bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimizing the medical equipment investment in primary care centres in rural China: evidence from a panel threshold model
Authors: Xu Wanchun , Pan Zijing , Zhang Liang , Lu Shan
Published: February 2024

Background

The previous “one-size-fits-all” practice in resource allocation can no longer adapt to the spatial variation in population and health needs. This study aimed to investigate the spatially heterogeneous effect of medical equipment investment in the township health centres in rural China to optimize the investment strategies.

Methods

Based on the national-scale stratified multistage cluster sampling, 319 township health centres from six provinces were included in the study. The retrospective data from 2013 to 2017 were collected for each sampled township health centres and the corresponding township community. The panel threshold regression model was applied to estimate the nonlinear effect of medical equipment increment on the service utilization due to the township communities’ urbanization degree. The influence of township community remoteness on the effects of equipment increment was investigated through subgroup analysis.

Results

Among the township health centres in the neighbouring towns of the county seat (travel time to the county seat < 1 h), the significant effect of medical equipment increment was only found in the township health centres of the towns with high urbanization degrees (the proportion of the residents living in the built-up area > 69.89%), of which the effect size was 774.81 (95% CI 495.63, 1053.98, p < 0.05). Among the township health centres in the remote towns (travel time ≥ 1 h), the effect of medical equipment increment in the township health centres of the low urbanized towns (urban ≤ 5.99%, β = 1052.54, p < 0.01) was around four times the size of that of the counterparts (urban > 5.99%, β = 237.00, p < 0.01).

Conclusion

This study demonstrated the spatially heterogeneous effect of medical equipment investment in the primary care centres in rural China. The priority of the equipment investment was suggested to be given to the township health centres in the remote towns with a low urbanization degree and those in the highly-urbanized neighbouring towns of the county seats.
Substantial health and economic burden of COVID-19 during the year after acute illness among US adults at high risk of severe COVID-19
Authors: Scott Amie , Ansari Wajeeha , Khan Farid , Chambers Richard , Benigno Michael , Di Fusco Manuela , McGrath Leah , Malhotra Deepa , Draica Florin , Nguyen Jennifer , Atkinson Joanna , Atwell Jessica E.
Published: February 2024

Background

Post-COVID conditions encompass a range of long-term symptoms after SARS-CoV-2 infection. The potential clinical and economic burden in the United States is unclear. We evaluated diagnoses, medications, healthcare use, and medical costs before and after acute COVID-19 illness in US patients at high risk of severe COVID-19.

Methods

Eligible adults were diagnosed with COVID-19 from April 1 to May 31, 2020, had ≥ 1 condition placing them at risk of severe COVID-19, and were enrolled in Optum’s de-identified Clinformatics® Data Mart Database for ≥ 12 months before and ≥ 13 months after COVID-19 diagnosis. Percentages of diagnoses, medications, resource use, and costs were calculated during baseline (12 months preceding diagnosis) and the post-acute phase (12 months after the 30-day acute phase of COVID-19). Data were stratified by age and COVID-19 severity.

Results

The cohort included 19,558 patients (aged 18–64 y, n = 9381; aged ≥ 65 y, n = 10,177). Compared with baseline, patients during the post-acute phase had increased percentages of blood disorders (16.3%), nervous system disorders (11.1%), and mental and behavioral disorders (7.7%), along with increases in related prescriptions. Overall, there were substantial increases in inpatient and outpatient healthcare utilization, along with a 23.0% increase in medical costs. Changes were greatest among older patients and those admitted to the intensive care unit for acute COVID-19 but were also observed in younger patients and those who did not require COVID-19 hospitalization.

Conclusions

There is a significant clinical and economic burden of post-COVID conditions among US individuals at high risk for severe COVID-19.
Upregulated microRNA-125b-5p in patients with asthma-COPD overlap mediates oxidative stress and late apoptosis via targeting IL6R/TRIAP1 signaling
Authors: Chang Yu-Ping , Tsai Yi-Hsuan , Chen Yu-Mu , Huang Kuo-Tung , Lee Chiu-Ping , Hsu Po-Yuan , Chen Hung-Chen , Lin Meng-Chih , Chen Yung-Che
Published: February 2024

Background

Among patients with chronic obstructive pulmonary disease (COPD), some have features of both asthma and COPD—a condition categorized as asthma-COPD overlap (ACO). Our aim was to determine whether asthma- or COPD-related microRNAs (miRNAs) play a role in the pathogenesis of ACO.

Methods

A total of 22 healthy subjects and 27 patients with ACO were enrolled. We selected 6 miRNAs that were found to correlate with COPD and asthma. The expression of miRNAs and target genes was analyzed using quantitative reverse-transcriptase polymerase chain reaction. Cell apoptosis and intracellular reactive oxygen species production were evaluated using flow cytometry. In vitro human monocytic THP-1 cells and primary normal human bronchial epithelial (NHBE) cells under stimuli with cigarette smoke extract (CSE) or ovalbumin (OVA) allergen or both were used to verify the clinical findings.

Results

We identified the upregulation of miR-125b-5p in patients with ACO and in THP-1 cells stimulated with CSE plus OVA allergen. We selected 16 genes related to the miR-125b-5p pathway and found that IL6R and TRIAP1 were both downregulated in patients with ACO and in THP-1 cells stimulated with CSE plus OVA. The percentage of late apoptotic cells increased in the THP-1 cell culture model when stimulated with CSE plus OVA, and the effect was reversed by transfection with miR-125b-5p small interfering RNA (siRNA). The percentage of reactive oxygen species-producing cells increased in the NHBE cell culture model when stimulated with CSE plus OVA, and the effect was reversed by transfection with miR-125b-5p siRNA. In NHBE cells, siRNA transfection reversed the upregulation of STAT3 under CSE+OVA stimulation.

Conclusions

Our study revealed that upregulation of miR-125b-5p in patients with ACO mediated late apoptosis in THP-1 cells and oxidative stress in NHBE cells via targeting IL6R and TRIAP1. STAT3 expression was also regulated by miR-125b-5p.
Gestational diabetes mellitus and risk of long-term all-cause and cardiac mortality: a prospective cohort study
Authors: Ying Qian , Xu Yao , Zhang Ziyi , Cai Luyi , Zhao Yan , Jin Liping
Published: February 2024

Background

To investigate the association between gestational diabetes mellitus (GDM) without subsequent overt diabetes and long-term all-cause and cardiac mortality.

Methods

This prospective cohort study included 10,327 women (weighted population: 132,332,187) with a pregnancy history from the National Health and Nutrition Examination Survey (2007 to 2018). Participants were divided into three groups (GDM alone, overt diabetes, and no diabetes). Mortality data was linked from the National Death Index up to December 31, 2019. Multivariable Cox regression analysis was performed to examine the association between GDM alone and overt diabetes with all-cause mortality and cardiac mortality. Data analysis was performed from October 2022 to April 2023.

Results

Among the participants, 510 (weighted 5.3%) had GDM alone and 1862 (weighted 14.1%) had overt diabetes. Over a median follow-up period of 6.7 years (69,063 person-years), there were 758 deaths. The GDM group did not show an increased risk of all-cause mortality (hazard ratio [HR] 0.67; 95% CI, 0.25–1.84), while the overt diabetes group had a significantly higher risk (HR 1.95; 95% CI, 1.62–2.35). Similarly, the GDM group did not exhibit an elevated risk of cardiac mortality (HR 1.48; 95% CI, 0.50–4.39), whereas the overt diabetes group had a significantly higher risk (HR 2.37; 95% CI, 1.69–3.32). Furthermore, sensitivity analysis focusing on women aged 50 or above showed that the HR of GDM history for all-cause mortality was 1.14 (95% CI, 0.33–3.95) and the HR for cardiac mortality was 1.74 (95% CI, 0.49–6.20).

Conclusions

GDM alone was not associated with an increased risk of all-cause and cardiac mortality, while overt diabetes was significantly associated with both types of mortality.
Reprogramming of lipid metabolism in the tumor microenvironment: a strategy for tumor immunotherapy
Authors: Wu Yuting , Pu Xi , Wang Xu , Xu Min
Published: February 2024

Lipid metabolism in cancer cells has garnered increasing attention in recent decades. Cancer cells thrive in hypoxic conditions, nutrient deficiency, and oxidative stress and cannot be separated from alterations in lipid metabolism. Therefore, cancer cells exhibit increased lipid metabolism, lipid uptake, lipogenesis and storage to adapt to a progressively challenging environment, which contribute to their rapid growth. Lipids aid cancer cell activation. Cancer cells absorb lipids with the help of transporter and translocase proteins to obtain energy. Abnormal levels of a series of lipid synthases contribute to the over-accumulation of lipids in the tumor microenvironment (TME). Lipid reprogramming plays an essential role in the TME. Lipids are closely linked to several immune cells and their phenotypic transformation. The reprogramming of tumor lipid metabolism further promotes immunosuppression, which leads to immune escape. This event significantly affects the progression, treatment, recurrence, and metastasis of cancer. Therefore, the present review describes alterations in the lipid metabolism of immune cells in the TME and examines the connection between lipid metabolism and immunotherapy.
Changes in microbial composition and interaction patterns of female urogenital tract and rectum in response to HPV infection
Authors: Dong Yong-Hong , Luo Yu-Hua , Liu Chen-Jian , Huang Wen-Yu , Feng Lin , Zou Xing-Yuan , Zhou Jin-Yan , Li Xiao-Ran
Published: February 2024

Background

Previous studies have shown that changes in the microbial community of the female urogenital tract are associated with Human papillomavirus (HPV) infection. However, research on this association was mostly focused on a single site, and there are currently few joint studies on HPV infection and multiple sites in the female urogenital tract.

Methods

We selected 102 healthy women from Yunnan Province as the research object, collected cervical exfoliation fluid, vaginal, urethral, and rectal swabs for microbial community analysis, and measured bacterial load, and related cytokine content. The link between HPV, microbiota, and inflammation was comprehensively evaluated using bioinformatics methods.

Findings

The impact of HPV infection on the microbial composition of different parts varies. We have identified several signature bacterial genera that respond to HPV infection in several detection sites, such as Corynebacterium, Lactobacillus, Campylobacter, and Cutibacterium have been detected in multiple sites, reflecting their potential significance in cross body sites HPV infection responses. There was a solid microbial interaction network between the cervix, vagina, and urethra. The interrelationships between inflammatory factors and different bacterial genera might also affect the immune system's response to HPV infection.

Interpretation

It might be an effective strategy to prevent and treat HPV infection by simultaneously understanding the correlation between the microbial changes in multiple parts of the female urogenital tract and rectum and HPV infection, and controlling the microbial network related to HPV infection in different parts.
Herpes simplex virus infection induces necroptosis of neurons and astrocytes in human fetal organotypic brain slice cultures
Authors: Rashidi Ahmad S. , Tran Diana N. , Peelen Caithlin R. , van Gent Michiel , Ouwendijk Werner J. D. , Verjans Georges M. G. M.
Published: February 2024

Background

Herpes simplex virus (HSV) encephalitis (HSE) is a serious and potentially life-threatening disease, affecting both adults and newborns. Progress in understanding the virus and host factors involved in neonatal HSE has been hampered by the limitations of current brain models that do not fully recapitulate the tissue structure and cell composition of the developing human brain in health and disease. Here, we developed a human fetal organotypic brain slice culture (hfOBSC) model and determined its value in mimicking the HSE neuropathology in vitro.

Methods

Cell viability and tissues integrity were determined by lactate dehydrogenase release in supernatant and immunohistological (IHC) analyses. Brain slices were infected with green fluorescent protein (GFP-) expressing HSV-1 and HSV-2. Virus replication and spread were determined by confocal microscopy, PCR and virus culture. Expression of pro-inflammatory cytokines and chemokines were detected by PCR. Cell tropism and HSV-induced neuropathology were determined by IHC analysis. Finally, the in situ data of HSV-infected hfOBSC were compared to the neuropathology detected in human HSE brain sections.

Results

Slicing and serum-free culture conditions were optimized to maintain the viability and tissue architecture of ex vivo human fetal brain slices for at least 14 days at 37 °C in a CO2 incubator. The hfOBSC supported productive HSV-1 and HSV-2 infection, involving predominantly infection of neurons and astrocytes, leading to expression of pro-inflammatory cytokines and chemokines. Both viruses induced programmed cell death—especially necroptosis—in infected brain slices at later time points after infection. The virus spread, cell tropism and role of programmed cell death in HSV-induced cell death resembled the neuropathology of HSE.

Conclusions

We developed a novel human brain culture model in which the viability of the major brain-resident cells—including neurons, microglia, astrocytes and oligodendrocytes—and the tissue architecture is maintained for at least 2 weeks in vitro under serum-free culture conditions. The close resemblance of cell tropism, spread and neurovirulence of HSV-1 and HSV-2 in the hfOBSC model with the neuropathological features of human HSE cases underscores its potential to detail the pathophysiology of other neurotropic viruses and as preclinical model to test novel therapeutic interventions.
Predictive value of systemic immune-inflammation index in the high-grade subtypes components of small-sized lung adenocarcinoma
Authors: Wei BoHua , Zhang Yi , Shi Kejian , Jin Xin , Qian Kun , Zhang Peilong , Zhao Teng
Published: February 2024

Background

Identification of micropapillary and solid subtypes components in small-sized (≤ 2 cm) lung adenocarcinoma plays a crucial role in determining optimal surgical procedures. This study aims to propose a straightforward prediction method utilizing preoperative available indicators.

Methods

From January 2019 to July 2022, 341 consecutive patients with small-sized lung adenocarcinoma who underwent curative resection in thoracic surgery department of Xuanwu Hospital, Capital Medical University were retrospectively analyzed. The patients were divided into two groups based on whether solid or micropapillary components ≥ 5% or not (S/MP5+ and S/MP5-). Univariate analysis and multivariate logistic regression analysis were utilized to identify independent predictors of S/MP5+. Then a nomogram was constructed to intuitively show the results. Finally, the calibration curve with a 1000 bootstrap resampling and the receiver operating characteristic (ROC) curve were depicted to evaluate its performance.

Results

According to postoperative pathological results, 79 (23.2%) patients were confirmed as S/MP5+ while 262 (76.8%) patients were S/MP5-. Based on multivariate analysis, maximum diameter (p = 0.010), consolidation tumor ratio (CTR) (p < 0.001) and systemic immune-inflammation index (SII) (p < 0.001) were identified as three independent risk factors and incorporated into the nomogram. The calibration curve showed good concordance between the predicted and actual probability of S/MP5+. Besides, the model showed certain discrimination, with an area under ROC curve of 0.893.

Conclusions

The model constructed based on SII is a practical tool to predict high-grade subtypes components of small-sized lung adenocarcinoma preoperatively and contribute to determine the optimal surgical approach.
Sestrin1, 2, and 3 are dispensable for female fertility in mice
Authors: Wang Mengchen , Chen Wenhui , Zeng Xinxin , Wang Taojun , Sun Yingpu , Yang Qingling
Published: February 2024

Background

Sestrins have been implicated in regulating aging in various organs through multiple pathways. However, their roles in ovarian aging remain unrevealed.

Methods

Female Sestrin1−/−, Sestrin2−/−, and Sestrin3−/− mice were generated using the CRISPR-Cas9 system. Body weights, little sizes, ovarian weights, estrous cyclicity, and follicle number in female mice were observed. ELISA was utilized to measure serum anti-Müllerian hormone (AMH) levels. Real time PCR, western blot, immunofluorescence, and Masson trichrome staining were employed for assessment of aging-related change.

Results

The deletion of Sestrin 1, 2, or 3 had no discernible impact on body weights,or serum AMH levels in female mice at the age of 12 months. And there were no discernible differences in litter sizes or estrous cyclicity which were assessed at the age of 8 months. At the age of 12 months, no significant differences were observed in ovarian weights or follicle numbers among the knockout mice. Consistently, the extent of fibrosis within the ovaries remained comparable across all experimental groups at this age. Additionally, autophagy, apoptosis, DNA damage, and inflammation within the ovaries were also found to be comparable to those in wild-type mice of the same age.

Conclusions

The loss of Sestrin 1, 2, or 3 does not exert a noticeable influence on ovarian function during the aging process. Sestrin1, 2, and 3 are not essential for female fertility in mice.
Exploring preliminary dietary intake results using a novel dietary assessment tool with pregnant participants enrolled in a birth cohort
Authors: Santarossa Sara , Redding Ashley , Connell Mackenzie , Kao Karissa , Susick Laura , Kerver Jean M.
Published: February 2024

Objective

We aimed to describe preliminary dietary intake results using DietID™ for dietary assessment during pregnancy. A sub-sample of participants in the Research Enterprise to Advance Children’s Health (REACH) prospective birth cohort from Detroit, MI received a unique web link to complete the DietID™ assessment multiple times during pregnancy. We present results for the first dietary assessment completed during pregnancy by each participant. DietID™ uses an image-based algorithm to estimate nutrient intake, dietary patterns, and diet quality and provides immediate results to participants. Descriptive statistics were used to summarize participant characteristics, nutrient intakes, dietary patterns, diet quality, and participant-rated accuracy of individual dietary assessment results. Differences in diet parameters were assessed by participant race with an independent t-test.

Results

Participants (n = 84) identified as majority Black (n = 47; 56%), reflective of the source population. Mean (SD) maternal age and gestational age at dietary assessment were 32 (5.6) years and 14.3 (4.8) weeks, respectively. Mean dietary quality, as reported in the DietID™ data output as the Healthy Eating Index (HEI), was 68 (range 12–98; higher scores indicate higher diet quality) and varied significantly between Black (mean [SD] 61 [23]) and White (mean [SD] 81 [19]) race (p < 0.01). Mean participant-rated accuracy of individual dietary assessment results was high at 87% on a scale of 0-100% (“not quite right” to “perfect”; range 47–100%).
DLM-DTI: a dual language model for the prediction of drug-target interaction with hint-based learning
Authors: Lee Jonghyun , Jun Dae Won , Song Ildae , Kim Yun
Published: February 2024

The drug discovery process is demanding and time-consuming, and machine learning-based research is increasingly proposed to enhance efficiency. A significant challenge in this field is predicting whether a drug molecule’s structure will interact with a target protein. A recent study attempted to address this challenge by utilizing an encoder that leverages prior knowledge of molecular and protein structures, resulting in notable improvements in the prediction performance of the drug-target interactions task. Nonetheless, the target encoders employed in previous studies exhibit computational complexity that increases quadratically with the input length, thereby limiting their practical utility. To overcome this challenge, we adopt a hint-based learning strategy to develop a compact and efficient target encoder. With the adaptation parameter, our model can blend general knowledge and target-oriented knowledge to build features of the protein sequences. This approach yielded considerable performance enhancements and improved learning efficiency on three benchmark datasets: BIOSNAP, DAVIS, and Binding DB. Furthermore, our methodology boasts the merit of necessitating only a minimal Video RAM (VRAM) allocation, specifically 7.7GB, during the training phase (16.24% of the previous state-of-the-art model). This ensures the feasibility of training and inference even with constrained computational resources.
Enhancing protein production and growth in chinese hamster ovary cells through miR-107 overexpression
Authors: Jari Maryam , Abdoli Shahriyar , Bazi Zahra , Shamsabadi Fatemeh Tash , Roshanmehr Farnaz , Shahbazi Majid
Published: February 2024

Chinese Hamster Ovary (CHO) cells are widely employed as host cells for biopharmaceutical production. The manufacturing of biopharmaceuticals poses several challenges, including restricted growth potential and inadequate productivity of the host cells. MicroRNAs play a crucial role in regulating gene expression and are considered highly promising tools for cell engineering to enhance protein production. Our study aimed to evaluate the effects of miR-107, which is recognized as an onco-miR, on erythropoietin-producing CHO cells (CHO-hEPO). To assess the impact of miR-107 on CHO cells, a DNA plasmid containing miR-107 was introduced to CHO-hEPO cells through transfection. Cell proliferation and viability were assessed using the trypan blue dye exclusion method. Cell cycle analysis was conducted by utilizing propidium iodide (PI) staining. The quantification of EPO was determined using an immunoassay test. Moreover, the impact of miR-107 on the expression of downstream target genes was evaluated using qRT-PCR. Our findings highlight and underscore the substantial impact of transient miR-107 overexpression, which led to a remarkable 2.7-fold increase in EPO titers and a significant 1.6-fold increase in the specific productivity of CHO cells (p < 0.01). Furthermore, this intervention resulted in significant enhancements in cell viability and growth rate (p < 0.05). Intriguingly, the overexpression of miR‑107 was linked to the downregulation of LATS2, PTEN, and TSC1 genes while concurrently driving upregulation in transcript levels of MYC, YAP, mTOR, and S6K genes within transgenic CHO cells. In conclusion, this study collectively underscores the feasibility of utilizing cancer-associated miRNAs as a powerful tool for CHO cell engineering. However, more in-depth exploration is warranted to unravel the precise molecular intricacies of miR-107's effects in the context of CHO cells.
Promoting higher-valent pediatric combination vaccines in China: challenges and recommendations for action
Authors: Li Jiuling , Chen Shu , Asturias Edwin , Tang Shenglan , Cui Fuqiang
Published: February 2024

Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social costs. However, China is conservative in the use of pediatric combination vaccines. By reviewing and synthesizing quantitative and qualitative data, in this commentary we identify gaps and challenges to combination vaccine use and make recommendations for promoting use of higher-valent pediatric combination vaccines in China. Challenges are in four dimensions: (1) legislation and regulation, (2) immunization schedule design, (3) vaccine awareness and price, and (4) research and development capacity. To optimize the use of combination vaccines to reduce vaccine-preventable disease burden, we make recommendations that address key challenges: (1) develop policies and regulations to strengthen enforcement of the Vaccine Administration Law and remove regulatory hurdles that hinder combination vaccine research and development, (2) establish an evidence-informed policy-making mechanism for combination vaccines, (3) resolve immunization schedule conflicts between monovalent and combination vaccines, and (4) implement effective interventions to increase vaccine awareness and reduce price.

Graphical Abstract
Features of optical coherence tomography angiography in age-related macular degeneration with residual fluid after three loading doses of aflibercept
Authors: Song Yong-Yeon , Seong Hyun-Je , Kim Jung-Tae , Lee Sung-Chul , Lee Min-Woo
Published: February 2024

Background

To identify the macular neovascularization (MNV) features in exudative age-related macular degeneration (AMD) patients who exhibited residual fluid after receiving three loading doses of aflibercept.

Methods

Patients were classified into two groups: Group 1, which did not exhibit intraretinal fluid (IRF) and subretinal fluid (SRF), and Group 2, which did exhibit IRF and/or SRF. Optical coherence tomography angiography (OCTA) features were assessed and compared between the groups.

Results

A total of 101 eyes were enrolled; 65 for Group 1 and 36 for Group 2. No significant differences were found in baseline MNV size (2.94 ± 2.51 µm2 vs. 2.22 ± 2.26 µm2, P = 0.178) or vessel density (47.1 ± 15.4 % vs. 41.3 ± 10.5%, P = 0.052) between Groups 1 and 2. There were significant differences in the presence of loops (52.3% vs. 75%, P = 0.026) and peripheral arcades (29.2% vs. 55.6%, P < 0.001) at baseline between the two groups. In Group 1, there was a significant reduction in the presence of branching (P < 0.001) and loops (P = 0.016) after treatment. In Group 2, only the presence of branching decreased significantly (P < 0.001) after treatment. Multivariable analysis revealed that the presence of a peripheral arcade (B = 4.77, P = 0.001) was significantly associated with residual fluid.

Conclusions

Although responding to treatment, the presence of loops and peripheral arcades in exudative AMD patients may contribute to residual fluid following the three loading doses of aflibercept. The peripheral arcade, in particular, may play a more significant role in the presence of residual fluid.
Housing differentiation from the spatial opportunity structure perspective: an empirical study on new-generation migrants in China
Authors: Mu Xueying , Cui Can , Cui Junru
Published: February 2024

Using data from the 2017 China Migrants Dynamics Survey, this study employs generalized structural equation modeling to examine the effects of migrants' places of origin and socioeconomic status on their destination choice and access to homeownership in the destination city. The analyses reveal significant disparities in access to homeownership among migrants from different places of origin. Furthermore, the position of the destination city in the urban hierarchy not only has a direct impact on migrants' access to homeownership but also plays an important mediating role. This study highlights the spatial foundations of housing inequality and builds an analytical framework that links spatial mobility with social mobility. Our findings have significant implications for housing policies and practices aimed at improving the housing conditions of new-generation migrants.
A rare case of liver regenerative and non-neoplastic lesion resembling a well-differentiated hepatocellular carcinoma
Authors: Hirose Kosuke , Toshima Takeo , Tobo Taro , Kai Satohiro , Hirakawa Masakazu , Higuchi Satoshi , Ofuchi Takashi , Hosoda Kiyotaka , Yonemura Yusuke , Hisamatsu Yuichi , Masuda Takaaki , Aishima Shinichi , Mimori Koshi
Published: February 2024

Background

Nodular regenerative hyperplasia (NRH) is a rare disease that presents pathologically as diffuse hepatic nodules without fibrous septa. It is believed to be caused by vasculopathy against a background of various systemic diseases, such as hematologic, autoimmune, and drug-induced diseases, with various symptoms. In spite of the recent imaging advances, various atypical cases of nodular lesions are observed in daily clinical practice. Cases that do not completely meet these criteria are referred to as -like or -similar lesions in clinical situations, making it difficult to understand their pathogenesis. We present a case in which two hepatic nodular lesions were noted and difficult to differentiate from malignancy preoperatively. The lesions were laparoscopically resected and a pathological diagnosis with non-neoplastic liver regenerative nodules resembling NRH was made.

Case presentation

A 49-year-old man with no alcohol or drug intake and no past medical history was identified as having liver tumors on screening examination without any symptoms. Contrast-enhanced computed tomography (CT) showed two hepatic tumors; approximately 2-cm tumors at S7 and S8. Gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) revealed fat inclusions in their contents. Ethoxybenzyl (EOB) uptake was also observed during the hepatobiliary phase. Based on preoperative examinations, we suspected well-differentiated hepatocellular carcinoma (HCC) and performed laparoscopic S7/8 partial resection for these lesions. Macroscopically, the resected specimens showed a non-cirrhotic yellowish-cut surface containing brownish, ill-defined lesions with irregular borders. Microscopically, these lesions showed zonal necrosis, congestion, and aggregation of hemosiderin-laden macrophages around the central vein. In these areas, the fatty deposition of hepatocytes was lower than that in the surrounding background hepatocytes. Histopathologically, neither neoplastic nor hyperplastic lesions were observed, and he was diagnosed as regenerative hepatic change with centrilobular necrosis.

Conclusions

Considering the pathological results, these lesions were thought to be a type of NRH-like lesion with possible hepatic vessel disorder. However, the lesion’s cause and classification was difficult to determine. The accumulation of these regenerative changes accompanying fatty liver is needed to clarify the mechanism and its clinical significance.
A randomized trial evaluating the utility of non-targeted biopsies for colorectal neoplasia detection in adults with inflammatory bowel disease: a pilot study protocol
Authors: Murthy Sanjay K. , Marderfeld Luba , Fergusson Dean , Ramsay Tim , Bernstein Charles N. , Nguyen Geoffrey C. , Jairath Vipul , Riddell Robert
Published: February 2024

Background

Persons with inflammatory bowel diseases are at increased risk of developing colorectal cancer and require frequent colonoscopy surveillance. Guidelines recommend taking 30 to 40 non-targeted biopsies throughout the colorectum to detect “invisible” neoplasia in this setting, despite a lack of evidence supporting this practice. We sought to assess the utility of this practice through a randomized controlled trial. We first propose an internal pilot study to assess recruitment potential, protocol adherence and data capture to guide the full trial.

Methods

We have designed a multi-centre, parallel-group, non-inferiority randomized controlled trial to test the utility of non-targeted biopsies as an adjunct to colonoscopy surveillance for neoplasia detection in persons with inflammatory bowel disease involving the colorectum in routine clinical practice. Participants are randomized 1:1, stratified by study site, to either standard of care high-definition white-light colonoscopy with 32 to 40 non-targeted biopsies of non-neoplastic-appearing mucosa along with a sampling of abnormal-appearing mucosa (control group) or modified colonoscopy with targeted sampling alone (intervention group). The primary outcome for the full trial will be the proportion of persons with ≥ 1 neoplastic focus detected during colonoscopy. For the pilot phase, we will assess the feasibility of recruiting a minimum of 15% of the estimated sample size within 1 year, under identical conditions as the full trial, while maintaining ≥ 90–95% rate of protocol adherence and data capture. These participants will contribute data to the full trial. The trial is being conducted at 12 centres across Canada, with a total sample size of 1952 persons.

Discussions

The trial protocol has been approved by the ethics committees of all participating sites, and the pilot study has received funding through the Canadian Institutes of Health Research (PJT 159607). If feasibility metrics are met during the pilot phase, we will complete the full trial. The trial outcomes will contribute to update the practice guidelines in this area.

Trial registration

ClinicalTrials.gov, NCT04067778.
Association of dietary fats with ischemic heart disease (IHD): a case–control study
Authors: Zeinalabedini Mobina , Ladaninezhad Maryam , Mobarakeh Khadijeh Abbasi , Hoshiar-Rad Anahita , Shekari Soheila , Askarpour Seyed Ali , Ardekanizadeh Naeemeh Hassanpour , Esmaeili Mina , Abdollahi Morteza , Doaei Saeid , Khoshdooz Sara , Ajami Marjan , Gholamalizadeh Maryam
Published: February 2024

Background

This study aimed to investigate the association between different types of dietary fats with ischemic heart disease (IHD).

Methods

This case–control study was conducted on 443 cases and 453 controls aged 40–80 years in Tehran, Iran. The semi-quantitative 237-item food frequency questionnaire (FFQ) was used to assess the amount of food intake. Nutritionist IV was applied to test the amount of consumption of dietary fats.

Results

The case group had a lower intake of docosahexaenoic acid (DHA) (11.36 ± 12.58 vs. 14.19 ± 19.57, P = 0.01) than the control group. A negative association was found between IHD and DHA (OR 0.98, CI 95% 0.97–0.99, P = 0.01). No significant association was observed between IHD with the intake of cholesterol, trans fatty acids (TFA), saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), eicosatetraenoic acid (EPA), and α-Linolenic acid (ALA).

Conclusion

It was found that DHA may reduce the risk of IHD, whereas there was no significant association between other types of dietary fats with the odds of IHD. If the results of this study are confirmed in future research, a higher intake of DHA in diet can be recommended as a strategy to prevent IHD events.
Convolutional neural network based data interpretable framework for Alzheimer’s treatment planning
Authors: Parvin Sazia , Nimmy Sonia Farhana , Kamal Md Sarwar
Published: February 2024

Alzheimer’s disease (AD) is a neurological disorder that predominantly affects the brain. In the coming years, it is expected to spread rapidly, with limited progress in diagnostic techniques. Various machine learning (ML) and artificial intelligence (AI) algorithms have been employed to detect AD using single-modality data. However, recent developments in ML have enabled the application of these methods to multiple data sources and input modalities for AD prediction. In this study, we developed a framework that utilizes multimodal data (tabular data, magnetic resonance imaging (MRI) images, and genetic information) to classify AD. As part of the pre-processing phase, we generated a knowledge graph from the tabular data and MRI images. We employed graph neural networks for knowledge graph creation, and region-based convolutional neural network approach for image-to-knowledge graph generation. Additionally, we integrated various explainable AI (XAI) techniques to interpret and elucidate the prediction outcomes derived from multimodal data. Layer-wise relevance propagation was used to explain the layer-wise outcomes in the MRI images. We also incorporated submodular pick local interpretable model-agnostic explanations to interpret the decision-making process based on the tabular data provided. Genetic expression values play a crucial role in AD analysis. We used a graphical gene tree to identify genes associated with the disease. Moreover, a dashboard was designed to display XAI outcomes, enabling experts and medical professionals to easily comprehend the prediction results.
Exchange-traded funds and the future of passive investments: a bibliometric review and future research agenda
Authors: Joshi Girish , Dash Ranjan Kumar
Published: February 2024

Passive investments such as exchange-traded funds (ETFs) provide an opportunity to invest in indexes, asset classes, and sectors with low maintenance costs and high transparency. Today ETFs dominate the world, with nearly 50% of the investment in the USA coming through ETFs. Numerous studies on specific aspects on ETFs have been done earlier; however, considering the scarcity of thorough summaries in the existing body of literature, this bibliometric and systematic review aims to adopt a methodical approach with the goal of delivering qualitative and quantitative understanding of ETFs, while highlighting general research trends. The authors analyzed 2058 articles associated with ETFs from the Scopus database during the last 50 years, i.e., from 1973 till date. The search was initially conducted using title, keyword, and abstract, yielding 2058 articles, which were narrowed to only include research papers and review papers, resulting in a final count of 958 items. The most important authors, highest cited articles, prominent journals, important themes, and associated countries have been identified using bibliometric research. The numerical and visual representations of the analysis show that ETFs are a widely studied research area, and the enormous rise in publications in 2020, 2021, and 2022 demonstrates that researchers are quite interested in the topic. According to affiliation statistics, most research is focused in the USA together with other developed nations, opening new options for the research on ETFs in relation to developing economies. The current analysis reconciles numerous exchange-traded fund studies associated with volatility, liquidity, risk-return trade-off, and tracking errors and identifies possible research gaps. Some of the emerging topics that evolved in passive investments include the use of machine learning, AI, and the emergence of ETFs associated with ESG and sustainability. This research will help lawmakers, scholars, and regulators understand the core principles of ETFs and identify areas that deserve additional investigation.
The portable hand streamer — Rapid seismic imaging for shallow targets
Authors: Liberty Lee M. , Otheim L. Thomas
Published: February 2024

In this paper, we introduce a portable hand streamer seismic system. The system is appropriate for characterizing the mechanical properties of geologic and engineered materials in the upper 5 to 10 m depth and for reflection imaging from tens to hundreds of meters depth. Unlike other seismic land streamer systems that are typically pulled behind a vehicle with a long string of geophones, our recording system and electric seismic source are contained within an electric utility cart to allow ease of mobility for a single operator. Our 48-channel contact-coupled streamer is tethered to the cart to enable low-effort data collection. Similar to a ground-penetrating radar system, this approach allows rapid data collection on roads, sidewalks, undeveloped paths, and native materials. Signal processing through standard surface- and body-wave approaches follows data collection. We present three case studies where we (1) map Quaternary and older strata to identify active faulting, (2) map shallow bedrock, and (3) identify the footprint of previous subsurface engineered structures. We suggest that this low-cost tool and approach can be used for decameter-scale subsurface site characterization in two or three dimensions. Future advances involve the integration of an autonomous vehicle with a fully programmable seismic source and wholly automated signal processing to enable real-time analysis of shallow seismic data.
3D electrical resistivity survey for reduction of groundwater drilling uncertainties in a clay-rich environment
Authors: McKnight John , Saneiyan Sina
Published: February 2024

Drilling for groundwater is expensive and challenging. It is even more challenging to find a location that will result in a high-yield well in heterogeneous environments. To tackle the heterogeneity issue, geophysical surveys can help in mapping the subsurface structure and delineating the drilling trajectory. The current study displays the effectiveness of 3D electrical resistivity tomography (ERT) to locate a permeable groundwater zone within a highly heterogeneous and clayey subsurface. Ground truthing the acquired geophysical data with in-situ sampling helps ensure accuracy in classifying groundwater zones in the final inverted 3D data set while also delineating boundaries between permeable groundwater zones and less permeable clayey structures. In-situ samples of groundwater and soil were used to measure the saturated region's resistivity in the laboratory using a column setup. Clay zones in the data set are classified from the nearby well data at similar depth ranges and from very low resistivity values from ERT data and laboratory measurements. The results display highly differentiating resistivity zones that are attributed to the scattered clay lenses (low resistivity) in conjunction with the freshwater zone (high resistivity). The distinction between clayey and nonclayey bodies is important to better inform drilling locations for optimal groundwater yield. This study concludes that with the aid of low-cost geophysical surveys and minimal in-situ sampling data correlations, permeable groundwater boundaries and clay lens volumes can be identified easily.
Depression, anxiety and brain volume after hearing loss and tinnitus: cohort study in the UK Biobank
Authors: Chen Xiaowan , Hu Kejia , Song Huan , Yin Li , Kaijser Magnus , Gurholt Tiril P. , Andreassen Ole A. , Valdimarsdóttir Unnur , Fang Fang , Duan Maoli
Published: February 2024

Background

Hearing loss and tinnitus have been proposed as potential indicators of impaired mental health and brain morphological changes.

Aims

To assess the associations of hearing loss and tinnitus with the risk of depression and anxiety and with brain volume.

Method

We conducted a community-based cohort study including 129 610 participants aged 40−69 years at recruitment to the UK Biobank with a follow-up period during 2006–2021 to estimate the risk of depression and anxiety after detection of hearing loss and reported tinnitus. We also assessed the associations of hearing loss and tinnitus with brain volume in a subsample with available brain magnetic resonance imaging data (N = 5222).

Results

We observed an increased risk of depression among individuals with hearing loss (hazard ratio [HR] 1.14, 95% CI 1.03–1.26), tinnitus (HR 1.30, 95% CI 1.21–1.41) or both (HR 1.32, 95% CI 1.15–1.52), compared with individuals with neither hearing loss nor tinnitus. Similar results were noted for anxiety (HR 1.18, 95% CI 1.07–1.30 for hearing loss; HR 1.32, 95% CI 1.22–1.43 for tinnitus; and HR 1.48, 95% CI 1.30–1.68 for both). Hearing loss was associated with decreased overall brain volume as well as decreased volume of different brain regions. The latter associations disappeared after adjustment for whole intracranial volume. Tinnitus was associated with greater left accumbens and right occipital pole volume after adjustment for the whole intracranial volume.

Conclusions

Individuals with tinnitus are at increased risk of depression and anxiety. Hearing loss, on the other hand, is associated with both mood disorders and altered brain morphology.
Acute behavioural disturbance: what's in a name?
Authors: Tracy Derek K.
Published: February 2024

Acute behavioural disturbance (ABD) is a highly contentious topic, with debate about its validity as a construct. Particular concerns have been raised about how it places societal problems ‘in’ people – disproportionately from minority ethnic backgrounds – medicalising being a victim of violence. The author reflects on his experiences ‘with’ ABD.
Changes in the Epidemiologic Pattern of Primary CNS Tumors in Response to the Aging Population: An Updated Nationwide Cancer Registry Data in the Republic of Korea
Authors: Byun Yoon Hwan , Ha Johyun , Kang Ho , Park Chul-Kee , Jung Kyu-Won , Yoo Heon
Published: February 2024

PURPOSE

Primary CNS tumors (PCNSTs) are tumors originating from the brain and surrounding tissues. These tumors account for a significant proportion of cancer deaths and morbidity globally. Accurate epidemiologic data are essential for shaping clinical practices, research priorities, and health care policies. This study presents the latest 2020 national data on PCNSTs from the Republic of Korea (ROK) and explores the trends in incidence and their societal implications in the context of an aging population.

METHODS

This is a cross-sectional, observational study conducted using data sourced from the Korea National Cancer Incidence Database by the Korea Central Cancer Registry. The study analyzed national data on PCNSTs in the ROK for the years 2010, 2013, 2016, and 2020.

RESULTS

In 2020, 15,568 new PCNST cases were diagnosed in the ROK. The overall crude rate was 30.32, and the age-standardized rate was 19.37 per 100,000 persons. A decade-long trend analysis revealed an increasing trend in newly diagnosed glioblastoma and lymphoma, and a decreasing trend in embryonal tumors, in relation to the aging population of the ROK.

CONCLUSION

This study shows the significant impact of demographic shifts on the epidemiologic patterns of PCNSTs in the ROK. Our findings emphasize the need for collaborative efforts to address the rising challenges posed by the changing incidence of PCNSTs related to an aging population.