bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Autonomic Nervous System Status with Sympathetic Skin Response in Patients Undergoing Laparoscopic Sleeve Gastrectomy for Morbid Obesity
Authors: Elkan Hasan , Ağırcan Dilek , Yüksekyayla Baran , Erdoğdu Hamza
Published: July 2024

Introduction and Purpose: Obesity is the most common metabolic disease of our time. Bariatric surgery is now accepted as the definitive treatment for morbidly obese patients. The most commonly performed bariatric surgery method is “Laparoscopic Sleeve Gastrectomy (LSG)”. Patients often report various complaints related to the autonomic nervous system after obesity surgery. Sympathetic Skin Response (SSR) is a simple and non-invasive test used for the early diagnosis of dysautonomia in peripheral neuropathy, demonstrating the function of postganglionic unmyelinated sympathetic sudomotor fibers by using changes in skin resistance. This study aims to evaluate the autonomic nervous system status in patients undergoing LSG for morbid obesity using Sympathetic Skin Response (SSR).
Method: The study was conducted prospectively with 40 volunteer patients who applied to Harran University Hospital General Surgery Department, had a BMI over 40, and underwent obesity surgery. Patients were neurologically evaluated in the preoperative period. The patients deemed suitable in the evaluation had their SSR recorded with tests conducted by the Neurology Department. The same group of patients had their sympathetic skin responses evaluated and recorded 6 months postoperatively, and statistical analyses were conducted.
Findings: The decrease in BMI and SSR latency values before surgery compared to after surgery (p<0.001; p<0.001, respectively) and the increase in SSR amplitude values were found to be statistically significant (p<0.001).
Discussion and Conclusion: Our study detected a significant increase in sympathetic skin response post-surgery. Hormonal changes such as the improvement of insulin resistance and the decrease in leptin levels, as well as the stressful nature of the surgical process, might lead to an increase in sympathetic nervous system activity. We believe that performing the low-cost and simple SSR test in patients undergoing obesity surgery could be important for the follow-up of potential neuropathies in the future.
Establishing a Certificate in the Analysis of Medical Data: A Cross-Sectional Evaluation of a Continuing Professional Development Course in Biostatistics in for healthcare professionals in Qatar
Authors: Ali Saima , Al-Sheikhly Deema , Mattar Laudy , Navti Phyllis , Dargham Soha , Healy Mark , Mahfoud Ziyad
Published: July 2024

Background: Healthcare professionals often face challenges in conducting and publishing research, citing a lack of biostatistical knowledge and skills as a significant barrier. In response, a Continuing Professional Development (CPD) course was developed to enhance local research capacity.
Objective: This paper aims to delineate the establishment and delivery of the biostatistics course for healthcare professionals, while presenting evaluation findings focused on self-reported enhancements in knowledge, competence, and performance. Additionally, potential areas for course refinement are explored.
Method: A cross-sectional descriptive analysis was conducted, utilizing routine data from evaluations aligned with accreditation standards. Data included attendance records, certificate completions, and findings from two self-report surveys administered post-course. The surveys gauged changes in knowledge and competence, achievement of course objectives, barriers to certificate completion, and long-term outcomes such as research publication.
Results: Findings indicated widespread consensus on meeting course objectives, albeit with challenges noted in certain intermediate and advanced topics. Participants reported notable improvements in knowledge, competence, and performance, underscoring the course's efficacy. Long-term assessment revealed sustained biostatistical skills, with a majority crediting the course for manuscript drafting (over 50%) and publication support (42%).
Conclusion: The CPD course in biostatistics yields positive outcomes in knowledge, competence, and performance among healthcare professionals. Identified challenges in advanced topics and certificate completion warrant improvements such as extending course duration, integrating cost-effective online platforms, and offering enduring material for comprehensive review. Rigorous research methodology is crucial for exploring causal relationships and enhancing the effectiveness of research capacity-building initiatives in the region.
The“Overlapping”Lymphaticovenous Anastomosis: an overlapped end-to-end anastomosis Supermicrosurgical Technique
Authors: Wang Cheng , Li Bowen , Zhong Zhumao , tao Weiye , zheng Youmao , Liang Junbo , Liu Chong
Published: July 2024

Objective
Lymphaticovenular anastomosis has become an increasingly common treatment for lymphedema. Supermicrosurgical techniques are essential for the successful performance of lymphaticovenular anastomosis, one of the most common hurdles faced by lymphatic surgeons while carrying out a LVA is a mismatch in sizes of the vein and the lymphatic vessels. This study aims to evaluate the effectiveness and safety of the "Overlapping" lymphaticovenular anastomosis technique, which involves overlapping the lymphatic and venous vessels to achieve size mismatch anastomosis.
Methods
The seventeen patients with lymphedema were included in the study, and three types of anastomosis were performed, including Overlapping, end-to-end and octopus anastomosis. The Overlapping technique involves traction of the lymphatic vessels into the venous vessels so that the lymphatic vessels overlap with the venous vessels to complete the anastomosis. Time anastomosis, method anastomosis, and patency rates, and lymphedematous volume was evaluated in this study.
Results
A total of 17 patients were treated over the course of this study. The overall success rate was 100% as measured by clinical observation (lymphatic reflux) and intraoperative ICG lymphography. The mean time of Overlapping anastomosis was 6.3 minutes. The mean amount of drainage was 472.29 ml (324.8-612.0ml ), and only one patient had poor ICG drainage after the procedure, but it improved after resuturing. It was found that the cuff anastomosis significantly reduced the operative time compared to the other two anastomotic techniques, and all patients showed significant improvement in postoperative limb edema.
Conclusions
The Overlapping technique could serve as a valuable addition to the current LVA technique. This technique has the potential to promote the broader application of LVA in the treatment and prevention of lymphedema.
Comparison of Left Ventricular Function after His Bundle Pacing vs Left Bundle Branch Area Pacing Implantation
Authors: Prakoso Kurniawan , Wibawa Kevin , Karwiky Giky , Akbar Mohammad Rizki , Martha Januar Wibawa , Iqbal Mohammad
Published: July 2024

Background
Right ventricular pacing may lead to deterioration of left ventricular (LV) function. Recent guideline suggests the use of conduction system pacing (CSP) with either his bundle pacing (HBP) or left bundle branch area pacing (LBBAP). This study aimed to investigate the difference of LV function between HBP and LBBAP.
Methods
This is a prospective cohort study enrolling patients age > 18 years requiring CSP implantation from June 2020 to January 2024 in Hasan Sadikin General Hospital, Bandung. Data regarding QRS duration and several echocardiography parameters were obtained at baseline and during follow up within 1 year after CSP implantation.
Results
From 66 patients, 35 were included in the HBP group. There was no difference in QRS duration at baseline between both groups with higher left ventricular ejection fraction (LVEF) in HBP group (51.17 ± 13.87% vs 45.58 ± 11.08%, p = 0.078). During follow up, HBP group showed narrower QRS duration (113.40 ± 17.06ms vs 120.81 ± 12.12ms, p = 0.029). LV function was preserved in HBP group while there was a trend of LV function improvement in LBBAP group (53.11 ± 11.67% in LBBAP vs 53.93 ± 11.45% in HBP group, p = 0.536). Further analysis in 33 patients with LV dysfunction showed a trend of LVEF improvement in both groups (35.31 ± 7.86% to 44.54 ± 11.28% in HBP and 38.75 ± 6.95% to 51.35 ± 13.14% in LBBAP group).
Conclusion
HBP resulted in narrower QRS complex. However, both HBP and LBBAP showed a trend of LV function improvement in patients with LV dysfunction.
Viral load in febrile phase rather than the duration of virus associates the severity of hemorrhagic fever with renal syndrome
Authors: Shi Lei , Wang Shipu , Wang Fenglan , Zhang Xi , Zheng Jie , Ren Danfeng , Tang Tiantian , Li Hongbin , Li Yanping , Wang Yawen , Hu Jinsong , He Yingli , Lin Shumei , Liu Zhengwen , Zhao Yingren , Chen Tianyan
Published: July 2024

Hemorrhagic fever with renal syndrome (HFRS) was Hantaviruses infectious disease with a mortality rate of 1-10%. In the previous studies, the duration of the virus and the relationship between the virus and the severity of the disease were still unclear. 137 patients with HFRS were enrolled in this study, patients were followed up every three days until the virus load was negative. Virus quantification was performed using RT-PCR method. Of all the 137 patients, 38 patients (28%) were classified as severe/critical cases. We found that the duration of the virus lasted much longer than we thought before. Most patients still have virus during the polyuria phase, and some patients even have virus in recovery phase. We confirmed that viral load in febrile phase rather than the duration of virus associated with the severity of Hantaan virus caused HFRS. This indicates that tissue damage in HFRS may not related to the virus, virus activated immune response in the early stages may responsible for the pathogenesis. Understanding the mechanism of virus in HFRS will provide ideas and guidance for better clinical treatment.
ONC201 Exerts Oncogenic Effects Beyond its Mitochondria-Disturbing Role in Neuroblastoma Subsets
Authors: Jiang Jyun-Hong , Lin Yu-Han , Liao Pei-Lin , Chen Ting-Ya , Chuang Hui-Ching , Huang Chao-Cheng , Hsu Wen-Ming , Chuang Jiin-Haur , Wei-Shiung Lian
Published: July 2024

Neuroblastoma (NB) is a formidable challenge in pediatric oncology due to its intricate molecular landscape, necessitating multifaceted therapeutic approaches. ONC201 is an imipridone antibiotic compound with a promising drug candidate leveraging its potent anticancer properties against the mitochondrial proteases ClpP and ClpX. Despite demonstrating early clinical promise, particularly in MYCN-amplified NB, its efficacy in non-MYCN-amplified NB remains a subject worthy of investigation. In this study, we extend the coverage of ONC201 to treat non-MYCN-amplified neuroblastoma, and our data implicated ONC201's inability to reduce tumor growth in animal models harboring SK-N-AS or SK-N-FI cell lines. Interestingly, ONC201 induced the expression of oncogenic markers c-Myc and LGR5 while downregulating the tumor suppressor ATRX. While it fails to attenuate tumor neovascularization in non-MYCN-amplified NB xenografts, its effectiveness differs from that of its MYCN-amplified counterpart. Rho zero (ρ0)-SK-N-AS cells treated with ONC201 showed comparable observed trends in parental SK-N-AS cells, including LGR5 upregulation and ATRX downregulation, suggesting that ONC201's multifaceted actions extend beyond mitochondrial targets. Our elucidation highlights the need to discern molecular signatures when deploying ONC201 monotherapy against NB, which lacks MYCN-amplification.
To develop a prediction model for cardiotoxicity induced by anthracyclines combined with chemotherapy
Authors: Pengxiang Zhang , Yan Zhang , Bing Duan , Jie Mi
Published: July 2024

Purpose:
Anthracyclines are commonly used as curative agents in chemotherapy for patients with breast cancer and lymphoma. Although the chemotherapeutic effect of anthracyclines is good, the cardiotoxicity caused by these drugs cannot be ignored. In this study, we included using anthracycline-based drugs in combination with chemotherapy in patients with breast Cancer and lymphoma, study its after Cancer chemotherapy related heart toxicity (Cancer therapy - related cardiac dysfunction, CTRCD) of the independent risk factors. LASSO regression analysis was used to screen predictive factors to construct a clinical prediction model (nomogram), and the identification accuracy and clinical efficacy of nomogram were verified to provide a theoretical basis for predicting CTRCD in such patients.
Methods:
1. Eligible patients were randomly assigned to the training and validation cohorts in a 5:1 ratio according to specified inclusion and exclusion criteria. With CTRCD as the primary endpoint, univariate and multivariate logistic regression analysis was performed on the training cohort to determine the independent prognostic factors of CTRCD. 2. Use LASSO regression to select predictors and develop a nomogram. Then, the calibration Curve, Hosmer-Lemeshow (H-L) goodness-of-fit test, Receiver Operating Characteristic (ROC) curve and Decisive Curve Analysis were used to analyze the nomogram. DCA was used to evaluate the performance of the nomogram. Internal validation was performed to check the stability of the model.
Results:
1. A total of 324 patients were included in this study. logistic multivariate regression analysis of the training cohort showed that Body Mass Index (BMI) ≥ 25, previous history of diabetes, Brain Natriuretic Peptide (BNP) ≥ 52pg/ml, pathological stage, low density lipoprotein (LDL) ≥ 3.37mmol/L, and cumulative dose of anthracyclines ≥ 550mg/㎡ were statistically significant (P < 0.005). 2. The C-index of the prediction model was 0.872 (95%CI:0.821–0.923) and 0.886 (95%CI:0.799–0.974), and the p value of H-L test was 0.837 and 0.700 in the training and validation cohorts, respectively.
Conclusion:
1. BMI ≥ 25, history of diabetes, BNP ≥ 52pg/ml, LDL ≥ 3.37mmol/L, pathological stage, cumulative dose of anthracyclines ≥ 550mg/㎡ are independent risk factors for CTRCD in breast cancer and lymphoma patients receiving anthracyclines combined chemotherapy.2. The prediction model has good discrimination, and can preliminarily predict the risk of cardiotoxicity in patients with lymphoma and breast cancer using anthracycline-based chemotherapy. This model has certain reference value for the prediction of cardiotoxicity in other chemotherapy regimens using anthracyclines.
Traditional Bone Setting in Nigeria from the Perspectives of Patients and Physiotherapists— Clinical Insights for Low Back Pain Management
Authors: Adje Mishael , Karstens Sven , Mbada Chidozie , Steinhäuser Jost
Published: July 2024

Background:Traditional bone setting (TBS) remains a prevalent healthcare practice in Nigeria, offering alternative treatments for musculoskeletal conditions such as low back pain (LBP). This study explores the perspectives of both patients and physiotherapists regarding TBS and its implications for the management of LBP.Methods:A qualitative research approach was employed, utilizing semi-structured interviews with 25 participants (12 patients who had utilised TBS services for LBP, and 13 physiotherapists). Theoretical sampling was employed in participant recruitment until saturation. Recordings were transcribed and thematic analysis was done as a secondary analysis. Reporting was informed by the Consolidated Criteria for Reporting Qualitative Research (COREQ).Results:Eleven (11) participants were female and 14 were male; with a mean age of 35 years. Five themes emerged from this study themes: driving impetus for TBS, influencing perceptions with information, turning to TBS as a final recourse, exploring the primary alternative, and integrating TBS. Shift towards TBS for LBP stems from deficiencies in prevailing healthcare practices in Nigeria. Patients and physiotherapists hold varying perspectives regarding cultural significance, and effectiveness and safety of TBS compared to conventional physiotherapy interventions. Accessibility, affordability, and perceived efficacy are common facilitators for the patronage of TBS among patients, while others were hesitant and viewed it as a last resort. Negative perception of physiotherapists about TBS for LBP were based on concerns regarding the lack of scientific evidence, standardized practices, and potential complications associated with the procedures.Conclusion:Participants view TBS as a viable alternative when conventional treatments fail, driven by expectations for therapist-guided techniques, physiotherapist shortage, combined with affordability and cultural factors. Physiotherapists remain cautious, citing a need for evidence-based interventions and noting the extreme complications sometimes seen from TBS. Despite differing views, some participants advocate for an inclusive healthcare approach that integrates TBS with conventional medicine, emphasizing collaboration and better communication between healthcare providers and TBS practitioners. Future research could examine formal training programs to integrate Traditional Bone Setting (TBS) with conventional medical practices.
The relationship between Cyberchondria and Health Literacy among first year Nursing Students: the mediating effect of health anxiety.
Authors: Mohammed Manal Saeed , Hendawi Nourhan Essam Hendawi , El-Ashry Ayman Mohamed , Ali Samira Saad
Published: July 2024

Background First-year nursing students are at a critical juncture in their education. They are transitioning from laypersons to healthcare professionals, students are frequently exposed to medical information both in academic settings and through personal research. This exposure can sometimes lead to cyberchondria, improving health literacy and managing health anxiety are key strategies in reducing the incidence of cyberchondria.Aim Investigate the mediating effect of health anxiety between Cyberchondria and Health Literacy among first year Nursing Students.Methods A descriptive correlational research design following STROBE guidelines used in this study. The study was conducted with 475 students in October 2023 during the first semester of the academic year 2023–2024.Results Cyberchondria and health literacy levels were both moderate. In addition, the degree of health anxiety among first year Nursing Students was moderate too. The results showed that the association between Cyberchondria and Health Literacy and cyberchondria is partially mediated by health anxiety .Conclusion This study highlights the sophisticated relationship between cyberchondria, health literacy, and health anxiety among first-year nursing students. It demonstrates that lower health literacy can lead to increased health anxiety, which in turn exacerbates cyberchondria. To mitigate these issues, it is essential to enhance health literacy and provide support for managing health anxiety within nursing education programs. By doing so, we can help nursing students effectively navigate online health information and reduce unnecessary health-related anxieties, promoting better educational outcomes and overall well-being.
Interactions between sexual signaling and body size drive ecology and evolution of wing colors in Odonata
Authors: Idec Jacob , Bybee Seth , Ware Jessica , Abbott John , Ferreira Rhainer Guillermo , Suvorov Anton , Kohli Manpreet , Eppel Louis , Kuhn William , Belitz Michael , Guralnick Robert
Published: July 2024

Insect coloration has evolved in response to multiple pressures, and in Odonata (dragonflies and damselflies) a body of work supports a role of wing color in a variety of visual signals and potentially in thermoregulation. Previous efforts have focused primarily on melanistic coloration even though wings are often multicolored, and there has yet to be comprehensive comparative analyses of wing color across broad geographic regions and phylogenetic groups. Percher vs. flier flight-style, a trait with thermoregulatory and signaling consequences, has not yet been studied with regard to color. We used a new color clustering approach to quantify color across a dataset of over 8,000 odonate wing images representing 343 Nearctic species. We then utilized phylogenetically informed Bayesian zero-inflated mixture models to test how color varies with mean ambient temperature, body size, sex and flight-style. We found that wing coloration clustered into two groups across all specimens - light brown-yellow and black-dark brown - with black-dark brown being a much more cohesive grouping. Male perchers have a greater proportion of black-dark brown color on their wings as do species with longer wings. In colder climates, odonates were more likely to have black-dark brown color present, but we found no relationship between the proportion of black and temperature. Light brown-yellow showed similar scaling with wing length, but no relationship with temperature. Our results suggest that black-dark brown coloration may have a limited role in thermoregulation, while light brown-yellow does not have such a role. We also find that the odonate sexes are divergent in wing color in percher species only, suggesting a strong role for color in signaling in more territorial males. Our research contributes to an understanding of complex interactions driving ecological and evolutionary dynamics of color in animals.
A telomere-related gene panel predicts the prognosis and Immune Status in gastric cancer
Authors: Zhang Dai , Song Dingli , Li Yiche , He Fenfen , Hao Qian , Deng Yujiao , Yang Si , Wang Hui , Chen Jianghao , Wang Ting
Published: July 2024

Telomeres play a crucial role in the development and progression of cancers. However, the impact of telomere-related genes (TRGs) on the prognosis and tumor immune microenvironment (TIME) of gastric cancer (GC) remains unclear. Therefore, a comprehensive investigation of the association between TRGs and GC is necessary. The TRG risk panel was constructed by combining differentially expressed gene analysis, weighted gene co-expression network analyses, the Least Absolute Shrinkage and Selection Operator regression, and stepwise regression analysis in the TCGA cohort and has been validated in a GEO cohort. The major impacts of the signature on the TIME and immunotherapy response were also evaluated. The prognosis model comprised 9 TRGs (CABP2, CALML6, CFAP58, DST, ELOVL2, HIST1H3G, MYF6, PDE1B and TOP3B), stratifying patients into two risk groups. Individuals with low-risk scores exhibited superior prognoses than those with high-risk scores (P < 0.001). The prognostic signature was found to be an independent factor with good predictive power for overall survival. The high-risk group tended to have higher TME scores and an inert immune status with a higher infiltration proportion of Treg cells, M2 macrophages, resting dendritic cells and resting NK cells. Additionally, the low-risk group had higher TMB, lower TIDE and a higher immunotherapy response rate. Additionally, we confirmed the expression of the nine genes in GC tissues using RT-qPCR. Our TRG-based panel has a significant role in the prognosis, TIME, and immunotherapy response. This may suggest that the TRG panel could be a powerful tool for guiding clinical treatment decisions.
Green synthesis of ZnO NPs from Melon by-products (Cucumis Melo L.) extract: antioxidant activity and total phenolic content
Authors: Kahraman Yusuf Sezai , Altınkeser Tuğçe , BOZKURT Rabia Nur , Kaba İbrahim
Published: July 2024

In this study, zinc oxide nanoparticles (ZnO NPs) were synthesized using melon by-products (Cucumis Melo L.) extract. Nanoparticles were characterized using different techniques such as X-ray Diffraction (XRD), Fourier Transform Infrared (FTIR), Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Diffraction (EDX), Transmission Electron Microscopy (TEM), Ultraviolet-Visible Spectrophotometry (UV-Vis), Ultraviolet-Visible Diffuse Reflection Spectroscopy (UV- DRS), Dynamic light scattering (DLS) analysis and Zetasizer. SEM and TEM analyzes were used to show that the material is relatively spherical in shape and nanosized. It is shown in the UV absorption peaks that ZnO NPs peak at 368 nm. XRD and additionally EDX confirmed the purity of the material, and FTIR spectra confirmed the functional group of ZnO NPs. Melon byproducts were evaluated for total phenolic and DPPH activity with different solvent concentrations. ZnO NPs synthesized using melon by-product extract rich in polyphenols were also evaluated in terms of total phenolic and DPPH activity. Nanoparticles exhibited antioxidant activity. It was understood that secondary metabolites from the extract were used as capping agents.
Electric Motor Health Monitoring Using a Deep Variational Autoencoder (D-VAE)
Authors: Dehghani Adnan , Rahim Sharafiz , Rez Khairil Anas Md , Abidin Abdul Murad Zainal , Mohd Azahar , KHALID SITI NOR AZILA , YUNUS MOHAMAD FIKRI MOHAMAD , RASHID ZAMIL HISHAM ABDUL
Published: July 2024

The integration of the Industrial Internet of Things (IoT) and machine learning techniques in condition-based maintenance (CBM) systems represents a significant advancement in the monitoring and maintenance of electromotors, particularly those used in elevator systems. This study explores the effectiveness of a Condition Based Maintenance (CBM) framework utilizing Arduino microcontrollers and Microelectromechanical Systems (MEMS) sensors for real-time vibration data collection, coupled with the analysis through a Deep Variational Auto-Encoder (D-VAE) model for anomaly detection in electromotor operation particularly in the elevator system. Traditional methods such as Isolation Forest and K-means clustering, enhanced by Principal Component Analysis (PCA), are also implemented for comparative analysis. The performance of these models is evaluated using unsupervised learning metrics, including the silhouette score, Davies-Bouldin Index, and Calinski-Harabasz score, to assess their efficacy in detecting anomalies within vibration data indicative of potential electromotor malfunctions. Our findings suggest the superior capability of the D-VAE model in discerning between normal and faulty operational states through detailed clustering, despite some limitations under problematic conditions. This study underscores the potential of data-driven approaches and IoT technologies in enhancing operational efficiency, reliability, and safety in elevator systems through predictive maintenance strategies.
Health-related quality of life of people with depression: pre-post intervention compared with age-matched general population in Vietnam
Authors: Hoa Truong Thi My , Ngan Tran Thu , Mai Vu Quynh , Minh Hoang Van , Thu Nguyen Khac , Nhu Tran Kieu
Published: July 2024

Background
There is a paucity of health-related quality of life (HRQoL) research on people with depression as well as a lack of evidence on supported self-management (SSM) intervention for depression on HRQoL in Vietnam. This study aimed to compare the HRQoL of people with depression and age-matched people in the Vietnamese population, evaluate the effects of Tele-SSM intervention on HRQoL, and examine the association between the changes in HRQoL score and mental health well-being (depression, anxiety, and stress).
Methods
This study was a pre- and post-study involving Vietnamese adults aged 18–64 who had depression symptoms (score ≥ 5 points in the PHQ-9). Participants (N = 58) completed Tele-SSM - a supported self-management intervention incorporating cognitive behavioral therapy and non-violent communication and using a task-shifting approach. To compare with the general population, we conducted 1-to-1 matching by age with an EQ-5D-5L valuation study with a nationally representative sample of the Vietnamese general population.
Results
HRQoL is significantly impaired in people with depression compared to the age-matched general population. Regarding health profile, participants reported the most difficulties in usual activities, pain/discomfort, and anxiety/depression dimensions. Significant improvements were observed in HRQoL scores post-intervention compared to pre-intervention in both EQ-VAS scores (from 59.84 to 79.48) and utility scores (from 0.79 to 0.09). These results remained lower than the age-matched general population (EQ-VAS score = 83.28, utility score = 0.96). Depression was associated with lower HRQoL while controlling for stress, anxiety symptoms and sociodemographic characteristics.
Conclusions
These results indicate that HRQoL is significantly impaired in people with depression and contribute to providing empirical evidence of Tele-SSM intervention in improving HRQoL. Further randomized controlled trials should be conducted to evaluate effectiveness and cost-effectiveness of the Tele-SSM intervention.
A Unsupervised graph comparison learning-based click-through rate prediction model
Authors: He Mingxiang , Bo Xina , li Guan , Sun Cheng'ai
Published: July 2024

Click-through rate (CTR) prediction refers to the estimation of the probability that a given user will click on a given advertisement, with the objective of displaying items of greater interest to the user. In this paper, we propose a clickthrough rate prediction model based on unsupervised graph comparison learning (USGCL-CTR) to address the issue of a decline in model prediction accuracy due to the neglecting the introduction of noise caused by useless feature interactions in existing CTR prediction models based on GNNs. To facilitate the transformation of the modeling task of feature interactions into the modeling of node interactions on the corresponding graph, the feature domain is visually represented as a graph structure following the embedding layer. Subsequently, noisy edges are removed by a designed feature interaction selection layer based on unsupervised graph comparison learning. In USGCL-CTR, we utilize metric learning to establish an ’anchor graph’, serving as a guide for the optimization of the graph structure. We then apply contrast loss to maximize the interaction information between the anchor graph and the learned structure. By eliminating unproductive feature interactions, the denoised feature map significantly enhances the precision of CTR predictions. Comparative experiments were carried out against eight baseline models on three open-source datasets. The results clearly showed that our proposed USGCL-CTR model surpassed all baseline models in performance.
An unusual case of acute pseudogout in the hand masquerading as cellulitis
Authors: meng yake , zhou lili , wang huang , yao jun , pan Hao
Published: July 2024

Calcium pyrophosphate dihydrate (CPPD) disease is the third most common inflammatory arthritides primarily affecting the elderly. We present a case of acute pseudogout of the hand whose symptoms mimicked cellulitis. Our patient presented with a swollen hand which were initially treated as acute cellulitis with antibiotics but without any improvement. A final diagnosis of acute chondrocalcinosis was made based on multiple intra-articular calcifications.
Brain Tumor and Mood Disorders: A Retrospective Analysis of Anxiety and Depression in Patients with Primary and Metastatic Brain Tumors
Authors: Kang Xiaoman , Ge Yulu , Zhang Xin , Yang Tianrui , Xia Yu , Wang Yaning , Li Junlin , Chen Wenlin , Zhang Kun , Xiao Zhiyuan , Wu Jiaming , Song Yixuan , Cao Yaning , Dong Yijun , Wang Yuekun , Xing Hao , Guo Xiaopeng , Wang Yu , Ma Wenbin
Published: July 2024

Brain tumors are associated with a dismal prognosis, and the diagnosis of intracranial tumors can evoke significant psychological disturbance. However, the evolution of patients' emotional status over the clinical course of brain tumors is less well understood. This study aims to document the prevalence of anxiety and depression in brain tumor patients and examine the risk factors associated with postoperative emotional derangement. Their psychological conditions were assessed using the Hospital Anxiety and Depression Scale (HADS) at various preoperative and postoperative time points. A total of 159 patients who underwent surgery and underwent HADS assessment between May 2018 and November 2020 were included in the analysis, with 112 gliomas and 47 metastatic brain tumors. After surgery, the incidence of anxiety increased for the glioma group (from 3.8–11.2%) and the metastatic brain tumor group (from 8.9–11.1%). Similarly, the prevalence of depression increased among glioma patients (from 8.6–18.4%) and metastatic tumor patients (from 20.0–31.1%). In either the glioma or metastatic group, tumors involving the frontal lobe were associated with a significant increase in postoperative HADS depression score. Univariate analysis among glioma patients indicated that males exhibited a reduced risk of postoperative exacerbation of anxiety, while right-sided tumors were associated with a decreased risk of postoperative worsening of depression. In the metastatic group, a BMI > 24 was a risk factor for postoperative anxiety exacerbation, whereas a temporal-lobe lesion was a protective factor in HADS depression worsening after surgery. The findings from the present research illustrate patient characteristics with a higher risk of psychological disturbance exacerbation postoperatively, aiding in early prevention and improving the quality of life among patients with intracranial tumors.
Uncommon Triple Vessel Spontaneous Coronary Artery Dissection in the Setting of Polyarteritis Nodosa: A Case Report
Authors: Lahmouch Nouhaila , Faraj Raid , Cherkaoui Soukaina , Nafii Omar , Sarsari Mohamed , Kerrouani Oualid , Allalat Idriss , Zarzur Jamila , Cherti Mohamed
Published: July 2024

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndromes (ACS) not related to atherosclerosis. It involves the sudden tearing of the coronary artery wall, separating the inner intimal lining from the outer vessel wall, typically affecting a single coronary vessel. In 20% of cases, the cause of SCAD is unknown. The other cases often occur in pregnant or postpartum women, or in individuals with conditions like connective tissue disorders or vasculitis. Here, we describe a case of a 69-year-old female presenting with non-ST-segment elevation myocardial infarction (NSTEMI). Coronary angiography revealed an unusual triple-vessel spontaneous coronary artery dissection (SCAD) affecting peripheral segments, with further investigations suggesting Polyarteritis nodosa (PAN). While triple-vessel SCAD and PAN are individually rare, their coexistence is exceptionally uncommon and presents diagnostic and therapeutic challenges. Clinicians should be alert to vasculitic causes in SCAD patients, especially with atypical clinical features.
Development of a quality indicator set for the optimal acute management of moderate to severe traumatic brain injury in the Australian context
Authors: Jeffcote Toby , Battistuzzo Camila R , Roach Rebecca , Bell Catherine , Bendinelli Cino , Rashford Stephen , Jithoo Ron , Gabbe Belinda J , Flower Oliver , O'Reilly Gerard , Campbell Lewis T , Cooper D James , Balogh Zsolt J , Udy Andrew U
Published: July 2024

Background

The aim of this study was to develop a consensus-based set of indicators of high-quality acute moderate to severe TBI (msTBI) clinical management that can be used to measure structure, process and outcome factors that are likely to influence patient outcomes. This is the first stage of the PRECISION-TBI program which is a prospective cohort study that aims to identify and promote optimal clinical management of msTBI in Australia.

Methods

A preliminary set of 45 quality indicators was developed based on available evidence. An advisory committee of established experts in the field refined the initial indicator set in terms of content coverage, proportional representation, contamination and supporting evidence. The refined indicator set was then distributed to a wider Delphi panel for assessment of each indicator in terms of validity, measurement feasibility, variability and action feasibility. Inclusion in the final indicator set was contingent on pre-specified inclusion scoring.

Results

The indicator set was structured according to the care pathway of msTBI and included pre-hospital, emergency department, neurosurgical, intensive care, and rehabilitation indicators. Measurement domains included structure indicators, logistic indicators and clinical management indicators. The Delphi panel consisted of 44 participants (84% physician, 12% nursing, 4% primary research) with a median of 15 years of practice. Of the 47 indicators included in the second round of the Delphi, 32 indicators were approved by the Delphi group.

Conclusion

This study identified a set of 32 quality indicators that can be used to structure data collection to drive quality improvement in the clinical management of msTBI. They will also be used to guide feedback to PRECISION-TBI’s participating sites.
Deciphering the Subtypes of Oily Sensitive Skin in Chinese Women: A Comprehensive Classification and Analysis
Authors: Kuang Xinjue , Lin Caini , Fu Yuanyuan , Wang Yuhui , Gong Junhua , Chen Yong , Liu Youting , Yi Fan
Published: July 2024

Background
Oily sensitive skin is complex that requires accurate identification and personalized care. However, the current classification method relies on subjective assessment.
Objectives
This study aimed to create a skin type and subtype classification using objective biophysical parameters to investigate differences in skin characteristics across anatomical and morphological regions.
Methods
This study involved 200 Chinese women. Noninvasive capture of biophysical measures and image analysis yielded 104 parameters. Key classification parameters were identified through mechanisms and characteristics, with thresholds set using statistical methods.
Results
This study identified the optimal ternary value classification method for dividing skin types into dry, neutral, and oily types based on tertiles of biophysical parameters, and further into barrier-sensitive, neurosensitive, and inflammatory-sensitive types. Oily sensitive skin showed increased sebum, pore, redness, dullness, wrinkles, and porphyrins, along with a tendency for oiliness and early acne. Subtypes exhibited specific characteristics: barrier-sensitive was rough with a high pH and was prone to acne; neurosensitive had increased TEWL and sensitivity; and inflammatory-sensitive exhibited a darker tone, with low elasticity and uneven redness.
Conclusions
This study established an objective classification system for skin types and subtypes using noninvasive parameters, clarifying the need for care for oily sensitive skin and supporting personalized skincare.
Heterozygous CELF4 variants in the N-term region crucial for the RNA-binding activity, leads to neurodevelopmental disorder and obesity.
Authors: Bruel Ange-Line , Silfhout Anneke Vulto-van , Bilan Frederic , Guyader Gwenaël Le , Gilbert-Dussardier Brigitte , Horn Xavier Le Guillou , Rondeau Sophie , RIO Marlène , Lee Kristen , Beil Adelyn , Suri Mohnish , Guerin François , Ruault Valentin , Goldenberg Alice , Lecoquierre François , Bertsch Nicole , Anderson Rhonda , Yang Xiao-Ru , Inness Micheil , Rikeros-Orozco Emi , Palomares-Bralo Maria , Hayek Jennifer , Cech Jennifer , Jhuraney Ankita , Kumar Runjun , Mercimek-Andrews Saadet , Ambrose Anastasia , Wakeling Erin , Wentzensen Ingrid , Torti Erin , Gooch Catherine , Faivre Laurence , Philippe Christophe , Duffourd Yannis , Vitobello Antonio , Thauvin-Robinet Christel
Published: July 2024

RNA-binding proteins play a key role in post-transcriptional events, such as mRNA splicing, transport, stability, translation and decay. Dysregulation of RNA life can have dramatic consequences. CELF RNA-binding proteins appear to be essential during embryo development. In this study, we identified fifteen patients with heterozygous missense or loss-of-function variants in the CELF4 gene by exome or genome sequencing. All variants affecting the N-terminus of the protein are essential and sufficient for the RNA-binding and splicing activity or RRM domains. Most patients presented with neurodevelopmental disorders including global developmental delay/intellectual disability (11/14), seizures (9/15), and overweight/obesity (10/14) that began in childhood. Clinical features are similar to the reported celf4-mouse mutant phenotype. This study highlights the essential role of CELF4 in development and its involvement as a novel etiology of neurodevelopmental disorders with obesity.
An improvement in visual acuity accompanied by the development of RPE tear: A Case Report
Authors: Liu Xinyu , Liu Shulin , Xu Zhiyan , Chen Youxin
Published: July 2024

Background
One well-known side effect of retinal pigment epithelial detachment was retinal pigment epithelium tear. It was widely acknowledged as a disastrous event causing major decline in visual acuity. However, in our case, the retinal pigment epithelium tear led to the improvement of visual acuity.
Case presentation:
A 68-year-old male complained of blurry vision in his right eye over a month. A diagnosis of pachychoroid neovasculopathy was made. After three anti-vascular endothelial growth factor injections once a month, the choroidal neovascular membrane gradually diminished, while the pigment epithelial detachment expanded, subretinal fluid increased and the patient’s visual acuity deteriorated. Three months later, a retinal pigment epithelium tear was detected near the fovea, surprisingly along with a complete resolution of the subretinal fluid and a remarkable improvement of visual acuity.
Conclusions
Our case report presents a significant improvement in visual acuity after the retinal pigment epithelium tear development. The main reason was the drainage of pigment epithelial detachment by retinal pigment epithelial tear. The case indicated that surgical drainage of pigment epithelial detachment can be an effective treatment and needs further exploration.
Clinical Diagnostic Study of Inflammatory Cytokines in Aqueous Humor of Patients with Posner-Schlossman Syndrome
Authors: Liu Yu , Kong Xiangmei , Li Shengjie , Wang Zhujian , Cao Wenjun , Gong Yifan
Published: July 2024

Purpose: To detect the levels of inflammatory cytokines in the aqueous humor (AH) of Posner-Schlossman syndrome (PSS) patients and to evaluate their correlation with ophthalmic parameters in PSS patients.
Methods: Aqueous humor (AH) samples were obtained from 29 eyes of PSS patients and 16 eyes of age-related cataract (ARC) patients (control group) diagnosed in the Eye and ENT Hospital, Fudan University. Multiplex microsphere flow cytometric immunoassay was used to detect multiple inflammatory cytokines in AH, including interleukin 1β (IL-1β), interleukin 2 (IL-2), interleukin 4 (IL-4), interleukin 5 (IL-5), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10), interleukin 12 (IL-12), interleukin 17 (IL-17), tumor necrosis factor (TNF)α, and interferon (IFN) γ. We collected ophthalmic parameters, including corneal endothelial cell density, visual acuity, intraocular pressure (IOP), and visual field respectively. Independent sample t-tests/Mann-Whitney U tests were used for intergroup comparisons, and ROC curves were analyzed using MedCalc19.6.
Results: The levels of IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IFN-γ, and TNF-α in the AH of PSS patients were significantly higher than that in the control group (P<0.05). IL-6 showed a positive correlation with PSS key ophthalmic parameters IOP (r=0.430, P=0.025) and relative decrease in CECD loss between the affected eye and the fellow eye (RECL) (r=0.453, P=0.039) and a negative correlation with corneal endothelial cell count (r=-0.463, P=0.035). The ROC curves showed that IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, IFN-γ, and TNF-α had diagnostic value for PSS (P<0.05).
Conclusion: The cytokine levels in the AH of PSS patients were abnormal, suggesting that inflammatory cytokines may also be involved in the pathogenesis of PSS.
Note: CECD, corneal endothelial cell density; RECL, relative decrease in CECD loss between the affected eye and the fellow eye
A digital twin study on thoracic endovascular repair for Stanford type B aortic dissection
Authors: Liu Xiao , Cao Zhongze , Luo Mingyao , Tao Fei , Shu Chang
Published: July 2024

Thoracic endovascular aortic repair (TEVAR) remains the treatment of choice for Stanford type B aortic dissection (TBAD). In this study, we apply a novel machine learning-based (ML-based) digital twin (DT) method to study the relationship between preoperative indicators, inflammation markers, endoleaks (EL) and long-term outcome of patients who received TEVAR. Our result shows that most postoperative indicators are closely related to their preoperative indicators. We also find that height and onset time of TBAD may be related to the occurrence of EL, while long-term outcome is more related to age, body weight and proximal diameter of endograft applied. Besides, our models successfully predict the occurrence of EL and long-term outcome of patients to some extent based only on pre-operative and operative information. In conclusion, this study represents a novel application of DT technology in clinical settings, which could lead to predictive, preventive and personalized treatments in future.
Neurochemical Dynamics during Two Hypnotic States: Evidence from Magnetic Resonance Spectroscopy
Authors: Bruegger Mike , de Matos Nuno Prates , Staempfli Philipp , Zoelch Niklaus , Seifritz Erich
Published: July 2024

This study explores neurochemical changes in the brain during hypnosis, targeting the parieto-occipital (PO) and posterior superior temporal gyrus (pSTG) regions using proton magnetic resonance spectroscopy (MRS). We examined 52 healthy, hypnosis experienced participants to investigate how two different hypnotic states of varying depth impacted brain neurochemistry in comparison to each other and to their respective non-hypnagogic control conditions. Alongside neurochemical assessments, we recorded respiration and heart rate variability (HRV) to further explore possible association between physiological correlates of hypnotic depth. Significant myo-Inositol concentration changes were observed in the PO region during the deeper hypnosis state, possibly indicating reduced neuronal activity. No significant neurochemical shifts were detected in the pSTG region. Additionally, our findings revealed notable physiological changes during hypnosis. Respiratory rates were significantly slowed in both hypnotic states compared to the respective controls, with more pronounced slowing in the deeper hypnotic state. Furthermore, breathing rate differed significantly between both hypnosis states with a stronger decrease during the deeper state This study contributes a first-time insight into neurochemical responses during hypnotic states. We hope offering a foundation for further research in understanding the neurobiological correlates of hypnosis in both, basic science and – down the line - clinical applications.
Combining restricted gene flow, local microhabitat, and habitat fragmentation shapes the fine-scale spatial genetic structure of Fagus hayatae Palib. ex Hayata in Micang Mountain
Authors: Chen Jiayu , Xie Gang , Jiang Chaoyang , Zhang Xuemei , Han Hongyan , Yin Qingxiao , Tang Kun , Gan Xiaohong
Published: July 2024

The beech species Fagus hayatae Palib. ex Hayata is an important relict tree species in subtropical China, which accumulated a wealth of genetic variation during evolution. To revealing its regeneration dynamics, we analyzed the spatial genetic structure and gene flow of Fagus hayatae natural population in Micang Mountain (MCM), China, by using 10 pairs of microsatellite primers. The genetic diversity of F. hayatae MCM population was at the low level among tall trees. The results of Fij and Sp analysis showed that the SGS strength of F. hayatae in MCM were 40 m, the strength of SGS was stronger in saplings compared to adult and old trees. The mean dispersal distance of pollen and seeds were 83.04 m and 30.14 m, respectively. In fine-scale space, F. hayatae population in MCM is poor in genetic variation due to the restricted gene flow and significant SGS, and the strength of SGS and the dispersal distance of gene flow of F. hayatae are influenced by the limited seed dispersal, habitat fragmentation, and microhabitats. During ex situ protection of F. hayatae, the sampling distance between individuals should be greater than 40 m to ensure the most complete genetic efficiency.