bluuebunny/crossref_metadata_2025 huggingface dataset:
Fome também é o que se come: as metáforas nos discursos do MST como construtoras de polêmica argumentativa sobre alimentos ultraprocessados
Authors: Mazza Amanda Guedes
Published: March 2024

Este artigo objetiva explorar a conexão entre metáforas e a construção de polêmica argumentativa, revelando de que maneira uma concepção de metáfora dimensionada pelos discursos, para além de mera figura de linguagem ou de pensamento, contribui para a compreensão de dissensos. Para isto, parte-se de um corpus composto por publicações no portal do Movimento dos Trabalhadores Rurais Sem Terra (MST) sobre alimentos ultraprocessados (Nupens-USP), entre 2020 e 2022, analisado sob uma perspectiva cognitivo-discursiva (Vereza, 2007, 2017; Gonçalves-Segundo, 2020) entrelaçada à argumentação polêmica (Amossy, 2017). Através da observação das metáforas e o papel por estas desempenhado, foi possível identificar o uso de metáforas situadas e distribuídas operando de maneira dialógica, e perspectivando um Terceiro alheio tanto ao Proponente (MST) quanto ao Oponente, para manutenção do dissenso entre a produção alimentícia industrial, ou atrelada ao agronegócio, e a produção de alimentos in natura, ou minimamente processados, por parte do MST.
No-Reflow Prediction in Acute Coronary Syndrome During Percutaneous Coronary Intervention: The NORPACS Risk Score
Authors: Dawson Luke P. , Rashid Muhammad , Dinh Diem T. , Brennan Angela , Bloom Jason E. , Biswas Sinjini , Lefkovits Jeffrey , Shaw James A. , Chan William , Clark David J. , Oqueli Ernesto , Hiew Chin , Freeman Melanie , Taylor Andrew J. , Reid Christopher M. , Ajani Andrew E. , Kaye David M. , Mamas Mamas A. , Stub Dion ,   on behalf of the MIG and BCIS Investigators
Published: March 2024

BACKGROUND:

Suboptimal coronary reperfusion (no reflow) is common in acute coronary syndrome percutaneous coronary intervention (PCI) and is associated with poor outcomes. We aimed to develop and externally validate a clinical risk score for angiographic no reflow for use following angiography and before PCI.

METHODS:

We developed and externally validated a logistic regression model for prediction of no reflow among adult patients undergoing PCI for acute coronary syndrome using data from the Melbourne Interventional Group PCI registry (2005–2020; development cohort) and the British Cardiovascular Interventional Society PCI registry (2006–2020; external validation cohort).

RESULTS:

A total of 30 561 patients (mean age, 64.1 years; 24% women) were included in the Melbourne Interventional Group development cohort and 440 256 patients (mean age, 64.9 years; 27% women) in the British Cardiovascular Interventional Society external validation cohort. The primary outcome (no reflow) occurred in 4.1% (1249 patients) and 9.4% (41 222 patients) of the development and validation cohorts, respectively. From 33 candidate predictor variables, 6 final variables were selected by an adaptive least absolute shrinkage and selection operator regression model for inclusion (cardiogenic shock, ST-segment–elevation myocardial infarction with symptom onset >195 minutes pre-PCI, estimated stent length ≥20 mm, vessel diameter <2.5 mm, pre-PCI Thrombolysis in Myocardial Infarction flow <3, and lesion location). Model discrimination was very good (development C statistic, 0.808; validation C statistic, 0.741) with excellent calibration. Patients with a score of ≥8 points had a 22% and 27% risk of no reflow in the development and validation cohorts, respectively.

CONCLUSIONS:

The no-reflow prediction in acute coronary syndrome risk score is a simple count-based scoring system based on 6 parameters available before PCI to predict the risk of no reflow. This score could be useful in guiding preventative treatment and future trials.
CTP-Defined Large Core Is a Better Predictor of Poor Outcome for Endovascular Treatment Than ASPECTS-Defined Large Core
Authors: Sui Yi , Chen Wenhuo , Chen Chushuang , Chang Yanting , Bivard Andrew , Wang Peng , Geng Yu , Parsons Mark , Lin Longting ,   on behalf of INSPIRE Investigators
Published: March 2024

BACKGROUND:

Recent trials confirmed the effectiveness of endovascular therapy in patients with large ischemic cores. Yet the optimal neuroimaging modalities to define large core remains unclear. We tried to address this question by comparing the functional outcomes in patients receiving thrombectomy selected by either noncontrast computed tomography Alberta Stroke Program Early Computed Tomography Score (ASPECTS) or computed tomography perfusion (CTP).

METHODS:

This study retrospectively selected patients enrolled in the International Stroke Perfusion Registry between August 2011 and April 2022. Patients with acute stroke with large vessel occlusion in anterior circulation treated with endovascular therapy were included. All received both CTP and noncontrast computed tomography. The primary outcome was defined as poor functional outcome represented by a modified Rankin Scale score of 5 to 6 at 3 months. Large cores were defined in terms of either (1) noncontrast computed tomography ASPECTS ≤5 or (2) core volume ≥70 mL on CTP.

RESULTS:

A total of 1115 patients were included in the analysis, of which 90 patients had ASPECTS ≤5 (8.1%) and 97 patients CTP core ≥70 mL (8.7%). A fair agreement between ASPECTS and CTP with a κ value of 0.31 (0.21–0.40) was found. Compared with patients with neither CTP nor ASPECTS large cores, those with only ASPECTS-defined large cores (ie, ASPECTS ≤5; n=56) did not have a higher adjusted odds of poor outcome (29%; odds ratio, 1.84 [0.91–3.73];
P
=0.089). However, patients with CTP large core but not ASPECTS-defined large core (n=63) had a higher adjusted odds of poor outcome (60%; odds ratio, 3.91 [2.01–7.60];
P
<0.001). In time-stratified subgroup analysis (>6 versus ≤6 hours), ASPECTS showed no discriminative difference between ≤5 and >5 in poor outcome for patients receiving endovascular therapy within 6 hours.

CONCLUSIONS:

CTP core ≥70 mL-defined large cores are more predictive of poor outcome than ASPECTS ≤5-defined core in endovascular therapy patients, particularly within 6 hours after stroke onset.
Knockdown of LincRNACOX2 Alleviates Oxidative Stress in Pathophysiology of Acute Lung Injury
Authors: Xie Shuhuai , Chen Yongming , Lin Yanping , Tan Guoliang
Published: March 2024

Acute lung injury (ALI) has a complicated etiology that involves oxidative stress and inflammation. The role of lncRNACox2 (lincCOX2) in ALI regulation remains unclear. In this study, the ALI model of mice and MLE-12 cell was induced by LPS. To investigate the expression of lncRNACox2
in these ALI models, we employed a nanomagnetic bead-based RNA extraction method for quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis. This enabled us to determine the levels of lncRNACox2 expression and evaluate knockdown efficiency. Moreover, we also examined
lung tissue histopathology using H&E staining. Cell survival and apoptosis rates were evaluated through CCK-8 and flow cytometry, respectively. The concentration of inflammatory factors was measured using ELISA. Additionally, the concentration (8-OHdG and MDA) and enzymatic activity (CAT,
GSH-Px, and SOD) of oxidative stress related factors were measured by biochemical method. The western blot was performed to present the key proteins expression level in Nrf2/ARE signaling pathway in cytoplasm and nucleoprotein. The ALI mouse model was successfully established. The histopathology
change and inflammatory cells were observed by H&E staining in LPS treated groups. The expression of lincCOX2 was up-regulated in ALI tissue. LPS induced more cell death in ALI, and the knockdown of lincCOX2 improved the cell survival and suppressed the apoptosis in ALI cell. Furthermore,
In addition, downregulation of lincCOX2 attenuated inflammation and oxidative stress in lung cells in ALI. The concentration of 8-OHdG and MDA were highest in the LPS group while reduced by the sh-lincCOX2, the activity of CAT, GSH-Px, and SOD was reduced in the LPS induced ALI and increased
by the sh-lincCOX2. In ALI, the distribution of Nrf2 protein is transferred from cytoplasm to nucleus. Furthermore, the lincCOX2 regulated oxidative stress via Nrf2/ARE signaling pathway in ALI. Overall, downregulation of lincRNACOX2 alleviates oxidative stress in ALI via Nrf2/ARE Pathway.
This study suggests that lincCOX2 may be a potential target for the treatment of ALI.
Chitosan and Hyaluronic Acid Nanopolyelectrolyte Combined with Tanshinone IIA Targets Signal Transduction Pathway to Prevent Atherosclerosis
Authors: He Dequan , Zhang Jiawei , Chen Youquan , Li Zhiliang
Published: March 2024

The purpose of this study was to evaluate the in vitro target impact of manufactured nanocarriers on vascular endothelial cells, as well as the effect of stable concentration and physicochemical properties of chitosan and hyaluronic acid nanoparticles loaded with tanshinone IIA,
on the successful adsorption of targeting antibody. Polyelectrolyte composite nanoparticles were prepared by neutralizing chitosan (CS) and hyaluronic acid (HA). Anti-atherosclerosis antibody was quantitatively adsorbed on CS-HA nanoparticles after 4 h in water or PBS. Nanocarriers created
in a lab are put through in vivo and in vitro tests on vascular endothelial cells and atherosclerotic plaques. Complexation and physicochemical properties of colloids were affected by external factors including charge mixing ratio and polymer content. The aforementioned method
was used to produce non-stoichiometric CS-HA nano-colloids that were stable in water or PBS (pH 7.4) for over a month. Its morphology was analyzed using a scanning electron microscope. Nanoparticles of the CS-HA/CD47 antibody have a positive Zeta potential. Using this nanocarriers in vivo
adsorbed to endothelial cells and plaques quite efficiently. Chitosan and hyaluronic acid nanopolyelectrolyte combined with tanshinone IIA nanoparticles were successfully synthesized. Customized nanocarriers may adsorb to endothelial cell lines and atherosclerotic plaques in vitro.
Mechanism of BRD4 Inhibitor-Mediated c-MYC Expression and Regulation of AR Expression to Inhibit Prostate Cancer
Authors: Wang Yuzhong , Liu Yongqiang , Wang Li , Yang Chunyan , Nie Zhengdong , Yuan Junfang
Published: March 2024

Prostate cancer is a major health challenge, probably because of regulatory role of hormones that has not been clearly studied. Our study explored BRD4’s role in the development of prostate cancer. BRD4 expression was detected in tumor tissues by RT-PCR method. Transwell detected
cell function after different BRD4 expressions, while Target scan detected the relationship between c-MYC and BRD4, including protein expression between the two luciferase activity and Western-blot. Western-blot detected the protein expression after addition of c-MYC, and further verified
the effect of c-MYC expression on AR. We proved that, BRD4 was highly expressed in tumor tissues, and inhibiting BRD4 expression significantly inhibited tumor cell invasion and proliferation. BRD4 targets negative feedback to regulate the expression of c-MYC. Further results showed that, addition
of BRD4 activated c-MYC signal transduction and inhibited prostate cancer development. Our study reveals that, BRD4 regulates AR to inhibit prostate cancer by regulating c-MYC. BRD4 is involved in AR-mediated regulation of PCa cells. In addition, inhibiting the expression of BRD4 can inhibit
pathological progression of prostate cancer cells.
Stanniocalcin-2: A Potential Predictor of Residual Breast Cancer After Neoadjuvant Chemotherapy
Authors: Li Yuan , Kong Xiangyi , Guo Changyuan , Guo Lei , Lei Chuqi , Zhang Ke , Wang Zhongzhao , Gao Jidong , Xuan Lixue
Published: March 2024

Compared to patients of pathological complete response (pCR), patients of residual lesion afterwards neoadjuvant chemotherapy (NAC) have worse prognosis and higher distant metastasis. Irrespective, there exists limited data on effective indicators and treatment methods for these patients.
In our study, we evaluated the relationship between stanniocalcin-2 (STC2) marker and the prognosis of breast cancer patients of residual lesion after receiving NAC. The relationship between STC2 and patients’ prognosis was evaluated by transcriptome analysis. The impact of the level
of STC2 on cell migration, invasion, and proliferation was evaluated at the cellular level. Immunohistochemistry was performed on 293 patients with residual disease after NAC to assess STC2 protein levels. The relationship between STC2 and survival rate was estimated using Cox regression model
and Kaplan Meier analysis. The results demonstrated that high level of STC2 significantly inhibited migration, invasion, and proliferation of breast cancer cells. Compared to patients with low STC2, high STC2 were directly proportional to overall survival (OS) and disease-free survival (DFS)
(OS: 86.96 vs. 84.62 months, P = 0.017 DFS: 77.33 vs. 66.95 months, P-value < 0.001). In conclusion, our research suggested that the of level STC2 may be a promising prognostic marker or therapeutic targe for breast cancer patients with residual lesion after NAC.
Women, political violence and economics
Authors: Ferrero Mario
Published: March 2024

The participation of women in armed insurgencies calls into question a widespread belief that women are inherently more peace loving than men on account of their hard-wired caring disposition. To explain why women engage in political violence, existing research either ignores the fundamental collective action problem involved because of motivations focused on the value of the cause, or looks for selective incentives in the form of loot and appropriation, which often cannot be found. This paper offers a simple gendered model of the supply of violence that can account for both peaceful and violent choices and make sense of the apparent extremism of some choices as rational, not fanatical behaviour. Crucially, it regards the individual reward for violence as not material gain, but the possibility of women of breaking out of the cage of traditional gender roles and making a statement by their deeds, thereby joining a cult of heroes and martyrs. For evidence, we turn to the extraordinary involvement of women in the Russian revolutionary movement leading up to the 1917 revolution.
Orochi impact formula: An evidence-based approach for quantifying the societal harm of County Lines drug supply
Authors: Dando Coral J , Jones Anthony , Harvey Nick , Milne Rebecca
Published: March 2024

The County Lines (CL) drug supply model is a rapidly increasing threat. Metropolitan Police Specialist Crime have developed a statistical formula, referred to as ‘Orochi impact formula’ for conservatively quantifying the quantity and monetary value of drugs sold per line. The novel formula, which uses known average daily consumption rates of Class A drug and customer demand telephony data, conservatively indicates deal line trade, systematically differentiating between deal lines to quantify the relative impact of each. This evidence-based approach has potential for supporting (i) prosecution of line holders, (ii) determining sentencing deterrents, and (iii) wider public information and knowledge exchange.
A rat model for acute limb ischemia using microsized gelatin beads
Authors: Menjo Yuki , Yasui Masaya , Fukushige Kaori , Hatayama Naoyuki , Yakura Tomiko , Naito Munekazu
Published: March 2024

Objective

Acute limb ischemia (ALI) is a rapid decrease in lower limb blood flow due to acute occlusion of peripheral arteries or bypass grafts. This study aimed to establish an ALI model using microsized gelatin beads and to investigate the pathophysiological conditions.

Methods

Male Sprague-Dawley rats were anesthetized, and a low or high dose of microsized gelatin beads was administered into the left femoral artery on days 0 and 7. A control, that is, normal saline (NS) group in which NS was administered in the left femoral artery, a femoral artery cut (FAC) group in which the left femoral artery was cut, and a sciatic nerve cut (SNC) group in which the left sciatic nerve was cut were prepared. After 21 days, the temperature changes and the muscle weights in the lower limbs were measured. To assess nerve damage, the L1–6 sympathetic ganglia were immunostained with activating transcription factor 3 (ATF3) antibody.

Results

In the Low-dose, High-dose, and FAC groups, a decrease in temperature was predominantly observed in the left limb. In the High-dose and SNC groups, the weight of the soleus muscle and extensor digitorum longus in the left limb decreased; however, no weight changes were observed in the Low-dose and FAC groups. Conversely, the weight of the gastrocnemius muscle significantly decreased in the Low-dose, High-dose, FAC, and SNC groups. In the High-dose and SNC groups, the number of ATF3-positive cells in the sympathetic ganglia significantly increased, and in the Low-dose, a small number of ATF3-positive cells were observed. However, ATF3-positive cells were rarely observed in the FAC and NS groups.

Conclusion

We established an ALI rat model using microsized gelatin beads. The results of this study suggest that autonomic neuropathy in ALI is related to both muscle damage and peripheral neuropathy.
The impact of pre-compression and temperature on perfluoroalkoxy alkane springs: Insights into spring relaxation
Authors: He Lihua , Gao Xinyu , Ni Jing , Cui Zhi , Sun Jingbo , Zhu Zefei
Published: March 2024

A predictive model was proposed for determining the high-temperature free height of perfluoroalkoxy alkane springs in air-operated double-bellow pumps with the aim of investigating their relaxation. The model incorporates classical spring deformation theory and considers the material, structure, and real-world operating conditions of the perfluoroalkoxy alkane springs. Experimental validation of the model is also conducted. This study examines the effects of varying temperatures and pre-compression values on the relaxation of perfluoroalkoxy alkane springs’ free height. It collects relaxation curves under different temperatures and various pre-compression conditions. The results indicate that spring relaxation increases with higher temperatures when there is no pre-compression. Furthermore, increasing pre-compression at the same temperatures leads to greater spring relaxation. Pre-compression has a more significant impact on spring relaxation. By comparing the experimental data with the simulated curve generated by the model, it is evident that the predicted spring free height relaxation closely aligns with the actual measurements. This verification demonstrates the effectiveness and accuracy of the proposed model in evaluating the relaxation of perfluoroalkoxy alkane springs’ free height. Moreover, the model provides a valuable tool for predicting the lifespan of similar perfluoroalkoxy alkane springs in engineering applications.
Characterization and in-vitro plant-based control of hindgut bacteria isolated from Odontotermes obesus Rambur (Termitidae) and Heterotermes indicola Wasmann (Rhinotermitidae)
Authors: Ashraf Asma , Qadeer Saima , Ullah Sana , Asad Muhammad , Fatima Huma , Nasir Muhammad Farhan , Shaheen Nargis , Qureshi Naveeda Akhtar
Published: March 2024

Termites cause a serious menace to wooden structures all over the world. They rely mostly on entozoic fauna residing in their hindgut for the digestion of cellulosic and hemicellulosic materials. One of the ways to control termites is through their gut symbionts. The present study was designed to characterize the hindgut bacteria isolated from Odontotermes obesus and Heterotermes indicola. Furthermore, the growth inhibitory effect of eight tropical plant extracts was investigated to find out potential control agents for these bacterial isolates. The characterization of bacteria was carried out based on their morphology, Gram staining, biochemical and amplification of 16SrRNA gene. Amplified products were sequenced to confirm their relationship with bacterial isolates from termites of other regions. The growth inhibitory effect of ethanolic leaf extracts of eight plants was evaluated in an invitro agar well diffusion method. Qualitative and quantitative phytochemical analysis of the most effective plant was carried out to learn about bioactive agents. The results confirmed the presence of five bacteria from each termite species. The Bacillus cereus, Escherichia coli, and Lysinibacillus fusiformis were common to both termites whereas Lysinibacillus xylanilyticus and Lysinibacillus macrolides were found in O. obesus only and H. indicola harbor Bacillus subtilis and Shigella sonnei in addition to common three ones. Among the plant extracts of Carica papaya, Eucalyptus camaldulensis, Osmium basilicum, Grevillea robusta, Eucalyptus globulus, Pongamia pinnata, Mentha longifolia, and Melia azedarach, the G. robusta >  E. camaldulensis > O. basilicum were found to have growth inhibitory effects with increasing concentrations from 100 to 2000 µg/mL. The biodiversity of the bacterial fauna is important for the biological control of termites. Leaf extracts of these medicinal plants can be used to control termite infestation in an environment-friendly manner to save huge economic loss.
Enabling massively parallel, ad hoc exploration of the design space for simulation models within a serverless environment
Authors: Gibson Andrew , Rossetti Manuel D
Published: March 2024

This paper presents a massively parallel, cloud-computing framework for the ad hoc evaluation of discrete-event simulation (DES) models to enable broad exploration of the design space for model parameters. Parallel evaluation is enabled through use of a serverless computing environment allowing thousands of simultaneous experiments, on demand, without the need to explicitly provision or manages hardware. A standard Simulation Evaluation application programming interface (API) was designed for evaluating simulation functions that enables language independence between client application and simulation model, encouraging reuse of simulation models for multiple purposes (what-if analysis, ranking and selection, sensitivity analysis, or optimization). Extensions to the Java Simulation Library (JSL)27 enable rapid deployment of models built with the JSL as parameterized serverless functions implementing the Simulation Evaluation API. New Java packages facilitate the calling of any serverless functions that implement the Simulation Evaluation API.
Challenges for Higher Education in the Indian States
Authors: Deb Surajit
Published: March 2024

The present contribution is the 19th part of the Social Change Indicators series. In this part, we examine the state of higher education and its various facets for different states of India.
Book review: Madhav Gadgil, A Walk Up the Hill: Living with People and Nature
Authors: Saberwal Vasant
Published: March 2024

Madhav Gadgil, A Walk Up the Hill: Living with People and Nature, Penguin Random House, 2023, 424 pp., ₹999, ISBN 9780670097043 (Hardcover).
Ventilation retrofit design for existing primary and secondary school classrooms under epidemic conditions
Authors: Zhou Kun , Ma Siyue , Shao Xingjiang , Li Shuting , Jin Qizuo
Published: March 2024

In the context of regular epidemic prevention and control, most primary and secondary schools in developing countries are naturally ventilated. They are unable to use measures such as air filters equipped with centralized mechanical ventilation systems and demand-controlled ventilation. Therefore, the feasibility of using automatic control of negative pressure ventilation (NPV) in conjunction with CO2 concentration detectors to reduce the rate of infection in the classroom was investigated. Firstly, the CO2 concentration threshold calculation for epidemic prevention was carried out, and then the measured data of the classroom was fitted with the Computational Fluid Dynamics (CFD) simulation data to establish a simulation and analysis platform to comprehensively evaluate different NPV conditions. The results show that NPV can control the direction of airflow and CO2 concentration in the teaching room, which can significantly reduce the risk of infection, and that Upward Supply Upward Return NPV with automatic control of the CO2 concentration detector and the combination of windshields can protect the students from cross-infection. The study aims to optimize classroom ventilation strategies for epidemic proofing through low-cost building modifications, which could inform the retrofitting of hundreds of thousands of established primary and secondary schools in developing countries.

Practical Application

Ventilation systems controlled by environmental parameters have the advantages of low cost, high automation, and ease of operation. This system makes designing classrooms to combat airborne epidemics easier by implementing simple retrofitting measures for developing countries where natural ventilation is predominantly used and where most classrooms are not equipped with fresh air ducts. Tests of the top inlet and top return ventilation system proposed in this paper found that the classroom’s measured indoor carbon dioxide concentrations were reduced to below the theoretical limits.
Bilateral, Sequential Sudden Hearing Loss in a Patient With Multiple COVID-19 Infections and Potential Implications on Subsequent Cochlear Implant Performance
Authors: Thodupunoori Sharanya , Cho Stella , Seper Eric , Imbery Terence E. , Sevier Joshua D.
Published: March 2024

Viruses are often implicated as a cause of sensorineural hearing loss (SNHL), particularly sudden cases, including COVID-19. Determining the viral mechanism that leads to hearing loss is necessary for its future prevention and treatment. The 47-year-old woman who is the subject of this case study presented with sudden SNHL following multiple infections of COVID-19. Following a trial of a contralateral routing of sound device, she received a right cochlear implant (CI). Following a period of high performance, additional cases of COVID-19 infection and device failure issues resulted in the explant/reimplant of 1 ear and implantation of the contralateral ear. Despite extensive rehabilitation after these events, the patient continues to experience difficulties in speech understanding, not reaching her initial high levels of right ear performance. Further research is needed to determine the implications of COVID-19 as it relates to SNHL. This case study aimed to highlight the course of treatment and provide insight into the impact of COVID-19 on sudden hearing loss and its relationship to CI performance.
Effect of oxygen delivery during cardiopulmonary bypass on postoperative neurological outcomes in patients undergoing cardiac surgery: A scoping review of the literature
Authors: Elsebaie Abdelrahman , Shakeel Ayesha , Zhang Shetuan , Alarie Marianne , El Tahan Mohamed , El-Diasty Mohammad
Published: March 2024

Background

Reduced oxygen delivery (DO2) during cardiopulmonary bypass (CPB) was proposed as a risk factor for the development of postoperative neurological complications (PONCs), including cerebrovascular accidents (CVA), delirium, and postoperative cognitive dysfunction (POCD). We aimed to review the current evidence on the association between intraoperative DO2 and the incidence of PONCs.

Methods

MEDLINE, Embase, the Cochrane Library, and Web of Science were electronically searched to identify comparative studies from inception until July 2023 that reported the association between intraoperative DO2 levels and the incidence of PONCs (as defined by the scales and diagnostic tools utilized by the studies’ authors) in adults patients undergoing cardiac surgery using CPB.

Results

Of the 2513 papers identified, 10 studies, including 21,875 participants, were included. Of these, three studies reported on delirium, two on POCD, and five on CVA. Eight studies reported reduced intraoperative DO2 in patients who developed delirium and CVA. There was a lack of consensus on the cut-off of DO2 levels or the correlation between the period below these threshold values and the development of PONC.

Conclusions

Limited data suggest that maintaining intraoperative DO2 above the critical threshold levels and ensuring adequate intraoperative cerebral perfusion may play a role in minimizing the incidence of neurological events in adult patients undergoing cardiac surgery on cardiopulmonary bypass.
Extracorporeal cardio-pulmonary resuscitation in a patient with missed diagnosis of sodium nitrite intoxication
Authors: Gaiani Francesco , Giani Marco , Vergnano Beatrice , Sardella Jeff , Cappellini Fabrizio , Casati Marco , Pozzi Matteo , Foti Giuseppe
Published: March 2024

Introduction

Critical poisoning with sodium nitrite (NaNO2) can present challenges in promptly identifying and managing acute methemoglobinemia.

Case report

We report the case of an overt self-intoxication by an initially unknown agent, leading to cardiac arrest. Despite prodromal signs of cyanosis, coma, desaturation, and hypotension, methemoglobinemia went unrecognized during extracorporeal cardiopulmonary resuscitation (ECPR) as the point-of-care test failed to provide methemoglobin levels, leading to untreated methemoglobinemia. The blood flowing through the oxygenator notably maintained the same brown colour. Return of spontaneous circulation was never achieved, and the patient was declared dead after 60 min of unsuccessful resuscitation. Cause of death by means of NaNO2 voluntary ingestion was later clarified and confirmed by postmortem finding of elevated nitrite and nitrate concentration.

Conclusions

This case highlights the risk of failure of ECPR in the context of cardiac arrest due to methemoglobinemia, emphasizing the critical need for prompt recognition of the causative agent and early administration of antidotes.
Light chain deposition disease presenting with gastrointestinal disorder as primary manifestation: report of two cases and literature review
Authors: Wei Chenxiang , Wang Min , Li Jiamin , Su Jiajun , Huang Jing , Tong Sunwing , Yang Dongye
Published: March 2024

Light chain deposition disease (LCDD) is an under-recognized condition characterized by deposition of abnormal monoclonal light chains in tissues, leading to organ dysfunction. LCDD involving the gastrointestinal tract is very uncommon, and its diagnosis is challenging. We herein report two cases of LCDD that manifested as inflammatory bowel disease-like symptoms and protein-losing gastroenteropathy. Both patients were women in their early 60s. Tissue biopsies from the gastrointestinal mucosa demonstrated extracellular deposits, which were negative by Congo red staining but positive for κ-light chain by immunohistochemistry. The recent literature on LCDD was reviewed. When patients unexpectedly show extracellular deposits in gastrointestinal biopsy specimens, evaluation of immunoglobulin chains is recommended for diagnosis of LCDD after systemic amyloidosis has been excluded.
Estimation of B-inhibin and anti mullerian hormone in functional azoospermia and their correlations with surgical sperm retrieval: A prospective case-control study
Authors: GamalEl Din Sameh Fayek , Nabil Nashaat , Moawad Hanan Hosni , Amer Medhat , Zohdy Wael , Bakry Abdel Rahman , Raoof Martina Tharwat , Mohammed Asmaa , Salem Yasser
Published: March 2024

Objectives:

The current study estimated the levels of anti mullerian hormone (AMH) and inhibin-B and reproductive hormones in non obstructive azoospermic (NOA) cases and obstructive azoospermic (OA) cases as well as comparing between them as regards the sensitivity and specificity in determining the sperm retrieval hope in the NOA cases. Finally, we analyzed any potential correlation between all the hormones measured in the current study.

Methods:

The current case control study was conducted at the andrology outpatient clinic from June (2021) to March (2022). The study recruited 135 participants divided equally into three groups NOA cases, OA cases and controls, respectively.

Results:

The mean inhibin-B was significantly lower in the NOA cases compared to the OA cases and the controls. There was a positive moderate correlation between AMH and Inhibin-B. Also, there was a positive moderate correlation between inhibin-B and free testosterone (FT) and positive weak correlation between beta Inhibin and leutinizing hormone (LH).

Conclusions:

The current study asserts the observation that inhibin-B is also expressed by Leydig cells as it has demonstrated positive correlations with FT and LH.
Development and Validation of Knowledge Assessment Scales for Dementia and Urinary Incontinence in Community Older People
Authors: Sun Hui , Liu Wenqi , Sun Xuemei , Gao Yinyan , Chen Yancong , Lin Yali , Song Jinlu , Zhang Zixuan , Wang Betty H. , Li Lingqi , Feng Hui , Tan Hongzhuan , Chen Qiong , Peng Linlin , Dai Wenjie , Wu Irene X. Y.
Published: March 2024

To develop and validate scales for reliably assessing dementia and urinary incontinence knowledge of older adults in the community. Items were generated through a literature review, refined through a Delphi study ( n = 19), and then revised through a pilot study ( n = 29). Item analysis and exploratory factor analysis were applied to finalize the scales ( n = 244). Construct validity, reliability, and acceptability were evaluated ( n = 243). The two knowledge assessment scales for dementia and urinary incontinence, respectively, comprised 12 items and 8 items. Model fit indicators of both met the criteria of confirmatory factor analysis. Cronbach’s α were .82 and .70, respectively. Completion ratio and completion time of the two scales was 83.51% and 4.22 ± 1.90 minutes. The knowledge assessment scales for dementia and urinary incontinence with satisfactory validity, reliability, and acceptability, could be served as valid tools for disease prevention and management among older adults in the community.
Influence of housing hole accuracy on the starting torque of self-lubricating spherical plain bearings
Authors: Wang Qiang , Gu Ruijie , Wang Lei , Wang Junhua , Zhao Shuaifeng , Xie Jianjun , Chen Bo
Published: March 2024

The accuracy of the housing hole mainly refers to the dimensional tolerance, ovality and surface roughness of the hole, which directly affects the swing flexibility and service life of the self-lubricating spherical plain bearings (SSPBs) after the bearing is fitted in the housing hole. The dimension tolerance between the bearing and the housing has been ordained in the aviation standard. However, it is found that the ovality and surface roughness of the housing hole also have a great influence on the interference fit state, thus affecting the starting torque. In this paper, the effects of the three indexes of the housing hole accuracy (dimensional tolerance, ovality and surface roughness) on the starting torque were studied. Firstly, a theoretical analysis of the liner deformation inside the bearing was carried out based on the Lame equation. Then, the concept of equivalent interference was proposed considering the interference fit caused by the ovality and surface roughness, and the amount of the equivalent interference was determined. Furthermore, the influences of the three indexes on the starting torque were studied quantitatively with theoretical solution, numerical analysis and experimental verification. The results showed that the proposed concept of the equivalent interference can analyze the influence of the ovality and the surface roughness effectively, and the ovality has a greater effect on the starting torque than the surface roughness. The three precision indexes of the housing hole are reasonably designed to ensure that the starting torque after fitted meets standard requirements.
Digital economy and urban green development: A quasi-natural experiment based on national big data comprehensive pilot zone
Authors: Wang Lianghu , Shao Jun
Published: March 2024

As the engine of economic growth in the modern age, the digital economy plays an indispensable role in boosting the green development of cities. In this research, the difference in difference model and the spatial Durbin difference in difference (SDMDID) model are utilized to empirically examine the influence of digital economy on urban green development by employing the national big data comprehensive pilot zone as a quasi-natural experiment. In addition, its mechanism of action is further investigated from the standpoint of industrial structure upgrading, technical innovation, and human capital. The findings demonstrate that the degree of urban green development has consistently increased over the research sample, and there were clear disparities across areas; the implementation of the national big data comprehensive pilot zone has a significant role in promoting the green development of cities, and the policy effect on central cities and small and medium-sized cities is significantly higher than that of other types of cities; SDMDID model research found that the implementation of the national big data comprehensive pilot zone has a spatial effect; the mechanism test shows that the implementation of the national big data comprehensive pilot zone can promote the improvement of urban green development by promoting the upgrading of industrial structure and improving the level of technological innovation, while the mechanism of human capital has not yet emerged.
YTHDF1-mediated sphingosine kinase 2 upregulation alleviates bupivacaine-induced neurotoxicity via the PI3K/AKT axis
Authors: Yuan Ru , Wu Chunxia
Published: March 2024

Background

Bupivacaine (BUP), a long-acting local anesthetic, has been widely used in analgesia and anesthesia. However, evidence strongly suggests that excessive application of BUP may lead to neurotoxicity in neurons. Sphingosine kinase 2 (SPHK2) has been reported to exert neuroprotective effects. In this study, we intended to investigate the potential role and mechanism of SPHK2 in BUP-induced neurotoxicity in dorsal root ganglion (DRG) neurons.

Methods

DRG neurons were cultured with BUP to simulate BUP-induced neurotoxicity  in vitro. CCK-8, LDH, and flow cytometry assays were performed to detect the viability, LDH activity, and apoptosis of DRG neurons. RT-qPCR and western blotting was applied to measure gene and protein expression. Levels. MeRIP-qPCR was applied for quantification of m6A modification. RIP-qPCR was used to analyze the interaction between SPHK2 and YTHDF1.

Results

SPHK2 expression significantly declined in DRG neurons upon exposure to BUP. BUP challenge substantially reduced the cell viability and increased the apoptosis rate in DRG neurons, which was partly abolished by SPHK2 upregulation. YTHDF1, an N6-methyladenosine (m6A) reader, promoted SPHK2 expression in BUP-treated DRG neurons in an m6A-dependent manner. YTHDF1 knockdown partly eliminated the increase in SPHK2 protein level and the protection against BUP-triggered neurotoxicity in DRG neurons mediated by SPHK2 overexpression. Moreover, SPHK2 activated the PI3K/AKT signaling to protect against BUP-induced cytotoxic effects on DRG neurons.

Conclusions

In sum, YTHDF1-mediated SPHK2 upregulation ameliorated BUP-induced neurotoxicity in DRG neurons via promoting activation of the PI3K/AKT signaling pathway.
Can MRI Replace Nasopharyngoscopy in the Evaluation of Velopharyngeal Insufficiency?
Authors: Williams Jessica L. , Perry Jamie L. , Snodgrass Taylor D. , Singh Davinder J. , Temkit M’hamed , Sitzman Thomas J.
Published: March 2024

Objective

To investigate whether flexible nasopharyngoscopy, when performed in addition to magnetic resonance imaging (MRI), influences the type of surgery selected or success of surgery in patients with velopharyngeal insufficiency (VPI).

Design

Cohort study.

Setting

A metropolitan children's hospital.

Patients

Patients with non-syndromic, repaired cleft palate presenting for management of VPI.

Interventions

MRI and nasopharyngoscopy or MRI alone for preoperative imaging of the velopharyngeal mechanism.

Main Outcome Measures

(1) Surgical selection and (2) resolution of hypernasality. All speech, MRI, and nasopharyngoscopy measurements were performed by raters blinded to patients’ medical and surgical history.

Results

Of the 25 patients referred for nasopharyngoscopy, 76% completed the exam. Of the 41 patients referred for MRI, the scan was successfully completed by 98% of patients. Completion of nasopharyngoscopy was significantly (p=0.01) lower than MRI. Surgical selection did not significantly differ (p=0.73) between the group receiving MRI and nasopharyngoscopy and the group receiving MRI alone, nor was there a significant difference between these groups in the proportion of patients achieving resolution of hypernasality postoperatively (p=0.63). Percent total velopharyngeal closure assessments on nasopharyngoscopy and MRI were strongly correlated (r=0.73).

Conclusions

In patients receiving MRI as part of their preoperative VPI evaluation, the addition of nasopharyngoscopy did not result in a difference in surgical selection or resolution of hypernasality. Routine inclusion of nasopharyngoscopy may not be necessary for the evaluation of velopharyngeal anatomy when MRI is available.
Feeding Management and Palate Repair Timing in Infants with Cleft Palate with and without Pierre Robin Sequence: A Multisite Study
Authors: Williams Jessica L , Lien Kari M , Kirschner Richard , Allen Gregory , Chapman Kathy ,   on behalf of the Cleft Outcomes Research NETwork (CORNET) Consortium
Published: March 2024

Objectives

Compare the feeding management practices in infants with cleft palate with and without Pierre Robin sequence (PRS) and determine if specific feeding difficulties or interventions predict delayed palate repair.

Design

Retrospective cross-sectional study.

Setting

Seventeen cleft palate teams contributed data.

Patients

414 infants were included in this study: 268 infants with cleft palate only and 146 infants with cleft palate and PRS.

Procedures

Data were collected via parent interview and electronic health records.

Main Outcome Measures

Outcomes for the primary objective included categorical data for: history of poor growth, feeding therapy, milk fortification, use of enteral feeding, and feeding difficulties. The outcome for the secondary objective was age in months at primary palate repair.

Results

Infants with PRS had a significantly higher prevalence of feeding difficulties (81% versus 61%) and poor growth (29% versus 15%) compared to infants with cleft palate only. Infants with PRS received all feeding interventions—including feeding therapy, milk fortification, and enteral feeding—at a significantly higher frequency. Infants with PRS underwent primary palate repair at a mean age of 13.55 months (SD = 3.29) which was significantly ( P < .00001) later than infants with cleft palate only who underwent palate repair at a mean age of 12.05 months (SD = 2.36). Predictors of delayed palate repair included diagnosis of PRS as well as Hispanic ethnicity and a history of poor growth.

Conclusions

These findings can be used to establish clinical directives focused on providing early, multimodal feeding interventions to promote optimal growth and timely palate repair for infants with PRS.
Health care Utilization and Expenditures in Health Professional Shortage Areas
Authors: McClellan Chandler B.
Published: March 2024

Healthcare provider shortages are associated with adverse health outcomes, presumably stemming from the lack of access to primary care. This study examines the impact of Health Professional Shortage Areas (HPSAs) on healthcare utilization and spending across different types of care. Using the Medical Expenditure Panel Survey from 2002 to 2019, this study estimates the difference in healthcare utilization in HPSAs compared with non-HPSAs using a generalized random forest, which allows for more complex modeling of the outcome and a principled examination of heterogenous treatment effects. The results indicate HPSAs are associated with a 5% reduction in medical office visits, but no reduction in hospital-based care. These effects are concentrated in older persons living in urban areas, Black persons, and Medicaid beneficiaries. No statistically significant effects on annual spending were observed. These results offer insight into potential areas for further policy efforts aimed at reducing provider shortages.
Comparison of performance and tribological properties of electromechanical brake with magnetorheological fluid and magnetic powder
Authors: Singh Rakesh Kumar , Sarkar Chiranjit
Published: March 2024

Brakes, which are the safety component of any automobile used to control the motion of the vehicle as per the driver's choice. In conventional brakes, friction lining materials are used, which affect the health of human beings and pollute the environment. Hence, there is a need to look for new types of brake systems. In the present work, a new type of electromechanical (EM) drum brake is designed that does not use friction lining materials for brake application. It can use magnetorheological (MR) fluid as well as magnetic powder (MP) for brake application. The presented brake has been designed to operate in hybrid mode that is, shear plus compression mode. When MR fluid is used, these brakes face the problem of the leakage of MR fluid which motivates to use of MP. In addition to the design of the new brake, the performance of the new brake has been tested with MR fluid and MP separately on a full-scale brake inertia dynamometer. The performance test results have been compared for both MR fluid and MP and compared with conventional friction brakes. 14.56% and 11.38% more braking torque have been observed for MP compared to that of MR fluid in shear and hybrid mode respectively. In addition to the performance study, the effect of MR fluid and MP on brake shoe surface properties has been studied.
Microstructure evolution and mechanical properties of wire-arc-additively manufactured Al–Cu–Mg–Ag alloy
Authors: Chen Shujun , He Zhi , Xiao Jun , Liu Liang , Gai Shengnan , Zhang Long
Published: March 2024

In this article, Al–Cu–Mg–Ag specimens were successfully wire-arc-additive-manufactured based on by gas metal arc process to investigate the evolution of microstructure and mechanical properties. The results showed that the grain morphology and pore size in the printed specimens varied in height direction. Under the influence of repeated thermal cycling, which affected the solid-state diffusion of the deviated elements at the grain boundaries, the distribution of the nanoscale second phase appeared significantly different in the height direction. The precipitation phase changes caused the microhardness of the printed specimens to decrease gradually from a peak of 125 HV and stabilise at around 100 HV. The changes in the printed specimens’ horizontal mechanical properties were insignificant mainly due to interlayer porosity.