bluuebunny/crossref_metadata_2025 huggingface dataset:
Micro-Scale Mapping of Soil Organic Carbon: The Potential of Soft X-Ray Spectromicroscopy
Authors: Dor Maoz , Regier Tom , Arthur Zachary , Guber Andrey , Kravchenko Alexandra
Published: August 2024

Soil organic carbon (SOC) plays a crucial role in soil fertility, productivity, and global carbon cycling. However, the mechanisms governing SOC persistence and turnover are not fully understood, hindering effective carbon management strategies. Especially limiting are challenges to visualize and characterize spatial distribution patterns of SOC within the intact soil. This study presents a novel approach to map carbon content and composition in intact environmental samples using synchrotron X-ray spectromicroscopy at a 4-100 µm resolution. X-ray fluorescence (XRF) maps provided an overview of the total carbon distribution, enabling the identification of carbon-rich regions of interest. Near edge X-ray absorption fine structure (NEXAFS) spectromicroscopy was then employed to obtain spatially resolved carbon speciation data within these regions. This method enabled the analysis of relatively large intact samples (16,000 µm Ø and 15,000 µm height), preserving a variety of root and organic matter fragments as well as pores ranging in size from 35 to 850 mm. Spectral fitting using reference standards revealed distinct spatial patterns of aromatic, aliphatic, and carboxylic carbon compounds associated with different structural features. Aromatic carbon was enriched around root fragments and the soil matrix, while carboxylic compounds were concentrated at pore-matrix interfaces, suggesting a correlation between soil pore structure and carbon chemical composition. The proposed novel approach provides opportunities for future unprecedented insights into the interplay between pore architecture and organic molecular diversity, the two key factors governing mechanisms of SOC protection and persistence in the soil.
Cerebellar transcranial direct current stimulation improves quality of life in individuals with chronic post-stroke aphasia
Authors: Zheng Zhong Sheng , Wang Jing , Lee Sharon , Wang Kevin Xing-Long , Zhang Ben , Howard Melissa , Rosario Emily , Schnakers Caroline
Published: August 2024

Background
The cerebellum has emerged as a potential target for transcranial direct current stimulation (tDCS) in post-stroke aphasia (PSA) due to its role in language processing and relative preservation compared to supratentorial lesions. Recent evidence also highlights the cerebellum's involvement in affective and social processes, suggesting potential broader effects of cerebellar modulation. This study investigated the efficacy of anodal tDCS over the right cerebellum paired with speech and language therapy in enhancing language functions and quality of life in individuals with PSA.
Methods
Twenty-two participants with chronic PSA received cerebellar tDCS, while historical sham control data from 25 participants were obtained. Language outcomes were assessed using the Western Aphasia Battery-Revised (WAB-R), and secondary outcomes included patient-reported measures of communication effectiveness and quality of life. Mixed-design analyses of variance were conducted to examine treatment effects.
Results
No significant Group x Time interaction was found for WAB-R scores, indicating that tDCS did not provide additional language benefits over speech therapy. However, a significant Group x Time interaction was observed for the Stroke and Aphasia Quality of Life Scale-39 scores, driven by improvements in the Psychosocial, Physical, and Energy subdomains in the tDCS group.
Conclusions
Cerebellar tDCS did not significantly improve language outcomes in PSA individuals but enhanced specific aspects of quality of life. These findings highlight the cerebellum's multifaceted role in cognitive, affective, and sensorimotor processes. Future research should focus on conducting well-powered, randomized, double-blind, and concurrent trials to validate these findings and explore optimal stimulation parameters in PSA rehabilitation.
Clinical Trial Registration: The trial is registered at ClinicalTrials.gov with the registration number NCT03699930. The date of registration is 10/05/2018.
Impact of pen space allowance in outdoor feedlot on cattle performance, and carcass and meat quality traits
Authors: Macitelli Fernanda , Costa M. J. R. Paranhos da
Published: August 2024

We analyzed the effects of feedlot pen space allowances on cattle performance and carcass and meat quality traits. Bulls (N = 1350) with an average age of 30 ± 6 months and weight of 392 ± 46 kg were assigned to one of three feedlot pen space allowances, 6 (T6), 12 (T12) and 24 (T24) m2/animal. The animals were weighed in the beginning and end of experimental period and individual average daily gain (ADG) was calculated. Hot carcass weight (HCW), fat cover (scored from 1 to 5), carcass bruise occurrences (classified as old or new and superficial, muscular, or severe), and meat pH24 were assessed in a commercial slaughterhouse. Treatment T24 showed higher (P<0.05) ADG than T6 and T12. T6 had lower (P<0.05) HCW than T12 and T24. T6 had the highest (P<0.05) percentage of carcass scored 3 for fat cover, followed by T24 and T12. In all the treatments pH24 were within the range that ensured good meat quality, ranging from 5.60 (T24) to 5.63 (T6). The mean of new bruises per carcass was lowest for T24 (P < 0.05) and did not differ between T6 and T12 (P>0.05). Superficial bruises were more frequent in T24 than in T6 and T12 carcasses (P<0.05), differing from each other, but the mean number of muscular bruises was higher in T6 than in T12 and T24 (P<0.05), which did not differ from each other (P>0.05). We conclude that reduced space in feedlot pens lessens beef cattle performance and downgrades carcass quality.
Two-Year Follow-Up clinical Study of Mini WELL Extended Depth-of-Focus Intraocular Lens Implantation: Performance and Safety Evaluation
Authors: Sborgia Alessandra , Curatolo Maria Cristina , Barattini Dionisio Franco , Niro Alfredo , Barattini Luca , Sborgia Giancarlo
Published: August 2024

Background
Cataracts can be effectively treated with intraocular lens (IOL) implantation following lens removal via phacoemulsification. The growing demand for additional correction of near and intermediate vision in the aging population has led to the development of multifocal intraocular lenses (IOLs). More recently, a novel class of intraocular lenses (IOLs), known as extended depth-of-focus (EDoF) IOLs, was introduced. The EDoF IOLs extend a single focal point over a range of distances, thereby enhancing intermediate and near performance and providing greater spectacle independence. Moreover, EDoF IOLs represent a promising solution to minimize photic phenomena and contrast sensitivity (CS) issues associated with traditional multifocal IOLs. Currently, there is a lack of long-term data on the performance and safety of EDoF lenses.
Methods
This monocentric, retrospective, observational, open-label investigation was aimed at assessing the long-term (two years) performance and safety of the EDoF Mini WELL after IOL implantation. The study included 23 male and female patients who underwent cataract surgery with the Mini WELL. Data collection included subjective refraction, defocus curve assessment, uncorrected and corrected visual acuity at all distances, binocular reading performance, contrast sensitivity (CS), Visual Function Questionnaire VF-11R, and the collection of potential adverse events during the two-year follow-up period.
Results
The results demonstrated that Mini WELL provided a long-term visual performance, safety profile, and improved reading speed. The defocus curve indicates a continuous range of vision without a significant loss in intermediate vision. A high percentage of patients maintained the clear vision outcomes, for both monocular and binocular measures, at the two-year follow-up. No adverse events (AEs) were reported.
Conclusion
The use of EDoF Mini WELL represents an interesting option for the long-term solution for visual correction of aphakia in adult patients with presbyopia.
Trial registration
The retrospective study was registered in the ClinicalTrials.gov database as NCT04801992 on March 15, 2021
Determinants of Developing Cardiovascular Disease Risk with Emphasis on Type-2 Diabetes and Predictive Modeling Utilizing Machine Learning Algorithms
Authors: Das Shatabdi , Rahman Riaz , Talukder Ashis
Published: August 2024

Background
This research aims to enhance our comprehensive understanding of the influence of type-2 diabetes on the development of Cardiovascular diseases (CVD) risk, its underlying determinants, and to construct precise predictive models capable of accurately assessing CVD risk within the context of Bangladesh.
Methods
This study combined data from the 2011 and 2017-18 Bangladesh Demographic and Health Surveys, focusing on individuals with hypertension. CVD development followed WHO guidelines. Eight machine learning algorithms (Support Vector Machine, Logistic Regression, Decision Tree, Random Forest, Naïve Bayes, K-Nearest Neighbor, Light GBM, and XGBoost) were analyzed and compared using six evaluation metrics to assess model performance.
Results
The study reveals that individuals aged 35–54 years, 55–69 years, and ≥ 70 years face higher CVD risk with adjusted odds ratios (AOR) of 2.140, 3.015, and 3.963, respectively, compared to those aged 18–34 years. 'Rich' respondents show increased CVD risk (AOR = 1.370, p < 0.01) compared to 'poor' individuals. Also, 'normal weight' (AOR = 1.489, p < 0.01) and 'overweight/obese' (AOR = 1.871, p < 0.01) individuals exhibit higher CVD risk than 'underweight' individuals. The predictive models achieve impressive performance, with 75.21% accuracy and an 80.79% AUC, with Random Forest (RF) excelling in specificity at 76.96%.
Conclusion
This research holds practical implications for targeted interventions based on identified significant factors, utilizing ML models for early detection and risk assessment, enhancing awareness and education, addressing urbanization-related lifestyle changes, improving healthcare infrastructure in rural areas, and implementing workplace interventions to mitigate stress and promote physical activity.
Impact of blood pressure control on left atrial diastolic function as determined by 2D speckle tracking echocardiography
Authors: MOUSA MOHAMED , El-Salam Zainab Abd , ElSawye Mostafa , Omran Azza , Aly Khaled
Published: August 2024

Aim and Objectives:
The study's objective is to investigate, in recently diagnosed individuals with systemic hypertension, the impact of appropriate blood pressure control on left atrial functions as assessed by 2D speckle echocardiography and electrocardiogram.
Patients and Methods:
Fifty patients with newly diagnosed systemic arterial hypertension who presented to Ain Shams University Hospitals were included in the study. The patients' demographic information, risk factors, general and local examinations, 12-lead ECGs, 2D speckle tracking echocardiograms, and laboratory measurements were evaluated. Following six months of appropriate blood pressure (BP) control in accordance with JNC 10, the patients were followed up.
Results
PALS (peak atrial longitudinal strain) increased in the current study, with a mean change of 35.04 ± 4.33 to 38.92 ± 5.52 and a P-value < 0. 001. The mean of PACS (peak atrial contraction strain) increased from 17.38 ± 4.67 to 20.46 ± 4.39, with a P-value of less than 0.001. The mitral peak early (E) and the septal mitral annular velocities (e`) and their average E/e' showed decrease with change of the mean from 8.8 ± 0.93 to 7.8 ± 1.16, with a P-value of less than 0.001. The mean of the left atrial stiffness index (LASI) decreased from 0.24 ± 0.04 to 0.2 ± 0.03, with a P-value less than 0.001. The ECG follow-up showed no discernible change in the P wave's duration or amplitude with P values of 0.135 and 0.785 respectively.
Conclusion
The results of this study showed that patients with hypertension may benefit from using speckle tracking imaging to identify mild impairment of left atrial (LA) function. PALS, PACS, E/e', and LASI improve in hypertensive patients when blood pressure is well controlled. Further research is warranted to better understand the significance of LA function using speckle tracking echocardiography (STE) in the prediction of atrial fibrillation and the risk of heart failure with preserved ejection fraction. This study highlights how important it is to measure LA function in hypertensive patients.
Association between palliative sedation and survival in terminally ill patients with cancer: a retrospective cohort study
Authors: Chen Mengmeng , Zhang Xinyan , Li Zhigang , Niu Jiejie , Zhang Zhen , Qi Jiachen , Lu Guijun
Published: August 2024

Background
Palliative care in China is in its early stages of development, with insufficient research on palliative sedation, especially concerning its potential effects on survival. This study aimed to conduct a cohort study among terminally ill patients with cancer in a palliative care ward to investigate the association between palliative sedation and survival.
Methods
This retrospective cohort study included patients admitted to the palliative care ward in Beijing Tsing Changgung Hospital from January 2019 to June 2023. Based on the administration of palliative sedation, patients were categorized into sedation and non-sedation groups. We compared survival between the two groups. Statistical analyses were performed using R and Free Statistics software.
Results
In this study, we included 212 terminal patients, with 121 undergoing palliative sedation and 91 not receiving sedation. The median survival for the sedation group was 12 days (95% CI: 9.519–14.481), compared to 7 days (95% CI: 4.811–9.189) for the non-sedation group, with a log-rank p-value of < 0.001, indicating significantly longer survival for the sedation group. After adjusting all key confounding factors, the mortality risk was 40% lower in the sedation group compared to the non-sedation group (HR = 0.6, 95% CI: 0.43–0.82, P = 0.002).
Conclusion
Our findings indicate that palliative sedation not only does not shorten but may potentially prolong the survival of terminally ill patients with cancer. This provides significant theoretical and practical support for palliative care physicians, allowing for the judicious use of palliative sedation when necessary.
Postoperative peritumoral edema is correlated with the prognosis in intracranial meningioma with preoperative peritumoral edema
Authors: Ying Yu-Zhe , Li Hao-Yi , Dong Ge-Hong , Ren Xiao-Hui , Wang Gui-Huai , Jiang Zhong-Li
Published: August 2024

Purpose
Peritumoral edema (PTE) in intracranial meningiomas correlates to surgical outcomes. But only depending on preoperative PTE in meningioma does not accurately predict the prognosis after resection. We aimed to investigate whether postoperative PTE could improve the prediction of prognosis of meningioma with preoperative PTE.
Methods
We retrospectively reviewed postoperative MRI scans in 3 months after operation of 371 patients with preoperative PTE of meningioma that underwent surgery between 2015 and 2017. All the patients were classified into two different groups according to whether had postoperative PTE receded within 3 months after operation. Clinical manifestations, histopathology characteristics, radiology data and follow-up outcomes were noted. T-tests and chi-square tests were used to compare clinical characteristics. Univariate and multivariate Cox analysis and Kaplan‒Meier methods were utilized to screen for clinical prognostic factors.
Result
Kaplan-Meier model showed that the progression-free survival of patients with postoperative PTE are shorter than who with postoperative PTE receded in 3 months after operation (HR = 3.30, P = 0.006). Multivariate Cox analyses showed that the risk factors of meningioma recurrence: high WHO grades (HR = 4.989, P<0.001), superior sagittal sinus invasion (HR = 2.290, P = 0.047), postoperative PTE in 3 months after operation (HR = 1.804, P = 0.044) and subtotal resection (HR = 3.940, P = 0.003).
Conclusion
According to our research, we found that postoperative PTE in 3 months after operation is related to the outcomes of meningioma with preoperative PTE. Besides, we demonstrated that there were also some factors for recurrence: male, high WHO grades, superior sagittal sinus invasion and subtotal resection.
Construction and immunotherapy analysis of hepatocellular carcinoma prognostic model based on membrane tension-related genes
Authors: zhu pengfei , Zhu Zijuan , Chen Zheling
Published: August 2024

Background：
The membrane of tumor epithelial cells is more flexible than normal cells, and higher membrane tension can effectively inhibit the migration and invasion of tumor cells. Innovative therapies targeting the physical characteristics of tumor cells are worthy of attention. To investigate the prognostic value of membrane tension-related genes (MTGRs) in hepatocellular carcinoma (HCC) and its relationship with immunotherapy.
Method:
We obtained RNA-seq data and clinical characteristics data for HCC from The Cancer Genome Atlas (TCGA) database, the (International Cancer Genome Consortium) ICGC database and GEO database. Combined with univariate Cox regression analysis and LASSO (least absolute shrinkage and selection operator) regression analyses, 3-MTRGs risk model was established. Kaplan-Meier survival analysis and receiver operating characteristic (ROC) curve were used to verify the model. The Nomogram model was constructed by combining the risk score and clinical characteristics, and its performance was evaluated by calibration curves. We conducted gene differential analysis and functional enrichment analysis on high- and low-risk groups, identifying relevant molecular pathways. Additionally, we analyzed the differences between the two groups in terms of immune cell infiltration, immune-related pathways, and immunotherapy. In addition, we analyzed single-cell sequencing data of HCC patients from the GEO database to study cellular infiltration in the tumor microenvironment and the distribution of model genes across different cell types. Finally, we validated the expression differences of model genes between HCC tissues and normal tissues using the GEO database (GSE121248 and GSE45267).
Results
3-MTRGs (CFL1, CRTC2, SRGAP2) were involved in the model construction, and the prognosis of patients in the low-risk group was better than that in the high-risk group. Kaplan-Meier survival curve and ROC curve illustrated that the model had reliable predictive value. Enrichment analysis showed that high-risk groups were mainly concentrated in the pathways related to TUMOR CELL CYCLE and ECM RECEPTOR INTERACTION. Immuno-correlation analysis of the two groups showed that the high-risk group was associated with immune escape. High-risk HCC patients exhibited notable sensitivity to chemotherapy drugs such as 5 - Fluorouracil, Dasatinib, Osimertinib and Paclitaxel. External data sets showed that the model genes were highly expressed in HCC tissues.
Conclusion
We selected three MTRGs ( CFL1, CRTC2 and SRGAP2) as prognostic indicators of HCC and established a Nomogram model to predict the prognosis and efficacy of immunotherapy in HCC patients.
Impact of Chromosomal Aberrations Detected by Chromosome Banding Analysis in Symptomatic Waldenström’s Macroglobulinemia
Authors: Ito Kenichi , Kitagawa Tomoko , Harada Kunihiko , Hirano Kazuhiko , Sekiguchi Naohiro
Published: August 2024

Background
The clinicopathologic features and prognostic impact of MYD88 L265P (MYDL265P) and CXCR4 mutations (CXCR4Mut) have been well reported, although little is known regarding the impact of chromosomal aberrations (CA) detected by chromosome banding analysis (CBA) in symptomatic Waldenström’s macroglobulinemia (sWM). Thus, we investigated the clinicopathologic features and prognostic impact in sWM with CAs identified by CBA.
Methods
We retrospectively analyzed the clinicopathologic results and genetic mutations by droplet digital PCR, fluorescence in situ hybridization (FISH), and CBA using the G-banding method from the bone marrow samples of sWM between April 2010 and March 2024 at our institute. The relationship between CAs and clinicopathologic features was evaluated, as well as the time to next treatment (TTNT).
Results
Thirty-five patients were enrolled. The median age was 71 years, and the median hemoglobin level was 10.1 g/dL. The median serum IgM and M-protein levels were 3,120 mg/dL and 3 g/dL, respectively. MYDL265P was found in 30/35 patients (85.7%), whereas CXCR4Mut was found in 3/35 patients (8.6%). Deletion 6q identified by FISH in 5/18 patients (28%), and CAs using CBA in 9/34 patients (26%), including 4/34 (12%) complex karyotypes. sWM with CAs had more anemia (p = 0.04) and hypoalbuminemia (p = 0.007), in addition to higher serum M-protein and IgM levels (p = 0.03). With a median follow-up of 73 months, the median TTNT in patients with and without CAs was 27 and 68 months, respectively.
Conclusions
CAs with CBA may be associated with clinical aggressiveness and shorter TTNT in sWM.
Assessing Knowledge, Attitude, and Practices (KAP) of Food Safety Among Dhaka City's Street Food Vendors : A Public Health Issue
Authors: Ahmed Md Jisan , Ali Mahabbat , Alam Kazi Estieque , Mamun Mustakim , Bhuiyan Md Ismile Hossain , Bhandari Prajwal , Chalise Ritu , Naem S. M. Zannatul , Rahi Md Afiqul Islam , Islam Khairul , Bristy Fahmida , Khatun Amina , Sabrin Mirza Synthia
Published: August 2024

Street food is a popular food culture in Bangladesh, offering affordable and accessible meals to the population. However, it raises significant public health concerns due to inadequate hygiene practices, leading to widespread foodborne illnesses. Therefore, this study aimed to assess the food safety knowledge, attitude, and practice (KAP) of food vendors in Dhaka. A cross-sectional study was conducted among 400 street food vendors in Dhaka City. Descriptive statistics were used to analyze the KAP, and multivariate models, including linear and ordinal logistic regression, were used to explore the associations between these factors. The study revealed that approximately 96% of sellers were male. Most of the participants (48.25%) had a primary level of education and 93.50% of vendors had no training in food safety. Approximately 62% of respondents had adequate knowledge of food safety, 81% had a righteous attitude, and only 12% exhibited a proper food safety practice regarding food handling. Factors such as experience, education, training in food safety and preparation, and body weight of vendors influenced KAP. These results highlight the need for focused education and training on food safety among vendors. The government needs to implement and uphold legislation and regulations concerning food safety among street food vendors.
Fumarate activates the IL-6/JAK/STAT3 pathway by inhibiting KDM4C-mediated H3K36me3 demethylation in FH-knockdown renal cancer cells
Authors: Chen Ni , Xian Jie , pan xiuyi , zheng linmao , yin xiaoxue , zhang mengxin , Wei Yu , Tan Junya , Zhang Mengni , Nie Ling , chen xueqin , Zeng Hao , Zhou Qiao
Published: August 2024

Fumarate is a small molecule metabolite that plays a key role in the malignant transformation of cells, yet the underlying mechanism remains unclear. Herein, we discovered that accumulated fumarate in fumarate hydratase (FH)-knockdown ACHN and HK-2 cells competitively binds to α-ketoglutaric acid (α-KG), effectively inhibiting the activity of the histone demethylase KDM4C and significantly increasing the level of histone 3 lysine 36 trimethylation (H3K36me3). The upregulation of H3K36me3 expression triggered the activation of the IL-6/JAK/STAT3 oncogenic signaling pathway and increased the expression of the chemokine CXCL10. Phosphorylated STAT3 (p-STAT3) further enhanced programmed cell death ligand 1 (PD-L1) expression. Therefore, our study identified a novel regulatory mechanism in FH-knockdown cells in which fumarate accumulation inhibits KDM4C activity, resulting in epigenetic and gene expression dysregulation. Collectively, these findings suggest that combining immune checkpoint blockade (ICB) with a STAT3 inhibitor may hold promise for patients with fumarate hydratase-deficient renal cell carcinoma.
Minimizing infectious complications following transrectal prostate biopsy: a proposal for a risk-adapted antibiotic treatment strategy with Ceftriaxone and Ertapenem as key components
Authors: Ortner Gernot , Fritz Veronika , Schachtner Jörg , Gkolezakis Vasilios , Herrmann Thomas R.W. , Nagele Udo , Tokas Theodoros
Published: August 2024

Purpose
To investigate the effect of pre-biopsy rectal swab and urine screening combined with a risk-adapted antibiotic treatment strategy on reducing post-biopsy infections (PBIs) following multiparametric magnetic resonance imaging (mpMRI)/ transrectal ultrasound (TRUS) fusion-targeted transrectal prostate biopsy (TRPBx).
Methods
1182 Patients undergoing mpMRI-TRUS fusion TRPBx between June 2017 and February 2024 were included. Patients were screened for rectal extended-spectrum beta-lactamase (ESBL)/multi-resistant gram-negative (MRGN) and urinary pathogens. Standard-risk patients (rectal non-ESBL/MRGN-carriers) either received Cefuroxime (2017–2020) or Ceftriaxone (2020–2024) intravenously before biopsy. For high-risk patients (rectal ESBL/MRGN-carriers) intravenous Ertapenem was used. Patients with positive urine cultures received oral targeted prophylaxis. PBIs were the primary outcome of the study. We used uni- and multivariate logistic regression analysis (MLRA) to reveal predictors for the main outcome.
Results
Rectal ESBL/MRGN prevalence was 6.3%. For standard-risk patients, PBI-rates were 8.1% and 0.24% for Cefuroxime and Ceftriaxone (p < 0.0001), respectively. Only 1.7% of high-risk patients treated with Ertapenem developed PBI. On MLRA, Cefuroxime (OR 19.3, 95%-CI: 6.96–68.1), Ciprofloxacin (OR 35.5, 95%-CI: 7.91–160), oral targeted antibiotics (OR 20.2, 95%-CI: 0.97–157) (reference Ceftriaxone, all p < 0.001) and prostate volume (OR 1.01, 95%-CI: 1.00-1.03, p = 0.033) were significant predictors for PBI whereas Ertapenem (OR 3.28 95%-CI: 0.17–22.6, p = 0.3) was not.
Conclusion
By integrating rectal swab ESBL/MRGN and urine screening, we developed a tailored antibiotic treatment strategy, resulting in low PBI-rates following TRPBx. Carbapenem-based treatment of high-risk patients is crucial. Ceftriaxone should be considered for routine use in standard-risk patients and shows comparable PBI-rates to the transperineal approach.
Safety and efficacy of dapagliflozin in recurrent ascites: a pilot study
Authors: Singh Virendra , De Arka , Aggrawal Rishav , Singh Akash , Charak Swati , Bhagat Naveen
Published: August 2024

Background
In cirrhosis, activation of renin-angiotensin-aldosterone system leads to sodium and water retention causing ascites. Dapagliflozin, a sodium glucose linked transporter-2 inhibitor, induces natriuresis in patients with heart failure. A similar natriuretic effect may improve ascites in patients with cirrhosis. In this pilot study, we evaluated the safety and efficacy of dapagliflozin in patients with cirrhosis with recurrent ascites.
Methods
Forty patients with recurrent ascites and cirrhosis were randomized to 1:1 in a double blinded fashion to receive either dapagliflozin (10 mg/day) with standard medical therapy (Group A) or placebo with standard medical therapy (Group B). The primary outcome was control of ascites at 6-months. Secondary outcomes were urine output, 24-hour urinary sodium, Child Turcotte Pugh (CTP), model for end stage liver disease (MELD) scores, survival at 6-months, incidence of acute kidney injury (AKI) and infections.
Results
The 2 groups were comparable at baseline. Control of ascites at 6-months was significantly better in group A than that in Group B (p = 0.04). Change in urinary sodium was significantly higher in Group A (p < 0.001]. However, there was no difference in change in urine output, CTP or MELD scores and survival (65% vs 72.2%, p = 0.75) between the groups at 6-months. Incidence of AKI (50% vs 15%, p = 0.04) and infections (55% vs 20%, p = 0.04) were significantly higher in Group A.
Conclusions
Significantly better control of ascites and higher natriuresis are observed with dapagliflozin. However, it does not improve disease severity scores or survival, and is associated with increased AKI and infections (NCT05014594).
Trial Registration Number- clinical trials.gov (NCT05014594)
Efficacy and Safety of Glp-1 Agonists on Metabolic Parameters in Non-diabetic Patients With Inflammatory Bowel Disease
Authors: St-Pierre Joëlle , Klein Jeremy , Choi Natalie K. , Fear Evan , Pannain Silvana , Rubin David T.
Published: August 2024

Background
Obesity in patients with IBD is increasing, accompanied by an increase in metabolic comorbidities. Although GLP-1 agonists have shown promise in weight reduction, their efficacy and safety in patients with IBD are underexplored. This study evaluated the impact of GLP-1-based therapies on weight loss and metabolic parameters in non-diabetic patients with IBD.
Methods
We conducted a single-center observational cohort study that included adult patients with IBD who were started on GLP-1-based therapy (semaglutide or tirzepatide) for weight loss from January 2021 to April 2024. The primary outcomes were changes in BMI and total body weight. Secondary outcomes included tolerability, safety, and changes in metabolic risk factors.
Results
The study included 36 patients with IBD, predominantly female (64%), with a median age of 45.5 years (IQR 41-51.5 years). The majority (67%) had Crohn's disease (CD) and on advanced therapy (86%). BMI significantly decreased from 34.0 (IQR 31.0-38.2) to 31.0 (IQR 29.0-36.1) with GLP-1-based therapy (p < 0.0001). Similarly, total body weight (TBW) significantly decreased by a median of 8.15 kg (IQR 15.9–2.2 kg; p < 0.0001). Although a decrease in total cholesterol and glycated hemoglobin was seen, this was not statistically significant (p = 0.0634 for total cholesterol, p = 0.0536 for glycated hemoglobin). No significant changes were observed in ALT or CRP levels. The most common side effects were nausea (31%) and constipation (25%).
Conclusions
GLP-1-based treatments can effectively reduce BMI in non-diabetic patients with IBD with manageable side effects. However, further studies are required to explore the long-term safety of GLP-1 agonists in the IBD population.
Age-related changes in sleep spindle characteristics in individuals over 75 years of age: a retrospective and comparative study
Authors: Poirson Bastien , Vandel Pierre , Bourdin Hubert , Galli Silvio
Published: August 2024

Background
Sleep and its architecture are affected and changing through the whole lifespan. We know main modifications of the macro-architecture with a shorter sleep, occurring earlier and being more fragmented. We have been studying sleep micro-architecture through its pathological modification in sleep, psychiatric or neurocognitive disorders whereas we are still unable to say if the sleep micro-architecture of an old and very old person is rather normal, under physiological changes, or a concern for a future disorder to appear. We wanted to evaluate age-related changes in sleep spindle characteristics in individuals over 75 years of age compared with younger individuals.
Methods
This was an exploratory study based on retrospective and comparative laboratory-based polysomnography data registered in the normal care routine for people over 75 years of age compared to people aged 65–74 years. We were studying their sleep spindle characteristics (localization, density, frequency, amplitude, and duration) in the N2 and N3 sleep stages. ANOVA and ANCOVA using age, sex and OSA were applied.
Results
We included 36 participants aged > 75 years and 57 participants aged between 65 and 74 years. An OSA diagnosis was most common in both groups. Older adults receive more medication to modify their sleep. Spindle localization becomes more central after 75 years of age. Changes in the other sleep spindle characteristics between the N2 and N3 sleep stages and between the slow and fast spindles were conformed to literature data, but age was a relevant modifier only for density and duration.
Conclusion
We observed the same sleep spindle characteristics in both age groups except for localization. We built our study on a short sample, and participants were not free of all sleep disorders. We could establish normative values through further studies with larger samples of people without any sleep disorders to understand the modifications in normal aging and pathological conditions and to reveal the predictive biomarker function of sleep spindles.
Modified Shiraki Procedure and Transverse Pedicled Island Flap Phalloplasty: A Clinical Study on Efficacy in Treating Severe Concealed Penis in Children
Authors: Pan Rifang , Li Zhaopan , Li Junzhong , Zhou Zhaowei , Liang Kunlan , Xiao Zhihua
Published: August 2024

Objective: To evaluate the clinical efficacy, advantages, and disadvantages of the modified Shiraki procedure and the transverse pedicled island flap phalloplasty in treating severe concealed penis in children.
Methods: This retrospective study included seventy children with severe concealed penis treated at Yulin First People's Hospital from June 2021 to January 2024. They were randomly assigned to either the observation group (n=35), undergoing the modified Shiraki procedure, or the control group (n=35), receiving the transverse pedicled island flap phalloplasty. We assessed average operation time, intraoperative blood loss, penile elongation, time until resolution of penile prepuce edema, flap infection or necrosis, penile erectile pain, prepuce skin redundancy, penile retraction, and overall penile appearance score six months postoperatively.
Results: The observation group showed significantly better average operative time and intraoperative blood loss compared to the control group (P < 0.05). The time for foreskin edema to regress was longer in the observation group (P < 0.05). No significant differences were noted in penile lengthening between groups (P > 0.05). The observation group had seven cases of refractory inner prepuce plate swelling and skin redundancy post-operation; two of these cases required secondary surgery，and without skin flap infection or necrosis . The control group reported one case of postoperative hemorrhage and four cases of infection and necrosis of the transferred flap, all resolved after prolonged dressing changes, with one case requiring surgical correction for scar contracture on the side of the penis. Neither group experienced penile erectile pain or retraction. Total complications and reoperations were similar between the groups. No significant difference in the overall penile appearance score was observed between the two groups six months post-surgery (P > 0.05).
Conclusion: Both the modified Shiraki procedure and the transverse pedicled island flap phalloplasty are effective for treating severe concealed penis in children. The former is characterized by shorter, simpler operations, while the latter offers better cosmetic outcomes despite its complexity.
Vitamin D Deficiency among Children Aged 2-59 Months with Severe Pneumonia attending a Ugandan Tertiary Hospital: a cross-sectional study
Authors: Elizabeth Jananga Imelda , Kiboneka Elizabeth , Ndeezi Grace , Malande Ombeva O. , Rebecca Nantanda , Elizabeth Kibaru
Published: August 2024

Background
Vitamin D is an immune modulator that regulates the production of antimicrobial peptides cathelicidin and Beta-defensins-2 which are important in the immune response. Global estimates of the deficiency are about 50% of the population. In Uganda, pneumonia is the 2nd leading cause of mortality and 3rd cause of morbidity in the under 5. The magnitude of Vitamin D deficiency among children with severe pneumonia in Uganda is unknown. The study was aimed at determining the prevalence and factors associated with vitamin D deficiency among children aged 2–59 months with severe pneumonia admitted to Mulago National Hospital.
Methods
A cross-sectional study done from January to December 2018. Patients were screened and consecutively enrolled. A pre-tested questionnaire was administered, detailed physical examination done, blood samples drawn for complete blood count, alkaline phosphate, calcium, and serum Vitamin D concentration 25(OHD)D was determined using an electrochemiluminescence assay. Data was analyzed using STATA version 14 software.
Results
One thousand one hundred and ninety-six patients were screened. Four hundred and four (404) met the inclusion criteria and were consecutively enrolled, three hundred and seventy-four (374) had completed information and their blood samples analyzed. Two hundred and thirteen (57%) had low vitamin D levels. Of these, 97 (25.9%) were vitamin D deficient (25OHD < 20ng/ml) CI: 21.68–30.56. The median age was 10 months (IQR: 4–19) with more than 60% being between the age of 2-12months. Factors statistically significantly associated with VDD was the caregiver's low level of education [AOR: 0.54(CI: 0.31–0.96)], WHZ <-3SD, high alkaline phosphate levels [AOR: 5.79(CI: 3.41–9.85)], presence of rachitic rosary [AOR: 4.42(CI: 2.04–9.55)] and widened wrist [AOR: 0.03(CI: 0.00-0.20)].
Conclusion
The prevalence of VDD was found to be high among children with severe pneumonia and this reduces with increasing age. One in every 4 children with severe pneumonia is vitamin D deficient. Children whose caretakers had post primary education were more likely to be vitamin D deficient. Interventional studies are recommended to explore more on the factors associated with Vitamin D deficiency may be necessary.
Adaptation Biases the Parallel Perception of Subitized Numerosities
Authors: Liu Wei , Zhao Xiaoke , Liu Ying , Li Yating , Li Jingguang
Published: August 2024

Numerosity adaptation, the phenomenon where prolonged exposure to a stimulus of greater numerosity makes the subsequent stimulus appear less numerous, and conversely, has been confined to moderated numerosities. This study investigated whether the estimation of small numerosities (1–4), which is performed rapidly and accurately due to the mechanism of subitizing, is susceptible to adaptation. After adapting to a 50-dot stimulus, participants were presented with stimuli consisting of 1–5 color sets. In some trials, participants were informed of the target color set before the presentation of the stimulus, while in others, they were instructed afterwards. When estimating dots in the single-color set or superset, no adaptation aftereffect was observed. The coefficient of variation (CV) was below 0.05, indicating the effective function of subitizing. However, when enumerating subsets in parallel, adaptation biased the estimation. The CV in estimating subitized numerosities was comparable to and correlated with that of estimating moderate numerosities, suggesting that subitizing was superseded by numerosity estimation. Greater aftereffects occur in the probe-after conditions, accompanied by higher perceptual uncertainty. The function of numerosity adaptation can be demonstrated within a Bayesian framework, where the prior adaptor is more weighted to optimize the detection of deviation under high uncertainty.
The Efficacy of 5% Apple Cider Vinegar Irrigant in Disinfecting the Necrotic Root Canals of Primary Teeth: A Randomized Clinical and Bacteriological Controlled Trial
Authors: Tolibah Yasser Alsayed , Mando Anas , Laflouf Mohannad , Achour Hassan , Alsalameh Samar
Published: August 2024

BackgroundIrrigants in endodontic treatment pose a challenge in Pediatric Dentistry, due to the complex anatomical characteristics of the primary teeth.ObjectivesTo assess the 5% apple cider vinegar effect in disinfecting the necrotic primary teeth root canals.Materials and MethodsThis clinical and bacteriological study included 30 anterior primary teeth in children aged 3 to 5 years. Canals received uniform isolation and mechanical preparation procedures. Sterile paper points were inserted for 60 seconds to collect preliminary swabs (S1) for a bacteriological study. Root canal walls were smoothed with an H-file corresponding to the last file used. Subsequently, canals were divided randomly at 1:1 allocation into two groups according to the irrigants used; Group1 consisted of 15 primary anterior teeth irrigated with 24 ml of 5% commercial apple cider vinegar solution, and Group 2 was irrigated with 24 ml of 5% sodium hypochlorite solution. Canals were dried with paper points, and paper points were placed in each canal for 60 seconds to collect a second bacterial swab (S2). Bacterial colonies of S1 and S2 were counted after 48-hour incubation at 37°C. Then, the bacterial colonies were compared using the decimal logarithm before and after applying the solution. The patients' guardians were interviewed 24 hours, 72 hours, and one week after the procedure to determine if the child had experienced any postoperative pain associated with the treated teeth.ResultsApple cider vinegar demonstrated a percentage of 51.56% reduction in CFU count, while the sodium hypochlorite group showed a rate of 87.49%. The postoperative pain assessment revealed no difference between the two groups regarding the utilized irrigants.ConclusionApple cider vinegar demonstrates effective antibacterial activity and could be a viable alternative irrigant to sodium hypochlorite for primary teeth.
Tactile false feedback biases emotional ratings through interoceptive embodiment
Authors: Patchitt Joel , Garkinkel Sarah , Strawson William H , Miller Mark , Tsakiris Manos , Clarke Andy , Critchley Hugo D
Published: August 2024

Mismatches between perceived and veridical physiological signals during false feedback (FFB) can bias emotional judgements. Paradigms using auditory FFB suggest perceived changes in heart rate (HR) increase ratings of emotional intensity irrespective of feedback type (increased or decreased HR), implicating right anterior insula as a mismatch comparator between exteroceptive and interoceptive information. However, few paradigms have examined effects of somatosensory FFB. Participants rated the emotional intensity of randomized facial expressions while they received 20 second blocks of pulsatile somatosensory stimulation at rates higher than HR, lower than HR, equivalent to HR, or no stimulation during a functional magnetic resonance neuroimaging scan. FFB exerted a bidirectional effect on reported intensity ratings of the emotional faces, increasing over the course of each 20 second stimulation block. Neuroimaging showed FFB engaging regions indicative of affective touch processing, embodiment, and reflex suppression. Contrasting higher vs lower HR FFB revealed engagement of right insula and centres supporting socio-emotional processing. Results indicate that exposure to pulsatile somatosensory stimulation can influence emotional judgements though its progressive embodiment as a perceived interoceptive arousal state, biasing how affective salience is ascribed to external stimuli. Results are consistent with multimodal integration of priors and prediction-error signalling in shaping perceptual judgments.
Epigenome-wide association study of objectively measured physical activity in peripheral blood leukocytes
Authors: Fragoso-Bargas Nicolas , Mcbride Nancy S , Lee-Ødegård Sindre , Lawlor Deborah A , Yousefi Paul D , Moen Gunn-Helen , Opsahl Julia O. , Jenum Anne Karen , Franks Paul W. , Prasad Rashmi B. , Qvigstad Elisabeth , Birkeland Kåre I. , Richardsen Kåre R. , Sommer Christine
Published: August 2024

Background
Few studies have explored the association between DNA methylation and physical activity. The aim of this study was to evaluate the association of objectively measured hours of sedentary behavior (SB) and moderate physical activity (MPA) with DNA methylation. We further aimed to explore the association between SB or MPA related CpG sites and cardiometabolic traits, gene expression, and genetic variation.
Results
For discovery, we performed cross sectional analyses in pregnant women from the Epigenetics in pregnancy (EPIPREG) sample with both DNA methylation (Illumina MethylationEPIC BeadChip) and objectively measured physical activity data (SenseWear™ Pro 3 armband) (European=244, South Asian=109). For EWAS of SB and MPA, two main models were designed: model 1) a linear mixed model adjusted for age, smoking, blood cell composition, including ancestry as random intercept, and model 2) which was additionally adjusted for the total number of steps per day. In model 1, we did not identify any CpG sites associated with neither SB nor MPA. In model 2, SB was positively associated (false discovery rate, FDR<0.05) with two CpG sites within the VSX1 gene. Both CpG sites were positively associated with BMI and were associated with several genetic variants in cis. MPA was associated with 122 significant CpG sites at FDR <0.05 (model 2). We further analyzed the ten most statistically significant MPA related CpG sites and found that they presented opposite associations with sedentary behavior and BMI. We were not able to replicate the SB and MPA related CpG sites in the Avon Longitudinal Study of Parents and Children (ALSPAC) with objectively measured physical activity from Actigraph (without steps/day available) and leucocyte DNA methylation measured in adolescence (n=408, European).
Conclusion
This study suggests associations of objectively measured SB and MPA with maternal DNA methylation in peripheral blood leukocytes, that needs to be confirmed in larger samples of similar study design.
Differences in placental pathology between COVID-19-induced preeclampsia-like syndrome and true preeclampsia
Authors: SERRANO Berta , GARRIDO-PONTNOU Marta , BONACINA Erika , GARCIA-RUIZ Itziar , GARCIA-MANAU Pablo , GARCIA-AGUILAR Paula , FERNÁNDEZ-HIDALGO Nuria , SULLEIRO Elena , CASTILLO-RIBELLES Laura , MAIZ Nerea , BARCO Ester DEL , CARRERAS Elena , SUY Anna , MENDOZA Manel
Published: August 2024

Background.
Women with COVID-19 may develop preeclampsia-like syndrome, which shares some of the clinical features of preeclampsia (PE) but lacking its characteristic angiogenic imbalance (elevated soluble fms-like tyrosine kinase-1-to-placental growth factor ratio (sFlt-1/PlGF ratio)), suggesting the absence of placental involvement. The aim of this study was to investigate whether pathological placental changes associated with PE, such as maternal vascular malperfusion (MVM), may be useful to discriminate true PE from COVID-19-induced PE-like syndrome.
Methods.
Prospective cohort study conducted from February 2020 to September 2021. Inclusion criteria were pregnancies with SARS-CoV-2 infection that met the diagnostic criteria for PE at ≥ 20 weeks. Cases with a normal sFlt-1/PlGF ratio (≤ 38) were classified as PE-like syndrome and cases with an abnormal sFlt-1/PlGF ratio were classified as true PE. A perinatal pathologist blinded to group allocation performed the placental histopathological examination for signs of MVM following the Amsterdam criteria.
Results.
During the study period, 106 pregnant women with severe COVID-19 were admitted to the Intensive Care Unit. Among them, 15 (14.2%) met the diagnostic criteria for PE, and 11 placentas (73.3%) were available for histopathological examination. Of the 5 true PE cases (median sFlt-1/PlGF ratio of 137.9; IQR: 63.7-302.2), 80.0% had placentas with maternal vascular malperfusion (MVM). In contrast, none of the 6 PE-like syndrome cases (median sFlt-1/PlGF ratio of 5.53; IQR: 4.02–14.6) had placentas that met the MVM criteria.
Conclusions.
None of the placentas from cases with PE-like syndrome had histopathological criteria of MVM, while 80.0% of the placentas from cases with true PE showed high-grade MVM. The absence of MVM in PE-like syndrome supports the initial evidence based on angiogenic factors: PE-like syndrome and true PE are different conditions with similar clinical features, but different etiologies.