bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of a Virtual Fracture Care review protocol on secondary healthcare utilization in trauma patients requiring semi-acute surgery: a retrospective cohort study
Authors: Willinge G. J. A. , Spierings J. F. , Geerdink T. H. , Twigt B. A. , Goslings J. C. , van Veen R. N.
Published: June 2024

Purpose

The demand for trauma care in the Netherlands is increasing due to a rising incidence of injuries. To provide adequate trauma care amidst this increasing pressure, a Virtual Fracture Care (VFC) review protocol was introduced for treatment of musculoskeletal injuries to the extremities (MIE). This study aimed to assess the influence of the Dutch VFC review protocol on secondary healthcare utilization (i.e., follow-up appointments and imaging) in adult trauma patients (aged ≥18 years) who underwent semi-acute surgery (2–14 days after initial presentation) for MIE, compared to traditional workflows. We hypothesized utilization of VFC review would lead to reduced secondary healthcare utilization.

Methods

This retrospective cohort study assessed the influence of VFC review on secondary healthcare utilization in adult trauma patients (aged ≥18 years) who underwent semi-acute surgery for a MIE. Patients treated before VFC review and the COVID-19 pandemic, from 1st of July 2018 to 31st of December 2019, formed a pre-VFC group. Patients treated after VFC review implementation from January 1st 2021 to June 30th 2022, partially during and after the COVID-19 pandemic (including distancing measures), formed a VFC group. Outcomes were follow-up appointments, radiographic imaging, time to surgery, emergency department reattendances, and complications. The study was approved by the local ethical research committee approved this study (WO 23.073).

Results

In total, 2,682 patients were included, consisting of 1,277 pre-VFC patients, and 1,405 VFC patients. Following VFC review, the total number of follow-up appointments reduced by 21% and a shift from face-to-face towards telephone consultations occurred with 19% of follow-up appointments performed by telephone in the VFC group vs. 4% in the pre-VFC group. Additionally, VFC review resulted in a 7% reduction of radiographs, improved time scheduling of surgery, and a 56% reduction of emergency department reattendances. Registered complication rates remained similar.

Conclusion

The utilization of VFC review for management of adult patients with a MIE requiring semi-acute surgery improves efficiency compared to traditional workflows. It results in a 21% follow-up appointment reduction, a shift from face-to-face to remote delivery of care, fewer radiographs, improved time scheduling of surgery, and reduces emergency department reattendances by 56%.
Energy expenditure estimation during activities of daily living in middle-aged and older adults using an accelerometer integrated into a hearing aid
Authors: Stutz Jan , Eichenberger Philipp A. , Stumpf Nina , Knobel Samuel E. J. , Herbert Nicholas C. , Hirzel Isabel , Huber Sacha , Oetiker Chiara , Urry Emily , Lambercy Olivier , Spengler Christina M.
Published: June 2024

Background

Accelerometers were traditionally worn on the hip to estimate energy expenditure (EE) during physical activity but are increasingly replaced by products worn on the wrist to enhance wear compliance, despite potential compromises in EE estimation accuracy. In the older population, where the prevalence of hearing loss is higher, a new, integrated option may arise. Thus, this study aimed to investigate the accuracy and precision of EE estimates using an accelerometer integrated into a hearing aid and compare its performance with sensors simultaneously worn on the wrist and hip.

Methods

Sixty middle-aged to older adults (average age 64.0 ± 8.0 years, 48% female) participated. They performed a 20-min resting energy expenditure measurement (after overnight fast) followed by a standardized breakfast and 13 different activities of daily living, 12 of them were individually selected from a set of 35 activities, ranging from sedentary and low intensity to more dynamic and physically demanding activities. Using indirect calorimetry as a reference for the metabolic equivalent of task (MET), we compared the EE estimations made using a hearing aid integrated device (Audéo) against those of a research device worn on the hip (ZurichMove) and consumer devices positioned on the wrist (Garmin and Fitbit). Class-estimated and class-known models were used to evaluate the accuracy and precision of EE estimates via Bland-Altman analyses.

Results

The findings reveal a mean bias and 95% limit of agreement for Audéo (class-estimated model) of −0.23 ± 3.33 METs, indicating a slight advantage over wrist-worn consumer devices (Garmin: −0.64 ± 3.53 METs and Fitbit: −0.67 ± 3.40 METs). Class-know models reveal a comparable performance between Audéo (−0.21 ± 2.51 METs) and ZurichMove (−0.13 ± 2.49 METs). Sub-analyses show substantial variability in accuracy for different activities and good accuracy when activities are averaged over a typical day's usage of 10 h (+61 ± 302 kcal).

Discussion

This study shows the potential of hearing aid-integrated accelerometers in accurately estimating EE across a wide range of activities in the target demographic, while also highlighting the necessity for ongoing optimization efforts considering precision limitations observed across both consumer and research devices.
Facilitators and barriers to the implementation of the picture exchange communication system (PECS): a systematic review
Authors: Paris Andreas , Denne Louise D. , Grindle Corinna F. , May Richard , Apanasionok Magdalena M. , Hastings Richard P.
Published: June 2024

Background and aims

Although there are several published systematic reviews and meta-analyses of the effectiveness of the Picture Exchange Communication System (PECS) protocol, no previous review has focused on factors affecting its implementation. The present review attempted to identify potential barriers and facilitators in implementing PECS, as well as examining authors’ and stakeholders’ views and experiences in terms of implementation.

Methods and procedures

A total of 49 studies were identified through a systematic review search process and were included in the data extraction phase. A Content Analysis of previous researchers’ comments was also carried out.

Outcome and results

During the data extraction and synthesis phase, it became evident that important features of PECS interventions are not systematically reported in published literature. Thus, our primary research question remained partially unanswered. A Content Analysis of previous researchers’ comments revealed four potential implementation factors, including Contextual & Environmental Factors, PECS Training/Consultation, Supervision and Implementation Fidelity and Adherence to the Protocol.

Conclusions and implications

The identification of potential barriers or facilitators affecting the implementation of PECS is not currently possible. The present review’s identified implementation factors were extracted from qualitative analysis of previous researchers’ anecdotal remarks or from the social validity measures. Implications in terms of previous PECS literature findings are discussed.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018099767.
Combining CEUS and ultrasound parameters in thyroid nodule and cancer diagnosis: a TIRADS-based evaluation
Authors: Borlea Andreea , Moisa-Luca Luciana , Popescu Alina , Bende Felix , Stoian Dana
Published: June 2024

Contrast-enhanced ultrasonography (CEUS) has been established as a diagnostic tool for assessing microvascularization, essential for understanding angiogenesis in neoplastic development. Aim: This study assesses the effectiveness of CEUS as a supplementary tool to TIRADS in enhancing the ultrasound-based diagnosis of thyroid cancer. Methods and Materials: Over one year, 157 nodules in 133 patients, with predominantly solid thyroid nodules, were examined using ultrasound and CEUS and underwent thyroidectomy, allowing for a comparison of ultrasound findings with pathological reports. Results: Thyroid cancer was identified in 31.21% (49/157) of cases. Significant CEUS high-risk features included inhomogeneous enhancement, enhancement defects, and complete hypoenhancement (AUC 0.818, 0.767, 0.864 respectively). Nodules exhibiting any of these features were classified as high-risk in CEUS. The diagnostic performance of TIRADS improved when combined with CEUS, with AUC increasing from 0.707 to 0.840 and improved sensitivity. Conclusion: The integration of CEUS with TIRADS significantly enhances the diagnostic accuracy and specificity in identifying thyroid cancer. This combination proves to be a more effective method for risk stratification and diagnosis, highlighting the value of CEUS as an adjunctive tool in thyroid cancer evaluation.
Assessing causal associations of blood counts and biochemical indicators with pulmonary arterial hypertension: a Mendelian randomization study and results from national health and nutrition examination survey 2003–2018
Authors: Liu Zhekang , Fu Qingan , Yu Qingyun , Ma Xiaowei , Yang Renqiang
Published: June 2024

Background

Blood counts and biochemical markers are among the most common tests performed in hospitals and most readily accepted by patients, and are widely regarded as reliable biomarkers in the literature. The aim of this study was to assess the causal relationship between blood counts, biochemical indicators and pulmonary arterial hypertension (PAH).

Methods

A two-sample Mendelian randomization (MR) analysis was performed to assess the causal relationship between blood counts and biochemical indicators with PAH. The genome-wide association study (GWAS) for blood counts and biochemical indicators were obtained from the UK Biobank (UKBB), while the GWAS for PAH were sourced from the FinnGen Biobank. Inverse variance weighting (IVW) was used as the primary analysis method, supplemented by three sensitivity analyses to assess the robustness of the results. And we conducted an observational study using data from National Health and Nutrition Examination Survey (NHANES) 2003–2018 to verify the relationship.

Results

The MR analysis primarily using the IVW method revealed genetic variants of platelet count (OR=2.51, 95% CI 1.56-4.22, P<0.001), platelet crit(OR=1.87, 95% CI1.17-7.65, P=0.022), direct bilirubin (DBIL)(OR=1.71, 95%CI 1.18-2.47,P=0.004), insulin-like growth factor (IGF-1)(OR=0.51, 95% CI 0.27-0.96, P=0.038), Lipoprotein A (Lp(a))(OR=0.66, 95% CI 0.45-0.98, P=0.037) and total bilirubin (TBIL)(OR=0.51, 95% CI 0.27-0.96, P=0.038) were significantly associated with PAH. In NHANES, multivariate logistic regression analyses revealed a significant positive correlation between platelet count and volume and the risk of PAH, and a significant negative correlation between total bilirubin and PAH.

Conclusion

Our study reveals a causal relationship between blood counts, biochemical indicators and pulmonary arterial hypertension. These findings offer novel insights into the etiology and pathological mechanisms of PAH, and emphasizes the important value of these markers as potential targets for the prevention and treatment of PAH.
Prediction of photovoltaic power generation based on a hybrid model
Authors: Zhang Xiaohua , Wu Yuping , Wang Yu , Lv Zhirui , Huang Bin , Yuan Jingzhong , Yang Jingyu , Ma Xinsheng , Li Changyuan , Zhang Lianchao
Published: June 2024

In order to fully exploit the relationship between temporal features in photovoltaic power generation data and improve the prediction accuracy of photovoltaic power generation, a photovoltaic power generation forecasting method is proposed based on a hybrid model of the convolutional neural network (CNN) and extreme gradient boost (XGBoost). Taking the historical data of China’s photovoltaic power plants as a sample, the high-dimensional mapping relationship of photovoltaic power generation variables is extracted based on the convolutional layer and pooling layer of the CNN network to construct a high-dimensional time-series feature vector, which is an input for the XGBoost. A photovoltaic power generation prediction model is established based on CNN-XGBoost by training CNN and XGBoost parameters. Since it is difficult for a single model to achieve optimal prediction accuracy under different weather conditions, the k-means clustering algorithm is used to group the power datasets and train independent models to improve prediction accuracy. Through the actual data verification of photovoltaic power plants, the proposed photovoltaic power generation prediction model can accurately predict the power, which shows high prediction accuracy and generalization ability compared with other methods.
Global diversity and biogeography of Lyophyllum inferred from amplicon datasets
Authors: Wei Shuwei , Qi Bao , Zhang Xiaozhuo , Peng Zhanwu , Li Yu , Wang Qi
Published: June 2024

Lyophyllum consists of rare edible and medicinal mushrooms. Considering this group’s economic and ecological significance, understanding its biodiversity could be strategically important. Our analysis involved an extensive examination of publicly available ITS sequences from NCBI-GenBank and fungal amplicon sequencing data obtained from NCBI-SRA. At a 98% sequence similarity level, we deliminated 88 Lyophyllum OTUs, 49 of which were not categorized as ‘known species’. The diversity of Lyophyllum is predominantly concentrated in the Northern Hemisphere and tends to display endemic distribution, and Europe is particularly notable for its high diversity of Lyophyllum. Given the escalating volume of data produced by amplicon sequencing, employing the amplicon dataset can facilitate an accurate survey of species diversity in Lyophyllum taxonomy. By using data from amplicon datasets, the fieldwork time and research funding for taxonomists can be saved, thereby significantly advancing the progress of the entire field of biodiversity research.
Estimation of biomass in various components of Pinus koraiensis based on Bayesian methods
Authors: Liu Hui , Dong Xibin , Zhang Ying , Qu Hangfeng , Ren Yunze , Zhang Baoshan , Gao Tong
Published: June 2024

Introduction

Pinus koraiensis is a dominant tree species in northeastern China. Estimating its biomass is required for forest carbon stock monitoring and accounting.

Methods

This study investigates biomass estimation methods for P. koraiensis components. A Bayesian approach was used to synthesize the parameter distributions of 298 biomass models as prior information to estimate the trunk, branch, leaf, and root biomass of P. koraiensis. The results were compared with non-informative prior and the minimum least squares (MLS).

Results

The results indicated that the Bayesian approach outperformed the other methods regarding model fit and prediction error. In addition, the responses of different components to tree height varied. The models of trunk and root biomass exhibited a smaller response to tree height, whereas those of branches and leaves showed a larger response to tree height. The model parameters yield precise estimations.

Discussion

In sum, this study highlights the potential of the Bayesian methods in estimating P. koraiensis biomass and proposes further enhancements to improve estimation accuracy.
The causal relationship between sleep and risk of psychiatric disorders: A two-sample mendelian randomization study
Authors: Chen Pei , Qin Jiuhang , Wang Yueying , Yuan Jinjin , Pan Yang , Zhu Bingqian
Published: June 2024

Introduction

Sleep is associated with psychiatric disorders. However, their causality remains unknown.

Methods

The study explored the causal relationship between seven sleep parameters (sleep duration, insomnia, sleep apnea, chronotype, daytime dozing, napping during the day, and snoring) and three psychiatric disorders including major depressive disorder (MDD), schizophrenia, and attention-deficit/hyperactivity disorder (ADHD) using two-sample Mendelian randomization (MR). Genome-wide association study (GWAS) summary data for sleep parameters were obtained from the United Kingdom biobank, FinnGen biobank, and EBI databases. MR-Egger, weighted median, inverse-variance weighted (IVW), simple mode, weighted mode, maximum likelihood, penalized weighted median, and IVW(fixed effects) were used to perform the MR analysis. The heterogeneity was detected by Cochran’s Q statistic. The horizontal pleiotropy was detected by MR Egger. The sensitivity was investigated by the leave-one-out analysis.

Results

Insomnia (OR = 2.02, 95%CI = 1.34–3.03, p = 0.001, False-discovery rate (FDR) corrected p-value = 0.011) and napping during the day (OR = 1.81, 95%CI = 1.34–2.44, FDR corrected p-value<0.001) were associated with an increased risk of MDD. Longer sleep duration (OR = 2.20, 95%CI = 1.24–3.90, FDR corrected p-value = 0.049) had an association with the increased risk of schizophrenia, while daytime dozing (OR = 4.44, 95%CI = 1.20–16.41, corrected p-value = 0.088)and napping during the day (OR = 2.11, 95%CI = 1.11–4.02, FDR corrected p-value = 0.088) had a suggestive association with an increased risk of schizophrenia. Longer sleep duration had a suggestive association with a decreased risk of ADHD (OR = 0.66, 95%CI = 0.42–0.93, FDR corrected p-value = 0.088).

Conclusion

This study provides further evidence for a complex relationship between sleep and psychiatric disorders. Our findings highlight the potential benefits of addressing sleep problems in the prevention of psychiatric disorders.
Sulfur dioxide inhibits mast cell degranulation by sulphenylation of galectin-9 at cysteine 74
Authors: Song Jiaru , Zheng Jie , Li Zongmin , Fu Ling , Yang Jing , Li Kun , Yu Xiaoqi , Lv Boyang , Du Junbao , Huang Yaqian , Jin Hongfang
Published: June 2024

Objectives

Mast cell (MC) degranulation is a key process in allergic reactions and inflammatory responses. Aspartate aminotransferase 1 (AAT1)-derived endogenous sulfur dioxide (SO2) is an important regulator of MC function. However, the mechanism underlying its role in MC degranulation remains unclear. This study aimed to investigate the mechanism by which endogenous SO2 controlled MC degranulation.

Methods

HMC-1 and Rat basophilic leukemia cell MC line (RBL-2H3) were used in the cell experiments. SO2 content was detected by in situ fluorescent probe. MC degranulation represented by the release rate of MC β-hexosaminidase was determined using a colorimetric assay. Sulfenylation of galectin-9 (Gal-9) in MCs and purified protein was detected using a biotin switch assay. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to determine the exact sulfenylation sites of Gal-9 by SO2. Animal models of passive cutaneous anaphylaxis (PCA) and hypoxia-driven pulmonary vascular remodeling were used to investigate the effect of SO2 on mast cell activation in vivo. Site-directed mutation of Gal-9 was conducted to confirm the exact site of SO2 and support the significance of SO2/Gal-9 signal axis in the regulation of MC degranulation.

Results

Degranulation was increased in AAT1-knockdowned MCs, and SO2 supplementation reversed the increase in MC degranulation. Furthermore, deficiency of endogenous SO2 contributed to IgE-mediated degranulation in vitro. Besides, SO2 inhibited IgE-mediated and hypoxia-driven MC degranulation in vivo. Mechanistically, LC-MS/MS analysis and site-directed mutation results showed that SO2 sulfenylated Gal-9 at cysteine 74. Sulfenylation of the 74th cysteine of Gal-9 protein was required in the SO2-inhibited MC degranulation under both physiological and pathophysiological conditions.

Conclusion

These findings elucidated that SO2 inhibited MC degranulation via sulfenylating Gal-9 under both physiological and pathophysiological conditions, which might provide a novel treatment approach for MC activation-related diseases.
Unveiling early stage autoimmune gastritis: novel endoscopic insights from two case reports
Authors: Yu Yunfeng , Shangguan Xueli , Yu Rong , Wu Yangpeng , Xu En , Tan Chuanchuan
Published: June 2024

The predominant characteristic of autoimmune gastritis (AIG) is corpus-dominant advanced atrophy, which is mostly observed in the middle to late stages. More reports are needed on the endoscopic features of the early stage. In this report, we present two cases of early-stage AIG in which endoscopic examinations showed no atrophy of the gastric mucosa but displayed a transition of collecting venules from a regular to an irregular arrangement. In addition, yellowish-white cobblestone-like elevations were observed in the fundic gland region. Histologically, the observed manifestations included pseudohypertrophy and protrusion of parietal cells into the lumen, possibly along with hyperplasia of G cells, lymphocytic infiltration and potentially pseudopyloric gland metaplasia. Serologically, the anti-parietal cell antibody returned positive results, whereas the anti-intrinsic factor antibody yielded negative results. In this study, we summarized some endoscopic features of two patients, aiming to provide clues for endoscopists to detect early-stage AIG.
Peripheral PD-1+NK cells could predict the 28-day mortality in sepsis patients
Authors: Tang Jia , Shang Chenming , Chang Yue , Jiang Wei , Xu Jun , Zhang Leidan , Lu Lianfeng , Chen Ling , Liu Xiaosheng , Zeng Qingjia , Cao Wei , Li Taisheng
Published: June 2024

Background

Unbalanced inflammatory response is a critical feature of sepsis, a life-threatening condition with significant global health burdens. Immune dysfunction, particularly that involving different immune cells in peripheral blood, plays a crucial pathophysiological role and shows early warning signs in sepsis. The objective is to explore the relationship between sepsis and immune subpopulations in peripheral blood, and to identify patients with a higher risk of 28-day mortality based on immunological subtypes with machine-learning (ML) model.

Methods

Patients were enrolled according to the sepsis-3 criteria in this retrospective observational study, along with age- and sex-matched healthy controls (HCs). Data on clinical characteristics, laboratory tests, and lymphocyte immunophenotyping were collected. XGBoost and k-means clustering as ML approaches, were employed to analyze the immune profiles and stratify septic patients based on their immunological subtypes. Cox regression survival analysis was used to identify potential biomarkers and to assess their association with 28-day mortality. The accuracy of biomarkers for mortality was determined by the area under the receiver operating characteristic (ROC) curve (AUC) analysis.

Results

The study enrolled 100 septic patients and 89 HCs, revealing distinct lymphocyte profiles between the two groups. The XGBoost model discriminated sepsis from HCs with an area under the receiver operating characteristic curve of 1.0 and 0.99 in the training and testing set, respectively. Within the model, the top three highest important contributions were the percentage of CD38+CD8+T cells, PD-1+NK cells, HLA-DR+CD8+T cells. Two clusters of peripheral immunophenotyping of septic patients by k-means clustering were conducted. Cluster 1 featured higher proportions of PD1+ NK cells, while cluster 2 featured higher proportions of naïve CD4+T cells. Furthermore, the level of PD-1+NK cells was significantly higher in the non-survivors than the survivors (15.1% vs 8.6%, P<0.01). Moreover, the levels of PD1+ NK cells combined with SOFA score showed good performance in predicting the 28-day mortality in sepsis (AUC=0.91,95%CI 0.82–0.99), which is superior to PD1+ NK cells only(AUC=0.69, sensitivity 0.74, specificity 0.64, cut-off value of 11.25%). In the multivariate Cox regression, high expression of PD1+ NK cells proportion was related to 28-day mortality (aHR=1.34, 95%CI 1.19 to 1.50; P<0.001).

Conclusion

The study provides novel insights into the association between PD1+NK cell profiles and prognosis of sepsis. Peripheral immunophenotyping could potentially stratify the septic patients and identify those with a high risk of 28-day mortality.
Experiment on MICP-solidified calcareous sand with different rubber particle contents and sizes
Authors: Xu Xinxing , Yan Xinning
Published: June 2024

Microbially induced calcite precipitation (MICP) is a new environmentally friendly technology, with the ability to improve the mechanical properties of calcareous sand. Rubber is a high-compressibility material with a higher damping ratio than that of calcareous sand. In this study, calcareous sand was replaced by equal volume contents (0%, 1%, 3%, 5%, 7%, and 9%) and different sizes (0–1, 1–2, and 2–3 mm) of rubber, and a series of water absorption and unconfined compressive strength (UCS) tests were conducted on MICP-solidified rubber–calcareous sand (MRS). The results showed that the water absorption is reduced when the rubber content is larger. The UCS of 0–1-mm MRS decreased with the increase in rubber content. For 1–2-mm and 2–3-mm MRS, the UCS was improved by 11.30% and 15.69%, respectively, compared with the clean sand. Adding rubber promoted the formation of calcium carbonate, but the strength and stiffness of rubber particles were lower than those of the calcareous sand. Therefore, higher rubber content weakened the sand frame bearing system, and the UCS decreased when the rubber content was more than 5%. Moreover, a large amount of 0–1-mm rubber led to the increase in transverse deformation of the samples, which caused the acceleration of the destruction of the sand structure. The water absorption of 0–1-mm MRS was higher than that of 1–2-mm and 2–3-mm MRS, but the UCS of 0–1-mm MRS was lower. The best rubber size is 1–2 mm and 2–3 mm, and the best rubber content is 3%–5%. The outcome of this study may, in the authors’ view, prove beneficial in improving the strength of calcareous sand when it is reinforced by MICP-combined rubber.
Changes in primary care visits for respiratory illness during the COVID-19 pandemic: a multinational study by the International Consortium of Primary Care Big Data Researchers (INTRePID)
Authors: Westfall John M. , Bonilla Angela Ortigoza , Lapadula María C. , Zingoni Paula L. , Wong William C. W. , Wensaas Knut A. , Pace Wilson D. , Silva-Valencia Javier , Scattini Luciano F. , Ng Amy P. P. , Manski-Nankervis Jo-Anne , Ling Zheng J. , Li Zhuo , Heald Adrian H. , Laughlin Adrian , Kristiansson Robert S. , Hallinan Christine M. , Goh Lay H. , Gaona Gabriela , Flottorp Signe , de Lusignan Simon , Cuba-Fuentes María S. , Baste Valborg , Tu Karen ,   on behalf of INTRePID
Published: June 2024

Objectives

The majority of patients with respiratory illness are seen in primary care settings. Given COVID-19 is predominantly a respiratory illness, the INTernational ConsoRtium of Primary Care BIg Data Researchers (INTRePID), assessed the pandemic impact on primary care visits for respiratory illnesses.

Design

Definitions for respiratory illness types were agreed on collectively. Monthly visit counts with diagnosis were shared centrally for analysis.

Setting

Primary care settings in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden and the United States.

Participants

Over 38 million patients seen in primary care settings in INTRePID countries before and during the pandemic, from January 1st, 2018, to December 31st, 2021.

Main outcome measures

Relative change in the monthly mean number of visits before and after the onset of the pandemic for acute infectious respiratory disease visits including influenza, upper and lower respiratory tract infections and chronic respiratory disease visits including asthma, chronic obstructive pulmonary disease, respiratory allergies, and other respiratory diseases.

Results

INTRePID countries reported a marked decrease in the average monthly visits for respiratory illness. Changes in visits varied from −10.9% [95% confidence interval (CI): −33.1 to +11.3%] in Norway to −79.9% (95% CI: −86.4% to −73.4%) in China for acute infectious respiratory disease visits and − 2.1% (95% CI: −12.1 to +7.8%) in Peru to −59.9% (95% CI: −68.6% to −51.3%) in China for chronic respiratory illness visits. While seasonal variation in allergic respiratory illness continued during the pandemic, there was essentially no spike in influenza illness during the first 2 years of the pandemic.

Conclusion

The COVID-19 pandemic had a major impact on primary care visits for respiratory presentations. Primary care continued to provide services for respiratory illness, although there was a decrease in infectious illness during the COVID pandemic. Understanding the role of primary care may provide valuable information for COVID-19 recovery efforts and planning for future global emergencies.
Bioinformatics and systems biology approaches to identify potential common pathogeneses for sarcopenia and osteoarthritis
Authors: Yang Jinghong , Zhong Jun , Du Yimin , Wang Zi , Jiang Lujun , Li Zhong , Liu Yanshi
Published: June 2024

Sarcopenia, a geriatric syndrome characterized by progressive loss of muscle mass and strength, and osteoarthritis, a common degenerative joint disease, are both prevalent in elderly individuals. However, the relationship and molecular mechanisms underlying these two diseases have not been fully elucidated. In this study, we screened microarray data from the Gene Expression Omnibus to identify associations between sarcopenia and osteoarthritis. We employed multiple statistical methods and bioinformatics tools to analyze the shared DEGs (differentially expressed genes). Additionally, we identified 8 hub genes through functional enrichment analysis, protein–protein interaction analysis, transcription factor-gene interaction network analysis, and TF-miRNA coregulatory network analysis. We also discovered potential shared pathways between the two diseases, such as transcriptional misregulation in cancer, the FOXO signalling pathway, and endometrial cancer. Furthermore, based on common DEGs, we found that strophanthidin may be an optimal drug for treating sarcopenia and osteoarthritis, as indicated by the Drug Signatures database. Immune infiltration analysis was also performed on the sarcopenia and osteoarthritis datasets. Finally, receiver operating characteristic (ROC) curves were plotted to verify the reliability of our results. Our findings provide a theoretical foundation for future research on the potential common pathogenesis and molecular mechanisms of sarcopenia and osteoarthritis.
Ultrasound assessment of diaphragmatic dysfunction in non-critically ill patients: relevant indicators and update
Authors: Yao Xin-Yu , Li Hong-Mei , Sun Bo-Wen , Zhang Ying-Ying , Feng Jian-Guo , Jia Jing , Liu Li
Published: June 2024

Diaphragm dysfunction (DD) can be classified as mild, resulting in diaphragmatic weakness, or severe, resulting in diaphragmatic paralysis. Various factors such as prolonged mechanical ventilation, surgical trauma, and inflammation can cause diaphragmatic injury, leading to negative outcomes for patients, including extended bed rest and increased risk of pulmonary complications. Therefore, it is crucial to protect and monitor diaphragmatic function. Impaired diaphragmatic function directly impacts ventilation, as the diaphragm is the primary muscle involved in inhalation. Even unilateral DD can cause ventilation abnormalities, which in turn lead to impaired gas exchange, this makes weaning from mechanical ventilation challenging and contributes to a higher incidence of ventilator-induced diaphragm dysfunction and prolonged ICU stays. However, there is insufficient research on DD in non-ICU patients, and DD can occur in all phases of the perioperative period. Furthermore, the current literature lacks standardized ultrasound indicators and diagnostic criteria for assessing diaphragmatic dysfunction. As a result, the full potential of diaphragmatic ultrasound parameters in quickly and accurately assessing diaphragmatic function and guiding diagnostic and therapeutic decisions has not been realized.
Dewatering performance of aerobic granular sludge under centrifugal with different sludge conditioning agent
Authors: Yan Ailan , Chen Yongfei , Li Ningyu , Ma Ting , Qi Yiting , Xu Dong
Published: June 2024

The aerobic granular sludge(AGS) technology draw scientific researchers attention, and more and more scientific research focuses on it, due to its superior advantages, such as good settling performance, high biological phase, high toxicity resistance and multiple biological effects. With the rapid development of AGS technology, a considerable amount of residual AGS will be produced, and dehydration is the biggest bottleneck of sludge reduction. This study investigated the dewatering process and method of residual AGS cultured by continuous flow experiment. Experiments were conducted using centrifugal dewatering technology with a dosing scheme to analyze the granular sludge dewatering process, and investigate the release process of EPS component in AGS dewatering. Our results implied the specific resistance of AGS has a very low value ((1.82 ± 0.03) × 109 m/kg) and it was not obvious for the conditioning effect of chemical conditioner on AGS dewatering. However, the moisture content can be reduced to 63.5% after dewatering with the presence of inorganic substances. The addition of drinking water treatment plant sludge (Alum sludge) can improve the efficiency of the dewatering of AGS. A possible dewatering process of AGS dewatering was proposed which was divided into two stages: First, a considerable amount of free water in the sludge was quickly removed under the action of gravity without pressure filtration. Second, the bound water release required cooperation between applying centrifugal or pressing force to grind granular cells and separate protein-like substances with the inorganic matter inside the granular sludge. The possible mechanism of AGS dewatering and hypothesis dewatering process are useful to optimize the AGS dewatering process.
Different effects of acute and chronic oxidative stress on the intestinal flora and gut-liver axis in weaned piglets
Authors: Zhang Hongyu , Xiang Xuan , Wang Chenyu , Li Tiejun , Xiao Xuping , He Liuqin
Published: June 2024

Introduction

Oxidative stress plays a pivotal role in modulating the balance of intestinal flora and the gut-liver axis, while also serving as a key determinant of the growth potential of weaned piglets. However, few studies have subdivided and compared acute and chronic oxidative stress.

Methods

In this study, an intestinal model of acute oxidative stress in weaned piglets using paraquat (PQ) and a chronic oxidative stress model using D-galactosa in weaned piglets were conducted. And we further systematically compare their effects.

Results

Both acute and chronic oxidative stress models impaired intestinal barrier function and liver function. Chronic stress caused by D-galactose can result in severe redox dysregulation, while acute stress caused by paraquat can lead to inflammation and liver damage. Additionally, the components involved in the CAR pathway were expressed differently. Chronic or acute oxidative stress can reduce the diversity and composition of intestinal flora. In the PQ group, the richness of Mogibacterium and Denitratisoma improved, but in the D-gal group, the richness of Catenisphaera and Syntrophococcus increased.

Discussion

Not only does this research deepen our understanding of the effects of acute and chronic oxidative stress on intestinal functions, but it also characterizes characteristic changes in the gut flora, potentially identifying novel therapeutic targets and opening new avenues for future research.
Identifying discriminative features of brain network for prediction of Alzheimer’s disease using graph theory and machine learning
Authors: Karim S. M. Shayez , Fahad Md Shah , Rathore R. S.
Published: June 2024

Alzheimer’s disease (AD) is a challenging neurodegenerative condition, necessitating early diagnosis and intervention. This research leverages machine learning (ML) and graph theory metrics, derived from resting-state functional magnetic resonance imaging (rs-fMRI) data to predict AD. Using Southwest University Adult Lifespan Dataset (SALD, age 21–76 years) and the Open Access Series of Imaging Studies (OASIS, age 64–95 years) dataset, containing 112 participants, various ML models were developed for the purpose of AD prediction. The study identifies key features for a comprehensive understanding of brain network topology and functional connectivity in AD. Through a 5-fold cross-validation, all models demonstrate substantial predictive capabilities (accuracy in 82–92% range), with the support vector machine model standing out as the best having an accuracy of 92%. Present study suggests that top 13 regions, identified based on most important discriminating features, have lost significant connections with thalamus. The functional connection strengths were consistently declined for substantia nigra, pars reticulata, substantia nigra, pars compacta, and nucleus accumbens among AD subjects as compared to healthy adults and aging individuals. The present finding corroborate with the earlier studies, employing various neuroimagining techniques. This research signifies the translational potential of a comprehensive approach integrating ML, graph theory and rs-fMRI analysis in AD prediction, offering potential biomarker for more accurate diagnostics and early prediction of AD.
Dietary supplementation with Lactium and L-theanine alleviates sleep disturbance in adults: a double-blind, randomized, placebo-controlled clinical study
Authors: Lim Su Eun , Kim Ho Seok , Lee Siwoo , Kang Eun Young , Lim Jong-Hyun , Kim Byung-Yong , Shin Seon-Mi , Baek Younghwa
Published: June 2024

Introduction

The use of natural products for the treatment of sleep disturbances is increasing owing to the side effects and limitations of traditional sleep therapy. Moreover, recent studies have shown a significant correlation between sleep quality and gut microbiota composition. This study aimed to assess the impact of LTC-022, a commercially available dietary supplement containing Lactium and L-theanine, on enhancing sleep quality.

Methods

Forty participants experiencing sleep discomfort were enrolled in a double-blind randomized controlled trial, wherein they received LTC-022 or a placebo orally for 8 weeks. The effects of treatment on sleep quality were assessed using the Pittsburgh Sleep Quality Index and Insomnia Severity Index. To comprehensively evaluate changes in sleep patterns, various parameters were evaluated, including the time in bed (TIB), total sleep time (TST), sleep onset latency (SOL), sleep efficiency (SE), wake after sleep onset (WASO) counts, and bedtime. These parameters were derived from daily sleep logs recorded over the 8-week study period, categorized into weekdays and weekends. Stool samples were analyzed for microbiome composition. The V4 region of bacterial 16S rRNA genes was amplified using specific primers (515F and 806R) and targeted for analysis. Microbial diversity, including operational taxonomic units, the Shannon and Chao indices, the Firmicutes/Bacteroidetes (F/B) ratio, and the variety of bacterial taxa, was assessed.

Results

No significant differences were observed in sleep quality and insomnia scale characteristics between the two groups. In-depth analysis using sleep diaries showed that WASO counts after 8 weeks and bedtime after 4 weeks showed significant differences between the LTC-022 and control groups. In the LTC-022 group, significant differences were observed in the increase in TST, decrease in SOL, increase in SE, decrease in WASO counts, and earlier bedtime. Microbiome analysis revealed that the abundance of the genera Blautia and Ruminococcus increased in fecal samples from the LTC-022 group.

Conclusion

These results suggest that continuous LTC-022 intake has a beneficial effect on maintaining sleep duration and an appropriate bedtime. Additionally, changes in the gut microbiota may be linked to changes in sleep patterns resulting from the consumption of Lactium and L-theanine.

Clinical trial registration

https://cris.nih.go.kr/cris/search/detailSearch.do/22841, KCT0007750.
The role of a radiopaque peri-rectal hydrogel spacer in aiding accurate daily image-guidance for prostate stereotactic radiotherapy
Authors: Icht Oded , Schlosser Shir , Weinstock-Sabbah Miriam , Rephael Mor , Bragilovski Dimitri , Moore Assaf , Shochat Tzippora , Limon Dror , Fredman Elisha
Published: June 2024

Introduction

Precise patient positioning with image guidance (IGRT) is essential for safe prostate radiotherapy. We present the first report of utilizing a CT-visible hydrogel spacer, used to decrease rectal radiation dose, as a surrogate fiducial marker to aid in daily IGRT with cone-beam CT (CBCT) in stereotactic radiotherapy (SABR) for prostate cancer.

Materials and methods

Prior to CT simulation, patients underwent placement of three intraprostatic gold fiducial markers and radiopaque hydrogel spacer per standard practice. At treatment, after initial setup, a CBCT was acquired and fused to the planning CT based on 3-dimensional matching of the spacer. A second alignment was then performed based on the fiducial markers. The six directional shifts (three linear and three rotational) were recorded, and the differences compared.

Results

140 individual fractions across 41 consecutive patients were evaluated. Mean/median differences between hydrogel spacer-based and fiducial-based alignment in linear (vertical, longitudinal, lateral) and rotational (rotation, pitch, roll) shifts were 0.9/0.6mm, 0.8/0.5mm, and 0.6/0.4mm, and 0.38/0, 0.62/0, and 0.35/0 degrees, respectively. No difference was observed in 9.9%, 22.9%, and 22.14% of linear shifts, and 65.7%, 65%, and 66.4% rotational shifts, respectively. Significantly smaller differences were observed in the latter 70 fractions vs. the former, and results were consistent across evaluators.

Conclusions

For precise daily IGRT with CBCT for prostate SABR, alignment using a radiopaque hydrogel spacer was highly comparable to intraprostatic fiducial markers. This represents the first report supporting an additional indication of IGRT for a CT-visible hydrogel spacer, to further enhance treatment accuracy and potentially obviate the need for the additional fiducial marker procedure.
Machine learning for screening and predicting the availability of medications for children: a cross-sectional survey study
Authors: Guo Jing-yan
Published: June 2024

Objective

The aim of the study was to explore the factors influencing the availability of medications for children, and establish a machine learning model to provide an empirical basis for the subsequent formulation and improvement of relevant policies.

Methods

Design: Cross-sectional survey. Setting: 12 provinces, China. Medical doctors from 25 public hospitals were enrolled. All data were randomly divided into a training set and a validation set at a ratio of 7:3. Three prediction models, namely random forest (RF), logistic regression (LR), and extreme gradient boosting (XGBoost), were developed and compared. The receiver operating characteristic curve (ROC) and the associated area under the curve (AUC) were used to evaluate the three models. A nomogram and clinical impact curve (CIC) for availability of medication were developed.

Results

Fifteen of 29 factors in the database that were most likely to be selected were considered to establish the prediction model. The XGBoost model (AUC = 0.915) demonstrated better performance than the RF model (AUC = 0.902) and the LR model (AUC = 0.890). According to the Shapley additive explanation values, the five factors that most significantly affected the availability of medications for children in the XGboost model were as follows: the relatively small number of specialized dosage forms for children; unaffordable medications for children; public education on the accessibility and safety of medication for children; uneven distribution of medical resources, leading to insufficient access to medication for children; and years of service as a doctor. The CIC was used to assess the practical applicability of the factor prediction nomogram.

Conclusions

The XGBoost model can be used to establish a prediction model to screen the factors associated with the availability of medications for children. The most important contributing factors to the models were the following: the relatively small number of specialized dosage forms for children; unaffordable medications for children; public education on the accessibility and safety of medication for children; uneven distribution of medical resources, leading to insufficient access to medication for children; and years of service as a doctor.
Molecular mechanisms, targets and clinical potential of berberine in regulating metabolism: a review focussing on databases and molecular docking studies
Authors: Sun Aru , Yang Haoyu , Li Tao , Luo Jinli , Zhou Ling , Chen Rui , Han Lin , Lin Yiqun
Published: June 2024

Background: Metabolic imbalance is the common basis of many diseases. As natural isoquinoline alkaloid, berberine (BBR) has shown great promise in regulating glucose and lipids metabolism and treating metabolic disorders. However, the related mechanism still lacks systematic research.

Aim: To discuss the role of BBR in the whole body’s systemic metabolic regulation and further explore its therapeutic potential and targets.

Method: Based on animal and cell experiments, the mechanism of BBR regulating systemic metabolic processes is reviewed. Potential metabolism-related targets were summarized using Therapeutic Target Database (TTD), DrugBank, GeneCards, and cutting-edge literature. Molecular modeling was applied to explore BBR binding to the potential targets.

Results: BBR regulates the whole-body metabolic response including digestive, circulatory, immune, endocrine, and motor systems through adenosine 5’-monophosphate (AMP)-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR), sirtuin (SIRT)1/forkhead box O (FOXO)1/sterol regulatory element-binding protein (SREBP)2, nuclear factor erythroid 2-related factor (Nrf) 2/heme oxygenase (HO)-1, and other signaling pathways. Through these reactions, BBR exerts hypoglycemic, lipid-regulating, anti-inflammatory, anti-oxidation, and immune regulation. Molecular docking results showed that BBR could regulate metabolism targeting FOXO3, Nrf2, NAD(P)H quinone oxidoreductase 1 (NQO1), glutathione peroxidase (Gpx) 4 and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA). Evaluating the target clinical effects, we found that BBR has the therapeutic potential of anti-aging, anti-cancer, relieving kidney disease, regulating the nervous system, and alleviating other chronic diseases.

Conclusion: This review elucidates the interaction between potential targets and small molecular metabolites by exploring the mechanism of BBR regulating metabolism. That will help pharmacologists to identify new promising metabolites interacting with these targets.