bluuebunny/crossref_metadata_2025 huggingface dataset:
Symptomatic HIV infection and in-hospital outcomes in acute myocardial infarction undergoing percutaneous coronary intervention: an insight of national inpatients sample
Authors: Cui Mingzhi , Qi Haohong , Zhang Ting , Wang Shixiong , Zhang Xiao , Cao Xiangmei , Ma Xueping , Huang Hui , Yan Ru , Jia Shaobin , Cong Guangzhi
Published: August 2023

HIV infection increases the risk of acute myocardial infarction (AMI). However, little is known about its effect on in-hospital outcomes and temporal trends in AMI patients undergoing percutaneous coronary intervention (PCI). We queried AMI patients who underwent PCI from the National Inpatient Sample Database (2003–2015) and stratified into three groups: symptomatic, asymptomatic, and HIV-negative. After 1:2 case-control matching (CCM), logistic regression analysis was conducted to determine how HIV infection affected in-hospital outcomes, and we also evaluatedtheir recent trends from 2003-2015. A total weighted national estimate of 2,191,129 AMI cases included 2,178,995 HIV/AIDS-negative cases, 4,994 asymptomatic HIV cases, and 7,140 symptomatic HIV cases. Symptomatic but not asymptomatic HIV patients endured an over tripled in-hospital mortality (aOR 3.84, 95% CI 2.63-5.62), over two-fold of the acute kidney injury (aOR 1.90, 95% CI 1.42–2.54) and the cardiac shock risk (aOR 1.83, 95% CI 1.24-2.70), a longer length of hospital stay (beta 1.27, 95% CI 1.04-1.51), and had more procedures (beta 1.30, 95% CI 1.16-1.44). These disparities related to symptomatic HIV infection lasted from 2003 to 2015. In AMI patients who underwent PCI procedures, symptomatic HIV infection is associated with higher in-hospital mortality and severe outcomes.
Understanding Long-term Requirements in Pulmonary Rehabilitation for COPD: Insights from Interviews with Respiratory Care Professionals
Authors: Chien Shih-Ying , Wong Alice May-Kuen , Tseng Winston , Hu Han-Chung , Cho Hsiu-Ying
Published: August 2023

Chronic obstructive pulmonary disease (COPD) is characterized by persistent obstruction to airflow through the lungs and long-term respiratory symptoms. Apart from dyspnea, a critical characteristic of patients with COPD is an impaired capacity to exercise, which limits their ability to participate in daily activities and severely impacts their quality of life. To provide a precise and effective exercise prescription, it is necessary to translate exercise science into evidence-based recommendations for pulmonary rehabilitation (PR).
This study aims to enhance our understanding of the continuous requirements for long-term PR in COPD patients. To achieve this, a series of semi-structured investigations will be conducted, focusing on three key aspects: exploring the essential tasks and conditions for implementing PR, identifying the specific requirements for assistive devices, and examining the health management practices for patients after hospital discharge. The interviews were carried out with a convenience sample of 24 respiratory care professionals who possess an average of 17 years of relevant clinical work experience and are actively involved in providing PR services to COPD patients.
Interviews were transcribed verbatim, and analysis was undertaken to identify the following themes: (1) Necessary Conditions for Clinical Pulmonary Rehabilitation ; (2) The Need for Assistive Devices in Pulmonary Rehabilitation ; and (3) Post-Discharge Care for Patients with Chronic Lung Disease.
Our findings indicate that the implementation of exercise training to enhance the exercise capacity of COPD patients is a complex process. Barriers associated with respiratory care professionals (RCPs) contribute to the challenges in effectively implementing exercise training programs. These barriers emphasize the importance of precise measurement and monitoring of physiological parameters. Furthermore, it is crucial to consider individual differences, limitations in workplaces and medical resources, and the effective utilization of technology for continuous monitoring of patient recovery.
Heading towards carbon neutrality: How marine carbon sinks become an important handle for promoting marine ecological civilization construction?Literature review and research prospect based on the CiteSpace
Authors: Chen Xiaolong , Di Qianbin , Liang Chenlu
Published: August 2023

As an efficient long-term carbon sink, the mechanism of marine carbon sink, carbon sink effect, carbon sink technology, carbon sink accounting and carbon sink trading market construction are becoming new topics that need to be explored in various disciplines. Based on the research literature related to marine blue carbon sink in the core databases of China National Knowledge Internet (CNKI) and Web of Science (WOS), we use bibliometric tools to quantitatively compare and analyze the main characteristics of domestic and foreign marine blue carbon sink research such as publication volume, time, journals, authors and institutions; explore the research hotspots, stage frontier areas and theme evolution trends through keyword clustering, emergent and co-occurring knowledge maps. Finally, the key research directions of marine carbon sinks are prospected, we should take multidisciplinary interdisciplinary research as the leader to promote the unified carbon sink market research of land and sea integration; take comprehensive ecological compensation mechanism of marine carbon sink protection, marine carbon sink related theory and technological innovation research as the guide to continue to explore the application mode of marine carbon sinks In order to explore the blue carbon cooperation mechanism of the countries along the Maritime Silk Road. In order to sort out the current situation of marine carbon sink research at home and abroad, promote the research in this field to a deeper level of scientific and rational development, and provide reference and reference for subsequent scholars to carry out related research.
An Explainable Artificial Intelligence Model to Predict Malignant Cerebral Edema after Acute Anterior Circulating Large Hemisphere Infarction
Authors: Cao Liping , Ma Xiaoming , Xu Geman , Wang Yumei , Huang Wendie , Liu Meng , Sheng Shiying , Yuan Jie , Wang Jing
Published: August 2023

Background: Malignant cerebral edema (MCE) is a serious complication and the main cause of poor prognosis in large hemisphere infarction (LHI). Therefore, rapid and accurate identification of potential patients with MCE is essential for providing timely therapy. However, most prediction models lack interpretability, limiting their use in clinical practice.To establish an interpretable model to predict MCE in patients with LHI. We utilize the SHapley Additive exPlanations (SHAP) method to explain the eXtreme Gradient Boosting (XGBoost) model and identify prognostic factors, providing valuable data for clinical decision-making.
Methods: In this retrospective cohort study, we included 314 consecutive patients with LHI admitted to the Third Affiliated Hospital of Soochow University from December 2018 to April 2023. The patients were divided into MCE and non-MCE groups, and we developed an explainable artificial intelligence prediction model. The dataset was randomly divided into two parts: 75% of the data were used for model training and 25% were used for model validation. Confusion matrix was utilized to measure the prediction performance of the XGBoost model. The SHAP method was used to explain the XGBoost model. Decision curve analysis was performed to evaluate the net benefit of the model.
Results: A 38.5% (121/314) incidence of MCE was observed among the 314 patients with LHI. The XGBoost model showed excellent predictive performance, with an area under the curve of 0.916 in validation. The SHAP method revealed the top 10 predictive variables of MCE based on their importance ranking, while the Alberta Stroke Program Early CT Score (ASPECTS) score was considered the most important predictive variable, followed by National Institutes of Health Stroke Scale (NIHSS) score, Collateral Status (CS) score, APACHE II score, glycated hemoglobin (HbA1c), atrial fibrillation (AF), neutrophil-to-lymphocyte ratio (NLR), platelet (PLT) count, Glasgow Coma Scale (GCS) and Age. We found that ASPECTS score < 6, NIHSS score >17, CS score < 2, APACHE II >14, HbA1c >6.3 and AF were associated with increased risks of malignant cerebral edema.
Conclusion: An interpretable predictive model can increase transparency and help doctors to accurately predict the occurrence of MCE in patients with LHI, providing patients with better treatment strategies and enabling optimal resource allocation.
Study on the effects of several amendments on the antioxidant defense system of Chinese cabbage in heavy metal contaminated soil
Authors: Zhao Changchun , Zhao Shuai , long li , Feng shiqing , Zhang lili , Liu Ke
Published: August 2023

In this paper, the effects of applying straw biochar, attapulgite, phosphate rock powder, diatomite, humic acid and other passivation materials on the physical and chemical properties of heavy metal contaminated soil and the antioxidant enzyme activity of Chinese cabbage were studied.The results showed:Soil pH increased by 0.26–1.15 units, and organic matter (OM) content increased by 1.23% -48.77%. The application of passivation agent effectively reduced the available content of heavy metals in soil, and the activities of catalase, acid phosphatase, urease and sucrase in soil were improved to varying degrees, especially in T4(biochar1.5% + humic acid1.5%) treatment; Compared with CK, the contents of heavy metals in the aboveground and underground parts of Chinese cabbage were significantly decreased ( p < 0.05 ), while the transport coefficients of Chinese cabbage under each treatment were different. Under different treatments, the activities of catalase(CAT), superoxide dismutase(SOD) and peroxidase ( POD ) in the leaves of Chinese cabbage were significantly increased, the contents of malondialdehyde ( MDA ) and non-protein thiol(NPT) were significantly lower than those in the control, and the activity of glutathione reductase(GR) was significantly decreased, especially in T4 ( biochar1.5% + humic acid1.5% ) treatment; Under each treatment, soil pH and OM were significantly negatively correlated with soil heavy metal content ( p < 0.05 ), positively correlated with soil enzyme activity, significantly positively correlated with CAT, SOD and POD of Chinese cabbage ( p < 0.05 ), and negatively correlated with MDA, GR and NPT content of Chinese cabbage.In summary, the combination of several passivation agents can effectively improve soil heavy metal pollution and reduce the effective state of soil heavy metals, thereby reducing the toxicity of heavy metals to Chinese cabbage.
pH and redox dual response nano suppository for the treatment of ulcerative colitis
Authors: Wu Yijun , Song Jinfeng , Wang Xiaochen , Li Longxia , Chang Jie , Ma yunfeng
Published: August 2023

In order to improve treatment compliance and provide sustained and slow drug release in the colon, we developed a hollow mesoporous silica nano-suppository based on pH and redox dual response. Hollow mesoporous silica nanoparticles containing disulfide bonds (HMSN-SS) were prepared and 5-ASA was loaded into the pores of HMSN-SS. Then, polydopamine (PDA) and chitosan (CS) were modified on the surface of HMSN-SS, and the suppository was prepared by mould, named 5-ASA@HMSN-SS-PDA-CS (5-ASA@HSPC). 5-ASA@HSPC acts directly on the lesion by rectal administration, CS helped the nanoparticles adhere to the surface of the colon, PDA dissociated from the surface of HMSN-SS by protonation in the acidic environment of the ulcerative colon, S-S was destroyed by the reducing environment of the colon, resulting in a stable and slow release of encapsulated 5-ASA from the pores of HMSN. In vitro release experiments and in vivo pharmacokinetic and pharmacodynamic experiments have shown that 5-ASA@HSPC is able to act slowly and steadily at the colonic site, while having an excellent safety profile, showing great potential in the treatment of ulcerative colitis.
Comparison of two different frailty metrics and associations with COVID-19: A bidirectional Mendelian randomization study
Authors: Han Lijian , chen Fei , Liu Jianping , Ma Tengfei , Shi Haicun , Xu Yun
Published: August 2023

Background Several traditional observational studies suggested a strong association between frailty with coronavirus disease 2019 (COVID-19). However, whether the observed association reflects causality remained unclear. We employed a bidirectional Mendelian randomization (MR) study to investigate the causal relationship of frailty, measured by the Frailty Index and Fried Frailty Score, with COVID-19. Methods We extracted summary genome-wide association statistics for the Frailty Index (N = 164,610), Fried Frailty Score (N = 386,565), COVID-19 (Ncase = 159,840, Ncontrol = 2,782,977), hospitalized COVID-19 (Ncase = 44,986, Ncontrol = 2,356,386) and severe COVID-19 (Ncase = 18,152, Ncontrol = 1,145,546). Independent single nucleotide polymorphisms at genome-wide significance for each phenotype were taken as instruments. The random-effects inverse‐variance weighted method was applied as the primary method, followed by various sensitivity and validation analyses. Results No causal effect of Frailty Index between COVID-19 was observed. Genetically predicted Fried Frailty Score was significantly associated with increased risk of COVID-19 hospitalization (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.45–2.91, P < 0.0001), and suggestively associated with higher risk of COVID-19 susceptibility (OR = 1.19, 95% CI 1.01–1.39; P = 0.035) and COVID-19 severity (OR = 2.10, 95% CI 1.10–4.01; P = 0.025). Sensitivity and validation analyses also received broadly concordant results. There is no insignificant association for reverse causation. Conclusion Our study demonstrated that Fried Frailty Score could increase the risk of COVID-19. Future development should focus on long-term mutual influence between frailty and COVID-19 to alleviate the complications of diseases.
Spatial arrangement of the environmental suitability for the maned wolf in a central province of Argentina
Authors: Ulibarrie Andrés , Orozco Marcela , Pautasso Andrés , Cristaldi Maximiliano Ariel
Published: August 2023

Climate and environmental features play a crucial role in shaping species' spatial distribution patterns, making this knowledge essential for defining conservation strategies, particularly those involving rescues and relocation of individuals. The maned wolf (Chrysocyon brachyurus), the largest canid in South America, it is currently categorized as “Vulnerable” in Argentina. Our aim was to determine the spatial arrangement of the environmental suitability for the maned wolf in the province of Santa Fe, Argentina. Our database consisted of species occurrence recorded from 1996 to 2019. We employed Maxent to identify association patterns between the spatial distribution of maned wolf’s occurrences in Santa Fe and climate variables (temperature and precipitation), landscape features and anthropic variables. The results revealed a positive relationship between environmental suitability and temperature, as well as precipitation during the wettest month. Areas with low or medium proportions of grassland, forests, temporarily flooded soils and proximity to permanent water bodies displayed higher environmental suitability scores. In contrast, areas characterized by crops exhibited lower environmental suitability scores compared to those where other environmental features prevailed predominated. The anthropic variables also had an association with environmental suitability for the species. This study highlights the importance of climate and habitat heterogeneity to characterize the environmental suitability, for the maned wolf in the Santa Fe province and its conservation implications.
Driving impact and spatial effect of the digital economy development on carbon emissions in typical cities: A case study of Zhejiang, China
Authors: Jiang Bin , Ding Lei , Fang Xuejuan , Zhang Qiong , Hua Yidi
Published: August 2023

The digital economy (DE) not only drives economic innovation and development but also has significant environmental effects by promoting lower carbon emissions. To investigate the spatial effects of DE on urban carbon emissions, this study comprehensively measures the level of DE development based on panel data from 11 typical cities in Zhejiang Province from 2011 to 2020, by comparing analysis using different regression models. The following conclusions are obtained: (1) The total carbon emissions (TC) of Zhejiang cities in general show a fluctuating change trend of first increasing and then slowly decreasing, while carbon emissions intensity and carbon emissions per capitain general show a fluctuating change trend of decreasing. Cities with high TC are primarily concentrated in the Hangzhou Bay city cluster, including Ningbo, Hangzhou and Jiaxing. The development of the DE in Zhejiang cities shows steady growth, but there are large differences among cities, with Hangzhou and Ningbo standing out as particularly prominent. (2) There is a significant inverted U-shaped relationship between the DE and the level of carbon emissions in Zhejiang Province. Thus, the DE increases carbon emissions in the early stages of development and has a dampening effect on carbon emissions in the mature stages of development. (3) Compared to the direct effect, the spatial spillover effect of the DE on carbon emissions is not significant. However, the allocation of transport resourcesshows a positive spatial spillover effect (increasing carbon emissions), technological progress shows a somewhat negative spatial spillover effect (decreasing carbon emissions). (4) Smart city pilot policy significantly reduces urban carbon emissions, and the effect of the DE on carbon emissions is found to pass the significance test the quadratic term when replacing the geographical and economic distance weight matrices, indicating that the empirical findings are robust to these tests. Finally, several carbon emission reduction countermeasures are proposed from the perspective of DE development.
Molecular characterization of a novel beny-like virus isolated from binucleate Rhizoctonia AG-A strain A46
Authors: Shi Rui , Chen Zebin , Mo Xiaohan , Chen Wurong , Yu Shuhui , Liu He , Li Yuchuan , Dai Lili , Li Yanqiong
Published: August 2023

In this study, the complete genome of a positive sense single-stranded RNA (ssRNA) virus designated binucleate Rhizoctonia beny-like virus 1 (BRBLV1) was determined. This virus was isolated from binucleate Rhizoctonia AG-A strain A46, and was found to exhibit genomic organization similar to that of Rhizoctonia solani beny-like virus 1 (RsBLV1). The 10,280 nt genome of BRBLV1 was found to contain a poly(A) tail and one open reading frame (ORF) encoding a polypeptide 376.30 kDa in size that includes N-terminal helicase, C-terminal helicase, and RNA-dependent RNA polymerase (RdRp) domains. This ORF exhibited the greatest sequence identity to RsBLV1 (44.61%), with a sequence coverage of 59%. Phylogenetic analyses additionally confirmed that BRBLV1 and RsBLV1 clustered together in a clade that was separate from clades containing benyviruses, alphaendornaviruses, and other beny-like viruses. The length of the BRBLV1 and RsBLV1 genomes was also greater than that for any other known beny-like viruses characterized to date. This suggests that BRBLV1 represents a novel mycovirus, and that BRBLV1 and RsBLV1 should be classified in a new mycoviral taxon closely related to the Benyviridae family.
Distinct pulmonary and systemic effects of dexamethasone in severe COVID-19
Authors: Fragiadakis Gabriela , Neyton Lucile , Patel Ravi , Sarma Aartik , Consortium UCSF COMET , Willmore Andrew , Haller Sidney Carrillo , Kangelaris Kristen , Eckalbar Walter , Erle David , Krummel Matthew , Hendrickson Carolyn , Woodruff Prescott , Langelier Charles , Calfee Carolyn
Published: August 2023

Dexamethasone is the standard of care for critically ill patients with COVID-19, but the mechanisms by which it decreases mortality and its immunological effects in this setting are not understood. We performed bulk and single-cell RNA sequencing of the lower respiratory tract and blood, and plasma cytokine profiling to study the effect of dexamethasone on systemic and pulmonary immune cells. We find decreased signatures of antigen presentation, T cell recruitment, and viral injury in patients treated with dexamethasone. We identify compartment- and cell- specific differences in the effect of dexamethasone in patients with severe COVID-19 that are reproducible in publicly available datasets. Our results highlight the importance of studying compartmentalized inflammation in critically ill patients.
Research on measurement and efficiency evaluation of high-quality economic development in Beijing
Authors: Yin Jieting , Yuan Junfeng
Published: August 2023

This paper constructs the evaluation index system of Beijing's high-quality economic development from six dimensions and using entropy weight TOPSIS and data envelopment analysis model with unexpected output to estimates the high-quality economic development level and static efficiency of Beijing from 2000 to 2019. The main conclusions are as follows. From the perspective of comprehensive measurement level, the high-quality economic development level is constantly improving, but there is still a certain gap from the optimal value. From the measurement level of the secondary index system, the coordinated development level remains at 0.17, the open development level shows a slight decline, while the economic development level, innovation development level, green development level and sharing development level have an obvious upward trend. From the static efficiency of high-quality development, the overall efficiency of 2000-2019 will increase later, and the scale efficiency has little difference, which is basically close to the scale efficiency.
Adult vasovagal syncope with abdominal pain during presyncope diagnosed by head-up tilt combined with transcranial doppler: a preliminary study
Authors: Wang Jingyi , Li Hua , Huang Xuming , Hu Huoyou , Lian Baorong , Zhang Daxue , Wu Jiarui , Cao Liming
Published: August 2023

Background
Syncope is a common condition that increases the risk of injury and reduces the quality of life; atypical syncope is prone to misdiagnosis. Abdominal pain as a precursor to vasovagal syncope (VVS) in adults is rarely reported and unfamiliar to clinicians. ​
Methods
We present three adult patients with VVS and presyncopal abdominal pain diagnosed by synchronous multimodal detection (transcranial doppler (TCD) with head-up tilt (HUT)) and discuss the relevant literature.
Results
Case 1: A 52-year-old man presented with recurrent decreased consciousness preceded by six months of abdominal pain. Physical examinations were unremarkable. Dynamic electrocardiography, echocardiography, head and neck computed tomography angiography, magnetic resonance imaging (MRI), and video electroencephalogram showed no abnormalities.
Case 2: A 57-year-old woman presented with recurrent syncope for 30+ years, accompanied by abdominal pain. Physical examination, electroencephalography, and MRI showed no abnormalities. Echocardiography showed large right-to-left shunts.
Case 3: A 30-year-old woman presented with recurrent syncope for 10+ years, with
abdominal pain as a precursor. Physical examination, laboratory analysis, head computed tomography, electrocardiography, and echocardiography showed no abnormalities. Syncope secondary to abdominal pain was reproduced during HUT. Further, HUTrevealed vasovagal syncope, and synchronous TCD showed decreased cerebral blood flow; the final diagnosis was VVS in all cases.
Conclusions
Abdominal pain may be a precursor of VVS in adults, and our findings enrich the clinical phenotypic spectrum of VVS. Prompt recognition of syncopal precursors is important to prevent incidents and assist in treatment decision-making. Abdominal pain in VVS may be a sign of sympathetic overdrive. Synchronous multimodal detection can help in diagnosing VVS and understanding hemodynamic mechanisms.
Impact of the Gulf Stream front on atmospheric rivers and Rossby wave train in the North Atlantic
Authors: Ma Xiaohui , Jia Yinglai , Han Ziqing
Published: August 2023

The Gulf Stream (GS) ocean front exhibits intense ocean-atmosphere interaction in winter, which has a significant impact on the genesis and development of extratropical cyclones in the North Atlantic. The atmospheric rivers (ARs), closely related with the cyclones, transport substantial moisture from the North Atlantic towards the Western European coast. While the influence of the GS front on extratropical cyclones has been extensively studied, its effect on ARs remains unclear. In this study, two sets of ensemble experiments are conducted using a high-resolution global Community Atmosphere Model forced with or without the GS sea surface temperature (SST) front. Our findings reveal that the inclusion of the strong GS front leads to approximately 25% enhancement of water vapor transport and precipitation associated with ARs in the GS region and a more pronounced downstream response in Western Europe, characterized by up to 60% (40%) precipitation increases (reductions) around Spain (Norway).
The influence of the GS front on ARs is mediated by both thermodynamic and dynamic factors. The thermodynamic aspect involves an overall increase of water vapor in both the GS region and Western Europe, promoting AR genesis. The dynamic aspect encompasses changes in storm tracks and Rossby wave train, contributing to downstream AR shift. Importantly, we find the co-occurrence of ARs and the GS front is crucial for inducing deep ascending motion and heating above the GS front, which perturbs the deep troposphere and triggers upper-level Rossby wave response. These findings provide a further understanding of the complex interaction between the oceanic front in the western boundary current regions and extratropical weather systems and the associated dynamics behind them.
Three-dimensional single-particle tracking by interferometric scattering microscopy with a double-helix point spread function
Authors: Zhang Douguo , Huang Mingchuan , chen Qiankun , Liu Yang , Zhang Chi , Zhang Rongjing , Yuan Junhua
Published: August 2023

Single-particle tracking (SPT) is an immensely valuable technique to study a variety of processes in the life sciences and condensed matter physics. Interferometric scattering (iSCAT) microscopy is a sensitive SPT technique that can track individual unlabeled particles with high spatial and temporal resolution. A difficulty in iSCAT is the low imaging contrast of its original image, and complicated imaging postprocessing method is necessary for deriving axial-location of the particle. Here, a planar photonic chip enhanced spin-to-orbital angular momentum conversion was introduced to the iSCAT microscopy, resulting in an axial-localization dependent double-helix point-spread-function (PSF) and high imaging contrast. This provides a new mechanism for 3D SPT over an extended axial-range in a label-free manner without use of complicated image postprocessing and optical components. The iSCAT microscopy was used to record the 3D trajectory of microbead labeled to the flagellum, facilitating precise analysis of the fluctuation in the motor dynamics. The enhanced iSCAT technique holds great promise for future applications in biological science.
Brain metabolism response to intrahospital transfers in neurocritical ill patients: Does the microdialysis probe location matter?
Authors: Pedrosa Leire , Hoyos John , Reyes Luis , Mosteiro Alejandra , Zattera Luigi , Topczewski Thomaz , Rodríguez-Hernández Ana , Amaro Sergio , Torné Ramon , Enseñat Joaquim
Published: August 2023

Intrahospital transfer (IHT), a routine in the management of neurocritical patients requiring imaging or interventions, might affect brain metabolism. Studies about IHT effects using microdialysis (MD) have produced conflicting results. In these studies, only the most damaged hemisphere was monitored, and those may not reflect the impact of IHT on overall brain metabolism, nor do they address differences between the hemispheres. Herein we aimed to quantify the effect of IHT on brain metabolism by monitoring both hemispheres with bilateral MD. In this study, 31 patients were included, with a total of 73 IHT. Glucose, glycerol, pyruvate and lactate were measured by MD in both hemispheres for 10 hours pre- and post-IHT. Alterations in metabolite levels after IHT were observed on both hemispheres; although these changes were more marked in hemisphere A (most damaged) than B (less damaged). Changes in metabolite levels in hemisphere B were more evident in cerebrovascular than in traumatic brain injury patients. Our results suggest that, brain metabolism is altered after an IHT of neurocritical ill patients, particularly but not limited to the damaged hemisphere. Bilateral monitorization may be more sensitive than unilateral monitorization for detecting metabolic disturbances not directly related to the course of the disease.
Increased pregnancy rates for recurrent implantation failure cases with embryos developed on autologous endometrial co-culture obtained in mono layer and determination of target patient group
Authors: Sertyel Nazike Semra Sümer , Çolakoğlu Mehmet Cengiz , Horasanlı Jule Eriç , İrez Tülay , Gümüş Meryem
Published: August 2023

Background: Although tremendous improvements have been implemented inconventional embryo culture systems, embryo side-products are still a major concern during extended culture. Although the cause of repeated implantation failure (RIF) seems to be multifactorial, several studies have indicated a possible beneficial role of endometrial co-culture systems on RIF cases via improving embryo quality and viability. This study is undertaken to analyze the cumulative contribution of endometrial co-culture (EC) in such cases compare with conventional culture results and to determine the most effective features to work.
Methods: Overall, 678 cycles in which co-culture with the indication of recurrent implantation failure (n≥3) have been performed were included in the study. Patients were retrospectively grouped according to culture media systems used. In 329 patients (group I) endometrial co-culture has been of choice throughout the culture period and in 349 cycles conventional culture media has been utilized. From pre-zygote stage to embryo transfer, daily embryo growth parameters were scored and clinical pregnancy rates compared between groups according to female age, the number of previous attempts and number of mature oocytes obtained.
Results: No statistically significant difference in main patient and cycle parameters such as female age, male age, BMI, gonadotropin ampoules used, MII oocytes collected and fertilized were found between groups. However, when embryo development characteristics were compared, PN (Pronucleus) arrest, cleavage arrest and 3rd day blastomere number and embryo fragmentation rates.
Conclusios: Our results show that culturing embryos on endometrial monolayer cells seems to increase the cleavage rate and the quality of embryos in recurrent implantation failure cases. Furthermore, by comparing all of the results the main target group of this co-culture patients defined (older than 38 age and higher than 2 items) is very important for identified in order to assure the usefulness of co-culture.
Clove oil down regulates the expression of genes encoding the efflux pump, virulence factors and quorum sensing in MDR Pseudomonas aeruginosa
Authors: El-Banna Tarek , Sonbol Fatma , Sallam Norhan , Al-Madboly Lamiaa
Published: August 2023

Background
The emergence of multi-drug resistant Pseudomonas aeruginosa and development of new resistant phenotypes are considered major public health issues. The present work aims to evaluate clove oil effect as anti-bacterial, anti-virulence, efflux pump and quorum sensing inhibitor.
Results
Susceptibility of P. aeruginosa to antimicrobials and clove oil either alone or combined with fluoroquinolones was tested using agar dilution method. Results revealed that 1/2 MIC of clove oil combined with fluoroquinolones showed synergism in 90% isolates. Effect of sub-MICs of clove oil on biofilm formation and some virulence factors was investigated. A significant reduction in virulence attributes as well as in the expression of efflux pump encoding genes (mexA and mexB) and quorum sensing regulatory genes (lasI, lasR, pqsA, pqsR) was recorded with 1/2 MIC of clove oil. An animal model for wound infection was used to assess the therapeutic effect of clove oil, in vivo. Clove oil reduced the bacterial burden in infected wounds by 92% and caused a decline in cell infiltration in excisional wound skin tissue.
Conclusions
Synergistic combinations between fluoroquinolones and sub-MICs of clove oil can be used to modify the antimicrobial resistance level. Clove oil (1/2 MIC) was reported to significantly decrease the expression of efflux and quorum sensing genes followed by reduction in expression of virulence machinery in P. aeruginosa. Clove oil may be used as an antimicrobial adjuvant in treatment protocols of P. aeruginosa infections by lowering the effective doses of the current antimicrobials.
A Nomogram for Diagnosis of BI-RADS 4 Breast Nodules Based on Three-dimensional Volume Ultrasound
Authors: Jiang Xianping , Chen Chen , Yao Jincao , Wang Liping , Yang Chen , Li Wei , Ou Di , Jin Zhiyan , Liu Yuanzhen , Peng Chanjuan , Wang Yifan , Xu Dong
Published: August 2023

Objective
To investigate whether the use of a nomogram prediction model with automated breast ultrasound (ABUS) can help improve accuracy in the differentiation of benign and malignant Breast Imaging Reporting and Data System (BI-RADS) 4 breast nodules.
Methods
Data were collected for a total of 257 nodules with breast nodules corresponding to BI-RADS 4 who underwent ABUS examination and for whom pathology results were obtained from January 2019 to August 2022. The patients were divided into a benign group (188 cases) and a malignant group (69 cases) using a retrospective study method. Ultrasound imaging features were recorded. Logistic regression analysis was used to screen the clinical and ultrasound characteristics. Using the results of these analyses, a nomogram prediction model was established accordingly.
Results
Age, distance between nodule and nipple, calcification and C-plane convergence sign were independent risk factors that enabled differentiation between benign and malignant breast nodules (all P < 0.05). A nomogram model was established based on these variables. The AUC values for the nomogram model, age, distance between nodule and nipple, calcification, and C-plane convergence sign were 0.86, 0.735, 0.645, 0.697, and 0.685, respectively. Thus, the AUC value for the model was significantly higher than a single variable.
Conclusions
A nomogram based on the clinical and ultrasound imaging features of ABUS can be used to improve the accuracy of the diagnosis of benign and malignant BI-RADS 4 nodules. It can function as a relatively accurate predictive tool for sonographers and clinicians and is therefore clinically useful.
Advances in knowledge statement:
we retrospectively analyzed the clinical and ultrasound characteristics of ABUS BI-RADS 4 nodules and established a nomogram model to improve the efficiency of the majority of ABUS readers in the diagnosis of BI-RADS 4 nodules.
Maximally informative feature selection using Information Imbalance: Application to COVID-19 severity prediction
Authors: Wild Romina , Sozio Emanuela , Margiotta Riccardo Giuseppe , Dellai Fabiana , Acquasanta Angela , Ben Fabio Del , Tascini Carlo , Curcio Francesco , Laio Alessandro
Published: August 2023

Clinical databases typically include, for each patient, many heterogeneous features, for example blood exams, the clinical history before the onset of the disease, the evolution of the symptoms, the results of imaging exams, and many others. We here propose to exploit a recently developed statistical approach, the Information Imbalance, to compare different subsets of patient features and automatically select the set of features which is maximally informative for a given clinical purpose, especially in minority classes. We adapt the Information Imbalance approach to work in a clinical framework, where patient features are often categorical, and are generally available only for a fraction of the patients. We apply this algorithm to a data set of ~ 1,300 patients treated for COVID-19 in Udine hospital before October 2021. Using this approach, we find combinations of features which, if used in combination, are maximally informative of the clinical fate and of the severity of the disease. The optimal number of features, which is determined automatically, turns out to be between 10 and 15. These features can be measured at admission. The approach can be used also if the features are available only for a fraction of the patients, does not require imputation and, importantly, is able to automatically select features with small inter-feature correlation. Clinical insights deriving from this study are also discussed.
Prediction error in implicit adaptation during visually- and memory-guided reaching tasks
Authors: Numasawa Kosuke , Miyamoto Takeshi , Kizuka Tomohiro , Ono Seiji
Published: August 2023

Human movements are acquired by motor adaptation in order to maintain their accuracy. There are two systems in motor adaptation, referred to as explicit or implicit adaptation. It has been suggested that the implicit adaptation is based on the prediction error and has been used in a number of motor adaptation studies. This study aimed to examine the effect of visual memory on prediction error in implicit visuomotor adaptation by comparing visually- and memory-guided reaching tasks. The visually-guided task is thought to be implicit learning based on prediction error, whereas the memory-guided task requires more cognitive processes. We observed the adaptation to visuomotor rotation feedback that is gradually rotated. We found that the adaptation and retention rates were higher in the visually-guided task than in the memory-guided task. Furthermore, the delta-band power obtained by electroencephalography (EEG) in the visually-guided task was increased immediately following the visual feedback. Our results suggest that the prediction error is larger in the visually-guided task, which contributes to updating the internal model to enhance the implicit visuomotor adaptation effectively. In contrast, the prediction error could be attenuated in the memory-guided task due to voluntary and cognitive processes.
Evolutionary diversification and succession of soil huge phages in glacier foreland
Authors: Liao Hu , Li Jian , Wang Yan-Zi , Li Hu , An Xin-Li , Wang Tao , chang ruiying , Zhu Yong-Guan , Su Jian-Qiang
Published: August 2023

Huge phages (genome length > 200 kbp) have been found in diverse habitats worldwide, infecting a variety of prokaryotes. Yet, our understanding of their evolution and adaptation strategy in soil is limited due to the scarcity of soil-derived genomes. Here we carried out a size-fractioned (0.22µm) metagenomic survey across a 130-year chronosequence of a glacier foreland in the Tibetan plateau and discovered 597 novel huge phage populations. Their communities in glacier foreland revealed a distinct pattern between the early (≤ 40 years) and late stages (> 40 years). A significant increasing in the diversity and abundance of huge phages in the late stage following glacier retreat were illuminated, which coincided with soil development and vegetation formation. The phages within the late-stage demonstrated remarkable higher microdiversity, gene flow frequency, and stronger phylogenomic clustering, suggesting that natural selection and genetic drift are key drivers of the huge phage speciation. Alongside the shift in huge phage communities, we noted a functional transition between the early and late stages, contributing to the survival and growth of their hosts. This study unravels the hidden diversity of huge phages in soil and highlights the importance of environmental changes in shaping the composition, evolutionary trajectories and function of huge phage communities.
Why do newborns die? Perspectives of community members and Health care providers in the Lawra Municipality in Upper West Region, Ghana
Authors: Bagrmwin Lawrence , Ziem Bernard , Kobekyaa Francis , Azie Reuben , Dun-Dery Frederick , Ajanaba Asakeboba Philomena , Nukpezah Ruth Nimota
Published: August 2023

BACKGROUND
Neonatal deaths contribute significantly to under-five deaths and are a crucial indicator of a country's socioeconomic development, quality of life, and health status. Neonatal deaths occur both at home and in health facilities. Hence community members' and health workers' perspectives collectively define neonatal survival.
AIM
This study explored the perceived causes of neonatal deaths among health service providers and community members.
METHODS
This study employed a qualitative descriptive design with a purposive sampling method of 30 participants (18 community members and 12 healthcare providers). Data were collected using Focus Group Discussion (FGD), transcribed verbatim, coded and analysed using the content analysis technique.
RESULTS
Three categories emerged to describe the factors perceived to cause newborn deaths at health facilities and in the community. These categories were: (1) human factors (newborns, their mothers/families and health staff); (2) place factors (logistics, equipment and their interaction with newborns); and (3) time factors (delays, transport and referral).
CONCLUSIONS
The study identified differences in perspectives between health workers and community members. These differences can affect interventions in neonatal care. Health authorities are encouraged to engage their communities with geographic-specific factors causing neonatal deaths to identify and understand the influencing factors and take everyday actions towards reducing neonatal deaths.
Long-term Treatment of congenital glaucoma and Turner syndrome associated with DMPK gene mutation
Authors: Guo Anqi , Zhang Weijia , Hong Ying
Published: August 2023

Background: Turner syndrome (TS) is a rare disorder associated with complete or partial deletion of the X chromosome, with clinical manifestations including short stature, hypogonadism, cardiovascular system abnormalities, autoimmune disease, and other systemic abnormalities. TS patients with congenital glaucoma are rare.
Case presentation: A 27-year-old female with the karyotype of (45,X) and the DMPK gene Kc.335T>C(p.M112T) on chromosome 19 was diagnosed with congenital glaucoma and TS, presenting with right eye atrophy, cataract, blue sclera, ptosis, amblyopia, and blue-violet blindness in the left eye. Systematic examination revealed the absence of menstruation, congenital uterine agenesis, hypertension, aortic valve malformation, mild aortic regurgitation, diabetes mellitus, abnormal thyroid function, frequent diarrhea, uneven density of the right posterior patella, left pleural adhesions, left renal atrophy, and congenital webbed neck. Multiple anti-glaucoma surgeries were performed, and the intraocular pressure (IOP) was under control in the left eye.
Conclusion: The case exhibited a rare coexistence of primary congenital glaucoma, Turner syndrome, and a DMPK gene mutation. Long-term treatment can keep IOP stable. The difficulty of congenital glaucoma treatment may be related to a specific type of genetic mutation.
The Practice and Determinants of Ambulance Service Utilization in Pre-Hospital Settings, Jimma City, Ethiopia
Authors: Adem Mohammed Ahmed , Tezera Zewdu Baye , Agegnehu Chilot Desta
Published: August 2023

Introduction:
Pre-hospital treatments and means of transport to arrive at appropriate health centers are as vital as in-hospital care, especially, in developing countries that severely suffer from mortality burden arising from emergency conditions. Yet, being a recent phenomenon in Ethiopia, empirical studies are inadequate with regard the practice and determinants of ambulance service utilization in pre-hospital settings. Hence, this study aimed to assess the ambulance service utilization and its determinants among patients admitted to the emergency departments within the context of pre-hospital care system in public hospitals of Jimma City.
Method
An institutional-based cross-sectional study design was conducted in two public hospitals in Jimma city, from June to July 2022. A systematic sampling technique was used to select 468 sample size. Interviewer-administered questionnaire was used to collect data. Data analysis was done using SPSS version 26.0; descriptive and logistic regressions were done, where statistical significance was determined at p < 0.05.
Results
Ambulance service was rendered to bring about 39.5% (of total sample, 451) patients to hospitals. The distribution of service by severity of illnesses was 48.7% among high, and 39.4% among moderately acute cases. The main determinants of ambulance service utilization were: service time (with AOR, 0.35, 95%CI, 0.2–0.6 for those admitted to ED in the morning, and AOR, 2.36, 95%CI, 1.3–4.4 for those at night); referral source (with AOR, 0.2, 95%CI, 0.1–0.4 among the self-referrals); mental status (with AOR, 1.9, 95%CI, 1-3.5 where change in the level of consciousness is observed); first responder (AOR, 6.3 95%CI, 1.5–26 where first responders were the police, and AOR, 3.4, 95%C1, 1.7–6.6 in case of bystanders); distance to hospital (AOR,0.37, 95%CI, 0.2–0.7 among the patients within ≤ 15km radius); and prior experience in ambulance use (AOR, 4.1,95%CI, 2.4-7).
Conclusion
Although the utilization of ambulance in pre-hospital settings was, generally, good in Jimma City; lower levels of service use among patients in more acute health conditions is problematic. Community-based emergency care should be enhanced to improve the knowledge and use of ambulance services.
Effect of spatial moving structure and topology optimization of the CNC turning machine Tools
Authors: Chan Tzu-Chi , Reddy Sabbella Veera Venkata Satyanarayana , Ullah Aman , roy Bedanta
Published: August 2023

In order to enhance the accuracy and productivity of CNC machine tools, Finite Element Method (FEM) is utilized for analyzing machining operations and machine tool structures. Through this approach, it becomes possible to assess and reduce machining errors, thereby improving the precision of machined parts. Additionally, by subjecting machine tool components to analysis of stress and deformations under real operating conditions, the overall performance and lifespan of the machine tool structures can be augmented. This study provides a comprehensive review of recent published papers focusing on the implementation of finite element methods for the analysis and optimization of CNC machine tool operations and structures. In this study, a virtual model of the Goodway CNC turning machine was used to study the machine's behavior. The first three vibrational modes analyzed through a modal analysis were 108.2Hz, 133.4Hz, and 191.7Hz, which were experimentally validated using modal tests. The design precision was supported using the harmonic response. For an applied external load of 500N on the head chuck, the tool turret's transient response was established through transient analysis at 0.4s. However, after the static analysis, the maximum deformation of the machine at the same external applied load on the tool turret was upheld at 7.6µm. The spatial position analysis rectified the modal performance of the machine at a variety of set working positions. As the principal cause of rigidity originates from the base of the machine, three sets of ground support combinations were claimed to test the machine's rigidity. After the topology optimization analysis was achieved, a better-optimized version of the design is suggested. The old and new models were compared, and an increase of 1.5% in the first three modal frequencies was observed.