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A meta-analysis on the impact of concurrent or pre-existing cancer diagnosis on acute myocardial infarction outcomes

Background There is still a significant gap in understanding the impact of concomitant or previous cancer diagnoses on clinical outcomes of acute myocardial infarction (AMI) Objective To provide updated evidence on the effect of concomitant or previous cancer diagnoses on mortality and risk of complications, specifically major bleeding, myocardial reinfarction, and stroke, of patients with AMI. Methods A literature search was conducted across PubMed, EMBASE, and Scopus databases. English-language cohort studies published in peer-reviewed journals were included. Pooled effect estimates were calculated using random-effects models and reported as odds ratio (OR) or hazards ratio (HR) with 95% confidence intervals (CI). The certainty of the evidence was assessed using the standard GRADE approach. Results A total of 22 studies were included. AMI patients with previous or concurrent cancer had increased risk of in-hospital mortality (OR 1.44, 95% CI: 1.20, 1.73), in-hospital mortality related to cardiovascular complications (OR 2.06, 95% CI: 1.17, 3.65), mortality at 30-days follow up (OR 1.47, 95% CI: 1.24, 1.74) and mortality at 1 year follow up (HR 2.67, 95% CI: 1.73, 4.11), compared to patients without cancer. The risk of major bleeding (OR 1.74, 95% CI: 1.40, 2.16), reinfarction (OR 1.20, 95% CI: 1.05, 1.37), and stroke (OR 1.16, 95% CI: 0.99, 1.37) was also higher in patients with previous or concurrent cancer. The certainty of evidence was rated as "low" for all outcomes, except for the risk of major bleeding, which was rated as "very low." Conclusion Based on the low to very low certainty of evidence, we conclude that the presence of previous cancer diagnosis or concurrent cancer may increase the risk of adverse outcomes in patients with AMI. Early interventions, such as close monitoring of cardiac function, lifestyle modifications, and targeted pharmacological therapies, might help mitigate the risk of AMI and improve overall clinical outcomes. However, further methodologically rigorous studies are needed to validate the findings of this review.

Universal conditional networks (UniCoN) for multi-age embryonic cartilage segmentation with sparsely annotated data

Women’s experiences and outcomes of abortion care in sub-Saharan countries: A mixed methods systematic review protocol

Introduction Abortion care experiences encompass various aspects, including women’s decision-making capability, physical and emotional experiences, service provision, and post-abortion experiences. The lack of woman-centred and respectful abortion services, influenced by stigma and restrictive abortion laws in certain contexts, poses a public health concern. These challenges may lead to variations in women’s experiences and care outcomes, potentially resulting in adverse physical, psychological, and emotional outcomes for individuals seeking abortions. Therefore, this systematic review aims to synthesise the available evidence on women’s abortion care experiences and outcomes in sub–Saharan Africa published from 2010 onwards. Methods Eight databases including Medline, Embase, Scopus, CINAHL, Cochrane Library, Psych-Info, Web of Science, and Global Health will be searched using subject headings and specific keywords related to women’s abortion care experiences, abortion care outcomes, and its measurement. Predetermined criteria will be used to select studies that meet the review’s inclusion criteria. These include all original studies published in English languages that focussed on induced abortion care and assessed women’s abortion care experiences and outcomes. After screening for title and abstract and full text, included studies will undergo data extraction, where information relevant to the methodological quality of each study will be collected. This review will integrate qualitative and quantitative data through a narrative synthesis approach. Discussion By synthesising abortion care experiences and outcomes across studies and analysing the commonalities and differences of the multifactorial challenges women face in health facilities, this study will improve the understanding of abortion care experiences and outcomes and inform evidence-based recommendations and future research directions. In addition, this systematic review will also discover and locate an existing measurement tool for abortion care experiences and outcomes for women while receiving the services in the facility.

Understanding empathy and theory of mind in Romanian dental students for improved educational strategies

Herbivore functions in the hot-seat: Resilience of Acanthurus triostegus to marine heatwaves

Herbivorous fishes play a crucial role in the conservation of coral reefs threatened by thermal stress (e.g., marine heatwaves and long-term ocean warming) by helping to maintain reefs in a coral-dominated state via the removal of algae. However, as thermally sensitive ectotherms, rising thermal stress may also pose a serious threat to these fishes and the critical ecosystem functions they deliver. Here we evaluate the consequences of thermal stress on the capacity of a common herbivorous coral reef fish (Acanthurus triostegus) to control finely filamentous matrices of Caulerpa sertularioides and C. verticillata algae in Hawaiʻi, by characterizing in-vivo changes in metabolic demands, diurnal foraging rates, activity patterns and individual condition in a laboratory setting during winter (24.0±0.1°C), summer (27.5±0.1°C), and at the peak of a representative marine heatwave, (31.0±0.1°C). Rising temperatures caused significant increases in standard metabolic rate (from ~135 O2 kg-1 h-1 in winter to 224 O2 kg-1 h-1 at the peak of a marine heatwave), but not in the proportion of time spent active (~83–96%) or foraging (~2.4 bites min-1). Consequently, A. triostegus gained body mass during summer and winter, but lost ~0.8% body mass per day during the marine heatwave. Given marine heatwaves can last for weeks to months, these results indicate that while herbivorous coral reef fishes may continue to remove algae during periods of thermal stress, their ability to control many macroalga may be limited due to precipitous reductions in individual performance. Therefore, in addition to algal types, the thermal sensitivity in herbivorous reef fishes will need to be considered for the successful implementation of coral-algal management strategies in a warmer world.

GPX4 expression changes in proximal tubule cells highlight the role of ferroptosis in IgAN

Vision impairment and associated daily activity limitation: A systematic review and meta-analysis

Background Vision impairment is a common disability that poses significant challenges to individuals’ ability to perform activities essential for independent living, including activities of daily living (ADL) and instrumental activities of daily living (IADL). Despite extensive research, the extent and nature of these associations remain unclear, particularly across varying levels and types of vision impairment. Objectives This meta‐analysis aims to estimate associations between vision impairment and difficulties with ADL and IADL. Methods We conducted a systematic review of relevant literature from the inception of the databases to February 2024, using electronic database searches, including PubMed, MEDLINE (Ovid), EMBASE, Cochrane CENTRAL, and CDSR. The articles were screened for title and abstract and then for the full-text reports by two independent reviewers and study quality was appraised. Meta‐analyses were performed using random effects models to calculate the pooled effect size, expressed as odds ratio (OR) with corresponding 95% confidence interval (CI) of each outcome. Results Forty-six studies involving 210,960 participants were included. A positive large correlation between vision impairment and difficulties with ADL (Correlation coefficient [r] = 0.55, 95% CI 0.37–0.68, p = 0.001) and IADL (r = 0.60, 95% CI 0.49–0.69, p = 0.001) was shown. We also found that vision impairment was associated with difficulties in ADL (OR = 1.77, 95% CI 1.56–2.01, p < 0.0001) and IADL (OR = 1.96, 95% CI 1.68–2.30, p < 0.0001). Subgroup analysis revealed that moderate to severe impairment resulted in difficulties in ADL (OR = 1.78, 95% CI 1.43–2.21, p = 0.02) and IADL (OR = 1.86, 95% CI 1.57–2.20, p = 0.0003). Further, there was a significant association between mild to moderate vision impairment and difficulties in IADL (OR = 1.38, 95% CI 1.23–1.55, p < 0.0001). Greater impact was observed in individuals with near vision impairment compared to those with distance vision impairment. Near vision impairment was significantly associated with higher difficulties in ADL (OR = 1.77, 95% CI 1.57–2.01, p < 0.0001) and IADL (OR = 1.79, 95% CI 1.32–2.42, p < 0.0001). In contrast, distance vision impairment showed lower but still significant associations with IADL (OR = 1.19, 95% CI 1.05–1.34, p = 0.005) and a nonsignificant association with ADL (OR = 1.12, 95% CI 0.90–1.40, p = 0.30). Meta-regression analysis indicated that for every one-year increase in age, ADL performance decreased by an average of 0.0147 units (p < 0.001), while IADL performance declined at a slower rate of 0.0047 units/year (p = 0.031). Conclusion The present systematic review and meta-analysis using several statistical methods indicates that vision impairment including near vision impairment, is associated with difficulties in ADL and IADL. Thus, vision impairment remains an urgent and increasingly important public health priority. These findings highlight the need for targeted measures to raise public health awareness to provide rehabilitation and eye care examination strategies to reduce the risk of developing disabilities in adults and the elderly who have vision impairment.

An optimization approach for improving steam production of heat recovery steam generator

Serum lipids mediate the association of per- and polyfluoroalkyl substances exposure and age-related macular degeneration

Background This study aims to investigate the connection between serum lipids, per- and polyfluoroalkyl substances (PFAS), and age-related macular degeneration (AMD) risk and assess whether serum lipids mediate the association between PFAS and AMD. Methods 1605 participants were enrolled from NHANES 2005–2008. Four serum PFAS levels with high detective rates, including perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorohexane sulfonic acid (PFHxS) were examined. Restricted cubic spline analysis (RCS) and weighted quantile sum (WQS) analysis were employed to detect nonlinear and mixed exposure effects. Results PFOS level was associated with any AMD (OR, 1.54; 95% CI, 1.12 to 2.11; P = 0.011), early AMD (OR, 1.43; 95% CI, 1.06 to 1.95; P = 0.024), and late AMD (OR, 3.35; 95% CI, 1.55 to 7.23; P = 0.004) risk. PFHxS (OR, 1.72; 95% CI, 1.01 to 2.93; P = 0.045) and PFOA (OR, 2.10; 95% CI, 1.21 to 3.63; P = 0.011) levels were associated with late AMD risk. The RCS showed a nonlinear connection between PFOS exposure and AMD risk (P nonlinear = 0.006). WQS analysis indicated a positive relationship between mixed PFAS exposure and AMD risk (OR, 1.34; 95% CI, 1.03 to 1.75; P = 0.030). Serum total cholesterol (TC) and high-density lipoprotein (HDL) cholesterol were associated with AMD risk (ORTC, 1.005; 95% CI, 1.001 to 1.009; P = 0.026. ORHDL, 1.028; 95% CI, 1.014 to 1.042; P<0.001), and mediated the relationship of PFOS exposure and AMD risk, with mediation proportions of 5.73% (P = 0.020) and 7.27% (P = 0.032), respectively. Conclusions PFOS exposure was connected with AMD risk and serum TC and HDL mediated this relationship.

Formulation of new drug delivery systems for insulin from natural bioactive biocompatible polymers

Abstract New insulin drug delivery systems (IDDs): insulin@chitin; insulin@chitin-grafted (g)-guar gum were prepared by using a modified sol–gel method. Insulin vials were loaded on the safe natural inert bioactive polymers (chitin and chitin-g-GG copolymer) carriers using water green solvent. Traces amount additives were below toxicity limits. Guar gum increased the numbers of the functional groups of the polymer carrier. Insulin release monitored at 37 ± 0.5 °C and buffer solutions of pH (1.2, 6.8 and 7.4) simulating physiological body fluids: stomach, intestine colon and blood stream. Insulin released from insulin@chitin only at pH 7.4. No release observed at pH 1.2, 6.8 due strong bonding to acetyl group of chitin. Insulin@chitin-GG system showed sustained targeting insulin-release at pH: 6.8 > 7.4 > 1.2. Release data obeyed pseudo second order kinetic model indicating that IDDs is heterogeneous solid surface of energetically different active sites. Each insulin molecule occupied two active sites. The slow release at pH 1.2 indicated protection against stomach juice. Release kinetic depend on physicochemical characteristics (porosity, swelling ratio as well as peptide and amino acid sequence). Both IDDs showed negative zeta potential indicating stability against aggregation. Gaur gum improved particle size distribution and insulin release.

The urinary microbiome in association with diabetes and diabetic kidney disease: A systematic review

Background The urinary microbiome, or urobiome, is a novel area of research that has been gaining attention recently, as urine was thought to be sterile for years. There is limited information about the composition of the urobiome in health and disease. The urobiome may be affected by several factors and diseases such as diabetes, a disease that often leads to kidney damage. Thus, we need to understand the role of the urobiome to assess and monitor kidney disease related to diabetes over time. Methods We conducted a systematic review to summarize knowledge about the urobiome in association with diabetes mellitus and diabetic kidney disease. The search was conducted in several electronic databases until November 2024. Results Eighteen studies were selected including cross-sectional case-control studies, cross-sectional surveys and one prospective longitudinal study. In total, the urobiome of 1,571 people was sequenced, of which 662 people had diabetes, and of these 36 had confirmed diabetic kidney disease; 609 were healthy individuals, 179 had prediabetes or were at risk of type 2 diabetes mellitus and 121 did not have diabetes but had other comorbidities. Eight studies analysed data from females, one was focused on male data, and the other nine had mixed female-male data. Most of the studies had a small sample size, used voided midstream urine, and used 16S rRNA sequencing. Conclusion This systematic review summarizes trends seen throughout published data available to have a first baseline knowledge of the urinary microbiome, and its microbiota, in association with diabetes including the decreased richness and α-diversity in urinary microbiota in individuals with diabetes compared to healthy controls and the decreased α-diversity with the evolution of kidney disease independently of the cause.

Polarimetric image recovery method with domain-adversarial learning for underwater imaging

Scutellarin combined with lidocaine exerts antineoplastic effect in human glioma associated with repression of epidermal growth factor receptor signaling

Purpose Glioma is the most common primary intracranial tumors. Although great achievements have been made in the treatment, the efficacy is still unsatisfactory, which imposes a hefty burden on patients and society. Therefore, the exploration of new and effective anti-glioma drugs is urgent. Methods Human glioma cell lines U251 and LN229 were included in the study. Cell proliferation was detected by cell counting kit-8 (CCK8), plate clone formation assay, EdU incorporation assay and xCELLigence real-time cell analyzer. Cell apoptosis was evaluated by TUNEL assay and flow cytometry. Then, transwell assay was used for assessing the migration. Moreover, tumor xenograft model was established to examine the effect of scutellarin (SCU) and lidocaine on the growth of glioma in vivo. Lastly, western blot was performed to detect the protein level of epidermal growth factor receptor (EGFR). Results In present study, we found that SCU and lidocaine suppressed the proliferation and migration, and induced the apoptosis of human glioma cell lines, including U251 and LN229 cells, in a dose-dependent manner in vitro. Moreover, the combination of SCU and lidocaine further restrained the proliferation and migration ability of U251 and LN229 cells, while induced their apoptosis in vitro. Additionally, SCU and lidocaine also inhibited the growth of glioma in vivo, and the effect of the combination was better. Above all, the toxicity of SCU and its combination with lidocaine was low to normal astrocytes and neurons. Mechanistically, the effect of SCU and its combination with lidocaine on glioma cells was partially associated with the repression of EGFR signaling. Conclusions Scutellarin and lidocaine exerted a synergistic effect on suppressing the proliferation and migration and inducing the apoptosis of glioma cells, which was partly associated with the repression of EGFR signaling.

Evaluation of tourism ecological security and its obstacles in semi-arid river valley urban: a case study of Lanzhou, China

Effect and safety of ethanolamine oleate in sclerotherapy in patients with difficult-to-resect venous malformations: A multicenter, single-arm study

Objective To evaluate the effect and safety of sclerotherapy in patients with difficult-to-resect venous malformations treated with ethanolamine oleate. Design and setting This investigator-initiated clinical trial employed a multicenter, single-arm design and was conducted in Japan. Patients Overall, 44 patients with difficult-to-resect venous malformations were categorized into two cohorts: 22 patients with cystic-type malformations and 22 patients with diffuse-type malformations, including children (<15 years old). Interventions Adult patients received injections of 5% ethanolamine oleate solution, double diluted with contrast or normal saline, with a maximum dose of 0.4 mL/kg. The same method of administration was used for children (<15 years old). The maximum volume of the prepared solution in one treatment was 30 mL. Evaluation methods Treatment effect was assessed by evaluating the difference in lesion volume using magnetic resonance imaging as a primary endpoint and differences in pain using a visual analog scale as a key secondary endpoint. Results Among the 45 patients who consented, one was excluded owing to potential intracranial involvement of venous malformations during screening. Regarding the primary outcome, 26 of 44 patients (59.1%, 95% confidence interval: 44.41–72.31%) achieved ≥ 20% reduction in malformation volume, with 16 patients having cystic lesions (72.7%, 51.85–86.85%) and 10 patients having diffuse lesions (45.5%, 26.92–65.34%). Both cohorts showed significant improvement in self-reported pain scores associated with lesions 3 months post-sclerotherapy. No death or serious adverse events occurred. Hemoglobinuria was observed in 23 patients (52%), a known drug-related adverse event. Prompt initiation of haptoglobin therapy led to full recovery within a month for these patients. Conclusions Ethanolamine oleate shows potential as a therapeutic sclerosing agent for patients with difficult-to-resect venous malformations.

The role of self-rumination and self-reflection in depressive symptoms among individuals with attention-deficit/hyperactivity disorder traits

Abstract While some types of rumination have been reported as exacerbating factors in depressive symptoms related to attention-deficit/hyperactivity disorder (ADHD) traits, the role of self-rumination remains underexplored. Additionally, self-reflection—a similar form of private self-consciousness which may have protective effects—has been even less examined. This study of 3,000 Japanese adults (aged 18–50 years) investigates self-rumination and self-reflection in depressive symptoms related to ADHD, using the Adult ADHD Self-Report Scale, Rumination–Reflection Questionnaire, and Beck Depression Inventory-II. Statistical analyses included Pearson’s correlation and linear regression for mediation/moderation. ADHD traits were correlated with depressive symptoms (r = 0.413, p < 0.001), mediated by self-rumination (indirect effect = 0.21, 95% confidence interval [0.17, 0.26]). Self-reflection was positively correlated with depressive symptoms (r = 0.193, p < 0.001) but had a protective effect when controlling for self-rumination (β = −0.75, p < 0.001). Moderated mediation analysis showed self-reflection reduced depressive symptoms related to ADHD traits by moderating both the impact of ADHD traits on self-rumination and the influence of self-rumination on depressive symptoms. These effects were particularly significant for inattention traits. Our findings suggest that self-reflection, by mitigating self-rumination, may serve as a therapeutic target for depressive symptoms in adults with ADHD traits.

Ventricular function assessment using an ultrafast spoiled gradient echo sequence with an intravascular blood pool contrast agent in pediatric patients

Background Balanced steady-state free processing (bSSFP) MR sequence has long been considered the gold standard method for ventricular function assessment (VFA), and normal values are based on this acquisition. However, bSSFP sequence suffers from susceptibility artifacts due to scenarios such as cardiac implants. The T1-TFE sequence, also known as ultrafast spoiled gradient sequence, is less affected by such susceptibility artifacts. While it is unclear if T1-TFE sequence yields similar VFA results as the bSSFP sequence. Purpose To validate if the T1-TFE sequence, with an intravascular blood pool contrast agent, yields similar results for VFA as the gold-standard non-contrast bSSFP approach, so that the T1-TFE sequence can be used for VFA when bSSFP approach fails. Methods Two sets of images from two different sequences were utilized in this study. T1-TFE (with contrast) scans were used as one while bSSFP-derived images were used as the other. 37 pediatric patients were recruited into this study. Semi-automated software (cvi42) was used to segment and derive ventricular volumes. Image quality was objectively assessed by comparing signal-to-noise (SNR) and contrast-to-noise ratio (CNR) scores. Last, two expert readers provided a subjective analysis of image quality. Paired t-tests were used to assess significant differences in volumetric values (end-diastolic and end-systolic) between T1-TFE and bSSFP sequences. A Bland-Altman analysis evaluated potential bias and agreement between these sequences. Results Ventricular function assessment via volumetric data analysis resulted in no statistically significant differences (P > 0.05), and high R2 values. SNR and CNR scores also presented with no statistically significant differences (P > 0.05), and nearly identical scores (SNR T1-TFE mean: 29.5 ± 3.1, SNR bSSFP mean: 28.8 ± 3.7, CNR T1-TFE mean: 28.8 ± 3.3, CNR bSSFP mean: 28.1 ± 4.0). Image quality assessment via expert subjective image analysis scores is consistent with the data. All Bland-Altman plots show good agreement and reveal no systematic bias or random error. Conclusion T1-TFE sequences in combination with Ferumoxytol allow reliable ventricular function assessment and overcome the limitations of traditional bSSFP MR sequences in this context.

Differences in risk factor profiles for peripheral artery disease compared to coronary, cerebral and carotid artery

Abstract The aim of this study was to evaluate the greatest drivers for development of lower extremity peripheral artery disease (PAD) in relation to coronary, precerebral, or cerebral artery disease This prospective study (Malmö Diet and Cancer study) included 26,681 participants. The diagnosis of incident PAD, coronary artery disease (CoAD), atherothrombotic ischemic stroke (IS) free from atrial fibrillation or flutter, and carotid artery disease (CaAD) was validated. A modified Lunn-McNeil competing risk analysis was performed to compare the Hazard Ratio (HR) strength of PAD in relation to CoAD, IS, or CaAD. The estimated population attributable risk fractions (PAF) for each atherosclerotic manifestation were estimated by first fit an age and sex adjusted Cox proportional hazard regression, and then estimate the PAF using the Direct method. Male sex, age, and hypertension were risk factors for development of all atherosclerotic manifestations. Current smoking accounted for 45.6% (95% CI 41.1–47.2), 16.1%, 14.0%, and 23.3% of the risk for development of PAD, CoAD, IS, and CaAD, respectively. Hypertension was more associated with development of PAD than CoAD (p = 0.009). Smoking and diabetes mellitus were positively associated with all four manifestations, but these associations were significantly stronger for PAD than the other three manifestations. Smoking and diabetes mellitus had a larger impact on incident PAD than incident coronary, cerebral or precerebral artery manifestations. Since the lower extremity arteries are the easiest to access and examine, they may be considered as the first arterial bed to examine in patients at increased risk for atherosclerotic manifestations.

Correction: Association between sanitary toilets and health poverty vulnerability among rural western Chinese adults aged 45 years and older: A cross-sectional study

Feasibility study of emotion mimicry analysis in human–machine interaction

Abstract Health apps have increased in popularity as people increasingly follow the advice these apps provide to enhance physical and mental well-being. One key aspect of improving neurosensory health is identifying and expressing emotions. Emotional intelligence is crucial for maintaining and enhancing social interactions. In this context, a preliminary closed-loop feedback system has been developed to help people project specific emotions by altering their facial expressions. This system is part of a research intervention aimed at therapeutic applications for individuals with autism spectrum disorder. The proposed system functions as a digital mirror, initially displaying an animated avatar’s face expressing a predefined emotion. Users are then asked to mimic the avatar’s expression. During this process, a custom emotion recognition model analyzes the user’s facial expressions and provides feedback on the accuracy of their projection. A small experimental study involving 8 participants tested the system for feasibility, with avatars projecting the six basic emotions and a neutral expression. The study results indicated a positive correlation between the projected facial expressions and the emotions identified by participants. Participants effectively recognized the emotions, with 85.40% accuracy demonstrating the system’s potential in enhancing the well-being of individuals. The participants were also able to mimic the given expression effectively with an accuracy of 46.67%. However, a deficiency in the performance of one of the expressions, surprise, was noticed. In the post processing, this issue was addressed and model enhancements were tailored to boost the performance by ~ 30%. This approach shows promise for therapeutic use and emotional skill development. A further wider experimental study is still required to validate the findings of this study and analyze the impact of modifications made.