bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Altitude with Mortality among Patients with Hypertension - A Cohort Study
Authors: Lu J , Pang L , Xia Y , Guo Z , Yang W , Duo L , Zhu Q , Wang T
Published: October 2024

Background

Available evidence falls short in assessing the risk of all-cause mortality and cardiovascular disease (CVD) mortality among individuals with hypertension residing at various altitudes. This study’s objective was to investigate the correlation between residential altitude and the rates of all-cause mortality and CVD mortality among hypertensive patients.

Methods

This prospective cohort study encompassed 67,275 hypertensive individuals aged 35 years and above in the year 2018. Participants were categorized into four distinct groups based on their residence altitude: those living below 500 meters, between 500 and 1499 meters, 1500 to 2500 meters, and above 2500 meters. The study spanned a mean follow-up duration of 4.78 years. The associations between residential altitude and the risks of all-cause and CVD mortality were analyzed using Cox proportional hazards regression models.

Results

Among the 67,275 hypertensive patients included in the study (mean age of 63.9 years, with 45.3% being male), 8,768 deaths were recorded, of which 5,666 were attributed to CVD. Following multivariate adjustment, when compared to the group residing at altitudes below 500 meters, the groups living at altitudes of 500-1499 meters, 1500-2500 meters, and above 2500 meters exhibited significantly elevated risks of all-cause mortality [hazard ratio, HR = 1.45 (95% CI: 1.36-1.54), 1.35 (95% CI: 1.36), and 1.41 (95% CI: 1.28-1.54), respectively] and CVD mortality [HR = 1.47 (95% CI: 1.35-1.58), 1.42 (95% CI: 1.33-1.52), and 1.46 (95% CI: 1.31-1.62), respectively]. For each 500-meter increment in altitude, the risk of all-cause and CVD mortality increased by 10% and 11%, respectively. Subgroup analyses and sensitivity assessments consistently supported this association.

Conclusions

This study’s findings indicate a substantial connection between long-term residential high-altitude exposure and increased risks of all-cause mortality and CVD mortality among individuals with hypertension.

Key messages

• Increased altitude of residence increases the risk of subsequent all-cause and CVD mortality in hypertensive patients.

• This study highlights that relevant guidelines and healthcare providers should consider altitude as an important factor in reducing the burden of hypertension and CVD.
Patient referral pathways to leisure providers: impacts on physical activity and falls risk
Authors: Cuddihy C , Jopling H
Published: October 2024

Background

Physical activity aids prevention and management of noncommunicable diseases. Yet many UK adults, particularly those with long-term health conditions, do not meet recommended activity levels. In 2021, West Suffolk Foundation Trust commissioned local leisure provider Abbeycroft to offer 24 week tailored physical activity programs as part of respiratory and frailty patient pathways.

Objectives

Evaluation of activity and outcome data for all 1670 individuals referred between January - December 2023 to determine future commissioning decisions.

Results

256 participants had completed a 24 week pathway by the time of analysis. Compared to baseline, they demonstrated statistically significant (p < 0.05) self-reported improvements on the Short Warwick Edinburgh Mental Well-being Scale (median 25 to 27) amongst 68.9% of participants; and on the self-reported International Physical Activity Questionnaire 62.1% reduced time spent sitting (average 436 to 300 minutes/ week), 75% increased metabolically active minutes (average 955 to 2632 minutes/week) and the proportion of participants with a low (inactive) score decreased by 61%. Of 40 frailty patients, 87.5% lowered their self-reported Short Falls Efficacy Scale Score (14.6 to 10.4) and observed Timed Get up and Go (13.55 to 9.53 seconds), indicative of moving from a higher risk to lower falls risk (p < 0.05). 24 week retention exceeded 80% for all ages except 16-20 years. 17.8% of participants were >75 years.

Lessons

Both pathways have been recommissioned and new tailored pathways for Parkinson’s disease, COPD and cancer are planned. This partnership working is a sustainable, integrated way to embed prevention in the community but needs time to build relationships and streamline data sharing.

Key messages

• Hospital and community referral pathways to leisure providers significantly improve patient well-being, physical activity and falls risk.

• These pathways are affordable, adaptable across conditions and show high retention.
Advancing transdisciplinarity as an epistemology for more ethical engagements with fishing communities
Authors: Strand Mia
Published: October 2024

Celebrated as one of the necessary solutions to more sustainable ocean governance by the UN Ocean Decade for Sustainable Development, transdisciplinarity, co-design, co-production, and co-creation of knowledge continue to be praised by a variety of scholars for their opportunities for impactful and socially significant research. However, despite increased recognition as necessary to respond to complex sustainability challenges, including transformative ocean governance, there are sustained differences in how people and scholars define and conceptualize transdisciplinarity and how people operationalize and apply transdisciplinary research. This perspective is not about what transdisciplinary research entails but is rather asking whether transdisciplinary research is always the appropriate approach. Without a clear understanding of what ethical and equitable transdisciplinarity entails, how do we ensure this does not negatively impact non-academic collaborators such as fishing communities? How do we make sure transdisciplinarity does not become yet another extractive research practice? The paper discusses the difference between partial and comprehensive transdisciplinarity, addresses coloniality of co-design, and reflects on who we cite and why as researchers. Finally, the paper considers how we can advance transdisciplinarity as an epistemology for more ethical engagements with fishing communities and invite fellow marine researchers to ask critical questions.
Asphalt pavement raveling recognition based on deep learning algorithms
Authors: Peng Yi , Yu Xinyi , Huang Yixin , Kong Lingyun , Liu Tangzhi , Liu Guangjiu , Zhu Hongzhou
Published: October 2024

Pavement raveling can lead to the development of issues such as potholes. Monitoring and providing real-time early warnings for road surface developments is crucial for timely maintenance planning and effectively controlling the occurrence and progression of surface issues. To achieve intelligent identification of raveling distress on asphalt pavement surfaces, we utilized a portable laser-based pavement surface scanning device to collect raveling images, followed by histogram equalization to eliminate noise caused by environmental factors. Additionally, data enhancement strategies such as rotation and mirroring were used to enrich training data and expand the sample size. A convolutional neural network was employed to perform multi-layer convolution and pooling operations on the images to quickly extract features of distress. Finally, five pre-trained transfer learning models—ResNet-18, DenseNet, VGG16, Inception, and EfficientNet—were introduced to identify the asphalt surface disease data and the normal surface data. The results showed that the accuracy and loss of the training sets of several models exhibited a positive trend, with the EfficientNet model demonstrating stable and superior performance under the same training conditions. The precision matrix, confusion matrix, precision, recall, and F1 score were used as evaluation indexes to assess the effectiveness of the models for identifying pavement raveling. The EfficientNet and Inception models had the best accuracy and comprehensive performance, with accuracy rates of 0.96 and 0.95, respectively. The precision, recall, and F1 score are 0.95, 0.96, and 0.96 for the EfficientNet model, respectively. A total of 146 images correctly predicted raveling disease and only four normal images were incorrectly predicted as diseased. For example, the EfficientNet model’s identification accuracy for pockmark disease on the PC platform was 0.963, verifying the model’s feasibility in practical applications. The principal contribution of this paper lies in the efficient and precise identification of asphalt pavement raveling, which adversely affects vehicular traveling comfortability. This provides theoretical and technical support for the intelligent identification of asphalt pavement defects and enhancing road asset maintenance management in the pavement engineering industry.
Chain event graphs for assessing activity-level propositions in forensic science in relation to drug traces on banknotes
Authors: Robertson Gail , Wilson Amy L , Smith Jim Q
Published: October 2024

Graphical models can be used to compare support given by evidence to propositions put forward by competing parties during court proceedings. Such models can also be used to evaluate support for activity-level propositions, that is, propositions referring to the nature of activities associated with evidence and how this evidence came to be at a crime scene. Graphical methods can be used to show different scenarios that might explain the evidence in a case and to distinguish between evidence requiring evaluation by a jury and quantifiable evidence from the crime scene. Such visual representations can be helpful for forensic practitioners, police, and lawyers who may need to assess the value that different pieces of evidence make to their arguments. In this article, we demonstrate how chain event graphs (CEGs) can be applied to a drug trafficking case. We show how different evidence (i.e. expert judgement and data from a crime scene) can be combined using a CEG and show how the hierarchical model deriving from the graph can be used to evaluate the degree of support for different activity-level propositions in the case. We also develop a modification of the standard CEG to simplify its use in forensic applications.
Further Evidence for Strong Nonneutrality of Yeast Synonymous Mutations
Authors: Shen Xukang , Song Siliang , Li Chuan , Zhang Jianzhi
Published: October 2024

Although synonymous mutations are commonly assumed neutral or nearly so, recent years have seen reports of fitness effects of synonymous mutations detected under laboratory conditions. In a previous study, we used genome editing to construct thousands of yeast mutants each carrying a synonymous or nonsynonymous mutation in one of 21 genes, and discovered that most synonymous and most nonsynonymous mutations are deleterious. A concern was raised that this observation could be caused by the fitness effects of potential CRISPR/Cas9 off-target edits and/or secondary mutations, and an experiment that would be refractory to such effects was proposed. Using genome sequencing, we here show that no CRISPR/Cas9 off-target editing occurred, although some mutants did carry secondary mutations. Analysis of mutants with negligible effects from secondary mutations and new data collected from the proposed experiment confirms the original conclusion. These findings, along with other reports of fitness effects of synonymous mutations from both case and systematic studies, necessitate a paradigm shift from assuming (near) neutrality of synonymous mutations.
Association Between Mycobacterium tuberculosis Sensitization and Insulin Resistance Among US Adults Screened for Type 2 Diabetes Mellitus
Authors: Magodoro Itai M , Aluoch Aloice , Claggett Brian , Nyirenda Moffat J , Siedner Mark J , Wilkinson Katalina A , Wilkinson Robert J , Ntusi Ntobeko A B
Published: October 2024

Background

Type 2 diabetes mellitus (T2DM) may be a long-term sequela of infection with Mycobacterium tuberculosis (Mtb) by mechanisms that remain to be fully explained. We evaluated the association between Mtb sensitization and T2DM and, via mediation analysis, the extent to which it is mediated by insulin resistance and/or β-cell failure.

Methods

Adults were assessed for T2DM by fasting plasma glucose, 2-hour oral glucose tolerance testing, and hemoglobin A1c; β-cell dysfunction and insulin resistance by homoeostasis model assessment 2; and Mtb sensitization by tuberculin skin testing. Associations between Mtb sensitization and T2DM were modeled with probit regression and decomposed into indirect effects of β-cell dysfunction and insulin resistance. Analyses were adjusted for sociodemographic, behavioral, and clinical characteristics.

Results

We included 1843 adults. Individuals with Mtb sensitization were older than those without Mtb (median [IQR], 54 [39–64] vs 47 [33–62] years). As compared with being uninfected, Mtb sensitization was associated with T2DM (adjusted absolute risk difference, 9.34% [95% CI, 2.38%–15.0%]; P < .001) and increased insulin resistance (adjusted median difference, 0.16 [95% CI, .03–.29]; P = .014) but not β-cell dysfunction (adjusted median difference, −3.1 [95% CI, −10.4 to 4.3]; P = .42). In mediation analyses, insulin resistance mediated 18.3% (95% CI, 3.29%–36.0%; P = .020) of the total effect of the association between Mtb sensitization and T2DM.

Conclusions

Definitive prospective studies examining incident T2DM following tuberculosis are warranted. Notwithstanding, our findings suggest that exposure to Mtb may be a novel risk factor for T2DM, likely driven by an increase in insulin resistance.
Comparing Different Pathways in Medical Education and Surgical Training: A Global Survey of Surgeons
Authors: Bucknor Alexandra , Pedreira Rachel , Bhat Deepa , Zamani Maryam , Nugent Nora , Furnas Heather J.
Published: October 2024

Background:

Currently, interest in surgical careers is declining globally, whereas aging populations are contributing to a rising demand for surgical procedures. Surgeons who conduct scientific investigations and share clinical advances internationally pay little attention to comparing differences in ways nations attract, educate, and train their surgeons. This study compares international pathways toward surgeon development with the aim of seeking best practices and improving the outlook of surgery as an attractive career.

Methods:

A 70-question anonymous survey was distributed internationally to surgeons of all specialties. Data were analyzed in SPSS Statistics for Macintosh (IBM). A value of P less than 0.05 indicates statistical significance.

Results:

The 463 respondents from the United States (59%), the United Kingdom (16%), Europe (10%), Canada (5%), and the rest of the world (10%) averaged age 46, and 64% were women. Non-US/Canadian respondents (93%) attended 5- and 6-year medical schools; US respondents were far more likely (91%) to attend nonmedical 4-or-more–year university before medical school. Weekly training-hour mandates spanned less than or equal to 48 (9%) to 80 or more (45%); 76% surpassed mandate hours, and just 9% reported accurate hours. Average educational debt ranged from $14,000 (Europe) to $179,000 (US). Few (19%) felt training allowed family building.

Conclusion:

Based on best practices from different countries, the authors recommend a 6-year maximum university/medical education requirement, elimination of nonsurgical training years (mandatory in some countries), single-program surgical training, objective measure of work hours, optimizing weekly hours, improved support for family building, and end-of-training certification options.
Thinning of the Medial Sural Artery Perforator Flap: The Anatomical Examination of the Medial Sural Artery Perforator Branch
Authors: Banjongleelahong Kittituch , Vongviriyangoon Tara , Piyaman Parkpoom , Akaranuchat Nutthawut
Published: October 2024

Background:

The medial sural artery perforator (MSAP) flap is thin, pliable, and versatile. This study aims to understand the anatomical basis of the MSAP flap and the subcutaneous course of the perforator for safe flap thinning.

Methods:

A total of 24 MSAP flaps were dissected under red silicone dye injection guidance. Full-thickness horizontal slides of flaps were performed, and the perforator courses were identified in the subcutaneous plane. Slides were placed on a millimeter board, and the perforator patterns were photographed and observed with loupes.

Results:

A total of 68 perforator courses were identified: type 1: 30.9%, type 2: 57.3%, and type 3: 11.8%. They traveled 1–25 mm to the subdermal plexus, with percentile 2.5 at 1 mm, percentile 90 at 18.2 mm, percentile 95 at 21.65 mm, and percentile 100 at 25 mm. The mean flap thickness was 7.75 ± 1.7 mm, with an average of 5.7 ± 1.3 perforators per flap. Perforators clustered between 2 and 18.4 cm from the popliteal crease and 0–8 cm from the posterior midline of the leg. The dominant perforators accounted for 45.2% (62 of 137), averaging 2.58 per flap. The medial sural artery branching pattern types were type 1: 37.5%, type 2: 50%, and type 3: 12.5%. The average pedicle length was 16.2 ± 1.3 cm, and the mean external diameter of the medial sural artery was 1.98 ± 0.13 mm.

Conclusions:

MSAPs branch within a maximal radius of 2.5 cm after emerging from the deep fascia. To maintain vascularity, the safe suprafascial dissection should be 2.5 cm apart from the point of emerging.
Renal denervation – radiofrequency vs. ultrasound: insights from a mixed treatment comparison meta-analysis of randomized sham controlled trials
Authors: Bangalore Sripal , Maqsood M. Haisum , Bakris George L. , Rao Sunil V. , Messerli Franz H.
Published: October 2024

Background and aims:

Multiple randomized trials have shown that renal denervation (RDN) reduces blood pressure (BP) when compared with sham control but the antihypertensive efficacy of radiofrequency vs. ultrasound-based RDN is uncertain. We aimed to compare the outcomes of radiofrequency RDN (rRDN) and ultrasound RDN (uRDN), when compared with sham in patients with hypertension.

Methods:

PubMed, EMBASE, and clinicaltrials.gov databases were searched for randomized sham-controlled trials (RCTs) of rRDN or uRDN or for trials of rRDN vs. uRDN. Primary efficacy outcome was 24-h ambulatory SBP. A mixed treatment comparison meta-analysis was performed comparing the efficacy and safety against sham and against each other.

Results:

Among 13 RCTs that enrolled 2285 hypertensive patients, rRDN reduced 24-h ambulatory SBP [(MD = 2.34 mmHg; 95% confidence interval (95% CI): 0.72–3.95], office SBP (MD = 5.04 mmHg; 95% CI: 2.68–7.40)], and office DBP (MD = 2.95 mmHg; 95% CI: 1.68–4.22) when compared with sham. Similarly, uRDN reduced 24-h ambulatory SBP (MD = 4.74 mmHg; 95% CI: 2.80–6.67), day-time ambulatory SBP (MD = 5.40 mmHg; 95% CI: 3.68–7.13), night-time ambulatory SBP (MD = 3.84 mmHg; 95% CI: 0.02–7.67), and office SBP (3.98 mmHg; 95% CI: 0.78–7.19) when compared with sham. There was significantly greater reduction in 24-h ambulatory SBP (MD = 2.40 mmHg; 95% CI: 0.09–4.71), day-time ambulatory SBP (MD = 4.09 mmHg; 95% CI: 1.61–6.56), and night-time ambulatory SBP (MD = 5.76 mmHg; 95% CI: 0.48–11.0) with uRDN when compared with rRDN. For primary efficacy outcome, uRDN ranked #1, followed by rRDN (#2), and sham (#3).

Conclusion:

In hypertensive patients, rRDN and uRDN significantly reduced 24-h ambulatory and office SBP when compared with sham control with significantly greater reduction in ambulatory BP with uRDN than with rRDN at 4 months (mean) of follow-up. A large-scale randomized head-to-head trial of rRDN or uRDN is warranted to evaluate if there are differences in efficacy.
Association of gut microbiota with critical pneumonia: A two-sample Mendelian randomization study
Authors: Li Yuanxiao , Fang Mengru , Li Dan , Wu Peirun , Wu Xuan , Xu Xiaonan , Ma Hanwei , Li Yan , Zhang Ni
Published: October 2024

This study investigated the causal effect of gut microbiota on critical pneumonia. Data came from a large-scale gut microbiota data set (n = 18,340) and the critical pneumonia genome-wide genotyping array (cases n = 2758 and controls n = 42,8607). Inverse variance weighting was used as the primary Mendelian randomization (MR) analysis method. Weighted median, MR-Egger, simple model, weighted model, and MR-Egger, were used to evaluate robustness. Sensitivity analysis used Cochran Q test, MR-Egger intercept test, and MR-PRESSO. For critical pneumonia, inverse variance weighting estimates suggested that Class Verrucomicrobiae (OR = 0.415; 95% CI: 0.207, 0.833; P = .013), Family Verrucomicrobiaceae (OR = 0.415; 95% CI: 0.207, 0.833; P = .013), Genus Akkermansia (OR = 0.415; 95% CI: 0.207, 0.833; P = .013), Genus LachnospiraceaeFCS020group (OR = 0.449; 95% CI: 0.230, 0.890; P = .021), Genus Parasutterella (OR = 0.466; 95% CI: 0.233, 0.929; P = .030), Genus Prevotella7 (OR = 0.645; 95% CI: 0.432, 0.960; P = .031), Order Verrucomicrobiales (OR = 0.415; 95% CI: 0.207, 0.833; P = .013), and Phylum Cyanobacteria (OR = 0.510; 95% CI: 0.272, 0.956; P = .036) had a reduced risk, while Family Enterobacteriaceae (OR = 2.746; 95% CI: 1.008, 7.474; P = .048), Genus RuminococcaceaeUCG003 (OR = 2.811; 95% CI: 1.349, 5.851; P = .006) and Order Enterobacteriales (OR = 2.746; 95% CI: 1.008, 7.474; P = .048) were associated with an increased risk. Sensitivity analyses confirmed that the aforementioned correlations were robust.
The impact of 3 different dietary interventions on overweight or obese adults: A network meta-analysis
Authors: Liao Tianrong , Su Jiayu , Quan Tingwei , Luo Yu , Zeng Yiqian , Chen Dandan , Tang Hongzhen
Published: October 2024

Objective:

This network meta-analysis aims to investigate and compare the effectiveness of 3 dietary interventions – Mediterranean, ketogenic, and low-fat diet – on overweight and obese adults, with a comparison to traditional low-calorie diet.

Methods:

A systematic review was conducted in both Chinese and English databases, including the China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), SinoMed, PubMed, Web of Science, Cochrane Library and Embase to identify relevant randomized controlled trials (RCTs) up to January 31, 2024. Two researchers independently screened and extracted data from the identified literature. The quality of these studies was assessed using the Cochrane bias risk assessment tool. A random-effects network meta-analysis was performed using Review Manager 5.4.1 and Stata 16.0 software.

Results:

A total of 17 randomized controlled trials involving 5802 subjects were included in this study. The network meta-analysis revealed a descending order of effectiveness for reducing body weight (BW), body mass index (BMI), and waist circumference (WC): ketogenic diet > low-fat diet > low-calorie diet > Mediterranean diet.

Conclusions:

The ketogenic diet was identified as the most effective intervention for reducing BW, BMI, and WC in the studied dietary comparisons. It consistently showed superior outcomes, ranking highest in effectiveness among the 4 evaluated dietary approaches. Nevertheless, additional high-quality randomized controlled trials are necessary to validate these findings.
Contrast-enhanced ultrasound findings of sclerotic nodules in Wilson disease: A case report
Authors: Hu Cong , Liu Kun , Liu Aihua , Huang Weiling , Zhao Zhiwei , Jiang Yuancheng , Chen Yixin , Zhang Qi , Wang Ying , Wu Meng
Published: October 2024

Rationale:

Wilson disease is an autosomal recessive genetic disease found by Samuel Alexander Kinnier Wilson and prevalent in childhood and adolescents.

Patient concerns:

An 18-year-old female patient presented to our hospital with a continuous decrease of 3 blood cell lines for more than 10 days, and diagnosed as decompensated cirrhosis. Ultrasonography showed diffuse lesions in the hepatic parenchyma, with multiple hypoechoic light masses in the parenchyma, the outline was still clear, and the internal echo was uneven. Contrast-enhanced ultrasound showed that the nodules were enhanced rapidly and uniformly, with an initial enhancement time of 9 seconds and a peak time of 17.2 seconds. The washing time was slightly earlier than that of the hepatic parenchyma and showed slightly higher enhancement in the delayed phase. Finally, ultrasound-guided biopsies showed unexplained liver cirrhosis.

Diagnoses:

Combined with clinical examination, it was inferred to be Wilson disease. It is difficult to diagnose hepatolenticular degeneration because of its concealed incidence, complex clinical manifestations, expensive detection of the ATP7B gene, and lack of other specific imaging signs.

Outcomes:

After admission, the patient was given symptomatic support treatment such as liver protection.

Interventions:

The patient was discharged after improvement of symptoms.

Lessons:

Here, the results of contrast-enhanced ultrasound in our case may provide a new idea for the diagnosis of Wilson.
Comparison of orexigenic and anorexigenic neuropeptide levels in hyperemesis gravidarum patients with normal pregnant women: A prospective cohort study
Authors: Yilmaz Mehmet , Aksin Şerif , Balsak Deniz , Aboalhasan Yasmin , Batmaz İbrahim
Published: October 2024

Background:

The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (α-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG).

Methods:

Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants’ age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, α-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay.

Results:

No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (α-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the α-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020).

Conclusion:

α-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.
Influencing factors of antibody response after 2 doses of inactivated COVID-19 vaccine among adults aged ≥18 years in Chongqing, China: A cross-sectional serological study
Authors: Wang Qing , Xu Jiawei , Liu Yu , Li Jianqiao
Published: October 2024

The study aimed to explore the influencing factors after 2 doses of inactivated COVID-19 vaccines (Sinopharm/BBIBP-CorV) in the real world. We conducted a cross-sectional serological study involving 316 volunteers aged ≧ 18 years from 7 vaccination hospitals in the Yubei districts, Yuzhong districts, and Jiulongpo districts of Chongqing. Serum samples were obtained about 1 month after 2 dose vaccination, and Nabs were tested using the pseudovirus-based neutralizing assay. Chi-square or Fisher exact tests were used to analyze the seropositive rates, while the Kruskal–Wallis H or Mann–Whitney U tests were used to analyze differences in Nabs level among stratified groups. Logistic regression analyses were conducted to identify the influencing factors. The results showed that seropositive rates was 76.27% and the GMT was 26.13 (95% CI: 23.03–29.66) after 2 doses of COVID-19 inactivated vaccination. The risk of being seropositive in 18 to 29, 30 to 39, 40 to 49, 50 to 59, and 60 to 69 years were 12.808-fold, 8.041-fold, 7.818-fold, 6.275-fold, 1.429-fold compared with the people aged ≥ 70 years (P < .05), and the risk of being seropositive of intervals 15 to 21 and 22 to 28 days were 0.273-fold and 0.286-fold compared with >28 days (P < .05), respectively. In conclusion, age may be a risk factor for reduced antibody production, and longer vaccination intervals-may be a protective factor that increases antibody production. These findings contribute to informing future vaccination strategies.
The relationship between the Prognostic Nutritional Index and lymphovascular and perineural invasion of the tumor in patients diagnosed with gastric cancer, and its effect on overall survival
Authors: Özcan Pırıltı , Çarkman Mehmet Sinan
Published: October 2024

A low Prognostic Nutritional Index (PNI) value, lymphovascular invasion (LVI), and perineural invasion (PeNI) have been identified as indicators of poor prognosis for many malignancies. We aimed to evaluate the relationship between PNI and LVI/PeNI, their prognostic significance, and their effect on overall survival in gastric cancer patients who underwent curative gastrectomy. A cutoff value of 39.8 was taken for the PNI, and PNI < 39.8 was defined as moderate to severe malnutrition. Patients were grouped as PNI-low (PNI < 39.8) and PNI-high (PNI ≥ 39.8). Paraffin-embedded tissue sections of surgical specimens were used to evaluate PeNI as defined by previously reported criteria. The study included 270 patients with ages ranging from 23 to 90 years. The mean PNI was calculated as 39.8 ± 6.35. PeNI was detected in 232 patients (85.93%), and LVI was identified in 248 patients (91.85%). It was observed that the PNI value of patients with an expired status in the PNI < 39.8 group was lower compared to those who survived, and in patients with PNI > 39.8, those without PeNI had better survival. The presence of PeNI in patients with PNI > 39.8 increased the mortality risk by 2.088 units, while in patients with PNI > 39.8, it was found that those without LVI had better survival, and the presence of LVI increased the mortality risk by 3.171 units. Mortality developed in 166 patients (61.48%) during the five-year follow-up period. The five-year overall survival was found to be 31.02 ± 21.73 months. In patients with gastric cancer, the PNI, LVI, and PeNI are independent prognostic factors for overall survival in postoperative patients. A low PNI score is an inherently poor prognostic factor. In patients with a high PNI score, the presence of positive LVI and PeNI negatively impacts survival. We found that in patients with a low PNI, the rates of PeNI and LVI are higher compared to those with a high PNI, and this significantly affects mortality.
Impact analysis of the driver’s license-type scoring system in the quality management of hospital medical records: An observational study
Authors: Gao Qin , Li Hai-Jun , Chen Yan , Ji Wen-Xiang , Ma Li-Li
Published: October 2024

The purpose of this study was to analyze the impact of implementing a driver’s license-type scoring system on the quality management of hospital medical records. We collected relevant medical record quality control data before (from April to November 2021) and after (from April to November 2022) the use of the driver’s license-type scoring management in the medical record quality management of a Grade-A tertiary general hospital in a prefecture-level city (“R Hospital” for short). We evaluated the impact by statistically analyzing the data using the χ
2 test and t test with the SPSSAU online statistical analysis software. Compared with before the implementation of the new system, the filling rate of discharge medical records within 2 days, logical rate of day diagnosis and treatment medical records, logical rate of day surgery medical records, and clinical tumor–node–metastasis staging evaluation rate before tumor treatment significantly increased, and the difference was statistically significant (P < .05); the rate of errors or omissions on the first page of inpatient medical records significantly decreased, and the difference between before and after implementation of the new system was statistically significant (P < .05). We found that the driver’s license-type scoring management adapted for use in the quality management of hospital medical records was effective in regulating the medical record writing behavior of physicians and improved the quality of medical records, thus meriting wide promotion.
Integrating network pharmacology and experimental verification to explore the pharmacological mechanisms of Guanxin Shutong capsule in treating heart failure
Authors: Yang Zheming , Li Jiayin , Song Haixu , Wu Hanlin , Zhang Shuli , Mei Zhu , Xue Yu , Zhang Xiaolin , Yan Chenghui , Han Yaling
Published: October 2024

The Guanxin Shutong capsule (GXST), a traditional Chinese medicine, is commonly used for treating cardiovascular disease, it has shown efficacy in improving symptoms and enhancing the quality of life for patients with heart failure (HF). However, the specific mechanism of action of GXST in HF remains unclear. In this study, we employed a comprehensive approach combining network pharmacology, molecular dynamics (MD) simulations, and in vitro validations to investigate the potential targets and molecular mechanisms of GXST against HF. We collected active ingredients and target genes of GXST, as well as related genes of HF, from multiple public databases. Using bioinformatics analysis, we constructed networks of ingredients-disease-targets and performed functional annotations of the core targets. MD simulations were conducted to verify the binding between the core protein–ligand complexes. In vitro evaluations, including cell proliferation, apoptosis, and protein expression in human umbilical vein endothelial cells (HUVECs) and H9C2 cells were treated with GXST, were performed for pharmacodynamics evaluation. Network analysis revealed 320 intersection genes and 74 active ingredients in the Herbs-ingredients-target genes-disease network. We identified key active ingredients and target genes that overlapped. The KEGG pathways of the intersection genes were primarily enriched in the PI3K-Akt signaling pathway and apoptosis. The protein–protein interaction network highlighted proteins such as AKT1, VEGFR2, and eNOS. MD simulations confirmed stable docking and lower binding energy between 4 identified ingredients (kaempferol, quercetin, (2R)-5,7-dihydroxy-2-(4-hydroxyphenyl) chroman-4-one, and ellagic acid) and their respective core proteins (VEGFR2, eNOS, and AKT). In vitro experiments demonstrated the protective effects of GXST against H2O2-induced apoptosis in both HUVECs and H9C2 cells. Notably, consistent with the in silico predictions, GXST effectively activates the VEGFR2/AKT/eNOS signaling pathways in HUVECs. This study provides insights into the underlying mechanism of GXST’s therapeutic effects in heart failure. The involvement of the VEGFR2/AKT/eNOS signaling pathways suggests their importance in further elucidating and applying GXST in the clinical treatment of heart failure.
Exploring the mechanism of comorbidity in patients with T1DM and COVID-19: Integrating bioinformatics and Mendelian randomization methods
Authors: Wang Tingliang , Zhang Yun , Wu Chunjiao , Huang Zhenxing , Liang Xinghuan , Luo Zuojie
Published: October 2024

During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of type 1 diabetes mellitus (T1DM) has increased. Additionally, evidence suggests that individuals with diabetes mellitus may have increased susceptibility to severe acute respiratory syndrome coronavirus 2 infection. However, the specific causal relationships and interaction mechanisms between T1DM and COVID-19 remain unclear. This study aims to investigate the causal relationship between T1DM and COVID-19, utilizing differential gene expression and Mendelian randomization analyses. Differentially expressed gene sets from datasets GSE156035 and GSE171110 were intersected to identify shared genes, analyzed for functional enrichment. Mendelian randomization models were employed to assess causal effects, revealing no direct causal link between T1DM and COVID-19 in the European population (P > .05). Notably, DNA replication and sister chromatid cohesion 1 (DSCC1) showed negative causal associations with both diseases (T1DM: OR = 0.943, 95% CI: 0.898–0.991, P = .020; COVID-19: OR = 0.919, 95% CI: 0.882–0.958, P < .001), suggesting a protective effect against their comorbidity. This genetic evidence highlights DSCC1 as a potential target for monitoring and managing the co-occurrence of T1DM and COVID-19.
Comprehensive analysis of the expression level, prognostic value, and immune infiltration of cuproptosis-related genes in human breast cancer
Authors: Chen Jian , Cao Wei , Li Yingliang , Zhu Jia
Published: October 2024

Background:

As a novel cell death form, cuproptosis results from copper combining with lipidated proteins in the tricarboxylic acid cycle. To the best of our knowledge no study has yet comprehensively analyzed the relationship between cuproptosis-related genes and breast cancer.

Methods:

The expression, prognostic value, mutations, chemosensitivity, and immune infiltration of cuproptosis-related genes in breast carcinoma patients were analyzed, PPI networks were constructed, and enrichment analyses were performed based on these genes. TIMER, UALCAN, Kaplan–Meier plotter, Human Protein Atlas, cBioPortal, STRING, GeneMANIA, DAVID, and R program v4.0.3 were used to accomplish the analyses above.

Results:

Compared to normal breast tissues, FDX1, LIAS, LIPT1, DLD, DLAT, PDHA1, MTF1, and GLS were down-regulated in breast cancer tissues, while CDKN2A was up-regulated. High expression of FDX1, LIAS, DLD, DLAT, MTF1, GLS, and CDKN2A were associated with favorable overall survival. Cuproptosis-related genes showed a high alteration rate (51.3%) in breast cancer, contributing to worse clinical outcomes. The expression levels of FDX1, LIPT1, DLD, DLAT, PDHA1, PDHB, MTF1, GLS, and CDKN2A were associated positively with 1 or more immune cell infiltrations in breast cancer. Patients with high levels of B cell, CD4+ T cell, CD8+ T cell, and dendritic cell infiltration had a higher survival rate at 10 years.

Conclusion:

This study comprehensively investigated relationships between cuproptosis and breast cancer by bioinformatic analyses. We found that cuproptosis-related genes were generally lowly expressed in breast carcinoma tissue. As the critical gene of cuproptosis, high expression of FDX1 was related to favorable prognoses in breast cancer patients; thus, it might be a potential prognostic marker. Moreover, genes associated with cuproptosis were linked to immune infiltration in breast cancer and this relationship affected the prognosis of breast cancer.
Comparison of a full tibial tunnel or an all-inside technique for anterior cruciate ligament reconstruction: An observational study
Authors: Xiang Shengwen , Ao Zhijiang , Ren Zihao , Cai Guangqing , Hu Zhen , Hu Weiguo , Liu Yangbo , Li Xing , Wei Licheng
Published: October 2024

This study aims to compare the effectiveness of anterior cruciate ligament (ACL) reconstruction performed with either a full tibial tunnel technique or an all-inside technique. Data from patients with ACL rupture who underwent ACL reconstruction using autogenous hamstring tendon grafts between January 2019 and July 2021 were retrospectively reviewed. Patients were followed up for a minimum of 24 months. Preoperative and postoperative International Knee Documentation Committee scores, Lysholm knee scores, visual analog scale pain scores, Tegner activity scale scores, C-reactive protein levels, erythrocyte sedimentation rate, white blood cell (WBC) count, D-dimer levels, and neutrophils were recorded. At the final follow-up, side-to-side differences were assessed with the pivot shift test, Lachman test, anterior drawer test, and a knee laxity-testing device. This study included 135 patients with ACL rupture, with 62 patients (43 males and 19 females, mean age: 34.42 ± 12.79 years) undergoing the full tibial tunnel technique, and 73 patients (58 males and 15 females, mean age: 32.41 ± 11.01 years) undergoing the all-inside techniques (AITs). There were no significant differences in postoperative International Knee Documentation Committee scores, Lysholm knee scores, or Tegner activity scale scores, except at postoperative 6 months. visual analog scale pain scores showed significant improvement in patients that underwent the AIT compared to the full tibial tunnel technique at postoperative 1 week, 2 weeks, and 1 month; however, there were no significant differences at postoperative 3, 6, 12, 18, and 24 months. C-reactive protein levels, erythrocyte sedimentation rate, WBC count, D-dimer levels, and neutrophils were significantly lower in patients that underwent the AIT compared to the full tibial tunnel technique at postoperative 1 month, but there were no other significant differences in these outcome measures, except for WBC count at postoperative 3 months. There was no significant difference in knee stability at the last follow-up. In ACL reconstruction, functional outcomes following the AIT are satisfactory and similar to the total tibial tunnel technique, but patients experience less pain and a reduced early postoperative inflammatory response. These results highlight the promising potential of AITs in the clinical management of ACL rupture and advocate for their widespread adoption.
Estimation of the graft failure by current value joint model, and extension to alternative parameterization structures: Cohort study
Authors: Bakir Alev , Atli Zeynep , Kaya Eda , Pekmezci Salih , Seyahi Nurhan
Published: October 2024

In clinical practice, individuals are followed up to predict the outcome event of interest, and their longitudinal measurements are collected on a regular or irregular basis. We aimed to examine the classical approach, joint model (JM), and alternative parameterization structures using data on the effect of time-varying longitudinal measurements on survival. The motivating cohort dataset included 158 consecutive kidney transplant recipients who had baseline and follow-up data. Although the longitudinal log-transformed estimated glomerular filtration rate (log[eGFR]) measurements and graft failure have an association clinically, the 2 processes are analyzed separately in the classical approach. In addition to the extended Cox model, the current value JM, the weighted cumulative effect JM, and dynamic predictions were performed in the study, by taking advantage of R codes. Of the 158 patients, 34.8% were males. The mean age was 29.8 ± 10.9 years, and the median age was 26 years at the time of transplantation. The hazard ratio for graft failure was 8.80 for a 1-unit decrease in log(eGFR) in the extended Cox model, 10.58 in the current value JM, and 3.65 in the weighted cumulative effect JM. The presence of coronary heart disease was also found to be associated with log(eGFR): 0.199 (P = .03) for the current value JM and 0.197 (P = .03) for the weighted cumulative effect JM. The current value JM was identified as a better model than the extended Cox model and the weighted cumulative effect JM based on parameter and standard error comparison and goodness of fit criteria. JMs should be preferred, as they facilitate better clinical decisions by accounting for the varying slopes and longitudinal variation of estimated glomerular filtration rate among patients. Suitable types of models should be practiced depending on baseline biomarker levels, their trends over time, the distribution of the biomarkers, and the number of longitudinal biomarkers.
COVID-19-induced extracorporeal circulation coagulation during continuous renal replacement therapy: A cross-sectional study
Authors: Wu Dibin , Yang Guang , Dai Shien , Khan Abbas , Liang Wei , Wang Aihong
Published: October 2024

After the control policies of the COVID-19 epidemic were lifted in China from December 5th, 2022, there was an increase in the demand for hemodialysis and continuous renal replacement therapy (CRRT) at our center, and patients experienced hypercoagulable blood states more frequently. This study aimed to investigate the effect of COVID-19 on extracorporeal coagulation during CRRT. All CRRT records were gathered from the Hemodialysis Center at our hospital from December 5th, 2022 to February 4th, 2023, and analyzed the incidence and risk factors associated with extracorporeal coagulation. COVID-19 substantially increased the likelihood of extracorporeal coagulation during CRRT. Venous pressure and transmembrane pressure were proportional to the severity of extracorporeal coagulation. Additionally, non-tunnel type conduit vascular access, and acute kidney injury had a positive correlation with the severity of coagulation. Blood tests demonstrated that COVID-19 altered 4 coagulation indices. Moreover, mitigation of coagulation can be achieved through increasing the dosage of low molecular weight heparin and administering regional citrate anticoagulation. Patients who fail anticoagulation may be switched to peritoneal dialysis. In conclusion, COVID-19 poses a heightened risk of extracorporeal coagulation during CRRT. This study underscores the importance of anticoagulant treatment in CRRT for infected patients with kidney failure and holds significant implications for clinical practice. In future, the epidemics of COVID-19 or any other pandemic, the metrics in this study can be referenced to determine coagulation risk, as well as relevant therapeutic practices may be considered.
Prevalence of swallowing disorder among older adults in nursing homes: A meta-analysis
Authors: Ran Xueman , Zhang Xinyu , Liu Wenqing
Published: October 2024

Background:

To determine the prevalence of swallowing disorders in nursing homes and to analyze the prevalence in China and abroad. Providing basis for intervention, treatment, and care for swallowing disorders in elderly residents of nursing homes.

Methods:

A systematic search of electronic databases, including PubMed, Medline, Embase, China National Knowledge Infrastructure, Chinese Biomedical Literature Database (CBM), Veip (VIP) database, and WanFang Database. The databases were searched from their inception until March 1, 2023, using keywords such as “swallowing disorders,” “nursing homes,” and “prevalence.”

Results:

A total of 163 articles were identified from all databases and seventeen articles were included in the meta-analysis, which showed a random-effects pooled prevalence of swallowing disorders in nursing homes of 33.2% (95% confidence interval: 28.4% to 38.0%). There was significant heterogeneity between the studies (I
2 = 99.3%). The prevalence varied by country (40.6% in Asia, 15.9% in Europe, and 39.3% in China) and by screening tool used (medical records or clinical assessment: 13.0%; Gugging Swallowing Screen: 56.6%; drinking test scale: 40.8%; self-screening scale: 38.9%). Interestingly, the prevalence was similar between genders (30.4% in men and 30.2% in women).

Conclusion:

The high prevalence of swallowing disorders in nursing homes (33.2%) identified in this study underscores the need for greater attention to screening, diagnosis, and intervention strategies.