bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of retrograde inferior parathyroid protection technique based on thymus preservation in thyroid surgery
Authors: Yan Shouyi , Chen Yuhan , Zhao Wenxin , Zhang Liyong , Cai Shaojun
Published: October 2024

Background The importance of parathyroid gland protection has been widely recognized in thyroid surgery. However, it remains difficult to quickly identify parathyroid gland, especially the inferior parathyroid gland (IPG). This study aimed to evaluate the effectiveness of retrograde inferior parathyroid protection technique (RIPPT) based on thymus preservation.Methods A total of 236 patients was enrolled in this study from August 2019 to December 2020. We used RIPPT to identify and protect inferior parathyroid gland (IPG), followed by analyzing its identification rate and anatomical types of IPG. Thereafter, we compared the parathyroid hormone (PTH) and serum calcium level of IPG orthotopic retention patients with that of IPG auto-transplantation patients among different IPG anatomical types.Results In all cases, the rate of IPG identification and auto-transplantation was 97.88% (231/236) and 74.46% (172/231) respectively. The proportion of patients with an anatomical relationship between the IPG and thymus was 77.97% (184/236). Furthermore, we found that PTH level in patients with IPG orthotopic retention was higher than that in those with IPG auto-transplantation in 1 day or 6 months after surgery; PTH level was also found higher in patients with superior parathyroid gland (SPG) and IPG orthotopic retention than the ones receiving both auto-transplantation.Conclusion Retrograde inferior parathyroid protection technique (RIPPT) argues for the primacy of the protection concept of inferior parathyroid gland (IPG) in thyroid surgery, and is proven to be effective in the rapid identification and functional protection of IPG based on short-term data.
Connexin 43 contributes to perioperative neurocognitive disorder by attenuating perineuronal net of hippocampus in aged mice
Authors: Zhang Qian , Zhang Yuxin , Cong Peilin , Wu Qianqian , Wan Hanxi , Huang Xinwei , Li Xinyang , Li Zhouxiang , Li Jingxuan , Wu Huanghui , Tian Li , Xiong Lize
Published: October 2024

Background
Perioperative neurocognitive disorder (PND) is a prevalent form of cognitive impairment in elderly patients following anesthesia and surgery. The underlying mechanisms of PND are closely related to perineuronal nets (PNNs). PNNs, which are complexes of extracellular matrix primarily surrounding neurons in the hippocampus, play a critical role in neurocognitive function. Connexin 43 (Cx43) contributes to cognitive function by modulating the components of PNNs. This study was designed to investigate the specific regulatory mechanisms of Cx43 on PNNs and its pivotal role in the development of PND.
Methods
Eighteen-month-old wild-type and Gja1fl/fl C57BL/6 mice were subjected to abdominal surgery under 1.4% isoflurane anesthesia. Cognitive functions, particularly learning and memory, were evaluated via the Y-maze test, Barnes maze (BM) and contextual fear conditioning test (CFT). The mRNA and protein expression levels of Cx43 were assessed by using quantitative reverse transcription polymerase chain reaction (qRT-PCR), fluorescent in situ hybridization (FISH), western blotting and flow cytometry. The quantity of PNNs was measured by Wisteria floribunda agglutinin (WFA) and Aggrecan staining.
Results
Aged mice subjected to anesthesia and surgery exhibited deficits in hippocampus-dependent cognitive functions, which were accompanied by increased Cx43 mRNA and protein expression. Conditional knockout (cKO) of Cx43 in astrocytes alleviated cognitive deficits and promoted the number of PNNs and dendritic spines in the hippocampus by targeting Dmp1. Knockdown of Dmp1 attenuated the beneficial effects of Cx43 cKO on cognitive deficits induced by anesthesia and surgery.
Conclusion
Our findings indicate that anesthesia and surgery induce an increase in Cx43 expression, which inhibits the formation of PNNs and dendritic spines in hippocampus by suppressing Dmp1 transcription, leading to cognitive deficits in aged mice. These results offer new mechanistic insights into the pathogenesis of PND and identify potential targets for therapeutic intervention.
Higher bone mineral density at six years of age in very preterm born infants fed human milk compared to formula - follow-up of an RCT
Authors: Toftlund Line H , Beck-Nielsen Signe Sparre , Agertoft Lone , Halken Susanne , Zachariassen Gitte
Published: October 2024

Purpose
In very preterm born infants’ nutritional intake is important to reduce the risk of severe metabolic bone disease including the risk of a lower bone mineral density (BMD). The aim of this study was to evaluate bone mineral content (BMC) and BMD (equals BMC per bone area (BA)) at six years of age in very preterm born infants fed different diets post discharge.
Methods
A prospective follow-up study of 281 children born very preterm (gestational age ≤32+0 weeks) and enrolled in a multicentre RCT on post discharge nutrition. Infants fed human milk (HM) were randomised to unfortified HM (UHM) or fortified human milk (FHM) from hospital discharge to four months corrected age. Those not fed HM received a preterm formula (PF). At six years of age, BMD and BMC were assessed by dual-energy X-ray absorptiometry (DXA) scan (Lunar Prodigy) and adjusted for sex, age, and anthropometrics.
Results
A number of 192 very preterm born children (59 fed UHM, 67 FHM and 66 PF) had a DXA scan performed at 6 (5.8 - 8.3) years of age. No significant difference was found comparing UHM and FHM according to height, weight, BA, BMC, and BMD at six years of age. A multiple regression analysis showed significantly improved BMD in breastfed children compared to PF fed children.
Conclusions
Fortified compared to non-fortified human milk post discharge did not improve BMD significantly at 6 years of age in very preterm born infants. Breastfed children demonstrated higher BMD than formula fed children.
A cross-sectional study of the Evaluation of Iodine Deficiency among Pregnant Women Attending Antenatal Clinic at a Community Health Centre
Authors: Antwi-Baffour Samuel , Mensah Benjamin Tetteh , Appiah Nana Yaa Asiedua , Armah Dorinda Naa Okailey , Annison Lawrence
Published: October 2024

Background
Iodine deficiency is a critical global health issue, especially among pregnant women. Iodine is essential for producing thyroid hormones, which are vital for metabolic regulation and the development of the nervous system, bones, and muscles during pregnancy and early childhood. Pregnancy increases the maternal thyroid gland's iodine requirement, and severe deficiency can cause hypothyroidism in both mother and fetus. This can lead to preterm birth, low birth weight, miscarriage, and impaired cognitive development in children.
Methods
This cross-sectional study aimed to evaluate the dietary habits and iodine levels among pregnant women was conducted from January to December 2021. It included 158 pregnant women who provided informed consent. Data were collected using a pretested questionnaire on sociodemographic characteristics and dietary intake, alongside urine samples for urinary iodine concentration (UIC) analysis.
Results
Participants had a mean age of 29.37 years and an average household size of 3.552. Dietary analysis through a modified food frequency questionnaire (FFQ) showed infrequent consumption of iodine-rich foods. Urine samples analyzed using the Sandell-Kolthoff reaction revealed a mean UIC of 200.24 µmol/L, with 50.6% of participants having levels below the recommended threshold for pregnant women.
Conclusions
The study revealed high prevalence of iodine deficiency among the participants, highlighting the need for improved public health interventions to boost iodine intake during pregnancy. The findings stress the urgent need for better dietary education and supplementation programs to ensure adequate iodine levels among pregnant women, particularly in Sub-Saharan Africa, to mitigate the adverse effects of iodine deficiency.
Histopathological growth patterns of liver metastases - a retrospective, consecutive, single- center, pilot study and literature review of non-colorectal carcinoma metastasis studies
Authors: Baráth Bence , Pósfai Boglárka , Abbasi Parsa , Zombori Tamás , Lantos Tamás , Sejben Anita
Published: October 2024

Objective
Histopathological growth patterns (HGPs) in liver metastases have been identified to have prognostic value; however, they currently do not influence therapeutic decisions, and the literature mainly focuses on colorectal adenocarcinoma metastases. Hitherto, they have only been examined in a consecutive setting in 5 studies.
Methods
Patients between 2011 and 2016 were included with the ICD code C7870. General clinicopathological data were obtained from medical charts. Histological slides of the metastases were evaluated by two pathologists with consensus. Statistical analyses were carried out by using the Kruskal-Wallis (continuous variables) and Fisher’s exact test (categorical variables). The Kaplan-Meier method was used to estimate progression-free (PFS) and overall survival (OS), and time-to-progression (TTP) curves, and the logrank test was applied to compare survival curves. All statistical tests were two-sided and p-values less than 0.05 were considered statistically significant.
Results
Altogether 41 patients were included in our study. The majority were diagnosed with secondary colorectal adenocarcinoma (n = 32). Replacement pattern proved to be the most common (n = 22), followed by desmoplastic (n = 15), and pushing (n = 4). There was no significant association found between HGPs and stage (p = 0.105), secondary tumour focality (p = 0.898), largest diameter primary (p = 0.316) and secondary carcinoma (p = 0.441), completeness of resection (p = 0.492), and the presence of venous spread (p = 1). There were no significant results found between HGPs and PFS (p = 0.417), OS (p = 0.297), and TTP (p = 0.267).
Conclusions
Further studies regarding the prognostic utility of HGPs have to be carried out in the future. Our results reflect that HGPs may not be valuable in a consecutive setting.
Novel Use of Siltuximab in a Patient with Somatic UBA1 Mutated VEXAS Syndrome
Authors: Cáceres-Nazario Beatriz , Rivenbark Joshua , Saha Manish K. , Mathews Stephanie , Rubinstein Samuel M.
Published: October 2024

VEXAS syndrome (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is an increasingly recognized disorder that occurs due to somatic mutations of a ubiquitin-activating enzyme encoded by ubiquitin-like modifier activating enzyme 1 gene, UBA1. Clinical findings associated with VEXAS syndrome include recurrent fevers, polychondritis, periorbital edema, pleural effusions, myocarditis and/or pericarditis, hepatosplenomegaly, myelodysplastic syndrome, cytopenias, inflammatory arthritis, neutrophilic dermatosis, and deep venous thrombosis. Novel renal manifestations like interstitial nephritis are infrequent, and to our knowledge, acute renal failure due to C3 glomerulonephritis (C3GN) has not yet been reported. Overwhelming systemic inflammation can result in morbid end-organ damage and death. While there is no formal guideline or established protocol for its management, treatment of VEXAS syndrome with tocilizumab, an interleukin-6 (IL-6)-directed therapy, has been described in the literature. Here, we report a case of a 71-year-old male patient presenting with C3GN as an initial manifestation of VEXAS syndrome and explore the rationale for our approach to treatment with IL-6 blockade. Our patient was initially treated with two inpatient doses of tocilizumab with successful transition to siltuximab in the outpatient setting. He continues to benefit from ongoing siltuximab treatment for more than one year to date without any safety issues or relapse of VEXAS syndrome.
Efficacy of Adipose Stromal Cells-Enriched High- Density Fat Graft Combined with BTX-A for Raynaud’s Phenomenon: A Prospective Cohort Study
Authors: Deng Chengliang , Liu Xin , Wei Miaomiao , Wu Bihua , Zhang Tianhua , Xiao Shune , Min Peiru , Zhang Yixin
Published: October 2024

Background: Conventional treatments for Raynaud’s phenomenon (RP) often show limited effectiveness due to their inability to address both vascular and inflammatory aspects. This study evaluates the combination of high-density fat grafting (HDFG) with botulinum toxin A (BTX-A) for treating RP.
Methods: Eleven patients with 20 affected hands diagnosed with RP were recruited and randomly assigned to receive either HDFG combined with BTX-A (intervention group, n=11) or HDFG alone (control group, n=9). Efficacy was assessed using Visual Analog Scale (VAS) pain scores and McCabe Cold Sensitivity Scores, along with finger ulcer healing time and infrared thermal imaging to evaluate blood perfusion improvements.
Results: The HDFG-BTX group showed significant improvements in hand symptoms. VAS pain scores decreased from a pre-treatment mean of 5.33 to 0.84 post-treatment (mean reduction of 4.49, p=0.018), indicating effective pain relief. McCabe scores improved from 272.73 to 75.00 (mean reduction of 197.73, p=0.001), demonstrating reduced cold sensitivity. Ulcer healing time was shorter in the HDFG-BTX group (14.25 days) compared to HDFG alone (25.6 days, p<0.001), highlighting faster recovery. Infrared imaging indicated significant enhancements in blood perfusion.
Conclusion: HDFG combined with BTX-A is a reliable and beneficial intervention for RP, leading to high patient satisfaction.
Non-invasive intracranial pressure monitoring in management of slit ventricle syndrome - Case report
Authors: Fagundes Walter , Cruz Paulo Vitor da , Valentim Wander , Frigieri Gustavo , Mir Wajid Majeed
Published: October 2024

Slit ventricle syndrome (SVS) is condition of severe headaches, usually intermittent, suffered by patients after ventricular shunting for hydrocephalus with normal or smaller ventricle size, although in some cases the correct diagnosis and management can be a significant challenge. This case report aims to highlight the application of non-invasive ICP monitoring (nICP) technology in the diagnose and management of SVS providing insights into its benefits and limitations. A 6-year-old boy with a known history of autism spectrum disorder had undergone a VPS for a communicating hydrocephalus. Post operative, patient was asymptomatic with magnetic resonance images (MRI) showing small ventricle size. However, the patient started to develop recurrent symptoms of headache, nausea, and vomiting, a fresh MRI was ordered which demonstrated findings consistent with the previous MRI. We therefore decided to evaluate ICP and compliance by non-invasive monitoring using brain4care technology. Noninvasive monitoring was suggestive of low ICP and hyperdrainage, leading to the adjustment of the shunt valve from a medium to high pressure device, which normalized ICP waves and ICP as well ventricles size and the patient became asymptomatic. Therefore, we propose that noninvasive ICP monitoring may be a helpful tool to better classify the SVS type and guide the appropriated management.
Genetic Screening of ATP7B Gene in Iranian Wilson Disease Patients: A diverse landscape of pathogenic variants
Authors: Hashemi Seyyed-Saleh , Jafari Seyed Ali , Gholoobi Aida , Hamzehloei Tayebeh
Published: October 2024

Background/Objective:
Wilson's disease (WD) is an autosomal recessive condition caused by mutations in the ATP7B gene, leading to the copper accumulation in various organs. Data on the ATP7B mutation spectrum in Iran and the Middle East is insufficient. This study aims to screen the ATP7B gene in unrelated Iranian families (n = 23) from northeastern Iran.
Methods
DNA was extracted from peripheral blood, and variant screening was performed using direct sequencing of the entire ATP7B gene coding region. The full 3D structure of the defective proteins was determined using the I-TASSER software.
Results
The overall frequency of causative variant detection was 84.7% (39/46). Among the 23 patients with WD, we identified 13 different causative variants: eight missense, two nonsense, one splicing, one deletion, and one deletion/insertion changes. Two of which were novel: c.3431delTinsAGA (p.Phe1144Ter) and c.1156G > A (p.Gly386Arg). The c.2807T > A (p.Leu936Ter) variant at exon 12 was the most prevalent in our study, with an allelic frequency of 17.39%, followed by c.3188C > T (p.Ala1063Val) at exon 14, exhibiting an allelic frequency of 13.04%. Exons 12, 13, and 14 were identified as mutation hot spots, with detection rate of 50% (23/46). Ten out of the 13 variants identified in our study were reported for the first time in Iran (this report).
Conclusion
We reported two novel variants that broaden the known spectrum of mutations associated with the ATP7B gene. The variants identified in this study can facilitate carrier screening and presymptomatic detection and can be used in prenatal genetic diagnosis in affected families.
Dietary habits and minerals intake in patients with grass pollen allergy
Authors: Rogacka Natalia , Jagielska Joanna , Grygiel-Górniak Bogna
Published: October 2024

Specific dietary components (e.g., fatty acids and micronutrients) are crucial in food allergy; however, their exact role in the diet in grass pollen allergy needs to be better established. Since specific macro- and microminerals (trace elements) can stimulate the immune system, this study aimed to estimate the dietary habits and mineral intake in patients with allergic diseases. Anthropometric, biochemical, serological, and nutritional habits analyses were done in patients with grass pollen allergy and compared to the healthy control group. Daily food rations (DFR) were improperly balanced, and high intake of protein and fat and low carbohydrate were observed in both groups. Saturated fatty acids (SFA), phosphorus, and copper were supplied in high amounts, while mono- and polyunsaturated fatty acids, magnesium, and zinc were within the reference range and comparable in both analyzed groups. Insufficient calcium intake resulted in a low Ca:P ratio. A similar analysis showed higher macronutrients, SFA, sodium, magnesium, and copper intake and lower calcium and phosphorus consumption in allergic patients than in the control group. Total IgE positively correlated with platelet level and negatively with zinc intake. The diet of patients with grass pollen allergy needs to be better balanced regarding macronutrients and selected elements. Correcting and controlling the number of nutrients that increase the risk of immune system dysregulation in such patients (particularly reducing excessive SFA intake and increasing insufficient calcium intake) is advisable.
The efficacy of second-line nivolumab versus tyrosine kinase inhibitors for renal cell carcinoma with bone metastases: A multi-institutional retrospective study
Authors: Yamamichi Gaku , Kato Taigo , Yoshimura Akihiro , Tani Masaru , Horibe Yuki , Liu Yutong , Sassi Nesrine , Okuda Yohei , Oka Toshiki , Uemura Toshihiro , Yamamoto Akinaru , Ishizuya Yu , Hayashi Takuji , Yamamoto Yoshiyuki , Hatano Koji , Kawashima Atsunari , Takao Tetsuya , Nishimura Kensaku , Takada Shingo , Tsujihata Masao , Nonomura Norio
Published: October 2024

Immune checkpoint inhibitor combination therapy has been standardized for first-line treatment for metastatic renal cell carcinoma (mRCC), leading to the changes in second-line treatment options such as nivolumab or tyrosine kinase inhibitors (TKIs). However, there have been few reports comparing the efficacy of these drugs in mRCC patients, especially with bone metastases (BM), which are associated with a poor prognosis. Therefore, we aimed to compare the efficacy of nivolumab and TKIs as second-line treatments for 87 mRCC patients with BM and the microenvironments of the primary tumor and BM lesions. Multivariate analysis revealed poor risk according to the IMDC classification (p < 0.01) and high serum ALP value (p = 0.031) as worse prognostic factors, while there was no significant difference of overall survival between patients with nivolumab and TKIs. However, the objective response rate at BM lesions was significantly higher with TKIs than with nivolumab (p = 0.014). Immunohistochemistry analysis also revealed that VEGFR2 expression was significantly higher at BM lesions compared to that in primary tumors, showing the potential benefit of TKIs over nivolumab in mRCC patients with BM. In conclusion, TKIs could be the promising second-line treatment for mRCC with metastasis limited to the bone.
Prediction and Unsupervised Clustering of Fertility Intention Among Migrant Workers Based on Machine Learning: A Cross- sectional Survey from China
Authors: Guo Xinghong , Chen Yiyang , Fang Chaoyang , Liu Jingru , Yan Shuming , Fei Fengyi , Xinya Cheng , Wu Jian , Ye Beizhu
Published: October 2024

Background
Although China has implemented multiple policies to encourage childbirth, the results have been underwhelming. Migrant workers account for a considerable proportion of China’s population, most of whom are of childbearing age. However, few articles focus on their fertility intentions.
Method
From August 3 to August 29, 2023, we conducted a cross-sectional survey in Henan Province, China, which included 18806 participants. Machine learning was used to construct a predictive model for the fertility intention of migrant workers, and unsupervised clustering was used to explore subgroup classification.
Result
Out of 18806 participants, only 1057 had fertility intention. We constructed a predictive model for fertility intention based on XGBoost, with an AUC of 0.83. Age, number of children, and marital status are the most important characteristics that affect the fertility intention of migrant workers. Subsequently, unsupervised clustering was conducted on participants without fertility intentions, and it was found that they could be divided into three categories of population. The first group of people is the youngest and mostly unmarried without pregnancy, the second group has the lowest monthly income and self-perceived economic level, and the third group is the oldest and has the highest proportion of women. Regardless of the group, economic and age factors are the main reasons for participants not having a family plan in the near future.
Conclusion
The fertility intention of the migrant workers is at an extremely low level. Improving childcare-related benefits and family support services to reduce the economic and time costs of childcare is an effective measure to reverse fertility intentions.
Identification of a risk allele at SLC41A3 and a protective allele HLA-DPB1*02:01 associated with sarcopenia in Japanese
Authors: Furutani Motoki , Kimura Tetsuaki , Fukunaga Koya , Suganuma Mutsumi , Takemura Marie , Matsui Yasumoto , Satakae Shosuke , Nakano Yukiko , Mushiroda Taisei , Niida Shumpei , Ozaki Kouichi , Hosoyama Tohru , Shigemizu Daichi
Published: October 2024

Background Age-related alterations in muscle tissue morphology and function, as well as chronic pro-inflammatory conditions, contribute to the development of sarcopenia. To elucidate the multidimensional pathogenesis of sarcopenia, we performed a comprehensive genetic analysis, including common variants, rare variants and human leukemia antigen (HLA).
Methods A total of 129 older adults were analyzed using WGS, including 67 sarcopenia patients and 62 normal controls. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. Whole-genome sequence (WGS) data and associated clinical data were obtained from the National Center for Geriatrics and Gerontology Biobank in Japan. We performed logistic regression adjusted for age, sex, and body mass index for common variant (minor allele frequency [MAF] ≧ 1%), rare variant (MAF < 1%) and HLA analyses. For the functional analysis, we performed RNA interference using human myoblasts and estimated gene expressions (MYOG, MYMK, MYMG) by quantitative PCR.
Results Rare variant analysis identified five rare coding variants of genes—SLC41A3, SYNRG, CLUAP1, CCHCR1, and ALDH2—expressed in skeletal muscle (P < 5×10-5). Of these, a deleterious frameshift deletion in SLC41A3 was associated with the pathogenesis of sarcopenia (P = 0.0012, odds ratio [OR] = 11.52, 95% confidence interval [CI] = 2.62 to 50.69). This deletion significantly reduced expression of myogenin (MYOG), a factor involved in myoblast differentiation. (P = 0.0094), but did not affect the fusion of myogenic cells. We also discovered a new protective allele, HLA-DPB1*02:01 associated with sarcopenia (OR = 0.17, 95% CI = 0.06 to 0.51, P = 0.0015), which has a high occurrence rate in the Northeast Asian population.
Conclusion Rare variant analysis identified a deleterious frameshift deletion in SLC41A3 as a risk factor for sarcopenia. Our findings suggest that the suppression of MYOG could play a role in myogenesis or muscle maintenance, although this mutation did not impact the terminal differentiation of human myoblasts. Additionally, HLA analysis revealed that HLA-DPB1*02:01 has a protective effect, especially in Northeast Asian populations. Our study enhances the understanding of the etiology of sarcopenia and provides new insights into the mechanisms of its pathogenesis.
Ononin, a natural isoflavone glycoside, alleviates postoperative cognitive dysfunction in aged mice by regulating neuroinflammation and oxidative stress
Authors: Li Ming , Peng Qingmei , Chen Changlin , Li Jiang , Zhu Min , Liu Qilin , Yang Simin , Gong Cansheng , Lin Jingyan , Yu Qingbo
Published: October 2024

Postoperative cognitive dysfunction (POCD) is a common and serious neurological complication. Currently, there is no effective clinical prevention and treatment for POCD. Ononin has been confirmed to exhibit potent neuroprotective effects in many diseases. This study aimed to investigate whether ononin could exert a neuroprotective role against POCD. The animal model of POCD was established in 18-month-old aged mice with unilateral nephrectomy. Ononin (30 mg/kg) was administered intraperitoneally to aged mice 15 min before surgery. On postoperative day 3, the Morris water maze and open field tests were used to assess the changes in cognitive function. Western blotting and immunofluorescence staining were employed to examine the hippocampal levels of Iba1 and microglial activation on postoperative day 3, respectively. An enzyme-linked immunosorbent assay was applied to gauge the expression of hippocampal IL-1β, IL-6, and TNF-α on days 1 and 3 postsurgery. To reflect the oxidative stress status, the levels of hippocampal malondialdehyde (MDA) and superoxide dismutase (SOD) activity were detected using the corresponding assay kits on postoperative days 1 and 3. We found that anesthesia/surgery induced overt memory deficits in aged mice. Conversely, ononin pretreatment significantly rescued the cognitive impairment. Mechanically, anesthesia/surgery triggered acute increases in hippocampal IL-1β, IL-6, TNF-α, Iba1, and MDA, paralleled by a decline in SOD activity. This phenomenon was also partially reversed by ononin. Our findings provide evidence that ononin may ameliorate anesthesia/surgery-induced cognitive deficits through its anti-inflammatory and antioxidant effects, which could be a novel preventive therapeutic strategy for POCD in elderly patients.
Cardiogenic Necrotizing Enterocolitis in Infants with Congenital Heart Disease: A Systematic Review and Meta-Analysis
Authors: Asztalos Ivor B , Hill Stephanie N , Schachtner Susan K , Palm Kelsey J , Nash Dutsin B
Published: October 2024

Context: Necrotizing enterocolitis (NEC) is a known cause of morbidity and mortality in infants with congenital heart disease (CHD), but reports about the burden of cardiogenic NEC frequently conflict.
Objective: To synthesize the extant literature on the incidence, risk factors, and prognosis of NEC in patients with CHD.
Data Sources and Study Selection: Medline, Cochrane, and EMBASE were searched from 1946 through 2023 for studies of NEC in infants 0-12 months of age with CHD.
Data Extraction: Risk of bias was assessed with validated tools for incidence and risk factors. Pooled estimates were meta-analyzed by risk of bias or synthesized without meta-analysis.
Results: Ninety-nine studies with a total of 100,809 participants were included. The incidence of cardiogenic NEC was 7.1% (95% CI 4.7-10.5%) in term infants and 13.0% (10.2-16.5%) in low birthweight preterm infants. NEC required surgery in 0.8% (0.5-1.1%) of term and 2.7% (2.0-3.7%) of premature infants, respectively. Only gestational age and birth weight were consistently associated with risk of NEC.
Limitations: Restricting pooled estimates to studies of moderate or low risk of bias significantly reduced the number of studies included.
Conclusions: Necrotizing enterocolitis is a common cause of morbidity in infants with CHD, but additional research is needed to determine which infants are at highest risk of developing NEC and would benefit most from a change in management.
Other: This systematic review and meta-analysis was conducted according to a prespecified protocol registered at the Prospective Register of Systematic Reviews (CRD42021282114).
Impact of targeted interventions on healthcare-acquired infection prevention and control of Clostridium difficile infections
Authors: Zhang Sisi , Duan Juping , Zhang Lina , Liu Sidi , Meng Xiujuan , Peng Xiaobei , Liu Wei , Wu Anhua , Li Chunhui
Published: October 2024

Background
Clostridium difficile infection (CDI) is one of the major causative factors leading to antibiotic-associated hospital-acquired and infectious diarrhea. Because C. difficile spores can be transmitted between healthcare systems, healthcare workers have become a key target for preventing and controlling C. difficile infection.
Methods
We conducted a 6-month intervention and collected 776 patients with diarrhea and 72 cases with hospital-onset C. difficile infection (HO-CDI) in Xiangya Hospital’s intensive care units (ICU). We created a questionnaire on prevention and control knowledge of C. difficile infection, investigated the correctness of healthcare workers' answers before and after the training, statistically described the use of antimicrobial drugs, and judged the validity of this study as a result of the rates of C. difficile infection and morbidities in the three phases.
Results
The rates of three-stage C. difficile infection (13.3%vs.8.79%vs.6.5%) and morbidities rate/10,000 hospital days (117.14%vs.99.30%vs.71.63%) decreased gradually. After the training, the knowledge, attitude, and practice on prevention and control of C. difficile infection among healthcare workers were much improved. Among all diarrhea patients, there was a decreasing trend in the utilization of cefoperazone sulbactam (P < 0.001), imipenem (P = 0.047), tigecycline (P = 0.044) in all three phases, and an increase in cefoxitin (P < 0.001). There was no statistical difference between the three phases of antimicrobial utilization among hospital-onset C. difficile infection patients.
Conclusions
This study demonstrated that our training of healthcare workers on C. difficile infection was effective, enhancing healthcare workers' prevention and control awareness of C. difficile infection effectively reducing incidences and morbidities of C. difficile infection, and emphasizing the importance of healthcare workers in the healthcare process.
Multiple Linear Regression Modeling in Determining the Contribution of Landshape Factors on the Quantitative Attributes and Diversity of Trees
Authors: Abedi Roya
Published: October 2024

Introduction
: Mountainous forests are a major part of the northwestern forests of Iran that are tasked to protect biodiversity. Therefore, mountainous conditions create diversity in landforms. Multiple linear regression models are used to create ‎the relationships between different attributes of the forest stands and various landforms to assess other characteristics ‎indirectly‎. In protective forests, the basal area and species diversity are the main attributes that are considered significant factors in forest planning and management. The main objective of current study was to understand the association of basal area and tree species diversity index with DBH, tree height, canopy cover, and landform indices in a natural mixed-species protected forest in northwest of Iran and develop estimation equations by using a multiple linear regression model.
Methods
The data collection from direct measurements of the stand to obtain the basic data (tree characteristics used to estimate the volume, basal area, etc.) was the systematic random method in various topographic conditions with diverse slopes and aspects located in Arasbaran forest, in the east Azarbayjan province of northwest Iran. After the data collection, in the second stage of the study, the dependent (basal area and diversity index) and independent (forest attributes and landform indices) variables were determined and the relationship between the factors was evaluated with the help of the multiple linear regression statistical method.
Results
The results of multiple linear regression showed that the Shannon diversity index was influenced by tree height, tree average crown diameter, AspE, TRASP, and SEI land shape indices. Cohen's f2 effect size of factors was 0.252, which is in the medium effect size range. In addition, we found that the basal area of trees was influenced by tree dbh, crown area, AspE, and SEI land shape indices. Cohen's f2 effect size was in the strong effect size category (0.323). In general, the multiple linear regression model results in the present study showed that the independent variables had a significant effect on dependent variables and these effects were at an acceptable level in the most cases.
Discussion
Our study highlights that modifications in basal area and diversity were corrected with landform indices which can be used as a base for organizing forest management plans including basal area increasing in protects forests with low commercial volume objects.
Development of a Molecular Assay for the Determination of Eimeria tenella Oocyst Viability
Authors: Kruth Perryn S , Whale Julia , Léveillé Alexandre N , Brisbin Jennifer , Barta John R
Published: October 2024

Coccidiosis is a cosmopolitan disease with major impacts on the commercial poultry industry. The causative agents, Apicomplexan parasites of the genus Eimeria, infect epithelial cells of the intestine causing diarrhea, secondary infections, and negatively impacting meat or egg production. The infective parasite stage, the oocyst, is shed in feces and must sporulate over several days in the environment to reach infectivity. The number of viable, sporulated oocysts ingested is proportional to the severity of disease. The self-limiting and highly immunogenic nature of infection by Eimeria spp. make live vaccination an effective means of coccidiosis control. High prevalence of drug resistance and consumer demand for poultry products with no “human medically important antibiotics” or raised without antibiotics indicates an increasing role for vaccination in the control of coccidiosis going forward. Paramount to vaccine efficacy is the ability to administer precise numbers of viable oocysts to stimulate the development of immunity without causing disease. Unfortunately, no rapid and accurate method for determination of oocyst viability is presently available. Time-consuming and expensive live-infection trials are the current gold standard. Work completed for this study demonstrated the development of a molecular assay for the determination of Eimeria tenella Tyzzer, 1929 oocyst viability. The assay used the quantification of specific biomolecules to assess changes in gene expression in response to heat stimulation that indicates viability of a sample of oocysts. Data showed strong predictive value for infectivity of an oocyst sample as confirmed by oocyst output (fecundity) in infection trials. Use of the assay would be low cost compared to the planning, resources, execution, and data collection required for infection trials. Additionally, the assay was shown to offer results in hours versus days for the live infection trials. Development of this first-generation assay paves the way for further development of assays for the determination of viability in mixed species samples (multivalent vaccines), for vaccine quality control at hatcheries, and with application in environmental monitoring (“early warning” programs) and on-farm diagnostics.
Identification and structural characterization of novel bacteriocins by genome-wide screening of hypothetical mini-proteins in Staphylococcus aureus
Authors: Dutta Anirudha , Deb Suman , Dasgupta Bishista , Khatoon Aleya , Mal Arpita , Kauser Taskeen
Published: October 2024

Bacteriocins are ribosomally synthesized small antimicrobial peptides secreted by bacteria to overcome colonization resistance from closely related competitive microorganisms. Staphylococcus aureus is an opportunistic pathogen, that colonizes the skin and nasal cavity of healthy individuals and causes both superficial and systemic infections. The bacteriocins are the primary tool of S. aureus to compete with other members of the human microbiota for effective colonization. Different S. aureus strains produce various bacteriocins with widely diverse target organisms, which are mostly unexplored. Identification of new bacteriocins and their target organism can help us to understand the ecology of the S. aureus infection and lead to finding better treatment. Moreover, bacteriocins can help in the alternative treatment of antibiotic-resistant infections as well as have major applications in food preservation and agriculture. A large section of the S. aureus genome encodes small proteins consisting of 100 or fewer amino acids called mini-proteins. Analyzing the amino acid sequence of the hypothetical mini-proteins for the co-occurrence of antimicrobial activity and signal for extracellular secretion, seven novel bacteriocins genes are identified from S. aureus NCTC 8325. Newly identified bacteriocin genes are found to have stress and starvation inducible upstream regulatory elements, which upregulate bacteriocin production in nutrient-limited or colonization-resistant induced stress environments. The identified peptides have a high net positive charge, which facilitates interaction with negatively charged bacterial membranes. Ab initio modeling of the peptides, molecular dynamic simulation and structural comparison with known AMPs identified structural elements important for membrane disruption and bactericidal activity.
Future options and their impact on the life cycle assessment and life cycle costing of Segment C/D passenger vehicles
Authors: Golkaram Milad , Ligthart Tom , Yildiran Aylin , Mehta Rajesh , Vogels Jack J.T.W.E. , Ferjan Spela , Someren Eugene
Published: October 2024

Electrification is needed to improve the environmental performance of the transportation sector but must be accompanied by technological innovations that eliminate ecological hotspots over the vehicle’s lifetime. Additionally, the lifetime costs of electric vehicles must be reduced. This study uses the battery electric vehicle sustainability impact assessment model (BEVSIM) to analyse the effects of potential changes in recycled plastic content and its waste treatment, electricity grid, and the price of battery electric vehicles (BEVs). Using recycled content in plastic parts improved their environmental performance in all categories except land use; e.g. using 40% recycled plastic reduced 107 kg CO2 eq. per passenger vehicle. Applying a combination of mechanical and pyrolysis technologies for plastic recycling improved several impact categories. However, a trade-off exists for a few impact categories. Finally, using 2030 and 2050 forecasts of electricity grid mixes revealed lifecycle CO2 emissions for BEVs to be 50% and 56% lower than ICE, respectively.
Population and community macroinvertebrates characterization in ephemeral stream in north Patagonian perennial forest relict (Rucamanque, 38°S, Araucanía, Chile)
Authors: Ríos-Escalante Patricio De los , González-Arratia Marcos , Cid-Alda Fernanda , Baaloudj Affef
Published: October 2024

The benthic macroinvertebrates in Patagonian streams are characterized by the presence of abundant aquatic insect larvae stages and crustaceans that can be used as water quality bioindicators. The studied site is an ephemeral stream, present only during rainy season and located in Rucamanque, a north patagonian park that is a relict of pristine perennial forest located at the northwest side of Temuco city. Benthic macroinvertebrates were first studied at population level, considering the spatial distribution of the taxa reported to determine if macroinvertebrates have a random, uniform or aggregated pattern with respective Poisson, binomial and negative binomial distribution. As second step, data were studied at community scale using null models, based on random presence on species co-occurrence and niche sharing. The results revealed that taxa such as Nematoda, presented a random and in consequence a Poisson distribution, while other groups such as Neuroperlopsis sp. (Plecoptera order), Psephenidae (Diptera order) and Aegla sp. (Decapoda order) presented a uniform with binomial distribution, and species from Diptera order such as; Tipulidae, Simulidae, Chironomidae, from Plecoptera order such as Diamphinopsis sp., from Ephenoptera order such as Leptophlebiidae and Chiloporter sp, from order Trichoptera (Smicridea sp) and Oligochaeta (Tubifex sp.) presented an aggregated negative binomial distribution. The results of null models’ analysis revealed that species associations were random, whereas the taxa share niche due interspecific competition. The exposed results of spatial distribution and null models were similar to previous observations in other Patagonian pristine rivers. At population level, only Nematoda had random distribution whereas at community level the random presence of species co-occurrence is due the presence of low species number with many repeated taxa by sample, that also would have niche sharing.
Better together: Combining expert and citizen science data improves our understanding of occurrence patterns of lynx and wolves in Lower Saxony, Germany
Authors: Ludolphy Catharina , Gräber Reinhild , Strauß Egbert , Klages Inga , Reding Raoul , Anders Ole , Middelhoff Tomma Lilli , Balkenhol Niko
Published: October 2024

The return of the two large carnivores wolf and lynx to the federal state of Lower Saxony, Germany, is a conservation success story. However, their return is accompanied by conflicts, which have to be resolved by comprehensive management strategies. Basis for such management is rigorous monitoring of spatial and temporal occurrence patterns of both species. Currently, there are two different monitoring approaches executed in Lower Saxony: the official one, established with the species’ return, is based on reporting opportunistic findings by the general public complemented with systematic camera trap surveys and scat searches. The other approach was implemented in 2014 as part of the “Wildlife Survey Lower Saxony”, an annual questionnaire sent out to owners and tenants of hunting districts, with the goal to obtain state-wide information on huntable wildlife. In this study, we therefore aimed to compare both monitoring approaches in terms of general, spatial and temporal congruence using an internal classification scheme. We showed that the different monitoring approaches provide similar information on the general development of lynx and wolf occurrence across Lower Saxony. Spatial differences were mainly found at the edges of known distributional ranges. In terms of temporal dynamics, the wildlife survey data seemed to be slightly ahead of the official monitoring programmes. We also found species-related differences, which may be related to different attitudes towards the two species. Overall, our findings indicate that the different approaches complement each other and inferences on species occurrence should be made in conjunction of the two data sets.
The impact of chemical fertilizer placement on crude protein synthesis in different organs of forage maize growing in semi-arid areas in China
Authors: wang hongli , Zhang guoping , Ma mingsheng , Fang yanjie , Hou huizhi , Lei kangning , Yin jiade
Published: October 2024

[Aim] Fertilizer placement affects the absorption and transport of nutrients, certainly affects protein synthesis in crops. This study aimed to elucidate the impact and regulation mechanisms of chemical fertilizer placement on crude protein synthesis in different organs of forage maize.
[Methods] The nitrogen/potassium (N/K) ratio, the activities of nitrate reductase [NR], glutamine synthetase [GS], and glutamic pyruvic transaminase [GPT], crude protein content in leaves, stems, and grains, as well as the relationships among the parameters were explored.
[Results] Deep fertilization (DF) significantly improved the N/K ratio. NR activity in DF increased by 26.30%, 35.56%, and 57.30% in leaves, stems, and grains when compared to conventional fertilization (CF), and by 54.22%, 43.27%, and 28.44% when compared to average fertilization (AF). GS activity in DF increased by 29.67%, 47.96%, and 47.46% in leaves, stems, and grains when compared to CF, and by 40.05%, 31.51%, and 40.62% when compared to AF. GPT activity in DF was significantly higher than CF and AF in grains and differences between treatments were significant. Crude protein content was significantly correlated with NR and GS activities in leaves, GPT activity in stems, as well as GS and GPT activities in grains. Crude protein content of leaves and grains in DF was significantly highert than CF and AF.
[Conclusion] DF significantly improvd crude protein synthesis, increased the crude protein content of forage maize by increasing the whole plant N/K ratio, NR and GS activities in leaves, as well as GS and GPT activities in grains.
Multifunctional Waveguide Design: Supercontinuum Generation, Modulation,
and Sensing with Photonic Crystal Arrays
Authors: Bigdeli Mahdi , Amirmazlaghani Mina
Published: October 2024

Waveguides, with their ability to control electromagnetic wave propagation, underpin diverse technologies requiring precise light manipulation. Supercontinuum (SC) generation within waveguides offers broadband light sources vital for advanced imaging, sensing, and spectroscopy. This work addresses the need for highly efficient and versatile SC sources by exploring advanced waveguide designs. A focus is placed on materials like chalcogenide glasses, known for their superior nonlinear properties, and planar configurations enabling on-chip integration. We present a novel photonic crystal-enhanced waveguide, tailored for operation within the telecommunications wavelength range. Designed for supercontinuum generation, modulation, and sensing, this innovation offers a pathway towards multifunctional optical devices with far-reaching applications in communications and medicine. Additionally, we propose a suspended-core As$_2$Se$_3$
tapered rib waveguide configuration. Simulations demonstrate a broad SC spectrum ($1-1.6$ \textmu m) from this compact design, addressing challenges associated with fabrication complexity and loss. These results contribute to the ongoing development of more efficient and adaptable SC sources.