bluuebunny/crossref_metadata_2025 huggingface dataset:
RAP-2 and CNH-MAP4 Kinase MIG-15 confer resistance in bystander epithelium to cell-fate transformation by excess Ras or Notch activity
Authors: Fakieh Razan A. , Reiner David J.
Published: December 2024

Induction of cell fates by growth factors impacts many facets of developmental biology and disease. LIN-3/EGF induces the equipotent vulval precursor cells (VPCs) in
Caenorhabditis elegans
to assume the 3˚−3˚−2˚−1˚−2˚−3˚ pattern of cell fates. 1˚ and 2˚ cells become specialized epithelia and undergo stereotyped series of cell divisions to form the vulva. Conversely, 3˚ cells are relatively quiescent and nonspecialized; they divide once and fuse with the surrounding epithelium. 3˚ cells have thus been characterized as passive, uninduced, or ground state. Based on our previous studies, we hypothesized that a 3˚-promoting program would confer resistance to cell fate-transformation by inappropriately activated 1˚ and 2˚ fate-promoting LET-60/Ras and LIN-12/Notch, respectively. Deficient MIG-15/CNH-MAP4 Kinase meets the expectations of genetic interactions for a 3˚-promoting protein. Moreover, endogenous MIG-15 is required for expression of a fluorescent biomarker of 3˚ cell fate, is expressed in VPCs, and functions cell autonomously in VPCs. The Ras family small GTPase RAP-2, orthologs of which activate orthologs of MIG-15 in other systems, emulates these functions of MIG-15. However, gain of RAP-2 function has no effect on patterning, suggesting its activity is constitutive in VPCs. The 3˚ biomarker is expressed independently of the AC, raising questions about the cellular origin of 3˚-promoting activity. Activated LET-60/Ras and LIN-12/Notch repress expression of the 3˚ biomarker, suggesting that the 3˚-promoting program is both antagonized by as well as antagonizes 1˚- and 2˚- promoting programs. This study provides insight into developmental properties of cells historically considered to be nonresponding to growth factor signals.
Tsg101 mimicry of canonical E2 enzymes underlies its role in ubiquitin signaling
Authors: Nyenhuis David A. , Watanabe Susan M. , Tjandra Nico , Carter Carol A.
Published: December 2024

Tsg101 is a highly conserved protein best known as an early-functioning component of cellular ESCRT machinery participating in recognition, sorting, and trafficking of cellular cargo to various intracellular destinations. It shares sequence and structural homology to canonical ubiquitin-conjugating (E2) enzymes and is linked to diverse events regulated by Ub signaling. How it might fulfill these roles is unclear. Here, we show that Tsg101 E2 mimicry permits interactions with diverse ubiquitin ligating (E3) enzymes and underlies its multifunctional capabilities. Coexpression of Tsg101 with the E3 ligase NNedd4-2s protected the enzyme from degradation and, remarkably, other widely divergent ligases as well. Structural alignment with UbcH5, a canonical E2 enzyme, revealed that recognition at the E2-E3 interface, a region broadly conserved despite sequence and structural differences in both E2 and E3 enzymes, was critical for protection. Nevertheless, UbcH5 failed to protect NNedd4-2s, indicating that the UEV chaperone function is unique to the variant. Studies using Cy5-Ub-VME showed that Tsg101-mediated protection reduced accessibility to Cys residues in the ligase. Access to Tsg101 Ub-binding sites was critical: Rabeprazole, which interferes with Tsg101 Ub-binding, diminished E3 ligase protection. Thus, E2 mimicry permitting control of E3 ligase ubiquitin signaling underlies Tsg101’s broad ability to participate in multiple cellular functions. The study provides mechanistic insight into how Tsg101, by partnering with diverse E3 ligases, can contribute to a broad range of cellular activities.
Carbon gain in upper but loss in deeper cropland soils across China over the last four decades
Authors: Zhou Zhenghu , Wang Chuankuan , Li Yu’e , Wang Xuhui , He Xinhua , Xu Minggang , Cai Andong
Published: December 2024

Increasing soil organic carbon (SOC) in agricultural systems is a primary nature-based option for mitigating climate change, improving soil fertility, and ensuring food security. However, the consequences of global warming and increases in carbon inputs on cropland SOC stocks over the last few decades remain largely unknown, particularly in deeper soil layers. Here, by using repeated measurements, we reassess variations in SOC stocks across a 0 to 100 cm soil profile at the same locations in China’s upland croplands in 1980 and 2023. We observe an overall net accumulation of 0.74 Pg SOC (7%) with a mean sequestration rate of 13.7 g SOC m
−2
y
−1
. This accumulation results from 0.86 Pg SOC gains at upper soil depths (0 to 60 cm) induced by carbon inputs, alongside 0.12 Pg SOC losses at deeper soil layers (60 to 100 cm) prompted by warming-enhanced decomposition. While our findings indicate a successful, though lower than expected, increase in overall net SOC stocks, the loss of more recalcitrant deeper SOC warrants further consideration of its effects on enhancing cropland SOC accumulation to achieve carbon neutrality over the long term.
Characteristics of complex network of heatwaves over China
Authors: Shen Xuemin , Hu Xiaodong , Feng Aixia , Wang Qiguang , Gu Changgui
Published: December 2024

Using complex network methods, we construct undirected and directed heatwave networks to systematically analyze heatwave events over China from 1961 to 2023, exploring their spatiotemporal evolution patterns in different regions. The findings reveal a significant increase in heatwaves since the 2000s, with the average occurrence rising from approximately 3 to 5 times, and their duration increasing from 15 to around 30 days—nearly doubling. An increasing trend of "early onset and late withdrawal" of heatwaves has become more pronounced each year. In particular, eastern regions experience heatwaves that typically start earlier and tend to persist into September, exhibiting greater interannual variability compared to western areas. The middle and lower reaches of the Yangtze River and Xinjiang are identified as high-frequency heatwave areas. Complex network analysis reveals the dynamics of heatwave propagation, with degree centrality and synchronization distance indicating that the middle and lower reaches of the Yangtze River, Northeast China, and Xinjiang are key nodes in heatwave spread. Additionally, network divergence analysis shows that Xinjiang acts as a "source" area for heatwaves, exporting heat to surrounding regions, while the central region functions as a major "sink," receiving more heatwave events. Further analysis from 1994 to 2023 indicates that heatwave events exhibit stronger network centrality and more complex synchronization patterns. These results suggest that complex networks provide a refined framework for depicting the spatiotemporal dynamics of heatwave propagation, offering new avenues for studying their occurrence and development patterns.
P(AN-co-MMA) nanofiber membrane decorated with greenly synthesized nanoparticles for heavy metal removal: a competitive study
Authors: Syed Abeer , Da’na Enshirah , Taha Amel , El-Aassar Mohamed R , Aldughaish Adnan M
Published: December 2024

Heavy metal contamination is a serious threat to water resources as it has been associated with carcinogenicity, mutagenicity, and toxicity. With the presence of heavy metals in water bodies reported from all over the globe, there is an urgent need for innovative water treatment strategies. The main goal of this study is to enhance the adsorption affinity of poly(acrylonitrile-co-methyl methacrylate) (P(AN-co-MMA)) nanofiber membrane for heavy metals by decorating the nanofiber membrane with greenly synthesized CoFe2O4 nanoparticles. Field emission scanning electron microscopy (FESEM) and transmission electron microscope (TEM) images confirmed the uniform dispersion of 30–40 nm CoFe2O4 nanoparticles within the P(AN-co-MMA) nanofiber membrane, having an average fiber diameter of 269 nm. x-ray diffraction (XRD) analysis showed the formation of highly crystalline CoFe2O4 nanoparticles without impurities. The CoFe2O4 nanoparticles exhibited type-IV isotherm, indicating the formation of mesoporous/macroporous materials with a specific surface area of 36.8 m2g−1. Thermal gravimetric analysis (TGA) demonstrated that both P(AN-co-MMA) and P(AN-co-MMA)CoFe2O4 begin to decompose at around 340 °C. The competitive adsorption behavior of the CoFe2O4, P(AN-co-MMA), and P(AN-co-MMA)CoFe2O4 was studied to determine their selectivity towards Pb2+, Hg2+, and Cd2+. The results showed a superior affinity of CoFe2O4 nanoparticles for Cd2+, with 100% removal within a concentration range of 20–80 ppm, compared to 50% removal using P(AN-co-MMA)CoFe2O4, and zero removal with P(AN-co-MMA). For Hg+, the efficiency of removal by the CoFe2O4 was the highest followed by P(AN-co-MMA), and then P(AN-co-MMA) CoFe2O4. Pb2+ showed exclusive affinity for the CoFe2O4 nanoparticles only. The presented eco-friendly nanocomposite presents a promising, efficient, and selective adsorbent for heavy metal removal from wastewater to address water pollution.
Investigation on the stress-strain relationship of rubberized concrete under uniaxial compression
Authors: Wang Jianfan
Published: December 2024

As urbanization progresses rapidly, addressing the disposal of waste tires has become an urgent global environmental concern. This research comprehensively examined how varying rubber proportions and particle dimensions impact the workability, axial compressive stress–strain response, splitting tensile resistance, and flexural capabilities of concrete, utilizing both experimental methods and theoretical assessments. Additionally, the energy dissipation properties of rubber-enriched concrete utilizing a toughness index and developed an analytical framework to predict the compressive stress–strain relationship in rubber-modified concrete were evaluated. When the rubber content was increased to 20%, it was observed that rubber reduced the workability and load-bearing capacity of concrete, with reductions of 44.7%, 26.9% and 30.5% in slump, peak stress and modulus of elasticity, respectively. The incorporation of rubber increased the peak strain of concrete, with the maximum increase reaching 26.2%. The ultimate deflection increased by about 8.0%. Meanwhile, the toughness index was found to increase, with an increase of about 36.8%. The established stress–strain analytical model can accurately predict the stress–strain behavior of rubberized concrete under axial compression. In summary, rubberized concrete shows significant potential in enhancing seismic performance in earthquake-prone regions, optimizing structural design, and addressing environmental issues related to waste tire disposal, aligning with sustainable development goals.
High entropy ceramics: research trends and reviewing mechanical properties using computer vision techniques
Authors: Kumar Bijendra , Bhattacharya Tapas Kumar , Modak Nipu , Mukherjee Alok , Chatterjeee Kingshuk , Haldar Partha
Published: December 2024

High entropy ceramics (HECs) represent a novel class of materials characterized by their unique multi-principal element compositions and exceptional properties. This study investigates the mechanical and thermal properties of high entropy ceramics through a comprehensive bibliometric analysis of 395 Scopus-indexed articles. Biblioshiny, VOSviewer and Gephi software are used to analyze different data linked with these articles. Data from abstracts are analyzed to identify properties like thermal conductivity, hardness, fracture toughness, etc Computer vision has been applied in data extraction and property characterization of HEC. Investigation reveals significant insights into the co-occurrence of keywords related to various mechanical properties, such as fracture toughness and compressive strength, alongside thermal characteristics like thermal conductivity. Visualizing these relationships highlights research clusters and identifies gaps in the current literature, paving the way for future exploration in this promising field.
Decolonizing language learning in digital environments through the voices of plurilingual learners in the Global South
Authors: Galante Angelica , Piccardo Enrica , Marcel Faith , Zeaiter Lana F , dela Cruz John Wayne N , Barise Aisha
Published: December 2024

Digital pedagogies of empowerment are needed to shift discourses on marginalization, facilitate additional language learning, and sustain multilingualism. Grounded in plurilingualism and decoloniality as theoretical frameworks, this transformative mixed methods study explored the affordances of PluriDigit, a plurilingual, decolonial, and digital approach to language learning. This study was conducted with thirty six language learners enrolled in online language courses in a multilingual program in São Paulo, Brazil. We explored whether learners’ plurilingual and pluricultural identities and competence would change over time and the potential emergent contributions of PluriDigit to learner empowerment. Results from inductive and deductive analyses of three types of data indicate a shift in learners’ mindset from monolingual to plurilingual and pluricultural identity and a significant increase in plurilingual and pluricultural competence scores over time. Moreover, results show that PluriDigit offered a critical lens to plurilingualism, facilitating decolonial learning, agency, and relationality, as well as the development of voice in the target language. We argue that PluriDigit is one possibility of digital decolonial pedagogy that can empower language learners in the Global South and beyond.
Co-culture of Aspergillus niger IFM 59706 and RAW264 cells enhances the production of aurasperone A with nitric oxide inhibitory activity
Authors: Ujie Yukiko , Saito Shun , Banno Tomoya , Yaguchi Takashi , Arai Midori A
Published: December 2024

Most actinomycetes and fungi have a multitude of silent biosynthetic genes whose activation could lead to the production of new natural products. Our group recently designed and used a co-culture method to isolate new natural products, based on the idea that pathogens might produce immune suppressors to avoid attack by immune cells. Here, we searched for compounds produced by the co-culture of immune cells with pathogenic fungi isolated from clinical specimens. The production of dimeric naphtho-γ-pyrone aurasperone A (1) was enhanced by the co-culture of pathogenic fungus Aspergillus niger IFM 59706 and RAW264 mouse macrophage-like cells. The absolute configuration of 1 was confirmed by comparison with the reported electronic circular dichroism spectrum. This is the first report of the inhibitory activity of 1 on nitric oxide production, an inflammatory mediator.
Dual-stage optimizer for systematic overestimation adjustment applied to multi-objective genetic algorithms for biomarker selection
Authors: Cattelani Luca , Fortino Vittorio
Published: December 2024

The selection of biomarker panels in omics data, challenged by numerous molecular features and limited samples, often requires the use of machine learning methods paired with wrapper feature selection techniques, like genetic algorithms. They test various feature sets—potential biomarker solutions—to fine-tune a machine learning model’s performance for supervised tasks, such as classifying cancer subtypes. This optimization process is undertaken using validation sets to evaluate and identify the most effective feature combinations. Evaluations have performance estimation error, measurable as discrepancy between validation and test set performance, and when the selection involves many models the best ones are almost certainly overestimated. This issue is also relevant in a multi-objective feature selection process where various characteristics of the biomarker panels are optimized, such as predictive performances and feature set size. Methods have been proposed to reduce the overestimation after a model has already been selected in single-objective problems, but no algorithm existed capable of reducing the overestimation during the optimization, improving model selection, or applied in the more general multi-objective domain. We propose Dual-stage Optimizer for Systematic overestimation Adjustment in Multi-Objective problems (DOSA-MO), a novel multi-objective optimization wrapper algorithm that learns how the original estimation, its variance, and the feature set size of the solutions predict the overestimation. DOSA-MO adjusts the expectation of the performance during the optimization, improving the composition of the solution set. We verify that DOSA-MO improves the performance of a state-of-the-art genetic algorithm on left-out or external sample sets, when predicting cancer subtypes and/or patient overall survival, using three transcriptomics datasets for kidney and breast cancer.
Due Diligence in International Law: A Useful Renaissance or ‘All Things to All People’?
Authors: Lanovoy Vladyslav
Published: December 2024

Few concepts have become as prominent in recent international law publications as ‘due diligence’. Still, its nature and content remain notably ambiguous. This essay reflects on the main takeaways from recent scholarly debates on due diligence. These takeaways are presented as five propositions that seek to capture the common findings or areas of agreement in the scholarship under review, having regard to the existing case law of international courts and tribunals. These propositions are intended to inform our understanding of the nature, content and scope of application of due diligence and are, in principle, agnostic as to the particular field of international law. With an eye to the future, this essay has also singled out certain areas in the debate where scholars disagree or where the law may not yet be settled. Those areas may benefit from further research, practice of states, clarification by international courts and tribunals and, likely, codification by the International Law Commission in the near future. These efforts will go a long way towards ensuring that due diligence remains a well-circumscribed concept and thus useful to states and other participants in the international legal order.
Charting the microbial frontier: a comprehensive guidebook for advancing microbiome research
Authors: Wu Hui
Published: December 2024

Specific microbial pathogens have evolved the capacity to sense immune mediators and use these signals to adapt and prepare against an incoming immune attack.
Parliamentary Interest in Foreign Security Policy: Insight from the Indian Lok Sabha
Authors: Ladwig Walter C
Published: December 2024

Existing scholarship argues that the effectiveness with which democracies craft foreign security policy depends on the level of engagement elected officials give the topic. Yet, there is little research on the factors driving individual parliamentarians’ interest in the topic beyond the notion that some issues have more resonance with the electorate than others. Introducing an original dataset of 10,180 parliamentary questions on foreign and defense matters in India, this study demonstrates that analysis of questions can have significant utility for the fields of international relations and foreign policy analysis by revealing the specific aspects of foreign security policy elected officials focus on, which, in this case, are at odds with the prevailing expectation that the mass political salience of an issue determines the level of attention given by elected officials. Moreover, factors such as electoral security, opposition party membership, representation of historically disadvantaged groups, and the geographic location of one’s constituency are shown to predict varying levels of attention by individual politicians operating in the same political environment.
Spatial and temporal patterns of zooplankton trophic interactions and carbon sources in the eutrophic Elbe estuary (Germany)
Authors: Biederbick Johanna , Möllmann Christian , Hauten Elena , Russnak Vanessa , Lahajnar Niko , Hansen Thomas , Dierking Jan , Koppelmann Rolf
Published: December 2024

Zooplankton in estuaries encounter complex physical and biogeochemical processes that affect the quantity, quality, and origin of their food sources. The knowledge about how zooplankton deal with highly variable organic matter sources is sparse. Here, we investigated the spatial and temporal patterns of zooplankton trophic dynamics and carbon sources in the intensively dredged, eutrophic Elbe estuary. For this purpose, we applied elemental and stable isotope analysis (δ13C and δ15N) on particulate organic matter (POM) and dominant meso- and macrozooplankton species, including ichthyoplankton, from five stations along the entire salinity gradient of the estuary in 2022. The δ13C values of POM (−29.2 to −23.0 ‰) indicated a mixture of riverine, terrestrial, and coastal carbon sources used by most taxa for their diet. Eurytemora affinis (−34.0 to −23.3 ‰) and Mesopodopsis slabberi (−22.2 to −20.0 ‰) exhibited a broader range in δ13C than POM, suggesting selective feeding on single POM components depending on the season. In winter and autumn, under high suspended matter loads and limited availability of high-quality autochthonous phytoplankton, zooplankton showed increased tendency for carnivory (higher δ15N values). Our study revealed a high trophic plasticity of estuarine Elbe zooplankton to buffer hydrological-related alterations in their food source by dietary niche partitioning and a flexible switch in their feeding behaviour.
Antonio Cassese and The Man in a Case
Authors: Gaeta Paola , Clapham Andrew
Published: December 2024

As we mark the 30th anniversary of the Tadić interlocutory appeal on jurisdiction of the International Criminal Tribunal for the former Yugoslavia, this special contribution commemorates the moment by looking at Antonio Cassese’s impact on international law, with a particular focus on his understanding of his own methodology, which could be described as ‘critical positivism’ and executed by a ‘judicious reformer’. ‘The Man in a Case’ in the title is a reference to a famous short story by Anton Chekov, a piece that Cassese particularly liked. With a wry smile, he used to say that lawyers who adhered to strict legal positivism risked becoming like the character in the story, Belikov, who lived a solitary existence and adhered strictly to a rigid set of rules and principles, building metaphorical walls around himself like a ‘man in a case’. Although Cassese recognized the safeguarding role that legal positivism can play in shielding legal discourse from ideological manipulation, he cautioned against the potential of pure positivism to put distance between lawyers and the socio-political challenges he thought we should be addressing in the real world. In his approach to law, as a scholar, a judge, and a practitioner, Cassese sought to balance methodological rigour with principled engagement. He emphasized the imperative for jurists to avoid becoming mere instruments of power and strove to maintain a delicate equilibrium between adherence to legal principles and active participation in moral and political discourse. In essence, Cassese’s approach sought to harness the protective function of legal positivism to his need to engage his moral and political commitments.
Optimizing Outcomes in Transcatheter Aortic Valve Replacement Addressing Cerebrovascular Complications and Enhancing Patient Safety
Authors: Chand Swati , Bujala Nishitha , Garg Jasmine , Tripathi Ashish , Thapa Sangharsha , Shah Sangam , Thapa Anish , Wagle Laxman , Frishman William H. , Aronow Wilbert S.
Published: December 2024

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis, becoming the gold standard for many patients. Despite its advantages over surgical aortic valve replacement, TAVR is associated with significant complications, including paravalvular leakage, conduction disorders, and cerebrovascular events. This review focuses on the pathophysiology, incidence, and management of cerebrovascular complications following TAVR. We explore the mechanisms leading to these events, including embolization of debris from the calcified valve and aortic arch, and the role of procedural factors. The review also discusses the timing of cerebrovascular events, diagnostic approaches, and potential preventive strategies, including embolic protection devices. Understanding these complications is crucial for improving patient outcomes and refining TAVR techniques.
Comparing Time to Recovery Between Initial and Repeat Concussion in Athletes
Authors: Wright Brandon S. , Dykowski Sara , Bretzin Abigail C. , Roberts Mark T. , Ichesco Ingrid K. , Almeida Andrea A. , Popovich Michael J. , Lorincz Matthew T. , Eckner James T.
Published: December 2024

Objective:

Compare time to recovery between initial and repeat concussions.

Design:

Retrospective review of electronic medical record.

Setting:

An interdisciplinary concussion clinic.

Patients:

Fifty patients (14.4 years old [±2.5]; 24 [48%] female) who sustained >1 concussion between 2016 and 2020 and were evaluated within 30 days of their concussion.

Intervention:

Injuries were divided into first, second, and/or last concussions.

Main Outcome Measures:

The primary outcome was time to recovery, as defined by clearance for return to sport. This was compared between first versus second concussion (primary analysis) and first versus last concussion (secondary analysis) using Cox regression. Multivariable models accounted for time from concussion to initial clinic visit and Sport Concussion Assessment Tool symptom severity score at initial encounter. Sensitivity analyses explored potential influences of initial encounter timing and interval between concussions.

Results:

Time to recovery did not differ between initial and repeat concussion in univariate or multivariable models (HR = 1.02, 95% CI, 0.65-1.62, P = 0.92; HR = 1.01, 95% CI, 0.64-1.62, P = 0.91 for multivariable models comparing first (ref) versus second and first (ref) versus last concussion, respectively). Similar results were obtained in sensitivity analyses stratifying by time to initial visit (≤7 days vs >7 days) or time between injuries (≤1 year vs >1 year).

Conclusions:

There were no differences in time to recovery between initial and repeat concussions sustained by the same athlete. A nonsignificant trend of shorter recovery after repeat concussions was observed for patients presenting within 1 week of injury and when repeat injuries occurred within 1 year.
Targeted combination chemotherapy effective in nuclear protein in testis carcinoma of lung origin: A case report and review of the literature
Authors: Li Ran , Zhang Ye , Liu Qian , Gao Aiqin , Dang Qi
Published: December 2024

Rationale:

Nuclear protein in testis carcinoma (NC) is a rare, aggressive, poorly differentiated squamous cell carcinoma. By reviewing the entire treatment process of the patient, we aim to explore the treatment experience of NC.

Patient concerns:

We report the case of a 27-year-old female patient with NC whose initial symptoms were occasional cough and chest tightness with abdominal distension for more than half a month without any other specific discomfort.

Diagnoses:

Computed tomography showed right lung hilar and right middle and lower lobe mass, malignant, right hilar and mediastinal lymph node metastasis, and bilateral cystic solid masses in the adnexal region, malignant possibility. Pathological diagnosis showed nuclear protein in the testis (+).

Interventions:

After the failure of first-line chemotherapy with immunocombination, second-line chemotherapy was switched to bevacizumab, which resulted in a progression-free survival of 6 months.

Outcomes:

The disease then reprogressed, and she died on November 7, 2022.

Lessons:

The patient achieved survival of nearly 1 year on multiple courses of therapy, well beyond the currently reported median survival. The patient achieved a 6-month progression-free survival, suggesting that combination therapy with antivascular endothelial growth factor class-targeted agents is a potential approach.
Electrical impedance tomography-guided positive end-expiratory pressure titration for perioperative oxygenation and postoperative pulmonary complications: A systematic review and meta-analysis
Authors: Chen Lifang , Yu Kang , Yang Jiaojiao , Han Xue , Liu Lei , Li Tianzuo , Miao Huihui
Published: December 2024

Background:

The electrical impedance tomography (EIT)-guided individual positive end-expiratory pressure (PEEP) approach is a noninvasive, radiation-free, and straightforward strategy. However, its validity to prevent postoperative complications remains unclear. To determine whether the EIT-guided PEEP titration in surgery has a higher oxygenation index and lower postoperative complications incidence in patients, we performed a meta-analysis to assess the efficacy. The study design is a systematic review and meta-analysis.

Methods:

Four databases (Cochrane, PubMed, Web of Science, and Embase) were searched from 2000 to November 2022 for this study. Randomized controlled trials of patients selected for general anesthesia were included. The main indicators of the study were oxygenation and postoperative pulmonary complications. Study quality was assessed using the Cochrane Risk and Bias Tool.

Results:

A total of 7 articles with 425 subjects were included and were eligible for analysis. Meta-analysis showed that patients had a higher oxygenation index (PaO2/FiO2) after EIT-guided individual PEEP titration compared with other modalities of PEEP titration (6 trials, 351 subjects, standardized mean check = 1.06, 95% confidence interval = 0.59–1.53). For subgroup analysis, the results were still statistically significant both in adult/elder groups and normal/obese groups. No significant advantage was found for the incidence of postoperative pulmonary complications between individual PEEP titration under EIT and other titration strategies (5 trials, 341 subjects, standardized mean check = 0.77, 95% confidence interval = 0.34–1.71). The same results were found in the subgroup analysis.

Conclusion:

EIT-guided individual PEEP setting significantly improved perioperative oxygenation index compared with other modalities of PEEP ventilation strategies for patients, but no significant differences were found in the incidence of the postoperative pulmonary complications.
Maximizing efficiency in emergency care: triple interventions to minimize left without being seen: An observational study
Authors: Kirby Jessica J. , Knowles Heidi C. , Asad Saba , d’Etienne James P. , Huggins Charles , Hoot Nathan , Schrader Chet , Moore Julie , Bryant Judson , Wang Hao
Published: December 2024

Left without being seen (LWBS) is a quality care metric associated with patient-centered outcomes. The risks affecting LWBS are complex and interventions targeting certain risks have diverse effects. We aimed to use different artificial intelligence and machine learning (AI/ML) algorithms to identify the risks affecting LWBS, implement triple interventions specifically targeted at such risks, and compare daily LWBS rate changes before and after the intervention. This is a retrospective observational study. Single urban Emergency Department (ED) daily throughput data from March 1, 2019, to February 28, 2023, were used for AI/ML model prediction. Model performance including accuracy, recall, precision, F1 score, and area under the receiver operating characteristics (AUC) were reported. The top risks affecting the LWBS were identified using the important function of the AI/ML feature. Triple interventions were implemented. The average daily LWBS rate was compared before (March 1, 2019, to February 28, 2023) and after (June 1, 2023, to May 31, 2024). A total of 1919 daily throughput metrics were analyzed, including 1461 daily metrics before the intervention, 92 daily metrics during the wash period, and 366 daily metrics after the intervention. Using data before the intervention, the Extreme Gradient Boosting (XGBoost) and Random Forest AI/ML algorithms predicted LWBS with a similar favorable performance. The 3 common factors influencing the increased daily LWBS rate were triage-to-bed (wait time), boarding time, and door-to-triage in the ED. Rapid triage, direct bedding, and boarding reduction (triple intervention) were implemented on March 1, 2023. We found 4.82% of daily LWBS before the triple intervention compared to 1.93% of daily LWBS after the triple intervention (P < .001). AI/ML approaches can identify common factors that are highly related to LWBS with favorable performance. Triple interventions targeting these factors can reduce the daily LWBS rate by approximately 60%, indicating the efficiency of the ED operational management.
Characteristics influencing acute laryngitis and laryngeal obstruction in children: A retrospective study
Authors: Zhu Yueting , Sun Xuyuan , Liu Guangping
Published: December 2024

Acute laryngitis lesions without appropriate management can lead to laryngeal obstruction, which is a life-threatening disease in children. This study analyzes the clinical characteristics that influence laryngeal obstruction in children with acute laryngitis. A total of 390 children who were treated in the hospital from February 2021 to February 2024 were retrospectively divided into 5 groups according to the degree of laryngeal obstruction (no, I°, II°, III°, and IV° laryngeal obstructions). The higher the degree of obstruction, the more significant the symptoms between the subgroups (P < .05). The sore throat, hoarseness, wheezing, barking cough, dyspnea, diffuse congestion and swelling of the laryngeal mucosa, and vocal cord congestion are most significant symptoms. The levels of biochemical markers in the IV° laryngeal obstruction group were higher than in the other 4 groups (P < .05). Multivariate logistic regression analysis showed that the tumor necrosis factor-alpha, interleukin (IL)-4, IL-6, IL-17, and interferon-gamma levels were risk factors for acute laryngitis complicated by laryngeal obstruction. Tumor necrosis factor-alpha, IL-4, IL-6, IL-17, and interferon-gamma levels were risk factors for severe laryngeal obstruction in children. These indicators should be concerned timely in monitoring the progression of laryngeal obstruction in children.
Factors affecting the return of spontaneous circulation in cardiac arrest patients
Authors: Avci Akkan , Yolcu Sadiye , Simsek Yeliz , Yesiloglu Onder , Avci Begum Seyda , Guven Ramazan , Tugcan Mustafa Oğuz , Polat Mustafa , Urfalioglu Ahmet Burak , Gurbuz Mesut , Cinar Hayri , Ozer Ali Ilker , Aksay Erdem , Icme Ferhat
Published: December 2024

The aim of this study was to determine the factors affecting the return of spontaneous circulation (ROSC) in cardiac arrest patients who underwent quality chest compressions as recommended by international guidelines. In this retrospective observational study, the data of nontraumatic out-of-hospital cardiac arrest (OHCA) patients (n = 784) brought by an ambulance to emergency between January 2018 and December 2019 were extracted from the validated hospital automation system. About 452 patients met inclusion criteria. All eligible patients for analysis were treated with an automatic cardiopulmonary resuscitation (CPR) device for chest compression.. Significance threshold for P-value was < 0.05. Logistic regression analysis was used to determine the factors affecting mortality. 61.7% (n = 279) of the study population was male and 65.0% of patients (n = 294) had OHCA. 88 patients (19.5%) had a shockable rhythm and were defibrillated. There was a 0.5-fold increase in mortality rate in patients with thrombocyte count < 199 × 109/L (OR: 0.482, 95% CI: 0.280–0.828) and CPR duration longer than 42 minutes led to a 6.2-fold increase in the probability of ROSC (OR: 6.232, 95% CI: 3.551–10.936) (P < .05). There is no clear consensus on the ideal resuscitation duration; however, our study suggests that it should last at least 42 minutes.
Association between pathological scar and hypertension: A two-sample Mendelian randomization study
Authors: Li Xiyang , Jiang Bo , Yao Chong , Li Site , Zuo Yuzhi , Yan Hong
Published: December 2024

Observational studies have linked pathological scars to hypertension; however, the causality remains ambiguous. In this study, we aimed to explore this issue using Mendelian randomization (MR). We obtained genome-wide association study data for hypertrophic scar and hypertension from the IEU Open genome-wide association study project [hypertension (containing 9851,867 SNPs, observation group of 124,227, and control group of 337,653), hypertrophic scars (containing 16,380,443 SNPs with a sample mass of 207,482), and keloids (containing 24,197,210 SNPs and sample volume of 481,912)]. The inverse variance weighted method and MR-Egger test were used, followed by a sensitivity analysis. With hypertension as the exposure and hypertrophic scar as the outcome, we obtained the IVW analysis results (OR = 0.264, 95% CI = 0.098–0.709, P = .008) and the MR-Egger test results (OR = 0.036, 95% CI = 0.002–0.544, P = .017); for keloid as the outcome, the results of IVW analysis showed OR = 0.592, 95% CI = 0.293–1.195, P = .143. Contrary to the findings of observational studies, our results revealed hypertension as a protective factor against hypertrophic scarring, and was unrelated to keloids.
Human albumin for adults with sepsis: An updated systematic review and meta-analysis of randomized controlled trials
Authors: Bai Zhaohui , Lai Yongjie , Han Kexin , Shi Luwen , Guan Xiaodong , Xu Yang
Published: December 2024

Background:

Sepsis affects millions of people and imposes a substantial economic and social burden worldwide. However, the role of human albumin in the management of septic patients remains unclear.

Methods:

EMBASE, PubMed, and Cochrane Library databases were searched. Randomized controlled trials regarding the use of human albumin in septic patients were eligible. The overall mortality and the intensive care unit (ICU), in-hospital/28-day, and 90-day mortality were pooled, respectively. Subgroup analyses were performed according to target population, type and dose of human albumin, and type of control group. Risk ratios (RRs) was calculated.

Results:

Twenty-four randomized controlled trials were finally included. Meta-analysis showed that human albumin cannot decrease the overall (RR = 1.02, P = .56), ICU (RR = 1.06, P = .65), in-hospital/28-day (RR = 1.01, P = .68), and 90-day (RR = 1.01, P = .65) mortality of total patients. Subgroup analyses showed that human albumin both cannot significantly decrease the overall, ICU, in-hospital/28-day, and 90-day mortality of sepsis and septic patients. Additionally, 20% human albumin (RR = 0.89, P = .03) and high daily dose of human albumin (RR = 0.90, P = .03) might benefit for the survival of patients with septic shock.

Conclusions:

Based on the current evidence, the general use of human albumin to improve the survival of septic patients cannot be recommended.
Tislelizumab plus AG regimen for long-term CR in 2 patients with metastatic BRCA-mutation pancreatic cancer: A case report
Authors: Gao Feng , Xu Xue , Chen Chunhong , Lv Lili
Published: December 2024

Rationale:

An increased risk of pancreatic cancer (PC) is associated with breast cancer susceptibility gene (BRCA) mutations. Given limited therapies, there remains an urgent need to explore novel treatment strategies.

Patient concerns:

We report 2 metastatic PC patients with BRCA mutations who initially did not respond to standard therapies.

Diagnoses:

Case 1 was diagnosed with metastatic PC harboring a BRCA1 mutation, and case 2 was diagnosed with metastatic PC harboring a BRCA2 mutation.

Interventions:

Both patients received a modified AG regimen (albumin-bound paclitaxel plus oxaliplatin) combined with tislelizumab, followed by maintenance therapy with olaparib plus tislelizumab after 6 cycles.

Outcomes:

Both patients achieved complete response, with complete response lasting for 19 months in case 1 and 18 months in case 2.

Lessons:

The combination of triple therapy followed by maintenance therapy shows promise as a potential treatment option for PC patients with BRCA mutations. Further clinical investigation is needed to confirm its efficacy and safety.
Stress management strategy of Education Scientists with high blood pressure: A case for multivariate analysis and implications for school management system
Authors: Anyaegbunam Ngozi , Igabari Queen E. , Egbule Elizabeth Osita , Agbigwe Ifeanyichukwu B. , Ede Kelechi R. , Agu Uzoamaka Patricia , Ezeaku Felicia Ngozi , Ezugwu Ifesinachi Jude , Ngwainmbi Desmon , Andor Sebastine Ebunmereh , Tijjani Jazuli , Oluka Beth Nnenne , Okereke Innocent Ebere , Okoro Ifeanyichukwu D. , Nwabuani Ogochukwu Vivian , Oneli Joy Obiageli
Published: December 2024

Background:

When under stress, the body secretes a large amount of hormones. These hormones cause the heart to beat more quickly and the blood vessels to constrict, leading to a temporary increase in blood pressure. The release of stress hormones and an accelerated heartbeat are 2 ways that improper stress reactions can raise blood pressure and increase the risk of a heart attack. Keeping this in mind, the current study aimed to investigate the effectiveness of the rational emotive behavior therapy (REBT) approach in reducing stress among Education Scientists with high blood pressure in higher institutions of learning in southeastern Nigeria.

Methods:

The study utilized a simple randomized controlled trial design, which included a pretest, posttest, and follow-up test. The study population consisted of 78 participants who were randomly assigned to either the treatment or control group, with 39 participants in each group. The treatment involved following a modified REBT manual.

Results:

The findings of the study indicated that REBT was successful in reducing the stress levels of academic staff who underwent the treatment. This effect was sustained during the follow-up test.

Conclusion:

Stress was found to be a result of irrational thoughts and erroneous beliefs. However, through the implementation of REBT principles and strategies, individuals were able to address their negative thought patterns, which were characterized by inflexibility, rigidity, and extremism. Further research is needed to confirm the impact of REBT on reducing depression, anxiety, and mental exhaustion in populations from institutions outside the southeastern region of Nigeria.
Optimizing concurrent training programs: A review on factors that enhance muscle strength
Authors: Wang Tao , Bo Shumin
Published: December 2024

The purpose of this study is to explore the factors that should be considered when designing concurrent training programs to minimize the “interference effect.” This study provides a comprehensive summary of various perspectives from existing studies on factors such as the ability level of the target group, the frequency and intensity of concurrent training, the order and interval time of resistance and endurance training, nutritional arrangements during training, and gender differences in concurrent training. The results of this study suggest that the emergence of the “interference effect” in concurrent training is influenced by several factors, with a particular emphasis on the adaptation status of muscle fitness when compared to resistance training alone. However, it is important to note that the current understanding of this theory remains somewhat ambiguous. The ability level of participants plays a crucial role in training adaptation and the specificity of post-training skeletal muscle molecular responses. Therefore, the participant’s capacity level is likely a key determinant of the extent of the interference effect in concurrent training. In addition to training-related factors such as frequency, duration, intensity, volume, training sequence, recovery time, and nutritional intake, non-training-related variables, including the methodology used to assess various metrics, also significantly impact the design of concurrent training programs. These factors collectively influence the overall outcomes and provide insight into the extent of the “interference effect” in concurrent training. Understanding these aspects is essential for comprehending the phenomenon of the “interference effect” in concurrent training.
Association between bisphenol A exposure and adiposity measures in children
Authors: Liu Cui , Liu Ying , Ning Jing , Wu Chunyan , Lu Xiuxia , Guo Yong , He Peisi , Qiu Chuhui , Wu Jieling
Published: December 2024

Bisphenol A (BPA) is a chemical that has adverse effects on human health and may cause childhood obesity. Nevertheless, the association between BPA exposure and adiposity measures in children remains controversial, especially in young children. A cross-sectional study was conducted on 208 randomly selected children 4 to 6 years old attending preschools in Guangzhou, China. BPA exposure was assessed through ultra-high performance liquid chromatography-tandem mass spectrometry of urinary samples. Childhood adiposity measures were determined, including body mass index, waist circumference, skinfold thickness, and upper arm circumference. BPA was detected in all urinary samples, and the median urinary BPA concentration was 0.54 (interquartile range, 0.05–5.81) μg/L. In the adjusted models, children with higher urinary BPA concentrations had a higher body mass index z-score (β = 0.471; 95% confidence interval [CI]: 0.303, 0.640), and they were at a greater risk of overweight or obesity (odds ratio [OR] = 3.308; 95% CI: 2.151, 5.089). Higher urinary BPA concentrations were associated with an elevated waist-to-height ratio (β = 0.007; 95% CI: 0.002, 0.012), and they were at a higher risk of abdominal obesity (OR = 1.711; 95% CI: 1.102, 2.655). Higher urinary BPA concentrations were also associated with increased upper arm circumference and skinfold thickness in the adjusted models (β = 0.546; 95% CI: 0.278, 0.813; β = 0.702; 95% CI: 0.139, 1.266, respectively). Higher urinary BPA concentrations in children 4 to 6 years old were associated with a greater risk of overweight/obesity and abdominal obesity. BPA exposure might increase the risk of obesity in children. Further investigations are needed to confirm this association and explore the underlying mechanisms.