bluuebunny/crossref_metadata_2025 huggingface dataset:
User Profiles and Perceptions for Predicting Acceptance with Fairness Assessment in Border Control Technologies
Authors: Shaikh Sarang , Yayilgan Sule Yildirim , Zoto Erjon , Abomhara Mohamed
Published: December 2024

In 2013, European border crossing points (BCPs) introduced border control technologies (BCTs) aimed at improving efficiency and security. However, these technologies face challenges in user adoption and acceptance, often due to limited traveler awareness and support at BCPs. Traditional models like the technology acceptance model (TAM) rely on structured data and struggle with complex, non-linear relationships, limiting their effectiveness in predicting technology acceptance. Recent advancements in machine learning offer enhanced accuracy for predicting technology acceptance by leveraging unstructured, large-scale data from sources like online social networks (OSNs) or questionnaires. Existing studies have focused primarily on individual attributes like age and gender, with limited attention to how these attributes interact with user perceptions. Despite these advancements, research on technology acceptance prediction for BCTs remains limited, particularly in integrating user profile attributes and perceptions and also no comprehensive relevant dataset exists for this purpose. This study addresses this gap by using an automated approach for developing technology acceptance score dataset that combines user profiles and perception attributes along with investigating how the integration of these attributes impact prediction accuracy and assess its fairness by considering bias and explainable AI (XAI) in the developed models. Our results indicate that this integrated approach significantly enhances the prediction of technology acceptance, with TabTransformer model achieving the highest accuracy of 76%. This study not only contributes to the existing research domain of technology acceptance prediction but also opens new directions for future research into technology acceptance for BCTs as well as for other types of technologies.
A randomized controlled trial of the Transdiagnostic Intervention for Sleep and Circadian dysfunction implemented via facilitation and delivered by community mental health providers: Improving the “fit” of psychological treatments by adapting to context
Authors: Harvey Allison G. , Agnew Emma R. , Hache Rafael Esteva , Spencer Julia M. , Diaz Marlen , Patino Estephania Ovalle , Milner Anne , Dong Lu , Kilbourne Amy M , Buysse Daniel J. , Callaway Catherine A. , Sarfan Laurel D.
Published: December 2024

Background. To determine if the use of theory, data and end-user perspectives to guide an adaptation of the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) yields better outcomes and improves the “fit” of TranS-C to community mental health centers (CMHCs), relative to the standard version.
Methods. Ten counties in California were cluster-randomized by county to Adapted or Standard TranS-C. Within each county, adults who exhibited sleep and circadian dysfunction and serious mental illness (SMI) were randomized to immediate TranS-C or Usual Care followed by Delayed Treatment with TranS-C (UC-DT). Facilitation was the implementation strategy. The participants were 93 CMHC providers who delivered TranS-C (Standard = 30; Adapted = 63) and 396 CMHC patients (Standard = 74; Adapted = 124; UC-DT = 198). Patient assessments were completed at pre-treatment, post-treatment, and six months after treatment (6FU). Provider assessments were completed at post-training, mid-treatment, and post-treatment.
Results. TranS-C (combining Adapted and Standard), relative to UC-DT before delayed treatment with TranS-C, was associated with improvement from pre- to post-treatment in sleep disturbance (b = -10.91, p < 0.001, d = -1.52), sleep-related impairment (b = -9.52, p < 0.001, d = -1.06), sleep health composite (b = 1.63, p < 0.001, d = 0.95), psychiatric symptoms (b = -6.72, p < 0.001, d = -0.52), and overall functional impairment (b = -5.12, p < 0.001, d = -0.71). TranS-C’s benefits for functional impairment and psychiatric symptoms were mediated by improvements in sleep and circadian problems. Adapted versus Standard TranS-C did not differ on provider ratings of fit and better fit did not mediate the relation between TranS-C condition and patient outcome.
Conclusions. TranS-C can be delivered by CMHC providers. Although Adapted and Standard TranS-C both fit the CMHC context, several advantages emerged for the adapted version.
Trial registration: Clinicaltrials.gov identifier: NCT04154631. Registered on November 6, 2019. https://clinicaltrials.gov/ct2/show/NCT04154631
Superiority of Suture Endobutton Augmentation in Type 2b Clavicle Fractures Fixation Using Locking Plate
Authors: Yağar Hilal , Çağlar Ceyhun , Asfuroğlu Zeynel Mert , Aydın Murat
Published: December 2024

Objective: Instability in distal clavicle fractures with impaired integrity of the CC ligament poses a serious risk for nonunion, necessitating surgical intervention. Despitea consensus onthe need for surgery in cases of unstable distal clavicle fractures, various surgical techniques are available. Aim of this study is to evaluate the radiological and functional outcomes of CC augmentation using the suture endobutton technique for Neer type 2b clavicle fractures.
Methods: 42 patients who met the criteria for this retrospective study divided into two groups; Group 1 (locking plate with CC augmentation) and Group 2 (locking plate without CC augmentation). Demographic data, the Constant–Murley scores(CS), union time, range of motion, complications, and implant failures during the follow-up period were recorded.
Results: 13 (31.0%) patients were female and 29 (69.0%) were male.The mean age was 40.5±11.5 years. Significant differences were found in union time (week) (t(40) = –2.11, p = 0.04) and the 6th-month CS (t(40) = 4.19, P = 0.01). No significant difference was observed in postoperative complications between the groups (p > 0.05).
Conclusion: CC augmentation with a suture endobutton in type 2b distal clavicle fractures, resulted in more favorable short-term functional and radiological outcomes.
Level of Evidence: Level 3; Retrospective comparative study; Treatment study
Molecular detection and genotyping of bovine viral diarrhea virus in four provinces of China
Authors: Liu Ying , Zhou Feng , Wang Xuan-ang , Chen Xi-Meng , Zheng Lan-Lan , Chen Hong-Ying , Ma Shi-Jie
Published: December 2024

Bovine viral diarrhea virus (BVDV) has long been one of the major pathogens hindering the development of the global beef industry. In the present study, to further investigate the epidemic profile and genetic diversity of the virus, 77 fecal samples were collected from cattle with diarrhea in Henan, Sichuan, Shandong and Hebei provinces of China during 2023–2024 and screened for the presence of BVDV using reverse transcription-polymerase chain reaction (RT-PCR). The positive samples for BVDV were subjected to the cloning and phylogenetic analysis of the 5ʹ-UTR and whole-genome sequences. The results showed that 35 out of 77 (35/77, 45.45%) bovine diarrhea samples tested positive for BVDV, with the highest proportion rate being observed in Henan province at 57.14% (20/35). Twenty 5ʹ-UTR and one whole-genome sequences of BVDV strains were acquired and analyzed. Phylogenetic analysis of the 5ʹ-UTR sequences indicated that 20 strains belonged to the BVDV-1m subtype, while the BVDV-385 strain from Henan province was clustered within the BVDV-3 genotype, indicating that the BVDV-1m subtype strains were the main strains circulating in China. Further amino acid analysis showed that a unique aa deletion and ten unique aa substitutions were exhibited in the E2 protein of the BVDV-385 strain, while seven unique aa sites in the NS5B protein. Furthermore, linear B cell epitope prediction indicated that four linear B cell potential epitopes were altered in the E2 protein, while predictions of N-glycosylation sites (NGS) revealed an additional glycosylation site (574 NPS) in the NS5B protein. Overall, this study reported the BVDV-3 strain was found in Henan Province, China, and performed a genetic evolutionary analysis of its whole genome sequence, which had important implications for understanding the genetic diversity of ongoing BVDV cases
Estimating cell compositions and cell-type-specific expressions from GWAS data using invariant causal prediction, deep learning and regularized matrix completion: Bridging GWAS and single-cell resolution in Biobank-scale studies
Authors: So Hon-Cheong , Yin Liangying , SHI YUJIA , Zhang Ruoyu , XIANG Yong , Qiu Jinghong , Sham Pak
Published: December 2024

Dissecting large bulk RNA-seq data into cell-type proportions and cell-type-specific expression profiles has the potential to significantly enhance our understanding of disease mechanisms at the cellular level. While single-cell RNA sequencing provides detailed cellular insights, its application is limited by small sample sizes and cost constraints. Conversely, large-scale GWAS datasets offer extensive sample sizes but lack cell-type resolution. We present CausalCellInfer, a framework that integrates invariant causal prediction, deep learning and regularized matrix completion to identify critical cell markers, deconvolute cell proportions and estimate cell-type-specific(CTS) expression profiles. We pioneered the application of the proposed framework to imputed expression data from large-scale genome-wide association studies (GWAS), enabling cell-type level analysis in biobank-scale datasets. We validated CausalCellInfer against state-of-the-arts methods like CIBERSORTx, DWLS, Scaden, and MuSic using real and pseudo-bulk samples. Our framework consistently outperformed others with significantly higher concordance correlation coefficient (CCC), lower mean absolute error (MAE) and root mean square error (RMSE) while demonstrating superior computational efficiency. Application to the UK Biobank revealed novel biological insights across 24 phenotypes. We deconvoluted tissue-specific cell proportions and estimated CTS profiles across the phenotypes. We revealed that cell-type proportions were associated with disease susceptibility, such as decreased alpha and beta cells in T2DM patients. Furthermore, CausalCellInfer achieved high positive predictive values in identifying cell-type-specific differentially expressed genes. Overall, CausalCellInfer represents a significant advancement in integrating single-cell resolution with biobank-scale data and comprehensive clinical phenotypes, providing a powerful tool for elucidating disease mechanisms at the cellular level.
Synthesis of Nanostructured Cubic Phase SnO2 Thin Film and Its Trace-Level Sensing of CO Gas
Authors: Karuppannan Ramesh , Sharma Keshav , Sharma Deepak , Bukhvalov Danil , Khandelwal Upanya , Nukala Pavan , Bhat Navakanta
Published: December 2024

In this study, we report the fabrication of a cubic phase SnO2 based thin film gas sensor with excellent sensitivity and selectivity for carbon monoxide (CO) gas at room temperature, with a high response of 25606% achieved at 2 ppm CO gas concentration, and a detection limit down to 1ppb. The cubic phase SnO2 thin films were synthesized via a simple sol-gel method. Our synthesis technique allows for stabilizing the cubic phase of SnO2, confirmed through XRD and TEM studies, which is otherwise reported at high pressures and temperatures. Further, our DFT simulations show that the cubic phase of SnO2 nanoparticles has a lower energy barrier for CO adsorption and desorption than the more common tetragonal phase. The low-voltage and ambient operating conditions of the sensor reported in this study make it highly practical for widespread use, thus offering a promising solution to the growing need for efficient and affordable gas sensing applications, including environmental monitoring, industrial safety, and medical diagnosis.
Development and Evaluation of a CDSS-Enabled Early Warning System for Venous Thromboembolism Risk in Advanced Lung Cancer Patients
Authors: Fan Jian , Gao Bai , Zhao Jiayi , Gao Xuefeng , Liu Baiqiu , Huang Kai , Shang Yan , Han Yiping
Published: December 2024

BACKGROUNDː This study establishes the clinical practice library of Venous Thromboembolism (VTE) complications in advanced lung cancer, forms a VTE risk warning system for advanced lung cancer patients based on the Clinical Decision Support System (CDSS) and plan to use it in hospitals in the future, and plays a role in preventing VTE complications in advanced lung cancer patients. METHODSː We summarized the VTE risk factors by searching the literature and constructed a knowledge base of advanced lung cancer complication VTE risk factors based on evidence-based medicine; collected real-world clinical data on lung cancer patients and constructed a real-world best-practice library of advanced lung cancer complication VTE by cleaning, quality control and analyzing clinical data; and constructed an equation for the prediction risk coefficient of advanced lung cancer complication VTE by logistic regression analysis. Finally, the three were combined to construct a CDSS-based VTE risk warning system for advanced lung cancer patients. Statistical analysis was performed using R software, with a test level of α = 0.05, and the difference was considered statistically significant at P < 0.05. RESULTS: A total of 12,222 patients were screened through the hospital's electronic medical record system, and 3,320 patients were included after screening in strict accordance with the exclusion criteria. The patients were divided into 67 cases in the group of lung cancer complicating VTE and 3253 cases in the group of uncomplicated VTE. According to the stepwise regression method and the AIC law, the equation of the predicted risk coefficient of advanced lung cancer complicating VTE was constructed. Combining the three basic factor modules of advanced lung cancer complicating VTE and the CDSS system, a CDSS-based risk warning system for advanced lung cancer complicating VTE was established, and the externally validated results showed that the AUC of 0.756 (95% CI: 0.726–0.785) was better than that of the Caprini risk scoring scale AUC of 0.654 (95% CI: 0.638–0.670). CONCLUSIONSː This study established a CDSS-based early warning system for the risk of concurrent VTE in advanced lung cancer. The results of comparative validation showed that this early warning system can improve the clinical diagnosis and treatment efficiency of advanced lung cancer patients with complications of VTE, and at the same time, it can achieve the purpose of real-time monitoring and timely diagnosis and treatment.
Fullerene-Decorated PdCo Nano-Resistor Network Hydrogen Sensors: Sub-Second Response and Part-per-Trillion Detection at Room Temperature
Authors: Ngo Tu Anh , Magar Ashwin , Pham Minh , Luong Hoang , Larsen George , Zhao Yiping , Nguyen Tho
Published: December 2024

We present a novel hydrogen (H2) sensor based on a hexagonal PdCo composite nano-resistance network, featuring an innovative layered nanostructure and advanced materials. This state-of-the-art PdCo network is deposited on a thin layer of nanoporous fullerene C60-coated glass substrate using a combination of nanosphere lithography and the glancing angle codeposition (GLACD) technique, which significantly enhances the quality, morphology, and surface-to-volume ratio of the PdCo sensing elements to their full potential. Remarkably, this approach not only simultaneously improves the sensor's response time and sensitivity but also effectively mitigates the clamping effect. Our results demonstrate that the sensor, composed of a 20 nm C60/5 nm Pd63Co37/30 nm Teflon AF composite hole array, achieves a response time (t90) of ≤ 0.8 seconds across the 1 – 100 mbar H2 pressure range, with a limit of detection (LOD) of 40 parts per billion (ppb). Remarkably, when the Pd63Co37 sensing layer is sandwiched by two TAF layers, the t90 and LOD reach 0.36 s at 1 mbar H2 and ~100 parts per trillion (ppt) H2, respectively. Additionally, when coated with an additional layer of Poly(methyl methacrylate) (PMMA), the sensor maintains robustness over hundreds of hydrogen cycling and aging effects and remains resilient against interference from gases such as CO2, CH4, and CO, as well as up to 90% relative humidity (RH). This low-cost, lightweight, and low-power hydrogen sensor platform holds significant potential to meet the stringent sensing requirements for automotive applications, concentration control, and environmental monitoring.
GHQ-12 score as a determinant for Postpartum depression: evidence from a tertiary care centre in Bhubaneswar, India
Authors: Patnaik Liwa , Kar Sonali , Mishra Alpana , Panda Jyochnamayi
Published: December 2024

Background
Odisha, a state in Eastern India, has made laudable progress in delivering MCH care through robust comprehensive obstetric care, and reduction of maternal deaths by 60–70% as per NFHS-5. However, the mental health component is under-represented in India, even in urban areas. Postpartum depression (PPD) in women can be scored by the validated tool Edinburgh postnatal depression scale (EPDS) and overall mental state at any time of adulthood is evaluated using General Health Questionnaire (GHQ)-12 scores.
Objectives
To assess the association of GHQ-12 score with EPDS score among the postpartum women soon after delivery and to determine variations in associations between the two scores at 2 points of assessment.
Methods
Women who gave birth, within 24–48 hours were selected as per convenient sampling, after taking consent. Questionnaire was used that elicited information on socio-demographic details. GHQ-12 scores were used as independent variable and a proxy measure of cumulative distress and familial stress. Validated tool EPDS was used on the subjects and scores calculated for PPD. Same tools were repeated on 2nd visit timed within 6–8 weeks of delivery. Scores were checked for correlation using Pearson’s r.
Results
Total 176 women participated and completed 2nd assessment. Prevalence of PPD was 10.8% as per EPDS. PPD burden increased in 2nd visit but the mean scores decreased. Similarly, psychological stress indicated by GHQ-12 scores increased in 2nd visit, although the mean scores decreased by 6–8 weeks postpartum. Both the time, GHQ 12 and EPDS scores show strong positive correlation (r = 0.69), that increased in 2nd visit (r = 0.74).
Conclusion
This indicates that robust healthcare services alone doesn’t address the holistic health of reproductive women. Psychological stress is a determinant of postpartum depression. PPD in this case among women increases within 6–8 weeks of delivery and hence a continuum of care is warranted to address PPD, which calls for screening of women for PPD and subsequently counselling them.
Efficacy of computer-aided design and computer-aided manufacturing-based braces for adolescent idiopathic scoliosis: a systematic evaluation and meta-analysis
Authors: Shen Xiaogang , Zhang Dailiang , Yuan Fei , Peng Qian , Lv Chunjiang , Qi Hongzhe , Zhao Mengyan , Chen Gongzhen , Ye Hao , Gao Gan , Guo Tao
Published: December 2024

Background
Adolescent idiopathic scoliosis (AIS) is commonly treated conservatively, with computer-aided design and manufacturing (CAD/CAM) emerging as a modern approach. The superiority of CAD/CAM braces over traditional hand-made orthotics remains unestablished, prompting an investigation into their comparative efficacy.
Objective
To systematically review and meta-analyze the available evidence on the effectiveness of CAD/CAM braces for AIS, incorporating biomechanical analysis, finite element analysis, or 3D printing.
Methods
A systematic search was conducted in PubMed, Web of Science (WOS), Embase, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang, VIP, and China Biology Medicine disc (CBM) databases through April 1, 2024. The search targeted randomized controlled trials (RCTs) and randomized controlled crossover trials (RCT-CTs). Eligible studies were assessed for quality, and data were extracted for meta-analysis.
Results
The initial search identified 13 trials involving 539 participants (1629 individual data points). After applying inclusion criteria, 11 trials with 469 participants (1424 individual data points) were included in the meta-analysis. The results indicated that CAD/CAM braces provided only marginally better or equivalent outcomes compared to traditional braces. The therapeutic advantages of CAD/CAM methods were not conclusively demonstrated by the current evidence.
Conclusion
The evidence base for the superiority of CAD/CAM braces in AIS treatment is insufficient. Future research with larger sample sizes and higher methodological quality is essential to enhance the evidence-based approach to medical practice in this field.
Toward an Effective Back Pain Prevention Program: A Qualitative Exploration of Employees' and Healthcare Professionals' Experiences and Perspectives
Authors: Bernaers Lisa , Willems Tine Marieke , Lam Hien Gia , Mahy Morgane , Rusu Dorina , Demoulin Christophe , de Velde Dominique Van , Braeckman Lutgart
Published: December 2024

Background
This study explored the experiences and perspectives of employees and healthcare professionals (HCPs) regarding a Belgian multidisciplinary-based rehabilitation (MBR) program for the secondary prevention of low back pain (LBP). The program, which is partially reimbursed by the Federal Agency for Occupational Risks, aims to prevent chronic LBP and facilitate return to work (RTW) for employees in ergonomically demanding jobs.
Methods
A qualitative design involving six multicenter, semistructured focus groups was employed. The participants included 15 employees who attended the program and 24 HCPs involved in its delivery. The data were analyzed via thematic analysis.
Results
Three major themes were identified: functional and work-related outcomes, content-related factors, and the program's duration and continuation. Positive outcomes included improvements in pain, function, and RTW, with workplace adaptations and ergonomic guidance playing key roles. Success factors such as education, exercise therapy, motivation, and social interaction were highlighted. However, challenges were identified, including difficulty maintaining long-term benefits, limited communication between centers and employers, insufficient psychological support, and a lack of follow-up to sustain the program’s effects.
Conclusions
As part of a broader initiative evaluating this program, this study highlights its strengths and identifies areas for improvement, offering a foundation for future research and enhanced rehabilitation strategies.
Predictive Modeling of Multidrug Resistance in Female Urinary Tract Infections: Implications for Clinical Management
Authors: Ihenetu Francis Chukwuebuka , Okoro Chinyere I. , Okechukwu Emeka , Ozoude Makuochukwu Maryann , Marwizi Farirai Melania
Published: December 2024

Background: Multidrug-resistant (MDR) organisms pose a significant challenge in the effective treatment of urinary tract infections (UTIs).
Method: This study investigated the prevalence of MDR organisms and clinical predictors of UTIs in 824 high vaginal swab (HVS) specimens collected from female patients aged 0–79 years with suspected UTIs over a four-year period. Data on age and clinical signs were gathered using structured questionnaires, and specimens underwent analysis through culture-based techniques and molecular methods, including PCR, to identify bacterial and fungal pathogens.
Results: Most specimens were from young adults (ages 20–39, 75%), with fewer from older adults and elderly patients (3.3% combined). Inflammatory symptoms (51.3%) were the most common presentation, followed by vaginal discharge (21.2%) and obstetric-related issues (11.5%). MDR organisms were identified in 21.8% of cases, while non-MDR organisms accounted for 79.2%. Pathogen isolation occurred in 83.4% of specimens, with Candida albicans (27.1%) and Staphylococcus aureus (26.7%) as the most prevalent isolates. Logistic regression analysis revealed a statistically significant reduction in MDR likelihood for patients with cysts and tumors (odds ratio = 0.92, p = 0.046). Enterococcus faecalis exhibited the highest MDR rate (40%), and Escherichia coli was significantly associated with MDR status (B = 3.220, p < 0.001). Chi-square tests found no significant associations between MDR status and patient age (χ² = 2.825, p = 0.985) (χ² = 1.964, p = 0.962). Evaluation of the predictive model revealed moderate explanatory power (Cox & Snell R² = 0.151, Nagelkerke R² = 0.233), acceptable discriminatory ability (AUC = 0.753, p < 0.001), and good overall fit (Hosmer-Lemeshow test, χ² = 2.506, p = 0.961). However, the model displayed low sensitivity for MDR classification (2.8%) and convergence issues.
Conclusion: These findings highlight the need for enhanced antimicrobial resistance (AMR) surveillance and updated clinical guidelines to improve UTI management and combat the growing AMR challenge. Further research should refine predictive models to better inform clinical decision-making.
The key celltype mediated by type I interferon-stimulated genes in systemic lupus erythematosus revealed by single-cell and bulk RNA- seq analysis
Authors: Huang Yuting , Ji Juan , Wei Yanan , Wang Yunan , Xu Yongxin , Yang Nengjie , Gu Zhifeng , Xia Yunfei , Yang Mei
Published: December 2024

Background
Systemic lupus erythematosus (SLE) is a complex autoimmune disease. Type I interferon (IFN-I) is one of the key pathogenic mechanisms, and overexpression of IFN-I leads to enhanced expression of its downstream interferon-stimulated genes (ISGs) and causes aberrant autoimmune responses. To date, a comprehensive assessment of ISG-mediated cell subsets in SLE remains lacking.
Methods
We analyzed single-cell transcriptomics data from peripheral blood mononuclear cells (PBMC) of seven SLE patients and five healthy individuals and retrieved 193 interferon-stimulated genes (ISGs) from the MSigDB database. Then, we performed the non-negative matrix factorization to identify different ISG-associated cellular subpopulations based on cellular ISG expression profiles and performed pseudotime trajectory analysis, differentially expressed gene (DEG) analysis, pathway enrichment analyses, transcription factor activity analyses, and cellular communication analyses on key cellular subpopulations. Bulk RNA-sequencing data from SLE also elucidated correlation of ISG-mediated microenvironmental patterns with other immune pathways.
Results
We find significantly higher proportions of CD8 T cells, NKT cells and monocytes and lower proportions of CD4 T cells and B cells. The CD8 T_ISG15, CD4 T_ISG15, NK_ISG15, NKT_ISG15, B_ISG15, and cDC_ISG15 subpopulations are significantly enriched for differential genes in the interferon-signalling-related pathway and had high expression of immune checkpoints, such as HLA-DRB5. In addition, we observe significantly higher activity of transcription factors, such as STAT1 and IRF7. Combined with bulk RNA-seq data, we find that the ISGs feature scores of each cell subpopulation are correlated with the immune-related pathway scores and HLA gene expression significantly in several datasets. In addition, ISG-mediated cell subtypes enhance intercellular communication.
Conclusion
This study comprehensively reveals that ISGs are highly expressed in key cell subpopulations of SLE and are closely associated with disease activity. These findings emphasize the central role of type I interferon-stimulated genes in SLE immunomodulation and disease progression, providing an important basis for precision therapy.
Efficacy and safety of the acupuncture combined with auricular acupressure for dry eye disease：study protocol for a multicenter randomized clinical trial
Authors: Li Zhuoyi , Mou Yika , Sun Shiyun , Fu Luyao , Chen Lingqian , Fu Yana , Du Cheng , Guo Qin , Liu Jing , Ma Ruijie
Published: December 2024

Introduction:
Dry eye disease (DED) is a chronic disorder of the ocular surface (OS) that is influenced by a variety of factors, resulting in ocular discomfort and visual impairment. Studies have also shown that dry eye syndrome detrimentally impacts patients' sleep quality (SQ), mental well-being, and overall mental health. This study aims to assess the efficacy and safety of the acupuncture combined with auricular acupressure in reducing ocular symptoms and enhancing sleep and mood among patients with DED.
Methods
In this multicenter, randomized controlled trial (RCT), 126 patients will be enrolled and randomly assigned in equal proportions to the intervention or control group. Participants in the intervention group will undergo three 30-minute sessions weekly over 8 weeks, whereas the control group will be treated with 0.1% sodium hyaluronate eye drop. Following the intervention, an eight-week follow-up will be conducted. Primary outcomes include the Ocular surface disease Index (OSDI), Breaking up time (BUT), Conjunctival Impression Cytology (CIC), and cornea fluorescein staining (CFS). Secondary outcomes are Tear meniscus height (TMH), Meibum quality score (MQS), Meibomian gland score (MGS), Meiboscore, Function of the meibomian gland, Pittsburgh Sleep Quality Index (PSQI), Self-rating depression Scale (SDS), and Self-rating anxiety scale (SAS). Evaluations will take place at weeks 0, 4, 8, 12, and 16.
Discussion
This research is intended to elucidate the advantages of acupuncture in mitigating symptoms of DED and in regulating disturbances in sleep and mood among patients.
Trial registration:
http://itmctr.ccebtcm.org.cn , ID: ITMCTR2024000673. Registered 7th November 2024.
Efficacy of topical corticosteroids and non-steroidal anti-inflammatory drugs for the treatment of diabetic macular oedema not in the context of intra-ocular surgery: a systematic review
Authors: Vassallo James , Galea Martin
Published: December 2024

Purpose
The aim of this systematic review was to assess whether current best evidence supports the use of topical anti-inflammatory medications for diabetic macular oedema (DMO).
Methods
A systematic review, limited to randomised controlled studies published from 2015 onwards, was carried out. MEDLINE, EMBASE, PubMed, Scopus, Web of Science Core Collection, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched on the 11th October 2024. Subjects with DMO treated with topical corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs) were included. The effect on central macular thickness was the primary outcome of interest.
Results
Seven out of the eight studies included partly/fully support the use of topical anti-inflammatory therapy to reduce macular thickness in DMO. Studies were very heterogenous and no meta-analysis was possible. The overall quality of the evidence was deemed to be moderate.
Conclusion
Topical corticosteroids and NSAIDs may be a viable therapeutic strategy for DMO. However, further studies are required to assess which agents and regimens would be most beneficial, and to allow better patient selection for this approach. Drugs with improved ocular penetration and efficacy may improve the success of this approach.
Developing and validating an innovative risk stratification model for non-metastatic clear cell renal cell carcinoma patients with venous tumor thrombus
Authors: Zhu Baohua , Mo Ziyang , Ta Na , Wang Linhui , Zhang Wei
Published: December 2024

Purpose: Exploring the survival influencing factors in patients with non-metastatic clear cell renal cell carcinoma (ccRCC) and venous tumor thrombus (VTT) is vital for tailored therapies. Our objective was to develop and validate a novel risk scoring system for the patients to predict the survival time and probability.
Methods: Data were gathered from non-metastatic ccRCC patients with VTT treated between 2011 and 2024. Participants were retrospectively assigned in a 7:3 ratio to training and testing cohorts. We evaluated and quantified clinicopathological characteristics of the primary tumor (PT) and VTT, constructing multivariable models to predict overall survival (OS).
Results: The study included 124 patients, with a median follow-up of 35 months. We developed a risk score system based on PT Sarcomatoid differentiation (p = 0.034), PT perirenal fat invasion (p = 0.046), VTT grade (p = 0.045) and Neutrophil to Lymphocyte Ratio(NLR) (p = 0.007). This system accurately identified a high-risk cohort exhibiting adverse outcomes among non-metastatic ccRCC patients with VTT, findings consistent in the testing group.
Conclusion: Our study presents a nomogram integrating clinicopathological features—PT Sarcomatoid differentiation, PT perirenal fat invasion, VTT grade and NLR—facilitating risk stratification and enhancing the precision in managing non-metastatic ccRCC patients with VTT.
68Gallium-FAPI-positron emission tomography for dignity assessment of mass-forming chronic pancreatitis and pancreatic ductal adenocarcinomas compared to laboratory parameters, ultrasound and computed tomography
Authors: Lang Matthias , Preussig Markus , Spektor Anna-Maria , von Goetze Isabelle , Wessendorf Joel , Glatting Frederik M. , Gutjahr Ewgenija , Pausch Thomas M. , Heger Ulrike , Mayer Philipp , Buchholz Hans-Georg , Schreckenberger Mathias , Kauczor Hans-Ulrich , Tjaden Christin , Hackert Thilo , Michalski Christoph , Haberkorn Uwe , Röhrich Manuel
Published: December 2024

Purpose:
The differentiation of mass-forming chronic pancreatitis (MFCP) and pancreatic ductal adenocarcinomas (PDAC) based on conventional imaging methods like ultrasound, CT and MRI is frequently not possible. Here, we applied static (60 minutes post injection) and dynamic PET/CT with 68Gallium-labelled Fibroblast Activated Protein Inhibitors (68Ga-FAPI-PET/CT) in 26 preoperative, treatment-naive patients with unclear pancreatic masses to evaluate its potential diagnostic value for MFCP and PDAC.
Methods:
26 Patients underwent static and dynamic 68 Ga-FAPI-PET/CT as well as dedicated fundamental (US) and contrast-enhanced ultrasonography (CEUS) before surgical resection or biopsy of pancreatic masses and subsequent histological analyses. Static parameters (SUVmax and SUVmean and target to background ratios) were generated from VOIs of pancreatic masses. Time activity curves and dynamic parameters were extracted from dynamic PET data.
Results:
Histology revealed 12 PDAC, 2 high-grade IPMN and 12 MFCP. We observed higher 68Ga-FAPI-uptake in PDACs (average SUVmax/mean 18.09 +/- 5.5 / 10.55 +/- 2.97) than in MFCP (average SUVmax/mean 11.55 +/- 3.88 / 6.83 +/- 2.20). In dynamic PET-imaging, PDAC and MFCP showed differential time activity curves and the average time to peak was markedly longer for PDAC (1094 +/- 945 seconds ) than for MFCP (449 seconds +/- 203). In ROC curves, static and dynamic imaging parameters showed higher sensitivity and specificity than laboratory parameters, CT- and US-size.
Conclusion:
68Ga-FAPI-PET/CT displays the fibrotic activity of MFCP. Static and dynamic 68Ga-FAPI-PET/CT should be considered, when clinical parameters and other imaging methods are not able to distinguish between PDAC and MFCP.
Time to achieve blood pressure control and its predictors among hypertensive patients treated at public hospitals in Afar region, North-Eastern Ethiopia: A retrospective cohort study
Authors: Gashe Abiyie Demelash , Worku Fentahun Agegnehu , Mahamud Kedir Ali , Woldemichael Dawit Zenebe , Eshete Tewodros , Endries Aman Yesuf
Published: December 2024

Background The timeframe from antihypertensive medication initiation to blood pressure (BP) control is an important yet underutilized measure of hypertension management. In Ethiopia, while studies have explored BP control rates, data on the time required to achieve control are limited. This study aimed to estimate time to BP control and identify predictors in Afar region of Ethiopia.Method A facility-based retrospective cohort study was conducted among adult hypertensive patients aged 18 years and older in five public hospitals between September 7, 2019 and January 8, 2023. Data were collected using a structured questionnaire, entered into EpiData version 3.1, and analyzed using Stata version 14.2. Kaplan-Meier survival analysis was used to estimate time to BP control. Cox regression analysis was applied to identify predictors of time to BP control. The adjusted hazard ratios (AHRs) and 95% confidence intervals (CIs) were computed at p < 0.05Result A total of 443 hypertensive individuals were retrospectively followed, of which, 410 (92.6%) met the inclusion criteria. The median duration of follow-up was 10 month. The median age of the participants was 56 year. The median time to achieve BP control was 13 months (95% CI: 11⎼15). Factors associated with quicker BP control included combination therapy (AHR = 1.849, 95% CI: 1.276–2.679) and the absence of comorbidities (AHR = 1.86, 95% CI: 1.276–2.679). In contrast, factors leading to delayed BP control included age ≥ 60 years (AHR = 0.378, 95% CI: 0.236–0.605), severe hypertension (AHR = 0.626, 95% CI: 0.467–0.839), creatinine ≥ 1.5 mg/dL (AHR = 0.371, 95% CI: 0.173–0.799), and fasting blood sugar (FBS) ≥ 126 mg/dL; AHR = 0.335, 95% CI: 0.152–0.738).Conclusion The median time to BP control in this study exceeds recommendations from clinical trials and prior estimates. Combination therapy and the absence of comorbidities significantly reduce time to BP control, while advanced age, higher baseline BP, and elevated creatinine and FBS levels are linked to delayed BP control. Our findings highlight the necessity for enhanced counseling, management of comorbidities, regular end-organ evaluation, and use of combination therapies to expedite timely BP control.
Effect of early parenteral nutrition versus enteral nutrition alone on all-cause mortality in critically ill adults: A systematic review and meta-analysis
Authors: Cai Yixuan , Liu Airan , Bao Jiaotong , Yin Xinyi , Yang Xi , Wang Wenya
Published: December 2024

Background
For nutritional support in critically ill patients, the early initiation of enteral nutrition (EN) in the presence of gastrointestinal function has been agreed upon by most scholars. However, EN support alone cannot fully meet the needs of the body in some cases, so considering supplemental parenteral nutrition (SPN) become the solution to meet patients’ energy target. However, there is no consensus on whom and when parenteral nutrition should be considered in critically ill patients as a total form of nutrition. So, we aimed to compare and evaluate the effect of early PN on the outcome and their safety in critically ill adults.
Methods
Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, Cochrane Library, and Web of Science (up to March 2024). Adults with critical illness treated with total parenteral nutrition (TPN) or SPN versus EN alone were enrolled. We screened studies and extracted data independently. The primary outcome was all-cause mortality which was evaluated by pooled risk ratio (RR) with the fixed-effects model. The risk of bias was evaluated using Cochrane risk bias of tool and a meta-analysis was conducted using RevMan 5.4 software. This study was prospectively registered in PROSPERO database (CRD42023462386).
Results
Twenty RCTs enrolling 11303 patients were eligible. No significant disparities were observed in 30-day all-cause mortality (relative risk [RR] 0.96, 95% confidence interval [CI] 0.90–1.03, P = 0.29), hospital mortality (RR 0.96, 95% CI 0.90–1.02, P = 0.17), or 90-day mortality (RR 0.95, 95% CI 0.86–1.04, P = 0.26) between the PN (TPN or SPN) and enteral nutrition (EN) alone groups. However, the use of PN in conjunction with EN was associated with a reduced ICU mortality rate compared to EN alone (RR 0.92, 95% CI 0.86–0.99, P = 0.03). PN therapy was linked to a modest elevation in the risk of infection (RR 1.12, 95% CI 1.05–1.21, P = 0.002), predominantly due to bloodstream infections (RR 1.24, 95% CI 1.08–1.51, P = 0.005). Additionally, PN was associated with a significant reduction in the duration of mechanical ventilation (standardized mean difference [SMD] = -1.47, 95% CI -2.72 to -0.23, P = 0.02) and a decreased incidence of gastrointestinal intolerance events (RR 0.85, 95% CI 0.77–0.94, P = 0.002).
Conclusion
Administration of PN can reduce ICU mortality, duration of mechanical ventilation and gastrointestinal intolerance events, although it increases total infection especially bloodstream infection rate among critically ill patients. More studies are warranted to confirm these findings.
Dysphagia Megalatriensis: A Case Report of Potentially Treatable Etiology of Dysphagia.
Authors: Nazeera Nahas Nazeer. , C.K Anees , Paul Ajay , Basheer Aneesh
Published: December 2024

Background - Dysphagia is commonly associated with structural or neuromuscular disorders of the oesophagus, but cardiovascular causes are rare. Dysphagia megalatriensis is an unusual condition characterized by oesophageal compression due to an enlarged left atrium, often secondary to decompensated heart failure. Timely recognition of this rare etiology can prevent unnecessary interventions and enable targeted therapy. Case Presentation - A 78-year-old male with a history of coronary artery disease and chronic heart failure with reduced ejection fraction presented with breathlessness and chest discomfort for 3 days. He also reported progressive difficulty swallowing solids over the past 20 days. Examination revealed hypoxia and bilateral pitting pedal oedema, while imaging demonstrated cardiomegaly with significant left atrial dilation compressing the oesophagus. The patient was diagnosed with dysphagia megalatriensis, a rare form of cardiac dysphagia. He was treated with diuretic therapy and nasogastric tube feeding, resulting in symptomatic improvement. Conclusions - Dysphagia megalatriensis, though rare, should be considered in the differential diagnosis of dysphagia, particularly in patients with significant cardiac comorbidities. This case highlights the role of non-invasive imaging and individualized management strategies, including medical optimization of heart failure, in addressing this unique condition.
Ankle pain after total knee arthroplasty: a study of lower extremity imaging parameters
Authors: huang ZiShuai , Zhang ShuAng , Yang Guang , feng haotian , Wang Jian
Published: December 2024

Purpose: This study investigates the relationship between ankle pain and lower extremity imaging parameters in patients following total knee arthroplasty (TKA).
Methods: From September 2023 to February 2024, 41 patients with knee osteoarthritis (KOA) who underwent primary TKA were included in this study. The incidence of ankle pain was assessed six months post-surgery, and lower limb imaging parameters were measured to analyze their relationship with ankle pain.
Results: Among the 41 patients, 13 experienced ankle pain six months after TKA, representing 31.7% of the cohort, while 28 patients (68.3%) reported no ankle pain. Preoperatively, the Hip-Knee-Ankle (HKA), Tilt Angle of the Ankle (TAA), Talar Tilt Angle (TTA), and Talus Inclination (TI) in the pain group were significantly greater than those in the ankle painless group (p<0.05). Six months postoperationly, the TAA, TTA, TI, and mechanical Lateral Distal Tibial Angle (mLDTA) in the ankle pain group remained significantly elevated compared to the no ankle pain group (p<0.05). No statistically significant differences were observed in the Anterior Distal Tibial Angle (ADTA) and Hindfoot Alignment view Angle (HAVA) between the two groups, both preoperatively and at six months post-TKA (p>0.05). Receiver operating characteristic (ROC) curve analysis indicated that the area under the curve (AUC) values for ΔHKA and ΔmLDTA in predicting postoperative ankle pain were 0.893 and 0.955, respectively.
Conclusion: The findings suggest that excessive correction of knee varus and inadequate compensation at the ankle joint may contribute to the development of ankle joint pain in patients following TKA.
Light-driven Lattice Soft Microrobot with Multimodal Locomotion
Authors: Xiong Wei , Zhang Mingduo , Liu Yuncheng , Deng Chunsan , Fan Xuhao , Zhang Zexu , Shi Shaoxi , Chen Fayu , Hu Huace , Xue Songyan , Deng Leimin , Liu Lige , Sun Tao , Gao Hui
Published: December 2024

Untethered microrobots hold significant promise in fields such as bionics, biomedicine, and micromechanics. However, replicating the diverse movements of natural microorganisms in artificial microrobots presents a considerable challenge. This paper introduces a laser-based approach that utilizes lattice metamaterials to enhance the deformability of hydrogel-based microrobots, resulting in untethered light-driven lattice soft microrobots (LSMR). Constructed from single-walled carbon nanotubes-poly(N-isopropylacrylamide) hydrogels and a truncated octahedron lattice structure, the LSMR benefits from reduced relative density, which increases flexibility and accelerates light-driven deformation. By employing sequential laser scanning, the LSMR achieves various locomotion modes, including linear peristalsis, in situ rotation, and hopping, through adjustments in scanning frequency, trajectory, and laser power. The LSMR achieves a remarkable continuous in situ rotation speed of 29.38°/s, nearly 30 times faster than previous studies, and exhibits the fastest peristaltic locomotion speed among sub-millimeter scale microrobots. The LSMR can autonomously perform programmed motions under closed-loop feedback control and navigate through narrow openings as small as 75% of its resting width by actively deforming. Compared to solid structure microrobots, the lattice design enhances energy conversion efficiency by 16.49 times under identical conditions. These advancements mark a significant leap forward in the design and functionality of light-driven soft microrobots, offering promising avenues for future research in biomedicine, bionics, and micromechanical engineering.
Impacts of Moderate Severity COVID-19 on Functional Capacity, Exercise Tolerance, Muscle Strength, Hang Grip and Quality of Life.
Authors: Alshammari Maha , Shanb Alsayed , Alsubaiei Mohammed , Ahsan Mohammad , Shanb Belal
Published: December 2024

Background
The COVID-19 pandemic has posed significant challenges to global health, affecting millions of individuals worldwide. While acute and severe cases COVID-19 receive considerable attention, those with moderate severity of COVID-19 are also prone to substantial functional impairments that make them warranted for investigations. This study aimed to investigate the impacts of COVID-19 with moderate-severity on functional capacity, exercise tolerance, isometric muscle strength, hand grip, and quality of life.
Methods
Ninety-six participants (48 with COVID-19, 48 without COVID-19) were recruited in this cross-section study. The effects on functional capacity, exercise tolerance, isometric muscle power, hand grip, and quality of life were measured by the 6-minute walk test, One-minute sit-to-stand test, Hand-held dynamometer, Hand grip dynamometer and Quality of Life Questionnaire respectively. Shapiro-Wilk's test was used to test normality of data, Mann-Whitney test was used to compare the significant differences between COVID-19 and matched groups. The Spearman correlation was used to determine the relationships among outcome measures.
Results
Mean values of functional capacity, isometric muscle power, hand grip, and quality of life reduced significantly in patients with moderate COVID-19 on comparison with their matched (p-values < 0.05), except exercise tolerance (p-values > 0.05). Positive relationships were detected between exercise tolerance, and strength of the hand grip and knee extensors; also, between distance of the 6-minute walk test and exercise tolerance, strength of the hand grip and knee extensors (p = < 0.001).
Conclusion
Patients with COVID-19 moderate severity have impairments in functional capacity, exercise tolerance, isometric muscle strength, hand grip, and quality of life. Exercise tolerance correlated positively with the 6 MWT, strength of the hand grip and knee extensors, thus multi-dimension health care training programs need to be extended for those patients whatever the severity degree of infection.