disease, opening translational opportunities beyond neuroinflammation. The antiviral properties of this molecule are in accord with the hypothesis of a viral etiology of MS, for which a credible culprit has been identified in the Epstein-Barr Virus. Likely, IFNs are crucial in the acute phase of SARS-CoV-2 infection, as demonstrated by inherited and acquired impairments of the interferon response that predispose to a severe COVID-19 course. Accordingly, IFN-β exerted protection against SARS-CoV-2 in people with MS (pwMS). In this viewpoint, we summarize the evidence on IFN-β mechanisms of action in MS with a focus on its antiviral properties, especially against EBV. We synopsize the role of IFNs in COVID-19 and the opportunities and challenges of IFN-β usage for this condition. Finally, we leverage the lessons learned in the pandemic to suggest a role of IFN-β in long-COVID-19 and in special MS subpopulations.
Addressing marine restoration success: evidence of species and functional diversity recovery in a ten-year restored macroalgal forest
Authors: Galobart Cristina , Ballesteros Enric , Golo Raül , Cebrian Emma
Published: June 2023

Active restoration actions are becoming increasingly common for the recovery of degraded ecosystems. However, establishing when an ecosystem is fully restored is rarely achieved, since the recovery of entire communities needs long-term trajectories. The lack of evidence of success is even more severe in marine ecosystems, especially in the context of macroalgal forests, where beyond the vegetation structure and species diversity there is no approximation determining the recovery of the overall functionality. Trait-based ecology facilitates the link between species composition and ecosystem functions and processes. In this study, we used a trait-based approach to assess functional recovery ten years after the start of a restoration action in a marine macroalgal forest. Species and functional diversity were compared among the restored locality, a nearby locality where the expansion of the restoration is naturally occurring, a neighbouring non-restored locality (at a distance of a few meters), and the only two remaining localities dominated by the same structural macroalga that were used as reference (non-perturbed). Species diversity and composition of the restored locality were similar to those found in reference macroalgal forests, while the non-restored and expansion locality showed different species composition and lower species diversity. Functional richness was 4-fold higher in the restored locality than in the non-restored one, even surpassing one reference macroalgal locality. The restored locality showed a greater number of trait categories, especially traits related to higher structural complexity and longer life spans, indicating changes in ecosystem functions and processes. The restoration of a canopy-forming macroalga is the first step to achieving the recovery of an entire macroalgal forest (i.e., associated species and functional diversity). The application of traditional taxonomical indices plus functional parameters provides useful insights into the assessment of the success of restoration actions at the community level, emerging as a promising approach to be replicated and contrasted in other marine and terrestrial ecosystems.
Multimorbidity patterns and health-related quality of life in Jamaican adults: a cross sectional study exploring potential pathways
Authors: Craig Leslie S. , Cunningham-Myrie Colette A. , Theall Katherine P. , Gustat Jeanette , Hernandez Julie H. , Hotchkiss David R.
Published: June 2023

Introduction

Multimorbidity and health-related quality of life (HRQoL) are intimately linked. Multiple chronic conditions may adversely affect physical and mental functioning, while poorer HRQoL may contribute to the worsening course of diseases. Understanding mechanisms through which specific combinations of diseases affect HRQoL outcomes can facilitate identification of factors which are amenable to intervention. Jamaica, a middle-income country with high multimorbidity prevalence, has a health service delivery system dominated by public sector provision via a broad healthcare network. This study aims to examine whether multimorbidity classes differentially impact physical and mental dimensions of HRQoL in Jamaicans and quantify indirect effects on the multimorbidity–HRQoL relationship that are mediated by health system factors pertaining to financial healthcare access and service use.

Materials and methods

Latent class analysis (LCA) was used to estimate associations between multimorbidity classes and HRQoL outcomes, using latest available data from the nationally representative Jamaica Health and Lifestyle Survey 2007/2008 (N = 2,551). Multimorbidity measurement was based on self-reported presence/absence of 11 non-communicable diseases (NCDs). HRQoL was measured using the 12-item short-form (SF-12) Health Survey. Mediation analyses guided by the counterfactual approach explored indirect effects of insurance coverage and service use on the multimorbidity–HRQoL relationship.

Results

LCA revealed four profiles, including a Relatively Healthy class (52.7%) characterized by little to no morbidity and three multimorbidity classes characterized by specific patterns of NCDs and labelled Metabolic (30.9%), Vascular-Inflammatory (12.2%), and Respiratory (4.2%). Compared to the Relatively Healthy class, Vascular-Inflammatory class membership was associated with lower physical functioning (β = −5.5; p < 0.001); membership in Vascular-Inflammatory (β = −1.7; p < 0.05), and Respiratory (β = −2.5; p < 0.05) classes was associated with lower mental functioning. Significant mediated effects of health service use, on mental functioning, were observed for Vascular-Inflammatory (p < 0.05) and Respiratory (p < 0.05) classes.

Conclusion

Specific combinations of diseases differentially impacted HRQoL outcomes in Jamaicans, demonstrating the clinical and epidemiological value of multimorbidity classes for this population, and providing insights that may also be relevant to other settings. To better tailor interventions to support multimorbidity management, additional research is needed to elaborate personal experiences with healthcare and examine how health system factors reinforce or mitigate positive health-seeking behaviours, including timely use of services.
A critical review of COVID-19 course and vaccination in dermatology patients on immunomodulatory/biologic therapy: recommendations should not differ between non-pregnant and pregnant individuals
Authors: Messas Tassahil , Lim Rachel K. , Burns Laura , Yumeen Sara , Kroumpouzos George
Published: June 2023

COVID-19 can have detrimental effects on immunosuppressed patients. Here, we evaluate the evidence regarding continuing immunomodulatory/biologic (IMBI) therapy in pregnant dermatology patients during the COVID-19 pandemic. Also, we discuss the risks of COVID-19 vaccination in pregnant dermatology patients on IMBI therapy. As indicated in this review, regarding continuing IMBI therapy in pregnant dermatology patients during the pandemic, there is no compelling reason for treating them differently than non-pregnant. The body of evidence indicates that mRNA COVID-19 vaccines are safe during pregnancy. Studies on rheumatology patients, a group that overlaps significantly with the dermatology group, provided essential findings. IMBI in a non-pregnant rheumatology patient was not associated with COVID-19 mortality (except for rituximab), and vaccination of the rheumatology patient during pregnancy improved the obstetric outcomes compared to the unvaccinated patient. Based on this data, it can be stated that after weighing the benefit–risk profile of the available COVID-19 vaccines, the recommendation for the pregnant dermatology patient speaks in favor of the COVID-19 vaccination. COVID-19 vaccine recommendations in pregnant dermatology patients on IMBI should not differ from those for their non-pregnant counterparts.
Sex differences in the relationship between axial length and dry eye in elderly patients
Authors: Ayaki Masahiko , Torii Hidemasa , Yotsukura Erisa , Negishi Kazuno
Published: June 2023

Purpose

The aim of this study was to explore the association between myopia and dry eye (DE)-related ocular parameters.

Methods

We recruited a total of 460 patients (mean age, 73.6 years; 40.2% men) and performed DE-related, axial length (AL) and retinal examinations. Statistical analysis revealed a significant sex difference in AL, strip meniscometry value, corneal staining score, corneal endothelial cell density, ganglion cell complex (GCC) thickness, and full macular thickness. AL was strongly age- and sex-dependent, so subsequent analyses were stratified by sex.

Results

Among DE-related parameters, strip meniscometry value (ß = −0.167, p = 0.033) and corneal endothelial cell density (ß = −0.139, p = 0.023) were correlated with AL in women but not in men. Regarding retinal parameters, GCC thickness and full macular thickness were correlated with AL in women but not in men.

Conclusion

The current results suggest a relationship between tear production and AL in elderly women and support the hypothesis that there may be a common upstream factor including the parasympathetic nervous system in the association between tear production and AL or DE and myopia.
Skin regeneration-related mechanisms of Calcium Hydroxylapatite (CaHA): a systematic review
Authors: Amiri Mojgan , Meçani Renald , Niehot Christa D. , Phillips Terri , Kolb Janina , Daughtry Hua , Muka Taulant
Published: June 2023

Introduction

Calcium Hydroxylapatite (CaHA) is a common dermal filler used in aesthetic medicine for volumizing and contouring. Understanding mechanisms of actions of CaHA can help improve our understanding of its clinical applications.

Methods

We performed a systematic review to summarize the skin-regeneration related mechanisms of CaHA. Five bibliographic databases were searched for English-language publications that evaluated CaHA in skin regeneration outcomes including neocollagenesis, cell proliferation and growth factors, angiogenesis, vascular dynamic and inflammatory markers, among others. Methodological rigor of included studies was assessed.

Results

Of 2,935 identified citations, 12 studies were included for final analysis. Collagen production was reported by nine studies, cell proliferation by four, elastic fibers and/or elastin by four, and three studies on angiogenesis, while limited studies were available on the other outcomes. Six were clinical/observational studies. Only seven studies had a control group. Overall, studies showed CaHA resulted in increased cell proliferation, increased collagen production and angiogenesis, as well as in higher elastic fiber and elastin formation. Limited and inconclusive evidence was available on the other mechanisms. The majority of the studies had methodological limitations.

Discussion

Current evidence is limited but indicates several mechanisms through which CaHA could lead to skin regeneration, volume enhancement, and contouring.

Systematic review registration

https://doi.org/10.17605/OSF.IO/WY49V.
The associations between gut microbiota and chronic respiratory diseases: a Mendelian randomization study
Authors: Shi Hanyu , Zhao Tong , Geng RuiHui , Sun Liang , Fan Haojun
Published: June 2023

Introduction

Growing evidence indicates that variations in the composition of the gut microbiota are linked to the onset and progression of chronic respiratory diseases (CRDs), albeit the causal relationship between the two remains unclear.

Methods

We conducted a comprehensive two-sample Mendelian randomization (MR) analysis to investigate the relationship between gut microbiota and five main CRDs, including chronic obstructive pulmonary disease (COPD), asthma, idiopathic pulmonary fibrosis (IPF), sarcoidosis, and pneumoconiosis. For MR analysis, the inverse variance weighted (IVW) method was utilized as the primary method. The MR–Egger, weighted median, and MR-PRESSO statistical methods were used as a supplement. To detect heterogeneity and pleiotropy, the Cochrane and Rucker Q test, MR–Egger intercept test, and MR-PRESSO global test were then implemented. The leave-one-out strategy was also applied to assess the consistency of the MR results.

Results

Based on substantial genetic data obtained from genome-wide association studies (GWAS) comprising 3,504,473 European participants, our study offers evidence that several gut microbial taxa, including 14 probable microbial taxa (specifically, 5, 3, 2, 3 and 1 for COPD, asthma, IPF, sarcoidosis, and pneumoconiosis, respectively) and 33 possible microbial taxa (specifically, 6, 7, 8, 7 and 5 for COPD, asthma, IPF, sarcoidosis, and pneumoconiosis, respectively) play significant roles in the formation of CRDs.

Discussion

This work implies causal relationships between the gut microbiota and CRDs, thereby shedding new light on the gut microbiota-mediated prevention of CRDs.
The efficacy of memory load on speech-based detection of Alzheimer’s disease
Authors: Bae Minju , Seo Myo-Gyeong , Ko Hyunwoong , Ham Hyunsun , Kim Keun You , Lee Jun-Young
Published: June 2023

Introduction

The study aims to test whether an increase in memory load could improve the efficacy in detection of Alzheimer’s disease and prediction of the Mini-Mental State Examination (MMSE) score.

Methods

Speech from 45 mild-to-moderate Alzheimer’s disease patients and 44 healthy older adults were collected using three speech tasks with varying memory loads. We investigated and compared speech characteristics of Alzheimer’s disease across speech tasks to examine the effect of memory load on speech characteristics. Finally, we built Alzheimer’s disease classification models and MMSE prediction models to assess the diagnostic value of speech tasks.

Results

The speech characteristics of Alzheimer’s disease in pitch, loudness, and speech rate were observed and the high-memory-load task intensified such characteristics. The high-memory-load task outperformed in AD classification with an accuracy of 81.4% and MMSE prediction with a mean absolute error of 4.62.

Discussion

The high-memory-load recall task is an effective method for speech-based Alzheimer’s disease detection.
Motor impulsivity but not risk-related impulsive choice is associated to drug intake and drug-primed relapse
Authors: Arrondeau Chloé , Urueña-Méndez Ginna , Bellés Lidia , Marchessaux Florian , Goutaudier Raphaël , Ginovart Nathalie
Published: June 2023

Introduction

Motor impulsivity and risk-related impulsive choice have been proposed as vulnerability factors for drug abuse, due to their high prevalence in drug abusers. However, how these two facets of impulsivity are associated to drug abuse remains unclear. Here, we investigated the predictive value of both motor impulsivity and risk-related impulsive choice on characteristics of drug abuse including initiation and maintenance of drug use, motivation for the drug, extinction of drug-seeking behavior following drug discontinuation and, finally, propensity to relapse.

Methods

We used the Roman High- (RHA) and Low- Avoidance (RLA) rat lines, which display innate phenotypical differences in motor impulsivity, risk-related impulsive choice, and propensity to self-administer drugs. Individual levels of motor impulsivity and risk-related impulsive choice were measured using the rat Gambling task. Then, rats were allowed to self-administer cocaine (0.3 mg/kg/infusion; 14 days) to evaluate acquisition and maintenance of cocaine self-administration, after which motivation for cocaine was assessed using a progressive ratio schedule of reinforcement. Subsequently, rats were tested for their resistance to extinction, followed by cue-induced and drug-primed reinstatement sessions to evaluate relapse. Finally, we evaluated the effect of the dopamine stabilizer aripiprazole on reinstatement of drug-seeking behaviors.

Results

We found that motor impulsivity and risk-related impulsive choice were positively correlated at baseline. Furthermore, innate high levels of motor impulsivity were associated with higher drug use and increased vulnerability to cocaine-primed reinstatement of drug-seeking. However, no relationships were observed between motor impulsivity and the motivation for the drug, extinction or cue-induced reinstatement of drug-seeking. High levels of risk-related impulsive choice were not associated to any aspects of drug abuse measured in our study. Additionally, aripiprazole similarly blocked cocaine-primed reinstatement of drug-seeking in both high- and low-impulsive animals, suggesting that aripiprazole acts as a D2/3R antagonist to prevent relapse independently of the levels of impulsivity and propensity to self-administer drugs.

Discussion

Altogether, our study highlights motor impulsivity as an important predictive factor for drug abuse and drug-primed relapse. On the other hand, the involvement of risk-related impulsive choice as a risk factor for drug abuse appears to be limited.