bluuebunny/crossref_metadata_2025 huggingface dataset:
Attributing practice variation by its sources: the case of varicose veins treatments in the Netherlands
Authors: Schippa Luca , Gaspar Katalin , Hijden Eric , Koolman Xander
Published: June 2023

Background
Unwarranted practice variation refers to regional differences in treatments that are not driven by patients’ medical needs or preferences. Although it is the subject of numerous studies, most research focuses on variation at the end stage of treatment, i.e. the stage of the treating specialist, disregarding variation stemming from other sources (e.g. patient preferences, general practitioner referral patterns). In the present paper, we introduce a method that allows us to measure regional treatment variation with that at different stages of the patient journey leading up to treatment.
Methods
A series of logit regressions estimating the probability of (1) initial visit with the physician and (2) treatment correcting for patient needs and patient preferences. Calculating the coefficient of variation (CVU) at each stage of the patient journey.
Results
Our findings show large regional variations in the probability of receiving an initial visit, The CVU, or the measure of dispersion, in the regional probability of an initial visit with a specialist was significantly larger (0.87–0.96) than at the point of treatment both conditional (0.14–0.25) and unconditional on an initial visit (0.65–0.74), suggesting that practice variation was present before the patient reached the specialist.
Conclusions
Our finding demonstrate that specialists’ decisions meaningfully diminish the amount of regional variation, but the variation does not entirely disappear at any stage, even after controlling for patient needs and patient preferences. Hence, a significant share of the treatment variation remains ‘unexplained’. Our findings also suggest that at least of the variation stems from the regional variation in providing referrals in Dutch primary care.
JEL classification
I11; I13; I18
The Labrador Sea sets a new reference point in the subpolar North Atlantic climate record
Authors: Yashayaev Igor
Published: June 2023

The Labrador Sea is the deepest, coldest and freshest subpolar North Atlantic basin. Here, open-ocean convection, driven by surface winter cooling, produces Labrador Sea Water (LSW), a dense voluminous water mass spreading across the ocean, filling and ventilating its intermediate-depth reservoir, and contributing to the Atlantic Meridional Overturning Circulation. The recent multiyear development of recurrently-deepening convection was initiated by increased winter cooling in 2012, continued past 2015, having 1994-2023-high surface cooling, and reached 2000 m, 1996–2023 record deep, in 2018. The convective deepening during 2016–2018 owes to water-column preconditioning by previous winter convections. Convection shallowed in the following winters completing the formation of the densest and largest LSW class since the mid-1990s. The most abrupt shifts in the Labrador Sea convection intensities and depths since the mid-1990s occurred in 2021 and 2023, when winter mixing could only reach 800 m and 700 m, respectfully, shallowing by more than 800 m from 2020 and 2022, and becoming the shallowest since 2011. Consequently, the entire intermediate layer has recently warmed and become less dense. The mentioned cases of abruptly shallowed convection and rapidly warmed ocean can be attributed to the 2021 and 2023 winter collapses of the Polar Vortex, which weakened and reversed the westerly winds, bringing anomalously warm air to the Labrador Sea, reducing the surface cooling to the lowest since 2010, and consequently inhibiting convection.
Simulation-guided Development of an Optical Calorimeter for High Dose Rate Dosimetry
Authors: Roberts Jackson , Moggre Alicia , Meyer Juergen , Marsh Steven
Published: June 2023

PURPOSE
Optical Calorimetry (OC) is based on interferometry and provides a direct measurement of spatially resolved absorbed dose to water by measuring refractive index changes induced by radiation. The purpose of this work was to optimize and characterize in software an OC system tailored for ultra-high dose rate applications and to build and test a prototype in a clinical environment.
METHODS
A radiation dosimeter using the principles of OC was designed in optical modelling software. Traditional image quality instruments, fencepost and contrast phantoms, were utilized in both software and experimentally in a lab environment to investigate noise reduction techniques and to test the spatial and dose resolution of the system. Absolute dose uncertainty was assessed by measurements in a clinical 6 MV flattening filter free (FFF) photon beam with dose rates in the range 0.2–6 Gy/s achieved via changing the distance from the source.
RESULTS
Design improvements included: equalizing the pathlengths of the interferometer, isolating the system from external vibrations and controlling the system’s internal temperature as well as application of mathematical noise reduction techniques. Simulations showed that these improvements should increase the spatial resolution from 22 to 35 lp/mm and achieve a minimum detectable dose of 0.2 Gy, which was confirmed experimentally. In the FFF beam, the absolute dose uncertainty was dose rate dependent and decreased from 2.5 ± 0.8 Gy to 2.5 ± 0.2 Gy for dose rates of 0.2 and 6 Gy/s, respectively.
CONCLUSIONS
A radiation dosimeter utilizing the principles of OC was developed and constructed. Optical modelling software and image quality phantoms allowed for iterative testing and refinement. The refined OC system proved capable of measuring absorbed dose to water in a linac generated photon beam. Reduced uncertainty at higher dose rates indicates the potential for OC as a dosimetry system for high dose rate techniques such as microbeam and ultra-high dose-rate radiotherapy.
Determining structures of individual RNA conformers using atomic force microscopy images and deep neural networks
Authors: Wang Yun-Xing , Degenhardt Maximilia , Degenhardt Hermann , Bhandari Yuba , Lee Yun-Tzai , Ding Jienyu , Heinz William , Stagno Jason , Schwieters Charles , Zhang Jinwei
Published: June 2023

The vast percentage of the human genome is transcribed into RNA, many of which contain various structural elements and are important for functions. RNA molecules are conformationally heterogeneous and functionally dyanmics1, even when they are structured and well-folded2, which limit the applicability of methods such as NMR, crystallography, or cryo-EM. Moreover, because of the lack of a large structure RNA database, and no clear correlation between sequence and structure, approaches like AlphaFold3 for protein structure prediction, do not apply to RNA. Therefore determining the structures of heterogeneous RNA is an unmet challenge. Here we report a novel method of determining RNA three-dimensional topological structures using deep neural networks and atomic force microscopy (AFM) images of individual RNA molecules in solution. Owing to the high signal-to-noise ratio of AFM, our method is ideal for capturing structures of individual conformationally heterogeneous RNA. We show that our method can determine 3D topological structures of any large folded RNA conformers, from ~200 to ~420 residues, the size range that most functional RNA structures or structural elements fall into. Thus our method addresses one of the major challenges in frontier RNA structural biology and may impact our fundamental understanding of RNA structure.
Modeling and optimization of triclosan biodegradation by the newly isolated Bacillus sp. DL4: Kinetics and metagenomics analysis
Authors: Li Xuejie , Hu Xiao-Min , Zhao Xin , Wang Fan , Zhao Yan
Published: June 2023

Overusing triclosan (TCS) endangered ecological safety and human health, and the pandemic of COVID-19 aggravates the accumulation of TCS in the aquatic environment. Therefore, reducing residual TCS concentrations in the environment is an urgent issue. An aerobic bacterium, Bacillus sp. DL4 was isolated with the capability of TCS biodegradation. Response surface methodology (RSM) and artificial neural network (ANN) were carried out to optimize and verify the different condition variables. All the variables were linear and the interaction of the three factors significantly affected TCS removal at the quadratic level (p < 0.001). Under the optimal conditions (35℃, initial pH 7.31, and 5% strain DL4), the TCS removal rate of 95.89 ± 0.68% was observed and found to be consistent with the predicted values from RSM and ANN models. In addition, statistical comparisons between the models indicated that the ANN model had a stronger predictive capability than the RSM model. Kinetic studies showed that TCS degradation was consistent with a pseudo-first-order kinetic model. Whole genome sequencing indicated that many functional genes were involved in and facilitated TCS degradation. Main metabolite products were detected and identified during the biodegradation process by LC-MS, and a possible degradation pathway was tentatively hypothesized. Overall, this study provides a theoretical foundation for the characterization and mechanism of TCS biodegradation in the environment by Bacillus sp. DL4.
A systematic review and meta-analysis of clinical efficacy of early and late rehabilitation interventions for ischemic stroke
Authors: Wei Xufang , Sun Shengtong , Zhang Manyu , Zhao Zhenqiang
Published: June 2023

Introduction: At present, stroke has become the first cause of death and disability among Chinese adults. With the coming of the aging population in China, the disease burden brought by stroke will be increasingly aggravated. And stroke is a leading cause of disability. There is a golden plastic period after stroke, during which timely and safe intervention and rehabilitation therapy can effectively improve the disability status. However, there is still controversy about the duration of interventional rehabilitation after stroke. This study conducted a meta-analysis on the influence of intervention in early and late ischemic stroke rehabilitation.
Method: Chinese language databases such as CNKI, Wanfang, and VIP, and English language databases such as PubMed, Web of Science, and The Cochrane Library were searched, and RCT related to early and late rehabilitation of ischemic stroke from the establishment of the database to May 2022 was collected. Review Manager 5.4.1 was used for relevant analysis.
Results: A total of 1635 patients were included in 14 studies. The results showed that, compared with late rehabilitation, early rehabilitation improved clinical efficacy. Barthel Index or Modified Barthel Index score was [MD=8.82, 95%CI(8.21,9.43), p < 0.001]; the score of Fugl-Meyer Assessment Scale was [MD=8.75, 95%Cl (7.0,10.47), P< 0.001]; the score of NIHSS was [MD=-1.42, 95% CI(-1.93,-0.91), P<0.001]; the result of China Stroke Scale score was [MD=-3.68, 95%CI(-5.43,-1.92), P<0.001].
Conclusion: In comparison with late rehabilitation, early rehabilitation can significantly improve self-care abilities, daily activities, and neurological functions of ischemic stroke patients.
Registration: This meta-analysis has been registered with Prospero, and the registration number is CRD42022309911. The registration period is March 22, 2022.
Network of Drones for Early Warning of Forest Fire and Dynamic Fire Quenching Plan Generation
Authors: S Manoj , Valliyammai C.
Published: June 2023

Wildfires, one of the most frequent natural disasters, significantly harm society, the economy, and the environment. Transfer learning algorithm and modern machine learning tools can help in early forest fire prediction, detection, and dynamic fire quenching. Also, a dynamic fire quenching plan is prescribed which takes into account the live status of forest fire. A network of drones which has high definition image processing and decision making capabilities are used for detection of forest fire in the very early stage there by preventing the forest fire. In case fire breaks out, the proposed system generates a fire quenching plan and alerts the fire and rescue departments so that they do plan early and stop the forest fire as soon as possible. ResNet, VGGNet, Mobile Net, Alexi Net, GoogLeNet models enhanced with transfer learning are used to predict the forest fire events in India. It is found that the proposed technique GoogLeNet-TL, which uses transfer learning with GoogLeNet has resulted in 96% accuracy and 97.56% F1 score than other models considered for forest fire prediction in Indian subcontinent.
Using stable isotopes and gut contents to investigate the foraging ecology of green turtles (Chelonia mydas) in New Caledonia
Authors: Read Tyffen C. , Wantiez Laurent , Keller Florent , Werry Jonathan M , de Merwe Jason P. van , Chateau Olivier , Farman Richard , Limpus Colin J.
Published: June 2023

Green sea turtles (Chelonia mydas) face many threats from anthropogenic activity, and are listed as Endangered on the International Union for the Conservation of Nature (IUCN) Red List of Threatened Species. They spend the majority of their lives in coastal foraging areas, and show strong fidelity to narrow foraging ranges. Understanding the foraging ecology of green turtles is therefore important for their management and conservation. Using stable isotopes analysis (n = 179) and identification of stomach contents (n = 21), this study investigated the foraging ecology of four distinct green turtle foraging populations (Goro, Isle of Pines, Ouen Island and Uo/Mato Islands) within the Grand Lagon Sud. This World Heritage Area located in New Caledonia supports regionally important nesting and foraging green turtle populations. The δ13C and δ15N values of skin samples ranged from − 19.3‰ to -7.3‰ and 2.8‰ to 15.9‰, respectively. Bayesian mixing model indicated mixed diets that were significantly different between locations, indicating the need for customised management strategies for green turtles in this area. There was generally a preference for an algal diet, and significant consumption of animal matter at all locations. This was generally supported by the stomach contents analyses, although not always, illustrating the importance of investigating SIA and stomach contents. This study provides important information on the foraging ecology of green turtles in New Caledonia, supporting management outcomes in this region. This collaboration with the tribes of the Grand Lagon Sud is also the first step towards the integrated management of the resource.
Restricting datasets to classifiable samples augments
discovery of immune disease markers
Authors: Glehr Gunther , Riquelme Paloma , Kronenberg Katharina , Lohmayer Robert , Lopez-Madrona Victor , Kapinsky Michael , Schlitt Hans , Geissler Edward , Spang Rainer , Haferkamp Sebastian , Hutchinson James
Published: June 2023

Immunological diseases are typically heterogeneous in clinical presentation, severity and response to therapy. Markers of immune diseases often reflect this variability, especially compared to their regulated behavior in health. This leads to a common, unarticulated problem that frustrates marker discovery and interpretation: Unequal variance of immune disease marker expression between patient classes necessarily limits a marker’s informative range. To solve this problem, we introduce dataset restriction, a procedure that splits datasets into classifiable and unclassifiable samples. Applied to synthetic flow cytometry data, restriction identified markers that were otherwise disregarded. In advanced melanoma, restriction found new markers of immune-related adverse event risk after immunotherapy and enabled multivariate models that accurately predicted immunotherapy-related hepatitis. Hence, dataset restriction augments discovery of immune disease markers, increases predictive certainty for classifiable samples and improves multivariate models incorporating markers with a limited informative range. This principle can be directly extended to any classification task.
Study of potential anti-bronchial asthma substances in Huagai San based on in vitro and in vivo substance analysis and network pharmacology
Authors: Zhou Nan , Wang Ran , Liu Linfeng , Liu Wei , Luo Xiaojian , rao xiaoyong , He Mingzhen
Published: June 2023

Huagai San(HGS) is an herbal compound commonly used in the treatment of bronchial asthma. Although its effectiveness has been demonstrated in clinical applications, current research on HGS has focused on its clinical efficacy, with a lack of systematic material basis studies of the components. The mechanism of action and bioactive components of HGS are still unknown. In this study, we propose an integrated strategy based on in vivo and in vitro substance analysis and network pharmacology. The aim of this study is to elucidate the chemical composition, clarify the constituents absorbed in the blood, predict the main bioactive components, discovery of potential therapeutic targets, and use it in the study of potential anti-bronchial asthma substances for HGS. A four-step filtering strategy was established by using UHPLC-Q-TOF-MS/MS and applied to the identification of the chemical composition of HGS. 185 compounds were analyzed in the herbal components, and 65 compounds including 40 prototypes and 25 metabolic products were identified in rats. Based on the in vivo composition analysis of HGS, the bioactive components and potential therapeutic targets in the treatment of bronchial asthma were investigated by network pharmacological analysis. The results provide a scientific basis for understanding the bioactive components of HGS and their pharmacological mechanisms.
RETRACTED: Riga stretched surface embedded in three-dimensional nano- Carreau fluid with non-uniform heat source/sink possessions: Symmetry analysis
Authors: Saleem Musharafa
Published: June 2023

The authors have requested that this preprint be removed from Research Square.
Fully implantable and battery-free wireless optoelectronic system for modulable cancer therapy and real-time monitoring
Authors: Kim Kiho , Min In Sik , Kim Tae Hee , Kim Do Hyeon , Hwang Seungwon , Kang Kyowon , Kim Kyubeen , Park Sangun , Lee Jongmin , Cho Young Uk , Lee Jung Woo , Yeo Woon-Hong , Jung Young Mee , Song Young Min , Yu Ki Jun
Published: June 2023

Photodynamic therapy (PDT) is attracting attention as a next-generation cancer treatment that can selectively destroy malignant tissues, exhibit fewer side effects, and lack pain during treatments. Although implantable PDT systems have recently been developed to resolve the issues of bulky and expensive conventional PDT systems and to implement continuous and repetitive treatment, they only focus on providing the function of cancer termination. In cancer treatment procedures, monitoring and treatment of cancer must be done simultaneously. Existing implantable PDT systems, however, are not able to perform multiple functions simultaneously, such as modulating light intensity, measuring, and transmitting tumor-related data. Furthermore, not only current PDT systems, but also most other existing portable cancer treating/monitoring systems provide only a single limited function, resulting in the complexity of cancer treatment. Here, we introduce a flexible and fully implantable wireless optoelectronic system capable of continuous and effective cancer treatment by fusing PDT and hyperthermia and enables tumor size monitoring in real-time. This system exploits micro inorganic light-emitting diodes (µ-LED) that emit light with a wavelength of 624 nm, designed not to affect surrounding normal tissues by utilizing a fully programmable light intensity of µ-LED and precisely monitoring the tumor size by Si phototransistor during a long-term implantation (2–3 weeks). The superiority of simultaneous cancer treatment and tumor size monitoring capabilities of our system operated by wireless power and data transmissions with a cell phone was confirmed through in vitro experiments, ray-tracing simulation results, and a tumor xenograft mouse model in vivo. This all-in-one single system for cancer treatment offers unprecedented opportunities to not only enable effective treatment of tumors located deep in the tissue but also enable precise and continuous monitoring of tumor size in real time.
Comparison of endoscopic sinus sampling versus intracranial sampling for microbiological diagnosis of intracranial infection in children: A case series and literature review
Authors: Kameda-Smith Michelle Masayo , Mendoza Maya , Brown Li-An , Hartley John , Aquilina Kristian , James Greg , Jeelani Owase Noor , Silva Adikarige Haritha Dulanka , Thompson Dominic , Tisdall Martin , Tahir M Zubair , Hatcher James
Published: June 2023

Introduction
Intracranial infection is often associated with contiguous sinus infection, with Streptococcus intermedius being the most common pathogen. Microbiological assessment is possible via sinus or intracranial sampling. Whilst a sinus approach is minimally invasive it is not clear whether this yields definitive microbiological diagnosis leading to optimised antimicrobial therapy and avoidance of intracranial surgery.
Methods
Retrospective review of a prospectively collected electronic departmental database identified patients between 2019–2022. Further demographic and microbiological information obtained from electronic patient records and laboratory management systems.
Results
Thirty-one patients were identified with intracranial subdural and/or epidural empyema and concurrent sinus involvement during the 3-year study period. Median age of onset was 10 years with a slight male predominance (55%). All patients had intracranial sampling with 15 patients undergoing sinus sampling in addition. Only 1 patient (7%) demonstrated identical organism(s) grown from both samples. Streptococcus intermedius was the most common pathogen in intracranial samples. Thirteen patients (42%) had mixed organisms from their intracranial cultures and 57% of samples undergoing bacterial PCR identified additional organisms, predominantly anaerobes. Sinus samples had a significant addition of nasal flora and Staphylococcus aureus which was rarely grown from intracranial samples. Of concern, 7/14 (50%) of sinus samples did not identify the main intracranial pathogen diagnosed on intracranial culture and additional PCR. Literature review identified 21 studies where sinus drainage was used to treat intracranial empyemas, with only 6 authors reporting concurrent microbiology results. This confirmed our cohort to be the largest comparative study in the current literature. No centre has observed a greater than 50% concordance in microbiological diagnoses.
Conclusion
Endoscopic sinus surgery may have therapeutic benefit, but it is not an appropriate approach for microbiological diagnosis in paediatric subdural empyemas. High rates of contaminating nasal flora can lead to misdiagnosis and inappropriate treatment. Routine addition of 16S rRNA PCR to intracranial samples is recommended.
Development and psychometric properties of a medication information literacy scale for Chinese pregnant women
Authors: Li Su-ya , Guo Jin-Yi , Zhou Jie , Shen Quan , Niu Shu-Ya , Wang Lan , Chen Hui-Jun , Ouyang Yan-Qiong , Redding Sharon R.
Published: June 2023

Background
Pregnant women are in a unique physiological state and the safety of medication is an important issue related to maternal and infant health. With the increasing variety of information resources, the ability of pregnant women to correctly understand and make decisions about medication information depends upon their level of medication information literacy. However, currently, there is no valid and reliable instrument to measure this concept. The purpose of this study was to develop a medication information literacy scale for use in Chinese pregnant women and to measure their medication information literacy.
Methods
Under the guidance of the Ellis’ Information-Seeking Model and the Comprehensive Model of Information Seeking, preliminary items were developed through a literature review, expert consultation and modification. Following a pilot study, items were selected or revised using item discrimination, item correlation analysis and feedback from the participants. The final version of the medication information literacy scale was reviewed by 731 women to establish reliability and validity.
Results
The final scale consisted of five domains with 22 items. The Cronbach’s α coefficient was 0.871 and test-retest reliability was 0.870. Total explained variation was 64.642%. The scale demonstrated good validity (χ2/df = 1.999, GFI = 0.899, AGFI = 0.871, SRMR = 0.046, IFI = 0.926, RMSEA = 0.054, CFI = 0.925, and TLI = 0.913). In a formal survey of pregnant women, only 27.9% of pregnant women had adequate medication information literacy.
Conclusion
The medication information literacy scale demonstrates good reliability and validity, and can be used to assess medication information literary of pregnant women in Chinese context, thus leading to targeted interventions for this unique population.
Exposure, distribution, and ecological risk of four new bisphenol analogs in the typical lake region of Taihu Lake
Authors: Han Ying , Liu Yuxuan , Rong Xiaolong , wang Mingxin , Xue Yingang , Dai Hao , Jiang Haixia
Published: June 2023

The development of the industrial economy in Taihu Lake has led to increased levels of bisphenol compounds (BPs), which are difficult to degrade and highly toxic, making them a research focus. This study aimed to determine the occurrence, sources, and ecological risks of bisphenol Z (BPZ), bisphenol C (BPC), bisphenol F (BPF), and bisphenol S (BPS). Surface water and sediment samples were collected and analyzed, revealing average BPs concentrations of 1227 ng/L and 11 ng/g (dry weight), respectively. BPS had the highest detection rate among the four BPs, followed by BPF. Pollutant levels were found to increase upstream and decrease downstream. In wild fish, the pollutants were found to be concentrated in the muscle, gill, liver, kidney, and brain tissues, indicating short-term exposure. Correlation and stable isotope analyses showed that BPF and BPS had similar origins, and sediments were found to be the primary source of the pollutants. Ecological and human health risk assessments showed low-risk levels, but the risks are still increasing and require attention. This study provides valuable information for the management and control of BP pollution in Taihu Lake.
Unravelling the role of Exosomes as early non-invasive predictors of disease state in Glioblastoma
Authors: Upadhyay Vinal , Bhadresha Kinjal , Rawal Rakesh
Published: June 2023

Background
Gliobastoma are the malignant grade 4 astrocytic tumours, which accounts for the major cause of recurrence or death amongst all the brain tumours. The biology to pathophysiology of the tumour being complex, the search for specific differential markers always remains the need of an hour for disease treatment and monitoring. Liquid biopsy approach has open newer avenues to study and regulate the disease in a non-invasive manner. The study focuses to find the some newer regulatory genes by a liquid biopsy approach.
Methodology:
Meta-analysis was carried for the already published datasets pertaining to Glioblastoma by Gene Spring software. The top listed genes were validated in tissue and exosomes of the patients. Sixty tissue samples and 30 blood (serum) samples were collected from the glioma patients. Expression analysis was carried out by quantitative real time PCR. The results were statistically analyzed using SPSS 16.0 and PRISM software.
Results
Meta-analysis fetched the top 9 highly upregulated genes inclusive of CD44, VEGFA, TGFβ1, THBS1, SERPINE1, TAGLN2, ATF3, FOSL2, FABP5. Amongst these genes, CD44, VEGFA, TGFβ1, THBS1 and SERPINE1 showed the significant differential expression between low grade and high grade gliomas tissue samples. These five significant genes when analysed in the exosomal RNA, prominent differential expression was observed.
Conclusion
The study conclusively shows that CD44, VEGFA, TGFβ1, THBS1 and SERPINE1 could collectively work as hub genes to differentiate high grade gliomas from low grade tumours. Moreover, blood serum could serve as a better liquid biopsy marker in case of high infiltrating GBM tumours.
Nonlinear Dynamics manuscript No. (will be inserted by the editor)
Prescribed-time stabilizing strategy for a class of time-varying nonlinear systems and its application to pendulum system
Authors: Li Jiao-Jiao , Sun Zong-Yao , Wen Changyun , Chen Chih-Chiang
Published: June 2023

In this paper, a new scheme is proposed to stabilize a class of nonlinear systems within a prescribed time, mainly motivated by the following two unsolved intricate problems: i) the singularity caused by infinity control magnitudes at the prescribed time instant and ii) the lack of formulating/manipulating state responses after the prescribed time. Under the proposed scheme,
an exquisite controller is constructed by entailing both the state scaling approach and a finite-time stabilizing procedure. It is shown that the obtained control is well defined with bounded magnitude on the whole time horizon and ensures the existence of the solutions of the closed-loop system. Superior to the existing prescribed time stabilization results, the proposed method
is capable of ensuring that the states of the closed-loop system converge to a prescribed compact set within the prescribed time, stay inside it thereafter and perform nite-time convergence eventually. A simulation example is presented to illustrate and verify the effectiveness of the proposed approach.
Methane-hydrogen-rich fluid migration triggers seismic failure in subduction at forearc depths
Authors: Giuntoli Francesco , Vitale-Brovarone Alberto , Menegon Luca , Siron Guillaume , Cognigni Flavio , Leroux Hugues , Compagnoni Roberto , Rossi Marco
Published: June 2023

Metamorphic fluids and deformation zones are fundamental carriers of carbon from the deep Earth to shallower reservoirs. It is well established that water weakens rocks and contributes to trigger seismicity. Conversely, the potential effects of carbon-rich aqueous fluids on deep-seated rocks remain little studied. Some of these fluids may be reduced and transport energy sources such as natural H2 and CH4. Mechanisms and pathways capable to transport these deep energy sources towards shallower reservoirs, where they may be used by microbial life in the subsurface biosphere, remain unidentified. Here we present direct geological evidence of seismic failure of mechanically strong rock types due to the accumulation of CH4-H2-rich fluids at deep forearc depths, which ultimately reached supralithostatic pore fluid pressure. These fluids originated from adjacent reduction of carbonates by H2-rich fluids during serpentinization at eclogite-to-blueschist-facies conditions. Thermodynamic modelling predicts that the production and accumulation of carbon-rich fluids can produce overpressure much more easily than C-poor aqueous fluids, and that CH4-H2-rich fluids are more favourable to produce overpressure than CO2-rich ones. This study provides tangible evidence for the migration of deep Earth energy sources along tectonic discontinuities and suggests causal relationships with brittle failure of hard rock types that may trigger seismicity at forearc depths.
Bilateral Cowper’s Syringocele in a Teenager: A Clinical Case
Authors: Osipov Igor , Lebedev Dmitry , Uzintseva Anastasiya , Sidorova Nadezhda
Published: June 2023

Background: Cystic enlargement of the excretory ducts of the bulbourethral glands (Cowper’s gland syringocele) (CGS) is a rare urethral pathology. This condition was first described in 1976. No more than 150 cases of CGS have been described in the literature, the vast majority of them in children. Bilateral CGS was mentioned in 8 cases. Descriptions of bilateral CGS with connection of cavities through the medial septum have not been found in the literature. We report a successful minimally invasive treatment of bilateral open CGS in an adolescent.
Case presentation: A 16-year-old teenager came to the clinic with complaints of painful urination and post-micturition drip of urine. Sick for 2 years. Examination revealed bilateral CGS.
Surgical treatment was performed: endoscopic resection of the roof and septum of the CGS chambers. At the control examination after 7 months, the complaints stopped, there was a complete normalization of urodynamics and recovery of the patient.
Conclusion: Urethroscopy, MRI and retrograde urethrography allowed the diagnosis. Minimally invasive surgical treatment of dual chamber CGS was successful and had no complications.
Predicting fertilizer concentration for precision irrigation under mixed variable-rate fertigation using machine learning: a case study of combined fertilization with dipotassium hydrogen phosphate and potassium chloride
Authors: Wu Menglong , Xiong Jiajie , Li Ruoyu , Dong Aihong , Lv Chang , Sun Dan , Abdelghany Ahmed Elsayed , Zhang Qian , Wang Yaqiong , Niu Wenquan
Published: June 2023

Variable precise fertigation is critical to precision irrigation. The question of how to monitor the combination of fertilizer concentration and variable irrigation components as accurately as possible is challenging. The primary goal of this study is to develop accurate prediction models integrated with machine learning (ML) to predict the concentration of each type of fertilizers in mixed variable-rate fertigation used for precision irrigation. First, the feasibility of predicting of fertilizer concentration by monitoring physical parameters such as electrical conductivity (EC), acidity (pH) and temperature in mixed variable-rate fertigation was confirmed. 11 selected ML algorithms were applied to develop regression models that can accurately predict each fertilizer concentration of the mixed fertilizer compared to the classical multivariate linear regression (MLR). In addition, cubic spline interpolation (CSI) was used to densify the data sets, and K-fold cross-validation was employed to fairly evaluate the generalization ability (GA) of these models. The statistical and diagnostic analyzes revealed the superiority of ML especially SVM, KNN, ETs, and MLP over MLR in predicting each type of fertilizer concentration in mixed variable-rate fertigation with an R2 range of 0.9499 ~ 0.9970 and an RMSE range of 0.0852 ~ 0.4434 g/L, better than MLR with an R2 range of 0.8544 ~ 0.9425 and an RMSE range of 0.3752 ~ 0.7559 g/L. Moreover, the contribution of CSI to the modeling accuracy was confirmed, but the sensitivity of the models to EC and pH increased with the data from CSI and the tuning of the model hyper-parameter. Overall, the feasibility and performance of the ML models for predicting mixed fertilizer concentration by monitoring temperature, EC, and pH indicate that the presented ML models have significant application potential for irrigation and fertilization monitoring management of mixed variable-rate fertigation in precision irrigation with high-precision sensor technology.
Annual and periodic variations of particulates and selected gaseous pollutants in Astana, Kazakhstan: Source identification via conditional bivariate probability function
Authors: Agibayeva Akmaral , Karaca Ferhat , Guney Mert , Bex Torekhan , Avcu Egemen
Published: June 2023

The degradation of air quality remains one of the most pressing environmental issues as exposure to air pollutants is extensively associated with various health problems including respiratory and cardiovascular diseases. The present study aims to (1) reveal the annual and periodic variations of PM2.5, total suspended particles (TSP), and selected gaseous pollutants (SO2, CO, NO2, HF) in Astana, Kazakhstan by analyzing two-year air pollution monitoring data (October 2018-September 2020) divided into 2 study cycles (October 2018-September 2019 and October 2019-September 2020, respectively); and to (2) identify potential air pollution sources in the region using conditional bivariate probability function (CBPF). Annual concentrations of PM2.5 and other gaseous pollutants were generally high, exceeding World Health Organization air quality guidelines and nationally adopted air quality standards; with heating periods (October - April) characterized, on average, by higher ambient concentrations than non-heating periods. Notably, the concentrations of observed pollutants were higher during the 2018-2019 study cycle than in 2019-2020. Obtained results are useful for subsequent estimation of the burden of respiratory and cardiovascular diseases in the region. The CBPF analysis of PM2.5 data suggested a general contribution of the coal-fired power plants as well as residential heating activities to the air pollution in the city, while a joint contribution of vehicular emissions and power plant activity was identified as the pollution source of SO2. Control measures for PM2.5 and SO2 emissions specifically arising from the coal-fired power plants need to be urgently implemented.
Proinflammatory impact of putative viral-specific CD8+ T cells infiltrating new-onset seropositive rheumatoid arthritis synovium
Authors: Wehr Pascale , Nel Hendrik , Zhou Chenhao , Andoniou Christopher , Schuster Iona , Yunis Joseph , Gras Stephanie , McGuire Helen , Weedon Helen , Small Annabelle , Lowe Katie , Cai Benjamin , Rae James , Parton Robert , Farrell Helen , Mehdi Ahmed , Steptoe Raymond , Degli-Esposti Mariapia , Yu Di , Wechalekar Mihir , Thomas Ranjeny
Published: June 2023

New-onset HLA-DR-associated anti-citrullinated protein autoantibody (ACPA)+ rheumatoid arthritis (RA) synovial tissue (ST) contains highly-expanded TCR-αβ clonotypes, some viral-antigen-reactive. However, it is unknown how viral-specific T-cells sustain ACPA+ RA. We studied paired peripheral blood (PB) and ST TCR repertoires in drug-naïve ACPA+ HLA-DRB1*04:01+ diffuse-myeloid RA ST pathology. To model effects of viral infection, we induced ovalbumin antigen-induced arthritis (AIA) in mice with latent murine-cytomegalovirus or recovered from acute lymphocytic-choriomeningitis virus. We show that most clonally-expanded CD8+ T cells had polyfunctional TNF+IFNγ+ cytotoxic T-lymphocyte (CTL) signatures. Transcriptomic profiles of ST CD4+ T-cell clonotypes were Th2-like and IL-6-signaled central memory-like. CMV-specific tetramers confirmed in-silico prediction of viral-epitope recognition by CTL. Perivascular GZMB+CD8+ T cells co-localized with CD4+ T-cells, dendritic cells, fibroblasts and IL-6. After viral infection, AIA severity increased with enhanced viral and ovalbumin-specific TNF+IFN-γ+ T-cell cytokines, suggesting that in the diffuse-myeloid rheumatoid-synovial perivascular niche, polyfunctional bystander-CTL reinforce myeloid- and CD4+ T-cell activation.
Multi-type Features Graph Neural Networks for Cocrystals Prediction using API-Coformers Interactions
Authors: Mswahili Medard Edmund , Jo Kyuri , Lee SeungDong , Jeong Young-Seob
Published: June 2023

Active pharmaceutical ingredients (APIs) have gained direct pharmaceutical interest, along with their in vitro properties, and thus utilized as auxiliary solid dosage forms upon FDA guidance and approval on pharmaceutical cocrystals as a potential and attractive route for drug substance development. In this study, we implemented graph neural networks to predict the formationof cocrystals using our first created API-co-formers interactions graph dataset. We further compared our work with previous studies that implemented descriptor-based models (e.g., random forest, support vector machine, extreme gradient boosting,and artificial neural networks). All built graph-based models show compelling performance accuracies (i.e., 91.36, 94.60, and 95.95% for GCN, GraphSAGE, and R-GCN respectively). Furthermore, R-GCN prevailed among the built graph-based models due to its capability to learn the topological structure of the graph from the additionally provided information (i.e., non-ionic andnon-covalent interactions or link information) between APIs and coformers.
Self-reported Determinants for Subjective Financial Distress: A Qualitative Interview Study with German Cancer Patients
Authors: Züger Andrea , Mathies Viktoria , Mehlis Katja , Pauge Sophie , Richter Luise , Surmann Bastian , Ernst Thomas , Greiner Wolfgang , Menold Natalja , Winkler Eva C.
Published: June 2023

Purpose. Patient-reported financial effects of a tumor disease in a universal healthcare setting are a multidimensional phenomenon. Actual and anticipated objective financial burden caused by direct medical and non-medical costs as well as indirect costs such as loss of income, can lead to subjective financial distress. To better understand the reasons for subjective financial distress and to identify aggravate (obstacles) and preventive (resources) determinants, the present study inquires how cancer patients interpret and explain the level of subjective distress due to financial consequences of their disease.
Methods. Semi-structured interviews with n=18 cancer patients were conducted between May 2021 and December 2021. Patients were recruited based on a purposive sampling strategy in outpatient and inpatient settings. The interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative content analysis.
Results. When explaining the degree of their subjective distress, interviewees refer to both distress-preventing and distress-increasing influencing determinants. Distress-preventing factors are material, social and systemic resources such as access to social and health care service; cognitive coping strategies; personal character traits and change of attitude. Distress was increased by administrative hurdles and expected objective financial burden.
Conclusion. Subjective financial distress depends on material, social, systemic and personality-specific determinants. To address them, not only individual counselling is needed, but also socio-politicalchanges.
Trial registration number NCT05319925
Latent categories analysis of postnatal post-traumatic stress disorder symptom profiles
Authors: yao qingfang , wang xianwei , jiang hu , xia lan , pu hengping
Published: June 2023

Aim
To explorelatent categories of postpartum post-traumatic stress disorder (PP-PTSD) symptom profiles and to analyse differences in the demographic characteristics of the various categories of mothers.
Methods
From August 2021 to April 2022, a questionnaire survey was conducted using the Urban Birth Trauma Scale and the General Information Questionnaire among women in the obstetric wards, outpatient clinics and pelvic floor muscle rehabilitation centre of a tertiary hospital in Zunyi, China to analyse thelatent categories of PP-PTSD symptom profiles. A questionnaire survey was conducted to explore thelatent categories of PP-PTSD symptoms and to explore the factors influencing thelatent categories through univariate analysis and multiple logistic regression.
Results
A total of 243 mothers were included, and PP-PTSD symptoms were classified into 3latent categories (P < 0.05), namely "high PP-PTSD symptoms group" (28.4%), "labour-related symptoms group" (40.3%), and "low PP-PTSD symptoms group" (40.3%), The "group with low prevalence of PP-PTSD symptoms" (31.3%). The mode of this delivery, the number of deliveries, and the month after delivery were the main influencing factors for the classification of PP-PTSD symptom profile.
Conclusions
There was heterogeneity and stage in the symptom profile of PP-PTSD, which was divided into 3latent categories. This suggests that health care professionals should pay attention to the heterogeneity and stages of PP-PTSD symptom profiles and provide specific symptom management for different categories of women.
Spatio-Temporal Climatology and Trends of Convective Available Potential Energy (CAPE) over Bangladesh, including three lightning hotspots during 40 years (1982-2021)
Authors: Kader Sakia Shabnam , Panda Subrat Kumar , Wasson Gitesh , Mondal Unashish , Sharma Devesh , Das Someshwar
Published: June 2023

This study investigates the climatology of Convective Available Potential Energy (CAPE) over Bangladesh and its eight administrative divisions, along with three lightning hotspots (Sherpur, Shahjadpur, and Bajitpur), using monthly, seasonal, and annual data for 40 years (1982–2021). The monthly CAPE data at 0000 UTC and 1200 UTC has been collected from the fifth generation of the European Centre for Medium-Range Weather Forecasts (ECMWF) atmospheric reanalysis data (ERA5) at 0.25° resolution. The study reveals that the increasing CAPE trend over Bangladesh may be responsible for the increased frequency of extreme events. Significant CAPE values were observed in Bangladesh’s south-west and southern parts from March to May. In April, there was a notable increasing trend in CAPE values, particularly in the north-western region. The average CAPE values for Bangladesh’s three lightning hotspot regions (Sherpur, Shahjadpur, and Bajitpur) is higher than 1500 J/kg during the pre-monsoon at 0000 UTC, directly correlating with the lightning and thunderstorm. The Mann-Kendall test has been employed to follow yearly and seasonal trends. Overall, this study provides valuable insights into the spatial distribution of CAPE and its association with thunderstorms in Bangladesh, which can inform the development of effective strategies to manage weather-related hazards in the country.
Prediction factors and clinical significance of different types of hemorrhagic transformation after intravenous thrombolysis
Authors: hao yanan , zhou Huan , Pan Chengzhen , Xie Guomin , Hu Jin , Zhang，MA Bing , Yan Shenqiang , Qian，MA Shuxia
Published: June 2023

Background and purpose Hemorrhagic transformation (HT) after intravenous thrombolysis (IVT) in acute ischemic stroke seriously affects the prognosis of patients. This study aimed to investigate the risk factors of different types of HT and their correlation with prognosis after IVT.Methods Based on the CASE II registry, we included patients with acute ischemic stroke who received IVT within 4.5 hours of onset. HT was further divided into hemorrhagic infarction (HI) and parenchymal hemorrhage (PH). Poor outcome was defined as a modified Rankin Scale (mRS) score of 3 to 6 at 3 months. Multivariate logistic regression analysis was used to determine the independent influencing factors of HT subtypes and clinical outcome.Results Among 13108 included patients, 541 patients (4.1%) developed HI and 440 (3.4%) developed PH. In multivariate analysis, age (OR 1.038, 95%CI 1.028 to 1.049,p < 0.001), atrial fibrillation (OR 1.446, 95%CI 1.141 to 1.943, P = 0.002), baseline diastolic pressure (OR 1.012, 95%CI 1.004 to 1.020, p = 0.005), baseline NIHSS score (OR 1.060, 95%CI 1.049 to 1.071, p < 0.001) and onset to treatment time (OTT) (OR 1.002, 95%CI 1.000 to 1.004, p = 0.020) independently predicted PH 24 hours after IVT. In the patients with HT, PH (OR 3.611, 95%CI 2.540 to 5.134, p < 0.001) and combination with remote hemorrhage (OR 1.579, 95%CI 1.115 to 2.235, p = 0.010) were independently related with poor outcome after IVT.Conclusions Different types of hemorrhagic transformation after IVT had different risk factors and clinical significance. The occurrence of PH and remote hemorrhage independently increased the risk of poor outcome.
Recurrent Thromboembolism due to Factor V Leiden Mutation: A Case Report
Authors: Kanwal Seema , Gul Fahad , Khan Hashim , Abbas Khawar , Malick Daniya Shahzad , Basit Jawad , Nashwan Abdulqadir J.
Published: June 2023

The Factor V Leiden (FVL) mutation is the most prevalent genetic risk factor for VTE, with a prevalence of roughly 5% in the Caucasian population. Our patient presented with progressive right leg swelling, cough, and shortness of breath for 3 months. Investigations revealed elevated hemoglobin and positive D-dimers, and a CT scan confirmed a bilateral massive subacute pulmonary embolism. Based on the results of thrombophilia testing, our final diagnosis was Recurrent Thrombo-embolism due to Factor V Leiden Mutation. The patient received anticoagulant therapy and underwent multiple venesections, subsequently improving symptoms. Follow-up examinations showed cor pulmonale secondary to the chronic thromboembolic phenomenon. This case report highlights the significance of identifying and managing thrombophilic conditions like Factor V Leiden mutation in patients with recurrent venous Thromboembolism.