bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Human Pathophysiological Responses to Exertional Hypobaric Decompression Stress
Authors: Connolly Desmond M. , Madden Leigh A. , Edwards Victoria C. , D’Oyly Timothy J. , Harridge Stephen D. R. , Smith Thomas G. , Lee Vivienne M.
Published: September 2023

INTRODUCTION: Consistent blood biomarkers of hypobaric (altitude) decompression stress remain elusive. Recent laboratory investigation of decompression sickness risk at 25,000 ft (7620 m) enabled evaluation of early pathophysiological responses to exertional decompression
stress.METHODS: In this study, 15 healthy men, aged 20–50 yr, undertook 2 consecutive (same-day) ascents to 25,000 ft (7620 m) for 60 and 90 min, breathing 100% oxygen, each following 1 h of prior denitrogenation. Venous blood was sampled
at baseline (T0), immediately after the second ascent (T8), and next morning (T24). Analyses encompassed whole blood hematology, endothelial microparticles, and soluble markers of cytokine response, endothelial function, inflammation, coagulopathy, oxidative stress, and brain insult, plus
cortisol and creatine kinase.RESULTS: Acute hematological effects on neutrophils (mean 72% increase), eosinophils (40% decrease), monocytes (37% increase), and platelets (7% increase) normalized by T24. Consistent elevation (mean five-fold) of the cytokine interleukin-6 (IL-6) at
T8 was proinflammatory and associated with venous gas emboli (microbubble) load. Levels of C-reactive protein and complement peptide C5a were persistently elevated at T24, the former by 100% over baseline. Additionally, glial fibrillary acidic protein, a sensitive marker of traumatic brain
injury, increased by a mean 10% at T24.CONCLUSIONS: This complex composite environmental stress, comprising the triad of hyperoxia, decompression, and moderate exertion at altitude, provoked pathophysiological changes consistent with an IL-6 cytokine-mediated inflammatory response.
Multiple persistent biomarker disturbances at T24 imply incomplete recovery the day after exposure. The elevation of glial fibrillary acidic protein similarly implies incomplete resolution following recent neurological insult.Connolly DM, Madden LA, Edwards VC, D’Oyly TJ, Harridge
SDR, Smith TG, Lee VM. Early human pathophysiological responses to exertional hypobaric decompression stress. Aerosp Med Hum Perform. 2023; 94(10):738–749.
UUD 1945 Sebagai Konstitusi Normatif (Pembatasan Masa Jabatan Presiden dan Wakil Presiden)
Authors: Ferdinandus Leonard Umbu Saingu
Published: September 2023

This paper will identify (or diagnose) the problem of extending the term of office of the president and vice president in the normative constitutional concept. To overcome this problem, this article argues that we need to be a nation that is more obedient to the constitution, which restrictively stipulates that the President and Vice President only hold office for five years and can be re-elected for one more term. Based on these provisions, it should be noted that the constitution of the Constitution is a normative constitution which then gave birth to teachings or ideas of limited power in casu restrictions on the powers of the president and/or vice president.

Keywords: Constitutionalism, Term of Office.
PENGGUNAAN SENJATA KIMIA OLEH SURIAH DIKAITKAN DENGAN KONVENSI INTERNASIONAL
Authors: Shenny Shenny , Wahyuni Lutfiyana Dewi , Fatwa Sarah , Triana Syafina Ramadhanti , Putra Rivan Mandala , Antoni Herli
Published: September 2023

This research uses a doctrinal approach  based on international agreements and international conventions that  aim to provide an understanding of the civil war in Syria that is linked to international conventions.  The UN Security Council uses regulations to punish those who use chlorine, one of which is in  the civil war, because it is related to article VII of the UN Charter. The provisions governing civil war are set forth in article 3 Kof the 1949  Jenewa convention. The Geneva Conventions and additional protocols are aimed at protecting the enemy.  Syria must take responsibility for a civil war in which the United Nations as an international organization plays a role in ensuring world peace, the ICRC carries out protection and humanitarian assistance, and the international court plays a role in prosecuting war crimes and crimes against humanity. In relation to article 146 of the IV Geneva Convention which means that everyone who has been proven to have committed an offense categorized as a gross human rights violation must be tried using the national re of his country to ensure legal certainty and provide justice to the victims affected.

Keywords: War, Chemical Weapons, Syria, Convention
KEKERASAN VERBAL DAN NON-VERBAL YANG DILAKUKAN SECARA KOLEKTIF DITINJAU DARI PERSPEKTIF KRIMINOLOGI
Authors: Alam Dippo
Published: September 2023

Crime in its simplest form can take the form of verbal and non-verbal violence. Verbal and non-verbal violence are often to be carried out collectively, and people who experience verbal or non-verbal violence to be hurt inside. Especially when the victims are children. The problem is why the verbal and non-verbal violence that was carried out collectively received less attention from law enforcement officials? Furthermore, what about the strategy to minimize verbal and non-verbal violence that is carried out collectively in society. This research is a qualitative research model with a normative juridical type by observing, studying, and considering various norms, proper behavior that lives and is practiced in society, as well as theories in criminology and various legal rules that apply in Indonesia, regarding these matters. Verbal and non-verbal violence, especially those carried out collectively, can be reported to law enforcement officials, but given that most of the sentences are under five years in prison, the resolution of this case is in the form of restorative justice, such mediation for peace takes place. In cases of verbal and non-verbal violence, the police encourage the perpetrators and victims to reconcile, because of the short sentence, psychological damage which is difficult to measure the level of loss. Strategies to minimize verbal and non-verbal violence are abandon the styles of language and behavior that ignite those verbal and non-verbal violence in everyday interactions and start humanist communication, which can be taught in early age.

Keywords: criminology, verbal violence, non-verbal violence
Emelkedett szívfrekvencia, hypertonia és cardiovascularis kockázat
Authors: Járai Zoltán
Published: September 2023

A vegetatív (paraszimpatikus és szimpatikus) idegrendszer aktivitása döntő szerepet játszik a keringési rendszer szabályozásában és a szervezet mindenkori, változó környezeti helyzethez történő adaptációjában. A paraszimpatikus és a szimpatikus idegrendszer egyensúlyi állapota (vagy éppen ennek megszűnése autonóm diszfunkció esetében) határozza meg ugyanis a szívfrekvenciát, a szívizomzat kontraktilitását, emellett a szimpatikus idegrendszer döntő szerepet játszik a perifériás vascularis rezisztencia mértékének meghatározásában is. Ezek a tényezők a vérnyomás szabályozásának alapelemei. Az elmúlt öt évtizedben végzett kiterjedt kutatások alapján körvonalazható a jelenkor gyakorló orvosa számára a kórosan emelkedett szívfrekvencia jelentősége, különösképpen a hypertoniás betegek cardiovascularis rizikóbecslése során. Jelen rövid összefoglaló az ezzel kapcsolatos legfontosabb irodalmi adatokat kívánta összegyűjteni.
Sztatinkezelés vesebetegekben: mit, mennyit, mikor?
Authors: Schneider Károly
Published: September 2023

A koleszterinszint-emelkedés és a szív- és érrendszeri kockázat közti összefüggés jól ismert. A koleszterinszint-csökkenésben igazi áttörést a sztatinok alkalmazása jelentett. Számos vizsgálat igazolta a sztatinok lipidszint-, cardiovascularis kockázatot (CV) csökkentő, valamint érelmeszesedést lassító, plakkregressziót okozó hatását. Az átlagpopulációhoz hasonlóan, a vesebetegek széles csoportjában is számos vizsgálat igazolja a sztatinok CV kockázatcsökkentésben játszott szerepét, amely főleg az enyhe-mérsékelt vesefunkció-beszűkülést mutató betegekben a legkifejezettebb, de még a dializált populációban is kimutatható hatékonyságuk. Szintén vizsgálatok igazolják hatékonyságukat a veseprogresszió lassításában és a proteinuria csökkentésében, de szerepük lehet a kontrasztanyag és aminoglikozid, valamint szívsebészeti beavatkozások akut vesekárosító hatásának kivédésében. Mind cardialis, mind egyéb renoprotectiv hatékonyságuk a lipidcsökkentés és pleiotrop hatásuk összeadódásával magyarázható. A vesebetegekben igazolt fokozott szív- és érrendszeri kockázat alapján a nemzetközi és hazai ajánlásokban a krónikus vesebetegséget a nagy, illetve igen nagy kockázatú csoportba sorolták, amelyekben meghatározott alacsony célértékek elérése csak agresszív antilipaemiás kezeléssel érhetők el. A sztatinok közül így előnyt élveznek az intenzívebb lipidcsökkentést elérő molekulák, nem kellő hatékonyság esetén vagy akár induláskor is már koleszterinfelszívódást gátló ezetimib hozzáadásával.
Characteristics of the Reactive Power Output of Metallized Polypropylene Capacitors at Thermal Stability Conditions
Authors: Vaidhyanathan V. , Shanker T. Bhavani , . Ukaram , Mohamed A. Sheik
Published: September 2023

The nature of loads in the Low Voltage (LV) systems is predominantly inductive. This leads to a lagging power factor in LV networks and hence it is essential to compensate for the lagging power factor with suitable LV capacitor banks. Low Voltage power factor compensation is done with shunt capacitors to maintain a power factor closer to unity. For LV shunt power factor compensation, LV capacitors of the Metallized Polypropylene (MPP) type are predominantly used. When used in LV systems, these capacitors are operated under full load and generally operate at maximum operating temperature. A study was undertaken to identify the reactive power output under such conditions in MPP-type capacitors of similar voltage and different power ratings and the results of the study are discussed in this paper.
Note sur deux lingots de cuivre romains trouvés en Méditerranée
Authors: Domergue Claude , Klein Sabine , Rico Christian , González Batanero Diego
Published: September 2023

El trabajo vuelve sobre dos lingotes ya conocidos, salidos a la luz recientemente, su epigrafía y sobre los análisis de isotopos de plomo que les atribuyen una procedencia hispánica y mas concretamente del Cinturón pirítico del suroeste peninsular. Son dos testimonios concretos de la vitalidad del comercio marítimo del cobre de esta zona de la Península durante el siglo II de nuestra era.
Una nueva inscripción del municipio Flavio Irnitano. El epígrafe de L.S.M.A.Q
Authors: González Fernández Julián , Bermejo Meléndez Javier
Published: September 2023

Los autores dan a conLos autores dan a conocer una nueva inscripción procedente de Irni, gravada sobre una uncia, con el nombre del edil que ha garantizado su peso de acuerdo con las atribuciones que le confiere el artículo 19 de la lex Irnitana. Este nuevo documento amplia el ya importante corpus epigráfico del municipio Flavio Irnitano, formado con inscripciones procedentes del propio yacimiento del Molino del Postero y de otros lugares próximos, que, sin duda, formarían parte del territorium de Irni.
At the Intersection of L1 Congruence and L2 Exposure: Collocational Knowledge of Advanced Arab Users of English
Authors: Zareva Alla
Published: September 2023

The study is quantitative research, examining the effects of learning environment and native language (L1) on the collocational knowledge of advanced Arab users of English as a second language (ESL) (n=34) and foreign language (EFL) (n=33). The participants were university students who completed two collocation tests, containing verb-noun and noun-adjective congruent (collocations with L1-L2 translation equivalents) and incongruent (L2-specific) collocations. The results showed that the two groups markedly differed in their collocational knowledge (both productively and receptively), with the ESL participants performing significantly better than the EFL students. As to the effects of the native language, the results revealed that the ESL participants experienced noticeable effects of Arabic both receptively and productively with the influences being significantly stronger for the incongruent collocations (L2-only) than the congruent ones (L1-L2). Interestingly, the EFL participants showed less L1 effects in their production and perception of collocations. The findings suggested that both L1 congruence and second language (L2) exposure have an effect on the acquisition of English collocations. The findings are discussed in light of some pedagogical expectations and instructional recommendations that can improve advanced ESL and EFL Arab students’ collocational knowledge productively and receptively..
Cultural capital schemes in Asia: mirroring Europe or carving out their own concepts?
Authors: Ocón David
Published: September 2023

Despite bearing similar names and sharing certain aims, the implementation of the cultural city/capital initiative in Europe and in the subregions of Southeast and Northeast Asia has been substantially dissimilar. In Europe, the annual European Capital of Culture (ECoC) status commonly constitutes an opportunity to showcase the best of the arts and culture of the host city, and counts on the support of sizable public funding. In Southeast Asia, the initiative scarcely receives any public or regional funds and the understanding of what the designation means varies widely from country to country. In Northeast Asia, regional diplomacy is one of the main motivations for initiating the scheme. This paper seeks to examine the cultural capital patterns chosen in these Asian subregions in comparison with their European counterpart, as well as their motivations and reasons to exist. Ultimately, the paper investigates how much ASEAN and Northeast Asia are simply trying to replicate the European model, carve their own concepts, or create hybrid schemes.
Using auditory texture statistics for domain-neutral removal of background sounds
Authors: Alishbayli Artoghrul , Schlegel Noah J. , Englitz Bernhard
Published: September 2023

Introduction

Human communication often occurs under adverse acoustical conditions, where speech signals mix with interfering background noise. A substantial fraction of interfering noise can be characterized by a limited set of statistics and has been referred to as auditory textures. Recent research in neuroscience has demonstrated that humans and animals utilize these statistics for recognizing, classifying, and suppressing textural sounds.

Methods

Here, we propose a fast, domain-free noise suppression method exploiting the stationarity and spectral similarity of sound sources that make up sound textures, termed Statistical Sound Filtering (SSF). SSF represents a library of spectrotemporal features of the background noise and then compares this against instants in speech-noise-mixtures to subtract contributions that are statistically consistent with the interfering noise.

Results

We evaluated the performance of SSF using multiple quality measures and human listeners on the standard TIMIT corpus of speech utterances. SSF improved the sound quality across all performance metrics, capturing different aspects of the sound. Additionally, human participants reported reduced background noise levels as a result of filtering, without any significant damage to speech quality. SSF executes rapidly (~100× real-time) and can be retrained rapidly and continuously in changing acoustic contexts.

Discussion

SSF is able to exploit unique aspects of textural noise and therefore, can be integrated into hearing aids where power-efficient, fast, and adaptive training and execution are critical.
Critical review of nuclear power plant carbon emissions
Authors: Liu Bojie , Peng Binbin , Lu Fei , Hu Jiang , Zheng Li , Bo Meifang , Shang Xin , Liu Weiwei , Zhang Yichi , Zhou Xiafei , Jia Pengfei , Liu Gengyuan
Published: September 2023

Nuclear power plays a crucial role in achieving the target of carbon neutrality to build a sustainable society. However, it is not “carbon-free” when considering its entire life cycle. Therefore, accurate accounting and monitoring of its generated carbon emissions are required to avoid miscalculations of nuclear energy as a clean energy source. In this study, the life-cycle carbon emissions of nuclear power plants (NPPs) with different reactor types are reviewed. In addition to the characteristic differences among different reactors, disparities in the review results originate from the varying emissions at the respective stages of the nuclear fuel cycle, technology choices at each stage and accounting methods and boundaries. The carbon emissions resulting from NPP construction and operation are underestimated due to the limited data and methods, which creates uncertainty in the evaluation of NPP carbon emissions. An integrated framework for carbon emissions accounting considering the construction and operation of NPPs (CACO-NPP) is proposed. This integrated framework aims to improve the accounting accuracy for carbon emissions originating from NPPs. An emerging Generation III NPP with the latest technology, HPR1000 (an advanced pressurized water reactor), was adopted as a case study. The results show that the total emissions resulting from vegetation loss, equipment manufacturing and labor input during construction and operation are 1232.91 Gg CO2 with a carbon intensity of 1.31 g CO2/kWh, indicating the notable mitigation capability of Generation III NPPs. By combining the maturity of HPR1000 technology with successive design improvements, the carbon emissions of such reactor types could be further reduced. This development is very important for realizing China’s carbon neutrality target.
Aging trajectories are trait- and sex-specific in the long-lived Alpine swift
Authors: Moullec Héloïse , Reichert Sophie , Bize Pierre
Published: September 2023

Senescence is defined as the general deterioration of the organism (i.e. physiology, morphology, reproduction), and is associated with increasing mortality and decreasing fertility with age. Although senescence has now been widely reported in wild animals, little is known on whether senescence affects all traits, whether this process is synchronized across traits, and whether males and females are affected in the same way. Using an individual-based monitoring of 20+ years in free-living population of Alpine swifts (Tachymarptis melba), we investigated age-dependent variation between sexes and between six biometric traits, 4 reproductive traits, and 1 measure of parasite burden. We accounted for selective disappearance and terminal effects in our analyses. Our results provide general support for age-dependent variation at adulthood in 8 out of the 11 traits investigated. Most traits showed a variation with 2 thresholds, with first a strong improvement until 4 to 12 years of age (e.g., increased fork length, decreased parasite load, or earlier laying date) followed by a plateau and a decline at older ages. The age of the second threshold showed sex specific asynchrony, with an earlier threshold in males than in females for tail length, parasite burden and laying date, as well as moderate asynchrony across traits. Rates of senescence differed between sexes, with stronger senescence of the tail in females than in males and with evidence of reproductive senescence in females but not in males. We also found evidence of terminal investment in males with respect to brood size at hatching and terminal decline with increased asymmetry of the fork and decreased body mass. We found evidence of selective appearance with males with longer fork and little fork asymmetry starting to reproduce earlier in life, and females that start to reproduce earlier tending to higher reproductive success. Finally, we found selective disappearance of males with longer tails and marginal effect of selective disappearance of females with lower body mass. We discuss how natural or sexual selection may have led to these trait- and sex-specific patterns of aging in this long-lived bird.
Case report: a novel deep intronic splice-altering variant in DMD as a cause of Becker muscular dystrophy
Authors: Berntsson Shala Ghaderi , Matsson Hans , Kristoffersson Anna , Niemelä Valter , van Duyvenvoorde Hermine A. , Richel-van Assenbergh Cindy , van der Klift Heleen M. , Casar-Borota Olivera , Frykholm Carina , Landtblom Anne-Marie
Published: September 2023

We present the case of a male patient who was ultimately diagnosed with Becker muscular dystrophy (BMD; MIM# 300376) after the onset of muscle weakness in his teens progressively led to significant walking difficulties in his twenties. A genetic diagnosis was pursued but initial investigation revealed no aberrations in the dystrophin gene (DMD), although immunohistochemistry and Western blot analysis suggested the diagnosis of dystrophinopathy. Eventually, after more than 10 years, an RNA analysis captured abnormal splicing where 154 nucleotides from intron 43 were inserted between exon 43 and 44 resulting in a frameshift and a premature stop codon. Normal splicing of the DMD gene was also observed. Additionally, a novel variant c.6291–13537A>G in DMD was confirmed in the genomic DNA of the patient. The predicted function of the variant aligns with the mRNA results. To conclude, we here demonstrate that mRNA analysis can guide the diagnosis of non-coding genetic variants in DMD.
Personalizing medicine in Africa: current state, progress and challenges
Authors: Owolabi Paul , Adam Yagoub , Adebiyi Ezekiel
Published: September 2023

Personalized medicine has been identified as a powerful tool for addressing the myriad of health issues facing different health systems globally. Although recent studies have expanded our understanding of how different factors such as genetics and the environment play significant roles in affecting the health of individuals, there are still several other issues affecting their translation into personalizing health interventions globally. Since African populations have demonstrated huge genetic diversity, there is a significant need to apply the concepts of personalized medicine to overcome various African-specific health challenges. Thus, we review the current state, progress, and challenges facing the adoption of personalized medicine in Africa with a view to providing insights to critical stakeholders on the right approach to deploy.
Transcriptome-based analysis of human peripheral blood reveals regulators of immune response in different viral infections
Authors: Ivanov Sergey M. , Tarasova Olga A. , Poroikov Vladimir V.
Published: September 2023

Introduction

There are difficulties in creating direct antiviral drugs for all viruses, including new, suddenly arising infections, such as COVID-19. Therefore, pathogenesis-directed therapy is often necessary to treat severe viral infections and comorbidities associated with them. Despite significant differences in the etiopathogenesis of viral diseases, in general, they are associated with significant dysfunction of the immune system. Study of common mechanisms of immune dysfunction caused by different viral infections can help develop novel therapeutic strategies to combat infections and associated comorbidities.

Methods

To identify common mechanisms of immune functions disruption during infection by nine different viruses (cytomegalovirus, Ebstein-Barr virus, human T-cell leukemia virus type 1, Hepatitis B and C viruses, human immunodeficiency virus, Dengue virus, SARS-CoV, and SARS-CoV-2), we analyzed the corresponding transcription profiles from peripheral blood mononuclear cells (PBMC) using the originally developed pipeline that include transcriptome data collection, processing, normalization, analysis and search for master regulators of several viral infections. The ten datasets containing transcription data from patients infected by nine viruses and healthy people were obtained from Gene Expression Omnibus. The analysis of the data was performed by Genome Enhancer pipeline.

Results

We revealed common pathways, cellular processes, and master regulators for studied viral infections. We found that all nine viral infections cause immune activation, exhaustion, cell proliferation disruption, and increased susceptibility to apoptosis. Using network analysis, we identified PBMC receptors, representing proteins at the top of signaling pathways that may be responsible for the observed transcriptional changes and maintain the current functional state of cells.

Discussion

The identified relationships between some of them and virus-induced alteration of immune functions are new and have not been found earlier, e.g., receptors for autocrine motility factor, insulin, prolactin, angiotensin II, and immunoglobulin epsilon. Modulation of the identified receptors can be investigated as one of therapeutic strategies for the treatment of severe viral infections.
Reconciling intrinsic properties of activating TNF receptors by native ligands versus synthetic agonists
Authors: Fromm George , de Silva Suresh , Schreiber Taylor H.
Published: September 2023

The extracellular domain of tumor necrosis factor receptors (TNFR) generally require assembly into a homotrimeric quaternary structure as a prerequisite for initiation of signaling via the cytoplasmic domains. TNF receptor homotrimers are natively activated by similarly homo-trimerized TNF ligands, but can also be activated by synthetic agonists including engineered antibodies and Fc-ligand fusion proteins. A large body of literature from pre-clinical models supports the hypothesis that synthetic agonists targeting a diverse range of TNF receptors (including 4-1BB, CD40, OX40, GITR, DR5, TNFRSF25, HVEM, LTβR, CD27, and CD30) could amplify immune responses to provide clinical benefit in patients with infectious diseases or cancer. Unfortunately, however, the pre-clinical attributes of synthetic TNF receptor agonists have not translated well in human clinical studies, and have instead raised fundamental questions regarding the intrinsic biology of TNF receptors. Clinical observations of bell-shaped dose response curves have led some to hypothesize that TNF receptor overstimulation is possible and can lead to anergy and/or activation induced cell death of target cells. Safety issues including liver toxicity and cytokine release syndrome have also been observed in humans, raising questions as to whether those toxicities are driven by overstimulation of the targeted TNF receptor, a non-TNF receptor related attribute of the synthetic agonist, or both. Together, these clinical findings have limited the development of many TNF receptor agonists, and may have prevented generation of clinical data which reflects the full potential of TNF receptor agonism. A number of recent studies have provided structural insights into how different TNF receptor agonists bind and cluster TNF receptors, and these insights aid in deconvoluting the intrinsic biology of TNF receptors with the mechanistic underpinnings of synthetic TNF receptor agonist therapeutics.
Effect of fiber type and content on mechanical properties of microbial solidified sand
Authors: Zhang Xiaogang , Zheng Chao , Xiong Kangwei , Yang Kun , Liang Shihua
Published: September 2023

Fibers are applied to construction works to improve the strength and brittle failure of the soil. In this paper, fibers with a length of 6 mm are added to the microbial cemented sand, and fiber types and content are research variable. Unconfined compressive strength (UCS), permeability coefficient, water absorption rate, dry density, and calcium carbonate precipitation of the solidified sand were tested. The physical and mechanical properties of fiber types and content on the immobilization of microorganisms were also analyzed from the micro–macro perspective. Results are presented as follows. The UCS of the Microbial induced calcium carbonate precipitation (MICP) treated sand increases first and then decreases with the increasing fiber content. This phenomenon is due to the promotion of calcium carbonate precipitation by short fiber reinforcement, the limited movement of the sand particles caused by the formed network between the fibers, and the enhanced strength of the microbial solidified sand. However, the agglomeration caused by additional fibers leads to the uneven distribution of calcium carbonate and the reduction in strength. The optimum fiber contents of polypropylene, glass, polyvinyl alcohol, and basalt fibers are 0.4%, 0.2%, 0.2%, and 0.1%, respectively.
Comparison of bloodstream and non-bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae in the intensive care unit: a 9-year respective study
Authors: Sun Xiangyuan , Zou Xiaocui , Zhou Boting , Yin Tao , Wang Ping
Published: September 2023

Background

Bloodstream infections (BSIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) have received much attention. However, few studies have identified risk factors for CRKP BSIs in comparison to CRKP non-bloodstream infections (non-BSIs). This study aimed to compare the epidemiology, risk factors, and outcomes of CRKP BSIs and CRKP non-BSIs.

Methods

We conducted a retrospective study of patients infected with CRKP in the ICU from January 2012 to December 2020. Clinical characteristics and outcomes were compared between CRKP BSIs and CRKP non-BSIs. Predictors associated with 28-day all-cause mortality in CRKP-infected patients were also evaluated.

Results

326 patients infected with CRKP were enrolled, including 96 patients with CRKP BSIs and 230 with CRKP non-BSIs. The rates of CRKP BSIs in CRKP infections were generally raised from 2012 (12.50%) to 2020 (45.76%). Multivariate logistic analysis indicated that the use of carbapenems within the prior 90 days was an independent risk factor for CRKP BSIs (p = 0.019). Compared to CRKP non-BSIs, CRKP isolates in the CRKP BSI group were found to be non-susceptible to more tested carbapenems (p = 0.001). Moreover, the CRKP BSI group exhibited a higher mortality rate (p = 0.036). The non-susceptibility of CRKP isolates to more tested carbapenems (p = 0.025), a high SOFA score (p = 0.000), and the use of antifungal drugs within the prior 90 days (p = 0.018) were significant factors for 28-day all-cause mortality in CRKP-infected patients.

Conclusion

The proportion of CRKP BSI increased progressively in CRKP-infected patients over 9 years. The use of carbapenems within the prior 90 days was an independent risk factor for the development of CRKP BSIs. The non-susceptibility of CRKP isolates to more tested carbapenems and a higher mortality rate were found in the CRKP BSI group.
Optimization of pneumonia CT classification model using RepVGG and spatial attention features
Authors: Zhang Qinyi , Shu Jianhua , Chen Chen , Teng Zhaohang , Gu Zongyun , Li Fangfang , Kan Junling
Published: September 2023

Introduction

Pneumonia is a common and widespread infectious disease that seriously affects the life and health of patients. Especially in recent years, the outbreak of COVID-19 has caused a sharp rise in the number of confirmed cases of epidemic spread. Therefore, early detection and treatment of pneumonia are very important. However, the uneven gray distribution and structural intricacy of pneumonia images substantially impair the classification accuracy of pneumonia. In this classification task of COVID-19 and other pneumonia, because there are some commonalities between this pneumonia, even a small gap will lead to the risk of prediction deviation, it is difficult to achieve high classification accuracy by directly using the current network model to optimize the classification model.

Methods

Consequently, an optimization method for the CT classification model of COVID-19 based on RepVGG was proposed. In detail, it is made up of two essential modules, feature extraction backbone and spatial attention block, which allows it to extract spatial attention features while retaining the benefits of RepVGG.

Results

The model’s inference time is significantly reduced, and it shows better learning ability than RepVGG on both the training and validation sets. Compared with the existing advanced network models VGG-16, ResNet-50, GoogleNet, ViT, AlexNet, MobileViT, ConvNeXt, ShuffleNet, and RepVGG_b0, our model has demonstrated the best performance in a lot of indicators. In testing, it achieved an accuracy of 0.951, an F1 score of 0.952, and a Youden index of 0.902.

Discussion

Overall, multiple experiments on the large dataset of SARS-CoV-2 CT-scan dataset reveal that this method outperforms most basic models in terms of classification and screening of COVID-19 CT, and has a significant reference value. Simultaneously, in the inspection experiment, this method outperformed other networks with residual structures.
Acute kidney injury in patients with COVID-19 compared to those with influenza: a systematic review and meta-analysis
Authors: Hsiao Chiu-Ying , Pan Heng-Chih , Wu Vin-Cent , Su Ching-Chun , Yeh Tzu-Hsuan , Chuang Min-Hsiang , Tu Kuan-Chieh , Wang Hsien-Yi , Kan Wei-Chih , Yang Chun-Chi , Chen Jui-Yi
Published: September 2023

Background

COVID-19 and influenza can both lead to acute kidney injury (AKI) as a common complication. However, no meta-analysis has been conducted to directly compare the incidence of AKI between hospitalized patients with COVID-19 and influenza. The objective of our study aims to investigate the incidence and outcomes of AKI among hospitalized patients between these two groups.

Materials and methods

A systematic search of PubMed, Embase, and Cochrane databases was conducted from December 2019 to August 2023 to identify studies examining AKI and clinical outcomes among hospitalized patients with COVID-19 and influenza. The primary outcome of interest was the incidence of AKI, while secondary outcomes included in-hospital mortality, recovery from AKI, hospital and ICU stay duration. The quality of evidence was evaluated using Cochrane and GRADE methods.

Results

Twelve retrospective cohort studies, involving 17,618 hospitalized patients with COVID-19 and influenza, were analyzed. COVID-19 patients showed higher AKI incidence (29.37% vs. 20.98%, OR: 1.67, 95% CI 1.56–1.80, p < 0.01, I2 = 92.42%), and in-hospital mortality (30.95% vs. 5.51%, OR: 8.16, 95% CI 6.17–10.80, p < 0.01, I2 = 84.92%) compared to influenza patients with AKI. Recovery from AKI was lower in COVID-19 patients (57.02% vs., 80.23%, OR: 0.33, 95% CI 0.27–0.40, p < 0.01, I2 = 85.17%). COVID-19 patients also had a longer hospital stay (SMD: 0.69, 95% CI 0.65–0.72, p < 0.01, I2 = 98.94%) and longer ICU stay (SMD: 0.61, 95% CI 0.50–0.73, p < 0.01, I2 = 94.80%) than influenza patients. In our study, evidence quality was high (NOS score 7–9), with low certainty for AKI incidence and moderate certainty for recovery form AKI by GRADE assessment.

Conclusion

COVID-19 patients had higher risk of developing AKI, experiencing in-hospital mortality, and enduring prolonged hospital/ICU stays in comparison to influenza patients. Additionally, the likelihood of AKI recovery was lower among COVID-19 patients.
Efficacy of Streptomyces melanosporofaciens strain X216 at controlling clubroot disease on oilseed rape
Authors: Ding Lin , Zhou Hu , Liang Hai-di , Tan Lin , Zhao Hui , Chen Xiao-jun , Ren Zuo-hua
Published: September 2023

Oilseed rape (Brassica napus L.) is highly susceptible to infection from the soilborne pathogen Plasmodiophora brassicae Woronin that causes clubroot disease and deleteriously affects production throughout the world. In this study, biological control resources were explored by isolating 237 strains of bacteria from fields of oilseed rape using the gradient dilution coating method. A strain with strong antagonistic ability was screened using a plate confrontation test and designated X216. It was identified as Streptomyces melanosporofaciens owing to its morphological characteristics and 16S rRNA gene sequence. This study also examined the lethality of strain X216 to the resting spores of P. brassicae, its influence on infection in root hairs, and its ability to control clubroot on oilseed rape. The corrected lethality rate on resting spores after strain X216 had been used for 14 days was 56.59% ± 1.97%, which was significantly higher than the use of 75% of the fungicides chlorothalonil WP and 20% Fluazinam SC. Significantly fewer root hairs were infected after this treatment. A pot test showed that X216 was 62.14% effective at controlling the disease, which was not significantly different from that of the fungicide 100 g L−1 cyazofamid SC diluted 1,000-fold but significantly higher than those of 75% chlorothalonil and 50% carbendazim WP. Strain X216 controlled 43.16% of the incidence of clubroot in the field, which could significantly reduce the disease index of oilseed rape clubroot. Therefore, strain X216 is promising to study for the biological control of oilseed rape clubroot.
Neurological telerehabilitation in the COVID-19 era – current perspectives through a bibliometric analysis
Authors: Lebioda Lúcia Aparecida , Pedroso Bruno , Santos Marlon Estevam Camilo dos , Pinto Guilherme Moreira Caetano , Welling Leonardo Christiaan
Published: September 2023

Objective

To identify bibliometric parameters and research trends regarding to telerehabilitation of patients with stroke in the COVID-19 era.

Methodology

This is an integrative review carried out in the Scopus database, from June to July 2021, through the Biblioshiny graphical interface, provided by the Bibliometrix program. The search terms used were “Stroke,” “COVID-19” and “Telerehabilitation.” Results were filtered by publication date from 2019 onwards. No language restrictions were imposed.

Results

Twenty two articles were included in the study and the results were presented in the form of figures demonstrating that the journal Frontiers in Neurology was the one with the most relevant studies and the author with the highest number of citations. The Brazilian Academy of Neurology was the institution with the greatest number of studies and China ranked first as the country with the greatest scientific production. The authors used recent references in their work. A thematic map showed the centrality and density of the words presented and, finally, a three-field graph showed a strong intimacy between countries, keywords and authors.

Conclusion

A greater interest in the subject was observed in China with greater relevance of journals and institutions focused on neurology. However, despite telerehabilitation being an effective alternative in the context of the pandemic, few studies have explored this modality.
Impact of home-based training and nutritional behavior on body composition and metabolic markers in cancer patients: data from the CRBP-TS study
Authors: Darmochwal Sophia , Bischoff Christian , Thieme René , Gockel Ines , Tegtbur Uwe , Hillemanns Peter , Schulze Antina , Voss Johannes , Falz Roberto , Busse Martin
Published: September 2023

Introduction

Obesity and physical inactivity are known to affect cancer's development and prognosis. In this context, physical aerobic and resistance training as well as a Mediterranean nutrition have been proven to have many positive health effects. The aim of this study was therefore to investigate the effect of home-based training on body composition and certain metabolic laboratory parameters.

Methods

Patients with breast, colorectal and prostate cancer who underwent curative surgery at stages T1N0M0–T3N3M0 were eligible for this trial and randomized to an intervention and control group. In the intervention group the patients carried out online-based strength-endurance home training during the 6-month study period. Body composition was assessed via bioelectrical impedance analysis (baseline, 3 months and 6 months). Metabolic blood parameters were also analyzed and nutrition behavior determined using the Mediterranean Diet Adherence Screener (MEDAS).

Results

The intervention group's fat mass decreased while their lean body mass increased (time effect p = 0.001 and p = 0.001, respectively). We found no interaction effect in body weight (p = 0.19), fat mass [p = 0.06, 6-months estimates −0.9 (95% CI −1.8 to −0.1)] and lean body mass (p = 0.92). Blood samples also failed to show a statistically significant interaction effect between time × group for HbA1c% (p = 0.64), Insulin (p = 0.33), Adiponectin (p = 0.87), Leptin (p = 0.52) and Triglycerides (p = 0.43). Only Adiponectin revealed significance in the time effect (p < 0.001) and Leptin in the group effect (p = 0.03). Dietary behavior during the study period was similar in patients in the intervention and control groups (interaction p = 0.81; group p = 0.09 and time p = 0.03).

Discussion

Individualized online-based home training in postoperative cancer patients revealed only minor changes, with no group differences in body composition or metabolic laboratory parameters, which were predominantly in the reference range at baseline. More studies investigating effects of online-based home training on body composition and nutrition behavior are needed.

Trial registration

https://drks.de/search/en/trial/DRKS00020499, DRKS-ID: DRKS00020499.
ctDNA-based detection of molecular residual disease in stage I-III non-small cell lung cancer patients treated with definitive radiotherapy
Authors: Lebow Emily S. , Shaverdian Narek , Eichholz Jordan E. , Kratochvil Leah B. , McCune Megan , Murciano-Goroff Yonina R. , Jee Justin , Eng Juliana , Chaft Jamie E. , Kris Mark G. , Kalashnikova Ekaterina , Feeney Jordan , Scalise Carly Bess , Sudhaman Sumedha , Palsuledesai Charuta C. , Malhotra Meenakshi , Krainock Michael , Sethi Himanshu , Aleshin Alexey , Liu Minetta C. , Shepherd Annemarie F. , Wu Abraham J. , Simone Charles B. , Gelblum Daphna Y. , Johnson Kaylie A. , Rudin Charles M. , Gomez Daniel R. , Razavi Pedram , Reis-Filho Jorge S. , Isbell James M. , Li Bob T. , Rimner Andreas
Published: September 2023

Background

Sensitive and reliable biomarkers for early detection of recurrence are needed to improve post-definitive radiation risk stratification, disease management, and outcomes for patients with unresectable early-stage or locally advanced non-small cell lung cancer (NSCLC) who are treated with definitive radiation therapy (RT). This prospective, multistate single-center, cohort study investigated the association of circulating tumor DNA (ctDNA) status with recurrence in patients with unresectable stage I-III NSCLC who underwent definitive RT.

Methods

A total of 70 serial plasma samples from 17 NSCLC patients were collected before, during, and after treatment. A personalized, tumor-informed ctDNA assay was used to track a set of up to 16 somatic, single nucleotide variants in the associated patient’s plasma samples.

Results

Pre-treatment ctDNA detection rate was 82% (14/17) and varied based on histology and stage. ctDNA was detected in 35% (6/17) of patients at the first post-RT timepoint (median of 1.66 months following the completion of RT), all of whom subsequently developed clinical progression. At this first post-RT time point, patients with ctDNA-positivity had significantly worse progression-free survival (PFS) [hazard ratio (HR): 24.2, p=0.004], and ctDNA-positivity was the only significant prognostic factor associated with PFS (HR: 13.4, p=0.02) in a multivariate analysis. All patients who developed clinical recurrence had detectable ctDNA with an average lead time over radiographic progression of 5.4 months, and post-RT ctDNA positivity was significantly associated with poor PFS (p<0.0001).

Conclusion

Personalized, longitudinal ctDNA monitoring can detect recurrence early in patients with unresectable NSCLC patients undergoing curative radiation and potentially risk-stratify patients who might benefit most from treatment intensification.
A genetic study of a Brazilian cohort of patients with X-linked hypophosphatemia reveals no correlation between genotype and phenotype
Authors: Borghi Mauro , Silva Leopoldo Muniz da , Bispo Luciana , Longui Carlos A.
Published: September 2023

Aim

X-linked hypophosphatemia (XLH) is the most common inherited form of rickets, and it is caused by pathogenic inactivating variants of the phosphate-regulating endopeptidase homolog X-linked (PHEX) gene. The main purpose of this study is to identify the presence of a genotype–phenotype correlation in a cohort of XLH patients.

Methods

This is a retrospective study including patients diagnosed with hypophosphatemic rickets, confirmed by clinical, radiological, and laboratory findings. Medical records were reviewed for phenotypic analyses. Genomic DNA was extracted from the peripheral blood lymphocytes, and PHEX sequencing was performed by exomic NGS sequencing. The Wilcoxon rank-sum test and the two-tailed Fisher's exact test were employed for the statistical analyses of this study.

Results

A total of 41 patients were included in this study, and 63.41% (26/41) of the patients were female. The mutation analyses identified 29.27% missense variants and 29.72% nonsense variants, most of them were considered deleterious (66.41%). Six novel deleterious variants in the PHEX gene were detected in seven patients. The median concentrations of pretreatment serum calcium, phosphorus, and parathyroid hormone (PTH) were not significantly different among patients with different genotypes. An orthopedic surgery due to bone deformity was required in 57.69%.

Conclusions

Our analysis did not identify any specific genotype as a predictor. No significant genotype–phenotype correlation was found, suggesting that the recognition of subjacent pathogenic mutation in the PHEX gene may have limited prognostic value. Despite this finding, genetic testing may be useful for identifying affected individuals early and providing appropriate treatment.
Fumigant activity and transcriptomic analysis of two plant essential oils against the tea green leafhopper, Empoasca onukii Matsuda
Authors: Tan Weiwen , Zhang Ni , Wang Jinqiu , Pu Tianyi , Hu Jifeng , Li Can , Song Yuehua
Published: September 2023

Introduction: The tea green leafhopper, Empoasca (Matsumurasca) onukii Matsuda, R., 1952 (Hemiptera: Cicadellidae), is currently one of the most devastating pests in the Chinese tea industry. The long-term use of chemical pesticides has a negative impact on human health, impeding the healthy and sustainable development of the tea industry in this region. Therefore, there is a need for non-chemical insecticides to control E. onukii in tea plants. The essential oils from plants have been identified for their potential insecticidal ability; however, there is a lack of knowledge regarding the effect of plant essential oils on E. onukii and its gene expression.

Methods: In order to address these knowledge gaps, the components of Pogostemon cablin and Cinnamomum camphora essential oils were analyzed in the present study using gas chromatography‐mass spectrometry. The fumigation toxicity of two essential oils on E. onukii was tested using sealed conical flasks. In addition, We performed comparative transcriptome analyses of E. onukii treated with or without P. cablin essential oil.

Results: The 36-h lethal concentration (LC50) values for E. onukii treated with P. cablin and C. camphora essential oils were 0.474 and 1.204 μL mL−1 respectively. Both essential oils exhibited the potential to control E. onukii, but the fumigation activity of P. cablin essential oil was more effective. A total of 2,309 differentially expressed genes were obtained by transcriptome sequencing of E. onukii treated with P. cablin essential oil.

Conclusion: Many of differentially expressed genes were found to contain detoxifification genes, indicating that these families may have played an important role when E. onukii was exposed to essential oil stress. We also found differential expression of genes related to redox-related gene families, suggesting the upregulation of genes associated with possible development of drug and stress resistance. This work offers new insights for the prevention and management of E. onukii in the future.