bluuebunny/crossref_metadata_2025 huggingface dataset:
The Information Processing Flexibility of Individuals with Obsessive- Compulsive Tendency: An Event-related Potentials Study
Authors: Xiaocui Miao , Hui Cheng , Xiaojuan Cheng , Haiyan Xiao , Rong Wang
Published: October 2024

Background
Obsessive-compulsive disorder (OCD) is a common clinical psychological disease. A large number of studies have shown that OCD patients have cognitive dysfunction, mainly in attention, decision-making, information processing, and so on. Previous studies of OCD information processing focus on processing ways, but studies of its flexibility are limited. As information processing flexibility is a component of executive function and OCD patients have a deficiency in executive function, information processing flexibility could indirectly reflect that OCD patients may be insufficient in information processing flexibility. Hence, we must explore its characteristics in flexible information processing.
Methods
To eliminate the effects of other comorbid factors, we use the Padua Inventory to screen high obsessive-compulsive tendency (HOC) and low obsessive-compulsive tendency (LOC) individuals as the research object university students. The final sample includes 16 HOC and 15 LOC participants. To make the experiment more in line with ecological validity, the study used a single probability-adjusted Flanker task (i.e., a cue of 20%, 50%, and 80% probability was given before each trial)， combined with an ERP study to investigate information processing flexibility and its corresponding brain mechanisms in individuals with obsessive-compulsive tendencies.
Results
(1)In the stage of cue presentation, there were no significant differences in P2 (150-250) among individuals with HOC under the three cue probability conditions, but there were significant differences among those with LOC. In the stage of stimulus presentation, there were no significant differences in N2 (100-200) and N3 (250-300) components among individuals with HOC under the three cues, while there were significant differences among those with LOC, and the amplitudes under 80% probability conditions were greater than those under 20% probability conditions; (2)The N2 amplitude of individuals with LOC under effective cues was significantly greater than that under ineffective cues, while there was no significant differences among individuals with HOC.
Conclusion
Individuals with HOC were less responsive to situational changes and had defects in information processing flexibility, while individuals with LOC were more flexible in information processing, which was manifested in both the cue presentation stage and the stimulus response stage;Individuals with HOC were not easily affected by cues and less strategic in regulating and controlling information processing.
Opioid use increases the risk of sarcopenia in elderly patients and is associated with inflammatory responses
Authors: Meng Guose , Lu Junda , Tang Bing , Liang Feiyuan , Han Jian , Cheng Jianwen , Wei Donglei
Published: October 2024

Sarcopenia is an aging-related disease that seriously affects the health of patients. Identifying modifiable risk factors is crucial for developing effective prevention and treatment strategies. Previous studies have shown a potential link between the use of opioids and non-opioid drugs and sarcopenia, but the causal relationship and related target mechanisms are still unclear. There was an interaction between gender and Poverty Income Ratio in patients with sarcopenia who had long-term opioid use and those who had not used opioids based on NHANES data. By combining Mendelian randomization analysis and network pharmacology analysis, we evaluated the positive causal effect of long-term use of non-opioids in patients with sarcopenia and identified 2 important potential drug targets IL-6 and IGF1R related to sarcopenia.
Unlocking Success: Community Engagement for Enhanced HIV Care Outcomes
Authors: Wiehe Sarah E. , Nelson Tammie L. , Hawryluk Bridget , Andres Unai Miguel , Aalsma Matthew C. , Rosenman Marc B. , Butler Michael S. , Harris Michelle , Moore Kem , Scott C. Dana , Gharbi Sami , Parks Lisa , Lynch Dustin , Silverman Ross D. , Fortenberry J. Dennis
Published: October 2024

Background: Though social determinants are the primary drivers of health, few studies of people living with HIV (PLWH) focus on non‐clinical correlates of insecure and/or fragmented connections with the care system. Our team has used linked clinical and multisector non‐clinical data to study how residential mobility and connection to social services influence the HIV care continuum. We engage a diverse group of invested patients and community members to guide and inform this research. Our objective is to generate stakeholder-informed, research-based interventions that are relevant to the community, and to share our engagement approach and findings so that other researchers can do the same.
Methods: Our research team partnered with the Indiana Clinical and Translational Sciences Institute’s Research Jam, to develop and implement a human‐centered design research plan to engage with individuals with lived experience relevant to our research. We recruited a panel composed of PLWH as well as clinicians and individuals from agencies that provide medical and non-medical services to PLWH in Marion County, Indiana. We used a variety of human-centered design tools and activities to engage individuals during six sessions, with results informing our engagement and research activities.
Results: Since the inception of the project, 48 individuals have joined the stakeholder panel. Thirty-five are actively engaged and have participated in one or more of the six sessions conducted to date. The panel helped guide and prioritize analyses, aided in identification of data missing from our ecosystem, helped interpret results, provided feedback on future interventions, and co-presented with us at a local health equity conference.
Conclusions: We utilized community engagement to expand the scope of our research and found that the process provided value to both stakeholders and research team members. Human-centered design enhanced this partnership by keeping it person-centered, developing empathy and trust, increasing stakeholder retention, and empowering stakeholders to collaborate meaningfully with the research team. The use of these methods is essential to conducting relevant, impactful, and sustainable research. We anticipate that these methods will be important for academic and public health researchers wishing to engage with and integrate the ideas of community stakeholders.
Occult Liver Nodules: their Detection and Characterization with CEUS
Authors: Qiao Andee , Samuel Anna S , Merrill Christina , Brahmania Mayur , Wilson Stephanie R
Published: October 2024

Objectives
Contrast enhanced ultrasound (CEUS) now joins the ranks of CT and MRI for noninvasive diagnosis of hepatocellular carcinoma (HCC). CEUS LI-RADS provides greater than 95% specificity for diagnosis within LR-5. Unlike CT/MRI, CEUS is nodule based. Currently, LI-RADS does not recommend CEUS of nodules occult or invisible on pre-contrast ultrasound except by experts. This study addresses our ability to find occult nodules using CEUS and characterize them with CEUS LI-RADS.
Methods
100 patients at risk for HCC, 81 with cirrhosis, with occult lesions were retrospectively identified from our archived patient logs. All patients had CEUS examination. Three specialized CEUS techniques (blindshot injection, portal venous (PVP) sweep of the liver, and on-top injection) are used to evaluate nodules.
Results
There were 114 occult lesions in 100 patients. The origin of 78(68%) lesions was an MRI (n = 69) or CT scan (n = 9) with an observation of abnormal enhancement, generally arterial phase hyperenhancement (APHE). All these patients had blindshot CEUS injection looking for a correlate with APHE. The remainder of occult lesions (n = 36)(32%) were first detected during CEUS, generally as washout foci on PVP sweeps or incidental APHE or washout nearby other targets. All washout areas had subsequent on-top injection to assess for APHE. Application of CEUS LI-RADS algorithm categorized 26 LR-5, 34 LR-4, and 5 LR-M. CEUS upgraded LI-RADS category of 24/50(48%) occult lesions reported on CT/MRI. 29(25%) occult lesions were offered treatment and from categories LR-5 and LR-M, 5 had biopsy confirmation and 15 were treated. From both sources, MR/CT and CEUS, there were 12 occult lesions scanned for treatment response, categorized as 7 LR-TR viable, 1 LR-TR nonviable, and 4 LR-TR equivocal on CEUS.
Conclusion
Our study shows we can find and characterize occult nodules using CEUS techniques and CEUS LI-RADS algorithm, with positive impact on clinical management.
Global burden and trend of substance use disorders, self-harm, and interpersonal violence from 1990 to 2021, with projection to 2040
Authors: An Jia , Wang Qiang , Bai Zihao , Du Xueying , Yu Di , Mo Xuming
Published: October 2024

Background: Alcohol use disorders (AUD), drug use disorders (DUD), interpersonal violence, and self-harm are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with this. To estimate the burden, trends, forecasts, and disparities of AUD, DUD, interpersonal violence, and self-harm among all ages and sexes from 1990 to 2021.
Methods: This was a cross-sectional study that used data from the Global Burden of Disease (GBD) 2021 in 204 countries and territories. The incidence, deaths, and disability-adjusted life years (DALYs), projection, and the inequality were estimated for AUD, DUD, interpersonal violence, and self-harm among all age and sex.
Finding: In 2021, there were 55.78 million new cases of AUD, 13.61 million new cases of DUD, 29.40 million new cases of interpersonal violence, 5.49 million new cases of self-harm globally, while in 2040 will be 51.98 million of AUD, 13.81 million of DUD, 36.01 million of interpersonal violence, and 10.55 million of self-harm. The burden of age standardized rates of incidence, mortality, and DALYs for AUD, DUD, interpersonal violence, and self-harm were higher in male than in female across all ages. Meanwhile, ages 15-49 have the highest burden of DUD, interpersonal violence, and self-harm, and ages 50-74 have the highest burden of AUD. We also found that 68.45% of attributable deaths due to self-harm and interpersonal violence were related to AUD, and 11.11% related to DUD based on GBD 2021 results. Between 1990 and 2021, both the slope index of inequality and relative concentration index decreased for AUD and interpersonal violence, and increased for DUD and self-harm.
Interpretation: Multilevel interventions should be initiated to prevent disease burden related to DUD, interpersonal violence, and self-harm among individuals ages 15-49, and the burden of disease related to AUD among individuals ages 50-75, especially among male. Policy for the management of alcohol and drug use can also simultaneously reduce the social burden of interpersonal violence and self-harm.
Tissue Factor Pathway Inhibitor 2 (TFPI2) is a Serum Biomarker for Clear Cell Renal Carcinoma
Authors: Ito Hiroki , Jikuya Ryosuke , Myoba Shohei , Tatenuma Tomoyuki , Noguchi Go , Ueno Daiki , Ito Yusuke , Komeya Mitsuru , Muraoka Kentaro , Yao Masahiro , Hasumi Hisashi , Nakaigawa Noboru , Makiyama Kazuhide
Published: October 2024

Tissue factor pathway inhibitor 2 (TFPI2), a serine protease inhibitor, has emerged as a promising serum biomarker for ovarian clear cell carcinoma. We evaluated the efficacy of TFPI2 as a biomarker for renal cell carcinoma (RCC). This single-center study enrolled patients with RCC who underwent radical nephrectomy or tumor biopsy, and healthy volunteers. Preoperative serum samples were collected from patients, and some patients underwent postoperative sampling. Serum TFPI2 levels were measured using automated enzyme-linked immunosorbent assay. Expression of TFPI2 in each cell type was evaluated using single-cell RNA sequencing. Survival analyses according to TFPI2 expression levels were performed based on publicly available databases. Serum TFPI2 was significantly elevated in patients with RCC compared to healthy volunteers, particularly those with clear cell histology. Metastatic RCC tumors exhibited higher TFPI2 levels than localized RCCs. Moreover, higher TFPI2 levels correlated with higher Fuhrman grades in clear cell RCC. Analyses of publicly available databases further supported this finding, showing an association between TFPI2 expression and overall survival, particularly in clear cell RCC. Single-cell RNA sequencing confirmed TFPI2 expression in clear cell RCC and normal kidney tubular epithelial cells, supporting its relevance. TFPI2 has emerged as a potential serum biomarker for RCC, offering avenues for improved detection and prognostication, similar to its utility in ovarian clear cell carcinoma. However, its clinical utility warrants further exploration in routine diagnostic and monitoring practices for patients with RCC.
Nosocomial Infection in Patients Treated with Venoarterial Extracorporeal Membrane Oxygenation: Incidence, Risk factors, and Outcomes
Authors: Zhou Hao , Ding Tao , Shi Yutong , Zhu Yi , Chen Chen , Zhang Zhongman , Mei Yong , Lv Jinru , Li Wei , Chen Xufeng
Published: October 2024

Background
The success rate of venoarterial extracorporeal membrane oxygenation (VA-ECMO) is related to complications such as nosocomial infection (NI), with multidrug-resistant organisms (MDROs) infection posing the toughest challenge, however, the incidence, risk factors, and prognosis of NI during VA-ECMO are unclear.
Methods
We performed a single-center, retrospective analysis of 152 patients receiving VA-ECMO. Patients were categorized into NI and non-NI groups, depending on whether pathogenic microorganisms were isolated between 48h after VA-ECMO initiation and within 24h weaning from VA-ECMO. Multivariate logistic regression analysis was performed to identify the independent risk factors of NI.
Results
The incidence of NI during VA-ECMO was 38.82% (59/152), and 71 microbial strains were isolated from the cultures, with Gram-negative bacteria accounting for 73.24% (52/71) and MDROs for 63.38% (45/71). The chi-square test showed that the probability of percutaneous dilatational tracheotomy (PDT) was elevated in the NI group (25.42% vs 8.6%). The rank sum test found that the NI group had longer hospitalization (18 vs 12 days), intensive care unit (ICU) stay (16 vs 9 days), and duration of VA-ECMO (6.63 vs 5.01 days), and invasive mechanical ventilation (IMV, 11 vs 6 days). Multivariate logistic regression analysis revealed that the occurrence of NI was independently associated with ICU stay (OR 1.128; 95%CI 1.004 ~ 1.268; P = 0.043) and the need for PDT (OR 3.459; 95%CI 1.051 ~ 11.389; P = 0.041).
Conclusions
The Gram-negative bacilli was the most common pathogens for NI during ECMO, with MDROs being the predominant species. The occurrence of NI in patients caused a prolonged ICU stay and increased probability of PDT.
Trial registration
ChiCTR1900026105 (Registration Date 20190921).
Molecular epidemiological analysis of Influenza viruses in Influenza-like illness cases: a retrospective study in Chongqing Hi-Tech Zone, China (2021-2024)
Authors: Cai Wei , Deng Yuhang , Xu Pan , Xue Jianjiang
Published: October 2024

The seasonal epidemiology and high variability of influenza viruses result in yearly differentiation of main pandemic strains. Effective prevention and control of influenza epidemics require enhanced surveillance, timely updates of vaccine components.Therefore, it is crucial to establish a continuous surveillance system to track epidemiological trends and develop appropriate vaccination and preventive measures.A retrospective analysis was conducted on the molecular epidemiological characteristics of influenza viruses in influenza-like cases at a hospital in Chongqing Hi-Tech Zone from 2021 to 2024. Among 39,986 ILI specimens tested using the immunocolloid gold method, 6,616 influenza viruses were detected, with a detection rate of 16.54%. Infections included 4,464 influenza A viruses (67.50%), 2,033 influenza B viruses (30.73%), and 119 co-infections of influenza A and B viruses (1.77%). From November 2021 to September 2022, the peak detection of influenza A virus occurred in January 2022, and influenza B virus peaked in April 2022. From July 2022 to March 2023, the influenza A virus peaked in December 2022, while the influenza B virus peaked in January 2023. Influenza B virus detection lagged behind influenza A virus detection. In this region, H3N2 was the predominant subtype of influenza A, and Victoria was the main subtype of influenza B. The "H1" subtype of influenza A did not appear throughout 2023 but accounted for 82% in January 2024 and 16% in February 2024. The "Yamagata" subtype of influenza B did not appear from 2023 to 2024. Influenza epidemics in the winter and spring seasons in Chongqing Hi-Tech Zone were predominantly caused by influenza A, with influenza B also circulating. Influenza A strains were mainly H3N2, while influenza B strains were primarily Victoria. This study provides essential data and a scientific basis for developing and optimizing influenza prevention and control strategies.
Growth Associated Protein 43 (GAP-43) predicts brain amyloidosis in Alzheimer’s Dementia Continuum: an [18F] AV45 study
Authors: Nemati Rezvan , Sadeghi Mohammad , Saberian Parsa , Ashlaghi Ahmadreza Sohrabi , Mardani Sajjad , Abadi Sina Jafari Hossein , Yaghoobpoor Ali , Heydari Atefeh , Khoshroo Niloofar , Rahnama Yassin , Mayeli Mahsa
Published: October 2024

Background
Alzheimer's disease (AD) is a global health concern with a rising prevalence. Growth Associated Protein 43 (GAP-43) is a crucial protein for neuronal growth and synaptic plasticity, essential for maintaining healthy brain function. In AD, changes in GAP-43 levels have been observed, potentially indicating synaptic dysfunction and neurodegeneration. This study investigates the potential of GAP-43 as a biomarker in AD by analyzing its correlation with amyloid-beta (Aβ) pathology, a hallmark feature of the disease using [18F] AV45.
Methods
We examined 1639 participants using a dataset extracted from the Alzheimer's Disease Neuroimaging Initiative (ADNI).
Results
A total of 226 subjects meeting the eligibility criteria were recruited from the ADNI dataset for enrollment. These individuals were categorized into three groups: 77 cognitively normal (CN) individuals, 111 with mild cognitive impairment (MCI), and 38 AD. Our results reveal elevated CSF GAP-43 levels in AD, and GAP-43 exhibited a stronger association with tau pathology than with Aβ. The study establishes a robust positive correlation between GAP-43 and [18F] florbetapir PET ([18F] AV45), a marker for Aβ plaques, independent of cognitive status. Additionally, logistic regression identified GAP-43) as significant predictors of AD.
Conclusion
The diagnostic accuracy of [18F] AV45, combined with GAP-43, enhances understanding of AD pathology. This study sets the stage for future research on GAP-43's trajectory in disease progression and the molecular mechanisms linking GAP-43 and amyloid-beta. The findings suggest promising avenues for novel therapeutic targets, contributing to advancements in early detection and treatment strategies for AD.
Initial Clinical Experiences of Robotic Distal Gastrectomy for Gastric Cancer Using the Da Vinci TM SP System
Authors: Ito Ayaka , Nakauchi Masaya , Fujita Masahiro , Umeki Yusuke , Suzuki Kazumitsu , Serizawa Akiko , Akimoto Shingo , Watanabe Yusuke , Tanaka Tsuyoshi , Shibasaki Susumu , Inaba Kazuki , Uyama Ichiro , Suda Koichi
Published: October 2024

Purpose
Reduced-port surgery has been utilized in gastric cancer surgery but was not predominantly used due to its high technical difficulty. A new single-port surgical robot named da Vinci™ SP System (DVSP) was launched and eventually approved for clinical use in Japan in November 2022. We initiated robotic gastrectomy for gastric cancer using DVSP in March 2023. Here, we report our initial experiences and assessments of the feasibility and safety of robotic gastrectomy for gastric cancer using DVSP.
Methods
This single-center retrospective study included 20 patients with gastric cancer who underwent robotic gastrectomy with DVSP from March 2023 to April 2024. The primary endpoint was the postoperative complication rate within 30 days postoperatively. Secondary endpoints were surgical outcomes, including intraoperative adverse events, operative time, blood loss, and the number of dissected nodes.
Results
Of the 20 patients, 6 (30.0%) were male. The median age was 76.5 years. Tumors in the middle to lower stomach were observed in 20 patients (100.0%), including 18 (90.0%) and 2 (10.0%) with clinical stages I and II diseases, respectively. All patients underwent distal gastrectomy. The postoperative complications of Clavien–Dindo grade ≥ II occurred in 3 (15%) patients. Intraoperative adverse events, including conversion to other approaches, were not observed. All patients underwent R0 resection. The median operative and console times were 283.5 and 240 min, respectively. The median blood loss was 11.5 mL with 49 dissected nodes.
Conclusion
This study revealed the safe performance of robotic distal gastrectomy with standard lymphadenectomy for gastric cancer using DVSP.
The construction and validation of integrated immune and metabolic gene signatures for clinical prognostic model of lung squamous cell carcinoma
Authors: Xue Haoyuan , Li Hongwei , Han Songyan , Zhang Xiaqin , Bu Peng , Liang Hua
Published: October 2024

Background:
Lung squamous cell carcinoma (LUSC) has a poor prognosis due to the lack of effective targeted therapies, and its incidence has dramatically increased in recent years. Therefore, new prognostic markers are urgently needed. Since tumour immune and metabolic heterogeneity can influence LUSC prognosis, systematic combinatorial analysis of immune-related and metabolism-related genomic patterns may identify such markers. Thus, this study aimed to construct a novel predictive model based on immune-related and metabolism-related genes for prognostic stratification in LUSC.
Methods:
Transcriptomic as well as clinical data of 502 and 43 LUSC cases were downloaded from The Cancer Genome Atlas Program (TCGA) and the Gene Expression Omnibus (GEO) databases. Core LUSC subtype genes were identified using nonnegative matrix factorization (NMF). A risk model based on prognostic LUSC genes was constructed using machine learning, LASSO regression, and multivariate Cox regression. Subsequently, we defined low-risk and high-risk expression profiles comprising these markers and revealed survival differences. Gene-Set Enrichment Analysis of these marker genes revealed the active pathways in the high-risk group versus the low-risk group. Diverse clinical treatment strategies for both risk groups were also examined. Immunohistochemical validation involving 42 patients demonstrated the expression patterns of the identified genetic markers.
Results:
The constructed risk model for nine LUSC genes effectively stratified patients into low-risk and high-risk subgroups with different survival rates, tumour mutation burden, and response to clinical therapy. High expression levels of NRTN, CYP2C18, TSLP, MIOX, and RORB and low expression levels of HBEGF, SERPIND1, PTGIS, and LBP were correlated with high survival rates. The high-risk group was strongly associated with immune pathways, and the low-risk group was strongly associated with metabolism pathways. The expression of model markers was stronger in tumours than in adjacent normal tissues.
Conclusions:
Six immune-related and three metabolism-related genes were identified as prognostic markers of LUSC, with their expression levels significantly associated with the survival rate. The prognostic model constructed using these markers has a strong predictive power. Accordingly, the findings are expected to guide decisions on treatment strategies.
Measuring and characterizing the quality of child care in Brazilian primary health care: a latent class analysis
Authors: Flores-Quispe Maria del Pilar , Passos Michelle , Almeida Josemir R. , Santos Ythalo H. S. , Aquino Rosana , Vieira-Meyer Anya PGF , Luz Leandro Alves , Anjos Eduarda Ferreira , Lima Acácia M. P. , Martufi Valentina , Ortelan Naiá , Ichihara Maria Yury Travassos , Barreto Mauricio L. , Amorim Leila D.A.F. , Pinto-Junior Elzo Pereira
Published: October 2024

Background
Ensuring the highest quality of care for children in Primary Health Care is essential to prevent or control risks that compromise a child's growth and development. This study aimed to characterize the quality of child health care provided by Primary Health Care (PHC) teams in Brazil and explore its relationship with municipal characteristics.
Methods
Using data from the external assessment of the first cycle of the National Program for Access and Quality Improvement in Primary Care, this cross-sectional study evaluated 16,566 PHC teams from the Family Health Strategy. Nine binary indicators of the quality of child care were created based on the recommendations of the Brazilian Ministry of Health. We used latent class analysis to characterize the quality care. Through a multinomial logistic regression, we assessed the association between belonging to a given latent class of quality of care and the municipal covariates region and Brazilian Deprivation Index.
Results
Three patterns (latent classes) of quality of care were identified: high, intermediate and low adequacy. The pattern labelled "High adequacy” included 31.2% of the PHC teams and had higher conditional probabilities in all nine indicators (over 70%). The pattern “Intermediate adequacy” involved 53.3% of PHC teams, and the "Low adequacy” pattern included only 15.4% of teams. The chance for a PHC team to belong to the "High adequacy” pattern was over two times (OR = 2.34; 95%CI: 1.15–4.76) in the Northeast region compared to the Center-West region. Relating to the Brazilian Deprivation Index, for PHC teams located in municipalities with moderate and low deprivation, the chance of belonging to the "High adequacy” pattern was 2.04 (95%CI: 1.44–2.89) and 9.08 (95%CI: 4.54–18.14) times, respectively, compared to the high deprivation municipalities.
Conclusions
This study identified three patterns of quality of child care. Most of the PHC teams were included in the “Intermediate adequacy” pattern. Furthermore, the quality of care was associated with the municipality characteristics. Our findings demonstrated that the methodology used in this study allowed us to characterize the quality of care in a more consistently way than with a conventional method using a set of indicators constructed from a national dataset.
Increasing the Number of Biopsy Cores Around Prostate Cancer Targeted Lesions in the Transition Zone to Improve Biopsy Accuracy: A Combined Retrospective and Prospective Study
Authors: Chen Xin , Huang Chen , Zhou Chenchao , Li Yu , Huang Renpeng , Bao Jie , Lin Yuxin , Truß Michael C. , Hou Jianquan , Huang Yuhua , Wei Xuedong
Published: October 2024

Background
Prostate biopsy (PBx) plays a pivotal role in diagnosing prostate cancer (PCa). However, the prostate biopsy results for transition zone (TZ) tumors were found to be less accurate than those for peripheral zone tumors. The objective of this study was to identify potential under-detection of TZ PCa and to validate a new biopsy template that increases the number of cores around TZ targeted lesions to improve biopsy accuracy for TZ tumors.
Materials and Methods
This study comprised two components: a retrospective analysis and a randomized clinical trial. The retrospective study included 217 patients who underwent radical prostatectomy following "12 + X" template transperineal transrectal ultrasound-magnetic resonance imaging-fusion PBx between 2018 and 2021 at our institution. The clinical trial investigated biopsy efficacy for clinically significant PCa (csPCa) in 400 patients who underwent either modified "18 + X" template PBx for TZ lesion or "12 + X" template PBx following systematic sampling between 2022 and 2023 at our center.
Results
The retrospective analysis revealed that the "12 + X" template, comprising 4 cores in TZ, failed to adequately detect csPCa in the TZ. “18 + X” template was constructed based on the results of retrospective analysis. Conversely, in the prospective trial, the "18 + X" template, with 10 cores in TZ, outperformed the "12 + X" template in detecting TZ csPCa without a corresponding increase in complications. Building upon the result, "18 + X" template was improved to the "New 12" and "New 12 + X" templates, with 8 cores in TZ and 4 cores in peripheral zone, while maintaining the same csPCa detection rate for TZ patients.
Conclusions
Our study demonstrated that increasing the number of biopsy cores around targeted lesions in the TZ improves biopsy accuracy and reduces the number of biopsies in non-targeted regions without compromising overall accuracy. The new template offers a promising approach to improve biopsy for patients with TZ lesions.
Trial Registration:
This study was approved by Clinical trial registration in China Clinical Trial Registry (ChiCTR2200056386). Registered 04 February 2022, https://www.chictr.org.cn
Stent placement can achieve same prognosis as endoscopic nasobiliary drainage in treatment of bile leakage after liver transplantation
Authors: Gu Yangjun , Chen Zhitao , Li Qiyong
Published: October 2024

Background
Both stent placement and endoscopic nasobiliary drainage are commonly employed for treating bile leakage following liver transplantation. However, little research compared the advantages of both.
Methods
Data of patients with bile leakage after liver transplantation were retrospectively collected in our center. The efficiency and prognosis were compared between two groups.
Results
We retrospectively collected data from total 50 patients diagnosed with bile leakage within one month after liver transplantation. Among them, 40 patients underwent endoscopic nasobiliary drainage (ENBD) and 9 patients received stent placement. Baseline patient characteristics, except white blood cell count (WBC), total bilirubin (TB), and direct bilirubin (DB) levels, were comparable between the two groups. Additionally, there was no significant difference in the rates of reconveyance or post-operative biliary stricture.
Conclusion
Both stent placement and endoscopic nasobiliary drainage are recommended for treating bile leakage after liver transplantation, as they exhibit similar efficacy and prognosis.
NMO-IgG causes primary retinal damage without optic nerve injury
Authors: Chen Biyue , Zhou Huanfen , Yang Kaishu , Song Honglu , Xu Quangang , Sun Mingming , Xu Xintong , Li Yuyu , Li Qianqian , Yu Yanyan , Wei Shihui , Chen Tingjun
Published: October 2024

Background
Neuromyelitis Optica (NMO) is a neuroimmune disorder primarily driven by autoantibodies against aquaporin 4 (AQP4), known as NMO-IgG. Although the mechanisms underlying NMO-IgG-induced retinopathy are not fully understood, the high expression of AQP4 in retinal Müller cells suggests a direct interaction that may trigger inflammatory processes in the retina. Previous studies indicate that microglia play a critical role in mediating immune responses, leading to neuronal dysfunction.
Methods
NMO-IgG obtained from clinical patients was administered via intravitreal injection to female C57BL/6 mice. Techniques such as optical coherence tomography (OCT), electroretinography (ERG), real-time fluorescence quantitative PCR (RT-qPCR), and immunofluorescence analyses were used to assess retinal changes. The potential for reversing retinopathy was explored by depleting microglial cells using the CSF1 receptor inhibitor PLX3397. Additionally, a Transwell co-culture system of MIO-M1 (Müller cells) and BV2 (microglia) cells was established to study their interactions.
Results
Intravitreal injection of purified NMO-IgG in mouse models led to its deposition in the retina and downregulation of AQP4 in Müller cells. Vascular leakage was observed, alongside retinal dysfunction characterized by thinning of the retinal nerve fiber layer (RNFL) and loss of retinal ganglion cells (RGCs), consistent with ERG findings. By day 7, C3 expression was upregulated in Müller cells, followed by microglial activation. Significant morphological changes in microglia were noted, with increased expression of iNOS and C1q, indicating substantial activation. Ablating microglia significantly mitigated NMO-IgG-induced injury to RGCs. In vitro, NMO-IgG-treated MIO-M1 cells secreted higher levels of C3, enhancing the activation and migration of BV2 cells compared to controls.
Conclusions
The retinal dysfunction observed in NMO may primarily be linked to the activation of Müller cells by NMO-IgG, leading to increased C3 secretion, which in turn activates microglia. Therapeutic strategies targeting Müller cell-microglia interactions in NMO-IgG-induced retinopathy could be promising in addressing the underlying retinal pathology in this condition.
Impacts of sugar and sweetener warning labels on substitution between sugar- and non-sugar sweetened beverages in a real-world selection task
Authors: Miller Caroline , Kay Enola , Dono Joanne , Ettridge Kerry
Published: October 2024

Background
Front-of-pack (FOP) warning labels have demonstrated effectiveness for reducing sugar-sweetened beverage (SSB) consumption and switching to water. However, an unintended consequence is that they may also increase switching to non-sugar sweetened beverages (NSSBs). A real-stakes experimental study examined the effectiveness of combining sugar and sweetener FOP warning labels to reduce sugary drink consumption and prevent NSSB substitution. The study also examined potential integration with Australia and New Zealand’s existing Health Star Rating (HSR) system to determine suitability for local context and other jurisdictions with interpretive labelling schemes already in place.
Methods
Participants (N = 414) accessed an online convenience store app via an on-campus laptop to select one drink from an array of 10 beverages, on three occasions. Drink options included a variety of SSBs, 100% fruit juice, NSSBs, and water. Following an escalating exposure procedure, drinks were presented (1) without any additional labelling, (2) with warning labels added to sugary drinks or to both sugary drinks and NSSBs (according to allocated condition), then (3) with HSR icons added to all drinks. Participants were informed they would receive a complementary drink, based on their selections, following the completion of a brief questionnaire.
Results
Baseline results indicated that SSBs and water were the most and least popular drink choices, respectively. Placing FOP warning labels on sugary drinks decreased selection of SSBs and increased NSSB and water choices. Water became the most popular individual drink choice in response to warnings on sugary drinks. Placing FOP warning labels on both sugary drinks and NSSBs successfully avoided an increase in NSSB choices, whilst also increasing water selections, but did not significantly decrease selection of SSBs until HSR ratings were added. The incorporation of HSR icons consolidated warning label effects on NSSB and water selection across both conditions.
Conclusions
Results demonstrate the potential of FOP sugar warning labels for addressing beverage consumption behaviours. The incorporation of sweetener warning labels may successfully avoid substitution towards NSSBs, whilst still promoting water choices, but may also dilute the impact of the sugary drinks warning labels. Warning labels were complementary to existing interpretive FOP labels.
Protective effects of Suberoylanilide hydroxamic acid and Dapagliflozin administration on liver of diabetic rats
Authors: Alamri Zaenah Zuhair , Melebary Sahar J.
Published: October 2024

Background
Type 2 diabetes mellitus (T2DM) is common metabolic disorders. T2DM patients had 2-fold increase to get liver disorders. Evidence that some antidiabetic substances treated liver disorders in T2DM patients is evolving. Current study aimed to investigate hepatoprotective actions of Suberoylanilide hydroxamic acid (SAHA) and dapagliflozin (DAPA) in T2DM rats.
Methods
T2DM occured by high fat diet (HFD) and single Streptozotocin (STZ) injection (35 mg/kg i.p.). Forty rats sorted into 4 groups: NC (negative control), T2DM, T2DM + SAHA (5 mg/kg/i.p. for 8 weeks) and T2DM + DAPA (1mg/kg/p.o. for 8 weeks). At experimental end, levels of fasting blood glucose (FBG), fasting insulin, hepatic function tests [gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, albumin, total protein], lipid profiles [total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG)] measured in serum. Hepatic tissue homogenization prepared for estimating oxidative stress biomarkers [glutathione (GSH), malonaldehyde (MDA), superoxide dismutase (SOD)]. Hepatic histopathological examination made under light microscope.
Results
Diabetic rats had significant rise in liver weights and hepatic enzymes (AST, ALT, GGT, total bilirubin), lipid profile [TG, TC, LDL-C) in serum, and elevation in MDA in liver homogenate, but significant decline in total proteins, albumin, HDL-C) in serum and SOD, GSH in liver homogenate. These changes associated with histopathological changes in liver tissue as degeneration, vacuolation of hepatocytes, dilatation, and congestion of portal veins with lymphocytic infiltration. SAHA and DAPA treatment decreased liver weights, FBG, insulin, insulin resistance (IR), AST, ALT, GGT, bilirubin, TG, TC, LDL-C. SAHA and DAPA increased antioxidant enzymes (GSH, SOD) levels, serum total protein, albumin and HDL-C. Interestingly, DAPA was better that SAHA in improving liver enzymes, lipid profile, decreased FBG but SAHA was better in improving antioxidants as SOD, insulin levels and IR. Also, there were marked improvements in liver histopathological changes in SAHA and DAPA groups that were better in SAHA group.
Conclusions
Suberoylanilide hydroxamic acid and dapagliflozin represent an approach to protect liver versus DM-induced disorders via suppression oxidative stress, improve lipid profile, hyperglycemia and IR progression thus conserving liver functions and structure.
Efficacy of a Modified Cocktail for Periarticular Local Infiltration Analgesia in Unicompartmental Knee Arthroplasty: A prospective, double-blind, randomized controlled trial
Authors: Zhu Yuchen , Shen Shaoning , Cui Longkang , Wu Lianguo , Zhang Bingbing
Published: October 2024

Background: Periarticular local infiltration analgesia (LIA) has become a widely used method for postoperative pain management after unicompartmental knee arthroplasty (UKA). The present study aimed to evaluate the efficacy of a modified LIA cocktail.
Methods: 61 patients who underwent UKA were enrolled and randomly assigned to receive periarticular infiltration of a modified cocktail (comprising ropivacaine, epinephrine, dexamethasone, magnesium sulfate, and sodium bicarbonate ) or a conventional cocktail(comprising ropivacaine, epinephrine, dexamethasone, ketorolac, and morphine). The outcomes included the consumption of patient-controlled intravenous analgesia (PCIA) medication used for postoperative analgesia, pain score, early joint functional recovery, discharge time, and complication rates.
Results: In the initial 12 hours after surgery, the conventional cocktail showed no superiority over the modified cocktail in visual analog scale (VAS) scores. However, from the second postoperative day, the analgesic effect was significantly prolonged in the modified group, leading to lower VAS scores and better knee functional recovery. Additionally, patients in the modified group required less pain medication via PCIA, both within the first 24 hours and cumulatively up to 48 hours after surgery. Both groups had similar rates of complications.
Conclusions: The present modification of a conventional cocktail significantly prolonged the analgesic effect and reduced pain medication consumption after UKA surgeries, which was associated with better functional recovery on early postoperative days.
Trial registration: Chinese Clinical Trial Registry, ChiCTR2200060500. 21 March 2023
Impact of universal contact precautions and chlorhexidine bathing on the acquisition of carbapenem-resistant Enterobacterales in the intensive care unit: A cohort study
Authors: Jung Jongtak , Park Hyein , Oh Sunmi , Choi Jiseon , An Seoyun , Jeong Yeonsu , Kim Jinhwa , Baek Yae Jee , Lee Eunjung , Kim Tae Hyong
Published: October 2024

Background
For the prevention of carbapenem-resistant Enterobacterales (CRE) acquisition in the intensive care unit (ICU), the effectiveness of universal contact precautions (UCP) and chlorhexidine gluconate (CHG) bathing is controversial.
Methods
With the aim of evaluating the effectiveness of UCP and CHG on CRE acquisition, this study was conducted in an ICU at a university-affiliated hospital in Seoul. Beginning in April 2017, all patients admitted to the ICU underwent CRE screening and surveillance tests weekly, and beginning in January 2018, UCP and CHG bathing were implemented for all patients. The pre-intervention period spanned from April to December 2017; the post-intervention period spanned from January 2018 to December 2019. The pre- and post- intervention CRE acquisition rates were then compared using Kaplan-Meier analysis and log-rank tests, and independent risk factors for CRE acquisition were analysed using Cox proportional hazard modelling.
Results
Of 1,747 patients, 35 acquired CRE during their ICU stay. Between the pre-intervention and post-intervention periods, the CRE acquisition rate did not differ significantly (p = 0.357). Additionally, multivariable Cox regression revealed that CRE acquisition was significantly associated with carbapenem exposure (adjusted hazard ratio [aHR] = 2.555, 95% confidence interval [CI] = 1.208–5.405, p = 0.013) and the presence of more than four patients colonised with CRE during their ICU stay (aHR = 2.639, 95%CI, 1.157–5.243, p = 0.019). However, UCP and CHG bathing had no significant association with CRE acquisition (aHR = 0.657, 95%CI = 0.301–1.433; p = 0.291).
Conclusions
UCP and CHG bathing did not affect the CRE acquisition rate in the ICU of a low-prevalence area. Therefore, a multimodal strategy including antibiotic stewardship is necessary for controlling the nosocomial spread of multidrug-resistant organisms.
CC chemokine receptor 2 mediated regulation of macrophages is involved in pancreatic cancer progression in the tumor microenvironment
Authors: Ijichi Hideaki , Kimura Gen , Sano Makoto , Notoya Genso , Miyabayashi Koji , Takahashi Ryota , Kishikawa Takahiro , Fujishiro Mitsuhiro
Published: October 2024

Objective: The interaction between pancreatic ductal adenocarcinoma (PDAC) cells and non-tumor cells is important in PDAC. In this study, we investigated the effects of CC chemokines in PDAC.
Design: According to microarray data of cancer-associated fibroblasts (CAFs) stimulated by PDAC cells, the expression of Cc chemokines was analyzed by quantitative RT-PCR. Macrophages were induced from the bone marrow cells of Cc chemokine receptor 2 (Ccr2)-wild-type (WT) and Ccr2-knockout (KO) mice, and their interaction with PDAC cells was examined. Differences in RNA and protein expression between Ccr2 WT and KO macrophages were examined also. Systemic KO of Ccr2 in a geneticallyengineered murine PDAC model was established to analyze the survival impact and histopathological phenotype using immunohistochemistry. The RNA sequences of PDAC cells stimulated with Ccr2-WT or KO macrophages were also examined.
Results:Ccl2 and Ccl7 expression was upregulated in CAFs. Ccr2 is expressed in macrophages in PDAC. Ccr2-WT macrophages promote the invasion of PDAC cells in vitro. Ccr2-KO decreases Cxc chemokine levels and increases interferon-a production in macrophages. Ccr2 KO PDAC mice showed significantly prolonged survival.
Conclusions:CCLs-CCR2 signaling affects the profile and function of macrophages, and Ccr2-KO in macrophages may alter the microenvironment in a tumor-suppressive manner in PDAC.
Feasibility of Extracting Usable DNA from Blood Samples Stored up to 21 Years in the DiPiS Study
Authors: Svärd Agnes Andersson , Viberg Ellen , von Platen India , Jönsson Ida , Lundgren Markus
Published: October 2024

This study assesses the feasibility of extracting high-quality DNA from blood samples stored at -20°C for up to 21 years under suboptimal conditions. It addresses sample mishandling in research, where many samples lack proper biobank protocols. Prior studies focused on short-term storage and controlled conditions, highlighting the negative effects of freeze-thaw cycles. This study evaluates whether DNA from long-term stored samples under suboptimal conditions can still meet quality standards for research purposes.
Genomic DNA was extracted from 1,012 capillary blood samples from the Diabetes Prediction in Skåne study. Samples were stored at -20°C for 7 to 21 years, and DNA was isolated using QIAamp DNA Blood Mini kits. DNA quantity, purity, and quality were analyzed using spectrophotometry and automated electrophoresis.
Overall, 75.7% of samples met quality standards for DNA quantity (≥20 ng/µL) and purity (A260/280 ratio 1.7–1.9), with the highest proportion in 12-year samples (83.5%). DNA quality was further assessed in 270 samples, where 57.8% had a DNA Integrity Number (DIN) of 7 or higher. Despite some contamination, the majority of samples were suitable for downstream applications like next-generation sequencing. This study suggests that historical blood samples stored under suboptmal conditions can still be viable for modern genomic analyses.
Transcriptomic Insights into Mycobacterium orygis Infection-associated Pulmonary Granulomas Reveal Multicellular Immune Networks and Tuberculosis Biomarkers in Cattle.
Authors: Kumar Rishi , Gandham Sripratyusha , Bhaskar Vinay , Praharaj Manas , Maity Hemanta Kumar , Sarkar Uttam , Dey Bappaditya
Published: October 2024

Mycobacterium orygis, a member of the Mycobacterium tuberculosis complex (MTBC), has emerged as a significant contributor to tuberculosis (TB) in cattle, wildlife, and humans. However, understanding about its pathogenesis and severity is limited, compounded by the lack of reliable TB biomarkers in cattle. This study delves into the comparative pathology and transcriptomic landscape of pulmonary granulomas in cattle naturally infected with M. orygis, using high-throughput RNA sequencing. Histopathological analysis revealed extensive, multistage granulomatous, necrotic, and cavitary lesions, indicative of severe lung pathology induced by M. orygis. Transcriptomic profiling highlighted numerous differentially expressed genes and dysregulated pathways related to immune response modulation and extracellular matrix remodeling. Additionally, cell type enrichment analysis provided insights into the multicellularity of the granulomatous niche, emphasizing complex cell-cell interactions within TB granulomas. Comparative transcriptomics leveraging publicly available bovine and human TB omics datasets, 14 key immuno-modulators (SOD2, IL1α/β, IL15, IL18, CCL2/MCP-1, CCL3/MIP-1α, CCL4/MIP-1β, CCL8/MCP-2, CCL20/MIP-3α, CXCL2/MIP-2, CXCL10/IP-10, CXCL11, and IFN-γ) were identified as potential biomarkers for active TB in cattle. These findings significantly advance our understanding of M. orygispathogenesis in bovine TB and highlight potential targets for the development of diagnostic tools for managing and controlling the disease.