bluuebunny/crossref_metadata_2025 huggingface dataset:
Disc Degeneration in Distal Unfused Segments: Cause or Consequence of Adding-On After Posterior Fusion of Lenke 3c, 5c, 6c Adolescent Idiopathic Scoliosis?
Authors: Yanik Hakan Serhat , Marasli Mert Kahraman , Ketenci Ismail Emre , Erdem Şevki
Published: December 2024

Background The aim of this study is to examine the association between adding-on (AO) and disc degeneration(DD) of distal unfused levels in Lenke 3C, 5C, 6C adolescent idiopathic scoliosis (AIS) patients with a follow-up of at least two years by comparing preoperative and postoperative magnetic resonance imaging (MRI).
Methods 47 AIS patients (32 females and 15 males) with structural thoracolumbar/lumbar (TL/L) curves treated with long segment thoracolumbar fusion were retrospectively evaluated. Patients were divided into two groups according to the occurrence of the AO (AO and Non-AO groups). The unfused discs were graded using the MRI images according to the Pfirrmann grading method. The Scoliosis Research Society-22 (SRS-22) questionnaire and Visuel Analog Scale (VAS) were used to determine clinical outcomes.
Results The frequency of AO was found to be 29.78%. Preoperative MT curve and TL/L curve angles; LIV translation, LIV disc angle, LIV +1 translation at final follow-up and the number of fused levels were significantly higher in the AO group. Postoperative total Pfirrmann Score was significantly associated with AO. L5-S1 disc in the AO group had a statistically significant higher Pfirrmann grade than the Non-AO group. No significant association was found between the VAS and SRS-22 scores related to AO, DD or other radiological outcomes.
Conclusion Although the AO was detected at a high rate in Lenke 3C, 5C, 6C AIS patients and its association with DD in distal unfused levels was demonstrated, no impact on clinical scores was found. Furthermore, patients with AO developed significantly higher DD in L5-S1 disc, even if it is not the segment adjacent to the fusion. Even if this DD does not cause complaints in the young AIS population, L5-S1 disc should be evaluated in patients with AO, since it may cause complaints in longer follow-up.
Cleaner wrasse can reach Piagetian stage 4 of object permanence when primarily exposed to stage 3
Authors: BONIN Leonore , DUC Sophie , BSHARY Redouan
Published: December 2024

Object permanence (OP) is the ability to retain a stable representation of an object, even if it is partially or completely out of sight. Despite its seeming simplicity, this concept has posed challenges for many species, with factors like life history and development being proposed as potential explanations. We tested for OP in the cleaner wrasse Labroides dimidiatus, a species that exhibits complex ecological strategies in the wild, who has been tested in a variety of cognitive experiments, and who could help shed light on differences in brain size and cognitive abilities between ectotherms and endotherms. In two separate series of experiments, we investigated the potential role of ecological relevancy and the complexity of the condition. To test for OP, we used a food reward, a conspecific, or a predator that we presented to cleaner wrasse Piagetian stage 3 or 4 and added a delay or a supplementary cognitive charge with an "A-not-B error" paradigm. Our findings suggest that cleaner wrasse possess some primary forms of OP that depend on training and are thus comparable in performance to some larger-brained endotherm species. Furthermore, ecological relevancy did not clearly influence cleaner wrasse performance. Our findings provide the first evidence of OP in cleaner wrasse; however, we discuss methodological improvements that could help minimize potential biases in future studies.
Predicting work ability impairment in Post COVID-19 patients: a machine learning model based on clinical parameters
Authors: Jebrini Tarek , Ruzicka Michael , Völk Felix , Fonseca Gerardo Jesus Ibarra , Pernpruner Anna , Benesch Christopher , Valdinoci Elisabeth , Von Baum Max , Weigl Martin , Subklewe Marion , von Bergwelt-Baildon Michael , Roider Julia , Mayerle Julia , Heindl Bernhard , Adorjan Kristina , Stubbe Hans Christian
Published: December 2024

The Post COVID-19 condition (PCC) is a complex disease affecting health and everyday functioning. This is well reflected by a patient’s inability to work (ITW). In this study, we aimed to investigate factors associated with ITW and to design a machine learning-based model for predicting ITW twelve months after baseline.
We selected patients from the post COVID care study (PCC-study) with data on their ability to work. To identify factors associated with ITW, we compared PCC patients with and without ITW. For constructing a predictive model, we selected nine clinical parameters: hospitalization during the acute SARS-CoV-2 infection, WHO severity of acute infection, presence of somatic comorbidities, presence of psychiatric comorbidities, age, height, weight, Karnofsky index, and symptoms. The model was trained to predict ITW twelve months after baseline using TensorFlow Decision Forests. Its performance was investigated using cross-validation and an independent testing dataset.
In total, 259 PCC patients were included in this analysis. We observed that ITW was associated with dyslipidemia, worse patient reported outcomes (FSS, WHOQOL-BREF, PHQ-9), a higher rate of preexisting psychiatric conditions, and a more extensive medical work-up. The predictive model exhibited a mean AUC of 0.83 (95% CI: 0.78; 0.88) in the 10-fold cross-validation. In the testing dataset, the AUC was 0.76 (95% CI: 0.58; 0.93).
In conclusion, we identified several factors associated with ITW. The predictive model performed very well. It could guide management decisions and help setting mid- to long-term treatment goals by aiding the identification of patients at risk of extended ITW.
Proportion of confirmed Lyme neuroborreliosis cases among patients with suspected early European Lyme neuroborreliosis
Authors: Ogrinc Katarina , Bogovič Petra , Rojko Tereza , Maraspin Vera , Ružić-Sabljić Eva , Kastrin Andrej , Strle Klemen , Wormser Gary P. , Strle Franc
Published: December 2024

Purpose To determine the frequency of confirmed Lyme neuroborreliosis (LNB) cases in adult patients with three different clinical presentations consistent with early LNB.Methods Data were obtained through routine health care at the UMC Ljubljana, Slovenia from 2005–2022, using clinical pathways. The patients were classified into three groups: i) radicular pain of new onset (N = 332); or ii) involvement of cranial nerve(s) but without radicular pain (N = 997); or iii) erythema migrans (EM) skin lesion(s) in conjunction with symptoms suggestive of nervous system involvement but without either cranial nerve palsy or radicular pain (N = 240). The diagnosis of LNB considered the following variables: the presence of: 1) neurologic symptoms consistent with LNB (with no other obvious explanation); 2) cerebrospinal fluid (CSF) pleocytosis (> 5x106 leukocytes/L); and 3) demonstration of intrathecal synthesis of borrelial antibodies, and/or cultivation of borrelia from CSF, and/or the presence of EM. Patients fulfilling only the first two criteria were interpreted as having possible LNB, while those who satisfied all three criteria were regarded as having confirmed LNB.Results Of 1569 adult patients, 348 (22.2%) had confirmed LNB and 70 (4.5%) others had possible LNB. The proportion of confirmed LNB cases was the highest for patients with radicular pain (217/332, 65.4%), followed by the group with EM and neurologic symptoms (47/240, 19.6%), and those with cranial neuritis (84/997, 8.4%).Conclusion Only 22% of patients evaluated had confirmed LNB. The proportion of confirmed LNB cases correlated with clinical presentation and was highest among patients with recent onset of radicular pain.
Endothelial and neuronal engagement by AAV-BR1 gene therapy alleviates neurological symptoms and lipid deposition in a mouse model of Niemann-Pick type C2
Authors: Rasmussen Charlotte Laurfelt Munch , Frederiksen Signe Frost , Heegaard Christian Würtz , Thomsen Maj Schneider , Hede Eva , Laczek Bartosz , Körbelin Jakob , Wüstner Daniel , Thomsen Louiza Bohn , Schwaninger Markus , Jensen Ole N. , Moos Torben , Burkhart Annette
Published: December 2024

Background: Patients with the genetic disorder Niemann-Pick type C2 disease (NP-C2) suffer from lysosomal accumulation of cholesterol causing both systemic and severe neurological symptoms. In a murine NP-C2 model, otherwise successful intravenous Niemann-Pick C2 protein (NPC2) replacement therapy fails to alleviate progressive neurodegeneration as infused NPC2 cannot cross the blood-brain barrier (BBB). Genetic modification of brain endothelial cells (BECs) is thought to enable secretion of recombinant proteins thereby overcoming the restrictions of the BBB. We hypothesized that an adeno-associated virus (AAV-BR1) encoding the Npc2gene could cure neurological symptoms in Npc2-/- mice through transduction of BECs, and possibly neurons via viral passage across the BBB.
Methods: Six weeks old Npc2-/- mice were intravenously injected with the AAV-BR1-NPC2 vector. Composite phenotype scores and behavioral tests were assessed for the following six weeks and visually documented. Post-mortem analyses included gene expression analyses, verification of neurodegeneration in Purkinje cells, determination of NPC2 transduction in the CNS, assessment of neuroinflammation, quantification of gangliosides and co-detection of cholesterol with NPC2 in degenerating neurons.
Results: Treatment with the AAV-BR1-NPC2 vector improved motor functions, reduced neocortical inflammation, and preserved Purkinje cells in most of the mice, referred to as high-responders. The vector exerted tropism for BECs and neurons resulting in a widespread NPC2 distribution in the brain with a concomitant reduction of cholesterol in adjacent neurons, presumably not transduced by the vector. Mass spectrometry imaging revealed distinct lipid alterations in the brains of Npc2-/- mice, with increased GM2 and GM3 ganglioside accumulation in the cerebellum and hippocampus. AAV-BR1-NPC2 treatment partially normalized these ganglioside distributions in high responders, including restoration of lipid profiles towards those of Npc2+/+ controls.
Conclusion: The data suggests cross-correcting gene therapy to the brain via delivery of NPC2 from BECs and neurons.
Utilizing Geospatial Tools for Assessing Climate Change Vulnerability: A Case Study of the Ratnapura District, Sri Lanka
Authors: Piyasena N. M.P.M. , Bandara S.M.G.Lekana
Published: December 2024

This study utilizes geospatial tools to assess the climate change vulnerability of the Ratnapura District, Sri Lanka, by examining three key dimensions: exposure, sensitivity, and adaptive capacity. Ratnapura is particularly prone to climate-related hazards, such as floods, landslides, and droughts, which pose significant threats to its socio-economic stability and environmental health. The assessment employs historical climate data and geographic information to develop exposure maps, while sensitivity is evaluated through an analysis of socio-economic and environmental conditions. Adaptive capacity is measured by examining local institutional frameworks and resource availability. The findings reveal high vulnerability levels, particularly in the Ratnapura and Kalawana Divisional Secretariat (DS) divisions, highlighting the urgent need for targeted adaptation strategies. This study demonstrates the effectiveness of geospatial analysis tools in conducting comprehensive climate vulnerability assessments, providing valuable insights for developing climate-sensitive policies and enhancing disaster risk reduction efforts. The results offer a foundation for local and regional authorities to implement proactive measures to build resilience against climate change impacts.
Smartphone Integration for Physical Sciences: the Readiness of South African Teachers and Learners
Authors: Muyambi Godfrey C. , Nkopodi Nkopodi , Jakovljevic Maria
Published: December 2024

Purpose: Historically, South African learners have struggled in science subjects due to resource limitations, including the high costs of building laboratories, acquiring equipment, and school vandalism. These challenges continue to hinder efforts to improve pass rates in Physical Science. However, the widespread accessibility of smartphones presents an opportunity to address these deficiencies.
This multiple case study examines the readiness of teachers and learners to integrate smartphones into Physical Science education. The objectives were to assess and compare both groups' preparedness to adopt smartphones as an instructional tool.
Methodology: A sequential mixed-methods approach was employed, using structured questionnaires and semi-structured interviews. The sample included 338 learners from grades 10, 11, and 12, and nine teachers from three purposefully selected schools. Quantitative data were analysed using descriptive statistics and t-tests, while qualitative data were manually coded, categorised and thematically analysed.
Findings: Despite challenges such as financial costs, inconsistent internet access, and concerns about teacher displacement, Smartphones received 66.7% of teachers' and 66.3% of learners' support in Physical Science learning, with calls for structured oversight and training. The findings reveal some consensus among teachers and learners that smartphones, when carefully integrated, can enhance Physical Science learning.
Novelty: This study provides a novel contribution by evaluating the readiness of both teachers and learners, highlighting smartphones’ potential to bridge resource gaps. It also emphasises the importance of considering stakeholders' perceptions in this integration.
Significance: The findings hold significant implications for science education policy, teacher training, and strategic planning, offering a practical solution for improving science outcomes in resource-constrained environments.
Laparascopic Assisted Approach to a Right Pelvi-ureteric Junction Obstruction With Incomplete Duplex System. A Case Report”
Authors: Jumbi Tim , Munyalo Syovata , Shipapa David , Marete Brian , Okebe Sarah
Published: December 2024

Introduction The concurrence of PUJO and duplicated systems is rare and more so when associated with a crossing vessel. Management is dependent on the variant anatomy based on imaging and intra-operative findings. The use of laparoscopic assisted technique can be employed with extracorporeal suturing in limited resource settings where intracorporeal suturing would increase operative time and would require a higher level of skill and experience. Case Presentation. A 6-year-old female presented with a prolonged history of right flank pain. Imaging revealed right hydronephrosis with impaired drainage on diuretic renography. Intra-operatively, an incomplete right duplex system was found with a lower pole crossing vessel causing extrinsic obstruction to both upper and lower moieties. A laparoscopic assisted technique with extra-corporeal suturing was used to perform an upper pole ureter to lower pole pyeloplasty and lower moiety Anderson Hynes pyeloplasty. The patient was followed up with complete resolution of symptoms at 3 months and 6 months post operatively. Conclusion. Surgical decision-making on Duplex systems with PUJO is based on imaging detail and intra-op dissection of the anatomic variants. A laparoscopic assisted technique has the advantage of reducing operative time by extracorporeal suturing and the benefit of laparoscopic dissection which offers adequate exposure.
Association between daily sitting time as well as vigorous activity and cardiovascular disease based on the National Health and Nutrition Examination Survey（NHANES）2007–2018: a cross-sectional study
Authors: Guo Zi-tong , Cheng Hui , Fu Wen-bo , Liu Yong , Naman Tuersunjiang
Published: December 2024

Objective
This study aimed to examine the correlation of sitting time with cardiovascular disease (CVD) risk and to elucidate whether vigorous activity can reduce the risk of CVDs.
Method
A large, cross-sectional study was carried out with the National Health and Nutrition Examination Survey database 2007–2018 derived data. Meanwhile, daily sitting time, CVD history, and vigorous activity in daily life were retrieved based on 24-h recall interviews and questionnaires, whereas to investigate the correlation, subgroup and logistic regression analyses were performed. For stratifying analysis, vigorous recreational activity was employed.
Results
A total of 29622 participants aged ≥ 20 years who had sufficient data were enrolled in the present study. The total prevalence of CVD was 12.7%. In overall and non-vigorous recreational activity participants, the prevalence of CVD increased with the elevation of a daily sitting time (P<0.001). Nonetheless, such a trend could not be detected among patients taking vigorous recreational activity (P>0.05). Moreover, the risk of CVDs is dramatically reduced by vigorous activity (P<0.001).
Conclusion
According to our findings, the prevalence of CVDs increases as daily sitting time elevates in overall participants especially those not having vigorous activity. Vigorous recreational activity may balance the risk of CVDs, which is because of prolonged daily sitting time.
Orthobiologic Injections for the Treatment of Hip Osteoarthritis and the Minimal Clinically Important Difference
Authors: Boffa Angelo , Franceschini Marco , Martino Alessandro Di , Mazzotta Alessandro , Dallari Dante , Zaffagnini Stefano , Filardo Giuseppe
Published: December 2024

Purpose: The Minimal Clinically Important Difference (MCID) is important to assess the clinical relevance of treatment results. The aim of this study was to establish the MCID values for VAS, WOMAC, and HHS scores in patients treated with intra-articular orthobiologic injections for hip osteoarthritis (OA).
Methods: Ninety-six patients (62.5% men, 37.5% women, 48.3 ± 12.0 years old) affected by hip OA and treated with orthobiologic injections were assessed through VAS for pain, WOMAC, and HHS scores at baseline and at 6 and 12 months after the injection. MCID values were calculated for each score at both follow-ups. Baseline variables, including age, sex, and Tonnis grade, were collected to investigate their possible influence on the improvement in terms of MCID achievement rate.
Results: The MCID values obtained in the current study were 10.1, 6.6, and 6, respectively for VAS pain, WOMAC, and HHS at 6 months after the injective treatment. Overall, these thresholds remained stable from 6 to 12 months of follow-up, being 10.2, 7.7, and 6.3, respectively. While an overall statistical improvement was documented for all scores, most patients did not reach clinically relevant benefits according to the identified MCID. Low OA grade and female patients were found to reach more likely the MCID.
Conclusion: This study defined the MCID thresholds ​​for VAS pain, WOMAC score, and HHS for patients affected by hip OA treated with orthobiologic injections. This can help clinicians interpreting the outcome obtained with injective treatments beyond the statistical difference and in light of clinically relevant benefits for patients.
Characterization of the intestinal microorganism in patients with congenital intestinal atresia: the exploration for establishment and influence of initial intestinal flora in newborns
Authors: Chen Yang , Zhou Ling , Liao Qianghui , Xiao Dong , Zhu Ledao , Yao Jinlong , Liu Jiashu , Zhang Xu'ning , Ma Xiaopeng , Ren Feng , Wang Zhiyong
Published: December 2024

Purpose The mechanism of initial establishment of neonatal intestinal flora was investigated by the analyzing the characteristics of microflora differences in the proximal and distal intestinal bowels of newborns with intestinal atresia. Meanwhile, the differential metabolic pathways were applied to function prediction on potential effects for the gravidas and fetus.
Method The microecological characteristics of intestinal flora were extracted by 16SrRNA sequencing technology. Then, the α and β diversity describing the composition of the microflora were compared between three groups. Furthermore, PCoA was applied to identify and quantify the differential microflora among samples. Finally, PICRUSt software was used to explore possible potential impacts due to differential metabolic pathways of the flora through comparison with public databases.
Result In this study, samples from 23 proximal and distal intestinal atresia as well as the first meconium from 25 normal neonates were collected according to the selection criteria. There was no significant difference in baseline information between control and intestinal atresia groups (P>0.05). The α-diversity analysis indicated that there were more flora species in the control group, the distal group showed more complex colony structure, but the proximal group showed the lowest species and diversity. While the β-diversity analysis suggested that there was a significant difference in the bacterial structure between the control group and the distal bowel group (P<0.05), and the difference in the bacterial structure between the distal bowel group and the normal control group was significantly higher compared to the proximal bowel group. Then, the functional prediction suggested that the differential metabolic pathway could protect the intestinal mucosal barrier, but it may also have negative effects on the blood glucose control and lipid transport of gravidas and fetuses, and may even bring negative emotions to pregnant women.
Conclusion Statistically different microflora in the three groups suggested that the establishment of neonatal initial flora may results from the combination of intestinal infection through the placenta and colonization through the digestive tract. Subsequently, the differential metabolic pathway was predicted to protect the intestinal tract of children, but it may also interfere with emotional control, the glucose and lipid metabolism.
Statin-intolerant patients are characterized by a decreased muscle quality index independent of lipid lowering therapy
Authors: Vinci Pierandrea , Girolamo Filippo Giorgio Di , Pellicori Federica , Panizon Emiliano , Pirulli Alessia , Tosoni Letizia Maria , Altamura Nicola , Rizzo Stefania , Perin Andrea , Fiotti Nicola , Biolo Gianni
Published: December 2024

Background and aims:
Statin-associated muscle symptoms (SAMS) is a frequent (2–3% of population) side effect of statin therapy, limiting its clinical use and increasing the cardiovascular risk. Its relationship with muscle performance and quality is not completely understood. The aim of our study was to retrospectively compare muscle quality, body composition and lipid profile in dyslipidemic patients according to their tolerance for statins.
Material and Methods
In a secondary level outpatient clinic for hypercholesterolemia, cardiovascular risk factors, body composition, handgrip (as a marker of muscle quality) and lipid profile were analyzed in 148 statin-intolerant (SI) and in 145 sex and age matched statin tolerant (ST) patients in a four-year follow-up.
Results
At baseline, Body Mass Index (BMI), fat mass, cholesterol and triglycerides in SI patients were higher than in ST patients. While, during follow-up, BMI further increased and total and low-density lipoproteins (LDL)-cholesterol remained significantly higher in SI than in ST patients. At the end of the follow-up, BIA-assessed fat mass percentage was higher in SI than in ST. Handgrip absolute value or standardized for BMI, fat free mass and appendicular muscle mass were significantly lower in SI patients (P < 0.001) but, in a sub-analysis, this was confirmed only in their non-dominant arm (P < 0.01 for all arms). Circulating Creatine Kinase (CK) levels were significantly higher in SI patients at baseline (P < 0.001) and decreased during follow-up, but remained higher in those who never restarted statins after re-challenge (0.029).
Conclusion
Statin intolerance is clinically associated with lower muscle quality, particularly in less exercised arms, suggesting a role for physical activity in prevention of muscle deterioration. Circulating muscle enzyme patterns suggests that the effects of SAMS persist also long time after statin discontinuation.
Effect of using a hemostatic gelatin sponge versus a dense polytetrafluorethylene membrane for socket sealing following immediate implant placement. A randomized clinical study
Authors: Shalash Mahmoud , Emara Aalaa
Published: December 2024

Background
Socket sealing following flapless immediate implant placement involves placing a barrier membrane to prevent the ingrowth of bacteria or contaminants to the dental implant during the early phase of healing. Dense polytetrafluoroethylene membranes have been the gold standard socket sealing barrier due to their impermeability to the oral flora, which allows for undisturbed implant healing. The search for a more cost-efficient material, that is easy to handle and apply for sealing the socket without compromising implant osseointegration was sought. This study aims to evaluate the effectiveness of socket sealing after immediate implant placement in the premolar/molar region using a gelatin sponge, as opposed to a dense polytetrafluoroethylene membrane, and its impact on clinical implant osseointegration.
Materials and Methods
The study was conducted on 20 patients, comprising 12 males and 8 females with an age range of 25–60 years. Those meeting the eligibility criteria of immediate implant placement were selected and divided equally into two groups. A control group, where an immediate implant and a dense polytetrafluorethylene membrane was used, and a test group where an immediate implant and a gelatin sponge was used. Exclusion criteria included smokers, presence of systemic or metabolic conditions, or a local pathology that would contraindicate implant placement. Teeth were extracted using a flapless approach. Implants were placed, and sockets were sealed using the allocated barrier. In the control group, the membrane was removed after 4 weeks. For the test group, the gelatin sponge was left to resorb spontaneously. After 4 months, implants were uncovered, and a 30 N/cm reverse torque test was applied to assess the clinical osseointegration.
Results
All implants healed uneventfully, without any radiographic evidence of bone loss. There was no clinical or radiographic difference between the outcomes in the control and the test groups. For the 20 dental implants subjected to a 30 N/cm reverse torque test, clinical integration was observed.
Conclusion
Within the limitations of this study, both dense polytetrafluorethylene membranes and gelatin sponges are effective methods for socket sealing, allowing for successful osseointegration following flapless immediate implant placement in posterior sites, with gelatin sponge offering easier handling and a reduced cost compared to dense polytetrafluorethylene. A larger study sample to verify the outcomes of this study is recommended.
Analysis of Efficacy and Safety of Body Gamma Knife Stereotactic Radiosurgery in Patients with Early- stage Non-small-cell Lung Cancer: A 10-Year Cohort Study
Authors: DENG Xuyan , HU Qilu , LIU Lihua , Kong Dechen , LI Hongqi
Published: December 2024

Introduction: Stereotactic body radiotherapy is frequently used for treating non-operable early-stage non-small cell lung cancer . Body gamma knife stereotactic radiosurgery is a specialized SBRT technique established in China. Here, the long-term efficacy, failure pattern, and toxicity of γ-SRS for initial-phase NSCLC were evaluated through a cohort study, including a 10-year follow-up.
Methods:To conduct this study, 29 patients with initial-phase NSCLC received γ-SRS treatment between 2007 and 2010. The prescribed doses for the Gross Target Volume (GTV), Clinical Target Volume (CTV), and Planning Target Volume (PTV) were 70, 60, and 50 gray (Gy), respectively, administeredin 10 fractions, with the creation of curves for the 50, 60, and 70% isodoses to cover 80, 90, and 100% of the GTV,CTV, and PTV, respectively. Patients underwent CT/PET-CT imaging at one, three, and six months post-treatment, followed by imaging every six months for two years, and later, annual examinations were conducted.
Results:Patients were aged 71 years on average, the mean follow-up was 166 months, overall survival（OS）was 75 months, and the corresponding median progression-free survival (PFS) was 57 months. Moreover, the first, third, fifth, and ten-year OS rates were 93.1, 75.9, 65.5, and 34.9%, while the PFS rates were 86.2, 65.3, 43.6, and 27.7%. Only two patients (6.9%) had grade 3 treatment-associated adverse events（Pneumonia）, while grade 4 or 5 events were not reported.
Conclusion:This study depicted the efficacy of γ-SRS for inoperable early-phase NSCLC patients or those who refused surgery. The primary patterns of failure outcomes were regional relapse and distant metastasis.
A study of the effects of vibration training at different frequencies on lower limb muscle strength in semi-elite short track speed skaters
Authors: Qi Qianrong , Gao Yuanyuan
Published: December 2024

The aim of this study is to examine the impact of lower limb muscle strength in semi-elite athletes engaged in short track speed skating through the lens of different frequency vibration training. The methodology employed in this study is as follows: The study employs an experimental methodology. Subsequent to the screening process, a total of 75 male semi-elite short track speed skaters were selected from the Shenyang Institute of Physical Education. The participants were randomly assigned to one of three groups: a 30 Hz frequency vibration group comprising 25 individuals, a 50 Hz frequency vibration group comprising 25 individuals, and a control group comprising 25 individuals. The experimental group underwent the intervention on two occasions per week, with three groups participating on each occasion. The total duration of the intervention was four weeks, with an amplitude of 2mm. Each session comprised 30 seconds of whole-body vibration training. The control group comprised 25 individuals who performed the same duration and posture of semi-squatting movement on the vibration platform, but without additional vibration stimulation. The maximum strength, rapid strength, and strength endurance of the knee flexors and extensors during centripetal contraction were evaluated both before and after the intervention. The results are presented in the following manner: (1) Maximum power: the peak moments of the knee flexor and extensor muscle groups of both legs of the subjects exhibited a notable enhancement in comparison to the values observed prior to the training period (P < 0.01). The vibration frequency of 50 Hz demonstrated a more pronounced impact on the improvement of the peak moments of the knee flexor muscle groups on both sides. (2) Rapid power: the 50Hz vibration frequency was observed to have a more significant enhancement effect on the peak power of the bilateral knee flexor muscle groups and the left knee extensor muscle groups (P < 0.05). (3) Muscular endurance: a significant difference was observed in the total work of the subjects' bilateral knee flexor and extensor muscle groups with different frequencies of vibration stimulation (P < 0.05), with a highly significant difference noted in the total work of the left knee flexor muscle group (P < 0.01). It can be concluded that four weeks of vibration training at different frequencies can significantly improve the muscle strength of the knee joints in semi-elite short track speed skaters. Furthermore, the results demonstrate that a vibration frequency of 50 Hz is more effective than 30 Hz in terms of maximal and rapid strength when the amplitude is 2 mm.
Scalable Reinforcement Learning for Large-Scale Coordination of Electric Vehicles Using Graph Neural Networks
Authors: Orfanoudakis Stavros , Robu Valentin , Duque Edgar Mauricio Salazar , Palensky Peter , Vergara Pedro
Published: December 2024

As the adoption of electric vehicles (EVs) accelerates, addressing the challenges of large-scale, city-wide optimization becomes critical to ensuring efficient use of charging infrastructure and maintaining electrical grid stability. This study introduces EV-GNN, a novel graph-based solution that addresses scalability challenges and captures uncertainties in EV behavior from a Charging Point Operator's (CPO) perspective. We prove that EV-GNN enhances classic RL algorithms' scalability and sample efficiency by combining an end-to-end Graph Neural Network (GNN) architecture with Reinforcement Learning (RL) and employing a branch pruning technique. We further demonstrate that the proposed architecture's flexibility allows it to be combined with most state-of-the-art deep RL algorithms to solve a wide range of problems, including those with continuous, multi-discrete, and discrete action spaces. Extensive experimental evaluations show that EV-GNN significantly outperforms state-of-the-art RL algorithms in scalability and generalization across diverse EV charging scenarios, delivering notable improvements in both small- and large-scale problems.
Tumor-derived exosomal miR-21-5p mediates lung fibroblasts activation via TNFAIP3/NF-kB signaling to promote non-small cell lung cancer cell migration and invasion
Authors: Fan Youqiang , Hao Jingduo , Cen Xueying , Song Kun , Yang Chunbo , Xiao Shengwen , Cheng Siming
Published: December 2024

MicroRNAs (miRNAs) have been recognized as significant mediators in non-small cell lung cancer (NSCLC). However, their particular effects on NSCLC remain largely unknown. In addition, fibroblasts are essential components of the tumor microenvironment (TME) and play significant roles in tumor development. It has been also reported that exosomes can mediate the communication between tumor cells and fibroblasts in TME. However, the role of extracellular miR-21 in the intercellular communication of tumor cells and fibroblasts remains elusive. The differentially expressed miRNAs between NSCLC and normal tissues were identified by screening the Gene Expression Omnibus (dataset, GSE63805) and The Cancer Genome Atlas databases using R language software. The bioinformatics analysis results showed that compared with normal tissues, miR-21-5p was upregulated in lung cancer tissues, while the increased expression levels of miR-21-5p were associated with worse survival rate in patients with NSCLC. Additionally, exosomes could deliver miR-21-5p from NSCLC cells to lung fibroblasts, thus enhancing the levels of miR-21-5p in fibroblasts. Furthermore, the results demonstrated that tumor necrosis factor α induced protein 3 (TNFAIP3) was a direct target of miR-21-5p in NSCLC cells. These results suggested that exosomal miR-21-5p derived from NSCLC cells could activate lung fibroblasts via targeting TNFAIP3-mediated nuclear factor κB (NF-κB) signaling. Most importantly, exosomal miR-21-5p could facilitate fibroblast activation, which in turn could enhance the migration and epithelial-mesenchymal transition of NSCLC cells. Overall, the findings of the present study revealed that NSCLC cell-derived exosomal miR-21-5p could mediate lung fibroblast activation via the TNFAIP3/NF-kB signaling pathway to promote NSCLC cell migration and invasion. Therefore, targeting exosomal miR-21-5p could provide a potential strategy for the prevention and treatment of NSCLC.
Association between Composite Dietary Antioxidant Index and cataract: a new insight from a cross-sectional study
Authors: Liu Xuefen , Wei Daheng , Hao Haitao , Wang Shuxia , Ding Guanyu , Liu Jiashun , Liu Hua
Published: December 2024

Objectives Growing evidence suggests that elevated CDAI may confer protection against various health conditions, despite the extensive examination of the association between the composite dietary antioxidant index (CDAI), an essential metric of antioxidant intake, and the risk of chronic diseases. However, the correlation between CDAI and the likelihood of age-related cataracts is inadequately characterized. To address this gap, we performed a cross-sectional investigation to evaluate a potential link between CDAI and cataract occurrence. Method The National Health and Nutrition Examination Survey (NHANES), which ran from 2005 to 2008, provided the data for this investigation. We evaluated dietary antioxidants using two 24-hour food recall interviews. To derive CDAI, we concentrated on six specific antioxidants. Based on a history of cataract surgery, we indirectly evaluated age-related cataracts. Logistic regression models were utilized to analyze the correlation between CDAI and cataract risk. Additionally, we investigated nonlinear relationships using curve-fitting methods and performed subgroup analyses to evaluate potential effect modifications. Results This research included 8,582 participants, of whom 5,296 were free of cataracts and 2,881 were diagnosed with cataracts. Compared with normal subjects, the CDAI of cataract patients was lower (-0.32 ± 3.47) (p < 0.001). In multivariate logistic regression, CDAI as a continued variable was inversely correlated with cataract risk [0.95 (00.93–0.97), p < 0.0001]. We looked at CDAI as a categorical variable and discovered that people in Q3 had a much lower risk of cataracts than people in Q1. For each unit increase in CDAI, cataract risk decreased by 15% [0.85(0.72–0.99), p = 0.039]. Subgroup analyses and interaction tests showed that factors like age, sex, level of education, marital status, tobacco use, alcohol consumption, hypertension, hyperlipidemia, and diabetic mellitus did not significantly change the negative relationship between CDAI and cataracts. Conclusions The inverse relationship between the CDAI and cataract risk persisted even after controlling for other possible factors. This suggests that eating a diet rich in antioxidants may reduce the risk of cataract.
Elimination of highly multidrug-resistant wound bacteria by the lactic acid bacterial drug candidate ILP100
Authors: -Tomenius Hava Lofton , Pang Yanhong , Pallin Anton , Myktybekova Zhanar , Lelham Ninus , Riesbeck Kristian , Vågesjö Evelina , Roos Stefan , Phillipson Mia Mia
Published: December 2024

The rise and spread of antibiotic resistance poses a global threat, further exacerbated by geopolitical conflicts. Limosilactobacillus reuteri genetically modified to produce human CXCL12 (ILP100) has previously been shown to accelerate wound healing. Here, we report that ILP100 has potent bactericidal effects against MDR wound pathogens isolated from Ukrainian war victims, suggesting ILP100 as an important therapeutic alternative for eradication of MDR infections, while shortening the time to fully healed.
Giant chlorine isotope effect of ion-molecule reaction
Authors: Tian Shan , Zhi Yaya , Hu Jie , Xie Jingchen , Wu Chun-Xiao
Published: December 2024

Isotope substitution profoundly influences chemical reactions, signifying different reaction rates due to mass-related nuclear quantum effects. Due to the smaller mass-difference ratio, heavy-atom isotope effect is usually much weaker than the hydrogen/deuterium effect, which has been the underlying principle for chemical isotope labelling, a prevailing technique of environmental assessments. Here we report a giant chlorine (35,37Cl) isotope effect of the collisional reactions between iso-dichloroethylene (naturally comprising 35,37Cl-isotopologues) and argon ion. As a grave challenge to conventional understandings, we find that the isotopic signature δ37Cl of the dehydrochlorination channel is one thousand times larger than the regular values, namely, an extraordinary priority of the product C2H37Cl+. Hydrogen-atom scrambling and roaming assisted 35Cl-elimination mechanisms are proposed for this unprecedentedly strong isotope effect. Our finding adds a new dimension of isotope effects and enlightens related methodological renovations of environmental assessment.
WITHDRAWN: Investigation of Factors Affecting Digital Game Addiction in 10-14 Age Group Children
Authors: Güler Funda , Gün Canan Sümeyra , Yıldırım Öznur , Çalışır Hüsniye
Published: December 2024

The full text of this preprint has been withdrawn, as it was submitted in error. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Damage evolution mechanism of aluminum alloy stiffened cylinders during flow forming
Authors: Meng Yehui , Yu Zhongqi , Wang Fengqi
Published: December 2024

Fracture is one of typical defects for complex stiffened cylinders during flow forming. The introduction of complex structures makes fracture prediction challenging. This study aims to assess the forming limits of stiffened cylinders during flow forming, alongside the selection of appropriate prediction models. Therefore, a spinnability method was proposed to evaluate the formability of stiffened cylinders and its corresponding finite element model was developed. The results show that cracks initiated at the stiffener downstream fillet in flow forming of AA6061-T6 stiffener cylinders, and then developed along the circumferential direction due to significant axial tensile stresses. Four typical uncoupled damage models were incorporated into the finite element model to simulate the damage evolution in spinnability tests of stiffened cylinders. The prediction results show that all selected models demonstrated an ability to correctly predict the location of cracking, but H-C model offers the most accurate predictions in spinnability tests of AA 6061-T6 stiffened cylinders. These approaches can provide an evaluation method for flow spinning process design of stiffened cylinders.
Fuzzy Mixed Method for Sustainability Assessment of Independent Smallholders’ Oil Palm Plantation Business
Authors: Safriyana Safriyana
Published: December 2024

In terms of productivity and economic benefits, oil palm plantations, particularly those managed by independent smallholders, exhibit rapid development. The urgency of addressing the oil palm plantation sector is highlighted by the disparities in quality and productivity experienced by independent smallholders. Additionally, sustainability issues are crucial due to market concerns about agricultural practices and certification requirements, which demand continuous traceability. The research objectives aimed to model sustainability evaluation using the Indonesian Sustainable Palm Oil (ISPO) standard as the national benchmark. This study designed an adaptive assessment and improvement model specifically for independent smallholders. The methodology included (1) a multidimensional scaling (MDS) analysis to evaluate sustainability performance and (2) an adaptive neuro-fuzzy inference system (ANFIS) to integrate the overall sustainability index. Nineteen indicators of sustainability were categorized into six dimensions: environmental, economic, social, technological, policy, and institutional. The results indicated the following sustainability levels for the independent smallholder plantations: 39.54% for environmental, 43.21% for economic, 42.82% for social, 42.93% for technological, 42.17% for policy, and 41.66% for institutional dimensions. The aggregated sustainability index showed an overall sustainability rate of 42.09%, reflecting a less sustainable condition. Recommendations for improving sustainability are provided based on the specific indicators evaluated.
UBE2T promotes PTC progression by activating the JAK/STAT3 pathway via negative regulation of SOCS2
Authors: Zhang Lijun , Li Chengyuan , Zhou Jianing , Li Lin , Zhang Xiang , Fang Haisheng , Cai Jingsheng , Tong Houchao , Wen Jianfei , Zhang Heda , Shen Meiping , Si Yan
Published: December 2024

Background
Thyroid cancer, particularly papillary thyroid carcinoma (PTC), is one of the most common malignant tumors of the endocrine system. Malignant biological behaviors such as tumor invasion and cervical lymph node metastasis are closely associated with the prognosis of PTC. To date, no effective method has been identified to accurately predict the invasive biological behavior of PTC.
Objective
This study aims to investigate the potential molecular mechanisms underlying the high invasiveness of PTC mediated by UBE2T.
Methods
We examined the expression of UBE2T in PTC using data from the TCGA and GEO databases and validated these findings in clinical samples from our institution, analyzing clinical pathological features. Subsequently, we explored the impact of UBE2T on the biological behavior of PTC cells through stable overexpression or knockdown of the UBE2T gene. Additionally, we elucidated the potential mechanisms by which UBE2T promotes PTC progression, with a particular focus on its role in activating the JAK-STAT signaling pathway.
Results
Our results demonstrate that UBE2T plays a crucial role in promoting PTC progression by activating the JAK-STAT signaling pathway. Correlation analysis and co-immunoprecipitation (co-IP) experiments identified cytokine signaling suppressor 2 (SOCS2) as a key molecule mediating UBE2T's action in the JAK-STAT pathway. Further rescue experiments and immunofluorescence (IF) assays confirmed that UBE2T promotes PTC progression by negatively regulating SOCS2, thereby activating the JAK-STAT3 pathway.
Conclusion
This study reveals the mechanistic role of UBE2T in the high invasiveness of PTC, highlighting its negative regulation of SOCS2 to activate the JAK-STAT3 signaling pathway and drive PTC progression. These findings provide new insights into the mechanisms of PTC invasion and may offer potential therapeutic targets for inhibiting PTC metastasis and recurrence.
Role of AMPK/ACC/SREBP-1 and MAPK Pathways in Glucose Intolerance and Liver Dysfunction of Largemouth Bass
Authors: liao zhihong , he xuanshu , gu xinyu , ye tao , chen anqi , guo yucai , zhao wei , Niu Jin
Published: December 2024

Background and Objectives Largemouth bass (Micropterus salmoides), a carnivorous fish, struggles to process dietary carbohydrates, often resulting in energy metabolism issues and fatty liver disease. This study explored the liver glycolipid accumulation and mitochondrial dysfunction in both largemouth bass and primary hepatocytes treated with high glucose.Methods An 8-week feeding experiment was conducted to evaluated the effects of high carbohydrate (HC) diet on liver morphology, fatty acid metabolism, bile acid metabolism, and MAPK signaling pathways in largemouth bass. Primary hepatocytes were treated with high-glucose (HG) medium to simulate the conditions of high carbohydrate feeding to further evaluated the effects of high-glucose treatment on cell growth, ROS production, antioxidant capacity, mitochondrial fusion, fission, mitophagy and mitochondrial apoptosis.Results The results showed that the HC diet significantly increased the hepatosomatic and visceral somatic indices, causing liver enlargement, mitochondrial damage, and glycolipid buildup. Compared to a control diet, the HC diet enhanced lipid synthesis through the AMPK/ACC/SREBP-1 pathway and increased the phosphorylation levels of ERK, JNK and p38 MAPK, while it decreased bile acid synthesis by downregulating cholesterol 7-hydroxylase (CYP7A1) and sterol 12-hydroxylase (CYP8B1). In vitro experiments showed that high glucose (HG) treatment in primary hepatocytes inhibited cell growth, promoted apoptosis, increased reactive oxygen species (ROS), and reduced antioxidant capacity. Mechanistically, HG treatment led to mitochondrial fission and damage. Damaged mitochondria bind to autophagosomes for lysosomal degradation, resulting in mitochondrion-dependent apoptosis by regulating p38 MAPK/BCL-2/CAS3 signaling pathway.Conclusions High glucose could not only induce accumulation of lipid and glycogen mediated by the AMPK/ACC/SREBP-1 signaling pathway, but could activate p38MAPK-mediated signaling to induce mitochondrial apoptosis.