bluuebunny/crossref_metadata_2025 huggingface dataset:
A cross-sectional study measuring management of third stage of labour by midwives and maternity nurses in Oman
Authors: Al-Jabri Noora Saleh , Kelly Janet , Harvey Gillian , Lynch Elizabeth , Cusack Lynette
Published: April 2024

Background The World Health Organisation (WHO) recommends implementing evidence-based active management of the third stage of labour (AMTSL) guidelines for all women during the third stage of labour (TSL). Midwives and maternity nurses play a major role in the management of third stage of labour and prevention of postpartum haemorrhage.Aim To investigate midwives' and maternity nurses' knowledge, attitude and self-reported practices in Oman towards management of third stage of labour and factors that influence implementation of AMTSL guidelines.Methods A cross-sectional survey of 300 midwives and maternity nurses working in childbirth wards in six hospitals in Oman between July and September 2019. Descriptive statistics and binary logistic regressions were used to identify the factors associated with knowledge, attitude and self-reported practice.Results The survey achieved a response rate of 80% (n = 240; 231 midwives and 9 maternity nurses). Just over half of the respondents (n = 132, 55%) correctly identified the core characteristics of the recommended management of TSL of WHO guidelines. Fewer respondents correctly identified specific components of AMTSL, such as the administration of recommended dose of oxytocin following birth (n = 108, 45%), cord clamping and cutting (n = 130, 54.2%) and no continuous uterine massage (n = 23, 9.6%). Regarding self-reported practice, 149 respondents (62%) reported always adhering to the AMTSL guidelines. Staff age and years of experience in the birthing ward were both independently associated with knowledge that was consistent with the WHO guidelines (p = 0.05). Hospital type, job title and staff age were associated with self-reported adherence to WHO guidelines (p = 0.05). Participants in all hospital types consistently identified lack of time and staff shortages as barriers to guidelines implementation.Conclusions There is a gap between knowledge and self-reported practice in the management of the third stage of labour, and between international WHO guidelines and current maternity care in Oman. This study provides insights for nursing and midwifery leaders and policymakers and informs future workforce training and strategies.
Study on the Osteogenesis Effect of Bio-Oss Bone Powder Combined with Medical Collagen Sponge Following Jaw Cyst Surgery
Authors: WEN Hailong , ZHANG Tonghan
Published: April 2024

Objective
The aim of this study is to evaluate the osteogenesis effect following jaw cyst surgery by comparing three scenarios: no use of filling materials, the use of a medical collagen sponge alone, and the combined application of Bio-Oss bone powder with a medical collagen sponge. This comparison aims to provide evidence for selecting appropriate filling materials for post-surgical treatment of jaw cysts.
Methods
This research involved 52 patients with jaw cysts at the Zhongshan City Stomatological Hospital from October 2022 to September 2023. Patients were randomly assigned to three groups: Group A (control group with no filling material), Group B (medical collagen sponge), and Group C (Bio-Oss bone powder combined with a medical collagen sponge). CBCT scans were taken before surgery and at 3 and 6 months post-operation. The Mimics 21.0 software was utilized to analyze changes in the volume of the cyst cavity and the bone density values.
Results
Significant statistical differences in changes to the volume of the cyst cavity and bone density were observed among the three groups (P < 0.01). Group C demonstrated the most effective osteogenesis, with a reduction in cyst cavity volume by 51.74% and an increase in bone density by 321.24% at 3 months post-operation. By 6 months, the cyst cavity volume had decreased by 80.54%, and the bone density had increased by 422.72%. Group B had the second-best outcomes, while Group A had the least effective bone regeneration.
Conclusion
The study concluded that the combination of Bio-Oss bone powder and medical collagen sponge leads to the most effective osteogenesis in patients undergoing surgery for jaw cysts. The use of a medical collagen sponge alone was the second most effective, while no filling material resulted in the least effective postoperative bone regeneration.
The Impact of PD-1 Inhibitor Combined with Bevacizumab on Tumor Immune Cells in MSS/pMMR Advanced Colorectal Cancer Patients with Failed First-Line Treatment
Authors: Chen Xiaoqian , Wang Liang , Li Wenkui , Lei Xiaogai , Li Zhanhong , Diao Yongzhi , Zhang Shenglin , Li Chengbiao , Wang Chengjun , Guo Qijing , Ma Xinfu , Luo Yushuang
Published: April 2024

Objective: To investigate the effects of PD-1 inhibitor combined with bevacizumab monoclonal antibody on tumor immune cells in patients with first-line treatment failure in MSS/pMMR advanced colorectal cancer.
Methods: A total of 40 patients with advanced colorectal cancer who failed first-line treatment were selected using a random number table method from Qinghai University Affiliated Hospital from October 2021 to June 2023. Ten patients in the control group were treated with FOLFIRI combined with bevacizumab. The experimental group of 30 patients was treated with sintilimab combined with bevacizumab, and the post-treatment effects of the two groups of patients were compared. The expression levels of CD8+ T cells, tumor-associated macrophages, and tumor-associated fibroblasts were evaluated comprehensively to assess the effects of sintilimab combined with bevacizumab on patients with first-line treatment failure in MSS/pMMR advanced colorectal cancer.
Results: There was no statistically significant difference in the positive expression rates of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment in both groups (P>0.05). There was no statistically significant difference in the comparison of the therapeutic effects of two groups of tumors (P>0.05), but the experimental group had higher PFS, mPFS, ORR, and DCR than the control group. There was no statistically significant difference in the occurrence rate of drug-related adverse reactions after treatment between the two groups (P>0.05).
Conclusion: By using the combination of sintilimab and bevacizumab in the first-line treatment of MSS/pMMR advanced colorectal cancer patients who failed first-line treatment, not only can the tumor immune microenvironment of patients be improved, but it can also transform the cold tumor immune suppression state into a hot tumor immune supportive state. While ensuring the safety of drug adverse reactions, it enhances the patients' anti-tumor ability and clinical treatment effects, further increasing the clinical application value.
Minimally invasive surgery of no tumor containment for cervical cancer surgery
Authors: Hu Min , Ji Limei , Jin Lanying , Shao Mingjun , Fu Xiujuan , Shi Baomei
Published: April 2024

The aim of this study is to evaluate the oncologic outcomes of minimally invasive radical hysterectomy with no tumor containment. Between January 2017 and June 2020, we recruited 350 women with early stage of cervical cancer, all eligible patients were informed of the potential complications and benefits of abdominal radical hysterectomy and laparoscopic radical hysterectomy. All patients in our study were refrain from using uterine manipulator, myoma drill or uterus suture combined with protective vaginal closure of the colpotomy such as clamp, vaginal cuff or vaginal suture instead, put the specimen in a collection bag, and extraction of the collection bag via the vagina. This research was approved by the Ethics Committee of Jinhua Municipal Central Hospital (2020 − 268). Over a median follow-up of 51 (range 30–72) months period, there were 5 patients lost to follow-up, and 3 patients refused to treatment after surgery. A total of 342 women with cervical cancer were ultimately analyzed in our study. Initial International Federation of Gynecology and Obstetrics (FIGO) 2018 stage was IA1 lymphovascular space invasion (LVSI+) 22 (6.29%), IA2 36 (10.29%), IB1 137 (39.14%), IB2 126 (36%), IIA1 14 (4%) and IIIC1p 15 (4.29%) respectively, and histology was squamous cell in 269 (76.86%), adenocarcinoma in 75 (21.43%), and adenosquamous in 6 (1.71%) patients. Lymphovascular invasion was confirmed in 80 (22.86%) patients. Lymph nodes were tumor-free in 325 (92.86%) patients. After radical hysterectomy, 83 (23.71%) patients underwent adjuvant chemoradiation or/and radiation. After a median follow-up of 51 (range 30–72) months, we noted the disease-free survival and overall survival rate were 95.71% (335/350) and 98.86% (346/350) respectively. The technique of minimally invasive surgery using maneuvers to avoid peritoneal contamination during surgery provides excellent oncologic outcome for patients with early cervical cancer. Our retrospective data suggest that laparoscopical surgery may be oncologically safe and may be validated in further randomized trials.
Engineering controllable alteration of malonyl-CoA levels to enhance polyketide production and versatility in E. coli
Authors: Keasling Jay , Klass Sarah , Wesselkamper Mia , Cowan Aidan , Lee Namil , Cheong Seokjung , Wang Zilong , Chen Yan , Gin Jennifer , Petzold Christopher
Published: April 2024

Engineering the heterologous expression of polyketide synthases (PKSs) in Escherichia coli has led to the production of various valuable natural and unnatural products. However, the limited availability of malonyl-CoA (M-CoA) in E. coli remains a significant impediment to efficient polyketide overproduction. In this study, engineered E. coli strains were developed to augment M-CoA levels for enhanced polyketide production by introducing a malonate transport and CoA ligation pathway. Additionally, control over the M-CoA pool was achieved by disrupting the endogenous M-CoA pathway and reconstituting it through malonate supplementation. The engineered strains exhibited increased M-CoA, fatty acid and polyketide titers, improved substrate selectivity of PKSs, and successful production of > 99% uniformly labeled 13C polyketides. Adaptive laboratory evolution of these strains provided valuable insights into pathways governing the M-CoA pools and the accumulation of mutations that resulted in significantly increased M-CoA and polyketide levels. This approach not only enhances the utility of E. coli as a heterologous host for polyketides but also illuminates the intricate dynamics of M-CoA modulation in these systems.
The mechanism study of THBS3 in regulating cartilage vascularization/bone coupling via the TGF-β/Smad2/3 pathway in osteoarthritis
Authors: Yan Jingyao , Zhao Yanping , Zhu Xiaoying , Lu Hanya , Wang Yanli , Wang Shuya , Zhang Zhiyi
Published: April 2024

Objective
Vascularization and osteogenesis coupling is observed in osteoarthritis (OA) cartilage. THBS-3 belongs to the extracellular matrix (ECM) proteins and is highly expressed in cartilage tissue. The effect of THBS-3 on OA is unclear. This study aims to explore the mechanistic role of THBS-3 in OA.
Design:
Expressions of THBS-3 was detected by Western blot (WB) and RT-qPCR. WB was employed to measure the expression levels of synthesis and degradation metabolism, as well as vascularization/ossification coupling. Migration and tube formation experiments were conducted to assess the migratory and tube-forming abilities of HUVECs influenced by THBS-3. Micro-CT was utilized for 3D imaging in mice. Immunohistochemistry was employed to detect the expression of synthesis, degradation metabolism, and vascularization/ossification coupling-related markers. Additionally, WB was utilized to assess the transforming growth factor-beta (TGF-β) signaling pathway.
Results
Proteinomics sequencing has revealed a higher expression level of THBS-3 in OA cartilage. Chondrocytes from OA joints exhibited significantly higher expression of THBS-3 relative to healthy individuals. In experiments conducted both in vivo and in vitro, THBS-3 exhibited a dual impact by enhancing catabolic metabolism, suppressing synthetic metabolism, and fostering the coupling of vascularization and osteogenesis within the cartilage. THBS-3 activated the TGF-β signaling pathway, and blockade of the TGF-β signaling pathway resulted in increased p-Smad2/3 expression in OA cartilage cells and decreased expression of vascularization /ossification coupling.
Conclusion
THBS-3 can promote the vascularization/ossification coupling of cartilage cells by activating the TGF-β/Smad2/3 signaling pathway, providing new insights and targets for the treatment of OA.
Risk factors associated with anemia among school age pupils in Tanzania; A Case Study of Pwani, Geita and Arusha regions
Authors: KIMARO OLIVA JOSEPH , KYATIKILA AARON WIGGINS , Pallangyo Edgar Elirehema , DIARZ ESTER JACOB , SICHONA FRANCIS , KILLEL ERICK , MCHAU GEOFREY , CHACKY FRANK
Published: April 2024

Background Anemia is a condition in which the number of red blood cells or the hemoglobin concentration in the blood is lower than normal and has been considered a health concern in developing countries like Tanzania. Primary school pupils are the most endangered groups of anemia. Anemia hurts one's well-being, rational growth, educational attainment, and job production if left untreated. This study aimed to determine factors associated with anemia among public primary school pupils aged 5–19 years in Tanzania. Methods The study was cross-sectional and involved 2,292 pupils from the selected regions. It used secondary data from a school malaria and nutrition survey conducted between August and October 2019 among public primary school pupils (5 to 19 years) in Tanzania. Binary and Multinomial logistic regression models were used to assess the possible association of independent and outcome variables. Results Anemia was higher (33%) among primary school pupils aged 15–19 (COR = 1.35, 95% CL: 1.11, 2.12) compared to the pupils aged 5–9 years. Most of the pupils who were malaria-positive were found to be anemic (COR = 1.67, 95%CL: 1.23, 2.27). Mild anemia was less common among pupils living in urban areas (COR = 0.57, 95% CL: 0.41, 0.80) compared to rural areas. Conclusion Therefore, malaria-positive, rural residents and older children (5 to 19 years) were among the major factors associated with anemia among public primary school pupils in the study area.
Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 years and Older
Authors: Alsehali Afrah , Alrajeh Haneen , AL-Jahdali Hamdan , Al-Safi Eiman , Layqah Laila , Baharoon Salim
Published: April 2024

Introduction
Tuberculosis is a significant contributor of morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential.
Method
Clinical, radiological features, treatment and outcome of TB in patients aged 75 years or older was evaluated retrospectively.
Results
Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p=0.007).
Conclusion
Tuberculosis is associated with high mortality in patients above age of 75. There is still a substantial delay in TB diagnosis in elderly. RIPE regimen is frequently changed due to side effect. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient’s population is needed to define the best effective therapeutic approach.
Conducting an Objective Structured Clinical Examination under COVID-Restricted Conditions
Authors: Gotzmann Andrea , Boulet John , Zhang Yichi , McCormick Judy , Wojcik Mathieu , Bartman Ilona , Pugh Debra
Published: April 2024

Background
The administration of performance assessments during the coronavirus disease of 2019 (COVID-19) pandemic posed many challenges, especially for examinations employed as part of certification and licensure. The National Assessment Collaboration (NAC) Examination, an Objective Structured Clinical Examination (OSCE), was modified during the pandemic. Reliability and validity evidence for the modified NAC Examination is presented. This paper outlines validity and reliability evidence for modifications required due to significant interruptions or changes to OSCEs.
Methods
Cronbach’s alpha, decision consistency, and accuracy values were calculated to quantify measurement error. Validity evidence includes comparisons of scores and sub-scores for demographic groups: gender (male vs female), type of International Medical Graduate (IMG) (Canadians Studying Abroad (CSA) vs non-CSA), postgraduate training (PGT) (no PGT vs PGT), and language of examination (English vs French). Criterion relationships were summarized using correlations within and between NAC Examination and the Medical Council of Canada Qualifying Examination (MCCQE) Part I scores.
Results
Reliability estimates were consistent with other OSCEs similar in length and previous NAC Examination administrations. Both total score and sub-score differences for gender were statistically significant. Total score differences by type of IMG and PGT were not statistically significant, but sub-score differences were. Administration language was not statistically significant for either the total scores or sub-scores. Correlations were all statistically significant with some relationships being small or moderate (0.20 to 0.40) or large (> 0.40).
Conclusions
The NAC Examination yields reliable total scores and pass/fail decisions, expected differences in total scores and sub-scores for defined groups were consistent with previous literature, and internal relationships amongst NAC Examination sub-scores and their external relationships with the MCCQE Part I supported both discriminant and criterion-related validity arguments. Modifications to OSCEs to address health restrictions can be implemented without compromising the overall quality of the assessment. This study outlines some of the validity and reliability analyses for OSCEs that had major modifications and interruptions.
Cytokinin oxidase2 deficient mutants improves panicle and grain architecture through cytokinin accumulation and enhance drought tolerance in indica rice
Authors: Rashid Afreen , Achary V. Mohan M. , Abdin MZ , Karippadakam Sangeetha , Parmar Hemangini , Panditi Varakumar , Prakash Ganesan , Bhatnagar-Mathur Pooja , Reddy Malireddy
Published: April 2024

Cytokinins (CKs) are multifaceted hormones that regulate growth, development, and stress responses in plants. Cytokinins have been implicated in improved panicle architecture and grain yield however are inactivated by the enzyme cytokinin oxidase (CKX). In this study we developed a cytokininn oxidase2 (Osckx2) deficient mutant using CRISPR/Cas9 gene editing in indica rice and assesses its function under water deficit and salinity conditions. Loss of OsCKX2 function increased grain number, secondary panicle branching and overall grain yield through improved cytokinin content in the panicle tissue. Under drought conditions, the Osckx2 mutant conserved more water and demonstrated improved water-saving traits. Through reduced transpiration, Osckx2 mutants showed improved survival response than wild type to unset dehydration stress. Further, Osckx2maintained chloroplast and membrane integrity and showed significantly improved photosynthetic function under drought conditions through enhanced antioxidant protection systems. The OsCKX2 function negatively affects panicle grain number and drought tolerance, with no discernible impact in response to salinity. The finding suggests the utility of the beneficial Osckx2 allele in breeding to develop climate-resilient high-yielding cultivars for future food security.
Automatic computation of 3D angle of pulmonary artery based on Web3D for preoperative planning in cardiac surgery
Authors: Tu Zhiyong , Zhang Yudong , Zhang Qian , Gilanyi Attila , Hong HaiFa
Published: April 2024

This paper proposes Web3D technology to improve the general, popular computation method of the 2D angle of the pulmonary artery for preoperative planning of children’s congenital cardiopathy. First, the Web3D technology automatically computes the 3D angle of pulmonary artery to remove the complex process of manual computation of the 3D angle of the pulmonary artery from the 2D angle. Second, due to the adoption of lightweight data transmission technology the computed 3D angle of the pulmonary artery is shown to the front client in the browser in less than 5 seconds in the case of a single 3D angle computation. At last, we test and compare computations of the 3D angle of the pulmonary artery with the mainstream Materialise Mimics. The experimental comparison reveals that our computation precision of the 3D angle of the pulmonary artery is 95 percent through the application of Web3D technology.
Prediction and Analysis of Hot Rolling Strip Tension Based on Back Propagation Neural Network
Authors: Yuan Hao , Ma Yiwei , Li Xu , Li Xiaohua , Luan Feng , Ji Yafeng
Published: April 2024

In modern hot strip mill control systems, strip tension control is the core control function, and its performance will be directly reflected in product quality. A strip tension prediction model based on Back Propagation (BP) neural network is proposed. To ensure that the true tension value is obtained, this paper proposes a four-dimensional judgment mode for the contact time between the looper and the strip steel and establishes a data set of tension parameters for hot rolled strip steel. The traditional BP neural network, genetic algorithm optimized BP neural network (GA-BP), and whale algorithm optimized BP neural network (WOA-BP) models were used to predict the strip tension, and their prediction performance was evaluated. The results show that the proposed WOA-BP model has the best prediction effect, with the highest model decision coefficient of 0.9330. At the same time, the contribution rate of each variable to the strip tension was studied, and the results showed that the looper angle and looper roller force had the greatest impact on it, consistent with physical laws. Propose improvement suggestions for the control performance of hot rolled strip tension based on the influence of looper angle on the prediction model.
Prognosis analysis of pyroptosis- and aging-related genes in colorectal cancer based on bioinformatic analysis
Authors: Pan Tianyan , Jin Yongdong
Published: April 2024

Background
Colorectal cancer (CRC) is the most prevalent gastrointestinal cancer worldwide. Our goal was to construct a model based on pyroptosis- and aging-related genes (PARGs) to predict CRC outcomes of colorectal cancer.
Methods
The Colon Adenocarcinoma/Rectal Adenocarcinoma Esophageal Carcinoma (COADREAD) dataset from the cancer genome atlas (TCGA) was obtained using R. Colorectal cancer-related datasets, namely, GSE74602, GSE87211, and GSE161158 were acquired from the Gene Expression Omnibus (GEO) database. PARGs were collected from various sources such as the GeneCards database, Molecular Signatures Database (MSigDB), and relevant literature. Differential expression analysis, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis, and Gene Set Enrichment Analysis (GSEA) were performed using R. Prognostic models were constructed utilizing LASSO (least absolute shrinkage and selection) regression analyses. Column line plots and calibration curve plots were generated using the R package. Immunohistochemical analyses were performed using the HPA (Human Protein Atlas) database.
Results
To obtain sets of genes related to both pyroptosis and aging (PARGs), we identified overlapping genes from two distinct datasets: one consisting of genes associated with pyroptosis (PRGs), and the other consisting of genes associated with aging (ARGs). We then created a risk signature that encompassed both pyroptosis and aging factors, which was further validated using diagnostic tools such as a Calibration Curve and decision curve analysis (DCA). The risk score derived from this signature significantly affects the overall survival of patients (CRC) patients. The stability and accuracy of this association were further confirmed using stratified survival analysis and DCA. Additionally, GSEA was performed to obtain results for both high-risk and low-risk groups.
Conclusions
CRC severity may be predicted using the PARGs signature, which is a reliable prognostic analysis model.
A Challenging Case of Anticoagulation: Acute Traumatic Brain Injury Complicated by Multifocal Venous Thromboembolism
Authors: Shen Jinyun , Ou Yingwei , Chen Lue , Tan Zhaowang , Fu Jin , Li Qian
Published: April 2024

Traumatic brain injury (TBI) poses a significant threat to human health and well-being, imposing substantial burdens on patients, families, and society at large. The mechanisms underlying coagulopathy induced by TBI remain elusive. Given the risk of exacerbated intracranial hemorrhage in the early stages of TBI, the initiation of anticoagulant therapy is often deferred. However, TBI is an independent risk factor for venous thromboembolism (VTE), and delaying anticoagulation increases the risk of VTE incidence and mortality. The early risk of hemorrhage and thrombosis presents a considerable challenge to treatment. This paper presents a case study of a 51-year-old male patient in the acute phase of TBI, complicated by extensive pulmonary embolism (PE) and deep vein thrombosis (DVT), treated with the insertion of an inferior vena cava filter (IVCF) followed by complications of IVCF thrombosis. Through this case and a review of relevant literature, we argue that anticoagulant therapy can be considered 7-14 days post-TBI based on individual circumstances. After IVCF placement, attention must be paid to complications, especially IVCF thrombosis.
The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
Authors: García Guillermo A , Galick David S , Smith Jordan M , Iyanga Marcos Mbulito , Rivas Matilde Riloha , Eyono Jeremías Nzamío Mba , Phiri Wonder P , Donfack Olivier Tresor , Smith David L , Guerra Carlos A
Published: April 2024

Background: Since 2015, malaria vector control on Bioko Island has relied heavily upon long-lasting insecticidal nets (LLIN) to complement other interventions. Despite significant resources utilised, however, achieving and maintaining high coverage has been elusive. Here, core LLIN indicators were used to assess and redefine distribution strategies.
Methods: LLIN indicators were estimated for Bioko Island between 2015 and 2022 using a 1x1 km grid of areas. The way these indicators interacted was used to critically assess coverage targets. Particular attention was paid to spatial heterogeneity and to differences between urban Malabo, the capital, and the rural periphery.
Results: LLIN coverage according to all indicators varied substantially across areas, decreased significantly soon after mass distribution campaigns (MDC) and, with few exceptions, remained consistently below the recommended target. Use was strongly correlated with population access, particularly in Malabo. After a change in strategy in Malabo from MDC to fixed distribution points, use-to-access showed significant improvement, indicating those who obtained their nets from these sources were more likely to keep them and use them. Moreover, their use rates were significantly higher than those of whom sourced their nets elsewhere.
Conclusions: Striking a better balance between LLIN distribution efficiency and coverage represents a major challenge as LLIN retention and use rates remain low despite high access resulting from MDC. The cost benefit of fixed distribution points in Malabo was deemed significant, providing a viable alternative for guaranteeing access to LLINs to those who use them.
Modeling of the denitration process of the SNCR system of coal-fired power plants based on Bi-LSTM
Authors: Yujie ZHU , Yuan HAN , Donghui YUAN , Yuanyuan CHEN
Published: April 2024

During the operation of thermal power units, a large amount of NOx pollutants is generated due to combustion. In order to reduce NOx emissions, the implementation and optimization of denitrification technology has become a key issue in the current environmental protection. In the selective non-catalytic reduction (SNCR) denitration control system, due to the delay in the chemical reaction time of sampling, it is impossible to accurately predict the NOx concentration and to quickly adjust the amount of ammonia injection. In this work builds a SNCR denitrification model based on Bi-LSTM to predict the main steam flow rate and the flow rate of urea solution in the furnace area at the current moment using upstream boiler operation parameters. Comparing with SVR, DNN, CNN, LSTM network, the proposed method performs the best in simulation. The MSEs of main steam flow and furnace zone urea solution urea flow are as low as 0.000151 and 0.001232, respectively, and the R2 s are as high as 0.998905 and 0.998905, respectively.
Nociception Level Index variations in ICU: curarized vs non-curarized patients. A pilot study
Authors: Bonvecchio Emilio , Vailati Davide , Mura Federica Della , Marino Giovanni
Published: April 2024

Purpose
Pain is a major physiological stressor that can worsen critical medical conditions in many ways. Currently, there is no reliable monitoring tool is available for pain monitoring in the deeply sedated ± curarized critically ill patients. This study aims to assess the effectiveness of the multiparameter nociception index (NOL®) in the critical care setting. We compared NOL with traditionally used neurovegetative signs and examined its correlation with sedation depth measured by bispectral index (BIS®) EEG monitoring.
Methods
This prospective monocentric cohort study was conducted in a general medical surgical ICU, including patients who required moderate to deep levels of sedation with or without continuous neuromuscular blockade. The performance of NOL was evaluated both in the entire studied population, as well as in two subgroups: curarized and non-curarized patients.
Results
NOL demonstrated greater accuracy than all other indicators in pain detection in the overall population. In the non-curare subgroup, all indices correctly recognized painful stimulation, while in the patients subjected to NMBA infusion, only NOL properly identified nociception. In the former group, EEG’s relation to nociception was on the border of statistical significance, whereas in the latter BIS showed no correlation with NOL.
Conclusion
NOL emerges as a promising device for pain assessment in the critical care setting and exhibits its best performance precisely in the clinical context where reliable pain assessment methods are most lacking. Our study demonstrates its feasibility in a mixed surgical and medical ICU population. Furthermore, our research confirms the distinction between sedation and analgesia, highlighting the necessity for distinct monitoring instruments to accurately assess them.
In vitro cluster buds regeneration and control of Shoot Tip Necrosis in tissue cultures of Trichosanthes cucumerina Linn.
Authors: LIU Cheng-Li , DENG Jie-Mei , YAN Hong-Mei , Huang Hengyu
Published: April 2024

Trichosanthes cucumerina Linn. is a medicinal vine with great potential that can be used as a vegetable. In this study, an efficient in vitro regeneration system of T. cucumerina was established by inducing adventitious buds and controlling Shoot Tip Necrosis (STN) in vitro culture. The results of hormone single factor and orthogonal experiments showed that 6-BA had a significant effect on inducing adventitious buds. The best medium for bud proliferation was MS + 6-BA 3.0 mg·L-1 + KT 2.0 mg·L-1 + NAA 0.5 mg·L-1, and the proliferation coefficient was 14.68. However, after three consecutive subcultures, a higher incidence of STN (78.86%) was observed. The results of the STN control experiment showed that reducing the concentration of inorganic salt, shortening the subculture interval, and increasing the Ca2+ in the medium could effectively control the occurrence of STN. When the subculture interval was 40 d, the stem segments obtained the lowest STN incidence (8.3%) and higher shoot proliferation coefficient (10.02) on the medium of MS + 3.0 mg·L-1 6-BA + 2.0 mg·L-1 KT + 0.5 mg·L-1 NAA + 360.36 mg·L-1 Ca2+. The best rooting medium for stem segments was MS + 0.50 mg·L-1 NAA; the rooting rate was 100%, and no STN occurred. After acclimation, the survival rate of the rooted plantlet reached 95% after 40 days in the soil matrix of coconut husk: humus soil: perlite = 2: 2: 1 (v/v). The results of this study not only reveal the mechanism of STN in T. cucumerina, but also provide technical support and a theoretical basis for its further artificial breeding and cultivation.
Causality between cathepsins and idiopathic pulmonary fibrosis: a Mendelian randomization study
Authors: Zhong Zhuen , Xu Ruochen , Xu Changhao , Zhu Yanlin , Xu Qian , Hua Yan
Published: April 2024

Background
The pathogenesis of idiopathic pulmonary fibrosis (IPF) is complex and difficult to diagnose and treat clinically. Cathepsins are involved in various physiological and pathological processes, and observational studies have shown an association between cathepsins and IPF. However, the causal relationship between them remains uncertain. Our aim was to assess the causal relationship between various cathepsins and IPF.
Methods
Protein quantitative trait loci (pQTL) data for cathepsins were obtained from INTERVAL studies, and summary statistics for IPF genome-wide association studies (GWAS) were obtained from the FinnGen R10 study. Univariable Mendelian randomization (UVMR), multivariable Mendelian randomization (MVMR), summary data-based Mendelian randomization (SMR) and Bayesian colocalization analysis were conducted in this study.
Results
UVMR analysis indicated that elevated cathepsin H levels reduced the overall risk of IPF (OR = 0.885,95%CI = 0.827 ~ 0.947, P = 3.86×10 − 4). MVMR showed that the effect of cathepsin H on IPF was still present after adjusting the interaction of cathepsins (OR = 0.895,95%CI = 0.834 ~ 0.961, P = 0.002). In addition, SMR analysis also suggested a causal association between cathepsin H and IPF (OR = 0.800,95%CI = 0.699 ~ 0.916, P = 0.001). Finally, we validated the results using the UK Biobank Pharma Proteomics Project (UKB-PPP) dataset (OR = 0.897,95%CI = 0.836 ~ 0.963, P = 0.003).
Conclusions
This study suggests that cathepsin H has a protective effect on IPF and may serve as a potential therapeutic target for IPF, providing inspiration and guidance for the diagnosis and treatment of IPF.
Synergistic Breakthroughs in Seawater Desalination: Zirconium-Based MOF/PVC-PVA Composite Membranes for Unprecedented Performance
Authors: El-Sawaf Ayman , Ahmed Sama , Nassar Amal , Mubarak Mahmoud
Published: April 2024

In this study, we employed the electrospinning technique to fabricate advanced composite membranes comprised of polyvinyl chloride (PVC) enriched with post-metallated metal–organic frameworks (MOFs), specifically UiO-66(COOH)2-Ag and ZIF-8-Ag. The innovative utilization of electrospinning resulted in the formation of highly stable PVC/MOFs-Ag membrane composites, which were systematically characterized through various analytical methods, including scanning electron microscopy, powder X-ray diffraction, thermogravimetric analysis, X-ray photoelectron spectroscopy, porosity analysis, and water contact angle measurement. The outcomes affirmed the successful incorporation of MOF crystals within the nanofibrous PVC membranes. Distinct morphological features were observed in the obtained composites, with larger fiber diameters noted for 5% and 10% MOF loadings and a reduced diameter for 20% loading. Moreover, the composites exhibited increased average pore sizes compared to traditional PVC membranes across the majority of MOF loading percentages. Antibacterial properties of the fabricated membranes were systematically investigated at varying MOFs-Ag loadings. The results demonstrated significant antibacterial activity, reaching up to 95%, against both Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria as the MOFs-Ag loading increased, maintaining a consistent silver concentration. This suggests a contact-based inhibition mechanism. The findings of this research hold paramount importance for the development of novel, stable, and highly effective antibacterial materials. These materials could serve as superior alternatives for face masks and be integrated into various applications requiring regular decontamination, including potential deployment in advanced water filtration systems.
Ferrofluid Reaction Wheel Development and in-orbit Verification
Authors: Ehresmann Manfred , Zajonz Sebastian , Korn Christian , Großmann Steffen , Dietrich Janoah , Kob Maximilian , Philipp Daniel , Turco Fabrizio , Steinert Michael , O'Donohue Michael , Heinz Nicolas , Gutierrez Elizabeth , Wagner Alexander , Bölke Daniel , Sütterlin Saskia , Schneider Maximilian , Remane Yolantha , Kreul Phil , Wank Bianca , Buchfink Manuel , Acker Denis , Hofmann Sonja , Karahan Bahar , Ruffner Silas , Schäfer Felix , Herdrich Georg Heinrich
Published: April 2024

In contemporary satellite systems, Reaction Control Systems (RCS) serve as one of the primary means for generating internal torques within the Attitude and Orbit Control System (AOCS). Notably, these systems encompass Reaction Wheels (RW) and Control Moment Gyros (CMG), both characterized by mechanically-mounted rotating disks engineered for maximized moment of inertia. However, this design inherently introduces challenges common to movingmechanical systems, including wear, (non-linear) friction effects, and potential degradation. For in space applications these challenges are more severe, as repairs are usually not possible or would entail significant resource allocation. An alternative to this is provided by fluid-based systems, which can prevent wear and tear of mechanical systems by completely replacing the mechanical interfaces in conventional system with a design based on a ferrofluid mechanism. Ferrofluid-based system concepts offer longer life due to reduced wear and tear as well as potentially lower production costs and overall increased durability and reliability. This paper aims to describe the development of a potential replacment of a reaction wheel by a fluid-based concept from the basic idea and proof of concept up to the data evaluation of the in-space verification of the system in the zero-gravity environment on the ISS (International Space Station). This ACS (Attitude Control System) experiment is called Ferrowheel as it is based on a stator of a brushless DC motor in combination with a rotor on a ferrofluidic bearing. This research was completed as part of the student project FARGO (Ferrofluid Application Research Goes Orbital).
FARGO is part of the Überflieger 2 student competition hosted by the space agency within DLR (German Aerospace Center). The experiment was operated on the ISS in March and April 2023. The project objective was to test and analyze three separate ferrofluid applications in the ISS micro-gravity environment.
Regulation of Pro-apoptotic and Anti-apoptotic Factors in Obesity-Related Esophageal Adenocarcinoma
Authors: Agrawal Swati , Podber Anna , Gillespie Megan , Dietz Nick , Hansen Laura A. , Nandipati Kalyana C.
Published: April 2024

Background: Obesity is a risk factor for esophageal adenocarcinoma (EAC). It is associated with increased levels of free fatty acids (FFA), leading to insulin resistance and increased expression of insulin like growth factor-1 (IGF-1) and diacylglycerol (DAG). The objective of the study is to investigate the role of apoptotic factors in control and EAC tissues in both relation to this signaling pathway in obese and non-obese patients.
Methods: We included 23 obese and nonobese patients with EAC or with or without Barrett’s esophagus (BE) after IRB approval. We collected 23 normal, 10 BE, and 19 EAC tissue samples from endoscopy or esophagectomy. The samples were analyzed for the expression levels of pro-apoptotic and anti-apoptotic factors, PKC-d, cIAP2, FLIP, IGF-1, Akt, NF-kB and Ki67 by immunofluorescence and RT-PCR. We compared the expression levels between normal, BE, and EAC tissue using Students’ t-test between two groups.
Results: Our results showed decreased gene and protein expression of pro-apoptotic factors (bad, bak and bax) and increased expression of anti-apoptotic factors (bcl-2, Bcl-xL) in BE and EAC compared to normal tissues. There was increased gene and protein expression of PKC-d, cIAP2, FLIP, NF-kB, IGF-1, Akt, and Ki67 in BE and EAC samples compared to normal esophagus. Further, an increased folds changes in mRNA expression of proapoptotic factors, antiapoptotic factors, PKC-δ, IGF-1, Akt, and Ki-67 was associated with obesity.
Conclusion: Patients with EAC had increased expression of cIAP2 and FLIP, and PKC-d which is associated with inhibition of apoptosis and possible progression of esophageal adenocarcinoma.
Navigating Drought: Analyzing Panama Canal Transit Disruptions Using AIS Big Data
Authors: Chico Cherryl , Wang Zhaowen , Reyes Ed Kieran C. , Mariasingham Mahinthan J.
Published: April 2024

The Panama Canal experienced historically low water levels due to a severe drought in 2023. In response, the Panama Canal Authority has imposed restrictions on daily transits since July 2023, causing significant backlogs of vessels awaiting passage. This study leverages big data from Automatic Identification System (AIS) to comprehen- sively analyze the impact of the drought on transit activities through the Panama Canal. We develops new methods for deriving indicators for passageways, including count of transits, waiting time, count of voyages from top economy pairs visited before and after transit, and count of vessels with rerouted voyages. Statistical analysis is carried out to recognize the evolving trend in the time series to quantify the drought’s impact on transit activities. The Mann-Kendall and Sen’s estimator are applied to identify and determine the magnitude of the trend. Furthermore, as a critical conduit connecting the Atlantic and Pacific Oceans, the Panama Canal holds immense impor- tance in regional and global trade. By utilizing AIS data, this study identifies the top 10 economy pairs that transit through the Panama Canal and investigates the monthly counts of transit activities between these economies during the drought. The number of vessels with rerouted voyages is also computed, shedding light on how the drought in Panama has impacted maritime transportation and the global supply chain. The ongoing water scarcity crisis in Panama serves as a reminder that climate change is fundamentally reshaping economic and trade landscapes, posing a significant threat to future growth and prosperity. Harnessing the potential of AIS data provides a pro- found and immediate understanding of the drought’s impact on the Panama Canal, empowering stakeholders to effectively mitigate economic vulnerabilities and ensure sustainable development amidst evolving climate patterns.
Immunoediting on the Brink: Dynamic Relationship Between Tumor Genotype and Microenvironment as Determinant of Immunotherapy Effectiveness in an informative case report of Lynch Syndrome
Authors: Zen Valentina , Cingarlini Sara , Mafficini Andrea , Luchini Claudio , Mattiolo Paola , Ciulla Calogero , Pavarana Michele , Conciatori Fabiana , Bazzichetto Chiara , Cucca Marina , Scarpa Aldo , Milella Michele
Published: April 2024

Background: Lynch syndrome is an autosomal-dominant inherited condition that significantly increases the risk of developing cancer; within the Lynch syndrome spectrum, Muir-Torre syndrome is an autosomal-dominant genodermatosis, associated with keratoacanthomas and sebaceous neoplasms (adenoma, carcinoma or epithelioma). Both are characterized by the presence of defects in mismatch repair genes resulting in the high mutational rate that accounts for elective sensitivity to immunotherapy with checkpoint inhibitors. However, up to 30% of patients experience refractoriness to treatment.
Case presentation: This report describes a potentially informative case of a Lynch/Muir-Torre syndrome patient, who developed gastric cancer while in complete metabolic response to immunotherapy for metastatic duodenal carcinoma and cutaneous epithelioma. Both tumors exhibited high mutational rates and microsatellite instability. Deregulation of the TGF-β2 axis and absence of CD11c-positive dendritic cells in tumor microenvironment together with the loss of IL-8 expression on tumor-associated macrophages represent intriguing findings in this Lynch Syndrome-related immuno-refractory neoplasia.
Conclusions: A comprehensive evaluation of the genetic features of tumor cells together with the assessment of intratumoral immune infiltrate may provide insights into the heterogeneous mechanisms of resistance to checkpoint inhibitors.
Integrated Pan-Cancer Profiling of RAC1: Prognostic, Immunomodulatory, and Therapeutic Resistance Insights
Authors: Shao Zhibo , Ren Hengyu , Wang Xuliren , Zhang Qi , Xue Jingyan , Chi Yayun , Xiu Bingqiu , Wu Jiong
Published: April 2024

RAC1, a member of the Rho family GTPases, has been implicated in various cancer types, but its pan-cancer landscape and clinical significance remain underexplored. In this study, we conducted a comprehensive analysis of RAC1 expression, its correlation with clinical outcomes, and its role in the tumour microenvironment across 33 cancer types. Our findings revealed that RAC1 is highly expressed in a broad range of cancers and is associated with poor prognosis. RAC1 expression was found to be significantly linked to genomic alterations, including copy number variations (CNVs), tumour mutational burden (TMB), and microsatellite instability (MSI). Moreover, RAC1 was negatively correlated with B cell infiltration, suggesting its potential role in shaping a "cold" tumour microenvironment. Functional enrichment analysis indicated that RAC1 is involved in pathways related to B cell activation and immune response. Loss-of-function experiments demonstrated that RAC1 knockdown reduces cell proliferation in breast and lung cancer cells, in vivo and in vitro, suggesting its oncogenic potential. Single-cell analysis uncovered that RAC1 predominantly exerts its influence within epithelial cells. This pan-cancer analysis provides a detailed understanding of RAC1's role in cancer progression and its potential as a prognostic biomarker and therapeutic target for immunotherapy.