bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonischemic or Dual Cardiomyopathy in Patients With Coronary Artery Disease
Authors: Bawaskar Parag , Thomas Nicholas , Ismail Khaled , Guo Yugene , Chhikara Sanya , Athwal Pal Satyajit Singh , Ranum Alison , Jadhav Achal , Hooker Mendez Abel , Nadkarni Ishan , Frerichs Dominic , Velangi Pratik , Ergando Tesfatsiyon , Akram Hassan , Kanda Adinan , Shenoy Chetan
Published: November 2023

BACKGROUND:

Randomized trials in obstructive coronary artery disease (CAD) have largely shown no prognostic benefit from coronary revascularization. Although there are several potential reasons for the lack of benefit, an underexplored possible reason is the presence of coincidental nonischemic cardiomyopathy (NICM). We investigated the prevalence and prognostic significance of NICM in patients with CAD (CAD-NICM).

METHODS:

We conducted a registry study of consecutive patients with obstructive CAD on coronary angiography who underwent contrast-enhanced cardiovascular magnetic resonance imaging for the assessment of ventricular function and scar at 4 hospitals from 2004 to 2020. We identified the presence and cause of cardiomyopathy using cardiovascular magnetic resonance imaging and coronary angiography data, blinded to clinical outcomes. The primary outcome was a composite of all-cause death or heart failure hospitalization, and secondary outcomes were all-cause death, heart failure hospitalization, and cardiovascular death.

RESULTS:

Among 3023 patients (median age, 66 years; 76% men), 18.2% had no cardiomyopathy, 64.8% had ischemic cardiomyopathy (CAD+ICM), 9.3% had CAD+NICM, and 7.7% had dual cardiomyopathy (CAD+dualCM), defined as both ICM and NICM. Thus, 16.9% had CAD+NICM or dualCM. During a median follow-up of 4.8 years (interquartile range, 2.9, 7.6), 1116 patients experienced the primary outcome. In Cox multivariable analysis, CAD+NICM or dualCM was independently associated with a higher risk of the primary outcome compared with CAD+ICM (adjusted hazard ratio, 1.23 [95% CI, 1.06–1.43];
P
=0.007) after adjustment for potential confounders. The risks of the secondary outcomes of all-cause death and heart failure hospitalization were also higher with CAD+NICM or dualCM (hazard ratio, 1.21 [95% CI, 1.02–1.43];
P
=0.032; and hazard ratio, 1.37 [95% CI, 1.11–1.69];
P
=0.003, respectively), whereas the risk of cardiovascular death did not differ from that of CAD+ICM (hazard ratio, 1.15 [95% CI, 0.89–1.48];
P
=0.28).

CONCLUSIONS:

In patients with CAD referred for clinical cardiovascular magnetic resonance imaging, NICM or dualCM was identified in 1 of every 6 patients and was associated with worse long-term outcomes compared with ICM. In patients with obstructive CAD, coincidental NICM or dualCM may contribute to the lack of prognostic benefit from coronary revascularization.
Systemic Lupus Erythematosus and the Ratio of Omega-3 to Omega-6 Fatty Acids Consumption among Women in the Adventist Health Study-2
Authors: Oh Jisoo , Oda Keiji , Brash Marissa , Beeson W. Lawrence , Sabaté Joan , Fraser Gary E , Knutsen Synnove F
Published: November 2023

Objective

To assess the associations of omega-3 and omega-6 fatty acids consumption, and the ratio between the two, with self-reported doctor told Systemic Lupus Erythematosus (SLE) diagnosis. Further, to assess whether initiation of omega-3 supplements intake was related to time/year of SLE diagnosis.

Methods

Data from 42,398 women in the Adventist Health Study-2 cohort were used for this cross-sectional study. Unconditional logistic regression modeling was used for all analyses with the following candidate covariates: age, race, education, smoking, and body mass index (BMI).

Results

Compared to non-cases, participants with a diagnosis of SLE reported higher intakes of total omega-3 fatty acids and about the same intakes of omega-6 fatty acids. Overall, they had higher ratios of omega-3 to omega-6 fatty acids. When assessing odds ratios of SLE diagnosis by quartiles of omega-3 to omega-6 and DHA+EPA to omega-6, there was a positive significant trend (p trend = 0.005). Additionally, among those reporting intake of fish oil, 87% had initiated fish oil consumption around the time of SLE diagnosis. SLE was more likely to occur among Black women compared to White women, among ever smokers compared to never smokers, among overweight women compared to women with normal/underweight, and among women 50–59 years compared to those 30–49 year old. When a smaller 6 year follow-up study identified 64 incident SLE cases and assessed their omega-3 intake at baseline (6 years earlier and before the SLE diagnosis) their intake of omega-3 and fish oil was no different than among non-cases.

Conclusion

We observed a significant positive association between the ratio of omega-3 to omega-6 fatty acids consumption and prevalence of SLE. Among those with prevalent SLE, their year of starting supplementation of omega-3 and fish oil was closely linked to year of SLE diagnosis. Further, baseline intake of omega-3 fatty acids was not increased among 64 incident SLE cases identified during 6 years of follow-up. Our surprising finding can best be explained by reverse causation. This could be an example of how public health information is assimilated and acted upon by a health conscious public.
Visualisation of Bluetongue Virus in the Salivary Apparatus of Culicoides Biting Midges Highlights the Accessory Glands as a Primary Arboviral Infection Site
Authors: Guimerà Busquets Marc , Brown Faye V. , Carpenter Simon T. , Darpel Karin E. , Sanders Christopher J.
Published: November 2023

Background

Arthropods transmit a wide range of pathogens of importance for the global health of humans, animals, and plants. One group of these arthropod vectors, Culicoides biting midges (Diptera: Ceratopogonidae), is the biological vector of several human and animal pathogens, including economically important livestock viruses like bluetongue virus (BTV). Like other arthropod-borne viruses (arboviruses), Culicoides-borne viruses must reach and replicate in the salivary apparatus, from where they can be transmitted to susceptible hosts through the saliva during subsequent blood feeding. Despite the importance of the salivary gland apparatus for pathogen transmission to susceptible animals from the bite of infected Culicoides, these structures have received relatively little attention, perhaps due to the small size and fragility of these vectors.

Results

In this study, we developed techniques to visualize the infection of the salivary glands and other soft tissues with BTV, in some of the smallest known arbovirus vectors, Culicoides biting midges, using three-dimensional immunofluorescence confocal microscopy. We showed BTV infection of specific structures of the salivary gland apparatus of female Culicoides vectors following oral virus uptake, related visualisation of viral infection in the salivary apparatus to high viral RNA copies in the body, and demonstrated for the first time, that the accessory glands are a primary site for BTV replication within the salivary apparatus.

Conclusions

Our work has revealed a novel site of virus-vector interactions, and a novel role of the accessory glands of Culicoides in arbovirus amplification and transmission. Our approach would also be applicable to a wide range of arbovirus vector groups including sand flies (Diptera: Psychodidae), as well as provide a powerful tool to investigate arbovirus infection and dissemination, particularly where there are practical challenges in the visualization of small size and delicate tissues of arthropods.
Safety assessment of Enterococcus lactis strains complemented with comparative genomics analysis reveals probiotic and safety characteristics of the entire species
Authors: Ahmed Noha A. , Khattab Rania Abdelmonem , Ragab Yasser M. , Hassan Mariam
Published: November 2023

Background

The gut microbiota is considered a rich source for potential novel probiotics. Enterococcus genus is a normal component of a healthy gut microbiota, suggesting its vital role. Nosocomial infections caused mainly by E. facalis and E. faecium have been attributed to the plasticity of the Enterococcus genomes. In this study, we assessed the probiotic and safety characteristics of two E. lactis strains isolated from the human gut microbiota using in-vitro and in silico approaches. Additionally, the safety of the E. lactis species was evaluated using comparative genomics analysis.

Results

The two E. lactis strains 10NA and 50NA showed resistance to bile salts and acid tolerance with antibacterial activity against Escherichia coli, Salmonella typhi, and Clostridioides difficile. For safety assays, the two strains did not display any type of hemolysis on blood agar, and the survival of Caco-2 cells was not significantly different (P-value > 0.05) compared to the control using cell free supernatants at 100% (v/v), 50% (v/v), 10% (v/v), and 5% (v/v) concentrations. Regarding antibiotic susceptibility, both strains were sensitive to vancomycin, tetracycline, and chloramphenicol. Comprehensive whole-genome analysis revealed no concerning associations between virulence or antibiotic resistance genes and any of the identified mobile genetic elements. Comparative genome analysis with closely related E. faecium species genomes revealed the distinctive genomic safety of the E. lactis species.

Conclusions

Our two E. lactis strains showed promising probiotic properties in-vitro. Their genomes were devoid of any transferable antibiotic resistance genes. In silico comparative analysis confirmed the safety of the E. lactis species. These results suggest that E. lactis species could be a potential source for safer Enterococcus probiotic supplements.
A case report of chronic dacryocystitis caused by nasal stones
Authors: Huo Yandi , Li Luoxiang , Mo Ya , Guo Sirui
Published: November 2023

Background

This paper reports a case of chronic dacryocystitis due to nasal stones.

Case presentation

An 84-year-old male patient was admitted to the hospital with chronic dacryocystitis of the right eye due to tearing and purulent discharge from the right eye for more than 1 month. Antibiotic treatments such as gatifloxacin eye drops were given at other hospitals but did not relieve the symptoms. A computed tomography(CT) scan of the lacrimal duct in our department showed a high-density shadow in the right lacrimal sac area, hypertrophy of the right inferior turbinate, and many nasal calculi in the nasal cavity. The patient was transferred to our otolaryngology department for further treatment, and nasal stones were removed under nasal endoscopy. Three days after surgery, the symptoms affecting the patient's right eye gradually resolved. One month after surgery, the patient underwent a follow-up examination in the ophthalmology clinic; there was no lacrimal purulent discharge from the right eye, and the lacrimal duct could be flushed smoothly.

Conclusion

Chronic dacryocystitis is often caused by primary nasolacrimal duct obstruction. Cases of chronic dacryocystitis caused by secondary nasolacrimal duct obstruction due to nasal stones are rare in the clinic. This case can serve as a reference for the clinical diagnosis and treatment of chronic dacryocystitis.
An explainable artificial intelligence framework for risk prediction of COPD in smokers
Authors: Wang Xuchun , Qiao Yuchao , Cui Yu , Ren Hao , Zhao Ying , Linghu Liqin , Ren Jiahui , Zhao Zhiyang , Chen Limin , Qiu Lixia
Published: November 2023

Background

Since the inconspicuous nature of early signs associated with Chronic Obstructive Pulmonary Disease (COPD), individuals often remain unidentified, leading to suboptimal opportunities for timely prevention and treatment. The purpose of this study was to create an explainable artificial intelligence framework combining data preprocessing methods, machine learning methods, and model interpretability methods to identify people at high risk of COPD in the smoking population and to provide a reasonable interpretation of model predictions.

Methods

The data comprised questionnaire information, physical examination data and results of pulmonary function tests before and after bronchodilatation. First, the factorial analysis for mixed data (FAMD), Boruta and NRSBoundary-SMOTE resampling methods were used to solve the missing data, high dimensionality and category imbalance problems. Then, seven classification models (CatBoost, NGBoost, XGBoost, LightGBM, random forest, SVM and logistic regression) were applied to model the risk level, and the best machine learning (ML) model’s decisions were explained using the Shapley additive explanations (SHAP) method and partial dependence plot (PDP).

Results

In the smoking population, age and 14 other variables were significant factors for predicting COPD. The CatBoost, random forest, and logistic regression models performed reasonably well in unbalanced datasets. CatBoost with NRSBoundary-SMOTE had the best classification performance in balanced datasets when composite indicators (the AUC, F1-score, and G-mean) were used as model comparison criteria. Age, COPD Assessment Test (CAT) score, gross annual income, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), anhelation, respiratory disease, central obesity, use of polluting fuel for household heating, region, use of polluting fuel for household cooking, and wheezing were important factors for predicting COPD in the smoking population.

Conclusion

This study combined feature screening methods, unbalanced data processing methods, and advanced machine learning methods to enable early identification of COPD risk groups in the smoking population. COPD risk factors in the smoking population were identified using SHAP and PDP, with the goal of providing theoretical support for targeted screening strategies and smoking population self-management strategies.
Risk perceptions of COVID-19, vocational identity, and employment aspirations of Chinese aviation students: a structural equation modeling approach
Authors: Qin Hongyao , Tang Yong
Published: November 2023

Background

The COVID-19 pandemic has wreaked havoc on the aviation and education sectors in China. This study examined the relationships between risk perceptions of the pandemic, vocational identity, and employment aspirations of Chinese aviation students.

Methods

The study used a convenience sampling approach to collect data (n = 276 respondents) from August 2 to 8, 2022. An online survey was sent via WeChat and QQ to Chinese students majoring in aviation service management who were under lockdown at six Chinese schools.

Results

In spite of the strong support for the stringent COVID policies and full awareness of infection risk and protective measures, respondents were worried about the current unstable situation and felt fear for its severity and long-lasting symptoms. The casual path from career commitment to employment aspiration was supported, but high risk perceptions of the pandemic failed to have any psychological effect on the two constructs of vocational identity and employment aspirations.

Conclusions

The findings not only demonstrate the power of career commitment on employment aspirations but also reveal that a relatively high self-assessment of career proficiency may not necessarily lead to a clear career aspiration, possibly due to poor risk communication and insufficient career planning guidance. Thus, Chinese aviation students should improve their career proficiency and commitment, broaden their career options and adaptability, and have a clear career plan, in order to be well prepared for the fierce job market that will face the next wave of the ongoing pandemic.
Acute respiratory distress syndrome in patients with COVID-19 vs. Non-COVID-19: clinical characteristics and outcomes in a tertiary care setting in Mexico City
Authors: Palacios-Moguel Paul , Esquivel-Pineda Alejandra , Flores-Andrade Xavier A. , Aguirre-Sanchez Janet S. , Cruz-Arellanes Nancy N. , Sauza-Sosa Julio C. , García-Gonzalez Naybeth , Manzur-Sandoval Daniel , Toledo-Aleman Enma , García-Cruz Edgar
Published: November 2023

Background

Acute Respiratory Distress Syndrome (ARDS) due tocoronavirus disease (COVID-19) infection has a unique phenotype generating a growing need to determine the existing differences that can alter existing evidence-based management strategies for ARDS. Research Question: What differences does the clinical profile of patients with ARDS due to COVID 19 and Non-COVID 19 have?

Study Design and methods

We conducted a comparative, observational, retrospective study in the Intensive Care Unit (ICU)of a third-level hospital in Mexico City, from March 2020 through March 2022. Clinical, echocardiographic, and laboratory variables were compared between patients with ARDS due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and those due to other etiologies.

Results

We enrolled 140 patients with a diagnosis of ARDS. The study group of COVID-19 etiology were younger males, higher body mass index, progressed to organ dysfunction, required more frequently renal replacement therapy, and higher SOFA score. There was no difference in rates of right ventricular dysfunction.

Interpretation

COVID-19 ARDS exhibit much greater severity that led to higher admission and mortality rates, whilst being younger and less comorbid.
Enhancing healthcare providers’ diagnostic and intervention skills to deal with suicidal patients at emergency departments in the Palestinian hospitals: a quasi experimental study
Authors: Jabr Samah , Mahamid Fayez , Hinnawi Zaynab , Bdier Dana
Published: November 2023

Background

Suicide cases in Palestine continue to record a remarkable annual increase, but we lack a comprehensive verified national data collection system of suicide and it is expected that real numbers of attempted/suicide in Palestine are higher because not all suicide or attempted suicide cases are reported. The purpose of this study was to test the effectiveness of a time-limited training intervention in enhancing healthcare providers’ diagnostic and intervention skills to deal with suicidal patients who visit emergency departments in Palestinian hospitals.

Methods

The sample consisted of 43 healthcare providers who work in public hospitals in the northern of the West Bank of Palestine, ranging from 25 to 56 years, involving 36 males and 7 females. A one-group quasi-experimental design was used, in which the experimental group received a training program to enhance healthcare providers’ diagnostic and intervention skills to deal with suicidal ideations and attempts, the intervention lasted for 8 weeks, with 1 session per week. The performance of the experimental group was tested before and after the intervention.

Results

Our findings revealed the effectiveness of the training intervention in enhancing participants’ suicide assessment, diagnosis, and self-care skills.

Conclusions

These results suggest that a brief and carefully developed training intervention can potentially change healthcare providers’ perceptions and behaviors toward suicide with a possible impact on clinical care therein.
Plasma glial fibrillary acidic protein as a biomarker of disease progression in Parkinson’s disease: a prospective cohort study
Authors: Lin Junyu , Ou Ruwei , Li Chunyu , Hou Yanbing , Zhang Lingyu , Wei Qianqian , Pang Dejiang , Liu Kuncheng , Jiang Qirui , Yang Tianmi , Xiao Yi , Zhao Bi , Chen Xueping , Song Wei , Yang Jing , Wu Ying , Shang Huifang
Published: November 2023

Background

Reactive astrogliosis has been demonstrated to have a role in Parkinson’s disease (PD); however, astrocyte-specific plasma glial fibrillary acidic protein (GFAP)’s correlation with PD progression remains unknown. We aimed to determine whether plasma GFAP can monitor and predict PD progression.

Methods

A total of 184 patients with PD and 95 healthy controls (HCs) were included in this prospective cohort study and followed-up for 5 years. Plasma GFAP, amyloid-beta (Aβ), p-tau181, and neurofilament light chain (NfL) were measured at baseline and at 1- and 2-year follow-ups. Motor and non-motor symptoms, activities of daily living, global cognitive function, executive function, and disease stage were evaluated using the Unified Parkinson’s Disease Rating Scale (UPDRS) part III, UPDRS-I, UPDRS-II, Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), and Hoehn and Yahr (H&Y) scales at each visit, respectively.

Results

Plasma GFAP levels were higher in patients with PD (mean [SD]: 69.80 [36.18], pg/mL) compared to HCs (mean [SD]: 57.89 [23.54], pg/mL). Higher levels of GFAP were observed in female and older PD patients. The adjusted linear mixed-effects models showed that plasma GFAP levels were significantly associated with UPDRS-I scores (β: 0.006, 95% CI [0.001–0.011], p = 0.027). Higher baseline plasma GFAP correlated with faster increase in UPDRS-I (β: 0.237, 95% CI [0.055–0.419], p = 0.011) and UPDRS-III (β: 0.676, 95% CI [0.023–1.330], p = 0.043) scores and H&Y stage (β: 0.098, 95% CI [0.047–0.149], p < 0.001) and faster decrease in MoCA (β: − 0.501, 95% CI [− 0.768 to − 0.234], p < 0.001) and FAB scores (β: − 0.358, 95% CI [− 0.587 to − 0.129], p = 0.002). Higher baseline plasma GFAP predicted a more rapid progression to postural instability (hazard ratio: 1.009, 95% CI [1.001–1.017], p = 0.033).

Conclusions

Plasma GFAP might be a potential biomarker for monitoring and predicting disease progression in PD.
Cost-effectiveness analysis of digital therapeutics for home-based cardiac rehabilitation for patients with chronic heart failure: model development and data analysis
Authors: Liu Tianyi , Zhan Yiyang , Chen Silei , Zhang Wenhong , Jia Jian
Published: November 2023

Background

In recent years, numerous guidelines and expert consensus have recommended the inclusion of digital technologies and products in cardiac rehabilitation. Digital therapeutics (DTx) is an evidence-based medicine that uses digital means for data collection and monitoring of indicators to control and optimize the treatment, management, and prevention of disease.

Objective

This study collected and reviewed real-world data and built a model using health economics assessment methods to analyze the potential cost-effectiveness of DTx applied to home-based cardiac rehabilitation for patients with chronic heart failure. From the perspective of medical and health decision-makers, the economic value of DTx is evaluated prospectively to provide the basis and reference for the application decision and promotion of DTx.

Methods

Markov models were constructed to simulate the outcomes of DTx for home-based cardiac rehabilitation (DT group) compared to conventional home-based cardiac rehabilitation (CH group) in patients with chronic heart failure. The model input parameters were clinical indicators and cost data. Outcome indicators were quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The robustness of the evaluation methods and results was tested using sensitivity analyses. Clinical indicators, cost data, and health utility values were obtained from real-world data, including clinical study data, published literature, and public website information.

Results

The Markov model simulated a time span of 10 years, with a cycle set at one month, for 120 cycles. The results showed that the per capita cost of the CH group was 38,442.11 CNY/year, with a QALY of 0.7196 per person per year. The per capita cost of the DT group was 42,300.26 CNY/year, with a QALY of 0.81687 per person per year. The ICER per person was 39,663.5 CNY/QALY each year, which was below the willingness-to-pay threshold of 85,698 CNY (China's GDP per capita in 2022).

Conclusions

DTx for home-based cardiac rehabilitation is an extremely cost-effective rehabilitation option compared with conventional home-based cardiac rehabilitation. DTx for home-based cardiac rehabilitation is potentially valuable from the perspective of healthcare decision-makers.
Immune checkpoint analysis in ear cancer
Authors: Klein M. , Polgart E. , Hallermann C. , Schulze H. J. , Hölzle F. , Wermker K.
Published: November 2023

Background

Among cutaneous squamous cell carcinomas, the ear (ecSCC) is one of the most common sites. Loco regional lymph node metastasis is found in six to eleven percent of cases, corresponding to increased metastasis compared to other sites. The aim of this study was to test the markers PD-L1, PD-1, CD4, CD8, and FoxP3 for suitability as prognostic predictive markers.

Methods

Sixty-four patients with ecSCC were included in this study. The expression of immunohistochemical markers (PD-L1, PD-1, CD4, CD8, FOXP3) was correlated with retrospective clinic pathological parameters (lymph node metastasis, distant metastasis, lymph node metastasis during follow-up, disease progression, disease-specific death).

Results

There was a correlation between increased disease specific death and a weak Foxp3 (p = 0.003) or reduced CD8 (p = 0.04). A PD-L1 expression > 1% was found in 39.1% of patients.

Conclusion

The investigated markers (CD4, CD8, FoxP3, PD-1, PD-L1) seem overall rather inappropriate for prognostic evaluation in ecSCC. Only the correlation of disease specific death with CD8 or FoxP3 seems to be worth testing in larger collectives.
Efficacy of Cal-Cemex as bone substitute for tibial plateau fractures
Authors: Pizzoli Andrea , Bondi Manuel , Piotto Laura , Tartaglia Nicola , Saracino Michele , Vyrva Oleg
Published: November 2023

Background

Various factors influence treatment and outcomes in tibial plateau fractures. Bone defects are among them. Many materials have been proposed to address this problem: allograft, bone–cements and various bone substitutes (BSM). Cal-Cemex (β-tricalciophosphate and polymethylmethacrylate) is a new hybrid bi-component BSM. A retrospective multicenter study was conducted based on the clinical experience of three European Hospitals, to demonstrate its clinical effectiveness, versatility and safety.

Materials and Methods

From December 2016 to March 2022, 45 displaced tibial plateau fractures were treated with internal fixation and augmentation using Cal-Cemex. The average age was 55.9 years. According to Schatzker classification, we included 13 type II, 24 type III, 3 type V and 4 type VI fractures. The postoperative follow-up (FU) consisted of clinical and radiological examinations at 6 and 12 weeks and 1 year after surgery. A CT scan was performed preoperatively and 1 year after surgery. Full weight bearing was permitted after less than 6 weeks. Clinical data were collected from patient charts, while functional data were evaluated using the Rasmussen knee function score, the KOOS score and the Hospital for Special Surgery knee rating score (HSS), to evaluate the range of motion, axis and functionality of the knee.

Results

The average FU was 42.8 months. CT scans taken at 1 year demonstrated a good surface osteointegration without radiolucent lines or osteolysis with good evidence of interdigitation and even bone ingrowth. At 1-year FU, the mean Rasmussen score was 24.7, the mean KOOS score was 90.7 and the mean HSS was 89.9 and the average full weight-bearing period 34.9. No patients had hardware failure or fracture secondary displacement.

Discussion

Cal-Cemex combines biological features and good mechanical performances. It guarantees biocompatibility and osteoconductivity, although it is not fully reabsorbable; β-tricalciophosphate component gives macro- and microporosity that allow fluids to penetrate inside the material, to stimulate bone ingrowth.

Conclusions

The study suggests that Cal-Cemex is an option for tibial plateau fractures, where augmentation and support are necessary for early full weight bearing. The absence of major complications, ease of application, the possibility to cut and perforate this material support its extensive use in bone augmentation for trauma cases.
SHMT2 regulates esophageal cancer cell progression and immune Escape by mediating m6A modification of c-myc
Authors: Qiao Zhe , Li Yu , Cheng Yao , Li Shaomin , Liu Shiyuan
Published: November 2023

Background

In recent years, the role of altered cellular metabolism in tumor progression has attracted widespread attention. Related metabolic enzymes have also been considered as potential cancer therapeutic targets. Serine hydroxymethyltransferase 2 (SHMT2) has been reported to be upregulated in several cancers and associated with poor prognosis. However, there are few studies of SHMT2 in esophageal cancer (EC), and the related functions and mechanisms also need to be further explored.

Methods

In this study, we first analyzed SHMT2 expression in EC by online database and clinical samples. Then, the biological functions of SHMT2 in EC were investigated by cell and animal experiments. The intracellular m6A methylation modification levels were also evaluated by MeRIP. Linked genes and mechanisms of SHMT2 were analyzed by bioinformatics and rescue experiments.

Results

We found that SHMT2 expression was abnormally upregulated in EC and associated with poor prognosis. Functionally, SHMT2 silencing suppressed c-myc expression in an m6A-dependent manner, thereby blocking the proliferation, migration, invasion and immune escape abilities of EC cells. Mechanistically, SHMT2 encouraged the accumulation of methyl donor SAM through a one-carbon metabolic network, thereby regulating the m6A modification and stability of c-myc mRNA in a METTL3/FTO/ALKBH5/IGF2BP2-dependent way. In vivo animal experiments also demonstrated that SHMT2 mediated MYC expression by m6A-methylation modification, thus boosting EC tumorigenesis.

Conclusion

In conclusion, our data illustrated that SHMT2 regulated malignant progression and immune escape of EC cell through c-myc m6A modification. These revealed mechanisms related to SHMT2 in EC and maybe offer promise for the development of new therapeutic approaches.
Influence of cyber-victimization and other factors on depression and anxiety among university students in Bangladesh
Authors: Rahman Tareq , Hossain Md. Mahin , Bristy Nurun Nahar , Hoque Md. Zahidul , Hossain Md. Moyazzem
Published: November 2023

Background and objectives

Cyber-victimization is closely linked with mental health problems such as anxiety, depression, etc., and has become a growing concern among university students in Bangladesh. In the era of globalization, smart gadgets, the internet, and other online resources are readily available, and these tools and devices have now become the primary method for cyberbullying. The authors aim to explore the impacts of cyber-victimization and other factors on anxiety and depression among university students in Bangladesh.

Methods

The primary data for this cross-sectional study were collected using a well-structured questionnaire. This study employs three widely used scales such as cyberbullying inventory, general anxiety disorder-7 (GAD-7), and patient health questionnaire-9 (PHQ-9). Descriptive statistics and multivariable logistic regression analyses are carried out to identify the factors associated with depression and anxiety among university students in Bangladesh.

Results

Findings depict that the prevalence of depression and anxiety among university students was 52.5% and 44.0%, respectively. Depressed respondents were considerably more likely to have difficulty sleeping (p < 0.001), spend more time on social media (p = 0.002), have suicidal thoughts (p < 0.001), and have a high cyber-victimization score (p < 0.001) compared to non-depressed respondents. In comparison with non-anxious respondents, anxious respondents were significantly more likely to: have sleeping difficulties (p < 0.001); spend more time on social media (p = 0.031); have suicidal thinking (p < 0.001); and have a comparatively high cyber-victimization score (p < 0.001). Multivariable logistic regression analysis identified that a one-unit increase in the cyber-victimization score results in a 1.24 times higher chance of experiencing depression (AOR: 1.24, 95% CI 1.17–1.31, p < 0.001), and a one-unit increase in the cyber-victimization score results in a 1.23 times higher chance of experiencing anxiety (AOR: 1.23, 95% CI 1.17–1.30, p < 0.001).

Conclusion

University students are struggling with cyberbullying, which can lead to depression and anxiety levels. Promoting more cyberbullying awareness is necessary since failing to do so could result in a sustained or increased prevalence of anxiety and depression levels among students, which could have disastrous repercussions.
Enhancement of material attributes of poorly compressible metformin hydrochloride through coprocessing with hydroxypropyl cellulose (HPC-L) using coprecipitation (CPT)
Authors: Chaturvedi Kaushalendra , Pongkulapa Pasaorn , Ding Xiaoyi , Shah Harsh S. , Kiang San , Kadajji Veeran
Published: November 2023

Coprocessing involves integration of multiple substances to improve the physical, chemical, mechanical, and biopharmaceutical properties of a material. Coprocessing is a promising technique in the pharmaceutical industry which support both drug substance and drug product processes. When active pharmaceutical ingredients (APIs) are coprocessed with excipients, it can enable direct compression and continuous manufacturing. Hydroxypropyl cellulose (HPC-L), a commonly used excipient in pharmaceutical formulations, can enhance drug stability, solubility, and bioavailability. In this study, we have employed coprecipitation (CPT) to coprocess metformin hydrochloride (MET) with HPC-L, resulting in the formation of agglomerates with improved physical attributes without any risk of polymorphic changes. Acetone/acetonitrile and heptane were used as solvent and antisolvent, respectively. Screening study revealed that the use of a rotor stator helps to control the size of metformin hydrochloride and HPC-L agglomerates (M-CPT) without negatively impacting bulk density and powder flow properties. The CPT agglomerates showed residual solvent levels within the specified ICH limits. Powder rheology results demonstrated a sixfold increase in FFC of M-CPT compared to neat MET. The compressibility, tabletability, compactability, and “In-Die” Heckel analysis data further suggested that the M-CPT agglomerates are directly compressible with no observable changes in the dissolution profile of MET. Overall, this study demonstrates application of CPT approach to tune the physical and mechanical properties, and HPC-L can be used as an excipient of choice for CPT technique to improve the compressibility and flowability of APIs.

Graphical Abstract
Using objective measures to examine the effect of suspect-filler similarity on eyewitness identification performance - Final Registered Report
Authors: McKinley Geoffrey L. , Peterson Daniel J.
Published: November 2023

When selecting fillers to include in a police lineup, one must consider the level of similarity between the suspect and potential fillers. In order to reduce misidentifications, an innocent suspect should not stand out. Therefore, it is important that the fillers share some degree of similarity. Importantly, increasing suspect–filler similarity too much will render the task too difficult reducing correct identifications of a guilty suspect. Determining how much similarity yields optimal identification performance is the focus of the proposed study. Extant research on lineup construction has provided somewhat mixed results. In part, this is likely due to the subjective nature of similarity, which forces researchers to define similarity in relative terms. In the current study, we manipulate suspect–filler similarity via a multidimensional scaling model constructed using objective facial measurements. In doing so, we test the “propitious heterogeneity” and the diagnostic-feature-detection hypotheses which predict an advantage of lineups with low-similarity fillers in terms of discriminability. We found that filler similarity did not affect discriminability. We discuss limitations and future directions.
An integrated approach to water conservation: fuzzy logic assessment of water tariffs in Abu Dhabi Emirate’s residential sector
Authors: AlHamad Issah M. , Al Hemyari Osamah , Shashati Ahmad , Al Seraihi Hazza , Albahlooli Hamad , Ewim Daniel Raphael Ejike , Al Nuaimi Saeed
Published: November 2023

Background

Abu Dhabi, a part of the United Arab Emirates, is situated in an arid region where water scarcity is a significant concern. The residential sector in Abu Dhabi consumes a large portion of the available water resources, leading to a critical need for effective water management strategies. This study aims to understand the relationship between water tariffs and water consumption in the residential sector in Abu Dhabi. It employs an integrated fuzzy logic model, a form of artificial intelligence, to assess the impact of water tariffs on water consumption. The model includes variables such as water tariffs, the level of water awareness, the level of water behavior, and the level of technology use. The objective of these variables is to evaluate their impact on the water-saving index, which represents the ratio of daily water consumption per capita in Abu Dhabi to the global average.

Results

The findings of this study, based on a survey measuring the level of water awareness, behavior, and technology use, revealed a potential strategy for reducing water consumption in Abu Dhabi’s residential sector. It was observed that increasing water tariffs, while maintaining current levels of water awareness, behavior, and technology use, could lead to a reduction in water consumption. However, it was also found that the impact of further tariff increases on water conservation diminishes after a certain threshold, indicating the necessity of a balanced approach in tariff adjustment. Interestingly, the study also highlights that Abu Dhabi residents demonstrate high levels of water behavior and technology use, indicating a positive trend toward water conservation.

Conclusions

This study emphasizes the importance of increasing water awareness among Abu Dhabi residents as a means to foster sustainable water consumption practices. While water tariffs can contribute to reductions in water consumption, the effects tend to decrease beyond a certain point. Therefore, a comprehensive approach involving water tariffs, increased water awareness, and the adoption of water-saving technologies may be the most effective strategy for water conservation. The insights from this study extend beyond Abu Dhabi and offer valuable guidance for addressing water conservation challenges worldwide. It highlights the importance of adopting a multi-faceted approach in water management, and the potential for such strategies to have international relevance in the pursuit of sustainable water consumption.
A deep learning aided differential distinguisher improvement framework with more lightweight and universality
Authors: Liu JiaShuo , Ren JiongJiong , Chen ShaoZhen
Published: November 2023

In CRYPTO 2019, Gohr opens up a new direction for cryptanalysis. He successfully applied deep learning to differential cryptanalysis against the NSA block cipher SPECK32/64, achieving higher accuracy than traditional differential distinguishers. Until now, one of the mainstream research directions is increasing the training sample size and utilizing different neural networks to improve the accuracy of neural distinguishers. This conversion mindset may lead to a huge number of parameters, heavy computing load, and a large number of memory in the distinguishers training process. However, in the practical application of cryptanalysis, the applicability of the attacks method in a resource-constrained environment is very important. Therefore, we focus on the cost optimization and aim to reduce network parameters for differential neural cryptanalysis.In this paper, we propose two cost-optimized neural distinguisher improvement methods from the aspect of data format and network structure, respectively. Firstly, we obtain a partial output difference neural distinguisher using only 4-bits training data format which is constructed with a new advantage bits search algorithm based on two key improvement conditions. In addition, we perform an interpretability analysis of the new neural distinguishers whose results are mainly reflected in the relationship between the neural distinguishers, truncated differential, and advantage bits. Secondly, we replace the traditional convolution with the depthwise separable convolution to reduce the training cost without affecting the accuracy as much as possible. Overall, the number of training parameters can be reduced by less than 50% by using our new network structure for training neural distinguishers. Finally, we apply the network structure to the partial output difference neural distinguishers. The combinatorial approach have led to a further reduction in the number of parameters (approximately 30% of Gohr’s distinguishers for SPECK).
Precipitating factors and outcome of acute asthma attack patients attended to the emergency unit at Cairo University Specialized Pediatric Hospital in 2019 “before COVID era”
Authors: Ahmed Khaled Amin Nasef , Aziz Iman Ali Abd El , Tarek Sara , Fattah Hager Mahmoud Abd El , Behairy Ahmed Said
Published: November 2023

Background

Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families, and the community.

Objectives

The aim of this study was to find a correlation between precipitating factors of acute asthma attacks of patients attending to emergency departments and different factors such as socioeconomic status.

Methods

The study included patients 2–12 years old of both sexes who were already diagnosed with bronchial asthma coming to ER with acute asthmatic attacks. Data were collected by a questionnaire which includes personal data (name, age, and sex), anthropometric data, score for assessment of socioeconomic status (SES), symptoms of asthmatic attack, risk factors, mode and type of treatment, compliance to treatment, or evaluation of asthma severity and outcome of patients attending to ER.

Results

This study included 170 patients. Males represented 63.5% of the patients. The mean age of the patients was 5.4 ± 2.7 years. Our patients were distributed into the following: 65.9% were low SES, 22.9% were very low SES, and 11.2% were moderate SES. As regards presenting symptoms of the study group, all the patients (100%) presented to ER with cough, while 88.2% of them presented with wheezes, 85.8% presented with dyspnea, 21.2% of them presented with tightness, and only 0.01% presented with cyanosis. As regards precipitating factors of asthma, the most common precipitating factors among our patients causing attending to ER were irritant inhalers (72.4%), passive smoking (60.6%), exercise (70.5%), certain foods (45.3%), upper respiratory tract infection (12.9%), and non-compliance to asthma treatment (85.2%). The most common causes of non-compliance to treatment were family negligence and illiteracy (34.1%) and poor socioeconomic conditions (17.1%). The majority of patients (96.5%) who could be stabilized with medications were discharged, whereas a merged proportion of critically ill patients (3.5%) required ICU admission. However, no deaths were reported.

Conclusion

The most common precipitating factors of our patients that led to more attending to ER in the previous 6 months were exercise, irritant inhalers, and non-compliance to asthma treatment.
The effect of cold packs, lidocaine spray, and flashlights on cannulation pain in patients undergoing hemodialysis: a randomized controlled trial
Authors: Gouda Khaled , EL said Tamer , Fahmy Sarah F.
Published: November 2023

Background

Pain is a frequent and critical problem in daily hemodialysis practice. The pain experienced during arteriovenous fistula cannulation varies from 12% to even 80% in hemodialysis patients depending on the pain assessment tools used. Pain can lead to sleep problems, decreased compliance with hemodialysis therapy, frequent hospital hospitalizations, a decline in quality of life, and high death rates. Despite utilizing several methods as pain relief, it is still unknown in the literature and practice which method is the most effective. The purpose of the study was to compare the effect of lidocaine spray, cold packs, and flashlights on the pain induced by arteriovenous cannulation in hemodialysis patients. This was a prospective randomized open-label controlled trial. Hundred and eight adult patients on regular hemodialysis were recruited and simply randomized into one of four groups (lidocaine spray, cold packs, flashlights, and control) before cannulation.

Results

The mean pain severity using visual analog scale was 4.3 (3.3–5.7) in lidocaine group, 4 (3–5.7) in cold packs group, 4.3 (3.3–5.3) in flashlight group, and 4.7 (3–6) in control group. There was a borderline significant difference between groups using Kruskal–Wallis test (p = 0.054). The post hoc Tukey test showed that only cold packs differ from control group with borderline significance (p = 0.051).

Conclusion

The results showed that cold packs were safe and effective than lidocaine spray or flashlights in reducing cannulation pain. It is suggested to implement this method before cannulation in hemodialysis patients to reduce pain and improve quality of life. Future studies are needed to compare different application times of cold packs and its impact on pain scores to recommend the optimum time needed to achieve maximum analgesic effect.

Trail registration: Clinical trials.gov NCT05822063, REC #194.

Graphical abstract
Modulation of limb mechanics in alligators moving across varying grades
Authors: Arias Adrien A. , Azizi Emanuel
Published: November 2023

Graded substrates require legged animals to modulate their limb mechanics to meet locomotor demands. Previous work has elucidated strategies used by cursorial animals with upright limb posture, but it remains unclear how sprawling species such as alligators transition between grades. We measured individual limb forces and 3D kinematics as alligators walked steadily across level, 15 deg incline and 15 deg decline conditions. We compared our results with the literature to determine how limb posture alters strategies for managing the energetic variation that accompanies shifts in grade. We found that juvenile alligators maintain spatiotemporal characteristics of gait and locomotor speed while selectively modulating craniocaudal impulses (relative to level) when transitioning between grades. Alligators seem to accomplish this using a variety of kinematic strategies, but consistently sprawl both limb pairs outside of the parasagittal plane during decline walking. This latter result suggests alligators and other sprawling species may use movements outside of the parasagittal plane as an axis of variation to modulate limb mechanics when transitioning between graded substrates. We conclude that limb mechanics during graded locomotion are fairly predictable across quadrupedal species, regardless of body plan and limb posture, with hindlimbs playing a more propulsive role and forelimbs functioning to dissipate energy. Future work will elucidate how shifts in muscle properties or function underlie such shifts in limb kinematics.