bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Water Quality Detection for Drinking and Irrigation Using Convolutional Neural Networks
Authors: Kareem Nagham K. , Aljanabi Mohammad , Mijwil Maad M. , Rabiei Hamid , Miralles-Pechuán Luis , Chadoundry Tanupriya , Kareem Aythem Khairi , Nafea Ahmed Adil , Abotaleb Mostafa
Published: September 2024

Water quality is essential for maintaining the health of ecosystems and the overall quality of life. It is crucial to monitor water quality for effective water resource management, as high-quality water suitable for domestic, drinking, irrigation, and industrial use is not always readily available. Polluted water has serious repercussions, leading to harmful environmental, human health, and infrastructure conditions. According to a United Nations (UN) report, 1.5 million people die each year due to diseases caused by polluted water. A recent study introduced a one-dimensional convolutional neural network (1D-CNN) approach for predicting water quality specifically for irrigation and drinking purposes. The prediction of water quality relies on physicochemical parameters. This study used two datasets—one for drinking water and the other for irrigation water—each with distinct features. The results show that the proposed model achieved 97.19% accuracy for irrigation and 100% accuracy for drinking water, demonstrating the model's effectiveness in accurately categorizing water samples suitable for drinking and providing robust support for decision-making processes related to potable water and irrigation.
Reliable diagnosis of nigrostriatal degeneration by dopamine transporter SPECT despite drug interaction with venlafaxine and bupropion
Authors: Apostolova Ivayla , Hellwig Sabine , Karimzadeh Amir , Klutmann Susanne , Meyer Philipp T. , Buchert Ralph
Published: September 2024

Purpose
This study examined the impact of venlafaxine and bupropion on the detection of nigrostriatal degeneration by dopamine transporter (DAT)-SPECT.
Methods
43 patients (70.7 ± 8.6y, 44% female) with [123I]FP-CIT-SPECT under venlafaxine (n = 26, 37.5-225mg/d), bupropion (n = 16, 150 or 300mg/d) or both (n = 1) were included retrospectively. The striatal specific [123I]FP-CIT binding ratio (SBR), its left-right asymmetry and the putamen-to-caudate ratio were transformed to z-scores and submitted to a cluster analysis for data-driven categorization.
Results
Two clusters were identified. The first cluster (37% cases) showed a Parkinson’s disease (PD)-like pattern: median striatal SBR/asymmetry/putamen-to-caudate z-score − 4.5/4.9/-3.8. The second cluster (63%) showed symmetric reduction with normal intra-striatal gradient: median striatal SBR/asymmetry/putamen-to-caudate z-score − 2.7/0.4/0.2. Patients with follow-up clinical reference diagnoses of neurodegenerative (n = 7) and non-neurodegenerative (n = 16) parkinsonism fell exclusively into the former or the latter cluster, respectively (p < 0.001).
Conclusion
Venlafaxine and bupropion cause uniform reduction of the striatal [123I]FP-CIT SBR that can be distinguished from PD-like reductions.
Analysis of the Correlation between Morphological Classification of the Middle Glenohumeral Ligament and Subscapularis Tears
Authors: Liu Tao , Meng Tao , Huang Zhen , Wang Yaning , Shi Hui , Wang Linwei , Lin Chao
Published: September 2024

Objective
The purpose of this study was to evaluate the correlation between the morphological classification of the middle glenohumeral ligament (MGHL) and subscapularis tears and to assess the necessity of releasing the MGHL.
Methods
A retrospective analysis was performed on the surgical videos of shoulder arthroscopic rotator cuff repair surgeries conducted by the same surgeon from September 2020 to September 2021. The MGHL was classified morphologically into two types: overall classification and lateral insertion classification, and the occurrence of subscapularis tears was recorded for each type. The chi-square test was used to analyze the differences in the number of subscapularis tears among the classification groups. It was approved by Binzhou Medical University Hospital Institutional Review Board(IRB No. 2023-LW-155).
Results
Out of 122 patients, 44 (36.07%) were male and 78 (63.93%) were female, with an average age of 55.03 ± 7.35 years. According to the overall classification of MGHL, there were 54 cases of Type Ⅰ (44.26%), 32 cases of Type Ⅱ (26.23%), 28 cases of Type Ⅲ (22.95%), 2 cases of Type Ⅳ (1.64%), and 6 cases of Type Ⅴ (4.92%). For the lateral insertion classification of MGHL, there were 53 cases of Type A (43.44%) and 69 cases of Type B (69%). There was no statistically significant difference in the number of subscapularis tears among the classification groups (p = 0.089, p > 0.05 for overall classification; p = 0.22, p > 0.05 for lateral insertion classification).
Conclusion
This retrospective study found no correlation between the morphological classification of MGHL and subscapularis tears. For patients with rotator cuff tears who do not have frozen shoulder, caution should be exercised when performing release of the MGHL.
The Effect of a U-shaped Toothbrush in Removing Plaque in Pre-school Children: A Randomized Controlled Trial
Authors: Abdulrahman Kamar , Tolibah Yasser Alsayed , Bshara Nada
Published: September 2024

This randomized controlled trial aimed to evaluate the U-shaped toothbrush in dental plaque removal in preschool children in comparison with traditional toothbrushes. Thirty children aged between 4–5 years old were randomly divided into two groups; Group 1 (n = 15): children used a traditional toothbrush for 21 days and then used the U-shaped toothbrush for 21 days, while Group 2 (n = 15): children used U-shaped toothbrush for 21 days and then used the traditional toothbrush for 21 days. Plaque accumulation was evaluated by two blinded examiners using Turesky modification of the Quigley–Hein plaque index (TMQHPI) at seven-time points (pre-brushing (T0), immediately after using the first toothbrush (T1), 7 days after using the first toothbrush (T2), 21 days after using the first toothbrush (T3), immediately after using the second toothbrush (T4), 7 days after using the second toothbrush (T5), and 21 days after using the second toothbrush (T6) to determine which toothbrush achieved better plaque removal. At T1, T2, T5, and T6, the plaque accumulation reduction was significantly lower when using the U-shaped toothbrush. In conclusion, U-shaped toothbrushes improved preschool children's ability for plaque control.
Empowering Geriatric care: Safe Beta-Lactam Allergy De-labeling Strategies
Authors: Goldhaber Gal , Confino-Cohen Ronit , Lachover-Roth Idit , Engler Anat Cohen- , Harel Saray Sity- , Rosman Yossi
Published: September 2024

Purpose: Drug allergies represent a significant health concern among the elderly, with beta-lactam (BL) antibiotics being one of the most implicated agents. There remains a paucity of data on the safety and efficacy of BL allergy de-labelling in this population.
We aimed to investigate the safety and efficacy of BL allergy evaluation in a cohort of geriatric patients bearing BL allergy labels.
Methods: A retrospective study, including patients aged > 65 years referred for allergy evaluation at the Allergy Unit of the Meir Hospital. Patients suspected to have BL allergy underwent a comprehensive anamnesis, skin testing, and oral challenge. Patients successfully de-labelled were subject to long-term follow-up to monitor BL use and outcomes.
Results: Over the course of 2009 to 2019, 166 elders with suspected BL allergies were evaluated. Ultimately, 145 (87.3%) patients had their BL allergies ruled out. Sixteen (9.6%) were diagnosed with IgE-mediated allergies, 4 (2.4%) with severe delayed-type hypersensitivity, and 1 (0.6%) with a benign rash. The evaluation process was safe, with no occurrences of severe reactions during oral challenges, and none of the patients required hospital admission or adrenaline treatment.
106 patients were available for long-term follow-up. Of these, 38 patients (35.8%) were subsequently treated with the previously suspected culprit drug. None reported immediate reactions or severe delayed hypersensitivity following exposure.
Conclusion: De-labelling of BL allergies is safe and effective in elders, underscoring the importance of this procedure. There is need to heighten awareness regarding allergic workups in geriatric populations bearing BL allergy labels.
Validation of the Distress Thermometer for detecting psychological distress in patients with stable chronic obstructive pulmonary disease: optimal cut-off score and influencing factors
Authors: Tian Xu , Liu Xiaoling , Gan Xiuni , Jimenez-Herrera Maria F. , Shang Hongcai , Ren Yi
Published: September 2024

Background Patients with chronic obstructive pulmonary disease (COPD) are at high risk for psychological distress, yet validated screening tools are not routinely used in clinical practice. The Distress Thermometer (DT), originally developed for cancer patients, is a brief screening tool for detecting psychological distress. However, the optimal cut-off in COPD patients remains unclear. Aim This study aims to validate the DT for use in stable COPD patients and to explore factors influencing psychological distress. Methods A cross-sectional study was conducted involving 386 stable COPD patients. Data were collected using sociodemographic questionnaires, the DT, and the Hospital Anxiety and Depression scale (HADS). Receiver Operating Characteristics (ROC) analysis was employed to determine the predictive metrics of various DT cut-off scores compared to the HADS. Bivariate binary logistic regression was used to identify factors influencing psychological distress. Results The mean DT reported by patients was 3.77, while the mean total HADS score was 29.68. The DT score showed a high correlation with the total HADS score (r = 0.640). An optimal DT cut-off score of ≥ 5 was identified, yielding a Youden index of 0.815, with sensitivity and specificity of 97.40% and 84.14%, respectively. Using this cut-off score, the incidence of significant psychological distress was found to be 32.1%. Risk factors for psychological distress included gender, number of children, educational level, frequency of exercise, GOLD degree, and number of acute exacerbations. Conclusions The DT is a valid screening tool for identifying psychological distress among COPD patients. With an optimal cut-off score of ≥ 5, the DT offers high sensitivity and specificity, making it a reliable measure for clinical use. This study also highlights significant factors contributing to psychological distress, emphasizing the importance of integrating routine psychological assessments and care into the routine management of COPD to improve patient outcomes.
Caloric Requirement Targets for Nutritional Support in Adult Autoimmune Encephalitis
Authors: li jinmei , wang jiaqi , li yinping , yan bo
Published: September 2024

Background
Autoimmune encephalitis (AE) is a severe neurological disease often accompanied by consciousness disturbances, severe swallowing difficulties, and gastrointestinal dysfunction, increasing the risk of malnutrition. Early nutritional support is believed to improve the recovery of neurological patients. However, the optimal caloric intake target during the acute phase of AE remains unclear.
Objective
This study aims to evaluate the impact of caloric intake on short-term clinical outcomes in acute AE patients, specifically focusing on the improvement in Clinical Assessment Scale for Autoimmune Encephalitis (CASE) scores, to provide recommendations for nutritional support during the acute phase.
Methods
A retrospective study analyzed clinical data from 128 adult AE patients requiring nutritional support, admitted to West China Hospital, Sichuan University, from January 2020 to January 2024. Patients were categorized into low-calorie intake (below 70% of requirements), standard-calorie intake (70%-100% of requirements), and high-calorie intake (above 100% of requirements) groups.
Results
Higher caloric intake was significantly associated with improved CASE scores (β = 8.58, SE = 3.75, 95% CI = 1.14 to 16.03, p = 0.02). Low caloric intake negatively impacted the improvement of CASE scores (p = 0.049), particularly in seizures and speech problems. The low-calorie intake group had significantly longer hospital stays and nutrition therapy durations (45.79 ± 30.98 days, p < 0.01; 40.39 ± 31.92 days, p = 0.02).
Conclusions
Adequate caloric intake has a significant positive impact on the short-term clinical outcomes of AE patients, suggesting that meeting or exceeding caloric requirements may promote neurological recovery in AE patients. Future prospective studies are needed to validate these findings and further optimize nutritional support strategies.
Association between Perioperative Potentially Inappropriate Medication Exposure Levels and Postoperative Hospital Length of Stay among Chinese Older Hospitalized Patients: A Retrospective Cohort Study
Authors: Gu Kai , Yang Yi , Li Jiajie , Chen Yuheng , Tang Yulin
Published: September 2024

Background
​Potentially inappropriate medication (PIM) administration in geriatric surgical patients is increasingly prevalent in the perioperative period. The relation between the variation in PIM exposure and other key postoperative geriatric outcomes, such as postoperative hospital length of stay (POLOS), however, has seldom been reported, and current researches mentioning perioperative PIM concentrate on preoperative long-term home medications or postoperative prescriptions that may not be actually taken. We aimed to investigate whether the level and the change of short-term PIM exposure in the immediate perioperative period was associated with prolonged POLOS (pPOLOS).
Methods
We performed a retrospective cohort study of patients ≥ 65 years of age who underwent elective inpatient surgery at a tertiary academic hospital from July 2022 and March 2023. PIMs were defined using the Beers Criteria as suggested by the American Geriatrics Society. Stage-varying exposure variables were used to quantify cumulative PIM exposure levels during the preoperative (Pre-PIMs), intraoperative (Intra-PIMs), and even the entire perioperative stage period (Total-PIMs, represented by summing Pre-PIMs and Intra-PIMs) for each participant. A multivariable logistic model and restricted cubic spline model were applied to explore the association and dose-response relationship of PIM exposure with the risk of pPOLOS in the total population and subgroups.
Results
196 (44.6%) of 439 participants had a prolonged postoperative length of stay. There was PIM exposure in 378 (86.1%) of the current cohort, analgesics were administered most frequently both preoperatively and intraoperatively albeit via quite different mechanisms of action. Compared to participants without PIM exposure, only those with continuous exposure to Pre-PIM and Intra-PIM (high exposure group) significantly increased risk of pPOLOS with an adjusted OR of 3.13 (95% CI: 1.24-8.80, P = 0.021). The effect of Total-PIMs on pPOLOS risk (OR: 1.21, 95%CI: 1.06-1.40, P = 0.006) was more significant than that of Pre-PIMs or Intra-PIMs, and also showed a more obvious linear dose-response trend visually in the restricted cubic spline analysis. In subgroup analysis, significant modification effects of Charlson Comorbidity Index on the association of Total-PIMs with pPOLOS risk were observed.
Conclusion
Combined exposure to Pre-PIMs and Intra-PIMs more independently indicates the risk of pPOLOS in older patients than its individual exposure. These findings could help clinicians to be aware of the possible vulnerability of elderly patients under continued preoperative to intraoperative exposure to PIMs, and highlight the potential value of medication optimization and deprescribing PIMs in the immediate perioperative setting.
The impact of learner autonomy on the performance in voluntary online cardiac auscultation courses
Authors: Fang Yudong , Fang Ligang , Zhu Wenling , Lin Xue
Published: September 2024

This study explores the impact of learner autonomy on academic performance in a free, non-mandatory online heart sound auscultation course, emphasizing the enhancement of online learning outcomes through learner autonomy. Medical students and doctors were recruited via WeChat groups and participated in four 2-hour live sessions over four weeks, delivered through Plaso teaching software. Participants engaged with real heart sounds using in-ear headphones and were evaluated through random questions during lectures and a comparison of scores on ten heart sound auscultation questions before and after training. Results from 122 doctors and 77 medical students showed that 146 (73%) attended and 46 (23%) completed all sessions, with heart auscultation scores improving significantly from 40 to 70 (p = 0.000). Full participation and active engagement were key predictors of successful exam performance, while intrinsic motivation correlated with complete course attendance (P = 0.045). Moreover, ROC curve analysis revealed that outstanding learners spent more time reviewing post-class materials. The study concludes that while learner autonomy is crucial for success in voluntary online courses, sole reliance on autonomy may not suffice. Effective learning requires identifying intrinsic needs, full participation, active interaction, and additional review. Course designers are advised to recruit learners precisely, incorporate interactive elements, and promote post-class review to enhance learner autonomy.
Prevalence and risk factors for persistent opioid use after thoracic surgery: a retrospective cohort study using claims data in a prefecture of Japan
Authors: Yokoyama Ryota , Iwagami Masao , Shimada Kensuke , Kawamura Chitose , Komiyama Jun , Taniguchi Yuta , Suzuki Ai , Sugiyama Takehiro , Inomata Shinichi , Tamiya Nanako
Published: September 2024

Background:
Thoracic surgery is known to lead to postoperative opioid dependence in countries with high opioid consumption; however, there are limited reports from countries with moderate to low opioid consumption, such as Japan. This study aimed to investigate the prevalence and risk factors for persistent opioid use after thoracic surgery in Japan.
Methods:
We conducted a retrospective cohort study using linked medical claims data of individuals covered by the National Health Insurance in Ibaraki Prefecture, Japan. The participants were patients aged ≥ 18 years who underwent thoracic (mediastinal or lung) surgery between October 2012 and September 2021. Based on previous studies, persistent opioid use was defined as opioid prescription from both (i) 0 to 14 days after surgery and (ii) 91 to 180 days after surgery. Multivariable logistic regression analyses were conducted to assess the factors associated with persistent opioid use.
Results:
Among the 6041 patients who underwent thoracic surgery during the study period, 3924 were included in the final analysis. The median age was 68 years (range, 64–71 years) and 2316 (61.0%) were male patients. Among the patients included in the final analysis, 130 (3.3%) developed persistent opioid use. Multivariable analysis showed that neoadjuvant therapy (chemotherapy or radiotherapy) (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.09–3.77; P = 0.027) and thoracotomy (vs video-assisted thoracoscopic surgery) (OR, 1.50; 95% CI, 1.01–2.24; P = 0.046) were independent risk factors for persistent opioid use.
Conclusions:
In a prefecture of Japan, 3.3% of patients who underwent thoracic surgery developed persistent opioid use. Neoadjuvant therapy (chemotherapy or radiotherapy) and thoracotomy were independent factors associated with persistent opioid use after thoracic surgery. Individualized perioperative pain management strategies should be considered for high-risk patients.
Unexpected High Frequency of Novel and Known Pathogenic Germline Variant of the Lgr4 Gene in the Ethnic Group of West Siberia
Authors: Gervas Polina , Molokov Aleksey , Babyshkina Nataliya , Zherebnova Anna , Choynzonov Evgeny , Cherdyntseva Nadezda
Published: September 2024

Background: Hereditary breast cancer (BC) is an autosomal dominant disease caused by mutations in genes such as BRCA1/2, BRAD1, RAD54L, RAD51, ATM, BRIP1, and others. The prevalence and range of mutations can differ among various regions and ethnic groups. In a previous study using whole exome sequencing, we identified a germline pathogenic variant of the LGR4 gene (rs34804482, NM_018490.3: c.2531A>G) in a young Tuvan BC patient (belonging to the Turkic-speaking tribes of Central Asia). The aim of this study was to determine the frequency of the germinal pathogenic variant rs34804482 of the LGR4 gene (NM_018490.3: c.2531A>G) in ethnic groups of West Siberia (comparing BC patients and healthy subjects) using the PCR-RT method.
Methods: The study involved 735 BC patients from various ethnic groups in Siberia, including Russians, Buryats, Tuvans, Yakuts, Altaians, and Khakassians, with a median age at diagnosis of 43±15.6 years. The control group consisted of 727 healthy women from the same ethnic groups in Siberia, with a median age of 43.05±13.5 years.
Results: In a general group of BC patients, the frequency of the pathogenic variant of the LGR4 gene (rs34804482) was 0.027. Specifically, the frequency of this variant was 0.015 in Russian BC patients, 0.022 in Buryat BC patients, and 0.069 in Tuvan BC patients. This variant was not detected in Khakassian and Yakut BC patients. In Tuvan women with BC, the frequency of the pathogenic variant of the LGR4 gene was significantly higher than in Russian BC patients (X2 = 8.153, p = 0.005). The frequency of the pathogenic variant of the LGR4 gene (rs34804482) in healthy Tuvan women was significantly higher than in healthy Russian women (0.066 versus 0.016, X2=6.368, p=0.012). The mutation frequency in healthy Russians was close to that in Europeans (0.016 versus 0.0219). The highest frequency of this pathogenic variant was found among healthy Tuvans (0.066), significantly higher compared to Americans (0.0000) and other ethnic groups (according to ExAc).
Conclusions: Our study was the first to investigate the frequency of the pathogenic variant of the LGR4 gene (rs34804482) in different ethnic groups of Siberia, comparing BC patients with healthy individuals. We found no statistically significant differences in the mutation frequency between BC patients and healthy individuals in the ethnic groups studied. The highest frequency of this pathogenic variant was observed among healthy Tuvans (0.066), which was significantly higher compared to other ethnic groups.
Joint zonated quantification of multiple parameters in hepatic lobules
Authors: Laue Hendrik Oliver Arp , Budelmann Daniel , Albadry Mohamed , Engel Christiane , Weiss Nick , Dahmen Uta , Schwen Lars Ole
Published: September 2024

Metabolic processes in the hepatic lobule are spatially organized. Consequently, many liver diseases have a distinct zonation pattern. Understanding the interplay between a zonated disease pattern and its impact on liver function requires the joint quantification of both phenomena. Our study presents an image analysis workflow for the joint zonated quantification of multiple parameters from whole-slide images of conventionally stained serial sections. Portal fields and central veins are annotated and transferred to adjacent slide images via image registration. This allows identifying the same lobules and zones in multiple slides, where zones are obtained by dividing the distance between portal fields and central veins in twelve intralobular zonal distributions of various parameter combinations quantified from multiple slides can then be plotted as scatter diagrams or visualized in the lobule/zone geometry. As a proof-of-concept, we quantify the distribution of periportal steatosis and pericentral cytochrome P-450 (CYP) expression using HE and immunohistochemically stained WSI. The data can be used to parameterize computational simulations of physiological processes in the lobules and zones more accurately.
Social Determinants of Alcohol Use Disorder in Patients Attending Private Primary Care Clinics in Nairobi Kenya
Authors: Elazia Verah Kabwayi , Mohamoud Gulnaz , Orwa James , Merali Mohamoud , Shabani Jacob
Published: September 2024

Introduction:
Socio-demographic factors are predictors of Alcohol Use Disorder (AUD). The Kenyan WHO STEPWISE survey indicated that 13% of adult Kenyans are heavy episodic drinkers. However, the relationship between social determinants of AUD among patients attending primary health care clinics has not been well investigated in Kenya. We aimed to determine the association between sociodemographic determinants and AUD in patients attending private primary care clinics in Nairobi, Kenya.
Methods
A cross-sectional survey design was used to purposively sample 389 patients. Data were collected using self-administered questionnaires adapted from the Alcohol Use Disorder Identification Test (AUDIT) Tool. The prevalence of AUD was calculated as a percentage of all the enrolled patients. Independent associations between explanatory variables and AUD were determined using the chi-square test. Variables with a p-value < 0.2 were considered for Multivariable Logistic Regression to identify factors associated with AUD.
Results
The prevalence of AUD in this cohort of participants was 18.5%. Significant social determinants for AUD were: tobacco and marijuana smoking (AOR 2.89 95%CI: 1.09–7.46), insomnia (AOR 3.40 95%CI: 1.52–7.70), and first-degree relatives who consumed alcohol (AOR 4.00 95% CI:1.86–8.63). The study showed that social determinants influenced the occurrence of AUD.
Conclusion
Alcohol users with insomnia, marijuana users and those with a family history of alcohol use should be prioritized for AUD screening. Further studies could explore the influence of these findings on AUD qualitatively.
Melatonin-Related Genes as Key Players in Alzheimer's Disease: Discovery of Promising Biomarkers for Treatment Targets for Alzheimer's Disease
Authors: Zhang Huaxiong , Hamit Dilmurat , LI Qing , Hu Xiao , LI San-feng , XU Fu , WANG Ming-yuan , BAO Guo-qing , LI Hong-yan
Published: September 2024

Background
Melatonin can improve mitophagy, thereby ameliorating cognitive deficits in Alzheimer’s disease (AD) patients. Hence, our research focused on the potential value of melatonin-related genes (MRGs) in AD through bioinformatic analysis.
Methods
First, the key cells in the single-cell dataset GSE138852 were screened out based on the proportion of annotated cells and Fisher’s test between the AD and control groups. The differentially expressed genes (DEGs) in the key cell and GSE5281 datasets were identified, and the MRGs in GSE5281 were selected via weighted gene coexpression network analysis. After intersecting two sets of DEGs and MRGs, we performed Mendelian randomization analysis to identify the MRGs causally related to AD. The biomarkers GSE5281 and GSE48350 were identified through receiver operating characteristic (ROC) curve and expression analyses. Furthermore, gene set enrichment analysis, immune infiltration analysis and correlation analysis with metabolic pathways were conducted, as well as construction of a regulator network and molecular docking.
Results
According to the Fisher test, oligodendrocytes were regarded as key cells due to their excellent abundance in the GSE138852 dataset, in which there were 281 DEGs between the AD and control groups. After overlapping with 3,490 DEGs and 550 MRGs in GSE5281, four genes were found to be causally related to AD, namely, GPRC5B, METTL7A, NFKBIA and RASSF4. Moreover, GPRC5B, NFKBIA and RASSF4 were deemed biomarkers, except for METTL7A, because of their indistinctive expression between the AD and control groups. Biomarkers might be involved in oxidative phosphorylation, adipogenesis and heme metabolism. Moreover, T helper type 17 cells, natural killer cells and CD56dim natural killer cells were significantly correlated with biomarkers. Transcription factors (GATA2, POU2F2, NFKB1, etc.) can regulate the expression of biomarkers. Finally, we discovered that all biomarkers could bind to melatonin with a strong binding energy.
Conclusion
Our study identified three novel biomarkers related to melatonin for AD, namely, GPRC5B, NFKBIA and RASSF4, providing a novel approach for the investigation and treatment of AD patients.
Asymmetric Nanocapsules via Elongated Liposome Templated Polymerization (ELTP) Mediated by RAFT Polymerization
Authors: Xiao Yunxin , Jackson Alexander W. , Tan Angel , Quinn John F. , Crawford Simon , Boyd Ben J.
Published: September 2024

Polymeric nanocapsules comprised of hydrophobic shells and hollow aqueous interiors are an extremely useful class of nanomaterial, particularly in the encapsulation and controlled delivery of hydrophilic cargo. Generally prepared via droplet or latex templation approaches, polymeric nanocapsules are mostly spherical. Controlling the morphology of hollow nanocapsules is an intriguing design challenge. Non-spherical, or elongated, templates are often inorganic materials which do not directly impart a hollow interior, and their post-polymerization removal is not straightforward. This study outlines a novel strategy for the preparation of elongated nanocapsules, wherein elongated liposomes are deployed as hollow templates. Initially, ciprofloxacin drug nanocrystals were utilized to facilitate the formation of elongated liposomes, followed by adsorption of reversible addition − fragmentation chain-transfer (RAFT) oligomers. Subsequent chain-extension polymerization furnished the desired elongated nanocapsule morphology. This proof-of-concept study contributes towards the goal of elongated nanocapsule synthesis, a morphology which can impart improved circulation times in the field of drug delivery.
Capturing acute and chronic myocardial infarction by MRI rotating frame relaxation times in mice in and ex vivo
Authors: Ylä-Herttuala Elias , Khan Muhammad Arsalan , Laidinen Svetlana , Heikura Tommi , Ylä-Herttuala Seppo , Liimatainen Timo , Laakso Hanne
Published: September 2024

Background
Cardiovascular diseases are the leading cause of death worldwide due to population growth and aging. Myocardial infarction is one of the most crucial cardiovascular diseases. Acute myocardial infarction is conventionally imaged with T2 mapping due to its sensitivity related to the correlation times of edema and free-water molecules. Chronic myocardial infarction, which contains fibrosis and scar tissue, is conventionally imaged with MRI with T1 weighting using contrast agents involved in late gadolinium enhancement and extracellular volume since contrast agent wash out from fibrosis and scar tissue is delayed compared to myocardium. So far, imaging acute myocardial infarcts is related to T2 mapping, and imaging of scar tissue and fibrosis has been limited to techniques with contrast agent injection. Rotating frame relaxation times T1ρ and T2ρ mapping were developed to provide robust measurements with relatively wide B1 and B0 range for these quantities. Since rotating frame methods have different correlation times than T2 and T1, these methods can be used to sensitively and specifically characterize both acute and chronic myocardial infarctions. In this study, acute (2 hours) and chronic (7 days after occlusion) myocardial infarcts in and ex vivo mouse models were imaged with rotating frame relaxation time mapping without the use of contrast agents.
Methods
In vivo imaging protocol contained adiabatic T1ρ and adiabatic T2ρ, both with two different HSn pulses, continuous wave T1ρ and conventional T2, together with cine imaging. Mice were imaged 2 hours and 7 days after myocardial infarction. Mice were sacrificed at the 2-hour or at the 7-day time point. Ex vivo measurements contained adiabatic T1ρ and adiabatic T2ρ with two different HSn pulses, continuous wave T1ρ, T1 and T2. After MRI studies, mouse hearts were fixed, and myocardial infarcts were verified using dystrophin and hematoxylin and eosin histology stainings.
Results
A clear difference between infarcted and normal myocardium was visible at the 2-hour time point in rotating frame relaxation time mapping. Relative relaxation time difference in adiabatic T2ρ with HS4 pulse might be sensitive to both acute edema reaction and chronic infarction. Also, in vivo and ex vivo results of adiabatic T1ρ with both HSn pulses and continuous wave T1ρ measurements showed relative relaxation time, the difference between infarcted and normal myocardium at 2 hours after the occlusion, and the difference increased at the 7-day time point.
Conclusion
This study showed that rotating frame relaxation time methods have the potential to be a non-invasive MR diagnostic marker for acute and chronic myocardial infarcts.
Demultiplexing and barcode-specific adaptive sampling for nanopore direct RNA sequencing
Authors: von Kleist Max , Toorn Wiep van der , Liu-Wei Wang , Bohn Patrick , Smyth Redmond , Olguin-Nava Marco
Published: September 2024

Nanopore direct RNA sequencing (dRNA-seq) enables unique insights into (epi-)transcriptomics. However, applications are currently limited by the lack of accurate and cost-effective sample multiplexing. We introduce WarpDemuX, an ultra-fast and highly accurate adapter-barcoding and demultiplexing approach. WarpDemuX enhances speed and accuracy by fast processing of the raw nanopore signal, use of a light-weight machine-learning algorithm and design of optimized barcode sets. We demonstrate its utility by performing a rapid phenotypic profiling of different SARS-CoV-2 viruses, crucial for pandemic prevention and response, through multiplexed sequencing of longitudinal samples on a single flowcell. This identifies systematic differences in transcript abundance and poly(A) tail lengths during infection. Additionally, integrating WarpDemuX into sequencing control software enables real-time enrichment of target molecules through barcode-specific adaptive sampling, which we demonstrate by enriching low abundance viral RNA. In summary, WarpDemuX is a broadly applicable, high-performance, and economical multiplexing solution for nanopore dRNA-seq, facilitating advanced (epi-)transcriptomic research.
Clinical Application of Suture anchors Surgery and Plate Internal Fixation Surgery in Sternoclavicular Joint Dislocation
Authors: Xie Hao , Zhang Qiang
Published: September 2024

Purpose
This retrospective study evaluates the effectiveness of plate internal fixation versus suture anchors and cable internal fixation in managing sternoclavicular dislocations.
Methods
Clinical data from 24 patients with sternoclavicular joint dislocations admitted to Beijing Jishuitan Hospital between May 2013 and May 2022 were analyzed. Patients were categorized into two groups based on the surgical intervention received: plate internal fixation and suture anchors and cable internal fixation. Constant-Murley(C-M) scores before surgery and at 1 and 4 weeks postoperatively were compared using independent sample t-tests.
Results
Among the patients, 45.8% sustained posterior dislocations, predominantly due to car accidents (n=12). All had previously unsuccessful closed reductions. Fourteen patients underwent incisional internal fixation, including six with plate internal fixation and eight with anchor nail fixation surgery; one patient received fixation via fiber wire drilled octagonal technique. The anchor nail fixation group demonstrated the most significant improvement compared to both the closed reduction failure group and the plate internal fixation group. 37.5% of patients experienced additional traumatic injuries, with two instances of postoperative plate fractures and one wound hematoma reported. No patients suffered from neurovascular injuries or long-term functional impairments.
Conclusion
Suture anchors internal fixation appears to be a highly effective method for treating sternoclavicular joint dislocations. This technique is simple, effective, and facilitates rapid recovery of joint function, thus offering a superior option for patients with this condition.
Level of Evidence: Level III, Retrospective Study.
Fire activity and drought increases ozone-plant damage to the Amazon rainforest.
Authors: Brown Flossie , Sitch Stephen , Folberth Gerd , Cheesman Alexander , Mercado Lina , Barningham Scott
Published: September 2024

Human activity is exposing the Amazon rainforest to increasing stressors including plant damage due to elevated ozone (O3) pollution. O3-plant damage reduces plant photosynthesis and the land carbon sink thus increasing atmospheric CO2. Factors that control O3-plant damage in the Amazon have not been characterised so damage may be exacerbated by recurrent extreme drought and fires. We identify drivers of interannual variability in O3-plant damage using a land surface model validated against satellite products. We find that O3-plant damage increases with fire activity, with additional interactive effects during major droughts. The indirect increase in atmospheric CO2 from fire-driven O3-plant damage is ~50% the magnitude of direct CO2 emissions from fires in non-drought years, suggesting the negative impact of fires on the Amazon carbon budget is severely underestimated. During droughts, leaves close their stomata, which reduces O3 uptake and should protect against O3 damage. However, due to higher fire activity, and elevated O3 concentrations, O3-plant damage during droughts is up to 77 Tg-C (or over 2 times) greater than average. As droughts are set to become more frequent, our results demonstrate that high fire activity associated with drought increases the O3-plant damage risk to the rainforest, especially in remote areas.
Group based trajectory modeling identifies distinct patterns of sympathetic hyperactivity following traumatic brain injury
Authors: Chowdhury Sancharee Hom , Chen Lujie Karen , Hu Peter , Badjatia Neeraj , Podell Jamie Erin
Published: September 2024

Background Paroxysmal Sympathetic Hyperactivity (PSH) occurs with high prevalence among critically ill Traumatic Brain Injury (TBI) patients and is associated with worse outcomes. The PSH-Assessment Measure (PSH-AM) consists of a Clinical Features Scale (CFS) and a Diagnosis Likelihood Tool (DLT), intended to quantify the severity of sympathetically-mediated symptoms and likelihood that they are due to PSH, respectively, on a daily basis. Here, we aim to identify and explore the value of dynamic trends in the evolution of sympathetic hyperactivity following acute TBI using elements of the PSH-AM.Methods We performed an observational cohort study of 221 acute critically ill TBI patients for whom daily PSH-AM scores were calculated over the first 14 days of hospitalization. A principled group-based trajectory modeling approach using unsupervised K-means clustering was used to identify distinct patterns of CFS evolution within the cohort. We also evaluated the relationships between trajectory group membership and PSH diagnosis, as well as PSH DLT score, hospital discharge GCS, ICU and hospital length of stay, duration of mechanical ventilation, and mortality. Baseline clinical and demographic features predictive of trajectory group membership were analyzed using univariate screening and multivariate multinomial logistic regression.Results We identified four distinct trajectory groups. Trajectory group membership was significantly associated with clinical outcomes including PSH diagnosis and DLT score, ICU length of stay, and duration of mechanical ventilation. Baseline features independently predictive of trajectory group membership included age and post-resuscitation motor GCS.Conclusions This study adds to the sparse research characterizing the heterogeneous temporal trends of sympathetic nervous system activation during the acute phase following TBI. This may open avenues for early identification of at-risk patients to receive tailored interventions to limit secondary brain injury associated with autonomic dysfunction and thereby improve TBI patient outcomes.
Storms regulate Southern Ocean summer warming
Authors: du Plessis Marcel , Nicholson Sarah-Anne , Giddy Isabelle , Monteiro Pedro , Prend Channing , Swart Sebastiaan
Published: September 2024

Sea surface temperature (SST) in the Southern Ocean is the fingerprint of ocean heat uptake1,2 and critical for air-sea interactions. However, Southern Ocean SST is biased warm in climate models, reflecting our limited understanding of the mechanisms that set its magnitude and variability3,4. An important factor driving SST variability is synoptic-scale weather systems, such as storms3,5, yet their impacts are difficult to directly observe. Using in-situ observations from underwater and surface robotic vehicles in the subpolar Southern Ocean, we show evidence that storms regulate the summer evolution of SST through altering the mixed layer effective heat capacity and entraining colder water from below. Through these mechanisms, we determine that interannual variations in Southern Ocean SST reflect changes in storm intensity and prevalence, which, in turn, are driven by the Southern Annular Mode. Our results demonstrate a causal link between storm forcing and SST variability, which has implications for addressing warming biases in climate models.
Assessing Burden Among Caregivers of Pediatric Dialysis and Kidney Transplant Patients
Authors: Borsheim Brianna , Krissberg Jill , Matossian Debora , Verghese Priya S.
Published: September 2024

Background
While the increased burden on the caregivers of children and adolescents with kidney disease is described, the full scope of this burden remains unrecognized and unquantified. The Pediatric Renal Caregiver Burden Scale (PR-CBS) is a validated tool that evaluates caregiver burden in this population.
Objective
To assess caregiver burden in pediatric kidney failure at a tertiary center pediatric hospital pre-kidney transplant (KT) on dialysis, early post-KT (30 days to 364 days), and late post-KT (> 1 year). We also aimed to demonstrate the feasibility of a translated PR-CBS among Spanish-speaking caregivers.
Methods
In this cross-sectional study, caregivers were approached during routine clinic visits to complete a hard copy of the PR-CBS independently. Total PR-CBS scores (ranging 51 to 255) and mean domain scores (ranging 1 to 5) were calculated with higher scores reflecting increased burden. Descriptive statistics and T-tests were performed to assess differences between caregivers of children on dialysis versus caregivers of children who received a transplant.
Results
Of the 30 caregivers approached, 26 consented: 5 of children receiving dialysis and 21 post-transplant. Participant survey completion was 100%. Total burden score was higher for caregivers of children on dialysis than after transplant, but not significantly (160 vs 117, P = 0.09). The mean score for every domain in the PR-CBS was higher for caregivers of children on dialysis with significant differences in family life and caregiver identity (respectively, p = 0.04 and p = 0.03). PR-CBS scores did not differ across demographics. Four surveys were completed in Spanish; no significant difference was found between those completed in Spanish and English.
Conclusion
Caregivers of children with kidney failure experience high levels of burden. While a small sample size limited our ability to achieve significance, there was a trend for higher burden scores among caregivers of children on dialysis compared to those caring for children after transplant. This study highlights an oft-ignored need for targeted interventions to enhance quality of life for children with kidney failure and their families. Further, a larger, multi-center, adequately powered study is needed to further assess the degree of burden in this population.
Effect of different placental attachment of placenta previa with placenta accreta spectrum on maternal and neonatal outcomes: a 5-year retrospective study
Authors: Kong hongfang , Lu Yong , Li Haiyan , Wang Fang , Su Yuan , Li Xia , Xin Hong
Published: September 2024

Background
Placenta previa (PP) with placenta accreta spectrum (PAS) is a common hemorrhagic disease in obstetrics; however, there are limited data on maternal and neonatal outcomes with regards to the different placental attachments seen in PP with PAS. This study aimed to analyze the effects of placental attachment sites on pregnancy outcomes in patients with complete PP and PAS.
Methods
We conducted a retrospective study of clinical-surgical and/or pathologically confirmed placenta accreta spectrum deliveries between January 2018 and August 2022. Maternal, pregnancy, and delivery characteristics were compared between different groups. Receiver operating characteristic curves were used to calculate the odds ratios to determine the distance from the posterior placental attachment to the anterior wall for PP with PAS disorders to evaluate the effect of the placental attachment site on adverse pregnancy outcomes.
Results
Different placental attachments in PP with PAS resulted in different pregnancy outcomes. There were increased adverse pregnancy outcomes with different placental attachments, particularly with anterior wall placentas, compared with that in posterior wall placentas. In addition, there was a statistically significant difference between the MNS and non-MNS groups in terms of the distance from the posterior placental turnover to the anterior wall. We found that attachment of the placenta to the posterior wall and its crossing of the anterior wall at a distance greater than 4.46 cm would elevate the incidence of critical pregnancy.
Conclusions
We found that when combined with ultrasound examination, an increased distance between the posterior wall of the uterus and the placental attachment to the anterior wall was associated with a higher incidence of critical maternal illness. Especially, the main placenta is attached to the posterior wall, ultrasound assessment of the placenta turning forward beyond 3.71cm increases the risk of adverse outcomes.
Understanding the Impact of He Ion Irradiation on the Microstructure and Mechanical Properties of a Ni-Cr-Mo Alloy: A Comprehensive Study
Authors: Srivast Amit P , Saini Sanjay , Menon Ranjini , Sharma S. K. , Nabhiraj P. Y. , Neogy Suman , Srivas Amit P.
Published: September 2024

The impact of helium ion irradiation on the evolution of microstructure and mechanical properties of a Ni-45%Cr-1.4%Mo (wt.%) alloy has been investigated. Analysis via transmission electron microscopy (TEM) of a pristine sample revealed an uneven distribution of alpha-Cr phase precipitates along with a few isolated planar arrangements of dislocations within the fcc γ-Ni matrix phase. A detailed study of irradiated samples established the presence of radiation-induced defect clusters, dislocation loops, network dislocations and He-stabilized voids as perceptible irradiation effects. Furthermore, examination of the irradiated sample revealed nearly complete dissolution of the native alpha-Cr precipitates, accompanied by a simultaneous increase in the Cr and Mo content of the matrix. X-ray diffraction (XRD) and positron annihilation spectroscopy (PAS) studies also confirmed lattice swelling as an effect of irradiation in this alloy, likely caused by helium-stabilized voids. A line profile analysis method which takes into account of planar defects, was employed on GIXRD (Grazing Incidence X-ray Diffraction) data to analyze changes in microstructural parameters such as domain size, microstrain, dislocation density, and lattice parameter as a function of irradiation dose. All of these irradiation-damage manifestations led to the increase in the hardness of the alloy in nano-indentation experiment. Overall, the findings of this work provide significant insights into the radiation-induced microstructural changes and their effect on the hardening behavior of the studied Ni-Cr-Mo alloy.