bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of longitudinal clinical outcomes after acute myocardial infarction using a dynamic machine learning algorithm
Authors: Jeong Joo Hee , Lee Kwang-Sig , Park Seong-Mi , Kim So Ree , Kim Mi-Na , Chae Shung Chull , Hur Seung-Ho , Seong In Whan , Oh Seok Kyu , Ahn Tae Hoon , Jeong Myung Ho
Published: April 2024

Several regression-based models for predicting outcomes after acute myocardial infarction (AMI) have been developed. However, prediction models that encompass diverse patient-related factors over time are limited. This study aimed to develop a machine learning-based model to predict longitudinal outcomes after AMI. This study was based on a nationwide prospective registry of AMI in Korea (n = 13,104). Seventy-seven predictor candidates from prehospitalization to 1 year of follow-up were included, and six machine learning approaches were analyzed. Primary outcome was defined as 1-year all-cause death. Secondary outcomes included all-cause deaths, cardiovascular deaths, and major adverse cardiovascular event (MACE) at the 1-year and 3-year follow-ups. Random forest resulted best performance in predicting the primary outcome, exhibiting a 99.6% accuracy along with an area under the receiver-operating characteristic curve of 0.874. Top 10 predictors for the primary outcome included peak troponin-I (variable importance value = 0.048), in-hospital duration (0.047), total cholesterol (0.047), maintenance of antiplatelet at 1 year (0.045), coronary lesion classification (0.043), N-terminal pro-brain natriuretic peptide levels (0.039), body mass index (BMI) (0.037), door-to-balloon time (0.035), vascular approach (0.033), and use of glycoprotein IIb/IIIa inhibitor (0.032). Notably, BMI was identified as one of the most important predictors of major outcomes after AMI. BMI revealed distinct effects on each outcome, highlighting a U-shaped influence on 1-year and 3-year MACE and 3-year all-cause death. Diverse time-dependent variables from prehospitalization to the postdischarge period influenced the major outcomes after AMI. Understanding the complexity and dynamic associations of risk factors may facilitate clinical interventions in patients with AMI.
Effect of anticoagulation on the incidence of venous thromboembolism, major bleeding, and mortality among hospitalized COVID-19 patients: an updated meta-analysis
Authors: Chen Xinwang , Zhang Suyun , Liu Haiyu , Zhang Qianyuan , Chen Jinghan , Zheng Qixian , Guo Ningjing , Cai Yuanyuan , Luo Qiong , Xu Qian , Yang Sheng , Chen Xiangqi
Published: April 2024

Objective

Anticoagulation is crucial for patients hospitalized with coronavirus disease 2019 (COVID-19) due to the high risk of venous thromboembolism (VTE). However, the optimal anticoagulation regimen needs further exploration. Therefore, we evaluated the efficacy and safety of diverse anticoagulation dosage dosages for COVID-19.

Methods

An updated meta-analysis was performed to assess the effect of thromboprophylaxis (standard, intermediate, and therapeutic dose) on the incidence of VTE, mortality and major bleeding among COVID-19 patients. Literature was searched via PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure (CNKI) database. The odds ratio (OR) and 95% confidence interval (CI) were calculated for effect estimates.

Results

Nineteen studies involving 25,289 participants without VTE history were included. The mean age of patients was 59.3 years old. About 50.96% were admitted to the intensive care unit. In the pooled analysis, both therapeutic-dose and intermediate-dose anticoagulation did not have a significant advantage in reducing VTE risk over standard dosage (OR = 1.09, 95% CI: 0.58–2.02, and OR = 0.89, 95% CI: 0.70–1.12, respectively). Similarly, all-cause mortality was not further decreased in either therapeutic-dose group (OR = 1.12, 95% CI: 0.75–1.67) or intermediate-dose group (OR = 1.34, 95% CI: 0.83–2.17). While the major bleeding risk was significantly elevated in the therapeutic-dose group (OR = 2.59, 95%CI: 1.87–3.57) as compared with the standard-dose regimen. Compared with intermediate dosage, therapeutic anticoagulation did not reduce consequent VTE risk (OR = 0.85, 95% CI: 0.52–1.38) and all-cause mortality (OR = 0.84, 95% CI: 0.60–1.17), but significantly increased major bleeding rate (OR = 2.42, 95% CI: 1.58–3.70). In subgroup analysis of patients older than 65 years, therapeutic anticoagulation significantly lowered the incidence of VTE in comparation comparison with standard thromboprophylaxis, however, at the cost of elevated risk of major bleeding.

Conclusion

Our results indicated that for most hospitalized patients with COVID-19, standard-dose prophylactic anticoagulation might be the optimal choice. For elderly patients at low risk of bleeding, therapeutic-dose anticoagulation could further reduce VTE risk and should be considered especially when there were other strong risk factors of VTE during hospital stay.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO, identifier, CRD42023388429.
Study on soil pressure of loose soil in cohesive soil tunnel considering soil arch effect
Authors: Dai Hongtao , Sun Yang , Rong Yao , Yu Junping , Wu Jiangpeng , Zhang Yongjun
Published: April 2024

Soil pressure in clay formation tunnels is closely related to soil arch effect and the development of slip surfaces. Firstly, numerical simulation software is used to simulate the actual situation of tunnel excavation, and the change rule of the slip-cracking surface of cohesive soil is analyzed. Secondly, based on the numerical simulation results and the ellipsoid theory, the pressure formula of Terzaghi loose Earth is modified considering that the principal stress trace is catenary. Finally, the calculation results are compared with the finite element calculation results to verify the rationality of the formula in this paper. The relationship between the internal friction angle, cohesion force c, eccentricity ε, looseness coefficient β, and the pressure of loose Earth is further studied. The results show that there is a gap between the sliding crack angles with or without dilatancy angle and it will affect the development form of soil arch. The slip angle decreases gradually with the increase of the buried depth ratio H/D and becomes stable when the buried depth ratio H/D≥3. Compared with deep-buried tunnels, the increase of internal friction angle in the shallow-buried tunnel is more conducive to reducing the overlying soil pressure. The loose soil pressure decreases with the increase of eccentricity ε and loose coefficient β, and the influence of eccentricity ε on loose soil pressure is significantly greater than that of loose coefficient β. Therefore, the change of eccentricity ε should be paid close attention in the project.
A systematic review of transparency in Lesson Study research: how do we report on the observation and reflection stages?
Authors: Kager Klara , Kalinowski Eva , Jurczok Anne , Vock Miriam
Published: April 2024

Lesson Study is a method of professional development for teachers that has gained traction in recent decades. However, publications routinely fail to describe crucial details of the implementation or to link the mechanisms that facilitate teachers learning in Lesson Study to theory. This makes it difficult to meaningfully synthesize and replicate research findings. Using a protocol based on three dimensions of transparency, this systematic review examines 129 articles on Lesson Study published between 2015 and 2020 to identify how transparent they were in their reporting of how teachers observed and reflected together. The findings indicate a lack of transparency across several dimensions of how the Lesson Study intervention is reported and highlight a current lack of theorization and coherence in the field. To address some of these issues, we propose a framing structure that empirical papers on Lesson Study should give critical attention to in order to ensure relevance and transferability.
Culturally responsive leadership: a critical analysis of one school district’s five-year plan
Authors: Mansfield Katherine Cumings , Lambrinou Marina
Published: April 2024

Centering the need for culturally responsive leadership (CRL), this study engages in a critical analysis of one large urban school district’s 5-year plan that aims to be culturally responsive and equity focused. We first define the various facets of CRL, connect its major components to culturally responsive teaching/pedagogy (CRTP) and student voice (SV), and offer an original, integrative framework as a tool for analysis. We argue that CRL is not enough on its own and needs more than the commitment of principals to reach its maximum potential. We also provide recommendations on what needs to happen to make culturally responsive schooling a reality for students and their communities.
Overview of the expression patterns and roles of Lipocalin 2 in the reproductive system
Authors: Krizanac Marinela , Mass Sanchez Paola Berenice , Weiskirchen Ralf , Schröder Sarah K.
Published: April 2024

The 25 kDa-sized protein Lipocalin 2 (LCN2) was originally isolated from human neutrophil granulocytes more than 30 years ago. LCN2 is an emerging player in innate immune defense, as it reduces bacterial growth due to its ability to sequester iron-containing bacterial siderophores. On the other hand, LCN2 also serves as a transporter for various hydrophobic substances due to its β-barrel shaped structure. Over the years, LCN2 has been detected in many other cell types including epithelial cells, astrocytes, and hepatocytes. Studies have clearly shown that aberrant expression of LCN2 is associated with a variety of disorders and malignancies, including several diseases of the reproductive system. Furthermore, LCN2 was proposed as a non-invasive prognostic and/or diagnostic biomarker in this context. Although several studies have shed light on the role of LCN2 in various disorders of the female and male reproductive systems, including tumorigenesis, a comprehensive understanding of the physiological function of LCN2 in the reproductive tract is still lacking. However, there is evidence that LCN2 is directly related to fertility, as global depletion of Lcn2 in mice has a negative effect on their pregnancy rate. Since LCN2 expression can be regulated by steroid hormones, it is not surprising that its expression fluctuates greatly during remodeling processes in the female reproductive tract, especially in the uterus. Well-founded details about the expression and regulation of LCN2 in a healthy reproductive state and also about possible changes during reproductive aging could contribute to a better understanding of LCN2 as a target in various diseases. Therefore, the present review summarizes current knowledge about LCN2 in the reproductive system, including studies in rodents and humans, and discusses changes in LCN2 expression during pathological events. The limited data suggest that LCN2 is expressed and regulated differently in healthy male and female reproductive organs.
Application of improved graph convolutional networks in daily-ahead carbon emission prediction
Authors: Pan Feng , Yang Yuyao , Ji Yilin , Li Jinli , Zhang Jun , Zhong Lihua
Published: April 2024

With the increasing complexity of power systems and the proliferation of renewable energy sources, the task of calculating carbon emissions has become increasingly challenging. To address these challenges, we developed a new method for predicting carbon emission factors. Bayesian optimization technique graphical convolutional networks with long- and short-term network (BO-TGNN) is used to predict the carbon emissions of the power system. The method aims to quickly predict the day-ahead carbon emissions of power system nodes with enhanced feature extraction and optimized network training hyperparameters. The effectiveness of the proposed method is demonstrated through simulation tests on three different power systems using four deep learning algorithms. The method provides a tailored solution to the evolving needs of carbon reduction efforts and is a significant step forward in addressing the complexity of carbon emission calculations for modern power systems.
Optimization of VAWT installation with spatial and temporal complexity considerations
Authors: Alqahtani Mohammed
Published: April 2024

The constant need for fuel to meet the commercial sector’s ever-increasing demand has driven researchers to discover and optimize renewable energy resources, paving the way for sustainable production of reliable and clean energy resources. The goal of the current work is to close the gap in process parameter optimization needed to convert wind energy wake from traffic on highways into electrical energy utilizing vertical-axis wind turbines (VAWTs). The energy output from the VAWT is analyzed to investigate how it is impacted by the variations in multiple parameter settings. Using the central composite design (CCD), a three-level four-factor array was used to investigate the following parameters: VAWT vertical distance (VD) and horizontal distance (HD) as continuous parameters, while road side (S) and location (L) of VAWT as categorical parameters. To find the most important parameter, response surface methodology (RSM) optimization and an analysis of variance (ANOVA) test are performed. L accounts for 66.67% of the total variable, with S coming in second with 51.80%. Using the best results from RSM and ANOVA, a confirmation test is run, and the results show yields of 88.75% ± 0.05% and 87.5% ± 0.05%, respectively. Therefore, RSM and ANOVA can be utilized equally for optimization at the same VAWT design. Lastly, the findings of the economic and environmental evaluation demonstrate that, in comparison to the basic settings, VAWT operating at optimal settings can save up to 180% and 200% more energy and reduce carbon emissions, respectively.
Minor straw return enhances net income in a maize-wheat rotation system
Authors: Li Juan , Guo Zhen , Ye Shenglan
Published: April 2024

Straw returning to the field is a common agricultural practice in China. Nevertheless, in the maize-wheat rotation system of the semi-arid region in Northwest China, it is essential to investigate the optimal approach for coupling straw return and fertilization in order to enhance soil quality and crop yield. A field trial conducted in the semi-arid region of northwest China from 2019 to 2021 examined eight different combinations of straw return and fertilization rates. The results indicated that while straw return had minimal impact on soil total nitrogen in the 0–60 cm layer, it did increase soil available phosphorus and potassium in the 0–40 cm layer. Additionally, all straw return treatments notably improved soil organic matter and humus content compared to the untreated control (CK). Specifically, applying N and P fertilizers in combination with returning 1/3 of the straw (NP+1/3S) produced in that season significantly boosted soil organic matter and humus content compared to the CK. Moreover, the NP+1/3S treatment led to a substantial enhancement in the grain yield of wheat and maize, as well as their yield components, including an increase in the number of ears/spikes per square meter, the number of grains per ear/spike, and the 100 or 1000-grain weight. The results may be attributed to a combination of factors, including improved nutrient availability, enhanced soil structure, and increased microbial activity due to the incorporation of straw. Economic analysis showed that NP+1/3S had the highest production to investment ratio (ROI), indicating its potential suitability for the region. This study highlights the significance of carefully selecting combinations of straw return and fertilization to maximize soil fertility, crop yield, and economic benefits in agricultural systems.
Can low-carbon city pilot policies improve urban energy efficiency? evidence from a quasi-natural experiment in China
Authors: Cheng Fangfang , Guo Feng , Tang Jiaomei , Liu Junxia
Published: April 2024

In the context of global efforts to alleviate climate change, this study focuses on investigating the significance and impact of low-carbon city pilot policies (LCCPP), a key strategy in the reduction of greenhouse gas emissions. Drawing on data from prefecture-level cities spanning 2004 to 2019, the study explores the potential of LCCPP in enhancing green total factor energy efficiency (GTFEE) employing a multitemporal Difference-in-Differences (DID) model and examines its transmission mechanisms. First, LCCPP is shown to be effective in enhancing GTFEE. Second, heterogeneity testing indicates that the impact of LCCPP on GTFEE is more pronounced in “two control zones”, namely, in developing and mature resource cities. Third, industrial restructuring is identified as the key mechanism through which LCCPP influences GTFEE.
Life cycle assessment approach of silviculture and timber harvesting of Norway spruce – a case study in the Czech Republic
Authors: Hájek Miroslav , Pulkrab Karel , Purwestri Ratna Chrismiari , Tichá Marie , Paduchová Martina
Published: April 2024

Compared to other sectors, the long rotation period in forest management makes it difficult to carry out a life cycle assessment (LCA). Data collection is not possible in a short time frame but would require decades. For this reason, forestry is often forced to rely on secondary data. To address this challenge, environmental impacts of the forestry sector in the Czech Republic were investigated according to the value chain corresponding to silvicultural and harvesting processes, without any further wood use options. The methodological procedure is based on the ISO 14040 and 14,044 standards, using SimaPro, an LCA software. The study was carried out in four phases of LCA in the scope of cradle-to-gate and focused on the early stages of the product life cycle. The system boundaries were set up to include seed collection, seedling production, establishment and tending of young forest stands up to 20 years of age, thinning, harvesting, maintenance of roads and extraction trails, with the endpoint is the hauling place. Three scenarios have been defined that differ in the method of harvesting. Scenario I– chainsaw felling, horse extraction. Scenario II– chainsaw (90% of hours worked) and harvester (10% of hour-worked), tractor extraction. Scenario III– chainsaw (23% of hour-worked) and harvester (77% of hour-worked), extraction by a tractor with a winch. The results show that the maintenance of the forest road network holds a significant share of the overall environmental impact of forest management. Other significant consequences are associated with timber harvesting. These impacts vary considerably depending on the mechanical equipment used. The highest impact was recorded for the third scenario, still, it is practically the most often applied, as it is the most cost-effective. The results show the need to optimize forest management practices in the future both from an economic and environmental point of view. The work on the life cycle assessment was particularly challenging because the silviculture and harvesting of raw timber involve 20 production operations. This research was based on long-term knowledge of forest typology, forest management planning, forest economics, experience with forest technologies, and regulatory measures. Thus, the findings serve for further analysis of LCA in timber production, and future analysis for other forest ecosystem services.
TMBcalc: a computational pipeline for identifying pan-cancer Tumor Mutational Burden gene signatures
Authors: Privitera Grete Francesca , Alaimo Salvatore , Caruso Anna , Ferro Alfredo , Forte Stefano , Pulvirenti Alfredo
Published: April 2024

Background:

In the precision medicine era, identifying predictive factors to select patients most likely to benefit from treatment with immunological agents is a crucial and open challenge in oncology.

Methods:

This paper presents a pan-cancer analysis of Tumor Mutational Burden (TMB). We developed a novel computational pipeline, TMBcalc, to calculate the TMB. Our methodology can identify small and reliable gene signatures to estimate TMB from custom targeted-sequencing panels. For this purpose, our pipeline has been trained on top of 17 cancer types data obtained from TCGA.

Results:

Our results show that TMB, computed through the identified signature, strongly correlates with TMB obtained from whole-exome sequencing (WES).

Conclusion:

We have rigorously analyzed the effectiveness of our methodology on top of several independent datasets. In particular we conducted a comprehensive testing on: (i) 126 samples sourced from the TCGA database; few independent whole-exome sequencing (WES) datasets linked to colon, breast, and liver cancers, all acquired from the EGA and the ICGC Data Portal. This rigorous evaluation clearly highlights the robustness and practicality of our approach, positioning it as a promising avenue for driving substantial progress within the realm of clinical practice.
Mucosal immunization with a low-energy electron inactivated respiratory syncytial virus vaccine protects mice without Th2 immune bias
Authors: Eberlein Valentina , Rosencrantz Sophia , Finkensieper Julia , Besecke Joana Kira , Mansuroglu Yaser , Kamp Jan-Christopher , Lange Franziska , Dressman Jennifer , Schopf Simone , Hesse Christina , Thoma Martin , Fertey Jasmin , Ulbert Sebastian , Grunwald Thomas
Published: April 2024

The respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections associated with numerous hospitalizations. Recently, intramuscular (i.m.) vaccines against RSV have been approved for elderly and pregnant women. Noninvasive mucosal vaccination, e.g., by inhalation, offers an alternative against respiratory pathogens like RSV. Effective mucosal vaccines induce local immune responses, potentially resulting in the efficient and fast elimination of respiratory viruses after natural infection. To investigate this immune response to an RSV challenge, low-energy electron inactivated RSV (LEEI-RSV) was formulated with phosphatidylcholine-liposomes (PC-LEEI-RSV) or 1,2-dioleoyl-3-trimethylammonium-propane and 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DD-LEEI-RSV) for vaccination of mice intranasally. As controls, LEEI-RSV and formalin-inactivated-RSV (FI-RSV) were used via i.m. vaccination. The RSV-specific immunogenicity of the different vaccines and their protective efficacy were analyzed. RSV-specific IgA antibodies and a statistically significant reduction in viral load upon challenge were detected in mucosal DD-LEEI-RSV-vaccinated animals. Alhydrogel-adjuvanted LEEI-RSV i.m. showed a Th2-bias with enhanced IgE, eosinophils, and lung histopathology comparable to FI-RSV. These effects were absent when applying the mucosal vaccines highlighting the potential of DD-LEEI-RSV as an RSV vaccine candidate and the improved performance of this mucosal vaccine candidate.
Exploring barriers and educational needs in implementing dual-task training for Parkinson’s disease: insights from professionals
Authors: Domingos Josefa , Dean John , Fernandes Júlio Belo , Família Carlos , Fernandes Sónia , Godinho Catarina
Published: April 2024

Introduction

There is growing evidence suggesting that dual-task training benefits people with Parkinson’s disease (PD) on both physical and cognitive outcomes. However, there is no known data regarding professionals’ educational needs and barriers to its implementation. This study aimed to explore the barriers and educational needs of healthcare and exercise professionals to integrate dual-task training into their practice with people with PD.

Methods

We conducted a study based on a web survey. Social media channels were used to recruit a convenience sample of exercise and healthcare professionals working with people with PD.

Results

Of the 185 eligible responses, the majority were physiotherapists (68.1%) followed by occupational therapists (10.8%). Most participants attended Parkinson specific training (88.6%) and employed the treatments set up in individual one on-one sessions (58.9%). We identified several barriers to dual-task training implementation, with lack of time (to prepare materials), staying creative and/ or accessing new ideas, unreliable tools for measuring gains, and insufficient expertise as the most referred by participants. The educational needs most referred included accessing examples of interventions in general, knowing what strategies to apply and their application for people with different symptoms.

Discussion

Our results highlight that professionals remain challenged to integrate dualtask training into PD clinical care mainly due to knowledge gaps, difficulties in accessing new ideas, and lack of time.
Effects of vaginal progesterone and placebo on preterm birth and antenatal outcomes in women with singleton pregnancies and short cervix on ultrasound: a meta-analysis
Authors: Peng Limin , Gao Yan , Yuan Chengkun , Kuang Hongying
Published: April 2024

Background

Vaginal progesterone in preterm birth and adverse outcomes caused by cervical insufficiency remains controversial. To address it, the effect of vaginal progesterone on preterm delivery and perinatal outcome of single pregnancy women with short cervix (less than 25 mm) was systematically evaluated by meta-analysis.

Methods

“Vaginal progesterone,” “placebo,” “ultrasound,” “cervix,” “singleton pregnancy,” “preterm birth,” and “antenatal outcomes” were entered to screen clinical studies PubMed, Embase, and the Chinese Biomedical Literature Database (CBM). The study population consisted of women with singleton pregnancies and a short cervix on ultrasound, and were assigned into the progesterone group (n = 1,368) and the placebo group (n = 1,373). Treatment began after the patient was diagnosed with short cervix until delivery. Neonatal survival rate, Neonatal Intensive Care Unit (NICU) admission rate, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), neonatal mortality, and birth weight <1,500 g were analyzed.

Results

A total of 8 articles, totaling 2,741 study subjects, were enrolled. The progesterone group exhibited an obvious reduced rate of preterm birth at <34 weeks (OR = 0.67, 95% CI: 0.53∼0.84; Z = 3.53, P = 0.004), preterm birth at <32 weeks (OR = 0.46, 95% CI: 0.28∼0.77; Z = 2.99, P = 0.003), NICU admission rate (OR = 0.45, 95% CI: 0.30∼0.66; Z = 0.15, P < 0.0001), RDS rate (OR = 0.42, 95% CI: 0.28∼0.63; Z = 4.25, P < 0.0001), IVH incidence rate (OR = 0.40, 95% CI: 0.17∼0.95; Z = 2.08, P = 0.04), neonatal mortality (OR = 0.25, 95% CI: 0.13∼0.46; Z = 4.39, P < 0.0001), and proportion of neonates with birth weight < 1,500 g (OR = 0.45, 95% CI: 0.32∼0.64; Z = 4.50, P < 0.0001).

Conclusion

Vaginal progesterone lowered the incidences of preterm birth and adverse pregnancy outcomes in women with singleton pregnancies and a short cervix.
Membrane stripping in group B streptococcus carriers does not impede adequate intrapartum antibiotic prophylaxis: a retrospective study
Authors: Kabiri Doron , Paltiel Ora , Ofek-shlomai Noa , Nir-Paz Ran , Sompolinsky Yishai , Ezra Yossef
Published: April 2024

Objective

Membrane stripping in group B streptococcus (GBS) carriers poses an increased risk of inadequate antibiotic prophylaxis, potentially due to accelerated labor, thereby potentially impacting the management of GBS colonization during delivery. We compared the adequacy of intrapartum antibiotic prophylaxis between pregnant women colonized with GBS, who underwent membrane stripping and those who did not. The study aimed to determine whether the performance of membrane stripping, by potentially shortening labor duration, increases the risk of inadequate antibiotic prophylaxis dispensation.

Study design

A retrospective cohort study was conducted on GBS screen-positive women with a full-term singleton pregnancy in cephalic presentation, who were eligible for vaginal delivery. The exposed group consisted of women who underwent membrane stripping, while the unexposed group consisted of women who did not undergo membrane stripping. The primary outcome was defined as inadequate duration of antibiotic prophylaxis during labor, wherein less than 4 h of beta-lactam antibiotics were administered prior to delivery. Neonatal outcome was compared between the groups.

Results

This retrospective cohort study comprised 1,609 women, with 129 in the exposed group (stripping group) and 1,480 in the unexposed group (no stripping group). Adequate intrapartum antibiotic prophylaxis was received by 64.3% (83/129) of the exposed group, compared to 46.9% (694/1,480) of the unexposed group (p = 0.003). Membrane stripping was associated with increased odds of receiving adequate prophylaxis (OR 1.897, 95% CI 1.185–3.037, p = 0.008). After excluding women who presented to the labor ward in active labor and delivered in less than 4 h, both the exposed and unexposed groups had similarly high rates of adequate intrapartum antibiotic prophylaxis (87.5% vs. 85.8%, respectively). No significant difference was observed in adverse neonatal outcomes between the groups.

Conclusion

The provision of membrane stripping did not impede adequate intrapartum antibiotic prophylaxis and was correlated with a higher rate of sufficient prophylaxis in comparison to non-swept patients. These observations suggest that membrane stripping can be considered a safe option for ensuring adequate antibiotic prophylaxis in women colonized with GBS.
Risks and benefits associated with the primary functions of artificial intelligence powered autoinjectors
Authors: Machal Marlon Luca
Published: April 2024

Objectives

This research aims to present and assess the Primary Functions of autoinjectors introduced in ISO 11608-1:2022. Investigate the risks in current autoinjector technology, identify and assess risks and benefits associated with Artificial Intelligence (AI) powered autoinjectors, and propose a framework for mitigating these risks. ISO 11608-1:2022 is a standard that specifies requirements and test methods for needle-based injection systems intended to deliver drugs, focusing on design and function to ensure patient safety and product effectiveness. ‘KZH’ is an FDA product code used to classify autoinjectors, for regulatory purposes, ensuring they meet defined safety and efficacy standards before being marketed.

Method

A comprehensive analysis of autoinjectors problems is conducted using data from the United States Food and Drug Administration (FDA) database. This database records medical device reporting events, including those related to autoinjectors, reported by various sources. The analysis focuses on events associated with the product code KZH, covering data from January 1, 2008, to September 30, 2023. This research employs statistical frequency analysis and incorporates pertinent the FDA, United Kingdom, European Commission regulations, and ISO standards.

Results

500 medical device reporting events are assessed for autoinjectors under the KZH code. Ultimately, 188 of these events are confirmed to be associated with autoinjectors, all 500 medical devices were seen to lack AI capabilities. An analysis of these events for traditional mechanical autoinjectors revealed a predominant occurrence of malfunctions (72%) and injuries (26%) among event types. Device problems, such as breakage, defects, jams, and others, accounted for 45% of incidents, while 10% are attributed to patient problems, particularly missed and underdoses.

Conclusion

Traditional autoinjectors are designed to assist patients in medication administration, underscoring the need for quality control, reliability, and design enhancements. AI autoinjectors, sharing this goal, bring additional cybersecurity and software risks, requiring a comprehensive risk management framework that includes standards, tools, training, and ongoing monitoring. The integration of AI promises to improve functionality, enable real-time monitoring, and facilitate remote clinical trials, timely interventions, and tailored medical treatments.
A novel front in sustainable microbial management: computational analysis of curcumin and mangiferin’s synergistic action against Bacillus anthracis
Authors: Perveen Kahkashan , Bukhari Najat A. , Alshaikh Najla A. , Kondaveeti Suresh Babu , Alsulami Jamilah A. , Debnath Sandip , Kumarasamy Vinoth
Published: April 2024

Background

Microorganisms are crucial in our ecosystem, offering diverse functions and adaptability. The UNGA Science Summit has underscored the importance of understanding microbes in alignment with the UN Sustainable Development Goals. Bacillus anthracis poses significant challenges among various microorganisms due to its harmful effects on both soil and public health. Our study employed computational techniques to investigate the inhibitory effects of curcumin and mangiferin on Bacillus anthracis, with the aim of presenting a novel bio-based approach to microbial management.

Methods

Employing high-throughput screening, we identified potential binding sites on B. anthracis. Molecular docking revealed that curcumin and mangiferin, when synergistically combined, exhibited strong binding affinities at different sites on the bacterium. Our findings demonstrated a significant drop in binding free energy, indicating a stronger interaction when these compounds were used together.

Findings

Results of Molecular docking indicated binding energies of −8.45 kcal/mol for mangiferin, −7.68 kcal/mol for curcumin, and a notably higher binding energy of −19.47 kcal/mol for the combination of mangiferin and curcumin with CapD protein. Molecular dynamics simulations further validated these interactions, demonstrating increased stability and structural changes in the bacterium.

Conclusion

This study highlights the effectiveness of natural compounds like curcumin and mangiferin in microbial management, especially against challenging pathogens like B. anthracis. It emphasizes the potential of sustainable, nature-based solutions and calls for further empirical research to expand upon these findings.
Whole-genome sequencing of Sphingobium baderi SC-1 and identification of a crucial 3-phenoxybenzoic acid-degrading gene
Authors: Li Qin , Zhou Qiao , Chen Yuan , Hu Kaidi , Sarrà Montserrat , Li Jianlong , Liu Aiping , Zou Likou , Liu Shuliang
Published: April 2024

As an efficient degradation strain, Sphingobium baderi SC-1 can breakdown 3-phenoxybenzoic acid (3-PBA) with high proficiency. To investigate the internal factors that regulate this process, we conducted whole-genome sequencing and successfully identified the pivotal 3-PBA-degrading gene sca (1,230 bp). After sca was expressed in engineered bacteria, a remarkable degradation efficiency was observed, as 20 mg/L 3-PBA was almost completely decomposed within 24 h. The phenol was formed as one of the degradation products. Notably, in addition to their ability to degrade 3-PBA, the resting cells proficiently degraded 4′-HO-3-PBA and 3′-HO-4-PBA. In conclusion, we successfully identified and validated sca as the pivotal enzyme responsible for the efficient degradation of 3-PBA from Sphingomonas baderi, providing a crucial theoretical foundation for further explorations on the degradation potential of SC-1.
Increase in activin A may counteract decline in synaptic plasticity with age
Authors: Zheng Fang , Dahlmanns Marc , Kessler Philipp , Alzheimer Christian
Published: April 2024

Activin A, a member of the transforming growth factor β (TGF-β) family, is widely recognized for its neurotrophic and neuroprotective function in the developing and injured brain, respectively. Moreover, in the healthy adult brain, activin A has been shown to tune signal processing at excitatory synapses in a fashion that improves cognitive performance. Because its level in human cerebrospinal fluid rises with age, we wondered whether activin A has a role in mitigating the gradual cognitive decline that healthy individuals experience in late-life. To interrogate the role of activin A in synaptic plasticity in the aging brain, we used an established transgenic mouse line, in which expression of a dominant-negative mutant of activin receptor IB (dnActRIB) serves to disrupt activin receptor signaling in a forebrain-specific fashion. In brain slices of young adult dnActRIB mice (2–4 months old), the NMDA receptor-dependent and -independent forms of long-term potentiation (LTP) at the Schaffer collateral—CA1 pyramidal cell synapse of the hippocampus were equally impaired relative to the extent of LTP measured in the wild-type preparation. Unexpectedly, the difference between the genotypes disappeared when the two forms of LTP were re-examined in slices from middle-aged mice (13–16 months old). Since the level of activin A and endogenous ActRIB both displayed a significant elevation in middle-aged hippocampus, we reasoned that with such a rise, the dominant-negative effect of the mutant receptors could be overcome. Substantiating this idea, we found that administration of recombinant activin A was indeed capable of restoring full-blown LTP in slices from young dnActRIB mice. Our data suggest that, beginning in the middle-aged brain, endogenous activin receptor signaling appears to become strengthened in an attempt to stave off cognitive decline. If further corroborated, this concept would also hold promise for new therapeutic venues to preserve cognitive functions in the aged brain.
Advancing autonomy through lifelong learning: a survey of autonomous intelligent systems
Authors: Zhu Dekang , Bu Qianyi , Zhu Zhongpan , Zhang Yujie , Wang Zhipeng
Published: April 2024

The combination of lifelong learning algorithms with autonomous intelligent systems (AIS) is gaining popularity due to its ability to enhance AIS performance, but the existing summaries in related fields are insufficient. Therefore, it is necessary to systematically analyze the research on lifelong learning algorithms with autonomous intelligent systems, aiming to gain a better understanding of the current progress in this field. This paper presents a thorough review and analysis of the relevant work on the integration of lifelong learning algorithms and autonomous intelligent systems. Specifically, we investigate the diverse applications of lifelong learning algorithms in AIS’s domains such as autonomous driving, anomaly detection, robots, and emergency management, while assessing their impact on enhancing AIS performance and reliability. The challenging problems encountered in lifelong learning for AIS are summarized based on a profound understanding in literature review. The advanced and innovative development of lifelong learning algorithms for autonomous intelligent systems are discussed for offering valuable insights and guidance to researchers in this rapidly evolving field.
Effect of nonpharmacological interventions on poststroke depression: a network meta-analysis
Authors: Li Ying , Wang Yuanyuan , Gao Lei , Meng Xiaohan , Deng Qidan
Published: April 2024

Purpose

To investigate the effects of nonpharmacological interventions (NPIs) on poststroke depression (PSD) in stroke patients.

Methods

Computer searches were conducted on the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases from their establishment to December 2023. The selection was made using the inclusion and exclusion criteria, and 40 articles were included to compare the effects of the 17 NPIs on patients with PSD.

Results

Forty studies involving seventeen interventions were included. The network findings indicated that compared with conventional therapy (COT), superior PSD improvement was observed for cognitive behavioral therapy (CBT) + acupoint acupuncture (CBTA) (mean difference [MD], −4.25; 95% CI, −5.85 to −2.65), team positive psychotherapy (MD, −4.05; 95% CI, −5.53 to −2.58), music therapy (MT) + positive psychological intervention (MD, −2.25; 95% CI, −3.65 to −0.85), CBT (MD, −1.52; 95% CI, −2.05 to −0.99), mindfulness-based stress reduction (MD, −1.14; 95% CI, −2.14 to −0.14), MT (MD, −0.95; 95% CI, −1.39 to −0.52), acupoint acupuncture + MT (AAMT) (MD, −0.69; 95% CI, −1.25 to −0.14). Furthermore, CBT (MD, −3.87; 95% CI, −4.57 to −3.17), AAMT (MD, −1.02; 95% CI, −1.41 to −0.62), acupressure + MT (MD, −0.91; 95% CI, −1.27 to −0.54), and narrative care + acupressure (MD, −0.74; 95% CI, −1.19 to −0.29) demonstrated superior Pittsburgh Sleep Quality Index (PSQI) improvement compared with COT.

Conclusion

Evidence from systematic reviews and meta-analyses suggests that CBTA improves depression in patients with PSD. Moreover, CBT improves sleep in these patients. Additional randomized controlled trials are required to further investigate the efficacy and mechanisms of these interventions.
Distinct eye movement patterns to complex scenes in Alzheimer’s disease and Lewy body disease
Authors: Yamada Yasunori , Shinkawa Kaoru , Kobayashi Masatomo , Nemoto Miyuki , Ota Miho , Nemoto Kiyotaka , Arai Tetsuaki
Published: April 2024

Background

Alzheimer’s disease (AD) and Lewy body disease (LBD), the two most common causes of neurodegenerative dementia with similar clinical manifestations, both show impaired visual attention and altered eye movements. However, prior studies have used structured tasks or restricted stimuli, limiting the insights into how eye movements alter and differ between AD and LBD in daily life.

Objective

We aimed to comprehensively characterize eye movements of AD and LBD patients on naturalistic complex scenes with broad categories of objects, which would provide a context closer to real-world free viewing, and to identify disease-specific patterns of altered eye movements.

Methods

We collected spontaneous viewing behaviors to 200 naturalistic complex scenes from patients with AD or LBD at the prodromal or dementia stage, as well as matched control participants. We then investigated eye movement patterns using a computational visual attention model with high-level image features of object properties and semantic information.

Results

Compared with matched controls, we identified two disease-specific altered patterns of eye movements: diminished visual exploration, which differentially correlates with cognitive impairment in AD and with motor impairment in LBD; and reduced gaze allocation to objects, attributed to a weaker attention bias toward high-level image features in AD and attributed to a greater image-center bias in LBD.

Conclusion

Our findings may help differentiate AD and LBD patients and comprehend their real-world visual behaviors to mitigate the widespread impact of impaired visual attention on daily activities.
Multiomics analysis investigating the impact of a high-fat diet in female Sprague–Dawley rats: alterations in plasma, intestinal metabolism, and microbial composition
Authors: Zhang Jiacheng , Hu Binhong , Deng Xin , Sun Rong , Zhang Rong , Chen Kuo , Guo Wenzhi
Published: April 2024

Introduction

With improvements in living conditions, modern individuals exhibit a pronounced inclination towards a high-fat diet, largely because of its distinctive gustatory appeal. However, the association between high-fat diets and metabolic complications has largely been ignored, and metabolic diseases such as obesity and non-alcoholic fatty liver disease now constitute a major public health concern. Because high-fat diets increase the risk of metabolic diseases, a thorough investigation into the impact of high-fat diets on gut microbiota and metabolism is required.

Methods

We utilize 16S rRNA sequencing and untargeted metabolomics analysis to demonstrate that SD rats fed a high-fat diet exhibited marked alterations in gut microbiota and plasma, intestinal metabolism.

Results

Changes in gut microbiota included a decreased abundance at phylum level for Verrucomicrobiota, and a decreased abundance at genus level for Akkermansia, Ralstonia, Bacteroides, and Faecalibacterium. Additionally, significant changes were observed in both intestinal and plasma metabolite levels, including an upregulation of bile acid metabolism, an upregulation of glucose-lipid metabolism, and increased levels of metabolites such as norlithocholic acid, cholic acid, D-fructose, D-mannose, fructose lactate, and glycerophosphocholine. We also investigated the correlations between microbial communities and metabolites, revealing a significant negative correlation between Akkermansia bacteria and cholic acid.

Discussion

Overall, our findings shed light on the relationship between symbiotic bacteria associated with high-fat diets and metabolic biomarkers, and they provide insights for identifying novel therapeutic approaches to mitigate disease risks associated with a high-fat diet.
Case report: Navigating treatment pathways for cardiac intimal sarcoma with PDGFRβ N666K mutation
Authors: Nishiyama Akihiro , Sato Shigeki , Sakaguchi Hiroyuki , Kotani Hiroshi , Yamashita Kaname , Ohtsubo Koushiro , Mizuguchi Keishi , Ikeda Hiroko , Iino Kenji , Takemura Hirofumi , Takeuchi Shinji
Published: April 2024

In the realm of rare cardiac tumors, intimal sarcoma presents a formidable challenge, often requiring innovative treatment approaches. This case report presents a unique instance of primary intimal sarcoma in the left atrium, underscoring the critical role of genomic profiling in guiding treatment. Initial genomic testing unveiled a somatic, active mutation in PDGFRβ (PDGFRβ N666K), accompanied by MDM2 and CDK4 amplifications. This discovery directed the treatment course toward pazopanib, a PDGFRβ inhibitor, following irradiation. The patient’s response was remarkable, with the therapeutic efficacy of pazopanib lasting for 16.3 months. However, the patient experienced a recurrence in the left atrium, where subsequent genomic analysis revealed the absence of the PDGFRβ N666K mutation and a significant reduction in PDGFRβ expression. This case report illustrates the complexities and evolving nature of cardiac intimal sarcoma treatment, emphasizing the potential of PDGFRβ signaling as a strategic target and highlighting the importance of adapting treatment pathways in response to genetic shifts.
Sustained release local anesthetics for pain management: relevance and formulation approaches
Authors: Getachew Melese , Tesfaye Hana , Yihunie Wubetu , Ayenew Tesfahun , Alemu Sintayehu , Dagnew Ephrem Mebratu , Biyazin Yalemgeta , Abebe Dehnnet , Degefu Natanim , Abebaw Abtie
Published: April 2024

This review attempted to ascertain the rationale for the formulation of sustained-release local anesthetics and summarize the various formulation approaches designed to date to achieve sustained and localized local analgesic effects. The incidence of pain, which is the concern of patients as well as health care professionals, is increasing due to accidents, surgical procedures, and other diseases. Local anesthetics can be used for the management of moderate to severe acute and chronic pain. They also allow regional analgesia, in situations where the cause and source of the pain are limited to a particular site or region, without the need for loss of consciousness or systemic administration of other analgesics thereby decreasing the risk of potential toxicities. Though they have an interesting antipain efficacy, the short duration of action of local anesthetics makes the need for their multiple injections or opioid adjuvants mandatory. To overcome this problem, different formulations are being designed that help achieve prolonged analgesia with a single dose of administration. Combination with adjuvants, liposomal formulations, lipid-based nanoparticles, thermo-responsive nanogels, microspheres, microcapsules, complexation with multivalent counterions and HP-β-CD, lipid-based nanoparticles, and bio-adhesive films, and polymeric matrices are among the approaches. Further safety studies are required to ensure the safe and effective utilization of sustained-release local anesthetics. Moreover, the release kinetics of the various formulations should be adequately established.