bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rare Cause of Intestinal Obstruction in Paediatric Patients
Authors:   Resident, Department of general surgery, Shri M.P. Shah Medical College and G.G Hospital Jamnagar 361006, Banaskantha, Gujarat, India., Bankola Jagdish , Chattopadhyay Arnab ,   Resident, Department of general surgery, Shri M.P. Shah Medical College and G.G Hospital Jamnagar 361006, Banaskantha, Gujarat, India.
Published: January 2024

Peutz-Jeghers syndrome is an autosomal dominant hamartomatous polyposis involving gastrointestinal tract associated with mucocutaneous hyperpigmentation involving lips, buccal mucosa ,hand and feet and predisposing the patient to various extraintestinal and intestinal cancers.This article includes case report of a 12 year female diagnosed with intussusception due to Peutz-JeghersSyndrome. This patient underwent emergency exploratory laparotomy followed by resection of about 30 cm necrosed , gangrenous ileum about 50cm proximal to ileocecal junction and then ileoileal anastomosis performed . This patient had pigmented hypermelanotic macules over lower lip ,buccal mucosa and face. This case was thoroughly examined and found to be a rare case of intestinal obstruction in paediatric patients. Key words: Peutz Jeghers syndrome; intussusception; hamartomatous polyposis
Gastric Volvulus Associated with Eventration of Diaphragm
Authors:   Associate professor, Department of surgery, Vydehi institute of medical sciences and research, Vijayanagar, Nallurhalli, Bengaluru, Karnataka 560066, India., Guptha Saikalyan , H Ravi Kumar ,   Professor, Department of surgery, Vydehi institute of medical sciences and research, Vijayanagar, Nallurhalli, Bengaluru, Karnataka 560066, India., Ghosh Shaurav ,   Junior resident, Department of surgery, Vydehi institute of medical sciences and research, Vijayanagar, Nallurhalli, Bengaluru, Karnataka 560066, India., R Harshitha ,   Junior resident, Department of surgery, Vydehi institute of medical sciences and research, Vijayanagar, Nallurhalli, Bengaluru, Karnataka 560066, India.
Published: January 2024

Diaphragmatic eventration is an abnormally elevated hemidiaphragm in thoracic cavity with poorly developed musculature. This condition can lead to abnormal displacement of intra-abdominal organs. It usually remains asymptomatic in early life. It presents later with respiratory and occasionally gastrointestinal complications. A clinical case of eventration of diaphragm, displacement of the splenic flexure of colon, omentum and spleen into thoracic cavity with gastric volvulus is uncommon. Gastric volvulus occurs when the stomach twists around one of its axis. It is commonly along its long axis (organoaxial volvulus) and less commonly along the vertical axis (mesenteroaxial).Mortality rate of gastric volvulus range from 30%-50%. Hence early diagnosis and prompt intervention prevents development of necrosis and perforation of stomach. We report a case of 30year old male having left sided diaphragmatic eventration associated with organoaxial gastric volvulus and displaced intra-abdominal organs treated with successful surgical intervention. Key words: Eventration; Diaphragm; Gastric; Volvulus; Malrotation; Organo-axial; Mesenteroaxial, Gastric outlet obstruction, Derotation; Gastropexy.
Fine Needle Aspiration Cytology Versus Incisional Biopsy in Breast Carcinoma
Authors:   Additional professor, Shri M P Shah Government Medical College, Jamnagar, Gujarat 361008, India., Pathak Aasit L , Modh Jaimin Rajesh kumar ,   Senior resident, Shri M P Shah Government Medical College, Jamnagar, Gujarat 361008, India., Vadaliya Akshat Keshubhai ,   3rd Year Resident, Shri M P Shah Government Medical College, Jamnagar, Gujarat 361008, India.
Published: January 2024

Mammary glands or breasts are distguishing features of mammals from puberty to death. The breast plays constant physical and physiological role in women's life, related to important life ecents such a menses, pregnancy, gestation, lactation and menopause. This is unique because its development and growth is under constant control of numerous horones. Currently accurate diagnosis of breast lesions depends on a "Triple assessment Approach" comprising clinical, imgaging and pathological examination, for the pathological assessment of breast lumps fine needle aspiration cytology and incisional biopsy are cosidered.
The Role of Indigenous Four Layer Regenerative Scaffold in the Management of Post Burn Raw Area
Authors:   Senior resident,Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., K Nishad , Chittoria Ravi Kumar ,   Professor, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Mohan Padmalakshmi Bharathi ,   Senior resident,Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Pathan Imran ,   Senior resident,Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., K Shijina ,   Senior resident,Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India., Thomas Neljo ,   Senior resident,Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India.
Published: January 2024

The understanding of wound healing has led to the inclusion of tissue regeneration therapy as an armamentarium to deal with both acute and chronic wounds. The bio constructs that aid in wound regeneration was made using natural, artificial, or a combination of both, widely known as regeneration scaffolds. The components of regeneration scaffolds promote the inherent self-renewal property of the skin and speed up the healing process by providing growth factors/stem cells. The scaffolds are in use for so many years. But the commercially available scaffolds are very expensive. Hence an indigenous scaffold was made use of multiple components like non-cultured keratinocytes, amniotic membrane, collagen, and silicone. Which was found to be in no way inferior to any of the commercially available scaffolds. Keywords: Regeneration Scaffold; Post Burn Raw area; Dermal Regeneration; Regenerative Therapy.
Plan de negocios para la comercialización de la bebida energizante a base de polen
Authors:   , Del Carpio Samanez Celeste Thalia , Lopez Sanchez Julio Enrique
Published: January 2024

El presente proyecto innovador tiene como objetivo realizar la venta de una bebida energizante y que su origen sea el polen, surgió debido al constante crecimiento que se está dando el consumo de bebidas energéticas naturales, que viene mostrando una alta demanda en el mercado de Lima Norte. Esto se debe, a que las personas buscan recuperar energías luego de un arduo trabajo, estudio o actividad deportiva. Por lo que se visualiza un interesante crecimiento y una gran oportunidad de negocio para concretarse. El plan de negocios tiene como fin la comercialización de una bebida, con el objetivo de proyectarnos al mercado de Lima Norte, las bondades que presenta el producto representa a una bebida natural con sabor frutal y a un excelente precio. Esta bebida está dirigida para consumidores de 18 a 45 años con un estatus socio económico medio y medio alto, interesados en un estilo de vida saludable y natural. El consumo promedio mensual estimado en el corto plazo será dependiente a la estación que será de 13,248, 15,897 y 17,222 bebidas de 250 ml, así también de 9,273, 10,598 y 13,248 de bebidas de 200 ml. Este consumo crecerá un 5% en los dos primeros años. La estrategia de distribución inicial será mediante canales directos a través de locales comerciales alquilados en las zonas de mayor movimiento comercial. También se hará alianzas estratégicas con gimnasios, centros deportivos, cruceristas y universidades. Para iniciar las operaciones de la comercialización del energizante Polen Drink se requerirá una inversión inicial de S/.219.918,84 de los cuales el 56% serán aportados por los socios de la empresa con un monto de S/.121,918.96 y un monto de S/. 97,099.88, que será financiado por terceros.
Quantifying antibody binding to Fcγ-receptors in malaria immunity
Authors: Feng Gaoqian , Beeson James
Published: January 2024

IgG can opsonise pathogens and mediate binding to Fcγ-receptors (FcγRs) expressed by various innate immune cells to promote antibody-mediated pathogen clearance via mechanisms including opsonic phagocytosis and antibody-dependent cellular cytotoxicity (ADCC). High levels of IgG that bind FcγRs has been associated with protection from malaria. This assay measures FcγR-binding by antigen-specific IgG using recombinant FcγRs in a plate-based method which is suitable for high throughput. The method is suitable for using recombinant proteins or whole malaria parasites in the assays. FcγRIIa and FcγRIIIa/b are low affinity receptors and need to be used as ectodomain dimers in assays in order to achieve good activity in the assays. FcγRI can be used as a monomeric protein.
Skeletal muscle reprogramming enhances reinnervation after peripheral nerve injury
Authors: Personius Kirkwood , Mehrotra Pihu , Jablonski James , Toftegard John , Zhang Yali , Shahini Shahryar , Wang Jianmin , Hung Carey , Ellis Reilly , Kayal Gabriella , rajabian Nika , Liu Song , Roballo Kelly , Udin Susan , Andreadis Stelios
Published: January 2024

Peripheral Nerve Injuries (PNI) affect more than 20 million Americans and severely impact quality of life by causing long-term disability. The onset of PNI is characterized by nerve degeneration distal to the nerve injury resulting in long periods of skeletal muscle denervation. During this period, muscle fibers atrophy and frequently become incapable of “accepting” innervation because of the slow speed of axon regeneration post injury. We hypothesize that reprogramming the skeletal muscle to an embryonic-like state may preserve its reinnervation capability following PNI. To this end, we generated a mouse model in which NANOG, a pluripotency-associated transcription factor can be expressed locally upon delivery of doxycycline (Dox) in a polymeric vehicle. NANOG expression in the muscle upregulated the percentage of Pax7+ nuclei and expression of eMYHC along with other genes that are involved in muscle development. In a sciatic nerve transection model, NANOG expression led to upregulation of key genes associated with myogenesis, neurogenesis and neuromuscular junction (NMJ) formation, and downregulation of key muscle atrophy genes. Further, NANOG mice demonstrated extensive overlap between synaptic vesicles and NMJ acetylcholine receptors (AChRs) indicating restored innervation. Indeed, NANOG mice showed greater improvement in motor function as compared to wild-type (WT) animals, as evidenced by improved toe-spread reflex, EMG responses and isometric force production. In conclusion, we demonstrate that reprogramming the muscle can be an effective strategy to improve reinnervation and functional outcomes after PNI.
Aberrant enhanced NLRP3 inflammasomes and cell pyroptosis in the brains of prion infected rodent models are largely associated with the proliferative astrocytes
Authors: Zhou Dong-Hua , Jia Xiao-Xi , Wu Yue-Zhang , Zhang Wei-Wei , Wang Yuan , Liang Dong-Lin , Gao Li-Ping , Xiao Kang , Chen Cao , Dong Xiao-Ping , Shi Qi
Published: January 2024

Neuroinflammation is a common pathological feature in a number of neurodegenerative diseases, which is mediated primarily by the activated glial cells. NLRP3 inflammasomes associated neuroinflammatory response is mostly considered. To investigate the situation of the NLRP3 related inflammation in prion disease, we assessed the levels of the main components of NLRP3 inflammasome and its downstream biomarkers in the scrapie infected rodent brain tissues. The results showed that the transcriptional and expressional levels of NLRP3, caspase1, ASC in the brains of scrapie infected rodents were significantly increased at terminal stage. The increased NLPR3 overlapped morphologically well with the proliferated GFAP-positive astrocytes, but little with microglia and neurons. Using the brain samples collected at the different time-points after infection, we found the NLRP3 signals increased in a time-dependent manner, which were coincidental with the increase of GFAP. Two main downstream cytokines, IL-1β and IL-18, were also upregulated in the brains of prion infected mice. Moreover, the GSDMD levels, particularly the levels of GSDMD-NT, in the prion infected brain tissues were remarkably increased, indicating activation of cell pyroptosis. The GSDMD not only co-localized well with the astrocytes but also with neurons at terminal stage, also showing a time-dependent increase after infection. Those data indicate that NLRP3 inflammasomes were remarkably activated in the infected brains, which is largely mediated by the proliferated astrocytes. Both astrocytes and neurons probably undergo a pyroptosis process, which may help the astrocytes to release inflammatory factors and contribute to neuron death during prion infection.
Survival outcomes in patients undergoing different treatments for small cell endocrine carcinoma of the cervix: a retrospective analysis
Authors: Liu Tong-Yu , Chen Li-Jun , Xu Lin-Yan , Liu Qin-Qing , Lin Shao-Wei , Hu Dan , Huang Rong-Fang , Ji Hai-Zhou , Lin Yu-Zhen , Xie Zuo-Lian , Lin Wan-Zhen , Xie Rong , Li Sang , Sun Yang
Published: January 2024

Background
To identify the optimal primary treatment strategy for small cell neuroendocrine carcinoma of the cervix (SCNECC).
Methods
This retrospective study included consecutive patients who received treatment for stage I-III SCNECC at Fujian Cancer Hospital from February 6, 2006 to July 30, 2019. Relapse-free survival (RFS) was analyzed using multivariate Cox proportional hazard regression. Results are shown as hazard ratio (HR) and 95% confidence interval (CI).
Results
The final analysis included 69 patients. Disease stage, as assessed by the 2018 FIGO criteria, was early (I–IIA) in 34 (49%) patients and advanced (IIB–IIIC) in the remaining 35 (51%) patients. Twenty patients (29%) received curative-intent radiotherapy followed by chemotherapy. The remaining 49 patients received curative surgical resection, followed by adjuvant chemotherapy in 16 (23%) patients or adjuvant chemoradiotherapy in 33 (48%) patients. Forty patients received neoadjuvant therapy prior to curative surgical resection. Within a median follow-up of 100 months (interquartile range: 59–120), recurrence or metastases occurred in 36 patients (52%). In patients with early-stage disease, the median RFS did not differ between patients undergoing curative-intent surgery vs radiotherapy (86 months, 95% CI 63–109 vs 86 months, 95% CI 56–116, P = 0.790). In patients with advanced-stage disease, there was a statistically non-significant trend for shorter median RFS in patients undergoing curative-intent surgery vs radiotherapy (61 months, 95% CI 38–85 vs 88 months, 95% CI 46–130, P = 0.590). In patients undergoing curative-intent surgery, patients with an extensive pathologic response to neoadjuvant chemotherapy had longer RFS than moderate response and minor response (P = 0.033). In multivariate Cox regression analysis, longer RFS was independently associated with extensive pathologic response to neoadjuvant therapy (HR = 0.01, 95% CI 0.00-0.41; P = 0.017) and neoadjuvant therapy (HR = 10.10, 95% CI 1.02–99.78; P = 0.048).
Conclusions
In patients with early-stage SCNECC, RFS did not differ patients undergoing curative-intent radiotherapy vs surgery. For advanced-stage SCNECC, curative-intent radiotherapy followed by chemotherapy seemed to be compatible with better prognosis.
Zebrafish knockout of frk gene shows social impairments relevant to autism and delays brain development by increasing cell proliferation
Authors: Jiang Kewen , Lin Xueting , Wu Jing , Ying Yingchao , Yan Binhong , Wang Jiangping , Zou Jian
Published: January 2024

Fyn-related kinase (FRK) belonging to the Src family of non-receptor protein tyrosine kinases functions during the cell cycle. Here, we reported an autism spectrum disorders (ASD) patient with intragenic mutation of FRK with two other ASD risk genes. Circumventing the barrier of murine model studies, we generated the CRISPR/Cas9-engineered frk−/− zebrafish. We found that frk-knockout led to increased brain sizes. Frk−/− fish exhibited an ASD-like behavior, including impaired social communication, altered anxiety level, and cognitive dysfunction in both larvae and adults, which could be rescued by the transgenic neuron-specific re-expression of frk. GO and KEGG analysis of RNA-sequencing data found that the frk-knockout-induced DEGs were mainly concentrated in processes and functions related to cell metabolisms. PPI network analysis of the detected DEGs suggested that the cyp24a1/tp53 pathway may play a key role in frk-knockout-induced ASD. Furthermore, we found that the numbers of BrdU+ cells were significantly increased in the frk−/− larval brains. Cyp24a1-inhibition or tp53-activation, reduced cell proliferation and partially ameliorated social impairments in frk−/− zebrafish. Overall, our work established an ASD model of frk-knockout with assessable behavior phenotype in zebrafish and provided key insights into cell proliferation and the influence of cyp24a1/tp53 pathway-regulated cell proliferation on frk-knockout-induced ASD-like behaviors.
Model-based Design of Reconfigurable Compliant Gripper Actuated with SMA Springs
Authors: Chen Qianyi , Duc Trung Tin Bui , Schott Dingena , Jovanova Jovana
Published: January 2024

Shape memory alloy (SMA) springs find extensive application in flexible actuation due to their significant capacity for deformability. However, each individual SMA spring only provides limited deformation modes, which prevents the SMA spring based grippers from applying in complicated grasping scenarios. In this study, a reconfigurable compliant gripper with multiple SMA springs is proposed to achieve multifunctional grasping tasks and large motion range. The proposed gripper uses multiple SMA springs for actuation, integrated in segments as building units to shape the gripper fingers. Also, the complete reconfigurable system was designed to accommodate for multiple compliant gripper fingers for flexibility. The reconfigurable compliant gripper is designed by numerical modeling and validated with lad-scaled experiments. The coupling method of Finite Element Analysis (FEA) and Multi Body Dynamics (MBD) was introduced in the modelling of the gripper. The results indicate that the numerical model shows very similar behavior as the experiments. Then, the multiple SMA spring allows for multidirectional bending behavior across the range of bending angle from 0 to 124 degrees. The reconfigurable compliant gripper system can grasp objects of different shapes and weights. Thus, the proposed reconfigurable compliant gripper can lead to a series of novel design solutions for different scales of grasping tasks.
The challenge of phasing out fossil fuel finance in the banking sector
Authors: Rickman Jamie , Falkenberg Max , Kothari Sumit , Larosa Francesca , Grubb Michael , Ameli Nadia
Published: January 2024

A rapid phase-out of bank lending to the fossil fuel sector is critical if Paris climate targets are to remain within reach. Here we use a systems lens to explore syndicated fossil fuel debt markets - a critical source of financing for fossil fuel companies - and find that they are resilient to uncoordinated and unregulated phase-out scenarios. In a setting where finance can be substituted between banks, phase-out is inefficient unless capital requirements rules limit banks’ exposure to fossil fuels. With capital requirements rules in place a tipping point is observed from inefficient to efficient phase-out as banks sequentially exit the sector. This tipping point depends critically on the stringency of capital requirements rules, and it is reached sooner in a targeted phase-out scenario where systemically important banks lead the phase-out. If sufficiently tightened, capital requirements rules can amplify the impact of individual banks’ phase-out and accelerate the decline of fossil fuel debt flows.
Inspiration4 Data Access through the NASA Open Science Data Repository
Authors: Costes Sylvain , Sanders Lauren , Grigorev Kirill , Scott Ryan , Saravia-Butler Amanda , Polo San-Huei Lai , Gilbert Rachel , Overbey Eliah , Kim JangKeun , Mason Christopher
Published: January 2024

The increasing accessibility of commercial and private space travel necessitates a profound understanding of its impact on human health. The NASA Open Science Data Repository (OSDR) provides transparent and FAIR access to biological studies, notably the SpaceX Inspiration4 (I4) mission, which amassed extensive data from civilian astronauts. This dataset encompasses omics and clinical assays, facilitating comprehensive research on space-induced biological responses. These data allow for multi-modal, longitudinal assessments, bridging the gap between human and model organism studies. Crucially, community-driven data standards established by NASA's OSDR Analysis Working Groups empower artificial intelligence and machine learning to glean invaluable insights, guiding future mission planning and health risk mitigation. This article presents a concise guide to access and analyze I4 data in OSDR, including programmatic access through GLOpenAPI. This pioneering effort establishes a precedent for post-mission health monitoring programs within space agencies, propelling research in the burgeoning field of commercial space travel's impact on human physiology.
Transplanting human infant gut microbiome species into Galleria mellonella
Authors: Gooch Harriet , Labedan Marjorie , Hall Lindsay , Maxwell Anthony
Published: January 2024

ObjectiveStudy of the human infant gut microbiome requires the use of surrogate mammalian species such as mice. We sought to investigate the usefulness of the greater wax moth larva, Galleria mellonella, as an alternative.
Results We have analysed the native gut microbiome of Galleria and developed methods for clearing the native microbiome and introducing species from human infant faecal samples. We find that some species, e.g. enterococci, are more successful at recolonisation, but that others, e.g. Bifidobacterium, are less so. The work paves the way for using Galleria rather than mice in this and similar work.
A Digitally-Supported Shared Decision Making Approach for Patients during Cardiac Rehabilitation: Protocol for a Randomized Controlled Trial.
Authors: Kizilkilic Sevda Ece , Ramakers Wim , Falter Maarten , Scherrenberg Martijn , bonneux cindel , Hansen Dominique , Dendale Paul , Coninx Karin
Published: January 2024

Background: Physical activity is a key component of cardiac rehabilitation. However, EUROASPIRE V concluded that intending 48% of coronary artery disease (CAD) patients do not intend to do physical activity in the next six months. Patient involvement improves patient satisfaction, adherence, and health outcomes and is a prerequisite for good clinical practice. Unfortunately, patients currently have only limited input in their exercise prescription. We developed SharedHeart, a digitally-supported shared decision making (SDM) approach that assists patients with heart disease and their caregivers in collaboratively setting up exercise goals and creating an exercise plan for the patient.
Objective: The aim of the study is to determine the effectiveness and cost-effectiveness of the combination of center-based CR and shared decision making based telerehabilitation. The study investigates the influence of a SDM approach supported by digital applications on the patient’s quality of life, exercise capacity, motivation to exercise, perception of rehabilitation and engagement in the shared decision making process.
Methods: The study is a prospective double-arm, randomized controlled trial that includes a usability study of the applications. In the usability study, instantaneous user friendliness and patients’ motivation will be investigated by testing the designed applications with 10 CAD patients and 5 physiotherapists. In the RCT, 80 patients will be randomized 1:1 between an intervention group and a control group. The intervention group will follow the SharedHeart approach, consisting of SDM encounters with caregivers and using the digital tools during phase II cardiac rehabilitation (i.e. 3 months). The primary outcome measure is patients’ quality of life, assessed with the HeartQoL questionnaire. Secondary outcomes are related to patients’ exercise capacity, motivation to exercise, perception of rehabilitation and engagement in the shared decision-making process.
All methods were performed in accordance with the relevant guidelines and regulations by including a statement in the Ethics approval and consent to participate section to this effect.
Discussion: This will be one of the first study to investigate the effects of a digitally-supported shared decision making approach. If the SharedHeart approach and supporting applications are found to be effective in increasing patients’ quality of life, exercise capacity, motivation to exercise, perception of rehabilitation and/or engagement in the shared decision making process, this can be a cost-effective and accessible solution to increase patient outcomes and patient involvement during cardiac rehabilitation.
Trial registration: ClinicalTrials.gov NCT05026957.
Research on seismic isolation performance of nuclear power plant containment structures
Authors: Xue Zhicheng , Cui Xiujun , Pei Qiang , Zhong Jintu , He Yongyi , Zhang Yao , Qi Pengfei
Published: January 2024

Non isolated structures have problems such as strong destructiveness and poor isolation effect when encountering earthquakes. Setting isolation bearings can extend the natural vibration period of the structure, reduce the horizontal seismic response of the structure, and also enhance the overall seismic performance of the structure.The new material - epoxy plate thick layer rubber isolation bearing has unique advantages compared to other bearings, such as effective energy absorption, simple construction, and low cost.This study establishes a three-dimensional isolated nuclear power plant containment structure based on the principle of similarity ratio, and compares and analyzes the acceleration, base reaction, and displacement responses of non isolated and isolated structures. At the same time, the incremental dynamic analysis method (IDA) is used to analyze the seismic vulnerability of the structure, and the isolation performance of the nuclear containment structure using epoxy plate thick layer rubber isolation bearings is comprehensively and deeply explored.The results show that the epoxy plate thick layer rubber isolation bearing effectively prolongs the natural vibration period of the structure, reduces the horizontal seismic response of the structure, and reduces the dome acceleration response by 66.55%, and the base horizontal shear force by 55.51%.Therefore, setting epoxy plate thick layer rubber isolation bearings in the isolation layer can effectively enhance the seismic performance of the structure, thereby improving the redundancy of the nuclear power plant containment structure. Keywords: epoxy plate thick layer rubber isolation bearing; Time history analysis; Seismic performance; Incremental dynamic analysis method.
Complete transection of bilateral main bronchus in a 5-year-old: A case report
Authors: Wang Weimin , Yang Yanliang , Bi Siming , lv Xiaozheng , Xu Huihui
Published: January 2024

Background
Tracheobronchial injuries caused by blunt chest trauma are rare in children, and they usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Here, we describe the case of a 5-year-old who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus.
Case presentation:
Chest computed tomography (CT) failed to detect a bronchial rupture. Continuous closed thoracic drainage resulted in a large amount of bubble overflow. Tracheal rupture was suspected. Fiberoptic bronchoscopy revealed complete rupture of the right main bronchus and rupture of the left main bronchus. Emergency tracheoplasty was performed under cardiopulmonary bypass (CPB). During the operation, we found that the bilateral main bronchi were completely ruptured. Postoperative recovery was smooth. The traditional surgical method for treating these injuries is lateral thoracotomy. However, a median thoracotomy provides a better opportunity for selective repair. Extracorporeal circulation-assisted surgery is required for patients with unstable breathing.
Conclusion
The patient with completely fracture the bilateral main bronchi is rare. Extracorporeal circulation-assisted tracheoplasty is a relatively safe option in children with difficult respiratory system maintenance, ensuring oxygenation ventilation and a clear surgical field.
Posting on Social-Media Undermines Academic Performance and Well-Being
Authors: Sayag Maayan , Most Carmel , Katzir Maayan , Luria Roy , Kross Ethan , Sheppes Gal
Published: January 2024

Medical authorities and policymakers raise mounting concerns regarding the detrimental influence of social-media on students’ academic performance and well-being. Surprisingly, empirical evidence that supports these strong concerns is unclear. We provide a novel psychological framework that specifies fundamental elements of social-interaction to predict under which conditions social-media usage will have its most pernicious effects. Our framework argues that posting personal social-media content (relative to scrolling through others' content) elicits opportunities to receive strong social-feedback from others, which tempts individuals to procrastinate on social-media instead of studying, resulting in negative academic and well-being consequences. Three experimental studies causally test our framework using state-of-the-art methods, behavioral measures, and outcomes. Experiments 1 (Facebook) and 2 (Instagram) demonstrated that experimentally having participants post (vs scroll), leads to enhanced procrastinatory social-media usage, that in turn undermines academic performance and well-being. Experiment 3 directly demonstrated the detrimental role of opportunities to receive strong social-feedback following posting, in showing that experimentally blocking social-feedback opportunities following posting, eliminates subsequent procrastinatory social-media behavior and its maladaptive consequences. These findings advise professionals and policymakers to shift from making generic recommendations to reduce overall social-media usage, to customized warnings about the negative academic and well-being consequences of posting on social-media.
COVID-19 Vaccination and Lethality Reduction: A Prospective Cohort Study in Venezuela
Authors: Forero-Peña David A. , Leyva Jéssica L. , Valenzuela María V. , Omaña-Ávila Óscar D. , Mendoza-Millán Daniela L. , Sánchez-Ytriago Elisanny A. , Hachem Andrea C. Lahoud-El , Farro Katherine R. , Maita Ana K. , González Romina del C. , Rodriguez-Saavedra Carlis M. , Hernández-Medina Fernando , Camejo-Ávila Natasha A. , Nobrega Diana C. Freitas-De , Celis Rodrigo T. , Forero-Peña José L. , Martínez Alfonso , Grillet María E. , Landaeta María E. , Carrión-Nessi Fhabián S.
Published: January 2024

Background
While rigorous randomized clinical trials have substantiated the efficacy of COVID-19 vaccines in reducing hospitalization and mortality rates, there is a paucity of post-authorization analyses conducted in real-world settings. In Venezuela, the primary vaccines administered are BBIBP-CorV (Sinopharm) and Gam-COVID-Vac (Sputnik-V). However, the performance and effectiveness of these vaccines within this specific population remain to be thoroughly investigated.
Methods
A prospective cohort study was undertaken from October 5, 2021, to March 31, 2022, across four sentinel hospitals in Venezuela. The outcomes were evaluated at two time points: day 28 and day 48, utilizing the WHO’s COVID-19 Clinical Progression Scale. For the purpose of analysis, patients were classified into two groups: vaccinated and unvaccinated.
Results
The study included a total of 175 patients, of which 85 (48.6%) were categorized as vaccinated, with the majority (76.5%) having received two doses. The median age of the patients was 68 years, with a slight predominance of females (53.1%), and the majority being unemployed/retired (60.6%). Hypertension (53.1%) and diabetes (18.3%) were the most prevalent comorbidities. The median Charlson index of the patients was 3 points, with no statistically significant differences observed between the groups (p = 0.2). Upon admission, dyspnea was more commonly observed in unvaccinated patients compared to vaccinated patients (76.7% vs. 62.4%, p = 0.039). Almost all laboratory parameters were comparable in both groups, with the exception of the median D-dimer level, which was significantly higher in unvaccinated patients (7.6 vs. 1.4 µg/mL, p = 0.015). A total of 50 patients (28.6%) died of the disease, with a higher proportion of deaths observed in unvaccinated patients compared to vaccinated patients (35.6% vs. 21.2%, p = 0.035). Factors such as advanced age (OR = 1.043, 95%CI = 1.015–1.071, p = 0.002) were associated with increased odds of death, while factors such as vaccination against COVID-19 (OR = 0.428, 95%CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95%CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95%CI = 0.093–0.917, p = 0.035) were associated with decreased odds of death.
Conclusion
In the course of the third and fourth waves of the pandemic, vaccination against COVID-19 was found to be associated with a 57% reduction in lethality among patients treated in four public hospitals in Venezuela.
Necrotising fasciitis with extensive necrosis caused by Lactobacillus: A case report
Authors: Nagayama Jun , Sao Takeo , Takanori Ishida , Kouji Koga , Mitsunobu Nakamura
Published: January 2024

Background
Necrotising fasciitis (NF) is a life-threatening soft-tissue infection that rapidly destroys the epidermis, subcutaneous tissue, and fascia. Despite their low virulence, Lactobacillus spp. can cause NF, and because of its rare incidence, there is limited knowledge about its molecular and clinicopathological characteristics. We report a rare case of NF in a patient with undiagnosed diabetes mellitus and severe obesity due to infection with two types of Lactobacillus spp. that manifested in extensive necrosis.
Case presentation
A 48-year-old woman was referred to our hospital with a complaint of difficulty in walking due to severe bilateral thigh pain. She presented with pale redness, swelling, and severe skin pain extending from the pubic region to the groin. The patient was morbidly obese, had renal dysfunction and had not been diagnosed having diabetes mellitus; her LRINEC (Laboratory Risk Indicator for Necrotising Fasciitis) score was 9, indicating a high risk of NF. An exploratory surgical incision was made and NF was diagnosed based on fascial necrosis. Emergent surgical debridement was performed, and cultures of the wound and abscess revealed two types of Lactobacillus spp.: Lactobacillus salivariusand L. iners. The patient was admitted to the intensive care unit (ICU), where antibiotics were administered and respiratory and circulatory managements were performed. Diabetic ketoacidosis was detected, which was treated by controlling the blood glucose level stringently via intravenous insulin infusion. The patient underwent a second debridement on day 11 and, skin suture and skin grafting on day 36. The patient progressed well, was transferred from the ICU to the general ward on day 41, and was discharged unassisted on day 73.
Conclusions
Lactobacillus spp. are rarely pathogenic to healthy individuals and can seldom trigger NF. However, these bacteria can cause rare infections such as NF in immunocompromised individuals, such as those with diabetes and obesity, and an early diagnosis of NF is imperative; surgical intervention may be required for prevention of extensive necrosis. The LRNEC score may be useful for the early diagnosis of NF even for less pathogenic bacteria such as the Lactobacillus.
Stability analysis and molecular profiling of Desi chickpea (Cicer arietinum L.)
Authors: kotegoudra Hanamantagouda , Aarya Madhuri , S HEMANTH , H Manoj S
Published: January 2024

A study was conducted during the 2021 rabi season to investigate and identify stable genotypes of desi Chickpea (Cicer arietinum L.). The investigation involved employing 15 SSR primers for screening and assessing thirty genotypes under three distinct sowing dates to evaluate their grain yield performance. The findings highlighted significant variance components associated with genotype, environment, and G x E interactions, signifying variability in both genotypes and environments and variations in performance among different genotypes. Linear components were also notable, suggesting the potential to anticipate variations in genotype performance. Particularly, genotype ICCV-18-1664 exhibited stability for grain yield per plant in favourable environments, while genotypes DC-17-1111 and DC-17-1115 showed stability in unfavourable environments. The dissimilarity index, derived from SSR data clustering, categorized the 30 genotypes into five primary clusters. Genetic structure analysis, based on 15 SSR primer loci, unveiled that the 30 desi chickpea genotypes comprise a blend of four major ancestral components in diverse combinations.
Post-COVID cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction: national prospective study
Authors: Michael Benedict , Wood Greta , Sargent Brendan , Ahmad Zain-Ul-Abideen , Tharmaratnam Kukatharamini , Dunai Cordelia , Egbe Franklyn , Martin Naomi , Facer Bethany , Pendered Sophie , Rogers Henry , Hübel Christopher , Wamelen Daniel van , Bethlehem Richard , Giunchiglia Valentina , Hellyer Peter , Trender William , Kalsi Gursharan , Needham Edward , Easton Ava , Jackson Thomas , Cunningham Colm , Upthegrove Rachel , Pollak Thomas , Hotopf Matthew , Solomon Tom , Pett Sarah , Shaw Pamela , Wood Nicholas , Harrison Neil , Miller Karla , Jezzard Peter , Williams Guy , Duff Eugene , Williams Steven , Zelaya Fernando , Smith Stephen , Keller Simon , Broome Matthew , Kingston Nathalie , Husain Masud , Vincent Angela , Bradley John , Chinnery Patrick , Menon David , Aggleton John , Nicholson Timothy , Taylor John-Paul , David Anthony , Carson Alan , Bullmore Edward , Breen Gerome , Hampshire Adam , Paddick Stella-Maria , corsortium COVID-CNS , Leek Charles
Published: January 2024

The spectrum, pathophysiology, and recovery trajectory of persistent post-COVID-19 cognitive deficits are unknown, limiting our ability to develop prevention and treatment strategies. We report the one-year cognitive, serum biomarker, and neuroimaging findings from a prospective, national longitudinal study of cognition in 351 COVID-19 patients who had required hospitalisation, compared to 2,927 normative matched controls. Cognitive deficits were global and associated with elevated brain injury markers and reduced anterior cingulate cortex volume one year after admission. The severity of the initial infective insult, post-acute psychiatric symptoms, and a history of encephalopathy were associated with greatest deficits. There was strong concordance between subjective and objective cognitive deficits. Treatment with corticosteroids during the acute phase appeared protective against cognitive deficits. Together, these findings support the hypothesis that brain injury in moderate to severe COVID-19 is immune-mediated, and should guide the development of therapeutic strategies.
Does pathologic type shape the hospitalization costs of advanced non- small cell lung cancer patients? A multicenter real-world data study
Authors: Yang Yi , Zhang Peng
Published: January 2024

Background:Lung cancer represents the highest incidence and mortality rates among all cancers in China. Limited studies have explored the hospitalization costs of advanced non-small cell lung cancer (NSCLC) among Chinese. This study aims to outline the hospitalization costs of NSCLC patients, differentiate influencing factors, examine different pathological types affecting hospitalization costs and evaluate influencing factors respectively.
Methods: In this real-world, multicenter, retrospective study, we collected electronic medical record data from January 2017 to December 2020 in two types of hospitals: comprehensive hospitals and specialized oncology hospitals. A total of 5362 patients were included. Patients' information on sociodemographic characteristics, disease-related characteristics, healthcare service utilization, and hospitalization costs were collected. Descriptive analysis, the Wilcoxon rank-sum test, and the generalized linear model were employed.
Results: The median hospitalization cost among advanced NSCLC patients was $17,254 per capita, with drug costs as the highest cost. The hospitalization cost among patients with non-squamous carcinoma ($18,003) was significantly higher than that among patients with squamous carcinoma ($15,024), and pathological type significantly influenced the costs (β=0.098, p<0.001). Common influencing factors of hospitalization costs for both types included health insurance, hospital type, department, hospitalization frequency, and average length of hospital stay. The varying significant factors comprised age, gender, and occupation type among non-squamous carcinoma patients, whereas these factors were not notable among squamous carcinoma patients.
Conclusion: Hospitalization costs pose a substantial economic burden on advanced NSCLC patients in China, particularly for the non-squamous carcinoma. The higher costs hinder adequate utilization and appropriate treatment among vulnerable populations.
Clustering What Matters in Constrained Settings (Improved Outlier to Outlier-Free Reductions)
Authors: Jaiswal Ragesh , Kumar Amit
Published: January 2024

Constrained clustering problems generalize classical clustering formulations, e.g., k-median, k-means, by imposing additional constraints on the feasibility of a clustering. There has been significant recent progress in obtaining approximation algorithms for these problems, both in the metric and the Euclidean settings. However, the outlier version of these problems, where the solution is allowed to leave out $m$ points from the clustering, is not well understood. In this work, we give a general framework for reducing the outlier version of a constrained k-median or k-means problem to the corresponding outlier-free version with only $(1+\varepsilon)$-loss in the approximation ratio. The reduction is obtained by mapping the original instance of the problem to $f(k,m, \varepsilon)$ instances of the outlier-free version, where $f(k, m, \varepsilon) = \left( \frac{k+m}{\varepsilon}\right)^{O(m)}$. As specific applications, we get the following results:\begin{itemize} \item First FPT ({\it in the parameters $k$ and $m$}) $(1+\varepsilon)$-approximation algorithm for the outlier version of capacitated k-median and k-means in Euclidean spaces with {\it hard} capacities. \item First FPT ({\it in the parameters $k$ and $m$}) $(3+\varepsilon)$ and $(9+\varepsilon)$ approximation algorithms for the outlier version of capacitated k-median and k-means, respectively, in general metric spaces with {\it hard} capacities. \item First FPT ({\it in the parameters $k$ and $m$}) $(2-\delta)$-approximation algorithm for the outlier version of the k-median problem under the Ulam metric.\end{itemize}
Our work generalizes the results of Bhattacharya et al. and Agrawal et al. to a larger class of constrained clustering problems. Further, our reduction works for arbitrary metric spaces and so can extend clustering algorithms for outlier-free versions in both Euclidean and arbitrary metric spaces.
Gender Related Differences in Clinical Presentation and Outcomes of Diabetic Ketoacidosis: A Retrospective Study
Authors: Salam Abdus , Ali Yasir , Rashid Owais , Ehsan Paghunda , Awuah Wireko Andrew , Abdul-Rahman Toufik , Khan Muhammad Salman , Islam Najmul
Published: January 2024

Background: Diabetic Ketoacidosis (DKA) is a well-known complication of Diabetes Mellitus (DM). Many studies have been conducted to observe the characteristics of DKA in both type 1 and type 2 DM. However, little is known about differences in the clinical features and outcomes of patients with DKA in relation to gender. In this study, we aimed to investigate whether there were any gender-related differences in the clinical presentation and outcomes of DKA patients. Methodology: We conducted this retrospective, descriptive study at the Aga Khan University Hospital (AKUH) Karachi, Pakistan, from July 2016 to July 2020. Data of patients above 16 years of age presented to the emergency department with DKA was reviewed. Information was collected regarding patient demographics, presenting symptoms, precipitating causes of DKA, vital signs, biochemical profiles, and outcomes at discharge.
Results: Of 234 patients, 120 (51.3%) were males (mean age=46.8±16.6), and 114 (48.7%) were females (mean age=44±18.8). Our results showed that females had a higher chance of having previous episodes of DKA (13.4% vs. 4.2%) than males (p=0.047). There was a higher proportion of New Onset type 1 (24.2%) and New Onset type 2 (5.8%) Diabetes at presentation in male patients, as compared to female patients (14.0 and 1.8%, respectively). More male patients presented with severely altered mental status (24.2%) than female patients (13.2%). The higher biochemical markers in males included Hemoglobin, BUN, Creatinine, and serum osmolality, while Amylase was significantly higher in females. Finally, there were no significant differences in the outcomes between the two groups.
Conclusion: As male patients in our population are more likely to present with New Onset type DM and are more likely to present with severe complications, preventive measures targeting male patients with risk factors for DM are paramount. Moreover, educational programs for both genders regarding complications and prevention are required. In order to form such plans, further studies at more centers need to be carried out so recommendations at a national level can be implemented.
Effect of plantain barrier plants on potyvirus-associated diseases in yam cultivation
Authors: Ramírez José Efraín González , Chávez Vaniert Ventura , Fereres Alberto , Portal Orelvis
Published: January 2024

Yam belongs to a very diverse plant genus (Dioscorea L.), comprising more than 600 species, both wild and cultivated. In Cuba, different species are distributed in the central and eastern regions, where the most widespread cultivars belong to the species water yam (Dioscorea alata L.) and white yam (Dioscorea cayenensis subsp. rotundata (Poir.) J. Miège). Among global major constraints facing the yam production areas are those caused by viral diseases. In this sense, potyviruses have the greatest economic impact, since they can cause losses of more than 50% in agricultural yields. In Cuba, the presence of yam mosaic virus and yam mild mosaic virus has been detected in commercial plantations by Enzyme-Linked ImmunoSorbent Assay (ELISA) tests. The movement of propagules between plantations without phytosanitary certification has facilitated the distribution of the viruses throughout the producing areas. Disease management involves a continuous process of events consisting of the selection and use of techniques aimed at reducing plant diseases to a tolerable level. Knowledge about the existing relationships between the host, virus, vector, and ecosystem is fundamental to the implementation of successful management. In the present work, by using potyvirus-free propagation material of two commercial yam cultivars and the perimeter protection with a live barrier based on plantain ‘Burro CEMSA’, it was possible to reduce the field incidence of viral diseases (average infection decreased from 60 to 15%). Likewise, the barrier avoided losses in agricultural yields ranging between 50–57% for both cultivars, compared to the farmer’s usual practices.