bluuebunny/crossref_metadata_2025 huggingface dataset:
KLASIFIKASI DIABETES PADA WANITA MENGGUNAKAN METODE NAIVE BAYES CLASSIFIER
Authors: Faisal Fahrul Mohammad , Hadikurniawati Wiwien
Published: March 2023

The report from Riskesdas shows that there is a 2x increase in diabetes every year in Indonesia. This is due to an increase in factors such as human population, age, obesity, irregular eating patterns and lack of physical activity. The increase in a factor that causes diabetes in Indonesia must be prevented. The first step in preventing diabetes is to detect the risk factors for diabetes that may occur. Influencing factors include behavioral factors and sociodemographic factors The increase in diabetes in a country is due to late identified factors. The number of factors that are collected in order to detect whether a person has diabetes or not requires a fairly large data processing system. The data used in this study are diabetes data obtained from the Pima Indian Diabetes Database with attributes of pregnant, glucose, diastolic, triceps, insulin, BMI, history of diabetes, age and 300 data output. The Naive Bayes Classifier method can be used to classify diabetes in women based on pregnant, glucose, diastolic, triceps, insulin, BMI, history of diabetes, age and output. The accuracy result of the Naive Bayes Classifier method in classifying diabetes in women is 84% ​​of 300 data which is divided into 2, namely 275 data as training data and 25 data as test data.
KLASIFIKASI TEKNIK BULUTANGKIS BERDASARKAN POSE DENGAN CONVULUTIONAL NEURAL NETWORK
Authors: Rizki Aditya Bobby , Zuliarso Eri
Published: March 2023

Convolutional Neural Network (CNN) is a deep learning algorithm which is the development of Multilayer Perception (MLP) which is designed to process data in two-dimensional form. At the stage of making the system there are several stages including sample data, data sources and data analysis methods. The dataset that is processed is the Badminton Technique, namely the Forehand Technique which consists of 374 images, the Service Technique consisting of 369 images and the smash technique consisting of 420 images with outliers of 146 images. After the data is cleaned of outliers, bootrapping is carried out again to unite all data from each separate class into one again. The results of this study say that the Classification of Badminton Techniques Based on Pose with Convolutional Neural Networks, it can be concluded that the process of testing pose classification with test data using several methods such as logistic regression, random forest, and KNN produces significant accuracy. values ranging from 80% to 90%.
PEMBUATAN PROFIL INSTANSI BALAI PENYULUHAN PERTANIAN KECAMATAN BELIK BERBASIS WEB MENGGUNAKAN FRAMEWORK CODEIGNITER
Authors: Muhamad Zen Shidqi
Published: March 2023

Belik Subdistrict Agricultural Extension Center (BPP Belik) is a government extension agency that fosters farmers in Belik village. Every month at BPP Belik many activities are carried out. Both indoor activities and outdoor activities. The PPL (Field Agricultural Extension) officers provide a lot of training and coaching to farmers in Belik Village. However, the involvement of the participating farmers is still very limited, considering that BPP Belik has very limited funds and time. This makes information not spread evenly to farmers in Belik Village. Dissemination of information in the form of training or articles evenly will certainly increase agricultural production. Based on the existing problems, it is necessary to have a new information system, namely the creation of a website profile of the Belik District Agricultural Extension Center as an effort to provide alternative solutions for PPLs in disseminating information to farmers. 
The development of information systems on the website profile of the Belik District Agricultural Extension Center is using the waterfall method. Which consists of the analysis process, system design, design and implementation. The data analysis stage was obtained from interviews. Creating a website profile for BPP Belik agencies using the PHP programming language and MySql database. As well as using the php Codeigniter framework. 
The system trial on the BPP Belik Agency profile website is using the black box method. This test was carried out by 2 admins and writers at BPP Belik. The tests carried out are testing the appearance / user interface on the admin page and on the main page of the website.
ANALISIS SISTEM PELAYANAN ADMINISTRASI KEPENDUDUKAN BERBASIS APLIKASI E-OPEN DI KELURAHAN PEJUANG KOTA BEKASI
Authors: Anriani Irma Aini , Sihombing Erene Gernaria
Published: March 2023

E-Open application user satisfaction is a level where the needs, desires and expectations of E-Open application users can be met which results in people using E-Open applications for administrative purposes in the village. The warrior village is one of the villages in the Medan Satria sub-district, Bekasi. There are many things that must be considered in using the E-Open application, namely by providing something that is in accordance with the needs of the warrior village community. Based on these problems, the researchers found that the suitability of the E-Open application with administrative activities in the urban village would make it easier to provide services to the warrior village. Sources of data were obtained from distributing questionnaires to people who had used the E-Open application in the warrior village to 101 people. The attributes used as parameters for evaluating the satisfaction of E-Open application users include: gender, age, occupation, E-Open Usability Level, E-Open Application Image, E-Open Service Quality, E-Open User Quality. The results of processing the C4.5 method using a decision tree after determining the Entropy and Gain. The model that has been formed is tested for accuracy by entering the initial data. For the value of user satisfaction of the E-Open application.
ANALISIS SENTIMEN ULASAN APLIKASI POSPAY DENGAN ALGORITMA SUPPORT VECTOR MACHINE
Authors: Safryda Putri Dea , Ridwan Taufik
Published: March 2023

Aplikasi Pospay merupakan salah satu bentuk teknologi finansial milik Pos Indonesia. Aplikasi Pospay di Google Play Store memiliki lebih dari 25 ribu ulasan pengguna. Semakin banyak ulasan pengguna, semakin sulit dan lama waktu yang dibutuhkan calon pengguna dan pengelola aplikasi untuk menyimpulkan informasi tentang tren sentimen pengguna yang berguna dalam membuat keputusan tentang penggunaan dan evaluasi aplikasi. Analisis sentimen adalah solusi untuk masalah ini karena analisis sentimen mampu mengklasifikasikan data yang tidak terstruktur untuk menghasilkan informasi sentimen secara efisien dengan menerapkan algoritma data mining. Penelitian ini menggunakan metode Knowledge Discovery in Database (KDD), dimana pada tahap data mining diterapkan algoritma Support Vector Machine dalam pembuatan model. Grid search diterapkan pada pengujian 3 skenario sehingga diperoleh proporsi pembagian data dengan akurasi terbaik yaitu 90 : 10 menggunakan kernel RBF dengan parameter: c = 1, ℽ = 1. Hasil dari penelitian ini berupa model dengan akurasi 95%, presisi 91%, penarikan 100%, dan skor f1 95%. Didapatkan juga informasi bahwa sentimen pengguna aplikasi Pospay di Google Play Store cenderung positif (54,1%) namun begitu tidak jauh dari persentase sentimen negatif (45,9%).
RANCANG BANGUN SISTEM KONTROL MOTOR LISTRIK BERBASIS RASPBERRY PI
Authors: Abrar Ali , Akbar Syaeful , Tukino Tukino
Published: March 2023

This study will develop and execute control of DC motors and servo motors on a 4WD robot controlled by a keypad and equipped with grippers and a USB webcam to broadcast video so that the gripper robot vehicle can view items in front of it. Control actions were implemented using Python-based user defined programming on a Raspberry Pi 4 with motor driver controller. The challenge described in this article is how to optimize a tool design utilizing a driver loaded directly on an SBC. The goal of this study is to create technical ideas in the area of electric motor control and mechatronics in the form of applications. The design, production, and testing stages are followed utilizing the Raspberry Pi, RPi Motor Driver Board, and Python as the major components. The study's findings include a prototype wheeled robot with a camera for image capture and an actuator in the form of a servo motor with a gripper/clamp as an attachment. The study's conclusion is that the design outcomes of electric motor control utilizing Raspberry Pi-based can perform more efficiently.
Emerging roles of circular RNAs in cancer therapy-induced cardiotoxicity
Authors: Cheng Ziji , Qin Wanting , Li Shaoling , Shao Shuijin , Liu Baonian
Published: March 2023

Cancer therapy-induced cardiotoxicity (CTIC) is an important cause of death in cancer survivors which often results in the withdrawal or discontinuation of drugs. The underlying mechanisms of CTIC remain unclear. Circular RNAs (circRNAs) are a class of non-coding regulatory RNA molecules which have emerged in recent years. They are generated by back splicing and have powerful biological functions, including transcription and splicing, isolating or building macromolecular scaffolds to interfere with microRNA activity and signaling pathways, and acting as templates for translation. Moreover, circRNAs demonstrate high abundance and significant stability. CircRNAs can be used as novel biomarkers because they often function in a cell-type and tissue-specific manner. CircRNAs have attracted increasing attention in cardiovascular disease research, and recent studies exploring the role of circRNAs in CTIC have had promising results. This review will summarize the current understanding of circRNAs’ biogenesis, regulation and function. Their clinical potential as biomarkers, therapeutic agents and drug targets will also be explored.
Social media and internet search data to inform drug utilization: A systematic scoping review
Authors: Keller Roman , Spanu Alessandra , Puhan Milo Alan , Flahault Antoine , Lovis Christian , Mütsch Margot , Beau-Lejdstrom Raphaelle
Published: March 2023

Introduction

Drug utilization is currently assessed through traditional data sources such as big electronic medical records (EMRs) databases, surveys, and medication sales. Social media and internet data have been reported to provide more accessible and more timely access to medications' utilization.

Objective

This review aims at providing evidence comparing web data on drug utilization to other sources before the COVID-19 pandemic.

Methods

We searched Medline, EMBASE, Web of Science, and Scopus until November 25th, 2019, using a predefined search strategy. Two independent reviewers conducted screening and data extraction.

Results

Of 6,563 (64%) deduplicated publications retrieved, 14 (0.2%) were included. All studies showed positive associations between drug utilization information from web and comparison data using very different methods. A total of nine (64%) studies found positive linear correlations in drug utilization between web and comparison data. Five studies reported association using other methods: One study reported similar drug popularity rankings using both data sources. Two studies developed prediction models for future drug consumption, including both web and comparison data, and two studies conducted ecological analyses but did not quantitatively compare data sources. According to the STROBE, RECORD, and RECORD-PE checklists, overall reporting quality was mediocre. Many items were left blank as they were out of scope for the type of study investigated.

Conclusion

Our results demonstrate the potential of web data for assessing drug utilization, although the field is still in a nascent period of investigation. Ultimately, social media and internet search data could be used to get a quick preliminary quantification of drug use in real time. Additional studies on the topic should use more standardized methodologies on different sets of drugs in order to confirm these findings. In addition, currently available checklists for study quality of reporting would need to be adapted to these new sources of scientific information.
Association of obesity with the development of end stage renal disease in IgA nephropathy patients
Authors: Wang Siqing , Qin Aiya , Dong Lingqiu , Tan Jiaxing , Zhou Xiaoyuan , Qin Wei
Published: March 2023

Background and aim

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. We aimed to evaluate whether obesity is a risk factor for IgAN patients.

Methods

A total of 1054 biopsy-proven IgAN patients were analyzed in this retrospective study. Patients were divided into four groups according to their body weight index (BMI) at the period of renal biopsy: underweight group (BMI< 18.5, N=75), normal weight group (18.5≤BMI<24, N=587), overweight group (24≤BMI<28, N=291) and obesity group (28≤BMI, N=101). The endpoint of our study was end stage renal disease (ESRD: eGFR <15 mL/min/1.73 m2 or having renal replacement treatment). Kaplan-Meier analyses and Cox proportional hazard models were performed to evaluate renal survival. Propensity-score matching (PSM) was performed to get the matched cohort to evaluate the role of obesity in IgAN patients. Besides, the effect modification of obesity and hypertension in IgAN patients was clarified by the synergy index.

Results

IgAN patients complicated with obesity had more severe renal dysfunction at the time of renal biopsy than those with optimal body weight. In addition, patients with obesity tended to have higher risk of metabolic disorders, such as hyperuricemia (64.4% vs 37%, p<0.001), hypertriglyceridemia (71.3% vs 32.5%, p<0.001) and hypercholesterolemia (46.5% vs 35.6%, p=0.036). It was observed that obesity patients had higher rate of unhealthy behaviors, such as smoking (27.7% vs 16.4%, p=0.006) and alcohol drinking (29.7% vs 19.9%, p=0.027). Although obesity was not confirmed as an independent risk factor for IgAN patients, we found that IgAN patients with obesity presented with higher incidence of hypertension, as well as lower event-free renal survival rate (log-rank p < 0.001), especially in patients with 24-h urine protein ≥ 1g (log-rank p =0.002). In addition, the synergy index showed that there was positive interaction between obesity and hypertension in IgAN.

Conclusion

Obesity is an important risk factor for IgAN patients when combined with hypertension. Hypertension appears to be common in obese IgAN patients.
Circadian rhythm of plasminogen activator inhibitor-1 and cardiovascular complications in type 2 diabetes
Authors: Yu Yongzhuo , Li Wenxuan , Xu Lili , Wang Yangang
Published: March 2023

Cardiovascular complications are a common death cause in type 2 diabetes patients, as they are often combined. Plasminogen-activator Inhibitor 1 (PAI-1) participates in the development and progression of cardiovascular complications in diabetes. Insulin resistance increases PAI-1 production, and high PAI-1 levels lead to an environment conducive to thrombosis and earlier and more severe vascular disease. Current evidence also suggests that PAI-1 has a rhythmic profile of circadian fluctuations and acrophase in the morning within a single day, which might explain the high morning incidence of cardiovascular events. Thus, PAI-1 is a possible drug target. Although several PAI-1 inhibitors have been developed, none have yet been allowed for clinical use. Research on rhythm has also led to the concept of “chronotherapy”, a rhythm-based drug regimen expected to improve the treatment of cardiovascular complications in diabetic patients. Herein, we searched several databases and reviewed relevant articles to describe the circadian rhythm characteristics and endogenous molecular mechanisms of PAI-1, its relationship with insulin resistance, the causes of cardiovascular complications caused by PAI-1, and the current development of PAI-1 inhibitors. We also summarized the possibility of using the circadian rhythm of PAI-1 to treat cardiovascular complications in diabetic patients.
Immunotherapy for NAFLD and NAFLD-related hepatocellular carcinoma
Authors: Jeong Seogsong , Shin Woo-Young , Oh Yun Hwan
Published: March 2023

The progression of non-alcoholic fatty liver disease (NAFLD), the most common liver disease, leads to non-alcoholic steatohepatitis and hepatocellular carcinoma. Despite the increasing incidence and prevalence of NAFLD, its therapeutic and preventive strategies to lower the disease burden is limited. In recent years, immunotherapy, including anti-programmed cell death 1/programmed cell death 1 ligand 1 treatment, has emerged as a potential approach to reach satisfactory modulation for the progression of NAFLD and treatment of NAFLD-related hepatocellular carcinoma. However, the effectiveness of immunotherapy against NAFLD and NAFLD-related hepatocellular carcinoma is in the early phase and it is yet not advanced. In addition, conflicting results are being reported regarding the prognosis of patients with NAFLD-related hepatocellular carcinoma and high expression of programmed cell death 1/programmed cell death 1 ligand 1. Herein, this review will discuss and elucidate the attempts and underlying mechanisms of immunotherapy against NAFLD and NAFLD-related hepatocellular carcinoma.
Exosomes in liver fibrosis: The role of modulating hepatic stellate cells and immune cells, and prospects for clinical applications
Authors: Liu Yufei , Zheng Yuhong , Yang Yang , Liu Ke , Wu Jianying , Gao Peiyang , Zhang Chuantao
Published: March 2023

Liver fibrosis is a global health problem caused by chronic liver injury resulting from various factors. Hepatic stellate cells (HSCs) have been found to play a major role in liver fibrosis, and pathological stimuli lead to their transdifferentiation into myofibroblasts. Complex multidirectional interactions between HSCs, immune cells, and cytokines are also critical for the progression of liver fibrosis. Despite the advances in treatments for liver fibrosis, they do not meet the current medical needs. Exosomes are extracellular vesicles of 30-150 nm in diameter and are capable of intercellular transport of molecules such as lipids, proteins and nucleic acids. As an essential mediator of intercellular communication, exosomes are involved in the physiological and pathological processes of many diseases. In liver fibrosis, exosomes are involved in the pathogenesis mainly by regulating the activation of HSCs and the interaction between HSCs and immune cells. Serum-derived exosomes are promising biomarkers of liver fibrosis. Exosomes also have promising therapeutic potential in liver fibrosis. Exosomes derived from mesenchymal stem cells and other cells exhibit anti-liver fibrosis effects. Moreover, exosomes may serve as potential therapeutic targets for liver fibrosis and hold promise in becoming drug carriers for liver fibrosis treatment.
Study on the influence of magnetic field on the performance of a 5 kW hall thruster
Authors: Yang L. , Wang P. Y. , Wang T.
Published: March 2023

Hall thruster is a kind of plasma optics device, which is used mainly in space propulsion. To study the influence of magnetic field on the performance of a 5 kW hall thruster, a two-dimensional PIC-MCC model was built. The Bohm diffusion was modeled by using a Brownian motion instead of the Bohm collision method and the near-wall conduction was modeled by a secondary electron emission model. When the mass flow rate is 5 mg/s, the thruster performance like thrust, efficiency and discharge current was simulated under a discharge voltage from 300 to 1,000 voltage. At first, the performance under constant magnetic field was simulated. The results showed that the magnetic field could not restrain the electrons as the discharge voltage increased. Later, the performance under varied magnetic field was simulated. The results showed that increasing the magnetic field strength with the increasing discharge voltage could restrain the electrons more efficiently, which proved that increasing the magnetic field strength is necessary for high specific impulse operation of hall thruster. At last, the performance measurement experiment of the thruster was carried out, and the experimental results verified the accuracy of the simulation results.
Spent lithium manganate batteries for sustainable recycling: A review
Authors: Lu Xinyu , Li Zongrun , Zou Jingtian , Peng Dezhao , Hu Wenyang , Zhong Yuanyuan , Li Pengfei , Su Shilin , Wang Xiaowei , Wang Shubin , Zhao Zaowen , Zhang Jiafeng
Published: March 2023

Lithium-ion batteries (LIBs) account for the majority of energy storage devices due to their long service life, high energy density, environmentally friendly, and other characteristics. Although the cathode materials of LIB led by LiFePO4 (LFP), LiCoO2 (LCO), and LiNixCoyMn1-x-yO2 (NCM) occupy the majority of the market share at present, the demand of LiMn2O4 (LMO) cathode battery is also increasing year by year in recent years. With the rising price of various raw materials of LIBs and the need of environmental protection, the efficient recycling of spent LIBs has become a hot research topic. At present, the recycling of spent LIBs mainly focuses on LFP, LCO, and NCM batteries. However, with the continuous improvement of people’s safety of LIBs, LiMnxFe1-xPO4 (LMFP) batteries show better potential, which also improves the recycling value of LMO batteries. Therefore, this paper reviews current methods of spent LMO recovery, focusing on the characteristics of the recovery and separation process, which can serve as a reference for subsequent research on LMO recovery, increasing environmentally friendly recovery routes. Finally, the future development direction of LIBs recycling is prospected. Overall, this review is helpful to understand the current progress of LMO battery recycling.
The management of acne vulgaris in young people in primary care: A retrospective cohort study
Authors: Moosa Aminath Shiwaza , Lim Shu Fen , Koh Yi Ling Eileen , Aau Wai Keong , Tan Ngiap Chuan
Published: March 2023

Background

Acne vulgaris (acne) is common among young persons (YPs). Clinical practice guidelines are available for acne management to minimize their physical and psychological impact. However, evidence of adherence to these guidelines is sparse in primary care practices. The study aimed to determine the demographic profile of YPs who sought primary care consultations for acne, their related prescriptions and referrals to specialists for further management.

Method

A retrospective study was conducted using data from a cluster of eight public primary care clinics in Singapore. Demographic, clinical, prescription, and referral data were extracted from the electronic health records of YPs aged 10–29 years with a documented diagnosis of acne (ICD-10 classification) from 1st July 2018 to 30th June 2020. The data were reviewed, audited for eligibility criteria, and de-identified before analysis.

Results

Complete data from 2,700 YPs with acne were analyzed. Male (56.1%) YPs and those of Chinese ethnicity (73.8%) had the most frequent attendances for acne. The mean and median age at presentation was 19.2 (standard deviation = 4.3) and 19 (interquartile range = 16–22) years, respectively. Only 69.7% of YPs received an acne-related medication; 33.5% received antibiotic monotherapy; 53.0% were prescribed oral doxycycline, 35.0% acne cream (combination of sulfur, salicylic acid, and resorcinol), and 28.4% benzoyl peroxide 5% gel; 54.3% of those treated with antibiotics were prescribed with a shorter duration than recommended; 51.3% were referred to a dermatologist on their first visit, and 15.8% had more than one visit.

Conclusion

Acne management for YPs can be enhanced with refresher training among primary care physicians for better adherence to its clinical practice guidelines.
A single dose of lipopolysaccharide elicits autofluorescence in the mouse brain
Authors: Yang Yanzhuo , Yu Qingting , Li Bin , Li Shijia , Yang Zuisu , Yuan Falei , Liu Zhongliang
Published: March 2023

One hallmark of aging is autofluorescence (AF) in the brain. However, the underlying mechanism for inducing AF remains unknown. This study aims to determine the cause(s) of this phenomenon. The endogenous expression pattern of AF in mice was examined at differing ages. Intraperitoneal injection of a single dose of lipopolysaccharide (LPS) was performed to induce AF. Copper sulfate was applied to remove AF to allow for further immunofluorescence staining. AF appeared in the mouse brain as early as 3 months of age. In the cortex, AF occurs in the lysosomes of microglia, astrocytes, endothelial cells, and oligodendrocyte lineage cells and its prevalence increases with age. Interestingly, AF never occurs in the pericytes of young or aged brains. LPS administration resulted in a rapid and marked induction of brain AF, similar to the normal aging process. Finally, age-related and induced AF can be eliminated by low concentrations of copper sulfate solution. This pre-treatment is safe for aging and lineage tracing studies. These findings depict that AF in the brain could be associated with the innate immune response against Gram-negative bacteria infection.
The role of endothelial TRP channels in age-related vascular cognitive impairment and dementia
Authors: Negri Sharon , Sanford Madison , Shi Helen , Tarantini Stefano
Published: March 2023

Transient receptor potential (TRP) proteins are part of a superfamily of polymodal cation channels that can be activated by mechanical, physical, and chemical stimuli. In the vascular endothelium, TRP channels regulate two fundamental parameters: the membrane potential and the intracellular Ca2+ concentration [(Ca2+)i]. TRP channels are widely expressed in the cerebrovascular endothelium, and are emerging as important mediators of several brain microvascular functions (e.g., neurovascular coupling, endothelial function, and blood–brain barrier permeability), which become impaired with aging. Aging is the most significant risk factor for vascular cognitive impairment (VCI), and the number of individuals affected by VCI is expected to exponentially increase in the coming decades. Yet, there are currently no preventative or therapeutic treatments available against the development and progression of VCI. In this review, we discuss the involvement of endothelial TRP channels in diverse physiological processes in the brain as well as in the pathogenesis of age-related VCI to explore future potential neuroprotective strategies.
Flexible intentions: An Active Inference theory
Authors: Priorelli Matteo , Stoianov Ivilin Peev
Published: March 2023

We present a normative computational theory of how the brain may support visually-guided goal-directed actions in dynamically changing environments. It extends the Active Inference theory of cortical processing according to which the brain maintains beliefs over the environmental state, and motor control signals try to fulfill the corresponding sensory predictions. We propose that the neural circuitry in the Posterior Parietal Cortex (PPC) compute flexible intentions—or motor plans from a belief over targets—to dynamically generate goal-directed actions, and we develop a computational formalization of this process. A proof-of-concept agent embodying visual and proprioceptive sensors and an actuated upper limb was tested on target-reaching tasks. The agent behaved correctly under various conditions, including static and dynamic targets, different sensory feedbacks, sensory precisions, intention gains, and movement policies; limit conditions were individuated, too. Active Inference driven by dynamic and flexible intentions can thus support goal-directed behavior in constantly changing environments, and the PPC might putatively host its core intention mechanism. More broadly, the study provides a normative computational basis for research on goal-directed behavior in end-to-end settings and further advances mechanistic theories of active biological systems.
Fasting blood glucose-to-glycated hemoglobin ratio for evaluating clinical outcomes in patients with ischemic stroke
Authors: Shao Tengfei , Liu Hui , Yang Guochao , Wang Huan , Li Di , Ni Huanyu , Xu Yun , Zhang Jinping
Published: March 2023

Background

Stress hyperglycemia frequently occurs in patients with acute ischemic stroke (AIS). The influence of stress hyperglycemia on the outcomes of patients with AIS remains ambiguous.

Methods

Data from our institution on patients with AIS between June 2020 and June 2021 were retrospectively analyzed. The severity of the stroke was assessed using the National Institutes of Health Stroke Scale (NIHSS) at admission, and the primary endpoint was functional outcomes. Stress hyperglycemia was measured by the glucose-to-HbA1c ratio. In the multivariable analysis, two models that retained or excluded the NIHSS were adopted to explore the relationship between stress hyperglycemia and outcomes. The receiver operating characteristic curve (ROC) was calculated to determine an optimized cutoff value.

Results

The optimal cutoff value was 1.135. When all patients were included, model 1 did not find an association between the glucose-to-HbA1c ratio and functional outcomes. In model 2, the glucose-to-HbA1c ratio×10 (Glucose-to-HbA1c ratio ×10) was the independent predictor of functional outcomes (OR 1.19, 95% CI 1.07–1.33, p < 0.01). Separately, in patients without diabetes, the glucose-to-HbA1c ratio×10 was the independent predictor of functional outcomes in both model 1 (OR 1.37, 95% CI 1.08–1.73, p = 0.01) and model 2 (OR 1.48, 95% CI 1.22–1.79, p < 0.01), but not in patients with diabetes. In addition, the glucose-to-HbA1c ratio×10 was the independent predictor of stroke severity (OR 1.16, 95% CI 1.05–1.28, p < 0.01).

Conclusion

The glucose-to-HbA1c ratio was associated with more severe AIS. Specifically, the glucose-to-HbA1c ratio was associated with the functional outcomes in patients without diabetes but not in patients with diabetes.
Copeptin adaptive response to SGLT2 inhibitors in patients with type 2 diabetes mellitus: The GliRACo study
Authors: Berton Alessandro Maria , Parasiliti-Caprino Mirko , Prencipe Nunzia , Bioletto Fabio , Lopez Chiara , Bona Chiara , Caputo Marina , Rumbolo Francesca , Ponzetto Federico , Settanni Fabio , Gasco Valentina , Mengozzi Giulio , Ghigo Ezio , Grottoli Silvia , Maccario Mauro , Benso Andrea Silvio
Published: March 2023

Introduction

In type 2 diabetes mellitus (T2DM), the antidiuretic system participates in the adaptation to osmotic diuresis further increasing urinary osmolality by reducing the electrolyte-free water clearance. Sodium glucose co-transporter type 2 inhibitors (SGLT2i) emphasize this mechanism, promoting persistent glycosuria and natriuresis, but also induce a greater reduction of interstitial fluids than traditional diuretics. The preservation of osmotic homeostasis is the main task of the antidiuretic system and, in turn, intracellular dehydration the main drive to vasopressin (AVP) secretion. Copeptin is a stable fragment of the AVP precursor co-secreted with AVP in an equimolar amount.

Aim

To investigate the copeptin adaptive response to SGLT2i, as well as the induced changes in body fluid distribution in T2DM patients.

Methods

The GliRACo study was a prospective, multicenter, observational research. Twenty-six consecutive adult patients with T2DM were recruited and randomly assigned to empagliflozin or dapagliflozin treatment. Copeptin, plasma renin activity, aldosterone and natriuretic peptides were evaluated at baseline (T0) and then 30 (T30) and 90 days (T90) after SGLT2i starting. Bioelectrical impedance vector analysis (BIVA) and ambulatory blood pressure monitoring were performed at T0 and T90.

Results

Among endocrine biomarkers, only copeptin increased at T30, showing subsequent stability (7.5 pmol/L at T0, 9.8 pmol/L at T30, 9.5 pmol/L at T90; p = 0.001). BIVA recorded an overall tendency to dehydration at T90 with a stable proportion between extra- and intracellular fluid volumes. Twelve patients (46.1%) had a BIVA overhydration pattern at baseline and 7 of them (58.3%) resolved this condition at T90. Total body water content, extra and intracellular fluid changes were significantly affected by the underlying overhydration condition (p < 0.001), while copeptin did not.

Conclusion

In patients with T2DM, SGLT2i promote the release of AVP, thus compensating for persistent osmotic diuresis. This mainly occurs because of a proportional dehydration process between intra and extracellular fluid (i.e., intracellular dehydration rather than extracellular dehydration). The extent of fluid reduction, but not the copeptin response, is affected by the patient’s baseline volume conditions.

Clinical trial registration

Clinicaltrials.gov, identifier NCT03917758.
Spatial-dependent suppressive aftereffect produced by a sound in the rat’s inferior colliculus is partially dependent on local inhibition
Authors: Asim Syed Anam , Tran Sarah , Reynolds Nicholas , Sauve Olivia , Zhang Huiming
Published: March 2023

In a natural acoustic environment, a preceding sound can suppress the perception of a succeeding sound which can lead to auditory phenomena such as forward masking and the precedence effect. The degree of suppression is dependent on the relationship between the sounds in sound quality, timing, and location. Correlates of such phenomena exist in sound-elicited activities of neurons in hearing-related brain structures. The present study recorded responses to pairs of leading-trailing sounds from ensembles of neurons in the rat’s inferior colliculus. Results indicated that a leading sound produced a suppressive aftereffect on the response to a trailing sound when the two sounds were colocalized at the ear contralateral to the site of recording (i.e., the ear that drives excitatory inputs to the inferior colliculus). The degree of suppression was reduced when the time gap between the two sounds was increased or when the leading sound was relocated to an azimuth at or close to the ipsilateral ear. Local blockage of the type-A γ-aminobutyric acid receptor partially reduced the suppressive aftereffect when a leading sound was at the contralateral ear but not at the ipsilateral ear. Local blockage of the glycine receptor partially reduced the suppressive aftereffect regardless of the location of the leading sound. Results suggest that a sound-elicited suppressive aftereffect in the inferior colliculus is partly dependent on local interaction between excitatory and inhibitory inputs which likely involves those from brainstem structures such as the superior paraolivary nucleus. These results are important for understanding neural mechanisms underlying hearing in a multiple-sound environment.
Tumor grade-associated genomic mutations in Chinese patients with non-small cell lung cancer
Authors: Wang Yang , Qin Shilei , Liang Yuepei , Yan Ling , Zheng Min , Zeng Yanwu , Lu Leilei
Published: March 2023

Background

Lung cancer is the most prevalent cancer worldwide and accounts for approximately 20% of cancer-related death in China every year. High-grade lung cancer poses a significant threat to patients, and developing a novel treatment for these patients requires an understanding of its underlying mechanism.

Methods

Chinese patients with lung cancer were enrolled. The tumor samples were collected by surgery or puncture and applied for next-generation sequencing. A panel of pan-cancer genes was targeted, and the sequencing depth was set to over 1,000 to improve the sensitivity of detecting mutations. Short-length mutations (substitution, insertion, and deletion), copy number variation, and gene fusion were called. Gene mutations were compared between low-grade, middle-grade, and high-grade tumors using Fisher’s exact test. The enriched pathways in each grade of tumors were also inferred.

Results

The study included 173 Chinese patients with non-small cell lung cancer, of whom 98 (56.6%) patients were female and 75 (43.4%) were male, with a mean age of 56.8 years. All patients were microsatellite stable; 66.4% were at the early stages (Stages 0, I, and II) with a tumor mutational burden of approximately 2.5 (confidence interval = [0, 48.3]). Compared to low-grade tumors, high-grade tumors had a significantly higher percentage of mutations in TP53 (75.9% vs 34.4%, p = 1.86e-3) and PIK3CA (24.1% vs. 0%, p = 3.58e-3). Pathway analysis found that high-grade tumors were enriched with mutations in bacterial invasion of epithelial cells (31% vs. 0%, p = 5.8e-4), Epstein–Barr virus infection (79.3% vs. 37.5%, p = 1.72e-3), and the Wnt signaling pathway (75.9% vs. 34.4%, p = 1.91e-3). High-grade tumors had a significantly higher tumor mutational burden than low-grade tumors (p-value = 0.0017). However, actionable mutations with high-level evidence were lower in high-grade tumors.

Conclusion

Patients with high-grade tumors from lung cancer may be more affected by bacteria and Epstein–Barr virus than low-grade tumors. High-grade tumors were specially mutated in TP53 and PIK3CA and may benefit more from immunotherapy. Further research on the underlying mechanism of high-grade lung cancer is necessary to develop new therapeutic options. Lung cancer, tumor grade, genomic mutations, Epstein–Barr virus, pathway analysis
Time interval from diagnosis to treatment of brain metastases with stereotactic radiosurgery is not associated with radionecrosis or local failure
Authors: Leu Justin , Akerman Meredith , Mendez Christopher , Lischalk Jonathan W. , Carpenter Todd , Ebling David , Haas Jonathan A. , Witten Matthew , Barbaro Marissa , Duic Paul , Tessler Lee , Repka Michael C.
Published: March 2023

Introduction

Brain metastases are the most common intracranial tumor diagnosed in adults. In patients treated with stereotactic radiosurgery, the incidence of post-treatment radionecrosis appears to be rising, which has been attributed to improved patient survival as well as novel systemic treatments. The impacts of concomitant immunotherapy and the interval between diagnosis and treatment on patient outcomes are unclear.

Methods

This single institution, retrospective study consisted of patients who received single or multi-fraction stereotactic radiosurgery for intact brain metastases. Exclusion criteria included neurosurgical resection prior to treatment and treatment of non-malignant histologies or primary central nervous system malignancies. A univariate screen was implemented to determine which factors were associated with radionecrosis. The chi-square test or Fisher’s exact test was used to compare the two groups for categorical variables, and the two-sample t-test or Mann-Whitney test was used for continuous data. Those factors that appeared to be associated with radionecrosis on univariate analyses were included in a multivariable model. Univariable and multivariable Cox proportional hazards models were used to assess potential predictors of time to local failure and time to regional failure.

Results

A total of 107 evaluable patients with a total of 256 individual brain metastases were identified. The majority of metastases were non-small cell lung cancer (58.98%), followed by breast cancer (16.02%). Multivariable analyses demonstrated increased risk of radionecrosis with increasing MRI maximum axial dimension (OR 1.10, p=0.0123) and a history of previous whole brain radiation therapy (OR 3.48, p=0.0243). Receipt of stereotactic radiosurgery with concurrent immunotherapy was associated with a decreased risk of local failure (HR 0.31, p=0.0159). Time interval between diagnostic MRI and first treatment, time interval between CT simulation and first treatment, and concurrent immunotherapy had no impact on incidence of radionecrosis or regional failure.

Discussion

An optimal time interval between diagnosis and treatment for intact brain metastases that minimizes radionecrosis and maximizes local and regional control could not be identified. Concurrent immunotherapy does not appear to increase the risk of radionecrosis and may improve local control. These data further support the safety and synergistic efficacy of stereotactic radiosurgery with concurrent immunotherapy.
Urinary KIM-1 is not correlated with gestational age among 5-year-old children born prematurely
Authors: Restrepo Jaime M. , Torres-Canchala Laura , Bonventre Joseph V. , Arias Juan C. , Ferguson Michael , Villegas Adriana , Ramirez Oscar , Filler Guido
Published: March 2023

Background

Preterm birth is associated with decreased nephron endowment. Currently, there is no reliable non-invasive biomarker to identify or monitor decreased nephron number in at-risk patients. Urinary Kidney Injury Molecule-1 (KIM-1) is a biomarker of acute and chronic renal injury. We measured urinary KIM-1 among a wide array of other potential biomarkers.

Methods

We conducted an ambispective cohort study of 5-years-old children born prematurely and healthy controls identified from city schools. Detailed anthropometrics, renal ultrasound dimensions, and biochemical parameters were measured. Urinary KIM-1 was measured using Luminex® technology. Age independent z-scores were calculated and compared. Spearman correlations were used for estimating the association between measures and KIM-1.

Results

We enrolled 129 children, 97 (75.2%) born pre-term and 32 (24.8%) healthy controls born at full-term. Pre-term patients had significantly lower weight and body surface area than controls. Pre-term patients and controls did not differ in current age, sex, race, height, blood pressure, urinary sodium, fractional sodium excretion, serum creatinine and estimated GFR. All spearman correlation between KIM-1 and gestational age, renal and serum measurements were weak without statistical significance

Conclusion

In 5-year-old children born prematurely, KIM-1 was not correlated with gestational age. Further prospective studies need to confirm this finding.
Outcomes of and factors associated with the development of bronchopulmonary dysplasia with pulmonary hypertension in very low birth weight infants: A retrospective study in a medical center
Authors: Chang Han-Pi , Lien Reyin , Chu Shih-Ming , Lin Jainn-Jim , Chiang Ming-Chou
Published: March 2023

Introduction

Bronchopulmonary dysplasia (BPD) with pulmonary hypertension (PH) leads to increased morbidity and mortality in extremely preterm infants. Recent studies have analyzed factors associated with development of PH in BPD; however, this research remains inconclusive, and controversy exists regarding the correlation between BPD and PH. This study aimed to investigate potential associated factors, clinical characteristics, and outcomes of BPD with pulmonary hypertension in very low birth weight (VLBW) preterm infants.

Methods

We conducted a retrospective study, reviewing the records of infants with gestational age (GA) <32 weeks and birth weight <1,500 g admitted to a tertiary neonatal intensive care unit between January 2020 and October 2021 who were diagnosed with moderate to severe BPD. Echocardiogram was performed at the postmenstrual age of 36 weeks or before discharge. The diagnosis of PH was based on the findings of echocardiogram. Prenatal and postnatal characteristics, demographic data, treatment details, and outcomes were collected and analyzed.

Results

A total of 139 VLBW infants with BPD were enrolled and divided into a PH group (n = 25) and a non-PH group (n = 114). The mean GA was 27.3 ± 2.3 weeks and the mean birth weight of infants with BPD was 927.3 ± 293.3 g. A multivariate logistic regression model revealed that a high positive end-expiratory pressure (PEEP) setting (OR: 2.105; 95% CI: 1.472–3.011; p < 0.001) in established BPD and surgical closure of patent ductus arteriosus (PDA; OR: 6.273; 95% CI: 1.574–24.977; p = 0.009) were associated with BPD–PH. Neonates with BPD who developed pulmonary hypertension remained hospitalized for longer (p < 0.001), received invasive mechanical ventilation support for longer (p < 0.001), had a higher incidence of retinopathy of prematurity (ROP; OR: 4.201; 95% CI: 1.561–11.304; p = 0.003), were more likely to require oxygen support at discharge (OR: 5.600; 95% CI: 2.175–14.416; p < 0.001), and were more likely to undergo tracheostomy (OR: 35.368; 95% CI: 4.03–310.43; p < 0.001).

Conclusion

PDA ligation and a higher PEEP setting were associated with BPD–PH in our cohort study. Compared with VLBW infants with BPD but without PH, infants with BPD and PH were hospitalized for longer, and also had a higher incidence of oxygen support after discharge, ROP, and tracheostomy.
Complete and incomplete Kawasaki disease: Clinical differences and coronary artery outcome from a national prospective surveillance study in Switzerland
Authors: Bressieux-Degueldre S. , Gradoux E. , Di Bernardo S. , Sekarski N.
Published: March 2023

Introduction

The aim of this national prospective surveillance study was to compare the clinical presentation, laboratory findings, treatment, and coronary artery outcome in patients with incomplete and complete Kawasaki disease (KD).

Methods

Between March 2013 and February 2019, children with a diagnosis of complete and incomplete KD were reported by the Swiss Paediatric Surveillance Unit and prospectively enrolled. Clinical data, laboratory values, treatment, and echocardiographic features were collected at diagnosis and 1 year of follow-up. Data were compared between children with complete or incomplete KD.

Results

A total of 351 questionnaires were registered from children with a diagnosis of KD. Of them, 219 (62.4%) children had complete KD, and 132 (37.6%) children had incomplete KD. Children with incomplete KD were younger and had a longer-lasting fever; however, there were no differences in the level of C-reactive protein. All but four children received intravenous immunoglobulin treatment, whereas 14% of children were treated with corticosteroids. Children with incomplete KD were more often treated with corticosteroids than children with incomplete KD (p = 0.01). At diagnosis, 39 (11.1%) patients had only coronary artery dilation and 57 (16.2%) had at least one coronary artery aneurysm. There were no differences in coronary artery involvement between the two groups. At follow-up, 273 of 294 (92.8%) patients had no coronary artery involvement, with no difference between the two groups (p = 0.609). The overall incidence of coronary artery aneurysms at diagnosis was 16.2%. At follow-up, most coronary artery aneurysms had regressed, and coronary artery aneurysms were present in only 5.8% of the patients. Coronary artery aneurysms were slightly more frequent in patients with incomplete KD at follow-up (p = 0.039) but not at diagnosis (p = 0.208).

Conclusion

Although the clinical presentation in children with incomplete and complete KD differs, the absence of coronary artery involvement does not. The use of corticosteroids appears to be preventive against the development of coronary artery aneurysms in these patients. However, the results of this study suggest a lower rate of coronary artery aneurysm regression in patients with incomplete KD. Further studies on a larger scale are needed to assess the risk of non-regression of coronary artery aneurysms in this particular group of patients.