bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood cell count combined with lower respiratory symptoms predict the risk of pulmonary complications in patients with influenza A without risk factors
Authors: Luo Jie , Wu Haojie , Gu Rui , Zhang Sen , Ai shanmu , Xu Fang , Tang Hong
Published: April 2024

Objective: To analyze the predictive value of blood cell count results and derived indicators combined with patient symptoms for pulmonary complications in patients without risk factors of influenza A.
Methods: A retrospective cohort study was conducted to analyze the clinical data of 54 patients with influenza A without risk factors .Patients with pulmonary complications were divided into PC group and the others into NPC group. The blood cell counts and derived indices (NLR, PLR, MLR, SII) were compared between the two groups, combining different symptoms , four different prediction models were constructed , and the receiver operating characteristic (ROC) curve was used to verify the predictive value of these models for pulmonary complications in patients without risk factors of influenza A
Results: The rate of lower respiratory symptoms in the PC group was higher than that in the NPC group；WBC count, neutrophil count, NLR, and SII in the PC group were significantly higher than those in the NPC group；WBC, neutrophils, and NLR could effectively predict influenza-associated pulmonary complications (P < 0.05). Among these indicators, NLR had the best predictive effect. The AUC values of the four prediction models were better than the independent predictor NLR. Among them, prediction model 4 (lower respiratory symptoms +NLR) had the best prediction effect.
Conclusions: NLR > 10.228 is the optimal independent risk indicator for pulmonary complications in influenza A patients without risk factors, and its predictive value is stronger when there are lower respiratory symptoms at the same time.
A Non-Invasive Fetal QRS Complex Detection Method Based on a Multi-Feature Fusion Neural Network
Authors: Huang Zhuya , Yu Junsheng , Shan Ying , Wang Xiangqing
Published: April 2024

Fetal heart monitoring, as a crucial part of fetal monitoring, can timely and accurately reflect the fetus's health status. To address the issues of high computational cost, inability to observe fetal heart morphology, and insufficient accuracy associated with the traditional method of calculating fetal heart rate using a four-channel maternal electrocardiogram (ECG), a method for extracting fetal QRS complexes from a single-channel non-invasive fetal ECG based on a multi-feature fusion neural network is proposed. Firstly, a signal entropy data quality detection algorithm based on the blind source separation method is designed to select maternal ECG signals that meet the quality requirements from all channel ECG data, followed by data preprocessing operations such as denoising and normalization on the signals. After being segmented by the sliding window method, the maternal ECG signals are calculated as data in four modes: time domain, frequency domain, time-frequency domain, and data eigenvalues. Finally, the deep neural network using three multi-feature fusion strategies—feature-level fusion, decision-level fusion, and model-level fusion—achieves the effect of quickly identifying fetal QRS complexes. Among the proposed networks, the one with the best performance has an accuracy of 95.85%, sensitivity of 97%, specificity of 95%, and PPV (Positive Predictive Value) of 95%. This method, employing the sliding window technique and lightweight deep neural networks, can quickly and accurately identify fetal QRS complexes from single-channel maternal ECG signals, laying the foundation for home-based fetal QRS shape recognition and fetal risk prediction.
Severe HSV1 pneumonia and EBV enteritidis in a patient with Felty syndrome and ulcerative colitis
Authors: He Jianjun , Liu Da , Jiang ShaLi , Wang Sai , Zhu Yongfeng , Yin Yafei , Yao Jingjiang
Published: April 2024

Background: Felty syndrome (FS), as a rare syndrome, primarily presents as splenomegaly and neutropenia in the context of rheumatoid arthritis (RA).although Inflammatory bowel disease and rheumatoid arthritis are both autoimmune diseases, they only appear together in rare cases.Herpesviruses can be activated in this pathological process, thereby precipitating associated infections, including severe herpes simplex virus type 1(HSV1) pneumonia, and Epstein-Barr virus (EBV) enteritidis in our case.
Case presentation: Here, we report a case illustrating the rapid deterioration of FS following the discontinuation of prednisone andmethotrexate. During the course, this patient exhibited fever, diarrhea, cold sores, and finally be dignosed severe HSV1 pneumonia, cheilitis, EBV enteritidis and ulcerative colitis.
Conclusions: In patients with rheumatoid arthritis, sudden cessation of anti rheumatic drugs may induce Felty syndrome, which in turn can induce the activation of herpesvirus in the body, leading to a series of herpesvirus related infections, such as ,cheilitis, pneumonia and enteritis. Early intravenous use of sufficient antiviral drugs and timely initiation of antirheumatic drugs may be a more appropriate solution.
The application of hip arthroscopy for the management of septic arthritis in adults
Authors: Chen Shu , Liu Zi-ye , Han Ya-guang , Zhou Yi-qin , Shao Jia-hua , Ding Zhe-ru , Zhang Lei , Cao Jia , peng Jinghui
Published: April 2024

Purpose Primary septic arthritis of the hip is a rare differential diagnosis of acute hip pain in adults, but if it is not diagnosed and treated in time, it often leads to irreversible joint damages. However, the diagnostic options of primary septic arthritis of the hip are limited. The accurate aspiration is difficult to achieve, and the traditional open arthrotomy is invasive and associated with high rates of potential complications. We used hip arthroscopy for the diagnosis and intervention of primary septic arthritis of the hip in adults and evaluated their safety and efficacy.
Methods Seven patients (4 female, 3 male), average age 48±17.3 years with unexplained acute pain and limited hip joint were included. Septic arthritis was confirmed by aspirated joint fluid analysis or synovial pathology. Surgical treatment consisted of immediate arthroscopic lavage using only 2 portals for debridement, high-volume irrigation, partial synovectomy, and drainage. Antibiotics were used according to drug susceptibility results or empirically. The symptoms, related primary disease, levels of inflammatory indicators, bacterial culture results, surgical complications, duration of antibiotic use, and follow-up results were all recorded and analyzed.
Results The median duration of symptoms prior to the arthroscopic lavage was 11.6 (4-45) days. All patients had different degrees of leukocytosis and elevated level of erythrocyte sedimentation rate (ESR) and C-reaction protein (CRP). 2 cases got positive results of preoperative bacterial culture results, and 6 cases got positive results of postoperative bacterial culture results, among which Staphylococcus aureus was the most frequently detected pathogen (3 cases). Antibiotics were administered for 4-6 weeks. After an average of 43 days after surgery, CRP returned to physiological levels, ESR returned to normal in 54 days, and after follow-up for 6 months, the average score of Visual Analogue Scale (VAS) decreased from 6.4±1.3 points to 1.3±0.2 points (p<0.05), and the average score of modified harris hip score（mHHS） increased from 53±9.8 points to 85±8.6 points (p < 0.05). None of the patients had significant surgical complications. During the mean follow-up for 24 months (range 18–30 months), no patient showed recurrence of infection, while 1 case underwent subsequent total hip arthroplasty due to serious destruction of articular cartilage and rapidly progressive degeneration.
Conclusion Hip Arthroscopic therapy is a safe and effective method for the diagnosis and intervention of primary septic arthritis of the hip without dissemination, which is reliable, tends to be less invasive and more thorough than the traditional open arthrotomy.
Usefulness of dual-layer detector spectral CT multi-parameter imaging in preoperative prediction of lymphovascular invasion and perineural invasion in patients with colorectal cancer
Authors: Yang Huiyi , Pu Qian , Yang Jianyang , Peng Pengfei , Yue Xun , Ming Yue , Yue Shuting , Zhang Xiaodi , Li Xinghui , Yang Lie , Sun Jiayu
Published: April 2024

Background
We aimed to investigate the usefulness of combining quantitative parameters obtained with dual-layer detector spectral CT (DLSCT) and clinical risk factors for preoperative prediction of lymphovascular invasion (LVI) and perineural invasion (PNI) in patients with colorectal cancer (CRC).
Materials and methods
From June 2022 to August 2023, 122 patients with clinically suspected CRC were prospectively enrolled in the study for spectral CT scanning, 49 patients were confirmed with CRC by histopathology. Using the pathological results, the patients were divided into LVI-positive and LVI-negative groups and PNI-positive and PNI-negative groups, and their clinical and imaging characteristics were determined. The spectral parameters of arterial-phase (AP) and venous-phase (VP) images in the CRC patients analyzed in this study. Intergroup comparisons of parameters were performed using the independent-sample t-test, Mann–Whitney U test, and chi-square test. Independent predictors of LVI group and PNI group were determined by univariate and multifactorial logistic regression analysis, and single parameter and combined parameter models were constructed accordingly. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the prediction effect of different models.
Results
Tumor maximum diameter (Tdia) and normalized iodine density (NID) in the AP (NIDAP) were independent predictors of LVI (P < 0.05), while Tdia, carcinoembryonic antigen 19 − 9 (CA19-9) level, and NID at the VP (NIDVP) were independent predictors of PNI (P < 0.05) in CRC patients. The area under the curve (AUC) values of Tdia and NIDAP for predicting LVI status in CRC patients were 0.795 and 0.776, respectively. Similarly, the AUC values of Tdia, CA19-9 level, and NIDVP for predicting PNI status among CRC patients were 0.804, 0.701, and 0.735, respectively. Models combining these independent predictors yielded AUC values of 0.899 (95% confidence interval [CI]: 0.781–0.966) and 0.871 (95% CI: 0.771–0.971) for predicting LVI and PNI status, respectively. Thus, the combined model was significantly better than any single independent predictor alone.
Conclusion
The combined models, which integrated quantitative DLSCT and clinical parameters, demonstrated good predictive capability for determining the LVI and PNI status among CRC patients, in order to provide imaging references for clinical treatment decision-making.
Utilizing Instagram Stories to Deliver Educational Content to Medical Students in Pediatrics: Curricular Design and Evaluation
Authors: Bellis Raymond , Kim Rachel , Lendway Rebecca , Sniffen Courtney , Smith Nathan , Chitkara Maribeth
Published: April 2024

Background:
Utilization of social media has been described in medical education, but Instagram as an educational platform for the pediatric clerkship has not been reported to our knowledge.
Methods:
We piloted an innovative curriculum on Instagram using the Instagram Story functionality to supplement the pediatric clerkship for third-year medical students. Engagement with this curriculum was measured over time and participating study subjects were surveyed at the completion of the clerkship for overall satisfaction.
Results:
A 29-item Instagram Story curriculum was created by study investigators and medical students in their core pediatric clerkship were invited to participate. Over a span of eight clerkship blocks, the average number of views on the first slide in a Story was 24.8 and the average number of views on the last slide of a Story was 13.3. Average retention rate was 54.3%, the average quiz engagement rate was 32.0%, and the average percent correct on quiz was 87.6%. Students positively rated the Instagram Stories project on feasibility (83.6%), clerkship relevance (89.1%), facilitating engagement in the material (65.5%), assisting in NBME pediatric subject exam preparation (61.8%), and recommending the modality to other clinical clerkships (69.1%).
Conclusions:
This study provides evidence that the use of social media within a core clinical clerkship is feasible, engaging, relevant and appreciated by medical students. We conclude that social media can be successfully integrated into medical education endeavors and should be strongly considered as a supplemental tool to aid learners and modernize curricula.
Evaluation of Tranexamic Acid Application without Closed-Suction Drainage versus with Closed Suction Clamping in Patients Undergoing Knee Arthroplasty: A Retrospective Assessment of Blood Loss and Transfusion
Authors: Demirçay Emre , Özgözen Alaaddin Levent
Published: April 2024

Background: The objective of this study was to evaluate the effects of eliminating closed suction drainage (CSD) and utilizing intravenous and intra-articular tranexamic acid on blood loss, blood transfusion, hospital stay, and dressing changes subsequent to total knee arthroplasty (TKA) surgery.
Methods: A retrospective analysis was conducted on 195 knees of 166 patients who underwent TKA surgery performed by a single surgeon between 2012 and 2022. Patients were divided into two groups based on their use of CSD. Group A (N: 78; 9 males, 69 females; mean age: 72.24±7.29 years) underwent CSD omission and received intravenous and intra-articular tranexamic acid, while Group B (N: 88; 4 males, 84 females; mean age: 71.3±6.9 years) had CSD clamped for 120 minutes postoperatively. Total blood volume loss, number of blood transfusions, length of hospital stay, and dressing changes were compared between the groups.
Results: Total blood volume loss was significantly lower in Group A (1155±88 ml) compared to Group B (716ml±78 ml) (p<0.001). Similarly, the mean number of blood transfusions was significantly lower in Group A (1.02±1.08) compared to Group B (0.04±0.194) (p<0.001). The mean hospital stay was 4.09±1.564 days in Group A and 4.7±1.18 days in Group B (p=0.005). The mean number of dressings was 1.18±0.5 in Group A and 3.07±0.85 in Group B (p<0.0001).
Conclusions:Administration of intravenous and intra-articular tranexamic acid without employing CSD substantially reduces total blood loss, blood transfusion requirements, number of dressing changes, and hospital stay following TKA surgery.
Efficacy of 577 nm subthreshold micropulse laser in central serous chorioretinopathy
Authors: Yu Jia , Xu Gezhi , Chang Qing , Liu Wei
Published: April 2024

To evaluate the effects of 577 nm subthreshold micropulse laser (SML) on central serous chorioretinopathy (CSC) and to investigate the possible factors associated with the efficacy of SML in CSC. CSC patients who received SML between July 2021 and March 2022 were included. The rate of complete resolution of subretinal fluid (SRF) at week 6 and week 12 after SML were assessed. The association between baseline factors and the outcome of SML was also investigated. The difference in best corrected visual acuity (BCVA) and the sub foveal choroidal thickness (SFCT) between 12 weeks after SML and those at baseline were assessed. Thirty-five patients(35 eyes)were included. The rate of complete resolution of SRF after SML in CSC patients was 25.7% at week 6 and 40.0% at week 12. Among baseline factors, only longer symptom duration was independently associated with persistent SRF after SML (aOR = 1.431, P = 0.023). The BCVA improved and SFCT decreased significantly at 12 weeks after SML (t = 3.274, P = 0.002, and t = 3.110, P = 0.004, respectively). The 577 nm SML was an effective method to promote resolution of SRF in CSC eyes, especially those with short symptom duration.
Robot-assisted Treatment Contributes to Regaining Upper Limb Motility in Stroke Patients:a Randomized-controlled Trial Based on Functional Near Infrared Spectroscopy
Authors: Xu Jiayue , Cai Guiyuan , Li Wanqi , Lin Tuo , Zhang Cailing , Jiang Junbo , Chen Gengbin , Chen Jialin , Liu Quan , Xu Guangqing , Lan Yue
Published: April 2024

Background
Robot-assisted treatment(RAT) has drawn a lot of interest in stroke motor rehabilitation. Theoretically, the best protocol for a patient should be selected based on features of the brain's functional reactions associated with RAT. However, due to a paucity of techniques for dynamic brain functional testing, the cortical reaction response to RAT has yet to be thoroughly understood.
Objective
This study concentrated on the treatment effect and brain functional responses to RAT obtained with functional near infrared spectroscopy (fNIRS) in individuals having experienced a stroke with upper limb mobility impairment to direct the application of clinical therapy.
Methods
Eighteen stroke patients were randomly distributed to the robotics group (RG) to receive RAT and the control group (CG) to receive motor training without robot-assistance. Therapies were administered five days per week, for one month, and the outcome indicators were assessed at baseline and 30 days after treatment onset. The clinical evaluations included administration of the Fugl-Meyer assessment for upper-extremity(FMA-UE), action research arm test(ARAT), together with fNIRS recordings.The relative variations in oxyhemoglobin (OxyHb) concentrations measured by fNIRS were used to determine cortical activity levels.
Results
After four weeks of rehabilitation training, the FMA-UE and ARAT points of both groups considerably increased. The FMA-UE and ARAT points of the RG improved more than those of the CG. In comparison to the CG, fNIRS recordings showed enhanced cortical activation of the primary motor cortex in the ipsilateral hemisphere (i-M1) in the RG. Correlation analysis demonstrated a significant positive correlation between FMA-UE points improvements and therapy-evoked increases in the OxyHb of i-M1 in both the RG(r = 0.88, p < 0.001) and CG (r = 0.71, p = 0.03).It also showed a substantial positive association of the ARAT score changes and therapy-evoked increases in the OxyHb of M1 in the RG (r = 0.92, p < 0.001) and CG(r = 0.87, p < 0.002).
Conclusion
Our findings suggest that RAT performed as well or better than classic therapy methods that could help patients with stroke with upper extremity motor dysfunction and activate M1. This activation may promote reorganization of brain function.
Trial registration
ChiCTR, ChiCTR1800019783. Registered 28 November 2018, https://www.chictr.org.cn/ ChiCTR1800019783
Vascular Hemodynamic Effects of Penille Revascularization Surgery and the Role of Resisti̇ve Index in Follow-up
Authors: Akdemir Fatih , Kayıgil Önder
Published: April 2024

Purpose
The aim of this study is to measure the effects of penile revascularization surgery performed in vascular origin erectile dysfunction on penile vascular hemodynamics and to determine the importance of vascular parameters in postoperative patient follow-up.
Methods
A total of 35 patients who underwent penile revascularization surgery due to vascular erectile dysfunction were included in this study. In the preoperative period and at the 3rd postoperative month, penile color doppler ultrasonography was performed to evaluate cavernosal arteries, dorsal arteries, deep dorsal vein and inferior epigastric artery separately. During this evaluation, peak systolic velocity, end diastolic velocity, and resistive index were measured. The International Index of Erectile Function questionnaire was applied to all patients in the preoperative period and at the 3rd postoperative month. The relationship between changes in International Index of Erectile Function questionnaire score and penile vascular hemodynamic changes in the postoperative period was evaluated.
Results
The average preoperative resistive index values of the operated cases were determined as 0.74 ± 0.07/0.73 ± 0.09 cm/s for the right cavernosal artery and left cavernosal artery, respectively. The same values were found as 0.95 ± 0.09/0.96 ± 0.06 cm/s at the last postoperative control. The average International Index of Erectile Function − 5, 15 scores were determined as 8.52 ± 4.83, 19.4 ± 8.54, respectively, in the preoperative period, and 15.26 ± 4.50, and 35.76 ± 13.65, respectively, at the last postoperative follow-up.
Conclusion
This study showed that the resistive index can be used in the diagnosis of vascular originated erectile dysfunction and in the postoperative follow-up of the patients.
Are Dual-Phase 18F-FDG PET-mpMRI Diagnostic Performances to Distinguish Brain Tumour Radionecrosis/Recurrence after Cranial Radiotherapy usable in routine?
Authors: Cailleteau Axel , Ferrer Ludovic , Geffroy Delphine , Fleury Vincent , Lalire Paul , Doré Mélanie , Rousseau Caroline
Published: April 2024

Purpose: Radionecrosis is a complex challenge in the post-radiotherapy management of these patients due to the difficulty to distinguish this complication from local tumour recurrence. MRI alone have a variable specificity and sensibility as well as PET-CT imaging. We aimed to investigate the diagnostic performance of dual-phase [18F]-FDG PET-MRI to distinguish cerebral radionecrosis from local tumor recurrence after cranial radiotherapy.
Materials and Methods: A retrospective analysis was conducted on patients who underwent dual-phase [18F]-FDG PET-MRI between May 2021 and September 2022. Inclusion criteria encompassed patients with inconclusive MRI findings post-radiotherapy and history of cerebral radiotherapy for primary or metastatic brain lesions. Lesions are assessed qualitatively and semi-quantitatively, with sensitivity and specificity calculations. The gold standard to assess radionecrosis was histopathology or a composite criteria at three months. The ethics committee approved the study (N° 2023-034 9th march 2023).
Results: The study evaluated 24 lesions in 23 patients. Qualitative analysis yielded 85.7% sensitivity and 75% specificity. Semi-quantitative analysis, based on contralateral background noise, achieved 100% sensitivity and 50% specificity. Moreover, using contralateral frontal lobe background noise resulted higher performances with 92% sensitivity and 63% specificity. Stratification by lesion type demonstrated a 100% sensitivity and specificity rates for metastatic lesions.
Conclusions: This study demonstrated the potential of dual-phase [18F]-FDG PET-MRI to distinguish cerebral radionecrosis from local recurrence. The method showed promising diagnostic performance, particularly in semi-quantitative data for metastatic lesions. This study sheded light on the importance of combined PET and MRI data and presented perspectives for a better post-therapeutic differential diagnosis.
Simulation of γ-Ray Radiation Shielding Utilizing Gd2O3/Bi2O3/Epoxy Resin
Authors: Cao Rongxing , Li Guangyao , Li Hongxia , Xue Yuxiong , Zeng Xianghua
Published: April 2024

In order to meet the requirement of radiation shielding materials for space nuclear reactors, gamma shielding effect of epoxy resin base added with Gd2O3/Bi2O3 particles was studied by Monte Carlo simulation platform Geant4 in this paper. Firstly, the gamma ray shielding effects of functional filler with different ratios and content were simulated. Then, based on the gamma-ray energy range generated by space nuclear reactors, the γ-ray protection performance of epoxy resin composites under different energy ranges was studied. Finally, the effects of the particle size and arrangement of the fillers on the γ-ray shielding properties of the composites were presented, and the results showed that the smaller of the particle size, the better the shielding effect will be; for the same size of the filler, the arrangement of the filler with a larger projection area has a better γ-ray shielding performance. The effect of Gd2O3/Bi2O3 added to epoxy resin base on low-energy gamma rays is obvious, but the effect on high-energy rays is less.
Mendelian Randomization revealed a one-way causal association between increased Isovalerylcarnitine (C5) levels and the risk of idiopathic pulmonary fibrosis
Authors: He Jing , Liao zhengyue , Chen Hongyu , Fu Jiaojiao , Liu sijing , Hua Yanan , Guo Jinlin
Published: April 2024

Background There have been multiple observational studies that have established a link between metabolite levels in the body and idiopathic pulmonary fibrosis (IPF), specifically focusing on metabolites derived from fatty acids. However, a complete understanding of the precise molecular and biological factors, as well as the causality between them, remains elusive.Objective The main objective of our study was to evaluate the potential causal relationship between blood metabolites and IPF by using Mendelian randomisation (MR).Methods To achieve this goal, we utilized the most comprehensive genome-wide association study (GWAS) to date, which identified genetic variants associated with blood metabolites (1,091 blood metabolites and 309 metabolite ratios). Summary statistics of IPF were collected from Finngen R8 (1,812 IPF patients and 338,784 controls), Inverse Variance Weighted method (IVW) is used as the main method in determining causality.Results Isovalerylcarnitine (C5) levels (OR = 1.2435, 95%CI: 1.0494–1.4736, PIVW = 0.0119) was found significantly related to higher risk of IPF. There was no significant heterogeneity in our study (IVW method: Pval = 0.132; MR-Egger method: Pval = 0.105) and horizontal pleiotropy (β=-0.027; se = 0.0337; Pval = 0.4310). The sensitivity analysis did not reveal any potential abnormal drivers (0.1 < All < 0.3).Conclusion Two-sample MR Method demonstrated the causal relationship between blood metabolites and IPF, and further studies found that C5 levels, as a potential biological risk factor for IPF, may provide a new target for the treatment of IPF.
Enhancement of meningeal lymphatic structure and function through running exercise mitigates amyloidosis in an Alzheimer’s disease mouse model
Authors: Mee-inta Onanong , Chiang Yu-Yi , Zhao Zi-Wei , Wang Tzu-Feng , Lee Hsueh-Te , Huang Chih-Chung , Wu Ping-Ching , Kuo Yu-Min
Published: April 2024

Background
The meningeal lymphatic (mLym) system is a route for waste clearance from the brain to the periphery that has been implicated in the pathogenesis of Alzheimer’s disease (AD). While exercise has been linked to enhanced cognition and delay of AD progression, the effects of exercise on the mLym system have remain largely undescribed.
Methods
Three-month-old 5xFAD transgenic mice were subjected to a 3-month period of wheel running exercise. Before and after the exercise period, mLym function (i.e., bulk flow of cerebrospinal fluid from the lateral ventricles to the deep cervical lymph nodes) was monitored in real time using high-frequency ultrasound imaging with a nanoparticle contrast agent. The relationships between mLym structure and function, amyloidosis, and learning and memory were examined. Additionally, serum and extracellular vesicles (EVs) were obtained from exercised animals and used to treat lymphatic endothelial cells (HDLECs). Expression of lymphatic vessel-related genes (LYVE-1 and VEGFR3) was monitored.
Results
Compared to 3-month-old 5xFAD mice (without significant amyloidosis) and age-matched wild-type mice, 6-month-old 5xFAD mice (with robust amyloid plaque deposition in the brain) exhibited decreased mLym function, deterioration of mLym vessels, and impaired learning and memory performance. Reductions were observed in the expression of lymphatic vessel-related genes (LYVE-1 and VEGFR3) in the meninges and VEGF-C in the brain of 6-month-old 5xFAD mice. Subjecting 3-month-old 5xFAD mice to 3 months of running exercise improved mLym vessel structure and function, reduced amyloidosis, and enhanced learning and memory performance compared to non-exercised controls. Conversely, ligating mLym vessels accelerated amyloidosis in 3-month-old 5xFAD mice. Exercise also upregulated the expression levels of LYVE-1 and VEGFR3 in the meninges and VEGF-C in the brain. Further in vitro studies showed that Aβ oligomers decreased VEGFR3 gene expression in HDLECs, while serum and EVs from exercised mice antagonized this effect.
Conclusions
This study reveals beneficial effects of running exercise on the mLym system, suggesting a non-pharmacological strategy to improve Aβ clearance from the brain, delay AD progression, and enhance cognitive function.
3D-printing Inherently MR-visible Accessories in Aiding MR-Guided Biopsies
Authors: Wang Yanlu
Published: April 2024

Background
Hard plastics are typically invisible in MRI images, while fluids are not. Objects manufactured using traditional Fuse Deposition Modelling (FDM) 3D-printing techniques are prone to leakage. 3D-printers which use UV-hardened resin to form objects possess a trait that is considered a technical inconvenience: Objects created using these techniques are inherently liquid-tight, and hollow parts require addition of drainage holes for uncured liquid resin to escape. If this is not done liquid resin will remain inside the object, which in some cases is the desired outcome. Digital Light Processing (DLP) is an affordable 3D-printing technique using UV-hardened resin. The technique also possesses superior dimensional accuracy and the ability to recreate fine details.
Purpose
We devised a method to produce an inherently MR-visible accessory using DLP technology with low dimensional tolerance to facilitate MR-guided breast biopsies.
Methods
By hollowing out the object without adding drainage holes and tuning printing parameters such as z-lift distance to retain as much uncured liquid resin inside as possible, objects that are inherently visible in MRI scans can be created without further treatment.
Results
Objects created through our method are simple and cheap to recreate, have minimal manufacturing steps, and are shown to be dimensionally exact and inherently MRI visible to be directly used in various applications without further treatment.
Conclusion
While this method may not always be suitable, we demonstrate that this process is viable in creating highly accurate objects that are inherently visible in MRI scans using equipment that is easy to obtain and trivial in cost.
Analysis of Water Evaporation and Crack Development in Expansive Soils under Dry Environment
Authors: Chen Aijun , Luo Junfeng , Zhao Shanshan , Chen Junhua , Shi Xiong
Published: April 2024

Expansive soil is highly susceptible to water loss and shrinkage cracking in dry conditions, resulting in the formation of crisscrossed cracks during tensile failure. This significantly compromises its engineering properties across various fields, including geotechnical, water conservancy, environmental, and agricultural engineering, and can trigger a range of geological hazards. To investigate the impact of initial water content, thickness-to-width ratio (the ratio of the sample's thickness to its side length), wind speed, and light intensity on water evaporation and crack development, drying and cracking tests were conducted on expansive soil specimens using homemade experimental setups and image recognition processing technology under controlled conditions. The findings reveal distinct stages in soil water evaporation and fracture development. Specifically, the initial water content greatly influences fracture generation and development, with higher initial water content leading to faster water evaporation during drying and an extended time for fracture stabilization. Additionally, the thickness-to-width ratio plays a significant role in water evaporation rate, correlating with crack area size and inversely correlating with crack length. Furthermore, ambient wind speed and light intensity promote water evaporation, accelerating crack generation to some extent, albeit with minimal impact on stabilized crack area. These research outcomes provide crucial insights for preventing and mitigating engineering geological issues associated with expansive soil drying and cracking.
Exploring the Potential of CPA4 Knockdown as a Prognostic Biomarker in Inhibiting Endometrial Cancer Proliferation
Authors: He Kang , Zheng Jingying , Zhang Tingyu , Lv Hao , Wang Kai , Wang Zeyu , Wang Longyun , Wu Shan , Zhao Lijing
Published: April 2024

Background: The rise in endometrial cancer rates globally calls for advanced diagnostic methods and new biomarkers. CPA4, known for its role in cancer development, has not yet been studied in relation to endometrial cancer, making it a promising research avenue.
Methods: We analyzed CPA4's mRNA expression using data from TCGA and GEO databases and validated these findings with 116 clinical samples through immunohistochemical analysis. The Ishikawa and Hec-1-A cell lines were used to examine CPA4's functionality. Additionally, we conducted correlation analysis, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Set Enrichment Analysis (GSEA), and survival analysis to understand CPA4's role in endometrial cancer prognosis. A nomogram model was developed for clinical prognostic predictions.
Results: CPA4 is significantly overexpressed in endometrial cancer, correlating with tumor progression and poor prognosis. Overexpression is linked to crucial functions like mitosis and cell cycle. Reducing CPA4 in cell lines inhibited tumor growth and spread. Kaplan-Meier plots and Cox regression analysis confirmed CPA4's significance in prognosis, with our predictive model showing high accuracy.
Conclusion: CPA4 emerges as a vital biomarker for diagnosing and prognosing endometrial cancer, presenting a novel pathway for research and clinical application. The study highlights its potential as a clinical tool, paving the way for improved patient management and treatment strategies in endometrial cancer.
Functional connectivity and graph theory of impaired central visual pathways in acute ischemic stroke based on fMRI
Authors: Chu Xiuli , Xue Bo , Yu Weibin , Liu Taotao , Zhang Ziyao
Published: April 2024

In the study of this paper, we first performed the analysis of whole brain static functional connectivity, we divided the whole brain into 90 regions of interest (ROIs) by applying AAL mapping, we compared the whole brain static functional connectivity analysis of the 14 patients and 26 healthy volunteers (HC) who completed the 3-months experiment (3months), the 14 patients and 26 healthy volunteers who completed the 7-days experiment (7days), the 12 patients and the 12 patients who completed the 7-days experiment (7days), the 12 patients and the 12 patients who completed the 3-months experiment (7days), and the 12 patients and 26 healthy volunteers ( HC), 14 patients who completed the 7-day experiment (7days), and 14 patients who completed the 3-month experiment (3months) were analysed for whole-brain static functional connectivity in all three groups, and 90 ROIs were mapped to the Yeo7 functional network for analysis. sFC analyses revealed significant alterations in the patients' VAN, and DMN networks. Secondly, we performed dynamic functional connectivity analysis based on AAL mapping with the sliding window method separately, and identified two dynamic functional connectivity pattern characteristics, i.e., state 1 with a connectivity pattern dominated by
high-frequency weak connectivity, and state 2 with a connectivity pattern dominated by low-frequency strong connectivity.Stroke patients spent significantly more time in state 1, and the number of state switches of the stroke patients in 7days significantly higher and were more likely to switch to the low-frequency strong connectivity mode state 2. Significant changes in connectivity were observed for DMN, VIS, FPN, and LIM. Finally, we built five machine learning models based on SFC features that differ between groups, namely linear support vector machine (SVM), radial basis function support vector machine (SVM-RBF), k nearest neighbours (KNN), random forest (RF), and decision tree (TREE). Based on the maximum AUC we identified the optimal feature subset and found that the SFC within the VIS, DMN, and LIM networks contributed significantly to the classification of AIS patients and HCs alike.The variation of FC within the VIS, DMN, and LIM networks may provide new insights into the neural mechanisms of AIS patients.
Longitudinal assessment of transcranial Doppler imaging in children with sickle cell disease without neurological symptoms
Authors: Asbeutah Akram M. , Asbeutah Saad A. , Al-Zahra Akmal , AlMajran Abdullah A. , Adekile Adekunle
Published: April 2024

Introduction
: Stroke is one of the most devastating complications of sickle cell disease (SCD). Transcranial Doppler Imaging (TCDI) is the least invasive screening method to predict patients at risk for developing stroke in the disease. After a 10-year follow-up, we longitudinally assessed the TCDI in children with SCD without neurological symptoms.
Methods
25 out of 43 pediatric patients with SCD studied 10-year previously were recruited. The remaining 18 patient were not available for follow-up, but their initial data are presented for comparison. TCDI scanning was carried out using a phased-array transducer of 1–3 MHz through the trans-temporal window. Peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged mean of the maximum velocity (TAMMV), resistive index (RI), and pulsatility index (PI) were obtained in the anterior and posterior Circle of Willis vessels.
Results
The highest initial and follow-up TAMMV (mean ± SD) were: 77.3 ± 20.9 and 71.6 ± 9.9 in the t-ICA, 94.3 ± 25.8 and 82 ± 18.2 in the MCA, 76.6 ± 25.6 and 70.6 ± 10.7 in the ACA, and 59.1 ± 15.8 and 63.9 ± 8.5 in the PCA, respectively. There was no statistically significant difference between initial and follow-up SCD data for all vascular parameters in all vessels on each side (P > 0.05) except for RI and PI (P < 0.05). There was significant correlation between TAMMV, PSV, and EDV (P = 0.001).
Conclusion
PSV, EDV can be used in parallel with TAMMV during TCDI. These vascular parameters do not suggest subclinical vascular deterioration.
Comparison of cognitive performance in first-episode drug-naïve schizophrenia, bipolar II disorder, and major depressive disorder patients after treatment
Authors: Tang Chaohua , Huang Wei , Tan Yukang , Liu Yiliang , Zheng Guangen , Li Bin , Chen Wensheng , Yang Yu , Xu Guohong , Li Xiaoling , Xu Caixia , Xie Guojun , Liang Jiaquan
Published: April 2024

Background: Cognitive impairment is a recognized fundamental deficit in individuals diagnosed with schizophrenia (SZ), bipolar II disorder (BD II), and major depressive disorder (MDD), among other psychiatric disorders. However, limited research has compared cognitive function among first-episode drug-naïve individuals with SZ, BD II, or MDD.
Methods: This study aimed to address this gap by assessing the cognitive performance of 235 participants (40 healthy controls, 58 SZ patients, 72 BD II patients, and 65 MDD patients) using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after 12 weeks of treatment in SZ, BD II, and MDD patients. To clarify, the healthy controls only underwent RBANS testing at baseline, whereas the patient groups were assessed before and after treatment. The severity of symptoms in SZ patients was measured using the Positive and Negative Syndrome Scale (PANSS), and depression in BD II and MDD patients was assessed using the Hamilton Depression Scale-24 items (HAMD-24 items).
Results: Two hundred participants completed the 12-week treatment period, with 35 participants dropping out due to various reasons. This group included 49 SZ patients, 58 BD II patients, and 53 MDD patients. Among SZ patients, significant improvements in immediate and delayed memory were observed after 12 weeks of treatment compared to their initial scores. Similarly, BD II patients showed significant improvement in immediate and delayed memory following treatment. However, there were no significant differences in RBANS scores for MDD patients after 12 weeks of treatment.
Conclusions: In conclusion, the findings of this study suggest that individuals with BD II and SZ may share similar deficits in cognitive domains. It is important to note that standardized clinical treatment may have varying degrees of effectiveness in improving cognitive function in patients with BD II and SZ, which could potentially alleviate cognitive dysfunction.
Ferroptosis-related genes MDM2 and CDKN1A as reliable biomarkers for COPD
Authors: Shi Rui , Wang Lueli , Du Xiaohua , Bai Chunyun , Wang Fang , Wang Chongyu , Liu Zefan , Wu Hongxiang , Zidai Wuyi , Zhang Jie , Song Na , Luo Min , Sun Shibo , Li Chaozhong , Xiao Chuang , Chen Alex F , Yang Weimin
Published: April 2024

Objective
Chronic obstructive pulmonary disease (COPD) is characterized by inflammation and immune response. However, the relationship of ferroptosis and COPD remains unknown. We aim to identify pivotal ferroptosis-related biomarkers in COPD and explore their roles in immune infiltration landscapes.
Methods
Differentially expressed genes (DEGs) were obtained from all current datasets of peripheral blood and lung tissues associated with COPD. DEGs were intersected with ferroptosis-related genes (FRGs) from FerrDb database to obtain FRDEGs. Hub FRDEGs were evaluated with WGCNA, GO, and KEGG enrichment, PPI network, LASSO-COX, and ROC curves analysis, and validated in blood of COPD patients. The association between hub FRDEGs and COPD was investigated. The role of hub FRDEGs in 17 types of respiratory tract diseases was analyzed, and potential drugs targeting these FRDEGs were predicted via CMAP drug database. Importantly, MDM2 and CDKN1A expressions were identified and verified H&E and Masson stainning, and Western blot analysis in the CS and LPS-induced COPD mice.
Results
MDM2 and CDKN1A were identified as the hub genes in all COPD patients and their expressions were significantly upregulated in lung tissues of COPD mice. 17 types of respiratory tract diseases were markedly associated with MDM2 and CDKN1A. The 2 genes markedly correlated to neutrophils. MDM inhibitor (AMG-232) was screened as a potentially key drug affecting MDM2.
Conclusion
MDM2 and CDKN1A could be potential targets for COPD by regulating neutrophils-involved inflammation. One drug with potential clinical application value was identified.
Genetic analysis in aid of delineation of Management Units for a wide-ranging marine mammal, the grey seal (Halichoerus grypus), in European waters
Authors: Steinmetz Kristina , Murphy Sinéad , Cadhla Oliver Ó , Hoffman Joseph Ivan , Jung Jean-Luc , Barnett James , Cronin Michelle , Galatius Anders , Hassani Sami , Jessopp Mark , Pomeroy Patrick , Mirimin Luca
Published: April 2024

The present study aims at filling genetic structure gaps of grey seals (Halichoerus grypus) in the Northeast Atlantic, where effective Management Units (MUs) must be established to fulfil international obligations set by OSPAR and the EU’s MSFD. Mitochondrial and nuclear genetic markers were analysed for seals from the island of Ireland, southwest England and the German/ Danish North Sea coasts, whereby the integration of previously published data led to the largest genetic dataset analysed for this species to date. Results revealed that individuals from the island of Ireland are part of a single interbreeding population, with Southwest England being a source of migrants to the island of Ireland, and the southern North Sea (Germany, Denmark) being either a source or sharing a common source of migrants to the island of Ireland. Based on observed genetic structure within the Northeast Atlantic, two MUs are proposed: (i) the Faroe Islands, Scotland and the North Sea and (ii) the island of Ireland, southwestern UK (Cornwall) and France. Additionally, Northwest Scotland and the English Channel/Dutch North Sea are proposed as transition zones. Given the species’ high mobility, an adaptive management plan based on an ongoing regional/ European scale monitoring programme is recommended.
Stakeholder-engaged development of a rapid test for detection of acute HIV infection
Authors: Rodriguez Natalia M. , Balian Lara , Kataki Ishita , Tolliver Cealia , Jesus Julio Rivera-De , Linnes Jacqueline C.
Published: April 2024

Background/Objective: The utilization of rapid HIV tests has been effective at reducing transmission rates in high-risk populations by allowing individuals to receive diagnosis in as little as one minute and begin treatment. However, no current rapid tests can detect HIV immediately after infection in the acute HIV infection (AHI) phase, when the virus is at its most infectious, and instead require a waiting period of up to 90 days after exposure. Rapid HIV tests to detect AHI are currently under development. Investigation of stakeholder perspectives and context-specific needs are critical to ensure successful translation of novel AHI tests. The objectives of this study were to 1) understand context-specific factors such as barriers to HIV testing in Indiana, a state with one of 48 prioritized counties for HIV elimination; 2) assess the acceptability of a novel rapid AHI test, and 3) identify key implementation considerations for such a device, including ideal end-users.
Methods: Semi-structured in-depth interviews were conducted with staff (n = 14) and clients (n = 5) of Indiana-based organizations that conduct HIV testing, including syringe service programs. Utilizing human-centered design frameworks, interview guides were developed and tailored to each participant group to understand their experiences with HIV testing, perspectives on a novel rapid AHI test in development, and preferences for self-testing versus testing by a community health worker (CHW) or a peer recovery coach. Thematic analysis was conducted to identify major themes, including barriers to HIV testing and perceived benefits and concerns of the proposed AHI test.
Results: Overall acceptability for a novel AHI rapid test was high with a greater preference for CHW/Peer-led testing. While self-testing was not a preferred modality, it was still seen as a potential tool to reach and address key barriers among high-risk individuals. Key considerations for implementation emphasized accuracy, cost-effectiveness, ease of use, ensuring access to counseling, education, and navigation to care while maintaining a human element to self-testing.
Conclusion: Stakeholder engagement is meaningfully informing the design, development, and implementation of rapid AHI testing in order to facilitate adoption among populations at high-risk for HIV.
A combined process of electrochemical machining and slotting for semi-blind hole involute internal splines enhanced by a new cathode design
Authors: Huang Yi , Fang Cong , Xu Yan , Gong Senlin , Wang Xi
Published: April 2024

Machining complex internal structures in high-hardness materials presents a significant challenge. Conventional cutting methods often suffer from issues such as extensive tool wear and prolonged production cycles. This research proposes a combined process that integrates roughing electrochemical machining (ECM) with a precision slotting to achieve fast involute internal spline shaping of intricate high-hardness components. To enhance the process stability of the spline ECM process, a curved cathode design tailored for ECM is introduced. Flow field simulations demonstrate that the proposed curved cathode design leads to a relatively uniform distribution of electrolyte flow in the machining area. A dedicated ECM fixture and system are established for conducting experiments. The obtained ECM outcomes substantiate the commendable capacity of the optimized curved cathode to accomplish high precise and efficient machining and shaping of splines. Consequently, the optimized curved cathode design exhibits substantial potential for widespread application in the large-scale production of intricate internal cavity components composed of challenging-to-machine materials.