bluuebunny/crossref_metadata_2025 huggingface dataset:
Unique Gene Expression Signature in Periadrenal Adipose Tissue Identifies a High Blood Pressure Group in Patients With Cushing Syndrome
Authors: Stifel Ulrich , Vogel Frederick , Caratti Giorgio , Reincke Martin , Tuckermann Jan
Published: August 2023

BACKGROUND:

Cushing syndrome (CS) is a rare disease caused by excess cortisol levels with high cardiovascular morbidity and mortality. Hypertension in CS promotes hypercortisolism-associated cardiovascular events. Adipose tissue is a highly plastic tissue with most cell types strongly affected by the excess cortisol exposure. We hypothesized that the molecular and cellular changes of periadrenal adipose tissue in response to cortisol excess impact systemic blood pressure levels in patients with CS.

METHODS:

We investigated gene expression signatures in periadrenal adipose tissue from patients with adrenal CS collected during adrenal surgery.

RESULTS:

During active CS we observed a downregulation of gene programs associated with inflammation in periadrenal adipose tissue. In addition, we observed a clustering of the patients based on tissue gene expression profiles into 2 groups that differed in blood pressure levels (CS low blood pressure and CS high blood pressure). The 2 clusters showed significant differences in gene expression pattens of the renin-angiotensin-aldosterone-system. Renin was the strongest regulated gene compared with control patients and its expression correlated with increased blood pressure observed in our patients with CS. In the CS high blood pressure group, systemic renin plasma levels were suppressed indicative of an abnormal blood pressure associated with periadrenal adipose tissue renin-angiotensin-aldosterone-system activation.

CONCLUSIONS:

Here, we show for the first time a relevant association of the local renin-angiotensin-aldosterone-system and systemic blood pressure levels in patients with CS. Patients from the CS high blood pressure group still had increased blood pressure levels after 6 months in remission, highlighting the importance of local tissue effects on long-term systemic effects observed in CS.
Differential Treatment and Outcomes for Patients With Heart Attacks in Advantaged and Disadvantaged Communities
Authors: Shen Yu‐Chu , Sarkar Nandita , Hsia Renee Y.
Published: August 2023

Background

Racially and ethnically minoritized groups, people with lower income, and rural communities have worse access to percutaneous coronary intervention (PCI) than their counterparts, but PCI hospitals have preferentially opened in wealthier areas. Our study analyzed disparities in PCI access, treatment, and outcomes for patients with acute myocardial infarction based on the census‐derived Area Deprivation Index.

Methods and Results

We obtained patient‐level data on 629 419 patients with acute myocardial infarction in California between January 1, 2006 and December 31, 2020. We linked patient data with population characteristics and geographic coordinates, and categorized communities into 5 groups based on the share of the population in low or high Area Deprivation Index neighborhoods to identify differences in PCI access, treatment, and outcomes based on community status. Risk‐adjusted models showed that patients in the most advantaged communities had 20% and 15% greater likelihoods of receiving same‐day PCI and PCI during the hospitalization, respectively, compared with patients in the most disadvantaged communities. Patients in the most advantaged communities also had 19% and 16% lower 30‐day and 1‐year mortality rates, respectively, compared with the most disadvantaged, and a 15% lower 30‐day readmission rate. No statistically significant differences in admission to a PCI hospital were observed between communities.

Conclusions

Patients in disadvantaged communities had lower chances of receiving timely PCI and a greater risk of mortality and readmission compared with those in more advantaged communities. These findings suggest a need for targeted interventions to influence where cardiac services exist and who has access to them.
New Users of Angiotensin II Receptor Blocker–Versus Angiotensin‐Converting Enzyme Inhibitor–Based Antihypertensive Medication Regimens and Cardiovascular Disease Events: A Secondary Analysis of ACCORD‐BP and SPRINT
Authors: King Jordan B. , Berchie Ransmond O. , Derington Catherine G. , Marcum Zachary A. , Scharfstein Daniel O. , Greene Tom H. , Herrick Jennifer S. , Jacobs Joshua A. , Zheutlin Alexander R. , Bress Adam P. , Cohen Jordana B.
Published: August 2023

BACKGROUND

Angiotensin II receptor blockers (ARBs) and angiotensin‐converting enzyme inhibitors (ACEIs) block distinct components of the renin‐angiotensin system. Whether this translates into differential effects on cardiovascular disease events remains unclear.

METHODS AND RESULTS

We used the ACCORD‐BP (Action to Control Cardiovascular Risk in Diabetes–Blood Pressure) trial and the SPRINT (Systolic Blood Pressure Intervention Trial) to emulate target trials of new users of ARBs versus ACEIs on cardiovascular disease events (primary outcome) and death (secondary outcome). We estimated marginal cause‐specific hazard ratios (HRs) and treatment‐specific cumulative incidence functions with inverse probability of treatment weights. We identified 3298 new users of ARBs or ACEIs (ACCORD‐BP: 374 ARB versus 884 ACEI; SPRINT: 727 ARB versus 1313 ACEI). For participants initiating ARBs versus ACEIs, the inverse probability of treatment weight rate of the primary outcome was 3.2 versus 3.5 per 100 person‐years in ACCORD‐BP (HR, 0.91 [95% CI, 0.63–1.31]) and 1.8 versus 2.2 per 100 person‐years in SPRINT (HR, 0.81 [95% CI, 0.56–1.18]). There were no appreciable differences in pooled analyses, except that ARBs versus ACEIs were associated with a lower death rate (HR, 0.56 [95% CI, 0.37–0.85]). ARBs were associated with a lower rate of the primary outcome among subgroups of male versus female participants, non‐Hispanic Black versus non‐Hispanic White participants, and those randomly assigned to standard versus intensive blood pressure (
P
interaction
: <0.01, 0.05, and <0.01, respectively).

CONCLUSIONS

In this secondary analysis of ACCORD‐BP and SPRINT, new users of ARB‐ versus ACEI‐based antihypertensive medication regimens experienced similar cardiovascular disease events rates, with important subgroup differences and lower rates of death overall.

REGISTRATION

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT01206062, NCT00000620.
Risk and Prognosis of Cancer in Patients With Cerebral Venous Thrombosis Compared With the Danish General Population
Authors: Skajaa Nils , Farkas Dóra Körmendiné , Adelborg Kasper , Sørensen Henrik Toft
Published: August 2023

BACKGROUND:

Whether cerebral venous thrombosis (CVT) is a marker of cancer in clinical practice remains unknown. Little is known about the prognosis of cancer detected subsequent to CVT.

METHODS:

We used Danish nationwide registries (1996–2019) to identify patients with a first-time primary inpatient diagnosis of CVT without a history of cancer (N=811, 65% women, median age 42 years). We assessed the risk of an incident cancer diagnosis using standardized incidence ratios (SIRs). This measure contrasts the number of observed cancers among patients with CVT to the number of expected cancers where patients with CVT have the same cancer risk as the general population. We used Kaplan-Meier survival analysis and Cox regression to compare the survival of patients with both cancer and CVT with the survival of patients with cancer but without CVT, matched on cancer site, sex, age, and year of cancer diagnosis.

RESULTS:

Observing 43 incident cancer cases during follow-up, the overall SIR was unity (SIR, 1.04 [95% CI, 0.75–1.40]). However, the risk was ≈7-fold the expected level in the first 3 months following CVT diagnosis (SIR, 7.00 [95% CI, 3.02–13.80]) and ≈2-fold the expected level from 3 to 12 months following CVT diagnosis (SIR, 2.21 [95% CI, 0.89–4.56]). By 12 months following CVT diagnosis, the risk resembled the expected level (SIR, 0.76 [95% CI, 0.50–1.09]). Survival among cancer patients with prior CVT versus cancer patients without prior CVT was 91% versus 87% after 6 months and 65% versus 70% after 5 years. The adjusted hazard ratio of death was 0.78 (95% CI, 0.44–1.38).

CONCLUSIONS:

Patients with CVT were not at overall increased risk of a cancer diagnosis, except in the first 3 months after diagnosis during which period the risk was elevated ≈7-fold. The estimate from this early period, however, was based on only a few cancer diagnoses. Unlike other forms of venous thrombosis, a prior diagnosis of CVT did not negatively impact cancer survival.
New and additional records of Anacroneuria Klapálek (Plecoptera: Insecta) from Tocantins state, Brazil
Authors: RIPPEL MELLIS LAYRA SOARES , SALLES FREDERICO FALCÃO , FERNANDES ANDRÉ SILVA , KROLOW TIAGO KÜTTER
Published: August 2023

In this study we provide an updated list of Plecoptera based on recent collections covering areas from northern to southeastern Tocantins state, Brazil. It is the first work focused on the geographical distribution of the order in this region. Herein, we register Anacroneuria atrifrons Klapálek, 1922, Anacroneuria jaciara Bispo & Neves, 2005, Anacroneuria manauensis Ribeiro-Ferreira, 2001, and Anacroneuria terere Righi-Cavallaro & Lecci, 2010 for the first time to Tocantins with notes and illustrations of diagnostic features for these four species. Our work raises the number of stoneflies known from Tocantins to 13 species. Despite this increase in the number of species, we highlight the importance of expanding field collection efforts in different locations of the state, especially in the west and south regions, as well as increasing collection effort in each location, aiming for a better comprehension of this fauna.
Research on Choice Preference of Parallel Trains for High-Speed Rail Heterogeneous Passengers
Authors: Yang Yun , Zhang Xiaoqiang , Gao Dongsheng , Xu Xinhao , Zheng Boyan
Published: August 2023

The passenger capacity utilization of parallel trains on China’s high-speed railway (HSR) varies greatly, which seriously affects the revenue and passenger service quality of railroad companies. One of the key factors contributing to this issue is the uniformity of fares. To address this, China’s railway enterprises are implementing differential pricing reforms for parallel trains. This paper presents a two-step method that combines latent class analysis (LCA) and random parameter logit (RPL) models to estimate the preferences of diverse passengers for parallel trains and quantify them using willingness to pay. To illustrate this, we conducted revealed preference and stated preference questionnaire surveys at Nanning East Railway Station, China, focusing on the Nanning-Guangzhou HSR route. These surveys gathered data on passengers’ personal and travel attributes. LCA was carried out according to passenger attributes, and passengers were divided into three categories according to the goodness-of-fit measures. Through the questionnaire data, the travel time and departure time period of each category of the passenger were converted into costs, and the absolute value of each influencing factor of passengers for parallel trains was obtained. Considering the limited rational choice behavior of passengers, the perceived value of each influencing factor of passengers on parallel trains was calculated through prospect theory. Finally, an RPL model for parallel train choice of heterogeneous passengers was constructed, and the parameters of each category of the passenger were estimated based on the absolute value and perceived value of the influencing factors.
Quantification of hydrogen cyanide in fire effluent
Authors: Hansen-Bruhn Iben , McKenna Sean T , Hull T Richard
Published: August 2023

Hydrogen cyanide is often the most toxicologically significant component in fire effluents from nitrogen-containing materials. Unlike the other major asphyxiant, carbon monoxide, sensors for continuous hydrogen cyanide quantification, at and above dangerous concentrations, are not commercially available. This article investigates the analysis of fire effluent captured in bubbler solutions, by colorimetric quantification of hydrogen cyanide using chloramine-T/isonicotinic acid. The bubbler samples were mixed with colorimetric reagents to give a blue dye in response to cyanide ions. A novel reaction scheme accounting for the formation of the blue dye from cyanide ions is presented. Dilute, standard cyanide solutions were found to be stable after storage for up to 1 year. Alkaline bubbler solutions, through which the fire effluent has passed, showed consistent cyanide concentrations, for samples stored between 5°C and 21°C, for up to 31 days after sampling. The effect of other common ions likely to be present in fire effluent solution samples (CO32−, SO32−, SO42−, NO2− and NO3−) was investigated for their potential interference. The most significant interference was sulphite which reduced the apparent cyanide concentration by 13% at 10 mg L−1SO32− concentration.
HAPLN1 matrikine: a bone marrow homing factor linked to poor outcomes in patients with MM
Authors: Chang Hae Yeun , Huynh Mailee , Roopra Avtar , Callander Natalie S. , Miyamoto Shigeki
Published: August 2023

The bone marrow (BM) microenvironment is critical for dissemination, growth, and survival of multiple myeloma (MM) cells. Homing of myeloma cells to the BM niche is a crucial step in MM dissemination, but the mechanisms involved are incompletely understood. In particular, any role of matrikines, neofunctional peptides derived from extracellular matrix proteins, remains unknown. Here, we report that a matrikine derived from hyaluronan and proteoglycan link protein 1 (HAPLN1) induces MM cell adhesion to the BM stromal components, such as fibronectin, endothelial cells, and stromal cells and, furthermore, induces their chemotactic and chemokinetic migration. In a mouse xenograft model, we show that MM cells preferentially home to HAPLN1 matrikine–conditioned BM. The transcription factor STAT1 is activated by HAPLN1 matrikine and is necessary to induce MM cell adhesion, migration, migration-related genes, and BM homing. STAT1 activation is mediated by interferon beta (IFN-β), which is induced by NF-κB after stimulation by HAPLN1 matrikine. Finally, we also provide evidence that higher levels of HAPLN1 in BM samples correlate with poorer progression-free survival of patients with newly diagnosed MM. These data reveal that a matrikine present in the BM microenvironment acts as a chemoattractant, plays an important role in BM homing of MM cells via NF-κB–IFN-β–STAT1 signaling, and may help identify patients with poor outcomes. This study also provides a mechanistic rationale for targeting HAPLN1 matrikine in MM therapy.
Source Quantitative Identification by Reference-Based Cubic Blind Deconvolution Algorithm
Authors: Luo Xin , Zhang Zhousuo , Gong Teng , Li Yongjie
Published: August 2023

The semi-blind deconvolution algorithm improves the separation accuracy by introducing reference information. However, the separation performance depends largely on the construction of reference signals. To improve the robustness of the semi-blind deconvolution algorithm to the reference signals and the convergence speed, the reference-based cubic blind deconvolution algorithm is proposed in this paper. The proposed algorithm can be combined with the contribution evaluation to provide trustworthy guidance for suppressing satellite micro-vibration. The normalized reference-based cubic contrast function is proposed and the validity of the new contrast function is theoretically proved. By deriving the optimal step size of gradient iteration under the new contrast function, we propose an efficient adaptive step optimization method. Furthermore, the contribution evaluation method based on vector projection is presented to implement the source contribution evaluation. Numerical simulation analysis is carried out to validate the availability and superiority of this method. Further tests given by the simulated satellite experiment and satellite ground experiment also confirm the effectiveness. The signals of control moment gyroscope and flywheel were extracted, respectively, and the contribution evaluation of vibration sources to the sensitive load area was realized. This research proposes a more accurate and robust algorithm for the source separation and provides an effective tool for the quantitative identification of the mechanical vibration sources.
Low-intensity transcranial ultrasound stimulation modulates neural activities in mice under propofol anaesthesia
Authors: Liu Meiqi , Yuan Yi , Wang Xingran , Wang Teng , Bian Nannan , Zhao Li , Cui Guangying , Liu Wenchao , Ma Zhongfeng , Yang Xiaochun , Liang Shujuan , Liu Zhuo
Published: August 2023

Background

Previous studies have reported that transcranial focused ultrasound stimulation can significantly decrease the time to emergence from intraperitoneal ketamine-xylazine anaesthesia in rats. However, how transcranial focused ultrasound stimulation modulates neural activity in anaesthetized rats is unclear.

Methods

In this study, to answer this question, we used low-intensity transcranial ultrasound stimulation (TUS) to stimulate the brain tissue of propofol-anaesthetized mice, recorded local field potentials (LFPs) in the mouse motor cortex and electromyography (EMG) signals from the mouse neck, and analysed the emergence and recovery time, mean absolute power, relative power and entropy of local field potentials.

Results

We found that the time to emergence from anaesthesia in the TUS group (20.3 ± 1.7 min) was significantly less than that in the Sham group (32 ± 2.6 min). We also found that compared with the Sham group, 20 min after low-intensity TUS during recovery from anaesthesia, (1) the absolute power of local field potentials in mice was significantly reduced in the [1–4 Hz] and [13–30 Hz] frequency bands and significantly increased in the [55–100 Hz], [100–140 Hz] and [140–200 Hz] frequency bands; (2) the relative power of local field potentials in mice was enhanced at [30–45 Hz], [100–140 Hz] and [140–200 Hz] frequency bands; (3) the entropy of local field potentials ([1-200 Hz]) was increased.

Conclusion

These results demonstrate that low-intensity TUS can effectively modulate neural activities in both awake and anaesthetized mice and has a positive effect on recovery from propofol anaesthesia in mice.
Poor preoperative performance at Clock Drawing Test is associated with postoperative decline in olfaction in older patients: an observational pilot study
Authors: Van Regemorter Victoria , Coulie Richard , Dollase Jordi , Momeni Mona , Stouffs Alexandre , Quenon Lisa , Mouraux André , Huart Caroline
Published: August 2023

Background

Decline in olfaction may occur after general anesthesia, but the exact incidence and underlying physiopathology remain scarcely investigated. Olfactory dysfunction arises with aging and is known to be linked to cognitive impairment. In this pilot study, we evaluated the incidence of immediate postoperative decline in olfaction and its association with a preoperative cognitive test, performance at Clock Drawing Test (CDT), in a group of older patients.

Methods

This pilot study is a sub-analysis of a prospective observational study. Patients ≥ 65 years old and scheduled for elective non-cardiac surgery under sevoflurane-based anesthesia were enrolled. CDT was part of the preoperative evaluation. We assessed olfaction on the day before and the day after surgery (between 16 and 26 h postoperatively) using the Sniffin’ Sticks 12-item identification test, which consists of pen-like devices displaying 12 different odors. Postoperative decline in olfaction was defined as a decrease of at least 1 standard deviation in the olfactory score.

Results

We included a total of 93 patients, among whom 19 (20.4%) presented a postoperative decline in olfaction. The incidence of postoperative decline in olfaction was higher in the “CDT low-score” (score ≤ 5/8) group (11/34, 32.4%) than in the “CDT high-score” (score ≥ 6/8) group (8/58, 13.6%) (P = 0.030). Despite adjusting for confounding variables, CDT score remained independently associated with immediate postoperative decline in olfactory identification function (OR 0.67, 95% CI 0.48 to 0.94, P = 0.022).

Conclusions

Postoperative decline in olfaction occurred in 20.4% of older patients and was associated with poor preoperative performance at CDT.

Trial registration

This study was retrospectively registered on https://clinicaltrials.gov/ under the NCT04700891 number (principal investigator: Victoria Van Regemorter), in December 2020.
Value of gym-based group exercise versus usual care for young adults receiving antipsychotic medication: study protocol for the multicenter randomized controlled Vega trial
Authors: Rafn Bolette Skjødt , Andersen Martin Færch , Sørensen Victor , Bjerre Eik Dybboe , Baandrup Lone , Vernal Ditte Lammers , Mors Ole , Knop Filip Krag , Wolf Rasmus Trap , Tolver Anders , Firth Joseph , Nøhr Nikolaj , Skou Søren T. , Ebdrup Bjørn H. , Midtgaard Julie
Published: August 2023

Background

Exercise is recommended to protect physical health among people with severe mental illness and holds the potential to facilitate long-term recovery. An inclusive exercise community provides an opportunity for life skill training and social connectedness and may reduce the experience of loneliness and internalized stigmatization which together may improve personal recovery. Using a pragmatic randomized design, we aim to examine the effectiveness of a gym-based exercise intervention tailored to young adults in antipsychotic treatment (i.e., Vega Exercise Community) compared to usual care. It is hypothesized that the Vega Exercise Community will be superior to usual care for personal recovery at four months.

Methods

The trial will be conducted at four sites in Denmark from which 400 participants, aged 18 to 35 years, who are in current treatment with antipsychotic medications for the management of schizophrenia spectrum or affective disorders, will be recruited. Participants will be randomized (2:1) to Vega Exercise Community or usual care. Vega Exercise Community includes three weekly group-based exercise sessions hosted in commercial functional training centers delivered by certified Vega instructors. After four months, participants in Vega Exercise Community will be randomized (1:1) to minimal versus extended support with regards to sustained physical activity. Data will be collected at baseline, four, six and 12 months. The primary outcome is personal recovery assessed by Questionnaire about the Process of Recovery at four months. Behavioral symptoms, health-related quality of life, metabolic health, and program costs will be evaluated to further determine the effectiveness and cost-effectiveness of the Vega Exercise Community. Finally, the quality of life and physical and mental health of the participants’ primary relative will be evaluated.

Discussion

The results of this trial may have important implications for health, sustained physical activity, and recovery for individuals in treatment with antipsychotics. Given the pragmatic design, positive results may readily be implemented by mental health care professionals to promote exercise as an integrated part of treatment of severe mental illness.

Trial registration

Clinical Trials.gov (NCT05461885, initial registration June 29th, 2022). WHO Universal Trial Number (UTN): U1111-1271–9928.
Effects of family function, depression, and self-perceived burden on loneliness in patients with type 2 diabetes mellitus: a serial multiple mediation model
Authors: Zhang Yu , Li Xiangning , Bi Yaxin , Kan Yinshi , Liu Hongyuan , Liu Lin , Zou Yan , Zhang Ning , Fang Li , Gong Weijuan
Published: August 2023

Background

Type 2 Diabetes mellitus (T2DM) has become a major lifestyle disease endangering human health worldwide. Patients with T2DM face varying degrees of loneliness, which adversely affects their family and the larger society. This study investigates the serial multiple mediating roles of depression and self-perceived burden between family function and loneliness in the T2DM population of China.

Methods

In total, 260 T2DM patients were included. They rated themselves based on UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Family Care Index, and Self-Perceived Burden Scale. Pearson and Spearman correlation analyses were conducted to clarify the association among variables. The SPSS macro-PROCESS program was used for a series of multiple mediation analyses.

Results

Family function, depression, self-perceived burden, and loneliness were significantly correlated (P < 0.01). Family function not only has a direct negative impact (effect = -2.809; SE = 0.213; 95%CI: LL = -3.228, UL = -2.390) on loneliness, but also has an indirect impact on loneliness through the independent mediating role of depression (effect = -0.862; SE = 0.165; 95%CI: LL = -1.202, UL = -0.567) and self-perceived burden (effect = -0.288; SE = 0.107; 95%CI: LL = -0.525, UL = -0.114) and the chain mediating role of depression and self-perceived burden (effect = -0.202; SE = 0.066; 95%CI: LL = -0.342, UL = -0.088).

Conclusions

Diversified interventions aimed at improving family function of T2DM patients would help in reducing the level of depression and self-perceived burden, and ultimately reducing loneliness.
Understanding the behavioral determinants that predict barriers and enablers of screening and treatment behaviors for diabetic retinopathy among Bangladeshi women: findings from a barrier analysis
Authors: Kalam Md Abul , Al Asif Chowdhury Abdullah , Hasan Md. Mehedi , Arif-Ur-Rahman Md. , Nag Dipak Kumar , Sen Pallab Kumar , Haque Akhanda Md. Aminul , Davis Thomas P. , Talukder Aminuzzaman
Published: August 2023

Background and aim

While early detection and timely treatments can prevent diabetic retinopathy (DR) related blindness, barriers to receiving these DR services may cause permanent sight loss. Despite having similar prevalence to diabetes and DR, women are less likely than men to perform these behaviors due to multi-faced barriers in screening and receiving follow-up treatments for DR. This study, therefore, aimed at identifying the barriers to – and enablers of – screening and follow-up treatments behaviors for DR among women aged more than 40 years with diabetes from the behavioral perspectives in Bangladesh.

Methods

This Barrier Analysis study interviewed 360 women (180 “Doers” and 180 “Non-doers”) to explore twelve behavioral determinants of four DR behaviors including screening, injection of anti-vascular endothelial growth factor (anti-VEGF medication), laser therapy and vitro-retinal surgery. The data analysis was performed to calculate estimated relative risk to identify the degree of association between the determinants and behaviors, and to find statistically significant differences (at p < 0.05) in the responses between the Doers and Non-doers.

Results

Access to healthcare facilities was the major barrier impeding women from performing DR behaviors. Difficulty in locating DR service centers, the need to travel long distances, the inability to travel alone and during illness, challenges of paying for transportation and managing workload significantly affected women’s ability to perform the behaviors. Other determinants included women’s perceived self-efficacy, perceived negative consequences (e.g. fear and discomfort associated with injections or laser treatment), and cues for action. Significant perceived enablers included low cost of DR treatments, supportive attitudes by healthcare providers, government policy, and perceived social norms.

Conclusion

The study found a host of determinants related to the barriers to and enablers of DR screening and treatment behaviors. These determinants included perceived self-efficacy (and agency), positive and negative consequences, perceived access, perceived social norms, culture, and perceived risk. Further investments are required to enhance the availability of DR services within primary and secondary health institutions along with health behavior promotion to dispel misconceptions and fears related to DR treatments.
Socioeconomic inequalities in diabetes prevalence: the case of Egypt between 2008 and 2015
Authors: Sidahmed Sahar , Geyer Siegfried , Beller Johannes
Published: August 2023

Background

There is a steady increase in diabetes prevalence globally and many studies imply that high socioeconomic status (SES) is inversely related to diabetes prevalence. However, there is scarcity in literature from countries like Egypt regarding this topic.

Methods

This study aims to investigate prevalence of diabetes in Egypt between 2008 and 2015, and the effect of SES. Diabetes prevalence -based on self-reports of past diagnosis- was measured using two datasets Egypt DHS 2008 (10,917 participants) and EHIS 2015 (16,485 participants). Logistic regression and odds ratios (ORs) with 95% confidence intervals (CIs) were applied for diabetes controlling for age, gender, educational level, employment status and place of residence. Extend of difference in diabetes prevalence between the two time points was measured by combining the two datasets using the EDHS 2008 as reference.

Results

Diabetes prevalence was higher in 2015 (4.83%) compared to 2008 (3.48%). It was more in women at both time points (4.08% and 5.16% in 2008 and 2015 respectively) compared to men (2.80% and 4.43% in 2008 and 2015 respectively). Older age and living in urban areas were positively related to diabetes prevalence at both time points. Men had a significant higher chance of developing diabetes in 2015 (OR = 1.45, p-value = 0.001). Men with higher education had higher chance of developing diabetes (OR = 1.76), in contrast to women (OR = 0.59). Employment decreased the chance of developing diabetes for men (OR = .72), but had minimal effect on women (OR = 1.06).

Conclusion

Diabetes prevalence in Egypt has increased between the years 2008 and 2015 and evident social inequalities were found. Women had more diabetes than men and were more affected with low SES. Unlike women, highly educated men had higher chance of developing diabetes in 2015 compared to 2008. This might be attributed to behavioral and sociocultural factors.
Biomechanical properties of lumbar vertebral ring apophysis cage under endplate injury: a finite element analysis
Authors: Wang Jian , Geng Ziming , Wu Jincheng , Liu Jianchao , Zhang Zepei , Miao Jun , Li Ruihua
Published: August 2023

Objective

This study aimed to compare the biomechanical properties of lumbar interbody fusion involving two types of cages. The study evaluated the effectiveness of the cage spanning the ring apophysis, regardless of the endplate's integrity.

Methods

A finite element model of the normal spine was established and validated in this study. The validated model was then utilized to simulate Lateral Lumbar Interbody Fusion (LLIF) with posterior pedicle screw fixation without posterior osteotomy. Two models of interbody fusion cage were placed at the L4/5 level, and the destruction of the bony endplate caused by curetting the cartilaginous endplate during surgery was simulated. Four models were established, including Model 1 with an intact endplate and long cage spanning the ring apophysis, Model 2 with endplate decortication and long cage spanning the ring apophysis, Model 3 with an intact endplate and short cage, and Model 4 with endplate decortication and short cage. Analyzed were the ROM of the fixed and adjacent segments, screw rod system stress, interface stress between cage and L5 endplate, trabecular bone stress on the upper surface of L5, and intervertebral disc pressure (IDP) of adjacent segments.

Results

There were no significant differences in ROM and IDP between adjacent segments in each postoperative model. In the short cage model, the range of motion (ROM), contact pressure between the cage and endplate, stress in L5 cancellous bone, and stress in the screw-rod system all exhibited an increase ranging from 0.4% to 79.9%, 252.9% to 526.9%, 27.3% to 133.3%, and 11.4% to 107%, respectively. This trend was further amplified when the endplate was damaged, resulting in a maximum increase of 88.6%, 676.1%, 516.6%, and 109.3%, respectively. Regardless of the integrity of the endplate, the long cage provided greater support strength compared to the short cage.

Conclusions

Caution should be exercised during endplate preparation and cage placement to maintain the endplate's integrity. Based on preoperative X-ray evaluation, the selection of a cage that exceeds the width of the pedicle by at least 5 mm (ensuring complete coverage of the vertebral ring) has demonstrated remarkable biomechanical performance in lateral lumbar interbody fusion procedures. By opting for such a cage, we expect a reduced occurrence of complications, including cage subsidence, internal fixation system failure, and rod fracture.
Breast stiffness, a risk factor for cancer and the role of radiology for diagnosis
Authors: Tarchi Sofia M. , Pernia Marin Monica , Hossain Md. Murad , Salvatore Mary
Published: August 2023

Over the last five decades, breast density has been associated with increased risk of developing breast cancer. Mammographically dense breasts are considered those belonging to the heterogeneously dense breasts, and extremely dense breasts subgroups according to the American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS). There is a statistically significant correlation between the increased mammographic density and the presence of more glandular tissue alone. However, the strength of this correlation is weak. Although the mechanisms driving breast density-related tumor initiation and progression are still unknown, there is evidence suggesting that certain molecular pathways participating in epithelial-stromal interactions may play a pivotal role in the deposition of fibrillar collagen, increased matrix stiffness, and cell migration that favor breast density and carcinogenesis. This article describes these molecular mechanisms as potential “landscapers” for breast density-related cancer. We also introduce the term “Breast Compactness” to reflect collagen density of breast tissue on chest CT scan and the use of breast stiffness measurements as imaging biomarkers for breast cancer screening and risk stratification.
RGS2 and female common diseases: a guard of women’s health
Authors: Xu Qiang , Yao Mukun , Tang Chao
Published: August 2023

Currently, women around the world are still suffering from various female common diseases with the high incidence, such as ovarian cancer, uterine fibroids and preeclampsia (PE), and some diseases are even with the high mortality rate. As a negative feedback regulator in G Protein-Coupled Receptor signaling (GPCR), the Regulator of G-protein Signaling (RGS) protein family participates in regulating kinds of cell biological functions by destabilizing the enzyme–substrate complex through the transformation of hydrolysis of G Guanosine Triphosphate (GTP). Recent work has indicated that, the Regulator of G-protein Signaling 2 (RGS2), a member belonging to the RGS protein family, is closely associated with the occurrence and development of certain female diseases, providing with the evidence that RGS2 functions in sustaining women’s health. In this review paper, we summarize the current knowledge of RGS2 in female common diseases, and also tap and discuss its therapeutic potential by targeting multiple mechanisms.
GDF-15 and hepcidin as a therapeutic target for anemia in chronic kidney disease
Authors: Farag Naglaa Makram , Mousa Mahmoud , Elsayed Eman , Ismeil Ahlam
Published: August 2023

Background

Anaemia is a common presenting feature among patients with chronic kidney disease (CKD) and associated with poor clinical outcomes. We evaluated the diagnostic validity of growth differentiation factor-15 (GDF-15) and hepcidin as it is not clear if they are useful as a biomarkers of anaemia among non-dialysis CKD egyptian patients.

Method

An analytical cross-sectional study was conducted among non-dialysis CKD patients (n = 60) and apparently healthy controls (n = 28) at Minia University maternity & children Hospital. Serum levels of GDF-15 and hepcidin were determined. Predictive logistic regression models were built and post estimation receiver operator characteristics were determined to evaluate diagnostic validity of hepcidin and GDF-15 for iron deficiency anaemia.

Results

Hepcidin and GDF-15 are significantly higher in cases than control p value (0.047 < 0.0001) respectively. The predictive value of diagnosing anaemia among CKD patients using hepcidin and GDF-15 was 72.0%, 70.0%. There was a weak negative correlation between hepcidin levels and glomerular filtration rate GFR (r = -.175, p = 0.105) in CKD patients, and significant correlation between serum GDF-15 and haemoglobin (r = -0.897, p < 0.0001), ferritin (r = 0.489, P < 0.000), Iron (r = -0.314, P = 0.002), CRP (r = 0.409, P < 0.0001).

Conclusion

Hepcidin and GDF-15 is a potential biomarker for predicting anaemia connected with inflammation among CKD Egyptian patients.
Proton pump inhibitors in critically ill mechanically ventilated patients with COVID-19: protocol for a substudy of the Re-EValuating the Inhibition of Stress Erosions (REVISE) Trial
Authors: Dennis Brittany B. , Thabane Lehana , Heels-Ansdell Diane , Dionne Joanna C. , Binnie Alexandra , Tsang Jennifer , Guyatt Gordon , Ahmed Aijaz , Lauzier François , Deane Adam , Arabi Yaseen , Marshall John , Zytaruk Nicole , Saunders Lois , Finfer Simon , Myburgh John , Muscedere John , English Shane , Ostermann Marlies , Hardie Miranda , Knowles Serena , Cook Deborah ,   For the REVISE Investigators the Canadian Critical Care Trials Group
Published: August 2023

Background

Critically ill patients commonly receive proton pump inhibitors (PPIs) to prevent gastrointestinal (GI) bleeding from stress-induced ulceration. Despite widespread use in the intensive care unit (ICU), observational data suggest that PPIs may be associated with adverse outcomes in patients with COVID-19 infection. This preplanned study is nested within a large randomized trial evaluating pantoprazole versus placebo in invasively ventilated patients. The 3 objectives are as follows: (1) to describe the characteristics of patients with COVID-19 in terms of demographics, biomarkers, venous thromboembolism, tracheostomy incidence and timing, and other clinical outcomes; (2) to evaluate the impact of COVID-19 infection on clinically important GI bleeding, 90-day mortality, and other outcomes compared to a propensity-matched non-infected cohort; and (3) to explore whether pantoprazole has a differential treatment effect on clinically important GI bleeding, 90-day mortality, and other outcomes in patients with and without COVID-19 infection.

Methods

The ongoing trial Re-EValuating the Inhibition of Stress Erosions (REVISE) compares pantoprazole 40 mg IV to placebo on the primary efficacy outcome of clinically important GI bleeding and the primary safety outcome of 90-day mortality. The protocol described in this report is for a substudy focused on patients with COVID-19 infection that was not in the original pre-pandemic trial protocol. We developed a one-page case report form to characterize these patients including data related to biomarkers, venous thromboembolism, COVID-19 therapies, tracheostomy incidence and timing, duration of mechanical ventilation, and ICU and hospital stay. Our analysis will describe the trajectory of patients with COVID-19 infection, a propensity-matched analysis of infected and non-infected patients, and an extended subgroup analysis comparing the effect of PPI among patients with and without COVID-19 infection.

Discussion

Prophylactic acid suppression in invasively ventilated critically ill patients with COVID-19 infection has unknown consequences. The results of these investigations will inform practice, guidelines, and future research.

Trial registration

REVISE Trial [NCT03374800 December 15, 2017], COVID-19 Cohort Study [NCT05715567 February 8, 2023].
Metabolomics analysis of visceral leishmaniasis based on urine of golden hamsters
Authors: Yuan Dongmei , Chen Jianping , Zhao Zhiwei , Qin Hanxiao
Published: August 2023

Background

Leishmaniasis is one of the most neglected tropical diseases and is spread mainly in impoverished regions of the world. Although many studies have focused on the host’s response to Leishmania invasion, relatively less is known about the complex processes at the metabolic level, especially the metabolic alterations in the infected hosts.

Methods

In this study, we conducted metabolomics analysis on the urine of golden hamsters in the presence or absence of visceral leishmaniasis (VL) using the ultra-performance liquid chromatography (UPLC) system tandem high-resolution mass spectrometer (HRMS). The metabolic characteristics of urine samples, along with the histopathological change and the parasite burden of liver and spleen tissues, were detected at 4 and 12 weeks post infection (WPI), respectively.

Results

Amino acid metabolism was extensively affected at both stages of VL progression. Meanwhile, there were also distinct metabolic features at different stages. At 4 WPI, the significantly affected metabolic pathways involved alanine, aspartate and glutamate metabolism, the pentose phosphate pathway (PPP), histidine metabolism, tryptophan metabolism and tyrosine metabolism. At 12 WPI, the markedly enriched metabolic pathways were almost concentrated on amino acid metabolism, including tyrosine metabolism, taurine and hypotaurine metabolism and tryptophan metabolism. The dysregulated metabolites and metabolic pathways at 12 WPI were obviously less than those at 4 WPI. In addition, seven metabolites that were dysregulated at both stages through partial least squares-discriminant analysis (PLS-DA) and receiver-operating characteristic (ROC) tests were screened to be of diagnostic potential. The combination of these metabolites as a potential biomarker panel showed satisfactory performance in distinguishing infection groups from control groups as well as among different stages of infection.

Conclusion

Our findings could provide valuable information for further understanding of the host response to Leishmania infection from the aspect of the urine metabolome. The proposed urine biomarker panel could help in the development of a novel approach for the diagnosis and prognosis of VL.

Graphical Abstract
The microsporidian polar tube: origin, structure, composition, function, and application
Authors: Chen Yuqing , Lv Qing , Liao Hongjie , Xie Zhengkai , Hong Liuyi , Qi Lei , Pan Guoqing , Long Mengxian , Zhou Zeyang
Published: August 2023

Microsporidia are a class of obligate intracellular parasitic unicellular eukaryotes that infect a variety of hosts, even including humans. Although different species of microsporidia differ in host range and specificity, they all share a similar infection organelle, the polar tube, which is also defined as the polar filament in mature spores. In response to the appropriate environmental stimulation, the spore germinates with the polar filament everted, forming a hollow polar tube, and then the infectious cargo is transported into host cells via the polar tube. Hence, the polar tube plays a key role in microsporidian infection. Here, we review the origin, structure, composition, function, and application of the microsporidian polar tube, focusing on the origin of the polar filament, the structural differences between the polar filament and polar tube, and the characteristics of polar tube proteins. Comparing the three-dimensional structure of PTP6 homologous proteins provides new insight for the screening of additional novel polar tube proteins with low sequence similarity in microsporidia. In addition, the interaction of the polar tube with the spore wall and the host are summarized to better understand the infection mechanism of microsporidia. Due to the specificity of polar tube proteins, they are also used as the target in the diagnosis and prevention of microsporidiosis. With the present findings, we propose a future study on the polar tube of microsporidia.

Graphical Abstract
Different associations between amyloid-βeta 42, amyloid-βeta 40, and amyloid-βeta 42/40 with soluble phosphorylated-tau and disease burden in Alzheimer’s disease: a cerebrospinal fluid and fluorodeoxyglucose-positron emission tomography study
Authors: Motta Caterina , Di Donna Martina Gaia , Bonomi Chiara Giuseppina , Assogna Martina , Chiaravalloti Agostino , Mercuri Nicola Biagio , Koch Giacomo , Martorana Alessandro
Published: August 2023

Background

Despite the high sensitivity of cerebrospinal fluid (CSF) amyloid beta (Aβ)42 to detect amyloid pathology, the Aβ42/Aβ40 ratio (amyR) better estimates amyloid load, with higher specificity for Alzheimer’s disease (AD). However, whether Aβ42 and amyR have different meanings and whether Aβ40 represents more than an Aβ42-corrective factor remain to be clarified. Our study aimed to compare the ability of Aβ42 and amyR to detect AD pathology in terms of p-tau/Aβ42 ratio and brain glucose metabolic patterns using fluorodeoxyglucose-positron emission tomography (FDG-PET).

Methods

CSF biomarkers were analyzed with EUROIMMUN ELISA. We included 163 patients showing pathological CSF Aβ42 and normal p-tau (A + T −  = 98) or pathological p-tau levels (A + T +  = 65) and 36 control subjects (A − T −). A + T − patients were further stratified into those with normal (CSFAβ42 + /amyR −  = 46) and pathological amyR (CSFAβ42 + /amyR +  = 52). We used two distinct cut-offs to determine pathological values of p-tau/Aβ42: (1) ≥ 0.086 and (2) ≥ 0.122. FDG-PET patterns were evaluated in a subsample of patients (n = 46) and compared to 24 controls.

Results

CSF Aβ40 levels were the lowest in A − T − and in CSFAβ42 + /amyR − , higher in CSFAβ42 + /amyR + and highest in A + T + (F = 50.75; p < 0.001), resembling CSF levels of p-tau (F = 192; p < 0.001). We found a positive association between Aβ40 and p-tau in A − T − (β = 0.58; p < 0.001), CSFAβ42 + /amyR − (β = 0.47; p < 0.001), and CSFAβ42 + /amyR + patients (β = 0.48; p < 0.001) but not in A + T + . Investigating biomarker changes as a function of amyR, we observed a weak variation in CSF p-tau (+ 2 z-scores) and Aβ40 (+ 0.8 z-scores) in the normal amyR range, becoming steeper over the pathological threshold of amyR (p-tau: + 5 z-scores, Aβ40: + 4.5 z-score). CSFAβ42 + /amyR + patients showed a significantly higher probability of having pathological p-tau/Aβ42 than CSFAβ42 + /amyR − (cut-off ≥ 0.086: OR 23.3; cut-off ≥ 0.122: OR 8.8), which however still showed pathological values of p-tau/Aβ42 in some cases (cut-off ≥ 0.086: 35.7%; cut-off ≥ 0.122: 17.3%) unlike A − T − . Accordingly, we found reduced FDG metabolism in the temporoparietal regions of CSFAβ42 + /amyR − compared to controls, and further reduction in frontal areas in CSFAβ42 + /amyR + , like in A + T + .

Conclusions

Pathological p-tau/Aβ42 and FDG hypometabolism typical of AD can be found in patients with decreased CSF Aβ42 levels alone. AmyR positivity, associated with higher Aβ40 levels, is accompanied by higher CSF p-tau and widespread FDG hypometabolism.
An analytical approach to the pricing of an exchange option with default risk under a stochastic volatility model
Authors: Jeon Jaegi , Huh Jeonggyu , Kim Geonwoo
Published: August 2023

The exchange option, which has two correlated underlying assets, is one of the most popular exotic options in the over-the-counter markets. This paper studies the valuation of exchange options with default risk of option issuer, where default is allowed only at maturity. Moreover, we consider three underlying assets with stochastic volatilities and assume that fast mean-reverting processes determine the stochastic volatilities. Based on the partial differential equation approach, we derive the analytical pricing formula of the exchange option price with default risk using the asymptotic expansion. To verify the accuracy and efficiency of our pricing formula, we compare the results by our pricing formula with those by Monte Carlo simulation, which is considered a benchmark. In addition, we provide several graphs to illustrate the properties of the option for significant parameters.