bluuebunny/crossref_metadata_2025 huggingface dataset:
Dual automatic relevance determination for linear latent variable models and its application to calcium imaging data analysis
Authors: Li Yuzhe , Funamizu Akihiro , Kuhn Bernd , Doya Kenji
Published: April 2024

In the analysis of high-dimensional data, applying dimensionality reduction techniques is often necessary. However, setting an suitable criterion for determining the extent of dimensionality reduction often poses a challenge. The use of automatic relevance determination (ARD) in a linear latent variable model, such as Bayesian PCA, offers a way to automatically identifying the effective dimensionality of the latent space. However, conventional ARD methods often fail to extract sparse representation of latent variables in dealing with noisy, non-Gaussian, or nonlinearly observed data, such as calcium imaging data. To encourage the sparsity of the latent space, we proposed a dual ARD method in a linear latent variable model that applies ARD priors to both loading weights and latent variables. We first detailed our dual ARD method and mathematically analyzed how the dual ARD priors promote more sparsity in the latent space. We then evaluated the performance of the dual ARD methods against existing dimensionality reduction techniques using both simulated datasets and actual calcium imaging data. While conventional methods could retrieve essential signals in linear Gaussian settings, the dual ARD method outperformed the previous models in extracting low-dimensional signals from simulated calcium imaging data that contain higher levels of nonlinear noise. In applying the dual ARD method to actual two-photon calcium imaging data, we were able to identify low-dimensional latent variables that were sufficient for performing a sound localization decoding task successfully. Additionally, decoding performance across different cortical depths reflects the varied roles that specific cortical layers play in sound localization. In conclusion, the dual ARD method is well-suited for automatically reducing dimensionality of calcium imaging data while preserving essential information for further analysis.
Construction of a cuproptosis genes prognostic model and associated competing endogenous RNA network in thyroid carcinoma
Authors: xu qin , Jiang Qi-Lan , Luo Bao-Yu , Jiang Rui , Zeng Yang , Jiang Jun
Published: April 2024

Background:The present study aimed to investigate the association between cuproptosis genes (CGs) and the prognosis of thyroid carcinoma (TC), and to construct a prognosis model of TC and its regulatory network based on CGs. Methods:The association between CGs and TC prognosis was analyzed. A prognostic model of TC related to CGs was constructed by the LASSO algorithm and multivariate Cox regression analysis. The starBase database was used to predict the upstream long non-coding RNA (lncRNA) and microRNA (miRNA).
Results:The results of the LASSO algorithm and multivariate Cox regression analysis on these 6 genes showed that ATP7B, DLD and PDHA1 could constitute the prognostic model of TC (P=0.015, C-index=0.76). Univariate (P<0.001) and multivariate (P<0.05) Cox analysis demonstrated that the risk score could independently predict the prognosis of patients with TC. Furthermore, the upstream lncRNA/miRNA regulatory network of model genes was predicted.
Conclusion:The cuproptosis-related TC prognosis model helped to predict the survival of patients with TC. In addition, regulating the upstream ceRNA network of model genes may aid to guide the clinical treatment of TC.
Clinical Audit of Cases and Outcomes of Patients Admitted to the Intensive Care Unit at Kamuzu Central Hospital, Lilongwe, Malawi
Authors: Bwanali Akim Nelson , Munthali Leonard , Napolo Upile , Lubanga Adriano Focus , Gundo Rodwell , Mpinganjira Samuel L.
Published: April 2024

In 2016 a new, improved and modern intensive care unit was constructed at Kamuzu Central Hospital in Lilongwe, Malawi. Having been operational for about 4 years, there has not been a systematic audit to gauge its performance. Therefore, this a quantitative retrospective cohort study aimed at investigating the performance of the intensive care unit at Kamuzu Central Hospital in Lilongwe, Malawi. We analysed the patterns of admission through 250 clinical cases and their respective outcomes spanning from 1st January 2019 to 31st December 2019 using STATA. Descriptive and inferential statistics were computed. Out of the 250 admissions, we evaluated 249 samples. About 30.8% of all patients were referred from the main operating theatre, 20.7% from the casualty and 10.5% from maternity high dependence unit. Head injury (26.7%) and peritonitis (15.7%) were the commonest causes of admission. The overall mortality was 52% with more females (57.5%) dying than males (47.9%). Head injury and peritonitis had the highest contribution to the mortality accounting for 25.3% and 16.9% of all deaths respectively. In conclusion, the intensive care unit registered an improved performance compared to previous years. However, it is still grappling with a number of challenges that need immediate attention including few working beds, shortage of critical care specialists and nursing staff and lack of standard admission criteria.
Assessing the Efficiency of Regional Healthcare Systems Amid Evolving Socio- Environmental Dynamics
Authors: Barik Parthasarathi , Goswami Prashant
Published: April 2024

The compounding influences of population growth, climate shifts, and socio-economic dynamics drive the burden of disease, intricately shaping healthcare outcomes. Vital for disease prevention, detection, and treatment, the efficacy of healthcare systems directly impacts mortality rates. This investigation delves into 28 Indian states, each representing distinct socio-climatic profiles, to scrutinize how climate change influences three prevalent diseases: acute respiratory disorders, diarrhea, and malaria. Notably, the analysis reveals correlations between case numbers and fatalities, suggesting healthcare system strain in several states. Remarkably, only a handful of states demonstrate significant links between case prevalence in the populace and the mortality rate among affected individuals. Our research presents a methodology transferable to diverse regions, furnishing a quantitative gauge of healthcare system efficacy within specific disease contexts.
Reduced Intensity transplantation vs chemotherapy. A prospective, pseudorandomized study in 50-70 year old AML patients
Authors: Ljungman Per , Brune Mats , Kiss Thomas , Andersson Harald , Nicklasson Malin , Delage Robert , Finke Jürgen , Gedde-Dahl Tobias , Hébert Josée , Höglund Martin , Kaare Ain , Lazarevic Vladimir , Möllgård Lars , Remes Kari , Ritchie David , Spyridonidis Alexandros , Sabloff Mitchell , Spearing Ruth , Wallhult Elisabeth
Published: April 2024

The aim of this prospective, international multicenter, pseudorandomized study using the donor versus no-donor concept to compare RICT HCT to standard-of-care chemotherapy in intermediate- or high risk AML patients 50 – 70 years in CR1. Part 1 included only patients with potential family donors (RD) at the date of HLA-typing of the first potential sibling or CR-date, if later. In Part 2), patients without a possible sibling donor could be included with the inclusion date at the start of an unrelated donor (URD) search.
360 patients were registered and 309 analyzed. The median follow-up was 47 months (1-168). There was no difference in overall survival (OS) between the RD (n=124) and the Control (n=77) groups (p=0.50, 3-year OS RD: 0.41(95% CI; 0.32-0.50); Controls: 0.49 (95% CI; 0.37-0.59)). The main cause of death was relapse (67% RD; 88% Controls). Comparing URD-HCT (n=86) and Controls (n=20), the 3-year survival was 0.60 (95% CI 0.50-0.70) for URD-HCT and 0.37 (95% CI 0.13-0.62) in the Controls, respectively (p=.10). When analyzing transplanted patients (Part 2), the OS at 3-years was higher for URD-HCT than RD-HCT (0.67 (0.55-0.76) vs. 0.42 (0.26-0.57; p=.005). The risks for severe acute and extensive chronic GVHD were lower in the URD-HCT group.
Sex Specific Associations of Sex hormone With Brain Volumes and Cerebral Blood Flow: A Cross Sectional Observational Study Within the Look AHEAD Type 2 Diabetes Cohort
Authors: Vaidya Dhananjay , Yeboah-Kordieh Yvette , Howard Marjorie , Hugenschmidt Christina E. , Nyquist Paul A , Michos Erin D , Kalyani Rita R , Yasar Sevil , Robusto Brian Andres , Yassine Hussein N , Clark Jeanne M , Espeland Mark A , Bennett Wendy L
Published: April 2024

Trial Registration: NCT00017953
Background: Females have greater brain volume and cerebral blood flow than males when controlling for intracranial volume and age. Brain volume decreases after menopause, suggesting a role of sex hormones. We studied the association of sex hormones with brain volume, white matter hyperintensity volumes and cerebral blood flow in people with Type 2 Diabetes and with overweight and obesity conditions that accelerate brain atrophy.
Methods: We analyzed data from 215 participants with overweight or obesity and Type 2 Diabetes from the Look AHEAD Brain Magnetic Resonance Imaging ancillary study (mean age 68 years, 73% postmenopausal female). Estradiol and total testosterone levels were measured with electrochemoluminescence assays. The ratio of brain measurements to intracranial volume was analyzed to account for body size. We analyzed sex hormones as quantitative measures in males, whereas in females we grouped those with detectable vs. undetectable hormone levels (Estradiol <73 pmol/L [20 pg/mL]: 79%; Total Testosterone < 0.07 mmol/L [0.02 ng/mL]: 37% undetectable in females).
Results: Females with detectable total testosterone levels had higher brain volume to intracranial volume ratio (median [25th, 75th percentile]: 0.85 [0.84, 0.86]) as compared to those with undetectable Total Testosterone levels (0.84 [0.83, 0.86]; rank sum p=0.04). This association was attenuated after age and body mass index adjustment (p=0.08). Neither white matter hyperintensity volumes or cerebral blood flow in females, nor any brain measures in males, were significantly associated with Estradiol or Total Testosterone.
Conclusions: In postmenopausal females with Type 2 Diabetes with overweight and obesity, detectable levels of total testosterone were associated greater brain volume relative to intracranial volume, suggesting a protective role for testosterone in female brain health. Our findings are limited by a small sample size and low sensitivity of hormone assays. Our suggestive findings can be combined with future larger studies to assess clinically important differences.
Trial Registration: NCT00017953
GRK6 palmitoylation dictates triple-negative breast cancer metastasis via recruiting the β-Arrestin 2/MAPKs/NF-κB signaling axis
Authors: Wang Wen-Ke , Lin Hui-Yu , Lin Che-Hsuan , Lee Hsun-Hua , Chen Yen-Lin , Lin Yu-Hsien Kent , Chiu Hui-Wen , Sheen-Chen Shry-Ming , Lin Yuan-Feng
Published: April 2024

Background: Triple negative breast cancer (TNBC) belongs to the worst prognosis of breast cancer subtype probably because of distant metastasis to other organs, e.g. lungs. However, the mechanism underlying TNBC metastasis remains largely unknown.
Methods: Bioinformatics analysis was conducted to evaluate the mRNA/protein expression and prognostic significance of G protein–coupled receptor kinase 6 (GRK6) in BC subtypes. RT-PCR assays were used to test the GRK6 expression in human BC tissues and cell lines. The in vitrocellular migration and in vivo lung colony-forming assays were established to estimate the metastatic potentials of TNBC cells. Western blotting was employed to examine protein phosphorylation, translocation and expression in the designed experiments.
Results: Here we show that GRK6 upregulation is extensively detected in TNBC compared to normal mammary tissues and other BC subtypes and correlates with an increased risk for distant metastasis in TNBC patients. GRK6 knockdown suppressed but overexpression potentiated the cellular migration and lung colony-forming abilities of TNBC cells. Moreover, our data demonstrated that the posttranslational palmitoylation of GRK6 is extremely critical for activating b-Arrestin 2/mitogen-activated protein kinases (MAPKs)/NF-kB signaling axis and fostering the metastatic potentials of TNBC cells. Accordingly, the pharmaceutical inhibition of GRK6 kinase activity dramatically suppressed the activation of b-Arrestin 2, MAPKs and NF-kB and the cellular migration ability of highly metastatic MDA-MB231 cells. Sequentially blocking the b-Arrestin 2/MAPKs/NF-kB axis with their inhibitors predominantly mitigated the GRK6-promoted migration ability of poorly metastatic HCC1937 cells.
Conclusion: Our results not only provide a novel mechanism for TNBC metastasis but also offer a new therapeutic strategy to combat metastatic TNBC via targeting GRK6 activity.
Isolation, characterization, and probiotic profiling of amylolytic lactic acid bacteria from Sonadi sheep milk
Authors: Rao Pallavi , Meena Kamalesh Kumar , Panwar Narayan Lal , Gupta Lokesh , Joshi Manvik
Published: April 2024

Probiotics are live, healthy bacteria that improve health when given to a host in sufficient quantities. This research explored the possible probiotic attributes of amylase-producing lactic acid bacteria (ALAB) from milk of Sonadi sheep breed. Five strains (P1, P2, P3, P4, and P5) out of 76 isolates were found to be amylase-producing LAB, which was characterized by morphological, phenotyping, and biochemical tests and identified by 16S rRNA sequencing and phylogenetic evaluation. The strains were characterized for probiotic attributes such as tolerance to bile salt and acid, resistance to lysozyme and phenol, antioxidative activity, simulated gastric and pancreatic digestion, cell surface properties (auto-aggregation and cell surface hydrophobicity), antimicrobial activity (antifungal and antibacterial), and safety assessment (antibiotic susceptibility, hemolytic and DNase activities). This study exhibited that Lactiplantibacillus plantarum P2 and Enterococcus faecium P1 were observed to have excellent probiotic traits and could be a putative candidate as a probiotic for the manufacturing of fermented products.
Granulomatous inflammation and fibrosis in the porcine gastro-intestinal tract after application of TachoSil and Biodesign patches
Authors: Budtz Eva , Marcussen Niels , Larsen Thomas , Ugianskiene Aiste , Einarsdottir Sylvia Oddny , Valsamidis Alexandros , Kjærgaard Benedict , Glavind Karin , lauszus Finn , Ellebaek Mark Bremholm , Helligsø Per , Nielsen Michael Festersen , Nielsen Kristian Als
Published: April 2024

Background. Leakage from gastrointestinal anastomoses (AL) is a serious complication associated with increased morbidity and mortality, prolonged hospitalization, and increased treatment costs. Moreover, AL in patients following colorectal resection is associated with an increased risk of cancer-related death and a reduced 5-year survival rate. Several studies imply that coating of gastrointestinal anastomoses with sealing devices such as fibrin glue and omental patches may enhance tissue healing and reduce the risk of AL.
Purpose. The present study was undertaken to examine the short (3 days) and long-term (4 weeks) effects of a fibrin patch (TachoSil) and a biological mesh (Biodesign) on connective tissue synthesis when applied on fascia and the serosal surfaces of the intestine.
Methods. TachoSil and Biodesign patches were applied on fascia, stomach, duodenum, small bowel, and colon in 8 pigs. The animals were sacrificed after 3 days and 4 weeks, respectively. Tissue samples from each anatomical site were obtained for histopathological examinations and histochemical analyses.
Results. Significant histopathological changes were only observed in samples from pigs sacrificed after 4 weeks. The analyses revealed granulomatous inflammatory responses in the subserosa with fibrosis, neovascularization, and a high concentration of myofibroblasts. Focally, destruction of muscularis propria was noted. The observed inflammatory responses did not differ substantially between the two patches.
Conclusion. The present study demonstrates that TachoSil and Biodesign promote connective tissue synthesis. This response has the potential to increase the long-term strength of the connective tissue thereby lowering the risk of AL.
Effects of person-centred care and intensive care experience on post-intensive care syndrome in critical care survivors: a multi-centre prospective cohort study
Authors: Kang Jiyeon , Yun Seonyoung
Published: April 2024

Background: Several risk factors for post-intensive care syndrome have been recognised, but the majority of them cannot be altered. While there is potential for negative experiences in the intensive care unit and person-centred care to impact post-intensive care syndrome, the evidence linking the three is insufficient. This study aimed to investigate the impact of person-centred care and the patient’s experience in the intensive care unit on post-intensive care syndrome among critical care survivors during the first year following hospital discharge.
Methods: The study was a prospective, multi-centre longitudinal cohort study. This study was conducted in 19 intensive care units at four university hospitals located in Busan, South Korea. The participants were 618 adults who had been admitted to the intensive care unit for more than 24 hours between May 2019 and July 2021. At the time of intensive care unit discharge, participants completed a person-centred care and an intensive care experience questionnaire. We evaluated the post-intensive care syndrome of the participants 3, 6 and 12 months after hospital discharge.
Results: The frightening experience in the intensive care unit was a factor that significantly increased post-intensive care syndrome at 3 and 6 months. Person-centred care partially mediated the impact of the frightening experience on post-intensive care syndrome, mitigating its effect. Female gender, older age, comorbidities, delirium and discharge to an extended care facility were factors that increased post-intensive care syndrome at 3, 6 and 12 months. Furthermore, comorbidities and discharge place had a statistically significant influence on the participants' post-intensive care syndrome changes over the course of one year.
Conclusions: The findings of this study support the development and implementation of person-centred interventions that reduce patients' frightening experiences in the intensive care unit in order to enhance long-term outcomes. Additionally, the post-intensive care syndrome of survivors who are discharged to an extended care facility requires special attention.
Registration: This study is registered at the Korean Clinical Research Information Service (#KCT0004045; date of registration: June 11, 2019; date of 1st participant recruitment: June 7, 2019).
Prevalence and Risk Factors of Concomitant Malleolar and Fibular Fractures in Distal Spiral Tibial Shaft Fractures
Authors: Lu Feiqi , Yuan Ye , Zhu Jianjin , Deng Jiuzheng , He Dawei , Zhao Zhe , Pan Yongwei
Published: April 2024

Purpose: (1) To evaluate the incidence and morphology features of concomitant malleolar and fibular fractures in patients with distal spiral tibial shaft fractures. (2) To evaluate the risk factors for concomitant malleolar fractures in patients with distal spiral tibial shaft fractures.
Methods: A retrospective review was performed on 64 cases of operatively treated distal spiral tibial shaft fractures with complete radiographs and computed tomography (CT) scans. Data were collected on age, sex, injured side, AO classification of tibial shaft fractures, relative fibular fracture location, patterns and severity of concomitant malleolar fractures. Univariate analysis was performed to analyze factors associated with concomitant malleolar fractures.
Results: The incidence of concomitant malleolar fractures in distal spiral tibial shaft fractures found in this study was 89.1%, including 50% of single fracture and 39.1% of multiple fractures. The most frequent being posterior malleolar fractures (PMF), followed by anterior inferior tibiofibular ligament (AITFL) avulsion fractures and lateral malleolar fractures (LMF). 58 cases (90.6%) had concomitant fibula fractures, with the most common location being proximal to the tibial fracture. There was a significant association between AO42B fractures and fibular fractures at the same level as the tibia. Age was associated with the severity of concomitant malleolar fractures (p=0.422), particularly with AITFL avulsion fractures (p=0.0251) and LMF (p=0.0129).
Conclusion: Distal spiral TSFs were highly associated with malleolar fractures, which may occur at single or multiple sites. A CT scan of the ankle joint is essential to avoid misdiagnosis and the potential need for additional fixation of malleolar fractures in distal spiral TSF. Age was associated with the severity of malleolar fractures, particularly with LMF and AITFL avulsion fracture in distal spiral TSF, but not with PMF or MMF.
Association Between VitaminE and 28-Day Mortality in adult sepsis patients: a retrospective cohort analysis
Authors: he yili , li yang , lao qifang , qin tao , xie xianlong , jiang wenyan
Published: April 2024

BACKGROUND There is currently no clear conclusion on the impact of isolated vitamin E in the nutritional composition on the 28-day mortality rate of adult sepsis patients. This study hypothesized that vitamin E could improve outcomes for patients with sepsis.
METHODS The primary objective of this project is to evaluate the relationship between Vitamin E and 28-Day Mortality. The secondary objective is to investigate whether variations in Vitamin E administration routes lead to differences in 28-day mortality rates. We analyzed adult sepsis patients (According to the international diagnostic criteria of sepsis3.0) from the Medical Information Mart for Intensive Care IV Database (MIMIC-IV). A multivariate regression, propensity score analysis, and interaction effects, survival curve was used to determine the associations between Vitamin E intake and 28-day mortality rates in ICU.
RESULTS This cohort study included 25 715 samples and 287 patients treated with the investigational drug. A significant reduction in 28-day mortality was observed among patients who used vitamin E (therapy group) compared to those who did not use it (control group) (HR = 0.71, 95% CI = 0.54~0.93, p=0.014). The adjusted Hazard Ratio was 0.62 (95% CI = 0.47~0.81, p<0.001). In the propensity score matching (PSM) model, the HR values are all <1, and the p-values are all <0.05, with consistent trends in all results. The survival curve demonstrated a significant difference in the same trend before and after propensity score matching (p=0.014). However, the 28-day mortality rate results of intravenous administration of vitamin E compared to other routes of administration is: (HR, 1.77; 95% CI, 0.97-3.21, p=0.062).
CONCLUSIONS In a general population of critically ill patients with adult sepsis, use of vitamin E is associated with improved 28-day mortality in ICU. The intravenous administration of vitamin E did not demonstrate better mortality outcomes compared to other routes of administration.
Impact of PDA Closure Methodology on Peri-procedural Opioid Utilization in Preterm Neonates, a Cross-sectional Review in a Tertiary Pediatric Healthcare System.
Authors: Saini Ashish , Hamrick Shannon , Adamson Marissa , Bhombal Shazia , Hash Sarah , Kim Dennis , LeFevre Ashley , Long Justin , Mills Marcos , Ligon Ronald
Published: April 2024

Objective- To study the association between PDA closure methodology and peri-procedural opioid utilization in preterm neonates. Study Design –A retrospective cohort study comprising all premature neonates and infants with a hemodynamically significant PDA who underwent surgical ligation (SL) between February 2020 – December 2022 or transcatheter PDA closure (TCPC) between August 2020 – February 2023. Intra-procedural and post-procedural opioid use was systematically quantified and compared between the two groups before and after propensity score matching. Result – The study included 52 preterm infants in the SL group and 74 in the TCPC group. After propensity score matching, infants undergoing TCPC received significantly lower intraprocedural (4.33 vs 5.99 µg/kg, p = 0.037) and post-procedural (0.09 vs 0.32 mg/kg, p < 0.001) opioids. A significantly lower proportion of infants undergoing TCPC were exposed to post-procedural opioids (60.8% vs 92.3%, p = < 0.001). Conclusion – Transcatheter PDA device closure is associated with significantly lower neonatal opioid exposure.
Evaluation of a Modified Short all oral Treatment Regimen for Rifampicin-Multidrug Resistant Tuberculosis in Dominican Republic
Authors: Rodríguez María , Bustos Yamile Celis , Encarnación Melanea , Muñoz Elisabet , Santos Sandra De los , Sánchez Ingrid , Portorreal Lissette , Sombie Seydou Benjamín , Sall Fatimata Bintou , Merle Corinne Simone , Perez Freddy
Published: April 2024

Background
This study aims to evaluate the effectiveness, safety, and impact on health-related quality of life (HQoL) of a fully oral shortened regimen for Rifampicin-Resistant/Multidrug-Resistant Tuberculosis (RR/MDR-TB) over 9 to 12 months under programmatic conditions.
Methods
A prospective cohort study was conducted on an all-oral modified Shortened Treatment Regimen (mSTR) comprising linezolid (Lzd), bedaquiline (Bdq), levofloxacin (Lfx), clofazimine (Cfz), and cycloserine (Cs). Patients with RR/MDR-TB were enrolled between January and December 2022 across seven drug-resistant TB units in the Dominican Republic.
Results
A total of 113 patients were enrolled, with 87% achieving culture conversion at two months. Treatment outcomes revealed that 79% of patients were successfully treated and didn’t relapse six months after the end of the treatment, 14% were lost to follow-up during the treatment, 6% deceased, and one experienced treatment failure due to Adverse Drug Reactions (ADRs). Adverse events (AEs) were common, with 82% of patients experiencing at least one AE with high proportion of QT interval prolongation, elevated transaminases, and anemia. A total of 12% of the patients experiencing Serious Adverse Events (SAEs). Improvement in HQoL dimensions was noted throughout treatment, with the EQ-VAS score increasing by an average of 15.5 by treatment end.
Conclusion
The high treatment success rate of the 5-drug mSTR facilitated the adaptation and integration of a shortened treatment regimen lasting 9 to 12 months in routine care in Dominican Republic. Although AEs were frequent, they were manageable in most cases. Continuous monitoring, especially regarding Lzd and Bdq use, is crucial to effectively mitigate risks. Since September 2023, this short all oral treatment regimen is now the one recommended for RR/MDR-TB patients in Dominican Republic.
Analysis of the pregnancy status and outcomes of pregnant women with α-thalassemia: a retrospective study
Authors: Li Yi , Feng Yuanyuan , Wei Yiyun , Huang Jing , Chen Hui , Wei Changqiang , Wei Kaiyi , Pang Lihong
Published: April 2024

Background
The prevalence of α-thalassemia co-occurrence with pregnancy may impede maternal system functions, with a consequent adverse effect on pregnancy progression and birth outcomes. The aim of this study was to provide guidance for the prevention and monitoring of perinatal complications of different types of α-thalassemia in pregnancy.
Methods
The observation group comprised 1371 singleton pregnant women with α-thalassemia. The control group comprised 680 non-thalassemia singleton pregnancies during the same period. The thalassemia genotypes of the observation group were tallied and categorized based on their respective genotypes within the group.
Results
The hemoglobin in the experimental group was lower than that in the control group, with the lowest hemoglobin in the intermediate group (P < 0.001), and serum ferritin trending in the opposite direction. The most significant decreases in hemoglobin and ferritin during pregnancy were observed in the intermediate group (P<0.001). The incidences of abnormal Electrocardiograph, abnormal liver function, hypertensive disorders, Gestational Diabetes Mellitus and thyroid disorders during pregnancy were higher in the observation group than in the control group (P<0.05). The incidences of preterm labor, caesarean section and postpartum hemorrhage were all higher in the observation group than in the control group (P<0.05). The delivery weight and neonatal hemoglobin in the observation group were lower than those in the control group (P<0.05).
Conclusions
Pregnant women with α-thalassemia have the more complications of pregnancy and childbirth than non-thalassemic pregnancies. Pregnancy-related indicators should be monitored and corrected in a timely manner.
Morphology and Structure Adaptation of Avicennia and Sonneratia Growing in Lagoon, Island, and Bay
Authors: Jeffry Syazana , Zakaria Muta Harah , Ramaiya Shiamala Devi , Bujang Japar Sidik
Published: April 2024

Mangrove ecosystems face increasing environmental threats and changes, making it crucial to unravel the complex interrelationship between Avicennia and Sonneratia and their diverse habitats. This study identified the environmental factors, including water salinity and substrate, that impact the distribution and abundance of Avicennia alba, A. marina, A. rumphiana, Sonneratia alba, and S. caseolaris. Three unique mangrove habitats include the isolated rocky island of Pulau Burong, the muddy-sand inland lagoon of Pengkalan Nangka, and the sandy mud to firm mud of coastal Teluk Buih. Pulau Burong is surrounded by marine water of salinity 31 to 35, Pengkalan Nangka is brackish water ranging from 12 to 19, and Teluk Buih is brackish to marine water of salinity 15 to 32. A. alba and A. marina from Pulau Burong have shorter leaf lengths, narrower widths, and thicker leaves compared to Pengkalan Nangka Lagoon and Teluk Buih (p<0.05). Similarly, S. alba from Pulau Burong has a shorter leaf length, narrower width, and thicker leaves than Teluk Buih. Water salinity had perfectly negative correlations with the leaf length of A. alba (r= -0.93) and A. marina (r= -0.91). A. marina leaf width and thickness were strongly negatively correlated with water salinity (r= -0.85 for leaf width and r= -0.84 for thickness). All three Avicenniaspecies' flowering responses, including cyme-like spike inflorescences, were documented. These findings enhance understanding of Avicenniaand Sonneratia ecology in the context of unique ecosystems facing environmental challenges.
A Nepal Demographic Health Survey Findings on Status of Women Empowerment Using Indicator as Employment Status in Nepal
Authors: Bhattarai Sandesh , Bishwas Sajan
Published: April 2024

Background: Empowering women through increased employment is crucial for sustainable development goals, yet globally, women face economic disparities and limited access to opportunities. In South Asia, including Nepal, low female labor force participation persists due to various challenges such as gender-based violence, discrimination, and societal norms. This study aims to investigate factors influencing women's employment status in Nepal focusing on education, children, wealth, partner's education, and other socio-economic factors.
Method: Data from the Nepal Demographic Health Survey 2016 was obtained through a DHS website. A working dataset was constructed, comprising 11 independent variables, and cleaned for analysis. Missing values were addressed, and the statistical analysis plan included descriptive analysis and chi-square tests to examine relationships between variables.
Results: The socio-demographic profile of married women aged 15-49 in Nepal reveals a predominance of male-headed households, urban residency, and secondary education attainment. Unadjusted logistic regression findings indicate significant associations between women's employment status and factors such as age, rural residency, lower education levels, more children, and poorer household wealth. However, multivariate analysis suggests that female-headed households have slightly lower employment likelihood. Age and education emerge as key determinants, with older and educated women more likely to be employed. Provincial disparities are evident, with certain provinces showing increased employment odds, while mobile phone ownership is associated with higher employment likelihood. These findings emphasize the complex interplay of factors influencing women's employment status, underscoring the need to address socio-economic disparities for enhanced empowerment and economic participation.
Conclusion: Findings reveal a higher prevalence of employment among women compared to the unemployment rate, yet disparities persist between male and female employment rates. Women with no education are more likely to be employed in daily waged labor-intensive jobs, indicating a need for targeted interventions to enhance employment opportunities, particularly in disadvantaged regions like Province 6. The study underscores the association between women's age and education levels with employment status, highlighting the importance of educational attainment in facilitating employment. Moreover, findings suggest a positive correlation between the husband's education level and women's employment, emphasizing the significance of household dynamics. Recommendations include the development of employment programs tailored to women's educational backgrounds and vocational training initiatives to enhance their participation in professional sectors, ultimately fostering economic independence and empowerment at the local level.
Comparative analysis of the clarus Aspergillus Galactomannan Enzyme Immunoassay for the Diagnosis of Invasive Pulmonary Aspergillosis in Bronchoalveolar Lavage Fluid
Authors: Sedik Sarah , Boyer Johannes , Egger Matthias Florian , Dichtl Karl , Prattes Juergen , Prüller Florian , Hoenigl Martin
Published: April 2024

Background: Galactomannan (GM) testing using Platelia Aspergillus enzyme immunoassay (Platelia GM) from bronchoalveolar lavage fluid (BALF) aids in early diagnosis of invasive pulmonary aspergillosis (IPA). Globally, only a minority of laboratories have the capability to perform on-site GM testing, necessitating accessible and affordable alternatives. Hence, we conducted a comparative evaluation of the new clarus Aspergillus GM enzyme immunoassay (clarus GM) with Platelia GM using BALF samples.
Methods: This is a single-center, prospective, cross-sectional study, where Platelia GM testing was routinely performed followed by clarus GM testing in those with true positive or true negative GM test results according to the 2020 EORTC/MSG and the 2024 FUNDICU consensus definitions. Descriptive statistics, ROC curve analysis, and Spearman’s correlation analysis were used to evaluate analytical performance of the clarus GM assay.
Results: This study enrolled 259 adult patients, of which 53 (20%) were classified as probable IPA, while 206 did not fulfill IPA criteria. Spearman's correlation analysis revealed a strong correlation between the two assays (rho = 0.727, p < 0.001). The clarus GM had a sensitivity of 96% (51/53) and a specificity of 74% (153/206) for differentiating probable versus no IPA when using the manufacturer recommended cut-off. ROC curve analysis showed an AUC of 0.936 (95% CI: 0.901-0.971) for the clarus GM, while the Platelia GM yielded an AUC of 0.918 (95% CI: 0.876-0.959).
Conclusions: Clarus GM demonstrated a strong correlation and promising test performance, comparable to Platelia GM, rendering it a viable alternative in patients at risk of IPA.
A Novel Noninvasive Diagnostic Method for Suspicious Cervical Lymph Nodes— Superb Microvascular Imaging
Authors: Xu Lilong , Zhou Ling , Yu Xiaoli , Zheng Lin-lin , Fan Gonglin , Zhang Min , Li Shiyan
Published: April 2024

Background
To explore the diagnostic value of superb microvascular imaging (SMI) for ultrasonically uncertain lymph nodes (LNs).
Methods
Our center prospectively collected clinical and imaging data of 74 patients who underwent fine-needle aspiration biopsy and thyroglobulin measurement from January 2022 to June 2022. First, univariate analysis was performed to obtain relevant variables that differed between benign and malignant LN groups. Then spearman correlation was used to analyze the correlation between effective variables and pathological results. Finally, receiver operating characteristic was used to analyze the diagnostic efficiency of effective variables.
Results
In this study, there were 43 benign LNs and 31 malignant LNs. In univariate analysis, gender, age, CDFI diagnosis results and SMI diagnosis results were significantly different in the differentiation of benign and malignant LNs (P = 0.026, P = 0.041, P = 0.001, P < 0.001). CDFI and SMI diagnosis results had good correlated with pathological findings (r = 0.403, P < 0.001, r = 0.707, P < 0.001). The diagnostic efficiency of SMI (AUC = 0.856, P < 0.001) was higher than that of CDFI (AUC = 0.704, P = 0.003). And the diagnostic results of SMI were superior to those of CDFI. The number of feeding vessels showed by CDFI and SMI in malignant LNs was higher than that in benign LNs (2.00 vs. 1.00, 3.00 vs. 2.00, all P < 0.001). In all enrolled LNs, SMI showed significantly more vessels than CDFI (2.53 ± 1.47 vs. 1.50 ± 1.13, P < 0.001).
Conclusions
SMI is better than CDFI in displaying small feeding vessels and has important diagnostic value in judging the nature of LNs with ultrasound uncertainty.
Associations between maternal characteristics, infant sleep, and perceived infant temperament in the first year of life: A longitudinal study
Authors: Hairston Ilana S , Mijalevich-Soker Elad , Handelzalts Jonathan E
Published: April 2024

Background: Maternal factors, such as her sleep, mood and bonding to her infant, are closely linked to her perceptions of the infant. As mothers tend to be the primary informants on their child’s health and behaviors in research, education and medical settings, a better understanding of the factors that influence maternal perceptions could improve methodologies for assessing infants’wellbeing in the absence of direct measurements. The present study examined the associations between maternal characteristics and perceptions of their infant’s sleep and temperament in the first year of life.
Methods: The participants were 195 mothers of 4- to 8-month-old infants (T0), 76 of whom completed questionnaires six months later (T1). The T0 questionnaires assessed infant sleep, mother’s sleep, postpartum depression, and mother-infant bonding. The T1 questionnaires were the same except for postpartum depression, with the addition of an infant temperament questionnaire.
Results: Despite increased total sleep time and decreased nighttime awakening, mothers’ perceptions of infant sleep problems remained stable across time points. Perceived infant sleep difficulties were primarily associated with concurrent measures of infants’ and mothers’ sleep, whereas perceived difficult temperament was associated with maternal postpartum depression symptoms and bonding difficulty.
Conclusions: Our findings suggest that from mothers’ perspective, sleep problems and difficult temperament are different cognitive constructs related to their child’s behavior and personality. Mothers’ perceptions of their infant sleep behaviors are grounded in temporally proximal infant sleep behaviors, whereas perceptions of the infant’s temperament, particularly negative affect, may reflect more long-term effects of maternal mental health.
Mining Tamarix ramosissima roots for endophytic growth promoting fungi to improve wheat root growth
Authors: Ebadi Mostafa , Najari Solmaz , Miandoab Leila Zarandi , Chaparzadeh Nader , Ebadi Ali
Published: April 2024

Endophytic fungi are commonly found in the root endosphere and can enhance plant growth through various mechanisms. The aim of this study was to isolate cultivable endophytic fungi associated with the roots of Tamarix ramosissima and to evaluate their plant growth promoting properties. About 35 isolated fungal endophytes belonging to the Ascomycota from four different genera were isolated from the endosphere of T. ramosissima: Alternaria, Aspergillus, Fusarium and Talaromyces. These fungal endophytes showed different abilities to solubilize phosphate and produce indole-3-acetic acid (IAA). The fungal isolates of T. allahabadensis (T3) and A. niger (T4) showed different efficiency in solubilizing phosphate. Almost all fungal isolates were able to produce IAA, and the highest value (0.699 µg/ml) was found in the isolate of F. solani (T11). Inoculation of wheat seeds with endophytic fungi significantly increased the initial growth of wheat roots. The results showed that inoculation with the endophytic fungus A. fumigatus T15 significantly increased root length by 75%. The extensive root system of T. ramosissima may be due to symbiosis with IAA-producing endophytic fungi, which enhance root development and water uptake in dry conditions. These fungi can also boost soil phosphorus levels, promoting plant growth.
Effect of Estradiol Supplementation on Luteal Support Following a Significant Reduction in Serum Estradiol Levels After hCG Triggering: A Prospective Randomized Controlled Trial
Authors: Li Na , Huang Yu , Fang LiJuan , Shi Zan , Cai He , Shi JuanZi , Wang Hui
Published: April 2024

Objective
This study aimed to evaluate the impact of adding 4mg estradiol valerate to progesterone for luteal support on pregnancy rates in IVF cycles following a long protocol with reduced luteal serum estradiol levels post-hCG triggering.
Design, setting, and participants
The prospective randomized controlled trial was conducted at a public tertiary hospital reproductive center with 241 patients who experienced a significant decrease in serum estrogen levels post-oocyte retrieval.
Interventions
Participants received either a daily 4 mg dose of estradiol valerate in addition to standard progesterone or standard progesterone alone for luteal support.
Results
The ongoing pregnancy rate did not show a significant difference between the E2 group and the control group (56.6% vs. 52.2%, with an absolute rate difference (RD) of 4.4%, 95% CI -0.087 to 0.179, P= 0.262). Similarly, the live birth rate, implantation rate, clinical pregnancy rate, early abortion rate, and severe OHSS rate were comparable between the two groups. Notably, the E2 group had no biochemical miscarriages, contrasting significantly with the control group (0.0% vs. 10.7%, RD -10.7%, 95% CI -0.178 to -0.041, P=0.000). In the blastocyst stage category, the clinical pregnancy rate was notably higher in the E2 group compared to the control group (75.6% vs. 60.8%, RD 14.9%, 95% CI 0.012 to 0.294, P=0.016).
Conclusion
Adding 4 mg estradiol valerate to progesterone for luteal support does not affect the ongoing pregnancy rate in embryo transfer cycles using a long protocol with a significant decrease in serum estradiol levels after hCG triggering. However, it may reduce biochemical miscarriages and positively impact clinical pregnancy rates in blastocyst embryo transfer cycles.
Trial registration：ChiCTR1800020342
Research on Photovoltaic MPPT Under Complex Conditions Based on an Advanced Great Wall Construction Algorithm Method
Authors: Wei Liming , Cao Linghao , Jia Hongdan , Wang Kaishuo
Published: April 2024

To mitigate the challenges posed by the non-linear multi-peak power-voltage output characteristics of photovoltaic (PV) systems operating under partial shading conditions, which often lead to suboptimal performance of conventional Maximum Power Point Tracking (MPPT) algorithms, a novel approach was introduced. The method, named LGWGWCA-P&O, combines the enhanced Great Wall Construction Algorithm (GWCA) with the Perturbation and Observation (P&O) technique, providing a robust solution for addressing PV MPPT challenges. The LGWGWCA-P&O method enhances the GWCA by integrating a positional update strategy from the Grey Wolf Algorithm (GWO) for the optimized distribution of solution agents. Moreover, it incorporates a Levy flight strategy to mitigate the issue of excessive randomness during the replacement and recombination of worker individuals, thereby enhancing the speed of tracking. Furthermore, as the algorithm nears the maximum power point of PV power generation, it transitions to the perturbation observation approach to capitalize on its swift convergence capability, thereby facilitating a quicker and more precise identification of the maximum power point.
Replacement or complement: A niche analysis of Weibo, Xiaohongshu, and TikTok
Authors: YANG J ING
Published: April 2024

Using Dimmick niche theory as a theoretical framework, this study investigated the competition among three social media, Weibo, Xiaohongshu and Tiktok, using the satisfaction and satisfaction opportunities obtained among them. In this study, an online questionnaire survey was conducted nationwide and 565 valid questionnaires were collected. This study drew three conclusions from the data analysis. (1) This study found that Xiaohongshu and Tiktok belong to generalist, while Weibo belongs to specialist. (2) Among them, Weibo and Tiktok have the most intense competition, but the three social media have different competitive advantages. Therefore, this study predicts that these three social media can coexist in the Chinese social media market. (3) Among the three media, Tiktok is the most competitive, Xiaohongshu is the second most competitive, and Weibo is the weakest.
Massive pulmonary embolism during the induction of labor in a middle-aged obese nulliparous woman – a case report
Authors: Killinger Kristina , Riedel Fabian , Fiedler Mascha O. , Müller Thomas , Wallwiener Markus , Wallwiener Stephanie , Elsässer Michael , Weigand Markus A. , Böckler Dittmar , Erhart Philipp , Grieshaber Philippe , Hackert Thilo , Germann Günter , Scholz Anna Sophie
Published: April 2024

Massive pregnancy-related pulmonary embolism is a rare but potentially life-threatening event. We report the sudden onset of dyspnea and loss of consciousness in a middle-aged obese nulliparous woman at 39 weeks of gestation during first stage of labor. Shortly after delivery by emergency cesarean section cardiac arrest was recorded. Transesophageal echocardiography during resuscitation showed right ventricular failure leading to the diagnosis of pulmonary embolism. Return of spontaneous circulation was achieved after emergency administration of thrombolysis with alteplase. Uterine hemorrhage, coagulopathy and persistent right ventricular failure resulted in persistent hemodynamic instability leading to supracervical hysterectomy and veno-arterial extracorporal life support. Both mother and baby survived without hypoxic brain injury. Our literature review highlights the crucial importance of individual and interdisciplinary decision-making during emergency situations in pregnant women. Therefore, we conducted a literature review to estimate the extent of evidence on the emergency management of pregnant women with pulmonary embolism. Manuscript