bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial distribution of nicotine concentrations in Berlin’s surface waters and their potential sources
Authors: Venohr Markus , Beusch Christine , Goldhammer Tobias , Nguyen Hong Hanh , Podschun Simone , Schmalsch Claudia , Wolter Christian
Published: December 2024

Nicotine is a ubiquitous emergent pollutant that mostly enters the environment through inappropriate disposal of cigarette butts. In a seven-week monitoring program, we took 56 water samples from 14 lakes, 9 ponds, 9 rivers, 8 canals, and 2 canalized brooks in Berlin. Nicotine was detected in all investigated surface waters. Observed concentrations ranged between 7 ng/l and 1,469 ng/l (mean: 73 ng/l, median: 28 ng/l). Rainy weather conditions generally led to an increase in nicotine concentrations, which was strongest in canals with a factor of 16. For water bodies receiving sewers discharges mean nicotine concentrations further increased with population density, while concentrations in surface waters without sewer connections were modulated by the presence of public transport stops or recreational areas. Our sampling revealed a high spatial temporal variability of nicotine concentrations in urban surface waters. We recommend a temporary systematic daily or event-based monitoring of nicotine concentrations to support our findings and to better understand and quantify emission sources and concentration decay phases. This could help to improve our still incomplete knowledge about ecological impacts, arising from long-term below-lethal nicotine concentrations in urban surface waters.
AxiWorm: a new tool using YOLOv5 to test antiparasitic drugs against Trichinella spiralis
Authors: Sánchez-Montejo Javier , Marín Miguel , Villamizar-Monsalve María Alejandra , Vieira María del Carmen , Vicente Belén , Peláez Rafael , López-Abán Julio , Muro Antonio
Published: December 2024

Trichinella spiralis drug development and control need an objective high throughput system to assess first stage larvae (L1) viability. YOLOv5 is an image recognition tool easily trained to count muscular first stage larvae (L1) and recognize morphological differences. Here we developed a semi-automated system based on YOLOv5 to capture photographs of 96 well microplates and use them for L1 count and morphological damage evaluation after experimental drug treatments. Morphological properties were used to distinguish L1 from debris after pepsin muscle digestion and distinguish healthy (serpentine) or damaged (coiled) L1s after 72 h untreated or treated with albendazole or mebendazole cultures. An AxiDraw robotic arm with a smartphone was used to scan 96 well microplates and store photographs. Images of L1 were manually annotated, and augmented based on exposure, bounding, blur, noise, and mosaicism. A total of 1309 photographs were obtained that after L1 labeling and data augmentation gave 27478 images. The final dataset of 12571 healthy and 14907 affected L1s was used for training, testing, and validating in a ratio of 70/20/10 respectively. A correlation of 92% was found in a blinded comparison with bare-eye assessment by experienced technicians. YOLOv5 is capable of accurately counting and distinguishing between healthy and affected L1s, thus improving the performance of the assessment of meat inspection and potential new drugs.
An exploratory qualitative study of perceived motivators and barriers to implementation of a smoke-free common area policy in multiunit housing in urban Bangladesh
Authors: Kibria Md. Golam , Islam Taslima , Alif Sheikh M , Islam Mohammad Shamimul , Hawlader Mohammad Delwer Hossain
Published: December 2024

In Bangladesh, city dwellers living in multiunit housing (MUH) are at high risk of secondhand smoke (SHS) exposure. Although smoke-free policies are a recognised intervention to protect MUH residents from such exposure, there are still no policy-supported residential buildings in the country. Therefore, we designed this study to determine the choice of smoke-free policies and explore the perceived motivators and barriers to implementing a smoke-free common area policy in MUH complexes in Bangladesh. An explorative qualitative study was conducted among 50 participants from three diverse groups- housing management committees, tobacco control civil society organisations, and fire service department using key informant interviews across divisional cities in Bangladesh. Thematic analysis was used to analyse the interviews. A majority of participants were 40 to 59 years old, completed at least a bachelor's degree, were job holders, lived in MUH for 10 to 19 years, and were non-smokers. Over half of the participants preferred a smoke-free common area policy for multiunit housing. This study identified four perceived motivators for implementing a smoke-free common area policy in MUH complexes: health protection, low maintenance costs, fewer conflicts, and reduced risk of fire accidents. Barriers to policy implementation were lack of support from flat owners, lack of understanding about the policy, monitoring difficulty, tenancy vacancy, and implementation costs. This study identified multiple motivators and barriers to the implementation of a smoke-free common area policy in MUH. For the successful implementation of the policy, both motivators and barriers should be addressed when developing policy implementation strategies. Further research can be conducted to better understand the implementation scenario of the smoke-free policy.
Function-on-Function Regression Models With Nonlinear Dynamic Effect and Linear Concurrent Effect
Authors: Jia Shifan , Shi Haolun , Guan Tianyu
Published: December 2024

We propose a function-on-function regression model that predicts a functional response by both a nonlinear dynamic effect of a functional predictor and a linear concurrent effect of another functional predictor. The nonlinear dynamic effect is characterized by taking an integral of a time-dependent two-dimensional smooth surface and the linear concurrent effect is modeled through a time-varying coefficient. The model structure combines the flexibility of nonlinear modeling with the interpretability of the linear concurrent effect. To approximate the two-dimensional surface, we use tensor product basis expansions, and for the time-varying coefficient in the concurrent effect, we employ B-spline expansions. The expansion parameters for each effect are estimated iteratively to account for the mutual dependencies between these two estimated effects. Each iteration of parameter estimation involves solving a penalized least squares problem. We establish the asymptotic properties of our estimator. The numerical performance of the proposed method is illustrated by simulation studies and two real data applications.
Improving Genomic Prediction of Vitamin C content in Spinach using GWAS-derived Markers
Authors: Rameneni Jana Jeevan , Islam A S M Faridul , Avila Carlos A. , Shi Ainong
Published: December 2024

Vitamin C (VC), also known as ascorbic acid and ascorbate, is a water-soluble antioxidant in plants that promotes skin health and immune function in humans. Spinach (Spinacia oleracea L.) is a leafy green widely consumed for its health benefits. Recent reports have shown that nutritional content, including VC, can be improved in spinach. However, due to its complex inheritance, new selection methods are needed to improve selection for cultivar development. In this study, single nucleotide polymorphism (SNP) markers identified by genome-wide association (GWAS) were used for genomic prediction (GP) to estimate VC content prediction accuracy (PA) for selection in spinach. A set of 147,977 SNPs generated from whole genome resequencing was used for GWAS in a panel of 347 spinach genotypes by six GWAS models. Sixty-two SNP markers distributed on all six spinach chromosomes were associated with VC content. PA for the selection of VC content was estimated with ten different SNP sets across six GP models. The results indicated that the PA can be > 40% after using 1,000 or more SNPs in five of the six models except the genomic best linear unbiased prediction (gBLUP); using GWAS-derived significant SNP markers would increase PA with a high r-value up to 0.82 by 62 associated SNP markers in compressed BLUP (cBLUP). Identified SNP markers resulting on high PA can be used in spinach breeding programs to select for high VC content.
Comparative Assessment of a Virtual Performance Measure with Self-Report and Performance-Based Outcomes in Patients with Hip Osteoarthritis
Authors: Razmjou Helen , Denis Suzanne , Robarts Susan , Wainwright Amy , Dickson Patricia , Roszkowski Ania , Murnaghan John
Published: December 2024

Background
The purposes of this study were to examine the reliability and factorial and convergent validity of a virtual performance measure (VPM) in patients with osteoarthritis of the hip joint and to compare the known-group validity of the VPM with traditional self-report and performance-based outcomes.
Methods
The VPM score was based on the results of 10 videos showing increasing difficulty in performing specific functional tasks. Patients were requested to choose the video that best reflected their own level of function. Clinical presentation and radiological findings were documented. Self-report measures were the lower extremity functional score (LEFS), pain scale, and performance-based measures were the 30- second Chair Stand Test (CST) and the 40-meter fast-paced walk test.
Results
Data of 100 patients, 64 (64%) females, mean age: 67 ± 7 were examined. The Cronbach’s alpha coefficient that examined internal consistency of the VPM total score was 0.88. Factor analysis showed two distinct domains. Moderate correlations were observed between the VPM total score and the LEFS, pain score, and 40-meter fast walk test (r > 0.50). The VPM and the LEFS were able to differentiate between candidates and non-candidates for hip arthroplasty and between those with and without assistive walking devices. There was no statistically significant difference between the overall accuracy of the VPM and LEFS in the area under the curve value (0.72 vs. 0.71) with respect to candidacy for surgery.
Conclusions
The VPM is a reliable and valid virtual outcome measure in patients with osteoarthritis of the hip joint. Digitally based outcome measures have the potential of enhancing remote measurement of functional difficulties in specific situations.
Sedoanalgesia With Dexmedetomidine in Daily Anesthesia Practices: a Prospective Randomized Controlled Trial
Authors: OĞUZ Ali Kendal , SOYALP Celaleddin , TUNÇDEMİR Yunus Emre , TEKELİ Arzu Esen , YÜZKAT Nureddin
Published: December 2024

Background: Patient safety is important in daily anesthesia practices, and providing deep anesthesia is difficult. There are ongoing debates about the anesthetic agents used today.
Objective: To evaluate the results of deep sedoanalgesia with dexmedetomidine in daily anesthesia practices.
Design: Prospective randomized clinical study
Settings: This study was carried out at Dursun Odabaş Medical Center
Patients: 80 patients aged 18--65 years, ASA I--II, scheduled for elective hysteroscopic intervention under sedoanalgesia
Main outcome measures: The primary aim was to evaluate patients' Ramsey sedation scores, VAS scores, and saturation values under deep sedation. The secondary outcomes were patient, surgeon and anesthesiologist satisfaction and evaluation of hemodynamic parameters.
Interventions: Patients who agreed to participate in the study were randomized into two groups of 40 patients: Group DP (dexmedetomidine‒propofol) and Group RP (remifentanil‒propofol).
A bolus of 1 mg/kg IV propofolwas administered to the patients in theDP group during the procedure. An IV bolus of 1 mcg/kg of 4 mcg/ml isotonic-dexmedetomidine solution was administered for 10 minutes. Then, infusion was started at a dose of 0.4 0.7 mcg/kg/hour.
A bolus of 1 mg/kg IV propofol was administered to patients in theRP group at the time of the procedure. A 0.25 mcg/kg I bolus of 20 mcg/ml isotonic-remifentanil solution was administered. Afterward, the infusion was performed at a dose of 0.025–0.1 mcg/kg/minute.
Results: The VAS score and desaturation rate were significantly (p < 0.05) lower in the DP group than in the RP group. The surgeon satisfaction score, patient satisfaction score, anesthesiologist satisfaction scoreand baseline, 1st minute, 5th minute, 10th minute, last measurement, and postop integratedpulmonary index (IPI) values were significantly (p < 0.05) greater in the DP group than in the RP group.
Conclusion: We believe that dexmedetomidine in combination with propofol can provide adequate anesthesia and analgesia for procedures commonly performed in day-case patients, such as hysteroscopy outside the operating room. Moreover, remifentanil provides more stable hemodynamics than does the combination of propofol and reduces the incidence of hypoxemia by affecting patients’ respiratory function less.
Trial Regıstratıon: Clinical Trials ID is NCT05674201
Whole Exome Sequencing in 11 Iranian Patients Expands the Mutational and Clinical Spectrum of Bardet- Biedl Syndrome
Authors: Seyedtaghia Mohammad Reza , Habibi Mohsen , Hashemi-Gorji Farzad , Tehrani-Fateh Sahand , Moghimi Parinaz , Golestani Ahmad , Ghasemi Mohammad-Reza , Sadeghi Hossein , Mirfakhraie Reza , Mosavai Pegah , Miryounesi Mohammad , Salehpour Shadab
Published: December 2024

Objective: Bardet-Biedl syndrome (BBS, OMIM 209900) is a rare autosomal recessive disorder characterized by a broad spectrum of clinical features including renal anomalies, learning disabilities, postaxial polydactyly, retinal dystrophy, obesity, and hypogenitalism. BBS is a heterogeneous syndrome, both genetically and clinically. To date, genetic variants in more than 28 genes have been associated with this syndrome and its subtypes. Most previous studies on BBS have failed to show clear genotype–phenotype correlations.
Design and Methods: In order to investigate the spectrum of genetic variation among Iranian BBS patients, 11 subjects from 9 families with clinically diagnosed BBS were included in this study. Following informed consent, we applied whole exome sequencing (WES) to the proband and their parents. We next performed Sanger sequencing to validate the identified variants.
Results: WES successfully identified three variants in the BBS9 gene: c.2014C>T, c.1789+1 G>A, and a novel deletion of exon 16. Two novel variants were identified in the BBS7gene: c.880G>C and c.719G>A. In addition, one novel variant was found in each of the CEP290 gene (c.5159C>G), TTC8 gene (c.462_465del), and MKKS gene (c.515_516delCT). One previously reported variant was also detected in the BBS10 gene (c.728_731del). Among the clinical manifestations observed, obesity and polydactyly were the most common findings.
Conclusions: Our findings further support the high heterogeneity of BBS: by discovering six novel variants, we expand the mutational spectrum of BBS-related genes and contribute to the understanding of this multisystem disease.
Taste of Morality – How morality modulates sensory experiences
Authors: Gier-Reinartz Nadine , Harms Regina , Mörlein Daniel , Kenning Peter
Published: December 2024

Morality affects human behaviour in manifold ways. But can it be tasted? To answer this question, we run a double-blind controlled sensory laboratory experiment to explore how morality impacts the marketing placebo effect (MPE). This effect arises when marketing actions influence the sensory experiences associated with using a product without physically changing it. In our experiment we apply labels for the credence attribute of animal welfare as such a marketing placebo, showing that these marketing actions are able to generate a MPE and, thus, affect the tasting experience on an individual level. More importantly, we find inter-individual differences that can be explained by the individual’s degree of morality.
Provocation of Brachial Plexus and Systemic Symptoms During the Elevated Arm Stress Test in Individuals With Myalgic Encephalomyelitis/chronic Fatigue Syndrome or Idiopathic Chronic Fatigue
Authors: III Charles C Edwards , Byrnes Julia M , Broussard Camille A , Azola Alba M , Swope Meghan E , Marden Colleen L , Swope Renee L , Lum YingWei L , Violand Richard L , Rowe Peter C
Published: December 2024

Background: We have noted that some adolescents and young adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) report difficulty with arms-overhead activities, suggestive of brachial plexus dysfunction or thoracic outlet syndrome (TOS). In the TOS literature, diagnostic maneuvers focus on the provocation of upper limb symptoms (arm fatigue and heaviness, paresthesias, neck and upper back pain), but not on systemic symptoms.
Objectives: To estimate the proportion of patients with fatiguing illness who experience systemic symptoms during a common maneuver used in evaluating TOS—the elevated arm stress test (EAST).
Methods: Patients were eligible for this retrospective study if they had been referred to the Johns Hopkins Chronic Fatigue Clinic between January 2020 and July 2023 and (a) reported difficulty with arms-overhead postures, (b) were evaluated with an abbreviated one-minute EAST, and (c) had not undergone surgery in the upper limb, neck, or skull base. Modified EAST procedure: patients sat with their arms in a “hands up” or “candlestick” position while opening and closing their hands every 2-3 seconds repeatedly for 1 minute, rather than the customary 3 minutes. The test was considered abnormal for local symptoms if the participant experienced pain, fatigue, heaviness, paresthesias, warmth or tremulousness in the upper limb, shoulder, neck, head, or upper back. The test was considered abnormal for systemic symptoms if the participant experienced overall fatigue, cognitive fogginess, lightheadedness, racing heart, diaphoresis, dyspnea, overall warmth, or nausea.
Results: Of 154 patients evaluated during the study period, 64 (42%) met the eligibility criteria (61/64 female, median age 18 years [range, 13 to 50]). Of the 64, 50 (78%) had ME/CFS, 13 (20%) had idiopathic chronic fatigue with associated orthostatic intolerance (OI), and one had idiopathic chronic fatigue without OI. Of the 64, 58% had evidence of joint hypermobility. Local symptoms were provoked by EAST in 62/64 (97%) within a median of 20 seconds. During EAST, 26/64 (41%) reported systemic symptoms (1 had only systemic but no upper limb symptoms), most commonly lightheadedness (19%) and generalized fatigue (11%).
Conclusions: Even with an abbreviated test duration, the EAST maneuver provoked local and systemic symptoms in a substantial proportion of patients with chronic fatigue, OI, and ME/CFS who had reported difficulty with arms-overhead postures. Further studies are needed to explore the prevalence of brachial plexus or TOS symptoms in unselected individuals with ME/CFS or OI, and the proportion with systemic symptoms during and after EAST.
Adverse effects of CoenzymeQ10 in the treatment of patients with chronic fatigue syndrome/myalgic encephalomyelitis (ME/CFS)
Authors: Olsson Gunnar L.
Published: December 2024

Purpose
In an ongoing study of oxidative stress and the effect of CoenzymeQ10 (CoQ10) at Bragée ME-Center in Stockholm, Sweden, incident and type of adverse effects were studied.
Method
Information of adverse effects were collected in three ways: 1: Study participants ending the study due to adverse effects. 2: Video consultations during the 12 weeks study where changes of symptoms and adverse effects were asked for. 3: At the end of the study the principal investigator (PI) asked for the occurrence of adverse effects.
Results
14 patients (11,7%) ended the study due to adverse effects. Most severe adverse effect was depression. During video visits 300 occurrences of changing symptoms/adverse effects were recorded. Most common were insomnia, headache and gastroenteric dysfunction. At the visit to the PI at the end of the study 47 participants reported adverse effects, most commonly mild reactions such as rashes, insomnia and gastrointestinal symptoms. More severe adverse effects reported were palpitations, depression, headache, and anxiety.
Conclusion
Adverse effects when taking CoQ10 seem to be common. Most often the symptoms are mild. Gastrointestinal symptoms, rashes and insomnia were common. A more severe adverse reaction was depression which previously has not been described.
Non-Communicable Diseases Challenges And Opportunities In Iran: A Qualitative Study
Authors: Torabi Zahra , Shakibazadeh Elham , Tajvar Maryam , Rezaei Negar
Published: December 2024

Background
To reduce noncommunicable diseases (NCDs) morbidity and mortality, policymakers should focus on decreasing risk factors and ensuring equitable access to effective preventive and therapeutic care for acute and chronic NCDs.The primary objective of this study was to identify challenges and opportunities in health promotion for NCDs in Iran.
Method
The analysis included semistructured, in-depth interviews with 14 participants. The participants consisted of policymakers, planners, and experts with experience in the areas of obesity, diabetes mellitus, hypertension, and cardiovascular disease management and control in Iran. The interviews were conducted over Skype; recorded, and transcribed verbatim. A deductive approch was used to extract codes and categories through open coding by reading the text and assigning related codes using MAXQDA 10 software.
Results
This qualitative study identified five primary categories and 14 subcategories related to the challenges and opportunities for addressing non-communicable diseases (NCDs) in Iran, closely aligned with the Ottawa Charter for Health Promotion. The first category, Policy Levers for NCD Prevention, highlights the role of legislation and economic growth in shaping effective NCD prevention strategies. The second category, Creating Health-Promoting Environments, focuses on the need to strengthen physical and social infrastructure to support healthier lifestyles. The third category, Community Empowerment for Health, underscores the importance of building social capital and encouraging public participation to improve community-level health outcomes. The fourth category, Empowering Individuals for Health, stresses the necessity of enhancing health literacy and the quality of education to enable individuals to take control of their health. Finally, Transforming Healthcare for Better Health identifies the need for restructuring healthcare systems and eliminating conflicting interests to ensure more effective NCD prevention and management. These findings illustrate the complex landscape of NCD challenges in Iran while offering clear opportunities for intervention through policy, community engagement, individual empowerment, and healthcare system reform.
Conclusion
This study identified key areas for addressing NCDs in Iran. Findings highlights the importance of policy, environment, community, and healthcare system factors. A multi-faceted approach is crucial for effective NCD prevention and control.
Psychological Flexibility as a Moderator of the Association Between Premenstrual Dysphoric Disorder, Depression, Anxiety, Positive Parenting, and Negative Parenting: A Cross-Sectional Study
Authors: Okajima Junko , OKAJIMA Isa
Published: December 2024

Background
This study investigated whether psychological flexibility moderates the relationship between premenstrual dysphoric disorder (PMDD) symptoms and depression, anxiety, positive parenting, and negative parenting.
Methods
A sample of 1,538 menstruating mothers with children aged 0 to 3 years (227 with 0-year-olds, 428 with 1-year-olds, 409 with 2-year-olds, and 424 with 3-year-olds) was assessed utilizing the Premenstrual Dysphoric Disorder Scale (PMDDS), Parental Acceptance and Action Questionnaire (PAAQ), and Hospital Anxiety and Depression Scale (HADS).
Results
The interaction effects between PMDDS and PAAQ scores were significantly associated with anxiety and positive parenting, after controlling for other variables. Notably, higher PAAQ scores were associated with increased positive parenting, even in the presence of worsened PMDD symptoms. Furthermore, psychological flexibility, as measured by the PAAQ, had an independent effect on both depression and anxiety, though no moderating effect was observed.
Conclusions
Interventions aimed at enhancing psychological flexibility may be beneficial for mothers with premenstrual dysphoric disorder who are raising infants and toddlers.
Local control and recurrence patterns after stereotactic irradiation delivered in more than 4 fractions for hepatocellular carcinomas and liver metastases: a retrospective study.
Authors: RENAN Alizée , BRUAND Marie , JOLNEROVSKI Maria , DIALLO Aboubacar , DEMOGEOT Nicolas
Published: December 2024

Background
Stereotactic Body Radiation Therapy (SBRT) is a safe and effective treatment for liver metastases or hepatocellular carcinoma (HCC) with a dose-response relationship for local control (LC). Proximity to organs at risk (OAR) often requires dose de-escalation. This study evaluated LC and recurrence patterns in patients administered hepatic SBRT in more than 4 fractions due to dosimetric constraints.
Methods
This retrospective study included 33 patients treated with SBRT (Cyberknife®) in more than 4 fractions for HCC or liver metastases, between January 2011 and December 2019. Patients were ineligible for treatment in 3 or 4 fractions due to OAR proximity. Recurrence patterns were analysed according to the volume shared between recurrence and initial target or treatment isodose volumes.
Results
The primary dose ranged from 35-50 Gy delivered in 5 to 7 fractions for the treatment of HCC (39%) or liver metastases (61%) mainly secondary to colorectal cancer (40%).
LC rate was 64%, with 12 patients showing recurrence volume overlap with the initial target volume or treatment isodose. In-field recurrence occurred in only 12.5% of patients with most relapses being out-of-field. No grade ≥3 events were reported.
Conclusion
Despite dose reductions to spare OAR, SBRT showed satisfactory LC with low toxicity. Out-of-field recurrence remains the most common pattern identified and likely related to underlying disease. Prospective data are necessary to determine whether preserving dose while reducing planning target volume (PTV) coverage could enhance LC.
Trial registration
All patients were retrospectively registered, and this study is registered at the Health Data Hub site (number HDH414).
The value of Ki-67 combined with Uroplakin-III in predicting the prognosis of bladder non-muscle invasive urothelial carcinoma
Authors: Wu Junchao , Qiu Xuede
Published: December 2024

Objective
To assess the predictive significance of Ki-67, Uroplakin-III, and their combination in bladder non-muscle invasive urothelial cancer patients.
Methods
Retrospective analysis of 224 bladder non-muscle invasive urothelial carcinoma patients who had transurethral resection at the Kunming Medical University Second Affiliated Hospital from January 2017 until December 2019 was performed. Patients were separated into Ki-67 high and low expression groups and Uroplakin-III positive and negative expression groups. Predictive models were built using univariate binary logistic regression, Cox proportional hazards regression model for multivariate analysis, unary linear regression, Kaplan-Meier survival analysis, nomogram, and AUC.
Results
Recurrence was substantially linked with tumor grade, Ki-67, and UP-III in univariate binary logistic regression. Tumor progression was linked to tumor number, stage, grade, type, Ki-67, and UP-III. Age, tumor size, stage, grade, type, and Ki-67 affected cancer survival. Ki-67 and UP-III positivity significantly decreased recurrence-free survival (RFS) in multivariate Cox regression analysis. PFS was dramatically lowered by high Ki-67. Age and elevated Ki-67 substantially affected cancer-specific survival. In unary linear regression and Kaplan-Meier analysis, high Ki-67 coupled UP-III positive lowered RFS, PFS, and CSS. AUC = 0.912, 0.870, and 0.942 on the ROC curves demonstrated that the model predicted 5 year RFS, PFS, and CSS rates well. The internal validation sett also performed well.
Conclusions
This study found that Ki-67 and UP-III are independent predictive markers for bladder non-muscle invasive urothelial carcinoma recurrence, progression, and death. Positive Ki-67 and UP-III expression are related with poor prognosis. Ki-67 with UP-III demonstrated good predictive discrimination and stability.
Factors associated with achieving various visual acuity outcomes during loading doses of aflibercept 2mg for treatment naïve exudative age-related macular degeneration: PRECISE Study Report 7
Authors: Sivaprasad Sobha , Chandak Swati , Gurudas Sarega , Muhammed Raheeba Pakeer , Kazantzis Dimitrios , Ghanchi Faruque , Grabowska Anna , Talks James , Pearce Ian , McKibbin Martin , Kotagiri Ajay , Menon Geeta , Burton Ben , Gale Richard
Published: December 2024

PURPOSE: To examine baseline OCT characteristics of patients initiated on aflibercept 2mg that achieved good and suboptimal VA after the first injection and post-loading.
METHODS: Patients with nAMD initiated on aflibercept therapy were recruited from December 2019 to August 2021. Demographic and OCT (Spectralis, Heidelberg Engineering) features associated with good VA (VA>=68 ETDRS letter score, Snellen >= 6/12) and poor VA (VA < 54 letter score, Snellen < 6/18) or lost >= 5 ETDRS letters after first injection (V2) and after the loading phase (V4) were analysed using logistic regression via generalised estimating equations.
RESULTS: A total of 1,999 eyes of 1,862 patients were analysed. The mean age was 79.3 (SD 7.8) years, 1,126 (60.5%) were female, predominantly white ethnic background (1,772 [95.2%]) and the mean presenting VA was 58.0 (SD 14.5) ETDRS letter score.
After V4, 930 (46.6%) of 1,994 eyes achieved VA>=68 ETDRS letter score and 457 (22.9%) achieved VA<54 ETDRS letter score.
The OCT parameters found to be associated with reduced odds of VA >=68 ETDRS letter score and increased odds of VA < 54 ETDRS letter score included foveal-involving IRF, PCV (vs. Type 1), RAP (vs. Type 1), Type 2 eyes (vs. Type 1), foveal-involving CNV (vs. non-foveal CNV), any component of CNV complex, increased CST, foveal-involving SRHM, foveal-involving atrophy, foveal-involving fibrosis, foveal-involving EZ loss, foveal-involving ELM loss, ungradable EZ loss, ungradable ELM loss and foveal-involving EZ/ELM loss.
CONCLUSION:
This study could help inform patients about their post-loading VA based on OCT characteristics at presentation.
Prediction of regional lymph node status in rectal cancer with radiomics features based on deep learning segmented tumor area
Authors: Zhao Wanting , Li Wanqing , Hao Yongfei , Qiao Xiaoai , Hou Guorui , Du Shaohua , Zhang Guangwen , Zhang Jinsong
Published: December 2024

Background: To predict regional lymph node metastasis (LNM) in rectal cancer (RC) using deep learning-based tumor auto-segmentation and radiomics.
Methods: This single-center research retrospectively analyzed 282 patients with RC from two MR vendors. The deep learning-based auto-segmentation models were constructed on T2WI and DWI with 3D U-Net, 3D V-Net, and nnU-Net v2 and assessed with the Dice Similarity Coefficient (DSC). Radiomics features on manual-based VOI (MbV) and deep learning-based VOI (DbV, with the highest DSC) were extracted respectively. After feature normalization and selection, five classifiers were used for radiomics model building and then for LNM prediction. The optimal model was selected using a 5-fold cross-validation strategy and evaluated with area under the curve (AUC), accuracy, specificity, and sensitivity.
Results: The DSC of the nnU-Net v2 was significantly higher than that of the 3D U-Net and 3D V-Net (T2WI: 0.886 vs 0.548 vs 0.616, p < 0.001; DWI: 0.906 vs 0.583 vs 0.433, p < 0.001; test set). The AUC of DbV based-radiomics models (0.700 for T2WI, 0.667 for DWI, and 0.800 for T2WI + DWI) were comparable to those of the corresponding MbV-based radiomics models (0.633 for T2WI, p = 0.638; 0.700 for DWI, p = 0.544; and 0.833 for T2WI + DWI, p = 0.248) in LNM prediction.
Conclusions: Radiomics features of T2WI and DWI based on nnU-net v2 segmented tumor area showed a reliable performance in predicting LNM in RC.
Influence of blending raw rubber and masterbatch of nitrile and acrylate rubbers on composite properties
Authors: Liang Jiuming
Published: December 2024

Rubber seals are used in various fields such as automobile engines and power system transformers. Currently, the seals used in automobiles and power system oil-filled transformers are mainly derived from nitrile rubber, but nitrile rubber is easy to age at high temperatures. Therefore, this study mainly considers two ways of using raw rubber blending of nitrile rubber and acrylate rubber and masterbatch concurrently to investigate its effect on the properties of composites. The results show that after the masterbatch is used in parallel, although the process is complicated, the comprehensive performance of the vulcanized rubber is better than that of the composites blended with raw rubber. High hardness, good aging resistance and low compression permanent deformation. The blending and parallel use of nitrile rubber and acrylate rubber can give play to their respective advantages, on the one hand, it can reduce the cost of the products, and on the other hand, it can also improve the performance of the sealing products, which has a good application prospect and popularization value.
Enhancing Healthcare Service Quality: The Role of Organizational Support in Stabilizing Health Policy Implementation
Authors: Yu Xintao , Guo Yuangeng , Liu Xiaochen , Gao Yongchuang
Published: December 2024

Background
Healthcare service quality is a core focus of China's health policy, aiming to achieve universal health coverage for its 1.4 billion population. The COVID-19 pandemic exposed threats to sustainable policy implementation, highlighting the need for organizational support to rebuild healthcare workers' confidence and ensure effective policy execution through enhanced commitment.
Methods
Using Hierarchical Linear Modeling (HLM), data were collected from 600 healthcare workers across 40 public hospitals in China. The study focused on evaluating how organizational support—including leadership, communication, and employee engagement programs—affects organizational commitment and how this commitment further impacts healthcare service quality. Data collection took place during the COVID-19 pandemic, providing a highly relevant context for analyzing these relationships.
Findings
The results demonstrate that organizational support positively influences healthcare service quality (H1), and this effect is mediated by organizational commitment (H3). During the pandemic, higher levels of perceived organizational support effectively reduced stress and trauma, enhancing healthcare workers' psychological resilience and job performance. Organizational support also increased emotional commitment among employees (H2), strengthening their sense of belonging and responsibility toward organizational goals. Employees who perceive high organizational support are more engaged and better equipped to maintain high standards of care under pressure. Additionally, the study found that organizational commitment significantly contributes to healthcare service quality, particularly in high-pressure environments. Employees with stronger organizational commitment exhibit behaviors that improve patient care, demonstrating greater resilience and adaptability in stressful situations.
Conclusion
This study provides critical insights into stabilizing the implementation of health policies by adopting a people-centered approach, emphasizing the role of hospital administrators in promoting organizational support to improve healthcare service quality and ultimately achieving the overarching goal of stable, universal health coverage. Sustaining these measures post-pandemic is essential for improving healthcare service quality, stabilizing health policy implementation, and achieving broader public health objectives, ultimately strengthening the healthcare system’s resilience and sustainability.
Integrated bioinformatic analysis of the expression and prognosis of ACAP1 in kidney renal clear cell carcinoma
Authors: Wang Jieyan , Hu Bowen , Chen Mujian , Zhong Qiong , Li Kangxin , Li Wentao , Jiang Yongjun , Liang Hui
Published: December 2024

Backgroud:
Kidney renal clear cell carcinoma (KIRC) is the subtype of kidney cancer which is one of the most malignant diseases with poor survival rate over the world. The expression of ACAP1 has been reported to associated with tumor immune infiltration and clinical outcome of Ovarian Cancer. However, its function in KIRC has not yet been fully elucidated.
Method
We utilized GEPIA, Human Protein Atlas, UALCAN, TIMER, and Metascape to determine the associations among ACAP1 expression, prognosis, and immune cell infiltration in KIRC.
Results
In this study, multiple bioinformatics tools and databases were performed to explore the expression level and clinical value of ACAP1 in KIRC. We found that the expression of ACAP1 was upregulated in KIRC. Further, the survival analysis showed that KIRC patients with higher expression of ACAP1 had poor survival outcomes. Meanwhile, our data showed that the expression of ACAP1 were correlated with immune infiltration levels. Functional enrichment analyses showed that chemokine signaling pathway, cytokine-cytokine receptor interaction, NOD-like receptor signaling pathway, NF-Kappa B signaling pathway, Toll-like receptor signaling pathway, B cell receptor signaling pathway are very key signaling pathways which correlated with ACAP1 in KIRC. ACAP1 correlated eight positive genes were significantly associated with KIRC prognosis including MAP4K1, ZAP70, DEF6, ARHGAP9, LIMD2, FMNL1, BATF and ARHGEF1. Knockdown of ACAP1 inhibit ACHN and 786-0 cells growth by promoting cell apoptosis, and decreasing cell migration and invasion.
Conclusions
In conclusion, our findings showed that ACAP1 is a key regulator of immune cell infiltration in KIRC and may serve as a potential prognostic biomarker.
Multifidus fat infiltration negatively influence the postoperative outcomes in lumbar disc herniation following transforaminal approach percutaneous endoscopic lumbar discectomy
Authors: Sun Kai , Qin Renjie , Wang Wenzhuo , Jiao Genlong , Sun Guodong , Chen Guoliang
Published: December 2024

Purpose
This study aims to investigate the influence of multifidus muscle fat infiltration on clinical outcomes in lumbar disc herniation (LDH) undergoing percutaneous endoscopic lumbar discectomy (PELD).
Methods
A retrospective analysis was conducted on 224 patients who underwent lateral PELD, with complete one-year follow-up data. Patients were divided into two groups based on preoperative MRI evaluation of L4 multifidus muscle fat infiltration: a mild group (< 25%) and a severe group (≥ 25%). Baseline characteristics and postoperative outcomes were recorded and compared.
Results
At the final follow-up, significant improvements in VAS scores for back and leg pain, ODI scores, and EQ-5D scores were observed in both groups. There were no statistically significant differences in preoperative VAS scores for back and leg pain, ODI scores, and EQ-5D scores between the two groups. However, significant differences were found in VAS scores for back pain, ODI scores, and EQ-5D scores at 3, 6, and 12 months postoperatively (P < 0.05), while no significant difference was noted in VAS scores for leg pain during follow-up. The total recurrence rate was 6.7% (15 out of 224 cases), with 12 cases in the severe group and 3 cases in the mild group, showing a statistically significant difference (P < 0.05).
Conclusion
The effectiveness of postoperative PELD in patients with LDH is impacted by severe multifidus muscle fat infiltration. Multifidus muscle fat infiltration represents a risk factor for recurrent LDH after PELD.
Heavy gravity combined with light gravity local anesthetic in subarachnoid anesthesia for cesarean section did not reduce the incidence of intraoperative hypotension in maternal women: a prospective cohort study
Authors: Qiao Wei , Liu Linlin , Zhang Xiaoxiao , Liu Kairui , Wang Lingzhi
Published: December 2024

Background
Subarachnoid anesthesia is the primary anesthetic method for elective cesarean section surgery, characterized by rapidly taking effect and reliable analgesia. However, subarachnoid anesthesia is prone to cause a high block level, resulting in a high incidence of maternal hypotension. How to reduce the incidence of maternal hypotension under subarachnoid anesthesia is a practical problem that needs to be solved urgently in clinical practice.
Methods
This prospective cohort study was performed at Nantong Maternal and Child Health Care Hospital in China between January and June 2023. This study compared the incidence of hypotension in maternal women undergoing subarachnoid anesthesia during elective cesarean section in four groups, including group A (control group) with 10 mg of 10% glucose solution; Group B with 5mg 10% glucose solution group; Group C with 4 mg 10% glucose solution group; Group D with 2 mg 10% glucose solution group. Each group was given a dose of 10 mg Ropivacaine with a concentration of 0.5% and a volume of 2 ml. The primary outcome was the incidence of maternal hypotension. The secondary outcomes were the plane of anesthesia, abdominal wall muscle relaxation degree and the incidence of adverse events.
Results
Data from 74 (18, A group; 26, B group; 15, C group; 15, D group) participants were analyzed. Heavy gravity combined with light gravity local anesthetic in subarachnoid anesthesia for cesarean section did not reduce the incidence of intraoperative hypotension in maternal women (P = 0.152). The plane of anesthesia gradually shifted from T4 to T10 as the specific gravity of ropivacaine decreased (P < 0.01). Satisfaction about abdominal wall muscle relaxation degree gradually decreased with the decrease of the specific gravity of ropivacaine (P = 0.04). And the incidence of adverse events gradually increased with the decrease of the specific gravity of ropivacaine (P = 0.027).
Conclusions
Heavy gravity combined with light gravity local anesthetic in subarachnoid anesthesia for cesarean section did not reduce the incidence of intraoperative hypotension in maternal women.
Molecular Manipulation of Polyamide Nanostructures Reconciles the Permeance–Selectivity Threshold for Precise Ion Separation
Authors: Han Gang , pan Zhenxiang , Lei Yalong , Yan Tiange , Zheng Fuxin , Liao Yu , Zhan Jiang , Zhang Tong , SHAO LU
Published: December 2024

Membrane nanofiltration (NF) has emerged as a prominent energy-efficient separation technology for widespread applications related to the water‒energy nexus. However, state-of-the-art polyamide (PA) NF membranes are markedly constrained by a ubiquitous, pernicious tradeoff between water permeance and selectivity. Leveraging the prestigious structure-determining performance rationale, this work conceives a facile and robust molecular engineering approach that enables simultaneous improvements in water permeance and co-cation selectivity through synthetic molecular construction of a PA nanofilm with unique cationic triazolyl heterocyclic polyamide (CTHP) structures during scalable interfacial polymerization. Experimental data in conjunction with molecular simulations reveal that the CTHP structures instigate exquisite regulation of the PA subnanometer pore architecture and the specific binding affinity with water and ions, which not only affords precise ion sieving ability and advanced Donnan exclusion selectivity but also energetically facilitates the partitioning and transport of water molecules. The exemplified PA membrane exhibits unparalleled divalent cation rejections of over 99%, accompanied by a 9-fold increase in monovalent/divalent cation sieving selectivity, which is substantially greater than that of the pristine benchmark, a superior water permeation rate, and excellent chemical and operational stability, circumventing the permeance/selectivity threshold. We believe that the molecular engineering strategy implemented in this work holds broad prospects for the rational design and fabrication of semipermeable polymeric NF membranes for sustainable and precision separations.
Integrating Green Logistics into Urban Agglomeration Networks: Efficiency Improvement Approaches and Case Study
Authors: tian yu , wang bangjun
Published: December 2024

Against the backdrop of global climate change and China's pursuit of carbon peaking and carbon neutrality, the logistics industry's role in emission reduction is crucial. However, existing research has mostly focused on world-class urban agglomerations, with relatively insufficient attention paid to the Huaihai urban agglomeration. This study takes the Huaihai urban agglomeration as the object and constructs a comprehensive evaluation system based on the theory of hub and spoke logistics network. By considering carbon emissions, an input-output evaluation index system from a network perspective is constructed. The two-stage network super efficiency SBM model is innovatively used to evaluate the logistics ecological efficiency, and an internal and external directed network is constructed by combining the improved gravity model and social network analysis to deeply analyze the development status of green and low-carbon logistics. The study found that the spatial distribution of logistics efficiency in this urban agglomeration is uneven, with cities such as Xuzhou showing outstanding performance, and the logistics network presenting specific structures and characteristics. Factors such as urbanization and green technology innovation have a significant impact on logistics efficiency. This study provides a basis for regional logistics planning and policy formulation, promotes sustainable development of regional logistics economy, and assists in the implementation of "dual carbon" strategy.