bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrops and Congenital Diaphragmatic Hernia: Reported incidence and postnatal outcomes. Analysis of the CDHSG Registry
Authors: Burgos Carmen Mesas , Ebanks Ashley , Löf-Granström Anna , Holden Kylie I , Johnson Anthony , Conner Peter , Harting Matthew
Published: January 2024

Obejctive: Congenital Diaphragmatic Hernia (CDH) associated with hydrops is rare. The aim of this study was to describe the incidence of this combination of anomalies and the postnatal outcomes from a large database for CDH.
Study design: Data from the multicenter, multinational database on infants with prenatally diagnosed CDH (CDHSG Registry) born from 2015 to 2021 were analyzed.
Results: A total of 3985 patients were entered in the registry during the study period, 3156 were prenatally diagnosed and 88 were reported to have associated fluid in at least 1 compartment, representing 2.8 % of all prenatally diagnosed CDH cases in the registry. The overall survival to discharge for CDH patients with hydrops was 43%.
The hydropic CDH group had lower birth weight and gestational age at birth, and increased incidence of right sided CDH (55%) and rate of non-repair (45%). However, the survival rate for hydropic infants with CDH undergoing surgical repair was 80%. Other associated anomalies were more common in hydropic CDH (50% vs 37%, p=0.001).
Conclusion: Hydropic CDH is rare, only 2.8% of all prenatally diagnosed cases, and more commonly occurring in right sided CDH. Survival rates are low, with higher rates of non-repair. However, early decision-making regarding goals of care and an aggressive surgical approach may result in survival rates comparable to non-hydropic cases.
Determinants of Construction Project Delay and Its Effect on Project Beneficiaries: Evidence from Gurage Zone, Ethiopia
Authors: Shedaga Tasew , Sahle Matiyos , Mekonen Endalkachew
Published: January 2024

The study aimed to identify the determinants of project delay and assess its socioeconomic effect on project beneficiaries. Regression analysis and relative importance index were employed to identify its determinants whereas key informant interview (KII) and focus group discussion (FGD) were used to assess its socioeconomic effect on beneficiaries. Poorly defined project scope, poor project control and management, incorrect estimate of cost and schedule, bad economic conditions, political instability, dearth of construction inputs and inadequate communication causes project delay. The regression results show project delay is positively associated with poor project initiation, planning and design, monitoring and control and communication and lack of project materials and inputs. KII and FGD reveals delays in project limit access to transport, unemployment, migration, disputes among project stakeholders, and congestion on public service delivery. Also it has health and health-related impacts such as many mothers have died with maternal complications, and children were unable to get vaccinated. Therefore, project monitoring, follow-up and control should be part and parcel of project implementation strategies. Project manager shall be selected based on meritocracy with good qualities of leadership. Project sponsors reconsider the broader social and economic implications of project delays in addition to cost and time overruns.
Monitoring seasonal variation and anomaly trend of daytime and nighttime land surface temperature using MODIS sensor in Shiraz, Iran
Authors: Karami Mokhtar , Zanganeh Yaghoub , Zandi Rahman , Khosravian Maryam
Published: January 2024

A major environmental problem in large cities and metropolitan areas is the increase in land surface temperatures (LST) caused mainly by heat islands in these areas. The LST anomaly plays an important role in climate studies, agriculture, and water resource management. This study aimed to investigate the seasonal changes and anomaly trends of daytime and nighttime LST in the Shiraz urban area. For the period 2001-2021, the LST anomaly was studied using the Terra satellite's MODIS sensor both day and night. The results revealed that the daytime temperature was positive in all seasons, with a minimum and maximum daytime temperature of 13.15°C in winter and 27.28°C in summer. In terms of location, LST was highest during the day in the central areas and in the summer season, with a temperature range of 38.44°C to 47.27°C. At night, LST does not reach a negative value at any time of the year. With a long-term average temperature of 8.09°C, the winter season in Shiraz had the lowest annual temperature, while the summer season showed the highest at 24.74°C. The maximum Z-score of the Mann-Kendall test indicated that the anomalies increased significantly in the high altitude areas such as the northeastern and northern regions of Shiraz city, changing from 0.5°C to 2.36°C. The anomaly trend of LST in this region averaged 0.84°C with a minimum of -1.29°C.
Long-term Cardiac Effects of Modern Treatment for Hodgkin’s Lymphoma
Authors: Bjerring Anders W , Smeland Knut HB , Stokke Thomas , Haugaa Kristina H , Holte Espen , Rösner Assami , Kiserud Cecilie E , Edvardsen Thor , Sarvari Sebastian Imre
Published: January 2024

Background: Hodgkin’s lymphoma (HL) is a hematological malignancy that affects both children and young adults. Traditional treatment is associated with a life-time prevalence of cardiac disease exceeding 50%. In the late 1990s protocols were modified to reduce cancer therapy-related adverse cardiac effects. This study aimed to assess the long-term impact of advances in treatment protocols on the cardiac health of HL survivors (HLS).
Methods: HLS (n=246) treated between 1997 and 2007 with anthracycline-based chemotherapy in three centers in Norway were included. Of these, 132 (53%) had also received mediastinal radiotherapy. HLS were compared to controls (n=58) recruited from the general population and matched for sex, age, smoking status, and heredity for coronary artery disease. All subjects underwent echocardiography, clinical assessment, and blood sampling.
Results: The HLS were 46±9 years old and had been treated 17±3 years before inclusion in the study. There was no significant difference between HLS and controls in ejection fraction (EF) (58%±5 vs. 59%±4, p=0.08) or prevalence of heart failure. HLS treated with both anthracyclines and mediastinal radiotherapy (AC+MRT) had slightly worse left ventricular global longitudinal strain than controls (‑19.3±2.5% vs. -20.8±2.0%, p<0.001), but those treated with only anthracyclines did not. HLS treated with AC+MRT had a higher prevalence of valve disease than those treated only with anthracyclines (12% vs. 4%, p<0.05).
Conclusions: HLS treated with anthracyclines after the late 1990s have similar cardiac outcomes as age-matched controls, apart from higher rates of valvular disease in those who also underwent mediastinal radiotherapy.
What Do We Know About Abnormal Uterine Bleeding Following Vaccination Against Covid-19 After Two and A Half Years Of Experience? A Systematic Review and Meta- Analysis
Authors: Sharon Nataly Zilberman , Maymon Ron , Svirsky Ran , Novikov Ilya , Cuckle Howard , Levtzion-Korach Osnat
Published: January 2024

Vaccination against COVID-19 is regarded to be most effective in preventing morbidity and mortality and limiting the spread of the virus. Publications in the media and scientific journals have raised a concern regarding abnormal uterine bleeding as a COVID-19 vaccine side effect. We aimed to estimate the prevalence of abnormal uterine bleeding after vaccination against COVID-19. Medline, PubMed, Embase and Google Scholar databases were searched between January 2020 and June 2022.English-language studies, including at least four women with abnormal uterine bleeding. Eligible studies were assessed for risk of bias using the Newcastle-Ottawa Scale. Data synthesis was accomplished by meta-analysis of frequencies of the abnormal uterine bleeding rate and meta-regression of the rate adjusted for the type of vaccine and number of vaccinations. There were 12 eligible studies including a total of 1,132,613 women of whom 41,344 (31.3%, 95CI 11.7-55.1%) reported abnormal bleeding following vaccination. Nine studies included clinical presentation: the abnormality was menorrhagia in 38%, irregular menses in 28%, intermenstrual bleeding in 12% and delayed menses in 9%). There was considerable heterogeneity in results which could not be accounted for by the method of recording abnormal bleeding, vaccine manufacturer or number of doses. COVID-19 vaccine carries the inconvenience of abnormal uterine bleeding in almost one-third of the women vaccinated, mostly irregular menses or menorrhagia. In addition, the innovative vaccine mechanism could be used against various potential targets, further highlighting the need to assess vaccine side effects.
Types of Violence Prevalence in Medical Residencies in Mexico
Authors: Corona-Vázquez Teresita , Fajardo-Dolci Germán , Sánchez-Guzmán Alejandra , Paz-Rodríguez Francisco , Vives-Varela Tania , Hamui-Sutton Liz
Published: January 2024

Background. Violence includes behaviours that medical residents in clinical settings perceive as humiliating, abusive, or hostile. The aim of the present study is to describe the prevalence and severity of different types of violence in medical residencies administrated by the National Autonomous University of Mexico.
Method. The project was conducted through an analytical cross-sectional study, the sample included 78 specialties, 113 medical units, six health institutions and residents with between one and eight years of study during the 2021-2022. An online survey was applied, which demonstrated a high degree of reliability with an alpha omega Ω of 0.835 (CI; 0.828-0.843).
Results. Of the 14,751 students enrolled 12,612 (85%) responded, 49.6% were women, and the average age was 31.1 years (SD 3.1). A total of 6,602 respondents (52.3%) reported suffering some type of violence on the last 12 months. The incidences included psychological violence 44.4%, physical violence 4.7%, sexual violence 6%, and academic mobbing and workplace violence 32.7%. Professors and third-year residents were the most common perpetrators approximately 50% and 25% of the cases, respectively. Women reported suffering more violence than men (p< 0.05).
Conclusions. The strength of this study is based on the fact that it includes all medical specialties, it assesses the severity and direction of the violence, and it considers gender.
Real-time ultrasound-guided sacral plexus block combined with mild sedation for hemorrhoidectomy and hemorrhoidal artery ligation in a patient with amyotrophic lateral sclerosis: A case report
Authors: Li Yan , Wang Qian , Liu Taotao , Gao Min , Hu Qianhui
Published: January 2024

Patients with amyotrophic lateral sclerosis (ALS) present perioperative challenges for clinical anesthesiologists for anesthesia-associated complications. A 54-year-old woman with a 2-year history of ALS was scheduled for hemorrhoidectomy and hemorrhoidal artery ligation. We performed real-time ultrasound-guided sacral plexus block with dexmedetomidine under standard monitoring. The anesthesia method met the surgical demands and avoided respiratory complications during the procedures. There was no neurological deterioration after the surgery and 3 months after the patients were discharged. Real-time ultrasound-guided sacral plexus block combined with mild sedation may be an effective and safe technique in patients with ALS undergoing hemorrhoidectomy and hemorrhoidal artery ligation.
Research on the main controlling factors and preferred formulations for chemical oil recovery in conglomerate reservoirs based on complex lithology
Authors: Yan Xiaolong , Tian Yu , Shi Yongmin , Wang Xiaoguang , Leng Runxi , Zheng Haoxuan , Liang BaoXing , Zhao Shuai
Published: January 2024

It is found that the mineralogical composition of conglomerate oil reservoirs in the Junggar Basin in northwest China is complex compared to conglomerate oil reservoirs in other regions. Among them, the most active physicochemical properties are zeolite minerals and clay minerals, which have the largest specific surface, the highest zeta potential, and they readily interact with surfactants used in chemical oil recovery. Experiments were conducted according to the actual surfactant/polymer binary composite drive chemical oil recovery model at the production site, and the interfacial tensions of 17 surfactants were measured, and the anionic surfactant KPS petroleum sulfonate, the nonionic surfactant coconut oil fatty acid diethanolamide 6501, and the amphoteric surfactant octadecyl betaine, which achieved ultra-low interfacial tensions, were screened out. Using the core of conglomerate reservoir, the contained minerals and oil and water, three surfactants were tested for adsorption performance, wettability test, emulsification performance evaluation, and finally, after the oil drive validation experiments, it was concluded that the specific surface of the minerals, zeta potential and the amount of adsorption of the chemical agent are positively correlated, and the amount of adsorption affects the recovery rate of chemical drive in conglomerate reservoirs, so that the 6501 was recommended to be the preferred surfactant. The research methodology adopted in the paper can be applied to chemical drive in reservoirs of different types and rock mineral compositions, and is also constructive for the promotion of chemical drive in similar reservoirs.
Ethical concerns about artificial intelligence: Evidence from a national survey in Taiwan
Authors: Chang Wendy Li-Yun , Liao Ying-Kai , Chao En , Liu Shiang-Yao , Lee Tony Szu-Hsien
Published: January 2024

Ethical concerns about how artificial intelligence (AI) impacts individuals and society are increasing rapidly, but few studies have systematically investigated the public awareness of AI ethics. This reseach collected and analyzed data from a public poll in Taiwan, an Asian region with a developed economy and specific social conditions, to identify societal views on AI ethics. The analysis of 84 AI ethics guidelines worldwide provided the survey framework covering 5 ethical principles: transparency, fairness, privacy, nonmaleficence, and accountability. The overarching goal was to determine the commonalities and differences in the ethical concerns of Taiwanese laypersons toward AI. Participants aged from 20 to 70 (n = 1,200) completed a computer-assisted random-digit-dial telephone survey, which utilized ethical scenarios to capture social views, and item validity was confirmed using focus-group interviews. Results found that respondents concerned about nonmaleficence the most, emphasizing that AI applications should not harm humans. Taiwanese people therefore tended to support strict AI technology regulation. It was particularly interesting that different patterns of public concern emerged about accountability, with the opinions on attributing responsibility to stakeholders varying with scenarios and the public's backgrounds. Those with higher education levels tended to attribute more responsibility to the industry, whereas those who had only received elementary-school education attributed accountability to AI developers. For self-driving cars, accountability was attributed to AI developers, whereas for medical decision-making, the accountability was attributed to the hospitals. These findings may help to elucidate the associations between societal views and the ethical principles of AI worldwide.
Efficacy and Safety of Methylene Blue for Patients with Septic Shock A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Hu Yuwei , Li Jiyun , Zhang Hang , Yang Haoyue , Wang Yu , Ren Junyi , Sun Mingwei , Wang Xiaomei , Jiang Hua , Zeng Qin , Wang Kai
Published: January 2024

Objective To evaluate the efficacy and safety of intravenous Methylene Blue(MB) therapy in patients with septic shock.
Background Sepsis is a dysregulated host response to infection, with an abnormal nitric oxide metabolism among its characteristics. MB is a specific inhibitor of the inducible nitric oxide synthase and its downstream enzyme soluble guanylate cyclase. However, the efficacy and safety of MB in patients with septic shock are unclear.
Methods A comprehensive search of the Pubmed, EMBASE databases, Web of Science, Cochrane Library, and Chinese biomedical literature database was performed to identify randomized controlled trials that evaluated the effect of MB vs. placebo/blank in septic shock patients. The primary outcome was mortality within 28 days. The secondary outcomes were mean arterial blood pressure, lactate, mechanical ventilation time, the length of stay in the intensive care unit (ICU) and adverse effects.
Results Altogether, eight RCTs with a total of 387 participants were included in the meta-analysis, of whom 161 were randomized to receive the MB treatment, whereas 160 received a placebo or blank. The MB therapy significantly reduced mortality among patients with septic shock [relative risk (RR) = 0.72, 95% confidence interval (CI): 0.54 - 0.96]. However, in subgroup analysis, the reduction in mortality was only significant in the patients who received a low dose of intravenous MB administration(<5mg/kg) (RR= 0.60, 95% CI: 0.41 - 0.88) and not significant in the high dose group (≥5mg/kg) (RR= 1.06, 95% CI: 0.67 - 1.69). The MB group had an increased MAP, decreased Lactate, and reduced length of stay in ICU and a shorter mechanical ventilation time when compared with the control group. There were no significant differences in the adverse effects between the intervention and control groups.
Conclusions A low dose of intravenous MB administration (<5mg/kg) is a safe and efficacious therapy in reducing mortality in septic shock. For patients experiencing septic shock, Methylene Blue has been shown to significantly increase MAP, reduce serum Lactate levels, and shorten LOS in ICU and mechanical ventilation time.
Registration: The information for this meta-analysis is available in PROSPERO (CRD42023417385).
Transcriptomic Alterations in the Hippocampus and Prefrontal Cortex of Chronic Unpredictable Stress Rats Induced by Low-Intensity Pulsed Ultrasound.
Authors: Ren Siyu , Guo Zinan , Zhang Jinniu , He Yi , Sun Zuoli , Yang Jian
Published: January 2024

Neuromodulation techniques have shown promise in the treatment of depression. In our previous study, we demonstrated that low-intensity pulsed ultrasound stimulation (LIPUS), a novel noninvasive neuromodulation tool, effectively ameliorated depression-like behaviors in a rat model of depression. However, the underlying mechanisms of its therapeutic effect remain unclear. The present study aims to elucidate the relevant mechanisms through transcriptomic research. To induce depression-like phenotypes, rats were subjected to chronic unpredictable stress (CUS) for six weeks. Throughout these six weeks, LIPUS was administered daily to the CUS rats, utilizing a pulse repetition frequency of 200 Hz. The transcriptome expression profiles in the hippocampus and prefrontal cortex (PFC) were subsequently analyzed by RNA sequencing techniques. We found that the CUS rats exhibited 3,464 differentially expressed genes (DEGs) in the hippocampus and 1,781 DEGs in the PFC when compared to the control group. Ultrasound stimulation was able to reverse the expression of 592 genes in the hippocampus and 254 genes in the PFC. Functional analysis revealed a significant enrichment of DEGs related to oxygen carrier activity and sugar metabolism. Subsequently, the alterations in the top ten genes were validated using real-time quantitative polymerase chain reaction. The significant changes in the expression of hemoglobin subunit beta, growth hormone 1, and glucokinase were confirmed. The results suggest that LIPUS may ameliorate depression-related manifestations by regulating cerebral oxygenation and sugar metabolism processes in the brain.
Effects of Soil Nutrient Availability on Ectomycorrhizal Communities’ Distribution in Two Dipterocarps Species Under Normal and Elevated Atmospheric Carbon Dioxide
Authors: Bakray Nur Aqilah Mustafa , Azman Alia Shafini , Kin Thi Bee , Mansor Patahayah , Mohti Azian , Jamar Nur Hidayah , Zohari Ahmad Fitri , Said Mohd Nizam Mohd
Published: January 2024

This study explores the impact of increasing atmospheric carbon dioxide (CO2) levels on belowground communities in tropical rainforests, focusing on the relationship between soil nutrient availability and the distribution of ectomycorrhizal (ECM) fungi on two dipterocarps seedlings, Shorea leprosula and S.lepidota in Tekam Forest Reserves, Pahang. Using the Free Air Carbon Dioxide Enrichment (FACE) hexagon plot, the research compared two different CO2 levels at normal (control plot) and elevated (FACE plot) concentrations. In the elevated CO2 plot, only four ECM species were found compared to five in the control plot. Notably, Geastrum sp. was exclusive to the control plot, while Lactarius sp., Russula sp., Tomentella sp., and Cenococcum sp. were present in both plots, indicating adaptability to varying soil nutrient and CO2 conditions. Statistical analyses (DCA, PCA, CCA) revealed associations between ECM fungi and plant hosts, soil nutrient composition, and a combination of parameters. For instance, S. lepidota exhibited a preference for phosphorus in the control plot, while S. leprosula preferred higher carbon contents. Tomentella sp. and Cenococcum sp. showed strong associations with nitrogen and potassium, respectively, while Lactarius sp. and Russula sp. correlated with the C:N ratio. In conclusion, this study underscores the importance of understanding the intricate relationship among soil nutrient availability, ECM distributions, and elevated atmospheric CO2 in tropical rainforest ecosystems.
Controllable Synthesis of Organopolysilazane Composite Coatings and Their Role in Protecting Combustible Cartridge Cases
Authors: Wu Mengde , Xiao Zhenggang
Published: January 2024

A series of organopolysilazane (OPSZ) composite coatings were synthesized via a grafting reaction between OPSZ and epoxy resin, which were applied to protect the surfaces of combustible cartridge cases. The chemical compositions were characterized by Fourier-transform infrared spectroscopy and X-ray photoelectron spectroscopy. The results of heat-resistance tests indicated that the optimum OPSZ composite coating could prevent combustible cartridge cases from burning for 175.56 s at 250°C. The glass transition temperatures (Tg) of the OPSZ composite coatings were dependent on the polymer structure and were in the range of 254.7–454.0°C. All of the coatings showed good thermal stability, with temperatures at which 50% weight loss occurred being greater than 600°C. The results indicated that the OPSZ composite coatings could effectively improve the heat resistance of combustible cartridge cases. Based on scanning electron microscopy images after salt water exposure tests and the water contact angle, the OPSZ composite coating could effectively improve the environmental adaptability of combustible cartridge cases. This study demonstrated that the ceramic precursor OPSZ, as a protective material, provides a novel way to fabricate various coatings to protect combustible cartridge cases from high temperatures, environmental humidity, and corrosive air.
Electrostatic Defectoscopy Method on Testing Water Interface in Dielectric Materials
Authors: Ivantsov Mikhail
Published: January 2024

Innovative development of a sensor is proposed that uses the principle of Fabry-Perot interferometer. Such a sensor is designed as some kind of contact mirror on which the tested object is placed. This is the same measuring mirror for detecting the high frequency polarization effect of water contained in the material being tested. In that case, the test object is additionally affected by an electrostatic field, which should change the polarization relaxation of water molecules. Since a change in polarization in electrostatic field occurs at the water interface, it is possible to register traces of water in the hidden defects of material. The electrostatic measurement method proposed here can be used to study the internal structure of dielectric materials.
Ni0.05Ti1.95Nb10O29: an advanced anode material for high-performance lithium-ion storage
Authors: chen xiuli , Su Mingru , Chen Xueli , Cui Pei , Zhou Yu , Ji Yunxuan , Zhang Panpan , Liu yunjian
Published: January 2024

Ti2Nb10O29 (TNO) has garnered significant research attention due to its high specific capacity and excellent safety features, positioning it as a promising anode material for lithium-ion batteries (LIBs). Nevertheless, its rate capability is significantly hampered by poor electronic and ionic conductivity. In this paper, Ni2+ doping has been first applied to address these issues. A series of Ni2+ doped TNO (Nix-TNO (x = 0.03, 0.05, 0.07) electrode materials have been prepared to unveil the effects of Ni2+ content. The experimental results unveil that Ni2+ doping maintains the Wadsley-Roth shear structure of TNO while augmenting the single-cell volume and introducing additional oxygen vacancies in TNO. This generates a wider diffusion path and more active sites for lithium ions (Li+). Besides, the introduction of Ni2+ can alter the conductive field distribution of TNO, giving rise to a much higher electronic conductivity of Nix-TNO. Among the synthesized Nix-TNO, Ni0.05-TNO shows the best electrochemical performance, demonstrating a reversible capacity of 306 mAh g–1 with a Coulombic efficiency of 91.46% in the first cycle at 0.1 C and 146.19 mAh g–1 at 10 C after 500 cycles.
Intermittent Multivariate Time Series Spindle Thermal Error Prediction under Wide Environmental Temperature Ranges and Diverse Scenario Conditions
Authors: Jia Guangjie , Zhang Xu , Shen Yijun , Huang Nuodi
Published: January 2024

As the integration of mechanical engineering and deep learning fields becomes increasingly intertwined, the application of experimental thermal error modeling in intelligent manufacturing has gained significant importance. In this paper, the issue of spindle thermal error is treated as a multivariate time series problem due to the thermal transfer characteristics. This study aims to address the challenge of modeling intermittent multivariate time series spindle thermal errors under a wide range of environmental temperatures and various operational scenarios. To tackle this challenge, a substantial volume of experimental data, capable of effectively reflecting the patterns of spindle thermal error variations, was collected through experiments conducted at multiple speeds and under various operational scenarios. Subsequently, the acquired thermal error data underwent intermittent multivariate time series transformation (IMTS) to suit the serialized deep learning model. The study introduces the Crossformer model into the field of thermal error modeling for the first time, which is a variant of the Transformer model. The Crossformer model exhibits remarkable adaptability to temporal aspects while effectively maintaining its focus on data features. Ultimately, this study resulted in the development of the IMTS-CrossformerR experimental thermal error model. Throughout the research, a comprehensive examination of various models was undertaken, including two traditional Transformer models, and other thermal error deep learning and machine learning models. The results indicate that the proposed model outperforms its counterparts across multiple model metrics and predictive capabilities. Particularly noteworthy is its substantial improvement in the Range (± 5) ratio of residual fluctuations reaching 95.7%, a key engineering metric. These findings emphasize the significant engineering application value of this research, offering novel methods and insights for the precise prediction of spindle thermal errors in the manufacturing industry.
Sepsis Management in Low- and Middle-Income Countries: A Systematic Review
Authors: Jenson Alexander , Loevinsohn Gideon , Lukacs Teagan , Osula Valerie , Jalbout Nour Al , Rao Aditi , Lorenz Kathryn , Chipendo Portia , Hansoti Bhakti
Published: January 2024

Background Optimal sepsis management in low-resource settings is the subject of active debate. Given resource limitations, prevalent co-morbidities, and unique infectious epidemiology, resuscitation strategies conceived in resource-rich settings may be difficult to apply more broadly. Evidence from low- and middle-income country (LMIC) settings is disparate and frequently discordant. We sought to synthesize the available data. Methods A systematic search of sepsis resuscitation interventions in LMIC was performed in PubMed, EMBASE, Scopus, Global Health Library databases, and the gray literature in accordance with PRSIMA guidelines. Studies were included if they defined a fluid or antibiotic intervention and measured the effect on in-hospital mortality for patients with undifferentiated sepsis. Studies were categorized based on the volume of fluid administered and the time to antibiotic administration. Results The search yielded 22,088 unique articles, of which 26 studies, encompassing 15,667 patients met the inclusion and were included. Over half the studies (14/26) evaluated the effect of fluid administration on mortality and found a trend toward increased mortality when more than 2 L were administered in the first 6 hours, while 1–2 L was associated with reduced mortality. Among the 15 studies evaluating the impact of antibiotic timing, administration within 3 hours was associated with reduced likelihood of in-hospital mortality. However, there was wide heterogeneity across study methodologies, outcomes, and resource variation. Conclusion Synthesis of the available data suggests that a judicious fluid strategy (between 1 and 2 liters within the first 6 hours) and early antibiotic administration are the most appropriate strategies for undifferentiated sepsis. More research is needed, especially in rural low-resource settings where we found a dearth of available research.
Cognitive Demands and Strategic Preparedness of Novice English Teachers for ELL Instruction in Zhejiang province, China
Authors: li Ruyang , Shah Mohamed Ismail Ahamad
Published: January 2024

This study explores the cognitive challenges and preparedness of novice English language teachers in Zhejiang Province, China, for teaching English Language Learners (ELLs). Addressing the gap in research on the application of theoretical frameworks in this context, the qualitative descriptive research involved 15 novice educators through interviews, observations, and document analysis. It is grounded in Illeris' Contemporary Learning Theory and Vygotsky's Sociocultural Theory. Key findings include the identification of significant cognitive challenges in addressing diverse learning needs and knowledge gaps among ELLs. The study also highlights the effective use of metacognitive techniques and scaffolding in ELL instruction. It underscores the need for comprehensive teacher training in China, advocating for programs that go beyond linguistic skills to include varied pedagogical strategies, catering to the complex requirements of ELL students.
A web-based knowledge database to provide evidence-based information to cancer patients: Utilization within the PIKKO study
Authors: Schneider Nico , Altmann Uwe , Brandt Florian , Hübner Jutta , Strauss Bernhard , Keinki Christian
Published: January 2024

Purpose
In the context of cancer, a high amount of dangerous disinformation exists online. High quality information websites are less visible in online searches, and profit-driven websites have lower quality. As part of the PIKKO project, a web-based knowledge database (WDB) was used to provide cancer patients with quality-assured, evidence-based information. This paper aims to provide information about the usage (Who? How? What?) and the effects regarding health literacy of WDB.
Methods
A patient survey and automatically generated logfile data were evaluated. Two user groups, patients and patient navigators (PNs), were compared.
Results
The 13 PNs were responsible for 1/3 of all accesses over the entire duration of the project. The 413 patients used WDB twice on average and spent an average of 12 minutes per session online (PNs: 9 minutes per session, more frequently). The top 3 topics of interest were ‘therapy’, ‘nutrition’ and ‘carcinogenesis’ for the patients, and ‘therapy’, ‘naturopathy’ and ‘legal regulations/support’ for the PNs. Of the patients surveyed, 69% said that WDB was helpful in making informed decisions, 76% found the information they wanted and 90% thought WDB was an appropriate way to provide information.
Conclusion
Our WDB provided important information about cancer and its treatment on a digital way both, to patients and PNs. In routine cancer care, the WDB can improve health literacy and informed decision-making.
Trial registration:
This study was retrospectively registered in the German Clinical Trial Register under DRKS00016703 (21 Feb 2019, retrospectively registered). https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016703
Pregnancy-Associated Events in Prognosis and Outcome of Lymphangioleiomyomatosis: A Single-Center Retrospective Analysis
Authors: Jingye Tai , Shihua Liu , Xinping Yan , Zixin Fan , Luantai Huang , Weilin Wang , Yingxin Pan , Hongyuan Huang , Zhen Zhao , Beini Xu , Jie Liu
Published: January 2024

Background: Lymphangiomyomatosis (LAM) is an uncommon condition that primarily impacts women in their reproductive years. Current guidelines discourage pregnancy behavior in women with LAM because to the belief that it raises the risk and does not result in favorable pregnancy outcomes. Pregnancy events have been linked to a higher likelihood of developing pneumothorax and chylothorax, as well as an acceleration in the deterioration of lung function. Currently, there is a deficiency of extensive clinical trials investigating the impact of pregnancy on LAM.Methods: The study conducted an integrative analysis by collecting data from the LAM patient registry at the First Hospital of Guangzhou Medical University in Guangzhou, China, as well as from LAM patient organizations in South China. Additionally, the study searched the MEDLINE, Scopus, Embase, and Cochrane Central databases for six relevant clinical articles using the keywords "lymphangiomatosis" and "pregnancy". Retrieve scholarly publications for systematic assessment.Results: The study had a total of 133 patients diagnosed with lymphangiomatosis. Out of the total number of patients, 91 individuals (68.4%) experienced irregularities in their menstrual cycles. A single patient was identified with lymphangioleiomyomatosis (LAM) after experiencing pneumothorax during pregnancy. Out of the 12 instances of pregnancy, LAM was identified before conception.One case of dyspnea, one case of renal abnormalities, and one case of tubal pregnancy were identified. Abnormal pregnancy events had place in 25 out of the 173 pregnancies (14.5%) that happened before the diagnosis of LAM. The analysis included six more studies, which reported an incidence of 13.47% for pneumothorax during pregnancy with LAM, 8.30% for dyspnea, and 3.32% for other respiratory abnormalities. Among the five studies that documented aberrant pregnancies, a total of 73 miscarriages (14%), 83 abortions (16%), and 12 other pregnancy outcomes (2%) were reported.Conclusions: The elevated incidence of monthly irregularities in individuals with lymphangiomatosis may be attributed to the use of sirolimus and the variable levels of estrogen in patients with lymphangiomatosis. Pregnancy significantly increases the likelihood of experiencing a sudden worsening of lymphangiomatosis-associated pulmonary disease (LAM). Pregnancy might cause a sudden worsening of LAM. LAM exhibits a substantial prevalence of unfavorable reactions during pregnancy, resulting in unfavorable pregnancy results. Consequently, it is advised against getting pregnant in individuals with LAM.
Study strategies and exam outcomes in medical education: Insights from renal physiology
Authors: Heltne Sofie Fagervoll , Hovdenakk Sigrid , Kvernenes Monika , Tenstad Olav
Published: January 2024

Background
Efficient learning strategies and resource utilization are critical in medical education, especially for complex subjects like renal physiology. This is increasingly important given the rise in chronic renal diseases and the decline in nephrology fellowships. However, the correlations between study time, perceived utility of learning resources, and academic performance are not well-explored, which led to this study.
Methods
We conducted a cross-sectional study by inviting second-year medical students from the University of Bergen, Norway, to participate in a survey on their preferred learning resources and the time dedicated to renal physiology in comparison to other subjects. The students' responses were then correlated with their end-of-term exam scores to identify effective learning behaviors.
Results
The study revealed no significant correlation between time spent studying and overall academic performance, highlighting the importance of study quality over quantity. Preferences for active learning resources, such as Team-Based Learning, interactive lessons and formative assessments, were positively correlated with better academic performance. A notable correlation was found between students’ valuation of teachers’ professional competence and their total academic scores. Conversely, perceived difficulty across the curriculum and reliance on self-found online resources in renal physiology correlated negatively with academic performance. 'The Renal Pod', a locally produced renal physiology podcast, was popular across grades. Interestingly, students who listened to all episodes once achieved higher exam scores compared to those who listened to only some episodes, reflecting a strategic approach to podcast use. Textbooks, while less popular, did not correlate with higher exam scores. Despite the specific focus of renal physiology, learning preferences are systematically correlated with broader academic outcomes, reflecting the interconnected nature of medical education.
Conclusion
The quality and strategic approach to learning, rather than the quantity of study time, significantly impacts medical students' academic performance. Successful learners in preclinical medical education, particularly in complex subjects such as renal physiology, tend to be proactive, engaged, and strategic, valuing expert instruction and active participation in learning activities. The findings support the integration of student-activating teaching methods and assessments that reward deep learning, with implications extending beyond renal physiology.
RETRACTED: PEMPS: A Phylogenetic Software Tool to Model the Evolution of Metabolic Pathways
Authors: McCloskey Nicholas S. , Mammedova Ayna , Liberles David A.
Published: January 2024

The authors have requested that this preprint be removed from Research Square.
Metal-containing zeolite composites with separated phases as catalysts for hydroisomerization of linear hexane
Authors: Voloshyna Yuliya G. , Pertko Olexandra P. , Yakovenko Angela V. , Povazhnyi Volodymyr A. , Patrylak Lyubov K.
Published: January 2024

In this work, composite catalytic systems of natural mordenite and synthetic MFI-type zeolite containing Pd and Ni nanoparticles (0.5–1.5% by weight in total) were prepared by mechanical mixing (1:1), optionally with the addition of α- or γ-Al2O3 as a binder. The samples were examined using IR spectroscopy, X-ray diffractometry, transmission electron microscopy, low-temperature nitrogen ad(de)sorption, and tested in the model reaction of n-hexane hydroisomerization in a micro-pulse mode to determine the effect of composition on the peculiarities of linear alkane transformation. It has been shown that in the obtained catalytic systems, modifications of aluminum oxide used as a binder affect the effectiveness of catalysts in the conversion of n-hexane. This is explained by the different dispersity of α- and γ-Al2O3 particles, which causes different porosity of the result composites, and possibly by the interaction of zeolite acid sites with binder acid sites, which leads to changes in their characteristics depending on the modification of aluminum oxide. In this respect, α-Al2O3 proved to be better than γ-Al2O3. Synergy between the two zeolite components in the formation of isomers has been found out, which was more effective in samples with an isotropic distribution of zeolite phases. In the applied micro-pulse reaction mode, the composite catalyst prepared without a binder was the best, showing a significantly lower temperature of the maximum yield of isomerization products and a high yield of dimethyl-branched isomers, and having selectivity for n-hexane isomers at the level of high selectivity of the Pd-containing component.
Male Sexual Dysfunction in Patients with Chronic Kidney Disease: A Cross-Sectional Study
Authors: Fu Ruijie , He Peihua , Hong Hongwei , Liang Yichun , Wang Wen , Yuan Shaoying , Liu Lichang
Published: January 2024

(1) Background: Sexual dysfunction is common in male with chronic kidney disease (CKD), but the prevalence and association between CKD and sexual dysfunction, especially PE, remain to be investigated in China;
(2) Objective: To investgate the prevlence and association between CKD and sexual dysfunction in male patients in China.;
(3) Methods: A cross-sectional, non-interventional, observational study was conducted at single center and 72 male patients with CKD were selected. The questionnaire included socio-demographic information, a 5-item version of the International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT) in Chinese version, the Patient Health Quentionnnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7). SPSS software 25.0 was used for data analysis;
(4) Results: 56.9% of 72 CKD patients had erectile dysfunction (ED) and the prevalence of premature ejaculation (PE) was 29.2%. Multiple factors such as vascular lesions and neuropathy of complications, psychological factors, medications were found to be associated with sexual dysfunction in CKD patients;
(5) Conclusion: Sexual function is common among CKD male patients, which can not be divorced from multifactors. Clinicians should pay more attention to sexual dysfunction in male patients with CKD and the pathogenesis should be further studied.
Identification of RAB3IP as a novel oncogene related to ovarian cancer
Authors: Li Xiaohao , He Qian , He Aiqin
Published: January 2024

Obejctive:
The incidence of ovarian cancer ranks third among gynecological malignancies, after cervical cancer and endometrial cancer. However, the mortality rate of ovarian cancer has always been the highest. The pathogenesis of ovarian cancer is not fully understood because the ovary is located deep in the pelvis, the onset of the disease is relatively insidious, and ovarian cancer is usually diagnosed at an advanced stage. The aim of our study was to explore new biomarkers and possible therapeutic targets for ovarian cancer.
Methods
We used public data from the cancer genome atlas TCGA and GTEx to explore the expression level of the RAB3IP gene in ovarian cancer patients.At the same time, we analyzed the correlation between the RAB3IP gene expression and patient survival,and use ROC curve to predict its clinical efficacy.We validated the level of RAB3IP in ovarian cancer tissue using WB and q-PCR. We used cck-8, wound-healing assay and colony formation assay to verify its potential biological function in ovarian cancer.By using molecular docking technology to predict potential drug targets.Pathway enrichment analyses was used to analyze the mechanism of the RAB3IP in the occurrence and development of ovarian cancer.
Results
In this study, we found that the expression of RAB3IP in ovarian cancer is high by bioinformatics and cell biology and verified it with tissue samples. The promotion of RAB3IP on the proliferation and migration of ovarian cancer was confirmed by cck-8, wound-healing assay and colony formation assay, and RAB3IP-related genes were enriched for their possible functions, which were believed to be involved in the immune and microenvironmental regulation of ovarian cancer to some extent.The expression level of RAB3IP is also significantly correlated with the prognosis of ovarian cancer. In addition, we performed drug target prediction of RAB3IP, identifying Austocystin D and Belinostat as potential target drugs that may play a role, and used molecular docking for preliminary validation.
Conclusion
All these results provide preliminary evidence that RAB3IP can be used as a new ovarian cancer biomarker to develop new therapeutic targets.
The Hemoglobin, albumin, lymphocyte, and platelet(HALP) score is associated with severe renal tubular atrophy/interstitial fibrosis in IgA nephropathy
Authors: Liang Xiaoli , Jiang Xue
Published: January 2024

Objective
This study was performed to investigate the relationship between hemoglobin, albumin, lymphocyte and platelet (HALP) score and Oxford classification severe tubular atrophy/interstitial fibrosis (T2) in IgA nephropathy (IgAN).
Methods
The clinical data and pathological findings of patients with IgA nephropathy diagnosed through renal biopsy at Hangzhou Hospital of Traditional Chinese Medicine between June 1, 2019 and May 31, 2022 were retrospectively collected and analyzed. The HALP score was calculated as hemoglobin (g/L)× albumin (g/L)× lymphocytes (/L)/ platelets (/L). According to the quartile of HALP scores in the study population, the subjects were divided into four groups: Quartile 1 (< 30.72), Quartile 2 (30.72-39.97), Quartile 3(39.97-53.25) and Quartile 4(>53.25). According to the extent of tubular atrophy/interstitial fibrosis, patients were categorized into mild to moderate injury (T0+T1, ≤50%) and severe injury (T2, > 50%). The relationship between HALP score and severe tubular atrophy/interstitial fibrosis was investigated using Spearman's rank correlation coefficient, logistic regression analysis, restricted cubic splines (RCS), and receiver operating characteristic (ROC) curve analysis.
Results
A total of 895 patients diagnosed with IgAN were included in this study, with an average age of 40.97±12.261 years. Among them, 384 (42.9%) were male and 61 (6.8%) exhibited severe tubular atrophy/interstitial fibrosis. Multifactorial logistic regression analysis revealed that HALP independently influenced T2 (OR=0.952, 95%CI: 0.923-0.982, P=0.002). Compared to Quartile 1, patients in Quartile 4 exhibited a significantly reduced risk of T2 (OR=0.205, 95%CI: 0.058-0.722, P=0.014). Restricted cubic splines analysis revealed a linear inverse association between HALP and T2 risk (nonlinear P=0.896). Furthermore, the receiver operating characteristic curve demonstrated that HALP possessed predictive value for T2 (AUC=0.693, Jorden index = 0.324), and the cut-off value of HALP score is 36.54.
Conclusion
The risk of severe renal tubular atrophy/interstitial fibrosis is higher in IgAN patients with low HALP. HALP less than 36.54 May reduce the risk of severe tubular atrophy/interstitial fibrosis.