bluuebunny/crossref_metadata_2025 huggingface dataset:
The Realist Approach to Social Policies (RASP) study: A study protocol for mixed-methods realist research combined with institutional action research, to reduce socioeconomic health inequalities through systems change
Authors: Berkel Jantien van , de Bruijn Ernst-Jan , Waardenburg Maikel , Grouw Yvonne la , Bennekom Eline van , Horst Hilje van der , Tonnon Susanne , Haggenburg-Mohammed Milou , Haveman Annemien , Madern Tamara , Knoef Marike , de Vet Emely
Published: October 2023

Introduction
Health inequalities are rooted in inequality in vital resources for health, including financial resources, a supportive informal network, a stable living situation, work or daytime activities, or education and literacy. About 25% of Dutch citizens experience deprivation in such resources. Social policy consists of crucial instruments for improving resources in those groups, but can also have adverse effects and lead to additional burden.
This project aims to contribute to the reduction of health inequalities through 1) better understanding how social policy interventions can contribute to reducing health inequality through the redistribution of burdens and resources, and 2) developing anticipatory governance strategies to implement those insights, contributing to a change in social policy systems.
Methods
Two systems approaches are combined for establishing a systems change. Firstly, a realist approach enables insights into what in social policy interventions may impact health outcomes, for whom, and under what circumstances. Secondly, an institutional approach enables scaling up these insights, by acknowledging the crucial role of institutional actors for accomplishing a systems change.
Together with stakeholders, we perform a realist review of the literature and identify existing promising social policy interventions. Next, we execute a realist evaluation of selected social policy interventions in seven municipalities, ranging from small, mid-size to large, and in both urban and rural settings. Simultaneously, through action research with (national) institutional actors, we facilitate development of anticipatory governance strategies.
Discussion
By combining a realist approach and an institutional approach, this study protocol not only sheds light on cross-domain impacts on health through realist review and evaluations, it also provides insight into how systems can be changed to benefit health, through action research. Thereby, it contributes to advancement of the concept “systems for health”, relevant to both science and (policy)practice.
The main ethical challenges of this project relate to the vulnerable positions of the populations under study. Extra attention is paid to prevent additional emotional burdening in the research process.
We co-develop knowledge products and activities, with the targeted professionals, students, citizens and governments, to stimulate uptake of the knowledge produced in the project.
Comparative analysis of the complete plastid genomes of desert trees Neltuma and Strombocarpa genera
Authors: Contreras-Díaz Roberto , Carevic Felipe S. , Brink Liesbeth van den , Huanca-Mamani Wilson , Jung Patrick
Published: October 2023

Neltuma alba (Algarrobo blanco), Neltuma chilensis (Algarrobo Chileno) and Strombocarpa strombulifera (Fortuna) are some of the few trees found in small highly fragmented populations, throughout the Atacama Desert, indicating their drought resistance. We found that the complete chloroplast genomes of N. alba and N. chilensis are larger in size compared to species of the Strombocarpa genus. However, the Strombocarpa species presented slightly more GC content than the Neltuma species. Therefore, we assume that Strombocarpa species have been exposed to stronger evolution than Neltuma species. We observed high variation values in the number of cpSSRs (chloroplast simple sequence repeats) and repeated elements among Neltuma and Strombocarpa species. Very low nucleotide diversity values were found in Neltuma, while ten highly variable regions found in Strombocarpa, can likely be used to resolve uncertainties in phylogeny, and for DNA barcoding. Although in general our study supports the phylogeny of other studies, the biggest inconsistency was the nesting of Prosopis cineraria within the Neltuma clade and showed a divergence time of 1.85 Mya. With this study we provide valuable information about isolated populations of tree species that provide important ecosystem services in hostile environments before they disappear, due to an ongoing fragmentation of their populations.
Creating an Atlas of Normal Tissue for Pruning WSI Patching Through Anomaly Detection
Authors: Nejat Peyman , Alsaafin Areej , Alabtah Ghazal , Comfere Nneka , Mangold Aaron , Murphree Dennis , Zot Patricija , Yasir Saba , Garcia Joaquin J. , Tizhoosh Hamid R.
Published: October 2023

Patching whole slide images (WSIs) is an important task in computational pathology. While most of the are designed to classify or detect the presence of pathological lesions in a WSI, the confounding role and redundant nature of normal histology are generally overlooked. In this paper, we propose and validate the concept of an “atlas of normal tissue” solely using samples of WSIs obtained from normal biopsies. Such atlases can be employed to eliminate normal fragments of tissue samples and hence increase the representativeness the remaining patches. We tested our proposed method by establishing a normal atlas using 107 normal skin WSIs and demonstrated how established search engines like Yottixel can be improved. We used 553 WSIs of cutaneous squamous cell carcinoma to demonstrate the advantage. We also validated our method applied to an external dataset of 451 breast WSIs. The number of selected WSI patches was reduced by 30% to 50% after utilizing the proposed normal atlas while maintaining the same indexing and search performance in leave-one-patient-out validation for both datasets. We show that the proposed concept of establishing and using a normal atlas shows promise for unsupervised selection of the most representative patches of the abnormal WSI patches.
Pd-skin tuned by rare earth rich sublayer for high performance methanol resistance oxygen reduction reaction
Authors: Cheng Yi , Kwofie Felix , Chen Jinfan , Zhang Ying , Liu Yujing , Yang Yang , Li Yang , He Zhenjiang , Li Yunjiao , Wu Feixiang , Wang Shuangyin
Published: October 2023

Lanthanide contraction resulting from the increased filling of the f-shell provides a continuous strain control to tune the activities, however, the synthesis of noble-metal and rare earth (RE) alloy remains a world-class challenge. Herein, we demonstrated a class of PdRE alloy with outstanding ORR activity through hydrogen-assisted magnesiothermic reduction, and the PdEr catalyst demonstrated a record high ORR activity among the Pd-based catalysts, showing a mass activity of 1.18 A gPd -1 in acid conditions, 15.7 and 7.4 times higher than that of Pd/C and commercial Pt/C-JM. The PdEr showed remarkable methanol resistance in the electrolyte with 2 M methanol, displaying a half-wave potential of 215 mV more positive and a mass activity 4 orders higher than that of commercial Pt/C-JM. The record high ORR performance of PdRE alloys is attributed to the surface strain and electronic structure modification of the Pd skin by RE elements enriched sublayer and thus tuning the adsorption strength of key intermediates.
Selective and Controllable Heating Model of Pig Skin under Radiofrequency Heating and Relevant Experimental Verification
Authors: Zhu Ping , Xie Chuanqi , Shu Fangjie , Li Liqiang , Su Zhaodi , Wang Zhichao , Mu Ziyu
Published: October 2023

Radiofrequency heating is widely used in the field of medical aesthetics, which essentially achieves the contraction of collagen in the dermis tissue by increasing its temperature. The paper aimed to study the selective and controllable heating mechanism of pig skin under radiofrequency heating by the finite element method and relevant experiments. A heating model of pig skin was constructed at 4 MHz radiofrequency with a mixed heating mode of fixed-point and reciprocating sliding. Based on the mixed radiofrequency heating, the dermis layer in pig skin was heated rapidly and uniformly due to its relatively high electrical conductivity and thermal conductivity compared to other skin tissue layers. This allowed the dermis temperature \(\stackrel{\text{-}}{\text{Σ}}\text{=55.1±0.1°C}\) to remain at a dynamic plateau period. Under the same conditions, the fresh hairless skin of young pig was heated to verify the model, and the experimental and theoretical results are consistent. The research results have a certain guiding significance in forecasting the changes in human skin temperature field under radiofrequency heating and provide novel insights for future research in related fields.
Synthesis of causal and surrogate models by non-equilibrium thermodynamics in biological systems
Authors: Sakurada Kazuhiro , Ishikawa Tetsuo
Published: October 2023

There is no general way to describe the time evolution of life phenomena in terms of governing equations or physical laws. In biology, models of causal mechanisms and information processing have been used to explain life phenomena for which initial conditions, causes, and consequences are known. Recently, surrogate models of biological phenomena have been developed based on machine learning of large amounts of data, enabling highly accurate prediction of changes in the state of living systems. However, these surrogate models are black boxes. Therefore, the reliability and reproducibility of the models are abrogated by data bias. Biological systems form a multi-hierarchical structure from chromosomes to ecosystems, creating coherent order through the exchange of matter, energy, and messages. Messages have the force to change the state of the biological system. We have focused on this point and developed a signaling force field theory. Here, we show that this theory allows us to describe time-evolving phenomena in biological systems by synthesizing causal and surrogate models.
Insight into mRNA and its regulating pathways in the susceptibility and resistance to malaria infection by RNA sequencing
Authors: Kataria Poonam , Chaudhary Amrendra , Chauhan Rubika , Kalkal Meenu , Surela Neha , Das Jyoti , Das Emily
Published: October 2023

Background: Malaria is a severe febrile sickness transmitted by Plasmodium parasites. During murine malaria infection, the host immune response exhibits distinct variations in response to two strains of Plasmodium yoelii (P. yoelii 17XL and P. yoelii XNL), which are known to be associated with varying levels of parasite virulence and malaria severity. The study focuses on change in molecular mechanisms that regulate transcriptional activity as well as the gene networks involved in pathogenesis and defence during lethal and non-lethal malaria infections at different time points.
Methods: The gene expression profiles of mRNAs in control mice, Py.17XNL, and Py.17XL infected animals were evaluated using RNA sequencing and bioinformatics methods, and the differentially expressed mRNAs were validated using RT-qPCR. These DE mRNAs were identified as, cellular components, molecular functions, and biological processes utilizing Kyoto Encyclopaedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses.
Results: The results reveal several differentially expressed mRNAs that were associated with T-cell differentiation, cytokine receptor activity, and other related processes. Some of these genes, including Erfe, Hk1, and Podxl, are found to be significantly expressed in lethal infections, potentially contributing to increased parasitaemia and susceptibility.
Conclusion: This study provides significant insights into the gene expression patterns that may be used to investigate the molecular mechanisms of the host's response to both lethal and non-lethal malaria infections. These mechanisms are involved in both the pathogenesis of the disease and the immune defence against malaria infection.
Primary medullary colon cancers: A case series and literature review
Authors: Maung Hein , Gregory Oliver , Hutchinson Matthew , Marino Matthew , Evans Tobias , Yeoh Adrian , Turner Richard C.
Published: October 2023

The authors have requested that this preprint be removed from Research Square.
Persistence of marine bacterial plasmid in the house fly (Musca domestica): marine-derived antimicrobial resistance genes have a chance of invading the human environment
Authors: Nawata Kanoko , Kadoya Aya , Suzuki Satoru
Published: October 2023

The house fly is known to be a vector of antibiotic-resistant bacteria (ARB) in animal farms. It is also possible that the house fly contributes to the spread of ARB and antibiotic resistance genes (ARGs) among various environments. We hypothesized that ARB and ARGs present in marine fish and fishery food may gain access to humans via the house fly. We show herein that pAQU1, a marine bacterial ARG-bearing plasmid, persists in the house fly intestine for 5 days after fly ingestion of marine bacteria. In the case of Escherichia coli bearing the same plasmid, the persistence period exceeded 7 days. This interval is sufficient for transmission to human environments, meaning that the house fly is capable of serving as a vector of marine-derived ARGs. Time course monitoring of the house fly intestinal microflora showed that the initial microflora was occupied abundantly with Enterobacteriaceae. Experimentally ingested bacteria dominated the intestinal environment immediately following ingestion; however, after 72 h, the intestinal microflora recovered to resemble that observed at baseline, when diverse genera of Enterobacteriaceae were seen. Given that pAQU1 in marine bacteria and E. coli were detected in fly excrement (defined here as any combination of feces and regurgitated material) at 7 days post bacterial ingestion, we hypothesize that the house fly may serve as a vector for transmission of ARGs from marine items and fish to humans via contamination with fly excrement.
Early Modulation of the Gut Microbiome by Female Sex Hormones Alters Amyloid Pathology and Microglial Function
Authors: Saha Piyali , Weigle Ian , Slimmon Nicholas , Blauth Pedro , Patel Priyam , Zhang Xiaogiong , Cao Yajun , Michalkiewicz Julia , Gomm Ashley , Zhang Can , Tanzi Rudolph , Dylla Nicholas , Al-Hendy Ayman , Sisodia Sangram
Published: October 2023

It is well-established that women are disproportionately affected by Alzheimer’s disease (AD). The mechanisms underlying this sex-specific disparity are not fully understood, but several factors that are often associated-including interactions of sex hormones, genetic factors, and the gut microbiome-likely contribute to the disease's etiology. Here, we have examined the role of sex hormones and the gut microbiome in mediating Aβ amyloidosis and neuroinflammation in APPPS1-21 mice. We report that postnatal gut microbiome perturbation in female APPPS1-21 mice leads to an elevation in levels of circulating estradiol. Early stage ovariectomy (OVX) leads to a reduction of plasma estradiol that is correlated with a significant alteration of gut microbiome composition and reduction in Aβ pathology. On the other hand, supplementation of OVX-treated animals with estradiol restores Aβ burden and influences gut microbiome composition. The reduction of Aβ pathology with OVX is paralleled by diminished levels of plaque-associated MGnD-type microglia while estradiol supplementation of OVX-treated animals leads to a restoration of activated microglia around plaques. In summary, our investigation elucidates the complex interplay between sex-specific hormonal modulations, gut microbiome dynamics, metabolic perturbations, and microglial functionality in the pathogenesis of Alzheimer's disease.
The Risk of Malnutrition and its Impact on Quality of Life in Head and Neck Cancer
Authors: Theurer Julie , Lynch Mark , Jovanovic Nedeljko , Doyle Philip
Published: October 2023

Objectives
Individuals with head and neck cancer (HNCa) are at an increased risk of malnutrition. Therefore, the use of self-administered, outpatient nutrition screens that seek information specific to nutritional concerns may yield benefits of identifying a need for intervention which may facilitate improved treatment outcomes and quality of life (QOL).
Methods
In this descriptive, cohort case series conducted at a tertiary care center, fifty participants (36 men, 14 women) completed one demographic and two QOL surveys, a nutrition assessment, two nutrition self-screening tools, and an ease-of-use questionnaire. Results obtained from nutrition screens were compared to those of the nutrition assessment. Additionally, the relationships between QOL, nutrition status, and demographics were examined.
Results
Thirty-two percent of participants were identified as nutritionally compromised. In this patient population, the sensitivity and specificity for the PG-SGA SF and Pt-Global Application were found to be 81.25% and 100%, and 68.76% and 100%, respectively. Additionally, alterations in nutrition status were associated with QOL.
Conclusions
Data suggest that self-administered nutrition screens may be a viable option which enable proactive identification of nutritional concerns associated with HNCa.
Decoding the Genetic Links Between Substance Use Disorder and Cancer Vulnerability
Authors: Su Xin , Mo Xiaoyan , Kan Jun , Zhang Bei
Published: October 2023

Background
Cancer is a leading cause of mortality and morbidity globally and burdens public health heavily. Cannabis and opioids are promising applications for cancer pain management. However, due to their widespread abuse and addiction potential, they have become the focus of public health attention. They may have critical long-term health effects, raising concerns about their possible association with cancer risk. However, their relationship with cancer vulnerability is highly controversial. This Mendelian randomization (MR) study aimed to investigate the causal relationship of cannabis use disorder (CUD) and opioids use disorder (OUD) on cancer vulnerability.
Methods
Two-sample MR study using summary statistics from genome-wide association studies (GWAS), FinnGen, and UK Biobank. The primary method was inverse-variance weighted (IVW), and we included a range of sensitivity analyses to assess the robustness of the findings.
Findings:
We found the IVW results showed a causal association between OUD and bladder cancer (OR = 1.040, 95% CI 1.004–1.078, P = 0.029, adj. P = 0.125), acute myeloid leukemia (OR = 0.931, 95% CI 0.885–0.978, P = 0.005, adj. P = 0.061) and ovarian cancer (OR = 0.937, 95% CI 0.891–0.984, P = 0.010, adj. P = 0.064). Sensitivity analysis is directionally consistent with IVW. In the reverse MR analysis, none of the methods produced statistically significant proof of a connection between OUD and three cancers (all P > 0.05). However, OUD did not prove a genetic causal relationship with other cancers (P > 0.05). We found no relevant evidence of a statistically significant potential causal effect of CUD on cancers (P > 0.05).
Summary: This study suggests that OUD may be causally linked to bladder, AML, and ovarian cancer, which needs to be further evaluated in extensive population studies.
Chronic intracranial recordings in the basal ganglia reveal patient-specific circadian rhythms in Parkinson's disease
Authors: de Hemptinne Coralie , Cagle Jackson , de Araujo Tiberio , Johnson Kara , Yu Jun , Fanty Lauren , Sarmento Filipe , Little Simon , Okun Michael , Wong Joshua
Published: October 2023

Adaptive deep brain stimulation (aDBS) is a promising therapeutic approach for subjects with Parkinson’s disease (PD) using neural signals as feedback control to adjust the level of therapy. However, the circadian fluctuation of neural signals may alter these control signals and possibly result in suboptimal therapy. We report a large retrospective cohort including 119 subjects with PD (165 hemispheres) with globus pallidus internus (GPi) and subthalamic nucleus (STN) activity recorded chronically in the home environment. Both GPi and STN activity was significantly altered by circadian rhythms. The direction of the circadian rhythm (increase versus decrease at night) depended on the frequency band in both the GPi and STN. The use of long-acting extended released dopaminergic medications significantly impacted the circadian rhythms in the GPi target. These findings demonstrate the variability of chronic circadian rhythms and suggest that aDBS will likely need to account for these patient-specific fluctuations to ensure successful implementation in real-world environments.
Nmu receptor of Siberian sturgeon (Acipenser baerii) and its role in food intake
Authors: Tang Ni , Kang Qin , Wu Hongwei , Li Yingzi , Yao Qin , Zhang Xin , Li Zhiqiong
Published: October 2023

Neuromedin U (NMU) exerts an annorexigenic role in mammals. In fish, only one study in gold-fish has identified neuromedin U receptors (NMURs), but the information about NMURs in ap-petite regulation is limited. To clarify the response mode of NMURs and the signal transduction pathway in NMU regulation of Feeding of Siberian sturgeon, the cDNA of nmur1 and nmur2 of Siberian sturgeon has been cloned and both of them are widely expressed in the 22 tissues ex-amined, especially higher in brain and gastrointestinal tract. Nmur1 and nmur2 were significant-ly upregulated after feeding. Long term fasting resulted in a significant downregulation of nmur1 in the hypothalamus, which returned to normal level after re-feeding, while the expres-sion pattern of nmur1 in the liver was completely opposite. In addition, after i.p. injection NMU-25, the nmur2 mRNA level significantly increased in hypothalamus and ileum. After i.c.v. injection NMU-25, the levels of nmur1 mRNA and nmur2 mRNA were significantly increased in the hypothalamus. NMURs of Siberian sturgeon can be activated by different nutritional states and are closely related to specific tissues and duration and the inhibitory effect of NMU-25 on appetite may be mediated jointly by NMUR1 and NMUR2 in the central nervous system, while in peripheral tissues, it may mainly be achieved through NMUR2. Our study, as a whole, laid the foundation for further exploring the molecular mechanism of NMU in appetite control in a fish model.
An Integrated Framework for Reference Site Selection and Benchmarking Soil Health Studies
Authors: Das Saurav , Hird Aaron , Maharjan Bijesh , Stephenson Mitchell , Kariyawasam Lithma
Published: October 2023

Comparative soil health studies are critical in soil conservation and gauging the success of different management practices in soil improvement. A primary challenge in these studies is the selection of a consistent natural reference site. Current choices vary widely, from minimally disturbed areas to pristine prairies. This methodological paper underscores the need for deliberate and thoughtful reference site selection for benchmark soil properties. Utilizing the State-and-transition models (STM), the study introduces a framework for this selection, drawing upon the ecological site (ES), and reference plant communities detailed in an ecological site description (ESD) within a respective Major Land Resource Area (MLRA). This study advocates for a localized classification within the framework of the Cropland Reference Ecological Unit (CREU), emphasizing the significance of local precipitation and soil data to ensure unbiased comparisons. Soil samples from eastern (MLRA106) and western (MLRA67A) Nebraska were collected, representing distinct pedogenetic and climatic differences. Analysis of SOM within an MLRA region displayed substantial variations, suggesting potential biases and complexities in soil health gap calculations when using reference sites and croplands not in the same MLRA, soil types (texture class), or precipitation zone. However, refining the comparisons by delineating MLRA, soil, and precipitation zones within the framework of CREU yielded more consistent and realistic comparative data. The integration of the MLRA and ES, complemented by granular soil and precipitation data provides a robust method for establishing soil health benchmark data.
Excessive cleavage of von Willebrand factor multimers by ADAMTS13 may predict progression of transplant-associated thrombotic microangiopathy
Authors: Matsumoto Masanori , Yamada Shinya , Sakai Kazuya , Kubo Masayuki , Hirokazu Okumura , Asakura Hidesaku , Miyamoto Toshihiro
Published: October 2023

Transplant-associated thrombotic microangiopathy (TA-TMA) is a fatal complication of hematopoietic stem cell transplantation (HSCT). Since little is known about multimer changes of von Willebrand factor (VWF) in TA-TMA, VWF-degradation product (DP) was analyzed to unravel the mechanism of change in the VWF multimer and disease course. This study enrolled 14 patients who underwent allogeneic HSCT at a single institute. VWF-associated markers were measured in blood samples collected every 7 days. There were two patients of definite TMA, and six patients that presented with probable TMA that did not progress to definite TMA. Each plasma sample was classified into three groups: definite TMA, probable TMA, and non-TMA. VWF multimer analysis showed the absence of high-molecular-weight (HMW)-VWF multimers in probable TMA, whereas the appearance of unusually-large VWF multimers was observed in definite TMA. The median value of the VWF-DP/VWF:antigen ratio in probable TMA was elevated to 4.17, suggesting that excessive cleavage of VWF multimers by VWF cleaving enzyme, ADAMTS13, resulted in the loss of HMW-VWF multimers. During the transition from probable to definite TMA, drastic VWF multimer changes imply a switch from bleeding to thrombotic tendencies. Extensive VWF-DP and VWF multimer analyses provided novel insights.
Assessing Urban Park Equity in Chaoyang District, Beijing using Online Review Data
Authors: Zou Ning , Mi Xiayuan , Xiao Yang , Li Yunyuan , Hu Nan
Published: October 2023

Urban parks are essential components of urban ecosystems, providing vital ecological resources for city residents. However, the rapid expansion of high-density urban areas has led to an unequal distribution of park resources, raising growing concerns about spatial equity. To address these challenges, we employed an improved Gaussian two-step floating catchment area (2SFCA) method, considering park quality variations and integrating sentiment scores from park reviews to calculate a comprehensive park accessibility index, accounting for both supply and demand dynamics among park users. The results demonstrate the significance of park management, as users prioritise convenience and cleanliness of public facilities. Recreational quality significantly influences park distribution equity, with areas near Beijing’s initial greenbelt zone showing improved accessibility (IA). Nonetheless, our analysis exposes disparities in urban park resource allocation within the Chaoyang District, indicating relative inequity. Spatial supply and demand mismatches, especially in the northwest and southeast, are evident. To enhance park layout equity, we recommend strategies like identifying and repurposing underused spaces, establishing pocket parks and micro-green areas, and improving recreational facilities. It is crucial to address the needs of vulnerable groups such as older residents and children. These insights stress the importance of ensuring fair urban park access to enhance the well-being of all city residents.
Non-linear relationship between pulse pressure and the risk of prediabetes： A 5-year cohort study in Chinese Adults
Authors: Huang Zhenhua , Wang Fangxi , Xiao Xiaoyong , Liu Dehong , Deng Zhe
Published: October 2023

Previous research has established a strong link between pulse pressure (PP) and diabetes, but there is limited investigation into the connection between PP and prediabetes. This study aims to explore the potential association between PP and prediabetes. A retrospective cohort study encompassed 202,320 Chinese adults who underwent health check-ups between 2010 and 2016. Prediabetes was defined in accordance with the World Health Organization (WHO) criteria, indicating impaired fasting glucose, with fasting blood glucose levels ranging from 6.1 to 6.9 mmol/l. To assess the PP-prediabetes relationship, we employed Cox regression analysis, sensitivity analysis, and subgroup analysis. Cox proportional hazards regression, coupled with cubic spline functions and smooth curve fitting, helped elucidate the non-linear PP-prediabetes relationship. Upon adjusting for confounding factors, we observed a positive association between PP and prediabetes (HR: 1.15, 95% CI: 1.11-1.18, P < 0.0001). Participants in the fourth quartile (PP ≥ 51 mmHg) had a 73% higher likelihood of developing prediabetes compared to those in the first quartile (PP < 36 mmHg) (HR: 1.73, 95% CI: 1.52-1.97, P < 0.0001). Moreover, the relationship between PP and prediabetes was non-linear. A two-piece Cox proportional hazards regression model identified an inflection point at 40 mmHg for PP (P for log-likelihood ratio test = 0.047). Sensitivity and subgroup analyses corroborated the robustness of our findings.Our study reveals a non-linear correlation between PP and prediabetes, signifying an increased risk of prediabetes when PP levels exceed 40 mmHg. This discovery has significant clinical implications for early prediabetes prevention and intervention, ultimately contributing to improved patient outcomes and quality of life.
Patients as teachers: a within-subjects randomized pilot experiment of patient-led online learning modules for health professionals
Authors: Ndjaboue Ruth , Beaudoin Caroline , Comeau Sandrine , Dagnault Anne , Dogba Maman Joyce , Numainville Sarah , Racine Charles , Straus Sharon , Tremblay Marie-Claude , Witteman Holly O.
Published: October 2023

Purpose: Many health professions education programs involve people with lived experience as expert speakers. Such presentations may help learners better understand the realities of living with chronic illness or experiencing an acute health problem. However, lectures from only one or a small number of people may not adequately illustrate the perspectives and experiences of a diverse patient cohort. Additionally, logistical constraints such as public health restrictions or travel barriers may impede in-person presentations, particularly among people who have more restrictions on their time. Health professions education programs may benefit from understanding the potential effects of online patient-led presentations with a diverse set of speakers. We aimed to explore whether patient-led online learning modules about diabetes care would influence learners’ responses to clinical scenarios and to collect learners’ feedback about the modules.
Method: This within-subjects randomized experiment involved 26 third-year medical students at Université Laval in Quebec, Canada. Participation in the experiment was an optional component within a required course. Prior to the intervention, participating learners responded to three clinical scenarios randomly selected from a set of six such scenarios. Each participant responded to the other three scenarios after the intervention. The intervention consisted of patient-led online learning modules incorporating segments of narratives from 21 patient partners (11 racialized or Indigenous) describing why and how clinicians could provide patient-centered care. Working with clinical teachers and psychometric experts, we developed a scoring grid based on the biopsychosocial model and set 0.6 as a passing score. Independent evaluators, blinded to whether each response was collected before or after the intervention, then scored learners’ responses to scenarios using the grid. We used Fisher’s Exact test to compare proportions of passing scores before and after the intervention.
Results: Learners’ overall percentage of passing scores prior to the intervention was 66%. Following the intervention, the percentage of passing scores was 76% (p = 0.002). Overall, learners expressed appreciation and other positive feedback regarding the patient-led online learning modules.
Discussion: Findings from this experiment suggest that learners can learn to provide better patient-centered care by watching patient-led online learning modules created with diverse patients.
Microstructural and mechanical characterization of Al/Cu interface in a bimetallic composite produced by compound Casting
Authors: Salout Shima Ahmadzadeh , Mirbagheri Seyed Mohammad Hossein
Published: October 2023

The bimetal set (Al/Cu) with Cu wire with 2.0, 2.5, and 3.0 mm diameters were cast at different casting temperatures and solidification times through the compound casting method. The microstructure of solid/liquid diffusion bonding at the Al/Cu interface was investigated, and the shear strength of the Al/Cu interface was measured by punch test. By characterizing the diffusion layer, the optimum parameters of the compound casting, including the casting temperature and the solidification soaking time, as well as the Cu wire diameter, were acquired. The intermetallic compounds (IMCs) such as CuAl2, CuAl, and Cu9Al4 were observed in the diffusion layer. The types of intermetallic phases and diffusion layer thickness affect the hardness and the shear strength. The result of casting at 680°C and solidification soaking time of 15 s for 3 mm Cu wire, shows that IMCs increased the micro-hardness of the Al/Cu bimetal up to 328 HV at the Al/Cu interface. Also, increasing the solidification soaking time at a constant temperature resulted in a growth of the interface layer’s thickness, which exhibits a lamellar eutectic microstructure containing IMCs. Furthermore, this action caused an increase in the shear strength.
‘Not me!’ a qualitative, vignette-based study of nurses’ and physicians’ reactions to spiritual distress on neuro-oncological units
Authors: Völz Daniela , Grabenweger Reinhard , Best Megan C. , Hau Peter , Jones Kate F. , Linker Ralf , Paal Piret , Bumes Elisabeth
Published: October 2023

Purpose
People with primary malignant brain tumors experience serious health-related suffering caused by limited prognosis and high symptom burden. The aim of this study was to analyze the attitudes and behavior of nurses and physicians when confronted with spiritual distress in these patients.
Methods
Neurospirit-DE is a qualitative vignette-based, multicentre, cross-sectional online survey that was conducted in Bavaria, Germany. Reflexive Thematic Analysis was used for data analysis.
Results
A total of 143 nurses and physicians working in neurological and neurosurgical wards in 46 hospitals participated in the survey. The participants questioned if the ability to provide spiritual care can be learned or is a natural skill. Spiritual care as a responsibility of the whole team was highlighted and the staff reflected on the appropriate way of involving spiritual care experts. The main limitations to spiritual care were a lack of time and not viewing spiritual engagement as part of the professional role. Some were able to personally benefit from spiritual conversations with patients, but many participants criticized the perceived emotional burden while expressing the imminent need for specific training and team reflection.
Conclusions
Most neuro-oncological nurses and physicians perceive spiritual care as part of their duty and know how to alleviate the patient’s spiritual distress. Nonetheless, validation of spiritual assessment tools for neuro-oncology and standardized documentation of patients' distress, shared interprofessional training, and reflection on the professional and personal challenges faced when confronted with spiritual care in neuro-oncology require further improvement.
Joint effect of multiple metals on blood lipid profile in overweight/obese and normal-weight adults: a cross-sectional study in China
Authors: Wu Shan , Zhao Dongwei , Ji Guiyuan , Li Lvrong , Xing Xiaohui , Li Jiajie , Ma Anping , Wei Yuan , Huang Huimin , Ma Wenjun , Dong Ming , Wu Banghua , Liu Tao , Chen Qingsong
Published: October 2023

Background: Dyslipidemia may be a potential links between metals exposure and adverse cardiovascular events, which may be different in overweight/obese (OW/OB) and normal-weight adults. However, the joint effect of various metals on lipid profiles and the contribution of each metal remain unknown.
Methods: 2808 adults were recruited from Guangdong, and the blood levels of 13 metals and the serum lipid levels were measured. Multivariate log binomial regression and quantile g-computation were applied to analyze the single and joint effects of various metals on lipid profiles and the contribution of each metal among OW/OB and normal-weight adults.
Results: HDL-C was significantly decreased in OW/OB subjects, while LDL-C and non-HDL-C were significantly increased in normal-weight adults. There were significant and positive joint effects of multiple metals on various blood lipid parameters in all, OW/OB or normal-weight participants. Quantile g-computation showed that Mo, As, Cr and V contributed most to the effect of the mixture for various lipid parameter in OW/OB participants, whereas Cd, Pb, Zn, Se, Co and V contributed the most in normal-weight participants. Our findings indicated that the joint effects of multi-metals on various blood lipid parameters were positive and significant. The relative importance of various metals in various lipid profiles among OW/OB and normal-weight adults were different. Further prospective studies in larger population are needed to clarify these findings.
Ammonium ion adsorption from aqueous solutions by using modified activated carbon derived from rice straw
Authors: Sedaghat Omid , Bahramifar Nader , Younesi Habibollah
Published: October 2023

Many of the health problems of organisms have been attributed to the excessive release of ammonia and nitrogen-containing compounds into the environment. The study was conducted to identify the potential use of oxidized activated carbon (OAC) to remove ammonium ions from aqueous solutions on modified activated carbon in batch system adsorption. BET, SEM, and FTIR analyses were used to characterize the obtained adsorbent. The effects of adsorbent dose, initial concentration of ammonium ions, pH, temperature and contact time on removal efficiency were evaluated. Additionally, kinetic, thermodynamic and isotherm models were investigated to understand the mechanism of adsorption of ammonium ions on OAC. The results showed that 97% of ammonium was removed by modified activated carbon. The adsorption of ammonium ions on OAC increases with increasing adsorbent dose, pH, and contact time. Moreover, it decreased with an increasing initial concentration of ammonium ions. The equilibrium ammonium ion adsorption data for OAC were better fitted with the Langmuir model (r2= 0.999), and a maximum adsorption capacity of 41.50 mg g-1 was achieved. The ammonium ion absorbance kinetics were best described by a pseudo-second-order model (r2=0.999). The prepared adsorbent maintained its efficiency for up to 10 adsorption/desorption cycles. Due to its high adsorption capability and good stability, modified activated carbon powder can be utilized as a worthy adsorbent in water and wastewater treatment.
Granularity Based Inter and Intra-Modal Fusion Network for Sarcasm Detection
Authors: Shi Yicong , Zhao Xiaoli , Chen Mingxuan
Published: October 2023

Multi-modal sarcasm detection is a task that involves detecting and identifyingsarcasm using multiple modalities of information. The key aspect of this task lies in how to model intra and inter-modality incongruity. Existing multi-modal sarcasm detection methods often focus on incongruity between modalities while overlooking the potential of fully exploring the semantic information within each modality. We tackle the problem in this paper by designing the Granularity Based Inter and Intra-Modal Fusion Network (GIIFN). Our approach combines tradi-tional image algorithms with deep learning models to extract comprehensive andrich semantic information from images. By incorporating a pre-trained languagemodel, we leverage knowledge from large-scale textual data to enhance the anal-ysis of images. Furthermore, our feature interaction model can effectively fuse and interact features at different granularities, capturing fine details and contex-tual information in the images. Through extensive experimental validation, we demonstrate the outstanding performance of our approach in multimodal satiredetection tasks, surpassing existing methods and outperforming state-of-the-art results.
Association between nonalcoholic fatty liver disease and erectile dysfunction among American Adults from the National Health and Nutrition Examination Survey: A cross-sectional study
Authors: Zhufeng Chen , youcheng lin , xun wu
Published: October 2023

Nonalcoholic fatty liver disease (NAFLD) is a pressing public health concern. NAFLD is recognized as a disease with systemic involvement. Erectile dysfunction is a prevalent condition among men.The study examined the relationship between nonalcoholic fatty liver disease, assessed via US Fatty Liver Index (USFLI), and erectile dysfunction.This study used cross-sectional data from individuals over 20 years old who took part in the National Health and Nutrition Examination Survey between 2001 and 2004, collecting details on their ED, USFLI, and several other essential variables. A USFLI score equal to or exceeding 30 was chosen to diagnose NAFLD, while a USFLI score below 10 was utilized to exclude the presence of fatty liver.There were 3 763 participants, with 29.1% (1,095/3,763) who experienced ED. After Accounting for all potential covariates, USFLI was positively associated with erectile dysfunction (OR, 1.02; 95% CI, 1.02 ~ 1.03; P < 0.001). Compared with individuals with Q1 (USFLI < 10), the adjusted OR values for USFLI and ED in Q2 (10 ≤ USFLI < 30) and Q3 (USFLI ≥ 30, NAFLD) were 1.84 (95% CI: 1.46 ~ 2.32, p < 0.001) and 2.18 (95% CI: 1.66 ~ 2.87, p < 0.001), respectively. The association USFLI and ED exhibited an L-shaped curve (nonlinear, P = 0.014). The OR of developing erectile dysfunction was 1.03 (95% CI: 1.021 ~ 1.04, P < 0.001) in participants with USFLI < 50.18. This study identified a positive correlation between USFLI and ED within the adult American population. Our findings imply that NAFLD might constitute an independent risk factor for ED.
Insights into the role of glycerol as a marker for differentiation of different flavor types of Baijiu
Authors: Wang Guangnan , Cheng Huan , Pan Haibo , Zheng Fuping , Ye Xingqian , Li Zexia , Zhang Yuhang , Sun Baoguo
Published: October 2023

Glycerol has essential effects on the flavor of alcoholic beverages. However, the non-volatility and low contents of glycerol and the presence of high ethanol content, make it difficult to detect in Baijiu. In this study, a derivatization method combined with gas chromatography-mass spectrometry was used to characterize and quantify glycerol in 12 main flavor types of Baijiu for the first time. The average contents of the glycerol in Soysauce (8.36 ± 2.78 mg/L), Sesame (15.96 ± 0.83 mg/L) and Feng (12.69 ± 2.38 mg/L) flavor types were higher than that in other types. One-way analysis of variance was used to analyze the differences of glycerol in different types of Baijiu among the selected variants, i.e., fermentation process, starter, fermentation container and raw material. The results showed that there were significant effects of these selected categories on the glycerol in Baijiu. The results of heatmap and hierarchical cluster analysis, further indicated that the production temperature of the fermentation starter may be the key factor affecting the contents of glycerol in Baijiu.
Artificial intelligence analysis of nuclear morphological features and molecular abnormalities of papillary thyroid carcinoma
Authors: Nishikawa Toui , Matsuzaki Ibu , Takahashi Ayata , Ryuta Iwamoto , Musangile Fidele Yambayamba , Sagan Kanako , Nishikawa Mizuki , Mikasa Yurina , Takahashi Yuichi , Kojima Fumiyoshi , Murata Shin-ichi
Published: October 2023

Papillary thyroid carcinoma (PTC) is the most common type of thyroid carcinoma and has characteristic papillary-like nuclear features. Genetic abnormalities of PTC affect recent molecular target therapeutic strategy towards RET-altered cases, and they affect clinical prognosis and progression. However, there has been insufficient objective analysis of the correlation between genetic abnormalities and papillary-like nuclear features. Using our newly-developed methods, we studied the correlation between nuclear morphology and molecular abnormalities of PTC with the aim of predicting genetic abnormalities of PTC.
We studied 72 cases of PTC and performed genetic analysis to detect BRAF/V600E mutation and RET/PTCrearrangement. Papillary-like nuclear features of PTC, such as nuclear grooves, pseudo-nuclear inclusions and glassy nuclei, were also automatically detected by deep learning models. After analyzing the correlation between genetic abnormalities and papillary-like nuclear features of PTC, logistic regression models could be used to predict gene abnormalities. Papillary-like nuclear features were accurately detected with over 0.90 of AUCs in every class. The ratio of glassy nuclei to nuclear groove and the ratio of pseudo-nuclear inclusion to glassy nuclei were significantly higher in cases that were positive for RET/PTC rearrangements (p = 0.027, p = 0.043, respectively) than in cases that were negative for RET/PTC. RET/PTCrearrangements were significantly predicted by glassy nuclei/nuclear grooves, pseudo-nuclear inclusions/glassy nuclei and age (p = 0.023).
Our deep learning models could accurately detect papillary-like nuclear features. Genetic abnormalities had correlation with papillary-like nuclear features of PTC. Furthermore, our artificial intelligence model could significantly predict RET/PTC rearrangement of classic PTC.
Single cell RNA-seq reveals that the Vibrio cholerae MakA toxin is required for killing of Tetrahymena pyriformis and for survival in protozoan expelled food vacuoles
Authors: Espinoza-Vergara Gustavo , Hoque M Mozammel , Noorian Parisa , To Joyce , Moon Jonah M. , Rice Scott A. , McDougald Diane
Published: October 2023

Vibrio cholerae uses multiple strategies to resist predation by heterotrophic protozoa. For example, V. cholerae releases toxic compounds such as ammonium and pyomelanin, that can kill protists such as Tetrahymena pyriformis. V. cholerae also survives intracellularly and escapes as viable cells inside protozoan expelled food vacuoles (EFVs). We previously reported that V. cholerae encased in EFVs are hyperinfectious, establishing an important link between anti-protozoal strategies and bacterial virulence. Although the intracellular resistance and escape of V. cholerae in EFVs has been reported, the molecular mechanisms behind this remain poorly understood. Here, we used single cell transcriptomics of V. cholerae exposed to T. pyriformis and captured a total of 5,344 bacterial cells with heterogeneous gene expression. Cells with the same pattern of gene expression were grouped, resulting in eleven clusters of cells with a unique gene expression profile. Genes encoding outer membrane proteins, F1F0-Na+/H+ ATPase, metabolites and toxins showed differential expression among the clusters. Furthermore, the motility-associated killing factor (Mak) toxins (makA, makB and makC) were differentially expressed. A V. cholerae ΔmakA strain was not capable of killing T. pyriformis and showed reduced survival inside EFVs compared to the wild type. Our findings reveal new insights into the grazing resistance mechanisms of V. cholerae, identify factors associated with the survival of V. cholerae within EFVs and more broadly, highlight the connection between antiprotozoal and virulence factors displayed by pathogenic bacteria.