bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of current characteristics and influencing factors of stress-load in nurses of obstetrics and gynecology based on stress-appraisal-coping theory: A cross-sectional study in China
Authors: Ye Qiqi , Kefu Zhong , Li Yuan , Huang Qihua , Xuefang Liang
Published: April 2024

Background
Long-term occupational stress of nurses and midwives in obstetrics and gynecology department will not only affect their mental health, but also threaten nursing safety and sleep quality of nursing staff. Personality characteristics and stress coping strategies may play an important and unique role in stress regulation
Introduction
Finding scientific methods to control the occupational stress of nurses in obstetrics and gynecology is great importantly. The purpose of this study is to determine the stress characteristics of obstetrics and gynecology nurses, and the stress differences of those with different personality characteristics and coping strategies.
Methods
From February 2023 to March 2023, a convenient sampling method was used to select 426 obstetric and gynecological nurses. The survey was conducted using the General Information Questionnaire, the Chinese Big Five Personality Questionnaire, the Trait Coping Style Questionnaire, and the Chinese version of the Stress Overload Scale.
Findings
The stress risk of obstetrics and gynecology nurses showed high-stress, impact and other characteristics, and the stress-load was at a medium level, with an average score of (65.30±17.27) points. There were statistically significant differences in stress-load among nurses with different marital status, hospital level, family occupational support and work motivation (P<0.05). The stress-load level of nurses with neurotic personality and negative coping tendency was the highest (P<0.01).
Discussion
Based on our findings and the existing literature, we have so suggestions to relieve the stress-load of obstetrics and gynecology nurses and midwives: (1) improve social support and family support; (2) increase the application of intelligent technology appropriately; (3) cultivate positive personality and weaken negative personality; (4) provide positive psychology training; (5) take advantage of the positive interaction between individual and situations.
Conclusion and Implications for Nursing Policy
Nursing managers should strengthen care for nurses with significant neurotic personality, adopt flexible or magnetic management and enhance group psychological intervention or case intervention, mobilize them to face stress events with a positive attitude, and establish a positive personality.
Investigating the socio-demographic characteristics and smoking cessation incidence among smokers accessing smoking cessation services in primary care settings of Qatar, a Historical Cohort Study
Authors: Zainel Abduljaleel Abdullatif , Mujalli Hanan Al , Yfakhroo Ameena Ibrahim , Ahmed Hafiz , Nuaimi Ahmed Al , Syed Muslim Abbas , Syed Mohamed Ahmed
Published: April 2024

Background
Tobacco dependence is a chronic disease that often requires repeated interventions and multiple attempts to quit. Cigarette smoking is the leading preventable cause of mortality. Globally, an estimated 1.3 billion people smoke.
In Qatar, Smoking cessation services (SCSs) are provided free of charge to citizens and at a minimal cost to non-citizens. This study aimed to measure the effectiveness of the smoking cessation program adopted by the Primary Health Care Corporation (PHCC) of Qatar. This was achieved through calculating the percentage of smoking cessation service users (survival probabilities) who maintained the non-smoking status after selected follow up periods. Moreover, the study highlightedthe possible association of selected explanatory variables with smoking cessation survival probabilities.
Methods
In this historical cohort study 490 participants were recruited by simple random sampling who attended the smoking cessation clinics (SCCs) in PHCC prior to 30/06/2021. The participants were contacted by phone and invited to participate in the study. The participants who agreed to participate in the study were interviewed utilizing a structured questionnaire.
Results
Initially 311 (63.5%) of the participants quitted smoking after receiving SCSs. There were statistically significant differences between quitting smoking and the nationality and the educational level of participants (p= <0.001 and 0.02 respectively). About one fourth (23.3%) of individuals who initially quitted smoking relapsed and resumed smoking as early as 6 months after completing their SCC visits. This relapse rate increased to 38.7, 47.2 and 51.1% after 12, 24 and 36 months respectively. Less than a half (45.8%) maintained the non-smoking status after 42 months from their initially quitting.
Conclusion and recommendations
The findings of the study substantiate the effectiveness of SCSs designed within PHCC both in short- and long-term basis. Younger individuals, smokers with Arab ethnicity, smokers falling within high income and education groups were identified as high-risk groups and need highest focus. The accessibility to the service among the local population can be increased by upscaling the advertisement of the existing services.
A case report and literature review: Mycobacterium leprae infection diagnosed by metagenomic next-generation sequencing of cerebrospinal fluid
Authors: Zhao Conglin , Liu Zhenzhen
Published: April 2024

Background
Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) that is responsible for deformities and irreversible peripheral nerve damage and has a broad spectrum of clinical and serological manifestations. Leprosy primarily affects the peripheral nerves and rarely presents with central nervous system involvement. Diagnosing leprosy can still be difficult in some cases, especially when the infection involves uncommon clinical manifestations and extracutaneous sites. Delayed diagnosis and treatment of leprosy may lead to irreversible damage and death.
Case Presentation
We report a case of a 30-year-old female presenting with "repeated high fever with symptoms of headache for 14 days". On the day of admission, physical signs of lost eyebrows and scattered red induration patches all over her body were observed. The patient's diagnosis was based on the clinical characteristics using a combination of metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) and slit-skin smear. After confirming Listeria meningitis and multibacillary leprosy with erythema nodosum leprosum (ENL), a type 2 reaction, she was treated with ampicillin sodium, dapsone, rifampicin, clofazimine, methylprednisolone, and thalidomide. A good clinical response with improved skin lesions and headaches was found at the 1-year follow-up.
Conclusion
This case highlights the importance of considering leprosy, which is a rare and underrecognized disease, in the differential diagnosis of skin rashes with rheumatic manifestations, even in areas where the disease is not endemic, and physicians should be alerted about the possibility of central nervous system infections. In addition, mNGS can be used as a complementary diagnostic tool to traditional diagnostic methods to enhance the diagnostic accuracy of leprosy.
Predictive Value of Cardiopulmonary Exercise Testing Parameters in Patients under PCI with High Pulse Pressure
Authors: Ren Qiang , Mu Xing-Bo , Li Yu-Shan , Zhang Jian , Liang Yan-Chun , Han Ya-Ling , Zhang Quan-Yu
Published: April 2024

Background and objective: The correlation of cardiopulmonary exercise testing (CPET) parameters and the prognosis of coronary artery disease (CAD) patients with high pulse pressure (PP) is uncertain. Present study evaluated the association and prognosis value of CPET parameters in high PP patients.
Methods: Patients with CAD who underwent percutaneous coronary intervention (PCI) and CPET were enrolled. Enrolled patients were divided into two groups according to PP after admission: high PP group and normal PP group. The primary endpoint was major adverse cardiovascular events (MACE). Cox regression analysis and univariate receiver operating characteristic (ROC) curves were used to identify optimal predictors of MACE.
Results: 111 patients with MACE occurred. Compared with the normal PP group, participants in the high PP group showed higher incidence of MACE (4.86% vs. 2.68%, P =0.005). In high PP group, patients had significantly lower peak heart rate, lower peak oxygen pulse, lower breathing reserve whereas higher ventilatory equivalents for carbon dioxide (VE/VCO2). Peak VO2 (HR 0.94, 95% CI 0.88 to 1.00, P = 0.038) and VE/VCO2 (HR 1.08, 95% CI 1.02 to 1.15, P = 0.007) were identified as significant predictive factors through multifactorial analysis. The area under the curve (AUC) of VE/VCO2 and peak VO2 were 0.62 (95% CI 0.557 to 0.673) and 0.58 (95% CI 0.515 to 0.634), respectively.
Conclusions: The prognosis of CAD patients with high PP was worse compared to the patients with normal PP. The peak VO2 and VE/VCO2 were predictors of prognosis of CAD patients with high PP.
Study on autophagy-related biomarkers in pancreatic cancer based on bioinformatics
Authors: Zheng Xiaorong , Tang Qi , Rao Xin , Sun Wen , Fang Huawei
Published: April 2024

Pancreatic cancer (PC) is a common malignant tumor whose incidence is increasing yearly and the 5-year survival rate is only 4\%. Early diagnosis is crucial for a better prognosis of PC, but additional research is needed to enhance existing technology. Current research clearly demonstrates a significant correlation between autophagy and PC pathology, so the related biomarkers possess immense potential for the early diagnosis of PC pathology. This study aimed to explore autophagy-related biomarkers in PC by detecting differentially expressed autophagy genes (DEAGs), providing new insights into the pathological progression of PC. GSE15471 and GSE16515 gene expression profiles of PC were downloaded from the Gene Expression Omnibus (GEO) database. R language was used to standardize and differentially expressed genes (DEGs) of PC expression profiles. A total of 324 autophagy genes were obtained from HADb, ATdb, and ATD autophagy gene databases. The differential genes of PC and autophagy genes were integrated and analyzed, and 11 DEAGs were selected. Then the potential biological functions of DEAGs were predicted. The correlation analysis reveals the potential correlation among 11 DEAGs. Finally, a total of 10 significant DEAGs (APOL1, CASP1, CEP55, CXCR4 ITGA3, ITGB4, NPC1, SLC6A14, SMS, SMURF1) were obtained by difference examination and receiver operating characteristic (ROC) curve, the area under curve (AUC) was 0.811, 0.675, 0.797, 0.807, 0.730, 0.795, 0.783, 0.827, 0.784, and 0.802, respectively. These results indicate that these genes may have application value in the study of PC, and could potentially be utilized as new biomarkers for the early diagnosis of PC. This study revealed a strong connection between DEAGs and PC, and the identified DEAGs could serve as a potential biomarker for PC, which offers a novel approach to early detection of the disease.
Drivers of persistent changes in the global methane cycle under aggressive mitigation action
Authors: Folberth Gerd , O'Connor Fiona , Jones Chris , Gedney Nicola , Wiltshire Andrew
Published: April 2024

To achieve the goals under the Paris climate agreement comprehensive mitigation of greenhouse gas emissions is required. Here methane plays an important role. Therefore, better understanding of the global methane cycle is indispensable for robust climate projections and assessments of multi-gas mitigation strategies. Here we simulate the global methane cycle fully interactively over the period 1850-2100, including a Shared Socioeconomic Pathway with strong mitigation action (SSP1-2.6 ). We show that under SSP1-2.6 the atmospheric methane burden recovers to almost pre-industrial levels, but wetland methane emissions show a persistent upward trend from 166 Tg(CH4) yr-1 in the 1850s to 221 Tg(CH4) yr-1 in the 2090s. Analogously, the atmospheric methane lifetime exhibits a persistent downward trend from 9.3 to 7.3 years. We identify the trend in net primary productivity as the dominant driver behind the trend in wetland methane emissions, with a correlation coefficient of 0.7. Significantly, our work demonstrates that important components of the global methane cycle such as wetland methane emissions and the methane lifetime are subject to feedbacks in the Earth system which elude methane mitigation action. Therefore, future methane mitigation strategies will need to take into account feedbacks in the Earth system.
Understanding the PULSAR Effect in Combined Radiotherapy and Immunotherapy through Attention Mechanisms with a Transformer Model
Authors: Peng Hao , Moore Casey , Saha Debabrata , Jiang Steve , Timmerman Robert
Published: April 2024

PULSAR (personalized, ultra-fractionated stereotactic adaptive radiotherapy) is the adaptation of stereotactic ablative radiotherapy towards personalized cancer management. For the first time, we applied a transformer-based attention mechanism to investigate the underlying interactions between combined PULSAR and PD-L1 blockade immunotherapy based on a murine cancer model (Lewis Lung Carcinoma, LLC). The proposed approach is able to predict the trend of tumor volume change semi-quantitatively, and excels in identifying the potential causal relationships through both self-attention and cross-attention scores.
Different effects of migraine associated features on disability and psychiatric conditions in patients with migraine without aura: a multicenter observational cohort study
Authors: Imai Noboru , Matsumori Yasuhiko
Published: April 2024

Background: Migraine is a multifactorial brain disorder characterized by recurrent disabling headaches and their associated features. Several studies have suggested that these features are related to migraine disabilities and psychiatric conditions. However, differences in the impact of each associated feature on migraine disability or psychiatric conditions remain unclear. This study aimed to assess the impact of migraine-associated features on disability and psychiatric conditions in patients with migraine.
Methods: We enrolled patients with migraine without aura (MwoA) to exclude those with migraine without headache and to avoid the influence of medication overuse headache, which is commonly associated with chronic migraine. We assessed the impact of associated features on disability or psychiatric conditions using multivariate logistic regression analyses. Associated symptoms included nausea, vomiting, photophobia, phonophobia, osmophobia, and allodynia. Migraine disability and psychiatric conditions were determined using the Headache Impact Test (HIT-6), Visual Analog Scale (VAS), Generalized Anxiety Disorder 7-item scale (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9).
Results: In total, 1103 patients with MwoA were enrolled in this study. One hundred twenty-five patients were excluded from the study because of missing data. Finally, 939 patients with MwoAs were included in this study. On multivariate logistic regression analyses, nausea (odd ratios [OR] 1.87, confidence interval [CI]: 1.37-2.54), vomiting (OR 1.57, CI: 1.11-2.23), photophobia (OR 1.67, CI: 1.18-2.35), and allodynia (OR 1.56, CI: 1.06-2.28) were independent positive predictors of higher HIT-6 scores, and nausea (OR 1.72, CI: 1.22-2.43), vomiting (OR 1.84, CI: 1.29-2.63), phonophobia (OR 1.58, CI: 1.10-2.25), photophobia (OR 1.49, CI: 1.07-2.08), and allodynia (OR 1.81, CI: 1.24-2.66) were independent positive predictors of higher VAS score. Nausea (OR 1.49, CI: 1.09-2.02), phonophobia (OR 2.00, CI: 1.42-2.82), and allodynia (OR 1.81, CI: 1.24-2.63) were independent positive predictors of GAD-7 score. Nausea (OR 1.66, CI: 1.21-2.28), phonophobia (OR 1.49, CI: 1.05-2.11), and allodynia (OR 1.68, CI: 1.16-2.45) were independent positive predictors and vomiting (OR 0.54, CI: 0.37-0.78) was an independent negative predictor of PHQ-9 score.
Conclusions: Our results suggest that nausea, vomiting, photophobia, phonophobia, and osmophobia have distinct effects on migraine disability and psychiatric conditions. Understanding these differences can aid in personalized management of patients with MwoA.
Influence of deep margin elevation on marginal quality of root–filled molars restored with different onlays
Authors: Zhang Jingqiu , Zhang Yali , Liu Li , Dong Lei , Huang Huiqun , He Shuqi
Published: April 2024

Background
This study evaluated the influence of deep margin elevation (DME) with composite resin when applied to deep margin defects in root–filled molars with mesiooccluso–distal (MOD) cavities, which were subsequently restored with computer-aided designed/computer-aided manufacturing (CAD/CAM) ceramic or composite onlays.
Methods
Forty–eight complete human third molars were removed and randomly distributed into 6 groups (n = 8). The MOD cavities were prepared with the distal gingival margin below the cementoenamel junction (CEJ) 2 mm and the mesial gingival margin above the CEJ 1 mm. All molars underwent endodontic treatment. The distal gingival margin was filled with 2 mm thick Filtek™ Z350 XT Flowable resin (FF) or Filtek™ Z350 XT Universal resin (FU) to the CEJ. Then, all molars were restored with onlays made by Vita MarkⅡ CAD (VC)/IPS e.max CAD (IC)/SHOFU ceramage (SC). Epoxy replicates were made before and after thermomechanical loading (5 ~ 55°C, 5000 cycles; 10 Hz at 360 N, 100000 cycles). Scanning electron microscopy (SEM) analysis was performed to analyze margin integrity. Statistical analysis was performed.
Results
All the interfaces exhibited a decrease in margin quality after thermomechanical loading(TML) (P < 0.05). At the onlay–resin interface, when comparing margin integrity with that of the same DME resin before TML, there were no significant differences among the FF/VC, FF/IC and FF/SC groups (P > 0.05), and there were no significant differences among the FU/VC, FU/IC and FU/SC groups (P > 0.05). After TML, FF/IC > FF/SC > FF/VC, and FU/IC > FU/SC > FU/VC, there was a significant differences among these groups (P < 0.05). When comparing marginal integrity with the same onlay material, there was no significant difference in marginal integrity between FU/SC and FF/SC, FU/IC and FF/IC, or FU/VC and FF/VC before and after TML (P > 0.05). At the resin‒dentin interface, before and after TML, the margin integrity of the dentin‒paste resin was greater than that of the dentin–flowable resin (P < 0.05).
Conclusions
In this study, after TML, the best marginal integrity was obtained at resin–onlay interface with IPS e.max CAD material. However, DME with paste or flowable resin had no significant effect on the marginal integrity of the resin–onlay interface. At the dentin–resin interface, this study revealed that the marginal integrity of the flowable resin was lower than that of the paste resin, but both resulted in acceptable marginal quality for use as DME materials.
Online field measurements of Chlorothalonil show that volatilization is key to pesticide exposure
Authors: Loubet Benjamin , Bedos Carole , Kammer Julien , Decuq Céline , Lafouge Florence , Esnault Baptiste , Ciuraru Raluca , Bsaibes Sandy , Buysse Pauline , Barriuso Enrique , Vuolo Maria Raffaella , Gros Valérie
Published: April 2024

Pesticide usage has been expanding since the 1950s. However, their use has been known to harm human and environmental health for decades. Recent studies have shown that these two factors are impacted by pesticide diffusion in the atmosphere. The gaseous diffusion of pesticides in the atmosphere is known as volatilization. Although it is a known process, pesticide volatilization has been scarcely measured, especially for periods beyond a few days after pesticide application. Pesticide concentration is usually measured mainly by offline gas-chromatography mass spectrometry, which makes it difficult to deploy in the field for long-term studies. In this study, we report the first online concentration measurements of Chlorothalonil, a fungicide, over a wheat field using a highly sensitive proton transfer reaction, quadrupole injection, time of flight, mass spectrometer (PTR-QI-TOF-MS) for several weeks after its application. The volatilization computed by inverse dispersion modeling was sustained over more than three weeks, leading to up to 50% of the applied quantity being lost by volatilization. High-temporal volatilization dynamics indicate that the understorey contributes significantly to the emissions. Our findings suggest that Chlorothalonil volatilization may contribute significantly to atmospheric exposure, and transfer by deposition to nearby fields and over larger areas. Online PTR-QI-TOF-MS measurements should be developed further to quantify human exposure and the spread of pesticides through the atmosphere.
A Novel Approach to Dementia Prediction Leveraging Recursive Feature Elimination and Decision Tree
Authors: Akbarifar Ahmad , Maghsoudpour Adel , Mohammadian Fatemeh , Mohammadzaheri Morteza , Ghaemi Omid
Published: April 2024

Early prediction of dementia and disease progression remains challenging. This study presents a novel machine learning framework for dementia diagnosis by integrating multimodal neuroimaging biomarkers and inexpensive, readily available clinical factors. Fractional anisotropy (FA) measurements in diffusion tensor imaging (DTI) provide microstructural insights into white matter integrity disturbances in dementia. However, acquiring DTI is costly and time-consuming. We applied Recursive Feature Elimination (RFE) to identify predictors from structural measures of the 9 Brain Atrophy and Lesion Index (BALI) factors and 42 Clinical Lifestyle for Brain Health (LIBRA) factors to estimate fractional anisotropy (FA) in DTI. The 10 most effective BALI/LIBRA features selected by RFE were used to train an interpretable decision tree model to predict dementia severity from DTI. A decision tree model based on biomarkers selected by Recursive Feature Elimination (RFE) achieved an accuracy of 96.25% in predicting dementia in an independent test set. This integrated framework pioneers the prediction of white matter microstructural changes from available structural/clinical factors using machine learning. By avoiding DTI acquisition, our approach provides a practical and objective tool to enhance dementia screening and progress monitoring. Identification of key predictive markers of BALI/LIBRA will also provide insights into lifestyle-related disease mechanisms, neurodegeneration, and white matter dysfunction.
Am I in Control? Explicit and Implicit Sense of Agency in Depersonalisation Experiences
Authors: Ciaunica Anna , Ayache Julia , Haggard Patrick , Nakul Estelle , Bonnet Emmanuelle , Auvray Malika
Published: April 2024

The sense of agency, the feeling of controlling one’s bodily actions and the world is altered in Depersonalisation (DP), a condition that makes people feel detached from one’s self and body. To investigate the link between depersonalization and both implicit and explicit sense of agency, an online study was conducted using the influential Intentional Binding paradigm in a sample of non-clinical DP participants. The results did nor reveal significant differences between individuals with low and high occurrences of DP experiences on implicit and explicit sense of agency. However, participants with high occurences of DP experiences showed a more time-sensitive explicit sense of agency and greater temporal distortions for short intervals in the absence of self-initiated motion. This suggests that there is a discrepancy between implicit and explicit sense of agency in people with high levels of depersonalization. Altogether, these findings call for further investigations of the key role of time perception on altered sense of self and agency in both non-clinical and clinical population, in order to disentangle the mechanisms associated with explicit and implicit sense of agency.
Pathogen-Epithelium Interactions and Inflammatory Responses in Salmonella Dublin Infections through Bovine Ileal Monolayer Models Derived from Adult Organoids
Authors: Kawasaki Minae , McConnel Craig S. , Burbick Claire R. , Ambrosini Yoko M.
Published: April 2024

Salmonella enterica serovar Dublin (S. Dublin) is an important enteric pathogen affecting cattle and poses increasing public health risks. Understanding the pathophysiology and host-pathogen interactions of S. Dublin infection is critical for developing effective control strategies, yet studies are hindered by the lack of physiologically relevant in vitro models. This study aimed to generate a robust bovine monolayer derived from adult ileal organoids, validate its feasibility as an in vitro infection model with S. Dublin, and evaluate the epithelial response to infection. A stable, confluent monolayer with a functional epithelial barrier was established under optimized culture conditions. The model's applicability for studying S. Dublin infection was confirmed by documenting intracellular bacterial invasion and replication and the resultant impacts on epithelial integrity, showing significant disruption of the monolayer, and a specific inflammatory response, providing insights into the pathogen-epithelium interactions. The study underscores the utility of organoid-derived monolayers in advancing our understanding of enteric infections in livestock and highlights implications for therapeutic strategy development and preventive measures, with potential applications extending to both veterinary and human medicine. The established bovine ileal monolayer offers a novel and physiologically relevant in vitro platform for investigating enteric pathogen-host interactions, particularly for pathogens like S. Dublin.
Population dynamics of Malassezia species on the skin of HIV-infected patients
Authors: Abdillah Abdourahim , RAVAUX Isabelle , MOKHTARI Saadia , Ranque Stephane
Published: April 2024

Malassezia species are lipid-dependent yeasts of the normal skin mycobiota in humans and some animals, which can cause skin infections. Yet, both the dynamic of Malassezia skin colonization and the associated fungal and bacterial skin microbiome remain unknown in HIV-infected patients. The purpose of this study was to compare Malassezia yeast community structure and associated microbiome on the healthy skin of HIV-infected patients and healthy controls. A total of 23 HIV-infected patients and 10 healthy controls were included and followed-up for a maximum of 5 visits over 10 to 17 months. At each visit, chest, face, nasolabial fold, and scalp skin samples were subjected to both culture and MALDI-TOF MS identification, and ITS/16S metabarcoding. The participants were categorized according to their Malassezia colony forming unit (CFU) abundance. Malassezia were cultured from each participant at each visit. HIV-infected patients were highly colonized on all visits with CFU > 100. M. sympodialis and M. globosa were the most dominant species overall. M. furfur and M. dermatis were more prevalent in HIV-infected than in healthy participants. M. sympodialis prevalence was stable at each sampling sites over time. M. furfur prevalence was stable and more abundant over time on HIV-infected patients’ chest. Although not statistically significant, the metagenomic analysis showed a higher fungal and bacterial diversity and an increased abundance of Cladosporium halotolerans and Streptococcus in HIV-infected patients than in controls. Our data showed a high skin colonization of Malassezia yeasts as well as a dysbiosis of both fungal and bacterial communities in HIV-infected patients.
Prevalence and Associated Factors of Depression among Resettled Older Bhutanese Adults in Ohio: A Cross-sectional Study
Authors: Karmacharya Isha , Chapadia Bunsi , Shrestha Aman , Subedi Janardan , Yadav Uday Narayan , Mistry Sabuj Kanti , Ghimire Saruna
Published: April 2024

There has been growing attention given to the mental health challenges faced by older adult populations, particularly among resettled refugee communities. Among these groups, the prevalence of depressive symptoms often remains high due to a multitude of factors associated with displacement, trauma, and acculturation stress. Since 2008, Bhutanese refugees have been resettled in the USA, making them one of the largest refugees in the country. However, mental health issues often remain obscured for this demographic, as they are typically subsumed within largely heterogeneous Asian populations. This study aimed to determine depression symptoms in resettled older Bhutanese adults and analyze the associated factors. Snowball sampling was used to collect data from 276 55+-year-old adults in Ohio from January to June 2022. The questionnaire covered demographics, lifestyle, social support, life satisfaction, chronic disease, and depression. Binary logistic regression assessed the associations between variables and depressive symptoms. Approximately one-third (31.8%) of the participants had depressive symptoms. Factors associated with lower odds of having depressive symptoms included better self-reported health, strong social support, life satisfaction, and high resilience. Individuals with chronic diseases were more likely to have depressive symptoms. The high percentage of depressive symptoms among resettled older Bhutanese adults emphasizes the need for a supportive environment in the host country, ensuring access to resources, and comprehensive and tailored interventions to address their mental health needs.
Investigate release of DOX drug in electrospun DOX@SiO2/PVA nanofiber
Authors: Naseri Roghayeh Soltani , Hamidinezhad Habib , Sazegar Mohammad Reza , Behjati Mohaddeseh
Published: April 2024

Electrospinning nanofibers (NFs) are an operational release system for drugs due to the high specific surface area. In this study, doxorubicin hydrochloride (DOX) is added to a mixture of tetraethyl orthosilicate (TEOS, Si (OC2H5)), hydrochloric acid (HCL), ethanol (C2H5OH), DOX, and distilled water during the formation of SiO2 using the sol-gel approach. The obtained DOX@SiO2 nanoparticles are then added into a 7% (wt) solution of polyvinyl alcohol (PVA) in water before electrospinning process. The prepared solution is delivered into the syringe for electrospinning. The morphology and structure of the fibers was studied by field emission scanning electron microscope (FESEM), X-ray diffraction analysis (XRD), and energy dispersive spectrometer (EDS). FTIR spectroscopy confirmed the occurrence of DOX attachment. Continual DOX release with three concentrations and in three types of pH was evaluated for several days. Finally, the results showed that drug release of nanofiber at pH = 5.4 compared to the other two pHs at the period of 540 hours has an approximate efficiency of 80%, 60% and 30% for a concentration of 2 ,1 and 0.5 ml, respectively. This method has high drug loading capacity and sustained release and therefore it could be considered as a suitable strategy for drug delivery systems.
RETRACTED: Integration of GPT3 and Dialog GPT Framework in Mental Health Chatbot - A Systematic Literature Research
Authors: Nandurkar Dhanraj A , Yuhaniz Siti S. , Sahu Madhuri
Published: April 2024

The authors have requested that this preprint be removed from Research Square.
The Interrater Reliability of the Swedish version of the Structured Clinical Interview for the DSM-5 Alternative Model for Personality Disorders, Module I and Module II for diagnosing personality disorders among adults referred to specialized psychiatric care – a pilot study
Authors: Steijer Sophie , Steingrimsson Steinn , Meyerson Niklas , Sand Peter
Published: April 2024

Background
There is an ongoing debate on which model for diagnosing personality disorders is optimal, with the DSM-5 Alternative Model for Personality Disorders being one of the most prominent. The structured interview has been tested and translated to several languages, however, not to Swedish.
Objectives
To obtain an understanding of a Swedish translation of the Structured Clinical Interview for DSM-5 Alternative Model Personality Disorders Module I and Module II (SCID-5-AMPD) for treatment seeking persons with suspected personality pathology including reliability and patient satisfaction in a Swedish clinical context.
Methods
This study of 38 outpatients with suspected personality disorder studied the interrater reliability (Intraclass correlation (ICC)), estimates of Cronbach’s alpha values and patient satisfaction (Likert scale 0–6) in a clinical setting.
Results
The main results were that ICC ranged between 0.1 and 0.56 for the domain scales of Module I and II, whereas the estimate of scale reliability (α) ranged 0.25–0.85. Patient satisfaction showed that 37 out of 38 participants, on average or higher, found that the interview captured their problems.
Conclusion
Considering the low ICC, the study suggests the potential applicability of the SCID-5-AMPD model in a Swedish context is uncertain. We remain somewhat skeptical about its substantial benefits compared to clinical practice without this tool. Caution is advised when interpreting interrater reliability and consistency in clinical settings. Further research is necessary to thoroughly assess its efficacy.
Utility of ITS and rbcL Sequences for Resolving Intraspecific Divergence in Saccharum spontaneum L
Authors: Rajesh Ramasamy , Selvavinayagam Karuppaiah Thirumalainayagam , Dharmar Koilpillai
Published: April 2024

Saccharum spontaneum L., commonly known as wild sugarcane or kans grass, is a close wild relative of sugarcane, representing the majority of terrestrial environments from the open ground to the shoreline. Due to its diverse applications as food, fodder, food ingredients, medicine, household products, pulp material, and even religious offerings, understanding the genetic relationships among populations is crucial. The present study attempted to understand the phylogenetic and evolutionary relationships of six field samples and two commercial samples from the chosen population of S. spontaneum in Tamil Nadu. The genomic material was extracted and amplified using nuclear ribosomal DNA internal transcribed spacer (nrDNA-ITS) and ribulose-1,5-bisphosphate carboxylase/oxygenase large subunit (rbcL) sequences and compared with those obtained from the NCBI database. The evolutionary history was inferred using MEGA11 software. The results showed that the presence of highly conserved sites in the rbcL region led to a close phylogenetic relationship falling under a common clade, which could be useful for molecular identification of this species. On the other hand, ITS markers were found to be useful for determining the phylogeny of S. spontaneum via both phenetic and cladistic approaches. The ITS region in this wild sugarcane has better discrimination ability despite the highly conserved sites with few rapidly evolving sites. Four of the collected specimens showed a close relationship, along with two commercial specimens, suggesting shared adaptations or a common geographic origin. Additionally, two other populations were found to have diverged from the rest of the specimens, exhibiting low genetic distance, indicating recent evolutionary divergence.
Inferior Vena Cava-Aortic Ratio Measurement as A Promising Modality in Assessing Intravascular Volume in Sepsis-Associated Acute Kidney Injury Among Children in Limited Resources
Authors: Hakim Dzulfikar Djalil , Widiasta Ahmedz , Sari Chindy Arya , Martiano Muhamad Rinaldhi
Published: April 2024

Introduction:
Hemodynamic monitoring is crucial for the comprehensive management of children with sepsis, particularly those involving the kidneys. Sepsis-associated acute kidney injury (S-AKI) is closely linked to patient outcomes, including an increased risk of end-stage kidney disorders, cardiovascular disorders, and death. In developing countries, due to the limited availability of USCOM, an invasive method such as central venous pressure (CVP) monitoring is needed to monitor intravascular volume, which has a high potential for complications and is costly. We conducted research to determine intravascular volume based on ultrasound examination in S-AKI patients.
Methods
A prospective cohort study was conducted between December 2023 and March 2024 in the Pediatric Intensive Care Unit (PICU) at Hasan Sadikin General Hospital. We divided the patients into two groups: those with sepsis and those with sepsis-associated acute kidney injury. The intravascular volume was measured by the IVC/Ao (Inferior vena cava/Abdominal aorta) ratio using two-dimensional ultrasonography and USCOM before and 24 hours after fluid treatment. The results were then analyzed using SPSS 25, with a significance level of p < 0.05.
Results
A total of 36 pediatric patients (aged between 1 month and 18 years) with sepsis were included in this study. The IVC/Ao ratio before and after the fluid intervention demonstrated significant differences between the two groups (p < 0.001). USCOM's CI before and after the intervention also showed significant differences between the two groups (p < 0.001). Patients with S-AKI exhibited a poor hemodynamic response in the IVC/Ao ratio two-dimensional ultrasonography and USCOM examination.
Conclusion
The IVC/Ao ratio can serve as an alternative for hemodynamic monitoring in facilities with limited resources.
Analytical solution for heave of underlying shield tunnel caused by adjacent tunnelling considering shear deformation
Authors: Wei Zheng
Published: April 2024

Excavating a shield tunnel may cause a series of unforeseen adverse impacts on the adjacent underlying in-service tunnels. Therefore, it is significant to reasonably evaluate the influence of the newly excavated tunnel on the existing underlying shield tunnel to ensure safety and applicability of the existing tunnels. In this study, a simplified analytical solution is proposed to rapidly evaluate the responses of an existing underlying tunnel caused by newly tunnel construction. An elastic Timoshenko beam model, considering the shearing deformation of the existing shield tunnel as well as the interaction between adjacent segments, is presented for evaluating the responses of underlying shield tunnel associated with the tunnelling-induced free ground settlement. An equilibrium differential equation, combined with the finite difference analysis, is derived for the responses of the underlying in-service tunnel. The adaptability and reliability of proposed analytical solution is verified in comparison with published measurements. The predicted values were compared with the calculation results of different foundation coefficients. Parametric analyses are showed to evaluate the effects of various factors on the responses of underlying in-service tunnel, including the skew angle, equivalent shear stiffness and bending stiffness of underlying existing tunnel.
Analysis of risk factors related to assisted reproduction and assisted pregnancy outcomes in infertile men
Authors: Wang Ke , Xu Yan , Qin Ningxin , Zheng Jinxia , Guo Yi , Bai Jie , Yang Ya'nan , Li Zheyuan
Published: April 2024

Objective This study investigated the risk factors of assisted pregnancy outcomes in infertile men receiving assisted reproductive treatment and established a risk prediction model.
Methods A cross-sectional survey was conducted on 1037 infertile men who underwent ICSI-ET assisted pregnancy at the Reproductive Medicine Center of Obstetrics and Gynecology Hospital Affiliated to Tongji University from March 2023 to September 2023, and the clinical information of 403 gestation cycles (study group) and 634 non-gestation cycles (control group) were compared. Logistic regression was used to analyze the risk factors of assisted pregnancy outcomes in infertile men. The R software was used to draw the histogram and receiver operating characteristics (ROC) curve.
Results Single factor results showed that there were differences between the two groups in age, BMI, smoking, drinking, drinking tea, daily sleep time, daily exercise time, anxiety, depression, stress, insomnia, forward motile sperm rate, inactive sperm rate, sperm DNA fragmentation index, sperm survival rate, chlamydia infection and other 16 factors (P < 0.05). Multivariate regression showed that age, BMI, smoking, drinking, daily sleep time, daily exercise time, anxiety, depression, insomnia, forward motility sperm rate, sperm DNA fragmentation index and sperm survival rate were independent risk factors for assisted pregnancy outcome of infertile men (P < 0.05). The nomogram and the area under ROC curve show that the risk prediction model has good performance.
Conclusion The assisted pregnancy outcome of male infertile patients is affected by many factors, and the medical staff can make a predictive plan according to the predicted results.
Methylprednisolone modulates the TFR/TFH balance in EAE neuroinflammation through the PI3K/AKT/FoxO1 and PI3K/AKT/mTOR signaling pathways
Authors: Wu Nan , Zhao Yun , Xiao Minjun , Liu Hui , Chen Hongliang , Liu Bin , Wang Xuezhen , Fan Xueli
Published: April 2024

Background
Methylprednisolone (MP) is a potent glucocorticoid, which can effectively inhibit immune system inflammation and brain tissue damage in MS patients. T Follicular helper (Tfh) cells are a subpopulation of activated CD4 + T cells, while T Follicular regulatory (Tfr) cells, a novel subset of Treg cells, possess specialized abilities to suppress the Tfh-GC response and inhibit antibody production. Dysregulation of either Tfh or Tfr cells has been implicated in the pathogenesis of MS. However, the molecular mechanism underlying the anti-inflammatory effects of MP therapy on experimental autoimmune encephalomyelitis (EAE), a representative model for MS, remains unclear.
Purpose
This study aimed to investigate the effects of MP treatment on EAE and elucidate its possible molecular mechanisms.
Method
We evaluated the effects of MP on disease progression, CNS inflammatory infiltration and myelination, microglia and astrocyte activation, as well as Tfr/Tfh differentiation and related molecules/inflammatory factors in EAE. Additionally, western blotting was used to assess protein abundance associated with the PI3K/AKT pathway.
Results
Our findings demonstrated MP treatment ameliorated clinical symptoms, inflammatory cell infiltration, and myelination. Furthermore, it reduced microglia and astrocyte activation. MP up-regulated the differentiation of Tfr cells and cytokine TGF-β1, while downregulating Tfh cells differentiation and cytokine IL-21, as well as regulating the imbalanced Tfr/Tfh ratio in EAE. The PI3K/AKT/FoxO1 and PI3K/AKT/mTOR pathways were found to be involved in EAE development; however, MP treatment inhibited their activation.
Conclusion
MP demonstrated the ability to reduce neuroinflammation in EAE by regulating the balance between Tfr/Tfh cells via inhibition of the PI3K/ AKT/FoxO1 and PI3K/AKT/mTOR signaling pathway.
Development and validation of prechiasmatic mouse model of subarachnoid hemorrhage to measure long-term neurobehavioral impairment
Authors: Diwan Deepti , Mehla Jogender , Nelson James W. , Zipfel Gregory J.
Published: April 2024

Controllable and reproducible animal models of aneurysmal subarachnoid hemorrhage (SAH) are crucial for the systematic study of the pathophysiology and treatment of this debilitating condition. Despite the variety of animal models of SAH currently available, attempts to translate promising therapeutic strategies from preclinical studies to humans have largely failed. This failure is likely due, at least in part, to poor replication of pathology and disabilities in these preclinical models, especially the long-term neurocognitive deficits that drive poor quality of life / return to work in SAH survivors. Therefore, there is an unmet need to develop experimental models that reliably replicate the long-term clinical ramifications of SAH – especially in mice where genetic manipulations are straightforward and readily available. To address this need, we developed a standardized mouse model of SAH that reproducibly produced significant and trackable long-term neurobehavioral deficits. SAH was induced by performing double blood injections into the prechiasmatic cistern – a simple modification to the well-characterized single prechiasmatic injection mouse model of SAH. Following SAH, mice recapitulated key characteristics of SAH patients including long-term cognitive impairment as observed by a battery of behavioral testing and delayed pathophysiologic processes assayed by neuroinflammatory markers. We believe that this new SAH mouse model will be an ideal paradigm for investigating the complex pathophysiology of SAH and identifying novel druggable therapeutic targets for treating SAH-associated long-term neurocognitive deficits in patients.
A theoretical study on mechanism and kinetics of the reaction between para-aminotoluene and OH radical
Authors: Pham Tien V.
Published: April 2024

We conducted an ab initio exploration of the potential energy landscape for the para-aminotoluene reaction with OH, employing the CCSD(T)//M06-2X/6-311 + + G(3df,2p) level of theory. Additionally, thermal rate constants and branching ratios spanning the 300–2000 K temperature range were calculated. These calculations relied on the CCSD(T) energies and the M06-2X structures of the involved species, utilizing statistical theoretical TST and RRKM master equation computations. The calculated results reveal that the reaction channel para-aminotoluene + OH → NH-C6H4-CH3 + H2O prevails under the 300–2000 K temperature range, with the branching ratio in the range of 41%- 72% at P = 760 Torr. The overall second-order rate constants of the titled reaction obtained at the pressure 760 Torr (N2) can be illustrated by the modified Arrhenius expression of k_total(T) = 2.04×10− 18 T2.07 exp[(11.2 kJ.mol− 1)/RT]. The total rate constant at the ambient conditions in this work, 2.16×10− 11 cm3 molecule− 1 s− 1, is about one order of magnitude larger than those for the toluene reaction with OH at the same conditions measured by Davis et al. (6.11 ± 0.4×10− 12 cm3 molecule− 1 s− 1), Doyle et al. (4.15 ± 1.49×10− 12 cm3 molecule− 1 s− 1), Hansen et al. (5.78 ± 0.58×10− 12 cm3 molecule− 1 s− 1), Tully et al. (6.36 ± 0.69×10− 12 cm3 molecule− 1 s− 1), Knispel et al. (7.0 ± 0.41×10− 12 cm3 molecule− 1 s− 1) or calculated by Zhang et al. (5.69×10− 12 cm3 molecule− 1 s− 1). However, the value 2.16×10− 11 cm3 molecule− 1 s− 1 is smaller than those of the aniline + OH reaction measured by Atkinson and co-workers (1.18 ± 0.11×10− 10 cm3 molecule− 1 s− 1), Rinke et al. (1.20 ± 0.24×10− 10 cm3 molecule− 1 s− 1), and Witte et al. (1.23×10− 10 cm3 molecule− 1 s− 1) or calculated by Abdel-Rahman et al. (4.4×10− 10 cm3 molecule− 1 s− 1) and Mai et al. (1.3×10− 10 cm3 molecule− 1 s− 1). This study provides a thorough comprehension of the mechanisms and kinetics associated with the interaction between para-aminotoluene and OH radical.
Assessment of Rational Medication Utilization in a Multi-specialty Hospital in Chennai: A Cross-sectional Study
Authors: Rajan Rachlyn. r. , Sahay Melina. I. , George Melvin , Sr D. K.
Published: April 2024

Rational use of medicines (RUM) ensures patients receive appropriate medications at the right dose, frequency, and duration. This study evaluated RUM in hospitalized adults at a multi-specialty hospital in Chennai, India. An inpatient cohort was screened for RUM compliance. Patient demographics, medical history, medications, and laboratory data were collected. Medications were assessed for rationality using standard guidelines and WHO prescribing core indicators. Gastrointestinal medications were the most irrationally prescribed, followed by antimicrobials and CNS agents. The most common irrationalities were drug use without proper indication, wrong drug selection, and incorrect dosing frequency. Polypharmacy and fixed-dose combinations (FDCs) negatively impacted prescription rationality. WHO core indicators revealed an average of 7 medications per prescription, exceeding the optimal range. This study identified a high prevalence of irrational medication use, particularly in the gastrointestinal category. Polypharmacy and FDCs contributed to these issues. Regular prescription audits and improved patient interactions are essential to promote RUM in hospital settings.