bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of hemostatic ability between spray coagulation and forced coagulation modes in endoscopic submucosal dissection in patients with early gastric neoplasms: A study protocol for multicenter randomized controlled trial (Spray-G trial)
Authors: Maehara Kosuke , Esaki Mitsuru , Sumida Yorinobu , Yamaguchi Daisuke , Nishioka Kei , Homma Hitoshi , Inada Taisuke , Shiotsuki Kazuo , Fukuda Shin-Ichiro , Akiho Hirotada , Nomura Tadahiro , Mizuta Yumi , Ishida Satoshi , Fujimoto Shun , Kimura Shunichiro , Tanaka Yuichiro , Hata Kaori , Shiga Noriko , Iwasa Tsutomu , Kimura Yusuke , Nakamura Norimoto , Suzuki Yusuke , Minoda Yosuke , Hata Yoshitaka , Ogino Haruei , Tagawa Koshiro , Ihara Eikichi , Ogawa Yoshihiro
Published: September 2023

Background: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric neoplasms (EGN). Controlling intraoperative bleeding is crucial for ensuring safe and reliable procedures. ESD using the Spray Coagulation Mode (SCM-ESD) has been developed to control bleeding more effectively than ESD using the conventional Forced Coagulation mode (FCM-ESD). This study aims to compare the hemostatic efficacies of SCM-ESD and FCM-ESD.
Methods: This multicenter, prospective, parallel, randomized, open-label superiority trial will be conducted in five Japanese institutions. Patients with a preoperative diagnosis of intramucosal EGC will be randomized to undergo either SCM-ESD or FCM-ESD. The primary outcome measure is the completion of ESD with an electrosurgical knife alone, without the use of hemostatic forceps. Secondary outcomes include the number and duration of hemostasis using hemostatic forceps, procedure time, curability, and safety. A total of 130 patients will be enrolled in this study.
Discussion:This trial will provide evidence on the hemostatic efficacy of SCM-ESD compared with FCM-ESD in patients with intramucosal EGN, potentially improving the safety and reliability of ESD procedures.
Trial Registration: The trial has been registered at the University Hospital Medical Information Network Clinical Trials Registration (UMIN-CTR) as UMIN000040518.
Spatio-temporal Analysis of Albedo Changes and its relationship with climatic and physiographic factors of the earth surface in Iran
Authors: nejad meysam toulabi , sharifi leyla , dolatshahi zeynab , nejad mehrshad toulabi
Published: September 2023

This research aims to analyze spatial-temporal changes of albedo. Cloudiness, topography and vegetation density (NDVI) in Iran were investigated based on the parameters of soil humidity (Wetness), using MEERA2 model with a resolution of 50 x 50 km from 2010 to 2020. The results of the spatial analysis of albedo values in Iran showed that the highest values belong to western and then central regions while the lowest albedo values belong to the north and northwest regions. The highest value is 30% on average recorded at 44 to 45 ºE and the lowest reflection value is14% on average recorded between 50 to 51 ºE, i.e. the eastern slopes of the Zagros mountain range. In terms of latitude, the lowest value was at 37.5 ºN and the highest value was at 30.5 ºN showing 17 and 29 percent, respectively. In terms of provincial changes of albedo value, the highest reflection being 25.3% belongs to Ilam province, and the lowest albedo value belongs to northern provinces (Gilan and Mazandaran) being 17.5% on average. Similarly, the results of time analysis on a seasonal scale showed that the highest recorded value of surface albedo is 21.1% in the summer and the lowest is 19.8%in the spring. In the areas with small amounts of surface albedo, cloud cover, vegetation and humidity are higher, and the slope is toward the southwest; but the areas with higher values of surface albedo have less vegetation cover, cloudiness and humidity and the slope is toward the north.
Effect of preinfusion of low-dose alfentanil on the induction of anesthesia with remimazolam in gynecological day surgery: a prospective, double-blind, randomized controlled study
Authors: Lu Dong , Qin Dalong , Gao Dong , Ji Fanceng , Zhao Xiaoyong , Shan Jinghua , Sun Meiyan
Published: September 2023

Purpose: Alfentanil has a synergistic sedative effect with benzodiazepines, and this study aimed to investigate the effect of preinfusion of low-dose alfentanil on the dose of remimazolam for loss of consciousness while observing the effect on hemodynamic changes and other adverse effects.Methods: Thirty-four gynecological day surgery patients were selected and randomly divided into the control group and the observation group; before anesthesia induction, both groups were given dexamethasone 5 mg, haloperidol 1 mg, and flurbiprofen ester 50 mg. Anesthesia induction: The control group was prefilled with 10 ml of saline, and remimazolam was pumped in rate of 6 mg/kg/h until consciousness disappeared; Micuronium chloride was injected slowly at 30 seconds, alfentanil 15 µg/kg was injected slowly at 30 seconds, and mechanical ventilation was carried out 2 minutes after placement of a laryngeal mask. In the observation group, first, 5µg/kg of alfentanil diluted to 10 ml was administered, remimazolam was pumped at rate of 6 mg/kg/h until consciousness disappeared, 0.2 mg/kg micuronium chloride was injected slowly for 30 seconds, 15 µg/kg alfentanil was injected slowly for 30 seconds, assisted ventilation was performed, a laryngeal mask was placed after 2 minutes, and mechanical ventilation was implemented. Anesthesia maintenance: remimazolam 1 mg/kg/h, alfentanil 40 µg/kg/h to maintain anesthesia, and micuronium chloride 0.05 mg/kg was given for more than 30 minutes of surgery; infusion of anesthetics was stopped at the end of surgery. The primary outcome was the dose of remimazolam for loss of consciousness; the secondary outcomes were the changes in hemodynamics during the induction period of anesthesia, and the incidence of adverse events such as hiccups and involuntary body movements during the induction period.Results:The dose of remimazolam for loss of consciousness in group A (13.14±2.51) mg was lower than that in group C (17.09±3.40) mg (p<0.05); the time to loss of consciousness in group A (123.81±21.08) s was lower than that in group C (156.80±30.67) s (p<0.05); the incidence rate of total adverse reactions in group A (12.5%) was lower than that in group C ( 46.6%); the heart rate of group A was slightly higher than that of group C (p=0.003), and there was no significant difference in MAP, SPO2 and BIS between the two groups (p>0.05).Conclusions: Preinfusion of a low dose of alfentanil significantly reduces the dose of remimazolam, causing loss of consciousness, speeds up induction, reduces the overall rate of adverse effects, and slightly increases heart rate.
Successful therapy by WBRT with concurrent intrathecal MTX for isolated leptomeningeal metastasis in ER+ HER2− breast cancer: case report
Authors: Liu Shuying , Pei Jinrui , Li Xiao , Gao Yating , Zhang Kaining , Yin Jierong , Li Xiaofei , Wang Xia , Zhang Huijuan , Zhang Dongfeng
Published: September 2023

Background: Leptomeningeal metastasis(LM) is a relatively rare but devastating manifestation of breast cancer, with an incidence rate of approximately 5%, half of these patients suffer from simultaneous brain metastasis. LM in breast cancer (LM-BC) carries a poor prognosis, with a median overall survival of approximately four weeks without treatment. However, there is no standardized therapy for LM yet.
Case presentation: We present a 63-year-old female with estrogen receptor (ER)-positive Her2− breast cancer after multiline treatment, her pathological examination of the cerebrospinal fluid (CSF) revealed numerous malignant cells, magnetic resonance imaging(MRI) of the brain with contrast demonstrated intense enhancement of the leptomeninges, without brain metastasis. She achieved complete intracranial remission and prolonged survival by whole-brain radiotherapy (WBRT) concomitant with intrathecal methotrexate (MTX). A literature review was included to summarize the present status of ER+ HER2− LM-BC.
Discussion and Conclusions: There are a great number of studies on the therapy of LM from HER2+ BC, but there is limited information on ER+ HER2− BC with isolated LM, which is rarer than other BC subtypes and predicts a worse prognosis. Concurrent WBRT with intrathecal MTX may improve the quality of life and prolong the survival of LM-BC, especially for ER+ HER2− ones. Our case indicated ER+ HER2− LM-BC can be effectively treated by radiotherapy with concurrent intrathecal chemotherapy (IC). To provide longer and better survival benefits for patients with ER+ HER2− LM-BC, further trials are urgently needed to explore the therapeutic order and therapeutic dose of radiotherapy and intrathecal chemotherapy.
Pseudo-Meigs’ syndrome caused by rapidly enlarging hydropic leiomyoma with elevated CA125 mimicking ovarian malignancy: A case report and literature review
Authors: Zou Longquan , Lou Jinlong , Huang Haoran , Xu Lian
Published: September 2023

Hydropic leiomyoma (HLM) is one of the rare subtypes of uterine leiomyoma. HLM is characterized by diffuse water degeneration and often secondary cystic changes. While HLM enlarged rapidly, especially with hydrothorax and ascites, they were often misdiagnosed as malignant tumors. Pseudo-Meigs’ syndrome is characterized by the presence of hydrothorax and ascites associated with pelvic masses (benign or malignant). Pseudo-Meigs’ syndrome presenting with elevated serum cancer antigen-125 (CA125) is rare and very likely misdiagnosed as a malignancy of the uterus or ovary. Pseudo-meigs’ syndrome with CA125 elevation caused by hydropic leiomyoma is rarer. Here, we reported a 45-year-old Chinese female with ascites, right hydrothorax and a rapidly enlarging pelvic mass. Preoperative abdominal and pelvic CT showed a giant solid mass in the fundus uteri, measuring 20×15×12 cm. The tumor marker CA125 was found to be elevated to 247.7 U/ml and 304.60 U/ml in serum and hydrothorax, respectively. She was initially diagnosed of uterine malignancy and underwent total abdominal hysterectomy and adhesiolysis. The final pathological diagnosis of the specimen was uterine hydropic leiomyoma with cystic changes. After the tumor removal, the ascites and hydrothorax disappeared rapidly and without recurrence. The serum CA125 dropped to 116.90 U/mL on day 7 and 5.6 U/mL on day 40. Follow-up was obtained at 6 months, 1 year, and 2 years after surgery, respectively. The patient's physical signs were all normal, with no recurrence of ascites or hydrothorax.
Identification of eQTL using different sets of single nucleotide polymorphisms associated with carcass and body composition traits in pigs
Authors: Freitas Felipe Andre Oliveira , Brito Luiz F. , Fanalli Simara Larissa , Gonçales Janaína Lustosa , Silva Bruna Pereira Martins , Durval Mariah Castro , Ciconello Fernanda Nery , Oliveira Camila Sabino , Nascimento Lucas Echevarria , Gervásio Izally Carvalho , Gomes Julia Dezen , Moreira Gabriel Costa Monteiro , Silva-Vignato Bárbara , Coutinho Luiz Lehmann , Almeida Vivian Vezzoni , Cesar Aline Silva Mello
Published: September 2023

Background Mapping expression quantitative trait loci (eQTL) in skeletal muscle tissue in pigs is crucial for understanding the relationship between genetic variations and phenotypic expression of carcass traits. Therefore, the primary objective of this study was to evaluate the impact of different sets of single nucleotide polymorphisms (SNP), including those pruned for linkage disequilibrium (LD), derived from SNP chip arrays and RNA-seq data from liver, brain, and skeletal muscle tissues on the identification of eQTL in theLongissimus lumborumtissue, associated with carcass and body composition traits in Large White pigs. SNPs identified from muscle mRNA were combined with SNPs identified in brain and liver tissue transcriptomes, as well as SNPs from the GGP Porcine 50K array. Cis- and trans-eQTL were identified based on the skeletal muscle gene expression level, followed by functional genomic analyses and statistical associations with carcass and body composition traits in Large White pigs. Results The number of cis- and trans-eQTL identified across different sets of SNPs (scenarios) ranged from 261 to 2,539 and from 29 to 13,721, respectively. Furthermore, 6,180 genes were modulated by eQTL in at least one of the scenarios evaluated. The eQTL identified were not significantly associated with carcass and body composition traits based on the association analyses but were significantly enriched for many traits in the "Meat and Carcass" type QTL. The scenarios with the highest number of cis- (n = 304) and trans- (n = 5,993) modulated genes were the unpruned and LD-pruned SNP set scenarios, identified in the mRNA of muscle. These genes include 84 transcription factor coding genes. Conclusions After LD pruning, the set of SNPs identified based on the transcriptome of the skeletal muscle tissue of pigs resulted in the highest number of genes modulated by eQTL. Most eQTL are of the trans type and are involved in genes influencing complex traits in pigs, such as transcription factors and enhancers. Furthermore, the incorporation of SNPs from other genomic regions to the SNPs identified in the porcine skeletal muscle transcriptome contributed to the identification of eQTL that were not identified based on the porcine skeletal muscle transcriptome alone.
A cross-sectional analysis between plasma trace elements and osteoarthritis
Authors: Zhu Yifang
Published: September 2023

Background: The expression level of trace elements and its correlation with inflammation and oxidative stress indicators in osteoarthritis (OA) patients were analyzed, which may lay a foundation for clarifying the role of trace elements in OA pathogenesis and progression.
Methods: A total of 86 subjects participated in the study, including 44 OA patients as case group and 42 healthy people as control group. The inductively coupled plasma mass spectrometer was used to detect copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg), Iron (Fe), plumbum (Pb), manganese(Mn), selenium (Se), and the differences between two groups were compared. Principal component analysis was used to find the principal variables and logistic regression was used to analyze risk factors for OA. The correlation between trace elements and inflammatory cytokines (TNF-α, IL-6, IL-1β) and oxidative damage markers (MDA, TAC) was analyzed.
Results: The concentrations of Zn, Mg, Fe, Mn and Se were significantly lower in case group than those in the control group, while the plasma levels of Ca were significantly higher than the control group. The concentrations of Cu and Pb in plasma have no difference between two groups. Gender may be one of the factors affecting the expression level of trace elements. The concentrations of Mn and Se in female OA patients were lower than the healthy women, while the concentrations of Zn and Mg in male OA patients were lower than the healthy men, suggesting that the level of trace elements were different in men and women, which should be treated discriminately. The results of correlation analysis indicated that there are intricate correlations among trace elements. Logistic regression analysis suggested that gender and Se were risk factors for OA. Correlation analysis showed that Mn was negatively correlated with inflammatory cytokine IL-6, Fe was positively correlated with IL-1β, Cu was positively correlated with oxidative stress, Zn and Se were negatively correlated with oxidative stress.
Conclusion:
The concentration of Zn, Mg, Fe, Mn, Se and Ca in the plasma of OA patients was changed, in which Mn and Se were lower in female OA patients, Zn and Mg were lower in male OA patients compared to control group. Gender and Se was the risk factor for OA pathogenesis. Trace elements are intricately related with each other. Mn, Fe, Cu, Zn and Se were associated with oxidative stress and inflammatory cytokines.
Supporting recovery, healing and wellbeing with Aboriginal communities of the southeast coast of Australia: a practice-based study of an Aboriginal community-controlled health corganisation’s response to cumulative disasters
Authors: Keevers Lynne , Mackay Maria , Cutmore Sue-Anne , Falzon Kristine , Finlay Summer May , Lukey Samantha , Allan Julaine , Degeling Chris , Everingham Ruth , Fox Mim , Pai Padmini , Olcon Katarzyna
Published: September 2023

Background
The recent crises of bushfires, floods, and the COVID-19 pandemic on the southeast coast of Australia were unprecedented in their extent and intensity. Few studies have investigated responses to cumulative disasters in First Nations communities, despite acknowledgement that these crises disproportionately impact First Nations people. This study was conducted by a team of Aboriginal and non-Aboriginal researchers in partnership with Waminda, South Coast Women’s Health and Wellbeing Aboriginal Corporation, an Aboriginal Community Controlled Health Organisation.
It investigated the collective experiences of people affected by cumulative disasters to identify the practices that support healing, and recovery for Aboriginal communities. The study addresses a knowledge gap of how Waminda, designs, manages and delivers responses to address complex health and social issues in the context of cumulative disasters.
Methods
Underpinned by practice theory this study employed Indigenous-Informed, Narrative Inquiry. Healthcare settings and organisations are turning to practice theory to understand health system responses and service user experience. Culturally-appropriate, multiple interpretive methods were used to collect data including: observations; yarns with Aboriginal community members, yarns with Waminda practitioners, management and board members; interviews-to-the-double, visual images and documentation. The data were collated and analysed using the phases of reflexive thematic analysis.
Results
The paper articulates a suite of culturally safe and place-based practices that enhance social, emotional and spiritual well-being following cumulative disasters. These practice bundles include: adopting a Country-centred conception of local communities; being community-led; viewing care as a collective, relational sociomaterial accomplishment and having fluid boundaries. These practice bundles ‘hang together’ through organising practices including the Waminda Model of Care, staff wellbeing framework and emergency management plan which orient action and manage risks.
Conclusions
The paper suggests crafting responses that focus on assisting communities (re)gain their sense of belonging, hope for the future, control over their lives and their capacities to care for and to be cared for by Country, are key to enhancing healing, health and well-being. ACCHOs are shown to play a crucial role, and their local responses to immediate community needs are grounded in contextual knowledge and use existing resources rather than relying on mainstream system-wide interventions.
DALK combined intralamellar tectonic patch graft: An alternative approach to treat frank corneal perforation
Authors: Xiao Gege , Ben Hanzhi , Gu Shaofeng , Hong Jing
Published: September 2023

Background
Deep anterior lamellar keratoplasty (DALK) has gained popularity in cases of corneal thinning and leaking descemetocele. In this study, we introduced an intralamellar tectonic patch graft in addition to conventional DALK procedures to treat frank cornea perforation.
Methods
This retrospective case series included 13 patients (13 eyes) with frank corneal perforations who underwent DALK combined with intralamellar tectonic patch graft between December 2015 and December 2021. In addition to the standard DALK procedure, the perforation site was repaired with an extra intralamellar tectonic patch graft. The collected data included patient demographics, aetiology, size and location of the corneal perforation, visual acuity, surgical details, and postoperative complications.
Results
Seven patients underwent autologous intralamellar patch grafts, whereas six received allogeneic ones. Anatomical success was achieved in all patients. The mean postoperative follow-up was 33.31 ± 25.96 months (6–73 months). The postoperative visual acuity (0.90 ± 0.65 logMAR) was significantly improved (P = 0.003) compared to the preoperative score (1.74 ± 0.83 logMAR). Best corrected visual acuity (BCVA) improved in 12 eyes (92.3%). The mean endothelial cell density was 2028 ± 463 cells/mm2, 6–12 months postoperatively. There was no recurrence of perforation, and the anterior lamellar graft remained transparent in 12 patients (92.3%). Postoperative complications included epithelial defects (23.1%), ocular hypertension (15.4%), and cataract (7.7%).
Conclusions
DALK combined with intralamellar tectonic patch graft may serve as a secure and effective alternative in treating frank corneal perforation, with reduced complications compared to conventional penetrating keratoplasty.
Exploring adverse events associated with sphingosine-1-phosphate modulators: a pharmacovigilance study using the FDA Adverse Event Reporting System Database
Authors: Wang Ling , Fang Meilin , Liang Weijie , Wang Cunze , Ruan Junshan
Published: September 2023

Background
Sphingosine-1-phosphate receptor (S1PR) modulators have been proposed as therapeutic agents for various diseases. However, the presence of S1PR in multiple tissues may lead to numerous off-target effects of S1PR modulators, potentially limiting their use. There are no real-world reports on adverse effects of S1PR modulators.
Aim
This study aimed to investigate post-marketing adverse event (AE) of S1PR modulators, and to explore risk factors for severe AE.
Method
Disproportionality analyses were performed on adverse event cases of S1PR modulators (2004-2022) collected from the US Food and Drug Administration Adverse Event Reporting System (FAERS). Risk prediction model was developed for severe AE of S1PR modulators using logistic regression analyses.
Results
A total of 95,577 AE reports were retrieved. The prominent risk signals of the S1PR modulators were fatigue, relapses in multiple sclerosis, and headaches. Age, thyroid preparations, and monoclonal antibodies were independent risk factors for severe AE (p < 0.05). The risk prediction model for severe AE and the corresponding nomogram exhibited discrimination ability and clinical applicability in both training set (AUC 0.6102) and validation sets (AUC 0.6079).
Conclusion
Our post-marketing pharmacovigilance analysis revealed the types and incidence of AE related to S1PR modulators. The nomogram may be useful for rapid clinical assessment on the occurrence of severe AE.
Predictive Value of Ultrasound Doppler Parameters in the Neoadjuvant Chemotherapy Response of Breast Cancer: Prospective Comparison with Magnetic Resonance and Mammography
Authors: Conz Livia , Jales Rodrigo Menezes , Dória Maira Teixeira , Meloni Isabelle , Lyrio Carla Andries Cres , Menossi Carlos , Derchain Sophie , Sarian Luis Otavio
Published: September 2023

Background: Neoadjuvant chemotherapy (NACT) is a treatment option for breast cancer patients who allows for the assessment of tumor response during treatment. This information can be used to adjust treatment and improve outcomes. However, the optimal imaging modalities and parameters for assessing tumor response to NACT are not well established.
Methods: This study included 173 breast cancer patients who underwent NACT. Patients were imaged with ultrasound, mammography, and MRI at baseline, after two cycles of NACT, and before breast surgery. Ultrasound parameters included lesion morphology, Doppler variables, and elastography measurements. Mammography and MRI were evaluated for the presence of nodules and tumor dimensions. The pathological response to NACT was determined using the residual cancer burden (RCB) classification.
Results: The ultrasound parameter with the highest power for predicting pathological complete response (PCR) was shear wave elastography (SWE) maximum speed inside the tumor at baseline. For nonluminal tumors, the end diastolic velocity measured by ultrasound after two cycles of NACT showed the highest predictive value for pCR. Similarly, SWE maximum speed after two cycles of NACT had the highest discriminating power for predicting RCB-III in luminal tumors, while the same parameter measured at baseline was most predictive for nonluminal tumors.
Conclusions: This study provides evidence that mid-treatment Doppler ultrasound and other imaging modalities can be used to predict the response to NACT in breast cancer patients. Functional parameters, such as blood flow velocities and SWE measurements, demonstrated superior predictive value for PCR, while morphological parameters had limited value. These findings have implications for personalized treatment strategies and may contribute to improved outcomes in the management of breast cancer.
Initial Results with [18F]FAPI-74 PET/CT in Idiopathic Pulmonary Fibrosis
Authors: Mori Yuriko , Kramer Vasko , Novruzov Emil , Mamlins Eduards , Röhrich Manuel , Fernández René , Amaral Horacio , Soza-Ried Cristian , Monje Barbara , Sabbagh Eduardo , Florenzano Matías , Giesel Frederik L. , Undurraga Álvaro
Published: September 2023

Idiopathic pulmonary fibrosis (IPF) is a chronic fibrosing interstitial lung disease with a poor prognosis.68Ga-labelled FAP ligands exhibited highly promising results due to the crucial role of activated fibroblasts in fibrosis imaging of the lung. However,18F-labelled FAP ligands might provide qualitatively much higher imaging results with accompanying economic benefits due to large-scale production. Thus, we sought to investigate the potential of [18F]FAPI-74 prospectively in a small patient cohort.Methods: Eight patients underwent both [18F]FAPI-74-PET/CT and HRCT scans and were then compared with a control group without any fibrosing pulmonary disease. The tracer uptake of fibrotic lung areas was analyzed in synopsis with radiological, and clinical parameters.Results: We observed a positive correlation of the fibrotic active volume, Hounsfield scale as well as vital and diffusing capacity of the lung.Conclusion: The initial results confirm our assumption that [18F]FAPI-74 offers a viable non-invasive assessment method for pulmonary fibrotic changes of patients with IPF.
Validating accurate placement of non-wire localization markers in non- palpable breast tumors using breast CT: a feasibility study
Authors: Wasser Martin , Coopmans Laurent , Kolditz Daniel , Dijkstra Jouke , Wetzl Matthias , Voormolen Nora , Hage Jos van der
Published: September 2023

Background
Dedicated photon-counting breast CT is an emerging imaging technology for imaging the breast without the need for compression of the breast and with a radiation dose comparable to that of mammography. In this study, we assessed the feasibility of using breast CT to confirm the accurate placement of localization markers in nonpalpable breast tumors before breast-conserving surgery.
Methods
We first evaluated the artifacts caused by 5 different metallic markers in 2 different phantoms and applied a computer algorithm to effectively remove the beam hardening artifacts. Next, we tested the potential of dedicated photon-counting breast CT combined with the artifact-removing algorithm to assess accurate marker placement in 5 patients with nonpalpable breast tumors.
Results
In the phantoms, all markers caused beam-hardening artifacts, but the computer algorithm successfully removed them. In the patients, the correct placement of the markers was visualized with breast CT and confirmed postsurgery, as all markers and tumors were present in the surgical specimen.
Conclusion
Dedicated photon-counting breast CT is an effective modality for demonstrating accurate placement of localization markers.
A robust artificial intelligence method detects almost non-reactive Non-stress pattern: What we expect?
Authors: Zhu Caixia , Li Zhuyu , Wang Xietong , Xu Bin , Guo Xiaohui , Huang Jingwan , Liu Bin , Li Hongyan , Kong Yan , Yang Xiaobo , Du Jingyu , Wang Zilian , Chen Haitian
Published: September 2023

Objective
To compare interpretation of prenatal non-stress (NST) pattern between obstetricians and artificial intelligence (AI), and to determine the degree of agreement of AI system.
Methods
One thousand records of prenatal NST pattern with 20 to 30 minutes were interpreted using AI system, as well as visual interpretation of five obstetricians, to explore the agreement and accuracy of AI system. Weighted kappa was used to assess reliability of AI for interpretation of prenatal NST pattern.
Results
A total of 967 cases enroll in this study. Moderate agreement (kappa, 0.48) was found among the five obstetricians for FHR pattern during antepartum period. The AI system recognized NST pattern like obstetricians, with a moderate kappa coefficient of agreement of 0.42. When AI was used to assess the strong consistent set of inter-obstetricians, the agreement was high (kappa, 0.75). AI could identify major non-reactive NST pattern, with high sensitivity of 91.67%. A concordant identification was observed 71.76% of preterm cases and 66.05% of term cases.
Conclusion
Based on the visual interpretation of obstetricians, AI was excellent for antepartum FHR monitoring interpretation, regardless gestational age. Further, AI showed a competitive ability to identify non-reactive NST pattern and the potential avoidance of unnecessary clinical intervention.
Effect of Different Exercise Modalities on Nonalcoholic Fatty Liver Disease: A Systematic Review and Network Meta-analysis
Authors: Peng Yang , Xue Yaqi , Zhang Litian , Ba Yi , Jin Gang
Published: September 2023

Physical exercise intervention can significantly improve the liver of patients with nonalcoholic fatty liver disease, but it is unknown which exercise mode has the best effect on liver improvement in NAFLD patients. Therefore, we systematically evaluated the effect of exercise therapy on liver and blood index function of NAFLD patients through network meta-analysis(NMA). Through systematic retrieval of PubMed, Cochrane Library, Web of Science, EBSCO, and CNKI(National Knowledge Infrastructure), two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies by means of databases from inception to December 2022. The NMA was performed using the inconsistency model. A total of 42 studies, 2070 NAFLD patients were included: aerobic training(n = 779), resistance training(n = 159), high-intensity interval training(n = 160), aerobic training + resistance training(n = 96). The results indicate that aerobic training + resistance training could significantly improve Serum total cholesterol (TC) (Surface under the cumulative ranking curve(SUCRA) = 71.7), Triglyceride(TG)(SUCRA = 96.8), Low-Density Lipoprotein Cholesterol(LDL-C)(SUCRA = 86.1) in patients with NAFLD including triglycerides. Aerobic training is the best mode to improve ALT(SUCRA = 83.9) and High density lipoprotein cholesterol (HDL-C) (SUCRA = 72.3). Resistance training is the best mode to improve aspartate transaminase (AST) (SUCRA = 81.7). Taking various benefits into account, we believe that the best modality of exercise for NAFLD patients is aerobic training + resistance training. In our current network meta-analysis, these exercise methods have different effects on the six indicators of NAFLD, which provides some reference for further formulating exercise prescription for NAFLD patients.
Long-Term Outcomes of Hyperadrenergic Orthostatic Hypotension
Authors: Castro Robert Alexander , Vernetti Patricio Millar , Biaggioni Italo , Raj Satish R. , Kaufmann Horacio , Shibao Cyndya A.
Published: September 2023

Purpose
Hyperadrenergic orthostatic hypotension is a subtype of orthostatic hypotension associated with elevated norepinephrine levels upon standing. Our previous study found that this subtype is characterized by less severe autonomic impairment compared to orthostatic hypotension with normal or low norepinephrine levels. However, long-term outcomes have not been determined. Thus, the purpose of this study was to evaluate the all-cause mortality and phenoconversion over 7 years.
Methods
In this prospective observational study, 92 patients with orthostatic hypotension were recruited from the Vanderbilt Autonomic Dysfunction Center. 34 patients with upright norepinephrine levels above 600 pg/mL were included in the hyperadrenergic cohort and 58 composed the orthostatic hypotension cohort. Both cohorts were followed for 7 years while assessing all-cause mortality and phenoconversion to neurodegenerative autonomic disorders.
Results
Hyperadrenergic patients showed an exaggerated orthostatic increase in norepinephrine to 938 ± 305 pg/mL upon head up tilt despite presenting with impaired autonomic reflexes. The 7-year mortality rate was 35% in the hyperadrenergic cohort compared to 22% in orthostatic hypotension (p = 0.01). The hyperadrenergic cohort had a greater phenoconversion rate to multiple system atrophy (p = 0.04), whereas the orthostatic hypotension cohort had greater phenoconversion to Parkinson’s disease and dementia with Lewy bodies.
Conclusions
Despite having less severe autonomic impairment, our data suggests that hyperadrenergic orthostatic hypotension has worse clinical outcomes than neurogenic orthostatic hypotension. Patients with hyperadrenergic orthostatic hypotension require careful monitoring, given that this condition may be associated with negative outcomes.
Causal relationship between obesity and spinal stenosis: two-sample Mendelian randomisation
Authors: deng guang-hua , Wang Hong , Tan Zhe , Chen Rong
Published: September 2023

Objective To investigate the causal relationship between obesity and spinal stenosis using Mendelian randomisation (MR).
Methods Genetic loci independently associated with obesity and spinal stenosis in people of European origin were selected as instrumental variables using pooled data from large-scale genomewide association studies (GWAS). Three MR analyses, MR-Egger, Weighted median and Inverse Variance Weighting (IVW), were used to investigate the causal relationship between obesity and spinal stenosis. Heterogeneity and multiplicity tests were performed, and sensitivity analyses were performed using the "leave-one-out" method to explore the robustness of the results.
Results The IVW results showed an OR (95% CI) of 1.12 (1.03–1.22), p = 0.010, indicating a causal relationship between obesity and the occurrence of spinal stenosis. And no heterogeneity and multiplicity were found by the test and sensitivity analysis also showed robust results.
Conclusion In this study, genetic data were analysed and explored using two-sample MR analysis, and the results showed that there is a causal relationship between obesity and the occurrence of spinal stenosis, and that there is a need to include more samples for the study.
Deciphering biomarker related to 12 programmed cell death to predict prognosis and response to immunotherapy in lung squamous cell carcinoma
Authors: Jiang Zhansheng , Dao Chenghuan , Wang Jiahe , Zhu Mingyu , Liu Fangchao , Zhao Yangyang , Li Jiayue , Yang Yinli , Pan Zhanyu
Published: September 2023

Background Different programmed cell death (PCD) plays different roles in lung squamous cell carcinoma (LUSC). We integrated twelve programmed cell death patterns, investigated the expression patterns of PCD-related genes to identify promising PCD-related biomarkers. Methods Twelve PCD patterns (apoptosis, pyroptosis, necroptosis, cuproptosis, entotic cell death, autophagy-dependent cell death, netotic cell death, parthanatos, ferroptosis, lysosome-dependent cell death, oxeiptosis and alkaliptosis) were analyzed for model construction, resulting in 1388 PCD-related genes. We explored the expression changes of PCD-related genes in LUSC patients from TCGA database, and constructed a combined prognostic signature by Cox regression analysis and LASSO Cox regression analysis. The independent prognostic performance of the gene signature was evaluate based on consensus clustering, univariate and multivariate Cox regression and Kaplan–Meier survival. The GEO dataset was used for validation. Finally, we investigated the role of the immune microenvironment in different prognosis groups. Results We constructed a network of seven PCD-related genes (FGA, CHEK2, PTGIS, CSF2, STXBP1, NACC2, TFR2). Utilized these 7-gene network to establish a cell death index (CDI) and grouped patients using the median of CDI. We found that LUSC patients with low CDI had a better prognosis. More importantly, CDI was associated with tumor microenvironment components according to integrated analysis, and the response to immunotherapy in the low CDI group was better than that in the high CDI group. Conclusion Our study identified 7-gene network based on PCD to establish a new model of CDI to predict the clinical prognosis of LUSC patients. We proposed that CDI may serve as a new biomarker to predict the prognosis and immunotherapy efficacy in LUSC.
Sedimentary microfacies and reservoir quality of the Nubian sandstone Formation, southern Gulf of Suez province, Egypt
Authors: Aziz Emad A. Abd El
Published: September 2023

The present work considered a combination study between analysis of core petrophysics and sedimentary microfacies to estimate the reservoir quality of the studied Nubian sandstone reservoir in Saqqara oil field. The SEM observation of the studied Nubian reservoir displays quartz, feldspars and detrital clays are the dominant framework grains. Patchy dolomite, pyrite, kaolinite and illite are the common authigenic components. Euhedral syntaxial quartz overgrowths are relatively less common. Generally, all the samples are well cemented with relatively close grain packing and poorly developed primarly intergranular porosity. Most of the samples are fine grained and moderately to well sorted. Point counted porosity ranged from nil to 34%. The studied reservoir sequence could be sub divided into two reservoir rock types (RRTs). RRT1 is the best rock type forming the most upper parts of the Nubian Formation which composed from well sorted, fine grained, moderately cemented sandstone with minor primary intergranular porosity, minor dispersed pore filling detrital clay matrix, minor poorly crystallized illite and highly fractured framework feldspar grains. Whereas the RRT2 composed from moderately sorted, fine grained, well cemented with rare primary intergranular porosity, common dispersed pore filling detrital clay matrix and kaolinite plates, well crystallized hairy-like illites locally replace clay matrix. The petrophysical properties of the Nubian sandstone are more affected by significant quantities of Kaolinite and locally patchy siderite that are the main factors in reducing point counted porosity. RRT1 represent the best reservoir quality which has fair to excellent horizontal permeability (1.9–2719 md), poor to good porosity (7.3–19%), tight to good reservoir quality index RQI (0.69–1.98 µm), tight to very good flow zone indicator FZI (3.21–10.52 µm). Whereas the RRT2 is the tightest reservoir rock type, it is composed of quartzwackes microfacies and has fair to good porosity (1.7–16.6%), tight to very good horizontal permeability (0.01–560 md), tight to good RQI and FZI values (0.02–0.86 µm and 0.66–6.07 µm, respectively.
Long-term Outcomes of Treatment Patterns and Survival for Esophageal Squamous Cell Carcinoma Over than 70 Years: A Multicenter Analysis of 726 Cases
Authors: Li Kexun , Nie Xin , Li Changding , He Wenwu , Lu Simiao , Liu Kun , Wang Chenghao , Du Kunyi , Li Jialong , Wang Kangning , Ni Kunhan , Jiang Longlin , Chen Junqiang , Xiao Zefen , Han Yongtao , Peng Lin , Wang Qifeng , Leng Xuefeng
Published: September 2023

Purpose: The main focus of this study is to investigate the impact of esophagectomy on the survival of elderly patients with esophageal squamous cell carcinoma (ESCC) in East Asia. Our team conducted this study to investigate whether comprehensive treatment based on surgery is suitable for elderly patients with ESCC and whether it provides an overall survival (OS) benefit.
Methods: To conduct this research, we collected data from two databases: the Sichuan Cancer Hospital & Institute Esophageal Cancer Case Management Database (SCCH-ECCM Database) and the department of radiation oncology multicenter database. A retrospective analysis was performed on ESCC patients aged 70 years or older, who underwent either esophagectomy or received radiotherapy/chemotherapy between January 2009 and December 2017. The patients were categorized into two groups: the upfront surgery group (referred to as the S group) and the non-surgery group (referred to as the NS group).
Results: The median follow-up period was 60.8 months. The S group exhibited a median overall survival (OS) of 41.9 months (95% CI, 35.2-48.5), whereas the NS group demonstrated a significantly lower median OS of only 24.0 months (95% CI, 19.8-28.3). The survival rates at 1, 3, and 5 years in the S group were 84%, 54%, and 40% respectively. Conversely, the NS group had lower survival rates at 1, 3, and 5 years, which were 72%, 40%, and 30%, respectively (HR, 0.689; 95% CI, 0.559-0.849; P＜0.0001). However, after employing propensity score matching (PSM), we did not observe a significant difference in OS between the two groups (HR, 0.871; 95% CI, 0.649–1.167; P=0.352).
Conclusion: For ESCC patients aged 70 years or older, our findings suggest that upfront esophagectomy does not significantly improve overall survival compared to non-surgical treatment involving radiotherapy and/or chemotherapy.
Sex-specific vocal repertoire in the Fragile X mouse model of autism
Authors: Giua Gabriele , Iezzi Daniela , Caceres-Rodriguez Alba , Strauss Benjamin , Chavis Pascale , Manzoni Olivier
Published: September 2023

Background: Pup-dam ultrasonic vocalizations (USVs) are essential to cognitive and socio-emotional development. In autism and Fragile X Syndrome (FXS), disruptions in pup-dam USV communication hint at a possible connection between abnormal early developmental USV communication and the later emergence of communication and social deficits.
Methods: Here, we gathered USVs from PND 10 FXS pups during a short period of separation from their mothers, encompassing animals of all possible genotypes and both sexes (i.e., Fmr1-/y vs. Fmr1+/y males and Fmr1+/+, +/-, and -/- females). This allowed comparing the influence of sex and gene dosage on pups’ communication capabilities. Leveraging DeepSqueak and analyzing vocal patterns, intricate vocal behaviors such as call structure, duration, frequency modulation, and temporal patterns were examined.
Results: The results show that FMRP-deficient pups of both sexes display an increased inclination to vocalize when separated from their mothers, and this behavior is accompanied by significant sex-specific changes in the main features of their USVs as well as in body weight. Moreover, analysis of the vocal repertoire and syntactic usage revealed that Fmr1 gene silencing primarily alters the USVs’ qualitative composition in males.
Conclusions: These findings highlight the interplay between Fmr1 gene dosage and sex in influencing communication during infancy.
A high-efficient capture-based NGS approach for comprehensive analysis of mitochondrial transcriptom
Authors: Wang Zhenni , Zhou Kaixiang , Yuan Qing , Chen Dongbo , Hu Xi'e , Xie Fanfan , Liu Yang , Xing Jinliang
Published: September 2023

Background
The transcription of mitochondrial genome is pivotal for maintenance of mitochondrial functions, and deregulated mitochondrial transcriptome contributes to various pathological changes. Despite substantial progress has been achieved in uncovering the transcriptional complexity of the nuclear transcriptome, many unknowns and controversies remain for the mitochondrial transcriptome, partially owing to the lack of high-efficient mitochondrial RNA (mtRNA) sequencing and analysis approach.
Methods
Here, we first comprehensively evaluated the influence of essential experimental protocols, including strand-specific library construction, two RNA enrichment strategies and optimal rRNA depletion, on accurately profiling mitochondrial transcriptome in whole transcriptome sequencing (WTS) data.
Results
Based on these insights, we developed a high-efficient approach specifically suitable for targeted sequencing of whole mitochondrial transcriptome, termed capture-based mtRNA seq (CAP), in which strand-specific library construction and optimal rRNA depletion was applied. Compared with WTS, CAP has a great decrease of required data volume, without affecting the sensitivity and accuracy of detection. In addition, CAP also characterized the unannotated mt-tRNA transcripts whose expression level is below the detection limits of conventional WTS. As a proof-of-concept characterization of mtRNAs, the transcription initiation sites and mtRNA cleavage ratio were accurately identified in CAP data. Moreover, CAP had a very reliable performance in plasma and single-cell samples, highlighting its wide application.
Conclusions
All together, the present study has established a high-efficient pipeline for targeted sequencing of mtRNAs, which may pave the way toward functional annotation of mtRNAs and mtRNA-based diagnostic and therapeutic strategies in various diseases.
Accurate Identification of Micro-scale Urban Functional Zones from the Perspective of Spatial Dialectic
Authors: Zhang Changfan
Published: September 2023

With the advancement of global urbanization, accurate identification of urban functional zones has become a crucial task for the high-quality development of cities. Traditional methods that rely on POI data are insufficient to accurately identify micro-scale urban functional zones. Thus, this study proposes a novel method for identifying urban functional zones based on VOI (Volume of Interest) data and applies it to a small region in Hong Kong for comparative research. Subsequently, the identification accuracy of the two methods is assessed using a confusion matrix and the Kappa Coefficient. The results show that the VOI data contains richer and more comprehensive urban spatial information compared to POI data, enabling a superior representation of connections and influences among different zones within cities. The study can be applied to analyse micro-scale urban functional zones in other cities, providing a new perspective for the in-depth research.
A new identified COL4A2 mutation contributes to astrocyte activation by activating JAK/STAT signaling in epilepsy
Authors: Hu Chunhui , Wang Yi
Published: September 2023

COL4A2 is the encoding gene of the α2 chains of type IV collagen, and missense mutations of COL4A2 is correlated with multiple diseases. However, the association of COL4A2 mutations with epilepsy remains elusive. Here, we aimed to explore the function of COL4A2 mutations in the development of epilepsy. We performed a full spectrum of family-enhanced whole-exome sequencing on a family lineage and examined the genetic change on COL4A2 gene. The kainic acid (KA)-induced in vivo model and lipopolysaccharide (LPS)-induced in vitro model were established. The production and secretion of inflammation cytokines were measured by qPCR, western blotting, and ELISA assay. Neuron damages and astrocyte activation were checked by Nissle and GFAP immunofluorescence staining. One heterozygous variant was detected in the COL4A2 gene: c.1148C > T(p.Pro383Leu). COL4A2 mutation significant induced the exacerbation of seizures and impaired the learning and memory phenotype of the KA rats. COL4A2 mutation promoted the hippocampal astrocyte activation, enhanced hippocampal neuronal injury in the rats. The levels of iNOS, COX-2, IL-1β, IL-6, and TNF-α elevated in KA-treated rats and LPS-treated astrocytes were further induced by COL4A2 mutation. Mechanically, COL4A2 mutation stimulated JAK/STAT signaling. JAK2 and STAT3 phosphorylation was promoted by COL4A2 mutation and JAK/STAT signaling inhibitor WP1066 could blocked the effect in primary astrocytes and CTX-TNA cells. These data indicated that a new identified COL4A2 mutation contributed to astrocyte activation by activating JAK/STAT signaling in epilepsy. Our findings provided a novel mechanism and treatment target of COL4A2 related epilepsy.