Yale Journal of Biology and Medicine最新文献

{"title":"Comparative Effectiveness Analysis of Lumpectomy and Mastectomy for Elderly Female Breast Cancer Patients: A Deep Learning-based Big Data Analysis.","authors":"Jiping Wang, Shunqin Zhang, Huangdi Yi, Shuangge Ma","doi":"10.59249/IAJU7580","DOIUrl":"10.59249/IAJU7580","url":null,"abstract":"<p><p><b>Objectives</b>: To evaluate the comparative effectiveness of treatments, a randomized clinical trial remains the gold standard but can be challenged by a high cost, a limited sample size, an inability to fully reflect the real world, and feasibility concerns. The objective is to showcase a big data approach that takes advantage of large electronic medical record (EMR) data to emulate clinical trials. To overcome the limitations of regression analysis, a deep learning-based analysis pipeline was developed. <b>Study Design and Setting</b>: Lumpectomy (breast-conserving surgery) and mastectomy are the two most commonly used surgical procedures for early-stage female breast cancer patients. An emulation trial was designed using the Surveillance, Epidemiology, and End Results (SEER)-Medicare data to evaluate their relative effectiveness in overall survival. The analysis pipeline consisted of a propensity score step, a weighted survival analysis step, and a bootstrap inference step. <b>Results</b>: A total of 65,997 subjects were enrolled in the emulated trial, with 50,704 and 15,293 in the lumpectomy and mastectomy arms, respectively. The two surgery procedures had comparable effects in terms of overall survival (survival year change = 0.08, 95% confidence interval (CI): -0.08, 0.25) for the elderly SEER-Medicare early-stage female breast cancer patients. <b>Conclusion</b>: This study demonstrated the power of \"mining large EMR data + deep learning-based analysis,\" and the proposed analysis strategy and technique can be potentially broadly applicable. It provided convincing evidence of the comparative effectiveness of lumpectomy and mastectomy.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 3","pages":"327-346"},"PeriodicalIF":2.5,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/be/yjbm_96_3_327.PMC10524818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Disparities in Invasive ICU Treatments Among Septic Patients: High Resolution Electronic Health Records Analysis from MIMIC-IV.","authors":"Sara Mohammed,&nbsp;João Matos,&nbsp;Matthieu Doutreligne,&nbsp;Leo Anthony Celi,&nbsp;Tristan Struja","doi":"10.59249/WDJI8829","DOIUrl":"10.59249/WDJI8829","url":null,"abstract":"<p><p><b>Background</b>: Low-resolution administrative databases can give biased results, whereas high-resolution, time-stamped variables from clinical databases like MIMIC-IV might provide nuanced insights. We evaluated racial-ethnic disparities in life-sustaining ICU-treatments (Invasive Mechanical Ventilation (IMV), Renal Replacement Therapy (RRT), and Vasopressors (VP)) among patients with sepsis. <b>Methods</b>: In this observational retrospective cohort study, patients fulfilling sepsis-3 criteria were categorized by treatment assignment within the first 4 days. The outcomes were treatment allocations. The likelihood of receiving treatment was calculated by race-ethnicity (Racial-ethnic group (REG) or White group (WG)) using 5-fold sub-sampling nested logistic regression and XGBoost. <b>Results</b>: In 23,914 admissions, 82% were White, 42% were women. REG were less likely to receive IMV across all eligibility days (day 1 odds ratio (OR) 0.87, 95% confidence interval (CI) 0.83-0.94, day 4 OR 0.80, 95% CI 0.72 - 0.87). There were no differences in RRT (day 1 OR 1.00, 95% CI 0.96-1.09, day 4 OR 1.00, 95% CI 0.94-1.06). REG were also less likely to be treated with VP at days 1 to 3 (day 1 OR 0.87, 95% CI 0.76-0.94), but not at day 4 (OR 0.95, 95% CI 0.87-1.01). These findings remained robust when relaxing eligibility criteria for treatment allocation. <b>Conclusion</b>: Our findings reveal significant disparities in the use of invasive life-saving ICU treatments among septic patients from racial and ethnic minority backgrounds, particularly with respect to IMV and VP use. These disparities underscore not only the need to address inequality in critical care settings, but also highlight the importance of high-resolution data.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 3","pages":"293-312"},"PeriodicalIF":2.7,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/78/ba/yjbm_96_3_293.PMC10524813.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomy of the Living Cell, Driving Force of Evolution","authors":"Ford Brian J","doi":"10.17352/jbm.000040","DOIUrl":"https://doi.org/10.17352/jbm.000040","url":null,"abstract":"Conventional biologists and medical doctors conceptualize the body as divided into cells. It is construed as a bag of organs, with one of everything down the center, and two of everything down the sides. My alternative view is the body as a community of autonomous living cells whose choreographed cohesion gives rise to the phenomenon we know as the body. Science reduces multicellular life to the biochemical interplay of its components, and systems biology to a concatenation of subunits acting according to the laws of chemistry and physics. Current studies of living cells concentrate on the subcellular components since mitochondria were designated the “powerhouse of the cell” though they can be seen to move, migrate, and respond to stimuli. Although we understand cells in communities and the organelles within each cell, we ignore the lives lived by individual cells as they conduct themselves in heuristic (decision-making) and in motivating evolutionary progress. Here we review original observations on the behavior of living cells and conclude that they are essential drivers of coordinated community cohesion.","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136193777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthesis, characterization, anti-cancer evaluation, and DNA-binding study of new bay-substituted perylene derivatives","authors":"Abourajab Arwa, Mostafanejad S Melika, Dinleyici Meltem, Al-Khateeb Basma, Kunter Imge, Tuzmen Sukru, Icil Huriye","doi":"10.17352/jbm.000039","DOIUrl":"https://doi.org/10.17352/jbm.000039","url":null,"abstract":"Two new perylene derivatives 1,7-di(3,5-diamino-pyrimidoxyl) perylene-3,4,9,10- tetracarboxylic acid bisanhydride (4) and 1,7-di(2-[3-[(4-amino-2-methylpyrimidin-5-yl)methyl]-4-methyl-1,3-thiazol-3-ium-5-yl]) ethoxyperylene-3,4,9,10-tetracarboxylic bisanhydride (6) have been synthesized. We aimed to study their interactions with G-quadruplex (G4) structures as potent G4 ligands and telomerase inhibitors. We used a PCR-amplified guanine-rich region from the human beta-globin gene, oligonucleotide from human telomeres (a-coreTT), an oncogene (c-kit), and SK-HEP-1 adenocarcinoma cells to characterize those compounds’ binding and stabilizing abilities to G4 structures and anti-cancer potential. All results obtained through UV-visible and fluorescence spectroscopies, agarose gel electrophoresis, and MTT assay on SK-HEP-1 adenocarcinoma cells were in good agreement. Compounds 4 and 6 are promising DNA-binding and cytotoxic compounds with a relatively antiproliferative effect on the selected tumour. In all studies, the formal positive charge carrier, compound 6, showed higher activity in terms of anti-cancer effects. These results may help elucidate the feasibility of the perylene derivatives as future chemo-therapeutic agents.","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"43 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81284484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coffee, Citrus, and Alcohol: A Review of What We Drink and How it May Affect our Risk for Skin Cancer.","authors":"Marcelo Paiva, Sara Yumeen, Benjamin J Kahn, Hongmei Nan, Eunyoung Cho, Elie Saliba, Abrar Qureshi","doi":"10.59249/EVKO3455","DOIUrl":"10.59249/EVKO3455","url":null,"abstract":"Climate change and environmental health are closely linked with agriculture and food supply. The environment influences accessibility, quality, and variety of foods and drinks that are available for consumption, which in turn influences population health. A growing area of research is the role of dietary intake of nutrients and how they may influence risk for skin cancer. In recent years, our group has studied dietary nutrients, particularly those found in commonly consumed beverages, such as those containing caffeine, citrus products, and alcohol, in large prospective cohorts to evaluate how their intake may influence risk for skin cancer. Our data suggest that intake of citrus juices, when consumed around once per day or more, or around 5 to 6 times per week, may be associated with increased risk for both keratinocyte carcinomas (KC) and malignant melanoma (MM). With regards to alcohol consumption, we have found that intake of white wine may be associated with increased risk for both KC and MM, while beer and red wine have not shown such associations. Lastly, our work suggests caffeinated beverages, including coffee, tea, and cola, may be associated with decreased risk for basal cell carcinoma (BCC) and MM. While the associations between food intake and skin cancer development are complex, and remain to be further analyzed in future studies, we hope that our summary may help guide individuals to small changes they may make towards potentially reducing their risk for certain skin cancers.","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 2","pages":"205-210"},"PeriodicalIF":2.7,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/74/yjbm_96_2_205.PMC10303256.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9811049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive Association of Aggression with Ambient Temperature.","authors":"Satbyul Estella Kim, Yoonhee Kim, Masahiro Hashizume, Yasushi Honda, Oka Kazutaka, Yasuaki Hijioka, Ho Kim","doi":"10.59249/RXZX5728","DOIUrl":"10.59249/RXZX5728","url":null,"abstract":"<p><p><b>Background</b>: Relatively little attention has been paid to the potential effects of rising temperatures on changes in human behavior that lead to health and social consequences, including aggression. This study investigated the association between ambient temperature and aggression using assault death data from Seoul, South Korea (1991-2020). <b>Methods</b>: We conducted a time-stratified case-crossover analysis based on conditional logistic regression to control for relevant covariates. The exposure-response curve was explored, and stratified analyses were conducted by season and sociodemographic characteristics. <b>Results</b>: The overall risk of assault deaths significantly increased by 1.4% per 1°C increase in ambient temperature. A positive curvilinear relationship was observed between ambient temperature and assault deaths, which flattened out at 23.6°C during the warm season. Furthermore, risk increases were higher in males, teenagers, and those with the least education. <b>Conclusion</b>: This study highlighted the importance of understanding the impact of rising temperatures on aggression in the context of climate change and public health.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 2","pages":"189-196"},"PeriodicalIF":2.5,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/df/yjbm_96_2_189.PMC10303254.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9757676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NGS analysis of unexplained Community-Acquired Pneumonia (CAP) cases in South Korea","authors":"Lim Sooyeon, Lee Jae Kyung, Lee Han Sol, Noh Ji Yun, Song Joon Young, Cheong Hee Jin, Kim Woo Joo","doi":"10.17352/jbm.000038","DOIUrl":"https://doi.org/10.17352/jbm.000038","url":null,"abstract":"In general, pneumonia has known to be closely associated with respiratory infection of viruses, bacteria, fungi, and parasites. In South Korea, pneumonia is a leading cause of death that continues to threaten public health every year. Through the tertiary hospital-based influenza surveillance system in South Korea, nasopharyngeal swab specimens were obtained from patients with unexplained cases of Community-Acquired Pneumonia (CAP) between 2011 and 2017. After real-time PCR screening using respiratory viral panels, the samples were found negative for 16 common respiratory pathogens including adenovirus, influenza viruses, rhinovirus, respiratory syncytial virus, coronavirus, metapneumovirus, and parainfluenza viruses. The aim of this study was to investigate the patient microbiota and examine the etiology of CAP requiring hospitalization. The nasopharyngeal microbiome of adult patients during CAP was analyzed using Next-Generation Sequencing (NGS) on the Illumina MiSeq platform and a subsequent bioinformatics pipeline. Viral nucleic acids were nearly absent in the samples and failed to generate any sequence reads. On the other hand, samples were enriched with a diverse bacterial community, which was mainly comprised of Corynebacterium, Staphylococcus, Streptococcus, Haemophilus, Moraxella, Acinetobacter, and Rhizobium genera. Despite the diversity of bacterial composition, only a few dominant species with > 1% abundance were identified in each patient sample. Population analysis at the genus level showed that microbial diversity varied according to age, sex, and location.","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"53 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87530204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Economics of Scientific Publishing.","authors":"Azmaeen Zarif","doi":"10.59249/OMSP9618","DOIUrl":"https://doi.org/10.59249/OMSP9618","url":null,"abstract":"<p><p>The peculiar nature of scientific publishing has allowed for a high degree of market concentration and a non-collusive oligopoly. The non-substitutable characteristic of scientific journals has facilitated an environment of market concentration. Acquisition of journals on a capabilities-based approach has seen market concentration increase in favor of a small group of dominant publishers. The digital era of scientific publishing has accelerated concentration. Competition laws have failed to prevent anti-competitive practices. The need for government intervention is debated. The definition of scientific publishing as a public good is evaluated to determine the need for intervention. Policy implications are suggested to increase competitiveness in the short-run and present prestige-maintaining alternatives in the long run. A fundamental change in scientific publishing is required to enable socially efficient and equitable access for wider society's benefit.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 2","pages":"267-273"},"PeriodicalIF":2.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/9a/yjbm_96_2_267.PMC10303255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10140464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change Imperils Pediatric Health: Child Advocacy Through Fossil Fuel Divestment.","authors":"Sandra H Jee,&nbsp;Elizabeth Friedman,&nbsp;Ruth A Etzel,&nbsp;Vi T Nguyen,&nbsp;Todd L Sack,&nbsp;Kathi J Kemper","doi":"10.59249/ZODD9375","DOIUrl":"https://doi.org/10.59249/ZODD9375","url":null,"abstract":"<p><p>Climate change poses an existential threat to children's health. Divestment of ownership stakes in fossil fuel companies is one tool available to pediatricians to address climate change. Pediatricians are trusted messengers regarding children's health and therefore bear a unique responsibility to advocate for climate and health policies that affect children. Among the impacts of climate change on pediatric patients are allergic rhinitis and asthma; heat-related illnesses; premature birth; injuries from severe storms and fires; vector-borne diseases; and mental illnesses. Children are disproportionately affected as well by climate-related displacement of populations, drought, water shortages, and famine. The human-generated burning of fossil fuels emits greenhouse gases (GHG) such as carbon dioxide, which trap heat in the atmosphere and cause global warming. The US healthcare industry is responsible for 8.5% of the nation's entire greenhouse gases and toxic air pollutants. In this perspectives piece we review the principle of divestment as a strategy for improving childhood health. Healthcare professionals can help combat climate change by embracing divestment in their personal investment portfolios and by their universities, healthcare systems, and professional organizations. We encourage this collaborative organizational effort to reduce greenhouse gas emissions.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 2","pages":"233-239"},"PeriodicalIF":2.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/fb/yjbm_96_2_233.PMC10303248.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9811042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exacerbation of Renal, Cardiovascular, and Respiratory Outcomes Associated with Changes in Climate.","authors":"David Baraghoshi,&nbsp;Cameron Niswander,&nbsp;Matthew Strand,&nbsp;Stefan Wheat,&nbsp;Julie Ramstetter,&nbsp;Nicholas Stoll,&nbsp;Jacob Fox,&nbsp;Katherine A James","doi":"10.59249/KYDF6093","DOIUrl":"https://doi.org/10.59249/KYDF6093","url":null,"abstract":"<p><p>Exposure to environmental variables including declining air quality and increasing temperatures can exert detrimental effects on human health including acute exacerbations of chronic diseases. We aim to investigate the association between these exposures and acute health outcomes in a rural community in Colorado. Meteorological and adult emergency department visit data were retrospectively collected (2013-2017); for asthma outcomes, additional data were available (2003-2017). Daily environmental exposure data included PM₁₀, maximum daily temperature (MDT), and mean humidity and precipitation. Total daily counts of emergency department (ED) diagnoses for myocardial infarction, congestive heart failure, urolithiasis, and exacerbation of chronic obstructive pulmonary disease (COPD) and asthma, were calculated during the study period. Time series models using generalized estimating equations were fit for each disease and included all four environmental factors. Between 2013 and 2017, asthma and COPD exacerbation accounted for 30.8% and 25.4% of all ED visits (n=5,113), respectively. We found that for every 5˚C increase in MDT, the rate of urolithiasis visits increased by 13% (95% CI: 2%, 26%) and for every 10μg/m³ increase in 3-day moving average PM₁₀, the rate of urolithiasis visits increased by 7% (95% CI: 1%, 13%). The magnitude of association between 3-day moving average PM₁₀ and rate of urolithiasis visits increased with increasing MDT. The rate of asthma exacerbation significantly increased as 3-day, 7-day, and 21-day moving average PM₁₀ increased. This retrospective study on ED visits is one of the first to investigate the impact of several environmental exposures on adverse health outcomes in a rural community. Research into mitigating the negative impacts of these environmental exposures on health outcomes is needed.</p>","PeriodicalId":48617,"journal":{"name":"Yale Journal of Biology and Medicine","volume":"96 2","pages":"159-169"},"PeriodicalIF":2.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/37/yjbm_96_2_159.PMC10303263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}