bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-alcoholic fatty liver disease risk prediction model and health management strategies for older Chinese adults: a cross-sectional study
Authors: Pan Hong , Liu Baocheng , Luo Xin , Shen Xinxin , Sun Jijia , Zhang An 
Published: November 2023

Abstract
Background
Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver condition that affects a quarter of the global adult population. To date, only a few NAFLD risk prediction models have been developed for Chinese older adults aged ≥ 60 years. This study presented the development of a risk prediction model for NAFLD in Chinese individuals aged ≥ 60 years and proposed personalised health interventions based on key risk factors to reduce NAFLD incidence among the population.

Methods
A cross-sectional survey was carried out among 9,041 community residents in Shanghai. Three NAFLD risk prediction models (I, II, and III) were constructed using multivariate logistic regression analysis based on the least absolute shrinkage and selection operator regression analysis, and random forest model to select individual characteristics, respectively. To determine the optimal model, the three models’ discrimination, calibration, clinical application, and prediction capability were evaluated using the receiver operating characteristic (ROC) curve, calibration plot, decision curve analysis, and net reclassification index (NRI), respectively. To evaluate the optimal model’s effectiveness, the previously published NAFLD risk prediction models (Hepatic steatosis index [HSI] and ZJU index) were evaluated using the following five indicators: accuracy, precision, recall, F1-score, and balanced accuracy. A dynamic nomogram was constructed for the optimal model, and a Bayesian network model for predicting NAFLD risk in older adults was visually displayed using Netica software.

Results
The area under the ROC curve of Models I, II, and III in the training dataset was 0.810, 0.826, and 0.825, respectively, and that of the testing data was 0.777, 0.797, and 0.790, respectively. No significant difference was found in the accuracy or NRI between the models; therefore, Model III with the fewest variables was determined as the optimal model. Compared with the HSI and ZJU index, Model III had the highest accuracy (0.716), precision (0.808), recall (0.605), F1 score (0.692), and balanced accuracy (0.723). The risk threshold for Model III was 20%–80%. Model III included body mass index, alanine aminotransferase level, triglyceride level, and lymphocyte count.

Conclusions
A dynamic nomogram and Bayesian network model were developed to identify NAFLD risk in older Chinese adults, providing personalized health management strategies and reducing NAFLD incidence.
Association of insulin resistance with polycystic ovary syndrome phenotypes and patients’ characteristics: a cross-sectional study in Iran
Authors: Rahmatnezhad Leili , Moghaddam-Banaem Lida , Behroozi-Lak Tahereh , Shiva Afshin , Rasouli Javad 
Published: November 2023

Abstract
Background
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. This disorder affects 6–15% of women of childbearing age worldwide. It is diagnosed with hyperandrogenism, polycystic ovaries, and chronic anovulation with insulin resistance. This study aimed to assess the prevalence of insulin resistance (IR) in 4 phenotypes of PCOS, and its relationship with demographic, clinical, and paraclinical individual characteristics in a sample of Iranian PCOS patients.

Methods
This particular cross-sectional investigation involved 160 female participants, aged between 18 and 45 years, who were receiving care at gynecology clinics in Urmia, northwestern Iran. All the participants had been diagnosed with PCOS and were categorized into one of four phenotypes. All the participants underwent clinical evaluations, paraclinical assessments, and ultrasound scans. IR was defined as HOMA-IR > 2.5. The statistical significance level was 0.05.

Results
Among the 160 participants, the prevalences of the 4 phenotypes were: A: 83 (51.9%), B: 37 (23.1%), C: 21 (13.1%), and D: 19 (11.9%). IR was detected in 119 participants (74.4%); its rate was significantly different between the 4 phenotypes (p-value: 0.008) as A: 62 (74.7%), B: 34 (91.9%), C: 12 (57.1%), D: 11 (57.9%). Linear and logistic regression analyses were performed to control confounding factors. In linear regression, PCOS phenotype, classic phenotype (A&B), economic status, and Hb levels were significantly related to HOMA-IR; in logistic regression Hb levels, exercise, economic status, and PCOS phenotypes were significantly associated with insulin resistance.

Conclusions
The most prevalent PCOS phenotype in this study was A. PCOS phenotypes were significantly related to insulin resistance and HOMA-IR, with the highest levels of insulin resistance and HOMA-IR observed in phenotype B. Determining the phenotype of PCOS may be helpful for better management of PCOS and its associated complications. However, further investigations are recommended in this regard.
Multi-omics study identifies that PICK1 deficiency causes male infertility by inhibiting vesicle trafficking in Sertoli cells
Authors: Jin Jing , Li Kaiqiang , Du Yaoqiang , Gao Fang , Wang Zhen , Li Weixing 
Published: November 2023

AbstractBackgroundInfertility affects approximately 10–15% of reproductive-age men worldwide, and genetic causes play a role in one-third of cases. As a Bin-Amphiphysin-Rvs (BAR) domain protein, protein interacting with C-kinase 1 (PICK1) deficiency could lead to impairment of acrosome maturation. However, its effects on auxiliary germ cells such as Sertoli cells are unknown.PurposeThe present work was aimed to use multi-omics analysis to research the effects ofPICK1deficiency on Sertoli cells and to identify effective biomarkers to distinguish fertile males from infertile males caused byPICK1deficiency.MethodsWhole-exome sequencing (WES) was performed on 20 infertility patients with oligozoospermia to identify pathogenicPICK1mutations. Multi-omics analysis of aPICK1knockout (KO) mouse model was utilized to identify pathogenic mechanism. Animal and cell function experiments of Sertoli cell-specificPICK1KO mouse were performed to verify the functional impairment of Sertoli cells.ResultsTwo loss-of-function deletion mutations c.358delA and c.364delA inPICK1resulting in transcription loss of BAR functional domain were identified in infertility patients with a specific decrease in serum inhibin B, indicating functional impairment of Sertoli cells. Multi-omics analysis ofPICK1KO mouse illustrated that targeted genes of differentially expressed microRNAs and mRNAs are significantly enriched in the negative regulatory role in the vesicle trafficking pathway, while metabolomics analysis showed that the metabolism of amino acids, lipids, cofactors, vitamins, and endocrine factors changed. The phenotype ofPICK1KO mouse showed a reduction in testis volume, a decreased number of mature spermatozoa and impaired secretory function of Sertoli cells. In vitro experiments confirmed that the expression of growth factors secreted by Sertoli cells inPICK1conditional KO mouse such as Bone morphogenetic protein 4 (BMP4) and Fibroblast growth factor 2 (FGF2) were decreased.ConclusionsOur study attributed male infertility caused byPICK1deficiency to impaired vesicle-related secretory function of Sertoli cells and identified a variety of significant candidate biomarkers for male infertility induced byPICK1deficiency.
Health system productivity in sub-Saharan Africa: tuberculosis control in high burden countries
Authors: Atake Esso-Hanam 
Published: November 2023

Abstract
Background
Sixteen of the 30 countries with a high tuberculosis (TB) burden are in Sub-Saharan Africa (SSA). Over 25% of TB deaths occur in the Africa region. This study aims to estimate the productivity changes of TB programs in 16 SSA countries where TB is endemic.

Methods
We used Hicks-Moorsteen index to compute and decompose Total factor productivity (TFP), and the β-convergence and σ-convergence tests to check for convergence patterns among SSA countries.

Results
We found that technological change has been the main driver of the TFP growth, and that increasing technical efficiency may be the first objective in efforts to improve TFP of TB programs. Moreover, the convergence tests reveal significant homogeneity in terms of TFP change between SSA countries studied.

Conclusion
The findings suggest that improving technical efficiency of TB programs mainly calls for better resource allocation, capacity building in governance and management of programs, improved training of the health providers and stronger prevention policies. Policymakers must design models for integration of TB treatment under the universal health insurance schemes.
Protective role of IL-17-producing γδ T cells in a laser-induced choroidal neovascularization mouse model
Authors: Chang Yu-Hsien , Hsing Chung-Hsi , Chiu Chiao-Juno , Wu Yi-Rou , Hsu Sheng-Min , Hsu Yu-Hsiang 
Published: November 2023

Abstract
Background
Vision loss in patients with wet/exudative age-related macular degeneration (AMD) is associated with choroidal neovascularization (CNV), and AMD is the leading cause of irreversible vision impairment in older adults. Interleukin-17A (IL-17A) is a component of the microenvironment associated with some autoimmune diseases. Previous studies have indicated that wet AMD patients have elevated serum IL-17A levels. However, the effect of IL-17A on AMD progression needs to be better understood. We aimed to investigate the role of IL-17A in a laser-induced CNV mouse model.

Methods
We established a laser-induced CNV mouse model in wild-type (WT) and IL-17A-deficient mice and then evaluated the disease severity of these mice by using fluorescence angiography. We performed enzyme-linked immunosorbent assay (ELISA) and fluorescence-activated cell sorting (FACS) to analyze the levels of IL-17A and to investigate the immune cell populations in the eyes of WT and IL-17A-deficient mice. We used ARPE-19 cells to clarify the effect of IL-17A under oxidative stress.

Results
In the laser-induced CNV model, the CNV lesions were larger in IL-17A-deficient mice than in WT mice. The numbers of γδ T cells, CD3+CD4+RORγt+ T cells, Treg cells, and neutrophils were decreased and the number of macrophages was increased in the eyes of IL-17A-deficient mice compared with WT mice. In WT mice, IL-17A-producing γδ T-cell numbers increased in a time-dependent manner from day 7 to 28 after laser injury. IL-6 levels increased and IL-10, IL-24, IL-17F, and GM-CSF levels decreased in the eyes of IL-17A-deficient mice after laser injury. In vitro, IL-17A inhibited apoptosis and induced the expression of the antioxidant protein HO-1 in ARPE-19 cells under oxidative stress conditions. IL-17A facilitated the repair of oxidative stress-induced barrier dysfunction in ARPE-19 cells.

Conclusions
Our findings provide new insight into the protective effect of IL-17A in a laser-induced CNV model and reveal a novel regulatory role of IL-17A-producing γδ T cells in the ocular microenvironment in wet AMD.
Thoracic day surgery versus thoracic inpatient surgery for treatment of patients with lung cancer: a systematic review and meta-analysis
Authors: Shen Cheng , Che Guowei 
Published: November 2023

Abstract
Background
The successful implementation of the Enhanced recovery after surgery (ERAS) concept in thoracic surgery has made it possible to complete the surgery in the day surgery unit. However, it is still unclear whether day surgery for lung cancer patients can achieve the same or even better results.

Methods
A systematic literature search was completed in common databases for studies published before May 2022 and the data analyzed using the Review Manager 5.3 software.

Results
We ultimately included 7 retrospective articles that met our criteria for the study. The results of age, smoking status, comorbidity and pulmonary function tests in day surgery group were better than in inpatient surgery group. Minimally invasive surgical method with segmentectomy was more used in day surgery group than in normal surgery group. The 30-day mortality was also lower in Day surgery group and it displayed that early discharged patients had fewer overall complications than the inpatient surgery group.

Conclusions
We demonstrate that younger patients, patients receiving segmental resections by VATS, and those with better pulmonary function tests or without comorbidity can be discharged early with low rates of complications and 30-day mortality, especial with ERAS program.
Educational needs of patients, families, and healthcare professionals to support the patient journey in haemophilia gene therapy in the UK
Authors: Boyce Sara , Fletcher Simon , Jones April , Kohli Ruchika , Mangles Sarah , Ong Min , Pollard Debra , Sivasubramaniyam Sujan , Stephensen David , Stoner Nicola , Kazmi Rashid 
Published: November 2023

AbstractWith the first gene therapies for haemophilia approved by the European Commission, the US Food and Drug Administration, and the Medicines and Healthcare products Regulatory Agency, it is important to consider the remaining unmet needs and challenges that may arise throughout patients’ treatment journeys. We discuss existing unmet needs and important considerations prior to, during, and following haemophilia gene therapy treatment in the UK, and propose potential next steps. Key areas for attention are education, psychological support, and guidance on implementation. Strategies are urgently required to fulfil these needs. An immediate priority for information providers should be comprehensive education for people with haemophilia (PWH) and healthcare professionals (HCPs). Greater access to resources and training in psychological services will be required throughout the treatment pathway. More specific guidance is required to define the implementation model, criteria for accreditation, and responsibilities of care centres. Furthermore, PWH may revisit discussions with HCPs multiple times pre-infusion, thus the patient journey is unlikely to be linear. Consideration of these challenges, and of potential strategies to address them, will be integral to optimising the future success of this promising therapy.
Cancer-associated fibroblasts-derived CXCL12 enhances immune escape of bladder cancer through inhibiting P62-mediated autophagic degradation of PDL1
Authors: Zhang Zhao , Yu Yongbo , Zhang Zhilei , Li Dan , Liang Zhijuan , Wang Liping , Chen Yuanbin , Liang Ye , Niu Haitao 
Published: November 2023

Abstract
Background
Cancer-associated fibroblasts (CAFs), the predominant stromal cell of tumor microenvironment (TME), play an important role in tumor progression and immunoregulation by remodeling extracellular matrix (ECM) and secreting cytokines. However, little is known about the details of the underlying mechanism in bladder cancer.

Methods
Bioinformatics analysis was performed to analyze the prognostic value of CAFs and CXCL12 using GEO, TCGA and SRA databases. The effects of CXCL12 on bladder cancer progression were investigated through in vitro and in vivo assays. The biological mechanism of the effect of CXCL12 on PDL1 were investigated using western blotting, immunoprecipitation, RT-PCR, immunofluorescence, mass spectrometry, protein stability, and flow cytometry.

Results
The results demonstrated that CAFs-derived CXCL12 promoted cancer cell migration and invasion and upregulated PDL1. Mechanistically, upon binding to its specific receptor, CXCL12 activated the downstream JAK2/STAT3 pathway and rapidly up-regulated the expression of deubiquitinase CYLD. CYLD deubiquitinated P62 causing P62 accumulation, which in turn inhibited the autophagic degradation of PDL1. In vivo experiments demonstrated that blocking CXCL12 inhibited tumor growth, reduced tumor PDL1 expression and increased immune cell infiltration.

Conclusions
This study revealed a novel mechanism for the role of CXCL12 in P62-mediated PDL1 autophagic regulation. Combined application of CXCL12 receptor blocker and PD1/PDL1 blocker can more effectively inhibit PDL1 expression and enhance antitumor immune response. Targeting CAFs-derived CXCL12 may provide an effective strategy for immunotherapy in bladder cancer.
Attitudes and barriers to participation in window-of-opportunity trials reported by White and Asian/Asian British ethnicity patients who have undergone treatment for endometrial cancer
Authors: Mandane B. , Amirthanayagam A. , Patel N. , Darko N. , Moss E. L. 
Published: November 2023

Abstract
Purpose
Window-of-opportunity trials (WOT) are a study design that have been used to investigate drug activity in endometrial cancer (EC). Recruitment to cancer clinical trials by patients from ethnic minority groups is reported to be lower than for patients of White ethnicity.

Methods
A verbal questionnaire was conducted with White and Asian/Asian British ethnicity patients who had undergone treatment for EC. Strategic purposeful sampling was used to recruit patients from diverse social/educational backgrounds. Questions explored: background knowledge of clinical research, WOT study design, and views on medications that might be investigated. Thematic analysis was used to explore motivations for WOT participation and perceived barriers.

Results
In total, 21 patients were recruited to the study (15 White and 6 Asian/Asian British). Views on optimum time to receive trial information differed, preferences ranging from 'at the time of diagnosis' to 'a few days after diagnosis'. The choice of medication under investigation had a strong influence on potential willingness to participate, with greater interest reported in medications derived from vitamins or food supplements rather than hormone-based drugs. Potential barriers to participation included concern over potential side-effects and the emotional/physical burden of a cancer diagnosis prior to major surgery.

Discussion
This study provides important insights into patients’ views on WOT participation in EC and raises issues that need to be considered for future trial design and participant recruitment materials. The timing and format of study information and type of substance under investigation were factors influencing potential participation. Future studies should consider using multi-lingual visual information videos to address information needs, as this may encourage participation by ethnic minority patients.
Awareness with paralysis and symptoms of post-traumatic stress disorder among mechanically ventilated emergency department survivors (ED-AWARENESS-2 Trial): study protocol for a pragmatic, multicenter, stepped wedge cluster randomized trial
Authors: Fuller Brian M. , Driver Brian E. , Roberts Michael B. , Schorr Christa A. , Thompson Kathryn , Faine Brett , Yeary Julianne , Mohr Nicholas M. , Pappal Ryan D. , Stephens Robert J. , Yan Yan , Johnson Nicholas J. , Roberts Brian W. 
Published: November 2023

Abstract
Background
Awareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1–0.2%. By contrast, AWP in mechanically ventilated emergency department (ED) patients is common, with estimated prevalence of 3.3–7.4% among survivors given NMB. Longer-acting NMB use is a critical risk for AWP, and we have shown an association between ED rocuronium use and increased AWP prevalence. As NMB are given to more than 90% of ED patients during tracheal intubation, this trial provides a platform to test an intervention aimed at reducing AWP. The overall objective is to test the hypothesis that limiting ED rocuronium exposure will significantly reduce the proportion of patients experiencing AWP.

Methods
This is a pragmatic, stepped wedge cluster randomized trial conducted in five academic EDs, and will enroll 3090 patients. Per the design, all sites begin in a control phase, under observational conditions. At 6-month intervals, sites sequentially enter a 2-month transition phase, during which we will implement the multifaceted intervention, which will rely on use of nudges and defaults to change clinician decisions regarding ED NMB use. During the intervention phase, succinylcholine will be the default NMB over rocuronium. The primary outcome is AWP, assessed with the modified Brice questionnaire, adjudicated by three independent, blinded experts. The secondary outcome is the proportion of patients developing clinically significant symptoms of post-traumatic stress disorder at 30 and 180 days after hospital discharge. We will also assess for symptoms of depression and anxiety, and health-related quality of life. A generalized linear model, adjusted for time and cluster interactions, will be used to compare AWP in control versus intervention phases, analyzed by intention-to-treat.

Discussion
The ED-AWARENESS-2 Trial will be the first ED-based trial aimed at preventing AWP, a critical threat to patient safety. Results could shape clinical use of NMB in the ED and prevent more than 10,000 annual cases of AWP related to ED care.

Trial registration
ClinicalTrials.gov identifier NCT05534243. Registered 06, September 2022.
Bacterial diversity from soil-feeding termite gut and their potential application
Authors: Korsa Gamachis , Beyene Abera , Ayele Abate 
Published: November 2023

Abstract
Purpose
High population growth and the expansion of industry from time to time produce a large amount of waste/pollution, which harms global environmental health. To overcome the above problems, soil feeding (mound/nest) builders of termite gut bacteria execute thriving since they can be obtained easily, available, and at low costs. The purpose of this review is to provide evidence of bacteria in the soil feeding termite gut and its potential role in various applications including reduction of methane gas emission, bio bocks/production of bricks, biomedicine, biocontrol (promising tool for sustainable agriculture), and bio-fertilizer (improve the fertility of the soil) and plant growth promote effectiveness all year.

Methods
This review was progressive in that it assessed and produced peer-reviewed papers related to bacteria in the soil feeding termite gut and its potential role in different applications for an environmentally sound. Based on the findings of reputable educational journals, articles were divided into four categories: methods used to distributions of soil-feeding termites, termite caste system, bacterial diversity, and strain improvement of bacteria in the termite guts for enhanced multipurpose and techniques.

Results
The bacterial diversity from termite guts of soil feeding termite caste systems/differentiations is vital for snowballing day to day due to their low cost and no side effect on the public health and environment becoming known improvement of the microbial bacteria rather than other microbes. So termites function as “soil engineers” in tropical agroforestry ecosystems that are of great benefit for economic importance to greener approach.

Conclusion
The present findings indicate that recovery was chosen as an appreciable bring out the bacteria in the soil feeding termite gut and its potential application of termite mounds/nests biotechnological applications. Because of the large amount of nutrients that have built up in termite embankment soil feeding, this type of termite is now known as a “gold-leaf excavation” for bacterial concentrations. This provides the assertion that termite insects are important from an ecological standpoint since they aid in nutrient flows in the ecosystem as a useful tool for various species.