bluuebunny/crossref_metadata_2025 huggingface dataset:
The westerlies control the zonal migration of rainy season over the Tibetan Plateau
Authors: Jiang Xingwen , Cai Fengying , Li Zhenning , Wang Zunya , Zhang Tuantuan
Published: April 2023

Precipitation over the Tibetan Plateau (TP) is modulated by both the South Asian summer monsoon and the midlatitude westerlies. However, their dissimilar impacts on the seasonal evolution of precipitation are not well explored. This study reveals that the onset and retreat of rainy season over the TP, presenting a west-east migration pattern, are mostly controlled by the westerlies. The annual cycle of precipitation amount over the TP is out-of-phase with that of westerly wind speed. The weakening of westerlies favors more precipitation over the TP by reducing input of dry and cold air at the west and output of moist and warm air at the east. Due to the northward shift of westerly jet before July, the weakening of westerlies over the TP leads to a westward shift of the low-level warm air center and associated low-pressure center, and a westward extension of moist air convergence. Consequently, rainy season advances westward. In contrast, the southward shift of westerly jet after August leads to a strengthening of westerlies and an eastward retreat of rainy season.
NKD1 targeting PCM1 regulates the therapeutic effects of HHT on colorectal cancer cells
Authors: Cao Jia , Tao Xiang , Shi Bin , Wang Jia , Ma Rong , Zhao Jufen , Tian Jinhai , Huang Qi , Yu Jingjing , Wang Libin
Published: April 2023

Background: Colorectal cancer (CRC) is the most common primary malignancy. Homoharringtonine (HHT) has potential therapeutic effects on solid tumors. However, the regulatory target and mechanism of HHT in CRC progression remain elusive.
Methods: CCK-8, Edu staining, flow cytometry and Western blotting assay to detect the effect of HHT on proliferation and apoptosis of CRC cells. Transcriptome sequencing screened the drug delivery target of HHT. In vitro rescue experiment and in vivo tumorigenesis experiment detect the targeted interaction between HHT and NKD1. Quantitative proteomics combined with CO-IP and IF experiments to verify the targeted interaction between NKD1 and PCM1.
Results: HHT suppressed CRC cells proliferation by inducing cell cycle arrest and apoptosis in vitro and vivo. HHT inhibited NKD1 expression in a concentration and time dependent manner. NKD1 was overexpressed in CRC and its depletion enhanced the therapeutic sensitivity of HHT on CRC, which indicating that NKD1 plays an important role in the development of CRC as the drug delivery target of HHT. Furthermore, proteomic analysis revealed that PCM1 participated the process of NKD1-regulated cell proliferation and cell cycle. NKD1 interacted with PCM1 and promotes PCM1 degradation through the ubiquitin-proteasome pathway. The overexpression of PCM1 effectively reversed the inhibition of siNKD1 on cell cycle.
Conclusions: These results suggested that NKD1 targeting PCM1 to participate in regulating the therapeutic effects of HHT on CRC. Our findings provide evidence for clinical application of NKD1-targeted therapy in improving HHT sensitivity for CRC treatment
For establishment of the healthcare information booklet after Turkey-Syrian earthquake based on the past disaster
Authors: Okuyama Junko , Seto Shuji , Fukuda Yu , Suzukamo Yoshimi , Okazaki Tatsuma , Furusawa Yoshihito , Izumi Shin-Ichi , Ito Kiyoshi , Imamura Fumihiko
Published: April 2023

After a natural disaster, it is important to maintain the health of the victims, but after the Turkey-Syria earthquake, this information has not yet been provided. Tohoku University has compiled information on maintaining health care after the Great East Japan Earthquake of March 2011 into a booklet, which is available to the public. The purpose of this study is to investigate user satisfaction with this booklet. A total of 505 organizations participated in this study by completing questionnaires and evaluating the booklet. Quantitative responses were analyzed and coded by theme. Open-ended responses indicated that it was difficult for the general public to understand the data in the booklet. This study shows the need to keep in mind the ease of understanding for the general public when providing information on post-disaster care. We hope that this study will lead to better health care information for the victims of the Turkey-Syria earthquake.
Machine learning-based somatic variant calling in cell-free DNA of metastatic breast cancer patients using large NGS panels
Authors: Jongbloed Elisabeth M. , Jansen Maurice P.H.M. , de Weerd Vanja , Helmijr Jean A. , Beaufort Corine M. , Reinders Marcel J. T. , Marion Ronald van , IJcken Wilfred F. J. van , Sonke Gabe S. , Konings Inge R. H. M. , Jager Agnes , Martens John W.M. , Wilting Saskia M. , Makrodimitris Stavros
Published: April 2023

Next generation sequencing of cell-free DNA (cfDNA) is a promising method for treatment monitoring and therapy selection in metastatic breast cancer (MBC). However, distinguishing tumor-specific variants from sequencing artefacts and germline variation with low false discovery rate is challenging when using large targeted sequencing panels covering many tumor suppressor genes. To address this, we built a machine learning model to remove false positive variant calls and augmented it with additional filters to ensure selection of tumor-derived variants. We used cfDNA of 70 MBC patients profiled with both the small targeted Oncomine breast panel (Thermofisher) and the much larger Qiaseq Human Breast Cancer Panel (Qiagen). The model was trained on the panels’ common regions using Oncomine hotspot mutations as ground truth. Applied to Qiaseq data, it achieved 35% sensitivity and 36% precision, outperforming basic filtering. For 20 patients we used germline DNA to filter for somatic variants and obtained 245 variants in total, while our model found seven variants, of which six were also detected using the germline strategy. In ten tumor-free individuals, our method detected in total one (potentially germline) variant, in contrast to 521 variants detected without our model. These results indicate that our model largely detects somatic variants.
Is a surgical drain necessary in elderly patients with femoral neck fractures treated with hemiarthroplasty? - A case-control study
Authors: Lee Seung-Hun , Kwak Dae-Kyung , Yoo Je-Hyun
Published: April 2023

Femoral neck fracture is a common osteoporotic fracture in elderly patients and is effectively managed with arthroplasty. However, the benefits and risks of surgical drain after arthroplasty in these patients are still debatable. Hence, we conducted this case-control study to investigate the necessity of surgical drain in elderly patients with femoral neck fractures treated with cementless bipolar hemiarthroplasty. This study enrolled elderly patients (aged ≥ 70 years) who underwent cementless bipolar hemiarthroplasty for femoral neck fractures between April 2016 and December 2021. The patients were classified into the control group comprising 199 patients with surgical drain after surgery performed between April 2016 and June 2020, and the study group, which comprised 134 patients with no surgical drain between July 2020 and December 2021. Demographics, perioperative data and postoperative complications were compared between the two groups. Estimated blood loss, perioperative transfusion volume and rate, and length of hospital stay were significantly lower in the study group than in the control group (p < 0.001, p < 0.001, p = 0.008, and p < 0.001, respectively). Although there were no significant intergroup differences in the length of intensive care unit stay and in-hospital, 1-month, and 1-year mortalities, the incidence of postoperative medical complications was significantly higher in the control group than the study group and the odds ratio was 2.10 (95% Confidence Interval = 1.32–3.34, p = 0.001). Surgical drain is not necessary after cementless bipolar hip hemiarthroplasty in elderly patients with femoral neck fractures, considering lower blood loss, transfusion and lower incidence of postoperative medical complications in the study group with no surgical drain.
Agoraphobia and panic attacks complicated by primary aldosteronism improved by treatment with eplerenone: a case report
Authors: Kijima Reoto , Tesen Hirofumi , Igata Ryohei , Okamoto Naomichi , Yoshimura Reiji
Published: April 2023

Background: Primary aldosteronism (PA) is an adrenal gland disease, that induces increased secretion of the mineralocorticoid, aldosterone, resulting in symptoms such as hypertension. This study reports a patient with agoraphobia and panic attacks, associated with PA. This patient's psychiatric symptoms improved after treatment with eplerenone, a mineralocorticoid receptor antagonist.
Case presentation: The patient was a 40-year-old female with agoraphobia, which refers to the irrational fear of situations that may cause anxiety, and panic attacks characterized by profuse sweating, palpitations, and generalized weakness. She was diagnosed with hypertension from PA. Subsequently, she received treatment with eplerenone, which improved her agoraphobia and panic attacks.
Conclusions: There have been no previous reports on PA associated with agoraphobia and panic attacks that improved with pharmacotherapy. Patients with agoraphobia and panic attacks should be evaluated for PA. In patients with PA, pharmacotherapy with eplerenone should be considerd.
Prevalence and factors associated with potential drug-drug interactions in prescriptions presented at private pharmacies in Mbarara city, southwestern Uganda
Authors: Lule Allan Phillip , Delic Ogwal Basil , Katunguka Keneth , Muwonge Francis , Yadesa Tadele Mekuriya
Published: April 2023

Background: Drug-drug interactions (DDIs) influence the effectiveness of medication and thus determine the treatment outcomes of diseases managed with pharmacotherapy. This study aimed to determine the prevalence, severity, and factors associated with potential drug-drug interactions in prescriptions presented at private pharmacies in Mbarara city.
Methods: DDIs were identified and classified basing on risk and severity using Lexicomp drug interaction database. STATA version 13 was used to analyze the collected data. Descriptive statistics were used to summarize the severity of potential DDIs identified. Bivariate and multivariate logistic regression was employed to identify different factors associated with the presence of potential DDIs.
Results: A total of 295 prescriptions from 18 private pharmacies were studied and the prevalence of clinically significant potential DDIs was 37.6%. About half (149, 50.5%) of the patients were females, the majority (199, 67.5%) were adults 18-59 years of age whereas most (208, 70.5%) had a comorbid condition. Over one half (162, 54.9%) of the prescriptions were received from hospitals and majority of the prescriptions had 4 drugs prescribed (n=175, 59.32%). Having one or more comorbidities and prescribing of therapeutic drug categories including anti-fungal, anti-hypertensives, analgesics, or corticosteroids were significantly associated with potential DDIs.
Conclusions: The prevalence of potential drug-drug interactions in outpatient setting in Mbarara city was high and majority of the potential DDIs were of moderate severity. Having 1 or more comorbidities and prescribing of therapeutic drug categories including anti-fungals, anti-hypertensives, analgesics, or corticosteroids were significantly associated with potential DDIs.
Effect of Nd Addition on the Microstructure and Cyclic Oxidation Behavior of NiAl-Cr(Mo) Eutectic Alloys
Authors: Atas Mehmet Sahin , Yildirim Mehmet
Published: April 2023

The effect of a minor amount of rare-earth element Nd addition (0.1 at.%) on the microstructural properties, microhardness, and cyclic oxidation resistance of NiAl-Cr(Mo) alloy is investigated in detail. The microstructure of investigated alloys is composed of NiAl-based dendrites and a eutectic mixture whose components are NiAl and Cr(Mo) phases. The minor amount of Nd addition refines the microstructure and increases the microhardness considerably. The results of the cyclic oxidation tests reveal that the surface scales of both alloys are mainly consisted of α-Al2O3 and little amount of Cr2O3. A Cr(Mo)-rich layer is observed in the metal/oxide interface. With Nd addition, the oxidation resistance of Ni-33Al-31Cr-3Mo alloy is strongly improved. The Nd-doped alloy exhibits lower oxidation mass gain and increased scale adherence.
A duct design for reducing grad-B MHD drag
Authors: Shimada Michiya , Salami Jabir Al , Hanada Kazuaki , Hu Changhong
Published: April 2023

Harsh heat load conditions on plasma-facing components (PFCs) in steady-state and transient phenomena (e.g., disruptions and ELMs) in DEMO fusion reactors question the feasibility of current approaches based on solid targets made of tungsten. This issue calls for the development of innovative plasma-facing components. Liquid metal PFCs with strong convection enhance heat removal capability and resilience after the transient phenomena. However, transporting liquid metal across magnetic fields gives rise to MHD drag. MHD drag for the case of uniform B, estimated analytically, is acceptable. Grad-B MHD drags with straight ducts could seriously drag the LM flow across non-uniform B. Expanding the duct along B and shrinking the duct in a perpendicular direction could make electromotive force |vBh| approximately constant along the duct and significantly reduces the grad-B MHD drag. Here v denotes the flow velocity along the duct, B is the magnetic field strength, and h is the vertical duct size. Three-dimensional simulations for internal and free surface thermo-MHD phenomena have demonstrated that the proposed duct design reduces the total pressure drop along the duct.
Effects of care of multimorbid patients in general practices by Advanced Practice Nurses (FAMOUS): Study Protocol for a non-randomized controlled trial
Authors: Stemmer Renate , Büchler Britta , Büttner Matthias , Dera-Ströhm Christina , Klein Joachim , Emilio Gianicolo
Published: April 2023

Background
Multimorbidity is a common phenomenon in patients treated in general practices. Key challenges of this group are functional difficulties, polypharmacy, treatment burden, fragmentation of care, reduced quality of life and increased healthcare utilisation. These problems cannot be solved in the short consultation time of a general practitioner (GP) since there is an increasing shortage of GPs. In many countries Advanced Practice Nurses (APNs) are successfully integrated into primary health care for multimorbid patients.
The objective of this study is to examine whether the implementation of APNs in the primary care of multimorbid patients in Germany leads to an optimized care of the target group and to a reduction in the workload of the GPs.
Methods
APNs care for multimorbid patients in general practice for twelve months; this is the intervention. Qualifications for APNs include a master's level academic degree and 500 hours of project-specific training. Their tasks are: in-depth assessment, preparation, implementation, monitoring and evaluation of a person-centred and evidence-based care plan.
In the design of a non-randomized controlled trial, a prospective multi-centre mixed methods study is conducted. Main inclusion criterion is: three chronic diseases. For data collection of the intervention group (n= 817), routine data from health insurance companies and Statutory Health Insurance Physicians (ASHIP) are used, as well as day-to-day documentation of the care process, standardized questionnaires and qualitative interviews. In addition, the intervention will be assessed in a longitudinal design. The control group (n= 1634) will receive standard care. For the evaluation routine data from health insurance companies are matched 1:2.
Outcomes are measured using emergency contacts and GP visits, treatment costs, health status of the patients and satisfaction of parties involved.
The statistical analyses use Poisson regression to compare outcomes between intervention and control groups. Descriptive and analytical statistical methods are used in the longitudinal analysis of the intervention group data. Cost analysis will compare total costs and subgroup costs between the intervention and control groups. Qualitative data will be analysed using content analysis.
Discussion
A challenge could be the political and strategic environment as well as the planned number of participants.
Trial registration DRKS00026172 on DRKS
Molecular Mechanisms of Na+-driven Bile Acid Transport in Human NTCP
Authors: Lu Xiaoli , Huang Jing
Published: April 2023

Human Na+ taurocholate co-transporting protein (hNTCP) is a key bile salt transporter to maintain enterohepatic circulation and is responsible for the recognition of hepatitis B and D viruses (HBV/HDV). Despite recent cryo-EM studies revealing open-pore and inward-facing states of NTCP stabilized by antibodies, the transport mechanism remains largely unknown. Here, we use molecular dynamics (MD) and enhanced sampling Metadynamics simulations to elucidate the intrinsic mechanism of hNTCP-mediated taurocholate acid (TCA) transport driven by Na+-binding. We uncover three TCA binding modes, one of which closely matches the limited cryo-EM density observed in the open-pore hNTCP. Several key hNTCP conformations in the substrate transport cycle were captured, including an outward-facing, substrate-bound state. Furthermore, we provide thermodynamic evidence supporting that changes in the Na+-binding state drive the TCA transport by exploiting the amphiphilic nature of the substrate and modulating the protein environment, thereby enabling the TCA molecule to flip through. Understanding these mechanistic details of Na+-driven bile acid transport may aid in the development of hNTCP-targeted therapies for liver diseases.
A Hybrid Method for Optimal Arrangement of Turbine Blades
Authors: Mehne Hamed Hashemi , Jafari Hadi
Published: April 2023

Installation of blades in the right positions around a disk stage is a critical problem in repairing gas turbines and jet engines. The arrangement may cause an imbalance in the rotor that increases vibration and affects the turbine's performance and lifetime. To find the optimum positions of blades around the disk an assignment problem is proposed in this article. A solving method is then developed based on an improved ant colony optimizer. The method is accelerated in combination with two exchange schemes. The results of implementation in three industrial cases show that the proposed hybrid method is accurate. In addition, it finds the arrangement of blades with a lower imbalance than the two prevalent algorithms.
Development of a deep learning-based grading model to evaluate fetal lung maturity from normal fetal lung ultrasound images
Authors: Zhao Yuli , Zhang Yixin , Wang Sen , Guo Huimin , Feng Li
Published: April 2023

Objectives
To develop a deep learning algorithm for quantifying fetal lung maturity from normal fetal lung ultrasound images.
Methods
This is a single-center analytical study that retrospectively cross-sectionally observes singleton pregnant woman without pregnancy complications at 20–41+ 6 weeks of gestation, and acquires axial images of their fetuses at the level of the four-chambered heart in order to create a model for evaluating the maturity of the fetal lungs using normal fetal lung ultrasound images. Assuming that the texture information of the fetal lung ultrasound image can represent the maturity of the fetal lung development, and the gestational age is proportional to the maturity of the fetal lung, the deep learning grading model based on the normal fetal lung ultrasound image is established with the gestational age as the baseline. The pictures were split into three classes according to the gestational weeks which were calculated at the last menstrual period of the pregnant woman as the reference standard: 20 to 29+ 6 weeks for class I, 30 to 36+ 6 weeks for class II, and 37 to 41+ 6 weeks for class III.
Results
This study had 350 pregnant women in total, and the deep learning model's classification accuracy for ultrasound images of fetal lungs at different gestational ages was 0.917.
Conclusion
The grading model based on deep learning can correctly and independently predict the fetal lung maturity from ultrasound images.
Species diversity of environmentally-transmitted bacteria colonizing Riptortus pedestris (Hemiptera: Alydidae) and symbiotic effects of the most dominant bacteria
Authors: Gook Do-Hun , Jung Minhyung , Kim Soowan , Lee Doo-Hyung
Published: April 2023

Riptortus pedestris (Hemiptera: Alydidae) establish endosymbiosis with bacteria in soil where R. pedestrisare exposed to extremely diverse microbiota. To better understand ecology and evolution of the symbiosis, it is important to characterize bacterial species diversity colonizing R. pedestris and evaluate their symbiotic effects. Nonetheless, previous research was limited to a model species, Caballeronia insecticola, when investigating the interactions between two groups. In this study, second-instar nymphs were provided with field soil and reared to adult. Then, bacteria colonizing the midguts of R. pedestris were analyzed for species identification based on 16S rRNA. First, a total of 15 bacterial species were detected belonging to Burkholderiaceae. Most R. pedestris were found to harbor single bacterial species, and the insects harbored at most two bacterial species simultaneously. Among R. pedestris harboring single bacterial species, 91.2% harbored genus Caballeronia. The most dominant species was Caballeronia jiangsuensis, not previously documented for symbiotic associations with R. pedestris. Second, in laboratory conditions, the most dominant species, C. jiangsuensis, significantly enhanced the development, body size, and reproductive potentials of R. pedestris, compared to individuals with no symbiotic bacteria. These results add novel information to address how evolutionary and ecological associations have been shaped in the symbiosis.
A Lidar-based computer vision system for monitoring of patients in medical scenes
Authors: Wu Xuan , Zhang Haiyang , Kong Chunxiu , Wang Yuanze , Ju Yezhao , Zhao Changming
Published: April 2023

Long-term monitoring for patients can improve patient safety, help doctors diagnose and evaluate the clinical situation. Limited manpower in hospitals makes it difficult to achieve continuous and nuanced monitoring. In this paper, we classify the patient's posture as standing, sitting, lying and falling. Using a non-intrusive, privacy-compliant lidar, a medical human pose dataset is collected in the First Affiliated Hospital, Sun Yat-Sen University, and a novel computer vision-based approach is presented to continuously detect patients pose and provide timely information to health care workers. The recognition accuracy reaches 93.46% and the recognition speed reaches 42FPS on 3080Ti. Experimental results show that the algorithm performs well on the medical human pose dataset, and can effectively solve the problem of human pose recognition in medical scenes.
Optimization of process parameters in Friction Stir Welding of dissimilar aluminum alloys (AA6061–T6 and AA5052–H32)
Authors: Heramo Wondu Tesfaye , Workneh Henok Zewdu
Published: April 2023

Friction stir welding (FSW) is a solid-state welding method for the welding of aluminum alloys and has been used in aerospace, railway, automotive and marine applications. Solid-state welding processes solve several problems that occur during fusion welding of Al-alloys like HAZ liquation cracking, porosity, and segregation. Aluminum Alloys of two different series AA 5052 and AA6061 thickness of 6mm are FS welded using process parameters like tool rotational speed (900,1100,1400) rpm, transverse speed (40,50,60) mm/min, and pin profiles (cylindrical, conical, and square). This article aims to optimize the mechanical and metallurgical properties of the above dissimilar combination to evaluate the performance and characteristics of the welded joints. The combined Taguchi and Grey relation analysis experimental method was chosen to construct the number of welding experiments. The plates are successfully welded, and the welded plates are tested at room temperature to examine their tensile strength and hardness. The findings indicate that the square pin profile, the rotational speed of 1400 rpm, and the transverse speed of 40 mm/min are the optimum parameters for joining these dissimilar joints.
The Role of EEG Functional Connectivity Coupled with Eye Tracking in Early Diagnosis of Autism Spectrum Disorder
Authors: Sun Binbin , Wang Bryan , Wei Zhen , Feng Zhe , Wu Zhi-Liu , Yassin Walid , Stone William S. , Lin Yan , Kong Xue-Jun
Published: April 2023

Background:Electroencephalography (EEG) functional connectivity (EFC) and eye tracking (ET) have been explored as objective screening methods for autism spectrum disorder (ASD), but no study has yet evaluated them simultaneously to measure restricted and repetitive behavior (RRBs) to infer early ASD diagnosis.Methods:Typically developing (TD) children (n=27) and ASD (n=32), age- and sex-matched, were evaluated with EFC and ET simultaneously, using the restricted interest stimulus paradigm. Network-based machine learning prediction (NBS-predict) was used to identify ASD. Correlations between EFC, ET, and Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) were performed. The Area Under the Curve (AUC) was measured to evaluate the predictive performance.Results:Under high restrictive interest stimuli (HRIS), ASD children have significantly higher α band connectivity and significantly more total fixation time (TFT)/pupil enlargement of ET relative to TD children (P<0.05). These biomarkers were not only significantly positively correlated with each other (R>0.7, P<0.05), but also with ADOS total scores and RRBs sub-score (R>0.7 P<0.01 for EFC and (R>0.6, P<0.02 )for TFT. The accuracy of NBS-predict in identifying ASD was 63.4%. ROC curve demonstrated TFT with 91% and 90% sensitivity, and 78.7% and 77.4% specificity for ADOS total and RRB sub-scores respectively.Conclusions:Simultaneous EFC and ET evaluation in ASD is highly correlated with RRB symptoms measured by ADOS-2. NBS-predict of EFC offered a direct prediction of ASD. The use of both EFC and ET substantially improves early ASD diagnosis.
On the Stability and Characteristics of Biogas/Methane/Air Flames Fired by a Double Swirl Burner
Authors: Abdulnaim A. , Elkholy A. , Elmously M. , Moneib H. , Roberts W. L. , Elbaz A. M.
Published: April 2023

CO2-diluted methane fuel is relevant to biogas combustion applications. Despite its poor heating value and low reactivity, which limit its practical applicability, biogas gains popularity as a renewable fuel. However, implementing it in combustion systems requires either modifying or replacing the existing burners. This study investigates the stability, temperature field, and pollutant emissions of CH4/CO2/air-premixed flames fired by a double-swirl burner. A CH4/air mixture of equivalence ratio, Φout was used in the outer stream, while a CH4/CO2/air mixture was supplied to the inner stream. The CO2 mole fraction, 𝒳CO2, in the inner fuel blend varied from 0 to 0.4 for various inner stream equivalence ratios, Φin. The stability diagram of these flames was mapped in terms of Φin verses 𝒳CO2 for a fixed Φout. Based on the stability map, the inflame temperature field was investigated for six flames. Increasing the %CO2 in the biogas modifies the stability map by increasing the inner stream lean blow-off limits. However, increasing Φout sustains the flame stability, while reducing the CO2 increases the overall flame below off equivalence ratio. Flame size growth with increasing 𝒳CO2 requires a longer residence time for efficient combustion. The addition of CO2 physically and chemically affects the thermal flame structure, and hence the pollutant emissions. In this burner, ultra-low NOX emission was reported, while an increase in the CO and UHC, with increasing 𝒳CO2 was observed. However, the results show that, for a given 𝒳CO2, controlling Φin and Φout could reduce CO and UHC emissions.
Quercetin alleviates osteoporosis in rat mandibles induced by ovariectomy through modulation of autophagy and inhibition of NLRP3 pathway
Authors: Xiong Yue , Huang Cheng-Wei , Shi Chao , Peng liang , Cheng Yu-Ting , Luo Rui , Liao Jian
Published: April 2023

Background With the aging population and the popularity of implant prostheses, more and more postmenopausal patients with osteoporosis (PMOP) have a need for implant restorations, but poor bone condition affects the long-term stability of their implant prostheses. The aim of this study was to investigate the therapeutic effect of quercetin (QR) compared to alendronate (ALN), the primary treatment for PMOP, on mandibular OP induced by ovariectomy in female rats (OVA).
Methods Adult female rats were treated with QR (50 mg/kg/day), ALN (6.25 mg/kg/week) by gavage for 8 weeks, chloroquine CQ (10 mg/kg/twice a week), and MCC950 (10 mg/kg/three times a week) by intraperitoneal injection for 8 weeks after bilateral ovariectomy. Blood samples were collected prior to euthanasia; the mandibles were harvested and subjected to MicroCT and pathological analysis.
Results The results showed that QR administration controlled weight gain and significantly improved bone microstructure in OVA rats, increasing bone mass, and Bone mineral density (BMD), reducing bone trabecular spacing, and decreasing osteoclast numbers. WB, rt-qPCR, and serum markers confirmed that QR inhibited the differentiation of osteoclasts on the NLRP3 pathway that promotes osteoclast differentiation of IL-1β, IL-18, Immunofluorescence, WB also confirmed that QR inhibited autophagy in OVA rats and suppressed the number of Trap-stained positive osteoclasts.
Conclusion QR may protect the skeleton and prevent bone loss in osteoporotic rats by inhibiting the NLRP3 pathway and autophagy in osteoclasts with comparable effects to ALN, thus QR has the potential to be a promising alternative supplement for the preventive and therapeutic treatment of postmenopausal osteoporosis.
Does the immediate reimbursement of medical insurance reduce the socioeconomic inequality in health among the floating population? Evidence from China
Authors: He Wen
Published: April 2023

Background
Enhancing health intervention for floating populations has become an essential aspect of public health around the world. China launched a policy reform aimed at implementing immediate reimbursement for trans-provincial inpatient treatments. The objective of this study was to investigate the effects of this policy change on socioeconomic inequality in health among the floating population.
Methods
This study used two waves of individual-level data from the China Migrants Dynamic Survey (CMDS) collected in 2017 and 2018 as well as administrative hospital data at the city level. The sample included 122061 individuals and 262 cities. Under a quasi-experimental research design, we built up the framework to employ the generalized difference-in-differences estimation strategy. We used the number of qualified hospitals that could provide immediate reimbursement to represent the degree and intensity of the implementation of this policy change. We also calculated the Wagstaff Index (WI) to measure socioeconomic inequality in health.
Results
This policy change and income level had a negative joint impact on the health status of floating population (odds ratio = 1.043, P < 0.01). Furthermore, as the number of qualified tertiary hospitals increased, the health inequality would decrease significantly on average at the city level (P < 0.05). In addition, total reimbursement significantly improved after the policy change, and the magnitude of increase was greater in the relatively lower-income group (P < 0.01), that is, after the implementation of immediate reimbursement, the floating population could obtain greater and more timely reimbursement, which significantly released its medical burdens promoted health and reduced the health inequality caused by socioeconomic factors. Last, only inpatient spending could obtain immediate reimbursement in the early stage, thus, compared with primary care, these impacts were greater in tertiary care.
Conclusions
Our study revealed that after the implementation of immediate reimbursement, the floating population could obtain greater and more timely reimbursement, which significantly released its medical burdens, promoted health, and reduced the health inequality caused by socioeconomic factors. These results suggest that a more accessible and friendly medical insurance scheme should be promoted for this group.
A Viewpoint-Guided Prototype Network for 3D Shape Classification
Authors: Han Li , He Jinhai , Dou Feng , Ma Huiwen , Xie Xinyang , Yang Wanwen
Published: April 2023

The authors have requested that this preprint be removed from Research Square.
Optimized strategy for schistosomiasis elimination: results from marginal benefit modeling
Authors: Li Qin , Zheng Jin-Xin , Jia Tie-Wu , Feng Xin-Yu , Lv Chao , Zhang Li-Juan , Yang Guo-Jing , Xu Jing , Zhou Xiao-Nong
Published: April 2023

Poverty contributes to the transmission of schistosomiasis via multiple pathways, with the insufficiency of appropriate interventions being a crucial factor. The aim of this paper is to provide more economical and feasible intervention measures for endemic areas with varying levels of poverty. We collected and analyzed the prevalence patterns along with the cost of control measures in 11 counties over last 20 years in China. Seven machine learning models, including XGBoost, support vector machine, generalized linear model, regression tree, random forest, gradient boosting machine, and neural network, were used for training. Among them, the XGBoost model had the highest prediction accuracy with an R2 of 0.7308. The XGBoost model was then used to calculate the marginal benefit of each measure in reducing the prevalence of the disease and to obtain the optimal integrated control strategy. Results showed that risk surveillance, snail control with molluscicides and treatment were the most effective interventions in controlling schistosomiasis prevalence; The best combination of interventions was interlacing seven interventions, including risk surveillance, treatment, toilet construction, health education, snail control with molluscicides, cattle slaughter, and animal chemotherapy. The marginal benefit of risk surveillance is the most effective interven-tion among nine interventions, which was influenced by the prevalence of schistosomiasis and cost. In conclusion, in the elimination phase of the national schistosomiasis program, emphasizing risk surveillance holds significant importance in terms of cost-saving.
TRIM69 suppressed the anoikis resistance and metastasis of gastric cancer through ubiquitin‒proteasome-mediated degradation of PRKCD
Authors: Shi Tongguo , Sun Linqing , Chen Yuqi , Xia Lu , Wang Jiayu , Zhu Jinghan , Li Juntao , Wang Kun , Shen Kanger , Zhang Dongze , Zhang Guangbo , Chen Weichang
Published: April 2023

The tripartite motif (TRIM) protein family has been investigated in multiple human cancers, including gastric cancer (GC). However, the role of TRIM69 in the anoikis resistance and metastasis of GC cells remains to be elucidated. We identified the differentially expressed genes in anoikis-resistant GC cells using RNA-sequencing analysis. The interaction between TRIM69 and PRKCD was analyzed by coimmunoprecipitation and mass spectrometry. Our results have shown that TRIM69 was significantly downregulated in anoikis-resistant GC cells. TRIM69 overexpression markedly suppressed the anoikis resistance and metastasis of GC cells in vitro and in vivo. TRIM69 knockdown had the opposite effects. Mechanistically, TRIM69 interacted with PRKCD through its B-box domain and catalyzed the K48-linked polyubiquitination of PRKCD. Moreover, TRIM69 inhibited BDNF production in a PRKCD-dependent manner. Importantly, overexpression of PRKCD or BDNF blocked the effects of TRIM69 on the anoikis resistance and metastasis of GC cells. Interestingly, a TRIM69−PRKCD+BDNF+ cell subset was positively associated with metastasis in GC patients. TRIM69-mediated suppression of the anoikis resistance and metastasis of GC cells via modulation of the PRKCD/BDNF axis, with potential implications for novel therapeutic approaches for metastatic GC.
Detection of tongue edema caused by endotracheal intubation tube in ICU patients by ultrasonography: A prospective, observational, clinical study
Authors: Bayram Hasan Huseyin , Onal Ozkan , Akpinar Seyma , Onal Merih , Ozturk Mehmet
Published: April 2023

Purpose: This study aimed to detect tongue edema which may develop due to the long-term application of pressure of the endotracheal intubation (ETI) tube on the tongue using submental ultrasonography (USG). Also, we aimed to investigate the relationship between tongue edema with oxygen saturation values (SpO2) two h after extubation.
Methods: A total of 100 patients aged 18–65 years, who underwent ETI and were followed up on mechanical ventilation were included. Patients (n = 57) who were followed up on mechanical ventilation for four days or longer after ETI were included in the study group. Those who were followed up on mechanical ventilation for three days or less after ETI were included in the control group (n = 43). The tongue cross-sectional areas (TSAs) of patients in both groups were measured twice with submental USG. The first measurement (TSA1) was performed on the 0th day of ETI in all patients in both groups. The second measurement (TSA2) was performed on the 4th day of ETI in the study group and just before extubation in the control group. The difference between TSA2 and TSA1 was defined as tongue edema.
Results: The tongue edema was more prevalent in the study group (p = 0.000). The SpO2 values two h after extubation were lower in patients with tongue edema than those without tongue edema (p = 0.000).
Conclusions: Tongue edema may develop due to the long-term application of pressure of the ETI tube on the tongue and may impair oxygenation after extubation.
ClinicalTrials.gov Identifier: NCT05249738
Biomechanical analysis of an FNS® fixation construct for femur neck fractures and clinical implications: a finite element method
Authors: Sohn Hoon-Sang , Kim Dong-Hee , Kang Sungwook , Jung Se-Lin , Lee Dong-Hyun , Jung Gu-Hee
Published: April 2023

Background Despite widely use of femoral neck system system (FNS®), there is little evidence for mechanical property according to type of femoral neck fracture. This study is to assess the structural/mechanical stability of fixation constructs with a femur neck system by using the finite-element (FE) analysis after simulating the femur neck fractures and to introduce the clinical implications. Methods We simulated the fracture models of subcapital, transcervical, basicervical, and vertical types by using the right femur model (SAWBONES®) and imported the implant model of FNS®to ANSYS®to place the implant in the optimal position. The distal end of the femur model was completely fixed and was abducted 7°. The force vector was set laterally at an angle of 3° and posteriorly 15° in the vertical ground. We did the analysis using Ansys®software with the von Mises stress (VMS) in megapascal (MPa). Results The max VMS of the fracture site was 67.01 MPa for a subcapital fracture, 68.56 MPa for a transcervical fracture, 344.54 MPa for a basicervical fracture, and 130.59 MPa for a vertical fracture. The max VMS of FNS®was 840.34 MPa for a subcapital fracture, 637.37 MPa for a transcervical fracture, 464.07 MPa for a basicervical fracture, and 421.01 MPa for a vertical fracture. The max VMS of the implant corresponded to the value of the entire fixation construct and thus, FNS®mainly functions as a load-bearing implant. When we compared the basicervical and vertical fractures, the stress distribution between the implant and the fracture sites differed significantly, and the basicervical fracture had higher VMS in the bone, implant, and fracture sites. Conclusion Considering the stress distribution of the assembly model, FNS® fixation should consider the osseous anchorage between the proximal bolt and cancellous bone of femoral head and might be appropriate for vertical fractures. Regarding the VMS of fracture site, FNS® might be applied cautiously just in the basicervical fracture of anatomical reduction without gap and comminution.
Dose escalation of Fractionated Stereotactic Radiotherapy (FSRT) for brain metastases from non-small cell lung cancer: protocol of a phase I study
Authors: Xu Xiao , Pan Kaicheng , Wang Bing , Liang Jiafeng , Tang Yi , Ma Shenglin , Zhu Lucheng , Xia Bing
Published: April 2023

Background
About half of lung cancer patients are found to have brain metastasis during the course of the disease. Fractionated stereotactic radiotherapy (FSRT) is a reliable treatment for patients with localized brain metastases. However, there is currently controversy over the prescription doses of FSRT. The aim of this study is to determine maximum tolerated dose of FSRT for brain metastasis from non-small cell lung cancer.
Methods
This study is a prospective mono-center phase I dose escalation trial which will recruit patients with brain metastases from non-small cell lung cancer receiving FSRT in 5 fractions. A standard 3 + 3 statistical design was employed. The dose escalation consists of 7 cohorts. FSRT will starting at 6 Gy × 5 fractions (dose level 1). The highest dose level will be 10 Gy × 5 fractions. The primary objective of this study is to determine the maximum tolerated dose. Secondary outcomes include acute and late toxicities following FSRT, intracranial progression-free survival (iPFS) and overall survival (OS).
Discussion
Since the prescription dose of FSRT treatment for patients with localized brain metastases are still unknow, we conducted a Phase I study to determine the maximum tolerated dose of FSRT for limited brain metastases. This trial protocol has been approved by the Ethics committee of Hangzhou cancer hospital. The ethics number is HZCH-2022 #124. This study was registered at ClinicalTrials.gov on 10/20/2022 (NCT05588206).
Robust Evidence C-Means Clustering Combining Spatial Information for Image Segmentation
Authors: Lan Rong , Mi Haowen , Qu Na , Zhao Feng , Yu Haiyan , Zhang Lu
Published: April 2023

Although evidence c-means clustering (ECM) based on evidence theory overcomes the limitations of fuzzy theory to some extent and improves the capability of fuzzy c-means clustering (FCM) to express and process the uncertainty of information, the ECM does not consider the spatial information of pixels, which makes it to be unable to effectively deal with noise pixels. Applying ECM directly to image segmentation cannot obtain satisfactory results. This paper proposes a robust evidence c-means clustering combining spatial information for image segmentation algorithm. Firstly, an adaptive noise distance is constructed by using the local information of pixels to improve the ability to detect noise points. Secondly, the pixel’s original, local and non-local information are introduced into the objective function through adaptive weights to enhance the robustness to noise. Then, the entropy of pixel membership degree is used to design an adaptive parameter to solve the problem of distance parameter selection in credal c-means clustering (CCM). Finally, the Dempster’s rule of combination was improved by introducing spatial neighborhood information, which is used to assign the pixels belonging to the meta-cluster and the noise cluster into the singleton cluster. Experiments on synthetic images, real images and remote sensing SAR images demonstrate that the proposed algorithm not only suppress noise effectively, but also retain the details of the image. Both the segmentation visual effect and evaluation indexes indicate its effectiveness in image segmentation.
Association of preoperative serum CA72-4 with prognosis in stage I-III colorectal cancer patients and its interaction with preoperative CEA: a multicenter retrospective cohort study Running head: Preoperative CA 72-4 and CEA in outcomes of colorectal cancer
Authors: Yanli Li , Pang Xiaolin , Zhao Li , Chen Yaxue , Liu Lizhu , You Ruimin , Zhang Yin , Liu Mengmei , Yang Guangjun , Li Zhenhui , Pu Hongjiang
Published: April 2023

BACKGROUND AND AIMS: Whether preoperative serum carbohydrate antigen (CA) 72-4 is an independent predictor of outcome and whether has an interaction between CA72-4 and the impact of carcinoembryonic antigen (CEA) on colorectal cancer (CRC) patients' risk of recurrence is still unknown.
PATIENTS AND METHODS: Patients with pathologically confirmed stage I-III colorectal adenocarcinoma who received direct radical resection at 2 hospitals from 2008 to 2017 were collected. According to the levels of CEA and CA72-4 before operation, the patients were divided into 4 groups: Group A with normal CEA and CA72-4 levels preoperatively (CEA≤5.0 ng/mL,CA72-4≤6.9 U/mL, n=952) ;Group B had normal preoperative CEA but high CA72-4 levels (CEA≤5.0 ng/mL,CA72-4>6.9 U/mL, n=217) ；Group C had elevated preoperative CEA but normal CA72-4 (CEA>5.0 ng/mL,≤6.9 U/mL, n=574) ；Group D had both elevated preoperative CEA and CA72-4 (CEA>5.0 ng/mL, CA72-4>6.9 U/mL, n=182). The Kaplan-Meier survival curve and a COX regression model was used to estimate the correlation between preoperative CA72-4 and overall survival (OS) and recurrence-free survival (RFS).
Results: A total of 3,651 patients (52.7%) are included in this study. Median age (IQR) : 60.0 (50.0, 68.0) years; Mean body mass index (BMI) (SD) : 22.718(3.256) kg/m2. Compared with normal CA 72-4 (≤6.9 U/mL, n=3252), patients with increased CA 72-4 (>6.9U/mL, n=399) had higher OS(HR:1.4;95% CI, 1.07-1.83; P = 0.0072). In Cox multivariate analysis, increased preoperative CEA and CA72-4 were associated with shorter RFS(HR:1.69;95% CI, 1.23- 2.32; P = 0.001) and OS (HR, 2.92;95% CI, 2.14-3.98; P < 0.001). However, patients with normal preoperative CEA, no matter if CA72-4 is increased or normal, were not associated with RFS and OS shortening, while patients with high CEA but normal CA72-4 were only associated with OS(HR:1.82;95% CI, 1.42-2.33; P <0.001).
Conclusion:CA72-4 is an independent predictor of outcome for patients with elevated preoperative CEA. The influence of preoperative CA72-4 level on prognosis is different under different CEA stratification. It is necessary to combine CA72-4 with CEA to predict the prognosis of patients.
The Vulnerable West African Dwarf Crocodile (Osteolaemus Sp. Aff. Tetraspis) is Worth Conserving in Urban Ecosystems: Evidence from Ghana
Authors: Naabeh Clement Sullibie Saagulo , Oppong Samuel Kingsley , Amoah Emmanuel , Ahmed Shamim , Anokye Akwasi
Published: April 2023

The study aims to investigate the population structure and encounter rates of the West African dwarf crocodile in urban landscapes, which have been neglected in research due to their perceived lack of biodiversity. The study was conducted in six purposively selected urban centers in the Kumasi metropolis of Ghana, where surveys were conducted using interviews, literature review, and standard diurnal crocodile survey methods. The study found no significant difference (P = 0.143) in encounter rates between urban and non-urban environments, but significant variations (P = 0.002) under an alpha level of 0.05 were observed at the site level. Population structures did not vary significantly, but there were differences in dwarf crocodile abundance among habitat types, with forest habitats recording the highest abundance. Based on the findings, the study recommends that habitats with forest fragments be given great conservation importance when planning urban crocodile management programs. This study provides baseline data that can serve as a guide for policymakers and management bodies in developing urban management strategies for the West African dwarf crocodile. The study's results highlight the need to consider biodiversity in urban planning and development, particularly for keystone species like the West African dwarf crocodile, to support sustainable and inclusive urban development.