bluuebunny/crossref_metadata_2025 huggingface dataset:
Kant’ın Pratik Felsefesinde İdelerin Yeri
Authors: Kına Fatih
Published: October 2024

Saf Aklın Kritiğinde Kant, bilginin oluşum sürecini, en başından, duyu algılarından başlayarak ele alır, oradan anlama yetisine ve daha sonra aklın saf idelerine ulaşır. Bu noktada ideler aklın bütünü kavrama taleplerine karşılık gelir ancak nesnel karşılıkları gösterilemez. Onlardan yalnızca, bilginin “düzenleyici ilkeler”i olarak bahsedilebilir. Bir başka deyişle onlar “transandant” varlıklar olarak değil ama bilginin “transandandal” koşulları olarak görülür. Kant’a göre bilme yetisinin uzanabildiği sınırlar içerisinde ancak bu kadarı gösterilebilir. Ancak onlar daha sonra Kant’ın pratik felsefesinde Ölümsüzlük, Özgürlük ve Tanrı olarak yeniden ele alınır ve tüm idelerin nesnel varoluşları denemese de kategorik bir gerekliliğin sonuçları olarak varlıkları kabul edilir (Heimsoeth, 1986:145). Bu çalışma idelerin Kant’ın pratik felsefesindeki yerini-fonksiyonunu tespit etmeyi amaçlar.
Kant’ın Matematik Anlayışı Karşısında Russell’ın Pozisyonu: Bir Yanlış Anlamanın Nedenleri Üzerine
Authors: Aşik Birlik Buşra
Published: October 2024

Günümüzde, Russell'ın mantıkçılığı ile Kant'ın matematik felsefesi arasındaki farklılıklar üzerinde yapılan tartışmalar oldukça zengindir. Bu tartışmaların geneli iki büyük filozofun düşüncelerinin tamamen birbirine karşıt olduğuna dair yaygın bir görüş birliğini barındırmaktadır. Yorumcular, Russell ve Kant arasındaki düşünsel farklılıkları incelerken, çoğu zaman kavramsal ayrımların ve bağlamsal farklılıkların derinlemesine analizini yapamamışlardır. Bu nedenle, iki filozof arasındaki felsefi karşıtlıkların yüzeysel ve bazen yanıltıcı bir şekilde sunulduğu görülmektedir. Dolayısıyla, Russell ve Kant arasındaki düşünsel çatışmanın, yorumcular tarafından ele alınış biçiminde metodolojik eksiklikler ve yanlış anlamalar bulunmaktadır. Bu çalışma, söz konusu yanılsamaların hangi noktalarda meydana geldiğini incelemeyi ve iki filozof arasındaki çatışmanın daha doğru bir şekilde anlaşılmasını sağlamayı amaçlamaktadır.
Saygı Bağlamında Kant Etiği
Authors: Okan Can
Published: October 2024

Bu makalede, tarihin en önemli filozoflarından Immanuel Kant’ın ahlâk felsefesinin kilit kavramlarından biri olan saygıya değinilecektir. Makale boyunca, Kant’ın Ahlâk Metafiziğinin Temellendirilmesi [Grundlegung zur Metaphysik der Sitten] ve Pratik Aklın Eleştirisi [Kritik der praktischen Vernunft] başlıklı yapıtları temel alınacaktır. Bu yapıtlarda yer alan başlıca kavramlardan ödev ve yükümlülükten yola çıkılarak, toplumsal bir varlık olan insanı ahlâklı yapan biçime değinilecektir. İnsanın kamusal alanda kurmak zorunda olduğu ilişkinin belirleyici ilkesi olan saygının, ödevle ve yükümlülükle bağıntısı üzerinden zorunluluğu ve kesinliği açıklanmaya çalışılacaktır. Toplumsal yaşamın iki temel olgusu olarak saygı ile sevginin birbirlerinden içerik ve kapsayıcılık bakımlarından ortaya çıkan farklarına işaret edilecektir. Kant’ın etik felsefesinin biçimselliği ve saf aklın doğal nedensellikten bağımsız şekilde ortaya çıkardığı ahlak yasası, uyumlu toplum yapılanmasının dayanağını oluşturmaktadır. Günümüzün kapitalist sömürü düzeninin boğuculuğunda gerekliliği açıkça ortaya çıkan ahlâk, haysiyet ve saygı noksanlığına karşı güncelliğini korumaya devam edecek ahlâk felsefesiyle Kant’ın düşünce biçiminin sarsılmaz önemi, söz konusu çalışmanın başlıca motivasyon nedeni olmuştur. Çalışma boyunca Kant etiğinin temel hatları incelenecek ve aynı zamanda, söz konusu düşüncelerden yola çıkılarak günümüzdeki etik problemlerin bir kısmına ışık tutulmaya çalışılacak.
Stop Using Black-Box Models: Application of Explainable Artificial Intelligence for Rate of Penetration Prediction
Authors: Meng Han , Lin Botao , Jin Yan
Published: October 2024

Rate of penetration (ROP) prediction plays a crucial role in optimizing drilling efficiency and reducing overall costs in the petroleum industry. Although modern artificial intelligence (AI) models have shown promising performance in this task, their lack of interpretability hinders their practical applications. This study introduces the neural basis model (NBM), a self-explainable model, for ROP prediction. The adopted NBM is benchmarked against some well-known methods using a publicly available data set, demonstrating its promising performance. The key advantage of the NBM lies in its ability to provide clear explanations, where the influence of the input drilling parameters on the predicted ROP can be clearly visualized and analyzed. The study also compares the models’ performance under two scenarios—continuous learning and all-for-one. The results indicate that the models’ performance under the continuous learning scenario, in which the models are iteratively updated with new data from the same well, outperforms that under the all-for-one scenario, where models are trained on data from previously drilled wells and applied to new wells. The discrepancy is probably due to the absence of detailed formation characteristics from the data set. Therefore, the model trained in other wells could not generalize well on new wells. Currently, in petroleum engineering, AI is gradually playing an increasingly important role; however, the majority of AI-related works often directly employ black-box models, which lack interpretability and might cause serious risks if deployed in practice. This work introduces an approach to using neural networks to build self-explainable AI (XAI), with the aim of promoting the application of XAI in the petroleum industry.
PAM-free diagnostics with diverse type V CRISPR-Cas systems
Authors: Jain Piyush , Rananaware Santosh , Meister Katelyn , Shoemaker Grace , Vesco Emma , Sandoval Luke Samuel , Lewis Jordan , Bodin August , Karalkar Vedant , Lange Ian , Pizzano Brianna , Chang Minji , Ahmadimashhadi M.Reza , Flannery Sarah , Nguyen Long , Wang Gary
Published: October 2024

Type V CRISPR-Cas effectors have revolutionized molecular diagnostics by facilitating the detection of nucleic acid biomarkers. However, their dependence on the presence of protospacer adjacent motif (PAM) sites on the target double-stranded DNA (dsDNA) greatly limits their flexibility as diagnostic tools. Here we present a novel method named PICNIC that solves the PAM problem for CRISPR-based diagnostics with just a simple ~10-min modification to contemporary CRISPR-detection protocols. Our method involves the separation of dsDNA into individual single-stranded DNA (ssDNA) strands through a high-temperature and high-pH treatment. We then detect the released ssDNA strands with diverse Cas12 enzymes in a PAM-free manner. We show the utility of PICNIC by successfully applying it for PAM-free detection with three different subtypes of the Cas12 family- Cas12a, Cas12b, and Cas12i. Notably, by combining PICNIC with a truncated 15-nucleotide spacer containing crRNA, we demonstrate PAM-independent detection of clinically important single-nucleotide polymorphisms with CRISPR. We apply this approach to detect the presence of a drug-resistant variant of HIV-1, specifically the K103N mutant, that lacks a PAM site in the vicinity of the mutation. Additionally, we successfully translate our approach to clinical samples by detecting and genotyping HCV-1a and HCV-1b variants with 100% specificity at a PAM-less site within the HCV genome. In summary, PICNIC is a simple yet groundbreaking method that enhances the flexibility and precision of CRISPR-Cas12-based diagnostics by eliminating the restriction of the PAM sequence.
Medical Student Perceptions of Effective and Ineffective Educators during their Surgical Clerkship
Authors: Rothman Deanna Palenzuela , Pradarelli Alyssa , Petrusa Emil , Moses Joy , Phitayakorn Roy
Published: October 2024

Purpose
While the operative experience is a core component of the surgical clerkship, studies have suggested interactions with strong teachers and mentors have the most significant impact on a student’s decision to pursue a surgical career. The goal of this study was to identify qualities of effective and ineffective educators from a medical student’s perspective and clarify successful educational techniques that can significantly impact medical students’ surgery clerkship experiences.
Methods
We conducted a qualitative analysis of all medical student Surgery clerkship evaluations of resident physicians and surgery faculty from 2018 to 2022 at four HMS affiliated tertiary care centers. We utilized grounded theory as a means of exploring and interpreting our data. Qualitative analysis was conducted with two reviewers per the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist guidelines for qualitative research.
Results
A total of 1,378 faculty evaluations were analyzed with a Cohen’s Kappa of 0.85, indicating excellent inter-rater reliability. The analysis revealed six key themes that resonated with medical students during surgical clerkships: Enabling Student Involvement, Investment in Student Learners, Positive Team Environment, High Yield Teaching, Clinical Role Models, and Personal Connection. Students valued educators who allowed independence, advocated for their involvement, and engaged with them both inside and outside the operating room. Effective educators prioritized educational experiences, set clear expectations, and provided feedback. They also shaped the team environment by including students and acknowledging their contributions. Successful teaching strategies included high-yield chalk-talks, multi-modal activities, and personalized topics. Students appreciated educators who demonstrated clinical excellence and sought personal connections, valuing mentorship and efforts to know them as individuals.
Conclusions
Surgical residents and attendings play a significant role in shaping the educational experience of medical students on the surgical clerkship. Based on our findings, we developed the “Surgical Educator’s Compass” to provide practical guidelines for educator interventions to incorporate varied teaching strategies, involve medical students, and maximize student education during the surgical clerkship.
Sex-specific differences in brain activity dynamics of youth with a family history of substance use disorder
Authors: Schilling Louisa , Singleton S. Parker , Tozlu Ceren , Hédo Marie , Zhao Qingyu , Pohl Kilian , Jamison Keith , Kuceyeski Amy
Published: October 2024

An individual’s risk of substance use disorder (SUD) is shaped by a complex interplay of potent biosocial factors. Current neurodevelopmental models posit vulnerability to SUD in youth is due to an overreactive reward system and reduced inhibitory control. Having a family history of SUD is a particularly strong risk factor, yet few studies have explored its impact on brain function and structure prior to substance exposure. Herein, we utilized a network control theory approach to quantify sex-specific differences in brain activity dynamics in youth with and without a family history of SUD, drawn from a large cohort of substance-naïve youth from the Adolescent Brain Cognitive Development Study. We summarize brain dynamics by calculating transition energy, which probes the ease with which a whole brain, region or network drives the brain towards a specific spatial pattern of activation (i.e., brain state). Our findings reveal that a family history of SUD is associated with alterations in the brain’s dynamics wherein: i) independent of sex, certain regions’ transition energies are higher in those with a family history of SUD and ii) there exist sex-specific differences in SUD family history groups at multiple levels of transition energy (global, network, and regional). Family history-by-sex effects reveal that energetic demand is increased in females with a family history of SUD and decreased in males with a family history of SUD, compared to their same-sex counterparts with no SUD family history. Specifically, we localize these effects to higher energetic demands of the default mode network in females with a family history of SUD and lower energetic demands of attention networks in males with a family history of SUD. These results suggest a family history of SUD may increase reward saliency in males and decrease efficiency of top-down inhibitory control in females. This work could be used to inform personalized intervention strategies that may target differing cognitive mechanisms that predispose individuals to the development of SUD.
Comparing Minimally Invasive Bariatric Techniques: A Systematic Review of Robotic Sleeve Gastrectomy vs. Endoscopic Sleeve Gastroplasty
Authors: Ansari Yusuf-Zain , Elsabbagh Tarek , Russell Ramdhan , Shimoni Yuval , Prasannakumar Rupesh , Siddiqui Faiz , Ansari Daniyal , Sivan Vijay , Marizcurena Florencia , Tohamy Aley
Published: October 2024

Background
Within bariatric surgery, endoscopic sleeve gastroplasty (ESG) and robotic sleeve gastrectomy (RSG) have emerged as minimally invasive procedures for weight loss and metabolic management. While both offer benefits for obesity, the comparative effects in terms of weight loss, efficacy, and safety remain uncertain.
Methods
A systematic search of PubMed/MEDLINE, and Cochrane Library was conducted to collect both prospective and retrospective studies assessing the effectiveness and safety of RSG and ESG in treating morbid obesity. Regression analysis was performed.
Results
We collected eleven studies (1182 patients) evaluating RSG and fourteen studies (3077 patients) evaluating ESG. Average patient ages for RSG were 42.79±11.31 years (63.9% females) with preoperative Body Mass Index of 47.81+8.00 and 38.52±9.69 years (86.1% females) with BMI of 35.20±4.29 for ESG. Mean operation time was 104.93 minutes for RSG, and 68.4 for ESG. RSG yielded a Estimated Weight Loss % (%EWL) of 51.26% at 18 months, while ESG yielded 73.01%. Complication rates were 2.71% (32/1182) for RSG and 8.88% (273/3077) for ESG, while reoperation rates were 0.59% for RSG and 1.34% for ESG. Average hospital stays were 2.71 days for RSG and 0.68 days for ESG.
Conclusion
The long-term clinical results of RSG and ESG for morbid obesity show similarly favorable outcomes. ESG has shorter operative times and hospital stays, but more complications. Additional research with larger cohorts and randomized trials is needed to determine the preferred procedure.
“We sometimes stress our own wives” - Perceptions of Maternal Mental Health Challenges and Recommendation towards Emotional and Psychological Support from Mothers, Fathers, Nurses, and Community Health Workers in Western Kenya
Authors: Dieteren Charlotte , Katuwal S. , De Sanctis T. , Waiyaiya E. , Wairimu R. N. , Otieno M. , Tol W. , Sidze E. M. , Janssens W.
Published: October 2024

Background In low- and middle-income countries (LMICs), maternal mental health (MMH) during and after pregnancy is often neglected despite ongoing global efforts to reduce maternal mortality and morbidity. The complex nature of MMH problems and their stigmatization require a thorough understanding from the perspective of the different parties involved. Hence, we assessed the drivers of MMH problems, challenges in seeking help, and perceptions towards emotional and psychological support for pregnant women among four stakeholder groups in Western Kenya.Methodology A qualitative approach was taken to examine the perspectives towards MMH among mothers, fathers, nurses and community health workers (CHWs). Focus Group Discussions (FGDs) were organized among the four groups. Participants were drawn from three hospitals in Kisumu County, Western Kenya. The socio-ecological model for health behavior structured the analyses, with an initial deductive approach. The identification of specific themes within each level was conducted inductively. Additionally, suggestions for locally acceptable MMH care were collected.Results In total, ten FGDs were held with 73 participants. We found a large level of consensus among stakeholders regarding common causes, consequences and coping strategies for MMH challenges, such as poverty, stigma, intimate partner violence and a lack of social support. In contrast to mothers, fathers also highlighted domestic disputes stemming from disagreements over (resuming) sexual activity. Nurses predominantly mentioned medical consequences of MMH challenges, while CHWs had a more holistic perspective. Participants expressed a need and made recommendations for contextualized MMH care, particularly for a group-based intervention led by CHWs with partner involvement.Conclusions The findings show that there is a need for MMH support in rural, low-resource settings. Mothers and CHWs showed a high level of convergence illustrating the importance of the liaison function of the CHWs between the nurses and mothers. Group-based MMH care was perceived as suitable by all stakeholders. The results of this study guided the design of an MMH intervention that was tested for feasibility and acceptability in the same setting.
A Pilot Study on Initial Stimulation Parameters for Neuroprosthetic Electrical Stimulation to Enhance Kinesthetic Sensation in Paretic Fingers of Patients with Chronic Hemiplegia
Authors: Tanabe Masaya , Kimura Akira
Published: October 2024

Purpose: To determine whether the optimal frequency of Neuro Prosthetic Functional Electrical Stimulation (NP-FES) to reawaken awareness of paralyzed hand movement for the purpose of disuse prevention in persons with chronic hemiplegia left with a paralyzed limb differs from that in the acute phase.
Design: Intervention study.
Setting: Japanese nursing home day care and community residents.
Participants: Eleven Elderly persons with hemiplegia aged 50-90 years.
Interventions: NP-FES applies 70Hz, 120Hz
Control: NP-FES applies 35Hz
Main Outcome Measures: Interviewing whether the patient was again aware of the movement of the paralyzed hand, wrist extension angle, Body Mass Index, and Pain.
Results: Awareness of the movement of the paralyzed hand again was answered positively in nine of the eleven participants. The wrist extension angle was stabilized and less pain was observed in five subjects at 70 Hz and in three subjects at 120 Hz.
Conclusions: Initial stimulation parameters for NP-FES to reawaken awareness of paralyzed hand movements in persons with chronic hemiplegia suggested different parameters than in the acute phase.
Ga-68 Pentixafor PET/CT in multiple myeloma and its correlation with clinical parameters – institutional pilot study
Authors: Gauthaman Dinesh Kumar , Muthukrishnan Indirani , K Ashish Acharya , Simon Shelley
Published: October 2024

Objective:
This study evaluates the role of Ga-68 Pentixafor PET/CT in staging and follow-up of multiple myeloma (MM) and its correlation with clinical parameters.
Methods:
Thirteen participants (9 males, 4 females; median age 65 years) with MM were recruited in this prospective observational study. Six participants were included for staging evaluation, seven were included for follow-up evaluation and underwent Ga-68 Pentixafor PET/CT. Focal PET-positive bone marrow lesions or diffuse bone marrow uptake (uptake more than liver) was considered a positive scan. Quantitative variables like SUVmax, SUVmean, total bone marrow volume and uptake (TBMV & TBMU) and tumor to background ratio (TBRmax) were obtained. Durie Salmon Plus Staging (DSPS) was used for MM staging by PET/CT and was compared with the International Staging System (ISS). Statistical comparison was performed between PET/CT quantitative variables and laboratory parameters.
Results:
Twelve participants (12/13) had positive Ga-68 Pentixafor PET/CT, among which one was diagnosed to have anaemia of chronic disease. One participant (1/13) who was clinically negative on follow-up had negative Ga-68 Pentixafor PET/CT. The sensitivity, specificity, PPV and NPV of Ga-68 Pentixafor PET/CT in MM (95% CI) was observed to be 100%, 50%, 91.6% and 100%, respectively. The correlation between DSPS and ISS in the patients who came for staging scans was found to be statistically significant (p-value 0.02). In quantitative analysis, either of the quantitative variables in Ga-68 Pentixafor PET/CT was positively correlated with clinical parameters related to tumor burden like CRAB score, Serum Protein Electrophoresis M-protein, beta 2 microglobulin, LDH, percentage of plasma cells infiltrates in bone marrow aspiration, ISS, serum free light chain and negatively correlated with haemoglobin, albumin (p-value < 0.5).
Conclusion:
Ga-68 Pentixafor PET/CT is a promising tracer and the only available non-invasive tool to assess the whole-body disease burden of CXCR4 receptors in staging and follow-up of MM. In addition, it has a vital role in the development of CXCR4-targeted theranostics. Dual tracer imaging using F-18 FDG and Ga-68 Pentixafor PET/CT may help in evaluating tumor heterogeneity in MM and add prognostic value at diagnosis and follow-up.
Alternative Splicing Analysis in a Spanish ASD (Autism Spectrum Disorders) Cohort: In silico Prediction and Validation
Authors: Dominguez-Alonso S , Tubío-Fungueiriño M , González-Peñas J , Fernández-Prieto M , Parellada M , Arango C , Carracedo A , Rodriguez-Fontenla C
Published: October 2024

Autism Spectrum Disorders (ASD) are complex and genetically heterogeneous neurodevelopmental conditions. Although alternative splicing (AS) has emerged as a potential contributor to ASD pathogenesis, its role in large-scale genomic studies has remained relatively unexplored. In this comprehensive study, we utilized computational tools to identify, predict, and validate splicing variants within a Spanish ASD cohort (360 trios), shedding light on their potential contributions to the disorder. We utilized SpliceAI, a newly developed machine-learning tool, to identify high-confidence splicing variants in the Spanish ASD cohort and applied a stringent threshold (Δ ≥ 0.8) to ensure robust confidence in the predictions. The in silico validation was then conducted using SpliceVault, which provided compelling evidence of the predicted splicing effects, using 335,663 reference RNA-sequencing (RNA-seq) datasets from GTEx v8 and the sequence read archive (SRA). Furthermore, ABSplice was employed for additional variant validation and to elucidate the tissue-specific impacts of the splicing variants. Notably, our analysis suggested the contribution of splicing variants within CACNA1I, CBLB, CLTB, DLGAP1, DVL3, KIAA0513, OFD1, PKD1, SLC13A3, and SCN2A. Complementary datasets, including more than 42,000 ASD cases, were employed for gene validation and gene ontology (GO) analysis. These analyses revealed potential tissue-specific effects of the splicing variants, particularly in adipose tissue, testis, and the brain. These findings suggest the involvement of these tissues in ASD etiology, which opens up new avenues for further functional testing. Enrichments in molecular functions and biological processes imply the presence of separate pathways and mechanisms involved in the progression of the disorder, thereby distinguishing splicing genes from other ASD-related genes. Notably, splicing genes appear to be predominantly associated with synaptic organization and transmission, in contrast to non-splicing genes (i.e., genes harboring de novo and inherited coding variants not predicted to alter splicing), which have been mainly implicated in chromatin remodeling processes. In conclusion, this study advances our comprehension of the role of AS in ASD and calls for further investigations, including in vitro validation and integration with multi-omics data, to elucidate the functional roles of the highlighted genes and the intricate interplay of the splicing process with other regulatory mechanisms and tissues in ASD.
Ethnicity-specific microbiome in early childhood caries: from the functional perspectives of oral biofilm
Authors: Hsu Kuei-Ling C. , Shaffer Isaac , Furstenau Tara N. , Ernst Robert K. , Fofanov Viacheslav Y.
Published: October 2024

National surveillance data has long shown a significant disparity in tooth decay among young children (early childhood caries, ECC). While factors including household poverty level, culture, health insurance, and infrastructure have been studied, the biomedical perspective is less explored. Using RNASeq technology, our findings show that, besides Streptococcus mutans, which is most commonly associated with caries, several additional dental plaque bacteria are significantly overexpressed in caries lesions. Notably, the bacterial species and functional profiles differ markedly between African American and Latin American Hispanic children. In African American children, gene expression profiles linked to Pseudopropionibacterium propionicum and Cardiobacterium hominis; in contrast, in Latin American Hispanic children, gene expression profiles were dominated by Propionibacterium acidifaciens, Selenomonas sp., Rothia dentocariosa, Atopobium parvulum, and Streptococcus sanguinis. This study underscores the diverse metabolic pathways in plaque bacteria contributing to ECC in minority populations, identifying significant bacterial species beyond common cariogenic bacteria. Main Text:
Predictive Markers of Rapid Disease Progression and Chemotherapy Resistance in Triple-Negative Breast Cancer Patients Following Postoperative Adjuvant Therapy
Authors: Ma Tao , Hao Xiao-meng , Chen Hong-dan , Zheng Min-hui , Chen Xiao-geng , Cai Shuang-Long , Zhang Jin
Published: October 2024

Background
Triple-negative breast cancer (TNBC) is a diverse category with a subset that displays particularly aggressive characteristics, referred to in this study as "rapid relapse" TNBC (rrTNBC). This term is defined as the occurrence of distant metastasis or death within 24 months post-diagnosis. The paper mainly studies the clinicopathologic traits of TNBC patients experiencing rapid disease progression and chemotherapy resistance and identify predictive markers for this outcome.
Methods
A retrospective evaluation was conducted on 2,294 TNBC patients who underwent surgery at Tianjin Medical University Cancer Hospital. Of these, 369 were categorized as experiencing rapid relapse, while 1,925 did not relapse rapidly. Logistic regression analysis was applied to determine potential markers predictive of rapid relapse post-chemotherapy.
Results
Both univariate and multivariate logistic regression analyses pinpointed several predictors of rapid relapse in TNBC patients post-chemotherapy. These include age at diagnosis (≥ 50 years, OR = 0.413, 95% CI: 0.289–0.590), postoperative pathological T staging (T2, OR = 2.557, 95% CI: 1.766–3.703; T3 + T4, OR = 3.725, 95% CI: 1.355–10.454), and N staging (N1, OR = 3.056, 95% CI: 2.021–4.619; N2, OR = 6.917, 95% CI: 3.920–12.206; N3, OR = 24.597, 95% CI: 11.875–50.948). Additionally, sTIL expression (intermediate, OR = 0.204, 95% CI: 0.139–0.300; high, OR = 0.020, 95% CI: 0.011–0.035) and Her2 expression (Her2 1+, OR = 0.470, 95% CI: 0.321–0.688) were identified as protective indicators against rapid relapse. A predictive model incorporating these predictors yielded a C-index of 0.898 in the training set and 0.938 in the validation set, with respective Brier scores of 0.079 and 0.073.
Conclusion
The study successfully established and validated a predictive model for rapid disease progression and chemotherapy resistance in TNBC patients post-chemotherapy, demonstrating robust discrimination and accuracy.
Prognostic Value and Oncogenic Role of STING-Related Genes GAB3 and IL16 in Lung Adenocarcinoma: Implications for Immune Evasion and Treatment
Authors: Ji Ting , Yang XiaoYan , Chen YongJie , Zhao TingTing , Xiang YuXin , Yang Kai , Chen Juan
Published: October 2024

Lung adenocarcinoma (LUAD) is the most prevalent subtype of lung cancer (LC), and the stimulator of interferon genes (STING) is critical in inhibiting its progression. This study investigates the prognostic significance and molecular mechanisms of STING-related genes (STING-RGs) in LUAD. Differential expression analysis, weighted gene co-expression network analysis, as well as Cox regression (CR) identified GAB3 and IL16 as key prognostic genes. A LASSO-based risk model categorized LUAD patients into high-risk group (HRG) and low-risk group (LRG). HRGs exhibited lower GAB3 and IL16 expression and worse survival outcomes. A nomogram integrating risk scores (RS) and clinical factors effectively predicted patient survival. Functional enrichment, immune landscape, and mutation analyses revealed that HRGs were more likely to immune evasion, while LRGs responded better to targeted therapies. Mutation analysis showed lower survival in patients with high-risk scores (HRS) as well as high tumor mutational burden. Immunohistochemical staining confirmed that GAB3 was upregulated in LUAD tissues. In vitro experiments demonstrated that GAB3 overexpression promoted cancer cell proliferation and migration, while siRNA-mediated knockdown of GAB3 inhibited these processes, suggesting its role as an oncogene. In conclusion, GAB3 and IL16 are key prognostic markers, providing insights into STING-related immunotherapy strategies for LUAD.
Gender Disparities in Financial Inclusion: the Potential of Digital Loans in Empowering Female Health Entrepreneurs in Kenya
Authors: Ashubwe Jacklyne , Wanyama Maureen , Siyumbu Joseph , Zuijlen Inès van , Mutegi Nick , Verschuur Sabine , de Wit Tobias Rinke , Mulder Dorien , Janssens Wendy , Dieteren Charlotte
Published: October 2024

In Sub-Saharan Africa, female entrepreneurs are well-represented in the healthcare sector but face significant challenges in accessing financial services. Digital financing technologies have the potential to close this gender-gap. This study aimed to assess the readiness, perspectives and gender disparities in (digital) loan characteristics among Kenyan health Small and Medium Enterprises (SMEs). We interviewed and surveyed 24 and 410 health SME owners respectively. Additionally, we analyzed real-world loan-history data from 850 health SMEs to compare loan profiles of traditional versus digital loans, with a focus on evaluating gender disparities. The IDIs identified low trust in digital lenders, but the survey results indicate a strong demand for loans among health SMEs, regardless of gender. Their digital infrastructure is well-equipped to support the adoption of digital loans. Health SME owners were more likely to take up a digital loan if they were above 50, prepared to take a risk, had monthly financial needs and a positive perception of digital loans. The loan-history data showed a gender difference in the initial traditional loan amount, with women-owned businesses receiving less, but this gap disappeared for digital loans. We also found that women-owned businesses benefit significantly from digital loans, since over 50% experienced substantial growth over time, indicating an increase in their digital revenues likely associated with these loans. This study shows that there is a financing gap among health SMEs in Kenya and underscore the potential of digital loans to boost financial inclusion in the healthcare sector. Trust in digital lenders remains low, especially among those without direct experience, underscoring the need for better information dissemination to build trust in digital financial products.
Knowledge, Attitude and Practice of Surgical Nurses on Enhanced Recovery after Surgery (ERAS) protocols: Multicentre Cross-sectional study
Authors: Alimawu¹ Agmuas Asichale , Tadesse Molla Amsalu , Kebede Fetene Seyoum , Fetene Melaku Bantie , Wondmu Emebet Seyuoum
Published: October 2024

Introduction:
Enhanced Recovery after Surgery (ERAS) protocols have been widely adopted in surgical practice to improve patient outcomes and optimize recovery. These protocols are evidence-based and focus on minimizing the physiological stress of surgery, promoting postoperative recovery, and reducing the length of hospital stays
Objective
The primary aim of this study was to assess knowledge, attitude and practice of surgical nurses on Enhanced Recovery after Surgery (ERAS) protocols.
Methods
A multicentre cross-sectional study was conducted from May 05/2024 to August 20/2024.
Result
A total of 462 surgical nurses were participated in the study. The study found that most participants (64.1%) had a strong understanding of ERAS protocols. Among participants, 51.9% showed positive attitudes towards ERAS protocol. However, when it came to actually applying the protocols, only 30.1% engaged in good practices. Level of education (AOR = 32.748, AOR = 5.023, AOR = 4.070), work experience (AOR = 6.408, AOR = 8.086), hospital type (AOR = 16.545, AOR = 2.121, AOR = 2.637), and on-the-job training (AOR = 6.525, 2.474, 1.974) were found to be highly associated with surgical nurses' knowledge, attitudes and practice of ERAS protocols with respective AOR.
Conclusion
The result this study emphasizes that age, education, work experience, hospital type, and on-the-job training play key roles in shaping surgical nurses' knowledge and attitudes towards ERAS protocols. It highlights the need for specialized educational and training programs designed for various nursing groups to improve their understanding and application of ERAS. Moreover, these factors also impact the effectiveness of ERAS protocol implementation in clinical settings.
Social networks and mental health: A study of elderly in rural Bihar, India
Authors: Raj Aditya Raj Aditya , Bhattacharjee Bijoy Bhattacharjee Bijoy
Published: October 2024

With record high population growth in India, the number of elderly has significantly increased. In Bihar (a state in India) with a high population density, the number of elderly is substantial, but they are under-studied. Moreover, there has not been any significant research on mental health concerns of the elderly, and none from rural Bihar. The elderly go through common mental health conditions like depression, which is often overlooked and neglected. In our study, the role of social networks on depression emerges as pivotal. This study used data from the Longitudinal Ageing Study in India (LASI) with a sample of 1255 older people (60 years or older) from rural Bihar. We used Berkman's conceptual model of how social relationships affect depression. The network was measured by Confirmatory Factor Analysis (CFA) given by Glass et al which shows that four types of social networks were formed- children's network, relative's network, friends’ network, and confidant network. Bivariate and multivariate analysis was done to understand the association and effect of specific networks on depression. The result establishes the importance of social networks for the community life of the elderly. It suggests that a strong social network with relatives and trusted confidence protected the elderly from depression in rural Bihar. This study highlighted the need for more social network centers for the elderly to engage with friends within or between communities and participate in group activities that promote good mental health.
Discovery of a Non-Secreting Pancreatic Neuroendocrine Tumor Mimicking Insulinoma in MEN1: A Novel Diagnostic Challenge with Atypical Biochemical and Genetic Profiles and a review of literature of pNETs etiologies
Authors: Khalil Zeyad , Fouly Mohamed , Tolan Ahmed
Published: October 2024

This case report presents the first documented instance of a non-secreting pancreatic neuroendocrine tumor mimicking insulinoma in a 42-year-old male with Multiple Endocrine Neoplasia Type 1 (MEN1). The patient exhibited recurrent episodes of severe fasting hypoglycemia, typically indicative of insulinoma. However, biochemical tests revealed normal insulin and C-peptide levels, contradicting the usual biochemical signature of functional pNETs. Imaging confirmed the presence of a pancreatic mass, but further investigations failed to demonstrate hormone secretion. Genetic analysis revealed a novel MEN1 gene mutation, suggesting a potential link between this mutation and the atypical behavior of the neuroendocrine tumor. Despite the absence of typical insulinoma markers, surgical resection of the tumor resulted in complete resolution of hypoglycemia, confirming the tumor's role in the patient’s symptoms. This case shows that non-secreting neuroendocrine tumors in MEN1 can clinically mimic functional tumors. This calls for a reconsideration of current diagnostic criteria in MEN1 and may prompt future investigations into the topic.
Long-Term Results of Subtalar Arthroereisis for Symptomatic Flexible Flatfoot in Pediatrics
Authors: Wang Jou-Hua , Chu Chia Hung , Chuang Hao-Chun , Chen Yan Yu
Published: October 2024

Purpose:
Subtalar arthroereisis (STA) is a clinical intervention used for the correction of flexible flatfoot (FFF) in the pediatric population. This study aims to evaluate the radiographic, clinical, and patient-reported outcomes of STA for symptomatic FFF in pediatric patients with a minimum follow-up period of nine years.
Methods:
A cohort of 19 patients (38 feet) who underwent STA for FFF treatment between 2011 and 2015 was analyzed. This study featured a minimum follow-up period of nine years and involved comprehensive radiographic measurements. Clinical function assessment included footprint analysis classified using the Viladot classification, the Foot and Ankle Outcome Score (FAOS), and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. We calculated the association between preoperative and postoperative angles and functional results. Receiver operating characteristic (ROC) curve analyses were conducted to establish the optimal threshold to predict good clinical outcomes.
Results:
The average age at the time of surgery was 11 ± 1.79 years, and the mean duration of follow-up was 10 ± 1.4 years. After the surgical intervention, all foot angles showed statistically significant improvements. Normal foot alignment according to the Viladot classification was noted in 71% of patients. Good to excellent functional outcomes, as measured by both the AOFAS-hindfoot score and FAOS score, were reported in 84.2% of patients. Significant correlations were found between the preoperative and postoperative angles and functional results. Based on ROC curve analysis, the cut-off values were determined to be 28.5 degrees for the talonavicular coverage angle, 19.5 degrees for Meary’s angle, and 37.5 degrees for the talar declination angle.
Conclusion:
Our study indicates that STA is an effective procedure for durable deformity correction in pediatric patients with FFF. Restoring the medial longitudinal arch and correcting forefoot abduction are essential for improving functional outcomes. Both preoperative and postoperative angles were significantly associated with functional results, and the identified preoperative cut-off values are helpful for selecting surgical candidates.
Assessment of PM2.5 and PM10 Exposure and Health Risks: A Study of Pedestrian and Two-Wheeler Transport During Peak-Traffic in Imphal, Manipur
Authors: Cheerfree K T , Singh Nongthombam Premananda
Published: October 2024

This study looks at the levels of PM2.5 and PM10 people are exposed to during busy traffic times when walking, riding two-wheelers, and at a fixed-site. Hourly average data was used to compare the amounts of particulate matter with the WHO air quality guidelines, which recommend limits of 15 µg/m³ for PM2.5 and 45 µg/m³ for PM10, respectively. The results showed that particulate matter levels changed a lot between morning and evening peak hours, with higher levels on weekdays compared to weekends. Two-wheeler users had the highest exposure, with average levels of 79.72±41.87 µg/m³ for PM2.5 and 131.48±69.32 µg/m³ for PM10 in the morning, and 109.15±38.63 µg/m³ for PM2.5 and 181.25±64.22 µg/m³ for PM10 in the evening, mostly due to traffic emissions and the design of the vehicles. In comparison, walking and fixed-site had more steady levels of particulate matter. All transport modes went over the WHO guidelines, with two-wheeler users facing the highest exposure with exceedance factor of 6.33 and 3.50 for PM2.5 and PM10, respectively. Whereas, exceedance factors of walking were 4.10 and 2.27 and for fixed-site were 4.10 and 2.32 for PM2.5 and PM10, respectively. The health risks from long-term exposure to these high levels are discussed, stressing the need for actions and strategies to improve air quality in cities.
Comparison of outcomes between in-hospital stroke and out-of-hospital stroke after endovascular therapy: Propensity-score matching analysis
Authors: Liu xiaoxia , Li Da , Fan Weinv , Chen Feiyu , Zhang Ou , yao yindan
Published: October 2024

Background：Only a few studies have investigated the outcomes of endovascular therapy (EVT) for in-hospital stroke (IHS). This study aimed to investigate patients with IHS secondary to large vessel occlusion (LVO) who had undergone EVT at our center and compare the outcomes between IHS and out-of-hospital stroke (OHS).
Methods: From January 2019 to December 2023 ,a total of 372 consecutive patients with acute ischemic stroke (AIS) secondary to LVO within 6 hours from onset who underwent EVT were enrolled in our stroke center. After propensity score matching (PSM) with a ratio of 1:2 (IHS:OHS), clinical characteristics and functional outcomes were compared between IHS and OHS groups.
Results: 31 IHS patients and 62 OHS patients were finally included.The intravenous thrombolysis rate was significantly lower (12.9% vs. 45.7%, p=0.002) than that in the OHS group. The proportion of patients with cancer in the HIS group was significantly higher (45.2% vs. 4.8%, P < 0.001) than that in the OHS group. The time intervals (min, mean±SD ) from stroke onset-to-imaging, onset-to-puncture, and onset-to-end EVT respectively were more favorable (79.29±59.36 vs. 182.34±87.69, 146.39±72.88 vs. 256.65±91.11, 203.48±79.33 vs. 311.97±96.09, all P < 0.001) in the IHS group, whereas OHS patients had lower door-to-imaging, door-to-groin times (24.02±15.01 vs.79.29±59.36 , 96.05±32.72 vs.146.39±72.88, all P < 0.001). Compared with OHS patients, the proportion of patients with good functional outcomes(mRS score of 0-3) at 90 d in the IHS group was significantly lower (64.5% vs. 41.9%%, p=0.038) and there was no significant difference in the proportion of patients with favorable functional outcomes (mRS score of 0-2) (48.4% vs. 35.5%, p=0.277).
Conclusion: Our study shows that although IHS patients had a significantly shorter time intervals from symptom onset to end EVT, IHS had worse good functional outcomes than OHS patients but with a similar rate of favorable functional outcomes. Delays in IHS management and more complications seem to be the main causes of poor prognosis of IHS.
Effect of Laser Polishing Parameters on Residual Stress, Surface Roughness, and Microhardness of Ti6Al4V
Authors: Balhara Rama , Hijam Justin , Vadali Madhu
Published: October 2024

The present study explores the impact of laser polishing (LP) process parameters of Ti6Al4V on the induced residual stress and surface properties. LP is a thermal process that involves melting a thin surface layer. The flows within the molten layer reduce the surface undulations caused due to initial surface roughness, resulting in a smoother surface. The material undergoes heating and cooling cycles in LP, resulting in residual stresses. This paper details the trade-offs between the residual stresses and the surface properties for various process parameters. The induced residual stresses show dependency on the cooling rate during the process, predicted using a validated finite element-based numerical model. For the set of process parameters, it was observed that the induced residual stress has no significant variation with a change in laser power. However, it increases with an increase in scan speed. A reduction of around 71% in surface roughness is observed at 100 W and 0.1 m/s, with a minimum induced residual stress of ~ 372 MPa. However, the surface hardness is maintained for all sets of process parameters. A comparative study is also conducted for the induced residual stress between pure Ti and Ti6Al4V. It is noted that for all process parameters, the induced residual stress is higher for Ti6Al4V. However, pure Ti also follows the trend of variation of laser power and scan speed on the induced residual stress.
Integrated transcriptome and single-cell sequencing reveals M2-like tumor-associated macrophages-related prognostic signatures in breast cancer
Authors: Xuyang Haochen , Lin Peiyan , Zhu Ye , Zhang Qin , Zhou Jinghong
Published: October 2024

Background: M2-like tumor-associated macrophages (M2-like TAMs) have crucial functions in the tumor microenvironment (TME) and cancer development. This study explored M2-like TAMs-related prognostic signatures in breast cancer (BRCA) by combining transcriptome and scRNA-seq.
Methods: All datasets (TCGA-BRCA, GSE20685, GSE176078) were downloaded from UCSC xena and GEO database. AUCell score of immune-related genes (IRGs) was calculated using R package. M2-like TAMs-related genes were screened by WGCNA. Signature genes predictive of BRCA prognosis were identified by univariate Cox and LASSOregression analyses. Then, RiskScore model was constructed and validated in external dataset. Nomogram was established by integrating RiskScore and clinical characteristics. Correlation analysis between RiskScore and TME or chemotherapeutic drugs was conducted.
Results: Macrophage exhibited the highest IRGs AUCell score in single-cell transcriptomic atlas of BRCA. Macrophage was split into C1 and C2 subtypes, and Macrophage C1 highly expressed the marker genes of M2 macrophages. Then, 903 M2-like TAMs-related genes were acquired. ARHGAP26, RILP, KLRB1, CSTA, KLHDC7B, PSMB8, KYNU, RNASE1, LONRF3, and TRPM2were screened as prognostic signatures to establish RiskScore model, exhibiting good robustness. Nomogram was constructed by combining stage, Age, and RiskScore, with good predictive performance. Besides, most immune cells showed a negative correlation with RiskScore. Eight drugs were notably correlated with RiskScore, and the high-risk group had higher half maximal inhibitory concentration (IC50) of Ribociclib_1632, conversely indicating that the BRCA patients with low RiskScore were more sensitive to Ribociclib_1632.
Conclusion: We identified 10 M2-like TAMs-related prognostic signatures, providing potential therapeutic targetsfor BRCA.
Investigation of the Bone Repair Mechanism in Femoral Head Necrosis Promoted by Spleen-invigorating Huo-Gu Formula Via the MPET Model
Authors: Sun Shiyi , Li Zeyan , Zhang Cheng , Wu Zixuan , Guo Liwei , Yang Tongjie , He Haijun , Chen Duanduan
Published: October 2024

Background
A three-dimensional blood perfusion simulation model of the femoral head is an innovative approach for studying blood flow and displacement deformation in the femoral head. Using this model, the mechanism by which spleen-invigorating Huo-Gu Formula (HGF) therapy exerts its effects on necrotic areas of the femoral head can be examined from the perspectives of blood supply and bone repair. This study aims to provide a theoretical foundation and objective basis for the use of HGF in the treatment of non-traumatic femoral head necrosis.
Methods
The multiple-network poroelastic theory (MPET) model, previously developed by our research team, was employed to analyse data from a patient with ARCO stage II femoral head necrosis. Color Doppler ultrasound and CT data of the patient’s medial circumflex femoral artery were collected before and three months after HGF treatment. Blood perfusion levels in the necrotic area, including arterial flow velocity, blood flow volume, and tissue deformation, were compared before and after treatment.
Results
The findings demonstrated that, following treatment with HGF, there was a significant increase in arterial flow velocity and blood flow volume in the necrotic area, accompanied by a reduction in tissue deformation.
Conclusion
HGF effectively enhances blood perfusion in the necrotic areas of the femoral head and promotes bone repair.