bluuebunny/crossref_metadata_2025 huggingface dataset:
Comorbid flow non-alcoholic fatty liver disease and osteoporosis
Authors: Fomina L. A.
Published: January 2025

SUMMARY

Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases. Its comorbid course with various diseases is noted. It has been established that bone disorders are often detected in NAFLD.

The purpose of the study. To clarify the effect of NAFLD on the condition of bone tissue, the dependence of changes in BMD and the severity of the pathological process in the liver.

Materials and methods. 98 women were examined, with an average age of 53.3±6.24 years. All individuals underwent a clinical examination, body mass index was calculated, ultrasound examination (ultrasound) of the abdominal cavity, two-energy X-ray absorptimetry of the lumbar spine (LS) and femoral neck (FN) with clarification of the value of the T-criterion, esophagogastroduodenoscopy, biochemical blood analysis were performed. All patients were divided into 3 groups: the first group consisted of 47 people with liver steatosis, the second group included 25 people with steatohepatitis. The control group included 26 women with the results of biochemical blood parameters within the reference values and unchanged liver ultrasound data. Results. The analysis of clinical symptoms showed the presence of asthenic syndrome/chronic fatigue in all patients with NAFLD, while the severity of symptoms increased with steatohepatitis. According to densitometry, the average values of the T-criterion in both SB and POP did not significantly differ in patients with liver steatosis and the control group. In patients with steatohepatitis, there was a significant decrease in the T-criterion in both study areas. The prevalence of osteoporosis (OP) and osteopenia in the first and control groups did not differ statistically. In steatohepatitis, OP was detected twice as often as in liver steatosis.

Conclusions. The presented data indicate that asthenic syndrome dominates the clinical picture of NAFLD. The results of the study confirm the comorbid course of NAFLD at the stage of steatohepatitis and OP.
The role of Acinetobacter baumanii in the etiology of nosocomial infections and possible options for rational antibiotic therapy in adults and children
Authors: Teplova N. V. , Postnikov S. S. , Rumyancev A. L. , Kostyleva M. N. , Gratsianskaya A. N. , Belousova L. B. , Dalakyan D. Yu.
Published: January 2025

In the mid‑20th century and later, the main bacterial threat in hospitals was gram-positive infections, with staphylococcus aureus (“staphylococcal plague”) playing the leading role. In the last 20 years, there has been an evolution, a change in flora, and now gram-negative infections, especially the triad (A. baumanii, K. pneumoniae, P. aeruginosa) from the ESCAPE group, determine hospital morbidity and mortality due to increasing resistance to carbapenems and cephalosporins and, accordingly, limited choice. In the review concerning the treatment options for A. baumanii in adults and children (especially infants and neonates), antibiotic therapy options are considered.
Modern monitoring methods informativeness in assessing the risk of hemodynamic disorders in on pump cardiac surgery (pilot study)
Authors: Kozlov I. A. , Krichevskiy L. A. , Ovezov A. M. , Rybakov V. Yu.
Published: January 2025

The objective was to study the prognostic significance of intraoperative parameters of pulmonary artery catheterization (PAC), transesophageal echocardiography (TEE) and transpulmonary thermodilution (TPTD) in relation to the hemodynamic disorders in coronary artery bypass grafting (CABG).Material and Methods. A prospective observational study involved 67 patients aged 53 [46–64] years who underwent on-pump CABG. Hemodynamic parameters were recorded after the induction of anesthesia (stage I) and at the end of the surgery (stage II). Hemodynamic disorders were considered to be the inotropic index in post-bypass period >5, the duration of inotropic support >12 hours, the intensive care unit (ICU) stay >24 hours, the use of intraaortic balloon pumping (IABP), the ICU mortality, the presence of one or more complications (composite outcome). Logistic regression and ROC analysis were used.Results. At stage I, the left ventricular stroke work index (LVSWI) cut-off <31.7 gs•m/m2 was associated with ICU stay >24 hours (OR 0.9291, 95 % CI 0.8670–0.9958, AUC 0.716), and LVSWI <32.5 gs•m/m2 – with a composite the outcome (OR 0.9550, 95 % CI 0.9133–0.9985, AUC 0.704). The left ventricular area contraction fraction <34.2 % predicted the use of IABP (OR 0.9089, 95 % CI 0.8397–0.9839, AUC 0.889). At the II stage, the LVSWI cut-off <28.8 gs•m/m2 was associated with ICU stay >24 hours (OR 0.8805, 95 % CI 0.8226–0.9884, AUC 0.716), cut-off <25.6 gs•m/m2 – with the use of IABP (OR 0.8274, 95 % CI 0.7101–0.9641, AUC 0.804), and cut-off <23.0 gs•m/m2 – with mortality (OR 0.7486, 95 % CI 0.5951–0.9415, AUC 0.892). The left ventricular ejection fraction <26.1 % was also associated with mortality (OR 0.8901, 95 % CI 0.8164–0.9705, ACC 0.948). The global heart ejection fraction <18 % was associated with a composite outcome (OR 0.9018, 95 % CI 0.8297–0.9802, AUC 0.716). The other predictors cut-off values were practically normal. The remaining indicators provided models of average quality or had no predictive significance.Conclusion. To assess the risk of possible hemodynamic disorders in on-pump CABG, PAC and TEE are the most informative. In prebypass and in postbypass periods, LVSWI, reduced by 1.5–2.2 times, is associated with the risk of various hemodynamic complications and prolonged ICU stay. Decreased TEE parameters of left ventricular systolic function is associated with myocardial dysfunction and with the risk of mortality. The prognostic significance of the TPTD needs further investigations.
Reduction of the microbial background in the intensive care unit of a surgical hospital with the systematic introduction of the Alpha‑06A pulsed ultraviolet system into disinfection measures (experimental study)
Authors: Strunin O. V. , Terekhova R. P. , Kozlova A. V. , Demidova V. S.
Published: January 2025

Relevance. Healthcare-associated infections (HAIs) are a significant problem in intensive care units. They contribute to increased mortality, lengthen hospital stays and increase treatment-related costs.The aim of the study was to evaluate the effectiveness of reducing the microbial background and cross-transmission of pathogenic microorganisms associated with the provision of medical care in the intensive care units of surgical hospital with the systemic use of the Alpha‑06A pulsed ultraviolet system with the “Areal” device (Scientific and Production Enterprise «Melitta», Russia).Materials and methods. The Alfa‑06A air, surface and local areas disinfection system with the “Areal” device was used in the intensive care unit for 2 months – August and September 2024. The “Areal” device directs ultraviolet radiation, generated by the pulsed xenon lamp of the Alfa‑06 installation, into a limited sector. The rest of the room is structurally protected from direct UV radiation. It is allowed to use it in the presence of patients and staff. The use of the installation complemented the standard anti-epidemic measures. At the end of the study period, the results of microbiological studies were retrospectively evaluated and compared with the results of the control period.Results. A statistically significant (Fisher’s criterion 0.00383, p<0.05) tenfold decrease in the number of positive samples from surfaces during the treatment period in the «Areal» mode was noted. A decrease in bacterial pollution of the environment led to a distinct tendency to reduce cases of contamination of patients with various bacterial flora, and the acquisition by the patients of multidrug-resistant organisms statistically significantly decreased by 100 % (p<0.5). As a result, the use of the Alpha system in the «Areal» mode reduced the cost of expensive antibacterial drugs by 18.9 % in absolute and 7.4 % in relative terms.Conclusion. The systematic use of Alfa‑06A in conjunction with the “Areal” device in the daily work of the intensive care unit significantly reduces the contamination of surfaces with microorganisms. This is reflected in a decrease in the number of positive samples from various patient loci. The number of cases of persistence of polyresistant problematic bacteria of the ESKAPE group is also decreasing. The improvement of the microbiological background shows a clear economic effect in terms of the cost of expensive antibacterial drugs.
THE NECESSITY OF CRIMINALIZATION OF SOME FORMS OF LOBBYISM IN RUSSIAN FEDERATION
Authors:   Lomonosov Moscow State University, Moscow, Russian Federation, SOVETOV D.I. , STUPIN D.D. , STUPIN R.D.
Published: January 2025

Relevance. This article considers the issue of criminalization of some forms of lobbyism, identifies the need for such a solution in the current conditions of criminal-legal and socio-economic reality of the Russian state. The paper points out the disadvantages and shortcomings of repeated attempts to incorporate this institution into Russian law enforcement practice.

Purpose. To outline the necessity of criminalization of some forms of this institution, to identify the public danger, the object of encroachment of this act.

Conclusions. This article forms conclusions and provisions that allow to take measures in favor of criminalization of some forms of lobbyism, points out the real public danger of this act and highlight threats to the constitutional order and public security of Russia.
Pedagogy in an Era of Escalating Political Violence
Authors: Nisly Krista
Published: January 2025

After the January 6th insurrection in 2021, violent political incidents have increased in American politics . Moreover, the effect of violent politics on many marginalized groups, including Black women and members of the LGBTQIA community, is magnified, as they are more apt to be the target of violent rhetoric and attacks . Political science professors, especially those who encourage students to actively participate in political activity, cannot overlook the negative effects this escalation in violent politics is likely to have on our students. They should modify their pedagogy in response to the current political environment and in response to students’ lived experiences and needs (Poloni-Staudinger and Strachan, 2020). This paper explores the possibility of three approaches that may be able to help students thrive despite an escalation in political violence, including encouraging civic engagement (Strachan, 2015), using praxis in the classroom (Freire, 1968 ), and educating for hope (Giroux, 2023).
The Digital Frontier: How Indonesia's Politics is Shaping the Fight against Human Trafficking
Authors: Molasy Honest Dody
Published: January 2025

This article explores the intricate relationship between Indonesia's political landscape and its efforts to combat human trafficking, particularly through the lens of digital advancements. Human trafficking remains a pressing issue in Indonesia, characterized by systemic challenges such as corruption, inadequate law enforcement, and socio-economic vulnerabilities. The study employs a qualitative research approach, utilizing policy analysis, and case studies to assess the effectiveness of current anti-trafficking strategies. Key findings highlight the potential of digital tools, including AI, big data analytics, and blockchain technology, in enhancing victim identification and improving coordination among law enforcement agencies. Furthermore, the role of public-private partnerships is emphasized as a critical component in advancing technological solutions and fostering community engagement. Despite these advancements, significant challenges persist, including disparities in digital infrastructure between urban and rural areas, cybersecurity concerns, and the need for enhanced training among law enforcement personnel. The article argues for Indonesia's leadership role in the Southeast Asian region, advocating for the adoption of comprehensive digital strategies that align with international human rights standards. By addressing the multifaceted nature of human trafficking through innovative approaches and collaborative efforts, Indonesia can strengthen its anti-trafficking framework and serve as a model for other nations facing similar challenges. This research contributes to the growing body of literature on human trafficking by providing insights into the intersection of politics, technology, and human rights, ultimately aiming to inform policy and practice in combating this global issue.
Development and effectiveness evaluation of an interactive e-learning environment to enhance digital health literacy in cancer patients: study protocol for a randomized controlled trial
Authors: Lange-Drenth Lukas , Willemer Hellena , Banse Mirjam , Ernst Anke , Daubmann Anne , Holz Anja , Bleich Christiane , Weg-Remers Susanne , Schulz Holger
Published: January 2025

Background

The Internet allows cancer patients to access information about their disease at any time. However, the quality of online information varies widely and is often inaccurate or does not provide all the details patients need to make informed decisions. Additionally, patients’ often limited ability to find and evaluate cancer-related online information can lead to misinformation.

Objective

An interactive e-learning environment to promote digital health literacy will be developed and evaluated for effectiveness.

Primary hypothesis

Cancer patients who use the e-learning environment (IG1.1–IG1.3) or the content of the environment as a non-interactive PDF file (IG2) will show greater improvement in their digital health literacy from baseline to 8 weeks after baseline compared to patients who receive no such intervention, but are referred to a standard information brochure.

Methods

The hypothesis will be tested in a stratified randomized controlled superiority trial with five parallel groups and the primary endpoint of digital health literacy. In an e-learning environment, patients will learn strategies to use when searching for reliable cancer-related online information. During development, a prototype will be refined through focus groups and tested for usability by experts and patients. 660 cancer patients will be recruited using convenience sampling and randomly assigned in a 3:1:1 ratio to IG1.1-IG1.3 (three variants of the environment), IG2, or the control group. Two thirds of the 660 participants will be recruited through the German Cancer Information Service (CIS) and one third through non-CIS routes. Allocation will follow stratified randomization, accounting for recruitment route (CIS vs. non-CIS) and cancer type (breast cancer vs. other cancers), with variable block length. The primary outcome, digital health literacy, will be measured at baseline, 2 weeks, and 8 weeks after baseline.

Conclusion

If the results support the primary hypothesis, then the e-learning environment could empower patients to retrieve more reliable information about their disease. Concerns about the generalizability of the results, since a disproportionate number of inquiries to the CIS come from breast cancer patients, are addressed by a proportionally stratified randomization strategy and diversified recruitment routes.
Making connections for children and teachers: using classroom-based implementation supports for teaching Pyramid Model practices in Head Start programs
Authors: Bulotsky-Shearer Rebecca J. , Ehrenreich-May Jill , Morris Chelsea T. , Mullins Casey , Lerner Bella S. , Howe Elizabeth , Bailey Jhonelle , Gruen Rinatte L. , Gonzalez Angelica C.
Published: January 2025

Introduction

In partnership with an urban school district Head Start program, we created a set of intervention supports that built upon the strengths of the district program services already in place.

Methods

We conducted a randomized control trial to test the use of natural helpers (teachers, special education coaches, and curriculum specialists) participating in practice-based coaching and monthly communities of practice, to augment a districtwide universal social-emotional program, The Pyramid Model for Promoting Social and Emotional Competence in Infants and Young Children. Participants included 53 preschool teachers and 519 preschool children, across 26 classrooms, and 9 schools in a high poverty area of the district. Teachers were randomized to a waitlist control or intervention condition. Intervention teachers participated in practice-based coaching and monthly communities of practice over the course of two years.

Results

Significant effects were found on participating intervention teachers’ observed increased implementation of positive social-emotional practices in the classroom, decreases in red flags (observed teaching behaviors counter to the Pyramid Model), and increased teacher reports of self-efficacy in the intervention group, compared to control teachers. No significant impacts on child classroom behavior problems, self-regulation, or approaches to learning skills were found for children enrolled in intervention classrooms, compared to children in the control classrooms.

Discussion

Future directions for research and implications for practice are discussed.
The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus
Authors: Zhai Ya-Jie , Li Fang , Lin Chen-Ying , Wu Fan , Qiu Hui-Na , Li Jing-Bo , Lin Jing-Na
Published: January 2025

Background

This study investigates the relationship between basal metabolic rate (BMR), body composition, obesity indices, and cognitive impairment (CI) in middle-aged and older type 2 diabetes mellitus (T2DM) patients, assessing their potential role in CI screening.

Methods

A cross-sectional study included 1243 T2DM patients over 45 years old. CI was assessed using the Montreal Cognitive Assessment. BMR and body composition indices were measured through bioelectrical impedance analysis. The associations and predictions related to CI were explored using multivariable-adjusted logistic regression, restricted cubic spline (RCS) models, and receiver operating characteristic (ROC) curve analyses. Mediation analysis explored the role of BMR adjusted by body surface area (BMR/BSA) in CI risk.

Results

Patients with CI showed significantly lower BMR, BMR adjusted for height squared (BMR/Height²), BMR/BSA, appendicular skeletal muscle mass (ASM), and fat-free mass (FFM), alongside higher waist circumference (WC) and percentage of body fat. Logistic regression showed that participants in the fourth quartile of BMR, BMR/Height2, and BMR/BSA had approximately a 54% reduced risk of CI (odds ratio range 0.457 to 0.463). RCS analysis indicated a linear decrease in CI risk with increasing BMR metrics. ROC analysis indicated high predictive efficacy for CI with combined indicators, particularly BMR and FFM (area under the curve 0.645). Mediation analysis suggested that BMR/BSA played a significant mediating role in WC, ASM and FFM on CI risk, with a mediation proportion ranging from 45.73% to 50.87%.

Conclusion

Low energy expenditure assessed by BMR/BSA is an independent risk factor for increased CI risk in middle-aged and elderly T2DM patients. Central obesity, low muscle mass, and low energy expenditure significantly elevate CI risk in this population.
Gender, FT4 levels, T stage, and BMI as predictors of TSH levels in thyroid cancer patients
Authors: Zhang Sen , Niu Shuli , Zhou Ling
Published: January 2025

Background

After initial treatment, levothyroxine (LT4) administration is necessary for thyroid cancer patients to achieve target thyroid-stimulating hormone (TSH) levels. However, the clinical efficacy of weight-based LT4 dosing has been suboptimal, highlighting the need to identify factors influencing the attainment of desired TSH levels and guide personalized treatment.

Methods

We constructed a retrospective cohort comprising 215 patients diagnosed with thyroid cancer. The identification of factors influencing the attainment of expected TSH levels was accomplished through univariate and multivariate logistic regression analyses. Subsequently, we developed a nomogram based on these prognostic factors and performed internal validation using the bootstrap resampling method.

Results

Univariate and multivariate logistic regression analyses were conducted to analyze the clinical and demographic parameters. A nomogram was constructed using bootstrap resampling to predict the risk of TSH suppression failure, which was validated. The nomogram demonstrated moderate discrimination in estimating the risk of TSH suppression failure, with a Hosmer-Lemeshow test p-value of 0.393 and a bootstrapped calibrated C-index of 0.757 (95% CI 0.687-0.814). The calibration curve indicated good consistency of the model, and decision curve analysis suggested that the nomogram had clinical utility.

Conclusion

Gender, preoperative serum free thyroxine (FT4) levels, T stage, and body mass index exhibit independent associations with the expected level of TSH. The established nomogram effectively predicts the risk of TSH suppression failure. Further research is warranted to investigate how these factors can be utilized in developing a personalized LT4 dosage calculator.
Low-carbon economic dispatch of integrated energy system with carbon capture power plant and multiple utilization of hydrogen energy
Authors: Wang Jiarui , Ji Xiu , Meng Xiangdong , Bai Yang , Li Meiyue
Published: January 2025

In the context of “dual carbon”, in order to promote the consumption of renewable energy and improve energy utilization efficiency, a low-carbon economic dispatch model of an integrated energy system containing carbon capture power plants and multiple utilization of hydrogen energy is proposed. First, introduce liquid storage tanks to transform traditional carbon capture power plants, and at the same time build a multi-functional hydrogen utilization structure including two-stage power-to-gas, hydrogen fuel cells, hydrogen storage tanks, and hydrogen-doped cogeneration to fully exploit hydrogen. It can utilize the potential of collaborative operation with carbon capture power plants; on this basis, consider the transferability and substitutability characteristics of electric heating gas load, and construct an electric heating gas comprehensive demand response model; secondly, consider the mutual recognition relationship between carbon quotas and green certificates, Propose a green certificate-carbon trading mechanism; finally establish an integrated energy system with the optimization goal of minimizing the sum of energy purchase cost, demand response compensation cost, wind curtailment cost, carbon storage cost, carbon purchase cost, carbon trading cost and green certificate trading compensation. Optimize scheduling model. The results show that the proposed model can effectively reduce the total system cost and carbon emissions, improve clean energy consumption and energy utilization, and has significant economical and low-carbon properties.
Evaluation of multi-source precipitation products for monitoring drought across China
Authors: Yuan Yongyi , Liao Boyi
Published: January 2025

Accurate precipitation data are crucial for effective drought monitoring, especially in China’s complex and diverse climatic regions. This study evaluates the performance of six multisource precipitation products-ERA5-Land, CMORPH CRT, GSMaP MVK, IMERG Late, and IMERG Final-in detecting drought across China from 2009 to 2019, using ground station observations for validation. By applying various drought and evaluation indices across various timescales, this analysis captures short and long-term climate variations, assessing each product’s accuracy across diverse regions. Spatial and temporal analyses revealed that IMERG Final closely aligns with observed precipitation, particularly in the high-rainfall areas like the Yangtze River Basin, while GSMaP MVK and ERA5 tend to overestimate precipitation in arid and semi-arid regions. Discrepancies are most pronounced in complex terrains such as the Qinghai-Tibet Plateau and southwestern mountains, where sparse observational networks exacerbate errors. Drought indices, including SPEI-3 and SPI-1, were used to measure each product’s effectiveness in detecting drought intensity, frequency, and duration. IMERG Final consistently showed the highest correlation with ground data across all drought levels (Light, Moderate, and Severe), while GSMaP MVK and ERA5 tended to overestimate drought occurrences in certain drought-prone areas. Hotspot analyses of indices such as CDD, PRCPTOT, and R95p further confirmed IMERG Final’s accuracy in identifying drought and wet event patterns, closely reflecting ground measurements, whereas ERA5 and GSMaP MVK occasionally overestimated drought frequencies. In summary, IMERG Final emerged as a relatively accurate and reliable product for drought monitoring, showing strong applicability across China’s diverse climatic regions. These findings aid in data correction, enhances understanding of regional drought variability, and integration strategies to improve water resource management and extreme event monitoring.
The success of the tumor immunotherapy: neutrophils from bench to beside
Authors: Zhu Meng , Jia Ru , Zhang Xiaojie , Xu Pingwei
Published: January 2025

The present immune therapy was focused on the immune checkpoint blockade or Chimeric Antigen Receptor T-Cell Immunotherapy (CART) transfer, but how to activate the innate immune system to antitumor still lags out. Neutrophils are the most abundant circulating leukocytes in human, and heterogeneous neutrophils have been increasingly recognized as important players in tumor progression. They play double “edge-sward” by either supporting or suppressing the tumor growth, including driving angiogenesis, extracellular matrix remodeling to promote tumor growth, participating in antitumor adaptive immunity, or killing tumor cells directly to inhibit the tumor growth. The complex role of neutrophils in various tumors depends on the tumor microenvironment (TME) they are located, and emerging evidence has suggested that neutrophils may determine the success of tumor immunotherapy in the context of the immune checkpoint blockade, innate immune training, or drug-loaded extracellular microvesicles therapy, which makes them become an exciting target for tumor immunotherapy, but still with challenges. Here, we summarize the latest insights on how to activate neutrophils in antitumor immunity and discuss the advances of neutrophil-targeted immunotherapy strategies.
Metabolic reprogramming and immunological changes in the microenvironment of esophageal cancer: future directions and prospects
Authors: Guo Zhi-Xun , Ma Jia-Li , Zhang Jin-Qiu , Yan Ling-Ling , Zhou Ying , Mao Xin-li , Li Shao-Wei , Zhou Xian-Bin
Published: January 2025

Background

Esophageal cancer (EC) is the seventh-most prevalent cancer worldwide and is a significant contributor to cancer-related mortality. Metabolic reprogramming in tumors frequently coincides with aberrant immune function alterations, and extensive research has demonstrated that perturbations in energy metabolism within the tumor microenvironment influence the occurrence and progression of esophageal cancer. Current treatment modalities for esophageal cancer primarily include encompass chemotherapy and a limited array of targeted therapies, which are hampered by toxicity and drug resistance issues. Immunotherapy, particularly immune checkpoint inhibitors (ICIs) targeting the PD-1/PD-L1 pathway, has exhibited promising results; however, a substantial proportion of patients remain unresponsive. The optimization of these immunotherapies requires further investigation. Mounting evidence underscores the importance of modulating metabolic traits within the tumor microenvironment (TME) to augment anti-tumor immunotherapy.

Methods

We selected relevant studies on the metabolism of the esophageal cancer tumor microenvironment and immune cells based on our searches of MEDLINE and PubMed, focusing on screening experimental articles and reviews related to glucose metabolism, amino acid metabolism, and lipid metabolism, as well their interactions with tumor cells and immune cells, published within the last five years. We analyzed and discussed these studies, while also expressing our own insights and opinions.

Results

A total of 137 articles were included in the review: 21 articles focused on the tumor microenvironment of esophageal cancer, 33 delved into research related to glucose metabolism and tumor immunology, 30 introduced amino acid metabolism and immune responses, and 17 focused on the relationship between lipid metabolism in the tumor microenvironment and both tumor cells and immune cells.

Conclusion

This article delves into metabolic reprogramming and immune alterations within the TME of EC, systematically synthesizes the metabolic characteristics of the TME, dissects the interactions between tumor and immune cells, and consolidates and harnesses pertinent immunotherapy targets, with the goal of enhancing anti-tumor immunotherapy for esophageal cancer and thereby offering insights into the development of novel therapeutic strategies.
Adalimumab induced psoriasis in Crohn’s disease and treatment with ustekinumab: case report and special histopathological findings
Authors: Qiu Fang , Chen Weiquan , Zhou Ying
Published: January 2025

This case report presents an instance of Tumor Necrosis Factor-α Inhibitor-induced psoriasis (TNFiIP), also known as paradoxical psoriasis, in a 30-year-old male with fistulizing Crohn’s disease. The patient developed extensive erythematous and scaly lesions on the palms, lower limbs, ankles, and soles after 4 months of adalimumab monotherapy. Histopathological analysis revealed a pattern of psoriasiform dermatitis with notable dermal neutrophil and eosinophil infiltration, distinguishing TNFiIP from idiopathic psoriasis. The patient’s condition significantly improved following the transition from adalimumab to ustekinumab, which highlights the importance of alternative therapeutic strategies for patients who exhibit paradoxical reactions to TNF-α inhibitors.
Psychological safety in health professions education: insights and strategies from a global community of practice
Authors: Dong Chaoyan , Altshuler Lisa , Ban Nobutaro , Wong Lee Yuen , Mohammed Fatima Elbasri Abuelgasim , Tang Chao Tian , Kachur Elizabeth
Published: January 2025

Psychological safety is the belief that one will not be punished or humiliated for speaking up, sharing ideas, raising concerns, or making mistakes. There are various threats to psychological safety in health professions education (HPE). This commentary applies Clark’s model of psychological safety (Inclusion Safety, Learner Safety, Contributor Safety, Challenger Safety) to five different HPE settings (classroom instructions, clinical training, simulation-based training, online instructions, interprofessional education). Setting-specific threats and strategies for enhancing psychological safety are discussed.
Gene mutation in diabetic patients with lung adenocarcinoma: a real-world retrospective cohort study
Authors: Yang Lei , Hong Yang , Zeng TingTing , Yue HongMei , Jiang DePeng
Published: January 2025

Purpose

The incidence of lung cancer is closely associated with diabetes; however, it remains unclear whether diabetes influences the genetic mutations present in lung cancer. Therefore, we will compare the genetic mutations in patients with lung adenocarcinoma (ADC) who have diabetes against those who do not.

Methods

We included 279 patients diagnosed with lung adenocarcinoma (143 with diabetes and 136 without diabetes) at the Second Affiliated Hospital of Chongqing Medical University between 2016 and 2023, and analyzed the clinical characteristics and genetic mutation profiles of all participants.

Results

In comparison to ADC patients without diabetes, those with diabetes exhibited a lower overall gene mutation rate (49.7% vs. 65.4%, P = 0.008). Female ADC patients demonstrated a higher total gene mutation rate and EGFR gene mutation rate than their male counterparts (49.3% vs. 66.9%, P = 0.003; 27.6% vs. 58.3%, P < 0.001, respectively), although their TP53 gene mutation rate was lower (8.6% vs. 2.4%, P = 0.027). ADC patients without a smoking history had a higher gene mutation rate and EGFR gene mutation rate than those with a smoking history (62.6% vs. 47.4%, P = 0.014; 51.6% vs. 22.7%, P < 0.001, respectively), but a lower KRAS gene mutation rate (4.4% vs. 14.4%, P = 0.003). Conversely, ADC patients with a drinking history had a lower EGFR gene mutation rate than those without (48% vs. 62.6%, P = 0.018; 31.0% vs. 47.5%, P = 0.007), yet a higher KRAS gene mutation rate (14.0% vs. 4.5%, P = 0.005). Univariate and multivariate linear regression analyses revealed that being female, having no smoking history, and being in phase II or IV of tumor stage were associated with gene mutation. Subgroup analysis indicated that the rate of gene mutation in male smoking lung adenocarcinoma patients with diabetes was significantly lower than in those without diabetes.

Conclusion

This retrospective study of real-world data suggests that patients with lung adenocarcinoma and diabetes may have a reduced likelihood of developing genetic mutations, particularly among male smokers. Furthermore, gender, smoking history, and tumor stage may be correlated with the presence of gene mutations.
Machine learning insights into early mortality risks for small cell lung cancer patients post-chemotherapy
Authors: Liang Min , Luo Fuyuan
Published: January 2025

Introduction

Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer, and chemotherapy remains a cornerstone of its management. However, the treatment is associated with significant risks, including heightened toxicity and early mortality. This study aimed to quantify the 90-day mortality rate post-chemotherapy in SCLC patients, identify associated features, and develop a predictive machine learning model.

Methods

This study utilized data from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2018) to identify prognostic features influencing early mortality in SCLC patients. Prognostic features were selected through univariate logistic regression and Lasso analyses. Predictive modeling was performed using advanced machine learning algorithms, including XGBoost, Multilayer Perceptron, K-Nearest Neighbor, and Random Forest. Additionally, traditional models, such as logistic regression and AJCC staging, were employed for comparison. Model performance was evaluated using key metrics, including the Area Under the Receiver Operating Characteristic Curve (AUC), calibration plots, the Kolmogorov–Smirnov (KS) statistic, and Decision Curve Analysis (DCA).

Results

Analysis of 12,500 eligible patients revealed 10 clinical features significantly impacting outcomes. The XGBoost model demonstrated superior discriminatory capability, achieving AUC scores of 0.95 in the training set and 0.78 in the validation set. It outperformed comparative models across all datasets, as evidenced by its AUC, KS score, calibration, and DCA results. Additionally, the model was integrated into a web-based platform to improve accessibility.

Conclusion

This study introduces a machine learning model alongside a web-based support system as critical resources for healthcare professionals, facilitating personalized clinical decision-making and enhancing treatment strategies for SCLC patients post-chemotherapy.
Deep learning–assisted diagnosis of acute mesenteric ischemia based on CT angiography images
Authors: Song Lei , Zhang Xuesong , Zhang Jian , Wu Jie , Wang Jinkai , Wang Feng
Published: January 2025

Purpose

Acute Mesenteric Ischemia (AMI) is a critical condition marked by restricted blood flow to the intestine, which can lead to tissue necrosis and fatal outcomes. We aimed to develop a deep learning (DL) model based on CT angiography (CTA) imaging and clinical data to diagnose AMI.

Methods

A retrospective study was conducted on 228 patients suspected of AMI, divided into training and test sets. Clinical data (medical history and laboratory indicators) was included in a multivariate logistic regression analysis to identify the independent factors associated with AMI and establish a clinical factors model. The arterial and venous CTA images were utilized to construct DL model. A Fusion Model was constructed by integrating clinical factors into the DL model. The performance of the models was assessed using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Results

Albumin and International Normalized Ratio (INR) were associated with AMI by univariate and multivariate logistic regression (P < 0.05). In the test set, the area under ROC curve (AUC) of the clinical factor model was 0.60 (sensitivity 0.47, specificity 0.86). The AUC of the DL model based on CTA images reached 0.90, which was significantly higher than the AUC values of the clinical factor model, as confirmed by the DeLong test (P < 0.05). The Fusion Model also showed exceptional performance in terms of AUC, accuracy, sensitivity, specificity, and precision, with values of 0.96, 0.94, 0.94, 0.95, and 0.98, respectively. DCA indicated that the Fusion Model provided a greater net benefit than those of models based solely on imaging and clinical information across the majority of the reasonable threshold probabilities.

Conclusion

The incorporation of CTA images and clinical information into the model markedly enhances the diagnostic accuracy and efficiency of AMI. This approach provides a reliable tool for the early diagnosis of AMI and the subsequent implementation of appropriate clinical intervention.
Comparative transcriptome analysis reveals molecular mechanisms of resistance in Chinese cabbage to Plasmodiophora brassicae pathotype 11
Authors: Qiu Yue , Zhang Jinhao , Deng Chunju , Yuan Jiasheng , Wang Bowen , Meng Han , Mohany Mohamed , Zeng Liting , Wei Lanfang , Ahmed Waqar , Ji Guanghai
Published: January 2025

Background and aims

Clubroot caused by the soilborne obligate parasite Plasmodiophora brassicae, is a devastating disease of Chinese cabbage and other crucifers. The innate diversity and adaptability of this pathogen pose significant challenges to effective control measures. However, the varied response mechanisms exhibited by hosts to pathotype 11 at a molecular level are still unclear.

Methods and results

This study investigated the resistance response and underlying molecular mechanism of two Chinese cabbage (Brassica rapa) varieties (JP and 83-1) to P. brassicae pathotype 11 through comparative transcriptome analysis and microscopic study. Results demonstrated that 14 days after inoculation (dai) is a critical time point of the infection process for resistant variety to inhibit the proliferation of P. brassica. Although the highly resistant variety JP did not exhibit a complete immune response to pathotype 11, it demonstrated a significant resistance level against P. brassicae pathotype 11 by restricting its proliferation in the xylem vessels. Microscopic analysis at 21 dai revealed that the resistant cultivar (JP) root structure remained largely unaffected, while the roots of the susceptible cultivar (83-1) exhibited significant tissue distortion and gall formation, underscoring the effectiveness of the resistance mechanisms. Comparative transcriptome analysis revealed substantial differences in the number and types of differentially expressed genes (DEGs) between the two cultivars, highlighting the key pathways involved in the resistance response. In the resistant cultivar (JP), a total of 9,433 DEGs were identified, with 4,211 up-regulated and 5,222 down-regulated. In contrast, the susceptible cultivar (83-1) exhibited 6,456 DEGs, with 2,781 up-regulated and 3,675 down-regulated. The resistant cultivar showed a pronounced activation of genes involved in hormone signaling, cell wall, secondary metabolism, redox state, and signaling process. Therefore, our speculation revolves around the potential resistant mechanism of this variety, which inhibits the proliferation of P. brassicae in the roots via secondary metabolites, cell wall, and ROS and also regulates physiological mechanisms mediated by plant hormones such as ABA to adapt to adverse environmental conditions such as water scarcity induced by the pathogen.

Conclusion

This study unveils the intricate defense mechanisms potentially activated within Chinese cabbage when confronted with P. brassicae pathotype 11, offering valuable insights for breeding programs and the development of novel strategies for managing clubroot disease in Brassica crops. Furthermore, this study highlights the pivotal role of host-specific molecular defense mechanisms that underlie resistance to P. brassicae pathotype 11.
Deciphering the fungal symphony: unveiling the fungal dynamics during the fermentation of traditional Chinese strong-flavor Daqu
Authors: Zhao Lina , Zhang Wenjing , Niu Yuting , Chen Xiaohan , Guo Jiuyang , Wu Ying , Li Xuan , Gu Shaobin
Published: January 2025

Daqu, a starter culture rich in microorganisms like bacteria and fungi, is central to vinification and liquor brewing, yet fungal contributions are often understudied. In this study, we used Illumina MiSeq sequencing to investigate the succession of fungal community during Chinese strong-flavor liquor fermentation. The results showed that the alpha and beta diversity of fungal community were significantly different during Daqu fermentation. The dominant phyla and genera are Ascomycota and Saccharomycopsis, respectively. Co-occurrence network analysis identified 10 keystone species during Daqu fermentation, displaying that the positive correlations (99.64%) dominated the fungal network. The redundancy analysis showed that moisture has the most significant influence on the Daqu fungal community. Concurrently, a robust association was observed between 10 keystone fungal genera and environmental parameters such as acidity and moisture. These findings not only elucidated the intricate dynamics of the fungal community succession and the interplays among fungi but also pinpointed the primary drivers of the fungal community and its keystone species during the Daqu fermentation process. Ultimately, this research presented novel perspectives for enhancing the quality and precision of liquor production by shedding light on the central role of keystone species in maintaining community stability and their adaptive responses to environmental stimuli.
Baseline liver fibrosis-4 score correlates to the progression of anxiety and cognitive impairment in patients with Parkinson’s disease
Authors: Cheng Yongqing , Chen Li , Zhu Honghong , Ge Yingchao , Li Lei , Guo Yan , Wang Xin , You Shuangfei , He Guojun , Xue Shouru
Published: January 2025

Background

Non-alcoholic fatty liver disease (NAFLD) or liver fibrosis may share similar pathophysiological features with Parkinson’s disease (PD), yet their correlation was unclear. This study aimed to explore their correlation between PD and liver fibrosis using the fibrosis-4 score (FIB-4) as a surrogate marker.

Methods

We analyzed Parkinson’s Progression Markers Initiative (PPMI) data and enrolled PD patients with comprehensive baseline and 5-year follow-up time-point clinical data. Participants were categorized based on FIB-4 levels to assess the association between FIB-4 scores and various clinical scales, controlling for potential confounders. Differences in the progression of clinical scales over five years were compared using generalized linear mixed models (GLMM).

Results

Baseline FIB-4 levels positively correlated to scores of baseline section III of the Unified-Parkinson Disease Rating Scale (UPDRS III) (r = 0.145, p = 0.017), Epworth Sleepiness Scale (EPSS) (r = 0.140, P = 0.022), Hopkins Verbal Learning Test (HVLT)-delayed recall (r = 0.128, P = 0.036) and HVLT-retention (r = 0.128, p = 0.036). GLMM analysis revealed an independent correlation between FIB-4 subgroup*time and several clinical scales including the State-trait Anxiety Inventory (STAI), Symbol Digit Modalities Test (SDMT), Semantic Fluency Test (SF), HVLT-total recall, and HVLT-delayed recall, with the high FIB-4 subgroup exhibiting a greater decline in these scores compared to the low FIB-4 subgroup (all p<0.05).

Conclusion

Elevated baseline FIB-4 correlated to more severe baseline daytime sleepiness, motor symptoms, and memory function in PD patients, along with a more rapid decline in cognitive functions such as executive function, information processing ability, and memory. Additionally, a high FIB-4 might confer a protective effect against anxiety.
Actors influencing cancer-related fatigue and the construction of a risk prediction model in lung cancer patients
Authors: Zhang Mei-Ning , Zhou Yi-Chen , Zeng Zhu , Zeng Cun-Liang , Hou Bo-Tao , Wu Gui-Rong , Jiao Qiao , Ma Dai-Yuan
Published: January 2025

Purpose

The paper aims to investigate the factors influencing cancer-related fatigue (CRF) in lung cancer patients and construct a CRF risk prediction model, providing effective intervention strategies for clinical medical staff.

Methods

This paper employs convenience sampling to select 400 lung cancer patients who visited a tertiary hospital in Dazhou, Sichuan Province, from January 2021 to January 2022. A questionnaire survey was conducted using the Revised Piper Fatigue Scale (PFS-R), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS) to collect data on patient demographics and sociological characteristics, disease-related information, physiological indicators, sleep quality, mental health, and other relevant factors. To explore the factors influencing CRF in lung cancer patients, single-factor analysis and multiple logistic regression analysis were performed. A CRF risk prediction model was then established, with its predictive performance and calibration evaluated using ROC curves.

Findings

The results of multivariate logistic regression analysis showed that gender, age, education level, living status, daily exercise, clinical stage, course of disease, treatment mode, chronic disease, BMI, hemoglobin, serum albumin, blood glucose, potassium concentration, magnesium concentration, PSQI score and HAD score were the influencing factors of CRF in lung cancer patients (P<0.05). The AUC of the model construction group and the model validation group were 0.863 and 0.838, respectively, and the results of Hosmer-Lemeshow fit test showed that χ2 = 7.540, P=0.378>0.05 of the model construction group and χ2 = 8.120, P=0.320>0.05 of the model validation group indicated that the model had high prediction accuracy.

Originality/value

The risk prediction model for CRF holds significant clinical value. It can help medical staff to promptly identify high-risk patients, develop personalized intervention strategies, alleviate fatigue symptoms, and improve overall patient quality of life.
The role of radiotherapy in small cell lung cancer: a new paradigm for the radiation oncologist
Authors: Borghetti Paolo , Ramella Sara , Ricardi Umberto
Published: January 2025

Small cell lung cancer (SCLC) is an aggressive tumor that presents in most cases as a metastatic disease. The prognosis is poor, but the advent of immunotherapy has rekindled hopes for outcomes. Radiotherapy plays a crucial role in this oncological scenario, and there are still many open questions on the correct application of radiotherapy and its integration with chemotherapy and immunotherapy. These issues are of great interest to the oncology community; among these, in particular, there are the choice of optimal fractionation and total dose for thoracic radiotherapy in limited SCLC and its biological implications, the role of prophylactic cranial irradiation and thoracic consolidation in the context of modern treatments with chemoimmunotherapy in extensive SCLC, the role and indications of stereotactic radiotherapy in oligometastatic scenario and finally the complex clinical and multidisciplinary management of SCLC. This perspective article aims to describe the strengths and limitations of the role of radiotherapy in SCLC, highlighting the critical role of radiotherapy and the radiation oncologist, with the need to implement specific knowledge and skills on SCLC.