bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations of glucose metabolism and diabetes with heart rate variability: A population-based cohort study
Authors: Yu Linling , Yang Meng , Nie Xiuquan , Zhou Min , Tan Qiyou , Ye Zi , Liu Wei , Liang Ruyi , Feng Xiaobin , Wang Bin , Chen Weihong
Published: March 2023

Objective
To investigate potential causal pathways and temporal relationships of glucose metabolism and diabetes with heart rate variability (HRV).
Methods
The cohort study was developed in 3858 Chinese adults. At baseline and 6 years follow-up, participants underwent HRV measurement (low frequency [LF], high frequency [HF], total power [TP], standard deviation of all normal-to-normal intervals [SDNN], and square root of the mean squared difference between adjacent normal-to-normal intervals [r-MSSD]) and determination of glucose homeostasis (fasting plasma glucose [FPG] and insulin [FPI], homeostatic model assessment for insulin resistance [HOMA-IR]). Cross-lagged panel analysis was used to examine the temporal relationships of glucose metabolism and diabetes with HRV.
Results
FPG, FPI, HOMA-IR, and diabetes were cross-sectionally negatively associated with HRV indices at baseline and follow-up (P <0.05). Cross-lagged panel analyses showed significant unidirectional paths from baseline FPG to follow-up LF (β=-0.06), and baseline diabetes to follow-up low TP group (β=0.08), low SDNN group (β=0.05), and low r-MSSD group (β=0.10) (P <0.05). No significant path coefficient from baseline HRV to follow-up impaired glucose homeostasis or diabetes was observed. The results were still statistically significant after excluding participants taking antidiabetics.
Conclusions
The findings provide strong evidence that elevated FPG and diabetes may be the causes rather than the consequences of HRV reduction over time.
Vitamin D deficiency impairs testosterone secretion and spermatogenesis in mice: the role of the transsulfuration pathway
Authors: Jamshidian-Ghalehsefidi Narges , Rabiee Farzaneh , Tavalaee Marziyeh , kiani Shaghayegh , Pouriayevali Farnaz , Razi Mazdak , Dattilio Maurizio , Nasr-Esfahani Mohammad Hossein
Published: March 2023

Vitamin D deficiency is a global health problem and has been linked to defective spermatogenesis and male infertility. In this study, we aimed to investigate the main enzymes are involved in transsulfuration pathway of 1-carbone metabolism, and spermatogenesis function. Therfore, sixteen male C57 mice were addressed to a control (standard diet) or vitamin D deficient (VDD) diet for 14 weeks. The results show that compared to the standard diet, VDD increased final body weight and reduced sperm quality, caused damage to the testicular structure, and decreased the serum levels of testosterone. In addition, serum concentrations of homocysteine, vitamin B12, and sperm oxidative stress markers increased. In testicular tissues, the CBS and CSE protein level were down-regulated whereas HO-1 was up-regulated at both mRNA and protein expression levels. Within a mice deprivation model, VDD deeply suppressed testosterone and impaired spermatogenesis with oxidative stress-mediated mechanisms. The effects of the deprivation appeared to be at least in part independent of genomic and receptor-mediated vitamin D actions and suggest a specific impairment of the alternative transsulfuration pathway.
An unequal new information priority grey forecasting air pollution urban model considering the regional socio-economic development
Authors: tu leping , Dang Yaoguo , Wang Junjie
Published: March 2023

The prediction of air quality has been a hot research topic in environmental issues. Due to the obvious regional characteristics of air pollution in Handan, the prediction of the Air Quality Composite Index (AQCI) in Handan was carried out considering the socio-economic factors in Handan and the surrounding cities. Firstly, the main factors affecting the AQCI of Handan were screened from the added value of primary industry, added value of industry, added value of construction industry, added value of tertiary industry, number of resident population and vehicle ownership in Handan and its five surrounding cities using a grey correlation analysis model. Then, considering the variability of development trends and information priorities among different city factors, a grey unequal new information priority multivariate convolution prediction model (UNGMC(1,N)) is proposed, and the particle swarm algorithm is used to adaptively optimize the nonlinear model parameters. The model comparison results show that the stability and prediction accuracy of the proposed UNGMC(1,N) model are significantly higher than those of other grey models and some popular air quality prediction methods. According to the research results, the air quality of Handan city is mainly influenced by the number of permanent residents in Handan city, and the air quality of Handan city is negatively correlated with the number of permanent residents in Handan city. In terms of regional pollution, the air quality of Handan city shows a positive correlation with the added value of tertiary industry in the neighboring city of Anyang. In addition, Handan's air quality will continue to improve in the future with U-shaped improvement efficiency and 2024 will be a critical year for Handan's air quality improvement efficiency.
Dietary management in pregnant Phenylketonuria (PKU) patients: comparison with protein and phenylalanine requirements in healthy pregnancies
Authors: Ennis Madeleine , Heath Annie Rosen , Branov Jennifer , Bosdet Taryn , Lehman Anna , Sirrs Sandra , Elango Rajavel
Published: March 2023

Background: Diet, with an emphasis on phenylalanine restriction, is recognized as an effective treatment for phenylketonuria (PKU). A similar approach is used in pregnant PKU patients to reduce teratogenic effects of elevated circulating phenylalanine. Our objective was to assess the dietary management of pregnant PKU individuals at Vancouver General Hospital, Canada, retrospectively including dietary recommendations, phenylalanine intake, patient compliance and a comparison with protein and phenylalanine requirements determined in healthy pregnancies.
Methods: We reviewed dietitian’s health records for pregnant patients monitored for PKU between 1999-2019 at the Adult Metabolic Diseases Clinic (AMDC). Data were extracted on demographics, gestational weight gain, gestational age at delivery, pregnancy outcomes, plasma analyses, reported health concerns, and dietary intake of phenylalanine, tyrosine, and protein. We present descriptive statistics of subject characteristics and clinical results. Paired sample t-test assessed for differences between prescribed phenylalanine and phenylalanine intake. Generalized additive mixed models approach was used to observe changes in phenylalanine concentration in blood spots and phenylalanine tolerance throughout the pregnancy.
Results: Eleven patients aged 20-40 years, with a total of 16 pregnancies, were included for analysis. Prescribed phenylalanine intake increased from 7.2 ± 4.3 to 16.7 ± 4.8 mg·kg-1·d-1 between early (13-19wk) and late (33-39wk) gestation. Actual phenylalanine intakes increased from 7.5.2 ± 4.3 to 17.7 ± 4.9 mg·kg-1·d-1 between these stages and were not statistically different. When compared to our previously determined mean phenylalanine requirements in healthy pregnancies during ~16wk pregnancy (15 mg·kg-1·d-1) and late (~36wk) pregnancy (21 mg·kg-1·d-1), phenylalanine intake was 50% lower at 13-19wk gestation and 16 % lower at 33-39wk gestation. Mean phenylalanine concentration in blood spots decreased as pregnancy progressed, with the mean concentration being highest preconception, and a slight increase between 8 and 12 wk.
Conclusions: Current management practices at AMDC are working well to achieve targeted metabolic control. Increase in phenylalanine requirements during early healthy pregnancy, combined with slight increase in blood spot phenylalanine in early PKU pregnancy is intriguing and suggests a need to directly determine phenylalanne needs. This natural history analysis provides reference values and management practices of pregnant PKU patients, contributing to the limited data available.
Biomechanical Comparison of Static and Dynamic Cervical Plates in terms of Bone Fusion, Tissue Degeneration, and Implant Behavior
Authors: Chung Tzu-Tsao , Hueng Dueng-Yuan , Lin Shang-Chih
Published: March 2023

Introduction:
Using an anterior cervical fixation device in the anterior cervical discectomy and fusion (ACDF) has evolved to various systems of static and dynamic cervical plates (SCP and DCP). Dynamic cervical plates have been divided into three categories: the rotational (DCP-R), translational (DCP-T), and hybrid (DCP-H) joints. However, little studies have been devoted to systematically investigate the biomechanical differences of dynamic cervical plates.
Materials and Methods
The biomechanical tests of load-deformation properties and failure modes between the SCP and DCP systems are implemented first by using the UHMWPE blocks as the vertebral specimens. The CT-based C2-C7 model simulates the strategies of cervical plate in ACDF surgery is developed with finite-element analyses. One intact, one SCP and two DCP systems are evaluated for their biomechanical properties of bone fusion and tissue responses.
Results
In the situation of biomechanical test, The mean values of the five ACDSP constructs are 393.6% for construct stiffness (p < 0.05) and 183.0% for the first yielding load (p < 0.05) less than those of the SCP groups, respectively. In the situation of finite-element analysis, the rigid-induced ASD is more severe for the SCP, followed by the DCP-H, and the DCP-R is the least.
Discussion and Conclusions:
Considering the degenerative degree of the adjacent segments and osteoporotic severity of the instrumented segments is necessary while using dynamic system. The mobility and stability of the rotational and translational joints are the key factors to the fusion rate and ASD progression. If the adjacent segments have been degenerative, the more flexible system can be adopted to compensate the constrained mobility of the ACDF segments. In the situation of the osteoporotic ACDF vertebrae, the stiffer system is recommended to avoid the cage subsidence.
Association between routine Cell Salvage use for Lower Segment Caesarean Section and post-operative iron infusion and hemoglobin during the Covid-19 Pandemic
Authors: Fox Tom P , Timpani Evelyn , Green Amanda , Parange Anupam , Sinha Romi , Kelly Thu-Lan , Hodyl Nicolette A , Froessler Bernd
Published: March 2023

Purpose
Intraoperative cell salvage is central to Patient Blood Management including for lower segment caesarean section. Prior to April 2020, we initiated intraoperative cell salvage during caesarean section based on risk assessment for hemorrhage and patient factors. As the pandemic broadened, we mandated intraoperative cell salvage to prevent peri-partum anemia and potentially reduce blood product usage. We examined the association of routine intraoperative cell salvage on maternal outcomes.
Methods
We conducted a single-center non-overlapping before-after study of obstetric patients undergoing lower segment caesarean section in the 2 months prior to change in practice (‘usual care = selective intraoperative cell salvage’, n = 203) and the 2 months following (‘mandated intraoperative cell salvage’, n = 228). Recovered blood was processed when a minimal autologous reinfusion volume of 100 ml was expected. Post-operative iron infusion and length of stay were modelled using logistic or linear regression, using inverse probability weighting to account for confounding.
Results
More emergency lower segment caesarean sections occurred in the Usual Care group. Compared to the Usual Care group, post-operative hemoglobin was higher and anemia cases fewer in the Mandated intraoperative cell salvage group. Rates of post-partum iron infusion were significantly lower in the Mandated intraoperative cell salvage group (OR = 0.31, 95% CI = 0.12 to 0.80, P = 0.016). No difference was found for length of stay.
Conclusion
Routine cell salvage provision during lower segment caesarean section was associated with a significant reduction in post-partum iron infusions, increased post-operative hemoglobin and reduced anemia prevalence.
Dengue Hemorrhagic Fever with bleeding and fluid overload in a patient with active Lupus Nephritis: a case report of diagnostic and therapeutic challenges
Authors: Vidanapathirana Manudi , Atukorale Inoshi
Published: March 2023

Background: Diagnosis and management of dengue hemorrhagic fever (DHF) can be challenging in the presence of confounding comorbidities. Important confounders are conditions that alter hematological parameters and intra/extra vascular fluid distribution. We report the case of a patient with active lupus nephritis, who developed DHF with subsequent bleeding and fluid overload. This is the first case report to highlight a unique set of diagnostic and therapeutic challenges in DHF in this context.
Case presentation: A seventeen-year-old girl with lupus nephritis class IV developed a renal flare of lupus and subsequently developed DHF with bleeding per vaginum. Due to acute kidney injury, she was managed with a restrictive fluid approach during the ascending limb with blood transfusion when required, and close monitoring for hemodynamic instability. During the descending limb, hourly input was transiently increased due to a rise in hematocrit. This precipitated nephrogenic pulmonary edema, which was managed with mechanical ventilation and continuous renal replacement therapy.
Conclusions: This patient posed two diagnostic challenges: diagnosis of dengue in a patient with lupus-related bicytopenia, and diagnosis of dengue leakage in a patient with nephrotic syndrome-related ascites. There were three therapeutic difficulties: deciding the fluid quota for DHF in the presence of renal impairment, and balancing the risks and benefits of steroids and anticoagulation in lupus nephritis with dengue. As decisions in such instances are patient-specific, sharing of individual experiences will help guide management decisions.
Association between lean mass and adolescent idiopathic scoliosis: A meta- analysis
Authors: Xu Wei , Zang Jiajie , Wu Fan
Published: March 2023

Objective: The objective of this meta-analysis was to evaluate the association between lean mass and adolescent idiopathic scoliosis (AIS).
Methods: English databases CENTRAL (The Cochrane Library and the Cochrane Back Review Group Trials Register), MEDLINE, EMBASE, PubMed, Web of Science and Chinese databases CBM, CNKI, VIP, WANGFANG DATA were searched for the relevant case control studies and cross-sectional studies. Two authors selected studies and extracted data independently. Data analysis was performed by Stata15.0.
Results: Six studies were included, with a total of 1742 cases of AIS and 6309 controls. AIS group had a lower lean mass compared to control group [MD = −2.15, 95% CI (−3.26, −1.04)]. In the subgroup analysis, female AIS patients had a lower lean mass than the control group [MD = −2.27, 95% CI (−4.13, −0.41)]. The mean difference of lean mass between AIS patients and control group in studies with adults [MD = −1.07, 95% CI (−1.68, −0.46)] is much greater than studies without adults [MD = −5.53, 95% CI (−9.09, −1.56)]. There was not statistically significant in European studies[MD = −2.11, 95% CI (−4.35, 0.14)], but in Asian studies lean mass in AIS patients was lower than the control group[MD = −2.55, 95% CI (−4.49, −0.61)]. Study type, gender, age, and geography condition were thought to have no effect on the primary outcome of lean mass by subgroup analysis.
Conclusion: In the meta-analysis, AIS group had a lower lean mass compared to control group, which indicated that lean mass may be involved in the pathogenesis of AIS. But limited by the number of studies we included; the above conclusions need to be validated by more high-quality studies.
The Chain Mediating Role of Rumination and Emotional Regulation Self-Efficacy in the Effect of Social Support on Depression in Chinese College Students
Authors: Zhang Junliang , Hu Zhongzheng , Zheng Shuang , Liu Yingyu
Published: March 2023

Objective: The purpose of this study was to explore the relationship between social support, rumination, emotion regulation self-efficacy (ERSE) and depression in college students, focusing on the mediating effect between social support and depression in college students.
Methods: A cross-sectional study of 1433 college students in Jiangxi, China was conducted between October and November 2022. A series of mediation analyses were performed using AMOS24.0 and the PROCESS macro to examine the mediation effects.
Results: The study found that depression was significantly positively correlated with rumination, while ERSE was significantly negatively correlated with social support and ERSE. Social support has a direct negative predictive effect on depression in college students. Rumination and ERSE play independent mediating and chain mediating roles in the mechanism of social support affecting college students' depression, with indirect effect values of 0.11, 0.02 and 0.01, respectively.
Conclusions: To alleviate and prevent depression in college students, emphasis should be placed on rumination and ERSE in addition to the influence of social support.
Morphological characterization using nonmetric variables in exotic oat (Avena SP.) accessions
Authors: belsariya Neha , Sahu Mayuri , Kak Anjali , Roy Sujit
Published: March 2023

Oat (Avena sativa L.) ranked 6th in the world cereal production which is an important annual crop of rabi season. The genus Avena is very large and diverse and includes diploid, tetraploid and hexaploid species (Kaur and Kapoor, 2017). Genus Avena includes 70 species, most of the oat’s production in worldwide belongs to the hexaploid species: Avena sativa L. (widely cultivated white oat) (2n = 6x = 42. AACCDD) and Avena byzantina C. Koch (red oats) (2n = 6x = 42. AACCDD). Other minor cultivated species includes Avena abyssinica (Ethiopian Oats) (2n = 4x = 28, AABB) and Avena strigosa (Known by Black Oats) (2n = 2x = 14, AsAs) (Gorash et.al., 2017). There is tremendous variability available in oat germplasm studied to characterize and evaluate the exotic genotypes excluding checks using DUS guidelines of different nonmetric traits. Two ninety-four oat genotypes belonging to ten different Avena species procured from NBPGR were characterized on the basis of observations recorded for eight morphological non-metric characters as per the guidelines for the conduct of test for Distinctiveness, Uniformity and Stability. The observations were recorded on five randomly selected plants in each genotype for the following thirteen non-metric traits viz., Early plant vigour, growth habit, leaf colour, leaf sheath pubescence, flag leaf attitude, Panicle attitude, awn per spikelet, seed colour, stem solidness, primary floret pubescence, spikelet shattering, hullness and biotic stress susceptibility at Research cum Instructional Farm, IGKV, Department of Genetics & Plant Breeding, Raipur during Rabi 2019-20. Coefficient of variation and principal component analysis revealed variability among the genotypes for the non-metric traits evaluated. Highly Significant positive correlation showed among traits viz., seed colour (black) and biotic stress susceptibility (very low). PCA analysis showed that genotypes namely EC0004456, EC0099165, EC0178761, EC0104007, EC0537811 were very different from each other. Cluster analysis separated genotypes into four sub cluster: genotype EC0022023 with erect flag leaf attitude and brown seed colour (Avena sativa) present in different cluster and 23 genotypes with brown seed present in one cluster, all belongs to Avena sativa only one genotype IC0282934 belongs to Avena byzantina. Genotype namely EC0108477, EC0039402, EC0039915 (Avena sterilis) showed black seed. The genotype EC0178761 having compact panicle attitude. stem solidness, primary floret pubescence, spikelet shattering, hullness shows only one class.
Post-traumatic responses to workplace violence among nursing professionals: A collaborative and comparative study in South Korea and Hong Kong
Authors: Hong Soyun , Nam Sujin , Wong Janet Yuen Ha , Kim Heejung
Published: March 2023

Background
Workplace violence has had a significant and negative psychological impact on nursing professionals worldwide. Concerted efforts worldwide to improve work environments have not yet removed nursing professionals from the threat of violence in East Asia. This study aimed to examine the differences in the rate, associated factors, and post-traumatic responses to workplace violence between South Korean nurses and Chinese nurses in Hong Kong among East Asian countries.
Methods
A cross-sectional, correlational study design recruited a total of 471 nurses (319 South Korean nurses and 152 Chinese nurses in Hong Kong) at online communities in South Korea and Hong Kong. The data were collected by conducting a Qualtrics survey from January 15, 2020, to July 24, 2021. A structured questionnaire was administered for data collection, including rate of workplace violence, perception of workplace violence, attitudes toward workplace violence, coping styles, post-traumatic cognitions, post-traumatic stress disorder, post-traumatic growth, and mental health indicators (depression, anxiety, and stress). T-test, chi-squared, and binary logistic regression analyses were conducted using SPSS version 25.
Results
In our sample, 30.7% South Korean nurses and 31.6% Chinese nurses in Hong Kong had experienced workplace violence. South Korean nurses and Chinese nurses in Hong Kong with experience of workplace violence had lower perceptions of it. Nurses with experience of workplace violence reported lower levels of mental health, and this trend was more prominent among South Korean nurses.
Conclusions
Our study findings showed a positive association between workplace violence and post-traumatic responses in both settings. We found that the close monitoring of post-traumatic responses associated with workplace violence could be improved by enhancing the nurses’ perception of workplace violence.
The endoscopic retrograde appendicitis therapy for acute appendicitis in children: a systematic review and meta-analysis
Authors: Liu Lan , Zeng Huiping , Fang Yifan , Zhang Bing , Yang Yingying , Bai Jianxi , Lin Sheng , Xie Siqi
Published: March 2023

Background:Acute appendicitis (AA) is one of the most common abdominal emergencies in children. There has been an increasing interest in endoscopic retrograde appendicitis treatment (ERAT) in the past twenty years. We performed a meta-analysis of ERAT for AA in children through a survey and an extensive literature search that summarized the clinical features and therapeutic efficacy of ERAT.
Methods: A systematic review and meta-analysis of retrospective studies published in PUBMED, MEDLINE, Cochrane, China National Knowledge Infrastructure (CNKI), WanFang and VIP Database. The search has a limit on date from Jan 1, 2012 to Jun 31, 2022, with the last search done on Oct 31, 2022. No publication restrictions or study design filters were applied. The registration number in PROSPERO was CRD42022377739.
Results: Seven retrospective cohort studies with 423 patients were enrolled in our study. In our study, almost 57.6% (95% confidence interval (CI) 52.8%-62.4%) of children who underwent ERAT were male, the pooled rate of successful intubation was 99.5%(95%CI 98.2%-100.0%), the average time of an ERAT is approximately 49 minutes(95% CI 48.179,49.833), and efficiency of ERAT for acute appendicitis was 99.0% (95% CI 96.5%-100.0%), while, the pooled rate of recurrence was 4.2% (95% CI 2.2%-6.7%), the mean time of hospital stays was 4.319 (95% CI 4.254-4.385) days probably, and occurrence of postoperative complication was about 3.9% (95% CI 2.0%-6.2%).
Conclusions: Our results testify the relevant morbidity, clinical characteristics and prognosis in the ERAT, in spite of an enormous heterogeneity among few primary studies. ERAT has high efficiency and low recurrence rate in children with acute uncomplicated appendicitis, and preserves the physiological function of the appendix and avoids sizeabledamage, so it can be a safe and effective treatment for appendicitis in children.
Integrated health care systems for asthma: A qualitative narrative study from the perspective of Ecuadorian health professionals
Authors: Granadillo Emily , Romero-Sandoval Adriana , Cisneros-Caceres María José , Montalvo-Yépez José Alfonso , Gómez-Urrego Juan Guillermo , Rodriguez-Alvarado Alejandro , Bachmann Max , Cruz Alvaro , Cooper Philip , Silva María Rejane Ferreira da , Romero-Sandoval Natalia
Published: March 2023

Background: Care coordination is a characteristic of integrated health service networks, understood as an action that, based on primary care, integrates the different levels of care. Care coordination can improve the quality of care, especially for chronic diseases such as asthma.
Objective: To analyse perspectives of health professionals within different levels of care on the care coordination for asthma in Ecuador.
Methods: Descriptive qualitative study. Guided by the Integrated Health Care Network Model, we completed 25 in-depth semi-structured interviews in three Ecuadorian cities between 2020 and 2021. Using purposive sampling, health care professionals were selected from primary, emergency, specialist, and managerial levels. We used narrative analysis to identify significant phrases from interviews. We followed the Standards for Reporting Qualitative Research.
Results: Participants highlighted the scarce use of institutional documents for the referral of patients with asthma from the first level to specialists and vice versa, as well as between the different health subsystems. They identified weaknesses in the follow-up for patients with asthma, lack of objectives shared between the different levels of care, duplication of tests and medical prescriptions, and lack of availability of appointments in the public system that limits access to specialized care. The managers highlighted the system's inability to assign appointments on time and failures in administrative processes for follow-up. Emergency professionals do not have access to previous clinical data for patients having an asthma attack, so they rely on the use of emergency treatments without scheduling a specialist referral afterwards.
Conclusions: From the perspectives of health professionals in Ecuador, asthma care coordination requires strengthening at all levels within the public health system, from the formulation of common goals to improved transfer of asthmatic patients between levels to optimize healthcare resources.
Intelligent situation awareness based on the fractal dimension and multidimensional reconstruction
Authors: Wang Peiyuan , Guan Xin
Published: March 2023

In order to realize autonomy and intelligence for situation awareness, this paper proposes an intelligent situation awareness model based on fractional dimension information mining and multi-dimensional information reconstruction. First, the spatial situation perception is established by 3D reconstruction of the input fusion information, 4D completes the situation comprehension and 5D reconstruction seeks the situation prediction. The three-level situation estimation model is optimized to a more robust situation estimation ternary model. Combined with the database system, the reasoning learning mechanism and the diversified human-machine interface concept, a basic framework of intelligent situation awareness is completed. Secondly, the system’s flexible configuration method is demonstrated. Thirdly, some basic evaluation methods are given for the intelligent situation awareness’s performance metrics and multi-node consistency. Fourthly, the paper gives a typical electromagnetic situation estimation example for a drilling platform to explain and validate the theory. Finally, several suggestions are put forward for the next construction of intelligent situation awareness system.
A single-center prospective study on pain alleviation during peroral upper endoscopy with an ultrathin endoscope
Authors: Aya Iwao , Ichijima Ryoji , Sugita Tomomi , Nakayama Masako , Takasu Ayaka , Ogura Kanako , Gotoda Takuji , Kogure Hirofumi
Published: March 2023

Background
The efficacy of transnasal endoscopy using an ultrathin endoscope has been reported in several studies. However, few studies regarding peroral endoscopy with an ultrathin endoscopes with high resolution have been reported. This study investigates the pain alleviation of peroral endoscopy with an ultrathin endoscope.
Methods
Patients with a history of peroral endoscopy using a conventional, normal-diameter scope with no-sedation who underwent peroral esophagogastroduodenoscopy (EGD) using a thin scope between April-July 2022 were included in this study. After the procedure, the patients completed a questionnaire evaluating pain during the examination and willingness to repeat the procedure. The physicians were surveyed regarding their level of satisfaction. The primary endpoint was patient satisfaction, which corresponded to the rate of patients who rated the thin endoscope as more comfortable or somewhat more comfortable than the previously-used, conventional endoscope.
Results
One hundred forty-five patients were included in the analyses. Patient satisfaction was achieved in 86.2% (125/145) of patients. The median visual analog scale pain score was 3 (0–7) points in this study, which is significantly lower than the pain score after the previous endoscopy (5 (0–10) points; p < 0.001). In addition, 96% (24/25) of patients who underwent EGD by an expert and 95.8% (115/120) who underwent EGD by a non-expert were willing to repeat endoscopy using the thin scope (p = 0.69).
Conclusion
Peroral endoscopy using a thin scope reduces patient pain regardless of the endoscopist’s experience.
Achieving health-oriented air pollution control requires integrating unequal toxicities of industrial particles
Authors: Wu Di , Zheng Haotian , Li Qing , Wang Shuxiao , Zhao Bin , Jin Ling , Li Xiangdong , Hao Jiming
Published: March 2023

Protecting human health from fine particulate matter (PM) pollution is the ambitious goal of clean air actions, but current control strategies ignore the role of source-specific PM toxicity. Here, we proposed health-oriented control strategies by integrating the unequal toxic potencies of the most polluting industrial PMs. Iron and steel industry (ISI)-emitted PM2.5 exhibit about one order of magnitude higher toxic potency than those of cement and power industries. Compared with the current mass-based control strategy (prioritizing implementation of ultralow emission standards in the power sector), the proposed health-oriented control strategy (priority control of the ISI sector) could generate 5.4 times higher reduction in population-weighted toxic potency-adjusted PM2.5 exposure among polluting industries in China. Furthermore, the marginal abatement cost per unit of toxic potency-adjusted mass of ISI-emitted PM2.5 is only a quarter of that of the other two sectors under ULE scenarios. We highlight a health-oriented air pollution control strategy is urgently required to achieve cost-effective reductions in particulate exposure risks.
Experimental study on the influence of graded-loading rate on the creep-hardening effect of anthracite
Authors: Yue Shaofei , Wang Kai , Zhang Xiaoqiang , Kang Tianhe , Yan Jianbing , Jiang Yulong , Guo Zexiong
Published: March 2023

To investigate the influence of graded-loading rate on the creep characteristics and hardening effect of anthracite, creep tests at different graded-loading rates (0.01–0.1 mm/s) were performed on anthracite standard samples using the LDHJ-III triaxial creep-testing machine. The effect of graded-loading rate on the instantaneous strain increment, instantaneous elastic modulus, and decay characteristics of the strain rate in the creep stage were analyzed and discussed. The results revealed the following. With the increase in the graded-loading rate, especially when the loading rate was higher than 0.04 mm/s, the axial instantaneous strain increment was obvious, the radial-strain hysteresis was significant, the actual yield stress of the specimen was decreased, the “hardening” effect of the specimen was obvious, the strain rate attenuation in the creep stage was more rapid. The research results could quantitatively describe the “hardening” effect of the graded-loading rate on anthracite creep and predict the creep failure of an anthracite specimen.
WITHDRAWN: Systematic Review of the Efficacy of Gluten-Free/Casein-Free diet or Supplementary Diets to Alleviate Symptoms of Autism Spectrum Disorder in Children
Authors: Kazem Zeina
Published: March 2023

Purpose: The aim of this systematic review is to provide literature data about the efficacy and safety of specific biomedical dietary interventions on clinical aspects of children with autism.
Methods: Pubmed was used as the source of the medical database to conduct a literature search on this topic. The date of the publication was not a restriction. Consideration was given to prospective studies conducted in child and adolescent populations (age 0 to 18) and evaluating the changes in the behaviour of those with Autism Spectrum Disorder (ASD). The specific types of dietary interventions evaluated in this review are gluten/casein free diet, the use of probiotics/prebiotics, and briefly mentioning other emerging suggestions.
Results: Currently, while literature data is generally encouraging, additional randomized clinical trials are needed to provide more conclusive evidence about the effects of specific dietary interventions on the clinical aspects of autism.
Conclusion: This systematic review concludes that exclusion diets or dietary supplementation are effective adjuvant therapeutic agents; however, more detailed studies are recommended to develop more effective therapeutic methods to improve the quality of life of children with autism spectrum disorders.
Lethal suicidal intoxication with propafenone and diazepam: a case report
Authors: Yan Shuangbing , Chen Bingwei , Xin Ting , Luo Xiaojie , Wang Yu
Published: March 2023

Background: Diazepam poisoning is a common emergency situation in internal medicine, but propafenone poisoning is rare relatively. At present, there is no reported case of propafenone poisoning combined with diazepam.
Case presentation: An 18-year-old woman was admitted to our hospital with an overdose of oral propafenone and diazepam, who presented with convulsions and syncope. She was treated with cardiopulmonary resuscitation, rehydration, atropine, sodium bicarbonate, and vasopressors including dopamine，epinephrine, norepinephrine, isoproterenol, but sinus rhythm could not recovery and cardiac arrest occurred. Temporary pacemaker was implanted. However, even with multiple electrode positions, effective capture could not be achieved. The patient died eventually.
Conclusion: This was the first reported case of propafenone poisoning combined with diazepam. We should be alert to the possibility of propafenone poisoning when we find similar situations in arrhythmia patients.
Low preoperative serum total bilirubin level is a risk factor for intraoperative blood loss in the laparoscopic hepatectomy ---a retrospective study
Authors: Liu Yang , Li Nan , Yang Chun , Liu Cunming , Liu Shijiang
Published: March 2023

Background
Reduction of Intraoperative blood loss (IBL) is necessary for laparoscopic hepatectomy (LH). However, the risk factors before liver resection for IBL in LH is poorly understood. The research aimed to analyze the risk factors before liver resection for IBL in LH.
Methods
The data of consecutive patients who underwent LH for hepatocellular carcinoma from 2021 to 2022, were retrieved retrospectively. The patients were divided into two groups: the group A was for those with an IBL less than 250 mL (Group A, IBL༜250ml), and the group B was for those with an IBL more than 250 mL (Group B, IBL ≥ 250ml).
Results
We analyzed 246 patients who underwent LH. Median IBL was 250 (IQR: 100–500) ml in our research. Tumor size ≥ 3cm contributed to a higher level of IBL with Odds ratio of 2.496(95% CI 1.422–4.381, p = 0.001). High preoperative total bilirubin levels may be a protective factor for IBL ≥ 250ml and Odds ratio was 0.438༈95% CI 0.258–0.743, p = 0.002༉and a dose-response relationship was observed. In other words, low preoperative total bilirubin levels may be a risk factor for IBL ≥ 250ml. After correcting for other variables of characteristics, their statistical significance remained unchanged. The incidence of postoperative complications was 16.3%. The incidence of postoperative complications was significantly higher in Group B compared to Group A (21.8 vs. 10.7%, p = 0.018).
Conclusions
Increased IBL (≥ 250 ml) may adversely impact the short-term outcomes. In addition to tumor size, low preoperative serum total bilirubin level may be a risk factor for blood loss in LH.
A Flexible Pressure Sensor Based on an Interlocked Micropillars Array with Secondary Nanoprotrusions for Health Monitoring
Authors: Wen Li , Liao Lirui , Zhou Shuneng , Yang Junfeng , Wang Zekun , Li Jingjie , Qiu Ziqiang , Yu Zhongxin , Wang Hai
Published: March 2023

Flexible pressure sensors are an essential component in artificial systems to monitor human health. Recently, flexible pressure sensors with micro-nanostructures in interlocked geometry have attracted extensive attention because they effectively improve the sensing performance. However, it is a challenge that the fabrication methods are complex and expensive, and the layered interface between microstructure and nanostructure is unstable. Here, a flexible pressure sensor with an interlocked polydimethylsiloxane (PDMS) micropillar array combined secondary nanoprotrusions on their surfaces is proposed, which can be shaped in one step with merits of simplicity, controllability and low cost. The unique combined micro-nanostructures ensure the sensor with a wide linear range (0~32 kPa), relatively high sensitivity (26.08 Ω/kPa), low detection limit (15 Pa), fast response speed (response time is 56 ms, and relaxation time is 140 ms) and excellent stability (>1000 cycles). These superior properties set a foundation for applying the sensor in detecting various human physiological signals from pulse to joint deformation. Based on this sensor, a smart mask integrated system is proposed, displaying and recording breathing conditions in real time. These results demonstrate that the sensor can be used in health monitoring and disease diagnosis, as well as its potential application in other wearable devices.
Characterization of the extracellular vesicles, ultrastructural morphology, and intercellular interactions of multiple clinical isolates of the brain-eating amoeba, Naegleria fowleri
Authors: Russell A. Cassiopeia , Bush Peter , Grigorean Gabriela , Kyle Dennis E.
Published: March 2023

As global temperatures rise to unprecedented levels, so too do the latitudes of habitable niches for the pathogenic free-living amoeba, Naegleria fowleri. This opportunistic parasite causes a rare, but > 97% fatal, neurological infection called Primary Amoebic Meningoencephalitis. Despite its lethality, this parasite remains one of the most neglected and understudied parasitic protozoans. To better understand amoeboid intercellular communication, we elucidate the structure, proteome, and secretion mechanism of amoeba-derived extracellular vesicles (EVs), which are membrane-bound communication apparatuses that relay messages and can be used as biomarkers for diagnostics in various diseases. Herein we show that N. fowleri secretes EVs in clusters from the plasma membrane, from multivesicular bodies, and via beading of thin filaments extruding from the membrane. Fusion assays demonstrate that EVs are taken up by other amoebae and mammalian cells, and we observed a real-time increase in metabolic activity for mammalian cells exposed to EVs from amoebae. Proteomic analysis revealed > 2,000 proteins within the N. fowleri-secreted EVs, providing targets for the development of diagnostics or therapeutics. Our work expands the knowledge of intracellular interactions among these amoebae and subsequently deepens the understanding of the mechanistic basis of PAM.
Parasites in wildlife in Federation of Bosnia and Herzegovina
Authors: Omeragić Jasmin , Kapo Naida , Softić Adis , Škapur Vedad , Goletić Šejla , Alić Amer , Goletić Teufik
Published: March 2023

Parasitic diseases of wild animals represent an important area of research. In addition to a significant impact on wildlife health and fitness, many of parasitic diseases have zoonotic implications. Scientific information regarding parasitic diseases in wildlife in Bosnia and Herzegovina (BiH) are scarce. Hence, the aim of this research was to investigate wildlife parasites in the Entity of the Federation of Bosnia and Herzegovina (FBiH), with an emphasis on zoonotic species. In the period April 2020 - November 2022, the research was performed in 9 species of wildlife. Out of a total of 1,278 collected samples, parasitic eggs or parasitic DNA were confirmed in 907 (70.9%). Parasitic infestations were confirmed in 15.9% of examined bears (11/69); 83.7% of examined red foxes (262/313); 67.6% of examined wolves (44/65); 25% of examined wild cats (1/4); 20% of examined badger (1/5); 43.7% of examined martens (7/16); 39.7% of examined wild boars (76/191); 84.5% of examined deer (350/414) and in 77.1% of examined rabbits (155/201) The finding of zoonotic parasites (Trichinella spp., Echinococcus multilocularis, Cryptosporidium spp.) is particularly important due to their potential detrimental effects on human health. Therefore, the monitoring of parasitic infections in wildlife has a paramount importance in developing the health care programs and control strategies.
Seismic floor acceleration and energy absorption comparison on residential framed buildings with typical retrofitting and combined with nonlinear dampers
Authors: Preciado Adolfo
Published: March 2023

Here is analyzed the seismic performance of typical 15-story framed buildings of reinforced concrete in original state and retrofitted with different stiff solutions and combined with passive dampers by fast nonlinear time-history analyses. The investigated conventional retrofitting solutions are infill masonry panels, diagonal/Chevron braces, rigid cores and passive dampers (fluid viscous and solid viscoelastic). It is compared the floor shear/bending distribution, peak floor acceleration, seismic energy dissipation and device’s hysteretic performance. The flexible behavior of the unretrofitted building was corrected with stiff retrofitting solutions, but, conversely, the peak floor accelerations were amplified (25–64%). Compared to conventional stiff solutions, the dampers allowed a reduction of distortions (floors 2–12), where the original building showed excessive flexibility. Viscoelastic dampers exhibited acceleration reductions on floors 4–12 (43%) and amplifications on top floors (15%). Conversely, fluid viscous dampers showed more acceleration reductions on almost all floors of 55% and less amplifications on top floors. The energy absorption effectiveness of the devices depended on the location, number of devices, shear forces and peak floor accelerations flow, especially when analyzed without dampers (only with stiff retrofitting). Fluid viscous dampers showed a better performance in terms of seismic energy absorption if compared to the combinations with viscoelastic dampers.
Climate Change Impacts on Broussonetia papyrifera Pollen - Metabolome Investigations and Prospects of Allergy Prevalence in Times of Climate Change
Authors: Humayun Muhammad , Naseem Saadia , Ali Zahid , Goodman Richard E.
Published: March 2023

Broussonetia papyrifera (B. papyrifera) is a tree producing allergenic pollen that grow at varied climatic conditions worldwide. The tree pollen disperse in the air causing allergies in susceptible humans. The study investigates climate change variable’s impact on B. papyrifera pollen’s composition, pollen metabolome, pollen allergenicity and their occurrence in the upcoming years. The tree pollens were collected in summer and spring from different regions in Pakistan. Pollens were subjected to morphological analysis, Fourier Transform Infrared Spectroscopy (FTIR), Liquid Chromatography-Mass Spectrometry (LCMS), and immunoblotting. The tree future-growth invasion was predicted through MaxEnt modeling. Light microscopy and FTIR showed seasonal and regional differences in pollen-morphology and pollen-metabolome that correlated to weather conditions’ shift. LCMS analysis detected four allergenic lipids having a potential role in allergies. Pollen protein immunoblotting-studies identified putative 15 kDa novel allergen, and verified previously known 40 kDa, 33 kDa, and 10 kDa allergens. B. papyrifera MaxEnt modeling through ACCESS1­0 and CCSM4 under 2-greenhouse gas emissions scenarios {representative concentration pathway (RCP) 4.5 and 8.5} projected the tree invasion by the years 2050 and 2070. The study findings demonstrate that climatic variables differences affect B. papyrifera-pollen physiology. The study discovered allergenic lipids and a 15 kDa potential novel allergen in B. papyrifera-pollen protein extracts, and predicted the tree invasion in future. These results predict potential changes in B. papyrifera-pollen allergy risks in the future and provide a model system for studying pollen morphology, plant invasion, and associated allergies in response to climate changes for other species.
Ultralow Threshold Surface Emitting Ultraviolet Lasers with Semiconductor Nanowires
Authors: Vafadar Mohammad Fazel , Zhao Songrui
Published: March 2023

Surface-emitting semiconductor lasers have changed our everyday life in various ways such as communication and sensing. Expanding the operation wavelength of surface-emitting semiconductor lasers to shorter ultraviolet (UV) wavelength range further broadens the applications to disinfection, medical diagnostics, phototherapy, and so on. Nonetheless, the UV surface-emitting lasers demonstrated so far are all using conventional vertical cavities, all with large lasing thresholds in the range of several hundred kW/cm^2 to MW/cm^2. Here, we report ultralow threshold surface-emitting lasing in the UV range using novel epitaxial nanowire photonic crystal structures. Lasing at 367 nm is measured, with a threshold of only 7 kW/cm^2, a factor of 100× reduction compared to the previously reported surface-emitting UV lasers at similar wavelengths. Further given the excellent electrical doping that has already been demonstrated in nanowires, this work offers a viable path for the development of the long-sought-after surface-emitting semiconductor UV lasers.
Customary light-gauge steel framing construction with flat strap bracing. Seismicity limits for short to mid-rise buildings in Europe
Authors: GRANADOS JORDI NAVARRO , Casafont Miquel , Bové Oriol , Bonada Jordi , López-Almansa Francisco
Published: March 2023

Ordinary (customary) light gauge steel framing is a convenient construction technology; however, given the studs low axial capacity, has been mainly considered for short buildings in low seismicity regions. This paper investigates the bounds of this type of steel framing (in moderate and high seismicity areas) by designing the structures of three representative 5, 7 and 10-story buildings in order to examine their feasibility. The necessity of using built-up columns consisting of two or more sections is observed. The axial capacity of studs is estimated by code-type analyses. The critical buckling stress is determined with well-known closed-form expressions; as they do not contemplate the flexibility of the screwed connections (in built-up sections), the obtained results are complemented with those of Finite Strip Method and Generalized Beam Theory formulations.