bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Affecting Mortality and Distribution of Co-morbidities in Chronic Obstructive Pulmonary Disease
Authors: Kim Sung-Soo
Published: March 2024

Objectives: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. This study aims to identify the rules associated with major comorbidities in patients with COPD and analyze how they affect death, thereby suggesting patient management measures that are efficient and can improve the quality of medical care.Methods: For this purpose, among the Korea Disease Control and Prevention Agency’s discharge injury in-depth survey data of more than 3 million cases from 2006 to 2021, adult patients aged 19 years or older with a principal diagnosis of chronic obstructive pulmonary disease were targeted. χ2-test and independent sample t-test were performed to analyze the distribution of deaths by demographic characteristics, and ARM (Association Rule Mining) was analyzed for association rules for comorbidities. Logistic regression analysis was performed on factors influencing death.Results: As a result of the analysis, the mortality rate was high in patients over 75 years of age, patients admitted to the emergency room, and patients discharged from medical institutions with more than 1,000 beds. The prevalence of comorbidities was high for E11 (Type 2 diabetes mellitus) and I10 (essential hypertension). As a result of analyzing the impact on death based on major association rules, other sepsis (A41) and essential hypertension (I10), other sepsis (A41) and pneumonia, organism unspecified (J18), sequelae of tuberculosis (B90) and J96 (respiratory Failure, NEC), sequelae of tuberculosis (B90), and I27 (other pulmonary heart diseases) were found to have a high probability of death.Conclusions: Based on the major association rules affecting death, we propose to apply them to a clinical decision support system for efficient patient management and personalized treatment.
A Survey on the Utilization of Big Data in the Healthcare Sector and the Demand for Integrated Data
Authors: Jung Jahye , Jhang Hoyol , Park Kyunik , Yun Ji Eun
Published: March 2024

Objectives: To investigate the status of secondary data and big data platform utilization and the demand for integrated data in the health care sector.Methods: An online survey was conducted using a structured questionnaire targeting members of six academic societies in the healthcare field. A total of 220 researchers responded to the survey.Results: 88.2% of respondents said they had experience using secondary data sources in the healthcare field, and 19.0% responded that they had experience linking data using the healthcare big data platform. Among the data in the health and medical field, the most used dataset was health insurance claims data, and if linking between dataset, the most desired linked data type is ‘National Health and Nutrition Examination Survey-Health Insurance Claims Data–National Health Examination-Death Information’. The advantages of linked data on big data platforms were ‘large volume of big data or representative’, ‘diversity of data’, and ‘long-term follow-up’. The major items requiring improvement were ‘delay in time to provide data’, ‘limitation of data provision range’, and ‘low linkage rate between dataset’.Conclusions: To promote the use of linked data in the health care field, comprehensive efforts are needed, including rapid data provision, improvement of the combination rate, standardization of data, and establishment of ethical guidelines.
Are people willing to pay for carbon neutrality? A survey from urban residents in Zhejiang, China
Authors: dong xuewang , huang huating , shao mengting , zhi ruizhi
Published: March 2024

Consumer responsibility is an important theoretical perspective for realizing China’s “carbon neutrality” policy goals. A theoretical model was developed based on the value-belief-norm perspective and the theory of planned behavior to estimate urban residents’ willingness to pay (WTP) for carbon neutrality. Based on the contingent valuation method, a single-bounded dichotomous choice elicitation format was used in the questionnaire survey, and 2,040 samples of urban family households in Zhejiang Province were randomly sampled. Subsequently, a binary logistic regression model was employed to estimate the carbon-offsetting WTP among urban households, and the influencing factors were analyzed. The study revealed that urban households in Zhejiang Province were willing to pay $11 per month and household to achieve carbon neutrality, and the respondents’ WTP for carbon offsetting was significantly affected by ascription of responsibility, subjective norms, age, income, and occupation. However, environmental values, attitudes, personal norms, an awareness of consequences, and education level did not significantly affect the respondents’ WTP. Finally, this study provides supporting data and policy suggestions for the formulation of more effective and reliable carbon offsetting standards and the realization of carbon neutrality goals in China.
Correlates of small screens play in 6–10-year-old children in China
Authors: Chen Lijian , liao jinjin , Ye Sunyue
Published: March 2024

IMPORTANCE Most of the current studies focus on fixed screens. However, the small mobile devices have been widely used among children of a younger age.
OBJECTIVE The aim of this study was to explore the factors associated with small screen use and its duration among first and second grade elementary school students based on Chinese cross-sectional data.
DESIGN, SETTING, AND PARTICIPANTS A total of 1121 students aged 6-10 years were recruited for this study. Logistic regression model was used to analyze the influencing factors of whether students use small screen devices and linear regression model was used to analyze the influencing factors of students' small electronic screen time. The data analysis spanned from August 21, 2023, to January 1, 2024.
EXPOSURES A questionnaire was used to collect basic information about students and parents and the use of small screens.
MAIN OUTCOMES AND MEASURES Recommendations for students' scientific use of small screen time in response to survey results.
RESULTS Girls (OR=0.74, p=0.035), having their own mobile phone (OR=3.66, p<0.001), unclear screen rules (OR=1.45, p<0.001), father's education level (OR=0.49, p=0.033), and mother's weekend screen time (<1 h/d as the reference group) 1-2 h/d (OR=2.49, p=0.001), 2-3 h/d (OR=2.7, p=0.001), ≥3 h/d (OR=2.27, p=0.009) were significantly associated with students’ use on screens. For total time (weekdays + weekends), girls spent more time on small screens compared to boys (β=58.88, p=0.043); having their own mobile phone or tablet computer (β=65.47, p=0.026), the less clear the family's screen time rules (β=60.55, p<0.001), and the longer mother's weekend screen time (β=142.61, p=0.027) were associated with longer total screen time for students.
CONCLUSIONS AND RELEVANCE Availability of their own small electronic devices, clarity of screen rules, father's education, and mother's weekend screen time were significantly correlated with students' screen time in China. Future studies with longitudinal design are needed.
Clinical study of plasma lymphocyte subsets and inflammatory factors in patients with acute coronary syndrome after COVID-19(omicron variant)infection
Authors: Liu Ran , Li Zixuan , Hou Yanjun , Zhai Guangyao
Published: March 2024

Background:The Omicron variant is the main circulating strain by the end of 2022,our study is to reveal the possible impact of COVID-19(Omicron variant) infection on ACS patients Through researching the changes of lymphocyte subsets and inflammatory factors.
Methods:This is a case-control study. 234 patients of COVID-19 infection accompany with acute coronary syndrome were enrolled,78 patients with only COVID-19 infection were enrolled as controls. Flow cytometry was used to detect lymphocyte subsets, Chemiluminescence assay was used to measure IL-6, IL-8, and TNF-α levels. The above indexes were compared in three groups during different stage of COVID-19 infection.
Results: 1) Compared with the control group,after COVID-19 infection,the STEMI and NSTE-ACS groups both showed a decrease in CD4+ T lymphocytes，while an increase in IL-6 and TNF-α levels only in STEMI group (P<0.05); Furtherly Within 3 months of COVID-19 infection,the STEMI group showed a decrease in CD4+ and CD8+ T lymphocytes, and an increase in CD4+/CD8+, IL-6, and TNF-α (P<0.05), while only CD4+ T decreased in the NSTE-ACS group (P<0.05); But after 3 months of COVID-19 infection, only the STEMI group showed a significant increase in IL-6 and TNF-α (P<0.05).2)Compared with the NSTE-ACS group, the STEMI group showed a significant decrease in CD8+ T lymphocytes and an increase in CD4+/CD8+ T lymphocytes within 3 months of COVID-19 infection(P<0.05)
Conclusions:Patients with a decrease in CD4+ T lymphocytes after COVID-19 infection maybe more prone to combined withacute coronary syndrome. Patients who develop STEMI within 3 months of COVID-19 infection may have a poorer prognosis.
Locus coeruleus injury modulates ventral midbrain neuroinflammation during DSS-induced colitis
Authors: Tansey Malú Gámez , Boles Jake , Holt Jenny , Cole Cassandra , Neighbarger Noelle , Urs Nikhil , Uriarte-Huarte Oihane
Published: March 2024

Parkinson’s disease (PD) is characterized by a decades-long prodrome, consisting of a collection of non-motor symptoms that emerges prior to the motor manifestation of the disease. Of these non-motor symptoms, gastrointestinal dysfunction and deficits attributed to central norepinephrine (NE) loss, including mood changes and sleep disturbances, are frequent in the PD population and emerge early in the disease. Evidence is mounting that injury and inflammation in the gut and locus coeruleus (LC), respectively, underlie these symptoms, and the injury of these systems is central to the progression of PD. In this study, we generate a novel two-hit mouse model that captures both features, using dextran sulfate sodium (DSS) to induce gut inflammation and N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) to lesion the LC. We first confirmed the specificity of DSP-4 for central NE using neurochemical methods and fluorescence light-sheet microscopy of cleared tissue, and established that DSS-induced outcomes in the periphery, including weight loss, gross indices of gut injury and systemic inflammation, the loss of tight junction proteins in the colonic epithelium, and markers of colonic inflammation, were unaffected with DSP-4 pre-administration. We then measured alterations in neuroimmune gene expression in the ventral midbrain in response to DSS treatment alone as well as the extent to which prior LC injury modified this response. In this two-hit model we observed that DSS-induced colitis activates the expression of key cytokines and chemokines in the ventral midbrain only in the presence of LC injury and the typical DSS-associated neuroimmune is blunted by pre-LC lesioning with DSP-4. In all, this study supports the growing appreciation for the LC as neuroprotective against inflammation-induced brain injury and draws attention to the potential for NEergic interventions to exert disease-modifying effects under conditions where peripheral inflammation may compromise ventral midbrain dopaminergic neurons and increase the risk for development of PD.
Predictors of functional improvement and pain reduction in rheumatoid arthritis patients who achieved low disease activity with disease-modifying antirheumatic drugs: a retrospective study of the FIRST Registry
Authors: Ochi Sae , Sonomoto Koshiro , Nakayamada Shingo , Tanaka Yoshiya
Published: March 2024

Background
Rheumatoid arthritis (RA) patients sometimes different levels of improvement in health assessment questionnaire-disability index (HAQ-DI) and subjective pain visual analogue score (VAS) even after achieving low disease activities (LDA). This study aimed to identify factors associated with improvement in HAQ-DI and pain VAS among those who achieved LDA.
Methods
Data of the FIRST registry, a multi-institutional cohort of RA patients treated with biological and targeted-synthetic DMARDs (b/tsDMARDs) were analyzed. Patients who were enrolled from August 2013 to February 2023 and who achieved clinical LDA [clinical disease activity index (CDAI) ≤ 10.0] at 6 months after starting treatment were included. Multiple logistic regression analyses were conducted to identify the factors that associated with achieving HAQ-DI normalization (< 0.5), HAQ-DI improvement (by > 0.22), or pain VAS reduction (≤ 40mm).
Results
Among 1424 patients who achieved LDA at 6 months, 732 patients achieved HAQ-DI < 0.5 and 454 achieved pain VAS reduction. The seropositivity and the use of JAK inhibitor compared with TNF inhibitor were associated with both HAQ-DI < 0.5 and pain VAS reduction at 6 months. On the other hand, older age, past failure in ≥ 2 classes of b/tsDMARDs, higher HAQ-DI at baseline, and use of glucocorticoid were associated with the lower likelihood of HAQ-DI normalization and pain VAS reduction. Longer disease duration, being female, and higher disease activity at baseline was negatively associated HAQ-DI normalization alone. Comorbidities were not associated with the outcomes.
Conclusions
These results suggest some preferable treatment may exist for improvement of HAQ-DI and pain VAS reduction in the early stage of the treatment, which is a clue to prevention of a criteria of difficult-to-treat RA.
Topology-enhanced machine learning for consonant recognition
Authors: Zhu Yifei , Feng Pingyao , Yi Siheng , Qu Qingrui , Yu Zhiwang
Published: March 2024

In artificial-intelligence-aided signal processing, existing deep learning models often exhibit a black-box structure. The integration of topological methods serves a dual purpose of making models more interpretable as well as extracting structural information from time-dependent data for smarter learning. Here, we provide a transparent and broadly applicable methodology, TopCap, to capture topological features inherent in time series for machine learning. Rooted in high-dimensional ambient spaces, TopCap is capable of capturing features rarely detected in datasets with low intrinsic dimensionality. Compared to prior approaches, we obtain descriptors which probe finer information such as the vibration of a time series. This information is then vectorised and fed to multiple machine learning algorithms. Notably, in classifying voiced and voiceless consonants, TopCap achieves an accuracy exceeding 96%, significantly outperforming traditional convolutional neural networks in both accuracy and efficiency, and is geared towards designing topologically enhanced convolutional layers for deep learning speech and audio signals.
Mechanistic Analysis of Riboswitch Ligand Interactions Provides Insights into Pharmacological Control over Gene Expression
Authors: Schneekloth John , Parmar Shaifaly , Bume Desta , Connelly Colleen , Boer Robert , Prestwood Peri , Wang Zhen , Labuhn Henning , Sinnadurai Krishshanthi , Feri Adeline , Ouillet Jimmy , Homan Philip , Numata Tomoyuki
Published: March 2024

Riboswitches are structured RNA elements that regulate gene expression upon binding to small molecule ligands. Understanding the mechanisms by which small molecules impact riboswitch activity is key to developing potent, selective ligands for these and other RNA targets. We report the structure-informed design of chemically diverse synthetic ligands for PreQ1 riboswitches. Multiple X-ray co-crystal structures of synthetic ligands with the Thermoanaerobacter tengcongensis (Tte)-PreQ1 riboswitch confirm a common binding site with the cognate ligand, despite considerable chemical differences among the ligands. Structure probing assays demonstrate that one ligand causes conformational changes similar to PreQ1 in six structurally and mechanistically diverse PreQ1 riboswitch aptamers. Single-molecule force spectroscopy is used to demonstrate differential modes of riboswitch stabilization by the ligands. Binding of the natural ligand brings about the formation of a persistent, folded pseudoknot structure, whereas a synthetic ligand decreases the rate of unfolding through a kinetic mechanism. Single round transcription termination assays show the biochemical activity of the ligands, while a GFP reporter system reveals compound activity in regulating gene expression in live cells without toxicity. Taken together, this study reveals that diverse small molecules can impact gene expression in live cells by altering conformational changes in RNA structures through distinct mechanisms.
Prediction of attention deficit hyperactivity disorder based on explainable artificial intelligence
Authors: Navarro-Soria Ignasi , Rico-Juan Juan Ramón , de Mier Rocío Juárez-Ruiz , Lavigne-Cerván Rocío
Published: March 2024

The aim of this study is to predict the probability being diagnosed with ADHD using ML algorithms and to explain the behavior of the model to support decision making. The dataset studied included 694 cases. Information was obtained on age, sex and WISC-IV scores. Algorithms belonging to different ML learning styles were tested. A stratified 10-fold-cross-validation was applied to evaluate the models. The metrics were used: accuracy, area under the receiver operating characteristic, sensitivity and specificity. We compared models using all initial features and a suitable wrapper-type feature selection algorithm. After, we calculated Shapley additive values to assign weights to each predictor based on its additive contribution to the outcome and explain the predictions. The Random Forest algorithm performed best on most metrics. The main predictors included, GAI-CPI, WMI, CPI, PSI, VCI, WMI - PSI, PRI and LN. The ML model adequately predicted ADHD diagnosis in 90% of cases.
Return-To-Work after mental illness: A qualitative study on factors promoting the reintegration into work
Authors: Braunwarth Sabrina , Lange Martin
Published: March 2024

Background: Mental illnesses have increased significantly in the past years and have a significant impact on individuals and work. Return-to-work (RTW) processes facilitate employees' return to work, help them regain workability, and prevent early retirement and long-term incapacity for work. However, the current state of evidence regarding RTW in the context of mental illness is not sufficient. The study aimed to identify (1) promoters and inhibitors of vocational rehabilitation from the patient's perspective, (2) potential differences in respondents' perceptions of various contextual factors, and (3) the relevance of professional, social, or economic influences on RTW acceptance.
Methods: The qualitative design used semi-standardized interviews. In total, eight people affected by mental illness were interviewed, of which seven were included in the thematic analysis. The interviews were conducted by the same person, either in person or by telephone. We used MaxQDA to develop a coding scheme in iterative revisions. Two additional independent individuals checked the final coding tree and data analysis.
Results: We identified, among other aspects, relationships with coworkers and supervisors, open communication about illness, or contact with peers as promotors of successful RTW. Inhibitors were triggers at the workplace, conflicts with supervisors, performance pressure, and a lack of understanding. Social support through family and daily routines were considered critical contextual factors. The constant justification of the illness or financial worries, e.g., were perceived as onerous. The exchange with peers and the role of stakeholders were revealed to be critical for a positive perception of the RTW process.
Conclusion: Our study showed that the return to work after or during a mental illness is a complex part of therapy. Work itself is an essential part of recovery after mental illness that can provide stability for those affected and minimize risk factors and remissions. This, in turn, assigns workplaces the role of a support system, including team members, supervisors, and daily routines and tasks. Our results underline that there is a collective responsibility for all stakeholders.
Translation, cross-cultural adaptation, validation, and reliability study of the Breast Cancer Fear Scale: Chinese version
Authors: Zhou Yanni , Li Xiaoxia , Lai Jie , Xiao Xiuyun , Wu Yanni
Published: March 2024

Background
Cancer-related fear has been identified as an important component of health-related behaviors. However, there is a lack of tools for measuring breast cancer fear in the Chinese healthcare context, which might hinder related studies in the Chinese population. The Breast Cancer Fear Scale developed by Champion was introduced, and its psychometric characteristics and factor structure were evaluated to provide a suitable and reliable measurement tool in China to assess the fear of breast cancer in Chinese women.
Methods
According to the Brislin back translation model, the Breast Cancer Fear Scale was translated into Chinese, 33 subjects were selected for the cognitive survey, 8 experts were invited for the content validity test, 245 subjects were surveyed via the convenience sampling method, and the reliability and validity of the scale were tested.
Results
The Chinese version of the Breast Cancer Fear Scale has 8 items in total. The content validity of the scale is 0.99, and the content validity of the item is 0.88 ~ 1.0. The expert's judgment basis (Ca) is 0.91, the expert's familiarity level (Cs) is 0.80, and the expert's authority coefficient (Cr) is 0.86. The Cronbach's α of the scale is 0.97. The retest reliability was 0.95. The project analysis shows that there are differences between groups, indicating that the discrimination of each item is good.
Conclusions
The Chinese version of the Breast Cancer Fear Scale has good reliability and validity and can be used to assess the fear of breast cancer in Chinese adult women.
Is poor oral health a risk factor for idiopathic granulomatous mastitis?
Authors: SAĞLIK Semih , Olgaç Şilan Bilek
Published: March 2024

OBJECTIVE:
Idiopathic granulomatous mastitis is a rare inflammatory disease of the breast that clinically and radiologically can be confused with carcinoma. Although its etiology remains unclear, it is stated that it may be related to pregnancy, lactation, hormonal imbalance, autoimmunity, smoking, α1-antitrypsin deficiency and various microorganisms. This study aimed to evaluate the relationship between idiopathic granulomatous mastitis and oral health.
PATIENTS AND METHODS:
Our study included 42 female patients diagnosed with idiopathic granulomatous mastitis as a result of histopathological evaluations between September 2018 and October 2023. The reference group consisted of 47 female patients with clinically, radiologically and laboratory proven non-specific mastitis and 36 healthy female individuals. The oral health of all individuals included in the study was evaluated by an experienced dentist using "Decayed, Missing and Filled Teeth" (DMFT) and "Simplified Oral Hygiene Index" (OHI-S) index values.
RESULTS:
The ages of idiopathic granulomatous mastitis patients included in the study ranged between 29-51 years (mean age 34.88±4.87). The most common clinical findings were pain (n=38), palpable breast mass (n=32), erythema (n=22), induration (n=14) and dermal sinus (n=10). When OHI-S and DMFT index values of the individuals included in the study were compared, both OHI-S and DMFT index values of individuals diagnosed with idiopathic granulomatous mastitis were statistically significantly higher than those of the reference group (p<0.05).
CONCLUSIONS
Our findings suggest that poor oral health may be involved in the etiology of idiopathic granulomatous mastitis. Therefore, it may be useful to consider oral health in the etiology of IGM in future studies and to investigate oral microbiota in samples obtained from the target tissue.
A facile method for the synthesis of foamed silicone rubber
Authors: Yang Jingjing , Zhu Zhichen , Jiang Li , Jin Xiang , Yang Hongjun , Jiang Qimin , Xue Xiaoqiang , Jiang Bibiao , Huang Wenyan
Published: March 2024

Foamed silicone rubber was prepared by mixing 45% vinyl silicone oil (Base), Karstedt platinum catalyst (Cata), and hydrogenated silicone oil (SiH) and the resulting material was subjected to secondary vulcanization, which led to its performance requirements. Vinyl silicone oil and hydrogenated silicone oil underwent an addition reaction under the action of a platinum catalyst to form an elastomer with a cross-linked network structure. The results showed that by increasing the content of hydrogenated silicone oil in the formulation, the elongation at break of the foamed silicone gel material decreased but the tensile strength increased. When the content of hydrogenated silicone oil in the formulation decreased, the elongation at break of the foamed silicone material increased. When the content of Karstedt catalyst in the formulation increased, the formation time of the reaction gel was greatly shortened, and the cell structure tended to be dense but delicate. When the proportion of vinyl silicone oil in the formulation increased, the elongation at break of the foamed, molded silicone rubber increased. However, the elastic modulus decreased, and the thermal stability improved. Finally, a more suitable formulation of VBase: VCata: VSiH= 32: 1: 2 was obtained, which showed a tear resistance of 5.52 KN/m, ductility of 133%, and limiting oxygen index of 26 with a stability temperature of 346.8 °C when the thermal mass loss reached 95%.
Synthesis of MnO-LiF Composite Cathode Material Using NH4F as a fluorine source
Authors: Tang Anping , Chen Juedong , Xu Guorong , Song Haishen , Wang Jinglun , Chen Hezhang
Published: March 2024

Non-intercalation cathode materials based on nanocomposites of lithium fluoride and Li-free transition metal compounds have drawn attention as materials for fabricating the cathode of lithium ion batteries owing to their high theoretical specific capacities and high redox voltages. In the present study, a nanocomposite of MnO-LiF was in situ synthesized by a quick annealing at 500 °°C for just 5 minutes using a mixture of ammonium fluoride, manganese acetate, and lithium acetate as precursor. The synthesized composite is investigated by X-ray diffraction, scanning electron microscopy, nitrogen sorption, and charge-discharge measurements. As a lithium-ion battery cathode, it delivers respectively an initial discharge specific capacity of 170 mAh g-1 and a discharge specific capacity of 137 mAh g-1 in the 50th cycle at a current rate of C/20, equivalent to a moderate capacity retention rate of 80.6%. The novel synthesis approach proposed offers access to electrochemically active composites of lithium fluoride and Li-free transition metal oxides.
Experimental investigation of the effect of interstitial liquid on the shear characteristics of geotechnical granular materials
Authors: Hu Yuxiang , Yang Dong , Niu Wenqing , Zhang Weilong , Zheng Hu
Published: March 2024

Interstitial liquid between particles is a significant factor affecting the shear characteristics of geotechnical granular materials. To further investigate this issue, this study systematically conducted ring shear tests on quartz sand of different saturations and particle sizes to study the effects of interstitial fluid on the effective friction coefficient, system fluctuations, volume strain, and particle breakage. It was found that the impact of saturation on the shear characteristics of quartz sand has a strong correlation with particle size. The effective friction coefficient of coarse sand shows a trend of increasing and then decreasing with increasing saturation. In contrast, the effective friction coefficient and system fluctuations of medium and fine sands are not sensitive to changes in saturation. The volume strain changes of quartz sand during shearing can be divided into three stages, with the trend in each stage significantly affected by saturation and particle size. The absolute crushing rate of coarse sand gradually decreases with increasing saturation. The smaller the particle size, the lower the likelihood of breakage. The impact of saturation on the absolute breakage rate of finer particles is not significant. Based on the results analysis, the interstitial liquid has an undeniable effect on the shear characteristics of geotechnical granular materials. The findings provide a scientific basis for further understanding the dynamic mechanisms behind the shear deformation and failure-induced disasters of geotechnical granular materials.
Brown adipose tissue-derived FGF21 mediates the cardioprotection of dexmedetomidine in myocardial ischemia/reperfusion injury
Authors: Ding Yi , Su Jiabao , Shan Beiying , Fu Xiao , Zheng Guanli , Wang Jiwen , Sun Haijian , Zhang Jiru
Published: March 2024

Brown adipose tissue (BAT) plays a critical role in regulating cardiovascular homeostasis through the secretion of adipokines, such as fibroblast growth factor 21 (FGF21). Dexmedetomidine (DEX) is a selective α2-adrenergic receptor agonist with a protection against myocardial ischemia/reperfusion injury (MI/RI). It remains largely unknown whether or not BAT-derived FGF21 is involved in DEX-induced cardioprotection in the context of MI/RI. Herein, we demonstrated that DEX alleviated MI/RI and improved heart function through promoting the release of FGF21 from interscapular BAT (iBAT). Surgical iBAT depletion or supplementation with a FGF21 neutralizing antibody attenuated the beneficial effects of DEX. AMPK/PGC1α signaling-induced fibroblast growth factor 21 (FGF21) release in brown adipocytes is required for DEX-mediated cardioprotection since blockade of the AMPK/PGC1α axis weakened the salutary effects of DEX. Co-culture experiments showed that DEX-induced FGF21 from brown adipocytes increased the resistance of cardiomyocytes to hypoxia/reoxygenation(H/R) injury via modulating the Keap1/Nrf2 pathway. Our results provided robust evidence that the BAT-cardiomyocyte interaction is required for DEX cardioprotection, and revealed an endocrine role of BAT in DEX-mediating protection of hearts against MIRI.
How (not) to Compute the Halting Probability.
Authors: Jalilvand Manizheh , Nikzad Behzad , Salehi Saeed
Published: March 2024

We study Chaitin’s well-known constant number Omega, and show that it is not a probability of halting the randomly chosen input-free programs. We suggest some methods for defining the halting probabilities by various measures.
Mathematics Subject Classification (2020): 60A10 · 28A05 · 68Q04 · 03D10.
Testing the Kuznets Curve Hypothesis at the Sector Level: Evidence from PNARDL for OECD Countries
Authors: Songur Mehmet , Uğurlu Erginbay , Muratoğlu Yusuf , Şanlı Devran
Published: March 2024

Since the contribution of economic sectors to GDP is heterogeneous, they also contribute differently to CO2 emissions and environmental degradation. Although many studies investigate the Environmental Kuznets Curve (EKC) hypothesis, there are still gaps in this literature, specifically in sectors. This study contributes to the literature in several ways. First, it examines the validity of the environmental EKC hypothesis for four different sectors (Agriculture, Industry, Manufacture and Service). Second, the impact of energy consumption on CO2 is examined asymmetrically. Finally, annual data from 38 OECD countries from 1990 to 2022 are used to fill this gap. The method used in the study is a new panel nonlinear ARDL to capture the asymmetric effect of energy consumption on CO2. The findings show that the EKC hypothesis is valid for sectors other than the industrial sector and for the overall economy. The turning point of the Kuznets Curve for the total economy is estimated as $29250 GDP per capita. The PNARDL model's error correction term (ec) is negative and significant. However, the magnitude of the term suggests that the system will return to long-term equilibrium after approximately 2.87 years following any shock. It has been determined that agriculture is the sector that causes the most environmental degradation by increasing CO2 emissions. This situation highlights the limited availability of productive capital equipment and renewable sources in the agricultural sector, even in OECD countries. Moreover, the empirical results clearly show that energy consumption has asymmetric effects on emissions in both the long and short run. Positive and negative shocks in energy consumption increase CO2 emissions in OECD economies in the long run. Asymmetric effects are valid for four sectors.
Jel Codes: Q42, Q43, Q53
Liver transplantation for hepatocellular carcinoma: a proposal for including preoperative serological indicators improves the Milan criteria expanded
Authors: JIAO Ning , YAN Cheng , HE Li , JIN Hai Long , OIU Shuang , LI Chao , ZHENG Zhi Sheng , LU Bin , WU Feng Dong , YANG Yang , CHEN Xin Guo , ZHANG Qing
Published: March 2024

Objective: To evaluate the predictive effect of preoperative serological indicators on long-term overall survival (OS) and tumor recurrence-free survival (TFS) of patients with hepatocellular carcinoma (HCC) after liver transplantation (LT), and to explore its significance for expanding the Milan criteria.
Methods: Clinical data of 253 patients after LT in HCC were collected retrospectively. The receiver operating characteristic curve was used to calculate the best cut-off value. χ2 test was used to analyze the correlation between preoperative serological indicators and tumor pathological features. Univariate and multivariate analyses were used to analyze the risk factors affecting the OS and TFS rates and the predictive values of different LT criteria were compared. Nomogram model was used to predict the OS and TFS rates of patients exceeding Milan criteria.
Results: Independent risk factors for poor OS and TFS rates were alpha-fetoprotein (AFP) >200 ng/mL, gamma-glutamyl transpeptidase (GGT) >80 IU/l, total tumor diameter (TTD) >8 cm and microsatellite lesions. Nomogram model showed patients beyond Milan criteria had better survival when AFP ≤200 ng/mL and GGT ≤80 IU/l or AFP ≤200 ng/mL, GGT ≤80 IU/l and TTD ≤8 cm. According to Milan criteria, AFP, GGT and DDT, Milan-AFP-GGT-TTD (M-AGT) criteria was established. There was no significant difference in OS and TFS rates among patients in M-AGT, Milan, Hangzhou, Malaya and UCSF criteria.
Conclusions: Preoperative serological indicators AFP and GGT can effectively predict long-term OS and TFS in HCC patients after LT. Establishing M-AGT criteria based on serological indicators is helpful to supplement the Milan criteria.
Prediction of pregnancy outcomes of single vitrified-warmed blastocyst transfer using combination of an automatic classification algorithm applied on cleavage stage embryos and blastocyst morphological assessment: a single - centre, retrospective study
Authors: Dinh Hop Vu , Manh Cuong An , Tu Anh Phi Thi , Lien Huong Nguyen Thi , Le Hoang , Van Hanh Nguyen
Published: March 2024

Background
To investigate a combination of the Early Embryo Viability Assessment (EEVA) system and blastocyst morphological assessment as a predictor of pregnancy outcomes of single vitrified-warmed blastocyst transfer, such as implantation and ongoing pregnancy.
Methods
The retrospective study was conducted in a single centre from 2020 to 2023 and included 511 single vitrified-warmed blastocyst transfer cycles. Blastocyst were selected for transfer based on conventional morphological assessment. Embryos Day 3 were evaluated using EEVA software. The correlation between the EEVA system alone, or a combination of the EEVA system and blastocyst morphological assessment, and pregnancy outcomes was qualified by generalized estimating equations (GEEs).
Results
The implantation rate and ongoing pregnancy were higher with lower scores generated by the EEVA software. A GEE model showed a negative association between a higher embryo score and lower odds of implantation and ongoing pregnancy. The OR of Score 3;4;5 vs. 1 were 0.350; 0.288; 0.282 (95%CI 0.201–0.607; 0.151–0.546; 0.125–0.636, p=0.000), respectively, for implantation. The OR of Score 3;4;5 vs. 1 were 0.321; 0256; 0.228 (95%CI 0.184-0.557; 0.129-0.505; 0.092-0.563, p=0.000), respectively, for ongoing pregnancy. The AUC of the model using the EEVA system for implantation and ongoing pregnancy potential is 0.651 and 0.655, respectively. The AUC of the model combining both systems for implantation and ongoing pregnancy potential is 0.730 and 0.726. The differences were statistically significant (p=0.0001).
Conclusions
The EEVA system can predict the success rates of assisted reproduction cycles, especially when combined with blastocyst morphological assessment in blastocyst selection for transfer.
Atypical Appearance of Recurrence and Metastasis of Gastrointestinal Carcinomas and Its Treatment Response: Solve 18F-FDG PET/CT Challenging Cases Using 68Ga-FAPI PET/MRI: a case-control study
Authors: Miao Jingxuan , Xu Yifei , Zhao Xuefeng , Su Xiaoyu , Zhu Gan , Wu Tao , Wang Hui
Published: March 2024

Background To compare the efficiency of Gallium 68 (68Ga)-labeled FAP inhibitor-04 (68Ga-FAPI-04) positron emission tomography(PET)/MRI with conventional fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT for the diagnosis of gastrointestinal tract(GI) cancers suspected of recurrence or metastasis, especially when glucose metabolism is atypical, which complicates diagnosis by 18F-FDG.
Methods 18F-FDG PET/CT and 68Ga-FAPI-04 PET/MRI scans were acquired independently for participants with pathologically or endoscopically confirmed GI tumors with signs of recurrence or metastasis, especially for postoperative patients. We used McNemar’s test to compare the diagnostic effects of these two technologies. The normalized maximum standardized uptake values(SUVmax) of selected lesions were measured and analyzed by Student’s t-test, between SUVmax of the primary lesion and treatment response was explored in patients who received systemic therapy.
Results Twenty-two(median age 61 years±7;12 males) participants were evaluated. 68Ga-FAPI-04 PET/MRI was more sensitive than 18F-FDG PET/CT to detect involved lymph nodes after surgery (100% [86/86] vs 90% [77/86], P = 0.003) as well as bone and visceral metastases (92% [24/26] vs 62% [16/26], P = 0.02). In addition, the uptake of 68Ga-FAPI-04 was higher than 18F-FDG in primary lesions (normalized SUVmax: 6.06 ± 2.27 vs 2.75 ± 1.52, P = 0.004), involved lymph nodes (normalized SUVmax: 9.07 ± 2.93 vs 3.96 ± 1.73, P < 0.001), bone metastases (normalized SUVmax:11.17 ± 2.18 vs 6.15 ± 1.39, P < 0.001), and liver metastases (normalized SUVmax: 3.75 ± 2.07 vs 2.55 ± 0.86, P = 0.047), etc.
Conclusion 68Ga-FAPI-04 PET/MRI provides superior diagnostic effects and visualization of atypical metabolism GI tumors which are difficult to diagnose with 18F-FDG PET/CT, especially for the postoperative recurrent metastases.
Hepatic infarction occurred after 125 I particle stent treatment for hepatocellular carcinoma with portal vein tumor thrombus: A case report
Authors: Yang Jiemin , Qin Yang , Lv Zhongyuan , Xiao Qingqing , Miao Ying , Huang Huiping , Mao Jingsong
Published: March 2024

Hepatic infarction is a rare liver condition. The purpose of this study is to report a case of hepatic infarction caused by thrombus formation following portal vein stent implantation in a patient with hepatocellular carcinoma and portal vein tumor thrombus, and to explore the underlying causes. The patient in this study was a 52-year-old male admitted with diffuse hepatocellular carcinoma involving the right lobe and portal vein tumor thrombus. After undergoing portal vein stent implantation and I125 particle strand implantation treatment, the portal vein was patent, and the pressure decreased. However, multiple instances of hepatic artery chemoembolization combined with targeted immunotherapy resulted in gradual reduction in the diameter of the hepatic artery and affecting hepatic arterial blood flow. Two months post-stent implantation, thrombus formation within the stent was noted, and the patient's condition did not improve with anticoagulant therapy, as evidenced by follow-up CT scans showing an increase in thrombi. Six months later, the patient suffered from gastrointestinal bleeding and, despite emergency esophagogastric variceal ligation and hemostatic treatment, developed hepatic parenchymal infarction and liver function failure. We reveal the underlying cause is that (1) thrombus formation within the portal vein stent, leading to portal vein embolism and obstructed blood flow due to exacerbated portal hypertension after various treatments; and (2) the effect of hepatic artery chemoembolization, immunotherapy, and targeted therapy on tumor angiogenesis, causing reduced hepatic artery diameter and impaired arterial blood flow. These factors disrupt the liver's dual blood supply system, ultimately contributing to hepatic infarction.To our knowledge, this is the first report of hepatic infarction as a complication following portal vein stent implantation for hepatocellular carcinoma with portal vein tumor thrombus, and it holds significant reference value for guiding the treatment of hepatocellular carcinoma with concurrent portal vein tumor thrombus in a clinical setting.
Association between preoperative cerebrovascular accidents with length of hospital stay among patients undergoing primary unilateral total knee arthroplasty in Singapore: a single-center retrospective study
Authors: Wang Jinpei , Hou Xinjiang , Yue Zhiyong , Wang Guaijuan , Liu Runna , Ren Jiasen
Published: March 2024

Background
Multiple studies have suggested that preoperative cerebrovascular accidents (CVA) are linked to unfavorable outcomes in elective orthopedic surgeries. The objective of this study was to evaluate whether a prior history of CVA has an independent association with the length of hospital stay (LOS) in patients who undergo primary unilateral total knee arthroplasty (TKA).
Methods
For this retrospective cohort study, a total of 2083 patients who underwent unilateral TKA at a tertiary academic medical center in Singapore between January 2013 and June 2014 were included. Univariate and multivariate linear regression analyses were utilized to identify the independent risk factors associated with LOS. Furthermore, subgroup and interaction analyses were conducted to assess the relationship between CVA and LOS.
Results
A total of 2083 eligible patients, comprising 1576 females and 507 males, were enrolled in the study. Among them, 2039 had a history of CVA, while the remaining 44 did not. The ethnic distribution was as follows: 83.7% (n = 1743) Chinese, 7.3% (n = 152) Indian, 6.0% (n = 125) Malay, and 3.0% (n = 63) from other ethnicities. The mean age of the sample was 66.5 years, with a median LOS of 4.0 days. The risk factors identified for prolonged LOS were as follows: age equal to or older than 65 years, regional anesthesia, perioperative blood transfusion of 1 unit, perioperative blood transfusion of more than 2 units, American Society of Anesthesiologist Physical Status (ASA) class III, diabetes mellitus, ischemic heart disease, CVA, creatinine level greater than 2 mg/dL, preoperative hemoglobin level between 11-12.9 g/dL, preoperative hemoglobin level greater than or equal to 13 g/dL, and TKA performed on Thursday. Furthermore, a significant association between CVA and LOS was observed using multivariable logistic regression analyses after adjusting for potential confounders. The adjusted odds ratio for prolonged LOS in patients with CVA compared to those without CVA was 3.24.
Conclusion
Patients with a previous history of CVA undergoing unilateral TKA are at a heightened risk of enduring a significantly prolonged LOS compared to those without a history of CVA. To enhance patient care and establish suitable perioperative guidelines, close collaboration among orthopedic, medical, and neurological teams is crucial.
Analysis of Lateral Dynamics of the Semi- Autonomous Vehicles for Lane Changes and Cornering Maneuvers
Authors: Yeneneh Kumlachew , Yoseph Bisrat
Published: March 2024

This paper investigates the challenge of maneuvering the safety and stability of semi-autonomous vehicles (SAVs) while tracking major aspects of their lateral dynamics under unpredictable situations and conditions. The common aspects of all these cases have been the necessity for balancing that model simplicity with the ability to be able to reflect the real system by using a simple geometric bicycle model, a realistic bicycle model taking into consideration forces, and state-space representation designed with capacity in mind to handle nonlinearities and disturbances. These are used in control strategies to safer and smother maneuvers. We evaluate how well SAVs maintain safety under various conditions based on lateral deviation, relative yaw angle (heading error), and steering wheel angle. The Model Predictive Control (MPC) maintains adaptability during changes, not only in terms of vehicle mass but also velocity, by the use of a cost function that governs smooth maneuvering with minimum deviation (convergence to zero). As an additional observation, at non-nominal velocities, the heavier ones may present a bigger recovery, whereas the lighter vehicles recover faster. The cost function used in MPC for the model will handle these variations so that once, stability and ride comfort can be predicted for different masses of vehicles and their respective speeds.
Reliability and validity of the Chinese Short Warwick-Edinburgh Mental Well-being Scale in people living with dementia
Authors: Leung Dara Kiu Yi , Wang Yun-Lin , Wang Yun-Han , Ng Zuna Loong Yee , Ma Maggie Sui Ling , Choy Jacky Chak Pui , Wong Gloria Hoi Yan
Published: March 2024

Background
Supporting people living with dementia to live well with the condition has been promoted as a policy and practice priority. A valid measure of mental well-being can facilitate related research in the growing Chinese dementia population. This study evaluated the reliability and validity of the Chinese Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) in Chinese people living with dementia in Hong Kong.
Methods
A total of 162 people living with dementia completed the SWEMWBS. Factorial validity of the scale was evaluated by confirmatory factor analysis (CFA). Convergent and divergent validity were assessed by Spearman’s correlations with Quality of Life in Alzheimer’s Disease (QoL-AD), EQ-5D-5L, EQ VAS, Neuropsychiatric Inventory Questionnaire (NPI-Q; depression and anxiety items). Known-group validity was examined based on sex, age, and education level. Congeneric reliability was assessed by standardized factor loadings and error variances, while internal consistency by Cronbach’s alpha.
Results
The one-factor structure of SWEMWBS was confirmed (CFI = 0.998, TLI = 0.996, RMSEA = 0.02). The scale had weak-to-moderate correlations with QoL-AD, EQ-5D-5L, EQ VAS, and NPI-Q Anxiety (r = − .025 to 0.42) but no correlation with NPI-Q Depression. Respondents who were younger, male, and had higher education levels reported higher levels of mental well-being. SWEMWBS showed good congeneric reliability (0.80) and internal consistency (0.80).
Conclusions
The Chinese SWEMWBS showed good validity and reliability for measuring mental well-being in the Chinese dementia population in Hong Kong. Known-group validity results indicate a potentially distinct pattern of well-being among people living with dementia.