bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives on telemedicine across urban, rural and remote areas in the Philippines during the COVID-19 pandemic
Authors: Fabian Noleen , De Mesa Regine Ynez , Tan-Lim Carol , Sandigan Gillian , Lopez Johanna , Loreche Arianna Maever , Dans Leonila , Benzon Zharie , Zabala Herbert , Sanchez Josephine , Sundiang Nanette , Rey Mia , Dans Antonio
Published: August 2024

Objectives

This study explored attitudes, subjective norms, and perceived behavioural control of participants across urban, rural and remote settings and examined intention-to-use telemedicine (defined in this study as remote patient–clinician consultations) during the COVID-19 pandemic.

Methods

This is a cross-sectional study. 12 focus group discussions were conducted with 60 diverse telemedicine user and non-user participants across 3 study settings. Analysis of responses was done to understand the attitudes, norms and perceived behavioural control of participants. This explored the relationship between the aforementioned factors and intention to use.

Results

Both users and non-users of telemedicine relayed that the benefits of telemedicine include protection from COVID-19 exposure, decreased out-of-pocket expenses and better work–life balance. Both groups also relayed perceived barriers to telemedicine. Users from the urban site relayed that the lack of preferred physicians discouraged use. Users from the rural and remote sites were concerned about spending on resources (ie, compatible smartphones) to access telemedicine. Non-users from all three sites mentioned that they would not try telemedicine if they felt overwhelmed prior to access.

Discussion

First-hand experiences, peer promotions, and maximising resource support instil hope that telemedicine can help people gain more access to healthcare. However, utilisation will remain low if patients feel overwhelmed by the behavioural modifications and material resources needed to access telemedicine. Boosting infrastructure must come with improving confidence and trust among people.

Conclusion

Sustainable access beyond the pandemic requires an understanding of factors that prevent usage. Sufficient investment in infrastructure and other related resources is needed if telemedicine will be used to address inequities in healthcare access, especially in rural and remote areas.
Estimation and determinants of direct hospitalisation cost for coronary heart disease in a low-middle-income country: evidence from a nationwide study in Iranian hospitals
Authors: Kazemi Zohreh , Emamgholipour Sara , Daroudi Rajabali , Yunesian Masud , Hassanvand Mohammad Sadegh
Published: August 2024

Background

Coronary heart disease (CHD) is the most prevalent type of cardiovascular disease in Iran. This study aims to investigate the estimation and determinants of direct hospitalisation cost for patients with CHD in Iranian hospitals.

Methods

We identified patients with CHD in Iran in 2019–2020. Data were gathered from the Iran Health Insurance Organisation information systems and the Ministry of Health and Medical Education. This was a cross-sectional prevalence-based study. Generalised linear models were used to find the determinants of hospitalisation cost for patients with CHD. A total of 86 834 patients suffering from CHD were studied.

Results

Mean hospitalisation cost per CHD patient was US$382.90±US$500.72 while the mean daily hospitalisation cost per CHD patient was US$89.71±US$89.99. In-hospital mortality of CHD was 2.52%. Hospitalisation accommodation and medications had the highest share of hospitalisation costs (25.59% and 22.63%, respectively). Men spent 1.12 (95% CI 1.11 to 1.13) times more on hospitalisation costs compared with women, and individuals aged 60 to 69 had hospitalisation costs 1.04 (95% CI 1.02 to 1.06) times higher than those in the 0–49 age range. Patients insured by the Iranian Fund have significantly higher costs 1.17 (95% CI 1.14 to 1.19) than the Rural fund. Hospitalisation costs for patients with CHD who received surgery and angiography were significantly 2.36 (95% CI 2.30 to 2.43) times higher than for patients who did not undergo surgery and angiography.

Conclusion

Applying CHD prevention strategies for men and the middle-aged population (50–70 years) is strongly recommended. Prudent use and prescribing of medications will be helpful to reduce hospitalisation cost.
Safety and efficacy of drug-eluting stents versus heparin-bonded stents in treatment of femoropopliteal peripheral artery disease: study protocol for a multicentre, prospective randomised controlled trial in China (ELITE trial)
Authors: Qi Yuhan , Zhang Huawei , Zhao Jichun , Yuan Ding , Wang Jiarong , Ge Jinting , Huang Bin , Weng Chengxin , Wang Tiehao
Published: August 2024

Introduction

Endovascular therapy has emerged as a prominent strategy for managing femoropopliteal peripheral artery disease, offering acceptable safety and efficacy compared with open surgical bypass. Both paclitaxel-eluting stents and heparin-bonded covered stents have exhibited enhanced clinical outcomes compared with bare metal stents. However, there is currently a lack of level I evidence comparing the safety and efficacy of paclitaxel-eluting stents and heparin-bonded covered stents. Therefore, the primary objective of this study is to systematically evaluate the efficacy and safety outcomes of these two types of stents.

Methods and analysis

The ELITE trial is a prospective, multicentre, parallel, randomised controlled trial. A total of 450 patients will be recruited. The primary endpoints of the study include primary patency at 1 year post-index procedure.

Ethics and dissemination

Ethical approval for this study was obtained from the Ethics Committee of West China Hospital of Sichuan University (approval number: 2023–1186). The results will be submitted to a major clinical journal for peer review and publication.

Trial registration

ELITE trial was registered on 27 September 2023 in the Chinese Clinical Trials Registry (ChiCTR2300076236).
Diagnostic prediction models for bacterial meningitis in children with a suspected central nervous system infection: a systematic review and prospective validation study
Authors: Groeneveld Nina S , Bijlsma Merijn W , van Zeggeren Ingeborg E , Staal Steven L , Tanck Michael W T , van de Beek Diederik , Brouwer Matthijs C
Published: August 2024

Objectives

Diagnostic prediction models exist to assess the probability of bacterial meningitis (BM) in paediatric patients with suspected meningitis. To evaluate the diagnostic accuracy of these models in a broad population of children suspected of a central nervous system (CNS) infection, we performed external validation.

Methods

We performed a systematic literature review in Medline to identify articles on the development, refinement or validation of a prediction model for BM, and validated these models in a prospective cohort of children aged 0–18 years old suspected of a CNS infection.

Primary and secondary outcome measures

We calculated sensitivity, specificity, predictive values, the area under the receiver operating characteristic curve (AUC) and evaluated calibration of the models for diagnosis of BM.

Results

In total, 23 prediction models were validated in a cohort of 450 patients suspected of a CNS infection included between 2012 and 2015. In 75 patients (17%), the final diagnosis was a CNS infection including 30 with BM (7%). AUCs ranged from 0.69 to 0.94 (median 0.83, interquartile range [IQR] 0.79–0.87) overall, from 0.74 to 0.96 (median 0.89, IQR 0.82–0.92) in children aged ≥28 days and from 0.58 to 0.91 (median 0.79, IQR 0.75–0.82) in neonates.

Conclusions

Prediction models show good to excellent test characteristics for excluding BM in children and can be of help in the diagnostic workup of paediatric patients with a suspected CNS infection, but cannot replace a thorough history, physical examination and ancillary testing.
Does an expanded allied health student training programme in regional New South Wales (Australia) result in a positive social return on investment? A protocol for a single-university education-based economic evaluation
Authors: Nott Melissa , Green Elyce , Anderson Micheal , French Louise , Lander Chelsea , McAleer Rachael , Brusco Natasha
Published: August 2024

Introduction

20 years ago, health professional student placements in rural areas of Australia were identified as an important rural recruitment strategy and funding priority. Since then, there has been a growing body of research investigating the value, impact, barriers and facilitators of student placements in rural areas of Australia. Charles Sturt University, Three Rivers Department of Rural Health, was recently awarded an Australian Government grant to expand their Rural Health Multidisciplinary Training (RHMT) programme, designed to increase multi-disciplinary student placements in rural areas of New South Wales (NSW), Australia. The aim of this study is to determine if the expanded RHMT has a positive social return on investment (SROI).

Methods and analyses

The RHMT Programme will expand into the Forbes/Parkes/Lachlan local government areas of NSW where there is a population of 21 004 people, including 3743 First Nations peoples. Data collection includes collecting programme outputs, programme costs and conducting surveys and interviews with students, host organisations, supervisors and community members including First Nations peoples. The SROI will quantify the ‘investment’ required to implement the RHMT programme, as well as the ‘social return’ on the RHMT programme from the student, organisational, supervisor and community perspectives. The SROI will compare the combined cost with the combined return, from a societal perspective, including a 3-year time horizon, with cost data presented in $A 2024/25.

Discussion

The findings of this SROI study may influence future Australian government investment in RHMT as a mechanism for supporting rural allied health recruitment and for investing in the local rural economy.

Ethics and dissemination

This study has been approved by the Charles Sturt University Human Research Ethics Committee (#H23589) and the Aboriginal Health and Medical Research Council of New South Wales (#2130/23). Results will be disseminated via a peer-review journal publication, as well as conference presentations.
Causal evidence of the association between green and blue spaces (GBS) and maternal and neonatal health: a systematic review and meta-analysis protocol
Authors: Khalaf Rukun K.S. , Akaraci Selin , Baldwin Faye D. , Geary Rebecca S. , Kolamunnage-Dona Ruwanthi , Hunter Ruth F. , Rodgers Sarah E.
Published: August 2024

Introduction

Previous systematic reviews investigating the effects of green and blue space (GBS) on maternal and neonatal health have mainly focused on cross-sectional evidence, limiting potential causal inferences. The last review on the topic was published in January 2024. This review focused on residential greenness effects and neonatal health only but did not include other green/blue space measures, or maternal health outcomes. This review also only included papers published up to June 2023; discounting the 15 studies that have been published since. Thus, this study will capture the growing number of studies that generate causal evidence and aims to investigate the association between GBS and maternal and/or neonatal health.

Methods and analysis

The study protocol was developed with reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review will include study designs such as experiments, quasi-experiments, longitudinal studies and more. The study independent variable must be a GBS, green space and/or blue space measure. Eligible maternal health outcomes are those reported during pregnancy and up to 1 year after pregnancy. Neonatal health outcomes are limited to neonates no older than 28 days. A total of seven online databases will be searched: Medline, Scopus, Web of Science, PsycInfo, Embase, Environment Complete, and Maternity and Infant Care Database. Abstract and full-text screenings will be undertaken by three reviewers. Risk of bias assessment will be conducted based on the Risk of Bias in Non-randomized Studies-of Exposure framework.

A narrative synthesis will be undertaken. If sufficiently comparable studies are identified, meta-analyses using random effects models will be conducted. We will explore heterogeneity using the I2test.

Ethics and dissemination

Ethical approval is not required as all the data will be derived from published primary studies that have already obtained ethical permissions. The findings will be disseminated through relevant conferences and peer-reviewed publications.

PROSPERO registration number

CRD42023396372.
Analyses of the association betweenHelicobacter pyloriantibody titre and pathogenicity before and after eradication: results of the Kyushu and Okinawa population study, a retrospective observational cohort study
Authors: Yamasaki Sho , Murata Masayuki , Ohta Azusa , Matsumoto Yuji , Ikezaki Hiroaki , Furusyo Norihiro
Published: August 2024

Objectives

To assess the utility ofHelicobacter pyloriantibody testing, we evaluated the correlation between theH. pyloriantibody titre andH. pylori-associated pathogenicity and the changes in antibody titre afterH. pylorieradication therapy.

Design

A retrospective observational cohort study.

Setting and participants

From 2004 to 2016, medical check-ups were performed in different regions of Japan. In total, 324 subjects infected withH. pyloriwho receivedH. pylorieradication therapy were enrolled;H. pyloriwas eradicated in 266 of these subjects. We examined the associations betweenH. pyloriantibody titre with pepsinogen and the presence or absence ofH. pylori-associated pathogenic proteins, such as cytotoxin-associated gene A and vacuolating cytotoxin gene A, at baseline and afterH. pylorieradication therapy.

Results

TheH.pyloriantibody titre showed a positive correlation with pepsinogen II and a negative correlation with the pepsinogen I/II ratio. Moreover, theH.pyloriantibody titre significantly correlated with the positive rates ofH. pylori-associated pathogenic protein before eradication therapy. Antibody titres decreased after eradication, the pepsinogen I/II ratio increased and theH. pylori-associated pathogenic protein-positive rate decreased in patients with successful eradication. The determination of eradication using the decline in antibody titre 6 months after eradication therapy was useful (area under the receiver operating characteristic curve: 0.98).

Conclusions

Our data indicate that theH. pyloriantibody titre may represent the degree of pathogenicity. TheH. pyloriantibody titre was associated with attenuation of pathogenicity in patients withH. pylorieradication, indicating the clinical utility ofH. pyloriantibody testing.
Comparative effect of different mindfulness-based intervention types and deliveries on depression in patients with breast cancer: a protocol for a systematic review and network meta-analysis
Authors: Zhang Deqi , Zhao Wenxin , Yuan Lin , Chen Qiang , Xu Qiling , Jiang Xiaoyu , Bi Hongyan
Published: August 2024

Introduction

Breast cancer has become the most common cancer worldwide. Various types of mindfulness-based interventions (e.g., mindfulness-based cognitive therapy, mindfulness-based stress reduction) have been conducted in different delivery methods (including face to face and internet delivered) to help patients with breast cancer mitigate their depression. However, at present, there are no studies that compare the effectiveness of all these types and deliveries of mindfulness-based interventions. Therefore, this protocol aims to conduct a systematic review and network meta-analysis to assess the effectiveness of various types and deliveries of mindfulness-based interventions in mitigating depression in patients with breast cancer.

Methods

This protocol is according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The electronic databases, including PubMed, Web of Science, the Cochrane Library, Embase, Google Scholar, The China National Knowledge Infrastructure and OpenGrey, will be comprehensively retrieved for related randomised controlled trials (RCTs) from inception to December 2023. Two reviewers will independently assess the risk of bias using the Cochrane Risk of Bias Tool for Randomised Trials 2.0 (RoB 2.0). The network meta-analysis will be performed using the STATA V.16.0, and the assessment of heterogeneity, inconsistency, publication bias, evidence quality, subgroup analyses and sensitivity analyses will be conducted.

Ethics and dissemination

This protocol does not require approval from an ethics committee as it is based on previous research findings. The results will be disseminated via peer-reviewed publications.

PROSPERO registration number

CRD42024495996.
Is there an association between serum 25-hydroxyvitamin D concentrations and obstructive sleep apnoea? A cross-sectional analysis of NHANES 2007–2008 data
Authors: Li Qingyuan , Yao Jun , Duan Ran , Feng Tong
Published: August 2024

Objectives

The study aimed to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) concentrations and obstructive sleep apnoea (OSA) and to assess the confounding effect of body mass index (BMI) on this relationship.

Design

This was a cross-sectional analysis using data from the 2007–08 National Health and Nutrition Examination Survey (NHANES).

Setting

Data were sourced from NHANES, a continuous survey sponsored by the Centres for Disease Control and Prevention, covering residents from 15 urban areas in the United States of America(USA).

Participants

The study included 4901 participants aged 16 years and older who had completed 25(OH)D data and responses to the OSA questionnaire.

Main exposure measure

Serum 25(OH)D concentrations were measured using liquid chromatography-tandem mass spectrometry.

Main outcome measure

The primary outcome was the self-reported diagnosis of OSA from questionnaires.

Results

After adjusting for age, sex and race (model 1), a significant negative association was observed between 25(OH)D and OSA (β=−3.21, 95% CI: −6.17 to –0.26). However, this association was no longer significant after further adjustment for BMI (model 2) (β=1.47, 95% CI: −1.48, 4.42). In the fully adjusted model (model 3), there was no significant association between 25(OH)D and OSA (β=0.92, 95% CI: −1.93, 3.76). Subgroup analyses stratified by sex, age, race or BMI also revealed no significant associations between 25(OH)D and OSA.

Conclusions

The study found no significant association between 25(OH)D and OSA. The observed correlation between lower levels of 25(OH)D and OSA may be due to confounding factors, such as higher BMI in the OSA group. Therefore, improving obesity management in OSA patients may be necessary to prevent 25(OH)D insufficiency. This underscores the importance of comprehensive management of both OSA and obesity to promote optimal health outcomes.
VIVALDI ASCOT and Ethnography Study: protocol for a mixed-methods longitudinal study to evaluate the impact of COVID-19 and other respiratory infection outbreaks on care home residents’ quality of life and psychosocial well-being
Authors: Bertini Lavinia , Schmidt-Renfree Nicola , Blackstone James , Stirrup Oliver , Adams Natalie , Cullen-Stephenson Iona , Krutikov Maria , Leiser Ruth , Goscé Lara , Henderson Catherine , Flowers Paul , Shallcross Laura , Cassell Jackie A , Cadar Dorina
Published: August 2024

Introduction

Older adults in care homes experienced some of the highest rates of mortality from SARS-CoV-2 globally and were subjected to strict and lengthy non-pharmaceutical interventions, which severely impacted their daily lives. The VIVALDI ASCOT and Ethnography Study aims to assess the impact of respiratory outbreaks on care home residents’ quality of life, psychological well-being, loneliness, functional ability and use of space. This study is linked to the VIVALDI-CT, a randomised controlled trial of staff’s asymptomatic testing and sickness payment support in care homes (ISRCTN13296529).

Methods and analysis

This is a mixed-methods, longitudinal study of care home residents (65+) in Southeast England. Group 1—exposed includes residents from care homes with a recent COVID-19 or other respiratory infection outbreak. Group 2—non-exposed includes residents from care homes without a recent outbreak. The study has two components: (a) a mixed-methods longitudinal face-to-face interviews with 100 residents (n=50 from group 1 and n=50 from group 2) to assess the impact of outbreaks on residents’ quality of life, psychological well-being, loneliness, functional ability and use of space at time 1 (study baseline) and time 2 (at 3–4 weeks after the first visit); (b) ethnographic observations in communal spaces of up to 10 care homes to understand how outbreaks and related restrictions to the use of space and social activities impact residents’ well-being. The study will interview only care home residents who have the mental capacity to consent. Data will be compared and integrated to gain a more comprehensive understanding of the impact of outbreaks on residents’ quality of life and well-being.

Ethics and dissemination

The VIVALDI ASCOT and Ethnography Study obtained ethical approval from the Health Research Authority (HRA) Social Care REC (24/IEC08/0001). Only residents with the capacity to consent will be included in the study. Findings will be published in scientific journals.
Density matrix renormalization group study of the interacting Kitaev chain with quasi-periodic disorder
Authors: Decker K. S. C. , Karrasch C.
Published: August 2024

We document the ground state phase diagram of the one-dimensional Kitaev chain with quasi-periodic disorder in the presence of two-body interactions. Our data were obtained for systems of $$L=1000$$

L
=
1000

sites using large-scale density-matrix renormalization group numerics and is benchmarked against known results for the clean system. We demonstrate that moderate quasi-periodic disorder stabilizes the topological phase both for repulsive and attractive interactions. For larger disorder strengths, the system features re-entrance behavior and multiple phase transitions.

Graphical abstract

Phase diagram as a function of the chemical potential and the disorder strength for repulsive interactions
Experiences from Running a Voice-Based Education Platform for Children and Teachers with Visual Impairments
Authors: Poddar Roshni , Naik Tarini , Punnam Manikanteswar , Chourasia Kavyansh , Pandurangan Rajeswari , Paali Rajesh S , Bhat Nagarathna R , Biradar Bhagyashree , Deshpande Venkatesh , Ghosh Devidatta , Chaudhuri Sudipta Ray , Chakraborty Dipanjan , Prakash Amit , Swaminathan Manohar
Published: August 2024

India has the world’s largest population of children with vision impairments (CVIs), a group facing significant educational barriers including inadequate accessible resources, limited school access, and a shortage of trained teachers. The authors from four different organizations including a non-profit dedicated to enhancing STEM education for CVIs through interactive, play-based learning and teacher training have collaborated to create SEEDS, Scalable Educational Experiences with Digital Scaffolding. This is a voice-based platform for educational experiences delivery, featuring an Android Teacher App, an Interactive Voice Response (IVR) system, and a comprehensive website for content management. The Teacher app facilitates educational experiences via group calls with students, while the IVR system offers students independent access to educational content using feature phones. To assess effectiveness and usability of SEEDS among students and teachers, we conducted a mixed-methods study involving 29 visually impaired students across five schools and five facilitators (3 sighted and 2 visually impaired) from
Vision Empower Trust
. Despite challenges like internet connectivity issues causing call drops, the study highlighted strong student engagement and a collaborative environment among facilitators. By open-sourcing the SEEDS codebase, we aim to improve the platform and increase its adoption among teachers in schools for CVIs across India and beyond.
The Operation Window of Lithium Iron Phosphate/Graphite Cells Affects their Lifetime
Authors: Zsoldos Eniko S. , Thompson Daphne T. , Black William , Azam Saad M. , Dahn J. R.
Published: August 2024

Lithium iron phosphate (LFP) battery cells are ubiquitous in electric vehicles and stationary energy storage because they are cheap and have a long lifetime. This work compares LFP/graphite pouch cells undergoing charge-discharge cycles over five state of charge (SOC) windows (0%–25%, 0%–60%, 0%–80%, 0%–100%, and 75%–100%). Cycling LFP cells across a lower average SOC results in less capacity fade than cycling across a higher average SOC, regardless of depth of discharge. The primary capacity fade mechanism is lithium inventory loss due to: lithiated graphite reactivity with electrolyte, which increases incrementally with SOC, and lithium alkoxide species causing iron dissolution and deposition on the negative electrode at high SOC which further accelerates lithium inventory loss. Our results show that even low voltage LFP systems (3.65 V) have a tradeoff between average SOC and lifetime. Operating LFP cells at lower average SOC can extend their lifetime substantially in both EV and grid storage applications.
A Fast Matrix Solver for Linear Boundary-Value Problem in the PEM Fuel Cell Impedance Model
Authors: Kulikovsky Andrei
Published: August 2024

A core physics-based model for PEM fuel cell impedance reduces to the numerical solution of a boundary value problem for two coupled, linear, complex–valued ordinary differential Eqs. with variable coefficients. We report a matrix formulation of a previously developed recurrent method for the fast numerical solution of this problem. This formulation does not require iterations and it utilizes only elementary functions and 4 × 4 matrix products, resulting in one to two orders of magnitude faster code compared to the standard Python boundary–value problem solver. This significantly improves the computational speed of the physics-based impedance model, making it competitive with the popular equivalent circuit modeling approach. The numerical calculation of cell impedance is demonstrated based on the model that includes proton transport in the catalyst layer and oxygen transport in the catalyst and gas-diffusion layers. Least–squares fitting of a real experimental spectrum shows that the matrix solver returns the cell transport parameters 50 times faster than the classic boundary–value problem solver.
Inclusion of genital, sexual, and gender diversity in human reproductive teaching: impact on student experience and recommendations for tertiary educators
Authors: Fimognari Nicholas , Kardol Leaf R. , O’Shannassy Terese , Sanders Katherine A. , Smith Jeremy T. , Wyrwoll Caitlin S.
Published: August 2024

We outline the teaching innovations that we have implemented to improve inclusion of diversity in reproductive biology and physiology contexts. This includes improved representation of genital, sexual, and gender diversity considerations in the curriculum. There is a critical need for these innovations as how we teach fundamentally shapes the understanding of our future medical and health professionals and researchers and thus influences the quality of future medical care and research.
“All of us are capable, and all of us can be scientists.” The impact of Scientist Spotlight assignments with undergraduates in physiology courses
Authors: Ovid Dax , Rose Acosta-Parra Ashley , Alemayehu Arsema , Francisco Gomez Jacob , Tran Dathan , Tripp Brie
Published: August 2024

Scientist Spotlights significantly enhance undergraduate students’ feelings of inclusion and learning in undergraduate physiology courses at an emerging Hispanic-serving institution. By engaging with assignments featuring counterstereotypical scientists, students in both majors and nonmajors physiology courses shifted in their relatability to and descriptions of scientists. These results suggest that an inclusive curriculum, combined with supportive instructor practices, can positively impact student success and representation in physiology education.
Stream Quality and Benthic Macroinvertebrate Diversity in the Badeye Area, Logone Occidental Province, Southwestern Chad
Authors: Theophile Djikoloum Beosso , Richard Akwanjoh Seino , Norbert Tchamadeu Ngameni
Published: August 2024

The aim of this study of benthic macroinvertebrates in the southwestern canton of Badeye in Chad was to analyze the community structure in relation to the physicochemical quality of water in the Man baptem tributary. A total of 4,012 benthic macroinvertebrates were identified and counted in 38 families. Arthropods were the most diverse, with 35 families and the most abundant (92.32%) of the total, followed by molluscs (6.65%) and annelids (1.02%). Insects predominated at all sampling stations (89.40%), followed by Gastropoda (6.75%), Malacostracans (2.85%), Hirudinea (0.57%), and Oligochaetes (0.45%). The preponderance of the Chironomidae, Psychodidae, and Physidae families in station A3 implies that the water at this station is of poor quality compared with the other 3 stations. The Shannon–Weaver and Pielou indices are higher at station A3, confirming some of the values of the physicochemical parameters at this station. In general, the four sampling stations are diverse. The abundance of certain benthic groups such as Diptera (Chironomidae) in the Man baptem tributary shows that this watercourse is subject to anthropogenic disturbance.
Cardiopulmonary Exercise Testing‐Guided Exercise Therapy in Hypertensive Patients: A Single Center Study
Authors: Lu Qin , Lu Jingjing , Li Che , Huang Ping , Jiang Fenfen , Zhao Xia , Zhang Jianqin , Huang Yi , Chu Zhenliang
Published: August 2024

Objective: To observe the effects of cardiac rehabilitation guided by cardiopulmonary exercise testing (CPET) on cardiorespiratory reserve function, blood pressure, blood pressure variability, and lipid metabolism in patients with hypertension.

Methods: A randomized trial enrolled 67 Grade 1 hypertensive patients on antihypertensive drugs, divided into conventional (n = 35) and CPET (n = 32) groups. Antihypertensive drugs were not adjusted in both groups during the study period. Blood pressure, cardiorespiratory indicators, lipid profile, and BMI were assessed pre/post 12 weeks.

Results: Postintervention, the CPET group exhibited significantly lower blood pressure levels and improved cardiac indicators compared to the conventional group (p < 0.05). CPET group showed greater improvements in cardiorespiratory endurance indicators (p < 0.05). The cardiorespiratory endurance indicators showed significantly greater increases in the CPET group compared to the conventional group (p < 0.05). Low‐density lipoprotein cholesterol (LDL‐C), total cholesterol (TC), triglycerides (TG), and body mass index (BMI) were significantly lower in the CPET group (p < 0.05).

Conclusion: In addition to drug treatment, cardiac rehabilitation guided by CPET can effectively improve blood pressure control, reduce blood pressure variability, improve cardiorespiratory function and lipid metabolism, and increase exercise endurance in patients with Grade 1 hypertension. Its efficacy is clear and safe, with clinical value for promotion.
Circulating Gastric Cancer Stem Cells as Blood Screening and Prognosis Factor in Gastric Cancer
Authors: Becerril-Rico Jared , Grandvallet-Contreras Julian , Ruíz-León M. Patricia , Dorantes-Cano Sebastián , Ramírez-Vidal Lizbeth , Tinajero-Rodríguez José M. , Ortiz-Sánchez Elizabeth
Published: August 2024

Gastric cancer (GC) is the fourth leading cause of cancer‐related death, associated with late diagnosis and treatment resistance. Currently, screening tests for GC are not cost‐effective or have low accuracy. Previously, we described an extended phenotype of gastric cancer stem cells (GCSCs; CD24+CD44+CD54+EpCAM+) that is associated with metastasis and tumor stage in GC patients. The goal of the current research is to evaluate the presence of these GCSCs in the peripheral blood of GC patients and healthy volunteers. A total of 73 blood samples were collected from 32 GC patients and 41 healthy volunteers. After peripheral blood mononuclear cell (PBMC) extraction, multiparametric flow cytometry was performed looking for GCSCs. Using clustering data through artificial intelligence (AI), we defined high/low levels of circulating GCSCs (cGCSCs) and proceeded to evaluate its association with clinical and prognostic variables. Finally, a diagnostic test analysis was performed evaluating patients and healthy volunteers. We found that cGCSCs are present in most GC patients with a mean concentration of 0.48%. The AI clustering showed two groups with different cGCSC levels and clinical characteristics. Through statistical analysis, we confirmed the association between cGCSC levels and lymph node metastasis, distant metastasis, and overall survival. The diagnostic test analysis showed sensibility, specificity, and area under the curve (AUC) of 83%, 95%, and 0.911, respectively. Our results suggest that the assessment of cGCSCs CD24+CD44+CD54+EpCAM+ could be a potential noninvasive test, with prognostic value, as well as highly sensitive and specific for screening or diagnosis of GC; however, a larger scale study will be necessary to confirm this.
Table S1 from Estrogen Receptor Blockade Potentiates Immunotherapy for Liver Metastases by Altering the Liver Immunosuppressive Microenvironment
Authors: Benslimane Yasmine , Amalfi Kevin , Lapin Sara , Perrino Stephanie , Brodt Pnina
Published: August 2024

Immunofluorescence staining antibodies.
Figure S5 from Estrogen Receptor Blockade Potentiates Immunotherapy for Liver Metastases by Altering the Liver Immunosuppressive Microenvironment
Authors: Benslimane Yasmine , Amalfi Kevin , Lapin Sara , Perrino Stephanie , Brodt Pnina
Published: August 2024

Macrophages analyses. Shown in (a) are the M1:M2 macrophages ratio analysis results using additional CD38 marker (n=3-4) and (b) TNF-alpha for M1-like macrophages characterization, and the use of the additional OVX+E2 experimental group which shows a reverse trend upon estrogen supplementation compared to the OVX group (n=3-4). Shown in (c) are the macrophages flow cytometry analysis results in FC1199 pancreatic liver metastasis model at Day 12 post-tumor injection (n=4).
Figure 5 from The Tumor Microbiome as a Predictor of Outcomes in Patients with Metastatic Melanoma Treated with Immune Checkpoint Inhibitors
Authors: Dravillas Caroline E. , Coleman Samuel S. , Hoyd Rebecca , Caryotakis Griffin , Denko Louis , Chan Carlos H.F. , Churchman Michelle L. , Denko Nicholas , Dodd Rebecca D. , Eljilany Islam , Hardikar Sheetal , Husain Marium , Ikeguchi Alexandra P. , Jin Ning , Ma Qin , McCarter Martin D. , Osman Afaf E.G. , Robinson Lary A. , Singer Eric A. , Tinoco Gabriel , Ulrich Cornelia M. , Zakharia Yousef , Spakowicz Daniel , Tarhini Ahmad A. , Tan Aik Choon
Published: August 2024

Prediction of response using gene expression and microbes. Mann–Whitney comparisons of the mean AUROC values from random forest model comparisons.
Data from The Tumor Microbiome as a Predictor of Outcomes in Patients with Metastatic Melanoma Treated with Immune Checkpoint Inhibitors
Authors: Dravillas Caroline E. , Coleman Samuel S. , Hoyd Rebecca , Caryotakis Griffin , Denko Louis , Chan Carlos H.F. , Churchman Michelle L. , Denko Nicholas , Dodd Rebecca D. , Eljilany Islam , Hardikar Sheetal , Husain Marium , Ikeguchi Alexandra P. , Jin Ning , Ma Qin , McCarter Martin D. , Osman Afaf E.G. , Robinson Lary A. , Singer Eric A. , Tinoco Gabriel , Ulrich Cornelia M. , Zakharia Yousef , Spakowicz Daniel , Tarhini Ahmad A. , Tan Aik Choon
Published: August 2024

Abstract
Emerging evidence supports the important role of the tumor microbiome in oncogenesis, cancer immune phenotype, cancer progression, and treatment outcomes in many malignancies. In this study, we investigated the metastatic melanoma tumor microbiome and its potential roles in association with clinical outcomes, such as survival, in patients with metastatic disease treated with immune checkpoint inhibitors (ICI). Baseline tumor samples were collected from 71 patients with metastatic melanoma before treatment with ICIs. Bulk RNA sequencing (RNA-seq) was conducted on the formalin-fixed, paraffin-embedded and fresh frozen tumor samples. Durable clinical benefit (primary clinical endpoint) following ICIs was defined as overall survival >24 months and no change to the primary drug regimen (responders). We processed RNA-seq reads to carefully identify exogenous sequences using the {exotic} tool. The age of the 71 patients with metastatic melanoma ranged from 24 to 83 years, 59% were male, and 55% survived >24 months following the initiation of ICI treatment. Exogenous taxa were identified in the tumor RNA-seq, including bacteria, fungi, and viruses. We found differences in gene expression and microbe abundances in immunotherapy-responsive versus nonresponsive tumors. Responders showed significant enrichment of bacteriophages in the phylum Uroviricota, and nonresponders showed enrichment of several bacteria, including Campylobacter jejuni. These microbes correlated with immune-related gene expression signatures. Finally, we found that models for predicting prolonged survival with immunotherapy using both microbe abundances and gene expression outperformed models using either dataset alone. Our findings warrant further investigation and potentially support therapeutic strategies to modify the tumor microbiome in order to improve treatment outcomes with ICIs.
Significance:
We analyzed the tumor microbiome and interactions with genes and pathways in metastatic melanoma treated with immunotherapy and identified several microbes associated with immunotherapy response and immune-related gene expression signatures. Machine learning models that combined microbe abundances and gene expression outperformed models using either dataset alone in predicting immunotherapy responses.
Loss of STK11 Suppresses Lipid Metabolism and Attenuates KRAS-Induced Immunogenicity in Patients with Non–Small Cell Lung Cancer
Authors: Principe Daniel R. , Pasquinelli Mary M. , Nguyen Ryan H. , Munshi Hidayatullah G. , Hulbert Alicia , Aissa Alexandre F. , Weinberg Frank
Published: August 2024

As many as 30% of the patients with non–small cell lung cancer harbor oncogenic KRAS mutations, which leads to extensive remodeling of the tumor immune microenvironment. Although co-mutations in several genes have prognostic relevance in KRAS-mutated patients, their effect on tumor immunogenicity are poorly understood. In the present study, a total of 189 patients with non–small cell lung cancer underwent a standardized analysis including IHC, whole-exome DNA sequencing, and whole-transcriptome RNA sequencing. Patients with activating KRAS mutations demonstrated a significant increase in PDL1 expression and CD8+ T-cell infiltration. Both were increased in the presence of a co-occurring TP53 mutation and lost with STK11 co-mutation. Subsequent genomic analysis demonstrated that KRAS/TP53 co-mutated tumors had a significant decrease in the expression of glycolysis-associated genes and an increase in several genes involved in lipid metabolism, notably lipoprotein lipase, low-density lipoprotein receptor, and LDLRAD4. Conversely, in the immune-excluded KRAS/STK11 co-mutated group, we observed diminished lipid metabolism and no change in anaerobic glycolysis. Interestingly, in patients with low expression of lipoprotein lipase, low-density lipoprotein receptor, or LDLRAD4, KRAS mutations had no effect on tumor immunogenicity. However, in patients with robust expression of these genes, KRAS mutations were associated with increased immunogenicity and associated with improved overall survival. Our data further suggest that the loss of STK11 may function as a metabolic switch, suppressing lipid metabolism in favor of glycolysis, thereby negating KRAS-induced immunogenicity. Hence, this concept warrants continued exploration, both as a predictive biomarker and potential target for therapy in patients receiving ICI-based immunotherapy.

Significance:

In patients with lung cancer, we demonstrate that KRAS mutations increase tumor immunogenicity; however, KRAS/STK11 co-mutated patients display an immune-excluded phenotype. KRAS/STK11 co-mutated patients also demonstrated significant downregulation of several key lipid metabolism genes, many of which were associated with increased immunogenicity and improved overall survival in KRAS-mutated patients. Hence, alteration to lipid metabolism warrants further study as a potential biomarker and target for therapy in patients with KRAS-mutated lung cancer.
Inflammatory Role of CCR1 in the Central Nervous System
Authors: Tian Qi , Yan Ziang , Guo Yujia , Chen Zhibiao , Li Mingchang
Published: August 2024

Background: Chemokine ligands and their corresponding receptors are essential for regulating inflammatory responses. Chemokine receptors can stimulate immune activation or inhibit/promote signaling pathways by binding to specific chemokine ligands. Among these receptors, CC chemokine receptor 1 (CCR1) is extensively studied as a G protein-linked receptor target, predominantly expressed in various leukocytes, and is considered a promising target for anti-inflammatory therapy. Furthermore, CCR1 is essential for monocyte extravasation and transportation in inflammatory conditions. Its involvement in inflammatory diseases of the central nervous system (CNS), including multiple sclerosis, Alzheimer’s disease, and stroke, has been extensively studied along with its ligands. Animal models have demonstrated the beneficial effects resulting from inhibiting CCR1 or its ligands. Summary: This review demonstrates the significance of CCR1 in CNS inflammatory diseases, the molecules implicated in the inflammatory pathway, and potential drugs or molecules for treating CNS diseases. This evidence may offer new targets or strategies for treating inflammatory CNS diseases.
Effects of Febuxostat Therapy on Circulating Adipokine Profiles in Patients with Overweight or Obesity and Asymptomatic Hyperuricemia: A Randomized Controlled Study
Authors: Dong Meijuan , Cui Zhaohui , Liu Yuanyuan , Bu Yanlong , An Kun , Mao Li
Published: August 2024

Introduction: Elevated levels of serum uric acid (SUA) are strongly associated with several components of the metabolic syndrome, particularly obesity. Previous studies have reported the correlation between SUA levels, xanthine oxidoreductase (XOR) activity, and the imbalanced adipokine levels that are characteristic of obesity. In this study, we explored the effect of febuxostat on circulating adipokine profiles in patients with overweight or obesity and asymptomatic hyperuricemia. Methods: This study was a single-center, randomized, and controlled clinical trial that enrolled 130 participants with asymptomatic hyperuricemia and obesity. One hundred seventeen participants were included in the final analysis, with 60 participants in the febuxostat group and 57 in the control group. We compared the circulating adipokine levels at 3 and 6 months, including high molecular weight (HMW) adiponectin, chemerin, omentin, monocyte chemotactic protein-1, asprosin, fibroblast growth factor 21, neuregulin-4, leptin, resistin, vaspin, visfatin, adipsin, and assessed the correlation between changes in adipokine levels (Δadipokines) and changes in XOR activity (ΔXOR) after febuxostat treatment. Results: The results showed that an increase in HMW adiponectin and omentin levels and a decrease in chemerin and asprosin levels at 3 or 6 months compared to the control group. Additionally, a positive correlation was observed between ΔXOR activity and Δasprosin. Furthermore, after adjusting for triglyceride (ΔTG) and serum uric acid (ΔSUA) in multiple linear regression analyses, we found that ΔXOR activity was independently correlated with Δasprosin. Conclusion: This study may provide important evidence that febuxostat could alleviate the imbalance in circulating adipokine levels in patients with overweight or obesity and asymptomatic hyperuricemia. Furthermore, we observed a positive correlation between changes in asprosin levels and changes in XOR activity after febuxostat treatment.
Penile Siliconoma
Authors: Ifran Ifran
Published: August 2024

Introduction. The use of liquid silicone, paraffin and other types of mineral oil with the aim of increasing the size and changing the contours of the penis is well known in primitive communities. Despite the many serious complications resulting from this practice. Cases of penile siliconoma have been widely reported.Case. A 66-year-old man comes to the Primary Health Center with complaints of swelling, accompanied by purulent wounds, pain, and shortening of the penis. The patient had injected silicone (Rita hair oil) in his penis by injecting the shaft of his penis, he began to wear silicone about ± 2 years ago. On genital exam found swelling and purulent wounds on the penis, contours irregular penis, flat surface and not bumpy, tenderness (+), with a soft consistency; laboratory examination showed leukocytosis (21 x 103/µL).Discussion. Siliconoma penis occurs due to continuous irritation over a long period of time with silicone. Rejection reaction to a foreign body as a normal response of the body appears in the form of inflammation, causing clinical symptoms such as pain, swelling of the penis, induration, ulceration, edema, scarring, discoloration of the skin on the penis, deformity, pain during erection and inability to perform sexual activities.Conclusion. Siliconoma of the penis occurs as a result of the injection of a liquid with a high viscosity in this case silicone with the aim of enlarging the penis has many consequences damaging the sexual and cosmetic functions of the organ.