bluuebunny/crossref_metadata_2025 huggingface dataset:
NQO1 polymorphism and susceptibility to ischemic stroke in a Chinese population
Authors: Wang Min , Shen Ying , Gao Yuan , Chen Huaqiu , Duan Fuhui , Li Siying , Wang Guangming
Published: April 2024

Background
Ischemic stroke (IS) is a major cause of death and disability worldwide. Genetic factors are important risk factors for the development of IS. The quinone oxidoreductase 1 gene (NQO1) has antioxidant, anti-inflammatory, and cytoprotective properties. Thus, in this study, we investigated the relationship between NQO1 gene polymorphism and the risk of IS.
Methods
Peripheral blood was collected from 143 patients with IS and 124 healthy controls in Yunnan, China, and NQO1 rs2917673, rs689455, and rs1800566 were genotyped. Logistic regression was used to analyze the relationship between the three NQO1 loci and IS susceptibility. The difference in the expression levels of NQO1 between the control and IS groups was verified using public databases and enzyme-linked immunosorbent assay.
Results
The rs2917673 locus increased the risk of IS by 2.375 times in TT genotype carriers under the co-dominance model compared with CC carriers and was statistically associated with the risk of IS (P = 0.046). In the recessive model, TT genotype carriers increased IS risk by 2.407 times compared with CC/CT carriers and were statistically associated with the risk of IS (P = 0.033).
Conclusions
NQO1 rs2917673 polymorphism is significantly associated with IS. Mutant TT carriers are risk factors for IS.
The Effect of Hormone Therapy on Physiological Uptake of the Endometrium on [18F]F-FDG PET in Postmenopausal Women
Authors: Nakamoto Ryusuke , Yakami Masahiro , Nobashi Tomomi Watanabe , Isoda Hiroyoshi , Nakamoto Yuji
Published: April 2024

Objective
The effects of hormonal therapy, estrogen-based hormone replacement therapy (HRT), and anti-tumor hormone therapy, such as tamoxifen, on the physiological uptake of the endometrium on 2-deoxy-2[18F]fluoro-D-glucose ([18F]F-FDG) positron emission tomography (PET) in postmenopausal women have not been determined. We explored the effect of hormone therapy, particularly HRT, on physiological uptake in the endometrium of postmenopausal women.
Materials and Methods
Postmenopausal women receiving hormone therapy who underwent cancer screening using PET/computed tomography (CT) between June 2016 and April 2023 were included in the hormone therapy group (n = 21). Postmenopausal women with no history of hormone therapy were included in the control group (n = 49). First, the physiological endometrial uptake at menopausal age and at least 1 year thereafter was compared quantitatively (SUVmax) and qualitatively (4-point scale) in the control group, to assess when the endometrium ceased to show significant physiological [18F]F-FDG uptake after menopause. Endometrial uptake was compared between the hormone therapy and control groups. The association between HRT duration (months) and endometrial uptake (SUVmax) was evaluated. Endometrial thickness, measured using transvaginal ultrasonography, was also compared between the two groups.
Results
Endometrial uptake was significantly reduced both qualitatively and quantitatively (P < 0.05) at least 1 year after menopause in control patients, by which time most women (93.9%) no longer had significant endometrial uptake. The hormone therapy group (n = 21) showed higher FDG uptake in the endometrium compared to the control group (median SUVmax: 2.3 vs 1.9, P = 0.0011), as well as a higher visual score (P < 0.0001). HRT duration did not correlate with endometrial uptake (P = 0.097). Endometrial thickness in the hormone therapy group was significantly thicker than in the control group (median: 3.9 mm vs 1.8 mm, P = 0.002).
Conclusion
Hormone therapy may affect physiological uptake in the endometrium in postmenopausal women.
The mediating role of achievement motivation in the relationship between proactive personality and entrepreneurial intention among college students
Authors: Zhang Jinyong , Deng Huaiqing
Published: April 2024

With the increasing number of college graduates and the popularization of college students, the employment of college students has become the focus of academic circles. This study explores the mediating role of achievement motivation between proactive personality and entrepreneurial intention of Chinese college students. In this study, 1021 college students from 5 universities in a certain city in China were measured by the proactive personality inventory, achievement motivation Inventory and entrepreneurial intention inventory. The results show that:(1) Entrepreneurial intention is positively correlated with proactive personality and success motivation respectively; (2) Proactive personality can positively and significantly predict entrepreneurial intention; (3) Success-seeking motivation plays an intermediary role in proactive personality and entrepreneurial intention; It shows that proactive personality can directly affect the entrepreneurial intention of college students, and can also indirectly affect the entrepreneurial intention of college students through the pursuit of success motivation.
3D-Printed Brachytherapy in Patients with Cervical Cancer: Improving Efficacy and Safety Outcomes
Authors: Lu Zenghong , zhu gangfeng , Qiu Zhengang , Guo Hailiang , Li Junyan , Zheng Liangjian , Chen Cixiang , Che Jie , Xiang Yi , Wang Yili
Published: April 2024

Objective: This study aims to evaluate the efficacy and safety of 3D printing technology in brachytherapy for cervical cancer, comparing its outcomes with conventional manual implantation brachytherapy.
Methods: A total of 57 cervical cancer patients treated at the First Affiliated Hospital of Gannan Medical College from January 2019 to July 2023 were included in this study. Patients were divided into two groups: 25 patients received intensity-modulated radiotherapy (IMRT) combined with 3D-printed brachytherapy, and 25 patients underwent IMRT combined with manual brachytherapy implantation. Key indicators analyzed included short-term therapeutic effects, survival outcomes, operation times, the number of CT scans, the number of needles inserted, dosimetric parameters, and complications.
Results: The use of 3D-printed brachytherapy significantly improved the safety of radiation therapy operations, especially for large tumors (≥30mm), by providing more precise dose distribution and reducing the radiation doses received by critical organs such as the bladder and rectum. The incidence of radiation enteritis was significantly lower in the 3D-printed brachytherapy group compared to the manual implantation group (P< 0.001). There were no significant differences in other complications between the two groups. Short-term therapeutic response rates were comparable, with no significant difference in overall survival observed between the two groups.
Conclusion: 3D-printed brachytherapy offers a more effective and safer therapeutic option for patients with cervical cancer, particularly for those with large tumors or complex anatomical structures.
Kirschner wires as blocking screws in extra-articular fractures of the distal tibia treated with intramedullary nail
Authors: Liu Jun , Dai Simin , Liu Lijin , Kuang Hailin , Yan Liang , Cai Qiangqiang , Shao Zongzuan , Wei Wenbo , Min Zhihai , Tang Wubing , Fu Xiaoxing
Published: April 2024

Background
To explore the clinical efficacy and safety of Kirschner wires (KWs) as a blocking screw technique for extra-articular fractures of the distal tibia treated with intramedullary nails (IMNs).
Methods
Fifty-three patients were treated with KW-assisted IMN for extra-articular fractures of the distal tibia via the blocking screw technique or poller screw (PS) technique. The operation time, number of fluoroscopies, number of blocking screws used, blood loss and time to union were compared between the two groups. Additionally, the functional outcomes of the two groups were compared using range of motion (ROM), visual analog scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS), and Lysholm scores.
Results
Compared with those in the PS group, the operation time in the KW group was significantly shorter, and the number of fluoroscopy procedures and amount of blood loss during KW surgery were also significantly lower (P = 0.014, 0.001, and 0.036, respectively). Regarding the functional outcomes, there were no significant differences in the ROM, VAS score, AOFAS score or Lysholm score between the two groups (P > 0.05).
Conclusion
In the treatment of extra-articular fractures of the distal tibia with nails, the use of KW as a blocking screw technique is safe and reliable.
Systematic Review of Natural Language Processing Applied to Gastroenterology & Hepatology: The Current State of the Art
Authors: Stammers Matthew , Ramgopal Balasubramanian , Obeng Abigail , Vyas Anand , Nouraei Reza , Metcalf Cheryl , Batchelor James , Shepherd Jonathan , Gwiggner Markus
Published: April 2024

Objective: This review assesses the progress of NLP in gastroenterology to date, grades the robustness of the methodology, exposes the field to a new generation of authors, and highlights opportunities for future research.Design: Seven scholarly databases (ACM Digital Library, Arxiv, Embase, IEEE Explore, Pubmed, Scopus and Google Scholar) were searched for studies published 2015–2023 meeting inclusion criteria. Studies lacking a description of appropriate validation or NLP methods were excluded, as were studies unavailable in English, focused on non-gastrointestinal diseases and duplicates. Two independent reviewers extracted study information, clinical/algorithm details, and relevant outcome data. Methodological quality and bias risks were appraised using a checklist of quality indicators for NLP studies.Results: Fifty-three studies were identified utilising NLP in Endoscopy, Inflammatory Bowel Disease, Gastrointestinal Bleeding, Liver and Pancreatic Disease. Colonoscopy was the focus of 21(38.9%) studies, 13(24.1%) focused on liver disease, 7(13.0%) inflammatory bowel disease, 4(7.4%) on gastroscopy, 4(7.4%) on pancreatic disease and 2(3.7%) studies focused on endoscopic sedation/ERCP and gastrointestinal bleeding respectively. Only 30(56.6%) of studies reported any patient demographics, and only 13(24.5%) scored as low risk of validation bias. 35(66%) studies mentioned generalisability but only 5(9.4%) mentioned explainability or shared code/models.Conclusion: NLP can unlock substantial clinical information from free-text notes stored in EPRs and is already being used, particularly to interpret colonoscopy and radiology reports. However, the models we have so far lack transparency, leading to duplication, bias, and doubts about generalisability. Therefore, greater clinical engagement, collaboration, and open sharing of appropriate datasets and code are needed.
A Novel Nomogram Based on inflammatory-nutritional Biomarkers For Gallbladder Cancer after Surgical Resection
Authors: Yin Xueqing , Ma Xinren , sun Pu , Shen Danyang , Tang Zuxiong
Published: April 2024

Purpose
Systemic inflammation and nutrition are vital for tumor progression. This study aimed to identify prognostic inflammation nutrition markers and develop a predictive nomogram for gallbladder cancer (GBC).
Methods
A total of 123 patients with GBC who underwent surgical resection at the First Affiliated Hospital of Soochow University and Suzhou Kowloon Hospital were included in our study. The final prognostic variables were identified using univariate and multivariate analyses. A nomogram model was then established, and the consistency index (C-index), calibration curves, and Kaplan-Meier analysis were performed to evaluate the accuracy and discrimination of the nomogram. The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) suggested that our nomogram had better predictive ability and clinical feasibility than a published model.
Results
The cox regression analysis showed that carcinoembryonic antigen (CEA) > 4.580, albumin-bilirubin (ALBI) > − 2.091, geriatric nutritional risk index (GNRI) < 90.83, T3–T4, and N2 are independent prognostic factors. A predictive nomogram was constructed with a C-index of 0.793. In the calibration curves, the nomogram-predicted 1-, 3-, and 5-year survival matched well with the actual survival. Kaplan-Meier analysis showed that the high-risk group had worse survival than the low-risk group (P < 0.001). Finally, our nomogram achieved better 1-, 3- and 5-year AUCs than an established model (0.871, 0.844, and 0.781 vs. 0.753, 0.750, and 0.693). DCA also confirmed that our model outperformed the established model.
Conclusions
In conclusion, our study revealed that CEA > 4.580, GNRI < 90.83, ALBI > − 2.091, T3–T4 stage, and N2 were related to clinical outcomes of patients with GBC after surgical resection. The constructed nomogram has superior predictive ability and clinical practicality.
Gastrointestinal health and serum proteins are associated with BMD in postmenopausal women: A cross-sectional study
Authors: Wang Han , Jiang Qiuxia , Yan Jiai , Ju Yang , Sun Jing , Wang Yingyu , Huang Gege , Zhang Feng , Cao Hong , Wang Xuesong , Li Dan
Published: April 2024

Background
With increasing age, the social and economic burdens of postmenopausal osteoporosis are steadily increasing. This study aimed to investigate the factors that influence the development of postmenopausal osteoporosis.
Methods
Postmenopausal women at the Affiliated Hospital of Jiangnan University from January 2023 to December 2023 were recruited for BMD examination. The patients were divided into a normal group, an osteopenia group and an osteoporosis group according to their T value. Questionnaires, including the Gastrointestinal Symptom Rating Scale and Short Form 12, were administered through face-to-face interviews. Bone turnover markers and serum protein levels of Fasting venous blood were detected.
Results
A total of 222 postmenopausal women met the inclusion criteria were recruited. Univariate analysis revealed statistically significant differences in age, education, BMI, supplementation with soy products, supplementation with dairy products, supplementation with other nutritional supplements, exercise frequency, gastrointestinal symptom score, quality of life, 25(OH)D, total protein, albumin and prealbumin among the three groups (P < 0.05). Pearson correlation analysis revealed that gastrointestinal symptoms (r = -0.518, P<0.01) was negatively correlated with BMD in postmenopausal women, while PCS (r= 0.194, P= 0.004), MCS (r= 0.305, P < 0.01), 25(OH)D (r= 0.531, P < 0.01), total protein (r= 0.324, P < 0.01), albumin (r= 0.341, P < 0.01) and prealbumin (r= 0.259, P < 0.01) were positively correlated with BMD.
Conclusion
Increasing age, low BMI, gastrointestinal disorders, decreased serum protein and 25(OH)D levels may contribute to an increased risk of postmenopausal osteoporosis. Supplementation with soy and dairy products and consistent exercise may prevent postmenopausal osteoporosis.
Multi-trajectories of body mass index, waist circumference, gut microbiota, and incident dyslipidemia: a 27-year prospective study
Authors: Zhang Xiaofan , Guan Fangxu , Gou Wanglong , Wang Qi , Du Shufa , Su Chang , Zhang Jiguo , Zheng Ju-Sheng , Wang Huijun , Zhang Bing
Published: April 2024

Background: Evidence is insufficient to establish a longitudinal association between combined trajectories of body mass index (BMI) and waist circumference (WC) and dyslipidemia. Our study aimed to explore the association between multi-trajectories of BMI and WC and incident dyslipidemia and identify microbiota and metabolite signatures of these trajectories.
Methods: Stratified by sex, we used a group-based trajectory modeling approach to identify distinct multi-trajectories of BMI and WC among 10,678 participants from the China Health and Nutrition Survey over a 24-year period. For each sex, we examined the associations between these multi-trajectories (1991-2015) and the onset dyslipidemia (2018) using multivariable logistic regression adjusting for sociodemographic and lifestyles factors. We characterized the gut microbial composition and performed LASSO and logistic regression to identify gut microbial signatures associated with these multi-trajectories in males and females, respectively.
Results: We identified four multi-trajectories of BMI and WC among both males and females: Normal (Group 1), BMI&WC normal increasing (Group 2), BMI&WC overweight increasing (Group 3), and BMI&WC obesity increasing (Group 4). Among males, Group 2 (OR: 2.10, 95% CI: 1.28–3.46), Group 3 (OR: 2.69, 95% CI: 1.56–4.63) and Group 4 (OR: 3.56, 95% CI: 1.85–6.83) had higher odds of developing dyslipidemia. However, among females, only those in Group 2 (OR: 1.54, 95% CI: 1.03–2.30) were more likely to develop dyslipidemia. In males, compared with Group 1, we observed lower alpha-diversity within Groups 2,3, and 4, and significant beta-diversity differences within Groups 3 and 4 (p ＝ 0.001). We also identified 3, 8, and 4 characteristic bacterial genera in male Groups 2, 3 and 4, and 2 genera in female Group 2. A total of 23, 25 and 10 differential metabolites were significantly associated with the above genera, except for Group 2 in males.
Conclusions: The ascending combined trajectories of BMI and WC are associated with a higher risk of dyslipidemia, even with normal baseline levels, especially in males. Shared and unique gut microbial and metabolic signatures among these high-risk trajectories could enhance our understanding of the mechanisms connecting obesity to dyslipidemia.
Improved CNN System for Face Mask Recognition
Authors: Jassim Ammar Hussein , Altaie Ahmed , Ajrash Amal Sufiuh
Published: April 2024

Deep learning, especially convolutional neural networks, has significantly improved performance in computer vision. Therefore, we designed and developed a modified deep convolutional neural network framework for detecting mask in facial images in a sizable synthesized and un-synthesized face mask dataset. The suggested method can be utilized to detect face masks in any image with a low-resolution, different alignments, complex, and noisy background by tuning the hyperparameters to accurately identify the existence of masks without generating overfitting. The experimentally obtained results demonstrate that the suggested model exhibits a significant efficiency level, achieving 97.39% accuracy, 97.34% precision, 97.41% recall, 97.37% F1-score, and 97.4% AUC. The empirical results have been documented after 35 iterations using optimized hyperparameter settings, and those predictive models were trained on 64,398 images with a 98% accuracy rate and 0.05 loss, proving the proposed work's reliability and robustness.
A heterozygous variant of SON gene in child with ZTTKS
Authors: Ma Dannv , Wang Jinjing , Song Xiao
Published: April 2024

Background Zhu-Tokita-Takenouchi-Kim syndrome (ZTTKS) is a rare, autosomal dominant genetic disorder caused by the variant of SON gene. Till now, only about 60 cases of ZTTKS were reported to date worldwide. Most pediatricians have limited knowledge about the disease, which leads to delays usually in diagnosis. Case presentation: A girl with feeding difficulties, hypotonia, and poor overall growth were noted. Physical examination showed a height of 77cm (< -10 SD) and a weight of 8kg ( < − 5 SD) at the age of 9.5 years old. She cannot communication and stand till now. She had characteristic dysmorphic facial features, including frontal bossing, small ophthalmic fissure, downslanting palpebral fissures, broad nasal bridge, nostril upturned thin upper lip, small mouth, low-set protruding ear, sparse hair, high-arched palate, edentulous, enamel dysplasia, and long and adduction left thumb. Extremely low insulin-like growth factor-1 (22.4 ng/mL) and low insulin-like growth factor binding protein 3 (0.72 g/ml) level was noted. Whole exome sequencing found a novel heterozygous variant, c.2207_2210del (p. Leu736Argfs*10), in the exon 3 of SON gene. Conclusions In patient with characteristic dysmorphic facial features, hypotonia, poor overall growth, and mental retardation, ZTTKS should be considered in the differential diagnosis. Next generation sequencing should perform early for these patients.
Promoting Low-Cost Water Purification Methods in the Urban Slum Area of Sindh, Pakistan: Using the Community as Partner Model
Authors: Khowaja Shaneela , Saleh Sony Muhammad , Dan Bhagti Davi Lachhman , Anwar Aqsa Muhammad , Bacho Abdul Hameed , Samar Victoria
Published: April 2024

This small-scale project used the community as partner (CAP) model to tailor evidence-based, cost-effective, and practical strategies for mitigating the issue of unsafe drinking water in the urban slum area of Jamshoro, where the other approaches for water purification were either scarce or difficult to access. The fieldwork was carried out from January to March 2023. Before starting the project, key stakeholders and the local people obtained verbal and written consent. Using the CAP model, the Year IV nursing students conducted a community assessment to determine the local community’s awareness regarding home-based water purification methods, water contamination, and waterborne diseases. Next, the action planning process was carried out, followed by teaching through awareness sessions. The study adopted a CAP approach, which was opposed to how research activities are carried out traditionally. In this study, the undergraduates and community partners were jointly involved in assessing, setting priorities, and implementing and evaluating the project. This equitable partnership was found to be beneficial in numerous ways, including context-based relevancy, acceptability of strategies, and sustainability of the project.
Deformed neutron stars
Authors: Quartuccio Jonathan , Moraes Pedro , Arbañil José
Published: April 2024

We present solutions for non-spherically symmetric neutron stars. We begin by deriving the Tolman-Oppenheimer-Volkoff equations from a parameterized metric that takes into account the deformation of the star due to differences in equatorial and polar pressures, expressed in terms of a parameter $\mathcal{D}$, which is the ratio between polar and equatorial radius. The stellar structure is solved using the GM1 equation of state and the Tolman-Oppenheimer-Volkoff equations for deformed objects are numerically integrated using the fourth-order Runge-Kutta method for different values of the parameter $\mathcal{D}$. We show that larger values of $\mathcal{D}>1$, that describe prolate neutron stars, yield smaller values of mass and radius, while for smaller values of $\mathcal{D}<1$, describing oblate neutron stars, larger values for mass and radius are attained. From the confrontation of our model theoretical predictions with recent observational data on pulsars, it is possible to constrain the values of the parameter $\mathcal{D}$.\\
\emph{Keywords}: general relativity; tov equation; neutron stars; deformation
Biodegradation of ethylene vinyl acetate using Klebsiella aerogenes isolated from Effective Microorganisms
Authors: Maidarjav Amarbayasgalan , Nyamjav Indra , Kim Hong Rae , Suh Dong-Eun , Lee Sukkyoo
Published: April 2024

The amount of global plastic waste on land or in the marine environment is a critical environmental issue. Plastic biodegradation by microorganisms, wax worms, and enzymes has become one of the most popular solutions because it produces no harmful environmental derivatives for ecological plastic waste. This study revealed the biodegradation pathway of ethylene vinyl acetate by the bacteria strain Klebsiella aerogenes EM011, which was isolated from effective microorganisms. We identified that K. aerogenes can survive in a carbon-free environment, using ethylene vinyl acetate films as the sole source of energy and decomposing ethylene vinyl acetate microparticles. Next, we examined the degradation of the plastic surface after bacterial treatment using scanning electron microscopy. We detected the modifications in the imaged area of the plastic by energy-dispersive x-ray spectroscopy. Based on the imaging analysis, we conducted Fourier-transform infrared spectroscopy and X-ray photoelectron spectroscopy analyses to detect changes in functional groups and chemical components, elucidating alterations on the surface of the treated plastics. Through these physicochemical analyses, the formation of carbonyl groups (C = O), ester groups (C-O), and hydroxyl groups (-OH) confirmed the degradation of EVA plastic. Furthermore, oxidation led to the decomposition of the ethylene vinyl acetate film, resulting in changes to the plastic characteristics. These alterations were validated by thermal gravimetric analysis and Gel Permeation Chromatography. These findings show that the K. aerogenes EM011 strain has a role in accelerating the biodegradation of ethylene vinyl acetate plastic.
Impact of HIV exposure without infection on hospital course and 30-day mortality among young children in sub-Saharan Africa: a multi-site cohort study
Authors: Lwanga Christopher , Aber Peace , Tickell Kirkby D. , Ngari Moses , Mukisa John , Atuhairwe Michael , Brown Lindsay , Mupere Ezekiel , Potani Isabel , Shahrin Lubaba , Morgan Brooks , Singa Benson , Nankabirwa Victoria , Mugambe Richard K. , Mukasa Zakaria , Walson Judd L. , Berkley James A. , Lancioni Christina L.
Published: April 2024

Background: HIV-exposed uninfected (HEU) young children are at increased risk of hospitalization and death as compared to HIV-unexposed uninfected (HUU) children. The drivers of poor outcomes among HEU children remain unknown, limiting the development of interventions to support this vulnerable population.
Methods: We performed a secondary analysis of data from a large multi-country prospective cohort Childhood Acute Illness and Nutrition (CHAIN) Network study. Hospitalized children aged 2-23 months were followed from an index admission for 6 months after discharge to determine acute and long-term outcomes. Data from the 5 sites in Uganda, Kenya, and Malawi were included. Using perinatal HIV exposure (HEU and HUU) as the primary exposure and adjusting for child, caregiver, and household characteristics, we compared 30-day survival outcomes, nutritional status, illness severity, and utilization of inpatient resources.
Results: We included 1486 children: 217 HEU and 1269 HUU. Wasting and stunting were more frequent in HEU than HUU children, with adjusted OR 1.46, 95% CI (1.06-2.01) and adjusted OR 2.03, 95% CI (1.42 – 2.90), respectively. HEU children were twice as likely to have a prolonged hospital stay compared to HUU children [adjusted OR 2.17, 95% CI (1.23- 3.80)], despite no significant difference in the prevalence of severe illness at admission [adjusted OR 1.25, 95% CI (0.88-1.77)]. Admission diagnoses and use of inpatient resources also did not differ significantly between groups. HEU children had an increased risk of mortality during the 30 days following hospital admission [adjusted hazard ratio 1.75, 95% CI (1.09- 2.80)].
Conclusions: HEU childrenare more likely to be wasted and stunted, have prolonged hospital stay, and die within 30 days of hospitalization, as compared to HUU children. Hospitals in settings where maternal HIV infection remains common should ensure that maternal HIV status is established among children requiring admission and build capacity to provide additional hospital monitoring and early post-discharge support for HEU children.
Patient Driven EKG Device Performance in Adults with Fontan Palliation
Authors: Laubham Matthew , Dodeja Anudeep K , Kumthekar Rohan , Shay Victoria , D’Emilio Nathan , Conroy Sara , Mah May Ling , Alvarado Chance , Kamp Anna
Published: April 2024

Objectives The aim of this study was to evaluate the accuracy of the KardiaMobile (KM) device in adults with a Fontan palliation, and to assess the KM function as a screening tool for atrial arrhythmias.Background While patient driven electrocardiogram (EKG) devices are becoming a validated way to evaluate cardiac arrhythmias, their role for patients with congenital heart disease is less clear. Patients with single ventricle Fontan palliation have a high prevalence of atrial arrhythmias and represent a unique cohort that could benefit from early detection of atrial arrhythmias.Methods This single center prospective study enrolled adult patients with Fontan palliation to use the KM heart rhythm monitoring device for both symptomatic episodes and asymptomatic weekly screening over a 1-year period. Accuracy was assessed by comparing the automatic KM to physician overread and traditional EKG.Results Fifty patients were enrolled and 510 follow up transmissions were received. The sensitivity and specificity of enrollment KM-auto compared to EKG was 65% and 100%, respectively. The sensitivity and specificity of enrollment automated KM interpretations (KM-auto) compared to the electrophysiologist interpretation (KM-EP) was 75% and 96%, respectively.Conclusion In the adult Fontan palliation, the accuracy of the KM device to detect a normal rhythm was reliable and best with a physician overread. Abnormal or uninterpretable KM device interpretations, symptomatic transmissions, and any transmissions with a high heart rate compared to a patient’s normal baseline should warrant further review.
Clinical features associated with poor response and early relapse following BCMA-directed therapies in multiple myeloma.
Authors: Kumar Shaji , Rees Matthew , Mammadzadeh Aytaj , Bolarinwa Abiola , Elhaj Mohammed , Bohra Arwa , Bansal Radhika , Khot Amit , Ailawadhi Sikander , Parrondo Ricardo , Chhabra Saurabh , HAYMAN Suzanne , Dispenzieri Angela , Buadi Francis , Dingli David , Warsame Rahma , Kapoor Prashant , Gertz Morie , Muchtar Eli , Kourelis Taxiarchis , Gonsalves Wilson , Rajkumar S , Lin Yi
Published: April 2024

Three classes of BCMA-directed therapy (BDT) exist: antibody drug-conjugates (ADCs), CAR-T, and T-cell engagers (TCEs), each with distinct strengths and weaknesses. To aid clinicians in selecting between BDTs, we reviewed myeloma patients treated at Mayo Clinic with commercial or investigational BDT between 2018–2023. We identified 339 individuals (1-exposure = 297, 2-exposures = 38, 3-exposures = 4) who received 385 BDTs (ADC = 59, TCE = 134, CAR-T = 192), with median follow-up of 21-months. ADC recipients were older, with more lines of therapy (LOT), and penta-refractory disease. Compared to ADCs, CAR-T (aHR = 0.29, 95%CI = 0.20–0.43) and TCEs (aHR = 0.62, 95%CI = 0.43–0.91) had better progression-free survival (PFS) on analysis adjusted for age, the presence of extramedullary (EMD), penta-refractory disease, multi-hit high-risk cytogenetics, prior BDT, and the number of LOT in the preceding 1-year. Likewise, compared to ADCs, CAR-T (aHR = 0.28, 95%CI = 0.18–0.44) and TCEs (aHR = 0.60, 95%CI = 0.39–0.93) had superior overall survival. Prior BDT exposure negatively impacted all classes but was most striking in CAR-T, ORR 86% vs. 50% and median PFS 13-months vs. 3-months. Of relapses, 54% were extramedullary in nature, and a quarter of these cases had no history of EMD. CAR-T demonstrates superior efficacy and where feasible, should be the initial BDT. However, for patients with prior BDT or rapidly progressive disease, an alternative approach may be preferable.
Forecasting Nigeria Foreign Exchange Rate Dynamics
Authors: Ampitan Kehinde Ronald , Akintunde Abosede Adeola
Published: April 2024

This study introduces an examination of the forecasting of Nigeria’s foreign exchange rate dynamics using time series data considering the Monthly official foreign exchange rate between the Nigerian Naira and the US Dollar. Utilizing the Box-Jenkins ARIMA approach, the monthly data spanning from January 2011 to December 2023 was forecasted. Analysis of the results indicated that the series achieved stationarity upon differentiation. Through diagnostic evaluation, it was determined that the ARIMA (0, 1, 2) model was the most suitable based on the Akaike’s information criterion (AIC). Projections for future exchange rates indicated a consistent revaluation of the Naira. These predictions could offer valuable insights for policymakers in Nigeria to anticipate the Exchange rate variations and potential fluctuation ranges of the Nigerian Naira against the US Dollar in the future.
Multi-Task Agent Hybrid Control in Sparse Maps and Complex Environmental Conditions
Authors: Wang Linhai , Yu Su , Li Mou , Wei Xiaolong
Published: April 2024

With the rapid development of space exploration technology, the detection of extraterrestrial bodies has become increasingly important. Among these, path planning and target recognition and positioning technologies are particularly critical for applications in intelligent agents with low computational power operating in complex environments. This paper introduces an A* path planning algorithm with an adaptive heuristic function, which demonstrates improved robustness in low-resolution maps and can plan paths that stay as far away from obstacles as possible, even when the accuracy of the prior map is limited. Additionally, this study proposes a Dynamic Environment Target Identification and Localization (DETIL) algorithm, which includes the identification of unknown obstacles and the spatio-temporal dimension clustering to locate points of interest. Simulation results of the mixed control scheme using both algorithms indicate that the improved A* algorithm reduces the maximum elevation difference by 55% and the maximum cumulative elevation difference by 68% compared to the traditional A* algorithm. The unknown obstacle identification component of the DETIL algorithm can recognize all obstacles along the path, while the spatio-temporal dimension clustering section improves the average number of target discoveries by 152% over the conventional DBSCAN clustering approach.
Can motion onset VEPs see through the blur?
Authors: Kordek David , Young Laura , Voda Petr , Kremláček Jan
Published: April 2024

Motion-onset visual evoked potentials (MO VEPs) are robust to dioptric blur when low contrast and low spatial frequency patterns are used for stimulation. To reveal mechanisms of MO VEPs robustness, we studied whether the resistance to defocus persists even when using a high-contrast checkerboard using digital defocus in the emmetropic eyes of 13 subjects (males 20–60 years). We compared the dominant components of MO VEPs to pattern-reversal VEPs (PR VEP), which are sensitive to the blur. For stimulation, we used checkerboard patterns with 15´ and 60´ checks. To defocus the checkerboard, we rendered it with a second-order Zernike polynomial (\({Z}_{2}^{0}\)) with an equivalent defocus of 0, 2, or 4 D. For PR VEP, the checkerboards were reversed in terms of their contrast. To evoke MO VEP, the checkerboard of 60´ checks moved for 200 ms with a speed of 5 or 10 deg/s in the cardinal directions. The MO VEP did not change in peak time (P ≥ 0.0747) or interpeak amplitude (P > 0.0772) with digital blur. In contrast, for PR VEP, the results showed a decrease in interpeak amplitude (P ≤ 6.65ˑ10 − 4) and an increase in peak time (P ≤ 0.0385). Thus, we demonstrated that MO VEPs evoked by checkerboard, structure containing high spatial content, can be robust to defocus.
Pan-cancer analysis shows that TNFSF4 is a potential prognostic and immunotherapeutic biomarker for multiple cancer types including liver cancer
Authors: Deng Zhaoda , Li Lincheng , meng Zihe , Zeng Guineng , Cao Rui , Liu Rong
Published: April 2024

Background
As a member of the TNF superfamily, TNFSF4 is expressed on antigen-presenting cells and activated T cells by binding to its receptor TNFRSF4. However, tumorigenicity of TNFSF4 has not been studied in pan-cancer. Therefore, comprehensive bioinformatics analysis of pan-cancer was performed to determine the mechanisms through which TNFSF4 regulates tumorigenesis.
Methods
RNA-seq data for 33 cancers was analyzed from UCSC XENA database. Online websites and databases were used to investigate TNFSF4’s biological function, epigenetic modifications, genetic alterations, and tumor immunity. Furthermore, cell phenotype experiment and tumor xenotransplantation experiment were performed to determine the biological functions of TNFSF4.
Results
The pan-cancer analysis showed that TNFSF4 was upregulated in several tumors. Significant relationships between TNFSF4 expression and single cells were also observed in numerous cancer types. TNFSF4 expression correlated with the expression of immune checkpoint genes and could influence various drug sensitivity. Vitro and vivo experiments showed that TNFSF4 could promote the development and progression of HCC.
Conclusions
TNFSF4 was upregulated in multiple cancer types and promoted the development and progression of cancers through several mechanisms including regulation of the tumor-infiltration of immune cells. Our study shows that TNFSF4 is a promising prognostic and immunotherapeutic biomarker in some malignant tumors.
Patterns of psychiatric healthcare use during pandemic times among boys and girls with pre-existing diagnoses: A Norwegian nationwide primary and specialist healthcare registry study
Authors: Lund Ingunn Olea , Jensen Pia , Madsen Christian , Hauge Lars Johan , Havdahl Alexandra , Reneflot Anne , Brandlistuen Ragnhild , Ask Helga
Published: April 2024

Background
The COVID-19 pandemic introduced complexities that were likely more demanding for some groups, such as children and adolescents, and especially those with pre-existing mental health diagnoses. This study examines long-term patterns of psychiatric healthcare utilization among this vulnerable group, providing insights into shifts in psychiatric healthcare use during a global health crisis.
Methods
We use data from the primary and specialist healthcare registries available from the Norwegian emergency preparedness register for COVID-19 (Beredt C19) to estimate patterns of psychiatric healthcare utilization. The data spans the years from 2017 to 2022, covering children and adolescents aged 6–19. We identified young people with recent diagnoses of mental health conditions and compared weekly consultation volumes before and during the pandemic for mental health conditions overall and the following diagnostic categories separately: anxiety/depression, Attention-Deficit Hyperactivity Disorders (ADHD), sleep problems, and Autism Spectrum Diagnoses (ASD). Analyses were stratified by gender.
Results
There was a consistent trend of lower-than-predicted weekly healthcare consultations among young people with pre-existing mental health diagnoses in both primary and specialist healthcare during the pandemic. The reduction was more pronounced in later follow-up periods. The study highlights gender disparities, with boys experiencing more notable declines in healthcare consultations, especially in specialist care. Additionally, the time trends varied across different diagnostic groups. While consultations for sleep problems and anxiety/depression were consistently below the predicted levels, declines in ADHD occurred later in the pandemic. Consultations for ASD were in line with predictions much of the time. However, there were periods with lower-than-predicted consultations before, during, and after social restriction phases. The data suggests an overall decline in healthcare utilization rather than a shift between sectors.
Conclusion
The findings offer insights into healthcare utilization during pandemic times among children and adolescents with pre-existing mental health diagnoses. The study underscores the importance of continuous monitoring and support for this group, ensuring accessible and responsive healthcare during public health emergencies.
The Role of Fetal Echocardiography in Predicting Postnatal Pulmonary Venous Obstruction in Neonates with TAPVR – A single center experience
Authors: Alqahtani Manal , Tolani Drishti , Dugulescu Mirela , Keelan Jenna
Published: April 2024

Totally anomalous pulmonary veinous return (TAPVR) is a high risk and rare cardiac malformation with a low prenatal detection rate and predicting obstruction in these cases is difficult. We sought to investigate fetal echocardiographic parameters associated with postnatal pulmonary venous obstruction (PPVO). We performed a retrospective review of 26 patients with TAPVR who had a fetal echocardiogram from 2010 to 2021. Blinded readers analyzed the fetal Doppler features of the pulmonary veins (PV) and vertical veins (VV) at final fetal assessment. Of the 26 patients, 17 (65%) were prenatally diagnosed and 10 (38.5%) developed PPVO. All patients had associated congenital heart disease. Compared to patients without PPVO, patients with PPVO had a lower VV variability index (VI) (0.51 (0.17–0.79) vs 1.43 (0.54–2.58); p = 0.003), a higher likelihood of having an abnormal VV or PV Doppler pattern (p = 0.042, p = 0.015 ), a higher VV minimum velocity (0.435 m/s (0.17–1.05) vs 0.14 m/s (-0.16-0.35) p = 0.001) and a higher VV mean velocity (0.641 m/s (0.31–1.15) vs 0.321 m/s (0.19–0.5); p = 0.009). A fetal VV VI of ≤ 0.8 was associated with PPVO (100% sensitivity, 86% specificity). Our data show that some fetal PV and VV Doppler indices are significantly different between those that develop PPVO and those who do not, with the most significant difference seen in the VV variability index and VV minimum velocity. Prenatal predictors of PPVO have the potential to influence prenatal counseling, perinatal care, surgical timing, and outcomes associated with this critical diagnosis.
High-entropy superparaelectrics with locally diverse ferroic distortion for high-capacitive energy storage
Authors: Li Hao , Duan Jianhong , Wei Kun , Du Qianbiao , Ma Linzhao , Yu Huifen , Qi He , Zhong Gaokuo
Published: April 2024

Superparaelectrics (SPEs) are considered promising candidate materials for achieving outstanding energy storage capabilities. However, due to the complicated local structural design, simultaneously achieving high recoverable energy density (Wrec) and energy storage efficiency (η) under high electric fields remains a challenge in bulk SPEs. Herein, we propose utilizing entropy engineering to disrupt long-range ferroic orders into local polymorphic distortion disorder with multiple BO6 tilt types and rich heterogeneous polarization configurations. This phenomenon reduces the switching barriers during polarization rotation, thereby facilitating the emergence of SPE behaviors with ideal polarization forms. Furthermore, it enables high polarization response, negligible remanent polarization, delayed polarization saturation, and enhanced breakdown electric fields (Eb) in high-entropy SPEs. Consequently, we achieve an extraordinary Wrec of 15.48 J cm–3 and an ultrahigh η of 90.02% under a high Eb of 710 kV cm–1, surpassing the comprehensive energy storage performance of reported bulk SPEs. This work demonstrates that entropy engineering is a viable strategy for designing high-performance SPEs.
Significant overlap of inflammatory and degenerative features on imaging among patients with degenerative disc disease, diffuse idiopathic skeletal hyperostosis and axial spondyloarthritis: a real-life cohort study
Authors: Ziade Nelly , Udod Melanie , Kougkas Nikolaos , Tsiami Styliani , Baraliakos Xenofon
Published: April 2024

Background
Differentiating between degenerative disc disease (DDD), diffuse idiopathic skeletal hyperostosis (DISH), and axial spondyloarthritis (axSpA) represents a diagnostic challenge in patients with low back pain (LBP). We aimed to evaluate the distribution of inflammatory and degenerative imaging features in a real-life cohort of LBP patients referred to a tertiary university rheumatology center.
Methods
In a retrospective cross-sectional analysis of patients referred for LBP, demographics and symptom information were collected. Conventional radiographs (CR) and MRIs of spine and sacroiliac joints (SIJ), ax. SpA-like changes were considered in the spine in the presence of erosions, sclerosis, squaring, and syndesmophytes on CR and bone marrow oedema (BMO), erosions, sclerosis, and fat lesions (FL) on MRI. SIJ CR were graded per New York criteria; BMO, erosions, FL, sclerosis and ankylosis were identified on MRIs. The final diagnosis made by the rheumatologist was the gold standard. Data were presented descriptively, by patient and by quadrant, and compared among the three diagnosis groups.
Results
Among 136 referred patients, 71 had DDD, 38 DISH, and 27 axSpA; median age 62 years [IQR55-73], 63% males. On CR, SpA-like changes were higher in axSpA in the lumbar (50%, vs DDD 23%, DISH 22%), in DISH in the thoracic (28%, vs DDD 8%, axSpA 12%), and in DDD in the cervical spine (67% vs. DISH 0%, axSpA 33%). On MRI, BMO was higher in DISH in the thoracic (37%, vs DDD 22%, axSpA 5%) and equally distributed in the lumbar spine (35%-42%). FL were more frequently identified in DISH and axSpA in the thoracic (56% and 52%) and in DDD and axSpA in the lumbar spine (65% and 74%, respectively). Degenerative changes were frequent in the three groups. Sacroiliitis (NY criteria) was identified in 49% (axSpA 76%, DDD 48%, DISH 29%).
Conclusion
A significant overlap was found among DDD, DISH, and axSpA for inflammatory and degenerative imaging features. Particularly, SpA-like spine CR features were found in one-fourth of patients with DISH, and MRI BMO was found in one-third of those patients.
A Fractional Adaptive Type-2 Fuzzy Structural Control System: Theorical/Experimental Study
Authors: Zhang Chunwei , Liu Meihua , Mohammadzadeh Ardashir , Taghavifar Hamid
Published: April 2024

A new modified sliding mode control (SMC) method based on type-2 fuzzy neural networks (T2FNNs) is introduced for the active mass damper (AMD) systems. An adaptive T2FNN is used in the switching part, and another adaptive T2FNN is used to estimate the uncertainty of the AMD system. T2FNNs are adopted to predict the system's uncertainties and establish a dynamic model of the AMD system, independent of the mathematical model. The chattering phenomenon is also taken into account and analyzed. The stability is studied by using the Lyapunov approach to derive training rules for both T2FNNs in dynamic modeling and switching part. Numerical simulation and experimental verifications confirm the feasibility and effectiveness of the designed T2FNN based SMC. The results reveal that the designed controller outperforms the conventional controllers in reducing the vibration peak and reducing the root mean square (RMS) value of structural displacement and acceleration. It also exhibits good robustness against external disturbances and structural dynamic perturbations. The suggested algorithm combines the advantages of adaptive control and fuzzy logic, addressing the issue of chattering in control and overcoming the lack of self-learning capability in conventional SMCs.
YOLO-DTO: Automotive door panel fastener detection algorithm based on deep learning
Authors: Xiao-hui Wang , Yun-shuo Jia , Feng-Juan Guo
Published: April 2024

The common detection of fasteners of automobile door panels is based on the template matching method, which has the problems of low detection accuracy and poor real-time performance under the influence of different lighting and different placement positions. To improve the detection speed and accuracy of fasteners in complex scenes, a small object detection algorithm YOLO-DTO (Detect Tiny Object) was proposed based on the YOLOv8 algorithm. Firstly, according to the characteristics of fasteners accounting for fewer image pixels, this paper reconstructs the early stage of the original algorithm by introducing the SPD (space-to-depth) module to retain more fine-grained information about fasteners, secondly, to enhance the algorithm's ability to pay attention to the context information of fasteners, the selective attention module is embedded in the Neck output position of the algorithm, and to optimize the regression efficiency of the bounding box, the CIOU loss function is replaced by the MPDIOU loss function. The experimental results show that the average detection accuracy of the YOLO-DTO algorithm is 98.8%, which is 9.1% and 1.7% higher than that of the template matching method and the YOLOv8 algorithm, respectively, which meets the detection standard of the factory production line and has practical value.