bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iron metabolism indexes as predictors of the incidence of cardiac surgery-associated acute kidney surgery
Authors: Chen Wenxiu , Zhang Hao , Shen Xiao , Hong Liang , Tao Hong , Xiao Jilai , Nie Shuai , Wei Meng , Chen Ming , Zhang Cui , Yu Wenkui 
Published: July 2024

Abstract

Background:Acute kidney injury (AKI) is a major complication following cardiac surgery. We explored the clinical utility of iron metabolism indexes for identification of patients at risk for AKI after cardiac surgery.
Methods: This prospective observational study included patients who underwent cardiac surgery between March 2023 and June 2023. Iron metabolism indexes were measured upon admission to the intensive care unit. Multivariable logistic regression analyses were performed to explore the relationship between iron metabolism indexes and cardiac surgery-associated AKI (CSA-AKI). Receiver operating characteristic (ROC) curve was used to assess the predictive ability of iron, APACHE II score and the combination of the two indicators. Restricted cubic splines (RCS) was used to further confirm the linear relationship between iron and CSA-AKI.
Results: Among the 112 recruited patients, 38 (33.9%) were diagnosed with AKI. Multivariable logistic regression analysis indicated that APACHE II score (odds ratio [OR], 1.208; 95% confidence interval [CI], 1.003-1.455, P = 0.036) and iron (OR 1.069; 95% CI 1.009-1.133, P = 0.036) could be used as independent risk factors to predict CSA-AKI. ROC curve analysis showed that iron (area under curve[AUC] = 0.669, 95% CI 0.572-0.757), APACHE II score (AUC = 0.655, 95% CI 0.557-0.744) and iron and APACHE II score combination (AUC = 0.726, 95% CI 0.632-0.807) were predictive indicators for CSA-AKI. RCS further confirmed the linear relationship between iron and CSA-AKI.
Conclusions:Elevated iron levels were independently associated with higher risk of CSA-AKI, and there was a linear relationship between iron and CSA-AKI.
Therapeutic effect of mifepristone combined with misoprostol in early missed miscarriage and prediction of incomplete abortion
Authors: Bai Xue , Li Tianjie , Lin Qing 
Published: July 2024

Abstract

Objective
This study aimed to evaluate the efficacy of mifepristone combined with misoprostol in first-trimester missed miscarriages. We also aimed to determine ideal cutoff values of clinical indicators to predict the need for surgical intervention for an incomplete abortion.
Methods
A cohort of 702 consecutive women diagnosed with missed miscarriages between January 2020 and May 2023 was retrospectively analyzed. Demographic and ultrasound parameters such as endometrial thickness, mean diameter of the mass, hCG levels before and 24 h, 1 week, 2 weeks, and 1 month after treatment were measured and compared. ROC was used to determine cut-off values for incomplete abortion.
Results
Overall, 146 patients were treated with mifepristone and misoprostol (medication group), and 556 patients underwent curettage (surgical group). The endometrial thickness and postoperative vaginal bleeding duration of the medication group were greater than those of the surgical group one month post-treatment (P < 0.05), and the menstrual volume reduction rate in the medication group was significantly lower than that in the surgical group (23.56%). Sixteen patients experienced incomplete abortion (2.88%) in the surgical group and underwent another curettage procedure, while 25 patients (17.12%) in the medication group had incomplete abortion. Fourteen patients (9.59%) in the medication group underwent curettage because of incomplete abortion, which was a significantly higher rate than that in the surgical group. Eleven patients with incomplete abortion in the medication group received long-term medication, and the residual tissue in the uterine cavity disappeared after 1–2 menstrual cycles. The ultrasound cutoff values indicating the need for surgical intervention for an incomplete abortion were an endometrial thickness > 1.21 cm at 24 h after medication abortion and a uterine residual diameter > 0.95 cm at 7 days after surgical abortion.
Conclusion
The efficacy of mifepristone combined with misoprostol for first-trimester missed miscarriages is equivalent to that of curettage. Ultrasonography should be periodically reviewed after treatment. Patients with an endometrial thickness > 1.21 cm 24 h after a medication abortion and postoperative residual uterine diameter > 0.95 cm 7 days should be vigilant against incomplete abortion.
A Systematic Review and Meta-analysis of the effect of Hyperglycemia on Admission for Acute Myocardial Infarction in Diabetic and non-Diabetic patients
Authors: Alawaji Reem , Musslem Mohammed , Alshalahi Emtenan , Alanzan Abdaluziz , Sufyani Albarra , Alhati Maram , Almutairi Alhanouf , Alqaffas Mahdi , Alattas Batool , Alselmi Adhari 
Published: July 2024

Abstract

Introduction:
Regarding a potential relationship between diabetes and the prognostic significance of hyperglycemia in patients presenting with acute myocardial infarction (AMI), there is still debate. Therefore, we aimed in this study to demonstrate the effect of hyperglycemia on different outcomes in AMI patients whether they are diabetic or not.
Methods
Using the following search strategy: “Diabetes” or “Diabetic” AND “Acute myocardial infarction” OR “AMI” AND “hyperglycemia” OR “glucose level”, we searched PubMed, Web of Science, and Scopus for eligible articles that should undergo the screening process to determine its ability to be included in our study. Using Review Manager version 5.4 software, we conducted the meta-analysis of the included studies by pooling the mean difference in continuous variables, number and total of dichotomous variables to measure the odds ratio (OR), and generic inverse variance of OR or hazard ratio (HR) as they were reported in the included studies.
Results
The difference between the diabetes and non-diabetes patients regarding blood glucose level was found to be statistically significant with SMD of 1.39 (95%CI: 1.12, 1.66, p < 0.00001). Hyperglycemia in diabetic patients was statistically significant associated with mortality with HR of 1.92 (95%CI: 1.45, 2.55, p < 0.00001) and OR of 1.76 (95%CI: 1.15, 2.7, p = 0.01). In non-diabetic patients admitted with AMI, hyperglycemia was statistically significant associated with mortality with HR of 1.56 (95%CI: 1.31, 1.86, p < 0.00001), and OR of 2.89 (95%CI: 2.47, 3.39, p < 0.00001). Moreover, hyperglycemia in diabetic patients admitted with AMI was statistically significant associated with occurrence of MACE with HR of 1.9 (95%CI: 1.19, 3.03, p = 0.007) and hyperglycemia in non-diabetic AMI patients was statistically significant associated with occurrence of MACE with HR of 1.6 (95%CI: 1.15, 2.23, p = 0.006).
Conclusion
Hyperglycemia in AMI patients is a predictor of worse outcomes including MACE, and mortality whether these patients are diabetic or not. Some factors act as predictors for mortality in these patients including older age, higher glucose levels on admission, and high Killip class.
Neuromodulation and Mindfulness as Therapeutic Treatment in Detoxified Patients with Alcohol Use Disorder
Authors: Rosenthal Annika , Haslacher David , Garbusow Maria , Pangratz Elisabeth , Apfel Björn , Soekadar Surjo , Romanczuk-Seiferth Nina , Beck Anne 
Published: July 2024

Abstract

Background
Alcohol use disorder (AUD) poses a significant global health challenge. Traditional management strategies often face high relapse rates, leading to a need for innovative approaches. Mindfulness-based relapse prevention (MBRP) has emerged as a promising intervention to enhance cognitive control, reduce cue-related craving and improve interoceptive processing. Neuroimaging studies suggest that mindfulness training can modulate brain networks associated with these factors, potentially improving treatment outcomes for AUD. Neuroimaging studies suggest that mindfulness training can modulate brain networks linked to these brain functions, potentially improving treatment outcomes for AUD. However, it is unclear how MBRP links to neurophysiological measures such as frontal midline theta oscillations (FMΘ) and whether the beneficial effects of MBRP can be increased by enhancing FMΘ. Here, we will use two different forms of neuromodulation to target and enhance these oscillations, and evaluate their impact on the effectiveness of MBRP.
Methods
This study will employ a four-arm randomized controlled trial to evaluate the synergistic effects of MBRP augmented with transcutaneous vagus nerve stimulation (tVNS) or closed-loop amplitude-modulated transcranial alternating current stimulation (CLAM-tACS) on cognitive control, cue reactivity and interoceptive processing in AUD patients. Participants will undergo six weekly group MBRP sessions and daily individual mindfulness practices. Assessments will include an inhibition task, cue-induced craving task, and heartbeat discrimination task, alongside heart rate variability and 32-channel EEG recordings. Participants will be assessed pre and post treatment, with a three-month follow-up to evaluate long-term effects on abstinence and alcohol consumption.
Discussion
This study will not only elucidate the causal link between FMΘ and efficacy of MBRP, but contribute to a better understanding of how combined psychological and neuromodulation interventions can improve treatment outcomes for AUD, potentially leading to more effective therapeutic strategies. This study also seeks to explore individual differences in response to treatment, which could inform future approaches to AUD management.
Trial registration
This study received approval by the Charité—Universitätsmedizin Berlin Institutional Review Board (EA1/030/23, 10.11.2023). It was registered on ClinicalTrials.gov (NCT06308484).
Maternal Factors Promoting Normal Linear Growth of Children from Impoverished Rwandan Households
Authors: Habimana Jean Dieu , Noel Korukire , Jewett Sara , Matsiko Eric , Umugwaneza Maryse , Rugema Lawrence , Munyanshongore Cypreien 
Published: July 2024

Abstract

Background
Linear growth faltering remains a pervasive public health concern, considering its persistent prevalence and repercussions. This study aimed to investigate potential maternal factors promoting normal linear growth among children from impoverished Rwandan households.
Methods
We used a multi-stage cluster sampling procedure. A structured questionnaire helped to collect data from 807 mother-child dyads selected. The primary outcome variable was height-for-age Z-scores. The main predictors were maternal income-generating activity, maternal education, maternal depression, household decision-making (HHDM), number of ANC visits, use of family planning method, family planning types, and mode of delivery. The potential confounding variables were child age, parents working, good handwashing practice, owning a vegetable garden, and the total number of livestock. We used univariate analysis to establish means, frequencies, and percentages. Additionally, we used the Kruskal-Wallis, Mann-Whitney U, and Spearman Rank Correlation tests for bivariate analysis and robust linear regression for multivariable analysis.
Results
Maternal factors promoting normal linear growth of children were the presence of the mother's income-generating activity (ꞵ=0.640 [0.0269 − 1.253], p-value = 0.041), mother’s involvement in household decision-making (ꞵ=0.147 [0.080 − 0.214], p-value < 0.001), and higher frequency of ANC consultations (ꞵ=0.189 [0.025 − 0.354], p-value = 0.024). Additionally, a combination of household decision-making with ANC visit numbers predicted an increase in child linear growth (ꞵ=0.032 [0.019 − 0.045], p-value < 0.001).
Conclusion
Maternal factors such as maternal income-generating activity, maternal involvement in household decision-making, and increased number of ANC visits were found to promote normal child linear growth and can provide valuable information for shaping interventions and policies to promote child growth in the Rwandan community.
Vascular Insult in Neonatal Retinal Hemorrhage
Authors: Lam Matthew R. , Colmenarez Jose A. , Dong Pengfei , Gu Linxia , Suh Donny W. 
Published: July 2024

Abstract

Common hypotheses for the biomechanical cause underlying neonatal retinal hemorrhage include elevated intracranial pressure (ICP) inducing venous outflow obstruction and retinal deformation. A finite element computational model of the eye, optic nerve, and orbit was simulated with particular attention to the retinal vessels to analyze stress and strain on these structures during external head compression associated with normal vaginal delivery. Pressure from maternal contractions displaced the eye backward into the orbit, and the stiff optic nerve sheath provided localized resistance to this posterior displacement at its insertion point, resulting in tensile strain of 2.5% in the peripapillary (central) retina. Correspondingly, retinal vessels experienced tensile stress of up to 2.3 kPa near the optic nerve insertion point and opposing compressive stress of up to 3.2 kPa further away. The optic nerve was longitudinally compressed and experienced a mean radial tensile strain of 2.0%. Overall, forces associated with maternal labor resulted in a pattern of eye deformation that stretched the central retina in this simulation, mirroring the classical posterior localization of neonatal retinal hemorrhage. The optic nerve increased modestly in diameter despite rising ICP, suggesting retinal deformation is a more likely mechanism for retinal hemorrhage than occlusion of the central retinal vein.
“Art is just something that makes people heal” - A Qualitative Investigation of Tattoo Artists’ Perspectives on Cancer Survivorship Therapeutic Tattoos
Authors: Daly Adam , Karl Johannes , Dunne Simon 
Published: July 2024

Abstract

Purpose
Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists’ (TAs’) perspectives on the types, impacts, barriers and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves.
Methods
Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analysed thematically.
Results
The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos.
Conclusion
This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs’ perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, a reduction in barriers to the practice and greater collaboration between HPs and TAs.
Implications for Cancer Survivors:
Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.
The impact of variant annotations on the diagnostic yield of exome sequencing for rare pediatric neurological diseases
Authors: Komatsu Kazuyuki , Kato Mitsuhiro , Kubota Kazuo , Fukumura Shinobu , Yamada Keitaro , Hori Ikumi , Shimizu Kenji , Miyamoto Sachiko , Yamoto Kaori , Hiraide Takuya , Watanabe Kazuki , Aoki Shintaro , Furukawa Shogo , Hayashi Taiju , Isogai Mayu , Harasaki Takuma , Nakashima Mitsuko , Saitsu Hirotomo 
Published: July 2024

Abstract

Variant annotations are crucial for the efficient identification of pathogenic variants. In this study, we retrospectively evaluated the impact of various annotations on identifying 273 pathogenic single nucleotide and small insertion/deletion variants (SNVs/small indels) from 242 patients. Although variant filtering based on allele frequency is essential for narrowing down candidate variants, we found that 13 de novo pathogenic variants in autosomal dominant or X-linked dominant genes had been registered in gnomADv4.0 or 54KJPN with an allele frequency of less than 0.001%, suggesting that very rare variants in large cohort data can be pathogenic de novo variants. Strikingly, 38.1% candidate SNVs/small indels had been registered in the ClinVar database as pathogenic or likely pathogenic, highlighting great utility of this database. SpliceAI can detect candidate variants affecting RNA splicing, leading to the identification of four variants located at 11 to 50-bp away from the exon-intron boundary. Prioritization of candidate genes by patients’ phenotypes using PhenoMatcher module revealed that approximately 95% of the candidate genes had a maximum PhenoMatch score of ≥ 0.6, suggesting the utility of variant prioritization using phenotypes. This study suggests that a combination of multiple annotations and the appropriate evaluation can improve the diagnostic yield of rare diseases.
Immunotherapy in advanced esophageal squamous cell cancer: earlier or later?
Authors: Wei Shuang , Li Zuoji , Liu Tingting , Sun Guizhen , Sun Hongfu , Huang Wei 
Published: July 2024

Abstract

Background and objective: Several large-scale phase III clinical trials have confirmed the survival benefit of immunotherapy in patients with locally advanced or metastatic esophageal cancer. The aim of this study is to investigate whether early use of immunotherapy can improve long-term survival.
Methods: Patients with locally advanced or metastatic esophageal squamous cell cancer (ESCC) diagnosed from January 2018 to December 2021were retrospectively analyzed. According to the time of immunotherapy, patients were divided into early immunotherapy group (EIT group, first-line immunotherapy ) and late immunotherapy group (LIT group, second-line immunotherapy) . A 1:1 propensity score matching (PSM) was applied to balance the observable potential confounding factors between the two groups. The primary outcome was overall survival (OS).
Results: A total of 359 patients were enrolled, after propensity score matching, the clinical features were well balanced between two groups included 107 patients each. The median OS was 15.7 months (95%CI: 12.81-18.59) in the EIT group and 17.7 months (95%CI: 14.89-20.57) in the LIT group, respectively. (P=0.185, HR=1.25). The PFS1 of patients were 8.7 months (95%CI: 7.53-9.87) and 7.6 months (95%CI: 5.90-9.30),respectively, and the difference was statistically significant (P=0.032, HR=0.72). The PFS2 of patients were 12.97months (95%CI: 11.37-14.58) and 12.93 months (95%CI: 11.65-14.21), respectively, and the difference was statistically significant(P=0.045,HR=0.73). Subgroup analysis showed that male patients with middle thoracic esophageal cancer, younger than 65 years old, only one site of metastasis, only lymph node progression, no combined radiotherapy after progression and TP (paclitaxel plus platinum) regimen chemotherapy may have greater benefits. COX multivariate analysis showed that the EIT group and the differentiation degree of tumor had an impact on overall survival (P：0.03、0.04, HR: 0.73、0.70).
Conclusions: For patients with locally advanced or metastatic advanced ESCC, earlyimmunotherapy can improve PFS without improving OS.
Exacerbated Hepatotoxicity in Non-alcoholic Fatty Liver by Copper Sulfide Nanoparticles
Authors: Cui Jinbin , Zhao Gang , Xie Wei , Yang Yang , Fu Xing , Meng Hezhang , Liu He , Tan Mengfei , Chen Dandan , Rong Chao , Wang Yangyun , Wang Yong , Zhang Leshuai W. 
Published: July 2024

Abstract

Background
Copper sulfide nanoparticles represent a promising photothermal agent with significant commercial potential. Despite these advantages, the safety assessment of copper sulfide NPs, particularly for tumor patients with liver diseases, remains insufficient. Non-alcoholic fatty liver (NAFL) is a condition characterized by the accumulation of excess fat in the liver, potentially leading to increased sensitivity to foreign substances and progression to more severe liver disease.
Results
To explore the differential hepatotoxicity of copper sulfide NPs in NAFL conditions, we synthesized and characterized large-sized (LNPs, 15.1 nm) and small-sized (SNPs, 3.5 nm) BSA@Cu2 − xS NPs. A NAFL rat model fed with high fat diet (HFD) was successfully established for a 14-day subacute toxicity study by daily repeated administration of BSA@Cu2 − xS NPs. Our findings from serum biochemistry and histopathological examinations revealed that copper sulfide at both sizes NPs induced more pronounced liver damage in NAFL rats compared to rats fed with normal diet. Additionally, LNPs exhibited significantly higher intrahepatic accumulation than SNPs, leading to more severe hepatotoxicity. Transcriptome sequencing analysis showed that LNPs activated inflammation and DNA damage repair pathways in the livers of NAFL rats, while SNPs displayed minimal inflammation. In vitro 3D NAFL spheroids experiments demonstrated that LNPs, but not SNPs, triggered a distinct release of inflammatory factors and increased reactive oxygen species through Kupffer cells.
Conclusions
These results highlight that NAFL condition exacerbated the hepatotoxicity of BSA@Cu2 − xS NPs, with SNPs emerging as relatively safer photothermal agents compared to LNPs, suggesting superior potential for clinical applications.