bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using virtual fieldwork to support interprofessional and community-based learning: students from four faculties investigate life on a remote island in Japan
Authors: Yatsushiro Rika , Matsuda Fumiyo , Causer Bo , Inoue Kazuhiro , Kikata Junne , Miura Naoki , Hashimoto Kumiko , Akasaki Yasuaki , Unedaya Keiko 
Published: October 2024

IntroductionThe Mishima Islands in Kagoshima Prefecture, Japan, are remote islands designated as medically underserved. Supporting the people living in such remote islands requires a multifaceted examination of the livelihoods of the residents, including their health, work, and living environment.MethodsStudents from the faculties of nursing, veterinary science, agriculture, and engineering participated in a 3-day virtual fieldwork session held synchronously from the campus of Kagoshima University and on a remote island in the Mishima Mura island group in Kagoshima Prefecture, Japan. Coursework and post-course surveys were analyzed to determine student engagement and learning. In particular, the analysis considered learning in relation to interprofessional learning and community-based learning.Results and discussionStudents expressed being able to conduct fieldwork online, collaborate with students from multiple faculties and graduate schools, and apply their expertise. These outcomes were reflected in the five-point Likert scale evaluation responses, highlighting a sense of accomplishment and satisfaction. Virtual fieldwork can contribute to student learning by introducing new concepts and allowing them to consider development issues in remote areas from multiple perspectives.
Efficacy of echolaser smart interface-guided laser ablation in volume reduction of symptomatic benign thyroid nodules
Authors: Malik Iftikhar , Mitchell Janeil , Thomas Johnson 
Published: October 2024

BackgroundThe management of benign symptomatic thyroid nodules until recent years has been limited to surgery, radioactive iodine treatment, or surveillance which is associated with the burden of morbidity of complications or symptom non-relief as well as cost. Laser ablation has emerged as a minimally invasive alternative, this uses laser energy to thermally ablate nodule tissue, leading to volume reduction and symptom relief. Long-term treatment response data is growing but remains limited in the United States. Our study aims to quantify the effectiveness of laser ablation in reducing the volume of thyroid nodules over a 12 to 18-month period.Materials and methodsRetrospective review of data was conducted for 63 adults with cytologically benign, solid symptomatic thyroid nodules ranging from 1.333 cm3 to 103.794 cm3 in volume. Ultrasound-guided laser thermal ablation was performed on all nodules using EchoLaser X4 Smart Interface device with 1064 nm diode laser to deliver total ablation energy (joules), calculated per device guidelines. Serial sonographic volume measurements were conducted 1 month, 3 -6 months, 6 - 12 months, and 12 to 18 months post-ablation intervals.ResultsStudy cohort was comprised of 63 thyroid nodules. reduction in nodule volume increased progressively over time, with median reductions of 46.05% [STD 21.8] at 1 month, 60.33% [STD 20.1] at 3-6 months, 68.69% [STD 18.8] at 6-12 months, and 64.04% [STD 19.27] at 12-18 months. A total of 62, 56, 42, and 17 nodules had available data for analysis at these respective intervals.ConclusionThis study demonstrated a marked progressive reduction of thyroid nodule volume following ablation. The treatment appears to be consistently effective in reducing symptoms across a wide range of nodule sizes, although the degree of volume reduction varies. The results of our study underscore the potential of laser ablation as a viable treatment option for thyroid nodules, with a sustained reduction in nodule volume observed over an extended post-procedure period.
Construction and validation of a diagnostic model for high-risk papillary thyroid microcarcinoma
Authors: Liang Yu , Fan ErXi , Zhang Jing , Xu Tong , Song Jun , Huang Fuhong , Wang Dong 
Published: October 2024

ObjectiveThe purpose of this study was to construct a diagnostic model by exploring the potential predictors of high-risk Papillary Thyroid Microcarcinoma (PTMC) and verifying its reliability.MethodsA retrospective analysis of PTMC patients who underwent surgical treatment from 2004 to 2015 in the SEER database (training set) and the clinical pathological ultrasound information of PTMC patients at the Sichuan Provincial People's Hospital from 2020 to 2022 (external validation set) was conducted. In the training set, univariate and multivariate logistic regression analyses were used to screen independent predictive factors for high-risk PTMC patients in pathology. A nomogram diagnostic model was further constructed. Additionally, ROC curves and calibration curves were drawn to evaluate the efficiency of the model. In the external validation set, the diagnostic model was indirectly evaluated based on preoperative ultrasound imaging features to explore the feasibility and reliability of diagnosing high-risk PTMC through preoperative ultrasound imaging features.ResultsA total of 1628 patients were included in the training set, and 530 patients were included in the test set. The independent risk factors for pathological high-risk PTMC were sex, age, tumor maximum diameter, tumor invasive, and cervical lymph nodes (P&lt;0.05). The C-index of the nomogram constructed based on these five factors was 0.947, with an optimal sensitivity of 96.7% and a specificity of 86.0%. The calibration curve showed that the model had high consistency. The area under the curve (AUC) value of the ROC curve for high-risk PTMC predicted by the risk score based on ultrasound features was 0.824 [95% CI (0.789, 0.860)], which was highly consistent with the risk score based on pathological features (κ= 0.758, P&lt;0.05).ConclusionIndirect evaluation of a high-risk PTMC diagnostic model based on preoperative ultrasound imaging features had high predictive efficiency and potential value for clinical application.
Patient satisfaction and operator proficiency in gasless transaxillary endoscopic thyroidectomy under IONM: a retrospective cohort study
Authors: Zhang Yushuai , Zhao Yishen , Tang Hong , Zou Hongrui , Li Yang , Bian Xuehai 
Published: October 2024

BackgroundThis study aims to evaluate the surgical safety and effectiveness of gasless transaxillary endoscopic thyroidectomy (GTET), assess patients’ short-term perceptions and long-term outcomes, and delineate the learning curve and key surgical techniques of the operators.Materials and methodsClinicopathological and postoperative follow-up data from patients with unilateral thyroid cancer in the same period were collected. These patients were divided into the GTET group and the traditional open surgery group to compare and analyze the differences and explore the factors affecting the learning curve of GTET.ResultsPatients who chose GTET had better general health and thyroid conditions than those in the open group, and the quality of postoperative life was better in the GTET group than in the open group, with the main differences between the two groups being appearance and neck and shoulder function. The GTET learning curve in this study peaked at 19 cases, with slight differences between left and right, and a larger sample size is still needed to explore the factors affecting the learning curve.ConclusionsGTET has a reliable safety and efficacy profile for patients with unilateral thyroid cancer. Intraoperative nerve monitoring (IONM) techniques require some adaptation in GTET. In some respects, patients’ postoperative experience and quality of life are superior to those of conventional open surgery. There is a learning curve for GTET, but large samples are still needed to explore its true significance.
Exploring lipodystrophy gene expression in adipocytes: unveiling insights into the pathogenesis of insulin resistance, type 2 diabetes, and clustering diseases (metabolic syndrome) in Asian Indians
Authors: Saxena Aditya , Tiwari Pradeep , Gupta Shalu , Mandia Rajendra , Banshiwal Ramesh C. , Lamoria Ravinder Kumar , Anjana Ranjit Mohan , Radha Venkatesan , Mohan Viswanathan , Mathur Sandeep Kumar 
Published: October 2024

BackgroundStudying the molecular mechanisms of lipodystrophy can provide valuable insights into the pathophysiology of insulin resistance (IR), type 2 diabetes (T2D), and other clustering diseases [metabolic syndrome (MetS)] and its underlying adipocentric disease (MetS disease).MethodsA high-confidence lipodystrophy gene panel comprising 50 genes was created, and their expressions were measured in the visceral and subcutaneous (both peripheral and abdominal) adipose depots of MetS and non-MetS individuals at a tertiary care medical facility.ResultsMost lipodystrophy genes showed significant downregulation in MetS individuals compared to non-MetS individuals in both subcutaneous and visceral depots. In the abdominal compartment, all the genes showed relatively higher expression in visceral depot as compared to their subcutaneous counterpart, and this difference narrowed with increasing severity of MetS. Their expression level shows an inverse correlation with T2D, MetS, and HOMA-IR and with other T2D-related intermediate traits. Results also demonstrated that individualization of MetS patients could be done based on adipose tissue expression of just 12 genes.ConclusionAdipose tissue expression of lipodystrophy genes shows an association with MetS and its intermediate phenotypic traits. Mutations of these genes are known to cause congenital lipodystrophy syndromes, whereas their altered expression in adipose tissue contributes to the pathogenesis of IR, T2D, and MetS.
Exploring carbon footprints and carbon intensities of Indonesian provinces in a domestic and global context
Authors: Rum Irlan A. , Tukker Arnold , Hoekstra Rutger , Koning Arjan de , Yusuf Arief. A. 
Published: October 2024

Within Indonesia, the structure of consumption and production differs significantly across provinces. This implies that carbon footprints and intensities between provinces are also diverse. This paper calculates historical consumption- and production-based carbon emissions at the provincial level using a multi-scale input-output (IO) database for 2010, in which an environmentally extended multi-regional IO (EE MRIO) table for 34 Indonesian provinces is integrated in the global EE MRIO EXIOBASE with data for 43 countries and 5 rest of the world regions. Emissions from consumption are detailed by product and their points of origin, while emissions from production are detailed by industry and their destinations. Our results show the heterogeneity of Greenhouse Gas (GHG) emissions under both sides. The Java region is a net importer of carbon emission, while Sumatra and Kalimantan are net exporters. In the global context, the Asia Pacific region plays important role in national GHG emissions. Services product contributed 57.1% of national consumption-based GHG emissions, followed by manufacture (30.6%), and agriculture (12.3%). On the national level, 63.5% of national GHG emissions are related to household consumption. There is a high disparity across provinces in Indonesia in carbon footprints. Provincial average per capita carbon footprints vary from 2 t CO2e/capita in East Nusa Tenggara to 13.84 t CO2e/capita in East Kalimantan. Carbon intensity also varies from 0.83 kt CO2e/M Euro in Jakarta to 2.37 kt CO2e/M Euro in North Kalimantan. Agriculture and food products dominate household carbon footprints, while construction leads in government carbon footprints. Utilities and transportation services play important roles on national carbon intensities. We further correlated the Human Development Index (HDI) with per capita carbon footprints and expenditure, and find that provinces with similar GHG emissions and expenditure per capita income as Java, tend to have a lower HDI. Understanding development status and province-level characteristics is important for selecting policy strategies.
Genetic investigation and diagnosis in adults with congenital heart disease with or without structural or neurodevelopmental comorbidity: a retrospective chart review
Authors: Edwards Moriah , Zhang Xue , Opotowsky Alexander R. , Brown Nicole , Shikany Amy R. , Weaver Kathryn Nicole 
Published: October 2024

IntroductionGenetic evaluation is indicated for individuals with congenital heart disease (CHD), especially if extracardiac anomalies are also present. Timely recognition of genetic diagnoses can facilitate medical management and as well as provide assessment of reproductive risk. At least 20% of the pediatric population with CHD has a syndrome or genetic diagnosis. Further, at least 30% have extracardiac congenital malformations and/or neurodevelopmental differences (NDD), and this is known to increase the likelihood of a genetic/syndromic diagnosis. However, little is known regarding whether these statistics also apply to the current population of adults living with CHD, many of whom were born prior to currently available genetic testing.MethodsThe primary aim of this study was to determine the prevalence of documented genetic and syndromic diagnoses in a cohort of adults with CHD followed by a dedicated adult CHD (ACHD) clinic. The secondary aims were to describe genetic testing and genetic referral patterns in this population and identify the presence of extracardiac comorbidities which are known to be indicative of an underlying genetic diagnosis in the pediatric CHD population. To answer these questions, we performed a retrospective chart review on a sample of adults with CHD (excluding those with isolated bicuspid aortic valve) seen at Cincinnati Children’s Hospital in the ACHD clinic between 2010–2021.ResultsAmong 233 adult CHD patients, 36 (14%) had a documented genetic or syndromic diagnosis but only 29 (13.7%) had received genetic testing, while 27 (11.6%) had received genetic referrals. Furthermore, of 170 patients without any documented genetics related care (defined as genetic testing, genetic referrals, or genetic diagnosis), 35 (20%) had at least one congenital and/or neurodevelopmental comorbidity. Factors associated with individuals having received genetics related care included younger age (&lt;40), male sex, and presence of extracardiac comorbidities.DiscussionOur results indicate important gaps in genetics-related care for adults living with CHD. The subset of our cohort with congenital and/or neurodevelopmental comorbidities who received no genetic-related care, represent a population of adults with CHD who may have unrecognized genetic diagnoses.
Implications of vitamin D levels or status for mortality in rheumatoid arthritis: analysis of 2001-2018 data from the National Health and Nutrition Examination Survey
Authors: Feng Yalin , Zhu Ping , Yan Dandan , Wang Xu , Chen Caiyun , Zhang Zhongyuan , Tian Yian , Wang Jiajia , Liu Shanshan , Li Ju , Meng Deqian , Wang Kai 
Published: October 2024

BackgroundInadequate levels of vitamin D (VitD) have been linked to increased rates of various health conditions and mortality. However, little is known about the relationship between mortality outcomes and 25-hydroxyvitamin D [25(OH)D] levels in individuals with rheumatoid arthritis (RA). This study aimed to examine this association using data from the National Health and Nutrition Examination Survey.MethodsA cohort of 2,290 individuals aged 20 to 85 years with RA was analyzed. Lower 25(OH)D levels were inversely associated with all-cause mortality, with a hazard ratio (HR) of 0.91 (0.87 to 0.96) per 10 nmol/L increase. Comparatively, the HR for the VitD insufficiency group was 0.64 (0.50 to 0.83), and for the VitD sufficiency group, it was 0.60 (0.44 to 0.80), both compared to the VitD deficiency group. Cause-specific analysis showed that higher 25(OH)D levels were associated with reduced mortality from heart disease (HR: 0.88, 0.82 to 0.95) and malignant neoplasms (HR: 0.86, 0.79 to 0.94). No significant correlation was found between 25(OH)D levels and cause-specific mortalities for other conditions.ResultsStratified by gender, the HR for males was 0.92 (0.85 to 0.99) and for females was 0.91 (0.86 to 0.98) per 10 nmol/L increase in 25(OH)D levels. Among individuals aged 20-59 years, no significant correlation was observed, while for those aged 60 years and older, the HR was 0.86 (0.82 to 0.90) per 10 nmol/L increase. Nonlinear analysis identified a sharp increase in HR below 59.95 nmol/L, while HR remained below 1 for 25(OH)D levels above 59.95 nmol/L.ConclusionThis study reveals a strong negative correlation between 25(OH)D levels and overall mortality in individuals with RA. Notably, this association is particularly significant for mortality related to heart disease and malignant neoplasms. Targeted VitD supplementation should be emphasized, especially in individuals aged 60 years and older with RA. The proposed minimum threshold for adequate 25(OH)D levels in the RA population is 60 nmol/L.
Comparative analysis of iPSC-derived NK cells from two differentiation strategies reveals distinct signatures and cytotoxic activities
Authors: Huyghe Matthias , Desterke Christophe , Imeri Jusuf , Belliard Nathan , Chaker Diana , Oudrirhi Noufissa , Bezerra Hudson , Turhan Ali G. , Bennaceur-Griscelli Annelise , Griscelli Frank 
Published: October 2024

PurposeThe ability to generate natural killer (NK) cells from induced pluripotent stem cells (iPSCs) has given rise to new possibilities for the large-scale production of homogeneous immunotherapeutic cellular products and opened new avenues towards the creation of “off-the-shelf” cancer immunotherapies. However, the differentiation of NK cells from iPSCs remains poorly understood, particularly regarding the ontogenic landscape of iPSC-derived NK (iNK) cells produced in vitro and the influence that the differentiation strategy employed may have on the iNK profile. MethodsTo investigate this question, we conducted a comparative analysis of two sets of iNK cells generated from the same iPSC line using two different protocols: (i) a short-term, clinically compatible feeder-free protocol corresponding to primitive hematopoiesis, and (ii) a lymphoid-based protocol representing the definitive hematopoietic step. Results and discussionOur work demonstrated that both protocols are capable of producing functional iNK cells. However, the two sets of resulting iNKs exhibited distinct phenotypes and transcriptomic profiles. The lymphoid-based differentiation approach generated iNKs with a more mature and activated profile, which demonstrated higher cytotoxicity against cancer cell lines compared to iNK cells produced under short-term feeder-free conditions suggesting that the differentiation strategy must be considered when designing iNK cell–based adoptive immunotherapies.
Application of a risk score model based on glycosylation-related genes in the prognosis and treatment of patients with low-grade glioma
Authors: Zou Binbin , Li Mingtai , Zhang Jiachen , Gao Yingzhen , Huo Xiaoya , Li Jinhu , Fan Yimin , Guo Yanlin , Liu Xiaodong 
Published: October 2024

IntroductionLow-grade gliomas (LGG) represent a heterogeneous and complex group of brain tumors. Despite significant progress in understanding and managing these tumors, there are still many challenges that need to be addressed. Glycosylation, a common post-translational modification of proteins, plays a significant role in tumor transformation. Numerous studies have demonstrated a close relationship between glycosylation modifications and tumor progression. However, the biological function of glycosylation-related genes in LGG remains largely unexplored. Their potential roles within the LGG microenvironment are also not well understood.MethodsWe collected RNA-seq data and scRNA-seq data from patients with LGG from TCGA and GEO databases. The glycosylation pathway activity scores of each cluster and each patient were calculated by irGSEA and GSVA algorithms, and the differential genes between the high and low glycosylation pathway activity score groups were identified. Prognostic risk profiles of glycosylation-related genes were constructed using univariate Cox and LASSO regression analyses and validated in the CGGA database.ResultsAn 8 genes risk score signature including ASPM, CHI3L1, LILRA4, MSN, OCIAD2, PTGER4, SERPING1 and TNFRSF12A was constructed based on the analysis of glycosylation-related genes. Patients with LGG were divided into high risk and low risk groups according to the median risk score. Significant differences in immunological characteristics, TIDE scores, drug sensitivity, and immunotherapy response were observed between these groups. Additionally, survival analysis of clinical medication information in the TCGA cohort indicated that high risk and low risk groups have different sensitivities to drug therapy. The risk score characteristics can thus guide clinical medication decisions for LGG patients.ConclusionOur study established glycosylation-related gene risk score signatures, providing new perspectives and approaches for prognostic prediction and treatment of LGG.
Prevalence and associated factors of self-medication among pregnant women in Sodo Town, Southern Ethiopia
Authors: Abebe Mesfin , Gashaw Silenat , Getahun Dinkalem , Wassu Wudit , Menshaw Tiruye , Lakew Serawit 
Published: October 2024

BackgroundSelf-medication is a widespread practice among pregnant women worldwide, with 44.55% practicing it. However, it may lead to incorrect diagnosis, inappropriate treatment, and failure to recognize contraindications. The adverse effects of self-medication are often unknown, and they pose potential risks to maternal and fetal health. This study aimed to address the gap in research on the prevalence and associated factors of self-medication among pregnant women in Southern Ethiopia, and to promote effective strategies and interventions.MethodsA community-based cross-sectional study was conducted among 425 pregnant women in Sodo Town from April to June 2021. Participants were enrolled using a two-stage sampling technique. Data were collected using a structured questionnaire and face-to-face interviews. The association between the outcome and independent variables was assessed through bivariate logistic regression analysis. Additionally, multivariable logistic regression analysis was carried out, including variables with an adjusted odds ratio (AOR) accompanied by a 95% confidence interval (CI) and a p-value of less than 0.05, which was considered statistically significant.ResultsIn this study, pregnant women aged 18–39 years participated with a 100% response rate. The study found that the prevalence of self-medication during pregnancy was 20.5%, with 8.2% using herbal medicine and 12.3% using conventional medicine. A history of self-medication and first-and second-trimester pregnancy were significantly associated with self-medication. A history of self-medication (AOR = 6.31, 95% CI: 4.89, 9.91) and being in the first trimester of pregnancy (AOR = 3.47, 95% CI: 1.63, 7.38) or second trimester of pregnancy (AOR = 2.14, 95% CI: 1.12, 4.08) were associated with a higher likelihood of self-medication.ConclusionThe study found that 20.5% of pregnant women engaged in self-medication. It also identified that a previous history of self-medication and gestational age were factors associated with self-medication. These findings underscore the need for targeted educational programs and policy interventions to mitigate the risks associated with self-medication during pregnancy, particularly in the early stages of gestation.