bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics and assessment of the electricity consumption of metro systems: A case study of Tianjin, China
Authors: Yu Yanzhe , You Shijun , Ye Tianzhen , Wang Yaran , Guo Xingguo , Chen Wenhua , Liu Tianqi , Wei Shen , Na Yanling
Published: October 2023

Owing to the complexity of metros, the energy consumption characteristics of metro systems exhibit variability and the energy‐saving management of the systems encounters challenges. To encapsulate the essential characteristics of energy usage and to objectively assess the energy performance of metro systems, this study presents a generalized framework and applies it to a case study conducted in Tianjin. The study also employs correlation analysis to investigate the applicability of the indicators relevant to ridership. The results indicate that the monthly traction electricity consumption exhibits slight variation, while station electricity usage demonstrates substantial fluctuation with seasonal changes. For Tianjin Metro, the passenger factor hardly shows any effect on the electricity use of metro lines. The median value of traction electricity use is approximately 2.0 kWh/(car‐km) and that of the average annual station electricity use of underground lines ranges from 95 to 155 kWh/m2. The emission from the traction sector is 12.2 kgCO2/(vehicle‐km) and from the station sector is 118.6 kgCO2/m2. The study also identifies the energy‐intensive lines of the Tianjin Metro and compares the energy utilization among various global metro systems. The authors hope that this study can help shed light on the assessment of the energy status of metro systems and serve as a source of information for other City‐Metros to implement energy‐saving management.
The neglected continuously emerging Marburg virus disease in Africa: A global public health threat
Authors: Srivastava Devang , Kutikuppala Lakshmi Venkata Simhachalam , Shanker Pooja , Sahoo Rudra Narayan , Pattnaik Gurudutta , Dash Rasmita , Kandi Venkataramana , Ansari Azaj , Mishra Snehasish , Desai Dhruv N. , Mohapatra Ranjan K. , Rabaan Ali A. , Kudrat‐E‐Zahan Md.
Published: October 2023

Background and Aim

Severe viral hemorrhagic fever (VHF) is caused by Marburg virus which is a member of the Filoviridae (filovirus) family. Many Marburg virus disease (MVD) outbreaks are reported in five decades. A major notable outbreak with substantial reported cases of infections and deaths was in 2022 in Uganda. The World Health Organisation (WHO) reported MVD outbreak in Ghana in July 2022 following the detection of two probable VHF patients there. Further, the virus was reported from two other African countries, the Equatorial Guinea (February 2023) and Tanzania (March 2023). There have been 35 deaths out of 40 reported cases in Equatorial Guinea, and six of the nine confirmed cases in Tanzania so far.

Methods

Data particularly on the several MVD outbreaks as reported from the African countries were searched on various databases including the Pubmed, Scopus, and Web‐of‐science. Also, the primary data and reports from health agencies like the WHO and the Centers for Disease Control and Prevention CDC) were evaluated and the efficacy reviewed.

Results

Chiroptera in general and bat species like Rousettus aegyptiacus and Hipposideros caffer in particular are natural reservoirs of the Marburg virus. MVD‐infected nonhuman primate African fruit‐bat and the MVD‐infected humans pose significant risk in human infections. Cross‐border viral transmission and its potential further international ramification concerns raise the risk of its rapid spread and a potential outbreak. Occurrence of MVD is becoming more frequent in Africa with higher case fatality rates. Effective prophylactic and therapeutic interventions to counter this deadly virus are suggested.

Conclusion

In the face of the lack of effective therapeutics and preventives against MVD, supportive care is the only available option which contributes to the growing concern and disease severity. In view of the preventive approaches involving effective surveillance and monitoring system following the “One Health” model is extremely beneficial to ensure a healthy world for all, this article aims at emphasizing several MVD outbreaks, epidemiology, zoonosis of the virus, current treatment strategies, risk assessments, and the mitigation strategies against MVD.
Machine learning‐based models to predict the need for neurosurgical intervention after moderate traumatic brain injury
Authors: Habibzadeh Adrina , Khademolhosseini Sepehr , Kouhpayeh Amin , Niakan Amin , Asadi Mohammad Ali , Ghasemi Hadis , Tabrizi Reza , Taheri Reza , Khalili Hossein Ali
Published: October 2023

Background and Aims

Traumatic brain injury (TBI) is a widespread global health issue with significant economic consequences. However, no existing model exists to predict the need for neurosurgical intervention in moderate TBI patients with positive initial computed tomography scans. This study determines the efficacy of machine learning (ML)‐based models in predicting the need for neurosurgical intervention.

Methods

This is a retrospective study of patients admitted to the neuro‐intensive care unit of Emtiaz Hospital, Shiraz, Iran, between January 2018 and December 2020. The most clinically important variables from patients that met our inclusion and exclusion criteria were collected and used as predictors. We developed models using multilayer perceptron, random forest, support vector machines (SVM), and logistic regression. To evaluate the models, their F1‐score, sensitivity, specificity, and accuracy were assessed using a fourfold cross‐validation method.

Results

Based on predictive models, SVM showed the highest performance in predicting the need for neurosurgical intervention, with an F1‐score of 0.83, an area under curve of 0.93, sensitivity of 0.82, specificity of 0.84, a positive predictive value of 0.83, and a negative predictive value of 0.83.

Conclusion

The use of ML‐based models as decision‐making tools can be effective in predicting with high accuracy whether neurosurgery will be necessary after moderate TBIs. These models may ultimately be used as decision‐support tools to evaluate early intervention in TBI patients.
Nano‐bioconvective anisotropic slip flow in anisotropic porous medium with Coriolis force effects
Authors: Khan W. A. , Uddin M. J.
Published: October 2023

The present paper examines the impact of the Coriolis force and anisotropic Darcian porous medium on the nonsteady convective flow of bio‐nanofluid along a three‐dimensional stretchable surface. The problem has applications in extrusion processes and the geographical movement of tectonic plates under a moveable ocean. Emphasis is placed on the combined effects of anisotropic porous medium, anisotropic momentum slip and temperature, and microorganism slips at the wall. The pertaining equations are condensed to a set of similarity equations before being simulated using the Keller‐box method, an efficient numerical technique. The study reveals that the friction factor along the y‐axis decreases as the rotation parameter increases. Moreover, the heat and nanoparticle volume fraction movement gradient decrease along the y‐axis when the Darcy number and stretching rate increase. However, these rates increase with a higher velocity slip. In addition, the density of microorganisms in the bio‐nanofluid decreases when there are higher levels of unsteadiness, rotation, and Darcy numbers, as well as with increased bioconvection parameters.
Mixed convection of transient MHD stagnation point flow over a stretching sheet with quadratic convection and thermal radiation
Authors: Balamurugan R. , Vanav Kumar A.
Published: October 2023

This study investigates the influence of quadratic (nonlinear) convection in transient magnetohydrodynamic (MHD) combined convection over a two‐dimensional stretching sheet. It explores the effects of thermal radiation, suction, and heat sources or sinks. The Crank–Nicholson implicit finite difference method is employed for numerical computations. The significance lies in considering secondary convection, which is crucial in understanding nonlinear convective effects affecting flow and heat transfer properties. The study aims to advance our comprehension of how secondary convection impacts the overall system behavior. Through numerical calculations validated against existing literature, strong agreement is demonstrated. The study evaluates secondary convection effects, magnetic, buoyancy, gravitational parameters, Prandtl number, and radiation parameters. Notably, strong quadratic convection alters flow patterns, affecting velocity and temperature profiles. Moreover, it is observed that when increasing the nonlinear (quadratic) convective factors, the temperature profile increases for and decreases for . The prevalence of nonlinear or second‐order convection highlights magnetic dominance. In essence, this research enhances our understanding of complex convection interactions in MHD flow, shedding light on the role of secondary convection in shaping system behavior.
Examining the relationship between inflammatory biomarkers during COVID‐19 hospitalization and subsequent long‐COVID symptoms: A longitudinal and retrospective study
Authors: Sykes Dominic L. , Van der Feltz‐Cornelis Christina M. , Holdsworth Luke , Hart Simon P. , O'Halloran Joseph , Holding Steve , Crooks Michael G.
Published: October 2023

Introduction

Long‐COVID is a heterogeneous condition with a litany of physical and neuropsychiatric presentations and its pathophysiology remains unclear. Little is known about the association between inflammatory biomarkers, such as interleukin‐6 (IL‐6) and C‐reactive protein (CRP) in the acute phase, and persistent symptoms after hospitalization in COVID‐19 patients.

Methods

IL‐6, CRP, troponin‐T, and ferritin were analyzed at admission for all patients with COVID‐19 between September 1, 2020 to January 10, 2021. Survivors were followed up 3‐months following hospital discharge and were asked to report persistent symptoms they experienced. Admission data were retrospectively collected. Independent t‐tests and Mann–Whitney U tests were performed.

Results

In a sample of 144 patients (62.5% male, mean Age 62 years [SD = 13.6]) followed up 3 months after hospital discharge, the commonest symptoms reported were fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%). In this sample, admission levels of IL‐6, CRP and ferritin were elevated. However, those reporting myalgia, low mood, and anxiety at follow‐up had lower admission levels of IL‐6 (34.9 vs. 52.0 pg/mL, p = .043), CRP (83 vs. 105 mg/L, p = .048), and ferritin (357 vs. 568 ug/L, p = .01) respectively, compared with those who did not report these symptoms. Multivariate regression analysis showed that these associations were confounded by gender, as female patients had significantly lower levels of IL‐6 and ferritin on admission (29.5 vs. 56.1, p = .03 and 421.5 vs. 589, p = .001, respectively) and were more likely to report myalgia, low mood and anxiety, when compared to males.

Conclusions

Our data demonstrate that female patients present more often with lower levels of inflammatory biomarkers on admission which are subsequently associated with long‐term post‐COVID symptoms, such as myalgia and anxiety, in those discharged from hospital with severe COVID‐19. Further research is needed into the role of serum biomarkers in post‐COVID prognostication.
Cine magnetic resonance imaging in evaluating retroperitoneal leiomyosarcoma arising from the inferior vena cava
Authors: Tobe Taisuke , Terakawa Tomoaki , Ueno Yoshiko , Sofue Keitaro , Hara Takuto , Furukawa Junya , Teishima Jun , Nakano Yuzo , Harada Kenichi , Fujisawa Masato
Published: October 2023

Introduction

Leiomyosarcoma of the inferior vena cava is associated with poor prognosis. Complete resection is the only curative treatment. We present a patient with this disease in whom cine magnetic resonance imaging was valuable in selecting the surgical strategy and mitigating invasiveness.

Case presentation

A 68‐year‐old woman presented with right‐sided abdominal pain. Computed tomography revealed an 86 mm tumor in the right retroperitoneal space that extended into the inferior vena cava and reached superiorly to the right atrium. Percutaneous needle biopsy confirmed leiomyosarcoma. Cine magnetic resonance imaging demonstrated no adhesions between the tumor and the upper segment of inferior vena cava wall, nor with the right atrial wall, indicating resectability. Radical tumor resection was successfully performed without requiring thoracotomy.

Conclusion

Cine magnetic resonance imaging appears to be useful in inferior vena cava leiomyosarcoma for evaluating adhesions between the tumor and vessel wall.
Priorities for protected area expansion so nations can meet their Kunming‐Montreal Global Biodiversity Framework commitments
Authors: Watson James E. M. , Venegas‐Li Ruben , Grantham Hedley , Dudley Nigel , Stolton Sue , Rao Madhu , Woodley Stephen , Hockings Marc , Burkart Karl , Simmonds Jeremy S. , Sonter Laura J. , Sreekar Rachakonda , Possingham Hugh P. , Ward Michelle
Published: October 2023

As part of the Kunming‐Montreal Global Biodiversity Framework (K‐M GBF), signatory nations of the Convention on Biological Diversity (CBD) aim to protect at least 30% of the planet by 2030 (Target 3). This bold ambition has been widely celebrated and its implementation seen as pivotal for the overall success of K‐M GBF. However, given that many CBD signatory nations prioritised quantity (e.g., area) over quality (e.g., important areas for biodiversity) when attempting to meet their 2010 CBD Aichi protected area commitments, it is critical that nations focus on protecting those terrestrial, inland waters and marine areas that have the best chance of halting and reversing biodiversity loss and thus contribute to Goal A of the K‐M GBF. Here we provide a review on the type of areas that nations need to prioritise when implementing Target 3 that relates to area ‘quality’: areas of particular importance for biodiversity and ecosystem functions and services, are effectively conserved and managed through ecologically representative, well‐connected and equitably governed systems. We show that data is available for 12 distinct biodiversity conservation and ecosystem service elements that can be mapped and, if conserved, will (with appropriate management) help meet the broad intention of Target 3. We highlight examples of the planning methods available that can be utilized so these areas can be targeted for protection. We discuss issues related to trade‐offs regarding how to prioritise amongst them as well as to operationalise some of the vaguer concepts like ‘representation’ and ‘ecosystem functions and services’ so that they achieve the best outcomes for biodiversity.
Enhanced Oral Cyclosporine Absorption With Water‐Soluble Vitamin E Early After Liver Transplantation
Authors: Pan Shi‐Hui , Lopez Richard R. , Sher Linda S. , Hoffman Allen L. , Podesta Luis G. , Makowka Leonard , Rosenthal Philip
Published: October 2023

We evaluated the effect of Liqui‐E, a water‐soluble vitamin E preparation, on cyclosporin A (CyA) whole blood concentration in liver transplant recipients, and its impact on the cost of CyA. Patients were 26 liver transplant recipients (19 adults, 7 children) who were unable to achieve and maintain therapeutic CyA whole blood concentrations with the standard recommended oral daily dose in the early post‐transplant period. Liqui‐E 6.25 IU/kg orally was administered with CyA every 12 hours (median time of starting Liqui‐E day 14.5). With Liqui‐E, the daily oral CyA requirements (mean ± SD) were decreased in adults from 22.6 ± 8.9 to 16.2 ± 7.3 mg/kg/day (p<0.001) and in children from 78.6 ± 34.1 to 53.7 ± 35.0 mg/kg/day (pl0.02); intravenous administration of CyA was unnecessary. The CyA trough concentrations (mean ± SD) before and after Liqui‐E were 670 ± 186 and 1012 ± 216 ng/ml, respectively, in adults (pl0.001) and 732 ± 187 and 1052 ± 166 ng/ml, respectively, in children (pl0.01). When given with Liqui‐E, the daily cost of CyA decreased by 26% in both adults and children. No clinical or biochemical evidence of Liqui‐E toxicity was observed. Thus its administration in the early post‐transplantation period can enhance CyA absorption in adults and children who are unable to achieve adequate whole blood concentrations with the usual recommended oral dosages. In addition, a significant cost saving can be realized by coadministration.
Antiproliferative Activity of Shark Cartilage With and Without Tumor Necrosis Factor‐α in Human Umbilical Vein Endothelium
Authors: McGuire Timothy R. , Kazakoff Peter W. , Hoie Eric B. , Fienhold Margery A.
Published: October 2023

We evaluated the antiangiogenic activity of shark cartilage, tumor necrosis factor‐α (TNF‐α), and a combination of the two using a human umbilical vein endothelial cell proliferation assay. Proliferation of endothelium is a hallmark of angiogenesis, and inhibition of endothelial cell proliferation indicates potential antiangiogenic activity. Shark cartilage produced a concentration‐dependent decline in endothelial cell 3H‐thymidine incorporation. This activity was heat stable and was found in molecular weight fractions of less than 10 kd. The antiproliferative effect of shark cartilage was specific for vascular endothelium and did not affect the proliferative rate of human astrocytoma cells or human skin fibroblasts. Shark cartilage at a concentration of 500 μg/ml and TNF‐α at a concentration of 10 ng/ml reduced endothelial cell proliferation by 32% and 29%, respectively. Treatment of endothelial cells with the combination of shark cartilage and TNF‐α resulted in a 44% reduction in endothelial cell proliferation. The isolation and identification of the active components of shark cartilage is continuing.
The Risk of Myocardial Infarction Associated with Antihypertensive Drug Treatment in Persons with Uncomplicated Essential Hypertension
Authors: Jick Hershel , Derby Laura E. , Gurewich Victor , Vasilakis Catherine
Published: October 2023

We conducted a case‐control study based on computer‐recorded information accrued in the United Kingdom General Practice Research Database to assess and compare the relation between different antihypertensive drug therapies and myocardial infarction in patients with no known clinical or laboratory risk factors for myocardial infarction other than hypertension. Cases were treated hypertensive patients with no other known risk factors who developed a first acute myocardial infarction between January 1, 1993, and October 31, 1994. They were ascertained from a review of the clinical record together with a questionnaire filled out by the attending general practitioner. Controls were matched to each case for age, sex, general practice, and index date. Antihypertensive therapy was derived from the computerized patient record. The study consisted of 210 cases and 793 controls. Compared with users of β‐blockers alone, the adjusted relative risk (RR) estimates for all other treatment regimens were close to 1.0. A comparison of users of calcium channel blockers alone with users of β‐blockers alone yielded a RR estimate of 0.9 (95% CI 0.5, 1.7). We conclude that the risk of acute myocardial infarction in otherwise healthy, treated hypertensive patients is not materially associated with the particular drug they receive.
New Pharmacologic Approaches to Acute Spinal Cord Injury
Authors: Rhoney Denise H. , Luer Mark S. , Hughes Melody , Hatton Jimmi
Published: October 2023

The incidence of spinal cord injury (SCI) in the United States is approximately 10,000 new cases per year. Strategies to prevent injury or salvage a few dermatomal levels may have significant effects on outcome. Several pharmacologic agents have been evaluated for their efficacy in patients with acute SCI. Methylprednisolone, when administered early, was the first drug to show significant improvement in outcome and is a standard of comparison for future agents. Several new drugs show promising results in animal models of SCI, with more extensive human trials currently under way. Results of more well‐controlled clinical trials are necessary to determine which agents have significant neurologic benefits.
A Review of the Safety and Efficacy of Acarbose in Diabetes Mellitus
Authors: Yee Helen S. , Fong Nancy T.
Published: October 2023

Acarbose is a novel oral antihyperglycemic agent approved for the treatment of noninsulin‐dependent diabetes mellitus. It inhibits α‐glucosidases in the small intestine, an action that delays the digestion and absorption of complex carbohydrates. Subsequently, there is a smaller rise in the postprandial plasma glucose levels and an overall decrease in the glycosylated hemoglobin by 0.5‐1.0%. Potential advantages of acarbose include a greater effectiveness in controlling postprandial hyperglycemia, a low risk of hypoglycemia, and a possible delay in initiating insulin therapy. Acarbose can potentiate the hypoglycemic effects of sulfonylureas or insulin. It has not been associated with weight gain and hyperinsulinemia, both of which can occur with sulfonylureas or insulin. Gastrointestinal adverse effects are common with acarbose, and may decrease with continued treatment. Although rare, elevated serum transaminase levels have been reported.
The Deaconess Informed Consent Comprehension Test: An Assessment Tool for Clinical Research Subjects
Authors: Miller Cheryl K. , O'Donnell Dannielle C. , Searight H. Russell , Barbarash Rick A.
Published: October 2023

We developed an instrument to assess comprehension of informed consent information among 275 adults entering one of four ambulatory trials. At the conclusion of trial enrollment, subjects rated their understanding of the information presented and completed the Deaconess Informed Consent Comprehension Test (DICCT). Subjects completed the vocabulary subtest of the revised Weschler Adult Intelligence Scale (WAIS‐R) and the reading subtest of the revised Wide Range Achievement Test (WRAT‐R). The DICCT for 50 subjects was scored by 2 blinded investigators. Interrater agreement was 0.84 (df = 49, p<0.001). To investigate the DICCT's potential validity, its scores were correlated with WAIS‐R vocabulary scores (r = 0.44, df = 199, p<0.01) and WRAT‐R reading scores (r = 0.39, df = 268, p<0.01). Understanding of consent information was rated as thorough by 70% of subjects. The mean ± SD DICCT score was 20.4 ± 3.9. The DICCT is a reliable instrument to assess comprehension of informed consent information. There is preliminary evidence for the scale's validity. The subjects believed that they had greater understanding of study information than was shown by the DICCT.
A Double‐Blind, Placebo‐Controlled Evaluation of Intranasal Metoclopramide in the Prevention of Postoperative Nausea and Vomiting
Authors: Wagner Bertil K.J. , Berman Stefanie L. , Devitt Patricia A. , Halvorsen Mark B. , O'Hara Dorene A.
Published: October 2023

Nausea and vomiting are common complaints in the postoperative period and contribute to patient distress and delay of discharge for outpatient surgical procedures. Laparoscopic procedures are associated with a high incidence of postoperative nausea and vomiting (PONV) episodes. Parenteral use of metoclopramide prevents and treats PONV. The intranasal route provides rapid and complete absorption of metoclopramide without many of the adverse effects observed with parenteral administration of the drug. We performed a prospective, double‐blinded, randomized, placebo‐controlled study to evaluate the safety and efficacy of metoclopramide 20 mg administered intranasally for emetic prophylaxis in laparoscopic surgery patients. The results from 109 patients enrolled in the study showed that this intranasal dose of metoclopramide may be ineffective in preventing the occurrence of PONV The poor performance of the intranasal metoclopramide formulation in this study cannot be attributed to patient‐specific and perioperative factors. It may be due to an inadequate dose or slow absorption of the drug. The small sample size, however, may also have been a factor.
Pharmacokinetics and Safety of Concentration‐Controlled Oral Zidovudine Therapy
Authors: Acosta Edward P. , Henry Keith , Page Linda M. , Erice Alejo , Balfour Henry H. , Fletcher Courtney V.
Published: October 2023

Study Objective. To evaluate the pharmacokinetics, safety, and feasibility of concentration‐controlled oral zidovudine therapy.

Design. Randomized, crossover, open‐label study.

Setting. University‐affiliated general clinical research center.

Patients. Eight individuals infected with the human immunodeficiency virus with CD4+ lymphocyte counts of 100 cells/μl or greater.

Intervention. During the 24‐week study, patients received oral zidovudine regimens that consisted of a standard fixed dose of 500 mg/day and a concentration‐controlled regimen designed to maintain a steady‐state plasma concentration (Css) of 0.187 ± 0.04 mg/L (0.7 ± 0.14 μM).

Measurements and Main Results. The mean Css during standard therapy was 0.170 ± 0.024 mg/L versus 0.205 ± 0.021 mg/L with the concentration‐controlled regimen (p=0.025). Respective mean changes in hemoglobin were −0.02 g/dl (range −0.9–0.9 g/dl) and −0.30 g/dl (range −1.5–0.4 g/dl, p=0.67). The absolute neutrophil count decreased 0.90 × 109/L during standard therapy and increased 0.40 × 109/L during concentration‐controlled therapy (p=0.07). The regimens did not differ in toxicity.

Conclusion. Concentration‐controlled oral antiretroviral therapy with zidovudine is feasible and safe, and provides pharmacologic data to determine the regimen's virologic and immunologic benefits.
Long‐Acting Diltiazem CD Is Safe and Effective in a Hypertensive Mexican‐American Population
Authors: Herrera Carlos R. , Lewin Andrew , Fiddes Robert , Friedman Jon , Linn William , Baker Thomas , Balanoff Diane , Beach C. L.
Published: October 2023

Study Objective. To evaluate the safety and effectiveness of diltiazem CD for reducing blood pressure in Mexican‐American patients with mild to moderate hypertension.

Design. Randomized, double‐blind, placebo‐controlled trial.

Setting. Twelve clinical sites in the United States.

Patients. Patients with baseline diastolic blood pressures between 95 and 115 mm Hg.

Interventions. Patients were treated with an average daily dose of diltiazem CD 246 mg (60 patients) or placebo (58 patients) to achieve a trough diastolic blood pressure below 90 mm Hg.

Measurements and Main Results. Diltiazem CD significantly reduced mean diastolic blood pressure compared with placebo, −8.2 versus −4.1 mm Hg, respectively (p=0.0025). Diastolic blood pressure below 90 mm Hg or a reduction of 10 mm Hg or more was achieved by 57% of diltiazem CD versus 28% of placebo recipients. Systolic blood pressure and heart rate were also reduced with diltiazem CD. Adverse events were mild, with similar frequency for diltiazem CD (15%) and placebo (19%).

Conclusion. Diltiazem CD is safe and effective in hypertensive Mexican‐Americans, and diastolic blood pressure reductions compare with those in non‐Hispanic white patients.
Prolonged Hypoglycemic Crisis Associated with Glyburide
Authors: Sills Michael N. , Ogu Chris C. , Maxa Jan
Published: October 2023

An elderly patient taking glyburide 5 mg/day for noninsulin‐dependent diabetes mellitus was hospitalized because of severe hypoglycemia. Laboratory results indicated both renal and hepatic abnormalities were present at the time of admission. Despite infusion of 10% dextrose and supplemental boluses of 50% dextrose, the hypoglycemic crisis persisted for 3 days. After it resolved, the patient's diabetes was controlled by diet alone. The patient's age and the presence of hepatic and/or renal impairment must be taken in account in prescribing glyburide. Recognizing patients who may require dosage changes, and educating them on the signs and symptoms of hypoglycemia, may help prevent hospitalizations resulting from this complication associated with glyburide.
Cost of Oral Antibiotic Therapy
Authors: Nightingale Charles H. , Quintiliani Richard
Published: October 2023

Many bacterial infections can be managed effectively with oral agents rather than parenteral therapy, significantly reducing treatment costs. With renewed interest in oral therapy, and with the importance of cost containment in the managed care environment, it is necessary to evaluate costs associated with different oral antimicrobials. Comparison of per‐dose cost and baseline treatment cost (cost/dose x doses/day x days of treatment) is straightforward. More difficult to determine is the overall treatment cost, which is influenced by probabilities that therapy will be effective, safe, and complete. Tolerability, complexity of dosage regimen, and potential for drug‐drug interactions may all affect therapeutic efficacy and overall cost. Compared with older agents, newer antibiotics are generally better tolerated and less likely to produce adverse reactions, resulting in better patient compliance, greater efficacy, and often lower overall cost of antimicrobial therapy.
Effect of Sustained Endotoxemia on α1‐Adrenergic Responsiveness in Parenterally Fed Rats
Authors: Dickerson Roland N. , Lima John J. , Kuhl David A. , Brown Rex O. , Hak Lawrence J.
Published: October 2023

We investigated the effect of endotoxemia on α1‐adrenergic receptor‐mediated smooth muscle contraction as measured by mean arterial pressure (MAP) in response to incremental doses of a vasopressor. Twelve male Sprague‐Dawley rats were randomized to receive parenteral nutrition alone (PN) or in combination with a continuous infusion of endotoxin (PN‐LPS) for 48 hours. Incremental doses of phenylephrine were given and peak MAP response was recorded. The endotoxin group had a decreased rise in MAP with the same dose of phenylephrine compared with the control group (59 ± 14 and 99 ± 12 mm Hg, respectively, p<0.001). However, the baseline MAP was higher in the endotoxin group (102 ± 18 and 71 ± 7 mm Hg, respectively, p<0.002). The overall maximum effect was the same for both groups (161 ± 16 and 170 ± 8 mm Hg, respectively, p=NS). These data indicate that sustained endotoxemia does not result in desensitization of α1‐adrenergic responsiveness. Other mechanisms are responsible for the ineffectiveness of vasopressors during advanced sepsis.
Hexokinase Present in Human Sperm Is Not Tyrosine Phosphorylated But Its Antibodies Affect Fertilizing Capacity
Authors: NAZ RAJESH K. , MORTE CARLES , AHMAD KHALIQ , MARTINEZ PAZ
Published: October 2023

ABSTRACT: The present study was conducted to investigate the presence of hexokinase in human sperm cell, its subcellular localization, its modulation and role in capacitation/acrosome reaction, and tyrosine kinase activity, if any. These studies were conducted using antibodies (Ab) raised against rat brain hexokinase (type I isozyme) that have significant cross‐reaction with various human tissue hexokinases and neutralize the catalytic activity of the enzyme. Hexokinase Ab reacted with acrosomal, mid‐piece and tail regions of methanol‐fixed (∼70–80%) and live (∼35–52%) sperm in the indirect immunofluorescence technique (IFT) and the immuno bead binding technique (IBT), respectively. Hexokinase Ab specifically recognized a band of 116 kDa on the Western blot of detergent‐ solubilized human sperm preparation that was different from the 95‐ kDa phosphotyrosine protein. Hexokinase Ab caused a significant (P < 0.01 to < 0.001) and concentration‐dependent inhibition of human sperm penetration of zona‐free hamster oocytes in the sperm penetration assay (SPA). These data indicate that the hexokinase of 116‐kDa molecular weight is present in acrosomal, mid‐piece, and tail regions of human sperm. The sperm hexokinase is a glycoprotein that is different from the 95‐kDa phosphotyrosine protein and is not phosphorylated at tyrosine residues; however, its antibodies cause agglutination and a concentration‐dependent inhibition of fertilizing capacity of human sperm.
Identification of Human Glandular Kallikrein hK2 From LNCaP Cells
Authors: GRAUER LANA S. , CHARLESWORTH M. CRISTINE , SAEDI MOHAMMAD S. , FINLAY JUDITH A. , LIU RU‐SHYA , KUUS‐REICHEL KRISTINE , YOUNG CHARLES Y.‐F. , TINDALL DONALD J.
Published: October 2023

ABSTRACT: Based on studies indicating that human glandular kallikrein (hK2) mRNA is present in the prostate, we prepared a monoclonal antibody to a synthetic peptide corresponding to the 41–56 region of hK2 to try to identify the hK2 protein. Although prostate‐specific antigen (PSA) and hK2 share 80% homology, the 41–56 amino acid sequence of hK2 is only 50% homologous with PSA. A monoclonal antibody, HK1A523, was identified that demonstrates high specificity for hK2. In western blot analysis, the antibody has a 1,000‐fold greater sensitivity for the detection of hK2 than for PSA.

The antibody was used to probe spent media from the prostate carcinoma cell line, LNCaP. An immunoreactive species was N‐terminally sequenced and identified as mature hK2. HK1A523 was also utilized to probe prostate tumor cytosols and seminal fluid where putative forms of hK2 were also identified. The hK2 protein therefore is expressed and secreted from prostate carcinoma cells.
Decreased Spermatogenesis as the Result of an Induced Autoimmune Reaction Directed Against the Gonadotropin Receptors in Male Rats
Authors: GRAF KRISTINE M. , DIAS JAMES A. , GRISWOLD MICHAEL D.
Published: October 2023

ABSTRACT: The presence of luteinizing hormone (LH) and testosterone is considered critical for the maintenance of spermatogenesis in the rat. However, the role and importance of follicle‐stimulating hormone (FSH) in the initiation and maintenance of spermatogenesis has been a subject of debate for some time. The objective of this study was to examine the role of FSH and LH in vivo in the developing and adult rat by inducing an autoimmune reaction against the receptors to these gonadotropins. Sperm numbers were reduced in animals immunized against either the FSH or LH receptor (FSHR/LHR). In animals immunized against both FSHR and LHR there was also a significant reduction in sperm number although spermatogenesis was never completely ablated. These results were seen in male rats immunized either prepubertal† (18 days of age) or as adults (80 days of age). To examine the requirements for FSH in early postnatal‐testicular development, pregnant females were also immunized against either FSHR, LHR, or both of the receptors, and the male offspring were examined at 30 days of age. Again, germ‐cell number was decreased with the greatest effect in those pups whose mothers were immunized against both FSHR and LHR. Radioligand‐receptor‐binding assays revealed that the antibody produced in the rats against FSHR was able to compete with FSH for binding sites in receptor‐membrane preparations. Therefore, the mechanism of disruption of spermatogenesis is probably due to suppression of hormone to receptor binding. The results of this study support a role for FSH in spermatogenesis not only during neonatal and early postnatal development but also in the adult animal.
Use of a Rat cDNA Probe Specific for the Y Chromosome to Detect Male‐Derived Cells
Authors: AN J. , BEAUCHEMIN N. , ALBANESE J. , ABNEY T. O. , SULLIVAN A. K.
Published: October 2023

ABSTRACT: A cDNA probe that exhibits specificity for the rat Y chromosome was generated by using a set of primers specific to the murine Sry gene, the sex‐determining region of the Y chromosome. A 459‐base pair (bp) DNA fragment was obtained by polymerase chain reaction (PCR) amplification from male, but not female, rat genomic DNA (EMBL Nucleotide Sequence Database accession number X89730). This DNA fragment was purified, cloned using a vector, and digested with EcoR1 to yield a 270‐bp DNA fragment. This 270‐bp cDNA fragment, when used as a probe in Southern blot analysis of rat DNA, was observed to bind to three separate bands of approximately 2.3, 5.0, and 7.0 kb in size. The binding was demonstrated with male, but not female, genomic DNA. Another set of primers was generated to sequences within the 270‐bp fragment that produced a PCR product of 104 bp. This DNA fragment, when used as a probe in Southern blot analysis, enabled PCR detection of at least 0.1% male cells in a mixed population of female cells. These cDNA probes should prove useful in studies designed to track cell populations (e.g., tumor metastasis and hemopoietic cells after bone marrow transplantation) in syngeneic male/female pairs. In addition, a cDNA probe that is specific for the rat Sry gene might be valuable in studies of fetal male sexual development or the study of spermiogenesis.
Estrogen Receptors Are Present in the Epididymis of the Rooster
Authors: KWON SEOK , HESS REX A. , BUNICK DAVID , KIRBY JOHN D. , BAHR JANICE M.
Published: October 2023

ABSTRACT: Our recent discovery that testicular germ cells and epididymal sperm contain active P450 aromatase suggests that the reproductive tract may be a target for estrogen. Therefore, the objective of this study was to determine if estrogen receptors (ER) are present in the avian epididymis using immunocytochemistry, northern blot analysis, and in situ hybridization. Immunoperoxidase staining for ER was found principally in nuclei of nonciliated epithelial cells of proximal and distal efferent ductules and the epididymis duct The ciliated cells also appeared to be slightly positive in the efferent ductules. Weak immunostaining was also observed in the connective tissue of the epididymis duct Immunostaining was more intense in epithelial cells of the efferent ductules than in epithelial cells of the epididymal duct or connective tissue cells. Strong specific hybridization signals for ER mRNA corresponded to the same areas exhibiting immunocytochernical localization. The presence of ER mRNA in the epididymis was confirmed by northern blot analysis, which showed a single band corresponding to approximately 7.8 kb, similar to that found in chicken oviduct. Based on these data, we suggest that the efferent ducts of the rooster are a primary target for estrogen and that estrogen may have a role in the regulation of avian epididymal function.
A Survey of Publicly Available MRI Datasets for Potential Use in Artificial Intelligence Research
Authors: Dishner Katharine A. , McRae‐Posani Bala , Bhowmik Arka , Jochelson Maxine S. , Holodny Andrei , Pinker Katja , Eskreis‐Winkler Sarah , Stember Joseph N.
Published: October 2023

Artificial intelligence (AI) has the potential to bring transformative improvements to the field of radiology; yet, there are barriers to widespread clinical adoption. One of the most important barriers has been access to large, well‐annotated, widely representative medical image datasets, which can be used to accurately train AI programs. Creating such datasets requires time and expertise and runs into constraints around data security and interoperability, patient privacy, and appropriate data use. Recognizing these challenges, several institutions have started curating and providing publicly available, high‐quality datasets that can be accessed by researchers to advance AI models. The purpose of this work was to review the publicly available MRI datasets that can be used for AI research in radiology. Despite being an emerging field, a simple internet search for open MRI datasets presents an overwhelming number of results. Therefore, we decided to create a survey of the major publicly accessible MRI datasets in different subfields of radiology (brain, body, and musculoskeletal), and list the most important features of value to the AI researcher. To complete this review, we searched for publicly available MRI datasets and assessed them based on several parameters (number of subjects, demographics, area of interest, technical features, and annotations). We reviewed 110 datasets across sub‐fields with 1,686,245 subjects in 12 different areas of interest ranging from spine to cardiac. This review is meant to serve as a reference for researchers to help spur advancements in the field of AI for radiology.

Level of Evidence

Level 4

Technical Efficacy

Stage 6
Serotonin antidepressants and atrial fibrillation burden from cardiac implantable electronic devices
Authors: Koh Youlin , Kwok Cecilia , Voskoboinik Aleksandr , Kalman Jonathan M. , Wong Michael
Published: October 2023

Objective

Depression and anxiety show a bidirectional relationship with atrial fibrillation (AF). Antidepressant use is associated with a reduction in the incidence of AF. However, no studies have examined the relationship between antidepressant use and AF burden (time in AF). This retrospective cohort study examined cardiac implantable device‐detected AF episodes and their relationship with antidepressant use, among other treatment factors.

Methods

Consecutive patients from the Western Health Cardiology Department attending pacemaker checks between 2015 and 2021 were included. Patients with permanent AF were excluded, yielding 285 patients with no or paroxysmal AF, with a total of 772 patient encounters. Generalized estimating equations were used to model two processes: binary AF (present/absent) and the number of days in AF for patients with AF.

Results

Each yearly increase with age was associated with an increase in the odds of developing AF (OR 1.03 [1.00–1.05], p = .027). Male gender conferred a reduction in AF incidence (OR 0.30 [0.13–0.68], p = .004). Digoxin use was associated with incident AF (OR 4.43 [1.07–18.4], p = .04). Sotalol and heart‐failure beta blocker use were associated with a decrease in AF burden (IRR 0.30 [0.12–0.78], p = .013 and 0.33 [0.14–0.81], p = .015). Selective serotonin reuptake inhibitor antidepressant use was associated with reduced AF burden (IRR 0.27 [0.09–0.81], p = .019), as was selective serotonin/noradrenaline reuptake inhibitor use (IRR 0.07 [0.03–0.15], p < .001).

Conclusions

Older age, female gender and digoxin are associated with a higher odds of developing incident AF. Sotalol, heart failure beta blockers and serotonin‐based antidepressants are associated with reduced AF burden. Further prospective study into the effects of antidepressants on atrial arrhythmias is warranted.
Protein and energy intake in intensive care unit survivors during the first year of recovery: A descriptive cohort study
Authors: Beumeler Lise F. E. , Visser Edith , Buter Hanneke , Navis Gerjan J. , Boerma E. Christiaan , van Zutphen Tim
Published: October 2023

Background

Many intensive care unit (ICU) survivors suffer long‐term health issues that affect their quality of life. Nutrition inadequacy can limit their rehabilitation potential. This study investigates nutrition intake and support during ICU admission and recovery.

Methods

In this prospective cohort study, 81 adult ICU patients with stays ≥48 h were included. Data on dietary intake, feeding strategies, baseline and ICU characteristics, and 1‐year outcomes (physical health and readmission rates) were collected. The number of patients achieving 1.2 gram per kilogram per day of protein and 25 kilocalories per kilogram per day at 3 months, 6 months, and 12 months after ICU admission was recorded. The impact of dietary supplementation during the year was assessed. Baseline characteristics, intake barriers, and rehabilitation's influence on nutrition intake at 12 months were evaluated, along with the effect of inadequate intake on outcomes.

Results

After 12 months, only 10% of 60 patients achieved 1.2 g/kg/day protein intake, whereas 28% reached the advised 25 kcal/kg/day energy target. Supplementary feeding significantly increased protein intake at 3, 6, and 12 months (P = 0.003, P = 0.012, and P = 0.033, respectively) and energy intake at 3 months (P = 0.003). A positive relation was found between female sex and energy intake at 12 months after ICU admission (β = 4.145; P = 0.043) and taste issues were independently associated with higher protein intake (β = 0.363; P = 0.036). However, achieving upper‐quartile protein or energy intake did not translate into improved physical health outcomes.

Conclusion

Continuous and improved nutrition care is urgently needed to support patients in reaching nutrition adequacy.
Quantitation of native and forced degraded collagens by capillary zone electrophoresis: Method development and validation
Authors: Olabi Mais , Wätzig Hermann
Published: October 2023

A new capillary zone electrophoresis method for collagen quantitation was developed and validated according to the International Council for Harmonization guideline Q2 (R1). The Sircol collagen assay and ultraviolet spectrometry were employed as reference methods. Capillary zone electrophoresis enables specific, simple, and fast determination within 9 min. It is less user‐dependent and more automated than the Sircol collagen assay. With a limit of detection of 18.0 μg/mL, the new method is less sensitive than the Sircol collagen assay, which has a limit of detection of 6.5 μg/mL. Nonetheless, capillary zone electrophoresis covers a wider linearity range (50‐400 μg/mL) compared to the Sircol collagen assay (5‐80 μg/mL), with similar precision. Additional advantages of capillary zone electrophoresis are the ability to gain information on collagen integrity and to simultaneously determine native and denatured collagens. This approach represents a modern and legitimate alternative to the Sircol collagen assay. The developed method has been successfully applied to the study of three collagen products and samples from forced degradation.
Effect of nutrient management and soil type on stoichiometric imbalances across the Yangtze River Basin pear districts, China
Authors: Fu Haoran , Chen Hong , Ma Zhengbo , Ma Qingxu , Mao Xiali , Liu Xiu , Zhou Jingjie , Hou Yuqi , Wu Lianghuan
Published: October 2023

Nutrition management affects soil carbon (C), nitrogen (N), and phosphorus (P) cycles, as well as their stoichiometry, causing further stoichiometric imbalances. However, research on the effect of nutrient management on soil stoichiometric imbalance is restricted to a single soil type, limiting our understanding of the interactions between these parameters. Therefore, we conducted a study comprising 212 sites throughout the Yangtze River Basin pear districts, for which nutrient management and soil properties were available under different soil types. Soil stoichiometric imbalances varied widely among the districts, with an average C:P imbalance value (C:Pim) of 6.67, higher than that of C:N imbalance (C:Nim; 6.43) and N:P imbalance (N:Pim; 2.83). Meanwhile, soil and microbial biomass stoichiometry, particularly for soil C:P and soil microbial biomass carbon and phosphorus (MBC:MBP), were significantly influenced by nutrient addition. Large N and P fertilizer inputs altered soil C:N and C:P in yellow–brown earth, while soil C:P was influenced by organic nutrient management in purplish soil. Moreover, adding organic nutrients altered the MBP, which further influenced MBC:MBP and MBN:MBP in saline–alkaline soil and yellow–brown earth. Furthermore, C:Pim increased with increasing organic nutrient input in purple soil and decreased with a large chemical fertilizer input in red soil. N:Pim and C:Nim were weakly associated with nutrient management in different soil types. In addition, nutrition management, soil type, soil properties, and microbe content collectively accounted for 45%, 32%, and 38% of the C:Pim, C:Nim, and N:Pim variation, respectively. Nutrient management also exerted a positive direct impact on C:Pim, while soil type elicited a negative direct impact on C:Nim and N:Pim. Meanwhile, all three stoichiometric imbalances were indirectly influenced by soil type. Taken together, our results indicate that soil stoichiometric imbalances, especially for C:Pim, are sensitive to nutrient management and soil type, providing novel insights into these imbalances that can inform the development of potential remedial strategies.