bluuebunny/crossref_metadata_2025 huggingface dataset:
Essential Oil Compositions and Antimicrobial Activities of Syzygium fluviatile (Hemsl.) Merr. & L.M.Perry: A Comparative Study on Collection Regions
Authors: Dai Do Ngoc , Xuyen Do Thi , Huong Le Thi , Anh Nguyen Thi Hoang , Ha Nguyen Xuan , The Son Ninh
Published: October 2024

Objective

Essential oils extracted from Syzygium species are known for various pharmacological purposes. Syzygium fluviatile (Hemsl.) Merr. & L.M.Perry is a flowering plant found in China and Vietnam. The current study aims to offer a comparison of chemical compositions in essential oils of S. fluviatile fruits and leaves, collected from five regions of Vietnam. The obtained oils were also taken into antimicrobial consideration, which was further aided by in silico approaches.

Methods

Phytochemical analysis of essential oils was carried out using GC-FID/MS (gas chromatography-flame ionization detection/mass spectrometry) analysis. An antimicrobial assay was performed using broth micro-dilution for in vitro screening. In silico considerations are mainly based on docking studies and toxicity assessments using the AutoDock Vina v1.2.3 program and the ProTox 3.0 web server, respectively.

Results

Hydro-distillation of S. fluviatile fresh fruits and leaves can lead to the production of yellow essential oil with yields of 0.21–0.32% v/w. In general, the obtained oils were dominated by monoterpene and sesquiterpene derivatives, as well as ( E)-caryophyllene (8.40-47.12%) being the principal compound. The oil samples showed strong antimicrobial activity against the Gram (+) bacteria Enterococcus faecalis ATCC51299, Staphylococcus aureus ATCC29213, and Bacillus cereus ATCC11778, and the yeast Candida albicans ATCC 60193 with the MIC and IC50 values 16–64 µg/mL and 5.12–24.68 µg/mL. Docking results indicated that ( E)-caryophyllene exhibited binding affinities from −6.728 kcal/mol to −5.729 kcal/mol with important amino acid residues in the DNA gyrase, PBP3, and SAP2 targets. The toxicity profile of ( E)-caryophyllene is also discussed.

Conclusion

The isolation of ( E)-caryophyllene from Vietnamese Syzygium essential oils as a purified compound is necessary. In vivo antimicrobial studies and molecular mechanisms of action are needed.
Injuries, Risk Factors, and Prevention Strategies in Bicycle Motocross (BMX): A Scoping Review
Authors: Rockliff Claire , Pulsifer Karen , Gupta Srijal , Jewell Carley B. , Black Amanda M.
Published: October 2024

Context:

Bicycle motocross (BMX) has become increasingly popular since its inclusion in the 2008 Olympics, but it has some of the highest injury rates (IRs) in multisport studies. To support planning for tailored primary prevention, understanding gaps in BMX injury prevention is crucial.

Objective:

To examine the evidence on injury incidence, prevalence, risk factors, prevention strategies, and prevention implementation in BMX.

Data Sources:

Ovid MEDLINE, Embase, APA PsycInfo, CINAHL, and SPORTDiscus were searched systematically in June 2023.

Study Selection:

Articles including BMX and any injury as the main topic or subtopic were searched across multiple databases.

Study Design:

A scoping review was designed following the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Level of Evidence:

Level 4.

Data Extraction:

BMX injury incidences, prevalence, risk factors, prevention strategies, and prevention implementation were extracted. Two reviewers screened all studies and extracted data independently.

Results:

Of the 1856 articles screened, 37 met inclusion criteria. Most studies used injury surveillance at elite competitions or emergency departments, and common injuries were contusions, lacerations, and fractures. IRs provided were based primarily on elite competition and were heterogeneous (eg, 2016 Olympics: 37.5 per 100 athletes; 2007 BMX World Championship: 11.7 per 100 athletes; 1989 BMX Euro Championship: 6.6 per 100 athletes). Only 1 study stratified IRs by BMX discipline (BMX freestyle: IR, 22.2 injuries per 100 athletes; BMX racing: IR, 27.1 per 100 athletes). Few prevention strategies have been evaluated, but reducing the number of riders per race could be helpful.

Conclusion:

Most BMX studies do not use recommended injury surveillance methodology. Studies based on emergency department data may underestimate minor injuries and do not adequately measure BMX exposures. Rigorous community-based prospective studies examining IRs for both BMX racing and freestyle, risk factors, and prevention strategies are needed to inform widespread evidence-based prevention strategies.
Fluctuation of Bone Marrow Lesions and Inflammatory MRI Markers over 2 Years and Concurrent Associations with Quantitative Cartilage Loss
Authors: Roemer Frank W. , Jansen Mylène P. , Maschek Susanne , Mastbergen Simon C. , Marijnissen Anne-Karien , Wisser Anna , Heiss Rafael , Weinans Harrie H. , Blanco Francisco J. , Berenbaum Francis , Kloppenburg Margreet , Haugen Ida K. , Eckstein Felix , Hunter David J. , Guermazi Ali , Wirth Wolfgang
Published: October 2024

Objective

To assess whether change of semiquantitatively magnetic resonance imaging (MRI)-defined bone marrow lesions (BMLs) and inflammatory markers is associated with change in quantitatively-assessed cartilage loss in the femorotibial joint (FTJ) in knees with radiographic osteoarthritis (OA) over 24 months.

Design

Participants were included from the IMI-APPROACH and the Osteoarthritis Initiative FNIH studies. Semiquantitative MRI assessment was performed for BMLs, Hoffa- and effusion-synovitis. Quantitative cartilage thickness measurements were performed manually. Definitions of change included number of subregions with BMLs, change in sum and change in maximum increase in size. Change in Hoffa-synovitis and effusion-synovitis was categorized in addition. Between-group comparisons regarding cartilage loss in the FTJ, medial and lateral compartments were performed using analysis of variance (ANOVA).

Results

A total of 629 participants were included. Knees without any BMLs at baseline (BL) and follow-up (FU) had significantly less cartilage loss compared to the other subgroups. Change in both directions in the sum score of BMLs was associated with increased rates of cartilage loss. Maximum increase in size of BMLs was associated with increased rates of cartilage loss (FTJ increase by 2 grades −0.183 mm, 95% CI [−0.335, −0.031], by 3 grades −0.306 mm, [−0.511, −0.101]). Worsening of Hoffa-synovitis was associated with increased rates of cartilage loss.

Conclusion

Knees without BMLs at BL and FU showed lowest rates of cartilage loss. Knees with an increase in BML size showed increased rates of concurrent cartilage loss. Approaches with the aim to inhibit BML development, avoidance of increase in size and avoidance of Hoffa-synovitis worsening may have beneficial effects on cartilage loss.
Passing Down the Mic Signals Trustworthy Intersectional Allyship and Promotes Organizational Identity-Safety
Authors: Pham Minh Duc , Chaney Kimberly E.
Published: October 2024

People belonging to more privileged groups are often given the default opportunity to address oppression over multiply marginalized people, perpetuating intersectional invisibility. The present research proposes passing down the mic as a strategy to disrupt intersectional invisibility. Black women ( Ntotal = 584; Experiments 1 and 2) perceived a White woman at an organization’s diversity, equity, and inclusion (DEI) meeting who passed a speaking opportunity to a Black woman to address Black women’s discrimination compared to speaking herself or allowing another White woman to address women’s or Black women’s discrimination, as a more trustworthy ally to Black women, and thus participants anticipated greater self-sacrificing allyship from the White woman, and greater identity-safety if they worked at the organization. Such benefits transferred, emerging for Latinx women participants whether the mic was passed to a Latina or Black woman ( N = 528; Experiment 3). Findings highlight an intervention route to equitably uplift multiply marginalized people and address intersectional disparities.
An Eastern Look at a Western Dilemma: Cross-Cultural Differences in Action-Balanced Trolley Dilemmas
Authors: Xu Xinyi , Bostyn Dries , Ren Xiaopeng , Roets Arne
Published: October 2024

Moral judgment has been extensively studied utilizing traditional trolley-like sacrificial dilemmas. However, by building on Western philosophies and relying on WEIRD samples, this approach has potentially introduced a Western-centric bias to our understanding of the morality of sacrificial harm, by (a) assuming an inherent opposition between utilitarian and deontological morality and (b) underestimating cultural differences on the moral value of inaction. To address this bias, our study examined cross-cultural differences in moral judgment using an adapted methodology that equally weighs action/inaction framing and considers utilitarian and deontological choices separately. The findings demonstrate that Chinese participants ( n = 273) embraced a more holistic moral construct with utilitarian and deontological moral approaches being positively correlated, whereas American participants ( n = 240) viewed them as opposing to each other. Moreover, we also found that Chinese participants were more, rather than less utilitarian than American participants in trolley-like dilemmas when balancing action and inaction.
Iron deficiency anemia: an early clinical presentation of cytomegalovirus-induced hemorrhagic colitis in chronic myeloid leukemia patients under dasatinib treatment
Authors: Sanchez-Paz Laura , Tirado Zambrana Pernilla Seidi , Villa Poza Carlos , Hernández-Rivas José-Ángel , Landete Hernández Elena
Published: October 2024

Dasatinib is a second-generation tyrosine kinase inhibitor employed for chronic myeloid leukemia (CML) treatment that achieves high rates of prolonged and complete molecular responses (MR). Among the adverse effects reported, it has been associated with hemorrhagic complications, mainly due to its inhibiting effects on platelet functions. In addition, immune alterations induced by dasatinib may elevate the risk of bleeding and cytomegalovirus (CMV) infection, particularly in the gastrointestinal tract, thus contributing to the development of hemorrhagic colitis. In this case report, we highlight three cases of CML receiving treatment with dasatinib where CMV hemorrhagic colitis occurred. All of them exhibited iron deficiency anemia as a premature clinical manifestation in the absence of intestinal symptoms, unlike cases previously reported in the literature. CMV infection was confirmed with stool samples or tissue quantitative polymerase chain reaction and/or immunohistochemistry staining in colon biopsies. All three cases could be managed with valganciclovir and iron supplements in an outpatient setting. Management strategies of dasatinib during and after CMV infection varied, as they are not yet established and need to be individualized based on the gravity of symptoms and disease state. Iron deficiency anemia during dasatinib treatment should raise suspicion for the potential presence of CMV colitis, prompting endoscopic studies to rule out this complication, even if intestinal symptoms are not present.
Keeping viewers hooked: Netflix’s innovative strategies for reducing churn
Authors: Neglur Indrani Sudhindra , PS Rajeswari
Published: October 2024

Netflix’s digital disruption in the entertainment industry has been significantly enhanced by digital nudging, which refers to using behavioural science techniques to subtly influence user decisions (Thaler and Sunstein, 2008). By leveraging data analytics, Netflix personalises the viewing experience, guiding users toward content they are likely to enjoy, which increases engagement and encourages binge-watching. The platform employs sophisticated algorithms to recommend titles, effectively nudging viewers to explore new genres or original content based on their viewing history (Lobato, 2019). This strategy has been pivotal in fostering a binge-watching culture, contrasting sharply with traditional broadcasting schedules offering weekly instalments. Netflix’s ability to analyse user data allows it to create content that aligns with viewer preferences, further enhancing its appeal. By understanding what resonates with audiences, Netflix can produce targeted original content that captures attention and retains subscribers. Digital nudging plays a crucial role in Netflix’s strategy, reinforcing its position as a leader in the streaming market while reshaping consumption habits across the industry. However, digital nudging presents both opportunities and challenges for customer churn management, raising critical ethical questions about autonomy and manipulation. Finding the right balance between effective customer retention strategies and ethical considerations will be vital for fostering trust and enhancing the overall user experience on the platform.
Why they don’t trust the media: The Chinese public’s perception and evaluation of news media in the social media era, taking the Liu Xuezhou incident as an example
Authors: Ye Xiaoyan , Sun Xuwen
Published: October 2024

With the advent of the post-pandemic era characterised by increasing social uncertainty, the public is placing higher demands on the trust in news media. According to the 2023 Edelman Trust Barometer, the image of the media in the public’s mind is deteriorating. Why don’t they trust the media? What are the reasons given by the public when the media is denounced as unscrupulous? Taking the Liu Xuezhou incident as a typical case, the study extracts key elements from 5,225 related microblog texts, identifies the main topics of public discussion with the help of LDA topic modelling, clarifies the referential dimension of unscrupulous media with the help of pointwise mutual information, and analyzes netizens’ evaluations related to different referential levels of the media through visual semantic networks, which can help formulate dialectical thinking on media trust in the context of China in the era of social media.
Reevaluating Informed Consent: Integrating Shared Decision-Making into Spinal Surgery for Better Patient Outcomes
Authors: Wang Jeffrey N. , Elhakeem Mohamed A. , Mesimer Matthew J. , Mastrokostas Paul G. , Ahmad Salman , Reed Tim , Klein Brandon , Bartlett Lucas E. , Bitterman Adam D. , Megas Andrew
Published: October 2024

Study Design

Narrative review.

Objectives

The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?

Methods

N/A.

Results

SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, alternatives, and postoperative expectations. Informed consent is a vital component of this process, ensuring that patients are fully informed and empowered to make decisions based on their values and preferences. This review highlights the current state of informed consent within the context of SDM in spine surgery and explores how enhancing this process can improve patient outcomes, reduce dissatisfaction, and decrease litigation. By emphasizing patient autonomy and improving the quality of risk communication, SDM fosters better physician-patient relationships and more positive clinical outcomes.

Conclusions

Orthopaedic surgery and neurosurgery are highly litigated specialties, with failure to obtain informed consent frequently cited in lawsuits. These legal challenges are costly and time-consuming for both physicians and patients. Integrating SDM into the informed consent process can help mitigate these issues, leading to improved patient satisfaction and fewer legal disputes.
Amorphous infrastructure: Contesting the proposed Yuam River water diversion project in the Salween River Basin
Authors: Fung Zali
Published: October 2024

Recent studies in human geography and political ecology have examined the anticipatory politics of proposed infrastructure and their effects. Less work analyses how speculation and rumour are mobilised to promote or resist such infrastructures. In this paper, I examine how speculative ideas about long-proposed hydropower dams and transbasin water diversions in the Salween River Basin are strategically deployed by differently placed actors working towards project development or demise. I draw on empirical research on the proposed Yuam River water diversion project in Northwest Thailand and near the Thai–Myanmar border. I develop a conceptualisation of proposed infrastructures as amorphous as they constantly change form and enrol a shifting network of actors, and development plans and imaginaries. The Yuam diversion becomes amorphous through the contested ‘facts’ of the case and over time. I illustrate this using two longitudinal examples. First, infrastructure is made amorphous through protracted development processes for the Yuam diversion and earlier iterations. Second, I examine speculative ideas about how the Yuam diversion is intertwined with proposed dams in the Basin including the Hatgyi Dam in Myanmar. In this case, the lack of confirmed project developers and financiers for the Yuam diversion, and rumours of Chinese actors’ involvement under the Belt and Road Initiative, creates strategic space for project promotion and resistance. What is at stake is not just theorising proposed infrastructures as speculative ideas but how the ‘amorphous’ qualities of infrastructure are deployed strategically, by whom, and to what effect.
The Effects of Coffee/Caffeine in Patients with Multiple Sclerosis; A Systematic Review
Authors: Salekzamani Shabnam , Baharomid Saman , Pakkhesal Sina , Balafkandeh Maryam , Gholipour-Khalili Elnaz , Talebi Mahnaz , Sanaie Sarvin , Naseri Amirreza
Published: October 2024

Background

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Caffeine, as the most widely consumed psychoactive substance, has been suggested to have potential effects on the clinical course and disability levels of MS patients. This study aimed to review the current evidence on the effects of coffee/caffeine in patients with MS.

Methods

This study followed the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and PRISMA 2020 statement. Clinical evidence regarding the effects of caffeine/coffee in MS patients was considered. A systematic search was performed in PubMed, Scopus, Web of Science, and Embase in October 2023, and updated via handsearching in March 2024. JBI's critical appraisal tools were utilized to scrutinize the risk of bias.

Results

Out of 297 screened records, eight studies were eventually found to meet our inclusion criteria. The sample size of the studies varied between 12 and 1372 and the study designs were retrospective cohort, RCT, single-blind crossover trial, single-arm pilot study (each one study), and cross-sectional (four studies). No significant association between the level of disability and coffee/caffeine intake has been reported, although it was reported to be associated with cognitive improvements.

Discussion

Evidence indicates an association between coffee/caffeine consumption, and improved cognitive outcomes in patients with MS, while there is no considerable relationship with the disease disability. Considering the limitations of the evidence, such as the small number of studies, and great diversity in study designs, the findings of this study should translate to clinical practice with caution.
CHRDL1 inhibits OSCC metastasis via MAPK signaling-mediated inhibition of MED29
Authors: Huang Songkai , Zhang Junwei , Qiao Yu , Pathak Janak Lal , Zou Rui , Piao ZhengGuo , Xie ShiMin , Liang Jun , Ouyang Kexiong
Published: October 2024

Background

CHRDL1 belongs to a novel class of mRNA molecules. Nonetheless, the specific biological functions and underlying mechanisms of CHRDL1 in oral squamous cell carcinoma (OSCC) remain largely unexplored.

Methods

RT-qPCR and immunohistochemical staining were employed to assess the mRNA and protein expression levels of the MED29 gene in clinical samples of OSCC. Additionally, RT-qPCR and Western Blot analyses were conducted to investigate the mRNA and protein expression levels of the MED29 gene specifically in OSCC. The impact of MED29 on epithelial-mesenchymal transition (EMT), invasion, and migration of OSCC was evaluated through scratch assay, transwell assay, and immunofluorescence staining. Furthermore, wound healing assay and Transwell assay were utilized to examine whether CHRDL1 influences the malignant behavior of OSCC by modulating MED29 in vitro. The regulatory role of CHRDL1 on MED29 was further elucidated in vivo through a tail vein lung metastasis model in nude mice.

Results

MED29 expression was elevated in tumor tissues of OSCC patients compared with adjacent cancer tissues. Moreover, in CAL27 and SCC25 cell lines, MED29 was upregulated and associated with increased cell migration and invasion abilities. Overexpression of MED29 facilitated EMT in OSCC cell lines, whereas knockdown of MED29 impeded EMT, resulting in diminished cell migration and invasion capacities. CHRDL1 exerted inhibitory effects on the expression of MED29, thereby suppressing EMT progression and consequently restraining the invasion and migration of OSCC cells. Furthermore, CHRDL1 mediated the inhibition of migration of OSCC cell lines to the OSCC through its regulation of MED29.

Conclusions

MED29 facilitated the epithelial-mesenchymal transition process in OSCC, thereby promoting migration and invasion. On the other hand, CHRDL1 exerted inhibitory effects on the invasion and metastasis of OSCC by suppressing MED29 through the inhibition of the MAPK signaling pathway.
Assessing personalized molecular portraits underlying endothelial-to-mesenchymal transition within pulmonary arterial hypertension
Authors: Wu Ruhao , Zhang Ge , Guo Mingzhou , Li Yue , Qin Lu , Jiang Tianci , Li Pengfei , Wang Yu , Wang Ke , Liu Yize , He Zhiqiu , Cheng Zhe
Published: October 2024

Pulmonary arterial hypertension (PAH) is a progressive and rapidly fatal disease with an intricate etiology. Identifying biomarkers for early PAH lesions based on the exploration of subtle biological processes is significant for timely diagnosis and treatment. In the present study, nine distinct cell populations identified based on gene expression profiles revealed high heterogeneity in cell composition ratio, biological function, distribution preference, and communication patterns in PAH. Notably, compared to other cells, endothelial cells (ECs) showed prominent variation in multiple perspectives. Further analysis demonstrated the endothelial-to-mesenchymal transition (EndMT) in ECs and identified a subgroup exhibiting a contrasting phenotype. Based on these findings, a machine-learning integrated program consisting of nine learners was developed to create a PAH Endothelial-to-mesenchymal transition Signature (PETS). This study identified cell populations underlying EndMT and furnished a potential tool that might be valuable for PAH diagnosis and new precise therapies.
Optimizing yield and water productivity in summer mung bean (Vigna radiata L.) through crop residue management and irrigation strategies
Authors: Tripathi Saurabh , Kaur Anureet , Brar Ajmer Singh , Sekhon Karamjit Singh , Singh Sukhpreet , Malik Anurag , Kisi Ozgur
Published: October 2024

A multi-season research trial entitled ‘crop residue management effects on yield and water productivity of summer mung bean (Vigna radiata L.) under different irrigation regimes in Indian Punjab’ was conducted at Punjab Agricultural University (PAU), Regional Research Station (RRS), Bathinda, during rabi 2020 and 2021. The field experiment was conducted in a split-plot layout with nine treatment combinations and replicated thrice. The treatments consisted of T1 (no wheat residue along with tillage), T2 (leftover wheat residue with zero tillage), and T3 (incorporated wheat residue along with tillage) in main plots and irrigation regimes viz., I1 (vegetative growth and flowering stage), I2 (vegetative growth, flowering, and pod filling stage) and I3 (vegetative growth, flowering, pod formation and pod filling stage) in sub-plots, respectively. The growth and yield attributing characters were significantly higher under T3 than T1 but statistically at par with T2 during both years. An increase of 24.1% and 19.0% in grain yield was found in residue incorporation (T3) and residue retention (T2) over residue removal (T1), respectively. Maximum crop and irrigation water productivity was observed under T3 due to reduced water use and increased yield. Among the irrigation regimes, the I3 recorded significantly higher grain yield (0.70 and 0.79 t ha− 1) than I1. It was at par with I2 during both years due to higher irrigation frequency at the pod formation and pod filling stage. Crop water productivity (CWP) was higher under I3, whereas irrigation water productivity (IWP) was higher under I1 during both years. Additional irrigation at the pod-filling stage increased the grain yield by 36.5%, and two additional irrigations at the pod-formation and pod-filling stage further increased yield by 46.2% compared to only two irrigations at the vegetative and flowering stages. The treatment combinations of T2I2 and T3I2 outperformed T1I3 in terms of growth and yield attributing characters viz. plant height, dry matter accumulation (DMA), leaf area index (LAI), pods plant− 1, seeds pod− 1, and 1000-seed weight, which resulted in higher grain yield in these treatment combinations over T1I3. Applying crop residue can help minimize water use and increase crop water productivity. So, retaining crop residue in summer mung bean resulted in saving irrigation water due to lesser evapotranspiration from the soil surface.
Hybridization has localized effect on genetic variation in closely related pine species
Authors: Szczepański Sebastian , Łabiszak Bartosz , Lasek Martyna , Wachowiak Witold
Published: October 2024

Background

Hybridization is a known phenomenon in nature but its genetic impact on populations of parental species remains less understood. We investigated the evolutionary consequences of the interspecific gene flow in several contact zones of closely related pine species. Using a set of genetic markers from both nuclear and organellar genomes, we analyzed four hybrid zones (384 individuals) and a large panel of reference allopatric populations of parental taxa (2104 individuals from 96 stands).

Results

We observed reduced genetic diversity in maternally transmitted mitochondrial genomes of pure pine species and hybrids from contact zones compared to reference allopatric populations. The distribution of mtDNA haplotypes followed geographic rather than species boundaries. Additionally, no new haplotypes emerged in the contact zones, instead these zones contained the most common local variants. However, species diverged significantly at nuclear genomes and populations in contact zones exhibited similar or higher genetic diversity compared to the reference stands. There were no signs of admixture in any allopatric population, while clear admixture was evident in the contact zones, indicating that hybridization has a geographically localized effect on the genetic variation of the analyzed pine species.

Conclusions

Our results suggest that hybrid zones act as sinks rather than melting pots of genetic diversity. Hybridization influences sympatric populations but is confined to contact zones. The spectrum of parental species ancestry in hybrids reflects the old evolutionary history of the sympatric populations. These findings also imply that introgression may play a crucial role in the adaptation of hybrids to specific environments.
Impact of semaglutide on weight and functional outcomes among obese heart failure patients: a propensity scores matching analysis
Authors: Balata Mahmoud , Becher Marc Ulrich
Published: October 2024

Background & objectives

Obesity is a common comorbidity in heart failure, yet effective pharmacological options for weight loss in these patients are limited. Semaglutide, a glucagon-like peptide 1 receptor agonist, has shown promise for weight reduction in obese adults. This study aims to evaluate semaglutide’s impact on weight loss, functional status, and clinical outcomes in obese patients with heart failure.

Methods

A retrospective analysis was conducted on all consecutive obese (BMI > 30 kg/m²) patients with heart failure at the University Hospital Bonn outpatient clinic from July 2019 to July 2022. Propensity score matching paired patients receiving semaglutide as an add-on therapy (SEMA) with those on medical therapy alone (Control).

Results

Among 1,942 patients with heart failure screened, 26 matched pairs were identified. At one year, the SEMA group exhibited significant weight loss, with a mean BMI reduction of -2.91 kg/m² (95% CI: -4.27 to -1.55; p < 0.001), while the control group showed a non-significant mean change of -0.41 kg/m² (95% CI: -1.08 to 0.26; p = 0.22). The difference in BMI between the two groups was statistically significant (mean difference: 3.42 kg/m², 95% CI: 1.43 to 5.42; p = 0.001). Improvements by at least one NYHA class were observed in 65% of the SEMA group (p < 0.001) compared to 15% of the control group (p = 0.18). The SEMA group also showed a significant increase in 6-minute walk distance (6MWD), with a mean difference of 75 m between the groups at one year (95% CI: 0.53 to 150.02; p = 0.049). NT-proBNP levels significantly decreased in the SEMA group (p < 0.001) compared to the control group (p = 0.78), with a statistically significant difference in NT-proBNP between the groups (p = 0.048). Both improvements in 6MWD and reductions in NT-proBNP were significantly correlated with BMI percentage reductions.

Conclusions

Semaglutide was associated with significant weight reduction in obese patients with heart failure, accompanied by improved NYHA classification and 6-minute walk distance. Larger, multi-center trials and prospective, randomized controlled trials are warranted. These studies should focus on assessing long-term outcomes, optimizing dosage, and exploring the potential cardiovascular benefits beyond weight reduction.
Estimating reference intervals from an IPD meta-analysis using quantile regression
Authors: Jiang Ziren , Chu Haitao , Wang Zhen , Murad M. Hassan , Siegel Lianne K.
Published: October 2024

Background

Reference intervals, which define an interval in which a specific proportion of measurements from a healthy population are expected to fall, are commonly used in medical practice. Synthesizing information from multiple studies through meta-analysis can provide a more precise and representative reference interval than one derived from a single study. However, the current approaches for estimating the reference interval from a meta-analysis mainly rely on aggregate data and require parametric distributional assumptions that cannot always be checked.

Methods

With the availability of individual participant data (IPD), non-parametric methods can be used to estimate reference intervals without any distributional assumptions. Furthermore, patient-level covariates can be introduced to estimate personalized reference intervals that may be more applicable to specific patients. This paper introduces quantile regression as a method to estimate the reference interval from an IPD meta-analysis under the fixed effects model.

Results

We compared several non-parametric bootstrap methods through simulation studies to account for within-study correlation. Under fixed effects model, we recommend keeping the studies fixed and only randomly sampling subjects with replacement within each study.

Conclusion

We proposed to use the quantile regression in the IPD meta-analysis to estimate the reference interval. Based on the simulation results, we identify an optimal bootstrap strategy for estimating the uncertainty of the estimated reference interval. An example of liver stiffness measurements, a clinically important diagnostic test without explicitly established reference range in children, is provided to demonstrate the use of quantile regression in estimating both overall and subject-specific reference intervals.
Metabolomic analysis to predict the onset and severity of necrotizing enterocolitis
Authors: Moschino Laura , Verlato Giovanna , Stocchero Matteo , Giordano Giuseppe , Pirillo Paola , Meneghelli Marta , Guiducci Silvia , Duci Miriam , Fascetti Leon Francesco , Baraldi Eugenio
Published: October 2024

Background

Necrotizing enterocolitis (NEC) is the most devastating gastrointestinal (GI) emergency in preterm neonates. Untargeted metabolomics may allow the identification of biomarkers involved in NEC pathophysiology.

Methods

We conducted a prospective study including preterm infants born at < 34 gestational weeks (GWs) whose urine was longitudinally collected at birth (< 48 h, T0) and at 14 (T1) and 28 days (T2). Neonates were followed for their development of NEC, spontaneous intestinal perforation (SIP), or other GI conditions and compared to those of matched healthy controls. Urine samples were investigated by untargeted metabolomic analysis based on mass-spectrometry.

Results

Thirty-five patients with NEC, 5 patients with SIP, 14 patients with other GI diseases and 113 controls were enrolled and selected for metabolomic analysis on the basis of their clinical characteristics and available samples. Considering urine samples at T0, the one-class classification approach was able to correctly classify 16/20 subjects (80%) who developed NEC, 3/3 (100%) who developed SIP and 5/7 subjects (71.4%) with other GI pathologies as not belonging to the control group. Neonates with surgical NEC had higher N-acetylaspartic acid, butyrylcarnitine and propionylcarnitine levels than did those with medical NEC. Considering the time evolution of the urinary metabolome, the NEC and control groups showed differences independently of the time point.

Conclusions

The urinary metabolome is closely associated with the underlying GI disease from birth. Urinary metabolic features characterize NEC patients from healthy controls until 28 days of life. The early urinary metabolome has the potential to predict surgical NEC. Future studies are needed to validate our results.
The application of Chinese version of SARC-F and SARC-CalF in sarcopenia screening against five definitions: a diagnostic test accuracy study
Authors: Guo Jia-Yu , Yu Kang , Li Chun-Wei , Bao Yuan-Yuan , Zhang Yu , Wang Fang , Li Rong-Rong , Xie Hai-Yan
Published: October 2024

Background

SARC-F questionnaire is a simple and convenient tool for sarcopenia screening, and SARC-CalF is a modified version of it. The developments of their Chinese versions are warranted for the clinical use for Chinese population. This study aimed to culturally adapt the SARC-F questionnaire into Chinese using standardized methods, validate the reliability and diagnostic accuracy of the Chinese version SARC-F and SARC-CalF against five sarcopenia diagnosis criteria, and determine optimal cut-off values for clinical practice in Chinese population.

Methods

The translation and cross-cultural adaptation of SARC-F into Chinese were conducted following the methodological report from European Union Geriatric Medicine Society Sarcopenia Special Interest Group. The Chinese version of SARC-F was validated through a diagnostic test, using diagnostic criteria of sarcopenia recommended by the revised 2019 European Working Group on Sarcopenia in Older People (EWGSOP2) consensus, Asian Working Group for Sarcopenia (AWGS2019) consensus, the International Working Group on Sarcopenia (IWGS), the Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium and the Sarcopenia Definition and Outcomes Consortium (SDOC). Additional analysis was done against the criteria of severe sarcopenia according to the revised EWGSOP2 and AWGS2019.

Results

The Chinese version of SARC-F was well translated and demonstrated good reliability and acceptability. The diagnostic test included 1859 community-dwelling older individuals from two medical centers. Against five different definitions of sarcopenia, the Chinese version of SARC-F showed reasonable diagnostic accuracy for sarcopenia screening (AUC 0.614–0.821), and was demonstrated low sensitivity (13.7–37.9%) but high specificity (94.8–97.7%) with a cut-off value of ≥ 4. SARC-CalF significantly enhanced the diagnostic accuracy of SARC-F when using definitions of EWGSOP2, AWGS2019 and IWGS (all P ≤ 0.001). A score of ≥ 2 for SARC-F and ≥ 7 for SARC-CalF were established as optimal cut-off points for identifying older individuals as at risk of sarcopenia in Chinese population.

Conclusions

The Chinese version SARC-F is of reasonable reliability and validity for sarcopenia screening. Despite its low sensitivity, it proves to be a useful tool to identify severe cases in community taking advantage of its simplicity. SARC-CalF appears to be a more suitable screening tool for clinical use in detecting sarcopenia.
Determinants of depressive symptoms among persons 80 years and older: longitudinal national evidence from the health, aging, and retirement study in Thailand, 2015–2022
Authors: Pengpid Supa , Peltzer Karl , Hajek André , Anantanasuwong Dararatt , Kaewchankha Wasin
Published: October 2024

Background

Few studies have longitudinally assessed the determinants of depressive symptoms among persons 80 years and older. The aim of this study was to estimate the determinants of depressive symptoms among persons 80 years and older based on 4-wave national longitudinal data from Thailand.

Methods

Data from the Health, Aging, and Retirement in Thailand study from 2015, 2017, 2020 and 2022 were utilized. The sample was restricted to community-dwelling persons 80 years and older (analytic sample: n = 2763 observations). For the pooled sample, average age was 85.0 years (range 80–117 years). Established measurements were used to assess depressive symptoms. Linear fixed effects regression was applied to assess the time-variant determinants and outcomes.

Results

Regressions found that higher functional disability and an increase in the number of chronic conditions worsened depressive symptoms. More favourable self-rated physical health, and higher exercise frequency improved depressive symptoms. In addition, among women higher subjective economic status decreased depressive symptoms.

Conclusions

This longitudinal study enhances our understanding of the determinants of depressive symptoms among persons 80 years and older. Strategies to delay or decrease functional disability, chronic conditions, increase physical activity, and improve subjective economic status may help in reducing depressive symptoms.
Hemodynamic monitoring during weaning from mechanical ventilation in critically ill pediatric patients: a prospective observational study
Authors: Abdelgawad Tarek Ahmed , Ibrahim Hanan M. , Elsayed Eman Mohamed , Abdelhamid Nehad Salah , Bawady Somia Abdel Hamid , Rezk Ahmed R.
Published: October 2024

Background

Cardiovascular dysfunction is a significant factor contributing to weaning failure in mechanically ventilated children. Understanding the cardiopulmonary pathophysiological changes that occur during weaning is a prerequisite for the early recognition of weaning failure of cardiovascular origin. This study aimed to assess the effect of weaning trials on central hemodynamics and to identify the indices predictive of cardiac-related weaning failure.

Methods

This prospective observational study was conducted in the Pediatric Intensive Care Unit (PICU) and included mechanically ventilated patients aged between 2 and 30 months who were on minimal ventilatory settings and ready for weaning. Patients who were hemodynamically unstable, diagnosed with neuromuscular diseases, or diagnosed with cardiac diseases were excluded. Hemodynamic parameters were evaluated during weaning from ventilation via echocardiography and noninvasive cardiometry during pressure support (PS) ventilation and at the end of the spontaneous breathing trial (SBT).

Results

The study included 50 patients, comprising 30 males (60%) and 20 females (40%) with ages ranging from 2 to 30 months. Echocardiography revealed a significant increase in the cardiac index (CI), tricuspid annular plane systolic excursion (TAPSE), and the E/A ratio at the end of SBT. Moreover, right ventricular systolic pressure (RVSP) significantly decreased. Noninvasive cardiometry revealed a significant increase in the index of contractility (ICON) and CI at the end of SBT (p-value = 0.023 and < 0.001, respectively). Of the 12 (25%) patients who failed their first extubation trial, they exhibited a significantly lower CI and TAPSE (p values = 0.001 and 0.001, respectively).

Conclusion

This study identified that weaning from mechanical ventilation in children is associated with hemodynamic changes, which can impact weaning success and reveal potential ventricular dysfunction. Bedside echocardiography was found to detect cardiac dysfunctions during weaning, and noninvasive cardiometry was considered a reliable tool that supports echocardiography for detecting changing trends in CI in PICUs. However, accurate values should be confirmed by echocardiography.
“Using dried blood spots beyond newborn screening – is Hong Kong ready?”: navigating the intersection of innovation readiness, privacy concerns, and Chinese parenting culture
Authors: Ngan Olivia Miu Yung , Fung Cheuk Wing , Kwok Mei Kwun , Yau Eric Kin Cheong , Lee Shing Yan Robert , Luk Ho-Ming , Belaramani Kiran Moti
Published: October 2024

Background

Newborn screening programmes offer an opportunity to obtain dried blood spots (DBS) cards that contain a wealth of biological information that can be stored for long periods and have potential benefits for research and quality assurance. However, the storage and secondary uses of DBS cards pose numerous ethical, clinical, and social challenges. Empirical research exploring public attitudes is central to public policy planning as it can indicate whether or not there is broad public support, define public concerns, and ascertain the circumstances required to alleviate concerns and ensure support. This study aims to describe the clinical experience and attitudes towards newborn screening and investigate the perceptions and expectations of Hong Kong parents and healthcare providers regarding the retention of DBS cards and their usage for research.

Methods

We conducted semi-structured in-person interviews with 20 parents and healthcare providers in Hong Kong. Thematic analysis was conducted.

Results

Awareness of the significant research value of secondary uses of dried blood spot cards is low. Parents and healthcare providers support the storage and secondary uses of DBS cards with some concerns, including privacy and confidentiality breaches, the risk of discrimination or stigmatisation based on genetic information, and their inability to oversee the use of their child’s biospecimen. Parents, however, prioritise their child’s health over privacy concerns and support identifiable storage using pseudonymity to gain more information about their children's health.

Conclusion

Child information takes precedence over potential concerns over privacy, underscoring the significance of engaging patients and the public in shaping public policy related to biobanking and healthcare research, in line with cultural and social values.
Sociodemographic differences in low back pain: which subgroups of workers are most vulnerable?
Authors: Beller Johannes , Sperlich Stefanie , Epping Jelena , Safieddine Batoul , Hegewald Janice , Tetzlaff Juliane
Published: October 2024

Background

Low back pain (LBP) is a common health problem in workers that contributes to work disability and reduces quality of life. However, studies examining vulnerable groups in relation to sociodemographic differences in LBP remain scarce. Therefore, the current study investigates which sociodemographic groups of workers are most affected by LBP.

Methods

Data from the 2018 BIBB/BAuA employment survey were used (N = 16252). Age, education, occupational group, income, working hours, atypical working time, relationship status, and having children were used as sociodemographic predictors. Gender-stratified logistic regression analyses and intersectional classification tree analyses were conducted.

Results

A higher prevalence of LBP was observed for women compared to men. Significant differences in LBP emerged for age, working hours, atypical working time, occupational group and education, with some gender differences in the importance of predictors: Age was a significant predictor mostly in men as compared to women, atypical working hours had a slightly greater effect in women, whereas differences in LBP according to the occupational group were more pronounced for men. Vulnerable groups were found to be women who work in occupations other than professionals or managers, work atypical hours and have an intermediate or low educational level as well as men who work as skilled agricultural workers, craft workers, machine operators, or elementary occupations and are between 35 and 64 years old.

Conclusions

Thus, workers with certain occupations and lower levels of education, middle-aged men and women with unfavourable working time characteristics are most affected by low back pain. These groups should be focused on to potentially increase healthy working life and prevent work disability.
Effect of Dexmedetomidine with or without Midazolam during procedural dental sedation in children: a randomized controlled clinical trial
Authors: ElKhatib Amira A. , Ghoneim Tamer A. M. , Dowidar Karin M. L. , Wahba Nadia A.
Published: October 2024

Background

Dental anxiety is a global problem in the realm of pediatric dentistry. The use of procedural sedation is recommended to avoid substandard or unsafe dental treatment in preschoolers. This study aimed to compare the effect sedation with Dexmedetomidine with or without Midazolam in terms of sedation level, analgesic effect and ease of treatment completion in preschool children.

Methods

A triple blind randomized controlled clinical trial comprised 72 healthy uncooperative children, 4–6 years old, were randomly allocated into three groups of 24 patients each: Group I patients were sedated with nebulized 5 μg/kg Dexmedetomidine (DEX), Group II with nebulized 3 μg/kg DEX followed by nebulized 0.3 mg/kg Midazolam (MID), and Group III with nebulized 0.5 mg/kg MID. Along the session, the three regimens were assessed and compared during the sedation level (children responsiveness) using the Modified Observer’s Assessment of Alertness/Sedation Scale, the analgesic effect using the Face, Leg, Activity, Cry, Consolability scale and ease of treatment completion using a separate 5-point scale. Vital signs were recorded before and during sedation, until full recovery.

Results

A significant difference was detected regarding children responsiveness during operative procedure in favour of DEX in comparison to MID and DEX/MID groups (P = 0.045). Within the DEX group, a significant difference was recorded regarding children responsiveness at optimum sedation and during the operative procedure (P = 0.04). Although, the analgesic effects of sedative drugs showed no statistically significant difference among the study groups (P = 0.20), the ease of treatment completion was statistically higher in the DEX than MID and DEX/MID groups (P = 0.03).

Conclusion

Dexmedetomidine provides a moderate level of sedation, that allowed better patient cooperation, and easy completion of performed dental procedures.