bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of manufacturing process for serotype 14 pneumococcal capsular polysaccharide
Authors: Li Yuelong , Xu Yongxue , Cao Xin , Wang Yanyan , Wang Jianlong , Zhao Yi , Wang Hui , Yao Hantian , Liu Jiankai
Published: October 2024

Streptococcus pneumoniae is a pathogenic bacterium that causes infections such as pneumonia, meningitis, otitis media, and bacteremia. The prevention of pneumococcal disease by vaccination has become more urgent due to increased antibiotic resistance. Pneumococcal capsular polysaccharides (CPS) are effective vaccine antigens that stimulate the host to produce protective antibodies. S. pneumoniae serotype 14 is one of most prevalent types in Latin America and across the world. However, the yield of S. pneumoniae serotype 14 CPS from existing fermentation processes remains low and requires improvement. In this study, various aspects of the fermentation process were optimized to improve pneumococcal growth and polysaccharide productivity, including feed medium, cultivation gas environment, fermentation pH, and temperature. A simplified purification method was also developed to obtain pure CPS, including ultrafiltration, acid and ethanol precipitation, diafiltration, and lyophilization. These fermentation optimizations significantly enhanced the optical density of pneumococcal bacterial cultures and increased fermentation yields to 2.4–2.6 g/L—significantly higher than previously achieved. Furthermore, the test results of pure CPS could meet the requirements in the European Pharmacopoeia (11th edition). These optimizations provide valuable insights into the nutritional requirements and impact of varying fermentation process parameters on pneumococcal growth and CPS productivity, thus contributing to the development of a more efficient and cost-effective method for the production of pneumococcal CPS—essential for manufacturing vaccines against pneumococcal infections.
Risk factors for identifying pneumocystis pneumonia in pediatric patients
Authors: Zhang Chunyan , Li Zheng , Chen Xiao , Wang Mengyuan , Yang Enhui , Xu Huan , Wang Shifu
Published: October 2024

Objectives

This study aimed to identify the risk factors and construct the diagnostic model associated with pneumocystis pneumonia (PCP) in pediatric patients.

Methods

This retrospective observational study analyzed 34 cases of PCP and 51 cases of other types of pneumonia treated at Children’s Hospital Affiliated to Shandong University between January 2021 and August 2023. Multivariate binary logistic regression was used to identify the risk factors associated with PCP. Receiver operating characteristic curves and calibration plots were constructed to evaluate the diagnostic model.

Results

Twenty clinical variables significantly differed between the PCP and non-PCP groups. Multivariate binary logistic regression analysis revealed that dyspnea, body temperature>36.5°C, and age<1.46 years old were risk factors for PCP. The area under the curve of the diagnostic model was 0.958, the P-value of Hosmer‐Lemeshow calibration test was 0.346, the R2 of the calibration plot for the actual and predicted probability of PCP was 0.9555 (P<0.001), and the mean Brier score was 0.069. In addition, metagenomic next-generation sequencing revealed 79.41% (27/34) and 52.93% (28/53) mixed infections in the PCP and non-PCP groups, respectively. There was significantly more co-infection with cytomegalovirus and Streptococcus pneumoniae in the PCP group than that in the non-PCP group (p<0.05).

Conclusions

Dyspnea, body temperature>36.5°C, and age<1.46 years old were found to be independent risk factors for PCP in pediatric patients. The probability of co-infection with cytomegalovirus and S. pneumoniae in the PCP group was significantly higher than that in the non-PCP group.
Instance segmentation models for detecting floating macroplastic debris from river surface images
Authors: Kataoka Tomoya , Yoshida Takushi , Yamamoto Natsuki
Published: October 2024

Quantifying the transport of floating macroplastic debris (FMPD) in waterways is essential for understanding the plastic emission from land. However, no robust tool has been developed to monitor FMPD. Here, to detect FMPD on river surfaces, we developed five instance segmentation models based on state-of-the-art You Only Look Once (YOLOv8) architecture using 7,356 training images collected via fixed-camera monitoring of seven rivers. Our models could detect FMPD using object detection and image segmentation approaches with accuracies similar to those of the pretrained YOLOv8 model. Our model performances were tested using 3,802 images generated from 107 frames obtained by a novel camera system embedded in an ultrasonic water level gauge (WLGCAM) installed in three rivers. Interestingly, the model with intermediate weight parameters most accurately detected FMPD, whereas the model with the most parameters exhibited poor performance due to overfitting. Additionally, we assessed the dependence of the detection performance on the ground sampling distance (GSD) and found that a smaller GSD for image segmentation approach and larger GSD for object detection approach are capable of accurately detecting FMPD. Based on the results from our study, more appropriate category selections need to be determined to improve the model performance and reduce the number of false positives. Our study can aid in the development of guidelines for monitoring FMPD and the establishment of an algorithm for quantifying the transport of FMPD.
Optimization model for distributed energy trading based on a market value allocation mechanism in the electricity spot market
Authors: Hu Baohua , Ding Sheng , Xu Zhaoyang , Cheng Xueting , Zhu Liangliang , Bao Yueshuang , Wang Kui
Published: October 2024

This study proposes a novel distributed energy trading market model with a value distribution mechanism to optimize the allocation and transactions of distributed energy resources (DERs). The framework incorporates a direct load management approach via an electricity aggregator agent, simplifying market processes and reducing transaction costs. A Nash bargaining model is employed to design a fair and efficient value distribution mechanism, promoting equitable benefit allocation among participants. The model integrates stochastic programming to account for uncertainties in real-time load and DER output, enhancing its robustness and applicability in real-world scenarios. The proposed mechanism quantifies each DER’s contribution using a market value contribution rate, serving as a foundation for the Nash bargaining model. This approach ensures individual rationality for both the aggregator and DERs while maximizing overall system benefits. Case studies validate the model’s effectiveness, demonstrating improvements in resource utilization and fair benefit allocation. This research contributes to the advancement of distributed energy markets, offering valuable insights for designing efficient and equitable market structures, ultimately promoting grid stability, renewable energy adoption, and the development of more sustainable and flexible energy systems.
The impact of pilot policies for low carbon city construction on the development of urban circular economy multiple time-point difference-in-differences model
Authors: Xiao Shumei , Liu Yulan , Rong Jing , Wang Wei
Published: October 2024

Introduction

As a means of environmental regulation, the low-carbon city pilot policy aims to address climate change and alleviate environmental resource pressures in economic development. The development of low-carbon cities often requires changes to the existing industrial and energy structures, which will have a significant impact on the regional economy.

Methods

The study is based on panel data from 273 prefecture level cities in China from 2012 to 2022, and uses the Analytic Hierarchy Process and Entropy Comprehensive Evaluation Method to construct an evaluation index system for urban circular benefits. Finally, the multiple time point differences model and mediation effect model were used to evaluate the impact and influencing factors of policies on urban economy.

Results

The results indicate that at the 1% level, the explanatory variable coefficient significantly improves the level of urban circular economy development after adding control variables. The construction of low-carbon pilot cities has improved the performance of circular economy development by about 6.42%. The mediating effect of industrial structure rationalization is significantly positive at the 1% significance level, indicating that the construction of low-carbon pilot cities has greatly promoted the coordinated development of industrial relations within China’s low-carbon development regions.

Discussion

It can be seen that the low-carbon city pilot policy has a significant promoting effect on China’s economic development and the development of urban circular economy. Therefore, it is recommended to further expand the pilot scope of low-carbon cities and fully leverage their promoting role.
From Sangbo to urban landscape: morphological and hydrological transformations of Xuanwu Lake through integrating historical interpretation and geographic analysis
Authors: Wang Xueyuan , Cheng Yuning
Published: October 2024

Introduction

Xuanwu Lake in Nanjing has undergone a rich history, evolving from native Sangbo to a naval training ground, from an imperial garden to farmland, and finally to a vibrant urban landscape. The lake's legacy can be attributed to its unique geographical and hydrological conditions. Exploring historical transformations of the lake and surrounding landscape patterns provides insights for optimizing urban water space in contemporary China.

Methods

Traditional analyses of lake changes based solely on historical records may lack precision due to deviations and artistic interpretations found in ancient maps. However, considering the reciprocal compatibility between local geomorphology, undulating terrains, and water bodies allows for accurate reduction of the lake's morphology by inferring and validating its geographical features. This research combines historical interpretation and geographical analysis to reconstruct the historical shape of Xuanwu Lake, uncover the intrinsic mechanisms driving spatial changes over time, and analyze the morphological changes and connectivity patterns of its hydrological system.

Results

The morphology and hydrological dynamics of Xuanwu Lake are deeply intertwined with the policies prevailing in different eras. In antiquity, Xuanwu Lake, as a natural body of water, sustained the surrounding ecosystem and the livelihoods of local inhabitants. During the imperial period, it was integrated into the royal gardens, with its utilization and configuration modified by political directives, including the establishment of a naval training facility and its conversion into a royal recreational venue. Subsequently, in response to economic imperatives, Xuanwu Lake was transformed into agricultural land, which led to challenges such as flooding and drought. Ultimately, due to ecological security and recreational needs under urbanization, it was restored to lake form.

Discussion

By interpreting the bidirectional adaptation between the lake's ecosystem functions and city development activities, this research provides insights for water space management and ecological restoration in contemporary Xuanwu Lake. The findings provide guidance for the sustainable development of city-lake relationships to enhance the resilience of urban ecological spaces.
The mechanism underlying B-cell developmental dysfunction in Kawasaki disease based on single-cell transcriptomic sequencing
Authors: Lin Qiuping , Wang Zhen , Ding Guohui , Li Guang , Chen Liqin , Qiu Qingzhu , Song Sirui , Liu Wei , Jiang Xunwei , Huang Min , Shen Libing , Xiao Tingting , Xie Lijian
Published: October 2024

Background

Kawasaki disease (KD) is an acute systemic vasculitis that can lead to acquired heart disease in children mostly from in developed countries. The previous research showed that B cells in KD patients underwent a profound change in both the cell numbers and types after intravenous immunoglobulin (IVIG) therapy.

Methods

We performed the single-cell RNA-sequencing for the peripheral blood mononuclear cells (PBMCs) from three febrile patients and three KD patients to investigate the possible mechanism underlying B cell developmental dysfunction in KD. The pseudo-time analysis was employed to study the developmental trajectories of the PBMCs in febrile control and KD patients.

Results

Overall single-cell expression profiles show that the biological processes of immunity, B cell activation pathway and their related biological entities are repressed in KD patients before IVIG treatment compared to febrile patient and KD patients after IVIG treatment. The differentially expressed gene analyses further demonstrate that B cell signaling pathway is downregulated in B cells and plasma blast cells of KD patients before treatment while cell cycle genes and MYC gene are upregulated in dendritic cells (DCs) and hematopoietic stem and progenitor cells (HSPCs) of KD patients before treatment. The biological process of immune response is upregulated in the HSPCs of KD patients before treatment in our dataset while the biological process of inflammatory response is upregulated in the HSPCs of KD patients before treatment in GSE168732 dataset. Single-cell trajectory analyses demonstrate that KD patients before treatment have a shortened developmental path in which B cells and T cells are failed to differentiate into separate lineages. HSPD1 and HSPE1 genes show an elevated expression level in the early cell development stage of KD patients before treatment accompanied with the repression of MYC, SPI1, MT2A and UBE2C genes. Our analyses of all B cells from KD patients before treatment show most of B cells are arrested in a transitional state with an ill developmental path compared with febrile patients and KD patients after treatment.

Conclusion

Our results indicate that the immune premature HSPCs accompanied with the abnormal expression dynamics of cell cycle and SPI1 genes are the mechanism underlying B cell developmental dysfunction in KD patients.
Calculated globulin can be used as a screening test for antibody deficiency in children and adolescents
Authors: Frias Sartorelli de Toledo Piza Cristina , Aranda Carolina Sanchez , Solé Dirceu , Jolles Stephen , Condino-Neto Antonio
Published: October 2024

Purpose

Calculated globulin (CG, total protein minus albumin levels) correlate well with IgG levels and has been proposed as a suitable screening method for individuals with primary antibody deficiencies (PADs). We aimed to show the correlation of CG with IgG levels in children and adolescents, utilizing a common method for albumin measurement, bromocresol green.

Methods

Individuals from two Allergy and Immunology clinics were invited to participate. Inclusion criteria were age < 18, stable conditions, and signed informed consent. We included 1084 individuals. Immunoglobulin G values were determined by immunoturbidimetry; the colorimetric bromocresol green method and the Architect Biuret method were utilized for the albumin and total protein (TP) measurements, respectively.

Results

A total of 1084 individuals were included in the analysis and divided into 4 age groups (0 to <1 year, 1 to <4 years, 4 to <10 years, and 10 to <18 years). For all patients, the mean age was 6.1 (± 5) years old, the mean IgG was 9.4 (± 4.7) g/L, and CG was 23.7 (± 5.9) g/L. The most frequent diagnosis were respiratory allergies, followed by inborn errors of immunity. IgG and CG varied according to age group. Cutoff values for hypogammaglobulinemia varied from 13.8 g/L in children < 1 year to 23.1 g/L in children and adolescents aged 10 to <18 years. CG sensitivity varied from 70.9% in children aged 1 to <4 years old to 95.8% in children 4 to <10. Specificity ranged from 87.5% in children 4 to <10 years old to 100% in children and adolescents aged 10 to <18 years.

Conclusion

CG is a suitable screening test for hypogammaglobulinemia in children less than 18 years of age.
Going digital: challenges in monitoring marine megafauna when comparing results from visual and digital aerial surveys
Authors: Quéroué Maud , Authier Matthieu , Besnard Aurélien , Heerah Karine
Published: October 2024

Since the first plans to develop offshore wind farms (OWFs), concerns have been raised about the impacts on marine megafauna. Today, it is required to assess these impacts over the whole lifecycle of the OWF. Before construction, initial assessments are often conducted by visual surveys, but subsequent monitoring over the lifecycle of the OWF has to be digital due to safety requirements, leading to challenges in data comparability. The aim of this study was to attempt to establish generalizable intercalibration factors for this transition between visual and digital monitoring methods. To this end, intercalibration surveys were conducted at five different sites and at different times of the year within a site, using both visual monitoring at low-altitude and digital monitoring at both low and high altitudes. We tested the potential for intercalibration of the results based on the ratio of abundance estimated from data collected by the different methods. We explored factors such as the species under study and site-specific conditions that may influence intercalibration. We computed more than 100 intercalibration factors and found that, on average, abundance estimates from digital methods were higher than those from visual methods and that flight altitude for digital monitoring did not significantly influence abundance estimates. Aside from divergent abundance estimates depending on monitoring method, the findings also revealed significant heterogeneity, only one-third of which was explained by contextual factors such as taxonomy or the sea conditions. This outcome presents a pessimistic outlook on the prospect for the intercalibration of results between an initial assessment carried out with visual observations and subsequent monitoring with digital methods after OWF construction and until decommissioning. The high heterogeneity prevents seamless transferability of intercalibration factors and highlights the importance of local context.
Epidemiological profile of patients hospitalized with Crohn’s disease due to severe acute respiratory infection during the COVID-19 pandemic: a 2-year report from Brazil
Authors: Nascimento Laís Silva , Marson Fernando Augusto Lima , dos Santos Raquel de Cássia
Published: October 2024

Background and aims

The novel coronavirus-induced severe acute respiratory syndrome (COVID-19) led to one of the most significant global pandemics of the 21st century, causing substantial challenges for healthcare systems worldwide, including those in Brazil. This study aimed to investigate the demographic and clinical profiles of hospitalized patients in Brazil who had both COVID-19 and Crohn’s disease (CD) over a 2-year period.

Methods

An epidemiological analysis was conducted using data from Open-Data-SUS. The study focused on describing the demographic characteristics, clinical manifestations, comorbidities, and hospitalization details of patients afflicted with severe acute respiratory syndrome due to COVID-19 and CD, with the aim of predicting mortality risk.

Results

The states of São Paulo, Paraná, and Minas Gerais accounted for 50% of the reported COVID-19 cases. The most affected racial group consisted of individuals who self-declared as mixed race. Common comorbidities included heart disease, diabetes mellitus, and obesity. The age group most affected was 25 to 60 years old, particularly among hospitalized patients with both CD and COVID-19 who ultimately succumbed to the illness. A multivariable analysis was conducted to identify the following significant risk factors for death: (a) the presence of neurological disorder (OR = 6.716; 95% CI = 1.954–23.078), (b) the need for intensive care (OR = 3.348; 95% CI = 1.770–6.335), and (c) the need for invasive mechanical ventilation (OR = 59.017; 95% CI = 19.796–175.944).

Conclusion

There was no discernible gender-based prevalence among hospitalized patients with CD and COVID-19; however, individuals of mixed race were disproportionately affected. The 25 to 60 age group emerged as the most vulnerable demographic group, with high risks of hospitalization and mortality. Moreover, the study highlights the potential for COVID-19 to induce systemic pathologies that may result in long-term degenerative effects and sequelae.
From Sudoscan to bedside: theory, modalities, and application of electrochemical skin conductance in medical diagnostics
Authors: Vittrant Benjamin , Ayoub Hanna , Brunswick Philippe
Published: October 2024

The human body has two main types of sweat glands: apocrine and eccrine. Eccrine glands are widely distributed across the skin, including areas with hair. While the eccrine glands on palms and soles help improve grip, those on the rest of the body primarily aid in thermoregulation. Sudomotor function, which controls sweating, is regulated by the sympathetic division of the autonomic nervous system through cholinergic and adrenergic pathways. The activation of eccrine glands involves intricate processes, including neurotransmitter binding, ion channel modulation, and voltage generation. Sudoscan technology utilizes electrochemical skin conductance (ESC) to non-invasively measure sudomotor function. This method, which has been standardized for accuracy, has established normative benchmarks and has proven reliable across diverse populations. Sudoscan’s diagnostic performance is comparable to invasive methods such as intraepidermal nerve fiber density testing, making it a valuable tool for diagnosing small fiber neuropathy. Moreover, it has been shown to correlate with corneal nerve fiber length, providing insights into various neuropathic conditions. Compared to traditional sudomotor function tests, Sudoscan proves superior in terms of its accessibility, simplicity, and reliability, with the potential to replace or complement existing diagnostic methods. It is important to differentiate ESC, as measured by Sudoscan, from other skin conductance measures, such as galvanic skin response (GSR) or electrodermal activity (EDA). Although these methods share a common physiological principle, ESC is specifically designed for diagnosing sudomotor function, unlike GSR/EDA, which is typically used for continuous monitoring. Sudoscan’s success has led to its integration into consumer health devices, such as the BodyScan from Withings, showcasing its versatility beyond clinical settings. Future research may explore ESC applications in diverse medical fields, leveraging real-world data from integrated consumer devices. Collaborative efforts between researchers and engineers promise to offer new insights into sudomotor function and its implications for broader health monitoring. This study provides a comprehensive overview of ESC, including topics such as eccrine gland physiology, sudomotor function, Sudoscan technology, normative benchmarks, diagnostic comparisons, and potential future applications.
Distinct acute stressors produce different intensity of anxiety-like behavior and differential glutamate release in zebrafish brain
Authors: Martins Milena Letícia , Pinheiro Emerson Feio , Saito Geovanna Ayami , Lima Caroline Araújo Costa De , Leão Luana Ketlen Reis , Batista Evander de Jesus Oliveira , Passos Adelaide da Conceição Fonseca , Gouveia Amauri , Oliveira Karen Renata Herculano Matos , Herculano Anderson Manoel
Published: October 2024

Anxiety disorder is one of the most well-characterized behavioral disorders in individuals subjected to acute or chronic stress. However, few studies have demonstrated how different types of stressors can modulate the neurochemical alterations involved in the generation of anxiety. In this study, we hypothesize that subjects exposed to different aversive stimuli (mechanical, chemical, and spatial restriction) present varied intensities of anxiety-like responses associated with distinct patterns of gamma-aminobutyric acid (GABA) and glutamate release in the brain. Adult zebrafish, Danio rerio (n = 60), were randomly divided into four experimental groups; control, acute restraint stress (ARS), conspecific alarm substance (CAS), and chasing with net (CN). After the stress protocols, the animals were individually transferred to a novel tank diving test for behavioral analysis. Subsequently, their brains were collected and subjected to GABA and glutamate release assay for quantification by HPLC. Our behavioral results showed that all aversive stimuli were capable of inducing anxiety-like behavior. However, the impact of anxiogenic behavior was more prominent in the CN and CAS groups when compared to ARS. This phenomenon was evident in all analyzed behavioral parameters (time on top, freezing, mean speed, maximum speed, and erratic swimming). Our data also showed that all aversive stimuli significantly decreased GABA release compared to the control group. Only animals exposed to CN and CAS presented an increase in extracellular glutamate levels. Different acute stressors induced different levels of anxiety-like behavior in zebrafish as well as specific alterations in GABAergic and glutamatergic release in the brain. These results demonstrate the complexity of anxiety disorders, highlighting that both behavioral and neurochemical responses are highly context-dependent.
Absence of oncomodulin increases susceptibility to noise-induced outer hair cell death and alters mitochondrial morphology
Authors: Murtha Kaitlin E. , Sese Weintari D. , Sleiman Kiah , Halpage Janith , Padyala Pravallika , Yang Yang , Hornak Aubrey J. , Simmons Dwayne D.
Published: October 2024

Cochlear outer hair cells (OHCs) play a fundamental role in the hearing sensitivity and frequency selectivity of mammalian hearing and are especially vulnerable to noise-induced damage. The OHCs depend on Ca2+ homeostasis, which is a balance between Ca2+ influx and extrusion, as well as Ca2+ buffering by proteins and organelles. Alterations in OHC Ca2+ homeostasis is not only an immediate response to noise, but also associated with impaired auditory function. However, there is little known about the contribution of Ca2+ buffering proteins and organelles to the vulnerability of OHCs to noise. In this study, we used a knockout (KO) mouse model where oncomodulin (Ocm), the major Ca2+ binding protein preferentially expressed in OHCs, is deleted. We show that Ocm KO mice were more susceptible to noise induced hearing loss compared to wildtype (WT) mice. Following noise exposure (106 dB SPL, 2 h), Ocm KO mice had higher threshold shifts and increased OHC loss and TUNEL staining, compared to age-matched WT mice. Mitochondrial morphology was significantly altered in Ocm KO OHCs compared to WT OHCs. Before noise exposure, Ocm KO OHCs showed decreased mitochondrial abundance, volume, and branching compared to WT OHCs, as measured by immunocytochemical staining of outer mitochondrial membrane protein, TOM20. Following noise exposure, mitochondrial proteins were barely visible in Ocm KO OHCs. Using a mammalian cell culture model of prolonged cytosolic Ca2+ overload, we show that OCM has protective effects against changes in mitochondrial morphology and apoptosis. These experiments suggest that disruption of Ca2+ buffering leads to an increase in noise vulnerability and mitochondrial-associated changes in OHCs.
Effects of a 6-month aerobic exercise intervention on brain morphology in women with breast cancer receiving aromatase inhibitor therapy: a sub-study of the EPICC trial
Authors: Molina-Hidalgo Cristina , Wan Lu , Velazquez-Diaz Daniel , Huang Haiqing , Grove George , Bender Catherine M. , Gentry Amanda L. , Sereika Susan M. , Kang Chaeryon , Crisafio Mary E. , Erickson Kirk I.
Published: October 2024

Objective

Physical exercise may increase brain volume and cortical thickness in late adulthood. However, few studies have examined the possibility for exercise to influence brain morphology in women treated for breast cancer. We conducted a nested sub-study within a randomized clinical trial to examine whether 6 months of moderate-intensity aerobic exercise in postmenopausal women with early-stage breast cancer influences brain morphology.

Methods

We included twenty-eight postmenopausal women newly diagnosed with Stage 0-IIIa breast cancer (M age = 62.96 ± 5.40) who were randomized to either 45–60 min of supervised aerobic exercise 3 days/week (n = 16) or usual care (n = 12). Before beginning aromatase inhibitor aromatase inhibitor therapy, and the exercise intervention, and again at 6-month follow-up, volumetric and cortical thickness measures were derived from magnetic resonance imaging scans.

Results

There were no significant intervention effects on brain volume and cortical thickness. However, greater average exercise intensity (%) during the intervention was associated with greater post-intervention cortical volume, mean cortical thickness, precentral gyrus thickness, and superior parietal thickness (all p < 0.05). Finally, total supervised exercise time was associated with higher precentral gyrus thickness after the intervention (p = 0.042, R2 = 0.263).

Conclusion

The exercise intervention did not significantly affect brain volumes and cortical thickness compared to the control group. However, positive associations were found between exercise intensity and brain morphology changes after the 6-month intervention, indicating that exercise may reduce the vulnerability of the brain to the deleterious effects of breast cancer and its treatment.
The subjective experience of transcranial electrical stimulation: a within-subject comparison of tolerability and side effects between tDCS, tACS, and otDCS
Authors: Bjekić Jovana , Živanović Marko , Stanković Marija , Paunović Dunja , Konstantinović Uroš , Filipović Saša R.
Published: October 2024

Low-intensity transcranial electrical stimulation (tES), including techniques like transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), and oscillatory transcranial direct current stimulation (otDCS), has been widely explored for its neuromodulatory effects on motor, cognitive, and behavioral processes. Despite well-established safety, these techniques can induce varying degrees of discomfort and side effects, potentially impacting their application. This study presents a within-subject sham-controlled experiment directly comparing the subjective experience and side effects of tDCS, tACS, and otDCS. Participants reported their discomfort levels at multiple time points during 20-min stimulation sessions and completed a side-effects questionnaire before and after each session. Results indicated that the overall discomfort levels were low across all conditions, with ≥95% reporting the absence of discomfort or mild procedure-induced discomfort. Nevertheless, tDCS and otDCS were slightly less comfortable compared to sham, especially at the beginning of stimulation, with tACS-induced discomfort levels being overall comparable to sham. The most common side / adverse effects were mild skin sensations, including itching and tingling, particularly with tDCS and otDCS, while tACS occasionally caused phosphenes and blurred vision. These findings provide a systematic comparison of tES-induced discomfort and side effects between different tES techniques, highlighting the high safety of tES, but also the importance of considering within- and between-person variability and time-course effects in tES applications.
Fuzzy C-means clustering algorithm applied in computed tomography images of patients with intracranial hemorrhage
Authors: Zhang Lintao , Song Dewen , Qiu Huiying , Ye Lin , Xu Zengliang
Published: October 2024

In recent years, intracerebral hemorrhage (ICH) has garnered significant attention as a severe cerebrovascular disorder. To enhance the accuracy of ICH detection and segmentation, this study proposed an improved fuzzy C-means (FCM) algorithm and performed a comparative analysis with both traditional FCM and advanced convolutional neural network (CNN) algorithms. Experiments conducted on the publicly available CT-ICH dataset evaluated the performance of these three algorithms in predicting ICH volume. The results demonstrated that the improved FCM algorithm offered notable improvements in computational time and resource consumption compared to the traditional FCM algorithm, while also showing enhanced accuracy. However, it still lagged behind the CNN algorithm in areas such as feature extraction, model generalization, and the ability to handle complex image structures. The study concluded with a discussion of potential directions for further optimizing the FCM algorithm, aiming to bridge the performance gap with CNN algorithms and provide a reference for future research in medical image processing.
Independent and joint influence of depression and advanced lung cancer inflammation index on mortality among individuals with chronic kidney disease
Authors: Zhou Jie , Liu Wenjun , Liu Xiaoxin , Wu Jijun , Chen Ying
Published: October 2024

Background

The combined effect of depression and nutritional-inflammatory status on mortality in the chronic kidney disease (CKD) population is unclear.

Methods

We prospectively analyzed 3,934 (weighted population: 22,611,423) CKD participants from the National Health and Nutrition Examination Survey (2007–2018). Depression and nutritional-inflammatory status were assessed with Patient Health Questionnaire 9 (PHQ-9) and Advanced Lung Cancer Inflammation Index (ALI), respectively. Weighted multivariate COX regression models, restricted cubic splines (RCS) models, and stratified analyses were used to investigate the association of PHQ-9 scores and ALI with all-cause mortality.

Results

During a median follow-up of 5.8 years (interquartile range 3.4–8.6 years), a total of 985 patients died (25.0%). Each point increase in a patient’s PHQ-9 score increased the risk of all-cause mortality by 4% (HR, 1.04; 95% CI, 1.02–1.06; p < 0.001), in the full adjusted model. However, an increase in ALI levels was associated with a decreased risk. HRs (95% CI) of 0.76 (0.65–0.90), 0.70 (0.57–0.86), and 0.51 (0.41–0.64) in the Q2, Q3, and Q4 of ALI compared with the Q1 of ALI, respectively. In addition, the joint analysis showed that CKD patients without depression and with higher ALI were associated with a reduced risk of all-cause mortality. Namely, patients in the highest ALI group (Q4) without depression had the lowest risk (HR, 0.32; 95% CI, 0.21–0.48). Furthermore, this combined effect was consistent across all subgroups, and no significant interaction was found (p > 0.05 for interaction).

Conclusion

In a nationally representative sample of US patients with CKD, coexisting depression and poorer nutrition-inflammation were associated with a significantly increased risk of all-cause mortality.
Association of triglyceride-glucose index and its combination with obesity indicators in predicting the risk of aortic aneurysm and dissection
Authors: Yu Wangqin , Wang Xiaoling , Du Zhongyan , Cheng Wenke
Published: October 2024

Background

The association between the triglyceride-glucose (TyG) index and its combination with obesity indictors in aortic aneurysm and dissection (AAD) remains unclear. We aimed to investigate the association between TyG and TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist height ratio (TyG-WHtR) and AAD risk.

Methods

This study included 387,483 baseline participants from the UK Biobank with complete data on TyG, TyG-BMI, TyG-WC and TyG-WHtR. Cox proportional hazard models evaluated the relationship between these four indicators and the risk of AAD occurrence. Restricted cubic spline (RCS) examined the non-linear relationship between these indicators and AAD risk, while receiver operating characteristic (ROC) curves assessed the predictive value of these four indicators for AAD risk.

Results

Over a median follow-up of 13.7 years, 3,041 AAD events were recorded. Multivariate Cox regression analysis indicated that for each standard deviation increase, the risk of AAD occurrence increased by 33% (HR: 1.33, 95%CI: 1.29–1.38), 25% (HR: 1.25, 95%CI: 1.21–1.29), 61% (HR: 1.61, 95%CI: 1.56–1.66) and 44% (HR: 1.44, 95%CI: 1.39–1.49) for TyG, TyG-BMI, TyG-WC and TyG-WHtR, respectively. RCS demonstrated a linear relationship between these indicators and AAD risk, with TyG-WC demonstrating the best performance in predicting AAD occurrence based on ROC curves.

Conclusion

The present study, based on a large prospective cohort design, showed that higher TyG index and its combination with obesity indices were significantly associated with the risk of AAD. Moreover, AFT models further showed that elevation of these indicators significantly advanced the onset of AAD. In addition, RCS analyses demonstrated a linear association between these indicators and the risk of AAD, and the TyG-WC showed higher predictive ability for AAD. These findings emphasize the potential application of the TyG index and its combination with obesity indicators in the early identification of AAD.
Perceptions of physicians caring for pediatric patients with cancer in Europe: insights into the use of palliative care, its timing, and barriers to early integration
Authors: Lacerda Ana , Bravo-Carretero Isabel M. , Ehrlich Bella S. , Job Godwin , Avilés Martínez María , Leiss Ulrike , Kokkinou Georgia , Scheinemann Katrin , Craig Finella , Krottendorfer Kerstin , Devidas Meenakshi , Baker Justin N. , Agulnik Asya , McNeil Michael J.
Published: October 2024

Background

Integrating pediatric palliative care (PPC) into pediatric oncology standard care is essential. Therefore, it is important to assess physicians’ knowledge and perceptions of PPC to optimize its practice.

Objective

To evaluate the knowledge, comfort levels, and perspectives of physicians regarding the timing and perceived barriers to integrating PPC into pediatric cancer care across Europe.

Design

The Assessing Doctors’ Attitudes on Palliative Treatment (ADAPT) survey, originally developed for other global regions, was culturally and contextually adapted for Europe.

Setting/Subjects

The survey was distributed via the European Society of Paediatric Oncology (SIOPE) membership listserv. Any physicians caring for children with cancer across Eastern, Southern, Central, and Northern Europe were invited to complete the survey.

Results

A total of 198 physicians from 29 European countries completed the ADAPT survey. Physicians demonstrated relative agreement with the World Health Organization’s guidance; median alignment was 83.4% (range 59.9%-94.1%). Although most respondents felt comfortable addressing physical (84.4%) and emotional (63.4%) needs, they felt less comfortable addressing spiritual needs (41.9%) and providing grief and bereavement support (48.5%). There were significant regional differences, such as physicians in Eastern and Southern Europe reporting a lack of PPC specialists, opioids, and home-based care, while those in Northern and Central Europe did not.

Conclusion

Physicians caring for children with cancer throughout Europe have a good understanding of PPC. However, misconceptions about PPC persist, requiring educational and capacity-building efforts. Additionally, the regional differences in perceived barriers must be addressed to ensure equitable access to PPC for all European children with cancer.
Comparison of different concentrations atropine in controlling children and adolescent myopia: an umbrella review of systematic reviews and meta-analyses
Authors: Chen Baizhou , Ni Yao , Chen Jinghan , Xing Shuwen , Zhang Zhaotian
Published: October 2024

Purpose

To evaluate the myopia control effect of different concentrations atropine in children and adolescent.

Methods

Meta-analyses and systematic reviews available in the Pubmed, Embase, and Cochrane Library databases from the databases’ inception to August 2023 were searched to evaluate the efficacy and tolerability of different concentrations’ atropine in controlling myopia progression. Overall effects were performed using random-effects model. AMSTAR 2 tool was used to assess the quality of included studies. Prespecified outcomes were weight mean difference (WMD) with 95% credible interval (95% CI) of annual spherical equivalent refraction (SER) changes and annual axial length (AL) changes.

Results

19 systematic reviews/meta-analyses of different atropine concentrations were included in the analysis. 14 studies reported SER changes, and 17 reported AL changes. In terms of the studies’ overall methodological quality level (measured using AMSTAR 2), 1 study was rated high, 7 moderate, 7 low, and 4 critically low. The 0.01% atropine was found to have statistically significance (annual SER change WMD 0.27 [95% CI 0.21 - 0.34] D/year; annual AL change WMD -0.09 [95% CI -0.1 to -0.07]) mm/year), 0.05% atropine was preferred considering efficacy and tolerability (annual SER change WMD 0.54 [95% CI 0.49 - 0.58] D/year; annual AL change WMD -0.21 [95% CI -0.12 to -0.02]) mm/year).

Conclusions

Different atropine concentrations alleviated children and adolescent myopia progression. However, higher-quality evidence and further investigation are needed to clarify the dose–response relationship, and practical guidelines must be developed to determine myopia control efficacy.
Febuxostat-induced agranulocytosis in a pediatric hematopoietic stem cell transplant recipient: Case Report and literature review
Authors: Curci Debora , Braidotti Stefania , Maximova Natalia
Published: October 2024

This report describes a pediatric case of isolated agranulocytosis occurring months after hematopoietic stem cell transplantation (HSCT). Secondary cytopenia, or secondary transplant failure, affects 10%–25% of HSCT recipients, with potential triggers including viral infection, graft-versus-host disease (GVHD), sepsis, and certain medications. Viral reactivation was ruled out based on negative PCR results, while GVHD and sepsis were ruled out based on the patient’s clinical presentation. The patient, who received an HLA 10/10 unrelated donor T-cell transplant, underwent standard myeloablative conditioning to minimize the risk of graft rejection. However, agranulocytosis persisted even after discontinuation of myelotoxic drugs such as valganciclovir and ruxolitinib. Further investigation revealed that the patient had been taking febuxostat, which was subsequently discontinued, leading to a recovery of the neutrophil count. The European Medicines Agency lists agranulocytosis as a rare side effect of febuxostat. The effect of candidate genes and variants involved in febuxostat pharmacokinetics and pharmacodynamics was done using the Pharmacogenomics Knowledge Base (PharmGKB) to accurately evaluate an individual’s risk for neutropenia. This case suggests that genetic variants in renal transporters ABCG2 (exonic non-synonymous variant, rs2231137), SLC29A1 (rs747199 and rs628031), and ABCC4 (3′UTR SNP, rs3742106 and rs11568658) may contribute to drug-induced agranulocytosis. This finding underscores the importance of genetic profiling in the management of patients undergoing HSCT to prevent adverse drug reactions.
Exploring the lived experience of performance-related health and wellbeing among flautists
Authors: Wang Jiayi , Welch Graham F.
Published: October 2024

Introduction

The study has investigated the lived experience of flautists, focusing on their experiences and perceptions of performance-related physical discomfort, injury and related mental health challenges that they might have encountered in practice and performance. The aims of the research have been to provide flautists with an opportunity to reflect on any physical or psychological performance issues in their own words, and to understand the subjective meaning of these experiences.

Methods

A basic qualitative approach was used for gathering data. All the fieldwork was undertaken during or immediately after the Covid-19 pandemic. Consequently, the participating flautists were deliberately selected using professional networks on the basis of their answers to a pre-interview initial questionnaire related to the characteristics of their personal backgrounds and their experiences, as well as being able to participate remotely. There have been two data collection phases. Phase 1 was a specially designed pre-interview questionnaire drawing on themes from appropriate literature. Phase 2 built on the pre-interview questionnaire responses and was designed as semi-structured interviews, undertaken on Zoom, and included a ‘River of Flute-playing Experience’ activity during the interview. The ‘River of Experience’ method is an autobiographical research tool in which participants were asked to annotate key biographical experiences and challenges at various points along their drawing of a meandering river. The combined data analyses drew on thematic analysis.

Results

The eight participants reported a personal history of performance-related health and wellbeing challenges that they had faced at some point in their lives. The findings reveal that flautists encounter health-related challenges associated with their practice and performances, and the data suggest that they each require an understanding of likely performance-related health challenges and supportive resources to assist them in managing these challenges.

Discussion

The participants’ diverse experiences highlight the importance of managing health and the value of supportive social connections. They cope with health challenges by integrating passion, resilience, and adaptability into their lives, finding ways to grow and continue to thrive in their flute-playing journey. The study underscores the need for comprehensive health education and support resources for flautists, emphasising the significance of resilience and adaptability in fostering health, wellbeing, and success.
In their narratives: academic socialization in the experience of sensory processing sensitivity among university students
Authors: Saglietti Marzia , Marini Mara , Livi Stefano
Published: October 2024

Introduction

While much of the worldwide contemporary research on sensory processing sensitivity (SPS) and environmental sensitivity (ES) has relied on the participation of university students, there remains a significant gap in understanding the academic social experiences of those scoring high in SPS (i.e., highly sensitive individuals).

Methods

To address this gap, this exploratory study aimed to investigate in detail students’ academic socialization through their narratives. We conducted nine interviews with Italian university students who self-identified as highly sensitive.

Results

Through thematic reflexive analysis, we identified and analyzed 6 themes (with subthemes and versions of subthemes) concerning their self-definitions, their university experience (in classroom, before, during, and after exams), and socialization with peers and teachers.

Discussion

After 20 years of research on SPS, this study integrates the relevant literature into the field of social psychology and academic socialization, emphasizing the importance of understanding SPS within real-life educational contexts and considering highly sensitive students’ perspectives on their resources and challenges in attending university. By contributing to the emerging qualitative literature on SPS and ES, this study provides practical implications for educators and policymakers seeking to foster inclusive learning environments for all students.