bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of the SMOTE Method on Machine Learning and Ensemble Learning Performance Results in Addressing Class Imbalance in Data Used for Predicting Total Testosterone Deficiency in Type 2 Diabetes Patients
Authors: Kıvrak Mehmet , Avci Ugur , Uzun Hakkı , Ardıç Cüneyt
Published: October 2024

Background and Objective: Diabetes Mellitus is a long-term, multifaceted metabolic condition that necessitates ongoing medical management. Hypogonadism is a syndrome that is a clinical and/or biochemical indicator of testosterone deficiency. Cross-sectional studies have reported that 20-80.4 % of all men with Type 2 diabetes have hypogonadism, and Type 2 diabetes is related with low testosterone. This study presents an analysis of the use of ML and EL classifiers in predicting testosterone deficiency. In our study, we compared optimized traditional ML classifiers and three EL classifiers using grid search and stratified k-fold cross-validation. We used the SMOTE method for the class imbalance problem.
Methods: This database contains 3397 patients for the assessment of testosterone deficiency. Among these patients, 1886 patients with type 2 diabetes were included in the study. In the data pre-processing stage, firstly outlier/excessive observation analyses were performed LOF and missing value analyses were performed with random forest. The SMOTE is a method for generating synthetic samples of the minority class. Four basic classifiers, namely MLP, RF, ELM and LR, were used as first level classifiers. Tree ensemble classifiers, namely ADA, AGBoost, and SGB, were used as second level classifiers.
Results: After SMOTE, while the diagnostic accuracy decreased in all base classifiers except ELM, sensitivity values increased in all classifiers. Similarly, while the specificity values decreased in all classifiers, F1 score increased. The RF classifier gave more successful results on the base-training dataset. The most successful ensemble classifier in the training dataset was the ADA classifier in the original data and in the after SMOTE data. The testing data, XGBoost is the most suitable model for your intended use in evaluating model performance. XGBoost, which exhibits a balanced performance especially when SMOTE is used, can be preferred to correct class imbalance.
Conclusions: SMOTE is used to correct the class imbalance in the original data. However, as seen in this study, when SMOTE was applied, the diagnostic accuracy decreased in some models, but the sensitivity increased significantly. This shows the positive effects of SMOTE to better predict the minority class.
Los albergues ante la migración
Authors: Vargas Reyes Bertha Esperanza
Published: October 2024

Ciudad Juárez es una localidad que tiene como una de sus principales características estar conformada por un alto porcentaje de población migrante proveniente de diferentes estados de la república. No obstante, a partir de 2018, tras la presencia de caravanas migrantes, este municipio se convirtió en uno de los espacios de recepción de personas de origen extranjero, procedentes en su mayoría de países del triángulo norte centroamericano -Honduras, Guatemala y el Salvador-.
COMPUTATIONAL AND EXPERIMENTAL IMPACT STUDY INITIAL PAIRING PARAMETER OF BANDAGE SHELVES PAIRS OF BANDED BLADES FOR STATIC STRESSES IN THE FEATHER OF THE SHOULDER BLADES
Authors: Shakalo Ruslan , Larin Oleksiy , Savchenko Kyrylo
Published: October 2024

The paper discusses the results of an experimental study of the influence of the initial parameter of the conjugation of the bandage flanges on static stresses in the blade feather, as well as a comparison of the results obtained with the calculated data. The work was carried out for both uncooled and cooled turbine rotor blades. It was found that with an increase in the initial conjugation parameter, the static stresses in the root section of the blades increase in direct proportion. It was found that the static stresses in the feather for the left and right blades are almost the same with the same conjugation parameter, both for non-cooled blades and for cooled blades. There is a significant error between the experimental and calculated values, while the nature of the dependence of stresses on the initial parameter is similar – rectilinear.
Efektivitas Teknologi Pendidikan Dalam Pembelajaran Matematika: A systematic Literature Review
Authors: Mardiana Tria , Hajron Kun Hisnan
Published: October 2024

Teknologi pendidikan dalam pembelajaran Matematika merupakan salah satu bentuk inovasi untuk menciptakan desain-desain pembelajaran yang menarik. Adanya desain pembelajaran yang menarik ini, diharapkan siswa dapat melaksanakan kegiatan pembelajaran Matematika lebih semangat dan focus. Tujuan penelitian ini adalah untuk mendeskripsikan bagaimana berbagai macam bentuk efektivitas teknologi Pendidikan dalam pembelajaran Matematika. Penelitian ini menggunakan metode Systematic Literature Review (SLR) yang bertujuan untuk mengenali, meninjau, dan mengevaluasi semua penelitian yang relevan sehingga menjawab pertanyaan suatu penelitian ditetapkan. Penelitian ini terdiri beberapa tahapan, yaitu perumusan pertanyaan penelitian, pencarian literatur, penetapan kriteria inklusi dan eksklusi, penyeleksian literatur, penyajian data, pengolahan data dan penarikan kesimpulan. Hasil dari penelitian adalah, hal-hal yang berdampak positif pada efektivitas pembelajaran Matematika di antaranya, penerapan media, penerapan aplikasi, penerapan E-Learning, serta penerapan model-model pembelajaran yang menarik. Dampak positif yang tercipta adalah, kemampuan komunikasi Matematika menjadi meningkat, hasil belajar Matematika semakin baik, prestasi belajar Matematika meningkat, kemampuan berpikir kritis semakin baik, serta minat belajar Matematika meningkat. Secara rinci, dampak positif tersebut bisa terkhusus pada materi Matematika tertentu, ataupun secara umum, mulai dari jenjang Pendidikan SD sampai S1.
Implementasi Algoritma Apriori untuk Mengidentifikasi Tren Pemilihan Jurusan
Authors: Sutoyo Muh. Nurtanzis , Mardianto Mardianto , Paliling Alders
Published: October 2024

Tujuan dari penelitian ini adalah untuk mengeksplorasi pola dalam pemilihan jurusan oleh calon mahasiswa melalui penggunaan algoritma Apriori pada data pendaftaran Jalur Mandiri di USN Kolaka. Dengan analisis terhadap 836 peserta jalur Mandiri, penelitian ini berhasil mengidentifikasi aturan asosiasi yang signifikan antara pilihan jurusan pertama dan kedua. Hasil yang menonjol adalah temuan bahwa peserta yang memilih Hukum sebagai pilihan pertama cenderung memilih Sistem Informasi dengan confidence sebesar 14.36%, dan Ilmu Komputer dengan confidence sebesar 31.19%, sebagai pilihan kedua. Hasilnya menunjukkan bahwa ada hubungan antara hukum dan teknologi, yang menunjukkan bahwa calon mahasiswa tertarik pada lebih dari satu bidang studi dan terbuka terhadap peluang untuk belajar lebih banyak dari bidang lain. Penelitian ini memberikan wawasan berharga bagi institusi pendidikan tinggi tentang bagaimana mengubah strategi penerimaan dan pengembangan kurikulum untuk memenuhi ekspektasi dan minat mahasiswa. Diharapkan temuan ini akan mendorong perguruan tinggi untuk lebih inovatif dalam menyusun jurusan yang memberikan keahlian tambahan dan mendalam di satu bidang, sehingga memperluas prospek karir mahasiswa.
Transparencia en las empresas de servicios públicos listadas en Latinoamérica: divulgación financiera en internet
Authors: Carlos Augusto  Rincón-Soto  , Mauricio  Gómez-Villegas  , Yaismir Adriana  Rivera-Arrubla
Published: October 2024

El propósito de este artículo es examinar las prácticas de divulgación de información financiera de las empresas de servicios públicos domiciliarios (EPSD) que cotizan en México, Chile, Colombia y Perú, identificando los determinantes de la divulgación de la información financiera en internet. Este estudio comprende una muestra de 70 ESPD cotizadas. Para ello, se emplea un índice de información financiera en internet (IFI) adecuado a las particularidades de la industria de las ESPD. Además, se utiliza un análisis multivariado por mínimos cuadrados ordinarios, con el propósito de identificar los determinantes de los resultados del índice de divulgación IFI. Los resultados muestran que las ESPD cotizadas presentan en promedio un 67,9 % de divulgación. Las variables de tamaño de la empresa y rentabilidad sobre el patrimonio mostraron tener una relación positiva y significativa, mientras que el endeudamiento y la rentabilidad sobre activos mostraron una relación significativa pero negativa.
A Sideroflexin/Connexin adaptor ties kinesin-3 to mitochondria in neurons
Authors: Barmaver Syed , Bayansan Odvogmed , Khawaja Muhammad Safwan , Ruckmani Vignesh Mahendran , Putri Dwika Sarnia , Shanmugam Muniesh Muthaiyan , Wagner Oliver
Published: October 2024

Various neurological diseases are linked to changes in mitochondrial trafficking in axons. Thus, it is crucial to understand how dynamics of mitochondria are regulated on the molecular level. From a candidate screen, we identified SFXN-1.2 to regulate both morphologies as well as dynamics of mitochondria. SFXN-1.2 is an ortholog of human Sideroflexin 1/3 associated with Alzheimer's disease and Parkinson's diseases. We demonstrate that SFXN-1.2 binds to kinesin-3 KIF1A(UNC-104) via CX32 (Connexin 32 or GJB1), a protein known to be linked to Charcot-Marie-Tooth disease. While SFXN-1.2 and CX32 affect the dynamics of mitochondria, they also affect the motility of the molecular motor UNC-104 alone. From yeast two-hybrid, co-immunoprecipitation and bimolecular fluorescent complementation assays, we narrowed down critical interaction schemes of the UNC-104/CX32/SFXN-1.2 complex providing a complex molecular model.Interestingly, though UNC-104 binds to synaptic vesicles via its PH domain, we found no role of this domain in linking the motor to mitochondria. While UNC-104 trafficking is diminished in neurons of sfxn-1.2 mutants, motility of conventional kinesin-1 UNC-116 remains unaffected. Our data suggest that UNC-104 and UNC-116 act in parallel pathways likely co-transporting mitochondria. We also show that sfxn-1.2-induced changes in mitochondrial morphologies are independent of the fusion/fission machinery and that neither mitochondrial bioenergetics nor mitophagy are affected by sfxn-1.2 mutations. Strikingly, mutations in SFXN-1.2 lead to motor- and sensory neuron defects in C. elegansnegatively affecting the animal's touch responses as well as restricting body movements - pathological phenotypes commonly seen in neurological diseases.
Quantifying batch effects for individual genes in single-cell data
Authors: Jin Shuilin , Zhou Yang , Sheng Qiongyu
Published: October 2024

Batch effects significantly impede the comparison of multiple single-cell experiment batches. Existing batch effect removal methods primarily focus on aligning cells across batches, often overlooking gene-level batch effects. Here, we introduce group technical effects (GTE), a quantitative metric to assess batch effects on individual genes. Using GTE, we show that batch effects unevenly impact genes within the dataset. A portion of highly technical genes (HTGs) differ between datasets and dominate the batch effects. Removing these genes effectively integrates the dataset. We demonstrate that as few as three HTGs are sufficient to introduce substantial batch effects. Furthermore, we observe that biologically similar cell types undergo similar batch effects, informing the development of data integration strategies. The GTE method is versatile and applicable to various single-cell omics data types.
Comparison of asymmetric and symmetric centration strategies for photorefractive keratectomy in myopic astigmatism patients
Authors: Salari Farhad , Ghassemi Hamed , Samadi Mahsan , Montazerian Zahra , Atighehchian Mehrnaz , Abdi Parisa , Latifi Golshan , Mosquera Samuel Arba , Zarei-Ghanavati Mehran
Published: October 2024

Purpose:
To compare differences in clinical outcomes of symmetric offset (SO) and asymmetric offset (AO) centration strategies in photorefractive keratectomy (PRK) in patients with myopia or myopic astigmatism.
Methods:
Forty refractive surgery candidates who visited Farabi Eye Hospital’s refractive surgery clinic from May to August 2022 were enrolled in the study. We randomly assigned one of each patient’s eyes to the AO and the other one to the SO group using random blocks. Patients were followed for four months. Ablation profile, Visual acuity (VA), and higher order aberrations (HOA) were evaluated. Effective optical zone (EOZ) and its circularity index were calculated automatically by a MATLAB-based algorithm.
Results:
There was no significant difference between the two groups' total ablation volume and maximum and central ablation depth (all P > 0.05). The two groups showed significant differences in minimum ablation depth, with a higher value for SO than AO (0.03 ± 0.03 and 0.01 ± 0.01, respectively, P-value < 0.001). There wasn’t a significant difference between postoperative mean RMS of higher order aberrations (HOA) among AO and SO groups (all P > 0.05). The EOZ was 6.046 ± 0.63 in the SO group and 6.047 ± 0.68 in the AO group (P value = 0.61, paired t-test).
Conclusions:
In conclusion, symmetric and asymmetric offset centration strategies result in safe and effective refractive correction. There was no significant difference between the two groups' higher-order aberration, visual acuity, refraction, and postoperative total ablation volume.
What Do Patients Learn from the Internet? Evaluation of the Quality of Zygomatic Implant Therapy Information among the Turkish Population: Methodological Study
Authors: Pektaş Muhammet yasin , Topal Olgun
Published: October 2024

As a result of informatics and technological developments, the Internet has become the primary source of reference for accessing information, including about health issues. This study uses the DISCERN instrument to evaluate the quality of Internet-based information Turkish patients use to learn about dental implant therapy. The key phrases “zygomatic implant therapy,” “zygomatic implant,” and “zygomatic screwed tooth” were searched using popular search engines, such as Google (www.google.com.tr), Yandex (www.yandex.com.tr), Yahoo (www.yahoo.com), and Bing (www.bing.com), on September 12–18, 2023. The top ten websites obtained from each search term were determined; 93 of the 120 websites included in the evaluation were measured using the DISCERN instrument, comprising 16 questions. Among the evaluated websites, 57 were dentists or dental clinics, 15 were general or dental health, 6 were news, and 15 were hospitals. The DISCERN score of the evaluated websites ranged from 18 to 52 (mean, 28.62), and the mean DISCERN rating score was 1.93. None of the sites was rated as “excellent,” and three were rated as “good.” The quality of information resources on the Internet about zygomatic implant therapy in Turkey was generally low: the source of the given information was often not cited, the treatment options were not clarified, and contraindications and complications of the treatment were not explained.
Comparative Study on Caesarian and Normal Vaginal Delivery, Rajshahi Division, Bangladesh
Authors: Khatun Mst. Abeda , Najnin Monira , Parvin Rehana , Sayam Mohammad Abdun Nur , Rana Md. Masud
Published: October 2024

Background: One of the most important public health concerns is the marked rise in the number of caesarean sections (CS). The World Health Organization advises against CS rates that are more than 10% and lower than 5% since both of these ranges have the potential to negatively impact the health of expectant mothers and newborns.
Objective: The study aimed to investigate influencing factors for selective CS among pregnant mothers and to determine the association for selective CSamong mothers with selected socio-economic characteristics in Rajshahi Division, Bangladesh.
Methodology: It was a cross-sectional study was conducted. In this study, data were collected July 2024. A semi structured questionnaire was used for collecting data, a total number of 393 delivery mothers were participated in Rajshahi Division, Bangladesh. A descriptive analysis, the chi-square test, and binary logistic regression model were utilized in the present study.
Results: The prevalence of lower educated mothers with normal vigilant delivery (NVD) and CS delivery was 59% and 41%, respectively, and Naogaon district mothers delivered their child by cesarian section compared to other districts in Bangladesh. The women ≥30 years old (AOR = 74.934; 95% CI: 12.831-437.613) were more likely to have preferred CS delivery compared to younger women, and these factors were statistically significant (p<0.01). The educated subjects (AOR = 83.469; 95% CI: 2.554–2727.394) were more likely to have preferred CS delivery compared to their lower educated counterparts, and these factors were statistically significant (p<0.05).
Conclusions: The study revealed that a large number of women preferred CS deliveryespecially higher educated women were mostly. The main reasons for choosing CS were to take advantage of certain socioeconomic and demographic variables, ensure the safety of both mothers and their infants. This study strongly recommended health education. sessions, especially in electronic and print media, about the disadvantages of CS delivery.
Developing an online calculator to estimate the overall survival benefit from adjuvant radiotherapy in patients with early-stage type II endometrial carcinoma
Authors: Chen Xi , Du Junhong , Cheng Yuemei , Wang Fengfeng , Wang Wenhua , Lang Tingyu , Liu Xiaowei , Li Hongli , Yang Yongxiu , liang Xiaolei
Published: October 2024

Objective
The benefit of adjuvant radiotherapy (aRT) on overall survival (OS) in early-stage type II endometrial carcinoma (EC) is not well established. This study aimed to develop nomograms and a web-based calculator to identify these patients who might benefit from aRT.
Methods
Research projects were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, and divided into the developing and validation cohorts. LASSO Cox regression identified prognostic factors, and nomograms were constructed to predict 1-, 3-, and 5-year OS with/without aRT. The expected OS benefit from aRT was indicated by the difference in predicted OS between the two nomograms. Validation involved ROC analysis, calibration curves, and decision curve analysis. A web calculator was created for estimating aRT's net OS benefit.
Results
Among 6084 patients, aRT did not improve OS across all patients but showed benefits in specific subgroups, such as those with clear cell carcinoma and carcinosarcoma. Nomograms were built for patients with and without aRT to predict OS at 1-, 3-, and 5-year, and they can accurately forecast OS, and the web-based calculator was developed to estimate the net OS benefit of aRT.
Conclusions
The nomograms provide accurate OS estimates for early-stage type II-EC patients with/without aRT, supporting individualized treatment decisions. The web calculator offers a quantitative tool for optimizing aRT use based on clinicopathological features.
Electromyographic evaluation of patients with temporomandibular disorders and limited mouth opening Part I: Masseteric activity during maximum opening
Authors: Lin Xiaoyu , Takaoka Ryota , Moriguchi Daisuke , Morioka Shion , Ueda You , Yamamoto Rie , Ono Emi , Ishigaki Shoichi
Published: October 2024

This study aimed to identify the differences in masseteric activity during maximum mouth opening among healthy volunteers, patients with limited mouth opening (LMO) and myofascial pain, and patients with LMO and disc displacement. Thirty-seven patients with temporomandibular disorders and LMO (< 37 mm) and 27 healthy volunteers participated in this study. Patients were categorized into three groups based on magnetic resonance imaging (MRI) findings and clinical symptoms: disc displacement (DD), disc displacement with myofascial pain (DD + M), and myofascial pain (M). After a five-minute relaxation period, the participants were instructed to perform maximum opening (Omax) and maintain the Omax position for five seconds, and this was repeated three times. Subsequently, the participants were asked to perform maximum voluntary clenching for five seconds, which was repeated twice. At rest, no significant masseter potential differences were observed among the DD, DD + M, M, and healthy groups (p > .05). However, during Omax, the DD + M and M groups exhibited significantly higher masseteric potential than the healthy and DD groups (p < .001). Furthermore, the masseteric potential during Omax correlated with the pain level. Overall, there are distinct differences in masseteric activity levels between patients with LMO and with or without myofascial pain or disc displacement.
Comparative efficacy of biochar vs. cooking charcoal in urea-based soil fertility management: Impacts on soil quality, nutrient Retention, and maize performance
Authors: Oyeyiola Yetunde Bunmi , Ewetola Esther Abosede , Kolawole Gani Oladejo , Lawal Babatunde Akeem
Published: October 2024

Biochar stands out for its valuable properties in promoting sustainable agricultural practices. However, Nigerian farmers face significant challenges in adopting biochar due to the high costs associated with acquiring pyrolizers or fabricating local kilns. They are, however, familiar with charcoal production for domestic use. This screen house trial was a factorial combination of three black carbon types: biochar, charcoal, and no black carbon (NBC) with each applied at 5 t/ha and three urea levels: 0, 30 and 60 kg N/ha). Maize was grown on the amended soils for six weeks. The Fourier Transform Infrared scans revealed differences between the two black carbons, with biochar showing sharper peaks at wavelengths 1588, 1375, and 1100 nm. Soils amended with biochar significantly outperformed those treated with charcoal or no black carbon, showing higher levels of soil organic carbon (7.05 g/kg compared to 5.12 and 4.09 g/kg for charcoal and NBC, respectively), available phosphorus (135.57 mg/kg compared to 4.12 and 5.48 mg/kg for charcoal and NBC, respectively), exchangeable bases, maize nitrogen and phosphorus uptake, and total dry biomass yield. Paired T-tests revealed significant differences in the impact of biochar and charcoal on soil organic carbon and nutrient conditions, ultimately affecting maize performance. Therefore, cooking charcoal cannot substitute for biochar when the soil and environmental benefits associated with biochar are desired.
Assessment of Seasonality of Stream Water Quality: a Case Study of River Kaljani in Alipurduar Municipality, West Bengal, India
Authors: Roy Mousami
Published: October 2024

In this study an attempt was made to determine the seasonality of stream water quality: A case study of river Kaljani in Alipurduar Municipality, West Bengal, India. Monthly observations of 21 water quality parameters for the periods between January 2010 and December 2022 were used as the database which was generated by West Bengal Pollution Control Board in accordance with the guideline established by the Central Pollution Control Board, Govt. of India. The Hierarchical Cluster Analysis (HCA) was applied to assess the seasonal pattern in water quality status while Spearman’s Rank Correlation was used for determining the association between water quality parameters with seasonal and monthly normal rainfall to determine the impact of rainfall in controlling such seasonality. The result of HCA shows that stream water quality changes following two distinct hydrogeochemical seasons, November to April and May to October which are governed by local rainfall. The result of Spearman’s rho displays that geogenic parameters (e.g., TSS, TFS, Turbidity etc.) follow rainfall-based seasonality while anthropogenic parameters (e.g., BOD, COD, Na+ etc.) do not follow rainfall-based seasonality. Since rainfall cannot fully explain the whole complexity of hydrogeochemical season, the role of other factors like discharge needs to be incorporated in this context.
Prediction of COVID-19 Severity and Mortality in Hospitalized Children Using Machine Learning Tree-based Classifiers
Authors: Karimi Mehran , Nafei Zahra , Shamsi Farimah , Akbarian Elahe
Published: October 2024

Background
Children make up a large percentage of Coronavirus Disease 2019 (COVID-19) hospital admissions, but there is little information available about the features to predict the severity status of the illness or mortality in pediatrics. Logistic regression, supporting vector machine and ensemble machine learning algorithms were used to develop predictive models and identify prognostic factors for severity and mortality of COVID-19 in hospitalized children.
Methods
A total of 183 children with COVID-19 under the age of 18 years hospitalized in a referral hospital in Yazd province, Iran, from March 1, 2020 to August 1, 2021 were considered for this study. Logistic regression, and machine learning classifiers including supporting vector machine, decision tree, random forest, Bagging classifier trees, Gradient boosted decision trees, and Adaptive boost classifier trees were employed to predict the development of mild/severe or critical COVID-19 and death occurrence during hospitalization. Each model performance was assessed through five-fold cross-validation method, with evaluation metrics and area under the curve. In addition, the best clinical predictive models were used to identify significant factors between severe and non-severe groups, as well as between survivors and non-survivors.
Results
Seven predictive models were developed using the medical files of 183 hospitalized children, consisting of 94 and 89 (48.6%) in non-severe and severe groups, respectively, as well as 159 survivors and 24 (13%) non-survivors. In prediction of severity status, both decision tree and random forest algorithms had the highest accuracy of 73.3% and 68.7% to predict severity status in balanced data, respectively. Based on decision tree, respiratory distress and cough at the time of admission could be regarded as the as the key factors to estimate the likelihood of severity status. The results also showed that Gradient boosted decision trees, and Adaptive boost classifier trees had the best performance for mortality prediction in balanced data considering the accuracy of 88.8% and 87.7%, respectively. Cough at the time of admission, age group of 1–13 years old, and non-normal WBC could be considered as predictive factors for death occurrence.
Conclusions
This study indicated that tree-based classifiers were the best machine learning approaches for predicting severity status and mortality in hospitalized children with COVID-19. Clinical symptoms at the time of admission identified as the most predictive features though optimal algorithms.
Comparative effectiveness of Statins for Chronic Obstructive Pulmonary Disease Patients with Pulmonary Hypertension: systematic review and network meta-analysis
Authors: Xu Guobo , Huang Wenrui , Fang Xingzi , Ou Xingyan , Chen Lei , Tang Xiaoxuan , Du Xuelian
Published: October 2024

Introduction and objectives: Statins may effectively treat PH-COPD, but current guidelines do not endorse their use. This study aims to assess the comparative effectiveness and safety of Statins in adult patients with pulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD) through a systematic review and network meta-analysis.
Material and methods: We searched 8 databases for randomized controlled trials (RCTs) involving Statins in individuals with PH-COPD from inception to July 1, 2024. We assessed bias using the ROB 2.0 tool and evaluated evidence quality with the CINeMA framework. We employed a Bayesian network meta-analysis approach to assess outcomes including pulmonary artery pressure, exercise tolerance, lung function, oxygenation parameters, inflammatory markers, and vasoactive substances. Using RStudio and other software, we generated forest plots, league tables, and SUCRA curves to evaluate both direct and indirect comparisons.
Results: We analyzed data from 41 RCTs involving 3,606 participants. Our analysis revealed that all 5 statins were effective in reducing Systolic Pulmonary Artery Pressure (sPAP) compared to standard treatment(ST). Rosuvastatin was the most effective, significantly lowering sPAP(MD=-8.8; (95%CI -11.68, -5.85)) and IL-6(MD=-16.41; 95%Cl -29.64, -3.04) and improving the 6-Minute Walk Distance (6MWD)(MD=67.03; 95%Cl 2.77, 130.86). Atorvastatin 20 mg was the most effective in improving lung function, increasing PO2, reducing inflammatory markers such as TNF-α and hs-CRP, and lowering ET-1. Finally, Simvastatin 20 mg+ST was identified as the most effective regimen for reducing PCO2 and increasing NO levels.
Conclusions: Our study demonstrates that statins are more effective than standard treatment for adults with PH-COPD. Rosuvastatin is the most effective at reducing sPAP. It also improves the 6MWD and lowers IL-6 levels. Additionally, statins have significantly enhanced lung function, oxygenation parameters, and inflammatory markers in PH-COPD patients, with Atorvastatin showing the best performance in these areas.
Building and validation based on machine learning methods: Predictive model for falls risk among community patients with chronic obstructive pulmonary disease in China
Authors: Chen Yong , Yu Yonglin , Yang Dongmei , Chen Xiaoju
Published: October 2024

Background
Falls in patients with chronic obstructive pulmonary disease (COPD) can have potentially devastating consequences; however, there is still a lack of accurate fall risk prediction models for community-dwelling patients with COPD in China. The aim of this study was to develop a risk prediction model for falls in COPD patients applicable to the Chinese community.
Methods
The clinical data of 809 Community COPD patients were analyzed by using the 2020 China Health and Retirement Longitudinal Study (CHARLS) database. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression were used to analyze predictors. Multiple machine learning (ML) classification models are integrated to analyze and identify the optimal model, and Shapley Additive exPlanations (SHAP) interpretation was developed for personalized risk assessment.
Results
The following eight variables: Memory_disease, Cardiology, Hyperlipidemia, Hypertension, Gender, Sleeping_time_at_night, ADL_score, and Age are predictors of falls in community-based COPD patients. Logistic classification model was the optimal model, test set area under curve (AUC) (95% confidence interval, CI): 0.693 (0.621–0.765), accuracy: 0.638, sensitivity: 0.627, and specificity: 0.642.
Conclusions
The model constructed in this study has relatively reliable predictive performance, which helps clinical doctors identify high-risk populations of community COPD patients prone to falls at an early stage.
A real-world pharmacovigilance study of Ocrelizumab based on FAERS database
Authors: Liang Haiping , Wu Junlin , Chen Lili , Shen Yonggang
Published: October 2024

Ocrelizumab is a humanized monoclonal antibody targeting CD20 for the treatment of multiple sclerosis (MS). The analysis of the FDA Adverse Event Reporting System database (FAERS) provides critical insights into the safety profile of Ocrelizumab. Signal detection and analysis for Ocrelizumab-related AEs were performed using disproportionality analysis techniques. Of 30622295 reports collected from the FAERS database, 143788 AE reports associated with Ocrelizumab were identified, involving 42301 patients. Among these reports, 427 preferred terms (PTs) met the criteria across four algorithms for signal detection, encompassing a total of 27 System Organ Classes (SOCs). The most frequently reported AEs included respiratory infections, urinary tract infections, Herpes virus infection, and infusion-related reactions, aligning with those documented in the drug label and clinical trials. Novel and unexpected AE signals were also detected, such as COVID-19, positive JC polyomavirus test, dental disease, cystitis, cellulitis, etc., with most adverse reactions occurring within the first month of dosing. Our study indicates that Ocrelizumab demonstrates a favorable safety profile, consistent with findings from existing clinical trials. This study has identified the adverse reactions associated with Ocrelizumab, providing valuable insights for its clinical use.
Psychosocial stress in young families after the pandemic: no time to rest
Authors: Richter Katharina , Buechel Catherine , Augustin Michaela , Friedmann Anna , Mall Volker , Nehring Ina
Published: October 2024

Background
During the pandemic, parenting stress and mental health challenges for both parents and children have increased. However, the lasting repercussions for families remain largely unexplored. Additionally, young families currently face stressors such as economic inflation, the Russia-Ukraine War, and the climate crisis, whose impacts on family well-being are not yet understood.
Methods
We conducted a cross-sectional study involving families (N = 17,333) with children aged 0–9 years to examine parenting stress and mental health issues among both parents and children in light of current societal challenges. Validated questionnaires were used to gather data, and potential factors contributing to parenting stress were investigated.
Results
We found that 53.7% of parents reported feeling stressed or very stressed in their parenting role, with 13.5% experiencing anxiety symptoms and 14.6% showing signs of depression. Additionally, 34.9% of the infants (0–24 months) had crying and/or sleeping difficulties, whereas emotional and behavioral problems were observed in 10.4% of the toddlers (2–4 years) and 8.7% of the pre- and primary schoolers (˃ 4 years). Economic inflation was perceived as stressful or very stressful for 59.3% of parents, with radicalization and social division (49.3%), the Russia–Ukraine War (37.9%), and the climate crisis (31.8%) also cited as sources of stress. For 31.6% of families, the lingering effects of the pandemic continued to be a (major) burden. Across all age groups, children's mental health issues and societal challenges were the primary predictors of parenting stress. Additionally, there was a positive correlation between the duration of external childcare and parenting stress among parents with toddlers and pre- and primary schoolers.
Conclusion
Our study underscores that psychosocial stressors for families with children remain pronounced even postpandemic and, in some cases, have intensified compared with the peak of the pandemic. Moreover, our findings highlight the impact of broader societal trends, such as economic inflation and social division, on family well-being. Addressing these stressors and promoting the mental health of infants while bolstering parental resilience by alleviating parenting stress should be key priorities for healthcare initiatives in the aftermath of COVID-19.
Single-Cell Sequencing Reveals the Role of NUSAP1 in Glioma and Its Potential for Precision Diagnostic and Prognostic Applications
Authors: Zhao Meng-Yu , Shen Zhao-Lei , Xu Wan-Yan , Gu Yu , Zhao Jie-Hui , Yu Tian-Hang , Wang Li-Na , Wang Cun-Zhi , Xu Jia-feng , Chen Guan-Jun , Chen Dong-Hui , Hong Wen-Ming , Zhang Fang
Published: October 2024

Background: Personalized precision medicine (PPPM) is a rapidly advancing field with significant potential. Gliomas, known for their poor prognosis, rank among the most lethal brain tumors. Despite advancements, there remains a critical need for precise, individualized treatment strategies.
Methods: We conducted a comprehensive analysis of RNA-seq and microarray data from the TCGA and GEO databases, supplemented by single-cell RNA sequencing (scRNA-seq) data from glioma patients. By integrating single-cell sequencing analysis with foundational experiments, we investigated the molecular variations and cellular interactions within neural glioma cell subpopulations during tumor progression.
Results: Our single-cell sequencing analysis revealed distinct gene expression patterns across glioma cell subpopulations. Notably, differentiation trajectory analysis identified NUSAP1 as a key marker for the terminal subpopulation. We found that elevated NUSAP1 expression correlated with poor prognosis, prompting further investigation of its functional role through both cellular and animal studies.
Conclusions: NUSAP1-based risk models hold potential as predictive and therapeutic tools for personalized glioma treatment. In-depth exploration of NUSAP1's mechanisms in glioblastoma could enhance our understanding of its response to immunotherapy, suggesting that targeting NUSAP1 may offer therapeutic benefits for glioma patients.
Executive function in preschool children who stutter: A behavioral assessment study
Authors: Kakuta Kohei , Kawasaki Akihiro
Published: October 2024

Developmental stuttering is a speech disorder characterized by the repetition, prolongation, and blocking of speech sounds. It has been suggested that a decline in executive function is a background factor for preschool children who stutter. Executive function is defined as “goal-oriented thought, action, and emotion regulation.” At present, there are few previous studies that have comprehensively investigated the subcomponents of executive function in preschool children who stutter through behavioral experiments. We herein conducted age- and gender-matched case–control study to explore the characteristics of the subcomponents of executive function in preschool children who stutter compared with preschool children who do not. Consequently, we found declines in verbal and visual working memories in preschool children who stutter. The results of this study indicated that children who stutter show declines not only in verbal short-term memory performance, as has been pointed out in the past, but also in the performance of the entire working memory system, including central executive function.
A novel nomogram for the early identification of coinfections in elderly patients with COVID-19
Authors: Zou Ju , Wang Xiaoxu , Li Jie , Liu Min , Zhao Xiaoting , Wang Ling , Kuang Xuyuan , Huang Yang , Quan Jun , Chen Ruochan
Published: October 2024

Background
This study aimed to establish a novel, precise, and practical nomogram for use upon hospital admission to identify coinfections among elderly patients with coronavirus disease 2019 (COVID-19) to provide timely intervention, limit antimicrobial agent overuse and hospitalisation costs, finally reduce unfavourable outcomes.
Methods
This prospective cohort study included COVID-19 patients consecutively admitted at multicenter medical facilities in a two-stage process. The nomogram was built on the multivariable logistic regression analysis. The performance of the nomogram was assessed for discrimination and calibration using receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) in rigorous internal and external validation settings.
Results
Between 7 December 2022 and 1 February 2023, in the first stage of this study, 916 COVID-19 patients were included. The coinfection rates in non-elderly and elderly patients determined to be 16.22% and 26.61%, respectively. Pneumonia caused by other pathogens (85.45%) was the most common coinfection-associated illness in the elderly group. Bacteria were the most common pathogens associated with coinfections in the elderly, especially gram-negative bacteria (48%) of Acinetobacter baumanii, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Fungi (38%) were the second most common pathogens isolated from coinfections in elderly patients with COVID-19. The nomogram was developed with the parameters of diabetes comorbidity, previous invasive procedure, and procalcitonin (PCT) level, which together showed areas under the curve of 0.86, 0.82, and 0.83 in the training, internal validation, and external validation cohorts, respectively. The nomogram outperformed both PCT or C-reactive protein level alone in detecting coinfections in elderly patients with COVID-19; in addition, we found the nomogram was specific for the elderly compared to non-elderly group. Calibration plots of the nomogram revealed excellent agreement between the predicted and actual probabilities of coinfection occurrence, and the DCA indicated favourable clinical consistency of nomogram results.
Conclusions
This novel nomogram will assist in the early identification of coinfections in elderly patients with COVID-19.
Trial registration:
This study was registered at https://ClinicalTrials.gov, with the registration NCT06321367 (registration Date: 2024-03-20).
The Effect of Alpha frequency transcranial alternating current stimulation of the parieto-occipital region on creative thinking
Authors: Liu Chunlei , Yang Jiaqin , Zhou Runze , Wang Jinqian , Huang Xinying , Man Xiaotong , Zhang An'ning
Published: October 2024

Background
Previous studies showed that creative thinking was related to Alpha oscillations, and individuals showed stronger fronto-parietal Alpha synchronization during creative activities. Creative thinking required the coordination of the default mode network (DMN) and executive control network (ECN) subregions in the frontal and parieto-occipital regions, which was mainly reflected in the changes of Alpha oscillations in EEG. The evidence of up-regulation of the DMN by alpha frequency transcranial alternating current stimulation (α-tACS) in the parieto-occipital region, and enhancement of Alpha Power by 10 Hz-tACS to enhance creativity suggested that α-tACS was associated with creative thinking. But whether there was a causal relationship between α-tACS and creative thinking was still unknown.
Methods
The effect of α-tACS in parieto-occipital region on creative thinking and their cognitive neural mechanisms were investigated by alternative uses task (AUT) using EEG and tACS. The experiment recruited 28 participants to complete the AUT after receiving Sham-Stimulus/α-tACS.
Results
Behavioral results showed that the novelty, flexibility and fluency of individuals treated with α-tACS in parieto-occipital regions were significantly higher than those in Sham-Stimulus. The EEG results based on time-frequency analysis showed that the Alpha Power of individuals in parieto-occipital regions treated with α-tACS was significantly higher than that in the Sham-Stimulus group.
Conclusions
In conclusion, Combined with the experimental results, the research basically proved that α-tACS of the parieto-occipital region positively affected creative thinking further suggesting that α-tACS promoted creative thinking.
Robotic-Assisted Surgery in Pediatric Gynecology: Preliminary Initial Outcomes
Authors: Delgado-Miguel Carlos , Reparaz Laura , Clarkson Wright , Desai Karina , Camps Juan
Published: October 2024

Introduction
Robotic-assisted surgery has become widely used in adult gynecology, but has not yet been widely used in pediatric patients. We report our initial experience in robot-assisted pediatric gynecologic surgery to determine its feasibility, safety and limitations in children.
Methods
A retrospective single-center study was performed among consecutive girls under 18-years who underwent ginecologic robotic-assisted procedures in our institution between 2012-2021. A three-arm robot (5 mm trocars) with one camera arm (12 mm trocar) was used in all cases by the same surgical team. Demographic data, type of robotic procedure, surgery time, complication rate, conversion rate to laparoscopic procedure, lenght of hospital stay (LOS) and postoperative complications were analyzed.
Results
A total of 10 patients were included (median age 11.9 years; range 2.5-17.4 years), who underwent robotic assisted surgery for adnexal pathologies: 3 for ovarian cystectomy, 3 for ovarian teratoma resection, 2 for oophorectomy, 1 for bilateral salpingo-oophorectomy for gonadal dysgenesis and 1 for hysterectomy in a patient with cerebral palsy and recurrent severe uterine bleeding. Median surgery time was 74 minutes (interquartile range: 66-82 minutes). Intraoperative blood loss was minimal (median: 35 ml) Conversion to laparatomy was not necessary in any case. Median LOS was 1 day (interquartile range: 1-2 days). No intra- or postoperative complications occurred.
Conclusion
Preliminar outcomes indicate that ginecologic robotic-assisted surgery is effective and safely applicable in the pediatric population. However, it is still too early to conclude that it provides better clinical outcomes than traditional laparoscopic surgery. Further prospective, comparative studies are still needed.
Type of study: Observational retrospective study
Level of evidence: IV
Clinical education in undergraduate nursing in Ghana: A gap analysis
Authors: Hobenu Kafui A. , Adefuye Anthonio O. , Naab Florence , Nyoni Champion N.
Published: October 2024

Background: Nursing education comprises theory and practice as two complementary parts. In Ghana, the clinical education space is inundated with many challenges disrupting the intended purpose of clinical education. The challenges are multifactorial and include student issues, nurse and educator concerns, management and resource issues. To find solutions, there is a need for a critical analysis of the current clinical educational practices to inform the development of feasible and sustainable approaches for nursing education. This article, therefore, reports on a gap analysis of clinical education in Ghana.
Method: A qualitative descriptive design underpinned the study and was executed through key informant interviews, focus group discussions and document analysis. A total of seventy-three participants, drawn from four nursing education institutions and eight clinical sites, located in four administrative regions in Ghana, participated in the study. These participants comprised four principals, four heads of accounts, eight clinical coordinators, eight nurse educators, twelve preceptors, and thirty-seven final-year registered general nursing students. Data analysis was done deductively against the Global Pillars for Nursing Education thematically yielding three themes and eleven sub-themes.
Results: For Pillar 1, the study revealed a lack of a comprehensive competency-based assessment, ineffective interprofessional communication, and a non-stimulating clinical education climate. For Pillar 2, disregard for available admission standards and non-integration of interprofessional education into the Diploma in Nursing curriculum were found. In the case of Pillar 3, insufficient clinical experience of nurse educators was detected, financial resources to support clinical activities optimally were insufficient, and there was a lack of independence of nursing schools to support nursing education effectively.
Conclusion: This study brought to the fore the gaps in the nursing education system in terms of learning outcomes, the nursing education programme, and the educational institution in Ghana. This indicates that although clinical education occurs in the clinical setting, the challenges emanate from multiple facets of the nursing education system. To enhance clinical learning and teaching in undergraduate nursing education, strategies should target specific problems that may stem from any aspect of the nursing education system through a comprehensive framework that aims to enhance clinical learning and teaching.
Clinical Trial Number: Not applicable.