bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetically predicted HLA-DR+ natural killer cells as potential mediators in the lipid-coronary artery disease/ calcification (CAD/CAC) causal pathway
Authors: Qian Dingding , Zhang Haoyue , Liu Rong , Ye Honghua 
Published: August 2024

BackgroundCoronary artery disease (CAD) imposes a significant global health burden, necessitating a deeper comprehension of its genetic foundations to uncover innovative therapeutic targets. Employing a comprehensive Mendelian randomization (MR) approach, we aimed to explore the genetic associations between lipid profiles, immune cell phenotypes, and CAD risk.MethodsUtilizing data from recent large-scale genome-wide association studies (GWAS), we scrutinized 179 lipid and 731 immune cell phenotypes to delineate their genetic contributions to CAD pathogenesis, including coronary artery calcification (CAC). Moreover, specific immune cell phenotypes were examined as potential mediators of the lipid-CAD/CAC causal pathway.ResultsAmong the 162 lipid species with qualified instrumental variables (IVs) included in the analysis, we identified 36 lipids that exhibit a genetic causal relationship with CAD, with 29 being risk factors and 7 serving as protective factors. Phosphatidylethanolamine (18:0_20:4) with 8 IVs (OR, 95% CI, P-value: 1.04, 1.02-1.06, 1.50E-04) met the Bonferroni-corrected significance threshold (0.05/162 = 3.09E-04). Notably, all 18 shared lipids were determined to be risk factors for both CAD and CAC, including 16 triacylglycerol traits (15 of which had ≥ 3 IVs), with (50:1) exhibiting the highest risk [OR (95% CI) in CAC: 1.428 (1.129-1.807); OR (95% CI) in CAD: 1.119 (1.046-1.198)], and 2 diacylglycerol traits. Furthermore, we identified HLA DR+ natural killer cells (IVs = 3) as nominally significant with lipids and as potential mediators in the causal pathway between diacylglycerol (16:1_18:1) or various triacylglycerols and CAD (mediated effect: 0.007 to 0.013).ConclusionsThis study provides preliminary insights into the genetic correlations between lipid metabolism, immune cell dynamics, and CAD susceptibility, highlighting the potential involvement of natural killer cells in the lipid-CAD/CAC causal pathway and suggesting new targets for therapy. Further evidence is necessary to substantiate our findings.
Multimodal optical imaging of iris flocculi in three consecutive generations: a case report
Authors: Jiang Anna , Liang Licong , She Kaiqin , Lu Fang 
Published: August 2024

BackgroundMultiple pigmented epithelial cysts at the edge of pupils, that is, iris flocculi, in both eyes, are rare ocular diseases. It has been demonstrated that this disease can be attributed to mutations in the smooth muscle α-actin 2 (ACTA2) gene, which mainly affects the function of smooth muscle cells (SMCs). SMCs are components of the iris, aorta, and several other systemic organs. In addition, iris flocculi are strongly correlated with familial thoracic aortic aneurysm and dissection (TAAD), which is caused by the mutation of amino acid 149 in the ACTA2 gene.Case descriptionA 6-month-old Chinese boy was found to have iris flocculi during ocular fundus screening for premature infants. His mother, a 30-year-old Chinese woman with a history of aortic dissection, underwent an ophthalmic examination and was found to have iris flocculi. Whole exome sequencing revealed a heterozygous c.445C &gt; T (p. Arg149Cys) mutation in ACTA2 in both the boy and his mother. After his family history was traced, the boy’s grandfather was diagnosed with similar iris flocculi. Due to the absence of any ocular complications caused by iris flocculi in the cases, no special treatment was given, and regular follow-up was recommended.ConclusionWe reported one case of familial iris flocculi caused by a heterozygous missense mutation in ACTA2 (p. Arg149Cys) and presented multimodal optical images of both the iris and fundus in three consecutive generations. This case report enriched the clinical features of retinal vasculature and macula associated with the mutation in the amino acid 149 of the ACTA2 gene.
Professional identity and its associated psychosocial factors among physicians from standardized residency training programs in China: a national cross-sectional study
Authors: Zeng Zixuan , Lu Zhanghong , Zeng Xiaoping , Gan Yong , Jiang Jiahui , Chen You , Huang Lei 
Published: August 2024

IntroductionShortage and high turnover intention rate of physicians are concerning problems in China. Professional identity has been shown as an influential factor for physicians’ turnover intention. Enhancing physicians’ professional identity in their early phase of career, standardized residency training program (SRTP), may help reduce the turnover rate. This study aimed to investigate the current status of professional identity and explore its associated psychosocial factors among Chinese SRTP trainees, hoping to provide evidence in strengthening the available medical human resources in China.MethodsThe final sample was comprised of 2,267 Chinese SRTP trainees in this cross-sectional survey conducted from 9 March to 20 March in 2023. Descriptive statistics were calculated. Bivariate analyses and hierarchical multiple linear regression were used to analyze potential associated factors of Chinese SRTP trainees’ professional identity.ResultsThe average score of respondents’ professional identity was 47.68 (standard deviation, SD = 8.61). Results from hierarchical multiple linear regression analysis showed that being married (β = 0.066, p &lt; 0.01), having work experience before SRTP (β = 0.036, p &lt; 0.05), being satisfied with annual income (β = 0.062, p &lt; 0.01), psychological distress (β = −0.144, p &lt; 0.001), depersonalization (β = −0.053, p &lt; 0.05), emotional exhaustion (β = −0.380, p &lt; 0.001) and resilience (β = 0.169, p &lt; 0.001) were associated with professional identity (F = 114.301, p &lt; 0.001). All associated factors can explain 41.1% of the variance in professional identity, and individual psychological variables make up a substantial portion (28.6%) of this influence.DiscussionIndividual psychological variables are strongly associated with professional identity. Helping SRTP trainees reduce psychological distress, alleviate burnout and enhance resilience may be effective ways to promote the formation of their professional identity.
Influencing factors on the quality of recovery after total knee arthroplasty: development of a predictive model
Authors: Shan Sen , Shi Qingpeng , Zhang Hengyuan 
Published: August 2024

IntroductionTotal Knee Arthroplasty (TKA) is a widely performed procedure that significantly benefits patients with severe knee degeneration. However, the recovery outcomes post-surgery can vary significantly among patients. Identifying the factors influencing these outcomes is crucial for improving patient care and satisfaction.MethodsIn this retrospective study, we analyzed 362 TKA cases performed between January 1, 2018, and July 1, 2022. Multivariate logistic regression was employed to identify key predictors of recovery within the first year after surgery.ResultsThe analysis revealed that Body Mass Index (BMI), age-adjusted Charlson Comorbidity Index (aCCI), sleep quality, Bone Mineral Density (BMD), and analgesic efficacy were significant predictors of poor recovery (p &lt; 0.05). These predictors were used to develop a clinical prediction model, which demonstrated strong predictive ability with an Area Under the Receiver Operating Characteristic (AUC) curve of 0.802. The model was internally validated.DiscussionThe findings suggest that personalized postoperative care and tailored rehabilitation programs based on these predictors could enhance recovery outcomes and increase patient satisfaction following TKA.
The work experiences and career development expectations of Chinese respiratory therapists: a descriptive qualitative study
Authors: Xu Jianfeng , Cheng Pengfei , Yu Hangqing , Zhou Niya , Lan Meijuan 
Published: August 2024

BackgroundRespiratory therapists (RTs) play a vital role in healthcare, specializing in the treatment and management of heart and lung conditions, particularly during the COVID-19 pandemic. Despite the importance of RTs, little attention has been paid to RTs in the Chinese health system. This study aimed to understand and describe the work experiences and career development expectations of RTs in China.MethodsThis study utilized a qualitative research design and conducted semi-structured, in-depth, audio-recorded interviews with 16 RTs aged 28–40 years, purposively selected from six regions in mainland China from May to June 2024. Qualitative thematic content analysis was conducted to identify and group the themes that emerged from the discourse. Interviews were transcribed and analyzed using thematic analysis.ResultsFour key themes were identified: (1) “Complex Career Motivation” delves into the career trajectories and role adaptations of RTs; (2) “Positive Career Feedback” explores feelings of job satisfaction and career accomplishments; (3) “Uncertain Career Predicament” sheds light on the negative impact of multidimensional career challenges; (4) “Demand-Driven Future Outlook” reflects RTs’ urgent expectations for professional advancement.ConclusionThe barriers and facilitators in the professional journey of Chinese RTs maintain a fragile balance, and the future development of the profession may determine whether they can persist in their careers. Healthcare managers and leaders should pay attention to the real needs of RTs, enhance their professional confidence, and adopt effective coping strategies to avoid the loss of human resources and promote the development of the professional team.
Toxicity of gold nanoparticles complicated by the co-existence multiscale plastics
Authors: Zhang Lan , Ma Yuyang , Wei Zhiliang , Wang Luyang 
Published: August 2024

IntroductionGold nanoparticles (AuNPs) have been developed as treatment materials for various diseases and shown magnificent potential. By contrast to the broad toxicological studies on the single exposure (AuNPs), how the other health risks modulate the toxicological profile of AuNPs remains to be investigated. Plastics are among the most common health risks in daily life due to the broad utilization of plastic products. Therefore, in this study, we aimed to reveal the toxicological effects induced by co-exposure of gold nanorod (AuR) and polystyrene micro- and nano-plastics (hereinafter, referred to as AuRmPS and AuRnPS, respectively) in mice.MethodsSystematic biochemical characterizations were performed to investigate the hepatotoxicity, nephrotoxicity, neurotoxicity, inflammatory responses, alterations in gut microbiota induced by co-exposure, and to analyze the toxicological phenomena from the roles of reactive oxygen species and gut-organ axis.ResultsIt has been found that hepatotoxicity, nephrotoxicity, neurotoxicity, and inflammation were exacerbated in AuRnPS and AuRmPS, and gut microbiota composition was more severely altered in AuRnPS exposure. These results suggest the necessity of reducing plastics exposure in AuNPs-based therapies. Moreover, protection against the nano-sized plastic particles holds higher priority.ConclusionThese findings will facilitate the explorations of methods to reduce therapeutic toxicity and improve biosafety for specific treatments by referring to the orders of importance in protecting different organs.
Impairments of social interaction in a valproic acid model in mice
Authors: Ukezono Masatoshi , Kasahara Yoshiyuki , Yoshida Chihiro , Murakami Yuki , Okada Takashi , Takano Yuji 
Published: August 2024

BackgroundA rodent autism spectrum disorder (ASD) model based on prenatal exposure to valproic acid (VPA) is widely recognized as a prominent model. Social behavior in rodent ASD models has primarily been evaluated through a three-chamber approach test. However, in this study, we focused on social attention in the VPA model of ASD.MethodsIn male C57BL/6 J mice, attentional behaviors toward conspecifics were examined through reaching tasks around 9–11 weeks of age. On embryonic day 12.5, pregnant mice underwent a subcutaneous injection of 600 mg/kg VPA sodium salt dissolved in 0.9% saline solution (VPA group) or saline solution alone (Sal group) into their neck fat. Thirty-six mice—nine each in the VPA and saline groups, and 18 partners—underwent training in reaching behavior. Subsequently, we examined whether the VPA or Sal group demonstrated focused attention toward their partners during reaching tasks. A two-way analysis of variance (ANOVA) (condition [VPA/Sal] × situation [face-to-face (attention)/not paying attention (not attention)]) was conducted on the average success rate of the situation. Additionally, we measured the duration of sniffing behavior between pairs of mice in an open field twice in total at 4 and 8 weeks of age before reaching task. The pairs were constructed by pairing a VPA or Sal group mouse with its partner, with the objective of facilitating initial encounters between the mice. A one-way ANOVA was conducted on the average duration of sniffing behavior data from 4 weeks and a second one-way ANOVA on data from 8 weeks.ResultsThe analysis revealed a significant interaction between condition and situation in the reaching task [F (1, 28) = 6.75, p = 0.015, ηp2 = 0.19]. The simple main effect test exhibited that the “not paying attention” rate was significantly higher than that of the “face-to-face” in the VPA group (p &lt; 0.01). The results revealed a not significant difference in the average duration of sniffing behavior at 4 weeks [F (3, 32) = 2.71, p = 0.06, n.s., ηp2 = 0.20], but significant difference at 8 weeks [F (3, 32) = 4.12, p &lt; 0.05, ηp2 = 0.28]. Multiple comparisons using the Bonferroni method revealed significant differences in the sniffing duration at 8 weeks between from the partner toward the VPA mouse and from the partner toward the Sal mouse (p &lt; 0.05).ConclusionThe VPA rodent model of ASD exhibited differences in social attention compared to the saline group. By focusing on social attention and exploring various ASD models, insights can be gained from the neural mechanisms underlying gaze abnormalities during social interaction in individuals with ASD.
Characteristics of central cortex and upper-limb flexors synchrony oxygenation during grasping in people with stroke: a controlled trial study protocol
Authors: Zhao Jiang-Li , Chen Pei-Ming , Zhang Tao , Xie Hao , Xiao Wen-Wu , Ng Shamay S. M , Wang Chu-Huai 
Published: August 2024

BackgroundUpper limb motor impairment is a common consequence of stroke, and the effectiveness and underlying mechanisms of rehabilitation therapy for improving upper limb function remain uncertain. Functional near-infrared spectroscopy, a reliable wearable neuroimaging technique, holds promise for investigating brain activity during functional tasks. This study aims to explore the synchronous oxygenation characteristics of the central cortex and upper-limb flexors during a grasping task and investigate the rehabilitation mechanisms of upper limb motor function in individuals with stroke.MethodsParticipants with stroke who demonstrate the ability to grasp and lift cubic wood blocks of different sizes (2.5cm3, 5cm3, and 10cm3) using their affected hand will be divided into three groups: A, B, and C. Each group will consist of twenty stroke patients, resulting in a total of sixty participants with stroke. Additionally, twenty matched healthy subjects will be enrolled as a control group. Comprehensive assessments will be conducted before and after the intervention, including blood oxygen parameter monitoring of the cerebral cortex and upper limb flexors using fNIRS during the grasping task. Other assessments will include MyotonPRO, the Modified Ashworth Scale, the upper extremity section of the Fugl–Meyer Assessment, the Action Research Arm Test, and the Modified Barthel Index. The study will be undertaken between January 2024 and September 2025.ConclusionsThe results of this trial will provide an in-depth understanding of the Characteristics of central cortex and upper-limb flexors synchronous oxygenation during grasping task and how it may relate to the rehabilitation mechanism of upper limb motor function in people with stroke.Clinical trial registrationhttps://www.chictr.org.cn, identifier ChiCTR2400080619.
Brain morphometric changes in children born as small for gestational age without catch up growth
Authors: Takatani Tomozumi , Shiohama Tadashi , Takatani Rieko , Hattori Shinya , Yokota Hajime , Hamada Hiromichi 
Published: August 2024

IntroductionMost infants born as small for gestational age (SGA) demonstrate catch up growth by 2–4 years, but some fail to do so. This failure is associated with several health risks, including neuropsychological development issues. However, data on the morphological characteristics of the brains of infants born as SGA without achieving catch up growth are lacking. This study aims to determine the structural aspects of the brains of children born as SGA without catch up growth.MethodsWe conducted voxel- and surface-based morphometric analyses of 1.5-T T1-weighted brain images scanned from eight infants born as SGA who could not achieve catch up growth by 3 years and sixteen individuals with idiopathic short stature (ISS) to exclude body size effects. Growth hormone (GH) secretion stimulation tests were used to rule out GH deficiency in all SGA and ISS cases. The magnetic resonance imaging data were assessed using Levene’s test for equality of variances and a two-tailed unpaired t-test for equality of means. The Benjamini–Hochberg procedure was used to apply discovery rate correction for multiple comparisons.ResultsMorphometric analyses of both t-statical map and surface-based analyses using general linear multiple analysis determined decreased left insula thickness and volume in SGA without catch up growth compared with ISS.ConclusionThe brain scans of patients with SGA who lack catch up growth indicated distinct morphological disparities when compared to those with ISS. The discernible features of brain morphology observed in patients born as SGA without catch up growth may improve understanding of the association of SGA without catch up growth with both intellectual and psychological outcomes.
Characterization of the flavor profile of Hulatang using GC-IMS coupled with sensory analysis
Authors: Yan Jing , Wang Heng , Yang Bing , Zhang Wanli , Cao Zhenxia , Zhao Penghui , Dong Zijie , Ren Fazheng , Chen Lishui 
Published: August 2024

BackgroundHulatang is a traditional specialty snack in Henan, China, and is well known for its unique flavor.MethodsIn this study, the volatile organic compounds (VOCs) in four kinds of Hulatang from two representative regions in Henan Province (Xiaoyaozhen and Beiwudu) were evaluated using headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS).ResultsThe results showed that Xiaoyaozhen Hulatang exhibited more ethers, fewer terpenes and ketones than Beiwudu Hulatang. Additionally, Hulatang from different regions were classified using the orthogonal partial least squares-discriminant analysis (OPLS-DA) based on GC-IMS data. Twenty aroma substances were selected as the potential markers using the variable importance in the projection (VIP) variable selection method. Additionally, fifteen aroma components significantly contributing to the aroma of Hulatang were screened using the relative odor activity value (ROAV) (ROAV &gt; 1). Combined with the sensory score results, twelve key substances with significant correlation with odor perception were selected. The flavor characteristics of the key substances revealed that the flavor of Hulatang was mainly composed of volatile components with camphor, green, almond, fatty, spicy, herbal, vegetable, fruity, floral, musty, and solvent aromas.ConclusionOverall, the experimental results provide a theoretical basis for evaluating the flavor characteristics of Hulatang from different regions using GC-IMS.
Changes in the gut microbiota of esophageal carcinoma patients based on 16S rRNA gene sequencing: a systematic review and meta-analysis
Authors: Zhang Li , Li Delin , Zhang Yongsheng , Hu Wenqi , Lv Haoyue , Zhang Xiaodong , Zhang Hongyu 
Published: August 2024

BackgroundThis study conducts a systematic review through meta-analysis, comparing the composition and diversity of the gut microbiome in patients with esophageal cancer and healthy individuals, and explores the relationship between risk factors and related factors of esophageal cancer.MethodsAccording to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we comprehensively searched the databases of PubMed, Web of Science, Embase, Cochrane Library. In addition, we applied the R programming language version 4.0.3 and Stata 15.1 software for data analysis. We also implemented the Newcastle-Ottawa Scale (NOS), funnel plot analysis, Egger’s test, and Begg’s test to assess the risk of bias.ResultsIn this study, a total of 328 studies were identified through the literature search. Among them, 117 duplicate studies were removed, and 202 studies were excluded based on inclusion and exclusion criteria. Finally, 9 studies were included in the analysis, involving a total of 216 patients with esophageal carcinoma and 352 healthy controls. Four studies provided Chao1 index for quantitative consolidation (ES = 637.41, 95% CI: 549.16 to 725.66, p = 0.000, I2 = 98.2%). Two studies [27, 29] reported ACE index (ES = 438.89, 95% CI: 362.42 to 515.35, p = 0.000, I2 = 97%). Seven studies [26,27,29,30,32] reported the Shannon index for quantitative consolidation (ES = 4.38, 95% CI: 3.95 to 4.81, p = 0.000, I2 = 99%). At the phylum level, the abundance of Bacteroidetes(ES = 37.8, 95% CI: 25.75 to 49.85, p = 0.000, I2 = 87.2%) and Proteobacteria(ES = 7.48, 95% CI: 5.02 to 8.85, p = 0.04, I2 = 2.4%) have statistical difference between ESCC and HC. There was no significant difference between ESCC and HC in the abundance of genera(p&gt;0.05).ConclusionsThis observational meta-analysis revealed that changes in the GM were correlated with esophageal carcinoma, and variations in some advantageous GM might involve regional differences. Additionally, the study aims to facilitate early diagnosis of esophageal cancer and improve screening and diagnostic efficiency.
A novel secondary ALK gene mutation which resistant to second-generation TKIs: a case report and literature review
Authors: Cheng Xiaqin , Liu Jia , Hu Qiongxia , Gao Yingchun , Zhou Lin 
Published: August 2024

BackgroundAdenocarcinoma with positive echinoderm microtubule-associated protein-like 4 gene and anaplastic lymphoma kinase (EML4-ALK) gene fusion accounts for 3-7% of lung cancer cases and can be targeted with ALK tyrosine kinase inhibitors (TKIs). Second-generation TKIs are the standard of care for targeted populations, especially those with central nervous system (CNS) metastasis. However, most patients eventually experience disease progression because of drug resistance caused by multiple mechanisms, predominantly secondary mutations.Case descriptionWe present a female advanced non-small cell lung cancer (NSCLC) case with positive EML4-ALK gene fusion, in which disease progression occurred in only 3 months after first-line treatment with alectinib. Two secondary mutations were detected by next-generation sequencing; one was V1180L located in exon 23, and the other was E803Q located in exon 14, which was a novel mutation that had never been reported. Ensartinib and ceritinib were administered as second-line and third-line treatments. However, the response to these TKIs was poor, and her overall survival was only 7 months.ConclusionThe secondary mutation E803Q located in exon 14 seems resistant to most second-generation ALK-TKIs. If there is an opportunity, the efficacy of the third-generation ALK-TKI loratinib should be tested.