bluuebunny/crossref_metadata_2025 huggingface dataset:
Paving the way for Hybrid Twins using Neural Functional Mock-Up Units
Authors: Thummerer Tobias , Kolesnikov Artem , Gundermann Julia , Ritz Denis , Mikelsons Lars
Published: March 2024

Porting Neural Ordinary Differential Equations (NeuralODEs), the combination of an artificial neural network and an ODE solver, to real engineering applications is still a challenging venture. However, we will show that Neural Functional Mock-up Units (NeuralFMUs), an evolved subgroup of NeuralODEs that contain Functional Mock-up Units (FMUs), are able to cope with these challenges. This paper briefly introduces to the topics NeuralODE and NeuralFMU and describes the procedure and considerations to apply this technique to a real engineering use case. Further, different workflows to apply NeuralFMUs dependent on tool capabilities and use case requirements are discussed. The presented method is illustrated with the creation of a Hybrid Twin of an hydraulic excavator arm, which has various challenges such as discontinuity, nonlinearity, oscillations and characteristic maps. Finally we will show, that the created Hybrid Twin, on basis of measurement data from a real system, gives more accurate results compared to a conventional simulation model based on first principles.
A Library to Simulate Processes in the Factory Hall
Authors: Gundermann Julia , Blochwitz Torsten
Published: March 2024

The Modelica language is well suited to model systems with discrete and continuous dynamics. If one wants to model the flow of items through manufacturing steps such as preparation, mounting, or transport in the shop floor, this feature is crucial. The library ProcessSimulation can be used to model such processes. By default, it omits the technical details of the process steps, and focuses on the flow of material items through the process steps. In addition to that, a base model to calculate the energy consumption in the different manufacturing steps is provided. It can be enriched with technical details of the components. The library can be used for the calculation of (net) energy consumption, but also for task planning.
Beyond FMI - Towards New Applications with Layered Standards
Authors: Bertsch Christian , Süvern Markus , Sommer Torsten , Schuch Klaus , Reim Kevin , R. Pierre , Menne Benedikt , Junghanns Andreas , Blochwitz Torsten , Blesken Matthias , Täuber Patrick
Published: March 2024

The FMI standard - just like any other standard - faces the challenge of balancing generality with enabling specific use cases. Including every domain or use-case specific extension in the core standard would significantly increase its length, making it unreadable and unimplementable. To allow for extensions of the core standard for specific use cases, the Modelica Association developed the concept of layered standards, first in the SSP standard and later in FMI. This paper presents the concept of layered standards and describes the layered standards currently under development by the FMI Project: XCP support of FMUs, network communication, and structured variables and regular maps in FMI 3.0.
MoCITempGen: Modelica Continuous Integration Template Generator
Authors: Jansen David , Wüllhorst Fabian , Hinrichs Sven , Müller Dirk
Published: March 2024

Modelica enables an object-oriented approach to model complex systems in product development and research, and, thus, the development of various model libraries. Library development requires collaborative development in a team of multiple developers. A typical challenge in collaborative development, especially in the area of open source, is to create models of uniform quality despite different levels of knowledge among developers. Techniques such as Continuous Integration (CI) from the field of software development, can help to solve these challenges. However, the adaptation of CI for the area of Modelica model development currently requires the manual creation of complex templates and a high degree of manual configuration. In this paper we present MoCITempGen, an open source tool for automated generation of CI structures for the widely used modeling language Modelica. The tool is succesfully applied on two Modelica libraries to demonstrate the functionality.
Simulation Study of Flow Instability in Parallel Multi-Channel Systems Based on Modelica
Authors: Tong Qiushi , LV Xing , Deng Kangjie , Zeng Xiaokang , Ding JI , Zhou Fanli
Published: March 2024

In parallel channels of a nuclear reactor core, flow instability can cause a significant decrease in critical heat flux (CHF) or mechanical oscillation of the fuel components, endangering the normal operation of the reactor. The NUMAP software, developed based on the two-fluid six-equation theory and using the Modelica language, is a multi-domain unified modeling and simulation platform for nuclear power plants. In this paper, a parallel dual-channel system model was constructed based on the NUMAP software, referencing a high-temperature and high-pressure steam-water two-phase thermohydraulic experimental device, to simulate flow instability phenomena. The comparison with experimental data validated the transient analysis ability of the NUMAP software for flow instability phenomena. Based on this, the flow instability boundary of a parallel multi-channel system was calculated under the same operating conditions. When the number of parallel channels was 2, 3, and 4, the calculated flow instability boundary error did not exceed ±5%, verifying that a parallel dual-channel structure can be used to obtain the flow instability boundary when there are multiple parallel heating channels.
Over-the-counter hearing aids: implementations and opportunities
Authors: Chung King , Zeng Fan-Gang
Published: March 2024

After decades of effort by shareholders, including government agencies, patient advocacy groups, and professional organizations, the U.S. Food and Drug Administration (FDA) established a new medical device category for over-the-counter (OTC) hearing aids on October 17, 2022. This FDA regulation allows adults aged 18 years or older with perceived mild-to-moderate hearing loss to purchase OTC hearing aids without a prescription or even a hearing test. The goal is to increase hearing aid accessibility, potentially leading to improved hearing and a better quality of life. In our analysis of the FDA Establishment Registration & Device Listing database, we found that the current OTC hearing aid market is still dominated by traditional hearing aid manufacturers, with limited disruptor from major consumer electronics and startup companies. Our technological analyses showed that the relatively high-level output specification without gain limitation allows sufficient amplification even for people with severe-to-profound hearing loss. Additionally, borrowing from the cochlear implant mapping strategy, we propose novel amplification algorithms for fitting OTC hearing aids without an audiogram. We argue that smartphones and true-wireless-stereo earbuds can functionally serve as OTC hearing aids, further increasing accessibility and affordability while reducing the stigma associated with hearing aids, especially in low- and mid-income countries. By treating more people at a younger age with less hearing loss than traditional prescription hearing aids, OTC hearing aids can potentially have a significant impact beyond hearing care, such as delaying or preventing cognitive decline in the elderly.
Study on the permanent deformation of asphalt mixtures based on the modified Burgers model
Authors: Yang Junren , Xie Jun , Tang Xu , Zhang Haijun
Published: March 2024

Based on the confined test results and the viscoelastic constitutive model of asphalt mixtures, a three-dimensional finite element model of an asphalt pavement was established to study the effect of different working conditions on asphalt pavement. With the actual pavement structure response, a comparative analysis was conducted to assess the stress and strain experienced by the asphalt pavement under various working conditions. The results show that the asphalt pavement structure model can reflect the effect of different working conditions on asphalt pavement; the transverse stress and strain of asphalt pavement are most significantly affected by the working conditions during cornering, and the position of the maximum value is concentrated on the outer edge line of the wheel and a distance away from it; however, the longitudinal tensile stress and strain of the asphalt pavement are most significantly impacted by the working conditions of driving and braking, and the position of the maximum value is mainly distributed in the center line of the single wheel. The research results can provide a reference for the design of asphalt pavement structures.
Identification of testis development-related genes by combining Iso-Seq and RNA-Seq in Zeugodacus tau
Authors: Liu Peipei , Li Ziniu , Zhang Qiuyuan , Qiao Jiao , Zheng Chenjun , Zheng Wenping , Zhang Hongyu
Published: March 2024

Introduction:Zeugodacus tau (Walker) is an invasive pest. An effective method to control this pest is the sterile insect technique (SIT). To better apply this technique, it is necessary to understand testis development progression.

Methods: Differentially expressed genes (DEGs) during testis development were analyzed by PacBio Iso-Seq and RNA-seq.

Results: RNA-Seq library of Z. tau testes on day 1, 6, and 11 post eclosion were constructed. We identified 755 and 865 differentially expressed genes in the comparisons of T6 (testes on day 6) vs. T1 and T11 vs. T1, respectively. The KEGG pathway analysis showed that the DEGs were significantly enriched in retinol metabolism, vitamin B6 metabolism, and ascorbate and aldarate metabolism pathways. Knockdown of retinol dehydrogenase 12-like (rdh12-like), pyridoxal kinase (pdxk) and regucalcin (rgn), the representative gene in each of the above 3 pathways, reduced the hatching rate of Z. tau offspring. In addition, we identified 107 Drosophila spermatogenesis-related orthologous genes in Z. tau, of which innexin 2 (inx2) exhibited significantly up-regulated expression throughout testis development, and the knockdown of this gene reduced offspring hatching rate.

Discussion: Our data indicated that rdh12-like, pdxk, rgn, and inx2 genes were related to testis development, and they were conserved in tephritid species. These results suggested that this gene might have the same function in tephritid. The findings provide an insight into testis development and spermatogenesis in tephritid species.
Bioinspired polyoxometalates as light-driven water oxidation catalysts
Authors: Sánchez-Lara Eduardo , Favela Roberto , Castillo Ivan
Published: March 2024

The design of molecular systems with capabilities to carry out the water oxidation reaction and thereby overcome the bottleneck of artificial photosynthesis is one of the scientific fields of most significant interest and urgency due to its potential to address energy demand and climate change. Nevertheless, the search for efficient and robust catalysts has been limited by the degradation of carbon-based ligands under oxidative conditions, leading to the search for fully inorganic catalysts. Polyoxometalates (POMs), an emerging class of carbon-free ligands with oxygen-enriched surfaces, offer a unique alternative as inorganic scaffolds to self-assemble and stabilize transition-metal clusters with unique redox properties. Under catalytic working conditions, POMs can undergo electron transfer reactions coupled to O2 formation without modifying their parental structure. As a result, these materials have recently entered the scene as catalytic players in designing new artificial photosynthetic platforms for water oxidation. We focus on the methods used to create these compounds, their unique structural characteristics, and how effectively they function as catalysts. We also explore the proposed mechanisms behind their ability to produce O2 and their potential use in designing photosynthetic devices.
Spectrum and antibiotic sensitivity of bacterial keratitis: a retrospective analysis of eight years in a Tertiary Referral Hospital in Southwest China
Authors: Guo Rui-Qin , Yang Ji , Yang Ya-Bin , Chen Ya-Nan , Xiao Yu-Yuan , Xiang Ping , Dong Meng-Jie , He Min-Fang , Wang Yin-Ting , Xiao Yun-Ling , Ke Hong-Qin , Liu Hai
Published: March 2024

Purpose

The objective of this study was to investigate the epidemiological characteristics, distribution of isolates, prevailing patterns, and antibiotic susceptibility of bacterial keratitis (BK) in a Tertiary Referral Hospital located in Southwest China.

Methods

A retrospective analysis was conducted on 660 cases of bacterial keratitis occurring between January 2015 and December 2022. The demographic data, predisposing factors, microbial findings, and antibiotic sensitivity profiles were examined.

Results

Corneal trauma emerged as the most prevalent predisposing factor, accounting for 37.1% of cases. Among these cases, bacterial culture results were positive in 318 cases, 68 species of bacteria were identified. The most common Gram-Positive bacteria isolated overall was the staphylococcus epidermis and the most common Gram-Negative bacteria isolated was Pseudomonas aeruginosa. Methicillin-Resistant Staphylococci accounted for 18.1% of all Gram-Positive bacteria. The detection rate of P. aeruginosa showed an increasing trend over time (Rs=0.738, P=0.037). There was a significant decrease in the percentage of Gram-Negative microorganisms over time (Rs=0.743, P=0.035). The sensitivity of Gram-Positive bacteria to linezolid, vancomycin, tigecycline, quinupristin/dalfopristin, and rifampicin was over 98%. The sensitivity rates of Gram-Negative bacteria to amikacin, meropenem, piperacillin/tazobactam, cefoperazone sodium/sulbactam, ceftazidime, and cefepime were all above 85%. In patients with a history of vegetative trauma, the possibility of BK should be taken into account in addition to the focus on fungal keratitis.

Conclusion

The microbial composition primarily consists of Gram-Positive cocci and Gram-Negative bacilli. Among the Gram-Positive bacteria, S. epidermidis and Streptococcus pneumoniae are the most frequently encountered, while P. aeruginosa is the predominant Gram-Negative bacteria. To combat Gram-Positive bacteria, vancomycin, linezolid, and rifampicin are considered excellent antimicrobial agents. When targeting Gram-Negative pathogens, third-generation cephalosporins exhibit superior sensitivity compared to first and second-generation counterparts. As an initial empirical treatment for severe cases of bacterial keratitis and those unresponsive to fourth-generation fluoroquinolones in community settings, the combination therapy of vancomycin and tobramycin is a justifiable approach. Bacterial keratitis can be better managed by understanding the local etiology and antibacterial drug susceptibility patterns.
Estimation of aortic stiffness by finger photoplethysmography using enhanced pulse wave analysis and machine learning
Authors: Hellqvist Henrik , Karlsson Mikael , Hoffman Johan , Kahan Thomas , Spaak Jonas
Published: March 2024

Introduction

Aortic stiffness plays a critical role in the evolution of cardiovascular diseases, but the assessment requires specialized equipment. Photoplethysmography (PPG) and single-lead electrocardiogram (ECG) are readily available in healthcare and wearable devices. We studied whether a brief PPG registration, alone or in combination with single-lead ECG, could be used to reliably estimate aortic stiffness.

Methods

A proof-of-concept study with simultaneous high-resolution index finger recordings of infrared PPG, single-lead ECG, and finger blood pressure (Finapres) was performed in 33 participants [median age 44 (range 21–66) years, 19 men] and repeated within 2 weeks. Carotid–femoral pulse wave velocity (cfPWV; two-site tonometry with SphygmoCor) was used as a reference. A brachial single-cuff oscillometric device assessed aortic pulse wave velocity (aoPWV; Arteriograph) for further comparisons. We extracted 136 established PPG waveform features and engineered 13 new with improved coupling to the finger blood pressure curve. Height-normalized pulse arrival time (NPAT) was derived using ECG. Machine learning methods were used to develop prediction models.

Results

The best PPG-based models predicted cfPWV and aoPWV well (root-mean-square errors of 0.70 and 0.52 m/s, respectively), with minor improvements by adding NPAT. Repeatability and agreement were on par with the reference equipment. A new PPG feature, an amplitude ratio from the early phase of the waveform, was most important in modelling, showing strong correlations with cfPWV and aoPWV (r = −0.81 and −0.75, respectively, both P < 0.001).

Conclusion

Using new features and machine learning methods, a brief finger PPG registration can estimate aortic stiffness without requiring additional information on age, anthropometry, or blood pressure. Repeatability and agreement were comparable to those obtained using non-invasive reference equipment. Provided further validation, this readily available simple method could improve cardiovascular risk evaluation, treatment, and prognosis.
Recent advances of myotubularin-related (MTMR) protein family in cardiovascular diseases
Authors: Wang Jia , Guo Wei , Wang Qiang , Yang Yongjian , Sun Xiongshan
Published: March 2024

Belonging to a lipid phosphatase family containing 16 members, myotubularin-related proteins (MTMRs) are widely expressed in a variety of tissues and organs. MTMRs preferentially hydrolyzes phosphatidylinositol 3-monophosphate and phosphatidylinositol (3,5) bis-phosphate to generate phosphatidylinositol and phosphatidylinositol 5-monophosphate, respectively. These phosphoinositides (PIPs) promote membrane degradation during autophagosome-lysosomal fusion and are also involved in various regulatory signal transduction. Based on the ability of modulating the levels of these PIPs, MTMRs exert physiological functions such as vesicle trafficking, cell proliferation, differentiation, necrosis, cytoskeleton, and cell migration. It has recently been found that MTMRs are also involved in the occurrence and development of several cardiovascular diseases, including cardiomyocyte hypertrophy, proliferation of vascular smooth muscle cell, LQT1, aortic aneurysm, etc. This review summarizes the functions of MTMRs and highlights their pathophysiological roles in cardiovascular diseases.
Beverage consumption and obesity in Kuwaiti school children
Authors: Alhareky Muhanad , Goodson Jo Max , Tavares Mary , Hartman Mor-Li
Published: March 2024

Sweetened beverage consumption is particularly important in countries such as Kuwait, where the prevalence of obesity is high, and most children drink sweetened beverages daily. To assess the relationship between three most commonly consumed beverages, (soda, milk, and juice) and the incidence of obesity among Kuwaiti children at the critical age of 10-12 year, Longitudinal cohort data of 6,305 children on initial presentation in 2012 (age, 10 years) and follow-up in 2014 (age, 12 years) were obtained from the Kuwait Healthy Life Study. The servings for the three beverages (soda, juice, and milk) were calculated as servings per day groups (0, 1-2, and 3 servings/day or more). Multivariate logistic regression was performed to assess the relationship between developing obesity during 2012-2014 and soda, juice, and milk consumption. Model selection was based on clinically relevant covariates and potential confounders using stepwise model selection. Six percent children become obese between baseline and follow-up visits. High soda drinking showed significant association with developing obesity. High milk consumption (more than 3 servings a day) was also significantly associated with developing obesity. Potential confounders included in the final model were age, sex, governorates, and fitness level, of which none were significant confounders or effect modifiers for the association. Children with high soda consumption had significantly higher prevalence of obesity. High obesity prevalence was observed with high milk consumption at a lower significance level but not with high juice consumption.
Cost-effective prognostic evaluation of breast cancer: using a STAR nomogram model based on routine blood tests
Authors: Wei Caibiao , Liang Yihua , Mo Dan , Lin Qiumei , Liu Zhimin , Li Meiqin , Qin Yuling , Fang Min
Published: March 2024

Background

Breast cancer (BC) is the most common and prominent deadly disease among women. Predicting BC survival mainly relies on TNM staging, molecular profiling and imaging, hampered by subjectivity and expenses. This study aimed to establish an economical and reliable model using the most common preoperative routine blood tests (RT) data for survival and surveillance strategy management.

Methods

We examined 2863 BC patients, dividing them into training and validation cohorts (7:3). We collected demographic features, pathomics characteristics and preoperative 24-item RT data. BC risk factors were identified through Cox regression, and a predictive nomogram was established. Its performance was assessed using C-index, area under curves (AUC), calibration curve and decision curve analysis. Kaplan-Meier curves stratified patients into different risk groups. We further compared the STAR model (utilizing HE and RT methodologies) with alternative nomograms grounded in molecular profiling (employing second-generation short-read sequencing methodologies) and imaging (utilizing PET-CT methodologies).

Results

The STAR nomogram, incorporating subtype, TNM stage, age and preoperative RT data (LYM, LYM%, EOSO%, RDW-SD, P-LCR), achieved a C-index of 0.828 in the training cohort and impressive AUCs (0.847, 0.823 and 0.780) for 3-, 5- and 7-year OS rates, outperforming other nomograms. The validation cohort showed similar impressive results. The nomogram calculates a patient’s total score by assigning values to each risk factor, higher scores indicating a poor prognosis. STAR promises potential cost savings by enabling less intensive surveillance in around 90% of BC patients. Compared to nomograms based on molecular profiling and imaging, STAR presents a more cost-effective, with potential savings of approximately $700-800 per breast cancer patient.

Conclusion

Combining appropriate RT parameters, STAR nomogram could help in the detection of patient anemia, coagulation function, inflammation and immune status. Practical implementation of the STAR nomogram in a clinical setting is feasible, and its potential clinical impact lies in its ability to provide an early, economical and reliable tool for survival prediction and surveillance strategy management. However, our model still has limitations and requires external data validation. In subsequent studies, we plan to mitigate the potential impact on model robustness by further updating and adjusting the data and model.
Total weight loss rather than preoperative body mass index correlates with remission of irregular menstruation after sleeve gastrectomy in patients with polycystic ovary syndrome
Authors: Zhao Yian , Xiong Sisi , Liu Teng , Shu Jiaxin , Zhu Tao , Li Shumin , Zhong Mingwei , Zhao Shigang , Huang Xin , Liu Shaozhuang
Published: March 2024

Introduction

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-aged women. Some retrospective studies with small sample sizes have reported that bariatric metabolic surgery is effective in remission of irregular menstruation in patients with PCOS and obesity. However, the correlation between preoperative body mass index (BMI), postoperative weight loss, and remission of irregular menstruation in patients with obesity and PCOS after sleeve gastrectomy (SG) is lack of consensus.

Methods

We enrolled 229 participants with obesity and PCOS who underwent SG. All patients were followed up for one year after surgery. Remission of irregular menstruation was defined as a spontaneous consecutive six-month menstrual cycle in one year. Subgroup analysis was conducted using tertiles of preoperative BMI and postoperative total weight loss (TWL)% to determine their correlation with the remission of irregular menstruation after SG.

Results

79.03% (181/229) patients achieved remission of irregular menstruation one year after SG with a TWL% of 33.25 ± 0.46%. No significant difference was detected in the remission rate among the subgroups with different BMI (P=0.908). TWL% was correlated with the remission of irregular menstruation (OR 1.78, 95% CI 1.18-2.69, P<0.05).

Conclusions

SG had a significant effect on the remission of irregular menstruation in patients with obesity and PCOS. Preoperative BMI did not emerge as a decisive factor correlated with remission; instead, TWL% showed potential as a key factor.
Clinical features of early-onset type 2 diabetes and its association with triglyceride glucose-body mass index: a cross-sectional study
Authors: Jiang Yanjuan , Lai Xiaoyang
Published: March 2024

Objective

The incidence of early-onset type 2 diabetes (T2D) has increased significantly, with insulin resistance (IR) and obesity being the main drivers of its onset. This study aims to investigate the clinical characteristics of early-onset T2D and its association with triglyceride glucose body mass index (TyG-BMI), an emerging surrogate of IR.

Methods

A total of 1000 adults newly diagnosed with T2D were enrolled and divided into early-onset T2D (18~40 years, N=500) and late-onset T2D groups (≥40 years, N=500). Independent t and chi-squared tests were used to compare the characteristics of the two groups, and logistic regression analysis, trend tests, restricted cubic spline curves (RCSs), and receiver operating characteristic (ROC) curves were used to identify the relationship between TyG-BMI and early-onset T2D.

Results

Patients with early-onset T2D were more likely to have a higher body mass index (BMI), hemoglobin A1C (HbA1c), fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), serum uric acid (SUA), triglyceride glucose index (TyG), and TyG-BMI (P < 0.05). A higher TyG-BMI was associated with an increased risk of early-onset T2D (P < 0.001). The RCSs showed a nonlinear relationship between TyG-BMI and early-onset T2D, and the slope of the curve increased with an increase in TyG-BMI (P for nonlinearity < 0.001). In the subgroup analysis, additive interactions between TyG-BMI and the risk of early-onset T2D were observed for sex, family history of diabetes, BMI, fatty liver, and hypertension (P < 0.001). ROC curve showed that the area under the curve of TyG-BMI was 0.6781, which was larger than its main components (TyG, BMI, FPG, TG). The best cutoff value was 254.865, the sensitivity was 74.6%, and the specificity was 53.6%.

Conclusion

Patients with early-onset T2D are characterized by severe IR, metabolic disorders, and being overweight/obese and an increase in TyG-BMI is independently associated with an increased risk of early-onset T2D.
Study on the impact of green finance on green total factor productivity in forestry—evidence from China
Authors: Gong Hao , Wang Zhenhong
Published: March 2024

China's forestry industry's ecological, economic, and social benefits have improved significantly. However, practical problems remain, such as irrational industrial structure, serious resource consumption, and low environmental transformation efficiency. The green total factor productivity is an important index to measure the transformation of economic development mode, and improving the green total factor productivity in forestry is of great significance in guiding the transformation of forestry economy, improving the structure of agricultural economy, and realizing the green development of forestry economy. Based on the panel data of 30 provinces and cities in China from 2006 to 2021, this article adopts the entropy value method and the Global Malmquist–Luenberger index based on the SBM directional distance function to construct the index system of green finance and forestry green total factor productivity and empirically analyzes the impact and mechanism of green finance on forestry green total factor productivity. It was found that 1) green finance can improve local forestry green total factor productivity and influence the neighboring regions to improve forestry green total factor productivity through economic spillover effect, and the coefficient of spatial spillover effect was 0.1041. 2) There were regional differences in the impact of green finance on forestry green total factor productivity, which was explicitly presented as a gradual decrease from east to west “ladder-like”. 3) There was a 30.46% intermediary effect of forestry industry structure in the influence of green finance on forestry green total factor productivity. 4) There was a double-threshold effect of human capital in the influence of green finance on forestry green total factor productivity, and there was a non-linear effect of marginal increment in the influence of green finance on forestry green total factor productivity after the threshold of 5.87 human capital. Based on China's ecological and economic development background, it was significant to utilize green finance to solve forestry economic development problems and promote China's green and sustainable development, and therefore put forward policy recommendations.
International support for abortion education in medical schools: results of a global online survey to explore abortion willingness, intentions, and attitudes among medical students in 85 countries
Authors: Janušonytė Eglė , Fetters Tamara , Cipriano Gabriela , Jemel Iheb , Espinoza Cecilia
Published: March 2024

Introduction

Access to safe abortion has been recognized as a fundamental human right and important public health priority. Medical schools provide a rare opportunity to expose medical students to comprehensive sexual and reproductive health (SRH) topics and normalize abortion care early in a physician's career.

Methods

This cross-sectional descriptive study used an online survey to explore abortion content in medical curricula and medical student intentions, attitudes, and beliefs regarding abortion provision among 1,699 medical students from 85 countries.

Results

Results demonstrate positive attitudes towards abortion provision, with 83% reporting that “access to safe abortion is every woman's right”. Students also reported a relatively high willingness to provide abortion professionally despite few opportunities to learn about this care. Only one-third of students surveyed reported having taken a gynecology course (n = 487; 33%); among these, one-third said they had no content on abortion care in their programs thus far (n = 155; 32%), including instruction on postabortion care. Among the two-thirds of students who had some content on abortion care (n = 335), either on induced abortion, postabortion care (PAC), or both, 55% said content was limited to one lecture and only 19% reported having an opportunity to participate in any practical training on abortion provision. Despite most students having no or very limited didactic and practical training on abortion, 42% intended to provide this care after graduation. Three-quarters of student respondents were in favor of mandatory abortion education in medical curricula.

Discussion

The findings of this study offer new evidence about abortion care education in medical curricula around the globe, indicating that there is no lack of demand or interest in increasing medical knowledge on comprehensive abortion care, merely a lack of institutional will to expand course offerings and content.
Immune pathogenesis of idiopathic granulomatous mastitis: from etiology toward therapeutic approaches
Authors: Wang Xiaoli , He Xiujing , Liu Junzhi , Zhang Haiyan , Wan Hangyu , Luo Jing , Yang Jiqiao
Published: March 2024

Idiopathic granulomatous mastitis (IGM) is a noncancerous, chronic inflammatory disorder of breast with unknown causes, posing significant challenges to the quality of life due to its high refractoriness and local aggressiveness. The typical symptoms of this disease involve skin redness, a firm and tender breast mass and mastalgia; others may include swelling, fistula, abscess (often without fever), nipple retraction, and peau d’orange appearance. IGM often mimics breast abscesses or malignancies, particularly inflammatory breast cancer, and is characterized by absent standardized treatment options, inconsistent patient response and unknown mechanism. Definite diagnosis of this disease relies on core needle biopsy and histopathological examination. The prevailing etiological theory suggests that IGM is an autoimmune disease, as some patients respond well to steroid treatment. Additionally, the presence of concurrent erythema nodosum or other autoimmune conditions supports the autoimmune nature of the disease. Based on current knowledge, this review aims to elucidate the autoimmune-favored features of IGM and explore its potential etiologies. Furthermore, we discuss the immune-mediated pathogenesis of IGM using existing research and propose immunotherapeutic strategies for managing this condition.
Potential for the development of Taraxacum mongolicum aqueous extract as a phytogenic feed additive for poultry
Authors: Dong Zhen , Liu Zhiqin , Xu Yufeng , Tan Bin , Sun Wenqing , Ai Qin , Yang Zihui , Zeng Jianguo
Published: March 2024

Introduction

Taraxacum mongolicum (TM) is a kind of medicinal and edible homologous plant which is included in the catalogue of feed raw materials in China. It is rich in polyphenols, flavonoids, polysaccharides and other active substances, and shows many benefits to livestock, poultry and aquatic products. The study aimed to assess the potential of TM aqueous extract (TMAE) as a substitute for poultry AGPs.

Methods

A total of 240 one-day-old Arbor Acker broilers were randomly assigned to four groups and fed a basal diet (Con) supplemented with 500, 1000, and 2000 mg/kg TMAE (Low, Medium, and High groups). The growth performance of the broilers was measured on day 21 and day 42. At the end of the trial, the researchers measured slaughter performance and collected serum, liver, spleen, ileum, and intestinal contents to investigate the effects of TMAE on serum biochemistry, antioxidant capacity, immune function, organ coefficient, intestinal morphology, flora composition, and short-chain fatty acids (SCFAs).

Results

The results showed that broilers treated with TMAE had a significantly higher average daily gain from 22 to 42 days old compared to the Con group. Various doses of TMAE resulted in different levels of improvement in serum chemistry. High doses increased serum alkaline phosphatase and decreased creatinine. TMAE also increased the antioxidant capacity of serum, liver, and ileum in broilers. Additionally, middle and high doses of TMAE enhanced the innate immune function of the liver (IL-10) and ileum (Occludin) in broilers. Compared to the control group, the TMAE treatment group exhibited an increase in the ratio of villi length to villi crypt in the duodenum. TMAE increased the abundance of beneficial bacteria, such as Alistipes and Lactobacillus, while reducing the accumulation of harmful bacteria, such as Colidextracter and Sellimonas. The cecum's SCFAs content increased with a medium dose of TMAE. Supplementing broiler diets with TMAE at varying doses enhanced growth performance and overall health. The most significant benefits were observed at a dose of 1000 mg/kg, including improved serum biochemical parameters, intestinal morphology, antioxidant capacity of the liver and ileum, immune function of the liver and ileum, and increased SCFAs content. Lactobacillus aviarius, norank_f_norank_o__Clostridia_UCG-014, and Flavonifractor are potentially dominant members of the intestinal microflora.

Conclusion

In conclusion, TMAE is a promising poultry feed additive and 1000 mg/kg is an effective reference dose.
Vaccination with staphylococcal protein A protects mice against systemic complications of skin infection recurrences
Authors: Mandelli Andrea Paola , Magri Greta , Tortoli Marco , Torricelli Stefania , Laera Donatello , Bagnoli Fabio , Finco Oretta , Bensi Giuliano , Brazzoli Michela , Chiarot Emiliano
Published: March 2024

Skin and soft tissue infections (SSTIs) are the most common diseases caused by Staphylococcus aureus (S. aureus), which can progress to threatening conditions due to recurrences and systemic complications. Staphylococcal protein A (SpA) is an immunomodulator antigen of S. aureus, which allows bacterial evasion from the immune system by interfering with different types of immune responses to pathogen antigens. Immunization with SpA could potentially unmask the pathogen to the immune system, leading to the production of antibodies that can protect from a second encounter with S. aureus, as it occurs in skin infection recurrences. Here, we describe a study in which mice are immunized with a mutated form of SpA mixed with the Adjuvant System 01 (SpAmut/AS01) before a primary S. aureus skin infection. Although mice are not protected from the infection under these conditions, they are able to mount a broader pathogen-specific functional immune response that results in protection against systemic dissemination of bacteria following an S. aureus second infection (recurrence). We show that this “hidden effect” of SpA can be partially explained by higher functionality of induced anti-SpA antibodies, which promotes better phagocytic activity. Moreover, a broader and stronger humoral response is elicited against several S. aureus antigens that during an infection are masked by SpA activity, which could prevent S. aureus spreading from the skin through the blood.
Recent advances in the therapeutic management of calcium pyrophosphate deposition disease
Authors: Voulgari Paraskevi V. , Venetsanopoulou Aliki I. , Drosos Alexandros A.
Published: March 2024

Calcium pyrophosphate deposition (CPPD) disease is a form of crystal-induced arthropathy that arises from the accumulation of calcium pyrophosphate crystals within joints and soft tissues. This process leads to inflammation and damage to the affected joints. It can present asymptomatically or as acute or chronic inflammatory arthritis. Risk factors and comorbidities, including prior joint injury, osteoarthritis, hereditary or familial predisposition, and metabolic diseases, should be evaluated in CPPD cases. The management of CPPD remains a challenge in the sparsity of randomized controlled trials. The lack of such trials makes it difficult to establish evidence-based treatment protocols for CPPD. This review provides an overview of the current pharmacological management of CPPD, focusing on reducing inflammation, alleviating symptoms, and preventing acute flares. Non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and colchicine are effective in managing acute CPP arthritis. Colchicine may also be used prophylactically to prevent recurrent flares. In cases where other treatments have failed, anakinra, an interleukin-1 receptor antagonist, can be administered to alleviate acute flares. The management of chronic CPP inflammatory arthritis includes NSAIDs and/or colchicine, followed by hydroxychloroquine, low-dose glucocorticoids, and methotrexate, with limited data on efficacy. Tocilizumab can be used in refractory cases. In small studies, synovial destruction using intra-articular injection of yttrium 90 can decrease pain. To date, no disease-modifying therapies exist that reduce articular calcification in CPPD.
Evaluation of peri-plaque pericoronary adipose tissue attenuation in coronary atherosclerosis using a dual-layer spectral detector CT
Authors: Jia Yulin , Zou Lei , Xue Ming , Zhang Xiaoyu , Xiao Xigang
Published: March 2024

Purpose

This study aimed to evaluate the differences between pericoronary adipose tissue (PCAT) attenuation at different measured locations in evaluating coronary atherosclerosis using spectral computed tomography (CT) and to explore valuable imaging indicators.

Methods

A total of 330 patients with suspicious coronary atherosclerosis were enrolled and underwent coronary CT angiography with dual-layer spectral detector CT (SDCT). Proximal and peri-plaque fat attenuation index (FAI) of stenosis coronary arteries were measured using both conventional images (CIs) and virtual monoenergetic images (VMIs) ranging from 40 keV to 100 keV. The slopes of the spectral attenuation curve (λ) of proximal and peri-plaque PCAT at three different monoenergetic intervals were calculated. Additionally, peri-plaque FAI on CI and virtual non-contrast images, and effective atomic number were measured manually.

Results

A total of 231 coronary arteries with plaques and lumen stenosis were finally enrolled. Peri-plaque FAICI and FAIVMI were significantly higher in severe stenosis than in mild and moderate stenosis (p < 0.05), while peri-plaque λ, proximal FAI, and proximal λ were not statistically different. Proximal FAI, peri-plaque FAI, and peri-plaque λ were significantly higher in low-density non-calcified plaque (LD-NCP) and non-calcified plaque (NCP) than in calcified plaque (p < 0.01). Peri-plaque FAI was the highest in the LD-NCP group, while proximal FAI was the highest in the NCP group. In severe stenosis and in LD-NCP, peri-plaque FAI was significantly higher than proximal FAI (p < 0.05). The manually measured parameters related to peri-plaque PCAT attenuation had a positive correlation with the results of peri-plaque FAI measured automatically.

Conclusion

Peri-plaque PCAT has more value in assessing coronary atherosclerosis than proximal PCAT. Peri-plaque PCAT attenuation is expected to be used as a standard biomarker for evaluating plaque vulnerability and hemodynamic characteristics.
Marine bacteriophages disturb the associated microbiota of Aurelia aurita with a recoverable effect on host morphology
Authors: Stante Melissa , Weiland-Bräuer Nancy , von Hoyningen-Huene Avril Jean Elisabeth , Schmitz Ruth Anne
Published: March 2024

The concept of the metaorganism describes a multicellular host and its diverse microbial community, which form one biological unit with a combined genetic repertoire that significantly influences health and survival of the host. The present study delved into the emerging field of bacteriophage research within metaorganisms, focusing on the moon jellyfish Aurelia aurita as a model organism. The previously isolated Pseudomonas phage BSwM KMM1 and Citrobacter phages BSwM KMM2 – KMM4 demonstrated potent infectivity on bacteria present in the A. aurita-associated microbiota. In a host-fitness experiment, Baltic Sea subpopulation polyps were exposed to individual phages and a phage cocktail, monitoring polyp survival and morphology, as well as microbiome changes. The following effects were obtained. First, phage exposure in general led to recoverable malformations in polyps without affecting their survival. Second, analyses of the community structure, using 16S rRNA amplicon sequencing, revealed alterations in the associated microbial community in response to phage exposure. Third, the native microbiota is dominated by an uncultured likely novel Mycoplasma species, potentially specific to A. aurita. Notably, this main colonizer showed resilience through the recovery after initial declines, which aligned with abundance changes in Bacteroidota and Proteobacteria, suggesting a dynamic and adaptable microbial community. Overall, this study demonstrates the resilience of the A. aurita metaorganism facing phage-induced perturbations, emphasizing the importance of understanding host-phage interactions in metaorganism biology. These findings have implications for ecological adaptation and conservation in the rapidly changing marine environment, particularly regarding the regulation of blooming species and the health of marine ecosystems during ongoing environmental changes.
Microbial diversity in camel milk from Xinjiang, China as revealed by metataxonomic analysis
Authors: Sun Miao , Shao Wei , Liu Zhengyu , Ma Xianlan , Chen He , Zheng Nan , Zhao Yankun
Published: March 2024

The quality of raw camel milk is affected by its bacterial composition and diversity. However, few studies have investigated the bacterial composition and diversity of raw camel milk. In this study, we obtained 20 samples of camel milk during spring and summer in Urumqi and Hami, Xinjiang, China. Single-molecule real-time sequencing technology was used to analyze the bacterial community composition. The results revealed that there were significant seasonal differences in the bacterial composition and diversity of camel milk. Overall, Epilithonimonas was the most abundant bacterial genus in our samples. Through the annotated genes inferred by PICRUSt2 were mapped against KEGG database. Non-parametric analysis of the bacterial community prediction function revealed a strong bacterial interdependence with metabolic pathways (81.83%). There were clear regional and seasonal differences in level 3 metabolic pathways such as fat, vitamins, and amino acids in camel milk. In addition, we identified lactic acid bacteria in camel milk with antibacterial and anti-tumor activities. Our findings revealed that camel milk from Xinjiang had serious risk of contamination by psychrophilic and pathogenic bacteria. Our research established a crucial theoretical foundation for ensuring the quality and safety of camel milk, thereby contributing significantly to the robust growth of China’s camel milk industry.
Psychometric evaluation and reference values for the German Postconcussion Symptom Inventory (PCSI-SR8) in children aged 8–12 years
Authors: Zeldovich Marina , Krol Leonie , Timmermann Dagmar , Krenz Ugne , Arango-Lasprilla Juan Carlos , Gioia Gerard , Brockmann Knut , Koerte Inga K. , Buchheim Anna , Roediger Maike , Kieslich Matthias , von Steinbuechel Nicole , Cunitz Katrin
Published: March 2024

Background

Post-concussion symptoms (PCS) are a common consequence of pediatric traumatic brain injury (pTBI). They include cognitive, emotional, and physical disturbances. To address the lack of age-adapted instruments assessing PCS after pTBI, this study examines the psychometric properties of the German 17-item post-TBI version of the Postconcussion Symptom Inventory (PCSI-SR8) in children aged 8–12 years. The study also aims to establish reference values based on data from a pediatric general population sample to better estimate the prevalence and clinical relevance of PCS after pTBI in clinical and research settings.

Methods

A total of 132 children aged 8–12 years from a post-acute TBI sample and 1,047 from a general population sample were included in the analyses. The questionnaire was translated from English into German and linguistically validated using forward and backward translation and cognitive debriefing to ensure comprehensibility of the developed version. Reliability and validity were examined; descriptive comparisons were made with the results of the English study. Measurement invariance (MI) analyses between TBI and general population samples were conducted prior to establishing reference values. Factors contributing to the total and scale scores of the PCSI-SR8 were identified using regression analyses. Reference values were calculated using percentiles.

Results

Most children (TBI: 83%; general population: 79%) rated at least one symptom as “a little” bothersome. The German PCSI-SR8 met the psychometric assumptions in both samples and was comparable to the English version. The four-factor structure comprising physical, emotional, cognitive, and fatigue symptoms could be replicated. The MI assumption was retained. Therefore, reference values could be provided to determine the symptom burden of patients in relation to a comparable general population. Clinical relevance of reported symptoms is indicated by a score of 8, which is one standard deviation above the mean of the general population sample.

Conclusion

The German version of the PCSI-SR8 is suitable for assessment of PCS after pTBI. The reference values allow for a more comprehensive evaluation of PCS following pTBI. Future research should focus on validation of the PCSI-SR8 in more acute phases of TBI, psychometric examination of the pre-post version, and child-proxy comparisons.