bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening biomarkers for systemic lupus erythematosus based on single-cell and bulk RNA sequencing
Authors: Yang Meng , Yang Di , Gan Linquan , Wu Yongzhuo , Pan Yanbin , Deng Guiyan , Cheng Xiangui , Zheng Wenjun
Published: November 2023

Systemic lupus erythematosus (SLE) is an autoimmune disease. The pathogenesis of SLE remains unclear, and the aim of this study was to identify novel biomarkers of SLE. First, key modules and key cell clusters for the trait of sample grouping were screened by weighted gene coexpression network analysis (WGCNA). The differentially expressed genes (DEGs) between SLE and normal samples in GSE72326 were screened. The candidate genes were obtained by overlapping DEGs, key module genes, and the marker genes of key cell clusters. The random forest algorithm was executed based on candidate genes, and the top 5 genes were selected as the hub genes. In addition, gene set enrichment analysis (GSEA) of hub genes was performed. Finally, expression validation, methylation analysis, and immunoinfiltration analysis were completed. A total of 90 DEGs were obtained between SLE and control samples in the GSE72326 dataset. By random forest analysis, the hub genes (TNFSF13B, FCGR1A, TNFSF10, ISG15, LAP3) were obtained. GSEA revealed that TNFSF13B and FCGR1A were involved in primary immunodeficiency, cytosolic DNA sensing pathway, ribosome, and TNFSF10, ISG15, and LAP3 were related to pyruvate metabolism, complement and coagulation cascade. TNFSF13B, FCGR1A, TNFSF10, ISG15, and LAP3 were identified as hub genes of SLE, which provides a new perspective to study SLE. Purpose: Systemic lupus erythematosus (SLE) is an autoimmune disease. The pathogenesis of SLE remains unclear, and the aim of this study was to identify novel biomarkers of SLE. Patients and methods: First, key modules and key cell clusters for the trait of sample grouping were screened by weighted gene coexpression network analysis (WGCNA). The differentially expressed genes (DEGs) between SLE and normal samples in GSE72326 were screened. The candidate genes were obtained by overlapping DEGs, key module genes, and the marker genes of key cell clusters. The random forest algorithm was executed based on candidate genes, and the top 5 genes were selected as the hub genes. In addition, gene set enrichment analysis (GSEA) of hub genes was performed. Finally, expression validation, methylation analysis, and immunoinfiltration analysis were completed. Results: A total of 90 DEGs were obtained between SLE and control samples in the GSE72326 dataset. By random forest analysis, the hub genes (TNFSF13B, FCGR1A, TNFSF10, ISG15, LAP3) were obtained. GSEA revealed that TNFSF13B and FCGR1A were involved in primary immunodeficiency, cytosolic DNA sensing pathway, ribosome, and TNFSF10, ISG15, and LAP3 were related to pyruvate metabolism, complement and coagulation cascade. Conclusion: TNFSF13B, FCGR1A, TNFSF10, ISG15, and LAP3 were identified as hub genes of SLE, which provides a new perspective to study SLE.
Variations in Land Surface Temperature Increase in South-East Asian Cities
Authors: Munawar Munawar , McNeil Rhysa , Jani Rohana , Buya Suhaimee , Tarmizi Tarmizi
Published: November 2023

Climate change and global warming are terms used to describe the increase in the Earth's mean temperature. One method for determining the temperature of a region is Land Surface Temperature (LST). The study of LST is important and closely related to climate change, as well as the provision of convenient living and working conditions in cities, which support economic growth. The NASA Moderate-Resolution Imaging Spectroradiometer (MODIS) database was deployed to obtain information on the LST of each subregion for the period from 2000 to 2022. The study area consists of 11 capital cities from Southeast Asian (SEA) nations, organized into nine sub-regional super-regions. The study's objective was to employ a cubic spline model with seven and eight knots to assess the periodic patterns and fluctuations of LST in SEA cities. A 95% confidence interval was then created using the LST variation. The findings showed a confidence interval of [0.295, 0.447]°C at a 95% confidence level and an overall average increase in LST in the SEA of 0.371°C per decade. While LST increased in Jakarta, Hanoi, Vientiane, Bangkok, Kuala Lumpur, Singapore, and Phnom Penh, it remained unchanged in the Bandar Seri Begawan super-region. On the other hand, LST was slightly lower in Naypyidaw and slightly higher in Manila.
Construct a prognostic model based on fatty acid metabolism/ferroptosis-related genes and reveal the immune heterogeneity and somatic mutation specificity of rectal adenocarcinoma in different groups
Authors: Wang Jie , Chen Hongyun , Qu Yanli , Xu Meng , Guo Genyan , Ju Qi , Yu Yang , Jiang Xin , Guo Xu , Zhao Guohua
Published: November 2023

Background: The prognosis of late stage rectal adenocarcinoma (READ) patients is poor and the recurrence rate is high. The aim of this research is to explore the prognostic value and underlying molecular mechanism of genes related to fatty acid metabolism/ferroptosis in READ.
Methods: All data and clinical information were obtained by accessing public databases. A risk model was constructed based on fatty acid metabolism/ferroptosis-related genes by LASSO algorithm and Cox regression analysis. Then, relationship between the risk score and various clinical characteristics was analyzed. Subsequently, a nomogram was constructed to assess survival. The characteristics of immune microenvironment and somatic mutations in different groups were also investigated.
Results: A risk score constructed based on 6 fatty acid metabolism/ferroptosis-related genes was found to be independent prognostic factors of READ and was also associated with disease progression. According to the Kaplan-Meier analysis, the overall survival of READ in the high-risk group score was lower. Moreover, the risk model has high predictive value and good predictive capacity in predicting the long-term prognosis of READ. Immune heterogeneity and somatic mutation specificity were also found in different risk groups. Immunotherapy could potentially provide greater benefits for the high-risk group.
Conclusion: Explored the prognostic value and potential mechanism of genes related to fatty acid metabolism/ferroptosis in READ, which is helpful to deepen the understanding of the pathological mechanism of patients and lay a theoretical foundation for subsequent research and treatment.
The mediating effects of hope on the relationships of social support and self-esteem with psychological resilience in patients with stroke
Authors: SUN Boru , WANG Nan , LI Ke , YANG Yan , ZHANG Fengjiao
Published: November 2023

Purpose
To explore the mediating effect of hope in the relationships between social support and self-esteem with psychological resilience among patients with stroke survivors in early rehabilitation.
Methods
A cross-sectional study design was adopted. Data from a cross-sectional survey of 210 patients undergoing early stroke rehabilitation were analysed using structural equation modelling. The variables of interest were measured using the Connor Davidson Resilience Scale, the Social Support Rating Scale, the Herth Hope Index, and the Self-Esteem Scale. This article reports according to the STROBE checklist.
Results
A positive relationship was found between social support and psychological resilience (β1 = .548), which was mediated by hope (β2 = .114), and social support had significant direct effect on resilience (β3 = .434). A positive relationship was also found between self-esteem and psychological resilience (β4 = .380), which was mediated by hope (β5 = .200), and self-esteem had significant direct effect on resilience (β6 = .179).
Conclusion
According to the results of this study, some strategies can be incorporated into the rehabilitation process to enhance psychological resilience, such as cultivating individual personality characteristics and improving patients’ social relationships. In the future, we need to explore methods for improving psychological resilience among patients with stroke in combination with their risk factors to improve their quality of life and reduce the incidence of post-stroke depression.
Development of Internet of Things (IoT) for air pollution monitoring of Nagpur metropolis
Authors: Bajpai Anju , Kumar T P Girish , Sreeniva G , Srivas S K
Published: November 2023

In the era of smart computing, edge computing, and machine intelligence, the Internet of Things (IoT) is paving a greater role in establishing hyperconnective, cost-effective infrastructure for monitoring the environment. With the increase in the level of urbanization, increasing air pollution in cities is an alarming situation. Therefore, it is necessary to continuously monitor the pollution and carry out spatial analysis of the changes in air pollution on a real-time basis. To monitor and manage air pollutants, it is essential to put in place monitoring stations to plan controlling measures. Although commercial pollution monitoring stations are present, they are limited in number, expensive, and fixed in specific strategic locations. A pollution monitoring system that can be replicated easily, automatically collects and analyzes data, and is cost-effective is essential. This study has involved the development and experimentation of a network of smart IoT sensors in Nagpur metropolis. The developed smart air pollution monitoring system combines IoT technology with real-time pollution monitoring. The developed smart air pollution monitoring system measures and monitors temperature, humidity and pollutant concentration of Carbon Monoxide, Ozone, Carbon Dioxide, Sulphur Dioxide and PM2.5 and Nitrous oxides simultaneously through one compact device. This paper discusses the architecture and design of the IoT system for air pollution monitoring, with a case study of its establishment in Nagpur metropolis. The study envisages to support Sustainable Development Goals – SDG11 which aims to reduce the environmental impact of cities by improving air quality.
Physiological and transcriptomic comparasions provide insights into the coordinated mechanisms of Dendrobium spp in response to cold stress
Authors: Li Zhiyuan , Lu Shunjiao , Yi Shuangshuang , Mo Shunjin , Yu Xiaoyun , Yin Junmei , Zhang Changqing
Published: November 2023

Background
Dendrobium spp is an tropical orchid with ornamental and medicinal value. Dendrobium spp is sensitive to low temperature, and the underlying cold–response regulatory mechanisms are unclear. Here, we compared the transcriptomic responses to cold stress of the cold–tolerant cultivar ‘Hongxing’ (HX) and the cold–sensitive cultivar ‘Sonia Hiasakul’ (SH).
Results
The chemometric results showed that the physiological response of SH in the later cold period was similar to that of HX during the entire period. The orthogonal partial least squares discriminant analysis (OPLS–DA) showed that soluble proteins (SP) and POD were key physiological parameters for assessing the cold tolerance of two Dendrobium spp cultivars. The weighted gene co–expression network analysis (WGCNA) results showed that many cold response genes and metabolic pathways significantly associated with physiological indices were enriched in the 11 modules. The KEGG and GO enrichment analysis of the 105 hub genes showed that Dendrobium spp could adapt to cold stress by regulating signal transduction, plant hormones, transcription factors, protein translation and modification, functional proteins, biosynthesis and metabolism, cell structure, light and circadian clocks. Among them, the hub genes of the cold response network include signal transduction–remorin gene pp34, signal transduction–ABA pathway–related genes PP2C, SnRK2, ABF1 and SKIP17, Ca2+ signaling–related gene CRSH1, carbohydrate–related gene SS2, cell wall synthesis gene CAD7, and endocytosis–related gene VPS52A.
Conclusion
The cold–responsive genes and metabolic pathways of Dendrobium spp revealed in this study may contribute to further investigation of the mechanisms of the cold–tolerance genetic enhancement, and cold–resistance breeding in related plants.
Research on Plasma Modified Fly Ash Denitration
Authors: QI Zhan-feng , Wang Shuo , GUO Xiu-li
Published: November 2023

The effects of reactor parameters and process parameters on the denitration rate of modified fly ash in different gas atmospheres were studied by using a dielectric barrier plasma reactor and using orthogonal experiments. The characteristics of modified fly ash were analyzed by using scanning electron microscope, specific surface area analyzer, X-ray diffraction, Boehm titration and Fourier transform infrared spectroscopy. The experimental data were processed by variance analysis and linear regression to induce the denitration mechanism. R2 of the linear regression analysis model is 0.789, which means that the adsorption pore size, acid groups and basic group can explain 78.9% of the change in denitration rate. The basic group will have a significant positive impact on the denitration rate, and the adsorption pore size and acidic group will have a significant negative impact on the denitration rate. Through variance analysis of the experimental data, it was found that the input power and discharge gap have a significant effect on the denitration rate, but the ionization time and discharge length have no significant effect. The input power affects the denitration rate by affecting the basic group, and the discharge gap affects the denitration rate by affecting the adsorption pore size. There are three denitration mechanisms on the surface of fly ash: physical adsorption, chemical adsorption and absorption process. Among them, chemical adsorption is the main mechanism of action, accounting for approximately 56.7%.
Ulnar Lengthening for Children with Forearm Deformity from Hereditary Multiple Exostoses: A Retrospective Study from A Tertiary Medical Center
Authors: Wang Shuo , Herman Bomansaan , Wu Yiheng , Lei Ming , Mutasa Blessing , Hong Pan , Li Jin
Published: November 2023

Background Patients with hereditary multiple exostosis (HME) usually present with forearm deformity with or without radial head dislocation. Ulna lengthening has been proposed to address this condition. Exostosis resection plus ulna lengthening has been adopted in our hospital since 2008, and patients with this condition were retrospectively reviewed. Herein, we aimed to investigate the optimal timing and clinical outcomes of this surgical approach.Methods In all, twenty-seven patients (32 forearms), including 18 boys and 9 girls, were enrolled in our study from July 2014 to September 2020. We divided the patients into 4 groups based on the age when they received surgery and the status of the radial head. Pronation and supination of the forearm, flexion and extension of the elbow, wrist ulnar deviation and wrist radial deviation, and radiological parameters including ulnar length (UL), ulnar variance (UV), the percentage of radial bowing (RB/RL), radio articular angle (RAA) and carpal slip (CS), were assessed and recorded.Results The mean UL was significantly improved after surgery in four Groups (P༜0.05). For the patients with radial head dislocation, the juniors demonstrated better improvement in % RB and RAA (p༜0.05, p = 0.003 and 0.031).Conclusion Exostosis resection and ulna lengthening with unilateral external fixation can effectively improve the function and radiological parameters of forearm deformity in HME children. For patients with radial head dislocation, early surgery can achieve better results. For patients not associated with radial head dislocation, we recommend regular follow-up and surgical treatment after 10 years of age.
Method of Home Tube Feeding and 2–3-year Neurodevelopmental Outcome
Authors: Dupont Tara , Fisher Allison , Ling Con Yee , Ermath Anna , Brinker Kristin
Published: November 2023

Objective: To describe the Bayley Scales of Infant Development 3rd Edition (Bayley-III) of infants discharged home receiving tube feeds
Study Design: Retrospective review of infants discharged with nasogastric or gastrostomy tube feeds and completed a Bayley-III assessment at 2-3-years of age through a neonatal follow-up program. Results were reported using descriptive statistics.
Results: Of infants discharged with nasogastric feeds, median Bayley-III scores were in the low-average to average range and full oral feeds were achieved in 75%. Of infants discharged with gastrostomy tube feeds, median Bayley-III scores were in the extremely low range and full oral feeds were achieved in 36%. Our data set did not demonstrate a distinct patient demographic that correlated to the type of feeding tube at discharge.
Conclusion: Neurodevelopmental outcome at 2–3 years does not appear to be negatively impacted by the decision to discharge an infant from the NICU with home NG feedings.
Clostridium butyricum Inhibits the Inflammation in Children with Primary Nephrotic Syndrome by Regulating Th17 / Tregs Balance via Gut-Kidney Axis
Authors: Li Ting , Ma Xiaolong , Wang Ting , Tian Wenyan , Liu Jian , Shen Wenke , Liu Yuanyuan , Li Yiwei , Zhang Xiaoxu , Ma Junbai , Zhang Xiaoxia , Ma Jinhai , Wang Hao
Published: November 2023

Background
Primary nephrotic syndrome (PNS) is a common glomerular disease in children. Clostridium butyricum (C.butyricum), a probiotic producing butyric acid, exerts effective in regulating inflammation. This study was designed to elucidate the effect of C.butyricum on PNS inflammation through the gut-kidney axis.
Methods
BALB/c mice were randomly divided into 4 groups: normal control group (CON), C.butyricum control group (CON + C.butyricum), PNS model group (PNS) and PNS with C.butyricum group (PNS + C.butyricum). The PNS model was established by a single injection of doxorubicin hydrochloride (DOX) through the tail vein. After 1 week of modeling, the mice were treated with C.butyricum or normal saline for 6 weeks. At the end of the experiment, the mice were euthanized and associated indications were investigated.
Results
Since the successfully modelling of the PNS, the 24h urine protein, blood urea nitrogen (BUN), serum creatinine (SCr), urine urea nitrogen (UUN),urine creatinine (UCr), lipopolysaccharides (LPS), pro-inflammatory interleukin (IL)-6, IL-17A were increased, the kidney pathological damage was aggravated, while a reduction of body weights of the mice and the anti-inflammatory IL-10 significantly reduced. However, these abnormalities could be dramatically reversed by C.butyricum treatment. The crucial Th17-Tregs axis in PNS inflammation also was proved to be effectively regulated by C.butyricum treatment. This probiotic intervention notably affected the expression levels of signal transducer and activator of transcription 3 (STAT3), Heme oxygenase-1 (HO-1) protein, and retinoic acid-related orphan receptor gamma t (RORγt). 16S rRNA sequencing showed that C.butyricum could regulate the composition of intestinal microbial community and found Proteobacteria was more abundant in urine microorganisms in mice with PNS. Short-chain fatty acids (SCFAs) were measured and showed that C.butyricum treatment increased contents of acetic acid, propionic acid, butyric acid in feces and acetic acid, valeric acid in urine. Correlation analysis showed that there was a closely complicated correlation among inflammatory indicators, metabolic indicators, microbiota and associated metabolic SCFAs in gut-kidney axis.
Conclusion
C.butyricum regulates Th17 / Tregs balance via the gut-kidney axis to suppress the immune inflammatory response in mice with PNS, which may potentially contribute to a novel, inexpensive, and safe therapeutic reagent for the control of the disease.
Comparison of the formula accuracy for calculating multifocal intraocular lens power in Asian patients
Authors: Kim Jinchul , JOONSUNG PARK , JO YOONJUNG
Published: November 2023

This study evaluated the accuracy of newer formulas (Barrett Universal II, EVO 2.0, Kane, Hoffer QST, and PEARL-DGS) and the Haigis formula in Asian patients with the Alcon TFNT multifocal intraocular lens. In total, 3,100 randomly selected eyes of 3,100 patients were retrospectively reviewed. After constant optimization, the standard deviation (SD) of the prediction error was assessed for the entire group, and the root mean square error (RMSE) was compared for short and long axial length (AL) subgroup analysis. The Cooke-modified AL (CMAL) was experimentally applied to the Haigis formula. All the newer formulas performed well, but they did not significantly outperform the Haigis formula. In addition, all the newer formulas exhibited clinically significant myopic outcomes in long eyes. Application of the CMAL to the Haigis formula with single constant optimization produced similar behavior and higher correlation with the newer formulas. The CMAL-applied triple-optimized Haigis formula yielded a smaller SD than the newer formulas. The AL modification algorithms such as the CMAL used in newer formulas to cope with optical biometry's overestimation of the AL in long eyes seemed to overcompensate, particularly in the long eyes of the Asian population.
Establishment and application of blocking ELISA method for detection of against Duck reovirus σC antibody
Authors: Han Jingyi , Huang Cong , Li Hongchang , Zhao Lu , Li Jia , Huang Yuanling , Tang Qijiang , Liu Yingnan , Liu Jingyi , Chen Hongjun , Shu Gang , Chen Zongyan
Published: November 2023

Duck reovirus disease is a duck-transmitted disease characterized by homorrhage and necrosis of the livers and spleens. Blocking ELISA has high sensitivity and simple operation, which can be used as a serological test for duck infection, to improve the detection efficiency of DRV infection. Duck reovirus σC protein is the main protein involved in the body's immune system, which can induce the production of neutralizing antibodies. Currently, there is no established blocking ELISA detection method based on this protein. This study aimed to produce and characterize σC monoclonal antibodies with the ultimate goal of developing a monoclonal antibody-based blocking ELISA for DRV antibody detection. This established detection method had no response to the serum after infection with ARV and MDRV, so it can also be used to distinguish DRV from ARV and MDRV infections. To evaluate the performance of the detection method, 87 serum samples (53 negative and 34 positive samples) were analyzed and receiver-operating characteristic (ROC) analysis was applied to determine the Cut-Off value. According to ROC analysis, the area under the curve (AUC) was 0.9789 (95% confidence interval: 95.13 to 100%), the Cut-Off value was set to 15.49%. The coefficients of inter- and intra-batches were < 10%, indicating the good repeatability of the method. The maximum dilution of positive standard serum detected by this blocking ELISA method was 1:512 and did not cross-react with other duck-derived viruses, illustrating strong specificity. In conclusion, the σC mAb-based blocking ELISA detection method established in this study has high sensitivity and specificity, which provides a reliable and useful tool for on-site surveillance and epidemiological studies in duck flocks.
Potential Involvement of beta-lactamase homologous proteins in resistance to beta-lactam antibiotics in gram-negative bacteria of the ESKAPEE group
Authors: Souza Joyce , Vieira Alexandre Zanatta , Santos Hellen Geremias dos , Faoro Helisson
Published: November 2023

Background
Enzymatic degradation mediated by beta-lactamases constitutes one of the primary mechanisms of resistance to beta-lactam antibiotics in gram-negative bacteria. This enzyme family comprises four molecular classes, categorized into serine beta-lactamases (Classes A, C, and D) and zinc-dependent metallo-beta-lactamases (Class B). Gram-negative bacteria producing beta-lactamase are of significant concern, particularly due to their prevalence in nosocomial infections. A comprehensive understanding of the evolution and dissemination of this enzyme family is essential for effective control of these pathogens.
Results
In this study, we conducted the prospecting, phylogenetic analysis, and in silico analysis of beta-lactamases and homologous proteins identified in 1827 bacterial genomes with phenotypic data on beta-lactam resistance. These genomes were distributed among Klebsiella pneumoniae (45%), Acinetobacter baumannii (31%), Pseudomonas aeruginosa (14%), Escherichia coli (6%), and Enterobacter sp. (4%). Using an HMM profile and searching for conserved domains, we mined 2514, 8733, 5424, and 2957 proteins for molecular classes A, B, C, and D, respectively. This set of proteins encompasses canonical subfamilies of beta-lactamases as well as hypothetical proteins and other functional groups. Canonical beta-lactamases were found to be phylogenetically distant from hypothetical proteins, which, in turn, are closer to other representatives of the penicillin-binding-protein (PBP-like) and metallo-beta-lactamase (MBL) families. Motif analysis revealed that, in general, catalytic residues are less conserved in homologous groups than in beta-lactamases. Comparison of the frequency of presence of protein groups in genomes of resistant strains in relation to sensitive ones, indicated that some groups of homologous proteins of classes B and C are more frequent in genomes of resistant than sensitive strains, particularly in those resistant to carbapenems.
Conclusions
The beta-lactamase-like domain is present in various proteins from the PBP-like and MBL superfamilies, widely distributed in gram-negative bacteria of the ESKAPEE group. Despite hypothetical proteins with this domain not demonstrating beta-lactamase characteristics, they are closely related to homologous families that exhibit enzymatic promiscuity against beta-lactam antibiotics beyond their traditional functions. The association of these homologous enzymes with canonical beta-lactamases and the selective pressure from the extensive use of beta-lactam antibiotics may favor the eventual optimization of these functions.
“They seemed to be like cogs working in different directions”: a longitudinal qualitative study on Long COVID healthcare services in the United Kingdom from a person-centred lens
Authors: Fang Chao , Baz Sarah Akhtar , Sheard Laura , Carpentieri JD
Published: November 2023

Background
Long COVID (LC) has presented significant challenges to healthcare, as people with persistent and fluctuating symptoms often face prolonged uncertainty when seeking medical support. Negative experiences with healthcare systems and trauma from previous health conditions may further compound this uncertainty. Despite an increasingly rich picture of LC healthcare challenges being captured, qualitative studies on LC so far have primarily focused on individual experiences rather than examining the structural aspects of healthcare
Methods
To better understand the healthcare experiences of those with LC, we conducted a longitudinal qualitative study with 80 participants and over 10 healthcare practitioners in the UK. We collected a total of 178 interviews (with some attrition) across two rounds, from November 2021 to March 2022, and from June to October 2022.
Results
Adopting a framework of person-centredness that acknowledges and supports interconnected individual, relational, and existential needs in healthcare, we explored LC healthcare experiences across primary, secondary, and specialist integrated care. Through this approach, we identified three overarching themes. Theme 1 focuses on the continued hurdle of accessing primary care as the first point of contact for LC healthcare; theme 2 highlights the complexity of navigating secondary care; and theme 3 captures the unique challenges of propagating LC integrated care. These themes were interconnected, with individuals often bouncing between systems and practitioners cooperating across their remits.
Conclusion
Using a person-centred lens allowed us to identify the multifaceted needs of LC sufferers and understand how these needs shape individual health and healthcare experiences in a nuanced way, considering their identity as a key source shaping their healthcare needs. The study aimed to explore how person-centred care can be delivered more effectively and sustainably across different healthcare settings and over time to better meet the needs of LC sufferers.
Medical History and Preoperative Coagulation Profile as Predictors of Outcomes in Elective Neurosurgery: A Meta-Analysis of 78,909 patients
Authors: Pichardo-Rojas Pavel S. , Calvillo-Ramirez Alejandro , Rio-Martinez Christopher J. , Fukumoto-Inukai Kenzo A. , Gonzalez-Hernandez Diana , Casas-Huesca Ana Paulina , Villarreal-Guerrero Cristina , Shah Siddharth
Published: November 2023

Introduction: In patients with unremarkable medical history, the role of comprehensive preoperative hemostasis screening in elective neurosurgical procedures remains debated. Comprehensive medical history has shown to be non-inferior to coagulation profile to evaluate surgical outcomes. This study aims to evaluate the predictiveness of preoperative coagulation screening and medical history for surgical outcomes.
Objective: We conducted a meta-analysis to analyze the predictiveness of preoperative hemostasis screening and clinical history for patient outcomes in elective neurosurgical procedures.
Methods: Databases were searched until April 22nd 2023 for observational cohort studies that reported preoperative hemostasis screening and clinical history prior to elective neurosurgical procedures. Outcomes of interest included postoperative transfusion, mortality, and complications. Pooled relative risk ratios (RR) were analyzed using random-effects models.
Results: Out of 604 studies, 3 cohort studies with a patient population of 78,909 met our inclusion criteria. Prolonged PTT (RR=1.42, 95%CI=1.14-1.77, p=0.002), elevated INR (RR=2.01, 95%CI=1.14-3.55, p=0.02), low platelet count (RR=1.58, 95%CI=1.34-1.86, p<0.00001), and positive bleeding history (RR=2.14, 95%CI=1.16-3.93, p=0.01) were associated with postoperative transfusion risk. High PTT (RR=2.42, 95%CI=1.24-4.73, p=0.010), High INR (RR=8.15, 95%CI=5.97-11.13, p<0.00001), low platelet count (RR=4.89, 95%CI=3.73-6.41, p<0.00001), and bleeding history (RR=7.59, 95%CI=5.84-9.86, p<0.00001) were predictive of mortality. Prolonged PTT (RR=1.53, 95%CI=1.25,1.86; p=<0.0001), a high INR (RR=3.41, 95%CI=2.63,4.42; p=< 0.00001), low platelets (RR=1.63, 95%CI=1.40,1.90; p=<0.00001), and medical history (RR=2.15, 95%CI=1.71,2.71; p=<0.00001) were predictive of complications.
Conclusion: Medical history was a non-inferior predictor to coagulation profile for postoperative transfusion, mortality, and complications in elective neurosurgery. Standardized clinical risk stratification tools, and cost-effective alternatives should be explored to promote affordable-patient care.
Assessment and Characterisation of Coronary Disorder in a Rheumatoid Arthritis Cohort: A Cross-Sectional Study
Authors: Guillaud-Rollin S. , Djaileb L. , De Leris N. , Canu M. , Barone-Rochette G. , Gaudin P. , Romand X. , Gastaldi R , Baillet A
Published: November 2023

Purpose
To assess the prevalence of macrovascular or microvascular coronary dysfunction in a cohort of rheumatoid arthritis patients with a heart score > 1%.
Materials and methods
We included, in a cross-sectional study, RA patients treated with biologic or targeted synthetic Disease Modifying Anti Rheumatic Drug, without history of cardiovascular disease, ≥ 50 years old and a pathological Heart Score > 1%. First, myocardial perfusion reserve (MPR), the ratio of myocardial blood flow in stress to myocardial blood flow at rest, was assessed with single photon emission computed tomography (SPECT). RA patients with impaired MPR < 2 were referred for invasive coronary angiography to assess macrovascular or microvascular coronary dysfunction. Demographics, RA outcomes and cardiovascular risk factors were recorded. A multivariate analysis was performed with variables significantly associated with coronary dysfunction.
Results
A total of 108 RA patients were screened for eligibility. Sixty patients were included. A total of 37/60 (61%) patients had impaired MPR on SPECT, of whom one patient presented significant ischemia on myocardial perfusion imaging. According to invasive coronary angiography, 17/31 (54%) had coronary microvascular dysfunction, 7/31 (22%) had macrovascular dysfunction and 7/31 (22%) had no coronary dysfunction. A total of 23/31 patients (74%) had cardiovascular medical treatment optimization. RA characteristics significantly associated with coronary dysfunction were higher disease activity and shorter disease duration.
Conclusion
This is the first study to reveal, on invasive coronary angiography, a high proportion of microvascular dysfunction in RA patients with impaired MPR. Coronary dysfunction screening could be considered in RA patients with a heart score > 1% (ESC guidelines), as SPECT and invasive coronary angiography showed coronary dysfunction in 44% of RA patients, which led to substantial cardiovascular treatments.
Trial registration
: Ethics approval was obtained from Comité de protection des personnes Sud-Est (22.04002.000195). Participants gave informed consent.
Abies pinsapo and forest fires: a long history of surviving extreme events in Sierra Bermeja (SW Baetic System)
Authors: Gómez-Zotano José , Pardo-Martínez Rubén , Olmedo-Cobo José Antonio , Martos-Martín Javier
Published: November 2023

Background Abies pinsapo is a species classified as endangered and currently occupies a very small and fragmented area of distribution in the southwest of the Baetic System. The uniqueness of these relict forests has motivated their study from different perspectives; however, the paleoecological characterisation of this fir is still clearly deficient. Consequently, there is hardly any information on the impact that fire has had on this conifer during the Holocene, nor the real effect that this disturbance has had on the Spanish fir in recent decades. To fill this knowledge gap, the present research uses the pedoanthracological network developed over the last few years in one of the natural habitats of the Spanish fir forest most affected by fire: Sierra Bermeja. This discipline is based on the analysis of the charcoals present in the natural soils, which are an unexplored resource and particularly useful for the reconstruction of paleo-fires and the knowledge of the dynamics of the vegetation. This paleoecological approach has also been complemented by the mapping of recent forest fires. Results The identification of Abies charcoal in places where this taxon is not present today supports the idea that the Spanish fir was more widely distributed in the past. Likewise, the available dates have revealed the existence of up to 28 events of forest fires that have affected the Spanish fir during the Holocene. The recurrence of fire could have caused its local extinction in the Sierra Palmitera. This regressive dynamic of this fir as a consequence of fire, as can be inferred from the cartography carried out, has been particularly intense during the last few decades. Conclusions Results report on the important role played by fire in the dynamics of the serpentine-soil Spanish firs of Sierra Bermeja from the Last Glacial Maximum to the present day. This is a phenomenon that has intensified in recent decades, affecting the Spanish fir in a very worrying way. To help ensure effective protection for the most important serpentine-tolerant ecosystem in Spain it is essential to include the whole of Sierra Bermeja in the Spanish National Park Network.
DHODH inhibition represents a therapeutic strategy and improves abiraterone treatment in castration-resistant prostate cancer
Authors: Wang Junjian , shaoqiang guo , miaomiao Miao , yufeng Wu , Qinyan Wu , dongyue Pan , Zhanfang Kang , Jianwen Zeng , Liu Chengfei , Guoping Zhong
Published: November 2023

Castration-resistant prostate cancer (CRPC) is an aggressive disease with poor prognosis, and there is an urgent need for more effective therapeutic targets to address this challenge. Here, we showed that Dihydroorotate dehydrogenase (DHODH), an enzyme crucial in the pyrimidine biosynthesis pathway, is a promising therapeutic target for CRPC. The transcript levels of DHODH were significantly elevated in prostate tumors and were negatively correlated with the prognosis of patients with prostate cancer. DHODH inhibition effectively suppressed CRPC progression by blocking cell cycle progression and inducing apoptosis. Notably, treatment with BAY2402234 activated androgen biosynthesis signaling in CRPC cells. However, the combination treatment with BAY2402234 and abiraterone decreased intratumoral testosterone levels and induced apoptosis, which inhibited the growth of CWR22Rv1 xenograft tumors and patient-derived xenograft organoids. Taken together, these results establish DHODH as a key player in CRPC and as a potential therapeutic target for advanced prostate cancer.
Resilience profiles and related factors among colorectal cancer inpatients with an enterostomy: A cross- sectional study
Authors: Sun Dandan , Zhang Yan , Ma Hui , Wu Jinqiu
Published: November 2023

Purpose
This study aimed to explore psychological resilience subgroups of colorectal cancer inpatients with an enterostomy through latent profile analyses and to identify the sociodemographic, clinical and psychological characteristics among resilience subgroup members.
Methods
A cross-sectional study was conducted. 226 colorectal cancer patients after enterostomy were recruited in the study. Data were collected with a general information questionnaire, Conner Davidson Resilience Scale, Medical Coping Modes Questionnaire, Stoma Self-Efficacy Scaleand Social Support Rating Scale.
Results
Three distinct subgroups of resilience were identified: “adaptation difficulty group” (33.6%), “moderate adaptation group” (29.2%) and “complete adaptation group” (37.2%). Monthly per capita family income, social support, and self-efficacy were predictors of resilience subgroups.
Conclusion
The resilience of colorectal cancer patients after enterostomy can be divided into several subgroups. The decrease in family income per month, self-efficacy and social support will increase the risk of patients belonging to the adaptation difficulty group or moderate adaptation group. Clinical nurses should develop targeted intervention programmes based on the characteristics of subgroups at high risk of resilience to further improve patient resilience.
Bladder cancer risk stratification with the Oncuria 10-plex bead-based urinalysis assay using three different Luminex xMAP instrumentation platforms
Authors: Furuya Hideki , Sakatani Toru , Tanaka Sunao , Murakami Kaoru , Waldron Richard T , Hogrefe Wayne , Rosser Charles J
Published: November 2023

Background: No single marker of bladder cancer (BC) exists in urine samples with sufficient accuracy for disease diagnosis and treatment monitoring. The multiplex Oncuria BC assay noninvasively quantifies the concentration of 10 protein analytes in voided urine samples to quickly generate a unique molecular profile with proven BC diagnostic and treatment-tracking utility. Test adoption by diagnostic and research laboratories mandates reliably reproducible assay performance across a variety of instrumentation platforms used in different laboratories.
Methods: We compared the performance of the clinically validated Oncuria BC multiplex immunoassay when data output was generated on three different analyzer systems. Voided urine samples from 36 subjects (18 with BC and 18 Controls) were reacted with Oncuria test reagents in three 96‑well microtiter plates on Day 1, and consecutively evaluated on the LED/image‑based MagPix, and laser/flow based Luminex 200 and FlexMap 3D (all xMAP instruments from Luminex Corp., Austin, TX) on Day 2. The BC assay uses magnetic bead‑based fluorescence technology (xMAP, Multi-analyte profiling; Luminex) to simultaneously quantify 10 protein analytes in urine specimens [i.e., angiogenin (ANG), apolipoprotein E (ApoE), carbonic anhydrase IX (CA9), CXCL8/interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9), matrix metalloproteinase-10 (MMP-10), serpin A1/alpha-1 anti-trypsin (A1AT), serpin E1/plasminogen activator inhibitor-1 (PAI-1), CD138/syndecan-1 (SDC1), and vascular endothelial growth factor-A (VEGF-A)].
Results: All three platforms categorized all 10 analytes in identical samples at nearly identical concentrations, with variance across systems typically <5%. While the most contemporary instrument, the FlexMap 3D, output higher raw fluorescence values than the two comparator systems, standard curve slopes and analyte concentrations determined in urine samples were concordant across all three units. Forty-four percent of BC samples registered ≥1 analyte above the highest standard concentration, i.e., A1AT (n=7/18), IL-8 (n=5), and/or ANG (n=2). In Controls, A1AT was higher in one sample.
Conclusion: Multiplex BC assays generate detailed molecular signatures useful for identifying BC, predicting treatment responsiveness, and tracking disease progression and recurrence. The similar performance of the Oncuria assay across three different analyzer systems supports test adaptation by clinical and research laboratories using existing xMAP platforms.
Trial Registration:This study was registered at ClinicalTrials.gov as NCT04564781, NCT03193528, NCT03193541, and NCT03193515.
The Effect of Dialysis Modality on Annual Mortality: a Prospective Cohort Study
Authors: Kim Yae Hyun , Kim Yeonjin , Ha Nayoung , Cho Jang-Hee , Kim Yon Su , Kang Shin-Wook , Kim Nam-Ho , Yang Chul Woo , Kim Yong-Lim , Lee Jung Pyo , Lee Woojoo , Oh Hyung Jung
Published: November 2023

Despite several studies on the effect of each dialysis modality on mortality, the subject is still controversial. We investigated the hazard rate of mortality for patients with incident end-stage renal disease with respect to initial dialysis modality (hemodialysis vs. peritoneal dialysis). We used a nationwide, multicenter, prospective cohort of patients with end-stage renal disease who were undergoing dialysis in South Korea. Among the 2 207 patients, 1 647 (74.6%) underwent hemodialysis. We performed the intention-to-treatment analysis, and employed inverse probability treatment weighting to reduce bias and the weighted Fine and Gray model over the follow-up period. Landmark analysis was used to identify the changing effect of the dialysis modality on individuals who remained event-free at each landmark point. No significant difference in hazard rate was observed between the two dialysis modalities when all participants were considered. However, the hazard rate in the peritoneal dialysis group was significantly higher than that in the hemodialysis group among patients aged <65 years after 4- and 5-year follow-up. A similar pattern was observed among patients with diabetes mellitus. Landmark analysis showed that the hazard ratio in the peritoneal dialysis group was significantly higher than that in the hemodialysis group at 2 years in both the education-others and married groups. This study could be useful for choosing a dialysis modality for young patients, especially in the presence of diabetes. Moreover, hemodialysis may be preferred to peritoneal dialysis when the follow-up duration is >3 years.
360-Degree Virtual Reality Video to Teach Neonatal Resuscitation: An Exploratory Development Study.
Authors: Tachejian Sevag , Moussa Ahmed
Published: November 2023

Simulation is an effective training method for neonatal resuscitation (NR). However, the limitations brought about by the COVID-19 pandemic, and other resource constraints, have necessitated exploring alternatives. Virtual reality (VR), particularly 360-degree VR videos, have gained traction in medical training due to their immersive qualities. The primary objectives of the study were to produce a high quality 360-degree virtual reality (VR) video capturing neonatal resuscitation (NR) and to determine if it could be an acceptable adjunct to teach NR. The secondary objective was to determine which aspects of NR could benefit from the incorporation of such a video in training. This was an exploratory development study. The first part consisted of producing the video using a GoPro action camera, Adobe Premiere Pro, and Unity Editor. In the second part participants were recruited, based on level of experience, to watch the video and answer questionnaires to determine acceptability (user experience and cognitive load) and aspects of NR which could benefit from the video. The video was successfully developed. Forty-six participants showed a strong general appreciation. User experience revealed high means (> 6) in the positive subscales and low means (< 4) for immersion side effect, with no difference between groups. Cognitive load was higher than anticipated. Participants indicated that this video could be effective for teaching crisis resource management principles, human and environment interactions, and procedural skills. The 360-degree VR video could be a potential new simulation adjunct for NR. Future studies are needed to evaluate learning outcomes of such videos.
A novel classification for guiding the surgical approach for cranio-orbital lesions: A single institution case series of 45 cases and a literature review.
Authors: Xie Bo , Qin Chaoying , Zhang Sen , Zhang Chi , He Yi , Tang Guodong , Wang Xiangyu , Liu Qing
Published: November 2023

Objectives
We aim to share our experience of the removal of COLs, and propose a novel classification to guide the approach selection.
Methods
We retrospectively reviewed 45 consecutive patients with COLs who underwent surgery performed by the same neurosurgeon between November 2010 and November 2022. The surgical approach was selected according to the anatomical region classification of the COLs. For lesions limited to space A (lateral superior orbital fissure, SOF), the pterion or extended pterion approach (PA or EPA) was used. For lesions limited to space B (extraconal compartment medial SOF, and cavernous sinus CS) and C (intraconal compartment, medial SOF, and CS), the pretemporal transcavernous approach (PTCA) was used. For lesions limited to space D (intraconal compartment and optic canals), the subfrontal approach (SA) was used. For lesions extending into the infratemporal fossa (ITF), the cranio-orbito-zygomatic approach (COZA) was used. For lesions involving pterygopalatine fossa (PPF), the endoscopic transnasal approach (ETNA) was used. We analyzed the clinical manifestations, imaging data, surgical approaches, surgical outcomes, neurological outcomes, and follow-up data.
Results
Gross total resection was performed in 35 patients (35/45, 77.8%). SA, PA, EPA, PTCA, COZA, and ETNA were performed in 9, 9, 10, 10, 6, and 1 case(s), respectively. Progression of the residual tumor was observed in 6 cases (1 adenoid cystic carcinoma and 5 meningiomas).
Conclusion
Surgical approach selection plays a vital role in patient prognosis. This novel classification based on the involvement of anatomic space could help surgeons select an appropriate approach to remove the COLs.