bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon credits and the “Peter Pan” forests
Authors: Brancalion Pedro , Balmford Andrew , Wheeler Charlotte , Strassburg Bernardo , Swinfield Tom
Published: December 2023

Natural Climate Solutions have gained prominence as pivotal strategies for climate change mitigation, with tropical reforestation an important and cost-effective approach. However, despite significant reforestation commitments, the potential of natural forest re-growth remains underutilized, with second-growth forests, akin to the perpetual youth of the fictional character Peter Pan, repeatedly cleared, hindering their contribution to carbon sequestration and biodiversity conservation. We investigate the persistent challenges faced by regenerating second-growth tropical forests and discuss the need for novel carbon crediting approaches to incentivize their protection and restoration. Current carbon accounting frameworks, designed for afforestation and reforestation, overlook the unique characteristics of Peter Pan forests. We argue for a paradigm shift in carbon accounting that places Peter Pan forest intermediate between avoided conversion (REDD+) and reforestation (ARR). To ensure additionality we propose a nuanced statistical approach, combining satellite-derived time series with economic pressure indicators. This method aims to generate credible counterfactual scenarios for assessing carbon stock increases relative to those in the absence of carbon finance. Moreover, we highlight the socio-economic factors influencing second-growth forest persistence, emphasizing the need for integrated food production and forest restoration policies.
Risk, Financing, Laws, and Regulations
Authors: Tzenios Nikolaos
Published: December 2023

Presented by Nikolaos Tzenios at the Massachusetts College of Pharmacy and Health Sciences on July 30, 2023, this insightful presentation delves into the critical aspects of patient safety risks, their financial and regulatory impacts, and effective mitigation strategies. It begins by identifying key patient safety risks such as misdiagnosis, healthcare-associated infections (HAIs), and emergency preparedness risks. The presentation highlights the alarming statistics and severe consequences associated with these risks, including the legal implications and the substantial financial burden they place on healthcare systems. Subsequently, it explores various risk mitigation measures, emphasizing collaborative medical diagnosis, staff training in healthcare technologies, and comprehensive emergency preparation plans. The presentation underscores the necessity of continuous risk assessment and proactive planning in healthcare organizations to reduce the incidence of misdiagnosis and HAIs, and to enhance emergency preparedness. A significant focus is placed on the financial and regulatory impacts of patient safety risks. It discusses how misdiagnosis leads to patient litigations and breaches of medical malpractice laws, how HAIs result in billions of dollars in lost productivity and mortality, and how lack of emergency preparedness can lead to financial losses and non-compliance with healthcare regulations. The conclusion of the presentation emphasizes the importance of addressing patient safety risks to save costs and improve compliance with healthcare industry laws and regulations. It advocates for promoting patient safety practices and facilitating adherence to laws governing medical practice as key strategies to mitigate risks and enhance healthcare quality.
PENGARUH KOMPOSISI KATALIS Cu-Fe/AL2O3 DAN PANJANG HOUSING CATALYTIC CONVERTER TERHADAP EMISI GAS BUANG MESIN 4 LANGKAH 125 CC
Authors: Rizza Muhammad  Akhlis , Puspito Buwono Haris , Fikrul Aksa Muhammad
Published: December 2023

Catalytic Converter is a device that is used to control exhaust gas emissions in the muffler. In the Catalytic Converter there is a media that is a catalyst, where the media is expected to help or accelerate the process of changing a substance (chemical reaction). Generally, the catalysts used today still use noble active metals, such as Platinum (Pt), Palladium (Pd), and Rhodium (Rh), which are low in availability and relatively expensive. Instead, other alternative materials are used, namely active transition metals such as Copper (Cu), Chromium (Cr), Nickel (Ni), and Iron (Fe) which are easy to find and have a lower price.The purpose of this study was to determine the effect of the Cu-Fe/Al2O3 composition on the catalytic converter catalyst on the exhaust emissions of a 125cc 4 stroke engine. The research method used is the experimental method by mixing the composition of 10% Cu, 0% Fe, 90% Al2O3; 2.5% Cu, 2.5% Fe, 90% Al2O3; 5% Cu, 5% Fe, 90% Al2O3; 2.5% Cu, 7.5% Fe, 90% Al2O3; 0% Cu, 10% Fe, 90% Al2O3; on the catalyst and housing length variations with sizes of 30 mm, 60 mm.The results of this study indicate that a catalyst with a housing length of 30 mm with a composition of 2.5 Cu – Fe 7.5% can reduce CO gas up to 0.8%. With an average of 1.82% compared to the standard exhaust which has an average of 4.86%, resulting in a decrease in CO gas of 3.06%. Also, there was a decrease in HC gas in the catalyst composition of 0% Cu – 10% Fe which was able to reduce HC gas up to 51 ppm. With an average of 53 ppm compared to the standard exhaust which has an average of 152 ppm, there is a decrease in HC gas of 99 ppm.
Identification of polymorphisms in TYRP1, DCT and RAB38 genes and their association with coat color in alpacas
Authors: Melo-Rojas Carola , Bravo-Matheus P. Walter , Amaht Araoz Cesar , Zapata-Coacalla Celso
Published: December 2023

Objective

The goal of this study was to characterize and investigate the effect of single nucleotide polymorphisms (SNPs) or InDels in tyrosinase related protein 1 (TYRP1), dopachrome tautomerase (DCT), and Ras-related protein 38 (RAB38) genes on coat color in South American camelids. TYRP1 is among one of the major regulators of pigmentation in mammals. DCT is a pigment cell-specific gene that plays an important role in the melanin synthesis pathway and the expression of skin color. RAB38 is involved in the transport of tyrosinase (TYR) and TYRP1, which are key enzymes in melanin production.

Methods

Five fleece color tones from 327 alpacas (white, black, brown, gray and light fawn) were investigated to characterize and identify polymorphisms that play a role in coat color. Among the SNPs and Indels identified in the coding region, statistical analysis was performed to determine the association between the polymorphisms and fleece color in camelids, as well as the determination of allelic frequencies.

Results

Twenty two polymorphisms in the coding region, seven of them were nonsynonymous, eleven were synonymous, three located in the 5’UTR region and one deletion in the 3’UTR region were identified in the TYRP1 gene; in the DCT gene were identified twenty two polymorphisms, where five of them were non-synonymous, twelve were synonymous, one polymorphism in the 5’UTR region and four in the 3’UTR region; in adition, in the RAB38 gene six polymorphisms were identified, one was nonsynonymous, two were synonymous, in addition to three polymorphisms in the 3’UTR region were found in the RAB38 gene. There were low to moderate polymorphisms in the populations. Significant differences (P<0.001) were found with color fiber in the alpaca populations studied for TYRP1 and DCT genes.
RCSB Protein Data Bank: visualizing groups of experimentally determined PDB structures alongside computed structure models of proteins
Authors: Segura Joan , Rose Yana , Bi Chunxiao , Duarte Jose , Burley Stephen K. , Bittrich Sebastian
Published: December 2023

Recent advances in Artificial Intelligence and Machine Learning (e.g., AlphaFold, RosettaFold, and ESMFold) enable prediction of three-dimensional (3D) protein structures from amino acid sequences alone at accuracies comparable to lower-resolution experimental methods. These tools have been employed to predict structures across entire proteomes and the results of large-scale metagenomic sequence studies, yielding an exponential increase in available biomolecular 3D structural information. Given the enormous volume of this newly computed biostructure data, there is an urgent need for robust tools to manage, search, cluster, and visualize large collections of structures. Equally important is the capability to efficiently summarize and visualize metadata, biological/biochemical annotations, and structural features, particularly when working with vast numbers of protein structures of both experimental origin from the Protein Data Bank (PDB) and computationally-predicted models. Moreover, researchers require advanced visualization techniques that support interactive exploration of multiple sequences and structural alignments. This paper introduces a suite of tools provided on the RCSB PDB research-focused web portal RCSB. org, tailor-made for efficient management, search, organization, and visualization of this burgeoning corpus of 3D macromolecular structure data.
The scaffold nucleoporins SAR1 and SAR3 are essential for proper meiotic progression in Arabidopsis thaliana
Authors: Fernández-Jiménez Nadia , Martinez-Garcia Marina , Varas Javier , Gil-Dones Félix , Santos Juan Luis , Pradillo Mónica
Published: December 2023

Nuclear Pore Complexes (NPCs) are embedded in the nuclear envelope (NE), regulating macromolecule transport and physically interacting with chromatin. The NE undergoes dramatic breakdown and reformation during plant cell division. In addition, this structure has a specific meiotic function, anchoring and positioning telomeres to facilitate the pairing of homologous chromosomes. To elucidate a possible function of the structural components of the NPCs in meiosis, we have characterized several Arabidopsis lines with mutations in genes encoding nucleoporins belonging to the outer ring complex. Plants defective for either SUPPRESSOR OF AUXIN RESISTANCE1 (SAR1, also called NUP160) or SAR3 (NUP96) present condensation abnormalities and SPO11-dependent chromosome fragmentation in a fraction of meiocytes, which is increased in the double mutant sar1 sar3. We also observed these meiotic defects in mutants deficient in the outer ring complex protein HOS1, but not in mutants affected in other components of this complex. Furthermore, our findings may suggest defects in the structure of NPCs in sar1 and a potential link between the meiotic role of this nucleoporin and a component of the RUBylation pathway. These results provide the first insights in plants into the role of nucleoporins in meiotic chromosome behavior.
Initialization shock in the ocean circulation reduces skill in decadal predictions of the North Atlantic subpolar gyre
Authors: Polkova Iuliia , Swingedouw Didier , Hermanson Leon , Köhl Armin , Stammer Detlef , Smith Doug , Kröger Jürgen , Bethke Ingo , Yang Xiaosong , Zhang Liping , Nicolì Dario , Athanasiadis Panos J. , Karami Mehdi Pasha , Pankatz Klaus , Pohlmann Holger , Wu Bo , Bilbao Roberto , Ortega Pablo , Yang Shuting , Sospedra-Alfonso Reinel , Merryfield William , Kataoka Takahito , Tatebe Hiroaki , Imada Yukiko , Ishii Masayoshi , Matear Richard J.
Published: December 2023

Due to large northward heat transport, the Atlantic meridional overturning circulation (AMOC) strongly affects the climate of various regions. Its internal variability has been shown to be predictable decades ahead within climate models, providing the hope that synchronizing ocean circulation with observations can improve decadal predictions, notably of the North Atlantic subpolar gyre (SPG). Climate predictions require a starting point which is a reconstruction of the past climate. This is usually performed with data assimilation methods that blend available observations and climate model states together. There is no unique method to derive the initial conditions. Moreover, this can be performed using full-field observations or their anomalies superimposed on the model's climatology to avoid strong drifts in predictions. How critical ocean circulation drifts are for prediction skill has not been assessed yet. We analyze this possible connection using the dataset of 12 decadal prediction systems from the World Meteorological Organization Lead Centre for Annual-to-Decadal Climate Prediction. We find a variety of initial AMOC errors within the predictions related to a dynamically imbalanced ocean states leading to strongly displaced or multiple maxima in the overturning structures. This likely results in a blend of what is known as model drift and initial shock. We identify that the AMOC initialization influences the quality of the SPG predictions. When predictions show a large initial error in their AMOC, they usually have low skill for predicting internal variability of the SPG for a time horizon of 6-10 years. Full-field initialized predictions with low AMOC drift show better SPG skill than those with a large AMOC drift. Nevertheless, while the anomaly-initialized predictions do not experience large drifts, they show low SPG skill when skill also present in historical runs is removed using a residual correlation metric. Thus, reducing initial shock and model biases for the ocean circulation in prediction systems might help to improve their prediction for the SPG beyond 5 years. Climate predictions could also benefit from quality-check procedure for assimilation/initialization because currently the research groups only reveal the problems in initialization once the set of predictions has been completed, which is an expensive effort.
Machine learning approaches for cardiovascular hypertension stage estimation using photoplethysmography and clinical features
Authors: Abdullah Saad , Kristoffersson Annica
Published: December 2023

Cardiovascular diseases (CVDs) are a leading cause of death worldwide, with hypertension emerging as a significant risk factor. Early detection and treatment of hypertension can significantly reduce the risk of developing CVDs and related complications. This work proposes a novel approach employing features extracted from the acceleration photoplethysmography (APG) waveform, alongside clinical parameters, to estimate different stages of hypertension. The current study used a publicly available dataset and a novel feature extraction algorithm to extract APG waveform features. Three distinct supervised machine learning algorithms were employed in the classification task, namely: Decision Tree (DT), Linear Discriminant Analysis (LDA), and Linear Support Vector Machine (LSVM). Results indicate that the DT model achieved exceptional training accuracy of 100% during cross-validation and maintained a high accuracy of 96.87% on the test dataset. The LDA model demonstrated competitive performance, yielding 85.02% accuracy during cross-validation and 84.37% on the test dataset. Meanwhile, the LSVM model exhibited robust accuracy, achieving 88.77% during cross-validation and 93.75% on the test dataset. These findings underscore the potential of APG analysis as a valuable tool for clinicians in estimating hypertension stages, supporting the need for early detection and intervention. This investigation not only advances hypertension risk assessment but also advocates for enhanced cardiovascular healthcare outcomes.
How young people’s perceptions of their physical education lessons and social skills varied in terms of sociodemographic features. The case of a rural area of China
Authors: Primo Laura , González-Hernández Juan , Yang Yin , Lopez de Subijana Cristina
Published: December 2023

The aim of this study was to examine whether motivation, support, basic-needs satisfaction, and social skills in physical education lessons differed among Chinese secondary students from rural areas depending on their sociodemographic profiles. Two hundred and seven students enrolled in a camp organized by a non-profit organization in Chengdu province (15.8 ± 0.8 years, 74% female and 26% male) completed validated Chinese versions of the pertinent questionnaires. Appropriate social skills were perceived higher by women that by men (z = 2.2; p = 0.014; r = 0.16). Inappropriate social skills (z = 2.9; p = 0.021; r = 0.22) were perceived higher among those students with lower annual home income (50,000 yuan or less). Perceived autonomy support (z = 2.9; p = 0.002; r = 0.20), basic-needs satisfaction (z = 2.9; p = 0.002; r = 0.20), and physical-education motivation (z = 4.2; p < 0.001; r = 0.30) were higher among students who practiced physical activity or sport outside school. Students who practiced during their physical-education team-sports lessons reported higher motivation for physical education (z = 2.9; p = 0.002; r = 0.20) than those who practiced individual sports. The findings from this study are relevant to practitioners who work with students from these underprivileged rural areas.
Reverse triage: a systematic review of the literature
Authors: Pollaris Gwen , De Bondt Frieda , Sabbe Marc
Published: December 2023

Background

Many techniques to increase hospital surge capacity in the case of a mass casualty incident (MCI) have already been studied, but a new technique, reverse triage, has gained attention. The objective of this systematic review is to provide a comprehensive literature overview regarding the use of the reverse triage principle in emergency and disaster medicine.

Methods

A systematic literature review was carried out adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Publications up to May 2023 in the Medline, Embase, CENTRAL, CINAHL, and Web of Science databases were considered. The risk of bias was assessed using the Methodological Items for Non-Randomized Studies, the Risk of Bias Assessment Tool for Systematic Reviews, and Johanna Briggs Institute tools for observational, systematic reviews, and expert opinions respectively.

Results

The initial search identified 21,259 unique records, of which 16 were included, consisting of 2 reviews, 5 expert opinions, and 9 observational studies. Across studies, an overall surge capacity of 20–30% could be achieved by implementing reverse triage and even more when combined with other strategies. Furthermore, the American framework that comprehended a safe discharge protocol for inpatients is being used in the development of new reverse triage discharge protocols. The risk of developing a complication (adverse event) due to early discharge is rather low.

Discussion

Due to the heterogeneity of the included studies, the interpretation of the results should be taken with caution. The most prominent differences were related to study size, university affiliation, health care system, and patient characteristics. Nevertheless, implementing the reverse triage principle in MCIs to guide early discharge of adult inpatients can create additional surge capacity with a minor occurrence of adverse events. A final assessment by a multidisciplinary discharge team (nurses and physicians) remains crucial.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022294136, identifier: CRD42022294136.
Exploring potential genes and mechanisms linking erectile dysfunction and depression
Authors: Yuan Penghui , Chen Yinwei , Sun Taotao , Cui Lingang , Wei Yinsheng , Li Teng , Meng Qingjun
Published: December 2023

Background

The clinical correlation between erectile dysfunction (ED) and depression has been revealed in cumulative studies. However, the evidence of shared mechanisms between them was insufficient. This study aimed to explore common transcriptomic alterations associated with ED and depression.

Materials and methods

The gene sets associated with ED and depression were collected from the Gene Expression Omnibus (GEO) database. Comparative analysis was conducted to obtain common genes. Using R software and other appropriate tools, we conducted a range of analyses, including function enrichment, interactive network creation, gene cluster analysis, and transcriptional and post-transcriptional signature profiling. Candidate hub crosslinks between ED and depression were selected after external validation and molecular experiments. Furthermore, subpopulation location and disease association of hub genes were explored.

Results

A total of 85 common genes were identified between ED and depression. These genes strongly correlate with cell adhesion, redox homeostasis, reactive oxygen species metabolic process, and neuronal cell body. An interactive network consisting of 80 proteins and 216 interactions was thereby developed. Analysis of the proteomic signature of common genes highlighted eight major shared genes: CLDN5, COL7A1, LDHA, MAP2K2, RETSAT, SEMA3A, TAGLN, and TBC1D1. These genes were involved in blood vessel morphogenesis and muscle cell activity. A subsequent transcription factor (TF)–miRNA network showed 47 TFs and 88 miRNAs relevant to shared genes. Finally, CLDN5 and TBC1D1 were well-validated and identified as the hub crosslinks between ED and depression. These genes had specific subpopulation locations in the corpus cavernosum and brain tissue, respectively.

Conclusion

Our study is the first to investigate common transcriptomic alterations and the shared biological roles of ED and depression. The findings of this study provide insights into the referential molecular mechanisms underlying the co-existence between depression and ED.
Corn silk polysaccharides attenuate diabetic nephropathy through restoration of the gut microbial ecosystem and metabolic homeostasis
Authors: Dong Wenting , Zhao Yuanyuan , Li Xiuwei , Huo Jinhai , Wang Weiming
Published: December 2023

Introduction

The pathogenesis of diabetic nephropathy (DN) is complex, inflammation is the central link among the inducing factors in the existing research, and the gutkidney axis could scientifically explain the reasons for the accumulation of chronic low-grade inflammation. As both a medicine and food, corn silk contains abundant polysaccharides. Historical studies and modern research have both confirmed its intervention effect on diabetes and DN, but the mechanism of action is unclear.

Methods

In this study, a DN rat model was generated, and the therapeutic effect of corn silk polysaccharides (CSPs) was evaluated based on behavioral, histopathological and biochemical indicators. We attempted to fully understand the interactions between CSPs, the gut microbiota and the host at the systemic level from a gut microbiota metabolomics perspective to fundamentally elucidate the mechanisms of action that can be used to intervene in DN.

Results

Research has found that the metabolic pathways with a strong correlation with CSPs were initially identified as glycerophosphate, fatty acid, bile acid, tyrosine, tryptophan and phenylalanine metabolism and involved Firmicutes, Bacteroides, Lachnospiraceae-NK4A136- group and Dubosiella, suggesting that the effect of CSPs on improving DN is related to changes in metabolite profiles and gut microbiota characteristics.

Discussion

CSPs could be harnessed to treat the abnormal metabolism of endogenous substances such as bile acids and uremic toxins caused by changes in gut microbiota, thus alleviating kidney damage caused by inflammation. In view of its natural abundance, corn silk is safe and nontoxic and can be used for the prevention and treatment of diabetes and DN.
Near-infrared fluorescent imaging for parathyroid identification and/or preservation in surgery for primary hyperparathyroidism
Authors: Pannu Arslan Y. , O’Connor-Manson Magdalena R. , Wyld Lynda , Balasubramanian Saba P.
Published: December 2023

Introduction

Near infrared autofluorescence (NIRAF) is a novel intraoperative technology that has shown promising results in the localisation of parathyroid glands (PGs) over the last decade. This study aimed to assess the potential utility of NIRAF in first time surgery for primary hyperparathyroidism (PHPT).

Methods

An observational study over a period of 3 years in patients who underwent surgery for PHPT was designed. Data on the use of NIRAF and fluorescent patterns in different organs (thyroid and parathyroid) and parathyroid pathology (single versus multi-gland disease) were explored. In addition, cure rates and operating times were compared between the NIRAF and no-NIRAF groups to determine the potential value of NIRAF in this cohort.

Results

In 230 patients undergoing first time surgery for PHPT, NIRAF was used in 50 patients. Of these 50 patients, NIRAF was considered to aid parathyroid identification in 9 patients (18%). The overall cure rate at 6 months of follow-up was 96.5% (98% in NIRAF and 96.1% without NIRAF; p=1.0). The median (interquartile range) operating time was longer in the NIRAF arm at 102 minutes (74-120 minutes) compared to the no-NIRAF arm at 75 minutes (75-109 minutes); however, this difference was not statistically significant (p=0.542). Although the median parathyroid to thyroid (P/T) auto-fluorescence (AF) ratio was similar between single gland and multi gland disease (2.5 vs to 2.76; p=1.0), the P/T AF ratio correlated negatively with increasing gland weight (p=0.038).

Conclusion

The use of NIRAF resulted in some potential “surgeon-perceived” benefit but did not lead to improvements in cure rates. The negative correlation between fluorescent intensity and gland weight suggests loss of fluorescence with pathology, which needs further investigation. Further studies on larger cohorts of patients, in depth analysis of fluorescence patterns between normal, adenomatous, and hyperplastic glands and evaluation of user experience are needed. Primary hyperparathyroidism, hyperparathyroidism, autofluorescence, near-infrared fluorescence, parathyroid glands, endocrine, surgery.
Predictive markers for anti-inflammatory treatment response in thyroid eye disease
Authors: Zhang Haiyang , Fan Jingyuan , Qu Jialu , Han Qinghe , Zhou Huifang , Song Xuefei
Published: December 2023

Anti-inflammatory treatment is the primary and vital therapeutic approach for active, moderate-to-severe thyroid eye disease (TED). Accurate pretreatment prediction of treatment response is of paramount importance for the prognosis of patients. However, relying solely on the clinical activity score asa determinant of activity has led to unsatisfactory treatment outcomes. In recent years, significant advancements have been made in identifying predictive markers for anti-inflammatory treatment response in TED, clinical markers, body fluid biomarkers and imaging biomarkers. Several clinical studies have developed prediction models based on these markers. However, there is still a lack of comprehensive elucidation or comparison between the different markers. Therefore, this review aims to provide a detailed analysis of the definition, characteristics, and application of predictive markers for anti-inflammatory treatment response in TED. Through detailed literature search, 26 articles applying anti-inflammatory treatment effect prediction with a total of 1948 TED patients were used for analysis and discussion. By gaining a better understanding of the current research on predictive markers, we can accelerate and guide the exploration of treatment prediction strategies, leading us towards an era of precise therapy for TED.
Precise emergency load shedding approach for distributed network considering response time requirements
Authors: Li Chao , Pan Tingzhe , Meng Zijie , Jin Xin , Cai Xinlei , Luo Hongxuan
Published: December 2023

Emergency load shedding (ELS) is a vital measure for power systems to manage extreme events, ensuring the safety, stability, and economic operation of the grid. The integration of distributed energy resources and controllable devices in modern power systems has bolstered grid flexibility. Consequently, developing precise load shedding strategies to balance economic and security goals has emerged as a prominent subject in power system optimization. However, existing methods exhibit inadequacies, including overlooking practical operability, privacy concerns, and a lack of adaptability to response time requirements. To address these gaps, this paper introduces a precise ELS approach for distributed networks with a focus on response time needs. Contributions encompass designing load shedding processes for various response times, integrating demand response, and partitioning networks for optimized load shedding. Through validation using standard test cases, the proposed approach effectively utilizes response time and demand-side resources for precise ELS control in distribution networks. It accommodates different scenarios, offering a robust solution for rapid and accurate load shedding during emergencies.
Incidence and predictors of treatment interruption among patients on anti-tuberculosis treatment in Nekemte public healthcare facilities, Oromia, Western Ethiopia
Authors: Getachew Robsan Gudeta , Tolossa Tadesse , Teklemariam Zelalem , Ayele Angefa , Roba Hirbo Shore
Published: December 2023

Introduction

Tuberculosis treatment interruption increases the risk of poor treatment outcomes and the occurrence of drug resistant Tuberculosis. However, data on the incidence and predictors of tuberculosis treatment interruption are still scarce in Ethiopia, as well as in the study area. Therefore, this study aimed to assess the incidence and predictors of treatment interruption among patients on tuberculosis treatment in Nekemte public healthcare facilities, Oromia region, Western Ethiopia, from July 1, 2017, to June 30, 2021.

Methods

A retrospective cohort study design was conducted among 800 patients enrolled in anti-tuberculosis treatment during the study period. Data were collected from patient cards who were enrolled in treatment from July 1, 2017 to June 30, 2021. Epidata version 3.2 was used for data entry, and STATA version 14 was used for analysis. A multivariable Cox regression model with a 95% confidence interval (CI) and adjusted hazard ratio (AHR) was used to identify the significant predictors at a p value < 0.05. Finally, the log likelihood ratio, and a Cox-Snell residual graph was used to check the adequacy of the model.

Results

A total of 800 patients were followed for a median time of 2.3 (95% CI: 2.20–2.36) months, and with a maximum follow-up time of 11.7 months. The overall incidence rate of treatment interruption was 27.4 per 1000 (95% CI: 22.8–32.8) person-month observations. Age 18–34 years (AHR = 1.8, 95% CI: 1.02–3.18), male (AHR = 1.63, 95% CI: 1.1–2.42), rural residence (AHR = 3, 95% CI: 1.98–4.64), presence of comorbidity (AHR = 10, 95% CI: 5.47–18.27) and lack of treatment supporters on the treatment follow-up (AHR = 2.82, 95% CI: 1.9–4.41) were found to be significant predictors of treatment interruption.

Conclusion

A high incidence rate of interruption was observed among TB patients in public health facilities in Nekemte town. Health facilities should provide supportive care for patients with co-morbidities and consider interventions that target middle-aged patients from rural areas that reduce treatment interruptions.
Wild and cultivated olive tree genetic diversity in Greece: a diverse resource in danger of erosion
Authors: Tourvas Nikolaos , Ganopoulos Ioannis , Koubouris Georgios , Kostelenos George , Manthos Ioannis , Bazakos Christos , Stournaras Vasileios , Molassiotis Athanassios , Aravanopoulos Filippos
Published: December 2023

The genetic relationships between Greek wild olive tree populations and cultivars were investigated. A total of 219 wild genotypes and 67 cultivar genotypes were analyzed by employing 10 SSR markers. Data evidenced that the wild populations exhibited high levels of genetic diversity and exclusively host 40% of the total number of alleles detected. Inbreeding was observed within populations, probably as a consequence of their fragmented spatial distribution. The genetic differentiation between cultivars and wild individuals, as well as within wild populations, was low. Nevertheless, three gene pools of wild trees were detected, corresponding to the geographical areas of Northeastern Greece, Peloponnese-Crete and Epirus. Most cultivars clustered in a separate group, while the rest of them formed a heterogenous group with membership coefficients akin to the three wild olive clusters. Regarding the history of olive cultivation in Greece, bidirectional gene flow was detected between populations of Peloponnese-Crete and the gene pool that composes some of Greece’s most important cultivars, such as "Koroneiki” and “Mastoidis”, which is inferred as an indication of a minor domestication event in the area. A strategy for the protection of Greek-oriented olive genetic resources is proposed, along with suggestions for the utilization of the genetically diverse wild resources with regard to the introgression of traits of agronomical interest to cultivars.
Current and future opportunities for the management of primary biliary cholangitis
Authors: Naffouj Sandra , Wang Jennifer
Published: December 2023

Primary biliary cholangitis (PBC) is a rare immune-mediated chronic cholestatic liver disease that can progress to liver fibrosis and, ultimately, cirrhosis if left untreated. Since the pathogenesis of PBC is not well understood, curative therapies have yet to be established. Ursodeoxycholic acid (UDCA), the standard of care treatment for PBC, has been proven to reduce disease progression and improve transplant-free survival. However, one third of patients have no response or partial biochemical response to UDCA and are at increased risk for disease progression. In such cases, second-line therapy with obeticholic acid (OCA) or peroxisomes proliferator-activated receptors (PPARs) should be considered in conjunction with UDCA. In this review article, we aim to provide an overview of the most recent data on PBC treatment in patients with inadequate response to UDCA, as well as novel therapies in the early stages of development.
Creeping fat exhibits distinct Inflammation-specific adipogenic preadipocytes in Crohn’s disease
Authors: Hwang Nahee , Kang Dongwoo , Shin Su-Jin , Yoon Bo Kyung , Chun Jaeyoung , Kim Jae-woo , Fang Sungsoon
Published: December 2023

Creeping fat (CrF) is an extraintestinal manifestation observed in patients with Crohn’s disease (CD). It is characterized by the accumulation of mesenteric adipose tissue (MAT) that wraps around the intestinal wall. Although the role of CrF in CD is still debated, multiple studies have highlighted a correlation between CrF and inflammation, as well as fibrostenosais of the intestine, which contributes to the worsening of CD symptoms. However, the mechanism underlying the potential role of CrF in the development of Crohn’s fibrosis remains an enigma. This study aimed to analyze CrF comprehensively using single-cell RNA sequencing analysis. The data was compared with transcriptomic data from adipose tissue in other disease conditions, such as ulcerative colitis, lymphedema, and obesity. Our analysis classified two lineages of preadipocyte (PAC) clusters responsible for adipogenesis and fibrosis in CrF. Committed PACs in CrF showed increased cytokine expression in response to bacterial stimuli, potentially worsening inflammation in patients with CD. We also observed an increase in fibrotic activity in PAC clusters in CrF. Co-analyzing the data from patients with lymphedema, we found that pro-fibrotic PACs featured upregulated pentraxin-3 expression, suggesting a potential target for the treatment of fibrosis in CrF. Furthermore, PACs in CrF exhibited a distinct increase in cell-to-cell communication via cytokines related to inflammation and fibrosis, such as CCL, LIGHT, PDGF, MIF, and SEMA3. Interestingly, these interactions also increased in PACs of the lymphedema, whereas the increased MIF signal of PACs was found to be a distinct characteristic of CrF. In immune cell clusters in CrF, we observed high immune activity of pro-inflammatory macrophages, antigen-presenting macrophages, B cells, and IgG+ plasma cells. Finally, we have demonstrated elevated IgG+ plasma cell infiltration and increased pentraxin-3 protein levels in the fibrotic regions of CrF in CD patients when compared to MAT from both UC patients and healthy individuals. These findings provide new insights into the transcriptomic features related to the inflammation of cells in CrF and suggest potential targets for attenuating fibrosis in CD.
The selective inhibition of the Syk tyrosine kinase ameliorates experimental autoimmune arthritis
Authors: Káposztás Eszter , Balogh Lili , Mócsai Attila , Kemecsei Éva , Jakus Zoltán , Németh Tamás
Published: December 2023

Autoimmune arthritis – such as rheumatoid arthritis – affect a significant proportion of the population, which can cause everyday joint pain, decreased mobility and reduced quality of life. Despite having more and more therapeutic options available, there are still a lot of patients who cannot reach remission or low disease activity by current therapies. This causes an urgent need for the development of new treatment options. The Syk tyrosine kinase plays an essential role in B cell receptor, Fc receptor and integrin signaling. It has been shown that the hematopoietic cell-specific deletion of Syk resulted in a complete protection against autoantibody-induced experimental arthritis. This prompted us to test the effect of entospletinib, a second generation, Syk-selective inhibitor, which has a tolerable safety profile according to hematological clinical trials, in experimental autoimmune arthritis. We found that entospletinib dose-dependently decreased the macroscopic signs of joint inflammation, while it did not affect the health status of the animals. In line with these findings, local neutrophil accumulation and cytokine levels were reduced compared to the vehicle-treated group, while macrophage accumulation and synovial fibroblast numbers were not significantly altered. Meanwhile, entospletinib dose-dependently decreased the cell responses of immune complex- or integrin ligand-activated neutrophils. Overall, we found that selective Syk inhibition by entospletinib reduced the activity of autoantibody-induced experimental arthritis, which seems to be based mainly on the effect of the inhibitor on neutrophil functions. Our data raise the possibility that entospletinib could be a good drug candidate in the treatment of human autoimmune arthritis.
Pathologic complete response prediction in breast cancer lesion segmentation and neoadjuvant therapy
Authors: Liu Yue , Chen Zhihong , Chen Junhao , Shi Zhenwei , Fang Gang
Published: December 2023

Objectives

Predicting whether axillary lymph nodes could achieve pathologic Complete Response (pCR) after breast cancer patients receive neoadjuvant chemotherapy helps make a quick follow-up treatment plan. This paper presents a novel method to achieve this prediction with the most effective medical imaging method, Dynamic Contrast-enhanced Magnetic Resonance Imaging (DCE-MRI).

Methods

In order to get an accurate prediction, we first proposed a two-step lesion segmentation method to extract the breast cancer lesion region from DCE-MRI images. With the segmented breast cancer lesion region, we then used a multi-modal fusion model to predict the probability of axillary lymph nodes achieving pCR.

Results

We collected 361 breast cancer samples from two hospitals to train and test the proposed segmentation model and the multi-modal fusion model. Both segmentation and prediction models obtained high accuracy.

Conclusion

The results show that our method is effective in both the segmentation task and the pCR prediction task. It suggests that the presented methods, especially the multi-modal fusion model, can be used for the prediction of treatment response in breast cancer, given data from noninvasive methods only.
Pediatric ultrasound-guided dorsal penile nerve block and sedation in spontaneous breathing: a prospective observational study
Authors: Dottore Bruno , Meroi Francesco , Tomasino Serena , Orso Daniele , Comuzzi Matteo , Vernaccini Nicola , Vetrugno Luigi , Intini Sergio , Bove Tiziana
Published: December 2023

Background

Worldwide, one of the most common surgical procedures in the pediatric population is circumcision. There is no consent on the best anesthesiologic approach. This study aimed to investigate ultrasound-guided dorsal penile nerve block (DPNB) plus sedation in spontaneous breathing as a time-saving, safe, effective, and opioid-sparing technique.

Aims

The primary outcome was the assessment of the time from the end of surgery and the discharge to the post-anesthesia care unit. Secondary outcomes were to evaluate the cumulative dosages of opioids, differences in pain levels between the two groups, and complications at the awakening, 4 h and 72 h after surgery, respectively.

Methods

This was a prospective study with a retrospective control group, approved by the Friuli–Venezia Giulia Ethics Committee. Children in the intervention group received an ultrasound-guided DPNB under sedation and spontaneous breathing. With the probe positioned transversally at the base of the penis using an in-plane approach with a modified technique, local anesthetic was injected under the deep fascia of the penis.

Results

We recruited 70 children who underwent circumcision at the University Hospital of Udine, Italy, from 1 January 2016 to 1 October 2021: 35 children in the ultrasound-guided DPNB group and 35 children in the control group. Children who received ultrasound-guided DPNB had a statistically significant lower time to discharge from the operating room, did not require mechanical ventilation, maintained spontaneous breathing at all times, received fewer opioids, had lower mean intraoperative arterial pressures, and lower pain levels immediately after surgery.

Conclusion

Ultrasound-guided DPNB associated with sedation and spontaneous breathing is a time-saving, opioid-sparing, safe, and effective strategy for the management of intraoperative and postoperative pain in children undergoing circumcision.

Clinical trial registration:ClinicalTrial.gov (NCT04475458, 17 July 2020).
Distribution and antimicrobial resistance analysis of gram-negative bacilli isolated from a tertiary hospital in Central China: a 10-year retrospective study from 2012 to 2021
Authors: Shi Ting , Xie Liangyi
Published: December 2023

Background

Gram-negative bacilli are one of the most common causes of various infections in clinical. The emergence and global spread of multi-drug resistant gram-negative bacilli has become a major challenge in the global public health field.

Methods

A total of 51,189 non-repetitive strains of gram-negative bacilli were isolated in clinical settings. The antimicrobial susceptibility testing was conducted by using the automated VITEK 2 compact system and the matched AST susceptibility test card, complemented by the disk diffusion method. The antimicrobial susceptibility results were interpreted by CLSI. Rates of MDR and XDR in Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa were investigated. Used the chi-square test to determine whether the antimicrobial resistance rates of four major gram-negative bacilli isolated from ICU and non-ICU department have statistical differences.

Results

Escherichia coli (31.4%), Klebsiella spp. (21.2%), Acinetobacter spp. (13.8%), and P. aeruginosa (11.0%) were the most frequently isolated gram-negative bacilli. Escherichia coli was the top one organism isolated from urinary tract (68.4%), bloodstream (39.9%), body fluid (33.2%), wound and pus (37%), except for respiratory tract (8.8%). Whereas Acinetobacter baumannii and K. pneumoniae were the major isolated organisms from respiratory tract. Acinetobacter baumannii showed high resistance to fluoroquinolones, β-lactam/β-lactamase inhibitor combinations class, ceftazidime, cefepime, imipenem, and meropenem, the resistance rates reached more than 70%. Ceftazidime showed a lower resistance rate to E. coli than ceftriaxone. For E. coli, fluoroquinolones showed a high resistance rate (ciprofloxacin 61.36% and levofloxacin 53.97%), whereas amikacin, carbapenems exhibited a lower resistance rate fluctuating at 2%. Acinetobacter baumannii and K. pneumoniae showed rapid increases in carbapenem resistance whereas E. coli had the lowest resistance rate and remain stable at 2%. Acinetobacter baumannii exhibited the highest rate of MDR and XDR, reaching 60–80 and 45–55%, respectively. Compared to non-ICU departments, the resistance rates of four major gram-negative bacilli in the ICU department were much higher and the differences were statistically significant (p < 0.05).

Conclusion

Amikacin, carbapenems, and piperacillin/tazobactam exhibited relatively high sensitivity, whereas fluoroquinolones showed high resistance rate whether they can be the first-line antimicrobials for empirical treatment of UTI should take more consideration. The gram-negative bacilli in ICU were more resistance than that in non-ICU. These findings are helpful for clinicians using antimicrobials reasonably.
Nitrospira dominant pin-point flocs with granule-like settleability in stirred tank reactors with oxic/hypoxic/oxic zones
Authors: Aqeel Hussain , Asefa Bruke , Liss Steven N.
Published: December 2023

The characteristics of biomass and microbial community dynamics, in relation to autotrophic nitrification, were studied in two 20 L stirred tank reactors (STR) with oxic/hypoxic/oxic zones. The bioreactors were fed with synthetic wastewater with stepwise increasing ammonia concentrations (50–200 N mg/L) without organic substrate in the first phase (autotrophic phase) for 35 days (R1) and 15 days (R2), followed by a heterotrophic phase (with supplementation of organic substrate). The settling properties of the biomass, represented by pin-point flocs, gradually improved in both reactors during the autotrophic phase. The pin-point flocs of R1 exhibited granule-like settling properties. The SVI30 in RI gradually improved to 29 mL/g MLSS, and the corresponding SVI30/ SVI10 gradually improved to 0.88 during the autotrophic phase. The settling properties of the biomass deteriorated in both bioreactors during the heterotrophic phase. The protein to polysaccharide ratio (PN:PS ratio) gradually increased in the extracted EPS (in both, loosely bound (LB) and tightly bound (TB) EPS) during the autotrophic phase, in both bioreactors. The TB:LB EPS ratio was higher when the pin-point flocs of R1 showed granule-like settling properties, followed by a decline in TB:LB EPS ratio during the heterotrophic phase. A combination of molecular approaches (droplet digital-PCR (dd-PCR) and 16S rRNA gene sequencing) revealed that Nitrospira were the predominant nitrifying bacteria in the pin-point flocs that show granular sludge-like settling properties during autotrophic phase in R1. Comammox Nitrospira was the dominant ammonia oxidizer in seed biomass and at low ammonia concentrations in both bioreactors. The relative abundance of canonical ammonia-oxidizing bacteria increased with an increase in influent-ammonia concentrations.
Mobip: a lightweight model for driving perception using MobileNet
Authors: Ye Minghui , Zhang Jinhua
Published: December 2023

The visual perception model is critical to autonomous driving systems. It provides the information necessary for self-driving cars to make decisions in traffic scenes. We propose a lightweight multi-task network (Mobip) to simultaneously perform traffic object detection, drivable area segmentation, and lane line detection. The network consists of a shared encoder for feature extraction and two decoders for handling detection and segmentation tasks collectively. By using MobileNetV2 as the backbone and an extremely efficient multi-task architecture to implement the perception model, our network has great advantages in inference speed. The performance of the multi-task network is verified on a challenging public Berkeley Deep Drive(BDD100K) dataset. The model achieves an inference speed of 58 FPS on NVIDIA Tesla V100 while still maintaining competitive performance on all three tasks compared to other multi-task networks. Besides, the effectiveness and efficiency of the multi-task architecture are verified via ablative studies.