bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathological Array of Cardiac Lesions in a Tertiary Care Hospital: An Autopsy Study
Authors:   Associate Professor, Department of Pathology, Raja Rajeswari Medical College & Hospital, Bangalore, Karnataka 560074, India., Maniyan Prakash Sumitha , Nalini Modepalli ,   Associate Professor, Department of Pathology, Raja Rajeswari Medical College & Hospital, Bangalore, Karnataka 560074, India., Sudarshan Tirumala Anisha ,   Associate Professor, Department of Pathology, Raja Rajeswari Medical College & Hospital, Bangalore, Karnataka 560074, India., Reddy Jyothi ,   Post graduate student, Department of Pathology, Raja Rajeswari Medical College & Hospital, Bangalore, Karnataka 560074, India., Mahanthachar Veerabasappa ,   Professor, Department of Pathology, Raja Rajeswari Medical College & Hospital, Bangalore, Karnataka 560074, India., Chippagiri Jayaprakash ,   Professor, Department of Pathology, Raja Rajeswari Medical College & Hospital, Bangalore, Karnataka 560074, India.
Published: January 2024

Context: Cardiovascular diseases constitute the most common cause of sudden death. In medicolegal autopsies it is proposed that every possible organ must be sampled for histopathological examination as they provide the most accurate clues to a better understanding of human cardiovascular pathology. Aims: The main aim of this study was to analyse the histopathological spectrum of cardiac diseases which play a major role as cause of death in autopsy specimens that were received in a tertiary care hospital. Settings and Design: The study was conducted at a tertiary care hospital in Bangalore, the study period was from January 2015 to December 2019 during which a total of 276 autopsies were received. Out of these 173 cases included specimens of heart and were considered in this study. Methods and Material: During the study period from January 2015 to December 2019, a total of 276 autopsies were received. Out of these 173 cases included specimens of heart and were considered in this study. Epidemiological data and post mortem findings were noted, gross findings documented and the heart opened through inflow outflow method. Microscopic findings on H and E stained sections were studied with special stains ordered wherever required. The histopathogical findings were analysed. Results: Males outnumbered females with 85% of the total cases and maximum number of cases were observed between 3rd decade to 5th decade. On histopathology, 60.4% of the cases showed atherosclerotic changes involving the coronary arteries followed by myocardial infarction (9%), myocardial hypertrophy (7%), cardiomyopathy (4.2%) cases, myocarditis (3.4%), 0.5% case each of aortic stenosis and infective endocarditis. 15% of cases showed no significant abnormalities on gross and microscopic examination. Conclusions: Atherosclerosis involving the coronaries is probably the commonest finding on histopathology of the heart in cases subjected to autopsies. Cardiomyopathy and Myocarditis presenting as sudden death is commom in the younger population.
Cutaneous Reactions Due to Accidental Exposure to Plant Growth Regulator: Occupational Pesticide Poisoning
Authors:   Associate Professor, Department of Forensic medicine and Toxicology, BLDE University, Shri BM Patil Medical College Hospital and RC, Vijayapura, Karnataka 586103, India., Bhuyyar Chandrashekhar B , mugadlimath Anand ,   Professor, Department of Forensic Medicine and Toxicology, SNMC Medical College, Bagalkot, Karnataka 587102, India., MR Tyagaraju ,   Assistant Professor, Department of Forensic medicine and Toxicology, Mahavir Jain medical College Vikarabad, Maharastra 587102., koulapur Vishal ,   Associate Professor, Departemnt of Forensic Medicine & Toxicology, KLE University,
Published: January 2024

Accidental Pesticide poisoning is an important health issue in developing country like India. Adverse health effects by pesticides are common among farmers due inappropriate handling. Plant growth regulator hydrogen cyanamide (Dormex) is used mainly for the bud-cleaving and growth promotion of grapes in north karnataka. Accidental exposure to hydrogen cyanamide may result in wide range of health hazards like irritant contact dermatitis. Here we discuss such a case where the patient suffered severe health hazards due to accidental exposure to hydrogen cyanamide.
Frequency of Urinary Anomalies in Perinatal Autopsies
Authors:   Assistant Professor, Department of Pharmacology, ESIC Medical College & Hospital, Kalaburagi Karnataka 585105., Pattar Pratima Manohar , Andola Sainath K ,   Professor, Department of Pathology, M.R Medical College, Indian College of Pathologists, Kalaburagi, Karnataka 585105, India., Patil Asha ,   Assistant Professor, Department of Pharmacology, ESIC Medical College & Hospital, Kalaburagi Karnataka 585105., B Suraj ,   Associate Professor, Department of Pharmacology, ESIC Medical College & Hospital, Kalaburagi Karnataka 585105.
Published: January 2024

Background: Congenital anomalies of urinary system are common and are found in 3-4% of population, and 10% of terminations of pregnancies are attributable to lethal urinary anomalies. Although timely detection of nonlethal anomalies depends on many aspects, for instance equipment quality, sonologist experience and timing of the ultrasound examination. However, to confirm the findings and to attain definite diagnosis, a fetal autopsy after the termination of a pregnancy is of utmost important and is also crucial for genetic counseling.In view of this, the present study aimed to determine the frequency and to identify the types of the urinary anomalies in perinatal autopsies. Methods: This study includes 391 perinatal autopsies conducted prospectively from July 2016 to June 2018 at M. R. Medical College, Basaveshwar Teaching and General Hospital, Kalaburagi. After obtaining the consent from either parent, each fetus was examined as per the predetermined protocol which included ultrasound diagnosis, photographs, external and internal examination. Results: The gestational age ranged from 16weeks to 44weeks and the mean weight was 1123.96gm. Out of 391 cases urinary anomalies encountered in 19 cases )4.9%). Out of 19 cases, anomalies of renal parenchyma were seen in 15 cases )78.9%) and anomalies of pelvi-ureters and bladder was seen in 4 cases )21.1%). Three cases of urinary anomalies were associated with syndromes and 8 cases were associated with other system anomalies. Conclusion: The perinatal autopsy after termination of pregnancy is essential to confirm the ultrasound findings and to make a definitive diagnosis.
A level Mathematics (England) grade distributions and grade boundaries 2019-2023
Authors: Glaister Paul
Published: January 2024

This article sets in context the A level Mathematics qualifications (in England) awarded in Summer 2023 with those awarded in 2019-2022, along with year-on-year overall comparisons of grade profiles, and year-on-year comparisons of grade boundaries and grade profiles for each of the four A level Specifications: Pearson/Edexcel, AQA, OCR A and OCR B (MEI).
Los desequilibrios geodemográficos en Canarias: una expresión de su especialización económica
Authors: Jerez Darias Luis Manuel , García Cruz Juan Israel
Published: January 2024

Canarias es actualmente la tercera comunidad autónoma con mayor densidad de población detrás de Madrid y País Vasco. Con casi 2,2 millones de habitantes, más una carga de 237 556 turistas/día, se articula un espacio fragmentado con una distribución de la población muy polarizada territorialmente, tanto a nivel regional como en cada isla. La dinámica común en todas ellas ha tendido a una litoralización creciente de las actividades económicas y residenciales, frente a un amplio espacio insular escasamente poblado. Este estudio pretende actualizar el análisis geodemográfico sobre la distribución de la población en Canarias, atendiendo a la relación economía-población. Se plantea que la creciente especialización de su economía en el sector terciario, con fuerte dependencia del turismo, ha profundizado el desequilibrio geodemográfica en las Islas. Para ello, se aplica una metodología apoyada en el manejo de la bibliografía, el análisis geoestadístico, datos económicos y la representación cartográfica del fenómeno analizado a distintas escalas.
HIV-1 interaction with an O-glycan-specific bacterial lectin enhances virus infectivity and resistance to neutralization by antibodies
Authors: Heindel Daniel , Acosta Dania Figueroa , Goff Marisa , Jan Muzafar , Wang Xiao-Hong , Petrova Mariya , Chan Kun-Wei , Kong Xiang-Peng , Chen Benjamin , Mahal Lara , Bensing Barbara , Hioe Catarina
Published: January 2024

Bacteria dysbiosis has been associated with an increased risk of HIV-1 transmission and acquisition. The prevalent idea is that bacteria dysbiosis compromises mucosal integrity and promotes inflammatory conditions to cause recruitment and activation of immune cells that harbor or are targeted by HIV-1. However, it is also possible that HIV-1 directly binds bacteria or bacterial products to impact virus infectivity and transmissibility. This study evaluated HIV-1 interactions with bacteria through glycan-binding lectins. The StreptococcalSiglec-like lectin SLBR-N, which is part of the fimbriae shrouding the bacteria surface and recognizes α2,3 sialyated O-linked glycans, was noted for its ability to enhance HIV-1 infectivity in the context of cell-free infection and cell-to-cell transfer. Enhancing effects were recapitulated with O-glycan-binding plant lectins, signifying the importance of O-glycans. Conversely, N-glycan-binding bacterial lectins FimH and Msl had no effect. SLBR-N was demonstrated to capture and transfer infectious HIV-1 virions, bind to O-glycans on HIV-1 Env, and increase HIV-1 resistance to broadly neutralizing antibodies targeting different regions of Env. Hence, this study highlights the potential contribution of O-glycans in promoting HIV-1 infection through the exploitation of O-glycan-binding lectins from commensal bacteria at the mucosa.
Adaptive thermal comfort analysis based on interaction between outdoor thermal environment and air pollution: Case study in Xi'an, China
Authors: Zhen Meng , Liu Xiangzi , Liu Xunlei , Bian Guangmeng
Published: January 2024

At present, urban haze pollution is a major problem that affects the outdoor environmental quality, thereby hindering the construction of an ecological civilization and healthy urban development. The urban outdoor thermal environment also influences the urban physical environment. Both the thermal environment and air environment have important effects on the subjective comfort evaluations of people. In this study, four typical spaces on a university campus in Xi'an, China, were selected to investigate the thermal environment and air environment in outdoor spaces. The particulate matter in the air was divided into three different concentrations. The adaptive thermal comfort due to the interaction between the outdoor thermal environment and air pollution was studied based on questionnaires and field measurements, and a strategy was developed for optimizing the thermal comfort of outdoor public space environments. The results showed that the influence of the thermal air quality environment on subjective comfort clearly varied among different spaces. The influence of haze pollution on subjective comfort was greater in high and low temperature environments, but less obvious in a moderate temperature environment. When the PM2.5 particle concentration was greater than 100 µg/m3, the evaluation of respiratory comfort was low in the high temperature environment. The perception of air pollution was less sensitive in the thermal environment in covered road sections. Heat pollution and air pollution will affect human health to varying degrees. People with mental diseases are affected most by the outdoor thermal environment and patients with respiratory diseases are affected most by haze pollution.
Familial risk for depression is associated with reduced physical activity: evidence from wrist-worn actigraphy
Authors: Dell'Acqua Carola , Benvenuti Simone Messerotti , Cellini Nicola , Brush C.J. , Ruggerone Alessandra , Palomba Daniela
Published: January 2024

Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease, aligning with the Sensorimotor Systems and the Arousal and Regulatory Systems of the RDoC, respectively. Wrist-worn actigraphy can be leveraged to show objective sleep-wake and daily activity disturbances. While a few studies have suggested that self-reported reduced physical activity and sleep-wake cycle disturbances might both be linked to depression vulnerability, objective actigraphy-based measures in vulnerable samples remain largely unexplored. Seven-day actigraphy data were collected from 20 (13 F) university students with a higher vulnerability to depression, which was determined by the presence of a family history of the condition but no current symptoms, and 32 (21 F) controls with neither a family history of depression nor current depressive symptoms. Actigraphy data were processed using open-source software (GGIR). Daily physical activity, namely gross motor activity, was quantified as average daily acceleration and time spent on moderate-vigorous physical activity (MVPA). The sleep-wake cycle and circadian rhythms were assessed as total sleep duration per night (in hours), sleep within sleep period time (in hours), sleep efficiency (%), and relative amplitude. Individuals with a familial risk for depression showed reduced daily acceleration and time spent in MVPA relative to the control group, particularly on the weekend during their free time away from scheduled activities. On the other hand, the two groups were comparable in terms of sleep estimates. Taken together, reduced physical activity, but not sleep-wake disturbances, seem to be associated with vulnerability to depression and might be a viable target for identification and prevention efforts.
A Beneficial Levels of 25-hydroxyvitamin D for a Decrease in thyrotropin receptor antibody (TRAB) in Patients with Graves' Disease: A Real-World Study
Authors: Zhang Yongze , Chen Yuxia , Lin Luxi , Shen Ximei , lingning Huang , Zhao Fengying , Yan Sunjie
Published: January 2024

Objective
This study aimed to determine whether a relationship exist between pre-therapy 25-hydroxyvitamin D levels and the remission/negative conversion rates of thyrotropin receptor antibody (TRAB) during treatment in patients with newly diagnosed Graves' disease (GD).
Methods
171 patients were included from the Endocrinology Department of the First Affiliated Hospital of Fujian Medical University in March 2013 to April 2016. Ninety-five patients of them were diagnosed at our hospital but transferred to local hospitals for treatment. Seventy-six patients were followed and treated at our hospital with a median follow-up time of 11.03 (range 6–27) months. Patients were divided into 3 groups according to baseline 25-hydroxyvitamin D levels; <20 ng/mL (31,43.05%), 20–29 ng /mL (20,27.78%), and ≥ 30 ng/mL (20,29.17%). The TRAB remission rate and negative conversion rate was assessed among each group.
Results
There was a higher TSH and lower TRAB titer in the 20–29 ng/mL group at initial diagnosis. Cox regression analysis suggested that 20–29 ng/mL group had significantly higher remission rates [RR; 95% CI: 7.505 (1.401–40.201), 8.975 (2.759–29.196),6.853(2.206–21.285), respectively] and negative conversion rates [RR; 95% CI: 7.835 (1.468–41.804),7.189(1.393–37.092), 8.122(1.621–40.688)] at the 6-, 12-, and 24-month follow-up, respectively .The level of 25-hydroxyvitamin D at the time of initial diagnosis was not associated with the re-normal of free Triiodothyronine(FT3), free thyroxineIndex(FT4) or TSH levels during the follow-up.
Conclusion
Newly diagnosed GD patients with appropriate baseline 25-hydroxyvitamin D levels (20–29 ng/mL) are beneficial for the reduction of TRAB during antithyroid therapy.
A Multi-objective Genetic Algorithm for Unequal Area Facility Layout Problem Considering Safety and Cost
Authors: Koosha Hamidreza , Mirsaeedi Fatemeh , Assadi Mohammad Taghi
Published: January 2024

Facility layout problem is crucial in the design of manufacturing systems across industries due to their significant economic implications and considerable impact on various decision criteria, such as safety considerations in the casting industry. The presence of hazardous equipment like furnaces and melt casting units underscores the necessity of layouts that mitigate safety risks. This study introduces a multi-objective programming model tailored for addressing unequal area layouts, simultaneously optimizing transportation costs and safety risks. The proposed nonlinear model is transformed into a linear equivalent to facilitate solution. To generate the non-dominated Pareto solutions, the NSGA-II algorithm is employed, further fine-tuned by the Taguchi method for parameter optimization. Additionally, Goal Programming is applied to derive a singular solution from the Pareto set. Empirical validation is conducted using real-world data from a casting workshop. The results underscore the model's practicality and effectiveness in a real-world context.
Nonlinear responses study of two beams coupled by multiple nonlinear elements considered cubic stiffness
Authors: Liu Hanlin , zhou rui , Sheng Xi , Xu Fei , Xu Jingmang , Wang Yi
Published: January 2024

Since the inception of nonlinear vibration theory, the majority of research has focused on elastic beams connected to a variety of nonlinear factors. Notwithstanding this, coupling beam systems with nonlinear coupling elements have been the subject of few investigations. In light of the fact that numerous coupling beam systems are typically connected via multiple couplers, this study develops a vibration model for two beams coupled by multiple nonlinear elements exhibiting cubic stiffness. The Lagrange method is utilized to compute the magnitude responses of the beam system. Once the accuracy and consistency of the magnitude responses associated with the beam system have been confirmed, a thorough investigation is conducted into the impact of nonlinear elements on the magnitude responses of two beams joined by multiple nonlinear elements exhibiting cubic stiffness. Nonlinear responses, such as peak jumping, intricate responses, and shifting resonance regions, are determined to be the result of nonlinear elements, according to simulation results. Modulating the parameters of nonlinear elements in a rational manner facilitates the regulation of vibrations across multiple resonance regions of the beam system. Parameter changes of nonlinear elements have a substantial impact on both the vibration states and peak values of magnitude responses for single-frequency vibration excitation in resonance regions. The incorporation of nonlinear components into the coupling beam system enables the regulation of both frequency and single-frequency responses. In the case of low damping, nonlinear vibration control for a system consisting of two beams through the use of multiple nonlinear elements with cubic stiffness is more effective.
Intelligent nonlinear predictive control for wheeled mobile robot on uncertain path
Authors: jalalnezhad mostafa
Published: January 2024

In this paper, the weak points have been investigated, the proposal to solve them, the application of the solution and the comparison of the results in the mode of simulation and experimental testing have been discussed. For this purpose, a four-wheel mobile robot has been considered for simulation and implementation, and a linear quadratic regulator controller and a nonlinear model predictive controller have been used to control it. But the combination of these classic and modern controllers with machine learning can greatly help to make these controllers work more accurately; As a result, in order to increase the accuracy of the performance of these controllers, by training neural networks of multilayer perceptrons, the controllers have been made intelligent. Controllers with cost function have coefficients as weighting to the matrix of system state variables and control input, which are greatly affected by changing these two weighting matrices of problem solving and optimization. For this reason, it is necessary to extract these two matrices for each separate path in order to improve the performance of the controller by trial and error. But by applying the proposed network which is trained with a new algorithm, not only the performance accuracy has increased, but the network extracts these two matrices without the need to spend human energy. Also, in order to reduce the existing time delays, especially in the implementation of the nonlinear controller on the robot in the experimental mode, by training other neural networks to optimally extract the benefit of the forecast horizon, reducing the calculations and increasing the speed of the solution has been achieved. In the hardware part, by examining and using operators such as the pixy camera and the U2D2 interface, which are faster than the usual method, the solution time has been reduced.
Dynamic Monolithic X-ray Imager with Enhanced Performance via Strain Relaxation in Metal-Halide Scintillator
Authors: Zheng Xiaojia , Shu Chongrui , Zhang Caixin , Yuan Ruihan , Liu Xixi , Tie Shujie , Yang Ning , Lian Xuan , Zhu Jianguo
Published: January 2024

Scintillation X-ray detectors have widespread applications in medical imaging, non-destructive testing, and security inspection. In recent years, metal halide materials have gained attention as scintillators due to their superior properties, such as excellent luminescent performance, non-toxicity, and cost-effectiveness etc. Here, we found the lattice strain in Cs5Cu3Cl6I2 can obviously deteriorate its scintillation performance, and the relaxion of lattice strain in Cs5Cu3Cl6I2 largely reduced nonradiative recombination and enhanced its stability. As a result, a high photoluminescence quantum yield (PLQY) of 99.5% was achieved in the strain-released Cs5Cu3Cl6I2 scintillator. We further developed the first monolithic X-ray imaging systems by integrating Cs5Cu3Cl6I2 scintillators with Complementary Metal Oxide Semiconductor (CMOS), which delivered superior imaging clarity with a high-resolution over 30 line-pairs per millimeter (lp mm− 1) and capability of fast dynamic X-ray imaging. Moreover, the Cs5Cu3Cl6I2 monolithic X-ray imaging system shows remarkable stability against heat, humidity, and continuous X-ray irradiation. This research presents a feasible pathway for fabricating monolithic X-ray imagers and highlights their potential for practical applications. We anticipate that our findings will offer new insights into strain engineering of metal halide scintillators and structural design of advanced X-ray imaging systems.
Improving practices in orthogeriatric care services: a multi-method study
Authors: VISADE Fabien , Havet Simon , Robinet Pierre , Maladry François , D'Hulster Quentin , Lerooy Alexandre , Maciejasz Pierre , Rousselet Louis , Preda Cristian
Published: January 2024

Purpose
Orthogeriatric units have proven to be relevant in the care of older patients. A combination of hospital and community care is recommended for optimized care when these older patients return home. However, general practitioners (GPs) have not provided any feedback on this. The aim of this study was to look at GPs’ opinions on the care provided in orthogeriatric units to identify areas for improvement.
Methods
Multi-method study combining one phase comprised of a retrospective analysis of data on older patients hospitalized in an orthogeriatric unit, and another phase analyzing GPs’ answers to a questionnaire. By comparing the results of the two analysis phases we were able to identify areas for improvement.
Results
355 hospital stays were analyzed. The mean age of the older patients was 87 years (SD = 5.8), and patients were predominantly women (n = 292, 82%). The most common surgery performed was femur surgery (n = 240, 68%). Patients suffered from undernutrition (n = 226, 64%), a vitamin D deficiency (n = 247, 70%) and chronic falls (n = 55, 16%). The questionnaire was completed by 51 GPs. Comparing the results of the retrospective analysis and questionnaire identified two areas for improvement: (i) helping patients receive osteoporosis care; (ii) involving occupational therapists more during the orthogeriatric unit stay.
Conclusion
Improvements in practices are always needed, especially when caring for older patients. In orthogeriatric units, this care must involve occupational therapists more and improve screening and treatment for osteoporosis.
Mitigating Natural Risks: Structural Assessment of Urban Trees in Belo Horizonte's Central Region Using Acoustic Tomography
Authors: DE GÓES MATHEUS BARRETO , Michelin Guilherme Antonio , de Oliveira Marina Ferreira Lapa , Carrasco Edgar Vladimiro Mantilla
Published: January 2024

Urban trees play an important role in the quality of life in cities, offering benefits such as shade, improved air quality, and a pleasant environment. This study analyzed urban trees in the central region of Belo Horizonte using an acoustic tomograph to assess their structural safety. The study focused on large trees, which are common in the area. Some trees showed degraded ends, but this did not represent a significant risk to their structural safety. These findings can be used as an argument to preserve the trees in this specific area, countering concerns related to structural safety. The use of acoustic evaluation methods, such as the acoustic tomograph, proved to be an efficient and accessible approach to detect internal defects in living trees. These methods can contribute to safety in public areas and provide quick and reliable results. Although the results of this study indicated that the analyzed trees are in good condition, it is important to consider other aspects related to the preservation of urban trees in order to promote a healthy and sustainable urban environment.
Comparison of Clinical Efficacy of Molecular Targeted Drugs Combined with Transcatheter Arterial Chemoembolization and Transcatheter Arterial Chemoembolization Alone for Primary Liver Cancer
Authors: Sun Xinru , Wang Bojiang , Zhang Yin , Liu Baodong , Sun Liping , Huang Guangming
Published: January 2024

Objective: it was to explore the therapeutic value of transcatheter arterial chemoembolization (TACE) combined with molecular targeted drugs (MTD) in patients with primary liver cancer (PLC).
Methods: 78 patients with PLC hospitalized in Zibo Central Hospital were randomly grouped. Group A was treated with TACE alone, group B with bevacizumab combined with TACE, and group C with sorafenib combined with TACE, 26 cases in each. The patients were followed up for 1 year, and the clinical efficacy, adverse drug reaction (ADR), laboratory indexes, and survival rate (SR) of the three groups were observed and evaluated.
Results: The effective rate and disease control rate of group C were 50% and 69.23%, respectively, which were clearly higher than those of groups A (15.38%, 38.46%) and B (34.61%, 53.84%). There was no obvious distinction in serum Alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) levels among them before treatment. Following treatment, group C (404.37±12.47 ng/mL; 246.52±38.17 ng/mL) were clearly lower than those in groups A (483.74±13.28 ng/mL, 367.28±47.03 ng/mL) and B (450.28±12.19 ng/mL, 291.72±43.69 ng/mL). The incidence of ADR in group C was generally lower than that in groups A and B, without obvious distinction in ADR of TACE among them. The overall survival time was obviously longer in group C (11.8 months) than in groups A (8.4) and B (10.1). Following 6 months of treatment, SR was not evidently different among them. Following 12 months of treatment, the SR was obviously superior in group C (84.61%) as against groups A (57.69%) and B (73.07%) (P < 0.05).
Conclusion: TACE combined with MTD is superior to TACE alone in the treatment of PLC. The efficacy, survival time, and SR of sorafenib are better than those of bevacizumab.
Dose-volume predictors of radiation dermatitis in patients undergoing radiotherapy after radical mastectomy for breast cancer
Authors: han ning , zhang yaotian , wu monan , weng chong , dong meiqi , zhang na
Published: January 2024

Purpose
To analyze incidence and dose-volume predictors of acute radiation dermatitis (ARD) in patients with breast cancer who undergo regional nodal irradiation.
Methods and materials:
Patients treated with Intensity-modulated radiation therapy (IMRT) in the chest wall, supraclavicular/subclavicular fossa, secondary axilla, and/or intramammary link after mastectomy were included. The prescribed dose was 50 Gy in 25 fractions. ARD was evaluated and graded once during radiotherapy(RT), 1 week after RT, and at the 1 month follow-up. Grading was performed according to the National Cancer Institute Common Toxicity Criteria for Adverse Events version 3.0. Total skin volume, mean dose, maximum dose, relative volume (RV5-RV45) and absolute volume (AV5-AV45) in patients receiving at least 5 to 45 Gy in 5 Gy increments were assessed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for ARD and to obtain ROC curves. Thresholds for skin dosimetry parameters were determined.
Results
A total of 134 patients with breast cancer who received recruited RT were included in this analysis. Among all patients the incidence of ≥ 2 ARD was 33.58% (45/134), of which the incidence of grade 2 ARD was 32.09% (43/134), and the incidence of grade 3 RD was 1.49% (2/134). No grade 4 or 5 ARD was observed. After univariate and multivariate analyses, age, BMI, BSA, sex, tumor laterality, vascular cancer embolus, nerve invasion, adjuvant chemotherapy were not significantly associated with the risk of grade ≥ 2 ARD. Internal mammary nodal irradiation (IMNI) (P = 0.049) and targeted therapy (P = 0.005) were independent risk factors for ARD. AV35 (P = 0.030) and AV40 (P = 0.025)of the skin were significantly associated with the risk of grade ≥ 2 RD. According to the ROC curves, the optimum thresholds were 199 mL for AV35 and 181.8 mL for AV40, respectively.
Conclusion
The receipt of targeted therapy during radiation therapy and IMNI are risk factors for the development of grade 2 ARD. Maintaining AV35 on the upper skin at < 199 mL and AV40 at < 181.8 mL may decrease the risk of ARD.
Guidewire-Assisted Endoscopic Guidance for Difficult Placement of Nasojejunal Tubes
Authors: Wang Ziwei , Ji Feng
Published: January 2024

Background
Effective nasojejunal tube feeding is valuable for patients at high risk of aspiration who are intolerant to oral or gastric feeding. Placement of nasojejunal tubes is difficult in patients with gastroduodenal obstruction due to inability of endoscopic guidance.
Aims
We report the technique of guidewire-assisted endoscopic guidance for difficult placement of nasojejunal tubes.
Methods
A retrospective study was conducted on 13 patients with gastroduodenal obstruction experiencing difficult nasojejunal placement at a single tertiary care center. The primary outcome was success rates of tube placement. Secondary outcomes included procedure time, complications, symptom remission and nutritional indicators.
Results
The primary outcome showed a 92.31% success rate of placement. The secondary outcome showed a 16.30 ± 7.05 minute average procedure time. There were significantly higher success rates of placement and improved nutritional status. Complication incidence was not significantly increased after placement.
Conclusions
Guidewire-assisted techniques are safe and effective for patients with difficulty in nasojejunal tube placement.
New insights into mapping lesion and neurotransmitter distribution comparisons in MOG-ab and AQP4-ab neuromyelitis optica spectrum disorders
Authors: Zhao Yinan , Liu Lei , Wu Pu-Yeh , Wu Jiali , Huang Xu , Wei Quanfeng , Gong Ruisi , Jiao Jinlin , Fan Guoguang , Cao Jibin , Cui Lingling
Published: January 2024

Objective: Both aquaporin-4 antibody (AQP4) associated optic neuromyelitis spectrum disease (NMOSD) and Myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) involve autoimmune-mediated neuronal damage. Brain damage can have direct or indirect effects on the neurotransmitter system, leading to disruptions and functional abnormalities in neural transmission. By examing a sizable and thoroughly characterized cohort of AQP4+ NMOSD and MOGAD patients, we aimed to compare the spatial distribution of brain lesions in the two diseases and to understand the theoretical bases for location preferences. Next, we explored and compared the association between the characteristics of lesion frequency map and the distribution of neurotransmitters in the whole brain to identify novel therapeutic targets based on neurotransmitter modulation.
Methods: We gathered clinical details and MRI data to construct a lesion frequency map in AQP4+ NMOSD and MOGAD patients. Probabilistic lesion distribution maps were created after lesions automatic segmentation and spatial normalization. Lobe-wise and voxel-wise quantitative comparisons of two distributions were performed. JuSpace toolbox was performed to explore whether the lesion frequency map correlated with an abnormal distribution of specific neurotransmitters.
Results: The findings showed that both AQP4+ NMOSD and MOGAD patients had supratentorial and infratentorial brain lesions, with the highest probability in the deep sublobular white matter (WM) region in both groups; The MOGAD patients' brain lesions were larger, more concentrated, and more likely to be in the deep sublobular WM, hippocampus, cerebellum, putamen, pons, medulla oblongata, cerebellum and gray matter (GM), as well as WM in the frontal, temporal, and occipital lobes. Eight neurotransmitter levels showed a substantial positive correlation with the lesion probability distribution in AQP4+ NMOSD. On the other hand, only dability distribution of MOGAD lesions and both mGluR5 and 5HT2a. Conversely, only noradrenergic (NAT) and dopaminergic (D2, DAT, FDOPA) neurotransmitters were substantially linked with the lesion probability distribution in MOGAD. Furthermore, mGluR5 and 5HT2a showed a somewhat negative correlation with the probability distribution of MOGAD lesions. The pattern of distribution of brain lesions showed also a significant spatial correspondence with a higher distribution of 5HT1a receptor in MOGAD patients comparing to AQP4+ NMOSD.
Conclusion: The lesion spatial distribution results improved our understanding of imaging characteristics in the MOGAD and AQP4+ NMOSD patients. We also revealed that the distribution pattern of brain lesions showed a spatial correspondence with specific neurotransmitter, opening up a novel way to assess lesion location predilection or lesion origin.
Association between tea intake and alcohol consumption and diabetes complications: A two sample Mendelian randomization study
Authors: Jia Ming-Jie
Published: January 2024

Background: Studies have indicated that there is a relationship between tea drinking, alcohol consumption, and a reduced risk of diabetes and its complications. However, there is currently no consensus on the potential relationships between tea drinking, alcohol consumption, and diabetes as well as its complications. In this study, we employed a two-sample Mendelian randomization (MR) analysis for the first time to systematically explore the causal relationships between tea intake, alcohol consumption, and diabetes as well as its complications.
Methods: Genetic instruments for tea drinking were identified from a genome-wide association study (GWAS) involving 447,485 individuals. Genetic instruments for alcohol intake were identified from a GWAS involving 462,346 individuals. Summary data for diabetes and its complications were obtained from various GWAS meta-analyses. Causal effects between tea drinking, alcohol consumption, and diabetes as well as its complications were examined. Inverse variance-weighted Mendelian randomization (MR) analysis was conducted as the primary method for causal inference. Further sensitivity analyses were performed to ensure the robustness of the results.
Results: The IVW assessment showed a causal relationship between alcohol intake and three diabetic complications. Type 2 diabetes with other specified/multiple/unspecified complications , Type 2 diabetes with ophthalmic complications and Type 2 diabetes with renal complications indicated an association with alcohol intake. However, there was horizontal pleiotropy in the study of alcohol intake and three diabetic complications, making the conclusions unreliable. The IVW assessment showed a causal relationship between tea intake and two diabetic complications. Type 1 diabetes with neurological complications, Type 1 diabetes with peripheral circulatory complications showed an association with tea intake.
Conclusion: Our research shows that tea and alcohol consumption have a protective effect against diabetic complications.This research contributes to a deeper understanding of dietary influences on diabetes, offering potential directions for future research and public health advocacy.
No Negative Influence On Complications of femoral neck fracture Children Age 14-17 years Treatment with Cannulated Screws Transphyseal fixation
Authors: Bo Rui , Liu Yang
Published: January 2024

Background
Hip fractures in children are rare, accounting for less than 1% of all pediatric fractures. The femoral head’s physeal closure at 14 to 17 years of age provides the capacity for spontaneous fracture remodeling. The primary objective of this retrospective study was to determine the impact of transphyseal fixation of cancellous screws on outcomes in this age group.
Methods
The study included patients aged between 14 to 17 years with Delbet type II and Type III hip fractures treated with cancellous screw fixation from April 2007 to August 2016. Patients were divided into two groups based on whether the cancellous screws threaded across the proximal femur epiphysis: the no cross epiphysis (NCE) group and the cross epiphysis (CE) group. The outcome was an analysis of osteonecrosis of the femoral head, nonunion, delayed union, premature epiphyseal closure (PPC), coxa vara, and overgrowth of the femoral neck.
Results
Of the 28 patients included in the study, most were male (92.9%). 19 were classified as Delbet type II, and 9 were type III. The CE and the NCE group both included 14 patients. The average follow-up time was 37.8 months (range 26–68 months). The rate of superficial infection, deep infection, AVN, non-union, delay union, coxa vara, PCE, and overgrowth was not significantly different between the two groups.
Conclusion
In conclusion, the study demonstrated that transphyseal fixation of cannulated screws has no negative impact on outcomes, particularly on femoral head osteonecrosis. Achieving accurate reduction and rigid fixation for this unique injury is more important than preserving the proximal femoral epiphysis.
Chromatographic evaluation of Safranal and Ellagic Acid in Ayurvedic Tea Formulation and its major Ingredients
Authors: Meena Ajay Kumar , Kumar Vivek , Kamra Jagriti , Kumar Vijay , Saini Pradyumn , N Srikanth
Published: January 2024

India is blessed with an extensive variety of plants, trees, shrubs, and herbs that are utilized in the traditional Indian medical system and have been reported to have excellent therapeutic effects in treating ailments. Historically, medicinal plants have been a primary source of compounds used in medicine to treat illnesses. In the indigenous medical system, Terminalia arjuna and Crocus sativusare the most beneficial and well-recognized medicinal plants for treating a wide range of serious illnesses. The goal of this study is thedevelopment of comparative chromatographic profiles ofAyurvedic tea formulation and its major ingredients for identification, and quantitative estimation of concerned PRS/Markers using HPTLC and HPLC. In this study, we have done HPTLC Fingerprint profiling of Ayurvedic tea formulation, Terminalia arjuna, Crocus sativus, Ellagic acid and Safranal.Safranal and Ellagic acid reference standards were visible in test solution of Crocus sativus extract, Terminalia arjuna and Ayurvedic tea formulation respectively and found comparable under UV light and after derivatization with derivatizing reagent. The quantification of Terminalia arjuna and Crocus sativus in formulation was done through HPLC. The quantitative evaluation of Safranal present in Ayurvedic tea formulation and Crocus sativus was 0.0330% and 0.1041% respectively. The quantitative evaluation of Ellagic acid present in Terminalia arjuna,stem bark and Ayurvedic tea formulation was 0.2814% and 0.1293% respectively.
Successful treatment of a B/T MPAL patient by chemo-free treatment with Venetoclax,Azacitidine and Blinatumomab
Authors: Liu Shaoyu , Cui Qingya , Li Mengyun , Li Zheng , Chen Sifan , Wu Depei , Tang Xiaowen
Published: January 2024

B/T mixed phenotype acute leukemia (MPAL), which represents only 2-3% of all MPAL cases, is classified as a high-risk leukemia subtype. Adults diagnosed with B/T MPAL have a notably low three-year survival rate, estimated at 20–40%. The rarity and undercharacterization of B/T MPAL present substantial challenges in identifying an optimal treatment protocol. This report aims to shed light on this issue by presenting a case in which a patient with a complex karyotype was treated using a combination of Venetoclax, Azacitidine, and Blinatumomab. This novel, chemo-free regimen resulted in the patient achieving both hematologic and molecular complete remission , with no severe organ or hematological toxicity observed. Notably, the patient continued to maintain molecular remission for 1 years following the transplantation. Based on these findings, the combination of Venetoclax, Azacitidine, and Blinatumomab could be considered a potential therapeutic approach for B/T MPAL patients, meriting further investigation.
Associated factors of sedentary behavior among patients with coronary artery disease based on health belief model
Authors: Jiang Yu-lu , Xin Xiao , Ni Xue-Ping , Cui Pei-Rong , Wang Qing-Qing , Huang Wen-Ni , Qing Shi-Yu , Li Xian-Hua
Published: January 2024

Background People’s health belief has been an important factor affecting health behavior. However, there has been little use of the health belief model (HBM) in determining the pathway effect of patients’ health belief on sedentary behavior among patients with coronary artery disease (CHD). The goal of our study was to evaluate determinants of sedentary behavior among patients with CHD based on the HBM.Methods It was a cross-sectional study. A survey about health belief and sedentary behavior was completed by 379 adults with CHD from February to August 2023. The causal relationship between HBM-related factors and sedentary behavior was explored using a structural equation model.Results A total of 379 complete responses were included; 67.0% of participants were male. The mean sedentary time was (7.18 ± 2.64) h/d. The model fit the data from the study well. Perceived barriers (total effect 0.296, P < 0.01) had promoting effects on sedentary behavior among patients with CHD. Self-efficacy (total effect − 0.253, P < 0.01), the knowledge of sedentary behavior (total effect − 0.279, P < 0.01), perceived susceptibility (total effect − 0.084, P < 0.05), perceived severity (total effect − 0.317, P < 0.01), perceived benefits (total effect − 0.266, P < 0.01) and health motivation (total effect − 0.105, P < 0.05) had negative effects on sedentary behavior. The relationship between the knowledge of sedentary behavior, perceived severity, perceived barriers, and perceived benefits on sedentary behavior were moderated by self-efficacy. The health belief could explain 32.9% of sedentary behavior among patients with CHD (P < 0.05).Conclusions The HBM constructs can serve as good predictors of sedentary behavior. Community medical staff can develop targeted sedentary behavior interventions among patients with CHD based on the health belief model in the future.
Bed Management Strategies in Hospital during the COVID-19 Pandemic
Authors: He Yuheng , Zhou Ailing , Zeng Zhongyi , Ma Li , Wei Yi
Published: January 2024

Background
In late 2022, China experienced a COVID-19 outbreak in which many infected individuals had to be hospitalized due to symptoms such as fever and body aches. This situation placed significant pressure on hospitals to effectively allocate their bed resources, leading to delays in hospital medical services. There was a clear shortage of general beds and intensive care unit (ICU) beds. Therefore, the rational allocation of bed resources to meet the admission needs of COVID-19 patients has become a pressing issue for hospital management. This study aimed to summarize the bed resource management model and experiences of a large hospital in China during the COVID-19 outbreak from December 2022 to February 2023. The goal was to provide a reference for the exploration of preventive and control strategies for future public health emergencies.
Methods
To describe the bed management strategies implemented at the hospital during the COVID-19 outbreak and evaluate the effectiveness of these strategies, we analysed indicators such as length of hospital stay and waiting time by using the Wilcoxon rank sum test.
Results
From December 7, 2022, to February 7, 2023, the hospital experienced a rapid recovery after a decline in the bed occupancy rate, but the number of patients waiting for admission far exceeded the hospital's capacity. The implementation of the aforementioned measures led to a significant reduction in the waiting time for emergency department patients. The waiting time for outpatient department patients increased compared to that in the previous period, while the length of stay for patients admitted through the outpatient department decreased. On the other hand, the average length of stay for patients admitted through the emergency department slightly increased.
Conclusion
To improve bed turnover and availability, the hospital actively implemented measures to dynamically adjust the bed allocation plan and shorten the average waiting time in the emergency department and the average length of stay in the outpatient and emergency departments. This study provides valuable experiences and strategic references for future similar public health emergencies.
Vitamin D deficiency and its association with Depression in under 18s: A mysterious relationship of sunlight with darkness
Authors: Khan Hayat
Published: January 2024

Vitamin D receptors are present in areas of the brain involved in mood regulation, such as the hippocampus and prefrontal cortex. It is suggested that Vitamin D may modulate the synthesis and release of neurotransmitters, including serotonin, dopamine, and norepinephrine, which play crucial roles in mood regulation and are implicated in depression. Vitamin D also has anti-inflammatory properties and can influence immune system functioning. Chronic inflammation has been linked to the development of depression. Vitamin D may help regulate the immune response, reducing inflammation and potentially mitigating depressive symptoms. The deficiency of this vitamin has been previously thought to be not as common as recognized now. This review examined multiple studies to investigate the correlation between Vitamin D deficiency and clinical depression in children and adolescents. While numerous studies conducted on adult cohorts have established a plausible association between Vitamin D deficiency and depression, the body of research focused on individuals under the age of 18 remains significantly limited. Drawing from the existing literature, it is imperative for mental health clinicians to uphold a vigilant clinical approach, emphasizing early identification and intervention for the diagnosis and management of Vitamin D deficiency in this demographic.