bluuebunny/crossref_metadata_2025 huggingface dataset:
Genome-wide identification of long non-coding RNA for Botrytis cinerea during infection to tomato (Solanum lycopersicum) leaves
Authors: Shi Haojie , Ding Guijuan , Wang Yun , Wang Jiaqi , Wang Xiaoli , Wang Dan , Lu Ping
Published: December 2024

Long non-coding RNA (lncRNA) plays important roles in animals and plants. In filamentous fungi, however, their biological function in infection stage has been poorly studied. Here, we investigated the landscape and regulation of lncRNA in the filamentous plant pathogenic fungus Botrytis cinerea by strand-specific RNA-seq of multiple infection stages. In total, 1837 lncRNAs have been identified in B. cinerea. A large number of lncRNAs were found to be antisense to mRNAs, forming 743 sense-antisense pairs, of which 55 antisense lncRNAs and their respective sense transcripts were induced in parallel as the infection stage. Although small RNAs were produced from these overlapping loci, antisense lncRNAs appeared not to be involved in gene silencing pathways. In addition, we found the alternative splicing events occurred in lncRNA. These results highlight the developmental stage-specific nature and functional potential of lncRNA expression in the infection stage and provide fundamental resources for studying infection stage-induced lncRNAs.
Evaluating the Prognostic Value of Radiomics and Clinical Features in Metastatic Prostate Cancer Using [68Ga]Ga-PSMA-11 PET/CT
Authors: Molin Kaylee , Barry Nathaniel , Gill Suki , Hassan G. M. , Francis Roslyn J. , Ong Jeremy S. L. , Ebert Martin A. , Kendrick Jake
Published: December 2024

Prostate cancer is a significant global health issue due to its high incidence and poor outcomes in metastatic disease. This study aims to develop models predicting overall survival for patients with metastatic biochemically recurrent prostate cancer, potentially helping to identify high-risk patients and enabling more tailored treatment options. A multi-centre cohort of 180 such patients underwent [68Ga]Ga PSMA-11 PET/CT scans, with lesions semi-automatically segmented and radiomics features extracted from lesions. The analysis included two phases: univariable and multivariable. Univariable analysis used Kaplan-Meier curves and Cox proportional hazards models to correlate individual features with overall survival. Multivariable analysis used the LASSO Cox proportional hazards method to create 13 models: radiomics-only, clinical-only, and various combinations of radiomic and clinical features. Each model included six features and was bootstrapped 1000 times to obtain concordance indices with 95% confidence intervals, followed by optimism correction. In the univariable analysis, 6 out of 8 clinical features and 68 out of 89 radiomic features were significantly correlated with overall survival, including age, disease stage, total lesional uptake and total lesional volume. The optimism-corrected concordance indices from the multivariable models were 0.722 (95% CI: 0.653–0.784) for the clinical model, 0.681 (95% CI: 0.616–0.745) for the radiomics model, and 0.704 (95% CI: 0.648–0.768) for the combined model with three clinical and three radiomic features, when extracting radiomics features from the largest lesion only. While univariable analysis showed significant prognostic value for many radiomic features, their integration into multivariable models did not improve predictive accuracy beyond clinical features alone.
A Hybrid Data Assimilation Method Based on Real-Time Ensemble Kalman Filtering and KNN for COVID-19 Prediction
Authors: Zhang SongTao , Yang LiHong
Published: December 2024

In the increasingly complex transmission pathways of modern society, using a single infectious disease prediction model has become increasingly limiting. For highly contagious viruses, even employing a time-depender Susceptible-exposedasymptomatic- infected-quarantined-removed (SEAIQR) model that is tailored to regional conditions still demonstrates inadequate predictive capability. To address these challenges, this paper introduces a hybrid data assimilation method that combines real-time Ensemble Kalman Filtering (EnKF), specifically adapted to epidemic dynamics, with the K-Nearest Neighbors (KNN) algorithm. This integration enhances the predictive capabilities of the time-dependent SEAIQR model. Numerical experiments are performed using reported COVID-19 cases from Xi’an, Shaanxi Province, China, spanning December 9, 2021, to January 8, 2022, as observational data. The results show a marked improvement in predictive accuracy compared to traditional forecasting models and other data assimilation techniques.This hybrid approach enhances the accuracy and reliability of predictive models, offering new insights for future epidemic forecasting and disease control strategies.
Examining Cognitions in an Anger Episode with and without Physical Aggression
Authors: DiBlasi Thomas , Keenan Kaleigh , Pisano Courtney , Tumbarello Gianna , Engel Vincent , Vincent Brittany , Loiacono Anthony
Published: December 2024

Background
Anger is a primary emotion that can lead to physical aggression 10% -25% of the time. Given this, it is important to understand which cognitions are present when anger leads to physical aggression.
Method
Using Prolific, 302 participants were randomly assigned to write about a time they were angry that they did or did not physically aggress. Using a mixed method approach, participants answered close-ended questions regarding the presence of eight angry cognitions. Additionally, their open-ended answers were coded for the same angry cognitions.
Results
Participants who physically aggressed (PA) when angry were more likely to endorse thoughts of just desserts and have more coded cognitions of low frustration tolerance and retribution than participants who did not physically aggress when angry (NPA). Participants in the NPA condition were more likely to endorse and have coded thoughts of demandingness than participants in the PA condition. Moreover, participants in the PA condition were more likely to have more coded angry cognitions in general than participants in the NPA condition.
Conclusion
Total angry cognitions, and specific cognitions (just desserts, low frustration tolerance, and retribution) may be important treatment targets for anger and physical aggression. Implications and additional treatment targets are discussed.
The structure and stability of Fe4+xS3 and its potential to form a Martian inner core
Authors: Man Lianjie , Li Xiang , Boffa-Ballaran Tiziana , Zhou Wenju , Chantel Julien , Néri Adrien , Kupenko Ilya , Aprilis Georgios , Kurnosov Alexander , Namur Olivier , Hanfland Michael , Guignot Nicolas , Henry Laura , Dubrovinsky Leonid , Frost Daniel
Published: December 2024

Seismic, geodetic and cosmochemical evidence point to Mars having a sulfur-rich liquid core. Due to the similarity between estimates of the core’s sulfur content and the iron - iron sulfide eutectic composition at core conditions, it has been concluded that temperatures are too high for Mars to have an inner core. Recent low density estimates for the core, however, appear consistent with sulfur contents that are higher than the eutectic composition, leading to the possibility that an inner core could form from a high-pressure iron sulfide phase. Here we report the crystal structure of a phase with the formula Fe4 + xS3, the iron content of which increases with temperature, approaching the stoichiometry Fe5S3 under Martian inner core conditions. We show that Fe4 + xS3 has a higher density than the liquid Martian core and that a Fe4 + xS3 inner core would crystalize if temperatures fall below 1960 (± 105) K at the center of Mars.
Analysis of prodromal symptoms and need for short-term prophylaxis in angioedema patients under long-term prophylaxis
Authors: Lochbaum Robin , Hoffmann Thomas K. , Greve Jens , Hahn Janina
Published: December 2024

Background
Patients with hereditary angioedema (HAE) experience recurrent, unpredictable episodes of edema. These swellings are often preceded by prodromal symptoms. HAE management includes acute treatment, long-term prophylaxis (LTP), and short-term prophylaxis (STP) before procedures with a risk of swelling. The effects of LTP on prodromal symptoms and the necessity for STP in patients on LTP remain unclear.
Methods
A questionnaire-based study involving HAE and AAE patients receiving LTP was conducted. Changes in prodromal symptoms and the incidence of procedures with an increased risk of swelling, including surgeries, dental procedures, and endoscopies were assessed.
Results
A total of 26 patients were included in the study. Among them, 18 experienced zero to three attacks since starting LTP. Abdominal attacks constituted 60% of all attacks, followed by swellings of the extremities and head and neck. The most frequently reported trigger factors were stress and mechanical stimuli, followed by infections. 9 patients reported surgical procedures, with 8 using STP. Of these, 4 experienced breakthrough attacks, including one laryngeal attack. 105 dental procedures were reported, with STP used for only one. Only one angioedema attack occurred after an intervention without STP. For endoscopies, 7 procedures were reported, 3 of which were performed under STP. Two abdominal attacks were reported by the same patient, both without prior STP. Prodromal symptoms remained consistent in type but varied in intensity and frequency under LTP.
Conclusions
For dental procedures, the mandatory use of STP in HAE patients on effective LTP should be reconsidered, provided acute treatment is available and other trigger factors are absent.
High prediction skill of North Atlantic and East Pacific tropical cyclones ten years ahead in the Met Office’s decadal prediction system DePreSys4
Authors: Monerie Paul-Arthur , Feng Xiangbo , Hodges Kevin , Toumi Ralf
Published: December 2024

The UK Met Office decadal prediction system DePreSys4 shows skill in predicting the number of tropical cyclones (TCs) over the eastern Pacific and tropical Atlantic Ocean up to a decade ahead. The high skill in predicting the number of TCs is due to the ability to predict multi-annual-to-multi-decadal trends and variability in the number of TCs associated with the temporal evolution of surface temperature and vertical wind shear in these two ocean basins. This is further related to the simulation of the externally forced response, with internal climate variability also allowing the improvement of the prediction skill. We applied a signal-to-noise calibration framework to further increase the skill of the TC decadal prediction. The decadal skill in predicting the number of TCs over the eastern Pacific and tropical Atlantic Ocean can be up to ACC = 0.93 and ACC = 0.83, retrospectively (measured by the Anomaly Coefficient Correlation—ACC). DePreSys4 predicts that the number of TCs will increase in the next decade (2023–2030) over the eastern Pacific and the tropical Atlantic Ocean, potentially leading to high economic losses.
Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit
Authors: Zhou Jian , Zhou Jingqian , Chen Min , Lü Pan , Jiang ChunMing
Published: December 2024

Introduction: Escherichia coli (E. coli) causes infections in neonates admitted to neonatal intensive care units (NICUs). Although β-lactam antibiotics are commonly used for neonatal infectious diseases, E. coli has exhibited resistance to them. Therefore, we investigated the resistance of E. coli strains isolated from a NICU to β-lactam antibiotics.
Methods: E. coli isolates were collected from patients admitted to a NICU from 2020–2023. The clinical characteristics of the patients were analyzed. The antimicrobial susceptibility was determined using the agar dilution method, and the distribution of β-lactamase genes was analyzed using PCR. Conjugation experiments were conducted to analyze the horizontal transferability of resistance genes on plasmids. Genomic DNA was extracted for whole genome sequencing, construction of plasmid physical maps, locating resistance genes, and analyzing flanking regions and the resistance gene-related sequences.
Results: Throughout the study period, 110 distinct E. coli strains were collected. Among these, 62 cases presented strains with high minimum inhibitory concentrations (MIC) associated with conditions such as ventilator-associated pneumonia (35/62), catheter-associated urinary tract infection (14/62), necrotizing enterocolitis (7/62), skin infection (1/62), and neonatal septicemia (5/62). Resistance of E. coli isolates to seven β-lactam antibiotics ranged from 2.73–56.36%. In 62 strains (56.36%, 62/110), six genotypes (11 sub-genotypes) of 111 β-lactamase genes were identified. Conjugation experiments revealed two transconjugants carrying the blaKPC-2 gene and two carrying the blaOXA-1 gene, exhibiting resistance to carbapenems and other β-lactams. The plasmids of four strains were successfully conjugated and transferred to recipient E. coli C600. PCR of the transconjugant resistance genes revealed that two carried a blaKPC-2 gene with a MIC increased up to 32-fold relative to the recipients, and the other two carried a blaOXA-1 gene with a 32-fold increased MIC. For isolate ECK03 carrying blaKPC-2, blaCTX-M-64, blaCTX-M-65, and blaTEM-1, sequencing results showed that blaKPC-2, blaCTX-M-64, and blaTEM-1 were harbored on a 114-kb pECK03_KPC-2 plasmid, whereas two identical blaCTX-M-64 genes were harbored in E. coli isolate ECF13.
Conclusion: These findings highlight the existence of E. coli β-lactam resistance within NICU populations, emphasizing the need for continual monitoring of β-lactamase isolates to facilitate effective antibiotic selection.
Enhancing tuberculosis case notifications through mapping sales of medicine in the private sector: A quasi-experimental study in Punjab Province, Pakistan
Authors: Kirubi Beatrice , Eman Kinz Ul , Lodhi Usman R. , Fatima Razia K. , Kazi Ghulam Nabi , Tahmeena Tahmeena , Shah Syed Karam , Creswell Jacob
Published: December 2024

Introduction:
In Pakistan, almost one-third of people who develop tuberculosis (TB) are missed by the National TB Program (NTP). A considerable number of people with TB receive treatment in the private sector but remain unnotified. This study documents the outcomes of an intervention to identify people with TB through private pharmacy engagement, building on mapping TB medicine sales in Punjab Province.
Methods
A comprehensive intervention was carried out in 4 districts of Punjab with high anti-TB drug sales, comprising a policy change requiring mandatory notification of TB medication sales, mapping and engaging pharmacies selling anti-TB drugs, reporting through a novel ‘eTB’ mobile application and providing support via a call center. We collected both historical and prospective TB notification data from the intervention and control districts. The primary outcome was the change in TB notifications during the intervention period compared with historical and control notifications.
Results
Over the 12-month intervention period, 15,669 people with TB were reported from 2,943 pharmacies in four districts. Among the people identified, 88% were male (n=13,673), 95% had pulmonary disease (n=14,969), and 4,256 (27%) were bacteriologically confirmed. Chain pharmacies (n=14) contributed to 39% of the yield. TB notifications increased by 17,462 (+34%) over the baseline period compared with an 8% increase in the control districts. The number of bacteriologically confirmed notifications increased by 32% compared with 16% in the control districts. The proportion of bacteriological confirmation was similar before and during the intervention.
Conclusion
The results of the largest TB intervention with pharmacies globally showed incredible potential to link people with TB who are receiving care in the private sector. Mapping TB medicine sales in the private sector with tailored interventions can contribute to closing the gap in notifications where anti-TB drug sales in the private sector are pervasive.
Relationship of monocyte-to-high density lipoprotein ratio (MHR) and other inflammatory biomarkers (SII, NLR and NHHR) with sarcopenia: a population-based study
Authors: Xue Zhiwei , Cao Jian , Mou Jianhui , Wang Rui , Liu Peng
Published: December 2024

Objectives
In previous studies, several inflammatory biomarkers derived from complete blood cell counts (CBC), including systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and non‑high‑density lipoprotein cholesterol to high‑density lipoprotein cholesterol ratio (NHHR) have been shown to act as predictors of sarcopenia. Whether Monocyte–to–High-Density Lipoprotein Cholesterol Ratio (MHR) can forecast the development of sarcopenia has never been demonstrated. Our study attempts to investigate the correlation between MHR and low muscle mass.
Methods
The study comprised 10,321 participants aged 20 years and above from the US. Survey-weighted logistic regression was performed to explore the association between ln-transformed MHR, SII, NLR, NHHR and low muscle mass. Furthermore, AUC values and ROC curves were used to assess the predictive effectiveness of ln-transformed MHR and other inflammatory markers (SII, NLR, and NHHR). The bootstrap estimated 95% Cl was shown with the AUC.
Results
In the fully adjusted model, ln SII, ln NLR, ln NHHR, and ln MHR were positively correlated with low muscle mass. (ln SII: OR = 1.59; 95% CI, 1.37–1.84; ln NLR: OR = 1.35; 95% CI, 1.13–1.60; ln NHHR: OR = 1.49; 95% CI, 1.27–1.75; ln MHR: OR = 1.98; 95% CI, 1.68–2.33) Compared to the lowest quartile of ln MHR, higher quartiles were significantly associated with increased OR for low muscle mass. (p for trend < 0.0001). In ROC analysis, ln MHR has higher AUC values than ln SII, ln NLR, and ln NHHR. (AUC = 0.7545, 95%CI = 0.7385–0.7705)
Conclusion
ln-transformed MHR, SII, NLR, and NHHR were positively associated with low muscle mass. MHR performs better in predicting sarcopenia compared to SII, NLR, and NHHR.
A new approach for hemodynamics of varicoceles: Perfusion patterns based on contrast- enhanced ultrasound
Authors: Zou Penglin , Fan Gaoxiang , Li Zheng , Tao Yuchen , Jia Chao , Liang Hongmei , Tian Ruhui , Shi Qiusheng , Hu Jianlin , Wu Rong
Published: December 2024

Background
Hemodynamic alterations in the spermatic vein are implicated in infertility among patients with varicocele (VC). Contrast-enhanced ultrasound (CEUS), a powerful tool for hemodynamic analysis, remains unexplored for VC. This study aimed to demonstrate the feasibility of using CEUS to evaluate spermatic vein hemodynamics in patients with VC and establish a clear correlation between specific hemodynamic patterns and impaired semen parameters. This study included 165 patients with left-sided VC and 50 healthy volunteers. All participants underwent CEUS of the spermatic veins, along with maximum venous diameter and testicular volume measurements and serum sex hormone levels and routine semen analyses. The sperm DNA fragmentation index was measured in 146 patients with VC and 37 healthy controls.
Results
The analyses revealed four distinct perfusion patterns ofthe spermatic vein: steady flow, intermittent stasis, intermittent reflux, and filling defect. In healthy spermatic veins, the predominant perfusion patterns included steady flow and intermittent stasis. Spermatic veins with VC exhibited a significant increase in the intermittent reflux and filling defect patterns, with the proportion rising as the clinical grade increased. The four patterns were further grouped into the “steady flow & intermittent stasis” and “intermittent reflux & filling defect” patterns for logistic regression analyses; the intermittent reflux & filling defect pattern was revealed as an independent risk factor for impaired sperm concentration, total sperm counts, progressive motility, morphology, and DNA fragmentation index.
Conclusions
This study validated the feasibility of CEUS for assessing the hemodynamics of the spermatic vein and established the intermittent reflux & filling defect pattern as an independent predictor of impaired semen parameters.
Short-term design methods evaluation of single self-piercing rivet joint at elevated temperatures
Authors: Zhao Lun , ye kai , Xiao Qiqi , QI Xiaozhi
Published: December 2024

The static mechanical properties of high-strength aluminum alloy and self-piercing rivet (SPR) joints were investigated through coupon tensile tests and tensile shear tests across a temperature range from -50 to 300°C. The study focused on 6061-T6 aluminum alloy, which was used as the substrate for both the coupon tensile and SPR specimens. The results demonstrated that the strength variation of SPR joints at different temperatures is intrinsically linked to the properties of the substrate material. Based on these findings, a high-temperature design code for 6061-T6 SPR joints was developed, which offers a practical framework for evaluating their mechanical performance. This study highlights the potential of SPR joints for application in construction structures, including scenarios requiring fire-resistant capacity, thereby broadening their suitability for use in prefabricated lightweight and high-performance buildings.
Influence of fuzzified dataset on classification and prediction of plant types - A case study
Authors: Swathi T. , Sudha S.
Published: December 2024

This research explores the use of fuzzification to improve the classification and prediction of plant types based on environmental and soil parameters. Fuzzification, a process that transforms numerical features into fuzzy sets, is used to handle the inherent uncertainty discovered in parameters such as soil pH, moisture, nutrients and temperature. The dataset obtained from Kaggle consists of 9 features and 10 plant types. Several Machine Learning models such as Naïve Bayes, Support Vector Machine, Random Forest, K-Nearest Neighbour, Decision tree, XGBoost and LightGBM are employed to classify and predict plants based on their environmental and soil features. These models are applied to fuzzified and non-fuzzified datasets for comparative performance analysis. The hyperparameters of each model is fine-tuned using the Bayesian optimization. SVM and KNN significantly benefit from the fuzzified dataset demonstrating the effect of fuzzification. XGBoost achieves an accuracy of 91.37% and AUC of 99.41% on the fuzzified dataset, while with the non-fuzzified dataset, accuracy and AUC of 91.34% and 99.42% respectively is found to be achieved. LightGBM shows an accuracy of 91.35% and AUC of 99.41% on the fuzzified dataset and 91.27% accuracy and AUC of 99.40% on the non-fuzzified dataset. From this research work, fuzzification is observed to improve the ability of certain models to manage complex data, leading to more accurate classification. These findings aid in the enhancement of more reliable and robust machine learning models for agricultural applications, particularly in prediction and management based on uncertain environmental and soil parameters.
Effectiveness of a Tailored Forest Package of Interventions, Including Topical Repellents, in Reducing Malaria Incidence in Myanmar
Authors: Win Kyawt Mon , Gimnig John E. , Linn Nay Yi Yi , Monti Feliciano , Khin Nu Nu , Hawley William A. , Hwang Jimee , Wiegand Ryan E. , Topcuoglu Ersin , Moran Alexander , Lin Khin , Thadar Hsu , Myint Aye Aye , Tun Kyaw Myint
Published: December 2024

Background
In Myanmar, progress towards malaria elimination has stagnated in some areas requiring deployment of new tools and approaches to accelerate malaria elimination. While there is evidence that networks of community-based malaria workers and insecticide-treated nets (ITNs) can reduce malaria transmission in a variety of settings, evidence for the effectiveness of other interventions, such as topical repellents is limited. Since malaria transmission in Myanmar occurs outdoors, mainly among forest-goers, we tested the effectiveness of topical repellents in combination with supplemental ITN distribution and strengthened networks of malaria workers.
Methods
Thirty-eight villages in the Tanintharyi Region and Rakhine State were initially selected for the study based on malaria incidence in previous years. An additional 31 villages were included as comparison areas. The implementation of interventions began in March 2020 and continued through June 2021. Malaria cases were detected in all villages through surveillance at health facilities and a network of malaria workers. Data were analyzed by interrupted time series. A nested case-control study was also conducted where forest-goers who tested positive for malaria by RDT were matched to up to three forest-goers who tested negative.
Results
A decrease in mean monthly incidence was observed in the intervention villages from 6.0 (95% CI: 4.9–7.1) to 3.7 (95% CI: 2.4–4.9) cases per 1,000 people at risk before and after the interventions. For the comparison villages, the mean monthly incidence increased from 1.1 (95% CI: 0.8–1.5) to 5.7 (95% CI: 2.1–9.3) cases per 1,000 people at risk. Malaria incidence was significantly lower following the implementation of the interventions (RR = 0.117; 95% CI = 0.061–0.223; p < 0.001) in the intervention villages, whereas that of comparison villages was higher after the implementation of the interventions (RR = 3.558; 95% CI = 0.311–40.750; p = 0.308). However, a significant trend for increasing malaria incidence after implementation was observed in the intervention villages (RR = 1.113; 95% CI = 1.021–1.214, p = 0.015), suggesting a waning effect. The nested case-control analysis showed that the odds of topical repellent use were significantly lower among cases than controls (aOR: 0.063, 95%CI: 0.013–0.313, p < 0.001).
Conclusion
The tailored intervention package for forest-goers helped reduce malaria incidence in Myanmar. Topical repellents may help to further reduce malaria transmission in elimination settings where high-risk populations such as forest-goers do not have easy access to routine health services or are less likely to use ITNs for malaria prevention.
Prognostic Value of Systemic Immune-Inflammation Index in Patients with Small-Cell Lung Cancer Treated with Immune Checkpoint Inhibitors
Authors: HAMAKAWA YUSUKE , Hirahara Ayumi , Hayashi Akiko , Ito Kota , Shinohara Hiroyuki , Shiba Aya , Higashi Yuko , Aga Masaharu , Miyazaki Kazuhito , Taniguchi Yuri , Misumi Yuki , Agemi Yoko , Nakamura Yukiko , Shimokawa Tsuneo , Okamoto Hiroaki
Published: December 2024

Introduction
The systemic immune-inflammation index (SII) has emerged as a promising prognostic marker in various malignancies. However, its prognostic significance in patients with small-cell lung cancer (SCLC) treated with immune checkpoint inhibitors (ICIs) remains unclear. In this study, we evaluated the prognostic impact of the SII in patients with SCLC after ICI use.
Methods
Of 62 patients with SCLC who received chemoimmunotherapy at our institution between September 2019 and July 2024, we retrospectively analyzed 36 patients who subsequently received ICI maintenance therapy following the initial chemoimmunotherapy treatment. The SII was calculated at the start of the second cycle of the ICI maintenance therapy. Patients were stratified into high (≥ 570) and low (< 570) SII groups. Overall survival (OS) and progression-free survival (PFS) were compared between the groups using the Kaplan–Meier method and log-rank test. Multivariate analysis using the Cox proportional hazards model was performed to identify independent prognostic factors.
Results
The high SII group exhibited a significantly shorter OS (median 12.1 vs. 24.1 months, P = 0.010) and PFS (median 5.2 vs. 8.1 months, P = 0.026) than those in the low SII group. A multivariate analysis identified SII ≥ 570 as an independent negative prognostic factor for OS (hazard ratio 3.83, 95% confidence interval 1.38–10.6, P = 0.010).
Conclusions
Elevated SII in the initial phase of ICI maintenance therapy was associated a with poor prognosis in patients with SCLC, supporting its utility as a prognostic biomarker in this setting. Therefore, prospective validation is required to confirm these findings.
High expression of CENPF predicts poor prognosis inHigh-Grade Serous Ovarian Carcinoma
Authors: Fu Aoyu , Jiang Yuanna , Guan Hongdan , He Zhouxiao , Xiang Xuan-ang , Li Fenghua , Tang Can-e , Wang Qian , Cao Lanqin
Published: December 2024

The aim of this study was to analyze the expression and clinical significance of Centromere Protein F (CENPF) in high-grade serous ovarian carcinoma (HGSOC) and to identify a new target for the prognostic assessment of HGSOC. In this study, by using the GEO database, CENPF was predicted to be overexpressed in HGSOC tissues. We investigated the expression patterns of CENPF via immunohistochemical staining (IHC) of 43 HGSOC tissues and 43 normal fallopian tube tissues with complete pathological parameters and survival data. CENPF protein was highly expressed in HGSOC tissues. The expression level of the CENPF protein was significantly correlated with FIGO stage, lymph node metastasis, and greater omentum metastasis in HGSOC patients. Survival analysis revealed that CENPF protein expression is significantly associated with short survival in HGSOC patients. Univariate and multivariate Cox regression analysis revealed that an advanced FIGO stage, the presence of lymph node metastasis, the presence of greater omental metastasis, and high CENPF expression were all significantly associated with overall survival (OS). In contrast, univariate and multivariate Cox regression analyses of progression-free survival (PFS) in HGSOC patients revealed that age, FIGO stage, lymph node metastasis, and greater omental metastasis were not significantly correlated with PFS.
Hemorrhagic Shock in a Pediatric Patient Undergoing Hirudotherapy: A Case Report and Recommendations for Vigilance
Authors: Shaw Susanna , Hinchcliff Katharine , Rafaat Karim , Frugoni Brian
Published: December 2024

Background: Hirudotherapy, the use of leeches for medicinal purposes, is a recognized treatment for various medical conditions, including digit replantation.
Case Presentation: We present a case of a 12-year-old male who developed hemorrhagic shock while undergoing hirudotherapy. Although there is evidence of its benefit, leech therapy can lead to substantial blood loss, especially in combination with additional anticoagulation measures.
Conclusions: This case emphasizes the need for extreme vigilance and continuous monitoring in pediatric patients undergoing hirudotherapy. We discuss potential risk factors, signs of occult bleeding, and recommend adjunctive measures to improve the assessment of critically ill patients in such situations.
The Correlation Between Serum Uric Acid Level And The Uric Acid-To-Creatinine Ratio In Paediatrics With Non-Alcoholic Fatty Liver Disease Running Title: Fatty Liver in Children with Obesity
Authors: Arsoy Hanife Ayşegül , Kara Özlem
Published: December 2024

It has been demonstrated that elevated serum uric acid (sUA) levels elicit both pro-inflammatory and pro-oxidative effects. A growing body of evidence suggests that this may play a contributory role in the development of Non-alcoholic fatty liver disease (NAFLD) in children with obesity. The objective of the present study was to evaluate the association between paediatric NAFLD and sUA levels and the sUA/creatinine (Cr) ratio. This single-center, cross-sectional, comparative study was conducted at the tertiary care center. The study cohort comprised 228 patients with obesity (body mass index (BMI) ≥ 95th percentile) and 167 controls, matched for age, sex and pubertal stage. A diagnosis of NAFLD was made following an ultrasound examination of the liver, with other possible causes of hepatic disease excluded. A significantly elevated level of sUA, and sUA/Cr values was observed in the group of patients with obesity in comparison to the control group (p < 0.001). In the group with obesity, NAFLD was detected by abdominal ultrasonography in 169 (74.1%) patients, whereas NAFLD was not detected in 59 (25.8%) patients. The levels of sUA and sUA/Cr were significantly elevated in the obese NAFLD group in comparison to the obese non-NAFLD and control groups (p < 0.001). An elevated WC, ALT, and the ratio of sUA/Cr are associated with an increased risk of NAFLD. A one-unit increase in sUA/Cr was found to be associated with an increased risk of NAFLD (OR = 1.323, 95% CI: 1.001–1.748).The findings of our study indicate that an elevated WC, ALT, and the ratio of sUA/Cr are associated with an increased risk of NAFLD. Nevertheless, no such correlation was identified between sUA and NAFLD.
A machine learning model for predicting outcomes of MitraClip therapy
Authors: Li Hui , Guo Ying , Gong Junsong , Hu Yiran , Qi Hongxia , Zhang Fengwen , Pang Xiangbin , Duan Fujian
Published: December 2024

Background:
Severe mitral regurgitation (MR) is a life-threatening mitral valve disease. The MitraClip intervention offers a percutaneous solution for patients who are unsuitable for surgery. However, limited information is available on outcomes post-MitraClip intervention. This study aims to develop an approach for predicting MR outcomes after MitraClip intervention using machine learning-enhanced echocardiography.
Methods:
We enrolled 164 patients with MR ≥ 3 + degree who underwent MitraClip intervention at our institution between 2021 and 2024. Patients were monitored for approximately three years. The analysis included clinical data and echocardiographic parameters. Study endpoints were the recurrence of MR (2 + or above) and major adverse events during follow-up. A total of 147 patients were randomly divided into training (80%) and testing (90%) sets. An additional 17 patients comprised the validation cohort.
Results:
The best-performing model for predicting clinical outcomes utilized 81 features in a logistic regression classifier. Using all 81 features in the logistic regression model, specificity increased to approximately 0.797 (95% confidence interval: 0.739 ~ 0.854) and sensitivity to about 0.459 (0.370 ~ 0.549), resulting in an overall accuracy of 0.688 (0.632 ~ 0.745) for the validation dataset. The best-performing model achieved a receiver operating characteristic area under the curve value of 0.773 in both the test and validation groups.
Conclusions:
Our machine learning model, leveraging echocardiographic characteristics, demonstrated superior predictive performance. This model effectively forecasts patient outcomes following MitraClip intervention, proving beneficial within a clinical setting.
Effect of Education Program regarding Pathological Jaundice on Nurses’ Performance and Neonates’ Bilirubin Induced Neurological Dysfunction
Authors: Ebrahim Nora Abd El-Alim , Bayoumi Madiha Hassan , Metwally Hanan El-Sayed
Published: December 2024

Background: Both term and preterm infants are susceptible to pathological jaundice, a frequent condition that can cause long-lasting neurological damage. A novel treatment for indirect pathological hyperbilirubinemia is bilisphere phototherapy, which lowers total serum bilirubin just as well as exchange transfusions.
Methods:A quasi-experimental research design was utilized in the current study. This study was conducted in Neonatal Intensive Care Unit at Benha Specialized Pediatric Hospital. A convenient sample of all available nurses (60) working in the previously mentioned setting. A purposive sample of neonates (90) with pathological jaundice which would be divided into control and study groups. Three tools were used: Tool I: A structured interview questionnaire sheet. Tool II: Observational checklist for caring neonates with pathological jaundice. Tool III: Neonatal outcomes assessment sheet.
Results: There were a positive correlation between nurses’ total performance regarding pathological jaundice and bilisphere phototherapy at pre/post education program implementation. Additionally, there were a positive correlation between neonates’ outcomes in the study group and nurses’ total performance post- program implementation.
Conclusion:The education program regarding pathological jaundice was effective in improving nurses’ performance and neonates’ bilirubin induced neurological dysfunction post compared to pre- education program implementation.
I Will ‘Go for it’ even if it Scares me! How Psychological Courage Relates to Well-being at Work through Reinforcement Sensitivity Systems
Authors: Pajestka Grzegorz , Skałacka Katarzyna
Published: December 2024

Psychological courage (PC) is believed to help individuals in dealing with fear and anxiety, allowing them to confront obstacles and discover purpose in their careers. This study investigated the relationship between PC, job satisfaction, meaning in work, perceived stress, and behavioral systems (BAS, BIS, FFFS) using structural equation modeling (SEM). A sample of 805 employees from various industries participated in the study. Results revealed a positive correlation between PC and both job satisfaction and meaning in work, while a negative correlation was found with perceived stress. SEM analysis further indicated that the behavioral activation system (BAS) mediates the relationship between PC and positive well-being outcomes. Conversely, the behavioral inhibition system (BIS) was associated with increased stress and decreased job satisfaction and meaning in work. These findings highlight the importance of PC in promoting positive work experiences. By activating the BAS and inhibiting the BIS, PC can contribute to greater job satisfaction, increased meaning in work, and reduced stress. Organizations can benefit from implementing interventions that foster psychological courage among employees, leading to improved overall well-being and job performance.
Synthesis and characterization of superparamagnetic PEGylated zero valent iron gold (Fe0Au) nanoparticles
Authors: Soto María Ana Rivera , Gattorno Geonel Rodríguez , López Marco Antonio González , Cárdenas Elena Marcia Gutiérrez , Benitez Maximo Berto Martinez , Trejo José de Jesús Olivares
Published: December 2024

Iron-gold (Fe0-Au) nanoparticles are forefront agents in biomedicine because of their magnetic and plasmonic properties and are prime candidates for advanced biomedical applications such as magnetic hyperthermia, targeted drug delivery, and bioimaging. Synthesizing biocompatible, stable iron phase, and minimal borate-related cytotoxicity, Fe0-Au hybrid nanoparticles are a great challenge, This study presents an optimized, two-step synthetic approach to produce PEGylated Fe0-Au hybrid nanoparticles, employing NaBH4 as a reducing agent under strictly anaerobic conditions. UV-Vis spectroscopy confirmed nanoparticle formation, with absorbance peaks at 260 nm for Fe0 and 526 nm for Au, accompanied by discernible color shifts in the colloidal suspension, indicative of successful metal reduction. High Transmission electron microscopy (HRTEM) revealed a uniform spherical morphology with an average diameter of 50 nm, while X-ray photoelectron spectroscopy (XPS) demonstrated substantial minimization of borate byproducts, reducing these potentially cytotoxic residues to 14 atomic percent. Magnetization assessments showed hysteresis-free superparamagnetic behavior with a saturation magnetization of 75 Am²/kg for the PEGylated NPs, validating their suitability for precision hyperthermia and magnetic resonance imaging. These findings indicate that PEG functionalization enhances colloidal stability and effectively mitigates toxicity risks, rendering these Fe0-Au nanoparticles as highly viable candidates for preclinical and potentially translational biomedical applications.
Comparison of clinical outcomes between high tibial osteotomy and total knee arthroplasty in older patients with severe osteoarthritis
Authors: Hamaoka Kodai , Okimura Shinichiro , Horita Kazushi , ikeda Yasutoshi , Okada Yohei , Kamiya Tomoaki , Teramoto Atsushi
Published: December 2024

Background:
The clinical outcomes of high tibial osteotomy (HTO) in older patients compared with total knee arthroplasty (TKA) in early older patients with severe osteoarthritis has not been studied. In this study, we aimed to compare these clinical outcomes.
Methods:
In this retrospective comparative single centre study, patients who underwent HTO and TKA for medial knee osteoarthritis were assigned to separate groups. The inclusion criteria were ages 65–74 years (early older), Kellgren–Lawrence grade 4, and a minimum post-operative 2-year follow-up. Clinical outcomes were assessed using the knee injury and osteoarthritis outcome score (KOOS), minimal clinically important difference (MCID), and patient-acceptable symptom state (PASS) achievement rate for the KOOS subscales at the final follow-up. The t-test, paired t-test, and chi-squared test were used, with statistical significance set at 0.05.
Results:
The HTO and TKA groups comprised 35 and 51 patients, respectively. The median ages were 69.1 and 71.2 years, respectively. Conversion to TKA after HTO was performed in three patients in the HTO group. Preoperatively, no significant difference was observed in any of the outcome scores subscales between the groups. However, at the final follow-up, the mean KOOS symptoms, pain scores and MCID achievement rate for KOOS symptoms scores were significantly better in the TKA group than in the HTO group. No significant differences were observed in the PASS achievement rates for the KOOS subscales.
Conclusion:
KOOS symptoms, pain scores and MCID achievement rate for KOOS symptoms scores after TKA were superior to those after HTO at a mean follow-up of 57 months. These findings suggest that TKA may be more beneficial in older patients with severe osteoarthritis.
Level of evidence
Retrospective comparative study, Level III
Waist circumference is a strong predictor of a positive outcome evaluated one year after sleeve gastrectomy
Authors: Bracha Marietta , Jaroch Alina , Wojtasik Jakub , Soja-Kukieła Natalia
Published: December 2024

Purpose
Bariatric surgeries, such as laparoscopic sleeve gastrectomy (LSG), not only result in significant weight loss but also improve the inflammatory state in obese patients. This study aimed to investigate the effects of LSG on weight loss and inflammation status in bariatric patients one year post-procedure.
Materials and Methods
This prospective cohort study was conducted from September 2022 till May 2024. Fifty obese adults were enrolled for LSG. All patients underwent assessments of body measurements, as well as levels of interleukin-6 (IL-6), interleukin-10 (IL-10) at baseline, and then at 3 and 12 months post-surgery.
Results
Twelve months post-surgery, body measurements showed a significant reduction, with a median excess weight loss (%EWL) of 56.8%, indicating clinical success of the bariatric procedure. %EWL showed a strong correlation with waist circumference (R= -0.738, p < 0.00001). A logistic regression model indicated that a reduction of just one centimeter in initial waist circumference increases the likelihood of a positive outcome in laparoscopic sleeve gastrectomy by 12%. Moreover, a significant increase was observed for IL-10 (p < 0.0001), simultaneously with a significant decrease in IL-6 (p < 0.0001).
Conclusions
This study provides valuable evidence supporting the benefits of laparoscopic sleeve gastrectomy for both weight loss and reducing inflammation. Waist circumference emerged as a strong predictor of metabolic success one year post-surgery, while increased IL-10 levels signaled positive immunological changes.
Step to it – can physical activity improve kids’ cognition? A six-month longitudinal study
Authors: McPherson Adrian , Duncan Scott , MacKay Lisa , Kunkel Jule
Published: December 2024

Background
Identifying the relationships among physical activity, cognition, and academic performance in children is important for targeted public health and education initiatives. However, the majority of research has been cross-sectional in nature; we have a limited understanding of the causal direction of these associations. Therefore, aim of this study was to utilise longitudinal data to explore causal relationships among physical activity, cognition and academic performance in elementary school children.
Methods
Data were sourced from 675 New Zealand children aged 5–11 years. Weekday home, weekday school, and weekend physical activity was measured by multiple pedometer step readings, cognition by four measures from the CNS Vital Signs assessment, and academic performance from the New Zealand Ministry of Education Assessment Tools for Teaching and Learning (asTTle) reading and maths scores. Measures were taken at baseline, two months, and six-month intervals. Data were analysed for 632 students identified with data for at least half of the 27 variables. A generalised linear mixed model was used to investigate changes in physical activity, cognition and academic performance over those three time periods while adjusting for gender, school, age, and socioeconomic status.
Results
No significant relationships were identified between physical activity and three of the cognitive domains. However, significant, positive relationships were observed between physical activity change at two-months and (1) composite memory change at six-months, (2) maths proficiency change at two-months, and (3) math proficiency change at six-months. Regression coefficients suggest that a child who doubles step count - a 100% increase in PA - will affect a 3.7% improvement in maths proficiency after two months, and after six months affect a 2.6% improvement in maths proficiency and a 4.7% improvement in composite memory.
Conclusions
This six-month longitudinal analysis identified that an increase physical activity led to small but significant improvements in composite memory and maths proficiency. The small associations suggest that substantial improvements in PA would be required to generate meaningful improvements in cognition and academic achievement. However, timeframes longer than six-months are recommended to identify long-term changes.
Neoadjuvant Short-course Radiotherapy and Subsequent Immunotherapy Plus Chemotherapy Followed by Surgery in Locally Advanced Rectal Cancer: a Retrospective Analysis
Authors: Han Xiaodan , Song Di , Shi Yonggang , Wang Huanhuan , Gu Zhuoyu , Zuo Xiaoxiao
Published: December 2024

Background
Neoadjuvant short-course radiotherapy (SCRT) followed by immunotherapy and chemotherapy has exhibited a higher pathological complete response (pCR) rate than long-course chemoradiotherapy in clinical trials for locally advanced rectal cancer (LARC). This study aimed to determine whether SCRT followed by immunotherapy plus chemotherapy could improve oncological outcomes compared to SCRT followed by chemotherapy alone as neoadjuvant treatment for LARC.
Patients and Methods:
Patients who were diagnosed with LARC and received SCRT at the First Affiliated Hospital of Zhengzhou University from July 2018 to May 2023 were collected. The patients who underwent surgery were divided into immunotherapy and non-immunotherapy groups based on whether immunotherapy was performed. Propensity score matching was performed between the two groups. The postoperative pathological response, treatment-related adverse events (TRAEs), overall survival (OS) and disease-free survival (DFS) were compared between the two groups. The associations with a pCR were investigated using univariate and multivariate analyses. Additionally, the effects of total mesorectal excision (TME) on the OS and DFS of patients, who achieved clinical complete remission (cCR), were evaluated.
Results
The immunotherapy group had a higher pCR rate than the non-immunotherapy group among patients who underwent surgery. No significant differences were observed in level 3–4 TRAEs, 3-year OS or DFS rates between the two groups. Univariate and multivariate analyses revealed that 1–3 and ≥ 4 cycles of immunotherapy were independently associated with a pCR. The cCR patients who selected the organ preserving strategy had a comparable 3-year OS rate but a lower 3-year DFS rate compared to those who received TME surgery.
Conclusions
SCRT and subsequent immunotherapy plus chemotherapy have an extraordinary pCR rate and manageable toxicity compared to SCRT plus chemotherapy, but they do not affect short-term OS and DFS rates. The selection of an organ preserving strategy should be discussed with LARC patients who have achieved a cCR.