bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and testing of mobile phone text messages for improving maternal and newborn care practice in Jimma Zone, Ethiopia. A user-centered design approach
Authors: Abdissa Hordofa Gutema , Duguma Gebeyehu Bulcha , Noll Josef , Sori Demisew Amenu , Koricha Zewdie Birhanu
Published: May 2024

Background
Mobile phone-based messaging for maternal education has indicated promising outcomes in promoting maternal and newborn care practices. However, most mobile phone-based messaging interventions are not tested before their implementation, and the evidence on the message content development process and methods is limited and underreported. The aim of this study was to develop and test text messages for interventions designed to improve maternal services utilization and newborn care practices.
Methods
The development process has 4 phases: engaging pregnant mothers and experts in selected districts of the Jimma Zone, Ethiopia. During phase 1, the draft messages were developed based on the message framing concept, and the number of messages was reduced after review. In phase 2, 12 mothers participated in card sorting and the messages were refined. In phase 3, 8 experts evaluated the messages using 10 items with a 5-point Likert scale. In phase 4, a pilot study (n = 30) was conducted to evaluate the messages and their delivery when they were sent to individuals’ mobile telephones. In this phase, a system usability scale was also used to assess the usability of the planned intervention.
Results
An initial bank of 120 messages was developed, 42 of which were discarded during the development process. Of these, 32 were discarded by the research team at phase 1, and 10 were discarded during the card sorting at phase 2. Based on the experts’ evaluations, 14 messages were reworded and refined in phase 3. During the pilot testing phase, the majority (80%) of the participants mentioned that the time they had been receiving the message was early, and 66.7% of the participants preferred the time to receive text messages about health. The mean SUS score was 72.26, which is acceptable for the usability of the mobile phone-based messaging intervention.
Conclusion
A final bank of 78 (39 for each framing type) messages was obtained after refinement according to feedback from participants. The SUS showed an acceptable score for the planned intervention. This message development process confirms that the messages are acceptable, and important for improving maternal and newborn health care practices.
Limitation of Site-stratified Cox Regression Analysis in Survival Data: A Cautionary Tale of the PANAMO Phase III Randomized, Controlled Study in Critically Ill COVID-19 Patients
Authors: Sandrock Christian , Song Peter X.K.
Published: May 2024

Current guidelines focus on a p-value threshold of a pre-specified primary endpoint tested in randomized controlled clinical trials to determine a treatment effect for a specific drug. However, a p-value does not always provide evidence on the treatment effect of a drug, especially when stratification of the data does not account for unforeseen variables introduced into the analysis. We report and discuss a rare case in which investigational site stratification in the pre-specified analysis method of a primary endpoint results in a loss of statistical power in the evaluation of the treatment effect due to data attrition of almost 17% of outcome data in the phase III randomized, controlled PANAMO study in critically ill COVID-19 patients. Other analyses utilizing no or different stratification (e.g., stratifying by country, region, pooling low enrollment clinical sites) evaluates 100% of patient data resulting in p-values suggesting positive treatment effect (p < 0.05). We demonstrate how this technical artifact occurs by adjustment for site-stratification within the Cox regression analysis for survival outcomes and how alternative stratification corrects this discrepancy.
Exploring Yoga Adherence, Experiences, Future Preferences and Barriers in the Medical University Community, A 6-Week Study
Authors: Nausheen Fauzia , Sheikh Shazia , Lyons Paul
Published: May 2024

Background
Despite yoga's known benefits for physical and mental health, studies face challenges like small samples and high attrition, especially with medical professionals showing low adherence to yoga practices.
Objectives
This study aimed to assess yoga practice adherence, participant experiences, future preferences, and its impact on participants' emotional states over a 6-week period.
Methods
the comprehensive yoga adherence program, developed and guided by a Principal Investigator (PI), a medical doctor and a certified yoga instructor, included a 30-minute instructional video and weekly motivational messages and reminders. The video, accessible on various devices, was divided into pre-yoga stretches, yogic asanas, breathing exercises, and guided meditation. The study involved 15 participants from diverse backgrounds, including medical students, staff, and faculty members (above 18 years of age). Data collection was through three surveys, focusing on daily adherence, practice frequency, reasons for missed sessions, emotional states post-practice, and future yoga practice preferences.
Results
On average, participants engaged in yoga practice four days per week, with 17% practicing daily.: 20% of participants discontinued the practice during the study. The majority reported feeling relaxed and happy after sessions, and none felt tired or bored. Common barriers to adherence included lack of time, motivation, and preference for alternative workouts. Participants expressed a strong desire to continue practicing yoga in the future, with varied preferences for virtual or in-person practice formats.
Conclusion
The study offers insights into the implementation challenges and feasibility of a comprehensive yoga adherence program. It highlights factors influencing participants' adherence and future practice preferences, contributing to effective strategies for promoting regular yoga practice and integrating it into wellness routines. The findings emphasize the need for tailored support to address diverse barriers to adherence and preferences for yoga formats. While there was significant adherence, understanding these factors is crucial for tailoring future programs to enhance participation and adherence.
Transient erythroblastopenia of childhood after Covid-19 infection: a case report
Authors: Rivetti Giulio , Abbate Fabio Giovanni , Longobardi Marialaura , Marrapodi Maria Maddalena , Lanzaro Francesca , Martino Martina Di , Vallefuoco Fara , D’Angelo Velia , Casale Maddalena , Tartaglione Immacolata , Perrotta Silverio , Roberti Domenico
Published: May 2024

Background
Transient erythroblastopenia of childhood (TEC) is an acquired, self-limited pure red cell aplasia that usually occurs in children 4 years old and younger. This clinical condition has been priorly described to be linked to numerous viral and immunologic mechanisms. COVID-19, caused by the coronavirus SARS-CoV-2 was initially discovered in China in December 2019. The disease quickly spread worldwide, resulting in pandemic.
Case Presentation
This report describes a new clinically relevant condition associated to COVID-19, describing a child with clinical and biochemical signs of Pure Red Blood cells aplasia and bone marrow complete absence of erythroblasts and signs of erythrophagocytosis at the bone marrow needle aspiration, resembling morphological signs such as in hemophagocytic lymphohistiocytosis (HLH), temporally associated to SARS-CoV-2 infection.
Conclusion
This report highlights a newly highlighted continuum laboratory and clinical spectrum of immune/hematological dysregulations secondary to SARS-CoV-2. SARS‐CoV‐2 infection-linked TEC has never been described in literature, but, according to our findings, should be considered in all the patients with transient erythroblastopenia without congenital red blood cell abnormalities and serology negative for major infections associated with TEC. This condition must be considered in the same spectrum of MIS-C and the inter-links among the two clinical manifestations, as well as a potential interdependence among them, should be considered in the future.
Science behind policy: Implementing a modern circumference-based body fat equation with a physical fitness threshold is associated with lower musculoskeletal injury risk
Authors: McClung Holly , Bartlett P. , Spiering Barry , Foulis Stephen , Oliver Tyler , Walker Leila , Nguyen Vy , Proctor Susan , McClung James , Taylor Kathryn
Published: May 2024

Background: Body composition influences physical fitness (PF) and risk of musculoskeletal injury (MSKI). Assessing the relationship between body fat (BF), PF and MSKI risk in a large diverse military population may provide evidence basis informing health-care policies, practices, and programs for military and civilian populations.
Objective: Evaluate validity of expedient methods to estimate BF (e.g., circumference-based equation (CBE) and bioelectrical impedance analysis (BIA)) and investigate relationships between BF and PF with MSKI risk in a large diverse population.
Methods: Participants were 1904 active-duty Soldiers (643 F) representing Army demographics sex, race/ethnicity (R/E) and age. PF, defined as most recent Army Combat Fitness Test (ACFT) score and incidence of MSKI were obtained from Army records. BF was determined by dual-energy x-ray absorptiometry (%BFDXA), bioelectrical impedance analysis (%BFBIA), and CBE using a 3-site (Hodgdon, %BFHE) and 1-site (Taylor-McClung, %BFTM) equations. Results were stratified by race and sex, to evaluate differences in accuracy of estimated %BF (weighted root mean squared error from %BFDXA). Associations of BF and PF with MSKI risk were evaluated with logistic regression.
Results: CBE and BIA underestimated %BF compared to %BFDXA. %BFBIA differed from %BFDXA overall and by sex. %BFTM underestimation was uniform across both sex and R/E compared to %BFDXA. Mean differences from %BFDXA by sex (M;F) were lower when measured by %BFTM (4.38; 4.59) compared to %BFHE (5.88; 4.39). Individuals had a greater likelihood of MSKI if they failed BF standards (odds ratio 1.32). Scoring ≥540 total on ACFT exhibited a 31% (95% CI: 0.52, 0.92) lower MSKI risk during the following 12 months than those with a lower score.
Conclusions: A single-site BF equation (%BFTM) maintained similar accuracy across the Soldier population by sex, age, and R/E. Implementing a PF score threshold in lieu of passing Army BF standards was associated with lower MSKI risk.
An Investigation of the Association between Parenting Style and Child’s Dental Caries
Authors: Ayoub Solafa , Finkelman Matthew D. , Swee Gerald J. , Hassan Mohammad , Loo Cheen Y.
Published: May 2024

To investigate the association between parenting style and child’s dental caries. Parents presenting with children for an initial exam or re-care appointment completed a demographic survey and the Parenting Styles and Dimensions Questionnaire. Child’s decayed, missing, and filled teeth (dmft) index, diet score, sex, and age were recorded, as were parent’s race, education level, and form of payment. Adjustment for confounders was done using multivariable negative binomial regression. The sample size was 210 parent/child dyads. In the multivariable analysis, parenting style and child’s dmft were not significantly associated (p > 0.05). Parents with an education level less than high school (p = 0.02) and at the high school graduate level (p = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the “needs improvement” category (p = 0.003). There was no significant evidence that parenting style is associated with child’s dental caries. Parent’s education level and child’s diet score were significantly associated with child’s dmft, less than high school (p = 0.02) and at the level of high school graduate (p = 0.008). Pediatric dental professionals should be aware of these risk indicators.
Exploring the challenges which influence General Dental Practitioners’ participation as Educational Supervisors in Dental Foundation Training in the Southwest of England.
Authors: Mills Ian , Matabdin Hesham , Rathbone Amy , Clarry Laura , Hanks Sally
Published: May 2024

Introduction
The NHS dental crisis is well documented and access to dental care continues to be a major issue for many patients. Recruitment and retention of dentists and the wider team have been identified as a key factor, particularly within rural and coastal communities. Availability and geographical location of Dental Foundation Training (DFT) placements is considered to be an important element in recruiting new dental graduates to poorly served areas. However, a recent decline in the number of dentists applying to act as Educational Supervisors (ES) for DFT has been observed, which has raised concerns over the impact this could have on recruitment and NHS dental access.
Aims
The study aimed to explore specific challenges faced by ESs that may act as influencing factors to participating in DFT in Southwest England.
Design
Cohort study of existing and previous ESs, using qualitative methodology.
Methods
ESs in the six schemes of the Southwest of England participated in semi structured one-to-one interviews to explore the challenges which they faced in their role as an ES for DFT. Data underwent inductive thematic analysis.
Results
Eighteen ESs were interviewed with the main challenges identified as increasing workload, financial, recruitment process, feeling valued and the ES application process.
Conclusion
An increasing number of challenges are undermining the positive benefits of being an ES. If these are not addressed this is likely to result in continuing difficulties in the recruitment and retention of ESs. Some of these challenges can be addressed at a regional or local level, but the factors related to funding, national recruitment and the increasing educational responsibility of the ES, need to be addressed at a national level.
Ultrasonic assessment of gastric solid contents in patients undergoing upper endoscope with sedation
Authors: Wang Jing , Yu Xuan , Wang Ying , Xu JieLei , Wang Zhao , Zhang Yi
Published: May 2024

Background: Perioperative reflux aspiration presents a grave concern during sedation or general anesthesia, particularly when solid gastric contents prompt acute upper respiratory obstruction, potentially resulting in fatal consequences for patients. Currently, there are limited means for promptly assessing solid gastric contents in clinical settings. Therefore, this study examined the efficacy of ultrasound assessment for solid gastric contents, offering a rapid and non-invasive approach for early detection and decision-making regarding interventions.
Methods: The study included 400 patients scheduled for upper endoscopy procedures, which encompassed both gastroscope and gastroscope combined colonoscopy examinations with sedation. Ultrasound scanning of the antrum was performed while patients were positioned semi-sitting or in the right lateral decubitus (RLD) posture. The evaluation of solid gastric contentsrelied on direct visual observation during endoscopy. Gastric volume measurement occurred subsequent to endoscopic suction of gastric contents. Receiver operating characteristic curves were utilized to assess the effectiveness of ultrasonography in discerning solid contents.
Result: Seven patients undergoing gastroscope with sedation were found to have solid gastric contents. The sensitivity, specificity, positive predictive value, and negative predictive value of the ultrasound qualitative evaluation of solid contents were 85.7%, 99%, 60%, and 99.7%, respectively.
Conclusion: Solid stomach contents can be evaluated qualitatively with reasonable accuracy using ultrasonography. Additionally, in patients undergoing upper endoscopy and assessed to have solid gastric contents with ultrasound, administration of mild sedation is recommended.
Trial registration: www.chictr.org.cn (ChiCTR2100048994); registered 19/07/2021
Prospective evaluation of a novel scoring system for managing foreign body ingestion in children
Authors: Miyamoto Ryosuke , Iwayama Hideyuki , Takahashi Sae , Honma Hitoshi , Masuda Yu , Ito Yoshinori , Okumura Akihisa
Published: May 2024

BACKGROUND: This study aimed to evaluate a recently developed scoring system for managing foreign body ingestion in children.
METHODS: We developed a foreign-body ingestion scoring system to help residents determine the appropriate course of actionin the emergency department. The assessment items included the patient's age, mood, and gastrointestinal symptoms, as well as the type, location, and size of the ingested foreign body. The pediatric patients were divided into three categories: observation at home (Class A), pediatrician consultation (Class B), and pediatrician consultation considering contrast-enhanced CT for possible gastrointestinal injury (Class C).
RESULTS: The treatment of 158 children was evaluated using the coring system, 79 of whom had confirmed foreign body ingestion. Class A resulted in a higher rate of follow-up, whereas the rate of invasive treatment increased significantly when rated as Class B or C. Few cases of unnecessary invasive treatment arose, and the recommendations suggested by the scoring system closely matched the results obtained using the reference management algorithm.
CONCLUSIONS: The novel scoring system will be useful to residents when considering the appropriate course of action to manage foreign body ingestion in pediatric patients.
Safety and efficacy of bariatric surgery in obesities class I vs. II in patients without diabetes: a matched control study from Tehran Obesity Treatment Study (TOTS)
Authors: Almasi Minoo Heidari , Barzin Maryam , Khalaj Alireza , Mahdavi Maryam , Valizadeh Majid , Hosseinpanah Farhad
Published: May 2024

Background
This study aimed to evaluate the 3-year outcomes of bariatric surgery in non-diabetic individuals with class I obesity.
Methods
A total of 84 participants with class I obesity and 84 patients with class II obesity, matched in terms of sex ratio (92.9% female), surgery type (92.9% sleeve gastrectomy), dyslipidemia, and hypertension were included in this prospective cohort study. Follow-up data consisting of metabolic, body composition, nutritional characteristics, and surgery complications were gathered at baseline, 6, 12, 24, and 36 months post-bariatric surgery. The micronutrient deficiency and comorbidities (hypertension, and dyslipidemia) were evaluated in both obesity groups by conditional logistic regression analysis. Clavien-Dindo classification was used for evaluating surgical complications.
Results
Baseline characteristics of both groups were similar (n = 84, mean age: 37.15 ± 8.9), and there were comparable results in weight loss, enhancement of cardiovascular risk factors, and remission of obesity-related comorbidities between class I and class II obesities three years following bariatric surgery (ΔTWL% and ΔEWL%, B (SE) were 1.69 (1.16) and 1.85 (4.37) with a P-value of 0.150 and 0.673, respectively). The occurrence of surgical complications and undesirable outcomes were also found to be similar between the two BMI classes.
Conclusion
Bariatric surgery is an effective and safe method in non-diabetic individuals with class I obesity as well as class II, to achieve weight loss, improve cardiovascular risk factors, and resolve obesity-related comorbidities.
The intersecting effects of race, wealth, and education on AIDS incidence, mortality, and case-fatality rate: a Brazilian cohort study of 28.3 million individuals
Authors: Lua Iracema , Magno Laio , Silva Andréa , Pinto Priscila , Bastos João Luiz , Jesus Gabriela , Coelho Ronaldo , Ichihara Maria , Barreto Mauricio , Santos Carlos Teles , Moucheraud Corrina , Gorbach Pamina , Macinko James , Souza Luis , Dourado Inês , Rasella Davide
Published: May 2024

The relationships between race, education, wealth, their intersections and AIDS morbidity/mortality were analyzed in retrospective cohort of 28.3 million individuals followed for 9 years (2007-2015). Together with several sensitivity analyses, a wide range of interactions on additive and multiplicative scales were estimated. Race, education, and wealth were each strongly associated with all of the AIDS-related outcomes, and the magnitude of the associations increased as intersections were included. A significantly higher risk of illness (aRR: 3.07, 95%CI:2.67-3.53) and death (aRR: 4.96, 95%CI:3.99-6.16) from AIDS was observed at the intersection of Black race, lower educational attainment, and less wealth. A higher case-fatality rate (aRR: 1.62, 95%CI:1.18-2.21) was also seen for the same intersectional group. Historically oppressed groups lying at the intersections of race, education, and wealth, had a considerably higher risk of illness and death from AIDS. AIDS-related interventions will require the implementation of comprehensive intersectoral policies that follow an intersectionality perspective.
Solution-Based Synthesis of Oxide-Free MoS2 Film: Exploring Interface Mechanisms
Authors: Alam Md Iftekharul , Sumichika Rikiya , Tsuchimotoi Junichi , Komeda Tadahiro , Teramoto Akinobu
Published: May 2024

We report a solution-based approach for the synthesis of oxidation-free MoS2 films, focusing on interface mechanisms. Through a sulfurization-free solution process and single-step annealing, the oxidation-free MoS2 film is successfully prepared on Si3N4 surfaces, showing improved uniformity with a surface roughness below 0.5 nm and a thickness of 4 nm at a precursor solution concentration of 30 mM, annealed between 700 and 800ºC. The MoS2 films exhibit a hexagonal lattice structure with crystallographic orientations of (1 1 0 0) and (1 2 1 0) with lattice spacings of 0.27 nm and 0.16 nm respectively. Interfacial analysis by X-ray photoelectron spectroscopy (XPS) on SiO2 reveals migration of oxygen species as evidenced by a shift in the Si 2p spectrum at binding energies between 102.6eV and 102.8eV. MoS2 films on Si3N4 show a complex Si 2p peak evolution at binding energies between 100.9 and 101.8 eV, providing valuable insights into the synthesis of oxide-free MoS2 films for potential applications in advanced electronic devices.
Temporal trends of blood-based markers in various mental disorders and their relationship with brain structure
Authors: Cheng Wei , Yujia Wang , Jia You , Yuzhu Li , Jujiao Kang , Yu Jintai , Jianfeng Feng , Linbo Wang
Published: May 2024

Background:
Studies have identified blood-based biomarkers for various mental disorders, but their temporal trends and relationship with brain structure remain unclear. This study aimed to assess the temporal trends of blood-based biomarkers across 10 years leading up to and following diagnosis and explore their association with brain structure.
Methods:
We conducted a nested case-control study using prospective community-based cohort data from UK Biobank (n = 502,617; aged 40 to 69 years; recruited from 2006 to 2010), which included both psychiatric assessments and blood-based biomarkers. Cases were defined as individuals with a diagnosis of mental disorders at baseline and during follow-up (individuals with bipolar disorder = 1,325; depression = 36,582; schizophrenia = 1,479; anxiety = 27,220). Nearly 5 controls without any mental disorders were matched for each case. Multivariable linear regression was used to assess the divergence evolution between cases and controls for each psychiatric assessment and blood-based biomarker.
Results:
In comparison to controls, 6, 15, 10, and 47 blood-based markers exhibited significant changes over time in bipolar disorder, anxiety, schizophrenia, and depression, respectively. These biomarkers could be grouped into distinct clusters with complex, non-linear temporal trends. Some clusters displayed monotonic changes, while others reversed near the time of diagnosis. The identified blood-based markers were associated with brain structure in the general population, including orbitofrontal, precuneus, and amygdala regions.
Conclusions:
These findings provide novel insights into the temporal trends of blood-based biomarkers in various mental disorders within 10 years before and after clinical diagnosis, as well as their correlations with brain structure. Monitoring and managing these biomarkers could potentially carry significant implications for the early detection and prevention of mental disorders in older adults.
The Genetic Risk Score with Variants at PDGFs and PDGFRB for the Risk of Major Cardiovascular Adverse Events in Patients with Coronary Artery Disease
Authors: Xu Xiaojuan , Li Wen , Liu Fangyuan , Chen Changying , Xie Hankun , Wang Feifan , Han Xu , Zhuang Qian , Zhao Xianghai , Sun Junxiang , Yin Yunjie , Wei Pengfei , Chen Yanchun , Shen Chong , Yang Song
Published: May 2024

Background
Previous studies linked platelet-derived growth factors (PDGFs) and its receptor beta (PDGFRB) genetic variants to coronary artery disease (CAD), but their impact on major adverse cardiovascular events (MACEs) remains unclear.
Methods
A cohort study of 3139 CAD patients, followed until December 1, 2022 (median 5.42 years), genotyped 13 tagSNPs in PDGFs/PDGFRB pathway genes to establish weighted genetic risk scores (wGRS). Adjusted Cox regression analyzed the association of SNPs and wGRS with MACE outcomes. The wGRS impact on traditional risk factors (TRFs) and Global Registry of Acute Coronary Events (GRACE) score for MACEs was assessed using the C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Multiple Cox regression examined coronary artery lesion counts and MACE occurrence in wGRS groups.
Results
The results showed that the A allele (vs G allele) of rs246390 was associated with an increased risk of MACEs (adjusted HR = 1.171, P = 0.013) and CVD (adjusted HR = 1.174, P = 0.036). Compared to low wGRSMACE (Q1 of quintile), high wGRSMACE (Q5 of quintile) had an increased risk of MACEs with adjusted HRs of 1.441 (P = 0.006). Additionally, patients with vessel lesions in medium wGRSCVD (Q2 ~ Q4) and high wGRSCVD (Q5) groups showed significantly higher CVD incidence than those with no vessel lesion and low wGRSCVD (Q1) levels, with adjusted HRs of 2.427 and 2.724 (P < 0.001) respectively.
Conclusions
Variants of the PDGF-PDGFRB pathway genes contribute to the risk of MACEs after CAD; the wGRS could serve as a risk predictor of MACEs in addition to TRFs.
Molecular characterization of ESBL and carbapenemase producing Uropathogenic Escherichia coli in hospitalized patients, Tehran, Iran
Authors: Mazandarani Mehdi Bozorgi , Kargar Mohammad , Kafilzadeh Farshid
Published: May 2024

Background Uropathogenic Escherichia coli (UPEC) with antibiotic resistance and virulence factors can cause urinary tract infections (UTIs). The aim of this survey was to evaluate the genetic characteristic of extended-spectrum beta-lactamases (ESBLs) and carbapenemase producing UPEC (CP-UPEC) isolates.Methods In this cross-sectional study, 300 UPEC isolates were collected from the urine samples of patients hospitalized between January 2019 and December 2020. The antibiotic susceptibility of the isolates was evaluated by disk diffusion method. The minimum inhibitory concentration (MIC) of meropenem and CAZ/AVI were determined by E-test, and that of colistin was determined by micro broth dilution method. Biofilm formation was assessed by microtiter plate assay. Antibiotic-resistant genes, virulence factors, phylogroups, and serogroups were detected by polymerase chain reaction (PCR) technique. The relationship between the isolates was evaluated by pulsed-field gel electrophoresis (PFGE) typing. Sequence type 131 (ST131) isolates were identified by PCR and confirmed by multilocus sequence typing.Results A total of 100 isolates were collected from UTI patients which 36% (n = 36) of isolates were ESBL producing E. coli (EP-E.coli). Among 36 EP-E.coli isolates, 14 (38.8%), 33.3% (n = 12), 25% (n = 9), and 16.6% (n = 6) were temocillin, carbapenem, CAZ/AVI, and colistin resistant. 33.5% (n = 11/36) of EP-E.coli were carbapnememase producing E.coli (CP-E.coli). Also, of these 36 isolates, 29 (80.5%) harbored blaCTX−M gene and 7 (19.4%) were detected to be ST131. In addition, blaOXA−48 and blaNDM carbapenemase genes existed in CP-E.coli isolates. Virulence genes were mostly fimH (97.2%; n = 35), iutA (86.1%; n = 31), and fuA (80.5%; n = 29). O1 (36.1%), and O25 (22.2%) were predominant serogroups. Phylogroup typing showed that 52.7% of isolates belonged to B2 phylogroup, and PFGE typing showed 32 singletons and 2 clusters.Conclusions Our findings revealed the high prevalence of antibiotic resistant in EP-E.coli isolates, likely due to the excess clinical use of antibiotics. In addition CP-E.coli isolates belonging to ST131-O25-B2 could carry blaNDM and blaOXA−48 genes and transferred between different ward of our hospital, since there are limited options to treat the infection caused by these isolates, surveillance is needed to control the spread of such multidrug-resistant strains of E. coli.
FRET analysis of unwrapping of nucleosomal DNA containing the sequence characteristic to the +1 nucleosome
Authors: Sunami Tomoko , Luo Di , Sato Shoko , Kato Junko , Yamanaka Miki , Akamatsu Ken , Kurumizaka Hitoshi , Kono Hidetoshi
Published: May 2024

Sequence-dependent mechanical properties of the DNA could play essential roles in nuclear processes by affecting the histone-DNA interactions. Previously, we found that the DNA entry site of the first nucleosomes from the transcription start site (+ 1 nucleosome) in budding yeast enriches AA/TT steps but not in the exit site, indicating the association with the gene activation. Because AA/TT is a rigid dinucleotide step, we considered that AA/TT causes DNA unwrapping. However, the MNase-Seq experiment with reconstituted nucleosomes left some doubt on the interpretation due to its high exonuclease activity. Furthermore, MNase cleavage could not provide direct evidence of the structural state. This study used Förster resonance energy transfer (FRET) measurement to investigate the salt-induced conformational change of the nucleosomal DNA containing AA/TT repeat at the entry site. We observed that the AA/TT region wrapped around the histone core was as likely as other DNA sequences under the physiological salt concentration. However, it unwrapped at a lower salt concentration, indicating weaker electrostatic interactions with the histone core. The ethidium-induced nucleosome disruption assay showed that the intercalator had more access to the DNA with AA/TT at the entry site. Taken together, we suggest that AA/TT at the entry sites induces DNA unwraping from the histone core in the promoter side, promoting transcription activation in response to the approach of the transcription-related proteins.
LFA-1 Knockout Leads to CD4 + and CD8 + T Cells Differentiation Disorder in Thymus Gland and is Related with ERK Signaling Pathway in Mice
Authors: 蒙 秀琼 , Huang Yiting , Kuang Yunxia , Ma Hongliang , Li Zhengyang , Zeng Ruyu , Chen Jugao , Li Jiangchao
Published: May 2024

T cell precursors from fetal liver bone marrow migrate into the thymus to initiate their development, including double-negative selection, double-positive selection, and single-positive selection. Subsequently, fully matured single-positive CD4+T cells or CD8+T cells traverse the bloodstream to the peripheral tissues, executing immune functions. Lymphocyte function-associated antigen-1 (LFA-1) is invovuled with thymic cortical epithelial cells facilitate positive selection. But LFA-1 mediates signaling pathways in thymic keep unknown. Here, Knockout LFA-1 displayed thymic atrophy and aberrant structural alterations in the cortical and medullary of the thymus in mice. And the cells populations of thymocytes during the positive and negative selection process was observed, characterized by CD4+T cells increased and CD8+T cells decreased. Furthermore, LFA-1 inhibitor also impact on thymic development. A significant downregulation of pERK1/2 in MAPK signaling pathway. The thymus gland medullary atrophy still was observed in LFA-1 knockout mice with tail vein tumor metastasis, along with CD4+T lymphocytes increased and a reduced CD8+T cells. The Genome Databases revealed that mutations in LFA-1 in clinical patients, suggesting that LFA-1 mutation individuals maybe affect the CD8+ T cells function. This study indicated that LFA-1 regulates the differentiation of CD4+T and CD8+T cells in the thymus, implying that LFA-1 mutation in health individuals may influence the tumor immunity or therapy when they get tumor.
Visual Engagement: Quantifying Campus Experiences in Urban Open Spaces Using a Computer Vision Model
Authors: Mohareb Nabil , Ashraf Abdelaziz
Published: May 2024

Introduction
Addressing the gap in quantitative analysis of spatial experiences within academic environments, this study introduces a groundbreaking framework designed to measure and quantify the visual experiences of individuals in academic campus settings. Focused on analyzing the visual composition of the built environment—including aspects such as visible sky, greenery, and spatial enclosure—our framework aims to provide a quantitative reflection of the subjective spatial experiences of campus users.
Methods
The methodology involves using mobile phones with digital cameras and GPS sensors to capture first-person visual data and track movements as they freely traverse campus open spaces. Computer vision techniques, including Instance segmentation and convolutional neural networks, will categorize architectural and natural elements within each frame image extracted from a recorded video, quantify proportional compositions and analyze relative amounts of greenery, open sky, walkways, buildings, and other built structures that participants visually experienced. The framework is translated into a Python model capable of producing quantitative outcomes.
The analysis will be further enriched by integrating Geographic Information Systems (GIS) for spatial analysis to identify navigation and visual engagement patterns. This comprehensive methodology quantifies the visual attributes of spaces and interprets their impact on the behavior and experiences of campus users.
Results and conclusions
The study outcomes reveal relationships between student’s navigation choices, visual experiences, and scene types. The results aim to guide urban designers in understanding university students’ open space needs based on their natural movement and viewing preferences and complement other qualitative approaches.
3D printed buttress augment combined with TM cups used in complicated revision hip arthroplasty
Authors: Sun Bo , Zhang Qian-Long , Li Ke-Wei , Wang Shao-Hua , Wang Jin-Liang
Published: May 2024

Objective: This paper introduces a new strategy for acetabular reconstruction, which involves implanting 3D printed Buttress augments and TM cups through double incisions to reconstruct Paprosky III type acetabular bone defects, and evaluates its clinical and radiological outcomes.
Methods: Between August 2019 and January 2022, 3D printed metal trabecular augments were used to reconstruct Paprosky III type acetabular bone defects in 9 cases of hip revision. The average time from initial replacement to revision was 15.8 years. The types of acetabular bone defects were Paprosky type ⅢA in 6 cases and Paprosky type ⅢB in 3 cases. Preoperative data, intraoperative information, treatment outcomes, complications, and imaging results were collected to evaluate the effectiveness and safety of this technique.
Results: The operation time ranged from 100-140 minutes, averaging 123 minutes; intraoperative bleeding volume was 700-1400 mL, with an average of 950 mL. The average follow-up period was 27 months (18-34 months). At the last follow-up, the Harris score of the hip joint was 78.55 ± 6.49 points, significantly higher than the preoperative score of 36.22 ± 5.69 points (p=0.00); the VAS score for pain was 1.77 ± 0.91 points, significantly lower than the preoperative score of 6.55 ± 1.34 points (p=0.00). The difference in length between the two lower limbs was 0.77 ± 0.24 cm, significantly reduced from the preoperative measurement of 2.97 ± 0.24 cm (p=0.00). The height and horizontal position of the rotation center of the affected hip were 2.16 ± 0.33 cm and 3.24 ± 0.30 cm, respectively, showing significant differences compared to preoperative measurements of 4.28 ± 0.28 cm and 3.62 ± 0.48 cm (p< 0.05); no complications such as prosthesis loosening, dislocation, periprosthetic fractures, or nerve injuries occurred during the follow-up.
Conclusion: In hip revision, 3D printed buttress augments can repair Paprosky type III acetabular defects, provide personalized matching of acetabular bone defects, reconstruct the relatively normal rotation center of the hip joint, and optimize and simplify surgical procedures. The short-term clinical effect is satisfactory, and the long-term effectiveness requires further follow-up.
High-Turbulence Fine Particle Flotation Cell Optimization and Verification
Authors: Xu QianDe , Hu Wentao , Zhang Ming
Published: May 2024

Microfine mineral particles have a small size, light weight, and low inertia, making it difficult for them to deviate from streamlines and collide with bubbles. Conventional flotation operations consume a large amount of reagents and exhibit poor flotation indicators. This study employs computational fluid dynamics (CFD) simulation and hydrodynamic testing to investigate the flow field within a high-turbulence microfine particle flotation machine equipped with a multilayer impeller–stator configuration, and validates the practical application performance of the microfine particle flotation machine through single-batch flotation experiments. Result shows that the impeller region of the traditional mechanical stirring flotation machine has a turbulent energy dissipation rate of 20 m²/s³, whereas that for the microfine particle flotation machine averages over 120 m²/s³. In the flotation verification, the cumulative recovery rate of the fine particle flotation machine is increased by 28% compared with that of the traditional KYF flotation machine. The flotation rate is also 1.3 times that of the KYF, demonstrating stronger selectivity for fine particle concentrates. It has certain guiding significance for the resource utilization of fine particle minerals.
Formulation, characterization, and in vitro antifungal efficacy of luliconazole-loaded nanostructured lipid carriers (LCZ-NLCs) against a panel of resistant fungal strains
Authors: Nosratabadi Mohsen , Barogh Robab Ebrahimi , Rahimnia Seyyed Mobin , Ebrahimnejad Pedram , Haghani Iman , Akhtari Javad , Hajheydari Zohreh , Abastabar Mahdi
Published: May 2024

Luliconazole (LCZ) is a topical imidazole antifungal agent with broad-spectrum activity. However, LCZ faces challenges like low aqueous solubility, skin retention, and penetration, limiting its dermal bioavailability and effectiveness in drug delivery. This study aims to formulate, characterize, and assess the in vitro antifungal efficacy of luliconazole-loaded nanostructured lipid carriers (LCZ-NLCs) against resistant fungal strains. The LCZ-NLCs were synthesized using a modified emulsification-solvent evaporation method. Characterization included poly-dispersity index (PDI), zeta potential, entrapment efficiency (EE %), Field Emission Scanning Electron Microscopy (FESEM), Differential Scanning Calorimetry (DSC) analysis, and Attenuated Total Reflectance Fourier Transform Infrared (ATR-FTIR) study. Additionally, in vitro drug release experiments, kinetic analysis of release data, cytotoxicity assays, and in vitro antifungal susceptibility tests were conducted. The results revealed that LCZ-NLCs exhibited nanoscale dimensions, uniform dispersion, and a favorable zeta potential. The encapsulation efficiency of LCZ in NLCs was around 90%. FESEM analysis showed spherical nanoparticles with consistent shape. ATR-FTIR analysis indicated no chemical interaction between LCZ and excipients. In vitro drug release experiments suggested that LCZ-NLCs significantly improved the drug's dissolution rate. Stability testing also showed consistent colloidal nanometer ranges in LCZ-NLCs samples. Also, cytotoxicity tests showed no toxicity within the tested concentration. Furthermore, in vitro antifungal susceptibility tests demonstrated potent antifungal activity of both LCZ and LCZ-NLCs against resistant fungal isolates. The study findings suggest that the LCZ-NLCs formulation developed in this research could be a promising topical treatment for superficial fungal infections, especially in cases of resistant infections.
Relationship between intraocular pressure-lowering effects and alterations in scleral birefringence following micropulse cyclophotocoagulation
Authors: Nemoto Hotaka , Honjo Megumi , Okamoto Michiaki , Tominaga Sou , Yamanari Masahiro , Aoyama Yurika , Arai Takahiro , Ishiyama Yukako , Sugimoto Koichiro , Sakata Rei , Saito Hitomi , Fujishiro Takashi , Aihara Makoto
Published: May 2024

To examine the changes in scleral birefringence, a marker of collagen-related fibrotic responses, following micropulse cyclophotocoagulation (MP-CPC) using polarization-sensitive optical coherence tomography, we conducted a prospective observational study involving 18 eyes of 16 glaucoma patients who underwent MP-CPC. The procedure employed a Cyclo G6 glaucoma laser system (IRIDEX, Mountain View, CA, USA) with laser power set at 2,500 mW and an 80-second duration per hemisphere. Over 6 months, we evaluated clinical outcomes and scleral birefringence, correlating them with intraocular pressure (IOP) reduction. Post-MP-CPC, IOP significantly decreased, while birefringence notably increased at 1 and 3 months compared to pre-treatment levels (pretreatment: 1.00 ± 0.08, 1 week: 1.20 ± 0.11, 1 month: 1.27 ± 0.06, 3 months: 1.42 ± 0.07, and 6 months: 1.26 ± 0.15). This elevation suggests collagen remodeling in the sclera post-laser therapy. Notably, a positive correlation was observed between IOP reduction rate and birefringence increase at 3 and 6 months post-procedure. Our findings indicate a substantial rise in scleral birefringence following MP-CPC, positively associated with IOP reduction. These results shed light on a potential mechanism for IOP reduction and underscore the clinical significance of birefringence assessment in MP-CPC.
Identification of Critical Paths for Medicare fraud -- Configuration Analysis Based on Fraud Triangle Theory
Authors: Wang Mei
Published: May 2024

Purpose The primary objective of this study is to address the urgent need to eliminate medical insurance fraud in the regulation of healthcare funds. Given the increasingly complex nature of fraud perpetrators, their methods, and the underlying motives, the supervision of medical insurance funds faces significant challenges.Methods To achieve this objective, we adopt a multi-faceted approach. Firstly, we draw upon the fraud triangle theory and insurance contract-related theories to establish an analytical framework. Secondly, we employ fuzzy-set qualitative comparative analysis (fs/QCA) to conduct a configurational analysis of medical insurance fraud cases from 31 provinces (including municipalities and autonomous regions) published by China's National Medical Insurance Administration.Results Our analysis reveals three primary pathways of medical insurance fraud: the "triangle-supported" type,the "pressure-driven" type, and the "opportunity-exploiting" type. Notably, the "pressure-driven" type emerges as the most prominent fraud pathway in China. Furthermore, private institutions are identified as high-risk areas for fraudulent activities compared to other entities.Conclusion In conclusion, this study offers valuable insights into the diverse and evolving nature of medical insurance fraud in China. By leveraging the fraud triangle theory and fs/QCA, we identify key fraud pathways and highlight the significant role of private institutions in perpetrating these fraudulent acts. The findings inform targeted strategies to strengthen the regulation of medical insurance funds and mitigate the risks associated with fraud.
Bridging the gap: examining circadian biology and fatigue alongside work schedules
Authors: Fedele Malena Mul , Casiraghi Leandro , Plano Santiago A. , Bellone Giannina , Golombek Diego A. , Vigo Daniel E.
Published: May 2024

The socio-cultural, industrial, and business demands of our current society require us to be active 24 hours a day, 7 days a week. This phenomenon implies working conditions that lead employees to perform their tasks in rotating shifts, during nighttime hours, and for extended shifts, thereby disrupting their biological rhythms, most fundamentally their sleep patterns. There is a need for naturalistic studies to evaluate the relationship between the specific design of work shifts and the actual amount of achievedsleep. To achieve this goal, we conducted a comprehensive study involving employees of the logistic chain of an oil company in Argentina. We compared three different types of work schedules that encompassed extended and rotating shifts work: 1) one in which workers completed two days of 12 h of daytime shifts followed by two consecutive 12 h night shifts, followed by four work-free days(“2x2x4x4x4” schedule), 2) one in which workers alternated four consecutive 12 h daytime shifts and four consecutive 12 h night shifts, flanked by four work-free days (“4x4x4” schedule), 3) and another, non-rotating, schedule involving continuous 12 h daytime shifts during 40 days, with no work-free days in between (“fixed 12h” schedule). Our study employed objective measurements such as wrist-actigraphy to record sleep patterns, temperature loggers to monitor peripheral temperature rhythms, as well as subjective self-reports regarding fatigue, somnolence, and psycho-affective features. In all cases, the duration of sleep during the resting period was significantly less than the recommended 7 hours of nocturnal sleep. The “2x2x4”schedule resulted in decreased sleep regularity and increased circadian disruption, associated with more nocturnal sleep time after diurnal work. Also, this shift exhibited higher levels of insomnia, increased fatigue impact, lower alertness levels, and heightened symptoms of depression. Our findings indicate that specific parameters vary depending on the type of schedule worked suggesting that, in practical terms, certain schedules are healthier and safer for these workers. These results provide valuable insights for the design of safer and healthier work schedules, with the potential to enhance worker well-being and overall productivity.
Efficient conversion of glutamic acid to healthy protein like thiomide with lycopene as catalyst using catalytic transfer sulfurization process
Authors: Ramesh Martha , Nagaraju Ravoori , kumar A Santhosh , Rao Venkateswara , reddy P Ramana
Published: May 2024

This paper describes a simple one-step catalytic transfer sulfurization technique that may be used to synthesize glutamic thiamides with the aid of lycopene. First, lycopene is made from fresh tomatoes using a solvent extraction technique, and it is then utilized to make the glutamic thiomides. Glutamic thiamide particles are characterized by Raman, FTIR, XRD, SEM and EDS. The lycopene acted as a catalyst for sulfurizing of glutamic acid in H2S atmosphere. According to Image J analysis, the average size of the glutamic thiomide enclosed by lycopene is estimated to be in the range of 30 nm - 10 nm, respectively. When lycopene or H2S are heated to 100°C for 45 min, lycopene shows 81.9 % catalytic activity in the conversion of glutamic acid to glutamic thiomide, and 89.2% with selectivity. Lycopene alone demonstrates 35.68% catalytic activity in the conversion of glutamic acid to glutamic thiomide with ethanol for the reaction time 15min. Moreover, lycopene-100 is stable and exhibits high catalytic efficiency in the decomposition of glutamic acids using various polar solvents.