bluuebunny/crossref_metadata_2025 huggingface dataset:
Reservoir Characterization in Transient Wellbore Conditions Resulting from Unintended Hydraulic Fracture Communications Utilizing MPD
Authors: Kvalo P. E. M. , Duarte M. , Vargas N. , Laird E. , Sullins T. , Boddy T. , Janes C.
Published: October 2023

MPD for reservoir characterization in green field applications is often seen as vital for providing operators with valuable information about the reservoir's physical properties while drilling. This aspect of Managed Pressure Drilling (MPD) in mature fields is not often a driver for implementation as these characteristics are typically well-defined. However, external factors such as unintentional communication between drilling and fracking operations can significantly alter known reservoir characteristics. The proppant exponentially enhances the permeability of both the child and parent well. While the fracturing fluid initially increases the pore pressure and stress environment in the near wellbore region, followed by its subsequent reduction, the rate of which is dependent on the dominant regime: flow back on the parent well, pressure equalization of the reservoir, and/or diffusion of fluid into the drilling mud.

The challenges and interactions associated with unintended frac communication and how primary reservoir characteristics are fundamentally altered as a result will be discussed. Additionally, the results of each reservoir characterization test can be interpreted to adjust the plan forward and utilized to navigate these transient wellbore conditions. Thus, providing clear insight into the wellbore's evolving drilling window, enabling the safe drilling and completion of the "fracked into" well.
Estimation of the Stimulated Reservoir Volume by Rate Transient Analysis for Marcellus Shale Horizontal Wells
Authors: Parrish Amanda , Sattari Arya , Aminian Kashy , El Sgher Mohammed , Ameri Samuel
Published: October 2023

Shale reservoirs are most commonly developed by horizontal wells coupled with multi-stage hydraulic fracturing to create a stimulated volume around the well. The interference among the hydraulic fracture stages in a horizontal well leads to an early boundary-dominated flow (BDF) period within the stimulated reservoir volume (SRV). The application of the rate transient analysis to the production and flowing pressure data from this period can provide an estimate of the gas in place in SRV.

A realistic model for a horizontal Marcellus shale well, with multiple fracture stages, was utilized in this study to simulate gas production and the flowing pressure data. The simulated data by the model were then analyzed by rate transient analysis (RTA) techniques to identify the early BDF period and to estimate the gas in place in SRV. To investigate the impact of the adsorbed gas, shale compaction, and hydraulic fracture spacing on the estimated gas in place in SRV, several sets of the production and flowing pressure data were then simulated and analyzed.

The analysis of the data from the early BDF period provided reliable estimates of the gas in place in SRV. These estimates are impacted by the shale compaction but not significantly by the adsorbed gas and fracture stage spacing. When the fractures are stages are closely spaced, the early BDF period established early and last for a relatively short time. Consequently, the identification of the early BDF becomes difficult leading to uncertainty in the estimated of the gas in place in SRV. However, when the fracture stages are spaced widely, the early BDF may last for a longer time and can be identified more readily.
Success Using Low Emissions API Class L Cement in Cementing Marcellus Production Strings
Authors: Dalton J. , Winegarden J. , Thomas T. , Townsend D. , Enos C.
Published: October 2023

The manufacture of Portland cement accounts for approximately 8% of the world’s total carbon dioxide emissions. Cement manufacturers and their end users are under immense pressure to find ways to reduce the amount of Portland cement in their processes. While the well-construction industry accounts for a very small portion of the cement produced worldwide, it is still our responsibility to be good stewards of the environment and do what is in our power to reduce greenhouse gas emissions. This paper describes the use of a novel API Class L cement with significantly reduced clinker content as a replacement for Class A in cementing Marcellus production casing strings in Monongalia County, West Virginia.

The testing team compared the cementing processes from two pads. The team cemented first pad using a single slurry consisting of 50:50 Poz:Class A cement, and they cemented the second pad using a new slurry consisting of 50:50 Poz:Class L cement. The study presents cement slurry lab results for comparison, as well as results of all jobs using a radial cement bond logging tool. The lab results show that Class L is an adequate replacement for Class A cement, exhibiting similar properties in standard oilwell cement testing. Slurry stability, thickening time, rheology, fluid loss and compressive strength can be tuned to similar ranges by making simple adjustments with commonly used cement additives. The radial cement bond log results show that the zonal isolation provided by the Class L cement is equivalent to that provided by Class A cement.
Shared genetic architecture between sleep behaviors and lifespan
Authors: Xiao Xiao , Wu Yong , Zhang Chu-Yi , Liu Xiaolan , Wang Lu , Li Ming , LI YI
Published: October 2023

Poor sleep health is associated with a wide array of increased risk for cardiovascular, metabolic and mental health problems as well as all-cause mortality in observational studies, suggesting potential links between sleep health and lifespan. However, it has yet to be determined whether sleep health is genetically or/and causally associated with lifespan. In this study, we firstly studied the genetic association between sleep behaviors and lifespan using GWAS summary statistics, and both sleep duration time and insomnia were negatively correlated and shared genetic loci with lifespan. Then, a two-sample Mendelian randomization (MR) and multivariable MR analysis strategy was applied to explore the causal effects between sleep behaviors and lifespan. We found that genetically predicted short sleep duration was causally and negatively associated with lifespan in univariable and multivariable MR analyses, and this effect was partially mediated by coronary artery disease (CAD) and type 2 diabetes (T2D). In contrast, we found that insomnia had no causal effects on lifespan. Our results further confirmed the negative effects of short sleep duration on lifespan and suggested that extension of sleep may benefit the physical health of individuals with sleep loss. Further attention should be given to such public health issues.
The endogenous opioid system in the medial prefrontal cortex mediates ketamine’s antidepressant-like actions
Authors: Pittenger Christopher , Jiang Cheng , DiLeone Ralph , Duman Ronald
Published: October 2023

Recent studies have implicated the endogenous opioid system in the antidepressant actions of ketamine, but the underlying mechanisms remain unclear. We used a combination of pharmacological, behavioral, and molecular approaches in rats to test the contribution of the prefrontal endogenous opioid system to the antidepressant-like effects of a single dose of ketamine. Both the behavioral actions of ketamine and their molecular correlates in the medial prefrontal cortex (mPFC) were blocked by acute systemic administration of naltrexone, a competitive opioid receptor antagonist. Naltrexone delivered directly into the mPFC similarly disrupted the behavioral effects of ketamine. Ketamine treatment rapidly increased levels of β-endorphin and the expression of the µ-opioid receptor gene (Oprm1) in the mPFC, and the expression of the gene that encodes proopiomelanocortin, the precursor of β-endorphin, in the hypothalamus, in vivo. Finally, neutralization of β-endorphin in the mPFC using a specific antibody prior to ketamine treatment abolished both behavioral and molecular effects. Together, these findings indicate that presence of β-endorphin and activation of opioid receptors in the mPFC are required for the antidepressant-like actions of ketamine.
Gut microbial CAZymes markers for depression
Authors: zheng peng , Xie Peijun , Zhou Xingyu , Li Yifan , Wu Jing , Zhang Hanping , Huang Yu , Tan Xunmin , Wen Lu , Olasunkanmi Oluwatayo Israel , Zhou Jingjing , Sun Zuoli , Liu Min , Zhang Guofu , Wang Ying , Xie Peng , Yang Jian
Published: October 2023

Major depressive disorder (MDD) is a serious mental illness, characterized by disturbances of gut microbiome, it is required to further explore how the carbohydrate-active enzymes (CAZymes) were changed in MDD. Here, using the metagenomic data from patients with MDD (n = 118) and heath controls (HC, n = 118), we found that the whole CAZymes signatures of MDD were significantly discriminated from that in HC. α-diversity indexes of the two groups were also significantly different. The patients with MDD were characterized by enriched Glycoside Hydrolases (GHs) and Polysaccharide Lyases (PLs) relative to HC. A panel of makers composed of 9 CAZymes mainly belonging to GHs enabled to discriminate the patients with MDD and HC with AUC of 0.824. In addition, this marker panel could classify blinded test samples from the two groups with an AUC of 0.736. Moreover, we found that baseline 4 CAZymes levels also could predict the antidepressant efficacy after adjusted confounding factors and times of depressive episode. Our findings showed that MDD was associated with disturbances of gut CAZymes, which may help to develop diagnostic and predictive tools for depression.
Interoceptive training impacts the neural circuit of the anterior insula cortex.
Authors: Sekiguchi Atsushi , SUGAWARA Ayako , KATSUNUMA Ruri , Terasawa Yuri
Published: October 2023

Interoception is the perception of afferent information that arises from anywhere and everywhere within the body. Recently, interoceptive accuracy could be enhanced by cognitive training. Given that the anterior insula cortex (AIC) is a key node of interoception, we hypothesized that resting functional connectivity (RSFC) from AIC was involved in an effect of interoceptive training. To address this issue, we conducted a longitudinal intervention study using interoceptive training and obtained RSFC using fMRI before and after the intervention. A heartbeat perception task evaluated interoceptive accuracy. Twenty-two healthy volunteers (15 females, age 19.9 ± 2.0 years) participated. After the intervention, interoceptive accuracy was enhanced, and anxiety levels and somatic symptoms were reduced. Also, RSFC from AIC to the dorsolateral prefrontal cortex (DLPFC), superior marginal gyrus (SMG), anterior cingulate cortex (ACC), and brain stem, including nucleus tractus solitarius (NTS) were enhanced, and those from AIC to the visual cortex (VC) were decreased according to enhanced interoceptive accuracy. The neural circuit of AIC, ACC, and NTS is involved in the bottom-up process of interoception. The neural circuit of AIC, DLPFC, and SMG is involved in the top-down process of interoception, which was thought to represent the cognitive control of emotion. The findings provided a better understanding of neural underpinnings of the effect of interoceptive training on somatic symptoms and anxiety levels by enhancing both bottom-up and top-down processes of interoception, which has a potential contribution to the structure of psychotherapies based on the neural mechanism of psychosomatics. Trial registration number: UMIN000037548.
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042812
Exploring Lessons from Regional Maintenance Workshop to Enhance Medical Equipment Functionality in Ethiopia
Authors: Bekele Abebe , Nyaruhirira Alaine Umubyeyi , Gashu Zewdu , Gebreyohannes Asfawesen , Gemechu Daniel , Habtewold Ashenafi , Assefa Solomon , Assefa Alemayehu , Beyene Rahel , Ahamed Beyan , Mekasha Fikru , Abera Sakata , Eshetu Kirubel , Biru Mulatu
Published: October 2023

Background
WHO estimates that around 50% of medical equipment in developing countries are not functional. In Ethiopia, lack of proper management of medical equipment has limited the capacity of health institutions to deliver adequate health care services.
Objective
To evaluate the status of regional medical equipment maintenance workshops in relation to their establishment purpose.
Methods
We conducted a cross-sectional study where we used structured questionnaires to determine the number of qualified biomedical engineers and biomedical technicians, the number of the health facilities beneficiaries, the management structure, the maintenance and the training activities of the maintenance workshop. The collected data were analyzed by Microsoft excel.
Results
In May 2021, assessments were carried out on 10 of 11 regional medical equipment maintenance workshops established by Ethiopia ministry of health.
The number of biomedical engineers and biomedical technicians working in the workshop vary from nine to two. The number of health facilities receiving maintenance service was as high as 87 and as low as one. 25% of preventive maintenance and 40% of corrective maintenance activities were practiced in the maintenance workshops. 13.3% of the training activities were practiced in the maintenance workshops. The management structure of the workshops was varying and lacked basic materials and a budget to provide training and maintenance services.
Conclusion
The assessment indicates that the role of maintenance workshop to support the functionality of medical equipment is not as desired which indicates the need of improvement plan by ministry of health and other stakeholders working on healthcare systems.
Comparison of plaque control record measurements obtained using intraoral scanner and direct visualization
Authors: Yoshiga Chiro , Doi Kazuya , Oue Hiroshi , Kawagoe Maiko , Kobatake Reiko , Umehara Hanako , Wakamatsu Kaien , Tsuga Kazuhiro
Published: October 2023

Background
Intraoral scanner (IOS) can acquire three-dimensional color images of teeth. Thus, the detection of areas with plaque adhesion stained by plaque-disclosing solutions using an IOS could be a potential oral hygiene evaluation method. This study aimed to verify the usefulness of obtaining O’Leary’s plaque control record (PCR) measurements using an IOS in clinical practice.
Methods
Twenty patients with > 20% PCR measurements who underwent oral prophylaxis were enrolled in this study. A plaque-disclosing gel was applied to stain the areas with plaque adhesion, and the dentition was scanned using the IOS. The PCR values obtained via the direct method and those obtained using the digital image were compared for the entire dentition, maxillary total area, the labial and palatal aspects of the maxillary anterior teeth, the buccal and palatal aspects of the maxillary posterior teeth, mandibular total area, the labial and lingual aspects of the mandibular anterior teeth, and the buccal and lingual aspects of the mandibular posterior teeth.
Results
The IOS group tended to have higher values than the direct observation group. The labial and palatal aspect of the maxillary anterior teeth, the labial and lingual aspects of the mandibular anterior teeth did not differ significantly between the groups.
Conclusion
Plaque adhesion was visualized more easily and conclusively using an IOS than by direct observation. As the large tip size often hinders its use, it is necessary to develop a smaller IOS tip in the future.
Trial registration
This clinical study was approved by the Hiroshima University Hospital Certified Review Board (CRB6180006). This study was conducted as a clinical research study (jRCTs062220068, Registration date November 8, 2022) in accordance with the Good Clinical Practice Guideline of the International Conference on Harmonization (ICH-GCP).
Metabolomic analysis identifies guanosine as an early biomarker in Diabetic Cognitive Dysfunction in high-altitude
Authors: Shi Jing , Meng li , zhang hui , Feng li , wang yuan , Li yan , Guo yue , Li mei , He lin , Cheng jian , wu hong
Published: October 2023

Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder frequently accompanied by cognitive dysfunction and affects nearly 30% of people with diabetes, is an independent risk factor for cognitive dysfunction. Exposure to high-altitudes (above 2500 meters above sea level) with hypobaric hypoxia can also lead to cognitive dysfunction. Which is also a risk factor for cognitive dysfunction. Therefore, the two risk factors of diabetes and high-altitude combined, the damage to cognitive dysfunction may be more serious, and may even develop into dementia. So, early diagnosis and discovery of cognitive function biomarkers of diabetes at high-altitude are of great significance for prevention and treatment. This study is to investigate the early specific metabolites biomarkers of diabetic cognitive dysfunction in high-altitude by using metabolomics technology. Total 400 subjects were divided into four groups, diabetics in high-altitude (H-T2DM), normal control in high-altitude (H-HC), diabetics in low-altitude (L-T2DM)，normal control in low-altitude (L-HC). Cognitive deficits were assessed in H-T2DM and L-T2DM using a cognitive function recognition test. The recognition test showed significant cognitive impairment in the H-T2DM. Serological results showed higher hemoglobin (HbA1c) values ​​in the H-T2DM. Four groups of serum samples were analyzed by ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS) platform. The stability of the model was verified by principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Metabolites with significant differences were screened out as potential biomarkers through the OPLS-DA model according to the importance of variables in the project (VIP ＞1) and the P value of the t-test (P＜0.05). Through multivariate statistical and integrated analysis, a total of 26 differentially expressed endogenous metabolites were identified (18 up-regulated and 8 down-regulated in H-T2DM). Through pathway topology analysis, we found that the pipecolic acid, lauric acid, guanosine and kaempferol could be accepted as early biomarkers of diabetic cognitive impairment in high-altitude. The prediction accuracy rate was as high as 92%. The identified biomarkers are mainly related to lysine degradation, fatty acid biosynthesis, purine metabolism and metabolic pathways. Through the verification of multi-center population, it was found that guanosine is the biomarker with the most potential to become an early biomarker. This study reveals for the first time reliable biomarkers for early diagnosis of diabetes at high-altitude. It may be provide new ideas and strategies for early diagnosis.
Comparing long-term patterns of spread of native and invasive plants in a successional forest
Authors: Yamamoto Matthew , Jones Chad
Published: October 2023

A fundamental question in invasive plant ecology is whether invasive and native plants have different ecological roles. Differences in functional traits have been explored, but we lack a comparison of the factors affecting the spread of co-occurring natives and invasives. Some have proposed that to succeed, invasives would colonize a wider variety of sites, would disperse farther, or would be better at colonizing sites with more available light and soil nutrients than natives. We examined patterns of spread over 70 years in a regenerating forest in Connecticut, USA where both native and invasive species acted as colonizers. We compared seven invasive and 19 native species in the characteristics of colonized plots, variation in these characteristics, and the importance of site variables for colonization. We found little support for the hypotheses that invasive plants succeed by dispersing farther than native plants or by having a broader range of site tolerances. Colonization by invasives was also not more dependent on light than colonization by natives. Like native understory species, invasive plants spread into closed-canopy forest and species-rich communities despite earlier predictions that these communities would resist invasion. The biggest differences were that soil nitrate and the initial land cover being open field increased the odds of colonization for most invasives but only for some natives. In large part, though, the spread of native and invasive plants was affected by similar factors.
Evaluation of Body Shape as a Human Body Composition Assessment in Isolated Conditions and Remote Environments
Authors: Wong Michael , Bennett Jonathan , Leong Lambert , Liu Yong , Kelly Nisa , Cherry John , Kloza Kate , Li Bosco , Iuliano Sandra , Sibonga Jean D. , Sawyer Aenor , Shepherd John
Published: October 2023

Background Individuals in isolated conditions and extreme environments can experience debilitating side effects from their environment, which may include a significant decrease in fat-free mass (FFM) from disuse and inadequate nutrition. At its most severe, the decrease in FFM may lead to sarcopenia and frailty. Although there are dietary and physical activity countermeasures, there lacks accessible methods to quantify regional and total FFM during long-isolated missions. The objective of this study was to determine the strengths and weaknesses of three-dimensional optical (3DO) imaging for monitoring body shape and composition in either simulated or actual remote and isolated environments.Methods Thirty healthy adults (ASTRO, male = 15) and twenty-two Antarctic Expeditioners (ABCS, male = 18) were assessed for body composition using a whole-body 3DO scanner. The 3D mesh was used as the 3DO scanner’s output. ASTRO participants completed duplicate whole-body 3DO scans while standing and inverted by gravity boots plus a single dual-energy X-ray absorptiometry (DXA) scan. The inverted scans were used as an analog for fluid redistribution from gravity changes. 3DO body composition estimates were compared to DXA with linear regression and reported with the coefficient of determination (R2) and root mean square error (RMSE). Duplicate 3DO scans were used for test-retest precision, which was reported with the percent coefficient of variation (%CV) and RMSE. ABCS participants received only duplicate whole-body 3DO scans on a monthly basis. An existing body composition model was used to estimate fat mass (FM) and FFM composition and longitudinal change from 3DO meshes.Results Standing ASTRO 3DO meshes achieved an R2 of 0.76, 0.97, and 0.78 with an RMSE of 2.62 kg, 2.04 kg, and 0.06 kg for FM, FFM, and visceral adipose tissue (VAT), respectively, in comparison to DXA. Inverted 3DO meshes achieved an R2 of 0.52, 0.93, and 0.39 with an RMSE of 2.84 kg, 3.23 kg, and 0.11 kg for FM, FFM, and visceral adipose tissue (VAT), respectively, in comparison to DXA. Test-retest precision of inverted 3DO meshes had good precision in total fat-free as well as arm, leg, and trunk fat-free mass (%CV = 2.3%, 2.95%, 1.34%, and 1.55%; RMSE = 1.32, 0.12, 0.14, and 0.47 kg, respectively). For the ABCS arm, mean weight, FM, and FFM changes were − 0.47 kg, 0.06 kg, and − 0.54 kg, respectively.Conclusion Simulated weightlessness and fluid redistribution decreased the accuracy of estimated body composition values from 3DO scans. However, FFM was the most robust. Overall, 3DO imaging showed good absolute accuracy and precision for body composition assessment in isolated conditions and remote environments.
Community stigma, victimization, and coping strategies among gays, bisexuals, and other cis-gender men who have sex with men in slum communities in Ghana. BSGH-003
Authors: Shamrock Osman Wumpini , Abu-Ba'are Gamji Rabiu , Zigah Edem Yaw , Dakpui Henry Delali , Adjaka Gideon , LeBlanc Natalie M. , Alio Amina P. , Nelson LaRon
Published: October 2023

Background
Gays, bisexuals, and cis-gender men who have sex with men (GBMSM) face severe consequences, especially within stigmatized environments. However, very little is known about the experiences of GBMSM living in slums in SSA and Ghana. This study investigates the experiences of stigma, victimization, and coping strategies and proposes some interventional approaches for combating stigma facing GBMSM in slum communities.
Methods
We engaged GBMSM living in slums in two major Ghanaian cities. We used a time-location sampling and collected data through in-depth individual interviews. Two major themes emerged from the study: 1) insecurities and criminalization of GBMSM activity, and 2) GBMSM coping strategies.
Results
Findings show GBMSM experienced negative attitudes from the community due to their sexual behavior/orientation. GBMSM also developed coping strategies to avert negative experiences, such as hiding their identities/behavior, avoiding gender non-conforming men, and having relationships with persons outside their communities.
Conclusion
We propose interventions such as HIV Education, Empathy, and Empowerment and Acceptance, and Commitment Therapy as possible measures to improve the experiences of GBMSM living in Ghanaian slum communities.
Time trends in real-world treatment patterns and survival in patients diagnosed with de novo HER2+ metastatic breast cancer: an analysis of the SONABRE registry
Authors: Geurts Sandra ME , Ibragimova Khava , Ding Nan , Meegdes Marissa , Erdkamp Frans , Heijns Joan , Tol Jolien , Vriens Birgit , Dercksen Marcus W , Aaldering Kirsten , Pepels Manon , de Winkel Linda van , Peters Natascha , de Wouw Agnes J van , Maaskant Sabrina , Dedroog Nathalie Teeuwen - , Nijnatten Thiemo van , de Boer Maaike , Tjan-Heijnen Vivianne
Published: October 2023

Purpose The aim was to determine whether the real-world first-line progression-free survival (PFS) of patients diagnosed withde novohuman epidermal growth factor receptor 2 positive (HER2+) advanced breast cancer (ABC) has improved since the introduction of pertuzumab in 2013. Methods Included were patients systemically treated forde novoHER2 + ABC in ten hospitals in 2008–2017 from the SONABRE Registry (NCT-03577197). First-line PFS in 2013–2017 versus 2008–2012 was determined using multivariable Cox proportional hazards modelling. First-given systemic therapy and the use of locoregional therapy within the first year following diagnosis were determined per period of diagnosis. Results Median and five-year PFS were 26.6 months and 24% in 2013–2017 (n = 85) and 14.5 months and 10% in 2008–2012 (n = 81) (adjusted HR = 0.65, 95%CI:0.45–0.94). Of patients diagnosed in 2013–2017 versus 2008–2012, 85% versus 60% received HER2-targeted therapy and 59% versus 0% pertuzumab-based therapy as first-given therapy. Respectively 27% and 23% of patients underwent locoregional breast surgery, and 6% and 7% surgery of a metastatic site during the first year following diagnosis. Conclusion The prognosis of patients withde novoHER2 + ABC has improved considerably. Since 2013 one in four patients were alive and free from progression on first-given therapy for at least five years.
Evaluation of Transgender Healthcare in Graduate Medical Education Trainees at a Mississippi Academic Medical Center
Authors: Coats Laura E. , Clericuzio Natalie , Pitts Lauren E. , Lutz Elizabeth A.
Published: October 2023

Background
Transgender patients experience longstanding health disparities influenced by improper training of healthcare professionals. Thus, there is a critical need to train medical professionals on how to care for this diverse population. Incorporating targeted and defined transgender healthcare training among the graduate medical education (GME) curricula could improve healthcare outcomes and alleviate healthcare disparities. The primary aim of this study was to assess transgender healthcare needs among GME trainees at the University of Mississippi Medical Center (UMMC) by evaluating their perceptions.
Methods
We administered a 16-question anonymous and voluntary email survey to all UMMC GME trainees (n = 647) from January to March 2022 (UMMC IRB 2021 − 1037).
Results
A total of n = 126 (19.5%) surveys were completed by primary (n = 52) and non-primary (n = 74) care specialists in all post-graduate years (PGY). Non-primary specialists were more confident in their ability to manage health concerns (36.5% “for the most part”; n = 27) (P < 0.01) and comfortable in caring for transgender patients (37.8% “for the most part”; n = 28) (P = 0.03). However, primary care specialists better recognized that they play a role in promoting transgender health (3.9% “not at all”; n = 2)(P < 0.01) and were more interested in learning about transgender healthcare issues (90.4% “yes”; n = 47)(P < 0.01). PGY did not influence responses among all questions.
Conclusions
This study shows limited confidence and awareness in transgender healthcare among GME trainees at a Mississippi academic medical center. These data indicate the necessity to implement transgender healthcare training and education into the GME curriculum. Yet, the transgender healthcare curricula should be tailored by specialty to create culturally competent and inclusive healthcare providers.
Hemophagocytic Lymphohistiocytosis and Myopericarditis Induced by Campylobacter: A Case Report
Authors: Chang Chia Hua , Kao Chih-Chuan
Published: October 2023

Background:
Hemophagocytic lymphohistiocytosis (HLH) is a severe disorder characterized by excessive activation of the immune system, leading to hypercytokinemia and damage to multiple organs. We report a rare case of HLH with myopericarditis caused by Corynebacterium infection.
Case presentation:
A 28-year-old male patient with a history of hypertension without medicine control presented at the hospital after a four-day fever, decreasing urine amount, rashes on his trunk and limbs, and other symptoms. He was admitted with a provisional diagnosis of atypical infection and allergic skin rash related to diclofenac. However, his condition deteriorated, and he developed shock, tachycardia, chest distress, and bilateral pleural effusion after admission. Further investigations revealed cardiogenic shock related to myopericarditis, and he was transferred to the ICU. In addition, a stool PCR panel subsequently revealed a positive result for Campylobacter. On day 6, he was diagnosed with HLH. Under Klaricid and dexamethasone infusion, leukocytosis, anemia and thrombocytopenia with cardiogenic shock status improved. Then, he was later discharged in stable condition.
Conclusions:
HLH and myopericarditis caused by Campylobacter are very rare. Early detection of Campylobacter-induced HLH and multiple organ failure, as well as prompt use of antibiotics and immunosuppressants, can be helpful for prognosis.
Paediatric drug development in Japan: A study over the past 15 years
Authors: Inagaki Rieko , Narukawa Mamoru
Published: October 2023

Introduction
The number of medicinal products labelled for paediatric use is limited. Regulatory measures to promote paediatric drug development in the US and Europe and the establishment of an international guideline (ICH-E11) have led to an increase in the number of paediatric labels. In Japan, efforts have been made to promote the development of paediatric drugs. This study was to examine whether paediatric drug development is being promoted, and whether off-label drug use by children is decreasing in Japan.
Methods
This study examined the number of new drugs approved for paediatric indications in Japan from 2006 to 2021, as well as the clinical data package, that is, characteristics of the approved paediatric drugs and paediatric clinical trials, and the percentage of extrapolation of adult data, in the most recent five-year period.
Results
The number of paediatric drug approvals underwent a temporary increase between 2006 and 2012. The proportion of drugs indicated for paediatric patients to the total number of approved drugs did not change markedly during the survey period, indicating that off-label use did not decrease. Simultaneous development in adults and children has increased, but the extrapolation of adult data to paediatric populations has not been widely utilized.
Conclusions
In Japan, the number of paediatric drug approvals has shown a slight upward trend but has not yet reached the point of significantly reducing off-label use. Appropriate development strategies, such as the extrapolation of adult data to paediatric populations, should be considered.
What Factors Influence Couples' Decisions for Childbearing? Evidence from a Systematic Scoping Review
Authors: Ranjbar Mohammad , Rahimi Mohammad Kazem , Heidari Edris , Baharinia Sajad , Alimondegari Maliheh , Lotfi Mohammad Hasan , Shafaghat Tahereh
Published: October 2023

BackgroundOne of the most significant demographic challenges over the past three decades has been the substantial reduction in fertility rates, worldwidely. As a developing country, Iran has also experienced a rapid decline in fertility over the past decades. Understanding factors influencing fertility is essential for development programs. Moreover, it's crucial to study the parameters that affect the intention for childbearing in any society. Therefore, through a systematic scoping review, the present study investigates the factors influencing couples' decisions toward childbearing.MethodsThis study was a systematic scoping review conducted in 2023. To design and conduct this scoping review, Joanna Briggs Institute’s Protocol (2015) was used and the framework presented by Levac et al. (2010) was also used as a guide for conducting this review. Studies were searched in three main databases including ISI Web of Sciences, PubMed, and Scopus, using a predefined search strategy. Google Scholar was also used for complementary search. The search period was from 2002 to 2022.ResultsA total of 18,454 studies were identified across three primary databases. After evaluating articles in three distinct phases based on title, abstract, and full-text, 46 articles were deemed eligible for inclusion in the scoping review. The qualitative analysis of the collected data from the selected studies through the scoping review led to classifying factors influencing households' desire for childbearing into eight main themes and 101 sub-themes. The main themes associated with factors impacting households' intention for childbearing encompass individual determinants, demographic and familial influencing factors, cultural elements, social factors, health-related aspects, economic considerations, insurance-related variables, and government support/incentive policies.ConclusionsComprehensive and holistic attention from governments and officials toward the various factors affecting households' intention and behavior regarding childbearing appears beneficial and effective. Furthermore, given the relative ineffectiveness of some of the current government's supportive/incentive policies to increase couples' desire for childbearing, it seems necessary to review and amend these policies. This review should address the most significant challenges and factors contributing to couples' reluctance to childbearing or strengthen factors that can play a substantial role in fostering fertility and childbearing desires.
Human land fragmentation drives tropical forest fires but dampens global burned area
Authors: Bowring Simon , Li Wei , Mouillot Florent , Rosan Thais , Ciais Philippe
Published: October 2023

Landscape fragmentation has been correlated with either increases or decreases in burned area (BA), but their causal mechanisms remain elusive. Here, road density, a fragmentation proxy, is implemented in a CMIP6 coupled land-fire model, enabling dynamic representation of bottom-up processes affecting fragment edges. Over 2000-2013, fragmentation altered BA by >10% in 16% of burned [0.5°] grid-cells and caused gross changes of -6.5% to +5.5% in global BA. Model output mimicked the global satellite-observed negative relationship between fragmentation and BA, although some regional BA decreases were matched by fire intensity increases. In recently-deforested tropical areas, however, fragmentation drove significant, observationally-consistent increases in BA (~1/4 of Brazilian, Indonesian total BA). Fragmentation BA’s relationship with population density is negative globally-averaged, but hump-shaped and largely positive in tropical and temperate forests. We suggest fragmentation could ‘tip’ toward net BA-amplification with future tropical forest degradation and fire-activity, providing policymakers a first quantification of fragmentation-fire risks.
PHLDA2 is a prognostic biomarker associated with tumor immunosuppressive microenvironment in hepatocellular carcinoma
Authors: Chen Bijun , Tang Ying , Wang Biao
Published: October 2023

PHLDA2 (pleckstrin homology-like domain, family A, member 2), is primarily found in the placenta and is known to regulate cell growth and apoptosis. It has also been linked to certain types of cancer, though its role in hepatocellular carcinoma (HCC) is unclear. To investigate further, we conducted a bioinformatic analysis, examining gene expression, prognostic function, potential pathways, the tumor microenvironment, and drug resistance. The analysis revealed that PHLDA2 expression generally increased in various tumors, including HCC, and was associated with worse survival rates. Additionally, PHLDA2 expression correlated positively with most immunosuppressive cells, such as tumor-associated macrophages and Tregs. Patients with elevated PHLDA2 expression tended to be resistant to anti-tumor medications. Overall, our study suggests that PHLDA2 may function as an oncogene and prognostic marker in HCC and other cancers, possibly contributing to an immunosuppressive microenvironment.
Applying Techno-economic Analysis to Evaluate the Economic Value of Residue Reuse of Makino Bamboo (Phyllostachys makinoi)
Authors: Lin Yu-Jen , Zhong Yi-Lin , Liu Wan-Yu
Published: October 2023

The bamboo industry in Taiwan was very prosperous in the early days. However, with the development of the industry, bamboo was replaced by plastics, metals, and composite materials. There are different ways to process bamboo waste from the bamboo processing industry. This study aimed to analyze the economic benefits of different processing methods for Makino waste materials using techno-economic analysis and cost-benefit analysis. This study divided the treatment methods into two categories: (a) remove, discard, and no longer use and (b) reuse to make fuel rods for sale. Category (a) includes one scenario: removing and sending the waste materials to the joss paper processing manufacturer to proceed with incineration and burial. Category (b) was divided into 6 scenarios according to whether they need to bear the cost of equipment and whether they need to hire additional full-time employees. The results show that different analysis methods all point out that Scenario 7 (the manufacturer does not have to bear the cost of equipment and does not hire additional professional employees) is the best solution. If using the net present value method, present value cost method, net annual value method, and annual cost method for evaluation, then scenario 6 (the manufacturer does not have to bear the equipment costs and hire additional professional manpower) and scenario 7 are better than scenario 1 (the bamboo waste was removed). If using the net present value rate method, profitability index method, and self-liquidating ratio for evaluation, then the results show that only scenario 7 is profitable, and no other scenarios should be selected. This means that the production of fuel rods from bamboo waste materials can increase the material output value, help manufacturers create economic benefits, and solve the regional environmental problems caused by the long-term accumulation of waste materials. Therefore, to minimize the waste of resources and through the government subsidizing the cost of equipment, the implementation of the applications of the circular economy can achieve a balance between environmental protection and socioeconomic benefits. It is recommended to apply industry-academia cooperation, hiring students from relevant departments to reduce labor costs and enable students to understand the bamboo industry.
Monitoring volcanic activity with distributed acoustic sensing using the Tongan seafloor telecommunications cable
Authors: Nakano Masaru , Ichihara Mie , Suetsugu Daisuke , Ohminato Takao , Ono Shigeaki , Vaiomounga Rennie , Kula Taaniela , Shinohara Masanao
Published: October 2023

The devastation caused by the January 2022 eruption of Hunga Tonga-Hunga Ha’apai volcano (HTHH) in the Tongan archipelago reminded us of the importance of monitoring shallow-sea volcanic activity. Seismic observations are essential for such monitoring, but there were no operational seismic stations in Tonga at the time of the eruption. There are only a few islands near Tongan volcanoes, and installation and maintenance of seismic stations on remote islands are expensive. Seismic observations based on distributed acoustic sensing (DAS) using a seafloor cable may provide a more practical and economical solution. To investigate the potential of this approach, we made preliminary DAS observations for one week using the seafloor domestic broadband telecommunications cable in Tonga. DAS equipment was installed at the landing station of the seafloor cable at Nuku’alofa on Tongatapu, the main island of Tonga. To provide reference data, we installed several seismometers on Tongatapu. The DAS data we obtained showed high noise levels in areas of shallow coral reef, but noise levels decreased greatly in deeper water areas, indicating that DAS is suitable for seismic observations of the deep seafloor. We detected many local and regional earthquakes during our week of observation and determined 17 earthquake hypocenters by picking P- and S-wave arrival times from the DAS and onshore seismic data. Although most of these were tectonic events related to the subduction of the Pacific plate along the Tonga trench, several events were detected around the volcanic chain of the Tongan archipelago including one event beneath the HTHH crater, implying that activity at HTHH has continued since the 2022 eruption. The much lower cost of installation of DAS equipment compared to that for pop-up type ocean-bottom seismometers and the ability of DAS systems to monitor seismic activity in real-time make it an attractive option for monitoring the activity of HTHH and other volcanoes near seafloor cables in the Tongan archipelago.
Patterns of neural activity in response to threatening faces are predictive of autistic traits: modulatory effects of oxytocin receptor genotype
Authors: Kendrick Keith , Zheng Xiaoxiao , Zhou Feng , Fu Meina , Xu Lei , Wang Jiayuan , Li Jialin , Li Keshuang , Sindermann Cornelia , Montag Christian , Becker Benjamin , Zhan Yang
Published: October 2023

Autistic individuals generally demonstrate impaired emotion recognition but it is unclear whether effects are emotion-specific or influenced by oxytocin receptor (OXTR) genotype. Here we implemented a dimensional approach using an implicit emotion recognition task together with functional MRI in a large cohort of subjects (N = 255) to establish associations between autistic traits and neural and behavioral responses to specific face emotions, together with modulatory effects of OXTR genotype. A searchlight-based multivariate pattern analysis (MVPA) revealed an extensive network of frontal, basal ganglia, cingulate and limbic regions exhibiting significant predictability for autistic traits from patterns of responses to angry relative to neutral expression faces. Functional connectivity analyses revealed a genotype interaction (rs2254298, rs2268491) for coupling between the orbitofrontal cortex and mid-cingulate during angry expression processing, with a negative association between coupling and autistic traits in the risk-allele group and a positive one in the non-risk allele group. Overall, results indicate extensive emotion-specific associations primarily between patterns of neural responses to angry faces and autistic traits in regions processing motivation, reward and salience but not in early visual processing. Functional connections between these identified regions were not only associated with autistic traits but also influenced by OXTR genotype. Thus, altered neural responses to threatening faces may be a potential biomarker for autistic symptoms although modulatory influences of OXTR genotype need to be taken into account.
Propagation of light wave around planets in cosmic space
Authors: Berceli Tibor
Published: October 2023

The propagation of light wave around planets is studied in the paper. There are planets having an atmosphere. The permittivity of atmosphere is high close to the planet surface and gradually decreases with elevation. These planets have an inhomogeneous medium around their surface. Based on the results of our investigations when the light beam propagates parallel to layers of atmosphere, its propagation direction is gradually deviating from the straight line toward higher permittivity layers. This way the light wave follows a curved route. Some planets have no atmosphere. Their surface is not smooth, in addition to plains, there are hills and mountains with varying heights. Therefore, layers of atmosphere parallel to the planet surface can be considered by an equivalent permittivity which is high at the planet surface and gradually decreases with the elevation. As its consequence a tangentially incident light beam deviates from the straight line and follows a curved route. Based on the results of present investigations, it is not necessary to assume that the cosmic space is curved close to a planet containing a huge mass.
Two-year cumulative live-birth rates and maximum number of transfer cycles in women aged >40 years
Authors: Nukaga Sakiko , Tokoro Mikiko , Asano Emiko , Inoue Daichi , Hashiba Yoshiki , Fukunaga Noritaka , Asada Yoshimasa
Published: October 2023

The objective of this retrospective study is to clarify the cumulative live-birth rates (CLBRs) from frozen–thawed embryo transfer without preimplantation genetic testing for aneuploidy (PGT-A) to evaluate the validity of infertility treatment in women of advanced reproductive age. A total of 1,011 patients aged ≥ 40 years undergoing their first nondonor in vitro fertilization without PGT-A at our hospital between January 2010 and September 2017 were included. They were followed up for up to two years, or until either treatment discontinuation or a pregnancy that resulted in a live birth. We also estimated the cost per live birth (LB) for each number of transfer cycles. The 2-year CLBRs were 55.6%, 39.0%, 31.3%, 19.1%, 10.6%, 4.4%, and 0% for patients of ages 40, 41, 42, 43, 44, 45, and > 46, respectively. In approximately 80% cases of LB, the patients aged 40–42 and 43–44 years became pregnant by the fourth and second transfer, respectively. The cost per LB exceeded $150,000 after the fourth, third, and second transfers at the age of 40, 41, and 42–43 years, respectively. Patients who showed no results after a certain number of transfers should be advised to quit fertility treatment.
Expanding chemical space of metal-organic frameworks via up-down approach
Authors: Choe Wonyoung , Kim Jiyeon , Nam Dongsik , Cho Hye Jin , Cho Eunchan , Sivanesan Dharmalingam
Published: October 2023

Metal-organic frameworks (MOFs) have become materials platform with vast structural diversity, tailorable for broad practical applications. Traditional bottom-up and top-down design approaches played a pivotal role for a rapid increase in MOF structures, yet the systematic screening for unknown synthesizable MOFs is still a daunting challenge. Herein, we developed a novel search paradigm, the Up-Down Approach (UDA), by merging the bottom-up and top-down approaches. Targeting the famous class of Zr-based MOFs, we searched promising topology candidates and unveiled 17 future structural configurations by considering the possible orientations of Zr6 clusters. Through ribbon representation and sophisticated analysis of the ligand angles, we suggested future structure models and successfully synthesized one of the suggested structures with a novel scu configuration. The UDA will accelerate the discovery of hidden MOFs, providing exciting new opportunities to effectively expand the chemical space of MOFs.