bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, Awareness and the Willingness to accept the RTS,S/AS01 malaria vaccine among mothers of under-five children in Lagos, Nigeria
Authors: Ojomo Qudus A. , Babalola Rahmotallah M. , Lawal Aminat O. , Udemba Jacintha C.
Published: October 2024

Background of the study: In October 2021, the World Health Organisation (WHO) recommended the use of RTS, S/AS01 malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission. This study aimed to investigate the willingness to receive RTS, S malaria vaccine as well as the knowledge and awareness of this vaccine among mothers of children under five years of age in Lagos, Nigeria. Methodology: This was a cross-sectional survey comprising structured questionnaires administered to mothers of children under the age of five attending immunization clinics in selected local government areas of Lagos, Nigeria (Alimosho, Ikeja, Kosofe, Ikorodu and Surulere). The study was conducted between February and May, 2023. Logistic regression analysis was used to determine the predictors of the likelihood of receiving the RTS, S malaria vaccine. A total of 395 mothers completed the survey. Results: The awareness of the RTS, S malaria vaccine among mothers of under-five children is fairly low (48%) in Lagos. However, more than two-thirds of the mothers (84.8%) were willing to accept the RTS, S malaria vaccine for their children. Surprisingly, mothers who are undecided on the possibility for the vaccine to infect their children with malaria were nine (9) times likely to accept the RTS/S malaria vaccine compared to those who are certain that the vaccine would not infect their children with malaria (OR = 9.075, 95CI% = 01.275–64.581, p = 0.028). Moreover, mothers that are aware of the RTS/S malaria vaccine (OR = 3.033, 95CI% = 1.366 –, 6.735, p < 0.05) are three (3) times more likely to accept the vaccine compared to those that are not aware of the vaccine. Conclusion: The findings of this study revealed the urgent need to increase awareness about the RTS, S malaria vaccine and assure mothers of under-five children of its safety. There is also a need for the Nigerian government to secure a large number of malaria vaccine doses since a majority of the mothers believe that the vaccine should be included in routine immunization.
Association of Maternal Serum Vitamin A Levels in the First Trimester with the Risk of Adverse Pregnancy Outcomes: A Prospective Cohort Study of Chinese Women
Authors: Ren Qinqin , Wang Yijin , Wang Yang , Yuan Hui , Liu Yao , Wei Yuanhuan , Sun Ruifang , Yang Hongguang , Tian Ping , Yang Jianjun , Deng Guifang
Published: October 2024

Objectives
To examine the association of serum vitamin A concentrations in early pregnancy with the risk of adverse pregnancy outcomes in Chinese women.
Methods
This prospective cohort study was conducted in the Department of Gynecology and Obstetrics at Shenzhen Nanshan People’s Hospital from 2019 to 2020. Serum vitamin A concentrations were measured during the first trimester (the first 6–13 weeks) of pregnancy, and pregnancy outcomes were recorded in the hospital information system. Serum vitamin A concentrations were categorised into the following quintiles: ≤ 0.57 µmol/L, 0.57–0.63 µmol/L, 0.63–0.69 µmol/L, 0.69–0.82 µmol/L, and > 0.82 µmol/L. The participants with serum vitamin A concentrations in the lowest quintile were used as the reference group. Statistical analysis was performed using multivariate logistic regression.
Results
One thousand and seventy-seven singleton mothers were recruited as participants. After multivariable adjustment, it was found that serum vitamin A concentrations > 0.82 µmol/L and within a safe range were associated with a decreased risk of gestational diabetes mellitus (GDM) (odds ratio [OR]: 0.50; 95% confidence interval [CI]: 0.31–0.81). In addition, compared with participants with serum vitamin A concentrations in the lowest quintile, those of participants with serum vitamin A concentrations in the highest quintile had a decreased risk of low birth weight (LBW) (OR: 0.26; 95% CI: 0.07–0.96). Moreover, after adjustment and compared with participants with serum vitamin A concentrations in the lowest quintile, those with serum vitamin A concentrations in the fourth quintile had a decreased risk of small for gestational age (OR: 0.32; 95% CI: 0.12–0.82). Furthermore, compared with participants with vitamin A concentrations ≤ 0.57 µmol/L, participants with vitamin A concentrations > 0.82 µmol/L had an increased risk of emergency caesarean section (OR: 2.31; 95% CI: 1.26–4.26).
Conclusion
During the first trimester, maternal serum vitamin A concentrations > 0.82 µmol/L and within a safe range were found to be associated with a reduced risk of GDM and LBW. However, an increase in serum vitamin A concentrations was found to be associated with an increase in the risk of emergency caesarean section.
METTL2B m3C RNA Transferase: Oncogenic Role in Ovarian Cancer Progression and its Link to the Tumor Immune Microenvironment
Authors: Meng Yizi , Meng Yimei , Zheng Hui , Huo Jinru , Li Peiling , Shan Yanhong , He Jin
Published: October 2024

Background
Aberrant expression of N3-methylcytidine methyltransferase 2B (METTL2B) has been observed in various human malignancies, including those of the prostate, liver, breasts, and bladder. However, its role in ovarian cancer (OC) remains largely unexplored. This research preliminarily investigated METTL2B expression in OC and elucidated the associated molecular mechanisms.
Methods
We utilized three publicly available cancer-related databases (Genotype-Tissue Expression, Gene Expression Omnibus, and The Cancer Genome Atlas) to identify gene signatures in patients with OC and normal individuals with a specific focus on METTL2B. The role of METTL2B in OC was evaluated using patient survival data, and its impact on oncogenic behaviors in both cell and animal models, including growth potential, migration, invasion, and the tumor microenvironment, was examined. This assessment was conducted using bioinformatics tools such as Gene Set Cancer Analysis, GeneMANIA, and Tumor Immune Single-cell Hub 2. Additionally, the association between drug sensitivity and METTL2B expression was analyzed using CellMiner.
Results
METTL2B expression was significantly elevated in OC, highlighting its potential clinical value in the diagnosis and prognosis of OC. Patients with lower METTL2B expression exhibited favorable survival. Furthermore, METTL2B knockdown significantly disrupted oncogenic behaviors in OC cell lines by suppressing the mTOR/AKT signaling pathway. Additionally, bioinformatics-based Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses suggested a close correlation between METTL2B and immune responses.
Conclusions
Our research confirmed the upregulation of METTL2B in OC, suggesting its oncogenic function and association with immune infiltration. These findings highlight the significant clinical value of METTL2B in the diagnosis and prognosis of OC.
Laparoscopic-Assisted abdominal small incision for management of adnexal mass during pregnancy: an academic institution study
Authors: Li Menghui , Zhang Zhiqiang , Mu Boran
Published: October 2024

Objective: To evaluate the safety and feasibility of Laparoscopic-Assisted abdominal small incision for the management of adnexal masses during pregnancy.
Design: Retrospective case series.
Setting: University-based tertiary-care hospital.
Patients: 12 pregnant women with an adnexal mass during the second-trimester.
Interventions: Laparoscopic-Assisted Minimally invasive surgery with abdominal small incision.
Measurements and Main results: Surgical and obstetric outcomes were evaluated. 1. The median age was 28.5 years (range, 25-40 years), all procedures were done during the second trimester, the mean gestation week was 16 weeks (range, 12-17weeks) at operation. 2. The mean operational time was 130 minutes (range, 45-200 minutes). The median blood loss was 10ml (range, 5-200ml). The mean decrease of hemoglobin was 12g/L (range, 2-35g/L). The mean onset of flatus was 24h (range, 22-56h). The mean hospital stay was 5.5days (range, 2-7days). 3. 13 ovarian cysts and 1 mesosalpinx cyst were sent to histopathological diagnosis and the most common diagnosis is corpus luteum cyst. Cystectomy was performed for all women. 4. All patients had an uneventful recovery. The median gestation at delivery was 39.5weeks (range, 33-41 weeks), and the median birth weight was 3,227.5 g (range, 1465-4,300 g). 5. The median follow-up time was 3.5 years (range, 0.5-7years). All babies were healthy.
Conclusion: Based on these initial findings, laparoscopic-Assisted abdominal small incision appears to be a safe and technically feasible alternative to multiport laparoscopic surgery for patients with adnexal mass during pregnancy.
Investigation of thiol-disulfide homeostasis in active ulcerative colitis
Authors: Ülfer Gözde , Akbaş Enver , Çakıcı Çağrı
Published: October 2024

Background/Aims:
This research sought to explore thiol-disulfide parameters among individuals in ulcerative colitis (UC) and determine the utility of such parameters as novel prognostic inflammatory markers.
Materials and Method
The study included 35 patients diagnosed with active UC via colonoscopy, constituting the case group, and 35 individuals without abnormal colonoscopy findings or acute/chronic illnesses, comprising the control group. Serum levels of native thiol, total thiol, and disulfide, as well as disulfide-native thiol and disulfide-total thiol ratios, were compared between the case and healthy control groups. These measurements were conducted using the automated spectrophotometric method.
Results
The measurements of total thiol, native thiol, and disulfide did not show statistically significant differences between the groups (p > 0.05). However, the disulfide-total thiol (%) ratio (p < 0.05) and the disulfide-native thiol (%) ratio (p < 0 .05) were notably higher in the case group compared to the controls. Receiver operating characteristic analysis was utilized to evaluate the accuracy of both the disulfide-total thiol (%) ratio and the disulfide-native thiol (%) ratio in diagnosing UC, yielding an area under the curve of 0.68 for both parameters.
Conclusion
The results revealed a significant elevation in disulfide-native thiol (%) ratio and disulfide-total thiol (%) ratio, indicating that the balance of thiol-disulfide homeostasis was impaired, shifting toward disulfide, in the presence of UC due to oxidative stress and tissue inflammation.
Comparison of early clinical efficacy of percutaneous endoscopic transforaminal lumbar decompression and single-level lumbar intervertebral fusion in the treatment of lumbar degenerative spondylolisthesis with lumbar spinal stenosis
Authors: Zhang Zhezhe , Zhang Zuxue , Li Pengfei , Song Youxin
Published: October 2024

Background
The clinical efficacy of decompression alone with and without fusion in the treatment of lumbar degenerative spondylolisthesis (LDS) with lumbar spinal stenosis (LSS) remains controversial, and this article compares the efficacy of percutaneous transforaminal lumbar discectomy (PTED) with that of lumbar decompression fusion in the treatment of LDS with LSS.
Method
From August 2018 to December 2020, 54 consecutive patients were diagnosed with LSS with DLS at our institution, 26 were treated with PTED, and 28 underwent single-segment lumbar fusion surgery. All patients were followed up for at least 1 year after surgery. Clinical outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified Macnab’s criteria.
Results
The mean age was 65.81 ± 8.04 years in the PTED group and 63.29 ± 4.60 years in the decompression fusion group. At 1 year postoperatively, the VAS and ODI scores of patients in both groups showed significant improvement compared with the preoperative scores (p < 0.05), with no significant difference between the two groups eventually. At 3 and 6 months postoperatively, the ODI values of patients in both groups were statistically significant (p < 0.05), and the postoperative recovery was faster in the PTED group than in the decompression fusion group. According to the modified Macnab criteria, the excellent rates were 92.31% and 92.86% in the PTED group and the decompression fusion group, respectively. And the operative time, blood loss, postoperative hospital stay, off-bed time and complication rate were significantly shorter in the PTED group. There was no significant difference in preoperative radiological parameters between the two groups. At the last follow-up, there was no significant difference in the slippage rate between the two groups.
Conclusion
The advantages of the PTED group over the decompression fusion group are faster postoperative recovery, less bleeding, and less trauma.There was no significant difference in the short-term clinical outcomes between the two groups, and the long-term outcomes and complications still need to be further explored and validated.
Clinical Features and Establishment of a Recurrence Prediction Model in Early Ovarian Clear Cell Carcinoma Patients
Authors: Cai Yuhan , Gao Yan , Fan Yiming , Wu Yu , Guo Hongyan
Published: October 2024

Purpose This study aims to summarize the clinical characteristics of early-stage ovarian clear cell carcinoma (OCCC) patients and establish a predictive model for recurrence.
Methods A retrospective analysis was conducted on clinical, pathological, and prognostic data of 129 early-stage OCCC patients treated at Peking University Third Hospital from January 2010 to June 2023. Clinical and pathological features of these patients were compared and summarized. Prognostic factors related to recurrence were explored, and a recurrence prediction model was established through nomogram.
Results The average age of patients was 54.38±8.66 years, with 110 cases (85.2%) in Stage I. The majority underwent comprehensive staging surgery (124 cases). Most patients exhibited positive expressions of NapsinA (92%) and HNF1β (98.9%). Immunohistochemical features were consistent with OCCC diagnosis, with negative expressions of ER (81.3%), PR (86%), and WT1 (94.2%). Among the 129 patients, 18 experienced recurrence, and 5 were lost to follow-up. The median progression-free survival (PFS) for recurrent patients was 16.5 months (range: 3-59 months). Significant prognostic factors associated with PFS were identified through univariate and multivariate analyses, including tumor FIGO stage, preoperative lower limb thrombosis, comprehensive staging surgery, age at diagnosis, parity, and menopausal status. A nomogram was constructed based on these variables to establish a recurrence prediction model. The AUC values for predicting the 1-year, 3-year, and 5-year recurrence were 0.831, 0.765, and 0.759, respectively, all exceeding 0.5.
Conclusion This study provides a comprehensive summary of the clinical and pathological characteristics of early-stage OCCC patients, explores prognostic factors related to recurrence and establishes a reliable recurrence prediction model. The model may serve as a reference for clinical counseling, treatment decision-making, and follow-up of early-stage patients who desire fertility sparing.
Risk of coimmunisation of hepatitis B-exposed children with unprotective antibodies based on machine learning algorithms
Authors: Liao Huiming , Li Yan , Li Yinzhi , Huang Sini , Gao Chenqian , Kong Jingjing , Liu Qi , Xia Jianhong
Published: October 2024

OBJECTIVE: The Guangdong Province Information Management System for Prevention of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B was utilized in this study's data collection to build and evaluate machine learning (ML)-based algorithms for predicting the likelihood that children exposed to hepatitis B will develop unprotective antibodies following combined immunization.
METHODS: The information reported by all midwifery institutions in 13 prefectures and cities was selected. Data reported in the Information Management System for Prevention of Mother-to-Child Transmission of HIV, Syphilis, and Hepatitis B in Guangdong Province between January 1, 2020, and December 31, 2021, were divided at random into a training cohort and a validation cohort (7:3). We developed predictive models for the production of unprotective antibodies in hepatitis B-exposed children after co-immunisation using six machine learning (ML) techniques including multilayer perceptron model (MLP), support vector machine (SVM), K-nearest neighbor algorithm (KNN), random forest (RF), decision tree (DT), and naive bayes (NBC). Decision Curve Analysis and Area Under the Curve (AUC-ROC) curves were used to assess and contrast the various prediction models (DCA).
CONCLUSION: It was discovered that the RandomForest model was a more powerful algorithm in terms of prediction. The model was created to assist with risk assessments in the future for children exposed to hepatitis B who do not have protective antibodies following co-immunization.
Predicting duration of surgery in hip and knee arthroplasty with machine learning: Operational factors are important.
Authors: Nejad Mohammad Chavosh , Matthiesen Rikke Vestergaard , Dukovska-Popovska Iskra , Jakobsen Thomas , Johansen John
Published: October 2024

Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most common surgeries in the healthcare system which highly consume hospital resources. An accurate prediction of the duration of surgery (DOS) can improve operating room scheduling and subsequently enhance hospital resource allocation efficiency. Currently, hospitals generally rely on historical data average or surgeons’ experience for DOS prediction which are prone to inaccuracy and personal bias. Besides, not enough attention has been paid to DOS prediction for these surgeries in the literature. This paper aims to develop machine learning (ML) models to predict surgery duration for patients undergoing hip and knee arthroplasty based on clinical and operational factors. Clinical and operational factors (n = 3,233) were extracted from Aalborg University Hospital’s database from 2017 to 2020. Three ML models (Extreme Gradient Boosting (XGBoost), Multilayer Perceptron, and Support Vector Machine) were developed and their performances were evaluated and compared with a baseline model. XGBoost demonstrated the best performance among all models (Mean Absolute Error = 12.86, Root Mean Squared Error = 16.67, Buffer Accuracy = 68.73). Furthermore, all models performed better than the baseline model. Analyzing feature importances indicated that the surgeon, temporal factors, and surgery type are the most contributing factors for predicting DOS. To conclude, machine learning models can improve the accuracy of DOS prediction for TKA and THA surgeries compared to the current methods. As an ensemble learning method, XGBoost can better deal with health data complexities related to DOS. Besides medical features, operational factors have a significant contribution to predicting DOS.
Facilitators and Barriers in Managing Elderly Chronic Heart Failure Patients in Primary Care: A Qualitative Study of Medical Personnel’s Perspectives Using the Socio-Ecological Model
Authors: Lou Yan , Zhang Min , Zou Yun , Zhao Le , Chen Yangfan , Qiu Yongzhen
Published: October 2024

Background
Primary care has been identified as a key factor in facilitating timely diagnosis and effective management of congestive chronic heart failure (CHF) in older patients. Understanding the current status of CHF management in community health care can therefore be effective in reducing the disease burden of CHF.
Objectives
The aim of this study was to evaluate the existing state of CHF services offered by healthcare facilities and to identify the primary obstacles faced by community medical personnel in China.
Methods
In this interpretive study, the social ecological model (SEM) was employed to facilitate interviews conducted using a semi-structured interview guide. Each participant underwent an interview lasting between 45 and 60 minutes. Thematic analysis was utilized for data analysis.
Results
This study incorporated a cohort of 30 participants. Facilitators and barriers were identified within the five domains of the SEM. (1) individual level: medical staff lack knowledge and experience in CHF management while patients’ weak health awareness. (2) interpersonal level: insufficient support from the patients’ family and lack of trust in community hospitals and health workers. (3) organizational level: inadequate medical knowledge and training programs for medical staff, shortage of medical staff and weak teamwork and few health promotion channels. (4) community level: Lack of regular screening and follow-up, medical equipment and an information technology-assisted monitoring system. (5) public policy level: lack of policy support, funding subsidies, national guidelines adapted to the local context and low medical insurance reimbursement rate.
Conclusion
There are many impediments to chronic disease management in the community, so it is vital to improve public understanding of CHF, as well as to improve the quality of community health equipment and services, to improve reciprocal referral mechanisms between hospitals and the community, and to develop policies on chronic disease management for chronic older people.
Identification of Safe Trocar Insertion Sites Guided by Ultrasonography to Minimize Epigastric Vessel Injuries in Pediatric Laparoscopic Procedures Pediatric Laparoscopy and Epigastric Vessel Safety
Authors: Bilir Cemal , Öcal Zeynep Ayvat
Published: October 2024

Objective:
This study aims to predict the location of epigastric vessels on the abdominal surface in pediatric patients using doppler ultrasonography and to identify safe trocar entry in laparoscopic surgery
Methods:
This study involved 90 pediatric patients who underwent color doppler ultrasound evaluation of the deep epigastric vessels before laparoscopic surgery. The deep epigastric vessels were identified at 5 equidistant levels between the xiphoid process and the symphysis pubis. Bilateral measurements of the distance of the epigastric vessels from the midline were taken at each level. Predictive analysis utilized a linear mixed model with maximum likelihood estimation.
Results:
The mean distances of the deep epigastric vessels to the midline at different levels in the abdominal region were 6.18 ± 0.7 cm at the right pubic symphysis, 4.64 ± 0.6 cm from the umbilicus, and 3.21 ± 0.5 cm at the level of the xiphoid. On the left, it was 6.46 ± 0.69 cm from the pubic symphysis, 4.64 ± 0.6 cm from the umbilicus, and 3.19 ± 0.5 cm at the level of the xiphoid.
Conclusion:
Significant variation in the distance of deep epigastric vessels from the midline in pediatric patients was observed, with no significant differences between male and female children. Consistent with the existing literature, the findings identify relatively safe avascular areas for lateral trocar placement in the pediatric population.
Incidence of RSPO3 rearrangements in advanced colorectal cancer patients detected by NGS and their relationship with disease characteristics
Authors: Tur Raquel , Abad Mar , Filipovich Elena , Rivas María Belén , Rodríguez Marta , Montero Juan Carlos , Sayagués José María
Published: October 2024

Colorectal cancer (CRC) is the second most frequent cause of cancer-related deaths. Mortality is largely due to limited treatment options for patients who present with advanced disease. Genomic abnormalities that are potentially characteristic of such advanced stages of the disease are complex and are not yet fully understood. In fact, only 30% of cases with advanced disease benefit from targeted treatments. The molecular heterogeneity of primary advanced CRC (aCRC) tumor samples was evaluated by next-generation sequencing (NGS) in 53 consecutive patients (pT4a-b). The genetic abnormalities found in primary tumors were most frequently mutations in TP53 (57% of cases), KRAS (45%), PI3KCA (27%), BRAF (15%) and RET (10%), as well as RSP03 fusions (8%). Alterations in the TP53 and NRAS genes were more commonly observed in the left colon, while BRAF mutations and RSPO3 fusions were more frequently detected in the right or transverse colon. We also show a strong association between the presence of RSPO3 rearrangements and patients with small, low histological grade tumors, with normal CEA levels, preferentially located on the right side of the colon. Furthermore, aCRC patients with PTPRK::RSPO3 fusions showed a higher frequency of deaths, and RSPO3 gene expression levels had an adverse impact on overall survival in two large, independent series of patients with CRC. We show that RSPO3 rearrangements occur very frequently in advanced disease, making it a promising therapeutic target for this subtype of patient.
Patient Satisfaction towards Telemedicine Services at the Satellite Centre of Tribal Health and Research in district Sirohi Rajasthan-A Mixed Method Study.
Authors: Dwivedi Rakhi , Jain Ridhi , Goyal Prachi , Goel Akhil Dhanesh , Bohra Gopal Krishna , Bhardwaj Abhishek , Singh Pratibha , Singh Kuldeep , Dwivedi Pradeep
Published: October 2024

Objective: This mixed-method study evaluates patient satisfaction towards telemedicine services at the Satellite Centre for Tribal Health and Research (STHR) in district Sirohi, Rajasthan.
Background: Telemedicine delivers remote medical care using technology, improving healthcare access for marginalised communities in tribal areas. This telemedicine centre at STHR aimed to provide high-quality healthcare services through telemedicine to the tribal population in the region.
Methods: Conducted from February 6, 2022, to May 31, 2024, the study involved 4570 tribal patients, with 3704 (81%) responding to a satisfaction survey using Telehealth Satisfaction Survey (TeSS) rated on a 3-point Likert scale. Quantitative data were analyzed using SPSS version 22, and qualitative data were collected via open-ended questionnaires and focus group discussions.
Results: The median age of respondents was 32 years, with 58.6% being male. Satisfaction scores ranged from 2.00 for voice quality to 2.31 for the courtesy of telemedicine staff, indicating a generally high satisfaction level. Thematic analysis identified key themes such as convenience, accessibility, and communication, despite challenges like internet connectivity issues.
Conclusion: Healthcare service satisfaction among patients helps in building and maintaining sustainable services and is also one of the key factors for service utilization. The telemedicine initiative at Satellite Centre for Tribal Health and Research has high satisfaction levels that underscore the potential of telemedicine to meet the healthcare needs of marginalized communities, provided technological and communication barriers are addressed.
Association between 5-minute Oxygen Saturation and Neonatal Death and Intraventricular Hemorrhage among Extremely Preterm Infants
Authors: Lee Henry , Jiang Siyuan , Cui Xin , Katheria Anup , Finer Neiil , Bennett Mihoko
Published: October 2024

Objective
To assess the relationship between 5-minute oxygen saturation (SaO₂) and outcomes in extremely preterm infants.
Study Design:
This cohort study included infants ≤ 28 weeks' gestation across nine hospitals from 2020 to 2022. Death and / or severe intraventricular hemorrhage (IVH) were compared between infants with 5-minute SaO2 < 80% and 80–100% using Poisson regression models. Two-piecewise segmented regression model was used to estimate breakpoint of 5-minute SaO₂ in relation to outcomes.
Result
Of 390 infants, 184 (47.2%) had 5-minute SaO₂ < 80%. A 5-minute SaO₂ < 80% was independently associated with increased risks of death and / or severe IVH, early death, and severe IVH. Analysis of SaO₂ as a continuous variable revealed a breakpoint at 80% (95% CI: 75–86%), above which no additional benefit in outcomes was observed.
Conclusion
Our findings support the current recommendation of 5-minute SaO₂ target of 80% for extremely preterm infants.
Acanthosis Nigricans as a Beacon for Hepatitis C
Authors: George Abe , Kumar Sumir
Published: October 2024

Background: Acanthosis nigricans (AN) is a dermatological condition often associated with insulin resistance and obesity. This case report presents an unusual occurrence of AN in a non-obese patient with newly diagnosed hepatitis C virus (HCV) infection.
Case Report: A 40-year-old male presented with dark, velvety skin patches on his face, neck, axillae, and groins. Clinical and histopathological examination confirmed AN. Laboratory investigations revealed HCV infection and indicators of insulin resistance.
Conclusion: This case strengthens the previous observations and uniquely suggests a potential association between HCV infection, insulin resistance, and the development of AN, highlighting the need for further research into this relationship.
Persistent oral health inequality in children—repeated cross-sectional studies in 2010 and 2019
Authors: Blomma Caroline , Davidson Thomas , Gerdin Elisabeth Wärnberg , Bågesund Mats , Lyth Johan
Published: October 2024

Background and aim: Children growing up in vulnerable circumstances have a higher risk of caries experience. Tracking the development of caries in relation to socioeconomic variables over time is essential for fair resource distribution to groups with higher caries risk and to even out inequalities in oral health. The aim was therefore to analyse the association between 6-year-olds´ caries prevalence and socioeconomic variables at family and residential area levels in 2010 and 2019 and the trends in these associations.
Methods: The study design is an epidemiological registry-based, repeated cross-sectional study based on caries data (grouped as 0, 1–3 and >3 dmft) for the population of 6-year-olds in 2010 (n =4,408, 95% coverage) and 2019 (n =5,199, 94% coverage) in a Swedish region. Multiple socioeconomic variables for the children’s families and residential areas were retrieved from official registries. Multinomial logistic regression was performed at both levels to produce models for each level and studied year.
Results: The variables that explained most of the association between caries and socioeconomic variables were mainly the same over the years at both levels. At the family level, these were: maternal age when having their first child (explained most of the association in both years, at 30 and 35%, respectively); maternal age when having the child in the study group; parental employment; parental and child’s migration background; maternal educational level; form of housing; and financial assistance (only 2010). At the residential area level, these were: migration background (explained most of the association both years; 82 and 52 %, respectively), educational level and number of persons per household. The association between socioeconomic variables and caries was consistently stronger for severe caries (dmft >3) than moderate (dmft 1–3). Multiple socioeconomic risk variables meant even greater likelihood of caries.
Conclusion: Over the studied years, variables related with socioeconomics vulnerability continued to be associated with caries in young children growing up under socially disadvantaged circumstances. Effective efforts for families living in socially vulnerable contexts are needed to achieve good and equal oral health, as is continued follow-up to evaluate whether the goal is reached.
Obervation of subrelativistic collisionless shocks generation and breakout dynamics
Authors: Tian Ye , Bai Yafeng , Zhang Dongdong , Zeng Yushan , mao jiakang , Song Liwei , Li Ruxin
Published: October 2024

Relativistic collisionless shocks1, which are ubiquitous in the cosmos, play a significant role in various astrophysical phenomena such as gamma-ray bursts2–4, PeVatrons5–7, and shock breakouts accompanying a supernova explosion8. To unravel these processes happening at enormous spatial and energy scales, the most convenient and feasible approach so far – laser – has been long sought to access such extreme conditions in an ultrafast and volume-efficient manner9–13. Yet observing a relativistic collisionless shock in a laboratory has remained out of reach. Here, we demonstrate that sub-relativistic collisionless shocks with velocities ~ 0.03c of astrophysical significance can be produced and characterized in a laboratory using a table-top femtosecond “laser engine”. We attribute the shock formation to a rapidly growing Weibel instability in a carefully adjusted low-density preplasma environment, which resembles the interstellar media near an astrophysical central engine. Owing to this Weibel instability, a magnetic field as high as ~ 5000 T is developed within 2.7 ps, leading to the formation of a collisionless shock and shock breakout is finally observed at the preplasma edge. Our results not only pave the way for further exploration of astrophysics related to relativistic collisionless shocks but also enable a new regime of ultrahigh magnetic field physics on a tabletop scheme14.
Short sleep duration as a risk factor for cataract in the elderly hypertensive patients in rural China
Authors: Yang Dongbin , Li Chen , Ma Mingze , Xue Yunhui , Guo Xinghong , Jia Shiyu , Zhao Lipei , Tarimo Clifford Silver , Dai Nengguang , Liu Rongmei , Zhao Qiuping , Miao Yudong , Wu Jian , Ye Beizhu
Published: October 2024

Background
In an aging society, cataracts continue to significantly impact the quality of life for an increasing number of elderly individuals. As a risk factor for cataract, hypertension is becoming increasingly prevalent among the elderly year by year. The association between sleep duration and cataract in elderly hypertensive demographic remains unclear and warrants further exploration to aid in strategizing early intervention programs.
Methods
Based on China’s National Basic Public Health Service Project (NBPHSP), a cross-sectional study was conducted in Jia County, Henan Province, China. A total of 17473 cases aged 65 years and over with hypertension were included in this study. Sleep duration was obtained through questionnaires and information on cataracts was derived from NBPHSP. Three logistic regression models were used to assess the association between sleep duration and cataract. Subgroup analysis and interaction tests were performed to address heterogeneity.
Results
The average self-reported sleep duration was (6.77 ± 1.80) hours, and the prevalence of cataracts was 11.9%. In the adjusted logistic regression model, elderly hypertensive patients with sleep duration < 6 hours had a higher risk of cataract compared to those with sleep duration between 7–8 hours (OR: 1.39, 95%CI: 1.21–1.59). However, non-significant association was found between long sleep duration and cataract. The findings from subgroup analysis indicated no significant interaction effect.
Conclusions
In rural China, elderly hypertensive patients with a sleep duration of less than 6 hours are at a significantly higher risk of developing cataracts. This finding underscores the importance of monitoring sleep patterns in this population. Promoting adequate sleep duration may be a key strategy in reducing cataract prevalence and improving the overall quality of life for elderly patients with hypertension.
Evaluating change in self-reported function and pain in clients with musculoskeletal concerns attending a physiotherapy student-led service
Authors: Prudden Chloe , Jones Taryn , Baque Emmah , Collings Tyler , Edwards Sandy , Shephard Renae , Hams Andrea
Published: October 2024

Musculoskeletal conditions are a major contributor to global health burden, often resulting in impaired function and persistent pain. Physiotherapy student-led services provide a model for addressing community healthcare needs while offering authentic clinical training experiences. Despite emerging research on stakeholder perceptions and satisfaction with student-led services, their impact on clinical outcomes remains unclear. This study aimed to evaluate changes in self-reported function and pain and describe demographics including presenting musculoskeletal conditions among clients attending single-site physiotherapy student-led service. Ninety-nine participants (Mdn age = 29 years, IQR = 22–40) were recruited from a South-East Queensland student-led service. Demographic and presenting condition data were collected at the initial appointment, while self-reported outcome measures of function (Patient Specific Functional Scale: PSFS) and pain (Numeric Pain Rating Scale: NPRS) were recorded on a 0–10 scale at all appointments. Results showed a significant positive correlation between appointment frequency and PSFS scores, with each appointment associated with a 0.766 unit increase in PSFS scores (95% CI [0.434, 1.10], t (390) = 4.53, p < .001). There was a significant negative correlation between appointment frequency and NPRS scores, with each appointment associated with a 0.58 unit decrease in NPRS scores (95% CI [-0.77, -0.39], t (141) = -5.99, p < .001). This study adds to growing evidence supporting student-led services as effective settings to improve self-reported function and reduce pain among clients with diverse musculoskeletal conditions. Further multi-site longitudinal research on student-led services is recommended.
Analysis of Dysmenorrhea-Related Factors in Adenomyosis and Development of a Risk Prediction Model
Authors: Fu Yudan , Wang Xin , Yang Xinchun , zhao Ruihua
Published: October 2024

Objective
To explore factors related to dysmenorrhea in adenomyosis and construct a risk prediction model.
Methods
A cross-sectional survey involving 1636 adenomyosis patients from 37 hospitals nationwide (November 2019 - February 2022) was conducted. Data on demographics, disease history, menstrual and reproductive history, and treatment history was collect.Patients were categorized into dysmenorrhea and non-dysmenorrhea groups. Multivariate logistic regression analyzed factors influencing dysmenorrhea, and a risk prediction model was created using a nomogram. The model's performance was evaluated through ROC curve analysis, C-index, Hosmer-Lemeshow test, and bootstrap method The nomogram function was used to establish a nomogram model. The model was evaluated using the area under the ROC curve (AUC), C-index, Hosmer-Lemeshow goodness-of-fit test, and bootstrap method. Patients were scored based on the nomogram, and high-risk groups were delineated.
Results
Dysmenorrhea was present in 61.31% (1003/1636) of the patients. Univariate analysis showed significant differences (P < 0.05) between groups in age at onset, course of disease, oligomenorrhea, menorrhagia, number of deliveries, pelvic inflammatory disease, family history of adenomyosis, exercise, and excessive menstrual fatigue. Significant factors included menorrhagia, multiple deliveries, pelvic inflammatory disease, and family history of adenomyosis as risk factors. Older age at onset, oligomenorrhea, and exercise were identified as protective factors. The model's accuracy, discrimination, and reliability were acceptable, and a risk score > 88.5 points indicated a high-risk group.
Conclusion
Dysmenorrhea is prevalent among adenomyosis patients. Identifying and mitigating risk factors, while leveraging protective factors, can aid in prevention and management. The developed model effectively predicts dysmenorrhea risk, facilitating early intervention and treatment.
Tackling intrinsic instability of mRNA vaccine by a rapid onsite microfluidic assembly (ROMA) technology
Authors: Xu Jiang , Zheng Zhouyi , Jiang Yue , Wang Qiuhe , Dai Zhiqi , Yuan Ruyue , Yu Zhibin , Gong Yue , Hou Fujun , Ding Jun , Zhang Wen , Gu Zhen , Jia William
Published: October 2024

Despite achieving unprecedented success, current mRNA vaccines face significant challenges, including thermo-instability, degradation, and infrastructure-dependence, making customizable supply a distant goal. Here, we describe a Rapid Onsite Microfluidic Assembly (ROMA) technology capable of generating ready-to-inject mRNA vaccines with a real-time quality inspection as a solution. Diverging from traditional manufacturing mechanism of directly assembling mRNA and lipids into mRNA-LNPs, ROMA technology utilizes mRNA and pre-made empty LNPs to form mRNA-LNPs that exhibit equivalent physiochemical parameters and in vivo expressions compared to conventional ones. Our ROMA prototype offers personalized options for mRNA vaccines, including lipid nanoparticle (LNP) sizes, compositions, mRNA types, and dosages tailored to individual needs, at a throughput of 200 doses/hour (∼100 µg mRNA/dose) with scalable potential. Crucially, ROMA mRNA vaccine, immediately deployable without the need for storage, fundamentally avoids the intrinsic thermal instability and degradation risks associated with conventional ones. This transformative ROMA technology offers unparalleled user-end convenience, unlocking the translational potential for personalized mRNA vaccines and treatments, thereby significantly expanding the scope of mRNA-based therapeutics.
Ascitic Shear Stress Activates GPCRs and Downregulates Mucin 15 to Promote Ovarian Cancer Malignancy
Authors: Horst Eric N. , Cotter Liam R. , Bonini Mia , Novak Caymen M. , Treacher Nina M. , Zhang Yeye , Jackson Zoe F. , Narayanan Ishwarya V. , Fischer Zachary S. , Sunshine Alec R. , Lin Zequan , Tran Linh A. , Ljungman Mats , Maturen Katherine E. , DiFeo Analisa , Nordsletten David A. , Mehta Geeta
Published: October 2024

The accumulation of ascites in patients with ovarian cancer increases their risk of transcoelomic metastasis. Although common routes of peritoneal dissemination are known to follow distinct paths of circulating ascites, the mechanisms that initiate these currents and subsequent fluid shear stresses are not well understood. Here we developed a patient-based, boundary driven computational fluid dynamics model to predict an upper range of fluid shear stress generated by the accumulation of ascites. We show that ovarian cancer cells exposed to ascitic shear stresses display heightened G protein-coupled receptor mechanosignaling and the induction of an epithelial to mesenchymal-like transition through p38α mitogen-activated protein kinase and mucin 15 modulation. An emergent immunomodulatory secretome and endoplasmic reticulum stress activation is also present in shear stimulated cancer cells, positioning elevated shear stress as a protumoural signal. Together, these findings suggest maintenance strategies for overcoming mechanotransduction mediated metastasis within the peritoneal cavity.
Cell Populations in Human Breast Cancers are Molecularly and Biologically Distinct with Age
Authors: McAllister Sandra , Parsons Adrienne , Colon Esther Sauras , Spasic Milos , Kurt Busem Binboga , Swarbrick Alexander , Freedman Rachel , Mittendorf Elizabeth , Galen Peter van
Published: October 2024

Aging is associated with increased breast cancer risk and outcomes are worse for the oldest and youngest patients, regardless of subtype. It is not known how cells in the breast tumor microenvironment are impacted by age and how they might contribute to age-related disease pathology. Here, we discover age-associated differences in cell states and interactions in human estrogen receptor-positive (ER+) and triple-negative breast cancers (TNBC) using new computational analyses of existing single-cell gene expression data. Age-specific program enrichment (ASPEN) analysis reveals age-related changes, including increased tumor cell epithelial-mesenchymal transition, cancer-associated fibroblast inflammatory responses, and T cell stress responses and apoptosis in TNBC. ER+ breast cancer is dominated by increased cancer cell estrogen receptor 1 (ESR1) and luminal cell activity, reduced immune cell metabolism, and decreased vascular and extracellular matrix (ECM) remodeling with age. Cell interactome analysis reveals candidate signaling pathways that drive many of these cell states. This work lays a foundation for discovery of age-adapted therapeutic interventions for breast cancer.
Word-In-Noise Perception Test in Adults
Authors: Zafarghandi Mohammad-Ebrahim Mahdavi- , Eghbalian Fatemeh , Najafi-Vosough Roya , Emami Seyed-Faranak
Published: October 2024

Background
The recently designed Word-in-noise Perception (WINP) test is a new technique for examining lexical-semantic scores by homotonic-monosyllabic words (HMWs) and white noise, which assesses auditory brain function in speech consonant detection. It is necessary to have a test that creates the best competitive conditions for evaluating meaning perception. Therefore, this study aimed to design a WINP test for adults using HMWs and spectrum speech noise (SSN).
Methodology:
This study was a test-development type that was conducted in a cross-sectional-comparative way, it included 110 young Persian speakers (61 men and 49 women) with mean age of 20 (0.56) years. The evaluations included checking the state of general health, sleep and mental states, basic audiological evaluations, dichotic digit test and WINP test using HMWs and SNN. HMWs consisted of 6 lists of 25 words with a vowel/consonant/vowel pattern, the words in each list have the same vowel. The content validity of HMWs was confirmed by 20 Persian language experts and calculated using content and index validity ratios. Its reliability was measured based on repeatability in test times, intraclass correlation coefficient and the comparison of HMWs scores in two repetitions. To calculate the norm values, the number of correct responses in the mean measurements was multiplied by 4 and expressed as a percentage. Mann-Whitney tests were used to compare the scores of the groups.
Results
The validity and reliability of WINP test using HMWs and SSN were determined. Mean CVR and mean CVI of the HMWs were equal to 0.99 and to 0.95 respectively. ICC in single and mean measurements were also calculated. An ICC close to 1 indicates greater validity of WPS and better consistency of HMWs across lists. The results showed that the obtained scores are stable and without measurement errors. Normal values of WINP test using HMWs and SSN were gotten, which were 54%, 69%, 82%, 90% and 94% at SNRs of -5, 0, + 5, +10, and + 15 dB, respectively. The variable of gender was not an effective factor for creating a difference in the mean scores of WINP test using HMWs and SSN (P = 0.989). There was no significant difference between WINP mean scores in SNR in different noises between the right and left ears. Also, there was significant difference between mean scores of WINP in SNRs from − 5 to + 15 for left and right ears.
Conclusion
Psychometric properties of the WINP test using HMWs and SNN have been confirmed for Persian speaking adults.
Ultrahigh through-plane thermal conductivity of graphite by reducing inter-plane twist
Authors: Sun Bo , Zhao Lu , Chen Zitao , Hu Song , Zhi Aomiao , Wu Junqiao , Kang Feiyu , Tian Xuezeng , Gu Xiaokun
Published: October 2024

Graphite is a cornerstone material in heat dissipation due to its exceptionally high in-plane thermal conductivity (~ 2000 W m− 1 K− 1). However, its low through-plane thermal conductivity remains a bottleneck for heat dissipation, typically limited to 5–9 W m− 1 K− 1. Here we reveal that graphite, when structure is optimized, delivers a record high through-plane thermal conductivity of up to 13.4 W m− 1 K− 1 at room temperature. This enhancement is achieved by reducing the helical twist within the graphite crystal structure. We demonstrate that while having minimal impact on in-plane conductivity, these twists significantly hinder heat-carrying phonons traveling through-plane. This work establishes a new benchmark for graphite's thermal properties and paves the way for unlocking its full potential in thermal management applications.