bluuebunny/crossref_metadata_2025 huggingface dataset:
Near-infrared spectroscopy combined with vascular occlusion test and acute kidney injury in patients undergoing cardiac surgery: a prospective observational study
Authors: Peng Ling , Zheng Yeying , Guo Fei , Su Mengdan , Wei Wei
Published: December 2024

Background Near-infrared spectroscopy (NIRS) monitoring combined with vascular occlusion test (VOT) can induce typical changes in tissue oxygen saturation (StO2), but little is known about its associations with patient outcomes. The objective of this study was to observe the associations between StO2-VOT characteristics and lactate level and acute kidney injury (AKI) in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Methods Between March 2020 and March 2021, 100 adult patients who scheduled to undergo cardiac surgery with mild hypothermic CPB were enrolled to this prospective observational surgery. StO2 was continuously monitored at the posterior rotation muscle of the right forearm and VOT procedure was repeated before, during, and after CPB. The association between the occurrence of AKI and intraoperative hyperlactatemia after cardiac surgery and StO2-VOT parameters were evaluated.
Results In our patient population (n=87), 17 patients (19.54%) presented with peak lactate ≥4 mmol/L and 12 patients (13.79%) developed AKI after surgery. Multivariable analysis revealed that CPB time and post-CPB desaturation speed (D-speed) were independently associated with AKI. Post-CPB D-speed had an area under receiver operating characteristic (ROC) curve of 0.79 (95% CI, 0.66-0.93) with a cutoff value of 0.08 %min-1 in predicting AKI. Pre-CPB resaturation time (T1) and during CPB D-speed were able to predict intraoperative hyperlactatemia with an area under the receiver operator characteristic (ROC) curve of 0.56 and 0.66.
Conclusions NIRS monitoring combined with VOT shows promise in predicting intraoperative hyperlactatemia and postoperative AKI in patients undergoing cardiac surgery with mild hypothermic CPB.
Trial registration: ChiCTR1900021436 with registered date 21/02/2019.
Comparative Analysis of Drought Indices for Different Climatic Zones in Benin
Authors: D. Abdoul - Aziz BIO BOUKO SIDI , Gao Bing , Abubakar Jabir , Annan Richard F. , Mutelo Admire M. , El–Saadani Zozo , Djessou Randal D. , Lekoueiry Dehah
Published: December 2024

The Standardized Precipitation Index (SPI) and the Standardized Precipitation Evapotranspiration Index (SPEI) are essential indices for assessing drought characteristics. This study evaluates the performance of SPI and SPEI across three climatic zones in Benin: zone 1 (northern region), zone 2 (central region), and zone 3 (southern region). The evaluation is conducted through analyses of temporal variations, the Mann-Kendall trend test, Pearson correlation, and cross wavelet transformations. Additionally, the relationship between Standardized Relative Humidity Index (SRHI) and both SPI and SPEI were analyzed to identify the most effective index for drought monitoring in Benin. Results revealed increasing consistency in the temporal variations of the SPI and SPEI as the time scales extended across all areas, but significant differences existed in the drought trends identified by the two indices in some areas. Overall, a strong correlation was observed between the two indices. The comparison with the SRHI reveals that both the SPI and the SPEI exhibit a weak positive correlation across all time scales, with the exception of the SRHI–3 and SPEI–3. This exception indicates that at the three-month timescale, SPEI can effectively substitute for SRHI in monitoring drought. Consequently, SPEI demonstrates greater utility than SPI in this context however, the adaptability of the SPI and SPEI may vary depending on the periods and the natural characteristics of the regions.
Identification of Core Genes related to exosomes and Screening of Potential Targets in periodontitis Using transcriptome profiling at the single-cell level
Authors: Wufanbieke Baheti , Dong Diwen , Li Congcong , Chen Xiaotao
Published: December 2024

Background: The progression and severity of periodontitis (PD) are associated with the release of extracellular vesicles by periodontal tissue cells. However, the precise mechanisms through which exosome-related genes (ERGs) influence PD remain unclear. This study aimed to investigate the role and potential mechanisms of key exosome-related genes in PD using transcriptome profiling at the single-cell level.
Methods: The current study cited GSE16134, GSE10334, GSE171213 datasets and 19,643 ERGs. Initially, differential expression analysis, three machine learning (ML) models, gene expression analysis and receiver operating characteristic (ROC) analysis were proceeded to identify core genes. Subsequently, a core gene-based artificial neural network (ANN) model was built to evaluate the predictive power of core genes for PD. Gene set enrichment analysis (GSEA) and immunoinfiltration analysis were conducted based on core genes. To pinpoint key cell types influencing the progression of periodontal at the single-cell level, a series of single-cell analyses covering pseudo-time series analysis were accomplished. The expression verification of core genes was performed through quantitative reverse transcription polymerase chain reaction (qRT-PCR).
Results: CKAP2, IGLL5, MZB1, CXCL6, and AADACL2 served as core genes diagnosing PD. Four core gene were elevated in the PD group in addition to down-regulated AADACL2. The core gene-based-ANN model had AUC values of 0.909 in GSE16134 dataset, which exceeded AUC of each core gene, highlighting the accurately and credibly predictive performance of ANN model. GSEA revealed that ribosome was co-enriched by 5 core genes, manifesting the expression of these genes might be critical for protein structure or function. Immunoinfiltration analysis found that CKAP2, IGLL5, MZB1, and CXCL6 exhibited positive correlations with most discrepant immune cells/discrepant stromal cells, which were highly infiltrated in PD. B cells and T cells holding crucial parts in PD were identified as key cell types. Pseudo-time series analysis revealed that the expression of IGLL5 and MZB1 increased during T cell differentiation, increased and then decreased during B cell differentiation. The qRT-PCR proved the mRNA expression levels of CKAP2 and MZB1 were increased in the blood of PD patients compared to controls. But the mRNA expression levels of AADACL2 was decreased in the PD patients compared to controls. This is consistent with the trend in the amount of expression in the dataset.
Conclusion: CKAP2, IGLL5, MZB1, CXCL6 and AADACL2 were identified as core genes associated with exosomes, helping us to understand the role of these genes in PD.
Study of the Microenvironment of the Lung Flora in Female Lung Adenocarcinoma Patients: From Benign Lesions to Invasive Lung Adenocarcinoma
Authors: Du Cheng-Cheng , Sun Da-Qian , Chen Yu-Xian , Li Jing-Shuo , Meng Hong , Li Chun-Hai , Kong Fan-Lei
Published: December 2024

Background: The number of female lung adenocarcinoma patients is increasing annually, but these patients are difficult to diagnose in the early stage without obvious clinical symptoms, leading to late-stage diagnoses and poor outcomes. Recent studies have shown that the lung microbiota is closely related to the occurrence and development of lung cancer, especially the characteristic changes in the lung microbiota of lung cancer patients, which opens a new research direction for the diagnosis and treatment of lung cancer. This study aimed to analyze the characteristics of the lung flora in different stages of female lung adenocarcinoma.
Methods: 16S rRNA sequencing technology was used to analyze the alpha diversity, beta diversity, composition, and function of the pulmonary flora in female patients with benign lesions (n=7), adenocarcinoma in situ (n = 16), microinvasive adenocarcinoma (n = 31), and invasive adenocarcinoma (n = 25).
Results: Progression to invasive lung adenocarcinoma is correlated with reduced alpha diversity in the lung flora. Compared with the other stages, only the invasive adenocarcinoma stage had significant differences in the beta diversity of the lung flora. At the phylum and genus levels, the abundance of major flora species decreased significantly as the disease progressed to the invasive adenocarcinoma stage, whereas the abundance of Bacillus spp. increased significantly. The abundance of phenotypes with mobile elements, biofilm-forming ability, oxidative stress tolerance, parthenogenetic anaerobic properties, and pathogenicity was significantly greater in invasive adenocarcinomas. The abundance of metabolic pathways was significantly lower in invasive adenocarcinomas.
Conclusions: Invasive adenocarcinoma has a unique flora structure characterized by decreased flora diversity and abundance and an increase in specific flora (e.g., Bacillus). In terms of bacterial function, adaptability and pathogenicity increased, and metabolic pathway activity decreased.
Early urea-to-creatinine ratio to predict rapid muscle loss in critically ill patients with sepsis: a retrospective observational study
Authors: Jiang Jie , Chen Hui , Meng Shan-shan , Pan Chun , Xie Jian-Feng , Guo Feng-Mei
Published: December 2024

Background
Sepsis patients in the ICU often experience rapid muscle loss. Urea-to-creatinine ratio (UCR) reflects protein metabolism and is often used to assess nutritional metabolic status. This study aimed to investigate whether the UCR can predict the development of rapid muscle loss in patients with sepsis.
Methods
Our retrospective observational study was performed in a university ICU from 2014 to 2021 on adult (≥ 18 years) sepsis patients. The primary outcome was the incidence of rapid muscle loss during ICU hospitalization. We utilized multivariate logistical regression to characterize the association between UCR/ΔUCR and rapid muscle loss. The area under curve (AUC) of the receiver operating characteristic (ROC) curve was calculated to quantify the performance of UCR/ΔUCR in predicting rapid muscle loss.
Results
Among all 482 patients, 141 patients (29.2%) had rapid muscle loss during ICU stay. Multivariate logistic regression analysis showed that ΔUCR was associated with an increased risk of rapid muscle loss, the Odds ratio was 1.02 [95% CI: 1.01,1.02]. The predictive ability of ΔUCR for rapid muscle loss was 0.76[95% CI 0.68–0.83]. The threshold was 19.4 for ΔUCR.
Conclusion
Our findings show that elevated UCR is independently associated with rapid muscle loss, and it can predict rapid muscle loss in sepsis patients. UCR provides a simple bedside marker for early identification and intervention of rapid muscle loss.
A new seed-setting species from the polyploid genus Curcuma of the ginger family (Zingiberaceae) based on morphological and molecular data
Authors: Chen Juan , Yan Jia-Wei , Wang Hui-Hong , Zeng Si-Jin , Zeng Lin-Ya , Tian En-Wei , Xia Nian-He
Published: December 2024

Background
The polyploid genus Curcuma L. is an economically important, yet taxonomically rather difficult genus, mainly distributed in South and Southeast Asia. Several Chinese important traditional medicinal herbs are from Curcuma, such as “jianghuang姜黄”, “yujin郁金” and “ezhu莪术”. During field investigation of plant resources in Yunnan, the distribution center of the genus in China, an unknown flowering and seed-setting species of Curcuma was discovered. Its morphological characters were assessed for further taxonomic treatment and molecular analysis was conducted to ascertain its phylogenetic position within the genus as well. Its genome size, chromosome number and ploidy level were evaluated by k-mer distribution analysis and cytological method.
Results
This species resembles Curcuma longa but can be distinctly differed in its yellow rhizomes, sometimes with pubescent abaxial surfaces, green or sometimes with vary faint and narrower purple stripes at the midrib, white tinged with pale purple to pale purple coma bracts. Its chromosome number is 2n = 42. The haploid genome size estimation of Curcuma flavescens based on k-mer distribution is 874.19 Mb. Smudgeplot analysis suggested it is a diploid heterozygous genome (AB). Plastid phylogenomic analyses indicated that this new species is embedded within subg. Curcuma. The comprehensive phylogenetic studies conducted on Curcuma species using nrITS regions showed it is nested with C. montana, a species from India and Bangladesh. Moreover, morphological analysis further reinforced the distinctiveness of this species from C. montana. It revealed several key differences across various anatomical features such as the color of rhizomes, the indumentum of leaves and the morphology of inflorescence and flowers. Our findings make a strong case for using next-generation sequencing to explore phylogenetic relationships and identify new species.
Conclusion
The morphological and molecular evidences support the recognition of Curcuma flavescens as a new species. This provides a good diploidy material for the further breeding work in the genus Curcuma, and might also contribute to the study of the polyploid origin in this genus.
The graphical fascination of NFT: Insights from tree-based methods
Authors: Zhao Yunfei
Published: December 2024

Non-Fungible Tokens (NFTs) have garnered significant attentions as an emerging digital asset class with unique properties that cannot be replicated. In this paper, this study analyzes the graphical factors affecting the pricing of NFTs represented by CryptoPunks using decision trees, random forests and XGB regression methods. This study reveals that various image attributes of CryptoPunks exhibit significant variability and exert an influence on their prices. These finding provides valuable insights into the pricing dynamics of NFTs and shed light on the key attributes that impact their value in the market.
WITHDRAWN: The value of T2WI-based intratumoral and peritumoral edema radiomics in predicting IDH-1 genotype in gliomas
Authors: Tang Wei , Yang Weixin , Tang Lei , Zhai Zhaohua
Published: December 2024

The full text of this preprint has been withdrawn by the authors while they make corrections to the work. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Homology Analysis of Multidrug-Resistant Acinetobacter Baumannii Genes in Different Regions of Xinjiang
Authors: Luo Bin , Li Zhiwei
Published: December 2024

Background: The prevalence of multidrug-resistant Acinetobacter baumannii is gradually increasing globally, posing a serious burden on patients and society, which is a significant public health issue.Testing the homology of multidrug-resistant Acinetobacter baumannii clones in hospitals in Xinjiang autonomous region can enable the hospital infection control department to better monitor the source and prevent the spread of drug-resistant characteristics.
Method: Multidrug resistant Acinetobacter baumannii detected in intensive care units of 9 urban hospitals in Xinjiang autonomous region were collected. After drug sensitivity testing, DNA was extracted, and homology analysis was performed.
Conclusion: 72 strains of carbapenem resistant Acinetobacter baumannii were multi drug resistant; The resistance rate of this bacterium to polymyxin B (1.3%) and tigecycline (1.7%) was low. The genotype of type 3 was unique to Urumqi; Type 4 is mainly distributed in Changji and Hotan, showing a unique significant band; Type 2 appeared in Urumqi and Hotan, and type 1 was prevalent throughout Xinjiang. It is distributed in all regions, and the similarity coefficient is 99%.
Radiogenomic analysis of the correlation between clinical, ultrasound characteristics and immune-related genes in breast cancer
Authors: Dou Tingyao , Chen Yaodong , Liu Lunhang , Zhang Yaochen , Pei Wanru , Li Jing , Lei Yan , Wang Yanhong , Jia Hongyan
Published: December 2024

Background: Breast cancer is the most commonly diagnosed cancer worldwide. Breast cancer screening, early diagnosis, and standardized treatment can effectively reduce the mortality of patients. Breast color Doppler ultrasound plays a significant role in the non-invasive screening and diagnosis of breast cancer. The application of immunotherapy for breast cancer can significantly prolong the overall survival rates of patients with advanced breast cancer, which is an important research area of breast cancer treatment. This study analyzed the correlation between the clinical and ultrasound characteristics of breast cancer and immune-related genes.
Methods: First, differential expression of immune-related genes were obtained using the GEO and IMMPORT database. Then, differentially expressed immune-related genes related to the overall survival of breast cancer were obtained using the GEPIA and Kaplan-Meier plotter platforms. Additionally, clinical, ultrasound characteristics and pathological specimens of breast cancer patients’ tumors were collected. Transcriptome sequencing and immunohistochemical staining were performed on the tumor specimens to obtain gene expression.
Results: CXCL2, MIA, NR3C2, PTX3, S100B, SAA1, SAA1, and CXCL9 genes were correlated with each other and with clinical and ultrasonic characteristics. The high expression of MIA was related to the positive expression of PR in breast cancer. The low expression of NR3C2 was correlated with the clinical characteristics of tumor size≥20mm, later stage, Her-2 positive, Ki-67≥20%. NR3C2 was negatively correlated with the value of PKI and AUC in contrast-enhanced ultrasound parameters, and positively correlated with the value of AT and TTP. The expression of the PTX3 gene was also negatively correlated with the value of PKI and Emax of shear wave elastography. SAA2 was related to the presence or absence of burrs on the edge of the tumor characterized by ultrasound. The expression of the CXCL9 gene was associated with the age of onset and tumor stage.
Conclusions: In this study, 8 differentially expressed immune-related genes related to the overall survival rate of breast cancer were screened, which can be further studied in the subsequent immunotherapy of breast cancer. Some clinical and ultrasonic characteristics of breast cancer were significantly correlated with immune-related genes, such as NR3C2, SAA2, and CXCL9. Further analysis of these genes provides new ideas for the diagnosis and treatment of breast cancer.
A Data-Driven Approach Using Deep Learning for the Classification of Indian Bird Species Facing Climate Change Challenges: Implications for Biodiversity Conservation
Authors: Gavali pralhad , Banu J Saira
Published: December 2024

Climate change poses a significant threat to global biodiversity, particularly impacting bird populations, which face the risk of extinction due to habitat loss and altered environmental conditions. This research addresses the difficulties of identifying and monitoring bird species in biodiversity-rich countries such as India. We propose an innovative approach that employs deep learning techniques to classify Indian bird species impacted by climate change. The study's primary aim is to create a precise and dependable classification algorithm using the advanced Inception-ResNet-v2 architecture, enhanced through transfer learning methods. To improve model reliability, we introduce a novel data augmentation technique that minimizes similarities between different species while refining fine-grained features. Our validation strategy includes a comprehensive approach with data swapping between training and validation sets, alongside fivefold cross-validation, ensuring strong predictive performance. The proposed methodology is evaluated on a diverse range of datasets, encompassing images of Indian bird species captured in various habitats and under differing environmental conditions. Initial findings reveal impressive classification accuracy, averaging 94%, with a precision of 96% across more than eight species categories. These outcomes highlight the model's potential for widespread application in biodiversity monitoring and conservation efforts. Future directions for this research include expanding the dataset, enhancing augmentation techniques, and investigating real-time monitoring capabilities. Through this work, we aim to make a meaningful contribution to conservation strategies for Indian bird species amidst the challenges of climate change.
Adding natural regeneration and trait-based models on the functional trajectory analysis for monitoring tropical forests under ecological restoration
Authors: MANHAES ADRIANA , Saavedra Mariana , Pansonato Marcelo P. , Andrade Moab T. , Camelo Beatriz , Machado Frederico , Paes Jorge Eduardo , Sansevero Jerônimo B. B. , Martini Adriana , Mantuano Dulce
Published: December 2024

Monitoring restoration areas is crucial for understanding how ecological succession and plant community trajectories evolve in a rapidly changing climate. The trait-based approach offers significant potential for restoration assessment due to its direct link with ecosystem functionality. We assessed the functional trajectory of a 10-year-old restoration community in a tropical forest, comparing two different planting designs: tree plantations (2 x 2 m spaced) and applied nucleation (0.3 m spaced). Using a multidimensional analysis of six key functional traits (leaf area, specific leaf area, leaf dry matter content, seed mass, wood density, and potential height), we enhanced the traditional Functional Trajectory Analysis (FTA) by incorporating natural regeneration and trait-based models for potentially redirecting undesirable trajectories. Our results indicated that natural regeneration pushed the trajectory away from the reference ecosystem, as the community under restoration was more functionally acquisitive, resembling an early succession stage. Natural regeneration within tree plantations exhibited distinct plant-size traits compared to those in the passive strategy, increasing trajectory length and distance from reference and planted community. By targeting higher functional diversity in the trait-based models, we compared the observed and estimated species abundances within planted communities and identified the species to be removed or added. These models can be a useful management tool when the functional trajectory does not align with the expected direction. Incorporating natural regeneration and trait-based models for species abundance estimation into FTA can significantly enhance monitoring and management. We offer a robust functional approach to guide restoration projects toward desired ecological outcomes.
Phase-dependent Sympathetic Dysinnervation in Takotsubo Syndrome Revealed with Transparent Heart Short title: Sympathetic Dysinnervation in Takotsubo Syndrome
Authors: Masuyama Kiyoshi , Lee Jong-Kook , Yokoyama Teruki , Li Jun , Yasutake Hideki , Kuramoto Yuki , Hidaka Kyoko , Sakata Yasushi
Published: December 2024

Takotsubo syndrome (TTS) is an acute cardiac syndrome characterized by transient left ventricular dysfunction. Although the wall motion abnormality resolves completely, the prognosis is poor. Defect of 123I-metaiodobenzylguanidine uptake, interpreted as sympathetic impairment, persisted in TTS patients, but the mechanism is not fully understood. We aimed to elucidate morphological sympathetic nerve change in a TTS model mouse using three-dimensional imaging techniques, with a particular focus on the role of factors in these alterations. The TTS model was induced by a single intraperitoneal injection of 2.0 mg/kg adrenaline to C57BL/6 mice, resulting in transient akinesis localized to the inferior apical region of the heart. Three-dimensional morphological assessment revealed that sympathetic nerve length within the inferior apical area of TTS mice reduced during the chronic phase compared with the sham mice. Notably, the study observed a pattern of denervation during the acute phase, followed by re-innervation and subsequent denervation in the chronic phase. The neurotrophic factors expressions changed in a time-dependent manner, corresponding to the phase-specific damage both to cardiomyocytes and sympathetic neurons. The bimodal change in sympathetic nerves and altered neurotrophic factors in TTS mice provide novel insights into the pathophysiological mechanism of TTS to establish therapeutic strategies for TTS.
EF-UV: Feature Enhanced fusion of U-Net and VIT Transformer for Brain Tumor MRI Image Segmentation
Authors: Sun Xinxin , Bhatti Uzair Aslam , Huang Mengxing , Zhang Yu
Published: December 2024

Medical image segmentation is important for medical diagnosis, and deep convolutional neural networks (CNNs) have made significant progress in this area. However, CNNs are deficient as they mainly focus on localized features. In contrast, the Transformer architecture is able to consider the entire input sequence and is therefore more effective in capturing global contextual information of medical images. In this study, we introduce an innovative approach to enhance the detailed information of images by firstly using three methods, namely, Contrast Constrained Adaptive Histogram Equalization (CLAHE), Modified Binary Otsu-Based Histogram Equalization (MBOBHE), and Modified Partitioned Histogram Equalization (MPHE), and then combining U-Net with the VIT Transformer framework for the further processing of MRI brain tumor medical images for further processing. Three methods are proposed in this study, the preprocessing method using CLAHE is called EF-UVit1, the method using MBOBHE is called EF-UVit2, and the method using MPHE is called EF-UVit3. This study achieves particularly outstanding results in the recognized dataset Brats2020, and the results of the evaluation metrics of the three methods proposed in this study are all more than 98%, and the results in the MSD dataset, although slightly inferior to the Brats2020 dataset, still compare favorably with other algorithms.
Parkinson’s Disease - Functional Movement Battery (PD-FUNC): a simple tool to objectively evaluate functional movement capacity of patients with Parkinson’s disease
Authors: Smits-Engelsman Bouwien , Duysens Jacques
Published: December 2024

Clinicians require quantitative measures of functional movement to inform care decisions for persons with Parkinson’s disease (PWPs). To address this need, we developed the Parkinson’s Disease - Functional Movement Battery (PD-FUNC), which includes valid items from existing assessments and evaluates five key areas from the MDS-UPDRS-III: manual dexterity, functional strength, locomotion, static balance, and activities of daily living. This study assessed the PD-FUNC’s ability to distinguish between PWPs and healthy controls based on effect sizes and analyzed differences according to disease progression using years since diagnosis and MDS-UPDRS-III scores, as well as Hoehn & Yahr (H&Y) stages. The test was administered to 81 PD patients (H&Y stages 1–3) and 81 age-matched controls. All items, except grip force, discriminated effectively, with dexterity tasks showing the highest sensitivity (effect size r = 0.52–0.63). The PD-FUNC distinguished PD stages well, revealing early symptoms through dexterity tests (p = 0.001) and late-stage symptoms via dynamic stability tests. The PD-FUNC provides a comprehensive assessment within 30–40 minutes and could be used to evaluate disease progression and medication effectiveness at home and in clinical settings.
The impact of league quality and player distribution on the performance of women’s national football teams
Authors: Wang Sihang , Shen Miao , Qin Yang , Li Pei
Published: December 2024

The purpose of this study was to examine the impact of league quality and player distribution on the women’s football performance of national teams. 50 European teams for three consecutive seasons (2021-2024) were analyzed. The league rankings and player distribution of 50 European countries were obtained through the official websites, the scores were assigned according to the respective leagues/clubs rankings, and finally correlation and regression analyses were conducted to analyze the league rankings, the league distribution rankings, and the rankings of the top clubs of each women’s national team. The results show that the league ranking, player league distribution, and player top club distribution have a highly positive correlation with FIFA world ranking in the past three seasons, and the R values are all greater than 0.7. The results of linear regression analysis show that the league ranking, the player distribution of league and top clubs have a significant positive influence on FIFA ranking, among which the leagues distribution has the highest degree of explanation for FIFA ranking (Adjusted R2=0.685, CI:1.878-2.762, P<0.001***). Therefore, these information encourages countries with lower rankings should prioritize league development and enhance the competitiveness of their football leagues to cultivate elite players.
Health system responsiveness to maternity care expectations: The case of African-born women residing in Melbourne, Australia
Authors: Bali Ayele Geleto , Vasilevski Vidanka , Sweet Linda
Published: December 2024

Background
Migrants come to host countries with different health needs, requiring access to new and complex health systems. Health system responsiveness is an important consideration in the delivery of both clinical and non-clinical care to migrant communities. Migration of women of childbearing age from African countries is increasing in Australia, however, the responsiveness of the health system to their maternity care needs has not been well studied. This study aimed to assess the health system responsiveness to maternity care expectations of African-born women living in Melbourne, Australia.
Methods
A cross-sectional survey was conducted from August to December 2023 among African-born women residing in metropolitan Melbourne, Australia. A standardised tool was used for data collection and a total of 248 complete responses were received. The data were analysed using descriptive and inferential statistics in STATA 18 software.
Results
Most respondents, 205 (82.7%), rated the Australian health system responsiveness as ‘acceptable’. The quality of basic amenities domain received the highest scores, while the choice for service providers obtained the lowest score. Health system responsiveness was more likely to be considered ‘unacceptable’ among women aged 26–35 years old compared to women younger than 25 years old (AOR: 4.71, 95% CI: (1.17–19.02) and migrant women as compared to humanitarian entrants (AOR: 2.51, 95% CI: (1.29–7.67). However, women who worked in non-professional jobs were less likely to report ‘unacceptable’ health system responsiveness as compared to women working in professional jobs (AOR: 0.54, 95% CI: (0.23–0.93).
Conclusions
This study suggested that the Australian health system was mostly responsive to the maternity care needs of African-born women. The domains that were rated with low scores, such as, choice for service providers, communication, autonomy, and prompt attention, could be addressed by improving African-born women’s health literacy using tailored strategies to support informed decision making.
A preliminary probabilistic nomogram model for predicting hyperuricemia in male participants
Authors: Zhang Shuai , Liang Hao , Zhu Ye
Published: December 2024

Objectives
Hyperuricaemia (HUA) is a major contributing factor to the development of gout and is linked to an increased risk of cardiometabolic disease, particularly in men. Despite this, there is a lack of simple tools for predicting HUA in male patients. This study aims to develop and validate a nomogram model to estimate the risk of HUA in male subjects.
Methods
A total of 21,953 eligible male participants, aged 18 years and older, were consecutively recruited during routine medical examinations at Northern Jiangsu People’s Hospital from July 2014 to August 2023. To identify factors related to HUA in male subjects, the least absolute shrinkage and selection operator (LASSO) regression and logistic regression methods were used. A nomogram was subsequently constructed to predict the likelihood of HUA in men.The performance of the proposed nomogram was evaluated based on a calibration plot, ROC curve and Harrell’s concordance index (C-index).
Results
Patients with hyperuricemia exhibited significantly elevated levels of BMI, red blood cell count, hemoglobin, hematocrit, blood glucose, serum urea, creatinine, total cholesterol, LDL-c, and triglyceride levels compared to those without hyperuricemia (P < 0.001). Conversely, the age and HDL-c levels of patients with hyperuricemia were notably lower than those without hyperuricemia (P < 0.001). Predictors used in the prediction nomogram included LDL-c, TG, HDL-c and serum Creatinine and RBC. Then, a nomogram model for predicting HUA was established based on the above indicators. Our model achieved well-fitted calibration curves and the C-indices of this model were 0.700 (95% CI: 0.692–0.708) and 0.705 (95% CI: 0.691–0.720) in the development and validation groups, respectively.
Conclusions
With excellent predictive abilities, the nomogram serves as a straightforward and dependable tool for estimating the risk of HUA among male participants.
Static magnetic field inhibits Epithelial-Mesenchymal Transition (EMT) and metastasis of glioma
Authors: Sun Ziyu , Zhao Wenxuan , Fei Xi-feng , He Bao , Shi Lei , Zhang Zhen , Cai Shi-zhong
Published: December 2024

Gliomas show suboptimal responses to conventional treatments, with tumor cell migration remaining a formidable challenge in glioma therapy. Epithelial-Mesenchymal Transition (EMT) facilitates invasion of glioma cells, and transforming growth factor β1 serves as a potent factor promoting proliferation, migration, and EMT in glioblastoma (GBM). Magnetic fields have been widely applied in the diagnosis and treatment of various diseases, but their effects on the EMT process in glioma cells remain unclear. In this study, we investigated whether a static magnetic field (SMF) could inhibit EMT and metastasis in glioma cells. Conduct functional analysis using U251 and U87 glioma cell lines. The results indicated that cells treated with TGF-β1 increased invasion and migration capabilities, while showing reduced apoptosis. However, when SMFs were combined with TGF-β1 treatment, there was a notable suppression of cell migration and invasion, accompanied by an increase in apoptosis. Additionally, this combination treatment significantly decreased the protein expression of mesenchymal markers N-cadherin and β-catenin, as well as reduced the levels of the recombinant protein MMP-2. Collectively, these findings suggest that SMFs may reduce glioma cell metastasis by inhibiting EMT. Therefore, SMFs could represent a promising therapeutic strategy for diminishing glioma metastasis.
Intention to use Virtual reality technology for clinical training and its predictors among Medical Students in Amhara Regional State Teaching Hospitals, Ethiopia,2024: unified theory of user acceptance technology (UTUAT2) model
Authors: Wassie Birhan , Fentahun Ashenafi , Zemene Wondosen , Wubete Aschale , Demis Nebebe , Alelegn Berihun , Tsegaw Adem , Addisu Eliyas , Dessie Kassahun
Published: December 2024

Background: Virtual Reality (VR) technology has emerged as a powerful tool with great potential in medical education and training. Virtual reality offers unique opportunities for medical students to improve clinical skills, know rare cases, improve patient safety and improve health outcomes. Despite the growing interest in Virtual reality in medical education, the actual adoption and usage of this technology among medical students in Ethiopia remain relatively unexplored. Therefore, this study assesses the intention to use Virtual reality technology for clinical training and its predictors among medical students in Ethiopia.
Methods: a cross-sectional study was conducted on 946 medical students from May 25 to June 24, 2024, in seven teaching hospitals in the Amhara region, Ethiopia. Proportionally allocated for each hospital and participants was selected using a computer-generated simple random sampling technique. The data were collected in all teaching hospitals through an interviewer-administered questionnaire. Descriptive statistics were done using SPSS version 27. The degree of association was assessed and validated using structural equation modeling using AMOS version 23.
Results: about 464(51.4%); 95% CI: [48.2–54.7] of participants have intention to use the Virtual reality technology for clinical training. Performance expectancy (β=0.13, 95% CI: [0.06–0.29], p-value<0.01), effort expectancy (β = 0.12, 95% CI: [0.05–0.24], p-value<0.01), hedonic motivation (β =0.14, 95% CI: [0.09–0.29], p-value<0.001), attitude (β=0.17, 95% CI [0.1- 0.33], p-value<0.001) and digital literacy (β=0.15, 95% CI: [0.10–0.33], p-value<0.01) had a positive relationship with intention to use virtual reality technology. In addition, attitude had a mediation effect between all constructs and behavioral intention to use. The relationship between hedonic motivation and intention to use virtual reality technology was moderated by gender.
Conclusion and recommendation: about half of medical students have intention to use virtual reality technology for clinical training. Intervention on Performance expectancy, effort expectancy, hedonic motivation, attitude and digital literacy had improved medical students’ intention to use virtual reality technology.
Impact of educational intervention on pharmacists’ management of acute uncomplicated urinary tract infections in adults - A double-blind randomised controlled trial
Authors: SHOWANDE Segun Johnson , ABDULHAFIZ Taofiq Tanimola
Published: December 2024

Background
Urinary tract infections (UTIs) are one of the most common minor ailments presented at pharmacies and often lead to significant morbidity and healthcare costs and can impact quality of life. The increasing prevalence of UTIs and rising antibiotic resistance highlight the need for effective management strategies within the community pharmacy setting. This study evaluated the effectiveness of an online educational intervention to improve community pharmacists' ability to manage acute uncomplicated UTIs.
Methods
A double-blind, randomised controlled trial was conducted among pharmacists in 51 community pharmacies in Ibadan, Nigeria. The study used a self-administered questionnaire and eight trained mystery patients (MPs) who delivered four different scripted scenarios at pharmacies before and after the intervention. The impact of an online educational intervention was assessed by the MPS between the pharmacists in the intervention group (IG = 24) and the control group (CG = 27). The primary outcome evaluated was a global score for pharmacists' ability to manage acute uncomplicated UTIs (a composite score for appropriate questions asked, recognition of minor ailments as UTIs, and suitable recommendations). Secondary outcomes included pharmacists' self-reported knowledge of UTI risk factors, symptoms, and management and barriers to UTI management. Between-group mean scores were compared using an independent sample t-test.
Results
A total of 408 MP visits were made to the pharmacies. The mean global score for pharmacists’ ability to manage UTIs improved post-intervention (CG = 6.89 ± 2.59, IG = 13.58 ± 3.76, p < 0.001, d = 2.10). Additionally, the mean scores for appropriate questions asked, recognition of minor ailments, and appropriate recommendations also improved in the IG. The mean percentage of pharmacists' knowledge across the three domains—risk factors, UTI symptoms, and management—was 32–38%. Perceived barriers to UTI management included inadequate consultation time, lack of knowledge, insufficient training, and service compensation.
Conclusions
The online educational intervention enhanced community pharmacists' ability to manage UTIs by improving their skills. However, barriers like limited consultation time and lack of compensation exist. Policymakers should promote the use of treatment guidelines and incentivise pharmaceutical care to support effective UTI management.
Trial registration
ClinicalTrials.gov with registration number NCT05399797
Early detection of anastomotic leak in intraperitoneal fluid after colorectal surgery
Authors: Lakyová Lucia Sukovská , Radoňak Jozef , Ján Chandoga , Tomečková Vladimíra , Sukovský Lukáš
Published: December 2024

Background:Anastomotic leak (AL) represents serious complications of colorectal surgery and significantly influences patients’ morbidity and mortality. We investigated whether the analysis of lactate and pyruvate in the peritoneal fluid can help detect AL earlier than the current non-specific biochemical examination.
Methods: Fifty-four adult patients (median age: 52 years) with colorectal carcinoma were enrolled in this prospective study. Patients were divided into the following three groups: group B – patients without AL after resection, group D – patients with AL after resection, and control group C – patients after palliative surgery without resection. We measured the concentration of lactate and pyruvate and calculated the lactate/pyruvate ratio in the peritoneal fluid of patients for the first 7 days after surgery.
Results: The most significant difference was recorded between groups D and C (P˂0.001). Statistically significant differences were observed in the concentration of lactate between group B and group D over 7 days, except on the first postoperative day (P˂0.001). Upon comparison of groups B and D and groups C and D, the lactate/pyruvate ratio showed the most significant difference on the second postoperative day (P=0.002).
Conclusion: High levels of lactate and lactate/pyruvate ratio allows early identification of AL as early as 2 days after surgery.
Investigating the Correlations Among Clinical, Laboratory, and Imaging Findings in Pediatric Patients with Osteomyelitis and Septic Arthritis: A 12- Year Retrospective Study
Authors: Barkhordarioon Amirali , Torshizi Mahdieh Mousavi , Shariatpanahi Ghazal , Mojtahedi Sayed Yousef
Published: December 2024

Background: Septic arthritis (SA) and Osteomyelitis (OM) are critical pediatric emergencies that can lead to severe complications, including mortality. The study aimed to investigate the relationships between risk factors and clinical, laboratory, and imaging findings in these diseases.
Methods: A retrospective study was conducted on 65 pediatric patients (46 diagnosed with SA and 19 with OM). Relevant demographic data, clinical, laboratory and imaging findings were analyzed.
Results: 45 (69.2%) patients were male. The mean age was 5.4 years for SA and 4.8 years for OM. The mean duration of hospitalization was 8.1 days for SA and 15.32 days for OM. Eight patients (12.3%) experienced comorbidity, leading to longer hospitalization. The most affected joints were the knee, hip, and ankle, whereas the most affected bones were the femur, tibia, and humerus. The main clinical symptoms and signs of OM included pain, tenderness, and fever, whereas those of SA included pain, limited mobility, and tenderness. Leukocytosis was observed in 57.9% of OM patients and 50% of SA patients. Erythrocyte Sedimentation Rate (ESR) elevation was found in 52.6% of OM patients and 54.3% of SA patients. Elevated C-Reactive Protein (CRP) was present in 68.4% of OM and 80.4% of SA patients. Blood cultures were positive in 23.1% of OM patients and synovial fluid cultures in 23.5% of SA patients, with Staphylococcus aureus being the most common organism isolated (75%). There was a correlation between hospitalization duration for SA patients and abnormal ultrasound or X-ray findings.
Conclusions: SA and OM were predominantly observed in boys aged 2–12 years. Comorbidities and immunosuppressive medications were associated with increased disease severity. Fever was recorded in less than 80% of the patients. The ESR emerged as the only parameter significantly associated with culture results, highlighting its importance in assessing infection severity and patient follow-up. The relationship between ultrasound findings and SA severity can guide clinical management. These findings identified MRI as the gold standard for diagnosing OM. The low culture positivity rates underscore the need for timely empirical treatment initiation, even in the absence of positive culture results.
Action to Scale Up Reduction of Teenage Pregnancies Among Vulnerable Girls in Eastern Uganda: Findings from a gender mixed methods study
Authors: Kagurusi Patrick , Kwikiriza Benson , Osinde Stephen Omejja , Elizabeth Nagawa , Ajok Dolly , Kapsandui Tony , Nankanja Maureen
Published: December 2024

Introduction:
Approximately one in every four Ugandan teenagers becomes pregnant by the age of 19. This is often due to early marriages, a practice deeply rooted in tradition, culture and is reinforced by gender inequalities. This limits the ability of women and girls to fully participate in, and benefit from SRHR programmes in Uganda. Therefore, this study explored gender differences, roles and power dynamics at baseline for a SRHR project in Namutumba and Bugiri districts.
Methods
An explanatory mixed methods study was conducted using systematic sampling of 207 participants from a baseline survey of a SRHR project. Participants were recruited after informed consent and assent. Data was collected using semi-structured and electronic questionnaires. deductive thematic and descriptive statistical analysis were done using Open Code software and STATA version 17 respectively.
Results
A total of 207 participants were interviewed, 29.6% were aged between 10–19 years and 53.1% were female. More than half [55.6%] of the participants were married/cohabiting. More women than men engaged in production [farming- 84.4%] and household activities [collecting water − 71.3%, preparing food − 85.2%]. 70.4% and 50.2% men had control and access to land respectively. Only 44% and 42% of both men and women had equal opportunities for personal development and decision making respectively. 51.9% of participants said GBV was happening in communities.
Conclusion
Cultural, patriarchal and religious norms influenced access and control of resources. This disproportionately affected women. Therefore, gender- sensitive interventions tailored to the needs and realities of the communities are recommended for increased access to SRHR services.
Medical Education and Technology: Post-Pandemic Solutions for Emergency Scenarios
Authors: Alves Rafael Arruda , Santos José Sebastião dos , Mazzo Alessandra , Pinto Vinícius Souza
Published: December 2024

Background
This study developed and implemented a teleactivity technology ensuring remote access and real-time interaction between academic and clinical environments in medical education. This solution aimed to minimize the need for physical presence during clinical and educational procedures, while maintaining the quality of teaching, especially in the context of the COVID-19 pandemic.
Methods
The technology was designed as a modular rack with cameras, microphones, and monitors to capture and transmit live procedures. The implementation took place at the Ribeirão Preto School of Medicine (FMRP-USP) and at the Bauru School of Medicine (FMBRU-USP), involving 66 participants. Data collection was carried out through electronic questionnaires, distributed after the educational activities. Quantitative analysis included ANOVA and Tukey's post-hoc tests, while qualitative analysis was conducted using the IRAMUTEQ software to identify emerging themes.
Results
The results showed that 96% of the participants considered that the transmission allowed a clear understanding of the procedures, and 93% evaluated the real-time interaction as effective for learning. The qualitative analysis revealed five main themes, such as the quality of the teaching-learning experience and challenges of adapting to remote teaching. The quantitative analysis highlighted the importance of audio quality for the satisfaction of the participants and identified the preference for the use of the Zoom and YouTube platforms.
Conclusion
The teleactivity technology developed proved to be effective in maintaining the quality of health education during the pandemic and presents itself as a sustainable alternative for medical education in the future. The proposal of a hybrid model, combining remote and face-to-face teaching, shows promise to face future challenges and expand teaching possibilities. Further research is recommended to explore the application of the technology in different areas of health and assess its long-term impact.