Identification of hub gene for the pathogenic mechanism and diagnosis of MASLD by enhanced bioinformatics analysis and machine learning

by Hong Lu, Ziyong Mao, Mengyao Zheng, Min Zhang, Heqing Huang, Yiling Chen, Long Lv, Zutao Chen

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a heterogeneous disease caused by multiple etiologies. It is characterized by excessive fat accumulation in the liver. Without intervention, MASLD can progress from steatosis to metabolic dysfunction-associated steatohepatitis (MASH), fibrosis and even to cirrhosis and hepatocellular carcinoma. However, the pathogenesis of MASH and the mechanism underlying the development of fibrosis remain poorly understood, posing challenges for accurate diagnosis of MASH and fibrosis. In this study, we analyzed tissue RNA-seq data and clinical information of healthy individuals and MASLD patients from multiple datasets, the key genes and pathways involved in the occurrence and progression of MASLD, MASH, and fibrosis were screened respectively. Our findings reveal that the development of MASLD, MASH and fibrosis is associated with lipid metabolism processes. Based on the RNA expression profiles of identified hub genes, we established three alternative diagnostic models for MASLD, MASH, and fibrosis. These models demonstrated excellent performance in the diagnosis of MASLD, MASH, and fibrosis, with AUC values exceeding 0.9, implicating its potential clinical values in disease diagnosis.

Barriers and facilitators in implementing early essential newborn care of well‐born babies in low‐ and middle‐income countries: A mixed‐method systematic review

Abstract

Background

Evidences have demonstrated the effectiveness of early essential newborn care. However, the implementation of early essential newborn care is suboptimal. The aim is to identify and synthesise the barriers and facilitators impacting the implementation of early essential newborn care in low- and middle-income countries.

Data Sources

PubMed, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, CNKI, Wan Fang Data, SinoMed and Google Scholar.

Methods

Two authors independently screened, performed quality assessment using the Mixed Methods Appraisal Tool and extracted data. This review includes papers that reported the barriers and facilitators of implementing early essential newborn care in low- and middle-income countries from the view of healthcare providers. Barriers and facilitators were coded according to the consolidated framework for implementation research in a deductive way and then been inducted into five common themes. This review followed synthesis without meta-analysis reporting guideline.

Results

A total of 28 studies were included. Five inductive common themes influencing implementing early essential newborn care in low- and middle-income countries were system-level healthcare factors, healthcare providers’ knowledge and beliefs, the requirements of mothers or families, adapting to routine practice and the working climate of organisation.

Conclusion

The factors were from system level, facility level and individual level and were inducted into five themes. Based on this review, decision-makers could tailor implementing strategies to narrow the gap between the evidence and implementation.

Relevance to Clinical Practice

The study offers guidance for health professionals to identify barriers and facilitators in implementing early essential newborn care and make tailored strategies when implementing early essential newborn care.

Patient or Public Contribution

No patient or public contributions.