bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of public environmental concerns on port sustainability: evidence from 44 port cities in China
Authors: Shen Jia , Ren Xiaohong , Feng Zhitao , Nie Jiayun
Published: January 2025

Port construction and operations significantly impact the surrounding environment, creating an urgent need to explore pathways for enhancing port sustainability. Public environmental concern plays a vital role in driving environmental governance and offers new directions for improving port sustainability. Using panel data from 44 coastal ports and their respective cities between 2010 and 2021, this study empirically analyzes the impact of public environmental concern on port sustainability and its underlying mechanisms. Additionally, we examine how this impact varies across different city samples. The baseline regression results demonstrate that public environmental concern has a significant positive impact on port sustainability. This finding remains robust after a series of robustness checks and addressing endogeneity issues. Mechanism analysis reveals that public environmental concern can enhance port sustainability by increasing local government environmental investments. Furthermore, the development of digital infrastructure can amplify the positive effect of public environmental concern on port sustainability. Heterogeneity analysis indicates that the positive impact of public environmental concern on port sustainability is stronger in cities with lower government environmental regulation intensity, lower pollution emissions, higher education levels, and greater transparency in environmental information disclosure.
Interplay between light and circadian rhythms in the regulation of photoreception and physiological processes in the stony coral Acropora digitifera
Authors: Shi Zongyan , Takemura Akihiro
Published: January 2025

Stony corals possess major components of the circadian system, which oscillate in response to light-dark cycles in aquatic environments. However, the extent to which the circadian system influences physiological processes remains unknown. This study investigated the role of circadian genes (cry1, cry2, cry3, clock, cycle, and slmb) in modulating the transcription of photoreceptor (opsin1, opsin2, and opsin3), calcification/metabolism-related (ca, pmca, sglt, and ppp1r), and homeostasis/stress-related (hif1α, egln, sod, and hsp70) genes in Acropora digitifera, a stony coral inhabiting shallow water. Nubbins of A. digitifera were reared under light-dark (LD) and constant darkness (DD) conditions and sampled at 4-h intervals. Quantitative PCR analysis revealed that cry1, cry2, cry3, and clock expression increased during the daytime under LD conditions and attenuated during the subjective daytime under DD conditions, suggesting that these genes are light-responsive. In contrast, cycle and slmb exhibited similar expression profiles with increases during the daytime/subjective daytime under both LD and DD conditions, implying robust roles in the circadian system. The abundance of opsin1 showed minimal change under LD and DD conditions, whereas the abundances of opsin2 and opsin3 increased during daytime/subjective daytime under both conditions, indicating circadian regulation. Some genes tested by qPCR significantly fluctuated with light (pmca, sglt, ppp1r, egln, sod, and hsp70) and time (ca, pmca, sglt, ppp1r, hif1α, egln, sod, and sod). Principal component analysis revealed significant correlations of circadian genes (cycle or slmb) with calcification/metabolism-related (pmca), oxygen homeostasis (hif1α), and stress indicator (sod) genes under both LD and DD conditions. Therefore, some physiological responses in A. digitifera exhibit daily changes and are partially regulated by the circadian system.
Predicting the risk of gastroparesis in critically ill patients after CME using an interpretable machine learning algorithm – a 10-year multicenter retrospective study
Authors: Liu Yuan , Zhao Songyun , Du Wenyi , Shen Wei , Zhou Ning
Published: January 2025

Background

Gastroparesis following complete mesocolic excision (CME) can precipitate a cascade of severe complications, which may significantly hinder postoperative recovery and diminish the patient’s quality of life. In the present study, four advanced machine learning algorithms—Extreme Gradient Boosting (XGBoost), Random Forest (RF), Support Vector Machine (SVM), and k-nearest neighbor (KNN)—were employed to develop predictive models. The clinical data of critically ill patients transferred to the intensive care unit (ICU) post-CME were meticulously analyzed to identify key risk factors associated with the development of gastroparesis.

Methods

We gathered 34 feature variables from a cohort of 1,097 colon cancer patients, including 87 individuals who developed gastroparesis post-surgery, across multiple hospitals, and applied a range of machine learning algorithms to construct the predictive model. To assess the model’s generalization performance, we employed 10-fold cross-validation, while the receiver operating characteristic (ROC) curve was utilized to evaluate its discriminative capacity. Additionally, calibration curves, decision curve analysis (DCA), and external validation were integrated to provide a comprehensive evaluation of the model’s clinical applicability and utility.

Results

Among the four predictive models, the XGBoost algorithm demonstrated superior performance. As indicated by the ROC curve, XGBoost achieved an area under the curve (AUC) of 0.939 in the training set and 0.876 in the validation set, reflecting exceptional predictive accuracy. Notably, in the k-fold cross-validation, the XGBoost model exhibited robust consistency across all folds, underscoring its stability. The calibration curve further revealed a favorable concordance between the predicted probabilities and the actual outcomes of the XGBoost model. Additionally, the DCA highlighted that patients receiving intervention under the XGBoost model experienced significantly greater clinical benefit.

Conclusion

The onset of postoperative gastroparesis in colon cancer patients remains an elusive challenge to entirely prevent. However, the prediction model developed in this study offers valuable assistance to clinicians in identifying key high-risk factors for gastroparesis, thereby enhancing the quality of life and survival outcomes for these patients.
Screening key genes for intracranial aneurysm rupture using LASSO regression and the SVM-RFE algorithm
Authors: Wu Qi , Yang Chunli , Huang Cuilan , Lin Zhiying
Published: January 2025

Background

Although an intracranial aneurysm (IA) is widespread and fatal, few drugs can be used to prevent its rupture. This study explored the molecular mechanism and potential targets of IA rupture through bioinformatics methods.

Methods

The gene expression matrices of GSE13353, GSE122897, and GSE15629 were downloaded. Differentially expressed genes (DEGs) were screened using the limma package. Functional enrichment analysis was performed, and a PPI network was constructed. Furthermore, candidate key genes were identified using the least absolute shrinkage and selection operator (LASSO) regression model, support vector machine-recursive feature elimination (SVM-RFE) analysis, and PPI network analysis. ROC analysis was conducted to further verify the diagnostic value of the key genes.

Results

A total of 334 DEGs were screened, including 175 upregulated genes and 159 downregulated genes. Further functional analysis suggested that the DEGs were enriched in inflammation and immune response pathways. Fourteen hub genes were identified using the two algorithms. The PPI networks of the hub genes were analyzed using the Cytoscape plugin CytoNCA to obtain two key genes (IL10 and Integrin α5 (ITGA5)). The ROC curve analysis showed that the AUC values of IL10 and ITGA5 were 0.801, and 0.786, respectively. In addition, the two key genes were significantly positively correlated with macrophages and Treg (T) cells. The immune score and ESTIMATE score of the ruptured IA group were significantly higher than those of the unruptured IA group.

Conclusion

The increase in IL-10 and ITGA5 may weaken the vascular wall by promoting inflammation in blood vessels and immune cells, which could have a harmful effect on the rupture of IAs.
Blood urea nitrogen-to-albumin ratio as a new prognostic indicator of 1-year all-cause mortality in patients with IPF
Authors: Ge Shaobo , Li Yuer , Li Rui , Liu Jin , Zhang Rui , Fu Hongyan , Tang Jingjing , Zhang Jie , Zhang Nali , Zhang Ming
Published: January 2025

Background

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterized by chronic inflammation and progressive fibrosis. The blood urea nitrogen-to-albumin ratio (BAR) is a comprehensive parameter associated with inflammation status; however, it is unknown whether the BAR can predict the prognosis of IPF.

Methods

This retrospective study included 176 patients with IPF, and 1-year all-cause mortality of these patients was recorded. A receiver operating characteristic (ROC) curve was used to explore the diagnostic value of BAR for 1-year all-cause mortality in IPF patients, and the survival rate was further estimated using the Kaplan–Meier survival curve. Cox proportional hazards regression model and forest plot were used to assess the association between the BAR and 1-year all-cause mortality in IPF patients.

Results

The BAR of IPF patients was significantly higher in the non-survivor group than in the survivor group [0.16 (0.13–0.23) vs. 0.12 (0.09–0.17) mmol/g, p = 0.002]. The area under the ROC curve for predicting 1-year all-cause mortality in IPF patients was 0.671, and the optimal cut-off value was 0.12 mmol/g. The Kaplan–Meier survival curve showed that the 1-year cumulative survival rate of IPF patients with a BAR ≥0.12 was significantly decreased compared with the patients with a BAR <0.12. The Cox regression model and forest plot showed that the BAR was an independent prognostic biomarker for 1-year all-cause mortality in IPF patients (HR = 2.778, 95% CI 1.020–7.563, p = 0.046).

Conclusion

The BAR is a significant predictor of 1-year all-cause mortality of IPF patients, and high BAR values may indicate poor clinical outcomes.
Improving ADR reporting in Jordan: a qualitative exploration of pharmacists’ perspectives
Authors: Suleiman Amal K.
Published: January 2025

Background

Community pharmacists are most accessible to patients. Hence, they have a crucial role in ensuring drug safety by detecting and reporting adverse drug reactions (ADRs). However, there may be gaps in their knowledge of ADR reporting systems and barriers they face in reporting.

Objective

This study aims to assess community pharmacists’ knowledge of ADR reporting systems in the Kingdom of Jordan, identify the barriers they face in reporting ADRs, and explore the broader factors that influence their involvement in pharmacovigilance activities.

Methods

In-depth, semi-structured, face-to-face interviews were held with 20 community pharmacists from different regions of Jordan to evaluate their understanding of ADR reporting, the obstacles they encountered, and the elements that could motivate them to report ADRs. The interviews were transcribed and subjected to thematic analysis to find recurrent themes and insights. The thematic analysis highlighted opportunities for continuing education and an absence of formal training as the main barriers to ADR reporting.

Results

Pharmacists reported dissatisfaction with time limits in their hectic work situations and the complexity of reporting procedures, especially the length and information demanded by ADR reporting forms. Another factor influencing low reporting rates was a perceived lack of acknowledgment and feedback. Participants proposed that encouraging ADR reporting with professional recognition or compensation and improving and digitizing the reporting process would promote increased participation.

Conclusion

ADR reporting presents considerable difficulties for community pharmacists in Jordan, mostly because of administrative obstacles and an absence of official support and training. Enhancing pharmacovigilance efforts in Jordan could be achieved by providing incentives, simplifying the reporting procedure, and incorporating reporting into the current pharmacy management software.
Sarcopenia is a risk factor for postoperative delirium in geriatric hip fracture patients: a retrospective study
Authors: Qi Yi-Ming , Li Hao-Tao , Chang Shi-Min , Hu Sun-Jun , Du Shou-Chao , Liu Chen-Dong , Chu Yong-Qian , Rui Yun-Feng
Published: January 2025

Background

Various factors contribute to postoperative delirium (POD) in elderly patients undergoing hip fracture surgeries. Sarcopenia was defined as the progressive loss of skeletal muscle mass and strength associated with aging. The aim of this study was to explore the prevalence of POD and sarcopenia in geriatric patients undergoing hip fracture surgeries and to investigate the correlation between preoperative sarcopenia and POD.

Methods

After applying specific inclusion and exclusion criteria, the information of 234 patients were retrospectively collected. POD was screened for with 4A’s Test and diagnosed with DSM-5 criteria. The incidences of POD and sarcopenia were calculated. The demographic and perioperative features as well as comorbidities of delirious and non-delirious patients were analyzed and the risk factors analysis for POD in elderly hip fracture patients were conducted through univariate analysis and multivariate regression analysis.

Results

48.7% patients were diagnosed of POD, 78.95% of which were females. The average age of delirious and non-delirious patients were 84.75 years and 80.63 years, respectively. The incidence of sarcopenia was 41.02% for all the included patients with 60.53% for delirious patients and 20.55% for non-delirious patients. Results of univariate analysis showed that sarcopenia (OR:5.281, 95%CI 2.988–9.337, p = 0.000), age increase per year (OR:1.128, 95CI 1.070–1.190, p = 0.000), operation duration increase (OR:1.017, 95%CI 1.004–1.030, p = 0.011), intertrochanteric fracture (OR:2.571, 95%CI 1.517–4.358, p = 0.000), dementia (OR: 6.029, 95%CI 2.532–14.359, p = 0.000), ASA > 2 (OR: 6.955, 95%CI 3.461–13.976, p = 0.000), coronary heart disease (OR: 2.201, 95%CI 1.257–3.854, p = 0.006), renal insufficiency (OR: 2.215, 95%CI 1.187–4.133, p = 0.012) and COPD (OR: 2.554, 95%CI 1.414–4.615, p = 0.002) were risk factors for POD. Results of multivariate analysis identified sarcopenia (OR: 2.457, 95% CI 1.226–4.923, p = 0.011), ASA > 2 (OR: 3.968, 95% CI 1.805–8.722, p = 0.001), dementia (OR: 3.912, 95% CI 1.390–11.014, p = 0.010) and coronary heart disease (OR: 2.176, 95% CI 1.044–4.538, p = 0.038) as independent risk factors for POD in geriatric hip fracture patients.

Conclusion

The incidences of POD and sarcopenia in geriatric hip fracture patients are high. Sarcopenia is an independent risk factor for POD in geriatric hip fracture patients.
Urbanized lands degrade surrounding grasslands by deteriorating the interactions between plants and soil microbiome
Authors: Fang Mengchao , Lu Guang , Zhang Shuping , Liang Wei
Published: January 2025

To mitigate overgrazing on grasslands, towns were constructed in some pastoral regions of China to relocate pastoralists. Nevertheless, whether and how the urbanized lands impact the surrounding grassland ecosystem remains unclear. We assessed the impacts of urbanized lands on the plant and soil interactions within the surrounding grasslands in order to ensure an eco-sustainable pastoralist relocation. The town with 1 km radius was selected as urbanization sample and a grassland with 1 km radius was selected as nature grassland sample. Plants and soil were investigated in nature grassland (NG), and areas 1 km (T-1 km), 2 km (T-2 km), and 3 km (T-3 km) from the center of the town. In T-1 km and T-2 km, compared to the NG, plant diversity, the abundance of dominant plant species, the abundance of soil wood saprotroph fungi, soil water content (SWC), and total organic carbon (TOC) decreased, while soil plant pathogen fungi, soil pH, and total phosphatase (TP) increased. Conversely, no such changes were observed in T-3 km. The results of Mantel test and Partial least squares path model suggest that the decrease in soil TOC and SWC, along with the increase in pH and TP in T-1 km and T-2 km, lead to a decline in wood saprotroph fungi and an increase in plant pathogen fungi, ultimately resulting in reductions in plant diversity and the abundance of dominant plant species. These results indicate that towns in pastoral areas can lead to surrounding grassland degradation by deteriorating the plant–soil interactions.
The role of neutrophilia in hyperlactatemia, blood acidosis, impaired oxygen transport, and mortality outcome in critically ill COVID-19 patients
Authors: Yasseen Basma A. , Elkhodiry Aya A. , El-sayed Hajar , Zidan Mona , Kamel Azza G. , Badawy Mohamed A. , Hamza Marwa S. , El-Messiery Riem M. , El Ansary Mohamed , Abdel-Rahman Engy A. , Ali Sameh S.
Published: January 2025

Introduction

COVID-19 severity and high in-hospital mortality are often associated with severe hypoxemia, hyperlactatemia, and acidosis, yet the key players driving this association remain unclear. It is generally assumed that organ damage causes toxic acidosis, but since neutrophil numbers in severe COVID-19 can exceed 80% of the total circulating leukocytes, we asked if metabolic acidosis mediated by the glycolytic neutrophils is associated with lung damage and impaired oxygen delivery in critically ill patients.

Methods

Based on prospective mortality outcome, critically ill COVID-19 patients were divided into ICU- survivors and ICU-non-survivors. Samples were analyzed to explore if correlations exist between neutrophil counts, lung damage, glycolysis, blood lactate, blood pH, hemoglobin oxygen saturation, and mortality outcome. We also interrogated isolated neutrophils, platelets, and PBMCs for glycolytic activities.

Results

Arterial blood gas analyses showed remarkable hypoxemia in non-survivors with no consistent differences in PCO2 or [HCO3−]. The hemoglobin oxygen dissociation curve revealed a right-shift, consistent with lower blood-pH and elevated blood lactate in non-survivors. Metabolic analysis of different blood cells revealed increased glycolytic activity only when considering the total number of neutrophils.

Conclusion

This indicates the role of neutrophilia in hyperlactatemia and lung damage, subsequently contributing to mortality outcomes in severe SARS-CoV-2 infection.
Self-reported health, persistent symptoms, and daily activities 2 years after hospitalization for COVID-19
Authors: Alhasan Roda , Rafsten Lena , Larsson Alexandra C. , Sunnerhagen Katharina S. , Persson Hanna C.
Published: January 2025

Introduction

Since the onset of the COVID-19 pandemic, 775 million cases have been reported globally. While many individuals recover fully, a significant proportion develop persistent symptoms. Numerous studies have investigated the long-term symptoms of COVID-19; however, the full extent and impact of these symptoms remain inadequately understood. The aim of this study was to investigate the prevalence of self-reported persistent symptoms, focusing on respiratory symptoms and fatigue and the impact on functional status 2 years after hospitalization for COVID-19.

Methods

This study is prospective and includes participants from a longitudinal multi-center cohort that follows patients previously hospitalized due to COVID-19 (n = 211). The current study encompasses the 2-year follow-up, using post-hospitalization questionnaire surveys. Analyzed data were collected before discharge and at the 2-year follow-up. Participants were grouped by age, sex and COVID-19 severity and group comparisons where conducted. Logistic regression analysis was used to study functional impairment.

Results

Two years after hospital discharge due to COVID-19, 125 participants completed the 2-year follow-up. The mean age of participants was 66 years (SD 12.2), and 68% were male. The majority of participants reported present respiratory symptoms (n = 83, 69%) and fatigue (n = 98, 78%) at the 2-year follow-up. Persistent respiratory symptoms and fatigue impacted functional status substantially (p = <0.001, p = 0.028, respectively). No significant differences were observed among groups depending on age, sex, or severity of COVID-19.

Conclusion

For some individuals regardless of age, sex or COVID-19 severity, respiratory symptoms and fatigue may persist for up to 2 years following COVID-19. Hence, having available support from professionals knowledgeable about COVID-19 is imperative. Further research is important to unravel the mechanisms of long-term symptoms following COVID-19 and to develop effective therapeutic and rehabilitative interventions.
Utilizing machine-learning techniques on MRI radiomics to identify primary tumors in brain metastases
Authors: Yang W. L. , Su X. R. , Li S. , Zhao K. Y. , Yue Q.
Published: January 2025

Objective

To develop a machine learning-based clinical and/or radiomics model for predicting the primary site of brain metastases using multiparametric magnetic resonance imaging (MRI).

Materials and methods

A total of 202 patients (87 males, 115 females) with 439 brain metastases were retrospectively included, divided into training sets (brain metastases of lung cancer [BMLC] n = 194, brain metastases of breast cancer [BMBC] n = 108, brain metastases of gastrointestinal tumor [BMGiT] n = 48) and test sets (BMLC n = 50, BMBC n = 27, BMGiT n = 12). A total of 3,404 quantitative image features were obtained through semi-automatic segmentation from MRI images (T1WI, T2WI, FLAIR, and T1-CE). Intra-class correlation coefficient (ICC) was used to examine segmentation stability between two radiologists. Radiomics features were selected using analysis of variance (ANOVA), recursive feature elimination (RFE), and Kruskal–Wallis test. Three machine learning classifiers were used to build the radiomics model, which was validated using five-fold cross-validation on the training set. A comprehensive model combining radiomics and clinical features was established, and the diagnostic performance was compared by area under the curve (AUC) and evaluated in an independent test set.

Results

The radiomics model differentiated BMGiT from BMLC (13 features, AUC = 0.915 ± 0.071) or BMBC (20 features, AUC = 0.954 ± 0.064) with high accuracy, while the classification between BMLC and BMBC was unsatisfactory (11 features, AUC = 0.729 ± 0.114). However, the combined model incorporating radiomics and clinical features improved the predictive performance, with AUC values of 0.965 for BMLC vs. BMBC, 0.991 for BMLC vs. BMGiT, and 0.935 for BMBC vs. BMGiT.

Conclusion

The machine learning-based radiomics model demonstrates significant potential in distinguishing the primary sites of brain metastases, and may assist screening of primary tumor when brain metastasis is suspected whereas history of primary tumor is absent.
Advances in fear memory erasure and its neural mechanisms
Authors: Guo Wenbo , Wang Xibo , Zhou Zihan , Li Yuhui , Hou Yani , Wang Keyan , Wei Ruyuan , Ma Xiaoyu , Zhang Hao
Published: January 2025

Background

In nature, animals must learn to recognize danger signals and respond immediately to threats to improve their environmental adaptation. However, excessive fear responses can lead to diseases such as post-traumatic stress disorder, wherein traumatic events result in persistent traumatic memories. Therefore, erasing pathological fear memories in vivo is a crucial topic in neuroscience for understanding the nature of memories and treating clinically relevant diseases.

Main text

This article reviews recent studies on fear memory erasure, erasure of short- and long-term memory, fear memory erasure and neuroplasticity, the neural circuitry and molecular mechanisms of fear memory erasure, and the roles of engram cells and perineuronal nets in memory erasure.

Conclusion

Research on the mechanism of memory erasure is limited, and a plausible explanation for the essential difference between memory erasure and memory extinction still needs to be provided. Notably, this review may guide future studies on fear memory and its underlying molecular mechanisms, which may help to develop novel treatment strategies for post-traumatic stress disorder, anxiety, and other mental disorders.
A time for sex: circadian regulation of mammalian sexual and reproductive function
Authors: Aten Sydney , Ramirez-Plascencia Oscar , Blake Chiara , Holder Gabriel , Fishbein Emma , Vieth Adam , Zarghani-Shiraz Arman , Keister Evan , Howe Shivani , Appo Ashley , Palmer Beatrice , Mahoney Carrie E.
Published: January 2025

The circadian clock regulates physiological and biochemical processes in nearly every species. Sexual and reproductive behaviors are two processes controlled by the circadian timing system. Evidence supporting the importance of proper clock function on fertility comes from several lines of work demonstrating that misalignment of biological rhythms or disrupted function of the body’s master clock, such as occurs from repeated shift work or chronic jet lag, negatively impacts reproduction by interfering with both male and female fertility. Along these lines, dysregulation of clock genes leads to impairments in fertility within mammals, and disruption of circadian clock timing negatively impacts sex hormone levels and semen quality in males, and it leads to ovulatory deficiencies in females. Here, we review the current understanding of the circadian modulation of both male and female reproductive hormones—from animal models to humans. Further, we discuss neural circuits within the hypothalamus that may regulate circadian changes in mammalian sexual behavior and reproduction, and we explore how knowledge of such circuits in animal models may help to improve human sexual function, fertility, and reproduction.
Modeling of auditory neuropathy spectrum disorders associated with the TEME43 variant reveals impaired gap junction function of iPSC-derived glia-like support cells
Authors: Kang Xiaoming , Ma Lu , Wen Jie , Gong Wei , Liu Xianlin , Hu Yihan , Feng Zhili , Jing Qiancheng , Cai Yuexiang , Li Sijun , Cai Xinzhang , Yuan Kai , Feng Yong
Published: January 2025

Auditory neuropathy spectrum disorder (ANSD) is an auditory dysfunction disorder characterized by impaired speech comprehension. Its etiology is complex and can be broadly categorized into genetic and non-genetic factors. TMEM43 mutation is identified as a causative factor in ANSD. While some studies have been conducted using animal models, its pathogenic mechanisms in humans remain unclear. TMEM43 is predominantly expressed in cochlear glia-like support cells (GLSs) and plays a vital role in gap junction intercellular communication. In this work, we utilized induced pluripotent stem cells from an ANSD patient carrying the TMEM43 gene mutation c.1114C>T (p.Arg372Ter) and directed their differentiation toward GLSs to investigate the effect of TMEM43 mutation on the function of gap junctions in cochlear GLSs in vitro. Reduced expression of genes associated with GLSs characteristics and reduced gap junction intercellular communication in TMEM43 mutant cell lines were observed compared to controls. Transcriptome analysis revealed that differentially expressed genes were significantly enriched in pathways related to cell proliferation, differentiation, extracellular space and adhesion. Furthermore, significant alterations were noted in the PI3K-Akt signaling pathway and the calcium signaling pathway, which could potentially influence gap junction function and contribute to hearing loss. In summary, our study based on patient-derived iPSCs sheds new light on the molecular mechanisms by which TMEM43 mutations may lead to ANSD. These mutations could result in developmental defects in GLSs and a diminished capacity for gap junction function, which may be implicated in the auditory deficits observed in ANSD patients. Our study explored the pathological effects of the TMEM43 mutation and its causal relationship with ANSD using a patient-derived iPSC-based GLSs model, providing a foundation for future mechanistic studies and potential drug screening efforts.
Exploring the role of epileptic focus lateralization on facial emotion recognition in the spectrum of mesial temporal lobe epilepsy
Authors: Iannaccone Fabio , Pizzanelli Chiara , Lorenzini Francesca , Turco Francesco , Milano Chiara , Scarpitta Claudia , Tommasini Luca , Tognoni Gloria , Morganti Riccardo , Bonanni Enrica , Siciliano Gabriele
Published: January 2025

Introduction

Evidence increasingly shows that facial emotion recognition (FER) is impaired in refractory mesial temporal lobe epilepsy (rMTLE), especially in patients with a right focus. This study explores FER in both mild (mMTLE) and refractory forms, examining the influence of epileptic focus lateralization on FER.

Methods

50 MTLE patients, categorized by epilepsy severity and focus lateralization, were compared with healthy controls. FER was assessed using the Ekman Faces Test (EFT), which evaluates recognition of six basic emotions, alongside a battery of cognitive and mood tests.

Results

mMTLE patients showed selective deficits in recognizing fear and anger, while rMTLE patients displayed broader deficits, affecting all emotions except surprise. Patients with a right focus underperformed across all negative emotions, whereas those with a left focus showed deficits mainly in fear and anger. Analysis indicated that early epilepsy onset was associated with poorer FER in right-focused patients; febrile seizures and mesial temporal sclerosis significantly impacted FER in left-focused patients.

Conclusion

MTLE affects circuits of FER even in mild subjects, although to a lesser extent than in refractory ones. Earlier onset of MTLE could disrupt the development of FER, possibly interfering during a critical phase of maturation of its circuits, when the focus is right. Conversely, left MTLE may cause less damage to FER circuits, requiring additional factors such as a history of febrile seizures and/or mesial temporal sclerosis for significant impact. Clinically, refractory and right-sided MTLE might be viewed as risk factors of FER deficits.
Evidence summary of lifestyle interventions in adults with metabolic dysfunction-associated steatotic liver disease
Authors: Chen Mei-jing , Chen Ying , Lin Jin-qing , Hu Rong , Liu Dun , Chen Jing-yi , Li Ka , Jiang Xiao-ying
Published: January 2025

Objective

In this study, our objective was to provide practice recommendations by thoroughly examining lifestyle interventions for adults diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD). This was achieved through a systematic review of the literature, specifically focusing on lifestyle modification interventions in adults with MASLD.

Methods

The PIPOST (Population, Intervention, Professional, Outcome, Setting, and Type of evidence) framework was used to identify the questions for summarizing evidence. Utilizing the 6S model for the hierarchy of evidence, a computerized search was conducted to retrieve articles pertaining to lifestyle interventions for adults with MASLD from websites such as the UpToDate Clinical Advisor, BMJ Best Practice, JBI Library, Cochrane Library, International Guidelines Library, and PubMed, among others. The available research included clinical decisions, clinical practice guidelines, evidence summaries, systematic evaluation, expert consensus, and expert opinions. Two researchers independently evaluated the methodology of the studies, and evidence was subsequently extracted and grouped thematically. Our review encompassed publications from January 2018 to March 2023.

Results

A total of 26 publications were identified for the final review, consisting of seven guidelines, nine systematic evaluations, and 10 expert consensuses/opinions. From these sources, we derived six themes, 28 pieces of evidence: intervention modalities, diet management, exercise management, weight loss management, personalized management, and multidisciplinary collaboration.

Conclusion

In the management of adults with MASLD, healthcare professionals should embrace a multidisciplinary team approach, adhere to the best available evidence, and develop structured and personalized interventions based on the best evidence for lifestyle modifications.
The effect of gut microbiome-targeted therapies in nonalcoholic fatty liver disease: a systematic review and network meta-analysis
Authors: Song Yijia , Liu Sutong , Zhang Lihui , Zhao Wenxia , Qin Yuanmei , Liu Minghao
Published: January 2025

Background

The incidence of NAFLD is increasing. Preclinical evidences indicate that modulation of the gut microbiome could be a promising target in nonalcoholic fatty liver disease.

Method

A systematic review and network meta-analysis was conducted to compare the effect of probiotics, synbiotics, prebiotics, fecal microbiota transplant, and antibiotics on the liver-enzyme, metabolic effects and liver-specific in patients with NAFLD. The randomized controlled trails (RCTs), limited to English language were searched from database such as Pubmed, Embase, Web of science and Cochrane Library from inception to November 2024. Review Manager 5.3 was used to to draw a Cochrane bias risk. Inconsistency test and publication-bias were assessed by Stata 14.0. Random effect model was used to assemble direct and indirect evidences. The effects of the intervention were presented as mean differences with 95% confidence interval.

Results

A total of 1921 patients from 37 RCTs were eventually included in our study. 23 RCTs evaluated probiotics, 10 RCTs evaluated synbiotics, 4 RCTs evaluated prebiotics, 3 RCTs evaluated FMT and one RCT evaluated antibiotics. Probiotics and synbiotics were associated with a significantly reduction in alanine aminotransferase [ALT, (MD: −5.09; 95%CI: −9.79, −0.39), (MD: −7.38, 95CI%: −11.94, −2.82)] and liver stiffness measurement by elastograph [LSM, (MD: −0.37;95%CI: −0.49, −0.25), (MD: −1.00;95%CI: −1.59, −0.41)]. In addition to, synbiotics was superior to probiotics in reducing LSM. Synbiotics was associated with a significant reduction of Controlled Attenuation Parameter [CAP, (MD: −39.34; 95%CI: −74.73, −3.95)]. Both probiotics and synbiotics were associated with a significant reduction of aspartate transaminase [AST, (MD: −7.81; 95%CI: −15.49, −0.12), (MD: −13.32; 95%CI: −23, −3.64)]. Probiotics and Allogenic FMT was associated with a significant reduction of Homeostatic Model Assessment for Insulin Resistance [HOMA-IR, (MD: −0.7, 95%CI: −1.26, −0.15), (MD: −1.8, 95%CI: −3.53, − 0.07)]. Probiotics was associated with a significant reduction of body mass index [BMI, MD: −1.84, 95%CI: −3.35, −0.33].

Conclusion

The supplement of synbiotics and probiotics maybe a promising way to improve liver-enzyme, LSM, and steatosis in patients with NAFLD. More randomized controlled trials are needed to determine the efficacy of FMT and antibiotics on NAFLD. And the incidence of adverse events of MTTs should be further explored.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, CRD42023450093.
Online grocery purchasing in Mississippi: associations with broadband, rurality, and household characteristics
Authors: Davis Will , Jones Jordan W. , Canales Elizabeth , Kim Ayoung , Buys David R.
Published: January 2025

Introduction

This study investigates the sociodemographic, economic, and area characteristics associated with Online Grocery Purchasing (OGP) use among adult residents of Mississippi. Understanding these factors is important in a largely rural and low-income state to address barriers and enhance accessibility.

Methods

Data were collected from a 2022 online pilot survey (n = 398) and secondary sources. A logistic regression model was used to analyze associations between self-reported OGP use and factors including local broadband quality, sociodemographic and economic characteristics, the local food environment, and participation in government nutrition assistance programs.

Results

The analysis revealed that higher education and income levels are positively associated with the likelihood of OGP use. Conversely, age and rural residence emerged as potential barriers. Although broadband disparities are widespread across Mississippi, self-reported home internet type and local internet speeds showed inconsistent associations with OGP participation across analyses.

Discussion

The findings underscore the nuanced interplay of accessibility and individual-level contexts in shaping OGP behavior. This study highlights the importance of addressing both structural and individual-level barriers to improve access to online grocery services in rural and low-income areas.
Inflammation mediates the association between muscle mass and accelerated phenotypic aging: results from the NHANES 2011–2018
Authors: Bao Shifu , Jimu Weibu , Mu Nai , Yan Fang , Xing Shuxing , Li Tao , Zhou Zheng
Published: January 2025

Background

Muscle mass plays a pivotal role in health maintenance, yet its connection to biological aging remains underexplored. This study investigates the association between appendicular skeletal muscle mass index (ASMI) and phenotypic age(PhenoAge), while examining the mediating role of systemic inflammation.

Methods

The analysis included 7,440 participants from the NHANES 2011–2018. Phenotypic Age Acceleration (PhenoAgeAccel) was calculated as the residuals from regressing PhenoAge on chronological age. Multivariable linear regression analyses were performed to assess the association between ASMI and PhenoAgeAccel. Mediation analysis was conducted to quantify the extent to which systemic inflammation contributes to this association.

Results

Our analysis revealed that higher ASMI is linked to slower biological aging, as evidenced by lower PhenoAgeAccel (β = −0.48, 95% CI: −0.66 to −0.29, p = 0.0001). Systemic inflammation partially mediated this effect, with a mediation proportion of 35.1%. The association varied notably across demographic and health-related subgroups, being particularly significant in females, individuals with obesity, and those with lower physical activity.

Conclusion

These findings highlight the critical importance of muscle mass in slowing biological aging, with systemic inflammation emerging as a key biological mediator. The public health implications are substantial, suggesting that targeted interventions—such as resistance training, anti-inflammatory diets, and personalized medical approaches—could play a pivotal role in decelerating biological aging and improving long-term health outcomes.
Dietary practice and associated factors among lactating mothers in Dangila District in the Awi Zone Amhara region Ethiopia, 2022: a cross-sectional study
Authors: Mulatu Sileshi , Mulatu Getasew , Gedif Azeb
Published: January 2025

Introduction

Lactation is the critical time for meeting the nutritional demands of mothers and infants. Mothers from low-income countries, including Ethiopia, are considered nutritionally vulnerable. Good dietary practices for mothers during lactation are therefore important for the good health of their children. The main objective of this study was to assess dietary practice and associated factors of lactating mothers in Dangila Zuria District, Amhara region, Ethiopia, 2022.

Methods

A community-based cross-sectional study was conducted among 609 lactating women from March 1st to May 1st 2022. The study participants were selected using a straightforward simple random sampling techniques. Data was collected by using structured questionnaires. The data was entered in Epi-data and exported to SPSS version 23 for analysis. Bi-variable and multi-variable logistic regression analyses were used to see the relevant associations. The variable significantly associated with dietary practice was identified based on a P-value ≤ 0.05.

Results

This study revealed that only one-third 204 lactating mothers, demonstrated good dietary practices. Notably, several factors were significantly associated with poor dietary practices: mothers with a family size greater than four had 3.01 times higher odds of inadequate dietary habits (AOR = 3.01; 95% CI: 1.56, 9.28), while those with birth intervals of <2 years faced 2.31 times greater odds (AOR = 2.31; 95% CI: 1.49, 3.56). Additionally, daily laborers exhibited a striking 9.35 times higher likelihood of poor dietary practices (AOR = 9.35; 95% CI: 8.02, 19.96), and food-insecure mothers had 4.93 times higher odds of inadequate nutrition (AOR = 4.93; 95% CI: 3.40, 7.16).

Conclusion

In conclusion, the dietary practices of lactating mothers were found to be suboptimal, falling below WHO and FAO recommendations. Factors such as family size, birth intervals, maternal occupation (especially daily laborers), and food insecurity were identified as significant contributors. Addressing these issues is crucial. Key stakeholders, including the Ministry of Health (MOH), Regional Health Bureaus (RHB), and health professionals, must work together to alleviate food insecurity, promote optimal family planning, and educate mothers on proper nutrition. Addressing these challenges is essential to achieving global objectives such as reducing malnutrition, improving maternal health, and ensuring healthy child development.
Association between weight-adjusted waist index and Hashimoto’s thyroiditis: insights from NHANES 2007–2012
Authors: Wen Xiaoyong , Mao Yu , Li Zeyu , Chen Guangji , Zhou Shiwei
Published: January 2025

Objective

While previous studies have explored the relationship between obesity and levels of thyroid autoantibodies, research using novel indicators such as weight-adjusted waist index (WWI) remains limited. This study aimed to evaluate the potential relationship between WWI and thyroid autoantibody levels, with the objective of improving our understanding of the links between central obesity and Hashimoto’s thyroiditis (HT).

Methods

We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) cycles from 2007 to 2012. We analyzed the relationship between WWI and levels of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) through multivariate linear regression and subgroup analyses.

Results

The study included 7,056 participants with an average age of 49.71 ± 17.66 years, comprising 49.18% females. Mean WWI across the cohort was 11.04 ± 0.84. Analysis revealed a significant positive association between WWI and TPOAb levels (β: 4.78, 95% CI: 1.52, 8.05, p = 0.0041), which remained consistent across all multivariate linear regression models. In contrast, no significant correlation was found between WWI and TgAb levels after adjusting for covariates. Subgroup analysis stratified by gender demonstrated a notable gender-specific effect, where the positive correlation between WWI and TPOAb levels was evident only in females (β: 8.13, 95% CI: 4.14, 12.12, p < 0.0001).

Conclusion

This study used WWI as a novel indicator of central obesity and identified a strong association with HT, particularly notable in females. However, further high-quality studies are needed to confirm these findings and explore the underlying biological mechanisms.
Axial length to corneal curvature radius ratio is negatively correlated with choroidal blood flow in myopic children
Authors: Ye Yurong , Hu Zizhong , Su Na , Shen Yeyu , Yuan Songtao
Published: January 2025

Background

The pathophysiologic mechanisms underlying early-onset myopia remain unclear; in this study, we investigate the pathogenesis by examining the interrelationships between axial length to corneal curvature radius ratio (AL/CR) and choroidal blood flow.

Methods

This cross-sectional study included 202 eyes from myopic children, categorized into 141 eyes with mild myopia, 47 eyes with moderate myopia, and 14 eyes with high myopia. Optical coherence tomography angiography (OCTA) was used to measure choroidal blood flow perfusion within a 6 mm × 6 mm area of the macular region, divided into nine subareas based on ETDRS partitioning: macular fovea, nasal side 1, superior 1, temporal side 1, inferior 1, nasal side 2, superior 2, temporal side 2, and inferior 2. Data on corneal curvature and ocular axial length were collected to calculate the AL/CR, with equivalent spherical lens power, gender, and age gathered for group comparisons, and the correlation between AL/CR and choroidal blood flow perfusion volume was analyzed.

Results

AL/CR was significantly negatively correlated with choroidal blood flow perfusion (P<0.001). Linear regression and mediation analyses indicated that for each unit increase in choroidal blood perfusion volume in nasal region 1, AL/CR decreased by an average of 0.421 units. This relationship is mediated by several factors, with axial length serving as a key mediator.

Conclusion

AL/CR correlates with choroidal blood flow perfusion, indicating a link between refractive biological parameters and ocular blood circulation. Myopia is an ischemic eye condition that warrants attention to fundus microcirculation changes in myopic children.
Multidrug-resistant ST11-KL64 hypervirulent Klebsiella pneumoniae with multiple bla- genes isolated from children's blood
Authors: Luo Rongmu , Ma Guannan , Yu Qian , Tian Zhengqin , Man Qihang , Shu Xiangrong , Liu Xuetong , Shi Yupeng , Zhang Lei , Wang Jingbo
Published: January 2025

Introduction

Hypervirulent carbapenem-resistant Klebsiella pneumoniae (hv-CRKP) poses an increasing public health risk due to its high treatment difficulty and associated mortality, especially in bone marrow transplant (BMT) patients. The emergence of strains with multiple resistance mechanisms further complicates the management of these infections.

Methods

We isolated and characterized a novel ST11-KL64 hv-CRKP strain from a pediatric bone marrow transplantation patient. Antimicrobial susceptibility testing was performed to determine resistance patterns. Comprehensive genomic analysis was conducted to identify plasmid types, virulence factors, and antimicrobial resistance genes, as well as potential resistance mechanisms associated with mutations and plasmid-mediated variants.

Results

The isolated hv-CRKP strain exhibited multidrug resistance to carbapenem, tigecycline, and polymyxin. Genomic analysis revealed that the IncHI1B/repB plasmid carried virulence factors (rmpA, ΔrmpA2, iucABCD, iutA), while IncFII/IncR and IncFII plasmids harbored resistance genes [blaCTX-M-65, blaTEM-1B, rmtB, blaSHV-12, blaKPC-2, qnrS1, blaLAP-2, sul2, dfrA14, tet(A), tet(R)]. The coexistence of blaCTX-M-65, blaTEM-1B, blaSHV-12, blaLAP-2,and blaKPC-2 in one hv-CRKP strain is exceptionally rare. Additionally, the Tet(A)-S251A variant in the conjugative plasmid pTET-4 may confer tigecycline resistance. Mutations in MgrB, PhoPQ, and PmrABCDK were identified as potential contributors to increased polymyxin resistance. Interestingly, plasmid-encoded restriction-modification systems and Retron regions were identified, which could potentially confer phage resistance.

Discussion

The combination of virulence and antimicrobial resistance factors in the ST11-KL64 hv-CRKP strain represents a significant challenge for treating immunocompromised pediatric patients. Particularly concerning is the resistance to polymyxin and tigecycline, which are often last-resort treatments for multidrug-resistant infections. The findings highlight the urgent need for effective surveillance, infection control measures, and novel therapeutic strategies to manage such hypervirulent and multidrug-resistant pathogens.