bluuebunny/crossref_metadata_2025 huggingface dataset:
Progress and success of Coronary Artery bypass Graft in TANZANIA, a retrospective review of patients operated at Jakaya Kikwete cardiac Institute: MUHIMBILI NATIONAL HOSPITAL
Authors: Nyawawa Evarist TM , Muhozya Angela N. , Kisenge Peter R. , Nyangasa Juma B. , Hailong Zhang , Byomuganyizi Moses , Ramadhan Khamis , Mahenda Shija , Ncheye Adelphina , Loth Alex , Mutagwaba Mujuni , Joseph Alex B. , Luchemba Robert , Assenga Mahawa , Wapalila David J. , Lyedenge Faraji , Mwasaga Fred , Nyawawa Evans E. , Mayala Henry , shilanaiman Hillary , Mlawi Vivianne , Janabi Mohamed , Mahalu William
Published: March 2023

Objective
The profile, success and progression of patients undergoing coronary artery bypass graft at the institute has not adequately been reviewed. Coronary artery bypass graft though a widely performed procedure in developed countries, it is uncommon procedure in a few centers found in developing countries. The procedure is skill and expertise demanding. The study aimed to evaluate patients’ characteristics, number and disposition of patients after coronary artery bypass graft surgery.
Methods
This was a retrospective study that enrolled all patients who underwent coronary revascularization at the centre from May 2016 through November 2022. Patients’ demographic was entered into a structured data sheet, excluded were those whom their surgical and clinical details could not be retrieved. Preoperative clinical details, intraoperative and postoperative patients’ profile were recorded and entered into a data sheet in SPSS version 20 program and analyzed; Chi square (χ2) was used to compare categorical variables.
Results
There was a total of 220 patients who underwent coronary artery bypass graft from May 2016 through November 2022. Male patients were 172 (78.2%) and female patients were 48(21.8%). Male patients outnumbered female patients by 3.6 folds. The minimum age was 42 years and maximum were 89 years with a mean year age of 63.7 ± 8years. The majority of patients were overweight and obese in 73%. The mean duration of presentation was 13.5 ± 8.6 months and the overall early mortality rate was 10.5%.
Conclusion
The key to a successful of a well-established cardiac centre in sub-Saharan countries of Africa and to any newly established cardiac center requires government commitment to invest in human resource; that in turn forms a local core cardiac team that should work focused to archive its goals. Investing into a well-planned structure that fits the requirement of a cardiac Centre. There should be a system that ensures availability and constant supply of consumables. The success and progress of open heart surgery demonstrated by Jakaya Kikwete Cardiac Institute from simple open heart procedures to complex surgical procedures required a well-planned short and long term plan with good coordination and focus, backed by unwavering government commitment.
Assessing pattern of the pediatric multisystem inflammatory syndrome (PMIS) in children during COVID-19 infection: Experience from the emergency department of a LMICs tertiary care hospital.
Authors: Bano Surraiya , Akhtar Saleem , Anis Iqra , Ihsan Muhammad Tayyab , Raheem Ahmed
Published: March 2023

Background
Pediatric multisystem inflammatory syndrome (PMIS) is a hyperinflammatory syndrome with multi organ involvement. In children, severe complications were reported with features similar to incomplete Kawasaki disease during later phases of COVID- 19 infection.
Objectives
This study aimed to determine the frequency, pattern of presentation, and significant laboratory parameters related to PMIS in children presenting to the emergency department during COVID − 19.
Method
This was a prospective observational study. Children (1 month − 16 years) with symptoms suggestive of PMIS were included. A predesigned questionnaire was used to collect data on demographics, presenting complaints, performing investigations, offering treatment, and the outcome during the emergency stay. Besides using descriptive statistics, the Mann-Whitney U test compared the in-hospital mortality with triage vitals to see any significant differences between Alive and Expired. The Chi-square test or Fisher exact test was used for categorical data to see the association.
Result
56 patients, majority male (85.7%), were diagnosed with the pediatric multisystem inflammatory syndrome with a mean age of 7.67 ± 4.8 (ranging from 1 to 16 years). COVID PCR was positive in only 18% (10) patients, whereas COVID antibodies were positive in 78.6% (44). The main presenting complaints were related to respiratory 70% followed by neurological 57% and Gastrointestinal 54% with the common clinical sign of delayed capillary refill time (93%) and low volume pulses (89%). Out of 12 patients with negative COVID antibodies, 10(83.3%) patients tested PCR positive, whereas only 2 (16.7%) patients had both antibody body and PCR negative. Based on the multivariate binary regression model indicated that the risk for mortality was higher in patients with ED Stay of more than 4 Hours (OR = 5.4), a total hospital stays of more than five days (OR = 0.17, 95% CI: 0.02 to 0.64).
Conclusion
Most children with PMIS were found to have positive antibodies against COVID-19. An increased ED stay was associated with poor outcomes.
Does the accelerometer-based navigation system reduce blood loss and transfusion in one-stage sequential bilateral total knee arthroplasty? A randomized double-blind controlled trial
Authors: Jarusriwanna Atthakorn , Pornrattanamaneewong Chaturong , Narkbunnam Rapeepat , Ruangsomboon Pakpoom , Thitithapana Paweena , Chareancholvanich Keerati
Published: March 2023

Background: Total knee arthroplasty (TKA) is associated with significant blood loss and postoperative transfusion. The accelerometer-based navigation (ABN) system guides the bone cutting plane without breaching the intramedullary canal, which may reduce bleeding. This study aimed to investigate blood loss and transfusion compared between the ABN system and the conventional procedure in patients undergoing one-stage sequential bilateral total knee arthroplasty (SBTKA).
Methods: A total of 66 patients scheduled for SBTKA were randomly allocated to either the ABN or conventional group. Postoperative hematocrit (Hct) level, drainage blood loss, transfusion rate, and amount of packed red cell transfusion were collected. Total red blood cell (RBC) loss was then calculated for the primary outcome.
Results: The mean calculated total RBC loss in the ABN and conventional group was 669.7 and 630.0 mL, respectively (p=0.572). There was no significant difference between groups for other evaluated outcome parameter, including postoperative Hct level, drainage blood loss, or packed red cell transfusion volume. All patients in the conventional group required postoperative blood transfusion while 96.8% of patients in ABN group were transfused.
Conclusions: The total RBC loss and volume of packed red cells transfusion were not significant difference between interventions, which suggest no benefit of the ABN system in reducing blood loss and transfusion in patients undergoing SBTKA.
Trial registration: The protocol of this study was registered in the Thai Clinical Trials Registry database no. TCTR20201126002 on 26/11/2020.
Exogenous spraying of IAA improved the efficiency of microspore embryogenesis in wucai (Brassica campestris L.) by affecting the balance of endogenous hormones, energy metabolism and cell wall metabolism
Authors: Wang Chenggang , Zhang Peiyu , Li Hong , He Yun , Huang Furong , Wang Xu , Zhu Shidong , Yuan Linyun , Hou Jinfeng , Chen Guohu , Wang Wenjie , Wu Jianqiang , Tang Xiaoyan
Published: March 2023

Background: Spraying indoleacetic acid (IAA) on the buds of Wucai (Brassica campestris L.) can increase the incidence of isolated microspore embryogenesis, but the mechanism of increasing microspore development remains unclear.
Results: The statistics of isolated microspore embryogenesis showed that spraying100 mg. L-1 IAA (purity 99%) to the bud was the optimal concentration for inducing isolated microspore embryogenesis in B. campestris L. Microscopic observation showed that IAA treatment accelerated the development process of microspores. In addition, the contents of amino acids, soluble total sugar, protein, and starch were significantly increased, and the dynamic balance between hormones was changed due to the change of endogenous hormone content. To explore the molecular mechanism of IAA affecting microspore embryogenesis, the mononuclear flower buds which were treated with IAA for 24h were selected and the mononuclear flower buds which were treated with the same dose of water at the same period were used as the control for transcriptome analysis. It was found that more DEGs was enriched in plant hormone synthesis and signal transduction pathways, pentose and glucuronic acid exchange pathway, and oxidative phosphorylation pathway, and most of them showed upregulation. These changes of DEGs broke the balance between endogenous plant hormones, initiated the generation of microspore embryos, accelerated the metabolism of the cell wall and the development of microspores.
Conclusions: This study helped to clarify the mechanism of microspore embryogenesis by IAA spring and provided a basis for further research on the molecular mechanisms of microspore development and the selection of key genes.
Light-oriented 3D printing of 4'-pentyl-4-cyanobiphenyl (5CB) liquid crystal/photocurable resins and its in-situ enhancement of mechanical performance
Authors: Sun Xiaolu , Chen Shaoyun , Qu Bo , Wang Rui , Zheng Yanyu , Liu Xiaoying , Li Wenjie , Gao Jianhong , Chen Qinhui , Zhuo Dongxian
Published: March 2023

A new printing resin with excellent performance (PR-5CB) was prepared by mixing 4'-pentyl-4-cyanobiphenyl (5CB) with acrylic photosensitive resin. The combination of the stereo lithography appearance (SLA) technique and the PR-5CB photosensitive resin allows precise adjustment of the existing morphology of liquid crystals in the resin to further control the mechanical properties of the printed product. Upon the addition of 5CB, the light-driven orientation of 5CB drives other acrylate prepolymers to orient along the orientation direction of 5CB, so that the entire fixed 3D printing polymer becomes anisotropic as observed by polarized optical microscopy. By controlling the 3D printing lamination method, printing resolution, and 5CB content, the mechanical properties of the 3D printed products can be effectively improved. The rheological properties, mechanical properties, and heat resistance of the PR-5CB resins were systematically investigated. The tensile strength, elongation at break, flexural strength, impact strength, and storage strength of the PC-5CB-3//(25 µm) printed products were 121.2 MPa, 25.5%, 222.0 MPa, 11.09 kJ/m2, and 1702.3 MPa respectively; these values are 281%, 241%, 270%, 275%, and 186% of those of the commercial inks. The initial decomposition temperature of the printed sample of PR-5CB-3// (25 µm) was 298.5 °C and the maximum decomposition temperature was 423.5 °C, which were also higher than those of the commercial resins. The results of this study are significant for the development of light-cured 3D printing. The developed approach offers unlimited potential for achieving autonomous design of structures that cannot be achieved by current additive manufacturing processes.
The Effect of Different Cleaning Materials on the Bond Strength of Resin Composite to Primary Teeth Dentin Contaminated with Root Canal Sealer
Authors: Çakır Asu
Published: March 2023

Background
In the literature review, no study was found on the bond strength of the adhesive on the dentin surface contaminated with root canal sealers in root canal treatment applications of primary teeth without underlying permanent teeth germ. This study aims to shed light on clinical applications by finding the most suitable material for cleaning primary tooth dentin contaminated with permanent tooth canal sealers.
Methods
The occlusal enamel layer was removed and the dentin of the primary tooth that was contaminated with root canal sealers (AH Plus, MTA Fillapex) was cleaned with different irrigation solutions (saline, NaOCI, ethanol). Specimens were restored with a self-etch adhesive (Prime & Bond Universal Dentsply) and composite (Nova Compo C Composite Imicryl Corporation). Sticks with a thickness of approximately 1 mm were obtained from each sample, and the bond strength of the samples was measured in a microtensile test device. The interfacial morphology of the bonded space was evaluated using scanning electron microscopy.
Results
The highest bond strength was determined in the control and AH Plus saline groups. The group cleaned with ethanol showed the lowest bond strength among all groups (p < 0.01).
Conclusion
Wet cotton pellets soaked in saline provided the best bond strength for cleaning dentin tissue. It has been determined that the most effective material for removing both epoxy resin-based and calcium silicate-based root canal sealants from the access cavity is saline.
Clinical Significance:
The results presented in this study are very important in increasing the clinical success of primary teeth without underlying permanent teeth germ in pedodontics clinics during root canal treatment.
Rescue of Xen45 Gel Stent Implant Occlusion In Refractory Glaucoma: A Case Report
Authors: zhang Yao , Xiang Haotian , Zhang Yangyang , Tang Li
Published: March 2023

Background
Xen Gel Stent implant is a new minimally invasive surgical treatment for glaucoma that has been proven effectiveness and safety profile. However, it may also lead to some complications. Xen Gel Stent occlusion is a relatively rare complication reported less frequently and has limited treatment experience. In our case report, we proposed a novel surgical treatment using a 10 − 0 nylon suture to recanalize the occluded Xen45 Gel Stent successfully.
Case presentation:
A 16-year-old female patient had bilateral juvenile glaucoma for the past 5 years. Her right eye had undergone three glaucoma surgeries but failed. At a presentation to our hospital, the intraocular pressure (IOP) in the right eye was 30 mmHg despite the application of four topical eye drops. Xen45 Gel Stent implant was chosen for treatment, but six days after implantation, the IOP rose to 40 mmHg due to an occlusion of the tip of Xen45 Gel Stent in the anterior chamber. Nd: YAG laser shockwave therapy was attempted but failed. The patient eventually had to return to the operating room for a revision procedure. A 10 − 0 nylon suture was threaded through the Xen45 Gel Stent to recanalize it. The IOP was successfully controlled in the 11-month follow-up.
Conclusion
If postoperative occlusion arises after Xen45 Gel Stent implantation, surgery using 10 − 0 nylon suture to recanalize Xen45 Gel Stent should be considered as a relatively safe, effective, and minimally invasive alternative that does not require removal or trimming of Xen45 Gel Stent.
Establishment of a multi-parameter prediction model for the functional cure of HBeAg-negative chronic hepatitis B patients treated with pegylated interferonα and decision process based on response-guided therapy strategy
Authors: Tang Qianqian , Ye Jun , Zhang Yafei , Zhang Peixin , Xia Guomei , Zhu Jie , Wei Shaofeng , Li Xu , Zhang Zhenhua
Published: March 2023

Background & Aims: This study aimed to establish multivariate prediction models according to a response-guided therapy (RGT) based strategy at baseline and week 12 and 24 of follow-up to predict the functional cure for HBeAg-negative patients with chronic hepatitis B (CHB) treated with pegylated interferonα (PEG-IFNα).
Methods: A total of 242 HBeAg-negative patients with CHB were treated with PEG-IFNα for 52 weeks and followed up for 24 weeks. Responses at the end of follow-up (EOF) were defined as hepatitis B surface antigen (HBsAg) loss, and patients were defined as either responders or non-responders.
Results: The three most meaningful predictors were an age ≤40 years,alanine aminotransferase (ALT) levels ≤40 U/L, and HBsAg levels ≤100 IU/mL at baseline; ALT levels ≥80 U/L, anti-HBc levels ≤8.42 S/CO, and HBsAg levels ≤50 IU/mLat week 12; and ALT levels ≥40 U/L, anti-HBc levels ≤8.46 S/CO, and HBsAg levels ≤0.2 IU/mL at week 24. The response rates of patients with a score of 0–1 and 4–5 at baseline, week 12, and 24 were 13.5%, 7.8%, and 11.7%; and 63.6%, 68.1%, and 98.1%, respectively. At week 12, the cumulative scores were 0–2, 3–4, 5–7, and 8–10 (response rates 5.0%, 18.9%, 41.3%, and 71.4%, respectively). At week 24, the cumulative scores were 0–3, 4–6, 7–10, and 11–15 (response rates: 1.3%, 12.3%, 37.0%, and 92.5%, respectively).
Conclusion: We established a multi-parameter prediction model for the functional cure of HBeAg-negative patients with CHB treated with PEG-IFNα.
A functional near-infrared spectroscopy study on hemodynamic changes of patients with prolonged disorders of consciousness responding to different auditory stimuli
Authors: Lu Haitao , Jiang Jin , Si Juanning , Wang Yizheng , Huang Fubiao
Published: March 2023

Treating prolonged disorders of consciousness (pDoC) is challenging. Thus, accurate assessment of residual consciousness in patients with pDoC is important for the management and recovery of patients. Functional near-infrared spectroscopy (fNIRS) can reflect brain activity through oxygenated cortical hemoglobin/deoxygenated hemoglobin (HbO/HbR) changes and has recently gained increasing attention for its potential applications in assessing residual consciousness. However, the number of fNIRS studies assessing residual awareness in patients with pDoC is still limited. The following study evaluates the brain function in 18 patients with pDoC (including 14 vegetative states [VS]) and 4 minimally conscious states [MCS]) and 15 healthy controls using two types of external stimuli, i.e., active stimulation (motor imagery) and passive stimulation (subject's own name [SON]) by fNIRS. The results showed that the mean concentrations of HbO/HbR in the prefrontal cortex of the healthy controls during the passive stimulation were significantly lower than those of the active stimulation, and the slope of the best-fit line was high. However, the hemodynamic responses of the patients with pDoC were opposite to the healthy controls. Additionally, the mean concentrations of HbO/HbR increased as the level of consciousness decreased during passive stimulation. Our findings suggest that the residual level of consciousness in pDoC patients can be assessed by measuring brain responses to different stimulations using fNIRS. The present study further demonstrates the feasibility andreliability of fNIRS in assessing residual consciousness in patients with pDoC, providing a basis for its expanded clinical application.
Very early onset of coronary artery aneurysm in a 3-month infant with Kawasaki disease: a case report and literature review
Authors: Jiao Wenyan , Wei Li , Jiao Fuyong , Pjetraj Dorina , Feng Jianying , Wang Jvyan , Catassi Carlo , Gatti Simona
Published: March 2023

Background
Kawasaki disease (KD) is a medium vessel vasculitis, of unknown etiology, typically presenting in children younger than 5 years of age. Prolonged fever (at least five days) is a major clinical criterion of KD, while cardiac involvement may occur in up to 25% of patients, generally in the second week of the disease.
Case presentation:
We describe the case of KD developing in a 3-month infant, with an early occurrence of coronary artery aneurism after only 3 days of fever, complicated by thrombosis, requiring aggressive treatments.
Conclusions
Time of development of cardiac complications can be different in young infants with KD and both diagnostic criteria and treatment indications should be individualized in this class of age.
PTH levels, sleep quality, and cognitive function in primary hyperparathyroidism
Authors: Wang Yuting , Xin Yunhui , Zhao Teng , Shen Hong , Liu Xing , Wang Jiacheng , Wang Qian , Feng Dalin , Shen Rongfang , Wei Bojun
Published: March 2023

Background
Cognitive function in patients with primary hyperparathyroidism (PHPT) may be affected and be identified to have been linked to the level of parathyroid hormone (PTH). Previous studies have suggested that patients with PHPT present poor sleep quality, which might interact with cognitive decline. The purpose of this study was to determine whether sleep quality mediates the association between PTH level and cognitive function and investigate whether surgery improves sleep quality and cognition in PHPT patients.
Methods
Between June 2019 and August 2022, we recruited 146 patients diagnosed with PHPT (n = 146). We collected clinical data from medical records and evaluated sleep quality and cognition preoperatively and 2 months postoperatively by using the Pittsburgh Sleep Quality Index and Min-Mental State Examination. We examined the mediation effects of sleep disturbance and latency on correlations between PTH level and cognitive impairment by using the Bootstrap method.
Results
The sleep quality and cognitive function were correlated with PTH level before surgery. Sleep latency or sleep disturbance exhibited a partial mediating effect on the association between PTH level and MMSE scores in PHPT patients. (p < 0.05) In PHPT patients, there was a significant decline in PTH levels and an improvement in cognitive function post-surgery compared to pre-surgery, but no significant differences in sleep quality.
Conclusion
Sleep disturbance and sleep latency may mediate the association between PTH level and cognitive impairment in PHPT before surgery. The surgery could reduce PTH levels and improve cognition, but might not improve sleep quality in PHPT patients.
Facilities, Challenges, Attitudes, and Preferences of Nursing Students Related to E-Learning in the Covid-19 Pandemic in Iranian Context: A Cross-Sectional Study
Authors: sadaf Amir mohammad Atashin , Amini Kourosh , Ramezanibadr Farhad , Long Tracey , Imanipour Mohammad
Published: March 2023

Background During the Covid-19 pandemic, nursing schools were forced to deliver nursing courses in ways other than the traditional face to face classroom setting. Many lessons were learned by nurse educators regarding electronic and online learning strategies. It is necessary to be aware of the factors affecting e-learning and identify the strengths and weaknesses to improve the student learning process in nursing school. Aim of study: The present study aimed to determine Facilities, challenges, attitudes, and preferences of nursing students regarding e-learning during the Covid-19 pandemic. Methods In this cross-sectional study, 228 undergraduate nursing students participated. The random sampling method used a standard questionnaire that students completed voluntarily. SPSS version 22 was used for data analysis. Results During the covid-19 pandemic, the majority of nursing students of Zanjan University of Medical Sciences participated in electronic classes at home using mobile phones. Students reported that physical problems increased by participating in e-classes. The level of complaints about these problems was related to the female gender of the students. The most significant challenges for students in online classes were difficulty typing and frequent internet outages. Classroom management for instructors was difficult due to students spontaneously leaving the virtual online classroom rather than attending the entire learning session. Overall, the attitudes of students towards various aspects of e-learning were positive. There was a noted correlation between student attitude by gender and educational background. Students preferred that professors used more PowerPoint, showed instructional videos, and had interactive group discussion sessions rather than lecture only. Students objected to attending more than two online classes in one day if the duration lasted more than 60 minutes and have a rest time of fewer than 30 minutes between classes. Conclusion Despite overall student satisfaction with e-learning, this method of education is still far from student preferences and requires planning for an effective learning experience that meets their priorities and preferences. Using a hybrid of face-to-face and e-learning approaches together can be a more effective teaching method than either strategy alone.
Empagliflozin effects on iron metabolism as a possible mechanism for improved clinical outcomes in non-diabetic patients with systolic heart failure
Authors: Angermann Christiane , Santos-Gallego Carlos , Requena-Ibanez Juan , Sehner Susanne , Zeller Tanja , Gerhardt Louisa , Maack Christoph , Sanz Javier , Frantz Stefan , Fuster Valentin , Ertl Georg , Badimon Juan J
Published: March 2023

Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve clinical outcomes in patients with heart failure (HF), but mechanisms of action are incompletely understood. In the EMPATROPISM trial, empagliflozin reversed cardiac remodeling and increased physical capacity in stable non-diabetic patients with systolic HF. EMPATROPISM-FE explored post hoc in this cohort, who had a high prevalence of iron deficiency, whether treatment effects were related to changes in iron metabolism. Here we show that myocardial iron content estimated by cardiac magnetic resonance T2* quantification increased after initiation of empagliflozin, but not placebo (between-group difference p = 0.01). T2* changes were significantly correlated with changes in left ventricular volumes, mass and ejection fraction, peak oxygen consumption and 6-minute walking distance; concomitant changes in red blood cell indices were consistent with augmented hematopoiesis. Our findings suggest that effects of empagliflozin on iron metabolism may be a potential mechanism mediating its beneficial clinical effects in patients with HF.
Clinical Trial Registration: www.clinicaltrials.gov; NCT03485222
Research on the Learning Experience of Virtual Simulation Class Experiment Teaching and Learning Based on the Perspective of Nursing Students
Authors: Gao Yazhuo , Zhu Xuehua
Published: March 2023

Background: With the enrichment of information technology means, the traditional teaching mode has been impacted. The emergence of virtual simulation class experiment teaching software has effectively improved the quality of nursing experiment teaching. To explore the learning experience of virtual simulation class experiment teaching and learning based on the perspective of nursing students, in order to provide a basis for improving related learning effects in the future.
Methods: A total of 14 undergraduate nursing students who met the inclusion and exclusion criteria were selected by purposive sampling method for semi-structured interviews. Colaizzi seven-step analysis method was used to collate and analyze the interview data.
Results: Learning experience can be divided into positive experience and negative experience. In the positive learning experience, undergraduate nursing students showed a deep memory of real and diverse scenes, which made the knowledge presentedin the characteristics of clear logic, symbolization and stereoscopic vision. Negative experience is manifested as the learning efficiency is significantly different in different grades and subjects, and the teaching feedback is difficult to be timely.
Conclusions: Virtual simulation experiment teaching can promote the subjective initiative of nursing students’ learning, and promote their image thinking and theoretical thinking to get better coordination and unity. By following the educational policy of our country, strengthening the information construction, combining with the characteristics of the discipline and bringing its superiority into full play. This paper provides reference for the future exploration of nursing education and further improving the construction of virtual simulation experiment teaching.
Lightning nowcasting with aerosol-informed machine learning and satellite-enriched dataset
Authors: Li Siwei , Song Ge , Xing Jia
Published: March 2023

Fast and accurate prediction of lightning occurrence is important for protecting human health and global environment. The machine learning (ML)-based model has advantages in computation efficiency; however it suffers low accuracy due to insufficient depiction of complex lightning mechanisms and poor training dataset. To address such limitations, here we propose a novel ML-based lightning nowcast model (LightGBM) by incorporating aerosol feature to better capture the lightning mechanisms, together with the aid of enriched satellite observations from Geostationary Lightning Mapper (GLM). The well-trained LightGBM model has successfully predicted spatially continuous (0.25° by 0.25°) and hourly level lightning occurrence over summertime Contiguous United Stated (CONUS) with improved performance (accuracy = 94.3%, POD = 75.0%, FAR = 38.1%, PRC-AUC = 0.727) from competitive baselines (POD < 60%, FAR > 40%). Besides enriched dataset, such improved performance is also associated with the inclusion of aerosol feature (with > 10% enhancement on correct rejection rate when demand for POD exceeds 75%) which is proven to be essential for predicting lightning but overlooked in previous studies. Furthermore, the model reveals the contribution of aerosol composition and loading to the formation of lightning, suggesting high loading of aerosols compositing of sulfate and organic compounds tend to enhance the lightning while black carbon inhibits it. These findings are consistent with the current scientific knowledge and demonstrate the great potentials to explore the complex mechanisms of lightning associated with aerosols.
Potency of Teleopthalmology As A Detection Tool for Diabetes Retinopathy
Authors: Li Liu , Jin Yu , Wang Jun Hua , Wang Sha Sha , Yuan Fang Xiu
Published: March 2023

Purpose: To explore the effect of application of teleopthalmology for screening of diabetes retinopathy in diabetic patients.
Methods: The retinal images of 1646 diabetic patients undergoing diabetes retinopathy screening through teleopthalmology in Nanchang First Hospital were collected for 30 months (January 2020 to June 2022). Retinal images were collected, stored by community general practitioner, and diagnosed by both community general practitioner and ophthalmologist of our hospital through teleopthalmology.
Results: A total of 1646 patients with 3185 eyes were examined, including 1936 eyes of diabetes retinopathy. The accuracy of community general practitioner was acceptable, which gradually improved with time.
Conclusions:Teleopthalmology is a detection tool for diabetes retinopathy, which makes it possible for community general practitioners to grade images with high accuracy after appropriate training through teleopthalmology.It is possible to solve the current shortage of eye care personnel.
Boosting the digitalization of social and care services: A methodological approach for the evaluation and uptake of Open Service Platforms in the Active and Healthy Ageing (AHA) domain
Authors: Abril-Jiménez Patricia , Carvajal-Flores Diego , Cabrera-Umpierrez María Fernanda , Gonzalez-Martinez Sergio , Montalva-Colomer Juan Bautista , Pérez Silvia de los Ríos , Waldmeyer María Teresa Arredondo
Published: March 2023

Background: The massive use of digital technologies has created a wide number of opportunities to improve Active and Healthy Ageing (AHA) services and products and respond to the socioeconomic and healthcare challenges caused by the growing ageing population. Therefore, a considerable number of digital AHA platforms have been produced in recent years. These platforms are operational on similar services within the same domain, competing or complementing each other in most cases. This makes it difficult for service providers, developers, and public administrations to choose based on the available options and their benefits.
Methods: Responding to the need of providing information on prioritization and understanding the real value of these platforms to support decision making on the correct selection, this study understands the different characteristics and differences of the currently available services platforms, to get a comprehensive view directly through the feedback of platforms owners (both developers and managers) with the participatory involvement of every of the stakeholders contributing in the AHA services provision and consumption.
Results: The paper develops and applies the proposed methodology into a specific AHA use case. Our findings suggest that this method can be considered an effective framework to define a set of Key Performance Indicators (KPIs) to track the successful uptake and evolution of existing platforms thanks to the combination of the different stakeholders’ visions and interests at the different interventions levels.
Conclusions: The proposed method led us to proposing a comprehensive list of KPIs, which has evolved along the process to a minimum set of KPIs, that are relevant for the methodologically measure the success of digital AHA platforms, according to four different perspectives: primary end-users, technological providers, end-users consumers and government, and at different levels of integration: user, community and municipalities.
Another HSS Spliting Theorem
Authors: Smotzer Thomas , Buoni John
Published: March 2023

In this paper, we study a variation of the HSS spliting which was first formulated by Bai. Golub and Ng. This variation is similar to that of Kellogg’s variation of the Peaceman Radford Method.
Mathematical subject classification: Primary 65F10, 65F50, Secondary 15A06
Extending loophole-free nonlocal correlations to arbitrarily large distances
Authors: Chaturvedi Anubhav , Viola Giuseppe , Pawłowski Marcin
Published: March 2023

One of the most striking features of quantum theory is that it allows spatially separated observers to share correlations that resist local-causal (classical) explanations, a phenomenon referred to as Bell nonlocality[1, 2]. Besides their foundational relevance, the nonlocal correlations enable distant observers to accomplish classically inconceivable information processing and cryptographic feats such as unconditionally secure device-independent key distribution schemes[3-5]. However, the distances over which nonlocal correlations can be realized in state-of-the-art Bell experiments remain severely limited owing to the high threshold efficiencies of the detectors and the fragility of the nonlocal correlations to experimental noise[6, 7]. Instead of looking for quantum strategies with marginally lower threshold requirements, we exploit the properties of loophole-free nonlocal correlations, which are experimentally attainable today, albeit at short distances, to extend them over arbitrarily large distances. Specifically, we consider Bell experiments wherein the spatially separated parties randomly choose the location of their measurement devices in addition to their measurement settings. We demonstrate that when devices close to the entanglement source are perfect and witness extremal loophole-free nonlocal correlations, such correlations can be extended to devices placed arbitrarily far from the source, with almost zero detection efficiency and visibility. To accommodate imperfections close to the source, we demonstrate a specific analytical tradeoff: the higher the loophole-free nonlocality close to the source, the lower the threshold requirements away from the source. We utilize this analytical tradeoff paired with optimal quantum strategies to estimate the critical requirements of a measurement device placed away from the source in the simplest non-trivial scenario and formulate a versatile numerical method applicable to generic network scenarios. Our results demonstrate that the properties of already feasible short-distance loophole-free nonlocal correlations can be exploited to extend them to longer distances, enabling device-independent information processing and cryptography fuelled by long-distance loophole-free nonlocal correlations to become near-term commonplace technologies.
Artificial axons - a biomimetic 3D myelination platform for the discovery and validation of pro-myelinating compounds
Authors: Jagielska Anna , Radzwill Kristin , Espinosa-Hoyos Daniela , Yang Mingyu , Kowsari Kavin , Farley Jonathan E. , Giera Stefanie , Byrne Ann , Sheng Guoqing , Fang Nicholas X. , Dodge James C. , Pedraza Carlos E. , Vliet Krystyn J. Van
Published: March 2023

Multiple sclerosis (MS), a chronic neurodegenerative disease driven by damage to the protective myelin sheath, is currently incurable. Today, all clinically available treatments modulate the immune-mediated symptoms of the disease but they fail to stop neurodegeneration in many patients. Remyelination, the regenerative process of myelin repair by oligodendrocytes, which is considered a necessary step to protect demyelinated axons and stop neuronal death, is impaired in MS patients. One of the major obstacles to finding effective remyelinating drugs is the lack of biomimetic drug screening platforms that enable quantification of compounds’ potential to stimulate 3D myelination in the physiologically relevant axon-like environment. To address this need, we built a unique myelination drug discovery platform, by expanding our previously developed technology, artificial axons (AAs), which enables 3D-printing of synthetic axon mimics with the geometry and mechanical properties closely resembling those of biological axons. This platform allows for high-throughput phenotypic myelination assay based on quantification of 3D wrapping of myelin membrane around axons in response to compounds. Here, we demonstrate quantification of 3D myelin wrapping by rat oligodendrocytes around the axon mimics in response to a small library of known pro-myelinating compounds. This assay shows pro-myelinating activity for all tested compounds consistent with the published in vitro and in vivo data, demonstrating predictive power of AA platform. We find that stimulation of myelin wrapping by these compounds is dose-dependent, providing a facile means to quantify the compounds’ potency and efficacy in promoting myelin wrapping. Further, the ranking of relative efficacy among these compounds differs in this 3D axon-like environment as compared to a traditional oligodendrocyte 2D differentiation assay quantifying area of deposited myelin membrane. Together, we demonstrate that the artificial axons platform and associated phenotypic myelin wrapping assay afford direct evaluation of myelin wrapping by oligodendrocytes in response to soluble compounds in an axon-like environment, providing a predictive tool for the discovery of remyelinating therapies.
Comprehensive Bioinformatics analysis of angiotensin-converting enzyme 2 (ACE2)
Authors: Zhang Shanshan , Zhang Yongtao , Liu Pengchao , Yang Wei , Li Xianxian , Zhang Chao , Yang Dan , Zhi Wei , Han Jinxiang , Lu Yanqin
Published: March 2023

ACE2, a member of the angiotensin converting enzyme family, plays an irreplaceable role in the renin-angiotensin system. And the variations of ACE2 are regarded as the key factor to human diseases such as the novel coronavirus pneumonia, cardiovascular disease, and tumors. Here, we summarized the mutation, expression, modification and function of the human ACE2 based on comprehensive bioinformatics analysis. Especially, the relationship between ACE2 expression and diseases, especially tumor was further discussed. ACE2 is highly conserved in different genera and families. We explored the correlation between ACE2 and disease based on the datasets of GCBI and GEO (Gene expression omnibus), and found the expression of ACE2 is related to heart failure. High prevalence of ACE2 mutations is observed in diffuse large B-cell lymphoma, uterine carcinosarcoma (UCS), and stomach adenocarcinoma (STAD). We first identified that highly expressed of ACE2 was linked to poor prognosis of overall survival for tumors of brain lower grade glioma (LGG). Specially, the expression level of ACE2 in kidney-related tumor tissues is much higher than that of normal kidney tissues. ACE2 is negatively correlated with the infiltration level of cancer-associated fibroblasts in most kinds of cancers, such as uterine corpus endometrial carcinoma (UCEC), esophageal carcinoma (ESCA), ovarian serous cystadenocarcinoma (OV) and kidney renal clear cell carcinoma (KIRC); positively correlation in testicular germ cell tumors (TGCT). The different phosphorylation sites of ACE2 were analyzed in CPTAC dataset, and the DNA methylation of ACE2 in colon adenocarcinoma (COAD), kidney renal papillary cell carcinoma (KIRP), and rectum adenocarcinoma (READ) was lower than that of normal control by using SMART database. Moreover, we summarized the interaction proteins and targeted miRNAs of ACE2 through bioinformatics. Then we found the endocrine process and the regulation of systemic arterial blood pressure were involved in the functional mechanisms of ACE2 by using KEGG and GO analysis. Our study offers a relatively comprehensive understanding of ACE2.
First trimester fetal ultrasonographic soft markers and adverse pregnancy outcomes
Authors: Ji Chunya , Sheng Liting , Zheng Chenhan , Yin Linliang , Deng Xuedong , Wu Guihua , Sun Lingling , Pan Qi , Yang Zhong , Zhang Jun , Ling Chen
Published: March 2023

Objective
To evaluate the relationship between first trimester (11 ~ 13+ 6 gestational weeks) ultrasonographic soft markers (USMs) and fetal adverse pregnancy outcomes.
Methods
A retrospective study, singleton pregnancies were recruited from the first-trimester scanning (FTS) during May 2017 to August 2021 at the Affiliated Suzhou Hospital of Nanjing Medical University. All fetuses were followed up till birth or induced abortion. The spectrum and detection rate of USMs during the first trimester were studied. The correlation between USMs and adverse pregnancy outcomes was analyzed to evaluate the management of fetus with 1st trimester USMs.
Results
Among 7355 fetuses who underwent FTS, 6868 fetuses with complete follow-up outcomes were recruited in the study. Total 1105 USMs were reported among 963 fetuses during the first trimester. According to the detection rate, the most frequently detected USMs were increased nuchal translucency (NT) thickeness (6.70%, 460/6868), followed by echogenic intracardiac focus (EIF) (5.10%, 350/6868), absent/reversed a-wave of ductus venosus (1.35%, 93/6868) and absence/hypoplasia of the nasal bone (NB) (1.03%, 71/6868). The incidence of adverse pregnancy outcomes in fetuses with two or more USMs was 36.44% (43/118), which was significantly higher (χ2 = 114.50, P < 0.001) than fetuses with single USM (5.68%, 48/845). The incidence of adverse pregnancy outcomes in fetuses who had both USMs and structural abnormalities was 72.60% (53/73), were also significantly higher (χ2 = 368.17, P < 0.001) than fetuses with isolated USMs without structural abnormalities (4.27%, 38/890). Logistic regression analysis showed increased NT thickness, absence/hypoplasia of the NB, absent/reversed a-wave of ductus venosus, tricuspid regurgitation (TR), choroid plexus cyst (CPC), echogenic bowel (EB) and single umbilical artery (SUA) were closely associated with the adverse pregnancy outcomes (P < 0.05). However, there was no significant correlation between EIF, mild pyelectasis (PYE) and fetal adverse pregnancy outcomes (P = 0.30; P = 0.77).
Conclusions
The ultrasonographic soft markers found during the first trimester, especially multiple USMs, or USMs are associated with structural malformations, are potential soft markers in predicting fetal adverse pregnancy outcomes.
Investigation on anti-quorum sensing activities of Chitosan AgNP’s-chitosanase against MDR pathogens
Authors: Sathiyamoorthy Jananishree , N Mahesh
Published: March 2023

Marine bio-nanotechnology is a new promising field with having high perspective in the area of biological research. In 2018 the production of crustacean shells especially from shrimp is about 54,500 tons on South East coast of India. The current study focuses on the use of extracted chitosan (Squilla shells) polymer in silver nanoparticle synthesis along with immobilized chitosanase synergistically improves the antimicrobial and quorum quenching effects against the multi drug resistant (MDR) pathogens. The main objective of the project is to synthesize the chitosan AgNPs and to immobilize the enzyme chitosanase with it and to study the anti quorum sensing (quorum quenching) activity against MDR pathogens. This study will render a new ideology to eliminate biofilm formation and suppress the pathogenicity of planktonic MDR pathogens. Since the combinations of chitosanase, as well as Chitosan silver nanoparticles, are very efficient in eliminating them.
Single-cell analysis of uterosacral ligament revealed cellular heterogeneity in women with pelvic organ prolapse
Authors: Liu Xiaochun , Sue Minna , Wei Lingyun , Zhang Jia , Wang Wenzhen , Hao Qian , Lin Xiling , Wang Lili
Published: March 2023

Pelvic organ prolapse (POP) markedly affects the quality of life of women, including significant financial burden. Different cell types and corresponding marker genes were identified in the vaginal wall of women with POP; however, no study has explored gene expression and cellular heterogeneity in the uterosacral ligament. Using single-cell RNA sequencing, we constructed a transcriptional profile of the uterosacral ligament and control samples, and identified 10 major cell types. We performed subpopulation analysis of POP primary cells, explored differentially expressed genes, and performed pseudo-time and transcription factor analyses. We verified previous cell clusters of human fibroblasts, neutrophils, and found new clusters of uterosacral ligaments. Additionally, we dissected pattern changes of cell–cell interaction between stromal and immune cells and transcription factors related to the extracellular matrix, development, and immunity in POP. Here we provide insight into the molecular mechanisms of POP and valuable information for future research directions.
Seasonal variation in spider abundance in Muthupet mangroves, South East coast of Tamilnadu, India
Authors: Raja Rethinam Bose , Muthukumaravel Kannayiram , Selvan K. Muthamizh , Pradhoshini Kumara Perumal , Ahmed Munawar Suhail , Musthafa Mohamed Saiyad , Burgos-Aceves Mario Alberto , Faggio Caterina
Published: March 2023

The abundance, dominance and diversity of the arachnid population are influenced by their habitat’s microclimate and environmental variables. Here we evaluated a seasonal dominance, diversity and richness pattern of the arachnid population and their guild composition in the Muthupet mangrove forest. Most of the spiders were aggregated from specific mangrove plants such as Avicennia and Rhizophora species by adopting standard hand-picking and net-sweeping methods and employing bark traps, pitfall traps and leaf litter traps. A total of 14 families, 29 genera and 47 species of arachnids were recorded. The sequence of the abundance of the families was: Araneidae > Tetragnathidae > Lycosidae > Salticidae > Oxyopidae > Eresidae > Liniphidae > Clubionidae > Sparassidae > Uloboridae > Hersilidae > Gnaphosidae = Thomisidae > Miturgidae. The annual average population density of spiders was maximum (36.13%) during the post-monsoon (January, February, and March) and summer seasons. The minimum seasonal mean population density was during the pre-monsoon and monsoon periods, attributed to the changes in temperature, relative humidity and rainfall. The Muthupet mangrove forest registered six types of guilds. The dominant group was orb-weavers (62.44%), followed by foliage runners (15.11%). The rest of the guilds were represented by tunnel web builders (15.78%), ground runners (2.23%), communal web weavers (4.41%), and ambushers (0.03%). Thus, changes in environmental parameters produced alterations in arachnid abundance and diversity. Moreover, the predatory potential of the arachnids relies chiefly on the composition of spider assemblages, which in turn, gets impacted by abiotic factors of its environment.